Infectious Diseases — MCQs

Infectious Diseases Indian Medical PG Practice Questions and MCQs

Question 661: Botulism is most commonly due to -

A. Egg
B. Milk
C. Meat
D. Home-canned vegetables (Correct Answer)

Explanation: ***Home-canned vegetables*** - **Home-canned vegetables** are the **most common** source of botulism, particularly improperly processed low-acid vegetables like beans, corn, and asparagus - *Clostridium botulinum* spores survive inadequate heat treatment and germinate in the **anaerobic, low-acid environment** of improperly canned foods - The **lack of sufficient heat sterilization** (pressure canning at 121°C/250°F is required) allows spore survival and subsequent toxin production - Most foodborne botulism outbreaks are traced to **home-canned vegetables** rather than commercially processed foods *Meat* - While improperly preserved meats can cause botulism, they are **not the most common source** in epidemiological data - Commercial meat processing standards and refrigeration significantly reduce this risk - Meat-associated botulism is more common in certain cultural practices involving fermented or preserved meats *Egg* - **Eggs** are not associated with botulism as they do not provide the anaerobic environment necessary for *Clostridium botulinum* toxin production - Eggs are more commonly linked to **Salmonella infections** if improperly handled or undercooked *Milk* - **Milk** and dairy products are not typical sources of botulism - **Pasteurization** and refrigeration prevent conditions favorable for *C. botulinum* growth - Dairy products are more associated with **Listeria** or **Campylobacter** if contaminated

Question 662: Pediculosis is caused by?

A. Louse (Correct Answer)
B. Mite
C. Tick
D. Black Fly

Explanation: ***Louse*** - **Pediculosis** is a parasitic infestation of the skin by blood-feeding insects called **lice**. - There are different types of lice, including head lice (Pediculus humanus capitis), body lice (Pediculus humanus humanus), and pubic lice (Pthirus pubis), all of which cause pediculosis. *Mite* - **Mites** are responsible for infestations like **scabies**, which is caused by Sarcoptes scabiei. - While both lice and mites are arthropods, they cause distinct parasitic conditions with different clinical presentations and treatments. *Tick* - **Ticks** are known vectors for various diseases, including **Lyme disease** (Borrelia burgdorferi), **Rocky Mountain spotted fever** (Rickettsia rickettsii), and **tick-borne encephalitis**. - Ticks are arachnids, not insects, and their bites can cause localized reactions but not pediculosis. *Black Fly* - **Black flies** (Simulium species) are vectors for **onchocerciasis** (river blindness), caused by the parasitic nematode Onchocerca volvulus. - Their bites are typically painful and can cause localized swelling and allergic reactions, but they do not transmit pediculosis.

Question 663: What is the most commonly reported bacterial sexually transmitted infection?

A. HSV
B. HIV
C. Syphilis
D. Chlamydia (Correct Answer)

Explanation: ***Correct: Chlamydia*** - **Chlamydia trachomatis** is the most frequently reported bacterial STI in many countries, often being **asymptomatic** and thus easily spread - Its high prevalence is due to efficient transmission and the widespread use of sensitive diagnostic tests that detect infections in asymptomatic individuals - Accounts for the majority of reported bacterial STI cases globally *Incorrect: HSV* - **Herpes Simplex Virus (HSV)** is a **viral STI**, not bacterial, and is characterized by recurrent outbreaks of **genital ulcers** or sores - While common, it does not qualify as a bacterial infection and is often not laboratory-confirmed due to mild or subclinical presentations *Incorrect: HIV* - **Human Immunodeficiency Virus (HIV)** is also a **viral STI**, not bacterial, that attacks the immune system leading to AIDS - Although highly impactful, HIV is not a bacterial infection and has lower incidence rates compared to Chlamydia *Incorrect: Syphilis* - **Syphilis**, caused by the bacterium **Treponema pallidum**, is a serious bacterial STI that can have long-term complications if untreated - While its incidence has been increasing in some regions, it is significantly less common than **Chlamydia** in terms of overall reported cases

Question 664: Which is the main vector of Dengue?

A. A. aegypti (Correct Answer)
B. Culex
C. Anopheles
D. Aedes scutellaris

Explanation: ***A. aegypti*** - **Aedes aegypti** is the primary vector responsible for transmitting the **Dengue virus** to humans. - It is a **day-biting mosquito** found predominantly in tropical and subtropical regions. *Culex* - **Culex mosquitoes** are known vectors for diseases like **Japanese encephalitis**, **West Nile virus**, and **filariasis**. - They are generally **night-biting** and do not play a significant role in Dengue transmission. *Anopheles* - **Anopheles mosquitoes** are the primary vectors for **malaria** in humans. - They are not associated with the transmission of the Dengue virus. *Aedes scutellaris* - While part of the **Aedes genus**, **Aedes scutellaris** is a secondary vector for Dengue in the **Pacific region**. - The main vector for Dengue globally remains **Aedes aegypti**, followed by **Aedes albopictus** in some regions.

Question 665: What is the osmolarity of the new Oral Rehydration Solution (ORS)?

A. 270
B. 245 (Correct Answer)
C. 290
D. 310

Explanation: ***245*** - The **new ORS (reduced osmolarity ORS)** has an osmolarity of **245 mOsmol/L**. - This reduced osmolarity formulation has been shown to be more effective in reducing stool output, vomiting, and duration of diarrhea compared to the standard ORS. *270* - While 270 mOsmol/L is closer to the target, it is not the exact osmolarity of the **new ORS formulation**. - The precise osmolarity of the new ORS is specifically designed for optimal water and electrolyte absorption. *290* - The **standard (or traditional) ORS** had an osmolarity of **310 mOsmol/L**, which is higher than 290 mOsmol/L. - An osmolarity of 290 mOsmol/L does not correspond to a recognized standard or new ORS formulation. *310* - The **standard (or traditional) ORS** formulation had an osmolarity of **310 mOsmol/L**. - The move to a new ORS with reduced osmolarity was to improve efficacy and reduce the risk of hypernatremia in some patients.

Question 666: What is the recommended Aedes Aegypti index for preventing Yellow Fever transmission?

A. Less than 1% (Correct Answer)
B. Less than 5%
C. Less than 10%
D. Less than 20%

Explanation: ***Less than 1%*** - An **Aedes Aegypti index** of **less than 1%** is the recommended threshold by WHO to effectively prevent Yellow Fever transmission. - Maintaining the vector index (House Index) below this critical level significantly reduces the chances of epidemic transmission. - This stringent target is essential for breaking the transmission cycle in endemic areas. *Less than 5%* - While an index of less than 5% represents moderate control, it is insufficient for reliable Yellow Fever prevention. - This threshold may be acceptable for the Breteau Index (measured differently), but for the House Index, 1% is the standard. - At this level, there remains significant risk of transmission during favorable conditions. *Less than 10%* - An index of **less than 10%** is considered inadequate for prevention of Yellow Fever transmission. - This level carries a substantial risk of outbreaks, as the vector population remains high enough to support sustained transmission. - Urgent vector control interventions are needed at this level. *Less than 20%* - An **Aedes Aegypti index** of less than 20% indicates a high-risk environment for Yellow Fever transmission. - This level is far above the recommended threshold and suggests a critical need for immediate and aggressive vector control measures. - At this level, epidemic transmission is highly likely if the virus is introduced.

Question 667: Which of the following is not typically screened for in blood donations?

A. HIV
B. HBV
C. HCV
D. Epstein-Barr Virus (EBV) (Correct Answer)

Explanation: ***Epstein-Barr Virus (EBV)*** ✓ - EBV is **NOT routinely screened** for in blood donations in India and most countries - While EBV is a common virus (>90% adults are seropositive), it is **not considered a major transfusion-transmitted infection** - The virus is primarily transmitted through saliva; transfusion-associated EBV transmission is **extremely rare and usually not clinically significant** in immunocompetent recipients - Risk-benefit analysis does not support routine screening due to **high prevalence, low clinical impact, and cost considerations** - EBV screening may only be considered for specific recipients (e.g., severely immunocompromised patients) *HIV* - **Routinely screened** in all blood donations worldwide - Screening includes HIV-1 and HIV-2 antibodies and/or HIV antigen/RNA testing - Transfusion-transmitted HIV causes AIDS with severe consequences - Mandatory screening under the Drugs and Cosmetics Act in India *HBV* - **Routinely screened** in all blood donations - Screening includes HBsAg (Hepatitis B surface antigen) testing, and often anti-HBc or HBV DNA - Can cause acute and chronic hepatitis, cirrhosis, and hepatocellular carcinoma - Mandatory screening in India and globally *HCV* - **Routinely screened** in all blood donations - Screening includes anti-HCV antibodies and/or HCV RNA (nucleic acid testing) - Major cause of chronic hepatitis, cirrhosis, and liver cancer - Mandatory screening under blood safety regulations

Question 668: The primary reservoir for leptospirosis transmission is:

A. Rat (Correct Answer)
B. Cat
C. Dog
D. Fish

Explanation: ***Correct Answer: Rat*** - **Rats** (and other rodents) are considered the primary natural reservoir for *Leptospira* bacteria worldwide and are **asymptomatic carriers**. - They excrete the bacteria in their urine, contaminating water and soil, which serves as the main source of human infection. *Incorrect: Cat* - While cats can become infected with *Leptospira*, they are **not typically considered significant reservoirs** for human transmission. - Their role in the epidemiologic cycle of leptospirosis is generally minor compared to rodents and some other mammals. *Incorrect: Dog* - **Dogs** can contract leptospirosis and excrete the bacteria in their urine, posing a risk to humans, but they are generally considered **incidental hosts or secondary reservoirs**, not the primary one. - Vaccination in dogs helps reduce their role in transmission. *Incorrect: Fish* - **Fish are not known to be reservoirs** for *Leptospira* bacteria. - Leptospirosis is primarily transmitted through contact with infected animal urine, not aquatic life like fish.

Question 669: Transovarian transmission is seen in which of the following infections?

A. Plague
B. Ebola fever
C. Yellow fever (Correct Answer)
D. None of the options

Explanation: ***Yellow fever*** - **Transovarian transmission** refers to the passage of a pathogen from an adult female arthropod (like a mosquito) to her offspring via the eggs. This mechanism allows the virus to persist in the **vector population** even in the absence of infected vertebrate hosts. - **Yellow fever virus** is known to undergo transovarian transmission in its mosquito vectors, particularly *Aedes aegypti* and other *Aedes* species. *Plague* - Plague is caused by the bacterium *Yersinia pestis* and is primarily transmitted by **flea bites** from infected rodents to humans. - It does not involve transovarian transmission; the fleas acquire the bacteria during a **blood meal** from an infected host. *Ebola fever* - Ebola virus is transmitted through **direct contact** with blood or bodily fluids of infected humans or animals. - It is not an **arthropod-borne disease** and therefore does not exhibit transovarian transmission. *None of the options* - This option is incorrect because **Yellow Fever** clearly demonstrates transovarian transmission within its mosquito vector.

Question 670: Which of the following is a zoonotic disease?

A. Hydatid cyst (Correct Answer)
B. Malaria
C. Filariasis
D. Dengue fever

Explanation: ***Hydatid cyst*** - This disease is caused by the larval stage of the tapeworm **Echinococcus granulosus**, which completes its life cycle in dogs and sheep. - Humans can become infected by ingesting material contaminated with **Echinococcus eggs**, typically from contact with infected dogs or contaminated food/water, making it a zoonotic disease. *Malaria* - Malaria is transmitted by the **Anopheles mosquito** biting infected humans and then uninfected humans. - While it involves a vector, its primary reservoir is humans and it is not typically considered zoonotic as there is no animal-to-human transmission from a non-human primary reservoir. *Filariasis* - Filariasis is spread by various mosquito vectors (e.g., **Culex, Anopheles, Aedes**) that transmit parasitic worms to humans. - The life cycle primarily involves humans and mosquitos, and it is not classified as a zoonotic disease. *Dengue fever* - Dengue fever is a viral infection transmitted by **Aedes mosquitoes** (primarily *Aedes aegypti* and *Aedes albopictus*) between humans. - Similar to malaria, while it involves a vector, the primary reservoir is humans, and it is not considered zoonotic.

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Communicable Disease Control Principles

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Vector-Borne Diseases

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Water-Borne Diseases

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Air-Borne Diseases

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Zoonotic Diseases

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Sexually Transmitted Infections

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HIV/AIDS Control Program

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Tuberculosis Control

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Leprosy Elimination

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Emerging and Re-emerging Infections

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Hospital-Acquired Infections

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Integrated Disease Surveillance Project

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