Infectious Diseases Practice Questions

Q: Reduced osmolarity ORS does not contain which of the following ions?

Lactate. ***Lactate*** - The **reduced osmolarity ORS** formulation replaced **bicarbonate** with **citrate** and does not contain lactate. - **Citrate** is preferred over lactate / bicarbonate due to its stability, longer shelf life, and ease of dissolution. *Sodium* - **Sodium** is a crucial component of ORS, as it is co-transported with glucose into enterocytes, facilitating water absorption through **solvent drag**. - Reduced osmolarity ORS has a **lower sodium concentration** (75 mEq/L) compared to standard ORS (90 mEq/L) to minimize hypernatremia risk and enhance water absorption. *Potassium* - **Potassium** is included in ORS to replace intestinal losses, as **diarrhea** leads to significant potassium depletion. - Maintaining adequate **potassium levels** is essential for normal cellular function and preventing hypokalemia-related complications. *Citrate* - **Citrate** is a component of ORS that serves as an **alkalinizing agent** to correct metabolic acidosis often associated with dehydration in diarrheal diseases. - It also enhances the absorption of sodium and water in the intestine.

Q: Which of the following screening methods is primarily used under the National Tuberculosis Elimination Program (NTEP)?

Passive. ***Passive*** - Under the NTEP, **passive screening** involves individuals presenting to health facilities with symptoms suggestive of TB. - This method relies on **patient self-reporting** and healthcare provider suspicion, rather than active outreach. - Passive case finding is the **primary screening strategy** used across the general population in the NTEP framework. *Active* - **Active screening** involves community-based interventions to proactively identify individuals with TB, often in high-risk populations. - While active case finding is crucial for specific vulnerable groups (contacts, HIV patients, etc.), it is **not the primary screening method** under the standard NTEP framework for initial detection across the entire population. *Mass* - **Mass screening** involves testing large numbers of people in the general population, regardless of symptoms, to detect disease. - This is generally **cost-prohibitive** and not routinely implemented as a primary screening strategy for TB by the NTEP due to resource limitations and low yield in the general population. *None of the options* - **Passive screening** is indeed a primary method used under the NTEP, making this option incorrect. - The NTEP heavily relies on individuals seeking care when they experience symptoms, which aligns with the definition of passive case finding.

Q: Reservoir of infection in enteric fever?

Man. ***Man*** - Humans are the **sole natural reservoir** for *Salmonella Typhi* and *Salmonella Paratyphi*, the causative agents of enteric fever (typhoid and paratyphoid fever). - The bacteria can persist in the **gallbladder** of asymptomatic carriers, who can then shed the bacteria in their feces, contributing to transmission. *Birds* - Birds are not considered a primary reservoir for the **causative pathogens of enteric fever** (*Salmonella Typhi* or *Paratyphi*). - They are more commonly associated with other *Salmonella* serotypes, such as *Salmonella Enteritidis*, which cause **gastroenteritis** rather than systemic enteric fever. *Cow* - Cows are not a primary reservoir for the organisms responsible for **enteric fever**; these pathogens are specifically adapted to humans. - While cows can carry various *Salmonella* species, they are typically associated with **foodborne outbreaks** of *Salmonella*-induced **gastroenteritis**, not typhoid fever. *Water* - Water is a **vehicle for transmission** of enteric fever, becoming contaminated with human feces containing *Salmonella Typhi* or *Paratyphi*. - It is not a reservoir because the bacteria do not naturally **multiply or persist indefinitely** in water without a human source.

Q: Which of the following is the most epidemiologically distinctive feature of chickenpox?

Secondary attack rate (SAR) is approximately 90%. ***Secondary attack rate (SAR) is approximately 90%*** - A **secondary attack rate (SAR)** of around 90% is exceptionally high, indicating that chickenpox is one of the most **contagious infectious diseases**, readily spreading among susceptible household contacts. - This high SAR highlights the disease's **distinctive epidemiological characteristic** of efficient person-to-person transmission within close-contact settings. *Caused by varicella-zoster virus* - While true, many diseases are caused by specific viruses, and this fact alone is not an **epidemiologically distinctive feature** in terms of transmissibility or population impact. - The causative agent defines the disease, but doesn't uniquely describe its spread or contagiousness in an epidemiological sense. *Most commonly affects children under 10 years old* - Many common childhood infections, such as measles or mumps, also primarily affect children, making this less of a **distinctive epidemiological feature** for chickenpox specifically. - The age group affected is common for many highly transmissible diseases of childhood. *Infectious period is 1-2 days before rash until all blisters have scabbed over* - Many infectious diseases have similar **infectious periods** spanning from a prodromal phase to resolution, making this a general feature of viral infections rather than one highly distinctive to chickenpox epidemiologically. - While important for infection control, it doesn't stand out as uniquely characteristic of chickenpox's epidemiological profile compared to other common infectious diseases.

Q: What is the most common mode of transmission of HIV?

Sexual contact. ***Sexual contact*** - **Unprotected sexual intercourse**, both heterosexual and homosexual, is overwhelmingly the most common way HIV is transmitted globally. - The virus can be exchanged through **bodily fluids** such as semen, vaginal fluids, and rectal fluids during sexual activity. - Accounts for approximately **80% of new HIV infections** worldwide. *Occupational exposure (needle stick injury)* - While a recognised mode of transmission, **needle stick injuries** account for a very small percentage of total HIV infections, primarily affecting healthcare workers. - The risk of transmission per exposure is relatively low (approximately **0.3%**), especially compared to sexual contact. *Perinatal transmission (mother to child)* - **Mother-to-child transmission** can occur during pregnancy, childbirth, or breastfeeding. - Although significant, especially in resource-limited settings, global efforts and **PMTCT programs** have resulted in a significant reduction in this type of transmission. *Transmission via blood and blood products* - This mode was once a major concern but is now extremely rare in countries with robust **blood screening programs**. - While sharing contaminated needles among **intravenous drug users** remains a risk, transfusion-related HIV is largely controlled.

Q: Which of the following statements about influenza infectivity is correct?

All of the options are correct.. ***All of the options are correct.*** - All statements provided accurately describe aspects of influenza infectivity and epidemiology. - The **communicable period**, the **primary source of infection**, and the potential for **subclinical cases** are all characteristic features of influenza. *Communicable period is 1 day before to 5-7 days after the onset of symptoms* - This statement is accurate, as influenza is transmissible **before symptom onset** and for several days afterward, which contributes to its rapid spread. - Peak viral shedding often occurs just before and in the first few days of symptomatic illness. - Adults typically shed virus from 1 day before to 5-7 days after symptom onset (can be longer in children and immunocompromised individuals). *The primary source of infection is a clinical case.* - This is correct, as **symptomatic individuals (clinical cases) are the PRIMARY source** of influenza virus transmission to others. - Respiratory droplets produced by coughing, sneezing, or talking from an infected person are the main mode of spread. - While subclinical cases can transmit, clinical cases with overt symptoms produce more respiratory droplets and are the major drivers of transmission. *There can be subclinical cases of influenza.* - This statement is correct; many individuals infected with influenza virus experience **mild or asymptomatic infections** (subclinical cases). - These subclinical cases can still transmit the virus, though typically to a lesser extent than symptomatic cases, further complicating control efforts.

Q: Among the following options, the minimum acceptable Rideal-Walker coefficient for disinfectant used for cholera stool would be?

2. ***2 (Minimum acceptable among given options)*** - The **Rideal-Walker coefficient** measures disinfectant efficacy relative to phenol as the standard reference - A coefficient of **2** means the disinfectant is **twice as effective** as phenol against test organisms (*Salmonella typhi* and *Staphylococcus aureus*) - While higher coefficients are preferred for highly infectious materials like cholera stool, **2 represents the minimum acceptable threshold** among the given options that still provides reasonable disinfection efficacy - Standard practice recommends disinfectants with RW coefficient ≥5 for cholera stool, but among the choices provided, 2 is the lowest that meets basic acceptability criteria *4 (Better choice but not the minimum)* - A coefficient of **4** means the disinfectant is **four times more effective** than phenol - This provides **more robust disinfection** and would be preferred over a coefficient of 2 - However, the question specifically asks for the **minimum acceptable** value, not the optimal value - Among the options, this is not the minimum *7 (Highly effective)* - A coefficient of **7** indicates the disinfectant is **seven times more potent** than phenol - This represents **very good disinfection efficacy** and exceeds minimum requirements - This is well above the minimum acceptable threshold *10 (Excellent efficacy)* - A coefficient of **10** means the disinfectant is **ten times more effective** than phenol - This represents **excellent disinfection power** with a very high safety margin - While ideal for high-risk situations, this far exceeds the minimum acceptable requirement

Q: Pneumonic plague is spread by:

Droplet infection. ***Correct: Droplet infection*** - Pneumonic plague is a severe form of plague that affects the **lungs** and is transmitted through **respiratory droplets** expelled by an infected person or animal during coughing or sneezing. - This direct person-to-person transmission distinguishes it from other forms of plague. - It is the **only form of plague** that can spread directly from human to human without an animal or flea vector. *Incorrect: Bite of infected flea* - This is the primary mode of transmission for **bubonic plague**, where the bacterium *Yersinia pestis* is transmitted from rodents to humans via infected fleas. - While bubonic plague can progress to pneumonic plague, the initial transmission route for the pneumonic form itself is not flea bites. *Incorrect: Direct contact with infected tissue* - Direct contact with infected tissues or fluids can lead to **septicemic plague** or sometimes bubonic plague, especially in cases where there is a break in the skin. - This is not the typical or primary route for the spread of pneumonic plague, which is respiratory. *Incorrect: Ingestion of contaminated food* - Ingestion of contaminated food or water is a route for various **gastrointestinal infections** and diseases like salmonella or cholera. - It is not a known or common method for the transmission of any form of plague, including pneumonic plague.

Q: Human, animal, fomite or objects from which infective organism enters the host is called?

Source of infection. ***Source of infection*** - The **source of infection** refers to the person, animal, object, or substance from which an infectious agent passes immediately to a host. - This can include humans, animals, fomites, or contaminated objects that directly transmit the infectious organism. - This is the proximate source from which the agent enters the host. *Infective Reservoir* - An **infective reservoir** is the long-term habitat where an infectious agent normally lives, grows, and multiplies. - The reservoir can be human, animal, plant, soil, or inanimate matter where the agent is normally found. - While a reservoir can be a source, the source is specifically the immediate point from which transmission occurs. *Infective Carrier* - An **infective carrier** is an infected person or animal that harbors a specific infectious agent without showing clinical symptoms but can transmit it to others. - A carrier is a type of source (when transmission occurs from them), but the term "source" is broader, encompassing inanimate objects and fomites as well. *None of the above* - This option is incorrect because **Source of infection** accurately describes the concept presented in the question.

Question 1

Reduced osmolarity ORS does not contain which of the following ions?

Accepted Answer

Lactate

Answer

Sodium

Answer

Potassium

Answer

Citrate

Question 2

Which of the following screening methods is primarily used under the National Tuberculosis Elimination Program (NTEP)?

Accepted Answer

Passive

Answer

Active

Answer

Mass

Answer

None of the options

Question 3

Reservoir of infection in enteric fever?

Accepted Answer

Man

Answer

Birds

Answer

Cow

Answer

Water

Question 4

Which of the following is the most epidemiologically distinctive feature of chickenpox?

Accepted Answer

Secondary attack rate (SAR) is approximately 90%

Answer

Caused by varicella-zoster virus

Answer

Most commonly affects children under 10 years old

Answer

Infectious period is 1-2 days before rash until all blisters have scabbed over

Question 5

What is the most common mode of transmission of HIV?

Accepted Answer

Sexual contact

Answer

Occupational exposure (needle stick injury)

Answer

Perinatal transmission (mother to child)

Answer

Transmission via blood and blood products

Question 6

Which of the following statements about universal precautions is false?

Accepted Answer

Consider that all body fluids are contaminated with blood

Answer

Includes use of hand washing

Answer

Includes use of gloves and masks

Answer

To prevent transmission of blood borne pathogens

Question 7

Which of the following statements about influenza infectivity is correct?

Accepted Answer

All of the options are correct.

Answer

Communicable period is 1 day before to 5-7 days after the onset of symptoms

Answer

There can be subclinical cases of influenza.

Answer

The primary source of infection is a clinical case.

Question 8

Among the following options, the minimum acceptable Rideal-Walker coefficient for disinfectant used for cholera stool would be?

Accepted Answer

2

Answer

4

Answer

10

Answer

7

Question 9

Pneumonic plague is spread by:

Accepted Answer

Droplet infection

Answer

Direct contact with infected tissue

Answer

Bite of infected flea

Answer

Ingestion of contaminated food

Question 10

Human, animal, fomite or objects from which infective organism enters the host is called?

Accepted Answer

Source of infection

Answer

Infective Reservoir

Answer

Infective Carrier

Answer

None of the above

Infectious Diseases — MCQs

Infectious Diseases — MCQs

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