Infectious Diseases Practice Questions

Q: Drug of choice for mass therapy under filariasis control programme?

DEC. ***Correct: DEC*** - **Diethylcarbamazine (DEC)** is the drug of choice for **mass drug administration (MDA)** campaigns aimed at eliminating lymphatic filariasis. - It effectively kills **microfilariae** and has some action on adult worms, reducing transmission. - In India's National Filariasis Elimination Programme, DEC is administered along with Albendazole in annual MDA campaigns. *Incorrect: Albendazole* - While **Albendazole** is co-administered with DEC in MDA programs, it is not the sole drug of choice for mass treatment of filariasis. - Its primary role is to provide **macrofilaricidal** activity (killing adult worms) and co-treatment for other helminth infections. - It enhances the effect of DEC but is not used alone. *Incorrect: Ivermectin* - **Ivermectin** is used in MDA programs for filariasis, particularly in areas co-endemic with **onchocerciasis** or where **Loa loa** is prevalent (as DEC is contraindicated in these areas). - However, in India and most lymphatic filariasis endemic areas, **DEC** remains the primary drug. *Incorrect: Mebendazole* - **Mebendazole** is an anthelminthic primarily used for treating **intestinal nematode infections** like ascariasis, trichuriasis, and hookworm. - It is **not used** in lymphatic filariasis mass treatment programs.

Q: In the context of malaria control, when is regular insecticidal spray recommended based on the Annual Parasite Index (API)?

> 2. ***> 2*** - Regular insecticidal spray, particularly **Indoor Residual Spraying (IRS)**, is a key malaria control measure recommended when the **Annual Parasite Index (API) is greater than 2**. - An API greater than 2 indicates **high endemicity** with a significant burden of malaria transmission in the community, necessitating aggressive vector control strategies. - According to **NVBDCP (National Vector Borne Disease Control Programme) guidelines**, API > 2 defines high-risk areas where routine IRS is implemented as a core intervention. *> 1* - An API between 1-2 represents **moderate endemicity**, where the focus is primarily on **active case detection, prompt treatment, and targeted interventions** rather than universal spraying. - While vector control remains important, routine widespread IRS is not the standard recommendation at this threshold. *< 2* - An API of less than 2 (which includes both moderate and low endemic areas) does not routinely warrant universal insecticidal spraying programs. - In areas with API < 2, **case management, surveillance, and selective vector control** are prioritized over widespread IRS campaigns. *< 1* - An API of less than 1 indicates **low endemicity**, where malaria transmission is minimal and sporadic. - In such areas, **surveillance, prompt case detection and treatment, and targeted interventions** are the mainstay, with IRS reserved only for focal outbreaks or high-risk pockets.

Q: Behavioral surveillance survey is done in?

AIDS. ***AIDS*** - Behavioral surveillance surveys are crucial for understanding and monitoring behaviors related to **HIV transmission**, such as sexual practices and drug use, among at-risk populations. - These surveys help in designing and evaluating **prevention programs** by identifying trends in risky behaviors and knowledge, attitudes, and practices (KAP) concerning HIV. *Filaria* - Surveillance for filaria primarily involves **entomological surveys** (mosquito monitoring) and **parasitological surveys** (blood examinations for microfilariae). - Behavioral aspects are less central to direct surveillance compared to disease vectors and infection rates. *TB* - Tuberculosis surveillance mainly focuses on **case detection**, **treatment outcomes**, and monitoring **drug resistance** through clinical and laboratory data. - While patient adherence to treatment involves behavior, there isn't a dedicated "behavioral surveillance survey" method specifically for TB. *Malaria* - Malaria surveillance involves monitoring **parasitemia rates**, **vector populations**, and **antimalarial drug resistance**. - Behavioral components like bed net usage are important, but the primary surveillance methods are not termed "behavioral surveillance surveys" in the same structured way as for HIV.

Q: Which of the following statements about Culex larvae is correct?

Siphon tube present. ***Siphon tube present*** - **Culex larvae** possess a prominent **siphon tube** at their posterior end, which is used for breathing by extending to the water surface. - This **siphon tube** is a key morphological feature that helps distinguish them from *Anopheles* larvae. *Rest parallel to surface water* - **Anopheles larvae** typically rest parallel to the water surface because they lack a long siphon and obtain oxygen directly through spiracles on their dorsal surface. - **Culex larvae**, due to their siphon tube, hang head-down at an angle from the water surface. *Long Palmate hair* - **Palmate hairs** are characteristic structures found on the abdomen of **Anopheles larvae** that help them float horizontally at the water surface. - **Culex larvae** do not possess well-developed palmate hairs. *All are false* - This statement is incorrect because the presence of a **siphon tube** is a defining characteristic of **Culex larvae**.

Q: Which of the following larvicide is used under urban Malaria Scheme?

Abate. ***Abate*** - **Abate (temephos)** is an organophosphate larvicide widely used in public health programs, including the urban malaria scheme, due to its effectiveness against mosquito larvae at low concentrations. - It is applied to water storage containers, wells, and other mosquito breeding sites to **prevent the development of adult mosquitoes**. *Malathion* - **Malathion** is an organophosphate insecticide primarily used as an **adulticide** for fogging operations against adult mosquitoes, not specifically as a larvicide in urban schemes. - While it can kill larvae, its primary application and efficacy are geared towards **adult mosquito control**. *Parathion* - **Parathion** is a highly toxic organophosphate insecticide that is generally **not used in public health programs** due to its significant environmental and human health risks. - Its use is largely restricted to agricultural pest control and is **not a recommended larvicide** for urban settings. *DDT* - **DDT (dichlorodiphenyltrichloroethane)** is a persistent organic pollutant whose use has been largely banned or severely restricted globally due to its **environmental impact** and long-term toxicity. - While historically used for mosquito control (both larvae and adults), it is **not used in current urban malaria schemes** due to its banned status in many regions and resistance issues.

Q: Which of the following statements about pathogenic mosquitoes is correct?

Anopheles mosquitoes are known for transmitting malaria.. ***Correct: Anopheles mosquitoes are known for transmitting malaria.*** - **Anopheles mosquitoes** are the **primary and only vectors** for **malaria**, a parasitic disease caused by Plasmodium parasites. - They transmit the parasite through their **saliva** when they bite humans, typically during **dusk and dawn**. - This is the most significant pathogenic association among the options. *Incorrect: Mansonia mosquitoes lay their eggs in rafts.* - **Mansonia mosquitoes** lay their eggs in **clusters attached to underwater parts of aquatic plants**, not in rafts. - **Culex mosquitoes** are the ones that lay their eggs in **raft-like formations** on water surfaces. *Incorrect: Culex mosquitoes are primarily vectors for West Nile virus.* - While **Culex mosquitoes** can transmit West Nile virus, in the **Indian context** they are primarily known as vectors for **lymphatic filariasis** (Wuchereria bancrofti) and **Japanese encephalitis**. - West Nile virus is more relevant in Western countries and is not the primary disease association for Culex in India. *Incorrect: Aedes mosquitoes are known for their distinctive black and white striped markings.* - While **Aedes aegypti** and **Aedes albopictus** do have **black and white striped markings**, this is a **morphological characteristic** rather than a primary **pathogenic association**. - The question asks about pathogenic mosquitoes, and Aedes is better characterized by its **disease transmission** (dengue, Zika, chikungunya, yellow fever) rather than its appearance. - As a pathogenic mosquito, its **daytime biting behavior** and **urban breeding habits** are more relevant than its markings.

Q: Which of the following infectious diseases has the highest proportion of asymptomatic chronic carriers?

Hepatitis B. ***Hepatitis B*** - **Hepatitis B** infection has a significant proportion of **chronic asymptomatic carriers**, particularly when infection occurs perinatally or in early childhood. - In adults, approximately **5% develop chronic infection** after acute exposure, and many of these chronic carriers remain asymptomatic while maintaining infectivity. - Chronic carriers can harbor the virus for years or decades without clinical symptoms, making them an important reservoir for transmission. - This is a major public health concern as asymptomatic carriers can unknowingly transmit the virus. *Measles* - **Measles** is highly contagious and typically presents with **symptomatic disease** in nearly all infected individuals. - Clinical features include characteristic maculopapular rash, cough, coryza, conjunctivitis, and Koplik's spots. - Asymptomatic infection is **extremely rare** with measles virus. *Diphtheria* - While **asymptomatic pharyngeal carriage** of *Corynebacterium diphtheriae* can occur, it is not the predominant pattern. - Clinical diphtheria typically presents with pseudomembrane formation, sore throat, and potential systemic toxin effects. - Carrier rates vary but are not as epidemiologically significant as with Hepatitis B. *Rabies* - **Rabies** is almost **100% symptomatic** once the virus reaches the central nervous system. - There is **no chronic asymptomatic carrier state** in humans. - Once clinical symptoms appear (encephalitis, hydrophobia, paralysis), the disease is virtually always fatal.

Q: Which of the following is an example of indirect transmission by a living vector?

Transmission by mosquito. ***Transmission by mosquito*** - This is the classic example of **vector-borne transmission**, where a living biological vector (the mosquito) acts as an intermediary to transmit the infectious agent from an infected host to a susceptible one. - The disease-causing microorganism does not pass directly from person to person but is carried and transmitted by the living vector. - Examples include malaria, dengue, and filariasis. *Vertical transmission* - This refers to transmission of disease from a **mother to her child** during pregnancy, childbirth, or breastfeeding. - This is a form of **direct transmission** where the pathogen passes directly between biologically related individuals without an intermediate living vector. *Soil contact* - This represents **vehicle-borne transmission** where soil acts as a non-living vehicle (fomite) carrying pathogens. - While this is technically indirect transmission, it does not involve a **living biological vector** as specified in the question. - Examples include tetanus, hookworm, and ascariasis transmitted through contaminated soil. *Droplet infection* - This is a form of **direct transmission** where infectious droplets are expelled from the respiratory tract of an infected person and directly contact the mucous membranes of a susceptible person. - The droplets travel a short distance in close proximity, representing direct person-to-person transfer without any intermediate vector.

Q: What is a major sign for AIDS surveillance in the WHO case definition?

Weight loss greater than 10%. ***Weight loss greater than 10%*** - **Weight loss >10% of body weight** is one of the **three major signs** in the WHO clinical case definition for AIDS surveillance. - The **three major signs** are: (1) Weight loss >10%, (2) Chronic diarrhea >1 month, and (3) Prolonged fever >1 month. - This symptom reflects **"wasting syndrome,"** a severe manifestation of advanced HIV disease indicating significant metabolic and immunological dysfunction. - Major signs are critical for AIDS surveillance, especially in resource-limited settings where laboratory diagnosis may not be readily available. *Chronic cough for more than 1 month* - This is classified as a **minor sign**, not a major sign, in the WHO AIDS surveillance definition. - While chronic cough can indicate opportunistic infections like tuberculosis or *Pneumocystis jirovecii* pneumonia in HIV-infected individuals, it does not meet the criteria for a major sign. - WHO clinical staging requires major signs to have greater specificity for advanced disease. *Generalized lymphadenopathy* - **Generalized lymphadenopathy** is a **minor sign** in the WHO case definition. - Also known as Persistent Generalized Lymphadenopathy (PGL), it is common in early to chronic HIV infection but does not typically signify AIDS-stage disease. - It involves lymph node enlargement in two or more non-contiguous sites (excluding inguinal nodes) for more than 3 months. *Disseminated herpes infection* - Chronic progressive or disseminated herpes simplex infection is classified as a **minor sign**, not a major sign. - While severe herpes infections (including recurrent herpes zoster) are associated with immunosuppression in HIV, they are part of the minor criteria in WHO AIDS surveillance. - Major signs are reserved for more specific indicators of severe immunodeficiency and wasting.

Question 1

Drug of choice for mass therapy under filariasis control programme?

Accepted Answer

DEC

Answer

Albendazole

Answer

Ivermectin

Answer

Mebendazole

Question 2

In the context of malaria control, when is regular insecticidal spray recommended based on the Annual Parasite Index (API)?

Accepted Answer

> 2

Answer

< 1

Answer

< 2

Answer

> 1

Question 3

Behavioral surveillance survey is done in?

Accepted Answer

AIDS

Answer

TB

Answer

Filaria

Answer

Malaria

Question 4

Which of the following statements about Culex larvae is correct?

Accepted Answer

Siphon tube present

Answer

Rest parallel to surface water

Answer

Long Palmate hair

Answer

All are false

Question 5

Which of the following larvicide is used under urban Malaria Scheme?

Accepted Answer

Abate

Answer

Malathion

Answer

Parathion

Answer

DDT

Question 6

What is the definition of a reservoir in the context of infectious diseases?

Accepted Answer

Person, animal or substance in which infectious agent lives and multiplies

Answer

Person, animal or object from which infectious agent is transmitted to host

Answer

Person or animal in which infectious agent causes a disease

Answer

Person or animal that transmits the infectious agent mechanically

Question 7

Which of the following statements about pathogenic mosquitoes is correct?

Accepted Answer

Anopheles mosquitoes are known for transmitting malaria.

Answer

Mansonia mosquitoes lay their eggs in rafts.

Answer

Culex mosquitoes are primarily vectors for West Nile virus.

Answer

Aedes mosquitoes are known for their distinctive black and white striped markings.

Question 8

Which of the following infectious diseases has the highest proportion of asymptomatic chronic carriers?

Accepted Answer

Hepatitis B

Answer

Measles

Answer

Rabies

Answer

Diphtheria

Question 9

Which of the following is an example of indirect transmission by a living vector?

Accepted Answer

Transmission by mosquito

Answer

Vertical transmission

Answer

Soil contact

Answer

Droplet infection

Question 10

What is a major sign for AIDS surveillance in the WHO case definition?

Accepted Answer

Weight loss greater than 10%

Answer

Chronic cough for more than 1 month

Answer

Generalized lymphadenopathy

Answer

Disseminated herpes infection

Infectious Diseases — MCQs

Infectious Diseases — MCQs

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