Infectious Diseases Practice Questions

Q: Multinucleated giant cells are seen in smear from the lesions of:

Herpes simplex virus. ***Herpes simplex virus*** - **Multinucleated giant cells** with intranuclear inclusions are characteristic findings in Tzanck smears from **herpes simplex virus (HSV)** lesions [1]. - This cellular morphology results from the fusion of infected cells, a cytopathic effect of the virus [1]. *HIV* - HIV primarily infects **CD4+ T-cells** and macrophages, leading to immunosuppression, but does not typically cause multinucleated giant cells in skin lesion smears. - While HIV can be associated with various opportunistic skin lesions, the hallmark cytological finding from the primary infection itself is not multinucleated giant cells. *Poliovirus* - Poliovirus is an **enterovirus** that primarily affects the central nervous system, causing paralytic disease. - It does not cause skin lesions characterized by multinucleated giant cells. *Rabiesvirus* - Rabiesvirus is a **neurotropic virus** that causes acute encephalitis in mammals. - The characteristic pathological finding in rabies is the presence of **Negri bodies** (intracytoplasmic inclusions) in neurons, not multinucleated giant cells in skin smears. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 365-366.

Q: "Medlar bodies" are seen in

Chromblastomycosis. ***Chromblastomycosis*** - "**Medlar bodies**" (also known as muriform cells or sclerotic bodies) are characteristic findings in the tissue biopsy of patients with **chromoblastomycosis**. - These are thick-walled, septate, dark brown fungal cells that reproduce by septation and are crucial for the diagnosis of this chronic fungal infection. *Coccidiomycosis* - This deep fungal infection is characterized by thick-walled **spherules containing endospores** in tissue, rather than Medlar bodies [1]. - It primarily affects the lungs but can disseminate to other organs. *Sporotrichosis* - The classic histological finding in sporotrichosis is the presence of **cigar-shaped budding yeasts** in tissue, especially in the suppurative granulomas. - **Asteroid bodies**, which are yeasts surrounded by eosinophilic material, may also be seen. *Histoplasmosis* - This fungal infection is identified by small, **intracellular budding yeasts** (2-4 µm) found within macrophages in tissue samples [1]. - It commonly affects the lungs and can disseminate, particularly in immunocompromised individuals [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, p. 717.

Q: Warthin-Finkeldey giant cells are seen in?

Measles. ***Measles*** - **Warthin-Finkeldey giant cells** are characteristic large, multinucleated cells found in lymphoid tissues during the prodromal and eruptive phases of **measles** (rubeola) [1]. - These cells represent **syncytia** formed by the fusion of infected lymphocytes and macrophages, a hallmark of **measles virus infection** [1]. *Rubella* - Rubella (German measles) is a milder viral infection and does not typically involve the formation of **Warthin-Finkeldey giant cells**. - While it can cause lymphadenopathy, the characteristic histological findings differ significantly from measles. *Rickettsial pox* - Rickettsial pox is caused by *Rickettsia akari* and presents with a rash and flu-like symptoms. - The pathology primarily involves **vasculitis** and does not feature **Warthin-Finkeldey giant cells**. *Influenza* - Influenza is a respiratory viral infection primarily affecting the respiratory epithelium. - It does not lead to the formation of **Warthin-Finkeldey giant cells** in lymphoid tissues. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 362-363.

Q: Eosinophilic ovoid intranuclear inclusion bodies seen in herpes infection is called as:

Lipschutz bodies.. ***Lipschutz bodies*** - **Lipschutz bodies** are characteristic **eosinophilic ovoid intranuclear inclusion bodies** found in cells infected with **herpes simplex virus (HSV)**. - They represent viral replication within the nucleus and are a key diagnostic feature in histopathology of herpes infections. - These inclusion bodies are typically seen in cervical, vulvar, and penile lesions caused by HSV. *Howell-Jolly bodies* - **Howell-Jolly bodies** are **round, dense, basophilic nuclear remnants** often seen in **red blood cells**. - Their presence indicates hyposplenism or asplenia, not viral infection. *Rushton bodies* - **Rushton bodies** are **hyaline bodies** found in the lining of **odontogenic cysts**, particularly radicular and dentigerous cysts. - They are not related to viral infections and represent keratin or mucous material. *Cowdry bodies* - **Cowdry bodies** are also intranuclear inclusion bodies but are classified into **Type A and Type B**. - **Type A Cowdry bodies** are acidophilic inclusions surrounded by a clear halo, seen in herpes and varicella-zoster infections [1], [2]. - Unlike Lipschutz bodies which are ovoid and eosinophilic, Cowdry A bodies have a characteristic halo and different morphology [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 366-367. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 365-366.

Q: What is the primary reason why pre-transfusion testing does not completely eliminate the risk of hepatitis transmission?

Some carriers may not have detectable HBsAg. ***Most carriers do not have HBsAg*** - Some carriers may not have detectable **HBsAg** during the **window period** of acute infection or in **chronic carriers** with very low viral loads [1]. - This creates a gap in screening where infectious individuals can donate blood despite negative **HBsAg** testing, leading to potential transmission [1]. *Present screening test is not sensitive for HBsAg* - Modern **HBsAg screening tests** are highly sensitive and can detect very low levels of the antigen using **enzyme immunoassays** and **chemiluminescent assays**. - The issue is not test sensitivity but rather the **biological absence** of HBsAg during certain phases of hepatitis B infection. *Post transfusions hepatitis is caused by CMV* - **Cytomegalovirus (CMV)** can be transmitted through transfusion but typically causes **mononucleosis-like symptoms** rather than classic hepatitis. - Post-transfusion hepatitis is primarily caused by **hepatitis viruses (B, C)** that specifically target liver cells and cause hepatocellular damage. *HCV not screened* - **Hepatitis C virus (HCV)** is routinely screened in blood donations using **anti-HCV antibody testing** and **nucleic acid testing (NAT)**. - Modern comprehensive screening has dramatically reduced the risk of **HCV transmission** from approximately 1 in 100 to less than 1 in 2 million units. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Liver and Gallbladder, p. 838.

Q: Lipschutz bodies are seen in ?

Herpes. ***Herpes*** - **Lipschutz bodies**, also known as **intranuclear eosinophilic inclusion bodies**, are characteristic cytopathic effects seen in cells infected with the **Herpes Simplex Virus (HSV)** [1]. - These inclusions are visible within the nucleus of epithelial cells, indicating active viral replication and aiding in the histological diagnosis of herpes infections [1]. *Yellow fever* - Yellow fever is caused by a **flavivirus** and does not typically present with Lipschutz bodies. - Histological findings in yellow fever include **Councilman bodies** (apoptotic hepatocytes) and fatty degeneration in the liver. *Hodgkin's disease* - Hodgkin's disease is a **lymphoma**, a type of cancer, and is characterized by the presence of large, often multinucleated **Reed-Sternberg cells**. - It is a neoplastic condition and not an infectious disease associated with viral inclusions like Lipschutz bodies. *Viral hepatitis* - Viral hepatitis, caused by various hepatitis viruses (e.g., HAV, HBV, HCV), primarily affects the **liver** [2]. - Histological changes in viral hepatitis include **hepatocyte necrosis**, inflammation, and immune cell infiltration, but not Lipschutz bodies [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 365-366. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 390-391.

Q: Giant cells in measles are called as:

Warthin-Finkeldey cells. ***Warthin-Finkeldey cells*** - **Warthin-Finkeldey cells** are multinucleated giant cells characteristic of **measles virus infection**. [1] - They are formed by the fusion of infected cells and are found in lymphoid tissues, such as the **lymph nodes**, tonsils, and appendix, during the acute phase of measles. [1] *Weinberger bodies* - **Weinberger bodies** are not a recognized term for giant cells in measles or any other medical condition. - This term does not correspond to any known pathological finding. *Koplik spots* - **Koplik spots** are **pathognomonic enanthem** of measles, appearing as small, white spots with erythematous halos on the buccal mucosa. [1] - While characteristic of measles, they are clinical lesions, not giant cells. *HP bodies* - **HP bodies** (also known as **Henderson-Paterson bodies**) are cytoplasmic inclusion bodies seen in cells infected with **molluscum contagiosum virus**. [2] - These are indicative of molluscum contagiosum, not measles. [2] **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 362-363. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Skin, pp. 1177-1178.

Q: Virchow Lepra cells are seen in:

Lepromatous Leprosy. ***Lepromatous Leprosy*** - **Virchow cells** (also known as **foamy macrophages** or **lepra cells**) are characteristic histological findings in **lepromatous leprosy** [1]. - These cells are macrophages distended with numerous **Mycobacterium leprae bacilli**, forming a foamy or vacuolated appearance due to the stored lipids and bacteria [1]. *Tuberculoid leprosy* - Characterized by a strong cell-mediated immune response, leading to few bacilli and often well-formed **granulomas** [1], [2]. - **Virchow cells** are typically absent because macrophages effectively clear the bacteria [1]. *Indeterminate leprosy* - This is an early, unstable form of leprosy with a low bacterial load and non-specific histological features. - It often lacks the distinct **Virchow cells** seen in lepromatous leprosy or the granulomas of tuberculoid leprosy. *Borderline tuberculoid leprosy* - This form lies between tuberculoid and lepromatous leprosy, with some features of both but leaning towards a more effective immune response than lepromatous. - While lymphocytes and some granuloma formation may be present, it generally does not show the prominent **Virchow cells** characteristic of lepromatous leprosy. **References:** [1] Kumar v, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 385-386. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Disorders Involving Inflammatory And Haemopoietic Cells, pp. 638-639.

Question 1

Multinucleated giant cells are seen in smear from the lesions of:

Accepted Answer

Herpes simplex virus

Answer

HIV

Answer

Poliovirus

Answer

Rabiesvirus

Question 2

"Medlar bodies" are seen in

Accepted Answer

Chromblastomycosis

Answer

Coccidiomycosis

Answer

Sporotrichosis

Answer

Histoplasmosis

Question 3

Warthin-Finkeldey giant cells are seen in?

Accepted Answer

Measles

Answer

Rubella

Answer

Rickettsial pox

Answer

Influenza

Question 4

Eosinophilic ovoid intranuclear inclusion bodies seen in herpes infection is called as:

Accepted Answer

Lipschutz bodies.

Answer

Rushton bodies.

Answer

Cowdry bodies

Answer

Howell-Jolly bodies

Question 5

Characteristic histopathological finding in Whipple's disease is?

Accepted Answer

PAS positive macrophages and rod shaped bacilli in lamina propria

Answer

Mononuclear infiltration at base of crypts

Answer

Shortened thickened villi with increased crypt depth

Answer

Blunting and flattening of mucosal surface and absent villi

Question 6

What is the primary reason why pre-transfusion testing does not completely eliminate the risk of hepatitis transmission?

Accepted Answer

Some carriers may not have detectable HBsAg

Answer

Present screening test is not sensitive for HBsAg

Answer

Post transfusions hepatitis is caused by CMV

Answer

HCV not screened

Question 7

Lipschutz bodies are seen in ?

Accepted Answer

Herpes

Answer

Yellow fever

Answer

Hodgkin's disease

Answer

Viral hepatitis

Question 8

Giant cells in measles are called as:

Accepted Answer

Warthin-Finkeldey cells

Answer

Weinberger bodies

Answer

HP bodies

Answer

Koplik spots

Question 9

Which of the following agents causing acute infectious diarrhea can be paired with the pathogenic mechanism of destruction limited to the mature villus cells of small intestine?

Accepted Answer

Rotavirus

Answer

E. coli

Answer

Vibrio cholerae

Answer

Shigella

Question 10

Virchow Lepra cells are seen in:

Accepted Answer

Lepromatous Leprosy

Answer

Tuberculoid leprosy

Answer

Indeterminate leprosy

Answer

Borderline tuberculoid leprosy

Infectious Diseases — MCQs

Infectious Diseases — MCQs

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