Infectious Diseases Practice Questions

Q: In tuberculosis the cytokine causing fever is

IL-1. ***ILI*** - **IL-1** plays a crucial role in the inflammatory response to tuberculosis, leading to symptoms such as **fever** and **malaise**. - It is primarily produced by activated **macrophages** in response to the presence of Mycobacterium tuberculosis [1]. *IL4* - IL-4 is mainly involved in **B-cell activation** and is associated with **allergic responses**, not directly causing fever. - Its role does not include the **pro-inflammatory** response seen in tuberculosis infections [2]. *IL3* - IL-3 is involved in the **stimulation of hematopoiesis**, promoting the growth of various blood cells. - It does not have a significant role in **fever** or inflammation associated with tuberculosis. *IL2* - IL-2 is primarily associated with the activation and proliferation of **T-cells**, playing a role in **adaptive immunity**, not acute inflammatory responses. - It is less related to the **fever** response seen in active tuberculosis infection. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 380-381. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, p. 380.

Q: Stellate granulomas are seen in

Cat scratch disease. ***Cat scratch disease*** - **Stellate granulomas** are a characteristic histological feature of **Cat scratch disease**, caused by **Bartonella henselae**. - These granulomas are composed of macrophages, lymphocytes, and neutrophils arranged in a **star-shaped or stellate pattern**, often with central necrosis. *Sarcoidosis* - Sarcoidosis is characterized by **non-caseating granulomas**, which are typically well-formed and discrete [2], [3]. - However, they do not usually have the distinct **stellate (star-shaped) morphology** seen in cat scratch disease [3]. *Cryptococcosis* - Cryptococcosis is a fungal infection that typically presents with **granulomas containing yeasts** within macrophages. - The granulomas formed in cryptococcosis are not classically described as **stellate granulomas**. *Histoplasmosis* - Histoplasmosis is another fungal infection that can cause granuloma formation, usually with **caseous necrosis** similar to tuberculosis [1]. - The granulomas in histoplasmosis do not exhibit the **stellate architectural pattern** [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, p. 717. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 198-200. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, pp. 700-701.

Q: Warthin-Finkeldey cells are seen in

Measles infection. ***Measles infection*** - **Warthin-Finkeldey cells** are characteristic large, multinucleated giant cells with acidophilic intranuclear and intracytoplasmic inclusions found in lymphoid tissues during the prodromal phase of **measles** [1]. - These cells result from the fusion of measles virus-infected lymphocytes and are a **histological hallmark** of the disease [1]. *Rubella infection* - Rubella, or German measles, typically presents with a milder rash and **arthralgia** in adults. - While it is a viral infection, it does **not characteristically form Warthin-Finkeldey cells** in lymphoid tissue. *Rabies infection* - Rabies is a viral encephalitis primarily affecting the nervous system. - The characteristic histological finding in rabies is the presence of **Negri bodies** (eosinophilic inclusions) in the cytoplasm of neurons, not Warthin-Finkeldey cells in lymphoid tissue. *Typhoid infection* - Typhoid fever is a **bacterial infection** caused by *Salmonella Typhi*. - Histological features include **macrophage hyperplasia** and **typhoid nodules** in lymphoid tissues (like Peyer's patches), but not Warthin-Finkeldey cells. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 362-363.

Q: Parasitosis of extraocular eye muscles is seen in?

Trichinella infection. ***Trichinella infection*** - **Trichinellosis** (caused by *Trichinella spiralis*) commonly involves the **extraocular muscles** during the muscle encystment phase [1]. - Ocular symptoms like **periorbital edema**, eosinophilic myositis of extraocular muscles, and subconjunctival hemorrhage are characteristic [1]. *Cysticercus infection* - **Cysticercosis**, caused by *Taenia solium* larvae, can affect the eye, predominantly forming **subretinal** or **vitreous cysts** [2]. - While it can involve orbital muscles, involvement of extraocular muscles is less typical and less specific than in trichinellosis [2]. *Amoebic infection* - **Amoebic infections** primarily cause **keratitis** (e.g., *Acanthamoeba*) [3] or can lead to granulomatous encephalitis in immunocompromised individuals. - They do not typically cause direct parasitosis of the extraocular muscles. *Ascariasis infection* - **Ascariasis**, caused by *Ascaris lumbricoides*, is an intestinal nematode and is not known to infect the extraocular muscles. - Ocular manifestations are rare and usually involve migration of adult worms to the orbit or eyelid, not muscle encystment. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 404-405. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 403-404. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 735-736.

Q: Hyaline degeneration is found in -

Alcoholic liver disease. ***Alcoholic liver disease*** - **Mallory bodies**, a form of hyaline degeneration, are characteristic histologic findings in hepatocytes in alcoholic liver disease. - They represent aggregates of **intermediate filaments** and other proteins, indicating severe hepatocellular damage. *Acute myocardial infarction* - Characterized by **coagulative necrosis** of cardiac myocytes due to ischemia, not hyaline degeneration. - Inflammation and subsequent repair with **fibrosis** are key features. *Alzheimer's disease* - Defined by the presence of **senile plaques** (amyloid-beta deposits) and **neurofibrillary tangles** (hyperphosphorylated tau protein). - These are specific protein aggregates, distinct from hyaline degeneration of cellular components. *Acute appendicitis* - Involves acute inflammation of the appendix, leading to **neutrophilic infiltration** and often **fibrinopurulent exudate**. - There is no characteristic hyaline degeneration associated with this inflammatory process.

Q: What does Ghon's focus indicate in the context of tuberculosis?

Primary complex. ***Primary complex*** - A **Ghon's focus** is the initial parenchymal lesion (typically subpleural) that develops during primary tuberculosis infection [1]. - The Ghon's focus, together with an enlarged regional lymph node (usually hilar or mediastinal), forms the **Ghon's complex** or **Primary complex** [2]. - When this complex undergoes calcification and healing, it is called a **Ranke complex**, which indicates past healed primary TB. *Post primary tuberculosis* - Also known as **reactivation tuberculosis** or **secondary tuberculosis**, this typically occurs years after the primary infection, usually in the apices of the lungs [2]. - It represents reactivation of dormant bacilli, not the initial primary infection lesion. - Characterized by cavitary lesions and often more severe pulmonary symptoms. *Miliary tuberculosis* - This is a form of progressive, widespread tuberculosis characterized by the presence of **tiny, millet-seed sized lesions** disseminated throughout the body via hematogenous spread [3]. - It indicates a severe and life-threatening form of TB resulting from massive lymphohematogenous dissemination. - Not related to the localized primary complex. *Tuberculous lymphadenitis* - This refers to **tuberculous infection of lymph nodes**, most commonly in the cervical region (scrofula). - While lymph node involvement is part of the primary complex, Ghon's focus specifically refers to the **parenchymal lung lesion**, not the lymph node component alone [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 379-380. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 319-320. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 320-321.

Q: Trophozoites in stool are characteristically seen in which of the following conditions?

**Note:** This question has significant issues. Trophozoites in stool are characteristically seen in **protozoal infections** such as *Entamoeba histolytica* (amoebiasis), *Giardia lamblia*, or *Balantidium coli* [1][2] - none of which are listed as options. ***None of the given options is medically accurate*** for characteristic trophozoites in stool. However, if forced to choose from these options: *Ascariasis* - **Ascariasis** is caused by the nematode *Ascaris lumbricoides* - Diagnosis is by identifying **ova (eggs)** in stool, not trophozoites - Trophozoites are protozoal forms, not associated with helminthic infections [2] *Strongyloidiasis* - Caused by *Strongyloides stercoralis* (nematode) - Typically diagnosed by finding **rhabditiform or filariform larvae** in stool - Not characterized by trophozoites in routine stool examination *Eosinophilic gastroenteritis* - Inflammatory condition with **eosinophilic infiltration** of GI tract - Not a parasitic infection - No trophozoites present - diagnosis is by endoscopic biopsy showing eosinophils *Allergic colitis* - Inflammatory condition related to **food allergies** (common in infants) - Presents with blood and mucus in stool with eosinophilia - Not an infectious process - no trophozoites present **Clinical Pearl:** Trophozoites (motile feeding stage of protozoa) in stool are diagnostic of **acute intestinal protozoal infections** like amoebiasis or giardiasis, where they must be identified in fresh, warm stool samples as they rapidly deteriorate [1][2]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 364-365. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 801-802.

Q: Bollinger bodies are seen in ?

Fowlpox. **IMPORTANT NOTE:** In **human pathology**, the term "Bollinger bodies" classically refers to **sulfur granules** seen in **actinomycosis** (Actinomyces infection), which appear as basophilic masses with radiating eosinophilic clubs. However, this question uses the **veterinary pathology** definition, where Bollinger bodies refer to viral inclusions in avian diseases. ***Fowlpox*** - In **veterinary pathology**, **Bollinger bodies** are characteristic large, eosinophilic **intracytoplasmic inclusion bodies** found in cells infected with the **fowlpox virus** (avipoxvirus). - These inclusions are visible under light microscopy and are a diagnostic feature of **fowlpox**, a widespread avian disease. - Note: Fowlpox is **not a human disease** but affects birds. *Chickenpox* - Chickenpox, caused by the **varicella-zoster virus (VZV)**, is characterized by **intranuclear inclusion bodies** (Cowdry type A) [1]. - It does not form **Bollinger bodies**. *Cowpox* - Cowpox is caused by the **cowpox virus**, an **orthopoxvirus**, and produces **A-type cytoplasmic inclusion bodies** (A-type inclusions). - While these are cytoplasmic inclusions, they are not referred to as **Bollinger bodies**. *Smallpox* - Smallpox, caused by the **variola virus** (orthopoxvirus), is associated with **Guarnieri bodies**, which are **cytoplasmic inclusion bodies**. - These inclusions are distinct from **Bollinger bodies**. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 366-367.

Q: The histological feature known as 'Mickey Mouse Ears' is characteristically seen in:

Paracoccidioidomycosis. ***Paracoccidioidomycosis*** - This characteristic appearance, often described as a **"ship's wheel"** or **"Mickey Mouse ears"**, refers to the multiple budding yeast cells seen in **Paracoccidioides brasiliensis** on histological examination. - The central mother cell has several smaller daughter buds emerging from its periphery, resembling the iconic Mickey Mouse ears. *Candidiasis* - **Candida** infections typically manifest as **pseudohyphae** and **budding yeast** cells, but they do not form the multi-budding, "Mickey Mouse ears" configuration [1]. - The budding of Candida is usually singular or in short chains, distinct from the broad-based multi-budding of Paracoccidioides [1]. *Tuberculosis* - **Tuberculosis** is caused by **Mycobacterium tuberculosis**, a bacterium, and is characterized histologically by **granulomas** with caseous necrosis. - It does not involve yeast forms or the "Mickey Mouse ears" morphology. *Leptospirosis* - **Leptospirosis** is a **bacterial infection** caused by **Leptospira interrogans**, a spirochete, which is seen as spiral-shaped bacteria under microscopy. - This disease affects various organs and is not associated with fungal yeast forms or the "Mickey Mouse ears" appearance. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, pp. 736-737.

Question 1

In tuberculosis the cytokine causing fever is

Accepted Answer

IL-1

Answer

IL-2

Answer

IL-3

Answer

IL-4

Question 2

Stellate granulomas are seen in

Accepted Answer

Cat scratch disease

Answer

Sarcoidosis

Answer

Cryptococcosis

Answer

Histoplasmosis

Question 3

Warthin-Finkeldey cells are seen in

Accepted Answer

Measles infection

Answer

Rubella infection

Answer

Rabies infection

Answer

Typhoid infection

Question 4

Parasitosis of extraocular eye muscles is seen in?

Accepted Answer

Trichinella infection

Answer

Cysticercus infection

Answer

Amoebic infection

Answer

Ascariasis infection

Question 5

Hyaline degeneration is found in -

Accepted Answer

Alcoholic liver disease

Answer

Alzheimer's disease

Answer

Acute myocardial infarction

Answer

Acute appendicitis

Question 6

What does Ghon's focus indicate in the context of tuberculosis?

Accepted Answer

Primary complex

Answer

Post primary tuberculosis

Answer

Miliary tuberculosis

Answer

Tuberculous lymphadenitis

Question 7

Trophozoites in stool are characteristically seen in which of the following conditions?

Answer

Ascariasis

Answer

Strongyloidiasis

Answer

Allergic colitis

Answer

Eosinophilic gastroenteritis

Question 8

Bollinger bodies are seen in ?

Accepted Answer

Fowlpox

Answer

Chickenpox

Answer

Cowpox

Answer

Smallpox

Question 9

The histological feature known as 'Mickey Mouse Ears' is characteristically seen in:

Accepted Answer

Paracoccidioidomycosis

Answer

Tuberculosis

Answer

Candidiasis

Answer

Leptospirosis

Question 10

In which condition is caseating necrosis most characteristically observed?

Accepted Answer

Tuberculosis

Answer

Leprosy

Answer

Infarct

Answer

Sarcoidosis

Infectious Diseases — MCQs

Infectious Diseases — MCQs

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