Infectious Diseases Practice Questions

Q: Ghon's focus with hilar lymphadenopathy is known as -

Tuberculoid Leprosy (TL). ***Tuberculoid Leprosy (TL)*** - This question describes a finding related to **tuberculosis**, not leprosy. **Ghon's focus** and **hilar lymphadenopathy** are classic signs of primary tuberculosis infection [1]. - While this option is incorrect in the context of the question's premise (it discusses tuberculosis, not leprosy), among the leprosy types provided, none directly relate to the described imaging findings [2]. Assuming a misinterpretation and seeking the correct leprosy definition. *Borderline Tuberculoid Leprosy* - This form of leprosy lies between tuberculoid and borderline lepromatous leprosy, characterized by a few **skin lesions** and moderate nerve involvement [2]. - It does not involve **Ghon's focus** or **hilar lymphadenopathy**, which are features of tuberculosis [1]. *Lepromatous Leprosy (LL)* - This is a severe, multi-bacillary form of leprosy with diffuse infiltration of skin, multiple **nodules**, and widespread **nerve damage** [2]. - It has no association with **Ghon's focus** or **hilar lymphadenopathy**. *Indeterminate Leprosy* - This is the earliest form of leprosy, characterized by a single patch or a few poorly defined **skin lesions**, with minimal or no nerve involvement [2]. - It does not present with **Ghon's focus** or **hilar lymphadenopathy**.

Q: Systemic miliary TB occurs when the spread of Mycobacterium tuberculosis happens via which route?

Hematogenous. ***Hematogenous*** - **Miliary TB** is characterized by the widespread dissemination of *Mycobacterium tuberculosis* to multiple organs via the **bloodstream (hematogenous route)**. - Hematogenous spread allows bacilli to be carried throughout the systemic circulation, leading to the formation of small, millet-seed-sized lesions in various tissues including lungs, liver, spleen, bone marrow, and other organs. - This typically occurs when bacilli from a primary focus erode into a blood vessel and gain access to the circulation. *Direct dissemination* - This route involves the local spread of infection from one tissue or organ directly to an adjacent one, without entering the bloodstream. - It does not account for the widespread, systemic involvement seen in miliary TB. *Lymphatic* - **Lymphatic spread** typically leads to involvement of regional lymph nodes and can contribute to dissemination, but it is not the primary route for the widespread, systemic involvement characteristic of miliary TB. - While bacilli can reach the bloodstream via the thoracic duct, the key mechanism for systemic miliary spread is direct hematogenous dissemination. *Aerial* - **Aerial spread** primarily refers to the transmission of *Mycobacterium tuberculosis* from person to person via airborne droplets, or the initial infection of the lungs. - It is the route of initial infection for pulmonary TB, not the mechanism for systemic dissemination within an infected individual leading to miliary disease.

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: Thymus gland abscess seen in congenital syphilis is called:

Dubois' abscess. ***Dubois' abscess*** - **Dubois' abscesses** are characteristic microscopic foci of necrosis and granulomatous inflammation that occur in the **thymus gland** in cases of **congenital syphilis**. - They are a specific pathological finding associated with **early congenital syphilis**, reflecting the systemic dissemination of *Treponema pallidum*. *Politzer's abscess* - **Politzer's abscess** is a term mainly associated with an abscess in the external or middle ear, often following **otitis media**. - It has no known association with **congenital syphilis** or the **thymus gland**. *Douglas abscess* - A **Douglas abscess** refers to a collection of pus in the **rectouterine pouch** (pouch of Douglas) in females, or the rectovesical pouch in males. - This is typically a complication of **pelvic inflammatory disease** or appendicitis and is unrelated to the thymus or syphilis. *Fouchier's abscess* - **Fouchier's abscess** is an older term sometimes used to describe an **epidural abscess**, particularly in the spine. - This condition involves an infection within the spinal canal and is not linked to the thymus or congenital syphilis.

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: 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.

Q: A patient from Himachal Pradesh gets a thorn prick and subsequently presents with a verrucous lesion on feet which on microscopy revealed "Copper penny bodies". The diagnosis is

Chromoblastomycosis. ***Chromoblastomycosis*** - The presence of **"copper penny bodies" (sclerotic bodies or Medlar bodies)** on microscopy is pathognomonic for chromoblastomycosis. - This chronic fungal infection typically presents as **verrucous lesions** on the skin, often in exposed areas like the feet, following **traumatic inoculation**, such as a thorn prick. *Eumycetoma* - Characterized by the formation of **grains or granules** composed of fungal hyphae within subcutaneous tissue, usually with **multiple draining sinuses**. - While it can be caused by a thorn prick and affect the feet, it does not typically show "copper penny bodies" on microscopy. *Sporothrix* - Causes **sporotrichosis**, which often presents as **lymphocutaneous nodules** that ulcerate and follow lymphatic drainage, or fixed cutaneous lesions. - Microscopic examination typically reveals **cigar-shaped budding yeasts** in tissue, not copper penny bodies. *Verruca vulgaris* - This is a common **viral wart** caused by the **Human Papillomavirus (HPV)**, presenting as a raised, rough, cauliflower-like papule [1]. - Histologically, it shows **koilocytes** (HPV-infected keratinocytes), but no fungal elements like "copper penny bodies." [1] **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Skin, p. 1178.

Q: Rickettsial infections cause 30% mortality due to?

Endothelial injury. ***Endothelial injury*** - **Rickettsiae** are obligate intracellular bacteria that primarily target and replicate within **endothelial cells**, leading to widespread **endothelial injury** [1]. - This damage results in increased **vascular permeability**, **edema**, and subsequent organ dysfunction, contributing to the high mortality rate in severe cases [1]. *Renal failure* - While **renal failure** can be a complication of severe rickettsial infections due to **hypoperfusion** and direct injury, it is a *consequence* of the initial widespread endothelial damage, not the primary cause of high mortality [1]. - The systemic nature of the endothelial damage affects multiple organs, including the kidneys, leading to multifactorial organ dysfunction rather than isolated renal pathology as the main driver of death [1]. *Hemodynamic instability* - **Hemodynamic instability**, characterized by **hypotension** and **shock**, is a critical manifestation of severe rickettsial infection [1]. However, this instability is a *result* of the widespread **fluid extravasation** and **vasodilation** caused by extensive **endothelial injury**. - The direct damage to the endothelium precedes and drives the hemodynamic changes that contribute to patient demise [1]. *Endocarditis* - **Endocarditis** (inflammation of the heart's inner lining) is an infrequent complication of rickettsial infections and is not considered a primary contributor to the high 30% mortality observed. - The main pathology in rickettsial diseases involves systemic **vasculitis** and microvascular damage rather than focal inflammation of the heart valves, differentiating it from common causes of high mortality. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 392-393.

Question 1

Ghon's focus with hilar lymphadenopathy is known as -

Accepted Answer

Tuberculoid Leprosy (TL)

Answer

Borderline Tuberculoid Leprosy

Answer

Lepromatous Leprosy (LL)

Answer

Indeterminate Leprosy

Question 2

Systemic miliary TB occurs when the spread of Mycobacterium tuberculosis happens via which route?

Accepted Answer

Hematogenous

Answer

Direct dissemination

Answer

Lymphatic

Answer

Aerial

Question 3

Warthin-Finkeldey giant cells are seen in?

Accepted Answer

Measles

Answer

Rubella

Answer

Rickettsial pox

Answer

Influenza

Question 4

Thymus gland abscess seen in congenital syphilis is called:

Accepted Answer

Dubois' abscess

Answer

Politzer's abscess

Answer

Douglas abscess

Answer

Fouchier's abscess

Question 5

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 6

Lipschutz bodies are seen in ?

Accepted Answer

Herpes

Answer

Yellow fever

Answer

Hodgkin's disease

Answer

Viral hepatitis

Question 7

Giant cells in measles are called as:

Accepted Answer

Warthin-Finkeldey cells

Answer

Weinberger bodies

Answer

HP bodies

Answer

Koplik spots

Question 8

Virchow Lepra cells are seen in:

Accepted Answer

Lepromatous Leprosy

Answer

Tuberculoid leprosy

Answer

Indeterminate leprosy

Answer

Borderline tuberculoid leprosy

Question 9

A patient from Himachal Pradesh gets a thorn prick and subsequently presents with a verrucous lesion on feet which on microscopy revealed "Copper penny bodies". The diagnosis is

Accepted Answer

Chromoblastomycosis

Answer

Sporothrix

Answer

Verruca vulgaris

Answer

Eumycetoma

Question 10

Rickettsial infections cause 30% mortality due to?

Accepted Answer

Endothelial injury

Answer

Renal failure

Answer

Hemodynamic instability

Answer

Endocarditis

Infectious Diseases — MCQs

Infectious Diseases — MCQs

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