Infectious Diseases

Infectious Diseases Indian Medical PG Question 1: The web-based IT system for case-based surveillance under National Tuberculosis Elimination Programme (NTEP, formerly RNTCP) is

• A. NIKSHAY (Correct Answer)
• B. E-TB Tracker
• C. SURAKSHA
• D. SAFETY-NET

Infectious Diseases Explanation: ***NIKSHAY*** - **NIKSHAY** is the official web-based IT system used by the National Tuberculosis Elimination Programme (NTEP, formerly RNTCP) in India for **case-based surveillance** and monitoring of TB cases. - Launched in 2012, it facilitates **real-time data entry**, tracking of patient outcomes, drug logistics management, and program monitoring, significantly improving the efficiency of TB control efforts. - It enables **notification of all TB cases**, both from public and private sectors, ensuring comprehensive surveillance. *E-TB Tracker* - **E-TB Tracker** is not the designated IT system for TB surveillance under NTEP in India. - This term may refer to other electronic tracking systems used in different contexts, but NIKSHAY remains the official platform for India's TB programme. *SURAKSHA* - **SURAKSHA** means safety or protection in Hindi and is not associated with any specific web-based IT system for TB surveillance under NTEP. - This is not a recognized TB surveillance platform in the Indian context. *SAFETY-NET* - **SAFETY-NET** is a generic term referring to social protection programs or health support systems. - There is no specific NTEP initiative for TB surveillance identified by this name.

Infectious Diseases Indian Medical PG Question 2: A 15-year-old boy presented with fever and chills for 3 days. On examination, he was found to have delayed skin pinch time and dry oral mucosa. Identify the pathogen involved based on the provided peripheral blood smear image.

• A. Babesia
• B. Plasmodium vivax (Correct Answer)
• C. Plasmodium falciparum
• D. Salmonella typhi

Infectious Diseases Explanation: ***Plasmodium vivax*** - The image shows **enlarged red blood cells** infected with various stages of *Plasmodium vivax*, including trophozoites and schizonts displaying **ameboid forms**. - The presence of **Schüffner's dots**, though not distinctly visible in this specific resolution, is characteristic of *P. vivax* infection. - *P. vivax* preferentially infects **reticulocytes** and young red blood cells, leading to the characteristic RBC enlargement. *Babesia* - *Babesia* infection typically presents with **ring forms** in red blood cells that lack pigment and often form **tetrads** (Maltese cross appearance), which are not seen here. - While it can cause fever and chills, the morphology of the parasites in the image is inconsistent with *Babesia*. *Plasmodium falciparum* - *P. falciparum* characteristically presents with **multiple small ring forms** in a single red blood cell and **crescent-shaped gametocytes**. - It infects red blood cells of all ages, does not typically enlarge the red blood cells, and early trophozoites (*ring forms*) are the most common stage seen in peripheral blood, which differs from the image. *Salmonella typhi* - *Salmonella typhi* is a bacterium that causes **typhoid fever** and is a systemic infection. - It does not infect red blood cells or present with intraerythrocytic parasites on a peripheral blood smear; diagnosis is typically made by **blood culture**.

Infectious Diseases Indian Medical PG Question 3: A man with chills, fever, and headache is thought to have "atypical" pneumonia. History reveals that he raises chickens, and that approximately 2 weeks ago he lost a large number of them to an undiagnosed disease. Which of the following is the most likely diagnosis of this man's condition?

• A. Leptospirosis
• B. Relapsing fever
• C. Anthrax
• D. Ornithosis (Correct Answer)

Infectious Diseases Explanation: ***Ornithosis*** - The patient's symptoms of **chills, fever, headache, and atypical pneumonia**, combined with a history of **raising chickens** that recently died from an undiagnosed disease, are highly suggestive of ornithosis (also known as **psittacosis** or **parrot fever**). [2], [3] - This zoonotic infection is caused by **Chlamydophila psittaci** and is transmitted to humans through inhalation of contaminated aerosols from infected birds (poultry, parrots, pigeons). [2] *Leptospirosis* - **Leptospirosis** is typically associated with exposure to **contaminated water or soil** with animal urine, not direct contact with sick poultry. - While it can cause fever and headache, it often presents with **jaundice, renal failure, and hemorrhagic manifestations**, which are not mentioned here. *Relapsing fever* - **Relapsing fever** is characterized by **recurrent episodes of fever** separated by afebrile periods, caused by **Borrelia** species transmitted by lice or ticks. - The clinical presentation does not align with the typical course or epidemiological link to sick chickens. *Anthrax* - **Inhalational anthrax** can cause severe respiratory symptoms and fever but is primarily associated with exposure to **Bacillus anthracis spores**, often from infected livestock (cattle, sheep) or bioweapon exposure. [1] - The rapid death of a large number of chickens and the patient's "atypical pneumonia" do not fit the typical presentation or common transmission routes of anthrax. [1]

Infectious Diseases Indian Medical PG Question 4: Match List-I with List-II and select the correct answer using the code given below the Lists:

• A. A→4 B→3 C→2 D→1 (Correct Answer)
• B. A→1 B→3 C→2 D→4
• C. A→1 B→2 C→3 D→4
• D. A→4 B→2 C→3 D→1

Infectious Diseases Explanation: ***A→4 B→3 C→2 D→1*** - A **symposium** (A) is characterized by a "discussion among the speakers" (4), where experts present different aspects of a topic, followed by interaction. - A **panel discussion** (B) involves a "series of speeches on a selected subject" (3) by panel members in front of an audience, often with interaction moderated by a chairperson. - A **workshop** (C) typically focuses on "arriving at a plan of action to solve the problem" (2) through practical, hands-on activities and collaborative problem-solving. - **Role-play** (D) is a technique where a "situation is dramatized" (1) by participants acting out roles to understand different perspectives or practice new skills. *A→1 B→3 C→2 D→4* - This option incorrectly matches "Symposium" with "Situation is dramatized" and "Role-play" with "Discussion among the speakers". - Role-play is about dramatizing a situation, while a symposium involves discussion among speakers. *A→1 B→2 C→3 D→4* - This option misaligns multiple matches, particularly with "Symposium" (A) and "Workshop" (C). - A workshop is about action plans, and a symposium is about discussions among speakers, not the other way around. *A→4 B→2 C→3 D→1* - This option incorrectly matches "Panel discussion" with "Arriving at a plan of action to solve the problem" and "Workshop" with "Series of speeches on a selected subject". - Workshops focus on action plans, and panel discussions involve a series of speeches.

Infectious Diseases Indian Medical PG Question 5: A patient with advanced HIV presents with cryptococcal meningitis. Which CSF finding is most characteristic?

• A. High opening pressure (Correct Answer)
• B. High protein
• C. Low glucose
• D. Neutrophilic pleocytosis

Infectious Diseases Explanation: ***High opening pressure*** - **Elevated intracranial pressure** is a hallmark of cryptococcal meningitis, often due to the **fungal burden** and associated inflammatory response, leading to impaired CSF outflow [1]. - This symptom is crucial for both diagnosis and management, as persistently high pressure can cause **neurological damage** and vision loss. *High protein* - While CSF protein can be mildly elevated in cryptococcal meningitis, it is **not the most characteristic finding** compared to the dramatic increase seen in bacterial meningitis [1]. - Protein levels typically increase with inflammation and breakdown of the **blood-brain barrier**, but less significantly than other findings in cryptococcal infection. *Low glucose* - **Low CSF glucose** (hypoglycorrhachia) is more typical of **bacterial meningitis** due to bacterial consumption of glucose. - In cryptococcal meningitis, glucose levels can be normal or mildly decreased, but **not as consistently low** as in bacterial infections. *Neutrophilic pleocytosis* - **Neutrophilic pleocytosis** (predominance of neutrophils) is a classic finding in **acute bacterial meningitis** [1]. - Cryptococcal meningitis typically presents with a **lymphocytic or mixed pleocytosis**, not neutrophilic, reflecting a more chronic or fungal inflammatory response.

Infectious Diseases Flashcard 1 of 5

Question: According to Ridley's logarithmic scale for bacterial index, _____ rating is >1000 bacilli, on average, in each oil-immersion field

Answer: 6+

Infectious Diseases Flashcard 2 of 5

Question: Dissemination of _____ from the lungs is most likely to occur in the skin and bones

Answer: Blastomycosis

Infectious Diseases Flashcard 3 of 5

Question: According to Ridley's logarithmic scale for bacterial index, _____ rating is 100-1000 bacilli, on average, in each oil-immersion field

Answer: 5+

Infectious Diseases Flashcard 4 of 5

Question: In certain infections like _____ bacteria the cellular infiltrate is dominated by continuously recruited neutrophils for several days

Answer: Pseudomonas

Infectious Diseases Flashcard 5 of 5

Question: Paths of Progression after Primary Mycobacteria tuberculosis infection: _____ infection aka miliary tuberculosis

Answer: disseminated/systemic