Serious & Notifiable Infections Practice Questions

Question 1

A 58-year-old woman with diabetes presents with severe foot pain and a deep ulcer exposing bone. X-ray shows osteolytic changes. What is the most likely complication?

Accepted Answer

Osteomyelitis

Answer

Cellulitis

Answer

Charcot arthropathy

Answer

Peripheral arterial disease

Answer

Deep vein thrombosis

Question 2

A 22-year-old student presents with fever, headache, and a petechial rash on her legs. CSF shows: protein 2.1 g/L, glucose 1.8 mmol/L (serum 5.2), WCC 850 (90% neutrophils). What is the most likely organism?

Accepted Answer

Neisseria meningitidis

Answer

Streptococcus pneumoniae

Answer

Haemophilus influenzae

Answer

Listeria monocytogenes

Answer

Enterovirus

Question 3

A 35-year-old man with HIV infection (CD4 count 80 cells/mm³, viral load 125,000 copies/mL, not on antiretroviral therapy) presents with a 4-week history of headache, fever, and confusion. CT head shows basal meningeal enhancement and multiple small nodules. Lumbar puncture shows: opening pressure 32 cmH2O, CSF white cells 45/mm³ (80% lymphocytes), protein 1.2 g/L, glucose 1.9 mmol/L (serum glucose 5.4 mmol/L). India ink stain is positive. Cryptococcal antigen is positive in both CSF and serum at titres of 1:2048 and 1:1024 respectively. He is started on liposomal amphotericin B and flucytosine. Which one of the following additional interventions has been shown to improve survival in this patient?

Accepted Answer

Performing daily therapeutic lumbar punctures until opening pressure normalizes

Answer

Commencing antiretroviral therapy immediately alongside antifungal treatment

Answer

Adding adjunctive dexamethasone 0.4 mg/kg daily for 6 weeks

Answer

Adding adjunctive interferon-gamma to enhance immune response

Answer

Inserting a ventriculoperitoneal shunt to manage hydrocephalus

Question 4

A 25-year-old woman presents with a 2-week history of sore throat, fever, and fatigue. She has cervical lymphadenopathy and splenomegaly. Her throat swab is negative for Group A Streptococcus. What is the most likely diagnosis?

Accepted Answer

Infectious mononucleosis

Answer

Viral pharyngitis

Answer

Bacterial pharyngitis

Answer

Diphtheria

Answer

Candidiasis

Question 5

A 62-year-old man with diabetes presents with a foot ulcer and fever. X-ray shows bone destruction. Blood cultures grow Staphylococcus aureus. What is the recommended antibiotic duration?

Accepted Answer

8-12 weeks

Answer

2 weeks

Answer

4 weeks

Answer

6 weeks

Answer

6 months

Question 6

A 37-year-old man presents with acute onset severe headache, fever, and neck stiffness. Lumbar puncture shows lymphocytic pleocytosis with normal glucose. HSV PCR is positive. What is the most appropriate treatment?

Accepted Answer

IV aciclovir

Answer

IV ceftriaxone

Answer

IV ampicillin

Answer

Supportive care only

Answer

IV immunoglobulin

Question 7

A 65-year-old man with diabetes presents with a non-healing foot ulcer for 3 months. X-ray shows osteolytic changes in the underlying bone. MRI confirms osteomyelitis. What is the most appropriate treatment duration for antibiotics?

Accepted Answer

12 weeks total therapy

Answer

2 weeks IV

Answer

4 weeks IV

Answer

6 weeks IV

Answer

4-6 weeks IV followed by 2-6 weeks oral

Question 8

A 19-year-old student presents with fever, headache, and a non-blanching purpuric rash on his legs. Lumbar puncture shows: WCC 2000/μL (95% neutrophils), protein 3.2 g/L, glucose 1.0 mmol/L. Gram stain shows gram-negative diplococci. What is the most appropriate treatment?

Accepted Answer

IV ceftriaxone

Answer

IV benzylpenicillin

Answer

IV vancomycin

Answer

IV ampicillin

Answer

Oral ciprofloxacin

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