BOF 6

Discussion in 'MRCP Forum' started by Guest, Dec 5, 2005.

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  1. Guest

    Guest Guest

    INFECTIOUS DISEASE

    1. which one of the following infection is transmitted by the route stated below?
    A. Meningococcal inf- feacal-oral spread
    B. Legionellosis- faecal-oral spread
    C. Giardiasis- faecal-oral spread
    D. Listeosis- airborne
    E. Gonococcal inf- transplacental

    2. Which one of these diagnostic techniques is clinically useful in the following infections?
    A. Gastric aspirate microscopy- Entamoeba histolytica
    B. Stool culture- pneumocystis carinii
    C. Bone marrow culture- streptococcus pneumoniae
    D. Rising titre of IgM antibodies- histoplasma capsulatum

    3. Which one of the following is contraindication to active immunization?
    A. Atopic disposition
    B. HIV inf if live vaccines are required
    C. Pregnancy if killed vaccines are required
    D. Chronic cardiac or respi failure
    E. F/o of allergy to vaccine

    4. In which one of the following infections is a live virus usually used for active immunization?
    A. Polio
    B. Pertussis
    C. Typhoid fever
    D. Hepatitis A
    E. Hepatitis B

    5. In which one of the following disorders is there an indication for passive immunization with human immunoglobulins?
    A. Hepatitis C
    B. Tetanus
    C. Influenza A
    D. Meningococcaemia
    E. Typhoid fever

    6. A 23 yr old student consults her GP with a history of painless diarrhoea lasting 5 days following her return from a holiday in north Africa. Which one of the following statements is true?
    A. Causative organism is unlikely to be identified from a stool culture
    B. Antibiotic t/t should be instituted after stool culture has been undertaken
    C. Antidiarrhoeal agents are particularly useful in children
    D. Ciprofloxacin therapy is of proven prophylactic benefit
    E. Doxycycline prophylaxis is advisable to all travelers to sub Saharan Africa.

    7. Which one of the following statements about HIV infections is true?
    A. An RNA retrovirus
    B. Transmission via drug abusers occur more often than by sexual transmission in UK
    C. There is no involvement of B lymphocytes
    D. The virus affects suppressor T lymphocytes more than helper T lymphocytes
    E. The presence of Kaposi’s sarcoma indicates a better prognosis

    8. Which one of the following statements about HIV infection is true?
    A. 80% of vertically transmitted infections are transplacental
    B. A child born to an infected mother has a 90% chance of acquiring HIV
    C. Transmission can occur via breast milk
    D. Risk of fetal transmission is unaffected by prepartum antiviral agents
    E. Vertical transmission is the major mode of transmission worldwide

    9. Following unprotected sex 3 weeks ago, a 19 yr old girl consults her GP for an HIV test. Which one of the following statements is true?

    A. ELISA testing has a high false negative rate
    B. Seroconversion typically occurs in under 3 weeks
    C. A full blood count should be undertaken to check the lymhocyte count
    D. The virus can be readily cultured from saliva
    E. Serial testing is necessary to confirm the infection in some individuals

    10. In a patient with AIDS, cryptococcal meningitis is
    A. Less likely to be the cause of meningitis than meningococcal infection
    B. Characterized by abrupt onset of classical features of a bacterial meningitis
    C. Diagnosed by Indian ink stain of CSF
    D. Typically associated with an abnormal cerebral CT scan
    E. Typically associated with a high CSF polymorph count

    11. pneumocystis carinii infection in an HIV positive patient is
    A. The commonest cause of respi inf in African patients
    B. Characterized by copious sputum production
    C. Characterized by widespread fine pul crackles
    D. More likely to occur when the CD4 count is <200/mm3
    E. Excluded by the finding of normal chest xray

    12. A 16 yr old boy consults his GP with a fever and morbiliform rash and a history that is 3 yr old sister has measles. One of the following statements is true?
    A. Measles inf is due to a DNA myxovirus
    B. Rhinorrhoea and conjunctivitis occurs during the recovery phase of the illness
    C. Koplik’s spots appear at the same time as the skin rash
    D. The skin rash typically desquamates as it disappears
    E. The infectivity of measles is confined to the prodromal phase

    13. Which one of the following features is typical of mumps
    A. Infection with DNA myxovirus
    B. High infectivity for 3 weeks after the onset of parotitis
    C. Dev of an acute lymphocytic meningitis
    D. Abdo painis usually attributable to mesenteric adenitis
    E. Orchitis is usually B/L and predominantly occurs prepubertally

    14. Which one of the followinf features is a typical of Rabies?
    A. An enterovirus infection
    B. An incubation period of 4-8 days
    C. A good prognosis if symptoms develop slowly
    D. Encephalitis or ascending paralysis
    E. Active and passive vaccination are useful in prevention and therapy

    15. Which one of the following statements about helicobacter pylori(HP) infection is true?
    A. The diagnosis can be confirmed by decreased urease conc in the gastric mucosa
    B. The presence of oesophagitis indicates the need for HP eradication therapy
    C. HP eradication is enhanced by low gastric pH
    D. Amoxicillin plus metronidazole therapy is more effective than amoxicillin alone
    E. HP eradication reduces recurrence rates of duodenal ulcers but not gastric ulcers

    16. A middle aged woman is referred to a hospital with fever, abdo pain and diarrhoea. Which one of the following statements about Yersinia infection is true?
    A. Transmission of the infection is waterborne
    B. There is an association with exudative pharyngitis and enterocolitis
    C. There is an association with chronic ileitis
    D. Erythema marginatum is a characteristic occurrence
    E. There is likely to be a good clinical response to benzylpenicillin therapy

    17. Which one of the following clinical features is typical of Lassa fever?
    A. Endemic infection in south America
    B. Transmission via mosquito
    C. No useful response to any antiviral agents
    D. Acute liver failure is a recognized complication
    E. An incubation period of 3-6 weeks

    18. Which one of the following features is typical of yellow fever?
    A. A togavirus inf is transmitted by mosquito
    B. An incubation period of 3-6 weeks
    C. Peripheral blood leucocytosis is contrast to viral hepatitis
    D. Fever, headache and severe myalgia with bone pain
    E. Response to ribavirin drug therapy

    19. Which one of the following is characteristic of an influenza virus infection?
    A. Occurs exclusively in humans
    B. Low levels of antigenic shift
    C. Transmissible by oro-feacal route
    D. An incubation period of 5-7 days
    E. Infection complicated by Reye’s syndrome

    20. Which one of the following features is typical of RSV infection?
    A. Infection more common in adults than children
    B. Infection is best diagnosed by serology
    C. Infants are protected from infection due to maternally acquired antibodies
    D. Infection is typically associated with bronchiolitis
    E. Involvement of the lower urinary tract is characteristic

    21. A young man is admitted with right sided abdo pain and jaundice. Which one of the following features is most consistent with a diagnosis of leptospirosis?
    A. Incubation period of 1-2 months
    B. History of leisure pursuits involving inland waterways
    C. Absence of fever or constitutional symptoms
    D. Dev of meningitis suggests infection with Leptospira icterohaemorrhagiae
    E. Gram-positive rods seen on the blood film

    22. Which one of the following statements about syphilis is true?
    A. Infection is usually caused by Treponema pertenue
    B. Untreated, infectivity is restricted to first 2 months
    C. The distinction between early and late syphilis is made at 2 yrs
    D. The incubation period for primary syphilis is typically 6 months
    E. Tertiary syphilis usually develops within the first year after the initial infection

    23. A 60 yr old man consults his GP ,worried he may have contracted syphilis. Which one of the following statements about sec syphilis is true?
    A. Macular rash occurs 6 months after the appearance of a penile rash
    B. Wart like papules on the perineum suggests tertiary syphilis
    C. Generalized lymphadenopathy and oro-genital mucous ulceration
    D. CSF cytology is likely to demonstrate pleocytosis
    E. The presence of soft, early diastolic murmur indicates sec syphilis

    24. In a 28 yr old woman presenting with vaginal discharge, which one of the following features suggests an alternative diagnosis to that of gonorrhoea?
    A. An incubation period of 3-4 weeks
    B. Presence of urethritis
    C. Right hypochondrial pain
    D. A pustular haemorrhagic rash
    E. An acute monoarthritis of the knee joint

    25. Which one of the following statements about bacteraemic shock is true?
    A. Endotoxin initiates disseminated intravascular coagulation
    B. Peripheral vascular resistance remains normal throughout
    C. Acute circulatory failure is usually due to cardiac failure
    D. Leucocytosis and thrombocythaemia indicates a poor prognosis
    E. Antibiotic therapy should await bacteriological results

    26. In a patient presenting with a sore throat, diphtheria rather than streptococcal tonsillitis is suggested by which one of the following findings?

    A. Tender cervical lymphadenopathy
    B. Blood stained nasal discharge
    C. A tonsillar exudates that is easily removed with a spatula
    D. Normal movement of the soft palate
    E. Onset with a high fever and rigors

    27. A farm worker presents with a fever following laceration of his left shin. Which one of the following features most suggests the dev of tetanus?
    A. An incubation period of 2-3 days
    B. Muscular spasms typically starting in the masseters
    C. Convulsions associated with loss of consciousness
    D. Absence of abdominal muscle rigidity
    E. Bacteriological isolation of Clostridium tetani from the wound

    28. Which one of the following statements about the t/t of tetanus is true?
    A. Tetanus toxoid should be given iv as soon as possible
    B. Wound debridement should be undertaken prior to any other therapy
    C. Human anti tetanus immunoglobulin should be given immediately
    D. Diazepam should be avoided because of the hazards of oversedation
    E. Cephalosporin therapy is the antibiotic t/t of choice

    29. Following meal at a lcal restaurant, a 31 yr old woman is admitted with collapse. Which one of the following features most suggests botulism?
    A. Ingestion of infected material 2-4 hours prior to the onset of symptoms
    B. Onset with an acute gastroenteritis associated with postural hypotension
    C. Absence of autonomic nervous system involvement
    D. Bulbar palsy developing slowly over 10-14 days
    E. Dramatic clinical response to parenteral antitoxin

    30. Which one of the following features is typical of anthrax?
    A. Occupational exposure to fish products
    B. An incubation period of 1-3 weeks
    C. Painful lymphadenopathy
    D. Presentation with bronchopneumonia
    E. Multiple antibiotic resistance is common

    31. Which one of the following features is characteristic of leprosy?
    A. An incubation period of 3-6 weeks
    B. Growth of the organism on Lowenstien-jensen medium after 2-3 months
    C. Spread of tuberculoid form on prolonged patient contact
    D. Spontaneous healing of the earliest macule
    E. A cell mediated immune response in the lepromatous form

    32. Which one of the following features is characteristic of lepromatous leprosy?
    A. Absence of infectivity of affected patients
    B. Unlike the tuberculoid form organisms are scanty in number
    C. Blood-borne spread from the dermis throughout the body
    D. Strongly positive lepromin skin test
    E. Anaesthetic hypopigmented skin macules and plaques

    33. Which one of the following statements about life cycle of plasmodium is true?
    A. Sporozoites disappears from blood 3-7 days post infection
    B. Merozoites re-entering RBC undergo sexual but not asexual reproduction
    C. All plasmodium multiply in the liver but not in the RBC
    D. Dormant hypnozoites remain within the liver cells in all species
    E. Fertilization of the gametocytes occurs in the human RBC

    34. Which one of the following statements about the diagnosis and therapy of amoebiasis is true?
    A. The presence of cystic forms of amoeba can be demonstrated in most amoebic liver abscesses
    B. Stool trophozoites are unlikely to be found in the rectal mucous
    C. Liver abscesses are often undetected b liver USG
    D. Metronidazole therapy is effective in both liver and colonic disease
    E. Diloxanide therapy is ineffective in eliminating amoebic cysts in the colon

    35. Which one of the following statements about visceral leishmaniasis is true?
    A. Spread of Leishmania donovani is principally via anophelline mosquito
    B. An incubation period of 1-2 weeks
    C. Rigors with hepatomegaly but no splenomegaly is a typical feature
    D. Diagnosis is best confirmed by microscopy of a peripheral blood film
    E. A good clinical response to pentavalent antimonial therapy is to be expected

    36. Which one of the following feature is typical of cutaneous leishmaniasis?
    A. Nasal and mouth mucosal ulcers
    B. Painful ulcers in the groin and axillae
    C. Marked splenomegaly and lymphadenopathy
    D. Ulcers which heal without scarring
    E. Negative leishmanin skin test

    37. Which one of the following feature is typical of schistosoma haematobium infection?
    A. Disease is confined to the urinary tract
    B. Presentation with painless haematuria
    C. Spontaneous resolution within a year of leaving endemic area
    D. Absence of involvement of the uterine cervix and seminal vesicles
    E. An endemic disease in china and the far east

    38. Which one of the following statements about coxsackie B virus infection is true?
    A. The virus is an RNA arbor virus
    B. It causes hand, foot and mouth disease
    C. It is typical cause of pancreatitis
    D. It is likely to cause aseptic meningitis
    E. It is likely cause of herpangina

    39. A 35 yr old man returns from holiday in Egypt with a fever, headache and severe limb pain. Which one of the following features is most suggests dengue fever?
    A. History of rat bite 2 weeks previously
    B. Marked peripheral blood leucocytosis
    C. Cervical lymphadenopathy
    D. Erythema nodosum
    E. Yellow fever vaccination prior to travelling

    40. Which one of the following infection is attributable to chlamydial organisms?
    A. Psittacosis
    B. Epidemic typhus
    C. Yellow fever
    D. Yaws
    E. Q fever

    41. Which one of the following statements about trachoma is true?
    A. Blepharospasm is a common presenting feature
    B. It is often complicated by acute glaucoma producing blindness
    C. Acute ophthalmia neonatorum is a recognized presentation
    D. T/t with penicillin eye drops is likely to be effective
    E. Blindness is usually due to the formation of cataract

    42. A 50 yr old housewife presents with a febrile illness characterized by a cough. Which one of the following features is most consistent with the diagnosis of psittacosis?
    A. An incubation period of 4 weeks
    B. An acute small joint polyarthritis
    C. Pul infiltrates on chest xray not apparent on clinical examination
    D. The family pet snake was recently unwell and required antibiotic therapy
    E. Prompt resolution with sulphonamide therapy

    ANSWERS

    1. C –as in campylobacter infection
    2. E, (A)-rectal biopsy and stool microscopy in amoebic dysentery, (B)-lung biopsy and sputum microscopy, (C) –useful eg brucellosis , TB, (D)- useful in brucella and other infections
    3. B-also contraindicated in other immunosuppressed states
    4. A
    5. B-for susceptible injured persons
    6. D, (A)-common causes include E.coli, (B)- most resolves spontaneously, (C)-avoid, may cause toxic dilation of the bowels, (E)-reserved for susceptible persons
    7. A, (B)- promiscuity and male homosexuality are more common in UK, (C)- greater effects on T lymphocytes , (D) –CD4 helper T cells are principally involved
    8. C-10-20% additional risk for breastfed babies
    9. E- because of delay in seroconversion in some patients
    10. C- and serum/CSF culture
    11. D- in 95% cases
    12. D, (A)- single stranded RNA paramyxovirus, (B)- at the onset the catarrhal phase, (E)- avoid contact for 7 days after the onset of the rash
    13. C
    14. D
    15. D- eradication rates are increased from 65% to 90% by therapy by these 2 antibiotics
    16. B
    17. D-in severe cases
    18. D
    19. E-occurs in children given aspirin therapy
    20. D- also pneumonia
    21. B- also abattoirs and farms
    22. C
    23. C-‘snail tract’ ulcers
    24. A- usually 2-10 days
    25. A
    26. B-suggests anterior nasal infection and myocarditis
    27. B- causing trismus
    28. C
    29. B
    30. D-also gastroenteritis and meningitis
    31. D
    32. C-no cell mediated immune response
    33. A- sporozoites enter the liver within 30 min of inoculation
    34. D- or tinidazole together with diloxanide therapy
    35. E-pentamidine is an effective alternative
    36. A-secondary to intial cutaneous ulceration
    37. B- due to early egg deposition in the bladder mucosa
    38. D- together with echoviruses causes 90% of cases of aseptic meningitis
    39. C
    40. A- chlamydia psittaci
    41. C
    42. C-as in other ‘atypical’ pneumonia
  2. Guest

    Guest Guest

    dear Amr.....a wonderful job....please continue...
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