Category: Quiz

Cytomegalovirus (CMV)

Cytomegalovirus (CMV)

Q. 1

The most common presentation of congenital CMV infection is –

 A

Hepatosplenomegaly

 B

Microcephaly

 C

Cerebral calcification

 D

Chorioretinitis

Q. 1

The most common presentation of congenital CMV infection is –

 A

Hepatosplenomegaly

 B

Microcephaly

 C

Cerebral calcification

 D

Chorioretinitis

Ans. A

Explanation:

Ans. is ‘a’ i.e., Hepatosplenomegaly

  1. CYTOMEGALOV1RUS(CMV)
  • Also known as salivary gland virus
  • CMV is the largest virus amongst herpes viruses
  • They are characterized by enlargment of infected cells (cytomegalic cells) and intranuclear inclusions.
  • Intranuclear inclusion is eccentrically placed and is surrounded by a halo – owl’s eye appearance
  • Once infected an individual carries CMV for life
  • CMV is the most common organism causing intrauterine infection.
  • CMV is the most common pathogen complicating organ transplantation.

Clinical manifestations

.   Most of the infections in immunocompetent persons are asymptomatic.

 


Q. 2

The most sensitive and rapid test for diagnosis of CMV retinitis is –

 A

Viral isolation from the intraocular fluid

 B

Nucleic acid detection from the intraocular fluid

 C

Viral antigen detection in vitreous

 D

Viral antibody detection in the blood by ELISA

Q. 2

The most sensitive and rapid test for diagnosis of CMV retinitis is –

 A

Viral isolation from the intraocular fluid

 B

Nucleic acid detection from the intraocular fluid

 C

Viral antigen detection in vitreous

 D

Viral antibody detection in the blood by ELISA

Ans. B

Explanation:

Ans. is ‘b i.e., Nucleic acid detection from the intraocular fluid

  • The diagnosis of CMV retinitis is usually made clinically.
  • However in a minority of cases with an atypically clinical presentation, the diagnosis should be confirmed by laboratory test.
  • Serological evidence of past infection with CMV (immunoglobulin C) is common in AIDS patients and thus has limited diagnostic value.
  • Blood or urine viral cultures may support the diagnosis and have been shown to be positive in 45% and 71% of new CMVR cases for blood and urine respectively.

– However, the predictive value of this indirect test is too low for it to be used for therapeutic decisions.

  • In difficult, atypical cases in which there is an urgent need for correct microbial diagnosis, a polymerase chain reaction (PCR) test from a vitreous or aqueus tap may be highly helpful.

– Vitreous PCR has been shown to 95% sensitive and highly specific in untreated cases of CMV retinitis.


Q. 3

All are true regarding CMV except – 

 A

It is a DNA virus

 B

Most commonly infects in last trimester

 C

Diagnosed by increased IgA in fetal blood

 D

Most common cause of congenital viral infection

Q. 3

All are true regarding CMV except – 

 A

It is a DNA virus

 B

Most commonly infects in last trimester

 C

Diagnosed by increased IgA in fetal blood

 D

Most common cause of congenital viral infection

Ans. C

Explanation:

Ans. is ‘c’ i.e., Diagnosed by increased IgA in fetal blood 

Quiz In Between


Q. 4

Most common disease caused by CMV in a post bone-marrow transplant patients –

 A

Pyelonephritis 

 B

Meningitis

 C

Pneumonia

 D

GI ulceration

Q. 4

Most common disease caused by CMV in a post bone-marrow transplant patients –

 A

Pyelonephritis 

 B

Meningitis

 C

Pneumonia

 D

GI ulceration

Ans. C

Explanation:

Ans. is ‘c’ i.e., Pneumonia 

.  Most common CMV syndrome in kidney transplant patient is fever (most common), leukopenia, hepatospleenomegaly, myalgia and arthralgia.


Q. 5

Which of the following does not establish a diagnosis of congenital CMV infection in a neonate

 A

Urine culture of CMV

 B

IgG CMV antibodies in blood

 C

Intra-nuclear inclusion bodies in hepatocytes

 D

CMV viral DNA in blood by polymerase chain reaction

Q. 5

Which of the following does not establish a diagnosis of congenital CMV infection in a neonate

 A

Urine culture of CMV

 B

IgG CMV antibodies in blood

 C

Intra-nuclear inclusion bodies in hepatocytes

 D

CMV viral DNA in blood by polymerase chain reaction

Ans. B

Explanation:

Ans. is `b’ i.e. IgG CMV antibodies in blood 

” Ig G antibody test is of little diagnostic value as positive results also reflects maternal antibodies.”


Q. 6

A new born presents with petechiae skin lesions, hematuria, and platelet count is 22,000/L. Most likely caused by –

 A

Congenital CMV infection

 B

Congenital rubella infection

 C

Premature infants

 D

a and b

Q. 6

A new born presents with petechiae skin lesions, hematuria, and platelet count is 22,000/L. Most likely caused by –

 A

Congenital CMV infection

 B

Congenital rubella infection

 C

Premature infants

 D

a and b

Ans. D

Explanation:

Ans. is ‘a’ i.e., CMV infection; ‘b’ i.e., Congenital rubella infection

o Both congenital CMV and Congenital rubella infections can cause thrombocytopenia and purpuric rash due to thrombocytopenia.

Quiz In Between


Q. 7

CMV causes:     

March 2013

 A

IUGR

 B

Sepsis

 C

Hydrocephalus

 D

Thrombocytosis

Q. 7

CMV causes:     

March 2013

 A

IUGR

 B

Sepsis

 C

Hydrocephalus

 D

Thrombocytosis

Ans. A

Explanation:

Ans. A i.e. IUGR

It also causes thrombocytopenia, microcephaly etc.


Q. 8

CMV belongs to which family of DNA viruses

 A

Poxviridae

 B

Herpesviridae

 C

Papovaviridae

 D

Paravoviridae

Q. 8

CMV belongs to which family of DNA viruses

 A

Poxviridae

 B

Herpesviridae

 C

Papovaviridae

 D

Paravoviridae

Ans. B

Explanation:

Ans. is ‘b’ i.e., Herpesviridae


Q. 9

True about CMV are all except

 A

Most common cause of post-transpinatation infection

 B

Most common cause of transplacental infection

 C

A non-enveloped DNA virus

 D

Produces intranuclear inclusions

Q. 9

True about CMV are all except

 A

Most common cause of post-transpinatation infection

 B

Most common cause of transplacental infection

 C

A non-enveloped DNA virus

 D

Produces intranuclear inclusions

Ans. C

Explanation:

Ans. is ‘c’ i.e., A non-enveloped DNA virus

CMV is an enveloped DNA virus, belongs to Herpesviridae.

Quiz In Between


Q. 10

Gancyclovir is used intravitreallyfor treatment of‑

 A

Influenza

 B

Rhinovirus

 C

HZV

 D

CMV retinitis

Q. 10

Gancyclovir is used intravitreallyfor treatment of‑

 A

Influenza

 B

Rhinovirus

 C

HZV

 D

CMV retinitis

Ans. D

Explanation:

Ans. is ‘d’ i.e., CMV retinitis

Some drugs which are used intravitreally are :‑

1) Bevacizumab : inhibits VEGF action; used in metastatic colorectal cancer; off label use as intravitreous injection to slow progression of neovascular macular degeneration.

2) Foscarnet : CMV retinitis.

3) Gancyclovir : CMV retinitis.

4) Ranibizumab : slow macular degeneration.

5) Pegaptanib : neovascular age related macular degeneration.


Q. 11

The hemoatoxylin and eosin staining of a lung section during autopsy of a patient suffering from AIDS shows desquamation of type 1 pneumocytes with prominent intracuclear basophilic inclusion bodies surrounded by a clear halo. The CD4 count was less than 100/mm3 before detnis- ‘ most likely diagnosis causing these featuresis:

 A

Acute respiratory distress syndrome

 B

Pneumocystic jiroveci pneumoni

 C

CMV pneumonia

 D

Mycobacterium avium-intracellulare pneumonia

Q. 11

The hemoatoxylin and eosin staining of a lung section during autopsy of a patient suffering from AIDS shows desquamation of type 1 pneumocytes with prominent intracuclear basophilic inclusion bodies surrounded by a clear halo. The CD4 count was less than 100/mm3 before detnis- ‘ most likely diagnosis causing these featuresis:

 A

Acute respiratory distress syndrome

 B

Pneumocystic jiroveci pneumoni

 C

CMV pneumonia

 D

Mycobacterium avium-intracellulare pneumonia

Ans. C

Explanation:

Ans. c. CMV pneumonia

Quiz In Between



Varicella Zoster

Varicella Zoster

Q. 1

In herpes zoster opthalmicus least involved nerve is?

 A Facial
 B

Infraorbital

 C Lacrimal
 D

Nasociliary

Q. 1

In herpes zoster opthalmicus least involved nerve is?

 A Facial
 B

Infraorbital

 C Lacrimal
 D

Nasociliary

Ans. A

Explanation:

Facial

REF: khurana 4th ed p. 126-127

  • Herpes zoster virus lies dormant in the gasserian ganglion of trigeminal nerve to appear later, particularly in elderly people with depressed cellular immunity in distribution of trigeminal nerve
  • Here all except facial nerve is branches of trigeminal nerve hence is the answer.

Q. 2

Tests of chicken pox-

 A

FAMA

 B

ELISA

 C

PCR

 D

All

Q. 2

Tests of chicken pox-

 A

FAMA

 B

ELISA

 C

PCR

 D

All

Ans. D

Explanation:

Ans. is ‘a’ i.e., FAMA; ‘b’ i.e., ELISA; ‘c’ i.e., PCR 

Laboratory Diagnosis ‑

A) Microscopy

  • Tzank smear – multinucleated giant cells
  • Cowdry type A intranuclear inclusion bodies

B) Virus Isolation

  • VZV does not grow in experimental animals or chick embryo.
  • It can be grown in tissue culture cell lines :

– Human fibroblast

– Human amnion

C) Serology

  • Demonstration either seroconversion or a fourfold or greater rise in antibody titre between convalescent and acute-phase serum.
  • Tests are :
  1. Fluorescent antibody to membrane antigen (FAMA)
  2. Enzyme-linked immunosorbent assay (ELISA)               most sensitive
  3. Immunofluorscent test.
  4. Immune adherence hemagglutination

D) PCR for detection of VZV DNA


Q. 3

Chickenpox –

 A

Is commonly seen in a congenital form

 B

May be severe in a newborn child infected by the mother in late pregnancy

 C

Affects the limbs more than the trunk

 D

May cause pneumonitis

Q. 3

Chickenpox –

 A

Is commonly seen in a congenital form

 B

May be severe in a newborn child infected by the mother in late pregnancy

 C

Affects the limbs more than the trunk

 D

May cause pneumonitis

Ans. B

Explanation:

Ans. is ‘b’ i.e., May be severe in a newborn child infected by the mother in late pregnancy 

  • Perinatal varicella is associated with a high mortality rate when maternal disease develops within 5 days before delivery or within 48 hr there after.

Quiz In Between


Q. 4

The risk of neonatal chicken pox is the maximum, if maternal infection occurs –

 A

During the first trimester

 B

During the second trimester

 C

Within five days of delivery

 D

Within six weeks of delivery

Q. 4

The risk of neonatal chicken pox is the maximum, if maternal infection occurs –

 A

During the first trimester

 B

During the second trimester

 C

Within five days of delivery

 D

Within six weeks of delivery

Ans. C

Explanation:

Ans. is ‘c’ i.e., Within 5 days of delivery

o Risk of neonatal chicken pox is maximum if maternal infection occurs near delivery ( 5 days before delivery or 48 hours after).


Q. 5

Which of the following is true of chicken pox

 A

Virus not found in scab

 B

Virus can be grown on the chick embryo

 C

Caused by RNA virus

 D

Does not cross the placental barrier

Q. 5

Which of the following is true of chicken pox

 A

Virus not found in scab

 B

Virus can be grown on the chick embryo

 C

Caused by RNA virus

 D

Does not cross the placental barrier

Ans. A

Explanation:

Ans. is ‘a’ i.e., Virus not found in scab 

  • The fluid of vesicle of chickenpox contains virus during first 3 days of illness, but scab is noninfective.

About other options

  • Option b

         VZV does not grow in experimental animal or chick embryo.

         It can be grown in tissue culture cell lines —> Human fibroblast, hela cells, vero cells.

o Option c

         VZV is a DNA virus.

o Option d

VZV can cross placenta and infect the fetus.


Q. 6

Chicken pox vaccine is –

 A

Live vaccine

 B

Killed vaccine

 C

Conjugated vaccine

 D

None

Q. 6

Chicken pox vaccine is –

 A

Live vaccine

 B

Killed vaccine

 C

Conjugated vaccine

 D

None

Ans. A

Explanation:

Ans. is ‘a’ i.e., Live vaccine 

Prevention of chickenpox

o For prevention of chickenpox following are used‑

i) Varicella zoster immunoglobulin (VZIG)

            VZIG is given within 72 hours of exposure in exposed susceptible individuals.

            It is given intramuscular with a repeat dose in 3 weeks.

            Because VZIG bind to varicella vaccine, the two should not be given concomitantly.

ii) Vaccine

            Varicella vaccine is live attenuated vaccine and is recommended for children between 12-18 months of age.

            Efficacy of vaccine is 90 – 95% and duration of immunity is probably 10 years.

Two doses are recommended in person older than 12 years of age.

Quiz In Between


Q. 7

Herpes zoster ophthalmicus is predictor of:

 A

Leukemia

 B

Lymphoma

 C

HIV

 D

All

Q. 7

Herpes zoster ophthalmicus is predictor of:

 A

Leukemia

 B

Lymphoma

 C

HIV

 D

All

Ans. D

Explanation:

A i.e. Leukaemia; B i.e. Lymphoma; C i.e. HIV

  • Herpes zoster ophthalmicus is caused by varicella-zoster virus Q (DNA virus)
  • After an infection with chicken pox in childhood or youth the virus lies dormant in Gasserian ganglion of trigeminal nerve Q to appear later, particularly in elderly people with depressed cellular immunity e.g. cancer, leukaemia, AIDS, lymphoma, immunosuppressed organ transplant recipients, metastasis, disseminated, T.B. Q etc.

Q. 8

Herpes zoster in geniculate ganglion causes:

 A

Bell’s palsy

 B

Ramsay Hunt syndrome

 C

Merkelson Rosenthal syndrome

 D

Frey’s syndrome

Q. 8

Herpes zoster in geniculate ganglion causes:

 A

Bell’s palsy

 B

Ramsay Hunt syndrome

 C

Merkelson Rosenthal syndrome

 D

Frey’s syndrome

Ans. B

Explanation:

Answer is B (Ramsay Hunt sSyndrome):

Herpes Zoster of geniculate ganglion causes Ramsay Hunt Syndrome.

The Ramsay Hunt Syndrome is caused by reactivation of Herpes Zoster in the geniculate ganglion and consists of a severe facial nerve palsy associated with a vesicular eruption in the external auditory canal and sometimes in the pharynx and other parts of the cranial integument ‘- Harrison


Q. 9

Systemic acyclovir in herpes zoster is useful:

 A

When started immediately after the onset of rash

 B

For post-herpetic neuralgia

 C

For ocular lesions only

 D

All of the above

Q. 9

Systemic acyclovir in herpes zoster is useful:

 A

When started immediately after the onset of rash

 B

For post-herpetic neuralgia

 C

For ocular lesions only

 D

All of the above

Ans. A

Explanation:

Ans. When started immediately after the onset of rash

Quiz In Between


Q. 10

Which is NOT a complication of chicken pox/ varicel­la:   

September 2012

 A

Pancreatitis

 B

Pneumonia

 C

Encephalitis

 D

Reye’s syndrome

Q. 10

Which is NOT a complication of chicken pox/ varicel­la:   

September 2012

 A

Pancreatitis

 B

Pneumonia

 C

Encephalitis

 D

Reye’s syndrome

Ans. A

Explanation:

Ans: A i.e. Pancreatitis


Q. 11

Cause of Herpes Zoster ‑

 A

Primary infection with VZV

 B

Recurrent infection with VZV

 C

Reactivation of latent infection of VZV

 D

Multiple infection with VZV

Q. 11

Cause of Herpes Zoster ‑

 A

Primary infection with VZV

 B

Recurrent infection with VZV

 C

Reactivation of latent infection of VZV

 D

Multiple infection with VZV

Ans. C

Explanation:

Ans. is ‘c’ i.e., Reactivation of latent infection of VZV

Varicella zoster virus infection

  • Varicella (Chicken pox) and Herpes zoster are different manifestations of the same virus infection. The virus is therefore called varicella zoster virus (VZA)
  • Primary infection with VZV causes chicken pox.
  • Reactivation of latent VZV, when immunity has fallen to ineffective levels causes-Herpes zoster
  • The virus remains dormant in sensory ganglion of trigeminal nerve and reaches the eye along one or more branches of the opthalmic division of the 5th nerve

Herpes Zoster (Shingles)

Occurs in old age 60 years or above

As a consequence of reactivation of latent infection from the dorsal root ganglion. o Unilateral vesicular eruptions within a dermatomal distribution

Dermatomes from T3 to L3 and trigeminal nerve (especially ophthalmic branch) are involved. o Zoster ophthalmicus – due to reactivation in ophthalmic branch of trigeminal (gasserian) ganglia o Ramsay Hunt Syndrome – due to reactivation in geniculate ganglion of facial nerve. o Complications Post herpetic neuralgia – most debilitating complication

  1. Meningeal irritation
  2. Transverse myelitis
  3. Cutaneous dissemination
  4. Patient’s with hodgkin’s disease and non hodgkin’s lymphoma are at greatest risk for progressive hespes zoster.
  5. Bacterial superinfection

Q. 12

Most common complication of chicken-pox –

 A

Bacterial infection

 B

Meningitis

 C

Pneumonia

 D

Nephritis

Q. 12

Most common complication of chicken-pox –

 A

Bacterial infection

 B

Meningitis

 C

Pneumonia

 D

Nephritis

Ans. A

Explanation:

Ans. is ‘a’ i.e., Bacterial infection

Complications of chicken pox

  • The most common infectious complication of varicella is secondary bacterial superinfection of the skin, which is usually caused by streptococcus pyogenes or Staphylococcus aureus.
  • The most common extracutaneous site of involvement in children is CNS.
  • Varicella pneumonia is the most serious complication following chickenpox in adults.

Quiz In Between


Q. 13

Wrong statement about chicken pox/ herpes zoster‑

 A

Caused by VZV

 B

Chicken-pox primary infection

 C

Herpes-zoster recurrent infection

 D

Latent infection in trigeminal ganglion

Q. 13

Wrong statement about chicken pox/ herpes zoster‑

 A

Caused by VZV

 B

Chicken-pox primary infection

 C

Herpes-zoster recurrent infection

 D

Latent infection in trigeminal ganglion

Ans. C

Explanation:

Ans. is ‘c’ i.e., Herpes-Zoster recurrent infection

Herpes-Zoster is due to reactivation of latent infection (not due to recurrent infection). Other options are correct.


Q. 14

Cowdry type A inclusion bodies are seen in ‑

 A

HBV

 B

Herpesvirus

 C

Adenovirus

 D

Poxvirus

Q. 14

Cowdry type A inclusion bodies are seen in ‑

 A

HBV

 B

Herpesvirus

 C

Adenovirus

 D

Poxvirus

Ans. B

Explanation:

Ans. is ‘b’ i.e., Herpesvirus

Intranuclear inclusion bodies were classified into two types by cowdry :

a) Cowdry type A :- These are of variable size and granular in appearance, e.g. in herpesvirus and yellow fever virus.

b) Cowdry type B :- These are more circumscribed and often multiple, as with adenovirus and poliovirus.


Q. 15

Prophylaxis for chicken-pox by varicella-zoster immmunoglobulin, true is ‑

 A

Should be given within 24 hours

 B

Given to newborn contact

 C

Can be given with varicella vaccine

 D

Can be given in established disease

Q. 15

Prophylaxis for chicken-pox by varicella-zoster immmunoglobulin, true is ‑

 A

Should be given within 24 hours

 B

Given to newborn contact

 C

Can be given with varicella vaccine

 D

Can be given in established disease

Ans. B

Explanation:

Ans. is b’ i.e., Given to newborn contact

Varicella-Zoster immunoglobulin (VZIG) given within 72 hours of exposure has been recommended for prevention of chickenpox in exposed susceptible individuals particularly in immunosupprressed persons.

These include :‑

a) Susceptible persons receiving imunosuppressive therapy

b) Persons with congenital cellular immunodeficiency

c) Persons with acquired immunodeficiency including HIV/AIDS

d) Susceptible and exposed, persons, in particular pregnant women

e) Newborn

f) Premature infants of low birth weight.

  • It has no therapeutic value in established disease.
  • VZIG is given by intramuscular injection in a dose of 12.5 units/kg body weight up to a maximum of 625 units, with a repeat dose in 3 weeks, if a high-risk patient remains exposed.
  • Because VZIG appears to bind the varicella vaccine, the two should not be given concomitantly.

Quiz In Between


Q. 16

Spread of chicken pox is maximum ‑

 A

After formation of scab

 B

Just before and after onset of rash

 C

One week before onset of rash

 D

During convelescence

Q. 16

Spread of chicken pox is maximum ‑

 A

After formation of scab

 B

Just before and after onset of rash

 C

One week before onset of rash

 D

During convelescence

Ans. B

Explanation:

Ans. is ‘b’ i.e., Just before and after onset of rash

Communicable period (period of maximum infectivity) in chicken pox is 2 days before to 5 days after onset of rash.


Q. 17

Secondary attack rate of chickenpox ‑

 A

70%

 B

90%

 C

65%

 D

80%

Q. 17

Secondary attack rate of chickenpox ‑

 A

70%

 B

90%

 C

65%

 D

80%

Ans. B

Explanation:

Ans. is `b’ i.e., 9%


Q. 18

True about rash of chicken pox ‑

 A

Deep seated

 B

Centripetal

 C

Affects palm & sole

 D

Slow evolution

Q. 18

True about rash of chicken pox ‑

 A

Deep seated

 B

Centripetal

 C

Affects palm & sole

 D

Slow evolution

Ans. B

Explanation:

Ans. is ‘b’ i.e., Centripetal

Quiz In Between


Q. 19

Tzank smear in varicella-zoster shows ‑

 A

Acantholysis

 B

Spongiosis

 C

Multinucleated Giant cell

 D

Necrotic cell

Q. 19

Tzank smear in varicella-zoster shows ‑

 A

Acantholysis

 B

Spongiosis

 C

Multinucleated Giant cell

 D

Necrotic cell

Ans. C

Explanation:

Ans. is ‘c’ i.e., Multinucleated Giant cell


Q. 20

Treatment of Herpes zoster –

 A

Zidovudin

 B

Valacyclovir

 C

Ribavarin

 D

Nevirapine

Q. 20

Treatment of Herpes zoster –

 A

Zidovudin

 B

Valacyclovir

 C

Ribavarin

 D

Nevirapine

Ans. B

Explanation:

Ans. is ‘b’ i.e., Valacyclovir

Herpes zoster

  • Reactivation of varicellazoster virus (VZV) that has remained dormant within dorsal root ganglia.
  • Shingles causes a painful rash that may appear as a stripe of blisters on the torso. Pain can persist even after the rash is gone (this is called post-herpetic neuralgia).
  • Treatments include pain relief and antiviral medication such as aciclovir or valaciclovir.
  •  A chickenpox vaccine in childhood or a shingles vaccine as an adult can minimize the risk of developing shingles.



Q. 21

Infectivity period of chickenpox is ?

 A

1 day before and 4 days after appearance of rash

 B

4 days before and 5 day after appearance of rash

 C

Only when scab falls

 D

Entire incubation period

Q. 21

Infectivity period of chickenpox is ?

 A

1 day before and 4 days after appearance of rash

 B

4 days before and 5 day after appearance of rash

 C

Only when scab falls

 D

Entire incubation period

Ans. A

Explanation:

Ans. is ‘a’ i.e., 1 day before and 4 days after appearance of rash 

Period of communicability:

  • Chicken pox: 1 – 2 days before to 4 – 5 days after appearance of rash
  • Measles: 4 days before to 5 days after appearance of rash
  • Rubella: 7 days before symptoms to 7 days after appearance of rash
  • Mumps: 4 – 6 days before symptoms to 7 days thereafter
  • Influenza: 1 – 2 days before to 1 – 2 days after onset of symptoms
  • Diphtheria: 14 – 28 days from disease onset
  • Pertussis: 7 days after exposure to 3 weeks after paroxysmal stage
  • Poliomyelitis: 7 – 10 days before and after onset of symptoms
  • Hepatitis A: 2 weeks before to 1 week after onset of jaundice
  • Hepatitis B: Till disappearance of HBs Ag & appearance of anti-HBs
  • Meningococcal: Until absent from nasal and throat discharge
  • Tuberculosis: As long as not treated

Quiz In Between



Coccidioides immitis

Coccidioides immitis

Q. 1

Endemic fungal infection –

 A

Coccidioides immitis

 B

Cryptococcus

 C

Histoplasmosis

 D

a and c

Q. 1

Endemic fungal infection –

 A

Coccidioides immitis

 B

Cryptococcus

 C

Histoplasmosis

 D

a and c

Ans. D

Explanation:

Ans. is ‘a’ i.e., Coccidioides immitis; ‘c’ i.e., Histoplasma

Endemic mycoses

.   Mycosis that is geographically restricted to specific area of endemicity.

.   Fungus causing endemic mycosis are : –

I. Coccidioidomycosis                 3. Blastomycosis

2. Histoplasmosis                         4. Paracoccidioidomycosis


Q. 2

In tissue, Coccidioides immitis produces ‑

 A

Spherules and endospores

 B

Encapsulated yeast cells

 C

Fine, delicate hyphae

 D

Coarse, septate hyphae

Q. 2

In tissue, Coccidioides immitis produces ‑

 A

Spherules and endospores

 B

Encapsulated yeast cells

 C

Fine, delicate hyphae

 D

Coarse, septate hyphae

Ans. A

Explanation:

Ans. is ‘a’ i.e., Spherules and endospores

Coccidioides immitis

.   It is a dimorphic fungus with septate hyphae.

.   Has two forms.

  1. White fluffy mould on most culture media
  2. Nonbudding spherical form-a spherule, in host tissue.

.   C. immitis reproduces in host tissue by forming small endospores within mature spherules.

.    Fungus is identified by its appearance by the formation of thick-walled barrel shaped spores, called arthrospores.

.    Infection is acquired by dust containing arthrospores.

.     Clinical manifestations

–    Most of the infections are asymptomatic Asymptomatic pulmonary nodule.

Many persons develop a self limited influenza like fever —> Valley fever or desert rheumatism. Acute pneumonia

–         Chronic fibrocavitatory pneumonia

–         Chronic dissemination:

Bone                                           Meninges

Skin                                             Joints Subcutaneous tissue


Q. 3

Valley fever or desert rheumatism is caused by ‑

 A

Sporothrix

 B

Cladosporium

 C

Phialophora

 D

None

Q. 3

Valley fever or desert rheumatism is caused by ‑

 A

Sporothrix

 B

Cladosporium

 C

Phialophora

 D

None

Ans. D

Explanation:

Ans. is ‘None’

Quiz In Between


Q. 4

Coccidioides immitis is identified in tissues on the basis of which of the following-

 A

Budding yeast cells with pseudohyphae

 B

Yeaslike forms with very large capsules

 C

Arthrospores

 D

None

Q. 4

Coccidioides immitis is identified in tissues on the basis of which of the following-

 A

Budding yeast cells with pseudohyphae

 B

Yeaslike forms with very large capsules

 C

Arthrospores

 D

None

Ans. C

Explanation:

Ans. is ‘c’ i.e., Arthrospores

.     C. immitis is identified by its appearance (endosporulating spherules) and by the formation of thick walled, barrel-shaped spores, called arthrospores.

Remember

.     Blastomyces dermatitidis      —> Yeast phase has spherical or oval double walled cells with single broad based bud.

  • Paracoccidioides brasiliensis —> Yeast phase has spherical thick walled cells with multiple buds.
  • Coccidioides immitis               –> Tissue phase has spherule with numerous endospores.

Q. 5

Dimorphic fungi are all except –

 A

Coccidioidomycosis

 B

Blastomycosis

 C

Candida

 D

None

Q. 5

Dimorphic fungi are all except –

 A

Coccidioidomycosis

 B

Blastomycosis

 C

Candida

 D

None

Ans. D

Explanation:

Ans. is None

  • All are dimorphic fungi

Quiz In Between


Q. 6

Barrel shaped spores (arthospores) is seen with –

 A

Blastomyces

 B

Histoplasma

 C

Coccidioides

 D

Candida

Q. 6

Barrel shaped spores (arthospores) is seen with –

 A

Blastomyces

 B

Histoplasma

 C

Coccidioides

 D

Candida

Ans. C

Explanation:

Ans. is ‘c’ i.e., Coccidioides

.  Arthrospores (arthroconidia) are formed by coccidioides.


Q. 7

Not be cultured in Sabouraund’s agar –

 A

Blastomyces

 B

Coccidiodes

 C

Sporotric hum

 D

Rhinosporidium seeberi

Q. 7

Not be cultured in Sabouraund’s agar –

 A

Blastomyces

 B

Coccidiodes

 C

Sporotric hum

 D

Rhinosporidium seeberi

Ans. D

Explanation:

Ans. is ‘d’ i.e., Rhinosporidium seeberi

Quiz In Between



Coxsackievirus

Coxsackievirus

Q. 1

Coxsackie virus is –

 A

Harpes virus

 B

Pox virus

 C

Enterovirus

 D

Myxovirus

Q. 1

Coxsackie virus is –

 A

Harpes virus

 B

Pox virus

 C

Enterovirus

 D

Myxovirus

Ans. C

Explanation:

Ans. is ‘c’ i.e., Enterovirus


Q. 2

Coxsackie group A commonly cause ‑

 A

Conjunctivits

 B

Aseptic meningitis

 C

Hepatitis

 D

Myocarditis

Q. 2

Coxsackie group A commonly cause ‑

 A

Conjunctivits

 B

Aseptic meningitis

 C

Hepatitis

 D

Myocarditis

Ans. B

Explanation:

Ans. is ‘b’ i.e., Aseptic meningitis

.   Aseptic meningitis is caused by all types group B Coxackies viruses and by many group ‘A’ Coxsakie viruses most commonly A7 and A9.

About other options

.  Acute hemorrhagic conjuctivitis can be caused by Coxsackie virus A-24, but it is not common. Mostly it is caused by enterovirus – 70.

.   Myocarditis and hepatitis are mainly caused by Coxsackie virus group B.


Q. 3

Herpangina is caused by –

 A

Adenovirus

 B

Enterovirus-72

 C

Coxsackie virus A

 D

Coxsackie virus B

Q. 3

Herpangina is caused by –

 A

Adenovirus

 B

Enterovirus-72

 C

Coxsackie virus A

 D

Coxsackie virus B

Ans. C

Explanation:

Ans. is ‘c’ i.e., Coxsackie virus A

  • Herpangina is caused by Coxsackie-A virus.

Quiz In Between


Q. 4

Coxsackie B virus causes all except –

 A

Aseptic meningitis

 B

Herpangina

 C

Myocarditis

 D

Bornholm disease

Q. 4

Coxsackie B virus causes all except –

 A

Aseptic meningitis

 B

Herpangina

 C

Myocarditis

 D

Bornholm disease

Ans. B

Explanation:

Ans. is ‘b’ i.e., Herpangina


Q. 5

Infantile myocarditis and pericarditis is due to

 A

Coxsackie A

 B

Coxsackie B

 C

Mumps

 D

Pox virus

Q. 5

Infantile myocarditis and pericarditis is due to

 A

Coxsackie A

 B

Coxsackie B

 C

Mumps

 D

Pox virus

Ans. B

Explanation:

Ans. is ‘b’ i.e., Coxsackie B

o The commonest cause of myocarditis is coxsackie B infection, which occurs any where from the age of a few hours to 7 weeks, with a peak around two weeks.


Q. 6

A Patient Presented with Blister as shown in the diagram on their hand , feet and Mouth ? Most Probable Causative Organism 

 A

Coxsackie – A virus

 B

Coxsackie – B virus

 C

EBV

 D

CMV

Q. 6

A Patient Presented with Blister as shown in the diagram on their hand , feet and Mouth ? Most Probable Causative Organism 

 A

Coxsackie – A virus

 B

Coxsackie – B virus

 C

EBV

 D

CMV

Ans. A

Explanation:

It is Hand Foot Mouth disease

Quiz In Between


Q. 7

Animals (Encircled) shown in image are  used for isolation of which virus which are transmitted by the fecal-oral route ?

 A

Poxvirus 

 B

Adenovirus 

 C

 Herpes virus 

 D

Coxsachie virus

Q. 7

Animals (Encircled) shown in image are  used for isolation of which virus which are transmitted by the fecal-oral route ?

 A

Poxvirus 

 B

Adenovirus 

 C

 Herpes virus 

 D

Coxsachie virus

Ans. D

Explanation:

Ans:D.)Coxsackie virus

Animal is suckling mice

 Coxsackievirus

  • It is a virus that belongs to a family of nonenveloped, linear, positive-sense single-stranded RNA viruses, Picornaviridae and the genus Enterovirus, which also includes poliovirus and echovirus. Enteroviruses are transmitted by the fecal-oral route. 
    • The coxsackieviruses were subdivided into groups A and B based on their pathology in newborn mice.
    • Both group A and group B coxsackieviruses can cause nonspecific febrile illnesses, rashes, upper respiratory tract disease, and aseptic meningitis.
    • Group A coxsackieviruses tend to infect the skin and mucous membranes, causing herpangina, acute hemorrhagic conjunctivitis, and hand, foot, and mouth (HFM) disease.
    • Group B coxsackieviruses tend to infect the heart, pleura, pancreas, and liver, causing pleurodynia, myocarditis, pericarditis, and hepatitis
  • It is necessary to employ suckling mice for the isolation of coxsackie viruses.
    • Inoculation is usually made by intracerebral, subcutaneous and intraperitoneal route.
    • Adult mice are not susceptible.

Q. 8

Coxsackie A virus does not cause ‑

 A

Herpangina

 B

Hand, foot and mouth disease (HFM)

 C

Laryngotracheobronchitis

 D

Aseptic meningitis

Q. 8

Coxsackie A virus does not cause ‑

 A

Herpangina

 B

Hand, foot and mouth disease (HFM)

 C

Laryngotracheobronchitis

 D

Aseptic meningitis

Ans. C

Explanation:

Ans. is ‘c’ i.e., Laryngotracheobronchitis 


Q. 9

What can be the cause of this condition?

 A

HSV

 B

EBV

 C

Coxsachie A virus

 D

Group A Streptococcus

Q. 9

What can be the cause of this condition?

 A

HSV

 B

EBV

 C

Coxsachie A virus

 D

Group A Streptococcus

Ans. C

Explanation:

Ans:C.)Coxsachie A virus

Hand,Foot,Mouth disease is shown in the image.

HAND,FOOT AND MOUTH DISEASE

  • It typically begins with a fever and feeling generally unwell.This is followed a day or two later by flat discolored spots or bumps that may blister, on the hands, feet, and mouth, and occasionally buttocks and groin.
  • Signs and symptoms normally appear 3–6 days after exposure to the virus. The rash generally goes away on its own in about a week.
  • HFMD is highly contagious and is transmitted by nasopharyngeal secretions such as saliva or nasal mucus, by direct contact, or by fecal-oral transmission.
  • Coxsackievirus A16 is the most common cause and Enterovirus 71 is the second-most common cause

Quiz In Between



Ebola Virus

Ebola Virus

Q. 1

Hemorrhagic fever is caused by

 A

West-Mile fever

 B

Sandfly fever

 C

Ebola virus

 D

All of the above

Q. 1

Hemorrhagic fever is caused by

 A

West-Mile fever

 B

Sandfly fever

 C

Ebola virus

 D

All of the above

Ans. C

Explanation:

Ans. is ‘c’ i.e., Ebola virus

  • Ebola virus belongs to hemorrhagic fever (see above explanation).

Q. 2

Ebola virus is a –

 A

Reovirus

 B

Filovirus

 C

Arbovirus

 D

Arenavirus

Q. 2

Ebola virus is a –

 A

Reovirus

 B

Filovirus

 C

Arbovirus

 D

Arenavirus

Ans. B

Explanation:

Ans. is ‘b’ i.e., Filovirus

.    Filoviridae includes –       Marburg virus, Ebola virus


Q. 3

Category A bioterrorism agents are-(

 A

Ebola

 B

Yersinia

 C

Clostridium botulinum

 D

All

Q. 3

Category A bioterrorism agents are-(

 A

Ebola

 B

Yersinia

 C

Clostridium botulinum

 D

All

Ans. D

Explanation:

Ans. is ‘a’ i.e., Ebola, ‘b’ i.e. Yersinia, ‘c’ i.e. C. botulinum

Bioterrorism

.    A bioterrorism attack is the delibrate release of viruses, bacteria or other germs ( agents) used to cause illness or death in people, animals or plants. These agents are typically found in nature, but it is possible that they could be changed to increase their ability to cause disease, make them resistant to current medicines or to increase their ability to be spread into the environment. Biological agents can be spread through the air, through water or in food. Terrorists may use biological agents because they can be extermely difficult to detect and do not cause illness for several hours to several days. Some bioterrorism agents, like the small pox virus, can be spread from person to person and some like anthrax, cannot.

Bioterrorism agent categories

Category A

.   These high priority agents include organisms or toxins that pose the highest risk to the public and national security because:

i)         They can be easily spread or transmitted from person to person.

ii)       They result in high death rates and have potential for major public health impact.

iii)      They might cause public panic and social disruption.

iv)     They require special action for public health preparedness.

Category B

.  These agents are second highest priority because:

i)         They are moderately easy to spread.

ii)       They result in moderate illness rates and low death rates.

iii)      They require specific enhancements of CDC’s laboratory capacity and enhanced disease monitoring. Category C

.    These third highest priority agents include emerging pathogens that could be engineered for mass spread in the future because:

i)         They are easily available.

ii)       They are easily produced and spread.

iii)      They have potential for high morbidity and mortality rates and major health impact.

CDC Category A, B, and C Agents

Category A

Anthrax (Bacillus anthracis)

Botulism (Clostridium botulinum toxin)

Plague (Yersinia pestis)

Smallpox (Variola major)

Tularemia (Francisella tularensis)

Viral hemorrhagic fevers

Arenaviruses : Lassa, New World (Machupo, Junin, Guanarito, and Sabia)

Bunyaviridae : Crimean Congo, Rift Valley

Filoviridae : Ebola, Marburg

Flaviviridae : Yellow fever; Omsk fever; Kyasanur Forest Category B

Brucellosis (Brucella spp.)

Epsilon toxin of Clostridium perfringens

Food safety threats (e.g., Salmonella spp., Escherichia coli 0157:H7, Shigella)

Glanders (Burkholderia mallei)

Melioidosis (B. pseudomallei)

Psittacosis (Chlamydia psittaci)

Q fever (Coxiella burnetii)

Ricin toxin from Ricinus communis (castor beans)

Staphylococcal enterotoxin B

Typhus fever (Rickettsia prowazekii)

Viral encephalitis [alphaviruses (e.g., Venezuelan, eastern, and western equine encephalitis)]

Water safety threats (e.g. Vibrio cholerae, Cryptosporidium parvum) Category C

Emerging infectious diseases threats such as Nipah, hantavirus, and SARS coronoavirus.

Quiz In Between


Q. 4

Ebola virus belongs to‑

 A

Picornaviridae

 B

Togaviridae

 C

Flaviviridae

 D

Filoviridae

Q. 4

Ebola virus belongs to‑

 A

Picornaviridae

 B

Togaviridae

 C

Flaviviridae

 D

Filoviridae

Ans. D

Explanation:

Ans. is ‘d’ i.e., Filoviridae


Q. 5

The virus shown in the picture below ,which is responsible for fatal hemorrhagic fever belongs to? 

 A

Picornaviridae.

 B

Togaviridae.


 C

Flaviviridae.

 D

Filoviridae.

Q. 5

The virus shown in the picture below ,which is responsible for fatal hemorrhagic fever belongs to? 

 A

Picornaviridae.

 B

Togaviridae.


 C

Flaviviridae.

 D

Filoviridae.

Ans. D

Explanation:

Ans:D.)Filoviridae.

The virus shown in the picture above represent Ebola virus. It belongs to filoviridae.

Ebola Virus

  • Filoviruses such as Ebola virus share a characteristic filamentous form, with a uniform diameter of approximately 80 nm but a highly variable length. Filaments may be straight, but they are often folded on themselves .
    • EBOV carries a negative-sense RNA genome .
  • The natural reservoir of Ebola virus is believed to be bats, particularly fruit bats .
  • In patients who have Ebola virus infection, 2 types of exposure history are recognized: primary and secondary.
    • A history of primary exposure usually involves travel to or work in an Ebola-endemic area, such as the Democratic Republic of Congo ,Sudan, etc.
    • Secondary exposure refers to human-to-human or primate-to-human exposures.
  • Ebola virus is responsible for outbreaks of severe human hemorrhagic fever
    • Incubation period of the disease caused by an ebola virus is about 2-21 days.
    • It kills up to 90% of people who are infected.

Q. 6

Incubation period of the fatal hemorrhagic fever caused by an organism shown in Photograph below is ? 

 A

1-3 days.

 B

1-7 days.

 C

2-21 days.

 D

14-42 days.

Q. 6

Incubation period of the fatal hemorrhagic fever caused by an organism shown in Photograph below is ? 

 A

1-3 days.

 B

1-7 days.

 C

2-21 days.

 D

14-42 days.

Ans. C

Explanation:

Ans:C.)2-21 days.

The organism shown in the picture above represent Ebola virus.

Ebola Virus

  • Filoviruses such as Ebola virus share a characteristic filamentous form, with a uniform diameter of approximately 80 nm but a highly variable length. Filaments may be straight, but they are often folded on themselves .
    • EBOV carries a negative-sense RNA genome .
  • The natural reservoir of Ebola virus is believed to be bats, particularly fruit bats .
  • In patients who have Ebola virus infection, 2 types of exposure history are recognized: primary and secondary.
    • A history of primary exposure usually involves travel to or work in an Ebola-endemic area, such as the Democratic Republic of Congo ,Sudan, etc.
    • Secondary exposure refers to human-to-human or primate-to-human exposures.
  • Ebola virus is responsible for outbreaks of severe human hemorrhagic fever
    • Incubation period of the disease caused by an ebola virus is about 2-21 days.
    • It kills up to 90% of people who are infected.


Quiz In Between



Differences between Exotoxins and Endotoxins

Differences between Exotoxins and Endotoxins

Q. 1 True for tetanus are all, except:
 A Due to exotoxin
 B Due to endotoxin
 C Both of the above
 D None of the above 
Q. 1 True for tetanus are all, except:
 A Due to exotoxin
 B Due to endotoxin
 C Both of the above
 D None of the above 
Ans. A

Explanation:

Due to exotoxin


Q. 2

Exotoxins are –

 A

Lipopolysaccharide in nature

 B

Produced by gram –ye bacilli

 C

Highly antigenic

 D

Very stable and resistant to chemical agents

Q. 2

Exotoxins are –

 A

Lipopolysaccharide in nature

 B

Produced by gram –ye bacilli

 C

Highly antigenic

 D

Very stable and resistant to chemical agents

Ans. C

Explanation:

Ans. is ‘c’ i.e., Highly antigenic


Q. 3

True about exotoxins –

 A

Lipopolysaccharide

 B

Not antigenic

 C

Can be toxoided

 D

Heat stable

Q. 3

True about exotoxins –

 A

Lipopolysaccharide

 B

Not antigenic

 C

Can be toxoided

 D

Heat stable

Ans. C

Explanation:

Ans. is ‘c’ i.e., Can be toxoided

  • Exotoxins can be toxoided.
  • Exotoxins are protein in nature, heat labile and has antigenic property.

Quiz In Between


Q. 4

Lipopolysaccharide structure is characteristic of –

 A

Exotoxin

 B

Endotoxin

 C

Both

 D

None

Q. 4

Lipopolysaccharide structure is characteristic of –

 A

Exotoxin

 B

Endotoxin

 C

Both

 D

None

Ans. B

Explanation:

Ans. is ‘b’ i.e., Endotoxin.


Q. 5

Toxoid is prepared from –

 A

Exotoxin

 B

Endotoxin

 C

Both

 D

None

Q. 5

Toxoid is prepared from –

 A

Exotoxin

 B

Endotoxin

 C

Both

 D

None

Ans. A

Explanation:

Ans. is ‘a’ i.e., Exotoxin 

Toxoids

o Certain organisms produce exotoxins e.g., diphtheria and tetanus bacilli.

o The toxin produced by these organisms are detoxicated and used in the preparation of vaccines.

o The antibodies produced neutralize the toxic moiety produced during infection, rather than act upon the organisms.


Q. 6

Which of the following is an exotoxin:

NIMHANS 07

 A

E. coli toxin

 B

Proteus

 C

Pseudomonas

 D

Tetanus toxin

Q. 6

Which of the following is an exotoxin:

NIMHANS 07

 A

E. coli toxin

 B

Proteus

 C

Pseudomonas

 D

Tetanus toxin

Ans. D

Explanation:

Ans. Tetanus toxin

Quiz In Between


Q. 7

True about endotoxin

 A

Protein

 B

Highly antigenic

 C

No enzymatic activity

 D

Produced by gram positive bacteria

Q. 7

True about endotoxin

 A

Protein

 B

Highly antigenic

 C

No enzymatic activity

 D

Produced by gram positive bacteria

Ans. C

Explanation:

Ans. is ‘c’ i.e., No enzymatic activity


Q. 8

True about exotoxin ‑

 A

Non-antigenic

 B

Enzymatic

 C

Non-protein

 D

Heat stable

Q. 8

True about exotoxin ‑

 A

Non-antigenic

 B

Enzymatic

 C

Non-protein

 D

Heat stable

Ans. B

Explanation:

Ans. is ‘b’ i.e., Enzymatic


Q. 9

All are true except ‑

 A

Exotoxin has enzymatic action

 B

Endotoxin has enzymatic action

 C

Exotoxin is highly antigenic

 D

Endotoxin is weakly antigenic

Q. 9

All are true except ‑

 A

Exotoxin has enzymatic action

 B

Endotoxin has enzymatic action

 C

Exotoxin is highly antigenic

 D

Endotoxin is weakly antigenic

Ans. B

Explanation:

Ans. is ‘b’ i.e., Endotoxin has enzymatic action

Quiz In Between



Sporothrix schenckii

Sporothrix schenckii

Q. 1 “Asteroid bodies” and “Cigar shaped globi” may be produced by:
 A Sporothrix
 B Sporotrichosis
 C Phialophora
 D Aspergillus
Q. 1 “Asteroid bodies” and “Cigar shaped globi” may be produced by:
 A Sporothrix
 B Sporotrichosis
 C Phialophora
 D Aspergillus
Ans. B

Explanation:

Sporotrichosis


Q. 2

A man developed a pustule after striking by a thorn in the garden. Laboratory examination of the tissue specimen shows cigar-shaped budding yeasts. Most probable causative agent is:

 A

Sporothrix

 B

Sporotrichosis

 C

Phialophora

 D

Aspergillus

Q. 2

A man developed a pustule after striking by a thorn in the garden. Laboratory examination of the tissue specimen shows cigar-shaped budding yeasts. Most probable causative agent is:

 A

Sporothrix

 B

Sporotrichosis

 C

Phialophora

 D

Aspergillus

Ans. A

Explanation:

Sporothrix schenckii, is a dimorphic fungus. The mold form lives on plants and the yeast form occurs in human tissue.
When spores of the mold are introduced into the skin, typically by a thorn, it causes a local pustule or ulcer with nodules along the draining lymphatics.
In the clinical laboratory, round or cigar-shaped budding yeasts are seen in tissue specimens. In culture at room temperature, hyphae occur bearing oval conidia in clusters at the tip of slender conidiophores (resembling a daisy).
The drug of choice for skin lesions is itraconazole.
Ref: Levinson W. (2012). Chapter 48. Cutaneous & Subcutaneous Mycoses. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.

Q. 3

A gardener has multiple vesicles on hand and multiple eruptions along the lymphatics. Most common fungus responsible is ?

 A

Sporothrix schenckii

 B

Cladosporium

 C

Histoplasma

 D

Candida

Q. 3

A gardener has multiple vesicles on hand and multiple eruptions along the lymphatics. Most common fungus responsible is ?

 A

Sporothrix schenckii

 B

Cladosporium

 C

Histoplasma

 D

Candida

Ans. A

Explanation:

Ans. is ‘a’ i.e., Sporothrix schenckii

  • Multiple vesicles on hand and multiple eruptions along the lymphatics in a gardner suggest the diagnosis of cutaneous sporotrichosis.

Quiz In Between


Q. 4

A woman who pricked her finger while pruning some rose bushes develops a local pustule that progressed to an ulcer. Several nodules then developed along the local lymphatic drainage. The most likely etiological agent would be?

 A

Aspergillus fumigatus

 B

Candida albicans

 C

Histoplasma capsula turn

 D

Sporothrix schenckii

Q. 4

A woman who pricked her finger while pruning some rose bushes develops a local pustule that progressed to an ulcer. Several nodules then developed along the local lymphatic drainage. The most likely etiological agent would be?

 A

Aspergillus fumigatus

 B

Candida albicans

 C

Histoplasma capsula turn

 D

Sporothrix schenckii

Ans. D

Explanation:

Ans. is ‘d’ i.e., Sporothrix schenckii


Q. 5

A patient, resident of Himachal Pradesh presented with a series of ulcers in a row, on his right leg. The biopsy from the affected area was taken and cultured on Sabouraud’s Dextrose agar. What would be the most likely causative organism ?

 A

Sporothrix schenckii

 B

Cladosporium spp.

 C

Pseudoallescheria boydii

 D

Nocardia

Q. 5

A patient, resident of Himachal Pradesh presented with a series of ulcers in a row, on his right leg. The biopsy from the affected area was taken and cultured on Sabouraud’s Dextrose agar. What would be the most likely causative organism ?

 A

Sporothrix schenckii

 B

Cladosporium spp.

 C

Pseudoallescheria boydii

 D

Nocardia

Ans. A

Explanation:

Ans. is ‘a’ i.e., Sporothrix schenckii

.   Series of ulcers in a row suggests the diagnosis of sporotrichosis.


Q. 6

A former from the sub-Himalayan region presents with multiple leg ulcers. The most likely causative agent is –

 A

Trichophyton Rubrum

 B

Cladosporium species

 C

Sporothrix Schenckii

 D

Aspergillus

Q. 6

A former from the sub-Himalayan region presents with multiple leg ulcers. The most likely causative agent is –

 A

Trichophyton Rubrum

 B

Cladosporium species

 C

Sporothrix Schenckii

 D

Aspergillus

Ans. C

Explanation:

Ans. is ‘c’ i.e., Sporothrix Schenckii

  • Presence of multiple ulcers in the leg (along the lymphatic channels) in a farmer (out door worker) from the sub himalyan region suggests a diagnosis of Sporothrix Schenkii.

Quiz In Between


Q. 7

Asteroid bodies and cigar shaped globi may be produced by-

 A

Sporothrix

 B

Sporotrichosis

 C

Phialophora

 D

a and b

Q. 7

Asteroid bodies and cigar shaped globi may be produced by-

 A

Sporothrix

 B

Sporotrichosis

 C

Phialophora

 D

a and b

Ans. D

Explanation:

Ans. is ‘a’ i.e., Sporothrix; ‘b’ i.e., Sporotrichosis

. Some times ‘asteroid bodies’ are seen in the lesion of sporotrichosis, composed of a central fungus cell with eosinophilic material radiating from it.

 


Q. 8

Which of the following is a dimorphic

 A

Rhizopus

 B

Sporothrix schenckii

 C

Tinea versicolor

 D

Microsporum

Q. 8

Which of the following is a dimorphic

 A

Rhizopus

 B

Sporothrix schenckii

 C

Tinea versicolor

 D

Microsporum

Ans. B

Explanation:

Ans. is ‘b’ i.e., Sporothrix schenckii

Quiz In Between



Human PapillomaVirus (HPV)

Human PapillomaVirus (HPV)

Q. 1

High Risk HPV includes :

 A

Type 16

 B

Type 18

 C

Type 11

 D

Option a and b both

Q. 1

High Risk HPV includes :

 A

Type 16

 B

Type 18

 C

Type 11

 D

Option a and b both

Ans. D

Explanation:

Ans. is a and b i.e. Type 16; and Type 18

On the basis of strength of association to Ca cervix – HPV has been classified into

Low risk type

  • Cause genital warts and subclinical HPV infection
  • Cause high grade CIN which progress to invasive cancer
  • Type 16, 18, 31. 33, 45, 58
  • Subtype of HPV 6.

Q. 2

HPV associated with Laryngeal Papilloma are?

 A 13 & 32
 B

16 & 18

 C 6 & 11
 D

16 & 32

Q. 2

HPV associated with Laryngeal Papilloma are?

 A 13 & 32
 B

16 & 18

 C 6 & 11
 D

16 & 32

Ans. C

Explanation:

6 & 11 REF: Robbins 7th edition page 324

See APPENDIX-31 for “HUMAN PAPILLOMA VIRUS”


Q. 3

Koilocytes with perinuclear halo on pap smear is pathognomic of?

 A HPV infection
 B

Metaplasia

 C Dysplasia
 D

Bacterial vaginosis

Q. 3

Koilocytes with perinuclear halo on pap smear is pathognomic of?

 A HPV infection
 B

Metaplasia

 C Dysplasia
 D

Bacterial vaginosis

Ans. A

Explanation:

HPV infection REF: Shaw’s Gynecology 13th ed p- 78, The pap test by Richard M. DeMay page 49-50

“Koilocytes, dyskeratocytes, macrocytes, etc. are some of the cytologic findings that are characteristic of condylomas (HPV). Koilocytes with perinuclear halo is pathognomonic of HPV infection”

Condition

Type of cell

Estrogen dominated uterus

Normal cornified cells

Progesterone dominated uterus

Intermediate cells

pregnancy

Intermediate cells , Navicular cells

menopausal

Basal , parabasal

HPV

Koilocytes, dyskeratocytes, macrocytes

with perinuclear halo.

 

Quiz In Between


Q. 4

The physician takes a sample for Pap smear analysis from a 15 year old girl. Review of the Pap smear demonstrates the presence of koilocytes, which are approximately the same size as an intermediate cells, with enlarged hyperchromatic nuclei and perinuclear halos. The abnormal cells observed in the Pap smear specimen are infected by which of the following viruses?

 A

AIDS virus

 B

Cytomegalovirus

 C

Herpes simplex l

 D

Human papillomavirus

Q. 4

The physician takes a sample for Pap smear analysis from a 15 year old girl. Review of the Pap smear demonstrates the presence of koilocytes, which are approximately the same size as an intermediate cells, with enlarged hyperchromatic nuclei and perinuclear halos. The abnormal cells observed in the Pap smear specimen are infected by which of the following viruses?

 A

AIDS virus

 B

Cytomegalovirus

 C

Herpes simplex l

 D

Human papillomavirus

Ans. D

Explanation:

Various strains of the human papilloma virus (HPV, notably types 16, 18, 31, 33, 35, and 39) have been implicated as causing a variety of genital lesions, including genital warts, cervical dysplasia, cervical cancer, vaginal dysplasia, vaginal cancer, and penile cancer. The koilocyte is the term used to describe the characteristic nuclear alterations and perinuclear halo seen with HPV infection in the cervical squamous epithelial cells.
 
Infection with the AIDS virus cannot be recognized by cytologic changes.
 
Cytomegalovirus infection causes nuclei to be large, eosinophilic, and “smudged”; cytomegalovirus is uncommonly seen in Pap smears.
 
Herpes simplex I and II infections cannot be distinguished cytologically, as both produce multinucleated cells whose nuclei develop a characteristic “ground-glass” appearance.
 
Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 29. Preinvasive Lesions of the Lower Genital Tract. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.

Q. 5

HPV belongs to –

 A

Papova virus

 B

Parvovirus

 C

Herpes virus

 D

Poxvirus

Q. 5

HPV belongs to –

 A

Papova virus

 B

Parvovirus

 C

Herpes virus

 D

Poxvirus

Ans. A

Explanation:

Ans. is ‘a’ i.e., Papova virus 

  • Human papilloma virus belongs to papovaviridae family.

Q. 6

HPV vaccine is –

 A

Monovalent

 B

Bivalent

 C

Quadrivalent

 D

Both bivalent and quadrivalent

Q. 6

HPV vaccine is –

 A

Monovalent

 B

Bivalent

 C

Quadrivalent

 D

Both bivalent and quadrivalent

Ans. D

Explanation:

Ans. is. ‘d’ i.e., Both bivalent and quadrivalent 

Human papillomavirus (HPV) vaccine

  • HPV is one of the most important risk factor for cervical cancer, widespread vaccination has the potential to reduce cervical cancer deaths around the world by as much as two thirds, if all women were to take the vaccine and if protection turns out to be long term.

.   In addition, the vaccine can reduce the need for medical care, biopsies and invasive procedures associated with the follow up from abnormal pap tests. Thus, helping to reduce the health care costs and anxieties related to abnormal pap tests and follow up procedures.

.   HPV vaccines are ‑

1)    Preventive vaccines

– The role of HPV vaccine is to prevent infection with certain species of Human papillomavirus associated with the development of cervical cancer, genital warts and some less common type of cancers.

– These vaccines are based on virus like particles (VLPs) assembled from recombinant HPV coat proteins (major capsid protein L1).

Currently, one quadrivalent product containing HPV types 6,11,16 and 18 has been licenced in US and

recommended by the centres for disease control and prevention for administration to girls and young women

9-26 years of age —> type 16 and 18 are most important as they cause 70% of cervical cancer world wide. – Another product contains HPV types 16 and 18 ( bivalent) and is likely to be available in the near future.

2)    Therapeutic vaccines (under trial)

– In addition to above two preventive vaccines, laboratory research and several human clinical trials are focused on the development of therapetic HPV vaccines. In general these vaccines focus on the main HPV oncogenes, E6 and E7. Since expression of E6 and E7 is required for promoting the growth of cervical cancer cells and cells within warts, it is hoped that immune responses against two oncogenes might eradicate established tumors.

Quiz In Between


Q. 7

True about HPV vaccination –

 A

Given in women age group 20-40 years

 B

Primary dose consists of 2 doses

 C

Efficacy > 70% for cervical cancer

 D

All

Q. 7

True about HPV vaccination –

 A

Given in women age group 20-40 years

 B

Primary dose consists of 2 doses

 C

Efficacy > 70% for cervical cancer

 D

All

Ans. C

Explanation:

Ans. is ‘c’ i.e., Efficacy >70% for cervical cancer

. There are two types of HPV vaccines :-

i)         Quadrivalent :- containing HPV types 6,11,16,18

ii)       Bivalent :- containing HPV types 16,18

.  Efficacy of vaccine has varied according to the immunologic and virological characteristics of study populations at baseline and according to the endpoints evaluated. Most of the time, rates of vaccine efficacy exceed 90%.

.  Vaccine is recommended for girls and young women 9-26 years of age.

.  The quadrivalent vaccine is administered intramuscularly as three separate doses, with second dose given at 2months after the first dose and the third dose 6 months after the first dose.


Q. 8

Condyloma accminatum is caused by HPV types of

 A

18,31

 B

17,12

 C

6,11

 D

16,18

Q. 8

Condyloma accminatum is caused by HPV types of

 A

18,31

 B

17,12

 C

6,11

 D

16,18

Ans. C

Explanation:

Ans. is ‘c’ i.e., 6,11

.    High risk HPV: HPV-16, 18, 31, 33 & 45 —> associated with cervical cancer.

.    Low risk HPV: HPV- 6 & 11 –> associated with precursor lesions CM and condyloma accuminatum

.    HPV-5 & 8    associated with squamous cell cancer in patients with epidermodysplasia verruciformis


Q. 9

Most common manifestation of HPV infection in children –

 A

Single papilloma

 B

Multiple papillomatosis

 C

Osteoma

 D

Sarcoma

Q. 9

Most common manifestation of HPV infection in children –

 A

Single papilloma

 B

Multiple papillomatosis

 C

Osteoma

 D

Sarcoma

Ans. B

Explanation:

Ans. is ‘b’ i.e., Multiple papillomatosis

o Multiple warts are common.

Quiz In Between


Q. 10

Bivalent HPV vaccine contains which types

 A

Type 6,11

 B

Type 6,16

 C

Type 16,18

 D

Type 11,18

Q. 10

Bivalent HPV vaccine contains which types

 A

Type 6,11

 B

Type 6,16

 C

Type 16,18

 D

Type 11,18

Ans. C

Explanation:

Ans. is ‘c’ i.e., Type 16,18

Human papillomavirus (HPV) vaccine

  • HPV is one of the most important risk factor for cervical cancer, widespread vaccination has the potential to reduce cervical cancer deaths around the world by as much as two thirds, if all women were to take the vaccine and if protection turns out to be long term.
  • In addition, the vaccine can reduce the need for medical care, biopsies and invasive procedures associated with the follow up from abnormal pap tests. Thus, helping to reduce the health care costs and anxieties related to abnormal pap tests and follow up procedures.
  • HPV vaccines are ‑

1) Preventive vaccines

  • The role of HPV vaccine is to prevent infection with certain species of Human papillomavirus associated with the development of cervical cancer, genital warts and some less common type of cancers.
  • These vaccines are based on virus like particles (VLPs) assembled from recombinant HPV coat proteins (major capsid protein L1).
  • Currently, one quadrivalent product containing HPV types 6,11,16 and 18 has been licenced in US and recommended by the centres for disease control and prevention for administration to girls and young women 9-26 years of age — type 16 and 18 are most important as they cause 70% of cervical cancer world wide.
  • Another product contains HPV types 16 and 18 ( bivalent) and is likely to be available in the near future.

2) Therapeutic vaccines (under trial)

  • In addition to above two preventive vaccines, laboratory research and several human clinical trials are focused on the development of therapetic HPV vaccines. In general these vaccines focus on the main HPV oncogenes, E6 and E7. Since expression of E6 and E7 is required for promoting the growth of cervical cancer cells and cells within warts, it is hoped that immune responses against two oncogenes might eradicate established tumors.

Q. 11

This condition  are most commonly caused by which of the following serotypes of HPV

 A

HPV 6

 B

HPV 16

 C

HPV 18

 D

HPV33

Q. 11

This condition  are most commonly caused by which of the following serotypes of HPV

 A

HPV 6

 B

HPV 16

 C

HPV 18

 D

HPV33

Ans. A

Explanation:

This condition is Genital Warts (condyloma accuminata)

Ans A

HPV is most commonly associated with anogenital carcinomas, which includes cervical carcinomas.
 
Certain human malignancies are associated with viruses.
  • Burkitt’s lymphoma (Epstein-Barr virus)
  • Hepatocellular carcinoma (hepatitis viruses)
  • Cervical cancer [human papillomavirus (HPV)]
  • T cell leukemia (retroviruses)

Q. 12

HPV causes ‑

 A

Condylomalata

 B

Condyloma acuminata

 C

Bubo

 D

Chancre

Q. 12

HPV causes ‑

 A

Condylomalata

 B

Condyloma acuminata

 C

Bubo

 D

Chancre

Ans. B

Explanation:

Ans. is ‘b’ i.e., Condyloma acuminata

Quiz In Between


Q. 13

Cervical warts are seen with which HPV ‑

 A

11,13

 B

6, 11

 C

17,18

 D

5, 8

Q. 13

Cervical warts are seen with which HPV ‑

 A

11,13

 B

6, 11

 C

17,18

 D

5, 8

Ans. B

Explanation:

Ans. is ‘b’ i.e., 6, 11


Q. 14

Most common type of HPV associated with cervical cancer ‑

 A

6, 11

 B

5, 8

 C

16, 18

 D

6, 8

Q. 14

Most common type of HPV associated with cervical cancer ‑

 A

6, 11

 B

5, 8

 C

16, 18

 D

6, 8

Ans. C

Explanation:

Ans. is `c’ i.e., 16, 18

  • HPV DNA of oncogenic types (High risk) in HPV-16, 18, 31, 33 and 45 → associated with cervical cancer 
  • HPV-6 and 11 (Low risk HPV) → associated with precursor lesions of cervical cancer (CIN) and Condyloma Acuminatum.
  • In patients with epidermodysplasia verruciformis, Squamous cell cancer develop frequently at sites infected with specific HPV types, including 5 and 8.
  • E6 and E7genes of HPV are responsible for carcinogenicity.

Quiz In Between



Borrelia and Relapsing Fever

Borrelia and Relapsing Fever

Q. 1 Epidemics of Relapsing Fever are caused by:
 A Louse
 B Soft tick
 C Hard tick
 D Rat flea 
Q. 1 Epidemics of Relapsing Fever are caused by:
 A Louse
 B Soft tick
 C Hard tick
 D Rat flea 
Ans. A

Explanation:

Louse


Q. 2

All of the following species of borrelia are associated with Tick Borne Relapsing Fever, EXCEPT:

 A

Borrelia Recurrentis

 B

Borrelia Hermsii

 C

Borrelia Turicatae

 D

Borrelia Duttanii

Q. 2

All of the following species of borrelia are associated with Tick Borne Relapsing Fever, EXCEPT:

 A

Borrelia Recurrentis

 B

Borrelia Hermsii

 C

Borrelia Turicatae

 D

Borrelia Duttanii

Ans. A

Explanation:

Epidemic relapsing fever or Louse-borne fever is caused by Borrelia Recurrentis and is transmitted from person to person by Pediculus humanus.

Ref: Harrison’s Principles of Internal Medicine, 17th Edition, Pages 1052-53; Clinical Laboratory Medicine By Macclatchey, 2nd Edition, Page 1119


Q. 3

Which one of the following microorganisms uses antigenic variation as a major means of evading host-defences –

 A

Streptococcus pneumoniae

 B

Borrelia recurrentis

 C

Mycobacterium tuberculosis

 D

Listeria monocytogenes

Q. 3

Which one of the following microorganisms uses antigenic variation as a major means of evading host-defences –

 A

Streptococcus pneumoniae

 B

Borrelia recurrentis

 C

Mycobacterium tuberculosis

 D

Listeria monocytogenes

Ans. B

Explanation:

Ans. is ‘b’ i.e., Borrelia recurrentis 

.  “Borrelia readily undergoes antigenic variations in vivo and this is believed to be the reason for the occurrence of relapses in the disease”.

Antigenic variations are caused by DNA rearrangements in linear plasmids present in borrelia. This rearrangement occurs within “Vmp genes” located in the plasmid. Vmp genes encode variable major proteins (VMPs) found on the spirochete’s outer membrane surface.

.  This ability to vary surface antigen allows bacteria to survive for a longer time because antibody produced in response to infection by one strain of pathogen will not protect against subsequent attacks from a different strain of that bacterium.

Quiz In Between


Q. 4

All of the following species of borrelia are associated with tick borne relapsing fever, except 

 A

Borrelia recurrentis

 B

Borrelia hermsii

 C

Borrelia turicatae

 D

Borrelia duttani

Q. 4

All of the following species of borrelia are associated with tick borne relapsing fever, except 

 A

Borrelia recurrentis

 B

Borrelia hermsii

 C

Borrelia turicatae

 D

Borrelia duttani

Ans. A

Explanation:

Ans. is. ‘a’ i.e. Borrelia recurrentis 


Q. 5

Tick born relapsing fever is/are caused by

 A

Borrelia recurrentis

 B

Borrelia duttonii

 C

Borrlia burgdorferi

 D

All

Q. 5

Tick born relapsing fever is/are caused by

 A

Borrelia recurrentis

 B

Borrelia duttonii

 C

Borrlia burgdorferi

 D

All

Ans. B

Explanation:

Ans. is ‘b’ i.e., Borrelia duttonii


Q. 6

Louse borne relapsing fever

 A

B duttoni

 B

B recurrentis

 C

B parkeri

 D

B burgdorferi

Q. 6

Louse borne relapsing fever

 A

B duttoni

 B

B recurrentis

 C

B parkeri

 D

B burgdorferi

Ans. B

Explanation:

Ans. is ‘b’ i.e., B. recurrentis 

Quiz In Between


Q. 7

Soft tick transmits –

 A

Relapsing fever

 B

KFD

 C

Tularemia

 D

Indian tick typhus

Q. 7

Soft tick transmits –

 A

Relapsing fever

 B

KFD

 C

Tularemia

 D

Indian tick typhus

Ans. A

Explanation:

Ans. is .a, i.e., Relapsing fever


Q. 8

True about Borrelia recurrentis are all except:

March 2007

 A

Causes epidemic relapsing fever

 B

It is transmitted by ixodes tick

 C

No other known animal reservoir of B. recurrentis exists

 D

It infects the person via mucous membranes

Q. 8

True about Borrelia recurrentis are all except:

March 2007

 A

Causes epidemic relapsing fever

 B

It is transmitted by ixodes tick

 C

No other known animal reservoir of B. recurrentis exists

 D

It infects the person via mucous membranes

Ans. B

Explanation:

Ans. B: It is transmitted by ixodes tick

Diseases caused by Borrelia are:

1. Lyme Borreliosis

The major Borrelia species causing Lyme disease are Borrelia burgdorferi, Borrelia afzelii, Borrelia garinii and Borrelia valaisiana. Lyme disease/ borreliosis is transmitted by ticks.

2. Relapsing fever

Borrelia recurrentis causes epidemic relapsing fever caused by the human body louse. No other known animal reservoir of B. recurrentis exists.

B. recurrentis infects the person via mucous membranes and then invades the bloodstream.


Q. 9

The vector shown in the photograph below can transmit all of the following except? 

 A

Borrelia recurrentis.

 B

Borrelia duttoni.

 C

Borrelia hermsii.

 D

Borrelia parkeri.

Q. 9

The vector shown in the photograph below can transmit all of the following except? 

 A

Borrelia recurrentis.

 B

Borrelia duttoni.

 C

Borrelia hermsii.

 D

Borrelia parkeri.

Ans. A

Explanation:

The vector shown in the photograph above represents soft tick.

Soft tick transfers all of the following except Borrelia recurrentis.

Quiz In Between



Mycobacteria other than Tuberculosis-MOTTS/Atypical mycobacteria

Mycobacteria other than Tuberculosis-MOTTS/Atypical mycobacteria

Q. 1

Which of the following is a scotochromogen?

 A

M.fortuitum

 B

M.kansasii

 C

M.ulcerans

 D

M.scrofulaceum

Q. 1

Which of the following is a scotochromogen?

 A

M.fortuitum

 B

M.kansasii

 C

M.ulcerans

 D

M.scrofulaceum

Ans. D

Explanation:

The organisms which produce the pigment chiefly in the dark are called scotochromogens. M. scrofulaceum causes scrofula, a granulomatous cervical adenitis, usually in children.

(M. tuberculosis also causes scrofula.) The organism enters through the oropharynx and infects the draining lymph nodes.


Its natural habitat is environmental water sources, but it has also been isolated as a saprophyte from the human respiratory tract.

Scrofula can often be cured by surgical excision of the affected lymph nodes.

Mycobacterium fortuitum-chelonae complex is composed of two similar species, M. fortuitum and M. chelonei.
They are saprophytes, found chiefly in soil and water, and rarely cause human disease.
Infections occur chiefly in two populations: (1) immunocompromised patients and (2) individuals with prosthetic hip joints and indwelling catheters.
It is a rapidly growing mycobacteria.
M. kansasii causes lung disease clinically resembling tuberculosis.
It is a photochromogen.
Do You Know:
Mycobacterium marinum causes “swimming pool granuloma,” also known as “fish tank granuloma”.
Ref – Levinson W. (2012). Chapter 21. Mycobacteria. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.

Q. 2

What is the etiological agent for buruli ulcer which usually occur in the tropics?

 A

Mycobacterium ulcerans

 B

Mycobacterium marinum

 C

Mycobacterium kansasii

 D

Mycobacterium fortuitum

Q. 2

What is the etiological agent for buruli ulcer which usually occur in the tropics?

 A

Mycobacterium ulcerans

 B

Mycobacterium marinum

 C

Mycobacterium kansasii

 D

Mycobacterium fortuitum

Ans. A

Explanation:

Mycobacterium ulcerans is the causative organism for Buruli ulcer disease. It is the third most frequent mycobacterial pathogen, after M. tuberculosis and M. leprae. Children are most often affected. Infected individuals develop severe ulceration involving the skin and subcutaneous tissue that is often progressive unless treated effectively. Surgical excision and grafting are usually needed. Antimicrobial treatment is often unsuccessful. 
 
Ref: Sethi A. (2012). Chapter 184. Tuberculosis and Infections with Atypical Mycobacteria. In L.A. Goldsmith, S.I. Katz, B.A. Gilchrest, A.S. Paller, D.J. Leffell, N.A. Dallas (Eds), Fitzpatrick’s Dermatology in General Medicine, 8e.

Q. 3

Which one of the following statement is true regarding pathogenicity of Mycobacteria species ‑

 A

M. tuberculosis is more pathogenic than M.bovis to the humans

 B

M. Kansasii can cause a disease indistinguishable from tuberculosis

 C

M.Africanum infection is acquired from the environmental source

 D

M.Marinum is responsible for tubercular lymphadenopathy

Q. 3

Which one of the following statement is true regarding pathogenicity of Mycobacteria species ‑

 A

M. tuberculosis is more pathogenic than M.bovis to the humans

 B

M. Kansasii can cause a disease indistinguishable from tuberculosis

 C

M.Africanum infection is acquired from the environmental source

 D

M.Marinum is responsible for tubercular lymphadenopathy

Ans. B

Explanation:

Ans. is ‘b’ i.e., M. Kansasii can cause a disease indistiguishable from tuberculosis

M. Kansasii can produce pulmonary and systemic disease indistinguishable from tuberculosis – Jawetz 

.   M tuberculosis and mycobacterium bovis are equally pathogenic for humans. 

Mycobacterium tuberculosis complex refers to a group of very closely related species, all of them cause tuberculosis in man and many other mammals. M. Africanum is one of the member of Mycobacterium tuberculosis complex, frequent sources of this are human or monkey. Environmental source is important for Atypical Mycobacteria (Non Tuberculosis mycobacteria)

.       Members of M. Tuberculosis complex

– M. tuberculosis

– M. bovis

– M. africanum

– M. microti

.    M. marinum causes swimming pool granuloma.


Quiz In Between


Q. 4

Which of the following is not a rapidly growing atypical mycobacteria causing lung infections ‑

 A

M. chelonae

 B

M.fortuitum 

 C

M.abscessus

 D

M.kansasii

Q. 4

Which of the following is not a rapidly growing atypical mycobacteria causing lung infections ‑

 A

M. chelonae

 B

M.fortuitum 

 C

M.abscessus

 D

M.kansasii

Ans. D

Explanation:

Ans. is ‘d’ i.e., M.kansasii 


Q. 5

Which of the following are photo-chromogens –

 A

M. kansasii

 B

M. chelonae

 C

M. fortuitum

 D

All

Q. 5

Which of the following are photo-chromogens –

 A

M. kansasii

 B

M. chelonae

 C

M. fortuitum

 D

All

Ans. A

Explanation:

Ans. is ‘a’ i.e., M. kansasii


Q. 6

Which of the following is not a pathogenic mycobacteria –

 A

M. Kansasii

 B

M. scrofulaceum

 C

M. cheolonei

 D

M. smegmatis

Q. 6

Which of the following is not a pathogenic mycobacteria –

 A

M. Kansasii

 B

M. scrofulaceum

 C

M. cheolonei

 D

M. smegmatis

Ans. D

Explanation:

Ans. is ‘d’ i.e., M.smegmatis 

Saprophytic mycobacteria not associated with human illness.

.     M. phlei                              . M. smegmatis

.     M. gordonae                      . M. paratuberculosis

Quiz In Between


Q. 7

Fish tank granuloma is seen in – 

 A

M fortuitum

 B

M kansasi

 C

M marinum

 D

M leprosy

Q. 7

Fish tank granuloma is seen in – 

 A

M fortuitum

 B

M kansasi

 C

M marinum

 D

M leprosy

Ans. C

Explanation:

Ans. is ‘c’ i.e., M. Marinum 

  • ‘ Fish tank granuloma’, also called swimming pool granuloma’ , is caused by M. marinum.

Q. 8

Tuberculosis complex include all except –

 A

M. tuberculosis

 B

M. bovis

 C

M. kansasii

 D

M. microti

Q. 8

Tuberculosis complex include all except –

 A

M. tuberculosis

 B

M. bovis

 C

M. kansasii

 D

M. microti

Ans. C

Explanation:

Ans. is ‘c’ i.e., M. kansasii 

  • M. kansasii is a non-tubercular (atypical) mycobacterium.
  • Members of TB complex are M. tuberculosis, M. bovis, M. africanum, M. microti and M. conettii.

Q. 9

Which of the following is scotochromogen- 

 A

M. scrofulaceum

 B

M. ulcerans

 C

M. Kansasii

 D

M. fortuitum

Q. 9

Which of the following is scotochromogen- 

 A

M. scrofulaceum

 B

M. ulcerans

 C

M. Kansasii

 D

M. fortuitum

Ans. A

Explanation:

Ans. is ‘a’ i.e., M. Scrofulaceum 

Quiz In Between


Q. 10

All are rapid growers except –

 A

M.fortuitum

 B

M.chelonae

 C

M.avium intracellulare

 D

M. Smegmatis

Q. 10

All are rapid growers except –

 A

M.fortuitum

 B

M.chelonae

 C

M.avium intracellulare

 D

M. Smegmatis

Ans. C

Explanation:

Ans. is ‘c’ i.e., M.avium intracellulare 


Q. 11

Not a pathogenic mycobacterium –

 A

M. paratuberculosis 

 B

M. kansasii

 C

M. ulcerans

 D

M. intracellulare

Q. 11

Not a pathogenic mycobacterium –

 A

M. paratuberculosis 

 B

M. kansasii

 C

M. ulcerans

 D

M. intracellulare

Ans. A

Explanation:

Ans. is ‘a’ i.e., M. paratuberculosis 


Q. 12

Which does not cause skin involvement

 A

M. tuberculosis

 B

M. Ulcerans

 C

M. Marinum

 D

M. Kansasii

Q. 12

Which does not cause skin involvement

 A

M. tuberculosis

 B

M. Ulcerans

 C

M. Marinum

 D

M. Kansasii

Ans. D

Explanation:

Ans. is ‘d’ i.e., M.kansasii 

Quiz In Between


Q. 13

Swimming pool granuloma is caused by- 

 A

M. Bovius

 B

M. Ulcerans

 C

M. Kansasii

 D

M. Balanei

Q. 13

Swimming pool granuloma is caused by- 

 A

M. Bovius

 B

M. Ulcerans

 C

M. Kansasii

 D

M. Balanei

Ans. D

Explanation:

Ans. is ‘d’ i.e., M.Balanei 

M. marinum also called as M.balanei causes swiming pool granuloma


Q. 14

M. avium intracellulare is:           

September 2009

 A

Non photochromogens

 B

Scotochromogens

 C

Photochromogens

 D

Rapid growers

Q. 14

M. avium intracellulare is:           

September 2009

 A

Non photochromogens

 B

Scotochromogens

 C

Photochromogens

 D

Rapid growers

Ans. A

Explanation:

Ans. A: Non photochromogens

Runyon Groups

• Pigmentation studies

– Scotochromogens: Pigmentation in the dark (and light)

– Photochromogens: Pigmentation only after exposure to light

– Non-photochromogens: No pigment forms

Group I: photochromogens

–          Mycobacterium kansasii

–          Mycobacterium marinum Group II: scotochromogens

–          Mycobacterium scrofulaceium

–          Mycobacterium gordonae Group III: non-photochromogens

–          Mycobacterium avium complex Group IV: Rapid growers

–          Mycobacterium fortuitum

–           Mycobacterium chelonei


Q. 15

Swimming pool granuloma is caused by:

March 2010

 A

Mycobacterium chelone

 B

Mycobacterium kansasii

 C

Mycobacterium marinum

 D

Mycobacterium ulcerans

Q. 15

Swimming pool granuloma is caused by:

March 2010

 A

Mycobacterium chelone

 B

Mycobacterium kansasii

 C

Mycobacterium marinum

 D

Mycobacterium ulcerans

Ans. C

Explanation:

Ans. C: Mycobacterium marinum

Aquarium granuloma/ Fishtank granuloma/swimming pool granuloma results when water containing an infectious organism, Mycobacterium marinum, enters a break in the skin. A localized infection called a granuloma results after about 3 weeks.

The person usually has a history of exposure to swimming pools, salt water aquarium, or ocean fish.

The lesions appear as reddish bumps (papules) that slowly grow into purplish nodules.

The elbows, fingers, back of the hands, and knees are the most common sites affected. The nodules may break down and leave an open sore, or spread up the limb.

A skin biopsy and culture is usually needed to confirm the diagnosis. A PPD tuberculin skin test will usually be positive.

Quiz In Between



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