Infectious Diseases — MCQs

Infectious Diseases Indian Medical PG Practice Questions and MCQs

Question 641: What is the annual infection rate of tuberculosis?

A. Percentage of total patients positive for tuberculin test
B. Percentage of new patients positive for tuberculin test (Correct Answer)
C. Percentage of sputum positive total patients
D. Percentage of sputum positive new patients

Explanation: ***Percentage of new patients positive for tuberculin test*** - The **annual infection rate of tuberculosis (AIRT)** is defined as the percentage of individuals (typically children aged 1-9 years) who show **tuberculin conversion** (from negative to positive) in a given year. - Among the given options, this is the **closest representation** as it focuses on **newly infected individuals** rather than prevalent cases. - AIRT is a key epidemiological indicator reflecting **ongoing transmission** and the **annual risk of tuberculous infection** in a community. - This measure helps assess TB control program effectiveness and disease burden. *Percentage of total patients positive for tuberculin test* - This represents the **prevalence of tuberculosis infection** in the population, including both old and new infections. - It does not specifically measure the **annual rate of acquiring new infections**, which is what AIRT captures. *Percentage of sputum positive total patients* - This indicates the **prevalence of active, infectious pulmonary tuberculosis** in a population. - It refers to individuals with **active TB disease** who are shedding bacteria in sputum, not latent infection detected by tuberculin testing. *Percentage of sputum positive new patients* - This represents the **incidence of new, active, infectious tuberculosis cases** (case detection rate). - While important for TB surveillance, it measures **active disease** rather than **infection rate** detected by tuberculin skin test.

Question 642: Based on the type of life cycle, zoonoses are classified into all of the following except -

A. Cyclo-zoonoses
B. Anthropozoonoses (Correct Answer)
C. Sporozoonoses
D. Meta-zoonoses

Explanation: ***Anthropozoonoses*** - This is **NOT a life cycle-based classification** of zoonoses. - It describes the **direction of transmission** (animals to humans), not the complexity or types of hosts required in the parasite's life cycle. - While a valid classification of zoonoses, it is based on **transmission pattern**, not life cycle characteristics. *Cyclo-zoonoses* - These are zoonoses that require **more than one vertebrate host species** to complete their life cycle, but **no invertebrate host** is involved. - This IS a life cycle-based classification. - Examples include **taeniasis** (tapeworm infections) where the parasite cycles between humans and livestock. *Meta-zoonoses* - These zoonoses require **both vertebrate and invertebrate hosts** to complete their life cycle. - This IS a life cycle-based classification. - The **invertebrate host** acts as an essential part of the life cycle for maturation or multiplication of the pathogen (e.g., **arboviruses** transmitted by mosquitoes, **plague** via fleas). *Sporozoonoses* - While this term is **not part of the standard WHO classification** of zoonoses by life cycle, the prefix "sporo-" refers to **spore-forming stages** in parasitic life cycles. - The standard WHO classification includes: **Orthozoonoses** (direct), **Cyclozoonoses**, **Metazoonoses**, and **Saprozoonoses** (requiring inanimate environment). - However, this term relates to life cycle characteristics (spore stages), not transmission direction.

Question 643: In typhoid, a person is considered a permanent carrier if they excrete bacilli for more than how many months?

A. 3 months
B. 6 months
C. 1 year (Correct Answer)
D. 3 years

Explanation: **1 year** - A person is defined as a permanent carrier of typhoid if they excrete **Salmonella Typhi** in their feces or urine for **more than one year** after the acute illness. - This long-term excretion is often associated with chronic infection of the **gallbladder**, particularly in individuals with gallstones. - The definition of chronic/permanent carrier status is set at **≥12 months** of continuous bacillary excretion. *3 months* - Excreting bacilli for 3 months after acute typhoid is considered a **convalescent carrier state**, not a permanent one. - Many individuals clear the infection within this timeframe without becoming chronic carriers. *6 months* - While prolonged, 6 months of excretion still falls under the definition of a **convalescent or temporary carrier**, rather than a permanent carrier. - The threshold for "permanent" or "chronic" carrier status is typically set at 12 months. *3 years* - While a person excreting bacilli for 3 years would certainly be a permanent carrier, the established definition for permanent carrier status is met at **1 year**, not 3 years. - This option represents an unnecessarily longer duration than the standard definition.

Question 644: Which of the following diseases is classified under category-B of bioterrorism?

A. Anthrax
B. Plague
C. Botulism
D. Cholera (Correct Answer)

Explanation: ***Cholera*** - **Cholera** is classified under **Category B** agents due to its moderate ease of dissemination, moderate morbidity rates, and low mortality rates. - While it can cause severe diarrheal disease, its treatment is relatively straightforward with **rehydration therapy**, and it poses a lower risk of mass casualties compared to Category A agents. *Anthrax* - **Anthrax** is a **Category A** bioterrorism agent, characterized by its high mortality rate, ease of dissemination, and potential for major public health impact. - It poses a significant threat due to its ability to form **spores** that are highly resistant and can cause severe lung infection. *Plague* - **Plague** is designated as a **Category A** agent because of its high potential for mass dissemination, high mortality if untreated, and potential to cause widespread panic. - It can be spread via **aerosols** and can lead to severe systemic illness. *Botulism* - **Botulism** is classified as a **Category A** agent due to the extreme potency of the **botulinum toxin**, even in minute quantities, which can cause severe flaccid paralysis and death. - It has a high potential for causing severe public health impact and requires complex medical interventions.

Question 645: All are features of yellow fever except?

A. Caused by vector aedes
B. IP 3-6 days
C. 1 attack gives life long immunity
D. Validity of vaccination begins immediately after vaccination (Correct Answer)

Explanation: ***Validity of vaccination begins immediately after vaccination*** - Yellow fever vaccine is highly effective, but **immunity does not develop immediately**; it typically offers protection starting **10 days after vaccination**. - This delay is crucial for travelers to endemic areas, as they need to be vaccinated well in advance to ensure protection. *IP 3-6 days* - The **incubation period (IP)** for yellow fever is indeed short, usually ranging from **3 to 6 days** after the bite of an infected mosquito. - This brief incubation period contributes to the rapid onset of symptoms once infected. *1 attack gives life long immunity* - Similar to many viral infections, a single bout of yellow fever infection generally provides **lifelong immunity** against future infections. - This is why the vaccine is so effective, as it mimics natural infection to induce comprehensive, long-term protection. *Caused by vector aedes* - Yellow fever is transmitted primarily by **Aedes mosquitoes**, particularly **Aedes aegypti**, which are responsible for urban and jungle cycles of transmission. - These mosquitoes are prevalent in tropical and subtropical regions of Africa and South America.

Question 646: The international quarantine period for yellow fever as approved by the Government of India is ?

A. 6 days (Correct Answer)
B. 9 days
C. 10 days
D. 12 days

Explanation: ***6 days*** - The **incubation period** for yellow fever is typically 3-6 days, and the 6-day quarantine period is internationally accepted to cover this range. - This period is established to prevent the importation and spread of the disease by ensuring that individuals arriving from endemic areas do not develop symptoms after arrival. *9 days* - This duration is **longer than the internationally recognized incubation period** for yellow fever and is not the standard quarantine period. - Implementing a 9-day quarantine would be excessive and not based on the typical disease progression. *10 days* - A 10-day quarantine period is also **not the standard** for yellow fever as approved by international health regulations or by the Government of India. - While some diseases may require a 10-day quarantine, yellow fever's incubation period makes 6 days sufficient. *12 days* - A 12-day quarantine is **significantly longer** than necessary for yellow fever, as virtually all cases would manifest symptoms within the first 6 days. - This period is typically associated with diseases with much longer incubation periods, which is not the case for yellow fever.

Question 647: Infectivity period of chickenpox is ?

A. 1 day before and 4 days after appearance of rash (Correct Answer)
B. Only when scab falls
C. Entire incubation period
D. 4 days before and 5 days after appearance of rash

Explanation: ***1 day before and 4 days after appearance of rash*** - The infectivity period of **chickenpox (varicella)** begins approximately **1-2 days (24-48 hours) before the rash appears**. - It extends until **all lesions have crusted over**, which typically occurs around **5-6 days after rash onset**, though some sources cite **4-5 days**. - This option represents the **commonly accepted timeframe** taught in Indian medical curricula and NEET PG examinations. *4 days before and 5 days after appearance of rash* - The **pre-rash infectivity period is too long** in this option; chickenpox is infectious for only **1-2 days before rash**, not 4 days. - While the "5 days after" is medically accurate, the incorrect pre-rash duration makes this option wrong. *Only when scab falls* - This statement is **incorrect**; infectivity starts much earlier, **1-2 days before the rash appears**. - By the time scabs fall, the person is **no longer infectious**, as crusted lesions contain non-infectious material. - This option ignores the critical **pre-rash and early rash infectious period**. *Entire incubation period* - The **incubation period** for chickenpox is usually **10-21 days**, during which the individual is **not infectious** for most of this time. - Infectivity begins only in the **last 1-2 days of incubation** (just before rash onset) and continues into the eruptive phase, not for the entire duration.

Question 648: What is the date observed as World AIDS Day?

A. 7 April
B. 3 May
C. 5 June
D. 1 December (Correct Answer)

Explanation: ***Correct Answer: 1 December*** - **World AIDS Day** is observed annually on **December 1st** to raise awareness about the AIDS pandemic caused by the spread of **HIV infection** and to mourn those who have died of the disease. - This date was chosen by James W. Bunn and Thomas Netter, two public information officers for the Global Programme on AIDS at the **World Health Organization (WHO)**, in August 1987. - The first World AIDS Day was observed in **1988**. *Incorrect: 7 April* - **April 7th** is recognized as **World Health Day**, which marks the anniversary of the founding of the World Health Organization (WHO) in 1948. - This day focuses on a specific health theme each year to highlight a priority area of concern for the WHO. *Incorrect: 3 May* - **May 3rd** is celebrated as **World Press Freedom Day**, which aims to raise awareness of the importance of freedom of the press and to remind governments of their duty to respect and uphold the right to freedom of expression. - This date does not have a direct association with AIDS awareness or public health campaigns. *Incorrect: 5 June* - **June 5th** is designated as **World Environment Day**, the United Nations' principal vehicle for encouraging worldwide awareness and action for the protection of our environment. - This day is focused on environmental issues and sustainability, not specifically on HIV/AIDS.

Question 649: What is the recommended concentration of diethylcarbamazine in DEC medicated salt for the treatment of endemic filariasis?

A. 5-10 gm/kg
B. 0.1-0.2 gm/kg (Correct Answer)
C. 0.5-1.0 gm/kg
D. 2-4 gm/kg

Explanation: ***0.1-0.2 gm/kg*** - The recommended concentration of **diethylcarbamazine (DEC)** in medicated salt for the treatment of endemic filariasis is typically 0.1-0.2 gm/kg of salt. - This low, sustained dose helps to gradually eliminate microfilariae and prevent transmission without causing severe adverse reactions. *0.5-1.0 gm/kg* - This concentration is significantly higher than the standard recommendation for mass drug administration using DEC medicated salt. - Such a higher dose would increase the risk of adverse drug reactions, making it unsuitable for community-wide use. *2-4 gm/kg* - This concentration is far too high for safe and effective use in DEC medicated salt programs. - Administering DEC at this level would likely lead to widespread and potentially severe side effects among the treated population. *5-10 gm/kg* - Concentrations in this range are excessively high and would be toxic if used in medicated salt for filariasis treatment. - This would result in widespread and severe adverse events, making it an unacceptable option.

Question 650: What is the most common Anopheles mosquito responsible for malaria in India?

A. Anopheles stephensi
B. Anopheles subpictus
C. Anopheles culicifacies (Correct Answer)
D. Anopheles fluviatilis

Explanation: ***Anopheles culicifacies*** - This species is the **most common and primary malaria vector in India**, responsible for approximately 60-70% of all malaria transmission in the country. - It is the **major rural vector** of malaria, especially in agricultural areas, and transmits both *Plasmodium vivax* and *P. falciparum*. - Given that the majority of India's population resides in rural areas where malaria burden is highest, *A. culicifacies* is the most important vector overall. *Anopheles stephensi* - This species is recognized as the **primary urban vector** of malaria in India, particularly for *P. vivax* and *P. falciparum*. - Its ability to breed in artificial containers makes it well-adapted to urban environments, but it accounts for a smaller proportion of total malaria cases compared to *A. culicifacies*. *Anopheles fluviatilis* - This species is an **important vector in hilly and forest areas** of India, rather than being the most common overall. - It is known to transmit both *P. vivax* and *P. falciparum* in these specific ecological niches. *Anopheles subpictus* - While present in India, *A. subpictus* is generally considered a **poor vector** of malaria due to its low susceptibility to Plasmodium infection. - It mainly breeds in diverse habitats including paddy fields and brackish water.

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