Infectious Diseases Practice Questions

Q: Warthin-Finkeldey giant cells are seen in?

Measles. ***Measles*** - **Warthin-Finkeldey giant cells** are characteristic large, multinucleated cells found in lymphoid tissues during the prodromal and eruptive phases of **measles** (rubeola) [1]. - These cells represent **syncytia** formed by the fusion of infected lymphocytes and macrophages, a hallmark of **measles virus infection** [1]. *Rubella* - Rubella (German measles) is a milder viral infection and does not typically involve the formation of **Warthin-Finkeldey giant cells**. - While it can cause lymphadenopathy, the characteristic histological findings differ significantly from measles. *Rickettsial pox* - Rickettsial pox is caused by *Rickettsia akari* and presents with a rash and flu-like symptoms. - The pathology primarily involves **vasculitis** and does not feature **Warthin-Finkeldey giant cells**. *Influenza* - Influenza is a respiratory viral infection primarily affecting the respiratory epithelium. - It does not lead to the formation of **Warthin-Finkeldey giant cells** in lymphoid tissues. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 362-363.

Q: Thymus gland abscess seen in congenital syphilis is called:

Dubois' abscess. ***Dubois' abscess*** - **Dubois' abscesses** are characteristic microscopic foci of necrosis and granulomatous inflammation that occur in the **thymus gland** in cases of **congenital syphilis**. - They are a specific pathological finding associated with **early congenital syphilis**, reflecting the systemic dissemination of *Treponema pallidum*. *Politzer's abscess* - **Politzer's abscess** is a term mainly associated with an abscess in the external or middle ear, often following **otitis media**. - It has no known association with **congenital syphilis** or the **thymus gland**. *Douglas abscess* - A **Douglas abscess** refers to a collection of pus in the **rectouterine pouch** (pouch of Douglas) in females, or the rectovesical pouch in males. - This is typically a complication of **pelvic inflammatory disease** or appendicitis and is unrelated to the thymus or syphilis. *Fouchier's abscess* - **Fouchier's abscess** is an older term sometimes used to describe an **epidural abscess**, particularly in the spine. - This condition involves an infection within the spinal canal and is not linked to the thymus or congenital syphilis.

Q: Eosinophilic ovoid intranuclear inclusion bodies seen in herpes infection is called as:

Lipschutz bodies.. ***Lipschutz bodies*** - **Lipschutz bodies** are characteristic **eosinophilic ovoid intranuclear inclusion bodies** found in cells infected with **herpes simplex virus (HSV)**. - They represent viral replication within the nucleus and are a key diagnostic feature in histopathology of herpes infections. - These inclusion bodies are typically seen in cervical, vulvar, and penile lesions caused by HSV. *Howell-Jolly bodies* - **Howell-Jolly bodies** are **round, dense, basophilic nuclear remnants** often seen in **red blood cells**. - Their presence indicates hyposplenism or asplenia, not viral infection. *Rushton bodies* - **Rushton bodies** are **hyaline bodies** found in the lining of **odontogenic cysts**, particularly radicular and dentigerous cysts. - They are not related to viral infections and represent keratin or mucous material. *Cowdry bodies* - **Cowdry bodies** are also intranuclear inclusion bodies but are classified into **Type A and Type B**. - **Type A Cowdry bodies** are acidophilic inclusions surrounded by a clear halo, seen in herpes and varicella-zoster infections [1], [2]. - Unlike Lipschutz bodies which are ovoid and eosinophilic, Cowdry A bodies have a characteristic halo and different morphology [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 366-367. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 365-366.

Q: Lipschutz bodies are seen in ?

Herpes. ***Herpes*** - **Lipschutz bodies**, also known as **intranuclear eosinophilic inclusion bodies**, are characteristic cytopathic effects seen in cells infected with the **Herpes Simplex Virus (HSV)** [1]. - These inclusions are visible within the nucleus of epithelial cells, indicating active viral replication and aiding in the histological diagnosis of herpes infections [1]. *Yellow fever* - Yellow fever is caused by a **flavivirus** and does not typically present with Lipschutz bodies. - Histological findings in yellow fever include **Councilman bodies** (apoptotic hepatocytes) and fatty degeneration in the liver. *Hodgkin's disease* - Hodgkin's disease is a **lymphoma**, a type of cancer, and is characterized by the presence of large, often multinucleated **Reed-Sternberg cells**. - It is a neoplastic condition and not an infectious disease associated with viral inclusions like Lipschutz bodies. *Viral hepatitis* - Viral hepatitis, caused by various hepatitis viruses (e.g., HAV, HBV, HCV), primarily affects the **liver** [2]. - Histological changes in viral hepatitis include **hepatocyte necrosis**, inflammation, and immune cell infiltration, but not Lipschutz bodies [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 365-366. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 390-391.

Q: Giant cells in measles are called as:

Warthin-Finkeldey cells. ***Warthin-Finkeldey cells*** - **Warthin-Finkeldey cells** are multinucleated giant cells characteristic of **measles virus infection**. [1] - They are formed by the fusion of infected cells and are found in lymphoid tissues, such as the **lymph nodes**, tonsils, and appendix, during the acute phase of measles. [1] *Weinberger bodies* - **Weinberger bodies** are not a recognized term for giant cells in measles or any other medical condition. - This term does not correspond to any known pathological finding. *Koplik spots* - **Koplik spots** are **pathognomonic enanthem** of measles, appearing as small, white spots with erythematous halos on the buccal mucosa. [1] - While characteristic of measles, they are clinical lesions, not giant cells. *HP bodies* - **HP bodies** (also known as **Henderson-Paterson bodies**) are cytoplasmic inclusion bodies seen in cells infected with **molluscum contagiosum virus**. [2] - These are indicative of molluscum contagiosum, not measles. [2] **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 362-363. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Skin, pp. 1177-1178.

Q: Virchow Lepra cells are seen in:

Lepromatous Leprosy. ***Lepromatous Leprosy*** - **Virchow cells** (also known as **foamy macrophages** or **lepra cells**) are characteristic histological findings in **lepromatous leprosy** [1]. - These cells are macrophages distended with numerous **Mycobacterium leprae bacilli**, forming a foamy or vacuolated appearance due to the stored lipids and bacteria [1]. *Tuberculoid leprosy* - Characterized by a strong cell-mediated immune response, leading to few bacilli and often well-formed **granulomas** [1], [2]. - **Virchow cells** are typically absent because macrophages effectively clear the bacteria [1]. *Indeterminate leprosy* - This is an early, unstable form of leprosy with a low bacterial load and non-specific histological features. - It often lacks the distinct **Virchow cells** seen in lepromatous leprosy or the granulomas of tuberculoid leprosy. *Borderline tuberculoid leprosy* - This form lies between tuberculoid and lepromatous leprosy, with some features of both but leaning towards a more effective immune response than lepromatous. - While lymphocytes and some granuloma formation may be present, it generally does not show the prominent **Virchow cells** characteristic of lepromatous leprosy. **References:** [1] Kumar v, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 385-386. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Disorders Involving Inflammatory And Haemopoietic Cells, pp. 638-639.

Q: A patient from Himachal Pradesh gets a thorn prick and subsequently presents with a verrucous lesion on feet which on microscopy revealed "Copper penny bodies". The diagnosis is

Chromoblastomycosis. ***Chromoblastomycosis*** - The presence of **"copper penny bodies" (sclerotic bodies or Medlar bodies)** on microscopy is pathognomonic for chromoblastomycosis. - This chronic fungal infection typically presents as **verrucous lesions** on the skin, often in exposed areas like the feet, following **traumatic inoculation**, such as a thorn prick. *Eumycetoma* - Characterized by the formation of **grains or granules** composed of fungal hyphae within subcutaneous tissue, usually with **multiple draining sinuses**. - While it can be caused by a thorn prick and affect the feet, it does not typically show "copper penny bodies" on microscopy. *Sporothrix* - Causes **sporotrichosis**, which often presents as **lymphocutaneous nodules** that ulcerate and follow lymphatic drainage, or fixed cutaneous lesions. - Microscopic examination typically reveals **cigar-shaped budding yeasts** in tissue, not copper penny bodies. *Verruca vulgaris* - This is a common **viral wart** caused by the **Human Papillomavirus (HPV)**, presenting as a raised, rough, cauliflower-like papule [1]. - Histologically, it shows **koilocytes** (HPV-infected keratinocytes), but no fungal elements like "copper penny bodies." [1] **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Skin, p. 1178.

Q: Rickettsial infections cause 30% mortality due to?

Endothelial injury. ***Endothelial injury*** - **Rickettsiae** are obligate intracellular bacteria that primarily target and replicate within **endothelial cells**, leading to widespread **endothelial injury** [1]. - This damage results in increased **vascular permeability**, **edema**, and subsequent organ dysfunction, contributing to the high mortality rate in severe cases [1]. *Renal failure* - While **renal failure** can be a complication of severe rickettsial infections due to **hypoperfusion** and direct injury, it is a *consequence* of the initial widespread endothelial damage, not the primary cause of high mortality [1]. - The systemic nature of the endothelial damage affects multiple organs, including the kidneys, leading to multifactorial organ dysfunction rather than isolated renal pathology as the main driver of death [1]. *Hemodynamic instability* - **Hemodynamic instability**, characterized by **hypotension** and **shock**, is a critical manifestation of severe rickettsial infection [1]. However, this instability is a *result* of the widespread **fluid extravasation** and **vasodilation** caused by extensive **endothelial injury**. - The direct damage to the endothelium precedes and drives the hemodynamic changes that contribute to patient demise [1]. *Endocarditis* - **Endocarditis** (inflammation of the heart's inner lining) is an infrequent complication of rickettsial infections and is not considered a primary contributor to the high 30% mortality observed. - The main pathology in rickettsial diseases involves systemic **vasculitis** and microvascular damage rather than focal inflammation of the heart valves, differentiating it from common causes of high mortality. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 392-393.

Q: What is the classic histopathological finding in chancroid?

Intraepidermal neutrophilic microabscesses. ***Intraepidermal neutrophilic microabscesses*** - Chancroid, caused by **Haemophilus ducreyi**, is characterized histopathologically by a three-zone pattern: a superficial layer of **neutrophilic microabscesses**, a mid-zone of **granulation tissue with prominent edematous blood vessels**, and a deep zone of **lymphocytic and plasma cell infiltration**. - The presence of **neutrophilic microabscesses** in the superficial zone is the most classic and distinctive diagnostic feature of chancroid. *Polymorphonuclear infiltrate with vasculitis* - While a polymorphonuclear (neutrophilic) infiltrate is present in chancroid, **vasculitis** (inflammation of blood vessels) is not a primary or classic distinguishing histological feature. - This description is too general and does not capture the specific three-zone pattern and microabscess formation characteristic of chancroid. *Plasma cells at base of ulcer* - Plasma cells are part of the chronic inflammatory response seen in the **deepest layer** of the chancroid ulcer, but they are not the most characteristic or diagnostic finding. - The presence of plasma cells alone does not differentiate chancroid from other chronic inflammatory conditions or other sexually transmitted infections. *Giant cells with intranuclear inclusion bodies* - **Giant cells with intranuclear inclusion bodies** are characteristic of **herpes simplex virus (HSV) infections**, particularly in a **Tzanck smear** or biopsy. - This finding is specific to viral infections and is not associated with the bacterial etiology of chancroid.

Question 1

Warthin-Finkeldey giant cells are seen in?

Accepted Answer

Measles

Answer

Rubella

Answer

Rickettsial pox

Answer

Influenza

Question 2

Thymus gland abscess seen in congenital syphilis is called:

Accepted Answer

Dubois' abscess

Answer

Politzer's abscess

Answer

Douglas abscess

Answer

Fouchier's abscess

Question 3

Eosinophilic ovoid intranuclear inclusion bodies seen in herpes infection is called as:

Accepted Answer

Lipschutz bodies.

Answer

Rushton bodies.

Answer

Cowdry bodies

Answer

Howell-Jolly bodies

Question 4

Lipschutz bodies are seen in ?

Accepted Answer

Herpes

Answer

Yellow fever

Answer

Hodgkin's disease

Answer

Viral hepatitis

Question 5

Giant cells in measles are called as:

Accepted Answer

Warthin-Finkeldey cells

Answer

Weinberger bodies

Answer

HP bodies

Answer

Koplik spots

Question 6

Virchow Lepra cells are seen in:

Accepted Answer

Lepromatous Leprosy

Answer

Tuberculoid leprosy

Answer

Indeterminate leprosy

Answer

Borderline tuberculoid leprosy

Question 7

A patient from Himachal Pradesh gets a thorn prick and subsequently presents with a verrucous lesion on feet which on microscopy revealed "Copper penny bodies". The diagnosis is

Accepted Answer

Chromoblastomycosis

Answer

Sporothrix

Answer

Verruca vulgaris

Answer

Eumycetoma

Question 8

Rickettsial infections cause 30% mortality due to?

Accepted Answer

Endothelial injury

Answer

Renal failure

Answer

Hemodynamic instability

Answer

Endocarditis

Question 9

What is the classic histopathological finding in chancroid?

Accepted Answer

Intraepidermal neutrophilic microabscesses

Answer

Polymorphonuclear infiltrate with vasculitis

Answer

Plasma cells at base of ulcer

Answer

Giant cells with intranuclear inclusion bodies

Question 10

Which feature best differentiates granuloma inguinale from lymphogranuloma venereum?

Accepted Answer

Tissue biopsy findings

Answer

Response to doxycycline

Answer

Presence of buboes

Answer

Systemic symptoms

Infectious Diseases — MCQs

Infectious Diseases — MCQs

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