Infectious Diseases Practice Questions

Q: Which of the following statements are correct about oral rotavirus vaccines? I. The storage should be at 2-8°C II. The vaccine should be used within 2 hours of reconstitution or opening III. Past history of intussusception is a contraindication IV. The vaccine can be given if the baby has ongoing diarrhoea Select the answer using the code given below :

I and III. ***I and III*** * **Oral rotavirus vaccines** require storage at **2-8°C** to maintain potency (cold chain maintenance is essential). * A past history of **intussusception** is an **absolute contraindication** due to increased risk of recurrence. *I and II* * While statement I is correct, statement II is incorrect because oral rotavirus vaccines (Rotarix, RotaTeq) are **ready-to-use liquid formulations** that do **not require reconstitution**. Once the container is opened, the vaccine should be **administered immediately** during the same vaccination visit, not stored for 2 hours. *II and IV* * Statement II is incorrect as oral rotavirus vaccines are **ready-to-use** and should be **administered immediately** after opening, without any reconstitution. * Statement IV is incorrect because the vaccine **should be postponed** if the baby has ongoing **moderate to severe diarrhoea** or vomiting, as this may affect vaccine absorption and effectiveness. Mild diarrhea is not a contraindication, but significant gastroenteritis warrants deferral. *III and IV* * While statement III is correct, statement IV is incorrect because ongoing **moderate to severe diarrhoea** is a reason to **postpone** administration of the rotavirus vaccine until the child recovers.

Q: All cases of severe measles and all cases of measles in areas with high case fatality rate need to be treated with which of the following vitamins?

Vitamin A. ***Vitamin A*** - **Vitamin A supplementation** is recommended for severe measles cases, especially in areas with high case fatality rates. - It helps to reduce morbidity and mortality by improving immune function and supporting the integrity of epithelial tissues. *Vitamin K* - **Vitamin K** is primarily involved in **blood clotting** and bone metabolism. - There is no established role for Vitamin K supplementation in the treatment or prognosis of measles. *Vitamin C* - **Vitamin C** is an **antioxidant** and supports immune function, but its role in measles management is not supported by strong evidence or recommendations. - While beneficial for overall immunity, it is not specifically indicated for severe measles as a life-saving intervention. *Vitamin D* - **Vitamin D** plays a crucial role in **bone health** and modulating the immune system. - Like Vitamin C, it has general immune benefits but is not a specific or recommended treatment for severe measles or its complications.

Q: In measles, when do the Koplik's spots appear?

1-2 days before the rashes appear. ***1-2 days before the rashes appear*** - **Koplik's spots** are considered an **enanthem**, a pathognomonic sign of **measles**. - These small, white spots with a bluish-white center on an erythematous base on the buccal mucosa typically appear 1-2 days before the generalized maculopapular rash. *On the day that rashes appear* - The generalized **maculopapular rash** of measles typically appears a few days *after* Koplik's spots. - While the rash is a hallmark of measles, it is preceded by the oral lesions. *On the day that fever occurs* - **Fever** is usually one of the initial symptoms of measles, often appearing several days before Koplik's spots. - The fever is part of the **prodromal phase**, which includes cough, coryza, and conjunctivitis. *1-2 days before the fever occurs* - Measles symptoms, including fever, are usually the first indicators of infection, making it unlikely for a specific sign like Koplik's spots to appear before the fever itself. - The incubation period precedes any symptoms, including fever.

Q: Varicella-Zoster Immunoglobulin (VZIG) is NOT recommended for which of the exposed susceptible individuals?

Healthy sibling. ***Correct: Healthy sibling*** - VZIG is administered to **susceptible individuals** upon exposure to **Varicella-Zoster Virus (VZV)** to prevent or attenuate the infection - A **healthy sibling** with a **competent immune system** would typically mount an adequate immune response to the virus - VZIG is therefore **NOT indicated** for immunocompetent individuals as they can handle the infection naturally - VZIG is reserved for **high-risk populations** where varicella could cause severe complications *Incorrect: HIV/AIDS positive* - Individuals with **HIV/AIDS** are considered **immunocompromised** and are at **higher risk** for severe varicella infection and complications - VZIG **IS recommended** for these patients after exposure to VZV to provide **passive immunity** and reduce disease severity - This is particularly important in patients with CD4 counts <200 cells/μL *Incorrect: Newborn* - **Newborns** whose mothers developed varicella **5 days before to 2 days after delivery** are at high risk for severe, disseminated neonatal varicella - **VZIG IS recommended** for these neonates to offer immediate protection against the virus - Also indicated for premature infants <28 weeks or <1000g who are exposed, regardless of maternal immunity *Incorrect: Pregnant women* - **Pregnant women** who are **non-immune to varicella** and exposed to VZV are at risk for both **maternal complications** (varicella pneumonia) and **fetal abnormalities** (congenital varicella syndrome) - **VZIG IS recommended** for susceptible pregnant women exposed to varicella to reduce the risk of severe maternal disease - Should be administered within **10 days** of exposure, preferably within 96 hours

Q: The classical triad of congenital defects in Congenital Rubella Syndrome include which of the following? 1. Hydrocephalus 2. Deafness 3. Cardiac malformations 4. Cataract

2, 3 and 4. ***2, 3 and 4*** - The classical triad of congenital defects associated with **Congenital Rubella Syndrome (CRS)** typically refers to **deafness**, **cataracts**, and **cardiac malformations**. - These are the most common and prominent features that result from transplacental infection during early pregnancy. *1, 2 and 3 and 4* - This option incorrectly includes **hydrocephalus** as part of the classical triad. While other neurological manifestations can occur in CRS, hydrocephalus is not a defining feature of the classical triad. - The three most prominent and characteristic defects in CRS are **deafness, cataracts, and cardiac malformations**. *1, 2 and 4* - This option incorrectly includes **hydrocephalus** and omits **cardiac malformations**, which is a key component of the classical triad. - The classical triad specifically highlights defects in the **eyes (cataracts)**, **ears (deafness)**, and **heart (cardiac malformations)**. *1, 2 and 3* - This option incorrectly includes **hydrocephalus** and omits **cataracts**, which is a definitive feature of the classical triad of CRS. - While cardiac and auditory defects (deafness) are part of the triad, ocular defects (cataracts) are equally crucial for the classical definition.

Q: Which of the following are the features of Rubella? 1. Rashes appear within 24 hours of onset of symptoms 2. Incubation period is 2 – 3 weeks 3. False membrane is formed in throat 4. Post auricular lymph nodes enlarge Select the correct answer using the code given below:

2 and 4 only. ***Correct: 2 and 4 only*** - **Incubation period of 2-3 weeks** is accurate for rubella (14-21 days) - **Postauricular lymphadenopathy** along with suboccipital and posterior cervical lymph node enlargement are **classic hallmark features** of rubella, often appearing before the rash - These two features correctly identify rubella infection *Incorrect: 1, 2 and 4* - While statements 2 and 4 are correct, **statement 1 is medically inaccurate** - The rubella rash does NOT appear within 24 hours of symptom onset - Rubella typically has a **prodromal period of 1-5 days** with low-grade fever and malaise before the rash appears - The rash spreads from face to trunk within 24 hours, but this is different from appearing within 24 hours of initial symptoms *Incorrect: 2 and 3 only* - While the incubation period (statement 2) is correct, **false membrane formation in the throat** is characteristic of **diphtheria**, not rubella - Rubella does not cause pseudomembranous pharyngitis - This option also omits the classic postauricular lymphadenopathy *Incorrect: 1, 2 and 3* - Statement 1 is inaccurate regarding rash timing - Statement 3 describes diphtheria, not rubella - Only statement 2 (incubation period) is correct in this combination

Q: Which one of the following is the recommended site for immunization with hepatitis B vaccine in young children for ensuring reliable absorption?

Anterolateral aspect of thigh. ***Anterolateral aspect of thigh*** - The **anterolateral aspect of the thigh** is the recommended site for intramuscular injections in infants and young children due to the sufficient muscle mass and lower risk of damaging nerves or blood vessels. - This site ensures reliable absorption of the vaccine due to its **large quadriceps femoris muscle**. *Gluteal region* - The **gluteal region** is generally avoided for intramuscular injections in young children due to the risk of injury to the **sciatic nerve**. - While it has significant muscle mass, the proximity of major nerves makes it less safe for routine vaccinations in this age group. *Anterior aspect of thigh* - The **anterior aspect of the thigh** is not specifically recommended; rather, the **anterolateral aspect** is preferred for its greater muscle mass and safety. - While muscles are present, using the exact anterior aspect might be less reliable for consistent absorption compared to the designated anterolateral site. *Deltoid region* - The **deltoid muscle** is generally too small and underdeveloped in young children and infants to safely administer intramuscular injections. - Using the deltoid in this age group increases the risk of injecting into subcutaneous tissue or hitting underlying nerves/blood vessels, leading to poorer absorption and potential injury.

Q: A 10 week old child comes for vaccination, with previous history of inconsolable cry & fever after getting vaccinated at 6 weeks. What should be done next?

Give DT. ***Correct Option: Give DT*** - **Inconsolable crying** (typically defined as crying ≥3 hours) following pertussis-containing vaccine is classified as a **precaution** for subsequent doses per IAP, CDC, and WHO guidelines - When a **precaution** exists, the pertussis component should be **withheld** from future doses - **DT vaccine** (diphtheria-tetanus without pertussis) ensures continued protection against diphtheria and tetanus while avoiding repeat exposure to the pertussis antigen that likely caused the reaction - This represents appropriate **risk-benefit assessment** in immunization practice *Incorrect: Give DPT vaccination* - Continuing DPT after inconsolable crying ignores established AEFI (Adverse Events Following Immunization) guidelines - While fever alone is not a contraindication, **inconsolable crying is a recognized precaution** that warrants modification of the vaccination schedule - Repeating the same vaccine risks recurrence of the adverse event *Incorrect: Defer for 1 month* - Simply deferring without changing the vaccine type doesn't address the underlying issue - The child would still receive the pertussis component later, risking another adverse reaction - Unnecessary delay in protection against diphtheria and tetanus when DT is available *Incorrect: Administer antibiotics* - **Post-vaccination fever and crying** are inflammatory responses to vaccine antigens, not bacterial infections - Antibiotics have no role in managing vaccine-related reactions - This approach doesn't address the need for continued immunization protection

Question 1

Which of the following statements are correct about oral rotavirus vaccines?
I. The storage should be at 2-8°C
II. The vaccine should be used within 2 hours of reconstitution or opening
III. Past history of intussusception is a contraindication
IV. The vaccine can be given if the baby has ongoing diarrhoea

Select the answer using the code given below :

Accepted Answer

I and III

Answer

I and II

Answer

II and IV

Answer

III and IV

Question 2

All cases of severe measles and all cases of measles in areas with high case fatality rate need to be treated with which of the following vitamins?

Accepted Answer

Vitamin A

Answer

Vitamin K

Answer

Vitamin C

Answer

Vitamin D

Question 3

In measles, when do the Koplik's spots appear?

Accepted Answer

1-2 days before the rashes appear

Answer

On the day that rashes appear

Answer

On the day that fever occurs

Answer

1-2 days before the fever occurs

Question 4

Varicella-Zoster Immunoglobulin (VZIG) is NOT recommended for which of the exposed susceptible individuals?

Accepted Answer

Healthy sibling

Answer

HIV/AIDS positive

Answer

Newborn

Answer

Pregnant women

Question 5

The classical triad of congenital defects in Congenital Rubella Syndrome include which of the following?

1. Hydrocephalus
2. Deafness
3. Cardiac malformations
4. Cataract

Accepted Answer

2, 3 and 4

Answer

1, 2 and 3 and 4

Answer

1, 2 and 4

Answer

1, 2 and 3

Question 6

Which of the following are the features of Rubella?

1. Rashes appear within 24 hours of onset of symptoms
2. Incubation period is 2 – 3 weeks
3. False membrane is formed in throat
4. Post auricular lymph nodes enlarge

Select the correct answer using the code given below:

Accepted Answer

2 and 4 only

Answer

2 and 3 only

Answer

1, 2 and 4

Answer

1, 2 and 3

Question 7

Which one of the following is the recommended site for immunization with hepatitis B vaccine in young children for ensuring reliable absorption?

Accepted Answer

Anterolateral aspect of thigh

Answer

Gluteal region

Answer

Anterior aspect of thigh

Answer

Deltoid region

Question 8

Which statement about congenital syphilis is FALSE?

Accepted Answer

Long bone radiographs are unnecessary in asymptomatic infants born to adequately treated mothers

Answer

Hutchinson's triad includes interstitial keratitis, Hutchinson's teeth, and eighth nerve deafness

Answer

Most infants are asymptomatic at birth

Answer

Treatment of maternal syphilis before 32 weeks gestation prevents most cases

Question 9

A child presents with complaints of fever, rash, body ache, and throat ache. He had a history of thorn prick injury a week back. What antibiotics would you give empirically to this child?

Accepted Answer

Amoxicillin+ clavulanate

Answer

Ceftriaxone

Answer

Vancomycin

Answer

Meropenem

Question 10

A 10 week old child comes for vaccination, with previous history of inconsolable cry & fever after getting vaccinated at 6 weeks. What should be done next?

Accepted Answer

Give DT

Answer

Defer for 1 month

Answer

Administer antibiotics

Answer

Give DPT vaccination

Infectious Diseases — MCQs

Infectious Diseases — MCQs

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