bacterial and viral

8/13/2019 Bacterial and Viral

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Test Questions by RSengson, MD

Bacterial Infections 2 and Viral Infection I & II

1. The most common focus of infection of group B streptococcal early-onset

disease of the newborn is the [MPL 0.!". s#in $ meningesB. lungs %. bone

&. "fter diagnosis of pertussis in a toddler' erythromycin should be gi(en to thepatient and to which family members) [MPL 0.*!

". "ll those younger than + years and older than , years of ageB. "ll those who are incompletely immunied$. "ll who are immunocompromised%. "ll regardless of age' symptoms' or immuniation status

*. " preterm normal-appearing infant was born to an 1-year-old female with ahistory of syphilis during the first trimester of pregnancy' as e(idenced by theserocon(ersion of her /%L results titer123' pre(ious nonreacti(e4. The womanrecei(ed one in5ection of benathine penicillin. "t deli(ery' her /%L had a titerof 12,3 637 increase4. 8n e(aluating this infant' the appropriate conclusion is that[MPL9 0.&!

". the mother has been ade:uately treated' and the infant re:uires no furthertherapy

B. the infant has a high probability of ha(ing congenital syphilis and re:uirese(aluation and treatment$. if the infant;s long bone radiographs show no abnormality' no treatment is

indicated%. this child may be gi(en a shot of benathine penicillin' and no further

serologic e(aluation is necessary

3. The best most sensiti(e4 culture specimen for diagnosing Salmonella typhienteric fe(er4 is [MPL90.!

". blood $ cerebrospinal fluidB. stool %. bone marrow aspirate

5. " *-year-old child presents with a fe(er of *


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,. >hat is the most infecti(e stage of Pertussis) [MPL91!". $atarrhal stage $. $on(alescent stageB. Paro7symal stage %. Pertussoid stage

+. " 1*-year-old male was brought to the ? because of difficulty of breathing.@pon arri(al' the physician noted that he was pale and in se(ere respiratorydistress' therefore was subse:uently intubated and was brought to the 8$@ formechanical (entilator support. Ais chest radiography re(ealed presence ofpneumotocoeles on his right lung field. Ae also has numerous s#in boils on all hise7tremities. >hich of the following is most li#ely the cause of his infection)[MPL90.&!

". Mycoplasma pneumoniae c. Staphylococcus aureusB. Bordetella pertussis d. Haemophilus influenzae

&. ou are doing your nursery rotation' and while monitoring' you noticed a neonatewith bright red s#in and multiple' bullous lesions. The infant was cryingincessantly beside his mother who 5ust deli(ered & days ago. The mother was a(ictim of rape' and had no prenatal chec#-up prior to her deli(ery. Because of thelac# of prenatal care and history of rape' your concern was that the baby mightha(e congenital syphilis.

>hat serologic initial screening test would you re:uest to answer your suspicion)[MPL9 0.!

". T. pallidumParticle "gglutination TP-P"4

B. apid Plasma eagin P4

$. =luorescent Treponemal "ntibody "bsorption =T"-"BC4

%. T. pallidumT-P$ test

*. >hat is the bacterial etiologic agent that causes acute febrile respiratory illness'nonproducti(e cough' and e7tensi(e interstitial pneumonia are some of themanifestations caused when inhaling aerosolied e7crements or secretions from

eyes or bea#s of birds) [MPL90.!

". Mycoplasma pneumoniae $. Chlamydophilia psittaci

B. Cryptococcus neoformans %.Mycobacterium bovis


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3. =or pseudomembranous colitis caused by Clostridium difficile' that is notresponsi(e to metronidaole' the drug of choice is2 [MPL91!

". ?rythromycin $. /ancomycin

B. $lindamycin %. "mi#acin

. "ll of the following neonatal infections (accine-pre(entable infections ?D$?PT[MPL90.!

". cytomegalo(irus $. tetanusB. rubella %. diphtheria

,. En e7amining a full-term newborn' the physician noted mild hepatomegaly. Theremainder of the physical findings was normal' including head circumference andretinas. " urine culture grew cytomegalo(irus $M/4. esults of head ultrasoundwere normal. >hat deficit is most li#ely to occur in the ne7t year) [MPL90.*!

". /isual loss $. $irrhosisB. Aearing loss %. Patent ductus arteriosus

+. " -month-old infant was admitted at the hospital because of recurrent diarrhea'persistent oral thrush' anemia' and fe(er of more than 1 month duration. =urther

information re(ealed that his mother was diagnosed to be A8/-positi(e with poorfollow-up. Based on the symptoms abo(e' what A8/-infection $L8F8$"L$"T?GE would this infant fall under) [MPL90.&!

". Fot symptomatic $. Moderately symptomaticB. Mildly symptomatic %. se(erely symptomatic

. "n A8/-seropositi(e female comes to her physician for ad(ice because she ispregnant. Che has ne(er been on any anti(iral medication because she hadremained healthy without symptoms of "8%C. Aowe(er' she wonders whetheranti(iral treatment might diminish the li#elihood of fetal A8/ infection. >hich of

the following statements is $E?$T) [MPL90.&!". Treatment of the pregnant woman will produce maternalthrombocytopenia

B. Treatment will result in (iral resistance in all infected infants$. Treatment will decrease the li#elihood of fetal infection by greater than

0H%. Treatment will ad(ersely affect the fetus and should be a(oided


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hich of the following is FET transmitted by feco-oral route) [MPL91!". Aepatitis " (irus c. Aepatitis % (irusB. Polio(irus d. ?ntero(irus

10." 1-year-old male came in for consult because of 1 wee# duration of cough'rhinorrhea' sorethroat' fe(er' and body malaise. Ae had a history of tra(el toAong#ong' 1 days prior to consult. @pon physical e7amination' he is in mildrespiratory distress' though still ambulatory. Ais blood test results re(ealedleucopenia. "s the attending physician' you suspect C"C. >hich of thefollowing management would you do) [MPL90.*!

". Gi(e oral prophyla7is to all those who handled the patient with oraliba(irin

B. Transfer the patient to an specialied tertiary hospital$. Place patient in an isolation room and ensure infection control and hand

hygiene are being implemented at all times%. Ctart the patient on broad-spectrum antibiotics and facilitate admission toan intensi(e care unit

11. >hich of the following statements is T@? for herpes simple7 (irus infections)[MPL90.*!

". Persons infected remains as reser(oir for infection throughout their lifetimeB. $apable to establish latency in macrophages and lymph nodes$. Person infected are almost always symptomatic%. Latent (irus can multiply within cells and are susceptible to anti(iral

therapy

1&. " +-month-old boy was ha(ing high-grade fe(er of * days with decreasedappetite. Ae continues to be febrile until the thday' when the fe(er suddenlydropped' the infant impro(ed but there were appearance of maculopapularrashes with a flushed face. ou suspect that this child had2 [MPL90.!

". Measles $. ?ntero(irusB. Par(o(irus %. oseola

1*. Aand-foot-and-mouth disease is caused by which (irus) [MPL90.!". $o7sac#ie(irus "1,B. Aerpes(irus type 1$. $o7sac#ie(irus B1%. Aerpes(irus type ,

13. Aighest (iral concentrations of polio(iruses are shed in2 [MPL91!". espiratory secretions $. $utaneous lesions


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B. Ctools %. =omitesI%ust

1.8n the detection of serologic antibody titers' the presence or ele(ated measles

8gM antibodies in a one 14 month old infant would indicate2 [MPL90.!

a. The infant has indicates primary or current measles infection

b. Presence of the measles 8gM on the infant could ha(e passi(ely ac:uiredand transferred from his mother;s placenta.

c. The infant does not ha(e congenital measles.

d. The infant had already reco(ered from measles infection

1,.The presence of gummas would indicate which stage of syphilis infection)

[MPL91!

". Primary stage $. Latent stage

B. Cecondary stage %. Tertiary stage

1+."n 1, year-old male came at the ? because of fe(er and sore throat. Enphysical e7amination' he has enlarged lymph nodes' e7udates on his tonsils andenlarged li(er and spleen. Ais $B$ re(ealed atypical lymphocytosis. Ae(olunteered that he #issed and cared for his girlfriend also had the same illness &

wee#s ago. >hat is the most li#ely etiologic agent for his condition) [MPL90.!". Aepatitis B (irusB. ?pstein-barr (irus$. 8nfluena (irus%. $o7sac#ie(irus "

1.>hich of the following is FET a complication of congenital rubella) [MPL90.!". $ataractsB. Patent ductus arteriosus$. Aydrocephalus

%. %ermal erythropoiesis

1


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$. Fibbling of s#in with bruisingIhematoma%. "ll $ategory 88 e7posures on the head and nec# area

&0.%iane is a pre(iously healthy 10 year old who arri(es at the EP% because of a

rash that appeared * days ago. The rash initially appeared as red papules ande(entually e(ol(ed into (esicles containing fluid. she claimed that her classmatewho sat beside her had the same lesions & wee#s ago. Che recei(ed only thefollowing (accines2 * doses of hepatitis B' * doses of %PT-Polio (accines and 1dose of measles (accine. ou suspect that she has (aricella. >hat would youad(ise the patient) [MPL90.!

". Che should stay at home for &-* wee#s until all her lesions are completelydried and crusted.

B. Che could ta#e aspirin if he has fe(er.$. Che should be admitted to start 8/ acyclo(ir therapy.%. 8t is alright for her to scratch her lesions to relie(e its itching.

&1.Aedes aegypti' which is a day-time biting mos:uito is the (ector for denguehemorrhagic fe(er. >hich of the following statements are T@? regarding this(ector) [MPL90.!

". 8t breeds in free-flowing dirty water.B. Male mos:uitos ta#es repeated meals and has the greatest potency as

(ectors.$. ?ggs resist desiccation when deposited in water containers.%. Mos:uito biting rate correlates which cooler temperatures.

&&. >hich of the following statements isIare indications for hospitaliations fordengue) [MPL91!

". =e(er lasting more than & days with an increasing hematocrit andIordecreasing platelet count

B. Patients with altered sensorium$. Mar#ed anore7ia and thirsting resulting in dehydration%. "ll of the abo(e are true and correct

&*. egarding the spectrum of rota(irus symptoms' all of the following statementsare true ?D$?PT [MPL90.!

". Most se(ere in ages 3 to *, months oldB. Cubse:uent infections are more se(ere$. $auses illness among adults%. $ould lead to se(ere dehydration

&3.%uring the reco(ery phase of dengue infections' the most common problem thatwould arise is2 [MPL90.!


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". Joint pains $. =luid o(erloadB. Aypotension %. Bleeding

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