Infectious diseases Flashcards by Irene Italou

From which age can influenza vaccination be administered?
A) 6 months
B) 12 months
C) 5 years
D) 18 years

A) 6 months

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Against which infectious disease is not post-exposure prophylactic vaccination available?
A) Hepatitis A
B) Tetanus
C) Varicella
D) Pertussis

D) Pertussis

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In case of injury with suspected tetanus infection, in addition to tetanus toxoid vaccination, the injured person should be given passive immunisation if the wound is severely damaged or contaminated with soil, a foreign body is present, in case of head injury, shock, bleeding, severe burn injury, radioactivity and if the time elapsed since the last vaccination of the person receiving the booster dose is more than:
A) 3 years
B) 5 years
C) 10 years
D) in all cases, the injured person must be given passive immunisation, regardless of the time elapsed since the previous tetanus vaccination

C) 10 years

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Minimum interval between therapeutic intravenous immunoglobulin (IVIG) and live virus vaccine is:
A) 4 weeks
B) 3 months
C) 11 months
D) 2 years

C) 11 months

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Contraindications to vaccination, EXCEPT:
A) Convulsions in the family history
B) Febrile illness
C) Vaccination of a pregnant woman with a live virus vaccine
D) Suspected or existing congenital immunodeficiency

A) Convulsions in the family history

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Administered as an oral vaccine:
A) DTaP
B) DTap + IPV + Hib
C) Varilrix/Varivax
D) Rotarix

D) Rotarix

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Effective antibiotic against Pseudomonas aeruginosa, EXCEPT:
A) piperacillin / tazobactam
B) ceftazidime
C) ciprofloxacin
D) cefotaxime

D) cefotaxime

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Common pathogens in endocarditis, EXCEPT:
A) Staphylococcus aureus
B) Alpha-hemolytic Streptococci
C) Enterococcus faecalis
D) Listeria monocytogenes

D) Listeria monocytogenes

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Antibiotic therapy expected to be effective against community-acquired MRSA infection:
A) amoxicillin/clavulanic acid
B) cefixime
C) co-trimoxazole
D) cefprozil

C) co-trimoxazole

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The minimum duration of intravenous treatment for paediatric osteomyelitis should ideally be:
A) intravenous treatment is not recommended
B) 3-4 days
C) 3-4 weeks
D) 6 weeks

B) 3-4 days

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Extrapulmonary manifestations of Mycoplasma pneumoniae may include:
A) acute disseminated encephalomyelitis (ADEM)
B) hepatitis
C) erythema multiforme
D) A, B and C are all correct

D) A, B and C are all correct

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A 13-month-old baby has monosymptomatic fever for 3 days. After resolution of fever maculopapular rash appears on the neck and torso which spread onto the limbs. The baby is in relatively good general condition throughout the course of the disease; appetite, fluid intake is not reduced. What is the most likely diagnosis?
A) Varicella
B) Exanthema subitum
C) Meningococcemia
D) Scarlet fever

B) Exanthema subitum

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Which therapy would you choose in RSV bronchiolitis?
A) dexamethasone
B) inhalatory ribavirin
C) supportive care only
D) remdesivir

C) supportive care only

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A 7-year-old child is hospitalised for 5 days with fever and bloody diarrhoea. Which pathogen is unlikely based on the symptoms?
A) Campylobacter jejuni
B) Salmonella enterica enteritidis
C) EHEC
D) Rotavirus

D) Rotavirus

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For a 3 years old, febrile child, who is returning from a tropical vacation, which test should always be performed?
A) Dengue virus detection
B) Thick and thin smear
C) Stool culture
D) Pharyngeal swab culture

B) Thick and thin smear

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After camping in the forest a 7 years old child is presented with a 10 cm diameter ring-shaped, non-painful, mildly pruritic erythematous macule on the back of his neck. What antibiotic therapy should be recommended?
A) amoxicillin
B) doxycycline
C) azithromycin
D) streptomycin

A) amoxicillin

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A 18 month old child experiences sore throat, fever for 2 days, and loss of appetite. On physical examination, you notice enlarged tonsils with white patches and nodules. Which empirical antibiotic treatment do you recommend?
A) amoxicillin
B) amoxicillin-clavulanic acid
C) cefixime
D) you don’t recommend antibiotic therapy

D) you don’t recommend antibiotic therapy

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A patient who came from Ukraine with unknown vaccination status temporarily gets better after a few days of fever, headache, and gastroenteric symptoms. After a few fever-free days, headache, neck and spinal pain, vegetative symptoms, and ascending paralytic flaccid paralysis appear. Which pathogen is essential to rule out?
A) Listeria monocytogenes
B) West Nile virus
C) Clostridium tetani
D) Poliovirus

D) Poliovirus

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A few hours after Christmas dinner, all members of a family (except the oldest sibling who is vegetarian) of a 9 years old patient are presented with vomiting and diarrhoea. How would you manage your 9 years old patient?
A) Start antibiotic therapy effective against Staphylococcus aureus, as it is the most likely pathogen
B) Start antibiotic therapy effective against Bacillus cereus, as it is the most likely pathogen
C) Put the patient in epidemiological isolation
D) If necessary initiate parenteral fluid replacement therapy

D) If necessary initiate parenteral fluid replacement therapy

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HIV infection can be transmitted through the following body secretions, EXCEPT
A) breast milk
B) blood
C) saliva
D) semen
E) vaginal secretions

C) saliva

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An 8 months old patient is referred to the emergency department with constipation, acute-onset hypotension and ptosis. An anamnesis recording reveals that 1 day earlier he consumed honey for the first time in his life. Which pathogen’s role is most likely?
A) Trichuris trichiura
B) Poliovirus
C) Neisseria meningitidis
D) Clostridium botulinum
E) Streptococcus agalactiae

D) Clostridium botulinum

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What are TORCH pathogens?
A) Toxoplasma gondii, “Others”, Rubella Virus, Cytomegalovirus, Herpes Simplex Viruses
B) Toxoplasma gondii, “Others”, Rubella Virus, Chlamydia spp., Herpes Simplex Viruses
C) Toxoplasma gondii, “Others”, Rubella Virus, Chlamydia spp., Human Papilloma Viruses
D) Toxoplasma gondii, “Others”, Rubella Virus, Chlamydia spp., Human Immunodeficiency Virus

A) Toxoplasma gondii, “Others”, Rubella Virus, Cytomegalovirus, Herpes Simplex Viruses

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Complications of intrauterine Zika-virus infection may include:
A) subacute sclerosing panencephalitis
B) microcephaly
C) chorioretinitis
D) saddle nose

B) microcephaly

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Peptidoglycan and glycopeptide. What are these?
A) antiretroviral drugs
B) component of certain cells and an antibiotic group
C) oral antidiabetics
D) antimycoticums

B) component of certain cells and an antibiotic group

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Which viruses from the list below can cause arthritis quite frequently? A) HIV, VZV B) virus HSV, measles C) Yellow fever virus D) Human parvovirus B19, rubella virus

D) Human parvovirus B19, rubella virus

Which ones are the typical pathogens in neonatal infection? A) S. pyogenes, H. influenzae B) S. agalactiae, E. coli C) S. aureus, VZV D) S. pneumoniae, M catarrhalis E) CONS, K. oxytoca

B) S. agalactiae, E. coli

Generally, how long a patient with chickenpox is infectious? A) 3-4 days B) 14-21 days C) 6-7 days D) longer than 21 days E) 14 days

C) 6-7 days

Which one is the most frequent agent causing acute hepatitis all over the world? A) EBV B) HAV C) HEV D) Ethyl alcohol E) CMV

C) HEV

Which virus does not belong to the herpesviridae family? A) VZV B) EBV C) HHV7 D) WNV E) CMV

D) WNV

During the first week of April a 2 months old baby was taken to your surgery who was born at 29 weeks of gestation and has been suffering from BPD. The infant was discharged from NICU a week ago. What vaccination would you recommend for the baby to have beside the scheduled ones? A) 1 dose influenza split vaccine in autumn B) 1 dose of inactivated influenza vaccine immediately C) no vaccine is recommended D) 2 doses of split vaccine in autumn 1 month apart E) 2 doses of inactivated influenza vaccine, first one urgently, second one in autumn

D) 2 doses of split vaccine in autumn 1 month apart

Patients with the following risk factors should receive PCP prophylaxis as they are at high risk for PCP, EXCEPT: A) patients with acute lymphocytic leukaemia B) patients with certain primary immunodeficiencies like SCID, hyper IgM syndrome C) solid organ transplant recipients, often for at least 6 months to one year following transplantation D) asthmatic patients who receive 2 mg/kg prednisolone for 5 days during acute attack

D) asthmatic patients who receive 2 mg/kg prednisolone for 5 days during acute attack

Which one was the most frequent bacterial diarrheal disease over the past years in Hungary? A) yersiniosis B) salmonellosis C) campylobacteriosis D) shigellosis

C) campylobacteriosis

Patient suffering from one of the following diarrheal diseases should be isolated on Infectology Ward: A) Salmonellosis B) Campylobacteriosis C) Clostridioides difficile infection D) None of them

D) None of them

One of the following clinical pictures is not related to any of human herpes viruses: A) Mononucleosis infectiosa B) Erythema infectiosum C) Varicella D) Burkitt-lymphoma E) Exanthema subitum

B) Erythema infectiosum

Most frequent cause of serous meningitis with a cumulative number of cases in the summer and in early autumn: A) Neisseria meningitidis B) Non-polio enterovirus C) Leptospira interrogans D) West Nile virus E) Herpes simplex virus 1 and 2

B) Non-polio enterovirus

Congenital CMV infection can be confirmed with one of the following laboratory test: A) Maternal CMV serology B) Baby's CMV serology is enough to confirm the diagnosis C) CMV PCR test on baby's urine sample during the first three weeks of life D) CMV PCR test on maternal blood sample

C) CMV PCR test on baby's urine sample during the first three weeks of life

Pregnant woman around 34 weeks of gestation had a flu-like illness. Couple of days later she gave birth to a preterm newborn with a birth weight of 2200 gs. Soon after birth the baby develops symptoms of RDS. Examining the placenta on the foetal side small white nodes can be seen. Newborn had neutropenia and thrombocytopenia. In gastric aspiration with Gram stain Gram-positive rods can be detected. What is the most likely causative agent from the list below? A) C. botulinum B) E. coli C) Group B Streptococcus D) L. monocytogenes E) S. aureus

D) L. monocytogenes

A 4 year old girl has been taken to GP surgery with fever (38.8°C) and cough. There is no severe illness in her medical history, on physical examination symptoms of URTI can be found. Chest x-ray shows a 5 x 6 cm inhomogeneous consolidation on the right side in the middle lobe. Which antibiotic would you choose from the list below to treat the patient? A) amoxicillin B) cefixime C) oxacillin D) tazocin E) ceftriaxone

A) amoxicillin

A patient attended at A&E with paleness, oedema and reduced urine output a week after he had recovered from bloody gastroenteritis. What could be the diagnosis? A) Hemolytic uremic syndrome B) Salmonella sepsis C) Reye syndrome D) Invasion of dysenteric toxin E) Clostridioides difficile infection

A) Hemolytic uremic syndrome

How would you manage an otherwise healthy patient with Salmonella gastroenteritis? A) Ampicillin treatment B) Electrolyte and fluid substitution C) Sumetrolim treatment D) Reasec tablet (antimotility agent) E) Torecan suppository (antiemetic)

B) Electrolyte and fluid substitution

Which infection from the forthcoming ones can mimic acute appendicitis causing mesenteric lymphadenitis? A) Campylobacter jejuni infection B) Yersinia enterocolitica infection C) Salmonella sp. infection D) Shigella infection E) Rotavirus infection

B) Yersinia enterocolitica infection

Your patient went hiking to the hills and 2 weeks later complained of flu-like symptoms. Following a couple of asymptomatic days he developed fever again accompanied by strabism, ataxia and paralysis in his shoulder. What could be the diagnosis? A) Lyme disease B) Epidemic meningitis C) Lymphocytic choriomeningitis D) Tick-borne encephalitis E) Guillain-Barré syndrome

D) Tick-borne encephalitis

Having this condition increases the risk of Candida infection in the highest degree: A) atopic/allergic diseases in anamnesis B) birth weight less than 2000 gs C) immunosuppressed condition D) indwelling bladder catheter E) tonsillectomy

C) immunosuppressed condition

A 6 year old boy has been brought to GP practice by parents with a 3 days history of high temperature (>39°C), malaise and vomiting. Fever is difficult to control. He has taken paracetamol 4 times a day and he also had two doses of sulfametoxazol/trimethoprime. Today he developed a widespread rash. On physical examination itchy, diffuse, pinpoint maculopapular rash can be seen which is more marked in the groin and axilla. Bilateral red cheeks are accompanied by circumoral pallor. White strawberry tongue and exudative tonsillopharyngitis are present with spotted redness on the soft palate. Palms and soles are not red and the hand is not oedematous. Which do you think is the most likely illness? A) Measles B) Rubella C) Scarlet fever D) Kawasaki disease E) Exanthema subitum

C) Scarlet fever

What is the first line treatment in case of scarlet fever? A) penicillin B) third generation cephalosporin C) second generation cephalosporin D) first generation cephalosporin E) erythromycin

A) penicillin

Which one of the forthcoming infections is followed by exuberant desquamation mainly on the palms and the soles? A) scarlet fever B) exanthema subitum C) erythema infectiosum D) rubella E) measles

A) scarlet fever

A 6 year old boy presents with vomiting, hepatomegaly and coma soon after varicella infection. What illness do you think of? A) Kawasaki disease B) Reye syndrome C) VZV hepatitis D) Still's disease E) Septic shock

B) Reye syndrome

What age below tetracycline should not be used because of the risk of tooth discoloration? A) 3 years B) 6 years C) 9 years D) 12 years E) 15 years

C) 9 years

Which microorganism is the leading cause of serious infection in HIV infected children? A) Cryptococcus neoformans B) Mycobacterium tuberculosis C) Pneumocystis jirovecii D) Toxoplasma gondii E) Yersinia enterocolitica

C) Pneumocystis jirovecii

HBsAg positive mother gave birth to a term baby, birthweight is 3.3 kg. Following a careful wash of the baby which vaccination order would you apply from the list below? A) Hepatitis B immunoglobulin (HBIG) and HBV vaccine at birth, 1 month and 6 month of age B) HBV vaccine at 2, 4, 6 and 18 month of age C) HBIG at birth, 1 and 6 month of age D) HBIG and HBV vaccine at 2,4,6 and 18 month of age E) HBIG at birth and 1 month of age and HBV vaccine at 2,4,6 and 18 month of age

A) Hepatitis B immunoglobulin (HBIG) and HBV vaccine at birth, 1 month and 6 month of age

There is a contagion in a nursery school. Children showing symptoms of upper airway infections, bronchitis, pneumonia, conjunctivitis and watery diarrhoea. Which virus is the most likely causative agent from the list below? A) adenovirus B) enterovirus C) herpesvirus D) parvovirus E) rhinovirus

A) adenovirus

A one year old infant has a three days history of fever of 39.4°C which is difficult to relieve. During the physical examination the baby is noted to have a maculo-papular, blanching rash on his trunk but his upper extremities, the face and the lower extremities are spared. At the time of attendance the infant is afebrile. Which virus is the most probably infective agent in this case? A) Adenovirus B) Enterovirus C) Human herpesvirus 6/7 D) Parvovirus B19 E) Rubella-virus

C) Human herpesvirus 6/7

One of the following statements is true in reference to toxoplasmosis: A) pregnant women are treated with pyrimethamine and sulfadiazine if they had tainted with toxoplasma before conception B) in case of congenital toxoplasmosis confirmed with serology test infants are treated with pyrimethamine and sulfadiazine C) to prevent congenital toxoplasmosis pregnant women should be treated with spiramycin during the first trimester D) lymphadenopathy due to toxoplasma infection should be treated with spiramycin E) in case of ocular toxoplasmosis systemic steroid therapy is sufficient

C) to prevent congenital toxoplasmosis pregnant women should be treated with spiramycin during the first trimester

A 6 year old boy presents with right sided, multiple, prae-auricular and cervical lymphadenopathy. It was noticed for the first time 5 weeks ago when he had right sided conjunctivitis as well, which has healed since. What is the most probable diagnosis? A) Staphylococcus aureus infection B) Cat scratch disease C) Tularemia D) Atypical mycobacterial infection E) Actinomycosis

B) Cat scratch disease

There is a valvulotomy in a 10 year old boy's distant anamnesis which was performed 7 years ago due to aorta stenosis. 10 days ago he developed chickenpox. Currently he has been sickly, has had a lack of appetite for six days, he has got low grade fever and has lost 2 kgs of weight. On examination he was found to have 4/6, high pitched diastolic murmur. What is the most probable diagnosis? A) congestive heart failure B) endocarditis C) myocarditis D) pericarditis E) rheumatic fever

B) endocarditis

A 4 year old girl who attends day-nursery has been taken to A&E with a two days history of flu-like symptoms, loose stools, low grade fever of 38°C and loss of appetite. Laboratory test results show elevated ALT (651 U/l) and bilirubin (30 mmol/l) levels. What diagnostic investigation would you suggest to perform? A) HAV antigen detection in stool sample B) HBsAg detection in serum C) Measurement of anti-HBsAg level in seum D) Measurement of anti-HAV IgM level in serum E) Stool culture to detect HAV

D) Measurement of anti-HAV IgM level in serum

What is the tailored therapy in established streptococcal toxic shock syndrome? A) iv penicillin G + iv gentamicin B) iv amoxicillin + clavulanic acid C) iv penicillin G + iv clindamycin D) iv vancomycin + iv clindamycin E) iv gentamicin + iv vancomycin

C) iv penicillin G + iv clindamycin

One of the following infections caused by Parvovirus B19. This one is: A) Mononucleosis infectiosa B) Typhus exanthematicus C) Exanthema subitum D) Erythema infectiosum E) Scarlet fever

D) Erythema infectiosum

Which virus from the following list is the leading cause of congenital infections? A) EBV B) Zika-virus C) CMV D) HSV E) Rubella-virus

C) CMV

How many percent of neonates with congenital CMV infection do have symptoms at birth? A) 5-10% B) 10-15% C) 15-20% D) 20-25% E) 25-30%

B) 10-15%

A seven year old girl had 7 days of cefixime treatment for UTI. Two days later she developed abdominal pain and diarrhoea with raised temperature up to 38.6 ºC. Her stool was mucous, bloody and has had loose bowel movements five times a day. On her physical examination distended abdomen and diffuse tenderness has been found. Which investigation would you perform to confirm the diagnosis? A) Detection of protozoa in stool sample B) Detection of Clostridioides difficile toxin and toxigenic C. difficile in stool sample C) Blood culture D) Detection of Rotavirus in stool sample E) Colonoscopy

B) Detection of Clostridioides difficile toxin and toxigenic C. difficile in stool sample

A 4 year old girl has been brought to the Emergency Department with a 2 days history of fever up to 40°C, frequent vomiting and left sided upper quadrant abdominal pain. Urine microscopy results suggest UTI. According to the parents and previous medical records she has not got any underlying condition and anomaly in her urinary tract. At 11 month of age she was hospitalised with purulent meningitis and she spent 1 week on PICU. As part of mandatory surveillance from her anal swab a vancomycin resistant Enterococccus faecium strain was isolated. In view of this information after taking appropriate microbiological samples which antibiotic treatment would you start from the list below? A) iv. amoxicillin-clavulanic acid B) iv. ampicillin + gentamicin C) iv. ceftriaxone D) iv. linezolid E) per os trimethoprim-sulfamethoxazole

C) iv. ceftriaxone

It is not typical manifestation of HIV infection in infancy and babyhood: A) Chronic weight loss B) Anaemia C) Infections with opportunistic pathogens D) Kaposi sarcoma E) Hepatosplenomegaly

D) Kaposi sarcoma

Clinical pictures related to Pseudomonas aeruginosa infection are, except: A) malignant external otitis B) erysipelas C) neutropenic patients' blood-stream infection D) ecthyma gangrenosum

B) erysipelas

A 16 year old adolescent 18 months ago had myeloablative therapy followed by HSCT due to hematologic malignancy. His GP initiated amoxicillin/clavulanic acid therapy and on the 6th day of the treatment he developed a mucus-watery diarrhoea, abdominal pain, distension and confusion. What test would you choose first to perform? A) CMV serology B) CMV PCR on blood and stool sample C) detection of Clostridioides difficile antigen and toxin in stool sample D) routine stool culture (suitable to demonstrate presence of Salmonella, Shigella, Campylobacter spp. and Yersinia enterocolitica) E) Rotavirus antigen detection with bedside test

C) detection of Clostridioides difficile antigen and toxin in stool sample

You examine a 4 year old child at A&E with a 2 weeks history of coughing spells which sometimes terminate with vomiting. Child was born in Hungary and he has had all scheduled vaccines. Preceding current symptoms she had had mild URTI, low grade fever and conjunctivitis treated by GP with Tobrex eye drops. 7-10 days before the onset of her illness, grandparents who live in Australia, spent a couple of days with the family. Which pathogen from the list below is the most likely causative agent in this case? A) Bordetella pertussis B) Mycobacterium tuberculosis C) Streptococcus pneumoniae D) Haemophilus influenzae E) Corynebacterium diphtheriae

A) Bordetella pertussis

How many patients will die due to antibiotic resistant bacterial infection in 2050 according to WHO's forecast? A) 2.5 million B) 10 million C) 25 million D) 100 million

B) 10 million

What is the most frequent infectious cause of death in childhood globally? A) bacterial pneumonia B) influenza C) malaria D) cholera

C) malaria

One year old child of a family living in rural areas has been taken to hospital due to purulent meningitis. Family also keeps poultry, goats and neats around the house. The CSF microscopy shows Gram-positive rods. What antibiotic would you choose to treat this child? A) ceftriaxone B) ampicillin C) meropenem D) ceftriaxone + metronidazole

B) ampicillin

A 13 year old girl has been transferred to the hospital with fever, malaise following a week long summer holiday spent in a forest camp in the hills. At the time of the admission she seemed to be confused and complained of headache only. Taking her medical history we have found out that she had had mandatory vaccinations only and over the last year she has had irregular periods. On physical examination an outstanding erythema was noted all over her body. Her blood pressure was 83/42 mmHg. What is the most likely diagnosis? A) Dengue fever B) Lyme borreliosis C) Meningitis caused by Neisseria meningitidis D) Toxic shock syndrome

D) Toxic shock syndrome

A 7 year old child attends your GP practice with a 2 days history of fever, blood diarrhoea and spasmodic abdominal pain related to bowel motions. A few of his classmates have had similar symptoms over the last week. Not long before the class received a terrarium as a present with two painted turtles. All children from the class look after the animals. What contagious disease is spreading in the class? A) Giardiasis B) Shigellosis C) Salmonellosis D) COVID-19

C) Salmonellosis

A 17 year old adolescent has been taken to the hospital by Ambulance with a couple of hours history of raised temperature, headache, vomiting with suspected meningitis. On physical examination neck stiffness, Kernig positivity and one-sided serous nasal discharge was noted. He was accompanied by his sister who in answer to questions explained that his brother has not got any chronic illness, has never had operation or long term hospitalization. 6 months ago he was a victim of a ski-accident and had been observed in a Northern Italian hospital for 24 hrs with minor head injury. They can not show any documentation regarding this hospital stay. What is the most likely organism causing meningitis in this case? A) Neisseria meningitidis B) Staphylococcus aureus C) Haemophilus influenzae D) Streptococcus pneumoniae

D) Streptococcus pneumoniae

These organisms can cause atypical pneumonia, except: A) Myoplasma pneumoniae B) Ureaplasma urealyticum C) Chlamydophila pneumoniae D) Respiratory viruses E) Chlamydophila psittaci

B) Ureaplasma urealyticum

Different live virus vaccines can be given at the same time (eg. MMR and varicella or MMR and yellow fever). However, if they are not given at the same time, there should be an interval of at least 4 weeks between the administration of live virus vaccines. A) true B) false

A) true

Target-like, non-growing erythema smaller than 5 cm is definitely not erythema migrans characteristic of Lyme disease. A) true B) false

A) true

Number one risk factor for childhood Streptococcal toxic shock syndrome is chickenpox. A) true B) false

A) true

Passive immunisation against RSV in preterm (<32 gestational weeks) infants who exclusively consume breast milk is not recommended because maternal antibodies provide adequate protection against infection. A) true B) false

B) false

In infants less than one year of age, the classic symptoms of increased intracranial pressure in bacterial meningitis are observed in all cases. A) true B) false

B) false

Scarlet fever can only occur in association with Streptococcus pyogenes tonsillopharyngitis. A) true B) false

B) false

BCG vaccine is primarily used to prevent pulmonary tuberculosis. A) true B) false

B) false

Most neonates with HSV disease are born to mothers with a history of genital HSV infection. A) true B) false

B) false

Age-related mandatory vaccination in Hungary: 1) BCG 2) DTPa + IPV + Hib 3) Varicella 4) HPV A) Answers 1, 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1, 2 and 3 are correct

Against which pathogens would you recommend vaccinations for a patient undergoing splenectomy? 1) S. pneumoniae 2) HPV 3) N. meningitidis 4) TBE A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

B) Answers 1 and 3 are correct

In which cases can the possibility of rabies be ruled out even with significant exposure? 1) bite caused by a laboratory animal 2) the animal causing the exposure is healthy and observable for 14 days 3) bite caused by an animal kept in a zoo 4) milk from a rabid animal has been consumed raw and undiluted 5 days before the onset of symptoms of the animal and mucosal injury of the person consuming the milk is also suspected (there was a wound, lack of epithelium in the mouth) A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1., 2 and 3 are correct

Possible complications of invasive salmonellosis may include: 1) osteomyelitis 2) endocarditis 3) meningitis 4) splenic abscess A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

E) All of the answers are correct

Antimicrobials used in the treatment of invasive aspergillosis: 1) fluconazole 2) voriconazole 3) acyclovir 4) amphotericin B A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

C) Answers 2 and 4 are correct

Which antiviral drugs are effective against CMV? 1) ganciclovir 2) oseltamivir 3) foscarnet 4) there's no approved treatment against CMV A) Answers 1, 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

B) Answers 1 and 3 are correct

Adequate therapy of laryngitis subglottica: 1) dexamethasone 2) inhalatory epinephrine 3) cold air 4) salbutamol A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1., 2 and 3 are correct

The following tests have to be performed on a 3 week old febrile neonate in all cases, EXCEPT: 1) lumbar puncture 2) blood culture 3) urinalysis and culture 4) abdominal ultrasound A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

D) Only answer 4 is correct

Possible complications of tonsillopharyngitis caused by group A Streptococcus may include: 1) Rheumatic fever 2) Glomerulonephritis 3) Toxic shock syndrome 4) Ritter's disease A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1., 2 and 3 are correct

Part of the MIS-C diagnostic criteria, EXCEPT: 1) rash 2) acute gastrointestinal symptoms 3) cheilitis 4) confirmed COVID-19 infection A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1., 2 and 3 are correct

A two week old newborn has been transferred to A&E by Ambulance with high fever, vomiting and seizures. What are the most likely pathogens in this case? 1) Streptococcus agalactiae 2) Herpes simplex virus 3) Listeria monocytogenes 4) Adenovirus A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1., 2 and 3 are correct

It could be symptom of congenital CMV infection: 1) microcephaly 2) intracranial calcification 3) hepatomegaly 4) conjugated hyperbilirubinemia A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

E) All of the answers are correct

Clinical features of congenital varicella syndrome could be: 1) cutaneous scars in a dermatomal pattern 2) ocular abnormalities – optic nerve atrophy, cataracts, microphthalmos 3) limb abnormality – hypoplasia, atrophy, paresis 4) cheiloschisis A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1., 2 and 3 are correct

Pathogens can cause hemorrhagic cystitis in patients with bone marrow transplantation are: 1) BK polyomavirus 2) CMV 3) Adenovirus 4) ESBL producing Klebsiella pneumoniae A) Answers 1, 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1, 2 and 3 are correct

Which clinical pictures could be manifestation of Bartonella infection? 1) monosymptomatic fever 2) cat scratch disease 3) trench fever 4) blood culture 'negative' endocarditis A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

D) Only answer 4 is correct

What are the characteristics of lipophilic antibiotics? 1) they have high volume of distribution 2) they have higher intracellular penetration and effectiveness 3) they reach damaged tissues and are degraded in the liver 4) they are cleared in kidneys A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1., 2 and 3 are correct

What would you take into consideration initiating empiric antibiotic therapy in paediatric outpatient settings? 1) at least 90% of bacteria come into question should be sensitive to the chosen at least 90% of bacteria come into question should be sensitive to the chosen antibiotic antibiotic 2) the antibiotic should be as cheap as possible 3) the antibiotic should be administered the fewest possible occasion (ideally 1-2 times a day) 4) the medicine should have savouriness A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

E) All of the answers are correct

Antibiotic treatment is justified in case of salmonellosis in childhood if: 1) the patient is younger than 3 months 2) patient with immunosuppression 3) if blood culture grows Salmonella sp. 4) if patients' stool culture is still positive beyond 2 weeks A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1., 2 and 3 are correct

Which illness/illnesses has/have been eradicated due to the global vaccination programme? 1) diphtheria 2) poliomyelitis 3) measles 4) variola A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

D) Only answer 4 is correct

Which one(s) is (are) not a live vaccine(s)? 1) PCV 13 2) MMR 3) DTaP 4) BCG A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

B) Answers 1 and 3 are correct

Illnesses mainly (or partially) transferred by mosquitoes occuring in Hungary are the followings: 1) West Nile fever 2) Chikungunya fever 3) Tularemia 4) Trench fever A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

B) Answers 1 and 3 are correct

A 2 year old boy has been taken to A&E with a couple of hours of fever, confusion and vomiting. On examination he was pale, somnolent, it was difficult to communicate with him. There were a couple of petechiae on his extremitas distally and throughout the examination they have been spreading and have become confluent. There were no neck stiffness or any other signs of meningism present. Heart rate was 210 beats per minute. What diagnostic and therapeutic steps would you make immediately? 1) lumbal puncture 2) taking blood culture followed by initiation of ceftriaxone therapy 3) head CT with contrast 4) starting excessive parenteral fluid supplementation A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

C) Answers 2 and 4 are correct

Gastroenteritis with blood in the stool can be caused by: 1) Campylobacter jejuni 2) Giardia lamblia 3) Entamoeba histolytica 4) Calicivírus A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

B) Answers 1 and 3 are correct

The first generation cephalosporins: 1) have good effect against most Gram-positive cocci 2) provide effective treatment in skin and soft tissue infections 3) have no effect against Enterococci and Listeria monocytogenes 4) are first line antibiotics to treat Escherichia coli caused UTIs A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1., 2 and 3 are correct

Complications of mumps could be: 1) meningitis 2) oophoritis 3) facial palsy 4) pancreatitis A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

E) All of the answers are correct

Symptoms of acute giardiasis could be: 1) diarrhoea 2) urticaria 3) foul smelling, fatty stools 4) bloody stools A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1., 2 and 3 are correct

A five year old boy has been taken to your GP surgery by his parents with 2 days of fever and bilateral non-suppurative conjunctivitis. What illnesses does the differential diagnosis include from the list below? 1) Kawasaki disease 2) Mumps 3) Measles 4) Chickenpox A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

B) Answers 1 and 3 are correct

Manifestations of Coxiella burnetii caused Q-fever could be: 1) granulomatous hepatitis 2) atypical' pneumonia 3) endocarditis 4) arthritis A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1., 2 and 3 are correct

Kawasaki disease symptoms are beside fever: 1) non-purulent conjunctivitis 2) mucositis 3) lymphadenopathy 4) rash with vesicles, blisters A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1., 2 and 3 are correct

The following are typical features of animal bite wounds: 1) on the average five different types of bacteria grow from wound swab 2) 60% of the infections caused by mixed aerob and anaerob bacteria 3) human skin flora can be detected 40% of the cases 4) Pasteurella multocida rarely isolated from bite wound A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

A) Answers 1., 2 and 3 are correct

Which immunocompetent patient should be treated with aciclovir? 1) 21 year old woman with recurrent genital HSV infection 2) 5 days old newborn with HSV skin infection 3) 9 year old child with herpes zoster 4) pregnant woman with varicella A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

C) Answers 2 and 4 are correct

A 19 year old undergraduate who lives in a student hostel was admitted to hospital with hepatitis A infection. To whom would you give prophylactic hepatitis A vaccine out of his contacts? 1) his room-mate 2) his parents 3) his girlfriend 4) his teachers at university A) Answers 1., 2 and 3 are correct B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct D) Only answer 4 is correct E) All of the answers are correct

B) Answers 1 and 3 are correct

CRP testing is essential for all children with fever, because the use of CRP as a diagnostic marker is as useful as in adults. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

E) Both the statement and the reasoning are false

Asymptomatic bacteriuria should be treated with antibiotics in pregnant women because of the association between pyelonephritis during pregnancy and low birth weight. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

B) Both the statement and the reasoning are true, but there is no connection between them

Influenza vaccination can be given safely during pregnancy and is recommended because it protects not the pregnant woman only but passively the newborn for approximately 6 months after birth also. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

A) Both the statement and the reasoning are true, there is a connection between them

If the diagnostic criteria for erythema migrans are met, the diagnosis of Lyme disease cannot be made with complete certainty and serological testing for Borrelia burgdorferi should be performed in all cases. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

E) Both the statement and the reasoning are false

For patients with progressive varicella or immunosuppressed condition who also have atypical rash, intravenous acyclovir is recommended because no oral treatment is available for the causal treatment of varicella. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

C) The statement is true in itself, but the reasoning is false

Shiga toxin-producing enterohemorrhagic E. coli (EHEC) infection requires immediate initiation of antibiotic therapy, as timely initiation of antibiotic therapy reduces the likelihood of developing HUS. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

E) Both the statement and the reasoning are false

Congenital heart defects in childhood are not considered to be an independent risk factor for infective endocarditis, as atherosclerotic plaques on the heart valves do not usually develop at this age. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

D) The statement is false, but the reasoning is true in itself

Treatment of chickenpox rashes with a zinc solution is recommended as impetiginization is a possible complication of excoriated vesicles. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

D) The statement is false, but the reasoning is true in itself

Passive immunity provided by maternal IgG antibodies that pass through the placenta develop in the third trimester of pregnancy, therefore the shortening of this period in preterm infants is accompanied by a decreased ability to fight against infections. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

A) Both the statement and the reasoning are true, there is a connection between them

Every pregnant woman with non-complicated varicella should receive oral aciclovir therapy because primary VZV infection during pregnancy has significant implications for maternal and foetal health. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

A) Both the statement and the reasoning are true, there is a connection between them

Corticosteroid should be given in conjunction with anti-Pneumocystis therapy in case of moderate and severe PCP to HIV infected patients because its use improves the clinical outcome and mortality without increasing the risk of other opportunistic infections. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

A) Both the statement and the reasoning are true, there is a connection between them

Congenital CMV infection is the leading cause of non-hereditary sensorineural hearing loss so all newborn diagnosed with congenital CMV infection should receive ganciclovir therapy. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

C) The statement is true in itself, but the reasoning is false

A two month old infant can't have herpes zoster infection because the first manifestation of VZV infection is chickenpox. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

D) The statement is false, but the reasoning is true in itself

Children who have had invasive Hib infection before 24 months of age can remain at risk for a subsequent episode of invasive Hib disease because natural infection at this age does not reliably result in protective antibody levels. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

A) Both the statement and the reasoning are true, there is a connection between them

Hepatitis A infected patients should be put in two weeks quarantine following the diagnosis has been established because hepatitis A infected patients become non-infectious a couple of days after they have turned jaundiced. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

D) The statement is false, but the reasoning is true in itself

As there is no viraemia during zoster infection so maternal zoster infection is as risky for the foetus as maternal varicella. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

C) The statement is true in itself, but the reasoning is false

Campylobacteriosis in childhood should be treated with antibiotics because this infection in this age-group presents as bloody diarrhoea in more than 50% of the cases. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

D) The statement is false, but the reasoning is true in itself

Amoxicillin/clavulanic acid combination is a good choice to treat otitis media caused by Pneumococcus with reduced penicillin/amoxicillin sensitivity because the rise of penicillin/amoxicillin resistance is due to changes in the structure of penicillin binding protein. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

D) The statement is false, but the reasoning is true in itself

Tailored antibioticum therapy of established MSSA infection is one of the anti-staphylococcal penicillins or first generation cephalosporin because vancomycin's effect against enterococci is bacteriostatic only. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

B) Both the statement and the reasoning are true, but there is no connection between them

Newborn with Chlamydia conjunctivitis should be treated with oral macrolide because the use of topical erythromycin or tetracycline does not eradicate the pathogen agent. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

A) Both the statement and the reasoning are true, there is a connection between them

In case of animal bites to treat wound infections the first choice antibiotic is amoxicillin/clavulanic acid combination, because this antibiotic is effective against most of the bacteria constituting the skin flore, the anaerobic bacteria and Pasteurella multocida as well. A) Both the statement and the reasoning are true, there is a connection between them B) Both the statement and the reasoning are true, but there is no connection between them C) The statement is true in itself, but the reasoning is false D) The statement is false, but the reasoning is true in itself E) Both the statement and the reasoning are false

A) Both the statement and the reasoning are true, there is a connection between them