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WISE > measles/ rubella/ tetanus/ pertussis/ varicella/ diphtheria > Flashcards

measles/ rubella/ tetanus/ pertussis/ varicella/ diphtheria Flashcards

1
Q

The following statement/s regarding the transmission of measles virus is/are true:
A. The portal of entry is through the respiratory tract or conjunctivae following contact with large droplets
B. Patients are infectious from 3 days before to up to 4-6 days after the onset of rash.
C. Face-to-face contact is necessary for transmission of large and small droplets containing the virus.
D. Only A and B are true

A

A. The portal of entry is through the respiratory tract or conjunctivae following contact with large droplets
B. Patients are infectious from 3 days before to up to 4-6 days after the onset of rash.

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2
Q

True regarding the manifestations of Measles:
A. The appearance of Koplik spot occur 1-4 days after the appearance of rash.
B. The rash of measles begins on the forehead and upper neck, spreading downward to the torso and extremities with sparing of the palms and soles.
C. The symptoms of measles increase until the first day of rash which fades about 7 days.
D. All of the above statements are true.

A

C. The symptoms of measles increase until the first day of rash which fades about 7 days.

Koplik spot appear BEFORE the appearance of rash.
The rash of measles spreads from head to extremities with involvement of the palms and soles

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3
Q 
Koplik spots appearing 1-4 days prior to the onset of rash may be found in:
A. inner aspect of the cheeks
B. vaginal mucosa
C. conjunctival folds
D. All of the above
A

D. All of the above

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4
Q 
The most common complication of measles is
A. Pneumonia
B. Acute otitis media
C. Diarrhea
D. Febrile seizures
A

B. Acute otitis media

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5
Q

Vitamin A administration for measles is
A. indicated for all patients with measles
B. administered at age-appropriate dose once a day for 2 days
C. A third dose is indicated in children with signs and symptoms of vitamin A deficiency 2-4 weeks after the second dose
D. Only A and B is correct
E. All of the above

A

E. All of the above

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6
Q 
The most important risk factor for severe congenital defect secondary to maternal rubella infection is:
A. maternal immune system status
B. age of gestation
C. presence of comorbidities
D. poor maternal nutriition
A

B. age of gestation

Maternal infection during the first 8 weeks of gestation results in the most severe and widespread effect.

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7
Q 
A 3 yr old child was brought to the OPD due to 3 days of low-grade fever, accompanied by a macular rash which was noted a few days ago, beginning from the face and neck and spreading centrifugally to the torso and extremities. On physical examination, petechial hemorrhages on the soft palate and postauricular lymph nodes were noted. This child may be suffering from:
1/1
A. Measles
B. Rubella
C. Rubeolla
D. Parvovirus B19 infection
A

B. Rubella

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8
Q 
The most common long term sequela of CMV infection is
A. Liver failure
B. Chorioretinitis
C. hearing loss
D. blindness
A

C. hearing loss

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9
Q 
A newborn infant was brought to the ER because of yellowish discoloration of skin and rashes noted on the 48th hour of life. On further examination, microcephaly and hepatomegaly was noted. This may be a case of :
A. Congenital CMV infection
B. Congenital Rubella syndrome
C. Congenital EBV infection
D. Human Herpesvirus
A

A. Congenital CMV infection

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10
Q

True regarding CMV infections
A. The diagnosis of congenital CMV infection must be made within the first 2-3 weeks of life.
B. An infant with congenital CMV infection may have a normal hearing screening exam but develop hearing loss later in infancy.
C. Laboratory findings include elevated hepatic transaminases, thrombocytopenia and indirect hyperbilirubinemia
D. Only A and B is true.
E. All of the above statements are true

A

A. The diagnosis of congenital CMV infection must be made within the first 2-3 weeks of life.
B. An infant with congenital CMV infection may have a normal hearing screening exam but develop hearing loss later in infancy.

Laboratory findings include DIRECT hyperbilirubinemia, thrombocytopenia and elevated hepatic transaminases.

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11
Q 
A 4 year old girl was brought to the clinic due to sore throat and rashes. on physical examination, marked tonsillar pharyngitis with exudates. 2 days PTC, consult was done with another pediatrician who gave Co-Amoxiclav for the exudative tonsillitis. On examination, enlarged tonsils with exudates, epitrochlear lymphadenopathy and a morbiliform, vasculitic rash was noticeable. The most probable diagnosis is:
A. Streptotoccal pharyngitis
B. EBV infection
C. CMV infection
D. Diphtheria
A

B. EBV infection

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12
Q 
Infection with this virus manifests with fever, body malaise and rhinorrhea accompanied a a transient aplastic anemia. Rash and arthritis occurs as a postinfectious phenomenon.
A. Adenovirus
B. Epstein Barr virus
C. Parvovirus B19 
D. Cytomegalovirus
A

C. Parvovirus B19

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13
Q 
Congenital parvovirus infection results in:
A. microcephaly
B. fetal hydrops
C. hydrocephalus
D. blueberry muffin rash
A

B. fetal hydrops

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14
Q

True regarding Subacute Sclerosing Panencephalitis
A. Neurodegenerative manifestations begin insidiously years after the initial measles infection.
B. Choreoathetosis, dystonia and lead pipe rigidity occurs in the 3rd stage as a result of destruction of cells in the thalamus.
C. The diagnosis is based on documentation of clinical compatible course
D. CSF analysis reveals normal cells but elevated IgG and IgM antibody titers in dilutions > 1:4

A

A. Neurodegenerative manifestations begin insidiously years after the initial measles infection.

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15
Q 
Tiny, rose-colored lesions or petechial hemorrhages on the soft palate in Rubella is called
A. Koplik spot
B. Forchheimer spots
C. Ampicillin rash
D. Nagayama spots
A

B. Forchheimer spots

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16
Q

True about Roseolla infantum, EXCEPT:
A. Caused by Human Herpesvirus 6 and 7
B. peak age of primary infecton is at 6-9 months of life
C. Primary infection is followed by a lifelong latency or persistence of virus
D. Fever is followed by the appearance of nonpruritic, morbiliform rash accompanied by ulcers at the uvulopalatoglossal junction known as Forchheimer spots
E. none of the above

A

D. Fever is followed by the appearance of nonpruritic, morbiliform rash accompanied by ulcers at the uvulopalatoglossal junction known as Forchheimer spots

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17
Q 
The most common complication of roseola is
A. Encephalitis
B. Seizures
C. Acute otitis media
D. Secondary bacterial infection
A

B. Seizures

18
Q 
The major virulence protein of B. pertussis is known as
A. Pertactin
B. Pertussis toxin
C. filamentous hemagglutinin
D. Tracheal cytotoxin
A

B. Pertussis toxin

19
Q

Which of the following statements about pertussis is true?
A. Pertussis is extremely contagious with 100% attack rates in susceptible individuals.
B. Chronic carriage of pertussis in humans is common.
C. The 3 clinical stages of pertussis in adults are distinctive, making source case finding easier on history taking.
D. The paroxysmal stage is distinct from the convalescent stage

A

A. Pertussis is extremely contagious with 100% attack rates in susceptible individuals.

B. Chronic carriage of pertussis in humans is not documented.
C. Adults have no distinct stages.
D. The paroxysmal stage overlaps and fades into the convalescent stage.

20
Q 
The 3 clinical stages of pertussis including catarrhal, paroxysmal and convalescent stage are NOT distinct in which of the following population?
0/1
A. Adolescents
B. Infants < 3 months
C. Previously immunized children
D. Adults
E. All of the above
A

C. Previously immunized children

Infants < 3 months old do not display the classic stages. Adolescents and previously immunized children have foreshortening of all stages of pertussis. Adults have no distinct stages. This makes early diagnosis and case finding more difficult in these populations.

21
Q

The cough of pertussis :
A. may begin escalating at 7-10 days
B. not continuous, but come in bursts
C. dry, intermittent initially and later becoming paroxysmal
D. paroxysms of cough are lengthy and may cause apnea
E. All of the above

A

E. All of the above

22
Q

Severe course and death in pertussis may be correlated with
A. increasing episodes of paroxysms
B. presence of secondary bacterial infection
C. rapid rise or extreme leukocytosis
D. presence of pneumomediastinum

A

C. rapid rise or extreme leukocytosis

23
Q

Typical paroxysms that are not life threatening are characterized by the following features, EXCEPT:
A. duration < 45 sec
B. Oxygen desaturation spontaneously resolves at the end of paroxysms
C. tachycardia
D. posttussive exhaustion
E. none of the above

A

E. none of the above

24
Q 
24. A 6 yr old child was brought in for consult due to chronic cough > 14 days. The mother claimed the illness started with mild sneezing and colds, followed by cough that increased in intensity and frequency after 1 week. There was no sore throat, myalgia, tachypnea, but the child appears in distress during paroxysms of cough. This could be a case of:
A. Adenoviral infection
B. Pertussis
C. Mycoplasma infection
D. Diphtheria
A

B. Pertussis

25
Q 
A 6 yrs old male was brought to the ER due to tachypnea. His mother claimed that he was having fever for the past 3 days accompanied by sore throat and body malaise. He was initially seen 2 days PTA at the RHU and was given Amoxicillin for pharyngitis. At the ER, ulceration of the nares was evident and thick grayish membrane and stridor was noted. What is the possible diagnosis?
A. Pertussis
B. GABHS pharyngitis
C. Diphtheria
D. EBV pharyngitis
A

C. Diphtheria

26
Q

True regarding cardiomyopathy in Diphtheria
A. the first signs occur during the 2nd and 3rd wk of illness as the pharyngeal disease improves
B. responsible for 50-60% of mortality
C. considered a poor prognostic sign when present in the 1st week of illness
D. only A and B is true
E. All of the above statements are true.

A

E. All of the above statements are true.

27
Q 
The treatment for Diphtheria includes:
A. Diphtheria antitoxin
B. Penicillin
C. Supportive care
D. All of the above
A

D. All of the above

28
Q 
The prognosis for patients with Diphtheria depends on:
A. virulence of the organism
B. Age of the patient
C. Site of infection
D. Speed of toxin administration
E. All of the above
A

E. All of the above

29
Q

True of cephalic tetanus
A. May be associated with chronic otitis media
B. Characterized by painful spasms of the bulbar musculature
C. Deviated gaze, trismus and risus sardonicus are common manifestations
D. only B and C are true
E. All of the above are true

A

E. All of the above are true

30
Q 
Rabies may be differentiated from tetanus by this feature:
A. Trismus
B. Seizures
C. Hydrophobia 
D. None of the above
A

C. Hydrophobia

31
Q

The classic triad of rash, lymphadenopathy and fatigue is suggestive of:

A

A. Infectious mononucleosis

32
Q

IP of Diphtheria

A

2-4 days

33
Q

IP of tetanus

A

2-14 days

34
Q

IP of EBV

A

30-50 days

35
Q

IP of measles

A

8-12 days

36
Q

IP of varicella

A

10-21 days

37
Q

rashes and edema of eyelids

A

ebv

38
Q

petechiae, hepatocellular dysfunction and thrombocytonia

A

CMV

39
Q

petechial hemorrhages on the soft palate

A

rubella

40
Q

red lesions with blusih white spots in the center of the inner aspect of the cheeks

A

measles

41
Q

Palatal petechiae at the junction of hard and soft palate

A

EBV

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