Infectious Diseases

1.    Urinary Tract Infection (UTI).
***) The commonest causes of urinary tract infections are:
A.    Proteus species
B.     Escherichia coli
C.     Klebsiella
D.    Pseudomonas
E.     Citrobacter species

Answer: B* Escherichia coli

***) A 3 year old boy presents to you with recurrent urinary tract infection. Renal ultrasound was normal. Your next step of investigation would be:
Intravenous urogram
Isotope scan
No need for further investigations
Voiding cystourethrogram
Cystoscopy

Answer: D* Voiding cystourethrogram

???) The major organic cause of recurrent abdominal pain in children is:
Peptic ulcer
Urinary tract infection
Meckel's diverticulitis
Megacolon
Regional enteritis

Answer: 2* Urinary tract infection

???) The definitive test for urinary tract infection in a 10 years old girl is:
IVP
MCU (Micturating cystouretherogram)
CBC
Urine routine analysis
Urine culture with significant bacteriuria

Answer: 5* Urine culture with significant bacteriuria

2.    Streptococcal Pharyngitis.
???) Which one of the following conditions needs treatment:
Erythema toxicum of the newborn
Withdrawal vaginal bleeding at third day of life
Mongolian spots
Mastitis neonatorum
Impetigo neonatorum

Answer: 5* Impetigo neonatorum

***) Concerning impetigo all of the following are true, except:
Is highly contagious
The drug of choice in children is tetracycline
Is usually caused by a staphylococcal infection
In an infant may be complicated by generalized exfoliation
It effects mainly the nostrils and perioral areas

Answer:  2* The drug of choice in children is tetracycline

3.    Scarlet Fever.
???) All of the following about rash are true, except:
In measles the rash is a maculopapular, begins on the head and spread downwards
In scarlet fever the rash is vesicular and petechial
In erythema infectiosum the rash begins as a marked erythema of the cheeks
In varicella rash is polymorphic, but mainly vesicular
In rubella the rash is maculopapular, associated with postauricular and suboccipital lymphadenopathy

Answer: 2* In scarlet fever the rash is vesicular and petechial

4.    Rheumatic Fever.
???) Which one of the following is not a collagen disease in children:
Rheumatic fever
Sclerema
Rheumatoid arthritis
SLE (systemic lupus erythematodes)
Dermatomyositis

Answer: 1* Rheumatic fever

???) ??? One of the following is the pathognomonic rash of rheumatic fever:
Erythema multiforme of the limbs
Erythema nodosum of the back
Erythema nodosum of the trunk
Purpura on the lateral aspect of buttocks
Purpura on the lower extremities

Answer: 1* Erythema multiforme of the limbs

5.    Infectious Mononucleosis.
***) All of the following are true about infectious mononucleosis, except:
Generalized lymphadenopathy
Splenomegaly in 50% of cases
The drug of choice in children is chloramphenicol
The classic picture is rarely seen in the blood film
Atypical lymphocytes are usually seen in the blood film

Answer: C* The drug of choice in children is chloramphenicol

***) The lymph node enlargement in infectious mononucleosis most commonly involve:
Cervical group
Occipital nodes
Axillary group
Epitrochlear group
Inguinal group

Answer: 1* Cervical group

***) In infectious mononucleosis all are true, except:
Hepatomegaly may present
Lymphadenopathy is presenting sign
Skin rash (maculopapular) may present
Aacyclovir is an effective therapy
The incubation period is 25-50 days

Answer: 5* The incubation period is 25-50 days

6.    Pertussis.
***) All of the following are the characteristics of pertussis, except:
A.    World-wide in distribution
B.     May occur in both sexes
C.     May occur at any age
D.    Newborn immune for about three months
E.     Lesions located principally in bronchiand bronchioles

Answer: D* Newborn immune for about three months

???) Concerning whooping cough all of the following are true, except:
The incubation period is 7-10 days
The diagnosis is achieved if proved bacteriologically
There is typically marked lymphocytosis
The paroxismal stage lasts four to six weeks
Specific treatment in infancy includes erythromycin

Answer: 2* The diagnosis is achieved if proved bacteriologically

7.    Varicella (Chickenpox).
***) All of the following are the characteristics of varicella (chickenpox), except:
A.    One attack confirms lifelong immunity
B.     Distribution of lesion predominantly centripetal
C.     The peripheral blood picture is essentially unchanged
D.    Incubation period ranges from 10 to 20 days
E.     Varicella is generally much more severe in children than in adults

Answer: E* Varicella is generally much more severe in children than in adults

***) The rash in chickenpox shows the following characteristic features, except:
A.    Centripetal in distribution
B.     All stages and sizes at the same time could be seen
C.     Superficial
D.    The causative agent is herpes virus
E.     Scalp and mucous membranes are preserved (not involved)

Answer: E* Scalp and mucous membranes are preserved (not involved)

***) Regarding chickenpox (varicella) all are true, except:
A.    Incubation period is 14-21 days
B.     Most common complication is subacute sclerosing panencephalitis
C.     Polymorphic rash
D.    The epidemics have been initiated by exposure to herpes zoster
E.     Children receiving steroids are at great risk for severe chickenpox

Answer: B* Most common complication is subacute sclerosing panencephalitis

***) Chickenpox is characterized by:
A.    Long prodromal period around 4 weeks
B.     Severe systemic symptoms in children
C.     High contagion index
D.    Maculo-papular rash
E.     Frequent occurrence of associated pneumonia

Answer: C* High contagion index

***) Regarding varicella (chickenpox), all are true except:
A.    It is vesicular rash
B.     Incubation period less than one week
C.     Different stages of maturation of skin lesions
D.    Its more benign in children than in adults
E.     Can lead to congenital varicella syndrome

Answer: B* Incubation period less than one week

8.    Roseola.
***) Which one of the following statements concerning Roseola is true:
A.    Etiology is believed to be due to Coxsackie virus
B.     Fever is usually high at the onset
C.     Rash begins with a slapped cheek appearance
D.    The illness is not contagious
E.     The rash leaves temporary hypopigmented areas after fading

Answer: B* Fever is usually high at the onset

9.    Measles.
***) Regarding the incubation period all of the following are true, except:
A.    Mumps 12-25 days
B.     Measles 14-21 days
C.     Rubella 14-21 days
D.    Hepatitis A 3-8 weeks
E.     Hepatitis B 6-24 weeks

Answer: D* Measles 14-21 days

***) Which one of the following infections typically has incubation period of less than 2 weeks:
A.    Mumps
B.     Varicella
C.     Rubella
D.    Measles
E.     Rabies

Answer: D* Measles

***) All of the following are features of measles, except:
A.    Prodromal signs such as fever and anorexia last 3 to 4 days
B.     The sub-occipital lymph nodes are enlarged
C.     Koplik’s spots are visible 2 to 3 days before the onset of rash
D.    The rash starts behind the ears and spreads to the forehead, face and down the body
E.     The incubation period is one to two weeks

Answer: B* The sub-occipital lymph nodes are enlarged

***) Regarding measles in Jordan all are false, except:
A.    The peak of incidence is among infants
B.     Vaccine coverage is complete
C.     Incidence among children is shifting to older age group
D.    The vaccine is made of killed bacteria
E.     The cold chain is weak

Answer: C* Incidence among children is shifting to older age group

***) In measles the rash and accompanying illness reach a climax on about the:
A.    2nd day
B.     3rd day
C.     6th day
D.    9th day
E.     12th day

Answer: C* 6th day

***) Koplik’s spots are pathognomonic of one of the following:
A.    Rubella
B.     Measles
C.     Chicken pox
D.    Scarlet fever
E.     Mumps

Answer: B* Measles

???) Comparing measles (Rubeola) with German measles (Rubella) all of the following are true, except:
The incubation period is shorter
The temperature is higher
Pre-rash symptoms are of longer duration
Koplik's spots are pathognomonic
Sub-occipital lymph nodes are more prominent

Answer: 5* Sub-occipital lymph nodes are more prominent

10.           Mumps.
***) Regarding Mumps, all are true except:
A.    Incubation period is 12-25 days
B.     Parotitis
C.     Conjunctivitis
D.    Orchitis
E.     Encephalitis

Answer: C* Conjunctivitis

***) The percent of persons who develop inapparent infection by Mixovirus parotitis (mumps) is:
A.    5%
B.     15%
C.     20%
D.    35%
E.     55%

Answer: D*35%

???) An 3,5 year old boy is brought with the history of fever and swelling in the left side of the neck of 2 days duration. All are true about the management of this boy, except:
The extension of swelling behind the ear lobe helps pointing to mumps rather than cervical adenitis
In mumps the serum amylase is elevated while it is normal in cervical adenitis
The treatment of cervical adenitis is by penicillin G
The best way to differentiate mumps from cervical adenitis is by needle aspiration of the swelling for culture purposes
If this proves to be mumps immunity will be lifelong

Answer: 4* The best way to differentiate mumps from cervical adenitis is by needle aspiration of the swelling for culture purposes

11.           Rubella (German Measles).
***) Concerning rubella all of the following statements are true, except:
A.    A large proportion of rubella cases are seen in infants and children
B.     Preventing infection of the fetus is a major objective of immunization program
C.     The only reliable evidence of rubella immunity is a history of having had the illness
D.    80-90% of young adults have serological evidence of post infection immunity
E.     Incubation period of rubella is 7-10 days

Answer: E* Incubation period of rubella is 7-10 days

***) The syndrome of congenital rubella includes all of the following abnormalities, except:
A.    Heart disease
B.     Cleft palate
C.     Auditory defect
D.    Hepatosplenomegaly and jaundice
E.     Meningo-encephalitis

Answer: E* Meningo-encephalitis

***) Which one of the following is usually not regarded as a manifestation of congenital rubella:
A.    Cataracts
B.     Deafness
C.     Microcephaly
D.    Meningocele
E.     Hepatosplenomegaly

Answer: D* Meningocele

***) One of the following is true:
A.    Incubation period of mumps 21-28 days
B.     Incubation period of varicella 7-14
C.     Incubation period of mononucleosis in adolescents is 2-3 weeks
D.    Incubation period of rubella is 14-21 days
E.     Incubation period of measles is 14-18 days

Answer: D* Incubation period of rubella is 14-21 days

12.           Erythema lnfectiosum.
***) The rash of erythema infectiosum appears first on the:
Face
Arms
Trunk
Legs
Hands

Answer: A* Face

13.           Reye Syndrome.
***) Reye’s syndrome is a disease characterized by;
A.    Encephalopathy
B.     Encephalopathy with recent history of paracetamol intake
C.     Encephalopathy with recent history of salicylate intake
D.    Meningitis with history of salicylate intake
E.     Meningo-encephalitis

Answer: C* Encephalopathy with recent history of salicylate intake

14.           Poliomyelitis.
???) Which of the following disease has the longest incubation period:
Mumps
Measles
Diphtheria
Chickenpox
Poliomyelitis

Answer: 5* Poliomyelitis

???) Poliomyelitis is characterized by all of the following, except:
Limbs weakness is symmetrical
Cerebrospinal fluid (CSF) cell count is high in the first weeks of illness
Fibrillations are present on electromyography examination
Caused by virus
Preventable by vaccination

Answer: 1* Limbs weakness is symmetrical

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