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PAPER 3
41. Dengue fever
a. is spread by the vector Aedes aegypti
b. has an incubation period of 2-3 weeks
c. is caused by a flavivirus
d. characteristically causes severe myalgia
e. is more likely to cause haemorrhage in patients previously infected by a Dengue virus
Answer 41
42. Spastic paraparesis is a recognised complication of infection with
a. Streptococcus pyogenes
b. Polio virus
c. Mycobacterium tuberculosis
d. Taenia saginata
e. Plasmodium vivax
Answer 42
43. Giardiasis
a. can be diagnosed by duodenal biopsy
b. leaves the small bowel morphologically normal
c. has an incubation period of less than 48 hours
d. causes abdominal distension
e. usually responds to treatment with metronidazole
Answer 43
44. The following are correctly paired:
a. Schistosoma haematobium: Biomphalaria ssp
b. Onchocerca volvulus: Culex quinquefasciatus
c. Loa loa: Chrysops dimidiata
d. Borrelia duttoni (relapsing fever): soft tick (Ornithodorus moubata
e. Rickettsia tsutsugamushi: tromboculid mite
Answer 44
45. Enteric fever
a. Bone marrow culture increases diagnostic yield in those previously given antibiotics.
b. is zoonotic
c. is associated with poor sanitation
d. the incubation period is usually 4-6 weeks
e. rose spots occur in typhoid but not paratyphoid fever
Answer 45
46. Brucellosis
a. is caused by a Gram positive bacillus
b. causes spondylitis
c. is treated with tetracycline
d. is a recognised cause if chronic depression
e. is contracted from unpasteurised milk
Answer 46
47. A 35 year old woman presented shocked with a one week history of sore throat and fever. Her blood pressure was 80 mmHg systolic, temperature 39.5C and pulse 130. She was mildly jaundiced and had a macular erythematous rash that blanched on pressure. She was oliguric and had biochemical evidence of renal failure. Her creatine kinase was twice the upper limit of normal. The differential diagnosis includes:
a. myocardial infarction
b. meningococcal septicaemia
c. leptospirosis
d. toxic shock syndrome
e. Rocky Mountain spotted fever
Answer 47
48. Travellers' diarrhoea
a. the single most common causative organism is entero-invasive E. coli
b. has an incubation period of at least 48 hours
c. may be due to Aeromonas ssp.
d. may be due to Cryptosporidium
e. should be treated with antibiotics
Answer 48
49 The following are recognised features of infective endocarditis
a. erythema marginatum
b. Roth spots
c. proteinuria
d. Osler's nodes
e. splenomegaly
Answer 49
50. The following are characteristic features of acute schistosomiasis
a. fever
b. eosinophilia
c. convulsions
d. myocarditis
e. incubation period of 4-6 weeks
Answer 50
51. Hepatocellular carcinoma
a. is more common in men than women
b. is radiosensitive
c. is associated with intake of aflotoxin
d. usually presents with weight loss, right hypochondrial pain and hepatomegaly
e. progress of the disease can be monitored by serial measurement of the tumour marker inhibin
Answer 51
52. The following are recognised associations
a. Hanta virus: haemorrhagic fever with renal syndrome
b. E.coli 0157/H7: haemolytic uraemic syndrome
c. Plasmodium vivax: tropical splenomegaly syndrome
d. HTLV-1: AIDS
e. Chlamydia trachomatis: Fitzhugh Curtis syndrome
Answer 52
53. Effective malaria control interventions include:
a. mass use of Fansidar chemoprophylaxis
b. use of pyrethroid impregnated mosquito nets
c. vaccination with SPf66
d. larviciding
e. eradication of mosquito breeding sites
Answer 53
54. In lepromatous leprosy
a. neuropathy occurs before skin lesions
b. skin lesions are typically anaesthetic
c. skin lesions are typically symmetrical
d. the lepromin test is positive
e. leonine facies occurs
Answer 54
55. The following occur in Chagas' disease (American trypanosomiasis)
a. lymphadenopathy
b. meningoencephalitis
c. Calabar swelling
d. mega-oesophagus
e. saddle-nose deformity
Answer 55
56. Chloroquine
a. is contraindicated in pregnancy
b. is schizonticidal for P.ovale
c. is the treatment of choice for non-falciparum malaria
d. causes cinchonism
e. inhibits plasmodial haemin polymerase
Answer 56
57. Blindness is a recognised complication of:
a. leprosy
b. onchocerciasis
c. vitamin A deficiency
d. cysticercosis
e. toxoplasmosis
Answer 57
58. The following may present with fever and diarrhoea
a. malaria
b. Entamoeba coli
c. dengue
d. Campylobacter enteritis
e. brucellosis
Answer 58
59. Chicken pox
a. has an incubation period of 3-5 days
b. rash is preceded by Koplic's spots in the mouth
c. fever settles when the rash appears
d. should be treated by topical acyclovir
e. may follow from close contact with a case of shingles
Answer 59
60. Hepatitis A
a. the virus has double stranded DNA
b. the incubation period is 2-6 weeks
c. the illness is milder in young people
d. is maximally infectious at the peak of jaundice
e. can be prevented by active immunisation
Answer 60
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