PAPER 4
61 Typical features of tropical splenomegaly syndrome are:
a. very low or absent malarial antibody titres
b. increased serum IgM
c. lymphocytic infiltration of hepatic sinusoids
d. Plasmodium falciparum parasitaemia
e. favourable response to prolonged anti-malarial drug therapy
Answer 61
62. Visceral leishmaniasis is typically caused by
a. L.donovani
b. L.tropica
c. L.chagasi
d. L.major
e. L.infantum
Answer 62
63. Concerning HIV infection in pregnancy:
a. pregnancy approximately doubles the rate of progression to AIDS
b. the rate of vertical transmission of HIV is greater than 50%
c. perinatal administration of zidovudine to the mother reduces vertical transmission
d. breast feeding increases vertical transmission.
e. transmission of HIV to the neonate is confirmed if the neonate is HIV antibody positive
Answer 63
64. Buruli ulcers are characteristically:
a. painful
b. undermined
c. caused by Fusobacterium
d. secondarily infected
e. responsive to penicillin
Answer 64
65. Concerning plague:
a. it is caused by Bacillus pestis
b. the main vector is the rat
c. the pneumonic form is more common than the bubonic form
d. fraction I antigen in the bacterial capsular envelope confers anti-phagocytic activity
e. direct person to person spread may occur (i.e. without a vector)
Answer 65
66. Rabies vaccination
a. should be given annually to dogs in endemic areas
b. may usefully be given many months after exposure
c. Post-exposure vaccination is unnecessary if pre-exposure vaccination has been given
d. Specific rabies immunoglobulin for human use may be prepared from horse serum
e. is unnecessary after cat bites
Answer 66
67. In a cholera epidemic
a. cases have copious watery diarrhoea
b. intravenous rehydration therapy has no place
c. the most important public health intervention is the provision of clean water and good sanitation
d. mass chemoprophylaxis with oral tetracycline should be arranged urgently
e. mass vaccination should be undertaken
Answer 67
68. Epstein-Barr virus is associated with
a. hairy cell leukaemia
b. leiomyosarcoma in young people with AIDS
c. nasopharyngeal carcinoma
d. teratogenesis
e. oral hairy leukoplakia
Answer 68
69. Concerning Hydatid disease:
a. Surgical removal of cysts should not be attempted
b. It is caused by dog tapeworm
c. It is usually accompanied by eosinophilia
d. It is treated with albendazole
e. It is best diagnosed by microscopy of fluid obtained from ultrasound guided aspiration of the suspected cyst
Answer 69
70. Vitamin A (retinol)
a. is found in green leafy vegetables
b. high dose supplementation in pregnancy is teratogenic
c. supplementation reduces mortality from measles
d. supplementation reduces mortality from diarrhoeal disease
e. supplementation reduces mortality from respiratory disease
Answer 70
71. Thalidomide is used in the treatment of
a. HIV-associated peripheral neuropathy
b. hyperemesis gravidarum
c. erythema nodosum leprosum
d. Behcet's disease
e. HIV-associated mouth ulcers
Answer 71
72. Hepatitis A vaccination (Havrix):
a. is a live vaccine
b. is teratogenic
c. has >75% protective efficacy
d. causes mild hepatitis in some patients
e. should be offered to haemophiliacs who are hepatitis A antibody negative
Answer 72
73. Yellow fever
a. has an incubation period of 3-6 days
b. has a case fatality rate of about 50%
c. is caused by a flavivirus
d. is spread by anopheline mosquitoes
e. epidemics should be controlled by strict isolation of cases
Answer 73
74. Tuberculosis control:
a. Sputum negative cases of pulmonary tuberculosis are of more public health importance than sputum positive cases because they are more likely to remain undiagnosed.
b. Children with tuberculosis have usually acquired their disease from a child contact.
c. Close contacts of a sputum positive case should be offered immediate BCG.
d. BCG is at least 50% effective in preventing pulmonary tuberculosis.
e. Twice weekly supervised treatment regimens have comparable efficacy to standard daily regimens.
Answer 74
75. Strep. pyogenes
a. is the most common bacterial cause of tonsillitis
b. asymptomatic pharyngeal carriage occurs in about 10% of children
c. septicaemia carries a mortality similar to meningococcal septicaemia
d. pharyngitis may be complicated by suppurative cervical adenitis
e. causes scarlet fever
Answer 75
76. Amphotericin B is used in the treatment of:
a. visceral leishmaniasis
b. dermatophyte infections of the nails
c. azole resistant oral candida
d. primary amoebic meningoencephalitis caused by Naegleria species
e. cryptococcal meningitis
Answer 76
77. Typical features of tropical pulmonary eosinophilia include:
a. lymphadenopathy
b. absolute eosinophilia
c. microfilaraemia
d. raised serum Ig E
e. rapid response to mebendazole
Answer 77
78. The following drugs are used in the treatment of Legionnaires' disease:
a. rifampicin
b. gentamicin
c. erythromycin
d. ciprofloxacin
e. azithromycin
Answer 78
79. Acute post-streptococcal glomerulonephritis of childhood:
a. occurs after cellulitis but not pharyngitis
b. should be treated with steroids
c. is fatal in about half of all cases
d. is usually crescentic on microscopy
e. usually presents with acute renal failure
Answer 79
80. Suppurative lymphadenopathy may be caused by:
a. cat scratch fever
b. lymphogranuloma venereum
c. tuberculosis
d. sarcoidosis
e. plague
Answer 80
