ID MCQs

1

Fish fanciers finger is caused by all of the following EXCEPT:

A Mycobacterium marinum

B Mycobacterium fortuitum

C Mycobacterium tuberculosis

D Mycobacterium ulcerans

Answer



2

Which of the following is FALSE regarding needlestick exposure from a
known positive source?

A Risk of HIV from percutaneous exposure = 0.3%

B Risk of HIV from mucocutaneous exposure = 0.09%

C Risk of HCV from percutaneous exposure = 2-10%

D Risk of Hep B from percutaneous exposure from Hep B +ve source = 10-
15%

Answer



3

Malaria, the following are true, EXCEPT

A P.falciparum causes the most morbidity and mortality

B Non-cardiogenic pulmonary oedema is most common in pregnant females
and carries a 80 % mortality

C Complications from cerebral malaria is the most common cause of death

D Haemolytic anaemia, thrombocytopenia, hyponatraemia represents a typical
triad in 80 % of cases.

Answer





4

Regarding soft tissue infections, which is TRUE?
A Coral cuts are usually treated with Flucloxacillin

B Infections of the feet are often caused by Pseudomonas

C The presence of gas on soft tissue X ray confirms the diagnosis of gas
gangrene

D Erysipelas is usually treated with Ciprofloxacin

Answer




6

Fourniers gangrene of the scrotum

A Has a mortality rate of up to 75%

B Causes marked palpable skin crepitation in most patients

C Is more common in Asian males

D Leads to skin necrosis and sloughing within 12-24 hours

Answer




5

Regarding HIV infection, which is TRUE?
A Tuberculosis is an uncommon late stage infection

B Brain abscess would be the most common reason for a ring enhancing
space occupying cerebral lesion

C Quantitative HIV RNA test is a poor prognostic indicator

D Cryptococcal meningitis is the most common cause of fever and neck
stiffness
Answer




7

Which is INCORRECT?

A 90% of contaminated wounds demonstrate Clostridium sp.

B Spontaneous gas gangrene is fatal in 2/3rds of cases

C 60% of cases of gas gangrene are post-traumatic and caused by Clostridium
perfringens

D Gas gangrene infection spreads at the rate of 2cm / day

Answer



8


The MOST common infective organism in cellulitis from wounds inflicted
underwater?

A Aeromonas Hydrophila

B Vibrio Cholera

C Staphylococci/Streptococci

D Anaerobes

Answer



9


Which infective organism is LEAST likely to exist in salt water?
A Vibrio Vulnificus

B Aeromonas Hydrophila

C E. Coli

D Staphylococcus Aureus

Answer



10

Regarding tetanus

A Suxamethonium is contraindicated in intubation for tetanus

B Neonatal tetanus has a good prognosis

C Tetanolysin is the more significant of the two exotoxins

D Magnesium may be useful in inhibiting adrenaline and noradrenaline release

Answer



11

All of the following increase your chance so having underlying bacterial
illness EXCEPT

A Temperature > 39.4

B ESR > 30

C WCC > 15,000

D diabetes mellitus

Answer



12

The following are all features of the SIRS EXCEPT

A Temp >39 or < 36

B Resp rate > 20

C Heart rate > 90

D WCC > 12,000

Answer



13

Which of the following statements is FALSE in regard to community acquired
methicillin resistant Staphylococcus aureus (MRSA) infections?

A They are potentially more virulent than non-MRSA Staphylococcal
infections.

B The Panton-Valentine leukocidin exotoxin is produced in a subset of S.
aureus isolates.

C Community acquired MRSA predominately causes cutaneous infections.

D Treatment guidelines suggest empiric treatment with Vancomycin as it is the
drug of choice.

Answer






14

Which statement regarding Anti-Retroviral drug therapy is FALSE?

A Inhaled Fluticasone and Ritonavir can cause Cushings syndrome.

B Anti-retroviral therapy is an independent risk factor for ischaemic heart
disease.

C Anti-retroviral therapy usually starts with 2 nucleoside(tide) analogue reverse
transcriptase inhibitors plus either a non-nucleoside reverse transcriptase
inhibitor or a ritonavir boosted protease inhibitor.

D Drug therapy should be commenced with CD4 count > 350/microlitre.

Answer



15

With regard to cellulitis all of the following associations are true EXCEPT

A Hot tub folliculitis and Strep pyogenes.

B Facial cellulitis and Staph aureus, H influenzae or Staph pneumoniae.

C Infections from wounds on the feet and Pseudomonas aeruginosa.

D Diabetics with cellulitis and anaerobes or gram negative organisms.

Answer



16

Listeriosis most commonly causes

A Meningo-encephalitis.

B Mild gastro-enteritis.

C Pneumonia.

D Septicaemia and shock.

Answer



17

Regarding Hepatitis C:

A Human Immunoglobulin is indicated post needle stick from known Hep C pt

B Sexual transmission is common

C Greater than 50% of infected patients develop chronic hepatitis

D Is a picornavirus

Answer




18

Which side effect profile is INCORRECT:

A Ototoxicity - aminoglycosides

B Tendon rupture - ciprofloxacin

C Doxycycline - oesophagitis

D Vancomycin pseudomembranous colitis

Answer



19

Regarding STDs all the following are true EXCEPT:

A Chlamydia is the leading cause of non-gonococcal urethritis

B The primary chancre of lymphogranuloma venereum is painful, thus
distinguishing it from syphilis

C Buboes are suppurative inguinal lymph nodes found in Chancroid and
Lymphogranuloma venereum

D The ulcerative lesions found in Donovanosis are painless and have a beefy
red appearance

Answer



20

In regards to infectious diseases and sepsis the following are true EXCEPT:

A Systemic inflammatory response syndrome (SIRS) is defined as the
presence of 2 or more of the following T > 38oC or <36oC, P >90, RR >20,
WBC > 12,000 or < 4000

B Jaundice in a febrile patient is unlikely to be due to viral hepatitis

C Early meningococcal rash may resemble early measles (ie macular)

D Peripheral venous lactate levels correlate well with arterial and central
venous levels

Answer




21

All the below are true statements EXCEPT:

A Asplenic patients are more prone to overwhelming pneumococcal
septicaemia

B Renal transplant patients are more prone to listeria meningitis

C Normal CSF examination excludes cerebral abscess

D Severe muscle pain in the absence of fever may be an early symptom of
staphylococcal or streptococcal bacteraemia

Answer



22

The following are true EXCEPT

A Herpes zoster affects up to 50% of patients>85 yrs

B EBV is associated with Infectious mononucleosis in over 90% of cases

C Acyclovir does not inhibit EBV replication

D Toxoplasmosis infections classically cause hepatosplenomegaly

Answer



23

Regarding TB

A The Ghon focus is classically perihilar

B Reactivation classically presents with apical lesions and pleural effusions

C Primary infection is usually a benign self limiting disease

D Immunization effectively prevents infection

Answer



24

With regard to animal and human bites, Which is TRUE?

A Lacerations are more likely to become infected than puncture wounds

B Pasteurella sp. are uncommon isolates from dog bites

C Prophylactic antibiotics are effective in preventing infection in cat and dog
bites

D There is an higher infection rate in cat vs dog bites

Answer



25

Regarding blood cultures, which is FALSE?
A The routine use of anaerobic cultures in not warranted
B It is not necessary to change needles between inoculation of culture bottles

C Corynebacterium species are typical contaminants
D Best yield is achieved if multiple samples are taken in rapid succession
during a period of fever

Answer


26

All of the following are AIDS indicator conditions EXCEPT

A Herpes zoster

B Kaposis sarcoma

C Herpes simplex

D Cryptococcosis

Answer



27

Which is LEAST likely to be an effective treatment of MRSA cellulitis?

A Cotrimoxazole

B Clindamycin

C Doxycycline

D Cefuroxime

Answer



28


Which of the following is TRUE re HIV?

A Blood transfusion in Australia is screened with an ELIZA test

B According to World Health Organization Guidelines, HIV is an absolute
contra-indication to breast feeding

C World wide, TB is the commonest fatal opportunistic infection

D Lumbar puncture is contra-indicated in suspected cryptococcal meningitis

Answer




29

Which of the following is FALSE re malaria

A Mefloquine and doxycycline chemoprophylaxis is effective in preventing
plasmodium falciparum malaria

B Primaquine should be given as part of P.vivax treatment

C Mosquito to human transmission has been recorded in Australia within the
past 20 years

D Pregnant women and children should be cautioned re travelling to an
endemic area

Answer



30


Which of the following pairs is CORRECT ?

A Cat bite and Klebsiella

B Fox and lyssavirus

C Beef tartare and pin worm.

D Eggs and Gp G streptococcus

Answer



31

With regard to types of/settings for skin infections and an expected
pathogen, which combination is FALSE?

A Dog bite Capnocytophaga canimorsus

B Belly piercing C tetani

C Hot tub Eikenella corrodens

D Fish tank Mycobacterium marinum

Answer





32

Which of the following pathogens is MOST likely to give a true positive nitrite
result on urinary dipstick in the setting of a UTI?

A Enterococcus faecalis

B Staphylococcus saprophyticus

C Corynebacterium spp.

D Proteus mirabilis

Answer




33

In regards to Inflammatory Bowel Disease, which of the following is TRUE?

A Cyclosporin is effective treatment of Crohns Dx

B Skip lesions are a feature of Ulcerative Colitis

C NSAIDs are preferred to opiates for analgesia

D Intra-abdominal sepsis is an indication for surgical admission

Answer



34

Regarding the development of dengue haemorrhagic fever, which factor increases
the risk?

A Increasing Age

B Prior Dengue Virus infection

C Malnourishment

D Black ethnicity

Answer



35

Regarding malaria, which of the following is FALSE?

A Falciparum malaria has the highest mortality and morbidity.

B Adults tend to recover more rapidly than children from severe malaria

C Renal failure is less common in children

D Non-cardiogenic pulmonary oedema is a significant cause of mortality in pregnant
women

Answer




36

Necrotising Fasciitis is NOT associated with

A Cutaneous nerve infarction

B Diabetes Mellitus

C Intravenous drug use

D Clostridial infection

Answer



37

Assuming there are 2 billion children worldwide, that 35% are nominally Christian
(and have all been good) with an average of 3 children per household, how fast
would Santas sleigh have to travel to visit all the children in the world on Christmas
Eve? Please do not include toilet stops or chimney time in your calculations.

A 734,320 km/hr

B 4,204,382 km/hr

C 10,703,437 km/hr

D 96,765,256 km/hr

Answer



38

If Santa eats a single mince pie at each household, approximately how many miles
will he have to walk to burn off the calories consumed? Assume Santa weighs
21stones and walks at 3 miles per hour.

A 450 million

B 315 million

C 120 million

D Its Christmas who cares?

Answer



39


Which of the following statements regarding antibiotics is INCORRECT
A 3
rd
generation cephalosporins have good activity against enterococcus

B Moxifloxacin has anti-pseudomonal activity

C Most anaerobes originating above the diaphragm are susceptible to penicillin

D Clindamycin achieves good tissue penetration

Answer





40

The organism that when cultured in blood most likely reflect contamination is:

A Bacillus spp.

B Streptococcus pneumoniae

C Salmonella spp.

D Bacteroides

Answer


Answers

1. C
2. D
3. D
4. B
5. D
6. A
7. D
8. C
9. B
10. D
11. A
12. A
13. D
14. D
15. A
16. B
17. C
18. D
19. B
20. D
21. C
22. D
23. C
24. D EM Practice article bites and stuff
25. D Dunn. Chapter 14: Infection diseases
26. A Tintinalli 6
th
edition page 927
27. D
28. C A False, PCR at a cost of $250 million per case HIV prevented compared with
ELIZA B False, more children die of malnutrition/gastro than breast milk HIV
transmission C T-WHO D False-LP therapeutic and diagnostic E False-can be very
difficult to diagnose with profound immunosuppression (often no classical changes)
29. A A F-buys time to get definitive treatment B T-treats hypnozoites C T- Cairns
airport D T-Higher likelihood of serious disease with fewer chemoprophylaxis options
E T-Can modify presentation
30. D Centor criteria. EMPRAC article Pharyngitis in ED, may 2004.Vol 6
31. C Pseudomonas aeruginosa. Eikenella from human bites (depends on hot tub
activities I guess....) Cameron, 3
rd
Ed, pg 427
32. D Ps aeruginosa and Gram positives give false negative results Cameron, 3
rd
Ed,
pg 420-423
33. D Cameron 3E pp353-5 A Cyclosporin is effective for UC B Skip lesions are
a feature of CD, UC is continuous C NSAIDS exacerbate IBD, Opiates may
increase risk toxic megacolon but are still preferred D Total colectomy curative
only in UC E Intraabdo sepsis, perforation, obstruction, toxic megacolon all warrant
surg admission
34. B Uptodate pathogenesis of dengue virus infection
35. B
36. D (gas Gangrene) Cameron Ch 9.6
37. C http://www.telegraph.co.uk/topics/christmas/6859529/Father-Christmass- Christmas-
Eve-in-figures.html
38. A or D http://www.telegraph.co.uk/topics/christmas/6859529/Father-Christmass-
Christmas-Eve-in-figures.html
39. A Dunn, EMP antibiotics in ED
40. A Cameron (Textbook of Paediatric Emergency Medicine), p. 268. B, C and D are
always significant when isolated from blood cultures