Previous year question on polio based on neet pg, usmle, plab and fmge or mci screening exams

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All of the following statements are true regarding poliovirus except: A: It is transmitted by feco-oral route B : Asymptomatic infections are common in children C : There is only a single serotype which cause infection D: Live attenuated vaccine produces herd immunity Correct Ans:C Explanation There are three serotypes of poliovirus. They are type 1, 2 and 3. Serotype 1 is the most common type, it is the most common serotype causing polio epidemic. Mutated Type 3 is the most common cause of vaccine induced paralysis. Poliovirus belong to enterovirus group. It is a single stranded RNA virus. It has a naked protein capsid and a dense central core of RNA. It is spread through feco-oral route. Infection with poliovirus gives lifelong immunity to the homologous virus type, but does not confer immunity to other two viral types. Ref: Oski's Essential Pediatrics By Michael Crocetti, 2nd Edition, Page 322 Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG,

Transcript of Previous year question on polio based on neet pg, usmle, plab and fmge or mci screening exams

All of the following statements are true regarding poliovirus except:

A: It is transmitted by feco-oral routeB: Asymptomatic infections are common in childrenC: There is only a single serotype which cause infectionD: Live attenuated vaccine produces herd immunity

Correct Ans:CExplanation

There are three serotypes of poliovirus. They are type 1, 2 and 3. Serotype 1 is the most common type, it is the most common serotype causing polio epidemic. Mutated Type 3 is the most common cause of vaccine induced paralysis.

Poliovirus belong to enterovirus group. It is a single stranded RNA virus. It has a naked protein capsid and a dense central core of RNA. It is spread through feco-oral route. Infection with poliovirus gives lifelong immunity to the homologous virus type, but does not confer immunity to other two viral types.

Ref: Oski's Essential Pediatrics By Michael Crocetti, 2nd Edition, Page 322

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

Which of the following viruses produce disease or sequelae that is/are more severe if the infection occurs at a very young age?

A: Epstein-Barr virusB: Hepatitis B virusC: Measles virusD: Poliovirus

Correct Ans:BExplanation

Infection with Hepatitis B virus (HBV) at birth or a very young age is associated with chronic HBV infection and the development of hepatocellular carcinoma later in life. In fact, infants born to Hepatitis B surface antigen (HBsAg)-positive mothers are commonly infected, and approximately 90% become chronic carriers of the virus. Chronic carriers suffer from hepatocellular carcinoma at an incidence over 200 times higher than a noncarrier.

The current recommendation for infants born of HBsAg-positive mothers is administration of hepatitis B immunoglobulin (HBIg) in the delivery room, with the first dose of the hepatitis B vaccine given at the same time or within 1 week. The second and third dose of the vaccine are then given at 1 and 6 months. With this protocol, 94% protection is achieved.

The Epstein-Barr virus is the agent of heterophile-positive infectious mononucleosis. In children, primary EBV infection is often asymptomatic. The measles virus often causes a more severe disease in adults. Over the age of 20, the incidence of complications, including pneumonia, bacterial superinfection of the respiratory tract, bronchospasm and hepatitis, is much higher than in children. Poliovirus causes asymptomatic or inapparent infections 95% of the time. Frank paralysis occurs in approximately 0.1% of all poliovirus infections. However, the probability of paralysis increases with increasing age.

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

A 9-month-old child is brought to the Health Department to receive the second dose of oral polio vaccine, 2 weeks after the first vaccination. The child has mild diarrhea, so the decision is made to defer further immunizations. Bacteriologic examination of a stool culture is unremarkable; however, a small, single-stranded, positive RNA virus is isolated from the specimen. The viral isolate was not inactivated by ether. Which of the following viruses was most likely isolated?

A: AdenovirusB: Hepatitis CC: Parvovirus B19D: Poliovirus

Correct Ans:DExplanation

Poliovirus, which is a single-stranded +RNA virus, is naked (i.e., non-enveloped) and hence will not be inactivated by lipid solvents such as ether. The live virus vaccine had colonized the intestinal tract of the infant and was still being shed 2 weeks after the earlier oral dose. This same virus, the vaccine strain, is likely to be found in sewage, as all vaccinated infants will shed virus for a period of time after immunization with OPV.

Adenoviruses and parvovirus B19 also may cause diarrheal disease and both are non-enveloped; however, they both have a DNA genome. Hepatitis C is an enveloped, single-stranded +RNA virus; its major target organ is the liver, not the intestinal tract. It is a fragile agent that does not survive well outside the body and would not be isolated from raw sewage effluent.

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

Which of the following statement is TRUE about polio?

A: Paralytic polio is most commonB: Spastic paralysisC: Increased muscular activity leads to increased paralysisD: Polio drop given only in <3 year

Correct Ans:CExplanation

Most of the Polio infections(95%) are asymptomatic. Paralysis occurs in only 0.01% cases of all poliovirus infections. The risk factors found to precipitate an attack of paralytic polio in individuals already infected with polio include, fatigue, trauma, IM injections, operative procedures like tonsillectomy undertaken especially during epidemics of polio and administration of immunizing agents. Pulse polio immunization is given to all children less than 5 years of age and not 3 years of age.

Also Know:

Vaccine-associated poliomyelitis is a remote risk with OPV. The hallmark of paralytic poliomyelitis is asymmetric flaccid

paralysis, with no significant sensory loss.

Ref: O.P. Ghai  6th Ed Page 210-212.

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

Which of the following viruses is capable of replication in enucleated cells?

A: AdenovirusB: CytomegalovirusC: PoliovirusD: Influenza virusCorrect Ans:CExplanation

Most RNA viruses (eg, poliovirus) replicate in the cytoplasm and therefore can replicate in enucleated cells. Poliovirus belongs to the family Picornaviridae. These viruses are nonenveloped and have an icosahedral nucleocapsid that contains positive-sense RNA.

The exception to the rule regarding RNA viruses is the family Orthomyxoviridae, the influenza viruses. Orthomyxoviruses undergo transcription and RNA replication in the nucleus of the host cell because they need to cannibalize the capped 5' termini of cellular RNAs for use as primers for viral mRNA transcription. For most DNA viruses, transcription and DNA replication occur in the nucleus of the host cell. The exception to this observation is the family Poxviridae, which carries out its replication in the cytoplasm. Poxviridae includes variola virus, vaccinia virus, molluscum contagiosum, and orf virus. Adenoviruses are non enveloped and have an icosahedral nucleocapsid that contains a double-stranded linear DNA genome. 

Cytomegalovirus is a member of family Herpesviridae. It is an enveloped virus with an icosahedral nucleocapsid that contains a double-stranded linear DNA genome. Ref: Ray C.G., Ryan K.J. (2010). Chapter 12. Enteroviruses. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e.

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

A neonate is born in very poor condition, with a severe, generalized encephalitis. Which of the following viruses is the most likely pathogen in this setting?

A: Eastern equine encephalitis virusB: Herpes simplex type IIC: Herpes zoster-varicella virusD: Poliomyelitis virus

Correct Ans:BExplanationViral causes of neonatal encephalitis include three members of the herpes family of viruses: herpes simplex I, herpes simplex II, and cytomegalovirus. All three types can have devastating effects on the neonate, with extensive CNS damage leading to mental retardation, seizures, and focal neurologic problems. Acyclovir may be of some help in modifying these infections, but both treatment and prognosis remain very problematic. Eastern equine encephalitis virus and St. Louis encephalitis virus are causes of epidemic encephalitis but are not the most likely cause of neonatal encephalitis. Herpes zoster-varicella virus, unlike herpes simplex, is not usually a cause of neonatal encephalitis. Poliomyelitis virus is a gastrointestinally transmitted virus that is not usually encountered in neonates. Ref: Levinson W. (2012). Part IX. Brief Summaries of Medically Important Organisms. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.

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An 8 year old boy is taken to a pediatrician because of behavioral changes, mild intellectual deterioration, and "laziness." Over the next several months the boy develops increasing clumsiness and periodic, involuntary, jerky movements every 3 to 6 seconds. Visual deterioration is apparent upon visual field testing, and optic atrophy is evident on funduscopic examination. Cerebrospinal fluid studies do not show significant pleocytosis, but oligoclonal bands of IgG are present on CSF electrophoresis. The electroencephalogram shows periodic discharges that are synchronous with the periods of myoclonus. Computed tomography (CT) of the head shows low-density white matter lesions and cerebral atrophy. At the age of 10, the boy dies. Prior infection with which of the following agents was probably related to the patient's condition?

A: Measles virusB: Mumps virusC: PapillomavirusD: Poliovirus

Correct Ans:AExplanationThe rare disease illustrated is subacute sclerosing panencephalitis (SSPE), which typically presents as in the question stem. SSPE appears to be due to a combination of persistent, possibly abnormal measles virus and to autoimmune damage caused by antibodies directed against the virus. Many patients developing SSPE have had measles at 2 years of age or younger; there is typically a six-year interval between measles infection and symptom development. A small proportion of cases have followed vaccination with live measles virus. Unfortunately, no effective therapy has been developed, although some experimental work with drugs such as isoprinosine shows some promise. Postinfectious encephalomyelitis, rather than SSPE, can follow mumps or varicella. Latent infection with the varicella virus causes shingles (herpes zoster). Papillomaviruses are associated with warts. They do not usually infect the brain. Poliovirus causes gastrointestinal disturbances, viremia, and paralysis. 

Ref: Ray C.G., Ryan K.J. (2010). Chapter 10. Mumps Virus, Measles, Rubella, and Other Childhood Exanthems. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e.

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

Which of the following strains of wild poliovirus forms the salk type 1 component of inactivated polio vaccine?

A: MEF – 1B: MahoneyC: SaukettD: Leningrad – 3Correct Ans:BExplanation

IPV is usually made from Mahoney (salk type I), MEF – 1 (salk type II) and saukett (salk type III) that are grown in cell culture. The harvested viral components are inactivated with formaldehyde. Leningrad – 3 is a strain of mumps virus used for making mumps vaccine.

Ref: Park, Edition 21, Page - 185

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Cluster testing technique is useful in which of the following conditions?

A: Sexually Transmitted DiseasesB: Poliomyelitis

C: MeaslesD: SmallpoxCorrect Ans:AExplanation

Explanation: Following methods are used for case detection of STD:

• CONTACT TRACING: Contact tracing is the term used for the technique by which the sexual partners of diagnosed patients are identified, located, investigated, and treated.

• CLUSTER TESTING: Here the patients are asked name other persons of either sex who move in the same socio-sexual environment. These persons are then screened.

Ref: Park’s textbook of Preventive and Social Medicine, 21stedition, Page 313

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

You are the medical officer of a PHC in Kerala and you confirm the diagnosis of polio in one of your patients. This can be considered as:

A: EndemicB: EpidemicC: Sporadic caseD: Pandemic

Correct Ans:BExplanation

Here this disease is an unusual occurrence in the community and is clearly in excess of the expected frequency. So even a single case of polio is an epidemic as per definition. A sporadic case means the case occurs irregularly, haphazardly from time to time and generally infrequent.

Ref: Park, Edition 21, Page – 89

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Which of the following disease is NOT included under diseases considered as eradicable by the International Task Force for Disease Eradication?

A: PolioB: MeaslesC: RubellaD: MalariaCorrect Ans:DExplanationOther diseases considered for global eradication include Filariasis, Dracunculiasis, Taeniasis and Mumps. Ref: Park, 21st Edition, Page 38.

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

Which of the following are strategies of polio eradication in India?

A: Sustain high levels of routine immunisation coverageB: Monitor OPV coverage at district level and belowC: Arrange follow up of all cases of AFP at 60 days to check for residual paralysisD: All the above

Correct Ans:DExplanation

The strategies for Polio eradication also include:

 1) Conduct pulse polio immunisation days every year for 3 – 4 years or until Poliomyelitis is eradicated.2)  Improve surveillance capable of detecting all cases of AFP due to Polio aetiology.3) Ensure rapid case investigation, including collection of stool samples for virus isolation.4) Conduct outbreak control for cases confirmed or suspected to be Poliomyelitis to stop transmission.

 Ref: Park, 17th Edition, Page 158

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In 2013, which country is not polio endemic?

A: AfghanistanB: Pakistan

C: KenyaD: NigeriaCorrect Ans:CExplanationPolio (poliomyelitis) mainly affects children under five years of age.

 One in 200 infections leads to irreversible paralysis. Among those paralysed, 5% to 10% die when their breathing muscles become immobilized.

 Polio cases have decreased by over 99% since 1988, from an estimated 350 000 cases then, to 223 reported cases in 2012. The reduction is the result of the global effort to eradicate the disease.

 In 2013, only three countries (Afghanistan, Nigeria and Pakistan) remain polio-endemic, down from more than 125 in 1988.

 As long as a single child remains infected, children in all countries are at risk of contracting polio. Failure to eradicate polio from these last remaining strongholds could result in as many as 200 000 new cases every year, within 10 years, all over the world. 

 Ref: http://www.who.int/mediacentre/factsheets/fs114/en/index.html

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

If the probability of full recovery following polio is 0.3 and the probability of partial recovery is 0.4, then the total probability of full or partial recovery following polio is:

A: 0.12B: 0.7

C: 1.2D: 0.1Correct Ans:BExplanation

In case of mutually exclusive events, for example total and partial recovery, the total probability can be calculated by applying the law of addition.i.e. P (full or partial recovery)= P(full recovery)+ P(partial recovery) =  0.4+0.3=0.7 Ref: Medical biostatistics, 1st edition pg: 191

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Vaccine associated paralytic poliomyelitis is suspected if AFP develops within how many days of receipt of OPV?

A: 30B: 45

C: 60D: 90Correct Ans:BExplanationVaccine associated paralytic poliomyelitis: Acute onset flaccid paralysis within 4 to 30 days of receipt of OPV or within 45 to 75 days of contact with a vaccine recipient and neurological deficits remaining 60 days after onset or death.

 Ref: Park 21st edition, page 105.

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A case of acute flaccid paralysis must be observed for how many days for residual weakness in poliomyelitis?

A: 30 daysB: 42 days

C: 60 daysD: 90 daysCorrect Ans:CExplanation

Poliomyelitis is an acute viral infection caused by a RNA virus which is primarily an infection of the gastro-intestinal tract affecting the central nervous system. Acute flaccid paralysis is a common presentation of poliomyelitis where the patient presents with paralysis of acute onset (less than 4 weeks) and affected limbs are flaccid with decreased tone and diminished or absent deep tendon reflexes.

Surveillance is done for all cases of AFP, where patients less than 15 years of age are investigated and should be kept under observation for a minimum of 60 days to check if there is any residual paralysis.

Ref: Park’s Textbook of Preventive and Social Medicine, 19th Edition, Pages 166-172; Epidemiology and Demography in Public Health By Japhet Killewo, Kristian Heggenhougen, Stella R. Quah, Pages 98–99; Recent Advances in Paediatrics, Pages 91–97; Approach to Practical Pediatrics By Narang, Pages 262–268.

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

Dharmendra's index and Jopling's classification deals with:

A: TBB: LeprosyC: SyphilisD: Polio

Correct Ans:BExplanation

Dharmendra’s index is for grading the bacterial index in Leprosy. The Ridley and Jopling classification is used for the classification of Leprosy.

 Ref: Park Textbook of Preventive and Social Medicine, 19th Edition, Page 577; Essentials of Dermatology, Venereology and Leprosy By Chattopadhyay, Page 159; Dermatology By Otto Braun-Falco, Page 223

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

Which is not true about Polio vaccine?

A: Difficult to maintain cold chainB: Salk vaccine doesn’t cause paralysisC: Helps in increasing immunityD: Immunity takes long time to developCorrect Ans:D

Explanation

There is no long term carrier state for poliovirus in immunocompetent individuals, polioviruses have no non-primate reservoir in nature, and survival of the virus in the environment for an extended period of time appears to be remote. Therefore, interruption of person to person transmission of the virus by vaccination is the critical step in global polio eradication. The injected Salk vaccine confers IgG-mediated immunity in the bloodstream, which prevents polio infection from progressing to viremia and protects the motor neurons, thus eliminating the risk of bulbar polio and post-polio syndrome.

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Which is the best way to prevent the spread of Polio during an epidemic?

A: OPV to all childrenB: Isolation of the infectedC: Giving IPV to childrenD: None of the above

Correct Ans:AExplanation

Administration of OPV to all children is the best way to control polio epidemics. Other advantages of OPV are ease of administration, induction of humoral and intestinal immunity, quick production of antibodies in large proportion of vaccinees, it is inexpensive and excretion of virus by the vaccinee which inturn infects others and immunize them.

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

Under national polio eradication programme, a case of acute flaccid paralysis is confirmed as polio by surveillance after how many days after the onset of paralysis?

A: 15 daysB: 30 days

C: 60 daysD: 90 daysCorrect Ans:CExplanationAcute flaccid paralysis is paralysis of acute onset (<4 weeks) duration in a child <15 years of age. Cases of acute flaccid paralysis are confirmed as polio, if they:

 1.  Are associated with isolation of wild poliovirus from the stool of the case, or2.  Have residual neurologic sequelae at 60 days after the onset of paralysis, or3.  Died before follow-up could determine whether residual neurologic sequelae was present at 60 days after onset of paralysis, or4.  If there was epidemiological linkage to a confirmed case

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91-96% of polio virus infection causes belongs to:

A: Sub clinical infectionB: Abortive polioC: Non paralytic polioD: Paralytic polio

Correct Ans:AExplanation

When an individual susceptible to polio is exposed, one of the following responses may occur:

INAPPARENT/ SUBCLINICAL INFECTION: This occurs approximately in 91-96 per cent of poliovirus infections. There are no presenting symptoms. Recognition is only by virus isolation or rising antibody titres.

ABORTIVE POLIO: Occurs in approximately 4 to 8%. lt causes only a mild or self-limiting illness due to viraemia. The patient recovers quickly. Recognition is only by virus isolation or rising antibody titre.

NON-PARALYTIC POLIO: Occurs in approximately 1% of all infections with presenting features of stiffness and pain in the neck and back. The disease lasts 2 to 10 days. Recovery is rapid.

PARALYTIC POLIO: Occurs in less than 1 % infections. The virus invades CNS and causes varying degrees of paralysis.

REMEMBER: India reported its last polio case on January 13, 2011 in West Bengal. In 2009, it reported 741 polio cases, more than anywhere else in the world. In 2010 only 42 cases were reported against 1.5 lakh in 1985.

Ref: Park’s textbook of Preventive and Social Medicine, 21stedition, page-185

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Which of the following is the correct time for administration of zero dose polio vaccine?

A: Before giving DPTB: Before the discharge from the hospital after the deliveryC: When child is having diarrhoeaD: When child is having Polio

Correct Ans:BExplanationThe WHO Programme on Immunization (EPI) and the National Immunization Programme in India recommend a primary course of 3 doses of OPV at one-month intervals, commencing the first dose when the infant is 6 weeks old. It is recommended that a dose of OPV (zero-dose) is required to be given to all children delivered in health institutions before their discharge from the hospital. 

 Ref: Textbook of Preventive and Social Medicine by K Park, 19th edition, Page 170.

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Which of the following vaccine is associated with Toxic Shock Syndrome?

A: Infected BCG vaccineB: Infected DPT vaccine

C: Infected Polio vaccineD: Infected Measles vaccineCorrect Ans:DExplanation

Toxic shock syndrome (TSS) occurs when measles vaccine is contaminated or the same vial is used for more than one session on the same day or next day. The vaccine should not be used after 4 hours of opening the vial. TSS is totally preventable and reflects poor quality of immunization services. Symptoms of TSS are severe watery diarrhoea, vomiting and high fever within few hours of vaccination. This may cause death within 48 hours. Case fatality rates are high.

 Ref: Park’s Textbook of Preventive and Social Medicine, 19th Edition, Pages 129, 138, 161, 170; Textbook of Pediatrics By K.N Agarwal, Page 177

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

Regarding polio which of the following statement is TRUE?

A: Most of the cases are asymptomaticB: Spastic paralysis is seenC: IM injections and increased muscular activity increases the risk of paralytic polioD: Pulse polio immunization is indicated in all children less than 3 years of age

Correct Ans:AExplanation

95% of patients with polio infections are asymptomatic. Patients who become ill develop manifestations such as abortive poliomyelitis, nonparalytic poliomyelitis and paralytic poliomyelitis.

 In patients with spinal poliomyelitis, flaccid paralysis occur over 2-3 days in an asymmetric distribution and affects the proximal muscles of the lower extremities more frequently. Paralysis of the shoulder girdle often precedes intercostal and diaphragmatic paralysis, which leads to diminish chest expansion and decreased vital capacity. 

 The 4 doses of oral polio vaccine and inactivated parenteral vaccine are given at age 2, 4, 6-18 and at 4-6 years.

 Ref: CURRENT Medical Diagnosis & Treatment 2014 chapter 32.

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A newborn has his leg inverted and the dorsum of his foot does not touch the front of tibia. What is the diagnosis of this condition?

A: Congenital vertical talusB: Congenital talipes equino varusC: Cerebral palsyD: Poliomyelitis

Correct Ans:BExplanationCongenital clubfoot (equinovarus foot; talipes equinovarus):

 

It is characterized by fixed ankle plantar flexion (equinus), inversion and axial internal rotation of the subtalar (talocalcaneal) joint (varus), and medial subluxation of the talonavicular and calcaneocuboid joints (adductus).

 

 

 

The typical radiographic findings of incompletely treated clubfoot include the following features:

 

Presence of hind foot plantar flexion; Lack of the normal angular relationship between the talus and calcaneus

(so-called parallelism of talus and calcaneus); and Residual medial subluxation or displacement of the navicular on the talus

and the cuboid on the calcaneus.

 

 

 

Ref: Rab G.T. (2006). Chapter 11. Pediatric Orthopedic Surgery. In H.B. Skinner (Ed), CURRENT Diagnosis & Treatment in Orthopedics, 4e.

 

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Vaccine contraindicated in pregnancy is the following: 

A: DiphtheriaB: Hepatitis-BC: MMRD: Killed polio vaccineCorrect Ans:CExplanationKilled virus, toxoid, or recombinant vaccines may be given during pregnancy. Diphtheria and tetanus toxoid, hepatitis B vaccine series, and killed polio vaccine may be administered during pregnancy to women at risk.

 Live attenuated vaccines (varicella, measles, mumps, polio, and rubella) should be given 3 months before pregnancy or postpartum. Live virus vaccines are contraindicated in pregnancy secondary to the potential risk of fetal infection.

 Secondary prophylaxis with immune globulin is recommended for pregnant women exposed to measles, hepatitis A, hepatitis B, tetanus, chicken pox, or rabies.

 Ref: Bernstein H.B., VanBuren G. (2013). Chapter 6. Normal Pregnancy and Prenatal Care. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e.

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Which of the following vaccine is routinely given in pregnancy?

A: InfluenzaB: Oral polioC: TetanusD: Rabies

Correct Ans:CExplanationTd vaccine should be given to pregnant women in the second or third trimester if they had not been vaccinated in the past 10 years. If a pregnant women received Td in the past 10 years Tdap should be given postpartum.

 American College of Obstetricians and Gynecologists recommend that influenza vaccine should be given only to pregnant women with serious underlying diseases such as chronic diseases or pulmonary problems.

 Ref: The Vaccine Handbook: A Practical Guide for Clinicians: the Purple Book By Gary S. Marshall page 252.

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An 18-year-old male presented with acute onset descending paralysis of 3 days duration. There is also a history of blurring of vision for the same duration. On examination, the patient has quadriparesis with areflexia. Both the pupils are non-reactive. What is the MOST  probable diagnosis in this patient?

A: PoliomyelitisB: BotulismC: DiphtheriaD: Porphyria

Correct Ans:BExplanationThe presence of acute onset of descending paralysis together with diplopia and non reactive pupils suggests a diagnosis of Botulism. Botulism is caused by the botulinum toxin produced by Clostridium botulinum. This toxin cause inhibition of acetylcholine release at the neuromuscular junction through an enzymatic mechanism.

 Patients presents with symmetric cranial nerve palsies followed by symmetric descending flaccid paralysis that may progress to respiratory arrest and death. Cranial nerve involvement produces diplopia, dysphonia, dysphagia and dysarthria. It is followed by flaccid, descending, symmetric paralysis of the voluntary muscles. Pharyngeal collapse secondary to cranial nerve involvement can compromise the airway. Extraocular muscle paralysis manifests as blurred vision or diplopia and an inability to accommodate near vision. patients can have ptosis, facial paralysis, depressed pupillary reflexes with fixed, dilated pupils.

 Ref: Harrison's Principles of Internal Medicine, 18e chapter 141, By Jeremy Sobel; Susan Maslanka.

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

A 33 year old male presented with homonymous hemianopia. He also has ataxia and personality changes. Characteristic inclusions are seen in oligodendrocytes. What is the MOST probable diagnosis in this patient?

A: Progressive multifocal leukoencephalopathyB: Cruetzfeld-Jacob diseaseC: Japanese encephalitisD: Poliomyelitis

Correct Ans:AExplanation

Progressive multifocal leukoencephalopathy(PML) is characterized pathologically by multifocal areas of demyelination of varying size distributed throughout the brain but sparing the spinal cord and optic nerves.

Characteristic microscopic feature:1. Oligodendrocytes have enlarged, densely staining nuclei that contain viral inclusions formed by crystalline arrays of JC virus (JCV) particles.2. Astrocytes are enlarged and contain hyperchromatic, deformed, and bizarre nuclei and frequent mitotic figures.

Clinical presentation:

Visual deficits (45%), typically a homonymous hemianopia Mental impairment (38%) (dementia, confusion, personality change) Weakness, including hemi- or monoparesis Ataxia

Ref: Roos K.L., Tyler K.L. (2012). Chapter 381. Meningitis, Encephalitis, Brain Abscess, and Empyema. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

Uhthoff's symptom is seen in:

A: Multiple sclerosisB: PoliomyelitisC: Guillain–Barré syndromeD: Myasthenia gravis

Correct Ans:AExplanation

Heat sensitivity refers to neurologic symptoms produced by an elevation of the body's core temperature. Uhthoff's symptom is the unilateral visual blurring that may occur during a hot shower or with physical exercise. It is also common in Multiple sclerosis. Such heat-related symptoms probably result from transient conduction block.

Ref: Harrisons principles of internal medicine, 18th edition, Page: 3398.

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

Tonsillectomy is contraindicated in which of the following condition?

A: Small atrophic tonsilsB: QuinsyC: Poliomyelitis epidemicD: Tonsillolith

Correct Ans:CExplanation

Performing tonsillectomy during poliomyelitis epidemic is an absolute contraindication. Unimmunised children may develop polio following tonsillectomy. A tonsillectomy may be performed long after the epidemic has passed and the child is immunised against polio.

 Indications for Tonsillectomy:

Recurrent episodes of acute tonsillitis that is more than four attacks a year 

Patients with recurrent sore throats and rheumatic fever and when tonsils cause repeated attacks of otitis media.

Presence or history of a peritonsillar abscess or of diphtheria carriers. Massive tonsillar hypertrophy causing respiratory obstruction in children Sleep apnea Glossopharyngeal neuralgia

Ref: Textbook Of The Ear, Nose And Throat By De Souza, C. Et Al. page 177-8.

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

All are complications of ulcerative blepharitis, EXCEPT:

A: PoliosisB: MadarosisC: TylosisD: TrichiasisCorrect Ans:AExplanationBlepharitis is a chronic inflammation of lid margin. Some of the complications of ulcerative blepharitis are madarosis, trichiasis, ectropion, epiphora, tylosis and milphosis. 

Madarosis is said to occur when eyelashes fall out of place and and are either replaced or not replaced by few and scattered eyelashes. 

Trichiasis refers to misdirected and distorted cilia rubbing against the cornea. 

Tylosis refers to hypertrophy of lid margin. Milphosis refers to permanent reddening of the lid margin.

Ref: Textbook Of Ophthalmology A 2Nd Ed. By E. Ahmed page 165.

 

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

In a post polio case, iliotibial tract contracture is most likely to result in which of the following?

A: Flexion at the kneeB: Extension at the hipC: Extension at the hip and kneeD: Flexion at the hip and the kneeCorrect Ans:AExplanation

Iliotibial tract is attached posteriorly and laterally to the axis of the knee joint, its contracture cause flexion of the knee, external rotation and posterior subluxation of tibia. Thus iliotibial contracture can cause flexion deformity of the knee, valgus of the knee, external rotation and posterior subluxation of tibia.

Ref: Textbook of Orthopedics and Trauma By GS Kulkarni, Volume 1, 2nd Edition, Pages 567-8 ; Orthopaedics for The Physical Therapist Assistant By Mark Dutton, Page 520

Sample Previous Year Question on Polio from Pathology based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes