Hiv aids sample questions based on neet pg , usmle, plab and fmge pattern (mci screening)4

27/04/2015 neetpgquiz.medicoapps.org/testCreation/preview.php?tid=23
http://neetpgquiz.medicoapps.org/testCreation/preview.php?tid=23 1/18
A preterm baby developed bullous lesion on the skin soon after birth. The X ray shows
periostitis. What should be the next investigation?
A: VDRL for mother & baby
B: ELISA for HIV
C: PCR for TB
D: Hepatitis surface antigen for mother
Correct Ans:A
Explanation
The baby described in the question stem is most likely suffering from the early
manifestations of congenital syphilis. As per the choices given VDRL is the test done to
diagnose syphilis.
Ref: Harrison’s Principles of Internal Medicine, 16th Edition, Page 981; Skin Diseases &
Sexually Transmitted Infections, Uday Khopkar – 6th Edition, Page 257; Nelson 17th
,COGDT 10th Edition, Page 667;CPDT 18th Edition, Page 56.
Sample Previous Year Question on HIV based on previous Year Questions of NEET PG,
USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such
Quizzes
Which response is not seen in newborns as a measure of thermogenesis?
A: Shivering
B: Breakdown of brown fat

C: Universal flexion
D: Cutaneous vasoconstrictions
Correct Ans:A
Explanation
Newborns capacity to generate heat by shivering is limited. Primary mechanism of heat
production in the neonate is through metabolism of brown fat or through non shivering
thermogenesis.
Major location of brown fat storage in neonates are upper back and neck, mediastinum
and around the kidneys. Brown fat contains hish stores of triglycerides which is broken
down into glycerol and fatty acids. Oxidation of fatty acids result in the generation of heat.
Quizzes
A preterm baby developed bullous lesion on the skin soon after birth. The X ray shows
periostitis. What should be the next investigation?
B: ELISA for HIV
C: PCR for TB
Correct Ans:A
Explanation
The baby described in the question stem is most likely suffering from the early
manifestations of congenital syphilis. As per the choices given VDRL is the test done to
diagnose syphilis.
Ref: Harrison’s Principles of Internal Medicine, 16th Edition, Page 981; Skin Diseases &
Sexually Transmitted Infections, Uday Khopkar – 6th Edition, Page 257; Nelson 17th

,COGDT 10th Edition, Page 667;CPDT 18th Edition, Page 56.
Quizzes
Which of the following investigation is the BEST method of diagnosing HIV in childhood?
A: CD4 cell counts
B: P24 antigen
C: ELISA
D: Anti HIV antibody
Correct Ans:B
Explanation
The two tests used for diagnosing HIV infection in in children less
than 18 months are detection of HIV nucleic acid (DNA or RNA)
AND detection of HIV p24 antigen. Definitive diagnosis requires
presence of reactive tests on two separate determinations using
one of the above tests after 4 or 6 weeks and confirmed by the
second test. Diagnostic testing should be done 6 weeks or longer
after complete cessation of breast feeding.
Laboratory criteria for diagnosing HIV infection in children more
than 18 months:

Serologic testing
Detection of HIV nucleic acid(DNA or RNA)
Detection of HIV p24 antigen

Ref: Advances in Pediatrics by Dutta By Jaypee Brothers, page 256.

Quizzes
Which of the following investigation is the BEST method of diagnosis of HIV in childhood?
A: CD4 cell counts
B: P24 antigen
C: ELISA
D: Anti HIV antibody
Correct Ans:B
Explanation
The two tests used for diagnosing HIV infection in in children less than 18 months are
detection of HIV nucleic acid (DNA or RNA) AND detection of HIV p24 antigen. Definitive
diagnosis requires presence of reactive tests on two separate determinations using one of
the above tests after 4 or 6 weeks and confirmed by the second test. Diagnostic testing
should be done 6 weeks or longer after complete cessation of breast feeding.

Infants born to HIV infected mothers will have HIV antibody until 618 months regardless
of infection status due to transplacental passage of maternal antibody. The preferred test
for infant diagnosis is detection of HIV DNA or RNA in blood, collectively referred to as
nucleic acid amplification testing (NAT).

Laboratory criteria for diagnosing HIV infection in children more than 18 months:

Serologic testing
Detection of HIV nucleic acid(DNA or RNA)
Detection of HIV p24 antigen

Ref: Advances in Pediatrics by Dutta By Jaypee Brothers, page 256. McFarland E.J.
(2012). Chapter 41. Human Immunodeficiency Virus Infection. In W.W. Hay, Jr., M.J.
Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment:
Pediatrics, 21e.

Quizzes
A patient with HIV is on therapy with protease inhibitors. He presents with limitation of
abduction and internal rotation of the hip. The most probable diagnosis is:
A: Tuberculosis of hip joint
B: Avascular necrosis (AVN) of femoral head
C: Secondary osteoarthritis of hip
D: Septic arthritis of hip
Correct Ans:B
Explanation
Limitation of abduction and internal rotation of hip is often seen in avascular necrosis of
femoral head or LeggCalvePerthes disease. Hypertriglyceridemia is a well known risk
factor of avascular necrosis of femoral head (AVN). It has been suggested that treatment
with protease inhibitors increase triglyceride levels, thereby increasing risk of avascular
necrosis of femoral head.
Ref: Current Diagnosis and Treatment of Pain (CDTP), 2006, Page 305; Antiretrovial
Therapy By Clercq, 2001, Page 167; Apley’s System of Orthopaedics and Fractures By
Louis Solomon, 9th Edition, Chapter 19, The Hip, Pages 51115

Quizzes
Which one of the following viruses is least likely to cross placenta?
A: Rubella
B: Herpes Simplex Virus
C: HIV
D: HBV
Correct Ans:D
Explanation
Considering all the above given options, the hepatitis B virus is least likely to cross the
placenta due to its larger molecular size (virion of 42nm in diameter) which gives it less
access through the placenta. It is not teratogenic.

Ref: Dutta Textbook of obstetrics 6th edition, Pages 292, 299300; Medical disorders in
pregnancy: an update By Hiralal Konar, Pralhad Kushtagi, Pages 6774.
Quizzes
All of the following interventions are recommended to prevent mother to child
transmission of HIV, except:
A: Avoid Ergometrine in third stage of labour
B: Highly Active Antiretroviral Therapy (HAART)

C: Elective Caesarean section
D: Intrapartum Zidovudine
Correct Ans:A
Explanation
Ergometrine is give the third stage of labour to reduce post partum haemorrhage, it has no
role in the prevention of HIV transmission.

Ref: Williams Obstetrics, 23rd Edition, Page 1251,1252, 1253; Textbook of Obstetrics By
DC Dutta, 6th Edition, Page 301; Disease Control Priorities in Developing Countries By
Dean T. Jamison, World Bank, Disease Control Priorities Project, Page 346
Quizzes
A: Avoid breast feeding
C: Vaginal delivery
Correct Ans:C
Explanation
For HIVinfected mothers, a scheduled cesarean delivery at 38 weeks can reduce the risk of mother
to child transmission of the virus. If, before her scheduled cesarean delivery, rupture of
membranes or she goes into labor, a cesarean delivery may not reduce the risk of mother tochild
transmission of HIV.
Ref: Recommendations for Use of Antiretroviral Drugs in Pregnant HIV1Infected
Women By Michael A. Stoto, Donna A. Almario, Institute of Medicine (U.S.). Committee on
Perinatal Transmission of HIV, National Research Council (U.S.). Board on Children,

Youth, and Families, Pages 358360.
Quizzes
Non Immune Hydrops Fetalis is caused by:
A: CMV
B: Parvovirus
C: HSV
D: HIV
Correct Ans:B
Explanation
Non immune hydrops can be caused by a variety of causes. Among the infectious cause,
parvovirus can lead to non immune hydrops.

Hydrops fetalis refers to excessive accumulation of fluid in at least two fetal body cavities.
It can be of two types, immune and non immune. Immune type result from hemolysis of
fetal RBC by maternal IgG antibodies to fetal antigen. Non immune type, is the result of
any non antibody mediated process that lead to hydrops.

Ref: Fetal Medicine : Basic Science and Clinical Practice, 2nd Edition, Page 522; Ian
Donald's Practical Obstetric Problems, 6th Edition, Page 218; William's Obstetrics, 23rd
Edition, Page 627; Moffet's Pediatric Infectious Diseases : A Problem Oriented Approach,
4th Edition, Pages 377, 643.
Quizzes
Premature baby of 34 weeks was delivered. Baby had bullous lesion on the body. X ray
shows periostitis. What is the next investigation?

B: ELISA for HIV
C: PCR for T.B
Correct Ans:A
Explanation
This child is suffering from congenital syphilis. Here, this mother and infant require
quantitative nontreponemal (VDRL, RPR) syphilis testing.

The earliest manifestations of congenital syphilis (appearing 2–6 weeks after birth)
include rhinitis, or “snuffles” (23%); mucocutaneous lesions (35–41%); bone changes
(61%), including osteochondritis, osteitis, and periostitis detectable by xray examination
of long bones; hepatosplenomegaly (50%); lymphadenopathy (32%); anemia (34%);
jaundice (30%); thrombocytopenia; and leukocytosis.

Ref: Ogle J.W., Anderson M.S. (2012). Chapter 42. Infections: Bacterial & Spirochetal.In
Hay W.W., Jr, Levin M.J., Deterding R.R., Abzug M.J., Sondheimer J.M. (Eds),CURRENT
Diagnosis & Treatment: Pediatrics, 21e.
Quizzes
A: Avoid Ergometrine in third stage of labour
C: Elective Caesarean section

Correct Ans:A
Explanation
Ergometrine is give the third stage of labour to reduce post partum haemorrhage, it has no
role in the prevention of HIV transmission.

Ref: Williams Obstetrics, 23rd Edition, Page 1251,1252, 1253; Textbook of Obstetrics By
DC Dutta, 6th Edition, Page 301; Disease Control Priorities in Developing Countries By
Dean T. Jamison, World Bank, Disease Control Priorities Project, Page 346
Quizzes
A: Avoid breast feeding
C: Vaginal delivery
Correct Ans:C
Explanation
For HIVinfected mothers, a scheduled cesarean delivery at 38 weeks can reduce the risk of mother
to child transmission of the virus. If, before her scheduled cesarean delivery, rupture of
membranes or she goes into labor, a cesarean delivery may not reduce the risk of mother tochild
transmission of HIV.
Ref: Recommendations for Use of Antiretroviral Drugs in Pregnant HIV1Infected
Women By Michael A. Stoto, Donna A. Almario, Institute of Medicine (U.S.). Committee on
Perinatal Transmission of HIV, National Research Council (U.S.). Board on Children,
Youth, and Families, Pages 358360.

Quizzes
Which of the following results in the least vertical transmission of HIV?
A: Forceps delivery
B: Normal delivery
C: Breast feeding
D: Cesarean Section
Correct Ans:D
Explanation
Caesarean section before onset of labour and rupture of membranes approximately halves
the risk of mothertochild transmission.

Timing Transmission rate
During pregnancy 5–10%
During labour and delivery 10–15%
During breastfeeding 5–20%
Overall without breastfeeding 15–25%
Overall with breastfeeding to six months 20–35%
Overall with breastfeeding to 18–24 months 30–45%

Quizzes
An HIV positive patient is pregnant. During which of the following stage is HIV
transmission maximum?
A: Labour
B: Early pregnancy
C: Late pregnancy
D: Post delivery
Correct Ans:A
Explanation
Majority of HIV transmission occur during labour (4080%).

Perinatal transmission of HIV:
Vertical transmission of HIV to the neonate is about 14 25%.
Transmission of HIV 2 is less frequent (14%) than HIV 1(1435%).
Vertical transmission of HIV is more in cases with preterm birth and with prolonged
membrane rupture.
Risk of vertical transmission is directly related to maternal viral load and inversely
to maternal immune status.
Maternal anti retro viral therapy reduces the risk of vertical transmission by 70%.
Breast feeding increases HIV 1 transmission by 14%.
Ref: Textbook of Obstetrics By D.C Dutta, 6th edn, page 300.


Quizzes
Which of the following congenital infections is associated with minimal teratogenic risk to
the fetus:
A: HIV
B: Rubella
C: Varicella
D: CMV
Correct Ans:A
Explanation
HIV infection in pregnant women has no proven teratogenic effects on the fetus. While
the other three are teratogenic infections.
Ref: Dutta textbook of Obstetrics 6th edition, page 299
Quizzes
All the following are true regarding HIV transmission, from mother to infant, except:
A: Nevirapine prophylaxis is used for the prevention of vertical transmission
B: Zidovudine should be given to both pregnant women and infants
C: Emergency CS increases the chance of transmission
D: Avoid breast feeding

Correct Ans:C
Explanation
In the short course prophylactic antiretroviral (ARV) regimens
Nevirapine is given to mother at the onset of labour and within 72
hours to child cesarean section decreases the transmission of HIV.
Quizzes
Non Immune Hydrops Fetalis is caused by:
A: CMV
B: Parvovirus
C: HSV
D: HIV
Correct Ans:B
Explanation

Non immune hydrops can be caused by a variety of causes. Among the infectious cause,
parvovirus can lead to non immune hydrops.

Hydrops fetalis refers to excessive accumulation of fluid in at least two fetal body cavities.
It can be of two types, immune and non immune. Immune type result from hemolysis of
fetal RBC by maternal IgG antibodies to fetal antigen. Non immune type, is the result of
any non antibody mediated process that lead to hydrops.

Ref: Fetal Medicine : Basic Science and Clinical Practice, 2nd Edition, Page 522; Ian
Donald's Practical Obstetric Problems, 6th Edition, Page 218; William's Obstetrics, 23rd
Edition, Page 627; Moffet's Pediatric Infectious Diseases : A Problem Oriented Approach,
4th Edition, Pages 377, 643.

Quizzes
Transmission of HIV from mother to child is prevented by all the following methods,
EXCEPT:
A:
Oral zidovudine to mother at 3rd trimester along with oral zidovudine to infant
for 6 weeks
B: Vit A prophylaxis to mother
C: Vaginal delivery
D: Stopping breast feeding
Correct Ans:C
Explanation
Maternal transmission of infection from mother to fetus occur most commonly during the
perinatal period. Vaginal delivery is not indicated in HIV positive mothers in an attempt to
minimize the exposure of infant to maternal blood and genital secretions. Methods to
reduce the risk of HIV transmission includes combine antiretroviral therapy with cesarean
section and avoidance of breast feeding.

The factors that increase the likelihood of transmission via breast milk include detectable
levels of HIV in breast milk, the presence of mastitis, low maternal CD4+ T cell counts,
and maternal vitamin A deficiency.

According to a study conducted in france, zidovudine given to HIVinfected pregnant
women from the beginning of the second trimester through delivery and of the infant for
6 weeks following birth had dramatically decreased the rate of intrapartum and perinatal
transmission of HIV infection from 22.6% in the untreated group to <5%.

Ref: Fauci A.S., Lane H.C. (2012). Chapter 189. Human Immunodeficiency Virus Disease:
AIDS and Related Disorders. 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.


Quizzes
Which of the following investigation is used in the detection and confirmation of HIV ?
A: Polymerase Chain Reaction (PCR)
B: Reverse TranscriptasePCR
C: Real Time PCR
D: Mimic PCR
Correct Ans:B
Explanation
Amount of virion packaged HIV 1 RNA in the peripheral blood is an important measure of
disease activity and effectiveness of antiretroviral therapy. This genomic viral RNA can be
measured by RTPCR. HIV1 RNA detection assays are highly sensitive and specific for
diagnosis of HIV1 infection.

PCR is extremely sensitive but cross contamination can occur. The standard blood
screening test for HIV infection is the ELISA. The most commonly used confirmatory test
is the Western blot. Western blot demonstrates antibodies to products of all three of the
major genes of HIV (gag, pol, and env).

The CD4+T cell count is the laboratory test generally accepted as the best indicator of the
immediate state of immunologic competence of the patient with HIV infection. The
hallmark of HIV disease progression is decline in the absolute number and percentage of
CD4 T lymphocytes and an increasing percentage of CD8 T lymphocytes.
In the early weeks after acute HIV infection acquired by highrisk behaviors, HIV
antibody may be absent. Most patients will seroconvert by 6 weeks.

Ref:Manual of Commercial Methods in Clinical Microbiology By Allan L. Truant, Page 101;
Textbook of Pediatric HIV Care By Steven Leonard Zeichne, Page 106
Quizzes
A patient diagnosed to have bronchiectasis develops features of nephrotic syndrome.
What is the most probable diagnosis ?

A: SLE
B: Cystic fibrosis
C: Amyloidosis
D: HIV
Correct Ans:C
Explanation
Amyloidosis is a wellknown cause of nephrotic syndrome and
renal failure, which is usually associated with chronic inflammatory
disease (e.g. rheumatoid arthritis), chronic infections (e.g.
tuberculosis and bronchiectasis) or familial Mediterranean fever
(FMF). All of these conditions are associated with elevated
circulating levels of serum amyloid A (SAA). SAA is one of the
acute phase proteins in inflammation and is a precursor of AA
amyloid.
Quizzes
All of the following statements regarding primary effusion lymphoma are true, except:
A: It generally presents in elderly patients
B: There is often an association with HHV8
C: The proliferating cells are NK cells
D: Patients are commonly HIV positive
Correct Ans:C

Explanation
Primary effusion lymphoma is an aggressive B cell lymphoma. The proliferating cells are B
cells and not NK cells. All other features mentioned above are associated with primary
effusion lymphoma.
Ref: Harrison's Principles of Internal Medicine, 16th Edition, Pages 112122.
Quizzes
80 year old, asymptomatic man present with a Total Leucocyte Count of 100,000, with
80% lymphocytes and 20% PMC's. What is the most probable diagnosis?
A: HIV
B: CML
C: CLL
D: TB
Correct Ans:C
Explanation
An elderly asymptomatic patient presenting with an incidental finding of absolute
lymphocytosis suggests the possible diagnosis of Chronic Lymphoid Leukemia (CLL).
Ref: Harrison’s Principles of Internal Medicine, 17th Edition, Page 693; 16th Edition,
Page 648; Davidson’s Principles and Practice of Medicine, 20th Edition, Page 1046
Quizzes

Hiv aids sample questions based on neet pg , usmle, plab and fmge pattern (mci screening)4

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (16)

Similar to Hiv aids sample questions based on neet pg , usmle, plab and fmge pattern (mci screening)4

Similar to Hiv aids sample questions based on neet pg , usmle, plab and fmge pattern (mci screening)4 (20)

More from Medico Apps

More from Medico Apps (20)

Hiv aids sample questions based on neet pg , usmle, plab and fmge pattern (mci screening)4