It gives all the important definitions used in infectious disease epidemiology and continues to elaborate on dynamics of disease transmission followed by prevention and control of infectious diseases.
Emerging and reemerging infectious diseasesarijitkundu88
Various emerging and reemerging diseases. Factors contributing to the emergence of infectious diseases. Antibiotic resistance. The global response to control them. Laboratories network in surveillance.
At the end of the session, the students shall be able to
Describe the HIV AIDS introduction, epidemiology of HIV AIDS, diagnosis of HIV AIDS, treatment of HIV AIDS and prevention control of HIV AIDS.
No commercially available malaria vaccine at the present time.
RTS,S/AS01 is the most advanced vaccine candidate against malaria.
Commonest infectious disease in the tropics
200 millions per year affected with malaria
3 millions per year die due to malaria
The lecture gives concise review about the main four groups of viruses causing hemorrhagic fever i.e. Flavivirues, Filoviruses, Arenaviruses and Bunyaviruses.
It gives all the important definitions used in infectious disease epidemiology and continues to elaborate on dynamics of disease transmission followed by prevention and control of infectious diseases.
Emerging and reemerging infectious diseasesarijitkundu88
Various emerging and reemerging diseases. Factors contributing to the emergence of infectious diseases. Antibiotic resistance. The global response to control them. Laboratories network in surveillance.
At the end of the session, the students shall be able to
Describe the HIV AIDS introduction, epidemiology of HIV AIDS, diagnosis of HIV AIDS, treatment of HIV AIDS and prevention control of HIV AIDS.
No commercially available malaria vaccine at the present time.
RTS,S/AS01 is the most advanced vaccine candidate against malaria.
Commonest infectious disease in the tropics
200 millions per year affected with malaria
3 millions per year die due to malaria
The lecture gives concise review about the main four groups of viruses causing hemorrhagic fever i.e. Flavivirues, Filoviruses, Arenaviruses and Bunyaviruses.
Polio: flaccid paralysis, major and minor
disease, fecal-oral
Coxsackievirus A: vesicular diseases,
meningitis; coxsackievirus B (body):
pleurodynia, myocarditis
Other echovirus and enteroviruses: like
coxsackievirus
Rhinoviruses: common cold, acid labile, does
not replicate above 33° C
Biology, Virulence, and Disease
• Small size, icosahedral capsid, positive RNA
genome with terminal protein
• Genome is sufficient for infection
• Encodes RNA-dependent RNA polymerase,
replicates in cytoplasm
Enteroviruses
• Capsid virus resistant to inactivation
• Disease due to lytic infection of important
target tissue
• Polio: cytolytic infection of motor neurons of
anterior horn and brainstem, paralysis
• Coxsackievirus A: herpangina, hand-foot-
and-mouth disease, common cold,
meningitis
• Coxsackievirus B: pleurodynia, neonatal
myocarditis, type 1 diabetes
Rhinoviruses
• Acid labile and cannot replicate at body
temperature
• Restricted to upper respiratory tract
• Common cold
Epidemiology
• Enteroviruses transmitted by fecal-oral route
and aerosols
• Rhinoviruses transmitted by aerosols and
contact
Diagnosis
• Immune assays (ELISA) or RT-PCR genome
analysis of blood, CSF, or other relevant
sample
Treatment, Prevention, and Control
• OPV and IPV polio vaccines
P
icornaviridae is one of the largest families of viruses and
includes some of the most important human and animal
viruses (Box 46-1). As the name indicates, these viruses are
small (pico) ribonucleic acid (RNA) viruses that have a
naked capsid structure. The family has more than 230
members divided into nine genera, including Enterovirus,
Rhinovirus, Hepatovirus (hepatitis A virus; discussed in
Chapter 55), Cardiovirus, and Aphthovirus. The enterovi-
ruses are distinguished from the rhinoviruses by the stabil-
ity of the capsid at pH 3, the optimum temperature
for growth, the mode of transmission, and their diseases
Webinar Series on COVID-19 vaccine: Jointly organized by Malaysian Society of Infection Control and Infectious Diseases (MyICID) & Institute for Clinical Research (ICR), NIH
Speaker: Dr. Low Lee Lee, Infectious Disease Physician at the Hospital Sultanah Bahiyah, Ministry of Health Malaysia.
Tuberculosis infection is very common in the world and the disease manifest when ever either the virulence of the organism increases or the resistance of the host goes down.it can affect any part of the body.the best method of control of tuberculosis is early diagnosis and treatment.despite international cooperation the problem of resistance in tuberculosis is increasing and great efforts are being made to tackle this problem both in diagnostic tools as well as in treatment modalities. the social factors also play a big role in the causation as well as emergence of resistance is concerned . a participatory approach is required to combat the problem.
Polio: flaccid paralysis, major and minor
disease, fecal-oral
Coxsackievirus A: vesicular diseases,
meningitis; coxsackievirus B (body):
pleurodynia, myocarditis
Other echovirus and enteroviruses: like
coxsackievirus
Rhinoviruses: common cold, acid labile, does
not replicate above 33° C
Biology, Virulence, and Disease
• Small size, icosahedral capsid, positive RNA
genome with terminal protein
• Genome is sufficient for infection
• Encodes RNA-dependent RNA polymerase,
replicates in cytoplasm
Enteroviruses
• Capsid virus resistant to inactivation
• Disease due to lytic infection of important
target tissue
• Polio: cytolytic infection of motor neurons of
anterior horn and brainstem, paralysis
• Coxsackievirus A: herpangina, hand-foot-
and-mouth disease, common cold,
meningitis
• Coxsackievirus B: pleurodynia, neonatal
myocarditis, type 1 diabetes
Rhinoviruses
• Acid labile and cannot replicate at body
temperature
• Restricted to upper respiratory tract
• Common cold
Epidemiology
• Enteroviruses transmitted by fecal-oral route
and aerosols
• Rhinoviruses transmitted by aerosols and
contact
Diagnosis
• Immune assays (ELISA) or RT-PCR genome
analysis of blood, CSF, or other relevant
sample
Treatment, Prevention, and Control
• OPV and IPV polio vaccines
P
icornaviridae is one of the largest families of viruses and
includes some of the most important human and animal
viruses (Box 46-1). As the name indicates, these viruses are
small (pico) ribonucleic acid (RNA) viruses that have a
naked capsid structure. The family has more than 230
members divided into nine genera, including Enterovirus,
Rhinovirus, Hepatovirus (hepatitis A virus; discussed in
Chapter 55), Cardiovirus, and Aphthovirus. The enterovi-
ruses are distinguished from the rhinoviruses by the stabil-
ity of the capsid at pH 3, the optimum temperature
for growth, the mode of transmission, and their diseases
Webinar Series on COVID-19 vaccine: Jointly organized by Malaysian Society of Infection Control and Infectious Diseases (MyICID) & Institute for Clinical Research (ICR), NIH
Speaker: Dr. Low Lee Lee, Infectious Disease Physician at the Hospital Sultanah Bahiyah, Ministry of Health Malaysia.
Tuberculosis infection is very common in the world and the disease manifest when ever either the virulence of the organism increases or the resistance of the host goes down.it can affect any part of the body.the best method of control of tuberculosis is early diagnosis and treatment.despite international cooperation the problem of resistance in tuberculosis is increasing and great efforts are being made to tackle this problem both in diagnostic tools as well as in treatment modalities. the social factors also play a big role in the causation as well as emergence of resistance is concerned . a participatory approach is required to combat the problem.
Previous year question on osteoporosis based on neet pg, usmle, plab and fmge...Abhishek Gupta
Revision with a Master Quiz of 38 questions based on NEET PG Sample Questions on Osteoporosis from Previous Year NEET PG Online Exams.
http://medicoapps.org
Compilation of syndromes for last minute revision tips for neet pg, usmle , p...Abhishek Gupta
A compilation of most commonly asked syndromes in various exams like NEET PG , PLAB, USMLE, FMGE (MCI Screening Exams) for learning as well as last minute revision.
Polio viruses and polio immunisation ppt by Dr Prince C PDR.PRINCE C P
The causative agent of poliomyelitis (commonly known as polio), is a human Enterovirus and member of the family of Picornaviridae.
Poliovirus was first isolated in 1909 by Karl Landsteiner and Erwin Popper.
Poliovirus is one of the most well-characterized viruses, and has become a useful model system for understanding the biology of RNA viruses.
A breakthrough came in 1948 when the virus was successfully cultivated in human tissue in the laboratory by John Enders.
Enders, Weller and Robins, passaged the same strain in non neuronal cell culture.
Vaccines against poliomyelitis: the formalin-inactivated vaccine (IPV) by Jonas Salk(1953) and the live-attenuated vaccines (OPV) by Albert Sabin (1956)
Please answer the following questions- Question #1- Which of the follo.pdfIan5L3Allanm
Please answer the following questions:
Question #1: Which of the following gene transfer method does not require DNA
recombination following the gene transfer event?
A. transformation
B. conjugation
C. transduction
Question #2: What is a R factor?
A. A protein that can digest invasive DNA
B. A section on a pathogen's chromosomal DNA that contains many virulent genes
C. A plasmid that carries several genes contributes to the host bacteria's resistance to antibiotics,
heavy metals, and/or cellular toxins.
D. A genetic element that's found on DNA that can enhance the expression of a bacterium's
resistance genes.
Question #3:
A nine-month-old infant had 12 clinic visits over a seven-month period due to recurring runny
nose and/or ear infections. During each episode, nasopharyngeal swabs were obtained for
bacterial culture, and Streptococcus pneumoniae was obtained.
Although all the infections were resolved with antibiotics , scientists gained insight into
pathogen evolution by seeing how the isolates compared.
Each isolate was first analyzed for seven genes that can indicate strain variability, a process
called multilocus sequence typing (MLST). The lab found two MLST types, indicating that the
patient was infected with two divergent strains of S. pneumoniae . However, when the complete
genomes of several of the isolates were sequenced and compared, four different genotypic strains
were identified, all of which evolved as a result of 16 distinct recombination events between
strains.
Curiously, the technicians noticed that some recombined sequences did not seem to come from
either of the two primary coinfecting strains. It appeared that this new DNA came from
uncultured and undetected strains of S. pneumoniae that had colonized the patient's throat at one
time or another.
Horizontal gene transfers (transformation) between the undetected and detected isolates appear
to have produced the new recombined strains of S. pneumoniae . The genome sequence data
clearly support the idea that S. pneumoniae evolution is characterized by high rates of horizontal
gene transfer and recombination.
The scientists concluded that this and other related bacterial species use horizontal gene transfer
to defeat the adaptive immunity of individual hosts by constantly changing their surface antigens,
possibly explaining the patient's recurring infections.
These types of bioinformatic comparisons suggest that horizontal gene transfers that produce
most of the genetic variation (e.g., different surface antigens) pathogens develop while persisting
within a host.
Based on the case description above, which of the following best explains the patient's
recurring Streptococcus pneumoniae ear infections?
A. The strains with which she was infected were antibiotic-resistant due to horizontal gene
transfer.
B. Because she is a baby, she has low immunity.
C. The strains with which she was infected varied in antigen production due to horizontal gene
transfer.
D. The strains with which .
A detailed assignment presenting information about poliomyelitis , piovirus and polio vaccination.
Polio virus is first virus in history to be obtained in crystalline form . Poliomyelitis has been life threatening disabling disease in human history before vaccination. Vaccination is only method to defeat the virus . Once we will get 0% of infected cases then we will stop the oral polio vaccination. Oral poilo vaccination is more effective in preventing epidemic of poliomyelitis caused by wild polio virus than IPV .
Poliovirus is a picornaviridae. it has 3 wildtypes, Wildtype 2 has been eradicated from the world. All countries have been declared polio free except Pakistan, Afghanistan and Nigeria. Global Polio Eradication Initiative has been discussed.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Previous year question on polio based on neet pg, usmle, plab and fmge or mci screening exams
1. 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, 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 virus
B:
Hepatitis B
virus
C: Measles virus
D: Poliovirus
Correct Ans:B
Explanation
2. 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: Adenovirus
B:
Hepatitis
C
3. C: Parvovirus B19
D: Poliovirus
Correct Ans:D
Explanation
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 common
B:
Spastic
paralysis
C: Increased muscular activity leads to increased paralysis
D: Polio drop given only in <3 year
Correct Ans:C
Explanation
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
4. 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
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Which of the following viruses is capable of replication in enucleated cells?
A: Adenovirus
B: Cytomegalovirus
C: Poliovirus
D: Influenza virus
Correct Ans:C
Explanation
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.
5. 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
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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 virus
B:
Herpes simplex type
II
C: Herpes zoster-varicella virus
D: Poliomyelitis virus
Correct Ans:B
Explanation
Viral 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.
6. 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 virus
B:
Mumps
virus
C: Papillomavirus
D: Poliovirus
Correct Ans:A
Explanation
The 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
7. 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.
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Which of the following strains of wild poliovirus forms the salk type 1 component
of inactivated polio vaccine?
A:
MEF –
1
B: Mahoney
C: Saukett
D: Leningrad – 3
Correct Ans:B
Explanation
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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8. Cluster testing technique is useful in which of the following conditions?
A: Sexually Transmitted Diseases
B: Poliomyelitis
C: Measles
D: Smallpox
Correct Ans:A
Explanation
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
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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:
Endemi
c
B: Epidemic
C: Sporadic case
D: Pandemic
Correct Ans:B
Explanation
9. 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: Polio
B: Measles
C: Rubella
D: Malaria
Correct Ans:D
Explanation
Other diseases considered for global eradication include Filariasis,
Dracunculiasis, Taeniasis and Mumps.
Ref: Park, 21st Edition, Page 38.
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Which of the following are strategies of polio eradication in India?
A: Sustain high levels of routine immunisation coverage
B:
Monitor OPV coverage at district level and
below
C: Arrange follow up of all cases of AFP at 60 days to check for residual paralysis
D: All the above
Correct Ans:D
10. Explanation
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: Afghanistan
B:
Pakista
n
C: Kenya
D: Nigeria
Correct Ans:C
Explanation
Polio (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
11. Sample Previous Year Question on Polio from Pathology based on previous Year
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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: 0.12
B:
0.
7
C: 1.2
D: 0.1
Correct Ans:B
Explanation
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: 30
B:
4
5
C: 60
D: 90
Correct Ans:B
Explanation
Vaccine 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 days
B:
42
days
C: 60 days
D: 90 days
Correct Ans:C
Explanation
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.
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Dharmendra's index and Jopling's classification deals with:
A: TB
B: Leprosy
C: Syphilis
D: Polio
Correct Ans:B
Explanation
13. 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
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Which is not true about Polio vaccine?
A: Difficult to maintain cold chain
B: Salk vaccine doesn’t cause paralysis
C: Helps in increasing immunity
D: Immunity takes long time to develop
Correct 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?
14. A: OPV to all children
B: Isolation of the infected
C: Giving IPV to children
D: None of the above
Correct Ans:A
Explanation
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.
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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 days
B:
30
days
C: 60 days
D: 90 days
Correct Ans:C
Explanation
Acute 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, or
2. Have residual neurologic sequelae at 60 days after the onset of paralysis, or
3. Died before follow-up could determine whether residual neurologic sequelae was
present at 60 days after onset of paralysis, or
4. If there was epidemiological linkage to a confirmed case
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91-96% of polio virus infection causes belongs to:
15. A: Sub clinical infection
B:
Abortive
polio
C: Non paralytic polio
D: Paralytic polio
Correct Ans:A
Explanation
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 DPT
B: Before the discharge from the hospital after the delivery
C: When child is having diarrhoea
D: When child is having Polio
Correct Ans:B
Explanation
The 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
16. 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 vaccine
B:
Infected DPT
vaccine
C: Infected Polio vaccine
D: Infected Measles vaccine
Correct Ans:D
Explanation
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
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Regarding polio which of the following statement is TRUE?
A: Most of the cases are asymptomatic
B:
Spastic paralysis is
seen
C: IM injections and increased muscular activity increases the risk of paralytic polio
D: Pulse polio immunization is indicated in all children less than 3 years of age
17. Correct Ans:A
Explanation
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 talus
B: Congenital talipes equino varus
C: Cerebral palsy
D: Poliomyelitis
Correct Ans:B
Explanation
Congenital 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).
18. 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: Diphtheria
B: Hepatitis-B
C: MMR
D: Killed polio vaccine
Correct Ans:C
Explanation
Killed 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.
19. 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:
Influenz
a
B: Oral polio
C: Tetanus
D: Rabies
Correct Ans:C
Explanation
Td 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: Poliomyelitis
B:
Botulis
m
20. C: Diphtheria
D: Porphyria
Correct Ans:B
Explanation
The 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.
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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 leukoencephalopathy
B:
Cruetzfeld-Jacob
disease
C: Japanese encephalitis
D: Poliomyelitis
Correct Ans:A
Explanation
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.
21. 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.
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Uhthoff's symptom is seen in:
A: Multiple sclerosis
B:
Poliomyeliti
s
C: Guillain–Barré syndrome
D: Myasthenia gravis
Correct Ans:A
Explanation
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.
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Tonsillectomy is contraindicated in which of the following condition?
A: Small atrophic tonsils
B: Quinsy
22. C: Poliomyelitis epidemic
D: Tonsillolith
Correct Ans:C
Explanation
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: Poliosis
B: Madarosis
C: Tylosis
D: Trichiasis
Correct Ans:A
Explanation
Blepharitis 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.
23. 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 knee
B: Extension at the hip
C: Extension at the hip and knee
D: Flexion at the hip and the knee
Correct Ans:A
Explanation
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