Arboviruses Multiple Choice Question And Answers

Arboviruses

Question 1. Crimean-Congo Haemorrhagic Fever [CCHF] is transmitted by:

1. Ticks
2. Mites
3. Catfish
4. Mosquitoes

Answer. (1) Ticks

• Crimean-Congo Haemorrhagic Fever [CCHF] is transmitted by tick

Read And Learn More: Micro Biology And Immunology Multiple Choice Question And Answers

Question 2. Confirmed clinical cases have been reported from India for which of the following viral hemorrhagic fevers?

1. Yellow fever
2. Marburg fever
3. Hantan virus pulmonary syndrome
4. Crimean Congo hemorrhagic fever

Answer. (4) (CCHF)

• Crimean Congo hemorrhagic fever (CCHF) in India – The first confirmed case of CCHF was reported in Ahmadabad, Gujarat, in 2011.
• Subsequently, outbreaks were reported from different districts of Gujarat every year.
• Other diseases given in the MC have never been reported from India.

Question 3. Which of the following is a true arbovirus?

1. HSV
2. JE
3. ECHO
4. Hanta

Answer. (2) (JE)

• Japanese encephalitis belongs to the flavivirus group of arboviruses.
• Hantaviruses, though a part of arboviruses, are not arthropod-borne.

Question 4. Viral hemorrhagic fever found in India are:

1. KFD
2. Dengue
3. Yellow fever
4. Crimean Congo fever

Answer. (1, 2, 4) (KFD, Dengue, Crimean Congo fever)

• Recently, a few cases of Crimean Congo hemorrhagic fever have been reported from Gujarat.

Question 5. Diseases not transmitted by Aedes aegypti is/are:

1. Dengue fever
2. Chikungunya fever
3. Yellow fever
4. Rift valley fever
5. Japanese encephalitis

Answer. (5) (Japanese encephalitis)

Question 6. All are mosquito-borne viral fevers except:

1. Dengue
2. Kysanur Forest disease
3. Yellow fever
4. Japanese encephalitis

Answer. (2) (Kysanur Forest disease)

• Kysanur Forest disease virus is transmitted by a tick.

Question 7. Which of the following is/are Arboviral diseases?

1. Japanese encephalitis
2. Dengue
3. Yellow fever
4. Hand-foot-mouth disease
5. Rocky Mountain spotted fever

Answer. (1, 2, 3) (Japanese encephalitis, Dengue, Yellow fever)

• Options a, b, and c already explained in a chapter review
• Option d- Hand-foot-mouth disease: Exanthematous fever affecting mainly young children, caused by Coxsackie A16, 9 and B 1-3 and Enterovirus-71-
• Option e – Rocky Mountain spotted fever – Spotted fever caused by Rickettsia rickettsii.

Question 8. Group B (flaviviruses) Arboviruses is/are:

1. Dengue fever
2. Rift valley fever
3. Chikungunya fever
4. JE
5. Yellow fever
6. Chikungunya

Answer. (1, 4, 5) (Dengue fever, JE, Yellow fever)

Question 9. A patient came with a history of joint pain and fever for one week. For which the patient took NSAIDs following which he developed a rash and hyperpigmentation on his nose. What is the most likely diagnosis?

1. Dengue
2. Chikungunya
3. Fixed drug eruption
4. Melisma

Answer. (2) (Chikungunya)

• Chik sign (also called brownie nose appearance): Rare presentation; characterized by hyperpigmentation over the centrofacial area; occurs due to increased intraepidermal melanin retention triggered by the chikungunya virus.

Question 10. The life cycle given below is shown by which of the following viruses?

1. JE (Japanese encephalitis) virus
2. Swine flu virus
3. West Nile virus
4. Hendra virus

Answer. (1) (JE virus)

• JE virus has two transmission cycles:
• Pigs → Culex → Pigs
• Ardeid birds → Culex → Ardeid birds

Question 11. The upper age limit administration of the JE vaccine is:

1. 3 years
2. 5 years
3. 10 years
4. 15 years

Answer. (4) (15 years)

Question 12. Japanese encephalitis in India all except:

1. In an Epidemic are 2–3 cases in a village
2. Mosquito bite is always associated with disease
3. Apparent and nonapparent ratio 1:100
4. The incubation period varies from 5–15 days

Answer. (3) (Apparent and nonapparent ratio 1:100)

• Option a- Correct
• The cases of encephalitis represent only the tip of the iceberg.
• ‘Encephalitis cases are scattered in distribution.
• It was observed in North India, the number of cases recorded per village were no more than 1-2’.
• Option b – correct: Culicine mosquitoes (tritaeniorhynchus, Vishnu) and some
• Anopheline mosquitoes are the vectors
• Option c – Incorrect: The ratio of overt disease to inapparent infection varies from 1:300 to 1:1000
• Option d – Correct: The incubation period varies from 5–15 days.

Question 13. In Japanese Encephalitis, pigs act as:

1. Amplifier
2. Definitive host
3. Intermediate host
4. Any of the above

Answer. (1) (Amplifier)

• Japanese encephalitis:
• Reservoir: Ardeid (wading) birds: Herons, cattle ergets, ducks
• Amplifying hosts: Pigs (asymptomatic), bats
• Mosquito attractant: Cattle and Buffalo (infected but not natural host of JE)
• Incidental hosts: Horses (only animal to be symptomatic), humans(dead end), others.

Question 14. Human-to-human transmission not seen in:

1. SARS
2. Japanese B encephalitis
3. Bird’s flu
4. Poliomyelitis
5. HIV

Answer. (2) (Japanese B encephalitis)

• Japanese encephalitis: Human infection is a tangential dead end and it occurs when the infected mosquitoes reach high-density
• SARS and Bird’s flu will be transmitted from man to man by direct contact with infected respiratory secretions
• HIV-transmitted from human to human by parenteral route, vertical (infected mother) and sexual route
• Poliomyelitis is transmitted through the fecal-oral route (ingestion), Inhalation, or through the conjunctiva.

Question 15. Culex tritaeniorhynchus is a vector of ……… disease:

1. JE
2. Dengue
3. KFD
4. Yellow fever

Answer. (1) (Japanese B Encephalitis)

Question 16. A patient had Dengue fever 2 years back caused by Dengue virus serotype 1. Now he is infected with serotype-4. Which is a correct statement.

1. The recent infection will cause mild disease
2. There are increased chances of Dengue hemorrhagic fever
3. There is no chance of Dengue hemorrhagic fever
4. Old infection has no bearing on recent infection

Answer. (2) (There are increased chances of Dengue hemorrhagic fever)

• The risk of acquiring Dengue hemorrhagic fever is higher when there is a second serotype infection (in this case serotype 1 followed by 4), as this promotes antibody-dependent enhancement which is the main pathogenesis behind DHF.

Question 17. True about Dengue is/are:

1. A person infected with one serotype if infected again with the same serotype will lead to dangerous infection
2. In 2009, WHO classified dengue into two categories–dengue hemorrhagic fever and dengue shock syndrome
3. Mostly presented as a mild infection
4. Pathogenesis of DHF is due to antibody-dependent enhancement
5. NS1 antigen is detectable as early as day 1 of fever

Answer. (3, 4, 5) (Mostly presented as mild infection, Pathogenesis of DHFis due to antibody-dependent enhancement, NS1 antigen is detectable as early as day-1 of fever)

• A person infected with one serotype if infected again with a different serotype leads to more severe infections such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS).
• This is due to an immunological phenomenon known as antibody-dependent enhancement which is the main pathogenesis behind DHF.
• In 2009 WHO classified dengue as– dengue with/without warning signs and severe dengue.
• Mostly presented as mild infection. DHF is rare but severe.
• NS1 antigen is detectable as early as day-1 of fever and remains positive up to 18 days.

Question 18. In a suspected patient of dengue, all of these are acceptable investigations on day 3 of presentation except:

1. NS1 antigen detection
2. Viral culture and isolation in Aedes albopticus C6/36 cell line
3. RT-PCR
4. ELISA for antibody against Dengue virus

Answer. (4) (ELISA for antibody against Dengue virus)

In dengue infection, IgM antibody appears after 5th day, whereas NS1 antigen appears in blood from day 1 itself.

Question 19. The tourniquet test is used for the diagnosis of:

1. Dengue
2. Zika virus
3. Chikungunya virus
4. Yellow fever virus

Answer. (1) (Dengue)

A tourniquet test of >20 petechial spots is one of the criteria used to diagnose DHF.

Question 20. Antibody-dependant enhancement (ADE) is a feature of which of the following?

1. Dengue hemorrhagic fever
2. SSPE
3. SSSS

Answer. (1) (Dengue hemorrhagic fever)\

• Antibody-dependant enhancement (ADE) is seen in DHF.

Question 21. The most virulent dengue fever strain is:

1. 1
2. 2
3. 3
4. 4

Answer. (2) (2)

1. Serotype 2 is the most virulent serotype of dengue virus.
2. Mixed serotype infection is more severe than single serotype infection.
3. Among all, serotype 1 followed by 2 is the most dangerous combination.

Question 22. True statements regarding dengue fever:

1. It can cause both endemic and epidemic
2. MC arboviral disease
3. Unaffected by ambient temperature
4. Decreased incidence in the last 30 years in India
5. Self-limiting

Answer. (1, 2, 5) (It can cause both endemic and epidemic, MC arboviral disease, Selflimiting)

• Dengue fever can occur epidemically or endemically.
• Over past 10–15 years, Dengue has become the leading cause of hospitalization and death next to diarrheal and respiratory infection among children in South East Asia region (SEAR) including India.
• Temperature also plays an important role in the transmission of Dengue by the Mosquito.
• Aedes aegypti kept at 26°C fails to transmit DEN-2 serotype.
• Dengue fever is a self-limiting condition and represents the majority of Dengue cases where as both Dengue hemorrhagic fever and Dengue Shock Syndrome are fatal.

Question 23. Dengue hemorrhagic fever is caused by:

1. Type I dengue virus
2. Reinfection with same serotype of dengue virus
3. Reinfection with a different serotype of dengue virus
4. Infection in an immuno-compromised host

Answer. (3) (Reinfection with a different serotype of dengue virus)

• Dengue hemorrhagic fever or dengue shock syndrome occurs in most patients who have had prior infection with one or more dengue serotypes.
• Possible reasons for Dengue hemorrhagic fever: Due to antibody-dependent enhancement
• Antibody raised against the 1st serotype persists and binds to the second serotype and protect it from the host immune system.

Question 24. True about dengue hemorrhagic fever:

1. Increase in hematocrit
2. Decrease in platelet count
3. +ve tourniquet test
4. Pleural effusion present
5. Aedes aegypti bites in day time

Answer. (1, 2, 3, 4, 5) (↑ Hematocrit, ↓ Platelet, +ve tourniquet test, Pleural effusion, Aedes aegypti bites in day time)

• Respiratory distress due to pleural effusion and ascites may occur in any time Criteria for Dengue Hemorrhagic Fever (DHF):
• Fever: Acute, high, continuous for 2–7 days
• Positive Tourniquest test: Petechial spot > 20 per square inch in cubital fossa
• Enlargement of liver
• Thrombocytopenia (< 100,000/mm3)
• Hematocrit raised by > 20%).

Question 25. Dengue virus appears to have a direct man-mosquito-man cycle in The mechanism of dengue virus survival in inter epidemic period is:

1. Nonhuman reservoir
2. Dormant or latent phase
3. Transovarian transmission in Aedes
4. Poor housekeeping in public

Answer. (3) (Transovarian transmission in Aedes)

• Aedes aegypti: Once infected, remains infective for life
• Transovarian transmission is seen by which infection can be spread to offspring.

Question 26. Vector of dengue virus:

1. Aedes aegypti
2. Aedes albopictus
3. Aedes polynesiensis
4. Aedes scutellaris

Answer. (1) (Aedes aegypti)

• Vector for dengue: Aedes aegypti mosquito (MC), but also by (Aedes albopictus, A.polynesiensis and scutellaris)

Question 27. MOST important factor for the prognosis of a patient in DHF?

1. Platelet count
2. Hematocrit
3. Hemoglobin
4. Liver function test

Answer. (1) (Platelet count)

• Platelet count is the most important prognostic factor in Dengue management.

Question 28. All are true about dengue hemorrhagic fever except:

1. Malnutrition is protective
2. Lamivudine is a drug of choice
3. The causative agent belongs to the Flaviviridae group
4. Aedes aegypti acts as vector

Answer. (2) (Lamivudine is a drug of choice)

There is no anti-viral drug available for dengue hemorrhagic fever.

Question 29. True about dengue fever:

1. Caused by 4 serotypes
2. Effective vaccines are widely available
3. Presents with fever and joint pain
4. The virus belongs to the flavivirus genus
5. Contain segmented RNA

Answer. (1, 3, 4) (Caused by 4 serotypes, Presents with fever and joint pain, Virus belongs to flavivirus genus)

1. Dengue virus has 4 serotypes (DEN-1 to DEN-4). However, the fifth serotype was discovered in 2013 in Bangkok
2. No effective vaccine is available for Dengue yet, however, recently a vaccine trial has cleared the Phase III clinical trial.
3. A live-attenuated tetravalent vaccine based on chimeric yellow fever-dengue virus (CYD-TDV) has been developed by Sanofi Pasteur Company.
4. Phase III clinical trial done in Latin America and is expected to be marketed by 2015.
5. Fever and joint pain are the cardinal manifestations of dengue fever.
6. Dengue virus belongs to the Family -Flaviviridae, Genus- Flavivirus.
7. Segmented RNA is present in Bunyavirus, Influenza, Rotavirus, and Arenavirus (CodeBIRA).

Question 30. Egg allergy, which vaccine is contraindicated:

1. MMR vaccine
2. Hepatitis B
3. DPT
4. Yellow fever vaccine

Answer. (4) (Yellow fever vaccine)

• Yellow fever vaccine and influenza vaccine are contraindicated in persons who develop allergy to egg

Question 31. Which of the following arbovirus diseases is not found in India?

1. Sandfly fever
2. Rift valley
3. West Nile
4. Yellow fever

Answer. (2, 4) (Rift Valley, Yellow fever)

• Yellow fever NOT found in India:
• Rift Valley fever: It is a mosquito-borne viral disease causing influenza-like illness and hemorrhagic fever outbreaks in Kenya, Yemen, and Saudi Arabia (not found in India)

Question 32. The incubation period of yellow fever:

1. 3–6 days
2. 3–4 weeks
3. 1–2 weeks
4. 8–10 weeks

Answer. (1) (3–6 days)

• The incubation period of yellow fever is 3–6 days (6 days for International Health Regulations)

Question 33. According to international health regulations, yellow fever transmission risk is minimal if the Aedes aegypti index is less than…:

1. 1%
2. 5%
3. 8%
4. 10%

Answer. (1) (1%)

• According to international health regulations, yellow fever transmission risk is minimal if the Breteau index (Aedes aegypti index) is < 1, surrounding 400 mt of airport

Question 34. Which of the following statements is true regarding Arbo viruses?

1. Yellow fever is endemic in India
2. Dengue virus has only one serotype
3. Kyasanur forest disease (KFD) is transmitted by ticks
4. Mosquito of culex vision-complex is the vector of Dengue fever

Question 35. Which is not useful for the prevention of KFD?

1. Vaccination
2. Deforestation
3. Prevention of roaming cattle
4. Personal protection

Question 36. Which of the following is not associated with the Zika virus?

1. Petechial rash
2. Conjunctivitis
3. Guillain-Barre syndrome
4. Fever with arthralgia

Answer. (None or a) (Petechial rash)

• This is a controversial MC as all the clinical features given in the options can be seen in Zika virus infection.
• The symptoms of Zika virus infection are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache.
• Zika virus is a trigger of Guillain-Barré syndrome

Question 37. True about Zika virus:

1. Can be transmitted by sexual route
2. NAAT from amniotic fluid can be used for prenatal diagnosis
3. 50% of infected patients develop symptoms
4. Aedes mosquito transmission
5. Antiviral therapy is the treatment of choice for ZIKV

Answer. (1, 2, 4) (Can be transmitted by sexual route, NAAT from amniotic fluid…, Aedes…)

• Zika virus is transmitted by bite of Aedes, sexually or by vertical route.
• No antiviral drug is available
• Symptomatic to asymptomatic ratio 1:5.
• NAAT can be used for prenatal diagnosis.

Question 38. VAPP is MC associated with Polio serotype:

1. Type 1
2. Type 2
3. Type 3

Answer. (3) (Type 3)

Question 39. Which is/are true about IPV?

1. Can be administered by intradermal route
2. Can be administered by IM route
3. 0.1 ml by intradermal route
4. 0.5 ml by IM route
5. Given at 14th week

Answer. (All are true)

1. WHO states that two fractional doses IPV (0.1 ml each) administered via the intradermal
2. (ID) route offers higher immunogenicity compared to one full intramuscular (IM) dose of IPV (0.5 ml).
3. IPV is safe, effective, and more immunogenic, can be given alone, or at the same time as any other vaccine, and also helps to “boost” mucosal immunity.
4. It is now under consideration to be introduced in routine immunization programs.

Question 40. Vaccine-associated polio occurs how many days after vaccination?

1. 4–30 days
2. 20–60 days
3. 60–90 days
4. 90–120 days

Answer. (1) (4-30 days)

The onset of symptoms with VAPP usually occurs 4–30 days following receipt of oral polio vaccine (OPV) or within 4–75 days after contact with a recipient of OPV.

Question 41. Which of the following is not a Vaccine-Derived Poliovirus?

1. aVDPV
2. cVDPV
3. mVDPV
4. iVDPVans – mVDPV

Answer. (3) (mVDPV)

• Vaccine-derived polioviruses (VDPVs)
• VDPV isolates exhibit a higher level of genetic divergence from their parental OPV strains at the VP1 sequence, which helps in their prolonged replication, and transmission.

Question 42. Polio is still transmitting in:

1. India
2. Pakistan
3. Nigeria
4. Afghanistan
5. Srilanka

Answer. (2, 3, 4) (Pakistan, Nigeria, Afghanistan)

• Polio is still endemic in Pakistan and Afghanistan. Nigeria was declared polio-free in 2015 but again became endemic in 2016.
•  To know details about the polio eradication update, Refer annexure at the beginning of the book.

Question 43. Diagnosis of polio:

1. Detection of poliovirus in stool
2. Serology
3. Limb wasting
4. AFP

Answer. (1) (Detection of poliovirus in stool)

The Polio virus is best identified by isolation of the virus from stool culture.

Question 44. True about polio:

1. Paralytic polio is the most common
2. Spastic paralysis
3. IM injections and increased muscular activity lead to increased paralysis
4. Polio drops are given only in < 3 year

Answer. (3) (IM injections and increased muscular activity lead to increased paralysis)

• IM injections and increased muscular activity: risk factor for increased paralysis in poliomyelitis
• Paralytic polio occurs in < 0.1% of all cases of poliomyelitis
• Poliomyelitis: results in Acute flaccid paralysis (AFP), not spastic paralysis
• Oral Polio drops are given to all children of < 5 years.

Question 45. The following lesions were seen in a child. The patient is suffering from a disease caused by which of these viruses?

1. Coxsackie A virus
2. Pox virus
3. Herpes simples type 1 virus
4. Toga virus

Answer. (1) (Coxsackie A virus)

• It is a case of hand-foot-mouth disease caused by the Coxsackie A virus; particularly with A-16.
• It is characterized by oral and pharyngeal ulcerations and vesicular rashes of the palm and sole.

Question 46. Coxsackie ‘A’ virus causes all except:

1. Aseptic meningitis
2. Conjunctivitis
3. Hepatitis
4. Hand-foot-mouth disease

Answer. (3) (Hepatitis)

Hepatitis is usually caused by Coxsackie B virus.

Question 47. Coxsackie ‘A’ virus mainly causes:

1. Hepatitis
2. Aseptic meningitis
3. Conjunctivitis
4. Myocarditis

Answer. (2) Aseptic meningitis

Aseptic meningitis is a common manifestation by Coxsackie A

Question 48. Which enterovirus causes acute hemorrhagic conjunctivitis:

1. 68
2. 69
3. 70
4. 71

Answer. (3) (70)

Acute hemorrhagic conjunctivitis: Caused by Coxsackie virus-A24 and also by enterovirus 70.

Question 49. Acute hemorrhagic conjunctivitis is caused by enterovirus:

1. 68
2. 69
3. 70
4. 71

Answer. (3) (70)

Acute hemorrhagic conjunctivitis is caused by enterovirus 70 and Coxsackie virus A24

Question 50. Common causative agents of hand-foot-and-mouth disease is:

1. Enterovirus
2. Coxsackie B4
3. Coxsackievirus A16
4. HPV
5. HAV

Answer. (1, 3) (Enterovirus, Coxsackievirus A16)

Coxsackievirus A5,10 and 16, and Enterovirus 71 are the common causes of hand, foot, and mouth disease.

Question 51. Which of the following is Picornaviridae?

1. Poliovirus
2. Coxsackievirus
3. Rhinovirus
4. Coronavirus
5. Reovirus

Answer. (1, 2, 3) (Polio, Coxasackie, Rhinovirus)

Picornaviridae include Enteroviruses (Polio, Coxasackie, Echovirus, Parechovirus,Enterovirus 68-72) and Rhinovirus

Question 52. Coxsackie virus is:

1. Herpes virus
2. Pox virus
3. Enterovirus
4. Myxovirus

Answer. (3) (Enterovirus)

The Coxsackie virus belongs to the Picornaviridae family.

Question 53. Herpangina is caused by:

1. Enterovirus
2. Rhinoviruses
3. Myxovirus
4. Rabies virus

Answer. (1) (Enterovirus)

Herpangina or vesicular pharyngitis is caused by Coxsackie virus-A.

Question 54. Enterovirus 72 is:

1. Hepatitis A
2. Hepatitis E
3. Hepatitis B
4. Hepatitis C

Answer. (1) (Hepatitis A)

Hepatitis A virus belongs to the Picornaviridae family and it is Enterovirus-72.

Question 55. The commonest viruses that can cause meningoencephalitis in children are:

1. Arboviruses
2. Enteroviruses
3. Herpes viruses
4. Mumps viruses

Answer. (2) (Enterovirus)

• Most common cause of meningoencephalitis in children is Enterovirus

Question 56. Herpangina is due to:

1. HSV
2. HIV
3. Coxsackie A
4. Coxsackie B

Answer. (3) (Coxsackie A)

Herpangina (vesicular pharyngitis) is due to Coxsackie A virus serotypes 1–6, 8, 10.

Question 57. True statement about Enteroviruses:

1. Composed of segmented RNA genome
2. Stable at pH 4
3. Cause pleurodynia
4. Cause encephalitis
5. Cause meningitis

Answer. (2, 3, 4, 5) (Stable at pH 4, Cause pleurodynia, Cause encephalitis, Cause meningitis)

• Enteroviruses (e.g. Polio and Coxsackie virus and Enterovirus type 1-33) are acid stable and, hence can survive in GIT.
• Many enteroviruses can cause aseptic meningitis and encephalitis
• Pleurodynia is caused by Coxsackie virus B
• Segmented RNA is present in Bunyavirus, Influenza, Rotavirus, and Arenavirus (CodeBIRA).

Question 58. Infantile pericarditis and myocarditis is caused by:

1. Coxsackie B
2. Coxsackie A
3. Polio
4. Adenovirus

Answer. (1) (Coxsackie B)

Question 59. Enterovirus associated with acute hemorrhagic conjunctivitis is:

1. Serotype 68
2. Serotype 69
3. Serotype 70
4. Serotype 71

Answer. (3) (Serotype 70)

Acute hemorrhagic conjunctivitis is caused by Enterovirus 70 and Coxsackie A-24.

Question 60. A corneal swab from a hydrophobic patient with a suspected case of rabies is taken, choice of test to be performed from the following options is:

1. Seller stain for Negri’s body
2. Immunofluorescence
3. RT PCR
4. RFFIT

Answer. (2) (Immunofluorescence)

Direct- Immunofluorescence staining is usually performed for demonstration of Rabies antigen in corneal smear or hair follicle of the nape of the neck.

Question 61. True about rabies post-exposure prophylaxis:

1. If a person with complete PEP gets a dog bite, then there is no need to Ig
2. Local treatment of wounds is necessary in all dog bites.
3. A vaccine is not given more than 3 days following dog bite
4. Category 2 bites need ARV
5. Category 3 bites need ARV and Ig

Answer. (1, 2, 4, 5) (If a person with complete PEP gets a dog bite, then there is no need for Ig, Local treatment of wound is necessary for all dog bites., Category 2 bites bites need ARV, Category 3 bites …)

• Postexposure prophylaxis of rabiesIf a previously completely vaccinated individual gets another dog bite, only repeat vaccination (2-3 doses) is requireRepeat is Ig not required.
• Local treatment of wounds is necessary to prevent secondary bacterial infection.
• A vaccine is not given for more than 3 days following a dog bite
• Category 2 bites are treated with six doses of anti-rabies vaccines (ARV).
• Category 3 bites need ARV and Ig.

Question 62. The following image belongs to which virus?

1. Rabies virus
2. Poliovirus
3. Rotavirus
4. Coronavirus

Answer. (1) (Rabies virus)

Question 63. Image belongs to which virus?

1. Rhabdovirus
2. Myxovirus
3. Picornavirus

Answer. (1) (Rhabdovirus)

Question 64. A patient has suddenly developed agitation, anger, and hyperactive after weeks of dog bites. The dog was found dead, brain biopsy of the dog is shown in the picture.

1. Identify.
2. Negri body
3. Molluscum body
4. Torres body
5. Paschen body

Answer. (1) (Negri bodies)

• Clue for diagnosis—The patient has suddenly developed agitation, anger, and hyperactivity after weeks of dog bites.
• Brain biopsy from the Dog- shows Negri’s bodies

Question 65. A patient presented to the hospital with severe hydrophobic corneal scrapings from the patient is obtained. What test should be done on this specimen for a diagnosis of Rabies?

1. RT-PCR for Rabies virus
2. Negri bodies (Sellar stain)
3. Antibodies to rabies virus by Indirect Immunofluorescence
4. Tzanck smear

Answer. (1) (RT-PCR for Rabies virus)

Antigen detection by direct IF or RT-PCR is the preferred method done on corneal smears of Rabies suspects.

Question 66. Negri bodies are abundant in the following cells of the CNS:

1. Subcortical white matter
2. Purkinje cells of the cerebellum
3. Hippocampus
4. Basal ganglia

Answer. (1) (Subcortical white matter)

Question 67. Rabies is identified by:

1. Guarneri bodies
2. Negri bodies
3. Cowdry A-bodies
4. Cowdry B bodies

Answer. (2) (Negri bodies)

• Negri bodies
• Diagnosis of Rabies may be made postmortem by demonstration of Negri bodies in the brain, but they may be absent in 20% of cases.
• Negri bodies are most abundant in the hippocampus and cerebellum
• Impression smears made from brain tissue are stained by Seller’s technique.
• Negri bodies are seen as intracytoplasmic, round/oval, purplish pink structures with characteristic basophilic inner granules.

Question 68. Rabies free zone in India:

1. Lakshadweep island
2. Rajasthan
3. Sikkim
4. Nagaland

Answer. (1) (Lakshadweep island)

Rabies free zone in India: Andaman and Nicobar Island and Lakshadweep Island.

Question 69. Bitten dogs should be observed for at least:

1. 5 days
2. 10 days
3. 15 days
4. 21 days

Answer. (2) (10 days)

• Bitten dogs and cats have to be observed for signs and symptoms for 10 days. If they are healthy, a vaccine is discontinued, if they develop symptoms, then they are humanly killed and tissue is examined.
• For other animal bites, this period of observation is not required they are immediately humanly killed and examined for the presence of rabies antigen in brain sections.

Question 70. For the prevention of human rabies, immediate flushing and washing of the wound(s) in animal bite cases, with plenty of soap and water, under a running tap should be carried out for how much time?

1. 2 minutes
2. 1 minute
3. 15 minutes
4. 5 minutes

Answer. (3) (15 minutes)

• Immediate flushing and washing of the animal bite wound, with plenty of soap and water, under a running tap should be carried out at least for 15 minutes.

Question 71. Antirabies vaccine is prepared by:

1. Street virus
2. Fixed virus
3. Live virus
4. Wild virus

Answer. (2) (Fixed virus)

• A vaccine is prepared from fixed viruses (i.e. viruses grown in serial subcultures in cell lines).
• They differ from wild viruses in many ways

Question 72. For the treatment of a case of class III dog bite, all of the following are correct except:

1. Give Ig for passive immunity
2. Give ARV
3. Immediately stitch the wound under antibiotic coverage
4. Immediately wash the wound with soap and water

Answer. (3) (Immediately stitch wound under antibiotic coverage)

Bite wounds are not sutured immediately to prevent additional trauma which may help spread of virus deeper into tissues.

Question 73. Class II exposure in animal bites includes the following:

1. Scratches without oozing blood
2. Nibbling of uncovered area
3. Scratch with oozing of blood on the palm
4. Bites from wild animals

Answer. (2) (Nibbling of uncovered area)

• Category II bites include
• Minor scratches or abrasions without bleeding or
• Nibbling of uncovered skin

Question 74. A boy got an unprovoked bite from a neighbor’s dog. The animal control authority caught the dog and it was found to be healthy. What will be the next step?

1. Test the antibody level of the dog
2. Withhold immunization and observe dog for 10 days for signs of rabies
3. Start postexposure prophylaxis and watch the dog for 10 days
4. Kill the dog and watch for Negri’s body in the brain

Answer. (3) (Start postexposure prophylaxis and watch the dog for 10 days)

• For category II and III types of exposure to Dogs, the guideline is that post-exposure prophylaxis (vaccine) should be started immediately and the dog should be observed for 10 days.
• Immunoglobulin is given in addition to category III exposure.
• If the dog is found to have abnormal behavior, it is humanly killed and brain tissue is examined for the presence of Negri bodies.