MCQs

1- Meningitis results from meninges become affected through

a. virus
b. bacteria
c. fungi
d. both A and B

2- Death can result due to meningitis caused by

a. virus b. bacteria
c. fungi d. amoeba

3- In order to help recover from bacterial meningitis,

a. endoscopy shall be done
b. ultrasounds may help
c. x-rays are treatment
d. antibiotics shall be administered

4- Life is not threatened if meningitis is caused by

a. virus b. bacteria
c. fungi d. amoeba

5. Which of the following hepatitis viruses is not RNA virus?

a. Hepatitis A virus
b. Hepatitis B virus
c. Hepatitis E virus
d. Hepatitis G virus

6. Which of the following nucleic acid is present in hepatitis B virus?

a. dsDNA b. ssRNA
c. ssDNA d. dsRNA

7. The agent representing an isolate of hepatitis G virus is :

a. GBA-A
b. GBV-B
c. GBV-C
d. none of these

8. Hepatitis G virus belongs to the family

a. Caliciviridae b. Flaviviridae
c. Hepadnaviridae d. Coronaviridae

9. Transmission of hepatitis G virus is :

a. Parenterally b. Sexually
c. Both (a) and (b) d. None of these

10. The most serious infection is :

a. superinfection of an HBsAg carrier by HDV
b. infection with HBV alone
c. coinfection of HBVand HDV
d. none of the above

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11. Which of the following specimens contain/s hepatitis B virus in an infected person?
a. Blood b. Semen
c. Saliva d. All of these

12. Vertical transmission may be seen in :

a. Hepatitis B virus
b. Hepatitis C virus
c. Hepatitis D virus
d. All of these

13. Which of the following viral infections can result in chronic carrier state?
a. HBV
b. HCV
c. HDV
d. All of these

14. Most reliable test for detection of hepatitis E infection is :

a. ELISA test for IgM anti-HEV
b. Western blot assay for IgM anti-HEV
c. Polymerase chain reaction for detection of HEV RNA
d. ELISA test for IgG anti-HEV

15. Hepatocellular carcinoma (Hepatoma) may be caused by :

a. Hepatitis A virus
b. Hepatitis C virus or Hepatitis B Virus
c. Both (a) and (b)
d. None of these

16. The defective satellite virus is :

a. hepatitis B
b. hepatitis C
c. hepatitis D
d. hepatitis A

17. All of the following viruses are enveloped except :

a. Hepatitis A virus
b. Hepatitis B virus
c. Hepatitis C virus
d. Hepatitis D virus

18. The diagnosis of hepatitis A virus infection is carried out from the method based on :
a. aminotransferase levels
b detection of faecal HAV by immunoelectron microscopy
c. both (a) and (b)
d. detection of IgM anti-HAV by ELISA

19. Which of the following is not correct for hepatitis A virus ?

a. It can be grown in cell cultures of primate and human cells
b. It is one of the most stable viruses infecting humans
c. It may cause hepatocellular carcinoma
d. None of the above

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20- Which of the following agent is used to prevent Malaria
a. Mebendazole
b. Chloroquine
c. Inactivated vaccine
d. Zinc table

21- In malaria, the form of plasmodia that is transmitted from mosquito to human is the
a. Sporozoite
b. Gametocyte
c. Merozoite
d. Hypnozoite\

22- Each of the following statements concerning Giardia lamblia is correct except:
a. G. lamblia has both a trophozoite and cyst stage in its life cycle
b. G. lamblia is transmitted by the fecal oral route from both human and animal sources
c. G. lamblia causes hemolytic anemia
d. G. lamblia can be diagnosed by the string test

23- A protozoan cyst that contains four nuclei, median bodies and axonemes should be
identified as:
a. Giardia lamblia
b. Trichomonas vaginalis
c. Dientamoeba fragilis
d. Pentatrichomonas hominis
ANSWER: A protozoan cyst that contains four nuclei, median bodies, and axonemes can be
identified as Giardia lamblia. None of the other intestinal flagellates mentioned have a cyst in
the life cycle. The correct answer is a.

24- In a patient with diarrhea, occasionally Entamoeba histolytica/E. dispar four nucleated
cysts (no chromatoidal bars) are identified as being present; however, these cells that
have been misdiagnosed as protozoa are really
a. Macrophages
b. Polymorphonuclear leukocytes
c. Epithelial cells
d. Eosinophils
ANSWER: When a patient has diarrhea, the intestinal contents move through the system very
quickly; consequently, there is no time for protozoan cyst formation. When polymorphonuclear
leukocytes (PMNs) are in the stool for some time, the lobed nuclei come apart and can resemble
protozoan cysts with four separate "nuclei" - however, these "protozoan cysts" are really human
cells. Therefore, the correct answer is b.

25- The pathogenic protozoon with extra-intestinal spread through blood is:
a. Giardia Lamblia
b. Entamoeba coli
c. Isasporabelli
d. Entamoeba histolytica .

26 - Naegleria fowleri is:

a. Permanent parasite of man
b. Free living amoeba
c. Non pathogenic
d. Found in running water stream

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27- Acanthamoeba species cause:
a. chronic primary meningoencephalitis
b. keratitis with blindness
c. granuloma of internal organs
d. all of the above

28- liver abscess is a known complication of infection with:

a. fasciola hepatica
b. giardia lamblia
c. schistosoma mansoni
d. entamoeba histolytica .

29- cryptosporidium multiplies in:

a. the lumen of small intestine
b. the brush border of epithelial lining of small intestine
c. the lumen of large intestine
d. non of the above

30- Giardia lamblia affects mainly:

a. upper small intestine
b. caecum
c. colon
d. rectum
e. stomach

31- flask shaped ulcers in the colon are caused by:

a. Giardia lamblia
b. Acanthamoeba
c. Entamoeba histolytica
d. Naegleria fowleri

32- The following statements are correct regarding giardiasis :

a. transmitted by ingestion of cyst
b. affects mainly the upper small intestine
c. diagnosed by examination of stool or duodenal contents
d. all are correct .

33- The following are true about Cryptosporidium :

a. Minimum infective dose – 10 to 100 oocysts
b. oocysts can persist in the natural environment for long periods of time
c. C. parvum oocyst is able to survive for several days in mild chlorine
d. all are correct

34- Cryptosporidium parvum can be diangnosed in Stool samples by:

a. microscopy(Z-N stain ,, fluorescence)
b. enzyme immunoassay
c. molecular biology methods (PCR)
d. all are correct

35. Giardia lamblia

a. is usually acquired by ingestion of food or water contaminated by the trophozoites
b. trophozoites have four flagella
c. can effectively be treated by mepacrine or metronidazole

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 d. cysts are killed by standard chlorination of water
e. cysts survive in water boiled for ten minutes

36. Steroids are of benefit in the treatment of

a. visceral leishmaniasis
b. Eschericia coli septicaemia
c. cerebral malaria
d. severe typhoid fever
e. herpes zoster recrudescence (shingles)

37. Rice water is the clinical name of diarrhea in

a. Cholera
b. Amoebiasis
c. Giardiasis
d. Shigellosis

38 Vivax malaria
a. may be complicated by anaemia
b. may be complicated by jaundice
c. in a traveller may present more than six months after exposure
d. is sensitive to chloroquine
e. All of the above

39. Quinine
a. is active against schizonts of Plasmodium malariae
b. resistance occurs in Plasmodium falciparum in South East Asia
c. cerebrospinal fluid levels are much lower than serum levels following oral or intravenous
administration
d. causes hypoglycaemia
e. All of the above

40. Cholera
a. Vibrio cholera of the 01 serotype is the only cause of clinical disease
b. low gastric pH protects against infection
c. cholera toxin produces its effect by reducing intracellular levels of cAMP
d. hypoglycaemia is not a recognised complication in children
e. fever is usual in adults

41. Giardiasis
a. cannot be diagnosed by duodenal biopsy
b. leaves the small bowel morphologically normal
c. has an incubation period of less than 48 hours
d. usually responds to treatment with metronidazole
e. All of the above

42. Brucellosis
a. causes spondylitis
b. is treated with tetracycline
c. is a recognised cause if chronic depression
d. is contracted from unpasteurised milk
e. All of the above

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43. Hepatitis A
a. the virus has double stranded DNA
b. the incubation period is 2-6 years
c. the illness is milder in old people
d. is maximally infectious at the peak of jaundice
e. can be prevented by active immunization

44. Typical features of tropical splenomegaly syndrome are:

a. very low or absent malarial antibody titres
b. increased serum IgG
c. Plasmodium falciparum parasitaemia
d. favourable response to prolonged anti-malarial drug therapy
e. All of the above

45. In a cholera epidemic

a. cases have copious watery diarrhoea
b. intravenous rehydration therapy has no place
c. mass chemoprophylaxis with oral tetracycline should be arranged urgently
d. mass vaccination should be undertaken

46. The following are recognised complications of meningococcal infection:

a. deafness
b. reactive polyarthritis
c. purulent monoarthritis
d. pericarditis
e. All of the above

47. E. coli causes disease by a variety of different methods. Which one of the following E. coli
types is characterized by the presence of LT (heat-labile) and ST (heat-stable) proteins?
a. Enteroinvasive (EIEC)
b. Enterotoxigenic (ETEC)
c. Enterohemorrhagic (EHEC)
d. Enteropathogenic (EPEC)
e. Enterohemolytic (EHEEC)

48. Diagnosis of enteric fever during the first week is done by:
a. Stool culture
b. Widal test
c. Isolation of the organism from urine
d. Blood culture

49. Which of the following organisms that infect gastrointestinal tract is the MOST frequent
cause of bacteremia?
a. Shigella flexneri
b. Campylobacter jejuni
c. Salmonella typhi
d. Vibrio cholera

50. Rabies virus can be isolated from following samples of a patient:

a. Cornea
b. Saliva
c. Facial skin

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 d. All of these

51. The following is true of rabies virus except

a. The majority of cases worldwide result from bat bites
b. Infection may be prevented by active and passive immunization
c. Rabies vaccine is a live attenuated vaccine
d. May be diagnosed by serology

52. Hepatitis A virus (HAV) is usually transmitted by:

a. Respiratory secretions
b. Contact with blood
c. Sexual contact
d. Fecal-oral route

53. The first symptom of tetanus is:

a. Tonic contraction of muscles of mastication
b. Lock jaw
c. Rhesus sardonicus
d. Opisthotonus

54. A unique feature of tetanus is:

a. Drooling (flow of saliva outside the mouth)
b. Fever
c. Sweating
d. Muscle spasm in the jaw and neck

55. Typhoid can be diagnosed by performing :

a. Dick's test
b. Widal's test
c.Weil Felix reaction
d. ELISA

56. Cholera toxin increases the activity of what enzyme in human intestinal cells?
a. Adenyl cyclase
b. DNase
c. Coagulase
d. cAMP

57. The intermediate host of malarial parasite is:

a. Culex
b. Man
c. Female anopheles
d. Monkeys

58. Hepatitis A
a. The virus has double stranded DNA
b. The incubation period is 2-6 months
c. The illness is milder in young people
d. Is maximally infectious at the peak of jaundice

59. Rabies is identified by:

a. Guarneri bodies
b. Negri bodies

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 c. Cowdry A bodies
d. Cowdry B bodies

60.Agglutination test for Brucella mainly identifies which class of antibodies?

a. IgG
b. IgM
c. IgA
d. IgE

61. Giardiasis (All are true except):

a. Can be diagnosed by duodenal biopsy
b. Leaves the small bowel morphologically normal
c. Causes abdominal cramps and malabsorption
d. Usually responds to treatment with metronidazole

62. How is hepatitis C diagnosed?

a. The presence of jaundice
b. Blood tests
c. The findings of an enlarged liver during a physical examination
d. Liver biopsy

63. Complications of Malignant malaria:

a. Black fever
b. Espaundia
c. Epidemic typhus
d. Cerebral malaria

64. Black water fever :

a. Caused by L.donovani
b. caused by P. falciparum
c. Treated By flagyl
d. Sudden intravascular haemolysis of infected RBCs.
Explanation: Complication of Malignant malaria is black water fever not black fever. Espundia
is mucocutaneous leishmaniasis

65. Malaria is caused by :

a. Entamoeba histolytica
b. Leishmania
c. Clostridium
d. Plasmodium

66. The germ plasmodium was discovered by :

a. Sir Ronald Ross
b. Golgi
c. Charles Laveran
d. Patric Manson

67. The sexual cycle of Plasmodium is completed in :

a. The gut of mosquito
b. RBC
c. Liver tissue
d. The salivary gland of the mosquito

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68. the most common of the human infecting malarial parasite is :
a. Plasmodium ovale
b. Plasmodium vivax
c. Plasmodium falciparum
d. Plasmodium malariae

69. Malarial parasite is best obtained from a patient :

a. an hour after rise of temperature
b. while temperature is rising sharply
c. after 24 hours when temperature is normal
d. after temperature becomes normal

70. Who is the primary host of malarial parasite ?

a. Man
b. Rat
c. Anopheles
d. None of the above

71. Which of the following is not a synthetic drug to cure malaria ?

a. Quinine
b. Paludrin
c. Pamaquine
d. Plasmochin

72. Vaccination in malaria has not been successful because :

a. Plasmodium produces antitoxins
b. Plasmodium produces minute bodies
c. It does not produce antibodies and antitoxins
d. None of the above

73. Quartan malaria is caused by :

a. Plasmodium vivax
b. Plasmodium ovale
c. Plasmodium malariae
d. Plasmodium falciparum

74. Malignant tertian malaria is caused by :

a. Plasmodium vivax
b. Plasmodium ovale
c. Plasmodium malariae
d. Plasmodium falciparum

75. A 30 year old man presented with bloody diarrheoa. This started 2 days ago. He returned
from a business trip to Egypt recently 1 week ago. What is the most likely causative
organism?
a. Cholera
b. E coli
c. Giardiasis
d. Shigella
e. Crytosporidiosis

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76. A patient with HIV is reviewed. Which one of the following is an example of a nucleoside
analogue reverse transcriptase inhibitors?
a. Zidovudine
b. Indinavir
c. Ritonavir
d. Ribavirin
e. Efavirenz

77. Which one of the following is least associated with rabies?

a. Hydrophobia
b. Opisthotonus
c. Pyrexia
d. Headache
e. Hypersalivation

78. Which one of the following vaccines uses an inactivated preparation of the organism or
virus?
a. Tetanus
b. Meningococcus
c. Oral polio
d. Rabies
e. Diphtheria

79. What is the most appropriate antibiotic to use in cholera?

a. Erythromycin
b. Metronidazole
c. Doxycycline
d. Penicillin V
e. Trimethoprim

80. Which of the following is true regarding the Salmonella species?

a. Rose spots appear in all patients with typhoid
b. They are normally present in the gut as commensals
c. They are anaerobic organisms
d. A relative bradycardia is often seen in typhoid fever
e. Salmonella typhi can be categorised into type A, B and C

81. Which one of the following best describes the action of aciclovir?
a. Inhibits uncoating of virus in the cell
b. Inhibits DNA polymerase
c. Interferes with the capping of viral mRNA
d. Inhibits RNA polymerase
e. Protease inhibitor

82. Which one of the following vaccines uses an extract of the organism or virus?
a. Rabies
b. Yellow fever
c. Oral polio
d. Measles
e. Meningococcus

83. Which of the following infections usually has the longest incubation period?
a. Meningococcus

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 b. Scarlet fever
c. Typhoid
d. Diphtheria
e. Influenza

84. What is the first line antibiotic in the treatment of Shigella dysentery?
a. Flucloxacillin
b. Vancomycin
c. Ciprofloxacin
d. Metronidazole
e. Ampicillin

85. A patient presents with hydrophobia, increased salivation, generalised spasms and
increasing respiratory muscle paralysis. What is the most likely cause?
a. Tetanus b. Rabies
c. Listeriosis d. Actinomycosis
e. Herpes encephalitis

86. An HIV-positive patient recently returned from the tropics presents with severe diarrhoea
(up to 30 times per day). What is the most likely cause?
a. Escherichia coli b. Staphylococcus aureus
c. Cryptosporidium
d. Entamoeba histolytica
e. Salmonella

87. A HIV-positive patient presents with watery diarrhoea, nausea, vomiting and fever. On
examination he looks dehydrated. What is the most likely diagnosis?
a. Toxoplasmosis b. Cryptosporidiosis
c. Salmonellosis d. Pneumocystis infection
e. Ulcerative colitis

88. A patient presents with an episode of diarrhoea followed by jaundice. What is the most
likely pathogen?
a. Hepatitis A virus b. E. coli
c. Salmonella
d. Mycobacterium tuberculosis
e. Staphylococcus

89. A 45-year-old lady returns from South Africawith confusion and headache, but with no
neck stiffness . She has a purpuric rash. Malaria prophylaxis using mefloquine was used.
Which investigation is most important in this case?
a. Lumbar puncture
b. Computerised tomography (CT) scan
c. Multiple blood cultures
d. Malaria films
e. Blood glucose levels

90. Giardia lamblia :

a. is usually acquired by ingestion of food or water contaminated by the trophozoites
b. trophozoites have four flagella
c. can effectively be treated by mepacrinec
d. cysts are killed by standard chlorination of water
e. cysts survive in water boiled for ten minutes

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91. Steroids are of benefit in the treatment of :
a. visceral leishmaniasis
b. Eschericia coli septicaemia
c. cerebral malaria
d. severe typhoid feverd
e. herpes zoster recrudescence (shingles)

92. Rice water is the clinical name of diarrhea in :

a. Cholera
b. Amoebiasis
c. Giardiasis
d. Shigellosis

93. Vivax malaria :

a. may be complicated by anaemia
b. may be complicated by jaundice
c. in a traveller may present more than six months after exposure
d. is sensitive to chloroquine
e. above. All of the

94. Quinine :
a. is active against schizonts of Plasmodium malariae
b. resistance occurs in Plasmodium falciparum in South East Asia
c. cerebrospinal fluid levels are much lower than serum levels following oral or intravenous
administration
d. causes hypoglycaemia
e. All of the abovee

95. Cholera :
a. Vibrio cholera of the 01 serotype is the only cause of clinical disease
b. low gastric pH protects against infection
c. cholera toxin produces its effect by reducing intracellular levels of cAMP
d. hypoglycaemia is not a recognised complication in children.
e. fever is usual in adults

96. Giardiasis
a. cannot be diagnosed by duodenal biopsy
b. leaves the small bowel morphologically normal
c. has an incubation period of less than 48 hours
d. usually responds to treatment with metronidazole
e. All of the above

97. Brucellosis
a. causes spondylitis
b. is treated with tetracycline
c. is a recognised cause if chronic depression
d. is contracted from unpasteurised milk
e. All of the above

98. Hepatitis A
a. the virus has double stranded DNA
b. the incubation period is 2-6 years
c. the illness is milder in old people

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 d. is maximally infectious at the peak of jaundice
e. can be prevented by active immunization

99. Typical features of tropical splenomegaly syndrome are:

a. very low or absent malarial antibody titres
b. increased serum IgG
c. Plasmodium falciparum parasitaemia
d. favourable response to prolonged anti-malarial drug therapy
e. All of the above

100. In a cholera epidemic :

a. cases have copious watery diarrhoea
b. intravenous rehydration therapy has no place
c. mass chemoprophylaxis with oral tetracycline should be arranged urgently
d. mass vaccination should be undertaken

101. The following are recognised complications of meningococcal infection:

a. deafness
b. reactive polyarthritis
c. purulent monoarthritis d. pericarditis
e. All of the above

102. E. coli causes disease by a variety of different methods. Which one of the following E. coli
types is characterized by the presence of LT (heat-labile) and ST (heat-stable) proteins ?
a. Enteroinvasive (EIEC)
b. Enterotoxigenic (ETEC)
c. Enterohemorrhagic (EHEC)
d. Enteropathogenic (EPEC)
e. Enterohemolytic (EHEEC)

103. Diagnosis of enteric fever during the first week is done by:
a. Stool culture
b. Widal test
c. Isolation of the organism from urine
d. Blood culture

104. Which of the following organisms that infect gastrointestinal tract is the MOST frequent
cause of bacteremia?
a. Shigella flexneri
b. Campylobacter jejuni
c. Salmonella typhi
d. Vibrio cholera

105. Rabies virus can be isolated from following samples of a patient:

a. Cornea
b. Saliva
c. Facial skin
d. All of these

106. The following is true of rabies virus except :

a. The majority of cases worldwide result from bat bites
b. Infection may be prevented by active and passive immunization
c. Rabies vaccine is a live attenuated vaccine

-13-
 d. May be diagnosed by serology

107. Hepatitis A virus (HAV) is usually transmitted by:

a. Respiratory secretions b. Contact with blood
c. Sexual contact
d. Fecal-oral route

108. The first symptom of tetanus is:

a. Tonic contraction of muscles of mastication
b. Lock jaw
c. Rhesus sardonicus
d. Opisthotonus

109. A unique feature of tetanus is:

a. Drooling (flow of saliva outside the mouth)
b. Fever
c. Sweating
d. Muscle spasm in the jaw and neck

110. Typhoid can be diagnosed by performing :

a. Dick's test
b. Widal's test
c. Weil Felix reaction
d. ELISA

111. Cholera toxin increases the activity of what enzyme in human intestinal cells?
a. Adenyl cyclase
b. DNase
c. Coagulase
d. cAMP

112. The intermediate host of malarial parasite is :

a. Culex
b. Man
c. Female anopheles
d. Monkeys

113. Hepatitis A
a. The virus has double stranded DNA
b. The incubation period is 2-6 months
c. The illness is milder in young peoplec.
d. Is maximally infectious at the peak of jaundice

114. Rabies is identified by:

a. Guarneri bodies
b. Negri bodies
c. Cowdry A bodies
d. Cowdry B bodies

115. Agglutination test for Brucella mainly identifies which class of antibodies ?
a. IgG
b. IgM
c. IgA

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 d. IgE

116. Giardiasis (All are true except) :

a. Can be diagnosed by duodenal biopsy
b. Leaves the small bowel morphologically normal
c. Causes abdominal cramps and malabsorption
d. Usually responds to treatment with metronidazole

117. How is hepatitis C diagnosed ?

a. The presence of jaundice
b. Blood tests
c. The findings of an enlarged liver during a physical examination
d. Liver biopsy

118. Complications of Malignant malaria:

a. Black fever
b. Espaundia
c. Epidemic typhus
d. Cerebral malaria

119. Black water fever:

a. Caused by L.donovani
b. caused by P. falciparum
c. Treated By flagyl
d. Sudden intravascular haemolysis of infected RBCs.
Explanation: Complication of Malignant malaria is black water fever not black fever.
Espundia is mucocutaneous leishmaniasis

120. Which of the following viral causes of hepatitis is transmitted by contaminated food or
water ?
a. Hepatitis D
b. Hepatitis E
c. Hepatitis C
d. Hepatitis B

121. Hepatitis D is commonly associated with what other type of viral hepatitis?
a. Hepatitis E
b. Hepatitis C
c. Hepatitis B
d. Hepatitis G

122. Which of the following features enteric fever in the first week
a. continued type pyrexia
b. pea-soup diarrhea
c. relative tachycardia
d. typhoid state

123. which is true in Widal test :

a. relapse bears relationship with agglutinin titre
b. agglutinins against flagellar antigen is most important
c. agglutinins begin to appear after third day of infection
d. agglutinins reach a peak titre during the fifth or sixth week

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124. Malta fever is caused by
a. Pasturella tularensis
b. Brucella abortus
c. Haemophilus infeluenzae
d. Pseudumonas mallei

125. Which is false regarding brucellosis

a. Acquired through contact or ingestion of raw goat´s milk
b. Brucella melitensis is the most common type of infection
c. Complement fixation test is more important in acute infection than that of
agglutination reaction
d. May present as pyrexia of unknown origin

126. Which is not a recognized complication of acute shigellosis

a. Haemolytic uraemic syndrome
b. Reiter´s syndrome
c. Liver abscess
d. Endotoxic shock

127. Which is not a complication of Salmonella species :

a. Endocarditis
b. Bronchiectasis
c. Osteomylitis
d. Pyelonephritis

128. Mosquitoes are the vector in the following disorders

a. onchocerciasis b. visceral leishmaniasis
c. myiasis
d. African trypanosomiasis
e. Bancroftian filariasis

129. Quinine
a. is gametocidal for mature gametocytes of Plasmodium falciparum.
b. Is not active against schizonts of Plasmodium malariae
c. cerebrospinal fluid levels are much lower than serum levels following oral or
intravenous administration
d. causes hyperglycaemia

130. A fever of two weeks' duration associated with neutropaenia is characteristically due to
a. Giardiasis b. malaria
c. influenza B d. amoebic liver abscess

131. Concerning meningococcal disease:

a. vaccine is not available for meningococci groups A and C
b. sporadic outbreaks in the UK. are not usually due to type B meningococcus
c. close contacts should be treated prophylactically with oral amoxycillin 3g as a single dose
d. outbreaks of disease occur seasonally in parts of sub-Saharan Africa.

132. Hepatitis A vaccination (Havrix):

a. is a live vaccine
b. is teratogenic
c. has >75% protective efficacy
d. causes mild hepatitis in some patients

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133. Concerning cholera:
a. it has an incubation period of 1-5 months.
b. it causes an inflammatory cell infiltrate in the lamina propria of the mucosa of the small
intestine
c. it causes muscle cramps
d. compared to the classical biotype, the El Tor strain produces more severe illness

134. Typical features of tropical splenomegaly syndrome are:

a. very low or absent malarial antibody titres
b. increased serum IgG
c. lymphocytic infiltration of hepatic sinusoids
d. Plasmodium falciparum parasitaemia

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