MCQ Community

Incubation period
1. Incubation period is :
The interval between the time of contact &/or entry of the agent and onset
of illness.
The time required for multiplication of the microorganism within the host to
produce symptoms.
It is the period during which the patient is infectious & excretes the agent.
X
(answer = period of communicability )
2.

Epidemiological importance of incubation period, it can be utilized for:

Preventive measures.
Medical supervision.
In quarantinable diseases (e.g. cholera & yellow fever), travelling of
exposed individuals is prohibited during the incubation period unless they
are immunized.
To trace the source of infection.
Estimating the prognosis of disease.
All the above.
3. The period during which the patient is infectious & excretes the agent is:
Incubation period
Period of communicability
Epidemiological cycle
True &False:
1. Epidemiology is the study of determinants & distribution of diseases to plan
for prevention & control measures.
2. Bilharziasis, HAV, HCV & diarrheal diseases are endemic in Egypt.
3. Examples of pandemic diseases are influenza & cholera.

4. Examples of diseases that spread as outbreaks are meningitis & food

poisoning.
5. Yellow fever is endemic in certain foci of the world, but not in Egypt.
6. Having subclinical (in apparent) infection of the disease is due to high
immunity or low virulence of the organism.
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7. Individuals with subclinical (in apparent) infection do not transmit infection

to others. X
8. In apparent infection is discovered only by investigations (to detect
organisms or antibodies).
9. Reservoir of infection may be human (case or carrier) or animal.
10. A Case is a patient showing manifestations of disease which are either
typical or atypical.
11. A Carrier is a person harboring the organism in his body, discharging it
without showing signs or symptoms of disease.
12. The 3 main types of carrier include incubatory, convalescent & contact
carrier.
13. Types of carrier as regard duration of carriage include chronic,
intermittent & temporary carrier.
14. Man & animal are the reservoirs of infection in measles, chicken pox &
poliomyelitis. X
15. Man is the reservoir of infection in measles, chicken pox & poliomyelitis.

16. Examples of diseases which have Convalescent carrier are: Typhoid,

Cholera & Diphtheria.
17. Examples of diseases which have Convalescent carrier are: Measles,
Rubella & Chickenpox. X
18.

Tuberculosis has no carrier state.

19. The case is the only source of infection in tuberculosis.

20. Typhoid, cholera & food poisoning are food borne infections.
21. Typhoid, cholera & food poisoning have multiple modes of transmission.
X
22. There is direct fecal oral (hand to mouth) infection in poliomyelitis,
typhoid, dysentery & HAV.
23. Man resists most of animal diseases.
24. Zoonosis is an infectious disease in animals that can be transmitted to
man.
25. Zoonotic diseases in which animal act as reservoir of infection include
plague, rabies, salmonella, bovine TB & anthrax.
26. Zoonotic diseases in which animal act as intermediate host & man is the
definitive host include taenia solium & taenia saginata.

27. Zoonotic disease in which animal act as definitive host & man is the
intermediate host is hydatid disease.
28. Contact transmission is the most important mode of transmission in
nosocomial (hospital acquired) infection.
29. Wound infection in hospital is through contaminated instruments &
dressings.
30. Chemoprophylaxis is the use of drugs for prevention of infectious
diseases.
31. Chemoprophylaxis is used in prevention of malaria, meningococcal
meningitis & streptococcal infection.
32. Active immunity may result from previous infection (manifest or in
apparent) or produced by immunization with an antigen to stimulate the
body immune system to produce antibodies (active immunization i.e.
vaccination).
33. Active immunization (vaccination) is the use of antigens to stimulate the
body immune system to produce specific antibodies.

34. Active immunization may be in the form of inactivated (killed) vaccine,

live attenuated vaccine, toxoid (altered toxin) or chemical extract of
organism (capsular polysaccharides).
35. Examples of inactivated (killed) vaccines are pertussis & Salk vaccine of
poliomyelitis.
36. Examples of live attenuated vaccines are BCG, measles, mumps,
rubella, MMR & Sabin vaccine of poliomyelitis.
37. Examples of toxoids are diphtheria & tetanus toxoids (DT)
38. Examples of toxoids are diphtheria, pertussis & tetanus (DPT). X
39. Example of capsular polysaccharide vaccine is pneumococcus.
40. Passive immunity may be acquired from the mother during pregnancy or
induced by injection of immune serum containing ready formed antibodies
(passive immunization or seroprophylaxis).
41. Passive immunity is temporary while active immunity is long lasting.
42. Passive immunization provides immediate protection while active
immunization provides slower protection.
43. Passive immunization (seroprophylaxis) is the use of immune serum
containing ready formed antibodies for prevention of infectious diseases.

44. Passive immunization may be in the form of human normal

immunoglobulin, human specific immunoglobulin & animal antiserum.
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45. Post-exposure passive immunization is given for protection in diseases

with short incubation period e.g. Measles.
46. Post-exposure active immunization is given for protection in diseases
with long incubation period e.g. Rabies.
47. Disadvantage of animal antisera is that it may cause serum reaction.
48. Animal antisera (antitoxic Sera) are used in the treatment & prevention
of diphtheria, tetanus & gas gangrene.
49. Antitoxic Sera are used for diphtheria, gas gangrene & cholera. X
50. Human normal immunoglobulins are derived from pooled adult Sera in
endemic area.
51. Human normal immunoglobulin protects against endemic diseases as
measles & HAV.
52. Human specific immunoglobulins are derived from convalescent serum
or actively immunized donors. It contains high levels of antibodies.
53. Human specific immunoglobulins are available for chickenpox, rabies &
HBV.
54. MMR, DPT & TAB are examples of mixed antigens (triple) vaccines.

55. Yellow fever vaccine is absolutely protective for 10 years or more.

56. There are no specific measures for contacts of streptococcal case. X
(answer: chemoprophylaxis)
57. DPT vaccine provides immunity for 3 - 5 years.
58. Passive immunization of contacts (by human normal immunoglobulin)
could prevent measles.

59. Chemoprophylaxis of contacts (by rifampicin) could prevent

meningococcal meningitis.
60. The effectiveness of TAB vaccine of enterica is 30-60%, its validity is 1-2
years.
61. Food handlers have to receive TAB & cholera vaccines. X
62. Food handlers have to receive TAB vaccine of enterica (= typhoid &
paratyphoid fever).
63. Cholera & yellow fever are quarantinable diseases that require
international measures.
64. Examples of throat & nasopharyngeal carriers are diphtheria,
streptococci & staphylococci.
65. There are intestinal carriers in typhoid, cholera & poliomyelitis.

66. There are intestinal, gall bladder & urinary carriers in typhoid.
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67. Typhoid bacilli could be detected in urine of cases & carriers.

68. In diseases having convalescent carrier, all convalescents become
chronic carriers. X (answer: a small proportion in few diseases)
69. Chronic carriers are only known in the convalescent type.
70. Examples of diseases which have chronic carrier are streptococcal
throat carrier, typhoid, hepatitis B & C and HIV (AIDS).
71. Urinary carriers are known for cholera. X
(answer: typhoid &
paratyphoid)
72. Exposure to infection is the only source of actively acquired immunity. X
(answer: exposure to infection & immunization)
73. MMR vaccine is a mixed antigen vaccine, made of live attenuated
strains of measles, mumps & rubella.
74. Live vaccines are contraindicated in pregnancy & immunodeficiency.
75. MMR vaccine is contraindicated in immunodeficiency because its a
heat-killed vaccine. X
76. Vaccines of small pox, measles, mumps, rubella, diphtheria & tetanus
are nearly absolutely protective (> 99% protective).
77. Yellow fever vaccine is absolutely protective (> 1oo% protective).
78. No attacks were reported among the vaccinated with yellow fever
vaccine during the period of validity ( 10 years).
79. Vaccines of poliomyelitis, BCG & pertussis are highly protective (80-95%
protective).
80. TAB & cholera vaccines are moderately protective (30 -60% protective).

81. Cholera vaccine has a short validity period of some months.

82. Measles vaccine has a solid (for life) validity period.
83. Yellow fever vaccine has a validity of 10 years or more.
84. Vaccines with a validity of few years include: TAB (1-2 y), small pox,
DPT (3-5 y) & BCG ( 5 y).
85. Incidence rate measures the number of new cases of particular disease.

86. Prevalence rate measures the number of old and new cases of
particular disease.
87. Sabin vaccine induces both local intestinal & humoral immunity.
88. Sabin vaccine induces humoral immunity only. X
89. The reservoir (source) of infection in TB is the carrier. X
90. There is no carrier state in TB.
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1. Animals could be the sources of infection for the following diseasesexcept one:
Tuberculosis
Salmonella food poisoning
Typhoid fever. X
Brucellosis
2. The following are examples of bacterial diseases with killed vaccinesexcept one:
Typhoid
Cholera
Diphtheria. X.
(Answer: toxoids)
Pertussis
3. The following are examples of live attenuated (avirulent) viral vaccinesexcept one:
Rubella
Measles
Salk.
X.
(Answer: killed)
Mumps
4. Compulsory immunization is against the following droplet infectionexcept one:
Diphtheria
Mumps
Rubella
Chickenpox.
X
5. Subclinical infection in - select one:
Syphilis & gonorrhea
Poliomyelitis & enterica.

Measles & chickenpox

None of the above
6. Compulsory immunization is against the following bacterial infectionsexcept one:
Pertussis
Diphtheria
Cholera. X
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4.

5.

TB
As regard Mode of transmission, Poliomyelitis is:
Fecal oral infection.
Droplet infection.
Arthropod borne infection.
X
Diseases have single mode of transmission- except one:
Cholera.
( food borne)
Typhoid.
(Food borne)
Poliomyelitis. X.
(Food borne & droplet)
Yellow fever.
(Arthropod borne)

6. The following diseases have multiple mode of transmission- except one:

Measles.
X.
(Droplet)
Poliomyelitis.
(Food borne & Droplet)
TB.
( Food borne & Droplet)
HBV.
( Blood borne, Sexual contact & Congenital)
7. Quarantinable diseases include all the following except:
Cholera.
Yellow fever.
Plague.
Anthrax.
Small pox.
Chicken pox.
X
8. Infections followed by permanent resistance to reinfection I.e. infecting
man once only in his life include:
Measles.
Yellow fever.
Rubella.
Influenza.
X

9. Diseases have acquired natural immunity- except one:

German measles (rubella)
Measles
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Tetanus. X
Mumps
10. Vaccine with high efficacy could not be effective in reducing incidence of
infectious disease, because- select one:
Poor storage of vaccine
Improper dosing & spacing of vaccination
Non-potent vaccine
Vaccination at wrong age
Unidentifiable host factors
All of the above.

11. The definition of epidemiology related to study "distribution of

disease" includes - select one:
Time: trend of disease & incubation period
Place: living & work environment
Person: age, sex & occupation
All of the above.
12. The definition of epidemiology related to study "determinants of
disease" includes - select one:
Causative agent (s)
Host factors that determine susceptibility
Environmental factors that determine host's exposure to causative agent
All of the above
13. Epidemiology is the science concerned with the study of - except one:
The natural history of the disease
Pattern of illness in the population
Modes of transmission
Treatment of individual cases. X
14. The following diseases have chemoprophylaxis - except one:
Typhoid. X
Streptococcal infection
Meningitis
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 TB
Cholera
15. The following diseases have seroprophylaxis (passive
immunization)- except one:
Diphtheria
Measles
Tetanus
Yellow fever. X
16. The following have intestinal carriers- except one:
Cholera
Bovine TB. X
Poliomyelitis
Typhoid
17. The following could cause in-utero infection - except one:
Syphilis
Rubella
Cytomegalo virus
Toxoplasma
TB.
X
18. The following are inactivated (killed) viral vaccines - except one:
Salk
Rabies
Hepatitis A (HAV)
MMR. X
19. The period during which satisfactory immunity level is maintained
following vaccination - is termed:
a) Effectiveness of the vaccine
b) Validity of the vaccine

c) Mixed antigen vaccine

20.

Protective value of vaccine is termed:

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a)
b)
c)
21.
a)
b)

Effectiveness of the vaccine

Validity of the vaccine

Mixed antigen vaccine
As regard Validity of the vaccine, it may be:
Short period (some months): in cholera vaccine.
Few years, in:
TAB vaccine of enterica: 1-2 years.
Small pox & DPT vaccines: 3-5 years.
BCG vaccine: 5 or more years.
c) 10 or more years: Yellow fever vaccine.
d) Solid (for life) immunity: Measles vaccine.
22. As regard Effectiveness of vaccine, it may be:
a) Absolutely protective (100%): in Yellow fever only.
b) Nearly absolutely protective (> 99%): in
Small pox
Measles, Mumps & Rubella (MMR)
Diphtheria & tetanus (DT)

c) Highly protective (80-95%): in Poliomyelitis, BCG & pertussis.

d) Moderately protective (30-60%): in TAB &Cholera.
23. The following are true about BCG vaccine- except one:
live attenuated vaccine
Effectiveness (efficacy) is 80 - 95%
Validity (protection) is 5 years or more
To be given to immunodeficiency cases.
X
20. As regard yellow fever:
One of the quarantinable diseases.
One of the zoonotic diseases (i.e. transmitted from animal to man).
Man to man transmission may occur. X
It is endemic disease in Egypt. X
It is arthropod borne infection.

Travelers to endemic areas must be actively immunized to yellow fever

(vaccinated).
Cases of yellow fever must be isolated in fever hospital or sanitary cordon.

Cases can be isolated at home.

X
Yellow fever vaccine is absolutely (100%) protective.
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 Yellow fever vaccine is 50 to 60% protective. X

Validity of Yellow fever vaccine is 10 years or more. X
24. The following are true about measles vaccine- except one:
Prevent the disease if given within 72 hours of exposure
Compulsory to children 12 - 18 years
Live attenuated vaccine
Inactivated viral vaccine. X
Effectiveness (efficacy) is more than 99%
Validity (protection) is for life.
Control of infectious diseases
True & False:
1. Medical supervision of contacts may be in the form of surveillance,
segregation or isolation.
2. Surveillance: is medical supervision of contacts for the incubation period
of the disease while they are doing their usual activity & movement e.g. go
to school or work, to spot any case.
3. In Segregation: contacts are excluded from work or school during the
incubation period to limit spread of infection.
4. Contacts of cholera are given chemoprophylaxis & isolated in hospital
until 3 negative stool cultures.

5. Contacts of pneumonic plague are isolated in hospital for 10 days.

6. Contacts of pneumonic anthrax are isolated in hospital for 7 days.
7.
1. Control of infectious diseases include:
Control of cases.
Control of contacts.
Control of environment.
Control of community.
All of the above.
2. Control of Cases in infectious diseases include:
Notification
Isolation
Disinfection
Treatment
Release
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All of the above.

3. Isolation of cases In infectious diseases of section I (quarantinable
diseases) must be in:
a) Fever hospital
b) Sanitary cordon
c) Home
d) a & b
e) all the above
4. In Terminal Disinfection all are true except one:
a) Done after cure or death of the patient in diseases of section I
b) it is the responsibility of local health office
c) Done for the place of isolation or belongings of the case
d) Done during the illness of the patient
X
5. In Concurrent Disinfection all are true except one:
a) Done during the illness of the patient
b) It is the responsibility of nursing disinfection
c) Done for articles & fomites, discharge, & excreta of the case
d) Done after cure or death of the patient
X
6. Release: - is permission of the case to leave the isolation place & to
resume his normal activities, after:
a) Recovery i.e. clinically free.
b) Having satisfactory general health.
c) Cessation of infectivity which is proved by 3 successive negative
bacteriological results.
d) After a period of time which cover the period of communicability.
e) All of the above

7. Control of Contacts in infectious diseases include:

a) Enlistment
b) Medical examination
c) Medical supervision
d) Specific protection
e) All of the above
8. Segregation of contacts from work or school during the incubation period
is indicated in except one:
a) Measles
b) Diphtheria
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c) Meningitis
d) Enteric fever

9. Isolation of contacts in fever hospital or sanitary cordon is indicated in

except one:
a) Cholera
b) Pneumonic plague
c) Pneumonic anthrax
d) Measles X
Occupational & work related disease
1. Occupational disease means:
Compensable & work specific.
Multifactorial. X
May occur due to other non work related causes. X
Hypertension is an example for occupational disease. X
2. Work related disease is:
a) Compensable. X
b) Multifactorial.

c) Ischemic heart disease is an example.

d). a & c are correct. X
e). b & c are correct.
1.
2.
3.
4.
5.
6.
7.

Nosocomial infection
Nosocomial infection is also termed hospital-acquired infection.
Hand wash is the single most important preventive measure of nosocomial
infection.
Wearing gloves is the single most important preventive measure of
nosocomial infection.
Disinfection is the single most important preventive measure of nosocomial
infection. X
The most common nosocomial infections are of the urinary tract, surgical
wounds, burns & respiratory tract.

Contact transmission is the most important & frequent mode of

transmission of nosocomial infection.
Other modes of transmission in nosocomial infection are airborne, food
borne & arthropod borne infections.
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8.

Prevention of nosocomial infection include:

Isolation precautions
Hand wash
Wearing gloves & disinfection
Sanitary hospital environment
Hospital personnel: pre-employment examination, supervision, active
immunization & chemoprophylaxis
Infection control department
Early screening & diagnosis of cases
Chemoprophylaxis in some infections
All the above.
9. The medical personnel are at risk of the following hospital infections except one:
Hepatitis B & C
HIV (AIDS)
Pulmonary TB
Typhoid. X
10. Chemoprophylaxis could be used for prevention of hospital infection in except one:
Puerperal sepsis
Surgical tetanus
Pre- & post-operative
Tetanus neonatorum.
X

Poliomyelitis
True & False:
1. Children with paralytic polio are protected against polio infection.
2. Children with paralytic polio have to be immunized.

X
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3. Poliomyelitis has incubatory, convalescence, contact & healthy carriers.

4. In poliomyelitis there are chronic carriers. X
5. In paralytic poliomyelitis motor nerve cells are destroyed but there is no
sensory loss.
6. Salk vaccine induces only humoral immunity.
7. Salk vaccine prevents polio infection. X
8. Herd immunity could result from Salk vaccine. X
9. Sabin vaccine produces both humoral & local tissue immunity.
10. Sabin vaccine produces both humoral & cell-mediated immunity.
X
11. The use of Sabin vaccine in developing countries could help in
eradication of poliomyelitis.
12. Poliomyelitis is more common in males than females. X
13. There is cross immunity between the 3 types of polio virus. X
14. In Egypt, polio infection is endemic affecting only younger age groups,
usually abortive & diagnosed as gastroenteritis, & is followed by permanent
immunity.
15. In advanced countries, polio infection occurs only in epidemics affecting
older age group & reaches the paralytic stage.
1. Preventive measures of poliomyelitis include - except one:
General prevention: health education & environmental sanitation.
Specific prevention: active immunization by Sabin or Salk vaccine.
Passive immunization & chemoprophylaxis.
X
2. The following are true about Sabin vaccine - except one:
Trivalent vaccine
Produces lifelong immunity
Parenteral immunizing & booster doses. X. (Answer: oral)
Causes natural mass vaccination
Given orally
3. The following are true about Salk vaccine - except one:
Inactivated vaccine
Produces humeral immunity only
Prevent carrier state. X
Trivalent vaccine
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4. Control measures for polio cases include:

Notification
Isolation
Treatment: symptomatic surgical & physical therapy
All the above.
5. The following are control measures to contacts of polio - except one:
Surveillance for 2 weeks
Avoid factors predisposing to paralysis as excessive fatigue, elective
operations & i.m injection
Seroprophylaxis by immunoglobulin. X
Booster dose of vaccine to < 5 year children
Health education
6. Control measures of the environment in poliomyelitis include:
Improve environmental sanitation
Trace the possible source of infection as water supplies & food handlers
Mass immunization
All the above.

7. The following are true about Salk vaccine - except one:

Formalin killed vaccine
Given by intramuscular injection
No more used in Egypt
Prevent 90% of paralytic cases
Prevent carrier state X
8. The following are the disadvantages of Salk compared to Sabin vaccine except one:
Given parenteral
Not prevent carrier state
Have some risk of vaccine associated paralysis. X
No local immunity
Protection is not life long
9. The following are the disadvantages of Sabin compared to Salk vaccine except one:
Vaccine associated paralysis may occur
It needs special conditions during storage
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 It is contraindicated in pregnancy & immunodeficiency

It is given parenteral.
X
10. Factors that enhance the development of paralysis in poliomyelitis
epidemics include:
Excessive fatigue
Pharyngeal operations e.g. tonsillectomy or adenoidectomy.
Intramuscular injections e.g. i.m diphtheria toxoid, pertussis vaccine &
penicillin
All the above.
Obesity
True & False:
1. Obesity increase the risk of ischemic heart disease, hypertension &
diabetes.
2. Obesity increase the risk of stroke, Osteoarthritis & gall bladder disease.

3. Obesity increase the risk of some cancers, depression & urinary

incontinence.
4. The key to maintain appropriate weight throughout life is a combination of
caloric restriction, low fat diet & physical exercise.
5. Obesity could lead to diabetes type 2 due to the associated insulin
resistance.
6. The majority of obesity cases are related to dietary & life style factors.
7. The majority of obesity cases are related to genetic, hormonal & metabolic
disorders. X
8. Psychological disorders associated with aging could lead to obesity.
9. Bottle fed babies are at risk for obesity.
10. Body mass index & relative weight are of the tools used to assess the
prevalence of obesity.
11. Body mass index (BMI) measures the percent deviation from standard
weight for height.
X
12. Body mass index (BMI) is the body weight in kg / (height in meter).
13. Relative weight (RW) is the percent deviation from standard weight for
height (= body weight in kg / desirable weight x 100 ).
14. If a person height is 190 cm & his weight is 100 kg and the tables
displaying the desirable weight for height shows that the desired weight
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should be 90 kg, the BMI is 111% .

X.
(correct answer: = 100 /
(1.9) = 27.7).
15. In the above example the relative weight (RW) is 111%.
16. Anthropometric measurements to assess obesity (nutritional status)
include weight, height & hemoglobin level. X
17. Anthropometric measurements to assess obesity include BMI, RW,
triceps skin fold thickness, waist circumference & waist-hip ratio.
18. BMI cut-offs apply differently to males & females.
X
19. Men are considered obese when the BMI is greater than 30 kg/m and
women are considered obese when the BMI is 18-30 kg/m.
X
20. An individual is considered obese when the BMI is greater than 27.5
kg/m & RW is 120% or more.
21. Both BMI & waist circumference cut-offs apply differently for males &
females. X
22. Waist circumference, skin fold thickness & waist-hip ratio cut- offs apply
differently to males & females.

23. Women with waist circumference more than 88 cm are at risk of

diabetes.
24. Men with waist circumference more than 102 cm are at risk of diabetes.

1. All are true about body mass index (BMI) except one:
Quantitative assessment of obesity (nutritional status).
The BMI cut-offs apply differently to males & females. X
BMI reflects the available energy stores within the body.
BMI reflects the body weight in relation to height.
2. If an adult height is 170 cm & his weight is 80 kg and the tables displaying
the desirable weight for height shows that the desired weight is 70 kg, the
relative weight ( RW) is:
100%
114%.

14%
None of the above
3. Women are considered obese when - except one:
Waist circumference more than 88 cm.
BMI more than 27.5 kg/ m.
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 RW more than 120%.

Waist circumference more than 102 cm. X
4. Preventive measures for obesity include all the following except:
Calorie restriction (< 400 calories/meal).
Low fat diet.
Physical exercise.
High fiber diet (4 gm /meal)
High carbohydrate & fat diet. X
Increase water intake in between meals & not during meals.
Step it up & down.
Use grocery bags as dumbbells.

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