[MCQ] Rheumatoid Arthritis-Rabies- Part 2

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Rheumatoid Arthritis-Rabies- Part 2

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Question 1

Phases of clinical rabies are all except ?

A	Prodrome
B	Acute neurologic phase
C	Chronic neurologic phase
D	Coma/death

Question 1 Explanation:

Clinical rabies has three general phases - prodrome, acute neurologic phase (Encephalitic and paralytic) and coma/death.

Question 2

Prodromal symptom suggestive of rabies is ?

A	Oozing of blood at the site of inoculation
B	Vesicles at the site of inoculation
C	Paresthesia / fasciculations at the site of inoculation
D	Gangrene at the site of inoculation

Question 2 Explanation:

Prodromal period usually lasts 2 to 10 days. The prodromal symptom suggestive of rabies is the complaint of paresthesia and/or fasciculations at or around the site of inoculation of virus - reported by 50 to 80% of patients.

Question 3

Hydrophobia or aerophobia in encephalitic rabies is due to involvement of neurons in ?

A	Cortex
B	Purkinje cells of cerebellum
C	Pyramidal cells in hippocampus
D	Brainstem

Question 3 Explanation:

Rabies encephalitis results in early brainstem involvement. Hydrophobia or aerophobia are probably due to dysfunction of infected brainstem neurons that normally inhibit inspiratory neurons near nucleus ambiguus resulting in exaggerated defense reflexes that protect the respiratory tract.

Question 4

Hydrophobia or aerophobia in encephalitic rabies is due to involvement of neurons in ?

A	Cortex
B	Purkinje cells of cerebellum
C	Pyramidal cells in hippocampus
D	Brainstem

Question 4 Explanation:

Question 5

Paralytic presentation during acute neurologic phase of rabies is seen in what percentage of cases ?

A	5 %
B	20 %
C	40 %
D	60 %

Question 5 Explanation:

Two acute neurologic forms of rabies seen in humans are encephalitic (furious) in 80% & paralytic in 20%.

Question 6

Features of rapidly progressive encephalitis and prominent brainstem signs is suggestive of ?

A	Flaviviruses (WNV, Japanese encephalitis virus)
B	HSV
C	Rabies
D	All of the above

Question 6 Explanation:

Patients with rapidly progressive encephalitis and prominent brainstem signs, symptoms or neuroimaging abnormalities may be infected by flaviviruses (WNV, Japanese encephalitis virus), HSV, rabies or L. monocytogenes

Question 7

Hydrophobia is due to painful, violent and involuntary contraction of which of the following muscles ?

A	Diaphragmatic
B	Pharyngeal
C	Laryngeal
D	All of the above

Question 7 Explanation:

Hydrophobia - the painful, violent, involuntary contraction of the diaphragmatic, accessory respiratory, pharyngeal, and laryngeal muscles initiated by swallowing liquids is seen in ~50% of cases of rabies

Question 8

“Dumb rabies” is similar in presentation to ?

A	Multiple sclerosis
B	Amotrophic lateral sclerosis
C	Landry Guillain-Barre´ syndrome
D	Amaurosis fugax

Question 8 Explanation:

Rabies may present as an ascending paralysis resembling the Landry Guillain-Barre´ syndrome (dumb rabies or rage tranquille).

Question 9

Paralytic rabies is characterized by ?

A	Early and prominent muscle weakness
B	Facial weakness
C	Sphincter involvement
D	All of the above

Question 9 Explanation:

Paralytic rabies is characterized by early and prominent muscle weakness, often beginning in the bitten extremity and spreading to produce quadriparesis and facial weakness. Sphincter involvement is common, but sensory involvement is usually mild.

Question 10

In rabies, without artificial supportive measures, maximum period of survival after onset of symptoms is ?

A	10 days
B	20 days
C	30 days
D	40 days

Question 10 Explanation:

The median period of survival after the onset of symptoms is 4 days, with a maximum of 20 days, unless artificial supportive measures are instituted.

Question 11

Which of the following is not a presentation of rabies ?

A	Autonomic nervous system dysfunction
B	Lower motor neuron paralysis
C	Cranial nerve palsies
D	Priapism and spontaneous ejaculation

Question 11 Explanation:

Evidence of upper motor neuron paralysis, with weakness, increased deep tendon reflexes, and extensor plantar responses, is the rule.

Question 12

Full-thickness skin biopsy sample for the antemortem diagnosis of rabies is obtained from ?

A	Nape of the neck
B	Site of inoculation
C	Scalp
D	Ear lobule

Question 12 Explanation:

Full-thickness skin biopsy sample from nape of the neck with at least 10 hair follicles is taken for diagnosis of rabies.

Question 13

Which of the following is the most sensitive test for demonstrating rabies virus specific antigen/antibody ?

A	Indirect fluorescent antibody test
B	Rapid fluorescent focus inhibition test (RFFIT)
C	Reverse transcription polymerase chain reaction (RT-PCR)
D	Direct fluorescent antibody (DFA) test

Question 13 Explanation:

With the exquisitely sensitive RT-PCR, the presence of rabies virus nucleic acid in fresh saliva can be confirmed or ruled out

Question 14

Which of the following does not constitute an exposure to rabies ?

A	Touching a rabid animal or person
B	Contamination of mucous membranes with infectious material
C	Infectious aerosol of rabies virus
D	Ocular contact with contaminated material

Question 14 Explanation:

Simply touching a rabid animal or person does not constitute an exposure to rabies.

Question 15

Rabies postexposure prophylaxis (PEP) includes ?

A	Local wound care
B	Active immunization
C	Passive immunization
D	All of the above

Question 15 Explanation:

Rabies PEP includes local wound care, active & passive immunization

Question 16

Rabies immune globulin (RIG) should not be administered how many days after the first vaccine dose ?

A	1 day
B	3 days
C	5 days
D	7 days

Question 16 Explanation:

All previously unvaccinated persons should be passively immunized with rabies immune globulin (RIG). RIG should not be administered 7 days after the first vaccine dose as endogenous antibodies are produced and passive immunization may be counterproductive.

Question 17

Dose of Rabies immune globulin (RIG) is ?

A	5 IU/kg
B	10 IU/kg
C	20 IU/kg
D	40 IU/kg

Question 17 Explanation:

Dose of RIG is 20 IU/kg and should be injected at site of bite and any remaining after infiltration of the bite site should be administered intramuscularly at a distant site.

Question 18

RIG in derived from ?

A	Cow
B	Dog
C	Sheep
D	Human

Question 18 Explanation:

RIG is purified from serum of hyperimmunized human donors (HRIG) and are better tolerated than equine-derived preparations (ERIG dose 40 IU/kg).

Question 19

After immunization, serum neutralizing antibody titers become detectable within ?

A	1 - 2 weeks
B	2 - 4 weeks
C	4 - 6 weeks
D	6 - 8 weeks

Question 19 Explanation:

After immunization, serum neutralizing antibody titers become detectable within 2 - 4 weeks.

Question 20

Human rabies postexposure prophylaxis (PEP) consists of five doses of purified inactivated rabies vaccine given on days ?

A	0, 3, 7, 14 and 28
B	0, 3, 7, 14 and 90
C	0, 7, 14, 21 and 28
D	0, 7, 14, 21 and 90

Question 20 Explanation:

1-mL doses of purified inactivated rabies vaccine are given on 0, 3, 7, 14, and 28 days.

Question 21

For adults, which is the preferred site for HDCV, RVA, or PCEC injections ?

A	Deltoid
B	Abdomen
C	Gluteal
D	Thigh

Question 21 Explanation:

The gluteal area should never be used for Human Diploid Cell Vaccine (HDCV), Rabies Vaccine Adsorbed (RVA), or Purified Chick Embryo Cell Vaccine (PCEC) injections because administration of HDCV in this area results in lower neutralizing antibody titers. Administration in anterolateral aspect of thigh is acceptable in children.

Question 22

According to Advisory Committee on Immunization Practices (ACIP), schedule of preexposure rabies vaccination is ?

A	Days 0, 3, and 21 or 28
B	Days 0, 3, and 90
C	Days 0, 7, and 21 or 28
D	Days 0, 7, and 90

Question 22 Explanation:

ACIP recommends preexposure rabies vaccination of 1-mL doses of modern cell culture vaccine administered intramuscularly on days 0, 7, and 21 or 28. When a previously immunized individual is exposed to rabies, two booster doses of vaccine should be administered on days 0 and 3. RIG should not be administered to previously vaccinated persons.

Question 23

Pasteur vaccine was made out of ?

A	Horse spinal cords
B	Rabbit spinal cords
C	Mouse spinal cords
D	Cow spinal cords

Question 23 Explanation:

Pasteur vaccine was made out of rabbit spinal cords.

Question 24

Semple vaccine is best related to ?

A	Coonoor
B	Kasauli
C	Chennai
D	Mumbai

Question 24 Explanation:

Semple vaccine is named after Dr David Semple, British director of Central Research institute (CRI) at Kasauli in 1911.

Question 25

Semple vaccine is manufactured from ?

A	Brains of adult sheep
B	Brains of adult horse
C	Brains of adult cow
D	Brains of adult mouse

Question 25 Explanation:

Semple vaccine is manufactured from brains of adult sheep.

Question 26

Shelf life of Semple vaccine is ?

A	Three months
B	Six months
C	Nine months
D	Twelve months

Question 26 Explanation:

Shelf life of Semple vaccine is six months.

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See all quizzes of Rheumatoid Arthritis-Rabies- Part 2 here:

1 Phases of clinical rabies are all except ?
A. Prodrome
B. Acute neurologic phase
C. Chronic neurologic phase
D. Coma/death

2 Prodromal symptom suggestive of rabies is ?
A. Oozing of blood at the site of inoculation
B. Vesicles at the site of inoculation
C. Paresthesia / fasciculations at the site of inoculation
D. Gangrene at the site of inoculation

3 Hydrophobia or aerophobia in encephalitic rabies is due to
involvement of neurons in ?
A. Cortex
B. Purkinje cells of cerebellum
C. Pyramidal cells in hippocampus
D. Brainstem

4 Paralytic presentation during acute neurologic phase of rabies is
seen in what percentage of cases ?
A. 5 %
B. 20 %
C. 40 %
D. 60 %

5 Features of rapidly progressive encephalitis and prominent
brainstem signs is suggestive of ?
A. Flaviviruses (WNV, Japanese encephalitis virus)
B. HSV
C. Rabies
D. All of the above

6 Hydrophobia is due to painful, violent and involuntary contraction
of which of the following muscles ?
A. Diaphragmatic
B. Pharyngeal
C. Laryngeal
D. All of the above

7 “Dumb rabies” is similar in presentation to ?
A. Multiple sclerosis
B. Amotrophic lateral sclerosis
C. Landry Guillain-Barre´ syndrome
D. Amaurosis fugax

8 Paralytic rabies is characterized by ?
A. Early and prominent muscle weakness
B. Facial weakness
C. Sphincter involvement
D. All of the above

9 In rabies, without artificial supportive measures, maximum period
of survival after onset of symptoms is ?
A. 10 days
B. 20 days
C. 30 days
D. 40 days

10 Which of the following is not a presentation of rabies ?
A. Autonomic nervous system dysfunction
B. Lower motor neuron paralysis
C. Cranial nerve palsies
D. Priapism and spontaneous ejaculation

11 Full-thickness skin biopsy sample for the antemortem diagnosis
of rabies is obtained from ?

A. Nape of the neck
B. Site of inoculation
C. Scalp
D. Ear lobule

12 Which of the following is the most sensitive test for demonstrating
rabies virus specific antigen/antibody ?
A. Indirect fluorescent antibody test
B. Rapid fluorescent focus inhibition test (RFFIT)
C. Reverse transcription polymerase chain reaction (RT-PCR)
D. Direct fluorescent antibody (DFA) test

13 Which of the following does not constitute an exposure to rabies ?
A. Touching a rabid animal or person
B. Contamination of mucous membranes with infectious material
C. Infectious aerosol of rabies virus
D. Ocular contact with contaminated material

14 Rabies postexposure prophylaxis (PEP) includes ?
A. Local wound care
B. Active immunization
C. Passive immunization
D. All of the above

15 Rabies immune globulin (RIG) should not be administered how
many days after the first vaccine dose ?
A. 1 day
B. 3 days
C. 5 days
D. 7 days

16 Dose of Rabies immune globulin (RIG) is ?
A. 5 IU/kg
B. 10 IU/kg
C. 20 IU/kg
D. 40 IU/kg

17 RIG in derived from ?
A. Cow
B. Dog
C. Sheep
D. Human

18 After immunization, serum neutralizing antibody titers become
detectable within ?
A. 1 – 2 weeks
B. 2 – 4 weeks
C. 4 – 6 weeks
D. 6 – 8 weeks

19 Human rabies postexposure prophylaxis (PEP) consists of five
doses of purified inactivated rabies vaccine given on days ?
A. 0, 3, 7, 14 and 28
B. 0, 3, 7, 14 and 90
C. 0, 7, 14, 21 and 28
D. 0, 7, 14, 21 and 90

20 For adults, which is the preferred site for HDCV, RVA, or PCEC
injections ?
A. Deltoid
B. Abdomen
C. Gluteal
D. Thigh

21 According to Advisory Committee on Immunization Practices
(ACIP), schedule of preexposure rabies vaccination is ?
A. Days 0, 3, and 21 or 28
B. Days 0, 3, and 90
C. Days 0, 7, and 21 or 28
D. Days 0, 7, and 90

221Pasteur vaccine was made out of ?
A. Horse spinal cords
B. Rabbit spinal cords
C. Mouse spinal cords
D. Cow spinal cords

23 Semple vaccine is best related to ?
A. Coonoor
B. Kasauli
C. Chennai
D. Mumbai

25 Semple vaccine is manufactured from ?
A. Brains of adult sheep
B. Brains of adult horse
C. Brains of adult cow
D. Brains of adult mouse

26 Shelf life of Semple vaccine is ?
A. Three months
B. Six months
C. Nine months
D. Twelve months

Rheumatoid Arthritis-Rabies

[MCQ] Rheumatoid Arthritis-Rabies- Part 2

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Rheumatoid Arthritis-Rabies- Part 2

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