Midterm Examination Prev Med II

Preventive Medicine II

1. True about the mission of National TB Control program except,

a. To reduce TB burden (TB incidence and TB mortality)
b. To eliminate TB prevalence
c. To achieve catastrophic cost of TB-affected households
d. To responsively deliver TB service
e. NOTA

2. All are included in the program components of National TB control program except,

a. Health Promotion

b. Health prevention

c. Human Resource

d. Information System

e. Regulation

3.Target population/client of National TB control program except:

a. Presumptive TB

b. TB affected households

c. latent TB

d. a and c

e. AOTA

4. What is the area of Coverage of the National TB control program?

a. Municipalwide

b. Regionwide

c. Nationwide

d. NOTA

e. Worldwide

5. The following are Non-Government Organization partner institution of National TB control Program
except:

a. Philippine Coalition against TB(PhilCat)

b. PBSP( Philippine Business for social Progress)

c. WHO
 d. NOTA

e. AOTA

6. Comprehensive TB elimination Plan Act of 2016 is :

a. RA 10768

b. RA 10767

c. RA 10769

d. RA 10770

e. RA 10765

7. . All are included in Strategies, Action Points and Timeline of the National TB control Program
except:

a. educate communities and patient groups to promptly access quality TB services

b. AOTA

c. Value clients and patients through integrated patient-centered TB services

d. Innovate TB information generation and utilization for decision making

e. NOTA

8. . All are included in Strategies, Action Points and Timeline of the National TB control
Program except:

a. Clash local and national efforts mobilize adequate and competent human resources

b. Innovate TB information generation and utilization for decision making

c. AOTA

d. Value clients and patients through integrated patient-centered TB services

e. NOTA

9.All are included in Strategies, Action Points and Timeline of the National TB control Program except:

a.Innovate TB information generation and utilization for decision making

b.Abate standards on TB care and prevention and use of quality products

c.Value clients and patients through integrated patient-centered TB services

d.Engage national, regional and local government units/ agencies on multi-sectoral

implementation of TB elimination plan

e.NOTA
 10. All are included in Strategies, Action Points and Timeline of the National TB control
Program except,

a. Innovate TB information generation and utilization for decision making

b.Value clients and patients through integrated patient-centered TB services

c. .Engage national, regional and local government units/ agencies on multi-sectoral

implementation of TB elimination plan

d. Disband with other government agencies to reduce out-of-pocket expenses and expand
social protection programs
e. NOTA

11. When is Lung Month celebration?

a. June

b.July

c. August

d. September

e.October

12. The WHO- recommended DOTS strategy was launched formally as Revised National TB control
programme in_________ in 1997 after pilot testing from 1993-1996.

a. Nepal

b. Philippines

c.Africa

d.Sri Lanka

e.NOTA

13. Which of the following statements is true regarding treatment of drug-susceptible TB?

a. In patients with drug-susceptible pulmonary TB, 4-month fluoroquinolonecontaining regimens2

should not be used and the 6-month rifampicin-based regimen 2HRZE/4HR remains the recommended
regimen

b. The use of fixed-dose combination (FDC) tablets is not recommended over separate drug formulations
in treatment of patients with drug-susceptible TB

c. In all patients with drug-susceptible pulmonary TB, the use of thrice-weekly dosing is recommended in
both the intensive and continuation phases of therapy, and daily dosing remains the recommended
dosing frequency

d. ART should be started in all TB patients living with HIV regardless if CD4 cell count is less than 50
cells/mm3
e. TB treatment should be initiated first, followed by ART as soon as possible within the first 12 weeks of
treatment

14. . Which of the following statements is true regarding treatment of drug-susceptible TB?

a. In patients with drug-susceptible pulmonary TB who are living with HIV and receiving antiretroviral
therapy during TB treatment, a 6-month standard treatment regimen is recommended over an extended
treatment for 8 months or more

b. HIV-positive patients with profound immunosuppression (e.g. CD4 counts less than 50 cells/mm3)
should receive ART within the first 4 weeks of initiating TB treatment.

c. In patients with tuberculous meningitis, an initial adjuvant corticosteroid therapy with

dexamethasone or prednisolone tapered over 8-12 weeks should be used

d. In patients who require TB retreatment, the category II regimen should be prescribed and drug-
susceptibility testing should be conducted to inform the choice of treatment regimen

e. Health education and counselling on the disease and treatment adherence should not be provided to
patients on TB treatment

15. Which of the following statements is true regarding treatment administration options may be
offered to patients on TB treatment.

a. Video observed treatment (VOT) can’t replace DOT when the video communication technology is
available and can be appropriately organized and operated by health-care providers and patients

b. DOT administered by trained lay providers or health-care workers is recommended over DOT
administered by family members or unsupervised treatment

c. Community- or home-based directly observed treatment (DOT) is not recommended over health
facility-based DOT or unsupervised treatment

d.AOTA

e.NOTA

16. Which of the statements regarding pre-screening treatment of TB is incorrect?

a. Baseline serum ALT and creatinine before starting anti TB treatment. In resource-limited settings,
baseline ALT and serum creatinine, at the least, should be requested for patients older than 60 years
old, and those with risk factors for liver or kidney disease before starting TB treatment

b. Provider initiated counseling and testing (PICT) for HIV for all patients with TB, specially with high-risk
behavior for HIV and those from areas with high HIV prevalence

c. Serum uric acid testing routinely recommended before starting anti-TB treatment

d. Screening for DM using FBS, RBS or 75g OGTT for all patients with TB, HbA1c not routinely
recommended due to standardization issues

e.NOTA
17. Which of the following Registration Categories of TB Cases previously known as “Return After
Default”?

a. Previous Treatment Outcome Unknown (PTOU)

b. Treatment after Failure

c. Relapse

d. Retreatment

e. Treatment after lost to follow-up (TALF)

18. Definition of Treatment after lost to follow up (TALF) is :

a. patient has previously been declared lost to follow-up after interruption of at least 3 consecutive
months at the end of most recent course of treatment and is now bacteriologically confirmed

b. . patient has previously been declared lost to follow-up after interruption of at least 3 consecutive
months at the end of most recent course of treatment and is now clinically diagnosed TB

c. patient has previously been declared lost to follow-up after interruption of at least 4 consecutive
months at the end of most recent course of treatment and is now bacteriologically confirmed or
clinically diagnosed TB

d. patient has previously been declared lost to follow-up after interruption of at least 6 consecutive
months at the end of most recent course of treatment and is now bacteriologically confirmed or
clinically diagnosed TB

e.NOTA

19. In the general population, identifying presumptive PTB has the following except

a. Cough of at least 2-weeks duration

b. Unexplained cough of any duration in a close contact of a known active TB case

c. Chest x-ray findings suggestive of PTB, with symptoms

d. Chest x-ray findings suggestive of PTB, without symptoms

e.NOTA

20. Which of the following statements is false regarding diagnosis of TB?

a. A case of PTB is already considered bacteriologically confirmed if at least two (2) sputum smear is
positive for acid-fast bacilli

b. TB culture remains the gold standard for TB diagnosis.

c. TB culture should be performed preferably in quality assured culture centers recommended by the
National TB Program

d. If culture-positive for Mycobacterium tuberculosis (MTB), case is bacteriologically-confirmed PTB.

e. NOTA

21. Which of the following conditions to complete Day 28 of Rabies vaccine is incorrect?

a. biting animal is laboratory proven to be rabid

b. biting animal is killed with laboratory testing

c.biting animal is died without laboratory testing

d.. biting animal has signs and symptoms of rabies

e.NOTA

22. False statement regarding omission of Day 28 dose of Rabies vaccine if:

a. biting animal is alive

b. biting animal remains healthy after the 2-week observation period

c. biting animal died within the 14 days observation period confirmed by veterinarian to have no signs
and symptoms of rabies or was FAT-negative

d. biting animal is died without laboratory testing

e. NOTA

23.In Active lmmunization Administration for Rabies, vaccine is administered to induce antibody and T-
cell production in order to neutralize the rabies virus in the body. It induces an active immune response
in __________days after vaccination, which may persist for years provided that primary immunization is
completed.

a. 14 -17

b. 5-6

c.21-25

d. 30

e.NOTA

24. The ID use of rabies vaccines shall be based on adherence to WHO requirements for that route and
approval by national health authorities as follows, which is not correct?

a. New vaccine manufacturers shall provide clinical evidence that their products are immunogenic and
safe when used intra dermally.
b. Clinical evidence shall include clinical trials involving a vaccine of known immunogenicity
and efficacy when used by this route as control, serological testing with rapid fluorescent focus
inhibition test, and publication in nationally peered-reviewed journals.”
c.NOTA

d.AOTA

25. To ensure that only safe and efficacious RIG are provided by the National Rabies Prevention
and Control Program to all ABTCs, the program shall be guided by the following criteria in
procuring the RIG. Which is not correct?
a. RIG must be proven to be safe and effective when used together with anti-rabies vaccine as
evidenced by publication on peer reviewed journals. This include studies on Safety
b. RIG must be proven to be safe and effective when used together with anti-rabies vaccine as
evidenced by publication on peer reviewed journals. This include studies on interference when
used with anti-rabies vaccine
c. RIG must be proven to be safe and effective when used together with anti-rabies vaccine as
evidenced by publication on peer reviewed journals. This include studies on Animal
survivorship, if any
d. RIG must be proven to be safe and effective when used together with anti-rabies vaccine as
evidenced by publication on peer reviewed journals. This include studies on post-marketing
surveillance
e. NOTA

26. Which of the following is true statement regarding skin testing for ERIG administration?
a. A skin test shall be performed prior to ERIG administration using a gauge 25 needle.
b. For skin testing, 0.01 mL of 1:10 dilution of solution is infiltrated to raise a bleb 3 mm and
read after 15 minutes.
c. A positive skin test is an induration 7 mm surrounded by a flare/erythema.
d. If initial skin test is positive, repeat skin test on the other arm; use distilled water as control
on the same arm.
e. The skin test shall be considered positive if the ERIG skin test is negative on the same arm
but the control is positive on the same arm.
27. Recommended antimicrobials for frankly infected wounds of animal bite with allergy to
penicillins for children is:
a. Doxycycline
b. Erythromycin
c. Cloxacillin
d. cefuroxime
e. amoxicillin-clavulanic acid
28. What is the Recommended therapeutic dose of cefuroxime for children antimicrobials for
frankly infected wounds of animal bite?
a. 30-45 mg/kg/day in 2 divided doses
b. 5-10 mg/kg/day in 2 divided doses
c. 50-75 mg/kg/day 2x a day
d. 10-15 mg/kg/day in 2 divided doses
e. NOTA

29. Which of the following statements is incorrect regarding management of adverse reactions
in Hypersensitivity to ERIG/F(ab’)2?
a. Give 0.1% adrenaline or epinephrine (1:10,000 or 1 mg/mL) underneath the skin or into the
muscle.
b. Adults – 0.5 mL
C. children – 0.01 mL/kg, maximum of 0.5 mL
d. Repeat epinephrine dose every 15 minutes for 3 doses
e. Give steroids after epinephrine
30. Which of the following statement is false regarding Treatment Regimen Schedule Updated
2-Site Intradermal Schedule?
a. This regimen is a modification of the original Thai Red Cross 2-site ID regimen where the day
90 dose has been transferred to day 28.
b. One dose for ID administration is equivalent to 0.1 mL for PCECV.

c. One dose shall be given on each deltoid on Days 0, 3, 7 and 28.

d. One intradermal dose shall have at least 0.5 IU vaccine potency.

e. NOTA

31. Which of the following statement is false regarding Treatment Regimen Schedule Updated 2-Site
Intradermal Schedule?

a. The ID injection shall produce a minimum of 3 mm wheal. In the event that a dose of vaccine is
inadvertently given subcutaneously or IM, the dose shall be repeated.

b. If delay is from day 3 schedule (i.e. day 4 from start of vaccination) – day 3 dose shall be given upon
visit and follow the original schedule of day 7 and day 28.

c. If delay is from day 3 schedule (i.e. day 7 from start of vaccination) – day 3 dose shall be given upon
visit, adjust succeeding doses (day 7 and 28) according to the prescribed interval.

d. If delay is from day 3 schedule (i.e. beyond day 7 from start of vaccination) – a new course shall be
restarted.

e. NOTA

32. Which of the following statement is false regarding Treatment Regimen Schedule Updated 2-Site
Intradermal Schedule?

a. If delay is from day 7 schedule (i.e. day 15 from start of vaccination) – day 7 dose shall be given upon
visit, give day 28/30 dose as originally scheduled.

b. If delay is from day 7 schedule (i.e. day 21 from start of vaccination) – day 3 dose shall be repeated
and revised according to the prescribed interval.

c. If delay is from day 7 schedule (i.e. beyond day 22 from start of vaccination) – a new course shall be
restarted

d. AOTA

e.NOTA

33. . Which of the following statement is false regarding Treatment Regimen Standard Intramuscular
Schedule?

a. Using the standard IM regimen, one dose is equivalent to 1 vial of 0.5 mL of PVRV or 1.0 mL of PCECV.
One (1) dose is given intramuscularly (IM) on days 0, 3, 7, 14 and 28

b. Treatment schedule shall be strictly followed to prevent treatment failure

c. Delay in fourth (i.e. day 14) dose, Day 7 dose shall be given upon visit and give day 14 dose after two
weeks
d. Delay in fifth (i.e. day 28) dose, Day 28 dose shall be given upon visit.

e. If RIG has already been administered, it shall not be given again

34. True statement regarding Shortened Intramuscular Schedule (CDC).

a. An alternative for healthy, fully immunocompetent, exposed people who receive wound care plus
high quality rabies immunoglobulin plus WHO-prequalified rabies vaccines, shall be given a pre-exposure
regimen consisting of 4 doses administered intramuscularly on days 0, 3, 7, and 14

b. An alternative for healthy, fully immunocompetent, exposed people who receive wound care plus
high quality rabies immunoglobulin plus WHO-prequalified rabies vaccines, shall be given a post-
exposure regimen consisting of 3 doses administered intramuscularly on days 0, 7, and 14

c. An alternative for healthy, fully immunocompetent, exposed people who receive wound care plus
high quality rabies immunoglobulin plus WHO-prequalified rabies vaccines, shall be given a post-
exposure regimen consisting of 4 doses administered intramuscularly on days 0, 3, 7, and 14

d. An alternative for healthy, fully immunocompetent, exposed people who receive wound care plus
high quality rabies immunoglobulin plus WHO-prequalified rabies vaccines, shall be given a pre and
post-exposure regimen consisting of 4 doses administered intramuscularly on days 0, 3, 7, and 14

e. An alternative for healthy, fully immunocompetent, exposed people who receive wound care plus
high quality rabies immunoglobulin or WHO-prequalified rabies vaccines, shall be given a post-exposure
regimen consisting of 4 doses administered intramuscularly on days 0, 3, 7, and 14

35. False statement regarding Post-Exposure Prophylaxis under Special Conditions.

A . Pregnancy and infancy shall NOT be contraindications to treatment with purified cell culture vaccines
(PVRV, PCECV) and RIG.

b. Babies who are born of rabid mothers shall be given rabies vaccination as well as RIG as early as
possible at birth.

c. Patients with hematologic conditions where IM injection is contraindicated shall receive rabies vaccine
by ID route.

d. Patients with chronic liver disease and those taking chloroquine, and systemic steroids shall be given
standard IM regimen as the response to ID regimen is not optimum for these conditions. Vaccination
shall not be delayed in these circumstances as it increases the risk of rabies.

e. Immunocompromised individuals (such as those with HIV infection, cancer/transplant patients,

patients on immunosuppressive therapy etc.) shall be given vaccine using standard ID regimen and RIG
for both Category II and III exposures.

36. False statement regarding Post-Exposure Prophylaxis under Special Conditions.

a. Exposed persons who present for evaluation or treatment weeks or months before the bite shall be
treated as if exposure has occurred recently. However, if the biting animal has remained healthy and
alive with no signs of rabies until 14 days after the bite, no treatment is needed

b. Interchangeability of modern rabies vaccine brands or types shall not be recommended.

c. However, each time circumstances made it inevitable to interchange vaccine used for administration.
Shifting from one vaccine brand to another shall not be recommended but may be warranted I certain
circumstances, provided that it is one of the WHO recommended cell culture vaccines

d. AOTA

e. NOTA

37. The following patients are considered to have completed the primary immunization:

a. Those who have received day 0, 7, 28 of post-exposure prophylaxis

b. Those who have received at least day 0, 3, 7 of pre-exposure treatment

c. Those who have received day 0, 7, 14 of pre-exposure prophylaxis

d. Those who have received at least day 0, 3, 7 of post-exposure treatment

e. AOTA

38. PEP shall not be required for bite/s of the following biting animals except :

a. rats and mouse

b. rabbits and snakes

c. reptiles and birds and other avian

d. insects and fish.

e.NOTA

39. The following procedures shall be observed when assessing animal bite patients and dispensing anti-
rabies immunizing agents except;

a. a. Assess the victim thoroughly and record in the Municipal/City/Hospital Rabies Surveillance Form
(Facility-based form).

b. Decide whether or not to initiate treatment using the Revised Guidelines on the Management of
Animal Bite Patients as reference

c. If the situation warrants immunization (Category II and Category III), the patient shall be given the
intramuscular regimen. The other approved regimens may be used if the ID regimen is not feasible.
d. If indicated, the patient shall be provided the required dose of passive immunization products/RIG, if
available, preferably ERIG or F(ab’)2.

e. Explain your decision to the patient with particular emphasis on adherence to treatment schedules, if
immunization is indicated.

40. The following shall be the program's order of priority for dispensing vaccines in animal bite
treatment: What is their proper arrangement?

1. Minor/superficial scratches/abrasions without bleeding, including those induced to bleed on the head
and neck.

2. Patients bitten by animals that are not available for observation (stray/slaughtered).

3. Patients bitten by animals found to be positive by IFAT or for "negri bodies" regardless of type of bite
exposure

4. Patients with Category II exposure

5.Individuals exposed to human rabies patients through bite/non-bite exposure.

a. 1,2.3.4.5

b.3,1,2,4,5

c. 3,2,1,5,4

d.3,1, 2, 5,4

e. 3,4,5,1,2

41. Which of the following statements about Lassa fever is correct?

a. The virus Phelebovirus which causes Lassa fever in humans can only sustained transmission through
the bite of an infected mosquito and other arthropods.

b. The Lassa virus which causes Lassa fever in humans, can have sustained transmission between;
animals to humans, mosquitoes to humans and human to human.

c. The reservoir of Lassa fever is asymptomatic in humans. The virus can be maintained in the human
population indefinitely due to this.

d. It is a zoonotic disease caused by the Lassa virus, an RNA virus of family Arenaviridae, that can be
transmitted from the Mastomys rodents to humans through contact with feces or urines of Mastomys
and/or catching and preparing Mastomys as a food source. It can also be transmitted from human to
human through contact with the body’s fluids of a Lassa infected person.

e.NOTA

42. Which of the following modes of transmission is correct about Lassa fever?
a. Ingestion of food contaminated by infected Mastomys rodent excreta or urines, person to person
through direct and indirect contact with body fluids of infected person and inhalation of aerosolized
virus.

b. From person to person only. Direct and indirect contact with body fluids of infected person (blood,
Saliva, vomitus, urine, stool, semen).

c. Bite from infected mosquitos such as the Aedes, Culex, Mansonia, Anopheles, Coquillettidia and
Eretmapodites.

d. Direct or indirect contact with camels and their infected fleas.

e.NOTA

43. Which of the following statements about Lassa fever is NOT correct?

a. Most cases of Lassa virus are secondary transmission; human to human transmission occurring
through direct contact with the blood, and other body fluids of an infected person.

b. Mastomys rodents are the reservoir and the Lassa virus maintains itself in the Mastomys rodent
population with chronically infected rodents.

c. Most cases of Lassa virus are through primary infection; humans infected through direct contact with
infected rodents by catching and preparing Mastomys as food source, ingestion of food contaminated
by infected rodent excreta and inhalation of aerosolized virus.

d. Well known locations of transmission between humans occurs at hospitals or health care facilities:
health care workers, other patients, and unsafe injections. Also at mass gathering during burial or
funeral ceremonies etc.

e. NOTA

44. Which of the following statements best describes the strategy for controlling Lassa fever outbreaks?

a. Stop rodents entering houses, maintain good personnel, community and house hygiene, store food
safely, follow strict hospital infection prevention and control protocols, trace contacts, support patients,
Safe and Dignified Burial (SDB).

b. Mass animal vaccination & human vaccination and reduction of mosquito breeding grounds

c. Slaughter all livestock within a 10 km radius, maintain movement controls of all domestic species in or
out of affected areas for next 6 months.

d. Keep public notification to a minimum to avoid panic. Treat contacts and suspected contacts as if they
are not infectious. Let the disease burn itself out naturally.

e. NOTA

45. Which of the following statements about the signs and symptoms of Lassa fever is NOT correct.

a. Incubation period for Lassa fever is 5-21 days with gradual onset of fever, headache, malaise
and other non-specific signs and symptoms.
 b. Hemorrahgic is seen in the majority of the cases of Lassa fever.

c. Very broad presentation of symptoms, hard to diagnosis even for an experienced clinician.
Therefore, patient history is essential to diagnosis. Looking for signs and symptoms with
exposure.

d. Pharyngitis, myalgia, retro-sternal pain, cough and gastrointestinal symptoms typically seen.
Minority of patients present with symptoms of bleeding, neck/facial swelling and shock.

e. NOTA

46. Ebola disease:

a. usually starts off with a cough and chest pain

b. can be airborne

c. always leads to haemorrhaging or bleeding

d. is severe and often fatal

e.NOTA

47. The Ebola virus is transmitted:

a. through the air, especially in crowded situations and public transport

b. through contaminated water, food, and drink

c. from person to person through direct contact with body fluids of an infected or dead person, or
articles and surfaces contaminated by them; or via droplets within close proximity of an infected person

d. from infected fruit bats to chickens, and then to humans through handling of sick birds in the farm or
market, or during food preparation

e.NOTA

48. Which of the following groups are most at risk of getting Ebola?

a. Response teams and clinical personnel adopting proper infection prevention and control measures

b. Family members of people sick with Ebola; day-to-day contacts at work or during travel and transport;
ambulance workers, health care providers, traditional healers, and burial teams

c. Populations of neighbouring countries, donor countries, and headquarters of international

organizations during outbreaks

d. Sexual partners, friends, relatives, and co-workers of asymptomatic patients

e.NOTA

49. Clinical management symptoms of Ebola include:

a. supportive care (including with oral and/or intravenous fluids), treatment of specific symptoms and
concurrent diseases, as well as psycho-social support
b. no treatment is available for Ebola, and patients have to recover using only their own inherent
strength

c. treatment with monoclonal antibodies in all cases as first line treatment

d. oral rehydration only, with treatment of underlying conditions such as malaria and strict bed rest

e.NOTA

50. Ebola prevention cannot be achieved by:

a. providing full-body PPE to all response personnel working in Ebola affected communities

b. strict adherence to infection prevention and control (IPC) measures when dealing with patients and
when handling dead bodies, as well as IPC measures in the home and community

c. proper hand washing with soap and water

d. alcohol-based products or commonly used disinfectants (i.e. bleach), which can kill the virus in the
environment

e. NOTA

51.Which of the following statement about leprosy is incorrect?

a. The guidelines recommend a 3-drug regimen of rifampicin, dapsone and clofazimine for all leprosy
patients

b. This represents a change from the current standard treatment for PB leprosy, which is rifampicin and
dapsone for 6 months, due to some evidence indicating better clinical outcomes with a 3-drug, 6-month
regimen over a 2-drug, 6-month regimen

c. A potential advantage of using the same three drugs for PB and MB leprosy is simplification of
treatment

d. AOTA

e. NOTA

52. Which of the following statements about “Prevention of leprosy through chemoprophylaxis” is
incorrect?

a. The guidelines recommend the use of single-dose rifampicin (SDR) as preventive treatment for adult
and child (2 years of age and above) contacts of leprosy patients, after excluding leprosy and
tuberculosis (TB) disease and in the absence of other contraindications

b. The ability of programmes to adequately identify and manage contacts of persons with leprosy is a
prerequisite for successful implementation of the recommendation.

c. Because leprosy is highly stigmatized, caution must be exercised when implementing SDR, particularly
for contacts inside the patient’s family.
d. When patients do not authorize disclosure, the GDG does not recommend identification or screening
of contacts, which is a prerequisite for prescribing preventive treatment

e. In hyperendemic settings, a blanket approach (i.e. treatment of all community members without
identifying contacts) might be more feasible and reduce potential harms related to disclosure of a
leprosy diagnosis.

53. Which of the following statements of recommendation regarding Diagnosis of leprosy and infection
is incorrect?

a. The diagnosis of leprosy may be based on clinical examination, with or without slit-skin smears or
pathological examination of biopsies.

b. There is currently no test recommended to diagnose leprosy infection (latent leprosy) among
asymptomatic contacts.

c. both A and B

d. NOTA

e.AOTA

54. Which of the following statement of recommendation is incorrect regarding Treatment of drug
resistant leprosy?

a. Leprosy patients with rifampicin resistance may be treated using at least two of the following second-
line drugs: clarithromycin, minocycline or a quinolone (ofloxacin, levofloxacin or moxifloxacin), plus
clofazimine daily for 6 months, followed by clofazimine plus one of the second-line drugs daily for an
additional 18 months.

b. Leprosy patients with resistance to both rifampicin and ofloxacin may be treated with the following
drugs: clarithromycin, minocycline and clofazimine for 6 months followed by clarithromycin or
minocycline plus clofazimine for an additional 18 months.

c. both A and B

d. NOTA

e.AOTA

55. Which of the following statement regarding Diagnosis of leprosy is incorrect?

a. the diagnosis of leprosy remains based on the presence of at least one of three cardinal signs: (i)
definite loss of sensation in a pale (hypopigmented) or reddish skin patch; (ii) thickened or enlarged
peripheral nerve with loss of sensation and/or weakness of the muscles supplied by that nerve; or (iii)
presence of acid-fast bacilli in a slit-skin smear

b. The clinical diagnosis of early leprosy and PB leprosy can be a challenge. Therefore, a number of
serological and other laboratory assays have been developed to supplement clinical diagnostic methods

c. Enzyme-linked immunosorbent assays (ELISA) and lateral flow assays are associated with high
diagnostic accuracy for PB leprosy.
d. Although some polymerase chain reaction (PCR)-based assays are associated with higher diagnostic
accuracy, they lack standardization, are not commercially available, and would be difficult to perform in
most primary health-care settings

e.NOTA

56. Which of the following is/are the Most common causes of Abnormal vaginal discharge -Cervicitis in
main STI syndromes?

a. Gonorrhea

b. Trichomoniasis

c. Chlamydia

d. A and B

e. A and C

57. Which of the following statement/s is/are incorrect regarding the Syndromic flowcharts of using the
main STI syndormes?

a. The syndromes are relatively easy to identify and it is possible to devise a flowchart for each one

b. A flowchart is a diagram or type of map representing steps to be taken through a process of decision-
making.

c. A major benefit of the flowcharts is that, once trained, service providers find them easy to use – so
non-STI specialists at any health facility are able to manage STI cases

d. there are opportunities for introducing preventive and promotive measures such as education and
condom distribution

e. you can offer later treatment because patients with STIs are treated at their first visit

58. How would you manage the treatment for genital ulcer using the syndromic approach ? Tick the best
of these options:

a. ) treat the patient for one cause only, and ask the patient to return if the sore does not get better, so
you can treat for the second cause

b. treat the patient for both conditions immediately

c. refer the patient for an etiological diagnosis.

d.AOTA

e.NOTA

59. Which of the following statement/s is/are incorrect regarding “Responding to criticisms of the
syndromic approach that The syndromic approach is not scientific?
a. it is based on a wide range of epidemiological studies in both the industrialized and developing world.
This case management approach has been used and adapted in more than 20 countries throughout the
world.

b. Validation studies have compared syndromic and laboratory diagnosis to assess the accuracy of
syndromic diagnosis and found their results to be similar, so syndromic diagnosis is accurate, with
limitations relating to only one of the syndromes, vaginal discharge

c. Other studies have thrown light on the possible impact of syndromic case management on the
incidence of STIs and HIV in a given population

d. NOTA

e.AOTA

60. . Which of the following statement/s is/are incorrect regarding “Responding to criticisms of the
syndromic approach that“The syndromic approach results in a waste of drugs, because patients are
being over-treated.?

a. studies have shown that the syndromic approach is less expensive than clinical or etiological
diagnoses

b. This is because, in weighing the alternatives, we need to include not only the high cost of etiological
diagnosis or wrong clinical diagnosis but also the biological and social costs, including infertility, loss of
income, family breakdown and so on.

c. Over-treatment in syndromic management couldn’t be said to be a waste when patients are treated
for a syndromic cause which is not the cause of the discharge

d.AOTa

E.NOTA
Answer Key;

1.B

2.B

3. C

4.C

5. C

6. B

7. A

8.A

9.B

10.D

11.C

12.E

13.A

14.A

15.B

16.C

17.E

18. E

19.E

20.A

21.B

22.C

23.E

24.B
25.B

26.C

27.B

28.D

29.A

30.E

31.E

32.A

33.C

34.C

35.E

36.A

37.D

38.E

39.C

40.C

41. D

42.A

43.A

44.A

45.B

46. D

47.C

48.B

49.A

50.A

51.E

52.C

53.D
54.D

55.C

56.E

57.E

58. B

59.D

60.C