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Sample 1·Infectious Disease
A 30-year-old returning from Yemen presents with fever, headache, and cyclical chills. Blood film shows ring forms in RBCs. Most likely diagnosis?
- ADengue fever
- BTyphoid
- ✓Malaria
- DBrucellosis
Explanation
Ring forms on thick/thin films are diagnostic of Plasmodium infection. Endemic in Yemen; species identification guides therapy.
Sample 2·Infectious Disease
A 40-year-old healthcare worker has needlestick injury from a HIV-positive source. Best action within 72 hours?
- AHIV antibody test only
- ✓Post-exposure prophylaxis for 28 days
- CImmediate ART start lifelong
- DImmunoglobulin
Explanation
PEP with tenofovir/emtricitabine + dolutegravir for 28 days, ideally within 1–2 hours, up to 72 hours.
Sample 3·Infectious Disease
A 45-year-old with productive cough for 6 weeks, night sweats and weight loss. CXR shows right upper lobe cavitation. Best confirmatory test?
- ATuberculin skin test
- ✓Sputum acid-fast bacilli smear and culture
- CInterferon-gamma release assay
- DBronchoscopy
Explanation
Active pulmonary TB is confirmed by sputum smear microscopy and culture; NAAT/GeneXpert also used.
Sample 4·Infectious Disease
A 25-year-old presents with dysuria, urgency and suprapubic pain. Urine dip: nitrites and leukocytes positive. Best first-line antibiotic in a non-pregnant woman?
- ATrimethoprim
- ✓Nitrofurantoin
- CCiprofloxacin
- DAmoxicillin
Explanation
Nitrofurantoin 100 mg BD for 3 days is NICE first-line for uncomplicated cystitis in women.
Sample 5·Infectious Disease
A 50-year-old with chronic hepatitis B has HBeAg positive, HBV DNA high, elevated ALT. Best treatment?
- AInterferon alpha
- ✓Tenofovir
- CRibavirin
- DLamivudine
Explanation
Tenofovir or entecavir are first-line oral antivirals for chronic HBV requiring treatment.