Measles, Mumps, Rubella and Other Viral Infections MCQs

Epididymo-orchitis is the next most common manifestation of mumps (after parotid gland swelling), developing in 15-30% of cases in postpubertal males, with bilateral involvement in 10 - 30% of those cases Reference: Harrison's Principles of Internal Medicine, 2st Ed, Ch:207 Pg: 1617

The newborn in the question shows characteristics of congenital CMV infection. In addition to those findings mentioned above, these patients can have petechiae and purpura, ventriculomegaly, periventricular calcifications, cerebral atrophy, cortical dysplasia, and chorioretinitis. The most important diagnostic study in the evaluation of newborn CMV disease is viral culture, preferably done before 3 weeks of life to help exclude the possibility of perinatal CMV acquisition. Viral PCR is a useful adjunct to culture techniques but does not replace viral culture. Tissue biopsy, while sometimes used for diagnosis, is not standard and is more commonly used in the lung and liver than in the brain. CMV antibody titers are generally not helpful in diagnosis. Tags : Topic : CONGENITAL INFECTIONS Difficulty level : GOOD TO KNOW PYQ : INICET NOV 2022; JULY 2021; NEET PG 2023

Breastfeeding has been suggested to have a possible protective effect in : Diarrhea Otitis media (option a) Urinary tract infections (option b) Necrotizing enterocolitis, Septicemia (option c) Infant botulism Celiac disease Childhood cancer Allergy Hospitalizations and infant mortality Tags : Topic : BREAST FEEDING & NUTRITION Difficulty level : MUST KNOW PYQ : INICET MAY 2022 Reference : Nutrition and child development, KE Elizabeth, 5 th ed., pg. 113

An interesting question, similar to what many of you may encounter in clinical practice too. Let us go stepwise. Information given: Infant with refractory hypocalcemia due to congenital hypoparathyroidism Some cardiac disease A microdeletion defect. Now, the microdeletion defect with hypoparathyroidism and cardiac disease is DiGeorge Syndrome. It occurs due to microdeletions in 22q11.2. Most of these patients have thymic aplasia due to 3 rd and 4 th pharyngeal pouch hypoplasia. Thymic aplasia causes reduced T-lymphocytes and cellular type of primary immunodeficiency. Such patients predisposed to recurrent viral and fungal infections. Thus D is the likely manifestation to be found in such patients. Reference: Nelson 21 st Ed, Chapter 151

The patient has recurrent rhinosinusitis, history suggesting bronchiectasis, but there is no situs inversus. Since semen analysis has been advised to check for azoospermia, the doctor is likely thinking about Young Syndrome. Young's Syndrome is a rare condition that encompasses a combination of syndromes such as bronchiectasis, rhinosinusitis and reduced male fertility. In individuals with this syndrome the functioning of the lungs is usually normal but the mucus is abnormally viscous. The reduced fertility (obstructive azoospermia) is due to functional obstruction of sperm transport down the genital tract at the epididymis, where the sperm is found in viscous, lipid-rich fluid. Possible causes include genetics, helminthic infections and exposure to mercury during childhood, but the cause is unknown. Reference: OP Ghai 10 th Edition, Page 417; Nelson 21 st Edition

This is a male child presenting with a triad of Atopic dermatitis-like rash Recurrent bloody stools indicating recurrent infections Petechiae due to thrombocytopenia. This is the classic triad seen in patients with Wiskott Aldrich Syndrome. The disease occurs due to mutations in WASp gene mutations, present on Chromosome 11p22.23 Hence, patient needs to be screened for WASp gene expression. Regarding other options Anti platelet antibody should be checked in isolated thrombocytopenia where you suspect ITP. Bone marrow aspiration will be needed in bicytopenia or pancytopenia. LFT and RFT have no role in the evaluation of such a case. Reference: Nelson textbook of Pediatrics, 21st edition, Chapter 152, Page 1117

Clues here Fever with Itchy rash Starts from trunk Polymorphous nature of the rash All these findings are suggestive of Chicken pox/Varicella infection. Regarding other options Measles presents with a non-itchy maculopapular rash which first starts on the face, behind the ears and then goes to the trunk Fifth Disease presents with bilateral slapped cheek appearance RMSF presents with non-itchy rash & the child has toxicity, petechiae and transaminitis commonly associated. Reference: OP Ghai 9 th Ed, Pg 210-11, Nelson 21 st Ed

Petechiae at the junction of soft and hard palate are often seen in patients of Epstein Barr Virus- EBV Infection. Also note that Nagayama spots are seen in 6 th disease, caused by HHV-6. Forchheimer Spots are seen in soft palate region in patients of Rubella, also called German Measles. Dew drops on rose petal appearance has been described for skin vesicular lesions seen in Varicella or Chicken Pox. Reference: OP Ghai 10 th Edition, Pages 232-234