Previous year question on rabies based on neet pg, usmle, plab and fmge or mci screening exams

The use of hyperimmune sera such as hepatitis B immune globulin, rabies immunoglobulin, and human tetanus immune globulin for prophylaxis or treatment is an example of what process?

A: Active immunityB: Passive immunityC: Humoral immunityD: Cellular immunity

Correct Ans:BExplanation

The use of hyperimmune sera for treatment or prophylaxis is referred to as “passive immunization”. This approach is used when allowing the development of a natural immune response would take too long and directly threaten patient survival.

This type of immunity is of short duration and has no memory component.

Ref: Levinson W. (2012). Chapter 57. Immunity. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.

Sample Previous Year Question on Rabies based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

Louis Pasteur is NOT associated with?

A: Vaccination of small poxB: Germ theoryC: Vaccination of rabiesD: Pasteurization

Correct Ans:AExplanation

Works of Louis Pasteur

Germ theory of fermentation Sterilisation techniques: steam steriliser, hot air oven and

autoclaving Vaccination against anthrax, rabies, cowpox and chickenpox.

Technique of pasteurization

Ref: Ananth Narayan 7/e, Page 5-7


Which of the following vaccine is developed by Louis Pasteur?

A: AnthraxB: RabiesC: Chicken choleraD: All of the aboveCorrect Ans:DExplanation

Pasteur’s contributions:

Pasteur proved that all forms of life, even microbes, arose only from their like and not de novo.

Introduced techniques of sterilization and developed steam sterilizer, hot-air oven and autoclave

Developed vaccines against anthrax, rabies, chicken cholera

Ref: Textbook of Microbiology By Ananthanarayan And Paniker, 7th edition, Page 1.


Which of the following findings can indicate a rabies infection?

A: Guarner bodiesB: Negri bodiesC: Cowdry A bodiesD: Cowdry B bodies

Correct Ans:BExplanationRabies is confirmed by the presence of intracytoplasmic inclusion body (negri body) especially in the neurons of the brain. Negri bodies can also be found in corneal imprints, biopsies of face and neck. Negri bodies are composed of fibrillar matrix and virus particles. Ref: Textbook of Microbiology, Ananthanarayan and Paniker, 7th Edition, Chapter 49, Page 449; Pathology and Pathogenesis of Human Viral Disease, John E. Craighead, Page 361; Zoonoses: Infectious Diseases Transmissible from Animals to Humans, H. Krauss, 3rd Edition, Chapter 1, Page 116; Alcamo's Fundamentals of Microbiology, Jeffrey C. Pommerville, 7th Edition, Chapter 12, Page 223


Which of the following statements is TRUE about Rabies Virus:

A: It is double stranded RNA virusB: Contains a DNA-dependent RNA polymeraseC: Negative sense RNA GenomeD: Affects motor neurons

Correct Ans:CExplanationThe Rabies virus belongs to the Rhabdoviridae family, and is the prototypic member of the genus lyssavirus. It has a single-stranded, non-segmented, negative-sense RNA genome.

The helical nucleocapsid is composed of a single-stranded negative-sense RNA genome and an RNA-dependent RNA polymerase enclosed in a matrix protein covered by a lipid bilayer envelope containing knob-like glycoprotein.

Note - Negative-sense RNA virus replicates in the cytoplasm Ref: Microbiology By Jawetz, 20th Edition, Page 482 ; Rabies By Alan C. Jackson, William H. Wunner, 2007, Page 24


All are true regarding Rabies virus, except?

A: Single Stranded RNA virusB: Linear

C: Negative senseD: Space vehicle shapedCorrect Ans:DExplanation

It is a bullet shaped virus with a single serotype. It is detected by immunofluoresence.

The rabies virus is a neurotropic virus. These viruses areenveloped and have a single stranded RNA genome with negative-sense. All transcription and replication events take place in the cytoplasm inside a specialized “virus factory“, the Negri body.


Which of the following statements is TRUE about rabies virus?

A: It is a double stranded RNA virus.B: Contains a DNA-dependent RNA polymerase.C: RNA has a negative polarityD: It is a double stranded DNA virus.Correct Ans:CExplanation

Rabies virus:It is enveloped RNA virus and is bullet-shaped. The helical nucleocapsid (N) is composed of a single-stranded negative-sense RNA genome and an RNA-dependent RNA polymerase enclosed in a matrix (M) protein covered by a lipid

bilayer envelope containing knob-like glycoprotein (G).

Since rabies virus is a negative-sense RNA virus, virion-associated RNA-dependent RNA polymerase transcribes the genome to make several mRNAs in the cytoplasm. These mRNAs are translated into various proteins, including nucleocapsid, matrix, RNA polymerase, and G glycoproteins.

Also Know:Replicates initially in muscle and then enters peripheral nervous system. It spreads to CNS gray matter. Negri bodies are found in neurons. The pathognomonic lesion is the Negri body, an eosinophilic cytoplasmic inclusion distributed throughout the brain, particularly in the hippocampus, cerebral cortex, cerebellum, and dorsal spinal ganglia.

Ref: Ray C.G., Ryan K.J. (2010). Chapter 17. Rabies. In C.G. Ray, K.J. Ryan (Eds),Sherris Medical Microbiology, 5e.


Which of the following is not an RNA virus?

A: EbolaB: Simian 40C: RabiesD: Vesicular stomatitis virusCorrect Ans:BExplanation

Simian vacuolating virus (SV40) is a small nonenveloped, icosahedral DNA tumour virus. Polyoma & SV40 produce malignant tumours when inoculated into the newborn mice / hamsters. These viruses have been widely employed in the study of viral oncogenesis.

Also Know: Oncogenic. RNA viruses - Avian leukosis viruses, Murine leukosis viruses, Human T cell leukaemia viruses, Leukosis - sarcoma virus.

Oncogenic DNA viruses - Polyomavirus, SV40, Molluscum contagiosum, Epstein-Barr virus, Cytomegalovirus, Herpes simplex viruses type 1& 2. Ref: Ananthanarayanan & Paniker’s textbook of microbiology 8th ed pg 549.


Which of the following inclusion body is seen in a patient with Rabies?

A: Cowdry-BB: Negri bodiesC: Guarneri bodiesD: Bollinger bodiesCorrect Ans:BExplanationNegri bodies are eosinophilic intracellular lesions found within cerebral neurons and are highly specific for Rabies. They are found in about 75% of proven cases of animal rabies.

Guarneri bodies are inclusion bodies seen in the cytoplasm of cells infected with small pox virus.

Bollinger bodies are found in the cytoplasm of a cell infected with fowl pox virus.

In herpes infection giant cells are present, they contain a conglomeration of several nuclei. Each nucleus contain a large inclusion body surrounded by a clear halo.

HSV infection is associated with two types of viral inclusions. Cowdry A inclusions are small, round and eosinophilic and are separated from the nuclear material by a halo.Cowdry B inclusions are large, ground glass, eosinophilic, centrally located structures that push nuclear materials to the rim of the nucleus.

Ref: Weber D.J., Wohl D.A., Rutala W.A. (2011). Chapter 152. Rabies. In J.E. Tintinalli, J.S. Stapczynski, D.M. Cline, O.J. Ma, R.K. Cydulka, G.D. Meckler (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. Microbiology:Application Based Approach By Pelczar page 427.


A adolescent was bitten by a stray dog. To rule out rabies in the animal, brain tissue sample was taken. Which of the part of brain tissue should be taken to see the characteristic Negri bodies?

A: HippocampusB: HypothalamusC: MedullaD: MidbrainCorrect Ans:AExplanationRapid diagnosis of rabies infection in the animal is usually made by examination of brain tissue by using either PCR assay, fluorescent antibody to rabies virus or histologic staining of Negri bodies in the cytoplasm of hippocampal neurons. Negri bodies are sharply demarcated, more or less spherical, and 2–10 μm in diameter, and they have a distinctive internal structure with basophilic granules in an eosinophilic matrix. Negri bodies contain rabies virus antigens. Ref: (2012). Chapter 39. RNA-Enveloped Viruses. In Levinson W (Eds), Review of Medical Microbiology & Immunology, 12e.


Passive–active immunity is useful for the exposure of the following infection:

A: RabiesB: Hepatitis BC: Varicella-zosterD: All of the aboveCorrect Ans:DExplanationPassive–active immunity is induced by giving both immunoglobulins to provide immediate protection and a vaccine to provide long-term protection.

Rabies immune globulin (RIG) is used in the prevention of rabies in people who may have been exposed to the virus. Hepatitis B immune globulin (HBIG) is used in the prevention of hepatitis B in people who may have been exposed to the virus either by needle-stick or as a neonate born of a mother who is a carrier of HBV. Varicella-zoster immune globulin (VZIG) is used in the prevention of disseminated zoster in people who may have been exposed to the virus and who are immunocompromised. Ref: Levinson W. (2012). Chapter 36. Viral Vaccines. In W. Levinson (Ed),Review of Medical Microbiology & Immunology, 12e.


Mili is suspected to have an infection on her second pre-natal visit. Her pet cat could act as a reservoir for which of the following conditions?

A: Toxoplasma gondiiB: RabiesC: Streptocerca infectionD: Plague


Toxoplasmosis is usually a self-limiting infection due to a parasite called Toxoplasma gondii.

The toxoplasmosis parasitic disease is capable of infecting almost all species of warm-blooded animals, including humans, but the primary host is the various members of the cat family. They are the only hosts in which the oocyst-producing sexual stage of Toxoplasma can develop.

A wide host range, comprising all the hot-blooded animals including birds and rodents, can serve as a reservoir of rabies. Monkeys are reservoirs for Streptocerca. Wild rodents such as field mice, gerbils, and skunks are the natural

reservoir of plague. In India, Tatera indica (wild rat) is considered the main reservoir and not Ratus ratus (domestic rat).


Which one of the following vaccines is contraindicated in pregnancy?

A: MMRB: RabiesC: Hep BD: None


MMR is a live vaccine prepared from live and generally attenuated organisms by passing repeatedly in the laboratory in tissue culture and thus it has lost their capacity to cause a full blown disease but retain their properties of immunogenicity. Live vaccines are contraindicated in pregnancy considering the risk of teratogenic harm to the fetus.

Rabies and Hepatitis B vaccines are killed or inactivated vaccines and no such contraindication exists to their use in pregnancy. Ref: Park’s Textbook of Preventive and Social Medicine By K. Park, 19th Edition, Pages 97-8; Side Effects of Drugs Annual By Jeffrey K. Aronson, Pages 581-582; Immunology for The Health Sciences By Nicholas J. Vardaxis, Pages 101-4


Post exposure prophylaxis in health care professionals is indicated in infections with all except?

A: HBVB: RabiesC: DiptheriaD: Measles

Correct Ans:CExplanation

Post exposure prophylaxis is used in HIV, HBV, Measles, Rabies, Tetanus, H.influenzae and Meningococcus.

Ref: Park, 20th Edition, Pages 139, 189, 240, 283.


Which of the following is a “water scarce disease”?

A: TrachomaB: Leprosy

C: RabiesD: TetanusCorrect Ans:AExplanationMany diseases are caused by scarcity of water in enough amount to be able to maintain personal hygiene and cleanliness. These are called water scarce disease or water washed disease. Examples include trachoma, conjunctivitis, lice infestation, scabies, ascariasis etc. Ref: Park, 21st Edition, Page 657.


Which of the following is a live attenuated vaccine?

A: Epidemic typhus vaccineB: Pertussis vaccineC: Rabies vaccineD: KFD vaccine


Live attenuated vaccines:

BCG Typhoral vaccine OPV Yellow fever Measles Rubella Mumps

Note: Live vaccines should not be used in people with depressed immune responses and pregnancy.

Ref: Park, 21st Edition, Page 91


What is the recommended schedule for pre exposure prophylaxis for rabies?

A: 0, 3, 7 daysB: 0, 7, 14 daysC: 0, 7, 28 daysD: 0, 3, 7, 14, 21 daysCorrect Ans:CExplanation

Persons who have a high risk of exposure to rabies such as staff working with rabies virus, veterinarians should be administered pre exposure prophylaxis against rabies. Such immunization consists of cell culture vaccine administered on days 0, 7 and 28.

Ref: Park 21st edition, page 256.


Which of the following is NOT an example of an epizootic?

A: MalariaB: BrucellosisC: AnthraxD: Rabies

Correct Ans:AExplanationEPIZOOTIC: It is an epidemic of disease in an animal population (often with the implication that it may also affect human populations). Only a few zoonotic agents cause major epidemics. Examples are anthrax, brucellosis, rabies, influenza, Rift valley fever, Japanese encephalitis and equine encephalitis.



Which of the following is not a route of transmission Rabies?

A: BiteB: LickC: AerosolD: IngestionCorrect Ans:DExplanation

The prinicple routes of transmission of rabies virus are animal bites, licks on abraded skin or mucosa, through aerosols and through person to person contact. Rabies can also be transmitted through corneal and organ transplants.


A wild life officer comes to clinic for recieving prophylactic vaccine against rabies. How many doses of HDCV is needed for pre exposure prophylaxis of Rabies?

A: 1B: 2

C: 3D: 4Correct Ans:CExplanation

Prophylaxis for rabies consist of administration of HDCV vaccine in a dose of either 1ml i.m/ 0.1ml intradermally on days 0, 7 and 28. One month after the third injection serum titers of antibodies are checked and if the titre is less than 0.5 IU/ml booster doses should be administered until antibodies becomes demonstratable.


All the following are modes of transmission of rabies, EXCEPT:

A: Person to person transmissionB: AerosolC: Ingestion of products made from infected animalsD: Licks


Aerosol transmission may occur in caves harbouring rabies infected bats. Person to person transmission is also on record. Eg – an infected child biting its parent. Ingestion of the virus is not believed to transmit the disease as the virus would be destroyed by stomach acid/enzymes.

Ref: Park, Edition 21, Page 252


Which among the following country is a ‘Rabies free country’?

A: USAB: RussiaC: AustraliaD: France

Correct Ans:CExplanationA “Rabies-free” area has been defined as one in which no case of indigenously acquired rabies has occurred in man or any animal species for 2 years. Australia, China (Taiwan), Cyprus, Iceland, Ireland, Japan, Malta, New Zealand, the U.K. and the islands of Western Pacific are all free of the disease. The Liberian Peninsula and Finland, Norway and Sweden are also rabies free.

In India, Union Territory of Lakshadweep and Andaman and Nicobar islands are free of the disease.

Ref: Textbook of Preventive and Social Medicine by K Park, 19th edition, Page 226.


Post exposure prophylaxis is given in A/E

A: RabiesB: MeaslesC: PertussisD: Hepatitis BCorrect Ans:CExplanationActive immunoprophylaxis after exposure to disease [Post exposure prophylaxis] is recommended for;RabiesTetanusHepatitis BMeasles (within three days of exposure)Varicella

Measles vaccination is given to the unvaccinated contacts within 3 days of exposure to the index case. If more than 3 days have elapsed since exposure, they are protected with human immunoglobulins, 0.25 ml/Kg, followed by measles immunization 2-3 months later.

Ref : Principles of Community Medicine by B. Sridhar Rao; 5th edition


Which one of the following vaccines is contraindicated in pregnancy?

A: MMRB: RabiesC: Hep BD: None


MMR is a live vaccine prepared from live and generally attenuated organisms by passing repeatedly in the laboratory in tissue culture and thus it has lost their capacity to cause a full blown disease but retain their properties of immunogenicity. Live vaccines are contraindicated in pregnancy considering the risk of teratogenic harm to the fetus.

Rabies and Hepatitis B vaccines are killed or inactivated vaccines and no such contraindication exists to their use in pregnancy.

Ref: Park’s Textbook of Preventive and Social Medicine By K. Park, 19th Edition, Pages 97-8; Side Effects of Drugs Annual By Jeffrey K. Aronson, Pages 581-582; Immunology for The Health Sciences By Nicholas J. Vardaxis, Pages 101-4


Which of the following regions in India has been identified as rabies free zone?

A: ChhattisgarhB: NagalandC: LakhswadipD: Mizoram

Correct Ans:C

Explanation

A rabies free zone is one where no indigenously acquired case of rabies has been reported in the last 2 years. In India, Andaman and Nicobar islands and Lakshwadip has been declared as rabies free zone.



Use of one of the following vaccination is absolutely contraindicated in pregnancy:

A: Hepatitis-BB: Cholera

C: RabiesD: Yellow feverCorrect Ans:DExplanation

It is a live attenuated vaccine, so it is contraindicated in pregnancy except if exposure is unavoidable.

Ref:PSM and Biostatistics: Slef Assessment and Review - Park, 18th Edition, Page 182


Which of the following vaccine is routinely given in pregnancy?

A: InfluenzaB: Oral polioC: TetanusD: Rabies

Correct Ans:CExplanationTd vaccine should be given to pregnant women in the second or third trimester if they had not been vaccinated in the past 10 years. If a pregnant women received Td in the past 10 years Tdap should be given postpartum.

American College of Obstetricians and Gynecologists recommend that influenza vaccine should be given only to pregnant women with serious underlying diseases such as chronic diseases or pulmonary problems.

Ref: The Vaccine Handbook: A Practical Guide for Clinicians: the Purple Book By Gary S. Marshall page 252.


Which among the following is not a feature of furious rabies?

A: HydrophobiaB: AerophobiaC: Constricted pupilsD: Seizure


Furious Rabies generally manifests as headache, fever, irritability, restlessness and anxiety. It is associated with dilated pupils, lacrimation, salivation and perspiration. Muscle pains, salivation and vomitting may follow.

A few days following exposure the patient may experience a stage of excitement or muscle spasms initiated from the ingestion of of saliva or water. As a result these individuals have a tendency to drool and begin to fear water or hydrophobia. This excited phase continues for a few days until the patient lapses into a coma and dies.

Dumb Rabies manifests itself in the opposite manner as Furious Rabies. Instead of demonstrating excitement the patient experiences depression and paralysis followed by a coma. Death eventually results from respiratory arrest. This form of the virus is often difficult to diagnose from a clinical perspective.


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Previous year question on rabies based on neet pg, usmle, plab and fmge or mci screening exams