CME Tropical Medicine (123847): self-assessment questionnaire

Format

Candidates are asked to choose the best answer from the five possible answers. This best of five format is used in many medical examinations.

The answering process

1. Go to www.rcplondon.ac.uk/SAQ

2. Log on using your usual RCP username and password

3. Select the relevant CME question paper

4. Answer all 10 questions by selecting the best answer from the options provided

5. Once you have answered all the questions, click on Submit

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1. Which one of the following is the principal vector for dengue globally?

   1. Aedes aegypti

   2. Aedes albopictus

   3. Anopheles gambiae

   4. Culex quinquefasciatus

   5. Haemagogus tropicalis

2. Concerning West Nile virus (WNV), which one of the following statements is true?

   1. Aedes mosquitoes transmit WNV

   2. Flaccid paralysis can be a feature of neuroinvasive WNV

   3. Roe deer are an important WNV reservoir

   4. WNV causes severe disease in 80% of infections

   5. Young adults are most vulnerable to severe WNV

3. Which of the following species of malaria is associated with the majority of deaths, both globally and in the UK?

   1. Plasmodium falciparum

   2. Plasmodium knowlesi

   3. Plasmodium malariae

   4. Plasmodium ovale

   5. Plasmodium vivax

4. A 34-year-old male attended the emergency department having returned from Burkina Faso 5 days previously. He was drowsy with a Glasgow coma score of 10. Temperature was 38.9°C, blood pressure 100/60 mmHg and respiratory rate 26 breaths per minute. Bloods showed haemoglobin of 109 g/dL, platelets of 93 × 10⁹/L, white cell count of 2.8 × 10⁹/L, creatinine of 183 μmol/L, PO₂ (on air) 9.5 kPa and pH 7.25. Blood film showed early and late trophozoites of P falciparum with 12% of red blood cells parasitised.

   What antimalarial should he receive?

   1. Atovaquone–proguanil (Malarone®)

   2. Dihydroartemsinin-piperaquine (Euartesim®)

   3. Intravenous quinine

   4. Intravenous artesunate

   5. Tafenoquine

5. Which of the following is a potential sign of severe malaria in adults?

   1. Glasgow coma score of 10

   2. Haemoglobin 10.1 g/dL

   3. Parasite count 1.3% of red cells parasitised

   4. Platelets below 90 x 10⁹/L

   5. Temperature >38.7°C

6. Which one of the following has an effective available vaccine?

   1. Crimean–Congo haemorrhagic fever

   2. Ebola virus

   3. Lassa fever

   4. Middle East respiratory syndrome coronavirus (Co-V)

   5. Zika virus

7. Which one of the following has improved the ability to offer good basic clinical care to patients during outbreaks of viral haemorrhagic fever?

   1. Evidence-based antiviral medications

   2. Inserting Wolbachia infection into mosquito populations to reduce transmission

   3. Locating isolation and treatment centres far from dense population centres

   4. Rapid near-patient biochemistry analysers

   5. Rapid transportation of samples to centralised laboratories

8. Which one of the following arboviruses are transmitted by day-biting mosquitos?

   1. Crimean–Congo haemorrhagic fever

   2. Dengue

   3. Malaria

   4. Middle east respiratory syndrome Co-V

   5. Monkeypox

9. Which one of the following activity does not form part of the strategy for Guinea worm eradication?

   1. Containment of infected individuals

   2. Distribution of water filters

   3. Provision of safe drinking water

   4. Vaccination against Dracunculus medinensis

   5. Vector control of cyclops crustacean

10. Mass drug administration forms a part of the control strategy for many neglected tropical diseases.

    Which one of the diseases has an alternative strategy proposed by World Health Organization?

    1. Echinococcosis

    2. Lymphatic filariasis

    3. Onchocerciasis

    4. Trachoma

    5. Yaws

CME Medical Masterclass SAQ

Answers to the CME SAQ published in Clinical Medicine in January 2019

Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Q10

(a) (e) (e) (a) (d) (d) (e) (d) (b) (c)