Skin, GI, Sexually Transmitted, and Vector-borne Infections Practice Questions

25 multiple-choice questions on Skin, GI, sexually transmitted, and vector-borne infections for paramedic and EMT students, from Chapter 27 (Infectious Diseases). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. MRSA is resistant to:

   1. A. Nearly every antibiotic now in use
   2. B. Vancomycin and linezolid
   3. C. All antiviral medications
   4. D. Methicillin and other beta-lactams
   Show answer

   Answer: D. Methicillin and other beta-lactams

   MRSA remains sensitive to drugs such as vancomycin and trimethoprim-sulfamethoxazole.

2. Community-acquired MRSA commonly causes:

   1. A. Meningitis
   2. B. Hepatitis
   3. C. Skin abscesses
   4. D. Isolated pneumonia
   Show answer

   Answer: C. Skin abscesses

   Abscesses are often mistaken for spider bites.

3. VRE is resistant to:

   1. A. Linezolid
   2. B. Vancomycin
   3. C. Daptomycin
   4. D. Antifungals
   Show answer

   Answer: B. Vancomycin

   Vancomycin-resistant enterococcus mainly affects hospitalized patients. Linezolid and daptomycin are drugs used to treat VRE, and antifungals do not act on bacteria.

4. A traveler back from Puerto Rico had 4 days of fever, which is now falling, but she has severe abdominal pain, repeated vomiting, and bleeding gums. You should suspect:

   1. A. Severe dengue
   2. B. Zika virus
   3. C. Chikungunya fever
   4. D. Traveler's diarrhea
   Show answer

   Answer: A. Severe dengue

   Dengue warning signs often appear as the fever breaks: severe abdominal pain, persistent vomiting, mucosal bleeding, and lethargy. Plasma leak can cause shock. Avoid NSAIDs and transport; ask about travel to areas with dengue. Zika and chikungunya cause fever, rash, and joint pain without the bleeding and warning signs of severe dengue, and traveler's diarrhea does not cause bleeding gums.

5. Since the rotavirus vaccine was introduced for infants in the US, which change has occurred?

   1. A. Infant ear infections have disappeared entirely
   2. B. Norovirus has stopped causing outbreaks in schools
   3. C. Children no longer need oral rehydration for diarrhea
   4. D. Far fewer infants are hospitalized for diarrhea
   Show answer

   Answer: D. Far fewer infants are hospitalized for diarrhea

   Before the vaccine, rotavirus caused tens of thousands of US hospitalizations for dehydrating diarrhea in young children each year; hospitalizations fell sharply after it was introduced in 2006. It is an oral vaccine given in infancy. Norovirus and other causes of diarrhea remain.

6. Norovirus is known for:

   1. A. Bloody diarrhea with high fever
   2. B. Rapid outbreaks of vomiting
   3. C. Weeks of greasy diarrhea
   4. D. Chronic liver disease and jaundice
   Show answer

   Answer: B. Rapid outbreaks of vomiting

   It spreads easily on cruise ships, in nursing homes, and in schools. Bloody diarrhea with high fever suggests Shigella or other invasive bacteria. Weeks of greasy diarrhea suggest Giardia, and norovirus does not cause liver disease.

7. After a cruise, a patient has profuse, painless, watery 'rice-water' diarrhea and is now lethargic with a weak pulse. The main danger is:

   1. A. Rapid fluid loss and shock
   2. B. Bowel perforation
   3. C. Toxic megacolon
   4. D. Bleeding into the bowel wall
   Show answer

   Answer: A. Rapid fluid loss and shock

   Cholera and other secretory diarrheas can cause the loss of liters of fluid per day, leading to hypovolemic shock within hours. Aggressive fluid replacement is life-saving. Use contact precautions and hand hygiene. Cholera does not damage the bowel wall, so perforation, toxic megacolon, and bleeding are not the danger.

8. A hiker finds a tick attached to his leg. The best way to remove it is to:

   1. A. Burn it off with the tip of a lit match
   2. B. Coat it with nail polish so it backs out
   3. C. Twist it off quickly by squeezing its body
   4. D. Grasp it near the skin; pull steadily
   Show answer

   Answer: D. Grasp it near the skin; pull steadily

   Use fine tweezers to grasp the tick as close to the skin as possible and pull upward with steady pressure, then clean the site. Heat, petroleum jelly, or nail polish delay removal, and squeezing the body can leave mouthparts behind. Lyme transmission usually needs 24 to 36 hours of attachment.

9. The classic early sign of Lyme disease is:

   1. A. A slapped-cheek rash
   2. B. Koplik spots
   3. C. A bull's-eye rash
   4. D. A sandpaper rash
   Show answer

   Answer: C. A bull's-eye rash

   Erythema migrans appears days to weeks after a tick bite.

10. Late Lyme disease can cause:

    1. A. Arthritis and heart block
    2. B. Hemolytic anemia and jaundice
    3. C. Kidney failure and hematuria
    4. D. Severe iron deficiency
    Show answer

    Answer: A. Arthritis and heart block

    It can also cause facial nerve palsy and meningitis. Hemolytic anemia from a tick bite suggests babesiosis, and Lyme disease does not typically damage the kidneys or cause iron deficiency.

11. Rocky Mountain spotted fever causes a rash that typically begins on the:

    1. A. Face and scalp
    2. B. Upper back
    3. C. Abdomen and flanks
    4. D. Wrists and ankles
    Show answer

    Answer: D. Wrists and ankles

    The rash spreads to the trunk and may involve the palms and soles.

12. Gonorrhea and chlamydia commonly cause:

    1. A. Painless genital ulcers
    2. B. Severe headache and stiff neck
    3. C. Urethral discharge and dysuria
    4. D. Jaundice and dark urine
    Show answer

    Answer: C. Urethral discharge and dysuria

    Many infections, especially in women, are asymptomatic.

13. Which PPE does CDC recommend for close care of a patient with suspected mpox?

    1. A. Gloves for any contact with the lesions
    2. B. N95, eye protection, gown, gloves
    3. C. A mask on the patient
    4. D. No PPE needed, since the lesions are dry
    Show answer

    Answer: B. N95, eye protection, gown, gloves

    Mpox spreads mainly by close contact with lesions and contaminated items, and possibly by respiratory secretions during prolonged face-to-face contact. CDC advises gown, gloves, eye protection, and an N95 for health care workers, and covering the patient's lesions.

14. A paramedic who suctioned a patient's mouth without gloves now has a painful, swollen fingertip with small clustered blisters. This is most likely:

    1. A. Contact dermatitis
    2. B. Herpetic whitlow
    3. C. A splinter abscess
    4. D. Frostbite blistering
    Show answer

    Answer: B. Herpetic whitlow

    Herpes simplex in oral secretions can infect broken skin on the fingers, causing painful clustered vesicles called herpetic whitlow. Gloves prevent it. It should not be lanced, and the provider should avoid patient contact with that hand until healed.

15. A nursing home resident has thick, crusted, scaly patches on the hands and body, and several staff now have itchy rashes. You should suspect:

    1. A. A flare of plaque psoriasis
    2. B. Simple dry skin of old age
    3. C. Crusted (Norwegian) scabies
    4. D. A drug rash from a new pill
    Show answer

    Answer: C. Crusted (Norwegian) scabies

    Crusted scabies occurs in older, debilitated, or immunocompromised people, who carry thousands of mites in thick crusts. It is highly contagious, causing outbreaks among staff. Use gloves and a gown, bag linens, and clean the stretcher.

16. A patient's apartment has bed bugs. Regarding the crew and ambulance, the main concern is:

    1. A. Catching HIV from the bed bug bites
    2. B. Spreading hepatitis B through the bites
    3. C. Catching Lyme disease
    4. D. Carrying bugs to other places
    Show answer

    Answer: D. Carrying bugs to other places

    Bed bugs cause itchy bites but are not known to transmit disease. The concern is carrying them on equipment and clothing. Limit what you bring inside, keep the stretcher off beds and couches, and inspect and clean equipment per policy.

17. Scabies is caused by:

    1. A. Mites
    2. B. Lice
    3. C. Fleas
    4. D. Bacteria
    Show answer

    Answer: A. Mites

    It causes intense itching, especially at night, with burrows between the fingers.

18. After transporting a patient with scabies or lice, you should:

    1. A. Discard the stretcher and mattress
    2. B. Clean the ambulance and bag linens
    3. C. Take oral antibiotics yourself
    4. D. No special action is needed
    Show answer

    Answer: B. Clean the ambulance and bag linens

    Use contact precautions and follow agency policy.

19. A high school wrestler has a round, scaly red patch with a clearer center on his arm. Several teammates have similar patches. This is most likely:

    1. A. A fungal infection (ringworm)
    2. B. A worm living under the skin
    3. C. Lyme disease from a tick bite
    4. D. A burn from the wrestling mat
    Show answer

    Answer: A. A fungal infection (ringworm)

    Tinea corporis (ringworm) is a fungal skin infection, not a worm, and spreads by skin contact and shared mats and gear in contact sports. Its ring-shaped rash can resemble the bull's-eye of Lyme disease, but the scaly border and team spread point to tinea.

20. Impetigo causes:

    1. A. A bull's-eye rash
    2. B. Black, painless eschar
    3. C. Honey-colored crusts
    4. D. Purple bruises
    Show answer

    Answer: C. Honey-colored crusts

    It is a contagious bacterial skin infection common in children.

21. A man has a small cut over a knuckle after punching someone in the mouth 2 days ago. The hand is now swollen and painful to move. This injury:

    1. A. Is minor and can simply be bandaged
    2. B. Needs just an ice pack and rest
    3. C. Is safe to close with tape strips
    4. D. Needs urgent hospital evaluation
    Show answer

    Answer: D. Needs urgent hospital evaluation

    A 'fight bite' drives mouth bacteria into the joint and tendon spaces of the knuckle, and these infections progress quickly and can destroy the joint. They need exploration, irrigation, and antibiotics, and should never be closed in the field.

22. Mpox (monkeypox) spreads mainly through:

    1. A. Close skin-to-skin contact
    2. B. Mosquito and tick bites
    3. C. Contaminated drinking water
    4. D. Airborne droplet nuclei
    Show answer

    Answer: A. Close skin-to-skin contact

    It causes fever and a rash of firm, deep lesions.

23. Ebola is spread through:

    1. A. Airborne droplet nuclei
    2. B. Mosquito and tick bites
    3. C. Contact with body fluids
    4. D. Contaminated food or water
    Show answer

    Answer: C. Contact with body fluids

    It requires enhanced PPE and strict protocols.

24. A man who took malaria prevention pills during a trip to Africa 2 months ago now has fever and chills. Regarding malaria, you should know that:

    1. A. The pills make malaria impossible
    2. B. Malaria can start just during the trip
    3. C. Symptoms appear within a single day
    4. D. It can still develop despite pills
    Show answer

    Answer: D. It can still develop despite pills

    No preventive drug is 100% effective, adherence is often imperfect, and malaria can appear weeks to months after return. Fever in a traveler from an endemic area within the past year needs urgent testing.

25. A traveler back from South Asia has had a high fever for a week that rises in steps, with abdominal pain and a slow pulse for the fever. You should suspect:

    1. A. Hepatitis A from contaminated food
    2. B. Typhoid (enteric) fever
    3. C. Traveler's diarrhea
    4. D. Jet lag and fatigue
    Show answer

    Answer: B. Typhoid (enteric) fever

    Typhoid fever, from Salmonella Typhi in food or water contaminated by stool, causes a sustained, rising fever, abdominal pain, and sometimes a relatively slow pulse and rose spots. It can cause intestinal perforation. Drug resistance is common in South Asia, so mention the travel. Hepatitis A brings jaundice rather than a week of step-wise fever with a slow pulse, and traveler's diarrhea and jet lag do not cause a sustained high fever.