Q.1 Which of the following is the most common cause of bacterial sepsis in adults?
Staphylococcus aureus
Escherichia coli
Streptococcus pneumoniae
Pseudomonas aeruginosa
Explanation - E. coli is the most frequent cause of bacterial sepsis, especially in older adults, often originating from urinary tract infections.
Correct answer is: Escherichia coli
Q.2 Which of the following is the first-line treatment for meningococcal meningitis?
Vancomycin
Ceftriaxone
Amoxicillin
Metronidazole
Explanation - Ceftriaxone is the recommended first-line antibiotic for meningococcal meningitis due to its broad coverage and ability to penetrate the cerebrospinal fluid.
Correct answer is: Ceftriaxone
Q.3 A patient presents with fever, hypotension, and purpura fulminans. What is the most likely causative organism?
Neisseria meningitidis
Streptococcus pyogenes
Listeria monocytogenes
Salmonella typhi
Explanation - Purpura fulminans with shock is a hallmark of severe meningococcemia, caused by Neisseria meningitidis.
Correct answer is: Neisseria meningitidis
Q.4 Which of the following is the earliest laboratory indicator of sepsis?
Elevated WBC count
Elevated lactate
Low platelet count
Elevated ESR
Explanation - Serum lactate rises early in sepsis due to tissue hypoperfusion and anaerobic metabolism, making it an early marker.
Correct answer is: Elevated lactate
Q.5 What is the recommended initial fluid resuscitation in septic shock for adults?
0.9% saline 30 mL/kg bolus
Dextrose 5% 500 mL
Ringer's lactate 10 mL/kg
Albumin 1 g/kg
Explanation - Current guidelines recommend rapid administration of crystalloids, usually 30 mL/kg of isotonic saline, for initial resuscitation in septic shock.
Correct answer is: 0.9% saline 30 mL/kg bolus
Q.6 Which infectious emergency is characterized by rapidly progressing soft tissue necrosis with severe pain out of proportion to clinical findings?
Cellulitis
Necrotizing fasciitis
Erysipelas
Abscess
Explanation - Necrotizing fasciitis presents with extreme pain, rapid tissue destruction, and systemic toxicity, requiring urgent surgical intervention.
Correct answer is: Necrotizing fasciitis
Q.7 A patient with a recent tick bite presents with fever, headache, and a rash that starts on the wrists and ankles and spreads centrally. What is the most likely diagnosis?
Lyme disease
Rocky Mountain spotted fever
Tularemia
Ehrlichiosis
Explanation - The classic rash of RMSF begins on wrists and ankles, spreads centrally, and is often accompanied by fever and headache.
Correct answer is: Rocky Mountain spotted fever
Q.8 Which of the following vaccines is most important in preventing pneumococcal sepsis in high-risk adults?
Pneumococcal conjugate vaccine (PCV13)
BCG vaccine
Hepatitis B vaccine
MMR vaccine
Explanation - PCV13 protects against severe pneumococcal infections including sepsis and meningitis in adults with comorbidities.
Correct answer is: Pneumococcal conjugate vaccine (PCV13)
Q.9 Which of the following signs is considered an early indicator of toxic shock syndrome?
Hypotension
Desquamating rash
Fever
Multi-organ failure
Explanation - Fever is an early symptom of toxic shock syndrome, with hypotension and multi-organ failure developing later.
Correct answer is: Fever
Q.10 Which pathogen is commonly associated with sepsis following cat or dog bites?
Pasteurella multocida
Clostridium perfringens
Staphylococcus aureus
Streptococcus pyogenes
Explanation - Pasteurella multocida is frequently isolated from infections following animal bites, causing rapidly developing cellulitis and sometimes sepsis.
Correct answer is: Pasteurella multocida
Q.11 A neonate presents with lethargy, poor feeding, and hypothermia. Blood cultures are pending. Which empiric antibiotic regimen is most appropriate?
Ampicillin + Gentamicin
Ceftriaxone alone
Vancomycin + Ciprofloxacin
Penicillin G alone
Explanation - Ampicillin and gentamicin provide broad coverage for common neonatal pathogens, including Group B Streptococcus and E. coli.
Correct answer is: Ampicillin + Gentamicin
Q.12 Which of the following organisms is most commonly associated with Waterhouse-Friderichsen syndrome?
Neisseria meningitidis
Staphylococcus aureus
Streptococcus pneumoniae
Haemophilus influenzae
Explanation - Waterhouse-Friderichsen syndrome, characterized by adrenal hemorrhage and shock, is classically caused by meningococcal sepsis.
Correct answer is: Neisseria meningitidis
Q.13 In toxic shock syndrome, the superantigen produced by Staphylococcus aureus acts primarily by:
Activating B lymphocytes
Directly lysing red blood cells
Non-specific activation of T cells
Inhibiting neutrophil function
Explanation - Superantigens cause massive T cell activation, leading to cytokine storm and multi-organ dysfunction in toxic shock syndrome.
Correct answer is: Non-specific activation of T cells
Q.14 A patient presents with sudden onset fever, hypotension, and rapidly spreading erythema with bullae. Which intervention is most urgent?
Intravenous antibiotics
Surgical debridement
Topical antiseptic application
Observation and monitoring
Explanation - Necrotizing soft tissue infections require immediate surgical intervention to remove necrotic tissue, along with antibiotics.
Correct answer is: Surgical debridement
Q.15 Which laboratory finding is most indicative of severe sepsis?
Mild leukocytosis
Hyperlactatemia
Mild anemia
Mild thrombocytosis
Explanation - Elevated lactate reflects tissue hypoperfusion and is a key marker for severe sepsis and septic shock.
Correct answer is: Hyperlactatemia
Q.16 Which of the following infections is a surgical emergency due to potential airway obstruction?
Epiglottitis
Strep throat
Otitis media
Sinusitis
Explanation - Epiglottitis can rapidly obstruct the airway and requires urgent airway management and intravenous antibiotics.
Correct answer is: Epiglottitis
Q.17 Which of the following is the mainstay of treatment for severe Clostridium tetani infection?
Tetanus immune globulin and supportive care
Penicillin alone
Metronidazole alone
Ceftriaxone and steroids
Explanation - Treatment of tetanus involves neutralizing toxin with immune globulin and providing supportive care, including muscle relaxants and airway support.
Correct answer is: Tetanus immune globulin and supportive care
Q.18 Which of the following organisms is a common cause of sepsis in patients with neutropenia?
Pseudomonas aeruginosa
Streptococcus pyogenes
Listeria monocytogenes
Neisseria meningitidis
Explanation - Pseudomonas is a frequent pathogen in immunocompromised and neutropenic patients, causing severe sepsis.
Correct answer is: Pseudomonas aeruginosa
Q.19 Which of the following is a classic feature of dengue hemorrhagic fever in the emergency setting?
Plasma leakage and thrombocytopenia
Fever without rash
Severe headache only
Painless lymphadenopathy
Explanation - Severe dengue can lead to plasma leakage, shock, and low platelet count, necessitating urgent fluid resuscitation.
Correct answer is: Plasma leakage and thrombocytopenia
Q.20 Which clinical feature helps differentiate staphylococcal toxic shock syndrome from streptococcal toxic shock syndrome?
Rapid onset hypotension
Presence of soft tissue infection
Fever
Multiorgan involvement
Explanation - Streptococcal TSS often involves a focal soft tissue infection, whereas staphylococcal TSS may occur without a clear infection site.
Correct answer is: Presence of soft tissue infection
Q.21 A patient presents with high fever, severe headache, nuchal rigidity, and photophobia. Which empiric therapy should be started immediately?
Ceftriaxone and vancomycin
Amoxicillin only
Metronidazole only
Doxycycline only
Explanation - Empiric coverage for bacterial meningitis should include ceftriaxone and vancomycin to cover the most common pathogens until cultures return.
Correct answer is: Ceftriaxone and vancomycin
Q.22 Which of the following is an important preventive measure for healthcare-associated sepsis?
Hand hygiene
Vitamin supplementation
Daily X-rays
Routine antibiotics for all patients
Explanation - Proper hand hygiene is the single most effective measure to prevent hospital-acquired infections leading to sepsis.
Correct answer is: Hand hygiene
Q.23 Which of the following viruses can cause hemorrhagic fever requiring emergency care?
Ebola virus
Rhinovirus
Norovirus
Adenovirus
Explanation - Ebola virus can lead to severe hemorrhagic fever with high mortality, requiring strict infection control and supportive care.
Correct answer is: Ebola virus
Q.24 In a patient with suspected septic arthritis, which is the most critical step in emergency management?
Joint aspiration for culture
Start topical antibiotics
X-ray of joint
MRI of joint
Explanation - Prompt joint aspiration allows diagnosis and targeted antibiotic therapy, which is crucial to prevent joint destruction in septic arthritis.
Correct answer is: Joint aspiration for culture