Dengue fever

DENGUE AND SMOG | Transport DepartmentDengue fever is a mosquito-borne viral infection that can cause flu-like symptoms and, in severe cases, potentially life-threatening complications. It is caused by the dengue virus, which is transmitted to humans primarily through the bite of infected female Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus. Dengue fever is common in tropical and subtropical regions of the world, including parts of Southeast Asia, the Pacific Islands, the Caribbean, and Central and South America.

Here are some key points about dengue fever:


The symptoms of dengue fever typically appear 4-10 days after being bitten by an infected mosquito and can include high fever, severe headache, pain behind the eyes, joint and muscle pain, rash, and mild bleeding. In some cases, dengue fever can progress to a more severe form known as dengue hemorrhagic fever or dengue shock syndrome, which can be life-threatening.

Dengue fever presents with a wide range of signs and symptoms that can vary in severity. The disease typically has an incubation period of 4-10 days after being bitten by an infected mosquito. The symptoms of dengue fever can be categorized into three phases: the febrile phase, the critical phase, and the recovery phase. Not all individuals with dengue infection will progress through all three phases, and the severity of symptoms can vary from mild to severe. Here are the common signs and symptoms associated with each phase:

  1. Febrile Phase (Acute Phase):

High Fever: Sudden onset of high fever, often reaching up to 104°F (40°C).

Severe Headache: Intense frontal headache, which is a common feature of dengue fever.

Pain Behind the Eyes: Pain or discomfort, especially when moving the eyes.

Joint and Muscle Pain: Severe joint and muscle pain, often referred to as “breakbone fever.”

Rash: A rash may develop, typically starting a few days after the onset of fever. It can be maculopapular (red and raised) and sometimes itchy.

Fatigue: Extreme fatigue and weakness.

Nausea and Vomiting: Some individuals may experience nausea and vomiting.

Mild Bleeding: Minor bleeding manifestations such as nosebleeds, gum bleeding, or easy bruising can occur.

  1. Critical Phase (Warning Signs):

Around the 3-7 day mark, some patients with dengue fever may progress to a critical phase. Warning signs indicate increased severity and the potential for complications. These signs include:

Persistent Abdominal Pain: Severe abdominal pain may develop, which can be a sign of impending complications like dengue hemorrhagic fever.

Vomiting with Blood: Vomiting blood (hematemesis) or passing blood in the stool (melena) can occur.

Bleeding: Severe bleeding, such as from the nose or gums, petechiae (small red or purple spots on the skin), or hematuria (blood in the urine).

Rapid Breathing: Increased respiratory rate and difficulty breathing.

Cold or Clammy Skin: Skin may become cold, pale, or clammy.

Restlessness: Agitation or restlessness may be observed.

  1. Recovery Phase:

After the critical phase, most patients gradually recover over the next few days to weeks.

The fever subsides, and other symptoms begin to improve.

Convalescence: Patients may experience fatigue and weakness during the recovery phase, which can persist for an extended period.

It’s important to note that not all individuals with dengue fever progress to the critical phase or develop severe symptoms. The majority of cases are mild, and with proper medical care and supportive treatment, the prognosis is usually favorable. However, severe dengue (such as dengue hemorrhagic fever or dengue shock syndrome) can be life-threatening and requires immediate medical attention.

If you or someone you know exhibits the warning signs of dengue fever, it’s crucial to seek medical care promptly to prevent complications and ensure appropriate treatment and monitoring.

Diagnosis: Dengue fever is usually diagnosed through blood tests that detect the presence of the dengue virus or antibodies produced in response to the virus.

Laboratory findings play a significant role in the diagnosis and management of dengue fever. The results of various laboratory tests can help confirm the presence of the dengue virus, assess the severity of the infection, and guide treatment decisions. Here are some of the key laboratory findings associated with dengue fever:

Dengue Serology (Antibody Tests):

IgM Antibodies: In the early stages of the illness (usually within the first week), dengue-specific IgM antibodies can be detected in the patient’s blood. The presence of IgM antibodies suggests a recent dengue infection.

IgG Antibodies: Dengue-specific IgG antibodies may appear later and persist for a more extended period. Elevated IgG levels may indicate a past dengue infection.

Polymerase Chain Reaction (PCR) Test:

Dengue PCR: This test detects the genetic material (RNA) of the dengue virus in a patient’s blood. It is most useful in the early days of infection, even before the appearance of IgM antibodies. PCR can help confirm an acute dengue infection and identify the specific serotype of the virus.

Complete Blood Count (CBC):

Platelet Count: One of the hallmark laboratory findings in dengue fever is a decrease in platelet count (thrombocytopenia). Platelets are essential for blood clotting, and low platelet levels can lead to bleeding tendencies.

Hematocrit (Hct) Levels: An elevated hematocrit (a measure of the proportion of red blood cells in the blood) can indicate hemoconcentration, which is common in dengue fever due to plasma leakage.

Liver Function Tests:

AST (Aspartate Aminotransferase) and ALT (Alanine Aminotransferase): Elevated levels of these liver enzymes are often seen in dengue patients, indicating liver involvement.

Coagulation Profile:

PT (Prothrombin Time) and APTT (Activated Partial Thromboplastin Time): These tests assess the blood’s clotting ability. Prolonged PT and APTT may be seen in severe cases of dengue with bleeding tendencies.

Electrolyte Levels:

Sodium (Na) and Potassium (K): Abnormal electrolyte levels can occur due to fluid imbalances in dengue patients, especially those with severe symptoms.

Creatinine and Urea Levels:

Kidney Function Tests: Elevated creatinine and urea levels may indicate kidney involvement in severe dengue cases.

Other Tests:

NS1 Antigen Test: This test can detect the presence of the dengue virus NS1 antigen in a patient’s blood and is useful for early diagnosis.

Dengue Serotyping: In areas with multiple dengue virus serotypes, it’s important to identify the specific serotype causing the infection as some serotypes are associated with more severe disease.

Laboratory findings in dengue fever can vary depending on the stage of the infection and the severity of the disease. These tests help healthcare providers confirm the diagnosis, assess the patient’s condition, and make decisions regarding treatment and monitoring. It’s important to note that dengue fever is a dynamic disease, and laboratory findings may change over the course of the illness, so repeated testing and close monitoring are often necessary, especially in severe cases.


The best way to prevent dengue fever is to avoid mosquito bites. This can be achieved by using insect repellent, wearing long-sleeved clothing, and staying in air-conditioned or screened-in accommodations. Additionally, efforts to reduce mosquito breeding sites, such as eliminating standing water around homes, are essential for dengue prevention.


As of my last knowledge update in September 2021, there was an approved dengue vaccine called Dengvaxia. However, its use and availability varied by country, and it was primarily recommended for individuals who had previously been infected with dengue. Vaccine availability and recommendations may have evolved since then, so it’s essential to check with local health authorities for the most up-to-date information on dengue vaccines.

It’s important to note that dengue fever can be a serious illness, and early detection and medical care are crucial for managing the disease effectively, especially in severe cases. If you suspect you have dengue fever or are in an area where the disease is prevalent, seek medical attention promptly.


There is no specific antiviral treatment for dengue fever. Management primarily involves relieving the symptoms and providing supportive care, such as staying hydrated and taking pain relievers like acetaminophen. Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided because they can increase the risk of bleeding.

The medical and nursing management of dengue fever involves a combination of supportive care and monitoring to alleviate symptoms, prevent complications, and promote recovery. Here’s a comprehensive overview of the medical and nursing management of dengue fever:

Medical Management:

Diagnosis: Accurate diagnosis through clinical evaluation and laboratory tests (serology or PCR) is essential to confirm dengue fever.

Hospitalization: Depending on the severity of the illness, some patients may require hospitalization. Hospitalization is especially crucial for patients with severe dengue or those at risk of complications.

Fluid Replacement: Adequate hydration is a cornerstone of dengue management. Intravenous (IV) fluids are often administered to maintain fluid and electrolyte balance. Nurses closely monitor patients’ fluid intake and output.

Pain and Fever Management: Analgesics such as acetaminophen are given to relieve pain and reduce fever. Non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin should be avoided, as they can increase the risk of bleeding.

Monitoring: Regular monitoring of vital signs, hematocrit levels, platelet counts, and other relevant parameters is crucial to assess the progression of the disease and the patient’s response to treatment.

Blood Transfusion: In severe cases of dengue with hemorrhagic manifestations, blood transfusion may be necessary to replace lost blood components.

Nursing Management:

Assessment: Nurses conduct a thorough assessment of the patient’s clinical status, including vital signs, hydration level, skin condition, and the presence of bleeding or shock symptoms.

Fluid Administration: Nurses administer IV fluids as prescribed by the physician, ensuring that the rate and type of fluid are appropriate for the patient’s condition.

Monitoring: Frequent monitoring of vital signs, especially blood pressure, pulse rate, and respiratory rate, is essential to detect any deterioration in the patient’s condition promptly.

Pain and Fever Control: Nurses administer pain relievers and antipyretics as ordered by the physician and monitor the patient’s response to these medications.

Emotional Support: Providing emotional support and reassurance to the patient and their family is essential, as dengue fever can be a distressing experience.

Education: Nurses educate patients and their families about the importance of hydration, medication compliance, and the signs and symptoms that require immediate medical attention.

Infection Control: Nurses ensure strict infection control measures to prevent the spread of the virus, particularly in healthcare settings. This includes proper hand hygiene and personal protective equipment (PPE) use.

Patient Education: Patients should be educated about the prevention of mosquito bites and the importance of seeking prompt medical care if their condition worsens.

Discharge Planning: When the patient is stable and ready for discharge, nurses provide instructions for continued care at home, including medication schedules and follow-up appointments.

The medical and nursing management of dengue fever should be tailored to the individual patient’s condition and may vary based on the severity of the illness. Close collaboration between healthcare providers, including physicians, nurses, and other healthcare staff, is crucial to ensure optimal patient care and recovery.

Question and Answers about Monkeypox.

What is monkeypox?

The monkeypox virus causes the disease monkeypox. It is a zoonotic viral illness, which means it may pass from animals to people. It may also transmit from humans to humans and from people to the environment.

What are the symptoms of monkeypox?

Monkeypox can produce a variety of symptoms. While some individuals experience milder symptoms, others may develop more serious illnesses and need hospitalisation. Pregnant women, children, and anyone with impaired immune systems are at a greater risk.

During the 2022 epidemic, the most frequent symptoms of monkeypox were fever, headache, muscular pains, back pain, poor energy, and enlarged lymph nodes, followed or accompanied by the formation of a rash that might last two to three weeks. The rash might appear on the face, palms of hands, soles of feet, groyne, genital, and/or anal areas. It may also be discovered in the mouth, throat, anus, or vagina, as well as on the eyes. The number of sores might vary between one and thousands. Sores on the skin begin flat, then fill with fluids before crusting over, drying up, and falling off, leaving a new layer of skin behind.

There are continuing research to monitor and better understand symptoms during this new epidemic, such as which regions of the body may be impacted and how long symptoms may remain.

Anyone experiencing symptoms of monkeypox or who has had contact with someone who has monkeypox should contact or see a health care practitioner for help.

Symptoms normally resolve on their own or with supportive treatment, such as pain or fever medicine. People are contagious until all lesions have crusted over, scabs have dropped off, and a new layer of skin has developed underneath.

Can people get seriously ill or die from monkeypox?

Most people with monkeypox get better on their own after a few weeks. But for some people, an illness can cause health problems or even death. From what we know about past monkeypox cases, we know that newborn babies, children, and people with weakened immune systems may be more likely to have more severe symptoms or even die from monkeypox.

Monkeypox can lead to complications like secondary skin infections, asthma, confusion, and problems with the eyes. Some newer problems are proctitis, which is painful spots and growth inside the rectum, and pain or trouble peeing. People with monkeypox have died between 1% and 10% of the time in the past. It’s important to remember that death rates can be different in different places because of things like how easy it is to get health care. Because monitoring for monkeypox hasn’t been very good in the past, these numbers may be too high.


Some deaths have been reported in the new countries where the latest outbreak is taking place. This shows how important monkeypox is and how people should keep doing everything they can to protect themselves and others.

How is monkeypox transmitted from person to person?

Close contact with someone who has a monkeypox rash distributes the disease from person to person. Face-to-face contact (such as talking, breathing, or singing close to one another, which can generate droplets or short-range aerosols); skin-to-skin contact (such as touching or vaginal/anal sex); mouth-to-mouth contact (such as kissing); or mouth-to-skin contact (such as oral sex or kissing the skin) are all examples of close contact. The processes of monkeypox transmission via the air are not fully known, and research is being conducted to understand more.

We are still learning how long people with monkeypox are infectious, but they are generally considered infectious until all of their sores have crusted over, the scabs have fallen off and a new layer of skin has formed beneath, and all sores on the eyes and in the body (in the mouth, throat, eyes, vagina, and anus) have healed as well.

When an infected individual touches clothes, bedding, towels, items, devices, or surfaces, the environment might become contaminated with the monkeypox virus. If anybody else touches these goods and has any scrapes or abrasions, or if they accidently contact their eyes, nose, mouth, or other mucous membranes, they may get infected. This is referred to as fomite transmission. Cleaning your hands after contacting potentially infected things may help avoid this form of transfer. Infection may also occur via inhaling skin flakes or viruses from clothes, beds, or towels. Experts are still attempting to figure out if this mechanism of transmission is important in the current epidemic.

The virus may also be transmitted to the foetus during pregnancy, during or after delivery by skin-to-skin contact, or from a parent infected with monkeypox to an infant or kid through intimate contact.

Although asymptomatic infection has been documented, it is unclear if persons who are asymptomatic may transmit the illness or whether the disease can spread via other body fluids. Although a live monkeypox virus has been isolated from sperm, it is unknown if infection may transmit through sperm, vaginal fluids, prenatal fluids, lactation, or blood. More research is being conducted to determine whether or not persons may transmit monkeypox via the sharing of these fluids during and after symptomatic illness.


How is monkeypox transmitted from animals to humans?

Monkeypox can be transmitted to humans through physical contact with an infected animal, such as a non-human primate, terrestrial rodent, antelope, gazelle, or tree squirrel, such as through bites or scratches, or through activities such as hunting, skinning, trapping, cooking, or playing with carcasses. The virus may also be acquired by consuming contaminated animals that have not been completely cooked. Avoiding unprotected contact with wild animals, particularly those that are ill or dead (including their flesh and blood), may lower the chance of contracting monkeypox from them. Any items including animal parts or meat should be fully prepared before consuming in regions where animals spread monkeypox.

Can monkeypox spread from humans to animals?

Monkeypox transmission from people to pets (dogs) is now being explored. Together with our One Health partners, the Food and Agriculture Organisation (FAO) and the World Organisation for Animal Health (WOAH), we are actively watching these developments and considering how to alter our outbreak response and advice if necessary.

Because many animal species are known to be vulnerable to the monkeypox virus, there is the possibility of viral spillover from humans to susceptible animal species in diverse situations, potentially leading to the establishment of new animal reservoirs.

People with monkeypox should avoid close physical contact with animals, including pets (such as cats, dogs, hamsters, gerbils, and so on), livestock, and wildlife.


Who is at risk of catching monkeypox?

People who live with or have close relationships (including sexual contact) with someone infected with monkeypox are the most vulnerable. Anyone who lives with someone who has monkeypox should take precautions to avoid being infected. A person with monkeypox should be evaluated by a health care practitioner to see whether they are healthy enough to be cared for at home and if isolation can be handled safely at home. To protect oneself when caring for monkeypox patients, health staff should practise infection prevention and control methods. Newborn newborns, young children, and persons with underlying immune weaknesses are at a greater risk of developing more severe symptoms, and in rare circumstances, dying from monkeypox. Pregnancy may also raise one’s chances of having a miscarriage or stillbirth.

People who were immunised against smallpox may be immune to monkeypox. Younger individuals, on the other hand, are unlikely to have had smallpox vaccine since the illness was eliminated in most settings worldwide in 1980. People who have received a smallpox vaccination should continue to take steps to protect themselves and others.

What can I do to protect myself and others against monkeypox?

In places where monkeypox is present, avoid unprotected contact with wild animals, particularly those that are ill or dead (including their flesh and blood). Any items containing animal parts or meat should be fully prepared before consumption.

Limit your contact with persons who have suspected or confirmed monkeypox to reduce your chance of contracting it from them. Maintain awareness of monkeypox in your community or social group, and have open dialogues with individuals with whom you have close contact (particularly sexual contact) about any symptoms you or they may be experiencing. Hands should be washed often with soap and water or an alcohol-based hand massage.

Clean and disinfect frequently touched surfaces in locations that might have been contaminated with the virus from an infected person.  The monkeypox virus may be killed with common home disinfectants or bleach solutions.

If you suspect you have monkeypox, get medical attention and isolate yourself from others until you have been assessed and tested. If you have monkeypox, you should separate yourself from people until all of your wounds have crusted over, the scabs have come off and a new layer of skin has grown underneath, and all of your internal sores have healed. This will prevent you from spreading the infection to others. Consult your health care provider about whether you should isolate at home or at a health institution. Use condoms as a precaution when having sexual contact for 12 weeks after you have recovered until more is known regarding transmission via sexual fluids.


Can I get monkeypox from touching things and surfaces in public?

Previous monkeypox outbreaks have shown that getting monkeypox after contacting infected materials is possible. If an infected person touches an object, surface, or fabric, it might get contaminated with the monkeypox virus. In some settings, the virus has been discovered to live on various surfaces for some time. However, in this epidemic, researchers are currently investigating whether humans may get monkeypox through contacting surfaces and objects.  Currently, practically all instances are connected to close contact, such as touching or intercourse.

To destroy the monkeypox virus, clean objects and surfaces with soap and water, basic home disinfectants, or a bleach product.

What should I do if I have signs of monkeypox or have been around someone who has it?

If you have had close contact with someone who has monkeypox or have been in an area that may have been contaminated with the virus, keep a watchful eye out for signs and symptoms for 21 days following your last exposure. Limit your close contact with other people as much as possible, and let your contacts know if it is unavoidable that you have been exposed to monkeypox.

If you suspect you have monkeypox, contact your healthcare professional for guidance, testing, and medical treatment. Isolate yourself from people as much as possible until you get your test results. Hands should be cleaned on a regular basis.

If you test positive for monkeypox, your doctor will tell you whether you should isolate at home or in a hospital, as well as what kind of treatment you need.

If I have monkeypox, what should I do to protect other people from getting infected?

If you have monkeypox, your doctor will tell you whether you should be treated in a hospital or at home. This will depend on the severity of your symptoms, whether you have risk factors that put you at risk for more severe symptoms, and if you can reduce your chances of infecting everyone you live with.

You should not go out if it is recommended that you isolate at home. Protect those with whom you live as much as possible by:

  • Inviting friends and relatives to assist you by providing items you need
  • Isolating yourself in a different room
  • Having a separate loo or washing after each use
  • Using soap and water and a home disinfectant, clean and disinfect regularly touched surfaces.
  • Avoid cleaning or vacuuming (this may dislodge virus particles and infect others).
  • Before sharing, use separate utensils, items, and devices, or thoroughly clean with soap and water/disinfectant.
  • There will be no sharing of towels, beds, or clothing.
  • Doing your own laundry (carefully lifting bedding, shirts, and towels without shaking them, placing them in a plastic bag before transporting them to the washing machine, and washing them in hot water > 60 degrees)
  • Ventilation may be improved by opening windows.
  • Encourage everyone in the family to wash their hands with soap and water or an alcohol-based hand sanitizer on a frequent basis.


If you can’t avoid being in the same room as someone else or having close contact with another person while isolating yourself at home, try to decrease their danger by:

  • Avoiding physical contact
  • Hands should be washed often with soap and water or an alcohol-based hand sanitizer.
  • Covering your rash with clothes or bandages (until you can isolate again – your rash heals quickest when left alone)
  • Leaving windows open around the house
  • Ensure that you and everyone else in the room are wearing properly fitted medical masks.
  • Keeping at least one metre apart from others
  • If you are unable to wash your own laundry and require someone to assist you, they should wear a well-fitting medical mask, disposable gloves, and follow the laundry procedures specified above.

Is there a vaccine against monkeypox?

Yes. There are three vaccinations available to protect against monkeypox. Despite the fact that supplies are now limited, get vaccinated if provided since they provide a vital degree of protection against the illness. After being vaccinated, continue to take precautions to avoid catching and spreading monkeypox; this is because immunity takes several weeks to develop after vaccination, and we don’t yet know how well the vaccines protect you or prevent you from infecting others, as efficacy data in this outbreak setting is needed.

Vaccination is recommended in several nations for those who are at risk. Many years of study have resulted in the creation of improved and safer vaccinations for smallpox, which may also be effective for monkeypox. Two of them (MVA-BN and LC16) have been licenced for monkeypox prophylaxis. Only those who are at risk (for example, someone who has had intimate contact with someone who has monkeypox) should be vaccinated. At this time, mass immunisation is not advised.

While the smallpox vaccination has previously been found to be protective against monkeypox, current evidence on the efficacy of newer smallpox/monkeypox vaccines in the prevention of monkeypox in clinical practise and in field settings is sparse. The study of the usage of monkeypox vaccinations wherever they are used will allow for the quick collection of more information on the efficiency of these vaccines in various circumstances.

How should someone take care of themselves if they have monkeypox? What care do they need?

The care someone need will be determined by their symptoms and their risk of developing a more serious condition. People who have monkeypox should listen to their doctor’s recommendations.  Symptoms often last two to three weeks and resolve on their own or with supportive treatment, such as pain or fever medication (such as analgesics and antipyretics).

It is critical for anybody suffering with monkeypox to remain hydrated, eat properly, and get enough sleep. People who are self-isolating should take care of their mental health by doing things they find relaxing and enjoyable, staying connected to loved ones through technology, exercising if they feel well enough and can do so while isolating, and seeking mental health support if necessary.

People suffering from monkeypox should avoid scratching their skin and take care of their rash by washing their hands before and after touching sores and keeping their skin dry and uncovered (unless they are forced to share a room with someone else, in which case they should cover it with clothing or a bandage until they can isolate again). The rash may be cleaned with sterile water or an antiseptic. Saltwater rinses may aid with mouth sores, while warm baths with baking soda and Epsom salts can help with body sores. If necessary, paracetamol may be given to assist control the discomfort produced by sores. A health expert should be consulted if greater pain medication is required.

Many years of study on smallpox therapies have resulted in the discovery of medications that may also be beneficial for treating monkeypox.  The European Medicines Agency authorised tecovirimat, an antiviral intended to treat smallpox, for the treatment of monkeypox in exceptional circumstances in January 2022. There has been little experience with these therapies in the setting of a monkeypox epidemic. As a result, their usage is often accompanied by enrollment in a clinical trial or extended access protocol, as well as the gathering of data that will increase understanding on how to effectively utilise them in the future.

Where in the world is there currently a risk of monkeypox?

A multi-country monkeypox epidemic is presently happening throughout Europe, the Americas, Africa, the Western Pacific, Eastern Mediterranean nations, and South East Asia, where the virus has not before been identified. More cases than usual have been documented in 2022 in previously reported areas of Africa, including Nigeria, the Democratic Republic of the Congo, and the Central African Republic. WHO is collaborating with all impacted countries to improve monitoring and give guidelines on how to contain the outbreak and care for patients.

Monkeypox has been documented in various African nations prior to the pandemic. Cameroon, Central African Republic, Republic of the Congo, Côte d’Ivoire, Democratic Republic of the Congo, Gabon, Liberia, Nigeria, and Sierra Leone are among them. Some of these nations experienced just a few instances, while others had continuous or recurring epidemics. Travel from Nigeria has been related to a few instances in other countries. The current epidemic, which is hitting many nations at the same time, is unlike earlier outbreaks.

Is there a risk of this becoming the next pandemic?

Monkeypox is not as infectious as other viruses because it needs intimate contact (e.g., face-to-face, skin-to-skin, mouth-to-skin, or mouth-to-mouth), a contaminated environment, or an infected animal to spread. We have a window of opportunity to stem the spread of this epidemic by collaborating closely with communities and groups at greater risk. It is critical that everyone work together immediately to limit the spread by understanding their risk and taking measures to reduce it. In July, the Director General of WHO declared the monkeypox epidemic a public health emergency of worldwide concern and issued Temporary Recommendations to assist nations in combating and controlling the outbreak.

To prevent future spread, WHO is reacting to this epidemic as a top priority. WHO is focused on learning more about how the virus is spreading during this epidemic and preventing additional individuals from being sick. Raising awareness about this new condition will aid in the prevention of future spread.

What do we know about monkeypox and sex?

Monkeypox may be transmitted by any kind of intimate contact, including kissing, touching, oral and penetrative vaginal or anal intercourse with an infected person.  People who have sex with several or new partners are more vulnerable. Although the monkeypox virus has been discovered in sperm, it is still unknown if monkeypox may be transmitted by sperm or vaginal secretions.

If you are having sex, check yourself for symptoms on a frequent basis and advise your partners to do the same. Anyone who develops new or unusual rashes or sores should avoid having sex or other close contact with other people until they have been tested for sexually transmitted diseases (STIs) and monkeypox. Remember that the rash may appear in regions that are difficult to view within the body, such as the mouth, throat, genitals, vagina, and anus/anal area.

Consider decreasing your number of sexual partners to lower your chance of monkeypox. You could wait a while before having sex with new people, or you could stop having sex until the outbreak is under control or until you can get vaccinated (and even then, it’s best to limit your number of partners because no vaccine provides 100% protection and you could still pass the virus on to others). Keep in mind that immunisations take many weeks to work.

If you’re having sex, have open, nonjudgmental talks with your partner or partners and exchange contact information so you may notify each other if you develop symptoms, even if you don’t intend to see each other again.

Wearing a condom will not completely prevent you from monkeypox, but it will minimise your risk or level of exposure and will also protect you and others from a variety of other STIs. People with monkeypox are recommended to wear condoms for 12 weeks following recovery until more is known about virus levels and possible infectivity in sperm during this time.

The virus spreads not just via sexual intercourse, but also through any sort of intimate contact with an infected person. Persons living in the same home are more vulnerable. Anyone experiencing signs of monkeypox should seek medical attention right once.

Are men who have sex with men at higher risk of catching monkeypox?

The danger of monkeypox is not confined to sexually active persons or men who have sex with males. Anyone in close touch with someone suffering from symptoms is at danger. However, the majority of the cases reported in the current epidemic have been detected in males who have intercourse with men.  Given that the virus is now spreading from person to person in these social networks, males who have sex with men may be more vulnerable to infection if they have intercourse or other intimate contact with someone who is contagious. People who have several or new sexual partners are the most vulnerable right now.

Monkeypox cases have been detected in sexual health clinics. One reason we’re getting more reports of monkeypox cases among communities of guys who have sex with males is that this demographic group is more health-conscious. Monkeypox rashes may mimic those of sexually transmitted illnesses such as herpes and syphilis, which may explain why these cases are being reported to sexual health clinics. We may find additional examples in the larger community as we learn more. Monkeypox has been discovered in some mothers and children.

Raising awareness among homosexual, bisexual, and other men who have sex with men is critical to protecting those most vulnerable. If you have intercourse with other males, be aware of your risk and take precautions to protect yourself and others. Anyone experiencing symptoms suggestive of monkeypox should seek medical attention promptly to be diagnosed and treated.

What is WHO’s response to stigma and discrimination related to monkeypox?

We’ve witnessed prejudice and messages stigmatising specific categories of individuals in the aftermath of the monkeypox epidemic. We want to make it quite clear that this is not acceptable. This epidemic response should be carried out in accordance with long-standing ideals of human rights, inclusivity, and the dignity of all persons and communities.

Anyone who comes into close personal contact with someone who has monkeypox, regardless of who they are, what they do, who they have sex with, or any other circumstance, is at danger. It is wrong to stigmatise somebody because of a sickness or condition. Stigma is simply going to make things worse and prevent us from stopping this pandemic as soon as possible. We must all work together to support anybody who has been infected or who is assisting in the care of those who are ill. We understand how to halt the spread of this illness and how we can all safeguard ourselves and others. Stigma and prejudice are never acceptable, and they are more so in the context of this epidemic. We’re in this together.

Is my risk of becoming infected, developing serious symptoms or dying from monkeypox higher if I am living with HIV?

Anyone who comes into touch with someone who has monkeypox is at danger of getting it.

HIV may impair your immune system if left untreated. There is some evidence that being immunocompromised may raise your chances of being infected and developing severe disease or dying from monkeypox if you are exposed. More evidence, however, is required to properly comprehend this.

People with preexisting immunological weaknesses may be more vulnerable to monkeypox. People living with HIV who are aware of their status, have access to, and utilise, medication, may achieve viral suppression. This implies that their immune systems are less susceptible to other illnesses than they would be if they were not receiving therapy. Many persons with monkeypox in the present epidemic also had HIV, but there have been very few severe instances of monkeypox, most likely because their HIV infection was well-controlled in the majority of cases. Studies are being conducted to have a better understanding of these issues.

People who have multiple sexual partners, including those living with HIV, are encouraged to take precautions to reduce their risk of exposure to monkeypox by avoiding close contact with anyone who has symptoms and avoiding high-risk situations where multiple contacts may occur, even with people who are unaware they have monkeypox. Having fewer sexual partners may lessen your risk.


Can children get monkeypox?

Children may get monkeypox if they come into touch with someone who is ill.  According to data from previously impacted nations, children are more susceptible to serious sickness than adolescents and adults.  There have been a few cases of monkeypox among youngsters in the current epidemic. Some children have been exposed to the virus at home via close contact with parents, carers, or other family members. Other children are teens who have had sexual relations with someone infected with monkeypox.

What should I do if a child in my care has symptoms that could be monkeypox?

At first glance, the monkeypox rash resembles other common children diseases such as chickenpox and other viral infections. Consult a healthcare practitioner if a kid you are caring for exhibits signs of monkeypox. They will assist them in getting tested and receiving the necessary treatment.

Children may be more vulnerable to severe monkeypox than adults. They should be constantly watched until they have healed in case they need further treatment. A health professional in charge of the kid may recommend that they be cared for at a health institution. In this case, a healthy parent or carer who is at low risk of monkeypox will be permitted to isolate with them.

What are the risks of monkeypox during pregnancy?

More study is required to better understand the hazards of monkeypox during pregnancy, as well as how the virus may be transmitted to the foetus in the womb, the baby during or after delivery, or during nursing. According to available evidence, acquiring monkeypox during pregnancy may be harmful to the foetus.

Avoid close contact with somebody who has monkeypox if you are pregnant. Anyone who comes into touch with an infected person, regardless of age, may get monkeypox.

Contact your healthcare practitioner if you believe you have been exposed to or are experiencing symptoms of monkeypox. They will assist you in getting tested and receiving the necessary treatment.


Can I continue to breastfeed if I have been diagnosed with monkeypox?

If you have confirmed or suspected monkeypox and are nursing, get guidance from your healthcare professional. They will analyse the danger of spreading monkeypox as well as the risk of depriving your child of nursing. If you can continue to breastfeed and have close contact, they will advise you on how to limit the risk by taking precautions such as covering your sores and wearing a mask to reduce the danger of viral transmission. The danger of infection must be carefully evaluated against the possible damage and suffering caused by discontinuing nursing and close parental-child interaction. It is unknown if the monkeypox virus may be passed from parent to kid via breastfeeding; additional research is needed in this area.

Why is this disease called ‘monkeypox’?

The illness is known as monkeypox because it was discovered in 1958 in study colonies of monkeys. It was only in 1970 that it was discovered in humans. Experts are being consulted on whether the illness should be renamed.

Can the monkeypox virus be spread through a blood transfusion?

You should never give blood if you are sick. If you have a blood donation appointment, examine your health and monitor any signs of monkeypox, and postpone if you don’t feel well.

When individuals may donate blood, severe processes are in place. The potential donor is questioned about their present state of health and any symptoms they are experiencing. This is done to limit the possibility of someone with an infectious illness donating blood.

There have been no cases of monkeypox being transmitted via blood transfusions.

Does past exposure to chickenpox provide any protection against monkeypox?

A separate virus (the varicella virus) causes chickenpox. Past chickenpox exposure does not protect against monkeypox (produced by the monkeypox virus, an orthopoxvirus).

Is there a test to check whether I have had monkeypox in the past?

There are tests available to determine if you have antibodies to orthopoxviruses (the viral family to which monkeypox belongs). These tests may assist determine if you had previously been immunised against smallpox or monkeypox or exposed to an orthopoxvirus. However, the tests cannot tell you if you were exposed to a vaccination, the monkeypox virus, or another orthopoxvirus in the past. As a result, antibody tests are seldom utilised to screen for prior monkeypox exposure or to diagnose a suspected new disease.

I’ve had monkeypox in the past. Can I catch it again?

Our knowledge of how long immunity lasts after monkeypox infection is still limited. We don’t know if a past monkeypox infection provides protection against subsequent infections, and if so, for how long. There have been rare reports of second infections. Even if you have previously had monkeypox, you should take every precaution to prevent being infected again.

If you have had monkeypox in the past and someone in your home now has it, you may protect others by being the designated carer, since you are more likely to be immune than others. You should, however, take all care to prevent being infected.

Are people who are immunosuppressed at higher risk of developing severe mpox?

Immunocompromised patients, notably those with untreated HIV and advanced HIV illness, seem to be at a greater risk of getting severe mpox and dying. Larger, more extensive lesions (particularly in the mouth, eyes, and genitals), secondary bacterial infections of the skin or blood, and lung infections are all symptoms of severe mpox. The statistics reveal that persons with significant immunosuppression (CD4 count fewer than 200 cells/mm3) had the worst symptoms.

People living with HIV who achieve viral suppression by antiretroviral therapy have no increased risk of severe mpox. In the event of infection, effective HIV therapy lowers the likelihood of developing severe mpox symptoms. People who are sexually active and do not know their HIV status should be tested for HIV if it is accessible. HIV-positive people who are receiving effective treatment have the same life expectancy as HIV-negative people. More information may be obtained from your health care provider.

Severe mpox instances in certain countries underscore the critical need to expand equitable access to mpox vaccinations and medicines, as well as HIV prevention, testing, and treatment. Most impacted groups will be left without the tools they need to preserve their sexual health and well-being if this does not happen.

If you have mpox symptoms or believe you may have been exposed, contact your health care provider to get tested for mpox and obtain the information you need to lower your risk of developing more severe symptoms.

Concept of Isolation

  • A state of separation between a person or group.
  • Isolation refers to various measures taken to prevent contagious disease from being spread from a patient to other patients, health care workers and visitors, or from other to a particular patient.

Types of Isolation

  • Strict isolation.
  • Respiratory isolation.
  • Contact isolation.
  • Enteric isolation.
  • Protective isolation.
  • Body fluid isolation.

Strict isolation


Suspected Highly infection transmissible bacterial or virulent disease by direct or indirect contact and air born routes of transmission.


Private room

Gown, mask, gloves, hand washing

Double bagged techniques for soiled articles.

Respiratory isolation

  • The indication is droplet transmission. Respiratory isolation is used for diseases that are spread through particles that are exhaled. Those having contact with or exposure to such a patient are required to wear a mask.
  • Requirements:

Private room

Gown, mask, gloves, hand washing

Patients with the same organism generally may share a room.

Labeled plastic bags are used for soiled articles.

Contact isolation


Infectious disease or multiple resistant microorganism that are spread by close or direct contact. Contact Precautions—used for infections, diseases, or germs that are spread by touching the patient or items in the room (examples: diarrheal illnesses, open wounds).


Private room

Gown, mask, gloves, hand washing.

Enteric isolation/enteric precaution


Infectious disease transmitted through

direct or indirect contact with infected feces.


A private room is required if the patient does not practice good hygiene measures.

Hand washing, gloves.

Gowns should only be worn when handling objects contaminated with feces.

Blood & body fluid precaution

  • Blood
  • Body fluid, blood semen, vaginal secretions, CSF, synovial fluid, pericardial fluid, peritoneal fluid, plural fluid, amniotic fluid, and tissues.


-Gloves, Mask, and protective eyes gear/cover.


-Contaminated needles should not be recapped.

-Use puncture resistant containers for used needles and other sharp items.

Relate isolation to the chain of infection Cycle

Source: – patient, employee, Environment, Equipment, visitors.

Method of transmission: –

Air tune, vehicle, vector,

Contact: (direct, indirect).

Host: – Age, immunity, treatment, nutrition, disease, lifestyle, skin injury, socioeconomics condition.

Identify nursing responsibilities in each type of isolation

1.Aseptic techniques

Always use aseptic technique any procedure in hospital

2. Isolation techniques-

Always use aseptic technique for the patient with communicable diseases (use of glove cap, Mask.

3. Fumigation-

Room and articles should be fumigation after death or discharge of patient with infectious disease or should be fumigated after specific interval.

4. Biological waste:

ward’s waste should be discarded in a proper way as per instruction.

5. Destruction of rodent and insects:

Rodent and insects also play a role in the spread of infection. They should be destroyed to prevent infection.

6. Hospital hygiene

The hospital should be well ventilated. The general cleanliness of the hospital maintained sweeping and mopping of the floor should be done, white washing of the walls windows, roofs, doors, should be done.

And other:

Droplet Isolation Precautions

  • Wear A Mask. …
  • Wear Goggles. …
  • Remove PPE and Perform Hand Washing After Completing Care and Leaving the Room. …
  • The Patient Should Be in a Negative-Pressure Room. …
  • Wear an Appropriate Respirator. …
  • Dispose of PPE in the Adjunct Room, Not Another Patient’s Room.

Concept of Asepsis


  • ASEPSIS: Asepsis is the state of being free from disease causing microorganisms such as bacteria, viruses, pathogenic fungi, and parasites.
  • Aseptic technique: It is a standard health care practice that helps to prevent the transfer of germs to or from an open wound and other susceptible areas on a patient’s body.
  • A technique used the practice and procedure to prevent contamination from pathogens.

Purpose: a septic technique helps to prevent health care associated infection.

  • Using aseptic techniques prevents the spread of infection by harmful germs.
  • Disinfecting a patient’s skin using antiseptic wipes.
  • Sterilizing equipment and instruments before a procedure.
  • Keeping sterilizing instrument inside plastic wrappers to prevent contamination before use.


Description automatically generated

Types of Aseptic Technique

  • There two types of techniques
  • Medical asepsis (“clean technique”): practices that kill some microorganisms to prevent them from spreading.
  • Surgical asepsis (“sterile technique”): practices that completely kill and eliminate microorganisms.

Medical or clean asepsis reduces the number of organisms and prevents their spread; surgical or sterile asepsis includes procedures to eliminate microorganisms from an area and is practiced by surgical technologists and nurses.


The spread of an infection within a community is described as a “chain,” several interconnected steps that describe how a pathogen moves about. Infection control and contact tracing are meant to break the chain, preventing a pathogen from spreading.

The transmission of infection depends on six elements which link together like chains.

The Spread of infection can be described as a chain with six components.

2. Understanding the Chain of Infection | ATrain Education

  1. Infection agent (Pathogen)
  2. Reservoir (the normal location of pathogens)
  3. Portal of exit from the reservoir
  4. Mode of transmission
  5. Portal of entry into a host
  6. Susceptible host

If any link is broken the chain is broken and infection cannot be transmitted.

1. The Infection Agent

(Pathogens) include not only bacteria but also viruses, fungi, and parasites. The virulence of these pathogens depends on their number, their potency, their ability to enter and survive in the body, and the susceptibility of the host. For example, the smallpox virus is particularly virulent, infecting almost all people exposed. In contrast, tuberculosis bacillus infects only a small number of people, usually people with weakened immune function, or those who are undernourished and living in crowded conditions.

Any disease-causing microorganisms (bacteria, virus, fungi, parasites etc).

2. The Reservoir

reservoir is any person, animal, arthropod, plant, soil or substance (or combination of these) in which an infectious agent normally lives and multiplies. The infectious agent depends on the reservoir for survival, where it can reproduce itself in such manner that it can be transmitted to a susceptible host.

Where the germs normally live e.g. person, water, food, animal, plant, soil or substance feces, intravenous fluid, and equipment in which an infectious agent normally lives and multiplies.

3. The Portal of exist

A portal of exit is the means by which a pathogen exits from a reservoir. For a human reservoir, the portal of exit can include blood, respiratory secretions, and anything exiting from the gastrointestinal or urinary tracts.

Route by which the infectious micro-organism escapes or leaves the reservoir,

  • Excretions
  • Secretions
  • Skin
  • Droplet flue cold 🡪 mucous secretions

4. The Mode of transmission (Spread) route

People release respiratory fluids during exhalation (e.g., quiet breathing, speaking, singing, exercise, coughing, sneezing) in the form of droplets across a spectrum of sizes. These droplets carry viruses and transmit infection. The largest droplets settle out of the air rapidly, within seconds to minutes.

The way of the pathogen gets from the reservoir to the new host. For example: –
Route of transmission from respiratory tract (Nose, Mouth)
Secretion of infected person, Example: – Cough and sneezing.

Droplet transmission
Agent is coughed or sneezed out into the air
and floats on droplets.

Diagram of Airborne Transmission

Direct spread by droplets:-

  • Close contact with infected person (<3ft)
  • Infected person coughs, sneezes, talks, sings,
  • Droplets land directly on mucous membranes.
  • (Eyes, Nose, Mouth) of susceptible person

Indirect spread by droplets: –

Someone touches contaminated object.

🡪Inhalation (e.g. Respiratory tract)

🡪Ingestion (e.g. GI tract)

🡪Absorption (e.g. mucous membranes of eyes)

🡪Break in skin (e.g. Needle stick, Cut).

🡪Interaction by medical procedure (catheter).

5. The Portal of Entry

Infectious agents get into the body through various portals of entry, including the mucous membranes, non-intact skin, and the respiratory, gastrointestinal, and genitourinary tracts. Pathogens often enter the body of the host through the same route they exited the reservoir, e.g., airborne pathogens from one person’s sneeze can enter through the nose of another person.

The route through which the pathogen enters its new host

  • Inhale germs
  • Sexual contact
  • Breaks in protective skin barrier
  • Ingestion

The Susceptible host

The final link in the chain of infection is a susceptible host, someone at risk of infection. Infection does not occur automatically when the pathogen enters the body of a person whose immune system is functioning normally. When a virulent pathogen enters an immune-compromised person, however, infection generally follows

A person who can get sick when exposed to a disease-causing pathogen.

  • Children who are very young.
  • People are on inadequate diets.
  • People who are chronically ill
  • People receiving medical therapy such as chemotherapy or high clothes.
  • People who are already ill.
  • People who open wounds.
  • If the chain is not broken the infectious organism is able to go on to develop disease in another person.

How to break the chain of infection?

  • Hand sanitizing and hand hygiene.
  • Cough and sneeze etiquette.
  • Proper use of personal protective equipment.
  • Sharp management.
  • Appropriate disposal of waste

Ways that infection may occur.

Three things are necessary for an infection to occur: Source: Places where infectious agents (germs) live (e.g., sinks, surfaces, human skin) Susceptible Person with a way for germs to enter the body. Transmission: Way germs are moved to the susceptible person.

  • Infectious disease can spread in a variety of ways.
  • Through air, from direct or indirect contact
    with another person, Soiled objects, skin or mucous membrane, saliva, urine, blood, and body secretions through sexual contact and through contamination of food and water.

Factors that increase the risk of infection: –

  • Diminished immune response.
  • Advanced age.
  • Malnutrition.
  • The presence of multiple chronic diseases.
  • Cognitive deficits, basic sanitary practices

(Hand washing).

  • Functional impairment such as incontinence or immobility.
  • Use of invasive devices like Catheters, ventilators, feeding tube.
  • Diminished ability to complain of or self-identify symptoms, or increased likelihood of presenting with atypical symptoms or signs of infection.


  • Example of common cold.
  • Any infection follows the same steps as that of chain of infection starting from infectious agent to susceptible host.
  • A flu virus deposited into the front of the nasal passages by contaminated fingers or by droplets from cough and sneezes.
  • Small dose of virus(1-30 particles)are sufficient to produce infection.

Role of health care personnel in infection control

Introduction to patient safety

  • Definition: patient safety is a discipline in the health care sector that applies safety science methods toward the goal of achieving a trust worthy system of health care delivery.
  • Patient safety is also an attribute of health care system ,it minimize the incidence and impact of adverse events and maximizes recovery from health problems.

Health care associated infection (HAI)

According to who:

  • HIA is also called nosocomial infection.
  • HIA is defined as:

An infection acquired in hospital by a patient who admitted for a reason other than that infection.

An infection occurs in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission.

Impacts of Nosocomial infection (HIA)

  • Increase patients suffering.
  • Lead to permanent disability.
  • Lead to death.
  • Prolonged hospital stays.
  • Increase need of higher level of care.
  • Increase the costs to patients and hospitals.

Prevent from infections

Requires health care provider who have to,

– Knowledge of common infections and their vectors.

– An attitude of cooperation and commitment.

– Skills necessary to provide safe care.

-use universal precautions.

– Knowledge about the extent of the problem.

– Knowledge of main causes, modes of transmission and types of infection.

Universal precautions

Definition: universal precautions are a set of precautions designed to prevent transmission of HBV, HCV, HIV and other blood –borne pathogens while providing healthcare to all patients regardless of their diagnosis or presumed infection status.

Standard precautions:

Are the precautions to be used by all health care workers in all situations involving the care of patient of contact with the environment.

  • Hand hygiene
  • Gloves, apron/ gown, footwear.
  • Mask, eye protection and or face shield.
  • Preventing occupation Exposure.
  • Accommodation patient placement isolation.
  • Environment
  • Laundry
  • Blood and body fluid spillage
  • Clinical waste.

Nursing student needs

  • To apply universal precautions.
  • To be immunized against hepatitis B
  • To Use personal protection method
  • To know what to do if expose
  • They encourage others to use universal precautions.


Microbiology MCQs/BCQs

1. The media used for culturing salmonella is
a. VL-broth
b. Sabouruad agar
c. Slanetz bartley
d. Meat broth
e. Selenite Broth

2. Structural and functional as well as basic unit of life which was discovered by Robert hook.
a. Cell
b. Tissue
c. Organ
d. System
e. Human
3. Area of the cytoplasm that contains the single bacterial DNA molecule
a. Plasma
b. Nucleoid region
c. Cytoplasm
d. Ribosomes
e. Vacuole

4. Cells have “little organs” in it are collectively known as
a. Cell parts
b. Inter cell
c. Cell organelles
d. Cytoplasm
e. Golgi bodies

5. It is called the power house of cell.
a. Golgi bodies
b. Plasma membrane
c. Mitochondria
d. Cell membrane
e. Food vacuole

6. The bodies ability to fight against pathogens is known as
a. Microbiology
b. Histology
c. Pathology
d. Immunity
e. Biology

7. A patient skin-tested with purified protein derivative (PPD) to determine previous exposure to Mycobacterium tuberculosis develops induration at the skin test site 48 hours later. Histologically, the reaction site would MOST probably show:
a. Neutrophils
b. Helper T cells and macrophages
c. B cells
d. Eosinophils
e. A cells

8. It is highly complex jelly like material in which other parts are embedded.
a. Apoptosis
b. Cytoplasm
c. Ribosomes
d. Endoplasmic reticulum
e. Nucleus

9. Part of microscope that is hollow cylindrical tube & support the ocular lens is named as
a. Objective
b. Lens
c. Eye piece
d. Body tube
e. Nose piece

10. It acts as a barrier to invasion.
a. Skin
b. Bones
c. Organs
d. Cell
e. Brain

11. According to mitosis cell division has
a. 10 phases
b. 4 phases
c. 2 phases
d. 5 phases
e. 6 phases

12. It is a chemical substance derivable from a mold or bacterium that kills microorganisms and cures infections.
a. Antibiotic
b. Antigen
c. Protein
d. Virus
e. Bacteria

13. A child stung by a bee experiences respiratory distress within minutes and lapses into unconsciousness. This reaction is probably mediated by:
a. IgM antibody
b. Sensitized T cells
c. IgE antibody
d. IgF antibody
e. Sensitized T cells

14. organism made up of one of single cell are known as
a. multi cellular
b. muti nucleoid
c. nucleus
d. unicellular
e. animal

15. It is a milky body fluid that contains a type of white blood cells.
a. Body
b. Cell
c. Lymph
d. Plasma
e. Membrane

16. An injection of a weakened form of the actual antigen that causes the disease is called
a. Injection
b. Syringe
c. Vaccine
d. Inmmune system
e. Lymphocytes

17. A patient with a central nervous system disorder is maintained on the drug methyldopa. Hemolytic anemia develops, which resolves shortly after the drug is withdrawn. This is MOST probably an example of:
a. Cell-mediated hypersensitivity
b. Immune-complex hypersensitivity
c. Atopic hypersensitivity
d. Cytotoxic hypersensitivity
e. Non hypersensitivity

18. Are chemical substance as protein, carbohydrates, lipids (fats) or nutic acid which stimulates specific immune response.
a. Antibiotic
b. Antigen
c. Protein
d. Virus
e. Bacteria

19. The 3rd phase of mitosis (cell division) is known as
a. Anaphase
b. Metaphase
c. Telophase
d. Prophase
e. Cytokinesis

20. A small dense(thick) body in nucleus that contain ribo nucleic acid is known as
a. Metacarpals
b. Meta tarsals
c. Nucleoli
d. Nucleus
e. Ribosomes

21. An immunoglobulin is a
a. Carbohydrate
b. Glycoprotein
c. Protein
d. Minerals
e. Amino acid

22. It is useful to stimulate antibody production
a. An adjuvant
b. A hapten
c. A protein
d. Red blood cells
e. Purified antigen

23. The resistance power of body against infectious agents like bacteria, virus etc.
a. Microbiology
b. Histology
c. Pathology
d. Immunity
e. Biology

24. In this type of cell division four haploid gametes are produced.
a. Mitosis
b. Meiosis
c. Decomposition
d. Photosynthesis
e. Sterilization

25. A part of microscope that is circular shutter which regulates the size of opening through which light processes in the condenser.
a. Condenser
b. Mirror
c. Arm
d. Diaphragm
e. Inclinations joint

26. A process of A-sexual reproduction or simple method of cell division that occurs in unicellular organisms.
a. Sterilization
b. Fertilization
c. Meiosis
d. Mitosis
e. Sanitization

27. The first person to identify microbes as causing disease was
a. Louis Pasteur
b. Robert Koch
c. Robert hook
d. Ivan lewin hook
e. Edward jenner
28. A minute animal or vegetable which can’t be seen by naked eye but just can be seen by micro-scope.
a. Macro organism
b. Micro organism
c. Human being
d. Ant
e. Elephant
29. A disease in which minute organisms, invisible to the naked eye, invade and multiply within the body.
a. Infectious disease
b. Healthy disease
c. Disease
d. Infection
e. Microscopic disease

30. Those diseases that are found normally in a population are named as
a. Epidemic
b. Endemic
c. Pendemic
d. Epizootic
e. Incidence


31. Respiratory acidosis and alkalosis are due to a problem with the
a. Heart
b. Lungs
c. Hands
d. Foot
e. Brain

32. Metabolic acidosis and alkalosis are due to a problem with the
a. Kidney
b. Pancreas
c. Gall bladder
d. Urinary bladder
e. Bones

33. The movement of molecules across the cell membrane and does not requires energy is known as
a. Passive transport
b. Active transport
c. Cellulose
d. Movement
e. Motion

34. A term for the language deficit accompanying cerebral stroke is
a. Agraphia
b. Anosognosia
c. Dysphagia
d. Aphasia
e. Euphoria

35. The inability to carry out a motor task on command given adequate strength, sensation, coordination and comprehension is called:
a. Aphasia
b. Apraxia
c. Alexia
d. Aprosodia
e. Abulia

36. A 64 year-old right handed male presents with right upper limb plegia, right lower limb paresis, a hemi sensory deficit, a decreased ability to comprehend verbal or written commands and poor language output. His lesion is most likely in the:
a. Basal ganglia
b. Middle cerebral artery distribution
c. Posterior cerebral artery distribution
d. Brain stem
e. Anterior cerebral artery distribution

37. A stroke affecting the back part of a brain could affect
a. Lungs
b. Heart
c. Sight
d. Taste
e. Smell

38. Hemorrhagic Stroke is associated with
a. Hypertension
b. Dialysis
c. Resting
d. Fatigue
e. Hepatitis

39. The carrier-mediated transport of large molecules through the cell membrane using transport proteins embedded within the cell membrane is known as
a. Passive transport
b. Active transport
c. Facilitated diffusion
d. Movement
e. Motion
40. A semi permeable membrane separating the blood from the cerebrospinal fluid, and constituting a barrier to the passage of cells, particles, and large molecules.
a. Permeable membrane
b. Cell membrane
c. Cell wall
d. Blood brain barrier
e. Kidney blood barrier


41. “The movement of solute molecules and water across a membrane by normal cardiovascular pressure” refers to
a. Permeability
b. Semi permeability
c. Filtration
d. Vibration
e. Movement

42. The sodium-potassium pump carries out a form of
a. Active transport
b. Passive transport
c. Sterilization
d. Filtration
e. Disinfection

43. The diffusion of a solute across a selectively permeable membrane. In this case the solute molecules always move from the stronger concentration (hypertonic) to the weaker (hypotonic).
a. Diffusion
b. Osmosis
c. Dialysis
d. Filtration
e. De colorization

44. The most important carbohydrate is
a. Fructose
b. Lactose
c. Glucose (monosaccharide)
d. Sucrose
e. Glycoprotein

45. Cholesterol is a type of
a. Protein
b. Carbohydrate
c. Amino acids
d. Lipids
e. Fats
46. Anti lipolytic hormone is
a. Insulin
b. Epinephrine
c. Nor epinephrine
d. Thyroid
e. Serotonin

47. The maintenance of steady levels of glucose in the body is known as
a. Lipid regulation
b. Fat regulation
c. Serotonin regulation
d. Gluco regulation
e. Thyroid regulation

48. The entire spectrum of chemical reactions, occurring in the living system is termed as
a. Metabolism
b. Anabolism
c. Catabolism
d. Ion regulation
e. Insulin regulation

49. Synthesis of glucose from non carbohydrate compounds is known as
a. Glycoprotein
b. Glycolipids
c. Glucose
d. Lactogenesis
e. Glycogenesis

50. Non essential amino acids are named as
a. Dispensable amino acids
b. Non dispensable amino acids
c. Regulatory amino acids
d. Retained amino acids
e. Fatty amino acids

Note: attempt any five questions. All questions carry equal marks
Qno1. Write a short note on blood brain barrier?
Qno2. Discuss briefly active and passive transport in general with examples and explain sodium potassium pump?
Qno3. Differentiate between trauma and cellular injury?
Qno4. Define microbiology and briefly discuss its importance in nursing?
Qno5. Define immunity and explain its types with at least two examples for each type?
Qno6 write short note any one of the following
a. Mitosis
b. meiosis
Qno7. Differentiate between unicellular and multi cellular organisms with examples and differentiate between eukaryotes and prokaryotes with examples?

Answer key
01 E
02 A
03 B
04 C
05 C
06 D
07 B
08 B
09 D
10 A
11 B
12 A
13 E
14 D
15 C
16 C
17 D
18 B
19 A
20 C
21 B
22 A
23 D
24 B
25 D


26 D
27 B
28 B
29 A
30 B
31 B
32 A
33 A
34 D
35 B
36 B
37 C
38 A
39 C
40 D
41 C
42 A
43 C
44 C
45 D
46 A
47 D
48 A
49 E
50 A