Answers

Single Based Answer (MCQ) — 1×10

1. B — Supporting health campaigns, contact tracing and vaccination under supervision
2. B — Moderation and diversity (little variety = lack of diversity; excessive harmful foods = lack of moderation)
3. B — Two doses provide up to 97% protection (one dose ≈93%, two doses ≈97%; herd immunity for measles actually needs ~93-95% coverage, not 75%; routine 2nd dose is at 4-6 years, not 12-15 months)
4. B — High transmissibility + immunity gaps + accumulation of susceptible children
5. C — Measles virus → Infected human → Respiratory secretions → Airborne/respiratory transmission
6. C — Children under five years (based on typical outbreak epidemiology where young unvaccinated children bear the highest burden; this figure is specific to your presentation slide, so cross-check against your course material)
7. B — Pneumonia (most common cause of measles death worldwide, per Park's PSM)
8. C — Shortly before the rash (Koplik spots are pathognomonic and precede the rash by 1-2 days, appearing during the prodromal 3 Cs phase)
9. B — IgM antibody (marker of acute/recent infection)
10. B — RT-PCR for measles RNA

True or False — 0.5×20

1. False — Koplik spots appear before (shortly preceding) the rash, not after
2. True — Airborne precautions are required for measles
3. True — Fit-tested N95 or equivalent respirator required for staff
4. False — MMR vaccine and immune globulin should NOT be given together; IG blunts the vaccine's immune response and must be separated by months
5. True — Vitamin A recommended, especially for children under 5
6. True — IgM is the standard serologic confirmation test
7. True — Rash classically starts at hairline/face and spreads down to trunk and limbs
8. False — Airborne precautions are needed; droplet precautions alone are insufficient
9. True — Post-exposure immune globulin can be given up to 6 days after exposure in high-risk contacts who cannot receive the vaccine
10. True — Isolate at least 4 days after rash onset (longer if immunocompromised)
11. True — Measles is highly contagious and airborne
12. True — Cough, coryza, conjunctivitis are the classic 3 Cs
13. True — Bluish-white spots on an erythematous base on buccal mucosa
14. False — Dengue and chikungunya ARE part of the febrile rash differential diagnosis for measles
15. False — Vitamin A dosing is age-specific and indication-based, not indiscriminate repeated high-dose therapy for everyone
16. True — Single room, preferably an airborne infection isolation room (negative pressure)
17. False — Door should be kept closed to maintain airborne isolation/negative pressure
18. True — Susceptible patients must be kept away from measles patients in shared areas
19. True — MMR PEP is ideally given within 72 hours of exposure
20. True — Nasopharyngeal/throat swabs are acceptable respiratory specimens for RT-PCR