Microbiology — Fever and Zoonoses, NMC MBBS licence examination syllabus (Nepal Medical Council).
Fever and zoonoses — NMC-style practice questions
Practice questions written for this chapter. These are not past NMC papers.
📋 About these questions: These are practice questions written to test the reasoning in this chapter. They are NOT reproduced from any past Nepal Medical Council examination, and no verified past NMC questions were supplied for this chapter. Rabies exposure categories, vaccine schedules and antibiotic choices come from national guidance.
Level 1–2 — recall and understanding
Q1. The single most effective IMMEDIATE measure after a dog
bite is:
A. Suturing the wound
B. WASHING thoroughly with SOAP AND RUNNING WATER for
several minutes
C. Applying a tourniquet
D. Oral antibiotics alone
ANSWER: B.
Why: thorough washing substantially reduces rabies risk on its
own, and rabies is essentially always fatal once symptoms
begin. Immediate suturing is avoided.
LEARNING POINT: then assess exposure category for
prophylaxis per the national programme, and check tetanus
status.
Q2. A painless black ESCHAR in a skinfold, with fever after
exposure to scrubland, suggests:
A. Leptospirosis
B. SCRUB TYPHUS
C. Dengue
D. Brucellosis
ANSWER: B — scrub typhus.
Why: the eschar marks the site of a mite bite and is
characteristically painless and hidden — axilla, groin, under
a breast, at the waistband.
LEARNING POINT: it is found only if the patient is undressed
and the skinfolds examined.
Level 3–4 — application and clinical reasoning
Q3. A farmer presents during monsoon with fever, severe calf
myalgia and red eyes without discharge, after working in
flooded fields. The likely diagnosis is:
A. Influenza
B. LEPTOSPIROSIS
C. Scrub typhus
D. Brucellosis
ANSWER: B.
Why: exposure to water contaminated with animal urine, severe
myalgia and conjunctival suffusion are characteristic. Severe
disease progresses to jaundice, renal failure and bleeding.
LEARNING POINT: exclude malaria and dengue too — they share
the season and setting.
Q4. A child is bitten by a neighbour's healthy-looking dog.
The family are told no prophylaxis is needed because the
dog is well. This is:
A. Correct
B. INCORRECT — an apparently well animal does not exclude
rabies risk
C. Correct if the dog is observed for a day
D. Correct because the bite was minor
ANSWER: B.
Why: rabies risk is assessed by exposure category and local
epidemiology, not by how the animal looks at the time. A lick
on broken skin also counts as exposure.
LEARNING POINT: wash thoroughly first, then assess prophylaxis
per national guidance.
Q5. A man has six weeks of fever, night sweats and weight
loss, with a NORMAL chest X-ray and no cough. The leading
consideration in this region is:
A. Viral infection
B. EXTRAPULMONARY or disseminated TUBERCULOSIS
C. Malaria
D. Anxiety
ANSWER: B.
Why: TB can present as prolonged fever with weight loss and no
respiratory symptoms, and a normal chest film does not exclude
extrapulmonary disease.
LEARNING POINT: also test for HIV, look for an occult
collection, and review drugs for drug fever.
Level 5 — exception-based
Q6. In prolonged fever without a diagnosis, which action is
usually MOST productive?
A. Adding another broad-spectrum antibiotic
B. RE-TAKING the history and RE-EXAMINING the patient
C. Repeating the same blood tests daily
D. Discharging and reviewing in a month
ANSWER: B.
Why: new physical findings appear over time, and patients
recall exposures they did not mention initially. More
diagnoses are made this way than by adding tests.
LEARNING POINT: blind antibiotics may also obscure cultures
and cause drug fever.
Q7. Which fever combination requires antibiotics BEFORE any
investigation?
A. Fever with jaundice
B. Fever with a NON-BLANCHING rash
C. Fever with myalgia
D. Fever with an eschar
ANSWER: B.
Why: fever with a non-blanching purpuric rash is meningococcal
disease until proven otherwise, and delay to the first
antibiotic dose is the factor most associated with poor
outcome.
LEARNING POINT: do not wait for lumbar puncture, imaging or
transfer.
Syllabus points
Recall and understanding questions
Application and clinical reasoning questions
Exception-based questions
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