How to use these questions
These eight single-best-answer cases test decisions that come up across infectious diseases: recognising severe illness, choosing the next step and knowing when prevention matters. They are not tied to one named examination. Read each case and select an option; the answer and reasoning follow in the question panel. Then use the explanations to identify which facts you need to revise.
Treatment guidelines can differ by country and change over time, particularly for antimicrobial choice and resistance. Use your local guidance when applying these principles to clinical care.
Eight infectious diseases practice questions
1. Severe malaria
This case tests recognition of severe malaria and the immediate antimalarial route of treatment.
A MySummaries practice question on severe malaria looks like this:
A 32-year-old returning traveller has a blood film positive for Plasmodium falciparum. They are confused and cannot take oral medication. What is the most appropriate immediate treatment?
Altered consciousness is a feature of severe malaria. Give intravenous artesunate promptly; do not wait for a parasite-density threshold or use oral treatment in a patient unable to take it. Once the patient can take oral medication, complete a full course of an effective oral combination regimen.
The strongest distractor is oral combination therapy: it is used to complete treatment when the patient can take oral medication, but it is not the initial route for severe malaria with impaired consciousness. Adult IV artesunate dosing commonly begins at 2.4 mg/kg at 0, 12 and 24 hours, then continues daily until oral treatment is possible; follow the relevant national protocol.
2. HIV post-exposure prophylaxis
This case tests the time-sensitive window for starting HIV post-exposure prophylaxis (PEP).
A MySummaries question on PEP focuses on the first decision:
A healthcare worker sustains a needlestick from a source known to have HIV. They present 36 hours later and have not started prophylaxis. What is the best next step?
PEP should be started as soon as possible after a significant exposure and no later than 72 hours in usual guidance. A 28-day course is standard. Do not delay an indicated start while waiting for a source result; assess the exposure and arrange baseline and follow-up testing under local guidance.
The most tempting distractor is waiting for more information about the source. Assessment and testing matter, but they should not create avoidable delay when PEP is indicated and the person is within the time window. Regimens and follow-up schedules should be checked against current local guidance.
3. Suspected infective endocarditis
This case tests the order of blood cultures and antibiotics in a clinically stable patient.
A MySummaries question on endocarditis checks whether you can preserve culture yield:
A haemodynamically stable adult has fever, a new murmur and suspected infective endocarditis. There is no immediate need for resuscitation. What should be done before starting empirical antibiotics?
In a stable patient, obtain multiple blood-culture sets before antibiotics to improve the chance of identifying the organism and guiding targeted treatment. Do not postpone urgent antibiotics in an unstable patient merely to complete sampling; obtain cultures promptly if this can be done without harmful delay.
The strongest distractor is waiting for echocardiography. Imaging helps assess the heart and complications, but it does not replace blood cultures. If the patient is unstable, prioritise resuscitation and timely antimicrobial treatment while obtaining cultures as quickly as practical.
4. HIV-associated cryptococcal meningitis
This case tests the importance of raised intracranial pressure as well as antifungal treatment.
A MySummaries question on cryptococcal meningitis tests the immediate management priority:
A person with advanced HIV has headache, fever and a positive cerebrospinal-fluid cryptococcal antigen. Opening pressure at lumbar puncture is markedly raised. Which action directly addresses the raised pressure?
Raised intracranial pressure in cryptococcal meningitis is managed with therapeutic lumbar punctures, removing cerebrospinal fluid as needed to relieve pressure. Start appropriate antifungal induction treatment as well; management should follow specialist and local guidance.
The strongest distractor is treating the infection alone and assuming that the pressure will resolve immediately. Raised pressure can cause substantial morbidity, so it needs active assessment and management. Acetazolamide is not a substitute for therapeutic lumbar puncture in this setting.
5. Pneumocystis pneumonia prevention in HIV
This case tests when CD4 count and viral load affect the decision to offer Pneumocystis jirovecii pneumonia (PJP) prophylaxis.
A MySummaries question on PJP prophylaxis focuses on the threshold:
An adult with HIV has a CD4 count of 78 cells/mm³ and has not started antiretroviral therapy. Which preventive measure is generally indicated?
A CD4 count below 100 cells/mm³ is a standard indication for PJP prophylaxis in adults with HIV. Trimethoprim-sulfamethoxazole is the usual first-line option, with alternatives for selected contraindications. Check local guidance for dosing, duration and other prophylaxis indications.
The strongest distractor is withholding prophylaxis until there is radiographic disease: prophylaxis is intended to prevent infection, not treat it. Some guidelines also recommend prophylaxis at higher CD4 counts in particular circumstances, such as detectable viraemia; learn the criteria used in your local or examination guidance.
6. Category III rabies exposure
This case tests wound care and post-exposure measures in a person not previously vaccinated against rabies.
A MySummaries question on rabies tests the combination of immediate actions:
A previously unvaccinated adult is bitten through the skin by a dog in a rabies-endemic area. The dog cannot be observed or tested. What is the appropriate immediate approach?
A transdermal bite is a severe exposure. Wash and flush the wound thoroughly as soon as possible, and arrange rabies post-exposure prophylaxis. For a person not previously vaccinated, this generally includes vaccine and rabies immunoglobulin, infiltrated into and around wounds where feasible, in line with national guidance.
The strongest distractor is vaccine alone. For a previously unvaccinated person with a severe exposure, immunoglobulin is generally part of post-exposure management as well as vaccine. Wound cleaning is an immediate, important measure; do not wait for symptoms.
7. Meningococcal disease contacts
This case tests who needs chemoprophylaxis after invasive meningococcal disease.
A MySummaries question on contact management tests the distinction between close and casual contact:
A university student is diagnosed with invasive meningococcal disease. Which person should generally be assessed promptly for antibiotic chemoprophylaxis?
Household members and other close contacts, including people with relevant direct exposure to oral or respiratory secretions, should be assessed for chemoprophylaxis promptly. The exact contact definition and recommended antibiotic depend on public-health guidance and local resistance patterns.
The strongest distractor is someone who was merely in the same large room. Routine casual proximity alone does not usually make a person a close contact. Public-health teams should be involved so that eligible contacts receive the recommended drug promptly.
8. Suspected bacterial meningitis in an adult
This case tests the timing of adjunctive dexamethasone without delaying antibiotics.
A MySummaries question on meningitis checks what to do alongside the first dose:
An adult has suspected acute bacterial meningitis and is about to receive the first dose of intravenous antibiotics. When should dexamethasone be given if it is indicated under the local guideline?
When adjunctive dexamethasone is indicated, give it before or with the first antibiotic dose where possible. Do not delay antibiotics to administer dexamethasone or to complete investigations. Recommendations can vary with the suspected organism and local guideline.
The strongest distractor is waiting for culture confirmation. Treatment of suspected bacterial meningitis is urgent; culture results come later. The key practical rule is to avoid delaying antibiotics while arranging investigations or adjunctive treatment.
Turn the answers into revision
Review the questions you missed and label the error: recognition, threshold, sequence or treatment choice. That label gives you a useful next action. For example, an error on PEP timing calls for practising the time window; an error on endocarditis calls for rehearsing the order of cultures and antibiotics.
A MySummaries weak-area view can sort topics by recent performance and how often they have been tested:
Use the weakest topic to choose what to study next, then answer fresh questions on it later. A MySummaries remediation card can turn a repeatedly missed point into a short retrieval prompt:
You lost this mark twice: after a severe rabies exposure in a previously unvaccinated person, what two immunological products are generally required, in addition to thorough wound washing?
How MySummaries helps
Build an infectious diseases board from your own notes, then use it to generate practice questions, track weak areas and revisit missed facts with spaced repetition. You can start from your material at portal.mysummaries.app.