FRCPath part 2: virology questions for practice

These are some scenario’s that we encounter in our day to day practice. You can practice these as a part of your preparation. I suggest you should also read the associated topics. For example, if you are preparing the answer for HBV, read about HCV, HIV as well. Most of these problems can be answered from relevant UK guidelines.

1. Management of a child found with scratch marks on his face in the morning. A bat was found in the same room in the morning. What should be the management?

2. A lady had a normal delivery. Some herpetic lesions were noted in the perineal region during delivery. What would you advice to the clinicians regarding the management of mother and baby.

3. 16 weeks pregnant school teacher had contact with a boy in her class with suspected Parvovirus B19 infection. What would you advice to the clinicians? What test would you perform?

4. 20 weeks pregnant lady had a tick bite. The GP is asking you for advice.

5. 28 weeks Pregnant lady had contact with chickenpox. What would you advise the clinicians? What additional information would you need to make a decision?
   If this lady was 39 weeks pregnant with an imminent delivery, what should be the management?

6. 39 weeks pregnant lady with chicken pox presented to labour ward and she was in a bay with three other patients before the clinical team came to know about chicken pox. The consultant contacted you for advice immediately. What advice would you give?

7. A baby born of hepatitis B positive mother (serological status unknown). Describe the tests you would do and management.

8. A renal transplant patient presents with deteriorating renal function? What are the possibilities? What serology/molecular test you would consider? What should be the management?

9. A pregnant lady presented to the midwife. Her son developed a rash the day before. What information would you ask for? What tests would you do? What advice would you give? Your laboratory informed you that there is no booking blood, what changes would you make in your management plan?

10. A young boy presented to the A&E after having a needlestick injury from a discarded needle in a playground. This playground is in an area known to have problems with IV drug abusers. What should be your advice?

11. A nurse presented with a needlestick injury. The source is an IV drug abuser, who refused test for blood borne virus. What advice would you give?

12. A patient presented after a pub brawl. He suffered from a human bite on his face. What advice would you give?

13. You have received a call from a doctor in accident and emergency. She has a patient, brought in by police, with a history of sexual assault. What advice would you give? What tests would be required? What precaution should be taken when a specimen being taken and being transferred to the laboratory and after that.

14. How would you do the work up for renal transplant?

15. An immunosuppressed patient presented with colitis. The gastroenterologist is asking for your advice. What investigations would you recommend?
    He reported back to you after a couple of days that some inclusion bodies have been found in HE stain. What would be your management strategy?

16. Patient presented with hepatic impairment. What virology tests would you recommend? Patient had a complaint of sore throat few days before this episode – what test would you ask for?

17. GP is requesting a Zika virus test for a patient recently returned from Cuba. She is planning for a pregnancy. What other information you should ask to assess the case? What advice would you give?

18. Your A&E consultant has called you out of hours that a suspected MERS-CoV patient is going to be admitted within the next hour. What would be your course of action?

19. A GP is asking for your advice regarding investigation of chronic fatigue syndrome. What would be your advice? Explain.

20. GP is investigating a patient with a possible history of tick bite. Your result C6 – reactive, Immunoblot IgG: P41, ospC reactive. IgM P41, ospC reactive. What would be your advice?