Section-1

Q.1 MCQ: (Compulsory) (6×1-6)

1.Who introduced the technique of vaccination?

a: Robert Koch

b.Edward a Jenner

c. Joseph Lister

d. Paul Ehrlich.

2.Mesophilic bacteria best grow at.

a.Below 20°C

b. 25-40° C

c. 45-70° C

d. More than 70° C

3.Filtration is used for:

a. Heat labile substances.

b.Heat stable substances

c. Milk

d. Sulphuric acid.

4.Which of the following drugs inhibits protein synthesis ?

a. Penicillin

b. Cephalosporins.

c. Bacitracin

d.Amikacin

5 The PCR test was invented by

a. Robert Koch.

b.Robert Langdon

c.weil Felix

d.Kerry Mullis

6. Capacity of microbe to cause disease is known as

a.Infection

b. Immunity

c.Pathogenecity

d. Virulence

Q.2 (Write Essay type question. (1×10-10)

1.Define sterilization. Enumarate different types of sterilization by heat and describe in detail about autoclaving

Sterilization :

Sterilization is the process of eliminating or destroying all forms of microbial life, including bacteria, viruses, fungi, and spores, from a surface, object, or fluid. It is an absolute method, meaning the item is either completely sterile or not sterile at all.

Enumeration of different types of sterilization by heat

Sterilization by heat is broadly classified into two types :

1. Moist Heat Sterilization (With Steam/Water)

Uses steam or water vapor under specific conditions to kill microorganisms by protein coagulation and denaturation.

Types

Autoclaving

121°C, 15 psi, 15–20 minutes

Used for surgical instruments, dressing, glassware, culture media

Boiling

100°C for 10–30 minutes

Not reliable for spores; used for disinfecting instruments at home

Pasteurization

63°C for 30 minutes (holder method)

72°C for 15 seconds (flash method)

Used for milk and dairy products

Tyndallization (Intermittent Sterilization)

100°C for 30 minutes on 3 consecutive days

Used for culture media with heat-sensitive components

Inspissation

75–80°C for 30 minutes on 3 successive days

Used to sterilize egg-based media (e.g., Loeffler’s serum)

2. Dry Heat Sterilization (Without Steam/Water)

Uses high temperature dry air to kill microorganisms by oxidation of cell contents.

Types

Hot Air Oven

160°C for 2 hours or 170°C for 1 hour

Used for glassware, metal instruments, powders, oils

Incineration

Burning at very high temperatures (>800°C)

Used to destroy hospital waste, infected materials

Flaming

Passing object through direct flame (e.g., Bunsen burner)

Used for inoculating loops, scalpel blades

Autoclaving

Autoclaving is a method of sterilization that uses moist heat under pressure to destroy all forms of microbial life, including bacteria, viruses, fungi, and bacterial spores. It is considered one of the most reliable and widely used methods of sterilization in medical, microbiological, and research settings.

Principle of Autoclaving :

The principle of autoclaving is based on the fact that when steam is applied under pressure, the boiling point of water increases, allowing the steam to reach higher temperatures. This moist heat causes coagulation and denaturation of microbial proteins, leading to complete sterilization.

Standard Conditions for Autoclaving :

Temperature: 121°C

Pressure: 15 pounds per square inch (psi)

Time: 15 to 20 minutes

For flash sterilization (rapid sterilization), higher temperatures (e.g., 134°C) and shorter time (3–5 minutes) are used.

Types of Autoclaves :

Gravity Displacement Autoclave – Steam displaces air by gravity.

Pre-vacuum Autoclave – Air is removed before steam is introduced, allowing better penetration.

High-speed Autoclave – Used for rapid sterilization of instruments (also called flash autoclave).

Uses of Autoclaving :

Sterilization of surgical instruments

Sterilization of glassware, dressings, rubber items

Preparation of culture media

Disposal of laboratory waste and contaminated materials

Autoclaving Procedure :

Preparation : Clean and arrange items to be sterilized.

Loading : Load items in the autoclave chamber properly, ensuring steam can circulate.

Setting Parameters : Set the required temperature, pressure, and time.

Sterilization : Start the autoclave cycle. Steam is generated and maintained under pressure.

Cooling : After the cycle, allow pressure to release and items to cool before removal.

Unloading : Carefully remove items with sterile gloves when safe.

Sterilization Indicators :

Chemical Indicators : Color-changing autoclave tapes or strips.

Biological Indicators : Use of heat-resistant spores (e.g., Geobacillus stearothermophilus) to confirm sterilization.

Mechanical Indicators : Monitors for time, temperature, and pressure during the cycle.

Advantages :

Very effective against all types of microorganisms

Economical and safe for many types of materials

Environmentally friendly (no harmful chemicals)

Disadvantages :

Not suitable for heat-sensitive or moisture-sensitive items

May cause corrosion of certain instruments if not dried properly

Requires proper training for operation and monitoring

2.Explain in detail the morphology, Cultural characteristics, Pathogenecity, and Laboratory Diagnosis of Streptococc

Morphology

Morphology is the branch of biology that deals with the form and structure of organisms and their specific structural features, including size, shape, structure, and appearance of an organism or its parts.

Types of Morphology

External Morphology (Eidonomy) :

Study of outer features of organisms like shape, color, limbs, wings, etc.

Example: Beak shape in birds, body segments in insects.

Internal Morphology (Anatomy) :

Study of internal structures such as organs, bones, and tissues.

Example: Structure of heart, lungs, kidneys, etc.

In Microbiology :

In microbiology, morphology refers to the shape and arrangement of microorganisms, particularly bacteria.

Bacterial Shapes :

Coccus (spherical)

Example : Streptococcus, Staphylococcus

Bacillus (rod-shaped)

Example : Escherichia coli

Spirillum (spiral-shaped)

Example : Spirillum minus

Vibrio (comma-shaped)

Example : Vibrio cholerae

Bacterial Arrangements :

Diplococci – pairs

Streptococci – chains

Staphylococci – clusters

Tetrads – groups of four

Sarcinae – cube-like groups of eight

In Botany :

Morphology studies parts of the plant like:

Root (tap root, fibrous root)

Stem (aerial, underground)

Leaf (simple, compound)

Flower (calyx, corolla, androecium, gynoecium)

Fruit and seed structure

Importance of Morphology :

Helps in classification and identification of organisms.

Understanding evolutionary relationships.

Aids in diagnosing diseases (in microbiology and pathology).

Important in forensic biology, paleontology, and ecology.

Cultural characteristics

Definition :

Cultural characteristics refer to the visible features of microbial growth on different culture media under laboratory conditions. These features help in the preliminary identification and classification of microorganisms like bacteria and fungi.

Explanation :

When microorganisms are grown on artificial nutrient media (e.g., nutrient agar, blood agar, MacConkey agar), they develop colonies that show specific features. These features include :

Shape : circular, irregular, rhizoid

Size : small, medium, large

Elevation : flat, raised, convex

Margin : entire, undulate, lobate

Surface : smooth, wrinkled, mucoid

Color : white, yellow, pink, green (pigmented or non-pigmented)

Opacity : transparent, translucent, opaque

Consistency : dry, moist, brittle, sticky

Odor : characteristic smell (e.g., fruity in Pseudomonas)

Medium reaction : hemolysis on blood agar, lactose fermentation on MacConkey agar

Pathogenecity

Pathogenicity is the ability of a microorganism (such as bacteria, viruses, fungi, or parasites) to cause disease in a host organism.

Pathogenicity refers to how capable a microbe is in producing disease by overcoming the host’s defense mechanisms. It depends on several factors such as :

Invasiveness : Ability to enter, survive, and multiply in host tissues

Toxigenicity : Ability to produce toxins (e.g., exotoxins, endotoxins)

Adherence : Ability to attach to host cells using pili, fimbriae, etc.

Evasion of immunity : Ability to avoid destruction by the immune system (e.g., capsule formation, antigenic variation)

Examples :

Streptococcus pyogenes – causes sore throat and produces toxins

Mycobacterium tuberculosis – highly pathogenic, causes TB

Escherichia coli – some strains are non-pathogenic, while others (like E. coli O157:H7) are highly pathogenic

Laboratory diagnosis for streptococcus

Definition :

Laboratory diagnosis of Streptococcus aims to identify the specific species or group of Streptococcus bacteria responsible for an infection using various clinical specimens and microbiological techniques

Laboratory Diagnosis

Microscopy (Gram Staining) :

Shows Gram-positive cocci in chains

Helps in preliminary identification

Culture :

Inoculated on Blood Agar

Colony appearance: small, round with hemolysis pattern:

Alpha hemolysis – partial (green zone) (S. pneumoniae)

Beta hemolysis – complete (clear zone) (S. pyogenes)

Gamma hemolysis – no hemolysis

Biochemical Tests :

Catalase test : Negative (helps differentiate from Staphylococcus)

Bacitracin sensitivity test : S. pyogenes is sensitive

Bile solubility and optochin sensitivity for S. pneumoniae

Serological Tests :

ASO (Anti-streptolysin O) titer – used to detect recent Streptococcus infection

Q.3 Write Short Notes on: (Any three out of four)

1.Antibiotics acting on the cell wall.

Antibiotics that act on the bacterial cell wall mainly interfere with the synthesis of peptidoglycan, a crucial structural component that provides shape and rigidity to bacteria. These drugs are bactericidal in nature, meaning they kill bacteria by weakening the wall, which causes osmotic lysis of the cell.

Mechanism of action :

The main mechanism involves inhibition of penicillin-binding proteins (PBPs), which are responsible for the cross-linking of peptidoglycan strands. Disruption of this process results in a fragile cell wall.

Main Classes of Antibiotics Acting on Cell Wall :

Penicillins – e.g., Penicillin G, Amoxicillin

Cephalosporins – e.g., Ceftriaxone, Cefazolin

Carbapenems – e.g., Imipenem, Meropenem

Monobactams – e.g., Aztreonam

Glycopeptides – e.g., Vancomycin, Teicoplanin

Clinical Uses :

These antibiotics are used to treat infections like :

Pneumonia

Meningitis

Skin infections

Urinary tract infections

Septicemia

Resistance Mechanisms :

Production of beta-lactamase enzymes

Altered PBPs (e.g., in MRSA)

Decreased permeability of bacterial cell wall

2.Gram straining

Definition :

Gram staining is a differential staining technique developed by Hans Christian Gram in 1884 to classify bacteria into two major groups: Gram-positive and Gram-negative, based on differences in their cell wall structure.

Principle :

The stain differentiates bacteria based on the thickness of the peptidoglycan layer.

Gram-positive bacteria retain the crystal violet stain due to a thick peptidoglycan layer.

Gram-negative bacteria lose the violet stain and take up safranin, appearing pink/red.

Reagents Used :

Primary Stain : Crystal violet

Mordant : Iodine solution

Decolorizer : Alcohol or acetone

Counterstain : Safranin

Steps of Gram Staining :

Apply crystal violet for 1 minute → all cells purple

Apply iodine for 1 minute → forms complex with crystal violet

Decolorize with alcohol (15–20 seconds) → Gram-positive retain color; Gram-negative lose it

Counterstain with safranin for 30–60 seconds → Gram-negative appear pink/red

Results :

Gram-positive : Purple or Blue in colour, Peptidoglycan Layer-Thick
Gram-negative : Pink or Red in colour, Peptidoglycan Layer-Thin

Examples :

Gram-positive : Staphylococcus aureus, Streptococcus pyogenes

Gram-negative : Escherichia coli, Salmonella typhi

Uses :

Quick bacterial classification

Helps guide antibiotic selection

First step in bacterial diagnosis in microbiology labs

3.Importance of Microbiology in nursing.

Microbiology is the study of microscopic organisms such as bacteria, viruses, fungi, and protozoa. For nurses, understanding microbiology is essential in delivering safe and effective care, especially in infection prevention, diagnosis, and patient education.

1. Infection Control

Helps nurses understand sources, transmission, and prevention of infections.

Essential for maintaining aseptic techniques, hand hygiene, sterilization, and disinfection procedures.

Crucial in managing nosocomial (hospital-acquired) infections.

2. Safe Nursing Procedures

Knowledge of microbiology guides safe handling of wounds, injections, catheters, IV lines, and surgical care.

Prevents cross-contamination during dressing changes, IV infusions, and specimen collection.

3. Identification of Pathogens

Nurses assist in collecting, transporting, and labeling clinical specimens for lab diagnosis (e.g., blood, urine, sputum).

Enables early detection and reporting of infections such as tuberculosis, MRSA, sepsis, etc.

4. Antibiotic Use and Resistance

Microbiology knowledge helps nurses understand antibiotics, sensitivity reports, and drug resistance (e.g., MRSA, VRE).

Educate patients about completing antibiotic courses and avoiding misuse.

5. Immunization and Disease Prevention

Nurses provide vaccinations and counsel on immunity against infectious diseases like hepatitis, influenza, and measles.

Understands the role of microbial antigens and vaccine-preventable diseases.

6. Understanding Emerging Diseases

Helps recognize and care for patients with new infections (e.g., COVID-19, Zika, Nipah virus).

Enhances response to outbreaks and public health emergencies.

7. Role in Health Education

Educates patients and communities about personal hygiene, sanitation, food safety, and disease prevention.

Promotes infection awareness and healthy behaviors.

4 Compound Microscope.

Definition :

A compound microscope is an optical instrument used to magnify small objects that are not visible to the naked eye. It uses two sets of lenses – objective lens and eyepiece (ocular) lens – to produce a highly magnified image of the specimen.

Parts of a Compound Microscope :

1. Optical Parts :

Eyepiece (Ocular lens) : Located at the top; usually 10x magnification

Objective lenses : Usually 3 or 4 lenses (e.g., 10x, 40x, 100x oil immersion)

Condenser : Focuses light onto the specimen

Mirror or Illuminator : Provides light for viewing

2. Mechanical Parts :

Body tube : Connects eyepiece to objective lenses

Arm: Supports the tube and connects to base

Stage : Flat platform where slides are placed

Coarse adjustment knob : Moves stage up/down for focusing

Fine adjustment knob : Sharpens the focus

Base : Bottom support of the microscope

Working Principle :

Light from the mirror or illuminator passes through the condenser to the slide.

The objective lens magnifies the image.

The image is further magnified by the eyepiece.

Total magnification = Eyepiece × Objective lens (e.g., 10x × 40x = 400x)

Uses in Nursing/Microbiology :

Observing microorganisms (bacteria, protozoa)

Examining blood cells, urine sediments

Diagnosing infections and parasites

Viewing stained slides like Gram stain, acid-fast stain

Q.4 Write very short answers: (Any two out of three) (3×2=6)

1.Name of two drug resistant organism with explanation.

MRSA (Methicillin-Resistant Staphylococcus aureus)

MRSA is a strain of Staphylococcus aureus that has developed resistance to methicillin and most beta-lactam antibiotics (e.g., penicillin, cephalosporins). It is commonly found in hospital settings and causes infections like wound infections, pneumonia, bloodstream infections, and surgical site infections.
It spreads through direct contact and requires strict infection control.

MDR-TB (Multi-Drug Resistant Mycobacterium tuberculosis)

MDR-TB is a form of tuberculosis caused by Mycobacterium tuberculosis that is resistant to at least isoniazid and rifampicin, the two most powerful first-line anti-TB drugs. It arises due to improper or incomplete treatment, and is harder and more expensive to treat, requiring second-line drugs for a longer duration.

2.Normal floora.

Definition :

Normal flora (also called normal microbiota) refers to the non-pathogenic microorganisms (bacteria, fungi, and sometimes viruses) that naturally live on or inside the human body without causing harm under normal conditions.

Normal flora is found on various parts of the body such as:

Skin – Staphylococcus epidermidis, Corynebacterium

Nose and throat – Streptococcus viridans, Neisseria species

Mouth – Lactobacillus, Streptococcus mutans

Intestine – Escherichia coli, Bacteroides, Lactobacillus

Vagina – Lactobacillus, Candida (in small numbers)

Functions :

Prevents colonization by pathogens (competitive exclusion)

Produces vitamins (e.g., Vitamin K by E. coli)

Stimulates immune system development

Helps in digestion (intestinal flora)

3.Pasteurisation.

Definition :

Pasteurization is the process of heating liquids, especially milk, to a specific temperature for a short time to kill harmful microorganisms such as Mycobacterium tuberculosis, Brucella, and Salmonella, without changing the taste or nutritional value.

Common Methods :

Low Temperature Long Time (LTLT) : 63°C for 30 minutes

High Temperature Short Time (HTST) : 72°C for 15–20 seconds

Ultra-High Temperature (UHT) : 135°C for 2–5 seconds

Uses of Pasteurization :

Milk (most common)

Juices (fruit juices, vegetable juices)

Wine and beer

Egg products

Advantages :

Increases safety by killing pathogens

Extends shelf life

Maintains nutritional quality

Limitations :

Does not kill spores

Not a substitute for refrigeration after treatment

Section-2

Q.5 ultiple choice questions. (7×1-7)

1.Antigen presenting cell are

a. Macrophases

b. Dendritic cells

c. Langerhans cells

d. All of above.

2.The antibody that can cross placental barrier is

a. IgM

b. IgG

c. IgA

d. IgE

3. Hay fever, asthama are examples of

a. Atopy

b. Hypersensitivity

c. Delayed Hypersensitivity

d. Cytotoxicity

4. Which of the following is a subunit Vaccine?

a. Measles

b. Mumps

c. Rubella.

d. Hepatitis B.

5. Which of the following has the characteristics drumstick apperance?

a. C tetani

b. C novyi

c. C histoluticum

d. C septicum

6. The medum used for mycobacterian tuberculosis is

a. Sabouraud’s dextroy agar

b. Lowenstein Jensen media

c. Thayer Marfin agar

d. Shart’s media

7. Most important aspect of hand washings

a. Time

b. Type of soap

c. Friction

d. Surface tension.

Q.6 Long Essay. (Any one) (1×10=10)

1 Describe in detail about BMW management in hospital.

Definition :

Biomedical waste refers to any waste generated during the diagnosis, treatment, or immunization of humans or animals, or during research activities and production/testing of biologicals. It may be infectious, hazardous, or radioactive.

Sources of Biomedical Waste in Hospitals :

Operation theatres

Wards and ICUs

Laboratories and pathology departments

Radiology and chemotherapy units

Central sterile supply department (CSSD)

Categories of Biomedical Waste (as per rules) :

Yellow

Waste Type : Human anatomical waste, soiled waste, expired drugs

Disposal Method : Incineration or deep burial

Red

Waste Type : Contaminated plastics (tubing, bottles, gloves)

Disposal Method : Autoclaving/Microwaving, shredding

White

Waste Type : (Translucent) Sharps (needles, scalpels, blades)

Disposal Method : Autoclaving followed by shredding

Blue

Waste Type : Glassware, broken vials, ampoules

Disposal Method : Disinfection/autoclaving then recycling

Steps in BMW Management in Hospital :

Segregation at Source :

Waste is separated immediately at the point of generation into color-coded bins.

Collection & Transportation :

Collected in leak-proof, labeled containers and transported safely to the temporary storage area.

Storage :

Stored for not more than 48 hours in a designated and secure area.

Treatment & Disposal :

Treated using autoclaving, incineration, deep burial, chemical disinfection, etc.

Final disposal in authorized common biomedical waste treatment facility (CBWTF).

Personal Protective Equipment (PPE) :

Staff involved in handling BMW must wear gloves, masks, aprons, goggles, and boots.

Record Keeping :

Hospitals must maintain daily logs, treatment records, and manifest copies for waste tracking.

Training and Awareness :

Regular training for healthcare staff on segregation, handling, and emergency measures.

Labeling and Signage :

Each container must be labeled with the biohazard symbol and relevant information.

1 Describe different types of hypersensitivity with example.

Hypersensitivity refers to an exaggerated or inappropriate immune response to an antigen (allergen), which results in tissue damage, inflammation, or disease. It occurs in previously sensitized individuals and involves immunological mechanisms such as antibody or T-cell mediated reactions.

Classification of Hypersensitivity

Hypersensitivity reactions are classified into four types (I–IV) by Gell and Coombs based on the immunologic mechanism and time course.

Type I – Immediate (Anaphylactic) Hypersensitivity

Mediated by : IgE antibodies

Onset : Within minutes of exposure

Mechanism : Allergen binds to IgE on mast cells → release of histamine & other mediators

Examples :

Anaphylaxis

Asthma

Hay fever (Allergic rhinitis)

Urticaria (hives)

Clinical features : Bronchospasm, hypotension, itching, swelling

Type II – Antibody-Mediated Cytotoxic Hypersensitivity

Mediated by : IgG or IgM antibodies

Mechanism : Antibodies target antigens on cell surfaces → cell lysis via complement or phagocytosis

Examples :

Hemolytic anemia

Blood transfusion reaction

Rh incompatibility (Erythroblastosis fetalis)

Myasthenia gravis

Outcome : Destruction of host cells

Type III – Immune Complex-Mediated Hypersensitivity

Mediated by : Immune complexes (antigen-antibody complexes)

Mechanism : Complexes deposit in tissues → activate complement → inflammation

Examples :

Systemic lupus erythematosus (SLE)

Rheumatoid arthritis

Serum sickness

Post-streptococcal glomerulonephritis

Symptoms : Fever, rash, joint pain, nephritis

Type IV – Delayed-Type (Cell-Mediated) Hypersensitivity

Mediated by : T-lymphocytes (no antibody involved)

Onset : 24–72 hours after exposure

Mechanism : Sensitized T-cells release cytokines → macrophage activation → tissue damage

Examples :

Tuberculin skin test (Mantoux test)

Contact dermatitis (e.g., poison ivy)

Graft-versus-host disease

Type 1 Diabetes Mellitus

Hallmark : Delayed inflammatory response

Q.7 Write Short Notes: (Any three) (3×5=15)

1.Nosocomial infection

Definition :

Nosocomial infection, also known as hospital-acquired infection (HAI), refers to an infection that is not present or incubating at the time of hospital admission but develops 48 hours or more after admission or within 30 days after receiving healthcare.

Common Sites of Nosocomial Infections :

Urinary Tract Infections (UTIs) – often due to catheterization

Surgical Site Infections (SSIs)

Pneumonia – especially ventilator-associated

Bloodstream Infections (BSIs) – often related to IV lines or catheters

Gastrointestinal infections – e.g., due to Clostridium difficile

Causative Microorganisms :

Bacteria :

Staphylococcus aureus (including MRSA)

Pseudomonas aeruginosa

Escherichia coli

Klebsiella pneumoniae

Fungi : Candida albicans

Viruses : e.g., norovirus, influenza (less common)

Risk Factors :

Indwelling devices (catheters, IV lines, ventilators)

Prolonged hospital stay

Immunocompromised state

Poor hand hygiene practices

Invasive surgical procedures

Prevention and Control :

Standard Precautions

Hand hygiene (before & after patient care)

Use of PPE (gloves, masks, gowns)

Sterile technique in invasive procedures

Safe injection practices

Environmental cleaning

Isolation precautions for patients with contagious infections

Proper sterilization and disinfection of medical equipment

Antibiotic stewardship – rational use of antibiotics to prevent resistance

2.Post exposure prophylaxis for Hepatitis B

Post-exposure prophylaxis (PEP) for Hepatitis B virus (HBV) refers to preventive measures taken after accidental exposure to blood or body fluids potentially infected with HBV. Common exposures include needle-stick injuries, mucosal contact, or perinatal transmission.

Key Components of PEP :

Immediate Wound Care :

Wash the exposed area with soap and water.

Avoid squeezing or scrubbing the wound.

Assessment of Source and Victim :

Determine HBsAg status of the source.

Check the vaccination and antibody status (anti-HBs) of the exposed individual.

Vaccinated Person with Adequate Antibody (>10 mIU/mL) :

No PEP required.

Vaccinated Person with Unknown or Inadequate Antibody (<10 mIU/mL) :

One dose of Hepatitis B vaccine booster ± 1 dose of HBIG (Hepatitis B Immune Globulin) depending on risk.

Unvaccinated or Incompletely Vaccinated Person :

Start full Hepatitis B vaccination series (0, 1, 6 months).

Give HBIG 0.06 mL/kg IM within 24 hours, preferably within 7 days of exposure.

Newborn of HBsAg Positive Mother :

Administer HBV vaccine + HBIG within 12 hours of birth.

Follow-up :

Test for HBsAg and anti-HBs after 6 months.

Monitor for clinical signs of hepatitis.

3.MMR. Vaccine

Definition :

The MMR vaccine is a combined live attenuated vaccine that provides protection against three viral diseases:

Measles

Mumps

Rubella

Composition :

Live attenuated strains of :

Measles virus (Edmonston strain)

Mumps virus (Jeryl Lynn strain)

Rubella virus (Wistar RA 27/3 strain)

Schedule (as per National Immunization Guidelines) :

9 months : First dose (as MMR or MR)
15–18 months : Second dose
4–6 years (booster) : Third dose (in some schedules or schools)

Route & Site of Administration :

Route : Subcutaneous (SC)

Site : Anterolateral aspect of the thigh (infants) or upper arm (older children)

Storage :

Stored at 2–8°C in the refrigerator

Protect from light (photosensitive)

Indications :

Prevention of :

Measles (highly contagious viral disease)

Mumps (causes swollen salivary glands and orchitis)

Rubella (can cause congenital rubella syndrome in pregnancy)

Contraindications :

Severe allergic reaction to neomycin or gelatin

Immunocompromised individuals (e.g., leukemia, HIV/AIDS with low CD4)

Pregnancy – live vaccine can harm the fetus

Common Side Effects :

Mild fever

Rash

Pain or swelling at injection site

Mild joint pain (especially rubella component in adolescent females)

Serious Adverse Effects (Rare) :

Febrile seizures

Thrombocytopenia

Anaphylactic reaction

Nursing Responsibilities :

Ensure vaccine cold chain maintenance

Obtain informed consent

Screen for contraindications

Educate parents about minor side effects

Advise to avoid pregnancy for at least 1 month after vaccination

4.Hookworm infestation.

Definition :

Hookworm infestation is a parasitic infection caused by intestinal nematodes (roundworms), primarily Ancylostoma duodenale and Necator americanus, which attach to the small intestine and feed on the host’s blood, leading to anemia and malnutrition.

Causative Agents :

Ancylostoma duodenale

Necator americanus

Mode of Transmission :

Infective larvae in contaminated soil penetrate intact skin, especially through bare feet.

Poor sanitation, open defecation, and barefoot walking increase the risk.

Life Cycle :

Eggs excreted in feces contaminate soil

Hatch into larvae → become infective

Larvae penetrate skin → migrate via blood to lungs

Ascend to throat → swallowed → reach small intestine

Mature into adult worms and suck blood

Signs and Symptoms :

Ground itch at skin penetration site

Abdominal cramps, bloating, diarrhea

Iron-deficiency anemia (pallor, fatigue)

Growth retardation in children

Protein loss, weakness

Diagnosis :

History collection

Physical examination

Microscopic stool examination → detects hookworm eggs

CBC → shows low hemoglobin (anemia)

Treatment :

Albendazole (400 mg single dose)

Mebendazole (100 mg twice daily for 3 days)

Iron and folic acid supplements for anemia

Nutritional support

Prevention :

Wear shoes to prevent skin contact with soil

Promote sanitation and use of toilets

Health education on hygiene and safe defecation

Deworming programs in schools and communities

Q.8 Short Answers: (Any two) (3×2=6)

1.Name methods to diagnose viral infection

Several methods are used to diagnose viral infections based on clinical samples like blood, throat swabs, CSF, urine, etc.

Common Diagnostic Methods :

Polymerase Chain Reaction (PCR) :

Detects viral genetic material (DNA or RNA)

Highly sensitive and specific

Used for viruses like HIV, COVID-19, Hepatitis B/C

Antigen Detection Tests :

Detect viral proteins (antigens) in samples

Rapid test kits (e.g., Dengue NS1, COVID-19 antigen test)

Serological Tests :

Detect antibodies (IgM, IgG) produced by the immune system

Example : ELISA test for HIV, Hepatitis B

Viral Culture :

Growing viruses in cell cultures

Time-consuming, used for research or special cases

Electron Microscopy :

Direct visualization of viruses using powerful microscope

Used in research labs

Rapid Diagnostic Tests (RDTs) :

Point-of-care tests providing results within minutes

Example : Rapid influenza test

2 Nurses role in specimen collection

1. Patient preparation

Explain the purpose and procedure of patient.

Ensure privacy, comfort, and informed consent.

Verify pre-test instructions (e.g., fasting, medication restrictions).

2. Proper Collection Technique

Use correct technique for each specimen type (urine, stool, blood, sputum, etc.).

Maintain aseptic technique to avoid contamination.

Collect specimen at the right time (e.g., early morning sputum).

3. Labeling and Documentation

Label specimen containers with patient name, ID, date, and time immediately.

Fill out lab request forms correctly.

Record the procedure in nurse’s notes.

4. Safe Handling and Transport

Handle specimens carefully to prevent spillage or contamination.

Send to the laboratory promptly using proper biohazard containers.

Maintain specific temperature if required (e.g., ice for some blood samples).

5. Infection Control and Waste Disposal

Perform hand hygiene and wear appropriate PPE.

Dispose of used materials as per biomedical waste guidelines.

Clean the area and equipment after use.

3 What is the difference between diarrhea and Dysentery

1. Definition :

Diarrhea :
It is the frequent passage of loose or watery stools, typically without blood or mucus. It may be caused by infections, food intolerance, or medications.

Dysentery :
It is an inflammatory disorder of the intestine, especially the colon, resulting in bloody, mucus-filled stools along with abdominal pain and fever. It is usually caused by bacterial or amoebic infections.

2. Causative Organisms :

Diarrhea :
Commonly caused by viruses (e.g., Rotavirus, Norovirus), some bacteria (e.g., E. coli, Vibrio cholerae).

Dysentery :
Caused by Shigella (bacillary dysentery) or Entamoeba histolytica (amoebic dysentery).

3. Stool Characteristics :

Diarrhea :
Watery, large-volume stools with no visible blood or mucus.

Dysentery :
Small-volume stools that contain blood and mucus.

4. Abdominal Pain :

Diarrhea :
Usually mild or crampy abdominal discomfort.

Dysentery :
Severe abdominal pain with tenesmus (painful straining during defecation).

5. Fever and Systemic Symptoms :

Diarrhea :
Fever may be mild or absent.

Dysentery :
Often accompanied by high fever, fatigue, and dehydration.

6. Duration and Severity :

Diarrhea :
Often self-limiting, especially viral diarrhea.

Dysentery :
Requires prompt treatment with antimicrobials to prevent complications.

7. Treatment Approach :

Diarrhea :
Focus is on rehydration therapy (ORS) and dietary management.

Dysentery :
Requires antibiotic/antiparasitic therapy in addition to fluid replacement.