CIC EXAM QUESTIONS AND ANSWERS
WITH SOLUTIONS 2024
ChainLofLInfectionL-
LANSWERL1)InfectiousLagent=LorganismLwithLabilityLtoLcauseLdisease;LgreaterLvirulence,Linvasiveness,LandL
pathogenicityL=>LincreasedLoddsLofLinfection
2)LReservoir:LplaceLwhereLmicrobesLcanLpersistLandLreproduce
3)LPortalLofLExit:LwayLforLmicrobeLtoLleaveLtheLreservoir
4)LModeLofLtransmission:LmethodLofLmicrobeLtransferLfromLoneLplaceLtoLanother
5)LPortalLofLentry:LopeningLthatLallowsLmicrobeLtoLenterLhost
6)LSusceptibleLhost:LLacksLimmunityLorLphysicalLresistanceLtoLpreventLinvasionLbyLmicrobe
IsLaLcircle;LeachLlinkLmustLbeLpresentLinLsequentialLorderLforLinfectionLtoLoccur
VirulenceL-LANSWERLMeasureLofLmicrobe'sLabilityLtoLinvadeLandLcreateLdisease
DependsLonLabilityLto:
SurviveLinLenvironmentLbetweenLhosts
TransmitLbetweenLhostsL(moving;Ladherence)
Proliferate
IgML-LANSWERLPentamer;LprimaryLresponse,Lshort-livedL(<6Lmonths);LbestLatLfixingLcomplement
IgGL-
LANSWERLMonomer;LmainLbloodLantibody,LsecondaryLresponse;LlongerLlived.LopsonizationLandLtoxinLneutr
alization.L4Lsubclasses
PhysicalLbarriersL-LANSWERLSkin;Lfever;LsecretedLantimicrobials;LinnateLimmunity
ComplementLsystemL-
LANSWERL11=proteinLcascade;LclassicallyLactivateLbyLab:agLcomplexes;LalternateLbyLpathogenLsurfaces
,SkinLdefects;LexamplesLandLassociatedLpathogensL-
LANSWERLWounds,Lburns,Ltrauma,LseriousLdermLproblems,LindwellingLdevices,Linjections.LSkinLflora-
LS.Laureus,LCNS,LstrepLpyo,Lcorynebacteria,LmalasseziaLfurfur
MucousLmembraneLbarrierLdefects;LexamplesLandLassociatedLpathogensL-LANSWERLchemo-
inducedLmucositosis,Lhead/neckLtrauma,Lsmoking,LinhalationalLinjury,Lantacids/PPIs.LResidentLflora-
Lanaerobes,LaerobicLGNR,Lcandida,Lenteroccus,Lbovis
BodyLpassageLobstruction;LexamplesLandLassociatedLpathogensL-
LANSWERLTumors,LforeignLbodies,Lstones,LcysticLfibrosis.LResidentLfloraLovergrowLorLinvade;Lsite-specific.
AbnormalLnumberLorLfunctionLofLgranulocytesL-
LANSWERLLeukemia,Lchemo,LcongenitalLdisorders,Ldiabetes.LIfLshortLtermL(<L2Lwks)LthenLaerobicLGNR,LSa,LC
oNS.LIFLlongLterm,LaddLfungiL(candida,Lt.Lglabrata,Laspergillus)
AbnormalitiesLofLcell-mediatedLimmunityL-
LANSWERLBMT,LHIV,Lsteroids,Lmalnutrition,L3rdLtriLpregnancy.LBacteria:LIntracellularLpathogensL(listeria,Lsal
monella,Lmycobacteria,Lnocardia,Llegionella).L
Fungi:Lcandida,LCryptococcus,Lcoccidioides,Lhistoplasma.LVirus:LHerpesLgroup
AlsoLtoxoplasmaLandLstrongyloides.
abnormalitiesLofLhumoralLimmunityL-
LANSWERLBMT,LHIV,LsomeLcancers,Laging.LStrepLpneumo,LencapsulatedLH.Lflu,LNeisseriaLmeningitidis
PreventingLinfectionLforLimmunocompromisedLpatientsL-
LANSWERLTakeLthoroughLpatientLhistory.LPrepareLbeforeLstartingLwithLallLvaccines,Lprocedures,LlineLplacem
ent,Lscreening.LSupportLgastricLacidity.LPreventLexposuresLwithLawesomeLhygiene,LappropLfoodLandLwaterL
precautions,LvisitorLeducation,LnoLflowersLorLplants,LandLpossibleLabxLprophyL(forLinfectionsLthatLmightLrea
ctivateLorLhigh-riskLforLpneumocystis)
MycoplasmaLspp.L-LANSWERLNoLcellLwallL--
>LlimitedLabxLchoices.LCauseLatypicalLpneumonia.LUsuallyLdiagnosedLbyLserology
,ChlamydiaeL-
LANSWERLobligateLintracellularLparasites.LElementaryLbody=infectious,Lreticulated=Lintracellular.LDFALorLEL
ISALforLdetectionLofLantigenLisLmostLcommon.LCanLalsoLdetectLantibodies.
RickettsiaeL-
LANSWERLobligateLintracellularLparasites.LarthropodLvectors.LRarelyLculturing;LdetectedLbyLserologyLusingLE
LISALforLantibodies.
TextbookLviralLreplicationLcycleL-
LANSWERL1.LAttachmentL2.Lpenetration/entryL3.LreplicationL4.Lmaturation/assemblyL5.Lrelease
SensitivityL-LANSWERL%LofLtrueL+LwhoLtestL+;LinherentLtoLtest
SpecificityL-LANSWERL%LofLtrueLnegLwhoLtestLneg;LinherentLtoLtest
PPVL-
LANSWERLLikelihoodLthatLaL+LtestLrepresentsLaLtrueLcaseL(%LT+/all+);LdependsLonLtheLtestLandLonLprevalenc
eLofLdiseaseLinLpopulation
NPVL-LANSWERLLikelihoodLthatLaLnegativeLtestLresultLisLaLtrueLnon-
caseL(%TN/allN);LdependsLonLtestLandLpopulationLprevalence
CSFLanalysis-LbacterialLmeningL-LANSWERL1000-
5000LWBCs,LmostlyLPMNs.LIncreasedLpressure.LIncreasedLproteinL.LDecreasedLglucose.LBacteriaLseenLonLs
mears.
CSFLanalysis-LviralLmeningL-
LANSWERLPressure,LglucoseLnormal.LLymphocytesLseen,LbutLfewLWBCLinLgeneral.LProteinLnormal-
elevated.LNothingLonLsmears.
CSFLanalysis-LfungusLmeningL-
LANSWERLPressureLvariable.LGlucoseLlow,LproteinLhigh.LWBCsLvary,LbutLlymphocytesLpredominate.LIndiaLin
kLsmearL+.
, CSFLanalysis-LTBLmeningL-
LANSWERLPressureLvariable.LGlucoseLlowLtoLmegalow.LWBCsLvary,LmostlyLlymphocytes.LProteinLelevated.LA
FBLstainL+
ColdLAgglutininsLtestL-
LANSWERLUsedLtoLdetectLantibodiesLforLMycoplasmaLpneumoniaeLorLmononucleosis.LPositiveLtestLisLhighLti
ter,LwithLrespLSxLindicatesLM.LpneumoLinfection,LviralLpneumo,LorLprimaryLatypicalLpneumo
CRPLtestL-
LANSWERLSerumLsampleLlookingLforLtheLCRLprotein;LnormalLvalueLisLnoneLorLlowLCRP.LIndicatesLcurrentLacu
teLinflammation
LiverLFunctionLTestsL-
LANSWERLchemistryLassaysLonLblood;LlookingLforLvariousLthingsLincludingLenzymes,Lbilirubin,Lammonia,Lan
dLalbumin.LGenerallyLhigherLisLworse.LHelpsLdetectLliverLproblems,LdifferentiateLamongLliverLproblems,Lme
asureLliverLdamage,LandLfollowLresponseLtoLTx.
ArterialLBloodLGasL(ABG)L-
LANSWERLbloodLfromLartery,LmeasuresLoxygenLandLCO2Ltension,LpH.LAssessesLgasLexchange,LwhichLisLhelpf
ulLinLrecognizingLpneumonia
SedimentationLrateL-
LANSWERLMeasuresLrateLofLRBCsLsinking;LfasterLindicatesLacuteLinfection/inflammationL(amongLotherLthin
gs,LisLnotLveryLspecific)
ToxinLproductionLtestsL-
LANSWERLManyLwaysLofLdoing,LincludingLEIALandLHPLC.LlimulusLamebocyteLlysateLtestsLforLendotoxin.
Weil-FelixLagglutinationL-
LANSWERLSerum,LtestLforLrickettsialLantibodies.LHighLtiterLorL4xLriseLinLtiterLindicatesLrickettsialLinfection.
UrinalysisL-
LANSWERLMultipleLtests.LNormalLhasLvariousLchemistryLvaluesLandLshouldLhaveLnoLorLfewLcells.LHighLWBCs,
LleukocyteLesterase,LandLnitriteLindicateLinfection.
WITH SOLUTIONS 2024
ChainLofLInfectionL-
LANSWERL1)InfectiousLagent=LorganismLwithLabilityLtoLcauseLdisease;LgreaterLvirulence,Linvasiveness,LandL
pathogenicityL=>LincreasedLoddsLofLinfection
2)LReservoir:LplaceLwhereLmicrobesLcanLpersistLandLreproduce
3)LPortalLofLExit:LwayLforLmicrobeLtoLleaveLtheLreservoir
4)LModeLofLtransmission:LmethodLofLmicrobeLtransferLfromLoneLplaceLtoLanother
5)LPortalLofLentry:LopeningLthatLallowsLmicrobeLtoLenterLhost
6)LSusceptibleLhost:LLacksLimmunityLorLphysicalLresistanceLtoLpreventLinvasionLbyLmicrobe
IsLaLcircle;LeachLlinkLmustLbeLpresentLinLsequentialLorderLforLinfectionLtoLoccur
VirulenceL-LANSWERLMeasureLofLmicrobe'sLabilityLtoLinvadeLandLcreateLdisease
DependsLonLabilityLto:
SurviveLinLenvironmentLbetweenLhosts
TransmitLbetweenLhostsL(moving;Ladherence)
Proliferate
IgML-LANSWERLPentamer;LprimaryLresponse,Lshort-livedL(<6Lmonths);LbestLatLfixingLcomplement
IgGL-
LANSWERLMonomer;LmainLbloodLantibody,LsecondaryLresponse;LlongerLlived.LopsonizationLandLtoxinLneutr
alization.L4Lsubclasses
PhysicalLbarriersL-LANSWERLSkin;Lfever;LsecretedLantimicrobials;LinnateLimmunity
ComplementLsystemL-
LANSWERL11=proteinLcascade;LclassicallyLactivateLbyLab:agLcomplexes;LalternateLbyLpathogenLsurfaces
,SkinLdefects;LexamplesLandLassociatedLpathogensL-
LANSWERLWounds,Lburns,Ltrauma,LseriousLdermLproblems,LindwellingLdevices,Linjections.LSkinLflora-
LS.Laureus,LCNS,LstrepLpyo,Lcorynebacteria,LmalasseziaLfurfur
MucousLmembraneLbarrierLdefects;LexamplesLandLassociatedLpathogensL-LANSWERLchemo-
inducedLmucositosis,Lhead/neckLtrauma,Lsmoking,LinhalationalLinjury,Lantacids/PPIs.LResidentLflora-
Lanaerobes,LaerobicLGNR,Lcandida,Lenteroccus,Lbovis
BodyLpassageLobstruction;LexamplesLandLassociatedLpathogensL-
LANSWERLTumors,LforeignLbodies,Lstones,LcysticLfibrosis.LResidentLfloraLovergrowLorLinvade;Lsite-specific.
AbnormalLnumberLorLfunctionLofLgranulocytesL-
LANSWERLLeukemia,Lchemo,LcongenitalLdisorders,Ldiabetes.LIfLshortLtermL(<L2Lwks)LthenLaerobicLGNR,LSa,LC
oNS.LIFLlongLterm,LaddLfungiL(candida,Lt.Lglabrata,Laspergillus)
AbnormalitiesLofLcell-mediatedLimmunityL-
LANSWERLBMT,LHIV,Lsteroids,Lmalnutrition,L3rdLtriLpregnancy.LBacteria:LIntracellularLpathogensL(listeria,Lsal
monella,Lmycobacteria,Lnocardia,Llegionella).L
Fungi:Lcandida,LCryptococcus,Lcoccidioides,Lhistoplasma.LVirus:LHerpesLgroup
AlsoLtoxoplasmaLandLstrongyloides.
abnormalitiesLofLhumoralLimmunityL-
LANSWERLBMT,LHIV,LsomeLcancers,Laging.LStrepLpneumo,LencapsulatedLH.Lflu,LNeisseriaLmeningitidis
PreventingLinfectionLforLimmunocompromisedLpatientsL-
LANSWERLTakeLthoroughLpatientLhistory.LPrepareLbeforeLstartingLwithLallLvaccines,Lprocedures,LlineLplacem
ent,Lscreening.LSupportLgastricLacidity.LPreventLexposuresLwithLawesomeLhygiene,LappropLfoodLandLwaterL
precautions,LvisitorLeducation,LnoLflowersLorLplants,LandLpossibleLabxLprophyL(forLinfectionsLthatLmightLrea
ctivateLorLhigh-riskLforLpneumocystis)
MycoplasmaLspp.L-LANSWERLNoLcellLwallL--
>LlimitedLabxLchoices.LCauseLatypicalLpneumonia.LUsuallyLdiagnosedLbyLserology
,ChlamydiaeL-
LANSWERLobligateLintracellularLparasites.LElementaryLbody=infectious,Lreticulated=Lintracellular.LDFALorLEL
ISALforLdetectionLofLantigenLisLmostLcommon.LCanLalsoLdetectLantibodies.
RickettsiaeL-
LANSWERLobligateLintracellularLparasites.LarthropodLvectors.LRarelyLculturing;LdetectedLbyLserologyLusingLE
LISALforLantibodies.
TextbookLviralLreplicationLcycleL-
LANSWERL1.LAttachmentL2.Lpenetration/entryL3.LreplicationL4.Lmaturation/assemblyL5.Lrelease
SensitivityL-LANSWERL%LofLtrueL+LwhoLtestL+;LinherentLtoLtest
SpecificityL-LANSWERL%LofLtrueLnegLwhoLtestLneg;LinherentLtoLtest
PPVL-
LANSWERLLikelihoodLthatLaL+LtestLrepresentsLaLtrueLcaseL(%LT+/all+);LdependsLonLtheLtestLandLonLprevalenc
eLofLdiseaseLinLpopulation
NPVL-LANSWERLLikelihoodLthatLaLnegativeLtestLresultLisLaLtrueLnon-
caseL(%TN/allN);LdependsLonLtestLandLpopulationLprevalence
CSFLanalysis-LbacterialLmeningL-LANSWERL1000-
5000LWBCs,LmostlyLPMNs.LIncreasedLpressure.LIncreasedLproteinL.LDecreasedLglucose.LBacteriaLseenLonLs
mears.
CSFLanalysis-LviralLmeningL-
LANSWERLPressure,LglucoseLnormal.LLymphocytesLseen,LbutLfewLWBCLinLgeneral.LProteinLnormal-
elevated.LNothingLonLsmears.
CSFLanalysis-LfungusLmeningL-
LANSWERLPressureLvariable.LGlucoseLlow,LproteinLhigh.LWBCsLvary,LbutLlymphocytesLpredominate.LIndiaLin
kLsmearL+.
, CSFLanalysis-LTBLmeningL-
LANSWERLPressureLvariable.LGlucoseLlowLtoLmegalow.LWBCsLvary,LmostlyLlymphocytes.LProteinLelevated.LA
FBLstainL+
ColdLAgglutininsLtestL-
LANSWERLUsedLtoLdetectLantibodiesLforLMycoplasmaLpneumoniaeLorLmononucleosis.LPositiveLtestLisLhighLti
ter,LwithLrespLSxLindicatesLM.LpneumoLinfection,LviralLpneumo,LorLprimaryLatypicalLpneumo
CRPLtestL-
LANSWERLSerumLsampleLlookingLforLtheLCRLprotein;LnormalLvalueLisLnoneLorLlowLCRP.LIndicatesLcurrentLacu
teLinflammation
LiverLFunctionLTestsL-
LANSWERLchemistryLassaysLonLblood;LlookingLforLvariousLthingsLincludingLenzymes,Lbilirubin,Lammonia,Lan
dLalbumin.LGenerallyLhigherLisLworse.LHelpsLdetectLliverLproblems,LdifferentiateLamongLliverLproblems,Lme
asureLliverLdamage,LandLfollowLresponseLtoLTx.
ArterialLBloodLGasL(ABG)L-
LANSWERLbloodLfromLartery,LmeasuresLoxygenLandLCO2Ltension,LpH.LAssessesLgasLexchange,LwhichLisLhelpf
ulLinLrecognizingLpneumonia
SedimentationLrateL-
LANSWERLMeasuresLrateLofLRBCsLsinking;LfasterLindicatesLacuteLinfection/inflammationL(amongLotherLthin
gs,LisLnotLveryLspecific)
ToxinLproductionLtestsL-
LANSWERLManyLwaysLofLdoing,LincludingLEIALandLHPLC.LlimulusLamebocyteLlysateLtestsLforLendotoxin.
Weil-FelixLagglutinationL-
LANSWERLSerum,LtestLforLrickettsialLantibodies.LHighLtiterLorL4xLriseLinLtiterLindicatesLrickettsialLinfection.
UrinalysisL-
LANSWERLMultipleLtests.LNormalLhasLvariousLchemistryLvaluesLandLshouldLhaveLnoLorLfewLcells.LHighLWBCs,
LleukocyteLesterase,LandLnitriteLindicateLinfection.
