Paper II — 2025 March (Supplementary (SAY)) (2019 Scheme) — Q4
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Paper II
2025 March (Supplementary (SAY)) (2019 Scheme) · 100 marks · 180 min
Question
A 25 year old presented to the emergency with breathlessness, cough and fever since five days.
The CT of the chest revealed bilateral ground glass opacities. A working diagnosis of viral
pneumonia was made and samples were sent for confirmation of the etiological agent.
(a) What are the samples to be collected and tests performed for confirming the diagnosis of
COVID-19 (1+2) 1 mark(s)
(b) What are the precautions to be taken for sample collection. Add a note on transmission based
precautions in the community. 2 mark(s)
Q43 marksShort Essays
Answer
(a) Samples and tests for confirming COVID-19: the standard sample is a nasopharyngeal (or combined nasopharyngeal/oropharyngeal) swab, placed in viral transport medium. Confirmatory tests: RT-PCR — detects SARS-CoV-2 RNA, the diagnostic gold standard, highly sensitive/specific; Rapid antigen test — faster, lower-cost, but meaningfully less sensitive, particularly in early/low-viral-load infection, so more suited to quick screening/serial testing than as a single definitive rule-out test.
(b) Precautions for sample collection and transmission-based precautions:
Sample collection precautions: the healthcare worker should wear appropriate PPE (N95 respirator, given the aerosol-generating nature of nasopharyngeal swabbing, along with eye protection/face shield, gown, and gloves); collection should be performed in a well-ventilated area or, ideally, a room with adequate air exchange; hand hygiene before and after the procedure; safe disposal of used swabs/PPE as biomedical waste; and correct swab technique to avoid contaminating the sample or the collector.
Transmission-based precautions in the community: SARS-CoV-2 spreads predominantly via respiratory droplets and aerosols, so community-level precautions include: mask usage (particularly in crowded/poorly ventilated indoor settings), physical/social distancing, hand hygiene, isolation of confirmed/suspected cases for the recommended period, quarantine of close contacts, avoidance of large gatherings during periods of high transmission, and improved ventilation of indoor spaces — reflecting the shift in understanding toward aerosol transmission (not just larger droplets) that emerged over the course of the pandemic, prompting revised guidance emphasizing ventilation alongside masking.
