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Quizzes > Health & Medicine

Chain of Infection Quiz: 6 Links and Modes of Transmission

Quick, free quiz on the six links of infection with instant results.

Editorial: Review CompletedCreated By: Vinay NegiUpdated Aug 27, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art chain with six links and a broken link representing infection transmission and prevention on dark blue background

This quiz helps you practice the chain of infection, from agent to susceptible host, and see how the six links and modes of transmission connect. Use it to check what you know before class or an exam, then reinforce infection control with the sterile processing quiz and improve safety with a sharps safety quiz. For broader context, compare disease types in the communicable vs ncd quiz.

Which list correctly names all six links in the chain of infection?
Pathogen, immunity, vector, symptoms, treatment, recovery
Reservoir, exposure, prophylaxis, isolation, sanitation, recovery
Infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host
Exposure, incubation, illness, decline, convalescence, immunity
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Which is the most likely portal of exit for influenza virus?
Skin desquamation from the feet
Respiratory droplets expelled from the nose and mouth
Blood from a needlestick
Urine from the bladder
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Tetanus typically enters the body through contaminated wounds. This describes which link?
Reservoir
Portal of exit
Portal of entry
Mode of transmission
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An N95 respirator is specifically intended to interrupt which mode of transmission?
Airborne transmission
Vehicle-borne transmission
Vector-borne transmission
Direct contact transmission
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Administering measles vaccine most directly targets which link of the chain of infection?
Susceptible host
Portal of exit
Reservoir
Mode of transmission
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Foodborne Salmonella from undercooked poultry illustrates which mode of transmission?
Vector-borne transmission
Direct contact transmission
Airborne transmission
Vehicle-borne transmission
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Which is NOT one of the six links of the chain of infection?
Incubation period
Mode of transmission
Reservoir
Portal of exit
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A standing puddle contaminated with Leptospira after animal urine is best classified as which link?
Portal of entry
Susceptible host
Mode of transmission
Reservoir
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For Clostridioides difficile, which measure most directly breaks the mode of transmission link in healthcare settings?
Providing N95 respirators to visitors
Administering influenza vaccine
Using sterile technique for surgery
Handwashing with soap and water after patient contact
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Norovirus spread when a person touches a contaminated doorknob and then their mouth is best described as which mode?
Airborne transmission
Vector-borne transmission
Indirect contact (fomite) transmission
Direct contact transmission
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In malaria, humans who harbor Plasmodium parasites in blood and liver primarily constitute which link of the chain of infection?
Portal of exit
Reservoir
Portal of entry
Susceptible host
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Placing a mask on a coughing patient in the waiting room primarily breaks which link?
Reservoir
Susceptible host
Portal of entry
Portal of exit
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Using sterile instruments for a surgical procedure primarily disrupts which link?
Portal of exit
Reservoir
Susceptible host
Mode of transmission (vehicle)
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Which situation exemplifies droplet transmission rather than airborne transmission?
Measles spread across a clinic via aerosols
Tuberculosis spread through droplet nuclei over long distances
Histoplasmosis acquired from aerosolized spores in caves
Influenza spread within 3 to 6 feet via respiratory droplets
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A closed container system that prevents aerosol release during sputum collection is designed to control which link?
Susceptible host
Portal of exit
Reservoir
Portal of entry
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A patient colonized (not infected) with MRSA in the nares represents which link in the chain?
Portal of entry
Reservoir
Susceptible host
Mode of transmission
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Placing a TB patient in a negative-pressure airborne infection isolation room primarily addresses which link?
Susceptible host
Portal of entry
Reservoir
Mode of transmission (airborne containment)
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Which control best targets the infectious agent link itself?
Sterilization of reusable medical devices
Patient cohorting by symptom
Hand hygiene before patient contact
Visitor screening for fever
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Negative-pressure rooms protect the susceptible host by pulling air from hallways into the isolation room.
True
False
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Which occupational control most directly reduces exposure to bloodborne pathogens during venipuncture?
Providing visitor masks
Using safety-engineered, retractable needles
Posting handwashing signs
Cohorting patients by diagnosis
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Study Outcomes

  1. Identify the 6 links in the chain of infection -

    Recognize and name each of the 6 links in the chain of infection, from the infectious agent and reservoir to the portal of entry and susceptible host.

  2. Describe the portal of entry chain of infection -

    Explain how pathogens gain access to the host through various portals of entry and why this step is critical in disease development.

  3. Analyze modes of transmission in the chain of infection -

    Differentiate between direct and indirect mode of transmission chain of infection and assess how each contributes to the spread of pathogens.

  4. Outline strategies to break the chain of infection -

    Apply targeted interventions at each step of the chain to prevent transmission and reduce infection risk in clinical and community settings.

  5. Evaluate risk factors for infection spread -

    Assess host, environmental, and agent-related factors that influence infection transmission and develop prevention plans accordingly.

  6. Test your knowledge with real-world scenarios -

    Use our interactive quiz to reinforce your understanding of the steps of chain of infection and sharpen your clinical decision-making skills.

Cheat Sheet

  1. Understanding the 6 Links in the Chain of Infection -

    The chain of infection is a model of six interconnected steps - infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host - that explain how pathogens spread (CDC, 2023). Visualize the steps of chain of infection using the mnemonic "I-REMP-H" (Infectious agent, Reservoir, Exit, Mode, Portal, Host) to remember each link. Mastering this overview helps you pinpoint where to break the cycle.

  2. Infectious Agent and Reservoir Dynamics -

    Not all microbes are equally virulent; characteristics like ability to survive outside a host and infectious dose determine risk (WHO, 2022). Recognize common reservoirs - humans, animals, soil, water - and link them to specific pathogens (e.g., Legionella in water systems). A quick mnemonic is "HASP" (Human, Animal, Soil, Pool) to recall reservoir types.

  3. Portal of Exit and Portal of Entry Chain of Infection -

    Portals of exit (e.g., respiratory droplets, blood) allow pathogens to leave their reservoir, while portals of entry (e.g., mucous membranes, breaks in skin) let them invade a new host (Johns Hopkins Medicine, 2021). Matching exit and entry sites - such as droplet exit/inhalation entry - clarifies transmission risk. Remember "SEE" (Skin, Eyes, Ears) to list major entry points quickly.

  4. Mode of Transmission Chain of Infection -

    Pathogens can spread via direct contact, indirect contact (fomites), droplet, airborne, or vector-borne routes (mode of transmission chain of infection) according to epidemiological studies (NEJM, 2020). Use the acronym "DIDAV" (Direct, Indirect, Droplet, Airborne, Vector) to categorize modes swiftly. Understanding each mode guides targeted prevention measures like PPE or environmental controls.

  5. Strategies to Break the Chain of Infection -

    Interventions - such as hand hygiene at the portal of exit, disinfection of reservoirs, barrier methods at portals of entry, and immunization of susceptible hosts - interrupt transmission (NIH, 2021). Apply the "SAFE" approach: Sanitize, Apply barriers, Filter air, and Educate patients to cover all six links. Consistent use of these steps of chain of infection reduces nosocomial and community infections.

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