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FINAL EXAMINATION JANUARY 2014 SEMESTER COURSE COURSE CODE DURATION FACULTY PROGRAMME LECTURER : : : : : CLINICAL MICROBIOLOGY I MLD 2143 2 HOURS 30 MINUTES BIOMEDICAL AND HEALTH SCIENCES DIPLOMA IN MEDICAL LABORATORY TECHNOLOGY : MR. MOHD AMIR ABDULLAH INSTRUCTIONS TO CANDIDATES This paper consists of three (3) sections: Section A – 30 questions (multiple choice questions) Section B – 3 questions (short answer questions) Section C – 3 questions (essay questions) Answer all questions in Section A and B and only two (2) questions in Section C. All answers of: Section A must be written in OMR objective paper provided. Section B must be written in answer booklet provided. Section C must be written in answer booklet provided. The answer for each question must start on a new page. Formula and table are provided at the end of question paper. Candidates are allowed to use calculator. Candidates are NOT ALLOWED to bring any unauthorized items into the exam hall except with the permission of your invigilator. Do Not Open the Question Paper Until Instructed This Question Paper Consists of Nine (9) Printed Pages CONFIDENTIAL FBHS/MLD2143/JAN2014 PART A: MULTIPLE CHOICE QUESTIONS (30 MARKS) Choose ONE best statement to answer the questions. 1. The bacterial species that has cocci in chain is (A) (B) (C) (D) Streptococcus spp. Pneumococcus spp. Staphylococcus spp. Corynebacterium spp. 2. A known culture of Salmonella typhi appears pink in Gram stain and bacilli in shape. This result could be (A) (B) (C) (D) incorrect as the bacteria are not bacilli correct as the bacteria is Gram negative incorrect as the bacteria is Gram positive correct because the bacteria show variability in colour and shape 3. In slide preparation for staining, what is the process that allows the bacterial cells to adhere to the glass slide? (A) (B) (C) (D) fixation smearing counterstaining decolourization 4. By definition, a bacterial isolate is Staphylococcus aureus if it (A) (A) (B) (C) ferments glucose produces coagulase produces free catalase produces hemolysis in blood agar 5. Which of the following statement is TRUE? (A) (B) (C) (D) Staphylococcus pyogens is resistant to 5µg bacitracin. Streptococcus viridans produces gamma hemolysis on blood agar. Catalase test is used to differentiate Streptococcus pneumonia from Streptococcus agalactiae. Novobiocin test is used to differentiate Staphylococcus epidermidis from Staphylococcus saprophyticus. CONFIDENTIAL/2 FBHS/MLD2143/JAN2014 6. Staphylococcus aureus can be differentiated from Streptococcus pyogens using the following test (A) (B) (C) (D) motility catalase oxidase coagulase 7. The Lancefield grouping of Streptococcus pyogenes is a (A) (B) (C) (D) Lancefield Group A Lancefield Group B Lancefield Group C Lancefield Group D 8. Which of the following is TRUE about Neisseria gonorrhoea? (A) (B) (C) (D) It is a Gram positive It can produce oxidase It is a bacillus in shape It metabolizes maltose and sucrose 9. Culture on Modified Thayer Martin (MTM) medium of a vaginal swab produced several colonies of Gram-negative diplococci that are oxidase positive. Given the following carbohydrate reactions. In the table 1, select the most likely causative organism. Carbohydrates Reaction Glucose Sucrose Lactose Maltose Result Positive Negative Negative Positive Table 1 (A) (B) (C) (D) Salmonella enteric Moraxella catarrhalis Neisseria meningitidis Corynebacterium diphteriae 10. Tellurite medium is normally used to isolate (A) (B) (C) (D) Staphylococcus aureus Neisseria gonorrhoeae Haemophilus parainfluenzae Corynebacterium diphtheriae CONFIDENTIAL/3 FBHS/MLD2143/JAN2014 11. Which of the following medium is NOT a transport media for Vibrio cholera? (A) (B) (C) (D) Cary-Blair Medium Loeffler’s serum slope Alkaline peptone water Venkatraman-Ramakrishnan medium 12. A bacteria which can be cultured on Skirrow’s medium, Gram-negative bacilli, actively motile, oxidase positive and identified by failure to grow at 25 °C is (A) (B) (C) (D) Vibro cholerae Echerichia coli Campylobacter jejuni Propionibacterium granulosum 13. Which of the following organisms requires "X (haemin)" factors for growth? (A) (B) (C) (D) Haemophilus ducreyi Haemophilus influenza Haemophilus parainfluenzae Haemophilus parahaemolyticus 14. The colonies that exhibit satellite formation near colonies of staphylococci belong to (A) (B) (C) (D) Shigella boydii Streptococcus pyogens Haemophilus influenza Neisseria gonorrhoeae 15. All Enterobacteriaceae share all of the following characteristics EXCEPT (A) (B) (C) (D) Gram negative ferment glucose oxidase negative reduce nitrates to nitrites CONFIDENTIAL/4 FBHS/MLD2143/JAN2014 16. Which of the following is FALSE about Proteus vulgaris? (A) (B) (C) (D) A Gram-negative bacilli A non lactose fermenting organism A non glucose fermenting organism An organism can produced swarming growth on blood agar medium 17. The Shigella boydii (A) (B) (C) (D) is motile can produce gas can produce hydrogen sulfide is a glucose fermenting organism 18. An organism isolated from urine is non lactose fermenting, Gram-negative bacilli, motile, capsulated and appeared as swarming growth colonies on blood agar. Figure 1 What is the presumptive identification of the organism described in figure 1? (A) (B) (C) (D) Proteus mirabilis Moraxella catarrhalis Listeria monocytogens Klebsiella pneumoniae 19. Which of the following is the characteristic genus Mycobacterium? (A) (B) (C) (D) is a cocci is a motile is an anaerobic has high cell wall lipid content 20. Dorset Egg and Lowenstein-Jensen medium are enriched media which is used to isolate (A) (B) (C) (D) Bacillus anthracis Salmonella bongori Actinomyces israelii Mycobacterium tuberculosis . CONFIDENTIAL/5 FBHS/MLD2143/JAN2014 21. The growth of Mycobacterium tuberculosis in the laboratory will normally take between (A) (B) (C) (D) 4-6 days 4-6 hours 4-6 weeks 4-6 months 22. Which of the following stain is required to prepare smear of sputum suspected of Mycobacterium leprae? (A) (B) (C) (D) Indian ink Gram stain Ziehl-Nielson Acid fast stain 23. Which of the following organisms is the aetiological agent for acne? (A) (B) (C) (D) Actinomyces species Staphylococcus species Peptotreptococcus species Propionibacterium species 24. Treponema pallidum can cause (A) (B) (C) (D) syphilis meningitis otitis media tuberculosis 25. Which of the following characteristic describe the Leptospira interrogans? (A) (B) (C) (D) non motile cocci bacteria Gram-positive seen under Dark Ground Microscope 26. Which disease is detected by the Wasserman complement fixation test? (A) (B) (C) (D) Leprosy Syphilis Diarrhoea Tuberculosis CONFIDENTIAL/6 FBHS/MLD2143/JAN2014 27. Which of the following is TRUE about Mycoplasma pneumoniae? (A) (B) (C) (D) It can be stained with Dienes stain It’s normal flora in the human lungs It can be transmitted to by insect bites It cannot hemolyze guinea pig red blood cells 28. Which of the following staining techniques is commonly used to identify Chlamydia trachomatis? (A) (B) (C) (D) Gram stain Diene’s stain Giemsa stain Acid-fast stain 29. When stained this organism is large, gram positive rods with square end, found in chains, non motile and has antiphagocytic capsule composed of D-glutamate. It’s causes anthrax. Figure 2 What is the presumptive identification of the organism described in figure 2? (A) (B) (C) (D) Bacillus antracis Campylobacter jejuni Neisseria gonorrhoeae Listeria monocytogenes 30. Which of the following staining techniques is commonly used to identify Corynebacterium diphtheriae? (A) (B) (C) (D) Albert stain Acid fast stain Warthin-starry silver stain Haematoxylin-Eosin stain CONFIDENTIAL/7 FBHS/MLD2143/JAN2014 PART B: SHORT ANSWER QUESTIONS (30 MARKS) Answer ALL questions. 1. a. Draw and name morphology of bacteria according to shape. (6 Marks) b. Briefly explain the general steps in diagnostic isolation and identification of bacteria. (4 Marks) 2. a. Determine FOUR (4) basic biochemical tests. (2 Marks) b. Briefly explain the purpose and the principle of FOUR (4) basic biochemical tests. (8 Marks) 3. a. Determine the general characteristics of the Escherichia Coli. (5 Marks) b. Briefly describe the laboratory diagnosis to detect Klebsiella pneumoniae. (5 Marks) CONFIDENTIAL/8 FBHS/MLD2143/JAN2014 PART C: ESSAY QUESTIONS (40 MARKS) Answer TWO (2) questions only. Question 1 Discuss and draw the schematic diagram for the identification Streptococcus species and describe the appearances of alpha, beta and gamma haemolysis on blood agar. Give ONE (1) example of an organism for each of the haemolysis. (20 marks) Question 2 Describe the general characteristics, method of acquiring and laboratory investigation of Salmonella enterica. (20 marks) Question 3 Describe important properties of Haemophilus influenzae including staining and morphological characteristics and laboratory investigation. (20 Marks) END OF QUESTION PAPER CONFIDENTIAL/9