Download Medical Microbiology II - E

ELECTIVE III - A MEDICAL MICROBIOLOGY – II
Mrs. T. DHANALAKSHMI
III UG MICROBIOLOGY
.UNIT- I Mycology: superficial infections- Dermatophytes- Microsporum –
Trichophyton,Epidermophyton- Madura mycosis- Opportunistic fungal infections- Candida
albicans, Aspergillus, Mucor.
Section A
1.
2.
3.
4.
5.
6.
Which of the following fungi is most likely to be found within reticuloendothelial cells.
a. Histoplasma Capsulatum
b. Sporothrix Schenckii
c. Cryptococcus neoformans
d. Candida albicans
Aspergillosis is recognized in tissue by the presence of
a. Metachromatic granules
b. Psuedohyphae
c. Septate hyphae
d. Budding cells
Fungi often colonize lesions due to other causes. Which of the following is least likely to
be present as colonizer
a. Candida
b. Sporothrix
c. Mucor
d. Aspergillus
A girl who pricked her finger while pruning some rose bushes develops a local pustule
that progresses to an ulcer. Several nodules then develop along the local lymphatic drainage.
The most likely agent is
a. Aspergillus fumigatus
b. Sporothrix schenckii
c. Cryptococcus neoformans
d. Candida albicans
Immunocompromised persons are suffered from several fungal diseases. Which of the
following is the least frequently associated
a. Cryptococcus neoformans
b. Aspergillus fumigatus
c. Malassezia furfur
d. Mucor species
Each of the following statements concerning Cryptococcus neoformans are correct
EXCEPT
a. Its natural habitat is the soil, especially associated with pigeon feces
b. Budding yeasts are found in the lesions
c. The initial site of infection is usually the lung
d. Pathogenesis is related primarily to the production of exotoxin A.
7.
Fungal cells that reproduce by budding are seen in the infected tissues of patients with
a. Candidiasis, cryptococcosis, and sporotrichosis
b. Mycetoma, candidiasis and mucormycosis
c. Tinea corporis, tinea unguium, and tinea versicolor
d. Sporotrichosis, mycetoma and aspergillosis
8.
Which of the following is not the characteristics of histoplasmosis
a. Person to person transmission
b. Specific geographic distribution
c. Yeasts in tissue
d. mycelial phase in the soil
9.
Infection with dermatophyte is most often associated with
a. intravenous drug abuse
b. inhalation of the organism from contaminated bird feces
c. adherence of the organism to perspiration moist skin
d. Fecal-oral transmission
10.
Each of the following statements concerning Candida albicans is correct except
a. C. albicans is a budding yeast that forms psuedohyphae when it invades tissue
b. C. albicans causes thrush
c. C. albicans is transmitted primarily by respiratory aerosol
d. Impaired cell mediated immunity is an important predisposing factor to disease
11.
Saprophytic fungi
a. engulf their food in order to break it down
b. secure their food from dead organic materials
c. Both
d. None
12. The fruiting body of a mushroom is called
a. Sorocarps b. Basidiocarps c. Ascocarps d. all
13. The amount of phagocytosis done by the Plasmodium
a. is greater than by the water mold mycelium
b. is lesser than by the water mold mycelium
c. is equal to by the water mold mycelium
d. None
14. Water molds belong to which division?
a. Ascomycota b. Oomycota c. Basidiomycota d. None
15. __________ produce basidiospores
a. Slime molds b. Dimorphic fungi c. Club fungi d. all
16. Which fungus causes mycoses of the hair, skin, and nails?
a. Cryptococcus b. Sporothrix c. Aspergillis d. All dermatophytes
17. A true fungal pathogen must exhibit what characteristic?
a. Produce spores b. Produce mycelia c.Thermal dimorphism d. Be distributed
worldwide
18. What are the most prevalent of all fungal infections?
a. Dermatophytoses b. Histoplasmosis c. Candidiasis d. all
19. Where do Aspergillus infections usually occur?
a. Skin b. Nail c. Lungs d. Hair
20. What is the reservoir for Cryptococcus neoformans?
a. Pigs b. Human c. Birds d. None
Section B
1. Briefly discuss pathogenesis of Aspergillosis.
2. List out the ringworm disease caused by dermatophytes.
3. Explain about the superficial infection of fungi.
Section C
1. Comprehensive the pathogenesis, laboratory diagnosis and etiology of Candida albicans
2. Explain about the Mucor.
UNIT -II
Parasitic diseases- Entamoeba histolytica, Giardia, Taenia solium, Ascaris, Enterobius, Trichuris
trichura, Plasmodium vivax, Wuchereria bancrofti
Section A
1.
Which of the following agent is used to prevent Malaria
a. Mebendazole
b. Chloroquine
c. Inactivated vaccine
d. Zinc table
2.
Each of the following statements concerning Ascaris lumbricoides is correct except:
a. Ascaris lumbricoides is one of the largest nematode
b. Ascaris lumbricoides can cause pneumonia
c. Both dogs and cats are intermediate host of Ascaris lumbricoides
d. A lumbricoides is transmitted by ingestion of eggs
3.
Each of the following statements concerning kala-azar is correct except:
a. Kala-azar is caused by leishmania donovani
b. kala-azar is transmitted by the bite of sandflies
c. Kala-azar occurs primarily in rural latin America
d. Kala-azar can be diagnosed by finding amastigotes in bone marrow
4.
Each of the following statements concerning hookworm infection is correct except:
a. Hookworm infection can cause pneumonia
b. Hookworm infection is acquired by humans when filariform larvae penetrate the skin
c. Hookworm infection is caused by Necatar americanus
d. Hookworm infection can be diagnosed by finding the trophozoite in the stool
5.
Each of the following statements concerning Trichomonas vaginalis is correct except:
a. T. vaginalis is transmitted sexually
b. T. vaginalis can be diagnosed by visualizing the trophozoite
c. T. vaginalis can be treated effectively with metronidazole
d. T. vaginalis causes bloody diarrhea
6.
Each of the following statements concerning Giardia lamblia is correct except:
a. G. lamblia has both a trophozoite and cyst stage in its life cycle
b. G. lamblia is transmitted by the fecal oral route from both human and animal sources
c. G. lamblia causes hemolytic anemia
d. G. lamblia can be diagnosed by the string test
7.
Each of the following statements concerning Malaria is correct except
a. The female anopheles mosquito is the vector
b. Early infection, sporozoites enter hepatocytes
c. Release of merozoites from red blood cells cause fever and chills
d. The principal site of gametocyte formation is the human gastrointestinal tract.
8. Each of the following parasite is transmitted by mosquitoes except:
a. Leishmania donovani
b. Wuchereria bancrofti
c. Plasmodium vivax
d. Plasmodium falciparum
9.
Pigs or dogs are the source of human infection by each of the following parasites except:
a. Echinococcus granulosus
b. Taenia solium
c. Ascaris lumbricoides
d. Trichinella spiralis
10.
In malaria, the form of plasmodia that is transmitted from mosquito to human is the
a. Sporozoite
b. Gametocyte
c. Merozoite
d. Hypnozoite
11.
All protozoan pathogens have a ……………… phase.
a. cyst b. sexual c. trophozoite d. blood
12. Which species of Trypanosoma is not a human pathogen?
a.T.cruzi b. T.rangeli c. T.gambiense d. T. Rhidesiense
13. A malarial infected person by blood transfusion does not have ………… in his body.
a. hypnosoite b. trophozoite c. schizont d. gametocyte
14. Rosette in RBC is a specific shape of ………… .
a. P.vivax b. P.falciparum c. P.ovale d. P.malariae
15.. ……………….. enzymes may be destroyed in infected persons by Giardia lamblia.
a. Lipase b. Cytolysin c. Collagenase d. Phosphatase acid
16. What is the pathogenic agent responsible for chiclero ulcer?
a. L.tropica b. L.major c. L.mexicana d. L.braziliensis
17. Which disease is related to Winterbottom’s sign?
a. Sleeping sickness b. Chagas disease c. Kalaazar d. Toxoplasmosis
18. Which of the following items is more important for differentiation between Entamoeba
histolytica and Entamoeba dispar?
a. Genomic methods b. Inoculation to specific culture media
c. Electron microscopic examination d. All items are correct
19. What is the result of exflagellation of Plasmodium?
a. Microgamet b. Micrgametocyte
c. Macrogamet d.Macrogametocyte
20. Which one is not zoonosis?
a. Cryptosporidium parvum b. Entamoeba histolytica
c. Balantidium coli d. Toxoplasma gondii
21. Which parasite is related to Oriental sore?
a. L.aethiopica b. L.infantum c. L.tropica d. L.donovani
22. Which parasitic form is related to congenital toxoplasmosis?
a. Tachyzoite b. Trophozoite c. Oocyst d. Tissue cyst
23. Flask shaped ulcers in human intestine are related to ………………….. .
a. Giardiasis b. Cryptosporidiosis c. Cyclosporidiasis d. Amoebiasis
24. Trophozoites of Toxoplasma gondii multiply by ……………….. .
a. Endodyogeny b. Schizogoni c. Binary fission d. Sporogony
25.Which form of leishmania is injected to animal model for
a. Epimastigote b. Trypomastigote c. Promastigote d. Amastigote
lishmanization?
Section B
1.
2.
3.
4.
Explain about the Entamoeba histolytica life cycle and pathogensis.
Describe the etiology of Giardia.
Write about the life cycle of Wuchereia bancrofti.
What is the pathogenesis of Trichuris trichura.
Section C
1. Explain about the Ascaris.
2. Explain about the Taenia solium life cycle, pathogesis and diagnosis.
3. Write about the enterobius and plasmodium vivax.
UNIT -III
Etiology and laboratory diagnosis of Urinary tract infection- Meningitis, Diarrhea, Respiratory
tract infections.
1. The most frequent bacterial cause to be considered is________________.
S. pyogenes. Corynebacterium diphtheriae,
2. What is Diagnosis?
(a) Identification of Diseases (b)Treatment for Diseases (c) Investigation with patients
Ans :a
2.Which one of the following will contaminate the specimen?
(a) Microorganism in Soil (b) Normal micro flora (c) Microorganism in an equipment
Ans :b
3. Whose role should be clearly defined in a written format in medical laboratory?
(a) Clinicians (b) Investigator/Physician(c) Patient
6.Which organism can cause Meningitis?
(a) Staphylococcus spp (b) Neisseria spp(c) None
Ans :b
7. Which of the following bacteria is not associated with Urinary Tract Infections?
(a) E.coli (b) Shigella sp (c) Lactobacilli sp
Ans :c
8. Which is the most specimen/sample collected for Streptococcal infection?
(a) Throat swab (b) Nose swab (3) pus
9. Which of the following represents a molecular method of testing?
(a) Microscopy (b) Selective media (c)DNA probe testing
Ans :c
10. The clinical microbiologist identifies agents and organisms based on which of the following?
(a) Microbiological examination (b) Sero diagnosis (c) Both
Ans :c
11.Which of the following would be used to collect urine specimens?
(a) Clean catheter (b) Clean beaker (c)None of the above
Ans :a
12. Which is the most common specimen collected in suspected cases of lower respiratory
infections?
(a) Saliva (b) Sputum (c) Throat swab
Ans :b
13.Each of the following agents is a recognized cause of diarrhea except
(a) Clostridium perfringens (b)Enterococcus faecalis (c) Vibrio cholerae (d) Escherichia coli
Ans :b
14. For liquifying Sputum sample _____ has been used.
(a) N acetyl (b) Saline (c) Both (d) None
Ans :a
15.The identification of bacteria by serologic tests is based on the presence of specific antigens.
Which of the following bacterial components is least likely to contain useful antigens?
a. Ribosomes
b. Cell wall
c. Capsule
d. Flagella
16 .Each of the following statements concerning the Gram stain is correct except:
a. Escherichia coli stains pink because it has a thin peptidoglycan layer
b. Streptococcus pyogens stains blue because it has a thick peptidoglycan layer
c Mycoplasma pneumoniae is not visible in the Gram’s stain because it does not have a cell wall
d. Mycobacterium tuberculosis stains blue because it has a thick lipid layer
17. An outbreak of sepsis caused by Staphylococcus aureus has occurred in the newborn
nursery. You are called upon to investigate. According to your knowledge of the normal flora,
what is the most likely source of the organism?
a. Nose
b. Colon
c. Vagina
d. Throat
18. Each of the following organisms is an important cause of urinary tract infections except:
a. Klebsiella pneumoniae
b. Escherichia coli
c. Bacteriodes fragilis
d. Proteus mirabilis
19.A 30 year old woman has non bloody diarrhea for the past 14 hours. Which one of the to
following organisms is least likely to cause this illness?
a. Streptococcus pyogens
b. Clostridium difficile
c. Shigella dysenteriae
d. Salmonella enteritidis
20.Each of the following agents is a recognized cause of diarrhea except
a. Clostridium perfringens
b. Vibrio cholerae
c. Enterococcus faecalis
d. Escherichia coli
Section B
1. Give general discuss on the UTI.
2. Explain about the Upper RTI and causes diseases.
3. Write about the lower RTI.
Section C
1. Give detail an account on etiology and laboratory diagnosis of UTI to causes Meningitis
and Diarrhea.
UNIT -IV
Pyogenic infections- Staphylococcus and Pseudomonas: Sexually Transmitted Diseases
Bacteria), Nosocomial infections - definition, sources and detection; phage typing, Bacteriocin
typing.
Section A
1. Each of the following statements about the classification of streptococci is correct except
a. Pneumococci (Streptococcus pneumoniae) are alpha-hemolytic and can be serotyped on the
basis of their polysaccharide capsule
b. Enterococci are group D streptococci and can be classified by their ability to grow 6.5%
sodium chloride
c. Viridans streptococci are identified by Lancefield grouping, which is based on the C
carbohydrate in the cell wall
d. Although pneumococci and the viridans streptococci are alpha-hemolytic, they can be
differentiated by the bile solubility test and their susceptibility to optochin
2. Which of the following bacteria has the lowest 50% infective dose (ID50)?
a. Campylobacter jejuni
b. Salmonella typhi
c. Vibrio cholerae
d. Shigella sonnei
3. Which of the following disease is best diagnosed by serologic means?
a. Pulmonary tuberculosis
b. Gonorrhea
c. Actinomycosis
d. Q Fever
4. The cogulase test is used to differentiate
a. Staphylococcus epidermidis from Neisseria meningitidis
b. Staphylococcus aureus from Staphylococcus epidermidis
c. Streptococcus pyogens from Staphylococcus aureus
d. Streptococcus pyogens from Enterococcus faecalis
5. Burn patients often develop nosocomial infection caused by?
(a) Corynebacterium spp (b)Staphylococcus aureus (c) Candida albicans.
Ans :b
6.. Clinical microbiology laboratory should contains how many sections?
(a) Seven (b) Eight (c) Ten
Ans :a
7.Which of the following bacteria is not a most common bacterial pathogen causing diarrhea?
a. Shigella spp b. Salmonella spp c. Enterococcus faecalis d. Campylobacter
8.Which of the following bacteria is rarely associated with Urinary Tract Infections?
a. E.coli b. Enterobacter spp c. Proteus spp d. Shigella spp
9. Which of the following statement regarding Campylobacter jejuni is not correct?
a. It is commonly cultured in antibiotic containing media
b. Incubation temperature is 42 Oc
c. It is cultured in an atmosphere containing 5% O2 and 10% CO2
d. It is a normal floraof intestine.
10.Which of the following bacteria is not most important causes of acute bacterial meningitis?
a. Neisseria menigitidis
b. Streptococcus pneumoniae
c. Haemophilus influenzae
d. Streptococcus pyogens
11.Which of the following Gram negative rod is not a blood borne bacterial pathogen?
a. Shigella spp
b. Escherichia Coli
c. Klebsiella pneumoniae
d. Pseudomonas aeruginosa
12.Throat culture is not useful to diagnose
a. Streptococcal sore throat
b. Diphtheria
c. Thrush
d. Pneumonia
13.Stool culture is primarily recommended when the complaint is
a. Bloody diarrhea (dysentery, enterocolitis)
b. Watery diarrhea
c. for both bloody and watery diarrhea
d. an indication of anaerobic infection
14.Which of the following bacteria causing sexually transmitted disease can not be grown on
artificial media?
a. Neisseria gonorrhoeae
b. Chlamydia trachomatis
c. Treponema pallidum
d. Both Treponema pallidum and Chlamydia trachomatis
15.Cold agglutinin test is useful for the diagnosis of
a. Mycoplasma pneumoniae
b. H. influenzae
c. N. menigitidis
d. Cryptococcus neoformans
16.Which of the following test is not recommended for the diagnosis of Syphilis?
a. VDRL test
b. Culture
c. FTA-ABS test
d. MHA-TP test
17. Toxic shock syndrome” is caused by the toxin of
1) Staphylococcus aureus (2) Streptococcus pyogenes(3) Vibrio cholerae (4) Candida
18.Causative agent of syphilis
a. T. pallidum (2) T. pertenue (3) T. carateum (4) T. endemicum
19. Specific test for syphilis is
(1) VDRL (2) ELISA (3) FTA (4) None of these
20. Pathogenic Staphylococci produces an enzyme_____
(1) Coagulase (2) Catalase (3) Amylase (4) None of these
Section B
1. Explain about the phage typing.
2. Explain about the pyogenic infection of Staphylococcus
3. Give detail an account on bacteriocin.
Section C
1. Explain about the pyogenic infection of Pseudomonas
2. Discuss on the sexually transmitted diseases by bacteria.
3. Define nosocomial infection , sources and detection.
UNIT –V
Antibiotics and chemotherapeutic agents- Mechanism of actions – Drug resistance –
Antimicrobial susceptibility testing- Disc diffusion- Kirby Bauer method
Section A
1. Sensitivity test can be done to check whether the infectious organism is sensitive to ________
or not?
(a) Antimicrobial agents (b)Environment (c) Temperature
Ans :a
2.. Susceptibility of microbes to antimicrobial agents is determined by ______
(a) Resistance of microbes to antibiotics(b) Sensitivity to antibiotics (c) Both (d)None
Ans :c
3. All of the following antibiotics bind to the 50S subunit of the ribosome thereby inhibiting
proteinsynthesis EXCEPT
a.
Chloramphenicol
b.
Erythromycin
c.
Linezolid
d.
Doxycycline
2.
Pharmacokinetics of doxycycline
a.
b.
c.
d.
3.
20% bound by serum proteins
60-70% absorption after oral administration
Absorption is impaired by divalent cations, Al3+, and antacids
Widely distributed especially into the CSF
Which of the following inhibits DNA gyrase?
4.
a.
Penicillin
b.
Trimethoprim
c.
Chloramphenicol
d.
Ciprofloxacin
Resistance to Penicillin and other  lactams is due to
a.
b.
c.
d.
Modification of target PBPs
Presence of an efflux pump
Inactivation of antibiotics by  lactamase
All of the above
5.
All of the following are recognised adverse effects of isoniazid EXCEPT
6..
a.
Hepatitis
b.
Peripheral neuropathy
c.
Retrobulbar neuritis
d.
 Phenytoin metabolism   Phenytoin blood levels and toxicity
Regarding fluoroquinolones
a.
b.
c.
d.
7.
Ciprofloxacin is ineffective in the treatment of gonococcus
Norfloxacin and Ciprofloxacin are predominantly faecally excreted
Norfloxacin and Ciprofloxacin have long half lives (12 hours)
May damage growing cartilage in children less than 18 years of age
Vancomycin
a.
Is never orally administered as it is poorly absorbed from the GIT
b.
Binds to the 30S unit on the ribosome and inhibits protein synthesis
c.
60% of vancomycin is excreted by glomerular filtration
d.
Adverse reactions to vancomycin are encountered in about 10% of patients
Regarding the “azole” group of antifungals
a.
Fluconazole has low water solubility
b.
Ketoconazole may be given IV/PO
c.
Itraconazole undergoes renal elimination
d.
they work by reduction of ergosterol synthesis by inhibition of fungal
cytochrome P450 enzymes
8.
9.
The fluoroquinolones
a.
b.
c.
d.
10.
May be administered to patients with severe campylobacter infection
Work by inhibiting dihydrofolate reductase
Have little effect against gram positive organisms
Are heavily metabolised in the liver
Clindamycin
a.
Inhibits bacterial cell wall synthesis
b.
Is often used for prophylaxis of endocarditis in patients with Valvular
disease who are undergoing dental procedures
c.
Penetrates through BBB into CSF well
d.
Works well against enterococci and gram negative aerobic organisms
11.
Which of the following is a second generation cephalosporin?
a.
b.
c.
d.
Ceftazidime
Cephalothin
Cefotaxime
Cefaclor
12.
The cephalosporin with the highest activity against gram positive cocci is
13.
a.
Cefaclor
b.
Cephalothin
c.
Cefuroxime
d.
Cefepime
Regarding the penicillins
a.
Penicillin ix excreted into breast milk to levels 3-15% of those present in the
serum
16.
b.
Absorption of amoxyl is impaired by food
c.
Benzathine penicillin is given PO
d.
Penicillins are 90% excreted by glomerular filtration
Rifampicin
a.
Inhibits hepatic microsomal enzymes
b.
Inhibits DNA synthesis
c.
Is bactericidal for mycobacteria
d.
Is not appreciably protein bound
Regarding resistance to antibiotics
a.
Penicillinases cannot inactivate cephalosporins
b.
Macrolides can be inactivated by transferases
c.
Mutation of aminoglycoside binding site is its main mechanism of resistance
d.
Tetracycline resistance is a marker for multidrug resistance
Concerning toxicity of antibiotics
17.
a.
Enamel dysplasia is common with aminoglycosides
b.
Grey Baby Syndrome occurs with rifampicin use
c.
A disulfiram like reaction can occur with macrolides
d.
Haemolytic anaemias can occur with sulphonamide use
Which of the following is considered to be bacteriostatic?
14.
15.
a.
Penicillin
18.
b.
Chloramphenicol
c.
Ciprofloxacin
d.
Cefoxitin
Half life of amphotericin B is
19.
a.
2 seconds
b.
20 minutes
c.
2 hours
d.
2 weeks
Regarding antiseptic agents – all of the following are true EXCEPT
20.
a.
Sodium hypochlorite is an effective antiseptic for intact skin
b.
Potassium permanganase is an effective bactericidal agent
c.
Formaldehyde may be used to disinfect instruments
d.
Chlorhexidine is active against gram positive cocci
Ciprofloxacin
21.
a.
Is a defluorinated analogue of nalidixic acid
b.
Inhibits tropoisomerases 2 and 3
c.
Has no gram positive cover
d.
Has bioavailability of 30%
Flucloxacillin
22.
a.
Is ineffective against streptococci
b.
Is active against enterococci and anaerobes
c.
Blocks transpeptidation and inhibits peptidoglycan synthesis
d.
Is poorly absorbed orally
Aminoglycosides
a.
b.
c.
d.
e.
23.
Have a  lactam ring
Can produce neuromuscular blockade
Are DNA gyrase inhibitors
Normally reach high CSF concentrations
Have good oral absorption but high first pass metabolism
Ribosomal resistance occurs with
a.
b.
c.
d.
e.
Sulphonamides
Penicillin
Fluoroquinolones
Macrolides
Trimethoprim
24.
Regarding antivirals
a.
b.
c.
d.
25.
Delvindine is a nucleoside reverse transcriptase inhibitor (NRTI)
Zidovudine (AZT) is a non nucleoside reverse transcriptase inhibitor (NNRTI)
NRTIs activate HIV-1 reverse transcriptase
NRTIs require intracytoplasmic activation to the triphosphate form
All of the following are true regarding metronidazole EXCEPT
a.
b.
c.
d.
It is used to treat giardia
It causes a metallic taste in the mouth
It inhibits alcohol dehydrogenase
It is used to treat gardnerella
Section B
1.
What is antibiotics? Explain different types.
2.
Expalin about the MIC of antibiotics.
3.
Write about the Disk diffusion method.
Section C
1.
Explain about the chemotherapeutic agents and mode of action.
2.
Write about the antibiotics susceptibility test – Kirby bauer method.