Microbiology and Parasitology

MICROBIOLOGY & PARASITOLOGY

1. Many of this type of bacteria do not possess superoxide dismutase and catalaseA. obligate aerobesB. obligate anaerobesC. facultative anaerobesD. microaerophiles

p. 66

2. It is the period when the bacterium is assessing the nutrients present in medium; the bacterium does not divide but there is an intense metabolic activity. The phase of bacterial growth is

A. LagB. LogC. StationaryD. Decline

p. 53

3. Which the best to sterilize scissors and other sharps?A. GlutaraldehydeB. FormaldehydeC. IodophorD. Phenol

p. 60

4. These are groups of genes that are clustered together in the DNA of some bacterial species and which may enable them to invade a host

A. Pathogenicity islandB. EpisomesC. TransposonsD. Replicons

p. 98

5. Which is true about the bacterial chromosome?A. Contains histones that stabilize the DNAB. Composed of a single pair of homologous chromosomesC. Replicates in a very different manner from that of eukaryotic chromosomesD. Contain single copy of each gene

p. 99

6. A non-encapsulated strain of Hemophilus influenzae acquires the gene for capsule production from a DNA extract of another encapsulated strain. The event that has occurred is

A. TransformationB. ConjugationC. TransductionD. Transcription

p. 106

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7. What is the substance primarily responsible for the structural integrity of the bacterial cell wall and is susceptible to lysozyme?

A. Cytoplasmic membraneB. Teichoic acidC. PeptidoglycanD. Lipopolysaccharide

p. 22

8. A hospitalized patient with dysuria and suprapubic pain is treated with ciprofloxacin. What is the mechanism of action of this antibiotic?

A. It inhibits DNA-dependent RNA polymeraseB. It inhibits protein synthesis by binding to the 30S ribosomal subunitC. It inhibits protein subunits by binding to the 50S ribosomal subunitD. It inhibits topoisomerase II (DNA gyrase)

p. 164

9. Which bacterial structure may carry gene for antibiotic resistance?A. MesosomeB. PeriplasmC. PlasmidD. Outer membrane

p. 98

10. What is the predominant indigenous flora of the colon?A. Anaerobic, gram-negative, non-spore-forming bacteriaB. Anaerobic, gram-positive, non-spore-forming bacteriaC. Aerobic, gram-negative, non-spore-forming bacteriaD. Aerobic, gram-positive, spore-forming bacteria

p. 199

11. Which of the following is the true regarding the bacterial cell?A. He motility of bacteria is due to flagella, axial filaments or ciliaB. The ability to colonize cell surfaces is dependent on toxic productionC. The ability to survive in soil for a long period of time is dependent on

the production of endosporesD. It has the same ribosomes as that of a eukaryotic cells

p. 35

12. Which of the following is the counterpart of mitochondria in a bacterial cell?A. Cell wallB. EndosporesC. RibosomesD. Cell membrane

p. 17

13. Which of the following agents possess either DNA or RNA?A. VirusesB. PrionsC. BacteriaD. Fungi

p. 2

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14. Most pathogenic microorganism grow best at the temperature range of about _____.A. 15-20ºCB. 30-37ºCC. 50-60ºCD. 80-100ºC

p. 65

15. A 22-year-old woman came in due to meningococcemia. Few hours after the admission, the patient experienced disseminated intravascular coagulation (DIC). The patient shock was due to what component of the causative agent?

A. Cell wallB. CapsuleC. LipopolysaccharideD. Endospores

pp. 155-156

16. Which one of the following antimicrobial agents acts on microorganisms by inhibiting nucleic acid synthesis?

A. StreptomycinB. CefalexinC. CiprofloxacinD. Erythromycin

p. 189

17. A newborn was diagnosed with neonatal meningitis. The causative agent was found out to be isolated in the vagina of the mother. Which one of the following microorganisms can be a part of the normal vaginal flora of the mother and can cause neonatal meningitis?

A. Mycoplasma pneumoniaeB. Staphylococcus aureusC. Escherichia coliD. Streptococcus agalactiae

p. 199

18. Which of the following is the “C3 activation unit” in the classical complement pathway?A. C1qB. C3C. C4b, C2aD. C5, C6, C7, C8 and C9

p. 136

19. The classic pathway of the complement system is activated when__A. The Fab portion of IgM binds to the C1s of the complement pathwayB. The Fc portion of IgE binds to the C1q of the complement pathwayC. The hypervariable regions of the heavy and light chains binds to the

membrane of the bacterial cellD. The mannose binding lectin stimulates mannose associated serine protease

p. 136

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20. Antigen-presenting cells that activate helper T cell must express which one of the following on their surfaces?

A. IgEB. Gamma interferonC. Class I MHC antigensD. Class II MHC antigens

p. 139

21. Increased susceptibility with Hepatitis virus and Candida albicans would be expected with a deficiency of which of the following cells?

A. PMNB. EosinophilsC. B cellsD. T cells

p. 138

22. In Type I hypersensitivity, the predominant antibody that is elicited is:A. IgAB. IgEC. IgGD. IgM

p. 140

23. Contact dermatitis is an example of:A. IgE mediatedB. Complement mediatedC. IgG mediatedD. Cell mediated

p. 141

24. This immunoglobulin is important in preventing diarrhea in the newbornA. IgAB. IgMC. IgED. IgD

p. 129

25. Main component in secondary response.A. IgAB. IgMC. IgGD. IgD

p. 135

26. At birth, the main source of Hematopoetic Stem Cell is the A. LiverB. SpleenC. Bone MarrowD. Thymus

p. 126

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27. Which method will you see to detect antigens directly from tissue?A. ELISAB. Ouchterlony technicC. ImmunofluorescenceD. Complement fixation

p. 142

28. Which is true about humoral immunity and antibodies?A. Antibodies found on the surface of B cells are IgAB. IgG has two bindings sites for an antigenC. IgM is the main protection of the newborn up to 6 (six) monthsD. The Fab region of IgE binds to mast cell receptor

p. 128

29. Which of the following complement cascade does not involve C3b?A. C5 convertase of the alternative pathwayB. C5 convertase of the classic pathwayC. C3 convertase of the alternative pathwayD. C3 convertase of the classic pathway

p. 136

30. Which of the following cells is a part of the innate immune response?A. B-lymphocytesB. T-helper lymphocytesC. T-cytotoxic lymphocytesD. Macrophages

p. 123

31. Which of the following is LEAST associated with Enterohemorrahgic E. coli?A. fermentation of sorbitolB. strain 0157:H7C. undercooked hamburgersD. hemolytic-uremic syndrome

p. 253

32. Which of the following is true about cholera and its causative agent?A. A secretory diarrhea due to increases in cGMP in the intestinal cellsB. The stool is described as ‘rice water-like’C. The causative agent is non-motile, nonfermentativeD. Grows poorly in medium with alkaline pH

p. 271

33. The appearance of moistpale papules or condylomas in the anogenital area is characteristic of

A. Primary syphilisB. Secondary syphilisC. Tertiary syphilisD. T. pallidum

p. 332

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34. A 4-year old Asian child develops an infection with Chlamydia trachomatis. How does infection with this organism cause blindness?

A. Retinal detachmentB. Cataract formationC. Hemorrhage of the anterior chamberD. Scarring of the cornea

p.360

35. Which is associated with atherosclerosis?A. K. pneumoniaeB. C. trachomatisC. S. pyogenesD. C. pneumoniae

p.364

36. Which of the following is LEAST effective against M. pneumoniae infection?A. ErythromycinB. TetracyclineC. KanamycinD. Vancomycin

p. 345

37. The only disease that can be diagnosed by demonstration of spirochetes in peripheral blood smear

A. Relapsing feverB. LeptopirosisC. PintaD. Lyme disease

p. 335

38. Which of the following is LEAST associated with Helicopter pylori?A. It requires at least 2% NaCl for growth (halophilic)B. It requires increased carbon dioxide tension and decreased oxygen tensionC. It is sensitive to the acidity of the gastric juiceD. Most commonly diagnosed by the demonstration of urease production

p.275

39. In which type of diarrhea is the use of antibiotics not recommended?A. SalmonellosisB. Campylobacter infectionC. CholeraD. Shigellosis

p. 259

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40. Which causes urinary tract infection characterized by alkaline urine and formation of urinary calculi?

A. Shigella dysenteriaeB. Escherichia coliC. Proteus mirabilisD. Enterobacter cloacae

p. 254

41. Which is LEAST acceptable as specimen for the diagnosis of anaerobic infectionA. Transtracheal aspirateB. Suprapubic aspirateC. Vaginal swabD. Sample of tissue from infected site

p. 309

42. Which of the following microorganisms takes up the color of Crystal violet upon properly performed Gram staining?

A. Neisseria gonorrheaeB. Clostridium perfringensC. Escherichia coliD. Pseudomonas sp.

p. 208

43. Which of the following is a Toxoid vaccine?A. PnuemococcalB. MeaslesC. VaricellaD. Diphtheria

p. 215

44. The most infectious stage in pertussis is:A. Catarrhal stageB. Prodomal stageC. Paroxysmal stageD. Convalescent stage

p. 283

45. Regarded as a TB marker in the diagnosis of tuberculous effusion:A. Gamma interferonB. AFB smearC. Caseation necrosisD. PPD positivity

p. 407

46. Presence of immunity to C. diphtheriae is indicated by:A. Positive elek testB. Negative elek testC. Positive schick testD. Negatice schick test

p. 215

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47. Which of the following is MOST likely acquired from caves?A. BlastomycosisB. HistoplasmosisC. CoccidioidomycosisD. Paracoccidioidomycosis

p. 642

48. Asteroid bodies are seen tissue infected with A. P. verrucosaB. P. boydiiC. S. schenckiiD. L. loboi

p. 634

49. The agents of chromomycosis are seen in infected tissues asA. Intracellular yeastB. GranulesC. Sclerotic bodiesD. Cigar-shaped bodies

p. 635

50. Which of the following is NOT dimorphic?A. P. boydiiB. H. capsulatumC. S. schenckiiD. C. immitis

p. 636

51. The agent of blastomycosis are seen in infected tissues asA. Intracellular yeastB. Single budding yeastC. Multiple budding yeastD. Cigar-shaped bodies

p. 642

52. The physician closely monitored the patient’s serum creatinine and ion levels. The patient is taking certain anti-fungal drug. What possible antifungal agent may affect the renal function of this patient?

A. KetoconazoleB. TerbinafineC. GriseofulvinD. Amphotericin B

p. 653

53. The primary site of echovirus multiplication in the human host isA. The muscular systemB. The alimentary tractC. The anterior horn cellsD. The respiratory system

p. 487

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54. Which of the following properties of polioviruses is not shared by rhinovirus?A. Icosahedral symmetryB. Resistance to lipid solventsC. Naked virusD. Stability at acid pH (pH3.0)

p. 489

55. Segmented, double-stranded RNA genome that is a common cause of viral gastroenteritis?

A. AstrovirusB. Norwalk virusC. CalicivirusD. Rotavirus

pp. 505-507

56. Diagnostic of Congenital rubella is the demonstration of rubella antibodies like:A. Maternal IgMB. Neonatal IgMC. Neonatal IgAD. Maternal IgA

p. 568

57. A viral cause of nephropathy in immunocompromised patient is A. Human papillomavirus, all typesB. Human papillomavirus, low-risk typesC. Hepatitis CD. Polyomavirus BK

pp. 598-599

58. Which of the following individuals may be at increased risk of acquiring and HIV infection?

A. A pregnant mother with a seafarers husbandB. A secretary at an AIDS institute C. A doctor with a colleague that is HIV positiveD. A male celebrity who has multiple sexual partner including a prostitute

pp. 616-617

59. Type of papillomavirus that is commonly associated with cervical carcinomaA. Type 1B. Type 6C. Type 9D. Type 18

p. 601

60. Progressive Multifocal leukuencepalopathy is associated with a virus that is described as __.

A. ssDNA, icosahedral, nakedB. dsDNA, helical, envelopedC. dsDNA, icosahedral, nakedD. ssRNA, segmented, naked

pp. 597-599

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61. Which of the following virus that can enter a skin through abrasions?A. AdenovirusB. PolyomavirusC. PapillomavirusD. Rhinovirus

p. 599

62. A 6-year old child had recently had fifth disease. Her 43-year old mother subsequently developed a rash and arthalgia. Which one of the following best describes the causative agent?

A. It has the same size as poxvirusB. It has a helical symmetryC. Inactivated by etherD. A single-stranded DNA genome

pp. 414-416

63. HIV is a retrovirus. A retrovirus is aA. Cause tumors in mouseB. Contain a DNA genomeC. Cause rapidly progressive neurological diseaseD. Multiplies in the nucleus

p. 605

64. Most common cause of post transfusion hepatitisA. HAVB. HBVC. HCVD. HDV

p. 466

65. Site of latent infections is at the sacral ganglia:A. HSV 1B. HSV 2C. EBVD. CMV

pp. 433-434

66. Which of the following viruses can establish a latent infection?A. PoxvirusesB. Rubella virusesC. HerpesvirusesD. Coronaviruses

p. 371

67. A 23-year-old medical student experienced fever, sore throat, and lymphadenopathy. These were accompanied by lymphocytosis and atypical cells in the blood smear. True statement regarding the causative agent

A. the major target cell of the virus is the T lymphocyteB. the agent multiplies in the cytoplasmC. it can be transmitted thru direct contact with the lesionD. it possess a double-stranded DNA genome

p. 429

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68. The following hepatitis B marker is indicative of active viral replicationA. HBsAgB. HBeAgC. Anti- HBsD. Anti- HBe

p. 468

69. The habitat is the large intestine.A. Entamoeba gingivalisB. Entamoeba histolyticaC. Giardia lambliaD. Naegleria fowleri

p. 104

70. The infective stage of Entamoeba histolytica to man hasA. PseudopodiaB. Ingested red blood cellsC. Bull’s eye karyosomeD. Pointed chromatoidal bodies

pp. 103-104

71. The most commonly involved area in Amoebiasis is theA. BrainB. CecumC. LiverD. Recto-sigmoid region

pp. 108-109

72. There is no increase in the number of nuclei ofA. Balantidium coliB. Entamoeba coliC. Entamoeba D. Giardia lamblia

p. 215

73. Tissue invasion is relatively slow and tends to stimulate granuloma formationA. Acanthamoeba castellaniiB. Balantidium coliC. Entamoeba histolyticaD. Naegleria fowleri

p. 142

74. Mosquito vector of Malaria in the Philippines isA. Aedes aegyptiB. Anopheles flavirostrisC. Culex quinquefasciatusD. Mansonia annulata

p. 164

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75. There is secondary exo-erythrocytic phase inA. Benign tertian malariaB. Malignant tertian malariaC. Quartan malariaD. Sub-tertian malaria

p. 177

76. The duration of the Erythrocytic-Schizogonic Cycle is 72 hours.A. A. Benign tertian malariaB. Malignant tertian malariaC. Quartan malariaD. Sub-tertian malaria

pp. 184-191

77. The gametocytes of the organism are described as banana or crescent-shaped.A. Plasmodium falciparumB. Plasmodium malariaeC. Plasmodium ovaleD. Plasmodium vivax

pp. 188-190

78. Produces rectal prolapse in heavy infection especially among childrenA. Capillaria philippinensisB. Trichinella spiralisC. Trchuris trichiuraD. Ascaris lumbricoides

p. 243

79. Bachman intradermal test & Xenodiagnosis are use for the diagnosis of infection cause by

A. Capillaria philippinensisB. Trichinella spiralisC. Trchuris trichiuraD. Ascaris lumbricoides

p. 239

80. The most common cause of Greeping Eruption or Cutaneous Larva MigranA. Ancytostoma brazilienseB. Enterobius vermicularisC. Strongyloides stercoralisD. toxocara canis

p. 281

81. The most common cause of Visceral Larva MigranA. Ancylostoma brazilienseB. Enterobius vermicularisC. Strngyloides stercolarisD. Toxocara canis

p. 325

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82. Produces autoinfection to manA. Ancylostoma duodenaleB. Ascaris lumbricoidesC. Necator americanusD. Strongyloides stercolaris

p. 256

83. What parasite produces Iron deficiency anemia to man?A. Ascaris lumbricoidesB. Necator americanusC. Strongyloides stercolarisD. Trichuris trichiura

p. 284

84. Associated with Noctrunal Pruritus Ani.A. Ascaris lumbricoidesB. Enterobius vermicularisC. Necator americanusD. Trichuris trichiura

p. 304

85. Graham Scotch tape technique is used for the diagnosis of the infection caused byA. A. Ascaris lumbricoidesB. Enterobius vermicularisC. Necator americanusD. Trichuris trichiura

p. 305

86. What parasite sucks and ingests blood?A. Ancylostoma duodenaleB. Ascaris lumbricoidesC. Enterobius vermicularisD. Trichuris trichiura

p. 284

87. What parasite shows Tramway sign in the X-ray?A. Ascaris lumbricoidesB. Enterobius vermicularisC. Necator americanusD. Trichuris trichiura

p. 317

88. The infective stage of the parasite is found in crabs or crayfishesA. Clonorchis sinensis B. Echinostoma ilocanumC. Fasciola hepaticaD. Paragonimus westermani

p. 465

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89. What parasite is associated with neoplasm of the biliary duct or cancer of the liver?A. Clonorchis sinensisB. Fasciola hepaticaC. Opisthorchis felineusD. Paragonimus westermani

p. 477

90. What parasite produces infection that stimulates tuberculosis?A. Clonorchis sinensisB. Fasciola hepaticaC. Opisthorchis felineusD. Paragonimus westermani

pp. 467-468

91. What is the infective stage of Schistosoma to man?A. CercariaeB. Embryonated eggC. MetacerciaeD. Miracidium

p. 417

92. Molluscan host of Schistosoma in the Philippines isA. Australorbis mystaxB. Biomphalaria alexandrinaC. Coxiella burnetiiD. Oncomelania quadrasi

p. 416

93. Laboratory procedure that makes use of the egg in the test isA. CFTB. CHRC. COPTD. Casoni test

p. 770

94. The infective of Diphyllobothrium latum to man to produce adult infection is the A. Cysticercoid larvaB. Cysticercus larvaC. Procercoid larvaD. Sparganum larva

p. 497

95. Produces Ocular cysticercosis to manA. Dipylidium caninumB. Taenia saginataC. Taenia soliumD. Hymenolepis nana

p. 518

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96. Lateral uterine branches in gravid proglottid are counted for diagnosis of infection cause by

A. Diphyllobothrium latumB. Dipylidium caninumC. Hymenolepsis nanaD. Teania saginata

p. 522

97. Taenia saginata is associated withA. CatB. CattleC. DogD. Pig

p. 521

98. Ultrasound and MRI usually help in the diagnosis of the infection cause byA. Dipylidium caninumB. Echinococcus granulosusC. Hymenolepis diminutaD. Hymenolepis nan

p. 532

99. This organism produces a blue-green pigment and therefore produces a characteristic blue-green pus.

A. Staph aureusB. Pseudomonas aeruginosaC. Aspergillus fumigatusD. Strep. pyogenes

Pseudomonas aeruginosa produce pyocyanin pigment w/c is blue green in color and also has antibiotic-like characteristics against some bacteriaReference: Zinsser p. 577

100. Each of the following statements concerning the surface structures of bacteria is correct EXCEPT:

A. Pili mediate the interaction of bacteria with mucosal epitheliumB. Polysaccharides capsules retard phagocytosisC. Both gram negative rods and cocci have polysaccharides (endotoxin in their

cell wall)D. Bacterial flagella are not antigenic in humans

Bacterial flagella are made of proteins and are useful in distinguishing serovars or variation of gram negative bacteria such as E. coli H. antigens Sal. H .antigens.Reference: Zinsser. Chapter 3

101. The most common site of asymptomatic gonococcal infection in women is the:

A. VaginaB. MyometriumC. UrethraD. Endocervix

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The columnar epithelial cells here are the ones that are being infected by N. gonorrhea.(A). Vaginal walls composed of stratified squamous epithelial cells which are not colonized. (B) and (C) are not affected.Reference: Zinsser p. 456

102. The following etiologic agents are known to cause diarrhea EXCEPT:A. Clostridium perfringensB. RotavirusC. V. choleraD. Proteus vulgaris

Protues vulgaris produce urinary tract infection. C. clostridium perfringens diarrhea thru it’s invasiveness so blood and mucus is (+) V. cholera-produced diarrhea by virtue of enterotoxin. Rotavirus most common cause of viral gastroenteritis in small children.Reference: Zinsser p. 552

103. A 20 year old male developed a carbuncle with surrounding cellulitis. Gram stain revealed gram positive cocci, catalase and coagulase positive. Which of the following antibiotics is initially appropriate for this patient?

A. VancomycinB. CloxacillinC. CefriaxoneD. Penicillin

90% of S. aureus strains are resistant to penicillin because pf production of plasmid-derived β-lactamses. Such organisms can be treated with β-lactamase-resistant penicillin such as cloxacillin or dicloxacillin oxacillin. Oxacillin and Nafcillin have unpredictable absorption by oral route, thus is not recommendedReference: Zinsser p. 412

104. Which of the following features help distinguish group A streptococcus from other streptococcal species?

A. Bacitracin susceptibilityB. Bile solubilityC. Optochin sensitivityD. Growth inhibition in 6.5 % NaCl

Group A streptococcus is a β-hemolytic streptococcus and can usually be distinguished from the other β-hemolytics by its bacitracin susceptibility or by precipitation with specific anti sera (against its "Lancefrield antigen"). Bile solubility test and optochin test distinguishes the L-hemolytic streptococci, S. pneumoniae is bile soluble and optochin sensitive. Among the hemolytic streptococci, S. viridans growth is inhibited by 6.5% NaCl while Enterococcus species grows in 6.5% NaCl.Reference: Zinsser p. 419

105. Which of the following Clostridia cause gangrene?A. Clostridium tetaniB. Clostridium botulinum C. Clostridium perfringensD. Clostridium difficile

C. tetani causes lockjaw. C. botilinum causes botulism. C. difficile causes antibiotic associated pseudomembranous colitis. C. perfringens cause gasgangrene and Food poisoning.Reference: Zinsser p. 639

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106. This gram positive rod is usually associated with bacterial vaginosis producing malodorous vaginal discharge and "clue cells"

A. Erysipelothrix rhusopathiaeB. Lactobacillus acidophilus C. Gardenella vaginalisD. Propionibacterium acnes

E. rhusopathiae causes erysipeloid skin infection that resembles erysipelas occurring among meat and fish handlers. L. acidphilus is normal flora of genital tract and is the main source of lactic acid. P. acnes produces lipase which contributes to the genesis of acne.Reference: Zinsser p. 604-605

107. Which of the following organisms is MOST likely to involve invasion of the intestinal mucosa.

A. Vibrio choleraB. Shigella sonnei C. Enterotoxigenic E. coliD. Clostridium botulinum

Shigella sonnei is the only invasive, presence of blood and mucus in the stool. Clostridium botilinum , V. cholera and Enterotoxigenic E. coli causes diarrhea by producing enterotoxinReference: Zinsser p. 561

108. Food poisoning that produces gastrointestinal symptoms approximately 1-2 hours after eating is most likely to be due to:

A. Salmonella enteritidisB. Campylobacter jejuniC. Clostridium perfringensD. Staph. aureus

Staph aureus – the incubation period is 1-2 hrs. after ingestion of contaminated food. Sal. enteritidis – 6 hrs. – 2 days. Campylobcacter – 8 hrs. – l day. C. perfringens – 8 hrs. – 12 hrs. Bacillus aureus – 8 hrs. – 12 hrs. V. cholera – 2 – 3 days. V. parahaemolyticus – 8 hrs. – 2 daysReference: Zinsser p. 412

109. A 30 year old pregnant woman had a normal delivery but the fetus was stillborn. CSF examination showed positive rods. The pathogen is most likely:

A. Listeria monocytogenesB. Gardenerella vaginalis C. Group B StreptococcusD. Staphylococcus aureus

Listeria monocytogenes is a gram positive rod and can infect pregnant women and poses the threat of stillbirth or serious damage to the fetus and also cause neurological disease. Gardenella vaginalis gives rise to frothy, fishy odor vaginal discharge, it can also cause premature births and low-birth-weight infants.Reference: Zinsser 484

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110. Which of these organisms is a major pathogen for nosocomial infections because of its ubiquitous present in the hospital environment?

A. Staph. AureusB. Staph. EpidermidisC. Serratia marcescensD. Pseudomonas aeroginosa

Pseudomonas aeruginosa, S. aureus - yellow gold pigment when cultured at room temperature. S, epidermidis - white pigment when cultured at room temperature. Serratia marcescens - red pigment Reference: Zinsser p. 577

111. An individual experiences severe diarrhea after eating sushi (raw fish) in a West Coast restaurant. The most probable etiologic agent is:

A. Yersenia enterocoliticaB. Salmonella enteritidis C. Shigella sonneiD. Vibrio parahaemolyticus

Vibrio parahaemolyticus - is a salt loving organism and found in fishes. Salmonella enteritidis - found in chicken, pig. Yersenia enterocolitica- reserviors rodentsReference: Zinsser p. 571

112. When symptoms to typhoid fever first become apparent, Salmonella typhi is most frequently isolated from:

A. FecesB. UrineC. BloodD. Bone marrow

Blood - on the first week of infection, Feces - second week. Urine - third week.Reference: Zinsser p. 563

113. The area in the body where Salmonella typhi resides if one is a chronic carrierA. small intestineB. kidneyC. blood stream D. gall bladder

Gall bladder - where organisms are found and are excreted in the stool and urine of the chronic carrier of Salmonella.Reference: Zinsser p. 562

114. A 3 year old boy was diagnose to have meningitis CSF culture on Chocolate agar showed growth of small gram negative rods. The most probable etiologic agent is:

A. N. meningitidesB. S. aureus C. Group B StreptococcusD. H. influenzae type b

H. influenzae type b - is the most commonly isolated etiologic gram negative rods causing meningitis. N. meningtidis - gram negative plo. Group B Strep - gram positive cocci.Reference: Zinsser p. 462

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115. Among the gram negative rods producing gastroenteritis, the most infectious is:A. V. choleraB. E. coli (0157)C. Sal. TyphimuriumD. Shig. Dysenteriae type 1

Shigella - only 200 cells is enough to cause diarrhea while A-C you need to 10 3 - 10 5 cells to produce infection.Reference: Tortora et al

116. Pneumococci primarily cause disease by:A. toxin productionB. enzyme productionC. eluding phagocytosis and favoring invasivenessD. producing delayed immunologic reaction

Pneumococci does not produce toxins and enzymes. Capsules are virulence factors which interfere with phagocytosis and favoring invasiveness.Reference: Zinsser p. 435

117. The formation of pseudomembrane in diphtheria is due to:A. inhibitions by toxin of protein synthesis by ADP ribosyslation of EF-2B. spores which spread subcutaneouslyC. invasion of mononuclear phagocytic cellsD. neutralization of exotoxin by antibody of blocking the interaction of fragment B

with receptors

Diphtheria toxin inhibits protein synthesis of eukaryotic cells thereby causing cell death. Pseudomembrane formation is due to accumulation of necrotic tissue.Reference: Zinsser p. 488

118. Lyme disease is an endemic inflammatory disorder with this distinctive skin disorder.A. Chronic dermatitisB. erythema marginatumC. erythema chronicum migransD. ecthyma gangrenosum

Erythema chronicum migrans is a tick-borne associated syndrome. Reference: Lippincott Illustrated Review in Microbiology p. 225

119. Serology in the diagnosis of Syphilis using a non-treponemal tests is the following EXCEPT:

A. Microhemagglutination assayB. Venereal Disease Research LaboratoryC. Fluorescent Antibody Tests D. Reiter Protein Complement Fixation

Two different types of test are used. Non-treponemal tests detects Wasserman or reagenic antibodies; a few examples of the nontreponemal tests include VDRL, automated regin, Kahn, plasmacrit, Hinton and Kline tests. Treponemal tests detect antibodies specific for treponemal antigens; they include FTA=ABS, T. pallidium immunobolization and hemagglutination tests.Reference: Zinsser p. 663-664

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120. Mycoplasmas are very pleomorphic and cannot be classified as to shape because they lack the following:

A. PeptidoglycanB. lipid bilayer C. nucleusD. lipopolysaccharide

Lacking cell walls, mycoplasmas are enclosed instead by a membrane composed of a lipid bilayer. They are therefore plastic and very pleomorphic.Reference: Zinsser p. 733

121. A definitive identification of M. tuberculosis can be obtained by doing the following procedure?

A. Ziehl-Neelsen stainB. AFB CultureC. Biopsy of Tuberculin testD. Nucleic acid amplification

Cultures can detect small numbers of organism in the original sample. The presence of Acid-fast organism on Ziehl Neelsen cannot distinguish on morphologic groups M. tuberculosis from the other mycobacteria that are saprophytic. Nucleic acid amplification utilizes enzymes that rapidly IGS ribosomal RNA which can be used for patients with positive smears and while culture results are pending.Reference: Lippincott Illustrated Review for Microbiology p. 251

122. Rifamficin a broad antimicrobial agent is effective treatment for tuberculosis by:A. selective inhibition of the biosynthesis of the arabinogalactan and lipo-

arabinomannanB. mediating drug permeability and efflux C. Inhibiting peptidoglycan synthesis by blocking action of D-alanise synthesisD. binding to RNA polymerase thereby interfering with mRNA synthesis

Rifamficin is a broad spectrum antimicrobial agent that acts the interferring with the synthesis of mRNA by binding to RNA polymerase. Selective inhibitions by ethamentol of the biosynthesis of arabinogalactan and lipoarabinomannan, key structural components of the mycobacterial cell wall. Cyclosine inhibits synthesis of peptidoglycan by blocking the action of the D-alanine synthetase.Reference: Tortora p. 561

123. In primary disease, M. tuberculosis survives and grows within these host cellsA. macrophagesB. basophils C. neutrophilsD. eosinophils

M. tuberculosis may continue to survive and remain dormant in activated macrophages where it is protected from phagocytosisReference: Lippincott Illustrated Review of Microbiology p. 247

124. Members of the genus Rickettsia are morphologically & biochemically similar toA. gram-positive bacteriaB. gram negative bacteria C. clostridiaD. viruses

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Rickettsias are short-rod shaped or cocci bacillary organisms measuring 0.8 to 2.0 um longReference: Lippincott Illustrated Review of Microbiology p. 259

125. The hallmark of viral infection of the cell is the production ofA. inclusion bodiesB. multinucleated giant cellsC. cytopathic effectD. granule formation

The hallmark of viral infection of the cell is the cytopathic effect. This change begin with a rounding and darkening of the cell and culminates in either lysis or giant cell formation. Infected cells frequently contain inclusion bodies which are discrete areas containing viral particles.Reference: Zinsser p. 943

126. The complete infectious forms of Hepatitis B is:A. HBeAgB. Dane particles C. HBsAgD. HBcAg

The Dane particle is the complete form of Hepatitis B whereas the antigens are subunit forms of the surface and core of the virus.Reference: Zinsser p. 1040

127. Which of the following virus/es contain/s Hemagglutinin on its surface?A. Hepatitis BB. Hepatitis CC. Influenza virusD. all of the above

The antigen hemagglutinin is characteristic of Influenza virus.Reference: Zinsser p. 995

128. In their multiplication, they produce DNA which is integrated into the cell genome.A. HepadnavirusB. Reovirus C. PicornavirusD. Herpesvirus

Hepadnavirus transforms non-permissive cells by integration of DNA transcripts into host cell genome. They carry an RNA-dependent DNA polymerase (reverse transcriptase).Reference: Zinsser p. 810

129. The most common intrauterine viral infection is caused by:A. CytomegalovirusB. Rubella C. AdenovirusD. Herpes simplex

Cytomegalovirus accounts for the biggest # of intrauterine infection followed by rubella.Reference: Zinsser p. 962

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130. Smallpox was eradicated by the global use of vaccine which contains:A. killed virusB. attenuated live virus C. preformed antibodiesD. preformed antibodies and live attenuated virus

Smallpox disease was eradicated by use of a live attenuated vaccine. Live vaccine are used because duration of immunity is longer with greater effectiveness of protection, both IgA and IgG are elicited when administered by the natural route of infection which is intradermally where the virus replicates. Cell mediated immunity is produced.Reference: Zinsser p. 949

131. The most important laboratory test for the detection of early Hepatitis B virus infection is:A. immunoassay for HBsAgB. immunoassay for HBeAg C. immunoassay for Anti HBcD. immunoassay for Anti HBs

HBsAg appears during the incubation period and is detectable in most patients during the prodrome and acute phase; falls to undetectable levels during convalescence. HBeAg arises during the incubation period and is present during the prodome and early acute disease. Its presence is an important indicator of transmissibility. Anti HBc is detectable during prodrome and acute disease. Anti HBs is detectable during late convalescence.Reference: Zinsser p. 1043

132. A common upper respiratory tract disease produced by adenovirus is:A. RhinitisB. atypical pneumoniaC. pharyngoconjunctivitisD. parotitis

Adenoviruses cause a variety of upper and lower respiratory tract disease. Pharyngoconjunctivitis is common.Reference: Zinsser p. 970

133. The virus that is increasingly being recognized as cause of nonbacterial infant diarrheaA. RetrovirusB. RotavirusC. OrbivirusD. Calicivirus

Rotavirus gastroenteritis is one of the most common childhood illness and a leading cause of infant deaths in developing countries.Reference: Zinsser p. 993

134. In the laboratory this protein from Influenza virus agglutinates red blood cells whereas in vivo, it binds to the surface receptor of the host cell to initiate infection.

A. HemagglutininB. NeuramidaseC. HemolysinD. capsid antigen

The Influenza virus has an envelope covered with 2 different spikes Hemagglutinatinin and neuramidase. Hemagglutination initiates infection in the host and in the lab causes agglutination of RBC's. Neuramidase cleaves

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neuramic acid (sialic acid) to release progeny virus from the infected cell. Hemolysin is from bacterial cells and causes hemolysis of RBC. Reference: Zinsser p. 778

135. In the prevention of poliomyeletis, the use of oral vaccine is preferred because:A. induces intestinal IgAB. induces humoral IgG C. can produce lifelong immunityD. can produce immunity to unimmunized adults

The oral vaccine or Sabin vaccine which is a live attenuated vaccine is preferred over the Salk vaccine or killed vaccine because (1) it interrupts fecal-oral transmission by inducing secretory IgA in the GIT; killed vaccine does not. Both kinds of vaccine induce humoral IgG. Infection provides lifelong type specific immunity.Reference: Zinsser p. 981

136. Hand-foot-and-mouth disease characterized by versicular rash on the hands and feet and ulcerations in the mouth, mainly in children is caused by:

A. EchovirusB. Parainfluenza virusC. Coxsackie virus Group AD. Coxsackie virus Group B

Echovirus causes aseptic meningitis. Parainfluenza causes croup. Coxsackie B causes pleurodynia. Coxsackie A causes herpangina and hand-foot-and-mouth disease.Reference: Zinsser p. 774

137. The most common fungal opportunistic infection is caused by:A. Aspergillus fumigatusB. Cryptococcus neoformansC. Candida albicansD. Mucor

Candida albicans - it is endogenous, a lot of risk factors like pregnancy, diabetic person, prolonged used of antibiotic, used of birth control pillsReference: Zinsser p. 1139

138. The most common mode of infection of systemic fungi is thru: A. ingestionB. traumatic implantation C. inhalationD. all of the above

Inhalation of infectious particles (spores) which are suspended in the air.Reference: Zinsser p. 1091

139. A 45 year old post kidney transplant patient develop fever and pneumonia with marked neutropenia. Bronchial washing show dichotomously branching filamentous fungi. The fungi involved is:

A. sprorothrixB. cryptococcusC. candidaD. aspergillus

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In immunocompromised patient, inhalation of spores of Aspergillus can lead to pneumonia and are seen as dichotomous branching hyphae (filamentous).Reference: Zinsser p. 1127

140. In a 7 year old malnourished boy with multiple nematode infections, the most severe complication will come from:

A. Ascaris lumbricoidesB. Trichuris trichiuraC. Necator americanusD. Enterobius vermicularis

Ascaris has a tendency to migrate to other openings causing more severe disease.Reference: Brown 6th ed. p. 141-142, Roberts and Janovy p. 422

141. Loeffler’s syndrome can be seen in the following parasitic infections EXCEPT:A. AscariasisB. Strongyloidiasis C. NecatoriasisD. Trichuriasis

Loeffler’s syndrome is eosinophilic lung. As the parasitic larvae (rhaditiform for Ascaris, filariform for Strongyloides and Necator) travels to the pulmonary-circulatory system, the body reacts with an anaphylactic type of hypersensitivity that produces the eosinophilic lung condition. Trichuris does not have a pulmonary circulatory pathway.Reference: Brown 6th ed. p. 141, 126, 130; Roberts & Janovy p. 386, 422

142. All cestodes require an intermediate host EXCEPT:A. Diphyllobothrium latumB. Taenia saginata C. Hymenolepis nanaD. Echinococcus granulosus

Man gets H. nana infection by ingesting the eggs directly. All other cestodes require an intermediate hostReference: Brown 6th ed. p. 192

143. Cysticercosis due to Taenia solium is acquired through ingestion of:A. cysticercus larvaB. cysticercoid larva C. procercoid larvaD. egg

A more dangerous sequence can occurs when a person ingests the egg of Taenia solium in contaminated food or water rather than eating raw or undercooked pork containing the larva cystercus. Cysticercoid larva pertains to D. caninum and H. nana. Procercoid larva is for D. latum. The ingested egg hatch in the small intestines and the oncopheres burrow through the wall into a blood vessel, where they can disseminate to many organs. This condition is called cysticercosis.Reference: Brown 6th ed. p. 207

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144. The infective stage to man of Necator americanus is:A. rhabditiform larvaB. filariform larvae C. embryonated eggD. Microfilaria

Filariform larvae of hookworms penetrate the skinReference: Roberts & Janovy p. 410

145. This cestode possess a quadrate scolex with 4 circular suckers and no rostellum or hooklets:

A. Diphyllobothrium latumB. Hymenolepis nanaC. Taenia saginataD. Echinococcus granulosus

D. latum has an elongated scolex. H. nana has a globular scolex with 4 suckers, a short retractile rostellum armed with a single row of hooklets. E. granulosus has 4 suckers with a rostellum and a double row of hooklets.Reference: Brown 6th p. 194, Roberts & Janovy p. 333

146. Amoebic abscess of the liver is mostly found in theA. left anteromedial lobeB. right posterosuperior lobe C. inferior lobeD. middle lobe

Spread of amoeba from the large intestines is by the portal vein and deposit on the right posterosuperior lobe Reference: Chatterjee p. 25

147. Little Joey was frequently sick of various infectious diseases. He was found to have low CD4+ lymphocytes titers. Which of the following immune response processes would still be functional in Joey’s body?

A. T cell help for B lymphocytesB. Recognition of peptide-MHC complexC. Phagocytic function for foreign moleculesD. T-dependent antigen recognition

This is an innate natural cellular immune ability of the host to respond to foreign molecules which is independent of the Th series.Reference: Stanley p. 92; 124

148. The host immune response in viral infections is mostly by:A. Th cellsB. B cellsC. Tc cellsD. NK cells

Viral infections produce endogenous peptides which are presented on the surface of cells in conjunction with MHC Class 2. These are recognize primarily by Tc cells. B cells are mostly for exogenous peptides that are antibody mediated mainly stimulated by Th cells while the NK cells’ major activity is to directly destroy aberrant cells such as in cancer.Reference: Roitt, Brostoff & Male p. 15.3-15.4

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149. A killed virus is the major component of the vaccine against this pathogenic organism.A. measlesB. rubella C. mumpsD. rabies

Measles, rubella, mumps vaccines contain living but attenuated virus (also for chickenpox, Sabin polio) Rabies vaccine (also for Hep A, Salk polio, influenza) contain killed or inactivated viruses. Hep B vaccine contains antigenic fragments of the virus usually using recombinant technology (yeast-derived). Subunit vaccines are also used as in pertussis. Tetanus and diphtheria utilize toxoids which are inactivated toxins or antitoxins, antibodies against these. H. influenzae type b vaccine is conjugated to a protein which can be a diphtheria toxoid.Reference: Tortora p. 502

150. Alkaline pH in urine seen in Proteus is due to its ability to split urea into:A. NH3 & C02 B. Cl & Ca C. Ca & Mg D. Na & Cl

Answer: A (pp.208)

151. It is responsible for Escherichia coli causing meningitis in infants A. H antigen B. LPS C. K antigen D. O antigen

Answer: C (pp.208)

152. Vi antigen for Salmonella typhi A. penetrates epithelial lining of the intestinal tractB. antigenic structure associated with invasivenessC. interfere with antibody binding to bacteriaD. confers a certain degree of immunity

Answer: B (p 209)

153. Initial recognition event for the activation of the alternative pathway A. C3b B. C1 C. C4 D. Factor D

Answer: A (p 108)

154. The characteristic morphologic feature of influenza responsible for antigenic changes of the virus

A. EnvelopeB. segmented genomeC. capsidD. nucleic acid

Answer: B (p 320)

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155. Replicate in the cytoplasm of the host cell A. AdenovirusB. OrthomyxovirusC. PoxvirusesD. HIV

Answer: C (p332)

156. The exudative lung parenchymal lesion with lympadenopathy in primary tuberculosis infection is called

A. tuberculosis B. granulomaC. ghon complexD. fibrotic lesion

Answer: C (p278)

157. Which of the following statement/s is correct regarding neonatal herpes A. infections are almost always asymptomaticB. most common route of infection is thru contact with herpetic lesion

during vaginal deliveryC. causes latent infectionD. usually cause by HSV 1

Answer: B (p376)

158. An 18 year old college student developed fever followed by jaundice. Acute viral hepatitis was entertained. Results of the hepatitis profile are as follows: anti-HAV IgM (-), anti-HbsAg (-), anti-HBc IgM (+), anti-HBc IgG negative. He most probably has:

A. Hepatitis AB. Hepatitis BC. Hepatitis CD. Hepatitis E

Answer: B ( p 410)

159. A 21 y/o male with history of sexual contact 4 days ago resents with painful urination and purulent penile discharge. Which of the following is most likely?

A. primary syphilisB. genital herpesC. gonorrheaD. lymphogranuloma venerum

Answer: C (p259)

160. A 1 and half y/o boy developed fever, coryza and cough followed 4 days later by maculopapular rashes starting from the hairline and becoming generalized. Fever persisted. The most likely etiology is a/an

A. RNA virusB. DNA virusC. gram positive coccusD. gram negative bacillus

Answer: A ( p 470)

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161. A neonate is born with the following features: microcephaly, jaundice, poor suck and chorioretinitis. A congenital infection is entertained. The most common congenital infection is due to:

A. ChlamydiaB. HIVC. CMVD. HSV

Answer: C ( p 382)

162. A 2 month old girl was brought to you because of milk curd-like lesions in the mouth noted for a week. The whitish lesions were adherent to the oral mucosa with pinpoint bleeding when the mother tried to remove them. This is caused by

A. herpes simplex 1B. Coxsackie AC. albicansD. neoformans

Answer: C ( p 550)

163. A 23 y/o office worker found out that his sexual partner had HIV infection. The screening procedure of choice for HIV infection is

A. PCRB. HIV ElisaC. western blotD. northern blot

Answer: B (p 525)

164. A 6 month old baby has acute watery diarrhea. Which of the following is the most common cause of diarrhea in this age group?

A. ETECB. RotavirusC. EPECD. V. cholerae

Answer: B ( p434)

165. A health worker who did not receive prior mumps vaccine developed parotid swelling and fever. The following belongs to the same virus family as mumps virus

A. A. german measlesB. RSVC. InfluenzaD. Japanese B virus

Answer: B ( p 471)

166. A 25 yr old saleslady developed high fever, chills and cough. On PE she had crackling rales on the right lung base. The diagnosis is pneumonia. The most common bacterial cause of this condition in this age group is:

A. S. aureusB. N. meningitidisC. S. pneumoniaeD. Hemophilus influenzae

Answer: C ( p 213)

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167. Infection with this organism is the most common risk factor for cervical CA A. HIVB. N. gonorrheaC. HPVD. HSV 2

Answer: C ( p512)

168. Most common cause of UTI in women is characterized by A. Urease productionB. fruity odor on cultureC. greenish metallic sheenD. swarming phenomenon

Answer: C ( p 219)

169. Which of the following laboratory tests can be used to monitor response to treatment in syphilis?

A. FTA-ABSB. VDRLC. Darkfield microscopyD. ELISA

Answer: B ( p 287)

170. An encapsulated fungi that causes meningitis is A. H. capsulatumB. neoformansC. C albicansD. immitis

Answer: B ( p 552)

171. The following statements are true regarding N. meningitidis A. it is the only specie that is oxidase positiveB. oxidizes maltose and glucoseC. oxidizes glucose onlyD. it is the only gram negative specie

Answer: B (p256)

172. The following statements are true about S. aureus A. it is catalase negativeB. can secrete preformed toxins C. prefers anaerobic conditionD. cannot grow in 7.5% NACL

Answer: B (p.199)

173. Toxic shock syndrome secondary to Staphylococcus tend to commonly cause infection among

A. tampon usersB. asthamticsC. IV drug usersD. infants

Answer: A (p 201)

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174. A 14 year old male has high fever for a week, tonsillitis, hepatosplenomegaly and cervical lymphadenopathy. Peripheral smear shows 10% atypical lymphocytes. The most likely diagnosis is:

A. Streptococcal sore throat B. leukemia C. infectious mononucleosisD. diphtheria

Answer: C (p 386)

175. Streptococcal sore throat is definitively diagnosed byA. ASO titer B. throat swab culture C. rapid antigen testing from throat swab D. Gram stain

Answer: B (p 210)

176. Which of the following, when positive, indicates an acute Epstein-Barr virus infection?A. anti-EBNA B. anti-VCA IgG C. anti-VCA IgM D. anti-EBV DNA

Answer: C (p 388)

177. The hallmark of Dengue Hemorrhagic Fever isA. thrombocytopenia B. shock C. plasma loss D. positive tourniquet test

Answer: C (p 452)

178. Dengue virus has how many serotypes? A. one B. two C. three D. four

Answer: D ( p 452)

179. The most common vector of Dengue virus is ( p 452)A. Anopheles minimus B. Mansonia sp. C. Aedes aegyptiD. Aedes albopictus

180. A 1 year old girl has high fever for four days, coryza, hacking cough and poorappetite. On PE, she has congested pharynx and Koplik’s spots. The causative agent of this condition

A. is a DNA virus B. has three serotypes C. belongs to the paramyxovirus family D. has double-stranded RNA

Answer: C ( P482)

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181. Which of the following diseases is currently vaccine-preventable? A. cytomegalic inclusion diseaseB. German measlesC. Dengue feverD. Hepatitis C

Answer: B ( p 485)

182. A 20 year old male developed fever, vomiting and poor appetite for four days followed by jaundice. A diagnosis of viral hepatitis is entertained. The resultsof the hepatitis profile are as follows: positive anti-HAV IgM, negative anti-HBsAg, positive HBsAg, negative anti-HBc IgM. Which is correct?

A. The patient has acute Hepatitis A and is most likely a Hepatitis B carrierB. He has acute Hepatitis B C. He has acute Hepatitis CD. He does not have acute viral hepatitis

Answer: A ( p 411)

183. The protective antibody following immunization against Hepatitis B is A. anti-HBc IgM B. anti-HBc IgG C. anti-HBsAg D. anti-HCV

Answer: C ( p 415)

184. Which of the following agents of viral hepatitis is fecal-oral in transmissionand causes more severe disease in pregnant women?

A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis E

Answer: D ( p 408)

185. Bovine spongiform encephalopathy (mad cow disease) is caused by an agent which has the following characteristic

A. double-stranded DNA B. single-stranded RNA C. double-stranded RNA D. does not contain nucleic acid

Answer: D ( p 500)

186. Human influenza virus which undergoes antigenic shift and can cause pandemics A. influenza A B. influenza B C. influenza C D. highly-pathogenic avian flu

Answer: A (p 463)

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187. Fetal hydrops is a prominent complication of maternal infection with A. rubella B. parvovirus B19 C. measles D. cytomegalovirus

Answer: B ( p 357)

188. An 8 month old girl developed high fever for three days but was otherwise playful. On the fourth day, fever was gone but she had maculopapular rashes on the facewhich rapidly spread all over the body. This common disease is caused by

A. measles virus B. human herpesvirus 6 C. parvovirus B19 D. rubella virus

Answer: B ( p389)

189. A 22 year old sex care worker wanted to be tested for human immunodeficiency virus (HIV). What test would you initially recommend?

A. Western blot B. HIV Elisa C. CD4:CD8 ratioD. VDRL

Answer: B ( p 526)

190. HIV infection causes the ratio of CD4 to CD8 T cell ratio to fall. CD4 T cells are also called

A. T cytotoxic cells B. cytolytic T cells C. T helper cells D. suppressor T cells

Answer: C (p 521)

191. The major function of CD8 T lymphocytes is A. to kill cells infected by intracellular pathogens like virusesB. antibody-dependent cellular cytotoxicityC. opsonizationD. phagocytosis

Answer: A (p 116)

192. A one and a half year old boy has recurrent bacterial pneumonia and middle earinfection. An antibody deficiency is entertained. Antibodies are produced in largequantities by

A. B lymphocytes B. T lymphocytes C. plasma cells D. mast cells

Answer: C (p 125)

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193. Immunoglobulins aid phagocytosis because they can bind to phagocytes via A. Fab receptors B. Fc receptors C. CD4 receptors D. C3b receptors

Answer: B ( p 125)

194. The following virus/viruses exhibit/s latency in nerve ganglia A. smallpox virus B. chickenpox virus C. cytomegalovirus D. adenovirus

Answer: B (p 378)

195. A virus which infects B lymphocytes by attaching to the latter’s complement Receptors

A. cytomegalovirus B. Epstein-Barr virus C. Japanese B encephalitis virusD. HIV

Answer: B ( p 386)

196. A 1 year old infant had exposure to a caregiver with cavitary tuberculosis. Chestx-ray was negative. Mantoux test done showed induration of 12 mm after 2 days.The Mantoux tuberculin test result is an example of

A. Type I hypersensitivity B. Type II hypersensitivityC. delayed-type hypersensitivity D. Arthus reaction

Answer: C ( p 130)

197. The following are characteristics of M. tuberculosis A. have minimal lipid content in their cell wallB. cannot be grown on artificial media C. retain carbolfuchsin dye after exposure to acid-alcoholD. appear as round chains on Gram stain

Answer: C ( p25)

198. Subacute sclerosing panencephalitis is a late complication of infection with this virusA. Varicella B. Rubeola C. West Nile virus D. poliovirus

Answer: B ( p483)

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199. A newborn presents with lethargy, purpura, chorioretinitis and pulmonary infiltrates. Which of the following could be a cause of this syndrome?

A. Amebiasis B. Candidiasis C. Cytomegalovirus D. Human papillomavirus

ANS: C Medical Microbiology by Jawetz.,23rd edition, page 445

200. Which one of the following is a subcellular structure that is found only in Gram negative bacteria?

A. endospores B. lipopolysaccharide C. mitochondria D. phosphatidylethanolamine

ANS: B Medical Microbiology by Jawetz., 23rd ed., page 28

201. Which one of the following statements best describes a function of the peptidoglycan layer in bacteria?

A. The ability of bacteria to survive changes in the osmolarity of their environment is due to the physical properties of the peptidoglycan layer.

B. The peptidoglycan layer contains all the enzymes responsible for the synthesis of membrane phospholipids.

C. The peptidoglycan layer protects bacteria from the effects of ultraviolet light.

D. The peptidolgycan layer renders Gram negative bacteria resistant to detergents.

ANS: A Medical Microbiology by Jawetz., 23rd ed., page 22

202. 4. Which one of the following structures is responsible for the passage of low molecular weight solutes through the outer membrane of Gram negative bacteria?

A. capsules B. endospores C. flagella D. porins

ANS: D Medical Microbiology by Jawetz., 23rd ed., page 27

203. Your patient, suffering from a bacterial infection, receives a penicillin injection and almost immediately experiences respiratory distress and loses consciousness. This reaction is MOST LIKELY mediated by

A. complement.B. CD8+ cytolytic T cells.C. macrophages.D. mast cells.


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204. Which one of these statements explains the origin of Rh antibodies in the blood of an Rh-negative mother?

A. They are naturally occurring in the blood of all Rh-negative persons.B. They are received through mis-matched blood transfusions.C. They are synthesized by the mother in response to Rh-positive cells

from her first child.D. They are transferred from the Rh-positive father during intercourse.

ANS: C Medical Microbiology by Jawetz., 23rd ed., page 135

205. Which one of the following bacterial pathogens requires selective culture conditions for reliable isolation from the stool, including media with antibiotics and incubation at 42 C in increased CO2?

A. Campylobacter jejuniB. Enterohemorrhagic Escherichia coliC. Salmonella sp. D. Shigella sp.

ANS: AMedical Microbiology by Jawetz., 23rd ed., page 273

206. 11. Which one of the following is considered facultatively intracellular for human macrophages?

A. Enteroinvasive Escherichia coliB. Enterotoxigenic Escherichia coliC. Salmonella typhi D. Shigella sp.

ANS: CMedical Microbiology by Jawetz., 23rd ed., page 258

207. A 20-year-old female presents with severe pelvic pain, fever, nausea and vomiting. She was on the second day of her menstrual cycle. A purulent cervical discharge was detected upon physical examination. Oxidase positive, Gram-negative diplococci were isolated on Thayer Martin agar from the endocervical swab. What is the MOST LIKELY identity of this organism?

A. Bordetella pertussisB. Chlamydia trachomatisC. Haemophilus ducreyiD. Neisseria gonorrhoeae

ANS: DMedical Microbiology by Jawetz., 23rd ed., page 295

208. A large outbreak of food poisoning occurred at a company picnic. Eighty people reported explosive vomiting and diarrhea within 3 hours after eating. All of the victims recovered within 24 hours without medical intervention. No known bacterial or viral pathogens were isolated from the stool of affected individuals. A survey of the food eaten at the picnic suggested that potato salad was the common source of the poisoning. The individual who prepared the salad had a sty on her left eye. Which one of the following is the MOST LIKELY cause of this outbreak?

A. Clostridium perfringensB. Salmonella typhimurium C. Staphylococcus aureusD. Staphylococcus epidermidis

ANS: C

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Medical Microbiology by Jawetz., 23rd ed., page 223

209. Gram-positive cocci and polymorphonuclear leukocytes are observed on Gram stain of sputum from a 60-year old alcoholic with pneumonia. Culture of the sputum reveals alpha-hemolytic, catalase-negative bacteria. Which one of the following laboratory tests is the MOST APPROPRIATE next step in the definitive identification of this organism?

A. bacitracin sensitivity testB. beta-lactamase production testC. ELEK testD. bile solubility test


210. A 19-year old female is admitted to an outpatient clinic with suprapubic pain, dysuria and an urgency to urinate frequently. She is otherwise healthy. A clean catch midstream urine specimen was collected and sent to the laboratory. Numerous neutrophils are detected in the urine sample. The bacteriology laboratory reports that less than 102 Gram-positive cocci and greater than 105 Gram-negative bacilli were recovered per milliliter of urine. Which one of the following is the most likely cause of her infection?

A. Escherichia coliB. Klebsiella pneumoniae C. Pseudomonas aeruginosaD. Staphylococcus aureus


211. A 40-year old male hog farmer complains of intermittent fever, night sweats and headaches to his physician. The patient is hospitalized and blood and bone marrow specimens are collected. The physician requests that the laboratory incubate the cultures for at least 6 weeks. Nine days after admission, Gram negative coccobacilli that require increased CO2 for growth are isolated from the blood and bone marrow cultures. The patient is most likely to be suffering from which one of the following diseases?

A. BrucellosisB. Bubonic plagueC. Legionnaire’s diseaseD. Rocky Mountain spotted fever


212. Which one of the following diseases is most likely to respond favorably to treatment with a -lactam antibiotic?

A. LegionellosisB. MycoplasmosisC. SyphilisD. Trachoma


213. A 20-year old woman comes to your clinic complaining of an irritating vaginal discharge. Upon examination, you find that the cervix and vaginal walls appear normal. The

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discharge is thin and milky, pH 5.5, and has a fishy odor when treated with potassium hydroxide. You are unable to detect pseudohyphae, buds, or flagellates upon microscopic examination. A Gram stain reveals numerous curved Gram-negative rods, epithelial cells, and clue cells, but relatively few Gram-positive rods or WBCs. Cervical and vaginal cultures are negative for STDs. What is your diagnosis?

A. Bacterial vaginosisB. CervicitisC. TrichomoniasisD. Vaginal candidiasis


214. A 75-year old man in a nursing home is treated with a broad spectrum antibiotic for bed sores. Two days later he develops bloody diarrhea. A stool specimen from the patient is positive in an ELISA test for a necrotizing cytotoxin, and his treatment is switched to vancomycin. The agent MOST LIKELY to be responsible for this clinical syndrome is

A. Bacteroides fragilis.B. Campylobacter jejuni.C. Clostridium difficile.D. Escherichia coli O157:H7.


215. Which one of the following toxins is responsible for scalded skin syndrome? A. Alpha hemolysinB. ExfoliatinC. Hyaluronidase D. Staphylococcal enterotoxin

ANS: BMedical Microbiology by Jawetz., 23rd ed., page 225

216. A 50-year old cancer patient with severe neutropenia became septic two weeks after being admitted to the hospital. An oxidase-positive, Gram-negative rod that did not ferment glucose was isolated from the patient’s blood. Which one of the following organisms is the most likely cause of the patient’s sepsis?

A. Enterobacter cloacaeB. Escherichia coliC. Klebsiella pneumoniaeD. Pseudomonas aeruginosa


217. Blood culture from a 12-year old with acute osteomyelitis yields Gram-positive cocci that are b hemolytic and catalase positive. Which one of the following laboratory tests is the MOST APPROPRIATE next step in the definitive identification of this organism?

A. Coagulase test B. Optochin sensitivity testC. Slide agglutination test for capsular antigen type D. Test for capacity to grow in bile esculin


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218. Activated macrophages are the effector cells in the expression of a protective, cell-mediated immune response against

A. Corynebacterium diphtheriae.B. Haemophilus influenzae type b. C. Listeria monocytogenes.D. Streptococcus pneumoniae.


219. A patient recovering from a crushing leg injury suffered during an a motorcycle accident develops a temperature of 100o F, a rapid pulse, and extreme pain at the site of his the wound two days after the accident. The skin overlying the patient’s sutured wound is brownish- white, shiny, and studded with vesicles. Gram stain of the watery exudate from the wound reveals Gram-positive rods, Gram-negative rods, and Gram-positive cocci. The Gram-positive rods are MOST LIKELY

A. Bacillus cereus.B. Bacteroides fragilis.C. Clostridium perfringens.D. Corynebacterium ulcerans.


220. A 13-year old and her 10-year old brother are seen at an emergency room with complaints of double vision, difficulty swallowing, and progressive muscular weakness. A detailed history reveals that both children attended a church picnic three days earlier but neither child has gastroenteritis. The MOST LIKELY presumptive diagnosis is

A. botulism.B. Chinese rice syndrome.C. Guillan-Barré syndrome.D. salmonellosis.


221. Epidemics of bacterial meningitis in young, previously healthy adults are MOST LIKELY caused by

A. Escherichia coli K-1.B. Haemophilus influenzae type b.C. Listeria monocytogenes.D. Neisseria meningitidis group A.


222. A 55-year old woman develops endocarditis following oral surgery. Gram-positive, alpha-hemolytic, catalase-negative cocci are isolated from a blood culture. The MOST LIKELY agent is

A. Enterococcus faecalis (group D streptococci).B. Staphylococcus aureus.C. Streptococcus pyogenes (group A streptococci). D. Viridans streptococci.


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223. A 2-month old infant is admitted to the hospital with fever, lymphocytosis, and bouts of violent coughing that often end in vomiting. The infant’s mother reveals that the child has not as yet received any immunizations. The attending physician swabs the infant’s nasopharynx and requests that the swab be plated on routine media as well as a special medium (Bordet-Gengou) that contains blood and glycerol. No organisms are found on blood or chocolate agar, but small Gram-negative rods are isolated on Bordet-Gengou agar. The MOST LIKELY cause of the infant’s illness is

A. Bordetella pertussis.B. Chlamydia pneumoniae.C. Moraxella catarrhalis.D. Mycoplasma pneumoniae.


224. Which one of the following viruses establishes a chronic persistent infection in humans?A. Hepatitis A virus B. Hepatitis C virus C. HerpesvirusD. Poliovirus

ANSWER: BMedical Microbiology by Jawetz., 23rd ed., page 475-476

225. Which one of the following viruses is transmitted via the gastrointestinal route?A. Delta-associated agentB. Hepatitis AC. Hepatitis BD. Hepatitis C

ANSWER: BMedical Microbiology by Jawetz., 23rd ed., page 474

226. A 33-year-old pregnant woman delivered a baby boy via a normal vaginal delivery. Neither she nor the father has a history of genital or oral herpes. Although she had chickenpox as a child, she was exposed to a child with chickenpox about 10 days before delivery. There was no evidence of vesicular skin lesions on either the mother or the child at the time of delivery. Three days after birth, the baby now develops vesicular skin lesions on his back, accompanied by a fever. Which one of the following viruses is MOST LIKELY to be the cause of the baby's infection?

A. CytomegalovirusB. Herpes simplex virus type 1C. Herpes simplex virus type 2D. Human herpesvirus 6

ANSWER: CMedical Microbiology by Jawetz., 23rd ed., page 434

227. Examination by dark-field microscopy of scrapings from a genital ulcer of 19-year old female reveals mobile, spiral-shaped organisms against a black background. The MOST LIKELY diagnosis is

A. chancroid.B. Chlamydia trachomatis infection.C. gonorrhea.D. syphilis.


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228. Gram-positive cocci are observed on a Gram stain of purulent discharge from a skin lesion of a 7-year-old. Culture of the exudate reveals beta-hemolytic, catalase-positive organisms. Which one of the following laboratory tests is the MOST APPROPRIATE next step in the definitive identification of this organism?

A. Bacitracin sensitivity test B. Bile solubility test C. Coagulase test D. Optochin sensitivity test


229. Which one of the following species or serovars of Chlamydia can be transmitted as a zoonotic infection?

A. Chlamydia pneumoniae B. Chlamydia psittaci C. Chlamydia trachomatis serovar C D. Chlamydia trachomatis serovar D


230. Gram stain of synovial fluid from the knee of a 20-year-old woman with arthritis reveals Gram-negative cocci. To isolate the MOST LIKELY responsible agent, the specimen should be plated on

A. Bordet-Gengou agar. B. Chocolate agar. C. Eosin Methylene Blue (EMB) agar. D. MacConkey agar.


231. The formation of colonic ulcers and absesses during Shigella dysentery is due to A. ability of bacteria to survive stomach acidity because of the production

of urease. B. bacterial survival within macrophages. C. invasion of enterocytes and cell-to-cell spread of the bacteria. D. production of a superantigen by the bacillus.

ANS: C Medical Microbiology by Jawetz., 23rd ed., page 255-256

232. Which one of the following organisms is the MOST COMMON cause of bacterial traveler’s diarrhea?

A. Campylobacter jejuni B. enterotoxigenic Escherichia coli C. Salmonella cholerasuis D. Shigella sonnei


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233. Dissemination of Salmonella typhi from the intestine to extraintestinal sites requires survival of this pathogen in which one of the following host cells?

A. Colonic enterocytes B. Gastric epithelial cells C. M cells D. Macrophages

ANS: D Medical Microbiology by Jawetz., 23rd ed., page 257-258

234. Gram stain of cerebrospinal fluid from a 3-year-old child with fever, petechiae, stiff neck and positive Kernig and Brudzinski's signs reveals PMNs and a few Gram-negative cocci. The MOST LIKELY agent is

A. Escherichia coli. B. Haemophilus influenzae type b. C. Neisseria meningitidis. D. Streptococcus agalactiae (group B streptococci ).


235. Listeria monocytogenes infection of an adult is MOST LIKELY to be acquired by A. ingestion of contaminated food. B. inhalation of contaminated aerosals. C. inoculation with a contaminated needle. D. person-to-person contact.


236. What is the mechanism of action of the antifungal drug fluconazole?A. Binds to ergosterol resulting in membrane disruptionB. Inhibits ergosterol synthesis C. Inhibits protein synthesisD. Inhibits RNA synthesis

ANS: B Medical Microbiology by Jawetz., 23rd ed., page 652-653

237. A 10-year-old with a dog complains of a “bump” on the back of his head. He says its redness and itching have increased over the last three weeks. The lesion is several centimeters in diameter, with hair involvement and scaling. Examination of several of his hairs in a KOH preparation reveals hyphae in and around the hair shafts. What is your diagnosis?

A. ActinomycosisB. CandidiasisC. Pityriasis versicolorD. Tinea capitis

ANSWER: D, Tinea capitis Medical Microbiology by Jawetz., 23rd ed., page 632

238. You are assigned to a hospital in Phoenix, Arizona. Several patients have been admitted in the past week with cough, chest pain, fever, and pneumonitis that has not responded to antibacterial therapy. You discover that most of the patients are new arrivals to Arizona who had been working outdoors during the dusty wind storms that had occurred over the past few weeks. The causative organism is observed in a KOH preparation of sputum. What is your presemptive diagnosis?

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A. BlastomycosisB. CoccidioidomycosisC. HistoplasmosisD. Psittacosis

ANSWER: B, Coccidioidomycosis Medical Microbiology by Jawetz., 23rd ed., page 637-638

239. A 65-year-old male develops endocarditis following urinary catheterization. Gram-positive, catalase-negative cocci are isolated from a blood culture. The MOST LIKELY agent is

A. Enterococcus faecalis (group D streptococci)B. Staphylococcus aureus.C. Staphylococcus epidermidis. D. Streptococcus pyogenes (group A streptococci).


240. A 22-year-old develops an abcess in his peritoneum following rupture of his appendix. Gram stain of the exudate from his foul-smelling abcess reveals numerous polymorphonuclear leukocytes, Gram-positive cocci, Gram-positive rods, and Gram-negative rods. Aerobic culture of the exudate at 37o C on blood and MacConkey agar plates yields only enterococci (group D streptococci). The Gram-negative rods are MOST LIKELY

A. Bacteroides fragilisB. Escherichia coliC. Pseudomonas aeruginosaD. Shigella dysenteriae.


241. Several people become ill within two hours after leaving a summer reunion picnic. The majority of people complain of vomiting and diarrhea without fever, and recovered within 24 hours after the onset of symptoms. The contaminated food is determined to be a bowl of coleslaw prepared by someone with a stye on her left eyelid. Which one of the following is the MOST LIKELY source of the food poisoning?

A. Clostridium botulinum B. Clostridium perfringens C. Staphylococcus aureus D. Shigella sonnei


242. A 35-year-old female presents with fever, headache and a non-productive cough. The patient is prescribed penicillin and sent home. Two weeks later, she returns with similar symptoms. A Gram stain and routine culture of the patient's sputum reveal only normal mouth flora. Sputum is then cultured on specialized medium containing sterols, and, after two days, tiny colonies were visible under a microscope. Which one of the following organisms does the physician suspect is the cause of the patient's pneumonia?

A. Corynebacterium diphtheriae B. Haemophilus influenzae type b C. Legionella pneumophila D. Mycoplasma pneumoniae

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243. A 70-year-old male, who is a chain-smoker, complains of fever, diarrhea, cough and chest pain. Evidence of pneumonia is seen by chest X-ray. Due to the inability of the patient to produce a sputum specimen, a transtrachial aspirate is obtained. No respiratory bacterial pathogen is isolated from aspirated fluid cultured on blood agar plates. However, poorly staining Gram-negative rods are isolated on buffered charcoal-yeast extract (BCYE) agar after three days of incubation. The physician had already begun treatment with erythromycin due to the detection of bacilli in the aspirated fluid using a fluorescently-labeled monoclonal antibody specific for the causative agent. The MOST LIKELY pathogen responsible for this pneumonia is

A. Haemophilus influenzaeB. Legionella pneumophilaC. Mycoplasma pneumoniaeD. Neisseria meningitides

ANS: B, Legionella pneumophila Medical Microbiology by Jawetz., 23rd ed., page 313

244. Which one of the following fungi exhibits thermal dimorphism? A. Aspergillus fumigatus B. Candida tropicalis. C. Cryptococcus neoformans D. Histoplasma capsulatum

Answer: D Medical Microbiology by Jawetz., 23rd ed., page 640

245. An otherwise healthy 35-year-old female florist presented to her primary care physician complaining of a persistent lesion on the third digit of her left hand. This had been present for several weeks and showed no sign of resolving. Upon examination, the patient was found to have a mild fever (1000F), the aforementioned lesion and two nodules on her left forearm. A biopsy of the lesion was performed, and the pathology report indicated the presence of numerous polymorphonuclear leukocytes and a rare elongated budding yeast. What is the MOST LIKELY etiologic agent?

A. Blastomyces dermatitidis B. Sporothrix schenckii C. Histoplasma capsulatum D. Nocardia asteroides

Answer: B Medical Microbiology by Jawetz., 23rd ed., page 632-633

246. Mode of transmission of Trichomonas vaginalis is:A. Ingestion of infested beef B. Skin contact with larvae C. Mosquito bites D. Sexual

ANS:D Medical Microbiology by Jawetz., 23rd ed., page 663-664

247. Mode of transmission of Enterobius vermicularis is:A. Sexual B. Blackfly bites C. Louse bites D. Fecal-oral

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http://www.med.jhu.edu/medcenter/quiz/objQuery.cgi?actionField=query&dbfield=micro&queryTypeFld=contains&queryFld=Enterobius+vermicularis

Ans. D Medical Microbiology by Jawetz., 23rd ed., page 689

248. Oxygen requirements of Neisseria gonorrhoeae is:A. Aerobic B. Facultative anaerobe C. Microaerophilic D. Obligate anaerobe

Ans. A Medical Microbiology by Jawetz., 23rd ed., page 295

249. Mode of transmission of Borrelia burgdorferi is:A. Direct contact with animals B. Conidia inhalation C. Sexual D. Tick bites


250. Therapy of Vibrio cholerae is:A. TMP-SMX B. ORS C. Ceftriaxone D. Erythromycin

Ans. B Medical Microbiology by Jawetz., 23rd ed., page 271

251. Family of Measles virus is:A. Paramyxoviridae B. Rhabdoviridae C. Orthomyxoviridae D. Flaviviridae


252. Family of Hepatitis A virus is:A. Papovaviridae B. Hepadnaviridae C. Parvoviridae D. Picornaviridae


253. Phenotypic characteristic of Streptococcus pyogenes is:A. Alpha-hemolytic B. Oxidase "+" C. H2S "-" D. Beta-hemolytic


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http://www.med.jhu.edu/medcenter/quiz/objQuery.cgi?actionField=query&dbfield=micro&queryTypeFld=contains&queryFld=Streptococcus+pyogenes

http://www.med.jhu.edu/medcenter/quiz/objQuery.cgi?actionField=query&dbfield=micro&queryTypeFld=contains&queryFld=Hepatitis+A+virus

http://www.med.jhu.edu/medcenter/quiz/objQuery.cgi?actionField=query&dbfield=micro&queryTypeFld=contains&queryFld=Measles+virus

http://www.med.jhu.edu/medcenter/quiz/objQuery.cgi?actionField=query&dbfield=micro&queryTypeFld=contains&queryFld=Vibrio+cholerae

http://www.med.jhu.edu/medcenter/quiz/objQuery.cgi?actionField=query&dbfield=micro&queryTypeFld=contains&queryFld=Borrelia+burgdorferi

http://www.med.jhu.edu/medcenter/quiz/objQuery.cgi?actionField=query&dbfield=micro&queryTypeFld=contains&queryFld=Neisseria+gonorrhoeae

254. Mode of transmission of Rickettsia prowazekii is:A. Droplet nuclei B. Direct contact with animals C. Louse bites D. Wound infection

Ans. C Medical Microbiology by Jawetz., 23rd ed., page 350

255. Phenotypic characteristic of Gonococcus is:A. Fastidious B. Mycolic acid in cell wall C. Catalase "-" D. Non-lactose fermenter


256. Staphylococcal food poisoning is the result of A. a heat labile enterotoxin. B. ingestion of a pre-formed enterotoxin produced by Staphylococcus

aureus during bacterial multiplication in contaminated food. C. ingestion and multiplication of coagulase-negative Staphylococcus sp. D. multiplication of Staphylococcus aureus in the small intestine.


257. A 19-year-old soldier develops fever, carditis, and migratory polyarthritis. While taking her history, the patient remembers that she had a "sore throat" three weeks previously. A throat culture of the patient yields normal flora only. The laboratory result MOST CONSISTENT with these findings is that the patient has high titers of antibody to:

A. meningococcal lipooligosaccharide. B. pneumococcal IgA protease. C. pneumococcal polysaccharide. D. streptolysin O.


258. A 65-year-old man with a colonic tumor undergoes a bowel resection. Three days later, the patient develops a fever, and the drainage from the surgical site is foul smelling. The skin near the site of the drainage is markedly erythematous. Gram stain of the drainage reveals Gram-positive cocci and Gram-negative rods. Aerobic culture of the drainage yields streptococci. The Gram-negative rod seen on Gram stain was most likely:

A. Bacteroides fragilis B. Clostridium perfringens C. Escherichia coli D. Pseudomonas aeruginosa


259. A 50-year-old rancher scrapes his hand with clippers while shearing sheep. Two days later he notices an ulcer surrounded by vesicles at the site of the wound. Eight days after the injury, the wound develops a black necrotic center (eschar) surrounded by

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http://www.med.jhu.edu/medcenter/quiz/objQuery.cgi?actionField=query&dbfield=micro&queryTypeFld=contains&queryFld=Gonococcus

http://www.med.jhu.edu/medcenter/quiz/objQuery.cgi?actionField=query&dbfield=micro&queryTypeFld=contains&queryFld=Rickettsia+prowazekii

edematous fluid. The rancher experiences mild systemic symptoms. The most likely cause of the infection is:

A. Bacillus anthracis. B. Clostridium tetani. C. Neisseria meningitidis. D. Streptococcus pyogenes (group A streptococci).

ANS: A Medical Microbiology by Jawetz., 23rd ed., page 202-203

260. A 19-year-old college sophomore dies 24 hours after the development of fever, petechiae, purpura, and disseminated intravascular coagulation. Culture of cerebrospinal fluid and blood obtained from the patient on admission to the hospital MOST LIKELY yielded:

A. Gram-negative, lactose fermenting rods. B. Gram-negative, oxidase positive diplococci. C. Gram-positive, catalase negative cocci. D. Gram-positive, catalase positive cocci.


261. The blood culture of a patient with a presumptive diagnosis of endocarditis yields non-hemolytic colonies of Gram-positive cocci. The isolate is catalase negative, can grow in 6.5% NaCl, and is resistant to penicillin. The isolate is MOST LIKELY:

A. Enterococci. B. Streptococcus agalactiae (group B streptococci). C. Streptococcus bovis. D. Streptococcus mutans (Viridans streptoccoci).


262. A 25-year-old, previously healthy woman develops fever within 24 hours of delivery of an infant born 6 weeks prematurely. Blood culture of the mother reveals Gram-positive cocci that are catalase negative, beta-hemolytic on blood agar, and resistant to bacitracin. The MOST LIKELY cause of the bacteremia is:

A. Enterococci. B. Staphylococcus aureus. C. Streptococcus agalactiae (group B streptococci). D. Streptococcus pneumoniae.


263. An HIV-infected homosexual man presents with Kaposi's sarcoma. Which viral genome is MOST LIKELY to be present in his tumor biopsy?

A. Herpes simplex virus tupe 1 B. Human cytomegalvirus C. Human herpesvirus type 6 D. Human herpesvirus type 8


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264. Which one of the following viral infections is not effectively prevented by vaccination? A. Hepatitis B virus B. Poliovirus C. Rhinovirus D. Rubella virus

Answer: C Medical Microbiology by Jawetz., 23rd ed., page 543

265. Prions cause spongiform encephalopathies including the human disease A. AIDS dementia complex. B. Creutzfeldt-Jacob disease. C. scrapie. D. subacute sclerosing panencephalopathy (SSPE).

Answer: B Medical Microbiology by Jawetz., 23rd ed., page 584

266. Congenital infection by which one of the following viruses can result in birth defects? A. Adenovirus B. Cytomegalovirus C. Hepatitis B virus D. Human immunodeficiency virus


267. Viral carditis of adolescents and adults is frequently caused by A. Coxsackieviruses. B. Orthomyxoviruses. C. Pseudorabiesvirus. D. Reoviruses.

Answer: A Medical Microbiology by Jawetz., 23rd ed., page 495

268. Several newborns housed in a neonatal intensive care unit have developed nosocomial pneumonia. Most are wheezing and some have required care such as mechanical ventilation, increased doses of oxygen, antibiotic therapy, or monitoring for apnea. A simple, rapid diagnostic test reveals a common viral antigen in nasal wash specimens from each of the patients. The virus MOST LIKELY to be responsible is

A. Coronavirus B. Echovirus B2 C. Respiratory syncytial virus D. Rubeola virus (measles)

Answer: C Medical Microbiology by Jawetz., 23rd ed., page 558-559

269. A 7 year-old newly adopted Russian child who has been in the United States 10 days presents with fever, malaise, sore throat, and a grey membrane on the tonsils, uvula, and soft palate. The child's immunization history is unknown. The physician obtains a swab of the child's throat which provokes bleeding of the membrane. The swab is sent to the laboratory for routine throat culture. Two days later the laboratory reports only the presence of normal flora in the specimen. The MOST LIKELY organism responsible for this child's illness is:

A. Bordetella pertussis. B. Corynebacterium diphtheriae.

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C. Haemophilus influenzae type b. D. Listeria monocytogenes.


270. Soft cheese imported from Mexico was implicated as the vehicle in an outbreak of meningitis and bacteremia that occurred among attendees of a large company picnic. Twenty of the 40 affected individuals were pregnant women. One of the victims had AIDS. Gram positive, non-spore forming rods were isolated from the cheese that had been stored in the cold. The MOST LIKELY organism responsible for this outbreak is:

A. Bacillus cereus B. Clostridium difficile C. Clostridium perfringens D. Listeria monocytogenes


271. A 25 year old patient presents at a sexually transmitted disease (STD) clinic with a painful genital ulcer. On examination, the ulcer does not appear to be typical of herpes simplex virus. Dark field microscopy of exudate from the ulcer is negative for spiral-shaped organisms. However, a small, gram negative rod is isolated from culture of the exudate on chocolate agar. The organism MOST LIKELY to be responsible for the lesion is:

A. Chlamydia trachomatis. B. Haemophilus ducreyi. C. Neisseria gonorrhoae. D. Treponema pallidum.


272. Which ONE of the following diseases is transmitted by lice? A. Epidemic typhus B. Ehrlichiosis C. Psitticosis D. Scrub typhus


273. A young army recruit presents at a sexually transmitted disease (STD) clinic with acute urethritis. A Gram-stained preparation of his urethral exudate reveals neutrophils with intracellular Gram-negative diplococci. The patient is treated with ceftriaxone and sent home. He is requested to return in one week so that a urethral culture can be obtained to test for proof of antibiotic cure. Which ONE of the following culture media should be used for the follow-up culture?

A. Blood agar B. Bordet Gengou agar C. MacConkey agar D. Thayer-Martin agar


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274. The growth in the vagina of which ONE of the following bacteria helps maintain a protective acid pH?

A. Bacteroides B. Gardnerella C. Lactobacillus D. Mobiluncus

Answer: C Medical Microbiology by Jawetz., 23rd ed., page 307

275. A 25 year-old sexually active woman complains of vaginal itching, odor, and discharge. The vaginal walls are red and slightly swollen, but the cervix is normal. A sample of her vaginal discharge is tested with 10% KOH, which produces a strong fishy odor. Upon microscopic examination of the discharge, you find clue cells but no pear-shaped flagellates or pseudohyphae. A Gram stain reveals numerous Gram-negative curved rods. What is your diagnosis?

A. Bacterial vaginosis B. Pelvic inflammatory disease (PID) C. Syphilis D. Trichomoniasis


276. A 25 year-old male develops an ulcerative lesion of the hand and several fluctuant nodules along the lymphatics draining that site. The patient is seen in the dermatology clinic at the Naval Hospital. Case history reveals that he is a weekend gardener who cultivates roses as a hobby. What is the MOST LIKELY fungal disease?

A. Chromoblastomycosis B. Mycetoma C. Phaeohyphomycosis D. Sporotrichosis


277. A 50 year-old farmer from Sorsogon who is fond of eating freshwater crabs is suffering from chronic pneumonia with hemoptysis. Which parasite etiology is MOST likely?

A. Capillaria philippinensisB. Necator americanus C. Paragonimus westermaniD. Schistosoma japonicum

278. Knowing the life cycle of Schistosoma japonicum, a rural health doctor is now tasked with educating the population of a district in Davao del Sur about prevention of this disease. Which specific developmental stage of this parasite should be avoided to prevent initial infection?

A. cercariaB. metacercariaC. miracidiumD. schistosomule

279. In relation to question #72 above, which of the following measures would this doctor teach is most practical for preventing S. japonicum infection?

A. avoid eating raw fresh water snails B. boil drinking water for 20 minutesC. clean and cook vegetables wellD. wear protective high boots while wading in streams

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280. A preventive measure against parasites is footwear. Which of these parasites enters through the skin and its infective stage is a filariform larva?

A. Necator americanusB. Trichinella spiralis C. Trichuris trichiuraD. Enterobius vermicularis

281. Some protozoans have organelles which enable them to move around. Which of the following species possess cilia as motility organelles?

A. Balantidium coliB. Entamoeba histolyticaC. Giardia lambliaD. Plasmodium malariae

282. Ten year-old Theira has been having vague periumbilical abdominal discomfort for three months. She does not have diarrhea. Her fecalysis reveals round golden brown tri-layered eggs with cortication. What is the causative agent of her abdominal infection?

A. Ascaris lumbricoidesB. Balantidium coliC. Taenia saginataD. Trichuris trichiura

283. Mrs. Sintas complains to her family doctor that she has been having vague abdominal pains and bloody diarrhea for the past two days. She had recently arrived from a business trip to Leyte. Which of the following intestinal parasitic diseases is LEAST LIKELY to present with bloody diarrhea?

A. AmebiasisB. GiardiasisC. TrichuriasisD. Strongyloidiasis

284. Adult stages of intestinal parasites have their own way of establishing themselves in their chosen habitat. Which of these species has a long anterior end which penetrates the mucosa to obtain tissues for its nutrition?

A. A. Ascaris lumbricoidesB. B. Enterobius vermicularisC. Strongyloides stercoralisD. Trichuris trichiura

285. Except for the Schistosome species, all trematodes have similar life cycles. The infective stage, for example is which of these developmental stages for the liver, lung, and intestinal flukes?

A. cercariaB. metacercariaC. rediaD. sporocyst

286. Hydatid Disease is endemic in small areas of Southern Luzon and Bicol region where sheep are raised. What is the causative parasite of this disease?

A. Ancylostoma duodenaleB. Brugia malayiC. Echinococcus granulosusD. Fasciolopsis buski

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287. The trophozoite stage of this protozoa has rbc as inclusions in the cytoplasm: (p. 121)A. Entamoeba coliB. Entamoeba histolyticaC. Endolimax nanaD. Entamoeba hartmanii

288. One of the following is not a pseudophyllidean tapeworm. (p. 513)A. Diphyllobothrium latumB. Ligula intestinalisC. Sparganum proliferumD. Taenia solium

289. Bachman intradermal test is a highly specific test for this disease. (p. 239)A. AscariasisB. Enterobiasis C. TrichinosisD. Amoebiasis

290. One of the following is not a common feature of uncomplicated P. falciparum in peripheral smear: (p. 186)

A. appliqué form of parasiteB. multiple infection of one rbcC. presence of Maurer’s cleftsD. rounded microgametocyte

291. A 10-year-old girl, with perianal pruritus, was brought by her mother to her pediatrician. What is your most probable diagnosis?

A. AscariasisB. TrichuriasisC. EnterobiasisD. Hookworm infection

Ref. Clinical Parasitology by Beaver and Jung 9th edition, pp. 304-305MPL: 0.75

292. A 40-year old male overseas worker complaining of muscle pains seek medical attention upon his arrival to the Philippines. Biochemical tests showed elevated creatinine, phosphokinase, lactate dehydrogenase and myokinase levels. Results of complete blood count showed high blood eosinophilia. What is your most probable diagnosis?

A. TaeniasisB. CapillariasisC. TrichinosisD. Filariasis

Ref. Clinical Parasitology by Beaver and Jung 9th edition, pp.238-239MPL: 0.5

293. Sexually active 26-year old woman consulted a VD control clinic for vaginal itching and purulent discharge. Your tentative diagnosis should include the following:

A. gonorrheaB. trichomoniasisC. candidiasisD. all of the above

Ref. Clinical Parasitology by Beaver and Jung 9th edition, pp. 50MPL: 0.25

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294. A 30-year old woman, native of Bulacan, traveled to Palawan for a vacation. After 2 weeks she consulted her doctor with chills and fever as her main complains. What parasitologic test would you request to establish your diagnosis?

A. sputum examination B. stool examination C. thick blood smearD. thick and thin blood smear


295. A 6-month old baby was brought in for a fever of one-day duration. She is found to have a temperature of 38.5°C and with hepatomegaly (3 cm) and splenomegaly (3 cm). Microscopic examination revealed infected RBC with presence of band form stages. What is your most probable diagnosis?

A. Not malaria B. Plasmodium falciparum C. Plasmodium vivaxD. Plasmodium malariae


296. Hepatosplenomegaly is the hallmark of this disease which is endemic in Leyte, Samar and Mindoro. This is caused by:

A. Schistosoma japonicumB. Echinostoma ilocanumC. Pila luzonicaD. Capillaria philippinensis

Reference: Brown & Neva, 1983. Basic Clinical Parasitology. 5th Edition. The McGraw Appleton-Century Crofts. p. 241

297. Pruritus vulvae is a characteristic symptom in :A. TrichinosisB. TrichomoniasisC. EnterobiasisD. Scabies

Reference: Brown & Neva, 1983. Basic Clinical Parasitology. 5th Edition. The McGraw Appleton-Century Crofts. p 46

298. Finding banana- or sausage-shaped gametocytes in peripheral smear is a unique characteristic of:

A. Plasmodium malariaeB. Plasmodium vivaxC. Plasmodium falciparumD. Plasmodium ovale

Reference: Brown & Neva, 1983. Basic Clinical Parasitology. 5th Edition. The McGraw Appleton-Century Crofts. p. 81-82

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299. Wearing protective footwear would NOT prevent transmission of which of the following parasite?

A. Ancylostoma B. LeptospiraC. TrichurisD. Schistosoma

Reference: Brown & Neva, 1983. Basic Clinical Parasitology. 5th Edition. The McGraw Appleton-Century Crofts. pp. 126

300. Taenia solium and Trichinella spiralis can be prevented by eating properly cooked:A. fishB. porkC. beefD. vegetables

Reference: Brown & Neva, 1983. Basic Clinical Parasitology. 5th Edition. The McGraw Appleton-Century Crofts. pp. 185, 111

301. Recommendation for the control of hookworm in endemic areas include the construction of sanitary facilities and :

A. wearing of footwearB. reduction of the stray cats populationC. through cooking of meats and fishD. use of insecticides to control mosquitoes and flies.


302. Humans become infected when they swallow the eggs and develop cysts in various organs to cause hydatidosis. This tapeworm is could be best prevented by:

A. reducing larval E. multilocularis in sheep and hogsB. reducing adult E. granulosus infection in dogsC. proper and sanitary disposal of waste D. surgical intervention


303. Dyspnea in Loeffler’s syndrome caused by larval invasion in massive ascariasis in the lungs could be best treated with:

A. salbutamol nebulizationB. giving mebendazole to treat the infectionC. both A and BD. neither A nor B

Reference: Brown & Neva, 1983. Basic Clinical Parasitology. 5th Edition. The McGraw Appleton-Century Crofts. Pp. 134-135

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Microbiology and Parasitology