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Flashcards in Micro/Para Deck (323):
1

Which of the following are examples of innate immunity?

- skin
- phagocytic cells
- complement components
- aota

All - skin, phagocytic cells, complement components

Innate immunity is an immediate response to the pathogen that does not confer long-lasting protective immunity. It is a nonspecific defense system and includes barriers to infectious agents, such as the skin (epithelium) and mucous membranes. It also includes many immune components important in the adaptive immune response, including phagocytic cells, natural killer (NK) cells, Toll-like receptors (TLRs), cytokines, and complement.

2

Betty has colds almost every three months. But she is not bothered because she noticed that even without treatment she gets better. The self-limiting nature of her colds which is often of viral etiology is partly attributed to:

- gamma interferon
- alpha interferon
- beta interferon
- alpha and beta interferon

- alpha and beta interferon

Virus infection itself triggers the production of type I IFNs. Type I IFNs comprise numerous genes and primarily include IFN-α and IFN-β.

3

Which of the follow statements best defines antigens?

- antigens are foreign entities to which the body mounts a host response
- antigens are substances which are recognized as "self" by the body
- both
- neither

- antigens are foreign entities to which the body mounts a host response

An antigen is substance that can provoke the production of an antibody. ere are a wide variety of features that largely determine immunogenicity.
They are: foreignness, size, chemical and structural complexity, genetic constitution of the host, antigen administration.

4

Which of the following pairs of cells are involved in immune response?

- macrophage and eosinophils
- T cells and B cells
- NK cels and monocytes
- reticulocytes and granulocytes

T cells and B cells

5

Which of the following Ig is the best complement activator?

- IgG
- IgM
- IgA
- IgE

- IgM

IgM is the main immunoglobulin produced early in the primary immune response. IgM is present on the surface of virtually all uncommitted B cells. It is the most efficient immunoglobulin in agglutination, complement xation, and other antigen–antibody reactions and is important also in defense against bacteria and viruses.

6

Which of the following Ig is the predominant antibody in secondary immune responses and constitutes an important defense against bacteria and viruses?

- IgG
- IgM
- IgA
- IgE

- IgG

IgG is the predominant antibody in secondary immune responses and constitutes an important defense against bacteria and viruses. It readily crosses the placenta and therefore is the most abundant immunoglobulin in newborns.

7

Which of the following Ig protects mucous membranes from attack by bacteria and viruses?

- IgG
- IgM
- IgA
- IgE

- IgA

IgA is the main immunoglobulin responsible for mucosal immunity and it is found in secretions such as milk, saliva, and tears and in other secretions of the respiratory, intestinal, and genital tracts.

8

Which of the following Ig trig- gers allergic responses of the immediate (anaphylactic) type through the release of mediators?

- IgG
- IgM
- IgA
- IgE

- IgE

The Fc region of IgE binds to its high-a nity receptor on the surface of mast cells, basophils, and eosinophils. is bound IgE acts as a receptor for the antigen that stimulates its pro-duction, and the resulting antigen–antibody complex trig- gers allergic responses of the immediate (anaphylactic) type through the release of mediators.

9

Which of the following is a feature of the primary immune response?

- high antibody peal
- persisten level of antibody
- shorter duration of lag phase
- IgM is the first antibody produced

- IgM is the first antibody produced

IgM is the main immunoglobulin produced early in the primary immune response. IgM is present on the surface of virtually all uncommitted B cells.

10

Which of the following is/are feature/s of the secondary immune response?

- IgG is produced
- development of memory cells
- high titer of antibodies
- antibody binds antigen more firmly
- aota

All

Secondary response is exposure months or years after the primary response. The antibody response is more rapid and rises to higher levels than during the primary response. This change in response is attributed to the persistence of antigen-sensitive “memory cells” following the first immune response. Much more IgG is produced, and the level of IgG tends to persist much longer than in the primary response. Furthermore, such antibody tends to bind antigen more firmly (ie, to have higher affinity) and thus to dissociate less easily.

11

Jake has typhoid fever. When he is seen by the doctor on the third week, he has started to feel better. If you can enter Jake's body which of the following items below would show that he had achieved an adaptive immune response against typhoid bacilli?

- physical barriers
- chemical barriers
- clonal expansion of effector cells
- phagocytosis

- clonal expansion of effector cells

12

Which of the following is/are effects of the complement activation?

- cell lysis
- inflammation
- immune phagocytosis
- aota

- aota

Activation of complement results in four major out- comes: (1) cytolysis, (2) chemotaxis, (3) opsonization, and (4) anaphylatoxins.

13

Doy was diagnosed to have an infectious disease of unknown etiology. Examination of his blood showed that the complement levels are normal. In infections, one defense against the agent is the activation of the complement. What then among the items below is the best trigger for the complement activation?

- IgG
- mannose-containing bacterial glycolipids
- microbial surfaces
- IgM-antigen immune complexes

- IgM-antigen immune complexes

It is the most efficient immunoglobulin in agglutination, complement xation, and other antigen–antibody reactions and is important also in defense against bacteria and viruses.

14

In this type of hypersensitivity, the effectors are the substances released by the degranulation of the mast cells.

- Type I
- Type II
- Type III
- Type IV

- Type I

Histamine exists in a preformed state in platelets and in granules of mast cells, basophils, and eosinophils.

15

Martin suffers from runny nose, itchy eyes and frequent sneezing especially during the months of March to Mar and November to January. He probably has the following hypersensitivity:

- Type I
- Type II
- Type III
- Type IV

- Type I

Type I hypersensitivity manifests itself in tissue reactions occurring within seconds a er the antigen combines with the specific IgE antibody. Its symptoms may manifest as a systemic anaphylaxis or as a local reaction.

16

Vivian was rushed to the hospital for shortness of breath. She gave a history of taking penicillin for her sore throat two days prior to admission. She gave no history of allergy to penicillin. Laboratory test done on her blood showed the presence of antibodies which hemolyses her own RBC. She is probably suffering from this type of hypersensitivity:

- Type I
- Type II
- Type III
- Type IV

- Type II

Type II hypersensitivity involves the binding of IgG anti- bodies to cell surface antigens or extracellular matrix molecules. Antibody directed at cell surface antigens can activate complement (or other e ectors) to damage the cells. e result may be complement-mediated lysis, which occurs in hemolytic anemias, ABO transfusion reactions, and Rh hemolytic disease.

17

Isabel becomes a different person during the month of December. In this month she is grouchy because of hay fever. Her doctor explained that she is allergic to pollen and the major culprit is the so-called IgE, which is a homocytotropic immunoglobulin which binds to all of the following cells below EXCEPT:

- eosinophils
- mast cells
- basophils
- neutrophils

- neutrophils

Histamine exists in a preformed state in platelets and in granules of mast cells, basophils, and eosinophils.

18

A 7-year-old girl was brough to the derma section of UPHR medical center for swollen, weeping earlobes with some signs of crusting. One earlobe has an almost embedded tiny earring. The doctor said the girl was probably allergic to the nickel component of the earring. The condition is also termed as:

- contact hypersensitivity
- tuberculin hypersensitivity
- atopic hypersensitivity
- immune complex hypersensitivity

- contact hypersensitivity

Type IV: Cell-mediated hypersensitivity is a function not of antibody but of specifically sensitized T lymphocytes that activate macrophages to cause an inflammatory response. The response is delayed.

Type IV: Contact hypersensitivity occurs after sensitization. In all cases, small molecules enter the skin and then, acting as haptens, attach to body proteins to serve as complete antigens. Cell-mediated hypersensitivity is induced, particularly in the skin.

Type IV: When a small amount of tuberculin is injected into the epidermis of a patient previously exposed to Mycobacterium tuberculosis, there is little immediate reaction. Gradually, however, indu- ration and redness develop and reach a peak in 24–72 hours.

Type I: Atopic hypersensitivity

Type III: Immune complex hypersensitivity

19

In the ELISA test:

- an enzyme is bound to an antibody
- specific substrate is added to the enzyme conjugated to the antibody
- both
- neither

- both; an enzyme is bound to an antibody AND specific substrate is added to the enzyme conjugated to the antibody

ELISA: enzyme-linked immunosorbent assay

To measure antibody, known antigens are fixed on a solid phase, incubated with test antibody dilutions, washed, and reincubated with an anti- immunoglobulin labeled with an enzyme. Enzyme activity, measured by adding the specific substrate and estimating the color reaction, is a direct function of the concentration of antibody bound.

20

Which pair of dyes are used in immunofluorescence?

- lugols iodine and red dye
- flourescein and rhodamine
- crystal violet and silver stain
- carbolfuchsin and methylene blue

- flourescein and rhodamine

Fluorescent dyes (eg, uorescein, rhodamine) can be cova- lently attached to antibody molecules and made visible by ultraviolet light in the fluorescence microscope.

21

In which immunofluorescence test does a reaction occur when known labeled antibody interacts directly with unknown antigen?

- direct immunofluorescence
- indirect immunofluorescence
- both
- neither

- direct immunofluorescence


- indirect immunofluorescence reaction occurs when a two-stage process is used (eg, a known antigen is attached to a slide, unknown serum is added, and the preparation is washed)

22

Carl has leukemia; unfortunately he was exposed to HBsAg positive blood. The best immediate managment which can be given to him is to administer:

- recombinant Hep B vaccine
- passive immunization
- anti-viral drugs
- vitamins

- passive immunization

Passive immunity is generated by administration of pre- formed antibodies. e primary advantage of passive immu- nization with preformed antibodies is the prompt availability of large amounts of antibody. is approach can be useful against certain viruses (eg, hepatitis B virus) a er a needle- stick injury to someone who has not been vaccinated.

23

Mario, a 45-year-old executive is a sickly guy. He always complains of coughs and colds. He used to be a smoker but he had stopped since he was in his early 30s. His doctor said that he is often attacked by organisms which attack/attach to the mucous membranes of his respiratory tract. These organisms then do which of the following actions against its host:

- breakdown of IgA by producing proteases
- evasion of phagocytosis by means of their capsule
- excretion of hyaluronidase
- neutralization of lysozymes

- breakdown of IgA by producing proteases

IgA is the main immunoglobulin responsible for mucosal immunity and it is found in secretions such as milk, saliva, and tears and in other secretions of the respiratory, intestinal, and genital tracts. It protects mucous membranes from attack by bacteria and viruses. Some bacteria (eg, Neisseria spp.) can destroy IgA1 by producing a protease and can thus overcome antibody-mediated resistance on mucosal surfaces.

24

A child who is breast fed is not usually prone to diarrhea, this is probably because of:

- the presence of hydrolytic enzymes in the saliva which kills most bacteria
- the acidity of the stomach
- presence of proteolytic enzymes and active macrophages in the small intestines
- aota

- aota

In the gastrointestinal tract, several systems function to inactivate bacteria: Saliva contains numerous hydrolytic enzymes; the acidity of the stomach kills many ingested bac- teria (eg, Vibrio cholerae), and the small intestine contains many proteolytic enzymes and active macrophages. Both fac- tors can destroy microorganisms in the small intestine.

25

Luna was diagnosed to have a starting skin cancer, which somehow spontaneously resolved. Aside from a possible miracle the doctor said it could be due to Luna's natural killer cells. Which is NOT a characteristic of NK cells?

- morphologically related to T cells
- they can lyse malignant cells
- they resemble large granular lymphocyte
- nota

- nota

Natural killer cells are large, granular lymphocytes mor- phologically related to T cells, which make up 10–15% of leukocytes in the blood. e NK cell can lyse target cells that have undergone malignant transformation and may play a role in immune surveillance against tumor establishment.

26

Which major antibody molecule has the ability to cross the placenta?
.
(A) IgG
(B) IgA
(C) IgM
(D) IgE
(E) IgD

(A) IgG

27

Which one of the following cell types expresses receptors for IgE on its cell surface that stimulate the cell to mount a response to parasites such as worms?
.
(A) T cells
(B) B cells
(C) Promonocytes
(D) NK cells
(E) Mast cells

(E) Mast cells

28

A cell that plays a critical role in the innate immune response and kills virus infected cells is:
(A) T cell
(B) Neutrophil
(C) NK cell
(D) Macrophage
(E) B cell

(C) NK cell

29

IgE-mediated histamine release is classi ed as what type of hypersensitivity reaction?
(A) Type 1
(B) Type 2
(C) Type 3
(D) Type 4

(A) Type 1

30

How is Streptococcus pyogenes differentiated from other streptococci?
.
- solubility in bile salt
- sensitivity to bacitracin
- alpha haemolytic
- catalase positive

- sensitivity to bacitracin

31

Which of the following streptococci is lancet shaped, diploid and with a big capsule?
.
- Streptococcus agalactiae
- Streptococcus pyogenes
- Streptococcus viridans
- Streptococcus pneumoniae

- Streptococcus pneumoniae

e pneumococci (S pneumoniae) are gram-positive diplo- cocci, o en lancet shaped or arranged in chains, possessing a capsule of polysaccharide that permits typing with speci c antisera.

32

What is the basis for the Lancefield classification of Streptococci?
.
- ribosomes
- cell wall carbohydrate
- capsule
- flagella

- cell wall carbohydrate

is carbohydrate is contained in the cell wall of many strepto- cocci and forms the basis of serologic grouping into Lance eld groups A–H and K–U. e serologic speci city of the group- speci c carbohydrate is determined by an amino sugar.

33

Which of the following tests will identify Streptococcus group B?

- quellung test
- CAMP test
- hemolysis in BAP
- catalase test

- CAMP test

Streptococcus agalactiae are the group B streptococci. e group B streptococci hydrolyze sodium hippurate and give a positive response in the so-called CAMP (Christie, Atkins, Munch-Peterson) test.

34

Dental caries is caused by streptococci which belong to:

- group A
- group B
- enterococci
- viridans group

- viridans group

Some viridans streptococci (eg, S mutans) synthesize large polysaccharides such as dextrans or levans from sucrose and contribute importantly to the genesis of dental caries.

35

What is the most common disease associated with Group B streptococci?
.
- UTI
- URTI
- Neonatal sepsis
- Glomerulonephritis

- Neonatal sepsis

36

Which of the following describes Streptococcus aureus?
.
- gram positive cocci, catalase positive
- gram positive, coagulase positive
- both
- neither

- both

37

Which of the following antibiotics is given to methicillin resistant s. aureus?
.
- quinolone
- macrolides
- vancomycin
- tetracyclines

- vancomycin

38

Which of the following toxin of s. aureus is a prototypical superantigen?
.
- exfoliative toxin
- hyaluronidase
- toxic shock syndrome toxin
- enterotoxin

- toxic shock syndrome toxin

39

The test that will identify s. aureus from the rest of the staphylococci:
.
- CAMP test
- Optochin test
- Coagulase test
- Oxidase test

- Coagulase test

Other
- CAMP test: Group B strep (agalactiae)
- Optochin test: Streptococcus pneumoniae
- Oxidase test:

40

Which of the following is/are true of s. epidermidis?
.
- can produce biofilms on prosthetic devices
- often more resistant to antimicrobial drugs than s. aureus
- both
- neither

- both

41

An elderly woman with pneumonia developed bloody diarrhea on the 7th hospital day, accompanied by abdominal cramps and fever. She was immediately placed in the ICU and all antibiotics were stopped. She has been on ampicillin for 5 days prior to admission and on admission was started with clindamycin and augmentin. Her condition is probably caused by:
.
- enterohemorrhagic escherichia coli
- shigella dysenteriae
- clostridium difficile
- vibrio parahemolyticus

- clostridium difficile

42

Severino had an accident that resulted in the amputation of his right leg, two inches above the knee. About five days post-op, signs of wound infection was evident. Local wound care was given and the exudate was sent to the lab. After two days the culture came with no organism isolated from the specimen as reported. They suspected anaerobic infection. anaerobic infection is usually suspected when:
.
- there is a presence of foul smell
- the site of infection is near a mucosal surface
- there is gas in tissues
- aota

- aota

- there is a presence of foul smell
- the site of infection is near a mucosal surface
- there is gas in tissues

43

George was rushed to the hospital for fever and pain in the right lower abdomen. Rectal exam was compatible with the diagnosis of appendicitis. On opening up, he was found to have a ruptured appendicitis with abscess formation around it. The exudates later yielded bacteroides fragilis. Which of the following factors promote abscess formation by B. fragilis?
.
- capsule
- lipopolysaccharide
- pili
- superoxide dismutase

- capsule

44

GC, a 20-year-old working in the call center, consulted a gynecologist because of whitish gray vaginal discharge with a bad order of about a week duration. The doctor got some fluid from the vaginal canal, placed some on the slide and some she tested for pH which was 5.5 against the normal value of 4.5 Wet mount showed many epithelial cells which appear granular. No PMN was noted. Which of the following is the most likely diagnosis?
.
- trichomonas vaginalis
- yeast vaginitis
- gonorrhea
- bacterial vaginosis

- bacterial vaginosis

45

A 67-year-old man was taken to the ER for difficulty of breathing. He has been feeling weak since 4 days ago. On physical examination inspiratory and expiratory wheezes and rales were noted over the right lower lung. His chest x-ray further revealed patchy lower right lung infiltrates. The differential diagnosis for this patient is:
.
- steptococcus pneumoniae
- legionella pneumophilia
- mycoplasma pneumoniae
- aota

- aota

- steptococcus pneumoniae
- legionella pneumophilia
- mycoplasma pneumoniae

46

Joe was diagnosed with lung cancer and in his bronchial washing acid-fast bacilli were seen mixed with the cancer cells. Joe had been given the full short course of the TB regimen before and so the doctor suspected a drug resistant staring. The bronchial washing was cultured and it grew orange colored colonies when exposed to light. The most probably etiologic agent is:
.
- mycobacterium tuberculosis
- mycobacterium smegmatis
- mycobacterium kansaii
- mycobacterium avium complex

- mycobacterium kansaii (orange, also seen with immunorepressed)

Other
- mycobacterium avium complex (MAC) - disseminated, non TB dz in AIDS

47

You are giving lectures to TB patients about the characteristics of mycobacterium tuberculosis. This is to convince them that they should cover their mouths when coughing and to avoid spitting in the environment. Which of the following characteristics should NOT be emphasized to them?
.
- organism is grown in complex media
- organism is resistant to drying and survive for long periods in dried sputum
- organism is resistant to acid and alkali
- organism is found in the droplet nuclei discharge by the infected person

- organism is grown in complex media

48

A visiting media team conducted the "search for the child with primary complex" in an elementary school in Tanay. After a thorough physical examination, the children in two grade one sections were skin tested using tuberculin at a dose of 5TU. Which of the following statements on PPD is correct?
.
- tuberculin skin test becomes positive within 4-6 weeks after primary infection
- immunization with BCG will result in a positive PPD which may last for 3-7 years
- persons who had been PPD positives before but are healthy may fail to give a positive PPD test when tested again
- aota

- aota

- tuberculin skin test becomes positive within 4-6 weeks after primary infection
- immunization with BCG will result in a positive PPD which may last for 3-7 years
- persons who had been PPD positives before but are healthy may fail to give a positive PPD test when tested again

49

About fifty percent of the grade one students from Barrio Tublay was found to have primary tuberculosis. Which of the following features of tuberculosis is most correct?
.
- characterized by acute exudative lesions which rapidly spreads to the lymphatics and regional lymph nodes
- all organism are killed when by the immune response that develop during primary infection
- it is often accompanied by severe pulmonary edema
- caseous materials streaked with blood often are seen in expectorated sputum

- characterized by acute exudative lesions which rapidly spreads to the lymphatics and regional lymph nodes

50

Paul, a 33-year-old lawyer from Ilocos was seen in the OPD with macupapular rash over his trunk but not in his mouth or on his palms. The attending doctor's impression was secondary syphilis. He ordered RPR test to be done which turns out to be reactive. Paul was advised to send his serum to a diagnostic test for TPHA or FTA-ABS test, which later turned out to be positive. Which of the following diseases can be ruled out?
.
- atypical measles
- secondary syphilis
- coxsackie virus infection
- german measles

- secondary syphilis

Other
- atypical measles: RPR/VDRL screen (non-temporal)
- secondary syphilis: FTA-ABS (specific for syphilis)

51

You Ming, a 14-year-old exchange student from China joined the annual boy's scout camping. You Ming together with some boys went to the forest and came back with many insect bites. You were so afraid because they even extracted a fat-bellied tick on his right leg. At the end of the two weeks, he noticed the tick bite to be reddish but flat. It grew bigger every day, with clearing of the central area. With the expansion of the lesion was fever, chills, myalgias, and headache. The most likely diagnosis is:
.
- leptospirosis
- lyme disease
- scrub typhus
- rat bite fever

- lyme disease

52

An MMDA traffic enforcer was admitted to the hospital for sudden onset of high fever (39C), headache, and pain in his calf muscles. On admission his blood tests showed increased PMN, abnormal liver and renal function test. On physical examination he also had subconjunctival hemorrhage. He also had a history of wading in the floodwaters of Tondo about 10 days prior to the illness. The diagnosis of the attending medical intern was leptospirosis. Which of the following would be most likely to confirm the diagnosis?
.
test acute and convalescent sera using the RPR
- culture the blood on Thayer Martin agar
- test acute and convalescent serum for antileptospiral antibodies
- do darkfield examination of serum and urine for leptospirosis

- test acute and convalescent serum for antileptospiral antibodies

53

The human vaccine for this viral infection is made of killed virus grown in human diploid fibroblast or chicken fibroblasts:
.
- rubella
- rabies
- jap b encephalitis
- measles

- rabies

other
- rubella - live attenuated
- measles - live attenuated
MMR is live attenuated

54

Luisa is an absent-minded medical intern. She was asked by the resident to get some influenza vaccines from the refrigerator in the call room and to bring them to the OPD for immunization of the old nurses in the section. Luisa followed the instructions. Unfortunately she did not find the resident so she placed the vaccine on the table with a short note. After 2-4 hours, the resident came and found the vaccines. Influenza is a killed viral vaccine. All of the following are its disadvantages EXCEPT:
.
- high stability at room temperature
- shorter duration of immunity
- poor CMI produced
- no IgA produced

- high stability at room temperature

55

Allan was bitten by his dog in the lower leg. The wound is not deep but it bled. In the decision to give post exposure prophylaxis the following are considered except which of the following:
.
- manner of attack
- nature of biting animal
- severity of bite
- nota

nota - check

56

Laura was in her 2nd month of pregnancy when she tested positive for Rubella antibodies. She delivered the baby 4 weeks early. The baby seemed normal. Which of the following could explain any abnormality that may be later seen in Laura's baby?
.
- infected cells in the baby have reduced growth rate
- hypoplastic organs results in abnormalities in the embryonic cells which have reduced growth rate
- structural anomalies due to hypoplastic organs
- aota

- aota

57

Which of the following is/are true of the rubella vaccine?
.
- live attenuated
- given to prevent congenital rubella infection
- vaccinated children pose no threat to mothers who are susceptible and pregnant
- aota

- aota

58

Jay, a 9-month old baby is rushed to the ER for fever and persistent cough. On examination, rales are heard on his left chest and an infiltrate in the left lung is seen on the chest x-ray film. The diagnosis given is pneumonia. Which of the following viruses is the most likely cause?
.
- rhinovirus
- respiratory syncytial virus
- adenovirus
- coronavirus

- respiratory syncytial virus

59

In this viral infection, humans are dead-end hosts thus virus shedding does not occur.
.
- measles
- rabies
- influenza
- chicken pox

- rabies

60

A 10 year old girl complained of difficulty and pain in swallowing. It was accompanied by runny nose and fever. Upon examination, the intern in the OPD noted slightly swollen tonsils and erythematous pharynx. No exudates were noted on the tonsilar surface. The diagnosis given was upper respiratory infection. The most likely etiologic agent for this case is:
.
- rhinovirus
- respiratory syncytial virus
- adenovirus
- coronavirus

- adenovirus

61

Ramon, a 4 year old boy was seen by a pediatrician for complains of low-grade fever, cold, and rash on the face which showed a typical "slapped cheek" appearance. Complain of flu-like symptoms such as malaise and myalgias were also noted. The pediatrician gave a diagnosis of erythema infectiosum of the fifth disease which is caused by which of the following viruses:
.
- hanta virus
- B19 parvovirus
- herpes simplex
- coxsackie viruses

- B19 parvovirus

62

Last sumer, a community hospital in Laguna, recorded 25 cases of pharyngoconjunctivits among the grade five students from a private school in th nearby municipality. It was learned that all of them attended a summer camp, which lasted for 2 weeks. Which of the following adenovirus serotypes are most likely involved?
.
- types 3 and 7
- types 1 and 40
- types 40 and 45
- types 8 and 10

- types 3 and 7

63

A 2.5 yo boy was noticed by his mother to have less appetite for solid food, but when given ice cream and soft drinks he was quite happy. This was unusual because he likes to eat and play with solid foods. The mother examined him and found that he has some swollen nodules in his neck. Suspecting something in the mouth, she examined the mouth and found vesicular lesions in the buccal mucosa. This is probably caused by:
.
- candida albicans
- streptococcus pyogenes
- measles virus
- herpes simplex virus

- herpes simplex virus

64

Yoyong, a 15 yo boy acquired chicken pox. When vesicular lesions became evident, he was "isolated" by his mother from the rest of the family. After a week, his picks subsided with some lesions already developing scabs. It was at this time that two other siblings started showing the same symptoms. Which of the following items below best describes the etiologic agent involved?
.
- the virus infects only humans
- the disease is highly contagious
- both
- neither

- both

65

Idang is due to deliver in two weeks time. Unfortunately she had premature labor and delivered a stillborn baby boy. The baby was autopsied and the one finding was the presence of cells which look like "owls eye" i.e. cells with large intranuclear inclusion bodies. The most probable diagnosis is:
.
- congenital measles
- congenital rubella
- congenital chicken pox
- congenital cytomegalovirus infection

- congenital cytomegalovirus infection

66

JR, a macho dancer from the red district did not report for work for almost three days. His friend found him with fever, headache, and feels weak and tired. They went tot he clinic and was found to have enlarged lymph node and spleen and slightly icteric conjunctiva. Blood exam showed large, atypical lymphocytes. The most probable diagnosis is:
.
- cytomegalovirus infectious mononucleosis
- infectious mononucleosis
- herpes simplex infection
- mumps

- infectious mononucleosis

67

A 28 yo woman has recurrent genital herpes. Which of the following about genital herpes infection is true?
.
- cannot be transmitted in the absence of apparent lesions
- reactivation of latent virus during pregnancy poses no threat to the newborn
- can be caused by either herpes simplex type 1 or type 2
- recurrent episodes are more sever than the primary infection

- can be caused by either herpes simplex type 1 or type 2

68

MR consulted a dermatologist for the small, pink, wart-like lesions on her face, arms, back and buttocks. The diagnosis given was moluscum contagiosum infection. Which of the following about this is NOT true?
.
- virus has a wide range of hosts
- transmission is by direct and indirect contract
- it is considered a STD
- the virus has a DNA genome

- virus has a wide range of hosts

69

Motong is a leukmia patient. He was admitted for post transfusion hepatitis. Test showed the etilogic agent to be flavivirus. This virus is:
.
- Hep A
- Hep B
- Hep C
- Hep E

- Hep C

70

Ferdie was diagnosed carrier of Hep B. In one of his follow-ups in the clnic, anti-HBe antibodies were detected in his serum. This means that:
.
- he is now developing resistance
- his HB virus titer is now low
- it has no meaning
- a mistake was committed because HBs Ag and anti-HBe do not exist together in the blood

- his HB virus titer is now low

71

Lola, a middle-aged woman, complained of acute onset fever and nausea. Her eyes were "yellow" and she was surprised to see her urine to be dark colored. She consulted a private clinic and the laboratory test done on her blood was positive for HAV IgM antibody. What will you tell Lola if you are the physician?
.
- she acquired the disease through sexual contact
- probably transmitted to other when she had blood transfusion
- to be very careful, she can transmit the infection to other members of her family by person-to-person spread
- she might develop liver carcinoma

- to be very careful, she can transmit the infection to other members of her family by person-to-person spread

72

Young woman was hospitalized for myopericarditis with mild congestive heart failure that increases over several weeks. The attending physician gave a diagnosis of Coxsackie B5 infection. Other than his conditions what other syndrome/s is/are associated with this virus?
.
- herpangina
- aseptic meningitis
- acute hemorrhagic conjunctivitis
- aota

- aota

73

After getting his first salary, Bitoy went to the seaside restaurant and feasted on seafoods, particular raw oyster with his favorite beer. After 24 hours, he became ill with sudden onset of vomiting, diarhhea and headache. He consulted a private clinic and the physician, after thorough examination, ruled out a bacterial etiology. To him the most probably viral etiologic agent is:
.
- Astrovirus
- Norwalk virus
- Rotavirus
- Hep A virus

- Norwalk virus

74

45 yo woman from a ranch in Mindanao, complained of fever, malaise and sore throat, followed by nausea, vomiting and then sudden stupor. She was diagnosed to be suffering from eastern equine encephalitis. The control of this disease in humans could be accomplished by eradication/control of:
.
- ticks
- bird
- mosquitos
- sandflies

- mosquitos

75

DJ went to Boracay last summer. He had a good tan except on some portion of his neck down to his upper back which showed minimal scaling. After a week, the tan portion of his skin started to peel. To his surprise the "untanned" portion of my his skin seemed to have become bigger. His started to return to its normal color but the "untanned" portion seemed to stand out this time looking more whitish than his normal light brown skin. The most likely diagnosis is:
.
- leprosy
- superficial mycoses
- avitaminosis
- nota

- superficial mycoses

76

DJ consulted a dermatologist for the whitish discoloration which showed after his Boracay escapade. The doctor made a KOH mount of the skin scrappings and found, short, stour, angular hyphal elements. The skin lesions also fluorescence under the Wood's lamp. The most likely etiologic agent is:
.
- tinea corporis
- pityriasis versicolor
- white piedra
- candiasis

- pityriasis versicolor

77

Melanie noticed that her left hand had blackish discoloration probably caused by handling charcoal. She tried to remove it using alcohol but to her surprised it had no effect on the "the dirt". After trying to remove it to no avail for a week, she decided to consult a doctor. The diagnosis given was tinea nigra. The etiologic agent of this is:
.
- hortea werneckii
- clasdosporium spp.
- trichophyton spp.
- exophiala hortai

- hortea werneckii

78

A group of "street oldies" were taken to the DSWD. They were given bath, fresh clothes and something to eat. A medical team was also present who did some quickie check up on them. One man was found to have soft, yellowish nodules on the hair of his axilla and beard.The most likely diagnoses for this is:
.
- black piedra
- trichophyton hair infection
- white piedra
- excess soap suds

- white piedra

79

Vic plays basketball almost everyday after school for the last 6 week, until the vesicular lesions in his both feet particularly in the toe webs became ulcerative and painful. Also he gets embarrassed in the shower room because his feet smell. The obvious diagnosis is athlete's foot. Three of the following dermatophytes below are common etiologic agents of athlete's foots EXCEPT
.
- t mentagrophyts
- t. rubrum
- e. flocossum
- m. canis

- m. canis

80

A 40 yo farmer consulted a dermatologist for the multiple sinuses in his left arm that seem to follow a line. The discharge from the sinuses showed oval budding ells that are variable in shape, but often fusiform. The discharge was cultured in SAB. Growth in SAB yielded septate hypae with small conidia clustered at the tip of the conidiophores, appearing like daisies with stem. The most likely identification of this organism is:
.
- trichophyton mentagrophytes
- phialophora speica
- sporothrix schenckii
- clasdosporium carrionii

- sporothrix schenckii

81

DoC for strep. pyogenes

penicillin G

82

doses of penicillin and erythromycin resulting in effecting tissue levels occurs in

10 days

83

DoC of strep. pneumoniae

penicillin G

84

Disease caused by trypanosoma cruzi

chaga's disease

85

id of trypanosoma cruzi

presence of C-shaped trypomastigotes

86

agent of winterbottom's sign

trypanosoma brucei

87

agent of visceral leishmaniasis, kala-azat or dumdum fever

l. donovani

88

definitive host of troxyplasma glondii

cat

89

follow undergoes incomplete metamorphesis EXCEPT

- lice
- flies
- true bugs
- arachnids

- flies

90

vector for yersiniapestis and black plague

xenophylia cheopis

91

simulium black fly transmits

filariasis

92

molting of arthropod is called

ecclysis

93

blood smear shows infeted RBC with double chromatin. Diagnosis

plasmodium flaciparum

94

infected RBC with band form stages. Diagnosis

plasmodium malariae

95

oval shaped infected RBC. Diagnosis

plamodium ovale

96

light microscope noted group of intracellular small rounded organisms. lab id it as amastigote stage. infection?

leishmaniasis

97

Personality changes. Laboratory examination of the CSF revealed presence of polymorphic with undulating membrane. parasitic infection?

trypanosomiasis

98

dipylidium canium is aka

dog tapeworm

99

intermediate host of rat tapeworm

tribolium confusem

100

basis for successful treatment of t. saginata

recovery of the scolex

101

largest ciliated intestinal protozoa found in normal individuals

balantidium coli

102

true of amoebiasis

- soft stools
- cysts viable for days in environment
- diagnosis is demonstration of amoeba in the stool
- aota

- aota

103

epidemic pleurodynia and myocarditis of newborn infants are both caused by

group B coxsackievirus

104

viruses produce a big nuclear inclusion with gives rise to owl's eye appearance

cytomegalovirus

105

which teratogenic viruses can be prevented by vaccine
- group b cox
- rubella
- herpes simplex 2
- rubeola

rubella

106

congenital cytomegalovirus infection more difficult than rubella because

the mother is almost always symptomless

107

best statement regarding hep A
- chronic hep
- long term carrier
- there are no extrahepatic manifestations of the acute infection

there are no extrahepatic manifestations of the acute infection

108

delta hepatitis agent is

incomplete hepatitis B virus

109

which is marker for Hep B is associated with immunity
- anti-HBs
- anti-HBe
- anti-HBc

- anti-HBe

110

HBsAg negative
IgM core antibody negative
HBs antibody positive
Diagnosis?

patient is immune to hep b

111

eradication of hep a is possible bc

only one serotype

112

Which hep viral agents cause chronic infections?

Hep B, C, and D

113

virus group responsible for acute respi disease, pharyngitis and epidemic keratocunjuntivitis

adenovirus

114

antigenic shift and antigenic drift usually occurs in
- type a flu
- type b flu
- type c flu
- aota

- type a flu

115

paul bunnel test diagnostic of

infectious mononucleosis

116

child with coryza, conjunctivitis, low grade fever and koplik's spots. Agent is from what group?

paramyxovirus

117

mumps virus related to
- varicella
- variola
- hep a
- measles
- rabies

measles

118

what other virus has been shown to cause infectious mononucleosis aside from EBV?

cytomegalovirus

119

rhinoviruses are enveloped RNA viruses that cause pneumonia primarily in AIDS patients.
.
true or false

false

120

roseola infantum associated with

human herpes virus 3

121

lymphocytosis with atypical cells with an increase in sheep cell agglutination. diagnosis

influenza

122

virus is no easily destroyed by head.
true or false

false

123

virus have virion. true or false

false

124

viral capsomers are accumulations of

identical protein blocks

125

proteins in the envelope of viruses are called

spikes

126

when RNA polymerase are present in a virus, they are typically found as one of the envelope proteins.
true or false

false

127

live vaccine can be given to immunocompromised patients since they induce mucosal IgA.
true or false

false

128

live attenuated polio vaccine produces alimentary tract resistance and confers herd, as well as individual immunity.
true or false

true

129

which is DNA virus?
- adenovirus
- dengue
- rubella
- mumps

- adenovirus

130

viruses are host specific.
true or false

false

131

hemagglutination is a cytopathic effect of viral infection.
true or false

false

132

transformation in viral infections is due to the host cells dividing indefinitely.
true or false

true

133

MOC of acyclovir on herpes?

inhibition of DNA polymerase

134

this/hese fungus/i has/have a thick capsule and causes granulomatous meningitis

ctryptococcal neoformans

135

ctryptococcal neoformans is found in

pigeon droppings

136

dematiaceous fungi causes

subcutaneous mycosis

137

tinia pedia is the most prevelent dermatophyte.
true or false

true

138

dermatophyte infects skin and nails. along in genus

epiermophytin floccacirum

139

acute bronchitis is common in first 2 years of life. common causitive agent.

respiratory syncitical virus

140

variola is associated with common cold.
true or false

false

141

croup is commonly caused by

parainfluenza type 1 and 3

142

herpes zoster spread through the bloodstream affecting multiple organs.
true or false

false

143

herpes simplex virus can be reactivated by emotional disturbances and by prolonged exposure to sunlight.
true or false

true

144

tzank test used in laboratory diagnosis of herpes simples.
true or false

true

145

chicken pox has several hosts.
true or false

false

146

Diagnosis of chicken pox can be done by
.
- symptomatology
- serology
- Tzank smear
- aota

aota

147

virus associated with cancer of cervix

HPV

148

HPV is highly tropic for epithelial cells of the skin and mucous membranes.
true or false

true

149

the rabies virus has 5 serotypes; hence the vaccine consists of five immunizations.
true or false

false

150

most practical test of rabies

detection of negri bodies or FAT

151

which of the following is a feature of the secondary immune response?

high antibody peal

152

confirmatory test for HIV infection

western blotting

153

human vaccine for this viral infection is made of killed virus grown in human VERD cells

rabies

154

herpes encephalities caused by

herpes simplex 1

155

virus with latent infection occuring in the neurons

varicella zoster virus

156

herpes virus infection will confer lifelong persistent infections.
true or false

true

157

cytomegalovirus latent infection occurs in glands and kidneys.
true or false

true

158

adjuvant not required for live vaccines.
true or false

true

159

hep A is a live viral vaccine.
true or false

false

160

Passive immunization is stimulated by administration of vaccines to develop a disease-specific immunity.
true or false

false

161

disease which is transmitted by inhalation of the spores of a certain fungus, which later will develop into sac-like structures with endospores in the tissues is most likely caused by

coccidiodomycosis

162

sudden development of bloody diarrhea with abdominal cramps and fever among chronically ill pts taking antibiotics is most likely suffering infection from

clostridium difficil

163

H proteins are major virulenxe factor and appear as hairlike projection of the cell wall.
true or false

true

164

Streptodonase is combined with streptokinase and used in enzymatic debridement and liquefaction of exudates.
true or false

true

165

act as superantigens stimulating t cells to release cytokines mediating shock and injury.
- erythogenic exotoxins
- phyrogenic toxins
- both
- neither

- both

166

disease usually follows an acute infection and is commonly preceded by a skin infection

glomerunephritis

167

congenital meningoencaphalits in children is associated with

acanthamoeba

168

amoeba that is morphologically similar to entamoeba histolytica but has a diameter of less than 10 um or smaller is

entamoeba hartmani

169

f buski is found in both man and

pigs

170

jaundice occurs in intestinal fluke infection.
true of false

false

171

diarrhea occurs in lung fluke infection.
true or false

false

172

paragonimiasis is not common in

europe

173

term for non-hermaphroditic helminths is

monoecious

174

this parasite's eggs may also be ingested while breathing

e. vermicularis

175

diagnosis of capillariasis can be made through

fecalysis and biopsy of intestinal tissue

176

. An elderly woman with pneumonia developed bloody diarrhea on the 7th hospital day, accompanied by abdominal cramps and fever. The doctors got worried because her fever caused by pneumonia had lysed as early as her 3rd hospital day. She was immediately placed in the ICU and all antibiotics were stopped. She has been on ampicillin for 5 days prior to admission and on admission was started with clindamycin and augmentin Her condition is probably caused by:
.
A. Enterohemorrhagic Escherichia coli
B. Shigella dysenteriae
C. Clostridium difficile
D. Vibrio parahemolyticus

C. Clostridium difficile

177

50. Severino had an accident that resulted in the amputation of his right leg, two inches above the knee. About five days post-op, signs of wound infection was evident. Local wound care was given and the exudate was sent to the lab. The doctors were willing to wait for the lab results before changing antibiotics. After two days the culture came with no organism isolated from the specimen as reported. They suspected anaerobic infection. Anaerobic infection is usually suspected when:
.
A. there is presence of foul smell
B. the site of infection is near a mucosal surface
C. there is gas in tissues
D. all of the above

D. all of the above

178

George was rushed to the hospital for fever and pain in the right lower abdomen. Rectal exam was compatible with the diagnosis of appendicitis. He was again rushed to the operating table because of unstable vital signs. On opening up, he was found to have a ruptured appendicitis with abscess formation around it. The exudates later yielded Bacteroides fragilis. Which of the following factors promote abscess formation by B. fragilis?
.
A. capsule
B. lipopolysaccharide
C. pili
D. superoxide dismutase

A. capsule

179

GC, a 20-year-old girl working in the call center, consulted a gynecologist because of whitish-gray vaginal discharge with a bad odor of about a week duration. Previous to it, she had several sexual relationships with her boyfriend of two months. With her condition, she felt guilty and decided to lead a clean life as soon as the she gets well. The doctor got some fluid from the vaginal canal, placed some on the slide and some she tested for pH which was 5.5 against the normal value of 4.5. Wet mount showed many epithelial cells which appear granular. No PMN was noted. Which of the following is the most likely diagnosis?
.
A. Trichomonas vaginalis
B. Yeast vaginitis
C. Gonorrhea
D. Bacterial vaginosis

D. Bacterial vaginosis

180

A 67-year-old man was taken to the ER for difficulty of breathing. He has been feeling weak since 4 days ago. He has a chronic cigarette cough since he was in his 40s, but did not bother to see a doctor for his complaints until his son noticed that he looked worst. On physical examination inspiratory and expiratory wheezes and rales were noted over the right lower lung . His chest x-ray further revealed patchy lower right lung infiltrates. The differential diagnosis for this patient is:
.
A. Streptococcus pneumoniae
B. Legionella pneumophilia
C. Mycoplasma pneumoniae
D. all of the above

D. all of the above

181

Joe was diagnosed with lung cancer and in his bronchial washing acid-fast bacilli were seen mixed with the cancer cells. Joe had been given the full short course of the TB regimen before and so the doctor suspected a drug resistant strain. The bronchial washing was cultured and it grew orange colored colonies when exposed to light. The most probable etiologic agent is:
.
A. Mycobacterium tuberculosis
B. Mycobacterium smegmatis
C. Mycobacterium kansasii
D. Mycobacterium avium complex

C. Mycobacterium kansasii

182

56. A visiting media team conducted the " search for the child with primary complex " in an elementary school in Tanay. After a thorough physical examination, the children in two grade one sections were skin tested using tuberculin at a dose of 5TU. Which of the following statements on PPD is correct ?
.
a. The tuberculin skin test becomes positive within 4-6 weeks after primary infection.
b. Immunization with BCG will result in a positive PPD which may last for 3-7 years.
c. Persons who had been PPD positives before but are healthy may fail to give a positive PPD test when tested again.
d. All are correct

d. All are correct

183

About fifty percent of the grade one students from Barrio Tubibi was found to have primary tuberculosis. Which of the following features of tuberculosis is most correct?
.
A. characterized by acute exudative lesions which rapidly spreads to the lymphatics and regional lymph nodes
B. all organism are killed when by the immune response that develop during primary infection
C. It is often accompanied by severe pulmonary edema
D. Caseous materials streaked with blood often are seen in expectorated sputum

A. characterized by acute exudative lesions which rapidly spreads to the lymphatics and regional lymph nodes

184

Paul, a 33-year-old lawyer from Ilocos was seen in the OPD with maculopapular rash over his trunk but not in his mouth or on his palms. He is a bachelor and travels around the Philippines a lot. The attending doctor's impression was secondary syphilis. He ordered RPR test to be done which turns out to be reactive. Paul was advised to send his serum to a diagnostic test for TPHA or FTA-ABS test, which later turned out to be positive. Which of the following diseases can be ruled out ?
.
A. atypical measles
B. Secondary syphilis
C. Coxsackie virus infection
D. German measles

B. Secondary syphilis

185

helminth which may be diagnosed through blood smear
.
- wicherenia brancrofti
- strongylloides seterocosis
- both
- neither

wicherenia brancrofti

186

helminth with neurologic complication

schistosoma japonicum

187

worm leads to malabsorption
.
- strongyloides sterocalis
- capilleria philippinensis
- both
- neither

- both

188

causes cutaneous larva migrans

ancylostoma ceylanicum

189

causes Loeffler's syndrome

ascaris lumbricoides

190

filariasis left untreated leads

to elephantiasis

191

cause of hookworm anemia

depletion of iron stores

192

fasciola hepatica
.
- not endemic in PH
- infective stage is metacercaria
- both
- neither

both

193

schistosomiasis
.
- infective stage is melacercaria
- 2 intermediate hosts
- both
- neither

neither

194

hymenolepsis diminuta
.
- causes hydatid disease
- considered zoonotic infection
- both
- niether

- considered zoonotic infection

195

parasite causes endemic hemoplysis
.
- strongyloides stercoralis
- paragominus westermani
- both
- neither

- paragominus westermani

196

parasitic infection that may be sexually transmitted
.
- strongyloides
- filariasis
- both
- neither

- neither

197

egg of trichuria
.
- barrel-shaped
- peanut-shaped

- barrel-shaped

198

diphyltobothrium latum
.
- aka fish tapeworm
- vit b12 deficiency
- both
- neither

- both

199

Athena was born December 2004. She has an older brother Bitoy who got sick of chicken pox when Athena was one month old. Ikay, another older sister of Athena got sick of chicken pox while she did not. This is because of:
A. Maternal IgA
B. Athena's IgA
C. Maternal IgG
D. Athena's IgG

C. Maternal IgG

200

Mike was sick of pneumonia, for which he almost died. Before his discharge from the hospital he asked the doctor to explain to him his illness and how he was able to recover. The doctor talked of the germs having slimly materials around them. That it was necessary for some substance to coat the germs so that the scavenger's cells in the body can eat them up. The doctor was referring to opsonization. Which of the following substances is involved in opsonization?
A. C3a
B. C3b
C. C2a
D. C2b

B. C3b

201

15. A 13-year-old boy from Ilocos tested negative in the lepromin test. He presents with multiple , erythematous, anesthetic lesions all over the body. The skin test shows which type of hypersensitivity:
a. Type I Hypersensitivity
b. Type II hypersensitivity
c. Type III hypersensitivity
d. Type IV hypersenitivity

c. Type III hypersensitivity

202

A baby born with congenital rubella was found to be deaf. Defects in rubella are grouped into broad categories, i.e temporary, developmental, permanent. Deafness is under :
a. temporary
b. developmental
c. permanent
d. none of the choices

c. permanent

203

A 28-year-old woman has recurrent genital herpes. Which of the following about genital herpes infection is true ?
.
A. cannot be transmitted in the absence of apparent lesions
B. reactivation of latent virus during pregnancy poses no threat to the newborn
C. can be caused by either herpes simplex type 1 or type 2
D. recurrent episodes are more severe than the primary infection

C. can be caused by either herpes simplex type 1 or type 2

204

Melanie is a cook in a small restaurant responsible for the barbecue stand. Later, because of arthritis she was reassigned to the counter as the one taking the orders. She noticed that her left hand still showed the blackish discoloration caused by handling charcoal. She had not noticed it before because after cooking she does not wash her hand often because of fear of " pasma". This time she used alcohol to clean the discoloration, but to her surprised it had no effect on the " dirt." After trying to remove it to no avail for a week, she decided to consult a doctor. The diagnosis given was tinea nigra. The etiologic agent of this is :
.
A. Hortaea werneckii
B. Cladosporium spp.
C. Trichophyton spp.
D. Exophiala hortai

A. Hortaea werneckii

205

50. Severino had an accident that resulted in the amputation of his right leg, two inches above the knee. About five days post-op, signs of wound infection was evident. Local wound care was given and the exudate was sent to the lab. The doctors were willing to wait for the lab results before changing antibiotics. After two days the culture came with no organism isolated from the specimen as reported. They suspected anaerobic infection. Anaerobic infection is usually suspected when:
.
A. there is presence of foul smell
B. the site of infection is near a mucosal surface
C. there is gas in tissues
D. all of the above

D. all of the above

206

Which of the following gram positive bacteria is catalase test negative
a. Corynebacterium diphtheria
b. Staphylococcus aureus
c. Listeria monocytogenes
d. Streptococcus pyogenes

d. Streptococcus pyogenes

207

The bacterial capsule is mainly composed of polysaccharides except:
a. Bacillus anthracis
b. Streptococcus pneumonia
c. Listeria monocytogenes
d. Clostridium perfringens

a. Bacillus anthracis

208

There is a variety of highly pathogenic gram-positive rods that are not currently common causes of human disease. Which of these are known to produce spores thatenhances its virulence?
a. Bacillus anthracis
b. Listeria monocytogenes
c. Corynebacterium diphtheria
d. Hemophilus influenza

a. Bacillus anthracis

209

The following gram positive bacteria produces food poisoning due to its toxins except
a. Bacillus cereus
b. Staphylococcus aureus
c. Clostridium perfrigens
d. Streptococcus pyogenes

d. Streptococcus pyogenes

210

Corynebacterium sp are small pleomorphic bacilli that requires special growth characteristics. Which of the following statements is correct
a. Typical calories grow best under anaerobic condition.
b. C diphtheria are differentiated from other corynbacteria by the appearance of calories
c. Cultured colonies are non hemolytic and show swarming due to the motility of the bacteria.
d. colonies are usually white and mucoid on selective agar

d. colonies are usually white and mucoid on selective agar

211

The diphtheria toxin is composed of 2 units that acts in the cytoplasm and inhibit protein synthesis irreversibly. What is the enzymatic process responsible for this action.
a. ATP hydroxylation
b. ADP ribosylation
c. EF-2 activation
d. Actin polymerization

b. ADP ribosylation

212

At room temperature, which of the
following gram positive bacilli produces tumbling motility in the fluid media?
a. Corynebacterium diphtheriea
b. Bacillus cereus
c. Listeria monocytogenes
d. Clostridium perfrigens

c. Listeria monocytogenes

213

Which of the following play an important role in the virulence of L. monocytogenes?
a. Growth at body temperature
b. Intracellular survival
c. Peritrichous flagella
d. Performed toxin

b. Intracellular survival

214

A 75 yr old man, known smoker, is admitted to a hospital because if temperature of 39.9C, chest pain and dry cough. Sputum is collected and revealed small gram negative rods able to grow only on charcoal yeast extract agar. The organism most likely is
a. Kiebsiella pneumonia
b. Hemophilus pneumonia
c. Legionella pneuphilia
d. Mycobacterium tuberculosis

c. Legionella pneuphilia

215

A hyperemic swelling of the larynx and epiglottis that rapidly cause respiratory obstruction in young children is most likely due to
a. Mycoplasma pneumonia
b. Hemophilus influenza
c. Neisseria meningitides
d. Kiebisella pneumonia

b. Hemophilus influenza

216

Angela a 5 yr old girl came in the ER due to cyanosis. Her condition started 3 weeks ago when she developed cough and colds. She was given unrecalled cough remedies. There was no improvement of condition. A few days prior to consult she developed episodes of dry, hacking cough hat usually terminates in the gasping of air which produced a high pitched sound. This occurred at least 3 times a day and in between attacks she see to be normal. A few hours prior to consult while coughing she became cyanotic hence the consult. What stage of pertussis is the patient experiencing?
a. Catarrhal
b. Paroxysmal
c. Subacute
d. Convalescence

b. Paroxysmal

217

Bacterial meningitis cause severe medical complications among newborns and young children. Which of the following causes cannot be prevented by vaccination
a. Neisseria meningitides
b. Streptococcus pneumonia
c. Hemophilus influenza
d. Listeria monocytogenes

d. Listeria monocytogenes

218

Which of the following does Not cause a zoonotic infection
a. Bordetella brinchoseptica
b. Yersinia enterocolitica
c. Pasturella multocida
d. Hemophilus parainfluenzae

d. Hemophilus parainfluenzae

219

Plaque, an infection of rodents transmitted to humans by the bite of infected fleas is caused by a small gram negative coccobacilli. Which of the following statement is NOT true for this infection
a. Urban transmission among rodents is the primary reservoir
b. Pneumonia can be acquired from animal and direct human contact
c. The organism is a non-motile, non sporeforming member of the family Enterobactericiae
d. Methylene blue stain of the organism reveals bipolar coccobacilli

b. Pneumonia can be acquired from animal and direct human contact

220

Legionaire’s disease was first documented in 1976 as an outbreak that led to discovery of new bacterium. Which of the following BEST describes the organism
a. Legionella pneumophilia is the most common specie that is composed of one sero group
b. In nature, amoebas in fresh water habitat act as reservoir
c. Commonly, infections are associated with aerosols from person-to-person contact and carriers
d. Facultative extracellular pathogen multiplies in alveolar macrophages

b. In nature, amoebas in fresh water habitat act as reservoir

221

Childhood pneumonia is caused by Hemophilis influenza. Which of the following does NOT describe this organism
a. The type b capsule is made up of polyer of ribose, ribitol, and phosphate
b. The nonencapsulated strain cause
acute otitis media(ear infection)
c. The pure polysaccharide vaccine for Hib is protective for most infants
d. Only capsulated strains are invasive

b. The nonencapsulated strain cause
acute otitis media(ear infection)

222

The ability of helicobacter pylori to produce this enzyme allows it to live in the stomach
a. Collagenase
b. Hyaluronidase
c. Urease
d. Protease
e. Lecithinase

c. Urease

223

The most common cause of traveler’s diarrhes is
a. EPEC
b. EIEC
c. ETEC
d. EHEC

c. ETEC

224

The gram negative enteric pathogen that infects only humans is
a. Salmonella typhi
b. Salmonella cholerosuis
c. E. coli
d. Salmonella enteritidis

a. Salmonella typhi

225

Enteric bacteria that produce red colonies on MacConkey agar are
a. Lactose fermenters
b. Non-lactose fermenters
c. Glucose fermenters
d. Nitrate fermenters

a. Lactose fermenters

226

Pediatric diarrhea caused by this strain can be fatal due to acute kidney failure or hemolytic uremic syndrome (HUS)
a. ETEC
b. EPEC
c. EHEC
d. EIEC

c. EHEC

227

All enteric ferment glucose and are facultative anaerobic
a. True
b. False

a. True

228

All organisms under Family Enterobacteriaceae are part of the normal flora of the GIT
a. True
b. False

b. False

229

E coli is normal flora of the gut EXCEPT for some types that cause diarrhea because they produce
a. Lysozymes
b. Proteases
c. Enterotoxigenic toxins
d. Plasmids

c. Enterotoxigenic toxins

230

Which of the following is NOT oxidase positive
a. E coli
b. Vibrio spp
c. Campylobacter spp
d. Pseudomonas

a. E coli

231

The identification of bacteria (e.g. Enterobacteriaceae) by serologic tests is based on specific antigens. Which one of the following bacterial components is least likely to contain useful antigens
a. Capsule
b. Cell wall
c. Flagella
d. Ribosomes

d. Ribosomes

232

Family Enterobacteriaceae are best differentiated from Vibrionaceae by
a. Oxygen requirement
b. Oxidase test
c. Coagukase test
d. Bile test

b. Oxidase test

233

All of the following are key characteristics of Gardnerella vaginalis EXCEPT
a. Clue cells
b. Wet mount showing flagellated organisms
c. pH of 5.5
d. fishy amine odor on whiff test
e. none of the choices

b. Wet mount showing flagellated organisms

234

A patient with a peptic ulcer was admitted to the hospital and a gastric biopsy was performed. The tissue was cultured on chocolate agar incubated in a microaerophilic environment at 37C for 5 days. At 5 days incubation, colonies appeared on the plate and were curved, gram negative rods, oxidase positive. The most likely identity of this organism is
a. Campylobacter jejuni
b. Vibrio parahemolyticus
c. Hemophilus influenza
d. Helicobacter (campylobacter) pylori

d. Helicobacter (campylobacter) pylori

235

An experimental compound is discovered that prevents the activation of adenyl cyclase and the resulting increase in cyclic AMP. The toxic effects of which of the following bacteria might be prevented with the use of this experimental compound
a. Vibrio cholera
b. Pseudomonas
c. Brucella
d. Corynebacterium diphtheria
e. Listeria monocytogenes

a. Vibrio cholera

236

In typhoid fever, the organism can be isolated from biological specimens best in which of the following conditions
a. From blood and feces on the first week
b. From blood on the first 10 days
c. Feces becomes the source of the organism from the 3rd week
onwards
d. A, B and C are correct
e. B and C only

e. B and C only

237

Clinical diagnosis of typhoid fever is based on the following EXCEPT
a. Hepatomegaly and Rose’s spots on the abdomen
b. Remittent fever, about 40C but slow pulse rate
c. Hemorrhagic rashes
d. Headache, constipation or diarrhea

c. Hemorrhagic rashes

238

Who among the following is the least candidate for chemophylaxis against N. meningitides
a. Those who have been in contact with the patient for as long as seven days before the onset of illness
b. All nurses and doctors in the hospital where patient was admitted
c. Housemates
d. None of the above, all are candidates for prophylaxis

d. None of the above, all are candidates for prophylaxis

239

There is no vaccine for this N. meningitidis serotype
a. Serotype A
b. Serotype B
c. Serotype C
d. Serotype W-135

b. Serotype B

240

Outbreaks of N. meningitidis infections is
common when
a. A high transmission rate i.e person
to person is present
b. A virulent capsulated strain of N.
meningitides is carried by
asymptomatic persons
c. Presence of susceptible population
d. All of the choices
e. Only A and C are correct

c. Presence of susceptible population

241

This is a common complication in
meningococcal infections
a. Guillain-Barre syndrome
b. Reye’s Syndrome
c. Waterhouse-Friederichsen syndrome
d. Hugh-fizt syndrome

c. Waterhouse-Friederichsen syndrome

242

True regarding the pathogenesis of
Neisseria meningitides
a. Many of the symptoms of meningococcemia can be attributed to endotoxin
b. The polysaccharide capsule of this organism is an important virulence factor
c. It is a gram negative rod which produces an exotoxin that activates adenylate cyclase
d. All are correct
e. A and B only

e. A and B only

243

The principal habitat of Neisseria meningitides in carriers is
a. Nasopharynx
b. Meninges
c. Lungs
d. Nasal mucosa

d. Nasal mucosa

244

Which culture medium is not used for Neisseria meningitides culture
a. Thayer martin
b. Chocolate agar
c. Blood agar
d. EMB

d. EMB

245

This is form of Chlamydia is metabolically active
a. Reticulate body
b. Discoid body
c. Elementary body
d. Vacuolated form

a. Reticulate body

246

Which of the following statements, does not correctly describe anaerobic gram negative wound infections
a. They are usually of endogenous origin
b. They are usually due to a single microbe infection
c. They are favored if the tissue E-Rh is reduced by growth of aerobic bacteria
d. They are producing potent exotoxins

b. They are usually due to a single microbe infection

247

Diagnosis of Chlamydia in specimen can be done by
a. Smears of specimens strained with giemsa
b. Specimen inoculated unto Mac coy cells
c. Serologic determination of antibodies to Chlamydia
d. All of the above
e. Only A and C are correct

d. All of the above

248

Which of the following is very sensitive to sulfonamides and forms inclusions containing glycogen
a. Chlamydia trachomatis
b. Chlamydia urealyticum
c. Chlamydia psittaci
d. A and C only

a. Chlamydia trachomatis

249

The drug of choice for this organism is Metronidazole
a. Clostridium perfringes
b. Gardnerella vaginalis
c. Bacteroides fragilis
d. Lactobacilli

b. Gardnerella vaginalis

250

True of the bacteroides fragilis except
a. The most common specie is bacteroides fragilis in the intestinal tract
b. Bacteroides fragilis has a capsule while other bacteroides do not
c. Its LPS has no endotoxin activity
d. Its LPS promotes leukocyte
migration and chemotaxis
e. None, all are True of B. fragilis

e. None, all are True of B. fragilis

251

Mycobacteria are found in
a. Animals, fish and birds
b. Humans
c. Environment
d. All of the choices
e. None of the choices

d. All of the choices

252

Which is not a characteristics of Mycobacterium tuberculosis
a. It has a gram negative cell wall
b. It is an obligate aerobe
c. It has mycolic acid in its cell wall
d. It is resistant to drying

a. It has a gram negative cell wall

253

Which of the following is/are correct of M. tuberculosis
a. Grows on Lowenstein medium
b. Generation time is long, about 12-
20 hours
c. Both
d. Neither

c. Both

254

Which of the following is responsible for the
serpentine growth of M. tb on solid media
a. Hyaluronidase
b. Cord factor
c. CAMP factor
d. M. protein

b. Cord factor

255

Transmission of M. tb is by
a. Inhalation of infectious nuclei
b. Blood transfusion c. Water-borne
d. All are correct
e. All are wrong

a. Inhalation of infectious nuclei

256

Which of the following diagnostic tools for TB would tell if the patient is infectious or not
a. Clinical history and PE
b. Sputum microscopy
c. Chest x ray
d. PPD skin test

b. Sputum microscopy

257

Which of the following test for TB will be
positive even in the presence of one bacillus
a. Sputum microscopy b. PCR
c. DNA probe
d. Culture

c. DNA probe

258

Which of the following test for TB is sensitive
at 10,000 organisms per ml of sputum
a. Sputum microscopy b. PCR
c. DNA probe
d. Culture

a. Sputum microscopy

259

Which of the following is/are characteristics of mycoplasma
a. They belong to the class of organisms with no cell membrane
b. They are insensitive to aminoglycosides
c. They are obligate anaerobes
d. All are correct
e. All are wrong

e. All are wrong

260

The human tubercle complex is composed of the following except
a. Mycobacterium africanum
b. Mycobacterium bovis
c. Mycobacterium smegmatis
d. Mycobacterium tuberculosis

c. Mycobacterium smegmatis

261

True of MDR-TB
a. Resistance of rifampicin and INH
b. Resistance to kanamycin
c. Both
d. Neither

a. Resistance of rifampicin and INH

262

Drug resistance in MTB is due to
a. Spontaneous mutations in the
chromosomes
b. Resistance gene in plasmid
c. Both
d. Neither

a. Spontaneous mutations in the
chromosomes

263

True of M. leprae
a. Obligate intracellular
b. Affects the nerves, skin cells and
nasal mucosa
c. Both
d. Neither

c. Both

264

Which is not true of M. leprae/leprosy
a. It is a curable disease
b. The disease is also known as Hansen’s disease
c. Incubation period is from 3-30 years
d. All are correct

d. All are correct

265

The Mycobacterium leprae can be grown in all except
a. Nude mice
b. L-J medium
c. 9 banded armadillo
d. Monkey

b. L-J medium

266

True of multibacillary leprosy
a. Lesions are found scattered in the body
b. CMIR is not working, has anergy to M.leprae
c. Both
d. Neither

c. Both

267

True of paucibacillary leprosy
a. Few or solitary lesion
b. Good CMIR
c. Few or no bacilli in the lesion
d. All are correct
e. All are wrong

d. All are correct

268

Which of the following is/are common pathogens of the genital tract
a. Ureaplasma urealyticum
b. Mycoplasma hopminis
c. Mycoplasma pneumonia
d. A and B only

d. A and B only

269

Which is the best statement concerning infection with Mycoplasma pneumonia
a. The cough is generally productive b. Pneumonia due to this bacterium
is more severe than that caused by other bacteria
c. It is described as primary atypical
pneumonia
d. Mycoplasma pneumonia accounts for more than 50% of all cases of pneumonia

c. It is described as primary atypical
pneumonia

270

Mycoplasma differs from Chlamydia in that mycoplasma
a. Are all resistant to penicillin
b. Can be propagated on cell free
media
c. Have no cell wall
d. All 3 are correct

d. All 3 are correct

271

Pneumonia caused by mycoplasma pneumonia
a. Has an insidious onset
b. Common community acquired
c. Patient looks better that he really is
d. All are correct

d. All are correct

272

Which of the following is/are characteristics of mycoplasma
a. They belong to the class of organisms with no cell membrane
b. They are insensitive to aminoglyceride
c. They are obligte anaerobes
d. All are correct
e. All are wrong

e. All are wrong

273

The following organism/s is/are subspecies Treponema pallidum
a. T. pertenue
b. T. carrateum
c. T. endemicum
d. All of the choices
e. A and B only

d. All of the choices

274

The following is /are serologic test/s used in the diagnosis of syphilis
a. Venereal disease Research laboratory
b. IFAT-ABS
c. Rapid plasma regain
d. All of the choices
e. A and B only

d. All of the choices

275

Pityriasis vesicolor is characterized by
a. Itchy, scaly lesions
b. Whistish/brownish coalescing lesions
c. Crusted warty lesions
d. Erythematous raised advancing
borders

b. Whistish/brownish coalescing lesions

276

Black piedra is seen as
a. Sclerotic bodies
b. Nodule
c. Cigar bodies
d. Oval-budding yeast

b. Nodule

277

Which of the etiologic agents of
subcutaneous mycosis is dimorphic
a. S. schenckii
b. P.verrucosa
c. Nocardia spp
d. Loboa loboi

a. S. schenckii

278

The hallmark of mycetoma
a. Cigar bodies
b. Sclerotic bodies
c. Granules
d. Brown fission bodies

c. Granules

279

Fungi elements seen in tissues in cases of chromoblastomycosis
a. Granules
b. Cigar bodies
c. Sclerotic bodies
d. Spherules

c. Sclerotic bodies

280

Cauliflower like lesions are seen in
a. Sporothrichosis
b. Mycetoma
c. Chromoblastomycosis
d. Entomophthoromycosis

c. Chromoblastomycosis

281

Involvement of lymphatic channels
a. Sporothrichosis
b. Mycetoma
c. Chromoblastomycosis
d. Mucormycosis

a. Sporothrichosis

282

The Splenodore-hoeppli phenomenon is seen in
a. Sporotrichosis
b. Mycetoma
c. Entomophthoromycosis
d. Mucormycosis

c. Entomophthoromycosis

283

The presence of dichotomously branching hyphae in tissue
a. Aspergillosis
b. Mucormycosis
c. Entomophthoromycosis
d. Phaehyphomycosis

a. Aspergillosis

284

Satellite lesion is seen in
a. Candidiasis
b. Tinea cruris
c. Rhinosporidosis
d. Sporotrichosis

a. Candidiasis

285

C. neoformans is associated with
a. Pigeon droppings
b. Chicken excreta
c. Alkaline soil
d. Guano

a. Pigeon droppings

286

The presence of neoformans in CSF can be shown by using
a. Gram stain
b. 10% KOH
c. India ink
d. LPCB

c. India ink

287

All of the following fungal structures can be seen in tissues EXCEPT
a. Broad-septate hyphae
b. Cigar bodies
c. Sclerotic bodies
d. Macroconidia

d. Macroconidia

288

The following are characteristic features of subcutaneous mycoses EXCEPT
a. Chronic infection
b. Traumatic implantation of
etiologic agent
c. Etiologic agents are soil saprophytes
d. Etiologic agents are dimorphic

d. Etiologic agents are dimorphic

289

Superficial mycoses affect the
a. Hair and skin
b. Skin and nail
c. Nail and hair
d. Skin, hair and nail

a. Hair and skin

290

Subcutaneous mycoses are characterized by the following Except
.
b. Whistish/brownish coalescing lesions
a. Chronic infection
b. Traumatic implantation of etiologic agent
c. Etiologic agents are soil saprophytes
d. Primary infection is pulmonary

d. Primary infection is pulmonary

291

Persons prone to candidiasis
a. Preganant
b. Swimmers
c. Farmers
d. Gardeners

a. Preganant

292

Candidiasis is characterized by
a. Lesions have raised erythematous
border
b. Crusted lesions
c. Satellite lesion
d. Cauliflower-like lesion

c. Satellite lesion

293

Fungi are characterized as
a. Heterotrophic
b. Eukaryotic
c. Both
d. Neither

c. Both

294

Host response to fungal infections is the
CMIR
a. True
b. False

b. False

295

The most common mounting fluid used for
the direct examination of clinical specimen for fungal diagnosis
a. LPCB
b. Wet mount
c. 10% KOH
d. PAS

c. 10% KOH

296

The barriers to fungal growth include
a. Body temperature
b. Host defense mechanism
c. Tissue redox potential
d. All of the above

d. All of the above

297

The following are asexual spores which is responsible for the dissemination of fungi
a. Sporangiospores
b. Arthrospores
c. Conidia
d. All of the above

d. All of the above

298

Direct examination of fungal lesions can be done with the use of
a. Wood’s ultraviolet lamp
b. Biopsy
c. Both A and B
d. None of the above

c. Both A and B

299

The fungus which is considered the great mimic
a. Histoplasma capsulatum
b. Pneumocystis carinii
c. Cryptococcus neoformans
d. Blastomycoses dermatitidis

a. Histoplasma capsulatum

300

Characteristic feature of Coccidioidomycosis
a. Has predilection to dark skinned
people
b. Dissemination is rare
c. Infective structures are
arthrospores
d. All of the above are true

d. All of the above are true

301

Aspergillosis can be manifested as
a. Allergy
b. Mycotoxicosis
c. Farmer’s lung
d. All of the above

d. All of the above

302

Cryptococcus neoformans is associated with
a. Pigeon droppings
b. Encapsulated budding yeast
c. Meningitis
d. All of the above

d. All of the above

303

Histoplasma capsulatum is associated with
a. Guano
b. Primary infection is pulmonary
c. Tuberculosis like infection
d. All of the above

d. All of the above

304

Dermatophytid
a. Also called “id reaction”
b. Means no fungus is present in the lesion
c. Is a hypersensitivity reaction
d. All of the above

d. All of the above

305

Which of the following statements is true
a. Mycetoma can be caused by a variety of fungi that are distributed worldwide
b. Serology Is the best diagnostic procedure for establishing sporotrichosis
c. Coccidioidomycosis occurs primarily in the Northest states of the USA
d. Blastomycosis is associated with a

a. Mycetoma can be caused by a variety of fungi that are distributed worldwide

306

Presence of sopper pennies in tissues is associated with
a. Mycetoma
b. Chromoblastomycosis
c. Sporotrichosis
d. Mucormycosis

b. Chromoblastomycosis

307

Presence of cigar bodies in tissues is associated with
a. Mycetoma
b. Sporotrichosis
c. Chromoblastomycosis
d. Mucormycosis

b. Sporotrichosis

308

Used in the treatment of fungal infections
a. 5-fluorocystosine
b. Metronidazole
c. Cefoxatin
d. KOH

a. 5-fluorocystosine

309

Sexual dimorphism is seen in all of the following except
a. Histoplasma capsulatum
b. Blastomyces dermatitidis
c. Coccidiodes immitis
d. Cryptococcus neoformans

d. Cryptococcus neoformans

310

All of the following are classified as opportunistic mycoses Except
a. Histoplasmosis
b. Cryptococcosis
c. Aspergillosis
d. Mucormycosis

d. Mucormycosis

311

The presence of this is diagnostic of Coccidiodes immitis in tissues
a. Spherule
b. Narrow based bud
c. Broad based bud
d. Pseudohyphae

a. Spherule

312

Guano and feces of starling is a good
substrate for growth of
a. Histoplasma capsulatum
b. Blastomyces dermatitidis
c. Coccidiodes immitis
d. Cryptococcus neoformans

a. Histoplasma capsulatum

313

Also known as South American blastomycosis
a. Paracoccidiodes brazilliensis
b. Blastomyces dermatitidis
c. Coccidiodes immitis
d. Cryptococcus neoformans

a. Paracoccidiodes brazilliensis

314

Bone involvement is rare in African histoplasmosis. This statement is
a. True
b. False

b. False

315

This is also known as great mimic
a. Histoplasma capsulatum
b. Blastomyces dermatitidis
c. Coccidiodes immitis
d. Cryptococcus neoformans

a. Histoplasma capsulatum

316

In Histoplasma capsulatum, the organisms are found in the
a. Histiocytes
b. PMN’s
c. Giant cells
d. Eosinophils

a. Histiocytes

317

The saprobic phase at 25C is also known as
a. Mycelial phase
b. Mold phase
c. Both A and B
d. Neither A nor B

c. Both A and B

318

Tuberculate macronidia is diagnostic of
a. Histoplasma capsulatum
b. Blastomyces dermatitidis
c. Coccidiodes immitis
d. Cryptococcus neoformans

a. Histoplasma capsulatum

319

Multiple budding cells or mariner’s wheel. Is the yeast phaseof
a. Paracoccidiodes brazillensis
b. Blastomycoses dermatitidis
c. Coccidiodes immitis
d. Cryptococcus neoformans

a. Paracoccidiodes brazillensis

320

The portal of entry of most systemic mycoses is the
a. Lungs
b. Skin
c. Unknown
d. GIT

a. Lungs

321

The presence of dichotomous 45C angle branching hyphae in fungus ball is seen in
a. Candidiasis
b. Cryptococcosis
c. Aspergillosis
d. Histoplasmosis

c. Aspergillosis

322

Rhino-orbital or rhinocerebral form is seen in mucormycosis
a. True
b. False

a. True

323

This fungus is mostly found in pigeon roots,
old barn and soil underneath trees,
a. Paracoccidiodes brazilliensis
b. Blastomycoses dermatitidis
c. Coccidiodes immitis
d. Cryptococcus neoformans

d. Cryptococcus neoformans