Jonelta Foundation School of Medicine University of Perpetual Help DALTA System DEPATME!T DEPATME!T "F M#$"%#"L"&' M#$"% #"L"&' A!D PAAS#T"L"&' %oard (uestions in Micro)iolo*y and Parasitolo*y Micro+Para MPL , -./01 Su)2ect3 Micro)iolo*y 4.56uestions7 MPL, 10/89 (#mmunolo*y7 #nstruction3 #nstruction 3 $hoose the )est ans:er/ 1. Carlo Carlo has leukemia; leukemia; unfortu unfortunat nately ely he was exposed exposed to HBsAg HBsAg positive positive blood. blood. he best immediate management whi!h whi!h !an be given to him is to give" A/ re!ombinant Hep B va!!ine %/ passive immuni;ation $/ anti#viral drugs D/ vitamins Answer" Answer" B $efe $efere ren! n!e" e" %edi %edi!a !all %i!r %i!rob obio iolo logy gy by by &awe &awet' t' )* rd ed. p.11+ %,-" 1
). %ario a /#year#old /#year#old exe!utive is a si!kly guy. guy. He always always !omplains !omplains of !oughs !oughs and !olds. He used to be a smoker but he had stopped sin!e he was in his early thirty0s. His do!tor said that he is often atta!ked by organisms whi!h atta!k atta!h to the mu!ous membranes of his respiratory tra!t. hese organism then do whi!h of the following a!tions against its host" A/ )rea
=. he gave a history of taking peni!illin for her sore throat two days prior to admission. >he gave no history of allergy to peni!illin. -aboratory test done on her blood showed the presen!e of antibodies whi!h hemolyses her own $BC. >he is probably suffering from" A. ype hypersensitivity B. Type ## hypersensitivity C. ype hypersensitivity 3. ype < hypersensitivity Answer" $eferen!e" %,-"
B %edi!al %i!robiology by &awet' )* rd ed. p.11 1
?. Athena was born 3e!ember )22. >he has an older brother Bitoy who got si!k of !hi!ken pox when Athena was one month old. kay another older sister of Athena got si!k of !hi!ken pox while she did not. his is be!ause of" A/ %aternal gA %/ Athena0s gA $/ Maternal #*& D/ Athena0s g@ Answer" $eferen!e" %,-"
C %edi!al %i!robiology by &awet' )* rd ed. p. 1) 2./
. sabel be!omes a different person during the months of 3e!ember. n these months she is grou!hy be!ause of hay fever. Her do!tor explained that she is allergi! to pollen and the maor !ulprit is the so#!alled g whi!h is a homo!ytotropi! immunoglobulin whi!h binds to all of the following !ells bellow DC," A. eosinophils B. mast !ells C. basophils D/ neutrophils Answer" $eferen!e" %,-"
+.
12.
Betty has !olds almost every three months. But she is not bothered be!ause she noti!ed that even without treatment she gets better he self#limiting nature of her !olds whi!h is often of viral etiology is partly attributed to" A. @amma interferon B. Alpha interferon C. Beta interferon D/ All choices are correct e=cept A Answer" $eferen!e" %,-"
3 %edi!al %i!robiology by &awet' )* rd ed. p 1*2 2.)/
3 %edi!al %i!robiology by &awet' )* rd ed. p. 1)/ 2.)/
%ike was si!k of pneumonia for whi!h he almost died. Before his dis!harge from the hospital he asked the do!tor to explain to him his illness and how he was able to re!over. he do!tor talked of the germs having slimly materials around them. hat it was ne!essary for some substan!e to !oat the germs so that the s!avenger0s !ells in the body !an eat them up. he do!tor was referring to opsoni'ation. 4hi!h of the following substan!es is involved in opsoni'ation9 A. C*a %/ $1) C. C)a 3. C)b Answer" B $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. 1*? %,-" 2.)/
11.
A ?#year#old girl was brought to the derma se!tion of E,H$ medi!al !enter for swollen weeping earlobes with some signs of !rusting. 6ne earlobe has an almost embedded tiny earring. he do!tor said the girl was probably allergi! to the ni!kel !omponent of the fan!y earrings. his !ondition is also termed as" A/ $ontact hypersensitivity B. uber!ulin hypersensitivity C. Atopi! hypersensitivity 3. mmune !omplex hypersensitivity Answer" $eferen!e" %,-"
A %edi!al %i!robiology by &awet' )* rd ed. p. 11 2.)/
1). 5onong was an 6F4 from ,uerto $i!o. He !ame home be!ause he was diagnosed to have syphilis. He !onsulted a lo!al do!tor for a se!ond opinion. he do!tor s!rapped off the base of the ul!er found in his bu!!al mu!osa. He explained to &oo that he will add to the spe!imen a substan!e whi!h he !alled antibody to whi!h will be atta!hed a !ertain dye whi!h will emit light under a G dark mi!ros!ope G.. his immunologi! diagnosti! test is probably" A. mmunoblotting %/ #mmunofluorescence C. ->A 3. $adioimmunoassay
Answer" $eferen!e" %,-"
B %edi!al %i!robiology by &awet' )* rd ed. p. 1) 1
1*. &ake had typhoid fever. 4hen seen by the do!tor he has already on the third weeks and had started to feel better. f you !an enter &ake0s body whi!h of the following item below would show that he had a!hieved an adaptive immune response against typhoid ba!illi9 a. physi!al barriers b. !hemi!al barriers c/ clonal e=pansion of effector cells d. phago!ytosis
Answer" $eferen!e" %,-"
C %edi!al %i!robiology by &awet' )* rd ed. p. 1* 1
1. 3oy was diagnosed to have an infe!tious disease of unknown etiology. xamination of his blood showed that the !omplement levels are normal. n infe!tions one defense against the agent is the a!tivation of the !omplement. 4hat then among the item below is the best trigger for the of !omplement a!tivation 9 a. g@ b. %annose#!ontaining ba!terial gly!olipids !. %i!robial surfa!es d/ #*M+anti*en immune comple=es
Answer" $eferen!e" %,-"
3 %edi!al %i!robiology by &awet' )* rd ed. p. 1? 2.)/
1/. A 1*#year#old boy from lo!os tested negative in the lepromin test. He presents with multiple erythematous anestheti! lesions all over the body. he skin test shows whi!h type of hypersensitivity" a. ype Hypersensitivity b. ype hypersensitivity c/ Type ### hypersensitivity d. ype < hypersenitivity Answer" C $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. 11 %,-" 1
1=. $oy was found to have antibodies to A3> by the ->A method. o !onfirm the diagnosis antigens of the virus must be dete!ted in his blood. 4hi!h of the following methods will identify the H< antigen mix in a !omplex mixture of proteins " a/ >estern )lottin* b. >outhern blotting !. astern blotting d. 5orthern blotting Answer" A $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. 1* %,-" 1 Su)2ect3 Micro)iolo*y 4?irolo*y7 #nstruction3 $hoose the correct ans:er/ 1?. he human va!!ine for this viral infe!tion is made of killed virus grown in human diploid fibroblasts or !hi!ken fibroblasts" a. $ubella )/ a)ies !. &ap B en!ephalitis d. %easles Answer" B $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. 12 %,-" 2.)/ 1. -uisa is an absent#minded medi!al intern. >he was asked by the resident to get some influen'a va!!ines from the refrigerator in the !all room and to bring them to the 6,3 for immuni'ation of the old nurses in the se!tion. -uisa followed the instru!tions. Enfortunately she did not find the resident so she pla!ed the va!!ine on the table with a short note. After )# hours the resident !ame and found the va!!ines. nfluen'a is a killed viral va!!ine all of the following are its disadvantages DC," a/ hi*h sta)ility at room temperature b. shorter duration of immunity !. poor C% produ!ed d. no gA produ!ed
Answer" $eferen!e" %,-"
A %edi!al %i!robiology by &awet' )* rd ed. p. 12 1
1+. Allan was bitten by his dog in the lower leg. he wound is not deep but it bled. n the de!ision to give postexposure prophylaxis the following are !onsidered ex!ept whi!h of the following " a. manner of atta!k b. nature of biting animal !. severeity of the bite d/ none of the choices
Answer" $eferen!e" %,-"
3 %edi!al %i!robiology by &awet' )* rd ed. p. /2 1
)2. -aura was in her ) nd month of pregnan!y when she tested positive for $ubella antibodies. nspite of this she de!ided to !ontinue with the pregnan!y. >he delivered the baby weeks earlier than the expe!ted date. A t a glan!e the baby seemed normal. >he asked her do!tor what !ould be the possible effe!t if her baby got !ongenital rubella. 4hi!h of the following !ould explain any abnormality that may be later seen in -aura0s baby 9 a. infe!ted !ells in the baby have redu!ed growth rate b. hypoplasti! organs results in abnormalities in the embryoni! !ells whi!h have redu!ed growth rate $/ stru!tural anomalies due to hypoplasti! organs D/ all of the a)ove Answer" 3 $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. /=? %,-" 2.)/
)1. A baby born with !ongenital rubella was found to be deaf. 3efe!ts in rubella are grouped into broad !ategories i.e temporary developmental permanent. 3eafness is under " a. temporary b. developmental !. permanent d/ none of the choices Answer" $eferen!e" %,-"
)).
C %edi!al %i!robiology by &awet' )* rd ed. p. /= 2.**
Ana is getting married and thus was advised to get her $ubella va!!ine shot. 4hi!h of the following isare true of the rubella va!!ine 9 a. it is live attenuated va!!ine b. it is given to prevent !ongenital rubella infe!tion !. va!!inated !hildren pose no threat to mothers who are sus!eptible and pregnant d/ all of the a)ove Answer" $eferen!e" %,-"
)*.
&ay a +#month old baby is rushed to the $ for fever and persistent !ough. 6n examination rales are heard on his left !hest and an infiltrate in the left lung is seen on the !hest x#ray film. he diagnosis given is pneumonia. 4hi!h of the following viruses is the most likely !ause9 A. $hinovirus %/ espiratory syncytial virus C. Adenovirus 3. Coronavirus Answer" $eferen!e" %,-"
3 %edi!al %i!robiology by &awet' )* rd ed. p. /=? 1
B %edi!al %i!robiology by &awet' )* rd ed. p. 2) 1
) n this viral infe!tion humans are dead#end hosts thus virus shedding does not o!!ur. A. measles %/ a)ies C. influen'a 3. !hi!ken pox Answer" $eferen!e" %,-"
)/.
B %edi!al %i!robiology by &awet' )* rd ed. p. 1+ 1
A ten#year#old girl !omplained of diffi!ulty and pain in swallowing. t was a!!ompanied by runny nose and fever. Epon examination the intern in the 6,3 noted slightly swollen tonsils and erythematous pharynx. 5o exudates were noted on the tonsillar surfa!e. he diagnosis given was upper respiratory infe!tion . he most likely etiologi! agent for this !ase is" A/ adenovirus B. $espiratory syn!ytial virus C. $hinovirus 3. Coronavirus Answer" A $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. 2) %,-" 2.)/
)=. $amon a year old boy was seen by a pediatri!ian for !omplains of low#grade fever !old and rash on the fa!e whi!h showed a typi!al G slapped !heek appearan!e. Complains of flu#like symptoms su!h as malaise and myalgias were also noted. he pediatri!ian gave a diagnosis of erythema infe!tiosum of the fifth disease whi!h is !aused by whi!h of the following viruses" A. Hanta virus %/ %@8 parvovirus C. Herpes simplex 3. Coxsa!kie viruses Answer" B $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. 1 %,-" 2.)/ )?.
-ast summer a !ommunity hospital in -aguna re!orded )/ !ases of pharyngo!onun!tivitis among the grade five students from a private s!hool in the nearby muni!ipality. t was learned that all of them attended a summer !amp whi!h lasted for ) weeks. 4hi!h of the following adenovirus serotypes are most likely involved9 A/ types 1 and B. types 1 and ?2 C. types 2 and / 3. types and 12 Answer" A $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. )/ %,-" 2.)/
).
A ) I#year#old boy was noti!ed by his mother to have less appetite for solid food but when given i!e !ream and soft drinks he was :uite happy. his was unusual be!ause he likes to eat and play with solid foods. he mother examined him and found that he has some swollen nodules in his ne!k. >uspe!ting something in the mouth she examined the mouth and found vesi!ular lesions in the bu!!al mu!osa. his is probably !aused by " A. Candida albi!ans B. >trepto!o!!us pyogenes C. %easles virus D/ Herpes simple= virus Answer" 3 $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. */ %,-" 2./
)+.
Joyong a 1/#year#old boy a!:uired !hi!ken pox. 4hen vesi!ular lesions be!ame evident he was Gisolated by his mother from the rest of the family by !onfining him to his room. After a week his po!ks subsided with some lesions already developing s!abs. t was at this time that two other siblings started showing the same signs and symptoms he had. 4hi!h of the following item below best des!ribes the diseaseetiologi! agent of involved in Joyong0s !ase9 A. the virus infe!ts only humans B. the disease is highly !ontagious $/ )oth are correct . neither one is !orre!t Answer" C $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p.* %,-" 2.)/
*2. dang is due two deliver in two weeks time. Enfortunately she had premature labor and deliverered a stillborn baby boy. he baby was autopsied and the one finding was the presen!e of !ells whi!h look like Gowls eye i.e. !ells with large intranu!lear in!lusion bodies. he most probable diagnosis is" A. Congenital measles B. Congenital rubella C. Congenital !hi!ken pox D/ con*enital cytome*alovirus infection Answer" 3 $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. * %,-" 2.)/
*1.
&$ a ma!ho dan!er from the red distri!t did not report for work for almost three days. $& his friend be!ame worried and went to his pla!e. He found &$ with fever heada!he and feels weak and tired. hey went to the !lini! and was found to have enlarged lymph nodes and spleen and slightly i!teri! !onun!tiva. Blood exam showed large atypi!al lympho!ytes. he most probable diagnosis is" A. Cytomegalovirus infe!tious mononu!leosis %/ #nfectious mononucleosis C. Herpes simplex infe!tion C. %umps Answer" $eferen!e" %,-"
B %edi!al %i!robiology by &awet' )* rd ed. p. ? 2.**
*). A )#year#old woman has re!urrent genital herpes. 4hi!h of the following about genital herpes infe!tion is true 9 A. !annot be transmitted in the absen!e of apparent lesions B. rea!tivation of latent virus during pregnan!y poses no threat to the newborn $/ can )e caused )y either herpes simple= type @ or type 0 3. re!urrent episodes are more severe than the primary infe!tion Answer" $eferen!e" %,-"
**.
%$ !onsulted a dermatologist for the small pink wart#like lesions on her fa!e arms ba!k and butto!ks. he diagnosis given was molus!um !ontagiosum infe!tion. 4hi!h of the following about this is 56 true9 A/ virus has a :ide ran*e of host B. transmission is by dire!t and indire!t !onta!t C. it is !onsidered a sexually transmitted disease 3. the virus has a 35A genome Answer" $eferen!e" %,-"
C %edi!al %i!robiology by &awet' )* rd ed. p. */ 2.)/
A %edi!al %i!robiology by &awet' )* rd ed. p. =* 2.)/
*.%otong is a leukemia patient. He was admitted for post transfusion hepatitis. est showed the etiologi! agent to be flavivirus. his virus is" A. Hepatitis A B. Hepatitis B $/ Hepatitis $ C. Hepatitis Answer" $eferen!e" %,-"
*/.
C %edi!al %i!robiology by &awet' )* rd ed. p.= 1
Ferdie was a diagnosed !arrier of Hepatitis B. n one of his follow#ups in the !lini! anti#HBe antibodies were dete!ted in his serum. his means that" A. he is now developing resistan!e %/ his H% virus titer is no: lo: C. it has no meaning 3. a mistake was !ommitted be!ause HBs Ag and anti#HBe do not exist together in the blood Answer" $eferen!e" %,-"
B %edi!al %i!robiology by &awet' )* rd ed. p. = 2.)/
*=.
-ola a middle#aged woman !omplained of a!ute onset fever and nausea. Her eyes were Gyellow and she was surprised to see her urine to be dark !olored. >he !onsulted a private !lini! and the laboratory test done on her blood was positive for HA< g% antibody. 4hat will you tell -ola if you are the physi!ian9 A. hat she a!:uired the disease through sexual !onta!t B. that probably it was transmitted to her when she had blood transfusion $/ to )e very carefulB )ecause she can transmit the infection to other mem)ers of her family )y person+to+person spread 3. that she might develop liver !ar!inoma in the future Answer" C $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. * %,-" 1
*?
A young exe!utive from %akati was hospitali'ed for myoperi!arditis with mild !ongestive heart failure that in!reases over several weeks. he attending physi!ian gave a diagnosis of Coxsa!kie B/ infe!tion. 6ther than his !onditions what other syndromes is are asso!iated with this virus9 A. herpangina B. asepti! meningitis C. a!ute hemorrhagi! !onun!tivitis D/ all of the a)ove Answer" 3 $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. +/ %,-" 2.)/
*.
After getting his first salary Bitoy went to the seaside restaurant and feasted on seafoods parti!ularly raw oyster with his favorite beer. After ) hours he be!ame ill with sudden onset of vomiting diarrhea and heada!he. He !onsulted a private !lini! and the physi!ian after thorough examination ruled out a ba!terial etiology. o him the most probable viral etiologi! agent is" A. Astrovirus %/ !or:al< virus C. $otavirus 3. Hepatitis A virus Answer" B $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. /1) %,-" 2.)/
*+.
A /#year#old woman from a ran!h in %indanao !omplained of fever malaise and sore throat followed by nausea vomiting and then sudden stupor. >he was diagnosed to be suffering from eastern equine encephalitis . he !ontrol of this disease in humans !ould be a!!omplished by eradi!ation !ontrol of" A. ti!ks B. birds $/ mos6uitoes 3. sandflies Answer" B $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. /)) %,-" 2.)/
Su)2ect3 Micro)iolo*y 4Mycolo*y7 #nstruction3 $hoose the correct ans:er/ 2. 3& went to Bora!ay last summer. He had a good tan ex!ept on some portion of his ne!k down to his upper ba!k whi!h showed minimal s!aling . After a week the tan portion of his skin started to peel. o his surprise the G untanned portion of his skin seemed to have be!ome bigger. His skin started to return to its normal !olor but the G untanned portion seemed to stand out this time looking more whitish that his normal light brown skin. he most likely diagnosis is " A. leprosy %/ superficial mycoses C. avitaminosis 3. none of the !hoi!es Answer" B $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. =) %,-" 2.)/
1. 3& !onsulted a dermatologist for the whitish dis!oloration whi!h showed after his Bora!ay es!apade. he do!tor made a 76H mount of the skin s!rapings and found short stout angular hyphal elements. he skin lesions also fluores!e under the 4ood0s lamp. he most likely etiologi! agent is" A. inea !orporis )/ Pityriasis versicolor C. 4hite piedra 3. !andidiasis Answer" B $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. =) %,-" 1 ).
%elanie is a !ook in a small restaurant responsible for the barbe!ue stand. -ater be!ause of arthritis she was reassigned to the !ounter as the one taking the orders. >he noti!ed that her left hand still showed the bla!kish dis!oloration !aused by handling !har!oal. >he had not noti!ed it before be!ause after !ooking she does not wash her hand often be!ause of fear of G pasma. his time she used al!ohol to !lean the dis!oloration but to her surprised it had no effe!t on the G dirt. After trying to remove it to no avail for a week she de!ided to !onsult a do!tor. he diagnosis given was tinea nigra. he etiologi! agent of this is " A/ Hortaea werneckii B. Cladosporium spp. C. Trichophyton spp. 3. Exophiala hortai Answer" $eferen!e" %,-"
A %edi!al %i!robiology by &awet' )* rd ed. p. =) 2.)/
*. A group of G street oldies were taken to the 3>43. hey were given bath fresh !lothes and something to eat. A medi!al team was also present who did some :ui!kie !he!k up on them. 6ne man be!ame the !enter of attra!tion of the do!tors and interns be!ause of the presen!e of soft yellowish nodules on the hair of his axilla and beard. he interns thought of them as the eggs and nits of li!e. he were however proven wrong after they had s:uee'ed some of it. he most likely diagnosis for this is " A. Bla!k piedra B. ri!hophyton hair infe!tion $/ >hite piedra 3. x!ess soap suds Answer" $eferen!e" %,-"
.
C %edi!al %i!robiology by &awet' )* rd ed. p. =) 2.**
3 %edi!al %i!robiology by &awet' )* rd ed. pp.=*1#=*) 2.)/
/.
$C a 2#year#old farmer !onsulted a dermatologist for the multiple sinuses in his left arm that seem to follow a line. A!!ording to him it started as small wounds !aused by rose0s thorns when he was pruning the ground roses. he dis!harge from the sinuses showed oval budding !ells that are variable in shape but often fusiform. he dis!harge was !ultured in >AB. @rowth in >AB yielded septate hyphae with small !onidia !lustered at the tip of !onidiophores appearing like daisies with stem. he most likely identifi!ation of this organism is" A. Trichophyton mentagrophytes B. Phialophora species $/ Sporothrix schenckii 3. Cladosporium carrionii Answer" $eferen!e" %,-"
C %edi!al %i!robiology by &awet' )* rd ed. p. =*) 2.)/
=. A farmer from -aguna !onsulted the distri!t hospital for his G big foot with draining sinuses. He has been with it for almost three years now. He was for!ed to see a do!tor be!ause he !ould no longer do his ob in the farm. he do!tor noted that bla!k granules are !oming out of the sinuses . he most probable diagnosis is" A. sporothri!hosis %/ mycetoma C. elephantiasis 3. !hromomy!osis Answer" $eferen!e" %,-"
B %edi!al %i!robiology by &awet' )* rd ed. p.=*= 2./
?.he bla!k granules !oming out of the sinuses in the G big foot of a farmer are hard and showed intertwined septate hyphae. 4hi!h of the following is the most likely etiologi! agent9 A/ Madurella *risea B. A!tinomy!es C. 5o!ardia spp. 3. ri!hophyton rubrum Answer" $eferen!e" %,-" .
A %edi!al %i!robiology by &awet' )* rd ed. p. =*2 2./
&oo a Filipino migrant in California !ame home for a two#month va!ation. He thought he !an relax but on his se!ond week in the ,hilippines he had no !hoi!e but to seek medi!al help for small draining sinus on his left !hest at the level of the axilla. 6ther symptoms were !ough and fever . xamination of the dis!harge using 12K 76H showed sa! like stru!ture with spore like stru!tures inside. he most likely diagnosis is" A. Histoplasmosis %/ $occidioidomycosis C. Blastomy!osis 3. uber!ulosis Answer" $eferen!e" %,-"
B %edi!al %i!robiology by &awet' )* rd ed. p. =* 2.**
Su)2ect3 Micro)iolo*y 4%acteriolo*y7 #nstruction3 $hoose the correct ans:er/ +. An elderly woman with pneumonia developed bloody diarrhea on the ?th hospital day a!!ompanied by abdominal !ramps and fever. he do!tors got worried be!ause her fever !aused by pneumonia had lysed as early as her * rd hospital day. >he was immediately pla!ed in the CE and all antibioti!s were stopped. >he has been on ampi!illin for / days prior to admission and on admission was started with !lindamy!in and augmentin Her !ondition is probably !aused by" A. Enterohemorrhagic Escherichia coli B. higella dysenteriae $/ Clostridium difficile 3. !ibrio parahemolyticus Answer" C $eferen!e" %edi!al %i!robiology by &awet' )* rd ed. p. )12 %,-" 2.** /2. >everino had an a!!ident that resulted in the amputation of his right leg two in!hes above the knee. About five days post#op signs of wound infe!tion was evident. -o!al wound !are was given and the exudate was sent to the lab. he do!tors were willing to wait for the lab results before !hanging antibioti!s. After two days the !ulture !ame with no organism isolated from the spe!imen as reported. hey suspe!ted anaerobi! infe!tion. Anaerobi! infe!tion is usually suspe!ted when" A. B. C. D/ Answer" $eferen!e" %,-"
there is presen!e of foul smell the site of infe!tion is near a mu!osal surfa!e there is gas in tissues all of the a)ove
3 %edi!al %i!robiology by &awet' )* rd ed. p. *2+ 1
/1. @eorge was rushed to the hospital for fever and pain in the right lower abdomen. $e!tal exam was !ompatible with the diagnosis of appendi!itis. He was again rushed to the operating table be!ause of unstable vital signs. 6n opening up he was found to have a ruptured appendi!itis with abs!ess formation around it. he exudates later yielded "acteroides fragilis. 4hi!h of the following fa!tors promote abs!ess formation by ". fragilis9 A/ capsule B. lipopolysa!!haride C. pili 3. superoxide dismutase Answer" $eferen!e" %,-" /).
A %edi!al %i!robiology by &awet' )* rd ed. p. *2+ 2.**
@C a )2#year#old girl working in the !all !enter !onsulted a gyne!ologist be!ause of whitish#gray vaginal dis!harge with a bad odor of about a week duration. ,revious to it she had several sexual relationships with her boyfriend of two months. 4ith her !ondition she felt guilty and de!ided to lead a !lean life as soon as the she gets well. he do!tor got some fluid from the vaginal !anal pla!ed some on the slide and some she tested for pH whi!h was /./ against the normal value of ./. 4et mount showed many epithelial !ells whi!h appear granular. 5o ,%5 was noted. 4hi!h of the following is the most likely diagnosis9 A Trichomonas #aginalis B. $east vaginitis C. @onorrhea D/ %acterial va*inosis Answer" $eferen!e" %,-"
3 %edi!al %i!robiology by &awet' )* rd ed. p. *1= 1
/*. A =?#year#old man was taken to the $ for diffi!ulty of breathing. He has been feeling weak sin!e days ago. He has a !hroni! !igarette !ough sin!e he was in his 2s but did not bother to see a do!tor for his !omplaints until his son noti!ed that he looked worst. 6n physi!al examination inspiratory and expiratory whee'es and rales were noted over the right lower lung . His !hest x#ray further revealed pat!hy lower right lung infiltrates. he differential diagnosis for this patient is" A. treptococcus pneumoniae B. %egionella pneumophilia C. &ycoplasma pneumoniae D/ all of the a)ove Answer" $eferen!e" %,-" /.
&oe was diagnosed with lung !an!er and in his bron!hial washing a!id#fast ba!illi were seen mixed with the !an!er !ells. &oe had been given the full short !ourse of the B regimen before and so the do!tor suspe!ted a drug resistant strain. he bron!hial washing was !ultured and it grew orange !olored !olonies when exposed to light. he most probable etiologi! agent is" '. &ycobacterium tuberculosis ". &ycobacterium smegmatis i. Mycobacterium kansasii C. &ycobacterium a#ium !omplex Answer" $eferen!e" %,-"
//.
C %edi!al %i!robiology by &awet' )* rd ed. p. *)? 2./
Jou are giving le!tures to B patients about the !hara!teristi!s of &ycobacterium tuberculosis. his is to !onvin!e them that they should !over their mouths when !oughing and to avoid spitting in the environment. 4hi!h of the following !hara!teristi!s should 56 be emphasi'ed to them9 a/ The or*anism is *ro:n in comple= media b. he organism is resistant to drying and survive for long periods in dried sputum !. he organism is resistant to a!id and alkali d. he organism are found in the droplet nu!lei dis!harge by the infe!ted person. Answer" $eferen!e" %,-"
/=.
3 %edi!al %i!robiology by &awet' )* rd ed. p. *1 2.)/
A %edi!al %i!robiology by &awet' )* rd ed. p. *)1 2.)/
A visiting media team !ondu!ted the G sear!h for the !hild with primary !omplex in an elementary s!hool in anay. After a thorough physi!al examination the !hildren in two grade one se!tions were skin tested using tuber!ulin at a dose of /E. 4hi!h of the following statements on ,,3 is !orre!t 9 a. he tuber!ulin skin test be!omes positive within #= weeks after primary infe!tion. b. mmuni'ation with BC@ will result in a positive ,,3 whi!h may last for *#? years. !. ,ersons who had been ,,3 positives before but are healthy may fail to give a positive ,,3 test when tested again. d/ All are correct Answer" $eferen!e" %,-"
3 %edi!al %i!robiology by &awet' )* rd ed. p. *)* 2.)/
/?.
About fifty per!ent of the grade one students from Barrio ubibi was found to have primary tuber!ulosis. 4hi!h of the following features of tuber!ulosis is most !orre!t9 A/ characteri;ed )y acute e=udative lesions :hich rapidly spreads to the lymphatics and re*ional lymph nodes B. all organism are killed when by the immune response that develop during primary infe!tion C. t is often a!!ompanied by severe pulmonary edema 3. Caseous materials streaked with blood often are seen in expe!torated sputum Answer" $eferen!e" %,-"
A %edi!al %i!robiology by &awet' )* rd ed. p. *)) 1
/. ,aul a **#year#old lawyer from lo!os was seen in the 6,3 with ma!ulopapular rash over his trunk but not in his mouth or on his palms. He is a ba!helor and travels around the ,hilippines a lot. he attending do!tor0s impression was se!ondary syphilis. He ordered $,$ test to be done whi!h turns out to be rea!tive. ,aul was advised to send his serum to a diagnosti! test for ,HA or FA#AB> test whi!h later turned out to be positive. 4hi!h of the following diseases !an be ruled out 9 A. atypi!al measles %/ Secondary syphilis C. Coxsa!kie virus infe!tion 3. @erman measles Answer" $eferen!e" %,-"
B %edi!al %i!robiology by &awet' )* rd ed. pp.**)#*** 1
/+. Jou %ing a 1#year#old ex!hange student from China oined the annual boy0s s!out !amping. hey stayed in the provin!e for two weeks. 6n their se!ond week Jou %ing together with some boys went to the forest and !ame ba!k with many inse!t bites. Jou was so afraid be!ause they even extra!ted a fat#bellied ti!k in his right leg. At the end of the two weeks he noti!ed the ti!k bite to be reddish but flat. t grew bigger every day with !learing of the !entral area. 4ith the expansion of the lesion was fever !hills myalgias and heada!he. At this point his guardian brought him to the hospital. he most likely diagnosis is" A. leptospirosis %/ lyme disease C. >!rub typhus 3. $at bite fever Answer" $eferen!e" %,-"
B %edi!al %i!robiology by &awet' )* rd ed. p. **= 2./
=2. An %%3A traffi! enfor!er was admitted to the hospital for sudden onset of high fever (*+ C8 heada!he and pain in his !alf mus!les. 6n admission his blood tests showed in!reased ,%5 abnormal liver and renal fun!tion test . 6n physi!al examination he also had sub!onun!tival hemorrhage. He also had a history of wading in the floodwaters of ondo about 12 days prior to the illness. he diagnosis of the attending medi!al intern was leptospirosis. 4hi!h of the following would be most likely to !onfirm the diagnosis9 A/ est a!ute and !onvales!ent sera using the $,$ %/ Culture the blood on hayer %artin agar $/ Test acute and convalescent serum for antileptospiral anti)odies D/ 3o darkfield examination of serum and urine for leptospires °
Answer" $eferen!e" %,-"
C %edi!al %i!robiology by &awet' )* rd ed. p. *2 2./
