Clinical Microbiology II MCQS

1. Whooping cough

Bordetella pertussis

Gram negative coccobacillus

strictly aerobic

non motile, capsulated

spread from person to person through tiny droplets

signs: violent coughing with whooping sound

symptoms: sneezing, runny nose, low-grade fever, mild cough

pathogenesis:

enter upper respiratory tract

adhere cilia, multiply, colonize nasopharynx

mucus secretion, inflammation

release toxins (pertussis toxin, tracheal toxin)

local mucosal damage, bronchial obstruction

clinical features:

Incubation 7~10 d

Catarrhal follows incubation period (approx. 1 w), last 2 w, very contagious, nasal congestion, mild cough, sneezing, low-grade fever (similar to common cold)

Paroxysmal 1~6 w, whooping, vomiting

Convalescent 2~3 w, coughing improvement, decreased paroxysm/whooping, healing of airways

Direct Fluorescent-Antibody Assay (DFA)

Nasopharyngeal swab culture

Bordet-Gengou: mercury drops colonies

Regan-Lowe

CBC count

PCR

serology test

transport medium: Regan-Lowe, Stainer-Scholte broth

cephalexin, azithromycin, erythromycin

2. Lymphogranuloma venereum

Chlamydia trachomatis

Gram negative coccoid/rod shape

obligate intercellular

non motile, non spore forming

STDs

enter through abrasions or lacerations

infect cells of conjunctiva or mucosal cells

Lymphogranuloma venereum: severe form of disease characterized by a transient genital lesion and a bubo in the groin

symptoms: females asymptomatic/vaginal bleeding, natural discharge, burning while urinating; males dysuria, pus discharge from penis, painful ejaculation, testicular swelling

clinical features:

incubation 3 d to 6 w
primary

painless papule, ulcer, vesicle on penis or vulva

secondary 2~6 w later

lymph nodes enlargement and abscess, bubo
fever, chills, arthralgia, arthritis
anorectal: proctitis, lower back pain

tertiary (urethrogenital perineal syndrome)

genital elephantiasis
fistula formation
rectal strictures

pus collected from bubo

Giemsa stain

Direct Immunofluorescence Test (DFI): inclusion bodies

PCR

Complement fixation

Enzyme-linked immunosorbent assay

prevention: abstinence or mutual monogamy

3. Meningitis: inflammation of meninges surrounding brain and spinal cord

Neisseria meningitidis

Gram negative cocci

transmitted through air droplets

symptoms: sudden high fever, headache, vomiting, nausea, stiff neck, drowsiness, muscle joint pain, seizures, decreased appetite

New York City Agar: ferments glucose and maltose

Blood test, chest X ray, CT scan, MRI

CSF analysis: lumbar puncture (L4/L5), one chemistry for glucose protein cell count, one microbe for Gram stain culture, one cytology

Culture media: 5% sheep blood agar, enriched choco agar, enrichment broth

complications: hydrocephalus, mental retardation, deafness, low BP, shock, myocarditis

Waterhouse-Friderichsen: adrenal gland failure

prevention: Hib, PCV7, PPV, MCV4

rifampin, ciprofloxacin, azithromycin, ceftriaxone

Kernig: lower back pain or posterior (back) thigh when lie in supine position and hip is flexed a right angle

Brudzinski: knee and hip flexion when neck is flexed in supine position

TB meningitis: Mycobacterium TB

symptoms: fever, severe headache, nausea, vomiting, stiff neck, photophobia, loss of consciousness and appetite, sluggishness

lab: sputum, tuberculin skin testing

complications: cerebral ischemia, seizures, motor paralysis, mental impairment, abnormal behavior, mesencephalic infarction, syringomyelia

prevention: BCG, PPD

4. Syphilis

Treponema pallidum

Gram negative spirochete

transmitted solely via sexual/intimate contact

spread from mother to fetus

rarely through blood transfusion

cannot spread through fomites

pathogenesis/clinical features:

primary

chancre (painless, hard lesion)

secondary

widespread rash, sore throat, headache, mild fever, malaise, myalgia

latent

no symptoms

tertiary

dementia, blindness, heart failure, paralysis, swollen lesion in bones or nervous tissue, gummas

cannot be cultured in artificial media

dark-field microscopy

DFA

Wasserman complement fixation

Kahn flocculation

Venereal Disease Research Lab

Rapid Plasma Reagin

TP immobilization/hemagglutination

Fluorescent treponemal Antibody Absorption

5. Diphtheria

Corynebacterium diphtheria

Gram positive rods

Chinese letter

transmitted by air droplets or fomites

signs: tough grayish membrane in throat, leather-like

symptoms: exotoxin production, sore throat, fever, general malaise, neck swelling

Albert's stain: metachromatic granules

Blood Agar: mitis colonies

Loeffler's serum slope: grows rapidly within 6~8h

Tellurite Blood Agar, gray/black intermedius colonies

6. Dysentery

Signs and symptoms include fever, nausea, vomiting, abdominal cramps and diarrhea which contain blood, mucus, or pus.

stool sample

colonoscopy, ultrasound

Enteroinvasive Escherichia coli

Escherichia coli is Gram negative bacilli.
Escherichia coli is facultative anaerobic. It is capsulated, non-motile, non-spore forming. It ferments glucose and lactose as a carbon source.
On MacConkey Agar, Escherichia coli shows lactose fermenting colonies.
In Double Sugar Iron Agar Reaction, Escherichia coli produces yellow slant and yellow butt. It produces gas but does not produce hydrogen sulfide (no black precipitate).

Shigella

Shigella is Gram negative rods. It is oxidase negative, non-spore forming, non-motile and facultative anaerobic. Shigella is fragile organisms. It ferments glucose but not lactose as carbon source.
On MacConkey Agar, Shigella produces colorless, non-lactose fermenting colonies. On CLED, blue colonies are produced. On Xylose-Lysine-Deoxycholate Agar, red colonies are produced.
In Double Sugar Iron Agar Reaction, Shigella produces red slant and yellow butt without hydrogen sulfide (black precipitate) and gas (air bubbles).

Campylobacter jejuni

Salmonella enterica

Vibrio parahemalyticus

7. Food poisoning

Signs and symptoms include nausea, vomiting, diarrhea, abdominal discomfort and dehydration.

Stool, rectal swab, vomitus, blood, serum or suspected food material

ELISA, latex agglutination, PCR

Staphylococcus aureus

Staphylococcus aureus is Gram positive cocci. It is facultative anaerobe and opportunistic pathogen. It is non-motile and non-spore forming.

Staphylococcus aureus is catalase, coagulase, DNAse and urease positive.

On Blood Agar, Staphylococcus aureus produces distinctive yellow colonies.

On MSA Agar, Staphylococcus aureus ferments mannitol which produces acid fermentation products. The phenol red indicator turns yellow. In antimicrobial sensitivity test, Staphylococcus aureus is sensitive to penicillin, cephalosporin, erythromycin, lincomycin, clindamycin and vancomycin.

Bacillus cereus

Bacillus cereus is Gram positive bacilli with square ends. It is non-capsulated, spore-forming, motile, and beta hemolytic. It does not ferment mannitol, oxidase and lactose. It is catalase, positive, and ferments glucose and sucrose as carbon source. On Nutrient Agar, it produces large, grey-white, granular colonies. On 5% sheep blood agar, it forms large feathery, dull, grey, granular, spreading colonies. It forms pink-orange colonies with an opaque halo on Bacara Agar. It produces pink colonies on MYP. The colonies are surrounded by a precipitate zone (lecithinase). Bacillus cereus can be isolated on MYPA and PEMBA agar.

Clostridium perfringens

anaerobic

non motile, capsulated, endospore forming

Clostridium botulinum

Gram positive bacilli

tennis racket

anaerobic

motile, non capsulated, spore forming

8. TB

Mycobacterium tuberculosis/Koch's bacillus

Gram positive slender bacilli

Acid-fast and fungus-like

airborne transmission, via aerial route

symptoms: fever, fatigue, weight loss, persistent cough, night sweats, no appetite, headache, swollen lymph nodes, skin rashes, joints abdominal chest pain

stages:

primary

lung tubercles, caseous, tuberculin skin reaction

secondary/reactivation

coughing and chronic weight loss

dissemination

extrapulmonary TB (lymph nodes, kidneys, bones, genital tract, brain, meninges)

obligate aerobic

non motile, non capsulated, non spore forming

grows slowly (doubling time 18h)

mycolic acid in cell wall

difficult to stain, resist decolorization

not grow on Blood Agar

Zeihl Nelson

Lowenstein-Jensen

BACTEC-radioactive CO2

niacin test coronary yellow

catalase-peroxide positive

9. Scalded skin syndrome

Staphylococcus aureus

10. Salmonellosis

Salmonella enterica

11. Pneumonia

Streptococcus pneumonia

12. Mycoses and Nematode

Intestinal protozoa

fecal-oral
Giardia lamblia: small intestine, malabsorption
Entamoeba histolytica: colon, bloody diarrhea, amoebic dysentery and liver abscess
Cryptosporidium parvum
Cyclospora cyatenesis: small intestine mucosa, diarrhea several w
Balantidium coli: motile, ciliated, colon of pigs human rodents, colonic ulceration
Enterocytozoon bienusi: microsporidian in small intestine

Systemic protozoa

blood
Plasmodium: malaria, falciparum, vivax, ovale, malariae (man)
Toxoplasma gondi: ingestion of oocysts from cat feces, neonatal toxoplasmosis
Leishmania: sand flies, visceral/cutaneous/mucocutaneous leishmaniasis
Trypanosoma: hemoflagellates

Africa sleeping sickness (Tsetse flies)
South America: Chaga's disease (Reduviid bug)--cruzi

Intestinal nematode

Trichuris (whipworm): soil transmitted helminth, warm humid, cause diarrhea, rectal prolapse, anemia
Ancylostoma and Necator (hookworms): anemia in tropics
Strongyloides: inhabits small bowel, severe in immunospressed ppl (AIDS, malnutrition, intercurrent ds)
Enterobius (pinworm or threadworm): prevalent in cold, children
Ascaris (roundworm): poor hygiene, small intestine, cause eosinophilia

Systemic nematode

Filaria:

Onchocerca volvulus: visual impairment, blindness, skin itch
Wuchereria bancrofti: major for lymphatic filariasis
Brugia malayi
Toxocara: common in child, visceral larva migrans (VLM), ingestion of embryonated eggs from dogs or cats feces

Intestinal cestode/flatworms

Systemic cestode

Trematode/flukes

Superficial mycoses

Tinea versicolor: mild scaling, skin mottling
White piedra: whitish/colored masses on long hairs
Balck piedra: dark, hard concretions on scalp hairs

Subcutaneous mycoses

Sporothrix schenckii: lymphocutaneous sporortrichosis, rose-gardener's ds, infects appendages and lungs, contaminated plant matter peentrates skin and pathogen forms a nodule then spreads to nearby lympho nodes
Pseudallescheria or Madurella: mycetoma, soil microbes implanted in skin, progressive tumorlike ds of hand or foot

Cutaneous mycoses/ringworm

Tinea capitis: scalp, hair-bearing regions of head, loss of hair
Tinea corporis: body, red ring lesions on skin
Tinea cruris: groin下体, scrotal, jock itch
Tinea pedis and Tinea manuum: foot and hand, Athlete's foot
Tinea unguium: nails of foot and hand

Systemic mycoses

Histoplasma capsulatum: histoplasmosis, typically dimorphis, grow in moist soil high N2, chronic lung ds
Coccidioides immitis: coccidioidomycosis, dimorphic, lives in alkaline soild in hot climates
Blastomyces dermatitidis: blastomycosis, dimorphic, free-living in soil, inhaled spores convert to yeasts and multiply in lungs, symptoms: cough and fever

Opportunistic mycoses

Candida albicans: forms off-white, pasty colony with yeasty odor, vulvovaginal candidiasis with AIDS, NF of oral cavity, genitalia, large intestine, skin
Cryptococcus neoformans: cryptococcosis, encapsulated yeast, in soil pigeon roosts bird droppings, AIDS cancer diabetes, cough fever lung nodules, dissemination of meninges and brain
Pneucystis carinii
Aspergillus: airborne soil fungus, invade eyes heart brain, mycotoxicosis (contaminated food), allergy and sequelae

Section B collection

1. Virus: sub microscopic entity consisting of a single nucleic acid surrounded by a protein coat and capable of replication only within living cells of bacteria, animals, or plants

Properties:

parasites that invade cells
consists either DNA/RNA
direct the synthesis of new virus within a host cell
newly made viruses infect other cells

do not breathe
do not metabolize
do not grow
do reproduce

Classification:

presence/absence of envelope
shape
size
kinds of cells they attack
genetic material

Attach to cell membrane, Penetrate, Losing capsid, Replicate (tricks cell into making more viral DNA/protein coat), Release (assembly of DNA and capsid into new virus, leave)

AIDS: HIV, envelopes ss RNA retrovirus, body fluid, encephalitis, meningitis, TB

Ebola: ss RNA filovirus, fruit bats, wild animals/body fluid/contaminated surfaces, headache, sore throat, chest pain, vomiting, diarrhea, fever, difficulty in breathing and swallowing

Influenza: enveloped ss RNA animal viruses, ducks chicken pigs, fever, runny nose, sore throat, coughing, nausea, vomiting, diarrhea, lethargy, loss of appetite (Asian Flu 1957, HK Flu 1968, Swine Flu 2009~2010)

2. UTI

bacteriuria

pyuria

dysuria

UTI lab: urinalysis, dipstick, urine culture, blood test, radiologic studies

classical symptoms: possibly hematuria, dysuria, frequency, urgency

3. GIT

diarrhea: E. coli, excess fluid in intestinal lumen results in frequent, loose, watery stools

dysentery: inflammation of intestine with passage of freuqnt stools containing blood and pus, abdominal cramps, fever

ETEC: travelers' diarrhea

EHEC: hemolytic urine syndrome

EIEC: shigellosis

EPEC: infantile diarrhea

food poisoning

stomach ulcer

enteric fever

worm infestations: GIT blockage/malnutrition

4. signs and symptoms

acute and chronic

5. route of transmission

6. symbiosis

7. osteomyelitis

blood culture positive in hematogenous cases

elevated C-reactive protein

elevated ESR

polymorphonuclear leukocytosis

bone biopsy

8. septic arthritis

severe pain leading to restriction of movement

generally single joint involvement -particularly knee

sudden onset, fever, swelling, redness over joint

crippling sequelae common

Staph aureus, N. menigitidis/gonorrhea, Mycoplasma hominis, Ureaplasma urealyticum, Borrelia burgdorferi

joint fluid examination, blood culture, serology, molecular DNA

9. disease pathogenesis:

transmission-portal of entry

adherence: between receptors and ligands, adhesins include pili tips, surface proteins

invasion: bacteremia, viremia

colonization

septicemia: infection where bacteria enter bloodstream and spread/blood infection where bacteria reproduce

evade host defenses with capsules, leukocidins, avoid phagocytosis

damage or disease-toxins and exoenzyme (coagulase, fibrinase, hyaluronidase)

10. disease development:

incubation--between infection and first signs and symptoms

prodromal--early, mild signs and symptoms

illness--acute and death

recovery--signs and symptoms are subsiding

convalescent--regain strength

11. syphilis

12. meningitis

November 2019

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. A disease that is always present in a population is called

(A) endemic*--steady frequency

(B) sporadic--occasionally at irregular intervals in random locales

(D) pandemic--worldwide

2. A symbiotic relationship in which one species benefits from the association while another species also benefits from the relationship is called

(A) parasitism--one benefit, one harm

(B) mutualism*

(D) commensalism--one benefits, one neutral

3. The study of factors and mechanisms of disease frequency and spread within a population is called

(A) endemic

(B) etiology

(D) epidemiology*

4. Streptococcus pneumoniae can cause

(A) diphtheria

(B) pharyngitis--strep pyogenes, cornyebacterium diphtheria

(D) whooping cough--pertussis

5. Scarlet Fever can be caused by

(A) Bordetella pertussis

(B) Streptococcus pyogenes*

(D) Corynebacterium diphtheriae

6. The following statements about tuberculosis are all true EXCEPT

(A) the pathogens have long generation time (12-18 hours).

(B) Mycobacterium tuberculosis is the most common causative agent.

(D) the pathogens are very sensitive to drying and die quickly in the environment.*

7. Urethritis is inflammation of the

(A) ureter

(B) urethra*

(D) renal parenchyma--pyelonephritis

8. Pyuria means

(A) discolored urine

(B) pain on urination--dysuria

(D) presence of white blood cells in the urine*

9. The ______________ can cause urinary tract infection.

(A) Bacillus cereus

(B) Neisseria meningitides

(D) Pseudomonas aeruginosa*--staph, E. coli, klebsiella pneumoniae

10. Helicobacter pylori can cause

(A) typhoid fever

(B) pyelonephritis

(D) lymphogranuloma venereum

11. Which of the following specimen should be examined in order to detect dysentery?

(A) pus

(B) urine

(D) cerebrospinal fluid

12. Which of the following microbe can cause food poisoning?

(A) Bacillus cereus*

(B) Klebsiella pneumonia

(D) Vibrio parahemolyticus

13. Which of the following bacteria can cause mucosal infections in sexually transmitted diseases?

(A) Hepatitis b

(B) Salmonella enterica

(D) Mycoplasma homonis

gonorrhea, chlamydia

14. Syphilis is caused by

(A) Neisseria gonorrhea

(B) Treponema pallidum*

(D) Chlamydia trachomatos

15. The Genital Herpes can

(A) caused by Hemophilus ducreyi

(B) transmitted solely via fecal oral route

(D) diagnosed by demonstration of chlamydial DNA following PCR amplification

16. Herpes simplex virus can cause

(A) AIDS

(B) hepatitis

(D) genital herpes*

17. Waterhouse-Friderichsen syndrome is a complication of

(A) Bordetella pertussis

(B) Chlamydia trachomatis

(D) Meningococcal meningitis*

18. The most common cause of meningitis in neonates is

(A) Escherichia coli*--Group B Strep, Listeria monocytogenes

(B) Helicoacter pylori

(D) Clostridium perfringins

19. What type of sample can be used to diagnose tuberculosis meningitis?

(A) sputum culture*

(B) urine examination

(D) cerebrospinal fluid analysis*

20. Which of the following is a symptom of meningitis?

(A) cystitis

(B) seizures*

(D) dysentery

21. Streptococcus pyogenes can cause

(A) stye--Staph aureus

(B) impetigo*--Staph aureus

(D) acne vulgaris--propionibacterium

22. The toxic epidermal necrolysis

(A) is an infection of the urethra

(B) also called Ritter-Lyell’s disease*--Scalded skin

(D) can transmitted solely via sexual contact

23. Which of the following statements concerns infant’s skin infections?

(A) boil

(B) styes

(D) pemphigus neonatorum*

24. Which statement is TRUE about viruses?

(A) Viruses can eat and metabolize food

(B) Viruses contain DNA, so they are alive--do not breathe, do not metabolize, do not grow, do reproduce

(D) Viruses have either DNA (Deoxyribose Nucleic Acid) or RNA (Ribonucleic Acid)*

25. Which of the method to control the spread of measles?

(A) the use of vaccines*

(B) proper hand washing

(D) the use of other types of bacteria

26. Which clinical sample is used to diagnose Ebola hemorrhagic fever?

(A) Blood*

(B) Liver biopsy

(D) Faeces samples

27. Human papilloma virus is primarily transmitted to human through the

(A) air borne droplets

(B) sexual intercourse*

(D) ingestion of larval in contaminated water

28. Which of the following parasites can be diagnosed using a blood sample?

(A) Trichuris trichuria--whipworm

(B) Trypanosoma brucei*

(D) Entamoeba histolytica--intestinal protozoa, fecal-oral route, cause bloody diarrhea, amoebic dysentery and liver abscess

29. What the disease cause by Trypanosoma cruzi?

(A) malaria

(B) trichomoniasis

(D) african sleeping sickness--African tryptonosomes, transmitted by Tsetse fly

30. Aspergillus fumigates is primarily transmitted to human through

(A) sexual intercourse

(B) inhalation of spores *

(D) ingestion of cysts in contaminated water

SECTION B : SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. Define virus. (2 Marks)

Sub microscopic entity consisting of a single nucleic acid surrounded by a protein coat and capable of replication only within living cells of bacteria, animals or plants

b. Determine properties of viruses. (4 Marks)

parasites that invade cells

consists either DNA or RNA

protected by capsid (protein coat)

presence or absence of envelope

direct the synthesis of new virus within a host cell

newly made viruses infect other cells

c. Briefly describe about acquired immunodeficiency syndrome (AIDS). (4 Marks)

caused by HIV

enveloped ssRNA retrovirus

transmission: direct contact with a bodily fluid containing HIV (blood, semen, vaginal fluid, shared needles, breastmilk)

courses: long and variable incubation time, collection of infections and tumors resulting from damage to host immune system, treatments only exist to slow virus progression

symptoms: encephalitis, meningitis, retinitis, pneuomyocystis pneumonia, TB, lungs GIT skin tumors, esophagitis, chronic diarrhea

2. a. Determine TWO (2) major types pathogenesis of medically important systemic mycoses and method of transmission to human. (4 Marks)

b. Explain THREE (3) major types of medically important protozoa with related disease and method of transmission to human. (6 Marks)

important intestinal protozoa

important systemic protozoa

important metazoa

3. a. Define bacteriuria. (1 Marks)

presence of bacteria in urine

b. Describe laboratory diagnosis to detect microbe involve in urinary tract infections. (4 Marks)

urinalysis

dipstick, microscopy

presence of nitrite is the most specific, because bacteria convert nitrate into nitrite in bladder

detects esterase released from broken down leukocytes

urine culture

blood tests

radiologic studies

c. Determine about “classical” symptoms of urinary tract infection. (5 Marks)

dysuria, frequency, urgency, suprapubic pain, possibly hematuria

SECTION C : ESSAY QUESTIONS (40 MARKS)

ANSWER ALL QUESTIONS

1. Discuss the pathogenesis, signs, symptoms, clinical features and laboratory investigations of whooping cough. (10 Marks)

Liberates numbers of antigen & toxins

Pathological changes in the respiratory tract (Nasophraynx to Bronchioles)

Inflammatory response to mucosa & secretion appear

Local epithelium damage & symptom appear

Symptoms include sneezing, runny nose, low-grade fever, mild cough

Bordetella pertussis spread from person to person through tiny drops of fluid from an infected person's nose or mouth

Common incubation period of 7-10 days with a range of 4-21 days

Severe rapid, violent cough

Bursts of coughing resulting in shortness of breath

After a coughing spell, the person breathes in deeply and the breathing pattern often makes a whooping sound followed by the next coughing spell

STAGE-I CATARRHAL (0~2w)

Catarrhal symptoms appear that are: Fever, Rhinitis, Sneezing, Anorexia, Nausea & Vomiting, Lacrimation, Irritating cough at night (nocturnal but later become diurnal)

STAGE-II PAROXYMAL (2~4w)

Cough means in paroxymus (repeatating) & is accompanied by vomiting. A typical attack consist of repeated series of many cough in expiration followed by sudden deep, violent inspiration with characterise crowing sound “WHOOP” . Ulcer of franulum of tounge. Sweating Congestion of neck & scalp vein. Patient appears suffocated with congested (red) face with or without cyanosis. Mouth opened, periorbital oedema Sub conjuctional haemorrhage Convulsion may be present.

STAGE-III CONVULSCENT (last 2w)

Disturbing cough & vomiting stops and apatite too imprones.(start of hungerness) Habit pattern of coughing may be longer to several weeks & month.

Direct Fluorescent Ab Assay

Bordet-Gengou

Regan-Lowe

Stainer-Scholte broth transport media

PCR, WBC count

antibiotic cephalexin, azithromycin and erythromycin.

https://www.lecturio.com/concepts/pertussis-whooping-cough/

2. Discuss the Lymphogranuloma Venereum, causative potential pathogen, symptoms, clinical features and laboratory diagnosis (10 Marks)

Lymphogranuloma venereum is the severe form of disease characterized by a transient genital lesion and a bubo in the groin

Chlamydia trachomatis

Females are asymptomatic

Males have painful urination, pus discharge from the penis

Diagnosed by demonstration of chlamydial DNA following PCR amplification

https://microbenotes.com/chlamydia-trachomatis/

3. Discuss the mode of transmission, signs and symptoms and laboratory identification of meningitis. (20 Marks)

April 2019

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. What term of disease when symptoms develop rapidly and it runs course quickly?

(A) focal infection--spreads to new location

(B) acute infection*--develop fast, short duration

(D) primary infection--initial infection, develop in otherwise healthy individual

latent--inactive for long period

secondary

2. Which of the following is an example of symptom?

(A) rash

(B) fever

(D) malaise*--aches, pain, sore throat

3. The spreading of exotoxins from the site of infection via the blood is called

(A) toxemia*

(B) invasion

(D) colonization--septicemia

4. What disease can be caused by Bordetella pertussis?

(A) cystitis

(B) chancroid

(D) Whooping cough*

5. Which of the following disease can be caused by Streptococcus pyogenes?

(A) carbuncle

(B) diphtheria

(D) genital herpes

6. What is the major etiology of lobar pneumonia?

(A) Klebsiella pneumonia

(B) Chlamydia trachomatos

(D) Streptococcus pneumonia*

7. Pyelonephritis is inflammation of the

(A) ureter

(B) kidney

(D) renal parenchyma*

8. Dysuria means

(A) discolored urine

(B) pain on urination*

(D) an increased volume of urine produced

9. Which is the causative agent in 80% of urinary tract infections?

(A) Escherichia coli*

(B) Neissera meningitides

(D) Corynebacterium diphtheriae

10. Which of following is NOT laboratory diagnosis for urinary tract infections?

(A) urinalysis

(B) feces tests*

(D) urine culture

11. What is the MOST common microbe that can cause dysentery?

(A) Mycoplasma homonis

(B) Clostridium botulinum

(D) Pseudomonas aeruginosa

12. What type of sample can be used to isolate Bacillus cereus infection?

(A) hair

(B) urine

(D) sputum

13. Which of the following bacteria can produce cytotoxin?

(A) Vibrio cholera--Enterotoxigenic E. coli, toxin A difficile, Campylobacter jejuni (enterotoxin)

(B) Bordetella pertussis

(D) Staphylococcus aureus--clostridium botulinum, bacillus cereus (neurotoxin)

14. Which of the following microbe can cause food poisoning?

(A) Treponema pallidum

(B) Neissera meningitidis

(D) Corynebacterium diphtheriae

15. Which of the following microorganisms can cause Lymphogranuloma venereum ?

(A) Escherichia coli

(B) Salmonella bongori

(D) Chlamydia trachomatos*

16. Which of the pathogen can cause ulceration in sexually transmitted diseases?

(A) Papilloma virus--proliferative

(B) Hepatitis B virus--HIV, systemic

(D) Neisseria gonorrhoeae--mucosal, chlamydia

17. Which of the following is a characteristic of Neisseria gonorrhoeae?

(A) It is a bacillus bacteria.

(B) It is a Gram-positive bacteria.

(D) It can secrete protease enzyme that cleave IgA.*

18. Which of the following is MOST common microorganism that can cause meningitis in infants?

(A) Shigella flexneri

(B) Haemophilus ducreyi

(D) Clostridium perfringins

19. Which of the following microorganisms can cause complication of Waterhouse-Friderichsen syndrome?

(A) Proteus mirabilis

(B) Neisseria meningitidis*

(D) Clostridium perfringins

20. Which of the following is a symptom of meningitis?

(A) jaundice

(B) dysentery

(D) pyelonephritis

21. Which of the following disease is caused by Streptococcus pyogenes?

(A) erysipelas*--impetigo

(B) carbuncles

(D) toxic epidermal necrolysis

22. Which of the following statements about Sycosis barbae is TRUE?

(A) infection of the urethra

(B) also called Ritter-Lyell’s disease

(D) transmitted solely via sexual contact

23. A disease that cause infant’s skin infections is

(A) furuncle

(B) impetigo

(D) pemphigus neonatorum*

24. Which statement is TRUE about viruses?

(A) Viruses can eat and metabolize food.

(B) Viruses contain DNA, so they are alive.

(D) Viruses can reproduce on their own at any time.

25. Which of the method to control the spread of viruses?

(A) the use of vaccines*

(B) proper hand washing

(D) the use of other types of bacteria

26. Which clinical sample is used to diagnose acquired immunodeficiency syndrome?

(A) blood*

(B) throat swab

(D) faeces samples

27. There is no vaccine against HIV because of which of the following?

(A) the virus is so antigenically variable*

(B) such a vaccine would be too expensive

(D) the virus can be controlled by a change in sexual habits

28. Which of the following parasites can be diagnosed using a blood sample?

(A) Trichuris trichuria

(B) Trypanosoma cruzi*

(D) Entamoeba histolytica

29. What the disease cause by Plasmodium falciparum?

(A) malaria*--P. vivax, ovale, malariae

(B) trichomoniasis

(D) african sleeping sickness

30. Histoplasma capsulatum is primarily transmitted to human through

(A) sexual intercourse

(B) inhalation of spores*

(D) ingestion of cysts in contaminated water

SECTION B : SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. Differentiate between symptoms and signs. (4 Marks)

signs objective, symptoms subjective

signs visible and observable by physician

patients feel symptoms

signs include fever, rash, edema

symptoms include malaise, pain, sore throat

b. Describe the process of disease development. (6Marks)

Incubation period (between infection and first signs/symptoms) depends on dose of microbes, which microbes, virulence, host health. For example, typhoid fever 10~14 days and AIDS 10 years.

Prodromal period of 1~2 days follows incubation in some diseases. It refers to the early, mild signs/symptoms such as malaise, fatigue, muscle aches.

Illness period when the disease is acute and death most likely.

Recovery period is the decline period (1~few days) when signs/symptoms are subsiding but most susceptible to secondary, opportunistic infections. Convalescent period is needed to regain strength.

2. a. Determine how are viruses classified (4 Marks)

genetic material

shape: helical, polyhedral, spherical, complex

presence or absence of envelope

kinds of cells they attack: bacteriophage, animal virus

size

b. Briefly describe about Ebola Hemorrhagic Fever. (6 Marks)

causes severe fatal hemorrhagic fever

ssRNA animal viruses, filovirus

present in fruit bats, chimpanzees, gorillas, monkeys, antelopes, porcupines, rodents, dogs, pigs

transmission: from wild animals, direct contact with bodily fluids (semen) of infected people animals contaminated surfaces

symptoms: headache, red eyes, hiccups, sore throat, difficulty breathing and swallowing, chest pain, stomach muscle joints ache, muscle weakness, vomiting, diarrhea, skin rash and bleeding, internal bleeding, fever, lack of appetite

3. a. Determine TWO (2) major types of opportunistic mycoses, name of the causative fungus and method of transmission to human. (4 Marks)

Candida albicans

Cryptococcus neoformans

Pneumocystis carinii

Aspergillus

b. Explain THREE (3) major types of medically important nematode. Name of nematode with related disease and method of transmission to human. (6 Marks)

intestinal nematode

systemic nematode

SECTION C : ESSAY QUESTIONS (40 MARKS)

ANSWER ALL QUESTIONS

1. Describe about the pathogenesis and clinical features of syphilis. (10 Marks)

Treponema pallidum is transmitted solely via sexual contact

can also be spread from mother to fetus

rarely through blood transfusion

cannot spread by fomites such as toilet seat, eating utensil or clothing

primary stage

small, painless, reddened, hard lesion called chancre forms at the site of infection

secondary stage

patient suffers sore throat, headache, mild fever, malaise, myalgia, widespread rash

latent stage

no symptoms

tertiary stage

years later patients experience dementia, blindness, heart failure, swollen lesion occurs in bones or nervous tissue

2. Discuss about the causative agent of diphtheria including the mode of transmission, signs and symptoms and the laboratory diagnosis. (10 Marks)

Corynebacterium diphtheria

transmitted by droplets or fomites

Signs of Diphtheria are a tough grayish membrane forms in the throat. It looks like a piece of leather.

Symptoms of Diphtheria are due to the production of an exotoxin that gets produced when Corynebacterium diphtheria is lysogenized by a phage. Symptoms include sore throat, fever, general malaise, and swelling of the neck.

Corynebacterium diphtheria is Gram positive rods with Chinese letter pattern.

There are metachromatic granules formed when Corynebacterium diphtheria is stained with Albert’s stain.

On Blood Agar, Corynebacterium diphtheria produces mitis colonies.

In Loeffler’s serum slope, Corynebacterium diphtheria grows rapidly within 6~8 hours.

On Tellurite Blood Agar, Corynebacterium diphtheria produces gray or black (intermedius) colonies.

3. Explain the signs, symptoms, causative agents of dysentery and its laboratory diagnosis. (20 Marks)

Signs and symptoms include fever, nausea, vomiting, abdominal cramps and diarrhea which contain blood, mucus, or pus.

Causative agents of dysentery include Shigella species, Enteroinvasive Escherichia coli, Campylobacter jejuni, Salmonella enterica, and Vibrio parahaemalyticus.

September 2018

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. A disease that is always present in a population is called

(A) endemic*

(B) sporadic

(D) pandemic

2. A symbiosis which species and association get benefits is called

(A) parasitism

(B) mutualism*

(D) commensalism

3. The study of factors and mechanisms frequency and spread of disease within a population is called

(A) endemic

(B) etiology

(D) epidemiology*

4. What disease can be caused by Streptococcus pneumonia?

(A) diphtheria

(B) pharyngitis

(D) whooping cough

5. What is the major etiology of Scarlet fever?

(A) Bordetella pertussis

(B) Streptococcus pyogenes*

(D) Corynebacterium diphtheriae

6. The following statements about tuberculosis are all true EXCEPT

(A) the pathogens have long generation time (12-18 hours).

(B) Mycobacterium tuberculosis is the most common causative agent.

(D) the pathogens are very sensitive to drying and die quickly in the environment.*

7. Urethritis is inflammation of the

(A) ureter

(B) urethra*

(D) renal parenchyma

8. Bacteriuria means

(A) discolored urine

(B) pain on urination

(D) an increased volume of urine produced

9. Which of the following organism can cause urinary tract infection?

(A) Bacillus cereus

(B) Neisseria meningitidis

(D) Pseudomonas aeruginosa*--E. coli, proteus, klebsiella, staph

10. Helicobacter pylori can cause

(A) typhoid fever

(B) pyelonephritis

(D) lymphogranuloma venereum

11. Which of the following specimen should be examined in order to detect dysentery?

(A) pus

(B) urine

(D) cerebrospinal fluid

12. Which of the following microbe can cause dysentery?

(A) Salmonella enterica*

(B) Haemophilus ducreyi

(D) Mycoplasma homonis

13. Which of the following bacteria can cause mucosal infections in sexually transmitted diseases?

(A) Hepatitis B

(B) Salmonella enterica

(D) Neisseria gonorrhoeae*--chlamydia

14. Syphilis is caused by

(A) Neisseria gonorrhea

(B) Treponema pallidum*

(D) Chlamydia trachomatos

15. The Genital Herpes can

(A) caused by Hemophilus ducreyi

(B) transmitted solely via fecal oral route

(D) diagnosed by demonstration of chlamydial DNA following PCR amplification

16. Herpes simplex virus can cause

(A) AIDS

(B) hepatitis

(D) genital herpes*

17. Waterhouse-Friderichsen syndrome is a complication of

(A) Bordetella pertussis

(B) Chlamydia trachomatis

(D) Meningococcal meningitis*

18. What type of sample can be used to diagnose tuberculosis meningitis?

(A) sputum culture*

(B) urine examination

(D) cerebrospinal fluid analysis*

19. Which of the following is a symptom of meningitis?

(A) cystitis

(B) seizures*

(D) dysentery

20. Streptococcus pyogenes can cause

(A) stye

(B) impetigo*

(D) acne vulgaris

21. The toxic epidermal necrolysis

(A) is an infection of the urethra

(B) also called Ritter-Lyell’s disease*

(D) can transmitted solely via sexual contact

22. Which of the following is a diseases of bone or joint?

(A) warts

(B) enteric fever

(D) pyelonephritis

23. Which of the following is a person in high risk group to get infection in prosthetic joints?

(A) Cystitis

(B) Hypertensions

(D) Diabetes mellitus*

24. Which statement is TRUE about viruses?

(A) Viruses can eat and metabolize food.

(B) Viruses contain DNA, so they are alive.

(D) Viruses can reproduce on their own at any time.

25. One important way to control the spread of viruses is through

(A) the use of vaccines*

(B) proper hand washing

(D) the use of other types of bacteria

26. Which clinical sample is used to diagnose hepatitis B?

(A) Blood*

(B) Throat swab

(D) Faeces samples

27. There is no vaccine against HIV because of which of the following?

(A) The virus is so antigenically variable*

(B) Such a vaccine would be too expensive

(D) The virus can be controlled by a change in sexual habits

28. Which of the following parasites can be diagnosed using a stool sample?

(A) Trypanosoma brucei

(B) Leishmania donovani

(D) Plasmodium malariae

29. What the disease cause by Trypanosoma cruzi?

(A) Malaria

(B) Trichomoniasis

(D) African sleeping sickness

30. Aspergillus fumigates is primarily transmitted to human through the

(A) sexual intercourse

(B) inhalation of spores*

(D) ingestion of cysts in contaminated water

SECTION B : SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. Define diarrhea. (2 Marks)

excess fluid in the intestinal lumen results in frequent, loose, watery stools

b. Name FOUR (4) causative agent for food poisoning. (2 Marks)

Staphylococcus aureus, Clostridium perfringins, Clostridium botulinum, Bacillus cereus

c. Explain laboratory diagnosis to detect microbes involved in food poisoning. (6 Marks)

Stool specimen, rectal swab, duodenal aspirate

Direct wet mount

Fluorescent Ab stain

ELISA

Culture

AST

2. a. Define virus. (2 Marks)

Sub microscopic entity consisting of a single nucleic acid surrounded by a protein coat and capable of replication only within living cells of bacteria, animals or plants

b. Explain transmission of the virus in Acquired Immune Deficiency Syndrome. (3 Marks)

direct contact with a bodily fluid containing HIV (blood, semen, vaginal fluid, shared needles, breastmilk)

c. Describe the characteristics of virus. (5 Marks)

do not breathe

do not metabolize

do not grow

do reproduce

consists either DNA or RNA

protected by capsid

presence or absence of envelope

3. a. Determine TWO (2) major types of mycoses, name of the causative fungus, and method of transmission to human. (4 Marks)

systemic--affecting internal organs

Histoplasma capsulatum

Coccidioides immitis

Blastomyces dermatitidis

opportunistic--NF to opportunistic

Candida albicans

Cryptococcus neoformans

Pneumocystis carinii

Aspergillus

inhalation of spores

b. Explain THREE (3) major types of medically important protozoa. Name of protozoa with related disease and method of transmission to human. (6 Marks)

SECTION C : ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Discuss mode of transmission, signs and symptoms and laboratory identification of whooping cough. (20 Marks)

Question 2

Define lymphogranuloma venereum and discuss the potential causative agent with symptoms, clinical features and related laboratory diagnosis. (20 Marks)

Question 3

Discuss mode of transmission, signs and symptoms and laboratory identification of meningitis. (20 Marks)

February 2018

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. What is a disease referred to when symptoms develop rapidly and it runs its course quickly?

(A) focal infection

(B) acute infection*

(D) primary infection

2. Which of the following is an example of symptom?

(A) rash

(B) fever

(D) malaise*

3. The spreading of exotoxins from the site of infection via the blood is called

(A) toxemia*

(B) invasion

(D) colonization

4. What disease can be caused by Bordetella pertussis?

(A) cystitis

(B) chancroid

(D) Whooping cough*

5. Which of the following disease can be caused by Streptococcus pyogenes?

(A) carbuncle

(B) diphtheria

(D) genital herpes

6. What is the major etiology of lobar pneumonia?

(A) Klebsiella pneumonia

(B) Chlamydia trachomatos

(D) Streptococcus pneumonia*

7. Pyelonephritis is inflammation of the

(A) ureter

(B) kidney

(D) renal parenchyma*

8. Dysuria means

(A) discolored urine

(B) pain on urination*

(D) an increased volume of urine produced

9. Which is the causative agent in 80% of urinary tract infections?

(A) Escherichia coli*

(B) Neissera meningitides

(D) Corynebacterium diphtheriae

10. Which of following is NOT laboratory diagnosis for urinary tract infections?

(A) urinalysis

(B) feces tests*

(D) urine culture

11. What is the MOST common microbe that can cause dysentery?

(A) Mycoplasma homonis

(B) Clostridium botulinum

(D) Pseudomonas aeruginosa*

12. What sample can be used to diagnosis Bacillus cereus infection?

(A) hair

(B) urine

(D) sputum

13. Which of the following bacteria can produce cytotoxin?

(A) Vibrio cholera

(B) Bordetella pertussis

(D) Staphylococcus aureus

14. Which of the following microbe can cause food poisoning?

(A) Treponema pallidum

(B) Neissera meningitidis

(D) Corynebacterium diphtheriae

15. Which of the following microorganisms can cause Lymphogranuloma venereum ?

(A) Escherichia coli

(B) Salmonella bongori

(D) Chlamydia trachomatos*

16. Which of the pathogen can cause ulceration in sexually transmitted diseases?

(A) Papilloma virus

(B) Hepatitis B virus

(D) Neisseria gonorrhoeae

17. Which of the following is a characteristic of Neisseria gonorrhoeae?

(A) It is a bacillus bacteria

(B) It is a Gram-positive bacteria

(D) It can secrete protease enzyme that cleave IgA*

18. Which of the following is MOST common microorganism that can cause meningitis in infants?

(A) Shigella flexneri

(B) Haemophilus ducreyi

(D) Clostridium perfringins

19. Which of the following microorganisms can cause complication of Waterhouse-Friderichsen syndrome?

(A) Proteus mirabilis

(B) Neisseria meningitidis*

(D) Clostridium perfringins

20. Which of the following is a symptom of meningitis?

(A) jaundice

(B) dysentery

(D) pyelonephritis

21. Which of the following disease is caused by Streptococcus pyogenes?

(A) erysipelas*

(B) carbuncles

(D) toxic epidermal necrolysis

22. Which of the following statements about Sycosis barbae is TRUE?

(A) Infection of the urethra

(B) Also called Ritter-Lyell’s disease

(D) Transmitted solely via sexual contact

23. A disease that cause infant’s skin infections is

(A) furuncle

(B) impetigo

(D) pemphigus neonatorum*

24. Impetigo can cause by

(A) Escherichia coli

(B) Bacillus anthracis

(D) Staphylococcus aureus*

25. Haematogenous osteomyelitis can cause by

(A) Neisseria gonorrhea

(B) Staphylococcus aureus*--Strep pyogenes, Hemophilus influenzae, Coliforms, Group B Strep

(D) Corynebacterium diphtheria

26. Which of following laboratory diagnosis is used to detect osteomyelitis?

(A) Blood cultures*--pus

(B) Feces examination

(D) Cebrospinal fluid analysis

27. Which of the following is NOT a laboratory diagnosis of Acute Septic Arthritis?

(A) ultrasound

(B) plain X-ray

(D) urine examination*

28. Which of the following statement is TRUE about fever of unknown origin (FUO)?

(A) Deformity with muscle spasm.

(B) More than 9 weeks' duration of illness.

(D) Failure to reach a diagnosis despite 10 week of in patient investigation.

29. The MOST common infection causes of fever of unknown origin (FUO) which is rare is

(A) urinary tract infection*

(B) central nervous infection

(D) gastrointestinal tract infection

30. Which of the following bacteria is NOT the cause of fever of unknown origin (FUO)?

(A) Propionibacter acnes*

(B) Neisseria meningitidis

(D) Mycobacterium tuberculosis

SECTION B : SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. Define signs of septicemia. (2 Marks)

infection that occurs when bacteria enter the bloodstream and spread

can cause sepsis

UTI, kidney infection, pneumonia

b. Explain the process of an infection and a disease. (8 Marks)

2. a. Determine the laboratory diagnosis for osteomyelitis. (4 Marks)

blood cultures positive in many hematogenous cases

pus collection

bone biopsy at open operation

elevated C-reactive protein

elevated ESR

polymorphonuclear leukocytosis

radiology

b. Explain the clinical features and causative agents of septic arthritis. (6 Marks)

severe pain leading to restriction of movement

generally single joint involvement, particularly knee

sudden onset, fever, swelling, redness over joint

crippling sequalae common

Staph aureus

Neisseria gonorrhea

Neisseria meningitidis

Mycoplasma hominis

Ureaplasma urealyticum

Borrella burgdorferi

3. a. Define meningitis. (1 Mark)

inflammation in meninges surrounding brain and spinal cord

b. Name the causal agent for meningococcal meningitis. (1 Mark)

Neisseria meningitidis

c. State THREE (3) clinical complications of the meningococcal disease. (3 Marks)

hydrocephalus

mental retardation

deafness

shock

d. Determine the laboratory diagnosis for meningitis. (5 Marks)

blood test

CSF analysis

chest x ray

CT scan/MRI

cultures of CSF, blood, urine, mucus (nose and throat), pus (skin)

SECTION C : ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Discuss about the causative agent of diphtheria including the mode of transmission, signs and symptoms and the laboratory diagnosis. (20 Marks)

Question 2

Explain the causative agents of dysentery and its laboratory diagnosis. (20 Marks)

Question 3

Describe in detail the pathogenesis and clinical features of syphilis. (20 Marks)

September 2017

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. A disease that is always present in a population is called

(A) endemic*

(B) sporadic

(D) pandemic

2. Normal flora is a microorganism that live in

(A) human body and cause disease

(B) dead body and can produce spore

(D) human body and do not cause disease*

3. Which of the following statements about host-microbes is TRUE?

(A) Bacterimia is presence of virus in the host blood.

(B) A host is any organism that harbors no other organism.

(D) In mutualism neither of the two species benefits from the relationship.

4. An example of an immune-mediated disorder that can result from Streptococcal pyogenes infection is

(A) impetigo

(B) Scarlet fever*

(D) acute rheumatoid arthritis

5. Which of the following statement about Tuberculosis is CORRECT?

(A) Infects the urinary tract

(B) Transmitted by droplets or fomites*

(D) Staphylococcus aureus can cause Tuberculosis

6. Whooping cough is caused by

(A) Bordetella pertussis*

(B) Staphylococcus aureus

(D) Mycobacterium tuberculosis

7. Urethritis is inflammation of the

(A) ureter

(B) kidney

(D) urinary bladder

8. The following are laboratory diagnosis for urinary tract infections EXCEPT

(A) stool tests*

(B) urinalysis

(D) radiologic studies

9. Which of the following bacteria can cause urinary tract infection?

(A) Bacillus cereus

(B) Neisseria meningitides

(D) Klebsiella pneumoniae*

10. Pyuria means

(A) discolored urine

(B) pain on urination

(D) presence of white blood cells in the urine*

11. Which of the following microbe can cause dysentery?

(A) Treponema pallidum

(B) Haemophilus ducreyi

(D) Clostridium perfringins

12. Which of the following sample should be examined in order to detect Gastroenteritis?

(A) pus

(B) urine

(D) cebrospinal fluid

13. Helicobacter pylori is the causative organism for

(A) chancroid

(B) gastric ulcer*

(D) toxic shock syndrome

14. Bacillus cereus is most commonly associated with

(A) food poisoning*

(B) venereal diseases

(D) urinary tract infections

15. Lymphogranuloma venereum is caused by

(A) Neisseria gonorrhea

(B) Treponema pallidum

(D) Chlamydia trachomatos*

16. Which of the following bacteria can cause ulcerative infections in sexually transmitted diseases?

(A) Hepatitis B

(B) Papilloma virus

(D) Neisseria gonorrhoeae

17. Which of the following statement about sexually transmitted diseases is TRUE?

(A) Haemophilus ducreyi can cause Gonorrhea

(B) Syphilis cannot be spread from mother to fetus

(D) Young people who experiment with sex are at risk*

18. The MOST common bacteria that cause meningitis in neonates is

(A) Listeria monocytogenes*

(B) Clostridium perfringins

(D) Streptococcus pneumonia

19. Which of the following is a symptom of meningitis?

(A) dysuria

(B) nocturia

(D) suprapubic pain

20. Waterhouse-Friderichsen syndrome is a complication of

(A) Serratia marcescens

(B) Enterobacter aerogenes

(D) Mycobacterium tuberculosis

21. Streptococcus pyogenes can causes

(A) stye

(B) impetigo*

(D) pemphigus neonatorum

22. Which of the following statement about Pemphigus neonatorum is TRUE?

(A) infection of Infant’s skin*

(B) also called Ritter-Lyell’s disease

(D) transmitted solely via sexual contact

23. The MOST common bacteria can cause of skin diseases and superficial infections are

(A) Enterococci

(B) Streptococci

(D) Enterobacteriaceae

24. Which of the following is a diseases of bone or joint?

(A) Cystitis

(B) Enteric fever

(D) Lymphogranuloma venereum

25. Which of the following is a person in high risk group to get infection in prosthetic joints?

(A) Cystitis

(B) Hypertensions

(D) Whooping cough

26. Which of following diagnosis are use to detect reactive arthritis?

(A) pus cultures*

(B) urine examination

(D) cerebrospinal fluid analysis

27. Which of the following can cause haematogenous osteomyelitis?

(A) Bordetella pertussis

(B) Shigella dysenteriae

(D) Staphylococcus aureus*--Strep pyogenes, Hemophilus influenzae, Coliforms, Group B Strep

28. Which of the following definition about a fever of unknown origin (FUO) is FALSE?

(A) deformity with abdominal pain

(B) more than 3 weeks' duration of illness

(D) failure to reach a diagnosis despite 1 week of in patient investigation

29. The following bacteria can cause fever of unknown origin (FUO) EXCEPT

(A) Neisseria meningitides

(B) Neisseria gonorrhoeae

(D) Mycobacterium tuberculosis

30. Fever of unknown origin (FUO) is caused by

(A) boil

(B) style

(D) acne vulgaris

SECTION B : SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. Define epidemiology. (2 Marks)

study of frequency and distribution of disease in order to set guidelines for disease prevention and control

b. Describe the process of disease development. (8 Marks)

2. a. Define bacteriuria. (1 Marks)

b. Identify laboratory diagnosis to detect microbe involve in urinary tract infections. (4 Marks)

c. Explain briefly “Classical” symptoms of urinary tract infection. (5 Marks)

3. a. State laboratory diagnosis to detect microbe involve in syphilis. (4 Marks)

b. Explain briefly clinical features and causal microbes can cause syphilis. (6 Marks)

Syphilis can be transmitted solely via sexual contact.
Syphilis can also be spread from mother to fetus.
Transmission of syphilis is rarely through blood transfusion.
Syphilis cannot be spread by fomites such as toilet seat, eating utensil or clothing.
Syphilis is caused by the pathogen called Treponema pallidum, a spirochete.
Treponema pallidum penetrates through mucosa or abraded skin by endo-flagella. It travels via the lymphatic system to regional lymph nodes and then throughout the body via the bloodstream. Invasion of CNS can occur during any stage of syphilis.
Incubation period (9~90 days) is variable.
Primary syphilis has the presence of chancre (painless, hard lesion). Secondary syphilis has widespread rash, sore throat, headache, mild fever, malaise, myalgia. Latent syphilis has no clinical signs. Tertiary syphilis has gummas, dementia, blindness, paralysis, heart failure.
Treponema pallidum is Gram negative, spiral shaped bacteria. It cannot be cultured in artificial media.
Dark field or immunofluorescence microscopy, direct fluorescent antibody (DFA) test and silver impregnation are required for identification. Non-specific serology tests include Wasserman complement fixation test, Kahn flocculation test, VDRL (Venereal Disease Research Laboratory) test, and RPR (Rapid Plasma Reagin) test is used for detection. Specific serology tests include T. Pallidum immobilisation (TPI) test, T. Pallidum hemagglutination test (TPHA) and Fluorescent treponemal Ab absorption test (FTA-ABS) is also used to detect Treponema pallidum.

SECTION C : ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Identify the etiological agents, signs, symptoms and laboratory confirmatory diagnosis of meningitis. (20 Marks)

Question 2

Explain about food poisoning, related microbe causes food poisoning and laboratory diagnosis to detect microbe. (20 Marks)

Question 3

Determine the mode of transmission, signs and symptoms and laboratory identification of tuberculosis. (20 Marks)

Tuberculosis is transmitted from person to person via aerial route. Droplets are expelled during coughing, sneezing and even talking.
Signs and symptoms of Tuberculosis include fever, fatigue, weight loss, persistent cough, blood in cough, night sweats, no appetite, headaches, swollen lymph nodes, skin rashes, painful joints, abdominal and chest pain.
Sputum specimen is collected for diagnosis.
Mycobacterium tuberculosis (Koch’s Bacillus) is gram-positive slender bacilli. It is fungus-like and acid-fast bacteria. It is obligate aerobic, non-motile, non-capsulated, and non-spore forming. It grows slowly (doubling time 18h) and the clinical specimen must be held for 6~8 weeks before being record as negative.
Mycobacterium tuberculosis has mycolic acid in the cell wall. Zeihl Nelson stain is used to detect mycobacterium tuberculosis. It is difficult to stain but resist decolorization.
Mycobacterium tuberculosis can be cultured on Lowenstein-Jensen medium (for 8 weeks). It will not grow on blood agar. It can grow on BACTEC medium with the production of radioactive carbon dioxide for 2 weeks.
Niacin test shows canary yellow color which is positive for tuberculosis. Catalase-peroxidase test is also positive for tuberculosis.

January 2017

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. What is a disease referred to when symptoms develop rapidly and it runs its course quickly?

(A) focal infection

(B) acute infection*

(D) primary infection

2. Which of the following is an example of symptom?

(A) rash

(B) fever

(D) malaise*

3. The spreading of exotoxins from the site of infection via the blood is called

(A) toxemia*

(B) invasion

(D) colonization

4. What disease can be caused by Bordetella pertussis?

(A) cystitis

(B) chancroid

(D) Whooping cough*

5. Which of the following disease can be caused by Mycobacterium tuberculosis?

(A) diphtheria

(B) pharyngitis

(D) genital herpes

6. What is the major etiology of lobar pneumonia?

(A) Klebsiella pneumonia

(B) Chlamydia trachomatos

(D) Streptococcus pneumonia*

7. Pyelonephritis is inflammation of the

(A) ureter

(B) kidney

(D) renal parenchyma*

8. Dysuria means

(A) discolored urine

(B) pain on urination*

(D) an increased volume of urine produced

9. Which is the causative agent in 80% of urinary tract infections?

(A) Escherichia coli*

(B) Neissera meningitides

(D) Corynebacterium diphtheriae

10. Which of following is NOT laboratory diagnosis for urinary tract infections?

(A) urinalysis

(B) feces tests*

(D) urine culture

11. What is the MOST common microbe that can cause dysentery?

(A) Mycoplasma homonis

(B) Clostridium botulinum

(D) Pseudomonas aeruginosa

12. What sample can be used to diagnosis Bacillus cereus infection?

(A) hair

(B) urine

(D) sputum

13. Which of the following bacteria can produce cytotoxin?

(A) Vibrio cholera

(B) Bordetella pertussis

(D) Staphylococcus aureus

14. Which of the following microbe can cause food poisoning?

(A) Treponema pallidum

(B) Neissera meningitidis

(D) Corynebacterium diphtheriae

15. Which of the following microorganisms can cause Lymphogranuloma venereum ?

(A) Escherichia coli

(B) Salmonella bongori

(D) Chlamydia trachomatos*

16. Which of the pathogen can cause ulceration in sexually transmitted diseases?

(A) Papilloma virus

(B) Hepatitis B virus

(D) Neisseria gonorrhoeae

17. Which of the following is a characteristic of Neisseria gonorrhoeae?

(A) It is a bacillus bacteria.

(B) It is a Gram-positive bacteria.

(D) It can secrete protease enzyme that cleave IgA.*

18. Which of the following is MOST common microorganism that can cause meningitis in infants?

(A) Shigella flexneri

(B) Haemophilus ducreyi

(D) Clostridium perfringins

19. Which of the following microorganisms can cause complication of Waterhouse-Friderichsen syndrome?

(A) Proteus mirabilis

(B) Neisseria meningitidis*

(D) Clostridium perfringins

20. Which of the following is a symptom of meningitis?

(A) jaundice

(B) dysentery

(D) pyelonephritis

21. Which of the following disease is caused by Streptococcus pyogenes?

(A) erysipelas*

(B) carbuncles

(D) toxic epidermal necrolysis

22. Which of the following statements about Sycosis barbae is TRUE?

(A) Infection of the urethra.

(B) Also called Ritter-Lyell’s disease.

(D) Transmitted solely via sexual contact.

23. A disease that cause infant’s skin infections is

(A) furuncle

(B) impetigo

(D) pemphigus neonatorum*

24. Impetigo can cause by

(A) Escherichia coli

(B) Bacillus anthracis

(D) Staphylococcus aureus*

25. Haematogenous osteomyelitis can cause by

(A) Neisseria gonorrhea

(B) Staphylococcus aureus*

(D) Corynebacterium diphtheria

26. Which of following laboratory diagnosis is used to detect osteomyelitis?

(A) Blood cultures*

(B) Feces examination

(D) Cerebrospinal fluid analysis

27. Which of the following is NOT a laboratory diagnosis of Acute Septic Arthritis?

(A) ultrasound

(B) plain X-ray

(D) urine examination*

28. Which of the following statement is TRUE about fever of unknown origin (FUO)?

(A) Deformity with muscle spasm.

(B) More than 9 weeks' duration of illness.

(D) Failure to reach a diagnosis despite 10 week of in patient investigation.

29. The MOST common infection causes of fever of unknown origin (FUO) which is rare is

(A) urinary tract infection*

(B) central nervous infection

(D) gastrointestinal tract infection

30. Which of the following bacteria is NOT the cause of fever of unknown origin (FUO)?

(A) Propionibacter acnes*

(B) Neisseria meningitidis

(D) Mycobacterium tuberculosis

SECTION B : SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. Define septicemia. (2 Marks)

b. Explain the process of an infection and a disease. (8 Marks)

2. a. Determine the laboratory diagnosis for osteomyelitis. (4 Marks)

b. Explain the clinical features and causative agents of septic arthritis. (6 Marks)

3. a. Define meningitis. (1 Mark)

b. Name the causal agent for meningococcal meningitis. (1 Mark)

c. State THREE (3) clinical complications of the meningococcal disease. (3 Marks)

d. Determine the laboratory diagnosis for meningitis. (5 Marks)

SECTION C : ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Discuss about the causal agent of diphtheria including the mode of transmission, signs and symptoms and the laboratory diagnosis. (20 Marks)

Question 2

Explain the causative agents of dysentery and its laboratory diagnosis. (20 Marks)

Question 3

Describe in detail the pathogenesis and clinical features of syphilis. (20 Marks)

August 2016

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. A disease that is always present in a population is called

(A) endemic*

(B) sporadic

(D) pandemic

2. A symbiotic relationship in which one species benefits from the association while another species also benefits from the relationship is called

(A) parasitism

(B) mutualism*

(D) commensalism

3. The study of factors and mechanisms of disease frequency and spread within a population is called

(A) endemic

(B) etiology

(D) epidemiology*

4. What disease can be caused by Streptococcus pneumonia?

(A) diphtheria

(B) pharyngitis

(D) whooping cough

5. What is the major etiology of Scarlet fever?

(A) Bordetella pertussis

(B) Streptococcus pyogenes*

(D) Corynebacterium diphtheriae

6. The following statements about tuberculosis are all true EXCEPT

(A) the pathogens have long generation time (12-18 hours)

(B) Mycobacterium tuberculosis is the most common causative agent

(D) the pathogens are very sensitive to drying and die quickly in the environment*

7. Urethritis is inflammation of the

(A) ureter

(B) urethra*

(D) renal parenchyma

8. Bacteriuria means

(A) discolored urine

(B) pain on urination

(D) an increased volume of urine produced

9. Which of the following organism can cause urinary tract infection?

(A) Bacillus cereus

(B) Neisseria meningitidis

(D) Pseudomonas aeruginosa*

10. Helicobacter pylori can cause

(A) typhoid fever

(B) pyelonephritis

(D) lymphogranuloma venereum

11. Which of the following specimen should be examined in order to detect dysentery?

(A) pus

(B) urine

(D) cerebrospinal fluid

12. Which of the following microbe can cause dysentery?

(A) Salmonella enterica*

(B) Haemophilus ducreyi

(D) Mycoplasma homonis

13. Which of the following bacteria can cause mucosal infections in sexually transmitted diseases?

(A) Hepatitis B

(B) Salmonella enterica

(D) Neisseria gonorrhoeae*--chlamydia

14. Syphilis is caused by

(A) Neisseria gonorrhea

(B) Treponema pallidum*

(D) Chlamydia trachomatos

15. The Genital Herpes can

(A) caused by Hemophilus ducreyi

(B) transmitted solely via fecal oral route

(D) diagnosed by demonstration of chlamydial DNA following PCR amplification

16. Herpes simplex virus can cause

(A) AIDS

(B) hepatitis

(D) genital herpes*

17. Waterhouse-Friderichsen syndrome is a complication of

(A) Bordetella pertussis

(B) Chlamydia trachomatis

(D) Meningococcal meningitis*

18. The most common cause of meningitis in neonates is

(A) Escherichia coli*

(B) Helicoacter pylori

(D) Clostridium perfringins

19. What type of sample can be used to diagnose tuberculosis meningitis?

(A) sputum culture*

(B) urine examination

(D) cerebrospinal fluid analysis*

20. Which of the following is a symptom of meningitis?

(A) cystitis

(B) seizures*

(D) dysentery

21. Streptococcus pyogenes can cause

(A) stye

(B) impetigo*

(D) acne vulgaris

22. The toxic epidermal necrolysis

(A) is an infection of the urethra

(B) also called Ritter-Lyell’s disease*

(D) can transmitted solely via sexual contact

23. Which of the following statements concerns infant’s skin infections?

(A) boil

(B) styes

(D) pemphigus neonatorum*

24. Which of the following is a diseases of bone or joint?

(A) warts

(B) enteric fever

(D) pyelonephritis

25. Which of the following is a person in high risk group to get infection in prosthetic joints?

(A) Cystitis

(B) Hypertensions

(D) Diabetes mellitus*

26. Which of the following specimen should be examined in order to detect osteomyelitis?

(A) pus*

(B) urine

(D) cerebrospinal fluid

27. The following are laboratory investigations of chronic osteomyelitis EXCEPT

(A) ultrasound

(B) plain X-ray

(D) urine examination*

28. Which of the following definition about a fever of unknown origin (FUO) is FALSE?

(A) more than 3 weeks' duration of illness

(B) painful urination and purulent discharge

(D) failure to reach a diagnosis despite 1 week of in patient investigation

29. Which of the following is NOT a laboratory investigation for fever of unknown origin (FUO)?

(A) serology

(B) urinalysis

(D) serum chemistry

30. The following bacteria can cause fever of unknown origin (FUO) EXCEPT

(A) Neisseria meningitidis

(B) Neisseria gonorrhoeae

(D) Mycobacterium tuberculosis

SECTION B : SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. Differentiate between acute and chronic diseases. (4 Marks)

acute short duration

acute disease develop fast

acute mainly neutrophils, macrophages

chronic mononuclear cells

acute common cold

chronic cancer

b. Describe the process of disease development. (6 Marks)

2. a. Define diarrhea. (2 Marks)

b. Name FOUR (4) causative agent for food poisoning. (2 Marks)

c. Determine laboratory diagnosis to detect microbes involved in food poisoning. (6 Marks)

3. a. Define pyuria. (1 Mark)

increased presence of WBC in urine

b. Describe briefly about laboratory diagnosis to detect microbe involve in urinary tract infections. (4 Marks)

c. Explain about “classical” symptoms of urinary tract infection. (5 Marks)

SECTION C : ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Discuss the mode of transmission, signs and symptoms and laboratory identification of whooping cough. (20 Marks)

Question 2

Define lymphogranuloma venereum and discuss the potential causative agent with symptoms, clinical features and related laboratory diagnosis. (20 Marks)

Question 3

Discuss the mode of transmission, signs and symptoms and laboratory identification of meningitis. (20 Marks)

January 2016

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. What is a disease referred to when symptoms develop rapidly and it runs its course quickly?

(A) focal infection

(B) acute infection*

(D) primary infection

2. Which of the following is an example of symptom?

(A) rash

(B) fever

(D) malaise*

3. The spreading of exotoxins from the site of infection via the blood is called

(A) toxemia*

(B) invasion

(D) colonization

4. What disease can be caused by Bordetella pertussis?

(A) cystitis

(B) chancroid

(D) Whooping cough*

5. Which of the following disease can be caused by Streptococcus pyogenes?

(A) carbuncle

(B) diphtheria

(D) genital herpes

6. What is the major etiology of lobar pneumonia?

(A) Klebsiella pneumonia

(B) Chlamydia trachomatos

(D) Streptococcus pneumonia*

7. Pyelonephritis is inflammation of the

(A) ureter

(B) kidney

(D) renal parenchyma*

8. Dysuria means

(A) discolored urine

(B) pain on urination*

(D) an increased volume of urine produced

9. Which is the causative agent in 80% of urinary tract infections?

(A) Escherichia coli*

(B) Neissera meningitides

(D) Corynebacterium diphtheriae

10. Which of following is NOT laboratory diagnosis for urinary tract infections?

(A) urinalysis

(B) feces tests*

(D) urine culture

11. What is the MOST common microbe that can cause dysentery?

(A) Mycoplasma homonis

(B) Clostridium botulinum

(D) Pseudomonas aeruginosa

12. What sample can be used to diagnosis Bacillus cereus infection?

(A) hair

(B) urine

(D) sputum

13. Which of the following bacteria can produce cytotoxin?

(A) Vibrio cholera

(B) Bordetella pertussis

(D) Staphylococcus aureus

14. Which of the following microbe can cause food poisoning?

(A) Treponema pallidum

(B) Neissera meningitidis

(D) Corynebacterium diphtheriae

15. Which of the following microorganisms can cause Lymphogranuloma venereum ?

(A) Escherichia coli

(B) Salmonella bongori

(D) Chlamydia trachomatos*

16. Which of the pathogen can cause ulceration in sexually transmitted diseases?

(A) Papilloma virus

(B) Hepatitis B virus

(D) Neisseria gonorrhoeae

17. Which of the following is a characteristic of Neisseria gonorrhoeae?

(A) It is a bacillus bacteria.

(B) It is a Gram-positive bacteria.

(D) It can secrete protease enzyme that cleave IgA.*

18. Which of the following is MOST common microorganism that can cause meningitis in infants?

(A) Shigella flexneri

(B) Haemophilus ducreyi

(D) Clostridium perfringins

19. Which of the following microorganisms can cause complication of Waterhouse-Friderichsen syndrome?

(A) Proteus mirabilis

(B) Neisseria meningitidis*

(D) Clostridium perfringins

20. Which of the following is a symptom of meningitis?

(A) jaundice

(B) dysentery

(D) pyelonephritis

21. Which of the following disease is caused by Streptococcus pyogenes?

(A) erysipelas*

(B) carbuncles

(D) toxic epidermal necrolysis

22. Which of the following statements about Sycosis barbae is TRUE?

(A) Infection of the urethra.

(B) Also called Ritter-Lyell’s disease.

(D) Transmitted solely via sexual contact.

23. A disease that cause infant’s skin infections is

(A) furuncle

(B) impetigo

(D) pemphigus neonatorum*

24. Impetigo can cause by

(A) Escherichia coli

(B) Bacillus anthracis

(D) Staphylococcus aureus*

25. Haematogenous osteomyelitis can cause by

(A) Neisseria gonorrhea

(B) Staphylococcus aureus*

(D) Corynebacterium diphtheria

26. Which of following laboratory diagnosis is used to detect osteomyelitis?

(A) Blood cultures*

(B) Feces examination

(D) Cerebrospinal fluid analysis

27. Which of the following is NOT a laboratory diagnosis of Acute Septic Arthritis?

(A) ultrasound

(B) plain X-ray

(D) urine examination*

28. Which of the following statement is TRUE about fever of unknown origin (FUO)?

(A) Deformity with muscle spasm.

(B) More than 9 weeks' duration of illness.

(D) Failure to reach a diagnosis despite 10 week of in patient investigation.

29. The MOST common infection causes of fever of unknown origin (FUO) which is rare is

(A) urinary tract infection*

(B) central nervous infection

(D) gastrointestinal tract infection

30. Which of the following bacteria is NOT the cause of fever of unknown origin (FUO)?

(A) Propionibacter acnes*

(B) Neisseria meningitidis

(D) Mycobacterium tuberculosis

SECTION B : SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. Define signs of septicemia. (2 Marks)

b. Explain the process of an infection and a disease. (8 Marks)

2. a. Determine the laboratory diagnosis for osteomyelitis. (4 Marks)

b. Explain the clinical features and causative agents of septic arthritis. (6 Marks)

3. a. Define meningitis. (1 Mark)

b. Name the causal agent for meningococcal meningitis. (1 Mark)

c. State THREE (3) clinical complications of the meningococcal disease. (3 Marks)

d. Determine the laboratory diagnosis for meningitis. (5 Marks)

SECTION C : ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Discuss about the causal agent of diphtheria including the mode of transmission, signs and symptoms and the laboratory diagnosis. (20 Marks)

Question 2

Explain the causative agents of dysentery and its laboratory diagnosis. (20 Marks)

Question 3

Describe in detail the pathogenesis and clinical features of syphilis. (20 Marks)

August 2015

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. Which of the following microorganisms is closely associated with dental caries?

(A) Candida albicans

(B) Neisseria subflava

(D) Staphylococcus epidermidis

2. Animal disease that can be transmitted to human is called

(A) enzootic

(B) epizootic

(D) epizootiology

3. Which of the following diseases is caused by Clostridium perfringens?

(A) tetanus

(B) pneumonia

(D) gas gangrene*

4. Which of the following organism caused meningitis in newborn?

(A) Listeria monocytogens*

(B) Neisseria meningitidis

(D) Streptococcus pneumonia

5. A massive lesion caused by spread of Staphylococcus aureus infection which often on neck and upper back is called

(A) boil

(B) pustule

(D) carbuncle

furuncle

https://microbeonline.com/mcq-microbiology-bacteriology-bacterial-skin-infections/

6. Which of the following organism caused gastric ulcer?

(A) Helicobacter pylori*

(B) Bordetella pertussis

(D) Acinetobacter baumanii

7. Which of the following stains is the appropriate stain to detect Mycobacterium organism in clinical sample?

(A) Gram stain

(B) Giemsa stain

(D) lactophenol cotton blue

8. Pyrogenic is a term for

(A) pus inducing

(B) fever inducing*

(D) acute glomerular nephritis

9. Whooping cough is caused by

(A) Bordetella pertussis*

(B) Staphylococcus aureus

(D) Mycobacterium tuberculosis

10. Which of the following organism caused the plague infection?

(A) Yersinia pestis*

(B) Trichinella spiralis

(D) Salmonella typhimuriam

11. Which of the following agents is a recognized cause of diarrhea?

(A) Vibrio cholera

(B) Proteus mirabilis

(D) Enterococcus faecalis*

12. The Beta- hemolysis of blood agar observed with Streptococcus pyogenes is due to the presence of

(A) catalase

(B) M protein

(D) hyaluronic acid

13. Which of the following diseases is INCORRECTLY matched with the causative agents?

(A) small pox- Variola virus

(B) viral conjunctivitis- Adenovirus

(D) gas gangrene- Staphylococcus aureus

14. Warts are caused by

(A) Measles virus.

(B) Papillomavirus.*

(D) Herpes simplex virus.

15. Which of the following host defense mechanism is the most important in preventing dysentery caused by Salmonella species?

(A) mucus

(B) gastric ucid

(D) salivary enzyme

16. Which of the following is TRUE about Salmonella typhi?

(A) They can cause enteric fever.*

(B) They are typically sensitive to tetracycline.

(D) They are widespread is nature and the hospital environment.

17. Which of the following is the most common of lower respiratory pathogen in infants?

(A) Rhinovirus

(B) Adenovirus

(D) Respiratory syncytial virus

18. Which of the following organism is the most prominent cause of urethritis in female?

(A) Escherichia coli

(B) Candida albicans

(D) Neisseria gonnorrheae*

19. All of the following are diseases of the skin EXCEPT

(A) blister

(B) roseola

(D) otitis externa*

20. Which of the bacteria can cause acnes on the skin?

(A) Staphylococcus aureus

(B) Streptococcus pyogens

(D) Propionibacterium acnes*

21. The most common organism cause of pyrexia of unknown origin is

(A) Brucella canis

(B) Salmonella typhi

(D) Mycobacterium tuberculosis*

22. Which of the following is TRUE regarding gonorrhea disease?

(A) It always shows clear symptoms.

(B) It is caused by the gonorrhea bacteria.*

(D) It can be spread causing inflammation in several reproductive organs.

23. This microorganism is commonly associated with fried rice and produces an vomiting toxin.

Figure 1

Which of the following is the causative agent regarding statement in figure 1?

(A) Bacillus cereus*

(B) Shigella flexneri

(D) Clostridium perfringens

24. Listeria monocytogens is primarily transmitted by

(A) direct contact

(B) bird droppings

(D) contaminated food*

25. Urinary tract infections (UTIs) include all the following conditions EXCEPT

(A) cystitis

(B) vaginitis*

(D) pyelonephritis

26. Which of the following term is referred to the bacteria flourish and grow in the bloodstream?

(A) viremia

(B) fungemia

(D) bacteriamia*

27. The most common cause of vaginitis is

(A) Escherichia coli

(B) Candida albicans

(D) Neisseria gonorrheae

28. Which of the following CORRECTLY match a sexually transmitted disease (STD) with its pathogens?

(A) Softsore - Bacillus brevis

(B) Urethritis - Bacillus anthrasics

(D) Gonorrhoea- Entamoeba histolytica

29. Which of the following organism can cause pneumonic plague?

(A) Yersinia pestis*

(B) Borrelia burgdorferi

(D) Chlamydia bunnyyensis

30. Which of the following step involves during microbes entering host cells in infection cycle?

(A) binding

(B) penetration

(D) portal of entry*

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. Name the main causative agent of urinary tract infections. (2 Marks)

E. coli, Klebseilla

b. Recognize the FOUR (4) important strains of the causative agent stated in the answer of 1 (a) and its associated disease. (8 Marks)

ETEC: travelers' diarrhea

EHEC: hemolytic uremic syndrome (HUS)

EIEC: shigellosis

EPEC: infantile diarrhea

Klebsiella penumoniae

2. a. List FIVE (5) routes of transmission of disease. (5 Marks)

direct contact

vehicleborne

vectorborne

airborne

droplet

fecal-oral

b. State FIVE (5) types of gastrointestinal tract infection. (5 Marks)

food poisoning

diarrhea

dysentery

enteric fever

stomach ulcers

worm infestations

3. a. Determine types of symbiosis between host and microbe. (3 Marks)

commensalism--one benefits, one neutral, microbes are NF/commensals

mutualism--both benefits

parasitism--microbe benefits and harms host

opportunistic pathogen--normally harmless becomes pathogenic

b. Briefly explain the mechanism of bacteria pathogenesis. (5 Marks)

Transmission--portal of entry, RIT via air, diphtheria

Adherence--attach to ligands by adhesins such as pili, surface proteins

Invasion--establish infection, bacterimia

Colonization--septicemia, blood infection where bacteria reproduce

Evade host defenses with capsules, leukocidins, catalase mainly by avoiding phagocytosis

Damage/Ds--toxemia, endo, exo, exoenzyme (coagulase, fibrinase, hyaluronidase)

Encounter--frequently from food or water contaminated by soil or feces; animals often the reservoir

Entry--feco-oral route (ingestion)

Spread--rare except for enteric

Multiplication--mostly extracellular; organisms that cause dysentery may invade intestinal epithelium

Evasion of Host Defenses--adherence, resistance to acid and bile

Damage--cell killing, toxins, inflammation

Transmission--lack of sanitation and clean water, improper food handling

c. Determine TWO (2) types of bacteria toxin caused disease to human. (2 Marks)

endotoxin

exotoxin

SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Discuss in details FOUR (4) laboratory methods for bacterial identification in term of principles, purpose and technique. (20 Marks)

Question 2

Describe the tuberculosis disease in term of causative agent, stages of disease with it symptoms and techniques for diagnosis. (20 Marks)

Question 3

Discuss the identification and laboratory technique of Gram positive bacteria that caused furuncles on skin. (20 Marks)

January 2015

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. The best descriptive term for the resident flora is

(A) parasites

(B) pathogens

(D) contaminants

2. Resident flora is commonly found in

(A) liver

(B) kidney

(D) salivary glands

absent in lung

3. Which of the following is an example of non-communicable infection?

(A) measles

(B) leprosy

(D) pneumonia

communicable--herpes, measles, common cold

contagious--chickenpox

4. Which of the following is the leading cause of meningitis in newborn?

(A) Listeria monocytogens*

(B) Neisseria meningitidis

(D) Streptococcus pneumonia

5. Which of the following produce the MOST deadly toxin?

(A) Clostridium tetani

(B) Clostridium botulinum

(D) Chlamydia trochomatis.

6. Corynebacterium diphtheria can cause

(A) diphtheria*

(B) pharyngitis

(D) whooping cough

7. Which of the following stains is BEST used to detect Mycobacterium organism in clinical sample?

(A) Gram stain

(B) Giemsa stain

(D) Lacto Phenol Cotton Blue

8. Pyrogenic is a term for

(A) pus inducing

(B) fever inducing*

(D) acute glomerular nephritis

9. Whooping cough is caused by

(A) Bordetella pertussis*

(B) Staphylococcus aureus

(D) Mycobacterium tuberculosis

10. Which of the following cause the plague?

(A) Yersinia pestis*

(B) Trichinella spiralis

(D) Salmonella typhimuriam

11. Which of the following is considered part of the microbiota of the lower respiratory system?

(A) Pneumocystis jiroveci*

(B) Staphylococcus aureus

(D) Haemophilus influenzae

12. A common characteristic of Neisseria gonorrhea is

(A) causes syphilis

(B) a gram positive cocci

(D) can be transmitted by sexual route*

13. Which is the MOST common cause of pneumonia in a 8 year old child?

(A) Klebsiella pneumoniae

(B) Chlamydophila psittaci

(D) Streptococcus pneumoniae*

14. Poliovirus is most often transmitted via

(A) droplets

(B) mosquitoes

(D) contaminated water*

15. What is the CORRECT sequence for a Gram stain?

(A) Gram’s iodine  crystal violet  alcohol  safranin

(B) Crystal violet  safranin  alcohol Gram’s iodine

(D) Alcohol  crystal violet  safranin Gram’s iodine

16. Which of the following is TRUE about Salmonella typhi?

(A) cause enteric fever*

(B) is sensitive to tetracycline

(D) is a saprophyte found in environment sources

17. Which of the following is the MOST common of lower respiratory pathogen in infants?

(A) Rhinovirus

(B) Adenovirus

(D) Respiratory syncytial virus*

18. Which of the following organism is the MOST prominent cause of urethritis in female?

(A) Escherichia coli

(B) Candida albicans

(D) Neisseria gonnorrheae*

19. All of the following are diseases of the skin EXCEPT

(A) blister

(B) roseola

(D) otitis externa*

20. Which of the bacteria can cause acnes on the skin?

(A) Staphylococcus aureus

(B) Streptococcus pyogens

(D) Propionibacterium acnes*

21. The MOST common cause of pyrexia of unknown origin is

(A) Brucella species

(B) Salmonella typhi

(D) Mycobacterium tuberculosis*

22. Which of the following is TRUE regarding gonorrhea disease?

(A) It always shows clear symptoms.

(B) It is caused by the virus gonorrheus.

(D) it can be spread causing inflammation in several reproductive organs.*

23. Which of the following organism can cause syphilis?

(A) Niesseria gonorrhea

(B) Herpes simplex virus

(D) Human immunodeficiency virus

24. Identify the structure associated with both the urinary system and reproductive system in males

(A) Ureter

(B) Kidney

(D) Urethra*

25. Urinary tract infections (UTIs) include all the following conditions EXCEPT

(A) cystitis

(B) vaginitis*

(D) phyelonephritis

26. Salmonella is MOST frequently acquired from

(A) fish

(B) beef

(D) human

27. The MOST common cause of vaginitis is

(A) Escherichia coli

(B) Candida albicans*

(D) Neisseria gonorrheae

28. Which of the following CORRECTLY match a sexually transmitted disease (STD) with its pathogens?

(A) Softsore - Bacillus brevis

(B) Urethritis - Bacillus anthrasics

(D) Gonorrhoea- Entamoeba histolytica

29. The coagulase test that causes plasma to clot is used to distinguish

(A) Streptococcus pyogenes from Enterococcus faecalis

(B) Streptococcus pyogenes from Staphylococcus aureus

(D) Staphylococcus aureus from other Staphylococcus species.*

30. Which part of the infection cycle involves microbes entering host cells?

(A) binding

(B) penetration

(D) portal of entry*

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. Name the main species cause urinary tract infections. (2 Marks)

E. coli

b. Explain the signs and symptoms of urinary tract infections. (8 Marks)

dysuria

frequency

urgency

suprapubic pain

possibly hematuria

abdominal pain

fever

vomiting

2. a. State FIVE (5) stages of infectious disease. (5 Marks)

*process of infection and disease

b. List FIVE (5) route transmission of disease. (5 Marks)

3. a. Identify FIVE (5) types of gastrointestinal tract infections (5 Marks)

b. Name the causative organism for each types of infection above. (5 Marks)

Food poisoning--staph aureus

diarrhea--e coli

dysentery--shigella

stomach ulcers--helicobacter pylori

enteric fever--salmonella typhi/enterica

SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Discuss the mechanism development of disease in human. (20 Marks)

Question 2

Discuss the potential pathogen, symptoms and stages of disease, treatment and techniques for diagnosis tuberculosis disease. (20 Marks)

Question 3

Discuss the potential organism and laboratory techniques that used in the laboratory for identification of organism caused scalded skin syndrome. (20 Marks)

Staphylococcus aureus

August 2014

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. A disease that is always present in a population is called

(A) endemic*

(B) sporadic

(D) pandemic

2. Normal flora is a microorganism that live in

(A) human body and cause disease

(B) dead body and can produce spore

(D) human body and do not cause disease*

3. Which of the following statements about host-microbes is TRUE?

(A) Bacterimia is presence of virus in the host blood.

(B) A host is any organism that harbors no other organism.

(D) In mutualism neither of the two species benefits from the relationship.

4. ______ is an example of an immune-mediated disorder that can result from Streptococcal pyogenes infection.

(A) Impetigo*

(B) Scarlet fever

(D) Acute rheumatoid arthritis

5. Which of the following statements about Tuberculosis is INCORRECT?

(A) Infects the respiratory tract

(B) The bacteria are Acid-fast bacillus

(D) Staphylococcus aureus can cause Tuberculosis*

6. Whooping cough is caused by

(A) Bordetella pertussis.*

(B) Staphylococcus aureus.

(D) Mycobacterium tuberculosis.

7. Urethritis is inflammation of the

(A) ureter

(B) kidney

(D) urinary bladder

8. The following are laboratory diagnosis for urinary tract infections EXCEPT

(A) stool tests*

(B) urinalysis

(D) radiologic studies

9. The ______________ can cause urinary tract infection.

(A) Bacillus cereus

(B) Neisseria meningitidis

(D) Klebsiella pneumoniae*

10. Pyuria means

(A) discolored urine

(B) pain on urination

(D) presence of white blood cells in the urine*

11. Which of the following microbe can cause dysentery?

(A) Treponema pallidum

(B) Haemophilus ducreyi

(D) Clostridium perfringins

12. Which of the following sample should be examined in order to detect Gastroenteritis?

(A) pus

(B) urine

(D) cebrospinal fluid

13. Helicobacter pylori is the causative organism for

(A) chancroid

(B) gastric ulcer*

(D) toxic shock syndrome

14. Bacillus cereus is most commonly associated with

(A) food poisoning*

(B) venereal diseases

(D) urinary tract infections

15. Lymphogranuloma venereum is caused by

(A) Neisseria gonorrhea

(B) Treponema pallidum

(D) Chlamydia trachomatos*

16. Which of the following bacteria can cause ulcerative infections in sexually transmitted diseases?

(A) Hepatitis B

(B) Papillomavirus

(D) Neisseria gonorrhoeae

17. Which of the following statement about STDs is FALSE?

(A) Neisseria gonorrhoeae can cause Gonorrhea.

(B) Syphilis cannot be spread from mother to fetus.*

(D) Young people who experiment with sex are at risk.

18. Which organism is the leading cause of meningitis in infants?

(A) Escherichia coli.

(B) Nesseria meningitidis*

(D) Streptocuccus pneumonias.

19. Which of the following is a symptom of meningitis?

(A) cystitis

(B) seizures*

(D) dysentery

20. Waterhouse-Friderichsen syndrome is a complication of

(A) Serratia marcescens

(B) Enterobacter aerogenes

(D) Mycobacterium tuberculosis

21. Streptococcus pyogenes can causes

(A) boil

(B) erysipelas*

(D) acne vulgaris

22. Which of the following statement about Pemphigus neonatorum is TRUE?

(A) Infection of Infant’s skin*

(B) Also called Ritter-Lyell’s disease

(D) Transmitted solely via sexual contact

23. The most common bacteria can cause of skin diseases and superficial infection are

(A) Enterococci

(B) Streptococci

(D) Enterobacteriaceae

24. Which of the following is a diseases of bone or joint?

(A) Cystitis

(B) Enteric fever

(D) Lymphogranuloma venereum

25. Which of the following is a person in high risk group to get infection in prosthetic joints?

(A) Cystitis

(B) Hypertensions

(D) Whooping cough

26. Which of following diagnosis are use to detect reactive arthritis?

(A) pus cultures*

(B) urine examination

(D) cebro spinal fluid analysis

27. The _______________ can cause haematogenous osteomyelitis.

(A) Bordetella pertussis

(B) Shigella dysenteriae

(D) Staphylococcus aureus*

28. Which of the following definition about a fever of unknown origin (FUO) is FALSE?

(A) deformity with abdominal pain*

(B) more than 3 weeks' duration of illness

(D) failure to reach a diagnosis despite 1 week of in patient investigation

29. Which of the following is NOT a laboratory diagnosis for fever of unknown origin (FUO)?

(A) serology

(B) urinalysis

(D) serum chemistry

30. Fever of unknown origin (FUO) is caused by

(A) boil

(B) style

(D) acne vulgaris

SECTION B : SHORT ANSWER QUESTIONS (30 MARKS)

ANSWER ALL QUESTIONS

1. a. Define epidemiology. (2 Marks)

b. Explain the process of infection and disease. (8 Marks)

2. a. Define bacteriuria. (1 Marks)

b. Identify laboratory diagnosis to detect microbe involve in urinary tract infections. (4 Marks)

c. Explain briefly “Classical” symptoms of urinary tract infection. (5 Marks)

3. a. State laboratory diagnosis to detect microbe involve in osteomyelitis. (4 Marks)

b. Explain briefly clinical features and causal microbes can cause septic arthritis. (6 Marks)

SECTION C : ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Identify the etiological agents, explain sign, symptoms and describe a laboratory confirmatory diagnosis of meningitis.

(20 Marks)

Question 2

Describe the signs and symptoms, method of acquiring and laboratory diagnosis of salmonellosis. (20 Marks)

Question 3

Determine the mode of transmission, signs and symptoms and laboratory identification of tuberculosis. (20 Marks)

January 2014

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

Choose ONE best statement to answer the questions.

1. A disease that is always present in a population is called

(A) endemic*

(B) sporadic

(D) pandemic

2. A symbiotic relationship in which one species benefits from the association while another species also benefits from the relationship is called

(A) parasitism

(B) mutualism*

(D) commensalism

3. The study of factors and mechanisms of disease frequency and spread within a population is called

(A) endemic

(B) etiology

(D) epidemiology*

4. Streptococcus pneumoniae can cause

(A) diphtheria

(B) pharyngitis

(D) whooping cough

5. Scarlet Fever can be caused by

(A) Bordetella pertussis

(B) Streptococcus pyogenes*

(D) Corynebacterium diphtheriae

6. The following statements about tuberculosis are all true EXCEPT

(A) the pathogens have long generation time (12-18 hours).

(B) Mycobacterium tuberculosis is the most common causative agent.

(D) the pathogens are very sensitive to drying and die quickly in the environment.*

7. Urethritis is inflammation of the

(A) ureter

(B) urethra*

(D) renal parenchyma

8. Pyuria means

(A) discolored urine

(B) pain on urination

(D) presence of white blood cells in the urine*

9. The ______________ can cause urinary tract infection.

(A) Bacillus cereus

(B) Neisseria meningitidis

(D) Pseudomonas aeruginosa*

10. Helicobacter pylori can cause

(A) typhoid fever

(B) pyelonephritis

(D) lymphogranuloma venereum

11. Which of the following specimen should be examined in order to detect dysentery?

(A) pus

(B) urine

(D) cerebrospinal fluid

12. Which of the following microbe can cause food poisoning?

(A) Bacillus cereus*

(B) Klebsiella pneumonia

(D) Vibrio parahemolyticus

13. Which of the following bacteria can cause mucosal infections in sexually transmitted diseases?

(A) Hepatitis B

(B) Salmonella enterica

(D) Mycoplasma homonis

14. Syphilis is caused by

(A) Neisseria gonorrhea

(B) Treponema pallidum*

(D) Chlamydia trachomatos

15. The Genital Herpes can

(A) caused by Hemophilus ducreyi.

(B) transmitted solely via fecal oral route.

(D) diagnosed by demonstration of chlamydial DNA following PCR amplification.

16. Herpes simplex virus can cause

(A) AIDS*

(B) hepatitis

(D) genital herpes

17. Waterhouse-Friderichsen syndrome is a complication of

(A) Bordetella pertussis

(B) Chlamydia trachomatis

(D) Meningococcal meningitis*

18. The most common cause of meningitis in neonates is

(A) Escherichia coli*

(B) Helicoacter pylori

(D) Clostridium perfringins

19. What type of sample can be used to diagnose tuberculosis meningitis?

(A) sputum culture*

(B) urine examination

(D) cerebrospinal fluid analysis*

20. Which of the following is a symptom of meningitis?

(A) cystitis

(B) seizures*

(D) dysentery

21. Streptococcus pyogenes can cause

(A) stye

(B) impetigo*

(D) acne vulgaris

22. The toxic epidermal necrolysis

(A) is an infection of the urethra

(B) also called Ritter-Lyell’s disease*

(D) can transmitted solely via sexual contact

23. Which of the following statements concerns infant’s skin infections?

(A) boil

(B) styes

(D) pemphigus neonatorum*

24. Which of the following is a diseases of bone or joint?

(A) warts

(B) enteric fever

(D) pyelonephritis

25. The _______________ can cause haematogenous osteomyelitis.

(A) Bordetella pertussis

(B) Shigella dysenteriae

(D) Staphylococcus aureus*

26. Which of the following specimen should be examined in order to detect osteomyelitis?

(A) pus*

(B) urine

(D) cerebrospinal fluid

27. The following are laboratory investigations of chronic osteomyelitis EXCEPT

(A) ultrasound

(B) plain X-ray

(D) urine examination*

28. Which of the following definition about fever of unknown origin (FUO) is TRUE?

(A) deformity with abdominal pain

(B) more than 6 weeks' duration of illness

(D) failure to reach a diagnosis despite 3 weeks of inpatient investigation

29. Which of the following is NOT a laboratory investigation for fever of unknown origin (FUO)?

(A) serology

(B) urinalysis

(D) serum chemistry

30. The following bacteria can cause fever of unknown origin (FUO) EXCEPT

(A) Neisseria meningitidis

(B) Neisseria gonorrhoeae

(D) Mycobacterium tuberculosis

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

Answer ALL questions.

1. a. Differentiate between symptoms and signs. (4 Marks)

b. Describe the process of disease development. (6 Marks)

2. a. Define dysentery. (2 Marks)

inflammation of intestine with passage of frequent stools containing blood and pus, abdominal cramps and fever

b. Name the causal agent for dysentery. (2 Marks)

shigella, campylobacter jejuni

c. Determine laboratory diagnosis to detect microbes involved in meningitis. (6 Marks)

3. a. Define bacteriuria. (1 Mark)

b. Describe laboratory diagnosis to detect microbe involve in urinary tract infections. (4 Marks)

c. Explain about “classical” symptoms of urinary tract infection. (5 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

Answer TWO (2) questions only.

Question 1

Discuss the mode of transmission, signs and symptoms and laboratory identification of meningitis. (20 Marks)

Question 2

Describe about Lymphogranuloma Venereum. Discuss the potential pathogen that causes Lymphogranuloma Venereum, symptoms, clinical features and related laboratory diagnosis. (20 Marks)

Question 3

Discuss the pathogenesis, signs, symptoms, clinical features and laboratory investigations of Whooping cough. (20 Marks)

August 2013

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

Choose ONE best statement to answer the questions.

1. A relationship in which microbes benefits from the association but they do not help or harm the host is called

(A) parasitism

(B) mutualism

(D) commensalism*

2. Which of the following statements about host-microbes is NOT TRUE?

(A) Viremia is presence of virus in the host blood.

(B) A host is any organism that harbors no other organism.*

(D) Symptoms of a disease are subjective changes in body function.

3. The disease that only pops up occasionally at irregular intervals in random locales is called a/an

(A) endemic

(B) sporadic*

(D) epidemiology

4. Streptococcus pyogenes can cause

(A) diphtheria

(B) pharyngitis*--otitis media, scarlet fever

(D) whooping cough

5. Tuberculosis is caused by

(A) Bordetella pertussis

(B) Staphylococcus aureus

(D) Mycobacterium tuberculosis*

6. Which of the following statements about Whooping cough is INCORRECT?

(A) The bacteria are Gram-negative cocco-bacillus.

(B) Violent coughing followed by whooping sound.

(D) Transmitted by tiny drops of fluid from an infected person's nose or mouth.

7. Cystitis is inflammation of the

(A) ureter

(B) urethra

(D) renal parenchyma

8. Which of following is a classical symptoms of urinary tract infection?

(A) diarrhea

(B) tonsillitis

(D) suprapubic pain*

9. Which of the following is most common organism that can cause urinary tract infection?

(A) Bacillus cereus

(B) Escherichia coli*

(D) Pseudomonas aeruginosa

10. Which of the following pair is CORRECT?

(A) Neisseria gonorrhoeae – AIDS

(B) Helicobacter pylori- Typhoid fever

(D) enteroinvasive Escherichia coli – Lymphogranuloma venereum.

11. Which of the following microbe can cause “fried rice” food poisoning?

(A) Bacillus cereus*

(B) Treponema pallidum

(D) Corynebacterium diphtheria

12. Which of the following refers to food poisoning?

(A) Urethritis can cause due to food poisoning.

(B) The symptom in food poisoning are dysuria and urgency.

(D) Urine culture is used to diagnosis the microbe involve in food poisoning.

13. Neisseria gonorrhoeae is characterized by all of the following EXCEPT

(A) Cleaves IgA

(B) Gram-negative diplococci

(D) the symptom of infection are painful urination and purulent discharge

14. Genital herpes is caused by

(A) Herpes simplex*

(B) Neisseria gonorrhea

(D) Chlamydia trachomatos.

15. Which of the following statements about syphilis is TRUE?

(A) Syphilis is caused by Treponema pallidum.*

(B) Syphilis cannot be spread from mother to fetus.

(D) Treponema pallidum can secrete protease enzyme that cleave IgA.--gonorrhea

16. Neisseria gonorrhea can cause

(A) AIDS

(B) hepatitis

(D) gonorrhea*

17. Waterhouse-Friderichsen syndrome is a complication of

(A) Bordetella pertussis

(B) Chlamydia trachomatis

(D) Meningococcal meningitis*

18. The most common bacteria that cause meningitis in neonates is

(A) Listeria monocytogenes*

(B) Clostridium perfringins

(D) Streptococcus pneumonia

19. The following diagnosis are use to detect tuberculous meningitis EXCEPT

(A) sputum culture

(B) stool examination

(D) cebro spinal fluid analysis

20. The following are symptoms of meningitis EXCEPT

(A) hematuria*

(B) drowsiness

(D) sudden high fever

21. Staphylococcus aureus causes all of the following EXCEPT

(A) stye

(B) acne vulgaris*

(D) scalded skin syndrome

22. Which of the following statement about Pemphigus neonatorum is TRUE?

(A) infection of infant’s skin.*

(B) also called Ritter-Lyell’s disease

(D) transmitted solely via sexual contact

23. Streptococcus pyogenes can cause

(A) boil

(B) erysipelas*

(D) sychosis barbae

24. Following are diseases of bone or joint EXCEPT

(A) osteomyelitis

(B) pyelonephritis*

(D) infection of prosthetic joints

25. The following organism can cause haematogenous osteomyelitis EXCEPT

(A) Vibrio cholerae*

(B) Staphylococcus aureus

(D) Haemophilus influenzae

26. Which of the following diagnosis are used to detect osteomyelitis?

(A) pus cultures*

(B) stool examination

(D) cebro spinal fluid analysis

27. The following are laboratory diagnosis acute Septic Arthritis EXCEPT

(A) ultrasound

(B) plain X-ray

(D) urine examination*

28. Which of the following definition about fever of unknown origin (FUO) is FALSE?

(A) deformity with abdominal pain*

(B) more than 3 weeks' duration of illness

(D) failure to reach a diagnosis despite 1 week of in-patient investigation

29. Fever of unknown origin (FUO) is caused by

(A) boil

(B) style

(D) acne vulgaris

30. The following bacteria can cause fever of unknown origin (FUO) EXCEPT

(A) Neisseria meningitidis

(B) Neisseria gonorrhoeae

(D) Mycobacterium tuberculosis

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

Answer ALL questions.

1. a. Define septicemia. (2Marks)

b. Describe the stage of an infectious disease. (8 Marks)

2. a. Define meningitis. (1 Mark)

b. Name the causal agent for meningococcal meningitis. (1 Mark)

c. State THREE (3) clinical complications of the meningococcal disease. (3 Marks)

d. Determine laboratory diagnosis to detect microbes involved in meningitis. (5 Marks)

3. a. Describe laboratory diagnosis to detect microbe involve in septic arthritis. (4 Marks)

b. Explain about clinical features and causal microbes that can cause chronic osteomyelitis. (6 Marks)

SECTION C: ESSAY QUESTIONS (40 MARKS)

Answer TWO (2) questions only.

Question 1

Discuss the mode of transmission, signs and symptoms and laboratory identification of pneumonia. (20 Marks)

Question 2

Explain about dysentery. Give an appropriate explanation regarding name of microbe causes dysentery and laboratory diagnosis to detect microbe involve in dysentery. (20 Marks)

Question 3

Discuss the pathogenesis, signs, symptoms, clinical features and laboratory diagnosis of syphilis. (20 Marks)

January 2013/2012

SECTION A: OBJECTIVE QUESTIONS (30 MARKS)

Choose ONE best statement to answer the questions.

1. A symbiotic relationship in which one species benefits from the association while the other species is harmed from the relationship is called

(A) parasitism*

(B) mutualism

(D) commensalism

2. Which of the following statements about host-microbes is TRUE?

(A) Bacterimia is presence of virus in the host blood.

(B) A host is any organism that harbors no other organism.

(D) In mutualism neither of the two species benefits from the relationship.

3. The study of factors and mechanisms of disease frequency and spread within a population is called

(A) endemic

(B) etiology

(D) epidemiology*

4. Corynebacterium diphtheria can cause

(A) diphtheria*

(B) pharyngitis

(D) whooping cough

5. Whooping cough is caused by

(A) Bordetella pertussis*

(B) Staphylococcus aureus

(D) Mycobacterium tuberculosis

6. Which of the following statements about diptheria is INCORRECT?

(A) Infects the upper respiratory tract

(B) Transmitted by droplets or fomites

(D) Toxin inhibits protein synthesis of cells

7. Pyelonephritis is inflammation of the

(A) ureter

(B) urethra

(D) renal parenchyma*

8. Classical symptoms of urinary tract infection is characterized by all of the following EXCEPT

(A) dysuria

(B) urgency

(D) frequent urination

suprabic pain, possibly hematuria

9. The following organism can cause urinary tract infection EXCEPT

(A) Bacillus cerues*

(B) Escherichia coli

(D) Pseudomonas aeruginosa

10. Which of the following pair is MISMATCHED?

(A) Shigella – typhoid fever

(B) enteropathogenic Escherichia coli – traveler's diarrhea

(D) Staphylococcus aureus – food poisoning due to enterotoxins A and D

11. Which of the following microbes can cause dysentery?

(A) Proteus mirabilis

(B) Salmonella enteric*

(D) Streptococcus pneumoniae

12. All of the following refers to food poisoning EXCEPT

(A) cystitis can cause due to food poisoning.*

(B) Vibrio cholerae infection can cause food poisoning.

(D) stool culture is used to diagnosis the microbe involve in food poisoning.

13. Neisseria gonorrhoeae is characterized by all of the following EXCEPT

(A) cleaves IgA

(B) Gram-negative diplococci

(D) the symptom of infection are painful urination and purulent discharge

14. Lymphogranuloma venereum is caused by

(A) Neisseria gonorrhea

(B) Treponema pallidum

(D) Chlamydia trachomatos*

15. Which of the following statements about sexually transmitted diseases is FALSE?

(A) Neisseria gonorrhoeae can cause Gonorrhea

(B) Syphilis cannot be spread from mother to fetus*

(D) Papilloma virus can cause proliferative infections

16. Haemophilus ducreyi can cause

(A) AIDS

(B) hepatitis

(D) gonorrhea

17. Waterhouse-Friderichsen syndrome is a complication of

(A) Bordetella pertussis

(B) Chlamydia trachomatis

(D) Meningococcal meningitis*

18. The MOST COMMON bacteria that cause meningitis in children is

(A) Clostridium perfringins

(B) Pseudomonas aeruginosa

(D) Calymmatobacterium granulomatosis

19. The following diagnosis are used to detect tuberculous meningitis EXCEPT

(A) sputum culture

(B) urine examination

(D) cebro spinal fluid analysis

20. The following are symptoms of meningitis EXCEPT

(A) jaundice*

(B) drowsiness

(D) sudden high fever

21. Staphylococcus aureus causes all of the following EXCEPT

(A) impetigo

(B) erysipelas*

(D) scalded skin syndrome

24. The following are diseases of bone or joint EXCEPT

(A) urethritis*

(B) osteomyelitis

(D) infection of prosthetic joints

25. The following organism can cause haematogenous osteomyelitis EXCEPT

(A) Salmonella typhi*

(B) Staphylococcus aureus

(D) Haemophilus influenzae

26. Which of following diagnosis are use to detect osteomyelitis?

(A) pus culture*

(B) urine examination

(D) cerebrospinal fluid analysis

27. The following are laboratory diagnosis acute Septic Arthritis EXCEPT

(A) ultrasound

(B) plain X-ray

(D) feces examination*

28. Which of the following definition about a fever of unknown origin (FUO) is FALSE?

(A) Deformity with abdominal pain*

(B) More than 3 weeks' duration of illness

(D) Failure to reach a diagnosis despite 1 week of patient investigation

29. Fever of unknown origin (FUO) is caused by

(A) boil

(B) style

(D) acne vulgaris

30. The following bacteria can cause fever of unknown origin (FUO) EXCEPT

(A) Neisseria meningitidis.

(B) Neisseria gonorrhoeae.

(D) Mycobacterium tuberculosis.

SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)

Answer ALL questions.

1. a. Differentiate between symptoms and signs. (4 Marks)

b. Describe the process of disease development. (6 Marks)

2. a. Define meningitis. (1 Mark)

b. Name the causal agent for meningococcal meningitis. (1 Mark)

c. State THREE (3) clinical complications of the meningococcal disease. (3 Marks)

d. Determine the laboratory diagnosis to detect microbes involved in meningitis. (5 Marks)

3. a. Describe laboratory diagnosis to detect pathogen that causes septic arthritis. (5 Marks)

b. Explain the characteristic and types of Escherichia coli. (5 Marks)

E coli is facultative anaerobic, capsulated, non motile, non spore forming, ferments glucose and lactose as carbon source.

SECTION C: ESSAY QUESTIONS (40 MARKS)

Answer TWO (2) questions only.

Question 1

Describe about Tuberculosis. Discuss the potential pathogen that causes Tuberculosis, symptoms, clinical features and related laboratory diagnosis. (20 Marks)

Question 2

Explain about food poisoning. Discuss the potential pathogens that cause food poisoning and related laboratory diagnosis. (20 Marks)

Question 3

Discuss the pathogenesis, signs, symptoms, clinical features and laboratory diagnosis of syphilis. (20 Marks)

1/2011/2012

PART A: OBJECTIVE QUESTIONS (30 MARKS)

Choose ONE best statement to answer the questions.

1. Worldwide spread of an infectious disease is called

(A) endemic.

(B)sporadic.

(D)pandemic.*

2. A healthcare worker fails to follow aseptic procedures while cleaning a wound, washes his hands properly afterwards and suffers no ill effects—this is an example of

(A) infection.

(B) infestation.

(D) commensalism.

3. The spreading of exotoxins from the site of infection via the blood is called

(A)toxemia.*

(B) adherence.

(C)septicemia.

(D)colonization.

4. Bordetella pertussis can cause

(A)Diphtheria.

(B) Pharyngitis.

(D)Whooping cough.*

5. The following statements about tuberculosis are all true EXCEPT

(A)the pathogens have long generation time (12-18 hours).

(B) Mycobacterium tuberculosis is the most common causative agent.

(D)the pathogens are very sensitive to drying and die quickly in the environment*

6. The major etiology of lobar pneumonia is

(A)Klebsiella pneumonia.

(B) Staphylococcus aureus.

(D)Streptococcus pneumonia.*

7. Cystitis is inflammation of the

(A) ureter.

(B) kidney.

(D)urinary bladder.*

8. Dysuria means

(A) discolored urine.

(B) pain on urination.*

(D)an increased volume of urine produced.

9. Which is the causative agent in 80% of urinary tract infections?

(A)Escherichia coli.*

(B) Staphylococcus areus.

(D)Pseudomonas aeruginosa.

10. The following are laboratory diagnosis for urinary tract infections EXCEPT

(A)feces tests.*

(B) urinalysis.

(D)radiologic studies.

11. Which of the following microbe can cause food poisoning?

(A)Treponema pallidum.

(B) Haemophilus ducreyi.

(D)Campylobacter jejeuni.

12. All of the following refers to food poisoning EXCEPT

(A)Scarlet Fever can cause due to food poisoning.*

(B) Bacillus cereus infection can cause food poisoning.

(D)Feces culture is used to diagnosis the microbe involve in food poisoning.

13. Which of the following bacteria can produce cytotoxin?

(A)Vibrio cholera.

(B) Clostridium difficile.*

(D)Staphylococcus aureus.

14. Gastroenteritis can be prevented by

(A) good hygiene.*

(B) poor hand washing.

(D)poor sewage disposal.

15. Chancroid is caused by

(A)Neisseria gonorrhea.

(B) Treponema pallidum.

(D)Chlamydia trachomatos.

16. Which of the following bacteria can cause ulcerative infections in sexually transmitted diseases?

(A) Hepatitis B.

(B) Papillomavirus.

(D) Neisseria gonorrhoeae.

17. Which of the following is TRUE about Genital Herpes?

(A)Transmitted solely via fecal oral route.

(B) Can cause from infection of Hemophilus ducreyi.

(D)Can diagnosed by demonstration of chlamydial DNA following PCR amplification.

18. The most common cause of meningitis in infants is

(A)Helicoacter pylori.

(B) Haemophilus ducreyi.

(D)Clostridium perfringins.

19. Which of the following diagnosis is use to detect tuberculous meningitis?

(A)CSF analysis.*

(B) Feces examination.

(D)Pap smear analysis.

20. Which of the following is a symptom of meningitis?

(A)Jaundice.

(B) Diarrhoea.

(D)Pyelonephritis.

21. Streptococcus pyogenes can causes

(A) boil.

(B) erysipelas.*

(D)acne vulgaris.

22. Which of the following statements about Sycosis barbae is TRUE?

(A)Infection of the urethra.

(B) Also called Ritter-Lyell’s disease.

(D)Transmitted solely via sexual contact.

23. Which of the following statements about infant’s skin infections?

(A)Styes.

(B) Impetigo.

(D)Pemphigus neonatorum.*

24. Which of the following is a diseases of bone or joint?

(A)Cystitis.

(B) Enteric fever.

(D)Lymphogranuloma venereum.

25. Which of the following organism can cause haematogenous osteomyelitis?

(A)Neisseria gonorrhea.

(B) Herpes simplex viruses.

(D)Corynebacterium diphtheria.

26. Which of following diagnosis are use to detect osteomyelitis?

(A)CSF analysis.

(B) Blood cultures.*

(D)Urine examination.

27. Which of the following is a laboratory diagnosis acute Septic Arthritis?

(A)Plain X-ray.

(B) Feces culture.

(D)Urine examination.

28. Which of the following is defined a fever of unknown origin (FUO)?

(A)Deformity with muscle spasm.

(B) More than 3 days duration of illness.

(D)A temperature greater than 38.3°C (101°F) on several occasions.*

29. Which of the following is a laboratory diagnosis fever of unknown origin (FUO)?

(A)Histology.

(B) Meteorology.

(D)Pap smear analysis.

30. The following bacteria can cause fever of unknown origin (FUO) EXCEPT

(A)Neisseria meningitidis.

(B) Neisseria gonorrhoeae.

(D)Propionibacter granulosum.*

PART B: SHORT ANSWER QUESTIONS (30 MARKS)

Answer ALL questions.

1. a. Define the mutualism and parasitism. (4 Marks)

mutualism: both benefit

parasitism: microbe benefits and harms

b. Describe the stage of an infectious disease. (6 Marks)

2. a. Explain “Classical” symptoms of urinary tract infection. (4 Marks)

b. Describe about THREE (3) groups of Escherichia coli. (6 Marks)

3. a. Describe about meningitis. (5 Marks)

b. Explain the symptoms of meningitis and laboratory diagnosis to detect microbe involve in meningitis. (5 Marks)

PART C: ESSAY QUESTIONS (40 MARKS)

Answer TWO (2) questions only.

Question 1

Determine the mode of transmission, signs and symptoms and laboratory identification of Diphtheria. (20 Marks)

Question 2

Explain about dysentery. Give an appropriate explanation regarding name of microbe causes dysentery and laboratory diagnosis to detect microbe involve in dysentery. (20 Marks)

Question 3

Discuss the mode of transmission, pathogen, pathogenesis, signs and symptoms and laboratory identification of syphilis. (20 Marks)

2/2009/2010

PART A: OBJECTIVE QUESTION. (30 MARKS)

Choose the best answer to the question.

1. Definitions below are correctly matched EXCEPT

A. Etiology – the study of disease*

B. Disease – occurs when the infection causes any change from the state of health

C. Infection – is invasion of the body by pathogenic microorganism.

D. Pathogen – microorganism that cause disease

2. Presence, but not multiplication, of bacteria in the blood of a host is known as

A. viremia

B. sapremia

C. septicemia*

D. bacteremia

3. Worldwide spread of an infectious disease is called

A. epidemic

B. endemic

C. sporadic

D. pandemic*

4. A common portal of entry for microorganisms is

A. body fluids

B. mucous membrane*

C. blood vessels

D. saliva ducts

5. An infection acquired in the hospital or other medical facility:

A. zoonosis

B. mycosis

C. nosocomial*

D. exogenous

6. Consider the pairs listed below. Which do not go together?

A. Tinea cruris—jock itch

B. Tinea unguium—ringworm of the nails

C. Tinea barbae—ringworm of the beard

D. Tinea corporis—ringworm of the face

7. Toxic shock syndrome is associated with all of the following EXCEPT

A. Staphylococcus aureus

B. Super-absorbent tampons

C. Elderly men

D. Women under 30 years of age

8. What are the signs associated with congenital syphilis?

A. Huchinson’s teeth

B. Saber shin

C. Saddle-nose

D. All of the above

9. Streptococcus pyogenes is a causative agent of:

A. scarlet fever*

B. bacillary dysentery

C. anthrax

D. diphtheria

10. The microorganism Staphylococcus aureus causes what condition?

A. gas gangrene

B. botulism

C. scalded skin syndrome*

D. cholera

11. Genital warts are caused by

A. moluscum contagiosum

B. human papillomavirus

C. cowpox

D. HZV

12. Which of the following conditions is most likely to lead to pneumonia?

A. sinusitis

B. bronchitis*

C. pharyngitis

D. epiglottitis

13. The etiology of whooping cough is

A. Rhinovirus

B. Bordatella pertussis*

C. Corynebacterium

D. Haemophilus

14. Dengue fever is transmitted via

A. mosquitoes.*

B. sand flies

C. mites

D. ticks

15. Infectious mononucleosis is characterized by all of the following EXCEPT

A. caused by Human herpes virus 4

B. also called the kissing disease.

C. most patients have a sore throat.

D. a vaccine is available.

16. Lyme disease is characterized by all of the following EXCEPT

A. etiology is Borrelia burgdorferi

B. bull’s eye rash

C. tick borne disease

D. hepatitis is a common sequelae

17. Viral meningitidis is consistent with all of the following EXCEPT

A. 15 % are caused by mumps virus

B. 30 % of cases remains unidentified

C. 40 % are caused by enteroviruses

D. it is always fatal

18. The characteristic sign for detecting Rabies is

A. finding Negri bodies in brain cells

B. finding anti-rabies antibodies in the serum

C. finding the symptoms of disease

D. immunofluorescent antibody test

19. Below are risk factors in infection in prosthetic joints EXCEPT

A. rheumatoid arthritis

B. diabetes melitus

C. heart problem

D. obesity

20. Most common affected site for bone disease in adult is

A. long bone

B. vertebrae

C. skull

D. diaphysis

21. Syphilis is caused by

A. dirty habits

B. Neisseria gonorrheaea

C. Treponema pallidum*

D. bad blood

22. Genital herpes is caused by

A. herpes simplex virus 1

B. herpes simplex virus 2*

C. herpes simplex virus 4

D. herpes simplex virus 7

23. The following statements are true about Trichomoniasis EXCEPT

A. it is a vaginal infections.

B. causes foul smelling discarge

C. inflammation of penis

D. there is no cure

24. AIDS has become the most common cause of death in

A. age 1 - 24

B. age 24 – 44

C. age 45 – 60

D. age 60 and above

25. Diagnostic test for AIDS is

A. indirect ELISA

B. complete blood count

C. urine test

D. X ray

26. Progression from initial HIV to AIDS typically takes

A. 2 years

B. 5 years

C. 7 years

D. 10 years

27. A major cause of UTIs is

A. eating something that doesn’t agree with you.

B. incomplete emptying of the bladder.

C. immunosuppression.

D. all of the above

28. Cystitis is inflammation of the

A. urinary bladder*

B. urethra

C. cystic duct

D. kidney

29. Dysuria means

A. an increased volume of urine produced

B. blood in the urine

C. discolored urine

D. pain on urination*

30. _____ is the causative agent in 80% of UTIs.

A. Escherichia coli*

B. Chlamydia trachomatis

C. Staphylococcus epidermidis

D. Pseudomonas aeruginosa

3. Write the word or phrase that best completes each statement or answers the

question. (5 marks)

A. Ebola virus causes ____________________________________.

B. Swelling that results from roundworms blocking the lymphatics is called

_______________________________.

C. ______________________ is a severe diarrhea that often contains large quantities of mucus and sometimes blood or even pus.

D. _____________________is the toxin that causes scalded skin syndrome.

E. ___________________ are the predominant bacteria on the skin, with at least a dozen different species living there.

4. Mahjanah took her small children with her when she went to help her parents. Her mom has shingles and needed some help around the house. In the third week of their visit the children developed chicken pox. Why? ( 5 marks )

5. Why STD infections can cause infertility if not treated. (5marks)

PART C: ESSAY QUESTIONS ( 45 MARKS )

Choose and answer THREE questions ONLY.

Question 1

a. What are the definition of Fever of Unknown Origin (FUO) according to Petersdorf and Beeson (5 marks)

b. Write the lab examination or diagnosis for FUO. (10 marks)

Question 2

a. What are the main diseases of the bones and joints. (5marks)

b. Write about septic arthritis clinical features and the causal organisms. (10marks)

Question 3

a. List routes of HIV transmission. (5marks)

b. Describe the stages of HIV infection. (10marks)

Question 4

a. What are the different types of symbiotic relationship between microbe and human. (5 marks)

b. What are the virulence factors that increase the pathogenicity of bacteria? ( 10 marks)

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