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Micro > Gram Nega > Flashcards

Gram Nega Flashcards

1
Q

. A 5 year old girl was bitten by a stray cat. 2 days later, the wound was red and swollen and drained purulent fluid. Pasteurella multocida was cultured from the wound. The drug of choice to treat this infection is
a. Clindamycin
b. Erythromycin
c. Penicillin G
d. Amikacin

A

C

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2
Q

All of the following are characteristics of Haemophilus except
a. Grows in blood agar
b. Colonizers of lower respiratory tract of humans
c. Pleomorphic organism
d. Gram negative cocci

A

D

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3
Q

All of the following cause zoonotic infections except
a. Bordetella pertussis
b. Brucella melitensis
c. Francisella tularensis
d. Leptospira interrogans

A

A

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4
Q

Agents useful in the treatment of F. tularensis except a. Gentamycin
b. Tetracycline
c. Streptomycin
d. Penicillin

A

D

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5
Q

Which of the following is not a recognized virulence factor of Bordetella pertussis?
a. Heat labile toxin
b. Tracheal cytotoxin
c. Filamentous hemagglutinin
d. Pertussis toxin

A

A

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6
Q

A 68-year-old woman had fever with increasing pain and swelling in her left knee during the past 3 weeks. Four years earlier, a prosthetic joint had been placed in her left knee. An aspirate of the fluid and was cultured showing colorless colonies smaller than 1 mm in diameter were seen on the blood and chocolate agar plates. The organism was a tiny gram-negative coccobacillus that was catalase positive and oxidase positive. A urea slant was inoculated and was positive for urease activity after overnight incubation. Which of the following microorganisms is most likely the cause?
a. Staphylococcus aureus
b. Haemophilus ducreyi
c. Brucella species
d. Francisella tularensis

A

C

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7
Q

The following causes undulant fever, EXCEPT
a. Pasteurella species
b. Brucella species
c. Haemophilus species
d. Malta fever

A

D

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8
Q

Which of the following is not a recognized virulence factor of Bordetella pertussis?
a. Tracheal cytotoxin
b. Filamentous hemagglutin
c. Pertussis toxin
d. Heat labile toxin

A

D

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9
Q

What stage of pertussis would the cough be described as explosive in character and with a “whoop” upon inhalation, and presents with dyspnea?
a. Paroxysmal stage
b. Convalescence stage
c. Catarrhal stage
d. Prodromal stage

A

A

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10
Q

The most common cause of bacterial meningitis in children aged 5 months to 5 years
a. H. influenzae type b
b. H. influenzae type d
c. H. influenzae type c
d. H. influenzae type a

A

A

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11
Q

F. Tularensis is highly resistant to
a. Streptomycin
b. Aminoglycosides
c. Tetracycline
d. B-lactam antibiotics
e. All of them

A

D

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12
Q

F. Tularensis grows on
a. Blood agar
tularensis grows on
b. Trypticase soy medium
c. Sheep’s blood agar
d. Buffered charcoal yeast extract (BCYE) agar
e. Brain heart infusion medium

A

D

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13
Q

The recommended treatment by the CDC for prevention for chancroid a. Ciprofloxacin
b. Ceftriaxone
c. Azithromycin
d. Erythromycin

A

C

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14
Q

Is oxidase positive and catalase positive, has a characteristic morphology, is motile and is a strong
producer of urease
a. Haemophilus aegyptius
b. Pasteurella multocida
c. Campylobacter jejuni
d. Helicobacter pylori

A

D

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15
Q

It may cause “kennel cough” and pneumonitis
a. B. bronchiseptica
b. F. tularensis
c. B. parapertussis
d. B. pertussis

A

A

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16
Q

All of the following statements regarding the etiologic agent of chancroid are correct except
a. The organism requires X factor but not V factor
b. The organism is susceptible to erythromycin
c. The organism is a small gram positive rod
d. The organism grows well on standard chocolate agar
e. On Gram stain of lesions, the organism occurs in strands

A

D

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17
Q

The causative agent of Brazilian purpuric fever
a. H. parainfluenzae
b. H. ducreyi
c. H. influenzae biotype III
d. Haemophilus aegyptius

A

C

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18
Q

Which of the following statements is NOT true for Fransicella?
a. Type A biogroup ferments glycerol, and contains citrulline ureidase
b. Type B biogroup produces milder disease in humans
c. Type B biogroup occurs only in North America, is lethal for rabbits
d. Type A biogroup produces severe illness in humans

A

C

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19
Q

The following causes undulant fever, EXCEPT
a. Brucella species
b. Haemophilus species
c. Malta fever

A

C

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20
Q

Factor X acts physiologically as _____, _____ can be replaced by nicotinamide adenine dinucleotide (NAD) or other coenzymes
a. Nicotinamide and factor X
b. Hemin and factor V
c. Adenine and factor IV
d. NAD and factor III

A

B

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21
Q

It is grown best from scrapings of the ulcer base that are inoculated onto chocolate agar containing 1% isoVitalex and ________, 3ug.mL; the agar is incubated in _____ CO2 at _______
a. Ampicillin, 50%, 30 oC
b. Amikacin, 15%, 35 oC
c. Erythromycin, 5%, 35 oC
d. Vancomycin, 10%, 33 oC

A

D

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22
Q

All of the following are true statements for Bordetella pertussis, EXCEPT
a. The “catarrhal stage” develops with mild coughing and sneezing
b. “cough plate” held in front of the patient’s mouth during a paroxysm
c. Swabs should be either dacron or rayon tipped for specimen collection
d. Associated with leukocytosis and absolute neutrophilia

A

D

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23
Q

This organism was formerly called the Koch-weeks bacillus and is associated with highly communicable form of conjunctivitis (pinkeye) in children
a. Haemophilus aegyptius
b. Haemophilus parahaemolyticus
c. Haemophilus haemolyticus
d. Actinobacillus actinomycetemcomitans

A

A

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24
Q

It directly inhibits H. pylori and appear to be potent urease inhibitors
a. Metronidazole
b. Bismuth subsalicylate
c. Proton pump inhibitors
d. Vancomycin
e. Tetracycline

A

C

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25
Q

It promotes lymphocytosis, sensitization to histamine and enhanced insulin secretion by means of adenosine diphosphate-ribosylating activity that disrupts function of transduction in many cell types
a. Pertussis toxin
b. Hemolysin
c. Tracheal cytotoxin
d. Adenylate cyclase toxin

A

A

26
Q

All of the ff are characteristics of Haemophilus group except
a. Gram negative cocci
b. Grows in blood agar
c. Pleomorphic organism
d. Colonizers of lower respiratory tract of humans

A

A

27
Q

All of the ff cause zoonotic infections except
a. Leptospira interrogans
b. Francisella tularensis
c. Bordetella pertussis
d. Brucella melitensis

A

C

28
Q

Capsular antigen (type b) and is considered H. influenzae’s major virulence factor
a. Polyribitol ribose phosphate
b. Somatic antigens
c. Factors X and V
d. Nontypeable (NTHi) antigen

A

A

29
Q

A 68-year-old woman had fever with increasing pain and swelling in her left knee during the past 3 weeks. Four years earlier, a prosthetic joint had been placed in her left knee. As aspirate of the fluid and was cultured showing colorless smaller than 1 diameter were seen on the blood and chocolate agar plates. The organism was a tiny gram-negative coccobacillus that was catalase positive and oxidase positive. A urea slant was inoculated and was positive for urease activity after overnight incubation. Which of the following microorganisms is most likely to cause?
a. Haemophilus ducreyi
b. Brucella species
c. Staphylococcus aureus
d. Francisella tularensis

A

B

30
Q

A normal inhabitant of the human respiratory tract, it has been encountered occasionally in infective endocarditis and in urethritis
a. H. parainfluenzae
b. H. ducreyi
c. H. influenzae
d. H. haemolyticus

A

A

31
Q

It is also known as potato-glycerol agar that contains penicillin G, 0.5 ug/mL
a. Regan-lowe medium
b. Skirrow’s agar
c. Chocolate agar
d. Bordet-Gengou medium

A

D

32
Q

An 18 year old male college student sought consult at the clinic because of cough non-productive of one month duration. Also noted weight loss and chills at night. As a clinician, what is the primary diagnostic method you request for this patient?
a. Chest X ray
b. Sputum culture
c. Tuberculin test
d. Sputum smear

A

D

33
Q

A 47-year old woman presents with a 3-month history of progressive cough, hemoptysis, weight loss and fever. Chest radiography shows bilateral cavitary disease suggestive of tuberculosis. A sputum specimen is obtained, and numerous acid fast bacteria are seen on the smear. Patient claimed of previous PTB infection 7 years ago and claimed loss to follow up. Which treatment regimen is most appropriate for this patient?
a. 2 HRZES/ 5 HRE
b. 2 HRZE/ 4HR
c. 2 HRZE/ 5 HRE
d. 2 HRZES/ 4 HRE

A

A

34
Q

A 47-year old man presents with a 3-month history of progressive cough, hemoptysis, weight loss and fever. Chest radiography shows bilateral cavitary disease suggestive of tuberculosis. What is the hallmark of M. tuberculosis?
a. Presence of monocytes
b. Epithelioid granuloma
c. Multinucleated giant cells
d. Histiocytes formation

A

B

35
Q

True regarding Mycobacterium leprae
a. The course is progressive and malignant, with nodular skin lesions; slow, symmetric nerve involvement
b. Eye involvement is uncommon
c. Organisms routinely are sensitive to first line antituberculosis drugs
d. Specimens used for diagnosis are scrapings from skin or oral mucosa

A

A

36
Q

The following does not describe Mycobacteria
a. Requires acid fast smear and tuberculin test for diagnosis
b. IGRAs can be used to screen persons for latent tuberculosis infection
c. Rod-shaped, aerobic organisms
d. Both nonselective and selective media in solid and liquid forms are used to recover
organisms from clinical material

A

D

37
Q

Considered as second line drugs for M. tuberculosis a. Cyclospamide
b. Kanamycin
c. Streptomycin
d. Ethambutol

A

B

38
Q

Which of the following Mycobacteria specie is/are considered rapid growers?
a. Mycobacterium gordonae
b. Mycobacterium chelonae
c. Mycobacterium avium
d. Mycobacterium leprae

A

B

39
Q

Not true of tuberculin test
a. Larger than 10mm of induration is considered a positive test result for low-risk population
b. 5mm or larger of induration is considered positive
c. Presence of induration no later than 72 hours after placement
d. Larger than 10mm is considered positive for persons with increased probability of recent infection

A

A

40
Q

Causes chronic cervical lymphadenitis in children
a. M. flavescens
b. M. gordonae
c. M. scrofulaceum
d. M.tb

A

C

41
Q

An 8 year old child has a primary pulmonary M. tuberculosis infection. Which of the following features of tuberculosis is most correct?
a. Exudative lesion in tissue often heals slowly
b. Involved most often the mid-lung fields or the mid base areas
c. Enlarged hilar, cervical and mediastinal lymph nodes are frequently observed
d. The lymph node undergoes massive caseation which usually calcifies

A

D

42
Q

Jodie, a 35-year-old consulted because of multiple nodular lesions on her face, earlobes and wrist. Skin slit smear of the nodule on the earlobe showed numerous acid fast bacilli (++++). What is the most likely classification of this patient?
a. Indeterminate leprosy
b. Lepromatous leprosy
c. Tuberculoid leprosy
d. Borderline leprosy

A

B

43
Q

Considered as atypical Mycobacteria
a. M. avium
b. M. bovis
c. M. leprae
d. M. africanum

A

A

44
Q

Initial treatment of MAC a. Isoniazid
b. Clarithromycin
c. Pyrazinamide d. Streptomycin

A

B

45
Q

The definition of extensively drug-resistant (XDR) tuberculosis includes
a. Resistance to ofloxacin
b. Resistance to isoniazid
c. Resistance to rifampin
d. Resistance to amikacin
e. All of the above

A

E

46
Q

newly characterized rapidly growing Mycobacterium that has emerged as an important cause of central venous catheter associated infection is?
a. Mycobacterium phlei
b. Mycobacterium xenopi
c. Mycobacterium mucogenicum
d. Mycobacteria smegmatis

A

C

47
Q

MOT of M. tuberculosis
a. Air-borne (aerosols)
b. Nasal secretions
c. Droplet spray
d. Direct contact

A

C

48
Q

Agar used in cultivation of Mycobacteria
a. MacConkey
b. Hektoen
c. Middlebrook 17H10/7H11 biplate
d. Lowenstein-Jensen

A

D

49
Q

Conventional methods for identification of mycobacteria include
a. Often require 8 weeks for identification
b. Often require 6-8 weeks for identification
c. Observation of rate of growth, number of colonies, and biochemical profiles
d. Incubation is at 35-37o C in 5-10% CO2 for up to 6 weeks

A

B

50
Q

First line therapy for both tuberculoid and lepromatous leprosy a. Ethambutol
b. Sulfones
c. Rifampicin

A

B

51
Q

Which of the following causes pulmonary infections that mimic tuberculosis? It responds to therapy with INH, RIF, and EMB.
a. M. chelonae
b. M. ulcerans
c. M. gordonae
d. M. kansasii

A

D

52
Q

True of Mycobacteria intracellulari
a. Disease has also been described in middle-aged to elderly women in the absence of chronic lung disease
b. Resembles M. tuberculosis
c. Most commonly isolated rapid grower from pulmonary infections d. Uncommon in immunocompromise patients

A

A

53
Q

In the experiments of Robert Koch, which made him known for his Koch’s postulate, he preferred the use for agar as a culture media because
a. It remained solid even at 42 degrees Celsius
b. It is cheaper than animal eyeball
c. It is widely available than gelatin
d. It is stable at room temperature for growing smallpox

A

A

54
Q

A 47-year-old woman presents with a 3-month history of progressive cough, weight loss, and fever. Chest radiography shows bilateral cavitary disease suggestive of tuberculosis. patient was given INH, PYR, RMP, EMB as initial medication. 2 weeks later, patient noted orange/ red color urine. Patient went back to your clinic. What would be the probable cause of the colored urine?
a. Rifampicin
b. Ethambutol c. Pyrazinamide d. Isoniazid

A

A

55
Q

Pulmonary Mycobacterium tuberculosis infection. Which of the following features of tuberculosis is most correct?
a. In primary tuberculosis all of the infecting microorganisms are killed by the patient’s immune system
b. If tuberculosis develops years later it is a result of another exposure to Mycobacterium
c. In primary tuberculosis, an active exudative lesion develops and rapidly spreads to
lymphatics and regional lymph nodes
d. The exudative lesion of primary tuberculosis often heals slowly

A

C

56
Q

An 18-year-old male college student sough consult at the clinic because of cough nonproductive of one month duration. Sputum was requested, the colonies were observed after four weeks. The colonies were described as rough, dry and buffed colored resembling “cauliflower”. What is the most likely causative agent?
a. Streptococcus pneumoniae C. diphtheriae
b. Mycobacterium leprae
c. Mycobacterium tuberculosis
d. Mycoplasma pneumoniae

A

C

57
Q

All are considered scotochromogens, EXCEPT
a. M. smegmatis
b. M. gordonae
c. M. asiaticum
d. M. flavescens

A

C

58
Q

All of the following species of Mycobacterium consider soil as reservoir, EXCEPT
a. M. smegmatis
b. M. gordonae
c. M. abscessus
d. M. chelonae

A

B

59
Q

Not true regarding Acid fast stain
a. Non acid fast organism lack the lipoidal material in their cell wall due to which they are easily
decolorized, leaving the cells colorless
b. Non acid fast cells retain the red color
c. Aim of this stain is to differentiate bacteria into acid fast group to non acid fast groups
d. Smear is decolorizing agent (3% HCL in 95% alcohol)

A

B

60
Q

A 44-year-old man sought consult for multiple areas of hypopigmentation and loss of sensation on various parts of his upper extremities. Upon PE there were hypoesthetic, hairless plaques on the upper extremities. What is the most likely organism?
a. Mycobacterium leprae
b. Staphylococcus epidermides

A

A

61
Q

Which of the following are true of Mycobacteria?
a. Mycobacteria cannot be classified as either gram positive or gram negative
b. Broth media (eg. Middlebrook 07H9 and 07H12) support the proliferation of small inocula
c. Media for primary culture of mycobacteria should include a nonselective medium
d. Are usually rod-shaped, anaerobic bacteria

A

A

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