MICRO BMEX Flashcards by Abby David

Meningococcemia is
A. common during gonorrhea
B. associated with vascular hemorrhage and petechiae
C. caused by a Gram-positive diplococcus
D. All of these choices are correct

B. associated with vascular hemorrhage and petechiae

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In the human _______ Escherichia coli begins to colonized while establishing infestation.
A. lungs
B. intestine
C. stomach
D. kidneys

D. kidneys

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An 8-month-old infant has been brought to the ER with a high fever. Her parents indicated that she has not been eating or drinking well and has been very irritable until the last few hours during which she has only been minimally responsive. Suspecting meningitis, a spinal tap is done and the SF sample is sent to the lab for analysis. The white blood cell count on the sample is profoundly elevated, the protein content is elevated, and the glucose level is depressed. The Gram-stained smear shows Gram-positive cocci in pairs. Cultures are done and after overnight incubation, alpha hemolytic colonies are observed on the blood plate. These colonies contain Gram-positive cocci, which are catalase negative. An optochin susceptibility test is done and there is a large zone of inhibition around the disk. What is the identification of this isolate?
A. Viridans streptococci
B. Streptococcus pneumoniae
C. Neisseria meningitidis
D. Enterococcus faecalis

B. Streptococcus pneumoniae

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In the lab, students were given two samples of bacteria; both were exposed to hydrogen peroxide. Bacterial sample #1 exhibited bubbles, whereas bacterial sample #2 did not. What enzyme was detected in sample #1?
A. Hydrolase
B. Helicase
C. Catalase
D. Lipase

C. Catalase

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The most immediate result of destruction of a cell’s ribosomes would be

A. destruction of the cell’s DNA
B. formation of glycogen inclusions
C. material would not be able to cross the cell membrane
D. protein synthesis would stop

C. material would not be able to cross the cell
membrane

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The M protein of Streptococcus pyogenes

A. is the basis for the organism belonging to Lancefield Group A
B. gives rise to a zone of beta hemolysis on blood agar
C. is also called streptokinase
D. protects against phagocytosis and enhances adherence

D. protects against phagocytosis and enhances adherence

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Which of the following is NOT a similarity between Bacillus cereus and Clostridium perfringens?

A. They are both Gram-positive, endospore-forming bacteria
B. They are both obligate anaerobes
C. Symptoms of infection with either bacteria include nausea, vomiting, and diarrhea
D. They cause disease through contaminated foods

B. They are both obligate anaerobes

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Which of the following makes possible the differentiation of members of the genus Mycobacterium and the genus Nocardia from other bacteria?

A. The capsule stain
B. The presence of flagella
C. The Gram stain
D. The acid-fast stain

C. The Gram stain

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All of the following pertain to endotoxins, except they

A. can stimulate fever in the human body
B. are found in acid-fast bacterial cell walls
C. are specific bacterial cell wall lipids
D. can cause shock in the human body

B. are found in acid-fast bacterial cell walls

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Which of the following does NOT pertain to Clostridium difficile infection?

A. It may be on the rise due to increased use of gastric acid inhibitors
B. It is a colitis that is a superinfection
C. It is a major cause of diarrhea in hospitals
D. It is due to ingestion of contaminated, improperly stored, cooked meats and gravies

D. It is due to ingestion of contaminated, improperly stored, cooked meats and gravies

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Streptococcal pharyngitis involves all of the following, except

A. it is usually caused by the viridans streptococci
B. it causes redness, difficulty in swallowing, and fever
C. it can lead to serious sequelae
D. it can lead to scarlet fever if it is an erythrogenic toxin-producing stain

A. it is usually caused by the viridans streptococci

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The outcome of the Gram stain is based on differences in the bacterial cell’s

A. inclusions
B. ribosomes
C. cell membrane
D. cell wall

D. cell wall

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All of the following structures contribute to the ability of pathogenic bacteria to cause disease, except

A. capsule
B. fimbriae
C. Gram-negative outer membrane
D. inclusions

D. inclusions

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Which of the following is NOT correct about Streptococcus pyogenes?

A. It can cause impetigo and erysipelas
B. Some of the streptococcal toxins act as superantigens
C. Humans are the only significant reservoir
D. Most strains do not have a capsule

D. Most strains do not have a capsule

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If bacteria living in salty seawater were displaced to a freshwater environment, the cell structure that would prevent the cells from rupturing is the
A. capsule
B. cell membrane
C. endospore
D. cell wall

D. cell wall

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The periplasmic space is
A. made up of lipopolysaccharides and phospholipids
B. an important reaction site for substances entering and leaving the cell
C. absent in Gram-negative bacteria Present
D. just external to the LPS layer of the outer membrane

B. an important reaction site for substances entering and leaving the cell

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A pregnant sex worker is told she has a positive CAMP test and should be treated with a course of antibiotics. This test is indicative of
A. Group A Streptococci
B. Group B Streptococci
C. S. saprophyticus
D. S. epidermidis

B. Group B Streptococci

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Bacterial cells could have any of the following appendages, except
A. fimbriae
B. cilia
C. flagella
D. sex pili

C. flagella

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Which of the following does NOT pertain to infant botulism?
A. Symptoms include flaccid paralysis and respiratory complications
B. Neurotoxin is not involved in the disease process
C. Symptoms include “floppy baby” appearance
D. Ingested spores can germinate in the immature
intestines of the neonate

B. Neurotoxin is not involved in the disease process

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A 48-year-old man has had nasal surgery and absorbent material has been inserted into his nasal cavity to control bleeding. Several hours ago he began to complain of a headache and has since developed a red rash over much of his body and is experiencing muscle cramps and diarrhea. His blood pressure has dropped to 75/50 mm Hg. This patient’s illness is most likely caused by

A. Staphylococcus aureus – toxic shock syndrome
toxin
B. Streptococcus pyogenes – streptolysin O
C. Streptococcus pyogenes – erythrogenic toxin
D. Staphylococcus aureus – exfoliative toxin

A. Staphylococcus aureus – toxic shock syndrome toxin

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A prokaryotic cell wall that is primarily composed of peptidoglycan with small amounts of teichoic acid and lipoteichoic acid is _______ and would most likely stain _______.
A. Gram-positive; blue
B. Gram-negative; red
C. Gram-negative; blue
D. Gram-positive; red

A. Gram-positive; blue

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Necrotizing fasciitis is
A. typically a sequelae of streptococcal pharyngitis
B. possibly caused by antibodies to Group A streptococci that cross-react with body tissues
C. not treatable with antimicrobic drugs
D. associated with strains of Streptococcus producing destructive enzymes and toxins

D. associated with strains of Streptococcus producing destructive enzymes and toxins

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Which structure protects bacteria from being phagocytized?
A. Slime layer
B. Capsule
C. Cell membrane
D. Fimbriae

B. Capsule

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In bacteria such as members of the Bacillus and Clostridium genera, nutrient depletion is likely to result in
A. sporulation
B. binary fission
C. plasmolysis
D. germination

A. sporulation

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Generally, what must healthy adults consume in order to contract botulism? A. Vegetative cells of C. botulinum B. Botulism toxin in contaminated food C. Endospores of C. botulinum D. Botulism toxoid in contaminated food

B. Botulism toxin in contaminated food

What do the bacteria that cause botulism, tetanus, and diphtheria have in common? A. Each of these diseases is caused by an endospore-forming bacterial species B. Each of these bacteria make an exotoxin that responsible for the disease C. Each of these diseases is caused by oligately anaerobic bacteria D. Vaccines are widely used to prevent each of these diseases

B. Each of these bacteria make an exotoxin that responsible for the disease

In which of the following situations would Staphylococcus epidermidis be the most likely etiologic agent? A. Cystitis in patient with temporary insertion of urinary catheter B. Septicemia in dialysis patient with intrajugular catheter C. Diarrhea in patient with nasogastric tube D. Ear infection in patient with hearing aid

B. Septicemia in dialysis patient with intrajugular catheter

A specimen was collected from a deep wound. A smear was prepared and Gram stained and samples were inoculated onto two blood agar plates. The Gram stain of the original specimen showed large Gram-positive bacilli. After inoculation, there was no growth on the blood agar plate that was incubated aerobically, but the plate incubated in the anaerobe jar grew beta hemolytic colonies. A Gram stain of these colonies showed large Gram positive bacilli, some with unstained inclusions, suggestive of endospores. What is the most likely genus of bacteria observed? A. Mycobacterium B. Clostridium C. Bacillus D. Corynebacterium

B. Clostridium

A seasonal farmworker has been brought into the emergency room showing early symptoms of tetanus, including spastic contractions of face and neck muscles. His coworkers indicated that he had received a puncture wound in his hand a week prior to the onset of symptoms. His tetanus vaccination status is uncertain. Which of the following should be administered to the patient first, as soon as possible? A. Tetanus toxoid B. Tetanus titer C. Tetanus immune globulin D. Antibiotics

C. Tetanus immune globulin

Rebecca Lancefield differentiated streptococci on the basis of differences in their A. Gram stain appearance B. cell wall carbohydrates in a serological test C. ability to produce catalase D. patterns of hemolysis on blood sugar

B. cell wall carbohydrates in a serological test

Which of the following characteristics of living things is/are not found among viruses? A. Cellular metabolism B. Ability to evolve C. Presence of nucleic acid D. All of these characteristics are lacking viruses

A. Cellular metabolism

Which of the following is the infectious period of measles virus infection? A. 5-7 days before rash to 3-5 days after the rash B. 1-2 days before prodrome to 4 days after the onset of rash C. 2 days before to 5 days after the onset of rash D. 3 days before to 7 days after the onset of rash

B. 1-2 days before prodrome to 4 days after the onset of rash

Viruses cannot multiply unless it invades a host cell; therefore, they are considered A. Automatic intracellular parasites B. True intracellular parasites C. Non-intracellular parasites D. Obligate intracellular parasites

D. Obligate intracellular parasites

The correct sequence of events in viral multiplication is A. adsorption, penetration, replication, assembly, maturation, release B. assembly, maturation, replication, release, penetration, adsorption C. replication, penetration, maturation, assembly, adsorption, release D. penetration, replication, maturation, adsorption, assembly, release

A. adsorption, penetration, replication, assembly, maturation, release

Which of the following is the most common life threatening complication of measles A. Measles encephalitis B. Meningitis C. Otitis media D. Pneumonia

D. Pneumonia

. All of the following pertain to virus envelopes, EXCEPT A. Are located between the capsid and nucleic acid B. Help the virus particle attach to host cells C. They are formed by the virus utilizing parts of the host cell membrane D. They contain special virus proteins

A. Are located between the capsid and nucleic acid

Which of the following is an example of a B subfamily of herpes virinae? A. Herpes simplex type 1 B. Cytomegalovirus C. Epstein Barr virus D. Varicella zoster virus

B. Cytomegalovirus

Corynebacterium diphtheria is made virulent by incorporated prophage genes encoding the diphtheria toxin. Which term describes this process? A. Lysogenic conversion B. Lytic phase C. Adsorption D. Latent phase

A. Lysogenic conversion

The nucleocapsid is composed of A. the envelope and capsid B. the capsomeres assembled into the capsid C. the nucleic acid of the virus only D. the nucleic acid along the capsid

D. the nucleic acid along the capsid

Which of the following statements is correct with regards to measles virus infection? A. Measles virus begins with malaise, low grade fever, and a morbilliform rash appearing on the same day B. Measles immune response are involved in disease pathogenesis C. Typical measles is diagnosed based on identification of the virus from nasopharyngeal and conjunctival swabs D. Measles virus is a member of the togavirus

B. Measles immune response are involved in disease pathogenesis

Susceptible individuals are those that belong to the extremes of age A. The production of multiple copies of a virus by a host cell B. The copying of the viral DNA in a DNA virus C. The copying of the genomic RNA in an RNA virus D. All of these choices are correct

D. All of these choices are correct

Helical and icosahedral are terms used to describe the shapes of a virus A. Core B. Envelope C. Capsomere D. Capsid

D. Capsid

A 75-year-old male, hypersensitive on Amlodipine 5 mg 1 tab once daily sought consult with his physician due to skin lesion on the left side of his back and chest, associated with itching and burning sensation. Condition was noted about 2 days PTC as onset of body malaise and undocumented fever. Patient had history of varicella infection during childhood. On examination there were grouped vesicles at the back and chest with erythematous base. Some lesions are beginning to get crushed. What will you give to this patient? A. Acyclovir 800 mg/tab 1 tab 5x a day for 7 days B. Vitamin A 50,000 IU single dose C. No need to give medicine for this patient D. Co-amoxiclav 625 mg 1 tab 2x a day for 7 days

A. Acyclovir 800 mg/tab 1 tab 5x a day for 7 days

Which of the following statements is more likely to be true of German measles (rubella) than measles (rubeola)? A. Transient arthralgia and arthritis are commonly seen in adults, especially women B. Koplik spots are present C. The rash, starts on the head and then spreads progressively to the chest, the trunk, and down the limbs, appears as light pink, discrete maculopapules that coalesce to form blotches, becoming brownish in 5-10 das D. Prodromal phase is characterized by low to moderate grade fever, sneezing, coughing, running nose and conjunctivitis

A. Transient arthralgia and arthritis are commonly seen in adults, especially women

In general, most DNA viruses multiply in the host cell’s ________ while most RNA viruses multiply in the host cell’s _______. A. cytoplasm; cell membrane B. cell membrane; cytoplasm C. nucleus; cytoplasm D. cytoplasm; nucleus

C. nucleus; cytoplasm

Which of the following causes exanthema subitum (roseola infantum) as well as infectious in immunocompromised patients? A. Rubella B. HHV 7 C. HHV 6 D. Rubeola

C. HHV 6

Which of the following statements is correct regarding measles and rubella virus? (MULTIPLE ANSWERS) A. Their virions contain an RNA polymerase B. They have single antigenic type C. They are RNA enveloped virus D. They are transmitted by respiratory aerosol

B. They have single antigenic type C. They are RNA enveloped virus D. They are transmitted by respiratory aerosol

A 50-year-old frail-looking woman with a 10-year medical history of systemic lupus erythematosus for which she was given corticosteroid treatment came to your clinic due to fever, cough, dyspnea, and hemoptysis. A direct sputum examination done reveals hyaline, septate, and uniform width hyphae that branch dichotomously. Which of the following is most likely the cause of her current condition? A. Bipolaris spp. B. Aspergillus spp. C. Mucor spp. D. Candida albicans

B. Aspergillus spp.

The most common mycotic pulmonary infection is caused by which of the following? A. Pneumocystis spp. B. Aspergillus fumigatus C. Rhizopus spp. D. Histoplasma capsulatum

D. Histoplasma capsulatum

Which of the following fungal diseases are NOT caused by the so-called “black molds”? A. Phaeohyphomycosis B. Maduromycosis C. Aspergillosis D. Chromoblastomycosis

D. Chromoblastomycosis

What laboratory dermatophyte identification method will show a long narrow septated and branching hyphase in dermatophytosis? A. Periodic acid-Schiff B. Potassium hydroxide preparation C. Dermatophyte test medium D. Culture

B. Potassium hydroxide preparation

Fungal cells that reproduce by budding are seen in the infected tissues of patients with which of the following diseases? A. Mycetoma, candidiasis, and mucormycosis B. Candidiasis, cryptococcosis, and sprorotrichosis C. Tinea corporis, tinea unguium, and tinea versicolor D. Sprorotrichosis, mycetoma, and aspergillosis

B. Candidiasis, cryptococcosis, and sprorotrichosis

A 60-year-old obese woman with long standing uncontrolled diabetes mellitus began to manifest swelling in the glabella associated with dark brown to black discoloration. As a resident physician in ENT training you called the attention of your consultant who considered rhinocerebral mucormycosis and insisted to have a direct examination of the nasal discharge ASAP. Which of the following findings would support the above diagnosis? A. Formation of pseudohyphae and cell budding B. Hyphae with production of blastoconidia C. Appearance of hyphae with uniform width, regular cross walls and bifurcations D. Presence of sparsely septated hyphae of uneven thickness and irregular branching

D. Presence of sparsely septated hyphae of uneven thickness and irregular branching

Which of the following statements associated with cutaneous mycoses are CORRECT? A. Clinical forms are based on site of involvement B. Lesions are somewhat worse with anthropophilic fungi as they produce the most number of irritants C. The choice location to obtain specimen for diagnosis is at the center of the lesion where hyphal growth is the most robust D. Zoophilic dermatophytes are easiest to identify because they produce the most number of conidia

A. Clinical forms are based on site of involvement

A 28-year-old florist had her finger pricked while pruning rose bushes. This leads to formation of localized pustule that became an ulcerated lesion. Few days later, nodules began to appear in her wrist and proximal arm. Tissue biopsy would most likely reveal which of the following? A. Granulomatous formation B. Presence of asteroid body C. Fusiform yeast cells D. All of the above

D. All of the above

A 10-year-old child undergoing chemotherapy for acute leukemia began to complain about recurring headaches, stiff neck, and disorientation. SF taken from a lumbar puncture reveal presence of encapsulated unicellular yeast cells on negative staining. The causative agent is best classified as a A. deuteromycete B. ascomycete C. basidiomycete D. zygomycete

C. basidiomycete

All of the following statements regarding Pneumocystis jiroveci are correct EXCEPT A. no known reservoir is demonstrated B. it does not cause disease in the absence of immunosuppression C. itraconazole is the drug of choice D. the cyst form is the infective stage

C. itraconazole is the drug of choice

1. Case: ENT referral of 57-year old male. Complaints: Sudden onset of fever, hypotension, tachycardia, no urine output, and a sunburn-like rash. History: Patient went to the ENT 3 days ago for epistaxis and was managed with a nasal pack. The patient went home against doctor’s advice. On examination, nasal packs still inside nostrils. Laboratory results: Elevated liver enzymes and elevated creatinine. Question: What toxin is primarily involved in this disease spectrum? A. ET B B. Spe A C. TSST-1 D. ET A

C. TSST-1

This virulence factor is considered important and, in fact, is the first requirement for successful infection of a host: A. Invasion factors B. Adherence factors C. Antigenic heterogeneity D. Antiphagocytic factors

B. Adherence factors

Case: 56-year old diabetic female Complaints: Fever, chills, and redness and swelling of her left posterior leg. PE: Affected site appears edematous, with an erythematous, raised lesion with sharp distinct edges between the affected area and unaffected skin. It was warm and tender to touch. Question: What is the most likely etiologic agent? A. Streptococcus agalactiae B. Streptococcus pneumoniae C. Streptococcus pyogenes D. Staphylococcus aureus

C. Streptococcus pyogenes

What is the drug of choice for B. anthracis treatment? A. Cephalexin B. Cotrimoxazole C. Clindamycin D. Ciprofloxacin

D. Ciprofloxacin

Which of the following show “cut glass” appearance on culture? A. Clostridium B. Corynebacterium C. Bacillus D. Mycobacterium

C. Bacillus

You find a microscopic slide from a patient’s specimen that contains S. mutans. The specimen is most likely: A. Pus from patient’s acne B. Patient’s vaginal secretions C. Plaque from patient’s tooth D. Patient’s stool

C. Plaque from patient’s tooth

Which of the following antibiotics can be used to suppress the toxin-producing bacteria causing pharyngeal pseudomembranous disease? A. Macrolides B. Cephalosporins C. Antifungals D. Aminoglycosides

A. Macrolides

Which of the following body fluids is NOT generally considered sterile? A. Tears B. Gall bladder bile C. Urinary bladder urine D. Blood

A. Tears

Which of the following media allows growth of gram-positive cocci only? A. CNA blood agar B. Blood agar C. MacConkey agar D. Chocolate agar

A. CNA blood agar

What causes the “bull neck” appearance in patients with diphtheria? A. Enlargement of lymph nodes B. Destruction of neck epithelium C. Necrosis of throat epithelium D. Edema of mediastinum

A. Enlargement of lymph nodes

These refer to microorganisms that are regularly found in a given area at a given age, and promptly reestablish themselves if disturbed: A. Transient microbiota B. Resident microbiota C. Pathogenic microbiota D. Opportunistic microbiota

B. Resident microbiota

It is during this phase of bacterial growth that sporulation of bacteria occur: A. Stationary B. Log C. Lag D. Death

A. Stationary

Which of the following statements concerning the staining of bacteria is correct? A. Mycoplasma pneumoniae is not visible using Gram’s stain B. Gram negative bacteria stains pink because it has a thick peptidoglycan layer C. Capsules are stained best with safranin D. Acid fast bacteria stains pink because it has a thick lipid layer

A. Mycoplasma pneumoniae is not visible using Gram’s stain

Considering its drug-resistant nature, which of the following is indicated in the treatment of enterococcal UTI in a 57-yo male with an indwelling urinary catheter? A. Amikacin B. Ampicillin C. Ceftriaxone D. Penicillin G

B. Ampicillin

What amino sugar can be found on the group-specific carbohydrate of the organism that causes scarlet fever? A. rhamnose-N-acetylgalactosamine B. glucopyranosyl-N-acetylgalactosamine C. rhamnose-N-acetylglucosamine D. rhamnose-glucosamine polysaccharide

C. rhamnose-N-acetylglucosamine

Case: 11-year old female. Complaints: Fever, difficulty and pain on swallowing for 3 days. PE: Erythema noted on uvula and tonsillo-pharyngeal areas, with multiple exudative lesions on both tonsillar pillars, and cervical lymphadenopathy. Question: For what reason would treatment immediately be started? To prevent: A. Poststreptococcal glomerulonephritis B. Rheumatic fever C. Streptococcal toxic shock syndrome D. Scarlet fever

B. Rheumatic fever

Which of the following has grape-like odor on culture? A. Mycoplasma B. Pseudomonas C. Bacillus anthracis D. Salmonella

B. Pseudomonas

This refers to threadlike appendages that are organs of locomotion: A. Fimbriae B. Cilia C. Flagella D. Pili

C. Flagella

Which of the following is TRUE about the bacterial cellular capsule? A. It functions as an effective permeability barrier B. It is located immediately exterior of the peptidoglycan layer of gram-negative bacteria C. It serves as protection against immune system attack D. It is made up of low-molecular weight disaccharides

C. It serves as protection against immune system attack

What kind of mutation results when one base pair is removed causing damage to DNA? A. Frameshift B. Missense C. Nonsense D. Rearrangement

A. Frameshift

Using a specific staining technique, certain bacteria did not stain positively with the primary stain and were decolorized after using a solution of 95% ethanol with 3% HCl. What stain did they absorb to produce a negative result? A. Methylene Blue B. Carbolfuchsin C. Crystal violet D. Safranin

A. Methylene Blue

hich of the following is NOT recommended as a diagnostic test for GABHS pharyngitis? A. PYR testing B. Susceptibility testing C. Gram stain D. Bacterial culture

C. Gram stain

What is the source of genetic material in bacterial transduction? A. Virophage B. Plasmid C. Donor cell D. Bacteriophage

C. Donor cell

What toxin is responsible for binding of Clostridium difficile to the receptors on the brush border of the gut? A. Theta toxin B. Toxin A C. Toxin B D. Alpha toxin

B. Toxin A

Case 29-year old Filipino male zoologist came home from New Zealand after research with sheep 3 weeks ago Complaint: Cough, dyspnea, and substernal pain Diagnostics: X-ray shows mediastinal widening Culture and Gram Stain: Large gram-positive rods What is the drug of choice to target the etiologic agent? A. Cotrimoxazole B. Ciprofloxacin C. Cefuroxime D. Clindamycin

B. Ciprofloxacin

What antiphagocytic factor is common in S. pneumoniae and N. gonorrhea? A. Endotoxin B. Protein F C. Capsule D. Pili

C. Capsule

Which of the following is characteristic of viridans streptococci? A. Pathogenic in the upper respiratory tract B. Not inhibited by optochin C. Soluble in bile D. Beta-hemolytic

B. Not inhibited by optochin

Case: Patient at the ER. Complaints: Fever and right-sided weakness. CT scan shows an infarct of the right MCA. Patient had a transcatheter mitral valve replacement 3 weeks ago. The attending physician’s main impression was an ischemic stroke caused by a thrombus from vegetation formed in the heart due to endocarditis. You know that the most common cause of this kind of endocarditis is: A. Staphylococcus epidermidis B. Staphylococcus aureus C. Streptococcus bovis D. Viridans streptococci

D. Viridans streptococci

Case: 6-year old male with cough, fever and ear pain with purulent ear discharge. Upon examination, he was irritable and cries significantly when ear lobe is pulled to examine. The impression of the attending physician was Otitis media due to pneumococcal infection. What is the most important virulence factor of the organism most likely considered to have caused the illness? A. M protein B. Lipoteichoic acid also in S. pyogenes cell wall C. Capsule D. Exotoxin production

C. Capsule

Which of the hepatitis infections is caused by a DNA virus? A. Hepatitis A B. Hepatitis D C. Hepatitis C D. Hepatitis B

D. Hepatitis B

What is the most common cause of transient aplastic crisis in patients with chronic hemolytic anemias? A. Parvovirus B19 B. Varicella zoster C. Rubeola D. Rubella

A. Parvovirus B19

Which of the following is correct regarding the treatment of rubella? A. Standard and droplet precautions are recommended for patients with rubella for 7 days after rash onset B. Absence of clinical signs after administration of immune globulin in a pregnant woman assures that congenital infection did not occur. C. IgG antibody can be used to detect maternal infection after exposure. D. In pregnant individuals, rubella vaccine administration within 3 days of exposure theoretically prevents illness

A. Standard and droplet precautions are recommended for patients with rubella for 7 days after rash onset

What group of viruses have a DNA genome but do not have icosahedral geometry? A. Papillomaviridae B. Hepadnaviridae C. Poxviridae D. Herpesviridae

C. Poxviridae

Which of these viral conditions CANNOT be prevented by vaccination? A. Rubella B. Rubeola C. Chickenpox D. 5th disease

D. 5th disease

Which of the following statements is correct with regards to Measles Virus Infection? A. Measles virus is a member of the togavirus. B. Measles immune response is involved in disease pathogenesis. C. Measles begins with malaise, low grade fever, and a morbilliform rash appearing on the same day. D. Typical measles is diagnosed based on identification of the virus from nasopharyngeal and conjunctival swabs.

B. Measles immune response is involved in disease pathogenesis.

Which of the following correctly describes the SARS virus? A. Naked RNA B. Naked DNA C. Enveloped RNA

C. Enveloped RNA

Which of the following statements is incorrect regarding measles and rubella virus? A. They are RNA enveloped viruses. B. They are transmitted by respiratory aerosol. C. They have a single antigenic type. Both of them have a single antigenic type. D. Their virions contain an RNA polymerase

B. They are transmitted by respiratory aerosol.

Primary mode of transmission of Fifth Disease is via: A. Airborne droplet nuclei B. Skin-to-skin contact C. An arthropod vector D. Respiratory droplet

D. Respiratory droplet

Which of the following disease presentations can be caused by a double-stranded RNA virus? A. Acute gastroenteritis in children B. Oral and genital warts C. Rashes localized around the mouth and distal extremities D. Inflammation of one or both parotid glands

A. Acute gastroenteritis in children

A 28-year-old female health care worker wants to be immunized with rubella vaccine because of fear that she might get infected in her workplace. She claimed that she could not recall her immunization history because her mother died when she was still 6 years old. What can you advise this patient regarding her concern? A. Inform her to watch out for febrile seizure as one of the adverse effects of this vaccine. B. Advise her not to get pregnant for 28 days after receiving the vaccine. C. Discourage the patient because of the potential risks of this vaccine. D. Tell her to isolate herself after immunization

B. Advise her not to get pregnant for 28 days after receiving the vaccine.

Which of the following statements regarding herpes viruses is correct? A. They establish latent infections and persist indefinitely in infected hosts. B. All herpes viruses differ in structure and morphology. C. DNA replication and capsid assembly occurs in the cytoplasm. D. They are reactivated in healthy patients.

A. They establish latent infections and persist indefinitely in infected hosts.

You are attending to a 4-year-old child in the ER who was brought in for fever and rashes. On examination, you noted spots in the child’s buccal mucosa, consistent with measles. Which of the following is TRUE about the disease? A. The causative agent is a segmented RNA virus. B. The virus has a negative-sense RNA genome. C. The disease has no vaccine yet. D. The disease is also called Rubella infection.

B. The virus has a negative-sense RNA genome.

Which of the following is the most sensitive test for the detection of herpes virus and is recommended for the diagnosis of herpes meningitis/encephalitis? A. Polymerase Chain Reaction B. Serology C. Cytopathology D. Isolation and identification of virus

A. Polymerase Chain Reaction

A 10-year-old was brought to the school clinic by his teacher because of the noted redness on his skin. His mother was called and said that 1 week ago the patient had onset of mild undocumented fever associated with colds. The symptoms resolved after 2 days but she noted raised erythematous rash on his cheeks and 4 days after, the rash now described as lacy pink to erythematous macules and papules spread down to the trunk, arms, and legs. As the school physician on duty, what is the best thing to do? A. Advise hospital admission and isolation B. Give supportive treatment C. Administer IV immune globulin to prevent complications D. May give vaccine once the patient recovers

B. Give supportive treatment

A 27-year-old female, currently on her 6 weeks age of gestation, sought consult at the clinic for medical advice. She has been exposed to her 3-year-old nephew who had measles infection. Upon history taking, the patient cannot recall her vaccination history. She denied having any childhood infections such as chickenpox, mumps, or measles. The patient asked you if she could have a measles vaccination and postexposure prophylaxis. What will you advise the patient? A. All individuals at risk should receive immunoglobulin prophylaxis within 6 days of exposure to measles virus. B. Exposed patients (excluding pregnant women and with impaired immune system) should also be given the measles vaccine 5-6 months later to confer protection. C. Measles vaccine administration is contraindicated in individuals who have immediate anaphylactic shock to previous measles vaccination, to pregnant women, HIV patients, and patients on immunosuppressive therapy. D. All of the above.

D. All of the above.

An 18-year-old male medical student sought consult at the University clinic due to malaise, low-grade fever, and a morbilliform rash appearing on the same day. The rash starts on the face, extends over the trunk and extremities, and rarely lasts more than 3 days. How will you manage this patient? A. Give Vitamin A 50,000 IU single dose. B. Give Cetirizine 10mg 1 tab once daily. C. Supportive treatment. D. Give Acyclovir 800mg 1 tab 5x a day for 7 days

C. Supportive treatment.

A 75-year-old male, hypertensive on Amlodipine 5mg 1 tab once daily sought consult with his physician due to skin lesions on the left side of his back and chest, associated with itching and burning sensation. Condition was noted about 2 days PTC as onset of body malaise and undocumented fever. Patient had history of Varicella infection during childhood. On examination, there was grouped vesicles at the back and chest with erythematous base. Some lesions are beginning to get crusted. What is recommended for this patient? A. Vitamin A 50,000 single dose. B. Valacyclovir 500mg/tab 2 tabs BID for 7 days. C. No need to give medicine for this patient. D. Co-amoxiclav 625mg 1 tab 2x a day for 7 days

B. Valacyclovir 500mg/tab 2 tabs BID for 7 days.

These are fleeting enanthem seen as smell, red spots (petechiae) on the hard palate. A. Forscheimer’s spots B. Rose spots C. Koplik’s spots D. Hermann’s rash

A. Forscheimer’s spots

“Blueberry muffin lesion” is one of the clinical manifestations of which of the following disease? A. Rubella B. Rubeola C. Roseola infantum D. Erythema infectiosum

A. Rubella

What family of viruses do Dengue viruses belong to? A. Flaviviruses B. Paramyxoviruses C. Retroviruses D. Togaviruses

A. Flaviviruses

A 10-year-old female is brought to you with fever, headache, and rashes. The mother first noticed the rashes on the child’s face and spread outward. You think it is a rubella infection. Which of the following is true about the infection? A. The virus has a lipid-containing envelope. B. The genome is double stranded RNA. C. The genome is a negative-sense RNA. D. The genome contains an RNA polymerase.

A. The virus has a lipid-containing envelope.

A mother brings her 4-year-old daughter due to fever and rashes that started at the hairline, and spreads to the face and body. After extracting immunizations history, you learn that the child did not receive her Rubeola vaccine at 9 months of age. Which of the following is TRUE about the causative organism? A. It belongs to the Paramyxoviridae family. B. It has segmental RNA. C. It belongs to the Togaviridae family. D. It is a double-stranded RNA virus.

A. It belongs to the Paramyxoviridae family.

This HPV virus is associated with oropharyngeal papilloma disease: A. HPV 18 B. HPV 6 C. HPV 16 D. HPV 11

C. HPV 16

A 5-year-old child develops fever, maculopapular rash that starts on the head and then spreads progressively to the chest, the trunk and down the limbs. Condition was also associated with coryza, conjunctivitis, and a small, bluish white ulcerations on the buccal mucosa opposite the lower molars. The physician can occlude that: A. Treatment of the child with the antiviral drug ribavirin should be initiated immediately to minimize the chance of development of acute encephalitis. B. A rash will soon develop on the child’s face and will last only 2-3 days. C. The child has probably not been successfully vaccinated with the MMR vaccine.

C. The child has probably not been successfully vaccinated with the MMR vaccine.

What is the most common complication of measles? A. Encephalitis B. Hepatitis C. Meningitis D. Otitis media

D. Otitis media

A 23-year-old female medical student presents to you with jaundice, right upper quadrant pain, and fever. She remembered to have eaten chicken proven after their long quiz a week ago. Considering a Hepatitis A infection, which of the following is TRUE about the disease? A. The causative agent is a double-stranded DNA virus. B. The causative agent is of the picornaviridae family. C. The causative agent has an envelope that adds to its virulence. D. The disease must have been transmitted through the blood.

B. The causative agent is of the picornaviridae family.

Which of the following statements about genital herpes infections is correct? A. Latent herpes simplex virus can be found in dendritic cells. B. Recurrent episodes caused by reactivation of latent virus tend to be more severe than the primary infection. C. Virus cannot be transmitted in the absence of apparent lesions. D. They can be caused by either herpes simplex virus type 1 or type 2.

D. They can be caused by either herpes simplex virus type 1 or type 2.

A 22-year-old lady came in with a chief complaint of pruritic rash, which began on the face, progressing to the neck, trunk, and extremities. On further history, there was low grade fever, muscle pain, headache, and cough which was noted approximately 5 days prior the onset of rashes, which spontaneously resolved. On physical examination, there was note of lymphadenopathy and pink to red macules and papules on the face, neck, trunk, and extremities. Which of the following is the cause of the patient’s condition? A. Parvovirus B19 B. Rubeola virus C. Rubella virus D. Varicella virus

B. Rubeola virus

An impoverished 51-year-old farmer was examined by a newly licensed freshly deployed doctor to the barrios. Patient exhibit swelling in his right foot with an oozing wound draining dark red to black granules. He confessed the condition developed 2 months after he stepped on something hard barefooted while preparing his land for the next planting season. It caused a tear on his heel which, until the time of consult, the wound has not fully healed. You sent the tissues for biopsy and culture studies to a university hospital 1 hour away by car. 2 weeks later, a classmate of yours in medical school, working in the said medical facility, sent a picture of the etiologic agent via your FB messenger without divulging the rest of the microbiologic report. Which anti-fungal drug would be the best suited for his condition? A. Nystatin B. Miconazole C. Flucytosine D. Ketoconazole

D. Ketoconazole

Which of the following is an appropriate association with aflatoxin? A. Amanita muscaria – urothelial carcinoma of the urinary bladder B. Phialophora verrucose – gastric adenocarcinoma C. Exophilia jeanselmei – renal cell carcinoma D. Aspergillus fumigatus – hepatocellular carcinoma

D. Aspergillus fumigatus – hepatocellular carcinoma

Which statement best describes dermatophytes? A. They are classified according to their natural habitats which include humans, soil, or water. B. All fungi are dermatophytes. C. Represented by more than 120 species divided among three genera. D. They are divided among three genera – Epidermophyton, Microsporum, and Trichophyton

D. They are divided among three genera – Epidermophyton, Microsporum, and Trichophyton

Dimorphism in fungi is usually dependent on: A. Ion concentration B. Temperature C. Oxygen availability D. Chitin content

B. Temperature

A 28-year-old florist had her fingers pricked while pruning rose bushes. This leads to formation of localized pustule that becomes an ulcerated lesion. Few days later, nodules began to appear in her wrist and proximal arm. Tissue biopsy would most likely reveal which of the following? Select one or more: 1. A granulomatous inflammation 2. Presence of asteroid body 3. Fusiform yeast cells 4. All of these

1. A granulomatous inflammation 2. Presence of asteroid body 3. Fusiform yeast cells 4. All of these

Fungal infections cause which type of inflammation? A. Suppurative B. Granulomatous C. Gangrenous D. Caseous

B. Granulomatous

All the following statements regarding Pneumocystis jiroveci are correct, EXCEPT: A. Itraconazole is the drug of choice. B. It does not cause disease in the absence of immunosuppression. C. The cyst form is the infective stage. D. No known reservoir is demonstrated.

A. Itraconazole is the drug of choice.

Cutaneous candida infection is diagnosed by: A. Typical appearance of pruritic eruption that appears as macerated red erythematous plaques, and thin patches with satellite vesicopustules B. KOH examination C. Typical appearance of pruritic eruption that appears as macerated red erythematous patches, and thin plaques with satellite vesicopustules D. Erythematous base with collarette detachable scale

C. Typical appearance of pruritic eruption that appears as macerated red erythematous patches, and thin plaques with satellite vesicopustules

Which of the following structures in both prokaryotes and eukaryotes A. Nucleus B. Mitochondria C. Ribosomes D. Peptidoglycan containing cell wall

C. Ribosomes

What is the growth rate of bacteria in stationary phase A. Constant B. Zero C. negative D. increasing

B. Zero

What is the temperature of hot air oven A. 100 °C for 1 hr B. 120°C for 1 hr C. 160 °C for 1 hr D. 250 °C for 1 hr

C. 160 °C for 1 hr

The pattern in the stationary phase is due to A. Death of all cells B. Exponential growth of all cells C. Growth and death of all cells equal D. Constant addition of nutrients to the system

C. Growth and death of all cells equal

The LPS serves as a virulence factor due to its endotoxin effect. It is found on which layer of the cell A. Inner membrane B. Periplasmic space C. Outer membrane D. Peptidoglycan layer

C. Outer membrane

Mycoplasma species lack which of the following components A. Lipoproteins B. Plasma membrane C. Ribosomes D. Peptidoglycan

D. Peptidoglycan

The bacteria with mucoid appearance due to the presence of a capsule A. Salmonella typhi B. Streptococcus pneumoniae C. Bacillus D. Corynebacterium

B. Streptococcus pneumoniae

Which of the following is required in the formation of a mating pair during the process of conjugation such as E.coli? A. Pilus B. Lysis of donor C. Restriction of endonucleases D. Integration of transposon

A. Pilus

Which one of the following microorganisms can be part of the normal vaginal flora and cause meningitis in newborns? A. C albicans B. Corynebacterium species C. S epidermidis D. Group B streptococci

D. Group B streptococci

Certain microorganisms are never considered to be members of normal human microbiota. Which of the ff organisms is always considered a pathogen? A. Escherichia coli B. Staphylococcus aureus C. Bacteroides fragilis D. Mycobacterium tuberculosis

D. Mycobacterium tuberculosis

Which of these organisms is a common resident of the upper respiratory tract, may settle on defective heart valves when introduced into the bloodstream during oral surgery and eventually may cause infective endocarditis? A. Diphtheroids B. Viridans streptococci C. Prevotella sp. D. Nonpathogenic Neisseria sp

B. Viridans streptococci

Which of the following interleukin mediates fever production as a result of release of lipopolysaccharides endotoxins) during lysis of gramnegative bacteria? A. 1 IL B. 2 C. 3 D. 4

A. 1 IL

Exotoxins are important in certain diseases. Which of the following diseases are correctly paired with each other? A. Cholera - E. Coli B. Toxc Shock Syndrome - Strep. C. Scarlet Fever - Bacillus Anthracis D. Gas Gangrene - Clostridium Perfringes

D. Gas Gangrene - Clostridium Perfringes

Which of the following statements is true about tetanus and tetanus toxoid? A. TT kills neurons B. The morbidity rate of Tetanus is less than 1% C. Double vision is the 1st sign of tetanus D. TT acts on inhibitory interneuron synapse

D. TT acts on inhibitory interneuron synapse

What is the biochemical test that helps in the identification of Clostridium perfringens A. Elek’s test B. Lecithinase activity C. Tumbling motility D. Production of H2S

B. Lecithinase activity

What is the drug of choice for treatment of infection caused by Actinomyces spp? A. Penicillin B. Erythromycin C. Tetracycline D. Trimethoprim-sulfamethoxazole

A. Penicillin

Important virulence factor of Bacillus anthracis? A. Lecithinase B. Protective antigen C. Lipopolysaccharide D. Toxin inhibits protein elongation factor EF 2

B. Protective antigen

A patient who has not maintained good dentition presents with induration and swelling of the mandibular area. On examination, you note purulent material draining from a small opening. The material appears yellowish, and there are some visible granules. You perform a Gram stain, and pleomorphic gram-positive rods with short branches are noted along with cells suggestive of acute and chronic inflammation. You suspect which of the following organisms? A. Actinomyces israellii B. Streptomyces somaliensis

A. Actinomyces israellii

Classmate noted non-painful wart like lesions on genitals. The causative agent is: A. Single stranded DNA virus B. Double stranded RNA virus C. Causative agent for cancers D. Has own reverse transcriptase

C. Causative agent for cancers

Which of the following diseases is caused by a virus of the flaviviridae family? A. Ebola B. Hepatitis C C. Marburg D. Norwalk sickness

B. Hepatitis C

What are the toxin superantigens of S. aureus? A. Exfoliatin ; TSST B. leucocidin ; Exfoliatin C. Protein A ; Lecocidin D. TSST ; Protein A

A. Exfoliatin ; TSST

Which polyomavirus can cause skin cancer? A. Papilloma virus B. Merkel cell virus C. HHV8 D. Langerhans cell virus

B. Merkel cell virus

Which of the herpesviridae is known to cause the sarcoma found in aids patients? A. HIV B. HHV C. HSV T D. HZV

A. HIV

What biochemical test is the bacteria’s capability needed to produce an enzyme that catalyzed the conversion of hydrogen peroxide into oxygen and water? A. catalase B. coagulase C. urease D. endospore

A. catalase

Which of these hepatitis-causing agents is an RNA virus and requires a concomitant hepatitis B infection? A. A B. C C. D

C. D

Which of the ff are correct regarding candidiasis? A. The vast majority of human infection is derived from indigenous microflora. B. Candida albicans is the most common candidal pathogen. C. Prolonged antibiotic use is the most common precipitating factor. D. All of the above

D. All of the above

A 63 year old patient with severe diabetes sought consult due to facial pain, headache, stupor, and bulging discolored eye. Examination of bloody nasal discharge shows hyphae elements branched at right angles, thin walls, lack crosswalls. Which of the ff statements is CORRECT? A. Patient may have inhaled large inoculum of conidia B. So-called breadmolds may be responsible C. The etiologic agent may be a dimorphous fungus D. Adequate treatment may include griseofulvin

. So-called breadmolds may be responsible

TRUE of cryptococcosis: A. Caused by a single-celled basiodiomycete that contains a proteoglycan capsule B. Systemic infection with impaired cell-mediated immunity C. May involve the brain and meninges

C. May involve the brain and meninges

Which systemic mycosis is transmitted through inhalation of arthrospoes? A. Histoplasmosis B. Blastomycosis C. Coccidodiomycosis D. Paracoccidodiomycosis

C. Coccidodiomycosis

Which of the following has a cigar-shaped appearance? A. Tinea capitis B.Sporothrix schenckii C. Diphyllobothrium latum D.Rhizopus

B.Sporothrix schenckii

the presence of sclerotic or muriform bodies or the so called copper pennies is highly indicative of what fungal infection? A. zygomycosis B. sporotrichosis C. chromoblastomycosis

C. chromoblastomycosis

True of mycetoma: A. May also be caused by actinomyces bacteria B. Actual leg not foot, is the common site of infection C. Reponsible organism include wagnellier dermatidis

A. May also be caused by actinomyces bacteria

The etiologic agent of tinea nigra

Hortaea wernickii

Which of the following hemolysis is demonstrated by Viridans Strep.? A.Alpha B. Beta C.Gamma D.Nonhemolytic

A.Alpha

Which of the following is the causative agent of acute bacterial endocarditis? A. Staphylococcus aureus B. Staphylococcus epidermidis C. Streptococcus pyogenes D. Streptococcus pneumoniae

A. Staphylococcus aureus

What is a beta-hemolytic, bacitracin susceptible, CAMP negative bacteria?

Group A Streptococcus

Which of the following test positive for quellung test?

Streptococcus pneumoniae

What virulent structure in S..aureus is responsible to the adherence to fibrinogen which forms fibrin clots? A. Catalase B. Clumping Factor (or Bound Coagulase) C. Protein A D. Panton-Valentine Leukocidin

B. Clumping Factor (or Bound Coagulase)

Which of the following is used for methicillin-resistant S. aureus? A. Nafcillin B. Vancomycin C. Linezolid D. Quinupristin-dalfopristin

B. Vancomycin

What is the most common causative agent of neonatal bacteremia A. S. aureus B. S. agalactiae C. S. pyogenes D. S. pneumoniae

B. S. agalactiae

Which of the following regarding herpes virus is CORRECT A. All herpes viruses differ in structure and morphology. B. They establish latent infections that persist indefinitely in infected hosts C. They reactivate in healthy patients D. DNA replication and caspid assembly occurs in the cytoplasm

B. They establish latent infections that persist indefinitely in infected hosts

A 4 years old child is brought to the ER for fever and rashes which starts from the hairline, to face and the body . Which is true of the causative agent A. Segmented genome Non-segmented B. Double stranded RNA Single stranded, negative RNA virus C. Circular DNA D. Member of the Paramyxoviridae family

D. Member of the Paramyxoviridae family

Which of the ff statements about genital herpes lesions is correct? A. Virus cannot be transmitted with the absence of apparent lesions B. Recurrent infection tend to be more severe than the primary infection C. Caused by either HSV1 or HSV2

A. Virus cannot be transmitted with the absence of apparent lesions

21 y/o male comes to the ER with these manifestations: fever and rash, noted initially on face and back; macules evolving to papules; vesicles w/ erythematous base (dewdrops on a rose petal); pustules forming crusts; lesions appearing in crops. What is the most probable diagnosis? A. Measles B. Varicella C. Dengue D. Rubella

B. Varicella

Which of the following statements is incorrect about measles and rubella virus? A. They are enveloped RNA viruses B. Their virion has an RNA polymerase C. They have a single antigenic type D. They are transmitted by respiratory aerosols

D. They are transmitted by respiratory aerosols

The incubation period for german measles viral infection mostly lasts ___ days. A. 5 B. >12 C. 8-15 D. 10-21

B. >12

Which of the following statements is more likely to be true of the german measles A. Transient arthralgia and arthritis is common in adults, especially in women B. Prodromal stage is characterized by low to moderate grade fever, sneezing, coughing, runny nose, and conjunctivitis C. Koplik spots are present D. The rashes, which start on the head then spreads progressively to the chest, the trunk, then down to the limbs appears as light pink maculopapules that coalesce to form blotches, becoming brownish in 5-10 days

A. Transient arthralgia and arthritis is common in adults, especially in women

An 18 year old male medical student sought consult at the university clinic d/t malaise, low-grade fever, and a morbilliform rash that occured on the same day. The rash started on the face, going to the trunk and extremities and rarely lasts more than 3 days. What is your diagnosis? A. Dengue fever B. Chicken pox C. Varicella D. German measles

D. German measles

Which is TRUE regarding development of herpes zoster? A. It is acquired from herpes zoster B. After exposure to persons with active varicella lesions C. It is mostly determined by host- virus relationship D. Immunocompetent seronegative persons easily acquire the disease with exposure from immunocompromised seropositive individual

C. It is mostly determined by host- virus relationship

Among immunocompromised individuals especially those with impaired neutrophil function, which of these infectious agents will most likely cause the disease? A. Non-bullous impetigo caused by Group A Streptococci B. Bullous impetigo caused by Coagulase negative Staphylococci C. Pyoderma caused by non Group A streptococci D. Exfoliative disease (SSSS) caused by Coagulase positive Staphylococci

D. Exfoliative disease (SSSS) caused by Coagulase positive Staphylococci

What is the most common cause of prosthetic valve endocarditis? A. Staphylococcus aureus B. Viridans Streptococci C. Staphylococcus epidermidis

C. Staphylococcus epidermidis

How long should contact precaution be observed for an infant infected with Rubella? A. 1 month B. 6 months C. 12 months

C. 12 months

Rubeola infected patients are considered infectious during: A. A. 1-2 days before onset of symptoms to 4 days after the appearance of rash B. 7 days after the appearance of rash C.1-2 days before onset of symptoms to 4 days after rash disappeared D.5 days before the onset of symptoms to 4 days after the rash crusted

A. A. 1-2 days before onset of symptoms to 4 days after the appearance of rash