MICROBIOLOGY

Physician’s Licensure Examination

June 4, 2008

1. Organisms that utilize only the fermentative pathways in their metabolism are known as:
A. Anaerobes
B. Obligate aerobes
C. Microaerophiles
D. Facultative anaerobes

2. At which stage in the growth of a bacteria is there a slow loss of cells through death that sis
just balanced by the formation of new cells through growth and division.
A. Acceleration
B. Maximum stationary
C. Lag phase
D. Exponential

3. Bacteremic shock is triggered by

A. Exotoxins
B. Endotoxins
C. Hyaluronidase
D. Hemolysin

4. The toxic property of endotoxin lies in the

A. Polysaccharide cord
B. Teichoic acids
C. Lipid A
D. Protein A

5. Which of the following components of a bacterial cell wall is susceptible to lysozyme?

A. Lipoprotein
B. Peptidoglycan
C. Teichoic acid
D. Phospholipid

6. The primary difference between Gram positive and Gram negative bacteria lies in the
A. Nucleus
B. Flagella
C. Cell wall
D. Ribosome

7. Koch’s postulates states the following except

A. The organism must be isolated in pure culture.
B. It must produce the same disease when pure culture is inoculated into experimental
animal.
C. The organism must be recovered in pure culture from the experimentally infected
animals.
D. The disease must be reproduced in susceptible animals by inoculation of cell-free
products of microbial growth.

8. One of the following is the appropriate sample for the isolation of Salmonella typhi during
the first week of a suspected cases of typhoid fever
A. Blood
B. Stool
C. Urine
D. CSF

9. Which of the following is not true for E. coli?

 A. Can cause meningitis in neonates
B. Used as index of fectal contamination of water
C. Most frequently isolated Gram negative organism from infection
D. Most abundant flora of the colon

10. The most frequently isolated type of H. influenzae in cases of bacterial meningitis in
children between 6 months to 2 years is
A. Serotype A
B. Serotype B
C. Serotype C
D. Serotype D

11. Which of the incorrect statement concerning gonorrhea?

A. Infection in men is more frequently symptomatic than in woman.
B. The definitive diagnosis can be made by detecting at least a 4-fold rise in antibody
titer to N. gonorrheae.
C. The main host defenses against gonorrhea are antibodies, complement and
neutrophils.
D. A presumptive diagnosis can be made by finding Gram negative, kidney bean-
shaped diplococci within neutrophils in urethral discharge.

12. The vaccine currently used for the prevention of S. pneumoniae is made from
A. A mixture of 23 recombinant S. pneumoniae strains
B. Killed form of the most prevalent S. pneumoniae serotypes
C. Capsular polysaccharides from 23 S. pneumoniae serptypes
D. Diphtheria toxoid conjugated with the capsular polysaccharide from 23 S.
pneumoniae serotypes

13. Which of the following tests is more specific in the diagnosis of syphilis?
A. TPHA (Treponema Pallidum Hemagglutination Test)
B. ART (Automated Regain Test)
C. RPR (Rapid Plasma Reagin)
D. VDRL (Venereal Disease Research laboratory)

14. The tubercle, a lesion in tuberculosis, is characterized by

A. Bacilli surrounded by lymphocytes and fibroblasts
B. Hyperplasia of epithelial cells
C. Dilation with erosion of pulmonary artery
D. Erosion of epithelial lining

15. The following are some general characteristics of Mycobacterium leprae except
A. Acid fast rods
B. Humans are the only significant reservoir
C. Can be grown readily in the laboratory using either artificial media or cell culture
D. Cell wall has high lipid content

16. The pathogenesis of Mycobacterium tuberculosis follows certain norms. Which of the
following statements is not true?
A. Mycobacterium tuberculosis produces an exotoxin and contains an endotoxin in its
cell wall.
B. Reactivation is seen primarily in debilitated or immunocompromised patients.
C. The primary lesion usually appears in the lungs.
D. Dissemination may be by bloodstream or erosion of tubercle and spread to
contagious areas.

17. The diagnosis of chickenpox can be done by

A. Symptomalogy, including characteristic appearance of lesions
B. Serology
 C. Tzanck’s smear
D. All of the above

18. A 21-year old female patient came to you complaining of profuse vaginal discharge with
finshy odor and itching of the vulva. Examination of the discharge showed vaginal epithelial
cells that contain tiny pleomorphic bacilli within the cytoplasm clue cells. The pathogen
involved is
A. Treponema paqllidum
B. Hemophilus ducreyi
C. Neissaria gonorrhea
D. Gardnerella vaginalis

19. A characteristic “rose spots” may appear in the second to the third week of this disease.
A. Shigellosis
B. Typhoid fever
C. Amoebic dysentery
D. Cholera

20. Which of the following would best describe disinfectants and antiseptics?
A. Disinfectants and antiseptics are highly toxic in living tissue.
B. They destroy all bacteria.
C. Disinfectants are used in inanimate objects while antiseptics are used for living
forms like human tissues.
D. Both are used to kill microorganisms in living tissues.

21. The essential antigen in pneumococcus that protects the organism from phagocytosis and is
used to classify the organism into specific antigenic types is
A. Somatic carbohydrate
B. Flagellar antigen
C. Capsular polysaccharide
D. Nucleoprotein structure

22. The isolation and identification of Staphylococcus epidermis from one bottle of a series of
three blood cultures most likely indicates which of the following conditions?
A. Acute staphylococcal endocarditis
B. Staphylococcal septicemia
C. Staphylococcal contamination
D. Toxic shock syndrome

23. Which specimen should not be refrigerated after collection even if it cannot be processed at
once?
A. Stool
B. Urine
C. Blood
D. Sputum

24. Coagulase test is used to classify

A. Staphylococci
B. Streptococci
C. Neisseria
D. Branhamella

25. CSF is collected in three vials for laboratory examination. Which vial should not be used for
bacteriology?
A. Vial 1
B. Vial 2
C. Vial 3
D. None of the 3 vials
26. The incubation period of influenza is commonly
A. 2 – 4 days
B. 6 – 7 days
C. 8 – 10 days
D. 14 – 21 days

27. The etiologic agent of about 90% of post-transfusion hepatitis is

A. Hepatitis B
B. Hepatitis C
C. Hepatitis D
D. Hepatitis G

28. The hepatitis profile done on a patient showed a HbsAg negative, IgM core antibody
negative and Hbs antibody prositive results. What would e the best interpretation for these
results?
A. The patient probably has chronic active hepatitis.
B. The patient is immune to Hepatitis B.
C. The patient is probably in the “window phase” of the infection.
D. The patient has acute Hepatitis B infection.

29. Which of the following is not a contraindication for administering a live attenuated viral
vaccine?
A. Pregnancy
B. Current febrile illness vaccine
C. Immunosuppressive condition
D. Administration of another live

30. Hepatitis C poses a big challenge in clinical practice because of the

A. Presence of genetic subtypes that present with different pathogenic mechanisms.
B. Difficulty in developing vaccines due to the genetic heterogeneity and possible
antigenic variability.
C. Problems in laboratory diagnosis due to possible antigenic variability among genetic
types
D. All of the above

31. Core window phase in HBV infection means

A. Negative for HBsAg but positive for anti-HBs markers
B. Positive for anti-HBe and anti-HBc antibodies
C. Positive for Hbs, Hbe and Hbc antigens
D. Negative for anti-Hbs, anti-Hbe and anti-Hbc antibodies

32. The presence of transient rashes among dengue patients has been abserved to be a
prognostic sign associated with
A. Mild illness and recovery
B. Development of encephalitis
C. Chronic relapsing infections
D. Development of hemorrhagic infections

33. The presence of antibodies against the primary cause of dengue infection means
A. Protection against the infecting serotypes for a long time
B. Long term cross protection against the other serotypes
C. Incomplete immunity to the infecting virus
D. Short term protection against reinfection with the same serotype
34. The cause of shock in dengue and other hemorrhagic fevers is
A. Partly due to virus
B. Largely due to immune-mediated damage virus-infected cells
C. Both A and B are correct
 D. Both A and B are wrong

35. The problem of cross infection with different serotypes of dengue relates to
A. Difficulties in developing a safe vaccine
B. Difficulty in establishing diagnosis
C. Both A and B are correct
D. Both A and B are wrong

36. Mycobacterium tuberculosis is an acid fast organism and this is due to which of the
following
A. Mycolic acid
B. Sulfatides
C. Cord factor
D. Peptidoglycan

37. Acute bronchitis is common in the first 2 years of life and results from inflammatory
obstruction of the small airways. The most common causative
A. Adenovirus
B. Parainfluenza
C. Mycoplasma
D. Respiratory syncytial virus

38. Blue green pus in wounds and burns is due to

A. Staphylococcus aureus
B. Pseudomonas aeruginosa
C. Streptococcus pyogenes
D. Klebsiella pneumoniae

39. A 23-year old pregnant woman decided to continue with her pregnancy even when she
tested for anti-rubella IgM on the 8th week of gestation. Which of the following findings will
indicate congenital rubella?
A. Anti-rubella IgG in the mother
B. Anti-rubella IgM in the mother
C. Anti-rubella IgG in the baby
D. Anti-rubella IgM in the baby

40. Which of the following statements on poliomyelitis is false?

A. Poliomyelitis may be transmitted via droplet or fecal-oral route
B. Among the poliovirus strains, type 1 is the paralytogenic
C. The oral polio vaccine is safe to given even to the immunocompromised
D. The Philippines, along with the other countries of the Western Pacific
Region, was declared Polio-free in 2000

41. Koplik’s spots are pathognomonic of

A. Rubeola
B. Chickenpox
C. Measles
D. Rubella

42. A 30-year old woman undergoing chemotherapy for acute lymphocytic leukemia came to
the OPD complaining of small vesicular eruptions across her left breast. The eruptions
progressed to ulceration and crushed pustules. She has similar experience about a year a
before. This person could be suffering from
A. Shingles
B. Measles
C. Rickettsialpox
D. Chickenpox
43. A 22-year old male complained of sore throat with fever and lymphadenopathy. Ther is
lymphocytosis with a typical cell agglutination. The probable diagnosis is
A. Infectious mononucleosis
B. Infectious hepatitis
C. Herpes infection
D. Influenza

44. Infection from Mycobacterium avium intracellulare are often seen in AIDS patients. The
following are attributes of pathogenicity for this except
A. It is an intracellular organism.
B. It is not considered contagious.
C. It is an opportunistic agent rather than a pathogen.
D. Cell wall is entirely different from M. Tubercolosis.

45. Which of the following appendages is involved in the transfer of DNA during bacterial
conjugation?
A. Peplomers
B. Axial filaments
C. Fibriae
D. Flagella

46. The following are true of Group B streptococci except

A. They are precipitated with streptococcus agalactiae antisera
B. They are an important causative organism of neonatal sepsis
C. An effective vaccine against the organism incorporates proteinaceous
capsular antigen
D. They are part of the vaginal flora

47. A 30-year old man had knee surgery following a car accident. A few days after the surgery,
the suture line was noted to be infected. Lab report showed Gram positive coccus, coagulase
positive, catalase positive and beta hemolytic. The organism is
A. Streptococcus pyogenes
B. Staphylococcus epidermis
C. Streptococcus agalactiae
D. Staphylococcus aureus

48. The following are four important genera of Gram positive rods. Which one among them is
anaerobic?
A. Corynebacterium
B. Clostridium
C. Listeria
D. Bacillus

49. Which of the following statements is NOT true of typhoid fever/Salmonella typhi?
A. Salmonella typhi may be considered part of the normal flora of humans.
B. The major vehicles of transmission are foods contaminated with animal
feces.
C. Fever, lethargy, abdominal pain are early symptoms with diarrhea
occurring in the second week of illness.
D. S. typhi can cause four disease states in humans: typhoid fever, carrier
state, sepsis and gastroenteritis.

50. Bacterial capsules are protective walls that surround the cell membranes. Which of the
following is NOT true about bacterial capsules?
A. Produced by both Gram positive and Gram negative bacteria
B. Usually composed of simple sugar residues except Bacillus anthracis whose
capsules is of amino acid residues
C. Capsule production is not influenced by environment and cultural conditions
 D. Capsules maybe visualized by India ink stain

51. The following diseases are caused by exotoxins produced by the etiologic agent except
A. Tetanus
B. Gonorrhea
C. Anthrax
D. Gas gangrene

52. The following statements refer to endotoxin except

A. Endotoxin is also commonlu referred to as lipopolysaccharide.
B. Endotoxin is produced exclusively by Gram negative bacteria.
C. Listeria monocytogenes can produce endotoxin.
D. It is heat stable compared to the more heat labile exotoxins.

53. Which of the following characteristics is unique for HIV?

A. Presence of two molecules of the viral genome
B. Possession of reverse transciptase enzyme
C. Ability to incorporate genome into the host cell chromosome
D. Virion envelope contains lipids from the host cell membrane

54. Which among the following generalizations in NOT true?

A. All RNA viruses have linear genomes.
B. DNA viruses replicate in the cytoplasm except poxviruses.
C. RNA viruses with helical symmetry are enveloped.
D. The nucleic acid of DNA viruses are double-stranded except parvoviruses.

55. The cell tropism of a virus is dictated by

A. Host cell receptors
B. Susceptibility to the host cell
C. Viral attachment proteins
D. Envelope

56. The viral replication step that constitutes the eclipse period in the viral one-step growth
curve is
A. Adsorption
B. Penetration
C. Uncoating
D. Maturation

57. The way virus enters and exits a host cell depends on the
A. Nature of genome
B. Capsid symmetry
C. Type of outer covering
D. Size of the virus

58. The large external domain of the viral envelope has the following functions except
A. Contains binding sites for cell surface virus receptors for attachment
B. Contains major antigenic determinants
C. Often essential for viral assembly
D. Mediates fusion of viral with cellular membrane entry

59. Viruses are the smallest infectious agent. The following are distinctive characteristics of the
viruses except
A. Viruses are very sensitive to the usual antibiotics
B. Viruses replicates from their own genetic material
C. Viruses are obligate intracellular parasites
D. Viruses contain only a single type of nucleic acid as their genome
60. Viral nucleic acid may be
A. Single stranded or double stranded
B. RNA or DNA but not both
C. linear or circular
D. All of the above

61. Enveloped viruses are sensitive to substances that

A. Deglycosylate the glycoprotein receptors
B. Dissolve the lipid membrane
C. Interfere with genome replication
D. Act as purine and pyrimidine analogues

62. The sequential steps in productive viral infection are

A. Entry-adsorption-eclipse-assembly-release
B. Adsorption-entry-assembly-eclipse-release
C. Adsorption-entry-eclipse-assembly-release
D. None of the above

63. Antiviral therapy is difficult to develop because

A. Viruses have an intracellular location
B. Viruses use host cell systems to replicate
C. Both are correct
D. Both are wrong

64. Which of the following viral architectures can lead to an abortive type of infection?
A. Helical symmetry
B. Icosahedral symmetry
C. Both A and B
D. Neither A or B

65. The release of progeny enveloped viruses usually involves

A. Cell lysis
B. Translocation
C. Fusion
D. Budding through cell membrane

66. An important characteristic of DNA viral infections is that they usually result in
A. Abortive infection
B. Latency
C. Malignant transformation
D. Cellular disintegration

67. A method that can be used both in the detection of viral antigens directly in clinical
specimens and as a confirmatory test for the viral isolates from cell culture
A. Hemagglutination tests
B. Enzyme immunoassays
C. Complement fixation tests
D. Immunofluorescence test

68. Interferons produced following viral infection include

A. Alpha IFN
B. Beta-IFN
C. Gamma IFN
D. All of the above

69. The virus plaque is analogous to the

A. Bacterial colony
B. Virus titer
 C. Efficiency of plating
D. End point dilution

70. Some viruses cause cancer attributed to the presence of oncogenes. Which of the following
is not an example of this?
A. Hepatitis B virus
B. Epstein Barr virus
C. Human papilloma virus
D. Hepatitis A virus

71. A 7-year old girl consulted the OPD due to scaly inflammatory patches on the scalp. The
condition started 3 weeks prior to consult and progressed to redness and local swelling. The hair
fluoresced under Wood’s light and primary smears of skin and hair contained septate hyphae. On
social history, it was reported that the child is fond of playing with their pet dogs. Which of the
following is the most probable etiologic agent?
A. Microsporum audouinii
B. M. canis
C. Trichophyton rubrum
D. T. tonsurans

72. Trichophyton mentagrophytes produces this enzyme that is capable of perforating that hair
shaft
A. Amylase
B. Urease
C. Keratinase
D. Protease

73. A 27-year old gym instructor consulted the OPD due to while patches on his shoulder. He
noticed these after coming back from a vacation in Boracay. He also complained to itchiness and
scaling in the area. The most probable etiologic agent is
A. Malassezia furfur
B. Microsporon gypseum
C. Trichophyton rubrum
D. Exophiala wernickii

74. The following is/are characteristics of superficial mycoses

A. Lacks immune response from the host
B. No invasion of living tissue
C. Infection is innocucous
D. All of the above

75. The following describes the causative agent of Pityriasis versicolor EXCEPT
A. Lipophilic yeast
B. Disease causation is associated with its overgrowth
C. Not part of the skin flora
D. None of the above

76. Which of the following cutaneous fungi causes dermatomycosis

A. Microsporon canis
B. Trichophyton rubrum
C. Candida albicans
D. Malassezia furfur

77. Dermatophytes have the following characteristic/s

A. Produces keratinases
B. Limited to non living tissue
C. Pathologic changes occur
D. A and C only
 E. All of the above

78. Enterobacteriaciae is composed of several bacteria having similar characteristics, which of

the following best describes this group?
A. All are gram negative cocci
B. All are oxidase negative
C. All ferment lactose
D. All are obligate anaerobes

79. The enteric bacteria that can cause gastroenteritis and which is exclusively transmitted by
human is:
A. Salmonella enteriditis
B. Shigella dysenteriae
C. Vibrio cholerae
D. Staphylococcus aureus

80. The examination of stool may suggest the mechanism of disease cause by the different
enteric microorganisms. The presence of pus cells and RBCs highly suggest:
A. Release of toxins
B. Invasion of the epithelium
C. Disruption of cell function
D. Adherence of bacteria

81. All the following statements illustrate the difference between SARS and Influenza EXCEPT
A. SARS can be transmitted by fecal-oral route other than by close
contact.
B. SARS cases are prevalent in older age group compared with influenza
which can affect all ages.
C. The best time to collect a specimen for virus isolation of SARS-CoV
is during the second week of illness instead of the first week which is the usual for
influenza diagnosis.
D. A suspect case for both diseases is defined by the clinical
characteristics and laboratory evidence.

82. Which among the factors below limit the laboratory diagnosis of enteric viruses?
A. Absence of antiviral agents
B. Self-limiting nature of viral infections
C. Short incubation period
D. All of the above

83. RNA viruses are prone to mutation. This characteristics is augmented for some RNA viruses
like influenza because of
A. Their ability to incorporate their genome to the chromosome of the most cell
B. The error-prone nature of the RNA polymerase
C. The circular form of the genome produced
D. Genome segmentation

84. The most common human exposure unit in fungal exposures:

A. Hyphal elements
B. Spores
C. Vegetative mycelium
D. None of the above

85. The culture media for Neisseria is a chocolate agar? Thayer Martin medium to which
antibiotics are added to kill competing organisms and fungi except Neisseria. Which of the
following antibiotics is not added?
A. Nystatin
B. Polymyxin
 C. Vancomycin
D. Chloramphenicol

86. Which of the following organisms has no cell wall?

A. Spirochetes
B. Mycobacteria
C. Chlamydia
D. Mycoplasma

87. Among the opportunistic mycoses, the fungi that will change its morphology in tissue is:
A. Aspergillus fumigatus
B. Crytococcus neoformans
C. Histoplasma capsulatum
D. Sporothrix schenckii

88. The following are characteristics of systemic mycoses except

A. Primary infection is usually respiratory
B. Host response involves mainly humoral immunity
C. Most agents are dimorphic fungi
D. Generally, infection requires large inoculom

89. Microscopic morphology of T. mentagrophytes is characterized by:

A. Variable microconidia
B. “en thyrse” microconidia
C. “en grappe” microconidia
D. Antler head
E. Spindle microconidia

90. Trychopyton spp can be different from Microsporum spp by the presence of:
A. Smooth walled macroconidia
B. Verrucose macroconidia
C. Absence of macroconidia
D. Coenocytic hyphae
E. Pseudohyphae

91. All of the following fungal structures can be seen in tissues EXCEPT
A. Broad-septated hyphae
B. Cigar bodies
C. Sclerotic bodies
D. Macroconidia

92. The hallmark of mycetoma

A. Cigar bodies
B. Sclerotic bodies
C. Granules
D. brown fission bodies

93. “Cauliflower” like lesions are seen in

A. Sporotrichosis
B. Mycetoma
C. Chromoblastomycosis
D. Entemophtheromycosis

94. The presence of dichotomously branching hyphae in tissue:

A. Aspergillosis
B. Mucormycosis
C. Entemophtheromycosis
D. Phaehyphomycosis
95. The pulmonary symptoms caused by this agent mimics tubercolosis
A. Blastomyces dermatitidis
B. Cryptococcus neoformans
C. Sporotrix schenckii
D. Systemic zygomycete

96. A 30-year old male has been receiving clidamycin for an anaerobic infection. He developed
intractable diarrhea with abdominal pain. Colonoscopy showed yellow white pseudomembranes and
an exotoxin was detected in the stool. We are probably dealing with
A. Clostridium difficile
B. E. coli
C. Shigella dysenteriae
D. Salmonella typhi

97. This is a low virulent Gram negative bacteria that does not contain lipid A in its outer
membrane but possesses a capsule
A. Neisseria gonorrhea
B. Pseudomonas aeruginosa
C. Campylobacter jejuni
D. Bacteriodes fragilis

98. The “common cold” syndrome has been associated with several viral agents. Which of the
following viruses is not associated with this syndrome?
A. Rhinovirus
B. Variola
C. Coronavirus
D. Adenovirus

99. A 5-year old presents with acute pharyngitis with yellowish exudates, regional
lymphadenopathy and often a higher fever. Laboratory diagnosis reveals a beta-hemolytic organism
which is inhabited by bacitracin. What is the etiologic agent to this infection?
A. mycobacterium tuberculosis
B. Streptococcus pyogenes
C. Streptococcus pneumoniae
D. Corynebacterium diptheriae

100. Viruses with this type of genome are generally infectious even when uncoated.
A. Double stranded DNA
B. Double stranded RNA
C. (+) single stranded RNA
D. (-) single stranded RNA