1. The results of blood smear from EDTA tube is as follows: 2.
2. Which culture medium does NOT inhibit Gram-positive organisms
 crescent-shaped gametocytes
 presence of all sizes of red blood cells
 Maurer's dots
 multiple delicate rings with 2 chromatin dots in red cells
What is the most likely organism identified?
A. Plasmodium vivax
B. Plasmodium falciparum
C. Plasmodium knowlesi
D. Plasmodium ovale
Plasmodium falciparum
 Size of Erythrocytes: normal, multiple-infected RBC are common
 Maurer's dots occasionally seen
 Young rings are small, delicate, often with double chromatin dots,
accole, applique
 >1 ring form can be found in 1 RBC (multiple infection)
 Gametocytes are crescent or elongated
 Pigment: black, coarse and conspicuous in parasite
 Number of merozoites: 6-32, average is 20-24
 Schizonts: bad prognosis
 Stages found in Circulating Blood: Young, growing trophozoites
(ring forms) and gametocytes
Plasmodium vivax
 Size of Erythrocytes: enlarged, maximum size may be 1-2 times
normal (attained with mature trophozoites and schizonts)
 Ring forms occupies 1/3 diameter of RBC
 Schuffner's dots present in all stages except early young forms
 Irregular, ameboid trophozoites, has spread-out appearance
 Pigment: Golden brown, inconspicuous
 Number of merozoites: 12-24, average is 16
 Stages found in circulating blood: all stages
Plasmodium ovale
 Size of erythrocytes: enlarged, maximum size may be 1 %-1%
 times normal, approximately 20% or more infected RBC are
 oval and fimbriated (border has irregular projections)
 Schuffner's dots present in all stages except early ring forms
 Rounded, compact trophozoites, occasionally slightly ameboid
 Growing trophozoites have large chromatin mass
 Pigment: dark brown, conspicuous
 No. of merozoites: 6-14, average is 8
 Stages found in circulating blood: all stages
Plasmodium malariae
 Size of erythrocytes: normal
 Ziemann's dots rarely seen
 Rounded, compact trophozoites with dense cytoplasm.
 Band form trophozoites occasionally seen
 Pigment: dark brown, conspicuous
 Rosette schizonts occasionally seen
 No. of merozoites: 6-12, average is 8
 Stages found in circulating blood: all stages
Plasmodium knowlesi
 in developing schizonts of P. knowlesi, Sinton and Muligan's
stippling may be observed.
 The nucleus continues to divide until there are up to 16 (average
10) merozoites.
 As the schizont matures, it fills the host RBC and the pigment
collects into one or a few masses.
 In the mature schizont, the merozoites may appear 'segmented'
and the pigment has collected into a single mass.
while allowing the growth of Gram negative rods?
A. Salmonella-Shigella Agar
B. Tetrathionate Broth
C. Blood Agar
D. Selenite broth
Growth on BAP (5% sheep's blood)
(Substitutes: horse's blood, rabbit's blood)
Staphylococci - white pinhead colonies
Types of Hemolysis
ᶐ hemolysis - incomplete hemolysis: greenish
B hemolysis - complete hemolysis; clear
y hemolysis - N0 hemolysis
ᶐ prime hemolysis -ᶐ - inner; ß outer
Enzyme: hemolysin (bacteria which has this enzyme has the ability to
cause anemia)
3. Protozoan trophozoites may be destroyed when processing stool
specimen using technique.
A. culture
B. concentration
C. viral isolation
D. direct microscopy
Trophozoites are easily destroyed in.
 Concentration techniques
 Lugol's iodine
 Refrigeration
 Unpreserved stool specimen (>1 hr.)
*Concentration techniques destroys Amoeba, unfertilized Ascaris ova.
It is not detected bc it is destroyed
4. What selective and diff medium is used to isolate Vibrio spp?
A. Thiosulfate citrate bile salts agar
B. Campy blood agar
C. Cefsulodin-Irgasan-Novobiocin agar
D. Thioglycollate broth
Thiosulfate citrate bile salts sucrose agar
o TCBS is the medium of choice for the isolation of V. cholerae
o Requires no autoclaving, and is highly differential and selective.
o Shelf life: 3 to 5 days
o NOT suitable for direct testing with V. cholerae O1 antisera.
o TCBS agar is green when prepared.
o Overnight growth (18 to 24 hours) of V. cholerae will produce
large (2 -4mm diameter), slightly flattened, yellow colonies with
opaque centers
5. Which special media is used for growing organisms that need low
oxygen content, reduced oxidation reduction potential & extra nutrient?
A. Alkaline Peptone Water
B. Lowenstein-Jensen medium
C. Thiogycollate broth
D. Pseudocel agar
Anaerobic media
• Anaerobic bacteria need special media for growth because they need
low 02 content, reduced oxidation-reduction potential & extra
nutrient
• Reduced media - Anaerobic BAP, Schaedler, Bacteroides Bile Esculin
• Laked Kanamycin Vancomycin BAP (LKVBA), Anaerobic PEA, Egg
Yolk Agar, Chopped Meat, Thioglycollate, Lombard Dowell Agar
6. What is the color change of the methylene blue infused strip when
an anaerobic environment has been achieved in an anaerobic jar?
A. Blue
B. Colorless
C. Green
D. White
7. The favorable energy source for many enteric pathogens is
A. mannitol
B. sodium citrate
C. Lysine
D. V factor
Gram-Negative Broth
A selective broth, gram-negative (GN) broth is used for the
cuitivation of gastrointestinal pathogens (i.e., Salmonella spp. and
Shigella spp.) from stool specimens and rectal swabs. The broth
contains several active ingredients, including sodium citrate and
sodium desoxycholate (a bile salt) that inhibit gram-positive
organisms and the early multiplication of gram-negative, nonenteric
pathogens. The broth also contains mannitol as the primary carbon
source.
 15. A flexible calcium alginate nasopharyngeal swab is the collection
Mannitol is the favored energy source for many enteric pathogens, but device of cholce for recovery of from the nasopharynx.
it is not utilized by many other non-pathogenic enteric organisms. To A. Corynebacterium diptheriae
optimize its selective nature, GN broth should be subcultured 6-8 hours B. Streptococcus pneumoniae
after initial inoculation and incubation. C. Staphylococcus aureus
D. Bacteroides fragilis
8. Which of the following is
the correct result for E. coll C. diptheriae must be
using the Methyl Red recovered from the deep layers of the
Voges-Proskauer test? pseudomembrane that forms in the
A. MR+ /VP- nasopharyngeal area. A flexible calcium
B. MR-/ VP- alginate nasopharyngeal swab is the
C. MR +/ VP+ best choice for collecting a specimen
D. MR-/ VP+ from the posterior nares and pharynx.

16. What is chocolate agar made of?

A. Lysed red blood cells
B. Clotted blood
9. Curved Gram negative bacilli with gastric ulcers. What can be used C. Brown-colored nutrient agar
to confirm a possible GI tract infection? D. Chocolate added to plain agar
A. H,S test
B. culture the organism in agar Chocolate agar
C. Urease test *a nonselective, enriched growth medium
D. PYR test • It is a variant of the blood agar plate, containing red blood cells that
have been lysed by slowly heating to 80°C.
10. Sealed centrifuge buckets with liquid culture media are * used for growing fastidious respiratory bacteria, such as
appropriately unloaded in a Haemophilus influenzae and Neisseria meningitides
A. fume hood Factor V= nicotinamide adenine dinucleotide (NAD)
B. dry laboratory bench Factor X = hemin
C. disinfected table top
D. biological safety cabinet 17. Stool specimen for the diagnosis of typhoid fever are positive
DURING SECOND WEEK of illness. (BUS)
11. The drug of choice for treatment of Paraganimus infections is
A. Praziquantel The invasive nature of bone marrow aspiration discourage from its use
B. Thiabendazole as a first line investigation for diagnosis of typhoid fever. In typhoid
C. Albendazole fever, stool cultures are usually positive from the second week of the
D. Ivermectin infection.

Praziquantel remains the drug of choice for 18. Transmission of food-borne trematodes may be influenced by
all trematode infections except fascioliasis, A. sex
for which bithionol is the drug of choice. B. geography
Praziquantel is recommended when bithionol is not available. C. climate change
D. age
12. Why is a second dengue infection worse than the first?
A. Infection with other serotypes 19. Which of the ff parasites cause a food-borne parasitic zoonous
B. Infection with related viruses causing an acute syndrome with cough, abdominal pain, discomfort
C. Inadequate treatment and low grade fever that may occur 2-15 days after infection. Long
D. Inadequate immune response term infection may mimic tuberculosis. Consumption of shellfish
specialty dishes are implicated in this condition
Subsequent dengue infection with one of the three remaining A. Ascaris lumbricoides
serotypes may result in IMMUNE-ENHANCED DISEASE (INADEQUATE B. Schistosoma japonicum
IMMUNE RESPONSE) in the form of severe hemorrhagic fever or C Entamoeba histolytica
dengue shock syndrome” D. Paragonimus westermani

13. When undercooked meat is ingested, the larvae of this parasite is Paragonimiasis
resistant to the gastric pH so that they eventually pass to the Infection with Paragonimus spp. can result in an acute syndrome with
intestines where they invade the mucosa. What organism is described? cough, abdominal pain, discomfort, and low grade fever that may
A. T. cati occur 2 to 15 days after infection. Persons with light infections may
B. T. canis have no symptoms. Symptoms of long-term infection may mimic
C. T. spiralis bronchitis or tuberculosis, with coughing up of blood-tinged sputum.
D. D. medinensis
20. Which of the following is the ultimate goal of the National External
Quality Assurance Scheme (NEQAS) for Parasitology?
A. An unsatisfactory result is a basis for discontinuing the testing
B. Validate the entire testing process
C. Validate performance characteristics of reagents
D. Verify accuracy and reliability of testing

21. When performing the disk diffusion method of antimicrobial

susceptibility testing, what is the MOST appropriate remedial action
when the zone diameters are too large or too small with all the
antimicrobials?
A. Standardize illumination
B. Take fresh culture from stock
C. Check the inoculum size
D. Check preparation of inoculum

22. An organism capable of growth in cold environment is a

A. mesophile
B. Thermophile
C. hyperthermophile
D. psychrophile
14. The specimen to be collected for Epstein Barr virus PCR
amplification is 23. The first larval stage of a trematode which is hatched from an egg
A. synovlal fluid often cillated and free-swimming is
B. serum A. rediae
C. whole blood in 5ml EDTA B. cercaria
D. sputum C. miracidium
D. metacercaria
24. During specimen collection, how do you minimze contamination of 32. What differentiates modified acid-fast staining from regular AFB
skin scrapes? staining?
A. Wipe the area with dry sterile gauze a. The staining time takes longer than AFB staining
B. Clean the area with 70% alcohol b. The decolorizer is weaker in modified acid-fast staining
C. Clean the area with soap and water than the acid alcohol in regular AFB staining.
D. Wipe the area with iodine disinfectant C. The stain is more concentrated when staining for AFB
d. A counterstain must be used for the modified methods
25. Identify the parasite form ingested by the female Anopheles
mosquito during a blood meal. • ACID ALCOHOL used in
A. Schizont : regular AFS (3% HCl in 95% Ethanol)
B. Gametocyte : modified AFS (1% H2SO4, in 70% Ethanol)
C. Merozolte
D. Sporozoite 33. All these aerobes have cell walls containing mycolic acid, EXCEPT:
A. Nocardia
Invertebrate Phase/ Sporogony B. Rhodococcus
• The definitive host to Plasmodium is female C. Corynebacterium
Anopheles mosquito. D. Streptomyces
• 4-15 days after ingestion of gametocyte
• Female Anopheles mosquito takes a blood meal
containing gametocytes from infected person
Microgametocytes-male
Nuclear division and exflagellation
Macrogametocytes- female
o Shifting of nucleus to the surface to form a projection
Microgamete penetrates macrogametes producing an ookinete

Vertebrate Phase / Schizogony

• The intermediate host to Plasmodium is human.
Mosquito injects sporazoites to man Acid-fast organisms:
Sporozoites disappear from the blood •"Mycolic acid / hydroxymethoxy acid - the substance unique in the
• Some are destroyed by the host immune system cell wall of AFO
• Enters liver parenchymal cells (hypnozoites in P. vivax and P. ovale)
34. A structure that helps in the locomotion of bacteria is:
26 Determining an organism's ability to liquefy aids in the A. flagellum
classification of the Enterobacteriaceae. B. Pili
A. peptone C. cilium
B. mannitol D. fimbria
C. nutrient gelatin
D. beef extract 35. In thioglycollate broth medium, where do you find obligate aerobe?
a. Middle of the tube
GELATIN LIQUEFACTION / HYDROLYSIS TEST b. At the bottom of the tube
Nutrient Gelatin is used to aid in classification of the c. At the top of the tube
Enterobacteriaceae by determining an organisms ability to liquify d. Evenly spread in the tube
gelatin. The breakdown of gelatin is a result of the production of the
enzyme gelatinase by an organism. The purpose of its proteolytic
enzyme is to break down large molecules so that they can be brought
into the cell to be metabolized. This ability to liquify gelatin is
characteristic of certain Enterobacteriaceae such as Proteus species
and Serratia species.

27. A solution used for routine examination of stool samples is

A. phosphate buffered sallne
B. normal saline
C. half normal saline

Types of Direct Fecal Smear

a. Unstained- 0.85-0.90% NSS (Normal Saline Solution) routine
b. Stained-Lugol's iodine

28. Purpose of flaming an inoculating loop before and after use? 36. Bacteria that thrive in extreme heat are called
A. To prevent accumulation of dust particles a. Thermophiles
B. To sterilize (dry heat) b. Psychrotrophs
C. To prevent cross-contamination C. Mesophiles
D. To test integrity of the loop d. Psychrophiles

29. What type of infection mimics acute viral enteritis, bacillary 37. At what phase of the bacterial growth curve are microorganisms
bacterial poisoning and traveler's diarrhea where the dysentery, most susceptible to antibiotics?
diarreheic stools lack blood, mucus, and cellular exudate? a. Lag phase
A. Cryptosporidiosis b. Log phase
B. Giardiasis C. Stationary phase
C. Balantidiosis d. Decline phase
D. Sarcocysticosis

30. What additional tests are included when IMVIC tests are done?
A. Sugar & Simmon's citrate
B. Motility & H2S
C. Oxidase & Urease
D. Catalase & Coagulase

These 4 IMViC tests (actually 6 tests if you include MOTILITY and H2S)
constitute, perhaps, the most critical tests used for identification of
bacteria after the gram stain.

31. Which of the ff can be used as positive control in Gram staining?

a. Escherichia coli – gram NEG control
b. Streptococcus pyogenes
c. Pseudomonas aeruginosa
d. Staphylococcus aureus
A Lag phase / Period of Rejuvinescence Enterovirus
 NO doubling cell 1. Poliovirus (Poliomyelitis)
 BIOSYNTHESIS Transmission: fecal-oral route: respiratory dropleta
 -adapt or adjusting to new environment anterior horn cells of the spinal cord
 Resistant to antibiotics SABIN live attenuated virus vaccine (oral)
B. Log phase /Exponential SALK inactivated virus
 doubling cells; BIOCHEMICAL PROCESS 2.Coxsackie A (Herpangina)
 Susceptible to antibiotics 3. Coxsackie B (Pleurodynia)
C. Plateau /Stationary 4. ECHO virus (aseptic meningitis)
 balance between cell division and dying organisms 5. Enterovirus 72 – Hepatitis A Virus (HAV)
 Evidence: drying of culture medium
D. Death/Period of Decline
 Death, cessation of bacterial growth, toxic waste

38. What does a desiccator do?

a. Preserve moisture-sensitive items
b. Precipitate
c. Dilute concentrated acids
d. Agglutinate

Desiccators are sealable enclosures containing desiccants used for

preserving moisture-sensitive items such as cobalt chloride paper for
another use. A common use for desiccators is to protect chemicals
which are hygroscopic or which react with water from humidity. 45. Scabies is a/an
(a)invasion
39. The aseptic collection of blood cultures requires that the skin be (b)Parasitism
cleansed with: (cjinfection
a. 2% iodine and then 70% alcohol solution (d)infestation
b. 70% alcohol and then 2% iodine or an iodophore
c. 70% alcohol and then 95% alcohol Human scabies
d. 95% alcohol only o is caused by an infestation o the skin by the human itch mite
(Sarcoptes scabiei var. hominis).
39. The aseptic collection of blood cultures requires that the skin be o The microscopic scabies mite burrows into the upper layer of the
cleansed with: skin where it lives and lays its eggs. The most common symptoms
a. 2% iodine and then 70% alcohol solution of scabies are intense itching and a pimple like skin rash. The
b. 70% alcohol and then 2% iodine scabies mite usually is spread by direct, prolonged, skin-to-skin
c. 70% alcohol and then 95% alcohol contact with a person who has scabies.
d. 95% alcohol only o Scabies occurs worldwide and affects people of all races and
social classes. Scabies can spread rapidly under crowded
Iodine + detergent = iodophore conditions where close body contact is frequent. Institutions such
Alcohol + iodine = tincture as nursing homes, extended-care facilities, and prisons are often
sites of scabies outbreaks
40. The wearing of masks is a precaution to prevent infection due to
a. Gram negative organisms 46. Animals that harbor parasites and serve as an important source of
b. Gram positive organisms infection are known as host.
C. Droplet nuclei a. Reservoir
d. Viruses b. Accidental
c. Natural
• Masks and respirators- protect mouth/nose d. Intermediate
Respirators - protect resp tract from airborne infectious agents
Droplet nuclei-are the small residues from the evaporation fluid from The traditional epidemiologic triad model Chain of infection
larger droplets & are light enough to remain airborne for long period holds that infectious diseases result from 1. Reservoir or source
the interaction of: 2. Mode of transmission
41. A lesion from the buccal mucosa of a patient with C. albicans in 1. Agent 3. Susceptible host
exudate shows 2. Host
(a)Blastoconidia, occasional mycelium 3. Environment
(b)Macroconidia, chlamydospores
(c)Macroconidia, blastoconidia 47. Activity during the pre-analytical phase of Parasitology testing?
(d)Blastoconidia, chlamydospores A. Correct patient identification.
B. Use of controls.
42. Which staining method is utilized to demonstrate the presence of C. Standardized reporting of parasite concentration.
diffuse capsule surrounding the bacteria? D. Ensure proper storage of reagents and stains being used.
a. Negative staining (Relief Stain)
e.g. india ink / nigrosin 48. An Entamoeba histolytica trophozoite has
a. Central karyosome, ingested RBCS, clear pseudopodia
43. Which of the following is NOT true of virions? b. Ingested RBCS, clear pseudopodia, uneven chromatin
a. Contains RNA c. Ingested RBCS, clear pseudopodia, large glycogen vacuoles
b. Reproduce independently d. Large, blotlike karyosome, ingested WBCS, granular pseudopods
c. Contains DNA
d. Extracellular 49. Which substance interferes with stool sample testing?
b. Mineral oil
General Characteristics of Viruses
1. Viruses are obligate intracellular parasites unable to self-replicate. • Certain drugs and compounds will render the stool specimens
Once inside living cells, viruses induce the host cell to synthesize virus unsatisfactory for examination.
particles. • The specimens should be collected before these substances are
2. The genome is either DNA or RNA (single or double stranded). administered, ar collection must be delayed until after the effects have
3. Viruses do not have a system to produce ATP passed • Such substances include: antacids, kaolin, mineral eil and
4. Viruses range in size from 25 to 270 nm. other oily materials, non-absorbable antidiarrheal preparations
5. The classification of viruses is based on nucleic acid type, size and barium or bismuth (7-10 days needed for clearance of effects)
shape of virion, and presence or absence of an envelope. antimicrobial agents (2-3 weeks)
gailbladder dyes (3 weeks)
44. The most common viral syndrome of pericarditis, myocarditis and
pleurodynia (pain upon breathing) is caused by:
a. Herpes simplex virus 50. Primary Amoebic Meningoencephalitis (PAM) is caused by
b. Respiratory syncytial virus a. Naegleria fowleri
c. Epstein-Barr virus b. Acanthamoeba spp.
d. Coxsackie B virus C. Entamoebag hartmanni