SSEVOVEDEEEDOPEEEEE EERE EEF REY Y MICROBIOLOGY ed with CamScanner Scanniow PIIVGVVGISIIVVIINIUUUULEELLEUEEE ‘QUESTION ANSWER EXPLANATION 41. The following are TRUE. © |. The drug of choice is iodoquino! regarding Giardiasis EXCEPT: , ‘The drug of choice for Giardiasis is ‘A. The mode of transmission is Metronidazole, not lodoquinol. through ingestion of mature ; cysts Drugs of choice for other intestinal B. Associated with villous protozoa: flattening and crypt bupeneehyas a Intestinal Drug of choice . The drug of choice is protozoa odoquinol D. Trophozoite is described as Entamoeba Todoquinol or heart-shaped histolytica paromomycin (Metronidazole for mild, moderate, severe intestinal disease) Cyclospora Trimethoprim sulfamethoxazole Cryptosporidium | Nitazoxanide for immunocompetent Rotorence: Riedel, (2018). Jawetz Melnick & Adelbergs Medical Merobiclogy (28h ed, p. 723, p. 727). MeGraw-il Edyeation Morse, S., Metzner, T.,& Mile, S. 2. A patient was brought to the ER for 2 3-month history of headache, nausea, vomiting, and repeated episodes of fever. He was diagnosed with neurocysticercosis. He most likely acquired the infecting organism through what method of transmission? A B Cc. D. Ingestion of trophozoites Ingestion of larvae Ingestion of eggs ‘Any of the above C. Ingestion of eggs Taenia solium: Ingestion of larvae ~ intestinal tapeworm Ingestion of eaas ~ cysticercosis or neurocysticercosis References: Le, T, Bhushan, V, & Sochat, M. (2023). Fist ‘Ad forthe USMLE Step 1 2022, Thirty Thied Edition (33rd od, p. 157). McGraw-Hill Education Riedel, S., Morse, S, Mietzner,T..& Miler, S. (2019) Jowote Moinick & Adelbergs Medical Microbiology. (2th ed, . 748). MeGraw-Hil Education 98 Scanned with CamScanner3, Microcytic aner infections by which of is seen in following parasites? A 8. c. 0. Strongyloides stercoralis, Diphyilobothrium latum Trichinella spiralis Necator americanus D. Necator americanus Hookworm disease (Necator americanus and Ancylostoma duodenale) is characterized by microcvtic anemia and iron deficiency. D. latum -+ can cause Vit. B12 deficiency T. splralis + can cause myositis or Trichinosis manifested by fever, vomiting, Periorbital edema, myalgia S. stercoralis + accelerated autoinfection in the immunocompromised can cause hyperinfection, References: ‘Le, T, Bhushan, V. & Sochal, M. (2023). First ‘Ald forthe USMLE Step 4 2022, Tity Third Edlion (331d ed. p. 186). McGraw Eaveation. ‘+ Riedel, S, Morse, S, Miotzner, .,& Miler, S (2019), Jawetz Melnick & Adelbergs Medical Niczobiclogy. (26th ed. . 746, p.749). MeGraw- Hal E¢ucaton, 4. Chocolate agar contains hematin and NAD* which are required for the isolation of which of the following organisms? A B. c. ©. Serratia marcescens Haemophilus influenzae Corynebacterium diphtheriae . Bordetella pertussis B, Haemophilus influenzae + Identification of Haemophilus influenzae involves using Factors V {NAD*) and X (hein) + Serratia alactose-fermenting enteric bacteria that grows pinke colonies on MacConkey agar. + Corynebacterium diphtheriae shows gram (+) rods with metachromatic granules. + Bordetella pertussis is isolated using Bordet-Gengou agar or Regan-Lowe medium References: ‘© Le, T, Bhushan, V., & Sochat,M. (2023). First ‘Aid lot the USMILE Stop 1 2022, Thity Third Eston (dep 124, 9,187} MeGraw aucation. © Riedel, S, Morse, S, Mietzner,T.,& Miler, S. (2019) Jawetz Melnick & Adelbergs Medical Micrcbiclogy (28th ed.,p. 275), McGraw Hil Education. Scanned with CamScanner AAA AAAAAAAAA AAAI 4 8448 RaQ angPPAIVVIIIIIIIVI IDV UUULELELUEEEEEEEL 5. In osteomyelitis caused by caused by S. aureus, the primary focus Is found in which part of the bone? A B. c. D. Metaphysis .Diaphysis Epiphysis No particular area ‘A Metaphysis In osteomyelitis caused by caused by S. aureus, the primary focus of growth is found in a terminal blood vessel of the long one's metaphysis. Reference: Riedel, S., Morse, S, Miotzner, T. & Miler, S. (2019), Jawetz Melnick & Adelbergs Medical Microbiology. (28th ed, p. 209). McGraw-Hill E¢ucation, 6. Which of the following toxins is ‘an important virulence factor in CA- MRSA? A. 9on Panton-Valentine Leukocidin Hyaluronidase CClumping factor Hemolysin A. Panton-Valentine Leukocidin Panton-Valentine Leukocidin (PVL) is mobile phage-encoded S. aureus toxin which can kill white blood cells of both humans and rabbits. Itis an important virulence factor in CA- MRSA. Other S. aureus enzymes and toxins: Enzymes and Function toxins Catalase © Converts hydrogen peroxide into water and oxygen. © Differentiates staphylococci (positive) from streptococci (negative), Coagulase —_| Synonymous with invasive pathogenic potential Clumping Responsible for the factor adherence of S. aureus to fibrinogen and fibrin Hyaluronidase |+ Aka “spreading factor’ ‘© Staphylokinase which results in fibrinolysis, 100 Scanned with CamScannerHemolysins | Lyses white blood cells through pore formation Roterencs Le, T, Bhushan, V, & Sochal, M. (2023) First ‘Aid forthe USMLE Step 1 2022, Thirty Thi Eéltion (23d ed, p. 138). McGraw Hil Education. ‘© Rledal, S, Morse, S, Mictzner,T. & Miler, S. (2019), Jawetz Melnick & Adelbergs Medical ‘Microbialogy (28th ed, pp. 207-208). McGraw Hal Education 7. A throat swab was done to a Patient which showed Gram (+) occ in pairs which are catalase negative. Itshowed complete hemolysis and was susceptible to bacitracin. The organism identified is most ikely: A. Staphylococcus aureus B. Streptococcus agalactiae C. Viridans streptococci D. Streptococcus pyogenes D. Streptococcus pyogenes ‘Ais incorrect since S. aureus is positive. talase Bis incorrect because Streptococcus. agalactiae is not inhibited by bacitracin. Cis incorrect because Viridans streptococci are alpha hemolytic (showing partial hemolysis), not beta hemolytic. A concise algorithm for the laboratory identification of Gram-positive organisms may be accessed in USMLE First Aid 2023, 33rd ed (p. 132). Reterence: Le, 7, Bhushan, V, & Sochat, M (2023) Fist Aid for the USMLE Step 1 2022, Thirty Third Eaiion (33rd 4, p. 132). McGraw-Hill Education. 8, The following HIV medications are nucleosidelnucleotide reverse transcriptase inhibitors (NRTIs), EXCEPT: A. Didanosine B. Tenofovir C. Enfuvirtide D. Zidovudine C. Enfuviriide Enfuvirtide is a fusion inhibitor. ‘The rest of the options are considered NRTIs. Other NRTIs: © Abacavir © Emtricitabine © Lamivudine © Stavudine Reference: Reedel, S., Morse, S.. Metzner, .,& Miler, S. (2019) Jawetz Meinick 8 Adelbergs Medical Mcrobiclogy 281 ed. p. 667). MeGraw-Hil Education 101 Scanned with CamScanner AAAAAAAAAAAAAANANN44 44 44a RRQ aa aPPPVIDAGG ATVI NGUUUELELLELLEEEEe ‘9. In neonates, the classic triad of chorioretinitis, hydrocephalus, and intracranial calcifications is associated with: A B. Ci D. Rubella cu ‘Toxoplasma gondii HIV ©. Toxoplasma gondi Congenital toxoplasmosis is characterized by the triad of ‘© Chorioretinitis «Hydrocephalus, and ‘© Intracranial calcifications Aside from the above, it can also lead to stillbirths, psychomotor disturbances or microcephaly. CMV is associated with chorioretinitis and periventricular calcifications, not Intracranial. References: +) Lo, T, Bhushan, V.& Sochal, M, (2023). Fast ‘Ai for the USMLE Stop 1 2022, Thity Third Editon (32d ed, p. 181). McGraw-Hill ‘Education + Rladol, S., Morse, S., Metzner, T, & Miler. S. {2010}, Jawelz Melnick & Adelbergs Medical Microbiology. (28th ed, p. 799). McGraw-Hill Eaucaton 10. What is the intermediate host of Taenia solium? pomp Rats Pigs Cattle Horse B. Pigs Pigs are the intermediate host of T. solium. But humans can also be intermediate hosts if they ingest T. solium eggs leading to eysticercosis. Reference: Rida, S., Morse, S, Mietzner,T., & Miler, S. (2019) Jonetz Melnick & Adelber9s Medical Microbialoay. (28th e.,p. 748). McGraw-Hill Education 11. Which of the following S, pyogenes toxins has been associated with streptococcal toxic shock syndrome? A 8. GC: ©. Pyrogenic exotoxin Streptokinase Deoxyribonuciease Hyaluronidase A. Pyrogenic exotoxin Pyrogenic exotoxins (aka erythrogenic ‘oxin A) are produced by group'A streptococci that carry a lysogenic phage. ‘They are associated wih the develdpment of siteplococeal toxic shock syndrome and scarlet fever ‘This is different from staphylococcal toxic shock syndrome which is promoted by staphylococcal toxic shock syndrome toxin- 1 0r TSST-1). 102 Scanned with CamScannerOther toxins and enzymes produced by S. pyogenes are: Streptokinase ‘© Allows escape from blood clots by fibrin digestion. ‘* Given IV for treatment of pulmonary emboli, coronary artery, and venous thromboses. Deoxyribonuclease © Helps in the spread of streptococci by liquefying pus. Hyaluronidase © "Spreading factor that spits hyaluronic acid in connective tissue. Relerence: Riedel, S., Morse, S. Mietzner, T. & Miller, S. (2019), Jawotz Melick & Adelborgs Medical Nierobioiogy. (280 ed, pp. 218-219). McGraw-Hill Education 12. Lowenstein-Jensen medium is used to culture which of the following organisms? 99> Escherichia coli ‘Mycoplasma pneumoniae Neisseria gonorhoeae ‘Mycobacterium tuberculosis D. Mycobacterium tuberculosis Mycobacterium tuberculosis is isolated using: ‘+ LowensteinJensen medium ‘* Middlebrook medium ‘© Rapid automated broth cultures. Eosin-methylene blue (EMB): isolation of E.coli. Eaton agar: Mycoplasma pneumonise ‘Thayer-Martin agar: isolation of Neisseria gonorthoeae and meningitidis: Reference: Le, 7, Bhushan, V., & Sochal, M. (2023), Firs Ai for the USMLE Stop 1 2022, Thy Td Eaton (33rd 4, p. 128) McGraw-Hill Education. 13, All of the following are TRUE regarding mycobacterial cell walls, EXCEPT? A ‘The presence of cord formation is correlated with virulence Cord factor is responsible for the inhibition of WBC migration 1D. None of the above Tubercle bacilli virulence is correlated with formation of serpentine cords by cord factor. Cord factor is associated with: ‘© Inhibition of WBC migration ‘© Formation of chronic granulomas Relerence: Riedel, 5, Morse, S., Metzner, T, & Miler, 5. 103 AAMAAAAAAAAAAAAAAIIINE ARR RRRAag Scanned with CamScannerPIV VIG GV GG VGN NGL UUELELLLELLEEEL C. Cord factor is associated with formation of chronic granulomas D. None of the above (2019). Jawetz Melnick & Adalbergs Medical ‘Microbiology. (28th ed, p. 326). MeGraw-Hil Education 14. A 60-year-old female presents to the clinic with painful vesicular lesions on her forehead and the tip of her nose. On examination, the lesions are present in CN V1 distribution. Which of the following is the possible etiology of her condition? ‘A. Herpes simplex 1 B. Herpes simplex 2 C. Varicella zoster D HIV C. Varicella zoster This is a case of herpes zoster ophthalmicus. ‘This is caused by reactivation of varicella zoster virus in the ophthalmic division of the trigeminal nerve. References: © Le, T., Bhushan, V., 8 Sochal, M. (2023) First ‘Ad for te USMLE Stop 1 2022, Thirty Third Edition (33rd ed, p. 162). McGraw: Hit Education + Riedel, S., Morse, S., Mitzner,T., & Miler, S. (2019) Jawetz Melnick & Adelbergs Medica! Microbiology. (28th ed, pp. 482-484). McGraw- il Education, 15. Destruction of the vasa vasorum occurs at which stage of syphilis? A. Primary B. Secondary C. Tertiary D. None of the above ©. Tertiary Stages of Syphilis and Clinical Manifestations Stage | Clinical manifestations Primary | Painless chancre Secondary | Constitutional symptoms Maculopapular rash Condylomata lata, Lymphadenopathy Patchy hair loss Tertiary ‘Gummas Aotitis Neurosyphilis, Argyll-Robertson pupil Congenital syphilis, ‘+ Facial abnormalities © Rhagades Snuffies Saddle nose Hutchinson teeth Mulberry molars 0 Short maxilla e000 104 Scanned with CamScanner‘0. Saber shins ‘+ CNVIII deafness Relerences: + Le,T,, Bhushan, V., & Sochal, M. (2023). First ‘Aid for the USMLE Stop 4 2022, Thity Third Edition (331d op. 145). MeGraw-Hit Education. ‘© Ride, §., Morso. S. Miotzner,T., 8 Mile, S, (2019), Jowetz Molnick & Adolborgs Medical ‘Nicrobiology. (2th ed, pp. 340-342). MeGraw- ill Education 16. A 24-year-old medical student presents to the clinic with fever and right upper quadrant pain. A diagnosis was confirmed, and surgical drainage was performed, revealing an abscess with an “anchovy paste” consistency. Which of the following agents is the most likely cause of these findings? Giardia lamblia Entamoeba histolytica Vibrio cholerae Shigella com> B. Entamoeba histolytica, This is most likely a case of amebic liver abscess caused by Entamoeba histolytica. ‘An “anchovy paste” characteristic of the abscess contents is seen upon surgical drainage. The contents are described as necrotic and bacteriologicaly sterile active amebae being confined to the walls Giardiasis: presents with non-bloody, foul- ‘smeling, fatty diarrhea Vibrio cholerae: rice-water stools Shigella: bloody, mucoid stools (bacillary dysentery) References: ‘© Le, T, Bhushan, V, & Sochat, M, (2023). First ‘Aid forthe USMLE Stop 1 2022, Thirty Thid Eaiion (3rd ed, p 182). MeGrow Hi + Riedel, S. Morse, S., Mictaner,T., & Miler, S. (2019), Jowetz Melnick & Adelbergs Medical Merobialogy. (28th ed, p. 728). MeGrawstil Eaveation 17. Crypt hypertrophy and villous atrophy or flattening is associated with which of the following? Entamoeba histolytica Giardia tamblia Trichur trichura Ascaris lumbricoides pop> B. Giardia lamblia G. lamblia: crypt hypertrophy and villous atrophy or flattening, E, histolytica: colon biopsy will show formation of a flask-shaped ulcer. Trichuris hiura: rectal prolapse in children. 105 Scanned with CamScanner AAAAAARAAAANAINAA4 Aa RR Rageer ee ee ee ‘Ascaris lumbricoides: ileocecal valve and biliary obstruction, intestinal perforation, Loeffler syndrome. Bhushan, V., & Sochal, M. (2023) First ‘Ni forthe USMLE Step 1 2022, Thity Third Exltion (23rd ed, p. 152, p. 156). MeGraw-Hil Education Miotzner,T.,& Miler, 8 Adelbergs Medical . 727). McGraw-Hill, 418, Visceral larva migrans may lead to signs and symptoms of inflammation of the liver, visual impairment, seizures, coma, and even myocarditis. ‘What nematode is responsible for this disease? A. Toxocara canis B. Ascaris lumbricoides C. Onchocerca volvulus D. Necator americanus A. Toxocara canis Visceral larva migrans may lead to signs and symptoms of inflammation of the liver, visual impairment, seizures, coma, and ‘even myocarditis. ‘This is caused by Toxocara canis, A. lumbricoides associated with Loeffier syndrome manifested by cough, eosinophilia and pulmonary infitrates. ©. volvulus is associated with “river blindness" and black skin nodules. Hookworms (Ancylostoma spp. and Necator americanus) are associated with ‘cutaneous larva migrans ({tchy, serpiginous rash), not visceral larva migrans. References: + Le, T,, Bhushan, V., & Sochat, M. (2023). First ‘Aid for tho USMLE Step 12022, Thirty Third Editon (33d ed, p. 156). McGraw-Hil Education. ‘© Ricdol,S., Mors, S., Mietzner, T., 8 Miler, S. (2019), Jawotz Melnick & Adelbergs Medical erin (2 ed. 78). MeGrow Ht S. aureus S. lugdunensis, S. pneumoniae S. dysenteriae .S. pneumoniae Encapsulated bacteria are opsonized and cleared by the spleen. Patients without spleens are at an increased risk for developing severe infections by encapsulated bacteria and thus require vaccination against the following: © Ne meningitidis ‘© S.pneumoniae © H influenzae 106 Scanned with CamScannerReferences: Le, T, Bhushan, V., & Socal, M. (2023). First ‘Ad forthe USMLE Stop 1 2022, Thity Third Edin (rd ed. p. 9, 1) MeGrow Ha ivcaion, + Riedel, 8, Morse, S., Metzner, T. & Miler, S. (2019). Jawotz Melnick & Adelbergs Medical Mirobiciogy. (28th ed, p. 303). MeGraw- Hil Edvealion A B. c. D. 20. Lymphatic filariasis is caused by the following, EXCEPT? . Wuchereria bancrofti Brugia malayi Brugia timori 1. Onchocerca volvulus D. Onchocerca volvulus Lymphatic filariasis is caused by the following: ‘Wuchereria bancroftt Brugia malayi + Brugia timori Relerens Riedel, S, Morse, ., Metzner, T., 8 Mile, S. (2019). Jawetz Melnick & Adelbergs Medical ‘Microbiology. (281 ed, p. 749). MeGraw- Hil Eeueaton. Caribt 21. An immigrant from the bean is diagnosed with ranuloma inguinale. The following true regarding the condition, EXCEPT? ‘A. Treatment is azithromycin B. Caused by Klebsiella granulomatis. C. Diagnosis is based on the visualization of elementary bodies in tissue smears or biopsy specimens. D. Mostly occurs in tropical regions C. Diagnosis is based on the visualization of elementary bodies in tissue smears or biopsy specimens. Granuloma inguinale is a chronic genital ulcer caused by Klebsiella granulomatis (formerly Calymmatobacterium granulomatis). On microscopy, there is the appearance of cytoplasmic Donovan bodies. The recommended treatment is azithromycin 1 g orally once per week {for at least three weeks or unlil all lesions are healed. An elementary body is an environmentally stable infectious particle seen in the developmental cycle of Chlamydia References: ‘+ Le,T, Bhushan, V, & Sochat, M. (2023). First ‘Aid for the USMLE Step 1 2022, Thity Third Editon (de, 180, MeGrow tit + Riedel, S. Morse, S. Metzner, T., & Miler S. (2019). Jawetz Melnick & Adelbergs Mecieat Merobiology (28th ed, p. 240, . 367). MeGravw- Hil Education 107 Scanned with CamScanner AAAAAAA AAAI 44448 RR Qay»> =~ ~~ =~ =) > => => > > <> <> => 3 MOVIVIVIIS IVI 22. The characteristic red pigment jiosin is produced by which of B. S. aureus ©. 8 morcosene | Serratia marcescens produce prodigiosin which gives it its characteristic red pigment. Actinomyces israel: yellow sulfur granules Staphylococcus aureus: forms gray to deep golden yellow pigment Pseudomonas aeruginosa: pyocyanin and pyoverdine (blue and yellow green pigment, respectively) -+ combination of pyocyanin and pyaverdine produce the bright green color characteristic ofthis ‘organism. Reference: Riedel, S., Morse, S., Miotzner,T., & Miler, S. (2019), sawete Melnick & Adelbergs Medical Microbiology. (28th e¢, p. 241, p. 253). McGraw-Hill Education 23. The following ribosomal subunits are present in prokaryotes, EXCEPT? 308 50S 70s 80S. pop D. 80s ‘The ribosomal subunits present in prokaryotes are: = 30S = 50S * 70S ‘The ribosomal subunits present in eukaryotes are: = 30S. = 508 * 708 References: + Le, T, Bhushan, V, & Sochat, M, (2023). Fist ‘Aid for ne USMLE Step 1 2022, Thy Thied Edition (83rd ed, p. 43). McGraw-Hill Education, + Riedel, 8. Morse, S., Metzner, T., & Mile. S. (2019) Jawotz Malnick & Adelbergs Medical Microbialogy. (28th od, p. 117). MeGraw- Hil Education 24. A hungry medical student eats the fried rice she has reheated for the third time this week and is now suffering from nausea and vomiting This happened 3 hours after eating C. Aheat-stable enterotoxin ‘The bacteria most likely responsible for this, patient's signs and symptoms is Bacillus cereus, a Gram (+) fad that causes food 108 Scanned with CamScannerthe said fried rice poisoning (reheated rice syndrome). ‘Which of the following is. Its 3t destroyed by cooking responsible forthe patient's Lee eee atee symptoms? thas 2 types: © Emeti A. Aheatlobile enterotoxin © Nausea, voritng within 4-5 B. Proliferation ofa strain that © Diarrhea! produces toxins A and B © Occurs within 8-18 h . Aheat-stable enterotoxin © Non-bloody, watery diarthea 1D. Production of a delta toxin i Reference: Le, T, Bhushan, V., & Sochet, M. (2028). Fist Aid for the USMLE Step 1 2022, Thirty Thid Editon (33rd ed, p. 138). McGraw-Hill Education. 25. The agents responsible for B |B.Proteins ‘causing spongiform encephalopathies are made up of The agents responsible for causing ae spongiform encephalopathies are made up of proteins called prions. A. Carbohydrates B. Proteins These prions are transmissible through C. Nucleic acids CNS-related tissues or BSE (bovine D. Allof the above spongiform encephalopathy)-contaminated food. Prions cause disease by causing conformation changes in the proteins of hosts leading to aggregation and dysfunction. Reteren Riedel, S., Morse, S, Mietaner, T., & Miler, S. (2019). Jawetz Monick & Adelberas Mocical Merobiciogy (28h ed, p. 443). McGraw-Hit Education. 26. Biliary tract disease and 8 — |B. Clonorchis sinensis, cholangiocarcinoma are associated with wich of the following? Clonorchis sinensis (Chinese liver fluke) excyst in the intestine and migrate up to the ‘A. Schistosoma haematobium common bile duct B. Clonorchis sinensis C. Echinococcus granulosus Mechanical irritation may result in fibrosis D. Hookworms and hyperplasia, It may also lead to chronic cholangitis may result to atrophy of liver parenchyma, portal fibrosis, jaundice due to biliary obstruction, 109 Scanned with CamScannerSVPVVVVVVGVIVVVVV GGG UGUUEULLLUEEEL and liver cirrhosis. {tis also linked to cholangiocarcinoma, The rest of the choices are not linked to cholangiocarcinoma. Referones Riedel, 5, Morse, S., Mietzner, T., & Miler, S- (2019), Jowetz Melnick & Adelbergs Medical Microbiology. (28th od, p. 752). McGraw-Hill Education 27. Which of the following trematodes can be acquired by eating raw crabs and other freshwater crustaceans? Paragonimus westermani Clonorchis sinensis Fasciola hepatica All of the above pop ‘A. Paragonimus westermani Paragonimus westermani is acquired by eating raw crabs and other freshwater crustaceans. Other trematode tissue infections: ‘* Clonorchis sinensis: acquired by eating undercooked freshwater fish «Fasciola hepatica: acquired by eating watercress or aquatic veget Reference: Riedel, S., Morse, S., Mictznor,T. & Mile, (2019), Jawotz Melnick & Aselbergs Medic Microbiology. (28th ed, p. 743). MeGraw-Hil Edueaton 28. A 7OIF was brought to the clinic for complaints of reddened vulva, with thick white discharge. On microscopy, there is presence of pseudohyphae. What is the most likely diagnosis? Bacterial vaginosis, Trichomoniasis Candida vulvovaginitis Syphilis seep C. Candida vulvovagi ‘The presence of thick, white, “cottage cheese" discharge in the vulvar area points. to Candida vulvovaginitis. Bacterial vaginosis: thin, white discharge with fishy odor with no inflammation. Trichomoniasis: Frothy, yellow-green, foul-smelling discharge with inflammation of the cervix known as strawberry cervix. Reference: Le, T, Bhushan, V, & Sacha, M. (2023) First Aid for the USMLE Step 1 2022, Thity Third Eaton (33rd 24, p, 179). McGraw-Hill Education 29. Which of the following ‘substances is found as a contaminant of peanuts and corn C. Aflatoxin Aflatoxin is a substance found as a 110 Scanned with CamScannerand is considered a cofactor for contaminant of peanuts and corn and is ‘hepatocellular carcinoma? considered a cofactor for hepatocellular aes carcinoma, B. Berytium Vinyl chioride is found in PVC pipes and may cause hepatic angiosarcoma. Arsenic may cause lung cancer and squamous cell carcinoma, not hepatocellular carcinoma, Beryllium exposure may cause lung cancer. References: ‘© Le, T, Bhushan, V,& Sochat, M. (2023). First ‘Ad forthe USMLE Step 1 2022, Thity Thre Edition (33:0 ep. 221). MeGrawHil Eaveation. + Riedel, S, Morse, S., Mictzner,T., & Miler, S (2019). Jawetz Melnick & Adelbergs Medical Microbiology. (28th ed, p. 645). McGraw-Hill Education. 30. An elderly patient in the ICU A | A Clostridium diffcite ‘was being treated with muttiple antibiotics for several days. He was A patient presenting with watery diarrhea referred to you today for watery ‘and was treated with Clindamycin makes diarrhea. Pseudomembranous colitis the most likely diagnosis. This is caused by On further history, he was given Clostridium difficile. Clindamycin for an anaerobic infection. Shigella and E. histolytica both present with bloody diarthea, not watery diarthea. ‘What is the most likely cause of the patient's signs and symptoms? wushan, V.,& Sochat, M, (2023). Fist ‘iG forthe USMLE Step 1 2022, Thy Third AA AAR AA ANIA ERh ahaa aR RRR ad ‘A. Clostridium aificta Eaton (31 of. 248) McGraw Hi B. Shigella Eduenion C. Entamoeba histolytica ‘+ Riedel S, Morse, S. Miter T. & Mile, S. the above (2018). Jawetz Motnick& Adstbergs Medical D: Any cite 3 Merobilogy. (2th ed, p. 191) MeGrow-Fal Eeveaton 31. Which ofthe following can be B |B. Metronidazole used to treat the patient case above? Vancomycin and metronidazole can be used in the treatment of C. cile. { A. Cephalosporins B. Metronidazole Reference 1 Bhushan, V., 8 Sochal, M, (2023). First Ai for ;G. Exorocuinatones JSMLE Step 1 2022, Thirty Third Edition (330 ©. Any of the above 182). MeGrave Hil Education AA. mt aannh Scanned with CamScanner32. An infant who was being given total parenteral nutr ICU develops an infection not responding to current antibiotics. Which of the following is the most likely etiologic organism causing the infection? A. Malassezia . Rotavirus 8. C. E.coli 0. |. Staphylococcus aureus jon while in the A. Malassezia In infants being given TPN, an infection with Malassezia can rarely occur because of potential contamination of the lipid emulsion. ‘The other organisms are not associated with contaminated TPN. Reference: Riedel, S,, Morse, S., Mietzner,T., & Miler S. (2019), Jawolz Metnick & Adelbergs Medical Microbiology. (28th ed., p. 681). McGrawHil Education. 33. A pregnant patient was diagnosed with Lyme disease. ‘Which of the following can be given for treatment? A 8. Cc. 0. . Doxycycline ‘Amoxicilin Vancomycin Clindamycin B. Amoxicillir ‘Treatment of Lyme disease is with Doxycycline as the first line. But this patient is pregnant so doxycycline use is discouraged. ‘Amoxicillin can be given for preanant patients or children <8 years old. Ceftriaxone can also be given if IV therapy is required. References: Le, Ta Bhushan, V., & Sochat, M. (2023). First ‘id forthe USMLE Step 1 2022, Thity Third Edition (33rd ed.,p. 144). McGraw-Hill Education + Riedel, S., Morse, S. Mietzner, ., & Miler, . (2019), Jawetz Melick & Adelbergs Medical Microbiology. (28th ed. p. 346). McGraw-Hill Education. 34. A patient presents with flesh- colored umbilicated papules. The causative agent of belongs to: A 8. C, o. Adenovirus Papillomavirus Polyomavirus Poxvirus skin lesions D. Poxvirus Flesh-colored umbilicated papules are caused by Molluscum contagiosum which is classified as a Poxvirus. References: +) Le, T,, Bhushan, V., & Socal, M. (2023). Fist ‘Aid for the USMLE Stop 1 2022, Thirty Third Edition (33rd 08, p. 161). McGraw-Hill Education + Riedel, S., Morse, S., Mietzner, T., & Miler, S. (2019), Jawetz Melnick & Adelbergs Medical Microbiology. (28th ed, p. 508). McGraw-Hill Education 112 Scanned with CamScanner35, Which of the following receptors is used by SARS-CoV-2 for entry into cells? P antigen on RBCs Nicotinic acetylcholine receptor ACE? coat P92 @> ed... 163), McGraw-Hill Education ©. ACE2 ACEZ receptor is used by SARS-CoV-2 for entry into cells. + Parvovirus B19: P antigen on RBCs Rabies: Nicotinic acetylcholine receptor + EBV:CD21 Bhushan, V., 8 Sochal M, (2023). Fst Ai for SSMLE Step 12022, Thity Third Edivon (rd 36. Which of the following provides Protection (immunity) from HIV infection? ‘A. Homozygous CCRS mutation B. Heterozygous CCRS mutation ©. Homozygous CXCR4 mutation D. Heterozygous CXCR4 mutation ‘A. Homozygous CCRS mutation Homozygous CCRS mutation -+ protection (immunity) Heterozygous CCRS mutation slower course References: ‘Le, T.. Bhushan, V, & Sochat, M. (2023). Fist Aid for te USMLE Step 1 2022, Thirty Third Editon 331d ed, p. 173). McGraw-Hill Eaucation * Riedel, S.. Morse, S, Mistzner,T., & Mile, S. (2019). Jawetz Melnick & Adetbergs Mecical erode. (2B. p 689) MeGrant Ht dueaton 37. Which of the following ‘Schistosoma species can cause urinary symptoms? A. 8. japonicum B. S. haematobium . S. mansoni D. Allof the above B. S. haematobium S. haematobium infections can cause urinary symptoms such as dysuria, urinary frequency, and hematuria, Itis also linked to development of ‘squamous cell carcinoma of the bladder. Reference: Riedol, S, Morse, S, Mitzna, T,& Mile, S. (2018). Jawetz Melnick & Adelberos Medical Microbiology. (28th ed, p. 753). MeGraw-Hal Education, 38. Which of the following Schistosoma species is identified as egg with terminal spine? B.S. haematobium Identification of Schistosoma species: 113 Scanned with CamScanner AA AA AA AANA OG RR RR QQQOVVVIVVSSGGVVVVVIIHVHLEELLULLOLEEEL A. S. japonicum B. S. haematobium . S. mansoni D. Allof the above * S. japonicum: egg with barely Visible nubby spine * S.haematobium: egg with terminal spine «8. mansoni: egg with lateral spine References: + Le, T., Bhushan, V., & Sochat, M. (2023). First ‘Aid forthe USMLE Stop 12022, Thirty Third Eciton (33rd ed, . 157). MeGraweHil Education + Riedel, S., Morso, S. Miotaner,T., & Miler, S. (2019), Jawetz Melnick & Adolbergs Medical Microbiology. (28th ed. p. 753). McGraw-Hill Education 39. Which of the following is transmitted in a fecal-oral manner? A. Hepatitis A B. Hepatitis B ©. Hepatitis C D. Hepatitis D ‘A. Hepatitis A The transmission of Hepatitis A and Hepatitis € is fecal-oral. Hepatitis 8, C, and D are transmitted parenterally. Reference: Riodal, S., Morse, S., Mietzner. ., & Miler, S, (2019), Jawelz Melnick & Adelbeigs Medical Microbiology. (28th ed, p. 512). MeGraw-Hil Education 40. Severe leptospirosis, referred to as Weil's disease, is characterized by the following, EXCEPT? Jaundice Renal impairment Hemorrhage Pulmonary edema oop> D. Pulmonary edema Severe leptospirosis, referred to as Weil's disease, is characterized by the following: © Jaundice ‘* Renal impairment * Hemorrhage Reforenes Loscalzo J, & Fauci A, & Kesper D, & Hauser S, & {Longo D, & Jameson J. (2022). Leptospirosis. n JP. Wagendar & M.G.A. Goris (Eds), Harrison's Principles of inlernal Medicine (2181 ed, Vo. 1, p 18171), New York, NY: MeGraw Hil ‘41. Rocky Mountain spotted fever is caused by__! Rickettsia ricketsii Rickettsia prowazekii Rickettsia typhi Allof the above oop> A. Rickettsia ricketsit Rickettsia ricketsil: Rocky Mountain spoited fever Rickettsia prowazekii: Epidemic typhus Rickettsia typhi: Endemic typhus 114 Scanned with CamScanner8 Sochal, M (2023). Fist ‘Ai forthe USMLE Stop 1 2022, Thy Third Eaton (32rd ed. p. 147). McGraw-Hill Eveation ‘© Riedel, 5, Morse, S. Mictzner,T. & Miler, . (2019), Jawetz Melnick & Adelbergs Medical Mecrobiclogy. (28th ed, . 357). McGraw-Hill Eaation 42, Adenovirus can cause alll of the following, EXCEPT? ‘A. Hemorrhagic cystitis B. Pneumonia C. Myocarditis 1D. None of the above D None of the above ‘Adenovirus can cause all ofthe folowing + Hemorthagic cystitis Pneumonia Myocarditis Conjunctivitis Gastroenteritis References: Ler T Bhushan, V. & Sochat, M (2023) First ‘Ad forthe USMLE Step 1 2022, Thity Tiré Edition (33rd ed. p. 181). McGraw Education. © Riedel, S. Morse, $., Mietener, T. 8 Miler, S. (2019). Jawete Melnick & Adelbergs Medial Mecrobicloy. 28th ed, p. 417) McGraw-Hill Eavcation, ‘43. Which of the following vaccines has intussusception as one of its adverse effects? A. MMR B. Rota C. Tdap D. HepB B. Rotavirus Rotavirus vaccine has been associated ‘with uncommon occurrence of intussusception. In 1998, an oral lve attenuated rotavirus was withdrawn a year after being licensed because of reports of intussusception as an adverse effect. Intussusception has also been associated with recent viral infection with adenovirus. References: +” “Le, T, Bhushan, V, & Sochat, M. (2023). Fst ‘Aid forthe USMLE Stop 1 2022, Tity Thid Edition (33rd ed. p. 382) MeGraw-Hil Eveation + Riedel 5. Morse, S., Mietzner. T..& Miler, S. (2019) Jawetz Minick 8 Adelbergs Medical Microbioiogy (28th ed». 551). MeGraw-Hil Equation 44. Which of the following is the ‘cause of hand-foot-and-mouth ‘A Coxsackie A 115 Scanned with CamScanner ann AAAAAAAAAAAAAaaeaqaaaaaga Aq Rascee ee ee ee ee ee ee ee ee disease (HFMD)? A Coxsackie A B. HHVE c o. HHV8 Parvovirus B19 HFMD is caused by Coxsackievirus A16 ‘and enterovirus 71. it presents with: ‘© Oral and pharyngeal ulcerations ‘© Vesicular rash of the palms and soles that may spread to the arms and legs. Reference Riede,'S, Morse, S, Mlctzner, T. & Mile, S. (2010), Jowets Moinick 8 Aelergs Medics Mierobclogy (aon ed. p29), MeGraw-Hil Edveaton 48. Which of the following is the ‘smallest DNA virus? A B. c. D. Poxvirus Papillomavirus Parvovirus Picomavirus C. Parvovirus ‘The smallest DNA viruses are the Parvoviruses. Reference: Riedel, S., Morse, S, Mictznor, T.,& Mile, S. (2019), Jewotz Melnick & Adelbergs Medical Microbiology. (28th ed, p. 487). MeGraw-Hil Edveaton. 46. Infection with JC virus in an HIV patient may result in which of the following? A B. G D. Bovine spongiform encephalopathy Alzheimer disease Progressive multifocal Teukoencephalopathy Aplastic crisis . Progressive multifocal eukoencephalopathy Infection with JC virus in an HIV patient (immunocompromised) may result in development of progressive multifocal leukoencephalopathy or PML. JC virus is a Polyomavirus. Reference: Le, T., Bhushan, V., & Sochat, M. (2023). Fist Aid for the USMLE Step 1 2022, Thirty Third Edition (33d 0... 161), McGraw-Hill Education, 47. A child with beta thalassemia was rushed to the ER for pallor. On workup, he was found to have an aplastic crisis. Which of the following agents must have precipitated his episode of aplastic crisis? pop Polyomavirus Parvovirus B19 Coxsackievirus A16 Hepatitis virus B. Parvovirus B19 Parvovirus B19 can cause transient aplastic crisis in patients with’ * Sickle cell disease © Thalassemias © Acquired hemolytic anemia in adults References: 5 T, Bhushan, V, & Sochal M, (2023). Fist {id for the USMLE Step 1 2022, Thity Third Editon (33d 04, p. 425). MeGraw-Hil Eaveation + Riedel, S. Morse, S. Mietzner,T., & Miler, . (2019), Jawelz Melnick & Adelbergs Medical Microbiology. (281 ed. p. 460). MeGraw- Hil Eaueaton 116 Scanned with CamScanner48. Which of the following nematodes is not acquired by the ingestion ofits eggs? A 8. c. ©. Enterobius Ancylostoma Trichuris Trichinella B. Ancylostoma The route of infection of the following nematodes is through the skin: ‘© Strongyloides. © Ancylostoma * Necator ‘The route of infection of the following nematodes is through Ingestion of eggs: + Enterobius © Ascaris * Toxocara Trichinella © Trichuris Reterences: 2 Le, T, Bhushan, V,& Sochal, M. (2023). Fist ‘Ad for the USMLE Step 1 2022, Tity Third Editon (33rd ed, p. 155). McGraw-Hit Edueaton ‘+ Riedel, S, Morse, S., Motaner, 7, & Miler, . (2010). Jawetz Melnick & Adelbergs Medical Microbiclogy. (26th ed, p. 742). McGraw Hit Education. 49. All ofthe following are TRUE ‘about Trichuris trichiura, EXCEPT? A B. G ©. Involves the cecum ‘Acquired through ingestion of eggs Treatment is with Praziquantel None of the above ©. Treatment is with Praziquantel ‘Treatment of Trichuris trichiura is with mebendazole, albendazole or pyrantel pamoate. Reference: Riedel, S, Morse, S, Mietzner, T. 8 Mil, S. (2010). Jawetz Melnick & Adebergs Medical Microbiology. (26th ed. p. 742) MeGraw Hil Education, 50. What is the most probable infecting organism in a patient with a history of lV drug abuse who developed infective endocarditis? A 8. c. D. ‘Staphylococcus epidermidis, ‘Staphylococcus aureus Coxiella Enterococcus B. Staphylococcus aureus In patients with history of 1V drug abuse, infective endocarditis can develop from the following organisms: ‘© S.aureus ‘* Pseudomonas * Candida Relerences: + Le, T, Bhushan, V., & Sachat, M. (2023). First {Aid forthe USMLE Stop 1 2022, Thirty Third Eaton Gd, . 318) McGraw ‘+ Riedal,S, Morse, S., Metzner, 7. & Mier, S. (2019). Jowete Melnick & Adelbergs Medal Microbiology (28th ed. p. 786). MeGraw- Hal 7 Scanned with CamScanner AAAAAAAAAAAAAA AAAI E448 6G RQ QQPP PVVVVV GGG GV VGN VU UUULULLLLLEeeL Education. 51. Culture-negative endocarditis ‘can be caused by ‘A. Staphylococcus epidermidis B. Staphylococcus aureus ©. Coxiella D. Enterococcus ©. Coxiella ‘Among the choices, culture-negative ‘endocarditis can be caused by Coxiella. Roterence: + Lo, T., Bhushan, V., 8 Sochat, M. (2023). First {Ad for tho USMLE Step 4 2022, Thity Third Editon (33rd ed, p. 318). McGraw-Hill Education ‘+ Loscalzo J, & Fauci A, & Kasper D, & Hauser S, & Longo D, & Jameson J, (2022), Bartonella infections, including eat-seratch disease. n M. Giladi& hi, Ephros (Eds.), Harison's Principles of iniernal Medicine (21st ed, Vol. 2, p. 772). ‘Now York, NY: McGraw Hill 52. Chronic enlargement of the limbs, breasts, and genitalia, known as elephantiasis, is caused by what form of the causative filariid nematodes? ‘Adult worms Microfilariae Eggs Levae poe> ‘A. Adult worms ‘The main cause of the inflammatory and fibrotic reactions which lead to the signs ‘and symptoms of elephantiasis is the adult worms residing in lymph tissues. Reference: Riedel, S., Morso, S. Mictzner,T.,& Miler, S. (2019), Jawetz Melnick & Adolbeigs Medical IMWierobiology. (28th ep. 750). MeGraw- Hil Education 53. Struvite stone formation in the kidney is associated with which of the following organisms: A. Clostridium difficile B. Pseudomonas spp. C. Proteus spp. D. Serratia marcescens C. Proteus spp. Struvite stone formation is associated with Proteus due to the presence of urease which splits urea into ammonia and CO2, thereby increasing urine pH and risk for stone formation, ‘The rest of the options are not urease- positive organisms and are not associated with struvite stone formation, References: + Lo, T., Bhushan, V., 8 Sochat, M. (2023), First ‘Aid for the USMLE Step 1 2022, Thity Third Editon (33d 66, p. 125). MeGraw- Hi Education. ‘© Radel, S., Morse, S. Miotzner, T.,& Miler, S. (2019) Jawote Melnick & Adelbergs Medical ‘Microbiology. (28th ed. p. 241). MeGraw-Hil Education 54. Which of the following organisms possesses a toxin that B. Clostridium perfringens 118 Scanned with CamScanner‘can cause myonecrosis and hemolysis? ‘A. Clostridium difficile B. Clostridium perfringens C. Streptococcus pyogenes D. Staphylococcus aureus C. perfringens secretes alpha toxin which ‘can cause myonecrosis in the form of gas ‘gangrene and hemolysis. Reterencs ‘Bhushan, V., & Sochat, M. (2023). Fest ‘id for the USMLE Stop 1 2022, Thity Third Ezition (331d ed, p. 131). MeGraw-Hil Euucalion, + Riedel, S., Morse, S. Mistzner,T. & Miler, S. (2019), Jawelz Melnick & Adelbergs Medical Microbiology. (28tn ed. p. 162). McGrow-Hal Education, '55. Patients with sickle cell disease are susceptible to bacteremia from ‘what organism? ‘A. Streptococcus B. Neisseria C. Salmonella D. Haemophilus C. Salmonella Patients with sickle cell disease are susceptible to bacteremia from Salmonella and S. aureus. References: © Le, T, Bhushan, V., & Sochal, M (2023). Fist ‘id forthe USMLE Step 4 2022, Thity Third Edition (33rd ed, p. 177). MeGraw-Hit Education. ‘+ Riedel, S., Morse, S, Mictzner, T. & Miler, S. (2019) Jawete Melnick & Adelbergs Medica! Merobiey. (280 ed, 248) MeGrow Ha lucation. ‘56. What is the most prevalent of all dermatophytoses? ‘A. Tinea corporis B. Tinea pedis C. Tinea cruris D. Tinea capitis, B. Tinea pedis ‘The most prevalent of all dermatophytoses is tinea pedis or athlete's foot. Reference: Riedel, S, Morse, 8. Metaner,T., & Miler, S. (2019). Jawetz Melnick & Acetbergs Mecical ‘Microbiology. (28th ed, p. 683). McGraw Hit Education. '57. What hemorthagic and necrotic skin lesion develops in patients with sepsis from P. aeruginosa? ‘A. Pyoderma gangrenosum B. Ecthyma gangrenosum C. Gas gangrene D. Allofthe above 8. Ecthyma gangrenosum Ecthyma gangrenosum is a hemorrhagic and necrotic skin lesion that develops in Patients with sepsis from P. aeruginosa. Pyoderma gangrenosum occurs in ulcerative coliis and Crohn disease. Gas gangrene is caused by C. perfringens. Relerences: Le, T. Bhushan, V, & Sochat,M. (2023). First ‘Aid forthe USMLE Step 1 2022, Thity Third Edition (3316 ed. p. 389). McGraw Hit 119 Scanned with CamScanner AAAAAA AAAI AAA aa eenngEucaton + Riedel, S.. Morse, (2019). Jawetz Microbiology. (281n ed. Edueaton 'S,, Mictzner, 7, & Mile. S. nick & Adolbergs Medical . 255). McGraw-Hil 58, Tetanus causes spastic ‘A A Inhibiting release of GABA and glycine aralysis by ee Tetanus causes spastic paralysis by A. Inhibiting release of GABA inhibiting the release of inhibitory and glycine neurotransmitters like GABA and alycine. Cleaving SNARE proteins : Releasing alpha toxin C. botulinum causes botulism by cleaving Inactivating 60S ribosome ‘SNARE proteins and decreasing acetylcholine release. poo C. perfringens releases aloha toxin. Shiga toxin inactivates 60S ribosome to cause hemolytic uremic syndrome. References: + Le, T., Bhushan, V.,& Sochal, M. (2023). First ‘Aid for the USMLE Step 1.2022, Thity Third Editon (33rd ed, p. 711). MeGraw-Hil Education ‘+ Riedel, S., Morse, S., Mietzner, T., & Miler, S. (2019), Jawetz Melnick & Adelborgs Medical Microbiology. (28th ed, p. 162). MeGraw-il Education ‘59. Which of the following is NOT A | A Produces a heat-stable toxin true of C. botulinum? ‘The toxin released by C. botulinum is heat- ‘A. Produces a heat-stable labile, not heat-stable. toxin B. Causes floppy baby C. botulinum causes floppy baby syndrome syndrome, C. Toxin decreases acetylcholine at the C. botulinum causes botulism by cleaving neuromuscular junction SNARE proteins and decreasing D. None of the above acetylcholine release. References: * Le, T,, Bhushan, ., & Sochat, M. (2023). Fits ‘Aid for he USMLE Step 1 2022, Thirty Third Edition (33rd ed, p. 136). McGraw-Hill Education ‘© Riedel, S., Morse, S., Mietzner, T., & Miler, S. (2019) Jawetz Melnick & Adelbergs Medical ‘Microbiology. (28th ed, p. 800). McGraw-Hil Education, 60. Which infection by the foliowing | A | AS. japonicum ‘organisms may result in portal 120 Scanned with CamScannerhypertension? A. S.japonicum B.S. haematobium C. Paragonimus westermani D. Allofthe above 'S. japonicum eggs may cause granulomatous reaction and fibrosis of the liver leading to portal hypertension. Paragonimus affects the lung which leads. to pulmonary symptoms such as cough and hemoptysis. Reference: Fede, S., Morse, S, Metzner T.,& Miler. S. (2019), Jawete Monick & Adelbergs Modical ‘Microbiology (28th e., pp. 752-753). McGraw-Hill Eoucaton. 61. Which of the following should be considered as an important differential diagnosis when ‘considering pulmonary TB? A. S. japonicum B. S. haematobium C. Paragonimus westermani ©. Fasciola CC. Paragonimus westermani Paragonimus affects the lung which leads to pulmonary symptoms such as cough and hemoptysis. These symptoms are similar to patients with PTB and therefore, should be Considered os an important differential diagnosis when considering PTB. Referones Riedel, 5. Morse, S, Mietzner,T. & Mile, S. (2010). Jawetz Melnick & Adelbergs Medical Nicrobiology. (28 ed, p. 752). MeGraw-Hit Education, 62. What diagnostic test for ‘Typhoid fever is considered the most sensitive? Urine culture Stool culture Bone marrow culture Serologic tests pomp C. Bone marrow culture ‘The most sensitive test for Typhoid fever is bone marrow culture but are clinically less. practical than other tests, Reference: Riedel, S, Morse, S., Mietzner, T., & Miler, S. (2019). Jawetz Mainck & Acelbergs Medical Microbiology. (28h ed, p. 247). MeGraw- Hi Education 63. What is the most common manifestation of salmonella infection? A. Bacteremia B. Enterocolitis C. Meningitis D. Osteomyelitis B. Enterocolitis Enterocolitis is the most common ‘manifestation of salmonela infection, Reterence: Riedel, S, Morse, S., Metzner, T., & Mile, S. (2019). Jawetz Meinick & Adeibergs Medical Microbiology (28th ed p. 247). MeGraw-Hit Education 64. What is the main cause of “black dot” tinea capitis? ‘A. Microsporum B. Trichophyton tonsurans €. Trichophyton rubrum B. Trichophyton tonsurans. ‘Trichophyton tonsurans produces spores inside the hair shaft (endothrix) and is the main cause of black dot tinea capitis. 121 Scanned with CamScanner AAADAAAAAAAATUARUTAEEAARAR RROD APOOP DSVVS GV IV VV VIG HUULUUELELLLELEEE D. Allof the above Reference: Riedel, S., Morso, S. Mietzner,T.. 8 Millet, S. (2019), Jawetz Melnick 8 Adelbergs Medical ‘Microbiology. (28th ed, . 684). McGraw Hil Education 65. A palient with HIV develops wart-like growth on the tongue. On examination, oral hairy leukoplakia was the most likely diagnosis. ‘What is the causative agent of this lesion? A. EBV B. CMV c. HSV D. vav A EBV Oral hairy leukoplakia is a focus of EBV replication and is described as wart-like ‘growth on the tongue. Reference: Riodol, S, Morso, S. Mlotzner, T., & Milo, S (2019), Jawotz Melnick & Adelberps Medical ‘Microbiology. 28th ed, . 482). McGraw-Hill Education, 66. EBV is associated with the following malignancies, EXCEPT? Hodgkin lymphoma ‘Non-Hodgkin lymphoma Nasopharyngeal carcinoma None of the above gop> D. None of the above EBV is associated with the following ‘malignancies: + Burkitt lymphoma + Hodgkin lymphoma ‘+ Non-Hodgkin lymphoma ‘Nasopharyngeal carcinoma * Gastric carcinoma Reference: Riedel, S., Morse, S., Mitzner,T., & Miler, S. (2016), Jawot Mainick & Adelbergs Masia ‘Microbiology. (28h ed, p. 487). MeGraw-Hil Equation 67. In pationts with infectious ‘mononucleosis, use of which of the following can cause a ‘maculopapular rash? ‘Amoxicilin Doxyeycline Azithromycin Allof the above gem> ‘A. Amoxicitin In patients with infectious mononucleosis, use of Amoxicilin (for a presumed streptococcal pharyngitis) can cause a maculopapular rash, Reference: Lo, ., Bhushon, V8 Sochat, M. (2023). Fist Aid for the USMLE Stop 1 2022, Thitty Third Edtion (Sea (4, p. 162), MeGrow-Hil Education, 68. The bite of an Anopheles ‘mosquito onto a human wil inject which of the following forms of the ‘malarial parasite? ‘A. Merozoite B. Sporozoite C. Gametocyte D. Schizont B. Sporozoite ‘The bite of an Anopheles mosquito will injoct sporozoites into the bloodstream of a human. Gametocytes are the form of the malarial parasite that is taken up and ingested by bloodsucking female Anopheles, 122 Scanned with CamScannerReterence: Reedel, S., Morse, S. Mietzner, T. 8 Mit (2010), Jewets Melnick & Adelbergs Medical Microbiology. (28th ed, p. 735). McGraw-#it Evcation 69. A thick and thin blood smear from a malaria patient from Palawan reveals crescent-shaped gametocytes and trophozoite rings within RBCs. ‘This is characteristic of which of the following? A. P. malariae P. falciparum B. C. P.ovale D. P. vivax B.P. falciparum On blood smear, P. falciparum infection will show: ‘© Crescent-shaped gametocytes, and ‘© Trophozoite rings within RECs P. malariae: Trophozoite rings within RBCs with round or oval gametocytes P. vivaxiovale: Trophozoites and Schufiner stippling within RBC cytoplasm References: ‘© Le, T, Bhushan, V., 8 Sochat, M (2023). First ‘Ad for he USMLE Stop 1 2022, Thirty Thea Edition 33rd ed. p. 184). McGraw-Hill Education, ‘+ Riedel S., Morse, S. Miotner, T. 8 Mile, S. (2018), Jawelz Meinick & Adetbergs Medical Microbiciogy. (28th ed, p. 736). MeGraw-Hil Eaveation 70. Which of the following malarial parasites is associated with cerebral malaria? A. P. malariae B. P. falciparum C._P.ovale D. P. vivax 8. P. falciparum P. falciparum infections are more severe land has a higher rate of fatal complications ‘such as cerebral malaria, Relerence: Riedel, S., Morse, S., Metzner, T. 8 Mile, S. (2019). Jawetz Melnick & Adeibergs Medical, Merobilogy. (28th ed, . 736). McGraw Hit Eaueation, 72. Whats the treatment of choice {or Toxoplasmosis? A. Fluconazole B. Pyrimethamine plus sulfadiazine ©. Amphotericin 8 D. Metronidazole Aside from the above, itcan also lead to Pyrimethamine + sulfadiazine is the treatment of choice for toxoplasmosis. ‘Toxoplasma infection in a pregnant woman may lead to congenital toxoplasmosis, Congenital toxoplasmosis is characterized by the triad of ‘© Chorioretinitis ‘© Hydrocephalus, and ‘© Intracranial calcifications 123 Scanned with CamScanner AAAAARARAAANN9994 44 aaa eannng ANGVUULLLLELELELEL weovvvsd SSI stilbirths, psychomotor disturbances, oF microcephaly. Reference: Riodol, 5, Morso, S., Miotzner,T. & Miler, S. (20109), Jawels Melnick & Adelbergs Medical ‘Microbiology. (28th ed. p. 725). MeGraw-Hit Education. 73, The classic triad of sensorineural deafness, cataracts, and patent ductus arteriosus is seen in which of the following? A CMV B. Rubella C. Rubeola D. Toxoplasma B. Rubella ‘The classic triad of sensorineural deafness, cataracts, and patent ductus arteriosus is, seen in patients with congenital rubella, Congenital toxoplasmosis is characterized by the triad of ‘© Chorioretintis ‘© Hydrocephalus, and # Intracranial calcifications Aside from the above, it can also lead to slillbiths, psychomotor disturbances, or microcephaly. shushan, V, & Sochat, M. (2023). Fist {Ad for tho USMLE Step 1 2022, Thirty Third Edition (33rd ed, p. 168, p. 181}, MeGrave Hal Education + Rodel, S, Morso, S., Miotznar,T..& Mir, S. (2019). Javotz Moinick & Adetbergs Medical ‘Microbiology. (28 ed, p. 728, p. 738). ‘MeGraw-Hill Education, 74. A patient presents to the clinic with a 2-month history of cough. On ‘workup, CBC showed eosinophilia CXR was also done which showed pulmonary infirates. What is the most likely cause of this patient's symptoms? Ascaris lumbricoides Ancylostoma duodenale Necator americanus Trichuris trichiura pop> ‘A. Ascaris lumbricoides ‘The patient's symptoms of cough, CBC which showed eosinophilia and CXR. showing pulmonary infiltrates point to a possible case of Loeffler syndrome from A. lumbricoides. B and C cause microcytic anemia from iron deficiency. D causes rectal prolapse in children. Reference: Riedel, S., Morso, S., Mitaner,T., & Miler, S (2019), Jawotz Melnick & Adelbergs Medi Nicrabialogy. (28h ed, p. 746). MeGraw-Hil Egueaton 75, Which of the following trematodes can sustain an infection for many years and can lead to a C. Strongyloides stercoralis Strongyloides stercoralis can sustain an 124 Scanned with CamScannerhnyperinfection syndrome in the immunocompromised state? A Ascaris lumbricoides B. Trichuris trichiura C. Strongyloides stercoralis D. Trichinella spiralis 2 Le, Ta Bhushan, V,& Sochat, M. (2023). First ‘Aid forthe USMLE Step 1 2022, Thity Third Edition (3d ed, p. 156). McGraw it (2019), Jowetz Malick & Adelbergs Medical Meroiony. (280 ed... 747, McGraw at 76. A female patient comes to the clinic complaining of a grayish vaginal discharge with a fishy smell. She denies any other symptoms. Microscopy showed “clue cells” What is the suggested treatment for her condition? A. Aaithromycin B. Metronidazole ©. Ceftriaxone D. Cefixime caused by Gardnerella vaginalis. ‘The patient presents with thin, whitish vaginal discharge that has a fishy odor. On microscopy, there are “clue cells” which are vaginal epithelial cells covered with Gardnerella Treatment is with metronidazole or clindamycin, Reterences: + Le, T, Bhushan, V, & Sochat, M. (2023). Fest ‘Ad for the USMLE Step 1 2022, Thirty Thi Eaiion (Sd ed. p. 147). McGraw-Hill Eoueaton. 1+ Rede, S. Morse, S., Mietzner,T.,& Miler, S. (2019) Jawetz Meinick& Adeibergs Medical Microbiology. (28th ed. p. 309) MeGraw-Hat Education This is a case of bacterial vaginosis 76. Trichinellosis is acquired by ‘A. Eating undercooked fish B. Eating undercooked pork C. Eating raw crabs D. Eating aquatic vegetation B. Eating undercooked pork Trichinellosis, caused by Trichinella spiralis, is acquired by eating undercooked pork Reference: Riedel, S, Morse, S, Mitaner, T.,& Miler, S. (2019). Jawetz Moinick& Adelbergs Medical Mobic. (28d, 742) MeGrowe Ha ‘dvealion 77. Which of the following antifungals binds to ergosterol in fungal cell membrane and creates pores? D. Amphotericin B Amphotericin B binds to ergosterol in fungal cell membranes and creates membrane pores that lead to leakage of 125, Scanned with CamScanner MARAAARAAAARAAAANNNE RAGA eennngGOVUELLLELELEEEEE v ev UVIVVIIIIVVIIG Fluconazole Terbinafine . Echinocandin . Amphotericin B gop> ions and small molecules. ‘Terbinafine works by inhibiting squalene epoxidase which is a fungal enzyme. Echinocandin functions to inhibit beta glucan synthesis. Fluconazole works by inhibiting fungal sterol synthesis. Referenc Lo, T., Bhushan, V., & Sochal, M. (2023), First [Nib for the USMLE Stop 1 2022, Thity Third Edition (33rd ed.,p. 196). McGrow- Hit Education. ‘© Ricdel, S, Morso,S., Mitzna, T.,& Miller, S. (2019), Javelz Melnick & Adelbergs Medical Microbiology. (28th ed, p. 712). MeGraw-Hil Education 78. A 31-year-old horticulturist presents with an oozing ulcer and odules on the dorsum of the left hand and arm, forming an ascending lymphangitic pattern. ‘Which of the following findings ‘would you expect to see on microscopy? A. Spaghetti and meatballs, appearance ‘Soap bubble appearance Cigar-shaped yeast None of the above poe . Cigar-shaped yeast This is a case of sporotrichosis. ‘The initia! lesion is granulomatous nodule that eventually forms a necrotic or ulcerative lesion with ascending lymphangits. ‘The causative agent is Sporothrix schenckii. it appears as a cigar-shaped yeast on microscopy. Malassezia: Spaghetti and meatballs Cryptococcus: Soap bubble appearance on MRI # Lo, T. Bhushan, V. & Sochal, M, (2023). Fist ‘Aid forthe USMLE Step 1 2022, Thy Third Edition (33rd ed, p. 151). McGraw-Hill Education + Rodel, $, Morso, S,Mitzner,T., & Miler, S (2019), Jawote Molnick & Adelbergs Medica! ‘Microbiology. (28th ed. p. 686). MeGraw-Hil Educaton 79. Alumbar puncture was done to an HIV patient which revealed encapsulated yeasts on India ink ‘What is the most likely organism identified? A. Cryptococcus neoformans ‘A. Cryptococcus neoformans Cryptococcus neoformans is characterized by encapsulated yeasts on 1m spp is found in stool (not CSF) as acid-fast oocysts. 126 Scanned with CamScannerB. Cryptosporidium spp ¢. EBV 0. cy In patients with HIV, EBV is responsible for ‘causing CNS Iymphoma while CMY is associated with linear ulcers on endoscopy ‘and cotton-wool spots on fundoscopy. References: Le, T., Bhushan, V. & Sechat, M. (2023). First Aid for the USMLE Step 12022, Thity Third Editon (330 ed, p. 174). MeGrawHil Education. 80. An HIV patient presented with symptoms of fever, dyspnea and ‘cough for the past few days. Chest imaging revealed diffuse, bilateral ground-glass opacties with some Pneumatoceles. ‘Which of the following should be Used to establish the diagnosis? A. Chest Xray B. Blood culture c. CBC D. Bronchoalveolar lavage D. Bronchoalveolar lavage This is most likely a case of Pneumocystis pneumonia caused by Pneumocystic Jiroveci. A bronchoalveolar lavage, tung biopsy, or pulmonary secretions with metheneamine silver stain are used to establish the diagnosis. Chest imaging will reveal diffuse, bilateral ground-glass opacities with some Pneumatoceles in these patients. References: ‘+ Le.T,, Bhushan, V, & Sochat, M. (2023). First ‘Aid forthe USMLE Step 1 2022, Thity Third Editon (3316 @9, p. 181), MeGrave Hi Eaucaton, ‘+ Riedel, S, Morse, S., Mitanor, .,& Mir, S. (2018). Jawetz Melnick & Aceiberge Medical écrobiology. (281 ed, . 708) McGraw-Hill Eaveation 81. Most cases of Pneumocystis ‘pneumonia occur at what level of (CD4 cell count? << 500/mm? < 400/mm? < 300/mm? < 200/mm* Sopp D. < 200!mm? Most cases of Pneumocystis pneumonia ‘occur at CD4 cell count of < 200/mm* Relerences: + Le. T., Bhushan, V, & Sochat, M. (2023) First {Ad forthe USMLE Step 1 2022, Thity Third Edition (3314 ed, p. 174), MeGraw-Hil Eaveation ‘© Loscalzo J, & Fauci A, & Kasper D, & Houser S, & Longo D, & Jameson J. (2022). Pneumocystis Infections. in A-Momrs &H. Masu (Eds.) Harrison's Principles of internal Medicine (218t 4. Vol. 2, p. 7339) New York, NY: MeGraw va £82. Which of the following is NOT true about Staphylococcus aureus? ‘A. Staphyloccal enterotoxin causes the most common B. Staphyloccal enterotoxin can be destroyed by cooking Staphyloccal enterotoxin can NOT be destroyed by cooking. I is heat stable, 127 Scanned with CamScanner MARAAAAAAARARA AANA e ee aamananagYVUUULLULELELEECELE u weevsdVIVIIIVVIVIIG form of food poisoning B. Staphyloccal enterotoxin can be destroyed by ‘cooking ©. Symptoms can appear 2-6 hours after ingestion of the toxin D. None of the above ‘Symptoms can appear 2-6 hours afler ingestion of the preformed toxin. ‘Staphylococcal food poisoning by staphycoccal enterotoxin is the most common form of food poisoning. Roferences: © Le, T,, Bhushan, V, & Sochat, M. (2023). First ‘Ad for the USMLE Stop 1 2022, Thity Third Editon (33rd ed, p. 138). MeGraw-Hil Education. * Riedel, S., Morse, S., Mictaner,T., & Miler, S. (2019), Jawotz Melnick & Adelbergs Medical Microbiology. (28th ed.,p. 163, p. 205). MeGraw-Hil Education. 83. Which of the following responsible for the resistance of MRSA? A. Lowsatfinity penicilin- binding protein Developing efflux pumps Mutations in DNA gyrase Allof the above poe A. Low-affinity penicilin-binding proteins Low-affinity penicillin-binding protei (PBP2a) are responsible for conferring resistance to MRSA. Efflux pumps and mutations in the DNA gyrase are the mechanisms of resistance of fluoroquinolones. References: +) Le, T,, Bhushan, V, & Sochat, M. (2023). Fis ‘Ad fot he USMLE Stop 1 2022, Thirty Third Eaion (Sided p33, p. 182). MeGrawta ‘Riedel. S.. Morse, S. Mietzner,T. & Miler, . (2019), Jawetz Melnick & Adelbergs Medical NMicrobilogy. (28th ed. p. 206). MeGraw- Hi Education 84. A 60M with uncontrolled Type 2 diabetes mellitus comes to the ER with erythematous, swollen and tender right lower extremity with necrotic areas and crepitus on palpation which progressed over the last few hours. ‘The resident mentioned that itis most likely due to an infection with “flesh-eating bacteria.” Which of the following bacteria is the resident most likely referring to? ‘A. Group A streptococci B. Staphylococcus aureus A, Group A streptococci ‘The patients signs and symptoms are consistent with necrotizing fascitis. Itcan be caused by group A streptococci which is sometimes termed “flesh-eating bacteria.” References: + Le, T., Bhushan, V., 8 Sochal, M. (2023) First Ald for te USMLE Step 1 2022, Thity Thi Editon (33rd ed. p. 487). McGraw-Hill Education ‘+ Riedel, S, Moree, S, Miotzner,T., & Miler, S. (2019) Jewete Melick & Adelbergs Medical Microbiology. (28th ed, p. 219). MeGraw-Hil 128 Scanned with CamScannerc. D. . Clostridium tetani ). Clostridium botulinum eaucaon al ‘85. Which of the following is the only bacteria that has a polypeptide capsule? A Clostridium tetani B. Bacillus cereus c. D. . Bacilus anthracis ). Clostridium botulinum C. Bacillus anthracis The only bacteria that has a polypeptide capsule (poly D-glutamate) is Bacillus. anthracis, References: Lo, T, Bhushan, V, & Sochot, M. (2023). Fist ‘Aid or the USMLE Step 1 2022, Thity Third elton (39d od, p. 138). McGraw-Hill Education. + Rodel &., Morse, S., Metzner, T., & Mile, S. (2019), Jawetz Melnick & Adelbergs Medical Microbiology. (28th od, p. 32). McGraw-Hil Education. 86. What anthrax toxin facilitates the entry of the other 2 toxins into the cell? A. B. c. o. \- Protective antigen Lethal factor Edema factor Alllof the above A. Protective antigen The 3 anthrax toxins are: ‘* Protective antigen ‘© Lethal factor * Edema factor Protective antigen facilitates the entry of the ‘other 2 toxins into the cell Relerence: Riedel, 5, Morse, S., Mietzner,T., & Miler, S. (2019), Jawetz Melnick & Acelbergs Medical ‘Microbiology. (28th ed. p. 184). McGraw-Hill Eucaion 87. An infant was brought to the linic for high fevers which occurred {or the past several days. This was then followed by the appearance of a diffuse macular rash. What is the etiologic agent of the most ikely diagnosis? pop> HHV-3 HHV-4 HHV-5, HHV-6 D.HHV-6 ‘The infant most likely has roseota infantum which is characterized by high fevers for several days which is then followed by the appearance of a diffuse macular rash. ‘The causative agent is HHV-6. HHV-3: Varicella-zoster HHV-4: Epstein Bare HHV-5: Cytomegalovirus, References: Le, T, Bhushan, V, & Sochol, M. (2023) Fist [Ad forthe USMUE Stop 12022, Thty Thed Edition (331d ed, p. 162), MeGrow-Hil Education + Riedel §. Morse, S, Mietzner,T. 8 Miler, S- 129 Scanned with CamScanner PARAAAAAAAAAAAAAR RR RaaagaaqananagPOPU V VV GV VV VV VGH UUEELLLLLEbEeEL (2019), Jawetz Melnick & Adelbergs Medical Microbiology (28h ed.,p. 493). McGraw-Hit Education. 88. A pediatric patient was brought to the clinic due to excessive coughing with a characteristic “whoop” on inspiration. Which of the following is the mechanism of action of the toxin produced by causative agent in this, case? A B. Inactivation of elongation factor (EF-2) Overactivation of adenylate cyclase by permanently activating Gs Inactivation of inhibitory G subunit and activation of adenylate cyclase None of the above C. Inactivation of inhibitory G subunit and activation of adenylate cyclase This is a case of whooping cough caused by Bordetella pertussis. The pertussis toxin acts by inactivating the inhibitory G subunit ~ activation of adenylate cyclase ~ increased cAMP. Inactivation of elongation factor (EF-2) is the mechanism of diphtheria toxin. Overactivation of adenylate cyclase by permanently activating Gs is the ‘mechanism of cholera toxin. Reference: Le, T., Bhushan, V., & Sochat, M. (2023). Fist Aid for the USMLE Stop 12022, Thity Third Exton (3316 4, p. 130). MeGrow-Hill Education. ‘89. Kala-azar is caused by which of the following parasites? pomp ‘Trypanosoma Leishmania Trichomonas Plasmodium Kala-azar is another term for visceral leishmaniasis, itis Hindi for "black fever’. Trypanosoma cruzi causes Chagas disease. Trichomonas vaginali trichomoniasis. Plasmodium causes malaria lors, S., Motaner, ., & Miler, S. (2019), Jawotz Melnick & Adelbergs Medical Microbiology. (28th ed. p. 733). MeGraw-Hil Education. $0. In patients with Typhoid fever who become chronic carriers, the organisms persist in whal organ? pep Liver Gallbladder Colon Pancreas B. Gallbladder In patients with Typhoid fever who become cchronic carriers, the organisms persist in the gallbladder and in the biliary tract Reference: Riedel, S., Morse, S., Motznor, T., & Miler, S. (2019), Javolz Mainck & Adelbergs Medical Microbiology. (28h e6, p. 249). NeGraw- Kil 130 Scanned with CamScannerEducation 91. Which of the following is ce [cov described as a defective virus that requires the HbsAg coat for HDV requires the HbsAg coat for transmission? transmission and is described as a defective virus. A. HAV B. HCV c. HOV D. HEV Merobiology. 28th ep. $18). McGraw Education ‘82. Which of the following Gram- A | A Campylobacter jejuni negative curved rods that are ‘oxidase (+) grows at 42 degrees . jejuni is a Gram-negative curved rod Celsius? that is oxidase (+) and grows in 42 degrees Celsius. ‘A. Campylobacter jejuni B. Vibrio cholerae Vibrio cholerae is also a Gram-negative C. Helicobacter pylori curved rod that is oxidase (+), but it grows D. Citrobacter in alkaline media, Helicobacter pylori is a Gram-negative ‘curved rod that is oxidase (+) and produces urease. Check out First Aid for a complete picture of the Gram-negative lab algorithm (p. 139). Reference: Le, T, Bhushan, V,& Sochat, M. (2023). First A for the USMLE Step 1 2022, Tity Thied Edtion (33rd 24, p. 139). MeGraw-Hil Educaton, 93. A patient was rushed to the ER DD. Neisseria meningitiais due to severe headache, vomiting, photophobia and stiff neck. He was ‘The patient's signs and symptoms are also noted to have high fever with a characteristic of fulminant ‘meningococcemia with high fever, hemorrhagic rash. After several hemorrhagic rash, shock and DIC. hours, he became hypotensive and developed DIC oe Weil disease, a severe form of leptospirosis, is characterized by a triad of jaundice, renal impairment, and hemorthages. None of these are present in A. Leptospira interrogans the patient, B. Haemophilus ducreyi C. Treponema pallidum D. Neisseria meningitidis What is the most likely etiologic agent in this patient case? Option B causes chancroia. 131 Scanned with CamScanner AAAAAAAAAAAAAAAANIIN eee eeanngBRU DTV V UU UG UU UU LULL eee ee vevu Option C causes syphilis. Relerenes Riedel, S., Morse, S., Metzner, T.. 8 Millet S. (2019), Jawetz Melnick & Adelberas Medica! Wicrobiology. (28th ed, p. 02). MeGraw-Hit Education, 94. Patients with Streptococcus gallolyicus (formerty S. bovis) endocarditis are at an increased risk for developing which of the following malignancies? Esophageal cancer Endometrial cancer pomp €. Colon cancer Patients with Streptococcus gallolyticus (formerly S. bovis) endocarditis are at an increased risk for developing colon cancer. References: + Le, T. Bhushan, V, & Sochat, M. (2023). First ‘Ad for tho USMLE Step 1 2022, Thity Third Golon canoes Edltion (93d ., p. 135). McGran-til Breast cancer Education + Riedel, S, Morse, S., Mietzner,T., & Miler, S. (2019), Jawelz Melnick & Adelbergs Medical Microbiology. (28th ed, p. 223). McGraw-Hill Education 95. The causative agent of the A. ssRNA COVID-19 pandemic is a__: The causative agent of the COVID-19 A. ssRNA pandemic is a (+) single-stranded RNA B. ssDNA virus. C. dsRNA D. dsDNA Reference: Le, T., Bhushan, V., & Sochat, M. (2023). Fist Aid for ‘the USMLE Step 1/2022, Thirty Third Editon (33rd 26, p. 170). MeGrave-Hil Education. 96. Which of the following is the strongest risk factor for severe COVID-19 illness? A. Sex B. Age C. Socioeconomic status D. Allof the above 8. Age Advanced age and medical comorbidities are the strongest risk factors for severe liiness or death from COVID-19. Reference: Le, T, Bhushan, V, & Sochat, M, (2023). Fist Aid for the USMLE Stop 12022, Tity Third Edion (33rd 0, p. 170). MeGraw- Hl Education. 97. The vector for the agent that causes African Sleeping Sickness 3 Sandfly Kissing bug Ixodes tick Tsetse fly pom> D. Tsetse fly Infective trypanosomes of Trypanosoma brucei are introduced through the bite of a tsetse fly, ‘Sandfly is the vector for Leishmania spp. Kissing bug is the vector for Tryoanosoma 132 Scanned with CamScannercruzi Ixodes deer tick transmits Borreli buradorferi which causes Lyme disease. Rel Riedel, S., Morse, S, Mitzner,T. & Miler, S- (2019) Jawotz Melnick & Adelbergs Medical Microbiology. (28th ed. p. 731). MeGraw-Hil Education {98. Viruses from the major group of human rhinoviruses use which of the following receptors? A. Pantigen BL ICAM1 C. CCRS D. coat B.ICAM-1 Human rhinoviruses can be divided into ‘major and minor receptor groups. ‘© Major group viruses: use intracellular adhesion molecule-1 (ICAM-1) as receptor ‘© Minor group viruses: bind members of the low-density lipoprotein receptor (LOLR) family P antigen: Parvovirus B19 CORS: HIV cbt: EBV References: Lo, T., Bhushan, V, & Soehat, M. (2029), Fist {id for the USMLE Step 1 2022, Thity The Eaiion (32rd ed, p. 163). MeGraw Hat Eaveation, + Riedel, S. Morse, S., Mietzner, T., & Miler, S. (2019). Jswot2 Melnick & Adelbergs Medical Merilogy. (2h 0, . 542) MeGeaw Hit ucation. treatment for influenza and works by A. Inhibiting neuraminidase B. Inhibiting viral RNA- dependent RNA polymerase . Acting as a guanosine analog D. Allof the above A. Inhibiting neuraminidase Oseltamivir is used as a treatment for influenza and works by inhibiting influenza neuraminidase. Reference: LT, Bhushan, V., & Sochat, M. (2023). Fist Aid for the USMLE Step 1 2022, Thy Third Edtion (3314 ep. 197). McGrow-Hil Education, 100. Chronic carriers of HBV are patients in whom HBsAg persists for how long? ‘A. More than 6 weeks CC. More than 6 months. Chronic carriers of HBV are patients in ‘whom HBSAg persists for > 6 months, 133 Scanned with CamScannerBUVVVV VSG GV VV VV GG HUUEEEELbLEsEuL B. More than 3 months C. More than 6 months D. More than 12 months Roferonce: Rledol,S., Morso, S., Mietzner,T. & Mile S. (2019), Jawotz Melnick & Adelbergs Medical robin. (28nd, p. 819). MeGraw cation. Scanned with CamScanner