Microbiology System-Wise from Sastry 3rd Ed

GENERAL MICROBIOLOGY (Pg. 3-130)

Group-B (Short Note)
1. Bacterial cell wall. (2019 P1) [pg 16-17]
2. Bacterial Capsule. (2020 P1) [pg 18-19]
3. ^Bacterial capsule. (2016 P1) = B2
4. ^Bacterial capsule. (2011 P1) = B2
5. Bacterial motility. (2018 P1) [pg 20 Table]
6. Bacterial spore. (2021 P1) [pg 21-22]
7. Bacterial spore. (2017 P1) = B6
8. ^Bacterial spore. (2015 P1) = B6
9. ^Bacterial spore. (2010 P1) = B6
10. LJ media (2021 P1) [pg 31]
11. Transport media. (2014 P1) [pg 31]
12. Transport media. (2010 P1) = B11
13. Enrichment media. (2013 P1) [pg 31]
14. Mutation. (2012 P1) [pg 53-54]
15. Plasmid. (2011 P1) [pg 53-54]
16. Inclusion Body. (2019 P2) (Pg. 89)
17. ^Inclusion bodies. (2017 P2) = B16
18. ^Inclusion Body. (2011 P2) = B16
19. Cytopathogenic effects. (2014 P1) (Pg. 93)
20. Opportunistic mycoses. (2018 P2) (Pg.119)
21. ^Opportunistic fungi. (2014 P1) = B20

Group-C (Comment on)

1. All bacteria do not obey Koch’s postulate. (2015 P1) [pg 4-5]
2. Structure of Gram positive cell wall is different from that of Gram negative organism (2012 P1) [pg 16]
3. India ink preparation is an important technique of laboratory diagnosis. (2018 P2) (Pg. 27)
4. Anaerobic bacteria need special culture techniques. (2020 P1) [pg 32,36]
5. ^Anaerobic bacteria do not grow on routinely prepared culture media. (2010 P1) = C4
6. There are many ways for genetic alteration in bacteria. (2017 P1) [pg 53-59]
7. Lysogenic cycle. (2010 P2) (Pg. 55)
8. Bacteriophages may cause genetic alterations in bacteria. (2014 P1) [Pg. 55]
9. Phages are important tools for gene transfer in bacteria. (2013 P1) [pg 55-57]
10. Antimicrobial resistance may be due to several factors. (2014 P1) [pg 61, 65-66]
11. Plasmid has an important role in transfer of drug resistance in bacteria. (2012 P1) [pg 65 + 58Box + 56]
12. Cultivation of virus needs Special techniques. (2020 P2) (Pg. 91+)
13. ^Viruses can be cultivated. (2014 P1) = C12
14. ^Cytopathic effects (CPE) help in viral diagnosis. (2019 P2) = B17
15. Interferon has some role in the containment of viral infection. (2013 P2) (Pg. 93,183)
16. Autoinfection can occur in some worm infections: comment on. (2010 P2) (Pg. 103,735)
17. SDA is said to be a selective media for fungal growth. (2021 P1) (Pg. 117)
18. ^SDA medium is a selective medium for fungal culture. (2017 P2) = C17

Group-D (Difference)
1. Eukaryote and prokaryote. (2015 P1) [pg 3 Table]
2. ^Gram positive and Gram negative cell wall. (2021 P1) = C2
3. ^Cell wall of gram positive and gram negative bacteria. (2016 P1) = C2
4. ^Gram positive and Gram negative bacterial cell wall. (2014 P1) = C2
5. Flagella and Fimbria. (2020 P1) [pg 19 vs 20]
6. ^Flagella and fimbriae. (2011 P1) = D5
7. Lag phase and log phase. (2012 P1) [pg 23]
8. Transcription and translation. (2018 P1) [pg 52]
9. Exotoxin and endotoxin. (2018 P1) (Pg. 71)
10. ^Exotoxin and endotoxin. (2014 P1) = D9
11. Streptococcus and staphylococcus (2021 P1) (Pg. 72,73)
12. Bacteria & Virus. (2020 P2) (Pg. 80)
13. Definitive host and intermediate host. (2016 P2) (Pg. 102-3)
14. Floatation and sedimentation method of stool concentration technique. (2014 P1) (Pg. 106)
15. Cestode and nematode (2013 P2) (Pg. 111)

IMMUNOLOGY (Pg. 133-225)

Group-B (Short Note)
1. Primary immune response. (2013 P1) [pg 137]
2. Heterophile antigen. (2012 P1) [pg 141]
3. IgL. (2010 P1) [pg 144-5]
4. IgM. (2011 P1) [pg 146]
5. IgA. (2018 P1) [pg 147-8]
6. ^IgA. (2016 P1) = B5
7. IgE. (2013 P1) [pg 148]
8. ^IgE. (2012 P1) = B7
9. Monoclonal antibody. (2014 P1) [pg 149-51]
10. Prozone phenomena. (2014 P1) [pg 153 Box, 156]
11. ELISA. (2020 P1) [pg 156-9]
12. ^ELISA test. (2017 P1) = B11
13. Cytokine. (2015 P1) [pg 180-3]
14. Type 1 Hypersensitivity reaction [pg 194]
15. Type 3 Hypersensitivity. (2019 P1) [pg 199]

Group-C (Comment on)

1. Complement takes part in both adaptive and innate immunity. (2015 P1) [pg 134 Table, 135,138]
2. For the diagnosis of infective conditions a rise in titre of antibodies is more meaningful. (2016 P1) [pg
137 Graph, 153?]
3. Secondary immune response is more prompt than primary response (2021 P1) [pg 137, 138 Table]
4. Unrelated antigen may be used as diagnostic test. (2011 P1) [pg 141]
5. Weil- Felix is a heterophile agglutination test. (2010 P1) [pg 141, 155, 312]
6. IgE immunoglobulin mediates type I hypersensitivity. (2011 P1) [pg 148, 194-5]
7. C3 plays the pivotal role in complement activation. (2017 P1) [pg 165 Fig]
8. T- helper cell in immunological response. (2016 P1) [pg 186]
9. Cell mediated immunity is important for recovery from viral infection. (2012 P1) [pg 188]
10. Immediate hypersensitivity reaction can be fatal. (2018 P1) [pg 195]
11. Self antigens are usually non antigenic, but there are exceptions. (2014 P1) [pg 204]
12. Live vaccines are more potent than killed vaccines. (2015 P1) (Pg. 221)
13. Passive immunisation is helpful in certain condition. (2016 P1) [pg 225, 137-8]

Group-D (Difference)
1. Active immunity & passive immunity. (2020 P1) [pg 137-8]
2. Difference between primary and secondary immune response. (2018 P1) [pg 137, 138 Table]
3. ^Primary immune response and secondary immune recponse. (2017 P1) = D2
4. Primary and secondary immunity. (2014 P1) [pg 138 Table?]
 5. Agglutination and precipitation. (2011 P1) [pg 153-4]
6. Immunofluorescence and ELISA. (2013 P1) [pg 160, 156]
7. CD4+ and CD8+ lymphocytes. (2012 P1) [pg 174]
8. T lymphocytes and B lymphocytes. (2019 P1) [pg 176 Table, 172, 174]
9. ^T lymphocyte and B lymphocyte. (2013 P1) = D8
10. Immediate and delayed hypersensitivity. (2015 P1) = [pg 193-4, 200]
11. Live and killed vaccine. (2018 P2) (Pg. 221+)

HOSPITAL INFECTION CONTROL (Pg. 229-283)

Group-B (Short Note)
1. Sterilisation. (2016 P1) [pg 251+253-7]
2. Fumigation of Operation Theatre. (2019 P1) [pg 267?]

Group-C (Comment on)

1. Hospital acquired infection. (2018 P1) (CAUTI, CLABSI, VAP, SSI) (Pg. 242+)
2. Quality control is essential to maintain proper function of autoclave. (2020 P1) [pg 254?]
3. Moist heat sterilization is more efficient than dry heat. (2021 P1) [pg 254 vs 256]
4. ^Moist heat sterilization is more efficient than dry heat. (2019 P1) = C3
5. Microbiological wastes should be segregated before disposal. (2021 P1) [pg 263-4]
6. ^Microbiological wastes should be segregated before disposal. (2013 P1) = C5
7. Post exposure prophylaxis. (2010 P2) (Pg. 269)

Group-D (Difference)
1. Sterilization and disinfection. (2018 P1) [pg 251]
2. Antiseptic and disinfectants. (2015 P1) [pg 251]
3. Dry heat and moist heat sterilisation. (2013 P1) = C3
4. Tyndallisation & Inspissation. (2017 P1) [pg 259?]

BLOODSTREAM AND CARDIOVASCULAR SYSTEM

(Pg. 287-386)
Group-A (Long Question)
1. A 40 year old man came to the OPD with a history of fever for 2 weeks. He had coated tongue, relative
bradycardia, mild hepatosplenomegaly and a rash of Roseola spots. What is your diagnosis? What are
the causative organisms? How will you proceed for the diagnosis? 1+2+7 (2021 P1)
Typhoid Enteric Fever (Pg. 303-4)

2. A 25 years female patient was brought to the hospital who has been suffering from fever and weakness
for last 10 days. Physical examination revealed raised body temperature and there was relative
bradycardia, coated tongue, splenomegaly and hepatomegaly. Write the probable clinical diagnosis.
Nome the causative bacterial agent. Describe the laboratory diagnosis of such a case. Mention how
occurrence of such disease can be prevented. 2+1+5+2 (2017 P1)
Similar to Q1

3. An adult male suffering from continuous fever for five days is brought to the hospital. On physical
examination he had coated tongue, mild splenomegaly and relative bradycardia. What is your
provisional diagnosis? Name the causative bacteria. How will you establish the laboratory diagnosis?
Name the vaccines used for prevention of this disease. 1+2+5+2 (2011 P1)
 Similar to Q1

4. A 38 year old woman comes to the OPD with unexplained fever, severe weight loss of more than 10%
and chronic diarrhoea of more than 1 month. Her husband, a 45 year old truck driver, gave history of
repeated exposure. What is the probable clinical diagnosis? Name the agent/agents responsible for the
condition. What laboratory methods are available for diagnosis of the condition? What fungal and
parasitic infection might develop in this patient with the progress of the disease? l+l+5+3 (2019 P2)
HIV/AIDS Clinical Stage 3 (WHO Classification) [Pg. 329 Table for Fungal/Parasitic Infections, Pg.
330 for Lab Diagnosis]
5. A 30 years old man, truck driver by profession, complained of generalized weakness along with
persistent diarrhoea for one month and loss of weight. He had history of exposure a few month back.
What might be the chemical condition? Which etiological agent are responsible for such a condition?
How will you process for library diagnosis? 1+2+7 (2017 P2)
Similar to Q4

6. Enumerate the arboviruses prevalent in India. Discuss the epidemiology of any one of them. Describe
the pathogenesis of dengue shock syndrome? 3+3+4 (2020 P2)
Dengue [Pg. 339+], Japanese encephalitis [Pg. 716], West Nile fever, Chikungunya fever [Pg. 342],
hemorrhagic fevers such as Crimean‐Congo hemorrhagic fever, Kyasanur forest disease [Pg. 343], etc.
are some of the arboviral infections prevalent in India [Pg.100]
Dengue Shock Syndrome [Pg. 339]

7. Enumerate the arboviruses prevalent in India. List the causative agent of viral haemorrhagic fever.
describe the immunopathogenesis of dengue shock syndrome. 3+3+4 (2018 P2)
Similar to Q6 +
VHFs are caused by viruses of three distinct groups:
a. Arboviruses: Transmitted by arthropod vectors. Examples include dengue, yellow fever viruses
b. Filoviruses such as Ebola and Marburg viruses
c. Rodent borne viruses such as Hantaviruses and Arenaviruses.

8. What are the arboviruses prevalent in India? Name the causative organisms of viral haemorrhagic Fever.
Describe the pathogenesis of Dengue shock syndrome. 3+3+4 (2015 P2)
Similar to Q6

9. A middle aged man presented with alternate day sudden onset fever associated with chill and rigor for
the last 10 days. Fever associated with sweating within a few hours. On examination, he was found to
be a anaemic and have mild hepatomegaly. What might be the most probable clinical condition?
Enumerate the possible etiological agent. What are the route/s of entry of such agents? Describe the
laboratory diagnosis of search Condition. 1+2+1+6 (2017 P2)
Malaria Every 48 hours > P. ovale, P. vivax, P. falciparum?? [Pg. 352]

10. A 30 years old cachectic male migrant labour from attended the medical OPD with complain of fever,
severe weakness, pallor and palpitation. On examination he had hepatomegaly and huge splenomegaly.
What is the clinical diagnosis and the causative agent of this condition? How will you confirm the
diagnosis in the laboratory? 1+1+8 (2016 P2)
**Malaria [Pg. 352] [Note: Cachexia (wasting syndrome) is an independent prognostic marker of
survival in many chronic diseases including heart failure and malaria]

11. A 35 year old man, who is a security guard by profession and working at Kolkata was brought to the
emergency room of your hospital with fever, headache and diarrhoea. As stated the fever is accompanied
by chill and rigor and coming intermittently for last 10 days. Each episode of fever persists for few hours
and comes down with profuse sweating. For these symptoms he had been treated with some antibiotics
by local medical practitioner. At the time of examination, his body temperature was raised, blood pressure
 was 110/70 and spleen was palpable. Name the probable clinical diagnosis. The common causative
micro- organism(s) and the vector implicated. Describe the laboratory diagnosis of such a case. 1+2+1+6
(2013 P2)
**Malaria (with diarrhea??) [Pg. 352]
12. A middle aged male patient was complaining of alternate day fever with chill and rigor for five days.
Name the parasites responsible for this. How will you establish the laboratory diagnosis? What are the
complications of this disease? 1+6+3 (2011 P2)
Similar to Q9 [Malaria in Q 9,10,11,12]

13. Enumerate the arthropod borne parasitic diseases. Draw a schematic diagram to describe the life cycle
of any one of them. How will you diagnose this disease in the laboratory? 3+3+4 (2020 P2)
Babesia microti (parasite, protozoan) [Pg. 358] ; Diphyllobothrium latum (parasite, cestode,
tapeworm) ; Diphyllobothrium spirometra (parasite, cestode, tapeworm) ; Trypanosoma cruzi
(parasite; protozoan) ; Trypanosoma brucei (parasite; protozoan) ; Loa loa (parasite; nematode;
roundworm) ; Plasmodium falciparum, P. malariae, P. vivax, P. ovale (parasite; protozoan) [Pg. 347];
Wuchereria bancrofti (parasite; nematode; roundworm) [Pg. 371] ; Brugia malayi (parasite;
nematode; roundworm); Leishmania [Pg. 361]

14. A farmer from Bihar presented with fever and gradual weight loss since last three months. He developed
blackish pigmentation of skin, loss of appetite and was found to have splenomegaly. Identify the clinical
condition. Name the agents causing such infections. How would you proceed to confirm the diagnosis
in the laboratory? What are the sequel that may develop after treatment and why? 1+1+4+4 (2018 P2)
Visceral leishmaniasis (VL) “kala‐azar or black fever” (Pg. 361+)

15. A 30 year old male from Pakur, Bihar has been admitted in the hospital with a history of continuous
fever. weakness. Blackening of skin and huge hepato-splenomegaly. What is the provisional diagnosis?
Name the causative agent. Describe the pathogenesis of the disease. How will you diagnose the disease
in the laboratory? 1+1+4+4 (2014 P1)
Similar to Q14

16. A patient has come to OPD with elephantiasis of one leg. What are the causative agents for the illness?
How the diseases is transmitted? Describe the pathogenesis of the disease. How will you diagnose the
case in laboratory? 1+1+4+4 (2012 P2)
Lymphatic Filariasis (Wuchereria bancrofti, Brugia malayi and Brugia timori) [Pg. 372‐373]

Group-B (Short Note)

1. Scrub Typhus. (2020 P1) (Pg. 313)
2. Dengue haemorrhagic fever. (2012 P2) (Pg. 339)
3. Enumerate viral, parasitic and fungal opportunistic infections associated with HIV infection. (2012 P2)
(Pg. 329 Table)
4. PKDL. (2012 P2) (Pg. 362)
5. Candida albicans. (2013 P2) (Pg. 377)
6. Dimorphic fungus. (2020 P2) (Pg. 379)
7. ^Dimorphic fungus. (2018 P2) = B6
8. ^Dimorphic fungi. (2016 P2) = B6
9. ^Dimorphic fungi. (2011 P2) = B6

Group-C (Comment on)

1. Coagulase negative staphylococcus are never pathogenic. (2014 P1)
[Wrong > Prosthethic Valve Endocarditis, SSI, CLABSI] (Pg. 289)
2. Rheumatic fever occurs as a result of repeated streptococcal infection. (2020 P1) (Pg. 293, 523)
3. Interpretation of Widal test depends on several factors. (2019 P1) (Pg. 306,7)
 4. ^Result of a single Widal test should be interpreted with caution. (2014 P1) = C3
5. Emergence of new dengue serotypes in endemic area is usually leads to complication. (2016 P2) (Pg.
339)
6. Complications of dengue viruses are immunologically mediated. (2013 P2) (Pg. 339)
7. *Role of cytokines may be important in malaria. (2014 P1)
8. Relapse is associated with Benign Tertiary (B.T.) malaria. (2013 P2) (Pg. 348)
9. Relapse is not associated with each and every malarial infection. (2012 P2) (Pg. 348)
10. Hypnozoites are responsible for relapse of malaria (2010 P2) (Pg. 347/8)
11. Diagnosis of plasmodium falciparum (2021 P1) (Pg. 352+)
12. ^PKDL. (2015 P2) = B4
13. LD Body (2021 P1) (Pg. 364)
14. The pathogenesis of lymphatic filariasis is multi-factorial (2021 P1) (Pg. 372)
15. Peripheral blood examination at mid night is important for diagnosis of classical filariasis (2011 P2)
[Periodicity of the microfilariae] (Pg. 373)
16. Microfilaria can be demonstrated in smear from peripheral blood in any time of the days (2016 P2)
[DEC Provocation Test] (Pg. 373)

Group-D (Difference)
1. Chloramphenicol in the treatment of typhoid. (2010 P1) (MDR S.Typhi / Old is Gold) (Pg. 308)
2. Ring form of P. vivax and P. falciparum. (2019 P2) (Pg. 353)
3. Gametocytes of P. vivax and P. falciparum. (2018 P2) (Pg. 353)
4. Morphological of early trophozoite of plasmodium vivax and plasmodium falciparum (2013 P2) (Pg.
353)
5. Amastigote and promastigote form of Leishmania donovani (2021 P1) (Pg. 360)
6. Wuchereria bancrofti and Brugia malayi. (2019 P2) (Pg. 370)
7. Microfilaria of Wuchereria bancrofti and Brugia malayi. (2014 P1) (Pg. 374 Fig)
8. ^Microfilariae of W. bancrofti and B. malayi. (2012 P2) = D6
9. *Cryptococcus and Candida albicans. (2016 P2) (?? 143, 377, 739)
10. Hyphae and pseudohyphae. (2015 P2) (Pg. 378 Table)

GASTROINTESTINAL (GI) SYSTEM (Pg. 387-472)

Group-A (Long Question)
1. A 10 year old boy is brought to the OPD with complaints of passage of stool mixed mucus and
occasional blood for more than 10 times for last 2 days. He has pain abdomen and cries on defecation.
What will be your provisional diagnosis? Enlist the bacterial pathogens associated with the clinical
condition. Describe the laboratory diagnosis of such a case. Name two systemic complications
associated with specific pathogens which could occur after resolution of clinical condition. 1+3+4+2
(2018 P1)
***Dysentery (Pg. 391,2 Table), Food Poisoning (Pg. 396), EnteroHemorrhagic E. coli (Pg. 396)
Shigellosis (Pg. 405 HLA-B27)
2. Two friends went to a Chinese restaurant. They had soup followed by fried rice and chilly chicken.
After 2 hours they started vomiting followed by diarrhoea. They also developed fever. On examination,
the blood pressure was found to be low. What is your diagnosis? What is the mechanism behind this
manifestation? How can you diagnose the case in the laboratory. 1+4+5 (2013 P1)
Bacillus cereus emetic toxin / S. aureus enterotoxin (Pg. 395)

3. A child has been brought to the hospital emergency with passage of rice water stool and severe
dehydration with tachycardia and feeble pulse. What is your provisional diagnosis? Write down the
pathogenesis of the disease. Give an outline of laboratory diagnosis of the disease. 1+3+6 (2016 P1)
 Cholera (Pg. 412)

4. A 12 year old boy has been brought to emergency with severe dehydration and cold clammy extremities
and history of frequent passage of painless watery stool. What is the clinical condition and aetiological
agent? Discuss the pathogenesis and laboratory diagnosis of this case. 1+4+5 (2012 P1)
***Non‐Inflammatory Acute Diarrhoea (Pg. 388 Table) (eg. Vibrio cholera Pg. 412)

5. A middle aged male patient came to the OPD with history of frequent passage of stool, mixed with
mucus and blood. What are the protozoa responsible for it? Discuss the laboratory diagnosis of
condition. Write in brief about 2 prevention. 3+6+1 (2021 P1) (Pg. 428)
(Pg. 388 Table, 427,430+,432> Entamoeba histolytica ,441-2 > Balantidium coli cause dysentery)

6. A boy aged 10 years. residing in a rural area with low sonic-economic status attends the OPD with
complaints of indigestion. weakness and occasional pain in the epigastrium. On examination he is found
to be anaemic with low haemoglobin level. Name the probable helminths causing such clinical
condition. Discuss the pathogenesis of such disease. Discuss the laboratory diagnosis of the disease.
2+4+4 (2014 P1)
The main anemia causing intestinal helminths are Hookworms (Ancylostoma duodenale, Necator
americanus) [Pg. 463+], Trichuris trichiura [Pg. 453] and Schistosomes [Pg. 454+], with hookworms
being most common.

Group-B (Short Note)

1. Diarrhoeagenic strains of Escherichia coli. (2019 P1) (Pg. 403)
2. Halophilic vibrio. (2013 P1) (Pg. 410)
3. Rota virus. (2013 P2) (Pg. 424)
4. NIH swab. (2017 P2) (Pg. 460)
5. Difference between Ancylostoma duodenale and Necator americanus. (2010 P2)
(Adult, L3 Morphology) (Pg. 463)
6. Candida albicans. (2013 P2) (Pg. 377)

Group-C (Comment on)

1. Though a commensal in GI tract, E. coli may cause diarrhoea (2012 P1) (Pg. 403)
2. Viruses are very often responsible for diarrhoea in child. (2016 P2)
[Rota, Noro, Adeno 40,41] (Pg. 424+)
3. *Stool microscopy is important in protozoa dysentery. (2020 P2) (Pg. 103, 430/4/8)
4. Examination of gravid segment of Taenia help in the identification of species. (2011 P2)
(Pg. 449 Table Proglottids)
5. Ascaris lumbricoides infestation may cause surgical complications. (2020 P2)
[Intussusception] (Pg.462/3)
6. ^Surgical intervention may be necessary in case of Ascaris infestation. (2017 P2) = C5
7. Anaemia as presenting features of hookworm infection. (2018 P2) (Pg. 464)

Group-D (Difference)
1. *Infection and toxin type of food poisoning. (2017 P1) (Pg. 396?)
2. ^Infection type and toxin type of food poisoning. (2010 P1) = D1
3. Classical and El Tor vibrio. (2019 P1) (Pg. 411)
4. ^Classical and El tor biotypes of Vibrio cholerae. (2011 P1) = D3
5. Cyst of Entamoeba histolytica & E. Coli. (2020 P2) (Pg. 433)
6. ^Cyst of E. histolytica and E. coli (2012 P2) = D5
7. Entamoeba histolytica and Entamoeba coli. (2017 P2) (Pg. 433)
8. T. Solium and T. Saginata. (2016 P2) (Pg. 449)
9. Cysticercus bovis and cellulose (2015 P2) (Pg. 448 / 449 Table Larvae)
10. Fertilized and unfertilized ova of Ascaris lumbricoides (2021 P1) (Pg. 462)

HEPATOBILIARY SYSTEM (473-502)

Group-A (Long Question)
1. A 10 years old thalassemic boy with history of multiple blood transfusions developed jaundice with
fever for last 7 days. What is the most probable diagnosis? What are the most probable causative agents?
What laboratory investigations you will perform to confirm the diagnosis? What are the vaccines
available for the prevention of this disease? 1+2+5+2 (2021 P1)
**Hepatitis Virus by Blood Transfusion HBV [Pg. 482], HCV [Pg. 485]

2. A 10 years old boy suffering from thalassemia was admitted to the hospital with complain of anorexia,
indigestion and yellow discolouration of eyes and urine. On examination he had moderate jaundice. He
also gave a history of multiple blood transfusion, what may be the probable diagnosis? How will you
proceed to make a microbiological diagnosis? What prophylactic measure may be taken to prevent such
a condition? 1+6+3 (2016 P2)
Similar to Q1
3. A girl while playing sustained injury for which she attended the ER at a health care, where she received
one dose of Tetanus Toxoid. After few weeks she developed jaundice, less of appetite and fever. What
is your diagnosis and what are the agents? How will you proceed for the diagnosis? Is there any vaccine
against and what is that? 2+6+2 (2012 P2)
**Hepatitis B/C due to Needle Contamination (Similar to Q1)
4. A 40 year old man complains of anorexia, indigestion, haematemesis, jaundice fever on and off
associated with hepatomegaly. He gives history of blood transfusion given about 6 years back when he
met with an accident in a private hospital in a small town. What could be the aetiological agent? What
laboratory investigations you will perform to confirm the diagnosis? How this disease could have been
prevented? As a responsible health officer what will be your advice to the community? 1+6+2+1 (2010
P2)
Hepatitis Virus? (Similar to Q1)
5. A 40 year old patient came to hospital OPD complaining of heaviness in the right hypochondrium. C.T.
scan reveals a cystic mass on the under surface of the liver. What is your provisional diagnosis? What
could be the causative agent? Name some possible complications that can occur in this condition. How
will you confirm the diagnosis in the laboratory? l+l+3+5 (2019 P2)
Hydatid Cyst, Echinococcus granulosus (Pg. 493‐5)

Group-B (Short Note)

1. Serological markers of Hepatitis B Virus. (2020 P2) (Pg. 482)
2. ^Serological marker of HepB. (2015 P2) = B1
3. ^Serological markers of HBV. (2011 P2) = B1
4. Hydatid cyst. (2021 P1) (Pg. 494)
5. ^Hydatid cyst (2017 P2) = B4
6. ^Hydatid cyst. (2011 P2) = B4
7. Larva migrans (2016 P2) (Pg. 499 Yellow Box)
Group-C (Comment on)
1. Hepatitis C virus. (2012 P2) (Pg. 484+)
2. Infections caused by E histolytica may have extra-intestinal manifestations. (2015
P2) (Amoebic Liver Abscess) (Pg. 491?)

SKIN, SOFT TISSUE AND MUSCULOSKELETAL SYSTEM

(503-586)
Group-B (Short Note)
1. Toxic shock syndrome. (2016 P1) (Pg. 512)
2. ^Toxic shock syndrome. (2014 P1) = B6
3. Nagler’s reaction. (2015 P1) (Pg. 531)
4. Treponema pertenue (2010 P1) (Yaws) (Pg. 545)
5. Differentiate between measles and German measles. Rubella (2010 P2) (Pg. 559/562)
6. Dermatophytes. (2019 P2) (Pg. 575+,118)
7. Macroconidia of Dermatophytes. (2017 P2) (Pg. 577)
8. Mycetoma. (2012 P2) (Pg. 578+,118)

Group-C (Comment on)

1. Gas gangrene is polymicrobial in nature. (2011 P1) (Pg. 529)
2. Different clinical presentation of anthrax infection. (2018 P1) (Pg. 540)
3. Nocardia differs in many ways from Actinomycetes. (2017 P1) (Pg. 544)
4. Varicella-Zoster differs from primary infection. (2011 P2) (Pg. 554)
5. Culture is necessary for dermatophytes. (2016 P2) (Pg. 576+)
6. Grains from discharging sinus help in identifying agents of Mycetoma. (2019 P2) (Pg. 579 Table)
7. Mycetoma like clinical features may be caused by bacteria as well as true fungi. (2015 P2)
(Pg. 579 Tables)

Group-D (Difference)
1. Anthrax bacilli and Anthracoid bacilli (2016 P1) [B.cereus, thuringiensis, G. thermophilus] (Pg. 539,
542)
2. Dermatophytes (short note). (2010 P2) = B6
3. Trichophyton and Epidermophyton. (2011 P2) (Pg. 575, 577)
4. Endothrix & Ectothrix. (2017 P2) (Pg. 576 Table)
5. Actinomycotic and Eumycotic Mycetoma. (2014 P1) (Pg. 579 Tables)

RESPIRATORY TRACT (587-686)

Group-A (Long Question)
1. A 8 year old child has been brought to chest OPD with complaints of fever for a month not exceeding
100OF, cough with occasional haemoptysis and weakness. i) What may be the clinical diagnosis? ii)
What is the etiological agents of the clinical condition? iii) How will you proceed to confirm the case in
laboratory? iv) Discuss briefly on immune-prophylaxis against the disease. 1+2+4+3 (2020 P1)
[Primary Pulmonary TB (Pg. 626), Pneumonic Plague (Y. pestis) (Pg. 616)?]

2. A 30 year old man has been brought to the hospital OPD with the complain of cough, fever and
 haemoptysis for the last one month. Name two clinical conditions that may be commonly considered in
the differential diagnosis for the above condition. Name a bacterial agent commonly responsible for
causing such a condition. Name a skin test useful in the diagnosis of the infection caused by this bacteria.
Describe briefly the steps of isolation and identification of above bacteria in the microbiology
laboratory. 2+1+1+6 (2019 P1)
[Similar to Q1]

3. A 10 years old child has been brought to the OPD with fever for last 3 days, pain in the throat and
difficulty in swallowing. On examination child had 100○C fever, throat was congested, cervical lymph
nodes were enlarged and tender and pus points seen over tonsillar follicles. What may be the clinical
diagnosis? Name the different bacteria causing the condition. How will you proceed to identify the
agent(s) and how would the clinician be benefitted from the laboratory report? What complication can
occurs following such infections? 2+2+4+1+1 (2018 P1)
Pharyngitis with Tonsilitis (Pg. 588) [Bacterial: S. pyogenes, C. diphtheria]
4. An eight year old boy comes to the hospital emergency with fever, asphyxia and toxaemia. On
examination a pseudomembranous patch is found over the faucial area. What is your provisional
diagnosis? Name the causative organism. How will you proceed to do laboratory diagnosis? Write
briefly one in vivo and one in vitro test to determine the virulence of the organism isolated. 1+1+4+4
(2015 P1)
Diphtheria (Pg. 599-601)
5. A female aged about 53 years presented with evening rise of temperature not exceeding 100 F for about
a month accompanied by cough, expectoration and occasional haemoptysis. X-Ray chest showed
opacity in the apical region of the right lung. What is the provisional diagnosis? Name the etiological
agent. Briefly discuss the laboratory methods for isolation and identification of the organism from the
sputum sample and methods of drug sensitivity testing. 1+1+5+3 (2015 P1)
Similar to Q1 [Pulmonary TB (Pneumonia has higher fever?)]

11. A middle aged person is suffering form low grade fever for 2 months along with cough and occasional
haemoptysis and gradual weight loss. Acid fast bacilli found on sputum smear examination. What is
your probable diagnosis? Name the etiological agent. Briefly discuss the procedures adopted in the
laboratory for the identification and isolation of AFB from the sputum sample. How the immune status
of such a patient can be assessed? 1+2+4+3 (2013 P1)
Similar to Q1
12. A 3 year old child presents to the OPD with acute sore throat, dysphagia, salivation and mild fever. On
examination, an adherent thick greyish patch is found over the tonsil and oropharynx which bleeds on
removal. What is the clinical condition? What is the causative bacteria? How will you collect the sample
and proceed for laboratory diagnosis? What is the method of prevention of such infection? 1+1+6+2
(2014 P1)
Similar to Q4 Diphtheria (Pg. 599‐601) [Contrast with Vincent’s Angina, peels off easily]
13. A two year old girl presented with fever swelling of the neck, pharyngitis and difficulty in degluttition,
a greenish black membrane in throat is seen on examination. What is the provisional diagnosis? What
other aetiological agent can be responsible for similar presentation? Describe briefly how you will
isolate the aetiological agent in the laboratory. 1+2+7 (2010 P1)
Similar to 4 [Diphtheria, Vincent’s Angina (Prevotella, Borrelia vincentii and Fusobacterium
species)]

Group-B (Short Note)

1. Environmental Mycobacteria. (2017 P1) (NTM) (Pg. 636)
2. Occult filariasis. (2020 P2) (Pg. 677)
3. ^Occult filariasis. (2018 P2) =B2
4. ^Occult filariasis. (2014 P1) = B2
5. Aspergillosis. (2015 P2) (Pg. 681)
Group-C (Comment on)
1. *All diphtheria bacilli are non-toxigenic. (2016 P1) (Pg. 600/1?)
2. Isolation of C. diphtheriae from clinical sample does not confirm diphtheria. (2021 P1)
(Diphtheroids) (Pg. 604)
3. Isolation of C. diphtheriae from clinical sample does not confirm diphtheria. (2013 P1) = C2
4. ^Only the presence of C. diphtheria in the throat does not suggest the person is suffering from
diphtheria. (2011 P1) = C2
5. H. influenzae infection in children is preventable. (2019 P1) (Hib vaccine) (Pg. 613)
6. Post primary tuberculosis differs in many ways from primary tuberculosis. (2017 P1) (Pg. 626)
7. Influenza viruses is usually associated with antigenic variation. (2013 P2) (Pg. 649)
8. Influenza vaccine does not give long term protection against influenza. (2012 P2) (Pg. 649)
9. Antigenic shift can cause pandemic. (2011 P2) (Pg. 649)
10. Difference between mucor and rhizopus. (2010 P2) (Rhizoid) (Pg. 681)

Group-D (Difference)
1. Streptococcus viridans and Streptococcus pneumoniae. (2020 P1) (Pg. 606)
2. ^Streptococcus Pneumoniae and Streptococcus viridans. (2016 P1) = D1
3. Typical and atypical mycobacteria (2021 P1) (Pg. 623,636)
4. Orthomyxovirus & Paramyxovirus. (2020 P2) [Smaller, Segmented RNA, 8 Structural Protein] (Pg.
648,655)
5. ^Orthomyxoviridae and paramyxoviridae. (2011 P2) = D4
6. Antigenic shift and antigenic drift. (2019 P2) (Pg. 649)

CENTRAL NERVOUS SYSTEM (687-744)

Group-A (Long Question)
1. A male baby of 4 weeks has been admitted to the hospital with fever, drowsiness, irritability, vomiting
and photophobia. On examination there was neck rigidity and CSF was turbid. What is your clinical
diagnosis? Name the predominant bacterial agents causing such illness. How will you proceed to
diagnose the ease in the laboratory? 1+3+5 (2016 P1)
Bacterial Meningitis (Pg. 689, 692‐3) [Neisseria meningitidis, meningococcal meningitis?] The
common agents of neonatal meningitis include Streptococcus agalactiae, gram‐negative bacilli such as
Escherichia coli and Klebsiella, and Listeria monocytogenes
2. A two year old boy has been brought to the emergency with high fever, vomiting and headache. On
physical examination, there was neck rigidity What is your provisional diagnosis? What are the causative
bacteria in such a case? How will you proceed for laboratory diagnosis of this disease? What are the
vaccines available? 1+1+5+3 (2014 P1)
Similar to Q1

3. A baby of four weeks is admitted to the hospital with fever, drowsiness, irritability, photophobia,
vomiting. On examination, he was found to have neck rigidity. On lumber puncture, CSF was found
turbid. What is your clinical diagnosis? Name the bacteria responsible for such illness. How will you
establish the diagnose laboratory? 1+3+6 (2011 P1)
Similar to Q1
4. A non-immunised child with a history fever and loose motion presented with left sided deltoid paralysis.
Name the clinical condition and etiological agent. How will you diagnose the case in the laboratory?
Discuss briefly the vaccine against this agent. What is the principle behind the recent mass immunisation
strategy against this agent in our country? 2+3+3+2 (2011 P2)
**Poliomyelitis Virus (Pg. 709+)

5. A boy having a history of dog bite 3 week ago, has been admitted in the hospital with fever, headache
and muscle spasms particularly while trying to drink water. What is the clinical diagnosis and etiological
 agent? Discuss the laboratory diagnosis of the disease. What is post exposure prophylactic treatment.
2+4+4 (2013 P2)
Rabies [Pg. 718+]
6. A middle aged man present at emergency with high fever, vomiting, neck stiffness ann convulsive
episodes. He was tested to be HIV seropositive six month back. On examination there was neck rigidity
and positive kernig’s sign. What is the likely diagnosis of this patient? What common fungal agent could
be responsible for this condition and what is the route of transmission? How will you proceed for
laboratory diagnosis? 1+2+2+5 (2015 P2)
Cryptococcal meningitis by Cryptococcus neoformans, which is capable of producing potentially fatal
meningitis in HIV infected people [Pg. 739+]

7. A 30-year old HIV positive male complains of headache, fever, vomiting and altered sensorium. He
showed signs of meningitis. CSF examination showed a capsulated budding organism. What is your
probable diagnosis? How will you confirm the microbiological diagnosis? Enumerate certain fungal
pathogens that can produce meningitis. 2+5+3 (2010 P2)
Cryptococcal meningitis (capsulated); Table 75.3 for Other Fungi [Pg. 739]

Group-B (Short Note)

1. Tetanospasmin (2021 P1) (Pg. 702)
2. Epidemiology of Japanese Encephalitis (2021 P1) (Pg. 716)
3. Japanese Encephalitis. (2016 P2) (Pg. 716)
4. Negri bodies. (2020 P2) (Pg. 721)
5. ^Negri Bodies (2015 P2) = B4
6. ^Negri bodies. (2013 P2) = B4
7. Post exposure prophylaxis in Rabies. (2018 P2) (Pg 722+)
8. Prion disease. (2016 P2) (Pg. 725)
9. ^Prion. (2014 P1) = B8
10. Cysticercosis. (2013 P2) (Pg. 735, 573)
11. ^Cysticercosis. (2010 P2) = B10

Group-C (Comment on)

1. Anti-rabies neural vaccines are not used now a days. (2017 P2) [Encephalitogenic] (Pg. 722)
2. Comment on: Observation period of 10 days is recommended when a biting dog can be observed in
case of rabies (2010 P2) [Pg. 722]
3. Prions cause slow viral disease. (2019 P2) (Pg. 724)
4. Measles may cause CNS infection. (2014 P1) [SSPE] (Pg. 724)
5. Primary amoebic encephalitis and granulomatous amoebic encephalitis. (2018 P2) (Pg. 728/9)
6. Infection of Taenia solium is more dangerous than Taenia saginata (2021 P1) [Cystecercosis] (Pg. 735)
7. Taenia solium infection is more dangerous than Taenia saginata (2019 P2) = C6

Group-D (Difference)
1. Oral and Inactivated Polio Vaccine. (2021 P1) (Pg. 711+)
2. OPV and IPV. (2017 P2) = D1
3. Live and killed polio vaccine. (2012 P2) [OPV, IPV] = D1
4. Street virus and fixed virus. (2011 P2) (Pg. 719)
5. Neural and non-neural vaccine for rabies. (2015 P2) [Pg. 722]
6. ^Neural and nonneural vaccines against rabis. (2013 P2) = D5
7. *Cryptococcus and Candida albicans. (2016 P2) (?? 143, 377, 739)
UROGENITAL TRACT (745-778)
Group-A (Long Question)
1. A 25 year old newly married female patient attended the hospital OPD with the complaints of fever,
frequency of micturition & burning sensation during micturition for last three days. Physical
examination revealed raised body temperature & tenderness over the loin. i) Name the probable clinical
diagnosis. ii) Name the common causative microorganism(s). iii) Discuss the laboratory diagnosis of
such a case. 1+3+6 (2020 P1)
[Lower UTI (Acute Urethral Syndrome Pg. 747) The endogenous flora such as gram-negative bacilli
(e.g. E. coli, Klebsiella, Proteus, etc.) and enterococci are the important agents]

2. A 23-year old lady, married recently, attended the hospital with the complaints of fever with chills
increasing urinary frequency along with urgency and dysuria for the past 24 hours. What IS the most
probable diagnosis? What could be the infecting organism? What other aetiological agents can be
responsible for such presentation? How will you proceed to find out the infecting organism in the
laboratory? 1+1+2+6 (2010 P1)
Similar to Q1

3. One young male patient came to the OPD with the complain of a painless penile ulcer for 7 days. He had
a history of exposure. Name the clinical condition. Name the organism responsible for the condition.
How will you confirm this in the laboratory? Enumerate the other important test to be done in this
situation. l+2+6+1 (2021 P1)
[Primary Syphilis (Pg. 757), Lymphogranuloma Venereum (LGV) by Chlamydia trachomatis (Pg. 763)]

4. A 35 year old bus conductor came to the OPD with the complain of a painless penile ulcer for 7 days and
a recent history of exposure. What could be the clinical condition? Name the organism responsible for
the condition. How will you confirm this in the laboratory? l+l+8 (2019 P1)
Similar to Q3

5. A truck driver age 26 years attend the hospital with complain of one painless ulcer over his external
genitalia. He gave history of sexual exposure 2 month back. Apart from the ulcer physical examination
revealed swollen non-tender discrete inguinal lymph node. Write the probable clinical diagnosis. Name
the probable causative bacteria. Describe the laboratory diagnosis of such a case. Mention the other test
you should perform to rule out any other infection that may accompany such case. 1+1+6+2 (2017 P1)
Primary Syphilis (Pg. 757)

6. A 35 year old man with a history of contact with a female sex worker has come to OPD with urethral
discharge. The urethral discharge did not show any gram negative diplococci. What is your diagnosis?
What are the possible etiological agents? How will you proceed for laboratory diagnosis of any one of
these agents? What is L farm? ½+1½+6+2 (2012 P1)
Non-Gonococcal Urethritis (NGU) include Chlamydia trachomatis, Mycoplasma genitalium and
Trichomonas vaginalis) (Pg. 766). *L-forms (Pg.21)?
Group-B (Short Note)
1. VDRL test. (2012 P1) (Pg. 760)
2. Non gonococcal urethritis. (2017 P1) (Pg. 766)
3. ^Non gonococcal urethritis. (2015 P1) = B2
4. ^Non gonococcal urethritis. (2011 P1) = B2

Group-C (Comment on)

1. Fungal meningitis can be diagnosed rapidly. (2021 P1) (Pg. 740)
2. Bacterial colony count is necessary for proper reporting of urinary tract infection (2018 P1)
[Pg. 748 Box]
 3. Enterococcus is known for its multidrug resistance. (2010 P1) (Intrinsic, VRE) (Pg. 751/2)
4. Diagnosis of secondary syphilis is based on serology. (2020 P1) (Pg. 759+)
5. ^Diagnosis of secondary syphilis is based on serology. (2018 P1) = C4
6. VDRL is not a specific test for syphilis. (2019 P1)
(Reagin Ab, BFP, Prozone, Low Sensitivity) (Pg. 760)
7. Non treponemal test cannot confirm syphilis. (2015 P1) (BFP) (Pg. 760)
8. Haemophilus ducreyi requires only X factor. (2010 P1) (Pg. 762; has pNAD1 plasmid with nadV gene)

Group-D (Difference)
1. VDRL and RPR tests. (2019 P1) (Pg. 760)
2. Comment on:- A combination of VDRL test and TPHA tests is better than either of them alone for
the diagnosis of exclusion of syphilis (2010 P1) (CDC Testing Algo) (Pg. 760-1)

MISCELLANEOUS INFECTIONS (779-816)

Group-B (Short Note)
1. Zika Virus. (2019 P2) (Pg. 798)
2. Oncogenic viruses. (2019 P2) (Pg. 800)

Group-C (Comment on)

1. Screening for TORCH group of infections is important during pregnancy. (2018 P2) (Pg.793,129)
2. Viruses can cause malignancies. (2020 P2) = B2
3. Some viruses are oncogenic. (2017 P2) = B2
4. Herpes virus may cause a variety of malignancies. (2015 P2) (EBV, HHV-8) (Pg. 800)
5. Epstein-Barr virus has a role in a number of malignant diseases. (2012 P2) (Pg. 802)

ANNEXURES (817-834)
Group-C (Comment on)
1. Sand fly. (2010 P2) (Pg. 825 Table)
2. Effective screening of blood at blood banks will help in preventing some transmissible disease. (2018
P2) (Transfusion-transmitted Infections) (Pg. 827)