SONYA ESTI KHOLIFA

Streptococcus

1. What strains of streptococcus sensitive to bacitracin?

1. S. pneumoniae
2. S. sanguis
3. S. bovis
4. S. viridans
5. S. pyogenes

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2. Based on Lancefield Grouping, name the representative species that belong to

group C ?

1. S. pyogenes
2. S. agalactiae
3. S. anginosus
4. S. dysgalactiae
5. S. mutans

4. S. dysgalactiae

3. Based on biochemical testing, name the representative species that not belong to
group mitis ?

1. S. oralis
2. S. pneumoniae
3. S. intermedius
4. S. mitis
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4. What is the name of species that the growth is inhibited by bacitracin disk ?

1. S. pyogenes
2. S. agalactiae
3. S. anginosus
4. S. dysgalactiae
5. S. mutans

1 . Streptococcus pyogenes

5. What is the name of species the growth is inhibited by optochin disk ?

1. S. agalactiae
2. S. anginosus
3. S. mitis
4. S.pneumoniae
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6. What species that popularly called “flesh-eating” bacteria, results from life-
threatening myonecrosis that caused by this organism ?
S. pyogenes
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7. S. pyogenes growth is optimal on enriched-blood agar media but is inhibited if

the medium contains a high concentration of what carbohydrate ?

1. Galactose
2. Glucose
3. Lactose
4. Sucrose
5. Maltose
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8. What virulence factor of Streptococcus pyogenes confers anti-phagocytosis?

M protein

9. Which class of Streptococcus pyogenes M protein that do not have exposed shared
antigens?
class II M proteins

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10. Which class of Streptococcus pyogenes M protein that cause rheumatic fever?
class I M protein

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11. What are the protein that mediated Streptococcus pyogenes invade into
epithelial cells ?
M protein and F protein

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12. What are Streptococcus pyogenes cell wall components that facilitate binding of
host cells by complexing with host cell surface fibronectin?
Lipoteichoic acid and F protein

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13. What is the name of streptococcal toxin that causes necrotizing fasciitis ?

streptococcal pyrogenic exotoxins (Spe)

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14. What is the virulence factor of Streptococcus pyogenes that produced in the
presence of serum and is responsible for the characteristic β-hemolysis seen on
blood agar media ?
Streptolysin S
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15. What is the virulence factor of Streptococcus pyogenes that oxygen-labile

hemolysin capable of lysing erythrocytes, leukocytes, platelets, and cultured cells
?
Streptolysin O
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16. What is the name of Antibodies that are readily formed against streptolysin O ,
and differentiating it from streptolysin S, and are useful for documenting recent
group A streptococcal infection ?
antistreptolysin O [ASO] antibodies
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17. What is the name of a complication disease of streptococcal pharyngitis that

occurs when the infecting strain is lysogenized by a bacteriophage that mediates
production of a pyrogenic exotoxin ?
1. Scarlet fever
2. Acute Glomerulonephritis
3. Rheumatoid fever
4. Streptococcal toxic shock syndrome
1. Scarlet fever
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18. What is the factor that is degrading C3b and help to interfere Streptococcus
pyogenes phagocytosis?

1. Factor A
2. Factor F
3. Factor H
4. Factor S
3. factor H

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19. Name the Streptococcus pyogenes enzyme that inactivates C5a ?

C5a peptidase
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20. What is the

etiologic agent ?
S. pyogenes
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21. Mention two non-suppurative complication of streptococcal disease ?

Rheumatic fever
Acute Glomerulonephritis
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22. What is the treatment for streptococcal pharyngitis ?

oral penicillin V / amoxicillin
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23. Where are the Group B streptococci colonize ?

1. Oropharynx
2. Nasopharynx
3. Upper gastrointestinal tract
4. Genitourinary tract.

4. the genitourinary tract.

And the lower gastrointestinal tract
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24. What is the monosaccharides that can inhibit activation of the alternative
complement pathway, thus interfering with the phagocytosis of group B
streptococci ?
Sialic acid
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25. What is the most important virulence factor of S. agalactiae that interferes
with phagocytosis until the patient develops type-specific antibodies ?

1. Polysaccharide capsule
2. Lipoteichoic acid and
3. F protein
4. M protein
5. Streptolysin

1. polysaccharide capsule
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26. What is the type of carbohydrate that found in Streptococcus agalactiae ?

rhamnose-glucosamine polysaccharide
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27. What test is used to distinguish Streptococcus agalactiae from it’s fellow
streptococci?

1. Bacitracin sensitivity test

2. CAMP test
3. Novobiocin sensitivity test
4. Optochin test
2. CAMP test

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28. What is the drug for chemoprophylaxis should be used for all women who are
either colonized or at high risk for Streptococcus agalactiae infection ?

penicillin G / ampicillin
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29. What species in viridans group that causes meningitis, bacteremia, and
streptococcal toxic shock syndrome?

1. S. mitis
2. S. suis
3. S. anginosus
4. S. intermedius
5. S. oralis
2. S. suis

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30. What is the color that is caused by viridan group of streptococci hemolysis in
blood agar?

1. Red
2. Yellow
3. Blue
4. Green
5. White
4. green

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31. Where are the viridans streptococci NOT colonize ?

1. Oropharynx
2. Nasopharynx
3. gastrointestinal tract
4. genitourinary tract

2. Nasopharynx

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32. On sheep blood agar, what is the major hemolytic pattern from colonies of
Streptococcus mitis ?

α-hemolytic

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33. Which viridans group that causes dental caries?

1. Anginosus
2. Mitis
3. Mutans
4. Bovis
5. Salivarius
3. Mutans

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34. What species that the colonies appear α-hemolytic on blood agar if incubated
aerobically and may be β-hemolytic if grown anaerobically ?

1. S. anginosus
2. S. intermedius
3. S. mitis
4. S. pneumoniae
5. S. oralis
4. S.pneumoniae
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35. Name the streptococci that is bile-soluble (are lysed by bile) ?

1. S. anginosus
2. S. intermedius
3. S. mitis
4. S. pneumoniae
5. S. oralis

4. Streptococcus pneumoniae
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36. A 65-year-old man develops pneumonia. The organisms isolated from the sputum
are gram-positive cocci that are alpha hemolytic on blood agar and sensitive to
optochin. Which structure of the causal agent provides protection against
phagocytosis?

1.Capsule
2.Catalase
3.Coagulase
4.M protein
5.Teichoic acid
1.Capsule
Streptococcus pneumoniae
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37. What is the name of enzyme that is produced by Streptococcus penumoniae and
enhances the organism’s ability to colonize the mucosa of the upper respiratory
tract by cleaving IgA ?

1. Secretory IgA protease

2.Catalase
3.Coagulase
4.Nuclease

1. secretory IgA protease

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38. What is the enzyme of S.pneumoniae that degrades hemoglobin, producing a green
product and make the α-hemolytic appearance ?

1. streptolysin S
2. streptolysin O
3. Pneumolysin
4. Fibrinolysin

3. pneumolysin
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39. What is the substance that is produced by Streptococcus pneumoniae and can
cause tissue damage by reactive oxygen intermediates?
hydrogen peroxide

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40. What is the name of an unique substance of S. pneumoniae cell wall and plays an
important regulatory role in cell wall hydrolysis. ?
Phosphorylcholine
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41. What is the name of S.pneumoniae cytotoxin that binds cholesterol in the host
cell membrane and creates pores ?

1. streptolysin S
2. streptolysin O
3. Pneumolysin
4. Fibrinolysin

3. Pneumolysin
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42. What is the name of test/reaction for Streptococcus pneumoniae polyvalent

anticapsular antibodies that mixed with the bacteria, and then the mixture is
examined microscopically ?
quellung test/ quellung reaction
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43. What is empirical treatment for S.pneumoniae infection ?

Vancomycin / ceftriaxone
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44. Mention the characteristics of scarlet fever ?

-erythematous rash
-The area around the mouth is generally spared (circumoral pallor)
-yellowish-white coating initially covers the tongue and is later shed, revealing a
red, raw surface beneath (“strawberry tongue”)
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45. What is the effective anticapsular vaccines of S.pneumoniae that recommended

for children older than 2 years and adults ?
23- valent pneumococcal polysaccharide vaccine
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46. What is the effective anticapsular vaccines of S.pneumoniae that currently

recommended for infants younger than 2 years ?
13-valent conjugated pneumococcal vaccine
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47. What is the main mechanism by which Streptococcus pneumoniae is resistant to

ampicillin?
Alteration of target to PBP

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48. A 55-year-old woman had her rheumatic heart valve replaced with a prosthetic
valve. Six blood cultures became positive after three days of incubation.
An optochin-resistant, catalase-negative gram-positive coccus that was alpha-
hemolytic was isolated. What was the most likely causal agent?

1.Viridans Streptococci
2. Streptococcus pyogenes
3. Serratia marcescens
4. Staphylococcus aureus
5. Streptococcus pneumoniae
1. Streptococcus viridans

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49. An infant presents with fever, convulsions, and nuchal rigidity during the
first month of life.
Which of the following agents is the most likely cause?

1. Streptococcus pyogenes
2. Haemophilus influenzae
3. Listeria monocytogenes
4. Streptococcus agalactiae
5. Streptococcus pneumoniae
4. Streptococcus agalactiae

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50. A 15-year-old girl develops a sore throat, fever, and earache of approximately
one week duration. Upon examination by her physician, an erythematous rash is noted
covering most of her body and her tongue appears bright red. Which of the following
is the description of the causal agent?
1. Gram-positive coccus, alpha hemolytic, catalase negative
2. Gram-positive coccus, beta hemolytic, catalase negative
3. Gram-positive coccus, alpha hemolytic, catalase positive
4. Gram-positive coccus, beta hemolytic, catalase positive
5. Gram-positive coccus, gamma hemolytic, catalase negative
2. Gram-positive coccus, beta hemolytic, catalase negative
Streptococcus pyogenes
Scarlet Fever
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