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Microbiology quiz2

GPC, GNC, GPB, Mycobacteria


1. Which one of the following is the virulence factor produced by
Staphylococcus aureus that prevents the activation of complement and
thereby reduces opsonization by C3b?

A. Catalase
B. Coagulase
C. *Protein A
D. Teichoic acid
2. The main reason why methicillin-resistant Staphylococcus aureus
(MRSA) strains are resistant to methicillin and nafcillin is:

A. They produce -lactamase that degrades the antibiotics


B. *They have altered penicillin-binding proteins that have reduced
binding of the antibiotics
C. They have mutant porin proteins that prevent the antibiotics from
entering the bacteria.
D. They have plasmid-encoded export proteins that remove the drug
from the bacteria.
3. A pore-forming exotoxin produced by Staphylococcus aureus that
kills cells and is important in the severe, rapidly spreading necrotizing
lesions caused by MRSA strains is:

A. coagulase.
B. enterotoxin.
C. exfoliatin.
D. *P-V leukocidin.
4. An outbreak of serious pneumococcal pneumonia and sepsis among
inmates in an overcrowded prison has occurred. Laboratory analysis
determined that one serotype was involved. The prison physician said
that the pneumococcal vaccine might have limited the outbreak. Which
one of the following structures of the pneumococcus is responsible for
determining the serotype and is also the immunogen in the vaccine?

A. *Capsule
B. Flagellar protein
C. O antigen
D. Peptidoglycan
5. Which one of following laboratory tests is the most appropriate to
distinguish Streptococcus pyogenes from other -hemolytic
streptococci?

A. Ability to grow in 6.5% NaCl


B. Activation of C-reactive protein
C. Hydrolysis of esculin in the presence of bile
D. *Inhibition by bacitracin
6. The Jones family of four had a delicious picnic lunch last Sunday. It was
a warm day, and the food sat in the sun for several hours. Alas, 3 hours
later, everyone came down with vomiting and nonbloody diarrhea. In
the emergency room, it was found that Mrs. Jones, who prepared the
food, had a paronychia on her thumb. Which one of the following is the
most likely causative organism?

A. Enterococcus faecalis
B. *Staphylococcus aureus
C. Staphylococcus epidermidis
D. Streptococcus agalactiae
7. Your patient is a 2-week-old infant who was well until 2 days ago, when
she stopped feeding and became irritable. She now has a fever to 380C,
developed a petechial rash all over her body, and is very difficult to arouse.
In the emergency room, a blood culture and a spinal tap were done. Gram
stain of the spinal fluid showed gram-positive cocci in chains. Culture of the
spinal fluid on blood agar revealed -hemolytic colonies that grew in the
presence of bacitracin and hydrolyzed hippurate. Which one of the
following is the most likely causative organism?

A. Staphylococcus aureus
B. *Streptococcus agalactiae
C. Streptococcus pneumonia
D. Streptococcus pyogenes
8. Your patient is a 70-year-old man with endocarditis caused by
Enterococcus faecalis. Which one of the following is the best combination
of antibiotics to treat the infection?

A. Azithromycin and trimethoprim-sulfamethoxazole


B. Doxycycline and levofloxacin
C. Metronidazole and clindamycin
D. *Penicillin G and gentamicin
9. Your patient has subacute bacterial endocarditis caused by a member of
the viridans group of streptococci. Which one of the following sites is MOST
likely to be the source of the organism?

A. Skin
B. Colon
C. *Oropharynx
D. Urethra
10. The coagulase test, in which the bacteria cause plasma to clot, is
used to distinguish:

A. Streptococcus pyogenes from Enterococcus faecalis


B. Streptococcus pyogenes from Staphylococcus aureus
C. *Staphylococcus aureus from Staphylococcus epidermidis
D. Staphylococcus epidermidis from Neisseria meningitides
11. Each of the following statements concerning Staphylococcus
aureus is correct EXCEPT:

A. Gram-positive cocci in grapelike clusters are seen on Gram-stained


smear.
B. The coagulase test is positive.
C. Treatment should include a -lactamaseresistant penicillin.
D. *Endotoxin is an important pathogenetic factor.
12. Three organisms, Streptococcus pneumoniae, Neisseria meningitidis,
and Haemophilus influenzae, cause the vast majority of cases of
bacterial meningitis. What is the MOST important pathogenic
component they share?

A. Protein A
B. *Capsule
C. Endotoxin
D. Beta-Lactamase
13. Each of the following statements concerning gonorrhea is correct
EXCEPT:

A. Infection in men is more frequently symptomatic than in women.


B. A presumptive diagnosis can be made by finding gram-negative kidney
bean-shaped diplococci within neutrophils in a urethral discharge.
C. *The definitive diagnosis can be made by detecting antibodies to
Neisseria gonorrhoeae in the patients serum.
D. Gonococcal conjunctivitis of the newborn rarely occurs in the United
States, because silver nitrate or erythromycin is commonly used as
prophylaxis.
14. Your patient is a 14-year-old girl who was sent home from school
because she had a fever of 102C, a severe headache, and was falling asleep
in class. When her fever rose to 104C, her mother took her to the
emergency room, where a blood pressure of 60/20 and several petechial
hemorrhages were found. Gramnegative diplococci were seen in a Gram
stain of the spinal fluid. Which one of the following is most likely to cause
the fever, hypotension, and petechial hemorrhages?

A. *Endotoxin
B. IgA protease
C. Oxidase
D. Superantigen
15. Disease caused by which one of the following sets of bacteria can be
prevented by a toxoid vaccine?

A. Bacillus anthracis and Clostridium botulinum


B. Bacillus anthracis and Clostridium perfringens
C. Bacillus cereus and Clostridium tetani
D. *Corynebacterium diphtheriae and Clostridium tetani
E. Corynebacterium diphtheriae and Listeria monocytogenes
16. Your patient is a 30-year-old man with a 2-cm lesion on his arm. It
began as a painless papule that enlarged and, within a few days, ulcerated
and formed a black crust (eschar). He works in an abattoir where his job is
removing the hide from the cattle. A Gram stain of fluid from the lesion
reveals large gram-positive rods. Which one of the following bacteria is
likely to be the cause?

A. *Bacillus anthracis
B. Clostridium botulinum
C. Clostridium perfringens
D. Listeria monocytogenes
17. An abattoir worker developed pustule which later progress to
necrotic ulcer. Which of the following stain is useful demonstration of
organism from smear made from pustule ?

A. *Polychromic methylene blue


B. Chalkofluor white
C. Geimsa
D. Modified kinyon stain
18. All of the following statements about Botulism are true except :

A. *Boutlism is caused by endotoxin


B. Honey ingestion causes infant botulism
C. Constipation is seen
D. Detection of antitoxin in the serum can aid in diagnosis
19. Naeglers reaction is shown by :

A. Cl. tetani
B. Cl. botulinum
C. *Cl. perfringenes
D. Cl. septicum
20. A 12 year old child presents with fever and cervical lymphadenopathy.
Oral examination shows a grey membrane on the right tonsil extending to
the anterior pillar. Which of the following medium will be ideal for the
culture of the throat swab for a rapid identification of the pathogen :

A. Nutrient agar
B. Blood agar
C. *Loefflers Serum slope
D. LJ Medium
21. The genetic mechanism responsible for the conversion of a
nontoxigenic strain of Corynebacterium diphtheriae to a toxigenic strain
is

A. *Lysogenic phage conversion


B. In vivo transformation
C. Reciprocal genetic recombination
D. Conjugation
22. In the management of leprosy, Lepromin test is most useful for :

A. Herd immunity
B. *Prognosis
C. Treatment
D. Epidemological investigations
23. Your patient is a 25-year-old homeless man who complains of a cough for the
past month. The cough is now productive of several tablespoons of bloodstreaked
sputum per day. The sputum is not foul-smelling. He has lost 10 pounds but says
that he doesnt eat regularly. On physical exam, temperature is 38C, and coarse
rales were heard in the apex of the left lung. An acid-fast stain of the sputum
reveals acid-fast rods. Culture of the sputum shows no growth at 7 days, but buff-
colored colonies are visible at 21 days. Of the following organisms, which one is
most likely to be the cause of this infection?

A. Mycobacterium fortuitum-chelonae
B. Mycobacterium leprae
C. Mycobacterium marinum
D. *Mycobacterium tuberculosis
24. True about M. tuberculosis is :

A. *Strict aerobe
B. Gram negative
C. Thin cell wall
D. Curved rod
25. In TB, immunity is provided by :

A. *CD 4+ T cells
B. CD 8+ T cells
C. IgG
D. IgM