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  • Question 1 - A patient is suspected to have Blastomyces dermatidis infection. The patient contracted the...

    Correct

    • A patient is suspected to have Blastomyces dermatidis infection. The patient contracted the disease most likely through which port of entry?

      Your Answer: Respiratory tract

      Explanation:

      Blastomycosis disease is a fungal infection acquired through inhalation of the spores. It caused by the organism Blastomyces dermatitidis and manifests as a primary lung infection in about 70% of cases. The onset is relatively slow and symptoms are suggestive of pneumonia.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      9
      Seconds
  • Question 2 - A 17-year-old female was given an antibiotic for a urinary tract infection. After...

    Correct

    • A 17-year-old female was given an antibiotic for a urinary tract infection. After taking the medication the patient developed Steven-Johnson syndrome. Which particular antibiotic usually causes Steven-Johnson syndrome?

      Your Answer: Sulphonamides

      Explanation:

      Stevens–Johnson syndrome (SJS) is a type of severe skin reaction. The most common cause is certain medications such as lamotrigine, carbamazepine, allopurinol, sulphonamide antibiotics, and nevirapine.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      9.1
      Seconds
  • Question 3 - A 15-year-old girl was diagnosed with bacterial meningitis. Gram staining of the spinal...

    Correct

    • A 15-year-old girl was diagnosed with bacterial meningitis. Gram staining of the spinal fluid shows numerous polymorphonuclear neutrophils and Gram-positive cocci. Which is the empiric drug of choice to be given to the patient until the antibiotic sensitivity report is available?

      Your Answer: Ceftriaxone

      Explanation:

      Acute meningitis is a medical emergency. All suspects should receive their first dose of antibiotics immediately and be transferred to hospital as soon as possible. If facilities for blood culture and/or lumbar puncture (LP) are immediately available, they should be performed before administration
      of the first dose of antibiotics (see contraindications to LP below). Neither procedure should lead to a significant delay in antibiotic administration.
      Administer ceftriaxone 80-100 mg/kg (maximum 2 g, 12 hourly) intravenously. The intramuscular or intraosseous route can be used if there is no vascular access. Penicillin allergy is not a contraindication to ceftriaxone in acute meningitis (C-1). Omit ceftriaxone only if there has been documented ceftriaxone anaphylaxis. Give chloramphenicol 25 mg/kg (maximum 500 mg) intravenously instead, if available. Administer adequate analgesia and transfer the patient immediately to hospital, detailing all administered
      medication in the referral letter.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      15.1
      Seconds
  • Question 4 - A 35 year-old man presents with high grade fever for 7 days after...

    Correct

    • A 35 year-old man presents with high grade fever for 7 days after returning from a trip to India. He tested positive for widal test. What is the most likely organism that caused his fever?

      Your Answer: Salmonella typhi

      Explanation:

      Typhoid fever is caused by virulent bacteria called Salmonella typhi. Salmonella typhi spread through contaminated food or water and occasionally through direct contact with someone who is infected.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      17.3
      Seconds
  • Question 5 - A 5-year-old child presents with fever and otalgia. Greenish pustular discharge was seen...

    Correct

    • A 5-year-old child presents with fever and otalgia. Greenish pustular discharge was seen in his left ear during physical examination. The patient is diagnosed with otitis externa. Which of the following organisms most likely caused the infection?

      Your Answer: Pseudomonas aeruginosa

      Explanation:

      P. aeruginosa is a multidrug resistant pathogen recognised for its ubiquity, its advanced antibiotic resistance mechanisms and its association with serious illnesses – especially hospital-acquired infections such as ventilator-associated pneumonia and various septic syndromes. The species name aeruginosa is a Latin word meaning verdigris (copper rust), referring to the blue-green colour of laboratory cultures of the species. This blue-green pigment is a combination of two metabolites of P. aeruginosa, pyocyanin (blue) and pyoverdine (green), which impart the blue-green characteristic colour of cultures.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      11.4
      Seconds
  • Question 6 - A patient is diagnosed with Brucellosis. What is the mode of transmission of...

    Correct

    • A patient is diagnosed with Brucellosis. What is the mode of transmission of this disease?

      Your Answer: Unpasteurised milk

      Explanation:

      Brucellosis is a highly contagious zoonosis caused by ingestion of unpasteurized milk or undercooked meat from infected animals, or close contact with their secretions.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      13.1
      Seconds
  • Question 7 - A 26-year-old female sought consultation due to excessive vaginal discharge. Vaginal smear showed...

    Correct

    • A 26-year-old female sought consultation due to excessive vaginal discharge. Vaginal smear showed numerous bacilli under the microscope. The organism was non-pathogenic. What is the most likely organism:

      Your Answer: Lactobacillus species

      Explanation:

      Lactobacillus is a Gram-positive facultative bacteria. It is commonly present in the vagina and the gastrointestinal tract. Colonization of Lactobacillus is usually benign and it makes up a small portion of the gastrointestinal flora.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      8.9
      Seconds
  • Question 8 - Gram positive bacteria differ from gram negative bacteria due to the presence of...

    Correct

    • Gram positive bacteria differ from gram negative bacteria due to the presence of which of the following structures?

      Your Answer: Outer membrane

      Explanation:

      The reason bacteria are either Gram-positive or Gram-negative is due to the structure of their cell envelope (the cell envelope is defined as the cell membrane and cell wall plus an outer membrane, if one is present.) Gram-positive bacteria, for example, retain the crystal violet due to the amount of peptidoglycan in the cell wall. It can be said therefore that the Gram-stain procedure separates bacteria into two broad categories based on structural differences in the cell envelope.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      10.8
      Seconds
  • Question 9 - A 60-year-old male who was admitted due to cerebrovascular disease on his 5th...

    Incorrect

    • A 60-year-old male who was admitted due to cerebrovascular disease on his 5th hospital stay developed pneumonia. The most likely organism that causes hospital acquired pneumonia is pseudomonas aeruginosa. What is the most likely mechanism for the pathogenesis on pseudomonas infection?

      Your Answer: Endotoxin

      Correct Answer: Exotoxin

      Explanation:

      Pseudomonas aeruginosa is a common Gram-negative, rod-shaped bacterium that can cause disease in plants and animals, including humans. It is citrate, catalase, and oxidase positive. P. aeruginosa uses the virulence factor exotoxin A to inactivate eukaryotic elongation factor 2 via ADP-ribosylation in the host cell, much the same as the diphtheria toxin does. Without elongation factor 2, eukaryotic cells cannot synthesize proteins and necrotise. The release of intracellular contents induces an immunologic response in immunocompetent patients.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      22.9
      Seconds
  • Question 10 - A 45-year-old woman was brought to the emergency department due to fever and...

    Correct

    • A 45-year-old woman was brought to the emergency department due to fever and chills. She has a history of recurrent UTI and complains of dysuria and urinary frequency. Urinary white blood cell count is >200 cell/high power field. If urine culture is performed, what is the most likely organism that will grow?

      Your Answer: Escherichia coli

      Explanation:

      The pathogen that most likely causes recurrent urinary tract infection in young women are E. coli, Enterococcus and Staphylococcus saprophyticus.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      13.2
      Seconds
  • Question 11 - Which of the following conditions can present with multiple abscesses that may discharge...

    Correct

    • Which of the following conditions can present with multiple abscesses that may discharge sulphur granules?

      Your Answer: Actinomycosis

      Explanation:

      Actinomycosis is primarily caused by any of the several members of the bacterial genus Actinomyces. These bacteria are generally anaerobes. And can cause multiple abscesses that may discharge sulphur granules.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      10
      Seconds
  • Question 12 - A 70-year-old female who underwent coronary artery bypass graft developed post-operative acute renal...

    Correct

    • A 70-year-old female who underwent coronary artery bypass graft developed post-operative acute renal failure. Her urinary catheter was left in place to monitor urine output. 6 days later she developed fever and chills. She also complained of suprapubic and left flank pain. She is found to have developed acute ascending pyelonephritis. Which of the following organism was most likely isolated during urine culture?

      Your Answer: Escherichia coli with pili

      Explanation:

      The most common cause of urinary tract infection is Escherichia coli. Pilated strains of E. coli ascend the urethra to infect the kidney and the bladder. Catheters have been associated with an increased risk of UTIs.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      33.6
      Seconds
  • Question 13 - A 25 year-old female medical student presents with fever, lack of appetite, rashes,...

    Correct

    • A 25 year-old female medical student presents with fever, lack of appetite, rashes, sore throat and lymphadenopathy. Peripheral smear shows atypical lymphocytes. Which is the most likely organism responsible for this patient's condition?

      Your Answer: Epstein–Barr virus

      Explanation:

      Epstein-Barr virus is in the herpes family of viruses and most people will become infected with EBV sometime during their lives. EBV commonly causes infectious mononucleosis, or mono, a contagious viral illness that initially attacks the lymph nodes in the neck and throat. When these tissues become less effective in fighting infection, sore throats, swelling of the nodes and fever may result.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      43.3
      Seconds
  • Question 14 - A 60-year-old female has sudden onset of high-grade fever associated with cough with...

    Correct

    • A 60-year-old female has sudden onset of high-grade fever associated with cough with productive rusty-coloured sputum. Chest x-ray showed left-sided consolidation. What is the most accurate test for the diagnosis of this patient?

      Your Answer: Sputum culture

      Explanation:

      Sputum culture is used to detect and identify the organism that are infecting the lungs or breathing passages.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      17.1
      Seconds
  • Question 15 - A 5-year-old child is rushed to the emergency department because of fever, erythema...

    Correct

    • A 5-year-old child is rushed to the emergency department because of fever, erythema and neck stiffness. The child is also hypotensive upon physical examination. Which is the most likely toxin responsible for this child's condition?

      Your Answer: Endotoxin

      Explanation:

       An endotoxin is part of the bacterial outer membrane, and it is not released until the bacterium is killed by the immune system. The body’s response to an endotoxin can involve severe inflammation. In general, the inflammation process is usually considered beneficial to the infected host, but if the reaction is severe enough, it can lead to sepsis.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      66.2
      Seconds
  • Question 16 - A 37-year-old woman with a history of rheumatic heart disease presents with 10...

    Correct

    • A 37-year-old woman with a history of rheumatic heart disease presents with 10 days recurrent low fever. Patient underwent laboratory work up and was diagnosed with infective endocarditis. What is the most likely organism that caused the infective endocarditis in this patient?

      Your Answer: Streptococcus viridans

      Explanation:

      Subacute bacterial endocarditis  is often due to streptococci of low virulence, mainly streptococcus viridans. It is a mild to moderate illness which progresses slowly over weeks and months (>2weeks) and has low propensity to hematogenously seed to extracardiac sites.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      18.9
      Seconds
  • Question 17 - A 5 year-old-child with fever complains of sore throat . She was brought...

    Correct

    • A 5 year-old-child with fever complains of sore throat . She was brought to her paediatrician for consult because she has also developed a rash and has swollen lymph nodes. Upon physical examination she cried when her liver was palpated and the tip of her spleen is slightly palpable. Full blood count shows haemoglobin 13 g/dL, Haematocrit 40%, white blood cell count 13x109/L with a WBC differential count of 45 neutrophils, 4 bands, 26 lymphocytes, 15 atypical lymphocytesm, 10 monocytes and 1 eosinophil. Whick is the most likely infectious agent that is responsible for the patient's condition?

      Your Answer: Epstein–Barr virus

      Explanation:

      Epstein-Barr virus (EBV), also known as human herpes virus 4,is a member of the herpes virus family. EBV spreads most commonly through bodily fluids, primarily saliva. EBV can cause infectious mononucleosis. Symptoms of EBV can include fatigue, fever, inflamed throat, swollen lymph nodes in the neck, enlarged spleen, swollen liver and rash.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      12.8
      Seconds
  • Question 18 - A 7-year old child from a rural setting complains of recurrent abdominal pain....

    Correct

    • A 7-year old child from a rural setting complains of recurrent abdominal pain. The child is found to have a heavy parasitic infestation and anaemia. Which type of anaemia is most likely seen in this patient?

      Your Answer: Iron deficiency anaemia

      Explanation:

      The most common cause of iron deficiency anaemia in children in developing countries is parasitic infection (hookworm, amoebiasis, schistosomiasis and whipworm).

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      83.8
      Seconds
  • Question 19 - Which of the following is NOT a Gram-negative rod? ...

    Incorrect

    • Which of the following is NOT a Gram-negative rod?

      Your Answer: Legionella

      Correct Answer: Clostridium tetani

      Explanation:

      Gram-positive rods include Clostridia, Listeria and diphtheroids.

      Gram-negative rods include Escherichia coli, Klebsiella, Yersinia, Haemohilus, Pseudomonas, Shigella, Legionella, proteus and Salmonella

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      21.3
      Seconds
  • Question 20 - An 26-year-old man sought admission due to persistent non-bloody diarrhoea. The patient is...

    Incorrect

    • An 26-year-old man sought admission due to persistent non-bloody diarrhoea. The patient is HIV-positive. Examination of stool sample showed numerous acid-fast cysts. Which of the following organism is the most likely cause of diarrhoea?

      Your Answer: Toxoplasma gondii

      Correct Answer: Cryptosporidium parvum

      Explanation:

      Cryptosporidium parvum is one of several species that causes cryptosporidiosis, a parasitic disease of the mammalian intestinal tract. Primary symptoms of C. parvum infection are acute, watery, and non-bloody diarrhoea. C. parvum infection is of particular concern in immunocompromised patients, where diarrhoea can reach 10–15 l per day.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      14.8
      Seconds
  • Question 21 - An 18 -year-old female is diagnosed with folliculitis in the left axilla. What...

    Correct

    • An 18 -year-old female is diagnosed with folliculitis in the left axilla. What is the most likely organism that could cause this condition?

      Your Answer: Staphylococcus aureus

      Explanation:

      Folliculitis is the inflammation of the hair follicles. It is usually caused by Staphylococcus infection.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      6
      Seconds
  • Question 22 - Which of the following toxins most likely results in continuous cAMP production, which...

    Correct

    • Which of the following toxins most likely results in continuous cAMP production, which pumps H2O, sodium, potassium, chloride and bicarbonate into the lumen of the small intestine and results in rapid dehydration?

      Your Answer: Cholera toxin

      Explanation:

      The cholera toxin (CTX or CT) is an oligomeric complex made up of six protein subunits: a single copy of the A subunit (part A), and five copies of the B subunit (part B), connected by a disulphide bond. The five B subunits form a five-membered ring that binds to GM1 gangliosides on the surface of the intestinal epithelium cells. The A1 portion of the A subunit is an enzyme that ADP-ribosylates G proteins, while the A2 chain fits into the central pore of the B subunit ring. Upon binding, the complex is taken into the cell via receptor-mediated endocytosis. Once inside the cell, the disulphide bond is reduced, and the A1 subunit is freed to bind with a human partner protein called ADP-ribosylation factor 6 (Arf6). Binding exposes its active site, allowing it to permanently ribosylate the Gs alpha subunit of the heterotrimeric G protein. This results in constitutive cAMP production, which in turn leads to secretion of H2O, Na+, K+, Cl−, and HCO3− into the lumen of the small intestine and rapid dehydration. The gene encoding the cholera toxin was introduced into V. cholerae by horizontal gene transfer.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      14.5
      Seconds
  • Question 23 - Anthrax is an infection caused by the bacterium Bacillus anthracis. Anthrax spores have been used...

    Correct

    • Anthrax is an infection caused by the bacterium Bacillus anthracis. Anthrax spores have been used as a biological warfare weapon. What is the drug of choice in treating anthrax infection?

      Your Answer: Ciprofloxacin

      Explanation:

      Early antibiotic treatment of anthrax is essential. A delay may significantly lessen the chances for survival of the patient. Treatment for anthrax infection include large doses of intravenous and oral antibiotics, such as fluoroquinolones (ciprofloxacin), doxycycline, erythromycin, vancomycin, or penicillin.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      15.8
      Seconds
  • Question 24 - A 34-year-old Asian male presents with cervical lymphadenopathy. The patient is suspected to...

    Correct

    • A 34-year-old Asian male presents with cervical lymphadenopathy. The patient is suspected to have tuberculous lymphadenopathy. Excision biopsy of one of the nodes showed granulomatous inflammation. Which histopathologic feature is most likely consistent with the diagnosis of tuberculosis?

      Your Answer: Caseation necrosis

      Explanation:

      The granulomas of tuberculosis tend to contain necrosis (caseating tubercles), but non-necrotizing granulomas may also be present. Multinucleated giant cells with nuclei arranged like a horseshoe (Langhans giant cells) and foreign body giant cells are often present, but are not specific for tuberculosis. A definitive diagnosis of tuberculosis requires identification of the causative organism by microbiological cultures.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      38.1
      Seconds
  • Question 25 - A 68-year-old man underwent sigmoid resection with diverting colostomy for a ruptured sigmoid...

    Correct

    • A 68-year-old man underwent sigmoid resection with diverting colostomy for a ruptured sigmoid diverticulum 10 days ago. He received gentamicin and ampicillin post-op. 2 days after he was discharged from the hospital, he was readmitted because of high grade fever and chills. His blood culture grew Gram-negative bacilli. Which organism is most likely responsible for the patient's infection?

      Your Answer: Bacteroides fragilis

      Explanation:

      Bacteroides fragilis is an anaerobic, Gram-negative, rod-shaped bacterium. It is part of the normal flora of the human colon and is generally a commensal, but can cause infection if displaced into the bloodstream or surrounding tissue following surgery, disease, or trauma.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      16.3
      Seconds
  • Question 26 - A 35 year-old female developed food poisoning 24H after eating canned food. She...

    Correct

    • A 35 year-old female developed food poisoning 24H after eating canned food. She complained of abdominal cramps, with nausea and vomiting. Shortly after she suddenly developed weakness, blurring of vision, difficulty in swallowing and breathing. Which of the following organisms is most likely associated with fatal food poisoning?

      Your Answer: Clostridium botulinum

      Explanation:

      C. botulinum is a Gram-positive, rod-shaped, spore-forming bacterium. It is an obligate anaerobe, meaning that oxygen is poisonous to the cells. Only botulinum toxin types A, B, E, and F cause disease in humans. Types A, B, and E are associated with foodborne illness. Botulism poisoning can occur due to preserved or home-canned, low-acid food that was not processed using correct preservation times and/or pressure. Signs and symptoms of foodborne botulism typically begin between 18 and 36 hours after the toxin gets into the body, but can range from a few hours to several days, depending on the amount of toxin ingested. Botulinum that is produced by Clostridium botulinum can cause respiratory and muscular paralysis.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      33.2
      Seconds
  • Question 27 - Staphylococcus aureus can be identified in the laboratory based on the clotting of...

    Correct

    • Staphylococcus aureus can be identified in the laboratory based on the clotting of plasma. Which microbial product is responsible for this activity?

      Your Answer: Coagulase

      Explanation:

      Staphylococcus aureus is the most pathogenic species and is implicated in a variety of infections.  S. aureus can be identified due to its production of coagulase. The staphylococcal enzyme coagulase will cause inoculated citrated rabbit plasma to gel or coagulate. The coagulase converts soluble fibrinogen in the plasma into insoluble fibrin.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      11.9
      Seconds
  • Question 28 - A 27 year-old male patient was admitted to the hospital due to recurrent...

    Correct

    • A 27 year-old male patient was admitted to the hospital due to recurrent fever for the past 2 weeks. The patient claimed that he is an intravenous drug user. Following work up, the patient was diagnosed with infective endocarditis. Which is the most likely organism responsible for this diagnosis?

      Your Answer: Staphylococcus aureus

      Explanation:

      Acute bacterial endocarditis is a fulminant illness lasting over days to weeks (<2weeks). It is most likely due to Staphylococcus aureus especially in intravenous drug abusers.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      17.9
      Seconds
  • Question 29 - The ability of the bacteria to cause disease or its virulence is related...

    Correct

    • The ability of the bacteria to cause disease or its virulence is related to :

      Your Answer: Toxin and enzyme production

      Explanation:

      The pathogenicity of an organism or its ability to cause disease is determined by its virulence factors. Many bacteria produce virulence factors that inhibit the host’s immune system. The virulence factors of bacteria are typically proteins or other molecules that are synthesized by enzymes. These proteins are coded for by genes in chromosomal DNA, bacteriophage DNA or plasmids. The proteins made by the bacteria can poison the host cells and cause tissue damage.

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      11.3
      Seconds
  • Question 30 - A 27-year-old HIV patient started on an antifungal agent. Which antifungal agent that...

    Correct

    • A 27-year-old HIV patient started on an antifungal agent. Which antifungal agent that inhibits the biosynthesis of fungal ergosterol was given to the patient?

      Your Answer: Ketoconazole

      Explanation:

      Ketoconazole is a synthetic imidazole antifungal drug used primarily to treat fungal infections. It inhibits the biosynthesis of ergosterol by blocking demethylation at the C14 site of the ergosterol precursor. Amphotericin B and Nystatin impair permeability of the cell membrane. Flucytosine interferes with DNA synthesis, while the target of griseofulvin is the microtubules

    • This question is part of the following fields:

      • Microbiology
      • Pathology
      10.2
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Microbiology (27/30) 90%
Pathology (27/30) 90%
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