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  • Question 1 - You suspected a fungal nail infection in a 50-year-old man who presented with...

    Incorrect

    • You suspected a fungal nail infection in a 50-year-old man who presented with an itchy, scaly rash between his toes and a thicker, discoloured nail on his big toe that has been there for almost one month already. Which of the following tests is most likely to confirm your suspected diagnosis?

      Your Answer: Nail clippings for NAAT

      Correct Answer: Nail clippings for microscopy and culture

      Explanation:

      Nail clippings for microscopy and culture are a diagnostic test for fungal infection. Because some fungi are restricted to the lower parts of the nail, clippings should be taken from the discoloured or brittle parts and cut back as far as possible from the free edge.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      62.9
      Seconds

  • Question 2 - A patient presents with nausea, anorexia, jaundice and right upper quadrant pain. A...

    Incorrect

    • A patient presents with nausea, anorexia, jaundice and right upper quadrant pain. A diagnosis of acute hepatitis B is suspected.
      Which of the following blood results is most suggestive of an acute hepatitis B infection? Select ONE answer only.

      Your Answer: HBsAg positive, IgM anti-HBc negative

      Correct Answer: HBsAg positive, IgM anti-HBc positive

      Explanation:

      Hepatitis B surface antigen (HBsAg) is a protein on the surface of the hepatitis B virus, that is the first serologic marker to appear in a new acute infection.It can be detected as early as 1 week and as late as 9 weeks. It can be detected in high levels in serum during acute or chronic hepatitis B virus infection. The presence of HBsAg indicates that the person is infectious. The body normally produces antibodies to HBsAg as part of the normal immune response to infection. HBsAg is the antigen used to make hepatitis B vaccine.
      Hepatitis B surface antibody (anti-HBs) indicates recovery and immunity from the hepatitis B virus infection. Anti-HBs also develops in a person who has been successfully vaccinated against hepatitis B.
      Total hepatitis B core antibody (anti-HBc): Appears at the onset of symptoms in acute hepatitis B and persists for life. The presence of anti-HBc indicates previous or ongoing infection with hepatitis B virus in an undefined time frame. It is not present following hepatitis B vaccination.
      IgM antibody to hepatitis B core antigen (IgM anti-HBc) indicates recent infection with hepatitis B virus (<6 months). Its presence indicates acute infection.
      The following table summarises the presence of hepatitis B markers according to each situation:
      Susceptible to infection:
      HBsAg = Negative
      Anti-HBc = Negative
      Anti-HBs = Negative

      Immune due to natural infection:
      HBsAg = Negative
      Anti-HBc = Positive
      Anti-HBs = Positive

      Immune due to vaccination:
      HBsAg = Negative
      Anti-HBc = Negative
      Anti-HBs = Positive

      Acute infection:
      HBsAg = Positive
      Anti-HBc = Positive
      Anti-HBs = Negative
      IgM anti-HBc = Positive

      Chronic infection:
      HBsAg = Positive
      Anti-HBc = Positive
      Anti-HBs = Negative
      IgM anti-HBc = Negative

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      99.1
      Seconds

  • Question 3 - You received a patient with a 2-day history of diarrhoea and vomiting. Later,...

    Incorrect

    • You received a patient with a 2-day history of diarrhoea and vomiting. Later, after examination, the patient was found to have progressive symmetric descending flaccid paralysis, initial development of blurred vision, dysphagia, and weakness of the upper limbs. The patient is apyrexial and his observations are all normal. Which of the following pathogens is responsible for the said symptoms?

      Your Answer: Clostridium difficile

      Correct Answer: Clostridium botulinum

      Explanation:

      A botulism infection results in neuroparalysis caused by the neurotoxin generated by Clostridium botulinum.

      Food-borne botulism symptoms often appear 12-36 hours after ingestion of the toxin-containing food and may include nausea, vomiting, stomach discomfort, and diarrhoea at first. The most common neurological pattern is an acute onset of bilateral cranial neuropathies with symmetric declining weakening.

      Other distinguishing characteristics include the absence of fever, the absence of cognitive abnormalities, the presence of a normal heart rate and blood pressure, and the absence of sensory defects.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      43.1
      Seconds

  • Question 4 - A 56-year-old man presents with pneumonia 8 days after being admitted for an...

    Incorrect

    • A 56-year-old man presents with pneumonia 8 days after being admitted for an open fracture of his tibia and fibula. Upon history taking and observation, it was established that he has no known drug allergies, has coarse left basal crackles and evidence of consolidation in the left lower lobe based on his chest X-ray.

      Which of the following antibacterial agents would be the most appropriate to prescribe according to the latest NICE guidelines?

      Your Answer:

      Correct Answer: Ciprofloxacin

      Explanation:

      The current NICE guidelines for hospital-acquired pneumonia are as follow:
      – First-choice oral antibiotic if non‑severe symptoms or signs, and not at higher risk of resistance (guided by microbiological results when available): co-amoxiclav

      – Alternative oral antibiotics if non‑severe symptoms or signs, and not at higher risk of resistance, for penicillin allergy or if co‑amoxiclav unsuitable (based on specialist microbiological advice and local resistance data): doxycycline, cefalexin, co-trimoxazole, levofloxacin

      – First-choice intravenous antibiotics if severe symptoms or signs (for example, symptoms or signs of sepsis) or at higher risk of resistance (based on specialist microbiological advice and local resistance data): piperacillin with tazobactam, ceftazidime, ceftriaxone, cefuroxime, meropenem, ceftazidime with avibactam, levofloxacin

      – Antibiotics to be added if suspected or confirmed methicillin-resistant Staphylococcus aureus infection (dual therapy with a first-choice intravenous antibiotic): vancomycin, teicoplanin, linezolid

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
      Seconds

  • Question 5 - Which of the following microbes adheres to the genital mucosa using fimbriae: ...

    Incorrect

    • Which of the following microbes adheres to the genital mucosa using fimbriae:

      Your Answer:

      Correct Answer: Neisseria gonorrhoeae

      Explanation:

      Infection of the genital mucosa by Neisseria gonorrhoeae involves attachment to and invasion of epithelial cells. Initial adherence of gonococci to columnar epithelial cells is mediated by type IV pili assembled from pilin subunit PilE proteins and pilus tip-associated PilC proteins, it then invades the epithelial layer, triggering a local acute inflammatory response.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      0
      Seconds

  • Question 6 - An 11-year-old girl presents with a 5-day history of persistent fever despite regular...

    Incorrect

    • An 11-year-old girl presents with a 5-day history of persistent fever despite regular paracetamol, throbbing left ear pain, ear discharge and deafness. Her parents have observed that she is not her usual self, not eating well, and has been lethargic. On examination there is a tender swelling in the post auricular region on the left hand side.

      What is the most likely causative organism?

      Your Answer:

      Correct Answer: Streptococcus pneumonia

      Explanation:

      Acute mastoiditis is a complication (rare) of acute otitis media (AOM) and the commonest causative organism is Streptococcus pneumoniae.

      Generally, acute mastoiditis presents with:
      Pyrexia
      Recent history of AOM
      Mastoid swelling and erythema
      Otalgia
      Otorrhoea and perforation of tympanic membrane
      Post-auricular pain
      Protrusion of the ears

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 7 - In adults in the United Kingdom, which of the following pathogens is the...

    Incorrect

    • In adults in the United Kingdom, which of the following pathogens is the most likely cause of viral infectious gastroenteritis:

      Your Answer:

      Correct Answer: Norovirus

      Explanation:

      Norovirus is the most common viral cause of epidemic gastroenteritis worldwide; it is also a common cause of endemic diarrhoea in community settings. In the United Kingdom, norovirus has become the most common cause of gastroenteritis in adults and children since the introduction of rotavirus vaccination.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds

  • Question 8 - A 33-year-old female, who recently returned from a trip to Bangladesh, presents to...

    Incorrect

    • A 33-year-old female, who recently returned from a trip to Bangladesh, presents to the infectious diseases clinic with complaints of productive cough with blood-stained sputum, night sweats, and weight loss for the past one month. Based on the history and examination findings, you suspect pulmonary tuberculosis.

      Which ONE of the following investigations is most appropriate to make a diagnosis of active tuberculosis?

      Your Answer:

      Correct Answer: Sputum for acid-fast bacilli smear

      Explanation:

      Multiple investigations may be done to establish a diagnosis of active tuberculosis. In this case, sputum for acid-fast bacilli would be the best option as it can be done immediately, give fast results, and promptly initiate treatment. Three-morning sputum samples are collected and tested for acid-fast bacilli using gram staining.

      Blood culture would yield results in tuberculous bacteraemia and would be less sensitive than sputum testing.

      A chest X-ray would not differentiate active tuberculosis from an old infection in which the Ghon complex has formed, and the body’s immune reaction contains the Mycobacterium tuberculosis bacteria.

      Mantoux test shows the presence of antibodies to tuberculosis and may be positive if the patient has had a previous infection or been vaccinated against tuberculosis.

      A CT chest would also be unable to differentiate between an active infection and the findings of old tuberculosis infection.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
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      Seconds

  • Question 9 - A 55-year-old woman with history of gastritis and reflux esophagitis tested positive for...

    Incorrect

    • A 55-year-old woman with history of gastritis and reflux esophagitis tested positive for Helicobacter pylori infection.

      Which of the following statements regarding Helicobacter pylori is considered true?

      Your Answer:

      Correct Answer: It is helix shaped

      Explanation:

      Helicobacter pylori is a curved or helix-shaped, non-spore forming, Gram-negative, microaerophilic bacteria. It is motile, having multiple flagella at one pole. It has a lipopolysaccharide component in its outer membrane.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 10 - Among the following microorganisms, which is considered to be transmitted by invasion of...

    Incorrect

    • Among the following microorganisms, which is considered to be transmitted by invasion of intact skin?

      Your Answer:

      Correct Answer: Leptospira spp.

      Explanation:

      Rodents and domestic animals are the primary reservoirs for the Leptospira spp, although other animals, including cows, horses, mongooses, and frogs, can also harbour the leptospires. Humans may be directly infected from animal urine or indirectly by contact with soil or water that is contaminated with urine from infected animals. Infected humans can shed leptospires in urine for up to 11 months, infected cows for 3.5 months, infected dogs for 4 years, and infected rodents possibly for their entire lifetime.

      The organisms enter the host through mucous membranes or abraded skin. The incubation period ranges from 5 to 14 days.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
      Seconds

  • Question 11 - A 45-year-old businessman returns from a trip to West Africa with headaches and...

    Incorrect

    • A 45-year-old businessman returns from a trip to West Africa with headaches and intermittent fevers. Thick and thin films are sent to the lab and a diagnosis is made of malaria. The patient is started on treatment but his condition deteriorates and he develops jaundice, renal failure and haemoglobinuria.
      Which of the following is the MOST likely causative organism? Select ONE answer only.

      Your Answer:

      Correct Answer: Plasmodium falciparum

      Explanation:

      Malaria is an infectious disease transmitted by female of theAnophelesgenus of mosquito. It is a parasitic infection caused by the genusPlasmodium. Five species are recognized as causing disease in humans;Plasmodium falciparum,Plasmodium ovale,Plasmodium vivax,Plasmodium malariaeandPlasmodium knowlesi.
      The classic symptom of malaria is the malarial paroxysm, a cyclical occurrence of a cold phase, where the patient experiences intense chills, a hot stage, where the patient feels extremely hot and finally a sweating stage, where the fever declines and the patient sweats profusely. On examination the patient may show signs of anaemia, jaundice and have hepatosplenomegaly without evidence of lymphadenopathy.

      Plasmodium falciparum is the most serious form and is responsible for most deaths. Severe or complicated malaria is suggested by the presence of impaired consciousness, seizures, hypoglycaemia, anaemia, renal impairment, respiratory distress and spontaneous bleeding.
      Plasmodium falciparum is the most likely type in this case in view of the presentation.
      Haemoglobinuria and renal failure following treatment is suggestive of blackwater fever, which is caused byPlasmodium falciparum. An autoimmune reaction between the parasite and quinine causes haemolysis, haemoglobinuria, jaundice and renal failure. This can be fatal.
      The benign malarias: P.vivax, P. malariae and P.ovale are usually treated with chloroquine. A course of primaquine is also required in P.vivax and P.ovale infection. Artesunate is the drug treatment of choice for Plasmodium falciparum malaria. Quinine can still be used where artesunate is not available. Often combination therapy with drugs such as doxycycline or fansidar is also required.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 12 - One of the following pathogens is a conditional pathogen: ...

    Incorrect

    • One of the following pathogens is a conditional pathogen:

      Your Answer:

      Correct Answer: Neisseria meningitidis

      Explanation:

      Obligate pathogens include Mycobacterium TB, HIV, Treponema pallidum, and Neisseria gonorrhoeae. Neisseria meningitidis, on the other hand, is a conditional pathogen.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      0
      Seconds

  • Question 13 - A patient with profuse watery diarrhoea was found to have C. difficile cytotoxin....

    Incorrect

    • A patient with profuse watery diarrhoea was found to have C. difficile cytotoxin. Which of the following complications is NOT a typical complication of pseudomembranous colitis:

      Your Answer:

      Correct Answer: Volvulus

      Explanation:

      Dehydration, electrolyte imbalance, acute kidney injury secondary to diarrhoea, toxic megacolon, bowel perforation, and sepsis secondary to intestinal infection are all possible complications of pseudomembranous colitis.

      When the intestine twists around itself and the mesentery that supports it, an obstruction is created. This condition is known as a volvulus. Volvulus is caused by malrotation and other anatomical factors, as well as postoperative abdominal adhesions, and not by Clostridium difficile infection.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds

  • Question 14 - Regarding hepatitis B, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding hepatitis B, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Chronic hepatitis B infection is indicated by the persistence of HBsAg for more than 6 months.

      Explanation:

      Chronic hepatitis B infection is indicated by the persistence of HBsAg for more than 6 months. Hepatitis B has a long incubation period of about 2 – 6 months. Hepatitis B vaccine has recently been introduced to the routine childhood immunisation schedule – given at 2, 3 and 4 months. It is also given to babies born to hepatitis B infected mothers at birth, four weeks and 12 months old. Treatment of acute hepatitis is supportive. Treatment with antivirals should be considered in chronic infection as responders have a reduced risk of liver damage and liver cancer in the long term.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds

  • Question 15 - You suspected typhoid disease in a patient who had recently returned from South...

    Incorrect

    • You suspected typhoid disease in a patient who had recently returned from South America and presented to the emergency department with fever, constipation, and a rose spot rash. Which of the following antibiotics will be administered to this patient?

      Your Answer:

      Correct Answer: Cefotaxime

      Explanation:

      Typhoid fever, often known as enteric fever, is a potentially fatal multi-systemic sickness caused predominantly by Salmonella enterica serotype typhi and, to a lesser extent, paratyphi A, B, and C.

      Cefotaxime is the first-line treatment for typhoid fever (or ceftriaxone). In cases of mild or moderate sickness caused by multiresistant pathogens, azithromycin is an option. If the bacterium is sensitive, ciprofloxacin is an option.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds

  • Question 16 - Which of the following virulence factors of E. coli is important for attachment...

    Incorrect

    • Which of the following virulence factors of E. coli is important for attachment to host epithelial cells in the pathogenesis of urinary tract infections:

      Your Answer:

      Correct Answer: Pili

      Explanation:

      Escherichia coli is the most common cause of urinary tract infection. Uropathic strains are characterised by pili with adhesion proteins that bind to specific receptors on the urinary tract epithelium. The motility of E. coli aids its ability to ascend the urethra into the bladder or ascend the ureter into the kidney.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
      Seconds

  • Question 17 - A 32-year-old woman presents with abdominal pain and bloody diarrhoea that has been...

    Incorrect

    • A 32-year-old woman presents with abdominal pain and bloody diarrhoea that has been going on for 3 days.

      Among the following microorganisms, which is considered to be a cause of infectious bloody diarrhoea?

      Your Answer:

      Correct Answer: Entamoeba histolytica

      Explanation:

      The following are organisms that are capable of producing acute, bloody diarrhoea:
      – Campylobacter jejuni
      – Escherichia coli O157:H7
      – Salmonella species
      – Shigella species
      – Yersinia species
      – Entamoeba histolytica

      Other E. coli strains, Giardia, Vibrio, and other parasites are associated with watery, but not bloody, diarrhoea.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 18 - All of the following single clinical risk groups is considered eligible to receive...

    Incorrect

    • All of the following single clinical risk groups is considered eligible to receive the seasonal influenza vaccination, except:

      Your Answer:

      Correct Answer: Patients with hypertension

      Explanation:

      The following is the list of all the health and age factors that are known to increase a person’s risk of getting serious complications from flu:
      – Adults 65 years and older
      – Children younger than 2 years old
      – Asthma
      – Neurological and neurodevelopmental conditions
      – Blood disorders (such as sickle cell disease)
      – Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
      – Endocrine disorders (such as diabetes mellitus)
      – Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
      – Kidney diseases
      – Liver disorders
      – Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
      – People who are obese with a body mass index [BMI] of 40 or higher
      – People younger than 19 years old on long-term aspirin- or salicylate-containing medications.
      – People with a weakened immune system due to disease (such as people with HIV or AIDS, or some cancers such as leukaemia) or medications (such as those receiving chemotherapy or radiation treatment for cancer, or persons with chronic conditions requiring chronic corticosteroids or other drugs that suppress the immune system)
      – People who have had a stroke
      – Pregnant people and people up to 2 weeks after the end of pregnancy
      – People who live in nursing homes and other long-term care facilities

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
      0
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  • Question 19 - An outbreak of acute pneumonia occurs in military recruits living in one barrack...

    Incorrect

    • An outbreak of acute pneumonia occurs in military recruits living in one barrack and only in those persons located near the air conditioner. Epidemiologic surveillance results in isolation of the causal organism from the patients and from the drip pans of the air conditioner. The organism is weakly Gram-negative. The most likely organism is:

      Your Answer:

      Correct Answer: Legionella pneumophila

      Explanation:

      Legionella pneumophilais a Gram negative bacterium that is found in natural water supplies and in the soil, transmitted predominantly via inhalation of aerosols generated from contaminated water (direct person-to-person spread of infected patients does not occur). It is the cause of Legionnaires’ disease. Outbreaks of Legionnaires’ disease have been linked to poorly maintained air conditioning systems, whirlpool spas and hot tubs.

      The clinical features of the pneumonic form of Legionnaires’ disease include:
      Mild flu-like prodrome for 1-3 days
      Cough (usually non-productive and occurs in approximately 90%)
      Pleuritic chest pain
      Haemoptysis
      Headache
      Nausea, vomiting and diarrhoea
      Anorexia
      Legionella pneumophilainfections can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used.
      The syndrome of inappropriate antidiuretic hormone secretion (SIADH) can occur with Legionnaires’ disease and will result in hyponatraemia as is seen in this case.
      Legionella pneumophilainfections are resistant to amoxicillin but can be successfully treated with macrolide antibiotics, such as erythromycin, or quinolones, such as ciprofloxacin. Tetracyclines, such as doxycycline, can also be used. The majority of cases of Legionnaires’ disease are caused by Legionella pneumophila, however many other species of Legionella have been identified.
      Legionella longbeachae is another less commonly encountered species that has also been implicated in outbreaks. It is predominantly found in soil and potting compost, and has caused outbreaks of Pontiac fever, the non-respiratory and less severe variant of Legionnaires’ disease.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
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  • Question 20 - A 71-year-old man treated with antibiotics for a chest infection returns with a...

    Incorrect

    • A 71-year-old man treated with antibiotics for a chest infection returns with a profuse, offensive smelling diarrhoea. A diagnosis of Clostridium difficile diarrhoea is made after investigations.

      The action most effective at minimizing spread to other patients is?

      Your Answer:

      Correct Answer: Hand washing

      Explanation:

      Clostridium difficile, a Gram-positive, anaerobic, spore forming bacteria is present in the gut of approximately 3% of healthy adults (2012 UK HPA estimates). Following use of broad spectrum antibiotics, which alter normal gut flora, Clostridium difficile associated diarrhoea (CDAD) occurs.

      Alcohol hand gel is not effective against Clostridium Difficile spores. Hand washing with soap and water is very essential for healthcare workers who come in contact with it.

      Wearing an apron and gloves, and isolation to a side room are important contact precautions. They are, however, ineffective if hand washing is neglected.

      Although oral vancomycin is the first-line treatment for C. difficile associated diarrhoea, it will not limit patient to patient spread.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds

  • Question 21 - A 71-year-old man treated with antibiotics for a chest infection returns with a...

    Incorrect

    • A 71-year-old man treated with antibiotics for a chest infection returns with a profuse, offensive smelling diarrhoea. A diagnosis of Clostridium difficile diarrhoea is made after investigations.

      Which antibiotic is associated with the greatest risk of causing Clostridium Difficile diarrhoea?

      Your Answer:

      Correct Answer: Ciprofloxacin

      Explanation:

      Clostridium difficile, a Gram-positive, anaerobic, spore forming bacteria is present in the gut of approximately 3% of healthy adults (2012 UK HPA estimates). Following use of broad spectrum antibiotics, which alter normal gut flora, Clostridium difficile infection (CDI) occurs. About 80% of Clostridium Difficile infections are seen in people over the age of 65 and its main clinical features are:
      Abdominal cramps, severe bloody and/or watery diarrhoea, offensive smelling diarrhoea, and fever.

      CDI is the most severe consequence of antibiotic treatment and is a major cause of morbidity and mortality.
      Risk for CDI has been found to be greatest with clindamycin followed by fluoroquinolones Tetracyclines are not associated with risk for CDI.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
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  • Question 22 - What is the main route of transmission of Mumps? ...

    Incorrect

    • What is the main route of transmission of Mumps?

      Your Answer:

      Correct Answer: Respiratory droplet route

      Explanation:

      Mumps is primarily transmitted person to person via respiratory droplets.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
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  • Question 23 - A 10-year-old girl that appears systemically well presents with a honey-crusted scab close...

    Incorrect

    • A 10-year-old girl that appears systemically well presents with a honey-crusted scab close to the corner of her mouth and states that the area is slightly itchy but not painful. The diagnosis given was impetigo.

      What is most likely the mode of transmission of the causative agent of the said diagnosis?

      Your Answer:

      Correct Answer: Direct contact

      Explanation:

      Impetigo is a common pyoderma that is most often seen in children. Historically, most cases were caused by group A streptococci (GAS; Streptococcus pyogenes), although S. aureus has become the predominant pathogen over the last 15 years.

      A bullous form of impetigo accounts for approximately 10% of cases. It is caused by strains of S. aureus that produce exfoliative toxins leading to the formation of bullae, which quickly rupture and form a transparent, light brown crust.

      Impetigo is spread mainly by person-to-person contact; it is rapidly spread through direct transmission. The diagnosis of impetigo can be made from a Gram stain and culture of the vesicular contents.

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
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  • Question 24 - A 26 year old male presents to emergency room with a 2 day...

    Incorrect

    • A 26 year old male presents to emergency room with a 2 day history of burning pain when passing urine, accompanied by a green urethral discharge. Gonorrhoea is suspected. The first line antibiotic for this condition is which of the following?

      Your Answer:

      Correct Answer: Ceftriaxone

      Explanation:

      When there is a high suspicion of gonorrhoea from clinical features, empiric treatment should be commenced whilst waiting for laboratory confirmation.
      The first line treatment for uncomplicated anogenital and pharyngeal disease includes ceftriaxone 500 mg IM (single dose) + azithromycin 1 g orally as a single dose. This covers concomitant chlamydia infection. For all people who have been treated for gonorrhoea, a test of cure is recommended

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
      0
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  • Question 25 - A 26-year-old woman is currently 9 weeks pregnant. Upon interview and history taking,...

    Incorrect

    • A 26-year-old woman is currently 9 weeks pregnant. Upon interview and history taking, she mentioned that she visited a friend whose child had just been diagnosed with slapped cheek disease.

      If the mother contracts an illness during pregnancy, which among the following is not known to cause fetal abnormalities?

      Your Answer:

      Correct Answer: Hepatitis A

      Explanation:

      Hepatitis A usually doesn’t pose a special risk to a pregnant woman or her baby. Maternal infection doesn’t result in birth defects, and a mother typically doesn’t transmit the infection to her baby. HAV is almost always transmitted by the faecal-oral route and is usually acquired through close personal contact or via contaminated food.

      When a woman has chickenpox in the first 20 weeks of pregnancy, there is a 1 in 50 chance for the baby to develop a set of birth defects. This is called the congenital varicella syndrome. It includes scars, defects of muscle and bone, malformed and paralyzed limbs, small head size, blindness, seizures, and intellectual disability.

      TORCH Syndrome refers to infection of a developing foetus or newborn by any of a group of infectious agents. “TORCH” is an acronym meaning (T)toxoplasmosis, (O)ther Agents, (R)ubella (also known as German Measles), (C)ytomegalovirus, and (H)erpes Simplex.
      Infection with any of these agents may cause a constellation of similar symptoms in affected newborns. These may include fever; difficulties feeding; small areas of bleeding under the skin, causing the appearance of small reddish or purplish spots; enlargement of the liver and spleen (hepatosplenomegaly); yellowish discoloration of the skin, whites of the eyes, and mucous membranes (jaundice); hearing impairment; abnormalities of the eyes; and other symptoms and findings.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
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  • Question 26 - A patient with a central line in situ for the past 10...

    Incorrect

    • A patient with a central line in situ for the past 10 days now has erythema surrounding the catheter insertion site and shows signs of sepsis. You suspect line sepsis.

      Which of these antibacterial agents would be most appropriate to prescribe for this patient?

      Your Answer:

      Correct Answer: Vancomycin

      Explanation:

      The current recommendation by NICE and the BNF is to use vancomycin as first-line in treatment of septicaemia related to vascular catheter. A broad-spectrum antipseudomonal beta-lactam antibiotic should be added to vancomycin if a Gram-negative sepsis is suspected especially in an immunocompromised patient.

      In any patient that has had a central venous catheter in situ for a period longer than a week, it should be suspected as the source of sepsis.

      The features suggesting the vascular catheter as the source of infection include:
      Presence of the catheter before onset of fever.
      The absence of another identifiable source of infection.
      Presence of inflammation or purulent material at the insertion site or along the tunnel.
      An immunocompetent patient without any underlying disease developing bacteraemia (or fungaemia).

    • This question is part of the following fields:

      • Microbiology
      • Principles Of Microbiology
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  • Question 27 - Which of the following statements is considered correct regarding Klebsiella infections? ...

    Incorrect

    • Which of the following statements is considered correct regarding Klebsiella infections?

      Your Answer:

      Correct Answer: Klebsiella spp. are non-motile

      Explanation:

      Klebsiella is a Gram-negative, rod-shaped, non-motile bacteria. The absence of motility distinguishes Klebsiella spp. from most other members of the family Enterobacteriaceae.

      K. pneumoniae is the most commonly isolated species and has the distinct feature of possessing a large polysaccharide capsule. The capsule offers the organism protection against phagocytosis and antimicrobial absorption,
      contributing to its virulence.

      Colonization of gram-negative bacilli in the respiratory tracts of hospitalized patients, particularly by K. pneumoniae, increases with the length of hospital stay. It is a frequent cause of lower respiratory tract infections among hospitalized patients and in immunocompromised hosts such as newborns,
      elderly patients, and seriously ill patients on respirators.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
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  • Question 28 - Which of the following antibiotics is the first line of treatment for a...

    Incorrect

    • Which of the following antibiotics is the first line of treatment for a patient who has been diagnosed with chlamydia infection?

      Your Answer:

      Correct Answer: Azithromycin

      Explanation:

      The Centres for Disease Control and Prevention (CDC) recommends azithromycin, a single 1 g dose, and doxycycline, 100 mg bd for 7 days, as first-line medications for chlamydial infection treatment.

      Second-line medications (such as erythromycin, penicillins, and sulfamethoxazole) are less effective and have more side effects

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
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  • Question 29 - Hepatitis A is transmitted by which of the following routes: ...

    Incorrect

    • Hepatitis A is transmitted by which of the following routes:

      Your Answer:

      Correct Answer: Faecal-oral route

      Explanation:

      Hepatitis A transmission is by the faecal-oral route; the virus is excreted in bile and shed in the faeces of infected people.

    • This question is part of the following fields:

      • Microbiology
      • Pathogens
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  • Question 30 - A 23-year-old has a known diagnosis of HIV. Blood is sent to the...

    Incorrect

    • A 23-year-old has a known diagnosis of HIV. Blood is sent to the laboratory for tests.

      AIDS be diagnosed at a CD4 counts below?

      Your Answer:

      Correct Answer: 200 cells/mm 3

      Explanation:

      A normal CD4 count ranges from 500-1000 cells/mm3.

      At CD4 count of less than 350 cells/mm3 treatment with anti-retroviral therapy should be considered.

      At a CD4 count of >200 cells/mm3 AIDS is diagnosed.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
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      Seconds

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