staphyloccous

streptocoocus

1) Most people are colonised with Staphylococcus aureus? T/F

False, most people colonised with coagulase negative staphylococci. Colonisation rate for
Staphylococcus aureus probably 10-20% of the population.

2) The nuc gene is found in Methicillin Resistant Staphylococcus aureus? T/F

True: The nuc gene found in all Staphylococcus aureus but is not the resistant determinant for
MRSA, which is MecA, coding for the PBP2A protein.

3) Methicillin is a commonly used antibiotic in many parts of the world? T/F

False: Essentially historical antibiotic, superseded by flucloxacillin, cloxacillin and dicloxacillin

4) Staphylococcus aureus can ferment mannitol? T/F

True: This creates acid by-product and turns phenol indicator in Mannitol Salt Agar to yellow,
giving yellow colonies.

5) Coagulase is not thought to be an important virulence factor for Staphylococcus aureus? T/F

True: However useful for discriminating between Staphylococcus aureus and “coagulase negative
staphylococci”

6) Staphylococcus aureus bacteraemia has a 30 day mortality of 15-20%? T/F

True: One of the hishest mortality rates for any bacterial species.

7) Staphylococcus aureus can cause food poisoning? T/F

True: Through the production of enterotoxins, usually with a short incubation period and short
duration of symptoms.

8) Staphylococcus aureus is a motile organism? T/F

False: As far as I am aware, it is non-motile.

9) Staphylococcus aureus can be intracellular in nasal epithelial cells? T/F

True: Explaining why Staphylococcus aureus colonisation can be difficult to eradicate, and the
lack of decolonisation activity of antimicrobials with little intracellular activity, such as
flucloxacillin.

10) Staphylococcus aureus is a common contaminant in blood cultures? T/F

False: Most of the time when found in blood cultures, is pathogenic. Occasionally a contaminant.
If only cultured from one bottle after a significant time period (ie >15hrs), this can be a pointer
towards it being a contaminant.

1. The bacteria which is novobiocin resistant is

A. Staphylococcus aureus

B. S epidermidis

C. S saprophyticus

D. None of these

Answer: Option C

2.The bacteria which are inhibited on crystal violet (1:500,000) blood agar, is/are

A. Streptococci

B. Staphylococci

C. Both (a) and (b)

D. None of these

Answer: Option B.

3. Which of the following Staphylococcal haemolysins does not possess leucocidal activity?

A. α haemolysin

B. γ haemolysin

C. β haemolysin

D. δ haemolysin

Answer: Option C

4. The genus/genera that belongs to the family Micrococcaceae is

A. Micrococcus

B. Staphylococcus

C. Planococcus

D. All of these
Answer: Option D

5.Identify the bacteria which is oxidase-negative and catalase-positive?

A. Staphylococcus

B. Streptococcus

C. Neisseria

D. Pseudomonas

Answer: Option A

6. Coagulase-reacting factor is necessary for

A. slide coagulase test

B. tube coagulase test

C. precipitation test

D. none of these

Answer: Option B

7. Bacteria which produces coagulase is

A. S epidermidis

B. S saprophyticus

C. S aureus

D. S hominis

Answer: Option C

8. Staphylococcal food poisoning usually manifests itself following ingestion of contaminated

food after

A. 2-6 hours

B. 8-12 hours

C. 12-18 hours

D. 18-36 hours

Answer: Option A
9.Which of the following Staphylococcal haemolysins does not cause lysis of human RBCs?

A. β haemolysin

B. γ haemolysin

C. α haemolysin

D. δ haemolysin

Answer: Option C

10. The toxin of Staphylococcus aureus that may result into scalded skin syndrome is

A. Enterotoxin

B. Leucocidin

C. Epidermolytic toxin

D. Haemolysin

Answer: Option C

11. The bacteria which can ferment mannitol anaerobically is

A. Staphylococcus aureus

B. S epidermidis

C. S saprophyticus

D. None of these

Answer: Option A

12. Protein A is found in cell wall of

A. coagulase-negative staphylococci

B. Staphylococcus aureus

C. Micrococci

D. none of these

Answer: Option B

13.The most common cause of cystitis (after Escherichia coli) in healthy sexually active women is
A. Staphylococcus saprophyticus

B. Proteus mirabilis

C. Pseudomonas aeruginosa

D. Klebsiella pneumoniae

Answer: Option A

14. Which of the following can be used to detect clumping factor?

A. tube coagulase test

B. slide coagulase test

C. precipitation test

D. none of these

Answer: Option B

15. Most strains of Staphylococcus aureus indicate

A. phosphatase production

B. a golden-yellow pigment

C. β-haemolysis on sheep blood agar

D. all of the above

Answer: Option D

What is the most serious pathogen within the genus Staphylococcus?

A) Staphylococcus epidermidis

B) Staphylococcus saprophyticus

C) Staphylococcus hominis

D) Staphylococcus aureus

E) Staphylococcus capitis

2 Why is Staphylococcus aureus considered a troublesome hospital pathogen?

A) Because its optimum growth temperature is 37°C.

 B) Because it resists the effects of many disinfectants and antibiotics.

C) Because it is a facultative anaerobe.

D) Because it grows in large, round opaque colonies.

E) Because it can digest proteins and lipids, and ferment a variety of sugars.

3 What is the most diagnostic species characteristic of Staphylococcus aureus?

A) The production of hyaluronidase

B) The production of penicillinase

C) The production of coagulase

D) The production of leukocidin

E) The production of -toxin

4 Which is not an effect of the Staphylococcus aureus -toxin?

A) It acts upon the human gastrointestinal tract.

B) It lyses red blood cells of various mammals.

C) It causes leukocyte damage.

D) It damages skeletal and heart muscle.

E) It damages kidney tissues.

5 Staphylococcus aureus is most frequently isolated from what body site?

A) Gastrointestinal tract

B) Genitourinary tract

C) Vagina

D) Nostrils

E) Stomach

6 What is the most common infection caused by Staphylococcus aureus?

A) Staphylococcal enterotoxicosis

B) Folliculitis
 C) Toxic shock syndrome

D) Osteomyelitis

E) Staphylococcal Bacteremia

7 Staphylococcal enterotoxicosis is associated with eating all but which of the following foods?

A) Custards

B) Chicken salad

C) Ham and processed meats

D) Hamburger

E) Cream pastries

8 What factor appears to support colonization and proliferation of both Staphylococcus aureus
and the coagulase-negative staphylococci within patients?

A) An open wound

B) A preexisting condition

C) A foreign body

D) A primary infection

E) The use of antibiotics

9 What is the key test that separates Staphylococcus aureus from other staphylococci?

A) Susceptibility to novobiocin

B) Mannose fermentation

C) Growth on blood agar

D) Coagulase test

E) Urease test

10 What is the principal reservoir for the pathogenic staphylococci?

A) Humans

B) Large primates

C) Soil
 D) Fresh and salt water

E) Herbivores

11 How are the streptococci differentiated from the staphylococci when viewed microscopically
following the Gram stain procedure?

A) Staphylococci are Gram positive, while streptococci are Gram negative.

B) Staphylococci are Gram positive and grow in grape-like clusters, while

streptococci are also Gram positive, but grow in chains.

C) Staphylococci are Gram positive cocci, while streptococci are Gram positive
bacilli.

D) Staphylococci are Gram negative bacilli, while streptococci are Gram negative
cocci.

E) They cannot be differentiated microscopically.

12 What is the most serious streptococcal pathogen of humans?

A) Streptococcus agalactiae

B) Streptococcus mutans

C) Streptococcus pyogenes

D) Enterococcus faecalis

E) Streptococcus sanguis

13 Why do toxic shock syndrome and necrotizing fasciitis cause such severe pathology to host
tissues?

A) The streptococcal toxins act as superantigens.

B) The organisms have been infected by a temperate bacteriophage.

C) The organisms possess M protein.

D) The organisms produce streptokinase and hyaluronidase.

E) The organisms are extremely resistant to antimicrobial drugs.

14 Primary infections caused by Streptococcus pyogenes are due to the organisms invading what
two body sites?

A) Nose and vagina

 B) Skin and eyes

C) Eyes and gastrointestinal tract

D) Mouth and urethra

E) Skin and throat

15 What species of the streptococci can be transferred to an infant during delivery?

A) Streptococcus pyogenes

B) Enterococcus faecalis

C) Enterococcus faecium

D) Streptococcus bovis

E) Streptococcus agalactiae

16 What test allows for the differentiation of Group A streptococci from other -hemolytic
streptococci?

A) CAMP test

B) Hippurate hydrolysis

C) Esculin hydrolysis

D) Bacitracin sensitivity

E) Growth in 6.5% salt

17 Which streptococcal species is involved in the production of cavities?

A) Streptococcus pneumoniae

B) Streptococcus agalactiae

C) Streptococcus pyogenes

D) Enterococcus faecalis

E) Streptococcus mutans

18 What is the major virulence factor of Streptococcus pneumoniae?

A) M protein

B) Pyogenic exotoxins
 C) Capsule

D) DNase

E) Hyaluronidase

19 What organism is responsible for the majority of cases of otitis media in children?

A) Streptococcus pneumoniae

B) Staphylococcus aureus

C) Streptococcus pyogenes

D) Streptococcus mutans

E) Staphylococcus epidermidis

20 Virulence factors of Neisseria gonorrhoeae include all except which of the following?

A) Pili that promote attachment

B) Surface molecules that promote attachment

C) IgA protease

D) Hemolysis

E) Pili that slow phagocytosis

21 Most cases of gonorrhea occur within what age range?

A) 14-18 years

B) 18-24 years

C) 24-26 years

D) 26-30 years

E) 30-35 years

22 How do Neisseria gonorrhoeae appear when stained with the Gram stain and viewed
microscopically?

A) Gram positive cocci in grape-like clusters

B) Gram negative rods

C) Gram positive diplococci

 D) Gram negative cocci in grape-like clusters

E) Gram negative diplococci

23 Meningitis associated with Neisseria meningitidis usually occurs as what type of disease?

A) Endemic

B) Epidemic

C) Pandemic

D) Isolated

E) Common-source

24 What is the reservoir of Neisseria meningitidis?

A) Soil

B) Saltwater

C) Human carriers

D) Domesticated animals

E) Reptiles

25 How is Neisseria meningitidis spread?

A) Through respiratory secretions or droplets

B) Through contaminated fomites

C) Through consumption of contaminated food or water

D) By insect vectors

E) Through sexual contact

1 Triple vaccine for the prevention of virus infections protects against:

A. mumps virus

B. coxsackie virus

C. measles virus

D. rubella virus
E. adenoviruses

True

False

True

True

False

2 Advantages of sterilisation by ionising radiation include

A. short sterilisation time

B. reliability of sterilisation

C. negligible rise in temperature

D. ability to sterilise equipment made of heat-sensitive materials,

e.g. polystyrene

E. no deleterious effects on glassware or textile fibre

True

True

True

True

False

Tetanus toxoid

A. need not be given for superficial wounds

B. is given three times to babies as a component of triple vaccine

C. confers passive immunity

D. should be avoided in the immunocompromised person

E. administration within the last five years obviates the need to give anti-biotics in a case of
tetanus-prone injury

False
True

False

False

False

4 Ethylene oxide is commonly used for the sterilisation of

A. fibre-optic endoscopes

B. glassware

C. rubber tubings and catheters

D. prosthetic cardiac valves

E. respiratory ventilators

False

False

True

True

True

Enterococcus faecalis is

A. a frequent cause of pyogenic infections

B. a Gram-negative coccus

C. usually sensitive to aminoglycosides

D. often resistant to cephalosporin antibiotics

E. associated with infection in hip prostheses

False

False

False

True
True

6 Methicillin-resistant Staphylococcus aureus (MRSA)

A. is usually sensitive to vancomycin

B. is more likely to cause deep-seated infection

C. is often resistant to many antistaphylococcal antibiotics

D. may cause asymptomatic colonisation

E. may be phage-typed for epidemiological purpose

True

False

True

True

True

Aminoglycoside antibiotics such as gentamicin

A. act on the bacterial cell wall

B. are active against staphylococci

C. are effective in the treatment of anaerobic myositis

D. are contra-indicated in patients with renal impairment

E. may cause loss of visual acuity in the elderly

False

True

False

False

false
8 In bacterial endocarditis

A. blood cultures may be negative

B. staphylococci are rare causative organisms

C. the inability to control infection with antibiotic therapy is an indication for replacement of the
affected valve

D. combination therapy with a penicillin and an aminoglycoside is advised in most cases

E. cystoscopy is a predisposing facto

True

False

True

True

True

Epididymo-orchitis

A. is associated with prostatitis

B. is a complication of gonococcal urethritis

C. is a manifestation of genital infection with Ureaplasma spp

D. occasionally complicates mumps

E. may be caused by Mycobacterium tuberculosis

True

True

False

True

True

10 The antistreptolysin O titre is raised in infections caused by

A. Streptococcus sanguis

B. Streptococcus pneumoniae
C. Streptococcus pyogenes

D. Streptococcus bovis

E. Streptococcus mutan

False

False

True

False

False

11 The following are causes of gas gangrene in man

A. Clostridium histolyticum

B. Clostridium septicum

C. Clostridium novyi

D. Clostridium sporogenes

E. Clostridium perfringens

True

True

True

False

True

12 The haemolytic uraemic syndrome

A. is more common in children

B. in the majority of cases is caused by infection with verotoxin-producing Escherichia coli

C. is rarely associated with haemorrhagic colitis

D. is caused by an infective agent that may be transmitted with food

E. may present as an acute abdomen

True

True

False

True

True

13 In tuberculous infection of the urinary tract

A. the renal pelvis is most commonly affected

B. nephrectomy is usually necessary in addition to antituberculous chemotherapy

C. the demonstration of acid-fast bacilli in an early morning sample of urine is usually diagnostic

D. sterile pyuria is a consistent laboratory finding

E. Mycobacterium tuberculosis is the species most commonly involved

True

False

False

True

True

14 The diagnosis of pseudomembranous colitis (PMC) is aided by

A. colonoscopic biopsy of lesions

B. positive blood culture for Clostridium difficile

C. raised antibody levels in blood to Clostridium difficile toxin

D. isolation of Clostridium difficile from the stool

E. detection of Clostridium difficile toxin in the stool

True

False

False
True

True

The identification of bacteria by serologic tests is based on the presence of specific antigens.
Which of the following bacterial components is least likely to contain useful antigens?

a. Ribosomes

b. Cell wall

c. Capsule

d. Flagella

Each of the following statements concerning the Gram stain is correct except:

a. Escherichia coli stains pink because it has a thin peptidoglycan layer

b. Streptococcus pyogens stains blue because it has a thick peptidoglycan layer

c Mycoplasma pneumoniae is not visible in the Gram’s stain because it does not have a cell wall

d. Mycobacterium tuberculosis stains blue because it has a thick lipid layer

An outbreak of sepsis caused by Staphylococcus aureus has occurred in the newborn nursery.
You are called upon to investigate. According to your knowledge of the normal flora, what is the
most likely source of the organism?

a. Nose

b. Colon

c. Vagina

d. Throat

Each of the following organisms is an important cause of urinary tract infections except:

a. Klebsiella pneumoniae

b. Escherichia coli

c. Bacteriodes fragilis

d. Proteus mirabilis

A 30 year old woman has non bloody diarrhea for the past 14 hours. Which one of the to
following organisms is least likely to cause this illness?
a. Streptococcus pyogens

b. Clostridium difficile

c. Shigella dysenteriae

d. Salmonella enteritidis

Each of the following agents is a recognized cause of diarrhea except

a. Clostridium perfringens

b. Vibrio cholerae

c. Enterococcus faecalis

d. Escherichia coli

Each of the following statements about the classification of streptococci is correct except

a. Pneumococci (Streptococcus pneumoniae) are alpha-hemolytic and can be serotyped on the

basis of their polysaccharide capsule

b. Enterococci are group D streptococci and can be classified by their ability to grow 6.5% sodium
chloride

c. Viridans streptococci are identified by Lancefield grouping, which is based on the C

carbohydrate in the cell wall

d. Although pneumococci and the viridans streptococci are alpha-hemolytic, they can be
differentiated by the bile solubility test and their susceptibility to optochin

Which of the following bacteria has the lowest 50% infective dose (ID50)?

a. Campylobacter jejuni

b. Salmonella typhi

c. Vibrio cholerae

d. Shigella sonnei

Which of the following disease is best diagnosed by serologic means?

a. Pulmonary tuberculosis

b. Gonorrhea

c. Actinomycosis
d. Q Fever

The cogulase test is used to differentiate

a. Staphylococcus epidermidis from Neisseria meningitidis

b. Staphylococcus aureus from Staphylococcus epidermidis

c. Streptococcus pyogens from Staphylococcus aureus

d. Streptococcus pyogens from Enterococcus faecalis

Protein A is a cell wall component of

a. Staphylococcus aureus

b. coagulase-negative staphylococci

c. micrococci

d. none of the above

Ans d

Which of the following toxin is responsible for staphylococcal scalded skin syndrome

a. enterotoxin

b. leucocidin

c. hemolysin

d. exfoliative toxin

Ans d

Slide coagulase test detects

a. free coagulase

b. bound coagulase

c.both of the above

d. none of the above

Ans b

Tube coagulase test detects

a. free coagulase

b. bound coagulase

c.both of the above

d. none of the above

Ans a

Which of the following bacteria produce coagulase enzyme

a. Staphylococcus aureus

b. Staphylococcus epiderm midis

c. Staph saprophyticus

d. none of the above

Ans a

Which of the following are novobiocin resistant

a. Staphylococcus aureus

b. Staphylococcus epiderm midis

c. Staph saprophyticus

d. none of the above

Ans c

All the following are coagulase negative staphylococcus except

a. Staphylococcus aureus

b. Staphylococcus epiderdimidis

c. Staph saprophyticus

d. Staph hemolyticus

Ans a

Draught’s man colony is characteristic of

a.Streptococcus pyogenes
b. Streptococcus pneumoniae

c. Enterococcus faecalis

d. viridans streptococcus

Ans a

The capsule of Streptococcus pneumoniae can be demonstrated by

a. India ink staining

b. quellung reaction

c. both of the above

d. none of the above

Ans c

Streptococcus pneumoniae may cause

a. lobar pneumonia

b. bronchopneumonia

c. meningitis

d. all the above

Ans d

Pneumococcal antigen in CSF can be demonstrated by

a. counterimmunoelectrophoresis

b. latex agglutination

c. coagglutination

d. all the above

Ans d

Which of the following test can be useful to identify Streptococcus pneumoniae

a.bile solubility test

b. insulin fermentation
c. optochin sensitivity test

d. all the above

Ans d

Which of the following bacteria produce alpha hemolysis on bacterial agar

a. Streptococcus pneumoniae

b. Strptococcus pyogenes

c. Staphylococcus aureus

d. all the above

Ans a

All the following are non pathogenic except

a. Neisseria flavesence

b. N sicca

c. N subflava

d. Moraxella catarrhalis

Ans d

Which of the following is selective medium for Neisseria gonorrhoea

a. modified Thayer-martin medium

b. blood agar

c. Mac conkey’s agar

d. potassium tellurite blood agar

Ans a

All the following are oxidase positive

a. Neisseria gonorrhoea

b. Neisseria meningitidis

c. Vibrio cholerae
d. Enterobacter

Ans d

How many sero groups of Neisseria meningitidis are known

a. 9

b. 12

c. 13

d. 15

Ans c

Which of the following rapid test may be used to detect meningococcal antigen

a. countercurrent immuno electrophoresis

b. coagglutination test

c. latex agglutination test

d. all the above

Ans d

Sreptococcus pneumoniae is

a. alpha hemolytic

b. beta hemolytic

c. gamma hemolytic

d. delta hemolytic

Ans a

Serological marker of retrospective diagnosis of skin infection due to Streptococcus pyogenes

a. ASO titre

b. anti-DNA ase antibody

c. anti-streptokinase antibody

d. hyaluronidase
Ans b

Catalase negative gram-positive bacteria are the following except

a. streptococcus

b. staphylococcus

c.pneumococcus

d. enterococcus

Ans b

The colour of the colonies of Staphylococcus aureus in Mac conkey agar

a.golden yellow

b. black

c. pink

d. green

Ans c

Selective media for staphylococcus aureus

a. salt milk agar(8-10%)NaCl

b. mannitol salt agar with 7.5% NaCl

c. Ludlam’s lithium chloride and tellurite media

d. all the above

Ans d

All the following are caused by streptococcus except

a. scarlet fever

b. erysipelas

c. toxic shock syndrome

d. psoriasis

Ans d
which of the following help us to differentiate staphylococcus aureus form non pathogenic form
of staphylococcus

a. beta type of hemolysis on blood agar

b. production of golden yellow pigment

c. coagulase production

d. all the above

Ans d

diabetic patient developed cellulitis due to staphylococcus aureus, which was found to be
Methicillin resistant on the antibiotic sensitivity testing. All the following antibiotics will be
appropriate except:

A. Vancomycin

B. Imipenem

C. Teicoplanin

D. Linezolid

correct answer : B. Imipenem

Most strains of MRSA are not sensitive to Imipenem

1. The following staphylococci are coagulase positive:

a. S. aureus

b. S. epidermidis

c. S. intermedius

d. S. hyicus

e. S. haemolyticus

2. True statements about Staphylococcus include:

a. they belong to the bacterial family Micrococcaceae

b. only coagulase positive species cause human diseases

c. they are oxidase negative

d. they are all catalase positive

e. the cells are about 1 micrometer in diameter

3. The following are true about Staphylococus aureus:

a. under microscope they appears as diplococci

b. they form yellow colony

c. they are found in the nasal passage of normal population

d. they cause haemolysis on blood agar

e. they are often coagulase positive

4. True statements about Staphylococcus epidermidis:

a. they form white colony

b. they cause haemolysis on blood agar

c. they form the normal flora on human skin

d. they are often coagulase positive

e. in hospital environment, they can become pathogen

5. The following features can distinguish Staphylococcus from

Streptococcus:

a. Staphylococcus is Gram positive whereas

Streptococcus is Gram negative

b. Staphylococcus has round cell whereas Streptococcus

has slightly oblong cell.

c. Staphylococcus is catalase positive whereas

Streptococcus is catalase negative

d. Staphylococcus appears as clusters under microscope

whereas Streptococcus appears as long chain

e. Staphylococcus divides in two planes whereas

Streptococcus divides in one plane only