University of Santo Tomas - Medical Technology Medical Microbiology and Parasitology

UNIVERSITY OF SANTO TOMAS | MEDICAL TECHNOLOGY
MEDICAL MICROBIOLOGY AND PARASITOLOGY
MICROBIOLOGY-PARASITOLOGY
EXAMINATION
1. Many of this type of bacteria do not possess superoxide dismutase and catalase
A. obligate aerobes
B. obligate anaerobes
C. facultative anaerobes
D. microaerophiles
2. It is the period when the bacterium is assessing the nutrients present in medium; the bacterium does not
divide but there is an intense metabolic activity. The phase of bacterial growth is
A. Lag
B. Log
C. Stationary
D. Decline
3. Which the best to sterilize scissors and other sharps?
A. Glutaraldehyde
B. Formaldehyde
C. Iodophor
D. Phenol
4. These are groups of genes that are clustered together in the DNA of some bacterial species and which
may enable them to invade a host
A. Pathogenicity island
B. Episomes
C. Transposons
D. Replicons
5. Which is true about the bacterial chromosome?
A. Contains histones that stabilize the DNA
B. Composed of a single pair of homologous chromosomes
C. Replicates in a very different manner from that of eukaryotic chromosomes
D. Contain single copy of each gene
6. A non-encapsulated strain of Hemophilus influenzae acquires the gene for capsule production from a DNA
extract of another encapsulated strain. The event that has occurred is
A. Transformation
B. Conjugation
C. Transduction
D. Transcription
7. What is the substance primarily responsible for the structural integrity of the bacterial cell wall and is
susceptible to lysozyme?
A. Cytoplasmic membrane
B. Teichoic acid
C. Peptidoglycan
D. Lipopolysaccharide
8. A hospitalized patient with dysuria and suprapubic pain is treated with ciprofloxacin. What is the
mechanism of action of this antibiotic?
A. It inhibits DNA-dependent RNA polymerase
B. It inhibits protein synthesis by binding to the 30S ribosomal subunit
C. It inhibits protein subunits by binding to the 50S ribosomal subunit
D. It inhibits topoisomerase II (DNA gyrase)
9. Which bacterial structure may carry gene for antibiotic resistance?
A. Mesosome
B. Periplasm
C. Plasmid
D. Outer membrane
10. What is the predominant indigenous flora of the colon?
A. Anaerobic, gram-negative, non-spore-forming bacteria
B. Anaerobic, gram-positive, non-spore-forming bacteria
C. Aerobic, gram-negative, non-spore-forming bacteria
D. Aerobic, gram-positive, spore-forming bacteria
11. Which of the following is the true regarding the bacterial cell?
A. He motility of bacteria is due to flagella, axial filaments or cilia
B. The ability to colonize cell surfaces is dependent on toxic production
C. The ability to survive in soil for a long period of time is dependent on the
production of endospores
D. It has the same ribosomes as that of a eukaryotic cells
12. Which of the following is the counterpart of mitochondria in a bacterial cell?
A. Cell wall
B. Endospores
C. Ribosomes
D. Cell membrane
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13. Which of the following agents possess either DNA or RNA?
A. Viruses
B. Prions
C. Bacteria
D. Fungi
14. Most pathogenic microorganism grow best at the temperature range of about _____.
A. 15-20ºC
B. 30-37ºC
C. 50-60ºC
D. 80-100ºC
15. A 22-year-old woman came in due to meningococcemia. Few hours after the admission, the patient
experienced disseminated intravascular coagulation (DIC). The patient shock was due to what
component of the causative agent?
A. Cell wall
B. Capsule
C. Lipopolysaccharide
D. Endospores
16. Which one of the following antimicrobial agents acts on microorganisms by inhibiting nucleic acid
synthesis?
A. Streptomycin
B. Cefalexin
C. Ciprofloxacin
D. Erythromycin
17. A newborn was diagnosed with neonatal meningitis. The causative agent was found out to be isolated in
the vagina of the mother. Which one of the following microorganisms can be a part of the normal vaginal
flora of the mother and can cause neonatal meningitis?
A. Mycoplasma pneumoniae
B. Staphylococcus aureus
C. Escherichia coli
D. Streptococcus agalactiae
18. Which of the following is the “C3 activation unit” in the classical complement pathway?
A. C1q
B. C3
C. C4b, C2a
D. C5, C6, C7, C8 and C9
19. The classic pathway of the complement system is activated when__
A. The Fab portion of IgM binds to the C1s of the complement pathway
B. The Fc portion of IgE binds to the C1q of the complement pathway
C. The hypervariable regions of the heavy and light chains binds to the membrane of
the bacterial cell
D. The mannose binding lectin stimulates mannose associated serine protease
20. Antigen-presenting cells that activate helper T cell must express which one of the following on their
surfaces?
A. IgE
B. Gamma interferon
C. Class I MHC antigens
D. Class II MHC antigens
21. Increased susceptibility with Hepatitis virus and Candida albicans would be expected with a deficiency of
which of the following cells?
A. PMN
B. Eosinophils
C. B cells
D. T cells
22. In Type I hypersensitivity, the predominant antibody that is elicited is:
A. IgA
B. IgE
C. IgG
D. IgM
23. Contact dermatitis is an example of:
A. IgE mediated
B. Complement mediated
C. IgG mediated
D. Cell mediated
24. This immunoglobulin is important in preventing diarrhea in the newborn
A. IgA
B. IgM
C. IgE
D. IgD
25. Main component in secondary response.
A. IgA
B. IgM
C. IgG
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D. IgD
p. 135
26. At birth, the main source of Hematopoetic Stem Cell is the

A. Liver
B. Spleen
C. Bone Marrow
D. Thymus
27. Which method will you see to detect antigens directly from tissue?
A. ELISA
B. Ouchterlony technic
C. Immunofluorescence
D. Complement fixation
28. Which is true about humoral immunity and antibodies?
A. Antibodies found on the surface of B cells are IgA
B. IgG has two bindings sites for an antigen
C. IgM is the main protection of the newborn up to 6 (six) months
D. The Fab region of IgE binds to mast cell receptor
29. Which of the following complement cascade does not involve C3b?
A. C5 convertase of the alternative pathway
B. C5 convertase of the classic pathway
C. C3 convertase of the alternative pathway
D. C3 convertase of the classic pathway
30. Which of the following cells is a part of the innate immune response?
A. B-lymphocytes
B. T-helper lymphocytes
C. T-cytotoxic lymphocytes
D. Macrophages
31. Which of the following is LEAST associated with Enterohemorrahgic E. coli?
A. fermentation of sorbitol
B. strain 0157:H7
C. undercooked hamburgers
D. hemolytic-uremic syndrome
32. Which of the following is true about cholera and its causative agent?
A. A secretory diarrhea due to increases in cGMP in the intestinal cells
B. The stool is described as ‘rice water-like’
C. The causative agent is non-motile, nonfermentative
D. Grows poorly in medium with alkaline pH
33. The appearance of moistpale papules or condylomas in the anogenital area is characteristic of
A. Primary syphilis
B. Secondary syphilis
C. Tertiary syphilis
D. T. pallidum
34. A 4-year old Asian child develops an infection with Chlamydia trachomatis. How does infection
with this organism cause blindness?
A. Retinal detachment
B. Cataract formation
C. Hemorrhage of the anterior chamber
D. Scarring of the cornea
35. Which is associated with atherosclerosis?
A. K. pneumoniae
B. C. trachomatis
C. S. pyogenes
D. C. pneumoniae
36. Which of the following is LEAST effective against M. pneumoniae infection?
A. Erythromycin
B. Tetracycline
C. Kanamycin
D. Vancomycin
37. The only disease that can be diagnosed by demonstration of spirochetes in peripheral blood smear
A. Relapsing fever
B. Leptopirosis
C. Pinta
D. Lyme disease
38. Which of the following is LEAST associated with Helicobacter pylori?
A. It requires at least 2% NaCl for growth (halophilic)
B. It requires increased carbon dioxide tension and decreased oxygen tension
C. It is sensitive to the acidity of the gastric juice
D. Most commonly diagnosed by the demonstration of urease production
39. In which type of diarrhea is the use of antibiotics not recommended?
A. Salmonellosis
B. Campylobacter infection
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C. Cholera
D. Shigellosis
40. Which causes urinary tract infection characterized by alkaline urine and formation of urinary calculi?
A. Shigella dysenteriae
B. Escherichia coli
C. Proteus mirabilis
D. Enterobacter cloacae
41. Which is LEAST acceptable as specimen for the diagnosis of anaerobic infection
A. Transtracheal aspirate
B. Suprapubic aspirate
C. Vaginal swab
D. Sample of tissue from infected site
42. Which of the following microorganisms takes up the color of Crystal violet upon properly performed Gram
staining?
A. Neisseria gonorrheae
B. Clostridium perfringens
C. Escherichia coli
D. Pseudomonas sp.
43. Which of the following is a Toxoid vaccine?
A. Pnuemococcal
B. Measles
C. Varicella
D. Diphtheria
44. The most infectious stage in pertussis is:
A. Catarrhal stage
B. Prodomal stage
C. Paroxysmal stage
D. Convalescent stage
45. Regarded as a TB marker in the diagnosis of tuberculous effusion:
A. Gamma interferon
B. AFB smear
C. Caseation necrosis
D. PPD positivity
46. Presence of immunity to C. diphtheriae is indicated by:
A. Positive elek test
B. Negative elek test
C. Positive schick test
D. Negatice schick test
47. Which of the following is MOST likely acquired from caves?
A. Blastomycosis
B. Histoplasmosis
C. Coccidioidomycosis
D. Paracoccidioidomycosis
48. Asteroid bodies are seen tissue infected with
A. P. verrucosa
B. P. boydii
C. S. schenckii
D. L. loboi
49. The agents of chromomycosis are seen in infected tissues as
A. Intracellular yeast
B. Granules
C. Sclerotic bodies
D. Cigar-shaped bodies
50. Which of the following is NOT dimorphic?
A. P. boydii
B. H. capsulatum
C. S. schenckii
D. C. immitis
51. The agent of blastomycosis are seen in infected tissues as
A. Intracellular yeast
B. Single budding yeast
C. Multiple budding yeast
D. Cigar-shaped bodies
52. The physician closely monitored the patient’s serum creatinine and ion levels. The patient is taking
certain anti-fungal drug. What possible antifungal agent may affect the renal function of this patient?
A. Ketoconazole
B. Terbinafine
C. Griseofulvin
D. Amphotericin B
53. The primary site of echovirus multiplication in the human host is
A. The muscular system
B. The alimentary tract
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C. The anterior horn cells
D. The respiratory system
54. Which of the following properties of polioviruses is not shared by rhinovirus?
A. Icosahedral symmetry
B. Resistance to lipid solvents
C. Naked virus
D. Stability at acid pH (pH3.0)
55. Segmented, double-stranded RNA genome that is a common cause of viral
gastroenteritis?
A. Astrovirus
B. Norwalk virus
C. Calicivirus
D. Rotavirus
56. Diagnostic of Congenital rubella is the demonstration of rubella antibodies like:
A. Maternal IgM
B. Neonatal IgM
C. Neonatal IgA
D. Maternal IgA
57. A viral cause of nephropathy in immunocompromised patient is
A. Human papillomavirus, all types
B. Human papillomavirus, low-risk types
C. Hepatitis C
D. Polyomavirus BK
58. Which of the following individuals may be at increased risk of acquiring an HIV infection?
A. A pregnant mother with a seafarers husband
B. A secretary at an AIDS institute
C. A doctor with a colleague that is HIV positive
D. A male celebrity who has multiple sexual partner including a prostitute
59. Type of papillomavirus that is commonly associated with cervical carcinoma
A. Type 1
B. Type 6
C. Type 9
D. Type 18
60. Progressive Multifocal leukuencepalopathy is associated with a virus that is described as __.
A. ssDNA, icosahedral, naked
B. dsDNA, helical, enveloped
C. dsDNA, icosahedral, naked
D. ssRNA, segmented, naked
61. Which of the following virus that can enter a skin through abrasions?
A. Adenovirus
B. Polyomavirus
C. Papillomavirus
D. Rhinovirus
62. A 6-year old child had recently had fifth disease. Her 43-year old mother subsequently developed a rash
and arthalgia. Which one of the following best describes the causative agent?
A. It has the same size as poxvirus
B. It has a helical symmetry
C. Inactivated by ether
D. A single-stranded DNA genome
63. HIV is a retrovirus. A retrovirus is decribed by which of the following
A. Cause tumors in mouse
B. Contain a DNA genome
C. Cause rapidly progressive neurological disease
D. Multiplies in the nucleus
64. Most common cause of post transfusion hepatitis
A. HAV
B. HBV
C. HCV
D. HDV
65. Site of latent infections is at the sacral ganglia:
A. HSV 1
B. HSV 2
C. EBV
D. CMV
66. Which of the following viruses can establish a latent infection?
A. Poxviruses
B. Rubella viruses
C. Herpesviruses
D. Coronaviruses
67. A 23-year-old medical student experienced fever, sore throat, and lymphadenopathy. These were
accompanied by lymphocytosis and atypical cells in the blood smear. True statement regarding the
causative agent
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A. the major target cell of the virus is the T lymphocyte
B. the agent multiplies in the cytoplasm
C. it can be transmitted thru direct contact with the lesion
D. it possess a double-stranded DNA genome
68. The following hepatitis B marker is indicative of active viral replication
A. HBsAg
B. HBeAg
C. Anti- HBs
D. Anti- HBe
69. The habitat is the large intestine.
A. Entamoeba gingivalis
B. Entamoeba histolytica
C. Giardia lamblia
D. Naegleria fowleri
70. The infective stage of Entamoeba histolytica to man has
A. Pseudopodia
B. Ingested red blood cells
C. Bull’s eye karyosome
D. Pointed chromatoidal bodies
71. The most commonly involved area in Amoebiasis is the
A. Brain
B. Cecum
C. Liver
D. Recto-sigmoid region
72. There is no increase in the number of nuclei of
A. Balantidium coli
B. Entamoeba coli
C. Entamoeba
D. Giardia lamblia
73. Tissue invasion is relatively slow and tends to stimulate granuloma formation
A. Acanthamoeba castellanii
B. Balantidium coli
C. Entamoeba histolytica
D. Naegleria fowleri
74. Mosquito vector of Malaria in the Philippines is
A. Aedes aegypti
B. Anopheles flavirostris
C. Culex quinquefasciatus
D. Mansonia annulata
75. There is secondary exo-erythrocytic phase in
A. Benign tertian malaria
B. Malignant tertian malaria
C. Quartan malaria
D. Sub-tertian malaria
76. The duration of the Erythrocytic-Schizogonic Cycle is 72 hours.
A. A. Benign tertian malaria
B. Malignant tertian malaria
C. Quartan malaria
D. Sub-tertian malaria
77. The gametocytes of the organism are described as banana or crescent-shaped.
A. Plasmodium falciparum
B. Plasmodium malariae
C. Plasmodium ovale
D. Plasmodium vivax
78. Produces rectal prolapse in heavy infection especially among children
A. Capillaria philippinensis
B. Trichinella spiralis
C. Trchuris trichiura
D. Ascaris lumbricoides
79. Bachman intradermal test & Xenodiagnosis are use for the diagnosis of infection cause by
C. Trchuris trichiura
D. Ascaris lumbricoides
80. The most common cause of Greeping Eruption or Cutaneous Larva Migran
A. Ancytostoma braziliense
B. Enterobius vermicularis
C. Strongyloides stercoralis
D. toxocara canis
81. The most common cause of Visceral Larva Migran
A. Ancylostoma braziliense
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C. Strngyloides stercolaris
D. Toxocara canis
82. Produces autoinfection to man
A. Ancylostoma duodenale
B. Ascaris lumbricoides
C. Necator americanus
D. Strongyloides stercolaris
83. What parasite produces Iron deficiency anemia to man?
A. Ascaris lumbricoides
B. Necator americanus
C. Strongyloides stercolaris
D. Trichuris trichiura
84. Associated with Noctrunal Pruritus Ani.
85. Graham Scotch tape technique is used for the diagnosis of the infection caused by
A. A. Ascaris lumbricoides
86. What parasite sucks and ingests blood?
B. Ascaris lumbricoides
C. Enterobius vermicularis
87. What parasite shows Tramway sign in the X-ray?
88. The infective stage of the parasite is found in crabs or crayfishes
A. Clonorchis sinensis
B. Echinostoma ilocanum
C. Fasciola hepatica
D. Paragonimus westermani
89. What parasite is associated with neoplasm of the biliary duct or cancer of the liver?
B. Fasciola hepatica
C. Opisthorchis felineus
90. What parasite produces infection that stimulates tuberculosis?
B. Fasciola hepatica
C. Opisthorchis felineus
91. What is the infective stage of Schistosoma to man?
A. Cercariae
B. Embryonated egg
C. Metacerciae
D. Miracidium
92. Molluscan host of Schistosoma in the Philippines is
A. Australorbis mystax
B. Biomphalaria alexandrina
C. Coxiella burnetii
D. Oncomelania quadrasi
93. Laboratory procedure that makes use of the egg in the test is
A. CFT
B. CHR
C. COPT
D. Casoni test
94. The infective of Diphyllobothrium latum to man to produce adult infection is the
A. Cysticercoid larva
B. Cysticercus larva
C. Procercoid larva
D. Sparganum larva
95. Produces Ocular cysticercosis to man
A. Dipylidium caninum
B. Taenia saginata
C. Taenia solium
D. Hymenolepis nana
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96. Lateral uterine branches in gravid proglottid are counted for diagnosis of infection cause by
A. Diphyllobothrium latum
B. Dipylidium caninum
C. Hymenolepsis nana
D. Teania saginata
97. Taenia saginata is associated with
A. Cat
B. Cattle
C. Dog
D. Pig
98. Ultrasound and MRI usually help in the diagnosis of the infection cause by
A. Dipylidium caninum
B. Echinococcus granulosus
C. Hymenolepis diminuta
D. Hymenolepis nan
99. This organism produces a blue-green pigment and therefore produces a characteristic blue-green pus.
A. Staph aureus
B. Pseudomonas aeruginosa
C. Aspergillus fumigatus
D. Strep. Pyogenes
Pseudomonas aeruginosa produce pyocyanin pigment w/c is blue green in color and also has
antibiotic-like characteristics against some bacteria
Reference: Zinsser p. 577
100. Each of the following statements concerning the surface structures of bacteria is correct EXCEPT:
A. Pili mediate the interaction of bacteria with mucosal epithelium
B. Polysaccharides capsules retard phagocytosis
C. Both gram negative rods and cocci have polysaccharides (endotoxin in their cell wall)
D. Bacterial flagella are not antigenic in humans
Bacterial flagella are made of proteins and are useful in distinguishing serovars or variation of
gram negative bacteria such as E. coli H. antigens Sal. H .antigens.
Reference: Zinsser. Chapter 3
101. The most common site of asymptomatic gonococcal infection in women is the:
A. Vagina
B. Myometrium
C. Urethra
D. Endocervix
The columnar epithelial cells here are the ones that are being infected by N. gonorrhea.(A).
Vaginal walls composed of stratified squamous epithelial cells which are not colonized. (B)
and (C) are not affected.
102. The following etiologic agents are known to cause diarrhea EXCEPT:
A. Clostridium perfringens
B. Rotavirus
C. V. cholera
D. Proteus vulgaris
Protues vulgaris produce urinary tract infection. C. clostridium perfringens diarrhea thru it’s
invasiveness so blood and mucus is (+) V. cholera-produced diarrhea by virtue of
enterotoxin. Rotavirus most common cause of viral gastroenteritis in small children.
103. A 20 year old male developed a carbuncle with surrounding cellulitis. Gram stain revealed gram positive
cocci, catalase and coagulase positive. Which of the following antibiotics is initially appropriate for this
patient?
A. Vancomycin
B. Cloxacillin
C. Cefriaxone
D. Penicillin
90% of S. aureus strains are resistant to penicillin because pf production of plasmid-derived

β-lactamses. Such organisms can be treated with β-lactamase-resistant penicillin such as
cloxacillin or dicloxacillin oxacillin. Oxacillin and Nafcillin have unpredictable absorption by
oral route, thus is not recommended
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104. Which of the following features help distinguish group A streptococcus from other streptococcal species?
A. Bacitracin susceptibility
B. Bile solubility
C. Optochin sensitivity
D. Growth inhibition in 6.5 % NaCl
Group A streptococcus is a β-hemolytic streptococcus and can usually be distinguished from

the other β-hemolytics by its bacitracin susceptibility or by precipitation with specific anti sera
(against its "Lancefrield antigen"). Bile solubility test and optochin test distinguishes the L-
hemolytic streptococci, S. pneumoniae is bile soluble and optochin sensitive. Among the
hemolytic streptococci, S. viridans growth is inhibited by 6.5% NaCl while Enterococcus
species grows in 6.5% NaCl.
105. Which of the following Clostridia cause gangrene?

A. Clostridium tetani
B. Clostridium botulinum
C. Clostridium perfringens
D. Clostridium difficile
C. tetani causes lockjaw. C. botilinum causes botulism. C. difficile causes antibiotic

associated pseudomembranous colitis. C. perfringens cause gasgangrene and Food
poisoning.
106. This gram positive rod is usually associated with bacterial vaginosis producing malodorous vaginal
discharge and "clue cells"
A. Erysipelothrix rhusopathiae
B. Lactobacillus acidophilus
C. Gardenella vaginalis
D. Propionibacterium acnes
E. rhusopathiae causes erysipeloid skin infection that resembles erysipelas occurring among
meat and fish handlers. L. acidphilus is normal flora of genital tract and is the main source
of lactic acid. P. acnes produces lipase which contributes to the genesis of acne.
Reference: Zinsser p. 604-605
107. Which of the following organisms is MOST likely to involve invasion of the intestinal mucosa.
A. Vibrio cholera
B. Shigella sonnei
C. Enterotoxigenic E. coli
D. Clostridium botulinum
Shigella sonnei is the only invasive, presence of blood and mucus in the stool. Clostridium
botilinum , V. cholera and Enterotoxigenic E. coli causes diarrhea by producing enterotoxin
108. Food poisoning that produces gastrointestinal symptoms approximately 1-2 hours after eating is most
likely to be due to:
A. Salmonella enteritidis
B. Campylobacter jejuni
D. Staph. aureus
Staph aureus – the incubation period is 1-2 hrs. after ingestion of contaminated food. Sal.
enteritidis – 6 hrs. – 2 days. Campylobcacter – 8 hrs. – l day. C. perfringens – 8 hrs. – 12
hrs. Bacillus aureus – 8 hrs. – 12 hrs. V. cholera – 2 – 3 days. V. parahaemolyticus – 8 hrs. –
2 days
109. A 30 year old pregnant woman had a normal delivery but the fetus was stillborn. CSF examination
showed positive rods. The pathogen is most likely:
A. Listeria monocytogenes
B. Gardenerella vaginalis
C. Group B Streptococcus
D. Staphylococcus aureus
Listeria monocytogenes is a gram positive rod and can infect pregnant women and poses the
threat of stillbirth or serious damage to the fetus and also cause neurological disease.
Gardenella vaginalis gives rise to frothy, fishy odor vaginal discharge, it can also cause
premature births and low-birth-weight infants.
Reference: Zinsser 484
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110. Which of these organisms is a major pathogen for nosocomial infections because of its ubiquitous present
in the hospital environment?
A. Staph. Aureus
B. Staph. Epidermidis
C. Serratia marcescens
D. Pseudomonas aeroginosa
Pseudomonas aeruginosa, S. aureus - yellow gold pigment when cultured at room

temperature. S, epidermidis - white pigment when cultured at room temperature. Serratia
marcescens - red pigment
111. An individual experiences severe diarrhea after eating sushi (raw fish) in a West Coast restaurant. The
most probable etiologic agent is:
A. Yersenia enterocolitica
B. Salmonella enteritidis
C. Shigella sonnei
D. Vibrio parahaemolyticus
Vibrio parahaemolyticus - is a salt loving organism and found in fishes. Salmonella enteritidis
- found in chicken, pig. Yersenia enterocolitica- reserviors rodents
112. When symptoms to typhoid fever first become apparent, Salmonella typhi is most frequently isolated
from:
A. Feces
B. Urine
C. Blood
D. Bone marrow
Blood - on the first week of infection, Feces - second week. Urine - third week.
113. The area in the body where Salmonella typhi resides if one is a chronic carrier
A. small intestine
B. kidney
C. blood stream
D. gall bladder
Gall bladder - where organisms are found and are excreted in the stool and urine of the
chronic carrier of Salmonella.
114. A 3 year old boy was diagnose to have meningitis CSF culture on Chocolate agar showed growth of small
gram negative rods. The most probable etiologic agent is:
A. N. meningitides
B. S. aureus
C. Group B Streptococcus
D. H. influenzae type b
H. influenzae type b - is the most commonly isolated etiologic gram negative rods causing
meningitis. N. meningtidis - gram negative plo. Group B Strep - gram positive cocci.
115. Among the gram negative rods producing gastroenteritis, the most infectious is:
A. V. cholera
B. E. coli (0157)
C. Sal. Typhimurium
D. Shig. Dysenteriae type 1
Shigella - only 200 cells is enough to cause diarrhea while A-C you need to 10 3 - 10 5 cells to
produce infection.
Reference: Tortora et al
116. Pneumococci primarily cause disease by:

A. toxin production
B. enzyme production
C. eluding phagocytosis and favoring invasiveness
D. producing delayed immunologic reaction
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Pneumococci does not produce toxins and enzymes. Capsules are virulence factors which
interfere with phagocytosis and favoring invasiveness.
117. The formation of pseudomembrane in diphtheria is due to:

A. inhibitions by toxin of protein synthesis by ADP ribosyslation of EF-2
B. spores which spread subcutaneously
C. invasion of mononuclear phagocytic cells
D. neutralization of exotoxin by antibody of blocking the interaction of fragment B with
receptors
Diphtheria toxin inhibits protein synthesis of eukaryotic cells thereby causing cell death.
Pseudomembrane formation is due to accumulation of necrotic tissue.
118. Lyme disease is an endemic inflammatory disorder with this distinctive skin disorder.
A. Chronic dermatitis
B. erythema marginatum
C. erythema chronicum migrans
D. ecthyma gangrenosum
Erythema chronicum migrans is a tick-borne associated syndrome.

Reference: Lippincott Illustrated Review in Microbiology p. 225
119. Serology in the diagnosis of Syphilis using a non-treponemal tests is the following EXCEPT:
A. Microhemagglutination assay
B. Venereal Disease Research Laboratory
C. Fluorescent Antibody Tests
D. Reiter Protein Complement Fixation
Two different types of test are used. Non-treponemal tests detects Wasserman or reagenic
antibodies; a few examples of the nontreponemal tests include VDRL, automated regin,
Kahn, plasmacrit, Hinton and Kline tests. Treponemal tests detect antibodies specific for
treponemal antigens; they include FTA=ABS, T. pallidium immunobolization and
hemagglutination tests.
Reference: Zinsser p. 663-664
120. Mycoplasmas are very pleomorphic and cannot be classified as to shape because they lack the following:
A. Peptidoglycan
B. lipid bilayer
C. nucleus
D. lipopolysaccharide
Lacking cell walls, mycoplasmas are enclosed instead by a membrane composed of a lipid
bilayer. They are therefore plastic and very pleomorphic.
121. A definitive identification of M. tuberculosis can be obtained by doing the following procedure?
A. Ziehl-Neelsen stain
B. AFB Culture
C. Biopsy of Tuberculin test
D. Nucleic acid amplification
Cultures can detect small numbers of organism in the original sample. The presence of Acid-
fast organism on Ziehl Neelsen cannot distinguish on morphologic groups M. tuberculosis
from the other mycobacteria that are saprophytic. Nucleic acid amplification utilizes enzymes
that rapidly IGS ribosomal RNA which can be used for patients with positive smears and
while culture results are pending.
Reference: Lippincott Illustrated Review for Microbiology p. 251
122. Rifamficin a broad antimicrobial agent is effective treatment for tuberculosis by:
A. selective inhibition of the biosynthesis of the arabinogalactan and lipo-arabinomannan
B. mediating drug permeability and efflux
C. Inhibiting peptidoglycan synthesis by blocking action of D-alanise synthesis
D. binding to RNA polymerase thereby interfering with mRNA synthesis
Rifamficin is a broad spectrum antimicrobial agent that acts the interferring with the
synthesis of mRNA by binding to RNA polymerase. Selective inhibitions by ethamentol of the
biosynthesis of arabinogalactan and lipoarabinomannan, key structural components of the
Page 11 of 29
mycobacterial cell wall. Cyclosine inhibits synthesis of peptidoglycan by blocking the action
of the D-alanine synthetase.
Reference: Tortora p. 561
123. In primary disease, M. tuberculosis survives and grows within these host cells
A. macrophages
B. basophils
C. neutrophils
D. eosinophils
M. tuberculosis may continue to survive and remain dormant in activated macrophages

where it is protected from phagocytosis
Reference: Lippincott Illustrated Review of Microbiology p. 247
124. Members of the genus Rickettsia are morphologically & biochemically similar to
A. gram-positive bacteria
B. gram negative bacteria
C. clostridia
D. viruses
Rickettsias are short-rod shaped or cocci bacillary organisms measuring 0.8 to 2.0 um long
Reference: Lippincott Illustrated Review of Microbiology p. 259
125. The hallmark of viral infection of the cell is the production of

A. inclusion bodies
B. multinucleated giant cells
C. cytopathic effect
D. granule formation
The hallmark of viral infection of the cell is the cytopathic effect. This change begin with a
rounding and darkening of the cell and culminates in either lysis or giant cell formation.
Infected cells frequently contain inclusion bodies which are discrete areas containing viral
particles.
126. The complete infectious forms of Hepatitis B is:

A. HBeAg
B. Dane particles
C. HBsAg
D. HBcAg
The Dane particle is the complete form of Hepatitis B whereas the antigens are subunit forms
of the surface and core of the virus.
127. Which of the following virus/es contain/s Hemagglutinin on its surface?

A. Hepatitis B
B. Hepatitis C
C. Influenza virus
D. all of the above
The antigen hemagglutinin is characteristic of Influenza virus.

128. In their multiplication, they produce DNA which is integrated into the cell genome.
A. Hepadnavirus
B. Reovirus
C. Picornavirus
D. Herpesvirus
Hepadnavirus transforms non-permissive cells by integration of DNA transcripts into host cell
genome. They carry an RNA-dependent DNA polymerase (reverse transcriptase).
129. The most common intrauterine viral infection is caused by:

A. Cytomegalovirus
B. Rubella
C. Adenovirus
D. Herpes simplex
Cytomegalovirus accounts for the biggest # of intrauterine infection followed by rubella.

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130. Smallpox was eradicated by the global use of vaccine which contains:
A. killed virus
B. attenuated live virus
C. preformed antibodies
D. preformed antibodies and live attenuated virus
Smallpox disease was eradicated by use of a live attenuated vaccine. Live vaccine are used
because duration of immunity is longer with greater effectiveness of protection, both IgA and
IgG are elicited when administered by the natural route of infection which is
intradermally where the virus replicates. Cell mediated immunity is produced.
131. The most important laboratory test for the detection of early Hepatitis B virus infection is:
A. immunoassay for HBsAg
B. immunoassay for HBeAg
C. immunoassay for Anti HBc
D. immunoassay for Anti HBs
HBsAg appears during the incubation period and is detectable in most patients during the
prodrome and acute phase; falls to undetectable levels during convalescence. HBeAg
arises during the incubation period and is present during the prodome and early acute
disease. Its presence is an important indicator of transmissibility. Anti HBc is
detectable during prodrome and acute disease. Anti HBs is detectable during late
convalescence.
132. A common upper respiratory tract disease produced by adenovirus is:

A. Rhinitis
B. atypical pneumonia
C. pharyngoconjunctivitis
D. parotitis
Adenoviruses cause a variety of upper and lower respiratory tract disease.

Pharyngoconjunctivitis is common.
133. The virus that is increasingly being recognized as cause of nonbacterial infant diarrhea
A. Retrovirus
B. Rotavirus
C. Orbivirus
D. Calicivirus
Rotavirus gastroenteritis is one of the most common childhood illness and a leading cause of
infant deaths in developing countries.
134. In the laboratory this protein from Influenza virus agglutinates red blood cells whereas in vivo, it binds to
the surface receptor of the host cell to initiate infection.
A. Hemagglutinin
B. Neuramidase
C. Hemolysin
D. capsid antigen
The Influenza virus has an envelope covered with 2 different spikes Hemagglutinatinin and
neuramidase. Hemagglutination initiates infection in the host and in the lab causes
agglutination of RBC's. Neuramidase cleaves neuramic acid (sialic acid) to release progeny
virus from the infected cell. Hemolysin is from bacterial cells and causes hemolysis of RBC.
135. In the prevention of poliomyeletis, the use of oral vaccine is preferred because:
A. induces intestinal IgA
B. induces humoral IgG
C. can produce lifelong immunity
D. can produce immunity to unimmunized adults
The oral vaccine or Sabin vaccine which is a live attenuated vaccine is preferred over the
Salk vaccine or killed vaccine because (1) it interrupts fecal-oral transmission by inducing
secretory IgA in the GIT; killed vaccine does not. Both kinds of vaccine induce humoral IgG.
Infection provides lifelong type specific immunity.
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136. Hand-foot-and-mouth disease characterized by versicular rash on the hands and feet and ulcerations in
the mouth, mainly in children is caused by:
A. Echovirus
B. Parainfluenza virus
C. Coxsackie virus Group A
D. Coxsackie virus Group B
Echovirus causes aseptic meningitis. Parainfluenza causes croup. Coxsackie B causes

pleurodynia. Coxsackie A causes herpangina and hand-foot-and-mouth disease.
137. The most common fungal opportunistic infection is caused by:

A. Aspergillus fumigatus
B. Cryptococcus neoformans
C. Candida albicans
D. Mucor
Candida albicans - it is endogenous, a lot of risk factors like pregnancy, diabetic person,
prolonged used of antibiotic, used of birth control pills
138. The most common mode of infection of systemic fungi is thru:

A. ingestion
B. traumatic implantation
C. inhalation
D. all of the above
Inhalation of infectious particles (spores) which are suspended in the air.

139. A 45 year old post kidney transplant patient develop fever and pneumonia with marked neutropenia.
Bronchial washing show dichotomously branching filamentous fungi. The fungi involved is:
A. sprorothrix
B. cryptococcus
C. candida
D. aspergillus
In immunocompromised patient, inhalation of spores of Aspergillus can lead to pneumonia

and are seen as dichotomous branching hyphae (filamentous).
140. In a 7 year old malnourished boy with multiple nematode infections, the most severe complication will
come from:
B. Trichuris trichiura
D. Enterobius vermicularis
Ascaris has a tendency to migrate to other openings causing more severe disease.
Reference: Brown 6th ed. p. 141-142, Roberts and Janovy p. 422
141. Loeffler’s syndrome can be seen in the following parasitic infections EXCEPT:
A. Ascariasis
B. Strongyloidiasis
C. Necatoriasis
D. Trichuriasis
Loeffler’s syndrome is eosinophilic lung. As the parasitic larvae (rhaditiform for Ascaris,
filariform for Strongyloides and Necator) travels to the pulmonary-circulatory system, the
body reacts with an anaphylactic type of hypersensitivity that produces the eosinophilic lung
condition. Trichuris does not have a pulmonary circulatory pathway.
Reference: Brown 6th ed. p. 141, 126, 130; Roberts & Janovy p. 386, 422
142. All cestodes require an intermediate host EXCEPT:

B. Taenia saginata
C. Hymenolepis nana
D. Echinococcus granulosus
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Man gets H. nana infection by ingesting the eggs directly. All other cestodes require an
intermediate host
Reference: Brown 6th ed. p. 192
143. Cysticercosis due to Taenia solium is acquired through ingestion of:

A. cysticercus larva
B. cysticercoid larva
C. procercoid larva
D. egg
A more dangerous sequence can occurs when a person ingests the egg of Taenia solium in
contaminated food or water rather than eating raw or undercooked pork containing the larva
cystercus. Cysticercoid larva pertains to D. caninum and H. nana. Procercoid larva is for D.
latum. The ingested egg hatch in the small intestines and the oncopheres burrow through
the wall into a blood vessel, where they can disseminate to many organs. This condition is
called cysticercosis.
Reference: Brown 6th ed. p. 207
144. The infective stage to man of Necator americanus is:

A. rhabditiform larva
B. filariform larvae
C. embryonated egg
D. Microfilaria
Filariform larvae of hookworms penetrate the skin

Reference: Roberts & Janovy p. 410
145. This cestode possess a quadrate scolex with 4 circular suckers and no rostellum or hooklets:
B. Hymenolepis nana
C. Taenia saginata
D. Echinococcus granulosus
D. latum has an elongated scolex. H. nana has a globular scolex with 4 suckers, a short
retractile rostellum armed with a single row of hooklets. E. granulosus has 4 suckers with a
rostellum and a double row of hooklets.
Reference: Brown 6th p. 194, Roberts & Janovy p. 333
146. Amoebic abscess of the liver is mostly found in the

A. left anteromedial lobe
B. right posterosuperior lobe
C. inferior lobe
D. middle lobe
Spread of amoeba from the large intestines is by the portal vein and deposit on the right
posterosuperior lobe
Reference: Chatterjee p. 25
147. Little Joey was frequently sick of various infectious diseases. He was found to have low CD4+
lymphocytes titers. Which of the following immune response processes would still be functional in Joey’s
body?
A. T cell help for B lymphocytes
B. Recognition of peptide-MHC complex
C. Phagocytic function for foreign molecules
D. T-dependent antigen recognition
This is an innate natural cellular immune ability of the host to respond to foreign molecules
which is independent of the Th series.
Reference: Stanley p. 92; 124
148. The host immune response in viral infections is mostly by:

A. Th cells
B. B cells
C. Tc cells
D. NK cells
Viral infections produce endogenous peptides which are presented on the surface of cells in
conjunction with MHC Class 2. These are recognize primarily by Tc cells. B cells are mostly
for exogenous peptides that are antibody mediated mainly stimulated by Th cells while
the NK cells’ major activity is to directly destroy aberrant cells such as in cancer.
Reference: Roitt, Brostoff & Male p. 15.3-15.4
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149. A killed virus is the major component of the vaccine against this pathogenic organism.
A. measles
B. rubella
C. mumps
D. rabies
Measles, rubella, mumps vaccines contain living but attenuated virus (also for chickenpox,
Sabin polio) Rabies vaccine (also for Hep A, Salk polio, influenza) contain killed or inactivated
viruses. Hep B vaccine contains antigenic fragments of the virus usually using recombinant
technology (yeast-derived). Subunit vaccines are also used as in pertussis. Tetanus and
diphtheria utilize toxoids which are inactivated toxins or antitoxins, antibodies against these.
H. influenzae type b vaccine is conjugated to a protein which can be a diphtheria toxoid.
Reference: Tortora p. 502
150. Alkaline pH in urine seen in Proteus is due to its ability to split urea into:
A. NH3 & C02
B. Cl & Ca
C. Ca & Mg
D. Na & Cl
151. It is responsible for Escherichia coli causing meningitis in infants
A. H antigen
B. LPS
C. K antigen
D. O antigen
152. Vi antigen for Salmonella typhi
A. penetrates epithelial lining of the intestinal tract
B. antigenic structure associated with invasiveness
C. interfere with antibody binding to bacteria
D. confers a certain degree of immunity
153. Initial recognition event for the activation of the alternative pathway
A. C3b
B. C1
C. C4
D. Factor D
154. The characteristic morphologic feature of influenza responsible for antigenic changes of the virus
A. Envelope
B. segmented genome
C. capsid
D. nucleic acid
155. Replicate in the cytoplasm of the host cell
A. Adenovirus
B. Orthomyxovirus
C. Poxviruses
D. HIV
156. The exudative lung parenchymal lesion with lympadenopathy in primary tuberculosis infection is called
A. tuberculosis
B. granuloma
C. ghon complex
D. fibrotic lesion
157. Which of the following statement/s is correct regarding neonatal herpes
A. infections are almost always asymptomatic
B. most common route of infection is thru contact with herpetic lesion during vaginal
delivery
C. causes latent infection
D. usually cause by HSV 1
158. An 18 year old college student developed fever followed by jaundice. Acute viral hepatitis was
entertained. Results of the hepatitis profile are as follows: anti-HAV IgM (-), anti-HbsAg (-), anti-HBc
IgM (+), anti-HBc IgG negative. He most probably has:
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Hepatitis E
159. A 21 y/o male with history of sexual contact 4 days ago resents with painful urination and purulent penile
discharge. Which of the following is most likely?
A. primary syphilis
B. genital herpes
C. gonorrhea
D. lymphogranuloma venerum
160. A 1 and half y/o boy developed fever, coryza and cough followed 4 days later by maculopapular rashes
starting from the hairline and becoming generalized. Fever persisted. The most likely etiology is a/an
A. RNA virus
B. DNA virus
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C. gram positive coccus
D. gram negative bacillus
161. A neonate is born with the following features: microcephaly, jaundice, poor suck and chorioretinitis. A
congenital infection is entertained. The most common congenital infection is due to:
A. Chlamydia
B. HIV
C. CMV
D. HSV
162. A 2 month old girl was brought to you because of milk curd-like lesions in the mouth noted for a week.
The whitish lesions were adherent to the oral mucosa with pinpoint bleeding when the mother tried to
remove them. This is caused by
A. herpes simplex 1
B. Coxsackie A
C. albicans
D. neoformans
163. A 23 y/o office worker found out that his sexual partner had HIV infection. The screening procedure of
choice for HIV infection is
A. PCR
B. HIV Elisa
C. western blot
D. northern blot
164. A 6 month old baby has acute watery diarrhea. Which of the following is the most common cause of
diarrhea in this age group?
A. ETEC
B. Rotavirus
C. EPEC
D. V. cholerae
165. A health worker who did not receive prior mumps vaccine developed parotid swelling and fever. The
following belongs to the same virus family as mumps virus
A. A. german measles
B. RSV
C. Influenza
D. Japanese B virus
166. A 25 yr old saleslady developed high fever, chills and cough. On PE she had crackling rales on the right
lung base. The diagnosis is pneumonia. The most common bacterial cause of this condition in this age
group is:
A. S. aureus
B. N. meningitidis
C. S. pneumoniae
D. Hemophilus influenzae
167. Infection with this organism is the most common risk factor for cervical CA
A. HIV
B. N. gonorrhea
C. HPV
D. HSV 2
168. Most common cause of UTI in women is caused by a bacteria which has a characteristic of
A. Urease production
B. fruity odor on culture
C. greenish metallic sheen
D. swarming phenomenon
169. Which of the following laboratory tests can be used to monitor response to treatment in syphilis?
A. FTA-ABS
B. VDRL
C. Darkfield microscopy
D. ELISA
170. An encapsulated fungi that causes meningitis is
A. H. capsulatum
B. neoformans
C. C albicans
D. immitis
171. The following statements are true regarding N. meningitidis
A. it is the only specie that is oxidase positive
B. oxidizes maltose and glucose
C. oxidizes glucose only
D. it is the only gram negative species
172. The following statements are true about S. aureus
A. it is catalase negative
B. can secrete preformed toxins
C. prefers anaerobic condition
D. cannot grow in 7.5% NACL
173. Toxic shock syndrome secondary to Staphylococcus tend to commonly cause infection among
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A. tampon users
B. asthamtics
C. IV drug users
D. infants
174. A 14 year old male has high fever for a week, tonsillitis, hepatosplenomegaly and cervical
lymphadenopathy. Peripheral smear shows 10% atypical lymphocytes. The most likely diagnosis is:
A. Streptococcal sore throat
B. leukemia
C. infectious mononucleosis
D. diphtheria
175. Streptococcal sore throat is definitively diagnosed by
A. ASO titer
B. throat swab culture
C. rapid antigen testing from throat swab
D. Gram stain
176. Which of the following, when positive, indicates an acute Epstein-Barr virus infection?
A. anti-EBNA
B. anti-VCA IgG
C. anti-VCA IgM
D. anti-EBV DNA
177. The hallmark of Dengue Hemorrhagic Fever is
A. thrombocytopenia
B. shock
C. plasma loss
D. positive tourniquet test
178. Dengue virus has how many serotypes?
A. one
B. two
C. three
D. four
179. The most common vector of Dengue virus is
A. Anopheles minimus
B. Mansonia sp.
C. Aedes aegypti
D. Aedes albopictus
180. A 1 year old girl has high fever for four days, coryza, hacking cough and poor appetite. On PE, she has
congested pharynx and Koplik’s spots. The causative agent of this condition
A. is a DNA virus
B. has three serotypes
C. belongs to the paramyxovirus family
D. has double-stranded RNA
181. Which of the following diseases is currently vaccine-preventable?
A. cytomegalic inclusion disease
B. German measles
C. Dengue fever
D. Hepatitis C
182. A 20 year old male developed fever, vomiting and poor appetite for four days followed by jaundice. A
diagnosis of viral hepatitis is entertained. The results of the hepatitis profile are as follows: positive anti-
HAV IgM, negative anti- HBsAg, positive HBsAg, negative anti-HBc IgM. Which is correct?
A. The patient has acute Hepatitis A and is most likely a Hepatitis B carrier
B. He has acute Hepatitis B
C. He has acute Hepatitis C
D. He does not have acute viral hepatitis
183. The protective antibody following immunization against Hepatitis B is
A. anti-HBc IgM
B. anti-HBc IgG
C. anti-HBsAg
D. anti-HCV
184. Which of the following agents of viral hepatitis is fecal-oral in transmission
and causes more severe disease in pregnant women?
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Hepatitis E
185. Bovine spongiform encephalopathy (mad cow disease) is caused by an agent which has the following
characteristic
A. double-stranded DNA
B. single-stranded RNA
C. double-stranded RNA
D. does not contain nucleic acid
186. Human influenza virus which undergoes antigenic shift and can cause pandemics
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A. influenza A
B. influenza B
C. influenza C
D. highly-pathogenic avian flu
187. Fetal hydrops is a prominent complication of maternal infection with
A. rubella
B. parvovirus B19
C. measles
D. cytomegalovirus
188. An 8 month old girl developed high fever for three days but was otherwise playful. On the fourth day,
fever was gone but she had maculopapular rashes on the face
which rapidly spread all over the body. This common disease is caused by
A. measles virus
B. human herpesvirus 6
C. parvovirus B19
D. rubella virus
189. A 22 year old sex care worker wanted to be tested for human immunodeficiency virus (HIV). What test
would you initially recommend?
A. Western blot
B. HIV Elisa
C. CD4:CD8 ratio
D. VDRL
190. HIV infection causes the ratio of CD4 to CD8 T cell ratio to fall. CD4 T cells are also called
A. T cytotoxic cells
B. cytolytic T cells
C. T helper cells
D. suppressor T cells
191. The major function of CD8 T lymphocytes is
A. to kill cells infected by intracellular pathogens like viruses
B. antibody-dependent cellular cytotoxicity
C. opsonization
D. phagocytosis
192. A one and a half year old boy has recurrent bacterial pneumonia and middle ear
infection. An antibody deficiency is entertained. Antibodies are produced in large
quantities by
A. B lymphocytes
B. T lymphocytes
C. plasma cells
D. mast cells
193. Immunoglobulins aid phagocytosis because they can bind to phagocytes via
A. Fab receptors
B. Fc receptors
C. CD4 receptors
D. C3b receptors
194. The following virus/viruses exhibit/s latency in nerve ganglia
A. smallpox virus
B. chickenpox virus
C. cytomegalovirus
D. adenovirus
195. A virus which infects B lymphocytes by attaching to the latter’s complement
Receptors
A. cytomegalovirus
B. Epstein-Barr virus
C. Japanese B encephalitis virus
D. HIV
196. A 1 year old infant had exposure to a caregiver with cavitary tuberculosis. Chest x-ray was negative.
Mantoux test done showed induration of 12 mm after 2 days. The Mantoux tuberculin test result is an
example of
A. Type I hypersensitivity
B. Type II hypersensitivity
C. delayed-type hypersensitivity
D. Arthus reaction
197. The following are characteristics of M. tuberculosis
A. have minimal lipid content in their cell wall
B. cannot be grown on artificial media
C. retain carbolfuchsin dye after exposure to acid-alcohol
D. appear as round chains on Gram stain
198. Subacute sclerosing panencephalitis is a late complication of infection with this virus
A. Varicella
B. Rubeola
C. West Nile virus
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D. poliovirus
199. A newborn presents with lethargy, purpura, chorioretinitis and pulmonary infiltrates. Which of the
following could be a cause of this syndrome?
A. Amebiasis
B. Candidiasis
C. Cytomegalovirus
D. Human papillomavirus
200. Which one of the following is a subcellular structure that is found only in Gram negative bacteria?
A. endospores
B. lipopolysaccharide
C. mitochondria
D. phosphatidylethanolamine
201. Which one of the following statements best describes a function of the peptidoglycan layer in bacteria?
A. The ability of bacteria to survive changes in the osmolarity of their
environment is due to the physical properties of the peptidoglycan layer.
B. The peptidoglycan layer contains all the enzymes responsible for the synthesis of
membrane phospholipids.
C. The peptidoglycan layer protects bacteria from the effects of ultraviolet light.
D. The peptidolgycan layer renders Gram negative bacteria resistant to detergents.
202. 4. Which one of the following structures is responsible for the passage of low molecular weight solutes
through the outer membrane of Gram negative bacteria?
A. capsules
B. endospores
C. flagella
D. porins
203. Your patient, suffering from a bacterial infection, receives a penicillin injection and almost immediately
experiences respiratory distress and loses consciousness. This reaction is MOST LIKELY mediated by
A. complement.
B. CD8+ cytolytic T cells.
C. macrophages.
D. mast cells.
204. Which one of these statements explains the origin of Rh antibodies in the blood of an
Rh-negative mother?
A. They are naturally occurring in the blood of all Rh-negative persons.
B. They are received through mis-matched blood transfusions.
C. They are synthesized by the mother in response to Rh-positive cells from her
first child.
D. They are transferred from the Rh-positive father during intercourse.
205. Which one of the following bacterial pathogens requires selective culture conditions for reliable isolation
from the stool, including media with antibiotics and incubation at 42° C in increased CO2?
A. Campylobacter jejuni
B. Enterohemorrhagic Escherichia coli
C. Salmonella sp.
D. Shigella sp.
206. Which one of the following is considered facultatively intracellular for human macrophages?
A. Enteroinvasive Escherichia coli
B. Enterotoxigenic Escherichia coli
C. Salmonella typhi
D. Shigella sp.
207. A 20-year-old female presents with severe pelvic pain, fever, nausea and vomiting. She was on the
second day of her menstrual cycle. A purulent cervical discharge was detected upon physical
examination. Oxidase positive, Gram-negative diplococci were isolated on Thayer Martin agar from the
endocervical swab. What is the MOST LIKELY identity of this organism?
A. Bordetella pertussis
B. Chlamydia trachomatis
C. Haemophilus ducreyi
D. Neisseria gonorrhoeae
208. A large outbreak of food poisoning occurred at a company picnic. Eighty people reported explosive
vomiting and diarrhea within 3 hours after eating. All of the victims recovered within 24 hours without
medical intervention. No known bacterial or viral pathogens were isolated from the stool of affected
individuals. A survey of the food eaten at the picnic suggested that potato salad was the common source
of the poisoning. The individual who prepared the salad had a sty on her left eye. Which one of the
following is the MOST LIKELY cause of this outbreak?
A. Clostridium perfringens
B. Salmonella typhimurium
C. Staphylococcus aureus
D. Staphylococcus epidermidis
209. Gram-positive cocci and polymorphonuclear leukocytes are observed on Gram stain of sputum from a 60-
year old alcoholic with pneumonia. Culture of the sputum reveals alpha-hemolytic, catalase-negative
bacteria. Which one of the following laboratory tests is the MOST APPROPRIATE next step in the
definitive identification of this organism?
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A. bacitracin sensitivity test
B. beta-lactamase production test
C. ELEK test
D. bile solubility test
210. A 19-year old female is admitted to an outpatient clinic with suprapubic pain, dysuria and an urgency to
urinate frequently. She is otherwise healthy. A clean catch midstream urine specimen was collected and
sent to the laboratory. Numerous neutrophils are detected in the urine sample. The bacteriology
laboratory reports that less than 102 Gram-positive cocci and greater than 105 Gram-negative bacilli
were recovered per milliliter of urine. Which one of the following is the most likely cause of her infection?
A. Escherichia coli
B. Klebsiella pneumoniae
C. Pseudomonas aeruginosa
D. Staphylococcus aureus
211. A 40-year old male hog farmer complains of intermittent fever, night sweats and headaches to his
physician. The patient is hospitalized and blood and bone marrow specimens are collected. The physician
requests that the laboratory incubate the cultures for at least 6 weeks. Nine days after admission, Gram
negative coccobacilli that require increased CO2 for growth are isolated from the blood and bone marrow
cultures. The patient is most likely to be suffering from which one of the following diseases?
A. Brucellosis
B. Bubonic plague
C. Legionnaire’s disease
D. Rocky Mountain spotted fever
212. Which one of the following diseases is most likely to respond favorably to treatment with a β-lactam
antibiotic?
A. Legionellosis
B. Mycoplasmosis
C. Syphilis
D. Trachoma
213. A 20-year old woman comes to your clinic complaining of an irritating vaginal discharge. Upon
examination, you find that the cervix and vaginal walls appear normal. The discharge is thin and milky,
pH 5.5, and has a fishy odor when treated with potassium hydroxide. You are unable to detect
pseudohyphae, buds, or flagellates upon microscopic examination. A Gram stain reveals numerous
curved Gram-negative rods, epithelial cells, and clue cells, but relatively few Gram-positive rods or WBCs.
Cervical and vaginal cultures are negative for STDs. What is your diagnosis?
A. Bacterial vaginosis
B. Cervicitis
C. Trichomoniasis
D. Vaginal candidiasis
214. A 75-year old man in a nursing home is treated with a broad spectrum antibiotic for bed sores. Two days
later he develops bloody diarrhea. A stool specimen from the patient is positive in an ELISA test for a
necrotizing cytotoxin, and his treatment is switched to vancomycin. The agent MOST LIKELY to be
responsible for this clinical syndrome is
A. Bacteroides fragilis.
B. Campylobacter jejuni.
C. Clostridium difficile.
D. Escherichia coli O157:H7.
215. Which one of the following toxins is responsible for scalded skin syndrome?
A. Alpha hemolysin
B. Exfoliatin
C. Hyaluronidase
D. Staphylococcal enterotoxin
216. A 50-year old cancer patient with severe neutropenia became septic two weeks after being admitted to
the hospital. An oxidase-positive, Gram-negative rod that did not ferment glucose was isolated from the
patient’s blood. Which one of the following organisms is the most likely cause of the patient’s sepsis?
A. Enterobacter cloacae
B. Escherichia coli
C. Klebsiella pneumoniae
D. Pseudomonas aeruginosa
217. Blood culture from a 12-year old with acute osteomyelitis yields Gram-positive cocci that are b hemolytic
and catalase positive. Which one of the following laboratory tests is the MOST APPROPRIATE next step in
the definitive identification of this organism?
A. Coagulase test
B. Optochin sensitivity test
C. Slide agglutination test for capsular antigen type
D. Test for capacity to grow in bile esculin
218. Activated macrophages are the effector cells in the expression of a protective, cell-mediated immune
response against
A. Corynebacterium diphtheriae.
B. Haemophilus influenzae type b.
C. Listeria monocytogenes.
D. Streptococcus pneumoniae.
Page 21 of 29
219. A patient recovering from a crushing leg injury suffered during an a motorcycle accident develops a
temperature of 100o F, a rapid pulse, and extreme pain at the site of his the wound two days after the
accident. The skin overlying the patient’s sutured wound is brownish- white, shiny, and studded with
vesicles. Gram stain of the watery exudate from the wound reveals Gram-positive rods, Gram-negative
rods, and Gram-positive cocci. The Gram-positive rods are MOST LIKELY
A. Bacillus cereus.
B. Bacteroides fragilis.
C. Clostridium perfringens.
D. Corynebacterium ulcerans.
220. A 13-year old and her 10-year old brother are seen at an emergency room with complaints of double
vision, difficulty swallowing, and progressive muscular weakness. A detailed history reveals that both
children attended a church picnic three days earlier but neither child has gastroenteritis. The MOST
LIKELY presumptive diagnosis is
A. botulism.
B. Chinese rice syndrome.
C. Guillan-Barré syndrome.
D. salmonellosis.
221. Epidemics of bacterial meningitis in young, previously healthy adults are MOST LIKELY caused by
A. Escherichia coli K-1.
C. Listeria monocytogenes.
D. Neisseria meningitidis group A.
222. A 55-year old woman develops endocarditis following oral surgery. Gram-positive, alpha-hemolytic,
catalase-negative cocci are isolated from a blood culture. The MOST LIKELY agent is
A. Enterococcus faecalis (group D streptococci).
B. Staphylococcus aureus.
C. Streptococcus pyogenes (group A streptococci).
D. Viridans streptococci.
223. A 2-month old infant is admitted to the hospital with fever, lymphocytosis, and bouts of violent coughing
that often end in vomiting. The infant’s mother reveals that the child has not as yet received any
immunizations. The attending physician swabs the infant’s nasopharynx and requests that the swab be
plated on routine media as well as a special medium (Bordet-Gengou) that contains blood and glycerol.
No organisms are found on blood or chocolate agar, but small Gram-negative rods are isolated on
Bordet-Gengou agar. The MOST LIKELY cause of the infant’s illness is
A. Bordetella pertussis.
B. Chlamydia pneumoniae.
C. Moraxella catarrhalis.
D. Mycoplasma pneumoniae.
224. Which one of the following viruses establishes a chronic persistent infection in humans?
A. Hepatitis A virus
B. Hepatitis C virus
C. Herpesvirus
D. Poliovirus
225. Which one of the following viruses is transmitted via the gastrointestinal route?
A. Delta-associated agent
B. Hepatitis A
C. Hepatitis B
D. Hepatitis C
226. A 33-year-old pregnant woman delivered a baby boy via a normal vaginal delivery. Neither she nor the
father has a history of genital or oral herpes. Although she had chickenpox as a child, she was exposed
to a child with chickenpox about 10 days before delivery. There was no evidence of vesicular skin
lesions on either the mother or the child at the time of delivery. Three days after birth, the baby now
develops vesicular skin lesions on his back, accompanied by a fever. Which one of the following viruses
is MOST LIKELY to be the cause of the baby's infection?
A. Cytomegalovirus
B. Herpes simplex virus type 1
C. Herpes simplex virus type 2
D. Human herpesvirus 6
227. Examination by dark-field microscopy of scrapings from a genital ulcer of 19-year old female reveals
mobile, spiral-shaped organisms against a black background. The MOST LIKELY diagnosis is
A. chancroid.
B. Chlamydia trachomatis infection.
C. gonorrhea.
D. syphilis.
228. Gram-positive cocci are observed on a Gram stain of purulent discharge from a skin lesion of a 7-year-
old. Culture of the exudate reveals beta-hemolytic, catalase-positive organisms. Which one of the
following laboratory tests is the MOST APPROPRIATE next step in the definitive identification of this
organism?
A. Bacitracin sensitivity test
B. Bile solubility test
C. Coagulase test
D. Optochin sensitivity test
Page 22 of 29
229. Which one of the following species or serovars of Chlamydia can be transmitted as a zoonotic infection?
A. Chlamydia pneumoniae
B. Chlamydia psittaci
C. Chlamydia trachomatis serovar C
D. Chlamydia trachomatis serovar D
230. Gram stain of synovial fluid from the knee of a 20-year-old woman with arthritis reveals Gram-negative
cocci. To isolate the MOST LIKELY responsible agent, the specimen should be plated on
A. Bordet-Gengou agar.
B. Chocolate agar.
C. Eosin Methylene Blue (EMB) agar.
D. MacConkey agar.
231. The formation of colonic ulcers and absesses during Shigella dysentery is due to
A. ability of bacteria to survive stomach acidity because of the production of urease.
B. bacterial survival within macrophages.
C. invasion of enterocytes and cell-to-cell spread of the bacteria.
D. production of a superantigen by the bacillus.
232. Which one of the following organisms is the MOST COMMON cause of bacterial traveler’s diarrhea?
A. Campylobacter jejuni
B. enterotoxigenic Escherichia coli
C. Salmonella cholerasuis
D. Shigella sonnei
233. Dissemination of Salmonella typhi from the intestine to extraintestinal sites requires survival of this
pathogen in which one of the following host cells?
A. Colonic enterocytes
B. Gastric epithelial cells
C. M cells
D. Macrophages
234. Gram stain of cerebrospinal fluid from a 3-year-old child with fever, petechiae, stiff neck and positive
Kernig and Brudzinski's signs reveals PMNs and a few Gram-negative cocci. The MOST LIKELY agent is
A. Escherichia coli.
C. Neisseria meningitidis.
D. Streptococcus agalactiae (group B streptococci ).
235. Listeria monocytogenes infection of an adult is MOST LIKELY to be acquired by
A. ingestion of contaminated food.
B. inhalation of contaminated aerosals.
C. inoculation with a contaminated needle.
D. person-to-person contact.
236. What is the mechanism of action of the antifungal drug fluconazole?

A. Binds to ergosterol resulting in membrane disruption
B. Inhibits ergosterol synthesis
C. Inhibits protein synthesis
D. Inhibits RNA synthesis
237. A 10-year-old with a dog complains of a “bump” on the back of his head. He says its redness and itching
have increased over the last three weeks. The lesion is several centimeters in diameter, with hair
involvement and scaling. Examination of several of his hairs in a KOH preparation reveals hyphae in and
around the hair shafts. What is your diagnosis?
A. Actinomycosis
B. Candidiasis
C. Pityriasis versicolor
D. Tinea capitis
238. You are assigned to a hospital in Phoenix, Arizona. Several patients have been admitted in the past week
with cough, chest pain, fever, and pneumonitis that has not responded to antibacterial therapy. You
discover that most of the patients are new arrivals to Arizona who had been working outdoors during the
dusty wind storms that had occurred over the past few weeks. The causative organism is observed in a
KOH preparation of sputum. What is your presemptive diagnosis?
A. Blastomycosis
B. Coccidioidomycosis
C. Histoplasmosis
D. Psittacosis
239. A 65-year-old male develops endocarditis following urinary catheterization. Gram-positive, catalase-
negative cocci are isolated from a blood culture. The MOST LIKELY agent is
A. Enterococcus faecalis (group D streptococci)
C. Staphylococcus epidermidis.
D. Streptococcus pyogenes (group A streptococci).
240. A 22-year-old develops an abcess in his peritoneum following rupture of his appendix. Gram stain of the
exudate from his foul-smelling abcess reveals numerous polymorphonuclear leukocytes, Gram-positive
cocci, Gram-positive rods, and Gram-negative rods. Aerobic culture of the exudate at 37o C on blood and
MacConkey agar plates yields only enterococci (group D streptococci). The Gram-negative rods are MOST
LIKELY
Page 23 of 29
A. Bacteroides fragilis
B. Escherichia coli
C. Pseudomonas aeruginosa
D. Shigella dysenteriae.
241. Several people become ill within two hours after leaving a summer reunion picnic. The majority of people
complain of vomiting and diarrhea without fever, and recovered within 24 hours after the onset of
symptoms. The contaminated food is determined to be a bowl of coleslaw prepared by someone with a
stye on her left eyelid. Which one of the following is the MOST LIKELY source of the food poisoning?
A. Clostridium botulinum
C. Staphylococcus aureus
D. Shigella sonnei
242. A 35-year-old female presents with fever, headache and a non-productive cough. The patient is
prescribed penicillin and sent home. Two weeks later, she returns with similar symptoms. A Gram stain
and routine culture of the patient's sputum reveal only normal mouth flora. Sputum is then cultured on
specialized medium containing sterols, and, after two days, tiny colonies were visible under a microscope.
Which one of the following organisms does the physician suspect is the cause of the patient's
pneumonia?
A. Corynebacterium diphtheriae
B. Haemophilus influenzae type b
C. Legionella pneumophila
D. Mycoplasma pneumoniae
243. A 70-year-old male, who is a chain-smoker, complains of fever, diarrhea, cough and chest pain. Evidence
of pneumonia is seen by chest X-ray. Due to the inability of the patient to produce a sputum specimen, a
transtrachial aspirate is obtained. No respiratory bacterial pathogen is isolated from aspirated fluid
cultured on blood agar plates. However, poorly staining Gram-negative rods are isolated on buffered
charcoal-yeast extract (BCYE) agar after three days of incubation. The physician had already begun
treatment with erythromycin due to the detection of bacilli in the aspirated fluid using a fluorescently-
labeled monoclonal antibody specific for the causative agent. The MOST LIKELY pathogen responsible for
this pneumonia is
A. Haemophilus influenzae
B. Legionella pneumophila
C. Mycoplasma pneumoniae
D. Neisseria meningitides
244. Which one of the following fungi exhibits thermal dimorphism?
A. Aspergillus fumigatus
B. Candida tropicalis.
C. Cryptococcus neoformans
D. Histoplasma capsulatum
245. An otherwise healthy 35-year-old female florist presented to her primary care physician complaining of a
persistent lesion on the third digit of her left hand. This had been present for several weeks and showed
no sign of resolving. Upon examination, the patient was found to have a mild fever (1000F), the
aforementioned lesion and two nodules on her left forearm. A biopsy of the lesion was performed, and
the pathology report indicated the presence of numerous polymorphonuclear leukocytes and a rare
elongated budding yeast. What is the MOST LIKELY etiologic agent?
A. Blastomyces dermatitidis
B. Sporothrix schenckii
C. Histoplasma capsulatum
D. Nocardia asteroides
246. Mode of transmission of Trichomonas vaginalis is:
A. Ingestion of infested beef
B. Skin contact with larvae
C. Mosquito bites
D. Sexual
247. Mode of transmission of Enterobius vermicularis is:
A. Sexual
B. Blackfly bites
C. Louse bites
D. Fecal-oral
248. Oxygen requirements of Neisseria gonorrhoeae is:
A. Aerobic
B. Facultative anaerobe
C. Microaerophilic
D. Obligate anaerobe
249. Mode of transmission of Borrelia burgdorferi is:
A. Direct contact with animals
B. Conidia inhalation
C. Sexual
D. Tick bites
250. Therapy of Vibrio cholerae is:
A. TMP-SMX
B. ORS
Page 24 of 29
C. Ceftriaxone
D. Erythromycin
251. Family of Measles virus is:
A. Paramyxoviridae
B. Rhabdoviridae
C. Orthomyxoviridae
D. Flaviviridae
252. Family of Hepatitis A virus is:
A. Papovaviridae
B. Hepadnaviridae
C. Parvoviridae
D. Picornaviridae
253. Phenotypic characteristic of Streptococcus pyogenes is:
A. Alpha-hemolytic
B. Oxidase "+"
C. H2S "-"
D. Beta-hemolytic
254. Mode of transmission of Rickettsia prowazekii is:
A. Droplet nuclei
B. Direct contact with animals
C. Louse bites
D. Wound infection
255. Phenotypic characteristic of Gonococcus is:
A. Fastidious
B. Mycolic acid in cell wall
C. Catalase "-"
D. Non-lactose fermenter
256. Staphylococcal food poisoning is the result of
A. a heat labile enterotoxin.
B. ingestion of a pre-formed enterotoxin produced by Staphylococcus aureus
during bacterial multiplication in contaminated food.
C. ingestion and multiplication of coagulase-negative Staphylococcus sp.
D. multiplication of Staphylococcus aureus in the small intestine.
257. A 19-year-old soldier develops fever, carditis, and migratory polyarthritis. While taking her history, the
patient remembers that she had a "sore throat" three weeks previously. A throat culture of the patient
yields normal flora only. The laboratory result MOST CONSISTENT with these findings is that the patient
has high titers of antibody to:
A. meningococcal lipooligosaccharide.
B. pneumococcal IgA protease.
C. pneumococcal polysaccharide.
D. streptolysin O.
258. A 65-year-old man with a colonic tumor undergoes a bowel resection. Three days later, the patient
develops a fever, and the drainage from the surgical site is foul smelling. The skin near the site of the
drainage is markedly erythematous. Gram stain of the drainage reveals Gram-positive cocci and Gram-
negative rods. Aerobic culture of the drainage yields streptococci. The Gram-negative rod seen on Gram
stain was most likely:
A. Bacteroides fragilis
C. Escherichia coli
D. Pseudomonas aeruginosa
259. A 50-year-old rancher scrapes his hand with clippers while shearing sheep. Two days later he notices an
ulcer surrounded by vesicles at the site of the wound. Eight days after the injury, the wound develops a
black necrotic center (eschar) surrounded by edematous fluid. The rancher experiences mild systemic
symptoms. The most likely cause of the infection is:
A. Bacillus anthracis.
B. Clostridium tetani.
C. Neisseria meningitidis.
D. Streptococcus pyogenes (group A streptococci).
260. A 19-year-old college sophomore dies 24 hours after the development of fever, petechiae, purpura, and
disseminated intravascular coagulation. Culture of cerebrospinal fluid and blood obtained from the patient
on admission to the hospital MOST LIKELY yielded:
A. Gram-negative, lactose fermenting rods.
B. Gram-negative, oxidase positive diplococci.
C. Gram-positive, catalase negative cocci.
D. Gram-positive, catalase positive cocci.
261. The blood culture of a patient with a presumptive diagnosis of endocarditis yields non-hemolytic colonies
of Gram-positive cocci. The isolate is catalase negative, can grow in 6.5% NaCl, and is resistant to
penicillin. The isolate is MOST LIKELY:
A. Enterococci.
B. Streptococcus agalactiae (group B streptococci).
C. Streptococcus bovis.
D. Streptococcus mutans (Viridans streptoccoci).
Page 25 of 29
262. A 25-year-old, previously healthy woman develops fever within 24 hours of delivery of an infant born 6
weeks prematurely. Blood culture of the mother reveals Gram-positive cocci that are catalase negative,
beta-hemolytic on blood agar, and resistant to bacitracin. The MOST LIKELY cause of the bacteremia is:
A. Enterococci.
C. Streptococcus agalactiae (group B streptococci).
D. Streptococcus pneumoniae.
263. An HIV-infected homosexual man presents with Kaposi's sarcoma. Which viral genome is MOST LIKELY
to be present in his tumor biopsy?
A. Herpes simplex virus tupe 1
B. Human cytomegalvirus
C. Human herpesvirus type 6
D. Human herpesvirus type 8
264. Which one of the following viral infections is not effectively prevented by vaccination?
A. Hepatitis B virus
B. Poliovirus
C. Rhinovirus
D. Rubella virus
265. Prions cause spongiform encephalopathies including the human disease
A. AIDS dementia complex.
B. Creutzfeldt-Jacob disease.
C. scrapie.
D. subacute sclerosing panencephalopathy (SSPE).
266. Congenital infection by which one of the following viruses can result in birth defects?
A. Adenovirus
B. Cytomegalovirus
C. Hepatitis B virus
D. Human immunodeficiency virus
267. Viral carditis of adolescents and adults is frequently caused by
A. Coxsackieviruses.
B. Orthomyxoviruses.
C. Pseudorabiesvirus.
D. Reoviruses.
268. Several newborns housed in a neonatal intensive care unit have developed nosocomial pneumonia. Most
are wheezing and some have required care such as mechanical ventilation, increased doses of oxygen,
antibiotic therapy, or monitoring for apnea. A simple, rapid diagnostic test reveals a common viral
antigen in nasal wash specimens from each of the patients. The virus MOST LIKELY to be responsible is
A. Coronavirus
B. Echovirus B2
C. Respiratory syncytial virus
D. Rubeola virus (measles)
269. A 7 year-old newly adopted Russian child who has been in the United States 10 days presents with fever,
malaise, sore throat, and a grey membrane on the tonsils, uvula, and soft palate. The child's
immunization history is unknown. The physician obtains a swab of the child's throat which provokes
bleeding of the membrane. The swab is sent to the laboratory for routine throat culture. Two days later
the laboratory reports only the presence of normal flora in the specimen. The MOST LIKELY organism
responsible for this child's illness is:
A. Bordetella pertussis.
B. Corynebacterium diphtheriae.
C. Haemophilus influenzae type b.
D. Listeria monocytogenes.
270. Soft cheese imported from Mexico was implicated as the vehicle in an outbreak of meningitis and
bacteremia that occurred among attendees of a large company picnic. Twenty of the 40 affected
individuals were pregnant women. One of the victims had AIDS. Gram positive, non-spore forming rods
were isolated from the cheese that had been stored in the cold. The MOST LIKELY organism responsible
for this outbreak is:
A. Bacillus cereus
B. Clostridium difficile
D. Listeria monocytogenes
271. A 25 year old patient presents at a sexually transmitted disease (STD) clinic with a painful genital ulcer.
On examination, the ulcer does not appear to be typical of herpes simplex virus. Dark field microscopy of
exudate from the ulcer is negative for spiral-shaped organisms. However, a small, gram negative rod is
isolated from culture of the exudate on chocolate agar. The organism MOST LIKELY to be responsible for
the lesion is:
A. Chlamydia trachomatis.
B. Haemophilus ducreyi.
C. Neisseria gonorrhoae.
D. Treponema pallidum.
272. Which ONE of the following diseases is transmitted by lice?
A. Epidemic typhus
B. Ehrlichiosis
Page 26 of 29
C. Psitticosis
D. Scrub typhus
273. A young army recruit presents at a sexually transmitted disease (STD) clinic with acute urethritis. A
Gram-stained preparation of his urethral exudate reveals neutrophils with intracellular Gram-negative
diplococci. The patient is treated with ceftriaxone and sent home. He is requested to return in one week
so that a urethral culture can be obtained to test for proof of antibiotic cure. Which ONE of the following
culture media should be used for the follow-up culture?
A. Blood agar
B. Bordet Gengou agar
C. MacConkey agar
D. Thayer-Martin agar
274. The growth in the vagina of which ONE of the following bacteria helps maintain a protective acid pH?
A. Bacteroides
B. Gardnerella
C. Lactobacillus
D. Mobiluncus
275. A 25 year-old sexually active woman complains of vaginal itching, odor, and discharge. The vaginal walls
are red and slightly swollen, but the cervix is normal. A sample of her vaginal discharge is tested with
10% KOH, which produces a strong fishy odor. Upon microscopic examination of the discharge, you find
clue cells but no pear-shaped flagellates or pseudohyphae. A Gram stain reveals numerous Gram-
negative curved rods. What is your diagnosis?
A. Bacterial vaginosis
B. Pelvic inflammatory disease (PID)
C. Syphilis
D. Trichomoniasis
276. A 25 year-old male develops an ulcerative lesion of the hand and several fluctuant nodules along the
lymphatics draining that site. The patient is seen in the dermatology clinic at the Naval Hospital. Case
history reveals that he is a weekend gardener who cultivates roses as a hobby. What is the MOST LIKELY
fungal disease?
A. Chromoblastomycosis
B. Mycetoma
C. Phaeohyphomycosis
D. Sporotrichosis
277. A 50 year-old farmer from Sorsogon who is fond of eating freshwater crabs is suffering from chronic
pneumonia with hemoptysis. Which parasite etiology is MOST likely?
B. Necator americanus
C. Paragonimus westermani
D. Schistosoma japonicum
278. Knowing the life cycle of Schistosoma japonicum, a rural health doctor is now tasked with educating the
population of a district in Davao del Sur about prevention of this disease. Which specific developmental
stage of this parasite should be avoided to prevent initial infection?
A. cercaria
B. metacercaria
C. miracidium
D. schistosomule
279. In relation to question #72 above, which of the following measures would this doctor teach is most
practical for preventing S. japonicum infection?
A. avoid eating raw fresh water snails
B. boil drinking water for 20 minutes
C. clean and cook vegetables well
D. wear protective high boots while wading in streams
280. A preventive measure against parasites is footwear. Which of these parasites enters through the skin
and its infective stage is a filariform larva?
A. Necator americanus
C. Trichuris trichiura
D. Enterobius vermicularis
281. Some protozoans have organelles which enable them to move around. Which of the following species
possess cilia as motility organelles?
A. Balantidium coli
C. Giardia lamblia
D. Plasmodium malariae
282. Ten year-old Theira has been having vague periumbilical abdominal discomfort for three months. She
does not have diarrhea. Her fecalysis reveals round golden brown tri-layered eggs with cortication. What
is the causative agent of her abdominal infection?
B. Balantidium coli
C. Taenia saginata
Page 27 of 29
283. Mrs. Sintas complains to her family doctor that she has been having vague abdominal pains and bloody
diarrhea for the past two days. She had recently arrived from a business trip to Leyte. Which of the
following intestinal parasitic diseases is LEAST LIKELY to present with bloody diarrhea?
A. Amebiasis
B. Giardiasis
C. Trichuriasis
D. Strongyloidiasis
284. Adult stages of intestinal parasites have their own way of establishing themselves in their chosen habitat.
Which of these species has a long anterior end which penetrates the mucosa to obtain tissues for its
nutrition?
A. A. Ascaris lumbricoides
B. B. Enterobius vermicularis
C. Strongyloides stercoralis
285. Except for the Schistosome species, all trematodes have similar life cycles. The infective stage, for
example is which of these developmental stages for the liver, lung, and intestinal flukes?
A. cercaria
B. metacercaria
C. redia
D. sporocyst
286. Hydatid Disease is endemic in small areas of Southern Luzon and Bicol region where sheep are raised.
What is the causative parasite of this disease?
B. Brugia malayi
C. Echinococcus granulosus
D. Fasciolopsis buski
287. The trophozoite stage of this protozoa has rbc as inclusions in the cytoplasm:
A. Entamoeba coli
C. Endolimax nana
D. Entamoeba hartmanii
288. One of the following is not a pseudophyllidean tapeworm.
B. Ligula intestinalis
C. Sparganum proliferum
D. Taenia solium
289. Bachman intradermal test is a highly specific test for this disease. (p. 239)
A. Ascariasis
B. Enterobiasis
C. Trichinosis
D. Amoebiasis
290. One of the following is not a common feature of uncomplicated P. falciparum in peripheral smear:
A. appliqué form of parasite
B. multiple infection of one rbc
C. presence of Maurer’s clefts
D. rounded microgametocyte
291. A 10-year-old girl, with perianal pruritus, was brought by her mother to her pediatrician. What is your
most probable diagnosis?
A. Ascariasis
B. Trichuriasis
C. Enterobiasis
D. Hookworm infection
292. A 40-year old male overseas worker complaining of muscle pains seek medical attention upon his arrival
to the Philippines. Biochemical tests showed elevated creatinine, phosphokinase, lactate dehydrogenase
and myokinase levels. Results of complete blood count showed high blood eosinophilia. What is your
most probable diagnosis?
A. Taeniasis
B. Capillariasis
C. Trichinosis
D. Filariasis
293. Sexually active 26-year old woman consulted a VD control clinic for vaginal itching and purulent
discharge. Your tentative diagnosis should include the following:
A. gonorrhea
B. trichomoniasis
C. candidiasis
D. all of the above
294. A 30-year old woman, native of Bulacan, traveled to Palawan for a vacation. After 2 weeks she consulted
her doctor with chills and fever as her main complains. What parasitologic test would you request to
establish your diagnosis?
A. sputum examination
B. stool examination
C. thick blood smear
Page 28 of 29
D. thick and thin blood smear
295. A 6-month old baby was brought in for a fever of one-day duration. She is found to have a temperature
of 38.5°C and with hepatomegaly (3 cm) and splenomegaly (3 cm). Microscopic examination revealed
infected RBC with presence of band form stages. What is your most probable diagnosis?
A. Not malaria
B. Plasmodium falciparum
C. Plasmodium vivax
D. Plasmodium malariae
296. Hepatosplenomegaly is the hallmark of this disease which is endemic in Leyte, Samar and Mindoro. This
is caused by:
A. Schistosoma japonicum
B. Echinostoma ilocanum
C. Pila luzonica
D. Capillaria philippinensis
297. Pruritus vulvae is a characteristic symptom in :
A. Trichinosis
B. Trichomoniasis
C. Enterobiasis
D. Scabies
298. Finding banana- or sausage-shaped gametocytes in peripheral smear is a unique characteristic of:
A. Plasmodium malariae
B. Plasmodium vivax
C. Plasmodium falciparum
D. Plasmodium ovale
299. Wearing protective footwear would NOT prevent transmission of which of the following parasite?
A. Ancylostoma
B. Leptospira
C. Trichuris
D. Schistosoma
300. Taenia solium and Trichinella spiralis can be prevented by eating properly cooked:
A. fish
B. pork
C. beef
D. vegetables
301. Recommendation for the control of hookworm in endemic areas include the construction of sanitary
facilities and :
A. wearing of footwear
B. reduction of the stray cats population
C. through cooking of meats and fish
D. use of insecticides to control mosquitoes and flies.
302. Humans become infected when they swallow the eggs and develop cysts in various organs to cause
hydatidosis. This tapeworm is could be best prevented by:
A. reducing larval E. multilocularis in sheep and hogs
B. reducing adult E. granulosus infection in dogs
C. proper and sanitary disposal of waste
D. surgical intervention
303. Dyspnea in Loeffler’s syndrome caused by larval invasion in massive ascariasis in the lungs could be best
treated with:
A. salbutamol nebulization
B. giving mebendazole to treat the infection
C. both A and B
D. neither A nor B
Page 29 of 29

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UNIVERSITY OF SANTO TOMAS | MEDICAL TECHNOLOGY

MEDICAL MICROBIOLOGY AND PARASITOLOGY

26. At birth, the main source of Hematopoetic Stem Cell is the

90% of S. aureus strains are resistant to penicillin because pf production of plasmid-derived

Group A streptococcus is a β-hemolytic streptococcus and can usually be distinguished from

105. Which of the following Clostridia cause gangrene?

C. tetani causes lockjaw. C. botilinum causes botulism. C. difficile causes antibiotic

Pseudomonas aeruginosa, S. aureus - yellow gold pigment when cultured at room

116. Pneumococci primarily cause disease by:

117. The formation of pseudomembrane in diphtheria is due to:

Erythema chronicum migrans is a tick-borne associated syndrome.

M. tuberculosis may continue to survive and remain dormant in activated macrophages

125. The hallmark of viral infection of the cell is the production of

126. The complete infectious forms of Hepatitis B is:

127. Which of the following virus/es contain/s Hemagglutinin on its surface?

The antigen hemagglutinin is characteristic of Influenza virus.

129. The most common intrauterine viral infection is caused by:

Cytomegalovirus accounts for the biggest # of intrauterine infection followed by rubella.

132. A common upper respiratory tract disease produced by adenovirus is:

Adenoviruses cause a variety of upper and lower respiratory tract disease.

Echovirus causes aseptic meningitis. Parainfluenza causes croup. Coxsackie B causes

137. The most common fungal opportunistic infection is caused by:

138. The most common mode of infection of systemic fungi is thru:

Inhalation of infectious particles (spores) which are suspended in the air.

In immunocompromised patient, inhalation of spores of Aspergillus can lead to pneumonia

142. All cestodes require an intermediate host EXCEPT:

143. Cysticercosis due to Taenia solium is acquired through ingestion of:

144. The infective stage to man of Necator americanus is:

Filariform larvae of hookworms penetrate the skin

146. Amoebic abscess of the liver is mostly found in the

148. The host immune response in viral infections is mostly by:

236. What is the mechanism of action of the antifungal drug fluconazole?

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