MICROBIOLOGY

3rd MBBS PART I

2023
…
01)
The diagram shows routes of transmission of infectious
diseases. Give one example of an infection transmitted by the
routes denoted by A,B,C,D & E in the picture.

A – Saliva, droplets →……………………………….

B – blood transfusion→…………………………….
C – vector bite →………………………………………
D – sexual transmission →…………………………
E – Faeco oral transmission →……………………
01)
There are many viral and bacterial infections that can be
transmitted through these routes.
A) Glandular mononucleosis
B) Influenza
C) Blood and mucus Diarrhoea/ Diarrhoea
D) Dengue
E) AIDS
02)
This is a method of bacterial gene transfer
A) Identify the method.
B) what are the factors of the bacteria that contribute
to this process
C) write two consequences that can result from the
method of transfer
02)
A) Transformation.
B) Recipient cell must be competent (able to transport
donor DNA across plasma membrane)and compatible
(DNA not destroyed by endonucleases)
C) Increase virulence, Transfer of antibiotic resistance
genes
03)
A) State the sites that bacteria
density is highest.
B) State one genus that occupies
site A and 2 genera that
occupy the site B
C) State one infection in each
site that caused by those
bacteria when they become
pathogenic.
03)
A) oral cavity, Colon
B) Oral cavity- streptococcus , large intestine-
clostridium, enterococci
C) Acute pharyngitis, UTI
04)
This bottles are use in
microbiological investigation. One
is used and other one is not use
A) What is the specimen taken
for this investigation?
B) List 3 indication to do this
investigation
C) If there is delay to send the
sample to lab. What are you
going to do?
04)
A) Blood sample
B) Pyrexia of unknown origin, Sepsis, Meningitis
C) Keep the sample in room temperature. Don't
refrigerate.
05)
28 year old female presented with chronic epigastric pain
and nausea for 1 year duration. Gram stain of gastric Antral
mucosa specimen taken from an endoscopic procedure is
shown.
A) What is the diagnosis
and aetiological agent
for this condition?
B) What is the characteristic
morphology of this
organism?
C) Name 2 therapeutic
agents used to treat for
this condition.
05)
A) Type B gastritis , Helicobacter pylori
B) Gram negative spiral shape bacteria with flagellate
C) Proton pump inhibitor( Omeprazole), Amoxicillin ( if
allergic use Metronidazole), Bismuth salicylate,
Tetracycline, Clarythromycin
06)
76 year old patients in ICU for
5days due to pneumonia,
develop profuse watery
diarrhoea, faecal culture
results given below.
A) What is the likely
diagnosis.
B) What is the possible
aetiological agent.
C) Give two antimicrobials
you can give to this
patient.
06)
A) Pseudomembranous colitis
B) Clostridioides difficile
C) Stop any antibiotics given, Give Oral vancomycin/
metronidazole
07)
A 48 Year old man admitted to the surgical ward with a para
vertebral abscess at L3-L4 level was investigated. Microscopy
of stained smear of aspiration is shown.
A) what is the diagnosis?
B) What is the etiological agent?
C) Out line the treatment procedure.
07)
A) Vertebral TB
B) mycobacterium tuberculosis
C) Rifampicin , isoniazid, pyrazinamide and ethambutol for
first two months , and only rifampicin and isoniazid
continued until 12 months
08)
HIV patient who hat top
treatments in hospital developed
respiratory distress with tracheal
aspirations. His CD4 cell count is
<200. His chest x Ray and silver
stain of sputum given below.
A) what is the clinical condition
and ethological agent.
B) Name one antibiotic to used
for this condition.
C) List 2 other infection that he
can get at this stage of illness.
08)
A) pneumonia ( HIV + ) , pneumocystis jirovecci
B) co- trimoxazole
C) CMV, Candidiasis
09)
This is a culture report of
specimen of faeces from a child
admitted to paediatric ward with
watery diarrhoea & mild fever
for 3 days duration.
A) What is the clinical diagnosis ?
B) List 3 aetiological agents that
can cause this condition.
C) Outline 2 aspects of
management of child.
09)
A) Viral Gastroenteritis
B) Rotavirus – commonest cause, Human Caliciviruses,
Norovirus, Astrovirus, Enteric adenoviruses (40,41), SRV
(Small Round Viruses), Corona viruses
C) Rehydration - Oral rehydration solution (ORS)/ Ringer
lactate ( IV) ,Giving Probiotics, Broad spectrum agent
nitazoxanide (antiprotozoal), Cohort isolation or Barrier
nursing
10)
Types of changes in CSF in meningitis are mentioned in below
chart.
A) What is the appearance of X?
B) What is the polymorphic cells value of Y?
C) What would you expect in Z?
10)
A) Turbid
B) Nil
C) low blood glucose level < 1/2 blood glucose or Nil
11)
A 5 year old boy presented to skin clinic with recurrent
infection in his face.
A) Identify the disease.
B) Name causative agent/s for this disease.
C) Mention 2 steps of management regarding this condition.
11)
A) Impetigo
B) Group A streptococcus/ Streptococcus pyogenes,
Staphylococcus aureus
C) 1. Treat with antibiotics
• (For localized, uncomplicated, non-bullous impetigo)topical
antibiotic therapy – Mupirocin, retapamulin, and fusidic acid
• (bullous impetigo, cases of non-bullous impetigo with more than five
lesions, deep tissue involvement, lymphadenopathy)Beta-
lactamase-resistant antibiotics such as cephalosporins, amoxicillin-
clavulanate
2. If not responding to antibiotic therapy take a bullous fluid
aspirate/ wound swab for culture and ABST
• If cultures are positive for MRSA, clindamycin or doxycycline
12)
A young boy presented with recurrent
episodes of ear discharge, fever , malaise ,
severe pain and swelling behind the ear. On
examination there was a protruding auricle,
fluctuant, erythematous tender area behind
the ear.
1. What is the diagnosis ?
2. Name 2 aetiological agents causing this
condition ?
3. Mention 2 steps of management
regarding this infection.
12)
1) Mastoiditis
2) Streptococcus pneumonia, Pseudomonas aeruginosa
3)
• Mastoidectomy- surgical procedure to remove diseased mastoid
air cells
• Myringotomy- tiny incision created in the ear drum to relieve
pressure caused by excessive build up of fluid and pus
• Tympanoplasty- surgical reconstruction of the perforated
eardrum or the small bones of the middle ear
• Antibiotic treatment-
amoxicillin/penicillin/erythromycin/azithromycin
13)
38 year old male patient presented to
the clinic with redness and pain in the
eye for 2 weeks duration. He has a
history of worked in a paddy field
recently.
A. Give two features help to identify
this condition.
B. what is the most likely diagnosis?
C. Give two etiological agents that
lead to cause this condition.
13)
A. Hypopyon, Stromal infiltrates
B. Fungal keratitis
C. Fusarium,Aspergillus , Acremonium, Curvularia , Candida
14)
A. What is the disease
associated with this
features?
B. Name A,B,C.
C. Mention one drug that
can use for this
condition?
14)
A. congenital syphilis
B. A - mulberry molars
B - Hutchinson's teeth
C - saddle nose
C. Benzyl penicillin
15)
This is a microbiological report of a 27 years
old married woman with dysuria, increased
frequency and lower abdominal pain
investigated in OPD.
A. How do you interpret this report?
B. Name likely etiological agent
C. What are the antibiotics that you can
give empirically?
15)
A. Without fever and systemic involvement only the
urinary tract involvement can be seen. Probably a
cystitis.
B. staphylococcus sapropiticus
C. Nitrofurantoin, nalidixic acid, ampicillin, cephalexin
16)
23 years old man, a MSM, treated for
primary syphilis in STI clinic for 6
weeks. Presented After defaulting
treatment for 2 weeks with Severe
Joint pain and swelling of left knee
joint.
A. what is the clinical condition?
B. Name a possible etiological agent.
C. What are the microbiological
investigations of diagnosis the
condition?
16)
A. Reiter's arthritis/ Reactive athritis
B. Neisseria gonorrhoea
C. aspirate the joint fluid and send for culture or
microscopy invistigation
17)
This is a cell that plays a major role
in innate immune response.
A. Identify the cell.
B. What is the main function of this
cell during infection.
C. Write immunological test that
use to identify it's function
17)
A. Neutrophils
B. Phagocytosis
C. Oxidative burst test
18) A cellular process is shown.
A. What is the name of this
process?
B. List the steps involved in
above mentioned process.
C. Name 1 immunological test
that tests the efficacy of
the final step in the above-
mentioned process.
18)
A. antibody dependant phagocytosis
B. opsonization, recognition and attachment,
engulfment, phagosome maturation and
phagolysosome formation, destruction and digestion,
exocytosis
C. antigen detection by ELISA , Flow cytometry
19)
A. What is the infection that using
this test to identify?
B. What is the active ingredient of
substance that use to inject?
C. What type of immune reaction is
responsible?
D. How is it administered ?
E. How do you interpret the test?
19)
A. Tuberculosis
B. Purified protein derivatives
C. Type 4 hypersensitivity
D. Intradermal
E. 24-72hr After injecting the materials wheal size will be
measured. Interpretation done according to the wheal
size
Normal patient >15cm - positive
If patient is in endemic area >10cm – positive
If immunocompromised patient >5cm - positive
20)
Direct microscopy of parker stained smear of a Sellotape
mount taken from a hypopigmented rash on the neck of a
female is shown below.
A. Name A & B
B. Write diagnosis
and Likely
aetiological
agent
20)
A. A - Clusters of round, budding yeast like cells
B - Short and broad hyphae
B. Diagnosis - Pityriasis versicolor
Aetiological agent - Malassezia furfur