INFECTIOUS DISEASES

1. Which of the following can impair mucociliary action in the respiratory tract?
A. Smoking
B. Aspiration
C. Intubation
D. Viral infection
E. All of the abQve

2. Which of the following statements is INCORRECT?

A. Gastric acid, pancreatic enzyme & bile secretion are the 1st line GIT defense against
enveloped viruses
B. IgA antibodies form the 2nd line defense against ingested pathogens.
C. Antibiotics can alter normal bacterial flora in the GIT, and so weakened host
defenses.
D. Mechanical obstruction or ileus can impair host GIT defense.
E. Antacids can impair host GIT defense.

3. Which of the following statements regarding intestinal pathogens is FALSE?

A. Vibrio Cholerae release enterotoxins in food, which causes secretory diarrhoea.
B. Salmonella typhi ulcerates gut mucosa to cause inflammation & haemorrhage.
C. Fungal GIT infection only occur in the immunosuppressed host.
D. Cysts of intestinal protozoa are resistant to gastric acid digestion.
E. Echinococcus passes through the gut briefly to access liver & lung.

4. Which of the following statements is TRUE?

A. Normal skin flora include bacteria, fungal species & some opportunistic species.
B. Low pH & fatty acid content of skin layer favours commensal bacteria over bacterial
pathogens.
C. Any breach of skin integrity is a potential portal of pathogen entry.
D. Heat & moisture can weaken skin resistence to pathogens.
E. All of the above.

5. Which of the following statement regarding microbial spread is FALSE?

A. Microbial spread tends to occur along tissue planes rather than across tissue planes.
B. Microbial access to bloodstream is usually via lymphatics.
C. All 2° foci of infection are small & multiple (ie. millet spread).
D. Persistant bacteraemia results in triggering of cytokines & mediators, leading to host
septic responses.
E. Major sites of infection can be distal to the portal of entry.

INFECTIOUS DISEASE· MCQ 1

6. Which of the following statements regarding vertical transmission of infection is
FALSE?
A. Treponema pallidum crosses placenta at the end of 2nd trimester to cause congenital
syphillus.
B. Toxoplasmosis infection is most dangerous late in pregnancy
C. Bacterial & mycoplasmal placentitis can cause premature delivery & stillbirth.
D. Vertical transmission of infection must be transplacental infection.
E. All of the above.

7. Which of the following statement regarding microbial transmission is FALSE?

A. Salivary gland viruses are primarily transmitted by aerosol.
B. Contagious agents are those that are directly transmissible from person to person via
contact or aerosol.
C. Bacterial spores or protozoan cysts can survive in cool, dry environment.
D. Aerosol transmission of bacteria & fungi only occur if there is open lesions in the
airway.
E. None of the above

8. Which of the following statements regarding viral infection is TRUE?

A. Viral tropism for host cells is partly due to presence of specific host cell receptors.
B. Some microbes induce host cell damage by evoking tissue damaging host immune
responses.
C. Uncoating of viruses within host cells leads to lost of viral infectivity.
D. Each virus family uses specific enzymes for transcription & replication.
E. All of the above.

9. Virus may kill host cells by:

A. Lysis of host cell by inserting viral protein into host cell membrane.
B. Inhibition of host cell DNA, RNA or protein synthesis.
C. Evoke damaging host immune response by expression of viral protein on host cell
surface.
D. Causing neoplastic growth
E. All of the above.

10. Which of the following statement is INCORRECT?

A. Gram positive bacterial membrane lipoteichoic acid only binds to blood cells & oral
epithelial cells.
B. Sex pili of bacteria is used to transmit plasmids or transposons between bacteria.
C. Bacterial tropism for host cell type is determined by minor protein on the tip of the
pili.
D. Each bacteria may have trophism for more than one cell type
E. All of the above

11. Which of the following pairing of intracellular facultative bacteria & their trophic cell
type is FALSE?

INFECTIOUS DISEASE - MCQ 2

A. Shigella - Epithelial cell.
B. Mycobacteria tuberculosis - Macrophage
C. Salmonella typhi - Epithelium & macrophage.
D. Legionella pneumophilia - Epithelial cell.
E. Yersinia - Macrophage

12. Which of the following statements regarding intracellular bacteria action in the
cytoplasm is FALSE?
A. Enteroinvasive E coli inhibits host protein synthesis & rapidly replicate to lyse host
cell.
B. Mycobacteria tuberculosis replicates in the macrophage phagolysosome
C. Legionella replicates within macrophage, and so avoided host immune response.
D. Toxoplasmosis inhibits increase of acidification that occurs with lysosome -endosome
fusion.
E. Salmonella replicates in macrophage phagolysosome.

13. Which of the following is NOT an example of exotoxin?

A. Diptheria toxin
B. Lipopolysaccahride
C. Vibrio cholerae enterotoxin
D. Clostridium perfringens alpha toxin
E. None of the above.

14. Which of the following statements regarding immune evasion is INCORRECT?

A. Clostridium difficle propogates in the intestinal lumen, and so is inaccessible to host
immune defenses including secretory 19A.
B. Malaria invade hepatocytes before host immune response becomes effective.
C. Hemophilus Influenzae type b hide their antigen within the carbohydrate capsule & so
escape phagocytosis.
D. Pneumococci changes their surface antigen during the infection to prevent immune
clearance.
E. Pseudomonas secrete leukotoxin to kill neutrophils.

15. Which of the following is not an encapsulated bacteria?

A. Meningococci
B. Gonococci
C. Pneumococci
D. Hemophilus Influenzae type b
E. Staphylococci

INFECTIOUS DISEASE - MCQ 3

16.Which of the following pairing of pathogen & pathogenic response is FALSE?
A. Spirochetes - Granulomatous inflammation
B. Viruses - Cytopathic/ cytoproliferative inflammation
C. Intracellular bacteria - suppurative inflammation
D. Clostridium perfringens - necrotising inflammation
E. Hepatitis B - necrotising inflammation

17. Which of the foJlowing statements regarding microbes is FALSE?

A. AJI viruses are obligate intraceJlular parasites.
B. Bacteriophage, plasmids & transposons are mobile genetic segments that encode
bacteria virulence.
C. Bacteria lacks nuclei but otherwise contain same organeJles as eukaryotes.
D. Mycoplasma lack a ceJl waJl.
E. Chlamydia lack ATP synthesis.

18. Which of the following statements regarding bacteria is TRUE?

A. Gram negative bacteria has 2 phospholipid bilayer with a peptidoglycan layer.
B. Gram positive bacteria has I phospholipid iblayer covered by a peptidoglycan layer.
C. Most GIT flora are anaerobes
D. There are 1012 skin flora on human skin.
E. AJI of the above

19. How many bacteria exists are normal GIT flora?

A. 1012
B. 1013
4
C. 101
D. 1015
E. 1016

20. Which of the foJlowing staements is INCORRECT?

A. All fungi are characterized by thick ergosterol waJl.
B. Systemic fungal infection only occurs in immunosuppressed host.
C. Dermatophytes are only confined to superficial skin layers.
D. AJI protozoa are motile organisms
E. All protozoa are transmitted by vectors.

21. Which of the following statements regarding respiratory tract flora is INCORRECT?
A. Mucosal damage in respiratory tract infection is usuaJly minimal.
B. Increased viscid exudation in airway is usuaJly the predominant manifestation.
C. Bronchociliary function is impaired.
D. 30% ofURTI is due to rhinovirus infection.
E. 2° bacterial infection may occur due to impaired bronchociliary function & airway
obstruction.

INFECTIOUS DISEASE - MCQ 4

22.Which of the following statements regarding upper respiratory tract infection is
FALSE?
A. Rhinovirus bind to ICAM-l on respiratory epithelium, which is also the site that
mediates T cell specific & antigen specific responses.
B. Rhinoviruses grows best at 37°C
C. Influenza A display significant antigenic drift & shift, resulting in epidemics of
influenza.
D. Influenza hemagluttinin molecules mediate viral entry to respiratory epithelial cell.
E. Cytotoxic T cells are responsible for clearance of URTI viruses.

23.Which of the following rotavirus infection is FALSE?

A. Viral gastroenteritis can cause severe dehydration & metabolic acidosis in infants.
B. Rotavirus infection is most common at the time of weaning from breast feeding.
C. Rotavirus is associated with epidemic outbreaks of gastroenteritis.
D. Rotavirus invade & destroy intestinal villus epithelial cells.
E. Diarrhoea in rotavirus infection is due to reduced bowel sodium & water absorption.

24. Which of the following statements regarding measles virus is INCORRECT?

A. MUltiple serotypes of measles virus exists.
B. Measles is transmitted by droplet spread.
C. Measles rash is a hypersensitivity response to viral antigen in the skin.
D. Koplik spot is pathognomic of measles infection.
E. Measles virus has trophism for respiratory epithelial cell & mononuclear cells.

25. Measles causes:

A. Protein losing enteropathy
B. Keratitis leading to blindness.
C. Pneumonia
D. SSPE
E. All of the above.

26. Regarding childhood infection, which of the following statements is TRUE?

A. 70% mumps parotitis is bilateral
B. Mumps orchitis may lead to testicular infarction
C. Poliovirus causes CNS infection in 1% cases
D. Sabin oral polio vaccine covers all 3 strains of polioviruses.
E. All of the above

27.EBV
A. has trophism for B cells & epithelial cells.
B. may lyse host cells during productive infection
C. induce polyclonal activation of B cells, which is seen as atypical lymphocytes in
peripheral blood.
D. induces formation of anti-viral-capside-antigen antibodies.
E. All of the above
28.Which of the following statements regarding VZV infection is FALSE?

INFECTIOUS DISEASE - MCQ 5

A. VZV disseminates by hematogenous route
B. . Trigeminal ganglion is the most likely site of latency
C. Incubation period is about 2 days.
D. VZV induce more severe infection in the immuno-compromised host, including
encephalitis, transverse myelitis & IS pneumonitis.
E. All of the above

29.Which of the following statements regarding bacterial pneumonia is FALSE?

A. Infants & elderly more commonly develop lobar pneumonia than bronchopneumonia.
B. Lobar distribution is a function of organism virulence & vulnerability of host defense.
C. Bronchopneumonia is commonly bibasal in distribution
D. Pleural fibrinous reaction may organize & leave permanent adhesions.
E. Bacterial pneumonia can be due to hematogenous spread of microbe from other foci
of infection.

30. Which of the following predisposes host to pneumonia?

A. Coma
B. Inhalation of corrosive & hot gases.
C. Immunosuppression
D. CCF
E. All of the above

3 I. Which is the most common aetiologic agent in bacterial pneumonia?

A. Hemophilus influenzae type b
B. Staphylococci
C. Streptococci pneumoniae
D. Pseudomonas
E. E Coli

32. Complication of pneumonia does NOT include the following:

A. Abscess formation
B. Carcinoma
C. Empyema
D. Organization & solidification of lung poction
E. 2° bacteria seeding to other organs.

33. Which of the following statements regarding Hemophilus influenzae is FALSE?

A. It secretes protease that degrade respiratory tract IgA
B. It secretes a factor to impair mucociliary ladder.
C. LPS endotoxin induces WC chemotaxis & leukocytosis
D. All hemophilus infections are due to encapsulated species.
E. Cell wall peptidoglycan of Hemophilus influenze damages the blood brain barrier.

INFECTIOUS DISEASE MCQ- 6

34.Hemophilus influenzae does NOT cause the following in the immunocompetent host:
A. Otitis media
B. Acute epiglottitis
C. Pneumonia
D. Conjunctivitis
E. Septicaemia

35.Hemophilus meningitis is most common in the following age group:

A. 0-5 years old
B. 5-10 years old
C. 20-60 years old
D. 60+ years old
E. All of the above

36.Mycobacteria tuberculosis is NOT:

A. a non spore fonning organism
B. an aerobic organism
C. transmitted by aerosol spread
D. take 4-6 weeks to culture
E. Multiple drug resistent species are 80% fatal in AIDs patient & 50% fatal in nonnal
host.

37.Which of the following statements regarding mycobacteria tuberculosis virulence

factor is WRONG?
A. Cord factor on the mycobacteria cell surface induces granulomatous fonnation.
B. Exotoxin is secreted by mycobacteria to degrade surrounding tissue
C. Sulfatides on mycobacteria cell surface inhibits macrophage lysosome fusion with
phagosome containing mycobacteria
D. Cell surface heteropolysaccharide LAM induces macrophage to secrete TNFa.
E. Cell surface heteropolysaccharide LAM induce 1L 10 secretion to inhibit T cell
proliferation which occurs in response to mycobacterial infection.

38.Granulomatous reaction due to mycobacterial tuberculosis infection develops over:

A. 2-3 days
B. 1 week
C. 2-3 weeks
D. 1 month
E. 2-3 months

INFECTIOUS DISEASE - MCQ 7

39. Which of the following statements regarding tuberculosis is TRUE?
A. Delayed hypersensitivity reaction controls 95% primary mycobacterial tuberculosis
infectionin the normal host
B. Ghon complex consists of primary infection calcified scar in the subpleural lung
parenchyma above or below the interlobular fissure between the upper & lower lobes
& the enlarged caseous hilar lymph node.
C. Secondary tuberculous granuloma is most often found in the lung apices.
D. Pulmonary cavitation in 2° TB predisposes to miliary spread via hematogenous route
as the cavities rupture into blood vessels.
E. All of the above.

40. Which of the following are uncommon sites of miliary TB spread?

A. Bone marrow, liver & spleen
B. Meninges & retina
C. Kidney, adrenals, fallopian tubes & epididymus
D. Heart, thyroid & pancreas
E. Bone (esp vertebrae)

41. Which of the following statements regarding tuberculosis in AIDs patients is TRUE?
A. Reactivation or new infection is common in CD 4+ count < 200/mm3•
B. MArs opportunistic infection develops in CD/ count < 60/mm3 •
C. Up to 80% AFB +ve on sputum of AIDs patients but only 33% are PPD +ve.
D. Extrapulmonary complication develops in 70%
E. All of the above

42. Which of the following regarding bacterial enteritis is TRUE?

A. Shigella cuses dysentery only in human
B. Shigella contains shiga toxin which is associated with hemolytic uremic syndrome.
C. Campylobacter jejuni causes both watery diarrhoea & dysentery.
D. Yersinia causes distal ileal & colonic disease with ulceration
E. All of the above.

43. Staphylococci epidermidis infection is predisposed by:

A. Intravenous drug use
B. Tampon use
C. Indwelling urinary catheter
D. Prosthetic heart valves
E. All of the above

INFECTIOUS DISEASE MCQ - 8

44. Which of the following staphylococci toxin is a super-antigen?
A. TSST-l
B. Exfoliative toxin
C. Enterotoxin
D. Alpha toxin
E. Beta toxin

45. How many percent of infective endocarditis is due to staphylococci aureus infection?
A. <10%
B. 20-30%
C. 30-40%
D. 40-50%
E. >50%

46. Complications of staphylococci aureus infective endocarditis include:

A. Focal GN
B. Diffuse GN
C. Septic emboli
D. Suppurative pericarditis
E. All of tbe above

47. Streptococci is NOT:

A. Facultative anaerobes.
B. Most are beta- hemolytic
C. Anti-streptococci M protein antibodies may cross react with host cardiac myosin.
D. Characterized by tbe tendency to form local destructiveness & abscesses.
E. Bind host Ig FcR & degrade C5a.

48. Which of the following pairing of Clostridium & its toxin is FALSE?
A. Clostridium Perfringens - alpha toxin
B. Clostridium Botulinum - botulinum toxin
C. Clostridium Difficle - Theta toxin
D. Clostridium Tetani - Tetanospasmin
E. None of the above

49. Which of the following statements regarding Clostridium is FALSE?

A. Tetanospasmin from clostridium tetani travels up the peripheral nerve to block
neurotransmitter release from the inhibitory nerves.
B. Botulium toxin is secreted by Clostridium botulinum.
C. Toxin A from clostridium difficle is a potent enterotoxin & chemoattractant
D. 50% clostridium perfringens infection follow trauma
E. Botulinum toxin blocks ACh release, leading to descending paralysis from central to
extremities.

ANSWERS:

INFECTIOUS DISEASE MCQ - 9

1. E II. D 21. D 31. C 41. E
2. B 12. C 22.B 32.B 42.E
3. A 13. B 23. C 33. D 43. B
4. E 14. D 24. A 34. E 44. C
5. C IS. B 2S. E 3S. A 4S. B
6. D 16.C 26. E 36. C 46. E
7. A 17. C 27. E 37. B 47. D
8. E 18. E 28. C 38. C 48. C
9. E 19. C 29. A 39. E 49. B
IO. A 20. E 30. E 40.D

INFECTIOUS DISEASE MCQ

- 10