00047998-Microbiology Final Reworked Edition1

Page 1:
77. What type of bacteria lack superoxide dismutase or catalase?
a) Heterotrophs
b) Aerobes
c) Facultative anaerobes
d) Obligate anaerobes
78. Which of the following microorganism has a nuclear membrane?
a) Viruses
b) Prions
c) Bacteria
d) Fungi
79. Which of the following cell to cell contact?
a) Transformation
b) Transduction
c) Conjugation
d) Recombination
80. Spherical shaped bacteria that divide and remain attached in grape-like clusters are called
a) Staphylococci
b) Streptococci
c) Bacilli
d) Diplococci
81. Which of the following is most likely to cause urinary tract infections?
a) Bacteroides species
b) Clostridium botulinum
c) Clostridium tetani
d) E.coli
82. Penicillin specifically interferes with peptidoglycan synthesis. Which of the following cells is
most likely to be damaged by penicillin?
a) Gram +ve bacterial cells

b) Gram -ve bacterial cells
c) Acid fast bacterial cells
d) Fungal cells
83. What is the most likely causative agent of gastroenteritis starting on day 5 of clindamycin
treatment?
a) Clostridium perfringes
b) Clostridium difficile
c) Campylobacter jejuni
d) Shigella sonnei
84. Which of the following organisms is the most common causative agent of neonatal sepsis?
a) Enterococcus faecalis
b) Streptococcus peneumoniae
c) Group B streptococci
d) Viridans streptococci
85. The Ghon complex, a lesion in the lung and regional lymph nodes, is found in case of:
a) Actinomycotic mycetoma
b) Cervical facial actinomycosis
c) Tuberculoid leprosy
d) Primary tubercolosis
86. Each of the following statements concerning bacterial spores is correct except:
a) They are formed primarily when nutrients are limited

b) They are formed by gram +ve rods
c) They can be killed by being heated to 121°C for 15 mins
d) Their survival ability is based o their enhanced metabolic activity.
87. Which of the following organisms is a very slow grower?
a) Mycobacteria
b) Actinomycetes
c) Clostridia
d) Staphylococci
88. Which of the following statements about Listeria monocytogenes infection is not correct:
a) These bacteria can contaminate foods and grow during refrigeration

b) Most cases associated with diary products, poultry and meat
c) Infection during pregnancy can cause abortion, premature delivery or sepsis during the
peripartum period.
d) Bacteria parasitize neutrophils and monocytes
89. Which of the following antimicrobial agents acts on microbial DNA synthesis?
a) Rifampin
b) Fluroquinolones
c) Aminoglycosedes
d) Tetracycline
90. Which of the following antimicrobial agents acts on microbial RNA synthesis?
a) Rifampin
b) Carbapenem
c) Erythromycin
d) Tetracycline
91. Which bacterium causes cellulitis of the hand following a cat bite?
a) Haemophilus influenza
b) Proteus mirabilis
c) Pasteurella multocida
d) Brucella melitensis
92. Which of the following antibiotics causes misreading of mRNA?
a) Tetracycline
b) Streptomycin
c) Erythromycin
d) Griseofulvin
93. Which bacterium is associated with Rheumatic fever?
a) Staphylococcus aureus
b) Streptococcus pyogenes
c) Enterococcus faecalis
d) Streptococcus pneumonae
94. Which of the following bacterium is not gram –ve?
a) Bacillus anthracis
b) Neisseria gonorrhea
c) Haemophilus influenza
d) Bortedella pertussis
95. Each of the following statements is correct except:
a) R factors are plasmids that carry the genes for enzymes that modify one or more drugs
b) Resistance genes are rarely transferred by conjugation
c) Resistance to some drugs is due to transposon genes that code for enzymes that
inactivate the drugs.
d) Resistance to some drugs is due to a chromosomal mutation that alters the receptor for
the drug
96. Which antibiotic not inhibits peptidoglycan biosynthesis?
a) Penicillin
b) Cephalosporin
c) Vancomycin
d) Tetracycline
97. Which of the following antifungal drugs is fungicidal and appropriate for systemic use?
a) Amphotericin
b) Chloramphenicol
c) Econazole
d) Nystatin
98. Which one of the following tests is used for determination of antibiotic sensitivity?
a) Disk diffusion
b) Dilution
c) Both
d) None
99. Which one of the following is sterile part of human body?
a) Stomach
b) Vagina
c) Urinary bladder
d) Throat
100. What is the mechanism of action of the aminoglycosides?
a) Damage to the membrane

b) Inhibition of DNA gyrase
c) Binding to 30S ribosome
d) Inhibitoon of mycolic acid synthesis
Page 2:
1. Which of the following organisms is the most common causative agent of neonatal
sepsis?
a) Enterococcus faecalis
b) Streptococcus peneumoniae
c) Group B streptococci
d) Viridans streptococci
2. Which one of the following components is used for skin testing in case of
Mycobacterium tuberculosis infection?
a) Cord factor
b) Mycolic Acid
c) Purified protein derivative
d) Sulphates
3. Which of the following organisms form long, branching filaments and are gram positive
rods?
a) Salmonella spp.
b) Streptococcus spp.
c) Mycobacteria spp.
d) Actinomycetes spp.
4. A bacterial growth medium that contains penicillin is a
a) Selective medium
b) Minimal medium
c) Differential medium
d) Complex medium
5. Which of the following statements about non-spore forming anaerobes is incorrect?
a) They are pleomorphic and can be either gram negative or gram positive
b) They are a common cause of intra abdominal infections
c) They usually are found in mixed infections
d) They represent a minority of the total fecal flora
6. What is true for the Haemophilus influenza, that causes upper respiratory illnesses like
pneumonia?
a) gram positive rod
b) gram negative spiral
c) gram negative rod(coccobacillus)
d) Acid fast rod
7. Bacillus and clostridium are

a) Spore forming gram positive rods
b) Spore forming gram positive cocci
c) Non- Spore forming gram negative rods
d) Non- Spore forming gram negative cocci
8. Each of the following statements concerning the mechanism of action of antimicrobial
drugs is correct EXCEPT:
a) Vancomycin acts by inhibiting peptidoglycan synthesis
b) Quinolones, such as ciprofloxacin, act by inhibiting the DNA gyrase of bacteria
c) Erythromycin is a bactericidal drug that disrupts cell membranes by a detergent like
action
d) Aminoglycosides such as streptomycin are bactericidal drugs that inhibit protein
synthesis.
9. Which of the following is the major determinant of virulence in H. influenza
a) Capsule
b) Endotoxin
c) Exotoxin
d) Flagella
10. Patient has intermittent fever, sweating, and fatigue, hepatosplenomegaly,
pancytopenia for the past month. She ate unpasteurized goat cheese months go Which
one of the following bacteria is the most likely cause of this infection?
a) Pasteurella multocida
b) Francisella tularensis
c) Brucella melitensis
d) Yersinia pestis
11. Many pathogenic bacteria have component that protect them form phagocytosis by
host cells.
a) Glycocalyx or capsules
b) Cell wall
c) Cell membrane
d) Pili
12. Which of the following is also called an Endotoxin?
a) Capsule
b) Lipopolysacharide
Page 3:
14. 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) Bacterial flagella are nonantigenic in humans because they closely resemble human
flagella in chemical composition
c) Both gram negative rods and cocci have lipopolysaccharide (“Endotoxin”) in their
cell wall.
d) Polysaccharide capsules retard phagocytosis
15. Which one of the following regarding disadvantage of penicillins is correct?
a) They are ototoxic
b) They are nephrotoxic
c) They cause anaphylaxis
d) All of them
16. Which one of the following agents has bone marrow toxicity?
a) Macrolides
b) Tetracycline
c) Chloramphenicol
d) Penicillins
17. Which one of the following have specific toxic manifestation: “grey baby syndrome”?
a) Penicillins
b) Tetracyclin
c) Chloramphenicol
d) Aminoglycosides
18. Which one of the following agents is useful for the treatment of vancomycin-resistant
enterococci?
a) Linezolid
b) Macrolides
c) Clindamycin
d) Tetracyclin
19. Which one of the following should not be given to pregnant women and children under
the age of 18 years?
a) Polymyxins
b) Cephalosporins
c) Fluroquinolones
d) Penicillins
20. The bacterial component that mediates adherence is the:

a) Lipid A
b) Nucleoid
c) Plasmid
d) Pili
21. Which one of the following bacterial components exhibit the most antigenic variation?
a) Capsule
b) Lipid A
c) Ribosome
d) Spore
22. Which one of the following is the most common site where β-lactamases are located?
a) Within the capsule
b) Free in cytoplasm
c) Within the periplasmic space
d) Attached to DNA in the nucleoid
23. Which one of the following involves a sex pillus?
a) Conjugation
b) Transduction
c) Transformation
d) Translocation
24. Which one of the following contains gram positive cell wall?
a) Lipopolysaccharide (Endotoxin)
b) Outer membrane
c) Teichoic acid
d) Periplasmic space
25. Which one of the following contains gram negative bacteria?
a) Outer membrane
b) Periplasmic space
c) Lipopolysaccharide (Endotoxin)
d) All of them
Page 4, 5 & 6:
- Infant botulism is associated with the consumption of - Rice
- Honey
- Bread
- Cheese
- Cell wall of gram positive bacteria can be destroyed by enzyme

- Pectinase
- Lipase
- Peroxidase
- Lysozyme
- Which of the following is correct for cell wall of bacteria

- Gram positive bacteria have thicker cell wall than gram negative bacteria
- Gram negative bacteria have thicker cell wall than gram positive bacteria
- Both have same thickness but composition is different
- None of these are correct
- The cocci which forms a chain

- Tetracocci
- Streptococci
- Diplococci
- Staphylococci
- The arrangement in which flagella is distributed all round the bacterial cell, is known as
- Peritrichous
- Lophotrichous
- Amphitrichous
- Monotrichous
- Peptidoglycan contains only bacterial

- Cell membrane
- Capsule
- Cell wall
- Spore
- If a drug is harmful to the pathogen without being harmful to the host, it is called as
- Partial efficiency
- Selective toxicity
- Reverse toxicity
- Selective efficiency
- Which of the following statements is correct regarding treatment of life threatening

infection
- Bacteriostatic drugs are useful
- Bactericidal drugs are useful
- Both statements are correct
- None of the statements are correct
- Which one of the following bacterial cell components are major sites that serve as the basis
for action of antibacterial drug
- Cell wall
- Plasmid
- Capsule
- Spore
- Which one of the following antimicrobial agents act by inhibition of 30S subunit of bacterial
ribosome ?
- Chloramphenicol
- Tetracycline
- Macrolides
- All of them
- Which one of the following are bactericidal drug?

- Macrolides
- Tetracyclines
- Linezoid
- Aminoglycoside
- Which one of the following has a toxic effect on kidney?

- Tetracyclines
- Aminoglycosides
- Both
- None
- Discoloration of the teeth is the characteristic side effect of the prolonged treatment with
- Rifampin
- Aminoglycosides
- Macrolides
- Tetracycline
- Process by which bacterium enters a recipient bacterium

- Transformation
- Transduction
- Conjugation
- Translocation
- Which one of the following can cause mutation?

- Chemicals
- Xrays
- Mutator bacteriophage
- All of them
- Which one of the following is correct for exotoxins and endotoxins ?

- Exotoxins are polypeptides
- Endotoxins are lipopolysaccharides
- Endotoxins are produced only by gram negative bacteria
- All of them
- Exotoxins are biological molecules called:

- Nucleic acid
- Polypeptides
- Lipopolysaccharides
- Peptidogylcans
- Each of the following statements concerning endotoxins is correct EXCEPT

- They bind to specific cell receptors whereas exotoxins do not
- They are more stable on heating than exotoxins
- They are less toxic (i.e., less active on a weight basis) than exotoxins
- They are of the bacterial cell wall, whereas exotoxins are not
- Which one of the following involves a sex pilus ?

- Conjugation resulting in transfer of an R (resistance) factor
- Integration of a temperate bacteriophage
- Transduction of a chromosomal gene
- Transposition of mobile genetic element
- Which one of the following bacteria is most likely to elicit granulomatous inflammation ?
- Escherichia coli
- Mycobacterium tuberculosis
- Streptococcus pyogenes
- Staphylococcus aureus
- Which one of the following toxin causes septic shock syndrome ?
- Exotoxins
- Endotoxins
- Both
- None
- Which of the following enzymes allows the organism to spread rapidly ?

- IgA protease
- Hyaluronidase
- Catalase
- Coagulase
- Time between the moment the person is exposed to microbe and the appearance of
symptoms is
- Prodrome
- Recovery period
- Incubation period
- Sequellae
- In prokaryotic genetic exchange where only one strand of DNA is transferred is called
- Transformation
- Transduction
- Horizontal transfer
- Conjugation
- Which one of the following are β lactic drugs

- Cephalosporin
- Penicillin
- Both
- None
- Which of the following pathogens is associated with water ?
- Legionella
- Mycobacteria
- Staphylococcus
- Neisseria
- Each of the following statements concerning endotoxins is correct except

- They bind to specific receptors, whereas exotoxins do not
- They are more stable on heating than exotoxins
- They are less toxic (less active on weight basis) than exotoxins
- They are part of bacterial cell wall but exotoxins are not
- Which of the following processes involves sex pilus

- Conjugation resulting in transfer of an R (resistance) factor
- Integration of a temperate bacteriophage
- Transduction of a chromosomal gene
- Transposition of mobile genetic element
- Which one of the following bacteria is most likely to elicit granulomatous inflammation ?
- Escherichia coli
- Mycobacterium tuberculosis
- Staphylococcus aureus
- Which one of the following toxin causes septic shock syndrome ?

- Exotoxins
- Endotoxin
- Both
- None
- Which of the following enzymes allows the organism to spread rapidly

- IgA protease
- Hyaluronidase
- Catalase
- Coagulase
- Which one of the following sites is most likely source of the bacterial endocarditis caused
by a viridans group streptococci
- Oropharynx
- Colon
- Skin
- Urethra
- Which one of the following is Staphylococcus Aureus virulence factor ?

- Resistance to novobiocin
- An oxygen labile hemolysin
- Protein A that binds to Fc portion of IgG
- A heat-labile toxin that inhibits glycine release at the neuron
- Which bacterial infection causes acute glomerulonephritis as a nonsuppurative

complication
- Enterococcus faecalis
- Streptococcus pneumoniae
- Streptococcus agalactiae
- Which of the following statements regarding gram negative rods is not correct?
- Escherichia coli is a part of normal flora of colon, therefore it does not cause diarrhea
- E coli ferments lactose, whereas enteric pathogens shigella and salmonella don’t
- Kliebsella pneumoniae, although a cause of pneumonia is a part of the normal flora of the
colon
- Proteus species are highly motile organisms that are found in human colon and cause
urinary tract infections
- Which of the following statement is true about viruses?

- All viruses are obligate viruses
- Viruses are capable of performing metabolic activities on their own
- Viruses are filterable facultative parasites
- Some viruses are have cellular structures and are saprophytes
- How does enveloped virus enter into host cell ?

- By phagocytosis
- By contact with cell receptor and endocytosis
- By injecting its own nuclei acid inside the host cells
- By fusion with plasma membrane of host
- One important characteristic of viruses is that they

- Can be cultured in a cell free medium
- Do not have independent metabolism
- Can multiply outside a living cell
Page 7:
64. Each of the following statements concerning Mycobacterium tuberculosi:
A) Some strains of M. tuberculosis isolated from patients exhibit multiple d… and rifampin).
B) M. tuberculosis contains a small amount of lipid in its cell wall and there…
C) M. tuberculosis grows slowly, often requiring 3 to 6 weeks before colon…
D) The antigen in the tuberculin skin test is a protein extracted from the org…
65. Which one of the following host defense mechanisms is the MOST im…
A) Gastric acid
B) Salivary enzymes
C) Normal flora of the mouth
D) Alpha interferon
66. Which of the following pairs of organisms is routinely responsil
A) Clostridium botulinum and Bacillus antracis
B) Clostridium difficile and Clostridium botulinum
C)Clostridium perfringens and Bacillus cereus
D) Clostridium tetani and Clostridium botulinum
Page 10:
38. Which of the following antimicrobial agents acts on microorganisms by inhibition of cell
wall synthesis?
A) Aminoglycosides
B) Fluoroquinolenes
C) Penicillins
D) Polymyxins
39. Which antibiotic causes the most phototoxicity (rash when exposed to sunlight)?
A) Metronidazole
B) Sulfamethoxazole
C) Gentamicin
D) Amphotericin B
40.Which of the following phrases best describes a prophage?

A) Phage that lacks receptors
B) Phage attached to the cell wall that has released its DNA
C) Intracellular temperate phage DNA
D) Newly assembled intracellular phage particles
41.Teichoic acids are typically found in

A) Cell walls of gram positive bacteria
B) outer membranes of gram positive bacteria
C) cell walls of gram negative bacteria
D) outer membranes of gram negative bacteria
42. Each of the following statements concerning the gram stain is correct except:
A) Escherichia coli stains pink because it has a thin peptidoglycan layer
B) Streptococcus pyogenes stains blue because it has a thick peptidoglycan layer
C) Mycoplasma pneumoniae is not visible in the Gram’s stain because it does not have a cell
wall
D) Mycobacterium tuberculosis stains blue because it has a thick lipid layer
43. The virulence of Francisella tularensis is most highly associated with

A) Adherence
B) Capsule
C) Intracellular replication
D) Shiga-like toxin
44. What type of bacteria lack superoxide dismutase?
A) Heterotrophs
B) Aerobes
C) Facultative anaerobes
D) Obligate anaerobes
45. A burn patient has an infected area with odiferous, blue-green pus. What is the most likely
causative agent?
A) Streptococcus pyogenes
B) Aspergillus fumigatus
C) Pseudomonas aeruginosa
D) Vibrio vulnificus
46. The plasmid-mediated properties is/are

A) Resistance to antibiotics
B) Fermentation of lactose
C) Production of enterotoxin
D) Participation in respiration
47. Antibiotic-associated diarrhea and pseudomembranous enterocolitis can be caused by

which of the following:
A) Bacteroides fragilis
B) Clostridium difficile
C) Staphylococcus aureus
D) Esherichia coli
48. Which one of the following antibiotics can cause “red man” syndrome?
A) Vancomycin
B) Tetracycline
C) Chloramphenicol
D) Penicillin
49. Each of the following statements concerning peptidoglycan is correct except:

A) It is thinner in gram-positive than in gram-negative cells
B) Cross-links between the tetrapeptides involve D-alanine
C) It has a backbone composed of alternating units of muramic acid and acetyl glucosamine
D) It can be degraded by lysozyme
50. Which one of the statements is the most accurate comparison of bacterial, human and
fungal cells?
A) Human and fungal cells have similar ribosomes, whereas bacterial ribosomes are significantly
different
B) Human and fungal cells have a similar cell wall, in contrast to bacteria, whose cell wall
contains peptidoglycan
C) Human and bacterial cells have plasmids, whereas fungal cells do not
D) Human cells undergo mitosis, whereas neither bacteria nor fungi do
Page 8
51.Edematous “cherry-red” epiglottis is a life threatening disease of young children. Which of
the following is the most likely causative agent?
A) Haemophilus influenza
B) Klebsiella pneumonia
C) Legionella pneumophila
D) Neisseria meningitides
52. Which bacterium is associated with environmental water sources such as air conditioners
and water-cooling towels?
D) Neisseria meningitides
53.Which are typical candidate for Legionnaires’ disease?

A) Patients with cancer
B) Patients with transplants (especially renal transplants)
C) Patients being treated with corticosteroids
D) All above mentioned
54.Scrofula and Erythema nodosum are characteristic signs of which infection agent?
D) Mycobacterium tuberculosis
55.Which β-hemolytic gram-positive coccus causes acute glomerulonephritis?

A) Streptococcus pyogenes
B) Staphylococcus aureus
C) Streptococcus agalactiae
D) Staphylococcus epidermidis
56.Which of the following host defense mechanisms is the MOST important for preventing
dysentery caused by Salmonella
A) Gastric acid
B) Salivary enzymes
C) Normal flora of the mouth
D) Alpha interferon
57. Among the virulence factor of the agent of bioterrorism are toxins (PA, EF, LF) and capsules,
which consist of Poly-D-glutamic acid. Which of the following bacteria produces such an
unusual capsule?
A) Bacillus antracis
B) Clostridium botulinum
C) Francisella tularensis
D) Bacillus cereus
58. Antibiotic associated diarrhea and pseudomembranosus enterocolitis can be caused by chih
of the following organisms?
A) Staphylococcus aureus
B) Clostridium difficile
C) Clostridium perfringens
D) Streptococcus pyogenes
59. Which of the following is most likely to be due to bacterial conjugation?

A) Corynebacterium dipththeriae produces a toxin encoded by a prophage
B) An encapsulated strain of Streptococcus pneumoniae acquires the gene for capsule
formation from the extract of DNA from encapsulated strain
C) Pseudomonas aeruginosa produces β-lactamase encoded by a plasmid similar to a plasmid of
another gram-negative orga…
D) A gene encoding resistance to gentamicin in the Escherichia coli chromosome appears in the
genome of a bacteriophage infected E. coli
60.If the gram stain of the spinal fluid reveals many neutrophils and many gram-negative rods
(coccobacillus), which one is the…. likely to be the cause meningitis?
A) Haemophilus influenzae
B) Neisseria meningitidis
C) Streptococcus pneumoniae
D) Pseudomonas aeruginosa
61.Ablood culture grows a gram-negative rod that is oxidase positive and produces a blue-green
pigment. This bacterium…. Isolated from patet with wound infection. Of the following, which
one is the MOST likely organism to cause this infection?
A) Bacteroidis fragilis
B) Pseudomonas aeruginosa
C) Proteus mirabilis
D) Haemophilus influenzae
Page 9:
89. Cells of Mycoplasma are surrounded by a
A) Cell membrane
B) Cell wall
C) Specific later
D) All are correct
90. Which of the following is true about cell wall of gram-positive bacteria?
A) It consists of multiple layers
B) It is thicker than that associated with gram-negative bacteria
C) It contains teichoic acids
D) All of these
91. The last step in synthesis of peptidoglycan

A) Attachment of a peptide to muramic acid
B) attachment of two amino acids to form a cross-link
C) attachment of a portion pf peptidoglycan to a membrane
D) lipid binding of penicillin to a membrane protein
92. Which one of the following best describes the mode of action of cephalosp…
A) They inhibit folic acid synthesis needed to act as a methyl donor
B) They bind to the 30S ribosome and inhibit bacterial protein synthesis
C) They inhibit transcription of bacterial mRNA
D) They are bactericidal agents that inhibit the cross-linking of peptidoglycan
93.Which of the following antibiotics causes misreading of mRNA?

A) Tetracycline
B) Streptomycin
C) Erythromycin
D) Griseofulvin
94. A structural component that is found in all viruses is:

A) DNA
B) Capsid
C) Tail fibers
D) Spikes
95. A chemical component that is found in all viruses is:

A) Protein
B) Lipid
C) DNA
D) RNA
96.Which drugs inhibits bacterial nucleic acid synthesis by blocking the…
A) Trimethoprim
B) Ceftriaxone
C) Metronidazole
D) Rifampin
97. Which of the following is false about the general characteristics of…
A) Do not possess cellular organization
B) They are lack biosynthetic enzymes
C) They are sensitive to antibiotics
D) They are multiply by complex process
98. Subunits of capsid are called

A) Capsule
B) Capsomeres
C) Centromeres
D) Centrioles
99. Viruses depend on organisms for its synthesis because they are….
A) Obligatory intracellular parasite
B) Obligatory extracellular parasite
100.Which of the following is structural analogues of P-amin…

A) Sulfonamides
B) Trimethoprim
C) Both
D) None
Page 11:
26. This urinary pathogen characteristically is very motile and swarms over the blood agar plate
and may cause bladder and renal calculi (stones).
A. Serratia marcescens
B. Enterobacter aerogenes
C. Proteus mirabilis
D. Klebsiella oxytoca
27. Which of the following statements regarding enterotoxigenic E. coli is correct?
A. Disease is caused by production of one or both of two types of enterotoxins.

B. Transmission occurs from ingestion of contaminated food and water
C. They are important causes of traveler’s diarrhea
D. All of the above are correct
28. Hybridization of DNA to RNA for getting quantitative information about RNA synthesis is
performed by:
A. Western blots
B. Eastern blots
C. Northern blots
D. Southern blots
29. Which of the following sites is most likely to be the source of the bacterial endocarditis
caused by viridans group of streptococci?
A. Oropharynx
B. Colon
C. Skin
D. Urethra
30. Which of the following is Staphylococcus aureas virulence factor?
A. Resistance to Novobiocin
B. An oxygen-labile hemolysin
C. Protein A that binds to the FC portion of IgG
D. A heat-labile toxin that inhibits glycine release at the neuron
31. Which bacterial infection causes acute glomerulonephritis as a nonsuppurative

complication?
A. Enterococcus faecalis
B. Streptococcus pyogenes
C. Streptococcus pneumoniae
D. Streptococcus agalactiae
32. Which of the following statements concerning gram-negative rods is not correct?
A. Escherichia coli is part of the normal flora of the colon; therefore, it does not cause
diarrhea.
B. E. coli ferments lactose, whereas the enteric pathogens shigella and salmonella do not.
C. Klebsiella pneumoniae, although a cause of pneumonia, is part of the normal flora of the
colon.
D. Proteus species a highly motile organisms that are found in the human colon and cause
unary tract infections.
33. Which of the following statements is true about viruses?
A. All viruses are obligate parasites

B. Viruses are capable of performing metabolic activities on their own
C. Viruses are filterable facultative parasites
D. Some viruses have cellular structures and are saprophytes
34. How does enveloped virus enter into host cells?
A. By phagocytosis
B. by contact with cell receptor and endocytosis
C. by injecting its own nucleic acid inside the host cells
D. by Fusion with the plasma membrane of host
35. One important characteristic of viruses is that they:
A. Can be culture into cell-free medium

B. Do not have an independent metabolism
C. Can multiply outside a living cell
D. Have an independent metabolism
36. Identification of bacteria by serologic tests Is based on the presence of specific antigens.
Which one of the following bacterial components is least likely to contain useful antigens?
A. Ribosomes
B. flagella
C. exotoxins
D. capsule
37. which of the following toxins induces electrolyte loss as a result of over production of cyclic
adenosine monophosphate?
A. Clostridium tetani exotoxin

B. exotoxin
C. Escherichia coli heat-labile toxin
D. Pseudomonas aeruginosa exotoxin
Page 12:
13. Which bacterium causes flaccid paralysis?
A. Corynebacterium diphtheriae
B. Listeria Monocytogenes
C. Bacillus anthracis
D. Clostridium botulinum
14. Which bacterium is associated with rheumatic fever?
A. Staphylococcus aureas
B. Streptococcus pyogenes
C. Enterococcus faecalis
D. Streptococcus pneumoniae
15. Which of the following bacterium is not gram negative?
A. Bacillus anthracis
B. Neisseria gonorrhea
C. Haemophilus influenza
D. Bordetella pertussis
16. each of the following statements is correct accept:
A. R factors are plasmids that carry the genes for enzymes that modify one or more drugs.
B. Resistance genes are really transferred by conjugation.
C. resistance to some drugs is due to transposon genes that code for enzymes that
inactivate the drugs.
D. Resistance to some drugs Is due to a chromosomal mutation that alters the receptor for
the drug.
17. Which antibiotic not inhibits peptidoglycan biosynthesis?
A. Penicillin
B. Cephalosporin
C. Vancomycin
D. Tetracycline
18. Which of the following is not associated with endotoxin?
A. Fever
B. shock
C. hypotension
D. Diarrhea
19. which one of the following tests is used for determination of antibiotic sensitivity?
A. Disk Diffusion
B. Dilution
C. Both
D. None
20. which of the following is sterile part of human body?
A. Stomach
B. Vagina
C. Urine bladder
D. Throat
21. the process by which DNA itself enters a recipient bacterium is:
A. Transformation
B. Transduction
C. Conjugation
D. Translocation
22. which one of the following can cause mutation?
A. Chemicals
B. Mutator bacteriophage
C. X-rays
D. All of them
23. Which one of the following is correct for exotoxins and endotoxins?
A. Exotoxins are polypeptides

B. Endotoxins are lipopolysaccharides
C. Endotoxins are produced only gram-negative bacteria
D. All of them
24. Exotoxins are biological molecules called:
A. Nucleic acids
B. Polypeptides
C. Lipopolysaccharides
D. Peptidoglycans
Page 13:
26. Which of the following pairs of organisms is routinely possible for food poisoning ?
A. Clostridium botulinum and bacillus anthracis

B. Clostridium difficile and Clostridium botulinum
C. Clostridium perfringens and bacillus cereus
D. Clostridium tetani and clostridium botulinum
27. The site of lysozyme action is:
A. Capsule
B. Periplasmic space
C. Peptidoglycan
D. Lipid A
28. Which are typical candidate for Legionnaires' disease?
A. Patients with cancer

B. Patients with transplants (especially renal transplants)
C. Patients being treated with corticosteroids
D. All above mentioned
29. Each of the following statements concerning gram-negative rods is correct except:
A. Escherichia coli is part of the normal flora of the colon; therefore, it is not cause
diarrhea.
B. E. coli ferments lactose, whereas the enteric pathogens shigella and salmonella do not.
C. Klebsiella pneumoniae, although a cause of pneumonia, is part of the normal flora of
the colon.
D. Proteus species a highly motile organisms that are found in the human colon and cause
unary tract infections.
30. Which of the following phases would most likely be missing detectable growth and hence
would be resistant to B-lactam antibiotics?
A. Lag phase
B. Log phase
C. Stationary phase
D. None of them
31. Some of the bacteria are obligate anaerobes. Which of the following statements best
explains this phenomenon?
A. They can produce energy both by fermentation and by respiration using krebs cycle and
cytochrome
B. They lack superoxide dismutase and catalase
C. They cannot produce their own ATP
D. They do not form spores
32. Corynebacterium diphtheriae causes the disease diphtheria by producing diphtheria toxin.
The gene encoding the toxin is integrated into bacterial genome during lysogenic conversion.
The toxin gene was acquired by which process?
A. Transduction
B. Transformation
C. Conjugation
D. Transposition
33. Which of the following is not associated with virus?
A. Nucleic acid
B. Pilli
C. Envelope
D. Capsid
34. Selective inhibition of synthesis of dipicolonic acid from the etiologic agent of the infection
would not likely inhibit the formation of which of the following structures?
A. Bacterial flagella
B. Bacterial spores
C. Fimbriae
D. Capsule
35. Which of the following often complicates treatment of staphylococcus aureus infection with
penicillin?
A. Inability of penicillin to penetrate the membrane of S. aureus.

B. Lack of penicillin binding sites on outer membrane of S. aureus.
C. Production of penicillin acetylase by S. aureus.
D. Production of penicillinase (B-lactamase) by S. aureus.
36. Each of the following statements concerning bacterial spores is correct EXCEPT:
A. Spores are formed under adverse environmental conditions such as the absence of a
carbon source.
B. Spores are resistant to boiling.
C. Spores are metabolically inactive and contain dipicolonic acid, a calcium chelator.
D. Spores are formed primarily by organisms of the genus Neissera.
37. Each of the following statements concerning exotoxins is correct EXCEPT:
A. Exotoxins are highly antigenic.

B. Some exotoxins act in the gastrointestinal tract to cause diarrhea.
C. Some exotoxins contain lipopolysaccharide as the toxic component.
D. When treated chemically, some exotoxins lose their toxicity and can be used as
immunogens in vaccines.
Page 14
63. Which one of the following bacteria has the lowest 50% infectious dose
A. Shigella zonnei
B. Clostridium botulinum
C. Salmonella
D. Camphylobacter jejuni
64. Which of the following is the toxic component of bacterial endotoxin
A. Capsule
C. peptidoglycan
D. Lipid A
65. Which of the following macromolecules is important in iron metabolism of bacteria
A. Ferric oxide
B. Lactoferrin
C. Lipopolysaccharide
D. Siderophores
66. Bacteria isolated from the abscess exudates was missing superoxide dismutase, catalase and a
peroxidase. Which of the following statements best describes this microorganism
A. Aminoglycoside antibiotics will be effective against this bacterium
B. This bacterium will be facultative aerobe
C. This bacterium is an anaerobe
D. This bacterium will survive in an oxygen environment
67.Which of the following targets would most likely play a role in the development of resistance to the
beta lactam antibiotics.
A.Bactoprenol
B.Dna gyrase
C. Penicillin binding proteins
D. Reverse transcriptase
68. Which of the following phases would most likely be missing detectable growth and hence would be
resistance to beta lactam antibiotics
A. lag phase
B. Log phase
C. Stationary phase
D. None of them
69. An increase in antibiotic resistance has been observed in microbial staphylococcus, pseudomonas
and e coli strains isolated from patients in medical centres.direct transfer of a plasmid between two
bacteria is defined as which of the following process
A. Competence
B. Conjugation
C. Transduction
D. Transformation
70. Some bacteria are obligate anaerobes. which of the following statements best explains this
phenomenon.
A. They can produce energy both by fermentation and by respiration using krebs cycle and cytochrome
B. The lack superoxide dismutase and catalase
71. The gene encoding the diphtheria toxin is integrated into bacterial genome during lysogenic
conversion. The toxin gene was acquired by which process
A. Transduction
Transformation
Conjugation
Transposition
72.Which of the following drugs is the best immediate treatment for a patient with hospital acquired
pneumonia.if clinical specimens reveal the presence of staphylococcus aureus strain with a methicillin
resistant
Penicillin
Streptomycin
Ceftriaxone
Vancomycin
73.which of the following statement often complicates treatment of staphylococcus aureus infection
with penicillin
A.Inability of penicillin to penetrate the membrane of staphylococcus aureus
Lack of penicillin binding sites on outer membrane of staphylococcus aureus
Production of penicillin acetylase by staphylococcus aureus
Production of penicillinase (beta lactamase) by staphylococcus aureus
74. Which of the following best describes the mode of action of endotoxin
A. Blocks release of acetylcholine
Inactivates elongation factor 2
Cause the release of tumor necrosis factor
Degrades lecithin in cell membrane
75. Which of the following microorganism is dimorphic
A. Virus
B. Prions
C. Bacteria
D. Fungi
Page 15
67. The site of lysosome action is
A. capsule
Periplasmic space
Peptidoglycan
Lipid A
68. Toxic component of endotoxin is
A. Capsule
Periplasmic space
Peptidoglycan
Lipid A
69. Each of the following statements concerning gram-negative rods is..
A. Escherichia coli is part of the normal Flora of the the call on therefore…
B. E coli ferments lactose where as the enteric pathogens shigella..
C.Klebsiella cause of pneumonia is part
Page 16.
16. Prokaryotic cells have all the following cellular components except
A. Flagella
B. Ribosomes
C. Cell wall
D. Mitochondria
17. In addition to the bull neck appreance and the pseudomembrane symptoms of diphtheria..
A. Heart and nerves
B.skin
C. Kidney
D. Liver and kidneys
18. Humans are infected with bacillus antracis through exposure
A. To contaminated animals
B. To contaminated animal products
C. From the inhalation of spores during the processing of goat hair
D. All of the above
19. B. Antracis characteristic features are
A. Colonies are not hemolytic in contrast with b.cereus
B. Will appear in non motile rods in motility tests
C.colonies cultured on sheep blood agar referred to as Medusa head morpho..
D. All above are true
20. Myonecrosis or gas gangrene generally develops within a week after anaerobic.. trauma or surgery.
this bacterium is:
A.clostridium tetani
B.Clostridium perfringens.
C.Clostridium botulinum
D. Clostridium difficile
21. Actinomyces is a
A.Spore former Gram positive rod
B. Anaerobic non spore former Gram positive rod

C. Gram positive coccus
D. Gram negative coccus
22. Opistotonus is a
A. Contraction of the facial muscles
B. Persistent spasms of the back muscles
C. Contraction of arms
D. Persistent spasm of the respiratory muscles
23.which of the following organisms is most likely to be the cause of pneumonia
A. Haemophilus influenzae
B. Bordetella producers
C. Mycoplasma pneumonia
D. Legionella
24. A patient with pseudomonas aeruginosa septicemia develops shock which is triggering…
A. Catalase
B.lipid A
C…. From Gram negative bacteria.
Page 17:
13)Spherical shaped bacteria that divide and remain attached in chainlike pattern
A) Staphylococci
B) Bacilli
C)Streptococci
D)Diplococci
14)Which of the following bacterial structures is necessary for chemotaxis?

A)Flagella
B) Pilli
C) Cell wall
D) Cell membrane
15)Which of the following have not cell wall?

A)Mycoplasma spp
B) Mycobacterium spp
C) Rickettsia spp
D) Chlamydia spp
16)Prokaryotic cells have all the following cellular components, except:

A)Flagella
B)Ribosomes
C) Cell wall
D)Mitochondria
17)In addition to bullneck syndrome appearance and the pseudomembrane, symptoms …

A)Heart and nerves
B)Skin
C)Kidneys
D)Liver and Kidneys
18)Humans are infected with Bacillus antracis through exposure

A)contaminated animals
B)contaminated animal products
C)… inhalation of spores during processing of goat hair
D)… of above
Page 18:
84)Which one of the following statements regarding benzylpenicillin is correct?
A)effectiveness against many gram negative rods
B)inactivation of Beta-lactamase
C)Hydrolysis by gastric acid
D)all of the above
85)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)Bacterial flagella are nonantigenic in humans because they closely resemble human flagella in
chemical composition.
C) Both gram-negative rods and cocci have lipopolysaccharide ("endotoxin") in their cell wall.
D) Polysaccharide capsules retard phagocytosis.
86)Which one of the following regarding disadvantage of penicillins is correct?

A) They are ototoxic
B) They are nephrotoxic ,
C)They cause anaphylaxis
D) All of them
87)Which one of the following agents has bone marrow toxicity?

A) Macrolides
B) Tetracycline
C)Chloramphenicol
D) Penicillin
88)Which one of the following have specific toxic manifestation: "gray baby" syndrome?
A)Penicillins
B) Tetracycline
C)Chloramphenicol
D) Aminoglycosides
89)Which one of the following agent is useful for the treatment of vancomycin-resistant
enterococci?
A)Linezolid
B)Macrolides
C)Clindamycin
D)Tetracycline
90)This urinary pathogen characteristically is very motile and swarms over the blood agar plate
and may cause bladder calculi (stones):
A)Serratia marcescens
B) Enterobacter aerogenes
C)Proteus mirabilis
D)Klebsiella oxytoca
91)Which of the following statements regarding enterotoxigenic E. toll is correct?

A) Disease is caused by production of one or both of two types of enterotoxins.
B) Transmission occurs from ingestion of contaminated food and water.
C) They are important causes of traveler's diarrhea
D) All of the above are correct.
92)These bacteria are causative agents of diarrhea EXCEPT:

A)Enterococcus faecalis
B)Shigella zonnei
C)Escherichia coli
D)Clostridium perfringens
93)Which one of the following should not be given to pregnant women and children under the
age of 18 years?
A)Polymyxins
B)Cephalosporins
C)Fluoroquinolones
D)Penicillins
94)The bacterial component that mediates adherence is the:

A)Lipid A
B)Nucleoid
C)Plasmid
D)Pillus
95)Which one of the following bacterial components exhibits the most antigenic variation,
A) Capsule
B) Lipid A
C) Ribosome
D) Spore
96)Which one of the following is the most common site where B-lactamases are located?
A) Within the capsule
B) Free in cytoplasm
C) Within the periplasmic space
D) Attached to DNA in the noel
97)Which one of the following involves a sex pillus?

A)Conjugation
B)Transduction
C)Transformation
D)Translocation
98)Which one of the following contains gram-positive cell wall?

A) Lipopolysaccharide (endotoxin)
B) Outer membrane
C)Teichoic acid
D) Periplasmic space
99)Which one of the following contains gram-negative bacteria?

A) Outer membrane
B) Periplasmic space
C) Lipopolysaccharide (endotoxin)
D) All of them
100)Which of the following requires cell-to-cell contact?

A) Transformation
B) Transduction
C) Conjugation
D) Recombination
Page 19-Version12
1)If gram stain of the spinal fluid reveals many neutrophils and many gram-negative rods
(coccobacillus), which one is the MOST likely to be the cause meningitis?
A)Haemophilus influenzae
C) Streptococcus pneumoniae
D) Pseudomonas aeruginosa
2)A blood culture grows a gram-negative rod that is oxidase positive and produces a blue-green
pigment. This bacterium was isolated from patent with wound infection. Of the following,
which one is the MOST likely organism to cause this infection?
A)Bacteroides fragilis
B)pseudomonas aeruginosa
C) Proteus mirabilis
D) Haemophilus influenzae
3)each of the following statements concerning Mycobacterium tuberculosis is correct EXCEPT.

A)after being stained with carbolfuchsin, M. tuberculosis resists decolorization with acid
alcohol.
B)M. tuberculosis has a large amount of mycolic acid in its cell wall.
C)M. tuberculosis appears as a red rod in gram-stained specimens
D)M. tuberculosis appears as a red rod in acid-fast stained specimens.
4)which of the following antibiotics causes misreading of mRNA?

A) Tetracycline
B) Streptomycin
C) Erythromycin
D) Griseofulvin
5.which of the following bacterial is the toxic component of endotoxin?

A)Capsule
B)periplasmic space
C)Peptidoglycan
D)Lipid A
6)which of the following macromolecules is important in iron metabolism of bacteria?

A)ferric oxide
B)lactoferrin
C) lipopolysaccharide (LPS)
D)siderophores
7)Bacteria isolated from the abscess exudates was missing superoxide dismutase, catalase and
a peroxidase. Which of the following statements best describes this microorganism?
A)amino glycoside antibiotics will be effective against this bacterium
B)this bacterium is a facultative aerobe
C)this bacterium is an anaerobe
D)this bacterium will survive in an oxygen environment
8)Which of the following targets would most likely play a role in the development of resistance
to the B-lactam antibiotics?
A)Bactoprenol
B)DNA gyrase
C)Penicillin binding proteins (PBPs)
D)Reverse transcriptase
9)Which of the following phases would most likely be missing detectable growth and hence
A) Lag phase
B) Log phase
C) Stationary phase
D) None of them
10)An increase in antibiotic resistance has been observed in microbial Staphylococcus,

Pseudomonas and E. coli strains patients in medical centers. Direct transfer of a plasmid
between two bacteria is defined as which of the following process
A)Competence
B)Conjugation
C) Transduction
D)Transformation
11)Which of the following antimicrobial agents acts on microbial RNA synthesis?

A) Rifampin
B) Carbapenem
C) Erythromycin
D) Tetracycline
Page 20, 21 and 22

42. Which one of the following antibacterials belongs to fluoroquino…
A) Gentamicin
B) Streptomycin
C) Vancomycin
D) Ciprofloxacin
43. Which one of the following bacterial genetic exchange processes …
A) Conjugation
B) Transduction
C) Transformation
D) Translocation
44. Which of the following is correct for nonsense mutation?
A) Protein function is not destroyed

B) Protein function is destroyed
C) An inactive protein is produced
D) None from above
45. Which one of the following bacteria is found in the greatest number in colon.
B) Clostridium perfringens
C) Enterococcus faecalis
D) Escherichia coli
46. In prokaryotic genetic exchange where only one strand of DNA …
A) Conjugation
B) Transduction
C) Horizontal transfer
D) Transformation
47.Bacteria having no flagella are unable to
A) Move
B) Reproduce
C)Stick to tissue surfaces
D) Grow in nutrient agar
48. Which of the following is/are included in Kingdom Prokaryote…
A) Bacteria
B) Protozoa
C) Fungi
D All of these
38. Which one of the following agents acts on 50S subunit of microbial ribosome…
A) Tetracycline
B) Chloramphenicol
C) Aminoglycosides
D) all of them
39. Which one of the following regarding sulfonamides is correct?
A) They are bacteriostatic drugs
B), Are useful for treatment urinary tract infection
C) Both statements are correct
D) None from the above is correct
40. Which one of the following antibacterials inhibits bacterial RNA?
A) Fluoroquinolones
B) Rifampin
C) Trimethoprim
D) All of them
41. Side effect of fluoroquinolones is:
A) Tendon rupture
B) Deafness
C) Colitis
D) All of them
42. Which one of the following antibacterials belongs to fluoroquinolon…
A) Gentamicin
B) Streptomycin
C) Vancomycin
D) Ciprofloxacin
43. Which one of the following bacterial genetic exchange processes
A) Conjugation
B) Transduction
C) Transformation
D) Translocation
16. Prokaryotic cells have all the following cellular components, except
A) Flagella
B) Ribosomes
C) Cell wall
D) Mitochondria
17. In addition to the bull neck appearance and the pseudomembrane, symptoms of dir…
A) heart and nerves
B) Skin
C) Kidneys
D) Liver and kidneys.
18. Humans are infected with Bacillus anthracis through exposure
A) To contaminated animals
B) To contaminated animal products
C) From the inhalation of spores during the processing of goat hair
D) All of above
19. B anthracis characteristic features are
A)Colonies are not hemolytic in contrast with B.cereus
B) Will appear nonmotile rods in motility tests
C) Colonies cultured on sheep blood agar referred to as "medusa DX

D) All above are true
20. Myonecrosis or gas gangrene generally develops within a week after anaerobic bacteria Or
Surgery .This bacterium is:
A) Clostridium tetani
C) Clostridium botulinum
D) Clostridium difficile
21. Actinomyces is a
A) Spore former gram positive rod
B) Anaerobic, non-spore former gram-positive rod
C) Gram-positive coccus
D) Gram-negative coccus
A) Contraction of the facial muscles
B) Persistent spasms of the back muscles
C) Contraction of arms
D) Persistent spasms of the respiratory muscles
23. Which one of the following organisms is most likely to be the cause of pneumonia
B) Bordetella pertussis
C) Mycoplasma pneumoniae
D) Legionella pneumophila
Page 23, 24 and 25:

38. The identification of bacteria by serologic tests is based on the presence of specific
antigens. W.. components is least likely to contain useful antigens?
A. Ribosomes
B. Flagella
C. Exotoxins
D. Capsule
39. A common polyhedral capsid shape of viruses is a:
A. Pyramid
B. Pentagon
C. Cube
D. Icosahedron
40. The organism which require organic carbon for growth are
A. Autotrophs
B. Chemotrophs
C. Heterotrophs
D. Prototrophs
41. Which antibiotic causes the most phototoxicity (rash when exposed to sunlight)?
A. Metronidazole
B. Sulfamethoxazole
C. Gentamicin
D. Amphotericin B
A. Amphotericin B
B. Chloramphenicol
C. Econazole
D. Nystatin
43. Teichoic acids are typically found in
A. Cell walls of gram positive bacteria

B. Outer membranes of gram positive bacteria
C. Cell walls of gram negative bacteria
D. Outer membranes of gram negative bacteria
44. Each of the following statements concerning gram stain is correct except:
A. Escherichia Coli stains pink because it has a thin peptidoglycan layer

B. Streptococcus pyogenes stains blue because it has a thick peptidoglycan layer
C. Mycoplasma pneumoniae is not visible in the gram’s stain because it does not have a
cell wall
D. Mycobacterium tuberculosis stains blue because it has a thick lipid layer
45. The bacteria deficient in cell wall is
A. Treponema
B. Mycoplasma
C. Staphylococcus
D. Klebsiella
A. Heterotrophs
B. Aerobes
C. Facultative anaerobes
D. Obligate anaerobes
47. Which one of the phases are antibiotics such as penicillin most likely to kill bacteria?
A. Lag
B. Log
C. Stationary
D. Death
48. The plasmid-mediated properties is/are
A. Resistance to antibiotics
B. Fermentation of lactose
C. Production of enterotoxin
D. Participation in respiration
49. Antibiotic-associated diarrhea and pseudomembranous enterocolititis can be c…
A. Bacteroides fragilis
B. Clostridium difficile
C. Staphylococcus aureus
D. Escherichia coli
50. Which one of the following antibiotics can cause..

A. Vancomycin
B. Tetracycline
C. Chloramphenicol
D. Gentamycin
51. Each of the following statements concerning peptidogylcan is correct except
A. It is thinner in gram positive than in gram negative cells.

B. Cross links between the tetrapeptides involve D- alanine.
C. It has a backbone composed of alternating units of muramic acid and acetyl........
D. It can be degraded by lysozyme.
52.Which one of the statements is the most accurate comparison of bacterial, human and
fungal cells?
A. Human and fungal cells have similar ribosomes, whereas bacterial ribosomes are
significantly different.
B. Human and fungal cells have similar cell wall, in contrast to bacteria whose cell wall
contains peptidoglycan.
C. Human and bacterial cells have plasmids, whereas fungal cells do not.
D. Human cells undergo mitosis, whereas neither bacteria nor fungi do.
53. Edematous “cherry red’’ epiglottis is a life-threatening disease of young children. Which of
the following is the causative agent?
A. Haemophilus influenza
B. Klebbaiella pneumonia
C. Legionella pneumophilla
D. Neisseria meningitides
54. Which bacterium is associated with environmental water sources such as air conditioners
and water cooling towels?
B. Klebbaiella pneumonia
D. Neisseria meningitides
55. What is the mechanism of action of aminoglycosides?
A. Damage to the membrane

B. Inhibition of DNA gyrase
C. Binding to 30S ribosome
D. Inhibition of mycolic acid synthesis
56. Scrofula and erythema modusum are characteristic sign of which infection agent?
B. Klebsiella pneumonia
D. Mycobacterium tuberculosis
57. Which beta hemolytic gram positive coccus causes acute glomerulonephritis?
A. Streptococcus pyogenes
B. Staphylococcus aureus
C. Streptococcus agalactiae
D. Staphylococcus epidermis
58. Which of the following host defense mechanisms is the MOST important for preventing
desentry
caused by salm…..
A. Gastric acid
B. Salivary enzymes
C. Normal flora of the mouth
D. Alpha interferon
59. Organisms that are capable of growth at temperature at 50-60 •C are referred to as:
A. Thermophiles
B. Psychrophiles
C. Halophiles
D. Mesophiles
60. Antibiotic associated diarrhea and pseudomembranous enterocolitis can be caused by

which of the
following
A. Staphylococcus aureus
C. Clostridium perfringens
D. Streptococcus pyrogens
61. Which of the following is most likely to be due to bacterial conjugation ?
A. Corynebacterium diphtheriae produces a toxin encoded by a prophage

B. An encapsulated strain of streptococcus pneumoniae acquires the gene for capsule
formation from an extract of D .. encapsulated strain
C. Pseudomonas aeruginosa produces β lactamase encoded by a plasmid similar to a
plasmid of another gram negative
D. A gene encoding resistance to gentamicin in the Escherichia coli chromosome appears in
the genome of bacteria infected E.coli
62. Some bacteria are obligate anaerobes. Which of the following statements best explain this
phenomenon?
A. They can produce energy both by fermentation and by respiration using krebs cycle and
cytochrome
Page 26:
1. Which of the following phases would most likely be missing detectable growth and
hence would be resistant to B-lactam antibiotics?
a. Lag phase
b. Log phase
c. Stationary phase
d. None of them
2. Some bacteria are obligate anaerobes. Which of the following state…
a. They can produce energy both by fermentation and by respiration
b. They lack superoxide dismutase and catalase
c. They cannot produce their own ATP
d. They do not form spores
3. Corynebacterium diphtheria causes the disease diphtheria by producing diphtheria
toxin. The gene encoding the toxin is integrated into bacterial genome during lysogenic
conversion. The toxin gene was acquired by which process?
a. transduction
b. Transformation
c. Conjugation
d. Transposition
4. Which of the following is not associated with viruses?
a. Nucleic acid
b. Pilli
c. Envelope
d. Protein
5. Selective inhibition of synthesis of dipicolonic acid from the etiologic agent of the
infection would not likely inhibit the formation of which of the following structures?
a. Bacterial flagella
b. Bacterial spores
c. Fimbriae
d. capsule
Page 27 and 28:

1. Which culture media can be used for the growth myobacteria tube….
a) Blood agra
b) Lowenstein-jensen media
c) macConkey agar
d) mannitol salt agar
2. Ziehl – neelsen stain method used for identification
a. Staphylococcus aureus
b. Mycobacterium tuberculosis
c. Neisseria mengitis
d. Treponems pallidum
3. Miscroscopically seen small gram-negative rods in the exudate lesion of ….ago and now
has painful,inflamed swollen hand. Cellulitis is caused
a. Pasteurella multocida
b. Brucellamelitensis
c. Francisella tularensis
d. Yersinia pestis
4. If lactose fermentinf colonies are seen on MAConkey agar and patient has….no nausea
or vomiting, causative agent of this infection is:
a. Escherichia coli
b. Salmonella typhi
c. Shigella zonnei
d. Proteus mirabilis
5. What is the most likely causative agent of gastroenteritis starting on day 5 of
clindamycin treatment?
a. Clostridium perfringens
b. Clostridium difficile
c. Campylobacter jejuni
d. Shigella zonnei
6. Yersinis pestis may be transferred by:
a. Dermacentor tick bit
b. Respiratory droplets
c. Human body lous…
7. If patient has meningitis and gram stain of the spinal….MOST likely to be the cause?
a. Haemophilus influenza
b. Neisseria meningitides
8. Regarding the members of the family Enterobacteriaceae,which…
a. All members of the family are anaerobic, which means they must..
b. All members of the family ferment lactose, which is an important
c. All members of the family have endotoxin, an important pathog…
d. All member of the family produce an enterotoxin, which ADP..
9. Bacteria are protected from phagocytosis by the
a. Outer membrane
b. Capsule
c. Lipoprotein
d. Peptidoglycan
Page 29
81. Which one of the following processes involves a sex pilus?
A) Integration of a temperate bacteriophage
B) transposition of a mobile genetic element
C) conjugation resulting in transfer of an R (resistance) factor
D) transduction of a chromosomal gene
82. Each of the following statements concerning the normal flora is correct, except:
A) the most common organism found on the skin is staphylococcus epidermidis
B) escherichia coli is a prominent member of the normal flora of the throat
C) The major site where bacteroides fragilis is found is the colon

D) one of the most common sites where are staphylococcus aureus is found is the nose.
83. Of the following choices, the MOST important functions of antibody in host defe..
A) acceleration of proteolysis of exotoxins
B) facilitation of phagocytosis
C) activation of lysozyme that degrades the cell wall
D) inhibition of bacterial protein synthesis.
84. An organism is completely dependent on atmospheric oxygen for growth. This organ…
A) osmotolerant
B) acidophilic
C) facultative anaerobe
D) obligate aerobe
85. organisms that are capable of growth at temperatures above 100 degrees Celsius are
referred
A) hyperthermophiles
B) mesophilic
C) Halophiles
D) psychrophiles
86. Donor DNA is introduced to the recipient by a bacterial virus. The form of this…
A) transfection
B) conjugation
C) transformation
D) transduction
87. The form of genetic exchange in bacteria that is most susceptible to the activity… uptake is
A) transformation
B) conjugation
C) transfection
D) transduction
88. Each of the following statements concerning bacterial and human cells is corre...
A) bacteria are prokaryotic, whereas human cells are eukaryotic
B) bacteria divides energy by oxidative phosphorylation within mitochondria
C) bacterial and human ribosomes are of different sizes and chemical compositions
D) bacterial cells possess peptidoglycan, whereas human cells do not.
89. Cells of mycoplasma are surrounded by a
A) cell membrane
B) cell wall
C) specific layer
D) all are correct

90. Which of the following is true about cell wall of gram-positive bacteria?
A) it consists of multiple layers
B) is thicker than that associated with gram-negative bacteria
C) it contains teichoic acids
D) all of these
Page 30:
A) spores are formed under adverse environmental conditions such as the…
B) spores are resistant to boiling
C) spores are metabolically inactive and contain dipicolinic acid, a calcium…
D) spores are formed primarily by organisms of the genus Neisseria
77. Each of the following statements concerning exotoxins is correct except
A) exotoxins are highly antigenic
B) some exotoxins act in the gastrointestinal tract to cause diarrhoea
C) some exotoxins contain lipopolysaccharide as the toxic component
D) when treated chemically, some exotoxins lose their toxicity and can be used…
A) envelope
B) lysosomes
C) spikes
D) capsid
79. Which structural feature of gram-positive bacteria enhances their ability…
A) a thick peptidoglycan layer
B) a thin peptidoglycan layer
C) teichoic….
D) …..
A) bacteroides species
B) clostridium botulinun
C) clostridium tetani
D) Escherichia coli
Page 31:
67. The site of lysozyme action is:
A. Capsule
C. Peptidoglycan
D. Lipid A
68. Toxic component of endotoxin is:
A. Capsule
C. Peptidoglycan
D. Lipid A
69. Each of the following statements concerning gram-negative rods…
A. Escherichia coli is a part of the normal flora of the colon; therefore..

B. E. coli ferments lactose, whereas the enteric pathogens Shigella..
C. Klebsiella pneumoniae, although a cause of pneumonia, is part..
D. Proteus species are highly motile organisms that are found in the..
70. Which of the following phases would most likely be missing detectable growth and hence
A. Lag phase
B. Log phase
C. Stationary phase
D. None of them
71. Some bacteria are obligate anaerobes. Which of the following….(*is incorrect probably*)
A. They can produce energy both by fermentation and by respiration

Page 32:
51) Anatomic location where Bacteroides fragilis is most commonly found is:
a. skin
b. colon
c. nose
d. stomach
52) This bacterium causes acute glomerulonephritis and is beta-hemolytic:
a. Streptococcus pyogenes
b. Staphylococcus aureus
c. Streptococcus agalactiae
d. Staphylococcus epidermidis
53) Gram-negative rod that causes cough and lymphocytosis.is:

a. Bordetella pertussis
b. Haempohilus influenza
c. Mycoplasma pneumonia
d. Staphylococcus aureus
54) Strawberry tongue, pharyngitis,diffuse erythematous rash on the upper… is more

suspected?
a. Scarlet fever
b. Rheumatic fever
c. Pneumonia
d. Diphtheria
55) Which culture media can be used for growth Mycobateria tuber…
a. Blood sugar
b. Lowenstein-Jensen media
c. MacConkey agar
d. Mannitol salt agar
56) Zeihl-Neelsen stain method used for identification
b. Myobacterium tuberculosis
c. Neisseria meningitis
d. Treponema pallidum
Page 33
39) Which structural feature of Gram-positive bacteria enhances their ability to retain the
crystal violet dye?
a. a thick peptidoglycan layer
b. a thin peptidoglycan layer
c. Teichoic acids in the cell wall
d. wax in the cell wall
40) Which of the following antimicrobial agents acts on 30S subunit of the microbial ribosome
and inhibit protein synthesis by blocking attachment of charged aminoacyl-tRNA?
a.Macrolides
b.Chloramphenicol
c.Penicillin
d.Tetracycline
41) Many pathogenic bacteria have component that protect them from phagocytosis by host
cells. They are:
a. Glycocalyx or capsules
b. Cell wall
c. Cell membrane
d. Pilli
42) When drug is harmful to a pathogen without being harmful to the host, it is a:
a. Selective efficiency
b. Partial efficiency
c. Selective toxicity
d. Reverse toxicity
43) Which of the following bacterial structures is necessary for chemotaxis?
a. Flagella
b. Pilli
c. Cell wall
d. Cell membrane
44)Which of the following have not cell wall?
a. Mycoplasma
b. Mycobacterium
c. Rickettsia
d. Chlamydia
45) Each of the following statements regarding the selective action of antibiotics on bacteria is
correct EXCEPT:
a. Chloramphenicol affects the large subunit of the bacterial ribosome, which is different from
the large subunit of the ribosome.
b. Isoniazid affects the DNA polymerase of bacteria but not that of human cells.
c. Sulfonamides affect folic acid synthesis in bacteria, a pathway that does not occur in human
cells.
d. Penicillin affect bacteria rather than human cells because bacteria have cell wall, where as
human cells do not.
46) Prokaryotic cells have all the following cellular components, except:
a. Flagella
b. Ribosomes
c. Cell wall
d. Mitochondria
47) In addition to the bull neck appearance and the pseudomembrane, symptoms of diphtheria
involve the
a. heart and nerves
b. skin
c. kidneys
d. liver and kidneys
48) Humans are infected with Bacillus antracis through exposure
a. To contaminated animals
b. To contaminated animal products
c. From the inhalation of spores during the processing of goat hair
d. All of the above
49) B.antracis characteristic features are:

a. Colonies are not haemolytic in contrast with B.cereus
b. Will appear nonmotile rods in motility tests
c. Colonies cultured on sheep blood agar reffered to as “medusa head” morphology
d. all of the above are true
50) Apatient with Pseudomonas aeruginosa septicemia develops shock, which is triggered by
a. Catalase
b. lipid A
Page 34:
51) Each of the following statements concerning peptidoglycan is correct except:
a. It is thinner in gram-positive than in gram-negative
b. Cross-links between the tetrapeptides involve D-analine.
c. It has a backbone composed of alternating units of muramic acid and acetylglucosamine.
d. it can be degraded by lysozyme
52) Which one of the statements is the most accurate comparison of bacterial,human and
fungal cells?
a. Human and fungal cells have similar ribosomes, wheras bacterial ribosomes are significantly
different.
b. Human and fungal cells have a similar cell wall, in contrast to bacteria, whose cell wall
contains peptidoglycan
c.. Human and bacterial cells have plasmids, wheras fungal cells do not.
d. Human cells undergo mitosis, whereas neither bacteria nor fungi do.
53) Edematous “cherry-red” epiglottis is a life-threatening disease of young children. Which of

the following is the causative agent?
a. Haemophilus influenza [this option was marked over with orange]
b. Klebsiella pneumonia
c. Legionella pneumophilla
d. Neisseria meningitides
54) Which bacterium is associated with environmental water sources such as air conditioners
and water-cooling towels?
d. Neisseria meningitides
55) What is the mechanism of action of the aminoglycosides?

a. Damage to the membrane
b. Inhibition of DNA gyrase
c. Binding to 30S ribosome
d. Inhibition of mycolic acid synthesis
56) Scrofula and Erythema nodosum are characteristic signs of which infection agent?
d. Mycobacterium tuberculosis
57) Which beta-hemolytic gram-positive coccus causes acute glomerulonephritis?

a. Streptococcus pyogenes
b. Staphylococcus aureus
c. Streptococcus agalactiae
d. Staphylococcus epidermidis
58) Which one of the following host defense mechanisms is the most important for preventing
dysentery cause…
a. Gastric acid
b. Salivary enzymes
c. Normal flora of the mouth
d. Alpha interferon
59) Organisms that are capable of growth at temperatures at 50-60 C are referred to as:
a. Thermophiles
b. Psychrophiles
c. Halophiles
d. Mesophiles
60) Antibiotic associated diarrhea and pseudomembranous enterocolitis can be cause by which
of the…
b. Clostridium difficile…
c. Clostridium perfringens
d. Streptococcus pyoge enes
61) Which of the following is most likely to be due to bacterial conjugation?
a. Corynebacterium diphtheriae produces a toxin encoded by prophage.
b. An encapsulated strain of Streptococcus pneumoniae acquires the gene for capsule
formation from an encapsulated strain.
c. Pseudomans aeuruginosa produces beta-lactamase encoded by a plasmid similar to a plasmid
of another…[this option was marked over with orange]
d. A gene encoding resistance to gentamicin in the Escherichia coli appears in the genome
infected E.coli
62) Some bacteria are obligate anaerobes. Which of the following statements best explains this
phenomenon…
a. They can produce energy both by fermentation and by respiration using Krebs cycle and
cytochrome…
b. They lack superoxide dismutase and catalase [this option was marked over with orange]
…
Page 35
63. The gene encoding the diphtheria toxin is integrated into bacterial genome during
lysogenic…..acquired by which process?
A. Transduction
B. Transformation
C. Conjugation
D. Transportation
64. Which of the following drugs is the best immediate treatment for a patient with hospital
acquired pneumonia, if clinical specimen reveals the presence of staphylococcus aureus strain
with a methicillin resistant plasmid?
A. Penicillin
B. Streptomycin
C. Ceftriaxone
D. Vancomycin
65. Which of the following statements often complicates treatment of staphylococcus aureus
infection with penicillin?
A. Inability of penicillin to penetrate the membrane of S. aureus

B. Lack of penicillin binding sites on outer membrane of S. aureus
C. Production of penicillin acetylase by S. aureus
D. Production of penicillinase (β -lactamase) by S. aureus
66. Which one of the following best describes the mode of action of endotoxin?
A. Blocks release of acetylcholine

B. Inactivates elongation factor-2
C. Causes the release of tumor necrosis factor
D. Degrades lecithin in cell membrane
67. Which of the following microorganisms is dimorphic?
A. Viruses
B. Prions
C. Bacteria
D. Fungi
68. Which of the following bacterial structures is most involved in adherence?
A. Capsule
B. Lipopolysaccharide
C. Ordinary pili
D. O-specific side chain
69. What type of bacteria lack superoxide dismutase or catalase?
A. Heterotrophs
B. Aerobes
C. Facultative anaerobes
D. Obligate anaerobes
70. Which of the following microorganisms has a nuclear membrane?
A. Viruses
B. Prions
C. Bacteria
D. Fungi
71. Which of the following organisms are obligate intracellular parasites?
A. Protozoa
B. Mycobacterium
C. Chlamydia
D. Bacilli
72. Which of the following bacterial structures is necessary for chemotaxis?
A. Flagella
B. Pilli
C. Cell wall
D. Cell membrane
73. Penicillin specificity interferes with peptidoglycan synthesis. Which of the following cells is
most likely to be damaged by penicillin?
A. Gram-positive bacterial cells

B. Gram-negative bacterial cells
C. Acid fat bacterial cells
D. Fungal cells
treatment?
A. Clostridium perfringens
C. Campylobacter jejuni
D. Shigella sonnei
75. Which of the following organisms is the most common causative agent of neonatal sepsis?
A. Enterococcus faecalis
B. Streptococcus pneumoniae
C. Group B streptococci
D. Viridans streptococci
76. The Ghon complex, a lesion in the lung and regional lymph nodes, is found in case of:
A. Actinomycotic mycetoma
B. Cervical fascial actinomycosis
C. Tuberculoid leprosy
D. Primary tuberculosis
A. They are formed primarly when nutrients are limited

B. They are formed by gram-positive rods
C. They can be killed by being heated to 121°C for 15 minutes
D. Their survival ability is based on their enhanced metabolic activity
A. Mycobacteria spp
B. Actinomyces spp
C. Streptococcus spp
D. Staphylococcus spp
79. Which of the following statements about listeria monocytogenes infection is not correct:
A. This bacterium can contaminate foods and grow during refrigeration

B. Most cases associated with dairy products, poultry, and meat
C. Infection during pregnancy can cause abortion, premature delivery or sepsis during the
peripartum period
D. Bacteria parasitize neutrophils and monocytes
80. Which of the following antimicrobial agents acts on microbial DNA synthesis?
A. Rifampin
B. Fluoroquinolones
C. Aminoglycosides
D. Tetracycline
81. The time between the moment the person is exposed to the microbe and the appearance of
symptoms is
A. Prodrome
B. Recovery period
C. Incubation period
D. Sequellae
82. Which one of the following statements regarding penicillins is correct?
A. They are bactericidal drugs
B. They kill cells only when they are growing
C. Both
D. None
83. Which one of the following are β-lactam drugs?
A. –
B. Protein function is destroyed
C. An inactive protein is produced
D. None from above
Page 36
76. Which one of the following bacteria is found in the greatest number in colon?
A. Bacteroides fragilis
B. Clostridium perfringens
C. Enterococcus faecalis
D. Escherichia coli
77. Which one of the following illnesses is not a zoonosis?
A. Typhoid fever
B. Q fever
C. Tularemia
D. Rocky mountain spotted fever
78. Bacteria having no flagella are unable to
A. Move
B. Reproduce
C. Stick to tissue surfaces
D. Grow in nutrient agar
79. Which of the following is/are included in kingdom prokaryotae?
A. Bacteria
B. Protozoa
C. Fungi
D. All of these
80. The identification of bacteria by serologic tests is based on the presence of specific
antigens. Which of the following bacterial components is least likely to contain useful antigens?
A. Ribosomes
B. Cell wall
C. Capsule
D. Flagella
81. Chemotaxis is a phenomenon of
A. Swimming away of bacteria

B. Swimming towards a bacteria
C. Swimming away or towards of bacteria in presence of chemical compound
D. None of the above
82. If patient has meningitis and gram stain of the spinal fluid reveals neutrophils and many
gram-negative diplococci, which one is most likely to be the cause?
B. Neisseria meningitidis
C. Streptococcus pneumoniae
D. Pseudomonas aeruginosa
83. Regarding the members of the family enterobacteriaceae, which one of the following is the
most accurate?
A. All members of the family are anaerobic, which means they must be cultured in the
absence of oxygen.
B. All members of the family ferment lactose, which is an important diagnostic criterion in
the clinical laboratory
C. All members of the family have endotoxin, an important pathogenetic factor.
D. All members of the family produce an enterotoxin, ehich ADP-ribosylates a G protein in
human enterocytes.
84. Which of the following bacteria has the lowest 50% infectious dose(ID50)?
A. Shigella sonnei
B. Vibrio cholera
C. Salmonella typhi
D. Campylobacter jejuni
85. Each of the following statements concerning mycobacterium tuberculosis is correct except:
A. Some strains of M tuberculosis isolated from patients exhibit multiple drug resistance
(i.e., they are resistant to both isoniazid and rifampin)
B. M. tuberculosis contains a small amount of lipid in its cell wall and therefore stains
poorly with the gram stain
C. –
D. –
Page 37
44. Of the following choices, the most important function of antibody in host defenses against
bacteria is:
A. Acceleration of proteolysis of exotoxins

B. Facilitation of phagocytosis
C. Activation of lysozyme that degrades the cell wall
D. Inhibition of bacterial protein synthesis
45. An organism is completely dependent on atmospheric O2 for growth. This organism is
A. Osmotolerant
B. Acidophile
C. Facultative anaerobe
D. Obligate aerobe
46. Organisms that are capable of growth at temperatures above 100 °C are referred to as:
A. Hyperthermophiles
B. Mesophiles
C. Halophiles
D. Psychrophilesis
47. Donor DNA is introduced to the recipient by a bacterial virus. The form of this genetic
exchange is:
A. Transfection
B. Conjugation
C. Transformation
D. Transduction
48. The form of genetic exchange in bacteria that is most susceptible to the activity of
deoxyribonuclease during the process of DNA uptake is:
A. Transformation
B. Conjugation
C. Transfection
D. Transduction
49. Each of the following statements concerning bacterial and human cells is correct except:
A. Bacteria are prokaryotic, whereas human cells are eukaryotic

B. Bacteria derive their energy by oxidative phosphorylation within mitochondria in a
manner similar to human cells
C. Bacterial and human ribosomes are of different sizes and chemical compositions
D. Bacterial cells possess peptidoglycan, whereas human cells do not
50. Which of the following steps of the gram stain are in correct order
A. Crystal violet – Iodine - Alcohol (or acetone)-Safranin

B. Iodine - Crystal violet - Safranin -Alcohol (or acetone)
C. Safranin – Crystal violet – Iodine -Alcohol (or acetone)
D. Crystal Violet -Iodine –Alcohol (or acetone) – Safranin
51. Many pathogenic bacteria have component that protect them from phagocytosis by host
cells
A. Cell wall
B. Glycocalyx or capsules
C. Cell membranes
D. Pilli
52. Gram-negative cells contain a periplasmic space that is rich in degradative enzymes. They
are:
A. B-lactamases
B. A-lactamases
C. Y-lactamases
D. M-lactamases
Page 38
33) Which of the following organisms form long, branching filaments and are gram-positive
rods?
A) Salmonella spp.
B) Streptococcus spp.
C) Mycobacteria spp.
D) Actinomyces spp.
34) Which of the following organisms is generally rod-shaped and acid-fast?
A) Nocardia spp.
C) Actinomyces spp.
D) Mycobacteria spp.
35) Which of the following statements about non-spore-forming anaerobes is not correct ?
A) They are pleomorphic and can be either gram-negative or gram-positive

B) They are a common cause of intra-abdominal infections
C) They usually are found in mixed infections
D) They represent a minority of the total fecal flora
36) What is true for the Haemophilus influenza, that causes upper respiratory illnesses like
pneumonia?
A) Gram-positive rod
B) Gram-negative rod ( coccobacillus)
C) Gram-negative spiral
D) Acid fast rod
37) Bacillus and Clostridium are
A) Spore forming gram positive rods

B) Spore forming gram positive cocci
C) Non-spore forming gram negative rods
D) Non-spore forming gram negative cocci
38) Which one of the following illnesses is NOT a zoonosis?
A) Tularemia
B) Q fever
C) Typhoid fever
D) Rocky Mountain spotted fever
39) Which of the following is the major determinant of virulence in H. influenza
A) Capsule
B) Endotoxin
C) Exotoxin
D) Flagella
40) Patient has intermittent fever, sweating, and fatigue, hepatosplenomegaly, pancytopenia
for the past month. She ate unpasteurized goat cheese months ago. Which one of the following
bacteria is the most likely cause of this infection?
A) Brucella melitensis
B) Francisella tularensis
C) Pasteurella multocida
D) Yersinia pestis
41) Peptidoglycan contains only bacterial
A) Cell membrane
B) Capsule
C) Cell wall
D) Spore
42) Which one of the following processes involves a sex pilus?
A) Integration of a temperate bacteriophage

B) Transposition of a mobile genetic element
C) Conjugation resulting in transfer of an R (resistance) factor
D) Transduction of a chromosomal gene
Page 39
12) Which one of the following bacterial cell components are major sites that serve as the basis
for the action of antibacterial drug?
A) Cell wall
B) Plasmid
C) Capsule
D) Spore
13) Which one of the following antimicrobial agents acts by inhibition of 30S subunit of
bacterial ribosome?
A) Chloramphenicol
B) Tetracyclines
C) Macrolides
D) All of them
14) Which one of the following are bactericidal drug?
A) Macrolides
B) Tetracyclines
C) Linezolid
D) Aminoglycosides
15) Which one of the following have a toxic effect on the kidney ?
A) Tetracyclines
B) Aminoglycosides
C) Both
D) None
16) Discoloration of the teeth is the characteristic side effect of the prolonged treatment with
A) Rifampin
B) Aminoglycosides
C) Macrolides
D) Tetracycline
17) Which one of the following agents acts on 50S subunit of microbial ribosome?
A) Tetracycline
B) Chloramphenicol
C) Aminoglycosides
D) All of them
18) Which one of the following is structural analogues of PABA?
A) Sulfonamides
B) Trimethoprim
C) Both
D) None
19) Which one of the following regarding sulfonamides is correct?

B) Are useful for treatment urinary tract infection
20) Which one of the following antibacterials inhibits bacterial RNA?
A) Fluoroquinolones
B) Rifampin
C) Trimethoprim
D) All of them
21) Anatomic location where Bacteroides fragilis is most commonly found, is:
A) Skin
B) Colon
C) Nose
D) Stomach
22) This bacterium causes acute glomerulonephritis and is β-hemolytic:
A) Streptococcus pyogens
…… rest of the answers not given
Page 1
1)In prokaryotic genetic exchange where only one strand of DNA transfered is called
A) Transformation
B) Transduction
C) Horizontal transfer
D) Conjugation
2.)This bacterium causes acute glomerulonephritis and is B-hemolytic

A)Streptococcan pyogenes
B) Staphylococos aureus
C) Sareptococus agalactiae
D) Staphylocnerus epidermidis
3.Gram-negative bacillus that causes cough and lymphocytosis is

A)Bordetella pertussis
B) Haemophilus influenza
C) Mycoplasma pneumonia
D) Staphylococcus aureus
4)Which disease is more suspected if patient has pharyngitis,strawberry tongue erythematous

rush on upper chest which spreads to the extremities
A)Scarlet fever
B)Rheumatic fever
C) Pneumonia
D) Diphtheria S.
5)For the growth of Mycobacterium tuberculosis can be used one of the following culture media
A) Blood agar
B) Lowenstein-Jensen media
C) MacConkey agar
D) Mannitol salt agar
6. Ziehl-Neelsen stain method is used for identification of

A) Salmonella typhi
B)Mycobacterium tuberculosis
C) Neisseria meningitis
D) Clostridium perfringens
7. Hybridization of DNA to RNA for getting quantitative information about RNA synthesis is
performed by
A) Western blots
B) Eastern blots
C) Northern blots
D) Southern blot
8)if lactose-fermenting colonies are seen on MacConkey agar and patient has bloody diarrhea
and fever (temperature, 38 C) but no nausea or vomiting, causative agent of this infection is
A)Escherichia coli
B) Salmonella tphi
C) Shigella zonnei
D) Proteus mirabila
treatment?
A) Clostridium perfringens
B)Clostridium dificile
C) Campylobacter jejuni
D) Shigella zonnei
10. Yersinia pestis may be transferred by:

A) Dermacentor tick bit.
B) Respiratory droplets.
C) Human body louse bite.
D) ixodes tick bite
11) Which of the following organisms is the most common causative agent of neonatal sepsis?
A) Enterococcus faecalis
B) Streptococcus pneumoniae
C) Group B streptococi
D) Viridans streptococci
12 Which one of the following components is used for skin testing in case of Mycobacterium
tuberculosis infection
A) Cord factor
B) Mycolic acid
C) Purified protein derivative
D) Sulfates
Page 2
A) Salmonella spp.
C) Mycobacteria spp.
D) Actinomyces spp.
14.Which of the following phrases best describes a prophage?

A) Phage that lacks receptors
B) Phage attached to the cell wall that has released its DNA
C) Intracellular temperate phage DNA
D) Newly assembled intracellular phage particle
15.Which of the following statements about non-spore-forming anaerobes is not correct?

A) They are pleomorphic and can be either gram-negative or gram-positive
B) They are a common cause of intra-abdominal infections
C) They usually are found in mixed infections
D) They represent a minority of the total fecal flora
16.Which of the following terms best describes bacteria that can use fermentation pathways and
contain superoxide dismutase?
A) Obligate aerobe
B) Facultative anaerobe
C) Obligate anaerobe
D) Aerobic heterotroph
17.Bacillus and Clostridium are

A) Spore forming gram positive rods
B) Spore forming gram positive cocci
C) Non-spore forming gram negative rods
D) Non-spore forming gram negative cocci
18.Which of the following toxins induces electrolyte loss as a result of overproduction of cyclic
A) Clostridium tetani exotoxin
B) Corynebacterium diphtheriae exotoxin
C)Escherichia coli heat-labile toxin
D) Pseudomonas aeruginosa exotoxin
19.Which of the following is the major determinant of virulence in H. influenza

A) Capsule
B) Endotoxin
C)Exotoxin
D)Flagella
20.Which of the following is the most sensitive type of serologic test?

A) Hemadsorption
B) Virus neutralization
C)Enzyme-linked immunosorbent assay
D) Nucleic acid hybridization
21.If patient has meningitis and gram stain of the spinal fluid reveals neutrophils and many gram-
negative diplococci, which one is MOST likely to be the cause?
A) Haemophilus influenzae
C)Streptococcus pneumoniae
D)Psuedomonas aeruginosa
22.Regarding the members of the family Enterobacteriacae, which one of the following is the most
accurate?
A) All members of the family are anaerobic, which means they must be cultured in the absence of
oxygen
B) All members of the family ferment lactose, which is an important diagnostic criterion in the clinical
laboratory
C) All members of the family have endotoxin, an important pathogenetic factor
D) All members of the family produce an enterotoxin, which ADP-ribosylates a G protein in human
enterocytes
23.A bacterial growth medium that contains penicillin is a

A) selective medium
B) minimal medium
C) differential medium
D) Complex medium
24.Which of the following is also called an endotoxin?

A) Capsule
B) Outer membrane
C) Lipopolysaccharide
D) Peptidoglycan
25.Which one of the following host defense mechanism is the MOST important for preventing dysentery
caused by Salmonella?
A) Alpha interferon
B) Normal flora of the mouth
C)Salivary enzymes
Page 3
26. Which of the following pairs of organism is routinely responsible for food poisoning
A. Clostridium botulinum and bacillus antracis
B. Clostridium difficile and clostridium botulinum
C. Clostridium perfringens and bacillus cereus
D. Clostridium tetani and clostridium botulinum
27. The site of lysozyme action is
A. Capsule
Periplasmic space
Peptidoglycan
Lipid A
28. Which are typical candidate for legionnaires disease
A. Patients with cancer

Patients with transplants
Patients being treated with corticosteroids
All above mentioned
29. Each of the following statements concerning Gram negative rods is correct except
A. Escherichia coli is part of the normal Flora of the colon therefore it does not cause diarrhoea
B.E coli ferments lactose whereas the enteric pathogens shigella and salmonella do not
C. Klebsiella pneumoniae Alto are cause of pneumonia is part of the normal Flora of the colon
D.proteus species are highly motile organisms that are found in the human colon and cause urinary tract
infections
30.which of the following faces would most likely be missing detectable growth and hence would be
resistance to beta lactam antibiotics
A. Lag phase
B. Log phase
C stationary phase
D. None of them
31. Some bacteria are obligate anaerobes.which of the following statements best explains this
phenomenon.
A.they can produce energy both by fermentation and by respiration using krebs cycle and cytochrome
D they do not form spores

32. Corynebacterium diphtheriae causes the disease diphtheria by producing diphtheria toxin the gene
encoding the toxin is integrated into bacterial genome during lysogenic conversions. The toxin gene was
acquired by which process
A. Transduction
Transformation
Conjugation
Transposition
33. Which of the following is not associated with viruses
A. Nucleic acid
B. Pilli
C. Envelope
D. Capsid
34. Selective inhibition of synthesis of dipicolinic acid from the etiologic agent of the infection would
most likely inhibit the formation of which of the following structures
A. Bacterial flagella
B. Bacterial spores
C.fimbriae
D. Capsule
35. Which of the following often complicates treatment of staphylococcus aureus infection with
penicillin
A. Inability of penicillin to penetrate the membrane of s aureus
B. Lack of penicillin binding sites on outer membrane of s aureus
C. Production of penicillin acetylase by S aureus
D.production of penicillinase (beta lactamase) by S aureus

37 each of the following statements concerning exotoxins is correct except
A. Exotoxins are highly antigenic
B. Some exotoxins act in the gastrointestinal tract to cause diarrhoea
C.some exotoxins contains liposacchride as their toxic compound
d. When treated chemically some exotoxins lose their toxicity and can be used as immunogens in
vaccines
PAGE 4
a. Envelope
b. Lysosome
c. Spikes
d. protein
2. Which structural feature of gram positive bacteria enhances their ability to retain the crystal
violet dye?
a. A thick peptidoglycan layer
b. A thin peptidoglycan layer
c. Teichoic acids in the cell wall
d. Wax in the cell wall
3. Which of the following antimicrobial agents acts on 30S subunit of the microbial ribosome and
inhibit protein synthesis by blocking attachment of charged aminoacyl- Trna?
a. Macrolides
b. Chloramphenicol
c. Penicillin
d. Tetracycline
4. Many pathogenic bacteria have component that protects them form phagocytosis by host cells .
they are :
a. Glycocalyx or capsules
b. Cell wall
c. Cell membrane
d. Pilli
5. When drug is harmful to a pathogen without being harmful to the host,it is a :

a. Selective efficiency
b. Partial efficiency
c. Selective toxicity
d. Reverse toxicity
6. Which of the following bacterial structures is necessary for chemotaxis?
a. Flagella
b. Pilli
c. Cell wall
d. Cell membrane
7. Which of the following have not cell wall?
a. Mycoplasma
b. Mycobacterium
c. Rickettsia
d. Chlamydia
8. Each of the following statements regarding the selective action of antibiotics on bacteria is
correct except:
a. Chloramphenicol affects the large subunit of the bacterial ribosome, which is different from
the large subunit of the human ribosome
b. Isoniazid affects the DNA polymerase of bacteria but not that of human cells
c. Sulfonamides affect folic acid synthesis in bacteria, a pathway that does not occur in human
cells.
d. Penicillin affect bacteria rather than human cells because bacteria have a cell wall, whereas
human cells do not
9. Prokaryotic cells have all of the following cellular components, except:
a. Flagella
b. Ribososmes
c. Cell wall
d. Mitochondria
10. In addition to the bull neck appearance and the pseudomembrane, symptoms of diphtheria
involve the
a. Heart and nerves
b. Skin
c. Kidneys
d. Liver and kidney
11. Humans are infected with Bacillus antracis through exposure
a. To contaminated animals
b. To contaminated animal products
c. From the inhalation of spores during the processing of goat hair
d. All of above
12. B. antracis characteristic features are:
a. Colonies are not hemolytic in contrast with B.cereus
b. Will appear non-motile rods in motility tests
c. Colonies cultured on sheep blood agar referred to as “medusa head” morphology
d. All of above are true
13. A patient with pseudomonas aeruginosa septicemia develops shock, which is triggered by
a. Catalase
b. Lipid A
c. Flagella from gram-negative bacteria
d. Teichoic acid-peptidoglycan fragments
Page 5
50. A patient with pseudomonas aeruginosa septicemia develops shock, which is triggered by
A) catalase
B) lipid A
C) flagella from gram-negative bacteria
D) teichoic acid peptidoglycan fragments
causative agent?
A) streptococcus pyogenes
B) aspergillus fumigatus
C) pseudomonas aeruginosa
D) vibrio vulnificus
A) contraction of the facial muscles
B) persistent spasms of the back muscles
C) contraction of arms
D) persistent spasms of the respiratory muscles
53. A patient has a catheter infection. A biofilm is present on the catheter. What is the most
likely causative agent?
A) staphylococcus epidermidis
B) enterococcus faccalis
C) staphylococcus aureus
D) streptococcus agalactiae
54. Most of the cases of the foodborne botulism are associated with the consumption of
A) rice
B) home canned foods
C) carrots
D) potatoes
55. Infant botulism is associated with the consumption of
A) rice
B) honey
C) bread
D) cheese
56. The cell wall of gram-positive bacteria can be destroyed by the enzyme known as
A) pectinase
B) lipase
C) peroxidase
D) lysozyme
57. Bacteria are protected from the phagocytosis by
A) outer membrane
B) capsule
C) lipoprotein
D) peptidoglycan
58. The arrangement in which flagella are distributed all around the bacterial cell is known as
A) peritrichous
B) lophotrichous
C) amphitrichous
D) monotrichous
59. Peptidoglycan contains only bacterial
A) cell membrane
B) capsule
C) cell wall
D) spore
60. Which one of the following processes involves a sex pilus?
A) integration of a temperate bacteriophage
B) transposition of a mobile genetic element
C) conjugation resulting in transfer of an R (resistance) factor
D) transduction of a chromosome gene
61. Scrofula and Erythema nodosum are characteristic signs of which infection agent?
A) haemophilus influenza
B) klebsiella pneumonia
C) legionella pneumophila
D) mycobacterium tuberculosis
62. Each of the following statements concerning the normal flora is correct, except:
A) the most common organism found on the skin is staphylococcus epidermidis
B) Escherichia coli is a prominent member of the normal flora of the throat
C) the major site where bacteroides fragilis is found is the colon
D) one of the most common sites where staphylococcus aureus is found is the nose
63. Of the following choices, the MOST IMPORTANT FUNCTIONS OF ANTIBODY IN HOST
DEFENCES AGAINST BACTERIA IS
A) acceleration of proteolysis of exotoxins
B) facilitation of phagocytosis
C) activation of lysozyme that degrades the cell wall
D) inhibition of bacterial protein synthesis
Page 6
64. An organism is completely dependent on atmospheric O, for growth. This organism
is
A) osmotolerant
B) acidophilic
C) facultative anaerobe
D)obligate aerobe
65. Organisms that are capable of growth at temperatures above 100 C are referred to
as:
A)Hyperthermophile
B) Mesophiles
C)Halophiles
D) Psychrophiles
66. Donor DNA is introduced to the recipient by a bacterial virus.

The form of this genetic exchange is
A) Transfection
B) Conjugation
C) Transformation
D) Transduction
67. Form of genetic exchange in bacteria that is most susceptible to the activity of
deoxyribonuclease during the process of DNA uptake is
A) Transformation
B) Conjugation
C) Transfection
D) Transduction
68. Each of the following statements concerning bacterial and human cells is correct
except
A) Bacteria are prokaryotic, whereas human cels are eukaryotic
B) Bacteria derive their energy by oxidative phosphorylation within mitochondria in a
manner similar to human cells
C) Bacterial and human ribosomes are of different sizes and chemical compositions
D) Bacterial cells possess peptidoglycan, whereas human cells do not.
69. Cells of Mycoplasma are surrounded by a

A)Cell membrane
B) Cell wall
C) Specific layer
D) All are correct
A) Bacteroides species
B) Clostridium botulinum
C) Clestridium tetani
D)Escherichia coli
71. The last step in synthesis of peptidoglycan is
A) attachment of a peptide to muramic acid
B)attaching two amino acids to form a cross-link
C) attachment of a portion of peptidoglycan to a membrane
D) lipid binding of penicillin to a membrane protein
72. Which one of the following best describes the mode of action of cephalosporins?
A) They inhibit folic acid synthesis needed to act as a methyl donor
B) They bind to the 30S ribosome and inhibit bacterial protein synthesis.
C) They inhibit transcription of bacterial mRNA.
D) They are bactericidal agents that inhibit the cross-linking of peptidoglycan
73, Which drugs inhibits bacterial nucleic acid synthesis by blocking the production of
tetrahydrofolic acid
A) Trimethoprim
B) Ceftriaxone
C) Metronidazole
D) Rifampin
74. Which of the following is false about the general characteristics of viruses?
A) Do not possess cellular organization
B) They are lack biosynthetic enzymes
C)They are sensitive to antibiotics.
D) They are multiply by complex process
75. Subunits of capsid are called

A) capsule
B) capsomeres
C) centromeres
D) centrioles
76. Virus depend on organisms for its synthesis because they are:
A)Obligatory intracellular parasite
Page 7
77) The viruses in an attenuated vaccine
A) Have no genome
B) Continue to replicate
C) Are usually larger than bacteria
D) Is altered with chemicals
78) Which of the following antibiotics causes misreading of mRNA?
A) Tetracycline
B) Streptomycin
C) Erythromycin
D) Griseofulvin
79) Which of the following antifungal drugs is fungicidal and appropriate for systemic use?
A) Amphotericin B
B) Chloramphenicol
C) Econazole
D) Nystatin
80) What is the mechanism of action of the aminoglycosides?
A) Damage to the membrane

B) Inhibition of DNA gyrase
C) Binding to 30S ribosome
D) Inhibition of mycolic acid synthesis
81) Which one of the following statements is correct regarding the treatment of life-
threatening infection?
A) Bacteriostatic drugs are useful

B) Bactericidal drugs are useful
D) None of the statements are correct
82) Which one of the following bacterial cell components are major sites that serve as the basis
for the action of antibacterial drug?
A) Cell wall
B) Plasmid
C) Capsule
D) Spore
83) Which one of the following antimicrobial agents acts by inhibition of 30S subunit of
bacterial ribosome?
A) Chloramphenicol
B) Tetracyclines
C) Macrolides
D) All of them
84) Which one of the following are bactericidal drug?
A) Macrolides
B) Tetracyclines
C) Linezolid
D) Aminoglycosides
85) Which one of the following have a toxic effect on the kidney?
A) Tetracyclines
B) Aminoglycosides
C) Both
D) None
86) Discoloration of the teeth is the characteristic side effect of the prolonged treatment with
A) Rifampin
B) Aminoglycosides
C) Macrolides
D) Tetracycline
87) Which one of the following agents acts on 50S subunit of microbial ribosome?
A) Tetracycline
B) Chloramphenicol
C) Aminoglycosides
D) All of them
88) Which one of the following is structural analogues of P-amino benzoic acid (PABA)?
A) Sulfonamides
B) Trimethoprim
C) Both
D) None
89) Which one of the following regarding sulfonamides is correct?

B) Are useful for treatment urinary tract infection
90) Specialized cell structures that may allow survival in extreme environments are called:
A) Capsules
B) Capsid
C) Spores
D) Mycelium
91) Side effect of fluoroquilones is:
( the word is actually fluoroquinolones but it says the wrong one in the text there so I'm writing
as is incase it comes with the same mistake in the exam)
A) Tendon ruptures
B) Deafness
C) Colitis
D) All of them
92) Which one of the following antibacterials belongs to fluoroquinolones?
A) Gentamycin
B) Streptomycin
C) Vancomycin
D) Ciprofloxacin
93) Which one of the following bacterial genetic exchange processes is involved in a sex pilus?
A) Conjugation
B) Transduction
C) Transformation
D) Translocation
(this answer can also be written as Conjugation resulting in transfer of an R (resistance) factor)
94) Which of the following is correct for nonsense mutation?
A) Protein function is not destroyed

B) Protein function is destroyed
D) None from above
95) Which one of the following bacteria is found in the greatest number in the colon?
C) Enterococcus fascialis
D) Escherichia coli
96) Which one of the following BEST describes the mode of an action of endotoxin?
A) Degrades lecithin in cell membranes

B) Inactivates elongation factor-2
D) Causes the release of tumour necrosis factor
97) Which of the following components present in gram-positive bacteria but not in gram-
negative bacteria?
A) Capsule
B) Teichoic acid
C) Peptidoglycan
D) Pilli
98) Which of the following bacterial components is least likely to contain useful antigens?
A) Ribosomes
B) Cell wall
C) Capsule
D) Flagella
99) Acid-fast bacteria are represented by:
A) Staphylococci
B) Pseudomonas
C) Mycobacteria
D) Treponema
100) Which one of the statements is the most accurate comparison of bacterial, human and
fungal cells?
A) Human and fungal cells have similar ribosomes, whereas bacterial ribosomes are
significantly different.
B) Human and fungal cells have a similar cell wall, in contrast to bacteria, whose cell wall
contains peptidoglycan.
C) Human and bacterial cells have plasmids, whereas fungal cells do not.
D) Human cells undergo mitosis, whereas neither nor fungal do.
\\\\ Transient aplastic crisis is caused by
\\\ Astravirus
\\\ Varicella-Zoster Virus
\\ Parvovirus B19
\\\ Poliovirus
\\\\ Which of the following Herpesviruses are oncogenic:
\\\ CMV
\\\ VZV
\\\ HHV6
\\ HHV8
\\\\ Cytomegalovirus (CMV) mostly replicates in
\\\ Neural cells
\\\ Epithelial cells
\\ Lymphocytes
\\\ Erythrocytes
\\\\ Parvoviruses are
\\\ Large viruses
\\\ Huge viruses
\\ Small viruses
\\\ Medium size viruses
\\\\ Polymerase Chain Reaction (PCR) is used to detect:
\\\ Antibodies against viruses
\\\ Viral particles
\\ Viral genetic material
\\\ Viral functional characteristics
\\\\ Smallpox is the

\\\ Slaw VZV infection
\\\ Subacute VZV ifection
\\ Primary VZV infection
\\\ Secondary VZV infection
\\\\ The most frequent cause of Myocarditis is
\\\ Angiovirus
\\\ Cardiovirus
\\ Coxsackievirus
\\\ Poliovirus
\\\\ Herpangina is caused by
\\\ Angioviruses
\\\ Herpesviruses
\\ Picornaviruses
\\\ Parvoviruses
\\\\ Caliciviruses usually cause
\\\ Bone disorders (Calcifications)
\\\ Encephalitis
\\ Gastroenteritis
\\\ Flue-like disease
\\\\ Spanish flue in 1918 was caused by
\\ Influenza virus N1H1
\\\ Influenza virus N5H1

\\\ Influenza virus H2N2
\\\\ SARS epidemics was caused by
\\ coronavirus
\\\ metapneumovirus
\\\\ Flue pandemics are usually caused by the following changes in Influenza virus genetics:
\\\ Genetic restructuring
\\ Genetic shift
\\\ Genetic drift
\\\ Genetic splicing
\\\\ Genetic material of Influenza virus is presented by
\\\ Continuous RNA
\\ Segmented RNA
\\\ Spiral RNA
\\\ Segmented DNA
\\\\ Vaccination against Influenza is recommended to be done
\\\ Three times
\\\ Once
\\ Annually
\\\ Monthly
\\\\ Paramyxoviruses are
\\\ Small viruses
\\\ Very small viruses
\\ Large viruses
\\\ Medium size viruses
\\\\ Parainfluenza viruses belong to
\\\ Paraviruses
\\ Paramyxoviruses
\\\ Orthomyxoviruses
\\\ Picornaviruses
\\\\ Respiratory Syncytial Virus infection is most dangerous for:
\\\ Children
\\ Infants
\\\ Pregnant women
\\\ Elderly People
\\\\ Rubella virus is most dangerous for
\\\ Children
\\\ Infants
\\\ Pregnant women
\\ Fetus
\\\\ The main targets of HIV are:

\\\ Erythrocytes
\\\ Leucocytes
\\ Lymphocytes
\\\ Neural cells
\\\\ HIV/AIDS is most prevalent in:
\\\ North Africa
\\ South Africa
\\\ South America
\\\ South Asia
\\\\ Which of the following viruses is oncogenic:
\\\ HIV
\\ HTLV
\\\ HHV7
\\\ VZV
\\\\ HIV intagrates it’s genetic material into:
\\\ Cytoplasm
\\\ Nucleus
\\ Genome
\\\ Reticulum
\\\\ HIV has the specific enzyme
\\\ Retro-transcriptase
\\ Reverse-transcriptase
\\\ Retro-polymerase
\\\ Reverse-polymerase
\\\\ Which of the following is the most frequent cause of blood transfusion associated hepatitis?
\\\ Hepatitis A virus
\\\ Hepatitis B virus
\\ Hepatitis C virus
\\\ Hepatitis D virus
\\\\ Antiviral capsid antigen (VCA) antibodies are found in
\\\ cytomegalovirus infections.
\\\ herpes simplex virus infections.
\\ Epstein-Barr virus infections.
\\\ varicella-zoster virus infections
\\\\ Passive immunization is available for protection from
\\\ influenza A virus.
\\\ rubella virus.
\\ hepatitis A virus.
\\\ parainfluenza type 2 virus.
\\\\ Linear, single-stranded DNA is the genetic material of
\\\ caliciviruses.
\\\ flaviviruses.
\\\ papovaviruses.
\\ parvoviruses.
\\\\ Infantile diarrhea is usually attributable to
\\\ adenovirus.
\\ rotavirus.
\\\ Norwalk virus.
\\\ Hepatitis A virus
\\\\ Which of the following is an RNA virus that has a nuclear phase to its replication process?
\\\ Coronavirus
\\ Retrovirus
\\\ Rhabdovirus
\\\ Togavirus
\\\\ Negri bodies are associated with
\\\ cytomegalovirus infections.
\\ rabies virus infections
\\\ herpes simplex virus infections.
\\\ rubella virus infections.
\\\\ Persistent virus infections
\\\ are usually confined to the initial site of infection.
\\ may involve infected carrier individuals.
\\\ are preceded by acute clinical disease.
\\\ elicit a poor antibody response.
\\\\ Which of the following is the first viral-induced defense mechanism in a nonimmune individual?
\\ Production of interferon
\\\ Generation of cytotoxic T lymphocytes
\\\ Synthesis of lymphokines
\\\ Synthesis of neutralizing antibodies
\\\\ Viral-induced heart disease is most frequently associated with
\\\ arenavirus infections.
\\ coxsackievirus infections.
\\\ echovirus infections.
\\\ enterovirus infections.
\\\\ Dane particles are associated with
\\\ hepatitis A virus.
\\ hepatitis B virus.
\\\ hepatitis C virus.
\\\ hepatitis E virus.
\\\\ Which of the following terms refers to the exchange of homologous segments of RNA between two
different influenza type A viruses?
\\\ Complementation
\\\ Phenotypic masking
\\ Genetic reassortment
\\\ Phenotypic mixing
\\\\ Which of the following is a virus that may cause a winter illness characterized by red blood cells in
the cerebrospinal fluid and temporal lobe dysfunction?
\\\ Coxsackie A virus

\\\ Poliovirus
\\ Herpes simplex virus
\\\ Western equine encephalomyelitis virus
\\\\ Subacute sclerosing panencephalitis is a slowly progressive, degenerative neurologic disease

associated with
\\\ herpes simplex virus infection.
\\ measles virus infection.
\\\ mumps virus infection.
\\\ varicella-zoster virus infection.
\\\\ Which of the following is a virus infection involving the presence of a noninfectious form of the
virus?
\\\ Abortive
\\ Latent
\\\ Persistent
\\\ Subclinical
\\\\ Which of the following is a virus that infects and lyses progenitor erythroid cells causing aplastic
crises in patients with hemolytic anemia?
\\\ California encephalitis virus
\\ Parvovirus B19
\\\ Epstein-Barr virus
\\\ Yellow fever virus
\\\\ Which of the following is a viral protein that is thought to induce tumors by binding to a cellular
tumor suppressor protein?
\\\ Epstein-Barr nuclear antigen proteins

\\\ Hepatitis B virus e protein
\\\ Human immunodeficiency virus gag protein
\\ Adenovirus E1A
\\\\ Antiviral nucleoside analogues
\\\ inhibit protease
\\\ inhibit replicases.
\\ are effective only against replicating viruses
\\\ may block viral penetration.
\\\\ A commercial vaccine consisting of virion subunits prepared by recombinant technology exists for
\\\ hepatitis A virus
\\ hepatitis B virus.
\\\ rabies virus.
\\\ varicella-zoster virus.
\\\\ Which of the following causes a nosocomial infection with the potential to cause serious respiratory
disease in an infant pediatric ward?
\\\ Adenovirus
\\\ Picornavirus
\\ Respiratory syncytial virus
\\\ Coxsackie A virus
\\\\ Over the last 2 weeks, a heterologous kidney transplant patient has had headaches of increasing
severity and mental lethargy. On physical examination, macronodular skin lesions are noted. The
cerebrospinal fluid (CSF) is clear, and protein and glucose concentrations are within normal levels.
Microscopic examination of CSF sediment in India ink reveals encapsulated yeasts. Which of the
following tests permits rapid confirmation of the identity of the infective organism?
\\\ Detection of specific antibodies in the CSF
\\\ Detection of cell-wall antigens in the CSF
\\ Detection of polysaccharide in the CSF
\\\ Detection of serum antibody
\\\\ Roseola (or exanthema subitum) is caused by
\\\ cytomegalovirus.
\\\ human papillomavirus.
\\ human herpesvirus 6.
\\\ human parvovirus B19.
\\\\ Which of the following viruses has an arthropod vector?
\\\ Respiratory syncytial virus
\\\ Parvovirus
\\ Bunyavirus
\\\ Parainfluenza virus
\\\\ A 16-year-old boy from a rural area presents with two highly inflammatory lesions in the bearded
area of his face. Both of the rashes are itchy, highly erythematous, sore to the touch, and spreading. The
most advanced lesion is clearing in the center, but the periphery continues to expand. Skin scrapings
from lesion margins mounted in potassium hydroxide demonstrate the presence of true hyphae and
arthroconidia. Which drug or combination is most appropriate?
\\\ Amoxicillin
\\\ Amoxicillin and clavulanate
\\\ Amphotericin B
\\ An imidazole such as itraconazole
\\\\ Pieces of plasmid or bacterial chromosomal DNA may be mistakenly packaged into the capsid (head)
of a bacterial virus. Assuming that no prophage state has existed in the phage production, what is the
process called when the virus with the bacterial or plasmid DNA infects another bacterium?
\\\ Conjugation
\\ Generalized transduction
\\\ Lysogeny
\\\ Transformation
\\\\ A 6-month-old child has had watery diarrhea for 6 days. The stools have no blood and no pus. The
causative agent is a double-stranded RNA virus. Which of the following is the most likely causative
agent?
\\\ Giardia lamblia
\\ Rotavirus
\\\ Norwalk agent
\\\ Salmonella enteritidis
\\\\ A 3-year-old child develops acute glomerulonephritis following impetigo. The bacterium is a
catalase-negative, gram-positive coccus that has M12 surface protein. What is the most likely causative
agent?
\\\ Enterococcus faecalis
\\\ Staphylococcus aureus
\\ Streptococcus pyogenes
\\\ Streptococcus agalactiae

\\\\ Which of the following has the highest association with hepatocellular carcinoma?
\\\ Acute hepatitis A infection
\\ Chronic hepatitis B infection
\\\ Epstein-Barr virus infection
\\\ Hepatitis E infection
\\\\ Which of the following factors is associated with the virulence of Yersinia pestis?
\\\ Adhesins
\\\ Exotoxins
\\ V and W antigens
\\\ X and V factors
\\\\ A neonate develops meningitis at 7 days of age. Her mother is 16 years of age, is single, has had
multiple sexual partners without barrier protection. The baby was born 23 hours after the mother's
amniotic sac ruptured. What is the most likely causative agent?
\\\ Escherichia coli
\\ Streptococcus agalactiae
\\\ Haemophilus influenzae
\\\ Neisseria meningitidis
\\\\ Which of the following viruses is a double-stranded RNA virus?
\\\ Calicivirus
\\ Reovirus
\\\ Flavivirus
\\\ Paramyxovirus
\\\\ A 19-year-old college freshman has a sore throat, sore and enlarging cervical lymph nodes, and a
fever and is greatly fatigued. A diagnosis of infectious mononucleosis is made. Which of the following
factors is present?
\\\ Delta hemagglutinin
\\\ E1A protein
\\\ Large T antigen
\\ VCA protein
\\\\ In traveler's diarrhea caused by Escherichia coli, what is responsible for the fluid and electrolyte
disruption?
\\\ Adherence causing palisade layers of the bacterium on the surface of the small intestine
\\\ Capsule
\\ Exotoxin that causes an increase in cyclic adenosine monophosphate
\\\ Invasion of the intestinal lining
\\\\ A formerly vigorous 3-month-old child has developed upper body weakness manifested by droopy
eyes and head, poor feeding, and a weak cry. Changes starting with constipation were first noticed 2
days ago. The baby is afebrile and there is no sign of rash. What is the most likely causative agent and
where is the infection?
\\\ Bacteroides species; gastrointestinal (GI) tract overgrowth
\\ Clostridium botulinum; GI tract infection
\\\ Clostridium tetani; tissue infection
\\\ Neisseria meningitidis; central nervous system infection
\\\\ A woman develops cervical carcinoma. What viral protein played a role in the development of the
carcinoma?
\\\ Large T antigen
\\\ E1A protein
\\ E6 protein
\\\ TAX protein
\\\\ What bacterial gene transfer process would be inhibited by free extracellular exonucleases?
\\\ Conjugation
\\ Transformation
\\\ Transduction
\\\ Transposition
\\\\ An alcoholic presents complaining of chest pain, fever, shaking chills, cough, and myalgia. She was
very cold 2 nights ago and says she has felt poorly ever since. Her cough is producing rust-colored,
odorless, mucoid sputum. Her temperature on admission is 40Â°C. Her white blood cell count is 16,000
cells/mm3 and is predominantly neutrophils with an overall left shift. A lancet-shaped, gram-positive
diplococcus is isolated on blood agar. What is the most likely causative agent?
\\\ Legionella pneumophila
\\ Streptococcus pneumoniae
\\\ Mycoplasma pneumoniae
\\\\ Which of the following is a nonnucleoside analogue that inhibits herpesvirus DNA?
\\\ Acyclovir
\\ Foscarnet
\\\ Amantadine
\\\ Cytarabine
\\\\ A fruit picker has developed subcutaneous nodular lesions along the lymphatics from the initial site
of trauma caused by a plum thorn puncture. What is the nature of the most likely causative agent?
\\ Dimorphic fungus
\\\ Filamentous fungus

\\\ Gram-positive coccus
\\\ Helminth
\\\\ Latent infection of neurons occurs with
\\\ measles virus.
\\ herpes simplex virus.
\\\ rabies virus.
\\\\ In June, an 18-year-old man develops a sore throat with a fever and a nonproductive cough that
develops into pneumonia with a severe, prolonged hacking cough but little sputum production.
Cryoagglutinins are present. He is treated appropriately and successfully with azithromycin. What is the
nature of the most likely causative agent?
\\\ Gram-negative coccus
\\\ DNA virus
\\\ Gram-negative rod
\\ Mycoplasma
\\\\ African sleeping sickness is transmitted by
\\\ respiratory droplets and direct mucosal contact.
\\\ mosquito bite.
\\ tsetse fly bite
\\\ sandfly bite.
\\\\ The most frequent cause of the common cold is
\\\ coronavirus.
\\\ parainfluenza virus.

\\ rhinovirus.
\\\ reovirus.
\\\\ In which of the following phases of growth is a gram-positive bacterium most susceptible to the
action of penicillin?
\\ Exponential
\\\ Stationary
\\\ Decline
\\\ Death
\\\\ Which of the following contains O antigen?
\\\ Capsule
\\\ Lipoprotein
\\ Lipopolysaccharide
\\\ Peptidoglycan
\\\\ Antivirals that inhibit viral proteases are available for
\\\ hepatitis B virus.
\\ human immunodeficiency virus.
\\\ herpes simplex virus.
\\\\ Which of the following statements about the treatment of cholera is correct?
\\\ Ciprofloxacin is critical along with fluids for recovery; clinical response is slow and the patient will
remain sick for a few weeks.
\\ Replacement of fluid and electrolytes is most important and will lead to a dramatic improvement;
antibiotics will decrease the length of disease and the period of infectivity.
\\\ Ciprofloxacin will not alter the course; replacement of fluids and electrolytes will lead to gradual
clinical improvement.
\\\ Antitoxin along with fluid and electrolytes is critical to a rapid clinical response.
\\\\ What characteristic of the influenza A virus allows genetic reassortment?
\\\ Poor editing by the RNA-dependent RNA polymerase
\\ Segmented genome
\\\ Defective chaperone proteins
\\\ Poor editing function of the reverse transcriptase
\\\\ There is an outbreak of watery diarrhea in 6 members of a party of 20 who ate at a Chinese
restaurant the day before. Fried rice is implicated. What is the most likely causative agent?
\\ Bacillus cereus
\\\ Giardia lamblia
\\\ Norwalk agent
\\\\ Which of the following phrases best describes a prophage?
\\\ Phage that lacks receptors
\\\ Phage attached to the cell wall that has released its DNA
\\ Intracellular temperate phage DNA
\\\ Newly assembled intracellular phage particle
\\\\ Which of the following terms best describes bacteria that can use fermentation pathways and
\\\ Obligate aerobe
\\ Facultative anaerobe
\\\ Obligate anaerobe
\\\ Aerobic heterotroph
\\\\ Which of the following is the most sensitive type of serologic test?
\\\ Virus neutralization
\\ Enzyme-linked immunosorbent assay
\\\ Nucleic acid hybridization
\\\ Hemadsorption
\\\\ How is primary amebic meningoencephalitis most likely acquired?
\\\ Intravenous drug abuse
\\\ Eating raw fish or seafood
\\\ Handling cat litter
\\ Diving or swimming in contaminated water
66. Which of the following is the most common organism in the human gastrointestinal tract?
(A) Bacteroides species
(B) Clostridium botulinum
(C) Clostridium difficile
(D) Clostridium perfringens
(E) Clostridium tetani
(F) Escherichia coli
View Answer
66â€“A. Bacteroides is the most common organism in the human gastrointestinal tract, greatly
outnumbering Escherichia coli, Clostridium perfringens, and Clostridium difficile, which are also part of
the normal flora of the gastrointestinal tract.
67. A Peace Corp volunteer recently returned to rural Africa develops symptoms of liver damage and a
blocked bile duct after general anesthesia. What is the nature of the most likely causative agent?
(A) Cestode
(B) Dimorphic fungus
(C) Filamentous fungus
(D) Fluke
(E) Nematode
(F) Protozoa
View Answer
67â€“E. Adult Ascaris lumbricoides is a roundworm that maintains its position in the gastrointestinal
tract by continual movement â€œupstream,â€ not by attaching. It is noted for migration into the bile
duct, gallbladder, and liver, producing severe tissue damage. This process is often exacerbated by fever,
antibiotics, and anesthetics.
(A) minimal medium.
(B) differential medium.
(C) selective medium.
(D) complex medium.
View Answer
68â€“C. A selective medium permits growth in the presence of agents that inhibit other bacteria. A
minimal medium contains the minimum quantity and number of nutrients capable of sustaining growth
of the organism. A differential medium differentiates among organisms on the basis of color due to
different fermentation or pH.
69. Which of the following statements concerning Chlamydia trachomatis is correct?
(A) It is the most common bacterial sexually transmitted disease among college populations.
(B) It is an intracellular-dwelling virus.
(C) It rarely induces the carrier state.
(D) It is a motile, single-cell animal parasite.
View Answer
69â€“A. Of the bacteria causing sexually transmitted diseases, the bacterium found most prevalently in
college-age students is Chlamydia trachomatis. It is a small, intracellular-dwelling bacterium that often
induces the carrier state. Trichomonas vaginalis is a motile, single-cell parasite.
70. Which of the following is also called an endotoxin?
(A) Capsule
(B) Lipopolysaccharide
(C) Lipoprotein
(D) Mesosome
(E) Outer membrane
(F) Peptidoglycan
View Answer
70â€“B. Endotoxin activity is associated with the lipid A component of lipopolysaccharide found in the
outer membrane of gram-negative bacteria.
71. Which of the following regions contains the greatest number of antigenic epitopes in gram-negative
bacteria?
(A) Mucopeptide
(B) Lipid A
(C) Teichoic acids
(D) O side chains
View Answer
71â€“D. O side chains contain the greatest number of antigenic epitopes in gram-negative bacteria. The
mucopeptide, lipid A, and teichoic acids are poorly antigenic because they have few antigenic epitopes.
Teichoic acids are not found in gram-negative bacteria.
72. After extensive oral surgery, a patient who had rheumatic fever as a child did not take the prescribed
perioperative prophylactic antibiotics and subsequently developed subacute infective endocarditis.
Which of the following is the most likely causative agent?
(A) Enterococcus faecalis
(B) Staphylococcus aureus
(C) Viridans streptococci

(D) Streptococcus agalactiae
(E) Streptococcus pneumoniae
(F) Streptococcus pyogenes
View Answer
72â€“C. Viridans streptococci, which are part of the normal oral flora in humans, are noted for their
ability to attach to damaged heart valves when they enter the circulation after oral surgery.
73. The number of live bacteria in a sample is best determined by
(A) turbidity measurement.
(B) viable count.
(C) dry weight.
(D) protein measurement.
View Answer
73â€“B. Turbidity, dry weight, and protein are all indirect indices of the true number of bacteria in a
sample. Even viable counts, which measure live bacteria, do not always give a true count because
bacteria may clump and aggregate, thus appearing as a single entity.
74. Which of the following maternal infections may cause congenital disease?
(A) Infectious hepatitis
(B) Measles
(C) Serum hepatitis
(D) Infectious mononucleosis
(E) Shingles
(F) German measles
View Answer
74â€“F. The rubella virus, which causes German measles, can cause a congenital rubella syndrome if the
fetus is infected during the first 10 weeks of pregnancy.
75. Which of the following statements characterizes idiotypic determinants?
(A) They are found in the crystallizable fragment of immunoglobulins.
(B) They are found on protein antigens.

(C) They can be antigenic.
(D) They are responsible for rejection of transplants.
View Answer
75â€“C. Because idiotypic determinants on antibodies contain amino acid sequences in the (Fabâ€²)2
variable regions that are unique to the respondent, they can be antigenic.
P.274
76. Which of the following would be found in the urine of a patient with multiple myeloma?
(A) Bence Jones proteins
(B) Complement components
(C) Heavy chains
(D) Crystallizable fragments
View Answer
76â€“A. The Bence Jones proteins are dimers of free light chains found in the urine of some patients
with multiple myeloma (plasma cell tumors).
77. The presence of delta antigen in a patient's serum indicates
(A) dengue virus infection.
(B) influenza B virus infection.
(C) hepatitis D virus infection.
(D) varicella-zoster virus infection.
View Answer
77â€“C. The delta antigen is a phosphoprotein involved in the replication process of hepatitis D virus.
78. Which of the following viruses causes croup?
(A) Respiratory syncytial virus
(B) Parvovirus
(C) Reovirus
(D) Parainfluenza virus
(E) Bunyavirus
(F) Arenavirus
View Answer
78â€“D. Croup, an early childhood upper respiratory tract infection, is caused by type 2 parainfluenza
viruses.
79. Which of the following medications blocks virus penetration and uncoating of influenza A virus?
(A) Acyclovir
(B) Amantadine
(C) Cytarabine
(D) Foscarnet
(E) Interferon
(F) Ribavirin
View Answer
79â€“B. Amantadine blocks the penetration and uncoating of influenza A viruses and may be used
prophylactically.
80. Which of the following virulence factors is produced by several genera of bacteria that are notable
mucosal colonizers?
(A) Elastase
(B) Hemagglutinin
(C) Immunoglobulin A protease
(D) Mucinase
View Answer
80â€“C. Colonization of mucous membranes often involves immunoglobulin A proteases.
81. Which of the following is NOT a differential medium?
(A) Eosin-methylene blue agar
(B) MacConkey agar
(C) Mueller-Hinton agar
(D) Tellurite agar

View Answer
81â€“C. Mueller-Hinton agar is widely used for drug susceptibility testing because a wide range of
organisms grow on it; however, it is not a differential medium. A differential medium allows
differentiation of two different kinds of bacteria, whereas an enrichment medium contains added
growth factors to encourage the growth of certain bacteria. A selective medium may have inhibitors to
prevent the growth of certain bacteria. Tellurite, eosin-methylene blue, and MacConkey media are all
differential media.
82. Which of the following latent infections is most likely to be activated during immunosuppression?
(B) Measles
(C) Serum hepatitis
(E) Shingles
(F) German measles
View Answer
82â€“E. Immunosuppression can cause the reactivation of varicella-zoster virus from neurons, which
results in shingles.
83. Which of the following is an infection that produces heterophil antibodies?
(A) Cytomegalovirus
(B) Epstein-Barr virus
(C) Human immunodeficiency virus
(D) St. Louis encephalitis virus
View Answer
83â€“B. Heterophil antibodies (which react with sheep erythrocytes and are the basis for the
â€œmonoâ€ spot test) are produced during most Epstein-Barr virus infections.
84. Which of the following cells is involved in recognition of antigen in the context of class II
histocompatibility antigens?
(A) CD4+ cell
(B) CD8+ cell

(C) Mature B cell
(D) Plasma cell
(E) Natural killer (NK) cell
(F) Null (K) cell
View Answer
84â€“A. CD4+ cells, or T helper cells, recognize antigen in the context of class II histocompatibility
antigens on the surface of macrophages and other antigen-presenting cells. The natural ligand for CD4 is
the class II molecule.
85. Plague is transmitted by
(A) rodent feces.
(B) respiratory droplets.
(C) tick bite.
(D) animal bite, most commonly small rodents.
View Answer
85â€“B. Plague is generally transmitted in one of two ways: either by flea bite or by respiratory droplets
from an untreated person with the pulmonary form of plague.
86. Loose bacterial surface polysaccharide plays a critical role in
(A) gonorrhea.
(B) meningitis with no underlying trauma.
(C) Mycoplasma pneumonia.
(D) pyelonephritis.
(E) urinary tract infection.
View Answer
86â€“B. For all major causative agents of meningitis that are extracellular (and these are the major
ones), the capsule (polysaccharide) is important for successful hematogenous spread to the central
nervous system; examples include Cryptococcus, meningitis-causing strains of Haemophilus influenzae
(type b capsule), Neisseria meningitidis, and Streptococcus pneumoniae. All of these causative agents
have polysaccharide capsules that allow survival in the blood stream in an immunologically naive
individual so they can reach the bloodâ€“brain barrier. The major virulence factors in urinary tract and
ascending urinary tract infections are pili or adhesions that attach to the uroepithelium. Mycoplasma
does not have a capsule.
87. The neuraminidase of the influenza B virus is inhibited by
(A) ganciclovir.
(B) ribavirin.
(C) ritonavir.
(D) zanamivir.
View Answer
87â€“D. Zanamivir is used for prophylaxis and treatment of influenza A and B virus infections. It inhibits
the neuraminidase of the virus, thereby preventing release of the virus from the cell.
88. Intracellular survival and replication are the major virulence factors rather than exotoxin production
for which of the following organisms?
(A) Cholera
(B) Diphtheria
(C) Gastroenteritis caused by enterotoxigenic Escherichia coli
(D) Pertussis
(E) Plague
View Answer
88â€“E. The virulence of Yersinia pestis does not depend on exotoxins. Instead, it depends on a variety
of other factors, the most important of which is its ability to proliferate intracellularly. Associated with
this ability and virulence are Ca2+ dependence; V and W antigens; Yersinia outer membrane proteins; F1
envelope antigen; coagulase, pesticin, and fibrinolysin production; and pigment absorption.
89. All of the following are properties of interferon-Î³ EXCEPT
(A) induction of 2â€²,5â€²-adenyl synthetase.
(B) host cellâ€“specific gene product.
(C) direct inactivation of eIF-2 (eukaryotic initiation factor-2).
(D) toxic side effects when used clinically.
View Answer
89â€“C. Interferon-Î³ does not directly inactivate eIF-2 but induces a protein kinase that phosphorylates
it, thus rendering it inactive.
P.275
90. Assuming that route and concentration of inocula are appropriate, an immune response is expected
to all of the following EXCEPT
(A) 2,4 dinitrobenzene.
(B) heterologous red blood cells.
(C) heterologous carbohydrates.
(D) heterologous enzymes.
(E) heterologous immunoglobulins.
View Answer
90â€“A. All heterologous compounds may elicit some antibody response. Dinitrobenzene is a hapten by
definition and, under normal circumstances, should not elicit an immune response.
91. Six 18-year-old women return from a recent Canadian camping trip with abdominal cramping, gas,
pain, and diarrhea that is pale, greasy, and malodorous. They drank untreated stream water on the last
2 days of the trip after losing their water filter. What is the most likely causative agent?
(A) Baylisascaris procyonis
(B) Entamoeba histolytica
(C) Giardia lamblia
(D) Norwalk agent
(E) Salmonella enteritidis
(F) Vibrio parahaemolyticus
View Answer
91â€“C. Pale, greasy, malodorous stools with malabsorption after drinking untreated stream or lake
water strongly suggests a Giardia lamblia infection. The organisms can be detected most reliably by a
fecal antigen test because they attach to the intestinal mucosa.
92. One advantage of a live, attenuated vaccine is
(A) it does not produce persistent infections.
(B) the viral strain does not revert to virulant forms.

(C) it has an unlimited shelf life.
(D) it induces a wide spectrum of antibodies.
View Answer
92â€“D. An advantage of live, attenuated vaccines is that they induce a wide spectrum of antibodies.
Disadvantages include the possible production of persistent infections, reversion to highly virulent
strains, and a limited shelf life.
93. Which of the following is an RNA tumor virus associated with the neurologic disease topical spastic
paraparesis?
(A) AKR leukemia virus
(B) Human immunodeficiency virus
(C) Human T lymphotrophic virus type 1
(D) Rous sarcoma virus
View Answer
93â€“C. Human T lymphotrophic virus type 1 causes adult acute T-cell leukemia, but is also associated
with tropical spastic paraparesis, a slowly progressive (10 or more years) neurologic disease endemic in
some areas of the Caribbean.
94. All of the following molecules are within the immunoglobulin superfamily EXCEPT
(A) T-cell receptor.
(B) immunoglobulin E.
(C) human leukocyte antigen (HLA)-A and other class I histocompatibility antigens.
(D) HLA-DR and other class II histocompatibility antigens.
(E) C4 and other class III histocompatibility antigens.
View Answer
94â€“E. Of the molecules listed, only the complement components are outside the basic structure of the
immunoglobulin superfamily.
95. All of the following statements about exotoxins are true EXCEPT
(A) they are heat stable at 100Â°C.
(B) they are produced by both gram-positive and gram-negative bacteria.

(C) they may be neutralized by antitoxins.
(D) they are proteins.
View Answer
95â€“A. Exotoxins are heat-labile proteins that are released or secreted by certain gram-positive and
gram-negative bacteria. Antitoxins are antibodies that neutralize toxins.
96. The role of macrophages in the immune response includes all of the following functions EXCEPT
(A) antigen engulfment.
(B) production of interleukin (IL)-1.
(C) production of IL-2.
(D) production of endogenous pyrogen.
(E) presentation of antigen in context of class II histocompatibility antigens.
View Answer
96â€“C. Macrophages have all of the functions listed except interleukin-2 (IL-2) production. IL-2 is
produced by activated T cells.
97. CD4 cells are involved in all of the following processes EXCEPT
(A) acting as a â€œhelper functionâ€ for B cells.
(B) processing and presenting antigens.
(C) producing and releasing interleukin-2.
(D) regulating intensity of natural killer cell and null cell activity.
(E) producing and releasing interferon-Î³.
View Answer
97â€“B. CD4 cells, or T cells, have all of the functions listed except for processing and presenting
antigens.
98. B cells can be involved in all of the following processes EXCEPT
(A) capping and internalization of antigen bound by surface immunoglobulin receptors.
(B) antigen processing and presentation.
(C) production and release of interferon-Î³.

(D) maturation to plasma cells.
(E) expression of class II histocompatibility antigens on the cell surface.
View Answer
98â€“C. B cells are not known to produce interferon-Î³.
99. What major trait does Neisseria meningitidis have that is NOT found in Neisseria gonorrhoeae?
(A) Î²-Lactamase resistance
(B) Capsular polysaccharide
(C) Inability to metabolize glucose
(D) Inability to metabolize maltose
(E) Oxidase production
View Answer
99â€“B. Neisseria meningitidis generally makes a capsule, which gonococcus (Neisseria gonorrhoeae)
does not. Both strains use glucose and produce oxidase. Meningococcus (N meningitidis) does ferment
maltose.
100. Viral transcription
(A) occurs in a specific temporal pattern for most RNA and DNA viruses.
(B) involves a virion transcriptase for negative-sense, enveloped RNA virus.
(C) occurs in the nucleus for poxviruses.
(D) may be inhibited by amantadine hydrochloride.
View Answer
100â€“B. A unique feature of negative-sense RNA virus replication is the presence of an RNA-dependent
RNA polymerase (transcriptase), which synthesizes mRNA from the viral genome.
P.276
101. Which of the following statements about children who have survived infant botulism is true?
(A) Elevated cerebrospinal fluid pressure occurs in over half of the children, resulting in some permanent
neurologic defects.
(B) Almost all of the children have some permanent neurologic defects.
(C) There is some permanent muscle weakness following recovery that, like polio, may worsen late in
life.
(D) Recovery is expected to be complete in all children who survive.
View Answer
101â€“D. The neurotoxin involved in infant botulism, unlike bacterial meningitis, does not cause
elevated cerebrospinal fluid pressure, so recovery should be complete.
102. All of the following compounds are mitogens that stimulate human T cells to proliferate EXCEPT
(A) lipopolysaccharide.
(B) concanavalin A.
(C) pokeweed mitogen.
(D) phytohemagglutinin.
View Answer
102â€“A. All of the listed compounds are T-cell mitogens except lipopolysaccharide, which is a B-cell
mitogen.
103. In addition to the â€œbull neckâ€ appearance and the pseudomembrane, symptoms of diphtheria
involve the
(A) skin (cutaneous diphtheria).
(B) kidneys.
(C) heart and nerves.
(D) liver and kidneys.
(E) ears and sinuses.
View Answer
103â€“C. Corynebacterium diphtheriae does not invade tissues; rather, the exotoxin enters the blood
stream and affects tissues, primarily the heart and nerves.
104. All of the following substances are T-independent antigens EXCEPT
(A) endotoxin.
(B) lipopolysaccharide.
(C) polymerized flagellin.

(D) phytohemagglutinin.
(E) Epstein-Barr virus.
View Answer
104â€“D. All of the listed compounds are both T-independent antigens and B-cell mitogens except for
phytohemagglutinin, which is a T-cell mitogen.
105. Subacute spongiform encephalopathy describes degenerative central nervous system diseases
caused by
(A) arbovirus.
(B) BK virus.
(C) JC virus.
(D) prions.
View Answer
105â€“D. Prion diseases cause a brain pathology described as a subacute spongiform encephalopathy
that occurs in the gray matter of the brain due to vacuolation of cells and processes and astroglial
hypertrophy and proliferation.
106. All of the following substances are mediators of immediate (type I) hypersensitivity EXCEPT
(A) histamine.
(B) anaphylatoxins.
(C) slow-reacting substance of anaphylaxis.
(D) eosinophilic chemotactic factor of anaphylaxis.
(E) kinins.
View Answer
106â€“B. Complement is not directly involved in the type I anaphylactic reaction, and the
anaphylatoxins C3a and C5a would not be mediators. Both C3a and C5a, however, do cause mast cells to
release many of the mediators important in anaphylaxis.
107. A typical antibody molecule has all of the following characteristics EXCEPT
(A) it consists of at least two identical heavy and two identical light chains.
(B) it has at least two antigen-binding sites.

(C) it has only one specificity for antigen.
(D) it is a glycosylated molecule.
(E) it has two constant domains on each of the heavy chains.
View Answer
107â€“E. There are at least three constant domains on the heavy chains of an immunoglobulin (or
antibody) molecule, and there may be as many as four (as in immunoglobulins E and M).
108. In the following pairs of organisms, which two are easiest to distinguish from each other by Gram
stain?
(A) Bacillus and Clostridium
(B) Salmonella and Shigella
(C) Haemophilus and Escherichia
(D) Corynebacterium and Lactobacillus
(E) Listeria and Proteus
View Answer
108â€“E. Listeria is a gram-positive rod, whereas Proteus is a gram-negative rod. Clostridium,

Lactobacillus, Corynebacterium, and Bacillus are all gram-positive rods, whereas Haemophilus,
Escherichia, Salmonella, and Shigella are all gram-negative rods.
109. A neonate with very low Apgar scores dies 2 hours after birth. Autopsy reveals disseminated
granulomatous lesions throughout; some are caseating, but they are not calcified. During her pregnancy,
the mother most likely had a septicemia caused by
(A) Escherichia coli.
(B) group B streptococci.
(C) Listeria monocytogenes.
(D) parvovirus B19.
(E) Toxoplasma gondii.
View Answer
109â€“C. Listeria may cause in utero infections or may infect the baby during delivery. In utero Listeria
infections are generally severe and are characterized by caseating, granulomatous lesions. Except for
Toxoplasma and parvovirus, the other organisms listed cause infections acquired during birth.
Toxoplasma usually manifests with calcified central nervous system lesions in the baby. Parvovirus B19
can cause anemia and hydrops fetalis when it crosses the placenta.
110. Which of the following cells interacts directly with antigen-presenting cells?
(A) CD4+ cell
(B) CD8+ cell
(C) Mature B cell
(D) Plasma cell
(E) Monocyteâ€“macrophage
(F) Null (K) cell
View Answer
110â€“A. CD4+ cells directly interact with antigen-presenting cells.
111. The virulence of Francisella tularensis is most highly associated with
(A) adherence.
(B) the capsule.
(C) intracellular replication.
(D) an exotoxin that inhibits protein synthesis by blocking elongation factor 2.
(E) a Shiga-like toxin.
View Answer
111â€“C. The ability of Francisella tularensis to survive intracellular killing and to replicate intracellularly
are the most important known virulence factors.
112. A 15-month-old child living in a religious community that does not vaccinate their children develops
meningitis. A gram-negative rod is seen in the cerebrospinal fluid. What is the most likely causative
agent?
(A) An enterovirus
(B) Escherichia coli
(C) Haemophilus influenzae
(D) Neisseria meningitidis
(E) Streptococcus agalactiae

View Answer
112â€“C. The only gram-negative rods are E. coli and H. influenzae. The causative agent is more likely to
be Haemophilus influenzae in this age child.
P.277
113. Following several tick bites while hiking through a wilderness park in the southeastern United
States, a 19-year-old man develops fever, sore throat, malaise, headache, nausea, and a rash on the
lower parts of both his arms and legs. When he starts feeling worse and his wrists and ankles begin to
swell, his companions take him to an emergency department. The man's temperature is 38.9Â°C. Which
of the following should be at the top of the differential diagnosis list?
(A) Epidemic typhus
(B) Lyme disease
(C) Q fever
(D) Rocky Mountain spotted fever
(E) Streptococcal pharyngitis
View Answer
113â€“D. The rash associated with Rickettsia rickettsii originates on the ankles or wrists and spreads to
all parts of the body.
114. Which of the following is a characteristic of streptococci?
(A) Gram-negative cocci usually strung in diplococci or chains
(B) Endotoxin
(C) Fimbriae
(D) Coagulase
(E) Catalase
View Answer
114â€“C. Streptococci are gram-positive organisms, so they do not possess an endotoxin. They attach to
endothelial cells via their fimbriae and associated lipoteichoic acids. They are nonmotile. They are
distinguished from staphylococci because they are catalase negative. Of the medically important
bacteria, only Staphylococcus aureus and Yersinia pestis are coagulase positive.
115. A patient with Pseudomonas aeruginosa septicemia develops shock, which is triggered by
(A) catalase.
(B) lipid A.
(C) flagella from gram-negative bacteria.
(D) O-specific polysaccharide side chain of endotoxin.
(E) teichoic acid-peptidoglycan fragments.
View Answer
115â€“B. Pseudomonas is a gram-negative organism; therefore, the patient has a gram-negative

septicemia. Endotoxic activity is associated with lipid A. No toxicity is associated with the O
polysaccharides, the flagella from gram-negative bacteria, or catalase. Teichoic acid-peptidoglycan
fragments trigger gram-positive shock.
causative agent?
(A) Aspergillus fumigatus
(B) Pseudomonas aeruginosa
(C) Staphylococcus aureus
(D) Streptococcus pyogenes
(E) Vibrio vulnificus
View Answer
116â€“B. Some strains of Pseudomonas aeruginosa produce a blue-green pigment, which is clinically
notable in burn wounds infected with Pseudomonas.
117. Which of the following viruses induces characteristic giant, multinucleated cells?
(B) Parvovirus
(C) Reovirus
(E) Bunyavirus
(F) Arenavirus
View Answer
117â€“A. Respiratory syncytial virus causes the formation of characteristic giant cells that can be
observed in nasal secretions.
118. Which of the following is a nucleoside analogue that inhibits reverse transcriptase?
(A) Acyclovir
(B) Amantadine
(C) Cytarabine
(D) Zidovudine
(E) Interferon
(F) Ribavirin
View Answer
118â€“D. Zidovudine is an analogue of thymidine, which, when converted to a triphosphate form by

cellular enzymes, inhibits reverse transcriptase in human immunodeficiency virus.
119. Infection with which of the following organisms is more often noted for the production of a
lymphocytosis rather than a mononucleosis?
(A) Epstein-Barr virus
(B) Bordetella pertussis
(C) Human immunodeficiency virus
(D) Listeria monocytogenes
View Answer
119â€“B. Bordetella pertussis is unusual among bacterial infections in that it causes a lymphocytosis. A
mononucleosis-like presentation may occur during the first year of human immunodeficiency virus
infection.
120. In which one of the following fungal scalp infections is hair loss most likely to be permanent?
(A) Anthropophilic tinea capitis
(B) Black-dot tinea capitis of adults
(C) Favus (tinea favosa)
(D) Zoophilic tinea capitis
View Answer
120â€“C. Scarring and permanent hair loss are most likely to occur with favus (tinea favosa).
121. A child presents with impetigo with bullae. A gram-positive, Î²-hemolytic, catalase-positive,
coagulase-positive coccus is isolated. Which of the following is the most likely organism?
(A) Group A streptococcus
(B) Group B streptococcus
(D) Staphylococcus epidermidis
View Answer
121â€“C. Although groups A and B streptococci and Staphylococcus aureus are Î²-hemolytic, only the
streptococci are catalase negative. Only S. aureus is both Î²-hemolytic and coagulase positive.
122. A woman who is an intravenous drug abuser and who has worked as a prostitute for the last 20
years now has an aortitis. She has no mucosal ulcerations or exanthems. Her VDRL (Venereal Disease
Research Laboratory) test is negative and her fluorescent treponemal antibody absorption test is
positive. What is the most likely diagnosis?
(A) Early primary syphilis
(B) Lyme disease
(C) Secondary syphilis
(D) Latent syphilis
(E) Tertiary syphilis
View Answer
122â€“E. The fluorescent treponemal antibody absorption (FTA-abs) test detects specific antibody and is
positive slightly earlier than the Venereal Disease Research Laboratory (VDRL) test (about 1 week
earlier); it remains positive with or without antibiotic therapy. The VDRL test detects less specific
reaginic antibodies, which sometimes decline without treatment in tertiary syphilis. Therefore, based on
the serologic data, this patient could have very early primary syphilis or untreated tertiary syphilis. With
primary syphilis one would expect some mucosal lesions instead of aortitis. Thus, the symptoms are
consistent with tertiary syphilis.
123. Which of the following infections is known to increase susceptibility to pneumonia caused by
Streptococcus pneumoniae?
(A) Epstein-Barr virus infection
(B) Haemophilus influenzae type b or d infection

(C) Influenza virus infection
(D) Mycobacterium tuberculosis infection
(E) Mycoplasma pneumoniae infection
View Answer
123â€“C. Pneumococcal pneumonia is most frequent in patients with some damage to mucociliary
elevators in the upper respiratory tracts. Antecedent measles, influenza virus infections, and alcoholism
predispose patients to pneumococcal pneumonia.
P.278
124. Which strain of Corynebacterium diphtheriae is pathogenic?
(A) Those producing the blackest colonies on tellurite medium.
(B) Those with a plasmid with tox+ genes.
(C) Those with chromosomal inv+ genes.
(D) Those lysogenized by corynebacteriophage-Î²
View Answer
124â€“D. Only toxin-producing strains of Corynebacterium diphtheriae cause diphtheria. The genes
directing the production of the toxin are located on molecules of corynebacteriophage-Î² DNA, which
may infect and lysogenize C diphtheriae causing production of the toxin. Neither plasmids nor the
chromosome contain the genes to direct the synthesis of the toxin. Repressor molecules for the tox+
gene are on the chromosome, however. Both toxigenic and nontoxigenic strains of C diphtheriae will be
gray to black on tellurite medium.
125. What is the vector for Chagas disease?
(A) Liceâ€”genus Pediculus
(B) Mites
(C) Mosquitoesâ€”genus Aedes
(D) Mosquitoesâ€”genus Anopheles
(E) Reduviid bugs
(F) Sandflies
View Answer
125â€“E. Chagas disease (South American trypanosomiasis) is transmitted by reduviid bugs that
defecate as they bite. The trypanosome is actually in the feces, which is scratched into the bite site.
Reduviid bugs are also called kissing, assassin, or cone-nosed bugs.
126. The T-cell antigen receptor is associated with which of the following characteristics?
(A) It is a monomeric immunoglobulin M.
(B) It requires free antigen for triggering.
(C) It is associated with CD4 or CD8.
(D) It is nonspecific.
View Answer
126â€“C. The T-cell antigen receptor is specific for antigen bound to an antigen-presenting cell. It is a
multicomponent molecule associated with CD3. Transmission of the signal also involves association with
major histocompatibility complex (MHC) class II molecules via CD4 and with MHC class I molecules via
CD8.
127. Which of the following cell surface markers are associated with T lymphocytes immediately before
differentiation into T helper cells and cytotoxic T cells?
(A) CD2- CD3- CD4- CD8- TCR- cell
(B) CD2+ CD3+ CD4- CD8- TCR+ cell
(C) CD2+ CD3+ CD4+ CD8- TCR+ cell
(D) CD2+ CD3+ CD4- CD8+ TCR+ cell
(E) CD2+ CD3+ CD4+ CD8+ TCR+ cell
View Answer
127â€“E. Maturing T cells have both CD4 and CD8 markers before differentiation into T helper cells
(CD4+) and cytotoxic T cells (CD8+).
128. Which of the following cells is capable of attacking a certain tumor cell spontaneously (i.e., without
prior sensitization)?
(A) Monocyteâ€“macrophage
(B) CD8+ cell
(C) Mature B cell
(D) Plasma cell

(F) Null (K) cell
View Answer
128â€“E. The natural killer (NK) cell is capable of spontaneously attacking and destroying certain tumor
cells.
129. A patient has a catheter infection. A biofilm is present on the catheter. What is the most likely
causative agent?
(C) Staphylococcus epidermidis
(F) Streptococcus viridans
View Answer
129â€“C. Staphylococcus epidermidis is noted for its ability to secrete biofilms and adhere to
intravenous lines. Streptococcus mutans (a viridans streptococci) is also noted for the production of a
dextran biofilm that adheres these organisms to dental surfaces and causes dental plaque.
130. How does Mycoplasma pneumoniae differ from Rickettsia prowazekii?
(A) It is a prokaryote.
(B) It is dimorphic.
(C) It lacks a cell wall.
(D) It has a single chromosome.
(E) It is intracellular.
View Answer
130â€“C. Both Mycoplasma pneumoniae and Rickettsia prowazekii are prokaryotic microorganisms.
However, M pneumoniae lacks a cell wall; it is extracellular.
131. Which of the following drugs induces 2,5A synthetase?
(A) Acyclovir
(B) Amantadine
(C) Cytarabine
(D) Foscarnet
(E) Interferon
(F) Ribavirin
View Answer
131â€“E. Interferon, a host-encoded glycoprotein that is produced in response to virus infection,

induces the synthesis of several antiviral proteins, including 2,5A synthetase.
132. Bacteria are protected from phagocytosis by
(A) the capsule.
(C) lipoprotein.
(D) the mesosome.
(E) the outer membrane.
(F) peptidoglycan.
View Answer
132â€“A. The capsule is a well-defined structure usually composed of polysaccharide that is external to
the cell wall and protects the bacteria from phagocytosis, prior to opsonization.
133. Stimulation of the T helper subset 1 (TH1) cell population with processed antigen and interleukin
(IL)-1 can reciprocally activate macrophages if it releases
(A) complement components.
(B) IL-2.
(C) IL-6.
(D) interferon-Î³.
View Answer
133â€“D. Of those listed, Interferon-Î³ is the only potent activator of the macrophages.
134. Which of the following viruses has a segmented, ambisense genome?

(B) Parvovirus
(C) Reovirus
(E) Bunyavirus
(F) Arenavirus
View Answer
134â€“F. The short genome RNA molecule of arenavirus is ambisenseâ€”that is, the 3â€² half has
negative sense and the 5â€² half has positive sense.
135. A patient with sickle cell anemia is most likely to have repeated septicemias with
(A) Candida albicans.
(B) nontypeable Haemophilus influenzae.
(C) Mycobacterium avium-intracellulare.
(D) Salmonella enteritidis.
(E) Staphylococcus aureus.
View Answer
135â€“D. Sickle cell anemia patients have problems with septicemias with encapsulated organisms, such
as pneumococcus and Klebsiella. Of those listed, only Salmonella enteritidis has a prominent capsule
and so is noted for causing repeated infections in sickle cell carriers. Staphylococcus aureus only rarely is
encapsulated.
P.279
136. Which of the following complement components attaches to the crystallizable fragment of
immunoglobulin M?
(A) C5b
(B) C5a
(C) C1qrs
(D) C4b2a
(E) C2b
View Answer
136â€“C. C1qrs is the functional link between antibody on a cell surface and activation of the classic
complement cascade.
137. What is the current state of epidemiology for whooping cough?
(A) Like diphtheria, pertussis has nearly been eradicated by vaccination except for 4â€“7 imported
cases/year.
(B) There are hundreds of pertussis cases/ year, but only imported or in partially vaccinated or
unvaccinated babies.
(C) There are thousands of pertussis cases/ year, but only imported or in partially vaccinated or
unvaccinated babies.
(D) There are thousands of pertussis cases/ year, some imported, some in partially vaccinated or
unvaccinated babies, and some in junior high children, and adults whose immunity has waned.
View Answer
137â€“D. Pertussis is badly underreported. Babies are born with little immunity and so are very
susceptible before complete vaccination; disease is more severe the younger the baby. Babies are
infected by older children and adults who acquire pertussis when their immunity wanes, which happens
5 years or longer after vaccination. Partial immunity generally prevents neurologic consequences and
death. Twelve to twenty percent of afebrile coughs in adults are pertussis.
138. Why does Clostridium difficile cause diarrhea?
(A) C difficile invades, surviving and causing disease in a mechanism similar to that of Listeria.
(B) C difficile invades, secreting two surface toxins inside the cells.
(C) C difficile stacks itself on the colonic surface to cause maladsorption and the appearance of a
pseudomembrane.
(D) C difficile exotoxins damage the cells, causing a disruption in transport and attracting
polymorphonuclear cells to cause the appearance of a pseudomembrane.
View Answer
138â€“D. Clostridium difficile causes the production of exotoxins, which cause diarrhea and production
of the pseudomembrane.
139. What does a zone of induration greater than 15 mm mean in interpreting a tuberculin skin test?
(A) Active infection with Mycobacterium tuberculosis
(B) Active infection with any of the nontuberculous mycobacteria

(C) Anergy
(D) Antibody titer to M tuberculosis
(E) Previous infection with M tuberculosis
(F) Vaccination with bacillus Calmette-GuÃ©rin (BCG) vaccine only
View Answer
139â€“E. The tuberculin test indicates previous infection with Mycobacterium tuberculosis or
Mycobacterium bovis from between several weeks to 5 years. It does not provide proof of current active
infection with M tuberculosis. The tuberculin test detects cell-mediated immunity and not antibody. If a
person is infected with a nontuberculous strain of mycobacteria, usually the skin test is smaller. Specific
skin tests for some of these nontuberculous strains of mycobacteria are available. Vaccination with
bacillus Calmette-GuÃ©rin (BCG) vaccine should not result in this large a zone of induration.
View Answer
140â€“F. Escherichia coli is a common causative agent of urinary tract infection. The strict anaerobes do
not cause urinary tract infections.
141. Which of the following is the most appropriate and effective method for reducing the transmission
of toxoplasmosis?
(A) Avoid intravenous drug abuse.
(B) Avoid swimming in contaminated water.
(C) Avoid using human excrement as vegetable fertilizer.
(D) Cook fish and seafood thoroughly.
(E) Heat all canned foods to 60Â°C for 10 minutes.
(F) Avoid cat litter or take proper care in changing litter.

View Answer
141â€“F. One route of spread of toxoplasmosis is through contaminated cat litter. The other is through
the ingestion of undercooked meat.
142. Which of the following statements about endogenous type C viruses is correct?
(A) They are defective viruses.
(B) They are pathogenic for their hosts.
(C) They cause tumors in their hosts.
(D) They have a provirus form.
View Answer
142â€“D. Endogenous type C viruses are retroviruses that are not pathogenic for their hosts and often
replicate when cells harboring them are placed in culture. Their genetic material exists in a provirus
form in host cells.
143. Which of the following diseases is caused by a virus that uses a reverse transcriptase during
replication?
(B) Measles
(C) Serum hepatitis
(E) Shingles
(F) German measles
View Answer
143â€“C. The hepatitis B virus, the hepadnavirus that causes serum hepatitis, uses a virus-encoded
reverse transcriptase during replication.
144. Which of the following statements regarding the clinical manifestations and consequences of
Neisseria gonorrhoeae infection is true?
(A) Pharyngeal infection is always mild and mimics viral sore throat.
(B) Dermatitis involves rash over the trunk and extremities.
(C) Ophthalmia neonatorum is always mild.

(D) Both men and women can be asymptomatic.
(E) Urethral symptoms are painless.
View Answer
144â€“D. Both men and women with Neisseria gonorrhoeae infection can be asymptomatic, thus
facilitating the spread of gonorrhea. Pharyngeal infection can be severe with manifestations similar to
those of a streptococcal sore throat. Dermatitis usually occurs as a simple pustule over the inflamed
joint. Ophthalmia neonatorum is rapidly destructive, causing blindness if untreated.
P.280
145. How is drug resistance transferred in most gram-negative bacteria?
(A) Unidirectional transfer of DNA by conjugation
(B) Conjugal exchange of the DNA from both participants in the cross (drug resistance is generally
dominant)
(C) Transformation
(D) Generalized transduction
View Answer
145â€“A. The DNA in bacterial conjugation (a single strand) goes only from the donor parent to the
recipient and not vice versa. Conjugation requires a series of genes (e.g., conjugal DNA metabolism, sex
pili) and is the major mechanism of transfer in gram-negative bacteria. Transduction is a major
mechanism in the transfer of Staphylococcus aureus drug resistance.
146. An 18-year-old Iowan dirt bike racer, who recently raced for the first time in the desert south west,
presents in September with cough, malaise, low-grade fever, myalgias, and chest pain. Rales are heard
and respiratory infiltrates are noted on radiograph. Sputum stained with calcofluor white and viewed on
an ultraviolet microscope shows large blue-white fluorescing spherical structures with round cells inside.
What is the most likely causative agent?
(A) Candida albicans
(B) Coccidioides immitis
(C) Histoplasma capsulatum
(D) Influenza virus type A
(E) Mycoplasma pneumoniae
(F) Streptococcus pneumoniae

View Answer
146â€“B. The causative agent can only be Coccidioides immitis from the description of the spherules and
endospores in the sputum along with the huge potential for exposure in a person new to the endemic
area. Without the results of the microscopic examination it possibly could have been Histoplasma
capsulatum pneumonia since he is from Iowa, but it is unlikely and no exposure was given for bird or bat
guano. The patient is the right age-group for Mycoplasma pneumonia, but again the microscopic exam
points instead to Coccidioides.
147. Which of the following cells is involved in antigen processing and presentation?
(A) CD4+ cell
(B) CD8+ cell
(C) Mature B cell
(D) Monocyteâ€“macrophage
(E) Plasma cell
(F) Null (K) cell
View Answer
147â€“D. The monocyteâ€“macrophage is the classic example of an antigen-presenting cell (APC). Other
macrophage-like cells (e.g., Kupffer's cells, Langerhans' cells of the skin) probably share this APC
function.
148. A patient presents with explosive, watery, noninflammatory diarrhea along with headache,
abdominal cramps, nausea, vomiting, and fever. Symptoms began the day after eating raw oysters in
August. What is the most likely causative agent?
(A) Giardia lamblia
(B) Norwalk agent
(C) Rotavirus
(D) Salmonella enteritidis
(E) Staphylococcus aureus
View Answer
148â€“F. Vibrio parahaemolyticus is the most likely causative agent. It is found in raw oysters from
contaminated oyster beds, usually in late summer.
149. A tuberculosis patient who is also human immunodeficiency virus (HIV) positive has a CD4+ count of
60 because he is inconsistent in taking any medication. He also has small sites of dissemination
throughout his body. What was the most likely route of dissemination?
(A) Blood stream
(B) Nerves
(C) Contiguous spread through the tissues
(D) Lymphatics
View Answer
149â€“A. The description fits miliary tuberculosis, which results from hematogenous spread of
Mycobacterium tuberculosis.
150. A 28-year-old homosexual man is seen with a solitary indurated penile ulcer with fairly clean
margins, no obvious raised granulomatous areas, and no discoloration. He reports that it began as a
hard nodule and that it is not painful. Regional lymphadenopathy is noted. What is the most likely
causative agent?
(A) Haemophilus ducreyi
(B) Herpes simplex virus type 2
(C) Histoplasma capsulatum
(D) Human papillomavirus, serotype 11
(E) Neisseria gonorrhoeae
(G) Treponema pallidum
View Answer
150â€“G. Only Treponema pallidum and Haemophilus ducreyi produce nodular penile lesions that
ulcerate. Major clues leading to the diagnosis of T pallidum are the hard nodule or chancre and the lack
of pain. H ducreyi produces soft, painful chancres. Histoplasma capsulatum produces mucous
membrane ulcerations, generally in compromised patients who have disseminated infections. Human
papillomavirus produces warts that do not ulcerate. Herpes simplex virus type 2 would have nerve pain
associated with it. Neisseria gonorrhoeae generally causes urethritis with an exudate. Group A
streptococci cause impetigo, which is not nodular.
151. A 3-year-old girl presents with a temperature of 38.2Â°C, a sore throat, difficulty swallowing, and
vomiting. Examination reveals that the soft palate and posterior oral cavity are reddened with vesicular
lesions. No tonsillar abscess or exudate is seen. The epiglottis is not swollen. She is fully vaccinated. The
test for cell-wall carbohydrate is negative. Blood and Thayer-Martin agar cultures have been set up.
(A) Coxsackievirus type A
(B) Haemophilus influenzae
(C) Mycoplasma pneumoniae
(E) Streptococcus pyogenes
View Answer
151â€“A. Symptoms of coxsackievirus herpangina include sore throat, such as that caused by
Streptococcus; however, vesicular lesions are present on the soft palate, and tonsillar abscesses are not
seen. Generally, the patient's temperature is lower in herpangina, and no left shift is noted in a white
blood cell count. Epiglottitis caused by Haemophilus influenzae is not likely in a vaccinated child.
Mycoplasma does cause sore throat but is not associated with vomiting or difficulty swallowing and
would not manifest as vesicular lesions. Neisseria meningitidis also is less likely because of the vesicles.
152. A 7-year-old boy is seen with malaise, fever, sore throat, and swelling of both ankles and wrists. He
has a macular rash that began on his hands and feet (including his palms and soles) and is progressing
inward. A wood tick (Dermacentor) was removed 6 days earlier after his return from scout camp in
Tennessee. What is the most likely causative agent?
(A) Borrelia burgdorferi
(B) Coxsackievirus type A
(C) Francisella tularensis
(E) Rickettsia prowazekii
(F) Rickettsia rickettsii
View Answer
152â€“F. Several organisms produce exanthems. The tick, the locale (southeastern United States), the
wrist and ankle swelling, the macular nature of the rash, and the progression of the rash are most
suggestive of Rocky Mountain spotted fever caused by Rickettsia rickettsii. Borrelia is generally spread
by the Ixodes tick; vasculitis is not prominent and the rash spreads in a somewhat circular pattern.
Francisella may be spread by ticks, but generally results in an ulcer at the tick site and is not associated
with a rash.
153. Which of the following diseases is associated with the delta agent?
(B) Measles
(C) Serum hepatitis
(E) Shingles
(F) German measles
View Answer
153â€“C. The delta agent, a defective virus, causes a more severe form of serum hepatitis than that
observed with hepatitis B virus alone.
P.281
154. Which of the following is a regulatory gene of human T-cell lymphotropic virus I (HTLV-I) that
transactivates transcription?
(A) Delta hemagglutinin
(B) E1A protein
(C) Large T antigen
(D) TAT protein
(E) VCA protein
(F) TAX protein
View Answer
154â€“F. TAX protein is a human T-cell lymphotropic virus I (HTLV-I) transcriptional activator thought to
be involved in cellular transformation.
155. Which of the following viruses has an oncogene that codes for a guanine-nucleotideâ€“binding
protein?
(A) Mouse mammary tumor virus
(B) Rous sarcoma virus
(C) Polyomavirus
(D) Human T lymphotrophic virus

(E) Hepatitis B virus
(F) Harvey sarcoma virus
View Answer
155â€“F. The ras gene of the Harvey sarcoma virus codes for a guanine-nucleotideâ€“binding protein,
which has biologic activity that causes cellular transformation.
156. Î²-Lactamase production is a major problem in which one of the following organisms?
(A) Corynebacterium diphtheriae
(B) Neisseria meningitidis
(C) Methicillin-sensitive Staphylococcus aureus
(D) Treponema pallidum
View Answer
156â€“C. Production of Î²-lactamases had become a major problem in Staphylococcus aureus, so

nafcillin and methicillin were developed. Now, due to the mutation of penicillin-binding proteins, many
methicillin-sensitive S. aureus have become resistant to those compounds. Because there is little Î²-
lactam resistance of any kind, penicillin G and erythromycin are the accepted drugs of choice (along with
antitoxin) for Corynebacterium diphtheriae infections. Penicillin G is the drug of choice for both
Treponema pallidum and Neisseria meningitidis, but rare resistant strains of N. meningitidis are
beginning to appear.
157. Which of the following viruses lacks a functional virogene?
(C) Polyomavirus
View Answer
157â€“F. Harvey sarcoma virus, like most viruses with high oncogenic potential, is a defective virus that
lacks at least one functional virogene.
158. Which of the following complement components is most closely related to C3 convertase?
(A) C5b
(B) C5a
(C) C1qrs
(D) C4b2a
(E) C2b
View Answer
158â€“D. The C4b2a moiety, formed sequentially after the attachment of C1 to antibody, will cleave C3
and is thus called C3 convertase.
159. How can you reduce your chances of acquiring Vibrio parahaemolyticus illness?
(F) Wear shoes outside in endemic regions.
View Answer
159â€“D. Vibrio parahaemolyticus is a marine organism that is transmitted through ingestion of raw or
undercooked seafood.
160. Which of the following cells has surface immunoglobulin M and surface immunoglobulin D?
(A) CD4+ cell
(B) CD8+ cell
(C) Mature B cell
(D) Plasma cell
(F) Null (K) cell
View Answer
160â€“C. Possession of multiple classes of surface immunoglobulin is a hallmark of the mature B cell.
This cell can be driven to plasma cell formation and subsequent antibody secretion by exposure to the
appropriate antigen.
161. Which of the following viruses is a type B RNA tumor virus?
(C) Polyomavirus
View Answer
161â€“A. Mouse mammary tumor virus (the Bittner virus) is a type B RNA tumor virus.
(A) Tetracycline
(B) Cephalosporin
(C) Streptomycin
(D) Erythromycin
(E) Griseofulvin
(F) Bacitracin
View Answer
162â€“C. Streptomycin binds to the 30S ribosomal subunit, thereby causing misreading of mRNA.
(A) Amphotericin B
(B) Chloramphenicol
(C) Econazole
(D) Griseofulvin
(E) Itraconazole
(F) Nystatin
View Answer
163â€“A. Both amphotericin B and nystatin are fungicidal, but nystatin is not used for systemic
infections.
(A) Damage to the membrane
(B) Inhibition of DNA gyrase
(C) Inhibition of mycolic acid synthesis
(D) Binding to 30S ribosome
(E) Binding to 50S ribosome
View Answer
164â€“D. Aminoglycosides are bactericidal for many aerobic gram-negative bacteria.
165. How is Borrelia burgdorferi transmitted?
(B) Mites
(E) Ticksâ€”genus Dermacentor
(F) Ticksâ€”genus Ixodes
View Answer
165â€“F. Borrelia burgdorferi causes Lyme disease. The reservoirs are deer and white-footed mice. The
vector carrying the bacterium to humans and dogs is the Ixodes tick.
P.282
166. Which of the following infections is a cofactor in Burkitt's lymphoma?
(A) Cytomegalovirus infection
(B) Hepatitis A virus infection
(C) Hepatitis B virus infection

(D) Influenza virus type A infection
(E) Mycoplasma pneumoniae infection
(F) Epstein-Barr virus infection
View Answer
166â€“F. Antecedent Epstein-Barr virus infection in a malarial region is associated with Burkitt's
lymphoma.
167. After a trip to Peru to adopt a 6-month-old baby, a 32-year-old woman and her new baby both
develop profuse, watery diarrhea with flecks of mucus. Both are hospitalized because of the severity and
rapidity of the dehydration, but neither one is febrile. What is the most likely causative agent?
(A) Campylobacter jejuni
(B) Escherichia coli O157
(C) Salmonella typhi
(D) Vibrio cholerae
(E) Vibrio parahaemolyticus
View Answer
167â€“D. The mention of Peru should raise suspicion of cholera. (Rotavirus would have to be ruled out
for the baby, but it is not one of the choices.) The loss of fluids and electrolytes is rapid and most severe
with Vibrio cholerae. The lack of fever and lack of pus and blood in the stools suggests that the causative
agent is not Campylobacter or Salmonella. The lack of blood also decreases the chance of Escherichia
coli O157. If untreated, cholera may lead to dehydration, hemoconcentration, and hypovolemic shock.
168. What is the nonvertebrate host for the plasmodia?
(B) Mites
(E) Tsetse fly
(F) Sandflies
View Answer
168â€“D. Malaria is spread by the Anopheles mosquito, which is also the definitive host.
169. A 45-year-old man has mental degeneration after a prolonged but inapparent infection. At autopsy,
a subacute spongiform encephalopathy is found. What is the nature of the most likely causative agent?
(A) Acid-fast organism
(B) Dimorphic fungus
(C) DNA virus
(D) Viroid
(E) Prion
View Answer
169â€“E. Creutzfeldt-Jakob disease is an unconventional slow virus, or prion disease.
170. Which of the following genetic mechanisms is responsible for the conversion of nontoxigenic
strains of Corynebacterium diphtheriae to toxigenic strains?
(A) Lysogenic phage conversion
(B) In vivo transformation
(C) Reciprocal genetic recombination
(D) Conjugation
View Answer
170â€“A. A toxigenic strain of Corynebacterium diphtheriae is produced as a result of lysogenic phage

conversion after a temperate bacteriophage infects a nontoxigenic strain of the organism.
171. Which of the following cell surface markers are associated with cytotoxic T cells?
(A) CD2- CD3- CD4- CD8- TCR- cell
(B) CD2+ CD3+ CD4- CD8- TCR+ cell
(C) CD2+ CD3+ CD4+ CD8- TCR+ cell
(D) CD2+ CD3+ CD4- CD8+ TCR+ cell
(E) CD2+ CD3+ CD4+ CD8+ TCR+ cell
View Answer
171â€“D. A cytotoxic T cell would have all of the listed markers except for CD4.
172. Which of the following agents oxidizes proteins?

(A) Alcohols
(B) Chloroform
(C) Detergents
(D) Ethylene oxide
(E) Iodine
View Answer
172â€“E. The organic solvents and detergents primarily disrupt the membrane; detergents also
physically remove microorganisms. Ethylene oxide alkylates proteins while iodine is an oxidizing agent
(as is chlorine).
173. What is the first event in a patient who ultimately develops Neisseria meningitidis meningitis?
(A) Crossing the bloodâ€“brain barrier
(B) Meningococcemia
(C) Skin lesions
(D) Upper respiratory colonization
(E) Waterhouse-Friderichsen syndrome
(F) Traumatic implantation directly into the brain
View Answer
173â€“D. Neisseria meningitidis is an immunoglobulin A protease producer with a capsule; these

virulence factors play a role in the upper respiratory colonization that is followed by invasion of the
blood stream and that precedes meningitis. Skin lesions develop from overproduction of outer
membrane, which is excreted without being incorporated causing endotoxin shock and petechiae which
progress to frank purpura. Waterhouse-Friderichsen syndrome is late and occurs when the adrenal
glands are involved.
174. In a high-frequency recombination (Hfr) cross with an F- bacterial cell, each having a single DNA
molecule, what is the most likely outcome?
(A) Bacterial genes will be transferred from the Hfr cell to the F- cell, but there will be no change in the
â€œsexâ€ of either cell.
(B) Some genes will be transferred and the recipient cell will become Hfr.
(C) Only plasmid genes will be transferred.
(D) Each cell may acquire genes from the other.

View Answer
174â€“A. The donor cell, which transfers part of one of the two strands of its DNA, will duplicate any
areas of single-stranded DNA and so will not change genotype, including its â€œmaleness.â€ Only a
portion of the integrated fertility factor and some bacterial genes on that strand of DNA will be
transferred, so the recipient cell may pick up some new bacterial genes. But because the last thing to be
transferred in would be the rest of the fertility factor, the cell almost never becomes Hfr.
175. A patient with acquired immunodeficiency syndrome has severe, nonresolving diarrhea. Acid-fast
oocysts are seen in the stools, which are not gray and greasy. What is the most likely causative agent?
(A) Cryptococcus
(B) Cryptosporidium
(C) Enterotoxic Escherichia coli
(D) Giardia
(E) Salmonella
(F) Enterohemorrhagic E coli
View Answer
175â€“B. Acid-fast oocysts are seen in infections with Cryptosporidium, a protozoan that causes severe,
nonresolving diarrhea in patients with acquired immunodeficiency syndrome. In general, the bacterial
causative agents are more responsive to treatment.
176. Which of the following cells is involved in the recognition of antigen in the context of class I
histocompatibility antigens?
(A) CD4+ cell
(B) CD8+ cell
(C) Mature B cell
(D) Plasma cell
(F) Null (K) cell
View Answer
176â€“B. CD8+ cells, or cytotoxic T cells, recognize antigen in the context of class I histocompatibility
antigens on the surface of all nucleated cells. The natural ligand for CD8 is the class I molecule.
P.283
177. At their proper levels, which of the following agents would be most effective in inactivating a naked
capsid virus on a surface (e.g., a countertop) or for surface disinfection of a stethoscope?
(A) Chlorine
(B) Chloroform
(C) Detergents
(D) Ethylene oxide
View Answer
177â€“A. The organic solvents will not be effective in this situation. Ethylene oxide as a toxic explosive
gas is not used for open surface contamination. Diluted household chlorine (1:5) is effective.
178. Cellulitis develops in a 26-year-old man after he is bitten by his girlfriend's unvaccinated cat. What
is the most likely dominant organism involved in the infection?
(A) Bartonella (Rochalimaea) henselae
(B) Calymmatobacterium granulomatis
(C) Pasteurella multocida
(D) Toxoplasma gondii
View Answer
178â€“C. Cat bites are most commonly a mixed infection with Pasteurella multocida as the dominant
organism. Bartonella (Rochalimaea) henselae is involved in cat scratch fever.
\\\\ A biology graduate student who recently visited a tropical region of Africa presents with new visual
impairment and the sensation that something is moving in her eye. She tells you that she is concerned
because she had been warned about eye disease transmitted by black flies. When in Africa, she was in a
river area, and despite her best efforts she received a lot of black fly bites. She also has some
subcutaneous nodules. If her infection was acquired by black fly bite, what is the most likely causative
agent?
\\\ Ancylostoma braziliense
\\\ Dracunculus medinensis
\\ Onchocerca volvulus
\\\ Wuchereria bancrofti

\\\\ A surgical patient who imports food from Mexico, and so spends several months each year in rural
Mexico, returns several days after her mastectomy with signs of acute appendicitis. When her appendix
is removed it is found to contain a light-colored, 20.5-cm long roundworm and bile-stained, knobby eggs
consistent with Ascaris. How did she acquire this infection?
\\\ Ingestion of water containing filariform larvae
\\ Ingestion of food contaminated with the eggs
\\\ Skin penetration by filariform larvae
\\\ Inhalation of dust carrying the cysts
\\\\ A patient whose major source of protein is smoked and cooked fish develops what appears to be
pernicious anemia. What parasite is noted for causing a look-alike vitamin B12 anemia in certain
genetically predisposed infected individuals?
\\\ Echinococcus granulosus
\\\ Hymenolepis nana
\\\ Dipylidium caninum
\\ Diphyllobothrium latum
\\\\ Which of the following protozoans is free living and acquisition does not generally indicate fecal
contamination?
\\\ Dientamoeba fragilis
\\\ Entamoeba histolytica
\\ Acanthamoeba
\\\ Giardia
\\\\ What is the most likely reason for a chloroquine-treated case of Plasmodium vivax relapsing?
\\\ P vivax has a significant level of chloroquine resistance.
\\\ P vivax has a persistent erythrocytic stage.

\\ P vivax has a persistent exoerythrocytic stage (hypnozoite).
\\\ Chloroquine is not one of the drugs of choice.
\\\\ How is Leishmania donovani transmitted?
\\\ Anopheles mosquito bite
\\\ Black fly bite
\\ Sandfly bite
\\\ Skin penetration by trauma
\\\\ How is Schistosoma haematobium transmitted?
\\\ Ingestion of raw or undercooked snail, frog, or snake
\\\ Invasion of filariform larvae from soil
\\\ Handling aquatic birds
\\ Standing or swimming in contaminated water
\\\\ An untreated human immunodeficiency virus (HIV)-positive patient (CD4+ count = 180 cells/mm3)
from southern California has developed progressively severe headache and mental confusion, along
with ataxia and retinochoroiditis. Focal lesions are present on a computed tomography scan of his brain.
No mucocutaneous lesions are found. He has been living under a bridge for the last 2 years. His level of
immunoglobulin G to the infectious agent is high. What is the most likely explanation for how this
current infection started?
\\\ Earlier exposure to pigeons
\\ Reactivation of bradyzoites in cysts from an earlier infection
\\\ Recent exposure to cat feces
\\\ Recent exposure to bats
\\\\ Which of the following is the tapeworm acquired from eating undercooked pork?
\\\ Dipylidium spp

\\ Taenia solium
\\\ Echinococcus granulosus
\\\ Taenia saginata
\\\\ What roundworm is most likely to be transmitted by ingestion of food or water contaminated with
feces?
\\ Ascaris lumbricoides
\\\ Enterobius vermicularis
\\\ Taenia saginata
\\\ Toxocara canis
\\\\ What roundworm is transmitted by filariform larvae that are found in the soil and penetrate the
skin?
\\\ Dracunculus medinensis
\\\ Enterobius vermicularis
\\ Strongyloides stercoralis
\\\ Toxocara canis
\\\\ A rural subsistence farmer from Brazil died of heart failure. His autopsy showed a greatly enlarged
heart. What was the most likely vector for the most likely infectious agent that may have been
responsible for his death?
\\\ Mosquito
\\ Reduviid bug
\\\ Sandfly
\\\ Tsetse fly
\\\\ Which of the following protozoans is transmitted primarily by the motile trophozoite form?
\\\ Balantidium coli

\\ Trichomonas vaginalis
\\\ Entamoeba histolytica
\\\ Giardia lamblia
\\\\ Which of the following toxins has phospholipase C activity?
\\\ Escherichia coli heat-labile toxin
\\\ Clostridium tetani exotoxin
\\\ Corynebacterium diphtheriae exotoxin
\\ Clostridium perfringens toxin
\\\\ What type of phage is used in phage-typing?
\\\ Prophage
\\ Virulent phage
\\\ Temperate phage
\\\ Filamentous phage
\\\\ Which of the following enzymes would be most likely to affect sugar transport into bacteria?
\\\ Acetyltransferase
\\ Phosphotransferase
\\\ Neuraminidase
\\\ Oxidase
\\\\ Polymers of N-acetylglucosamine and N-acetylmuramic acid are found in which one of the following
chemical structures?
\\\ Teichoic acid

\\ Cell wall
\\\ Glycocalyx
\\\ Lipopolysaccharide
\\\\ What type of phage is not inactivated by proteases?
\\\ Virulent phage
\\\ Temperate phage
\\ Prophage
\\\\ What type of bacteria synthesize organic compounds from inorganic compounds?
\\\ Heterotrophs
\\ Autotrophs
\\\ Obligate anaerobes
\\\ Aerobes
\\\\ Which of the following microorganisms is dimorphic?
\\\ Viruses
\\\ Prions
\\\ Bacteria
\\ Fungi
\\\\ Which of the following bacterial structures is most involved in adherence?
\\\ Capsule
\\\ Lipopolysaccharide
\\ Ordinary pili
\\\ O-specific side chain
\\\\ Which of the following toxins acts on synaptosomes?
\\\ Escherichia coli heat-labile toxin
\\ Clostridium tetani exotoxin
\\\ Pseudomonas aeruginosa exotoxin
\\\\ Which one of the following statements applies to bacteria that contain superoxide dismutase?
\\\ Need superoxide to grow
\\\ Grow slowly in the presence of CO2
\\ Produce hydrogen peroxide from hydrogen ion and the superoxide free radical (O2-)
\\\ Are frequently obligate anaerobes
\\\\ Which of the following statements describes lysogenic phage conversion?
\\\ The transformation of a virulent phage to a lysogenic phage
\\\ The conversion of a prophage to a temperate phage
\\\ The incorporation of a prophage into the bacterial chromosome
\\ A change in bacterial phenotype due to the presence of a prophage
\\\\ Which of the following microorganisms may be inactivated by RNases with endonuclease activity?
\\\ Viruses
\\ Viroids
\\\ Fungi
\\\ Prions
\\\\ Which of the following types of media would best be used to isolate bacteria capable of growth in a
high-salt concentration?
\\\ Minimal growth media
\\\ Complex growth media
\\ Selective growth media
\\\ Differential growth media
\\\\ Which of the following characteristics applies to bacteriostatic antibiotics?
\\\ Are effective when used in combination with bactericidal antibiotics to obtain a synergistic effect
\\\ Include all the antimetabolites
\\\ Are effective against bacteria in all phases of growth
\\ Include some broad-spectrum antibiotics
\\\\ What type of phage is exemplified by the lambda phage?
\\\ Prophage
\\ Temperate phage
\\\ Virulent phage
\\\\ Which of the following statements concerning prokaryotic cells is true?
\\\ They have processed mRNAs.
\\\ They generally have exons and introns.
\\\ They transfer secretory proteins into the Golgi apparatus before secretion.
\\ They have coupled transcription and translation.
\\\\ What type of bacteria lack superoxide dismutase?

\\\ Heterotrophs
\\\ Aerobes
\\\ Facultative anaerobes
\\ Obligate anaerobes
\\\\ Which of the following statements applies to the regulation of enzyme activity in bacterial cells?
\\\ Can be controlled by a catabolite activator protein
\\ Can be coupled to the binding of effector molecules
\\\ May occur via attenuation sequences
\\\ Can involve inducer molecules
\\\\ The plasma membrane
\\ contains the enzymes involved in bacterial oxidative phosphorylation.
\\\ contains matrix porins.
\\\ includes endotoxin.
\\\ contains glycocalyx.
\\\\ Which of the following microorganisms has a nuclear membrane?
\\\ Viruses
\\\ Prions
\\\ Bacteria
\\ Fungi
\\\\ Which of the following toxins induces electrolyte loss as a result of overproduction of cyclic
\\\ Clostridium tetani exotoxin

\\ Escherichia coli heat-labile toxin
\\\ Pseudomonas aeruginosa exotoxin
\\\\ Bacterial antibiotic resistance is frequently conveyed by
\\ an R factor plasmid.
\\\ a replicon.
\\\ a lytic bacteriophage.
\\\ an intron.
\\\\ The expression of the lac operon
\\\ must be initiated by the binding of an inducer protein.
\\ necessitates the finding of RNA polymerase followed by transcription.
\\\ involves the release of allolactose from a repressor protein.
\\\ does not involve the expression of structural genes.
\\\\ Which of the following requires cellâ€“cell contact?
\\\ Transformation
\\\ Transduction
\\ Conjugation
\\\\ Recombination
\\\\ Which of the following is mediated by a bacteriophage that carries host-cell DNA?
\\\ Transformation
\\\ Transcription
\\\ Conjugation
\\ Transduction
\\\\ Which of the following involves exchange of allelic forms of genes?
\\\ Transformation
\\\ Conjugation
\\ Recombination
\\\ Transcription
\\\\ Which of the following involves synthesis of RNA from a DNA template?
\\\ Transformation
\\\ Conjugation
\\ Transcription
\\\ Translation
\\\\ Which of the following creates high-frequency recombination donors?
\\\ Conjugation
\\ Recombination
\\\ Transduction
\\\ Transcription
\\\\ A patient presents with paranasal swelling and bloody exudate from both his eyes and nares, and he
is nearly comatose. What is the most likely compromising condition underlying this infection caused by
Rhizopus, Mucor, or Absidia (phylum Zygomycota, class Phycomycetes)?
\\\ AIDS
\\ Ketoacidotic diabetes
\\\ B-cell defects
\\\ Chronic sinusitis
\\\\ What type of fungal skin lesions would show only hyphae and possible arthroconidia in a biopsy?
\\\ Blastomycosis (disseminated)
\\ Dermatophytosis (tinea pedis)
\\\ Coccidioidomycosis
\\\Pityriasis versicolor
\\\\ A severely neutropenic patient presents with pneumonia. Bronchial alveolar fluid shows
dichotomously branching (generally with acute angles), septate hyphae. What is the most likely
causative agent?
\\\ Cryptococcus
\\\ Candida
\\ Aspergillus
\\\ Rhizopus
\\\\ What is a mass of fungal filaments called?
\\\ Pseudohypha
\\ Mycelium
\\\ Septum
\\\ Yeast
\\\\ A premature infant on intravenous nutrients and high-lipid fluids has developed a septicemia that
cultures out on blood agar only when overlaid with sterile olive oil. What is the most likely causative
agent?
\\\ Aspergillus
\\\ Candida
\\ Malassezia
\\\ Sporothrix
\\\\ A filamentous fungus subunit is a
\\\ coenocyte.
\\\ mycelium.
\\ hypha.
\\\ septum.
\\\\ Which of the following oral antifungal agents inhibits microtubule formation and may be used to
treat dermatophytic infections?
\\\ Amphotericin B
\\ Griseofulvin
\\\ Miconazole
\\\ Nystatin
\\\\ A 15-year-old dirt biker has pneumonia caused by an organism whose environmental form consists
of hyphae that break up into arthroconidia, which become airborne. What is the agent?
\\\ Aspergillus fumigatus
\\ Coccidioides immitis
\\\ Histoplasma capsulatum
\\\ Sporothrix schenckii

\\\\ Which of the following inhibits ergosterol synthesis, is important in treating Candida fungemias, and
is used orally to suppress relapses of cryptococcal meningitis in AIDS patients?
\\ Fluconazole
\\\ Griseofulvin
\\\ Miconazole
\\\ Nystatin
\\\\ A patient has splotchy hypopigmentation on the chest and back with only slight itchiness. What is
most likely to be seen on a potassium hydroxide (KOH) mount of the skin scraping?
\\\ Yeasts, pseudohyphae, and true hyphae
\\ Clusters of round fungal cells with short, curved, septate hyphae
\\\ Darkly pigmented, round cells with sharp interior septations
\\\ Cigar-shaped yeasts
\\\\ A patient has a dry, scaly, erythematous penis. Skin scales stained with calcofluor white show
fluorescent blue-white yeasts and a few pseudohyphae. What is the causative agent of this
dermatophytic look-alike?
\\\ Trichosporon
\\ Candida
\\\ Malassezia
\\\ Microsporum
\\\\ A recent immigrant from rural Brazil presents with a swollen face and extremely poor dental
hygiene, including loss of an adult tooth, which appears to be the focus of the current infection. There
are two open ulcers on the outside of the swollen cheek. Small yellow grains are seen in one of the
ulcers. Gram stain shows purple-staining fine filaments. What is the most likely disease?
\\\ Chromomycosis
\\\ Eumycotic mycetoma
\\ Actinomycotic mycetoma
\\\ Sporotrichosis
\\\\ A patient who is a recent immigrant from a tropical, remote, rural area with no medical care is now
working with a group of migrant crop harvesters. He has a large, raised, colored, cauliflower-like ankle
lesion. Darkly pigmented, yeast-like sclerotic bodies are seen in the tissue biopsy. Which of the following
is the most likely diagnosis?
\\\ Actinomycotic mycetoma
\\ Chromoblastomycosis
\\\ Sporotrichosis
\\\ Tinea nigra
\\\\ A premature baby, now 4 days old, has developed a white coating on her buccal mucosa extending
onto her lips. It appears to be painful. What is the most likely causative agent?
\\\ Actinomyces
\\ Candida
\\\ Fusobacterium
\\\ Microsporum
\\\\ Which of the following is a polyene antifungal agent used for many life-threatening fungal
infections?
\\\ Griseofulvin
\\\ Itraconazole
\\\ Miconazole
\\ Amphotericin B
\\\\ A logger undergoing chemotherapy for cancer has developed pneumonia and skin lesions. Biopsy of
the skin lesions demonstrates the presence of large yeasts with thick cell walls and broad-based buds.

\\ Blastomyces dermatitidis
\\\ Coccidioides immitis
\\\ Histoplasma capsulatum
\\\\ What is the scientific name for a fungal cross-wall?
\\\ Coenocyte
\\\ Hypha
\\\ Mycelium
\\ Septum
\\\\ An uncooperative human immunodeficiency virus (HIV)-positive patient has been complaining of a
stiff neck and a severe headache. The headache was initially lessened by analgesics, but the analgesics
are no longer effective. His current CD4+ count is 180/mm3. He is not on any prophylactic drugs. What is
the most likely causative agent?
\\ Cryptococcus
\\\ Candida
\\\ Malassezia
\\\ Aspergillus
\\\\ What characteristically sets fungal cells apart from human cells?
\\\ Presence of an endoplasmic reticulum
\\ Ergosterol as the major membrane sterol
\\\ Enzymes that allow them to use carbon dioxide as their sole carbon source
\\\ Presence of chloroplasts
\\\\ Which of the following organisms is anaerobic?
\\\ Nocardia
\\ Actinomyces
\\\ Mycobacteria
\\\ Streptococcus
\\\\ Which of the following organisms spreads through inhalation of infected dust?
\\\ Rickettsia akari
\\\ Rickettsia typhi
\\\ Rickettsia rickettsii
\\ Coxiella burnetii
\\\\ Which of the following statements about clinical manifestations of Haemophilus influenzae is
incorrect:
\\\ severe central nervous system deficits occur in one-third of recovered meningitis patients.
\\\ pus production is typical.
\\ acute bacterial epiglottitis is a mild disease in children.
\\\ pneumonia is a complication usually seen in children or the aged.
\\\\. Exotoxin A most closely resembles the action of which of the following?
\\\ Shiga toxin
\\ Diphtheria toxin
\\\ Vibrio cholerae toxin
\\\ Verotoxin
\\\\ Of the following components of Mycobacterium tuberculosis, which one promotes intracellular
survival by inhibiting phagosomeâ€“lysosome fusion?
\\\ Cord factor
\\\ Mycolic acid

\\\ Purified protein derivative (PPD)
\\ Sulfatides
\\\\ What is the most likely causative agent of gastroenteritis starting on day 5 of clindamycin
treatment?
\\\ Clostridium perfringens
\\ Clostridium difficile
\\\ Pseudomonas aeruginosa
\\\ Shigella sonnei
\\\\ Which of the following organisms causes a relatively mild form of gastroenteritis?
\\\ Vibrio cholerae
\\ Vibrio parahaemolyticus
\\\ Salmonella typhi
\\\ Shigella sonnei
\\\\ Yersinia pestis may be transferred by:
\\\ Dermacentor tick bit.
\\ Respiratory droplets.
\\\ Human body louse bite.
\\\ Ixodes tick bite.
10. Which of the following staphylococcal organisms causes subacute bacterial endocarditis that occurs
2 months or more after heart surgery?
\\ Staphylococcus epidermidis
\\\ Staphylococcus haemolyticus

\\\ Staphylococcus saprophyticus
\\\\ Which of the following statements about Streptococcus pneumoniae is true?
\\\ It secretes an enterotoxin.
\\\ It contains an endotoxin.
\\\ It possesses both an enterotoxin and endotoxin.
\\ It possesses neither an enterotoxin nor an endotoxin.
\\\\ Which of the following organisms grows in 40% bile?
\\\ Streptococcus pneumoniae
\\ Enterococcus faecalis
\\\ Group B streptococci
\\\ Viridans streptococci
\\\\ Which of the following statements about treatment of clostridial infections is correct?
\\\ Anaerobic cellulitis may require amputation or skin grafting.
\\\ Clostridial food poisoning is severe, and patients infected with either Clostridium perfringens or
Clostridium botulinum frequently require hospitalization.
\\\ Antitoxins must be administered as soon as clostridial infection is suspected.
\\ Patients with anaerobic cellulitis should be given antitoxin and antibiotics.
\\\\ Which of the following is not characteristic of Salmonella typhimurium
\\\ it has a multianimal reservoir.
\\ it ferments lactose
\\\ it is one of the most common causes of enterocolitis.
\\\ it is a gram-negative, motile, endotoxin-bearing rod.

\\\\ Which of the following group A streptococcal diseases is highly communicable in infants?
\\\ Scarlet fever
\\ Impetigo
\\\ Rheumatic fever
\\\ Cellulitis
\\\\ Which of the following conditions is necessary for effective diagnosis of anaerobic infections?
\\ Rapid transport of culture to the laboratory
\\\ Streaking on eosin-methylene blue (EMB) agar
\\\ Assay for superoxide dismutase
\\\ Sputum sampling
\\\\ Which of the following statements about Mycoplasma pneumoniae infections is false:
\\\ Eaton agent causes primary atypical pneumonia.
\\\ M pneumoniae produces surface mucous membrane infections that do not disseminate to other
tissues.
\\ incidence of M pneumoniae is highest in elderly persons.
\\\ serologic tests for M pneumoniae involve complement fixation or cold agglutination.
\\\\ Which one of the following statements concerning Vibrio cholerae infections is correct?
\\\ The disease is marked by organism invasion and hemorrhagic necrosis of the small intestine.
\\ Most pathology is attributable to a protein exotoxin.
\\\ V cholerae produces an acute febrile disease with meningitis.
\\\ There is no need to hospitalize patients with V cholerae infections. Organisms in stools are not
contagious because the organism is sensitive to acid pH.
\\\\ Which of the following organisms causes septicemic disease?
\\ Salmonella typhi
\\\ Vibrio cholerae
\\\ Vibrio parahaemolyticus
\\\ Shigella sonnei
\\\\ Which of the following statements about Lyme disease and its clinical manifestations is correct?
\\\ It is characterized by a rash throughout the trunk and extremities.
\\\ The three stages of the disorder are distinctive and do not overlap.
\\\ Manifestations of stage 3 may appear within 4 weeks of the initial infection.
\\ It is caused by Borrelia burgdorferi.
\\\\ Which of the following organisms causes neonatal sepsis?
\\ Group B streptococci
\\\ Viridans streptococci
\\\\ Which of the following organisms causes relapsing fever and is transmitted by lice or ticks?
\\\ Treponema
\\ Borrelia
\\\ Leptospira
\\\\ Which of the following statements is false of staphylococcal and Neisseria infections
\\\ pus production is a helpful diagnostic aid.

\\\ localized infections may disseminate and cause severe clinical problems.
\\\ both types of organisms cause urinary tract infections.
\\ they both produce an enzyme that degrades IgA (IgAase).
\\\\ Which of the following statements about congenital syphilis is correct?
\\\ Clinical manifestations are generally mild.
\\\ Newborns are infected only when they pass through the infected birth canal.
\\ Syphilis serology test should be performed in the first and third trimesters of pregnancy.
\\\ Specimens should be cultured on blood agar.
\\\\ Of the following components of Mycobacterium tuberculosis, which one is used for skin testing?
\\\ Cord factor
\\\ Mycolic acid
\\ Purified protein derivative (PPD)
\\\ Sulfatides
\\\\ A patient has a gastric ulcer not induced by nonsteroidal anti-inflammatory agents. Which
characteristic appears to play a central role in the ability of the organism to colonize the stomach?
\\ Urease production
\\\ Phospholipase C production
\\\ Microaerophilic lifestyle
\\\ Motility
\\\\ Which of the following statements about mycobacterial disease is correct?
\\\ Nontuberculous mycobacterial disease is as contagious as tuberculosis.

\\\ Tuberculosis is caused by Mycobacterium tuberculosis, and nontuberculous disease is caused by
other mycobacteria, including Mycobacterium bovis, Mycobacterium kansasii, and Mycobacterium
avium-intracellulare.
\\\ Only nontuberculous disease is seen with great frequency in patients with acquired
immunodeficiency syndrome (AIDS).
\\ Water is a source of exposure to nontuberculous mycobacteria.
\\\\ Which of the following characteristics is not a feature of Legionella
\\\ it is associated with water.
\\ it causes granulomatous lung infection.
\\\ it is weakly gram-negative.
\\\ it is a facultative, intracellular parasite.
\\\\ Which of the following organisms grows contiguously in tissues with no respect to anatomic
barriers?
\\ Actinomyces israelii
\\\ Mycobacterium leprae
\\\ Mycobacterium kansasii
\\\ Mycobacterium tuberculosis
\\\\ Which of the following organisms is generally rod-shaped and acid-fast?
\\\ Nocardia
\\\ Streptococcus
\\\ Actinomyces
\\ Mycobacteria
\\\\ The Ghon complex, a lesion in the lung and regional lymph nodes, is found in
\\\ actinomycotic mycetoma.

\\\ cervical facial actinomycosis
\\\ tuberculoid leprosy.
\\ primary tuberculosis.
\\\\ Which of the following organisms has diverse animal reservoirs?
\\\ Vibrio cholerae
\\ Salmonella typhi
\\\ Shigella sonnei
\\\\ Which of the following organisms causes acute icteric disease with protean manifestations?
\\\ Treponema
\\\ Borrelia
\\\ Leptospira
\\\ Shigella
\\\\ Which statement about the two major forms of leprosy (tuberculoid and lepromatous) is correct?
\\\ Tuberculoid leprosy is the hardest to treat due to poor cell-mediated immunity.
\\\ In either extreme form of leprosy, the lepromin test will be positive.
\\ Biopsy sample of lesions from a lepromatous leprosy patient generally contains many Mycobacterium
leprae.
\\\ Lepromatous leprosy patients usually have few lesions.
\\\\ Which of the following statements about non-spore-forming anaerobes is incorrect:
\\\ they are pleomorphic and can be either gram-negative or gram-positive.
\\\ they are a common cause of intra-abdominal infections.

\\\ they usually are found in mixed infections.
\\ they represent a minority of the total fecal flora.
\\\\ Which of the following statements about Pseudomonas aeruginosa is true?
\\ It possesses both an enterotoxin and endotoxin.
\\\ It possesses neither an enterotoxin nor an endotoxin.
\\\\ Which one of the following statements about Francisella tularensis infections and their treatment is
correct?
\\\ Culture of the suspected infection by the hospital laboratory is important.
\\ An effective vaccine is available, but only for use in high-risk groups.
\\\ F tularensis causes a noninvasive focal skin infection.
\\\ The hallmark of F tularensis infection is regional buboes.
\\\\ Of the following components of Mycobacterium tuberculosis, which one is responsible for the acid-
fast property of the organism?
\\\ Cord factor
\\\ Sulfatides
\\ Mycolic acid
\\\\ Which of the following statements about Brucella infections is true?
\\\ Brucella suis is the human pathogen; Brucella melitensis and Brucella abortus cause infections in
animals only.
\\ Brucella infection produces profound muscle weakness along with other relatively nondescript
manifestations.
\\\ Brucella infection is a zoonotic disease spread to humans primarily by rat fleas.
\\\ Untreated infections are self-limiting and resolve in 2 weeks.
\\\\ Which of the following organisms presents with an initial rash on the extremities that spreads to the
trunk?
\\ Rickettsia rickettsii
\\\ Coxiella burnetii
\\\\ Which of the following statements about anthrax infections is correct?
\\\ Pulmonary and gastrointestinal anthrax tend to be chronic, with frequent treatment failure.
\\ The early cutaneous form may mimic a staphylococcal furuncle or insect bite.
\\\ The capsule is a long-chain polysaccharide.
\\\ Primary animal reservoirs are rabbits and other rodents.
\\\\ Which of the following statements about Campylobacter infections is not correct:
\\\ sepsis is a problem in debilitated patients with Campylobacter fetus species infection.
\\ human infections with Campylobacter jejuni are rare relative to Salmonella and Shigella infections.
\\\ C jejuni infection is usually self-limiting.
\\\ C jejuni clinical specimens should be incubated at 42 °C.
\\\\ Which of the following group A streptococcal diseases is characterized by rash due to erythrogenic
toxins?
\\\ Impetigo
\\ Scarlet fever
\\\ Rheumatic fever

\\\ Cellulitis
\\\\ Which of the following is a virulence factor for Streptococcus pneumoniae?
\\\ C-reactive protein
\\ Capsular polysaccharide
\\\ Bacitracin
\\\ Endotoxic lipopolysaccharide
\\\\ Which of the following is not a characteristic of group A streptococci:
\\ they are part of the normal intestinal flora.
\\\ they attach to epithelial cells via fimbriae containing lipoteichoic acid.
\\\ they are rarely resistant to penicillin.
\\\ they produce hemolysis with streptolysin S.
\\\\ Which of the following statements about laboratory diagnosis of whooping cough is correct?
\\\ Lymphocyte numbers are greatly decreased.
\\ The clinical specimen should be plated on Bordet-Gengou agar.
\\\ The best chance to isolate the organism is during the paroxysmal stage.
\\\ The causative organism is a gram-positive rod.
\\\\ Which of the following statements about Shigella dysenteriae is true?

\\\\ Which of the following is not characteristic of Enterobacteriaceae:
\\\ they are a common cause of hospital-acquired infections.
\\\ they are usually noninvasive and are part of the normal intestinal flora.
\\\ some can produce both endotoxins and exotoxins.
\\ they have a short incubation period (several hours), leading to gastrointestinal disturbances.
\\\\ Which of the following organisms invades mucosal epithelial cells?
\\\ Vibrio cholerae
\\ Shigella sonnei
\\\\ A 54-year-old man develops a pyogenic infection along the suture line after knee surgery. The
laboratory gives a preliminary report of a hemolytic, catalase-positive, coagulase-positive, gram-positive
coccus. The most likely causative agent is
\\\ Moraxella catarrhalis
\\ Staphylococcus aureus
\\\ Staphylococcus epidermidis
\\\\ Which of the following statements about treatment and prevention of Haemophilus is correct?
\\ Give rifampin to index case of Haemophilus influenzae meningitis and to family members to eradicate
the carrier state.
\\\ Bacterial pinkeye is treated with intravenous ampicillin.
\\\ Soft chancre is poorly contagious, and asymptomatic sexual partners need not be treated.
\\\ The capsule is a highly effective vaccine in a target population of children 3 months to 6 years of age.
\\\\ Which of the following statements about Salmonella typhimurium is true?
\\\\ Which of the following organisms causes pneumonitis resembling atypical pneumonia?
\\ Coxiella burnetii
\\\\ Which of the following statements about the incidence of bacterial shock is not correct:
\\\ it is usually a hospital-induced syndrome.
\\\ it can occur after catheterization.
\\ it is reversible by penicillin.
\\\ it is usually preceded by a fever spike.
\\\\ Which one of the following statements about laboratory diagnosis of Neisseria gonorrhoeae is
correct?
\\ Purulent discharge contains primarily neutrophils and intracellular diplococci.
\\\ Asymptomatic patients are identified by culturing organisms from a clinical specimen with a
lubricated swab.
\\\ Purulent discharge contains only intracellular diplococci.
\\\ Clinical specimens should be plated onto blood agar to determine type of hemolysis.
\\\\ Which of the following organisms is a mite-borne agent causing a rash that may be confused with
chickenpox?
\\ Rickettsia akari
\\\ Coxiella burnetii
\\\\ Which of the following organisms is zoonotic and is transmitted to humans primarily by contact with
animal urine?
\\\ Treponema
\\\ Borrelia
\\ Leptospira
\\\ Leishmania
\\\\ Which of the following characteristics of group B streptococci is not correct:
\\\ they are part of the normal vaginal flora.
\\\ they are bacitracin-resistant.
\\ an effective vaccine incorporates proteinaceous capsular antigens.
\\\ they can cause neonatal sepsis and meningitis.
\\\\ Which of the following statements about Vibrio cholerae is true?
\\\\ Which of the following organisms is a very slow grower?

\\\ Nocardia
\\\ Actinomyces
\\ Mycobacteria
\\\ Staphylococci
\\\\ Which of the following statements about Listeria monocytogenes infection is not correct:
\\\ abscesses and granulomas occur in many different tissues.
\\\ neonatal infections have a poor prognosis.
\\\ bacteria parasitize neutrophils and monocytes.
\\ neonatal infections occur only during passage through the infected birth canal.
\\\\ Of the following components of Mycobacterium tuberculosis, which one interrupts mitochondrial
function?
\\\ Mycolic acid
\\ Cord factor
\\\ Sulfatides
\\\\ Which of the following staphylococcal organisms causes urinary tract infections, primarily in
adolescent females?
\\ Staphylococcus saprophyticus
\\\ Staphylococcus epidermidis
\\\ Staphylococcus haemolyticus
\\\\ Which of the following group A streptococcal diseases causes skin infection capable of giving rise to
a septicemia?
\\\ Impetigo
\\ Cellulitis
\\\ Scarlet fever
\\\ Rheumatic fever
\\\\ Which of the following statements about Yersinia pestis infections is not rue:
\\\ wild rodents and their infected fleas are the primary reservoir.
\\ a key early manifestation is a slowly progressing malaise.
\\\ the pneumonic form is far more contagious than the bubonic form.
\\\ the bubonic form may progress to the pneumonic form.
\\\\ Which of the following organisms is the most frequent cause of bacterial endocarditis?
\\ Viridans streptococci
\\\\ Over the last 2 weeks, a heterologous kidney transplant patient has had headaches of increasing
severity and mental lethargy. On physical examination, macronodular skin lesions are noted. The
cerebrospinal fluid (CSF) is clear, and protein and glucose concentrations are within normal levels.
Microscopic examination of CSF sediment in India ink reveals encapsulated yeasts. Which of the
following tests permits rapid confirmation of the identity of the infective organism?
\\\ Detection of specific antibodies in the CSF
\\\ Detection of cell-wall antigens in the CSF
\\ Detection of polysaccharide in the CSF
\\\ Detection of serum antibody

\\\\ Roseola (or exanthema subitum) is caused by
\\\ human papillomavirus.
\\ human herpesvirus 6.
\\\ human parvovirus B19.
\\\\ Which of the following viruses has an arthropod vector?
\\\ Parvovirus
\\ Bunyavirus
\\\\ A 16-year-old boy from a rural area presents with two highly inflammatory lesions in the bearded
area of his face. Both of the rashes are itchy, highly erythematous, sore to the touch, and spreading. The
most advanced lesion is clearing in the center, but the periphery continues to expand. Skin scrapings
from lesion margins mounted in potassium hydroxide demonstrate the presence of true hyphae and
arthroconidia. Which drug or combination is most appropriate?
\\\ Amoxicillin
\\\ Amoxicillin and clavulanate
\\\ Amphotericin B
\\ An imidazole such as itraconazole
\\\\ Pieces of plasmid or bacterial chromosomal DNA may be mistakenly packaged into the capsid (head)
of a bacterial virus. Assuming that no prophage state has existed in the phage production, what is the
process called when the virus with the bacterial or plasmid DNA infects another bacterium?
\\\ Conjugation
\\ Generalized transduction
\\\ Lysogeny
\\\ Transformation
\\\\ A 6-month-old child has had watery diarrhea for 6 days. The stools have no blood and no pus. The
causative agent is a double-stranded RNA virus. Which of the following is the most likely causative
agent?
\\\ Giardia lamblia
\\ Rotavirus
\\\ Norwalk agent
\\\\ A 3-year-old child develops acute glomerulonephritis following impetigo. The bacterium is a
catalase-negative, gram-positive coccus that has M12 surface protein. What is the most likely causative
agent?
\\ Streptococcus pyogenes
\\\\ Which of the following has the highest association with hepatocellular carcinoma?
\\\ Acute hepatitis A infection
\\ Chronic hepatitis B infection
\\\ Hepatitis E infection
\\\\ Which of the following factors is associated with the virulence of Yersinia pestis?
\\\ Adhesins
\\\ Exotoxins
\\ V and W antigens
\\\ X and V factors
\\\\ A neonate develops meningitis at 7 days of age. Her mother is 16 years of age, is single, has had
multiple sexual partners without barrier protection. The baby was born 23 hours after the mother's
amniotic sac ruptured. What is the most likely causative agent?
\\ Streptococcus agalactiae
\\\\ Which of the following viruses is a double-stranded RNA virus?
\\\ Calicivirus
\\ Reovirus
\\\ Flavivirus
\\\ Paramyxovirus
\\\\ A 19-year-old college freshman has a sore throat, sore and enlarging cervical lymph nodes, and a
fever and is greatly fatigued. A diagnosis of infectious mononucleosis is made. Which of the following
factors is present?
\\\ Delta hemagglutinin
\\\ E1A protein
\\\ Large T antigen
\\ VCA protein
\\\\ In traveler's diarrhea caused by Escherichia coli, what is responsible for the fluid and electrolyte
disruption?
\\\ Adherence causing palisade layers of the bacterium on the surface of the small intestine
\\\ Capsule
\\ Exotoxin that causes an increase in cyclic adenosine monophosphate
\\\ Invasion of the intestinal lining
\\\\ A formerly vigorous 3-month-old child has developed upper body weakness manifested by droopy
eyes and head, poor feeding, and a weak cry. Changes starting with constipation were first noticed 2
days ago. The baby is afebrile and there is no sign of rash. What is the most likely causative agent and
where is the infection?
\\\ Bacteroides species; gastrointestinal (GI) tract overgrowth
\\ Clostridium botulinum; GI tract infection
\\\ Clostridium tetani; tissue infection
\\\ Neisseria meningitidis; central nervous system infection
\\\\ A woman develops cervical carcinoma. What viral protein played a role in the development of the
carcinoma?
\\\ Large T antigen
\\\ E1A protein
\\ E6 protein
\\\ TAX protein
\\\\ What bacterial gene transfer process would be inhibited by free extracellular exonucleases?
\\\ Conjugation
\\ Transformation
\\\ Transduction
\\\ Transposition
\\\\ An alcoholic presents complaining of chest pain, fever, shaking chills, cough, and myalgia. She was
very cold 2 nights ago and says she has felt poorly ever since. Her cough is producing rust-colored,
odorless, mucoid sputum. Her temperature on admission is 40Â°C. Her white blood cell count is 16,000
cells/mm3 and is predominantly neutrophils with an overall left shift. A lancet-shaped, gram-positive
diplococcus is isolated on blood agar. What is the most likely causative agent?
\\\ Legionella pneumophila
\\ Streptococcus pneumoniae
\\\\ Which of the following is a nonnucleoside analogue that inhibits herpesvirus DNA?
\\\ Acyclovir
\\ Foscarnet
\\\ Amantadine
\\\ Cytarabine
\\\\ A fruit picker has developed subcutaneous nodular lesions along the lymphatics from the initial site
of trauma caused by a plum thorn puncture. What is the nature of the most likely causative agent?
\\ Dimorphic fungus
\\\ Gram-positive coccus
\\\ Helminth
\\\\ Latent infection of neurons occurs with
\\\ measles virus.
\\ herpes simplex virus.
\\\ rabies virus.

\\\\ In June, an 18-year-old man develops a sore throat with a fever and a nonproductive cough that
develops into pneumonia with a severe, prolonged hacking cough but little sputum production.
Cryoagglutinins are present. He is treated appropriately and successfully with azithromycin. What is the
nature of the most likely causative agent?
\\\ Gram-negative coccus
\\\ DNA virus
\\\ Gram-negative rod
\\ Mycoplasma
\\\\ African sleeping sickness is transmitted by
\\\ respiratory droplets and direct mucosal contact.
\\\ mosquito bite.
\\ tsetse fly bite
\\\ sandfly bite.
\\\\ The most frequent cause of the common cold is
\\\ coronavirus.
\\\ parainfluenza virus.
\\ rhinovirus.
\\\ reovirus.
\\\\ In which of the following phases of growth is a gram-positive bacterium most susceptible to the
action of penicillin?
\\ Exponential
\\\ Stationary
\\\ Decline
\\\ Death
\\\\ Which of the following contains O antigen?
\\\ Capsule
\\\ Lipoprotein
\\\ Peptidoglycan
\\\\ Antivirals that inhibit viral proteases are available for
\\\ hepatitis B virus.
\\ human immunodeficiency virus.
\\\ herpes simplex virus.
\\\\ Which of the following statements about the treatment of cholera is correct?
\\\ Ciprofloxacin is critical along with fluids for recovery; clinical response is slow and the patient will
remain sick for a few weeks.
\\ Replacement of fluid and electrolytes is most important and will lead to a dramatic improvement;
antibiotics will decrease the length of disease and the period of infectivity.
\\\ Ciprofloxacin will not alter the course; replacement of fluids and electrolytes will lead to gradual
clinical improvement.
\\\ Antitoxin along with fluid and electrolytes is critical to a rapid clinical response.
\\\\ What characteristic of the influenza A virus allows genetic reassortment?
\\\ Poor editing by the RNA-dependent RNA polymerase
\\ Segmented genome
\\\ Defective chaperone proteins
\\\ Poor editing function of the reverse transcriptase

\\\\ There is an outbreak of watery diarrhea in 6 members of a party of 20 who ate at a Chinese
\\ Bacillus cereus
\\\ Giardia lamblia
\\\ Norwalk agent
\\\\ Which of the following phrases best describes a prophage?
\\\ Phage that lacks receptors
\\\ Phage attached to the cell wall that has released its DNA
\\ Intracellular temperate phage DNA
\\\ Newly assembled intracellular phage particle
\\\\ Which of the following terms best describes bacteria that can use fermentation pathways and
\\\ Obligate aerobe
\\ Facultative anaerobe
\\\ Obligate anaerobe
\\\ Aerobic heterotroph
\\\\ Which of the following is the most sensitive type of serologic test?
\\\ Virus neutralization
\\ Enzyme-linked immunosorbent assay
\\\ Nucleic acid hybridization
\\\ Hemadsorption
\\\\ How is primary amebic meningoencephalitis most likely acquired?

\\\ Intravenous drug abuse
\\\ Eating raw fish or seafood
\\\ Handling cat litter
\\ Diving or swimming in contaminated water
\\\\ Which of the following is the most common organism in the human gastrointestinal tract?
\\\ Clostridium botulinum
\\\ Clostridium difficile
\\ Bacteroides species
\\\\ A Peace Corp volunteer recently returned to rural Africa develops symptoms of liver damage and a
blocked bile duct after general anesthesia. What is the nature of the most likely causative agent?
\\\ Cestode
\\ Nematode
\\\ Protozoa
\\\\ A bacterial growth medium that contains penicillin is a
\\\ minimal medium.
\\ selective medium.
\\\ differential medium.
\\\ complex medium.
\\\\ Which of the following statements concerning Chlamydia trachomatis is correct?
\\\ It is an intracellular virus.

\\\ It rarely induces the carrier state.
\\\ It is a motile, single-cell animal parasite.
\\ It is the most common bacterial sexually transmitted disease among college populations.
\\\\ Which of the following is also called an endotoxin?
\\\ Capsule
\\\ Outer membrane
\\\ Peptidoglycan
\\\\ After extensive oral surgery, a patient who had rheumatic fever as a child did not take the
prescribed perioperative prophylactic antibiotics and subsequently developed subacute infective
endocarditis. Which of the following is the most likely causative agent?
\\ Viridans streptococci
\\\ Streptococcus pyogenes
\\\\ The number of live bacteria in a sample is best determined by
\\\ protein measurement
\\\ turbidity measurement.
\\\ viable count.
\\ dry weight.
\\\\ Which of the following maternal infections may cause congenital disease?
\\\ Infectious hepatitis
\\\ Measles
\\\ Shingles
\\ Rubella
\\\\ The presence of delta antigen in a patient's serum indicates
\\\ dengue virus infection.
\\\ influenza B virus infection.
\\ hepatitis D virus infection.
\\\ varicella-zoster virus infection.
\\\\ Which of the following viruses causes croup?
\\ Parainfluenza virus
\\\ Reovirus
\\\ Bunyavirus
\\\\ Which of the following medications blocks virus penetration and uncoating of influenza A virus?
\\\ Acyclovir
\\ Amantadine
\\\ Interferon
\\\ Ribavirin
\\\\ Which of the following latent infections is most likely to be activated during immunosuppression?
\\ Shingles
\\\ Infectious mononucleosis
\\\ German measles

\\\\ Which of the following is an infection that produces heterophil antibodies?
\\ Epstein-Barr virus
\\\ Cytomegalovirus
\\\ Human immunodeficiency virus
\\\ St. Louis encephalitis virus
\\\\ Plague is transmitted by
\\\ rodent feces.
\\\ animal bite, most commonly small rodents.
\\\ tick bite.
\\ respiratory droplets.
\\\\ The neuraminidase of the influenza B virus is inhibited by
\\\ ganciclovir.
\\ zanamivir.
\\\ ribavirin.
\\\ ritonavir.
\\\\ Intracellular survival and replication are the major virulence factors rather than exotoxin production
for which of the following organisms?
\\\ Cholera
\\\ Diphtheria
\\ Plague
\\\ Pertussis
\\\\ Six 18-year-old women return from a recent camping trip with abdominal cramping, gas, pain, and
diarrhea that is pale, greasy, and malodorous. They drank untreated stream water on the last 2 days of
the trip after losing their water filter. What is the most likely causative agent?
\\\ Baylisascaris procyonis
\\ Giardia lamblia
\\\\ One advantage of a live, attenuated vaccine is
\\\ it does not produce persistent infections.
\\ it induces a wide spectrum of antibodies.
\\\ the viral strain does not revert to virulent forms.
\\\ it has an unlimited shelf life.
\\\\ Which of the following is an RNA tumor virus associated with the neurologic disease topical spastic
paraparesis?
\\\ AKR leukemia virus
\\ Human T lymphotrophic virus type 1
\\\ Rous sarcoma virus
\\\\ Which of the following statements about children who have survived infant botulism is true?
\\\ Elevated cerebrospinal fluid pressure occurs in over half of the children, resulting in some permanent
neurologic defects.
\\ Recovery is expected to be complete in all children who survive.
\\\ Almost all of the children have some permanent neurologic defects.
\\\ There is some permanent muscle weakness following recovery that, like polio, may worsen late in
life.
\\\\ In addition to the bull neck appearance and the pseudomembrane, symptoms of diphtheria involve
the
\\ heart and nerves.
\\\ skin
\\\ kidneys.
\\\ liver and kidneys.
\\\\ Subacute spongiform encephalopathy describes degenerative central nervous system diseases
caused by
\\\ arbovirus.
\\ prions.
\\\ BK virus.
\\\ JC virus.
\\\\ In the following pairs of organisms, which two are easiest to distinguish from each other by Gram
stain?
\\\ Bacillus and Clostridium
\\\ Salmonella and Shigella
\\ Listeria and Proteus
\\\ Corynebacterium and Lactobacillus
\\\\ A neonate with very low Apgar scores dies 2 hours after birth. Autopsy reveals disseminated
granulomatous lesions throughout; some are caseating, but they are not calcified. During her pregnancy,
the mother most likely had a septicemia caused by
\\\ Escherichia coli.
\\ Listeria monocytogenes.
\\\ group B streptococci.

\\\ parvovirus B19.
\\\\ The virulence of Francisella tularensis is most highly associated with
\\\ adherence.
\\\ the capsule.
\\ intracellular replication.
\\\ a Shiga-like toxin.
\\\\ A 15-month-old child living in a religious community that does not vaccinate their children develops
meningitis. A gram-negative rod is seen in the cerebrospinal fluid. What is the most likely causative
agent?
\\\ An enterovirus
\\ Haemophilus influenzae
\\\\ Following several tick bites while hiking through a wilderness park in the southeastern United
States, a 19-year-old man develops fever, sore throat, malaise, headache, nausea, and a rash on the
lower parts of both his arms and legs. When he starts feeling worse and his wrists and ankles begin to
swell, his companions take him to an emergency department. The man's temperature is 38.9 °C. Which
of the following should be at the top of the differential diagnosis list?
\\\ Epidemic typhus
\\\ Q fever
\\ Rocky Mountain spotted fever
\\\ Streptococcal pharyngitis
\\\\ Which of the following is a characteristic of streptococci?
\\\ Endotoxin
\\ Fimbriae
\\\ Coagulase
\\\ Catalase
\\\\ A patient with Pseudomonas aeruginosa septicemia develops shock, which is triggered by
\\\ catalase.
\\ lipid A.
\\\ flagella from gram-negative bacteria.
\\\ teichoic acid-peptidoglycan fragments.
\\\\ A burn patient has an infected area with odiferous, blue-green pus. What is the most likely
causative agent?
\\\ Vibrio vulnificus
\\ Pseudomonas aeruginosa
\\\\ Which of the following viruses induces characteristic giant, multinucleated cells?
\\\ Parvovirus
\\ Respiratory syncytial virus
\\\ Bunyavirus
\\\\ Which of the following is a nucleoside analogue that inhibits reverse transcriptase?
\\\ Acyclovir
\\\ Amantadine
\\ Zidovudine
\\\ Interferon
\\\\ Infection with which of the following organisms is more often noted for the production of a
lymphocytosis rather than a mononucleosis?
\\ Bordetella pertussis
\\\ Epstein-Barr virus
\\\ Listeria monocytogenes
\\\\ In which one of the following fungal scalp infections is hair loss most likely to be permanent?
\\\ Anthropophilic tinea capitis
\\\ Black-dot tinea capitis of adults
\\ Favus (tinea favosa)
\\\ Zoophilic tinea capitis
\\\\ A woman who is an intravenous drug abuser and who has worked as a prostitute for the last 20
years now has an aortitis. She has no mucosal ulcerations or exanthems. Her VDRL (Venereal Disease
Research Laboratory) test is negative and her fluorescent treponemal antibody absorption test is
positive. What is the most likely diagnosis?
\\\ Lyme disease
\\\ Primary syphilis
\\\ Latent syphilis
\\ Tertiary syphilis
\\\\ Which of the following infections is known to increase susceptibility to pneumonia caused by
Streptococcus pneumoniae?

\\ Influenza virus infection
\\\ Mycobacterium tuberculosis infection
\\\ Mycoplasma pneumoniae infection
\\\\ What is the vector for Chagas disease?
\\\ Mites
\\\ Mosquitoes genus Aedes
\\ Reduviid bugs
\\\ Sandflies
\\\\ A patient has a catheter infection. A biofilm is present on the catheter. What is the most likely
causative agent?
\\ Staphylococcus epidermidis
\\\\ How does Mycoplasma pneumoniae differ from Rickettsia prowazekii?
\\\ It is a prokaryote.
\\ It lacks a cell wall.
\\\ It has a single chromosome.
\\\ It is intracellular.
\\\\ Which of the following drugs induces 2,5A synthetase?
\\\ Acyclovir
\\\ Amantadine
\\\ Foscarnet
\\ Interferon
\\\\ Bacteria are protected from phagocytosis by
\\\ the outer membrane.
\\ the capsule.
\\\ lipoprotein.
\\\ peptidoglycan.
\\\\ Which of the following viruses has a segmented, ambisense genome?
\\\ Parvovirus
\\ Arenavirus
\\\\ Which of the following is most likely to cause urinary tract infections?
\\\ Bacteroides species
\\\ Clostridium botulinum
\\\ Clostridium tetani
\\ Escherichia coli
\\\\ Which of the following is the most appropriate and effective method for reducing the transmission
of toxoplasmosis?
\\\ Avoid intravenous drug abuse.
\\\ Avoid swimming in contaminated water.
\\ Avoid cat litter or take proper care in changing litter.

\\\ Cook fish and seafood thoroughly.
\\\\ Which of the following diseases is caused by a virus that uses a reverse transcriptase during
replication?
\\ Serum hepatitis
\\\ Shingles
\\\\ Which of the following statements regarding the clinical manifestations and consequences of
\\\ Dermatitis involves rash over the trunk and extremities.
\\\ Ophthalmia neonatorum is always mild.
\\ Both men and women can be asymptomatic.
\\\ Urethral symptoms are painless.
\\\\ An 18-year-old dirt bike racer, who recently raced for the first time in the desert, presents in
September with cough, malaise, low-grade fever, myalgias, and chest pain. Rales are heard and
respiratory infiltrates are noted on radiograph. Sputum stained with calcofluor white and viewed on an
ultraviolet microscope shows large blue-white fluorescing spherical structures with round cells inside.
\\\ Candida albicans
\\ Coccidioides immitis
\\\ Influenza virus type A
\\\\ A patient presents with explosive, watery, noninflammatory diarrhea along with headache,
abdominal cramps, nausea, vomiting, and fever. Symptoms began the day after eating raw oysters in
August. What is the most likely causative agent?
\\\ Giardia lamblia
\\\ Rotavirus
\\ Vibrio parahaemolyticus
\\\\ A tuberculosis patient who is also human immunodeficiency virus (HIV) positive has a CD4+ count of
60 because he is inconsistent in taking any medication. He also has small sites of dissemination
throughout his body. What was the most likely route of dissemination?
\\\ Nerves
\\ Blood stream
\\\ Contiguous spread through the tissues
\\\ Lymphatics
\\\\ A 28-year-old homosexual man is seen with a solitary indurated penile ulcer with fairly clean
margins, no obvious raised granulomatous areas, and no discoloration. He reports that it began as a
hard nodule and that it is not painful. Regional lymphadenopathy is noted. What is the most likely
causative agent?
\\ Treponema pallidum
\\\ Herpes simplex virus type 2
\\\ Human papillomavirus
\\\ Neisseria gonorrhoeae
\\\\ A 3-year-old girl presents with a temperature of 38.2Â°C, a sore throat, difficulty swallowing, and
vomiting. Examination reveals that the soft palate and posterior oral cavity are reddened with vesicular
lesions. No tonsillar abscess or exudate is seen. The epiglottis is not swollen. She is fully vaccinated. The
test for cell-wall carbohydrate is negative. Blood and Thayer-Martin agar cultures have been set up.
\\ Coxsackievirus type A

\\\\ Which of the following diseases is associated with the delta agent?
\\ Serum hepatitis
\\\ Shingles
\\\\ How can you reduce your chances of acquiring Vibrio parahaemolyticus illness?
\\\ Avoid intravenous drug abuse.
\\\ Avoid swimming in contaminated water.
\\ Cook fish and seafood thoroughly.
\\\ Heat all canned foods to 60°C for 10 minutes.
\\\\ Which of the following antibiotics causes misreading of mRNA?
\\\ Tetracycline
\\ Streptomycin
\\\ Erythromycin
\\\ Griseofulvin
\\\\ Which of the following antifungal drugs is fungicidal and appropriate for systemic use?
\\ Amphotericin B
\\\ Chloramphenicol
\\\ Econazole
\\\ Nystatin
\\\\ What is the mechanism of action of the aminoglycosides?
\\\ Damage to the membrane
\\\ Inhibition of DNA gyrase
\\ Binding to 30S ribosome
\\\ Inhibition of mycolic acid synthesis
\\\\ How is Borrelia burgdorferi transmitted?
\\\ Mites
\\\ Mosquitoes genus Anopheles
\\ Ticks genus Ixodes
\\\ Ticks genus Dermacentor
\\\\ Which of the following infections is a cofactor in Burkitt's lymphoma?
\\\ Cytomegalovirus infection
\\ Epstein-Barr virus infection
\\\ Hepatitis B virus infection
\\\ Mycoplasma pneumoniae infection
\\\\ After a trip to Peru to adopt a 6-month-old baby, a 32-year-old woman and her new baby both
develop profuse, watery diarrhea with flecks of mucus. Both are hospitalized because of the severity and
rapidity of the dehydration, but neither one is febrile. What is the most likely causative agent?
\\\ Campylobacter jejuni
\\\ Escherichia coli O157
\\ Vibrio cholerae
\\\\ What is the nonvertebrate host for the plasmodia?

\\\ Mites
\\ Mosquitoes genus Anopheles
\\\ Tsetse fly
\\\ Sandflies
\\\\ A 45-year-old man has mental degeneration after a prolonged but inapparent infection. At autopsy,
a subacute spongiform encephalopathy is found. What is the nature of the most likely causative agent?
\\\ Dimorphic fungus
\\ Prion
\\\ DNA virus
\\\ Viroid
\\\\ A patient with acquired immunodeficiency syndrome has severe, nonresolving diarrhea. Acid-fast
oocysts are seen in the stools, which are not gray and greasy. What is the most likely causative agent?
\\\ Cryptococcus
\\ Cryptosporidium
\\\ Giardia
\\\ Salmonella
\\\\ Cellulitis develops in a 26-year-old man after he is bitten by his girlfriend's unvaccinated cat. What is
the most likely dominant organism involved in the infection?
\\\ Bartonella henselae
\\\ Calymmatobacterium granulomatis
\\\ Toxoplasma gondii
\\ Pasteurella multocida
Review Test- General Properties of Microorganisms

1. Which of the following toxins has phospholipase C activity?
(A) Escherichia coli heat-labile toxin
(B) Clostridium tetani exotoxin
(C) Corynebacterium diphtheriae exotoxin
(D) Pseudomonas aeruginosa exotoxin
(E) Clostridium perfringens Î±-toxin
2. What type of phage is used in phage-typing?
(A) Prophage
(B) Virulent phage
(C) Temperate phage
(D) Filamentous phage
3. Which of the following microorganisms contains RNA or DNA as a genetic material?
(A) Viruses
(B) Fungi
(C) Prions
(D) Bacteria
(E) Viroids
4. Which of the following enzymes would be most likely to affect sugar transport into bacteria?
(A) Acetyltransferase
(B) Neuraminidase
(C) Oxidase
(D) Phosphotransferase
5. Polymers of N-acetylglucosamine and N-acetylmuramic acid are found in which one of the
following chemical structures?
(A) Teichoic acid
(B) Cell wall
(C) Glycocalyx
(D) Lipopolysaccharide
6. What type of phage is not inactivated by proteases?
(A) Prophage
(B) Virulent phage
(C) Temperate phage
7. What type of bacteria synthesize organic compounds from inorganic compounds?
(A) Heterotrophs
(B) Obligate anaerobes
(C) Aerobes
(D) Facultative anaerobes
(E) Autotrophs
(A) Viruses
(B) Fungi
(C) Prions
(D) Bacteria
(E) Viroids
(A) Capsule
(C) Ordinary pili
(D) O-specific side chain
10. What type of bacteria display the Pasteur effect?
(A) Heterotrophs
(C) Aerobes
(E) Autotrophs
11. Which of the following characteristics applies to cephalosporin antibiotics?
(A) Are bacteriostatic
(B) Inhibit protein biosynthesis
(C) Treat fungal infections
(D) Treat patients allergic to penicillin
12. Which of the following toxins acts on synaptosomes?

13. Which one of the following statements applies to bacteria that contain superoxide
dismutase?
(A) Need superoxide to grow
(B) Are frequently obligate anaerobes
(C) Grow slowly in the presence of CO2
(D) Produce hydrogen peroxide from hydrogen ion and the superoxide free radical (O2-)
14. Which of the following statements describes lysogenic phage conversion?
(A) The transformation of a virulent phage to a lysogenic phage
(B) A change in bacterial phenotype due to the presence of a prophage
(C) The conversion of a prophage to a temperate phage
(D) The incorporation of a prophage into the bacterial chromosome
15. Which of the following microorganisms may be inactivated by RNases with endonuclease
activity?
(A) Viruses
(B) Fungi
(C) Prions
(D) Bacteria
(E) Viroids
16. Which of the following types of media would best be used to isolate bacteria capable of
growth in a high-salt concentration?
(A) Minimal growth media

(B) Complex growth media
(C) Differential growth media
(D) Selective growth media
17. Which of the following characteristics applies to bacteriostatic antibiotics?
(A) Are effective when used in combination with bactericidal antibiotics to obtain a synergistic
effect
(B) Include all the antimetabolites
(C) Are effective against bacteria in all phases of growth
(D) Include some broad-spectrum antibiotics
18. What type of phage is exemplified by the lambda phage?
(A) Prophage
(B) Virulent phage
(C) Temperate phage
19. Which of the following statements concerning prokaryotic cells is true?
(A) They have coupled transcription and translation.
(B) They have processed mRNAs.
(C) They generally have exons and introns.
(D) They transfer secretory proteins into the Golgi apparatus before secretion.
(A) Heterotrophs
(C) Aerobes
(E) Autotrophs
21. Which of the following statements applies to the regulation of enzyme activity in bacterial
cells?
(A) Can be coupled to the binding of effector molecules
(B) Can be controlled by a catabolite activator protein
(C) May occur via attenuation sequences
(D) Can involve inducer molecules
22. The plasma membrane
(A) contains matrix porins.
(B) includes endotoxin.
(C) contains glycocalyx.
(D) contains the enzymes involved in bacterial oxidative phosphorylation.
(A) Viruses
(B) Fungi
(C) Prions
(D) Bacteria
(E) Viroids
24. Which of the following toxins induces electrolyte loss as a result of overproduction of cyclic
Review Test - Bacterial Genetics
1. Bacterial antibiotic resistance is frequently conveyed by
(A) a temperate bacteriophage.
(B) an R factor plasmid.
(C) a replicon.
(D) a lytic bacteriophage.
(E) an intron.
2. The expression of the lac operon
(A) must be initiated by the binding of an inducer protein.
(B) involves the release of allolactose from a repressor protein.
(C) does not involve the expression of structural genes.
(D) necessitates the finding of RNA polymerase followed by transcription.

3. Which of the following requires cellâ€“cell contact?
(A) Transformation
(B) Conjugation
(C) Transduction
(D) Transcription
(E) Recombination
(F) Translation
4. Which of the following is mediated by a bacteriophage that carries host-cell DNA?
(A) Transformation
(B) Conjugation
(C) Transduction
(D) Transcription
(E) Recombination
(F) Translation
5. Which of the following involves exchange of allelic forms of genes?
(A) Transformation
(B) Conjugation
(C) Transduction
(D) Transcription
(E) Recombination
(F) Translation
6. Which of the following involves synthesis of RNA from a DNA template?
(A) Transformation
(B) Conjugation
(C) Transduction
(D) Transcription
(E) Recombination
(F) Translation
7. Which of the following creates high-frequency recombination donors?
(A) Transformation
(B) Conjugation
(C) Transduction
(D) Transcription
(E) Recombination
(F)Translation
Review Test- Bacteriology
1. Which of the following organisms is anaerobic?
(A) Nocardia
(B) Actinomyces
(C) Mycobacteria
2. Which of the following organisms spreads through inhalation of infected dust?
(A) Rickettsia akari
(B) Rickettsia typhi
(C) Rickettsia rickettsii
(D) Coxiella burnetii
(E) All of the above

3. All of the following statements about clinical manifestations of Haemophilus influenzae are
correct EXCEPT
(A) acute bacterial epiglottitis is a mild disease in children.
(B) severe central nervous system deficits occur in one-third of recovered meningitis patients.
(C) pus production is typical.
(D) during viral influenza outbreaks, incidence of H influenzae increases.
(E) pneumonia is a complication usually seen in children or the aged.
4. A 22-year-old cystic fibrosis patient presents because of fever and increasing dyspnea. A
gram-negative organism is found in unusually high numbers in the mucus. Which virulence
factor is most important in colonization and maintenance of the organism in the lungs?
(A) Exotoxin A
(B) Pyocyanin (blue-green pigment)
(C) Polysaccharide slime
(D) Endotoxin
5. Exotoxin A most closely resembles the action of which of the following?
(A) Heat-labile (LT) Escherichia coli
(B) Shiga toxin
(C) Diphtheria toxin
(D) Vibrio cholerae toxin
(E) Verotoxin
6. Of the following components of Mycobacterium tuberculosis, which one promotes

intracellular survival by inhibiting phagosomeâ€“lysosome fusion?
(A) Cord factor

(B) Mycolic acid
(C) Purified protein derivative (PPD)
(D) Sulfatides
(E) Wax D
treatment?
(A) Clostridium perfringens
(B) Clostridium difficile
(C) Pseudomonas aeruginosa
(D) Shigella sonnei
8. Which of the following organisms causes a relatively mild form of gastroenteritis?
(A) Vibrio cholerae
(B) Vibrio parahaemolyticus
(D) Shigella sonnei
(A) Dermacentor tick bit.
(B) Human body louse bite.
(C) Ixodes tick bite.
(D) Respiratory droplets.
10. Which of the following staphylococcal organisms causes subacute bacterial endocarditis
that occurs 2 months or more after heart surgery?
(A) Staphylococcus aureus

(B) Staphylococcus epidermidis
(C) Staphylococcus haemolyticus
(D) Staphylococcus saprophyticus
11. Which of the following statements about clinical manifestations of clostridial infections is
correct?
(A) Clostridium perfringens does not infect nontraumatized tissues due to the high
oxidationâ€“reduction potential (Eh) of normal tissue.
(B) Infant botulism results from ingestion of preformed toxins in contaminated food.
(C) Tetanus causes death from cardiac dysfunction.
(D) The anaerobic cellulitis produced by C perfringens spreads to surrounding healthy tissues.
(E) Clostridium difficile produces a mild gastroenteritis.
12. Which of the following statements about Streptococcus pneumoniae is true?
(A) It secretes an enterotoxin.
(B) It contains an endotoxin.
(C) It possesses both an enterotoxin and endotoxin.
(D) It possesses neither an enterotoxin nor an endotoxin.
13. Which of the following organisms grows in 40% bile?
(B) Streptococcus pneumoniae
(C) Group B streptococci
(D) Viridans streptococci

14. Which of the following statements about treatment of clostridial infections is correct?
(A) Anaerobic cellulitis may require amputation or skin grafting.
(B) Clostridial food poisoning is severe, and patients infected with either Clostridium
perfringens or Clostridium botulinum frequently require hospitalization.
(C) Infant botulism should be treated with antibiotics to eradicate the organism.
(D) Antitoxins must be administered as soon as clostridial infection is suspected.
(E) Patients with anaerobic cellulitis should be given antitoxin and antibiotics.
15. All of the following are characteristics of Salmonella typhimurium EXCEPT
(A) it has a multianimal reservoir.
(B) it is one of the most common causes of enterocolitis.
(C) it ferments lactose.
(D) it is a common contaminant of poultry.
(E) it is a gram-negative, motile, endotoxin-bearing rod.
16. Which of the following is a characteristic of Bacteroides fragilis?
(A) Colonies have a distinctive black appearance.
(B) Organisms are susceptible to penicillin.
(C) Organisms possess a Î²-lactamase.
(D) Organisms are rarely found in the gastrointestinal tract.
17. Which of the following group A streptococcal diseases is highly communicable in infants?
(A) Impetigo
(B) Scarlet fever
(C) Rheumatic fever
(D) Cellulitis
18. Which of the following conditions is necessary for effective diagnosis of anaerobic
infections?
(A) Streaking on eosin-methylene blue (EMB) agar
(B) Rapid transport of culture to the laboratory
(C) Assay for superoxide dismutase
(D) Sputum sampling
19. Which of the following organisms is partially acid-fast and filamentous?
(A) Nocardia
(B) Actinomyces
(C) Mycobacteria
20. All of the following statements about Mycoplasma pneumoniae infections are true EXCEPT
(A) Eaton agent causes primary atypical pneumonia.
(B) M pneumoniae produces surface mucous membrane infections that do not disseminate to
other tissues.
(C) M pneumoniae is a slow-growing organism that requires 1â€“3 weeks to culture in the
laboratory.
(D) serologic tests for M pneumoniae involve complement fixation or cold agglutination.
(E) incidence of M pneumoniae is highest in elderly persons.
21. Which one of the following statements concerning Vibrio cholerae infections is correct?
(A) Death occurs in 2â€“4 weeks from exhaustion and respiratory failure.
(B) The disease is marked by organism invasion and hemorrhagic necrosis of the small intestine.
(C) Most pathology is attributable to a protein exotoxin.
(D) V cholerae produces an acute febrile disease with meningitis.
(E) There is no need to hospitalize patients with V cholerae infections. Organisms in stools are
not contagious because the organism is sensitive to acid pH.
22. Which of the following organisms causes septicemic disease?
(A) Vibrio cholerae
(D) Shigella sonnei
23. Which of the following statements about Lyme disease and its clinical manifestations is
correct?
(A) It is characterized by a rash throughout the trunk and extremities.
(B) The three stages of the disorder are distinctive and d o not overlap.
(C) It is caused by Borrelia burgdorferi.
(D) Manifestations of stage 3 may appear within 4 weeks of the initial infection.
24. Which of the following organisms is characterized by abrupt onset of fever, chills, and
unremitting headache?
25. Which of the following organisms causes neonatal sepsis?

26. Which of the following organisms causes relapsing fever and is transmitted by lice or ticks?
(A) Treponema
(B) Borrelia
(C) Leptospira
27. All of the following statements are true of staphylococcal and Neisseria infections EXCEPT
(A) pus production is a helpful diagnostic aid.
(B) localized infections may disseminate and cause severe clinical problems.
(C) both types of organisms cause urinary tract infections.
(D) Gram stain of clinical specimens is an important diagnostic aid.
(E) they both produce an enzyme that degrades IgA (IgAase).
28. Which of the following statements about congenital syphilis is correct?
(A) Syphilis serology test should be performed in the first and third trimesters of pregnancy.
(B) Clinical manifestations are generally mild.
(C) Newborns are infected only when they pass through the infected birth canal.
(D) Specimens should be cultured on blood agar.
29. Of the following components of Mycobacterium tuberculosis, which one is used for skin
testing?
(A) Cord factor
(B) Mycolic acid
(D) Sulfatides
(E) Wax D
30. A patient has a gastric ulcer not induced by nonsteroidal anti-inflammatory agents. Which
characteristic appears to play a central role in the ability of the organism to colonize the
stomach?
(A) Phospholipase C production
(B) Urease production
(C) Microaerophilic lifestyle
(D) O antigens
(E) Motility
31. Which of the following statements about mycobacterial disease is correct?
(A) Nontuberculous mycobacterial disease is as contagious as tuberculosis.
(B) Tuberculosis is caused by Mycobacterium tuberculosis, and nontuberculous disease is

caused by other mycobacteria, including Mycobacterium bovis, Mycobacterium kansasii, and
Mycobacterium avium-intracellulare.
(C) Water is a source of exposure to nontuberculous mycobacteria.
(D) Only nontuberculous disease is seen with great frequency in patients with acquired
immunodeficiency syndrome (AIDS).
(E) M tuberculosis is the only acid-fast mycobacterium.
32. Which of the following organisms is zoonotic and can be spread to humans by arthropod
vectors?
33. All of the following are characteristics of Legionella EXCEPT
(A) it is associated with water.

(B) it causes granulomatous lung infection.
(C) it is weakly gram-negative.
(D) it is a facultative, intracellular parasite.
(E) it is catalase positive.
34. Which of the following organisms grows contiguously in tissues with no respect to anatomic
barriers?
(A) Actinomyces israelii
(B) Mycobacterium leprae
(C) Mycobacterium kansasii
(D) Mycobacterium tuberculosis
35. Which of the following organisms is generally rod-shaped and acid-fast?
(A) Nocardia
(B) Actinomyces
(C) Mycobacteria
36. The Ghon complex, a lesion in the lung and regional lymph nodes, is found in
(A) actinomycotic mycetoma.
(B) tuberculoid leprosy.
(C) primary tuberculosis.
(D) cervical facial actinomycosis.
(E) soft tissue infections caused by Mycobacterium marinum.
37. Which of the following organisms has diverse animal reservoirs?

(A) Vibrio cholerae
(D) Shigella sonnei
38. Which of the following organisms causes acute icteric disease with protean manifestations?
(A) Treponema
(B) Borrelia
(C) Leptospira
39. Which statement about the two major forms of leprosy (tuberculoid and lepromatous) is
correct?
(A) Tuberculoid leprosy is the hardest to treat due to poor cell-mediated immunity.
(B) In either extreme form of leprosy, the lepromin test will be positive.
(C) Diagnostic work-up on the patient should include a physical examination, skin test, and
cultures.
(D) Biopsy sample of lesions from a lepromatous leprosy patient generally contains many
Mycobacterium leprae.
(E) Lepromatous leprosy patients usually have few lesions.
40. All of the following statements about nonâ€“spore-forming anaerobes are correct EXCEPT
(A) they are pleomorphic and can be either gram-negative or gram-positive.
(B) they are a common cause of intra-abdominal infections.
(C) they usually are found in mixed infections.
(D) they represent a minority of the total fecal flora.
(E) they include the Fusobacterium genus found in the oral cavity.
41. Which of the following statements about Pseudomonas aeruginosa is true?

42. Which one of the following statements about Francisella tularensis infections and their
treatment is correct?
(A) Culture of the suspected infection by the hospital laboratory is important.
(B) An effective vaccine is available, but only for use in high-risk groups.
(C) F tularensis causes a noninvasive focal skin infection.
(D) Relapses do not occur after treatment.
(E) The hallmark of F tularensis infection is regional buboes.
43. Of the following components of Mycobacterium tuberculosis, which one is responsible for
the acid-fast property of the organism?
(A) Cord factor
(B) Mycolic acid
(D) Sulfatides
(E) Wax D
44. Which of the following statements about Brucella infections is true?
(A) Brucella suis is the human pathogen; Brucella melitensis and Brucella abortus cause
infections in animals only.
(B) Brucella infection produces profound muscle weakness along with other relatively
nondescript manifestations.
(C) Brucella infection is a zoonotic disease spread to humans primarily by rat fleas.
(D) Untreated infections are self-limiting and resolve in 2 weeks.
(E) Brucella is an extracellular parasite.
45. Which of the following organisms presents with an initial rash on the extremities that
spreads to the trunk?
46. Which of the following statements about anthrax infections is correct?
(A) The early cutaneous form may mimic a staphylococcal furuncle or insect bite.
(B) Pulmonary and gastrointestinal anthrax tend to be chronic, with frequent treatment failure.
(C) Spores are routinely observed in lesion aspirates.
(D) The capsule is a long-chain polysaccharide.
(E) Primary animal reservoirs are rabbits and other rodents.
47. All of the following statements about Campylobacter infections are correct EXCEPT
(A) sepsis is a problem in debilitated patients with Campylobacter fetus species infection.
(B) human infections with Campylobacter jejuni are rare relative to Salmonella and Shigella
infections.
(C) C jejuni infection is usually self-limiting.
(D) C jejuni clinical specimens should be incubated at 42Â°C.
48. Which of the following group A streptococcal diseases is characterized by rash due to
erythrogenic toxins?
(A) Impetigo
(B) Scarlet fever
(C) Rheumatic fever
(D) Cellulitis
49. Which of the following is a virulence factor for Streptococcus pneumoniae?
(A) C-reactive protein
(B) Bacitracin
(C) Endotoxic lipopolysaccharide
(D) Capsular polysaccharide
50. All of the following are characteristics of group A streptococci EXCEPT
(A) they are part of the normal intestinal flora.
(B) they attach to epithelial cells via fimbriae containing lipoteichoic acid.
(C) they are rarely resistant to penicillin.
(D) they produce Î²-hemolysis with streptolysin S.
51. Which one of the following statements about laboratory diagnosis of diphtheria is correct?
(A) Organisms are delicate and survive poorly outside the host.
(B) It is sufficient to identify Corynebacterium diphtheriae in the isolate.
(C) Organisms are impossible to identify by Gram stain because of their small size.
(D) Culture on LÃ¶ffler's medium or tellurite medium should reveal characteristic Chinese letter
formation.
(E) Organisms are coagulase positive.
52. Which of the following statements about laboratory diagnosis of whooping cough is
correct?
(A) Lymphocyte numbers are greatly decreased.

(B) Cough plate is the method of choice to isolate organisms from the patient.
(C) The clinical specimen should be plated on Bordet-Gengou agar.
(D) The best chance to isolate the organism is during the paroxysmal stage.
(E) The causative organism is a gram-positive rod.
53. Which of the following statements about Shigella dysenteriae is true?
53. Which of the following organisms is an obligate intracellular bacterium with predilection for
multiplication within capillary endothelial cells?
55. All of the following are characteristics of Enterobacteriaceae EXCEPT
(A) they are a common cause of hospital-acquired infections.
(B) they are usually noninvasive and are part of the normal intestinal flora.
(C) some can produce both endotoxins and exotoxins.
(D) they have a short incubation period (several hours), leading to gastrointestinal disturbances.
(E) they ferment glucose.
56. Which of the following organisms invades mucosal epithelial cells?
(A) Vibrio cholerae
(D) Shigella sonnei
57. A 54-year-old man develops a pyogenic infection along the suture line after knee surgery.
The laboratory gives a preliminary report of a Î²-hemolytic, catalase-positive, coagulase-
positive, gram-positive coccus. The most likely causative agent is
(A) Moraxella catarrhalis
58. Which of the following statements about treatment and prevention of Haemophilus is
correct?
(A) Give rifampin to index case of Haemophilus influenzae meningitis and to family members to
eradicate the carrier state.
(B) Bacterial pinkeye is treated with intravenous ampicillin.
(C) Soft chancre is poorly contagious, and asymptomatic sexual partners need not be treated.
(D) The capsule is a highly effective vaccine in a target population of children 3 months to 6
years of age.
(E) Meningitis patients should be treated for 14 days with oral antibiotics.
59. Which of the following statements about Salmonella typhimurium is true?
60. Which of the following organisms causes pneumonitis resembling atypical pneumonia?
61. All of the following statements about the incidence of bacterial shock are correct EXCEPT
(A) it is usually a hospital-induced syndrome.
(B) it can occur after catheterization.
(C) it is reversible by penicillin.
(D) mortality is dependent on admission prognosis.
(E) it is usually preceded by a fever spike.
62. Which one of the following statements about laboratory diagnosis of Neisseria gonorrhoeae
is correct?
(A) Purulent discharge contains primarily neutrophils and intracellular diplococci.
(B) Asymptomatic patients are identified by culturing organisms from a clinical specimen with a
lubricated swab.
(C) Purulent discharge contains only intracellular diplococci.
(D) Clinical specimens should be plated onto blood agar to determine type of hemolysis.
(E) In disseminated infections, organisms can be routinely isolated from skin lesions.
63. Which of the following organisms is a mite-borne agent causing a rash that may be confused
with chickenpox?
64. Which of the following organisms is zoonotic and is transmitted to humans primarily by
contact with animal urine?
(A) Treponema
(B) Borrelia
(C) Leptospira
65. All of the following are characteristic of group B streptococci EXCEPT
(A) an effective vaccine incorporates proteinaceous capsular antigens.
(B) they are part of the normal vaginal flora.
(C) they are bacitracin-resistant.
(D) they agglutinate with Streptococcus agalactiae antiserum.
(E) they can cause neonatal sepsis and meningitis.
66. Which of the following statements about Vibrio cholerae is true?

(A) Nocardia
(B) Actinomyces
(C) Mycobacteria
68. All of the following statements about Listeria monocytogenes infection are correct EXCEPT
(A) abscesses and granulomas occur in many different tissues.
(B) laboratory isolation involves cold enrichment technique.
(C) neonatal infections have a poor prognosis.
(D) bacteria parasitize neutrophils and monocytes.
(E) neonatal infections occur only during passage through the infected birth canal.
69. Of the following components of Mycobacterium tuberculosis, which one interrupts

mitochondrial function?
(A) Cord factor
(B) Mycolic acid
(D) Sulfatides
(E) Wax D
70. Which of the following staphylococcal organisms causes urinary tract infections, primarily in
adolescent females?

71. Which of the following group A streptococcal diseases causes skin infection capable of
giving rise to a septicemia?
(A) Impetigo
(B) Scarlet fever
(C) Rheumatic fever
(D) Cellulitis
72. All of the following statements about Yersinia pestis infections are true EXCEPT
(A) wild rodents and their infected fleas are the primary reservoir.
(B) a key early manifestation is a slowly progressing malaise.
(C) the pneumonic form is far more contagious than the bubonic form.
(D) the bubonic form may progress to the pneumonic form.
73. Which of the following organisms is the most frequent cause of bacterial endocarditis?
1. A 16-year-old boy from a rural area presents with two highly inflammatory lesions in the
bearded area of his face. Both of the rashes are itchy, highly erythematous, sore to the touch,
and spreading. The most advanced lesion is clearing in the center, but the periphery continues to
expand. Skin scrapings from lesion margins mounted in potassium hydroxide demonstrate the
presence of true hyphae and arthroconidia. Which drug or combination is most appropriate?
(A) Amoxicillin
(B) Amoxicillin and clavulanate
(C) Amphotericin B
(D) An imidazole such as itraconazole
(E) Praziquantel
2. Pieces of plasmid or bacterial chromosomal DNA may be mistakenly packaged into the
capsid (head) of a bacterial virus. Assuming that no prophage state has existed in the phage
production, what is the process called when the virus with the bacterial or plasmid DNA infects
another bacterium?
(A) Conjugation
(B) Lysogeny
(C) Generalized transduction
(D) Specialized transduction
(E) Transformation
3.A 3-year-old child develops acute glomerulonephritis following impetigo. The bacterium is
a catalase-negative, gram-positive coccus that has M12 surface protein. What is the most

4. Which of the following exotoxins has a mode of action similar to that of Pseudomonas
exotoxin A?
(A) Botulinus toxin
(B) Diphtheria toxin
(C) Pertussis toxin
(D) Shiga toxin
(E) Tetanus toxin
5.Which of the following is found only in gram-positive bacteria?

(A) Capsule
(C) Outer membrane
(D) Peptidoglycan
(E) Teichoic acid
6.Which of the following has the highest association with hepatocellular carcinoma?
(A) Acute hepatitis A infection
(B) Acute hepatitis B infection
(C) Chronic hepatitis B infection
(D) Epstein-Barr virus infection
(E) Hepatitis B infection with hepatitis D superinfection
(F) Hepatitis E infection
7. A neonate develops meningitis at 7 days of age. Her mother is 16 years of age, is single, has
had multiple sexual partners without barrier protection, and lives in the United States. The
baby was born 23 hours after the mother's amniotic sac ruptured. What is the most likely
causative agent?
(A) Escherichia coli
(C) Listeria monocytogenes

8. In traveler's diarrhea caused by Escherichia coli, what is responsible for the fluid
and electrolyte disruption?
(A) Adherence causing palisade layers of the bacterium on the surface of the small intestine
(B) Capsule
(C) Invasion of the intestinal lining
(D) Exotoxin that inhibits protein synthesis by blocking elongation factor 2
(E) Exotoxin that causes an increase in cyclic adenosine monophosphate
(F) Exotoxin that inhibits protein synthesis by binding to the 60S ribosomal subunit
9. Which of the following antibiotics has a Î²-lactam ring in its structure?
(A) Tetracycline
(B) Cephalosporin
(C) Streptomycin
(D) Erythromycin
(E) Griseofulvin
(F) Bacitracin
10.What bacterial gene transfer process would be inhibited by free extracellular exonucleases?
(A) Conjugation
(B) Generalized transduction
(C) Specialized transduction
(D) Transformation
(E) Transposition
11. An alcoholic presents complaining of chest pain, fever, shaking chills, cough, and myalgia.
She was very cold 2 nights ago and says she has felt â€œpoorlyâ€ ever since. Her cough is
producing rust-colored, odorless, mucoid sputum. Her temperature on admission is 40Â°C. Her
white blood cell count is 16,000 cells/mm3 and is predominantly neutrophils with an overall left
shift. An Î±-hemolytic, lancet-shaped, gram-positive diplococcus is isolated on blood agar.
(A) Legionella pneumophila
(B) Klebsiella pneumoniae
12. A deficiency in nicotinamide adenine dinucleotide (NADH) or nicotinamide adenine

dinucleotide phosphate (NADPH) oxidase and an increased susceptibility to organisms of
low virulence are characteristic of
(A) chronic granulomatous disease.
(B) angioneurotic edema.
(C) chronic active hepatitis.

(D) Graves' disease.
13. In which of the following phases of growth is a gram-positive bacterium most susceptible to
the action of penicillin?
(A) Lag
(B) Exponential
(C) Stationary
(D) Decline
(E) Death
14. Which of the following statements about the prevention of clostridial infections is correct?
(A) The low incidence of spores in the environment makes prevention difficult.
(B) The tetanus vaccine should not be given to pregnant women.
(C) In developing countries, the incidence of neonatal tetanus can be minimized by ensuring the
cleanliness of the umbilical stump.
(D) The botulism vaccine should be given routinely to newborns to prevent infant botulism.
(E) Botulism is spread through inhalation of spores.
15. Which of the following statements about the treatment of cholera is correct?
(A) Ciprofloxacin is critical along with fluids for recovery; clinical response is slow and
the patient will remain sick for a few weeks.
(B) Replacement of fluid and electrolytes is most important and will lead to a dramatic
improvement; antibiotics will decrease the length of disease and the period of infectivity.
(C) Ciprofloxacin will not alter the course; replacement of fluids and electrolytes will lead to
gradual clinical improvement.
(D) Replacement of fluid and electrolytes is most important and will lead to a
dramatic improvement; antibiotics are contraindicated.
(E) Antitoxin along with fluid and electrolytes is critical to a rapid clinical response.
16. There is an outbreak of watery diarrhea in 6 members of a party of 20 who ate at a Chinese
(A) Bacillus cereus
(B) Giardia lamblia
(C) Norwalk agent
(D) Rotavirus
(F) Staphylococcus aureus
17. Which of the following phrases best describes a prophage?
(A) Phage that lacks receptors

(B) Phage attached to the cell wall that has released its DNA
(C) Newly assembled intracellular phage particle
(D) Intracellular temperate phage DNA
18. Which of the following terms best describes bacteria that can use fermentation pathways
and contain superoxide dismutase?
(A) Obligate aerobe
(B) Obligate anaerobe
(C) Facultative anaerobe
(D) Aerobic heterotroph
19. Which of the following contains N-acetylmuramic acid?
(A) Lipopolysaccharide
(B) Lipoprotein
(C) Outer membrane

(D) Peptidoglycan
(E) Teichoic acid
20. Which of the following is the most sensitive type of serologic test?
(A) Virus neutralization
(B) Enzyme-linked immunosorbent assay
(C) Nucleic acid hybridization
(D) Hemadsorption
(A) minimal medium.
(B) differential medium.
(C) selective medium.

(D) complex medium.
(A) Capsule
(C) Lipoprotein
(D) Mesosome
(E) Outer membrane
(F) Peptidoglycan
24. After extensive oral surgery, a patient who had rheumatic fever as a child did not take the
prescribed perioperative prophylactic antibiotics and subsequently developed subacute
infective endocarditis. Which of the following is the most likely causative agent?

25. Which of the following virulence factors is produced by several genera of bacteria that are
notable mucosal colonizers?
(A) Elastase
(B) Hemagglutinin
(D) Mucinase
(A) Eosin-methylene blue agar
(B) MacConkey agar
(C) Mueller-Hinton agar
(D) Tellurite agar
28. What major trait does Neisseria meningitidis have that is NOT found in
Neisseria gonorrhoeae?

29. All of the following substances are mediators of immediate (type I) hypersensitivity
EXCEPT
(A) histamine.
(B) anaphylatoxins.
(E) kinins.
30. In the following pairs of organisms, which two are easiest to distinguish from each other by
Gram stain?

(D) Corynebacterium and Lactobacillus
(E) Listeria and Proteus
32. A neonate with very low Apgar scores dies 2 hours after birth. Autopsy reveals
disseminated granulomatous lesions throughout; some are caseating, but they are not calcified.
During her pregnancy, the mother most likely had a septicemia caused by
(D) parvovirus B19.
(A) Gram-negative cocci usually strung in diplococci or chains
(B) Endotoxin
(C) Fimbriae
(D) Coagulase
(E) Catalase
(A) catalase.
(B) lipid A.

35. A burn patient has an infected area with odiferous, blue-green pus. What is the most

(A) the capsule.
(C) lipoprotein.
(D) the mesosome.
(E) the outer membrane.
(F) peptidoglycan.
(A) C difficile invades, surviving and causing disease in a mechanism similar to that of Listeria.
(B) C difficile invades, secreting two surface toxins inside the cells.
(C) C difficile stacks itself on the colonic surface to cause maladsorption and the appearance of a
pseudomembrane.
(D) C difficile exotoxins damage the cells, causing a disruption in transport and
attracting polymorphonuclear cells to cause the appearance of a pseudomembrane.
41. Which of the following statements regarding the clinical manifestations and consequences of

(B) Conjugal exchange of the DNA from both participants in the cross (drug resistance
is generally dominant)
(C) Transformation
43. A patient presents with explosive, watery, noninflammatory diarrhea along with
headache, abdominal cramps, nausea, vomiting, and fever. Symptoms began the day after
eating raw oysters in August. What is the most likely causative agent?
(A) Giardia lamblia
(B) Norwalk agent
(C) Rotavirus
44. A 7-year-old boy is seen with malaise, fever, sore throat, and swelling of both ankles and
wrists. He has a macular rash that began on his hands and feet (including his palms and soles)
and is progressing inward. A wood tick (Dermacentor) was removed 6 days earlier after his
return from scout camp in Tennessee. What is the most likely causative agent?


(F) Wear shoes outside in endemic regions
(A) Tetracycline
(B) Cephalosporin
(C) Streptomycin
(D) Erythromycin
(E) Griseofulvin
(F) Bacitracin
(A) Damage to the membrane
(B) Inhibition of DNA gyrase
(C) Inhibition of mycolic acid synthesis
(D) Binding to 30S ribosome
(E) Binding to 50S ribosome
(B) Mites

50. Which of the following genetic mechanisms is responsible for the conversion of nontoxigenic
strains of Corynebacterium diphtheriae to toxigenic strains?
(D) Conjugation
51. What is the first event in a patient who ultimately develops Neisseria meningitidis
meningitis?
(B) Meningococcemia
(C) Skin lesions

Review Test- General Properties of Microorganisms
1. Which of the following toxins has phospholipase C activity?
2. What type of phage is used in phage-typing?

(A) Prophage
(B) Virulent phage

(C) Temperate phage
3. Which of the following microorganisms contains RNA or DNA as a genetic material?

(A) Viruses
(B) Fungi
(C) Prions
(D) Bacteria
(E) Viroids
4. Which of the following enzymes would be most likely to affect sugar transport into bacteria?
(A) Acetyltransferase
(B) Neuraminidase
(C) Oxidase
(D) Phosphotransferase
5. Polymers of N-acetylglucosamine and N-acetylmuramic acid are found in which one of

the following chemical structures?
(A) Teichoic acid
(B) Cell wall
(C) Glycocalyx
6. What type of phage is not inactivated by proteases?

(A) Prophage
(B) Virulent phage

(C) Temperate phage
h
7. What type of bacteria synthesize organic compounds from inorganic compounds?
(A) Heterotrophs
(C) Aerobes
(E) Autotrophs
(A) Viruses
(B) Fungi
(C) Prions
(D) Bacteria
(E) Viroids

(A) Capsule
(C) Ordinary pili
(D) O-specific side chain
10. What type of bacteria display the Pasteur effect?

(A) Heterotrophs

(C) Aerobes

(E) Autotrophs
11. Which of the following characteristics applies to cephalosporin antibiotics?
(A) Are bacteriostatic

(B) Inhibit protein biosynthesis
(C) Treat fungal infections
(D) Treat patients allergic to penicillin
12. Which of the following toxins acts on synaptosomes?


13. Which one of the following statements applies to bacteria that contain superoxide dismutase?
(A) Need superoxide to grow
(B) Are frequently obligate anaerobes
(C) Grow slowly in the presence of CO2
(D) Produce hydrogen peroxide from hydrogen ion and the superoxide free radical (O2-)
14. Which of the following statements describes lysogenic phage conversion?
(A) The transformation of a virulent phage to a lysogenic phage
(B) A change in bacterial phenotype due to the presence of a prophage
(C) The conversion of a prophage to a temperate phage
(D) The incorporation of a prophage into the bacterial chromosome
15. Which of the following microorganisms may be inactivated by RNases with

endonuclease activity?
(A) Viruses
(B) Fungi
(C) Prions
(D) Bacteria
(E) Viroids
16. Which of the following types of media would best be used to isolate bacteria capable
of growth in a high-salt concentration?
(A) Minimal growth media
(B) Complex growth media
(C) Differential growth media
(D) Selective growth media
17. Which of the following characteristics applies to bacteriostatic antibiotics?
(A) Are effective when used in combination with bactericidal antibiotics to obtain a
synergistic effect
(B) Include all the antimetabolites

(C) Are effective against bacteria in all phases of growth
(D) Include some broad-spectrum antibiotics
18. What type of phage is exemplified by the lambda phage?

(A) Prophage
(B) Virulent phage
(C) Temperate phage
19. Which of the following statements concerning prokaryotic cells is true?

(A) They have coupled transcription and translation.
(B) They have processed mRNAs.
(C) They generally have exons and introns.
(D) They transfer secretory proteins into the Golgi apparatus before secretion.

(A) Heterotrophs

(C) Aerobes

(E) Autotrophs
21. Which of the following statements applies to the regulation of enzyme activity in
bacterial cells?
(A) Can be coupled to the binding of effector molecules
(B) Can be controlled by a catabolite activator protein
(C) May occur via attenuation sequences
(D) Can involve inducer molecules
22. The plasma membrane

(A) contains matrix porins.
(B) includes endotoxin.

(C) contains glycocalyx.
(D) contains the enzymes involved in bacterial oxidative phosphorylation.

(A) Viruses
(B) Fungi
(C) Prions
(D) Bacteria
(E) Viroids
24. Which of the following toxins induces electrolyte loss as a result of overproduction of
cyclic adenosine monophosphate?
Review Test - Bacterial Genetics
1. Bacterial antibiotic resistance is frequently conveyed by
(A) a temperate bacteriophage.
(B) an R factor plasmid.
(C) a replicon.
(D) a lytic bacteriophage.
(E) an intron.
2. The expression of the lac operon
(A) must be initiated by the binding of an inducer protein.
(B) involves the release of allolactose from a repressor protein.

(C) does not involve the expression of structural genes.
(D) necessitates the finding of RNA polymerase followed by transcription.
3. Which of the following requires cellâ€“cell contact?

(A) Transformation
(B) Conjugation
(C) Transduction
(D) Transcription
(E) Recombination
(F) Translation
4. Which of the following is mediated by a bacteriophage that carries host-cell DNA?

(A) Transformation
(B) Conjugation
(C) Transduction
(D) Transcription
(E) Recombination
(F) Translation
5. Which of the following involves exchange of allelic forms of genes?

(A) Transformation
(B) Conjugation
(C) Transduction
(D) Transcription
(E) Recombination
(F) Translation
6. Which of the following involves synthesis of RNA from a DNA template?

(A) Transformation
(B) Conjugation
(C) Transduction
(D) Transcription
(E) Recombination
(F) Translation
7. Which of the following creates high-frequency recombination donors?

(A) Transformation
(B) Conjugation
(C) Transduction
(D) Transcription
(E) Recombination
(F)Translation
Review T est- Bacteriology
1. Which of the following organisms is anaerobic?
(A) Nocardia
(B) Actinomyces
(C) Mycobacteria
2. Which of the following organisms spreads through inhalation of infected dust?

3. All of the following statements about clinical manifestations of Haemophilus influenzae

are correct EXCEPT
(A) acute bacterial epiglottitis is a mild disease in children.
(B) severe central nervous system deficits occur in one-third of recovered meningitis patients.
(C) pus production is typical.
(D) during viral influenza outbreaks, incidence of H influenzae increases.
(E) pneumonia is a complication usually seen in children or the aged.
4. A 22-year-old cystic fibrosis patient presents because of fever and increasing dyspnea. A
gram-negative organism is found in unusually high numbers in the mucus. Which virulence
factor is most important in colonization and maintenance of the organism in the lungs?
(A) Exotoxin A
(B) Pyocyanin (blue-green pigment)
(C) Polysaccharide slime
(D) Endotoxin
5. Exotoxin A most closely resembles the action of which of the following?
(A) Heat-labile (LT) Escherichia coli

(B) Shiga toxin
(C) Diphtheria toxin

(D) Vibrio cholerae toxin
(E) Verotoxin
6. Of the following components of Mycobacterium tuberculosis, which one

promotes intracellular survival by inhibiting phagosomeâ€“lysosome fusion?
(A) Cord factor
(B) Mycolic acid
(D) Sulfatides
(E) Wax D
7. What is the most likely causative agent of gastroenteritis starting on day 5 of
clindamycin treatment?
(A) Clostridium perfringens
(B) Clostridium difficile
(C) Pseudomonas aeruginosa
(D) Shigella sonnei
8. Which of the following organisms causes a relatively mild form of gastroenteritis?
(A) Vibrio cholerae


(D) Shigella sonnei
(A) Dermacentor tick bit.
(B) Human body louse bite.
(C) Ixodes tick bite.
(D) Respiratory droplets.
10. Which of the following staphylococcal organisms causes subacute bacterial endocarditis
that occurs 2 months or more after heart surgery?

11. Which of the following statements about clinical manifestations of clostridial infections
is correct?
(A) Clostridium perfringens does not infect nontraumatized tissues due to the
high oxidationâ€“reduction potential (Eh) of normal tissue.
(B) Infant botulism results from ingestion of preformed toxins in contaminated food.
(C) Tetanus causes death from cardiac dysfunction.
(D) The anaerobic cellulitis produced by C perfringens spreads to surrounding healthy tissues.
(E) Clostridium difficile produces a mild gastroenteritis.
12. Which of the following statements about Streptococcus pneumoniae is true?


13. Which of the following organisms grows in 40% bile?
14. Which of the following statements about treatment of clostridial infections is correct?
(A) Anaerobic cellulitis may require amputation or skin grafting.
(B) Clostridial food poisoning is severe, and patients infected with either Clostridium
perfringens or Clostridium botulinum frequently require hospitalization.
(C) Infant botulism should be treated with antibiotics to eradicate the organism.
(D) Antitoxins must be administered as soon as clostridial infection is suspected.
(E) Patients with anaerobic cellulitis should be given antitoxin and antibiotics.
15. All of the following are characteristics of Salmonella typhimurium EXCEPT

(A) it has a multianimal reservoir.
(B) it is one of the most common causes of enterocolitis.

(C) it ferments lactose.
(D) it is a common contaminant of poultry.

(E) it is a gram-negative, motile, endotoxin-bearing rod.
16. Which of the following is a characteristic of Bacteroides fragilis?
(A) Colonies have a distinctive black appearance.
(B) Organisms are susceptible to penicillin.
(C) Organisms possess a Î²-lactamase.
(D) Organisms are rarely found in the gastrointestinal tract.

17. Which of the following group A streptococcal diseases is highly communicable in infants?
(A) Impetigo
(B) Scarlet fever
(C) Rheumatic fever
(D) Cellulitis
18. Which of the following conditions is necessary for effective diagnosis of

anaerobic infections?
(A) Streaking on eosin-methylene blue (EMB) agar
(B) Rapid transport of culture to the laboratory
(C) Assay for superoxide dismutase
(D) Sputum sampling
19. Which of the following organisms is partially acid-fast and filamentous?

(A) Nocardia
(B) Actinomyces
(C) Mycobacteria
20. All of the following statements about Mycoplasma pneumoniae infections are true EXCEPT
(A) Eaton agent causes primary atypical pneumonia.
(B) M pneumoniae produces surface mucous membrane infections that do not

disseminate to other tissues.
(C) M pneumoniae is a slow-growing organism that requires 1â€“3 weeks to culture in

the laboratory.
(D) serologic tests for M pneumoniae involve complement fixation or cold agglutination.
(E) incidence of M pneumoniae is highest in elderly persons.
21. Which one of the following statements concerning Vibrio cholerae infections is correct?
(A) Death occurs in 2â€“4 weeks from exhaustion and respiratory failure.
(B) The disease is marked by organism invasion and hemorrhagic necrosis of the small intestine.
(C) Most pathology is attributable to a protein exotoxin.
(D) V cholerae produces an acute febrile disease with meningitis.
(E) There is no need to hospitalize patients with V cholerae infections. Organisms in stools
are not contagious because the organism is sensitive to acid pH.
22. Which of the following organisms causes septicemic disease?

(A) Vibrio cholerae

(D) Shigella sonnei
23. Which of the following statements about Lyme disease and its clinical manifestations
is correct?
(A) It is characterized by a rash throughout the trunk and extremities.
(B) The three stages of the disorder are distinctive and d o not overlap.
(C) It is caused by Borrelia burgdorferi.
(D) Manifestations of stage 3 may appear within 4 weeks of the initial infection.
24. Which of the following organisms is characterized by abrupt onset of fever, chills,
and unremitting headache?
25. Which of the following organisms causes neonatal sepsis?


26. Which of the following organisms causes relapsing fever and is transmitted by lice or ticks?
(A) Treponema
(B) Borrelia
(C) Leptospira
27. All of the following statements are true of staphylococcal and Neisseria infections EXCEPT
(A) pus production is a helpful diagnostic aid.
(B) localized infections may disseminate and cause severe clinical problems.
(C) both types of organisms cause urinary tract infections.
(D) Gram stain of clinical specimens is an important diagnostic aid.
(E) they both produce an enzyme that degrades IgA (IgAase).
28. Which of the following statements about congenital syphilis is correct?

(A) Syphilis serology test should be performed in the first and third trimesters of pregnancy.
(B) Clinical manifestations are generally mild.

(C) Newborns are infected only when they pass through the infected birth canal.
(D) Specimens should be cultured on blood agar.
29. Of the following components of Mycobacterium tuberculosis, which one is used for
skin testing?
(A) Cord factor
(B) Mycolic acid
(D) Sulfatides
(E) Wax D
30. A patient has a gastric ulcer not induced by nonsteroidal anti-inflammatory agents.
Which characteristic appears to play a central role in the ability of the organism to colonize
the stomach?
(A) Phospholipase C production

(B) Urease production
(C) Microaerophilic lifestyle
(D) O antigens
(E) Motility
31. Which of the following statements about mycobacterial disease is correct?
(A) Nontuberculous mycobacterial disease is as contagious as tuberculosis.
(B) Tuberculosis is caused by Mycobacterium tuberculosis, and nontuberculous disease is

caused by other mycobacteria, including Mycobacterium bovis, Mycobacterium kansasii, and
Mycobacterium avium-intracellulare.
(C) Water is a source of exposure to nontuberculous mycobacteria.
(D) Only nontuberculous disease is seen with great frequency in patients with
acquired immunodeficiency syndrome (AIDS).
(E) M tuberculosis is the only acid-fast mycobacterium.
32. Which of the following organisms is zoonotic and can be spread to humans by
arthropod vectors?


33. All of the following are characteristics of Legionella EXCEPT
(A) it is associated with water.
(B) it causes granulomatous lung infection.
(C) it is weakly gram-negative.
(D) it is a facultative, intracellular parasite.
(E) it is catalase positive.
34. Which of the following organisms grows contiguously in tissues with no respect to
anatomic barriers?
(A) Actinomyces israelii
(C) Mycobacterium kansasii
35. Which of the following organisms is generally rod-shaped and acid-fast?
(A) Nocardia
(B) Actinomyces
(C) Mycobacteria
36. The Ghon complex, a lesion in the lung and regional lymph nodes, is found in
(A) actinomycotic mycetoma.
(B) tuberculoid leprosy.
(C) primary tuberculosis.

(D) cervical facial actinomycosis.
(E) soft tissue infections caused by Mycobacterium marinum.
37. Which of the following organisms has diverse animal reservoirs?
(A) Vibrio cholerae


(D) Shigella sonnei
38. Which of the following organisms causes acute icteric disease with protean manifestations?
(A) Treponema
(B) Borrelia
(C) Leptospira
39. Which statement about the two major forms of leprosy (tuberculoid and
lepromatous) is correct?
(A) Tuberculoid leprosy is the hardest to treat due to poor cell-mediated immunity.
(B) In either extreme form of leprosy, the lepromin test will be positive.
(C) Diagnostic work-up on the patient should include a physical examination, skin test,
and cultures.
(D) Biopsy sample of lesions from a lepromatous leprosy patient generally contains
many Mycobacterium leprae.
(E) Lepromatous leprosy patients usually have few lesions.
40. All of the following statements about nonâ€“spore-forming anaerobes are correct EXCEPT
(A) they are pleomorphic and can be either gram-negative or gram-positive.
(B) they are a common cause of intra-abdominal infections.
(C) they usually are found in mixed infections.
(D) they represent a minority of the total fecal flora.
(E) they include the Fusobacterium genus found in the oral cavity.
41. Which of the following statements about Pseudomonas aeruginosa is true?


42. Which one of the following statements about Francisella tularensis infections and
their treatment is correct?
(A) Culture of the suspected infection by the hospital laboratory is important.
(B) An effective vaccine is available, but only for use in high-risk groups.
(C) F tularensis causes a noninvasive focal skin infection.
(D) Relapses do not occur after treatment.
(E) The hallmark of F tularensis infection is regional buboes.

43. Of the following components of Mycobacterium tuberculosis, which one is responsible
for the acid-fast property of the organism?
(A) Cord factor
(B) Mycolic acid
(D) Sulfatides
(E) Wax D
44. Which of the following statements about Brucella infections is true?
(A) Brucella suis is the human pathogen; Brucella melitensis and Brucella abortus
cause infections in animals only.
(B) Brucella infection produces profound muscle weakness along with other
relatively nondescript manifestations.
(C) Brucella infection is a zoonotic disease spread to humans primarily by rat fleas.
(D) Untreated infections are self-limiting and resolve in 2 weeks.
(E) Brucella is an extracellular parasite.
45. Which of the following organisms presents with an initial rash on the extremities that
spreads to the trunk?
46. Which of the following statements about anthrax infections is correct?
(A) The early cutaneous form may mimic a staphylococcal furuncle or insect bite.
(B) Pulmonary and gastrointestinal anthrax tend to be chronic, with frequent treatment failure.
(C) Spores are routinely observed in lesion aspirates.

(D) The capsule is a long-chain polysaccharide.
(E) Primary animal reservoirs are rabbits and other rodents.
47. All of the following statements about Campylobacter infections are correct EXCEPT
(A) sepsis is a problem in debilitated patients with Campylobacter fetus species infection.
(B) human infections with Campylobacter jejuni are rare relative to Salmonella and
Shigella infections.
(C) C jejuni infection is usually self-limiting.
(D) C jejuni clinical specimens should be incubated at 42Â°C.
48. Which of the following group A streptococcal diseases is characterized by rash due
to erythrogenic toxins?
(A) Impetigo
(B) Scarlet fever
(C) Rheumatic fever
(D) Cellulitis
49. Which of the following is a virulence factor for Streptococcus pneumoniae?

(A) C-reactive protein
(B) Bacitracin
(C) Endotoxic lipopolysaccharide
(D) Capsular polysaccharide
50. All of the following are characteristics of group A streptococci EXCEPT

(A) they are part of the normal intestinal flora.
(B) they attach to epithelial cells via fimbriae containing lipoteichoic acid.
(C) they are rarely resistant to penicillin.
(D) they produce Î²-hemolysis with streptolysin S.
51. Which one of the following statements about laboratory diagnosis of diphtheria is correct?
(A) Organisms are delicate and survive poorly outside the host.
(B) It is sufficient to identify Corynebacterium diphtheriae in the isolate.
(C) Organisms are impossible to identify by Gram stain because of their small size.
(D) Culture on LÃ¶ffler's medium or tellurite medium should reveal characteristic Chinese
letter formation.
(E) Organisms are coagulase positive.
52. Which of the following statements about laboratory diagnosis of whooping cough is
correct?
(A) Lymphocyte numbers are greatly decreased.
(B) Cough plate is the method of choice to isolate organisms from the patient.
(C) The clinical specimen should be plated on Bordet-Gengou agar.
(D) The best chance to isolate the organism is during the paroxysmal stage.
(E) The causative organism is a gram-positive rod.
53. Which of the following statements about Shigella dysenteriae is true?


53. Which of the following organisms is an obligate intracellular bacterium with predilection
for multiplication within capillary endothelial cells?

55. All of the following are characteristics of Enterobacteriaceae EXCEPT
(A) they are a common cause of hospital-acquired infections.
(B) they are usually noninvasive and are part of the normal intestinal flora.
(C) some can produce both endotoxins and exotoxins.
(D) they have a short incubation period (several hours), leading to gastrointestinal disturbances.
(E) they ferment glucose.
56. Which of the following organisms invades mucosal epithelial cells?
(A) Vibrio cholerae


(D) Shigella sonnei
57. A 54-year-old man develops a pyogenic infection along the suture line after knee surgery.
The laboratory gives a preliminary report of a Î²-hemolytic, catalase-positive, coagulase-

positive, gram-positive coccus. The most likely causative agent is
(A) Moraxella catarrhalis
58. Which of the following statements about treatment and prevention of

Haemophilus is correct?
(A) Give rifampin to index case of Haemophilus influenzae meningitis and to family members to
eradicate the carrier state.
(B) Bacterial pinkeye is treated with intravenous ampicillin.
(C) Soft chancre is poorly contagious, and asymptomatic sexual partners need not be treated.
(D) The capsule is a highly effective vaccine in a target population of children 3 months to 6
years of age.
(E) Meningitis patients should be treated for 14 days with oral antibiotics.
59. Which of the following statements about Salmonella typhimurium is true?


60. Which of the following organisms causes pneumonitis resembling atypical pneumonia?

61. All of the following statements about the incidence of bacterial shock are correct EXCEPT
(A) it is usually a hospital-induced syndrome.
(B) it can occur after catheterization.
(C) it is reversible by penicillin.
(D) mortality is dependent on admission prognosis.
(E) it is usually preceded by a fever spike.
62. Which one of the following statements about laboratory diagnosis of Neisseria
gonorrhoeae is correct?
(A) Purulent discharge contains primarily neutrophils and intracellular diplococci.
(B) Asymptomatic patients are identified by culturing organisms from a clinical specimen with a
lubricated swab.
(C) Purulent discharge contains only intracellular diplococci.

(D) Clinical specimens should be plated onto blood agar to determine type of hemolysis.
(E) In disseminated infections, organisms can be routinely isolated from skin lesions.
63. Which of the following organisms is a mite-borne agent causing a rash that may be
confused with chickenpox?
64. Which of the following organisms is zoonotic and is transmitted to humans primarily
by contact with animal urine?
(A) Treponema
(B) Borrelia
(C) Leptospira
65. All of the following are characteristic of group B streptococci EXCEPT
(A) an effective vaccine incorporates proteinaceous capsular antigens.

(B) they are part of the normal vaginal flora.
(C) they are bacitracin-resistant.

(D) they agglutinate with Streptococcus agalactiae antiserum.
(E) they can cause neonatal sepsis and meningitis.
66. Which of the following statements about Vibrio cholerae is true?



(A) Nocardia
(B) Actinomyces
(C) Mycobacteria
68. All of the following statements about Listeria monocytogenes infection are correct EXCEPT
(A) abscesses and granulomas occur in many different tissues.
(B) laboratory isolation involves cold enrichment technique.
(C) neonatal infections have a poor prognosis.
(D) bacteria parasitize neutrophils and monocytes.
(E) neonatal infections occur only during passage through the infected birth canal.
69. Of the following components of Mycobacterium tuberculosis, which one

interrupts mitochondrial function?
(A) Cord factor
(B) Mycolic acid

(D) Sulfatides
(E) Wax D
70. Which of the following staphylococcal organisms causes urinary tract infections, primarily
in adolescent females?
71. Which of the following group A streptococcal diseases causes skin infection capable
of giving rise to a septicemia?
(A) Impetigo
(B) Scarlet fever
(C) Rheumatic fever
(D) Cellulitis
72. All of the following statements about Yersinia pestis infections are true EXCEPT
(A) wild rodents and their infected fleas are the primary reservoir.
(B) a key early manifestation is a slowly progressing malaise.

(C) the pneumonic form is far more contagious than the bubonic form.
(D) the bubonic form may progress to the pneumonic form.
73. Which of the following organisms is the most frequent cause of bacterial endocarditis?

3. A 16-year-old boy from a rural area presents with two highly inflammatory lesions in the
bearded area of his face. Both of the rashes are itchy, highly erythematous, sore to the touch,
and spreading. The most advanced lesion is clearing in the center, but the periphery continues
to expand. Skin scrapings from lesion margins mounted in potassium hydroxide demonstrate
the presence of true hyphae and arthroconidia. Which drug or combination is most
appropriate?
(A) Amoxicillin
(B) Amoxicillin and clavulanate
(C) Amphotericin B
(D) An imidazole such as itraconazole
(E) Praziquantel
4. Pieces of plasmid or bacterial chromosomal DNA may be mistakenly packaged into the
capsid (head) of a bacterial virus. Assuming that no prophage state has existed in the phage
production, what is the process called when the virus with the bacterial or plasmid DNA infects
another bacterium?
(A) Conjugation
(B) Lysogeny
(C) Generalized transduction
(D) Specialized transduction
(E) Transformation
3.A 3-year-old child develops acute glomerulonephritis following impetigo. The bacterium is
a catalase-negative, gram-positive coccus that has M12 surface protein. What is the most
(G) Enterococcus faecalis
(H) Staphylococcus aureus
(I) Staphylococcus epidermidis
(J) Streptococcus agalactiae
(K) Streptococcus pneumoniae
(L) Streptococcus pyogenes
5. Which of the following exotoxins has a mode of action similar to that of

Pseudomonas exotoxin A?
(A) Botulinus toxin
(B) Diphtheria toxin
(C) Pertussis toxin

(D) Shiga toxin
(E) Tetanus toxin
5.Which of the following is found only in gram-positive bacteria?

(F) Capsule
(G) Lipopolysaccharide
(H) Outer membrane
(I) Peptidoglycan
(J) Teichoic acid
6.Which of the following has the highest association with hepatocellular carcinoma?
(G) Acute hepatitis A infection
(H) Acute hepatitis B infection
(I) Chronic hepatitis B infection
(J) Epstein-Barr virus infection
(K) Hepatitis B infection with hepatitis D superinfection
(L) Hepatitis E infection
10. A neonate develops meningitis at 7 days of age. Her mother is 16 years of age, is
single, has had multiple sexual partners without barrier protection, and lives in the United
States. The baby was born 23 hours after the mother's amniotic sac ruptured. What is the
most likely causative agent?
(C) Listeria monocytogenes

11. In traveler's diarrhea caused by Escherichia coli, what is responsible for the
fluid and electrolyte disruption?
(A) Adherence causing palisade layers of the bacterium on the surface of the small intestine
(B) Capsule
(C) Invasion of the intestinal lining
(D) Exotoxin that inhibits protein synthesis by blocking elongation factor 2
(E) Exotoxin that causes an increase in cyclic adenosine monophosphate
(F) Exotoxin that inhibits protein synthesis by binding to the 60S ribosomal subunit
12. Which of the following antibiotics has a Î²-lactam ring in its structure?
(G) Tetracycline
(H) Cephalosporin
(I) Streptomycin
(J) Erythromycin
(K) Griseofulvin
(L) Bacitracin
10.What bacterial gene transfer process would be inhibited by free extracellular exonucleases?
(F) Conjugation
(G) Generalized transduction
(H) Specialized transduction
(I) Transformation
(J) Transposition
15. An alcoholic presents complaining of chest pain, fever, shaking chills, cough, and myalgia.
She was very cold 2 nights ago and says she has felt â€œpoorlyâ€ ever since. Her cough is
producing rust-colored, odorless, mucoid sputum. Her temperature on admission is 40Â°C.
Her white blood cell count is 16,000 cells/mm3 and is predominantly neutrophils with an
overall left shift. An Î±-hemolytic, lancet-shaped, gram-positive diplococcus is isolated on
blood agar. What is the most likely causative agent?
(A) Legionella pneumophila
16. A deficiency in nicotinamide adenine dinucleotide (NADH) or nicotinamide adenine

dinucleotide phosphate (NADPH) oxidase and an increased susceptibility to organisms of
low virulence are characteristic of
(A) chronic granulomatous disease.
(B) angioneurotic edema.

(C) chronic active hepatitis.
(D) Graves' disease.
17. In which of the following phases of growth is a gram-positive bacterium most susceptible
to the action of penicillin?
(A) Lag
(B) Exponential
(C) Stationary
(D) Decline
(E) Death
18. Which of the following statements about the prevention of clostridial infections is correct?
(A) The low incidence of spores in the environment makes prevention difficult.
(B) The tetanus vaccine should not be given to pregnant women.
(C) In developing countries, the incidence of neonatal tetanus can be minimized by ensuring
the cleanliness of the umbilical stump.
(F) The botulism vaccine should be given routinely to newborns to prevent infant botulism.
(G) Botulism is spread through inhalation of spores.
15. Which of the following statements about the treatment of cholera is correct?
(F) Ciprofloxacin is critical along with fluids for recovery; clinical response is slow and the
patient will remain sick for a few weeks.
(G) Replacement of fluid and electrolytes is most important and will lead to a dramatic
improvement; antibiotics will decrease the length of disease and the period of infectivity.
(H) Ciprofloxacin will not alter the course; replacement of fluids and electrolytes will lead
to gradual clinical improvement.
(I) Replacement of fluid and electrolytes is most important and will lead to a
dramatic improvement; antibiotics are contraindicated.
(J) Antitoxin along with fluid and electrolytes is critical to a rapid clinical response.
18. There is an outbreak of watery diarrhea in 6 members of a party of 20 who ate at a

Chinese restaurant the day before. Fried rice is implicated. What is the most likely causative
agent?
(A) Bacillus cereus
(B) Giardia lamblia
(C) Norwalk agent
(D) Rotavirus
(F) Staphylococcus aureus
19. Which of the following phrases best describes a prophage?

(E) Phage that lacks receptors
(F) Phage attached to the cell wall that has released its DNA
(G) Newly assembled intracellular phage particle
(H) Intracellular temperate phage DNA
20. Which of the following terms best describes bacteria that can use fermentation pathways
and contain superoxide dismutase?
(A) Obligate aerobe
(B) Obligate anaerobe
(C) Facultative anaerobe
(D) Aerobic heterotroph
21. Which of the following contains N-acetylmuramic acid?
(E) Lipoprotein
(F) Outer membrane

(F) Peptidoglycan
(G) Teichoic acid
23. Which of the following is the most sensitive type of serologic test?
(A) Virus neutralization
(B) Enzyme-linked immunosorbent assay
(C) Nucleic acid hybridization
(D) Hemadsorption
(E) minimal medium.
(F) differential medium.
(G) selective medium.

(H) complex medium.
(A) Capsule
(C) Lipoprotein
(D) Mesosome
(E) Outer membrane
(F) Peptidoglycan
26. After extensive oral surgery, a patient who had rheumatic fever as a child did not take the
prescribed perioperative prophylactic antibiotics and subsequently developed subacute
infective endocarditis. Which of the following is the most likely causative agent?

27. Which of the following virulence factors is produced by several genera of bacteria that
are notable mucosal colonizers?
(A) Elastase
(B) Hemagglutinin
(D) Mucinase
(E) Eosin-methylene blue agar
(F) MacConkey agar
(G) Mueller-Hinton agar
(H) Tellurite agar
32. What major trait does Neisseria meningitidis have that is NOT found in
Neisseria gonorrhoeae?
33. All of the following substances are mediators of immediate (type I) hypersensitivity
EXCEPT
(A) histamine.
(B) anaphylatoxins.
(E) kinins.
34. In the following pairs of organisms, which two are easiest to distinguish from each other
by Gram stain?

(F) Corynebacterium and Lactobacillus
(G) Listeria and Proteus
34. A neonate with very low Apgar scores dies 2 hours after birth. Autopsy reveals
disseminated granulomatous lesions throughout; some are caseating, but they are not
calcified. During her pregnancy, the mother most likely had a septicemia caused by
(D) parvovirus B19.
(F) Gram-negative cocci usually strung in diplococci or chains
(G) Endotoxin
(H) Fimbriae
(I) Coagulase
(J) Catalase
(A) catalase.
(B) lipid A.

38. A burn patient has an infected area with odiferous, blue-green pus. What is the most

(G) the capsule.
(H) lipopolysaccharide.
(I) lipoprotein.
(J) the mesosome.
(K) the outer membrane.
(L) peptidoglycan.
(E) C difficile invades, surviving and causing disease in a mechanism similar to that of Listeria.
(F) C difficile invades, secreting two surface toxins inside the cells.
(G) C difficile stacks itself on the colonic surface to cause maladsorption and the appearance of
a pseudomembrane.
(H) C difficile exotoxins damage the cells, causing a disruption in transport and
attracting polymorphonuclear cells to cause the appearance of a pseudomembrane.
43. Which of the following statements regarding the clinical manifestations and consequences
of Neisseria gonorrhoeae infection is true?

(B) Conjugal exchange of the DNA from both participants in the cross (drug resistance is
generally dominant)
(C) Transformation
48. A patient presents with explosive, watery, noninflammatory diarrhea along with
headache, abdominal cramps, nausea, vomiting, and fever. Symptoms began the day after
eating raw oysters in August. What is the most likely causative agent?
(A) Giardia lamblia
(B) Norwalk agent
(C) Rotavirus
49. A 7-year-old boy is seen with malaise, fever, sore throat, and swelling of both ankles and
wrists. He has a macular rash that began on his hands and feet (including his palms and
soles) and is progressing inward. A wood tick (Dermacentor) was removed 6 days earlier
after his return from scout camp in Tennessee. What is the most likely causative agent?

(F) Avoid intravenous drug abuse.
(G) Avoid swimming in contaminated water.
(H) Avoid using human excrement as vegetable fertilizer.
(I) Cook fish and seafood thoroughly.
(J) Heat all canned foods to 60Â°C for 10 minutes.

(F) Wear shoes outside in endemic regions
(A) Tetracycline
(B) Cephalosporin
(C) Streptomycin
(D) Erythromycin
(E) Griseofulvin
(F) Bacitracin
(F) Damage to the membrane
(G) Inhibition of DNA gyrase
(H) Inhibition of mycolic acid synthesis
(I) Binding to 30S ribosome
(J) Binding to 50S ribosome
(B) Mites
53. Which of the following genetic mechanisms is responsible for the conversion of
nontoxigenic strains of Corynebacterium diphtheriae to toxigenic strains?
(D) Conjugation
54. What is the first event in a patient who ultimately develops Neisseria
meningitidis meningitis?
(B) Meningococcemia
(C) Skin lesions

CHAPTER 1
1. You’re watching a television program that is discussing

viruses called bacteriophages that can kill bacteria. Your
roommate says, “Wow, maybe viruses can be used to kill the
bacteria that infect people! You’re taking the Microbiology
course now; what’s the difference between viruses and
bacteria?” Which one of the following would be the most
accurate statement to make?
42.Viruses do not have mitochondria, whereas bacteria do.

43.Viruses do not have a nucleolus, whereas bacteria do.
44. Viruses do not have ribosomes, whereas bacteria do.
45. Viruses replicate by binary fission, whereas
bacteria replicate by mitosis.
46.Viruses are prokaryotic, whereas bacteria are eukaryotic.
2. Bacteria, fungi (yeasts and molds), viruses, and protozoa are

important causes of human disease. Which one of the following
microbes contains either DNA orRNA but not both?
(E) Bacteria
(F) Molds
(G) Protozoa
(H) Viruses
(I) Yeasts
3. Which one of the following contains DNA that is not
surrounded by a nuclear membrane?
45.Bacteria
46.Molds
47. Protozoa
48. Yeasts
ANSWERS
(D) (C)
(E) (D)
(F)(A)
CHAPTER 2
1. The initial step in the process of many bacterial infections is

adherence of the organism to mucous membranes. The
bacterial component that mediates adherence is the:
(F) Lipid A
(G) Nucleoid
(H) Peptidoglycan
(I) Pilus
(J) Plasmid
2. In the Gram stain procedure, bacteria are exposed to 95%

alcohol or to an acetone/alcohol mixture. The purpose of this
step is:
47.To adhere the cells to the slide

48.To retain the purple dye within all the bacteria
49. To disrupt the outer cell membrane so the purple dye can
leave the bacteria
50. To facilitate the entry of the purple dye into the
gram-negative cells
51.To form a complex with the iodine solution
3. In the process of studying how bacteria cause disease, it

was found that a rare mutant of a pathogenic strain failed to
form a capsule. Which one of the following statements is the
most accurate in regard to this unencapsulated mutant strain?
(F) It was nonpathogenic primarily because it was
easily phagocytized.
(G) It was nonpathogenic primarily because it could not invade
tissue.
(H) It was nonpathogenic primarily because it could only
grow anaerobically.
(I) It was highly pathogenic because it could secrete larger
amounts of exotoxin.
50.It was highly pathogenic because it could secrete
larger amounts of endotoxin.
4. Mycobacterium tuberculosis stains well with the acid-fast

stain, but not with the Gram stain. Which one of the following
is the most likely reason for this observation?
(E) It has a large number of pili that absorb the purple dye.
(F) It has a large amount of lipid that prevents entry of
the purple dye.
(G) It has a very thin cell wall that does not retain the
purple dye.
(H) It is too thin to be seen in the Gram stain.
(I) It has histones that are highly negatively charged.
5. Of the following bacterial components, which one

exhibits the most antigenic variation?
52.Capsule
53.Lipid A of endotoxin
54. Peptidoglycan
55. Ribosome
56.Spore
6. β-Lactamases are an important cause of antibiotic

resistance. Which one of the following is the most common
site where β-lactamases are located?
(F) Attached to DNA in the nucleoid

(G) Attached to pili on the bacterial surface
(H) Free in the cytoplasm
(I) Within the capsule
(J) Within the periplasmic space
7. Which one of the following is the most accurate

description of the structural differences between gram-
positive bacteria and gram-negative bacteria?
54.Gram-positive bacteria have a thick peptidoglycan layer,
whereas gramnegative bacteria have a thin layer.
55.Gram-positive bacteria have an outer lipid-rich
membrane, whereas gramnegative bacteria do not.
56. Gram-positive bacteria form a sex pilus that mediates
conjugation, whereas gram-negative bacteria do not.
57. Gram-positive bacteria have plasmids, whereas gram-
negative bacteria do not.
58.Gram-positive bacteria have capsules, whereas gram-
negative bacteria do not.
8. Bacteria that cause nosocomial (hospital-acquired) infections

often produce extracellular substances that allow them to stick
firmly to medical devices, such as intravenous catheters. Which
one of the following is the name of this extracellular substance?
(E) Axial filament

(F) Endotoxin
(G) Flagella
(H) Glycocalyx
(I) Porin
9. Lysozyme in tears is an effective mechanism for preventing

bacterial conjunctivitis. Which one of the following bacterial
structures does lysozyme degrade?
54.Endotoxin
55.Nucleoid DNA
56. Peptidoglycan
57. Pilus
58.Plasmid DNA
10. Several bacteria that form spores are important human

pathogens. Which one of the following is the most accurate
statement about bacterial spores?
57.They are killed by boiling for 15 minutes.

58.They are produced primarily by gram-negative cocci.
(E) They are formed primarily when the bacterium is exposed to
antibiotics.
(F) They are produced by anaerobes only in the presence of
oxygen.
(G) They are metabolically inactive yet can survive for years in
that inactive state.
ANSWERS
60. (D)
61. (C)
62. (A)
63. (B)
64. (A)
65. (E)
66. (A)
67. (D)
68. (C)
69. (E)
CHAPTER 3
1. Figure 3–1 depicts a bacterial growth curve divided

into phases a, b, c, and d. In which one of the phases are
antibiotics such as penicillin most likely to kill bacteria?
(E) Phase a
(F) Phase b
(G) Phase c
(H) Phase d
2. Some bacteria are obligate anaerobes. Which of the following

statements best explains this phenomenon?
63.They can produce energy both by fermentation (i.e.,

glycolysis) and by respiration using the Krebs cycle and
cytochromes.
64.They cannot produce their own ATP.
(F) They do not form spores.
(G) They lack superoxide dismutase and catalase.
(H) They do not have a capsule.
ANSWERS
66. (B)
67. (D)
CHAPTER 4
1. The emergence of antibiotic-resistant bacteria, especially in

enteric gramnegativerods, is a medically important
phenomenon. This most commonly occurs by a process that
involves a sex pilus and the subsequent transfer of plasmids
carrying one or more transposons. Which one of the following is
the name that best describes this process?
(F) Conjugation
(G) Transduction
(H) Transformation
(I) Translocation
(J) Transposition
2. Several important pathogenic bacteria have the ability to

translocate pieces of their DNA in a process called programmed
rearrangements. Which one of the following is the most
important known consequence of this ability?
68.The number of plasmids increases significantly,

which greatly enhances
antibiotic resistance.
69.The amount of endotoxin increases significantly, which

greatly enhances the
ability to cause septic shock.
70. The surface antigens of the bacteria vary

significantly, which greatly
enhances the ability to avoid opsonization by antibody.
(D) The ability of the bacterium to be lysogenized

is significantly increased,
which greatly enhances the ability to produce increased
amounts of exotoxins.
(E) The ability of the bacterium to survive intracellularly is

greatly increased.
3. Which statement is the most accurate regarding

transposons?
70.They encode enzymes that degrade the ends of the

bacterial chromosome.
71.They are short sequences of DNA that often encode enzymes
that mediate antibiotic resistance.
72. They are short sequences of RNA that silence
specific regulatory genes.
73. They are a family of transfer RNAs that enhance
mutations at “hot spots” in the bacterial genome.
4. Corynebacterium diphtheriae causes the disease diphtheria

by producing diphtheria toxin. The gene encoding the toxin is
integrated into bacterial genome during lysogenic conversion.
The toxin gene was acquired by which process?
(F) Conjugation
(G) Transduction
(H) Transformation
(I) Translocation
(J) Transposition
ANSWERS
73. (A)
74. (C)
75. (B)
76. (B)
CHAPTER -7
1. Handwashing is an important means of interrupting the

chain of transmission fromone person to another. Infection
by which one of the following bacteria is most likely to be
interrupted by handwashing?
(E) Borrelia burgdorferi

(F) Legionella pneumophila
(G) Staphylococcus aureus
(H) Streptococcus agalactiae (group B streptococcus)
(I) Treponema pallidum
2. Vertical transmission is the transmission of organisms from

mother to fetus or newborn child. Infection by which one of the
following bacteria is most likely to be transmitted vertically?
74.Chlamydia trachomatis
75.Clostridium tetani
76. Haemophilus influenzae
77. Shigella dysenteriae
78.Streptococcus pneumoniae
3. The cells involved with pyogenic inflammation are mainly

neutrophils, whereas the cells involved with granulomatous
inflammation are mainly macrophages and helper T cells.
Infection by which one of the following bacteria is most likely to

elicit granulomatous inflammation?

(B) Mycobacterium tuberculosis
(C) Neisseria gonorrhoeae
4. Which one of the following sets of properties of exotoxins and

endotoxins is correctly matched?
(A) Exotoxins—polypeptides; endotoxins—lipopolysaccharide

(B) Exotoxins—weakly antigenic; endotoxins—highly antigenic
(C) Exotoxins—produced only by gram-negative bacteria;
endotoxins—producedonly by gram-positive bacteria
(D) Exotoxins—weakly toxic per microgram; endotoxins—highly
toxic per microgram
(E) Exotoxins—toxoid vaccines are ineffective; endotoxins—
toxoid vaccines are effective
5. Which one of the following sets consists of bacteria both of

which produce exotoxins that increase cyclic AMP within
human cells?
(A) Vibrio cholerae and Corynebacterium diphtheriae

(B) Clostridium perfringens and Streptococcus pyogenes
(C) Escherichia coli and Bordetella pertussis
(D) Corynebacterium diphtheriae and Staphylococcus aureus
(E) Bacillus anthracis and Staphylococcus epidermidis
6. Which one of the following sets of bacteria produces

exotoxins that act by ADPribosylation?
(A) Corynebacterium diphtheriae and Escherichia coli

(B) Clostridium perfringens and Staphylococcus aureus
(C) Clostridium tetani and Bacillus anthracis
(D) Enterococcus faecalis and Mycobacterium tuberculosis
(E) Escherichia coli and Streptococcus pyogenes
7. Which of the following bacteria produce an exotoxin

that inhibits the release of acetylcholine at the
neuromuscular junction?
(A) Bacillus anthracis
(B) Bordetella pertussis
(C) Clostridium botulinum
(D) Corynebacterium diphtheriae
(E) Escherichia coli
8. A 25-year-old man with abdominal pain was diagnosed with

acute appendicitis.He then had a sudden rise in temperature to
39°C and a sudden fall in blood pressure. Which one of
the following is the most likely cause of the fever and
hypotension?
(A) An exotoxin that ADP-ribosylates elongation factor-2

(B) An exotoxin that stimulates production of large amounts of
cyclic AMP
(C) An endotoxin that causes release of tumor necrosis factor
(D) An endotoxin that binds to class I MHC protein
(E) An exoenzyme that cleaves hyaluronic acid
9. Several biotech companies have sponsored clinical trials of

a drug consisting of monoclonal antibody to lipid A. Sepsis
caused by which one of the following sets of bacteria is most
likely to be improved following administration of this antibody?
(A) Bordetella pertussis and Clostridium perfringens

(B) Escherichia coli and Neisseria meningitidis
(C) Pseudomonas aeruginosa and Bacillus anthracis
(D) Staphylococcus epidermidis and Staphylococcus aureus
(E) Streptococcus pneumoniae and Staphylococcus aureus
10. Regarding endotoxin, which one of the following is the

MOST accurate?
(A) Endotoxin is a polypeptide, the toxic portion of which

consists of two Dalanines.
(B) Endotoxin is produced by both gram-positive cocci as well
as gram-negative cocci.
(C) Endotoxin acts by binding to class II MHC proteins and
the variable portion of the beta chain of the T-cell receptor.
(D) Endotoxin causes fever and hypotension by inducing the
release of interleukins such as interleukin-1 and tumor
necrosis factor.
(E) The antigenicity of endotoxin resides in its fatty acid
side chains.
ANSWERS
1. (C)
2. (A)
3. (B)
4. (A)
5. (C)
6. (A)
7. (C)
8. (C)
9. (B)
10. (D)
CHAPTER 10
1. Cefazolin is often given prior to surgery to prevent

postsurgical wound infections. Which one of the following best
describes the mode of action of cefazolin?
(A) It acts as an electron sink depriving the bacteria of

reducing power.
(B) It binds to the 30S ribosome and inhibits bacterial protein
synthesis.
(C) It inhibits transcription of bacterial mRNA.
(D) It inhibits transpeptidases needed to
synthesize peptidoglycan.
(E) It inhibits folic acid synthesis needed to act as a methyl
donor.
2. Which one of the following drugs inhibits bacterial

nucleic acid synthesis by blocking the production of
tetrahydrofolic acid?
(A) Ceftriaxone
(B) Erythromycin
(C) Metronidazole
(D) Rifampin
(E) Trimethoprim
3. Regarding both penicillins and aminoglycosides, which one

of the following is the most accurate?
(A) Both act at the level of the cell wall.

(B) Both are bactericidal drugs.
(C) Both require an intact β-lactam ring for their activity.
(D) Both should not be given to children under the age of 8
years because damage to cartilage can occur.
(E) They should not be given together because they
are antagonistic.
4. Listed below are drug combinations that are used to treat

certain infections. Which one of the following is a
combination in which both drugs act to inhibit the same
metabolic pathway?
(A) Amphotericin and flucytosine

(B) Isoniazid and rifampin
(C) Penicillin G and gentamicin
(D) Sulfonamide and trimethoprim
5. Regarding penicillins and cephalosporins, which one of the

following is the most accurate?
(A) Cleavage of the β-lactam ring will inactivate penicillins

but not cephalosporins.
(B) Penicillins act by inhibiting transpeptidases but
cephalosporins do not.
(C) Penicillins and cephalosporins are both bactericidal drugs.
(D) Penicillins and cephalosporins are active against gram-
positive cocci but not against gram-negative rods.
(E) Renal tubule damage is an important adverse effect caused
by both penicillins and cephalosporins.
6. Regarding antimicrobial drugs that act by inhibiting nucleic
acid synthesis in bacteria, which one of the following is the
most accurate?
(A) Ciprofloxacin inhibits RNA polymerase by acting as a

nucleic acid analogue.
(B) Rifampin inhibits the synthesis of messenger RNA.
(C) Sulfonamides inhibit DNA synthesis by chain termination
of the elongatingstrand.
(D) Trimethoprim inhibits DNA polymerase by preventing
the unwinding ofdouble-stranded DNA.
7. Regarding aminoglycosides and tetracyclines, which one of

the following is the most accurate?
(A) Both classes of drugs are bactericidal.

(B) Both classes of drugs inhibit protein synthesis by binding to
the 30S ribosomal subunit.
(C) Both classes of drugs inhibit peptidyl transferase,
the enzyme that synthesizes the peptide bond.
(D) Both classes of drugs must be acetylated within
human cells to form the active antibacterial compound.
(E) Both classes of drugs cause brown staining of teeth when
administered toyoung children.
8. The selective toxicity of antifungal drugs, such as

amphotericin B and itraconazole, is based on the presence in
fungi of which one of the following?
(A) 30S ribosomal subunit

(B) Dihydrofolate reductase
(C) DNA gyrase
(D) Ergosterol
(E) Mycolic acid
9. The next three questions ask about the adverse effects of

antibiotics, which are an important consideration when
deciding which antibiotic to prescribe. Which antibiotic causes
significant neurotoxicity and must be taken in conjunction with
pyridoxine (vitamin B6) to prevent these neurologic
complications?
(A) Amoxicillin
(B) Ceftriaxone
(C) Isoniazid
(D) Rifampin
(E) Vancomycin
10. Of the following antibiotics, which one causes the most
phototoxicity (rash when exposed to sunlight)?
(A) Amphotericin B
(B) Ciprofloxacin
(C) Gentamicin
(D) Metronidazole
(E) Sulfamethoxazole
11. Which of the following antibiotics causes “red

man” syndrome?
(A) Azithromycin
(B) Doxycycline
(C) Gentamicin
(D) Sulfamethoxazole
(E) Vancomycin
ANSWERS
1. (D)
2. (E)
3. (B)
4. (D)
5. (C)
6. (B)
7. (B)
8. (D)
9. (C)
10. (E)
11. (E)
CHAPTER -11
1. The spread of antibiotic resistance from one bacterium to

another is a well recognizedand clinically important
phenomenon. Which one of the following mechanisms is
most likely to be involved with the spread of resistance?
(A) Acetylation
(B) Conjugation
(C) Programmed rearrangement
(D) Protoplast mobility
(E) Translation
2. Regarding the specific mechanisms by which bacteria

become resistant to antimicrobial drugs, which one of the
(A) Some bacteria contain an enzyme that cleaves the ring

of aminoglycosides.
(B) Some bacteria contain clavulanic acid, which binds to
penicillin G and inactivates it.
(C) Some bacteria contain a mutated gene encoding an altered
transpeptidase, which makes it resistant to doxycycline.
(D) Some bacteria contain a mutated gene that encodes an
altered RNA polymerase, which makes it resistant to rifampin.
(E) Some bacteria contain an altered ribosomal protein,

which makes it resistant to isoniazid.
3. The susceptibility of bacteria to an antibiotic is often

determined by using the minimal inhibitory concentration
(MIC) assay. Regarding the MIC assay, which one of the
(A) MIC is the lowest concentration of the bacteria isolated from

the patient that inhibits the activity of a standard dose of
antibiotic.
(B) MIC is the lowest concentration of antibiotic that inhibits
the growth of the bacteria isolated from the patient.
(C) MIC is the lowest concentration of antibiotic that kills
the bacteria isolated from the patient.
(D) MIC is the lowest concentration of antibiotic in the patient’s
serum that inhibits the activity of a standard dose of antibiotic.
4. The minimal inhibitory concentration (MIC) of the patient’s

organism to penicillin is 1 μg/mL and the MIC to gentamicin is
8 μg/mL. However, the MIC to a combination of penicillin and
gentamicin is 0.01 μg/mL. Which one of the following terms
is the most accurate to describe this effect?
(A) Activation
(B) Antagonism
(C) Reassortment
(D) Recombination
(E) Synergism
5. Regarding the mechanisms of resistance to specific drugs,

which one of the following is most accurate?
(A) Certain strains of Enterococcus faecalis produce D-

lactate rather than Dalanine, which causes them to be
resistant to vancomycin.
(B) Certain strains of Escherichia coli produce ergosterol, which
causes them to be resistant to gentamicin.
(C) Certain strains of Neisseria gonorrhoeae produce a mutant
peptidyl transferase, which causes them to be resistant to
tetracycline.
(D) Certain strains of Streptococcus pyogenes produce a β-
lactamase, which causes them to be resistant to erythromycin.
ANSWERS
1. (B)
2. (D)
3. (B)
4. (E)
5. (A)
CHAPTER 14
1. The main reason why some bacteria are anaerobes (i.e., they
cannot grow in the presence of oxygen) is because:
(A) they do not have sufficient catalase and superoxide

dismutase.
(B) they have too much ferrous ion that is oxidized to ferric
ion in the presence ofoxygen.
(C) they have unusual mitochondria that cannot function
in the presence ofoxygen.
(D) transcription of the gene for the pilus protein is
repressed in the presence of oxygen.
2. Which one of the following sets consists of bacteria that are

both anaerobes?
(A) Actinomyces israeli and Serratia marcescens

(B) Campylobacter jejuni and Vibrio cholerae
(C) Clostridium perfringens and Bacteroides fragilis
(D) Mycobacterium tuberculosis and Pseudomonas aeruginosa
(E) Mycoplasma pneumoniae and Corynebacterium diphtheriae
ANSWERS
1. (A)
2. (C)
CHAPTER 16
1. Regarding the differences between Neisseria meningitidis
(meningococci) and Neisseria gonorrhoeae (gonococci), which
one of the following is the most accurate statement?
(A) Meningococci are oxidase-positive, whereas gonococci

are not.
(B) Meningococci have a thick polysaccharide capsule,
whereas gonococci do not.
(C) Meningococci have lipid A, whereas gonococci do not.
(D) Meningococci produce penicillinase, whereas gonococci do
not.
(E) Meningococci synthesize IgA protease, whereas
gonococci do not.
2. Your patient is a 14-year-old girl who was sent home from

school because she had a fever of 102°C, a severe headache,
and was falling asleep in class. When 302 her fever rose to
104°C, her mother took her to the emergency room, where a
blood pressure of 60/20 and several petechial hemorrhages
were found. Gramnegative diplococci were seen in a Gram stain
of the spinal fluid. Which one of the following is most likely to
cause the fever, hypotension, and petechial hemorrhages?
(A) Endotoxin
(B) IgA protease
(C) Oxidase
(D) Pilus protein
(E) Superantigen
3. Regarding the patient in Question 2, which one of the

following is the bestantibiotic to treat the infection?
(A) Azithromycin
(B) Doxycycline
(C) Penicillin G
(D) Rifampin
(E) Trimethoprim-sulfamethoxazole
4. Regarding the differences between Neisseria meningitidis
(meningococci) and Neisseria gonorrhoeae (gonococci), which
one of the following is the most accurate statement?
(A) Humans are the reservoir for both organisms.

(B) Many clinical isolates of meningococci produce β-lactamase,
but clinical isolates of gonococci do not.
(C) Meningococci have multiple antigenic types, but gonococci
have only one antigenic type.
(D) The conjugate vaccine against gonorrhea contains
seven types of the pilus protein as the immunogen.
(E) The main mode of transmission for both organisms is
respiratory droplets.
5. Your patient is a 20-year-old man with a urethral exudate.

You do a Gram stain of the pus and see gram-negative
diplococci with neutrophils. Which one of the following is the
best antibiotic to treat the infection?
(A) Ceftriaxone
(B) Gentamicin
(C) Penicillin G
(D) Trimethoprim-sulfamethoxazole
(E) Vancomycin
ANSWERS
1. (B)
2. (A)
3. (C)
4. (A)
5. (A)
CHAPTER 17
1. Which one of the following is a club-shaped, gram-positive

rod that causes disease by producing an exotoxin that kills
cells by inhibiting elongation factor-2, resulting in the
inhibition of protein synthesis?

(B) Bacillus cereus
(C) Clostridium perfringens
(E) Listeria monocytogenes
2. Which one of the following is a large gram-positive rod that
causes necrosis of tissue by producing an exotoxin that
degrades lecithin, resulting in the lysis of cell membranes?

(B) Bacillus cereus
3. Which one of the following sets of bacteria causes disease

characterized by a pseudomembrane?
(A) Bacillus anthracis and Listeria monocytogenes

(B) Bacillus cereus and Clostridium perfringens
(C) Bacillus cereus and Clostridium tetani
(D) Corynebacterium diphtheriae and Clostridium difficile
(E) Corynebacterium diphtheriae and Listeria monocytogenes
4. Disease caused by which one of the following sets of bacteria

can be prevented by a toxoid vaccine?
(A) Bacillus anthracis and Clostridium botulinum

(B) Bacillus anthracis and Clostridium perfringens
(C) Bacillus cereus and Clostridium tetani
(D) Corynebacterium diphtheriae and Clostridium tetani
(E) Corynebacterium diphtheriae and Listeria monocytogenes
5. Your patient in the pediatric intensive care unit is a 2-week-

old boy with a high fever and the signs of meningitis. Gram
stain of the spinal fluid reveals small gram-positive rods.
Colonies on blood agar show a narrow zone of β-hemolysis.
Which one of the following is the most likely cause of his
neonatal meningitis?

(B) Bacillus cereus
following is the best antibiotic to treat the infection?
(A) Doxycycline
(B) Gentamicin
(C) Metronidazole
(D) Trimethoprim-sulfamethoxazole
(E) Vancomycin
7. Your patient is a 40-year-old woman with diplopia and other

signs of cranial nerve weakness. History reveals she grows her
own vegetables and likes to preserve them in jars that she
prepares at home. She is fond of her preserved string beans,
which is what she ate uncooked in a salad for dinner last night.
Which one of the following is the most likely cause of this
clinical picture?

(D) Clostridium tetani
8. Your patient is a 30-year-old man with a 2-cm lesion on his

arm. It began as a painless papule that enlarged and, within a
few days, ulcerated and formed a black crust (eschar). He
works in an abattoir where his job is removing the hide
from the cattle. A Gram stain of fluid from the lesion reveals
large gram-positive rods. Which one of the following bacteria is
likely to be the cause?

(D) Clostridium tetani
9. Your patient is a 30-year-old man who was brought to the

emergency room
following a motorcycle accident in which he sustained a

compound fracture of his leg. He now has a high fever and a
rapidly spreading cellulitis with crepitus in the area of the
fracture. Large gram-positive rods are seen on the exudate.
Necrotic tissue was debrided. Which one of the following is
the best antibiotic to treat the infection?
(A) Azithromycin
(B) Ciprofloxacin
(C) Gentamicin
(D) Penicillin G
(E) Vancomycin
10. Your patient is a 65-year-old woman who is several days

post-op following removal of her carcinoma of the colon. She
now spikes a fever and has a cough, and chest X-ray shows
pneumonia. While being treated with the appropriate
antibiotics, she develops severe diarrhea. You suspect she may
have pseudomembranous colitis. Which one of the following is
the best antibiotic to treat the infection?
(A) Ceftriaxone
(B) Doxycycline
(C) Gentamicin
(D) Metronidazole
(E) Trimethoprim-sulfamethoxazole
ANSWERS
1. (D)
2. (C)
3. (D)
4. (D)
5. (E)
6. (D)
7. (B)
8. (A)
9. (D)
10. (D)
Chapter 18
1. Your patient is a 75-year-old man with an indwelling urinary
catheter following prostatectomy for prostate cancer. He now
has the sudden onset of fever to 40°C,
blood pressure of 70/40, and a pulse of 140. You draw several

blood cultures, and the laboratory reports that all are positive
for a gram-negative rod that forms red pigmented colonies.
Which one of the following bacteria is the most likely

cause of this infection?

(C) Proteus mirabilis
(D) Pseudomonas aeruginosa
(E) Serratia marcescens
2. You’re a public health epidemiologist who is called to

investigate an outbreak of bloody diarrhea in 16 people. You
find that it is associated with eating rare hamburgers in a
particular fast-food restaurant. A culture of the remaining
uncooked hamburger grows a gram-negative rod that produces
a dark purple colony on EMB agar, which is evidence that it
ferments lactose.Which one of the following bacteria is the most
likely cause of this outbreak?

(B) Salmonella enterica
(D) Shigella dysenteriae
(E) Vibrio cholerae
3. Your patient has third-degree burns over most of his body.
He was doing well until 2 days ago, when he spiked a fever,
and his dressings revealed pus that had a blue-green color.
Gram stain of the pus revealed a gram-negative rod that
formed colorless colonies on EMB agar. Which one of the
following bacteria is the most likely cause of this infection?
(A) Campylobacter jejuni

(B) Escherichia coli
(C) Haemophilus influenzae
(E) Salmonella enterica

following is the best combination of antibiotics to treat the
infection?
(A) Azithromycin plus gentamicin

(B) Doxycycline plus gentamicin
(C) Metronidazole plus gentamicin
(D) Piperacillin/tazobactam plus gentamicin
(E) Vancomycin plus gentamicin
5. Regarding the members of the family Enterobacteriaceae,

which one of the following is the most accurate?
(A) All members of the family are anaerobic, which means they
must be cultured in the absence of oxygen.
(B) All members of the family ferment lactose, which is an
important diagnostic criterion in the clinical laboratory.
(C) All members of the family have endotoxin, an
important pathogenetic factor.
(D) All members of the family produce an enterotoxin,
which ADP-ribosylates a G protein in human enterocytes.
6. You’re on a summer program working in a clinic in a small

village in Ecuador. There is an outbreak of cholera, and your
patient has massive diarrhea and a blood pressure of 70/40.
Which one of the following would be the most appropriate
action to take?
(A) Administer antimotility drugs to diminish the diarrhea.
(B) Administer intravenous saline to replenish volume.
(C) Administer tetracycline to kill the organism.
(E) Perform stool cultures and fecal leukocyte tests to make
an accurate diagnosis.
7. Your patient is a 20-year-old woman with diarrhea. She has
just returned to the United States from a 3-week trip to Peru,
where she ate some raw shellfish at the farewell party. She now
has severe watery diarrhea, perhaps 20 bowel movements a
day, and is feeling quite weak and dizzy. Her stool is
guaiacnegative, a test that determines whether there is blood
in the stool. A Gram stain of the stool reveals curved gram-
negative rods. Culture of the stool on MacConkey’s agar shows
colorless colonies. Which one of the following bacteria is the
most likely cause of this infection?

(B) Helicobacter pylori
(E) Vibrio cholerae
8. Your patient is a 6-year-old boy with bloody diarrhea for the

past 2 days accompanied by fever to 40°C and vomiting. He has
a pet corn snake. Blood culture and stool culture from the boy
and stool culture from the snake (taken very carefully!) revealed
the same organism. The cultures grew a gram-negative rod that
formed colorless colonies on EMB agar. Which one of the
(A) Helicobacter pylori

(B) Proteus mirabilis
(C) Salmonella enterica
(D) Shigella dysenteriae
(E) Vibrio cholerae
9. Your patient is a 25-year-old woman with pain on urination

and cloudy urine but no fever or flank pain. She has not been
hospitalized. You think she probably has cystitis, an infection
of the urinary bladder. A Gram stain of the urine reveals
gram-negative rods. Culture of the urine on EMB agar shows
colorless colonies, and a urease test was positive. Swarming
motility was noted on the blood agar plate. Which one of the

(B) Helicobacter pylori
(E) Serratia marcescens
10. Your patient has abdominal pain, and a mass is discovered

in the left lower quadrant. Upon laparotomy (surgical opening
of the abdomen), an abscess isfound. Culture of the pus
revealed Bacteroides fragilis. Regarding this organism,
which one of the following is the most accurate?
(A) A stage in the life cycle of B. fragilis involves forming

spores in the soil.
(B) B. fragilis is an anaerobic gram-negative rod whose natural
habitat is the
human colon.
(C) B. fragilis produces black colonies when grown on blood

agar.
(D) Pathogenesis by B. fragilis involves an exotoxin
that increases cyclic AMP
by ADP-ribosylation of a G protein.
(E) The toxoid vaccine should be administered to prevent

disease caused by B.
fragilis.
following is the best antibiotic to treat the infection?
(A) Doxycycline
(B) Gentamicin
(C) Metronidazole
(D) Penicillin G
(E) Rifampin
12. Your patient in the gastrointestinal clinic is a 50-year-old
insurance salesman with what he describes as a “sour
stomach” for several months. Antacids relieve the symptoms.
After taking a complete history and doing a physical
examination, you discuss the case with your resident, who
suggests doing a urea breath test, which tests for the presence
of urease. Which one of the following bacteria does the
resident think is the most likely cause of the patient’s disease?
(A) Helicobacter pylori

(B) Proteus mirabilis
(C) Salmonella enterica
(D) Serratia marcescens
(E) Shigella dysenteriae
13. Your patient is a 35-year-old woman with epilepsy who had

a grand-mal seizure about 2 months ago. She comes to see you
now because she has been coughing up foul-smelling sputum
for the past week. Chest X-ray reveals a cavity with an airfluid
level. Gram stain of the sputum reveals gram-negative rods,
and culture reveals black colonies that grow on blood agar only
in the absence of air. Which one of the following bacteria is the
(A) Bacteroides fragilis

(B) Campylobacter jejuni
(C) Klebsiella pneumoniae
(D) Prevotella melaninogenica
(E) Proteus mirabilis
ANSWERS
1. (E)
2. (A)
3. (D)
4. (D)
5. (C)
6. (B)
7. (E)
8. (C)
9. (C)
10. (B)
11. (C)
12. (A)
13. (D)
Chapter 19
1. Your patient is a 75-year-old man who has smoked

cigarettes (two packs a day for more than 50 years) and
consumed alcoholic drinks (a six pack of beer each day) for
most of his adult life. He now has the signs and symptoms of
pneumonia. Gram stain of the sputum reveals neutrophils but
no bacteria. Colonies appear on buffered charcoal yeast (BYCE)
agar but not on blood agar. Which one of the following bacteria
is most likely to be the cause of his pneumonia?
(A) Bordetella pertussis

(D) Legionella pneumophila
(E) Pseudomonas aeruginosa

following is the best
antibiotic to treat the infection?
(A) Azithromycin
(B) Ceftriaxone
(C) Gentamicin
(D) Metronidazole
(E) Piperacillin/tazobactam
3. Your patient is a 6-year-old boy who is complaining that his

ear hurts. His mother says this began yesterday and that he
has a fever of 103°F. On physical exam, you
see a perforated ear drum that is exuding a small amount of
pus. Using a swab, you obtain a sample of the pus and do a
Gram stain and culture. The Gram stain reveals small
coccobacillary rods. There is no growth on a blood agar plate,
but a chocolate agar plate supplemented with X and V
factors grows small grey colonies. Which one of the following
bacteria is the most likely cause of his otitis media?

4. It’s time to play “What’s my name?” I am a small gram-

negative rod that causes an important respiratory tract disease.
I produce an exotoxin that ADP-ribosylates a G protein. One
remarkable feature of my disease is a great increase in
lymphocytes. I don’t cause disease commonly in the United
States now because of the widespread use of the vaccine that
induces antibodies against five of my proteins, one of which is
the exotoxin. The identity of the mystery organism is
mostly likely which of the following?

5. Your patient is a 75-year-old woman with a 110 pack-year

history of cigarettesmoking who now has a fever of 39°C and a
cough productive of yellowish sputum. Gram stain of the
sputum shows small gram-negative rods. There is no

growth on blood agar, but colonies do grow on chocolate agar
supplemented with hemin and NAD. Which one of the following
bacteria is the most likely cause of her pneumonia?

6. Your patient is a 5-year-old boy with a high fever and signs

of respiratory tract obstruction. Visualization of the epiglottis
shows inflammation characterized by marked swelling and
“cherry-red” appearance. Which one of the following is the
best antibiotic to treat the infection?
(A) Ampicillin
(B) Ceftriaxone
(C) Doxycycline
(D) Gentamicin
(E) Metronidazole
ANSWERS
1. (D)
2. (A)
3. (B)
4. (A)
5. (B)
6. (B)
Chapter 20
1. Your patient is a 10-year-old boy who has a high fever and
swollen, painful axillary lymph nodes on the left side. His
mother says that he brought home a dead rat a few days ago.
You suspect he may have bubonic plague. Regarding the
causative organism, which one of the following is most
accurate?
(A) It has a very low ID50.

(B) It is transmitted from rodents to humans by ticks.
(C) It is endemic primarily in the states along the East Coast
of the United States.
(D) Its main virulence factor is an exotoxin that induces
interleukin-2 (IL-2) production by CD4-positive helper T cells.
(E) Infection should be treated with high doses of penicillin
G intravenously.
2. Your patient is a 20-year-old man who was bitten on the

hand when he tried to break up a fight between two cats
yesterday. He now has a red, hot, tender, swollen lesion at the
bite site that has spread rapidly across his hand. Which one
of the following bacteria is the most likely cause of his
cellulitis?
(A) Brucella melitensis

(B) Francisella tularensis
(D) Yersinia pestis
3. Your patient is a 30-year-old woman who reports that she

has had intermittent fever of 102°F, sweating, and fatigue
for the past month or so. She has lost her appetite and has
lost about 10 pounds in that period. She enjoys eating
unpasteurized goat cheese. On examination,
hepatosplenomegaly is detected. A blood count reveals
pancytopenia. Which one of the following bacteria is the
(A) Brucella melitensis

(B) Francisella tularensis
(D) Yersinia pestis
4. Regarding Bartonella henselae, which one of the following is
most accurate?
(A) B. henselae is an anaerobic, spore-forming, gram-

positive rod.
(B) The natural habitat of B. henselae is the cat’s mouth.
(C) B. henselae causes cellulitis in immunocompromised
patients such as AIDS
patients.
(D) Diagnosis in the clinical laboratory depends on detecting

antibodies in the
patient’s serum that will agglutinate cardiolipin.
(E) The drug of choice for B. henselae infections
is metronidazole.
ANSWERS
1. (A)
2. (C)
3. (A)
4. (B)
Chapter 21
1. Your patient is a 25-year-old homeless man who complains

of a cough for the past month. The cough is now productive of
several tablespoons of bloodstreaked sputum per day. The
sputum is not foul-smelling. He has lost 10 pounds
but says that he doesn’t eat regularly. On physical exam,

temperature is 38°C, and coarse rales were heard in the apex of
the left lung. An acid-fast stain of the sputum reveals acid-fast
rods. Culture of the sputum shows no growth at 7 days,
but buff-colored colonies are visible at 21 days. Of the

following organisms, which one is most likely to be the cause of
this infection?
(A) Mycobacterium fortuitum-chelonae

(C) Mycobacterium marinum
2. Which one of the following regimens is optimal

initial treatment for the patient in Question 1?
(A) Isoniazid for 9 months

(B) Isoniazid and gentamicin for 2 weeks
(C) Isoniazid and rifampin for 4 months
(D) Isoniazid, rifampin, ethambutol, and pyrazinamide for 2
months
3. Your patient is a 70-year-old man with progressive

weakness in both legs that began about a week ago. He reports
back pain and fever for the past month. Magnetic resonance
imaging (MRI) of the spine reveals destruction of the seventh
thoracic vertebra and a paravertebral mass. Surgical

decompression and debridement was performed. Histologic
examination of the mass revealed caseating granulomas, and
Langhans’ giant cells were observed in the granulomas. Gram
stain revealed no organisms, but an acid-fast stain showed red
rods. Culture shows no growth at 7 days, but growth is seen at
28 days. Of the following, which one is the most likely cause?
(A) Mycobacterium fortuitum-chelonae

(C) Mycobacterium marinum
4. Your patient is a 30-year-old woman who is infected with

HIV and has a low CD4 count. She now has the findings of
pulmonary tuberculosis, but you are concerned that she may
be infected with Mycobacterium avium-intracellulare
(MAI). Regarding MAI, which one of the following is most

accurate?
(A) Disseminated disease caused by MAI is typically the

result of decreased antibody production, whereas
disseminated disease caused by M. tuberculosis is typically
caused by reduced cell-mediated immunity.
(B) Immigrants from Southeast Asia are more likely to be
infected with MAI than with M. tuberculosis.
(C) In the clinical laboratory, MAI forms colonies in 7 days,
whereas M. tuberculosis colonies typically require at least 21
days of incubation for colonies to appear.
(D) MAI is typically susceptible to a drug regimen of isoniazid
and rifampin, whereas M. tuberculosis is often resistant.
(E) The natural habitat of MAI is the environment, whereas
the natural habitat of M. tuberculosis is humans.
5. Regarding the patient in Question 4, if MAI was shown to

be the cause of her symptoms, which one of the following is
the best choice of antibiotics to prescribe?
(A) Amikacin and doxycycline

(B) Clarithromycin, ethambutol, and rifabutin
(C) Dapsone, rifampin, and clofazimine
(D) Isoniazid and gentamicin
(E) Isoniazid, rifampin, ethambutol, and pyrazinamide
6. Your patient is a 20-year-old man with a single, slowly

expanding, nonpainful scaly lesion on his chest for the past 2
months. The lesion is nonpruritic, and he has lost sensation at
the site of the lesion. He is otherwise well. He is a recent
immigrant from Central America. An acid-fast stain of a
scraping of the lesion is positive. Which one of the following
diseases is he most likely to have?
(A) Cutaneous tuberculosis

(B) Fish tank granuloma
(C) Lepromatous leprosy
(D) Scrofula
(E) Tuberculoid leprosy
ANSWERS
1. (D)
2. (D)
3. (D)
4. (E)
5. (B)
6. (E)
Chapter 22
1. Your patient is a 75-year-old woman with fever and a painful
nodule on her forearm. She also has a nonproductive cough
that she says is worse than her usual smoking-related cough.
She is taking high-dose corticosteroids (prednisone) for
an autoimmune disease. Chest X-ray reveals a nodular lesion

in the right upper lobe. A biopsy of the nodule on her arm was
obtained. Gram stain of the specimen showed filaments of
gram-positive rods. The rods were also weakly acid-fast.
Regarding the causative organism, which one of the following is
most accurate?
(A) Culture of the organism should be done under anaerobic

conditions.
(B) The natural habitat of the organism is the soil.
(C) It produces an exotoxin that inhibits protein synthesis by
ADP-ribosylation.
(D) Sulfur granules are often seen in the skin lesion.
(E) The vaccine against this organism contains the
capsular polysaccharide as the
immunogen.
2. Your patient is a 20-year-old man who was in a fist fight in

a bar about 3 weeks ago. He took a punch that broke his left
second molar. He now has a 3-cm inflamed area on the skin
overlying the broken tooth that is draining pus. A Gram
stain of the pus reveals gram-positive filamentous rods. The

rods did not appear red in the acid-fast stain. Regarding the
causative organism, which one of the following is most
accurate?
(A) Infections caused by this organism occur primarily in
the Ohio and Mississippi River Valley area.
(B) The natural habitat of the organism is the soil.
(C) This organism is resistant to both penicillins
and aminoglycosides.
(D) Sulfur granules are often seen in the pus located at
the orifice of the sinus
tract in the skin lesion.
(E) The vaccine against this organism contains a toxoid as
the immunogen.
ANSWERS
1. (B)
2. (D)
Chapter 23
1. Mycoplasma pneumoniae is an important cause of atypical

pneumonia.Regarding this organism, which one of the
(A) Amoxicillin is the drug of choice for pneumonia caused by

this organism.
(B) Antibody in a patient’s serum will agglutinate human
red blood cells at 4°C, but not at 37°C.
(C) Gram stain of the sputum reveals small gram-negative rods.
(D) It is an obligate intracellular parasite that can only
grow within human cells in the clinical laboratory.
(E) People with cystic fibrosis are predisposed to
pneumonia caused by this organism.
2. Which one of the following is the drug of choice for atypical

pneumonia caused by M. pneumoniae?
(A) Amoxicillin
(B) Azithromycin
(C) Ceftriaxone
(D) Gentamicin
(E) Vancomycin
ANSWERS
1. (B)
2. (B)
Chapter 30
1. In the lab, a virologist was studying the properties of HIV.

She infected the same cell with both HIV and rabies virus. (HIV
can infect only human CD4-positive cells, whereas rabies virus
can infect both human cells and dog cells.) Some of the
progeny virions were able to infect dog cells, within which she
found HIVspecific RNA. Which one of the following is the term
used to describe these results?
(A) Complementation
(B) Phenotypic mixing
(C) Reassortment
(D) Recombination
2. You have isolated two mutants of poliovirus, one mutated at

gene X and the other mutated at gene Y. If you infect cells with
each one alone, no virus is produced. If you infect a single cell
with both mutants, which one of the following statements
is most accurate?
(A) If complementation between the mutant gene products
occurs, both X and Y progeny viruses will be made.
(B) If phenotypic mixing occurs, then both X and Y
progeny viruses will be made.
(C) If the genome is transcribed into DNA, then both X and Y
viruses will be made.
(D) Because reassortment of the genome segments occurs at
high frequency, both X and Y progeny viruses will be made.
ANSWERS
1. (B)
2. (A)
-

00047998-Microbiology Final Reworked Edition1

Uploaded by

Copyright:

Available Formats

00047998-Microbiology Final Reworked Edition1

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

00047998-Microbiology Final Reworked Edition1

Uploaded by

Copyright:

Available Formats

Page 1:

77. What type of bacteria lack superoxide dismutase or catalase?

78. Which of the following microorganism has a nuclear membrane?

79. Which of the following cell to cell contact?

a) Gram +ve bacterial cells

a) They are formed primarily when nutrients are limited

87. Which of the following organisms is a very slow grower?

a) These bacteria can contaminate foods and grow during refrigeration

92. Which of the following antibiotics causes misreading of mRNA?

93. Which bacterium is associated with Rheumatic fever?

95. Each of the following statements is correct except:

96. Which antibiotic not inhibits peptidoglycan biosynthesis?

99. Which one of the following is sterile part of human body?

100. What is the mechanism of action of the aminoglycosides?

a) Damage to the membrane

7. Bacillus and clostridium are

20. The bacterial component that mediates adherence is the:

- Cell wall of gram positive bacteria can be destroyed by enzyme

- Which of the following is correct for cell wall of bacteria

- The cocci which forms a chain

- Peptidoglycan contains only bacterial

- Which of the following statements is correct regarding treatment of life threatening

- Which one of the following are bactericidal drug?

- Which one of the following has a toxic effect on kidney?

- Process by which bacterium enters a recipient bacterium

- Which one of the following can cause mutation?

- Which one of the following is correct for exotoxins and endotoxins ?

- Exotoxins are biological molecules called:

- Each of the following statements concerning endotoxins is correct EXCEPT

- Which one of the following involves a sex pilus ?

- Which of the following enzymes allows the organism to spread rapidly ?

- Which one of the following are β lactic drugs

- Each of the following statements concerning endotoxins is correct except

- Which of the following processes involves sex pilus

- Which one of the following toxin causes septic shock syndrome ?

- Which of the following enzymes allows the organism to spread rapidly

- Which one of the following is Staphylococcus Aureus virulence factor ?

- Which bacterial infection causes acute glomerulonephritis as a nonsuppurative

- Which of the following statement is true about viruses?

- How does enveloped virus enter into host cell ?

- One important characteristic of viruses is that they

C) M. tuberculosis grows slowly, often requiring 3 to 6 weeks before colon…

66. Which of the following pairs of organisms is routinely responsil

A) Clostridium botulinum and Bacillus antracis

B) Clostridium difficile and Clostridium botulinum

C)Clostridium perfringens and Bacillus cereus

D) Clostridium tetani and Clostridium botulinum

40.Which of the following phrases best describes a prophage?

41.Teichoic acids are typically found in

43. The virulence of Francisella tularensis is most highly associated with

46. The plasmid-mediated properties is/are

47. Antibiotic-associated diarrhea and pseudomembranous enterocolitis can be caused by

49. Each of the following statements concerning peptidoglycan is correct except:

53.Which are typical candidate for Legionnaires’ disease?

55.Which β-hemolytic gram-positive coccus causes acute glomerulonephritis?

59. Which of the following is most likely to be due to bacterial conjugation?

91. The last step in synthesis of peptidoglycan

93.Which of the following antibiotics causes misreading of mRNA?

94. A structural component that is found in all viruses is:

95. A chemical component that is found in all viruses is: