SPIROCHETES

1. Spirochetes can be differentiated from other bacteria because they : a. Motile with axial filaments b. Have a rigid cell wall c. Unable to grow on artificial culture media d. Have no cell wall 2. All a. b. c. d. of the following characteristics are true for primary syphilis EXCEPT: There is a non-tender ulcer usually on genitalia Treponema are demonstrated in the chancre by dark field examination The spirochete is not limited to the primary site The initial lesion appears one month after contact

3. Secondary syphilis is characterized by all of the following EXCEPT : a. Skin and mucous membranes involvement b. Onset 2 to 4 month after chancre c. Inability to find spirochetes from lesions d. There is blood stream dissemination 4. The stage of syphilis characterized by granulomatous lesions in various organs of the body, including cardiovascular and neurological disorders, is : a. Primary b. Secondary c. Tertiary d. Congenital 5. Primary syphilis is best diagnosed by : a. Clinical signs and serum antibody testing b. Clinical signs and dark field examination c. Dark field examination and serum antibody testing d. Growth on culture media and Gram stain 6. A patients serum yields a positive RPR and negative FTA test. These results most likely indicates : a. Syphilis infection b. False-negative FTA due to low sensitivity of the test c. False-positive RPR due to cross-reacting antibodies d. Patient in remission for syphilis 7. Which statement does NOT accurately describe tertiary syphilis? a. Occurs years after primary syphilis b. Chronic granuloma in internal organs c. Presence of spirochetes in small numbers in the lesion d. The patient is highly infectious in this stage

8. A 22-year-old male presents to his physician, complaining of a sore on his penis. Physical examination shows a firm, raised, red, non-tender chancre of the genitalia. Which of the following is the most appropriate course of action for the physician? a. Swab the chancre and culture on Thayer-Martin agar b. Swab the chancre and perform a Gram stain c. Perform a dark-field examination on a swab of the active lesion d. Swab the chancre and culture on blood agar 9. The propable cause for the relapsing nature of relapsing fever caused by Borrelia recurrentis is : a. The appearance of new antibiotic resistant variants b. Successive appearance of antigenic variants c. Defect in cell-mediated immunity d. Multiplication of the organisms in the blood 10. The best diagnostic method for relapsing fever is : a. Biochemical identification b. Giemsa stain of blood smears c. Serological techniques d. Growth on culture media 11. Which statement is INCORRECT for Leptospira icterohaemorrhagia? a. Tightly coiled spiral with terminal hooks b. Primarily pathogenic on vertebrates other than humans c. Stain well with Gram stain d. Infection may involve liver, kidney and CNS 12. Leptospirosis is an occupational disease, which one of the following workers is the most likely to be exposed? a. Butchers b. Sewer workers c. Woolsorters d. Food handlers

MYCOPLASMA
1. Non-gonococcal urethritis due to ureaplasma urealyticum is treated with : a. Tetracycline b. Penicillin G c. Chloramphenicol d. Vancomycin

2. Which is the most specific laboratory test used for diagnosis of Mycoplasma pneumoniae? a. Detection of cold agglutinins b. Gram stain c. Detection of specific antibodies in serum by ELISA d. Culture of sputum 3. A distinguishing feature of human mycoplasma species is that : a. Stain well with Giemsa and Gram stain b. Contain no bacterial peptidoglycan c. Cannot be cultivated in vitro d. Rapid grower under microaerophilic condition 4. Post-partum fever due to Mycoplasma hominis is treated with : a. Tetracycline b. Penicillin G c. Gentamycin d. Vancomycin 5. Mycoplasma pneumoniae is sensitive to the antimicrobial action of : a. Cycloserine b. Tetracycline c. Penicillin d. Cephalosporin 6. Each of the following correctly describes the mycoplasma EXCEPT : a. They contain both DNA and RNA b. They do not have a cell wall c. They cannot replicate outside host cells d. They are the smallest free-living organisms known 7. Mycoplasma pneumonia : a. Is the etiologic agent of primary atypical pneumonia b. It is mainly identified through culture and biochemical reactions c. Responds well to penicillin therapy d. All of the above 8. Which of the following is TRUE for cold agglutinins as indicative of current infection with Mycoplasma pneumoniae? a. It is specific method for diagnosis of infection b. It is IgG autoantibodies that agglutinate group A antibodies at 4oC c. It is IgM autoantibodies that agglutinate group O antibodies at 4oC d. It is IgM autoantibodies that agglutinate group O antibodies at 37oC

9. Mycoplasma colonies are identified by the following : a. Fried egg appearance b. Giemsa stain c. IF technique d. All of the above 10. Characteristics of Mycoplasma & Ureaplasma include : a. The presence of a thin gram positive-like cell wall with no cell membrane b. Rapid growth on Mac Conkeys agar, slow growth on basic nutrient agar c. The presence of only a cell membrane with no cell wall d. Rapid growth on Mac Conkeys medium & routine blood agar plates 11. All a. b. c. d. of the following regarding Mycoplasma is true EXCEPT : Parasitic Mycoplasma requires 10% serum in its growth medium Mycoplasma pneumoniae is responsible for 10%of all pneumonis Ureaplasma urealyticum requires 10% of urea in its growth medium Ureaplasma urealyticum is responsible for 10% of non-gonococcal urethitis cases

CHLAMYDIAE
1. Chlamydiae resemble bacteria in all of the following EXCEPT : a. They possess both RNA and DNA b. They multiply by binary fission c. They can be inhibited by many antimicrobials effective against bacteria d. They are closely related to Gram positive bacteria 2. Which one of the following is characteristic of Chlamydia trachomatis? a. Reticulate bodies are infectious, extracellular form of the organism b. Produce granular conjunctivitis c. Inclusion bodies are formed from division of elementary bodies d. Sensitive to B-lactam antibiotics 3. All the followings are true statements about Chlamydia trachomatis EXCEPT : a. Can grow on artificial culture media b. It has a number of serotypes (about fifteen) that correlate with the syndrome produced on infection c. It causes sexually-transmitted disease d. It can be detected by direct IF examination of pathological specimen 4. A feature of Chlamydiae that is unique to this genus is : a. It is obligate intracellular parasite b. Its replicative cycle is distinguished by two morphologic forms in infected cells c. They lack muramic acid in its cell envelope d. Cannot grow on artificial culture media

5. Which of the following statements does NOT describe trachoma? a. It causes mucopurulent conjunctivitis b. It can lead to blindness c. It is caused by C.trachomatis serotype D-K d. It is diagnosed by isolation of the organism on yolk sac 6. Trachoma is diagnosed by detection of inclusion bodies in conjunctival scraping smear stained by : a. Gram stain b. Methylene blue stain c. Giemsa stain d. Modified ZN stain 7. Which statement CORRECTLY describes the genus Chlamydia? a. Classified as viruses b. Do not contain both DNA and RNA c. Obligate intracellular bacteria d. Smallest free-living organisms 8. Each of the following conditions has been associated with C.trachomatis EXCEPT : a. Lymphogranuloma venereum b. Non-gonococcal urethritis c. Atypical pneumonia d. Granular conjunctivitis 9. Which of the following serotypes are associated with Chlamydia diseases acquired through the venereal route? a. A, B, Ba and C b. D-K c. L4, L5 and L6 d. All of the above 10. Which of the following is TRUE about Chlamydia and separates them from Rickettsiae? a. Is an obligate intracellular parasite b. It has a complicated growth cycle c. Contains both types of nucleic acid DNA & RNA d. It is sensitive to antibiotics like tetracycline 11. Chlamydia can be recognized by all the following laboratory procedures except: a. Microscopic examination of Giemsa-stained scrapings from infected tissues b. Culture on agar medium c. Culture in tissue culture cells d. Polymerase chain reaction

A 45-year-old woman is admitted to the hospital following a sudden onset of fever, malaise, severe headache and prostration. She has a dry cough. WBC is normal. Her husband states that her parrot died 3 days before the onset of the patients illness. 12. The diagnosis that is most strongly suggested is : a. Tuberculosis b. Psittacosis c. Rickettsial pox d. Q fever e. Epidemic typhus 13. If the patient has psittacosis : a. The respiratory tract is the main portal of entry b. She must have been bitten by a mite c. A rising of specific antibody titre is not essential for diagnosis d. Tetracycline would be ineffective 14. Which of the following statements is TRUE assuming that the correct diagnosis is psittacosis? a. Chlamydia psittaci can cause severe pneumonia b. Chlamydia psittaci cannot be isolated from clinical specimens like sputum c. Chlamydia psittaci can be isolated from the blood d. It can be cultured on ordinary media 15. If the condition is Psittacosis : a. Infection from man to man is common b. The organism can grow well in tissue culture c. The drug of choice for treatment is sulphonamides d. Gram stained film is done to detect elementary bodies

RICKETTSIAE
1. All a. b. c. d. 2. All a. b. c. d. of the following statements are true concerning rickettsial pox EXCEPT : Mite serves as the vector It is caused by R.rickettsii It is characterized by inward spreading rash It is diagnosed by detection of Rickettsia antigen in skin biopsy by IF of the following statements describe the Rickettsiae EXCEPT : They are small Gram negative bacilli They are obligate intracellular parasites They cannot be isolated on ordinary culture media They all produce fever and rash in humans

3. Which of the following is TRUE concerning Rocky Mountain spotted fever? a. It produces widespread vascular endothelial damage b. It can be transmitted only from mite bite c. Humans are the only known host d. It is characterized by outward spreading rash 4. Which of the following is NOT true concerning epidemic typhus? a. It produces vascular endothelial damage b. It is transmitted only by louse c. Rodents are the only known reservoir 5. Rickettsiae : a. Grow only extracellularly b. Are eukaryotic cells c. Are sensitive to penicillin d. Generally invade the endothelial lining of capillaries causing hemorrhages 6. The vector of epidemic typhus is : a. Dog tick b. Rat flea c. Human body louse d. Mite 7. Choose INCORRECT statement regarding Coxiella burnetii : a. It can survive outside the host b. It can affect humans as well as animals c. It is sensitive to tetracycline d. Manifested by trunk rash that spreads to the extremities 8. Choose INCORRECT statement regarding epidemic typhus : a. Disease characterized by centrifugal rash b. Disease is caused by Rickettsia prowazekii c. Patients who recover from this disease may develop later Brills disease d. The causative organisms is transmitted from rodents to human by tick A 10-year-old boy is admitted to a teaching hospital because of severe chills, fever, headache, malaise, joint pains and myalgia. A rash appeared on the extremities, then on the trunk and becomes generalized. On clinical examination, liver and spleen show enlargement. 9. The most likely diagnosis is : a. Influenza b. Typhus fever c. Rocky Mountain spotted fever d. Q fever

10. Assume that this patient has Rocky Mountain spotted fever, it has been transmitted by : a. Mite bite b. Flea feces c. Louse feces d. Tick bite 11. There is fourfold rise in titre in the immunofluorescent antibody test. The rise in titre indicates : a. There is no infection b. A recent rickettsial infection c. The patient is completely recovered d. The patient has developed immunity 12. The treatment of choice for Rocky Mountain spotted fever is : a. Penicillin b. Tetracycline c. Sulfonamides d. Antitoxic serum

NEISSERIA GONORRHOEAE
1. Neisseria species are positive for the enzyme : a. Coagulase b. DNase c. Oxidase d. Catalase 2. Which statement CORRECTLY describes the toxins associated with Neisseria? a. The toxins are released by the living bacterial cell b. The toxins are composed of lipopolysaccharide - components of the cell wall c. The toxins are categorized as exotoxins d. The toxins are similar to the enzymes of Staph. aureus 3. Virulence of Neisseria gonorrheae is due to : a. Pili b. Outer membrane protein c. Lipopolysaccharides d. Protease enzyme e. All of the above 4. The most appropriate specimen for diagnosis of acute gonorrhoea : a. Mid-stream urine b. High vaginal swab in females c. Prostatic secretion in males d. Urethral discharge

5. One of the following is NOT considered a virulent factor of N. gonorrhoea : a. Pili b. Capsule c. IgA protease d. Outer membrane protein 6. Regarding N. gonorrhoea, choose the CORRECT statement : a. Carriers in the general population are 5% b. Repeated gonococcal infections are uncommon c. Serotyping is based on capsular polysaccharide d. Differentiated from N. meningitidis by its inability to ferment maltose

ANSWERS
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 SPIROCHETES MYCOPLASMA CHLAMYDIAE RICKETTSIAE N.GONORRHOEAE A A D B C C C B D B C B A A E C A B C D B B C D B C C C C D D A C D C C C D B D B C B C B D C A B B B B B A A B