Microbiology

Which of the following is the causative agent of Kaposis sarcoma?

A HIV
B Human herpesvirus 4
C Human herpesvirus 8
D Human T-lymphotrophic virus 1
E All of the above

A 50-year-old woman has ongoing pelvic pain; she has had a coil in situ for the last
8 years. She has a pelvic mass; histological sampling of the mass at laparoscopy
shows a suppurative and granulomatous inflammatory process with the presence
of sulphur granules.
Which is the most likely causative agent?
A Actinomyces israelii
B Chlamydia trachomatis
C Gardnerella vaginalis
D Neisseria gonorrhoeae
E Neisseria meningitides

A 63-year-old man with an open fracture of the femur develops the rare
complication of gas gangrene and requires leg amputation.
What is the most likely causative agent?
A Clostridium botulinum
B Clostridium perfringens
C Clostridium tetani
D Escherichia coli
E Klebsiella pneumonia

A woman who is 16 weeks pregnant calls the gynaecology clinic. She is a primary school teacher
and there is an outbreak of chicken pox in her class. Her GP sent some bloods for testing. VZV-IgG
came back positive and the VZV- IgM was negative. The best management plan is:
Administration of VZV immunoglobulin
Expectant management
Follow up with ultrasound
Invasive prenatal testing
VZV vaccination

Which white blood cell type is elevated in an acute cytomegalovirus infection?

Neutrophils
Monocytes
Lymphocytes
Eosinophils
Basophils

A pregnant woman at 18 weeks of gestation presents with bloody diarrhoea. Stool microscopy and
culture identifies Gram-negative, facultative anaerobic rods. Which organism is most likely to be
responsible?
Streptococcus
Staphylococcus
Salmonella
Campylobacter
Borrelia

Which organism is not classically associated with bacterial vaginosis?

Mycoplasma hominis
Mobiluncus species
Histoplasma capsulatum
Gardnerella vaginalis
Bacteroides species

What is the incubation period of rubella?

1428 days
1421 days
1320 days
1014 days
57 days

MRSA infections may respond to which antibiotic?

Vancomycin
Clindamycins
Cephalosporins
Carbapenems
Augmentin

A 29-year-old woman who is 39 weeks pregnant presents to the delivery suite in labour. Her
previous child was affected by group B streptococcus (GBS) infection. She is allergic to penicillin.
Which antibiotic should be prescribed for her as a prophylaxis for GBS?
Metronidazole
Gentamycin
Clindamycin
Cephalosporins
Ampicillin

A 30-year-old woman presents to the antenatal clinic after a visit to her home country in Africa. She
is suffering from flu-like symptoms, myalgia and her posterior cervical lymph nodes are found to be
enlarged. Her temperature is 38.4C. Her blood test results are:
Haemoglobin 14 g/dl
White blood cell count 9 x 109/l
Platelets 150 x 109/Ll
Erythrocyte sedimentation rate (ESR) 6 mm/hr
C-reactive protein (CRP) < 5 mg/l
What is the likely diagnosis?
Typhoid fever
Toxoplasmosis
Leptospirosis
Epstein-Barr virus
Brucellosis

A 30-year-old woman presents to the antenatal clinic with a history of cytomegalovirus (CMV)
infection. Which test would be the most sensitive for diagnosis of congenital infection in pregnancy?
Ultrasound scan of the fetus
CMV-specific IgM
CMV-specific IgG
Antenatal serology
Amniotic fluid PCR

What is the incubation period for varicella infection?

1421 days
1020 days
1014 days
710 days
57 days
A pregnant woman is diagnosed with toxoplasmosis. What is the drug of choice for reducing the risk
of fetal infection?
Spiramycin
Penicillin
Metronidazole
Intrauterine blood transfusion
Aciclovir

Which infection is known to produce an aplastic crisis in people with sickle cell disease?
Rubella virus
Parvovirus
Paramyxovirus
Herpes virus
Cytomegalovirus

What is the potential cause of small white umbilicated white papules on the labia majora?
Trichomonas vaginalis
Molluscum contagiosum
Human papillomavirus
Haemophilus ducreyi
Chlamydia DK

Which organism causes lymphogranuloma venereum?

Chlamydia trachomatis L1L3
Chlamydia trachomatis DK
Chlamydia trachomatis AC
Chlamydia psittaci
Chlamydia pneumonia

Which organisms contain ribosomes, do not have a rigid cell wall but cannot be grown on inanimate
culture?
Viruses
Rickettsiae
Mycoplasma
Chlamydia
Bacteria

Question 1 of 54
Which of the following is not considered to be 'high risk' HPV (human papillomavirus)? (Please
select 1 option)
HPV 16
HPV 18
HPV 23
HPV 31
HPV 35

Question 2 of 54
What is the mechanism of action of glycopeptides (for example, vancomycin)? (Please select 1
Cell wall inhibition
Inhibition of folic acid metabolism
Inhibition of protein synthesis (transcription)
Inhibition of protein synthesis (translation)
Interference with DNA replication

Question 3 of 54
What is the mechanism of action of trimethoprim?
Cell wall inhibition
Inhibition of folic acid metabolism
Inhibition of protein synthesis (transcription)
Inhibition of protein synthesis (translation)
Interference with DNA replication

Question 4 of 54
What is the mechanism of action of ciprofloxacin?
Cell wall inhibition
Inhibition of folic acid metabolism
Inhibition of protein synthesis (transcription)
Inhibition of protein synthesis (translation)
Interference with DNA replication

Question 5 of 54
Gentamicin (7 mg/kg once daily) is administered to an elderly patient with severe urosepsis. Twenty
four hours postadministration gentamicin levels are more than 2 mg/L.
Which of the following complications is this patient at most risk of?
Encephalopathy
Hepatotoxicity
Nephrotoxicity
Peripheral neuropathy
Retinopathy

Question 6 of 54
A woman presents to the outpatient department with increased vaginal discharge.
Examination reveals a homogenous discharge with a fishy odour. Clue cells are found on
microscopy.
Which one of the following options is the most likely diagnosis?
Bacterial vaginosis
Chlamydia trachomatis
Neisseria gonorrhoeae
Physiological discharge
Trichomonas vaginalis

Question 7 of 54
A woman in the outpatient clinic tells you that she has been diagnosed with Trichomonas vaginalis.
What kind of organism is Trichomonas vaginalis?
(Please select 1 option)
Flagellated protozoan
Intracellular diplococcus
Phthiriasis
Pox virus
Question 8 of 54
A 24yearold female presents to a GUM clinic, complaining of clear vaginal discharge. A high vaginal
swab is taken, and a diagnosis is later made of bacterial vaginosis. Which of the following laboratory
results would lead to this diagnosis?
Positive polymerase chain reaction (PCR)
Presence of 'clue cells'
Presence of Gram negative intracellular diplococci
Presence of sulphur granules
Protozoa seen on microscopy

Question 9 of 54
Which of the hepatitis viruses is the only DNA virus?
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Hepatitis E

Question 10 of 54
Regarding urinary tract infections, which microorganism is most likely to be associated with bladder
catheterisation?
Bacteroides
Escherichia coli
Proteus
Pseudomonas
Trichomonas

Question 13 of 54
Which one of the following organisms is the most likely causative agent of pseudomembranous colitis?
Clostridium difficile
Clostridium perfringens
Escherichia coli
Haemophilus influenzae
Staphylococcus aureus

Question 14 of 54
Which of the following microorganisms can be described as an obligate intracellular Gram
negative bacterium?
Candida spp.
Chlamydia trachomatis
Herpes simplex virus
Human immunodeficiency virus
Gardnerella vaginalis

Question 15 of 54
Which of the following microorganisms is best described as neutrophils containing Gram negative diplococci?
Gardnerella vaginalis
Human immunodeficiency virus
Human papilloma virus
Neisseria gonorrhoeae
Treponema pallidum

Question 18 of 54
Which of the following is true of Staphylococcus aureus?
Less than 20% of strains have a capsule
They are diplococcic on microscopy
They are found in the nasal passage of >60% of healthy adults
They are motile
They cause haemolysis on blood agar

Question 23 of 54
Which of the following is true of Toxoplasma gondii?
Is a cause of congenital hydrocephalus
Is a Rickettsia
Is identified by Gram staining
Is transmitted by inspiring infected air droplets
Proliferates in the peripheral nerves

Question 24 of 54
Which of the following is true of exotoxins?
Are derived only from Gram positive bacteria
Are less toxic than endotoxins
Are neutralised by their homologous antitoxin
Cannot be converted to a toxoid

Question 25 of 54
The germination of tetanus spores in a wound is enhanced by which of the following?
Antiseptic dressings
Hypoxia
Injection of antitoxin
Intravenous gentamycin
Steroid administration

Question 26 of 54
To which of the following is Staphylococcus aureus not sensitive?
(Please select 1 option)
Cefuroxime
Flucloxacillin
Methicillin
Metronidazole
Vancomycin

Question 33 of 54
Which of the following is true regarding hospital acquired infections?
Contact between individuals is an unlikely route of infection
Contaminated equipment is a higher infection risk if dry
Gramnegative organisms are usually spread by the aerosol route
Sterilisation may leave some bacterial spores intact

Question 34 of 54
Which of the following is correct regarding bacterial endotoxins?
(Please select 1 option)
Are components of the cell membrane in Gram negative bacteria
Are destroyed by heat, such as boiling for five minutes
Are lipopolysaccharides
Are proteins

Question 37 of 54
Which of the following is correct regarding Escherichia coli 0157/H7?
Can be prevented from causing clinical illness by vaccination
Causes pseudomembranous colitis
Is a bowel commensal
Is an important cause of choleralike illness
Is a recognised cause of the haemolytic uraemic syndrome

Question 35 of 54
Features of tetanus include which of the following?
A soft abdomen
Carpopedal spasm
Clouding of consciousness
Hypocalcaemia

Question 36 of 54
Which one of the following is not associated with urinary tract infections (UTIs)?
Candida
Chlamydia
Enterobacter
Klebsiella

Question 38 of 54
Which of the following is true of Staphylococcus epidermidis?
Are destroyed by povodine iodine
Are usually sensitive to penicillin
Grown in blood cultures are due to contamination and should be ignored
Is coagulase positive

Question 40 of 54
Which of the following is true of human immunodeficiency virus?
Decreases the risk of opportunistic infection
Induces an increase in CD4 lymphocytes, monocytes and antigenpresenting
Is a single stranded DNA retrovirus
Patients can be infective prior to seroconversion illness at about three months

Question 39 of 54
Which of the following is correct of smooth muscle cells?
Adjacent cells are not linked electrically coupled
Are controlled by the somatic nervous system
Do not possess actin and myosin
Microscopically have a striated appearance
Show spontaneous muscle contraction

Proteolytic enzymes are released by which one of the following organisms?

All Clostridium botulinum
Mycobacterium tuberculosis
Neisseria meningitides
Salmonella typhi
Streptococcus pyogenes
Which of the following is true regarding Pseudomonas aeruginosa?
Can cause osteomyelitis
Is a Gram positive bacterium
Is an uncommon cause of contact lens acquired infection
Is sensitive to chloramphenicol

Question 43 of 54
Microorganisms that can cause latent infection do not include which of the following?
Chlamydia trachoma
Cytomegalovirus (CMV)
Hepatitis A
Mycobacterium tuberculosis

Which of the following statements is true of wound infections?

Anaerobic organisms exert their lethal effects by producing endo and exotoxins
MRSA wound infection is usually the result of wound contamination by the patient
Necrotising fasciitis is commoner in carriers of MRSA
Opportunistic organisms tend to affect young healthy adults

Recognised virulence factors in bacteria do not include which of the following?

Beta lactamases
Gonococcal pili
Ig Aproteases
Streptococcal M protein
Which of the following is correct regarding pelvic abscesses?
Are an uncommon cause of intraperitoneal abscess
Are associated with a pyothorax Incorrect answer selected
Can only be identified on CT if there is a full bladder
Commonly present with pneumaturia
May spontaneously drain via the rectum

Question 47 of 54
A 68yearold woman presents with pyrexia of unknown cause. A septic screen, including blood cultures are
taken.
Which of the following regarding blood cultures is correct?
Are best obtained when the patient is afebrile
Are unreliable if the patient has already been commenced on antibiotics
Are usually positive
Grow and identify organisms within 24 hours

Question 50 of 54
Rigors are a characteristic feature of which of the following?
(Please select 1 option)
Acute cholecystitis
Acute pancreatitis
Acute pyelonephritis
Hodgkin's disease
Ureteric calculi

Question 51 of 54
Which of the following is correct regarding Trichomonas vaginalis?
Infection occurs particularly in association with diabetes mellitus
Is a cyst forming organism
Is a protozoan
Is an intracellular organism
Is an obligatory anaerobe

Question 52 of 54
Which of the following is correct with regard to T lymphocytes?
Are infected by EpsteinBarr virus in infectious mononucleosis
Are the primary host response in bacterial infection.
T cell lymphoma has a better prognosis
They compose the majority of lymphocytes in plasma
They produce IgG

Question 53 of 54
A pregnant woman is found to have a positive Treponema pallidum enzyme immunoassay (TPHA). Which of
the following is the likely cause?
Leishmaniasis
Lyme disease
Past yaws infection
Systemic lupus erythematosus

Question 54 of 54
An HIV positive woman is 39 weeks into an uncomplicated pregnancy. Which of the following HIV properties
will be involved in assessment of the mode of delivery (i.e. normal vaginal versus caesarean section)?
Carries the p24 antigen
Contains RNA
Infects CD4 lymphocytes
Inhabits sanctuary sites in the body
Is vertically transmitted in 50% pregnancies

A 30 year old women comes to see you and advises she has felt a little unwell with diarrhoea and flu like
symptoms.
She is 28 weeks pregnant. Upon questioning she discloses she ate a soft cheese and deli meats platter 5 days
earlier. A blood culture confirms listeria infection. What is the appropriate treatment (she has no known dug
allergies)?
Cefuroxime
Cefalexin
Gentamicin
Amoxicllin

A 29 year old women wants to speak to you regarding infections in pregnancy. Her two year old son has
sensorineural deafness as a result of infection in her previous pregnancy. She tells you he was born with a
"blueberry muffin" rash. What was the most likely infection?
Toxoplasmosis
Parvovirus B19
Rubella
Varicella Zoster
CMV

You are asked to see a 26 year old patient following her first visit to antenatal clinic. She is 9 weeks pregnant
and
bloods have shown her to be non-immune to Rubella. She is concerned about congenital rubella syndrome
(CRS).
What is the most appropriate advice to give?
Reassure that CRS is the result of infection during the first 6 weeks of pregnancy
Advise vaccination as soon as possible
Advise vaccination after birth and when breast feeding has ceased
Advise vaccination after birth regardless of breast feeding status
Advise vaccination prior to 16 weeks gestation

Herpes Simplex is which type of virus

single stranded RNA
double stranded RNA
single stranded DNA
double stranded DNA
Retrovirus

A 29 year old women on labour ward has just gone into labour. A normal vaginal delivery is planned. Her last
child,
born 2 years ago, had early-onset neonatal group B streptococcal (EOGBS) disease. Vaginal swab taken 2
weeks
ago was negative for GBS. What antibiotic treatment should be administered?
No treatment
IV Clindamycin 900 mg
IV Clarithromycin 500mg
IV Amoxicillin 1g
IV Benzylpenicillin 3g

Which of the following is the most appropriate for diagnosis of Bacterial Vaginosis (BV)?
Amsel's criteria
Fitz-Hugh-Curtis score
Gardnerella vaginalis wet prep culture
Gardnerella vaginalis PCR
SAPS III score

what is the incubation period of Scarlet Fever (in days)?

1-7
3-11
7-14
14-21
14-28

which of the following is a gram negative obligate anaerobe?

Bacteroides
Clostridia
Chlamydia
Escherichia coli
Salmonella

Which streptococcus causes Scarlet fever?

Streptococcus viridans
Streptococcus pyogenes
Streptococcus anginosus
Streptococcis dysgalactiae
Streptococcus agalactia

What epithelium cell type lines the endometrium?

Columnar
Cuboidal
Stratified Squamous
Pseudostratified Squamous
Transitional

You are asked to speak to a patient following a recent cervical smear. Microscopy has revealed trichomoniasis
infection. The patient has had no symptoms. What percentage of trichomoniasis infections are asymptomatic?
2%
5%
10%
50%
90%

A 29 year old patient who is 8 weeks pregnant comes to see you. She currently has chickenpox. She is
concerned her baby may get congenital fetal varicella syndrome (FVS). What would you advise her the risk of
this is?
0.4%
2.0%
5.0%
10.0%
25.0%

A patient presents to clinic with a maculopapular rash to the hands and soles of the feet. Examination also
reveals some wart like lesions to the vagina. You diagnose condyloma latum. What stage of syphilis infection
is this
Primary
Secondary
Tertiary
Early Latent
Late La
You see a 23 year old women in clinic complaining of vaginal discharge. The lab phone to tell you microscopy
and
staining shows a gram negative diplococcus. Which organism is most likely to be responsible?
Chlamydia trachomatis
Neisseria gonorrhoeae
Gardnerella vaginalis
Treponema pallidum
Mycoplasma hominis

You are asked to review a 65 year old ladies legs pre-operatively. You diagnose cellulitis. What is the most
common causative organism?
Staphylococcus Aureus
Staphylococcus Epidermidis
Clostridium Perfringens
Streptococcus Mutans
Streptococcus Pyogene

You are asked to review a 25 year old patient who is currently 14 weeks pregnant. She has several anogenital
warts which she finds psychologically distressing. Which of the following options
is NOTappropriate?
Podophylline paint
Trichloracetic acid
Liquid nitrogen cryotherapy
Imiquimod 5% cream
LASER treatement

The HPV vaccine Gardasil is what type of vaccine?

Live attenuated viruses
Inactivated viruses
Toxoid based vaccine
Polysaccaride based vaccine
Recombinant vaccine of virus-like particles (VLPs)

What type of virus is HIV?

Rubivirus
Hepacivirus
Lentivirus
Flavivirus
Enterovirus

A patient is seen in the sexual health clinic. Speculum examination reveals a firm 12mm ulcerated lesion with
smooth edges to the cervix. The patient denies any pain. What is the likely cause?
Herpes Simplex Type 1
Herpes Simplex Type 2
Neisseria gonorrhoeae
Chlamydia Trachomatis D-K
Treponema pallidum

What is the fetal case mortality rate associated with listeria infection during pregnancy?
1%
10%
25%
50%
95%
you see a patient in clinic who complains of vaginal soreness and discharge. Examination reveals vulval
irritation and a "strawberry" cervix. A wet smear is sent for microscopy which confirms trichomoniasis. What
percentage of trichomoniasis cases would you expect to see a strawberry cervix?
2%
10-20%
50%
70%
>90%

Congenital Cytomegalovirus (CMV) infection effects how many pregnancies?

1 in 10
1 in 150
1 in 500
1 in 1,000
1 in 10,000

Which group of beta haemolytic streptococci is associated with liver abscess formation?
A
B
C
F
G

You see a 23 year old women in clinic complaining of odourus vaginal discharge. Which facultative anaerobic
bacteria is most likely to be responsible?
Chlamydia trachomatis
Neisseria gonorrhoeae
Gardnerella vaginalis
Treponema pallidum
Mycoplasma hominis

What percentage of HPV infections will be cleared by the host within 1 year?
5%
20%
50%
70%
90%

You are asked to review a patient 7 days after a laparoscopic oophorectomy. One of the port sites has notable
surrounding erythema and there is some pus visible at the site of the incision. What is the most likely causative
organism?
Streptococcus viridans
Escherichia coli
Pseudomonas aeruginosa
Streptococcus pyogenes
Staphylococcus aureus

What percentage of infants with congenital CMV infection are symptomatic?

>99%
50%
10%
1-2%

A 28 year old women who is known to be HIV positive delivers a term baby by planned C-section. Maternal
viral load was < 50 HIV RNA copies/mL at 36 weeks gestation. She is takingn cART. The infant had a negative
HIV test on the day of discharge and is discharged on Zidovudine monotherapy for 4 weeks. The mum plans to
exclusively formula feed. What would you advise the mother regarding timing of the next HIV test for the
infant?
No further tests required if remains formula fed
Next test at 18 months of age
Next test at 6 months of age
Next test at 6 weeks of age
Next test in 4 weeks

A mother develops her 1st episode of genital herpes 4 weeks prior to delivery. Following delivery her baby
develops disseminated neonatal herpes. What is the mortality rate associated with disseminated neonatal
herpes assuming appropriate antiviral treatment is given?
5%
10%
30%
50%
80%

Which of the following is LEAST appropriate for the diagnosis of Bacterial Vaginosis (BV)?
Nugents score
Amsels criteria
Positive vaginal culture for Gardnerella vaginalis
Hay/Ison Criteria
OSOM BVBlue

What is the causative organism of Scarlet Fever?

Staphylococcus aureus
Streptococcus epidermidis
Streptococcus pyogenes
Streptococcus Pneumonia
Parvovirus B19

A 32 year old patient develops painful ulcerated genital lesions and inguinal lymphadenopathy. She is 32
weeks pregnant. You suspect genital herpes and send swabs. Which of the following is appropriate
management according to the 2014 BASHH/RCOG guidelines?
a.Send bloods to check antibody status. If this supports this is a first episode genital HSV then patient should
be advised to have C-section delivery
b.Give Aciclovir 400mg TDS orally for 5 days
c.No medical treatment required
d.Admit for intravenous Aciclovir for 5 days
e.Give Aciclovir 800mg 5 times daily for 5 days

A 24 year old patient who is 14 weeks pregnant has her urine dipped during an antenatal visit. This shows
leucocytes ++ and nitrites ++. You suspect a UTI and send a urine sample for culture. According to NICE
guidance which of the
following is most appropriate treatment option?
No treatment until culture result received
Trimethoprim 200mg BD for 3 days
Trimethoprim 200mg BD for 7 days
Nitrofurantoin 50mg QDS for 7 days
Amoxicillin 500mg TDS for 7 days

Which of the following micro organisms involved in formation of metachromatic granules?

A.haemophilus influenza
B.listeria monocytogens
C.corynebacterium diphtheriae
D.klebsiella
E.E.coli

The presence of which haematological characteristic is associated with increased

incidence of malaria?
A Haemoglobin C
B Beta-thalassaemia
C Duffy antigen
D Glucose-6-phosphate dehydrogenase deficiency

A 34-year-old woman, G l PO, presents for her second prenatal visit at 9 week's gestation. A review of prenatal
laboratory results reveals she is rubella nonimmune. The risk to the fetus should she contract rubella
includes which constellation of findings:
A.Blindness, deafness, and microcephaly
B.Cerebral palsy, sensorineural hearing loss, and musculoskeletal deformity
C. Chorioretinitis, hydrocephalus, and intracranial calcifications
D.Ergogenic liver foci, microcephaly, ventriculomegaly, and deafness
E.Nonimmune hydrops, placentamegaly, and anemia

A spore-forming organism that infects sheep and causes sepsis in iv drug users
A Actinomyces israelii
B Clostridium perfringens
C Listeria monocytogenes
D Pseudomonas aeruginosa
E Bacillus anthracis

Which of the following is gram pos obligate anaerobe?

A staphylococcus
B.streptococcus
C.clostridia
D.Listeria
E.bacteroids.

Following are the gram positive bacilli except

A)listeria
B)actinomyces
C)proteus
D)bacillus
E)cornybacteria

A 30 year old women comes to see you and advises she has felt a little unwell with diarrhoea and
flu like symptoms. She is 28 weeks pregnant. Upon questioning she discloses she ate a soft cheese
and deli meats platter 5 days earlier. A blood culture confirms listeria infection. What is the
appropriate treatment (she has no known dug allergies)?
A. Cefuroxime
B. Cefalexin
C. Gentamicin
D. Amoxicllin
E. No treatment required

Which of the following is predominant type of bacteria in the vagina during pregnancy:
A-lactobacillus.
B-peptostreptococcus.
C-listeria monocytogenous.
D-streptococcus agalactia.
An 18-year-old G1 P0 woman has a clinical presentation of intra-amniotic infection. She denies any
leakage of fluid per vagina, and repeated speculum examinations fail to identify rupture of
membranes. Which of the following organisms is most likely to be the underlying etiology........????
A. Group B streptococci
B. Listeria monocytogenes
C. Clostridia difficile
D. Chlamydia trachomatis
E. Escherichia coli
Coz listeria can pass the intact membrane

According to the UK NSC and NICE which of the following should be screened for during routine
antenatal care?
A.Syphilis
B.Chlamydia
C.Hepatitis C
D.Group B streptococcus
E.CMV

Which age group has the highest rates of chlamydia infection?

A. 15-19 year olds
B. 20-24 year olds
C. 25-30 year olds
D. 30-40 year olds
E. 40+

Niserria gonorrhae is?????

A.gram pos bacilli
B.Gram pos cocci
C.gram neg bacilli.
D.gram neg cocci
E.spirochetes.

Which antibiotic does not act by inhibiting bacterial cell wall synthesis?
A Penicillin
B Cefalexine
C Vancomycin
D Teicoplanin
E Gentamicin

What percentage of women develop antibodies to Human papiloma virus following infection ?
A.5%
B.25%
C.50%
D.75%
E.99%

In type 2 necrotising fasciitis what is the most likely organism?

A.Clostridia perfringens
B.Clostridia gehani
C.staphylicoccus
D.strptococcus viridians
E.Strptococcus pyogenes

A 24 year old undergoes an SRI due to development of dysuria 5days earlier. The results are +be for
chlamydia infection. With regard to contact tracing What is the recommended action regarding tracing and
informing sexual partners in this case?
A.All sexual partners past 4wks
B.All sexual partners past 6wks
C.All sexual partners past 4 months
D.All sexual partners past 6 months
E.Last sexual partner should be informed and tested

A cervical smear report the presence of 'clue cells'. Other wise the smear was reprted as normal . Clue cells
are associated with which organism?
A.Human papilloma virus
B.Herpes genitallis
C.Gardenerella vaginalis
D.Candida species
E.Actinomysis

Which of the following infections is most commonly associated with an increased risk of ectopic pregnancy?
A.Neisseria gonorrhoea
B. Chlamydia trachomatis
C.Gardnerella vaginalis
D. Group B streptococcus
E.Mycoplasma hominis

What is the incubation period of Rubella?

A.2-3 days
B.5-6 days
C.5-9days
D.12-23 days
E.2-6 wks

The RCOG define septic shock as the persistence of hypoperfusion despite adequate fluid replacement
therapy.
What is the mortality rate in patients with septic shock?
5%
10%
20%
35%
60%

A 28 year old women who is known to be HIV positive delivers a term baby by planned C-section.
Maternal viral load was < 50 HIV RNA copies/mL at 36 weeks gestation. She is taking cART. The
infant had a negative HIV test on the day of discharge and is discharged on Zidovudine
monotherapy for 4 weeks. The mum plans to breastfeed. What would you advise the mother
regarding additional HIV testing for the infant when breastfeeding?
No additional infant testing required if maternal viral load maintained at < 50 HIV RNA copies/mL
Additional infant testing every 6 months
No additional infant testing unless breastfeeding for more than 1 year
Additional infant testing every 1 month
No additional infant testing unless breastfeeding for more than 18 months

1. An HIV-positive patient asks you if you can tell him the chances of him progressing to symptomatic AIDS.
Which one of the following tests would be most useful?
a. CD4 lymphocyte count
b. HIV antibody test
c. HIV RT PCR
d. Neopterin
e. HIV p24 antigen
The answer is c. (Ryan, pp 552554.) HIV RT PCR, a nucleic acid amplification test for HIV RNA, has recently been shown to be the most
valuable test for a) monitoring a patients progress during triple drug therapy and b) determining the chances of progres sion to AIDS. A viral
load of 750,000 copies per ml significantly increases the chance of progression to AIDS within 5 years. The other tests liste d do not accurately
predict progression to AIDS. The figure below shows the basic structure of HIV including the enzyme, reverse transcriptase.

Q. Which of the following antigenic types of hepatitis B virus is present in the envelope?
A. HbsAg
B. HBcAg
C. HBeAg
D. HBxAg

kaposi sarcoma is caused by

a. HHV1
b. HHV3
c. HHV4
d.HHV8
e. HHV 6

In which herpes viral infection, infected cell have characterstic "OWL EYE" inclusions,
A. HSV-1
B. HSV-2
C CMV
D. VZV
E. EBV

What is the incubation period for CMV?

2-3 days
5-12 days
2-3 weeks
3-12weeks
3-6months

You are asked to see a 33 year old women who is 16 weeks pregnant. She complains of frothy yellow vaginal
discharge and vaginal soreness. A wet smear is sent and microscopy reveals Trichomoniasis. What
percentage of
women with trichomoniasis infection have the classic frothy yellow PV discharge?
2%
20%
50%
90%
60%

What is the tubal factor infertility rate following a single episode of Pelvic Inflammatory disease?
1-2%
5%
12.5%
25%
50%

A 24 year old patient decides to take a Chlamydia screening test whilst in the GP surgery. He is asymptomatic.
The results are positive for chlamydia infection. His partner attends for testing and wants to know the risk of
contracting Chlamydia. What is the risk of chlamydia infection following intercourse with an asymptomatic
chlamydia positive partner?
5-10%
25%
40%
65%
>90%
What is the approximate risk of HIV transmission during a single episode of vaginal unprotected sexual
intercourse with a known HIV positive person?
0.01%
0.05%
0.1%
0.5%
1.0%

You are asked to speak to a 27 year old patient who is pregnant for the first time. She is concerned as her
friend recently gave birth and the baby was found to have profound hearing loss. Her friend was told this was
due to an infection whilst she was pregnant. What is the most common infective cause of congenital hearing
loss?
Toxoplasmosis
Rubella
Cytomegalovirus
Mycobacteria
Zika

When is the highest risk of maternal-fetal transmission of Toxoplasma Gondii during pregnancy?
0-10 weeks
10-16 weeks
26-40weeks
24-26weeks
16-20weeks

Which of the following is a single stranded DNA virus?

Parvovirus B19
HPV
EBV
CMV
Hepatitis B

Which of the following is a double stranded RNA virus?

Parvovirus B19
Rotavirus
EBV
CMV
Herpes simplex 2

What percentage of women with a diagnosis of Gonorrhoea will develop pelvic inflammatory disease?
2%
5%
15%
25%
50%

Cytomegalovirus (CMV) infection is common. Which one of the following statements best characterizes CMV?
a. It can be transmitted across the placental barrier
b. While a common infection, CMV is almost always symptomatic
c. The CMV can be cultured from red blood cells of infected patients
d. Unlike other viral infections, CMV is not activated by immunosuppressive therapy
e. There is no specific therapy for CMV
The risk of vertical transmission of HIV in untreated non-breastfeeding women in Europe is
A 1-2%
B 5-10%
C 15-20%
D 20-25%
E 30-35%

With respect to screening for HIV infection in pregnancy in the UK, which statement is not true?
A HIV testing is offered to all pregnant women
routinely
B If a woman declines HIV testing, this should be
documented in her antenatal notes
C The HIV test results of HIV positive women
should not be documented in their hand-held
notes
D HIV tests detect both the HIV antibody and the p24 HIV antigen
E HIV test can be undertaken using buccal swab

Actinomycete israelii
A Is part of the normal flora in the mouth
B Is a common cause of vaginal discharge
C Is an aerobic organism
D Causes genital tract infection associated with the use of tampons
E Causes infection that spreads through the
lymphatic system

Trichomonas vaginalis
A Spirochete
B Gram positive bacteria
C Protozoa
D Gram negative bacteria
E Helminth

Which technique is not used to diagnose Chlamydia trachomatis infection ?

A ELISA
B PCR
C LCR
D Immuno-fluorescence
E Serology

Which one is not a recognised cause of biological false positive syphilis serology?
A Treatment with methyl dopa
B Pregnancy
C Systemic lupus erythematosus
D Malaria infection
E Recent immunisation

Test results in a pregnant woman with latent syphilis

A VDRL test is negative
B VDRL positive and fluorescent treponemal
antibody tests positive
C VDRL test negative and fluorescent treponemal antibody tests positive
D VDRL test positive and fluorescent treponemal
antibody tests negative
E Fluorescent treponemal antibody tests negative
Which one is not an anti-fungal drug?
A Clotrimazole
B Cotrimoxazole
C Flucytosine
D Nystatin
E Fluconazole

A 23 year old woman is found to have chlamydia cervicitis at 6 weeks gestation. If untreated,
infection is associated with
A 1-2% risk of congenital anomalies
B 1-2% risk of neonatal chlamydia infection
C 5-10% risk of neonatal chlamydia infection
D 15-20% risk of neonatal chlamydia infection
E Over 50% risk of neonatal chlamydia infection

Infection with Clostridium tetani

A Has an incubation period of 3-6 months
B Results in life-long immunity
C Is characterized by an extensive local
inflammatory response
D Is treated with tetanus immune globulin
E Is treated with metronidazole

Infection with listeria monocytogenes

A Is best treated with cephalosporins
B Is sensitive to metronidazole
C Is resistant to ampicillin
D Is associated with the formation of granulomas
E Is more common in the first trimester

Which one is a spore-forming bacterium?

A Clostridium difficile
B Actinomyces israelii
C Corynebacterium diphtheria
D Listeria monocytogenes
E Pseudomonas aeruginosa

A 34 year old woman develops listeriosis at 6 weeks gestation. Which one of the above
statements is correct?
A.The infection is sensitive to ampicillin
B.The most likely source of the infection is sexual intercourse with a partner who is a carrier
C.The risk of miscarriage is not increased
D.The fetus is at increased risk of congenital anomalies
E.Termination of pregnancy should be recommended

doctor has suffered a needle-stick injury during caesarean section and the patient is known to
be HIV positive. The risk of the doctor becoming infected is
A < 1%
B 2-5%
C 5-10%
D 10-15%
E 15-20%

Which organism is typically sensitive to penicillin?

A E Coli
B Staph. Aureus
C Bacillus anthracis
D Clostridium difficile
E Staph epidermides

Zika virus belong to which genus

enterovirus
Flavivirus
Rubivirus
Hepavirus

A 30 year old women comes to see you and advises she has felt a little unwell with diarrhoea and
flu like symptoms. She is 28 weeks pregnant. Upon questioning she discloses she ate a soft cheese
and deli meats platter 5 days earlier. A blood culture confirms listeria infection. What is the
appropriate treatment (she has no known dug allergies)?
A. Cefuroxime
B. Cefalexin
C. Gentamicin
D. Amoxicllin
E. No treatment required

Which of the following is an obligate anaerobic organism?

A. Bacteroides
B. Escherichia coli
C. Listeria
D. Mycobacteria
E. Pseudomonas

A spore-forming organism that infects sheep and causes sepsis in iv drug users
A Actinomyces israelii
B Clostridium perfringens
C Listeria monocytogenes
D Pseudomonas aeruginosa
E Bacillus anthracis

Which micro-organism typically crosses the placenta?

A HIV
B Listeria monocytogenes
C Group B streptococcus
D Plasmodium falciparum
E Bacillus anthracis

The following can be associated with toxoplasmosis infection during pregnancy EXCEPT :
A. Rhinitis
B. Brain calcification
C. Hepatic Splenomegaly
D. Hydrocephalus
E. Spina bifida

Zika virus infection during pregnancy causes mostly!??

A.Hydrocephalus
B.Microcephaly
C.Cardiac malformations
D.Lymphoma
E.Cataracts
Which congenital anomaly is not typically associated with Toxoplasma gondii infection in pregnancy?
A Intra-cranial calcification
B Microcephaly
C Hydrocephalus
D Scarring in a dermatomal pattern
E Chorioretinitis

A 29 year old patient who is 15 weeks pregnant comes to see you. She currently has chickenpox. She is
concerned her baby may get congenital fetal varicella syndrome (FVS). What would you advise her the risk of
this is?
0.4%
2.0%
5.0%
10.0%
20.0%

During pergnancy which infection is associated with symmetrical IUGR?

A.CMV
B.toxoplasmosis
C.HSV
D.Rubella
E.vericella zoster

A healthy 28 Years woman develops chickenpox 3 days after vaginal delivery which one is correct?
A.neonate is not at risk because of antibodies acquired from the mother
B.vericella Zooster immune globulin should b given to neonate
C.woman should b re admitted to hospital
D.neonate should b observed for signs of chicken pox for 7 day after maternal rash
E.prophylatic acyclovir should b given to neonate

A 24yr old woman who is 18wk pregnant presents for review. Earlier in the morning she came into
contact with a child who has chicken pox. she is unsure whether she had the condition herself as a
child.
most appropriate action???
A. advice her,if rash appears within 24hr,then take acyclovir
B. give vericella immunoglobulin
C. check vericella antibody
D. prescribe oral acyclovir
E. reassure het,as she has no risk of fetal complications

The normal range of vaginal pH

A 2.0 3.5
B 3.8 4.5
C 4.8 5.7
D 5.0 7.0
E 7.2 8.0

Vertical transmission of HIV infection mostly occurs

A In the first trimester
B In the second trimester
C In the third trimester
D During labour and delivery
E In the neonatal period through breastfeeding

A 21 year old woman is thought to have primary genital herpes at 6 weeks gestation. The diagnosis
should be confirmed using
A Clinical history and examination
B Viral culture
C PCR
D Serology
E Electron microscopy

Sulphonamide antibiotics...
A Are analogues of d-alanyl-d-alanine
B Inhibit bacterial cell wall synthesis
C Inhibit bacterial protein synthesis
D Are a recognized cause of Stevens-Johnson syndrome
E Are metabolized by beta-lactamase

Which statement regarding beta lactam antibiotics is not true?

A Inhibit bacterial cell membrane synthesis
B Are analogues of a-alanyl-d-alanine
C Include penicillin
D Include cephalosporins
E Are typically effective against gram positive
bacteria

Causes sore throat, wound and skin infections

A Strep. Viridans
B Strep. Pneumonia
C Strep. Algalactiae
D Strep. Fecalis
E Strep. Pyogenes

Causes Rheumatic fever

A Strep. Viridans
B Strep. Pneumonia
C Strep. Algalactiae
D Strep. Fecalis
E Strep. Pyogenes

A 17 year old woman attends the antenatal clinic at 20 weeks gestation. She has a
history of
genital herpes
A The virus is an RNA virus
B There is an increased risk of congenital
anomalies
C The virus has an incubation period of 10-21 days
D Herpetic lesions may be present on her cervix
E In the absence of vesicles or a prodrom, there is no risk to the neonate following vaginal birth

Iodophores used for surgical disinfection

A Are aqueous solutions of iodine
B Have no activity against endospores
C Have no activity against Mycobacterium
tuberculosis
D Have no activity against fungi
E Activity is unaffected by organic matter
Iodophores (7.5 10%)

Preparation containing iodine complexed with a solubilizing agent, such as a surfactant or povidone (povidone-
iodine)
Result in a solution that releases free iodine
Excellent activity against gram positive and most gram negative bacteria
 Fair activity against TB
No activity against endospores
Good activity against viruses and fungi
Activity is moderately affected by organic matter
Useful as surgical scrub and skin prep
Can be used on mucous membranes
Iodine may be absorbed by the neonate and affect thyroid function

With respect to the sterilization / disinfection of surgical equipment

A Ultra-violet irradiation is the most effective method of sterilization
B Autoclaving utilizes dry heat
C Autoclaving is effective against the spores of
clostridium botulinum
D Boiling is more effective than autoclaving
E Pasteurization uses temperatures of 160-180C

Which antibiotic should not be administered by an intravenous bolus?

A Benzyl penicillin
B Vancomycin
C Cefuroxime
D Teicoplanin
E Flucloxacillin
B because of red man syndrome

Glycopeptide antibiotics
A Are not absorbed from the gastro-intestinal tract
B Include gentamicin
C Inhibit bacterial cell membrane synthesis
D Are effective against E. coli infections
E Cannot be administered by intravenous route

Which antibiotic does not act by inhibiting bacterial cell wall synthesis?
A Penicillin
B Cefalexine
C Vancomycin
D Teicoplanin
E Gentamicin
E. It inhibit protein synth

With respect to infection with Toxoplasma gondii during pregnancy

A The risk of fetal infection decreases with
increasing gestation age
B The risk of the fetus being affected decreases with increasing gestation age
C Maternal infection typically presents with
septicaemia
D Infection in pregnancy is treated with erythromycin
E Infection in pregnancy is typically detected during routine screening

Which antibiotic is not used to treat Candida albicans infection?

A Fluconazole
B Nystatin
C Amphotericin B
D Clotrimazole
E Azithromycin
 A 29-year-old woman who is 39 weeks pregnant presents to the delivery suite in labour.
Her previous child was affected by group B streptococcus (GBS) infection. She is allergic
to
penicillin. Which antibiotic should be prescribed for her as a prophylaxis for GBS?
Metronidazole
Gentamycin
Cephalosporins
Ampicillin
Erythromycin

What type of fungus is Candida albicans?

Yeast-like fungus
True yeast
Trimorphic fungus
Filamentous fungus
Dimorphic fungus

A pregnant woman is identified as being susceptible to rubella from her first trimester
booking blood results. When discussing this result at the next antenatal clinic
appointment, what is the most appropriate advice that she should be given?
A. A single dose of MMR (mumps measles rubella vaccine) should be offered at the six-
week postnatal check
B. A single dose of MMR should be offered immediately postnatally
C. A single dose of rubella immunoglobulin should be offered as soon as possible
D. A single dose of rubella vaccine should be offered as soon as possible
E. A single dose of MMR should be offered immediately postnatally with a second dose at the six-
week postnatal check.

In prenatal infection???
A. Rubella can be prevented by administration of rubella vaccine during pregnancy
B. Toxoplasma is a virus
C. HIV virus infect the baby more readily when delivered vaginally than caesarean section
D. Cytomegalovirus causes macrosomic babies
E. In HIV patient breast-feeding is encouraged

Transplacental infection occur with all, EXCEPT:

A. Cytomegalovirus.
B. Toxoplasma
C. Rubella
D. Syphilis
E. Gonorrhea

Regarding Rubella immunization :

A. Rubella negative patients should be vaccinated during pregnancy
B. Rubella vaccine is a Toxoid
C. The majority of pregnant patients are rubella non immune
D. Breast feeding should be inhibited if vaccine is given postnatally
E. Pregnancy should be avoided for 3 months after vaccination

Regarding Rubella vaccination, choose the correct answer :

A. It's a live attenuated virus.
B. Should be given in pregnancy in non-immune mother.
C. Should be given to all pregnant mothers in the 1st antenatal visit.
D. Pregnancy should be avoided for one year after the vaccination.
E. It's a toxoid.
The vaccine for measles, mumps and rubella (MMR) is best characterized as
A. Synthetic peptide vaccine
B. Killed virus vaccine
C. Inactivated virus vaccine
D. Live virus vaccine
E. Recombinant viral vaccine

32-year-old G5 delivers a stillborn fetus at 34 weeks. The placenta is noted to be much larger than normal.
The fetus appeared hydropic and had petechiae over much of the skin. What is the most likely causative
agent?
a. Herpes simplex
b. Parvovirus
c. Rubella virus
d. T. pallidum
e. Varicella zoster
The answer is d.
In the past, syphilis accounted for about one-third of all stillbirths. Transplacental infection can occur with any stage of syphilis, but the
highest incidence of congenital infection occurs in women with primary or secondary disease. The fetal and neonatal effects include
hepatosplenomegaly, edema, ascites, hydrops, petechiae or purpuric skin lesions, osteochondritis, lymphadenopathy, rhinitis, pneumonia,
myocarditis, and nephrosis. The placenta is enlarged, sometimes weighing as much as the fetus. While parvovirus can cause stillbirth and fetal
hydrops, it is not associated with skin lesions or placental hypertrophy

38-year-old woman from Sri Lanka attends her general practitioner at 10 weeks gestation. She is complaining
of fever and has pains in her joints. She developed a rash yesterday. On examination, she has a temperature
of 38.1C, postauricular lymphadenopathy and a maculopapular rash over her torso. Rubella is diagnosed.
What is the most likely fetal abnormality to occur as a result of this acute infection?
A .Cerebral palsy
B. Failure to thrive
C. Limb hypoplasia
D. Microcephaly
E. Sensorineural hearing loss

A 32-year-old primiparous school teacher is 16 weeks pregnant. She is seen in the antenatal clinic, where she
reports a maculopapular rash and coryzal symptoms. The general practitioner has already sent serology and
you review the result.
Rubella IgG: positive Rubella IgM: negative Parvovirus B19 IgG: negative Parvovirus B19 IgM: positive
What is the most likely diagnosis?
A. Non-immunity to parvovirus B19
B .Non-immunity to rubella
C. Recent infection with rubella
D .Recent infection with parvovirus B19
E .None of the above

Most common single defect of congenital rubella syndrome is:

A. Cataract and glaucoma
B. PDA
C. Sensorinueral deafness
D. Neonatal purpura
E. HepatosplenomegLy

Which of the following has oncogenic properties in humans?

A.Enteroviruses
B.Hepatitis B virus
C Papovavirus
D.Rabies virus
E.Rubella virus

through which route is cmv inf most common transmitted?

a. breastfeeding
b. contact with saliva
c. sexual contact
d. sneezing
e. social contact

Which antibiotic is used to treat syphilis infection in the first trimester of pregnancy?
A Azithromycin
B Erythromycin
C Procaine penicillin
D Clindamycin
E Tazocin

Gas gangrene is caused by

A Actinomycetes israelii
B Clostridium perfringens
C Clostridium difficile
D Bacillus anthracis
E Staphylococcus epidermidis

Which bacteria typically cause toxic shock syndrome?

A Group A streptococci
B Group B streptococci
C Coagulase negative staphylococci
D Coagulase positive staphylococci
E Actinomycetes Israelii

52.HPV high risk group include

a) 6
b) 11
c) 16
d) 18
e) 31 and both c and d

51.Wrong statement regarding hepatitis b virus infection is :

a) Infant delivered of HBsAg and HBeAg positive should be given vaccine and HBIg
b) Infant delivered of HBsAg and anti- HBe positive should be given vaccine without HBIg
c) Infant delivered of HBsAg and HBeAg status not known should be given vaccine and HBIg
d) DNA virus
e) Transmitted by contaminated water

50.Chances of transmission of HIV 1 infection from mother to fetus in absence of antiretroviral treatment and
with treatment and caesarean section is
a) 50% & 20%
b) 80% & 20%
c) 15% & 2%
d) 30% & 2%
e) 2% & 30%

49.Parvovirus B19 bind to globoside (P antigen ) present on

a) RBC
b) WBC
c) Platelets
d) Lymphocyte
e) Nerve cells
48.Incidence of rubella infection in fetus of women with rubella infection upto 12 week of gestation is :
a) 54%
b) 80%
c) 25%
d) 15%
e) 40%

47.Indications for delivery in case of corona virus infection are:

a) Maternal rapid deterioration
b) Failure to maintain adequate ventilation
c) Multi organ failure
d) Difficulty in mechanical ventilation due to gravid uterus
e) All of above

46.30 years old sexually active women presented with purulent vaginal discharge, itching, ph> 5.0. On wet
mount preparation organism with of size of white blood cell with flagella present. Probable organism is :
a) Candida albicans
b) T. Vaginalis
c) T. Gondi
d) G. Lamblia
e) Cyptococcus

45.Primigravida 34 weeks with gestatinal diabetes mellitus presented with curdy white vaginal discharge with
formation of pseudohyphae in culture and formation of germ tube in serum, organism can be:
a) Cryptococcus neoformans
b) Candida albicans
c) Histoplasma capsulatum
d) Trichophyton
e) Microsporum

44. false statement among following is:

a) Basic time temperature use in UK for pure steam autoclaving is 134-137oc for 3 min.
b) In downward displacement autoclave instruments are packed loosely
c) Cetrimde is commonly used against P. Aeruginosa in laboratory
d) For processing of endoscope mechanical washer should be used
e) Ethelene oxide is used to sterilize heat sensitive devices

43.Srerilization is defined as not a single organism in

a) One million surgical packs
b) One lakh surgical packs
c) Ten thousand surgical packs
d) Thousand surgical packs
e) Hundred surgical packs

42.Antisepsis was first demonstrated by:

a) Josep lister
b) Berkeley moyhnihan
c) Robert koch
d) Lou paster
e) Edward jenner

41.Antibiotic resistance is not mediated by:

a) Antibiotics may not get into cell
b) Rapidly eliminatedby efflux mechanism
c) Enzyme may destroy antibiotics
d) Target site may get altered
e) None of above

40.Antibiotics acting on ribosomes are:

a) Erthromycin
b) Clindamycin
c) Tetracyclin
d) Amynoglycoside
e) All of the above

39. Antibiotics acting on cell wall are:

a) Penicillin
b) Cephalosporins
c) Monobactams and carbapenems
d) Vancomycin & teicoplanin
e) All of the above

38. False statement among the following is:

a) Mycoplasma hominis is found in 20% of sexually active women
b) Ureaplasma urealyticum found in 80% of sexually active women
c) Mycoplasma should be consider as cause of post partum pyrexia and treatment with tetracyclin should be
consider if fever not settle down.
d) Chlamydia can be cultured in artificial media
e) N. Gonorrhoeae commonly infect columnar
epithelium cells

37.Which of the following is not a feature of vaginosis:

a) Presence of clue cells
b) Fishy smell
c) Presence of vaginal wall gland infection
d) Watery vaginal discharge
e) Ph > 5.0

36.False statement regarding listeria monocytogen is :

a) Infection occure in late pregnancy
b) One of the organism responsible for preterm labour
c) Miliary granuloma with focal necrosis is common lesion found in post partum examination of placenta
d) Intrapartum infection will lead to predominantly
meningitis in neonate with incubation period of 5 to 7 days
e) Colonize intrauterine devices

35.Which of the following commensals present in vaginal flora responsible for acidic ph:
a) Lactobacilli
b) Diphtheroid
c) Staphylococci
d) Alpha haemolytic streptococci
e) Actinomyces

34.Wrong statement among following is:

a) Specimen for culture should be taken before treatment start
b) Specimen should be kept for 4 0c and transported to laboratory
c) Chlamydiae and virus survive better at -700c
d) Gonococcus should be directly plated bedside or rapidly transported to laboratory
e)To increase likelihood of positive result swab stick dipped in pus is always preferred than liquid pus
33.Which of the following is aerobic gram positive cocci:
a) Stphyloccocus aureus
b) Peptostreptococci
c) Bacillus species
d) Neisseria gonorrhea
e) Vibrio cholera

32.False statement among following is:

a) Plasmid code for antibiotic resistant
b) Pasmid code for sugar fermentation
c) Bacteria can transfer antibiotic resistance through plasmid
d) Mycoplasma have rigid cell wall
e) Chlamydiae lack peptidoglycans

31.Target for beta lactam antibiotics is:

a) Penicillin binding protein
b) N acetyl glucosamine
c) N acetyl muramic acid
d) Teichoic acid
e) Beta lacamase in p
a, it inhibits synthesis of peptidoglycan layer of cell wall and binds to penicillin binding protein.

30) 25 year sexually active women presented with increase frequency of micturition. Culture is non diagnostic.
Likely organism is:
a) Mycoplasma
b) E. Coli
c) N. Gonorrea
d) Chlamydia
e) Streptococci

29) Infectious form of chlamydia is:

a) Elementary body
b) Reticular body
c) Inclusion body
d) None of above
e) All of above

28) Q-fever caused by:

a) Coxiella burnetti
b) Treponema pallidum pertenue
c) Treponema pallidum carateum
d) Ureaplasma urealyticum
e) Mycoplasma

26) Organism with no cell wall and fried egg

appearance on culture is:
a) Treponema pallidum pallidum
b) Treponema pallidum pertenue
c) Treponema pallidum carateum
d) Mycoplasma
e) Bacillus anthracis

25) Which of following is not feature of borrelia:

a) Borelia burgdorferi carried by ixodes tick
b) Cause lyme disease
c) Culture is difficult
d) Isolated bell`s palsy
e) none of above
Borrelia
B. Burgdorferi is carried by ixodes ticks, which usually infect deer .
Infection results in lyme disease, characterized by an initial rash at the site of the tick bite (erythema chronicum migrans)followed by
chronic neurological or bone/joint problems; a common manifestation is isolated Bells palsy.
Culture of the organism is difficult and serology is used for diagnosis

24) Painless chancre is characteristic of

a) Primary syphilis
b) Secondary syphilis
c) Tertiary syphilis
d) Haemophilus ducreyi
e) Bacillus anthracis

23) Long slender coiled bacterium which cause syphilis is

a) Treponema pallidum pallidum
b) Treponema pallidum pertenue
c) Treponema pallidum carateum
d) Haemophilus ducreyi
e) Bacillus anthracis

22) Long slender coiled bacterium which cause pinta is

a) Treponema pallidum pallidum
b) Treponema pallidum pertenue
c) Treponema pallidum carateum
d) Haemophilus ducreyi
e) Bacillus anthracis

20) 25 years male presented with cough with sputum since 20 days not responding to antibiotics. Sputum
examination show gram positive acid fast bacilli. Likely characteristic of bacilli is
a) It is mycobacterium tuberculosis
b) Ziehl neilson stain and auramine stain used for identification
c) Take several weaks for culture
d) Lowenstein-jensen media used for culture
e) All of above

19) Gram positive spore forming anaerobic rod

responsibe for gas gangrene is:
a) Clostridium perfringes
b) Clostridium botulinum
c) Clostridium tetani
d) Haemophilus ducreyi
e) Bacillus anthracis

18)Gram positive spore forming anaerobic rod

responsible for food poisoning in canned foodis
a) Clostridium perfringes
b) Clostridium botulinum
c) Clostridium tetani
d) Haemophilus ducreyi
e) Bacillus anthracis

17) Gram positive spore forming anaerobic rod

responsible for tetanus is
a) Clostridium perfringes
b) Clostridium botulinum
c) Clostridium tetani
d) Haemophilus ducreyi
e) Bacillus anthracis

16) Soft ulcer is caused by:

a) Haemophilus influenzae
b) Actinomyces
c) Stretptococci pyogens
d) Haemophilus ducreyi
e) Bacillus anthracis

15) Gram negative cocci which occur in pair isolated from endocervix of sexually active women likely organism
is:
a) N. Gonorrhoeae
b) E. Coli
c) Stretptococci pyogens
d) Staphylococcus aureus
e) Bacillus anthracis

14) Most common cause of urinary tract infection is.(clue: it is a gram negative rods, facultative
anaerobic,ferment lactose):
a) Nocardia asteroid
b) Actinomyces
c) Stretptococci pyogens
d) Staphylococcus aureus
e) E. Coli

13) Food poisoning because of reheated rice due to:

a) Bacillus anthracis
b) Bacillus cereus
c) Stretptococci pyogens
d) Staphylococcus aureus
e) Enterococci

12) Anthrax is caused by:

a) Nocardia asteroid
b) Actinomyces
c) Stretptococci pyogens
d) Staphylococcus aureus
e) Bacillus anthracis
e: Gram negative Rods.

11) Gram positive aerobic bacilli responsible for preterm labour is:
a) Listeria monocytogen
b) Actinomyces
c) Stretptococci pyogens
d) Staphylococcus aureus
e) Enterococci
A : Gram +ve Bacilli. associated with Meningitis, hepatosplenomegaly, bradycardia. Transmission is Fecal oral. Transplacental . (
Miliary Granuloma, Focal necrosis ). Fetal mortality, 50%

10) 13 years male. Presented with pharyngitis.

Microscopy show gram positive bacilli aerobic bacilli.Likely organism is:
a) Nocardia asteroid
b) Corynebacterium diphtheriae
c) Stretptococci pyogens
d) Staphylococcus aureus
e) Enterococci

9) 40 years female having poor oral dentition presented with cervicofacial abscess and abdominal pain pus
from lesion show non acid fast, anaerobic organism with sulphur granules. Likely organism is:
a) Nocardia asteroid
b) Actinomyces
c) Stretptococci pyogens
d) Staphylococcus aureus
e) Enterococc

8) 40 years male HIV positive presented with brain abscess.Microscopy show gram positive, aerobic, weakly
acid fast. Likely organism is:
a) Nocardia asteroid
b) Actinomyces
c) Stretptococci pyogens
d) Staphylococcus aureus
e) Enterococci
Key is A
Nocardia is aerobic, and is also (weakly) acid -fast (see
mycobacteria section below). It is normally an environmental
organism and tends to infect the immunocompromised or those
with chronic lung disease. Typical diseases are brain abscess
and persisting suppurative lung infection.The most common species is N. Asteroides .

7) False statement about streptococci:

a) Beta haemolytic streptococci cause partial haemolysis on blood agar
b) Beta haemolytic streptococci classified according to carbohydrate present on outer cell surface
c) Group B beta haemolytic streptococci i.e
streptococcal algectasia is important cause of neonatal sepsis
d) Streptococci sensitive to penicillin

6) Staphylococcus aureus:
a) Cause cellulitis, boil and surgical site infection
b) Toxic shock syndrome in tampon users
c) Mrsa have mutation in penicillin binding protein
d) Flucloxacillin is effective in beta-lactamase producing bacteria
e) All of above

5) Transfer of genetic material from one bacteria to another bacteria by forming sex pilus is called:
a) Transduction
b) Transformation
c) Conjugation
d) Plasmapherosis
e) Organogenesis

4) Process of transfer of DNA from one bacteria to another with help of virus is called:
a) Transduction
b) Transformation
c) Conjugation
d) Plasmapherosis
e) Organogenesis

3) Process of taking free DNA from environment is called:

a) Transduction
b) Transformation
c) Conjugation
d) Plasmapherosis
e) Organogenesis

2) Neisseria is:
a) Gram negative
b) Gram positive
c) Strict anaerobes
d) Form yellow colony on culture
e) Bacilli

The following RNA virus belongs to the Toga group

A. Measles
B. HIV-1
C. Rubella
D. Poliomyelitis virus
E. Dengue fever virus

Regarding spirochetes infection

A. Treponema carateum is a motile bacteria causing Yaw disease
B. Weils disease is caused by contact with infected stool of brown rats with Leptospira
icterohaemorrhagiae
C. Lyme disease is caused by motile Treponema pertenue bacterium
D. Treponema Pallidum Pallidum is a motile spirochete, which is resistant to water and drying
E. Treponema pertenue causes Vincent angina

The following anaerobic, gram +ve, Hemolytic bacilli is a vaginal commensal

A. Actinomycosis
B. Clostridium welchii
C. Clostridium Tetani
D. Mycoplasma
E. Group A (beta-hemolytic) Streptococcus

The following gram positive coagulase positive cocci causes pneumonia and resistant to penicillin
A. Pneumococci
B. Klebsiella
C. Staphylococcus Aureus
D. Mycobacterium tuberculosis
E. Group A (beta-hemolytic) streptococcus

The following gram positive aerobic cocci causes toxic shock syndrome and sensitive to
penicillin
A. Staphylococcus Aureus
B. Staphylococcus Epidermidis
C. Streptococcus Viridians
D. E-Coli
E. Streptococcus pyogenes

Peptidoglycan layer in the bacterial cell wall

A. Is exposed in gram positive bacteria
B. Binds to lactam ring of penicillin
C. Does not present in Chlamydia
D. Stained violet with gram stain
E.All of the above
The following organism/s is/are vaginal flora
A. Corynebacterium Diphtheria
B. Clostridium Tetani
C. Streptococcus Viridians
D. Enterobacter
E. Clostridium welchii

Which of the following is not true for Enterococci??

A.growth in presence of bile
B.growth in 6.5% NaCl
C.non hemolytic
D.enterococcus fecalis causes 85-90%of infection.
E.it's not a part of normal intestinal flora.

Streptococcus pneumoniae is ...

A.Gram negative
B.beta hemolytic
C.penicillin resistant
D.normal flora of upper respiratory tract in 5-40% of individuals.
E.causes atypical pneumonia

Which of the following is best described by streptococcus agalactia?

A.alpha hemolytic
B.gamma hemolytic
C.it causes sepsis in adults
D.it's a part of normal vaginal/rectal flora in 5-25% women
E.it dosnt cause neonatal sepsis d/t chorioamnionitis.

Which of the following is not caused by streptococcus pyogenes?

A.pharyngitis
B.scarlet fever
C.scalded skin syndrome
D.rheumaticfever
E.cellulitis

Which one of the following is relatively common cause of UTI in young sexually active
women?
A.E.coli
B.salmonella
C.staphylococcus saprophyticus
D.staphylococcus aureus
E.pseudomonas aeruginosa

Micro organism that do not cause latent infection includes??

A.chlamydia trachomatis
B.CMV
C.hepatitis A
D.mycobacterium
E.varicella zoster

Which of the following is correct regarding trichomonas vaginalis?

A.infection occurs in particular association with DM
B.is cyst forming organism.
C.is a protozoan
D.is an intracellular organism
E.is an obligate anaerobe
Which of the following is not true regarding HIV/AIDS ...
A.can b transmitted by breast milk.
B.is a RNA virus .
C.is destroyed by 1% gluteraldehyde.
D.is destroyed by pasteurization.
E.is transmitted to the fetus in utero more than 90% of seropositive women .

Which of Following is true regarding staphylococcus epidermidis ?

A.is destroyed by povidone iodine.
B.are usually sensitive to penicillin.
C.grown in blood cultures are d/t contamination & should b ignored
D.is coagulase positive.
E.on microscopy are gram pos cocci in chains

Which of the following is true for actinomyces Israelii.

A.forms golden granules in pus.
B.is a commensal in anal canal.
C.is a normal commensal in vagina.
D.is usually resistant to penicillin

Regarding UTI which micro organism is most likely to b associated with bladder
catheterization.
A.bacteroids
B E.coli.
C.proteus
D.pseudomonas
E.trichomonas..

Which one of the following is notifiable disease?

A.MRSA Infection
B.measles
C pneumococcal pneumonia
D.rheumatic fever.

Which of the following vaccines must not b administered to HIV positive patients?
A BCG
B.hepatitis A vaccine
C.hep B vaccine
D.rabies vaccine
E.cholera vaccine

Which pathogen is commonly responsible for cellulitis?

Streptococcus pyogenes
Staphylococcus epidermidis
Staphylococcus aureus
Pseudomonas aeruginosa
Clostridium perfringens

A woman presents at 28 weeks gestation with vomiting, headache, night sweats and
abdominal pain. She has recently returned from the African country of Mali. Urgent blood
films show the presence of Plasmodium falciparum, with a parasitaemia of 3%. After a
diagnosis of malaria has been made she is treated with intravenous quinine.The
presence of which haematological characteristic is associated with increased incidence
of malaria?
A Haemoglobin C
B Beta-thalassaemia
C Duffy antigen
D Glucose-6-phosphate dehydrogenase deficiency
E Sickle cell trait
A 38-year-old woman is readmitted via the emergency department 10 days
postemergency caesarean section complaining of vaginal bleeding, abdominal pain and
foul-smelling vaginal discharge. Abdominal examination reveals suprapubic tenderness
and the uterus is palpable 2 cm below the umbilicus. You suspect endometritis.
Which of the following is the most likely causative organism?
A Chlamydia trachomatis
B Group B Streptococcus
C Mycoplasma genitalia
D Neisseria gonorrhoea
E Ureaplasma
Key is surprisingly E
Endometritis may be acute or chronic. In this case, the patient has an acute endometritis after caesarean section.
Causes to be considered include retained
products of conception and ascending infection from the lower genital tract, with prolonged rupture of membranes
being a particular risk factor. Acute endometritis from an obstetric cause is most often polymicrobial, involving
vaginal commensals. These bacteria include Ureaplasma, Gardnerella and group B Streptococcus. Other bacteria
implicated in endometritis are those associated with sexually transmitted infections including Chlamydia and
gonorrhoea. Treatment includes initial resuscitation and swift administration of broad spectrum antibiotics. Other
investigations include a full blood count, C-reactive protein, clotting profile and pelvic ultrasound.

23-year-old woman attends her general practitioner complaining of numbness and

tingling in both feet. She recently started treatment for pulmonary tuberculosis.
Which drug is most likely to be responsible for these symptoms?
B Isoniazid
C Pyrazinamide
D Rifampicin
E Streptomycin..

A 40 year female having poor oral dentition presented with cervico fascial abscess &
abdominal pain. pus from lesion shows non acid fast,anaerobic organism with sulphur
granules.likely organism is ..
A.nocardia
B.actinomyces
C strept pyogenes
D staph aureus
E.enterococci

50 year old male HiV positive presented with brain abscess.microscopy shows gram
positive aerobic weakly acid fast.likely organism is...
A.nocardia
B.actinomyces
C.strep pyogenes
D.staphylococcus aureus
E.enterococci.

Staphylococcus aureus
A.gram positive
B.pathogenic
C.coagulase positive
D.form yellow colonies on culture
E.all of the above

28-year-old primiparous woman who is 16 weeks pregnant reports mild dysuria;

otherwise she is well. Urine dipstick shows leucocytes ++ and is positive for nitrites. She
is prescribed appropriate antibiotics.
What is the most likely causative organism of her urinary tract infection?
A Citrobacter freundii
B Escherichia coli
C Klebsiella pneumoniae
D Proteus mirabilis
E Staphylococcus saprophyticus
35-year-old multiparous woman has presented to labour ward in spontaneous labour.
You see from her antenatal notes that she is HIV positive. She is currently using highly
active antiretroviral therapy and has a viral load of 43 copies/mL.
Which of the following is associated with increased risk of vertical transmission of HIV?
A Co-existent Group B Streptococcus carriage
B Chorioamnionitis
C Paternal HIV-infection
D Post-dates gestation
E Vaginal examination during labour
Membranes are ruptured for a long time ....ascending infection

A 23-year-old woman attends antenatal clinic at 22 weeks gestation. This is her second
pregnancy and she is very concerned as during her first pregnancy she had an infection,
which led to the permanent disability of her child. He is deaf, with delayed development
and is small for his age. He became jaundiced shortly after birth.
What was the most likely cause of her son's condition?
A Cytomegalovirus
B Herpes
C Parvovirus B19
D Rubella
E Varicella zoster

Antenatal screening of a 25-year-old patient is suggestive of hepatitis B infection. The

results of her serology are as follows:
HBsAg Positive
HBeAg Positive
Anti-HBeAb Negative
Anti-HBsAb Negative
Total anti-HBc Positive (IgM anti-core Ab negative, IgG anti-core Ab positive)
Which of the following is most likely to represent her hepatitis B status?
A Acute infection (recent)
B Acute infection (resolving)
C Chronic infection (high infectivity)
D Chronic infection (low infectivity)
E Following vaccination

A 63-year-old man with an open fracture of the femur develops the rare complication of
gas gangrene and requires leg amputation.
What is the most likely causative agent?
A Clostridium botulinum
B Clostridium perfringens
C Clostridium tetani
D Escherichia coli
E Klebsiella pneumonia

A 35-year-old man presents at a sexual health clinic with a new painless round lesion on
his penis; he also has non-tender inguinal lymphadenopathy.
What is the most likely causative agent of his symptoms?
A Chlamydia trachomatis
B Neisseria gonorrhoeae
C Treponema pallidum carateum
D Treponema pallidum pallidum
E Treponema pallidum pertenue

18-year-old woman presents to a sexual health clinic requesting a sexually transmitted

infection screen; she is asymptomatic, however she is concerned as her new boyfriend is
complaining of dysuria, penile discharge and scrotal pain.
What is the most likely cause of his symptoms?
A Actinomyces israelii
B Candida albicans
C Chlamydia trachomatis
D Toxoplasma gondii
E Treponema pallidum pallidum

22-year-old woman delivers a 7-lb male infant at 40 weeks without any complications. On
day 3 of life, the infant develops respiratory distress, hypotension, tachycardia,
listlessness, and oliguria. What is the most likely cause of the infants illness?
a. Cytomegalovirus
b. Group B streptococcus
c. Hepatitis B
d. Herpes simplex
e. L. monocytogenes

A 25-year-old female in her first pregnancy delivers a 6-lb male infant at 38 weeks. The
infant develops fever, vesicular rash, poor feeding, and listlessness at 1 week of age.
What is the most likely cause of the infants signs and symptoms?
a. Cytomegalovirus
b. Group B streptococcus
c. Hepatitis B
d. Herpes simplex
e. Listeria monocytogenes

38-year-woman at 39 weeks delivers a 7-lb infant female without complications. At 2

weeks of life, the infant develops fulminant liver failureand dies. What is the most likely
causative virus?
a. Cytomegalovirus
b. Hepatitis B
c. Herpes simplex
d. Parvovirus
e. Rubeola

32-year-old G5 delivers a stillborn fetus at 34 weeks. The placenta is noted to be much

larger than normal. The fetus appeared hydropic and had petechiae over much of the
skin. What is the most likely causative agent?
a. Herpes simplex
b. Parvovirus
c. Rubella virus
d. T. pallidum
e. Varicella zoster

A 20-year-old G1 patient delivers a live-born infant with cutaneous lesions, limb defects,
cerebral cortical atrophy, and chorioretinitis. Her pregnancy was complicated by
pneumonia at 18 weeks. What is the most likely causative agent?
a. Cytomegalovirus
b. Group B streptococcus
c. Rubella virus
d. Treponemal pallidum
e. Varicella zost

What's the characteristic features of primary syphilis?

A.chancroid
B.chancre
C.asymptomatic
D.cardiovascular syphilis
E.gummas

Why's the time period of tertiary syphilis from primary infection?

A.4-6 weeks after primary infection
B.<1 year after secondary stage
C.>2 year after secondarystage
D.3+ years after primary infection
E.5+ years after primary infection

What is the incubation period of primary syphilis?

A.4-10 weeks
B.3-90 days
C.3-7 months.
D.2 years
E.3 years

Gummas are in which stage of syphilis?

A.primary
B.secondary
C.tertiary
D.early latent
E.late latent

Whts the primary causative organism of bacterial vaginosis?

A.gardenella vaginalis
B.E.coli
C.Mycoplasma hominis
D.chlamydia trachomatis.
E.actinomyces israelli

With respect to syphilis

A Secondary syphilis is not infectious
B Secondary syphilis is characterized by central
nervous system involvement
C Mouth ulcers typically occur in latent syphilis
D Both primary and secondary syphilis are
infectious
E Tertiary syphilis is characterised by generalised lymphadenopathy

Which infection is not caused by Neisseria gonorrhoea?

A Arthritis
B Endocarditis
C Epididymitis
D Salpingitis
E Stomatitis

Human papilloma virus

A Is a DNA virus
B Is terratogenic
C Infection in pregnancy is treated with ganciclovir
D Primary infection at term is an indication for
caesarean section
E Infection always results in a chronic carrier state

Answer is E
Which one of the above statements regarding Group B streptococcus infection /
colonisation in pregnancy is correct?
A.It is associated with an increased risk of congenital anomalies
B.It is more commonly isolated from the rectum than the vagina
C.Is best detected by taking high vaginal swabs
D.It can be isolated from the genital and lower gastro-intestinal tract of 25% of pregnant women
E.It is associated with an increased risk of miscarriage

Which one of the above statements regarding Varicella zoster is correct?

A.The incubation period is 3-6 weeks
B.It is infectious 48h before the rash appears
C.It is no longer infectious once the rash has appeared
D.10% of pregnant women in the UK are IgG positive
E.Women from tropical countries are more likely to be immune

A healthy 35 year old woman who is 15 weeks pregnant has been in contact with a child
with Fifth disease (parvovirus B19). Which one of the above statements is correct?
A.She should be reassured that the virus does not pose a risk to her pregnancy
B.If the woman is parvovirus IgG negative, she should be reassured
C.If the woman is parvovirus IgM negative, she should be reassured
D.If the woman is IgG negative and IgM positive, she should be re-tested in 3 weeks
E.If the woman is IgG negative and IgM negative, she should be re-tested 3 weeks after exposure

For which one of the above infections is routine screening recommended in pregnancy?
A.Chlamydia
B.Bacterial vaginosis
C.Cytomegalovirus
D.Asymptomatic bacteriuria
E.none of above

Which one of the above statements regarding the hepatitis B virus is not correct?
A.Is a DNA virus
B.Is not terratogenic
C.Causes sub-clinical infection in the majority of patients
D.Infection in adulthood results in 90% of individuals becoming chronic carriers
E.Vertically acquired infection results in 90% of individuals becoming chronic carrier

Test results in a pregnant woman with treated syphilis

A VDRL test is negative
B VDRL and fluorescent treponemal antibody tests are negative
C VDRL test negative and fluorescent treponemal antibody tests positive
D VDRL test positive and fluorescent treponemal
antibody tests negative
E Fluorescent treponemal antibody tests negative
Primary: VDRL (+ve or -ve), FTA-Abs (+ve). FTA-Abs usually becomes positive before VDRL
Secondary : VDRL and FTA-Abs (+ve)
Latent : VDRL (usually +ve), FTA-Abs (+ve)
Tertiary / quaternary : VDRL (+ve or -ve), FTA-Abs (+ve)
Treated : VDRL (-ve), FTA-Abs (+ve)
The VDRL test becomes negative with treatment and can be used to monitor treatment. The FTA-Abs test
can remain positive for several years after adequate treatment

Terratogenic virus
A Hepatitis B
B Herpes simplex
C Varicella zoster
D Human papilloma virus
E Parvovirus B 19
Which surgical disinfectant is effective against endospores?
A Iodine (3%)
B Iodophores (7.5-10%)
C Isopropyl alcohol (70%)
D Chlorhexidine (2-4%)
E Triclosan