HEMATOPOIETIC & LYMPHATIC SYSTEM - MICROBIOLOGY -

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Rafe Fletcher
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1 HEMATOPOIETIC & LYMPHATIC SYSTEM - MICROBIOLOGY - PULSE 1. Which of the following is associated with Cat-scratch? a. B.bacilliformis b. B.quintata c. B.henselae Note: Cat scratch disease: fever & severe regional lymphadenitis. 2. All of the following happen in chagas disease except : A. Romans sign B. Cardiomyopathy C. Megalocolon D. Megoesophagus E. Winterbottom s sign Note : Winterbottom's sign : visible swollen lymph nodes of the posterior cervical region, seen in the early phase of African trypanosomiasis (sleeping sickness). 3. Regarding the P.falciparum, which of the following is correct : A. young ring form... Crescent shaped gametocyte B. Old ring form crescent shaped gametocyte C. young ring form Band shaped gametocyte Answer :young ring form... Crescent shaped gametocyte 4. Defenetive Host for malaria : A.mosquito B. Human

2 5. - All of the following correct except : A. Rose bengal test... Brucella B. Weil-felix... Rickettsia C. paul-bunnel test Ehrlichia D. Morular Ehrlichia Note: Paul-bunnel test (heterophile antibody test) is a rapid test for infectious mononucleosis due to Epstein Barr virus (EBV). 6. coprofloxacin cause : Answer : tendonitis 7. which of the following drugs is mismatched : A. Tularemia aminoglycosides B. Sulphonamided Rikkettsia C. Doxycycline.. Q fever 8. Which of the following is not a result of Q Fever : A. Hepatitis B. Meningo-encephalitis C. Endocarditis D. Jaudince E. rash 9. Which of the following does not require a vector : A. Salmonnela B. Coxiella burnetti 10. which of the following is the least likely to be recovered from blood culture : A. salomonella typhi B. Rikkitesia C. T.Cruzi D. T.Bruzi E. Vibro cholera

3 11. Which of the following can happen as long healthy carrier microorganism : A. salomonella typhi B. Rikkitesia C. T.Cruzi D. T.Bruzi E. Vibro cholera 12. Regarding the blood collecting and culture, which of the following is wrong : A. Select the venipuncture site, clean it with ethanol followed by iodine B. allow the sample time for drying and do not touch the cleaned area C. Mix the contents of the bottles gently after inoculation D. Refrigerate the samples for later use Note: Specimen should NOT be refrigerated. 13. Tick mediated disease : A. Bartonella bacilliformis B. Bartonella quintane C. Bartonella hensela D. Babesia 14. The least prone to tularaemia are : a. Farmers b. veterinarians c. lab workers d. fisher workers (work with fishes!) 15. All of the following are a zoonotic disease except : Answer : Typhoid fever (enteric fever) Note: zoonotic disease is a disease that can be passed between animals and humans.

4 EHSAN 1. -The least prone to tularemia are? a. Farmers b. veterinarians c. Lab workers d. A job related to fishing 2. -Which of the following is associated with Cat-scratch? a. B.bacilliformis b. B.quintata c. B.henselae d. S.typhi 3. -Rocky mountain spotted fever (RMSF) is transmitted by? a. Rat flea b. Mick bite c. Tick bite d. Body louse Note : Rocky Mountain spotted fever (RMSF) is a tickborne disease caused by the bacterium Rickettsia rickettsii. it's transmitted to humans by the bite of infected tick species. Typical symptoms include: fever, headache, abdominal pain, vomiting, and muscle pain. a rash may also develop. 4. -Which of the following drugs must not be used for the treatment of Rocky mountain spotted fever : A. Streptomycin B. Doxycycline c. Sulfonamides D. Chloramphenicol E. Erythromycin Note : Sulfonamides are contraindicated in rickettsial infections.

5 5. -The maximum acceptable percentage of contaminated blood cultures is : a. 10% b. 3% c.20-30% 6. -Which of the following can't be isolated from lab culture? a. Trypansoma Cruzi b. Trypansoma brucei c. L.donovani 7. Calabar swelling occurs due to? a. Loa-loa b. W.bancrofti c.o.volvulus Note: Calabar swelling :a transient subcutaneous swelling 8..Which of the following isn t transmitted by a vector? Answer: Q fever 9. Which of the following is transmitted by the Cheopis flea? Answer: Plague 10. Which of the following is transmitted by aerosolized particles? A.Trypanosoma B.Parvovirus B-19 C.Leishmania D.Salmonella Typhi 11. Brucella utilizes which of the following nutrients found in animals but not in humans? Answer: Erythritol 12. All of the following are true about SPS blood culture except? A. It contains anticoagulant B % C. It enhances the growth of Neisseria Meningitides -Which of the following microorganisms are associated with malignancy? Answer: Clostridium Septicum

6 13. Which of the following bacteria is most isolated from people with endocarditis (valve disease)? Answer: Viridans Streptococci -Which of the following the least likely to be recovered from blood culture : A. Salmonella typhi B. Salmonella typhimurium C. Salmonella enteritidis D. Vibrio cholera 14. NNN medium is used to culture all of the following except? a. Leishmania.tropica b. leishmania.donovani c. leishmaina.mexicana d. T.cruzi e. T.brucei Note: NNN medium is a culture medium used to grow Leishmania & Trypanosoma cruzi. It consists of (0.6% sodium chloride) added to a simple blood agar. 15.Relapse of tertian malaria? a. Gametocytes b. Trypomastigotes c. Amastigote HOPE 1. Reduviid bug transmit which of the following parasites : Trypanosoma cruzi 2. Which of the following clinical specimens in typhoid fever will isolate Salmonella typhi in any stage of the illness? Stool specimen.

7 3. Which of the following organisms isolated from blood is highly associated with malignancy: streptococcus bovis. 4. All of the following are true of SPS that is used in blood culture except : enhance the growth of N.meningitidis. 5. -Blood group P antigen act as a receptor of which of the following : Parvovoirus b What is the infective stage of leishmania promastigote. 7. -Which of the following anatomical sites is the most responsible for extravascular source of blood stream infections? genitourinary system. 8. Resins in blood culture bottles are used in order to : neutralize the affect of antibiotics. 9. -All of the following are true concerning vaccination against brucellosis EXCEPT? giving to infants during the first year of life. 10. Which of the following clinical specimens in typhoid fever is the best to use in making a diagnosis of typhoid fever during the acute stage of the disease after the first week of illness? Blood culture. 11. Resins in blood culture bottles are used in order to? Neutralizes the effects of antibiotics. 12. Slapped cheeks rash is a clinical condition occurs following severe anemia in children, which of the following organisms is responsible for such condition? Parvovirus B19

8 13. Which of the following organisms is responsible for the development of an Eschar? Orienta tsutsugamushi. 14. All of the following bacteria are considered as obligate intracellular in their pathogenesis EXCEPT? Francisella tularensis. 15. Phospholipase is virulent factor seen in which of the following organisms? Rickettsia rickettsii. 16. The following infectious agents are associated with the etiology of lymphoma, EXCEPT? Streptococcus pneumoniae. 17. All of the following are true concerning vaccination against brucellosis EXCEPT? given to humans & animals at the same time. 18. All of the following parasites can be diagnosed by a blood film EXCEPT? Plague. 19. Which of the following disease develops a skin rash that is exacerbated by sunlight and emotional stress? Parvovirus B Simulium Fly is responsible for the transmission of : Onchocerciasis. 21. Phospholipase is virulent factor seen in which of the following organisms? Yersinia pestis. 22. Which of the following organisms is responsible for the development of an Eschar? Rickettsia akari. 23. Which of the following blood culture systems uses sensors to detect increase pressure of gas in the blood culture bottle cap? ESP system.

9 Others 1) Antigens of Salmonella Typhi are A. H antigen type d of flagella B. O antigen 9 of LPS C. Vi antigen D. All 2) Epstein Par Virus A. facilitates by saliva exchange B. associated with typical lymphocytosis C. affects T lymphocytes only D. have ssdna presence and a non-enveloped virus 3) Which antigens are not expressed by EPV? A. Early antigen-recurrence B. Early antigen-diffuse C. Nuclear antigen D. Viral capsid antigen

10 4) Presence of both anti-vca and anti-ebna indicate? A. recent infection B. past infection C. future infection D. A & B 5) Presence of anti-vca and not anti-ebna indicate? A. recent infection B. past infection C. future infection D. A & B 6) Which is the indicator of infectious mononucleiosis? A. apetite loss B. anorexia C. sore throat D. spleen enlargement 7) Aplastic crisis in patients with chronic haemolytic anemia is associated with A. EBV infection B. Enteric fever C. Parvovirus B19 D. Yersinia pestis

11 8) B19 Parvovirus infection is dangerous for A. sickle cell anemic patients B. pregnant women C. cardiac arrest D. A & B 9) Which disease is associated with B19 Parvovirus infection? A. Gross tonsillar and pharyngeal edema B. Fifth disease C. Infectious mononucleiosis D. plague 10) Coxilla burnetti A. is associated with hardy organisms B. causes Q fever which is a zoonotic disease C. A&B 11) A chronic Q fever may develop into A. Granulomatous hepatitis B. Erythema Infectiosum C. Endocarditis D. Cardiomyopahty

12 12) To treat chronic Q fever, we give A. Sterptomycin B. Tetracycline C. Doxycycline D. Doxycycline+Cirprofloxacin+Rifampicin 13) F1, phospholipase, protease and fibrinolysis are some virulence factors of A. Yersinia pestis B. Coxilla burnetti C. B19 Parvovirus D. R. typhi 14) Which is true regarding bubonic type? A. associated with internal organ hemorrhage B. enter by inhalation through respiratory tract C. non-contagious D. A&B 15) The most common complication of bubonic plague is A. Meningitidis B. Pneumonia C. DIC D. Cyanosis

13 16) Which is the treatment for plague? A. Formalin inactivated vaccine (Killed Vaccine) B. Oxytetracycline C. Streptomycin D. A&C E. All 17) Widal test is used to observe the presence of A. S. typhi B. Coxilla burnetti C. Yersinia pestis D. Trypanosoma cruzi 18) Black death is associated with A. Yersinia pestis B. Salmonella paratyphi C. R. prowazekii D. R. tsutsugamushi 19) Bipolar of safety pin appearance can be seen by using Giemsa stain to show the presence of A. coxilla burnetii B. brucellosis C. R. prowazekii D. Yersinia pestis

14 20) Which organism contains mucopeptide and diaminopimelic acid (DAP)? A. Rickettsiae B. Yersinia pestis C. Trypanosoma cruzi D. Plasmodium malariae 21) Which organisms are cultivated in embryonated chicken eggs and cell cultures in the lab? A. yersninia pestis B. rickettsiae C. loa loa D. coxilla burnetii 22) These organism may cause a transient bacteremia and spread to liver and spleen as they invade M cells and macrophages. It refers to A. Parvovirus B19 B. R. tsutsugamushi C. Salmonella typhi D. Brucella 23) Weil Felix reaction is an agglutination test of confromative diagnosis for presence of A. brugia malayi B. salmonella paratyphi C. rickettsiae D. trypanosome cruzi

15 24) All the followings are drugs used to treat Rickettsiae infection except A. Chloramphenicol B. Erythromycin C. Oxytetracycline D. Sulfonamides 25) Macchiavello stain and Castaneda stain will stain the organism with what color? A. blue, bright red B. bluish purple, blue C. bright red, blue D. bluish purple, bright red 26) Which is not true regarding Louse Borne Typhus A. transmitted by human body louse B. is an endemic typhus C. the causative agent is R.prowazekii D. associated with Brill-Zinsser disease 27) Which typhus is transmitted by mites? A. Epidemic Typhus B. Endemic Typhus (murine) C. Scrub Typhus

16 28) Immunefluorecent staining of skin cryostat section is the lab diagnosis of which disease? A. Rickketsial Pox B. Malta fever C. Enteric fever D. Rocky Mountain Spotted fever 29) It is caused by R.akari and transmitted byhouse mite. The disease is known as A. Rickketsial Pox B. Malta fever C. Enteric fever D. Rocky Mountain Spotted fever 30) Attenuated vaccine is a vaccine to prevent the spread of A. Q fever B. Black Death C. Typhoid Fever D. Brucellosis 31) Which organism grows in capnophilic condition? A. Leishmania Donovani B. Leishmania tropica C. Salmonella typhi D. Brucella

17 32) All the followings are treatment for typhoid fever except A. laxatives and enemas B. ceftriaxon C. ciprofloxacin D. Fluids and IV electrolytes 33) Brucella posses a typical LPS endotoxin and two major serological determinants that are A and M. A. true B. false 34) It causes late term abortion, birth of dead kids and retained placenta. It refers to A. B. abortus B. B.meletensis C. B. suis D. B. canis 35) One of symptoms of Brucellosis is multiple spleen and liver abscess. It is due to which Brucella? A. B. abortus B. B.meletensis C. B. suis D. B. canis

18 36) Which is the treatment of Brucellosis? A. doxycycline + streptomycin/rifampicin B. tetracycline + Aminoglycosides or without aminoglycosides C. sulfonamides D. A & B E. All 37) Which plasmodium causes the mildest form of malaria? A. Plasmodium vivax B. Plasmodium ovale C. Plasmodium malariae D. Plasmodium falciparum 38) A brownish-black pigment that is related to degradation of Hb ferriprotoporphyrin IX is a A. Hemosiderin B. Hemipexin C. Hemazoin D. Hemachromatosis 39) Schuffner dots or eosinophilic stipplings can be seen following Wright staining in A. Plasmodium vivax B. Plasmodium ovale C. Plasmodium malariae D. Plasmodium falciparum E. A&B

19 40) Maurer dots are seen in A. Plasmodium vivax B. Plasmodium ovale C. Plasmodium malariae D. Plasmodium falciparum 41) We can seen more than 1 ring in initiation stage of A. Plasmodium vivax B. Plasmodium ovale C. Plasmodium malariae D. Plasmodium falciparum 42) We can see rosette shape of schizonts in A. Plasmodium vivax B. Plasmodium ovale C. Plasmodium malariae D. Plasmodium falciparum 43) The formation of oval, fimbriated RBC is due to the action of A. Plasmodium vivax B. Plasmodium ovale C. Plasmodium malariae D. Plasmodium falciparum

20 44) Band forms are seen in A. Plasmodium vivax B. Plasmodium ovale C. Plasmodium malariae D. Plasmodium falciparum 45) Which plasmodium can stay latent in liver and associated with relapse? A. Plasmodium vivax B. Plasmodium ovale C. Plasmodium malariae D. Plasmodium falciparum E. A&B 46) Which plasmodium infects senile RBC only? A. Plasmodium vivax B. Plasmodium ovale C. Plasmodium malariae D. Plasmodium falciparum 47) Which is worng A. Plasmodium has the ability to make folate B. PfEMP1 is the adhesion that attaches to RBC receptors C. Blood transplantation and transfusion cannot transmit malaria

21 D. P. vivax can recognize Duffy blood group as receptor 48) Which type of people is not resistant to malaria? A. Hereditary Spherocytosis B. Thalassemia patients C. Pyridoxal kinase deficiency D. G6PD deficiency 49) Which plasmodium endures quartan malaria for every 72 hours? A. Plasmodium vivax B. Plasmodium ovale C. Plasmodium malariae D. Plasmodium falciparum 50) Which is wrong? A. Acridine orange stains DNA B. ParaSight F test detects the HRP2 protein on the malaria C. OptiMal test detects lactate dehydrogenase D. None 51) To treat relapsing malaria in erythrocytic gametocyte and hepatic schizont, we use A. chloroquine, primaquine B. sulphonamides, artemisinin C. antifolates, quinine D. 4-aminoquinolones, 8-aminoquinolones

22 52) To treat clinical attack of Chloroquine Resistant Falciparum malaria (CRFM) iin eryhtrocytic schizont, all can be used except A. primaquine B. antifolates C. sulphonamides D. artemisinin 53) Which causes river blindness and skin disease? A. Wucheria Bancrofti B. Brugia Malayi C. Loa Loa D. Onchocerca Volvulus 54) Which organism has no gonads at the terminal but has a sheath? A. Wucheria Bancrofti B. Brugia Malayi C. Loa Loa D. Onchocerca Volvulus 55) Caliber swellins associated with A. Wucheria Bancrofti B. Brugia Malayi C. Loa Loa D. Onchocerca Volvulus

23 56) Drug of choice to treat this Loa Loa filarial worm is diethyl Carbamezele A. true B. false 57) Which filarial worms birth occur in the day (diurinal)? A. Wucheria Bancrofti B. Brugia Malayi C. Loa Loa D. Onchocerca Volvulus 58) Which is wrong about Trypanosoma cruzi? A. caused by reduvid bug and causes Chancre B. can be seen as C or U shape after doing blood film C. associated with megacolon, mega esophagus and heart involvements as the manifestation D. shows Romana s sign if enter through the eye E. None 59) All the followings are treatment for Trypanosoma cruzi except A. Melarsoprol B B. Allupurinol C. Benznidazole D. Nitrofuramox

24 60) Melarsoprol B, Eflornithin and suramine are some drugs used to treat A. Chagas disease B. Sleeping sickness C. Baghdad boil D. Kala Azar 61) Choose a wrong combination A. trypanosome cruzi - Chagas disease B. leishmainia tropica - cutaneous leishmanias C. leishmania braziliensis - subcutaneous leishmanias D. leishmania donovani - visceral leishmanias 62) Dark pigmentation of the skin or Kala Azar can be seen due to A. Leishmania Tropica B. Leishmania Braziliensis C. Leishmania Donovani 63) Damage of hard palate, septum of nose and ears are due to A. Leishmania Tropica B. Leishmania Braziliensis C. Leishmania Donovani

25 64) Oriental sore is associated with A. Leishmania Tropica B. Leishmania Braziliensis C. Leishmania Donovani 65) Which is not component of kinetoplast? A. Axoneme B. Glossina C. Parabasal body D. Blepharoblast 66) Zymodemes are produced by the following except A. T. cruzi B. T. gambiense C. T. rhodensiense D. T. brucei 67) Hepatosplenomegaly is due to the action of A. Leishmania Tropica B. Leishmania Braziliensis C. Leishmania Donovani

26 68) Renal failure and fever are the complications of A. Leishmania B. Trypanosoma C. Loa Loa D. Wucheria Bancrofti 69) Which disease has the characteristics of variable surface glycoprotein (VSG)? A. African Trypanosomiasis B. American Trypanosomiasis 70) The intermediate host of Leishmainia is A. Phlebotomus fly B. Tse Tse fly C. Glossina D. Assasin bug 71)Which of the following is susceptible to malignant tertiary malaria: a.person with F Hb b.person with RBC's expressing A antigen c.person with Duffy blood group (FyaFyb) d.person with HbS e.person withg6pd deficiency

27 72)All of the following MO need a vector to be transmitted except : a.coxiella pernetii b.ehrlishia c.rickettesia reckettesie d.rickettesia prwazaki 73)YOPs protein are associated with : a.yersina pestis b.coxiella pernetii c.salmonella typhi d.brucella 74)In All of the following the MO can be seen in blood film except: a.elephantiasis b.plage c.plasmodium in malaria d.toxoplasma e.babesiosis 75)The MO which favor erythritol is: a.brucella abortus 76)In EBV.Recent infection is seen in: a.(+) to VCA antibodies b.(+) to EB-NA antibodies

28 77)Regarding Rocky Mountain spotted fever, all the following are false EXCEPT: a. Gram Stain will show the organism in red color. b. The drug of choice for treatment is amphotericin B. c. The rash that appears is a hemorrhagic rash. d. Transmission is via fecal-oral route. 78) Regarding infectious mononucleosis, all of the following are false EXCEPT: a. The common disease associated with it is Hodgkin's Lymphoma. b. It's a very common infection in population and 90% of the population will have +ve IgM against herpes simplex virus. c. During the disease, the virus mainly infects T-cells. d. We can use acyclovir in the treatment. 79)Which of the following bacterial products produce the enteric typhoid fever? A. endotoxin B. exotoxin C. urease enzyme D. hemolysin E. protease

29 80)Targeting the gametocytes of falciparum malariae and preventing the transmission of the disease is achieved by treatment with: A. chlorquine B. sulfonamides C. primaquine D. pyrimethanamine E. melarsoprol B 81)What is the drug of choice for the treatment of meningo encephalitis caused by trypanosoma brucei? A. tetracycline B. allopurinol C. melarsoprol B D. suramin E. pentamidine 82)The malarial pigment hemozoin is a hemoglobin degradation product of: A. Duffy blood group FYa Fyb B. blood group A C. bilirubin D. protoporphyrin E. ferriprotoporphyrin IX

30 83)caveolae-vesicle complexes on the surface of the RBCs of plasmodium vivax makes: A. shuffners dot B. maurers dots C. schiznot D. merozoite E. ring stage 84) Which of the following proteins represent stages of viral replication? A. EBNA B. VCA C. EA D. VCA and EA E. all of the above 85)The transmission of Q fever usually by A. arthropods bite B. inhalation C. sexual contact D. rodent mites E. rat fleas

31 86)Which of the following is false concerning the coxiella burnetii? A. multiplies in phagolysosome B. resists lysosomal enzyme C. grow the low ph D. sensitive to drying E. cause of Q fever 87)All of the mentioned below can be seen in blood smear EXCEPT A. elephantiasis B. leishmania C. brucellosis D. Chagas disease E. Q fever 88)Zoonoses of bacteria etiology are all of the following except: A. Plaque B. Q Fever C. Branzills disease D. Brucellosis E. enteric fever 89)Which microorganism is present with erythritol in the placenta? A. brucella abortus B. trypanosoma C. salmonella

32 90)Which of the following microorganism has Ysc proteins at the virulence factor? Yesinia pestis 91)Which of the following cannot be recognized using the blood film? A. Yersinia Pestis B. Coxiella Burnetii C. Rickettsia D. ehrlichia 92)Plasmodium species that cause tertiary malignant malaria mainly effects A. Duffy blood group B. blood group A C. Hb S D. blood group O 93)Regarding Epstein Barr Virus, which of the following refer to recent infection? A. +ve anti VCA B. +ve anti VCA and +ve anti EBNA C. +ve anti VCA and ve anti EBNA D. +ve anti EBNA

Diagnosis of Infectious Agents in the Peripheral Blood Smear. Meredith Reyes, MD July 24, 2006

Diagnosis of Infectious Agents in the Peripheral Blood Smear Meredith Reyes, MD July 24, 2006 Pathogens detected in PS Bacteria Neisseria meningitidis Streptococcus pneumoniae Staphylococcus sp. Bartonella