1 The following are common causes of viral meningitis:

- Enteroviruses T
- Mumps T
- Measles F
- Influenza F
- Smallpox F
2 egar!ing herpes simplex viruses:
- Transmission of "S#2 is generall$ via oral contact F
- "erpes simplex can cause fatal necrotizing encephalitis of the temporal lo%e T
- "S#1 generall$ remains latent after primar$ infection in the trigeminal ganglion T
- In herpes simplex infections there is usuall$ no viremia T
- eactivation of "S# stimulates a rise in anti%o!$ titer F
& egar!ing influenza:
- Ma$ cause pan!emics from time to time !ue to antigenic !rift F
- "as a segmente! negative sense ss'( genome T
- Influenza )* together with aspirin* is associate! with e$e+s s$n!rome T
- Influenza is the onl$ '( virus which has a replication step in the nucleus F
- Influenza causes its s$stemic s$mptoms such as fever* malaise an! m$algia %ecause of
viremia
F
, Factors contri%uting to smallpox+s complete era!ication inclu!e:
- Smallpox has man$ animal reservoirs F
- #accinia is efficient in stimulating an immune response to smallpox virus T
- Smallpox is virulent an! sprea!s easil$ from one person to another F
- Smallpox is easil$ recognize! clinicall$* an! has no carrier state T
- Smallpox infection !oes not involve a viremic stage F
- The following !rug . virus pairs are true:
- i%avirin . hepatitis / T
- (manti!ine . parainfluenza F
- 0anc$clovir . herpes simplex virus F
- (c$clovir . varicella zoster virus T
- 1amivu!ine . "I# T
2 egar!ing a!enoviruses:
- The$ can cause gastroenteritis an! c$stitis T
- The$ are sprea! via the respirator$ route T
- #accination is routinel$ !one in the militar$ T
- The vaccine use is a 3ille! vaccine F
- Incu%ation perio! ta3es months F
4 The following viruses are important causes of s3in lesions:
- Measles T
- Influenza F
- Mumps F
- 5engue T
- "epatitis ( F
6 egar!ing hepatitis ( virus:
- Incu%ation perio! is shorter than hepatitis ) T
- #iral particles are she! onl$ when clinical s$mptoms appear F
- There is a 3ille! vaccine availa%le for travelers to en!emic countries T
- Infection can %e reactivate! $ears later in times of immunosuppression F
- Infection can %e cause! %$ consuming contaminate! raw o$sters an! coc3les T
7 egar!ing hepatitis viruses that cause latenc$:
- "epatitis / infections are more prone to chronicit$ than hepatitis ) T
- )oth hepatitis ) an! hepatitis / viruses have effective vaccines F
- "epatitis ) virus is more li3el$ to esta%lish chronicit$ in new%orns rather than in a!ults T
- "epatitis ) %ut not hepatitis / infections can %e transferre! %$ sexual contact F
- "epatitis ) infection is consi!ere! chronic if ")s(g is foun! to %e positive & months
apart
F
18 The following statements are true:
- "epatitis ) virus is a 5'( virus with reverse transcriptase T
- "I# infects /5,9 T l$mphoc$tes using the p2, protein coat F
- a%ies can %e prevente! %$ a live attenuate! vaccine F
- 5engue hemorrhagic fever is thought to %e cause! %$ the presence of enhancing
anti%o!ies !uring a su%se:uent infection with !ifferent !engue serot$pe from the first
T
- /M# mononucleosis can %e !iagnose! using the Monospot test F
11 egar!ing "I#:
- "I# virion contains a positive sense ss'(* reverse transcriptase* an! integrase T
- (ntigenic !rift ma3es it !ifficult for vaccine !evelopment against "I# T
- It is the gp,1 gl$coprotein that %in!s to /5, an! coreceptors F
- (I5S is !iagnose! when /5,9 cell count !ips %elow 288;<l* an! several (I5S !efining
illnesses are !iagnose!
T
- "I# can %e effectivel$ cure! with a "((T regimen over the long term F
12 egar!ing E)#:
- Infectious mononucleosis !ue to E)# is confirme! %$ presence of at$pical l$mphs in
peripheral %loo!
F
- E)# is en!emic worl!wi!e* with a large proportion of the worl!+s population infecte! T
- The $ounger a person is infecte!* the more li3el$ he;she will !evelop s$mptoms F
- In the =est* the most common neoplastic manifestation of E)# is )ur3itt+s l$mphoma F
- >atients with infectious mononucleosis rash shoul! %e prescri%e! ampicillin to prevent
secon!ar$ %acterial infection
F
1& The following statements are true regar!ing congenital viral infections:
- >arvovirus )17 is a fre:uent cause of fetal malformations F
- u%ella an! /M# are strongl$ associate! with fetal malformations T
- u%ella must alwa$s %e suspecte! an! exclu!e! in a pregnant mother who has a rash T
- /M# infecte! cells !o not characteristicall$ show much />E F
- Infections !uring the first trimester usuall$ gives rise to serious fetal malformation
resulting in the nee! to a%ort the fetus
T
1, egar!ing !engue virus:
- Is an example of a vector-%orne infection* transmitte! %$ the (e!es mos:uito T
- ?ne of the characteristic features of !engue is severe m$algia an! arthralgia T
- 5engue has an effective vaccine F
- 5iagnosis of hemorrhagic complications of !engue t$picall$ inclu!es a platelet count T
- 5engue treatment t$picall$ involves a potent antiviral !rug an! if necessar$* intravenous
flui! infusion to com%at shoc3
F
1- The following viral infections ma$ %e prevente! %$ live attenuate! vaccines:
- Measles* mumps an! ru%ella T
- @apanese encephalitis F
- Aellow fever T
- "epatitis ) F
- Influenza F
12 MaBor causes of %acterial communit$-ac:uire! pneumonia inclu!e:
- Salmonella enterica F
- Streptoccus pneumoniae T
- Streptoccus p$ogenes F
- "emophilus influenzae T
- M$coplasma pneumoniae T
14 Fast onset vomiting is t$picall$ associate! with:
- Salmonella enterica F
- /amp$lo%acter BeBuni F
- Staph$lococcus aureus T
- /lostri!ium !ifficile F
- )acillus cereus T
16 egar!ing Streptococcus p$ogenes:
- These %acteria have a variet$ of M proteins* which have anti-phagoc$tic properties T
- Serological !iagnosis !emonstrate the presence of antistreptol$sin anti%o!ies T
- Is associate! with %oth suppurative an! immunogenic con!itions T
- ?ne of the most common post-streptoccal complications is reactive arthritis F
- Is often resistant to %enz$lpenicillin F
17 egar!ing Staph$lococcus aureus:
- >ro!uces protein ( which %in!s to Fa% portion of Ig0* inhi%iting opsonization an!
phagoc$tosis
F
- Is a 3nown cause of right-si!e! infective en!ocar!itis in intravenous !rug users T
- >ro!uces a host of exotoxins which me!iate various s$stemic manifestations li3e toxic
shoc3 s$n!rome
T
- Most strains are usuall$ sensitive to %enz$lpenicillin F
- Is an uncommon cause of septic arthritis an! acute osteom$elitis F
28 The following are associate! with neonatal sepsis an! meningitis:
- 'eisseria meningiti!is F
- Streptococcus agalactiae T
- Escherichia coli T
- 1egionella pneumophila F
- "emophilus influenzae F
21 egar!ing 'eisseria meningiti!is:
- Meningococcal meningitis is a me!ical emergenc$C empirical proph$laxis with %roa!
spectrum anti%iotics is in!icate! %efore an$ la%orator$ test is !one
T
- 0ram stain of /SF show gram-negative !iplococci within >M's T
- It is !ifficult to treat F
- /learance of nasal carriage re:uires treatment with ciprofloxacin an! rifampicin T
- There is an effective vaccine against the capsule of all strains of 'eisseria meningiti!is F
22 egar!ing toxin-me!iate! %acterial !isease:
- Tetanus can %e prevente! %$ vaccination with tetanus toxoi! T
- /holera toxin wor3s %$ inhi%iting elongation factor 2* causing cell !eath F
- 5iphtheria immunization is part of the national chil!hoo! immunization program in
Singapore
T
- #eroc$totoxin-pro!ucing ED coli is usuall$ treate! %$ the a!ministration of high !ose
anti%iotics using culture an! sensitivit$ tests as a gui!eline
F
- /lostri!ium perfringens toxin is a lecithinase which !estro$s cell mem%ranes* causing
m$onecrosis
T
2& egar!ing 'eisseria gonorrhoae:
- 0rows well on %loo! agar F
- Ferments %oth glucose an! maltose F
- (long with /hlam$!ia tracomatis* is a common cause of ophthalmia neonatorum T
- Is usuall$ as$mptomatic in males* %ut commonl$ causes infection of genitalia in females F
- Ma$ cause an ascen!ing infection in females* exten!ing into the uterus an! fallopian
tu%es an! even into the peritoneal cavit$
T
2, The following !rug . %acteria pairs are appropriate:
- )enz$lpenicillin . viri!ans streptococci T
- /eftriaxone . "emophilus influenzae T
- /iprofloxacin . 'eisseria gonorrhoae T
- /o-trimoxazole . 'ocar!ia asteroi!s T
- (mpicillin . M$coplasma pneumoniae F
2- egar!ing M$coplasma pneumoniae:
- /an %e grown on conventional cell-free* although it ta3es a long time F
- /auses at$pical Ewal3ing+ pneumonia T
- Is usuall$ !iagnose! %$ serolog$ T
- /ell wall contains pepti!ogl$can F
- Ma$ cause an autoanti%o!$-me!iate! hemol$tic anemia T
22 The following !isease . %acteria pairs are correct:
- 1$mphogranuloma venerum . /al$mmato%acterium granulomatis F
- /hancroi! . "emophilus !ucre$i T
- Scru% t$phus . ?rientia tsutsugamushi T
- Meningitis . Streptococcus pneumoniae T
- /ancer . "elico%acter p$lori T
24 egar!ing the genuses /hlam$!ia an! /hlam$!ophila:
- /hlam$!ophila psittaci is transmitte! through close human-to-human contact F
- /hlam$!ia trachomatis serot$pes (* )* )a an! / can cause an e$e lesion calle! trachoma T
- /hlam$!ia an! /hlam$!ophila exist in the forms of an infective reticulate %o!$ an! a
replicative elementar$ %o!$
F
- Immunit$ against these genuses is usuall$ cell-me!iate! T
- Mem%ers of the penicillin group of !rugs are not routinel$ use! in its treatment T
26 egar!ing "emophilus influenzae:
- e:uires %oth F an! # factors for growth T
- 0rows well on %loo! agar F
- Gsuall$ causes life-threatening epiglottitis in $oung chil!ren T
- ( common cause of meningitis an! pneumonia T
- /are must %e ta3en when ta3ing a throat swa%* as pressing the tongue !own ma$ cause
acute respirator$ o%struction
T
27 egar!ing vaccination against %acterial !iseases:
- "emophilus influenzae can %e prevente! %$ a conBugate vaccine T
- "emophilus influenzae vaccination is part of the Singapore immunization program F
- (cellular pertussis vaccine has fewer si!e effects than whole cell vaccine T
- Streptococcus pneumoniae vaccine covers onl$ 18 capsular t$pes F
- The )/0 vaccine is ver$ effective in preventing a!ult T) pulmonar$ !isease F
&8 egar!ing tu%erculosis:
- M$co%acterium tu%erculosis stimulates a t$pe I h$persensitivit$ reaction F
- M$co%acterium tu%erculosis is sprea! via air%orne respirator$ !roplets T
- 5iagnosis via aci!-fast staining of a sputum sample is confirmator$ F
- M$co%acterial culture will show results after & wee3s F
- Tu%erculosis ma$ affect Bust a%out an$ organ in an immunocompromise! host T
&1 egar!ing s$philis:
- #isualization of Traponema palli!um is !one using !ar3 groun! microscop$ T
- Secon!ar$ s$philis often involves the central nervous s$stem* causing general paresis of
the insane an! ta%es !orsalis
F
- ( positive T>"( test is !iagnostic for current s$philis infection F
- The !raw%ac3 of the #51 test is its false positives T
- /ongenital s$philis is characterize! %$ "uchinson+s tria! . /' #III !eafness* interstitial
3eratitis* an! neurological !eficits
F
&2 The following statements are true:
- )orrelia recurrentis causes a relapsing fever transmitte! %$ the soft tic3 F
- 1eptospira interrogans causes 1$me !isease F
- 1$me !isease ma$ %e treate! using !ox$c$cline an! ceftriaxone T
- (cineto%acter %aumanii is foun! onl$ in hospitals F
- /oxiella %urnetii causes culture-negative en!ocar!itis T
&& egar!ing "elico%acter p$lori:
- Together with >roteus mira%ilis* is urease positive T
- /auses acute inflammation of the gastric mucosa F
- 1i3e /amp$lo%acter* is culture! un!er aero%ic con!itions at &4H/ F
- Is implicate! in the !evelopment of peptic ulcers an! chronicall$* gastric carcinoma T
- Treatment consists of cimeti!ine* omeprazole* an! co-trimoxazole F
&, The following %acteria are implicate! in urinar$ tract infections:
- Staph$lococcus saproph$ticus T
- Escherichia coli T
- >roteus mira%ilis T
- Enterococcus fecalis T
- Ile%siella pneumoniae T
&- The following statements are true:
- There is a low inci!ence of penicillin resistance among Escherichia coli strains F
- >seu!omonas aeruginosa* li3e Ile%siella an! ED coli* is lactose fermenting F
- ( ris3 factor in the !evelopment of melioi!osis is !ia%etes mellitus T
- (ll group 5 streptococci are penicillin resistant F
- Microscop$ of sulfur granules showing %ranching* gram negative ro!s are !iagnostic for
(ctinom$ces israelii
F
&2 The following statements are true:
- 'asophar$ngeal carcinoma commonl$ occurs in the far east an! is associate! with E)#
infection
T
- Staph$lococcus aureus pro!uces epi!ermol$tic exotoxins which cause scarlet fever F
- Tumor viruses commonl$ inclu!e ")#* "/#* "># an! "S# F
- Most of the cases of malaria in Singapore are ac:uire! locall$ F
- >neumoc$stis carinii pneumonia is an (I5S !efining illness T
&4 egar!ing malaria:
- >lasmo!ium falciparum is a%le to infect er$throc$tes of all !evelopmental stages T
- >lasmo!ium vivax an! ovale infections exhi%it latenc$ T
- Malaria is a%le to cause a multi-s$stem illness an! ma$ culminate in fatalit$ T
- Meflo:uine effectivel$ target >lasmo!ium vivax h$pnozoites F
- ( common feature amongst most antimalarials is car!iotoxicit$ T
&6 The following parasites are vector %orne:
- 'aegleria fowleri F
- Trichomonas vaginalis F
- Tr$panosoma %rucei T
- Schistosoma Baponicum F
- ?nchocerca volvulus T
&7 The following statements are true:
- /r$ptococcus neoformans is treate! using fluc$tosine an! amphotericin ) T
- Tremato!e infections are t$picall$ treate! with prazi:uantel T
- Fluconazole is extensivel$ meta%olize! in the liver F
- >neumoc$stis carinii is usuall$ treate! with amphotericin ) F
- /hemotherap$ is a useful option for fungal Ma!ura foot F
,8 The following organism . !isease pairs are correct:
- /r$ptococcus neoformans . gastroenteritis F
- Malassezia furfur . er$thema chronicum migrans F
- =ucheria %ancrofti . river %lin!ness F
- Tr$panosoma cruzi . (frican sleeping sic3ness F
- Sporothrix schenc3ii . Ma!ura foot F
,1 egar!ing protozoan parasites:
- Entamoe%a histol$tica c$sts have 6 nuclei F
- )oth Entamoe%a histol$tica an! Trichuris trichuria can cause !$senter$ T
- Metroni!azole can %e use! to treat %oth 0iar!ia lam%lia an! Trichomonas vaginalis T
- /$sts of Toxoplasma gon!ii can %e !etecte! %$ aci!-fast staining F
- The progression of s$mptoms for 'aegleria fowleri usuall$ ta3es months F
,2 egar!ing pneumonia:
- 1egionella pneumophila is a rare cause of pneumonia in the communit$ T
- 1egionella transmission involves coughing an! fomites F
- /hlam$!ia infections cannot %e treate! using %eta-lactams F
- M$coplasma pneumoniae infections cannot %e treate! using %eta-lactams T
- Signs of pneumonia inclu!e fever* cough* %reathlessness* an! pleuritic chest pain T
,& The pathogenesis of M$co%acterium tu%erculosis involves:
- Th1 cells T
- IF'-gamma T
- I1-, F
- I1-2 T
- I1-12 T
,, In t$pe I h$persensitivit$ reactions* the following pla$ an important role:
- Ig0 F
- IgE T
- 'I cells F
- Mast cells T
- "istamine T
,- The following infections are cause! %$ !ermatoph$tes:
- Tinea niagra F
- =hite pie!ra F
- Tinea corporis T
- Tinea vesicolor F
- Tinea pe!is T
,2 egar!ing pseu!omem%raneous colitis:
- >recipitating causes inclu!e clin!am$cin an! ampicillin T
- Is cause! %$ /lostri!ium perfringens F
- (nti-!iarrheal !rugs are in!icate! F
- #ancom$cin is the first line treatment F
- /ases in hospital shoul! %e isolate! T
,4 Sexuall$-transmitte! !iseases inclu!e:
- Trichomonas vaginalis T
- 1$mphogranuloma venerum T
- Epstein-)arr #irus F
- "erpes Simplex #irus t$pe I T
- "epatitis ( F
,6 egar!ing enteroviruses:
- Enteroviral infections can %e effectivel$ treate! with potent antiviral !rugs F
- The$ are aci! la%ile F
- The$ have ss'( Jnegative senseK genomes F
- /oxsac3ie ( viruses causes herpangina an! han!* foot* an! mouth !isease T
- /oxsac3ie ) viruses are implicate! in )ornholm+s !isease Jpleuro!$naK T
,7 The following are zoonoses:
- 5engue F
- @apanese encephalitis T
- )rucella T
- Salmonella t$phi F
- ic3ettsia prowaze3ii F
-8 The following !rugs are significantl$ meta%olize! in the liver:
- Metroni!azole T
- >enicillin F
- #ancom$cin F
- 5ox$c$cline T
- Er$throm$cin T
-1 The following organism . !rug pairs are appropriate:
- Escherichia coli ?1-4:"4 . gentamicin F
- 'ocar!ia asteroi!es . sulphamethoxazole-trimethoprim T
- /$tomegalovirus . ac$clovir F
- >neumoc$stis carinii . amphotericin ) F
- "emophilus influenzae . azithrom$cin T
-2 The function of the following molecules are correctl$ !escri%e!:
- /T1(-, . to !ownregulate T cell activation T
- I1-2 . for ) cell proliferation an! IgE class-switching F
- I1-18 . inhi%its the Th1 !ifferentiation pathwa$ T
- IF'-gamma . important me!iator in t$pe I# h$persensitivit$ T
- /lass I M"/ . presents pol$sacchari!e antigens to /5,9 T cells F
-& egar!ing anti%iotic proph$laxis:
- ifampicin is an appropriate !rug for proph$laxis of T) contacts F
- heumatic fever is an in!ication for proph$laxis of %enz$lpenicillin T
- >atients who have recurrent GTI shoul! %e given proph$lactic anti%iotics T
- >atients who are at ris3 from /lostri!ium perfringens un!ergoing surger$ shoul! %e given
proph$lactic %enz$lpenicillin for & !a$s
F
- (ppropriate anti%iotics for proph$laxis against meningococcal infections in contacts
inclu!e vancom$cin
F
-, Functions of anti%o!ies inclu!e:
- (ctivation of complement via the alternative pathwa$ F
- T$pe II h$persensitivit$ response T
- /learance of immune complexes F
- ?psonization an! phagoc$tosis T
- (re effective in the treatment of lepros$ F
-- ifampicin can cause:
- ?range urine T
- Throm%oc$topenia T
- "epatitis T
- 'ephrotoxicit$ T
- 5ecrease in clearance of other !rugs F
-2 egar!ing aminogl$cosi!es:
- "ave ver$ poor oral %ioavaila%ilit$ T
- Is well !istri%ute! to the /SF F
- e:uires therapeutic !rug monitoring T
- Is most active against gram-negative %acteria T
- /auses hepatitis F
-4 The following contrain!ications are true:
- (nti%iotics are contrain!icate! in Escherichia coli ?1-4:"4 infections T
- (mpicillin is contrain!icate! in E)# infectious mononucleosis T
- 0entamicin is contrain!icate! in those with renal failure F
- Meflo:uine is contrain!icate! in neurological !isor!ers T
- (spirin is contrain!icate! in influenza ( F
-6 The following relating to post-infectious !isor!ers are true:
- ( maBor criteria for rheumatic fever is S$!enham+s chorea T
- Streptococcus p$ogenes is commonl$ implicate! in 0uillian-)arrL s$n!rome F
- M$coplasma pneumoniae infections ma$ cause man$ post-infectious !isor!ers T
- /amp$lo%acter infections ma$ precipitate the hemol$tic-uremic s$n!rome F
- eiter+s s$n!rome has a strong association with "1(-)6 F
-7 The following clinical s$n!romes . etiolog$ pairs are true:
- 0astroenteritis . #i%rio parahemol$ticus T
- ose spots . ic3ettsia t$phi F
- "erpangina . /oxsac3ie ) virus F
- Er$sipelotrix . /or$ne%acterium minutissimum F
- at %ite fever . )artonella henselae F
28 ?ncogenic infections inclu!e:
- "I# F
- Epstein-)arr #irus T
- "elico%acter p$lori T
- Fasciola hepatica T
- >arvovirus )17 F