MICROBIOLOGY

COMPREHENSIVE EXAM

Jun Furigay, a 4 y/o boy, is brought to the clinic due to cough of 2 weeks. His mother reports no other complaints
and she claims he eats well and inactive. He has not been given any medicines for his current illness. On
examination, Jun has fever for 2 weeks, wheezes and had low weight for his age. His father is currently being
treated with Pulmonary Tuberculosis Cat 2, DSSM revealed no Acid Fast Bacilli seen/noted on the specimen
submitted. CXR revealed hazy infiltrates in the right upper lung field. TST was done revealing 12 mm induration.

1. The ff are the course of actions to be undertaken as a health care provider, EXCEPT:
a. Refer patient to the nearest DOTS facility with PMDT services for screening or an Xpert site for
testing
b. Intensified case finding shall be done among close contacts especially household members
c. DSSM shall be the primary diagnostic tool for the case presented above
d. Tuberculin skin test can be used as the sole diagnostic tool for TB in children especially those
who are unable to expectorate
e. NOTA

2. What is the bacteriological status of the patient?
a. Clinically diagnosed
b. Bacteriologically Confirmed
c. EPTB-Bacteriologically confiremed
d. EPTB-Clinically diagnosed
e. NOTA

3. What is the Category of Treatment for the patient presented above?
a. Cat 1
b. Cat 1a
c. Cat 2
d. Cat 2a
e. NOTA

4. After 6 months, the patient was re-evaluated and revealed a gradually improved health status including
his weight. Unremarkable PE findings with no evidence of infection. CXR was repeated revealing nodular
scar on the right upper love with no noted hazy infiltrates. What is the treatment outcome of the patient?
a. Treatment Failed
b. Cured
c. Treatment Completed
d. Not Evaluated
e. NOTA

5. The acid fastness of Mycobacterium tuberculosis is due to?
a. Trehalose dimycolate
b. LAM (Lipoarabinomannose)
c. Phosphatides
d. Muramyl Dipeptide
e. NOTA

6. A person with infectious TB who is responsible for transmitting TB to another person?
a. Presumptive TB
b. Index Case
c. Source Case
d. TB disease
e. NOTA

7. Type of Drug resistance against an Anti-TB drug in which there is demonstrated resistance to Ciprofloxacin
+ Amikacin + Rifampicin + Isoniazid?
a. Polydrug Resistant TB
b. Multi-drug Resistant TB
c. RR-TB
d. Monoresistant TB
e. NOTA

8. How many sputum smear (+) slides are needed to confirm diagnosis of TB?
a. 1
b. 2
c. 3
d. 4
e. NOTA

9. In a sputum smear positive patient, how many weeks after initiation of treatment will the patient tagged
as uninfectious?
a. 1 week
b. 2 weeks
c. 3 weeks
d. 4 weeks
e. NOTA

10. Gold standard for the diagnosis of tuberculosis?
a. Diagnostic Sputum Smear Microscopy
b. Culture
c. Gene Xpert
d. Chest Xray
e. NOTA

11. An adverse reaction of Streptomycin?
a. Gastrointestinal intolerance
b. Peripheral neuropathy
c. Anemia
d. Albuminuria
e. NOTA

12. Rifampicin Drug Interactions, EXCEPT:
a. Furosemide
b. Ritonavir
c. Itraconazole
d. Hydrochlorothiazide
e. NOTA

13. The following anti-TB drugs are hepatotoxic, EXCEPT:
a. Rif
b. INH
c. PZA
d. Ethambutol
e. NOTA

14. An anti-TB drug with the highest prevalence of causing Adverse Drug Reaction is?
 a. Rif
b. INH
c. PZA
d. Ethambutol
e. NOTA

15. A 36 y/o woman is a G8P8 (8008) currently taking Oral Contraceptive Pills (OCP). 1 month age she was
diagnosed of PTB category 1 and was subsequently started with the corresponding anti-TB regimen. On
her follow-up after 2 months, she was found out 4 weeks pregnant. What anti-TB drug was responsible
for such case?
a. Rif
b. INH
c. PZA
d. Ethambutol
e. NOTA

16. When Pyrazinamide is taken with Probenecid, what analyte is disrupted?
a. Glucose
b. Cholesterol
c. Low Density Lipoprotein
d. Creatinine
e. NOTA

17. A virulence factor of Mycobacterium tuberculosis, which inhibits phagolysosomal fusion?
a. Tumor Necrosis Factor
b. Trehalose dimycolate
c. Cord Factor
d. Sulfatides
e. NOTA

18. A microorganism, which shows a bisected pearl colony on charcoal medium?
a. Clostridium tetani
b. Haemophilus influenza
c. Mycobacterium tuberculosis
d. Bordetella pertussis
e. NOTA

19. A virulence factor of Mycobacterium tuberculosis, which inhibits macrophage maturation and induces
release of TNF-alpha?
a. Tumor Necrosis Factor-Alpha
b. Trehalose dimycolate
c. Cord Factor
d. Sulfatides
e. NOTA

20. Tuberculoid Leprosy, EXCEPT:
a. Large macules in cooler areas of the body
b. Positive Lepromine Test
c. Intact Cell Mediated Immunity
d. Benign, Non progressive
e. NOTA

21. Characterized by “marshmallow-like colonies” on blood agar plates?
 a. Mycobacterium tuberculosis
b. Mycobacterium chelonei
c. Mycobacterium fortuitom
d. Mycobacterium kansasii
e. NOTA

22. True of Nocardia, EXCEPT:
a. DOC for Nocardiosis: TMP-SMX
b. Weakly Acid Fast Bacilli
c. Gram (+) anaerobe
d. Found in soil
e. NOTA

23. Implicated causes of Pseudomembranous colitis, EXCEPT:
a. Ampicillin
b. Clindamycin
c. Cephalosporins
d. Metronidazole
e. NOTA

24. DOC for Pseudomembranous colitis?
a. Pen G
b. Metronidazole
c. Ampicillin
d. Ceftriaxone
e. NOTA

25. True of Clostridial myonecrosis, EXCEPT:
a. Most commonly caused by Clostridium perfringens Type C
b. On tissue biopsy, there is a characteristic absence of PMN’s despite extensive tissue destruction
c. Usually caused secondary to trauma/deep muscle laceration
d. On Physical Examination, there is pain and crepitus and death is due to circulatory failure
e. NOTA

26. The most potent bacterial toxin known is?
a. Tracheal cytotoxin
b. Endotoxin
c. Tetanus toxin
d. Botulinum Toxin
e. NOTA

27. Most common cause of Floppy Baby Syndrome?
a. Clostriudium tetani
b. Group B Streptococci
c. Clostridium botulinum
d. Clostridium difficile
e. NOTA

28. DOC for Whooping Cough?
a. Macrolide
b. Cephalosporin
c. Quinolone
d. Aminoglycoside
 e. NOTA

29. Which of the ff is incorrect with regards to Lag Phase of the Microbial Growth Curve?
a. Represents a period during which the cells depleted of metabolites and enzymes as the result of
unfavorable conditions existed in the previous culture history, adapt to environment
b. Enzymes and its intermediates are formed and accumulate
c. If the cells are taken from a same medium, it happens that they are genetically incapable of
growth in the new medium
d. In such cases, a long lag may occur, representing the period necessary for a few mutants in the
inoculum to multiple sufficiently for a net increase in cell number to be apparent
e. NOTA

30. Phase in the microbial growth curve wherein the cells are most sensitive to the effects of Penicillin?
a. Lag phase
b. Exponential phase
c. Stationary phase
d. Decline phase
e. NOTA

31. Genetic elements most frequently transferred by conjugation?
a. Plasmid
b. DNA
c. RNA
d. Kinetoplasts
e. NOTA

32. This test differentiates Staphylococci from Streptococci:
a. Mannitol Fermentation Test
b. Coagulase Test – Tube Method
c. Coagulase Test – Slide Method
d. Novobiocin Sensitivity Test
e. NOTA

33. Maria Pasang Awa, 16 y/o, was brought to the emergency room due to loose bowel movement. History of
present illness revealed 4 hours PTA, she ate a macaroni salad, which resulted to crampy abdominal pain,
projectile vomiting, loose bowel movement and generalized body weakness. Final Diagnosis upon
discharge was Acute Gastroenteritis secondary to Staphylococcal infection. What specific toxin is
responsible for the manifestations?
a. Alpha
b. Beta
c. Delta
d. Gamma
e. NOTA

34. This is considered as the major virulence factor for Methicillin Resistant Staphylococcus Aureus?
a. Hemolysin
b. Exfoliative Toxin
c. Exotoxin
d. Enterotoxin
e. NOTA

35. Marvin Rejano, a 40 y/o man, is brought to the ER with headache, nausea, vomiting and fever. Patient has
a low-grade fever, tachycardia, altered sensorium, nuchal rigidity, (+) Babinski reflex on physical
 examination. Diagnostic tests revealed gram-positive cocci, catalase negative, encapsulated, Optochin test
(+). What is the isolate?
a. Staphylococcus aureus
b. Streptococcus agalactiae
c. Streptococcus viridans
d. Streptococcus pyogenes
e. NOTA

36. Mario Duma, 36 y/o, male from Baggao, Cagayan presents to the ER complaining of sudden onset pain
and swelling in his knee of 3 hours duration. The patient is a basketball player who reports having had
repeated arthroscopic procedures on both knees. In addition to his sudden pain, he notes associated
fever and chills. No other joint involvement was noted, and he denies any prior heart valve disease or IV
drug use. Left knee shows significant erythema, warmth and marked tenderness to light palpation, active
range of motion limited by pain; passive range of motion intact. Synovial Fluid Analysis: WBC =>
100,000/ul; Culture: PYR (+); colony + Hydrogen peroxide = bubbling; on microscopy: Gram’s staining:
Violet colored cocci. What is the isolate?
a. Staphylococcus albus
b. Staphylococcus epidermidis
c. Streptococcus pyogenes
d. Streptococcus viridans
e. NOTA

37. Josanna, a 29 year old, sexually active female, who works at Macapagal KTV bar in Tuguegarao City
complains of dysuria. Directed questioning reveals that the patient had also experienced increased urinary
frequency and urgency. PE revelead mild suprapubic tenderness, no costoverbal angle tenderness.
Diagnostic workup revealed: blue colored cocci on gram’s staining, non hemolytic, no clot formation when
a colony is added to a citrated plasma. What is the isolate?
a. Streptococcus pneumonia
b. Streptococcus viridans
c. Enterococcus faecalis
d. Staphylococcus aureus
e. NOTA

38. What if the result of the diagnostic workup revealed: blue colored rod/bacilli on gram’s staining, non-
hemolytic, no clot formation when a colony is added to a citrated plasma. What is the isolate?
a. Streptococcus pneumonia
b. Streptococcus viridans
c. Enterococcus faecalis
d. Staphylococcus aureus
e. NOTA

ITEMS 39-43: Kutingting, 58 y/o man develops chest pain, fever and shaking chills. He complains of cough with
purulent rusty colored sputum. He is a chronic heavy smoker with COPD. He reports having had Upper Respiratory
Tract Infection 1 week ago. On Physical examination: decreased breath sounds, inspiratory rales, dullness to
percussion and increased tactile fremitus over the right lower lung field.

39. What is the most common isolate based on the history presented?
a. Staphylococcus aureus
b. Streptococcus pyogenes
c. Streptococcus agalactiae
d. Enterococcus faecalis
e. NOTA

 40. If the sputum would be subjected to diagnostic tests, what would be the expected results?
a. Bacitracin sensitive; Hippurate Hydrolysis (-)
b. Bacitracin resistant; Hippurate Hydrolysis (+)
c. Optochin resistant; Bile solubility (-)
d. Catalase (+); Coagulase (+)
e. NOTA

41. What is the Lancefield classification of the isolate from the case presented above?
a. A
b. B
c. C
d. D
e. NOTA

42. Hemolytic Reaction of the given isolate?
a. Alpha
b. Beta
c. Gamma
d. Delta
e. NOTA

43. Lancefield classification for Streptococci is based on the presence of this compound in the cell wall of
bacteria?
a. CHO
b. CHON
c. Lipids
d. Sphingomyelin
e. NOTA

44. What strain of Group A beta hemolytic streptococci is associated with Post Streptococcal Acute
Glomerulonephritis?
a. M3
b. M6
c. M12
d. M48
e. NOTA

45. Otherwise known as the “Flesh Eating Streptococcus”?
a. Group A Strep
b. Group B Strep
c. Group C Strep
d. Group D Strep
e. NOTA

46. It is by far considered the most common cause of osteomyelitis?
a. Staphylococcus aureus
b. Staphylococcus epidermidis
c. Streptococcus pyogenes
d. Streptococcus pneumonia
e. NOTA

47. Robin Padilpat, 30 y/o male from Pengue Ruyu was admitted to CVMC due to loose bowel movement.
Admitting diagnosis is Acute Gastroenteritis with severe signs of dehydration. IV hydration is part of the
 management. During his hospital stay, about 7 episodes of “IV OUT” was noted by Nurse Zol. After 24
hours, patient had low grade fever with shaking chills. What isolate is the most common cause of fever
based on the history presented?
a. Staphylococcus aureus
b. Staphylococcus epidermidis
c. Streptococcus bovis
d. Enterococcus faecalis
e. NOTA

48. Marco Polo, 4 y/o boy presented 1 week PTC generalized peeling of the dermo-epidermal junction causing
bacteremia leading to septic condition. What toxin is most commonly responsible for the above clinical
scenario?
a. Leukocidin
b. Penicillase
c. Coagulase
d. Hemolysin
e. NOTA

49. Most common contaminant of blood culture and sensitivity is characterized as?
a. Catalase (+), Coagulase (-)
b. Coagulase Negative Staphylococci
c. Bacitracin Sensitive, Optochin sensitive
d. Quellung reaction (+); PYR (+)
e. NOTA

50. Catalase (-), Optochin Resistant, Alpha hemolytic?
a. Staphylococcus aureus
b. Streptococcus pyogenes
c. Streptococcus saprophyticus
d. Streptococcus pneumonia
e. NOTA

51. Which among the ff fungi is associated with favus type of tinea capitis?
a. Trichophyton tonsurans
b. Trichophyton schoenleini
c. Trichophyton rubrum
d. Trichophyton mentagrophytes
e. NOTA

52. Which among the ff does not possess any conidia at all?
a. Trichophyton violaceum
b. Trichophyton verrucosum
c. Trichophyton tonsurans
d. Trichophyton rubrum
e. NOTA

53. What makes up the cell wall of fungi?
a. Proteins
b. Carbohydrates
c. Glycols
d. Sterols
e. AOTA

 54. Which is true regarding nitrogen requirement of fungi?
a. Fungi require more nitrogen as compared with bacteria
b. Fungi can create its own nitrogen thus does not need external source of nitrogen
c. Fungi does not need nitrogen at all
d. Fungi needs the same amount of nitrogen with bacteria
e. Fungi needs lesser amount of nitrogen as compared with bacteria

55. Which among the ff has cigar shaped bodies at 37C and daisy like arrangement at room temperature?
a. Sporothrix Schenkii
b. Blastomyces dermatitidis
c. Histoplasma capsulatum
d. Candida albicans
e. Coccidioides immitis

56. An AIDS patient had fever and headache for 2 weeks. On India ink stained smear of CSF, you noted
budding yeasts with capsule. What is the probable etiology?
a. Blastomyces dermatitidis
b. Candida albicans
c. Cryptococcus neoformans
d. Histoplasma capsulatum
e. Paracoccidioides brasiliensis

57. What bacteria is most common human pathogen that can be isolated from animal bite wounds and
respiratory secretions?
a. Pasteurella multocida
b. Leptospira interrogans
c. Toxocara canis
d. Haemophilus aegyptius
e. Haemophilus suis

58. Which among the ff appears as “school of red fish” on gram stained smear?
a. Listeria
b. Bordetella
c. Haemophilus
d. Actinobacillus
e. Alcaligenes

59. What bacteria is a Gram-negative, rod-shaped, motile, non-nitrate reducing, oxidase positive, catalase
positive, alpha hemolytic, and citrate positive obligate aerobe that is commonly found in environment?
a. Alcaligenes faecalis
b. Acinetobacter baumannii
c. Alcaligenes xylosoxidans
d. Bordetella pertussis
e. Acinetobacter calcoaceticus

60. Which among the ff has colonies that will show diffuse zone of hemolysis, appearing small, smooth,
convex with a pearly luster, resembling mercury drops, colonies are mucoid and tenacious?
a. Alcaligenes faecalis
b. Acinetobacter baumanii
c. Pasteurella multocida
d. Bordetella pertussis
e. Haemophilus influenzae

 61. Which among the following is most likely to cause meningitis?
a. Alcaligenes faecalis
b. Acinetobacter baumanii
c. Acinetobacter calcoaceticus
d. Acinetobacter iwoffi
e. Alcaligenes xylosoxidans

62. What is the causative agent of pink eye disease?
a. Koch’s Week’s Bacillus
b. Swine Flu Bacillus
c. Ducreyi’s bacillus
d. Chancroid bacillus
e. Pfieffer’s bacillus

63. Which among the ff is an obligate anaerobe?
a. Pseudomonas aeruginosa
b. Yersinia pestis
c. Bacillus subtilis
d. Clostridium tetani
e. Escherichia coli

64. Who discovered the live attenuated vaccine against rabies?
a. Pasteur
b. Jenner
c. Koch
d. Snow
e. Buchner

65. Which among the ff is NOT a contribution of Robert Koch?
a. Discovery of Mycobacterium anthracis & Mycobacterium tuberculosis
b. Isolation of etiologic agents of typhoid fever, cholera, pneumonia, tetanus, diphtheria
c. Preparation bacterial smear including chemical fixation
d. Use of Petri dish to contain culture media
e. AOTA

66. TRUE regarding Bacterial Genetics?
a. Bacterial DNA is circular while human DNA is linear
b. Bacteria have duplicate chromosomes located in the nucleoid
c. Plasmids are intrachromosomal DNA pieces encoding both exotoxins and enzymes
d. Euekaryotic cells are haploid while bacterial cells are diploid
e. AOTA

67. There are different methods of acid fast staining, which among the ff is TRUE?
a. In Pappenheim’s method, M. lacticola will be stained red while M. tuberculosis will be blue
b. In Baumgarten’s method, M. leprae will be stained red while M. tuberculosis will be blue
c. In Ziehl Neelsen method, M. tuberculosis will stain blue while other bacillus will not be stained
d. In Kinyoun’s method, M. tuberculosis will be red while other bacilli are blue
e. In Gabbet’s method, M. tuberculosis will be stained green while other bacilli are red

68. What is the causative agent of “Madura foot” seen in mycetoma?
a. Histoplasma
b. Blastomyces
c. Madurella
 d. Coccidioides
e. Sporothrix

69. Which of the ff can cause hypersensitivity reaction in the form of erythema nodosum called Valley fever
or Desert Rheumatism?
a. Paracoccidioides brasiliensis
b. Coccidioides immitis
c. Histoplasma capsulatum
d. Sporothrix schenkii
e. NOTA

70. What is the most common opportunistic fungi in diabetics?
a. Candida albicans
b. Cryptococcus neoformans
c. Aspergillus fumigatus
d. Trichophyton sp.
e. Histoplasma capsulatum

71. What is the causative agent of “rose gardener’s disease”?
a. Paracoccidioides brasiliensis
b. Coccidioides immitis
c. Histoplasma capsulatum
d. Sporothrix schenkii
e. NOTA

72. Which of the ff causes itchiness in between inguinal area called “jock itch”?
a. Tinea capitis
b. Tinea barbae
c. Tinea nigra
d. Tinea cruris
e. Tinea inguinale

73. Which of the ff is a fungal infection that appears soft, yellow or pale brown aggregations around the hair
shaft, facial, genital and scalp regions?
a. White piedra
b. Black piedra
c. Soft piedra
d. Hard piedra
e. AOTA

74. Which among the ff may infect the skin and hair?
a. Madurella mycetomatis
b. Epidermophyton floccosum
c. -
d. Trichophyton sp
e. Tinea sp

75. What is the most common cause of tinea unguium?
a. Trichiphyton rubrum
b. Trichophyton tonsurans
c. Microsporum canis
d. Microsporum audinii
e. AOTA
 76. What is the asexual spore of Aureobasidium?
a. Conidiospore
b. Blastospore
c. Chlamydospore
d. Arthrospore
e. Sporangiospore

77. What asexual spore develops at the ends of the hyphae but not enclosed in a sac?
a. Conidiospore
b. Blastospore
c. Chlamydospore
d. Arthrospore
e. Sporangiospore

78. What sexual spore is formed on the surface of a basidium?
a. Ascospore
b. Basidiospore
c. Arthrospore
d. Oospore
e. Zygospore

79. Generally, all gram positive bacteria have no endotoxin. Which of the ff gram positive bacteria produces
endotoxin as an exemption?
a. Listeria monocytogenes
b. Bacillus anthracis
c. Mycoplasma pneumonia
d. Staphylococcus aureus
e. Mycobacterium tuberculosis

80. Who promulgated that through physical contact and fomites, living agents causing diseases can transfer
communicable diseases?
a. Carolus
b. Martinius
c. Fracastorius
d. Winogradsky
e. Domagk

81. Which among the ff can mimic mRNA?
a. Positive sense ssRNA
b. Negative sense ssRNA
c. Ambisense
d. Retrovirus
e. NOTA

82. Which among the ff is the reason why there is not much available vaccine for RNA viruses?
a. RNA viruses have a wide variety of species
b. RNA viruses cannot be cultured thus creation of vaccine is not possible
c. RNA viruses are susceptible to mutation
d. RNA viruses are resistant
e. It is expensive and difficult to create a vaccine

83. Which of the ff can be transmitted by oral-fecal route?
a. Poliovirus
 b. Rhinovirus
c. Hepa A virus
d. Hepa C virus
e. Mumps virus

84. Which among the ff is usually transmitted by arthropods?
a. Chikungunya
b. Hantaan
c. Borna disease
d. New castle disease
e. HTLV

85. Which of the ff is the causative agent of measles?
a. Respirovirus
b. Henipavirus
c. Ferlavirus
d. Morbilivirus
e. Rubulavirus

86. What strain of Coronavirus has caused the outbreak last 2005?
a. HCoV-OC43
b. SARS-CoV
c. New Haven coronavirus
d. HKU1-CoV
e. Novel coronavirus

87. Which among the ff can induce syncytia?
a. Paramyxoviridae
b. Rhabdoviridae
c. Flaviviridae
d. Togaviridae
e. Caliciviridae

88. What is the most common cause of acute gastroenteritis in infants?
a. Norwalk virus
b. Rotavirus
c. Hepa A virus
d. Enterovirus
e. Aphthovirus

89. What is the most common cause of colds?
a. Adenoviridae
b. Paramyxoviridae
c. Picornaviridae
d. Orthomyxoviridae
e. Caliciviridae

90. What is responsible for the translation of negative sense RNA into a positive sense?
a. RNA polymerase
b. Reverse transcriptase
c. RNA replicase
d. DNA polymerase
e. Integrase
 91. Which of the ff is ether resistant?
a. Adenoviridae
b. Paramyxoviridae
c. Picornaviridae
d. Orthomyxoviridae
e. Caliciviridae

92. Which among the ff possess some club shaped peplomers?
a. Rhabdoviridae
b. Togaviridae
c. Coronaviridae
d. Retroviridae
e. Bunyaviridae

93. Which among the ff is typically bullet shaped?
a. Rhinovirus
b. Rubeola virus
c. Rubella virus
d. Aphthovirus
e. Rabies virus

94. Which among the ff is not a single stranded RNA virus?
a. Picornaviridae
b. Caliciviridae
c. Birnaviridae
d. Arteriviridae
e. Togaviridae

95. Which among the ff is an enveloped RNA virus?
a. Picornaviridae
b. Togaviridae
c. Caliciviridae
d. Reoviridae
e. Birnaviridae

96. Which among the ff is NOT a helical RNA virus?
a. Bunyaviridae
b. Orthomyxoviridae
c. Coronaviridae
d. Rhabdoviridae
e. Picornaviridae

97. Which among the ff has acidophilic intracytoplasmic perinuclear inclusion bodies?
a. Reoviridae
b. Bunyaviridae
c. Paramyxoviridae
d. Caliciviridae
e. Togaviridae

98. Negri bodies are found in which part of the cell?
a. Cytoplasm
b. Nucleus
c. Perinucleus
 d. Endoplasmic reticulum
e. Mitochondria

99. Which among the ff is not a stable virus?
a. Picornaviridae
b. Flaviviridae
c. Caliciviridae
d. Reoviridae
e. Birnaviridae

100. Which among the ff replicates in the nucleus?
a. Retroviridae
b. Bunyaviridae
c. Arteriviridae
d. Bornaviridae
e. Togaviridae