MODULE II
COCCI INFECTIOUS DISEASES
1. The case of staphylococcal infection is registered in the student’s hostel. Which preparation should be used for
immediate specific prevention of its infection?
A. Antibiotic
B. Interferon
C. Diagnostic
D. Serum
*E. Bacteriophage
2. Doctor diagnosed that the patient has staphylococcal infection. What microorganism causes this infection?
A. Shigella dysenteria
*B. Staphylococcus aureus
C. Staphylococcus epidermidis
D. Salmonella enteritidis
E. Salmonella typhi
3. The blood of patient with the diagnosis of staphylococcal infection was sent to the laboratory. Which nutrition
medium can the bacteriologist use for the isolation of pure culture of Staphylococcus aureus?
A. Endo medium
*B. Blood agar
C. Hiss medium
D. Chocolate medium
E. Bile broth
4. The confirming of diagnosis of an infections disease demands using of bacteriological method based on culturing
of examined material on nutritional media. What is its aim?
A. Revealing of specific antibodies
B. Revealing of specific antigen
*C. Isolation of pure culture of an agent
D. Revealing infections allergy
E. Revealing immune reconstruction of an organism
5. While studying inoculations of air taken from chemists a bacteriologist found a sanitary – indicative
microorganism. What is this microorganism?
A. Escherichia coli
B. Vibrio cholerae
C. Streptococcus pneumonia
*D. Staphylococcus aureus
E. Mycobacterium tuberculosis
6. To determine the agents sensitivity to antibiotics the method was used in which the small filtrating paper disks
soaked with antibiotics are brought on the medium inoculated with staphylococcal culture. How do we call this
method?
A. Sedimentations method
B. Serological method
*C. Diffusion test
D. Membrane filter method
E. Dilution test
7. Staphylococcus is isolated from a discharge of middle ear. A bacteriologist inoculated an isolated culture into a
test – tube with citrate rabbit plasma. What enzyme of aggression did he want to reveal?
*A. Coagulase
B. Hemolysin
C. Leucocidin
D. Fibrinolysin
E. Hyaluronidase
8. Pathogenic staphylococcus was isolated from a suppurative wound of a patient, its sensitivity to antibiotics was
determined. Penicillin caused a zone of growth retention – 8mm; oxacillin – 9mm; ampicillin – 10mm; gentamicin –
22mm; lincomycin – 11mm. What antibiotic should be chosen for treatment of the patient?
A. Penicillin
*B. Gentamicin
C. Ampicillin
D. Lincomycin
E. Oxacillin
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9. While determining the sensitivity staphylococcus to antibiotics, the following results were obtained: diameter of
zone of growth retention of penicillin – 7mm; oxacillin – 8mm; ampicillin – 26mm; gentamicin – 22mm; lincomycin –
15mm. What method of investigation was used?
A. Bacteriological
B. Serological
*C. Diffusion test
D. Chemical test
E. Dilution test
10. Corresponding nutritious media are used in bacteriological laboratories to isolate a pure culture and identify the
isolated microorganism. What medium is used to isolate and identify staphylococcus?
A. Endo medium
B. Hiss medium
*C. Blood agar
D. Chocolate medium
E. MPA
11. At present the description of ten kinds of staphylococci is represented. They are revealed in people, domestic and
animals. But only one kind is of great importance in the infectious pathology of man. How do we call this kind?
A. Staphylococcus epidermidis
B. Staphylococcus saprophyticus
C. Staphylococcus albus
*D. Staphylococcus aureus
E. Staphylococcus citreous
12. Staphylococcus aureus is isolated from pus. A bacteriologist plated an isolated culture on blood agar. What
enzyme of aggression did he want to reveal?
A. Fibrinolysin
B. Hyaluronidase
*C. Hemolysin
D. Leucocidin
E. Endotoxin
13. The phage typing is useful in the investigation of Staphylococcus aureus infection. What biological preparation
may be employed for it?
A. Antibiotics
B. Serum
C. Toxins
*D. Typing set of phages
E. Diagnostic
14. A laboratory study is performed to confirm a clinical diagnosis of an infectious disease. What method is used in
this case for the isolation of a pure culture of Staphylococcus aureus?
A. Serological
B. Biological
C. Bacterioscopical
*D. Bacteriological
E. Allergic
15. A girl consulted a doctor before complaining of frequent furuncles on her face, neck and shoulders. What
microorganism caused this condition?
A. Spirochetes
*B. Staphylococci
C. Enterococci
D. Bacilli
E. Rickettsiae
16. What is the most probable source of the organism in an outbreak of sepsis caused by Staphylococcus
aureus in the newborn nursery?
A. urethra
B. colon
C. vagina
*D. nose
E. throat
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17. A culture of skin lesion from a patient with impetigo shows colonies with beta-hemolysis on a blood
agar. If these gram-positive cocci found to be catalase-negative, which of the following organisms is the
most probable cause of disease?
A. Staphylococcus aureus
B. Streptococcus faecalis
*C. Streptococcus pyogenes
D. Staphylococcus epidermidis
F. Streptococcus pneumonia
18. The coagulase test for plasma clotting is used to distinguish:
A. Strptococcus pyogenes from Staphylococcus epidermidis
B. Str. pyogenes from Str. faecalis
*C. Staph, aureus from Staph, epidermidis
D. Staph, aureus from Neisseria meningitidis
F. Str. pneumoniae from Str. pyogenes
19. Which one of the followings is considered a main virulence factor of Staphylococcus aureus?
*A. an alpha-hemolysin
B. endotoxin
C. a heat-labile neurotoxin
D. pilli
F. resistance to novobiocin
20. The most probable cause of acute pharyngitis in children, with extensive erythematous rash and
suppurative complications is:
A. Viridans group streptococci
*B. Streptococcus pyogenes
C. Neisseria meningitides
D. Streptococcus agalactiae
F. Staphylococcus aureus
21. The patient has subacute endocarditis caused by the viridans group of streptococci. Which site is most
likely the source of the organism?
A. colon
B. skin
*C. oropharynx
D. all of the above
F. urethra
22. Two hours after a dinner of potato salad and roast turkey the family of four experience vomiting and
diarrhea. Which one of the following organisms is most likely to cause the symptoms?
A. Salmonella enteritidis
*B. Staphylococcus aureus
C. Streptococcus pyogenes
D. Escherichia coli
F. Neisseria meningitidis
23. Which of the following statements concerning Staph, aureus is correct EXCFPT:
A. Gram-positive cocci in grape-like clusters
B. The coagulase test is positive
C. Can produce several types of exotoxins
*D. Fndotoxin is a main pathogenicity factor
F. Penicillinase-resistant penicillins should be used for treatment
24. Which one of the followings is considered an important virulence factor of Streptococcus pyogenes?
A. capsule
B. pili
C. endotoxin
*D. streptolysins O and S
F. an alpha-hemolysin
25. Staphylococcal scalded skin syndrome typically seen in infants and in children below 5 years is due to
the production of:
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A. enterotoxin A
*B. exfoliative toxin
C. erythrogenic toxin
D. leukocidin
E. coagulase
26. In acute streptococcal infections, diagnosis is established on the base of:
*A. antigen detection and culture
B. microscopy and serology
C. culture and phage typing
D. microscopic examination of the pus
E. demonstration of antibody and nucleic acids assay
27. The virulence of S. pneumoniae is primarily due to the presence of:
A. pneumolysin
B. M protein
C. cell wall teichoic acids
*D. polysaccharide capsule
E. peptidoglycan
28. Which one of the following organisms is the most probable cause of neonatal meningitis, betahemolytic, and is bacitracin resistant?
A. S. pneumonia
B. Staph, aureus
C. S. pyogenes
D. Staph, enteritidis
*E. S. agalactiae
29. Which one of the following organisms is the most probable cause of otitis media infection, alphahemolytic, and is optochin sensitive?
*A. S. pneumonia
B. Staph, aureus
C. S. pyogenes
D. Staph, enteritidis
E. S. agalactiae
30. A clinical diagnosis of rheumatic fever was developed in a 13-year-old boy that has polyarthritis, fever,
and a new cardiac murmur. Which one of the following tests will be of higher diagnostic value on this stage
of the disease?
A. A Gram stain of the joint fluid shows gram-positive cocci in chains
*B. An anti-streptolysin O assay (ASO) is positive
C. A throat culture is positive for S. pyogenes
D. A throat culture is positive for S. pneumonia
E. A blood culture is positive for Staph, aureus
31. A gram-negative heavily encapsulated diplococcus was isolated from the cerebrospinal fluid of 12-year
old boy with acute purulent meningitis. It was oxidase positive and ferment glucose and maltose, but not
lactose. The disease most probably caused by which one of the following organism:
A. Staphylococcus epidermidis
*B. Neisseria meningitidis
C. Haemophilus influenza
D. Neisseria gonorrhoeae
E. Escherichia coli
32. Immunity to meningococcal infections is related to opsonizing and bactericidal antibodies to:
*A. group specific polysaccharide (capsule)
B. endotoxin
C. type-specific O-streptolysin
D. pili variants
E. IgA protease
33. Each of the following statements concerning gonorrhea is correct, EXCEPT:
A. a presumptive diagnosis can be made by microscopy
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B. infection in men is more frequently symptomatic than in women
*C. the definitive diagnosis can be made by detecting of rising antibody titer
D. gonococcal conjunctivitis may occur in newborns
E. erythromycin is commonly used for gonococcal conjunctivitis prophylaxis
34. Which one is not important in characteristic of either N. meningitidis or N. gonorrhoeae?
A. polysaccharide capsule
B. pili
*C. M protein
D. IgA protease
E. endotoxin
35. A 20-year-old woman suddenly develops fever and a severe headache. Gram stain of the spinal fluid
reveals many neutrophils and extracellular and intracellular Gram-negative diplococci. Which bacteria
are most likely to be a cause of the disease?
A. Haemophilus influenza
B. Streptococcus pneumonia
C. Neisseria gonorrhoeae
D. Pseudomonas aeruginosa
*E. Neisseria meningitidis
36. The major adherence factor ofN. gonorrhoeae is the:
*A. pilus
B. A protein
C. lipopolysaccharide
D. lipoteichoic acid
E. capsule
37. Each of the following statements concerning Neisseria meningitidis is correct, EXCEPT:
A. It is oxidase-positive, Gram-negative diplococcus
B. It has a polysaccharide capsule with anti- phagocytic property
C. It contains endotoxin in the cell wall
D. It produces IgA protease
*E. It produces an exotoxin
38. The most serious sequelae of infection of the genital mucous membranes in females with N.
gonorrhoeae is:
A. urethritis
B. salpingitis
*C. pelvic inflammatory disease (PID)
D. proctitis
E. conjunctivitis
39. The most common route of gonococcal infection is:
*A. sexual contact
B. insect bites
C. fecal-oral route
D. intravenous injection
E. each route is important in transmission
40. Gonococcal ophthalmia neonatorum is usually acquired:
A. during sexual contact
B. via fomites
C. during breast feeding of newborns
D. via saliva of mother
*E. during passage through the infected birth canal
41. The virulence factor of Neisseria meningitidis responsible for many toxic effects is:
A. peptidoglycan
*B. lipooligosaccharide
C. pilus
D. IgA protease
E. exotoxin
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42. A vaccine against meningococcal infection is available, containing:
A. toxoid
B. cell wall endotoxin of 13 types
*C. capsule polysaccharide
D. pilus protein
E. live attenuated strain
43. A 3 year-old boy develop acute fever, chills, malaise, petechial rash on skin. A Gram-negative
diplococci were isolated from the lesions and identified as Neisseria meningitidis. Therapy should be
started with:
A. tetracycline
*B. penicillin G
C. sulfonamides
D. amphotericin B
E. interferon
44. Which one of the following factors is responsible for survival of N. gonorrhoeae inside phagocytes?
A. potent cytotoxic exotoxin
B. cell wall peptidoglycan
C. production of IgA protease
*D. outer membrane proteins
E. heavy polysaccharide capsule
45. Which one of the following factors is responsible for survival of N. meningitidis inside phagocytes?
A. potent cytotoxic exotoxin
B. cell wall peptidoglycan
C. production of IgA protease
D. outer membrane proteins
*E. heavy polysaccharide capsule
46. Gonococcal infection is transmitted only between human to human. How do we call its infection?
*A. Anthroponotic
B. Zoonotic
C. Anthropozoonotic
D. Mixed infection
E. Secondary infection
47. Doctor diagnosed that the patient has gonococcal infection. What microorganism causes this infection?
A. Shigella dysenteria
B. Staphylococcus aureus
*C. Neisseria gonorrhoeae
D. Neisseria meningitides
E. Salmonella typhi
48. The pus of patient with the diagnosis of gonococcal infection was sent to the laboratory. Which nutrition medium
can the bacteriologist use for the isolation of pure culture of Neisseria gonorrhoeae?
A. Endo medium
*B. Serum agar
C. Hiss medium
D. Chocolate medium
E. Bile broth
49. The one method of diagnostics of gonococcal infection is a bacterioscopical method. What is the purpose of this
method of investigation?
A. Reviling of specific antibodies
B. Reviling of specific antigen
C. Isolation of pure culture of an agent
*D. Making the preparation – smear of examined material
E. Reproduction of infection in susceptible laboratory animals
50. Gonococcal infection is highly contagious infection amongst humans. What is the main mechanism of
transmission?
A. Aerogenic
B. Fecal-oral
C. Transplacental
*D. Direct contact (sexual)
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E. Indirect contact
51. A doctor made a smear of a purulent discharge of urethra and colored it according to Gram. The microscopy
revealed the leucocytes whose cytoplasm had a great amount of gram negative bean form of diplococci. The results
of which process is observed in the preparation?
A. Complete phagocytosis
B. Induced phagocytosis
*C. Uncompleted phagocytosis
D. Spontaneous phagocytosis
E. Bacteriolysis
52. Mucus from the posterior walls of the nasopharynx was taken in a patient to isolate meningococci. What should
be added to the medium for the isolation of this microorganism?
A. Blood
B. Urine
*C. Serum
D. Salt
E. Peptone
53. Gram negative bean formed diplococci situated in and out of leucocytes were revealed in smear-preparation
stained by gram while examining purulent discharge from uterine cervix. What agent caused this disease?
A. Staphylococci
B. Streptococci
C. Bacilli
D. Spirochetes
*E. Gonococci
54. A patient who came to the doctor because of his infertility was administered to make tests for toxoplasmosis and
chronic gonorrhoeae. Which reaction should be performed to reveal latent toxoplasmosis and chronic gonorrhoeae
of the patient?
A. Immunoblot analysis
B. RIHA - Reverse indirect hemagglutination assay
*C. CFT- complement fixation test
D. IFA - Immunofluorescence assay
E. RDHA - Reverse direct hemagglutination assay
LABORATORY DIAGNOSTIC OF THE DISEASES, CAUSED BY PATHOGENIC SPIROCHETES AND
PROTOZOA
55. Each of the following statements concerning VDRL (flocculation) test for syphilis is correct, EXCEPT:
*A. The antigen used is inactivated T. pallidum
B. The non-specific reagins will be demonstrated
C. The antibody titer declines with adequate therapy
D. The test is usually positive in secondary syphilis
E. The reagins found in positive reaction are directed against cardiolipin
56. Each of the following statements concerning Treponema species is correct, EXCEPT:
A. Species of Treponema are part of normal flora of the mouth
B. Species of pathogenic Treponema do not have animal reservoirs
C. Species of Treponema have a number of distinctive ultra structural features used in diagnosis
D. Species of Treponema cause jaws, bejel, and pinta
*E. Species of Treponema cause only venereal diseases
57. Which of the following statements is true about a chancre observed in primary syphilis?
A. It is found throughout all stuges of syphilis
B. It can be usually found on penis, chest, extremities
*C. It is a hard, painless lesion
D. It is a painful and purulent
E. It disappears within 4-6 weeks leaving a scar
58. The treatment of choice for syphilis is:
A. Aminoglycosides
B. Neutralizing antibody
C. Azidofhimidine
*D. Penicillin
E. Vancomycin
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59. In which of the following stages of syphilis the damage to various parts of the body can be seen,
including the blood vessels, heart, CNS?
A. Secondary stage
*B. Tertiary stage
C. Incubation period
D. Quaternary stage
E. Primary stage
60. Syphilis manifests itself how many stages (not including incubation period)?
A. 2
B. 5
C. 1
D. 4
*E. 3
61. Which of the following statements concerning the chancre formed during primary syphilis is correct?
A. It lasts throughout all stages of the disease
B. It will be developed 2-3 days after T. pallidum enters the body
C. The chancre is free from the organisms and non-infective
*D. It heals spontaneously within 2 months that gives the patient a false sense of relief
E. A purulent discharge from the chancre can be cultured for lab diagnosis
62. Each of the following statements concerning the fluorescent treponemal antibody-absorbed (FTA-Abs)
test for syphilis is correct, EXCEPT:
A. The test is usually positive in secondary syphilis
*B. False-positive results are more frequent than with VDRE flocculation
C. The test can give false-negative result in primary syphilis
D. The antibody titer remains positive despite adequate therapy
E. The antigen used is inactivated T. pallidum
63. Which of the following statements concerning Treponema species is correct?
*A. Treponema species include typically motile organism with fastidious growth requirements
B. Treponema species often produce exotoxins, the main cause of diseases
C. Treponema species diseases can be transmitted primarily by inhalation or ingestion
D. Treponema species are all highly pathogenic for humans and animals
E. Treponema species have pronounced gram-positive stain reaction
64. In which of the following stages of syphilis a cooper-colored rash, various pustular rashes and skin
eruption occurs?
A. Incubation period
B. Primary stage
*C. Secondary stage
D. Tertiary stage
E. Quaternary stage
65. Which one of the listed below bacteria paired with a mode of transmission is correct?
A. Borrelia burgdorferi –bite
B. Treponema pallidum-skin-to-skm contact
*C. Leptospira interrogans-infected urine
D. Borrelia duttoni-louse-bite
E. Borrelia recurrentis-water aerosol
66. The cause of the relapses in relapsing fever is:
*A. Changing in pathogen's antigens
B. Late release of the exotoxins
C. Reduction in antibody immune response
D. Reduction in cellular immune response
E. Development of the antibiotic resistance of the pathogen
67. Each of the following statements about Weil's disease is correct, except:
*A. It can be transmitted from animals to humans by tick bite
B. It is the most severe clinical form of leptospirosis
C. It is caused by Leptospira interrogans
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D. It is a zoonotic disease
E. It can be diagnosis by serogroup-specific microagglutination test
68. The lab test which can be used to distinguish epidemic and endemic relapsing fever is:
*A. Animal inoculation test
B. VDRL test for regain antibody
C. Demonstration of the antigenic structure of bacteria
D. Culture of Borrelia using ordinary culture media
E. Serological test for IgM antibody
69. Which of the following diseases is not a zoonotic disease?
A. Leptospirosis
B. Lyme disease
C. Plaque
D. Endemic relapsing fever
*E. Epidemic relapsing fever
70. Which one of the following statement regarding Lyme disease is correct?
*A. Ticks are the principle mode of transmission of the disease
B. There is no vaccine available for human protection
C. The causative agent is a small gram-positive rod
D. The basis for diagnosis is culturing of the organism on chocolate agar
E. It is caused by Borrelia recurrentis
71. Spirochete that does not have an animal reservoir is:
A. Leptospira biflexa
*B. Borrelia recurentis
C. Borrelia duttoni
D. Borrelia burgdorferi
E. Leptospira interrogans
72. Alternate periods with fever along with the periods without fever are characteristic for the disease
caused by:
A. Leptospira biflexa
B. Treponema carateum
C. Borrelia burgdorferi
*D. Borrelia recur entis
E. Leptospira interrogans
73. For which of the following disease vaccine is available for human protection?
A. Endemic relapsing fever
B. Venereal syphilis
C. Epidemic relapsing fever
D. Non venereal syphilis
*E. Lyme disease
74. Spirochaetes are stained with:
A. Gram-stain and Giemsa's stain
B. Ziehl-Neelsen stain
C. Indian ink
*D. Silver impregnation
E. All of the above
75. The doctor used Wasserman’s reaction for revealing the antibodies in the patient’s serum. Which reaction is
used?
A. Reaction of agglutination
*B. Complement fixation test
C. Reaction of neutralization
D. Hemagglutination test
E. Precipitation reaction
76. What reaction did a bacteriologist use to reveal antibodies in the serum of a patient with the syphilis?
A. Hemagglutination inhibition test
B. Vidal's test
C. ELISA
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*D. Wasserman's test
E. Hemagglutination test
77. A patient with fever lasting two weeks was admitted to infectious clinic. The spiral microorganisms with acute
ends of blue-violet colour were revealed in the blood slider coloured according to Romanovskiy-Gimza. What
microorganisms caused this infection?
A. Leptospira
B. Staphylococci
C. Streptococci
*D. Borrelia
E. Treponema
78. For the identification of the microorganisms it is necessary to determine their motility. What method can be used
for it?
A. Gram
B. Neisser
*C. Occurring during their lifetime colour
D. The method of luminescent microscopy
E. The isolation of pure culture
79. The spirochetes with 8-14 equal eddies performing different forms of movements were revealed in the smears
while studying the ulcer content. In what way was the agent discovered?
A.Colouring according to Gram
B.Silvering according to Morosov
C. Coloring according to Neisser
D. Coloring according to Romanovskiy-Gimza
*E. Hanging drop technique
80. There is a method of coloring which gives the possibility to paint in different colour the spirochetes of the genus
Borrelia, Leptospira, Treponema. How do we call it?
A. Coloring according to Gram
B. Silvering according to Morosov
C. Coloring according to Neisser
*D. Coloring according to Romanovskiy-Gimza
E. Coloring according to Burry
81. Under microscopic examination of blood, the micro-preparation colored according to Romanovskiy-Gimza , a
bacteriologist revealed a micro-organism in the form of a thin thread of blue violet color with several gross curls and
acute ends. The agent of which infectious disease looks like that under the microscope?
A. Syphilis
B. Toxoplasmosis
*C. Relapsing fever
D. Gonorrhea
E. Diphtheria
82. Parents with an ill child consulted an infectionist. They had been working in one of Asian countries for a long
time. The child has sallow skin, loss of appetite, laxity, enlarged liver, spleen, peripheral lymph nodes. What
protozoan illness can be suspected?
*A. Visceral leishmaniasis
B. Lambliasis
C. Toxoplasmosis
D. Balantidiasis
E. Amebiasis
ZOONOTIC DISEASES (BRUCELLOSIS, PLAGUE, TULAREMIA AND ANTHRAX)
83. Plague is a zoonotic infection. Who may be the source of infection in this case?
A. Diseased person
*B. Infected animal
C. Acute carrier
D. Chronic carrier
E. Subacute carrier
84. A patient suspected with pneumonic plague was admitted to the infection hospital. What method of examination
was used to make an early diagnostics of plague?
A. RF
*B. RIF
C. Biologic
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D. Serologic
E. Bacterioscopical
85. Under the microscopy of sputum of a patient with a working diagnosis of acute pneumonia they revealed
chaotically distributed ovoid micro-organisms with more intensive coloring at the poles. What diagnosis is most
probably true in this case?
*A. Plague
B. Dysentery
C. Cholera
D. Typhoid fever
E. Tuberculosis
86. A patient was admitted to the hospital with a diagnosis of pneumonic plague. What material was taken for
examination?
A. Blood
B. Serum
*C. Sputum
D. Urine
E. Feces
87. The authenticity of bacteriological examination in diagnostics of plague increases on using the reaction of
immunofluorescence. Describe the obtained microscopic picture.
*A. Green cells
B. Red cells
C. Blue cells
D. Brown cells
E. Violet cells
88. Doctor diagnosed that the patient has plague. What microorganism causes this infection?
A. Shigella dysenteria
*B. Yersinia pestis
C. Yersinia enterocolitica
D. Yersinia pseudotuberculosis
E. Salmonella typhi
89. What reaction did a bacteriologist use to reveal antibodies in the serum of a patient with the tularemia?
A. Hemagglutination inhibition test
B. Vidal's test
C. ELISA
D. Wasserman's test
*E. Reaction of agglutination
90. What reaction did a bacteriologist use to reveal antigens in the lungs of a rat with the plague?
A. Reaction fluorescence
B. Vidal's test
*C. Reaction of immune fluorescence
D. Wasserman's test
E. Reaction of agglutination
91. The doctor used serological reaction for revealing antibodies in serum of patient with tularemia. Which reaction
is used and what diagnostic titer of antibodies?
*A. Reaction of agglutination 1:100
B. Reaction of agglutination 1:50
C. Reaction of agglutination 1:200
D. Reaction of inhibition of hemagglutination 1:80
E. Reaction of inhibition of hemagglutination 1:160
92. Doctor diagnosed that the patient has tularemia. What microorganism causes this infection?
A. Brucella sues
B. Yersinia pestis
C. Yersinia enterocolitica
*D. Francisella tularensis
E. Salmonella typhi
93. What virulence factor of Yersinia pestis is slightly associated with disease transmission from infected flea to
animal and/or human?
A. Murine toxin
B. Endotoxin
C. Fraction-I envelope protein
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*D. Coagulase
E. Fibrinolysin
94. Each of the following statement concerning plague is correct, EXCEPT:
*A. plague is eradicated from the whole world
B. plague can produce dark-brown colonies when cultured on blood agar
C. plague is caused by gram-negative rods
D. wild animals may be a reservoir of the causative agent of plague
E. plague is transmitted to humans by flea bite
95 Buboes in the inguinal lymph nodes are seen in which one of the following diseases?
A. Cutaneous anthrax
*B. Bubonic plague
C. Tuberculosis
D. Trachoma
E. Yersiniosis
96. Rat flea transmits which of the following disease?
A. Anthrax
B. Typhoid fever
*C. Plague
D. Epidemic typhus
E. Salmonelloses
97. Which of the following statements concerning epidemiology of plague is NOT correct?
A. Plague can be transmitted from domestic animals by flea bite
*B. Plague is a zoonotic disease and can not be transmitted from human to human
C. There are natural reservoirs of the plague
D. Many mammals can be infected by Y. pestis
E. Sylvatic cycle involves wild rodents and carnivores
98. Which one of the statements concerning vaccine against plague is correct?
A. Vaccination gives long-life immunity
B. Vaccination is recommended for routine use
C. Live attenuated vaccine is used for humans vaccination
*D. Whole-killed vaccine is used for humans
E. Anti-plague vaccine gives protection against all Yersiniosis
99. The "string of pearl" colonies on nutrient agar are produced when which of the following organisms is growing
on penicillin-containing medium?
A. Staphylococcus
B. Corynebacterium
*C. Bacillus
D. Clostridia
E. Mycobacteria
100. Which of the following clinical forms of anthrax most likely has a poor prognosis?
*A. Pulmonary anthrax
B. Latent anthrax
C. Intestinal anthrax
D. Secondary anthrax
E. Cutaneus anthrax
101. Which one of the followings is the major reservoir for B. anthraces infection?
A. Spores in human blood
B. Vegetative cells in soil
*C. Spores in soil
D. Vegetative organisms in animal blood
E. Spores in a bodies of unsusceptible animals
102. Which one of the followings zoonotic disease has not arthropod vector?
A. Lyme disease
B. Endemic relapsing fever
C. Epidemic typhus
*D. Anthrax
E. Plague
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103. What organism produces a frequently misdiagnosed food poisoning associated with fried rice?
A. Clostridium perfringens
B. Bacillus subtilis
C. Bacillus anthraces
*D. Bacillus cereus
E. Clostridium botulinum
104. Which one of the following statements concerning B. anthraces organism is correct?
*A. It can spread in a body via lymphatic or blood stream and cause septicemia
B. It can cause latent infection and can be re-activated after several months
C. It can be transmitted from human to human by an insect vector
D. It has a strong endotoxin that can cause shock like state after antibiotic administration
E. It can produce potent neurotoxins that results in nerve system damage
105."Medusa head" colonies on nutrient agar is seen when the diagnosis is developed of:
A. Leptospirosis
B. Syphilis
C. Plague
*D. Anthrax
E. Gas gangrene
106. A vaccine is available against anthrax, which is:
A. Highly virulent heat-killed whole organism
B. Live attenuated strain produced by passage through the organisms of unsusceptible animals
C. Polysaccharide capsule
*D. Live attenuated strain produced by culturing at non-optimal temperature
E. Peptidoglycan of the cell wall
107. What of the following paired properties are the important virulence determinants of B.anthraces?
A. Flagella and capsule
B. Exotoxin and endotoxin
*C. Edema and necrotizing toxins
D. Adhesive pili and hyaluronidase
E. All of the above
108. It is planned to use the territory of an old cattle burial ground (which is not used for more than 50 years) for
building houses. But ground analysis revealed presence of the pathogen of a very dangerous illness. Which of the
indicated microorganisms is likely to remain in the ground for such a long time?
A. Mycobacterium bovis
B. Francisella tularensis
C. Yersinia pestis
D. Brucella abortus
*E. Bacillus anthracis
109. A veterinarian’s assistant consulted a doctor complaining of fever, articular pains, malaise and sweating at
night. The doctor suspected brucellosis. What material take from the patient can be investigated in a common
microbiological laboratory?
A. Serum
*B. Blood
C. Feces
D. Urine
E. Sputum
110. A patient was admitted to the hospital with a diagnosis of brucellosis. A doctor suspected that the patient had
bacteriemia and sent material for bacteriological analysis to the laboratory. What was taken for examination?
*A. Blood
B. Serum
C. Bile
D. Urine
E. Feces
111. Anthrax bacilli are highly resistant to environmental factors. They are preserved in the soil for many years and
can get into the digestive tract of animals. What provides such properties for the bacilli?
A. Flagella
B. Capsule
C. Structural element of cell
D. Chemical composition of wall
*E. Spore
13
112. The doctor used Rit’s reaction for revealing the antibodies in the patient’s serum. Which reaction is used?
*A. Reaction of agglutination
B. Complement fixation test
C. Reaction of neutralization
D. Hemagglutination test
E. Precipitation reaction
113. The doctor used Huddleston’s reaction for revealing the antibodies in the patient’s serum. Which reaction is
used?
*A. Reaction of agglutination
B. Complement fixation test
C. Reaction of neutralization
D. Hemagglutination test
E. Precipitation reaction
114. What reaction did a bacteriologist use to reveal antigens in the skin of an animal with the anthrax?
*A. Precipitation reaction
B. Vidal's test
C. ELISA
D. Wasserman's test
E. Reaction of agglutination
115. The doctor used Askoli's reaction for revealing the Bacillus anthraces in the soil. Which reaction is used?
A. Reaction of agglutination
B. Complement fixation test
C. Reaction of neutralization
D. Hemagglutination test
*E. Precipitation reaction
LABORATORY DIAGNOSTICS OF INFECTIOUS DISEASES CAUSED BY PATHOGENIC CLOSTRIDIA
(BOTULISM, TETANUS, AND GAS GANGRENE)
116. What characteristic listed below is NOT typical for Clostridial
*A. Facultative anaerobes
B. Sporogenous
C. Gram-positive bacilli
D. Found in soil
E. Toxigenic
117. Which one of the following statements concerning immunization against diseases caused by Clostridia
is CORRECT?
A. Antitoxin against tetanus protects against botulism as well, because they share antigens
B. Vaccines containing alpha toxin (lecithinase) are effective in protecting against gas gangrene
*C. Tetanus toxoid induces effective protection against tetanus
D. There is a vaccine against botulism in common use
E. Antitoxins for botulism are not available for passive immunization
118. Each of the following statements concerning wound infections caused by Clostridium perfringens is
correct, EXCEPT:
A. An exotoxin play a role in pathogenesis
B. Gram-positive rods are found in the exudates
*C. The organism is grown only in cell culture, but not on cell-free medium
D. Anaerobic culture of the wound site should be performed
E. Neutralizing Nagler's test can be used for alpha-toxin identification
119. Patient admitted to a hospital experiences vomiting, double vision, difficulties with swallowing 4 hours
after home-made canned vegetables consumption. Doctor develops clinical diagnosis. What diagnostic
method should be used to confirm the diagnosis?
A. Allergic test, serology
B. Culture method
C. Microscopy
*D. Biological in vivo assay
E. Genetic, serological
120. Which one of the following statements about Clostridium perfringens is NOT correct?
14
A. it causes gas gangrene
*B. it is gram-negative rod
C. it causes food poisoning
D. it can produces lecithinase
E. it produces potent exotoxins that cause necrosis
121. The mechanism of action of Clostridium tetani exotoxin is that:
*A. it blocks the release of neurotransmitters causing spastic paralyses
B. it binds irreversible to elongation factor-2 and inhibits protein synthesis
C. it has wide spectrum of cytotoxicity
D. it activates cAMP causing loss of fluid
E. it facilitates invasiveness of the organism
122. The most important protective function of the antibodies stimulated by tetanus immunization is:
A. to opsonize the pathogen
*B. to neutralize the toxin
C. to prevent adherence of the organism
D. to prevent growth of the organism
E. all of the above
123. What clinical conditions is NOT typical for Clostridium botulinum?
A. toxemia
B. colonization of infant's intestinal tract
C. wound infections
D. food poisoning
*E. myonecrosis (gas gangrene)
124. What is the most important laboratory test for rapid diagnosis of food borne botulism?
A. isolation of the organism from the feces
B. isolation of the organism from the blood
C. hypersensitivity skin test
*D. toxin neutralizing bioassay
E. examination of serum in order to detect specific anti-Clostridium antibodies
125. Which of the following normal flora agents is etiologically associated with pseudomembranous
enterocolitis?
A. Escherichia coli
B. Staphylococcus aureus
C. Candida albicans
D. Klebsiella pneumonia
*E. Clostridium difficile
126. What clinical conditions germinating of C botulinum spores in the GIT of infant can produce?
A. pseudomembranous colitis
*B. 'floppy baby' syndrome
C. gas gangrene
D. food poisoning
E. 'lockjaw'
127. A cattleman had received a serious wound but refused medical treatment and developed rhisus
sardonicus 3 weeks later. What type of vaccine could prevent this?
A. capsular polysaccharide
B. whole killed vaccine
C. live, attenuated
D. naked DNA vaccine
*E. toxoid
128. Each of the following statements concerning Clostridia is correct? EXCEPT:
A. Pathogenic Clostridia are found both in soil and in the normal flora of the colon
B. Pseudomembranous colitis is due to a toxin produced by C. difficile
*C. Anaerobic conditions at the wound site are not required to cause tetanus, because spores will form in the
presence of oxygen
D. Botulism can be prevented by boiling food prior to eating
15
E. C. perfringens can cause food poisoning
129. Which one of the following agents is never associated with food poisoning?
A. Staphylococcus aureus
*B. C. tetani
C. C perfringens
D. Salmonella typhimurium
E. C. botulinum
130. Which one of the following statements about immunoprophylaxis and immunotherapy of clostridial
diseases is MOST accurate?
A. Passive immunization with tetanus antitoxin is enough to give protection for 5 years
B. Vaccine containing enterotoxin of C. difficile is available to prevent development of enterocolitis
C. Immunogen in anti-tetanus vaccine is a purified tetanospasmin
*D. Combined active-passive immunization is used to prevent tetanus
E. The patients that have survived foodborne botulism do not need vaccination, because they develop antitoxins
as a result of the disease
131. A case of anaerobic infection took place in the hospital after planned surgery. Which material should be given
for bacteriological examination for revealing the cause of infection?
A. Urine
B. Faeces
C. Serum
*D. Insufficiently sterilized materials
E. Phlegm
132. A patient was admitted to the hospital due to loss of appetite, doubling of the vision and difficulty in swallowing.
What methods of diagnostics must be used to confirm the diagnosis?
*A. Serological
B. Biological
C. Allergic
D. Bacterioscopical
E. Bacteriological
133. Clostridium tetani are highly resistant to environmental factors. They are preserved in the soil for many years
and can get into the digestive tract of animals. What provides such properties for the bacilli?
A. Flagella
B. Capsule
C. Structural element of cell
D. Chemical composition of wall
*E. Spore
134.The most effective and dangerous biological toxin is the exotoxin of one of the kinds of bacteria which stands an
acid reaction, freezing, high concentration of common salt and the effect of digestive enzymes. A dose of 0.3mkg is
lethal for a human. How do we call an infectious disease resulting from the intake of food products containing this
toxin?
A. Dysentery
B. Cholera
*C. Botulism
D. Tetanus
E. Gas gangrene
135. Botulism is an acute severe disease characterized by affliction of the CNS, SSS it has a characteristic clinical
picture. What is the characteristic of such a disease provided with?
A. Action of endotoxin
*B. Action of exotoxin
C. Spore
D. Flagella
E. Capsule
136. In some diseases the infection results from getting the spores of bacilli into the wound. What diseases may
develop in such a case?
*A. Tetanus
B. Tuberculosis
C. Plague
D. Cholera
E.
Dysentery
16
Laboratory diagnostics of diphtheria, and whooping cough. Laboratory diagnostics of
tuberculosis.
137. Each of the following statements concerning exotoxin is correct, EXCEPT:
*A. Diphtheria toxin production is under chromosomal genes control
B. Cholera toxin acts by stimulating adenylate cyclase
C. Diphtheria is caused by an exotoxin that inhibits protein synthesis by inactivating an elongation factor-2
D. Diphtheria toxin is a major virulence factor of C. diphtheriae
E. Botulinistic and tetanus exotoxins are both neurotoxins
138. Toxigenicity of Corynebacterium diphtheriae strains can be detected by all of the following methods,
EXCEPT:
A. Polymerase chain reaction (PCR)
*B. Antibiotic sensitivity testing
C. Gel precipitation test (Elek's test)
D. in vitro cytotoxicity test
E. In vivo bioassay: subcutaneous or intracutaneous test in guinea-pigs
139. The site of C. diphtheriae infection may be:
A. Laryngeal or nasal
B. Genital
C. Otitic or conjunctival
D. Cutaneus
*E. All of them
140. Based on the cultural ('colonies' morphology) and biochemical properties C. diphtheriae isolates can be
classified into:
A. Two biovars (classical and El - Tor)
B. Three serological groups (I, II, III)
C. Two clinical forms (toxic and nontoxic)
D. Four phagovars
*E. Four biovars (mitis, gravis, intermedins, belfanti)
141. A five year-old boy has malaise, sore throat and a low-grade fever. On examination a pseudo membrane firmly
adhered to respiratory tissues was found and it was difficult to dislodge it without making the underlying tissues
bleed. Which one of the organisms is most likely cause of the disease?
A. Gram-positive thick rods with subterminal spores
B. Long spiral-shaped rods that cannot be Gram-stained
C. Gram-positive cocci arranged in chains
D. Gram-negative curved highly motile rods
*E. Gram-positive pleomorphic rods in palisade arrangement demonstrating met achromatic nature
142. The A portion of diphtheria exotoxin:
*A. Interferes with protein synthesis by inactivating elongation factor II
B. Attaches to the membrane of a susceptible cells
C. Attaches to the 30S ribosome
D. Attaches 50 S ribosome
E. Blocks neurotransmission at peripheral cholinergic synapses by preventing release of the acetylcholine
143. Each of the following statements concerning Corynebacterium diphtheriae is correct EXCEPT:
A. C. diphtheria is a gram-positive rod that does not form spores
B. Toxin production is depend on the organism's being lysogenized by a bacteriophage
C. Antitoxin should be used to treat patients with diphtheria
*D. Major virulence factor responsible for clinical manifestation is an endotoxin
E. Vaccine against diphtheria containing toxoid
144. Methods for demonstration of C. diphtheriae strains toxigenic are:
*A. Gel precipitation test (Elek's test)
B. Serotyping and phage typing of isolates
C. Studying of sugar fermentation patterns
D. Neutralization (Nagler's) test
E. Microscopy of smears stained with methylene blue to observe typical arrangement
145. A 10 year-old boy was admitted to a hospital and non-toxigenic mild respiratory diphtheria was diagnosed. On
tellurite agar, the colonies appear small, round, convex, and black. Which one of the C. diphtheriae biovars is the
most likely cause of the disease?
A. Intermedins
17
B. Gravis
*C. Mitis
D. Belfanti
E. All of them
146. Complications in patients with severe diphtheria are due to which of the following virulence factors:
A. The release of endotoxin during the autolysis of organisms
B. The high specificity of surface bacterial antigens to respiratory epithelium
C. The presence of unique chemical composition of the cell wall
D. The presence of long-term bacteriemia within recovery period
*E. The release of exotoxin that inhibits protein synthesis in different type of cells
147. Which one of the following statements about non-diphtheria Corynebacterium is correct?
A. They are strictly pathogenic gram-positive rods
B. They are well-recognized human intestinal pathogens
C. They are saprophytes, which can not cause disease in humans
*D. They are opportunistic pathogens that cause cutaneus, UT and RT infections
E. They produce diphtheria-like toxin
148. In 1994 an outbreak of diphtheria occurred in Ukraine and Russia. What specific protective means had to be
undertaken to control spreading of the agent and to develop hard immunity?
A. Isolation of the case patients
B. Passive immunization with ADS
C. Active immunization with DPT vaccine
*D. Active immunization with Td vaccine
E. Improve environmental sanitation and hygiene
149. A patient skin test with purified protein derivative (PPD) to determine previous exposure to
Mycobacterium tuberculosis develops induration at the skin test site 48 hours later. Histologically, the
reaction site would MOST probably show:
A. eosinophils
B. neutrophils
C. B cells
D. NK cells
*E. helper T cells and macrophages
150. Mycobacteria resist intracellular killing due to which cell wall constituent?
*A. mycolic acids (wax D)
B. lipopolysaccharide
C. lipoteichoic acid
D. peptidoglycan
E. periplasmic enzymes
151. Which of the following statements characterizes Mycobacteria tuberculosis better?
*A. M. tuberculosis cases strong hypersensitivity reaction type IV in infected patients
B. M. tuberculosis produces highly potent exotoxin
C. M. tuberculosis induces production of protective antibodies in infected patients
D. M. tuberculosis can be effectively killed by macrophages
E. M. tuberculosis grow fast on ordinary media
152. Each of the following statements concerning Mycobacterium tuberculosis is correct EXCEPT:
A. It has a large amount of mycolic acid in the cell wall
*B. It appears as a red rod in Gram-stained specimens
C. It appears as a red rod in acid-fast staining
D. It can be detected by light microscopy
E. After being stained with carbolfucshin it resists decolorization with acid
153. On routine physical examination of computer programmer for insurance, a spot is noted on his lungs
in the right lobe. He also has been experiencing night sweats, weight lost. What is the most likely cause of
disease?
A. Streptococcus pneumonia
*B. Mycobacterium tuberculosis
C. Borrelia burgdorferi
D. Pseudomonas aeruginosa
E. Treponema pallidum
18
154. Which one of the following statements concerning Mycobacterium tuberculosis is NOT correct?
A. Some strains, isolated from individuals with previously untreated cases are resistant to isoniazid
*B. It contains a small amount of lipid in a cell wall and stains poorly by gram-stain
C. The organism grow slowly, often requiring 3-6 weeks before colonies appear
D. The antigen in a skin test is a protein extracted from the organism
E. Lowenstein-Jensen medium could be used for organism culture
155. The most common species of Mycobacterium associated isolated from AIDS patients is:
A. Mycobacterium kansasii
B. Mycobacterium leprae
C. Mycobacterium microti
D. Mycobacterium ulcerans
*E. Mycobacterium avium-intracellulare
156. Which one of the following pathogenic determinant can be considered a virulence factor of M.
tuberculosis?
*A. cord factor
B. polysaccharide capsule
C. exotoxin with cytotoxicity
D. LPS
E. enzymes of invasiveness (collagenase, hyaluronidase, protease)
157. BCG vaccine contains:
A. capsular polysaccharide
*B. live attenuated M. bovis
C. toxoid
D. live attenuated M. tuberculosis
E. whole killed M. tuberculosis
158. Each of the following statements concerning M. leprae is correct, EXCEPT:
A. In lepromatous leprosy, large numbers of organisms are usually seen in smears stained by acid-fast stain
B. A tuberculoid leprosy case patient is less infective than that with lepromatous leprosy
*C. The organism grows will grow well on Lowenstein-Jensen medium in 3 to 6 weeks
D. Skin test with lepromin is useful in diagnosis
E. Some in vivo animals models are currently developed to culture M. leprae
159. A 14 year-old boy developed night sweats, and a low-grade fever. He has shortness of breath and a
productive cough with sputum. Acid-fast bacilli have been seen in sputum. Select most appropriate
treatment.
A. penicillin
B. rifampin
C. ribavirin and acyclovir
D. streptomycin and lincomycin
*E. isoniazid and PAS (paraaminosalicilic acid)
160. Which one of the following statements explains better the use of acid-fast stain, but not Gram-stain
procedure in Mycobacterium, tuberculosis staining?
A. It lacks a cell wall and can not retain crystal violet
B. It has a thick polypeptide capsule that does not accept non-concentrated dye
*C. It has a large amount of lipids in a cell wall that prevents entry of crystal violet
D. It has a thick peptidoglycan layer which can be decolorized very easy with alcohols
E. It has a large amount of proteins in outer membrane that interfere with staining by crystal violet
161. Mantua test was taken from 7year old children during a medical test. had a negative response. What should be
done with the children with negative response?
*A. To revaccinate them with vaccine BCG
B. To revaccinate them with vaccine ABDT
C. To revaccinate them with diptheric anatoxinum
D. To repeat Mantua test
E. To inject antitoxic serum
162. A child with diphtheria after 10 days of introducing of antitoxic antidiphtheric serum developed a rash along
with severe itchiness, increase in temperature up to 38˚C and joint-pain. What could be the reason for these
symptoms?
19
*A. Serum disease
B. Anaphylactic reaction
C. Atopia
D. Contact dermatitis
E. Immediate hypersensitivity
163. Due to outbreak of diphtheria it is necessary to carry on the preventive work at the student’s hostel. Which
preparation must be used to form an artificial active immunity?
A. Serum
B. Antibiotic
C. Interferon
*D. Toxoid
E. Immunoglobulin
164. An infectious allergy is observed in the tuberculosis infection. What preparation is used to reveal the degree of
the organism’s sensibility to these microorganisms?
A. BCG vaccine
*B. Tuberculin
C. Anatoxinum
D. Serum
E. IgM
165. A patient with diphtheria after being treated with antidiphtheric antitoxic serum developed eruption, joint-pain
and increase in temperature. What disease developed in the patient?
A. Serum disease
*B. Anaphylactic reaction
C. Atopia
D. Contact dermatitis
E. Immediate hypersensitivity
LABORATORY DIAGNOSTICS OF DISEASES CAUSED BY CHLAMYDIA AND MYCOPLASMA
LABORATORY DIAGNOSTICS OF DISEASES CAUSED BY RICKETS
166. A 25-year-old man complains of a urethral discharge. Gram stain of discharge reveals neutrophils but
no organisms. Which one of the listed organisms is more likely to cause discharge?
*A. Chlamydia trachomatis
B. Candida albicans
C. Mycoplasma pneumoniae
D. Treponema pallidum
E. Coxiella burnetii
167. Obligate intracellular parasite that forms elementary bodies is:
*A. Chlamydia pneumoniae
B. Ricketsia rickettsii.
C. Mycobacterium leprae
D. Mycoplasma pneumoniae
E. Mycobacterium tuberculosis
168. Each of the following statements concerning chlamydial genital tract infections is correct, EXCEPT:
A. There is no protective vaccine against this infection
B. Infection can persist after administration of penicillin
C. Symptomatic infection can be associated with cervical discharge
*D. Infection can be diagnosed by finding antichlamydial antibody in a serum specimen
E. It is the cause of lymphogranuloma venereum
169. Most cases of nongonococcal urethritis are caused by:
A. Streptococcus pyogenes
B. Neisseria gonorrhoeae
C. Treponema pallidum
D. Escherichia coli
*E. Chlamydia trachomatis
170. The infectious particle in chlamydial infections is a (an):
A. Bacterial cell
B. Reticulate body
20
C. Spore
*D. Elementary body
E. All particles are infectious
171. Each of the following statements about chlamydiae is correct, EXCEPT:
A. Chlamydiae are strict intracellular parasites because they can not synthesize their ATP
B. Chlamydiae possess both DNA and RNA
C. C. trachomatis has multiple serotypes
D. C. psittaci has one serotypes
*E. Most chlamydiae are transmitted by arthropods
172. Mycoplasmas are different from most other bacteria in that they have no:
A. Proteins
*B. Cell wall
C. Nucleic acid
D. Cell membrane
E. Flagella
173. Lower respiratory tract infections, associated with non-productive cough, lobular pneumonia, high
serum titers of cold agglutinins, and mucoid sputum containing a paucity of bacteria upon Gram stain,
indicates infection by:
A. Klebsiella pneumoniae
B. Streptococcus pneumoniae
C. Legionella pneumophila
*D. Mycoplasma pneumoniae
E. Chlamydia trachomatis
174. Which one of the following types of the organisms is NOT an obligate intracellular parasite and
therefore can replicate on bacteriological cell-free medium?
A. Chlamydia
*B. Mycoplasma
C. Orientia
D. Rickettsia
E. Herpesvirus
175. Respiratory pathogen without a cell wall is:
A. Chlamydia pneumoniae
B. Mycobacterium avium-intracellulare
*C. Mycoplasma pneumoniae
D. Leptospira interrogans
E. Chlamydia trachomatis
176. Which property does Mycoplasma differ from bacteria?
А. Structure of the nucleoid
В. Absence of cell wall
С. Intracellular parasite
D. Tinctorial properties
*Е. Structure of cytoplasmatic membrane
177. Which one of the following organism principally infects vascular endothelial cells?
A. Coxiella burnetii
B. Treponema pallidum
*C. Rickettsia typhi
D. Borrelia burgdorferi
E. Salmonella typhi
178. For which one of the following disease ticks and mites are not essential in transmission?
*A. Q-fever
B. Scrub typhus
C. Lyme disease
D. Endemic relapsing fever
E. Rocky Mountain spotted fever
179. A vaccine is NOT available for which of the following disease?
21
A. Epidemic typhus
B. Q-fever
C. Rocky Mountain spotted fever
D. Typhoid fever
*E. Scrub typhus
180. Each of the following statements concerning epidemic typhus is correct, EXCEPT:
A. The disease is characterized by a rash
B. The disease is caused by Rickettsia provazekii
C. The Weil-Felix test can aid in diagnosis
D. The causative agent is transmitted from animal to human by a louse
*E. The causative agent is transmitted from animal to human by a tick
181. For which of the following disease a recrudescent (Brill-Zinsser) disease can occur after 10-20 years?
*A. Epidemic typhus
B. Rocky Mountain spotted fever
C. Scrub typhus
D. Q-fever
E. Rickettsialpox
182. Which one of the following organisms is an obligate intracellular parasite?
A. Mycoplasma pneumonia
B. Treponema pallidum
C. Mycobacteria avium-intracellulare
*D. Rickettsia provazekii
E. Coxiella burnetii
183. Listed below are five bacteria paired with a mode of transmission. Which one of the parings is
correct?
A. Rickettsia ricketts ia-contaminated food
*B. Rickettsia provazeki-louse feaces
C. Borrelia burgdorferi-mosquito bite
D. Rickettsia typhi - louse bite
E. Coxiella burnetii- chiggers bite
184. Each of the following statements concerning Q-fever is correct, EXCEPT:
A. It is transmitted by respiratory aerosol
*B. Rash is a prominent feature of the disease
C. The disease is caused by Coxiella burnetii
D. Domestic animals are the important reservoir
E. The target cells are macrophages
185. The intracellular parasites of cocci form were revealed in the smear coloured according to Zdradovsky. What
group of microorganisms is an agent referred to?
A.Cocci
B. Mycoplasma
C.Spirochetes
D.Bacilli
*E. Rickettsiae
186. A special method of staining is used for revealing Rickettsiae. What is this method?
A. Gram
B. Morosov
C. Neisser
D. Romanowsky-Giemsa’s
*E. Zdradovsky
INTESTINAL DISEASES
187. The confirming of diagnosis of an intestinal disease demands using of bacteriological method based on culturing
of examined material on nutritional media. What’s its aim?
A. Revealing of specific antibodies
B. Revealing of specific antigen
*C. Isolation of pure culture of an agent
D. Revealing infections allergy
22
E. Revealing immune reconstruction of an organism
188. Numerous red colonies grew on Endo medium at bacteriological study of faeces in 4-month-old child with
intestinal infection. What are these microorganisms?
A. Salmonella
*B. Escherichia
C. Shigella
D. Streptococcus
E. Staphylococcus
189. The growth of Escherichia coli is very depressed in inoculation of defecation of patient on Ploskyrev’s medium.
What factors promote this phenomenon?
A. Blood
B. Bile
*C. Brilliant green
D. Fuchsin
E. Methylene blue
190. The attachment of intestinal bacillus to epithelial cells with the help of special formations and their producing
the adhesines are important at the first stage of pathogenesis of escherichioses. How do we call these formations?
A. Capsules
B. Spores
C. Flagella
*D. Fimbrae
E. Grains of volutine
191. There is a natural immunity against the agents of coli-infection that is colienteritis in children of early age. It
depends on some factors. Which of these factors is interconnecting and promotes the formation of intestinal
biocenosis in the first days of a child’s life?
A. Antibodies of mother’s milk
*B. Colonization of epithelium of gastro-intestinal tract with bifidumbacteria
C. Fermentative activity of intestinal bacilli
D. A number of microorganisms in the intestine
E. The properties of intestinal flora
192. An intestinal bacillus was isolated from faeces of a sick child; it was attributed to serological group O26. What
diagnosis can be made in this case?
*A. Escherichioses
B. Salmonelloses
C. Cholera
D. Dysentery
E. Yersiniosis
193. A large number of colonies of dark-red color grew on Endo medium at the study of defecation of 5-month-old
child with the symptoms of acute intestinal infection. What microorganisms could cause the disease?
A. Salmonella
*B. Escherichia
C. Shigella
D. Streptococcus
E. Staphylococcus
194. The main method of diagnostics of escherichioses is a bacteriological method. What is the purpose of this
method of investigation?
A. Revealing of specific antibodies
*B. Revealing of specific antigen
C. Isolation of pure culture of an agent
D. Making the preparation – smear of examiner material
E. Reproduction of infection in susceptible laboratory animals
195. Faeces of a child with colienteritis was inoculated on Endo medium. The growth of red colonies was observed on
the surface of the medium 24 hours later. How to reveal the colonies containing enteropathogenic intestinal bacillus
among grown colonies?
A. Determining the mobility
B. Making and staining the preparation smear according to Gram
C. Phage typing
*D. Reaction of agglutination with polyvalent OB-serum
E. Re-inoculation of colonies on Ressel’s medium
23
196. On suspicion of colienteritis, the faeces of an examined person is inoculated on Endo medium. What groups of
nutritional media according to its function the medium belong to?
A. Selective medium
*B. Differential diagnostic medium
C. Special medium
D. Enrichment medium
E. Liquid agar
197. On suspicion of dysentery the faeces on examined patient in inoculated on Levin’s medium as the intestinal
bacillus is inhibited on this medium. What factor causes this phenomenon?
*A. Methylene blue
B. Fuchsin
C. Crystal violet
D. Blood
E. Bile
198. Doctor diagnosed that the patient has enteric fever. What micro-organism causes this infection?
A. Shigella dysenteria
B. Staphylococcus aureus
C. Escherichia coli
D. Salmonella enteritidis
*E. Salmonella typhi
199. The blood of patient with the diagnosis of enteric fever was sent to the laboratory. Which nutrition medium can
the bacteriologist use for the isolation of pure culture of Salmonella typhi?
A. Endo medium
B. Blood Agar
C. Hiss medium
D. Chocolate medium
*E. Bile broth
200. For treatment of the patient with enteric fever, doctor prescribed levomycetin. In the next day, the patient’s
health got worse with increase in temperature to 39ºC. Why did his condition get worse?
A. Reinfection
*B. Action of endotoxin of salmonella
C. Insensitivity of salmonella to levomycetin
D. Allergic reaction
E. Secondary infection
201. Bacteriologist sourced the feces of patient with enteric fever on the selective nutrition medium. Within 24 hrs on
the surface of the medium, grew black colonies. Which nutrition medium did the bacteriologist use for sourcing?
A. Endo medium
B. Blood agar
*C. Bismuth – sulphite agar
D. Hiss medium
E. Bile broth
202. The doctor used Vidal’s reaction for revealing the antibodies in the patient’s serum. Which reaction is used?
*A. Reaction of agglutination
B. Complement fixation test
C. Reaction of neutralization
D. Hemagglutination test
E. Precipitation reaction
203. The clinical symptoms of the patient showed high temperature for 8 days. The doctor diagnosed it to be enteric
fever. What material for investigation can be used in this stage of infectious disease?
A. Serum
B. Faeces
C. Urine
D. Bile
*E. Blood
204. The patient had enteric fever. He continued shedding typhoid bacilli in feces for more than a year .What is he
considered as?
A. Convalescent carriers
*B. Chronic carriers
C. Transient carriers
D. Permanent carriers
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E. Suspected carriers
205. Salmonella typhi differs from other species of Salmonella in:
A. Is found mainly in animals.
B. Produces enteritis in small intestine
C. Causes acute dysentery
*D. Causes inflammation in the lymphatic nodes in the small intestine
E. Causes food poisoning infection.
206. The most common infection caused by Salmonella in developed countries is:
A. Pseudomembranal colitis
B. Typhoid fever
C. Septicemia
*D. Gastroenteritis
E. Enteric fever
207. The main method of diagnostics of enteric fever is a bacteriological method. What is the purpose of this method
of investigation?
A. Reviling of specific antibodies
B. Reviling of specific antigen
*C. Isolation of pure culture of an agent
D. Making the preparation – smear of examined material
E. Reproduction of infection in susceptible laboratory animals
208. Which one of the following organisms causes bloody diarrhea, is non-motile, does not ferment lactose and does
not produce H2S:
A. Salmonella typhi
*B. Shigella flexneri
C. Salmonella enteritidis
D. Escherichia coli
E. All of them
209. Which one of the following exotoxins can stimulate hypersecretion of fluids and electrolytes?
A. Shiga-toxin of Shigella dysenteriae
B. Toxic shock syndrome toxin of S. aureus
C. Endotoxin of all Enterobacteriaceae
D. Enterotoxin of Salmonella typhi
*E. Heat-labile and heat-stable enterotoxin of E. coli
210. Which one of the following exotoxins can kill Vero cells in culture?
A. Heat-stable enterotoxin of E. coli
*B. Shiga-toxin of Shigella dysenteriae
C. Heat-labile enterotoxin of E. coli
D. Endotoxin of all Enterobacteriaceae
E. Toxic shock syndrome toxin of S. aureus
211. Which one of the following organisms is the most common cause of uncomplicated urinary tract infections in
humans?
A. Staphylococcus aureus
B. Pseudomonas aeruginosa
C. Streptococcus pyogenes
*D. Escherichia coli
E. Klebsiella pneumonia
212. Factors responsible for the pathogenicity of E. coli include all of the following EXCEPT:
A. Heat-labile enterotoxin
B. Capsular (K) antigen
*C. Lipoteichoic acid
D. Heat-stable enterotoxin
E. Endotoxin
213. Which one of the following agent of enteric illnesses has the lowest 50% infective dose?
A. Salmonella typhimurium
*B. Shigella sonnei
C. Enterotoxigenic Escherichia coli
D. Salmonella typhi
E. Enterophatogenic Escherichia coli
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214. A 5-year-old girl develops bloody diarrhea and no vomiting 3 days after visiting her friend's birthday. Stool
culture on Endo's agar grows both lactose-positive and lactose-negative rods with Gram-negative stain reaction.
Which one of the following organisms is the most likely to be the cause?
A. Salmonella cholera-sues
B. Clostridium difficile
C. Klebsiella pneumonia
*D. Shigella flexneri
E. Staphylococcus aureus
215. The most important source of Salmonella typhi infection is:
A. Poultry and wild birds
*B. Typhoid bacilli carriers
C. Warm-blooded animals
D. Humans that develop typhoid fever
E. All of the above
216. The virulence factor that can be responsible in part for all diseases caused by enteric pathogens is:
*A. Endotoxin
B. Flagella
C. Capsule
D. Peptidoglycan
E. Vi - antigen
217. Bacteriological diagnosis of typhoid fever can be developed BEST by culture of:
A. Faeces taken during the course of the disease and during convalescence
*B. Blood taken during the first week of the disease
C. Urine
D. Blood taken during the second or third week of the disease
E. Pus from suppurative lesions
218. Salmonella typhi differs from other species of Salmonella in that it:
A. Is found mainly in animals
B. Produces enteritis in the small intestine
C. Causes acute dysentery
D. Produces a heat-stable enterotoxin
*E. Has a predilection for lymphoid tissues in the liver and spleen
219. Each of the following statements about Gram-negative rods is correct EXCEPT:
*A. E. coli is a part of normal flora and can not cause diarrhea
B. E. coli ferments lactose, whereas the enteric pathogens Salmonella and Shigella do not
C. Klebsiella pneumonia is a part of the normal flora of the colon
D. Proteus species are highly motile normal flora organisms, which can cause urinary tract infections
E. Identification of Enterobacteriaceae is based on the biochemical and antigenic properties of the organisms
220. The pathogenesis of which one of the following diseases does NOT involve an exotoxin?
*A. Typhoid fever
B. Scalded skin syndrome.
C. Scarlet fever
D. Tetanus
E. Toxic shock syndrome
221. The unique surface antigen that is used in identification of particular enteric pathogen is:
A. M protein antigen
B. H flagella antigen
C. A protein antigen
*D. Vi capsular antigen
E. Teichoic acid antigen
222. A key characteristic of the etiological agent of bacillary dysentery is:
A. Strict localization of the pathogen in the small intestine
B. The organism is found mainly in animals
*C. Production of a potent cytotoxin responsible for invasiveness
D. The organism is transmitted by droplet aerosol
E. It is a member of normal flora of the human body
223. Blood and leukocytes are seen frequently in the stool during:
A. Salmonellae food poisoning
B. Staphylococcal food poisoning
C. Traveler's diarrhea
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*D. Shigellosis
E. Disbiosis
224. The predominant virulence factor of Shigella dysenteria is a (an):
*A. Enterotoxin/cytotoxin
B. Potent endotoxin
C. Polysaccharide capsule
D. Flagella
E. Plasmid mediated antibiotic resistance factor
225. A 30-year-old woman developed watery diarrhea, little vomiting, nausea, and low-grade fever on the airplane
when she was returning from vacation in the Middle East. A stool culture reveals only lactose-positive colonies on
MacConkey's agar. Which one of the following organisms is the most likely to be the cause?
*A. Escherichia coli
B. Salmonella paratyphi A
C. Klebsiella pneumonia
D. Salmonella enteritides
E. Shigella flexneri
226 The patient’s faeces has a lot of erythrocytes and mucous. What infection did the doctor think about?
A. Enteric fever
B. Cholera
C. Escheriosis
*D. Dysentery
E. Salmonelloses
227. Cases of falling sick with dysentery are registered in a kinder garden. Name a possible way of transmission of
this infection?
A. Aero droplets
*B. Alimentary
C. Transplacental
D. Transmissive
E. Direct contact
228. Dysenterial bacteriophage was used by the doctor for a child infected with shigella dysentery. What was the
doctor’s intention in doing so?
A. Prophylaxis
B. Treatment
C. Phage typing
D. Specific prophylaxis
*E. Specific treatment
229. From the feces of the patient, pure culture of shigella was isolated. After identification of micro-organism, the
bacteriologist started serological variant for shigella. By which particularities was the micro-organism identified?
A. Biologic
*B. Antigenic
C. Morphologic
D. Biochemical
E. Sensitive antibiotics
230. Dirty hands are the main factor of transmission of bacterial dysentery. What microbe from the family
Enterobacteriaceae causes its infection?
A. Escherichia
B. Salmonella
C. Yersinia
*D. Shigella
E. Pseudomonada
231. Dysentery is transmitted only between human to human. How do we call its infection?
*A. Anthroponotic
B. Zoonotic
C. Anthropozoonotic
D. Mixed infection
E. Secondary infection
232. The main mechanism of transmission of dysentery is fecal-oral. Who might be the source of infection in this
disease?
A. Infected person
B. Carrier
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C. Acute carrier
D. Chronic carrier
*E. Infected person and the carrier
233. A 2 year old girl was hospitalized in the infection department. The person has the following clinical symptoms:
high temperature, abdominal pain, diarrhea with blood and mucus. The doctor diagnosed it to be dysentery. Which
material for investigation is necessary to be taken?
A. Urine
B. Bile
C. Blood
D. Saliva
*E. Faeces
234. The case of bacterial dysentery is registered in the student’s hostel. Which preparation should be used for
immediate specific prevention of its infection?
A. Antibiotic
B. Interferon
C. Diagnostic
D. Serum
*E. Bacteriophage
235. Bacteriologist sourced the feces of patient with dysentery on the differential – diagnostic nutrition medium with
methylene blue. Within 24 hrs on the surface of the medium, grew colorless colonies. Which nutrition medium did
the bacteriologist use for sourcing?
A. Endo medium
B. Ploskyrev's medium
C. Bismuth – sulphite agar
*D. Levin's medium
E. Bile broth
236. 50-year-old woman returned from India, where there was an epidemic of cholerae. She now has multiple
episodes of diarrhea, characterized as:
A. Watery diarrhea without blood, no PMNs in the stool, and growth of curved Gram-negative rods in the blood culture
*B. Watery diarrhea without blood, no PMNs in the stool, and no organisms in the blood culture
C. Bloody diarrhea, PMNs in the stools, and growth of curved Gram-negative rods in the blood culture
D. Bloody diarrhea, PMNs in the stools, and no organisms in the blood culture
E. All of following episodes can occur
237. The best enrichment medium for V. cholerae is:
A. Selenite broth
B. Peptone water
C. TCBS medium
D. Salt – yolk medium
*E. Alkaline peptone water
238. The best selective medium for V. cholerae is:
A. Selenite broth
*C. TCBS
E. Peptone water
239. Vibrio cholerae strains can be classified into how many serogroup on the base of O-Ag:
A. 3 (Ogava, Inaba, Hikojima)
B. 2 (El Tor and Classical)
C. It can not be classified because it is antigenically homogenous
*D.139 (01 -0139)
E. It can not be classified because it does not have O-Ag
240. Which one of the following exotoxins can stimulate hypersecretion of fluids and electrolytes?
A. Shiga-toxin of Shigella dysenteriae
B. Endotoxin of all gram-negative rods
*C. Choleragen of V. cholerae
D. Shiga – like toxin of EHEC
E. Staphylococcal enterotoxin
241. The predominant virulence factor of V. cholerae is a (an):
A. Polysaccharide capsule
*B. Phage-mediated exotoxin
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C. Flagellum
D. Plasmid- mediated antibiotic resistance
E. Enterotoxin with cytotoxicity
242. A 55-year-fisherman who was working on his boat in the waters of the Black Sea developed rapid progressive
cellulites, of the right leg, high fever and chill. Which one of the following organisms is the most likely to be the
cause?
A. Shigella dysenteriae
B. Vibrio cholerae
*C. Vibrio vulnificus
D. Salmonella paratyphi A
E. E. coli
243. Factors responsible for the pathogenicity of V. cholerae include all of the following EXCEPT:
A. Endotoxin
B. Mucinase
C. Flagellum
D. Heat – labile enterotoxin
*E. Capsular (K) antigen
244. A 40-year-old man develops diarrhea, vomiting, abdominal pain, and fever after he ate some raw sea food at the
party. Halophilic, hemolytic coma-shaped bacteria were isolated from the feces. Which one of the following
organisms is the most likely to be the cause?
A. Salmonella typhimurium
*B. Vibrio parahaemolyticus
C. Shigella flexneri
D. E. coli
E. Staphylococcus aureus
245. Which one of the following serotypes of V.cholera is of greatest medical importance?
A. O139
B. O90
*C. O1
D. O25
E. All of the above
246. 50-year-old woman returned from India, where there was an epidemic of cholerae. She now has multiple
episodes of diarrhea, characterized as:
*A. Rice water stools
B. Watery diarrhea with blood
C. Diarrhea with blood and leucocytes
D. Mucous stools
E. All the options are right
247. Vibrio cholerae strains can be classified into serogroup on the base of O-Ag:
*A. Ogava, Inaba, Hikojima
B. El Tor and Classical
C. It can not be classified because it is antigen common for all vibrions
D. It can be classified in five serogroup
E. It can not be classified because it does not have O-Ag
248. A 15 year old boy is admitted to the hospital. He suffers from abdominal pain, vomiting, rice water stools ten
times a day. What is the diagnosis?
A. Dysentery
B. Enteric fever
*C. Cholerae
D. Escherichioses
E. Staphylococcal infection
249. A patient is a 20-year-old woman who has just returned from a trip to Indonesia. Now she has rice water stools,
with mucus with 10 liters of liquid lost per day, nausea and marked dehydration. Which one of the following
exotoxins can stimulate the hypersecretion of fluids and electrolytes?
A. Shiga toxin of shigella dysenteriae
B. Staphylococcal enterotoxin
*C. Choleragen of V.cholerae
D. Salmonella endotoxin
E. Endotoxin of all gram negative rods.
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250. Cholera belongs to the group of exceptional chorentinnal infections. What is the main mechanism of
transmission for its infection?
A. Transmissive
B. Aerogenic
*C. Fecal-oral
D. Direct contact
E. Transplacental
251. Cholera mostly affects during summer. What is the main factor of transmission of this infection?
A. Food
*B. Water
C. Insects
D. Dirty hands
E. Private things
252. Cholera may be caused by two biological variants of V.cholerae. Which of them causes this infection in the
recent years in the world?
A. Classical Vibrio cholerae
*B. Vibrio El-Tor
C. Vibrio Al-Benzis
D. Vibrio proteus
E. Vibrio Mechnikovskii
253. There was an epidemic of cholerae in the city. Which method of expressed diagnostics can be used in this case?
A. Reaction of agglutination
B. Complement fixation test
C. Precipitation reaction
D. Reaction of neutralization
*E. Immunofluorescence reaction
254. Bacteriologist prepared glass smear from patient’s feces from cholera and stained according Gram. Which
form has got Vibrio cholerae?
A. Short rod
B. Long rod
C. Cocci
D. Diplococci
*E. Coma shaped form
255. Specific prevention of cholerae in the epidemic regions is used. What immunobiological preparation is used for
specific prophylaxis of this infection?
A. Serum
*B. Vaccine
C. Gamma-globulin
D. Interferon
E. Tetracycline
256. There was an epidemic of cholera in the city. Cholera may be caused by two biological variants of V. cholerae.
Who discovered classical V.cholerae?
A. Louie Pasteur
*B. Robert Koch
C. Gram
D. I.I.Mechnikov
E. Neisser
257. There was an epidemic of cholerae in the city. What preparation is used for non specific prevention of this
infection?
A. Serum
B. Vaccine
C. Gamma-globulin
D. Interferon
*E. Tetracycline
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