microbiology mcqs

 The human microbiome:

1. The colon is the site of the largest number of normal flora bacteria. Which of the following bacteria is
found in the greatest number in the colon?

(A) Bacteroides fragilis

(B) Clostridium perfringens

(C) Enterococcus faecalis

(D) Escherichia coli

(E) Lactobacillus species

2. A 76-year-old woman with a prosthetic (artificial) hip comes to you complaining of fever and pain in
that joint. You are concerned about an infection by S. epidermidis. Using your knowledge of normal
flora, what is the most likely source of this organism?

(A) Dental plaque

(B) Mouth

(C) Skin

(D) Stomach

(E) Vagina

3. Your patient is a 30-year-old woman with a previous history of rheumatic fever who has had fever for
the past 2 weeks. On examination, you find a new heart murmur. You suspect endocarditis and do a
blood culture, which grows a viridans group Streptococcus later identified as S. sanguinis. Using your
knowledge of normal flora, what is the most likely source of this organism?

(A) Duodenum

(B) Skin

(C) Throat

(D) Urethra

(E) Vagina

4. An outbreak of postsurgical wound infections caused by S. aureus has occurred in the hospital. The
infection control team was asked to determine whether the organism could be carried by one of the
operating room personnel. Using your knowledge of normal flora, which of the following body sites is
the most likely location for this organism?

(A) Colon

(B) Gingival crevice

(C) Mouth

(D) Nose

(E) Throat

  Host defence:
1. Which one of the following host defense processes is the MOST important in preventing the action of
exotoxins?

(A) Binding of cytokines to exotoxin-specific receptors inhibits the attachment of exotoxins.

(B) Degradation of exotoxins by the membrane attack complex of complement.

(C) Lysis of exotoxins by perforins produced by cytotoxic T cells.

(D) Neutralization of exotoxins by antibody prevents binding to target cell membrane.

(E) Phagocytosis of exotoxins by neutrophils and subsequent destruction by hypochlorite.

2. An inflammatory response in the skin is characterized by erythema (redness). Which of the following
is the most important cause of this erythema?

(A) C3b component of complement

(B) Gamma interferon

(C) Histamine

(D) Hypochlorite

(E) Superoxide

3. A 1-year-old child with repeated infections was diagnosed with chronic granulomatous disease (CGD).
A defect in which of the following is the cause of CGD?

(A) Gamma interferon receptor

(B) LFA-integrins

(C) Mannose-binding protein

(D) NADPH oxidase

(E) Nitric oxide

4. Opsonization is the process by which:

(A) Bacteria are made more easily phagocytized.

(B) Chemokines attract neutrophils to the site of infection.

(C) Neutrophils migrate from the blood through the endothelium to reach the site of infection.
(D) The acute-phase response is induced.

(E) The alternate pathway of complement is activated.

 Pathogenesis
1. Handwashing is an important means of interrupting the chain of transmission from one person to
another. Infection by which of the following bacteria is most likely to be interrupted by handwashing?

(A) Borrelia burgdorferi

(B) Legionella pneumophila

(C) Staphylococcus aureus

(D) Streptococcus agalactiae (group B Streptococcus)

(E) Treponema pallidum

2. Vertical transmission is the transmission of organisms from mother to fetus or newborn child.
Infection by which of the following bacteria is most likely to be transmitted vertically?

(A) Chlamydia trachomatis

(B) Clostridium tetani

(C) Haemophilus influenzae

(D) Shigella dysenteriae

(E) Streptococcus pneumoniae

3. The cells involved with pyogenic inflammation are mainly neutrophils, whereas the cells involved
with granulomatous inflammation are mainly macrophages and helper T cells. Infection by which of
the following bacteria is most likely to elicit granulomatous inflammation?

(A) Escherichia coli

(B) Mycobacterium tuberculosis

(C) Neisseria gonorrhoeae

(D) Streptococcus pyogenes

(E) Staphylococcus aureus

4. Which of the following sets of properties of exotoxins and endotoxins is correctly matched?

(A) Exotoxins—polypeptides; endotoxins—lipopolysaccharide

(B) Exotoxins—weakly antigenic; endotoxins—highly antigenic

(C) Exotoxins—produced only by gram-negative bacteria; endotoxins—produced only by gram-positive

bacteria
(D) Exotoxins—weakly toxic per microgram; endotoxins— highly toxic per microgram

(E) Exotoxins—toxoid vaccines are ineffective; endotoxins—toxoid vaccines are effective

5. Which of the following sets consists of bacteria both of which produce exotoxins that increase cyclic
AMP within human cells?

(A) Vibrio cholerae and Corynebacterium diphtheriae

(B) Clostridium perfringens and Streptococcus pyogenes

(C) Escherichia coli and Bordetella pertussis

(D) Corynebacterium diphtheriae and Staphylococcus aureus

(E) Bacillus anthracis and Staphylococcus epidermidis

6. Which of the following sets of bacteria produces exotoxins that act by ADP-ribosylation?

(A) Corynebacterium diphtheriae and Escherichia coli

(B) Clostridium perfringens and Staphylococcus aureus

(C) Clostridium tetani and Bacillus anthracis

(D) Enterococcus faecalis and Mycobacterium tuberculosis

(E) Escherichia coli and Streptococcus pyogenes

7. Which of the following bacteria produces an exotoxin that inhibits the release of acetylcholine at
the neuromuscular junction?

(A) Bacillus anthracis

(B) Bordetella pertussis

(C) Clostridium botulinum

(D) Corynebacterium diphtheriae

(E) Escherichia coli

8. A 25-year-old man with abdominal pain was diagnosed with acute appendicitis. He then had a
sudden rise in temperature to 39°C and a sudden fall in blood pressure. Which of the following is the
most likely cause of the fever and hypotension?

(A) An exotoxin that ADP-ribosylates elongation factor-2

(B) An exotoxin that stimulates production of large amounts of cyclic AMP

(C) An endotoxin that causes release of tumor necrosis factor

(D) An endotoxin that binds to a class I MHC protein

(E) An exoenzyme that cleaves hyaluronic acid

9. Several biotech companies have sponsored clinical trials of a drug consisting of monoclonal
antibody to lipid A. Sepsis caused by which of the following sets of bacteria is most likely to be
improved following administration of this antibody?

(A) Bordetella pertussis and Clostridium perfringens

(B) Escherichia coli and Neisseria meningitidis

(C) Pseudomonas aeruginosa and Bacillus anthracis

(D) Staphylococcus epidermidis and Staphylococcus aureus

(E) Streptococcus pneumoniae and Staphylococcus aureus

10. Regarding endotoxin, which of the following is the MOST accurate?

(A) Endotoxin is a polypeptide, the toxic portion of which consists of two d-alanines.

(B) Endotoxin is produced by both gram-positive cocci and gram-negative cocci.

(C) Endotoxin acts by binding to class II MHC proteins and the variable portion of the beta chain of the T-
cell receptor.

(D) Endotoxin causes fever and hypotension by inducing the release of interleukins such as
interleukin-1 and tumor necrosis factor.

(E) The antigenicity of endotoxin resides in its fatty acid side chains.

 ANTIMICROBIAL DRUG
1. Cefazolin is often given prior to surgery to prevent postsurgical wound infections. Which of the
following best describes the mode of action of cefazolin?

(A) It acts as an electron sink depriving the bacteria of reducing power.

(B) It binds to the 30S ribosome and inhibits bacterial protein synthesis.

(C) It inhibits transcription of bacterial mRNA.

(D) It inhibits transpeptidases needed to synthesize peptidoglycan.

(E) It inhibits folic acid synthesis needed to act as a methyl donor.

2. Which of the following drugs inhibits bacterial nucleic acid synthesis by blocking the production of
tetrahydrofolic acid?

(A) Ceftriaxone

(B) Erythromycin

(C) Metronidazole

(D) Rifampin

(E) Trimethoprim
3. Regarding both penicillins and aminoglycosides, which of the following is the most accurate?

(A) Both act at the level of the cell wall.

(B) Both are bactericidal drugs.

(C) Both require an intact β-lactam ring for their activity.

(D) Both should not be given to children under the age of 8 years because damage to cartilage can occur.

(E) They should not be given together because they are antagonistic.

4. Listed below are drug combinations that are used to treat certain infections. Which of the following
is a combination in which both drugs act to inhibit the same metabolic pathway?

(A) Ceftriaxone and azithromycin

(B) Isoniazid and rifampin

(C) Penicillin G and gentamicin

(D) Sulfonamide and trimethoprim

5. Regarding penicillins and cephalosporins, which of the following is the most accurate?

(A) Cleavage of the β-lactam ring will inactivate penicillins but not cephalosporins.

(B) Penicillins act by inhibiting transpeptidases but cephalosporins do not.

(C) Penicillins and cephalosporins are both bactericidal drugs.

(D) Penicillins and cephalosporins are active against grampositive cocci but not against gram-negative
rods.

(E) Renal tubule damage is an important adverse effect caused by both penicillins and cephalosporins.

6. Regarding antimicrobial drugs that act by inhibiting nucleic acid synthesis in bacteria, which of the
following is the most accurate?

(A) Ciprofloxacin inhibits RNA polymerase by acting as a nucleic acid analogue.

(B) Rifampin inhibits the synthesis of messenger RNA.

(C) Sulfonamides inhibit DNA synthesis by chain termination of the elongating strand.

(D) Trimethoprim inhibits DNA polymerase by preventing the unwinding of double-stranded DNA.

7. Regarding aminoglycosides and tetracyclines, which of the following is the most accurate?

(A) Both classes of drugs are bactericidal.

(B) Both classes of drugs inhibit protein synthesis by binding to the 30S ribosomal subunit.

(C) Both classes of drugs inhibit peptidyl transferase, the enzyme that synthesizes the peptide bond.
(D) Both classes of drugs must be acetylated within human cells to form the active antibacterial
compound.

(E) Both classes of drugs cause brown staining of teeth when administered to young children.

8. The next three questions ask about the adverse effects of antibiotics, which are an important
consideration when deciding which antibiotic to prescribe. Which antibiotic causes significant
neurotoxicity and must be taken in conjunction with pyridoxine (vitamin B6) to prevent these
neurologic complications?

(A) Amoxicillin

(B) Ceftriaxone

(C) Isoniazid

(D) Rifampin

(E) Vancomycin

9. Of the following antibiotics, which causes the most phototoxicity (rash when exposed to sunlight)?

(A) Nafcillin

(B) Ciprofloxacin

(C) Gentamicin

(D) Metronidazole

(E) Sulfamethoxazole

10. Which of the following antibiotics causes “red man” syndrome?

(A) Azithromycin

(B) Doxycycline

(C) Gentamicin

(D) Sulfamethoxazole

(E) Vancomycin

 Sterilization and disinfectants

1. Regarding sterilization and disinfection, which one of the following is the most accurate statement?

(A) Seventy percent alcohol is a better antiseptic than iodine, so 70% alcohol should be used to disinfect
the skin prior to drawing a blood culture rather than iodine.

(B) Disinfectants kill both bacterial cells and bacterial spores.

(C) During sterilization by autoclaving, the temperature must be raised above boiling in order to kill
bacterial spores.
(D) Transmission of milk-borne diseases can be prevented by pasteurization, which kills both bacterial
cells and spores.

(E) Ultraviolet light used in the operating room to disinfect the room kills bacteria primarily by causing
oxidation of lipids in the cell membrane.

2. Which one of the following chemicals is used to sterilize heatsensitive materials, such as surgical
instruments, in the hospital?

(A) Benzalkonium chloride

(B) Phenol

(C) Ethylene oxide

(D) Thimerosal

(E) Tincture of iodine