NACTE REGISTRATION NUMBER: ________________________________________

KILIMANJARO CHRISTIAN MEDICAL UNIVERSITY COLLEGE

(A Constituent College of Tumaini University Makumira)
FACULTY OF MEDICINE
DEPARTMENT OF HEALTH LABORATORY SCIENCES
BASIC CERTIFICATE IN MEDICAL LABORATORY SCIENCES
(NTA LEVEL 6)
CONTINUOUS ASSESSMENT TEST 1
MODULE CODE: MLT 06209
MODULE NAME: DIAGNOSTIC PATHOLOGY
MICROBIOLOGY IMMUNOLOGY

THEORY QUESTION PAPER

TIME 2:00 HOURS DATE: 08TH JULY, 2020
GENERAL INSTRUCTIONS
1. Read all instructions carefully
2. Write your examination number and NACTE registration number on each page of the
answer sheet you use
3. Attempt all questions. The responses should be written in the spaces provided as
instructed on each section
4. Cellular phones and unauthorised materials are NOT allowed in the examination room
5. Each essay question to be answered on not more than 2-3 hand written pages
6. No additional answer sheets will be provided
7. Failure to follow instructions will lead to loss of marks
8. This paper consists of (4) sections
FOR OFFICIAL USE ONLY
SECTION TYPES OF ALLOCATED SCORED INITIAL INITIAL
QUESTIONS MARKS MARKS SIGNATUR SIGNATUR
E OF E OF
MARKER VERIFIER
A MULTIPLE 20
CHOICE
B MULTIPLE 20
TRUE/FALS
E
C SHORT 30
ANSWERS
D ESSAY 30

TOTAL 100

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NACTE REGISTRATION NUMBER: ________________________________________

SECTION A: MULTIPLE CHOICE QUESTIONS 20 MARKS

Instructions:
 This section consists of Twenty (20) questions
 Encircle the most correct answer
 One (1) mark will be awarded for each correct answer

1. A 15 -year-old girl goes to the student health centre because of dysuria,

frequency, and urgency on urination for 24 hours. She has recently become sexually
active. On urinalysis, many polymorphonuclear cells are seen, gram shows gram
positive cocci. Suggest the tests which can be used to rule out the causative agent
A) Catalase and coagulase
B) Coagulase and Manitol fermentation
C) Citrate utilization and urease
D) Catalase and bacitracin sensitivity
E) Bile solubility test and optochin sensitivity

2. A 55-year-old homeless man with alcoholism presents with severe multilobar

pneumonia. He requires intubation and mechanical ventilation. A Gram stain of
his sputum reveals numerous polymorphonuclear leukocytes and gram-negative
rods that appear to have a capsule. The organism is a lactose fermenter on
MacConkey agar and is very mucoid. It is non motile and lysine decarboxylase
positive. What is the most likely organism causing this man’s illness?
A) Serratia marcescens
B) Enterobacter aerogenes
C) Escherichia coli
D) Klebsiella pneumoniae
E) Morganella morganii

3. An 18-year-old student has abdominal cramps and diarrhoea. The clinical

presentation suggests shigellosis or salmonellosis, What Media can be suitable for
performing stool culture?
A) XLD or SSA
B) MCA or SSA
C) BA or MEA
D) Citrate agar or CLED
E) XLD or CLED
4. A seven days old neonate was admitted to KCMC Hospital with a case of meningitis,
CSF gram staining shows gram negative rods, Also the organism shows pink
colonies on MCA. What is the most probable etiologic agent of this meningitis case?
A) E. coli
B) Neisseria meningitidis
C) Listeria monocytogenes
D) K. pneumoniae

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NACTE REGISTRATION NUMBER: ________________________________________

E) Group streptococci
5. A 25-year-old male presents with urethritis. The Gram stain shows intracellular
gram positive cocci, the organism is also oxidase opositive. The organism grows only
on enriched media like Chocolate agar. What is the most likely organism?
A) Chlamydia trachomatis
B) Ureaplasma species
C) Neisseria gonorrhoeae
D) Haemophilus ducreyi
E) Neisseria meningitidis
6. A urine culture from an 18-year-old woman with similar symptoms also grew a pure
culture of more than 100,000 colonies/ml of an organism on sheep blood agar (SBA)
and MacConkey’s agar (lactose fermenting colonies on MCA). The gram stain also
showed gram negative rods. What is the most likely organism?
A) Escherichia coli
B) Enterococcus species
C) Staphylococcus epidermidis
D) Staphylococcus saprophyticus
E) Proteus mirabilis
7. General-purpose media such as Nutrient broth, peptone water and nutrient agar
support growth of microorganisms, which do not have special nutritional
requirements such as,
A) Staphylococcus and Streptococci
B) Neisseria species
C) Enterobacteriaceae species
D) Hemophilus species
E) Treponema palidum
8. Alkaline Peptone water is used for cultivation of,
A) Vibrio Cholerae
B) Escherichia coli
C) Salmonella Typhi
D) Shigella species
E) Yersinia pestis
9. Which of the following culture media is used to differentiate sucrose fermenting
from non-sucrose fermenting Vibrio cholerae species.
A) TCBSA
B) XLD
C) DCA
D) MCA
E) CLED
10. Crystal violet blood agar (in which crystal violet is added) is an enriched, selective,
and differential medium for
A) Streptococcus pyogenes
B) Enterococcus species
C) Staphylococcus epidermidis
D) Staphylococcus saprophyticus
E) Streotococcus pneumoniae

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NACTE REGISTRATION NUMBER: ________________________________________

11. To avoid false positive results during performing catalase test, bacteria culture
grown on one of these media should not be used,
A) MCA
B) CLED
C) BA
D) Nutrient Agar
E) Nutrient broth
12. Which of the following is the right temperature in degrees Celsius scale for storage
of rabbit plasma if it is to be used 20 days to come,
A) -30
B) -80
C) -20
D) 2
E) 2 to 8
13. During performing Coagulase test by slide method colonies from one of the
following media should not be used,
A) BA
B) Salt Manitol Agar
C) Chocolate Agar
D) Nutrient Agar
E) CLED
14. After preparation of Blood Agar, one of the following organisms must be used to test
performance of the media
A) S aureus
B) Enterococcus faeclis
C) Staphylococcus epidermidis
D) Enterobacter aerogenes
E) Streptococci Viridans
15. Which of the following is a right temperature (in degrees Celcius) for incubation of
most pathogenic bacterial species,
A) 25 degrees
B) 35-38 degrees
C) 39 degrees
D) 36 degrees
E) 45-47 degrees
16. Mueller Hinton agar is a recommended medium for culture and sensitivity of
isolated organisms because
A) It is well defined.
B) Grows the organism rapidly
C) Does not lead to antagonism
D) Has stable PH
E) Is hypertonic.

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NACTE REGISTRATION NUMBER: ________________________________________

17. Which is a right temperature of the media to add blood during Blood Agar
preparation,
A) 60ᵒC
B) 50ᵒC
C) 45ᵒC
D) 40ᵒC
E) 55ᵒC
18. The suitable pressure for sterilization during autoclaving the culture media,
A) 20 PSI
B) 15 PSI
C) 30 PSI
D) 12PSI
E) 121 PSI
19. Bacterial growth is measured by determining number of bacteria through one of
the following methods
A) Viable count
B) Macroscopic counting of cells
C) Through culturing on selective media
D) Through amplification of nucleic acids
E) Counting cell fragments
20. A sample collected from the heart valve of a patient with endocarditis was cultured,
the organism grew was a gram positive cocci, and also Esculin positive. Which of the
following is most likely to be the causative agent.
A) Streptococcus pyogenes
B) Enterococcus species
C) Staphylococcus epidermidis
D) Staphylococcus saprophyticus
E) Streotococcus pneumoniae

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NACTE REGISTRATION NUMBER: ________________________________________

SECTION B: MULTIPLE TRUE/FALSE QUESTIONS 20 MARKS

Instructions:
 This section consists of Eight (8) questions with five options each.
 Write the word “TRUE” and NOT letter ‘T’ for a correct statement and the word
“FALSE” NOT letter ‘F’ for incorrect statement in the space provided before each
option.
 All responses should be in CAPITAL letters.
 Half (1/2) mark will be awarded for each correct response.
 Responses with letters ‘T’ and ‘F’ will not be awarded any mark.
 There will be a penalty of half (1/2) of allocated marks for responses with small
letters
1. Comment on the following statements regarding MCA
A. ___________ it is a selective media
B. ___________it is a differential media
C. ___________It can only support growth of Lactose fermenters
D. ___________It can only support growth of gram positive bacteria
E. ___________it support growth of all gram negative bacteria

2. Comment on the following statements regarding Chocolate agar

A. ___________It support only growth of fastidious organisms like s. pneumonie.
B. ___________ Can be used as a differential media
C. ___________it ca support all bacteria which grow on other laboratory culture
media
D. ___________it may inhibit growth of enterobacteriaceae
E. ___________ it is prepared by heating blood agar at 80ᵒC

3. Comment on the following statements regarding CAMP test

A. ___________Must be conducted on Blood Agar
B. ___________S aureus must be used as part of procedure
C. ___________it is used to identify S pyogenes
D. ___________can be conducted on nutrient agar
E. ___________it is used to identify S aglactiae

4. Comment on the following statements regarding Streptococci

A. ___________All are catalase positive
B. ___________Member species are classified base on hemolysis on blood agar
C. ___________all are coagulase positive
D. ___________All are gram positive cocci in clusters
E. ___________Member species are grouped based on the surface antigens on
their cells according to Rebeca lancefield

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NACTE REGISTRATION NUMBER: ________________________________________

5. Comment on the following about Nutrient agar

A. ____________ used to culture Neisseria species
B. _____________Acts as a general purpose media.
C. ____________can be used to make blood agar
D. _____________cannot be used to make enriched media
E. _____________cannot be used for lactose fermenters

6. Comment on the following about Streptococcus pyogenes

A. ____________It is bacitracin resistant
B. ____________it is optochin sensitive
C. ____________Camp test positive
D. ____________optochin sensitive
E. ____________it is hydrolysed by bile salts

7. Comment on the following about Streptococcus pneumoniae

A. ____________It is bacitracin resistant
B. ____________it is optochin sensitive
C. ____________Camp test positive
D. ____________optochin sensitive
E. ____________it is hydrolysed by bile salts

8. Comment on the following about Enteroccoci

A. ____________It is bacitracin resistant
B. ____________it is optochin sensitive
C. ____________Camp test positive
D. ____________optochin sensitive
E. ____________Esculin positive

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NACTE REGISTRATION NUMBER: ________________________________________

SECTION C: SHORT ANSWER QUESTIONS 30 MARKS

Instructions:
 This section consists of Six (6) questions.
 Write your answers in the space provided on each question.
 Write a readable handwrite; DIRTY WORK IS NOT ALLOWED.
1. Define the following terms 1mark each
a) Zone of inhibition
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b) Solute
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c) Solvent
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d) Antimicrobial sensitivity testing
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e) Autoclaving
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2. The manufacture’s explanation on the bottle of Nutrient agar states that ‘Weigh
2.8grams of powder for one litre of distilled water’.
i) Show how you would prepare 300ml of a media. 3marks
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ii) Mention two uses of Nutrient agar 2marks
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NACTE REGISTRATION NUMBER: ________________________________________

3. Briefly explain how the following media differentiate microorganisms

a) MCA. 2marks
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b) Blood agar. 2mark
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c) CLED 1 mark
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4. Briefly explain the principles behind the following microbiological tests
a) Catalase 2 marks
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b) Coagulase ( both bound and free) 3marks
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5. Briefly differentiate gram positive cocci. Start from genus level then concentrate on genus
staphylocci. Clearly mention the tests and results to differentiate species.
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6. Explain the principle behind gram staining. 5marks
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NACTE REGISTRATION NUMBER: ________________________________________

SECTION D: LONG ESSAY QUESTUIONS 30 MARKS

Instructions
 This section consists of three (3) questions which are supposed to be answered in a
narrative way.
 Write your answer on the empty papers provided.
1. Write an essay on types of media according to function. Include Quality control
organisms where applicable in your work. 10 marks
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NACTE REGISTRATION NUMBER: ________________________________________

2. Write an essay on quality control of general purpose culture media (use blood agar
as a reference). 10 marks
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NACTE REGISTRATION NUMBER: ________________________________________

3. Write an essay on Crystal violet Capsule Stain. Base on general description and
mechanism of action. 10 marks
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