Microbiology A Systems Approach Test Bank

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A 49-year-old countryman got an itching papule on the dorsum of his right hand. In the centre there is a vesicle with serosanginous exudate. Within the next 2 days the patient developed a painless edema of hand and forearm. On the 4th day the temperature rose to 38,5oC, in the right axillary region a large painful lymph node was found. One daybefore the onset of the disease the patient had examined a dead calf. What is the most likely diagnosis?

  • A. Cutaneous anthrax
  • B. Bubonic plague
  • C. Carbuncle
  • D. Lymphocutaneous tularemia
Correct Answer: D

Rationale: The most likely diagnosis is D: Lymphocutaneous tularemia. The key clues include exposure to a dead animal, vesicle with serosanginous exudate, painless edema progressing to lymph node involvement, and fever. Tularemia is caused by Francisella tularensis, commonly acquired through contact with infected animals. The characteristic ulcer at the site of entry, lymphadenopathy, and systemic symptoms point towards tularemia. Cutaneous anthrax (A) presents with a painless ulcer and black eschar. Bubonic plague (B) typically presents with buboes (swollen lymph nodes) and fever. Carbuncle (C) is a deep skin infection typically caused by Staphylococcus aureus.

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A disease that is generally present in a given population is:

  • A. pandemic
  • B. epidemic
  • C. sporadic
  • D. endemic
Correct Answer: D

Rationale: The correct answer is D: endemic. Endemic refers to a disease that is consistently present in a particular population or region at a relatively stable level. This means the disease is always present in that specific area. Pandemic (A) refers to a disease that spreads across multiple countries or continents. Epidemic (B) refers to a sudden increase in the number of cases of a disease above what is normally expected in that population. Sporadic (C) refers to occasional cases of a disease occurring irregularly in a population. Therefore, the correct choice is D as it specifically describes a disease that is generally present in a given population.

Bacterial infections of the female reproductive system include:

  • A. vaginitis, toxic shock syndrome, endometritis, and salpingitis
  • B. nephritis, endometritis, vaginitis, and pelvic inflammatory disease
  • C. toxic shock syndrome, nephritis, endometritis, and cystitis
  • D. endometritis, vaginitis, cystitis, and toxic shock syndrome
Correct Answer: A

Rationale: Rationale:
1. Vaginitis is a common bacterial infection in the female reproductive system.
2. Toxic shock syndrome can be caused by certain bacterial infections.
3. Endometritis is inflammation of the endometrium often due to bacterial infections.
4. Salpingitis is inflammation of the fallopian tubes, commonly caused by bacteria.

Summary:
- Choice B: Nephritis is a kidney infection, not related to female reproductive system infections.
- Choice C: Nephritis and cystitis are not specific to the female reproductive system.
- Choice D: Cystitis is a bladder infection, not typically considered part of female reproductive system infections.

A 40 year old man noticed a reddening and an edema of skin in the area of his neck that later developed into a small abscess. The incised focus is dense, yellowish-green. The pus contains white granules. Histological examination revealed drusen of a fungus, plasmatic and xanthome cells, macrophages. What type of mycosis is the most probable?

  • A. Actinomycosis
  • B. Aspergillosis
  • C. Candidosis
  • D. Sporotrichosis
Correct Answer: D

Rationale: The correct answer is D: Sporotrichosis. Sporotrichosis is caused by the fungus Sporothrix schenckii, which commonly presents as a subcutaneous infection. In the given case, the presence of a small abscess with yellowish-green pus containing white granules is indicative of sporotrichosis. The histological examination showing drusen of a fungus, plasmatic and xanthome cells, and macrophages further supports the diagnosis of sporotrichosis.

Choice A: Actinomycosis is a bacterial infection caused by Actinomyces species, not a fungal infection.
Choice B: Aspergillosis is caused by Aspergillus species and typically presents as a pulmonary infection, not a subcutaneous abscess as described in the case.
Choice C: Candidosis is caused by Candida species and usually presents as mucocutaneous infections, not a subcutaneous abscess with the

Group II category diseases as established by the NIAID include:

  • A. new foodborne pathogens
  • B. diseases considered eradicated
  • C. diseases used specifically as bioterrorism agents
  • D. reemerging diseases
Correct Answer: D

Rationale: The correct answer is D: reemerging diseases. Group II category diseases by the NIAID are those that have reemerged or have the potential to reemerge. This classification helps prioritize research and resources. Choice A is incorrect because new foodborne pathogens fall under different categories. Choice B is incorrect as eradicated diseases are not part of the reemerging group. Choice C is incorrect because bioterrorism agents are classified separately. Therefore, the correct answer is D as it aligns with the purpose of Group II category diseases.

Microscopic analysis of tissue sampling from affected area of mucous membrane of oral cavity revealed bacillus in form of accumulations that looked like a pack of cigarettes. Ziehl-Neelsen staining gives them red colour. What kind of pathogenic organism was most likely revealed in tissue sampling?

  • A. M.leprae
  • B. M.tuberculosis
  • C. A.bovis
  • D. A.israilii
Correct Answer: B

Rationale: The correct answer is B: M.tuberculosis. The description of bacillus in the form of accumulations resembling a pack of cigarettes and staining red with Ziehl-Neelsen staining is characteristic of Mycobacterium tuberculosis. M.leprae (Choice A) is associated with leprosy and does not typically appear as described. A.bovis (Choice C) is a type of Mycobacterium but is not typically found in the oral cavity. A.israilii (Choice D) is not associated with the characteristics mentioned in the question. Therefore, based on the specific characteristics described, M.tuberculosis is the most likely pathogenic organism revealed in the tissue sampling.

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