[MICROPARA BACTE] Part 6 - Gram Stain Limitations

a. Mycoplasma pneumoniae

Smallest free living organism which is pleomorphic and has no cell wall.

a. Mycoplasma pneumoniae

b. Ureplasma urealyticum

c. Chlamydia

d. Legionella pneumophila

e. Rickettsia

a. Mycoplasma pneumoniae

Identified in Diene's stain as fried egg colonies.

a. Mycoplasma pneumoniae

b. Ureplasma urealyticum

c. Chlamydia

d. Legionella pneumophila

e. Rickettsia

a. Mycoplasma pneumoniae

Causes atypical pneumonia or walking pneumonia which include mild symptoms such as fever, cough, dyspnea.

a. Mycoplasma pneumoniae

b. Ureplasma urealyticum

c. Chlamydia

d. Legionella pneumophila

e. Rickettsia

a. Macrolides

Treatment for Mycoplasma pneumoniae infection.

a. Macrolides

b. Doxycycline

c. Tetracycline

d. Chloramphenicol

b. Ureplasma urealyticum

Causes non-gonococcal urethritis in males, salpingitis and post-partum fever in females, and also associated with lung disease in premature infants of low birth weight.

a. Mycoplasma pneumoniae

b. Ureplasma urealyticum

c. Chlamydia

d. Legionella pneumophila

e. Rickettsia

c. Chlamydia

Obligate intracellular parasite which has differnt forms such as elementary body, extracellular, metabolically inert, infective form, reticulate body and intracellular reproductive form.

a. Mycoplasma pneumoniae

b. Ureplasma urealyticum

c. Chlamydia

d. Legionella pneumophila

e. Rickettsia

a. Chlamydia trachomatis

Can cause neonatal inclusion conjunctivitis, adult inclusion conjunctivitis, and chronic follicular conjunctivitis.

a. Chlamydia trachomatis

b. Chlamydia pneumoniae

c. Chlamydia psittaci

a. Chlamydia trachomatis

Can cause male genital infection manifested as penile discharge, dysuria, urethritis, asymptomatic infection in females, and self-limited genital ulcer characterized as swelling of inguinal lymph nodes known as lymphogranuloma venerum.

a. Chlamydia trachomatis

b. Chlamydia pneumoniae

c. Chlamydia psittaci

b. Chlamydia pneumoniae

Formerly known as Taiwan acute respiratory (TWAR) agent which causes atypical pneumonia and is risk factor for atherosclerosis.

a. Chlamydia trachomatis

b. Chlamydia pneumoniae

c. Chlamydia psittaci

c. Chlamydia psittaci

Transmitted from inhalation from dried bird excrement.

a. Chlamydia trachomatis

b. Chlamydia pneumoniae

c. Chlamydia psittaci

c. Chlamydia psittaci

Can cause parrot fever.

a. Chlamydia trachomatis

b. Chlamydia pneumoniae

c. Chlamydia psittaci

a. Doxycycline

Treatment for Chlamydia trachomatis.

a. Doxycycline

b. Amoxicillin

c. Macrolides

d. Ampicillin

c. Macrolides

Treatment for Chlamydia pneumoniae.

a. Doxycycline

b. Amoxicillin

c. Macrolides

d. Ampicillin

c. Macrolides

Treatment for Chlamydia psittaci.

a. Doxycycline

b. Amoxicillin

c. Macrolides

d. Ampicillin

e. All

Can cause atypical pneumonia.

a. Legionella

b. Chlamydia

c. Mycoplasma

d. a and b

e. All

a. Legionella pneumophila

May spread through air-conditioning units that use water cool air or any bodies of water.

a. Legionella pneumophila

b. Rickettsia rickettsi

c. Coxiella burnetti

d. Treponema pallidum

e. Leptospira interrogans

f. Borrelia burgdorferi

a. Legionella pneumophila

Can cause pontiac fever.

a. Legionella pneumophila

b. Rickettsia rickettsi

c. Coxiella burnetti

d. Treponema pallidum

e. Leptospira interrogans

f. Borrelia burgdorferi

c. Macrolides

Treatment for Legionella pneumophila infection.

a. Doxycycline

b. Amoxicillin

c. Macrolides

d. Ampicillin

b. Rickettsia

Obligate intracellular parasite which is vector transmitted and diagnosed by Weil-Felix reaction.

a. Legionella

b. Rickettsia

c. Coxiella

d. Treponema

e. Leptospira

f. Borrelia

e. Tetracycline, Chloramphenicol

Treatment for Rickettsia.

a. Doxycycline

b. Amoxicillin

c. Macrolides

d. Ampicillin, Gentamicin

e. Tetracycline, Chloramphenicol

a. Rickettsia rickettsi

Causes rocky mountain spotted fever and transmitted through tick.

a. Rickettsia rickettsi

b. Rickettsia akari

c. Rickettsia prowazekii

d. Rickettsia typhi

e. Orientia tsutsugamushi

b. Rickettsia akari

Causes Rickettsial pox and transmitted through mite.

a. Rickettsia rickettsi

b. Rickettsia akari

c. Rickettsia prowazekii

d. Rickettsia typhi

e. Orientia tsutsugamushi

c. Rickettsia prowazekii

Causes epidemic typhus and transmitted through louse.

a. Rickettsia rickettsi

b. Rickettsia akari

c. Rickettsia prowazekii

d. Rickettsia typhi

e. Orientia tsutsugamushi

d. Rickettsia typhi

Causes epidemic typhus and transmitted through flea.

a. Rickettsia rickettsi

b. Rickettsia akari

c. Rickettsia prowazekii

d. Rickettsia typhi

e. Orientia tsutsugamushi

e. Orientia tsutsugamushi

Causes scrub typhus and transmitted through chigger mite.

a. Rickettsia rickettsi

b. Rickettsia akari

c. Rickettsia prowazekii

d. Rickettsia typhi

e. Orientia tsutsugamushi

c. Coxiella burnetti

Previously under Rickettsia transmitted through ticks and causes Q fever.

a. Legionella pneumophila

b. Rickettsia rickettsi

c. Coxiella burnetti

d. Treponema pallidum

e. Leptospira interrogans

f. Borrelia burgdorferi

c. Tetracycline, Ciprofloxacin

Treatment for Coxiella burnetti infection.

a. Doxycycline

b. Amoxicillin

c. Tetracycline, Ciprofloxacin

d. Ampicillin, Gentamicin

e. Tetracycline, Chloramphenicol

LTB

Leptospira

Treponema

Borrelia

Spirochetes:

d. Treponema pallidum

Has "coiled hair" appearance with axial filament for corkscrew movement and causes hard painless chancre.

a. Legionella pneumophila

b. Rickettsia rickettsi

c. Coxiella burnetti

d. Treponema pallidum

e. Leptospira interrogans

f. Borrelia burgdorferi

a. Primary Syphilis

Hard, painless chancre that is elf-limiting and diagnosed through dark field microscopy.

a. Primary Syphilis

b. Secondary Syphilis

c. Latent Syphilis

d. Tertiary Syphilis

e. Congenital Syphilis

b. Secondary Syphilis

Condylomata lata or wart-like lesions on the genitals diagnose through serological testing.

a. Primary Syphilis

b. Secondary Syphilis

c. Latent Syphilis

d. Tertiary Syphilis

e. Congenital Syphilis

b. Penicillin

DOC for secondary syphilis caused by Treponema pallidum.

a. Doxycycline

b. Penicillin

c. Tetracycline, Ciprofloxacin

d. Ampicillin, Gentamicin

e. Tetracycline, Chloramphenicol

e. Congenital Syphilis

Acquired during the 1st trimester of pregnancy which causes intrauterine death and congenital abnormalities characterized by Hutchinson's triad.

a. Primary Syphilis

b. Secondary Syphilis

c. Latent Syphilis

d. Tertiary Syphilis

e. Congenital Syphilis

d. Treponema pallidum

May cause Jarisch-Herxheimer reaction.

a. Legionella pneumophila

b. Rickettsia rickettsi

c. Coxiella burnetti

d. Treponema pallidum

e. Leptospira interrogans

f. Borrelia burgdorferi

e. Leptospira interrogans

Transmitted through mucous membrane or breaks in the skin coming in contact to water with infected urine of rodents, cats, dogs, humans.

a. Legionella pneumophila

b. Rickettsia rickettsi

c. Coxiella burnetti

d. Treponema pallidum

e. Leptospira interrogans

f. Borrelia burgdorferi

e. Leptospira interrogans

Causes Weil's disease which include meningitis, renal failure, liver failure wherein cause of death is pulmonary hemorrhage.

a. Legionella pneumophila

b. Rickettsia rickettsi

c. Coxiella burnetti

d. Treponema pallidum

e. Leptospira interrogans

f. Borrelia burgdorferi

a. Doxycycline - 200mg OD for 3 to 5 days

Prophylaxis for leptospirosis.

a. Doxycycline

b. Penicillin

c. Ciprofloxacin

d. Ampicillin

e. Tetracycline

a. Doxycycline

Treatment for mild Leptospira infection.

a. Doxycycline

b. Penicillin

c. Ciprofloxacin

d. Ampicillin

e. Tetracycline

b. Penicillin

Treatment for moderate to severe symptoms caused by Leptospira infection.

a. Doxycycline

b. Penicillin

c. Ciprofloxacin

d. Ampicillin

e. Tetracycline

b. Leptospiuric

Leptospirosis infection in the urine causing acute kidney clearance manifested with high creatinine, low CrCl and low GFR.

a. Leptospiremic

b. Leptospiuric

c. Both

d. None of these

a. Leptospiremic

Leptospirosis infection in the blood causing fever and calf tenderness.

a. Leptospiremic

b. Leptospiuric

c. Both

d. None of these

c. Both

Weil's syndrome which is a severe leptospirosis.

a. Leptospiremic

b. Leptospiuric

c. Both

d. None of these

f. Borrelia burgdorferi

Bacteria from Ixodes tick which causes Lyme's disease manifested as bull's eye rash, erythema chronicum migrans or expanding rash.

a. Legionella pneumophila

b. Rickettsia rickettsi

c. Coxiella burnetti

d. Treponema pallidum

e. Borrelia recurrentis

f. Borrelia burgdorferi

f. Borrelia burgdorferi

Biggest bacteria which infection is treated with doxycycline.

a. Legionella pneumophila

b. Rickettsia rickettsi

c. Coxiella burnetti

d. Treponema pallidum

e. Borrelia recurrentis

f. Borrelia burgdorferi

e. Borrelia recurrentis

Causes relapsing fever or recurrent fever wherein endemic form is from tick bite (rodent host) and epidemic form is from body louse (human host).

a. Legionella pneumophila

b. Rickettsia rickettsi

c. Coxiella burnetti

d. Treponema pallidum

e. Borrelia recurrentis

f. Borrelia burgdorferi

a. Mycobacterium tubercolosis

Aka Koch's bacillus which airborne and the #8 leading cause of morbidity in the Philippines.

a. Mycobacterium tubercolosis

b. Mycobacterium avium-intracellulare complex

c. Mycobacterium leprae

a. Mycobacterium tubercolosis

Has tuberculin and mycolic acid which stimulates type IV hypersensitivity/ cell-mediated immunity causing damage to the body.

a. Mycobacterium tubercolosis

b. Mycobacterium avium-intracellulare complex

c. Mycobacterium leprae

a. Mycobacterium tubercolosis

May be associated with Pott's disease when it infects the vertebral column.

a. Mycobacterium tubercolosis

b. Mycobacterium avium-intracellular complex

c. Mycobacterium leprae

a. Mycobacterium tubercolosis

Cultured in Lowenstein-Jensen medium and diagnosed through sputum microscopy, Tuberculin Skin Test (TST)/Purified Protein Derivative (PPD)/ Mantoux Test.

a. Mycobacterium tubercolosis

b. Mycobacterium avium-intracellular complex

c. Mycobacterium leprae

e. All

Extrapulmonary TB may include:

a. Tuberculosis meningitis

b. Pott's disease

c. Scrofula

d. a and b

e. All

c. Scrofula

Most common extrapulmonary TB.

a. Tuberculosis meningitis

b. Pott's disease

c. Scrofula

d. a and b

e. All

a. Tuberculosis meningitis

CNS tuberculosis.

a. Tuberculosis meningitis

b. Pott's disease

c. Scrofula

d. a and b

e. All

b. Pott's disease

Vertebral column tuberculosis.

a. Tuberculosis meningitis

b. Pott's disease

c. Scrofula

d. a and b

e. All

f. None

Important presentation of TB except:

a. Cough for 2 weeks or more

b. Hemoptysis

c. Weight loss

d. Night sweats and easy fatigability

e. Dyspnea and chest or back pain

f. None

f. None

Pillars of DOTS except:

a. Political commitment

b. Case detection

c. Treatment partners

d. Steady drug supply

e. Recording and evaluation

f. None

e. None

1st line agents for TB except

a. Isoniazid (H)

b. Rifampicin (R)

c. Pyrazinamide (Z)

d. Ethambutol (E)

e. None

a. Isoniazid (H)

Isonicotinylhydrazide which inhibit the mycolic acid synthesis.

a. Isoniazid (H)

b. Rifampicin (R)

c. Pyrazinamide (Z)

d. Ethambutol (E)

b. Rifampicin (R)

Inhibit DNA dependent RNA polymerase which is cidal with slowly dividing bacilli.

a. Isoniazid (H)

b. Rifampicin (R)

c. Pyrazinamide (Z)

d. Ethambutol (E)

b. Rifampicin (R)

Main side effect is red orange discoloration of urine.

a. Isoniazid (H)

b. Rifampicin (R)

c. Pyrazinamide (Z)

d. Ethambutol (E)

c. Pyrazinamide (Z)

Has unknown MOA but is converted into pyrazinoic acid in acidic pH which has the activity.

a. Isoniazid (H)

b. Rifampicin (R)

c. Pyrazinamide (Z)

d. Ethambutol (E)

c. Pyrazinamide (Z)

Most hepatotoxic TB first line agent that causes hyperuricemia.

a. Isoniazid (H)

b. Rifampicin (R)

c. Pyrazinamide (Z)

d. Ethambutol (E)

c. Pyrazinamide (Z)

Added to make duration of treatment 6 months from 9 months.

a. Isoniazid (H)

b. Rifampicin (R)

c. Pyrazinamide (Z)

d. Ethambutol (E)

c. Pyrazinamide (Z)

Can be sterilizing agent.

a. Isoniazid (H)

b. Rifampicin (R)

c. Pyrazinamide (Z)

d. Ethambutol (E)

d. Ethambutol (E)

The only non-hepatotoxic TB first line agent.

a. Isoniazid (H)

b. Rifampicin (R)

c. Pyrazinamide (Z)

d. Ethambutol (E)

d. Ethambutol (E)

Inhibits arabinogalactan synthesis which is a cell wall component.

a. Isoniazid (H)

b. Rifampicin (R)

c. Pyrazinamide (Z)

d. Ethambutol (E)

d. Ethambutol (E)

The only static first line agent for TB.

a. Isoniazid (H)

b. Rifampicin (R)

c. Pyrazinamide (Z)

d. Ethambutol (E)

d. Ethambutol (E)

Causes dose dependent retrobulbar neuritis which is red green blindness.

a. Isoniazid (H)

b. Rifampicin (R)

c. Pyrazinamide (Z)

d. Ethambutol (E)

f. None

2nd line agents for TB except:

a. Streptomycin

b. Fluoroquinolone

c. Polypeptide, Thionamides

d. Cycloserine

e. P-aminosalicylic acid

f. None

e. Streptomycin

Only 1st line anti-TB agent that is parenteral.

a. Isoniazid (H)

b. Rifampicin (R)

c. Pyrazinamide (Z)

d. Ethambutol (E)

e. Streptomycin

a. Monoresistant TB

Resistant to one 1st line agent.

a. Monoresistant TB

b. Polydrug resistant TB

c. Multidrug resistant TB (MDR-TB)

d. Extensively drug resistant TB (XDR-TB)

b. Polydrug resistant TB

Resistant to >1 1st line agent.

a. Monoresistant TB

b. Polydrug resistant TB

c. Multidrug resistant TB (MDR-TB)

d. Extensively drug resistant TB (XDR-TB)

c. Multidrug resistant TB (MDR-TB)

Resistant to at least both HR.

a. Monoresistant TB

b. Polydrug resistant TB

c. Multidrug resistant TB (MDR-TB)

d. Extensively drug resistant TB (XDR-TB)

d. Extensively drug resistant TB (XDR-TB)

Resistant to at least any fluoroquinolone and aminoglycoside combined.

a. Monoresistant TB

b. Polydrug resistant TB

c. Multidrug resistant TB (MDR-TB)

d. Extensively drug resistant TB (XDR-TB)

b. Mycobacterium avium-intracellular complex

2 combined species which causes TB in AIDS patients (AIDS-defining illness: usually seen in patients with advanced HIV infection/ AIDS) and treated with Macrolides + Rifampicin and Ethambutol.

a. Mycobacterium tubercolosis

b. Mycobacterium avium-intracellular complex

c. Mycobacterium leprae

c. Mycobacterium leprae

Obligate intracellular parasite with predisposition to cooler parts of the body and is also known as Hansen's bacillus.

a. Mycobacterium tubercolosis

b. Mycobacterium avium-intracellular complex

c. Mycobacterium leprae

c. Mycobacterium leprae

Isolated in armadillo foot pad and transmitted through nasal discharge from untreated lepromatous leprosy patients.

a. Mycobacterium tubercolosis

b. Mycobacterium avium-intracellular complex

c. Mycobacterium leprae

a. Tuberculoid leprosy

Strong cell-mediated immunity.

a. Tuberculoid leprosy

b. Lepromatous leprosy

b. Lepromatous leprosy

Weak cell-mediated immunity.

a. Tuberculoid leprosy

b. Lepromatous leprosy

a. Tuberculoid leprosy

Positive in lepromin skin test.

a. Tuberculoid leprosy

b. Lepromatous leprosy

b. Lepromatous leprosy

Negative in lepromin skin test.

a. Tuberculoid leprosy

b. Lepromatous leprosy

a. Tuberculoid leprosy

Low paucibacillary.

a. Tuberculoid leprosy

b. Lepromatous leprosy

b. Lepromatous leprosy

High multibacillary

a. Tuberculoid leprosy

b. Lepromatous leprosy

a. Tuberculoid leprosy

Hyposthetic hypopigmented skin lesions.

a. Tuberculoid leprosy

b. Lepromatous leprosy

b. Lepromatous leprosy

Leonie facies, saddle nose, nodular skin lesions.

a. Tuberculoid leprosy

b. Lepromatous leprosy

f. All - Rifampicin + Dapsone + Clofazimine

Treatment for lepromatous leprosy.

a. Rifampicin

b. Dapsone

c. Clofazimine

d. a and b

e. b and c

f. All

d. a and b - Rifampicin + Dapsone

Treatment for tuberculoid leprosy.

a. Rifampicin

b. Dapsone

c. Clofazimine

d. a and b

e. b and c

f. All

e. Leptospira interrogans

Ice tongs, shephera’s crook, question mark shaped

a. Legionella pneumophila

b. Rickettsia rickettsi

c. Coxiella burnetti

d. Treponema pallidum

e. Leptospira interrogans

f. Borrelia burgdorferi

b. Microscopic Agglutination Test (MAT)

What is the gold standard serological test for the diagnosis of Leptospirosis?

a. Macroscopic Agglutination Test

b. Microscopic Agglutination Test (MAT)

c. Monoclonal Antibody Titration

d. Mycoplasma Antigen Test

b. Blood, cerebrospinal fluid (CSF), and urine

To isolate Leptospira interrogans, which of the following represents the correct combination of specimens that can be cultured?

a. Blood, stool, and sputum

b. Blood, cerebrospinal fluid (CSF), and urine

c. Urine, bone marrow, and pleural fluid

d. Sputum, CSF, and peritoneal fluid

c. Latent stage

Which phase of a Treponema pallidum infection is defined by the complete absence of clinical symptoms despite positive serology?

a. Primary stage

b. Secondary stage

c. Latent stage

d. Tertiary stage

d. Tertiary Syphilis

A patient presents with chronic granulomatous lesions (gummas) on their skin and bones, along with signs of central nervous system involvement (neurosyphilis). Which stage of syphilis are these features classic for?

a. Primary Syphilis

b. Secondary Syphilis

c. Latent Syphilis

d. Tertiary Syphilis

c. Darkfield microscopy

Classic diagnostic technique used to directly visualize motile Treponema pallidum spirochetes from active lesion exudates?

a. Gram stain

b. Acid-fast stain

c. Darkfield microscopy

d. Wright-Giemsa stain

c. Mycobacterium avium

Which of the following Mycobacterium species is the key component of MAC (Mycobacterium Avium Complex), a major opportunistic pathogen that causes disseminated disease in late-stage HIV/AIDS patients?

a. Mycobacterium tuberculosis

b. Mycobacterium bovis

c. Mycobacterium avium

d. Mycobacterium leprae

d. Mycobacterium bovis

Which Mycobacterium species is famously classified as a milk-borne pathogen because it can be transmitted to humans through the consumption of unpasteurized milk from infected cows?

a. Mycobacterium avium

b. Mycobacterium tuberculosis

c. Mycobacterium leprae

d. Mycobacterium bovis

b. Children

Primary PTB (initial infection) is most commonly seen in which population?

a. Adults

b. Children

c. Elderly

d. Immunocompromised

c. Ghon complex

What is the classic parenchymal lung lesion and lymph node combination seen in Primary PTB?

a. Gumma

b. Aschoff body

c. Ghon complex

d. Seller's block

b. Reactivation

Postprimary / Secondary PTB in adults is primarily caused by which mechanism?

a. Acute reinfection

b. Reactivation

c. Spontaneous mutation

d. Environmental inhalation

b. Apex

Which anatomical region of the lungs does Secondary PTB characteristically affect?

a. Base

b. Apex

c. Middle lobe

d. Pleural cavity