Download PGI PG 2020 May Micro Solved Question Paper

1. All of the following are part of
innate immunity except:
a) Complement

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b) NK cells
c) Macrophages
d) T cells
e) None
Correct Answer - D

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Ans. (d) T cells Ref Harrison 17/e; p 2021, 2031, 18/e, p 2651.
2668 Components of the Adaptive Immune System
Thymus-derived (T) lymphocytes - T cell precursors in
the thymus; naive mature T lymphocytes before antigen
exposure; memory T lymphocytes after antigen contact;

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Cellular
helper T lymphocytes for B and T cell responses;
cytotoxic T lymphocytes that kill pathogen- infected
target cells.
Bone-marrow-derived (B) lymphocytes - B cell precursors

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Humoral in bone marrow; naive B cells prior to antigen recognition;
memory B cells after antigen contact; plasma cells that
secrete specific antibody.
Cytokines Soluble proteins that direct focus and regulate
specific T versus B lymphocyte immune responses.

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Major Components of the Innate Immune System
Pattern
C type lectins, leucine-rich proteins, scavenger
recognition
receptors, pentraxins, lipid transferases;

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receptors(PRR) integrins
a-Defensins, 8-defensins, cathelin,

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Antimicrobial
protegrin, granulysin, histatin, secretory
peptides
leukoprotease inhibitor, and probiotics
Macrophages, dendritic cells, NK cells, NK-

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Cells
T cells, neutrophils, eosinophils, mast
cells, basophils, and epithelial cells.
Classic and altAutocrine, paracrineernative
Complement

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complement pathway, and proteins that
components
bind complement components
Autocrine, paracrine, endocrine cytokines that
mediate host defence and inflammation, as well

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Cytokines
as recruit, direct, and regulate adaptive immune
responses

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2. Which is true about syphilis:
a) VDRL test detects antibodies
b) Jarisch herxheimer reaction-IgE mediated

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c) Penicillin is preferred treatment for primary and
secondary stage
d) RPR can be done for CSF
e) None
Correct Answer - A:C

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Ans (a and c) VDRL test detects antibodies, Penicillin is
preferred treatment for primary and secondary stage
Jarisch: Herxheimer reaction is mediated by release of lipoproteins,
cytokines and immune complex.
Evaluation for neurosyphilis:

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Pleocytosis, increased protein concentration
CSF VDRL is highly specific and when reactive is considered
diagnostic of neurosyphilis
Patient with RPR titre 1:32 are at higher risk for developing
neurosyphilis.

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3. True regarding leptospirosis is?
a) Rats are the only reservoirs

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b) Fluoroquinolones are the DOC
c) Person to person transmission rare
d) Hepatorenal syndrome occurs in 50% cases
e) None
Correct Answer - C

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Ans. (c) i.e. Person to person transmission rare
Note: - Weil syndrome develops in 5-10% of infected
individual Treatment of choice for leptospirosis is Ampicillin
Doxycycline is the drug of choice for chemoprophylaxis.

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4. Function of reverse transcriptase:
a) RNA dependent DNA synthesis
b) DNA dependent RNA synthesis
c) DNA dependent DNA synthesis

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d) RNA dependent RNA synthesis
e) Involved in protein synthesis
Correct Answer - A
Ans. a. RNA dependent DNA synthesis

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5. True about staphylococcus aureus -
a) Micro aerophilic
b) Produce lemon yellow colonies

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c) Grows with 10% Nacl
d) All are true
e) None
Correct Answer - C
Ans. is 'c' i.e., Grows with 10% Nacl [Ref: Ananthanarayan 9th

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le p. 199-202]S
staphylococcus is facultative anaerobe. Optimum pH for growth is
7.4 - 7-6 and optimum temperature is 37?C.
Staph aureus produces golden yellow pigment, which is maximum at
22?C.

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Most of the staphylococcus species grow in the presence of 10%
NaCl.
On nutrient agar slope there is characteristic Oil paint appearance.
For primary isolation, sheep blood agar is recommended. Human
blood should not be used at it may contain antibodies or other

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inhibitors
Staph aureus
Golden yellow colonies
Staph epidermidis (also called staph albus) White colonies
Staph citrus Lemon yellow colonies

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6. Gram negative cell wall contains?
a) Peptidoglycan
b) Lipopolysaccharides
c) Lipids

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d) Teichoic acid
e) All of the above
Correct Answer - A:C
Ans. is 'a' i.e., Peptidoglycan & 'c' i.e., Lipids
[Ref: Ananthanarayan 9th/e p. 15 & 8th/e p. 17; Bailey &

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Scott's diagnostic microbiology p. 19]
Lipoploysacharide are found in the outer membrane of cell wall, not
in cell wall itself
The peptidoglycan layer of gram positive bacteria is thick and
contain teichoic acid, while in gram negative bacteria it is thin and

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does not contain teichoic acid.
cell wall is composed of mucopeptide (peptidoglycan or murein)
scaffolding formed by N acetyl glucosamine and N acetyl
muramic acid molecules alternating in chains, which are cross
linked by peptide chains.

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The outer membrane is a bilayered structure composed of
lipopolysaccharide.
Scattered throughout the lipopolysaccharide macromolecules are
protein structures called porins. These control the passage of
nutrients and other solutes, including antibiotics, through outer

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membrane.

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7. Which of the following organism(s) is/are
not cultivable?
a) Mycobacterium leprae
b) Klebsiella rhinoscleromatis
c) Rhinosporidium seeberi

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d) Pneumocystis jiroveci
e) None
Correct Answer - C:D
Ans. is 'c' i.e., Rhinosporidium seeberi,
The life cycle of pneumocystis probably involves sexual and asexual

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reproduction, although definitive proof awaits the development of a
reliable culture system
Rhinosporidium seeberi has not been cultivated in media.
M. leprae is obligate intracellular organism, thus cannot be grown in
cell free culture medium. Two animals are used for cultivation.

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8. Halophilic vibrios include?
a) Vibrio cholare
b) Vibrio parahymolyticus
c) Vibrio vulnificus
d) Vibrio alginolyticus

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e) Vibrio mimicus
Correct Answer - B:C:D
Ans. is 'b' i.e., Vibrio parahymolyticus,
Vibrios that have a high requirement of sodium chloride are known
as halophilic vibrios. They are abundant in coastal water

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throughout the world.
All vibrios are halophilic except V cholerae and V mimicus.
Examples are - V. Parahaemolyticus, V. fluvialis, V. alginolyticus, V.
Hallisae, V. Vulnificus, V. furnissii, V. damsel.
Vibrio alginolyticus is the most salt tolerant (most halophilic) species

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of vibrio.

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9. Lymphatic filariasis is caused by?
a) Loa loa

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b) Wuchreria bacrofti
c) Brugia malayi
d) Brugia timori
e) Onchocerca volvulus
Correct Answer - B:C:D

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Ans. is 'b' i.e., Wuchreria bacrofti, 'c' i.e., Brugia malayi & 'd' i.e.,
Brugia timori [Ref: Harrison 19th/e p. 1418 & 17th/e p.1324,
Panikar 6th le p.196]
Filariasis is a parasitic and infectious tropical disease, that is caused
by filarial nematode worms.

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Lymphatic filariasis : Wuchereria bancrofti, Brugia malayi,Brugia
timori.
Lymphatic filariasis is caused by Wauchereria bancrofti: Most
commonly(Bancroftian filariasis); and B. malayi & B. timori
(Brugian filariasis).

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Man is the definitive host and mosquito is the intermediate host.
Microfilariae resides in the blood and adult worm in the lymphatics.
The inflammatory phase is characterized by Lymphangitis,
lymphadenitis and adenolymphangitis. It lasts for a few days, then
subsides spontaneously & recurs at irregular intervals for a period of

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weeks to months.

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10. Fever with rash is caused by?
a) Streptococcus pyogens
b) Staphylococcus aureus
c) Meningococcus
d) Vibrio cholera

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e) Salmonella typhi
Correct Answer - A:B:C:E
Ans. is 'a' i.e., Streptococcus pyogens, 'b' i.e. Staphylococcus
aureus, 'c' i.e
Vesiculobullous eruptions are caused by Scarlet fever, Streptococcal

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toxic shock syndrome, Staphylococcal toxic shock syndrome,
Staphylococcal scalded-skin syndrome
Central distributed maculopapular eruption are caused by Scarlet
fever, Typhus, Rickettsial spotted fever, Ehrlichiosis, Typhoid
fever (S. typhi), Leptospirosis,

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11. Larva in stool can be seen in?
a) Echinococcus granulosus
b) Ankylostoma duodenale

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c) Ascaris lumbricoides
d) Strongyloides stercoralis
e) Trichinella spiralis
Correct Answer - B:D:E
Ans. is 'b' i.e., Ankylostoma duodenale, 'd' i.e. Strongyloides

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stercoralis & `e' i.e. Trichinella spiralis [Ref Chatterjee 12thie
p. 172; Panikar 7th/e p. 162; Rajesh karyakarte p. 121
Infective forms of helminthes in stool (larva)
. Strongvloides stercoralis (filariform larva)
. Ancylostoma duodenale (filariform larva)

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. Nector americans (filariform larva)
. Trichinella spiralis (encysted larva)
Infective forms of helminthes in stool (EGGS)
. T-solium
. Echinococcus granulosus

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. H. Nana
. Ascaris lumbricoidus(enibryonated ergs)
. Enterobius (embryonated egg)
. Trichuris Trichiura (embryonated egg)

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12. Which of the following is false regarding
electron microscopy?

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a) There is arisk of radiation leakage
b) Can magnify upto 30,000 times
c) Both fixed and living specimens can be studies
d) Vaccume is not required for proper functioning
e) Black and white image

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Correct Answer - C:D
Ans. is 'c' i.e., Both fixed and living specimens can be studies
& 'd' i.e. Vaccume is not required for proper functioning [Ref
Essentials of medical microbiology]

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13. Antibody present in antigen binding site
of B-cells?

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a) Ig G
b) Ig M
c) Ig A
d) Ig D
e) Ig E

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Correct Answer - B:D
Ans. is 'b' i.e., IgM & 'd' i.e. IgD [Ref Ananthanarayan 9thle p. 136
& 8thle p. 100] B-cells
B cells are part of adaptive immunity. B cells constitute 10% to 20%
of the circulating peripheral lymphocytes. B cells originate as well

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as mature in bone marrow.
Ig M and Ig D, present on the surface of all naive B cells, constitute
the antigen binding component of B-cell receptor complex.
Combination of cell membrane bound Ig M or Ig D with the
corresponding antigen leads to specific stimulation of the B cells -

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either activation and cloning to produce antibody, or suppression.

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14. Which of the following is not associated
with Borrelia burgdorferi?
a) Relapsing fever

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b) Lyme disease
c) Vincent's angina
d) Transmitted by ixodid tick bite
e) Culture in BSK medium
Correct Answer - A:C

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Ans. is 'a' i.e., Relapsing fever & 'c' i.e. Vincent's angina [Ref:
Ananthanarayan Whie p. 380 & 8thle p. 381]
Lyme disease : Caused by B. burgdorferi transmitted by the
bite of Ixodid ticks
Relapsing fever : Caused by B. recurrentis, B duttoni, B.

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hermsii, B. Parkeri, B. turicatae, B. persica, B. hispanica.
Vincent's angina : Caused by B. vincenti.
The culture of B. burgdorferi in Barbour - Stoenner - kelly (BSK)
medium permits definitive diagnosis, but this complex method
has been used only research studies.

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15. Pre-formed toxin is?
a) Staphylococcus aureus exotoxin
b) Emetic toxin of bacillus cereus
c) Clostridium botulinum toxin

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d) Vibrio cholera toxin
e) Shigella toxin
Correct Answer - A:B:C
Ans. is 'a' i.e., Staphylococcus aureus exotoxin, 'b' i.e.
Emetic toxin of bacillus cereus & 'c' i.e. Clostridium

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botulinum toxin [Ref Essentials of Microbialogy p. 820,
Harrison MI p. 1088 & 17h/e p. 816, 817]
Enterotoxins are produced by : Shigella, B. cereus, Staphylococcus
aureus, CI perfringens, V. cholera, ETEC, EHEC, Cl difficle,
Yersinia enterocolitica, Rota virus.

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Preformed toxins are produced by : Staph aureus, B. cereus, Cl
botulinum and Cl perfringens.
Heat labile toxins are produced by : Cl perfringens, LT of ETEC, V.
cholerae, Diarrheal form of B. cereus.
Heat stable toxins are produced by : Staph aureus, Y. enterocolitica,

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ST of ETEC, emetic form of B. cereus.

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16. Indications of use of antibiotics in acute
diarrhea include?
a) Traveller's diarrhea

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b) Bacillary dysentery
c) Caused by shiga like toxin producing E.coli
d) Cholera
e) All of the above
Correct Answer - A:B:D

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Ans. is 'a' i.e., Traveller's diarrhea, 'b' i.e. Bacillary dysentery
& 'd' i.e. Cholera
Bacillary dysentery is associated with species of bacteria from the
Enterobacteriaceae family. The term is usually restricted to
Shigella infections.

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when used appropriately, antibiotics are effective for shigellosis,
cholera, C. difficile (pseudomembranous enterocolitis),
traveler's diarrhea, and protozoal infections.
If the patient's clinical presentation suggests the possibility of Shiga
toxin-producing E. coli (e.g., bloody diarrhea, history of eating

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seed sprouts or rare ground beef proximity to an outbreak),
antibiotic use should be avoided because it may increase the risk
of hemolytic uremic syndrome.
In traveller's diarrhoea, antimicrobial therapy is unequivocally
effective; Traveller's diarrhoea is mainly due to bacterial

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enteropathogens (approximately 80%), the most frequently
isolated being enterotoxigenic E coli; Quinolone antibiotics are
now the

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treatment of choice

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17. All is are true about Rotavirus infection

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except:
a) Most commonly seen in adult of > 30 year age group
b) Person to person transmission may occur
c) Severity of disease decreases with each repeat infection
d) Commonest cause of diarrhea in infants and children

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e) Single infection provide lifelong immunity against reinfection
Correct Answer - A:E
Answer: (a) Most commonly seen in ... (e) Single
infection provide...
[Ref: Ananthanarayan 9th/560-61; Park 23'223;Harrison

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19th/1287-88 ;Jawetz 27h/534-35; Greenwood 16th/525-26]
Reinfections are cornn on, but the severifir of dkease dzcreases with
each repeat intectlon. Therefore, severe rotavirus infections are
less common among older children and adults than among younger
individuals.

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Rota diarrhea is usually seen in children below the age of five years,
but is most frequent b/w 6 and 24 months of age.

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18. True about pseudomonas aeruginose:
a) Not lysine decarboxylase positive

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b) Oxidase positive
c) Produce pyocyanin pigment
d) Gram-negative bacilli
e) Has 6-12 flagella
Correct Answer - A:B:C:D

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Answer a)Not lysine decarboxylase positive (b) Oxidase
positive (c) Produce pyocyanin pigment (d) Gram-
negative bacilli
[Ref: Ananthanarayan 9th/314-16; Harrison 19th/1042-
43 ;Jawetz 27th/137-39; Greenwood 16th/282,16]

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It is positive in the indophenol oxidase test, and is Simmon's citrate
positive, 1-arginine dihydrolase positive, 1-lysine decarboxylase
negative, and 1-ornithine decarboxylase negative.
P. aeruginosa : Motile by virtue of one or two polar flagella"
P aeruginosa is a non fastidious, motile, gram-negative rod that

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grows on most common laboratory media, including blood and
MacConkey agars.
TWo of the identifying biochemical characteristics of p aeruginosa
are an inability to ferment lactose onMacConkey agar and a
positive reaction in the oxidase test.

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19. Which of the following is/are DNA viruses:
a) Herpes virus
b) Hepadnaviridae
c) Parvovirus
d) Orthomyxoviridae

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e) Enteroviruses
Correct Answer - A:B:C
Answer: (a) Herpes virus, (b) Hepadnaviridae, (c) Parvovirus
[Ref: Ananthanarayan 9th/428,439-40; Harrison 19th/214e-1
;Jawetz 27th/852]

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herpes viruses consists of a relatively large, double-stranded, linear
DNA genome encased within an icosahedral protein cage called
the capsid, which is wrapped in a lipid bilayer called the envelope.
Partially dsDNA circular genome, about 3.2 kb.
Parvoviruses are linear, nonsegmented, single-stranded DNA

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viruses, with an average genome size of 5-6 kb.

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20. True about ZIKA virus:
a) Belong to flavivirus

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b) First case detected in 1953 in Nigeria
c) RT PCR is useful in diagnosis
d) Causes macrocephaly
e) May presents with conjunctivitis
Correct Answer - A:C:E

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Answer: (a) Belong to flavivirus, (c) RT PCR is useful in
diagnosis, (e) May presents with conjunctivitis (Ref:
Harrison 19th/1314; www. cdc. gov;www. nytimes. corn]
It is spread mostly by the bite of an infected Aedes species
mosquitoes (A. aegptiand A. albopictus). T

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It can be passed to a pregnant woman to her fetus. Infection during
pregnancy can cause certain birth defects..
Real-time reverse transcription-polymerase chain reaction (RT PCR)
testing should be performed on serum collected during the first two
weeks after symptom onset.

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There's no vaccine or specific treatment tor tlw disease. Treatment
instead focuses on relieving symptoms and includes rest,
rehydration and medications for fever and pain.
A maculopapular rash, conjunctivitis, myalgia, and arthralgia usually
accompany or follow those manifestations.

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21. Autoclave is/are used for sterilization of:
a) Wooden material

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b) Metallic instrument
c) Plastic
d) Glasswares
e) Fibro-optic bronchoscope
Correct Answer - B

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Ans: (b) Metallic instrument [Ref: Ananthanarayan 50/37,30-32;
Greenwood 16th/77-78;Chakraborty 2nd/45-46; en.wikipedia.org]
Autoclaves in operation theaters is used to sterilize surgical
instrument, OT garments, linen, gloves, masks, gown etc.
However, it is not suitable for plastics"-Community Medicine with

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Recent Advances by Suryakantha

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22. Parasite which infects through ingestion
of aquatic vegetation:
a) Fasciola hepatica

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b) Fasciolopsis buski
c) Paragonimus westermani
d) Watsonius watsoni
e) Gastrodiscoides hominis
Correct Answer - A:B:D:E

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Answer: (a) Fasciola hepatica, (b) Fasciolopsis buski,
(d) Watsonius watsoni, (e) Gastrodiscoides hominis
[Ref: Paniker's Parasitology 7th/151; Chatterjee
Parasitology 13"/174; Harrison 19th/245e-1]
mode of infection of Fasciola hepatica' The definitive host sheep

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and, man, get infection by ingestion of metacercariae encysted
on aquatic vegetation.
Infective form of Fasclolopsls Bush: Encysted metacercariae on
aquatic vegetarian.
Second intermediate host of fasciolopsis BusKi Encystment occurs

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on aquatic plants, roots of the lotus, bulb of water chestnut which
act as second intermediate host.
Second intermediate host of Gastrodiscoides hominis: aquatic plant.
The cercariae encyst on water pl.ants. Man and animals become
infected by feeding upon vegetations harbouring the metacercaria".

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23. Which of the follwing is/are true about
Dengu fever:
a) Positive Tourniquet test means more than 10 petechiae
per square inch
b) Caused by flavivirus

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c) Aedes aegypticus and albopictus are most important vector
in India
d) IgM/IgG ratios may be used to distinguish primary
from secondary infection
e) No vaccine available at present

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Correct Answer - A:B:C:D:E
Answer: A, Positive Tourniquet test means... B,Caused
by... C,Aedes aegypticus and albopictus... D,IgM/IgG ratios
may be used... E,No vaccine available... (Ref.: Park 23' /246-56;
Davidson 22'/323,-Ananthanarayan 9th/523; Harrison

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19th/1318-19;Jawetz 27h/552-54]
Positive torniquet test (i,e. 10 or more petechiae per square inch) is
most common hemorrhagic phenomenon. In DHF the test usually
gives a definite positive with 20 petechiae or more- Park 23'd /249
Vaccine- So far there is no satisfactory vaccine and no immediate

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prospect of preventing the disease by immunization- Park 23' /254
"The diagnosis is made by IgM ELISA or paired serology during
recovery or by antigen-detection ELISA or RT-PCR during the acute
phase"- Harrison 19m/1318-19

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24. which of the following dyads of vector
with disease is/are correctly matched:
a) Rat flea- Endemic typhus
b) Sand flea-Oriental sore
c) Blackfly-Kafaazar

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d) Cyclops-Dracunculus
e) Louse-Chagas Disease
Correct Answer - A:B:D
Answer: (a) , (b) and (d) [Ref Park 23'/768;Paniker's
Parasitology 7th/223]

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Rat flea Bubonic plague, endemic typhus, chiggerosis,
hymenolepis diminuta.
Sandfly Kala-azar, oriental sore, sa ndfl y fever, oroya fever.
Cyclops Guinea-worm disease, fish topeworm (D. lotus).

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25. All are features of scrub typhus except:l

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a) Black eschar
b) Maculo-papular rash
c) More common in rural areas
d) Ciprofloxacin is drug of choice
e) Tick borne disease

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Correct Answer - D:E
Answer: (d) Ciprofloxacinis is drug of choice, (e) Tick
borne disease
(Ref: Ana nthanarayan 9th/408 ; Harrison 19th/1159 ; Park
23rd/300; Medical microbiology by Greenwood 16th /372]

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"Scrub typhus: One typical feature is the punched-out ulcer covered
with a blackened scab(eschar) which indicates the location of mite
bite"
"Scrub typhus,:Most travel-acquired cases occur during visits to rural
areas in endemic countries for activities such as camping, hiking or

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rafting, but urban cases have also been described. Tetracycline is
drug of choice"- Park 23rd/300
""Scrub typhus, originally found in scrub jungles, has also been
identified in a variety of other habitats, such as sandy
beaches, mountain deserts and equatorial rain-forests"-

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Ananthanarayan 9th/408

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26. Unlike nocardia, Actinomycosis is;
a) Facultative anaerobes
b) Not acid fast
c) Endogenous Cause Of disease
d) Environmental saprophyte

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e) Grow at wide range of temperature range
Correct Answer - A:B:C
Ans. (a) Facultative anaerobes, (b) Not acid fast, (c)
Endogenous cause of disease [Ref: Ananthonarayan
gh/j9l-93;Jawetz 2vh/295,198-99;Greenwood l6h/221-22;

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Hanison lN/l088
Actinomycete are facultative anaerobes, but often fail to grow
aerobically on primary culture. They grow best under anaerobic or
microaerophilic conditions with the addition of 5-10% carbon dioxide.
Facultative anaerobes, Grow at 35-37?C, Oral commensals, Non-acid

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fast mycelia, Endogenous cause of disease

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27. All of the following are caused by
dermatophytes except:
a) Madura foot
b) Athlete's foot

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c) Athlete's foot
d) Favus
e) None
Correct Answer - A
Answer: (A) Madura foot [Ref: Ananthanarayan 9th/596-97

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; Harrison 19th/1358]
"Madura foot(eumycetoma or nadurantycosis) is caused by fungi-
scedosporium,
madurella
mycetomatis

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and
M.grisea,
acremonium spp., exophiala spp., aspergillus spp. fusarium spp."
"Favus: A chronic type of ringworm in which dense crusts (scutula)
develop in the hair follicles, leading to alopecia and scattering.

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"Kerlon: Severe boggy lesions with marked inflammatory reaction that
sometimes develops in scalp infection due to dermatophyte s"

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28. All are true about dengue virus except:
a) Belong to flaviviridae
b) Type DEN 4 is most common in India
c) Main vectors are aedes aegypti and aedes albopictus

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d) Virus has positive sense RNA
e) Vector is sensitive to DDT
Correct Answer - B
Ans: (b) Type DEN 4 is most common... (Ref: Park 23'/246-56;
Ananthanarayan 9th/523; Harrison 19th/1318-19;Jawetz

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27th/552-541
Belong to genus flavivirus with positive sense RNA(Harrison
19th 214e-1 table)
All the 4 serotypes i.e dengu 1,2,3 and 4 have been isolated in India
but at present DENV-1 and DENV-2 serotypes are widespread,

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Vector- Aedes aegypti and Aedes albopictus are the two most
important vectors of dengue

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29. Which of the following has least minimum
infective dose(MID) required for causing
infection:
a) Salmonella typhi
b) Campylobacter jejuni

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c) Shigella dysentery
d) Vibrio cholera
e) None
Correct Answer - C
Ans. (c) Shigella dysentery [Ref: Ananthanarayan

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9th/287,295;Greenwood 16th/261,252,289]
"Shigella cause bacillary dysentery. Infection occur by ingestion. The
minimum infective dose is low: as few as I0-I(N bacilli are capable
of initiating the disease, probably because they survive gastric
acidity better than other enterobacter"- Ananthanarayan.

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30. True about Gas gangrene:
a) Onset is usually acute
b) Painless condition

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c) Wound is swollen
d) At first wound is dusky or red, later becomes pale
e) Caused by gram +ve organism
Correct Answer - A:C:E
Ans: (a) Onset is usually acute, (c) Wound is swollen,

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(e) Caused by gram +ve organism
[Ref: Davidson 22''d/305;L and 826`/57;; Harrison 19th/990-
95; Ananthanarayan 9th/257-59; Jawetz 27th/186-
87;Greenwood 16th/231-35]
Gas gangrene (clostridia) myonecrosis) is defined as acute invasion

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of healthy living muscle undamaged by previous trauma, and is
most commonly caused by C. perfringens.
Severe pain, crepitus, brawny induration with rapid progression to
skin sloughing, violaceous bullae, and marked tachycardia are
characteristics found in the majority of patients.

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Traumatic gas gangrene C. perfringens myonecrosis (gas gangrene)
is one of the most fulminant gram-positive bacterial infections of
humans.
The infection is characterized by the sudden onset of excruciating
pain at the affected site and the rapid development of a foul-

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smelling wound containing a thin serosanguineous discharge and
gas bubbles.
The wound produces a thin, brown, sweet-smelling exudate, in
which Gram staining will reveal bacteria.

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31. Which type of bacteria can not survive in
absence of oxygen:
a) Obligate aerobe
b) Facultative anaerobes
c) Microaerophilic

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d) Obligate Anaerobes
e) Facultative aerobes
Correct Answer - A
Ans. (a) Obligate aerobe [Ref: Ananthanarayan 50/
24-25;Greenwood 16th/41]

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Aerobic bacteria require oxygen for growth. They may be obligate
aerobes like the cholera vibrio, which will grow only in the
presence of oxygen, or facultative anaerobes which are ordinarily
aerobic but can also grow in the absence of oxygen, though less
abundantly.

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Most bacteria of medical importance are facultative anaerobes.
Anaerobic bacteria, such as clostridia, grow in the absence of
o>rygen and the obligate anaerobes may even die on exposure
to oxygen.
Microaerophilic bacteria are those that grow best in the presence of

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low oxygen tension.

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32. Which of the following mechanism is/are
used by bacteria to escape host defence
mechanism:
a) Mycobacterium tuberculosis prevent intracellular killing

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by inhibiting phagolysosome formation
b) Streptococcus pyogenes by M protein
c) Neisseria meningitidis by capsular polysaccharide
d) Staphylococcus aureus by iron-regulated outer
membrane proteins

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e) Polysaccharide capsules of H. influenzae
Correct Answer - A:B:C:E
Answer: (a) Mycobaterium tuberculosis... (b) Streptococcus
pyogenes... (c) Neisseia men in gti tides... (e) Polysaccharide...
[Ref: Ananthanarayan 9`'/350,212;

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textbookofbacteriology.net/antiphago ;Jawetz 27h/158-
65; Greenwood 16th/244]
The bacteria survive inside of phagosomes because they prevent
the discharge of lysosomal contents into the phagosome
environment. Specifically, phagolysosome formation is inhibited

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in the phagocyte. This is the strategy employed by Salmonella,
M. tuberculosis, Legionella and chlamydiae.
Survival inside the phagolysosome-Mycobacteria (including
M. tuberculosis and Mycobacterium leprae).
M protein and fimbriae of Group A streptococci Surface slime

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(polysaccharide) produced as a biofilm by Pseudomonas
aeruginosa

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M protein and fimbriae of Group A streptococci Surface slime
(polysaccharide) produced as a biofilm by Pseudomonas
aeruginosa
antiphagocytic substances on bacterial surfaces
include:Polysaccharide capsules of S. pneumoniae, Haemophilus

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influenzae,Treponema pallidum and Klebsiella pneumoniae

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33. All are true about H I NI influenza except:
a) Zanamivir commonly given through IV route
b) Fatality more in some high risk group
c) RT-PCR is used for investigation

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d) WHO latest trivalent influenza vaccine contains two influenza
A subtypes (H3N2 and H1N1) and one influenza B component
e) CDC latest quadrivalent influenza vaccine contains two
influenza A subtypes (H3N2 and H1N1) and two influenza
B component

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Correct Answer - A
Answer (a) Zanamivir commonly given through IV route [Ref:
Park 23'd/l 56-59;Ananthanarayan Eh/4gg-504 ; Harrison 1
Eh/t 209-t 4; KDT 7h/802-03]
WHO: It is recommended that trivalent vaccines for use in the 2017

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southern hemisphere influenza season contain the following
. An A/Michigan/45/2015 (H1N1)pdm09-like virus;
. An A/Hong Kong/4801/2014 (H3N2)-like virus; and
. A B/Brisbane/60/2008-like virus.
RT-PCR provides the most timely and sensitive detection of the

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infection
Pandemic influenza A (Hl nl) Treatment: oseltamivir adult oral dose
is 75 mg twice daily for 5 days. Zanamivir dose is two inhalation (2
x 5 mg) twice daily for 5 days

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34. True about serum marker of inactive
carrier phase of chronic Hepatitis B:

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a) Hbs Ag +ve
b) Hbe Ag +ve
c) Anti-HBe antibody positive
d) Low level DNA
e) Increased ALT

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Correct Answer - A:C:D
Answer: (a) Hbs Ag +ve, (c) Anti-H Be antibody positive, (d)
Low level DNA (Ref: Ananthanarayan 9`h/543-48; Harrison
19th/2032-33,2007 ;Davidson 22"?/950-52;Park 23rd/215.1
Chronic HBV Infection:Inactive carriers are patients with circulating

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hepatitis B surface antigen (HBsAg), normal serum
aminotransferase levels, undetectable HBeAg, and levels of HBV
DNA that are either undetectable or present at a threshold of 103
IU/mL.
The relatively replicative phase is characterized by the presence in

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the serum of HBeAg and HBV DNA levels well in excess of 103-104
IU/mL, sometimes exceeding 109 IU/mL; by the presence in the
liver of detectable intra hepatocyte nucleocapsid antigens (primarily
hepatitis B core antigen [HBcAg]); by high infectivity; and by
accompanying liver injury.

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35. In which of the following condition(s),
children are prone to fungal & viral
infection:
a) Thymic aplasia
b) Agammaglobulinemia

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c) Lymphocytopenia
d) Severe combined immune deficiencies (SCID)
e) Chediak-Higashi syndrome
Correct Answer - A:C:D
Ans: (A) Thymic aplasia (C) Lymphocytopenia (D)

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Severe combined immune deficiencies (SCID)
[Ref Harrison 19th/2104-08; Ananthanarayan 9th/171-76;
Jawetz 27th/146-47; Greenwood 16th/148J
T cell disorders affect both cell-mediated and humoral immunity
making the patient susceptible to viral, protozoal and fungal

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infections. Viral infections such as those by cytomegalovirus
and attenuated measles in the vaccine can be fatal in these
patients.
Lymphocytopenia is most often due to AIDS or undernutrition, but it
also may be inherited or caused by various infections, drugs, or

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autoimmune disorders. Patients have recurrent viral, fungal, or
parasitic infections.
Hypogammaglobulinemia leads to recurrent bacterial infections.
Viral & fungal infections are controlled by cell-mediated
immunity, which is normal in hypogammaglobulinemic individual.

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36. Which of the following is type 3

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hypersensitivity reaction (immune
complex disease):
a) SLE
b) Diabetes Mellitus I
c) Goodpasteur syndrome

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d) Multiple sclerosis
e) Bronchial asthma
Correct Answer - A
Ans: a. SLE
[Ref Ananthanarayan 9th/162-67; Robbins 9th/201; lawetz

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27th/145 46; Greenwood 16th/144]
Type 3 Hypersensitivity reaction (Immune complex disease)
Ananthanarayan 9th/162, It is two types-arthus reaction &
serum sickness.
the damage is caused by antigen-antibody complexes. These may

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precipitate in & around small blood vessels causing damage to
cells secondarily, or on membranes, interfering with their function .

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37. Which of the following infection has
incubation period
a) Brucella
b) Gonorrhoea
c) Syphilis

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d) HBV
e) Leishmaniasis
Correct Answer - A:B:C
Ans: (A) Bruce...,(B) Gonorrho..., (C) Syphilis
[Ref Harrison 19th/1134, 194e-2, 1005; Ananthanarayan 9th/341 .1]

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Brucella: The incubation period is usually about 10-30 days, but
may be sometimes be very prolonged" (Ananthanarayan 9th/341)
"Brucella: The incubation period varies from 1 week to several
months, and the onset of fever and other symptoms may be
abrupt or insidious" (Harrison 19th/194e-2)

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Syphilis: Clinical disease sets in after an incubation period of about
a month(range 10-90 days)" (Ananthanarayan 9th/372)
"Syphilis: The median incubation period in humans (-21 days)
suggests an average inoculum of 500-1000 infectious organisms
for naturally acquired disease; the incubation period rarely exceeds

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6 weeks.
Gonococcal infection in men: Acute urethritis is the most common
clinical manifestation of gonorrhea in male patients. The usual
incubation period after exposure is 2-7 days, although the
interval can be longer & some men remain asymptomatic

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(Harrison 19th/1005)

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38. Stain used for Mycobacterium
tuberculosis is/are:
a) Ziehl-Neelsen technique of staining

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b) Auramine-rhodamine stain
c) Gomori methenamine silver stain
d) Kinyoun stain
e) Gram staining
Correct Answer - A:B:D

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Ans: a. Ziehl-Neelsen techni..., b. Auramine-rhodamine sta...,
d. Kinyoun stain
[Ref Harrison 19th/1113; Ananthanarayan 9th/346-48; Lippincott
Microbiology 3rd/ 21; Jawetz 27th/38; Text Book of Diagnostic
microbiology by Connie R. Mohan 3rd/691;Greenwood 16th/15]

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When stained with carbol fuchsin by Ziehl-Neelsen method or by
fluorescent dyes(Auramine 0, Rhodamine), mycobacterium
tuberculosis reist decolourisation by 20% sulphuric acid & are
therefore called acid fast.
Ziehl-Neelsen method d phenol-auramine procedures are methods

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of great practical importance in the diagnosis of mycobacterial
diseases" .
The Kinyoun method, or Kinyoun stain, is an acid-fast procedure
used to stain any species of the genus Mycobacterium and
Nocardia species. It involves the application of a primary stain

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(carbol fuchsin), a decolorizer (acid-alcohol), and a counter stain
(methylene blue)"

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39. Food borne diseases are:
a) Japanese encephalitis
b) Hemophilia

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c) HBV
d) Botulism
e) Typhoid fever
Correct Answer - D:E
Ans: d. Botuli..., e. Typhoid ...,[Ref Park 23rd/657]

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The term" food-borne disease" is defined as: "A disease, usually
either infectious or toxic in nature, caused by agents that enter the
body through the ingestion of food." With the catering systems,
food-borne diseases are on the increase throughout the world.
Due to toxins produced by certain bacteria LIKE Botulism,

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Staphylococcus poisonS
Bacterial diseases:- Typhoid,fever, Paratyphoid fever,
salmonellosis, staphylococcal intoxication, C. perfringens,
Shigellosis brucellosis etc.

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40. Which of the following is NOT lysine
positive non-fermentor:

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a) Burkholderia pseudomallei
b) Burkhomelia mallei
c) Burkholderia cepacia
d) Stenotrophomonas maltophilia
e) Pseudomonas aeruginosa

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Correct Answer - A:B:E
Ans: a. Burkholderia..., b. Burkhomelia..., e. Pseudomonas Aeru
......
The Burkholderia cepacia complex (BCC) and Stenotrophomonas
maltophilia are closely related groups of non fermenting gram-

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negative bacilli (NFGNBs) having a similar spectrum of infections
ranging from superficial to deep-seated and disseminated infections.
Identification of these lysine decarboxylase-positive NFGNBs lags
behind in most Indian laboratories. A simplified identification scheme
was devised for these two pathogens that allowed us to isolate them

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with an increasing frequency at our tertiary care institute.

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41. A person is suffering from acquired
immunodeficiency disease(AIDS) & visited
the zoo. After some days, he is com

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plaining of headache & cough. He has
also have some neurological symptoms.
On staining of CSF sample, it shows cap
sulated yeast. Likely infection is:
a) Histoplasma

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b) Aspergillus
c) Cryptococcus
d) Blastomycosis
e) Coccidioidomycosis
Correct Answer - C

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Ans: C, Cryptococcus
Like CNS disease, pulmonary cryptococcosis can follow an indolent
course, and the majority of cases probably do not come to clinical
attention.
Pulmonary cryptococcosis can be associated with antecedent

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diseases such as malignancy, diabetes, and tuberculosis.
Cryptococcus Infection can be acquired by inhalation of
desiccated yeasts(or basidiospores) from feces of pigeon or
other birds
Direct microscopic examination of India ink-stained wet films of

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material from lesions reveals capsulated, budding yeast cells;
the

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capsule are prominent in the India ink preparatio

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42. Normal flora of Oral cavity is/are except:

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a) Veillonella
b) Anerobic micrococci
c) Geotrichum
d) Gemella
e) Yersinia

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Correct Answer - A:B:C:D
Ans: a. Veillone..., b. Anerobic microc..., c. Geotrich..., d.
Gemell.
More than 700 bacterial species or phylotypes, of which over 50%
have not been cultivated, have been detected in the oral cavity.

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The mouth contains a plethora of organisms- pigmented & non-
pigmented micrococci; some of which are aerobic, gram
positive, aerobic, spore bearing bacilli, coliforms, proteus &
lactobacilli
The gum pocket b/w the teeths, & the crypts of the nostrils have a

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wide spectrum of anaerobic flora- anerobic micro-cocci,
microaerophilic & anaerobic streptococci, vibrios, fusiform bacilli,
corynebactrium species, actinomyces, leptothrix, mycoplasma,
Neisseria eb? bacteriodes are all found in varying extents.
Among fungi, candida er geotrichum have been reported.

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43. Gold standard diagnostic test for
babeiosis is:
a) Peripheral blood smear examination
b) Blood Culture

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c) PCR
d) ELISA
e) Indirect fluorescent antibody (IFA) test
Correct Answer - A
Ans: a. Peripheral blood smear ...,

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[Ref Harrison 19th/1385-86; Paniker Parasitology
7th/85;Chatterjee Parasitology 13th/137; Lippincott Microbiology
3rd/225; Jawetz 27th/708; Greenwood 16th/599]
Microscopic examination of stained blood smear is gold standard
test for babesiosis"

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A specific diagnosis usually is established by microscopic
examination of Giemsa-stained thin blood smears.
Babesia trophozoites appear round, pear-shaped, or
ameboid.
The ring form is most common and lacks the central brownish

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deposit (hemozoin) typical of Plasmodium falciparum
trophozoites. Other distinguishing features are the absence of
schizonts and gametocytes and the occasional presence of
tetrads ("Maltese cross").
If parasites cannot be identified by microscopy and the disease is

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still suspected, amplification of the babesial 18S rRNA gene by
polymerase chain reaction (PCR) is recommended. Quantitative
PCR has greatly lowered the threshold for detection of B. microti

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DNA

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44. True about listeria monocytogens
infection:
a) Common in pregnant women
b) Common in elderly

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c) Common in children
d) Common in newborns
e) Ampicillin is drug of choice
Correct Answer - A:B:D:E
Ans: a. Common in pregnant..., b. Common in elderly...,d.

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Common in newborns..., e. Ampicillin.
[Ref Harrison 19th/982-84; Ananthanarayan 9th/395-
96; Lippincott Microbiology 3rd/ 98; Jawetz 27th/ 197-
98; Greenwood 16th/195-96]
Listeria infections are most common in pregnant women, fetuses

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and newborns, and in immunocompromised individuals, such
as older adults and patients receiving corticosteroids"
(Lippincott Microbiology 3rd/ 98).
The disease affects pregnant women, newborns, adults with
weakened immune systems, and the elderly,

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Listeria monocytogenes is a food-borne pathogen that can cause
serious infections.
Meningitis in older adults (especially with parenchymal brain
involvement or subcortical brain abscess) should trigger
consideration of L. monocytogenes infection.

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45. True about Japanese encephalitis:
a) Most severe epidemic spread occured in 2006
b) Main vector in India is culex tritaeniorhynchus
c) Spread by aedes mosquito
d) India still not able to develop vaccine indigenously

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e) Pigs are amplifier host
Correct Answer - B:E
Ans: (B) Main vector in India is culex tritaeniorhynchus (E)
Pigs are amplifier host
[Ref Park 23rd/284-87;Harrison 19th/1315;

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Ananthanarayan 9th/52022, 519]
During 2006, there was a large outbreak of chikungunya in India,
with 1. 39 million officially reported cases spread over 16 states;
attack rates were estimated at 45% in some areas"
The virus is particularly common in areas where irrigated rice fields

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attract the natural avian vertebrate hosts and provide abundant
breeding sites for mosquitoes such as Culex tritaeniorhynchus,
which transmit the virus to humans.
Additional amplification by pigs, which suffer abortion, and horses,
which develop encephalitis, may be significant as well. Vaccination

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of these additional amplifying hosts may reduce the transmission
of the virus.

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46. Not AIDS defining cancer:
a) Anal carcioma
b) Hodgkin's lymphoma
c) Cervial cancer

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d) Non -Hodgkins lymphoma
e) Kaposi carcinoma
Correct Answer - A:B
Ans: (A) Anal carcioma (B) Hodgkin's lymphoma
[Ref Harrison 19th/1268; Ananthanarayan 9th/576-77;

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Lippincott Microbiology 3rd/ 302]
The neoplastic diseases considered to be AIDS defining conditions
are Kaposi's sarcoma, non-Hodgkin's lymphoma, and invasive
cervical carcinoma.
In addition, there is also an increase in the incidence of a variety of

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non-AIDS-defining malignancies including Hodgkin's disease;
multiple myelotna; leukemia; melanotna;and cervical, brain,
testicular, oral, lung, gastric, liver, renal, and anal cancers.

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47. True about Plasmodium falciparum:
a) Increased size of infected RBC
b) Crescentric shaped gametocyte
c) Delicate ring present

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d) Small & multiple rings common
e) Erythrocyte preference- old cells
Correct Answer - B:C:D
Ans: (B) Crescentric shaped gametocyte (C) Delicate
ring present (D) Small & multiple rings common

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[Ref Harrison 19th/1369; Parasitology by Chatterjee
13th/103; Parasitolgy by Paniker 7th/75]
Ring stage- delicate, small, double chromatin, multiple rings
common, Accole forms found
Macrogametocyte- Crescentric, deep blue cytoplasm, large diffuse

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nucleus
The mature gametocytes are round in shape, except in P,
falciparum, in which they are crescent-shaped
Schizont: Fills two-third of red blood cell which is not enlarged-
Chatterjee 13th/103

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Infected erythrocyte- Normal size, Maurer's cleft, sometimes
basophilic stippling
Erythrocyte preference- young erythrocyte, but can infect all stages

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48. Which of the following statement is/are
true about Giardia:

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a) Cause bloody diarrhorea
b) Invasive to GI mucosa
c) More common in hypogammaglobulinemic person
d) Less common in achlorohydria
e) Metronidazole is effective in treatment

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Correct Answer - C:E
Ans: (C) More common in hypogammaglobulinemic person (E)
Metronidazole is effective in treatment [Ref Parasitology by
Chatterjee 13th/47-48;Parasitolgy by Paniker 7th/32-
33;Harrison 19th/1406]

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Metronidazole, trimidazole, furazoilidone have been found to be
effective for giardiasis
G. lamblia is typically seen within the crypts of duodenal & jejunal
mucosa. It does not invade the tissue, but remains tightly adhered
to intestinal epithelium by means of the sucking disc

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Te person having agammaglobulinemia, malnourished persons are
more susceptible to giardiasis

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49. In which organism can be isolated:
a) CSF specimen of tetanus infection
b) CSF specimen of listeria monocytogenes
c) From valves in rheumatic valvulitis

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d) From myocardium in diphtheric myocarditis
e) Meningococcal rash
Correct Answer - B:E
Ans: (B) CSF specimen of listeria
monocytogenes (E) Meningococcal rash

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L. monocytogenes : The diagnosis is typically made by culture of
blood, cerebrospinal fluid (CSF), or amniotic fluid. L.
monocytogenes may be confused with "diphtheroids" or
pneumococci in gram-stained CSF or may be gram-variable and
confused with Haemophilus spp.

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Petechial lesion: Meningococci may sometimes be demonstrated in
petechial lesions by microscopy & culture.

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50. Which are transmitted by Dog:
a) Echinococcus granulosus
b) Toxocara Canis

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c) Echinococcus multiocularis
d) Toxoplasma Gondii
e) None
Correct Answer - A:C
Ans: A. Echinococcus granulosus C. Echinococcus

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multiocularis" [Ref Park 23rd/ 3}4;Hanison 1 9th/ 1 432, 1 67
e- 1 : Chatterjee Parasitology 1 3th/ 1 59; CMDT 20 16/ 12801.
Alveolar echinococcosis (AE) is caused by infection with the larval
stage of Echinococcus multilocularis. The adult tapeworm is
normally found in foxes, coyotes, and dogs. Infection with the larval

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stages is transmitted to people through ingestion of food or water
contaminated with tapeworm eggs.
Toxocara canis: Human infection is by ingestion of eggs, which are
shed in feces of dog.
Toxoplasma gondii: Man acquires infection by ingestion of

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contaminated food and water containing sporulated oocyst (from
cat) or by ingestion of undercooked meat containing tissue cysts"

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51. All are true about gas gangrene except:
a) Type 1 gangrene is fournier's gangrene

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b) Devitalized tissue predispose to gas gangrene
c) High 02 tension in tissue is important precondition
d) a -toxin is main cause of the toxaemia associated with
gas gangrene
e) Mainly caused by C. perfringens

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Correct Answer - E
Ans: E. Mainly caused by C. perfringens[Ref Harrison
19th/990-95; Ananthanarayan 9th/257-59; Jawetz 27th/186-
87;Greenwood 16th /231-35]
C. perfringens in association with mixed aerobic and anaerobic

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microbes can cause aggressive life-threatening type I
necrotizing fasciitis or Fournier's gangrene.
Predisposing host factors include debility, old age & diabetes
a -toxin is generally considered to be the main cause of the
toxaemia associated with gas gangrene

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"a-toxin: This is the most important toxin biologically & is responsible
for profound toxaemia of gas gangrene"

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52. True about cytomegalovirus -
a) Characteristic owl eye appearance
b) Type 5 Human herpesvirus type

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c) Lymphocyte enlargement
d) Cause congenital infection
e) Lymphoproliferative
Correct Answer - A:B:D
Ans: a. Characteristic..., b. Type 5 Human..., d. Cause

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congenital ....
[Ref Harrison 19th/1190-91; Ananthanarayan 9th/473-74;
Jawetz 27th/470-74]
It is cytomegalic (not lymphoproliferative, which occur in HHV4, 6 &
7)

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Characterized by enlargement of infected cells
Congenital infection- Intrauterine infection leads to fetal death or
cytomegalic inclusion disease of newborn which is often fatal

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53. Which of the following is/are true about
Mycoplasma pneumonia infection except:

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a) Causes many extrapulmonary manifestations
b) Cold agglutinin titer is not increased
c) Cause atypical pneumonia
d) Paucity of respiratory signs on physical examination
e) Cough is typically productive

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Correct Answer - B:E
Ans: b. Cold agglutinin..., e. Cough is typically
Cold hemagglutinins for group 0 human erythrocyte appear in about
50% of untreated patients, in rising titer, with the maximum
reached in the third or fourth week after onset.

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A titer of 1:64 or more supports the diagnosis of M. pneumoniae
infection.
The cough is typically nonproductive, but some patients produce
sputum. Headache, malaise, chills, and fever are noted in the
majority of patients.

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54. Serological test is/are useful in diagnosis
of which of the following disease:
a) Typhoid
b) Q fever

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c) Acanthamoeba infection
d) Scrub typhus
e) Brucellosis
Correct Answer - A:B:D
Ans: a. Typhoid b. Q fever d. Scrub typhus

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The diagnosis of Q fever is based mainly on serological tests, such
as microagglutination, complement fixation, immunofluorescence &
ELISA.
Serological tests: There are not used for early diagnosis of rickettsia!
diseases(including Q fever, scrub typhus), from a treatment

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perspective, but to confirm the diagnosis for epidemiological
investigations.
Scrub typhus: Serological assay (indirect fluorescent antibody,
indirect immunoperoxidae & enzyme immunoassays), are
mainstays of laboratory diagnosis.

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Tube agglutination is routinely used for serological diagnosis of
typhoid, brucellosis & typhus fever.

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55. True about enteroviruses:
a) In 1999, wild polio virus 2 was eradicated from world
b) Vaccine associated paralytic poliomyelitis(VAPP)

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most frequently caused by serotype 1 vaccine
c) Bivalent OPV contains type 1 & type 3 strain
d) Primary course of OPV consists of only 1 dose
e) Coxasackie A7 & enterovirus type 71 causes aseptic meningitis
Correct Answer - A:C:D:E

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Ans: (A) In 1999, wild polio virus 2 was eradicated from world
(C) Bivalent OPV contains type 1 & type 3 strain (D) Primary
course of OPV consists of only 1 dose (E) Coxasackie A7 &
enterovirus type 71 causes aseptic meningitis
[Ref Park 23rd/ 202-09; Harrison 19th/1289-91;

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Ananthanarayan 9th/485]
Of the 3 strains of wild poliovirus, wild poliovirus type 2 was
eradicated in 1999 & case numbers of type 3 are down to the
lowest-ever levels with the last case reported in Nov 2012
from Nigeria.

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The WHO programme on immunization(EPI) & the national
immunization programme in India recommended a primary course
of 3 doses of OPV at one-month intervals, commencing the first
dose when infant is 6 weeks old.
Poliovirus type 1 is responsible for most epidemics of paralytic

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poliomyelitis. Type 3 also causes epidemics to a lesser extent. .
Type 2 usually causes inapparent infections in western countries
but in India paralysis due to type 2 is quite common"

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GROUP
SEROTYPE
Poliovirus

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1-3
Coxsackie virus A 1-22 AND 24
Coxsackie virus B
1-6
s

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Echovirus
1-9, 11-27,
29-34
Numbered
(EV) 68-78

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echovirus

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56. Biosafety level 4 infection includes:
a) Hantavirus
b) Nile virus
c) Ebola virus
d) Crimean-Congo HF

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e) Lyssa Fever
Correct Answer - C:D:E
Ans: c. Ebola virus d. Crimean-Congo HF e. Lyssa Fever [Ref
Harrison 19th/1323, 1328; consteril. corn/biosafety-levels;
thecerebrallounge. wordpress. corn]

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Filoviruses (includes three genera: Cueva virus, Ebola virus, and
Marburg virus) are categorized as World Health Organization
(WHO) Risk Group 4 Pathogens.
Biosafety Level 4- Hemorrhagic fevers, Marburg virus, Ebola
virus, Lassa virus, Smallpox

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57. True about chickengunya fever:
a) Caused by single stranded RNA arbovirus
b) Excruiting arthralgia in peripheral joints

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c) Antiviral therapy is very effective
d) Absolute lymphocytosis is present
e) Vector is aedes mosquitoes
Correct Answer - A:B:E
Ans: (A) Caused by single stranded RNA

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arbovirus (B) Excruiting arthralgia in peripheral
joints (E) Vector is aedes mosquitoes.[Ref Harrison 19th/13j3;
park 23ril/289; Ananthanarayan gth/440,519; Jawetz 27th/ 548.
Chickengunya: Blood counts may be normal, or patients may have
leukopenia with relative lymphocytosis.

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The vector is Aedes aegypti, It is caused by arbovirus (Family-
Togaviridae, Genus- Al?phavirus) (Ananthanarayan 9th/517)
The Chikungunya virus by single stranded RNA virus?
Chikungunya is a local word meaning doubling up owing to
excruciating joint pains

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There is no specific treatment & usually self limiting. Analgesics &
antipyretics along with fluid supplementation are recommended
to manage infection & relieve fever, joint pains & swelling. Drugs
like aspirin & steroids should be avoided

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58. True about Zika virus:
a) Sexually transmitted
b) 50% infected person develop symptoms
c) Effective therapy available
d) Transmitted by Aedes vector

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e) Transmission in utero
Correct Answer - A:D:E
Ans: a. Sexually transmitted d. Transmitted by Aedes vector
e. Transmission in utero[Ref Harrison 19th/1314;
It is spread mostly by the bite of an infected Aedes species

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mosquitoes (A. aegypti and A. albopictus). These mosquitoes
are aggressive daytime biters.
It can be passed from a pregnant woman to her fetus. Infection
during pregnancy can cause certain birth defects.
It can be passed through sex from a person who has Zika to his or

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her partners. It can be passed through sex, even if the infected
person does not have symptoms at the time.
The majority of people infected with Zika virus do not display any
symptoms

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59. Which of the following dyad of disease
and incubation period is/are correctly

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matched ?
a) Measles : 4-5 day
b) Chicken pox : 3-20 day
c) Bubonic plague: 2-5 day
d) Leptospirosis: 4-20 days

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e) Heptatis A : 45-180 day
Correct Answer - C:D
Ans. is 'c' i.e., Bubonic plague:2-5 days; & d. Leptospirosis;
4-20 days [Ref Park's 24thIe p.157; Ananthanarayan 9th/e p.
322, 512, 381; Harrison's 19ffi/e p,1 /831

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Bubonic plague caused by Yarsinia pestis 2-7 days
Leptospirosis caused by H1N1 Type A influenza 1-4 days 1-3

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60. True about Human papilloma virus?
a) Belongs to family papovaviridae
b) DNA virus
c) RNA virus

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d) Enveloped
e) Causes anal warts
Correct Answer - A:B:E
Ans. is 'a' i.e., Belongs to family papovaviridae; 'b' Le., DNA
virus & `e' i.e., Causes anal warts [Ref: Ananthanarayan 9th/e

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p.553; Harrison's 19thle p. 1197-99; Robbins (SEA) 9Thle p. 326].
HPV is a non enveloped DNA virus (ds DWA), belongs to
Papovaviridae.
HPV causes anogenital warts (condyloma accuminata).

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61. All are true about Ebola virus infection
except?

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a) Air dropler is most common mode of transmission
b) Haemorrhagic manifestation may occur
c) Thai forest type - most common species in epidemics
d) presents as sudden onset of fever and sore throat
e) Case fatality rate may be high as 70%

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Correct Answer - A:C
Ans. is 'a' i.e., Air dropler is most common mode of
transmission & 'c' i.e., Thai forest type - most common
species in epidemics ]Ref Park 24m/e p. 374]
The virus is transmitted through direct contact with blood, organs,

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body secretions or other body fluids of infected animals like
chimpanzees, gorillas, monkeys, fruit bats etc.
Human to human transmission is through blood or body fluids of an
infected symptomatic person or through exposure to objects (such
a needle) that have been contaminated with infected secretions.

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It is not transmitted through air, water, or food.
The virus is transmitted through direct contact with blood, organs,
body secretions or other body fluids of infected animals like
chimpanzees, gorillas, monkeys, fruit bats etc.
Human to human transmission is through blood or body fluids of an

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infected symptomatic person or through exposure to objects (such
as needle) that have been contaminated with infected secretions
It is not transmitted through air, water, or food
The illness is characterized by sudden onset of fever, intense

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weakness, muscle pain, headache, sore throat, vomiting,
diarrhea, rash, impaired kidney and liver function and in some

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both internal and external bleeding.
The virus family Filoviridae includes three genera: Cuevavirus,
Marburgvirus, and Ebolavirus.
Within the genus Ebolavirus, five species have been identified:
Zaire, Bundibugyo, Sudan, Reston and TalForest.

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The first three, Bundibugyo ebolavirus, Zaire ebolavirus, and
Sudan ebolavirus have been associated with large outbreaks
in Africa.

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62. Antigen presenting cell(s) is/are?

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a) Skin langerhans cell
b) T-lymphocytes
c) Macrophages
d) Kuffer cell
e) Thymic epithelial cells

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Correct Answer - A:C:E
Ans. is 'a' i.e., Skin langerhans cell; 'c' i.e., Macrophages; ie.,
Kuffer cell; & `e' i.e., Thymic epithelial cells [Ref
Ananthanarayan 9th/e p. 137-38; Greenwood 16thle p. 133-34]
Important antigen presenting cells are macrophages, B-cells,

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dendritic cells and Langherhans cells. Dendritic cells are the
most potent and effective antigen presenting cells.
CD4helpar T cells are activated only when antigen is presented
by MHC-class II of APC --> MHC - H restricted.
CD8 cytotoxic T-cells recognize antigen that is presented by MHC

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- class I --> MHC - I restricted.
B-cells receptors (i.e. surface immunoglobulin) can be bind to
antigen and activate B-cells without involvement of MHC and
antigen presenting cells Antigen processing and presentation
by APCs is not required for B cells (in contrast to T-cells).

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63. Deficiency of both T and B lymphocyte
involved in all except?

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a) Chronic mucocutaneous candidiasis
b) Wiskott-Aldrich syndrome
c) DiGeorge syndrome
d) Ataxia Telangiectasia
e) Common variable immunodeficiency

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Correct Answer - A:C:E
Ans. is 'a' i.e., Chronic mucocutaneous candidiasis; 'c'
i.e., DiGeorge syndrome; & `e' i.e., Common variable
immunodeficiency [Ref Ananthanarayan 9th/e p.174-
75; Robbin's 7h/e p. 239-401

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64. Dimorphic fungi is/are?
a) Histoplasma capsulatum
b) Sporothrix schenckii

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c) Malassezia furfur
d) Cryptococcus neoformans
e) Aspergillus
Correct Answer - A:B
Ans. is 'a' i.e., Histoplasma capsulatum; & 'b' i.e., Sporothrix

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schenckii [Ref Ananthanarayan ele p. 601,609; Jawetz 23'/e p.
6451.
Fungi that have two growth forms, such as mold (filaments) and a
yeast, which develop under different growth conditions.
In host tissues or cultures at 37?C they occur as yeasts, while in the

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soil and in cultures at 22?C they appear as moulds.
Yeasts are seen as rounded single cells or as budding
organisms. Candida and Cryptococcus are traditionally classified as
yeasts.
Most fungi causing systemic infections are dimorphic fungi

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Dimorphic Fungi are Jawetz 27th/853
Blastomycosis dermatitidis
Paracoccidioides brasiliensis
Coccidioides posadasii & Coccidioides immitis
Histoplasma capsulatum

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Sporotrix schenckii
Penicillium marneffe

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65. Non ture about Donovanosis?
a) Caused by Klebsiella granulomatis
b) Associated with pseudobuboes
c) Caused by Leishmania donovani

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d) Drug of choice is Miltefosine
e) Drug of choice is sodium stibogluconate
Correct Answer - C:D:E
Ans. is 'c' i.e., Caused by Leishmania donovani; 'd' i.e., Drug
of choice is Miltefosine; & `e' i.e., Drug of choice is sodium

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stibogluconate [Ref Ananthanarayan 9th/e p.397; Harrison's
19th/e p. 298e 1-2; Greenwood tele p.310; Park's 24th/e p.350]
Donovanosis is caused by Calymmatobacterium granulomatis, a
gram negative intracellular bacteria. Incubation period of
donovanosis is 1 to 4 weeks. It begins as one or more

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subcutaneous nodules that erode through skin to produce an ulcer.
Azithromycin is the DOC Alternatives are doxycycline (2" choice)
and chloramphenicol. Streptomycin, once used, is not in use
now. Note :Calymmatobacterium granulomatis is now called as
Klebsiella granulomatis.

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66. True about Actinomycosis?

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a) Caused by madurella mycetomatis
b) Caused by anaerobic or microaerophilic bacteria
c) Cervicofacial is the most common site affected
d) Sulphur granules are present in lesion
e) Belongs to growth factor category of oncogene

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Correct Answer - B:C:D:E
Ans. is 'b' i.e., Caused by anaerobic or microaerophilic bacteria
; 'c' i.e., Cervicofacial is the most common site affected; `d'
i.e., Sulphur granules are present in lesion; & `e' i.e., Belongs to
growth factor category of oncogene [Ref Ananthanarayan 9"'/e

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p.391-93, 600-01; Greenwood 16"/e p.221-22;
Harrison's 19th/e p.1088]
These are considered as a transitional form between bacteria and
fungi.
Actinomyces are `gram-positive'non-motile"non-capsulated"non-

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acid fast' and 'non-sporing' filaments that break up into bacillary
and coccoid elements.
They are anaerobic or microaerophilic (Ananthnarayan 9th/e p.
391-393)
Two important species are A. israelli and A. bovis. Most cases are

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due to A israelli.
Actinomyces are members of normal oral flora and are often
cultured from bronchi, G.I. tract, and the female genital tract.
Actinomycosis in human beings is an endogenous infection.
The critical step in the development of actinomycosis is disruption of

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mucosal barrier.

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67. Water loss of 5fi)-l0ffiml/hour in cholera
is know as-
a) Cholera gravis

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b) Cholera mitis
c) Cholera majoris
d) Cholera intermedius
e) Cholera totalis
Correct Answer - A

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Anwer-Ans. is 'a' i.e., Cholera gravis [Ref Harrison's
19m/e p, 1063; www.ncbi.nlm.nih.gov]
Vibrio cholera infection manifestations range from asymptomatic to
mild diarrhea to severe diarrhea.
Massive watery diarrhea (known as cholera gravis) may cause loss

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of 1000 ml water per hour. This can cause hypotensive shock &
death.

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68. Organism(s) commonly causing

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infection in cystic fibrosis patients
a) Burkholderiacepacia
b) Pseudomonas Aeruginosa
c) Staphylococcus Aureus
d) Burkholderia Mallei

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e) Streptococcus Pyogenes
Correct Answer - A:B:C
Ans. is 'a' i.e., Burkholderia cepacia; 'b' i.e., Pseudomonas
aeruginosa; & 'c' i.e., Staphylococcus aureus [Ref Harrison
19m/e p. 1699]

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Infections seen in cystic fibrosis are caused by
- Burkholderia cepacia
Pseudomonas aeruginosa (mucoid type)
Atypical mycobacteria
Non-typeable hemophilus influenzae

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Staphylococcus aureus (including MRSA

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69. Wbich of the following is/are Tick-
borne.disease-
a) Murine typhus
b) Epidemic thyphus

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c) Lyme's disease
d) Tularemia
e) Trench fever
Correct Answer - C:D
Ans. is 'c' i.e., Lyme's disease; & 'd' i.e., Tularemia [Ref Park's

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24m/e p.817, 805; Ananthanarayan le p.407; Greenwood 16m
le p. 350]
Hard tick Tick typhus, viral encephalitis, viral hemorrhagic fever,
KFD, Tularemia, tick paralysis, human habesiosis, Lyme's disease.
Soft tick Q fever, relapsing fever, KFD.

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70. Barrel shaped eggs is/are seen in -
a) Hookworm

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b) Pin worm
c) Roundworm
d) Whipworn
e) Strongyloides stercoralis
Correct Answer - D

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Ans. is 'd' i.e., Whipworm [Ref Rajesh karykarte 1"/e p. 1661
Eggs of Trichuris-trichura (whipworm) are barrel-shaped with
mucous plug at each pole. Shell is yellow to brow (bile-stained) and
plugs are colourless. They float in saturated solution of common
salt. When freshly passed, they contain unsegmented ova and are

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not infective to man.

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71. Which of the following is true about
malaria -
a) Chloroquine resistance occurs in India
b) Relapses is usual for vivax and ovale malaria

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c) Sexual cycle occurs in mosquito
d) Not a public problem in India
e) None
Correct Answer - A:B:C
Ans. is 'a' i.e.,Chloroquine resistance occurs in India; 'b' i.e.,

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Relapses is usual for vivax and ovale malaria; & 'c' i.e.,
Sexual cycle occurs in mosquito [Ref KDT 7Ve p. 822; Park
24th le p. 272-75]
Malaria contiues to pose a major public health problem in India,
especially due to P. falciparum.

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Chloroquine - resistant P. falciparum malaria in India is widespread.

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72. True about tapeworm is/are -
a) Taenia saginata is beef tapeworm

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b) Taenia solium is more prevalent
c) Infection is acquired by ingestion of cysticercus in raw beef
d) Infectious form to animal is egg
e) None
Correct Answer - A:C:D

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Ans. is 'a' i.e., Taenia saginata is beef tapeworm; 'c' i.e.,
Infection is acquired by ingestion of cysticercus in raw
beef;`d' i.e., Infectious form to animal is egg [Ref Medical
microbiology E-book 215]
Two species of Taenia infect man :?

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. Taenia saginata : The beef tapeworm.
. Taenia solium : The pork tapeworm.
Mode of infection of tapeworms
. T. saginata - Under cooked beef containg cysticercus bovis.
. T. solium Undercooked pork containg cysticercus cellulosae &

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rarely by ingestion of egg (autoinfection).
Occasionally man gets infected in the same way as pig, by ingestion
of eggs (either by drinking contaminated water or by eating
uncooked vegetables infected with eggs). In this cycle man acts
both as definitive as well as intermediate host.

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73. Which of the following Nanoparticle(s)
inhibit both E coli and Staph aureus ?
a) Zinc oxide

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b) Silver nanoparticle (SNP)
c) Copper oxide
d) Aluminum oxide
e) None
Correct Answer - A:C

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Ans. is 'a' i.e., Zinc oxide; 'c' i.e., Copper oxide [Ref
Clinical Nanomedicine handbook]
A number of nanoscale metals, metal oxides, oral natural &
synthetic polymers possers antimicrobial properties.
ZnO Staphylococcus, Escherichia coli

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ZnO ions Pseudomonas aeruginosa, S aureus Candida albleari
SNP E. coli, Vibrio cholera, Salmonella lyphi, P. aeruginosa
AI203 E. coli, B. subtilis, Pseudomonas fluorescens

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74. True about aspergillus infection -
a) Forms hyphae
b) Branched at 90?
c) Nonseptate

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d) Septate
e) Causes subcutaneous infections
Correct Answer - A:D
Ans. is 'a' i.e., Forms hyphae; 'd' i.e., Septate [Ref
Ananthnarayan 8th/e p. 613; Harrison 19'Ve p. 1346]

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75. Most common cause of non-gonococcal
urethritis -
a) Mycoplasma hominis

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b) Mycoplasma genitalium
c) Ureoplasma urealyticum
d) Chlamydia trachomatis
e) Haemophilus ducrey
Correct Answer - D

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Ans. is 'd' i.e., Chlamydia trachomatis [Ref: Essentials
of microbiology 3rdle p. 786]
urethritis
Gonococcal
Nongonococcal

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Neisseria gonorrhea
Chlamydia Trachomatis (most
common)
Ureoplasmaurealyticum
Mycoplasmagenitalium

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Bacterioides
Haemophilus species
Candida albicans
T.vaginalis

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76. Lesions caused by spirochetes are -

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a) Syphilis
b) Yaws
c) Legionella pneumonia
d) Pinta
e) Lyme's disease

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Correct Answer - A:B:D:E
Ans. is 'a' i.e., Syphilis; 'b' i.e., Yaws; 'd' i.e., Pinta; 'e'
i.e., Lyme's disease
Spirochetes are elongated, spirally coiled, flexible bacteria.
Characteristic feature of spirochetes is presence of endoflagella

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which do not protrude outside.
Pathogenic spirochetes belong to three genera : Treponema,
Borrelia And Leptospira.
Spirochete species
disease

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Treponema Pallidum
Syphilis
Endemicum Bejel
Pertunae
Yaws

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Carateum Pinta
Borrelia
Burgdorferi Lyme disease
Recurrentis Relapsing fever
Vincenti

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Vincent angina
Leptospira Interrogans Weil's disease

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77. Not true about candida albicans -

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a) Dimorphic fungus
b) Yeast like fungus
c) Reynolds-Braude phenomenon
d) Forms true hyphae
e) Forms pseudohyphae

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Correct Answer - A:B:C:D:E
Ans. is 'None' i.e., All options are correct [Ref Ananthnarayan
Stile p. 607; Essentials of Microbiology p. 717
Candida is a yeast like fungus.
All candida species pathogenic for humans are also encountered as

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commensals of humans, particularly in the mouth, stool and vagina.
They grow rapidly on simple media as oval budding cells at 25? to
37?C.
In tissue, both yeasts and pseudohyphae are present.
Candida albicans is differentiated by other candida :

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It forms true hyphae (mycelia) or germ tubes when grown in serum.
It forms thick walled large spores called chlamydospores when
grown in corn meal agar.
It is dimorphic. Candida albicans can produce yeast, true hyphae
and pseudohyphae.

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A rapid method of identifying C. albicans is based on its ability to
form germ tubes within two hours when incubated in human serum
at 37?C --> Reynolds - Braude phenomenon ( Also known as
germ tube test).
Candida yeast cells and pseudohyphae are the only fungi that are

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usually gram - positive on smears.

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78. True about streptococcus agalactiae -
a) Catalase positive
b) Catalase negative

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c) Beta hemolytic
d) Alpha hemolytic
e) Bacitracin resistant
Correct Answer - B:C:E
Ans. is 'b' i.e., Catalase negative; 'c' i.e., Beta hemolytic; 'e'

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i.e., Bacitracin resistant
Streptococcus agalactiae is bacitracin resistant. Only streptococcus
sensitive to bacitracin is streptococcus pyogenes.
Sensitivity to bacitracin is employed as a convenient method for
differentiating str. pyogenes from other hemolytic streptococci

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(Maxted's observation).
Streptococcus agalactiae (also known as group B streptococcus or
GBS) is a gram-positive coccus (round bacterium) with a tendency
to form chains (as reflected by the genus name Streptococcus). It
is a beta-hemolytic, catalase-negative, and facultative anaerobe.

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79. True about cellulitis Vs erysipelas -
a) Cellulitis is deep
b) Erysipelas is deep
c) Both caused by streptococcus pyogenes
d) Cellulitis starts abruptly

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e) Erysipelas starts slowly
Correct Answer - A:C
Ans. is 'a' i.e., Cellulitis is deep; 'c' i.e., Both caused by
streptococcus pyogenes [Ref Text book of Dermatology p. 1531
Erysepelas and cellulitis are caused mostly by streptococcus

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pyogenes
Cellulitis affects the deeper loose subcutaneous tissue. As in any
continum of disease, some overlap can occur. Despite their
common etiology, significant differences in presentation, signs, and
clinical course are noted.

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Almost all cases erysipelas are caused by Str pyogenes. Whereas
cellulitis is caused most commonly by Str pyogenes, rarely it can
also be caused by staphylococcus, ldebsiella, H influenzae

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80. Painful penile ulcer with suppurative
lymphadenopathy is seen in ?

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a) Syphilis
b) Hard chancre
c) Soft chancre
d) Haemophilus ducreyi
e) Donovanosis

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Correct Answer - C:D
Ans. is 'c' i.e., Soft chancre; 'd' i.e., Haemophilus ducreyi
Chancroid (Soft chancre), Haemophilus Ducreyi*, 1-14 days, ?
Painful non indurated ulcer (soft chancre), Painful lymphadenopathy

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81. True about treatment of leprosy ?
a) Multibacillary leprosy is treated by 3 drugs
b) Paucibacillary leprosy is treated by 1 drug
c) Paucibacillary leprosy is treated for 1 year

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d) Post-treatment surviellance for multibacillary leprosy is for
5 years
e) Clofazimine is first line drug
Correct Answer - D:E
Ans- d) Post-treatment surviellance for multibacillaryleprosy

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is for 5 years; 'e' i.e., Clofazimine is first line drug [Ref
Harrison 19th le p. 11261 .
Paucibacillary : Bacteriological index is less than 2 with 5 or less
skin lesions. It includes Borderline tuberculoid (BT), Tuberculoid
(TT) and Indeterminate leprosy.

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Multibacillary : Bacteriological index is 2 or more with 6 or more skin
lesions. It includes Borderline (BB). Borderline lepromatous (BL)
and Lepromatous (LL) leprosy.
Drugs used for leprosy are :-
First line : Rifampicin, dapsone and clofazimine.

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Other : Minocycline, Quinolones (oxacilin), ethionamide,
clarithromycin, rifapentine and moxifloxacin.
Rifampicin is the most active (rapidly acting and bactericidal drug)
for leprosy

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82. Deficiency of both B and T lymphocytes is
seen in ?
a) Wiskott Aldrich syndrome
b) Digeorge syndrome
c) Ataxia telangiectasia

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d) Common variable immunodeficiency
e) Chronic mucocutaneous candidiasis
Correct Answer - A:C
Ans. is 'a' i.e., Wiskott Aldrich syndrome; 'c' i.e.,
Ataxia telengectasia [Ref Atlas of immunology p. 537]

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Combined immunodeficiencies (B and T cell defects)
Cellular immunodeficiency with abnormal immunoglobulin synthesis
(Nezelof syndrome)
Ataxia telangiectasia
Wiskott-Aldrich syndrome

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Immunodeficiency with thymoma
Immunodeficiency with short-limbed dwarfism 0 Episodic
lymphopenia with lymphocytotoxin
Severe combined immunodeficiencies
'Swiss type' agammaglobulinemia

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Reticular dysgenesis of de Vaal
Adenosine deaminase (ADA) deficiency

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83. True regarding erysipelas are -
a) Caused by S pyogenes
b) Superficial skin lesion

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c) More seen on face than trunk
d) Has history of recent sore throat infection
e) None
Correct Answer - A:B:C:D
Ans. is 'a' i.e., Caused by S pyogenes; 'b' i.e., Superficial skin

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lesion; 'c' i.e., More seen on face than trunk; i.d., Has history
of recent sore throat infection [Ref Text book of Dermatology
p. 1531
Erysipelas is a superficial skin infection affecting upper dermis and
extends into the superficial lymphatics.

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It is caused mostly by streptococcus pyogenes (group A Beta
hemolytic streptococcus).
Symptoms and signs of erysipelas are usually abrupt in onset and
often accompanied by fevers, chills and shivering.
Erysipelas predominantly affects the skin of the lower limbs, but

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when it involves the face it can have a characteristic butterfly
distribution on the cheeks and across the bridge of the nose.
The affected skin has a very sharp, raised border.
It is bright red, firm and swollen. It may be finely dimpled (like an
orange skin).

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It may be blisthered, and in severe cases may become necrotic.
Bleeding into the skin may cause purpura.

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84. Most common route of transmission of

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tuberculosis to neonate -
a) Aerosol infection
b) Skin contact
c) Transplacental infection
d) Venous route

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e) Haematogenous infection
Correct Answer - C:D:E
Ans. is 'c' i.e., Transplacental infection; 'd' i.e., Venous route; 'e'
i.e., Haematogenous infection [Ref Clinical neonatology 4thie
p. 153]

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Transplacental spread:
It is the most common mode of transmission
Tubercle bacilli cross the placenta through the umbilical vein and a
primary focus develops in the fetal liver with involvement of
periportal lymph nodes and the bacilli infect secondarily the lung. It

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is a hematogenous infection and is called congenital infection by
vertical transmission of TB.
Aspiration or ingestion
Neonate may acquire the disease in utero or during child birth
(intrapartum) by aspiration or ingestion of infected aminiotic fluid.

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It causes primary infection of fetal lungs and gut.

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85. CD marker on natural killer cells ?

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a) CD-16
b) CD-56
c) CD-3
d) CD-4
e) CD-8

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Correct Answer - A:B:C
Ans. is 'a' i.e.,CD-16; `b' i.e., CD-56; 'c' i.e., CD-3 [Ref
Anantanarayan Sole p. 137; Harrison 19th/e p. 372]
Null cells are called so because they lack features of surface
markers of both B and T lymphocytes. The account for 5 to 10%

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of peripheral blood lymphocytes.
They are also called "large granular lymphocytes (LGL)" as they
contain large azurophilic cytoplasmic granules. They express
CD16 and CD56 markers. They proliferate in response to IL-2.
LGLs arise in both bone marrow and thymic microenvironment. In

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contrast to T-cells, they are not MHC restricted.
NK-cells are positive for CD16 and CD56.
NK cells are usually negative for CD3, but a subset is positive for
CD3 called NK/T-cells.
IL-2 acts as a growth factor for NK cells. NK cells activity is

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augmented by interferon. NK cells secrete peroforin (resembles
comlement C9) which causes transmembrane pores through which
cytotoxic factors (e.g. TNF-(3) enters the cells and induce
apoptosis.

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86. Incorrect statement(s) regarding HPV is
are -

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a) DNA virus
b) RNA virus
c) 16, 18 types cause carcinoma
d) Verrucus vulgaris is most common
e) Recently approved vaccine is trivalent

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Correct Answer - B:E
Ans. is 'b' i.e., RNA virus; 'e' i.e., Recently approved vaccine
is trivalent
HPV is a non-enveloped DNA virus (ds DNA), belongs to
Papovaviridae.

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HPV selectively infects the epithelium of skin and mucous
membrane and may immortalize the keratinocytes leading
either asymptomatic infection, or warts or neoplasia.
Products of E-genes (E6, E7) are related to immortalization or
malignant transformation of keratinocytes by interfering with p53

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and Rb genes, respectively.
HPV infects only human skin and grows only in organ cultures of
human skin.
Warts are benign extra growth of skin and mucous membrane
resulting from infection with human papilloma virus (HPV). They

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are common in children and young adults
There are two types of HPV vaccines :-
Quadrivalent :- containing HPV types 6,11,16,18
Bivalent :- containing HPV types 16,18

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Efficacy of vaccine has varied according to immunologic and
virological characteristics of study populations at baseline and
according to the endpoints evaluated. Most of the time, rates

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of vaccine efficacy exceed 90%.
Vaccine is recommended for girls and young women 9-26 years of
age.

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87. Correct about adenovirus -
a) Causes conjunctivitis
b) Diarrhea is caused by serotype 40
c) Single stranded DNA virus
d) Causes intussusception

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e) Type 14 causes most severe disease
Correct Answer - A:B:D:E
Ans. is 'a' i.e., Causes conjunctivitis; 'b' i.e., Diarrhea is
caused by serotype 40; 'd' i.e., Causes intussusception & `e'
i.e., Type 14 causes most severe disease.

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Non-enveloped, DNA (ds DNA) Virus
Has characteristic morphology consisting of an icosahedral shell
composed of 20 equilateral triangular faces and 12 vertices -3
space vehicle appearance.
Human adenovirus grows only in tissue culture of human

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origin, such as human embryonic kidney, HeLa or HEP-2.
Cytopathic effects in tissue culture ---> cell rounding and
aggregation into grape like clusters.
Adenovirus has been used as a vector for gene therapy.
Adenovirus cause infections of the respiratory tract and eyes and

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less often of the intestine and urinary tract.
Most frequently affect infants and children
Most common manifestation in children is an acute upper respiratory
tract infection with prominent rhinitis.
Most common manifestation in adult ARDS.

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Adenovirus serotype 14 has been associated with severe and
potentially fatal outbreak of pneumonia.

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88. Griffith experiment was done on ?

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a) Salmonella
b) Streptococcus pneumoniae
c) Enterococcus
d) Staphylococcus
e) None

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Correct Answer - B
Ans. is 'b' i.e., Streptococcus pneumoniae [Ref
Advanced biology p. 396]
In 1928, Frederick Griffith's experiment first demonstrated
transformation in streptococcus pneumoniae.

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Frederick Griffith's experiment on pneumococcus (streptococcus
pneumoniae) proved that genetic characters are transmitted
from one generation to the other through transformation.
It is transfer of genetic information through the agency of free DNA.
It was the first example of genetic exchange in bacteria to be been

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discovered Griffith in 1928 found that mice died when injected with a
mixture of live non-capsulated (R) Streptococcus pneumoniae
& heat killed capsulated (S) S.pneumoniae, neither of
which separately proved fatal

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89. True about chancroid:
a) Bacilli causing the disease shows School of fish appearance
b) Painful ulcer

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c) Incubation period is 10-90 day
d) Presents as painless lymphadenopathy
e) Sharply demarcated & elevated edge
Correct Answer - A:B:D
Ans: a. Bacilli causing..., b. Painful..., d. Presents.[Ref

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Ananthanarayan 9th/ 331;Harrison 19th/880,1012-13]
Chancroid or soft sore is a venereal disease characterized by
tender non-indurated irregular ulcers on the genitalia
The bacilli may be arranged in small groups or whorls or in parallel
chains, giving a 'school of fish' or 'rail road track' appearance

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The infection remains localized, spreading only to the regional lymph
nodes which are enlarged & painful
Infection is acquired as the result of a break in the epithelium during
sexual contact with an infected individual.
Approximately half of patients develop enlarged, tender inguinal

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lymph nodes, which frequently become fluctuant and
spontaneously rupture.

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90. Which of the following spread by
ingestion of eggs:
a) Strongyloides

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b) Trichinella
c) Trichuris
d) Ascaris
e) Ancylostoma duodenale
Correct Answer - C:D

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Ans: c. Trichuris d. Ascaris
Strongyloides: Infective form is filariform larva (Panikar 7th/178)
"Trichinella: Infective form is encysted larva found in muscles of pigs
& other animals" (Panikar 7th/168)
"Ancylostoma duodenale- Infective form is third stage filariform

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larva" (Panikar 7th/168)
. By ingestion
. Eggs: Ascaris, enterobius, Trichuris
. Larva within intermediate host: Dracunculus
. Encysted larvae in muscle: Trichinella

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. By penetration of skin: Ancylostoma, Necator, Strongyloides
. By blood sucking insects: Filariae
. By inhalation of dust containing eggs: Ascaris, enterobius

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91. To check the efficiency of the heat

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sterilization, which of the following
microbe is/are used :
a) Geobacillus stearothermophilus
b) Bacillus subtilis
c) Salmonella

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d) Pneumococcus
e) Bacillus stearothermophilus
Correct Answer - A:B:E
Ans: a. Geobacillus stearothermophilus b. Bacillus
subtilis e. Bacillus stearothermophilus[Ref

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Ananthanarayan 9th/30,32 ; Greenwood 16th/771
Sterilisation Control (Dry Heat)
The spores of a non-toxigenic strain of clostridium tetani or Bacillus
subtilis subspecies niger are used as a microbial test of dry heat
efficiency.

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For determining the efficacy of moist heat sterilization, spores of
Bacillus stearothermophilus are used as the test organism
"Geobacillus stearothermophilus (or Bacillus stearothermophilus) is
constantly used in the biotech industry to test the success of
sterilization cycles of equipment.

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Due to the bacteria's high resistance to heat, it is a suitable
biological Indicator of microbe life after a sterilization cycle.

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92. All are true about cytomegalovirus except:
a) May be transmitted from pregnant mother to foetus

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b) Type 5 Human herpes virus
c) Lymphocyte enlargement
d) Cause congenital diseases
e) May lead to fetal death
Correct Answer - C

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Ans: c. Lymphocyte enlargement [Ref Harrison 19th/1190-
91; Ananthanarayan 9th/473-74 ; Jawetz 27th/470-74]
Cytomegalovirus (Human Herpes Virus Type 5)
It is cytomegalic (not lymphoproliferative, which occur in HHV4, 6 &
7)

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Characterized by enlargement of infected cells
Congenital infection- Intrauterine infection leads to fetal death or
cytomegalic inclusion disease of newborn which is often fatal The
hallmark of such infection is the appearance of atypical lymphocytes
in the peripheral blood; these cells are predominantly activated

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CD8+ T lymphocytes.

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93. True about bacteriorhodopsin:
a) Present in the cell membrane
b) It acts as proton pump

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c) Generate ATP
d) Use light energy
e) Same as rhodopsin found in human
Correct Answer - A:B:C:E
Ans: a. Present in the cell membrane b. It acts as proton pump

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c. Generate ATP d. Same as rhodopsin found in human
Bacteriorhodopsin is a protein used by Archaea, most notably by
Halobacteria, a class of the Euryarchaeota.
It acts as a proton pump; that is, it captures light energy and uses it
to move protons across the membrane out of the cell. The

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resulting proton gradient is subsequently converted into chemical
energy.
Bacteriorhodopsin is a trans-membrane protein found in the cellular
membrane of Halobacterium salinarium, which functions as a light-
driven proton pump.

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Bacteriorhodopsin is a proton pump found in Archaea, it takes light
energy and coverts it into chemical energy i.e. ATP, that can be
used by the cell for cellular functions.

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94. Burkdholeria cepacia infection is/are
typically associated with:

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a) Cystic fibrosis
b) Chronic bronchitis
c) Chronic granulomatous disease
d) Multiple myeloma
e) Myeloperoxidase deficiency

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Correct Answer - A:C
Ans: a. Cystic fibrosis & c. Chronic granulomatous disease
[Ref Ananthanarayan 9th/316; Medical microbiology by
Greenwood 16th/286-88; Jawetz Microbiology 27th/248-49]
Burkholderia cepacia is increasingly being recognized as an

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opportunist environmental pathogen, particularly in those with
cystic fibrosis or chronic granulomatous disease, in whom it
causes fatal necrotizing pneumonia" (Ananthanarayan 9th/316;
Greenwood 16th/286-88)
Burkholderia cepacia is an environmental organism that is able to

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grow in water, soil, plants, animals, and decaying vegetable
materials.
B cepacia grows on most media used in culturing patients'
specimens for gram-negative bacteria. Selective media containing
colistin also can be used. B cepacia grows more slowly than

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enteric gram-negative rods, and it may take 3 days before colonies
are visible

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95. T. saginata is differentiated from T. solium

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by presence of:
a) Hooks in scolex (head)
b) 4 large pigmented sucker
c) Uterus is thin & dichotomous
d) Short neck

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e) Egg is not infective to man
Correct Answer - B:C:E
Ans: b. 4 large pigmented sucker , c. Uterus is thin &
dichotomous & e. Egg is not infective to man.[Ref
Paniker's Parasitology 7th/121; Medical microbiology by

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Greenwood 16th/610-11]
Taenia saginata
Taenia solium
Length
5-10 Medical

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2-3 m
Transcriptionists
Large quadrate,
Small and globular,
Rostellum and hooks Rostellum and hooks are

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Scolex
are Absent, Suckers present,
may be Pigmented Suckers not pigmented
Neck
Long

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Short
Proglottids
1, 000-2, 000
Below 1, 000
Measurement 20 mm x 5 mm

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12 mm x 6 mm
Expelled passively in chains
Expulsion
Expelled singly
of 5 or 6

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Lateral branchesl5- Lateral branches 5-10 on
Uterus
30 on each side; thin each side; thick and

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anddichotomous

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dendritic
Vagina
Present
Absent
Accessary

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Absent
lobe of ovary
Present
Testes
300-400 follicles

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150-200 follicles
Cysticercus
Cysticercus cellulosae;
Larva
bovis;present in cow present in pig and also

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not in
in man
man
Egg
Not infective to man Infective to man

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96. Laboratory finding (s) of a patient having
chronic hepatitis B infection with low viral
load:
a) HBsAg

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b) Anti-HBs
c) Anti-HBe
d) Anti-HBc IgG
e) HBeAg
Correct Answer - A:C:D

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Ans: a. HBsAg , c. Anti-HBe & d. Anti-HBc IgG [Ref
Ananthanarayan 9th/546-48; Park 23rd/215; Harrison
19th/2016-181
The first virologic marker detectable in serum within 1-12 weeksQ,
usually between 8-12 weeks, is HBsAg. Q

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In typical case, HBsAg becomes undetectable 1-2 months after the
onset of jaundice and rarely persists beyond 6 months. After
HBsAg disappears, antibody to HBsAg (anti-HBs) detectable in
serum and remains detectable indefinitely thereafter.
Testing for IgM anti-HBc may be useful to distinguish between acute

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or recent infection (IgM anti-HBc-positive) and chronic HBV
infection (IgM anti-HBc-negative, IgG anti-HBc-positive).
Another serologic marker that may be of value in patients with
hepatitis B is HBeAg. Its principal clinical usefulness is as an
indicator of relative infectivity. Because HBeAg is invariably

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present during early acute hepatitis B, HBeAg testing is indicated
primarily during follow-up of chronic infection.

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Anti-HBs is rarely detectable in the presence of HBsAg in patients

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with acute hepatitis B, but 10-20% of persons with chronic HBV
infection may harbor low-level anti-HBs

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97. True about Botulinum toxin:

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a) Interfere with adrenergic transmission
b) Interfere with Cholinergic transmission
c) Increase release of synaptic vesicles
d) Inhibit release from synaptic vesicles
e) Act also on CNS

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Correct Answer - B:D:E
Ans: b. Interfere with Cholinergic transmission, d. Inhibit
release from synaptic vesicles & e. Act also on CNS [Ref K. D.
T 7th/99-100, 121; Ananthanarayan 9th/264]
"Two toxins interfere with cholinergic transmission by affecting

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release: botulinum toxin inhibit release, while black widow
spider toxin induces massive release er depletion"- K.D. T
7th/99
A localized injection can be used in treatment of a number of spastic
& other neurological conditions due to overactivity of cholinergic

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nerves like blepharospasm, spastic cerebral palsy, strabismus,
spasmodic torticollis, nystagmus, hemifacial spasm, poststroke
spasticity, spasmodic dysphonia, axillary hyperhydrosis etc
It acts by blocking the production or release of acetylcholine at the
synapses & neuromuscular junctions

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Onset is marked by diplopia, dysphagia & dysarthria due to cranial
nerve involvement
A symmetric descending paralysis is the characteristic pattern,
ending in death by respiratory paralysis

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98. True about Swine flu:

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a) Older bird influenza vaccine is equally effective in swine flu
b) Oseltamivir is effective in prevention
c) Zanamivir can be used for treatment
d) Influenza vaccine provides immunity just after vaccination.
e) None

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Correct Answer - B:C
Ans: b. Oseltamivir is effective in prevention & c. Zanamivir
can be used for treatment [Ref Park 23rd/156-59;
Ananthanarayan 9th/503]
Swine influenza- emerged in march 2009 as new H1N1 virus

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disease, Also called as swine origin influenza, It spread from
person to person & caused a pandemic.
Pandemic influenza A (H1N1) 2009- Currently susceptible to
oseltamivir zanamivir but resistant to amantadine or
rimantadine, Treatment: oseltamivir adult oral dose is 75 mg

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twice daily for 5 days. Zanamivir dose is two inhalation (2 x 5
mg) twice daily for 5 days
Chemoprophylaxis: Oseltamivir is drug of choice for
chemoprophylaxis. It should be given till 10 days after last
exposure, Influenza vaccine only become effective about 14 days

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after vaccination. Those infected shortly before (1-3 days) or shortly
after immunization can still get the disease., Vaccinated individuals
can also get influenza caused by a different strain of influenza
virus, for which the vaccine does not provide protection

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99. True statement regarding NK cells are all
except:
a) Also called as Large granular lymphocyte
b) Can kill viral infected cell

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c) Forms first line of defence
d) Can kill tumour cell
e) No role in cell mediated immunity
Correct Answer - E
Ans: e. No role in cell mediated immunity [Ref

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Ananthanarayan
9th/137;
Robbins
9th/192;
Medical

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microbiology by Greenwood 16th/129; Harrison 19th/372e6-7]
NK cells are endowed with the ability to kill a variety of virus-infected
cells and tumor cells, without prior exposure to or activation by
these microbes or tumors. This ability makes NK cells an early line
of defense against viral infections and, perhaps, some tumors

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The function of NK cells is to destroy irreversibly stressed and
abnormal cells, such as virus-infected cells and tumor cells. NK
cells make up approximately 5% to 10% of peripheral blood
lymphocytes.
NK cell: They have CD 16 & CD 56Q on their surface. They release

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several cytolytic factors; one of these, perforins, which resembles
complement C9, cause transmembrane pores through which
cytotoxic factor enter the cell. NK cell activity is augmented by
interferon0.
N K cell: Form part of innate immunity as it does not require prior

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sensitisation by antigen. Their cytotoxicity is not antibody
dependent or MHC restricted.

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100. All are true about severe combined

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immunodeficiency except:
a) B & T cell deficiency
b) Adenosine deaminase deficiency may occur
c) Affected child can survives beyond adolescence
without treatment

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d) Can transmit either as X-linked or autosomal recessive defect
e) Person susceptible to recurrent & severe infections
Correct Answer - C
Ans: (C) Affected child can survives beyond adolescence
without treatment [Ref Ananthanarayan 9th, 174-75;

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Robbins 9th/239-4
Adenosine deaminase deficiency: This the first immunodeficiency
disease associated with an enzyme deficiency, Deficiency of
both humoral & CMI response.
Persons with SCID are extremely susceptible to recurrent, severe

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infections by a wide range of pathogens, including Candida
albicans, Pneumocystis jiroveci, Pseudomonas, cytomegalovirus,
varicella, and a whole host of bacteria.
The most common form, accounting for 50% to 60% of cases, is X-
linked, and hence SCID is more common in boys than in girls. The

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genetic defect in the X-linked form is a mutation in the common y-
chain (yc) subunit of cytokine receptors.
Autosomal recessive SCID: The remaining forms of SCID are
autosomal recessive disorders. The most common cause of
autosomal recessive SCID is a deficiency of the enzyme

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adenosine

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deaminase (ADA). Other is Mutations of an intracellular kinaseJak3
& Mutations in recombinaseactivating genes (RAG)

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The SCID syndrome is inherited either as an X-linked or autosomal
recessive defect, and affected infants rarely survive beyond 1 year
without treatment.

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101. Which of the following is/are true about
HIV-2:
a) HIV-2 first detected in West Africa in 1986
b) Donated blood is only screened for HIV-1, not HIV-2

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c) More virulent than HIV 1
d) More closely related to simian immunodeficiency virus than
HIV 1
e) Mode of transmission is like HIV1
Correct Answer - A:D:E

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Ans: a. HIV-2 first detected in West Africa in 1986 , d. More
closely related to simian immunodeficiency virus than HIV 1
& e. Mode of transmission is like HIV1,
[Ref Ananthanarayan 9th/573, 194-95; Harrison 19th/1216,
1222; Greenwood 16th/527]

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HIV strains first isolated from West Africa in 1986, which react with
HIV type 1 antiserum very weakly or not at all have been termed
HIV type 2, HIV 2 has only 40% genetic identity with HIV 1.
It is more closely related to simian immunodeficiency virus than to
HIV 1, It is much less virulent than HIV 1

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It is largely confined to West Africa, through isolations have been
reported from some other areas, including western & southern
India.
HIV-2 is transmitted by the same routes as HIV-1- Greenwood
16th/535

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Line immune assays (LIAs): These assays allow for application of
antigens from more than one virus, thereby allowing them to act
as combination assays & to differentiate infection by HIV 1 & HIV
2.

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102. Which of the following is picornaviridae:
a) Polio virus

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b) Coxsackievirus
c) Rhinovirus
d) Coronavirus
e) Reovirus
Correct Answer - A:B:C

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Ans: a. Polio virus , b. Coxsackievirus & c. Rhinovirus[Ref
Ananthanarayan 9th/484-85, 440; Harrison 19th/1289-95;
Jawetz 27th/5141
Rheovirus belongs to reoviridae family ,Corona virus belongs to
coronaviridae (Ananthanarayan 9th/441)

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Enteroviruses, members of the family Picornaviridae, are so
designated because of their ability to multiply in the
gastrointestinal tract.
Despite their name, these viruses are not a prominent cause of
gastroenteritis.

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Enteroviruses encompass more than 100 human serotypes: 3
serotypes of poliovirus, 21 serotypes of coxsackievirus A, 6
serotypes of coxsackievirus B, 28 serotypes of echovirus,
enteroviruses 68-71, and multiple new enteroviruses (beginning
with enterovirus 73) that have been identified by molecular

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techniques.
Human enteroviruses have been reclassified into four species
designated A-D. Echoviruses 22 and 23 have been reclassified as
parechoviruses 1 and 2 on the basis of low nucleotide homology
and differences in viral proteins.

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The Picornaviridae family contains 12 genera Rhinoviruses

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historically were placed in separate genus but are now considered
to be members of Enterovirus genus.

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103. Features of stage III HIV infection is/are:
a) Fever > 38. 5 OC
b) Oral hairy leukoplakia
c) Candidiasis

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d) Diarrhoea of >20 day duration
e) > 26% CD4 count in adults
Correct Answer - B:C
Ans: b. Oral hairy leukoplakia , c. Candidiasis [Ref Park
23rd/349; Ananthanarayan 9th/575; Harrison 19th/1215-16,

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1257] We will answer on applying both criteria CDC & WHO as
it is not specifically mentioned .
The current U. S. CDC classification system for HIV infection and
AIDS categorizes people on the basis of clinical conditions
associated with HIV infection and CD4+ T lymphocyte

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measurement.
A confirmed HIV case can be classified in one of five HIV infection
stages (0, 1, 2, 3, or unknown).
If there was a negative HIV test within 6 months of the first HIV
infection diagnosis, the stage is 0, and remains 0 until 6 months

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after diagnosis.
Advanced HIV disease (AIDS) is classified as stage 3 if one or more
specific opportunistic illness has been diagnosed Otherwise, the
stage is determined by CD4 test results and immunologic criteria
If none of these criteria apply (e.g., because of missing information

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on CD4 test results), the stage is U (unknown).

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104. Microbiological organism can be
recoverd from:
a) Sulphur granules of actinomycetes

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b) Streptococci from Valve leaflet lesion in rheumatic valvulitis
c) Petechial purpura for Meningococci
d) Corynebacterium in pseudomembrane in throat
e) None
Correct Answer - A:C:D

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Ans: a. Sulphur granules of actinomycetes, c. Petechial
purpura for Meningococci & d. Corynebacterium in
pseudomembrane in throat,
[Ref Ananthanarayan 9th/392; Harrison 19th/979;
Greenwood 16th/189-90]

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Isolation in culture: Sulphur granules or pus containing
actinomycetes are washed & inoculated" (Ananthanarayan
9th/392)
Petechial lesion: Meningococci may sometimes be demonstrated in
petechial lesions by microscopy & culture" (Ananthanarayan

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9th/230)
Throat samples should be submitted to the laboratory for culture
with the notation that diphtheria is being considered. This
information should prompt cultivation on special selective medium
and subsequent biochemical testing to differentiate C. diphtheriae

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from other nasopharyngeal commensal corynebacteria:' (Harrison
19th/979)
The diphtheria bacilli within the membrane continue to produce toxin
actively.

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Rheumatic valvulitis is manifestation of rheumatic heart disease.
Rhematic fever is an acute, immunologically mediated,
multisystem inflammatory disease classically occurring a few week

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after an episode of group A streptococcal infection.
Acute rheumatic fever: This occur after 1-3 week after acute
infection of S. pyogens so that organism may not be detectable
when sequelae set in. Essential lesion is characterized by
Aschoff nodules.

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105. All are the feature (s) of chancorid
except:
a) Ulcer bleed easily

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b) Painful
c) Bubo formation
d) Typically indurated
e) Caused by H. ducreyi
Correct Answer - D

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Ans: d. Typically indurated, [Ref Ananthanarayan 9th/331;
Robbins 9th/370; Harrison 19th/101213; Greenwood 16th/309]
Chancroid or soft sore is characterized by tender non-indurated
irregular ulcers on the genitalia
The infection remains localized, spreading only to the regional lymph

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nodes which are enlarged & painful
"Haemophilus ducreyi: After an incubation period of 4-7 days, the
initial lesion--a papule with surrounding erythema--appears.
In 2 or 3 days, the papule evolves into a pustule, which
spontaneously ruptures and forms a sharply circumscribed ulcer that

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is generally not indurated. The ulcers are painful and bleed easily;
little or no inflammation of the surrounding skin is evident.
Approximately half of patients develop enlarged, tender become
fluctuant and spontaneously rupture" (Harrison 18th)

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106. True about plague:
a) Seasonal spread

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b) No vaccine is available
c) Tetracycline is used both for chemoprophylaxis & treatment
d) Caused by gram negative motile bacteria
e) All ages are equally affected
Correct Answer - A:C

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Ans: a. Seasonal spread. , c. Tetracycline is used both
for chemoprophylaxis & treatment
Epidemic generally occur in cool, humid seasons that favour the
multiplication of fleas, leading to higher flea index
Fleas do not thrive in hot, dry weather & the transmission of infection

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is interrupted
Two types of vaccine have been in use- Killed vaccine (prepared at
the Haffkine Institute, Mumbai) & live vaccine (it is no longer
recommended)
Streptomycin, doxycycline & chloramphenicol are effective ? Park

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23rd/292-97)
Outbreaks of plague are usually seasonal in nature. In northern
India, the plague season starts from September until may. The
disease tends to die out with the onset of hot weather. On the
contrary, in south india, there was no definite plague season

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Temperature & humidity: A mean temperature of 20 to 25 deg. C, &
a relative humidity of 60% & above are considered favourable for
spread of plague
Agent: Y. pestis- a gram negative, non-motile, cocco-bacillus that
exhibit bipolar staining with special stains (e. g Wayson'd stain)

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Source of infection: Infected rodents & fleas & case of pneumonic
plague

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107. All are true about Toxoplasma infection
except:
a) May occur due to ingestion of oocyst from cat's faeces

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b) May spread by organ transplantation
c) Toxoplasmosis is symptomatic in usually immunocompetent
person
d) Infection is severe & progressive in immunocompromised host
e) Human infection is dead end for parasite

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Correct Answer - C
Ans: c. Toxoplasmosis... [Ref Paniker Parasitology 6th/100:
Harrison 19th/1398-1405,
Infective stage for man: Oocyst with sporozoites & tissue cyst with
bradyzoites

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Freshly passed oocyst is not infective (needs development in the
soil)
Human infection is dead end for the parasite
The principal source of human Toxoplasma infection remains
uncertain.

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Transmission usually takes place by the oral route and can be
attributable to ingestion of either sporulated oocysts from
contaminated soil or bradyzoites from undercooked meat
Intrauterine infection from infected mother to babies. Rarely by blood
transfusion or transplantation from infected donors.

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108. Which of the following disease (s) is/are
not toxin mediated:
a) Diphtheria
b) Tetanus

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c) Pertussis
d) Anthrax
e) Syphilis
Correct Answer - E
Ans: e. Syphilis...[Ref Ananthanarayan 8th/233, 317;

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Greenwood Microbiology 16th/91]
Virulent strains of diphtheria bacilli produce a very powerful exotoxin.
The pathogenic effects of the bacillus are due to toxin.
Pertussis toxin (PT): This is present only in Bordetellae pertussis. It
play an important role in the pathogenesis of whooping cough. PT

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toxoid is the major component of acellular pertussis vaccines
The anthrax toxin is a complex of three fractions: the edema factor
(OF or Factor I), the protective antigen factor (PA or Factor II) &
the lethal factor (LF or Factor III)"
Toxins inhibiting protein synthesis: 1) Shigella dysenteriae I (Shiga

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toxin) 2) Diphtheria 3) Pseudomonas 4) Verotoxin 1=Shiga like toxin
of E.coli)

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109. Commonly used stain (s) for identifying
fungus include (s):
a) Periodic acid-Schiff (PAS) stain
b) Von Kossa stain
c) Muramine silver stain

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d) Gomori's methenamine silver
e) Giemsa stain
Correct Answer - A:D
Ans: a. Periodic ..., d. Gomori's... [Ref: Ananthanarayan
8th/601: Harrison 19th/1330, 18th/1637]

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The PAS & methenamine silver stains are valuable methods for the
demonstration of fungal elements in tissue section. The
commonest culture media used in mycology are Sabouraud's
glucose agar, Czapek-Dox medium & Corn meal agar.
The von Kossa stain is used to quantify mineralization in cell culture

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and tissue section.
Giemsa stain is used in cytogenetics and for the histopathological
diagnosis of malaria and other parasites.
The stains most commonly used to identify fungi are periodic acid-
Schiff and Gomori methenamine silver. Candida, unlike other fungi,

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is visible on gram-stained tissue smears. Hematoxylin and eosin
stain is not sufficient to identify Candida in tissue specimens. When
positive, an India ink preparation of cerebrospinal fluid (CSF) is
diagnostic for cryptococcosis. Most laboratories now use calcofluor
white staining coupled with fluorescent microscopy to identify fungi in

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fluid specimens.

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110. Verruga peruana is caused by:
a) B. Bacilliformis
b) B.Henselae
c) B.Quintana

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d) B.Elizabethae
e) B. Grahamil
Correct Answer - A
Ans: (A) B bacilliformis..[Ref Ananthanarayan 8th/411-
12: Harrison 19th/1083, 1079, 18th/ 13191

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Bartonellosis, or Carrion's disease, is caused by B. bacilliformis. The
disease is characterized by two distinct phases: (1) an acute febrile
hematic phase, known as Oroya fever; and (2) an eruptive phase
manifested by cutaneous lesions, known as verruga peruana"
(Harrison 19th/1083,18th/1319)

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Verruga Peruana or Peruvian Wart: It is characterized by an eruptive
phase, in which the patients develop a cutaneous rash produced by
a proliferation of endothelial cells and is known as "Peruvian warts"
or "verruga peruana".

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111. Non-treponemal test includes:
a) RPR
b) VDRL
c) FTA-ABS
d) TPHA

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e) TPI
Correct Answer - A:B
Ans: a. RPR, b. VDRL [Ref Ananthanarayan 8th/375-76:
Harriosn 19th/1137-38, 18th/1384; CMDT 2016/1464; Greenwood
Microbiology 16th/347]

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There are two general categories of serologic tests for syphilis: (1)
Nontreponemal tests detect antibodies to lipoidal antigens present
in the host after modification by T pallidum. (2) Treponemal tests
use live or killed T pallidum as antigen to detect antibodies specific
for pathogenic treponemes.

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The RPR and VDRL tests are recommended for screening or for
quantitation of serum antibody. The titer reflects disease activity,
rising during the evolution of early syphilis and often exceeding 1:
32 in secondary syphilis. After therapy for early syphilis, a
persistent fall by fourfold or more (e.g., a decline from 1: 32 to 1: 8)

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is considered an adequate response.
Treponemal tests measure antibodies to native or recombinant T
pallidum antigens and include the fluorescent treponemal
antibody-absorbed (FTA-ABS) test and T. pallidum particle
agglutination (TPPA) test, both of which are more sensitive for

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primary syphilis than the previously used hemagglutination tests.
The most widely used nontreponemal antibody tests for syphilis are

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the rapid plasma reagin (RPR) and Venereal Disease Research
Laboratory (VDRL) tests, which measure IgG and IgM directed

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against a cardiolipin-lecithin cholesterol antigen complex.

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112. Which of the following has incubation
period of < 5 day:

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a) Salmonella typhi
b) Vibrio parahaemolyticus
c) Campylobacter jejuni
d) Shigella dyseneteriae
e) Yersinia pestis

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Correct Answer - B:C:D:E
Ans: b. Vibrio c. Campylobacter d. Shigella and e. Yersinia...
[Ref Ananthanarayan 8th/293, 299, 506, 312; Harrison
18th/1294; Greenwood 16th/300;]
Vibrio parahaemolyticus: After an incubation period of 4 hr to 4 days,

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symptoms develop & persists for a median period of 3 days"
(Harrison 18th/1294)
"Shigellae cause bacillary dysentery. It has a short incubation period
(1-7 days, usually 48 hours)' (Ananthanarayan 8th/285)
"Campylobacter jejuni: The incubation period is 1-7 days"?

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Ananthanarayan 8th/398
"Enteric fever (Salmonella typhi): The incubation period is usually 7-
14 days but may range 3-56 days" (Ananthanarayan 8th/293)
"Salmonella gastroenteritis (caused by any salmonella other than
s.typhi): Clinically the disease develops after short incubation period

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of 24 hours or less, with diarrhea, vomiting, abdominal pain & fever".

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113. Which of following Culture media
combination is/are true except:

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a) Thayer-Martin media: Gonorrhoea
b) Chocolate agar-: enriched media
c) Lowenstein-Jensen Medium: Mycobacterium tuberculosis
d) Muller-Hinton agar: Corynebacterium diphtheriae
e) Mac Conkey's agar: Non lactose fermenters

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formcolourless colonies
Correct Answer - D
Ans: d. Muller-Hinton...[Ref Ananthanarayan 8th/39-43,
229] Thayer-Martin is a useful selective media for Neisseria
gonorrhoeae''.

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Mueller-Hinton is enriched media for Neisseria.
C diphtheriae and other corynebacteria grow aerobically on most
ordinary laboratory media. On Loeffler's serum medium,
corynebacteria grow much more readily than other respiratory
organisms, and the morphology of organisms is typical in

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smears.
Lowenstein-Jensen Medium. It is used to culture tubercle bacilli. It
contains egg, malachite green and glycerol.
Chocolate Agar or Heated Blood agar: Prepared by heating blood
agar. It is used for culture of pneumococcus, gonococcus,

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meningococcus and Haemophilus. Heating the blood inactivates
inhibitor of growths.

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114. All of the following are true regarding
legionella except:
a) Cause pontiac fever
b) Aerobic gram negative bacilli

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c) Can grow on simple medium
d) Grow on BCYE agar
e) Communicable from infected patients to others
Correct Answer - C:E
Ans: c. Can grow on.... e. Communicable... [Ref

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Ananthanarayan 8th/400-401: Harrison 19th/1014-17,
18th/1236 39; Greenwood 16th/320-21; CMDT 09/1278]
Members of the Legionellaceae are aerobic gram-negative bacilli
that do not grow on routine microbiologic media. Buffered charcoal
yeast extract (BCYE) agar is the medium used to grow Legionella.

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Pontiac feverQ, caused by Legionella Pneumophila, is a milder,
nonfatal influenza-like illness with fever, chills, myalgia.

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115. All are true about gonorrhea except:
a) Gonorrhoea means flow of seed
b) Discharge may contain neutrophil
c) Initially discharge is scanty & mucoid in urethritis

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d) Caused by gram positive cocci
e) Symptom is more severe in female than males
Correct Answer - D:E
Ans: d. Caused ..., e. Symptom...[Ref Harrison 19th/1005,
18th/1220-25; Ananthanaran 8th/227-30, 7th/227-229;

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Greenwood Microbiology 16th/247-248; CMDT 09/1287]
The name gonorrhea derives from the Greek words gonos (seed) &
rhoia (flow) e.9- described a condition in which semen flowed from
the male organ without erection.
Acute urethritisQ is the most common clinical manifestation of

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gonorrhoea in males & although some men remain
asymptomatic. Urethral discharge & dysuria, usually without
urinary frequency or urgency, are the major symptoms.

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116. Which of the following is/are true about
pasteurerlla multiocuda:

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a) May cause meningitis
b) Transmitted by unpasteurized milk
c) Cause disease exclusively in human
d) Gram-negative coccobacillus
e) None

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Correct Answer - A:D
Ans: (A) May cause meningitis & (D) Gram-negative
coccobacillus [Ref Ananthanarayan 8th/326: Greenwood
Microbiology 16th/334- 35;Park 23rd/655;Harrison 19th/183e-
3, 18th/12351

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P. multocida is a bipolar-staining, gram-negative coccobacillus that
colonizes the respiratory and gastrointestinal tracts of domestic
animals; oropharyngeal colonization rates are 70-90% in cats and
50-65% in dogs.
Patients at the extremes of age or with serious underlying disorders

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(e.g., cirrhosis, diabetes) are at increased risk for systemic
manifestations, including meningitis, peritonitis, osteomyelitis and
septic arthritis, endocarditis, and septic shock, but cases have also
occurred in healthy individuals.
P multocida can be transmitted to humans through bites or

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scratches, via the respiratory tract from contact with
contaminated dust or infectious droplets, or via deposition of the
organism on injured skin or mucosal surfaces during licking.

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117. Feature (s) of Taenia capitis is/are all
except:
a) May presents as a boggy swelling

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b) Most commonly occurs in elderly
c) May present as black dot
d) Caused by trichophyton & microsporum but not
by epidermophyton
e) Scutulum formation

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Correct Answer - B
Ans: (B) Most commonly occurs in elderly.[Ref Neena khanna
3rd/244; Ananthanarayan 8th/604-06: Greenwood 16th/574]
T.capitis: Caused by microsporum any species cf. Trichophyton
most species-Ananthanarayan 8th/606, Tinea capitis is

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dermatophytosis or ringworm of the scalp and hair. Age: Invariably
a child.
the chief cause of "black dot" Tinea capitis, produces spores within
the hair shaft (endothrix). These hairs do not fluoresce; they are
weakened and typically break easily at the follicular opening. In

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prepubescent children, epidemic tinea capitis is usually self-
limiting.

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f)
All of the following is/are true regarding

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candidiasis:
3. Commonly involve mucosa & skin
4. Not involve nails
5. Caused by yeast like fungus
6. Diabetes is most important risk factor

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7. Causes meningitis in immunocompromised persons
Correct Answer - B
Ans: (B) Not involve nails.[Ref Ananthanarayan 8th/607-08:
Harrison 19th/1342-44, 18th/165153]
It is an infection of skin, mucosa & rarely of internal organs

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It is caused by yeast like fungus, Candida albicans & occasionally by
other candida species
Ubiquitous in nature, these organisms are found on inanimate
objects, in foods, and on animals and are normal commensals of
humans. They inhabit the gastrointestinal tract (including the

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mouth and oropharynx), the female genital tract, and the skin.
It is an opportunistic endogenous infection, the commonest
predisposing factor being diabetes.

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4. All statements are true about mycetoma
except:

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5. Eumycetoma is caused by bacteria
6. Surgery is important component of treatment
7. Usually painless
8. Diagnosis can be made by examination of lesion
9. Can affect lower & upper extremities

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Correct Answer - A
Ans: a. Eumycetoma...[Ref Ananthanarayan 8th/393, 608:
Harrison 19th/1355, 18th/258, 1667, 1329, e34-16f; Neena
khana lst/228; Greenwood 16th/223-224, 578]
Treatment of eumycetoma involves both surgical extirpation of the

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lesion and use of antifungal agents. Surgical removal of the
lesions of eumycetoma is most effective if performed before
extensive spread has occurred.
Mycetoma or Madura Mycosis or Madura Foot: Mycetomas are
chronic, slowly progressive infections of the subcutaneous

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tissue, usually of the foots & rarely of the other parts of the body
like handsQ, gluteal region & thigh.
Maduromycosis (also known as eumycetoma) is the term used to
describe mycetoma caused by the true fungi and by
phylogenetically diverse organisms.Actinomycotic mycetoma is

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caused by Nocardia and Actinomadura species.

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120. True about non-industrial anthrax:
6. May occur in butcher
7. Animal hair is a source of infection
8. Commonly occurs in factory worker

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9. Stomoxys calcitrans insect may transmit the infection
10.
It is a zoonosis
Correct Answer - A:B:D:E
Ans: (A) May occur in butcher, (B) Animal hair is a source

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of infection, (D) Stomoxys calcitrans insect may transmit
the infection, (E) It is a zoonosis,
[Ref Ananthanarayan 8th/245: Greenwood Microbiology
16th/225-29; Harrison 19th/261e1-3, 18th/1768-70]
Cutaneous anthrax generally occurs on exposed surfaces of the

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arms or hands, followed in frequency by the face and neck. A
pruritic papule develops 1-7 days after entry of the organisms or
spores through a scratch.
Cutaneous anthrax used to be caused by shaving brushes made
with animal hair

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Stomoxys calcitrans & other bitings insects may occasionally
transmit infection mechanically

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7. Which of the following is not niacin
positive:
8. Mycobacterium bovis

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9. Mycobacterium sonei
10.
Mycobacterium chelonae
11.
Mycobacterium tuberculosis

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12.
Mycobacterium simiae
Correct Answer - C:D:E
Ans: c. Mycobacterium..., d. Mycobacterium..., e.
Mycobacterium..

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[Ref Ananthanarayan 9th/347-48; Medical Microbiology
by Greenwood 16th/201; Harrison 19th/1102-05]
Human tubercle bacilli form niacin when grown on an egg medium
The test is positive with human type (M.tuberculosis) negative with
bovine type of the bacilli

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It can, however, be positive for M.simiae & a few strains of
M.cheloneii

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122. Feed oral transmission occur in :

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9. Hepatitis A
10.
Hepatitis B
11.
Hepatitis E

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12.
Rotavirus
13.
Herpes simplex
Correct Answer - A:C:D

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Ans: a. Hepatitis A, c. Hepatitis E & d. Rota..[Ref
Ananthanarayan 9th/561; Harrison 19th/2013]
Herpes simplex: Humans are the only natural hosts & the source
of infection are saliva, skin lesions or respiratory
secretions. Transmission occurs by close contact & may be

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venereal in genital herpes.

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123. Which is not spirochetes:
10.

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Borrelia
11.
Leptospira
12.
Fusobacterium

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13.
Lactobacillus
14.
Varicella
Correct Answer - C:D:E

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Ans: c. Fusobacterium. d. Lactobacillus & e. Varicella
[Ref.Ananthanarayan 9th/j7 1; Hanison l9th/ I I 32.
"Lactobacillus genus consists of anaerobic gram positive bacilli"
"Veillonella are anaerobic gram negative cocci" .
Spirochetes are Elongated, motile, flexible bacteria twisted spirally

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along the long axis are termed spirochetes (from speira, meaning
coil & chaite, meaning hair)
Spirochetes belong to the order spirochaetales, comprising 2
families- spirochaetaceae & leptospiraceae Spirochaetaceae
contains genera spirochaeta, cristispira, treponema & borrelia,

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leptospiraceae containing the genus leptospira

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124. Oroya fever is caused by:
f) B. bacilliformis
g) B. henselae
h) B. quintana
i) B. elizabethae

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j) B. clarridgeiae
Correct Answer - A
Ans: a. B. bacilliformis [Ref Ananthanarayan 9th/412;
Medical Microbiology by Greenwood 16th/325-26]
Bartonellosis, or Carrion's disease, is caused by B. bacilliformis

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Bartonellosis, or Carrion's disease, is caused by B. bacilliformis. The
disease is characterized by two distinct phases:
. an acute febrile hematic phase, known as Oroya fever; and
f) an eruptive phase manifested by cutaneous lesions, known
as verruga peruana

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125. True about 8th pandemic of cholera:
. Caused by serotype 0 classical
. Caused by serotype 0 Eltor
. Caused by serotype 0 139
. It spread in Indonesia in 1961

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. It spread in Bangladesh in 1992-93
Correct Answer - C:E
Ans: (C) Caused by serotype 0 139 & (E) It spread in
Bangladesh in 1992-93
As event of great significance was the sudden emergence of non-

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O-l V.cholera (formely NAG vibrio) as the cause of epidemic
cholera (8th pandemic).
In october 1992, a new non-O-| vibrio was isolated from a
cholera outbreak in Madras (Chennai). Similar outbrealcs soon
followed in dffirent parts of India. By January 1993,

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Some consider the cholera causedby the serotype OIi9 strain to be
the eighth pandemic that began in the Indian subcontinent in 1992-
1993, with spread to Asia. The disease has been rare in North
America since the mid 1800s, but an endemic focus exists on the
Gulf Coast of Louisiana and Texas.

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126. Vector for O.tsugami is/are :
13.
Chigger
14.

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L.deliensis larva
15.
Xenopsylla cheopis
16.
Pediculus humanus corporis

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17.
None
Correct Answer - A:B
Ans: a. Chigger, b. L.deliensis...(Ref Ananthanarayan
9th/408; Medical Microbiology by Greenwood 16th/369-72;

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Harrison 19th/1155, 1159]
Scrub typhus is caused by orientia tsutsugamushi (formerly R.
tsutsugamushi or R.orientalis). The vectors are trombiculid mites of
genus Leptotrombidium- L.akamushi in Japan & L.deliensis in
India. Humans are infected when are bitten by mite larvae

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(chiggers)"
0. tsutsugamushi differs substantially from Rickettsia species both
genetically and in terms of cell wall composition (i.e., it lacks
lipopolysaccharide). 0. tsutsugamushi is maintained by
transovarian transmission in trombiculid mites.

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Illness varies from mild and self-limiting to fatal. After an incubation
period of 6-21 days, onset is characterized by fever, headache,
myalgia, cough, and gastrointestinal symptoms.
Some patients recover spontaneously after a few days. The classic
case description includes an eschar where the chigger has fed,

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regional lymphadenopathy, and a maculopapular rash--signs that
are seldom seen in indigenous patients

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f)
Meningococcal infection is predisposed
by which of the following deficiency of

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complement factor
14.
C1-C3
15.
C3-C4

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16.
C5-C9
17.
C1-C4
18.

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Properdin
Correct Answer - C:E
Ans: (C) C5-C9 (E) Properdin[Ref: Ananthanarayan 9th/ 229;
Harrison 19th/2 106-07
Meningococcal disease is favoured by deficiency of the terminal

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complement components (C5-C9
Deficiencies in the alternative pathway (factors D and properdin)
are associated with the occurrence of invasive Neisseria
infections.
Lastly, deficiencies of any complement component involved in the

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lytic phase (C5, C6, C7, C8, and, to a l*ser extent, C9) predispose
affected individuals to systemic infection by Neisseria. This is
explained by the critical role of complement in the lysis of the thick
cell wall possessed by this class of bacteria.

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f)
Weil felix reaction in scrub typhus is/are

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positive for:
15.
OX -19
16.
OX-2

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17.
Both OX -19 & OX-2
18.
OX -K
19.

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OX -19, OX-2 & OX -K
Correct Answer - D
Ans: d. OX -K [Ref Ananthanarayan 9th/410;
Medical Microbiology by Greenwood 16th/373]
This reaction is an agglutination test in which sera are tested for

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agglutinins to the 0 antigens of certain non-motile Proteus
strains OX-19, OX-2 & OX-X
The basis of test is the sharing of an alkali-stable carbohydrate
antigen by some rickettsiae & by certain strains of proteus, P.
vulgaris OX 19 & OX 2 & P.mirabilis OX K.

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disease OX-19
OX-2
OX-K
Epidemic +++
+

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_
typhus
Brill-
Usually(?
Zinsser ve)or weakly

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-
disease (+ve)
Endemic +++
+/-
-

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typhus
Tickborne
spotted ++
++
-

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fever
Scrub
-

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-
+++
typhus

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129. Minimum infective dose of shigella is :
f) 1-10
g) 10-100

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h) 103-106
i) Same as enteric fever
j) Same as V.cholera
Correct Answer - B
Ans: b. 10-100 [Ref Ananthanarayan 9th/287, 307, 341]

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It has been shown that 106 pathogenic vibrios administered to
fasting normal chlorhydric volunteers, without food or buffer, did
not produce infection, while the same dose along with food or
sodium bicarbonate caused clinical cholera in 80-100 % of them.
Shigella cause bacillary dysentery. Infection occurs by ingestion.

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The minimum infective dose is low- as few as 10-100 bacilli are
capable of initiating the disease, probably because they survive
gastric acidity better than other enterobacteria.

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f)
Acute hemorrhagic conjunctivitis is/are
caused by:

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17.
Coxsackie virus type A 24
18.
Corona virus
19.

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Enterovirus-70
20.
Herpes simplex
21.
Adeno virus

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Correct Answer - A:C:E
Ans: a. Coxsackie..., c. Enterovirus-70 & e. Adeno..[Ref
Ananthanarayan 9th/491, 493; Greenwood 16th/459]
Acute hemorrhagic conjunctivitis is caused by enterovirus type 70:
The symptoms are sudden swelling, congestion, watering & pain

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in the eyes. Subconjunctival hemorrhage is a characteristic
feature.
Coxsackievirus type A24 also produces the same disease
Corona virus cause severe acute respiratory syndrome, Adenovirus
11 also causes Acute hemorrhagic conjunctivitis.

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131. H.parainfluenzae requires factor:
f) V

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g) VI
h) VII
i) X
j) XII
Correct Answer - A

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Ans: (A) V [Ref Ananthanarayan 9th/328]
Factor V &X are accessory growth factors which is present in blood-
(Ananthanarayan 9th/327)
Growth
Hemolysis on horse blood

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species
requirement
agar
X V CO2
H influenzae

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+ + -
-
H aegyptius
+ + -
-

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H ducreyi
+
VARIABLE VARIABLE
H. parainfluenzae - + -
-

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H. haemolyticus + + -
+
H.
parahaemolyticus - + -
+

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h aphrophilus
+ - +
-
H paraphrophilus - + +
-

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18. Zones of operation theatre includes all
except:
f) Septic zone
g) clean zone
h) Protective zone

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i) Sterile zone
j) Disposal zone
Correct Answer - A
Ans: a-septic zone Protective Zone: Areas
included in this zone are:

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Reception
Waiting area
Trolley bay
Changing room
Clean Zone: Areas included in this zone are:

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Pre-op room
Recovery room
Plaster room
Staff room
Store

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Sterile Zone: Areas included in this zone are:
Operating Suite
Scrub Room
Anesthesia Induction Room
Set up Room

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Disposal Zone: Areas included in this zone are:
Dirty Utility

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Disposal corridor

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133. True about acanthamoeba infection :
f) Causes keratitis
g) Contact lens increases risk of keratitis
h) Cause keratitis in contact lens wearer

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i) Also causes encephalitis
j) Immunodeficiency is a risk fact
Correct Answer - A:B:D:E
Ans: (A) Causes keratitis (B) Contact lens increases risk of
keratitis (D) Also causes encephalitis (E) Immunodeficiency is

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a risk fact
[Ref Paniker's Parasitology 7th/27-28; Khurana 6th/112-
13; Harrison 19th/1367-68, 245e; Greenwood 16th/595;
Parson 22nd/208]
Acanthamoeba keratitis: It has also been seen to occur in non-

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contact lens wearers & may be related to swimming or bathing
in contaminated water.
This is an opportunistic protozoan pathogen found worldwide in the
environment in water & soil, Infection usually occur in patients with
immunodeficiency, diabetes, malignancies, malnutrition, SLE or

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alcoholism, It presents chiefly as 2 chronic
conditions- keratitis encephalitis
Acanthamoeba keratitis: majority of such cases have been
associated with the use of contact lens.

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