Download University of Jaffna MBBS 2021 January Microbiology Paper II Question Paper

Time allowed: 2 hours

Answer all four questions.

Answer each question in a separate answer book.

1. A 45-year-old patient developed rapidly spreading pain and swelling of the lower limb following a prick injury. On examination, severe edema of the lower limb was noted with erythema, blistering and bullae formation. Gas gangrene was clinically suspected.

   1. State the most likely anaerobic bacteria contributing to this presentation. (10 marks)

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   2. Describe the pathogenesis of this condition. (60 marks)
   3. State three principles in managing this patient. (30 marks)

2. A 28-year-old man presented to the dermatology clinic with an itchy rash. On examination, the rash was found to be an annular, scaly lesion with a slightly elevated reddish edge and sharp border. The dermatologist started empirical treatment with antifungal drugs.

   1. What is the most likely clinical diagnosis for the above stated condition? (10 marks)

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   2. Name three fungal genera that might be responsible for the above lesion. (15 marks)
   3. Name two other sites where the same fungal genera may cause infection. (10 marks)
   4. Describe the specimen collection from all three sites and transport to identify the fungal aetiology in this patient. (40 marks)
   5. Describe the antifungal agents used to treat the infections in all three sites. (25 marks)

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3. A 36-year-old man was diagnosed as infected with HIV.

   1. Describe the possible sources, modes of transmission and risk factors for this infection in this man. (30 marks)
   2. Describe briefly the pathogenesis of HIV infection and its possible consequences in this man. (20 marks)
   3. Describe the tests used for screening, confirmation and monitoring the progress of HIV infection. (20 marks)
   4. A nursing officer accidentally got a needle stick injury while collecting blood from this patient. Describe the post exposure management for this nursing officer. (30 marks)

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4. 1. Explain the term 'sepsis.' (10 marks)
   2. Briefly describe the pathogenesis of sepsis. (40 marks)
   3. State the bedside clinical criteria of sepsis (gSOFA) and indicate how organ dysfunction is recognized using the gSOFA score. (20 marks)
   4. 1. Name 5 likely source of sepsis in a 70 year old ventilated patient in the Intensive Care Unit (ICU). (15 marks)

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      2. State what samples you would send the microbiology laboratory from this patient to identify the bacterial cause of sepsis. (15 marks)

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