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2monthsagoFirstNoninvasiveDNAScreeningforColorectalCa0Comment

AIIMSNOV2001:MICROBIOLOGY
DECEMBER2,2014BYADMININMBBS:PARTII,MICROBIOLOGY,MICROBIOLOGY:AIIMS0COMMENT

1.Autoinfectionisseenwith
a)Ankylostoma
b)Enterobius
c)Echinococcus
d)Ascariasis
Answer:Enterobius
Explanation:
Causeofautoinfection
Enterobius
Strongyloides
H.nana
2.Whichofthefollowingiscalicivirus?
a)HepatitisE
b)HepatitisB
c)HepatitisC
d)HepatitisA

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Answer:HepatitisE
Explanation:
Calicivirusaresmall,nonenvelopedviruswithsinglestrandedRNAofpositivepolarity.
Calicivirushavelargegenomeanddistinctivespikesonthesurface.
TherearetwohumanpathogensintheCalicivirusfamily:NorwalkvirusandHepatitisE.
NorwalkvirusandotherCalicivirusproduceinfectionsthatcauseacutediarrheaandvomiting(gastroenteritis),
abdominalcramps,myalgias,malaise,headache,nausea,andlowgradefever.
ThehepatitisEvirus,onceconsideredacalicivirus,nowbelongstoanunassignedgenuscalledthehepatitisE
likeviruses.
3.Recenthepatitisinfectionisbestdiagnosedby
a)HbsAg
b)IgGantiHBeab
c)IgMantiHBcab
d)AntiHBsAgab

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Answer:IgMantiHBcab
Explanation:
Reference:http://emedicine.medscape.com/article/177632workup#aw2aab6b5b2
AcutehepatitisBdisease:
Hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) are the first markers that can be
identifiedintheseruminacutedisease.
HepatitisBcoreantibody(antiHBc)immunoglobulinM(IgM)follows.
IgMantiHBcAgRecentinfection
IgGantiHBcAgPastinfection
Forpatientswhorecover,seroconversiontohepatitisBsurfaceantibody(antiHBs)andhepatitisBeantibody
(antiHBe)isobserved.TheantiHBcisoftheIgGclass.
PatientswithpersistentHBsAglastingmorethan6monthsareconsideredtohavechronichepatitis.
InactivehepatitisBdisease:
SuchindividualshavenormalASTandALTlevels,withmarkersofinfectivity,suchasHBeAg,beingnegative
andHBVDNAgoingundetected.
HBsAg,antiHBcofIgGtype,andantiHBearepresentintheserum.
ChronicactivehepatitisBdisease:
ChronicactiveHBVdiseaseiscategorizedintoHBeAgpositiveandHBeAgnegativedisease.
SubtypewildtypeorHBeAgpositivedisease:
HBVDNAlevelsarehighduringthisphase.HBsAgandantiHBcofIgGorIgMtype(incaseofreactivation)are
identifiedintheserum.
SubtypechronicHBVHBeAgnegativedisease:
HBeAgnegativitycanbeassociatedwithgreaterHBVDNAreplicationandmorerapiddiseaseprogressionin
patientswhocarrymutationsineithertheprecoreorthebasiccorepromoterregionoftheHBVgenome.

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4.AcutehepatitisBcanbeearliestdiagnosedby
a)IgMantiHBcab
b)AntiHBsAgab
c)HbsAg
d)IgGantiHBeab
Answer:HbsAg
Explanation:
Hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) are the first markers that can be
identifiedintheseruminacutedisease.
ThemostimportantlaboratorytestforthedetectionofearlyHBVinfectionistheimmunoassayforHBsAg.
HBsAgappearsduringtheincubationperiodandisdetectableinmostpatientsduringtheprodromeandacute
disease.
Itfallstoundetectablelevelduringconvalescenceinmostcases.
Forpatientswhorecover,seroconversiontohepatitisBsurfaceantibody(antiHBs)andhepatitisBeantibody
(antiHBe)isobserved.TheantiHBcisoftheIgGclass.
PatientswithpersistentHBsAglastingmorethan6monthsareconsideredtohavechronichepatitis.
HBsAbisnotdetectableinthechroniccarrierstate.
HBeAgandHBeAb:
HBe Ag Its presence indicates a high likelihood of transmissibility and conversely the finding of HBe Ab
indicatesalowerlikelihood.
ViralDNA:ThedetectionofviralDNAintheserumisstrongevidencethatinfectiousvirionsarepresent.
WindowPhase:
There is a period several weeks when HBs Ag has disappeared but HBs Ab is not yet detectable. This is
windowphase.
AtthispointTheHBCAbisalwayspositiveandcanbeusedtomakethediagnosis.

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5.Enteroviruscausesall,except
a)Hemorrhagicfever
b)Pleurodynia
c)Herpangina
d)Asepticmeningitis
Answer:Hemorrhagicfever
Explanation:
ClinicalfeaturesofNonpolioEnteroviruses:
Nonspecificfebrileillness:Thisisthemostcommonpresentationofenterovirusinfection.
Pleurodynia:Pleurodyniamanifestationsincludeasuddenonsetoffeveraccompaniedbymuscularpaininthe
chestandabdomen.
Myopericarditis:Enterovirusesappeartobethemostcommonviralcauseofmyopericarditisandaccountfor
atleasthalfofallcasesofacutemyopericarditis.
Acutehemorrhagicconjunctivitis:Thishighlycontagiousocularinfectioncancauselargescaleepidemics.
Asepticmeningitis
Herpangina: Described as a vesicular enanthem of the tonsillar fauces and soft palate that principally affects
childrenaged310years.
Handfootandmouthdisease:Thisismainlyadiseaseofchildrenmostpatientsareyoungerthan10years.
Encephalitis:Frankencephalitisisanunusualmanifestationofenterovirusinfection.
Nonpoliovirus paralytic disease: Enterovirus 71 and coxsackievirus A7 have been associated with large
outbreaksofpoliomyelitislikediseaseinRussia,EasternEurope,Thailand,andTaiwan.
6.Invasiveamoebiasiscanbebestdiagnosedby
a)ELISA
b)Countercurrentimmunoelectrophoresis
c)Indirecthemagglutinationtest
d)Complementfixationtest
Answer:Countercurrentimmunoelectrophoresis
Explanation:
Bestmethodfordiagnosisofinvasiveamoebiasisisserologicaltest.
Indirecthemagglutinationassay(IHA):
ItdetectsantibodyspecificforEhistolytica.IHAisveryspecific(99.1%),butitislesssensitivethanELISA.
Itisnotusefulindifferentiatingacuteinfectionfrompreviousinfection,becausehightitersmaypersistforyears
aftersuccessfultreatment.
ELISA:
ELISA,theassaymostcommonlyusedworldwide,measuresthepresenceofserumantilectinantibodies(IgG).
The sensitivity of ELISA for detection of antibodies to E histolytica in patients with amebic liver abscess is
97.9%,anditsspecificityis94.8%.
IE,CIEandID:
IE,CIEandIDusetheprecipitationpropertyofantigenantibodycomplexesinagar.
CounterImmunoElectrophoresis(CIE)istimeconsumingbuthasasensitivityof100%ininvasiveamoebiasis.
Immunodiffusion (ID) is simple to perform and thus ideal for laboratories that only rarely perform amebic
serologyhowever,itrequiresaminimumof24hours,comparedwith2hoursforIHAorELISA.
IDisslightlylesssensitivethanIHAandELISAbutisequallyspecific.

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Complementfixation(CF)islesssensitivethanothertechniques.
7.Preformedtoxinisimportantinfoodpoisoningduetoall,except
a)Staphaureus
b)Clostridiumbotulism
c)ETEC
d)B.cereus
Answer:ETEC
Explanation:
Shortincubation(ie,within1d,usually<16h):
Saureus:NauseaandvomitingarecausedbytheactionofpreformedenterotoxinsAE.
Bacilluscereus:Thissporeformingrodispresentinrawricegrains.Theemetictoxinisapreformedheatstable
toxinproducedupongerminationofthespores.
Bcereus(diarrhealsyndrome):Thediarrhealtoxinisaheatlabiletoxinformedaftersporulation.
CperfringenstypeA:Sporesgerminateandelaboratetheenterotoxin.
Intermediateincubation(13d):
Botulism:Thediseaseismediatedbypreformedtoxininolderchildrenandadults,butitmayfollowingestionof
sporesininfants.
E coli after multiplication in intestine produce an enterotoxin that causes diarrhoea. So mechanism of food
poisoningisnotthroughpreformedtoxin.
8.WhichofthefollowingisagoodmediatouseforthediagnosisofLegionnairesdisease?
a)ThayerMartinMedia
b)BCYEagar
c)BordetGengouMedia
d)Chocolateagar
Answer:BCYEagar
Explanation:
Buffered charcoal yeast extract (BCYE) agar is a selective growth medium used to culture or grow certain
bacteria,particularlytheGramnegativespeciesLegionellapneumophila.
9.InapatientwithUTI,CLEDmediaispreferredOVERMacConkeysmediabecause
a)Itisdifferentialmedia
b)ItinhibitsswarmingofProteus
c)PromotesgrowthsofPseudomonas
d)PromotesgrowthsofStaphaureusandCandida
Answer:PromotesgrowthsofStaphaureusandCandida
Explanation:
CLEDandMacConkeysmedia:
Differentialmedia
Differentiatesbetweenlactosefermentingandnonlactosefermenting
InhibitsswarmingofProteus
Showsgreenishcolor,mattsurfaceandroughperipheryofPseudomonascolonies
CLEDmediahasadvantageinsupportinggrowthofcertainStaphylococcus,StreptococcusandCandida.
10.TrueaboutPrionProteindiseaseisall,except
a)Myoclonusisseenin10%ofpatient
b)Causedbyinfectiousprotein
c)Brainbiopsyisdiagnostic
d)Commonlymanifestsasdementia
Answer:Myoclonusisseenin10%ofpatient
Explanation:
The prion diseases are a large group of related neurodegenerative conditions, which affect both animals and
humans.
These illnesses tend to affect the gray matter of the central nervous system (CNS), producing neuronal loss,
gliosis,andcharacteristicspongiformchange.
Prusinerintroducedthetermpriontoindicatethatscrapieisrelatedtoaproteinaceousinfectiousparticle(PrP).
MostcommonhumanpriondiseaseisCJD,accountingforabout85%ofallhumanpriondisease.
CreutzfeldtJakobdisease:
About 40% of patients with sporadic CJD present with rapidly progressive cognitive impairment, 40% with
cerebellardysfunction,andtheremaining20%withacombinationofboth.
Almost all patients with sporadic CJD develop myoclonic jerks that involve either the entire body or a limb.
During the course of sporadic CJD, most patients develop a characteristic picture on EEG with periodic or
pseudoperiodicparoxysmsofsharpwavesorspikesonaslowbackground.
A definitive diagnosis can be made by microscopic examination of brain tissue showing the characteristic
spongychange.
11.ApatientofRHDdevelopedinfectiveendocarditisafterdentalextraction.Mostlikelyorganismcausingthisis
a)Streptococcusviridans
b)Streptococcuspneumoniae
c)Streptococcuspyogenes

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d)Staphylococcusaureus
Answer:Streptococcusviridans
Explanation:
Streptococcusviridans:
Mostpeoplewhodevelopinfectiousendocarditishaveunderlyingheartdiseaseorvalveproblems.
However,anorganismcommonlyfoundinthemouth,Streptococcusviridans,isresponsibleforabout50%ofall
bacterialendocarditiscases.
This is why dental procedures increase your chances for developing this condition. Such procedures are
especiallyriskyforchildrenwithcongenitalheartconditions.
Asaresult,itiscommonpracticeforchildrenwithsomeformsofcongenitalheartdiseaseandadultswithcertain
heartvalveconditionstotakeantibioticsbeforeanydentalwork.
MostcommoncauseofendocarditisinnativevalveStaphaureus
MostcommoncauseofendocarditisinIVdrugabusersStaphaureus
Mostcommoncauseofearlyprostheticvalveendocarditis(<2months)CoagulasenegativeStaph
Mostcommoncauseofprostheticvalveendocarditis(>12months)Streptococcusviridans
MostcommoncauseofinfectiveendocarditisafterdentalextractionStreptococcusviridans
12.Trueabouttoxoplasmosisisall,except
a)Inadultstoxoplasmosisisusuallyasymptomatic
b)IgGantibodiesarediagnosticincongenitaltoxoplasmosis
c)Isaanthroponoticdisease
d)Encephalitisisuncommon(Rare)inimmunocompetentindividuals
Answer:IgGantibodiesarediagnosticincongenitaltoxoplasmosis
Explanation:
An anthroponotic disease is an infectious disease in which a disease causing agent carried by humans is
transferredtootheranimals.Itmaycausethesamediseaseoradifferentdiseaseinotheranimals.
ToxoplasmosisiscausedbyinfectionwiththeprotozoanToxoplasmagondii,anobligateintracellularparasite.
Only1020%oftoxoplasmosiscasesinadultsandchildrenaresymptomatic.Toxoplasmosisisaseriousand
oftenlifethreateningdiseaseinimmunodeficientpatients.
Approximately8090%ofpatientsareasymptomaticinimmunocompetentpersons.
Diagnosis:
SerialIgGmeasurement(formaternalinfection)
AmnioticfluidPCR(forfetalinfection)
DetectionofIgMinneonatesserumforcongenitaltoxoplasmosis
ThedoublesandwichIgMELISAtestismoresensitiveandspecificthanotherIgMdetectiontests.
IgAandIgEELISAshouldbedeterminedwhentheinfantsIgMtitersarenegativeorequivocal.Determinationof
ToxoplasmaspecificIgAorIgEismoresensitivethandetectionofIgMforcongenitaltoxoplasmosis.
13.45yearsoldSeetaRamhasintraabdominalsepsis.Thecausativeorganismwasfoundtobevancomycin,
gentamycinandampicillinresistant.Itgrowswellinpresenceof6.5%NaClandarginine.Bileesculinhydrolysis
ispositive.Whichofthefollowingistheorganism?
a)Streptococcusagalactae
b)Enterococcusfecalis
c)Streptococcusbovis
d)Streptococcuspneumoniae
Answer:Enterococcusfecalis
Explanation:
Enterococcusfecalis:
Grampositivecocciinchain
Alpha,betaornonhemolyticcoloniesonbloodagar
Growsin6.5%NaCl
Hydrolyzesesculininpresenceof40%bile
Diseases:UTI,biliarytractinfectionandabdominalabscess
Endocarditisrarebutlifethreatening
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