INFECTIOUS DISEASE MIDTERM EXAMS 2017

Name: Score:
Date:
GENERAL INSTRUCTIONS;
This is a closed-book, closed notes examination.
Cell phones are not permitted for use in any way.
Any discussion or otherwise inappropriate communication between examinees, as well
as the appearance of any unnecessary material or cell-phone usage, will bedealt with
severely. Violations may result in an F" for this exam, F" for the class, suspension, or
expulsion.
Read and understand very well before answering the questions.
PART I. MCQ
Case study: Ms X, 24 y.o. female visited her family doctor in an out-patient clinic.
Chief complaint:
History of frequency, burning, and pain upon urination for >2 days; lower abdominal pain-
progressing ; vaginal discharge >4 days.
PMH
Recurrent UTI ( already had 4 UTIs this year alone); gonorrhea; chlamydia; G4P3.
Past Surgical History
Tubal ligation
F/S History:
Unwed mother but currently lives with her new boyfriend and kids, history of multiple
heterosexual flings; denies smoking tobacco and alcohol, and IVDA.
Medication history: NONE
Allergies: TMP/SMX- rashes
P/E: Female in moderate distress
VS: BP 100/80, HR 80, RR 16, T 37C, Wt 60 kg
ABD: Soft, tender bilaterally, increased suprapubic tenderness
GU: Cervical motion tenderness, adnexal tenderness, foul smelling vag discharge
Pertinent laboratory tests:
Urinalysis: Straw-colored, 1.015, 8.0 pH, prot (-), gluc (-), ket (-), many bacteria, Lkcs 10-15,
RBC 0-1
Urine Gram stain: Gram-negative rods
Vaginal discharge culture: Gram-negative diplococcic, N. gonorrhea; sensitivities pending
Positive monoclonal AB for Chlamydia, KOH preparation, wet preparation and VDRL- negative
1. Patient presents with all of the following signs and symptoms of a cystitis except:
a. Urinary frequency c. Dysuria
b. Urinary urgency d. Vaginal discharge
2. All of the following factors identified in the patients medical history probably contributed to
her UTI, except:
a. Sexual history c. Past history of tubal ligation
b. Past history of UTIs d. Female sex
3. What microorganism is the most likely cause of the patient's UTI?
a. Klebsiella c. Proteus
b. Pseudomonas aeruginosa d. E. Coli
4. What made the patient candidate for prophylactic antibiotics for recurrent UTIs?
a. The severity of her current UTI
b. The number of UTIs she has had this year
c. The number of STDs she has had this year
d. The number of pregnancies she has had in her lifetime
5. What is another antibiotic that could have been used as a prophylactic antibiotic for the
patient?
a. Norfloxacin c. Gentamicin
b. Amoxicillin d. Ampicillin
6. All of the following oral regimens are possible treatments for patient's gonorrhea, except:
a. Azithromycin l g PO x l C. Ciprofloxacin 500 mg PO x 1
b. Cefixime 400 mg PO x 1 d. Ofloxacin 400 mg PO x 1

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 7. If doxycycline were used to treat the patient's chlamydia, what is the recommended length of
therapy?
a. Single dose c. 7 davs
b. 3 days d. 10 days
8. What would you include in your counseling session with AM if she had been prescribed doxycycline?
a. Take doxycycline with a full glass of milk to prevent esophagitis
b. Avoid unnecessary and prolonged sun exposure
c. Avoid sunscreen with UVA and UVB protection
d. Take an antacid with doxycycline to prevent GI distress
9. Based on current CDC guidelines for uncomplicated gonococcal infection, recommended regimen
dose not include
a) Ceftriaxone 250mg PO single dose plus Azithromycin 1 g PO as single dose
b) Cefixime 400mg PO single dose plus azithromycin 1gm PO as single dose
c) Ceftriaxone 250mg IM single dose plus Azithromycin 1gm PO single dose
d) Cefoxitin 2gm IM with probenecid 1 g PO single dose plus Azithromycin 1gm PO single
dose
10-19. True/False.
10. The asexual reproduction stage of malaria develops in humans, whereas the sexual stage occurs in
the mosquito.
a) True b) False
11. The only means that an Infective larva that cause hookworm diseases enters the host via
contaminated food or water.
a) True b) False
12. Diagnosis of Enterobiasis is made by demonstrating the characteristic egg in the stool.
a) True b) False
13. Diagnosis of Giargiasis show the presence of Giardia cysts in a fresh stool specimen
a) True b) False
14. HBV is not spread through food or water, sharing eating utensils, breastfeeding, hugging, kissing,
hand holding, coughing, or sneezing.
a) True b) False
15. If the HBV vaccine series is interrupted after the first or second dose of vaccine, the series need to be
restarted from 0 dose.
a) True b) False
16. The same vaccine product should be used for the entire 3-dose series of HBV.
a) True b) False
17. The same vaccine product should be used for the entire 3-dose series HPV.
a) True b) False
18. HPV can survive outside the body and still be capable of causing infection.
a) True b) False
19. Tuberculosis is greatest killer worldwide due to a single infectious agent.
a) True B) False
20-55. MCQ:
20. STD
a) Chancroid d) B and C
b) Campylobacter infection e) A, B and C
c) Scabies
21. Neonatal infections of STD are acquired
a) passage through an infected cervix d) A and C
b) passage through an infected vagina e) A, B and C
c) transplacentally
22. Which of the following statement is FALSE? Nonoxynol-9
a) Is a vaginal contraceptive jelly d) AOTA
b) Is a vaginal lubricant e) NOTA
c) increase the risk of HIV transmission
23. Which of the following statement(s) is/are true. Impetigo is a superficial skin infection that is
a) easily transmitted from person to person d) A and C only
b) most common in places with cold weather e) A, B and C
c) Impetigo is highly communicable and readily spreads

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24. Which is not considered a primary Skin and Soft Tissue Infection
a) Impetigo d) Cellulitis
b) Erysipelas e) Diabetic Foot infections
c) Folliculitis
25. Folliculitis
a) Infection of superficial skin layers and cutaneous lympathics
b) Infection of hair follicle
c) Infection of lateral and posterior nail fold
d) Follicular infection known as an abscess or boil
26. Furuncle -
a) Infection of superficial skin layers and cutaneous lympathics
b) Infection of hair follicle
c) Infection of lateral and posterior nail fold
d) Follicular infection known as an abscess or boil
27. Drug of choice for the management to Dermatophytosis includes the following, except:
a) Terbinafine d) Astemizole
b) Clotrimazole e) Econazole
c) Miconazole
28. Erysipelas -
a) Infection of superficial skin layers and cutaneous lympathics
b) Infection of hair follicle
c) Infection of lateral and posterior nail fold
d) Follicular infection known as an abscess or boil
29. Which of the following Antimicrobials is not indicated for treatment of impetigo?
a) Dicloxacillin d) Clindamycin
b) Amoxicillin/clavulanic acid e) Ciprofloxacin
c) First-generation cephalosporins
30. Classified as a secondary skin and soft tissue bacterial infection
a) Erysipelas d) Necrotizing fasciitis
b) Cellulitis e) Impetigo
c) Bite wounds
31. Commonly known as St. Anthonys fire
a) Impetigo c) Erysipelas
b) Cellulitis d) Lymphangitis
32. Which of the following statement is FALSE. Nonbullous impetigos is
a) the more common form of impetigo d) cause almost exclusively by S aureus
b) also known as impetigo contagiosa e) classified as primary bacterial SSTI
c) more contagious than the bullous
type
33. Isoniazid is a primary antitubercular agent that
a) requires pyridoxine supplementation.
b) may discolor the tears, saliva, urine, or feces orange red.
c) causes ocular complications that are reversible if the drug is discontinued.
d) may be ototoxic and nephrotoxic.(E) should never be used because of hepatotoxic potential.
34. Important clinical signs especially prevalent in subacute infective endocarditis?
a) Osler nodes d) All of the above
b) Janeway lesions e) None of the above
c) Roth spots
35. The most important diagnostic test in the diagnosis of endocarditis
a) Echocardiogram d) Urinalysis
b) Electrocardiogram e) CBC
c) Erythrocyte Sedimentation Rate
36. Mode of transmission of bacteria in secondary peritonitis
a) enter the abdomen via bloodstream by transmigration through the bowel wall
b) through an indwelling peritoneal dialysis catheter
c) result of perforation of GI tracts caused by disease or traumatic injury
d) Via the fallopian tubes

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37. The primary reasons for deaths by malaria includes the following, except
a) Failure to take chemoprophylaxis d) Delay in seeking medical care
b) Poor sanitation e) Misdiagnosis
c) Inappropriate chemoprophylaxis
38. Most common intestinal parasite responsible for bloody diarrhea
a) Giardia intestinalis
b)Entameba histolytica d) Strongyloides stercoralis
c) Giardia lamblia e) Taenia solium
39. Management of cysticercosis include:
a) surgery c) antihelminthic therapy
b) anticonvulsants d) no treatment option
40. An helmintic infection
a) Amoebiasis c) Enterobiasis
b) Giardiasis d) Scabies
41. All of the following drugs are appropriate therapies for a lower urinary tract infection
owing to Pseudomonas aeruginosa except
a) norfloxacin. d) tobramycin.
b) trimethoprim-sulfamethoxazole. e) methenamine mandelate.
c) ciprofloxacin.
42. Drugs usually active against penicillinase-producing Staphylococcus aureus include which of the
following?
(I) piperacillin-tazobactam
(II) amoxicillin-clavulanate
(III) nafcillin
a) if I only is correct d) if II and III are correct
b) if III only is correct e) if I, II, and III are correct
c) if I and II are correct
43. Which among the factors listed is NOT responsible for the inhibiting and killing capabilities of urine
under normal conditions
a) urine alkaline pH c) high urea concentration in the urine
b) extremes in urines osmolality d) acidic pH
44. The only antimicrobial for syphilis to a pregnant women
a) Azithomycin c) Spectinomycin
b) Penicilline G d) Quinolones
45. Chronically infected patient with HBV would have a serologic result of
a) HBsAg positive d) A and B only
b) anti-HBc positive e) A, B and C all correct
c) anti-HBs negative
46. Cefepime, Cefpirome, Cefclidine
a) 1st gen cephalosporins? d) 4th gen cephalosporins?
nd
b) 2 gen cephalosporins? e) 5th gen cephalosporins?
c) 3rd gen cephalosporins?
47. Cefalexin (Keflex), Cephradine (Velosef), Cefazoline (Kefzol), Cefadroxil
a) 1st gen cephalosporins? d) 4th gen cephalosporins?
b) 2nd gen cephalosporins? e) 5th gen cephalosporins?
rd
c) 3 gen cephalosporins?
48. Ceftobiprole, Ceftaroline, Ceftolozane
a) 1st gen cephalosporins? d) 4th gen cephalosporins?
nd
b) 2 gen cephalosporins? e) 5th gen cephalosporins?
c) 3rd gen cephalosporins?
49. Cefoxitin (Mefoxin) Cefuroxime (Zinacef), Cefaclor (Ceclor) Cefprozil
a) 1st gen cephalosporins? d) 4th gen cephalosporins?
b) 2nd gen cephalosporins? e) 5th gen cephalosporins?
rd
c) 3 gen cephalosporins?
50. Cefixime , Cefotaxime, Ceftazidime, Ceftriaxone
a) 1st gen cephalosporins? d) 4th gen cephalosporins?
nd
b) 2 gen cephalosporins? e) 5th gen cephalosporins?
rd
c) 3 gen cephalosporins?

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51. Doxycycline HCl, Minocycline HCl, Vibramycin, Tigecycline
a) Macrolides? d) Beta Lactams?
b) Aminoglycosides? e) Tetracyclines?
c) Quinolones?
52. Levofloxacin, Norfloxacin, Ofloxacin, Ciprofloxacin
a) Macrolides? d) Beta Lactams?
b) Aminoglycosides? e) Tetracyclines?
c) Quinolones?
53. Clarithromycin, Roxithromycin, Erythromycin, Zithromax
a) Macrolides? d) Beta Lactams?
b) Aminoglycosides? e) Tetracyclines?
c) Quinolones?
54. Meropenem, Imipenem, Aztreonam, Ertapenem
a) Macrolides? d) Beta Lactams?
b Aminoglycosides? e) Tetracyclines?
c) Quinolones?
55. Garamycin, Tobramycin, Amikacin, Gentamicin
a) Macrolides? d) Beta Lactams?
b) Aminoglycosides? e) Tetracycline
c) Quinolones?

PART IIA. MATCHING TYPE.

COLUMN A B. Offending Parasite /Pathogen

_____1.Giardiasis A. Ancylostoma duodenale
_____2. Amebiasis B. Ascaris lumbricoides
_____3. Hookworm C. C. trachomatis
_____4. Roundworm D. E. coli
_____5. Pinworm E. Entamoeba histolytica
_____6. Strongyloidiasis F. Enterobius vermicularis
_____7. Tapeworm G. Giardia lamblia
_____8. Scabies H. H simplex type I and II
_____9. Head louse I. HBV
____10. Uncomplicated UTI J. Pediculus humanus capitis
____11. Chlamydia infection K. Plasmodium malariae
____12. Syphilis L. Sarcoptes scabiei
____13. Genital herpes M. Strongyloides stercoralis
____14. Bacterial prostatitis N. T. pallidum
____15.Malaria (worldwide) O. Taenia solium

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PART IIB. MATCHING TYPE.

A. BCG L. Havrix V. Paromomycin
B. Benzathine penicillin G M. Intravenous Quinidine W. Twinrix
C. Cycloserine gluconate X. Permethrin 5%
D. Loperamide N. ORT Y. Pyridoxine
E. Chloroquine phosphate O. Isoniazid Z. Rifampin
F. Ciprofloxacin P. Ivermectin AA. Ringer lactate solution
G. Ceftriaxone Q. Mebendazole (Vermox), BB. Tigecycline
H. Engerix R. Mefloquine (Lariam) CC. Trimethoprim-
I. Dicloxacillin, oxacillin S. Meropenem. sulfamethoxazole
J. Erythromycin T. Metronidazole (Flagyl) DD. Tubersol
K. Gardasil U. Nystatin EE. Pre-pen

_____1. A Primary anti-tuberculosis drug

_____2. Acute malaria
_____3. Enterotoxigenic diarrhea
_____4. Scabies
_____5. Best therapeutic options in the management of chronic bacterial prostatitis
_____6. Ophthalmia neonatorum
_____7. Chemoprophylaxis for all species of Plasmodium
_____8. Gonorrhea
____ 9. Chemoprophylaxis in area with chloroquine-resistant P falciparum strains
____10. Drug of choice for patients documented with hospital-acquired MRSA
____11. Drug of choice for strongyloidiasis
____12. Effective for single-dose therapy for all stages of syphilis
____13. Used to treat MDR-TB
____14. Hepatitis A vaccine-
____15. HPV vaccines
____16. Hepatitis B vaccine
____17. Oral antifungal agent
____18. Patients who cannot tolerate ORT
____19. Penicillinase-resistant penicillin
____20. Preferred drug for treating latent TB infection
____21. Preferred luminal agent in pregnant patients.
____22. Prophylactic vaccine against TB.
____23. Purified Protein Derivative
____24. Reduce the incidence of peripheral neuropathies in pregnant women
____25. Antimotility drug
____26. The agent of first choice in hookworm
____27. Tissue-acting antiamoebic agents
____28. Combination hepatitis A and hepatitis B vaccine
____29. -lactam-lactamase inhibitor combination
____30. Penicillin skin testing