1.

26 year old male client of Pasay city entertainment district came to you with penile lesion, 1 cm,
irritated, soft chancre like. He also has regional lymphadenitis. A gram negative rod was isolated from
the lesion and from the lymph node. You are probably dealing with
a. Lymphogranuloma venereum
b. Syphillis
c. Gonorrhea
d. Chancorid

2. 22 yaer old student developed a fever, severe headache, muscle pain and conjunctival suffusion. He
gave a history of swimming in Pollileo Island about 8 days ago. Work up was done including blood
culture of Fletcher’s semisolid media. The orgasism grown fine coiled spirochetes. The organism we
are dealing with is:
a. Borrelia recurrentis
b. Treponema pallidum
c. Trponema perenue
d. Leptospira interrogans

3. 30 year old government employee has severe perennial allergic rhinitis and has to absent herself from
work for about a week every month. Various medications offer only temporary relief. Skin tests
positive reaction to pollen and house dusts. Which is your best therapeutic intervention:
a. Immunotherapy against known offending antigen
b. Topical adrenergic agonist
c. Antihistamine decongestant preparations
d. Oral steroids

4. A pregnant patient 10 weeks AOG was exposed to rubella and has had vaccination. The best thing to
do is:
a. Administer hyperimmune gammaglobulin
b. Reassure her because nothing can be done anyway
c. Administer rubella vaccine
d. Determine immune status with rubella antibody

5. 22 year old ale, complained of sore throat, with fever and lymphadenopathy. There are lymphocytes
with atypical cells with an increase in sheep-cell agglutinins. Your probable diagnosis is:
a. Infectious hepatitis
b. Herpes infection
c. Infectious mononucleosis
d. Influenza

6. 25 year old teacher presented to the emergency room with the following complaints of headache,
neck stiffness, vomiting, high grade fever, photophobia and petechial rashes. P.E reveals an ill-
appearing woman unable to flex her neck without eliciting pain and diffuse petechial rashes in her
extremities. Kernig and Brudzinskis sign are positive. CSF analysis reveals low glucose, increased
protein and increased neutrophils. Which of the following is the most likely causative agent?
a. E. coli
 b. L. monocytogenes
c. N. meningitides
d. H. influenza

7. 75 year old atient with an episode of acute urinary retention was characterized. 3 days later, he
developed fever and suprapubic pain. Culture of the urine revealed a thin fil of bacterial growth over
the entire blood sugar plate, and urease test was positives. Which of the following is most likely
organism to cause this infection?
a. Proteus mirabilis
b. E. coli
c. S. marcescens
d. P. Aeruginosa
8. 9 month old baby rushed to he ER because of severe cough and fever. On physical examination, rales
and high pitched wheezes are heard in his lung fields. The child also presents with AOM and bluish
discoloration of skin due to lack of oxygen. X-ray result showed bilateral patchy consolidation in a
predominantly pre-hilar distribution extending to the bases. The diagnosis given is pneumonia. Which of
the following viruses is the most likely cause?
a. Rhinovirus
b. RSV
c. Adenovirus
d. Coronavirus
9. 4 day old male neonate born to 23 years old G2P1 mother with term pregnancy with no sepsis by
cesarean delivery was transferred to maternity ward. Baby was average birth weight (2.9kg) and ready
to accept breastfeeding. On the 4th day of life, he developed watery stool, 10-15x, curdly white and has
a fishy odor with 6-7 episodes of vomiting. On examination baby was irritable with sunken eyes,
depressed anterior fontanel and dry oral mucus membrane. There was prolonged capillary filling time
and feeble peripheral pulses with HR 168/min and RR 64/min. Blood investigation showed evidence of
leukocytosis and hyperglycemia with no azotemia and dyselectrolytemia. CRP and blood culture was
negative. Stool examination showed darting motility on hanging drop method and stool culture revealed
growth of bacteria on TCBS medium. Baby was immediately resuscitated with Ringer lactate and was
treated with Ciprofloxacin. Which of the following microorganisms causes the childs diarrhea?
a. V. Cholera
b. G. Lamblia
c. E. Coli
d. S. Typhi
10. 15 year old teenager was brought to the office for evaluation of cough and fever. His illness began
several days ago with low grade fever, headache, myalgias, and fatigue, and has slowly worsened. He
now has a persistent cough. Tried over the counter drugs but with no relief. No significant medical or
Family history. One of his good friend had “walking pneumonia”. On examination, he is coughing
frequently but is not particularly ill appearing. His temperature is 38.5C . CXR shows patchy infiltration.
A sputum Gram stain shows white blood cells but no organism. What is the most likely etiology?
a. K. Pneumonia
b. M. Pneumonia
c. S. Pneumonia
d. L. Pneumonia
11. 33 year old drug addict male with aortic and mitral valve prosthesis and history tooth extraction 2 mos
ago came with high fever and chest pain and was found to have infective endocarditis. Culture was
positive for streptococcus spp. On three different occasions. TEO showed tow dangling vegetations on
prosthetic valve. The patient received intensive inpatient treatment wit antibiotics and underwent
another successful prosthetic valve replacement. Which of the following groups of streptococci is
implicated in infective endocarditis?
a. Group D strep
b. Group B strep
c. Viridans strptococci
d. AOTA

12. 22 year old male had an outing wih his friends and developed fever of 38.5C, diarrhea and vomiting
following eating chicken salad 24 hours back. 2 of his friends developed the same symptoms. Most
probble diagnosis is:
A. Salmonella enteritidis poisoning
B. B. Cereus
C. S. Aureus
D. V. Cholera

13. 4 year old boy brought to the pediatrician because of abdominal pain, vomiting and diarrhea
containing mucus and blood. The child has a fever of 39.4C. On stool culture, the causative organism
is shown to be a non-lactose fermenting and non hydrogen sulfide producing bacterium. Which of the
following is the most likely responsible for the childs illness?
A. E. Coli
B. V. Cholera
C. Salmonella spp.
D. Shigella spp
14. 2 year old child presents to the physicians office with her mother. The mother states that for the past
few days the child has a low grade fever, Upper respiratory tract symptoms, and has been tugging at
her right ear. An examination of the right ear with the pneumatic otoscope reveals a hyperemic,
opaque, bulging, tympanic membrane with poor motility. The physician makes the diagnosis of right
otitis media. Which of the following organisms is the most likely causative pathogen?
A. Group B streptococci
B. Staphylococcus pyogenes
C. Streptococcus pneumonia
D. H. Influenza

15. 7 year old girl brought to the pediatrician because of fever of 37.9C, trouble swallowing, and drooling.
Within few minutes of arriving at the office, she develops inspiratory stridor and respiratory distress.
An x-ray of her neck from the side showed a thumbprint sign presentation. Which of the following is
most likely responsible for the patients condition?
A. H. influenza
B. M. Pneumoniae
C. Parainfluenza virus
 D. RSV
16. 13 year old child brougt to the pediatrician because of purulent yellow disvharge oozing from his eyes.
On physical examination, both eyelids are swollen, and the conjunctivae appear inflamed. Under
microscopic view, scraping from the conjunctival surface show epithelial cells with basophilic
inclusions in the cytoplasm, called Halberstaeder-Prowazek bodies. Which of the following orgnism is
most likely responsible for his condition?
A. Adenovirus
B. C. Trachomatis
C. N. Gonorrhea
D. T. Pallidum

17. 25 year old male came to the ER department because of fever, jaundice, severe myalgia, and conjunctival
suffusion. 7 days ago, he participated in the ‘esteros’ clean up dive spear headed by the barangay council. The
canals are filthy, stagnant and have become breeding grounds for rats and diseases. What does patient have?
a. typhoid fever
b. malaria
c. cholera
d. Weil’s disease

18. 29 female patient came to you complaining of profuse vaginal discharge with fishy odor itching of the
vulva. Examination of discharge showed vaginal epithelial cells that contain tiny pleomorphic bacilli within
the cytoplasm (clue cells). Pathogen involved is:
a. Treponema pallidum
b. Hemophilus ducreyi
c. Gonococcus
d. Gardnerella vaginalis

19. 40 year old farmer is seen in the ER. He had wound in the left leg which was worsened and is now tender,
edematous with exudates and crepitus. Some necrosis in the area is noted. Your probable offending
organisms is:
a. Clostridium perfringens
b. Clostridium tetani
c. Streptococcus
d. S. aureus

20. 26 year old pregnant patient during prenatal screening at 34 weeks AOG was found positive for Group B
streptococcus and had PROM at 37 weeks. The following are antimicrobial prophylaxis maybe used, EXCEPT:
a. Erythromycin
b. Tetracycline
c. Penicillin G
d. Ampicillin

21. 22 year old homosexual man came to the STD clinic complaining of penile ulceration the organism
identified to be small, gram negative, non-motile, and non-spore forming bacilli.
a. Chancroid
b. Syphillis
c. Gonorrhea
d. Chlamydia infection

22. 25 year old female was diagnosed with cervicitis and PID. Gram stain from the cervix showed only
polymorphonuclear leukocytes and no organism. Coloscopy and Pap smear were negative and there was no
growth in ordinary culture media on Thayer-Martin media. The organism is:
a. Gonococcus
b. HPV
c. Chlamydia
d. Mycobacterium tuberculosis

23. A recent immigrant from rural area presents with a swollen face and extremely poor dental hygiene,
including loss of an adult tooth, which appears to be the focus of the current infection. There are two open
ulcers on the outside of the swollen cheek. Small yellow grains are seen in one of the ulcers. Gram stain shows
purple-staining fine filaments. What is he most likely disease?
a. Actinomycotic mycetoma
b. Chromomycosis
c. Eumycotic mycetoma
d. Sporotrichosis
e. Paracoccidioidomycosis

24. Your patient complains of an “itching rash” on her abdomen. On examination, you found that the lesions
are red, circular, with a vesiculated border and a healing central area. You suspect Tinea corporis. Of the
following choices, the most appropriate laboratory procedure to make the diagnosis is a:
a. Giemsa stain for multinucleated giant cells
b. fourfold ride in antibody titer against the organism
c. Fluorescent antibody stain of the vesicle fluid
d. Potassium hydroxide mount of skin scrapings

25. 55 year old man who recently recovered uneventfully from heart valve transplant presents to the ER with
pleuritic chest pain, hemoptysis, fever, and chills. While he is being examined, he has a myocardial infarction
and the medical team is unable to revive him. An autopsy revealed septate, acutely branching hyphae in many
tissues. Which of the following organisms is most likely to be identified?
a. Cryptococcus neoformans
b. Histoplasma capsulatum
c. Mucor pecies
d. Blastomyces dermatitis
e. Aspregillus fumigatus

26. A non-compliant HIV- positive patient has been complaining of stiff neck and severe headache. You
suspect that your patients disease may be caused by Cryptococcus neoformans. Which of the following would
be the most useful in establishing the diagnosis?
a. A positive heterophil agglutination test
b. Recovery of an acid fast organism from the patients sputum
c. A history of recent travel in the Mississippi river valley area
d. the finding of encapsulated budding cells in the spinal fluid

27.A patient who is a recent immigrant from a tropical, remote, rural area with no medical care is now
working with a group of migrant crop harvesters. He has a large, raised, colored, cauliflower-like ankle lesion.
Darkly pigmented, yeast like sclerotic bodies are seen in the tissue biopsy. Which of the following is the most
likely diagnosis?
A. Actinomycotic mycetemia
B. Chromobastomycosis
C. Eumycotic mycetoma
D. Sporotrichosis
E. Tinea nigra

28.26 year old woman with uncomplicated malaria who was treated initially with chloroquine now has
relapsed. what is the reason for chloroquine- treated case of P. vivax relapsing?
A. P. vivax has a significant level of chloroquine resistance
B. P. vivax has a persistent erythrocytic stage
C. P. vivax has a persistent exoerythrocytic stage (hypnozoite)
D. Chloroquine is not one of the drug of choice

29.48 year old subsistence farmer from rural area dies of heart failure. His autopsy shows a greatly enlarged
heart. What was the vector for the most likely infectious agent that may have beed responsible for his death?
A. Ixodes tick
B. Mosquito
C. Reduviid bug-Chagas dse. T. cruzii
D. Sandfly
E. Tsetse fly

30.16 year old man who recently returned from camping in Canada presents with fatty diarrhea and acute
abdominal pain following many meals. How does the most likely agent cause the diarrhea?
A. Co-infection with bacteria
B. Enterotoxin production?
C. Suction disk attachment
D. Tissue invasion leading to an inflammatory response and prostaglandin production

31. 35 year old man comes to the emergency department complaining of high fever, chills, severe headache,
and confusion. A peripheral blood smear reveals multiple ring structures and crescent shaped gametes. Which
of the following organism is the most likely cause?
A. P. Vivax
B. P. Malariae
C. P. Falciparum
D. P. Ovale
E. Leishmania spp.
32. 32 year old woman who returned from travelling in eastern europe 1 week ago. While on the trip she
experienced anorexia, nausea, but no vomiting, and abdominal bleeding. For the last 2 days she has had
explosive watery diarrhea. An examination of her stool revealed pear-shaped, flagellated, motile organisms.
Of the following, which is the most likely causing this infection?
A. C. Parvum
B. E. Histolytica
C. G. Lambia
D. T. Vaginalis

33. 30 year old peace corps volunteer who has recently returned from central america. She now has fever ad
right upper quandrant pain. She reports that she has bloody diarrhea 2 mos ago. A CT scan revealed a
radioluscent area in the liver that is interpreted to be an abscess. Aspiration of material from the abscess was
performed. Microscopic examination revealed motile, non flagellated trophozoites with ameboid movement.
Of the following which one is the most likely cause of the infection?
A. Cryptosporidium parvum
B. E. Histolytica
C. G. Lambia
D. T. Vaginalis

34. 13 year old boy fro India was brought to the emergency room with a prolapsed rectum. Examination of
the rectum reveals small worms hat resemble whips attached to the mucosa. A stool sample reveals egg that
are barrel shaped, with bipolar plugs. Which of the following is the most likely cause?
A. Trichuris trichura
B. Echinococcus granulosus
C. Ascaris lumricoides
D. G. Lambia
E. E. Histolytica

35. 10 year old girl from Samar was brought to manila with an enlarging abdomen. Exam showed
hepatosplenomegaly and thick smear is positive for eggs. You are probably edaling with?
A. Taenia saginata
B. Ascaris lumricoides
C. G. Lambia
D. Schictosoma japonicum

36. First year medial students, finds it difficult to identify malarial histology slides in the laboratory. Their first
validated thin blood smear slide on loan shows Maurer dot as stippling in erythrocytes containing a larger
form of plasmodium parasite. The slide simply explain about the blood protozoan:
A. P. Vivax
B. P. Ovale
C. P. falciparum
D. P. Malariae

37. 55 year old developed case of diarrhea and stomach cramps during the 2 nd week of camping in the
mountains of los banos laguna. Trophozoites with pear shaped features and cysts were observed in his stool
specimen. A duodenum string test was also positive for trophozoites The stools appear fatty but without any
blood or mucus. Which of the following is the most likely culprit causing the disease?
A. G. Lambia
B. Trichomonas hominis
C. Balantidium coli
D. E. Histolytica

38. 2 year old boy who plays in the sandbox and also has family of cats for children to play with presents with
wheezing, hepatosplenomegaly, and prominent peripheral blood eosinophils. Which of the following is most
likely the cause?
A. Ascariasis
B. Pinworm infection
C. Visceral larva migrans
D. Loefflers syndrome

39. 4 year old abaca farmer from northern samar was brought to hospital because of gross swelling on his
right leg for more than 4 years. On examination, the whole leg was edematous, bluish in color, deep skin fold,
at junction of middle and lower one third, non-discharging sinus above the fold anteriorly, absence of nodules
or warts and hairs. Non pitting in nature. On admission, X-ray revealed calcified fimbriae. He was labelled as
a case of lymphatic filariasis. How is elephantiasis transmitted to human?
A. Penetration of the human skin host by filariform larvae
B. Infected by dringking water containing copepods rhabditiform larvae
C. Propagated primarily through the bite of an infected mosquito
D. Ingestion of infected egg from fecal contaminated vegetables

40. Sexually active 24 year old woman complains of vaginal itching and malodorous purulent vaginal
discharge. To verify your tentative diagnosis of trichomoniasis, you should include one of the following in
your work up
A. Specific serologic test
B. Ova and parasite fecal smear
C. Wet mount of vaginal fluid
D. ELISA
E. Stool culture

41. An apparently run down but alert 38 year old woman has spent 6 mos as a teacher in rural thailand village
school. Chief complaint includes frequent headaches, occasional nausea and vomiting and periodic fever. You
suspect malaria and indeed find RBC parasites in thin smear of finger stick blood. To rule out the dangerous
falciparum form of malaria, which one of the choices would fit a diagnosis of P falciparum malaria based on
microscopic examination of blood smear?
A. Numerous large ovoid parasites in some of the red blood cells
B. Enlarged, somewhat misshapen parasitized red cells
C. Diciding parasites in red cells with 8-12 progeny
D. Double ring forms found in the smear
42. This july a group of 30 volunters went to kenya to help build a school and all of them took prophylaxis to
prevent malaria. They claim that they took the medication as prescribed 2 weeks before, during their stay,
and for 4 weeks after returning home. In october, one person developed malaria and by April of this year, 9
of the volunteers had been treated for malaria. Which of the following is the least likely explanation for this
patient for this apparent failure of prevention?
A. This is most likely P. vivax or ovale which have a latent stage in their life cycle that persists in the liver
and can result in disease weeks to months after exposure ?
B. Most of the medication used for prophylaxis of malaria acts only on the red blood cell stage of the
infection
C. This could be P. malariae which is known to result in a more chronic chronic malaria state
D. This could be P. falciparum that was not completely treated by the prophylaxis
E. The nine who got malaria must not have taken the medication as prescribed since this should have
prevented malaria

43. 42 year old admitted with fever, right upper abdominal pain and is found to have a cystic mass of the
liver. You suspect an amebic abscess and order stool exams that re reported a positive for E. histolytica and
an ameba serology is positive at 1:256. Which statement is false regarding ameba?
A. He should be treated with two medications. One to kill active trophozoites and a second to kill the
cyst.
B. Transmission is by fecal oral means
C. Amebic liver abscess can ususally be treated with medication and do not need to be drained
D. Transmission to a new person is generally done by the more resistant cyst form of the life cycle
E. Aspirate from the liver cyst can be used to make the diagnosis because they are located with WBC and
E. histolytica cyst.

44. 20 year old female complains of vaginal bleeding, discharge, pain with intercourse and discomfort with
urination. She has had 3 different sexual partners over the past 2 years. You did wet mount of vaginal
secretions and see a flagellated organisms about he size of WBC “twitching motility” that makes you think of
trichomonas vaginalis. What statement is false regarding trichomonas?
A. Men are most likely asymptomatic but efficient transmitters of this organism
B. The cyst form of the life cyle is most common method of transmission
C. Simultaneous treatment of the patient and her sexual contacts will decrease the chance of
recurrences
D. In severe cases the regional may be red with petechial lesions and the cervix has been described as a
strawberry cervix
E. Patients found to have trichomonas should be evaluated for other venereal transmitted diseases

45. 22 year old is seen because he has had severe chronic diarrhea and a stool for O&P is positive for giardia
lambia. He has lost 50 pounds in weight and has been treated for giardia on 6 occasions only to have it reoccur.
You are concerned that he has an immunodefficiency and lab results demonstrate a very low IgA level.which
of the following statements would be false?
A. It is one of the causes of H2S or rotten egg gas
B. It is often self limiting disease
 C. A weight loss of 50 pounds due to giardia is very unusual
D. You are not surprised of 5 of 11 dorm mates are found to have giardia because t is spread from person
to person easily
E. It often results in iron deficiency anemia due to GI blood loss

46. 74 year old with a group A streptococcal cellulitis resulting form massive swelling of both lower legs from
elephantiasis. Which of the following is false regarding elephantiasis caused by W. bancrofti?
A. if these infections are not treated early they rapidly progress to massive swelling of the involved
lymphatic drainage area
B. It is transmitted to humans by the mosquito
C. Humans are the definitive host
D. The microfilaria in the blood stream of man can be transfused to another personwithout establishing
a new infection.
E. The adult organisms live in the lymphatic channels of man and can result in scarring of he lymphatic
channels

47. Elderly male was diagnosed with multiple myeloma (a form of cancer) and has been treated with
chemotherapy agents for two months. He was then admitted to the hospital with new asthma symptoms
that became worse when he was treated with steroids. Many small larvae were found in his sputum and he
was found to have a hyper infection with strongiloides stercoralis. Which statemnet is false regarding this
organism?
A. It is a common cause of IDA just like hookworm
B. The initial infection occurs when the larvae penetrate the skin from the soil
C. Auto infection occurs when the ova hatch and mature in the intestinal tract and then penetrate the
skin from the soil
D. Eosinophilia is present during the migrating phase of the life cycle
E. Recurrent bacterial infections can develop when bacteria are carried by the larvae into sterile areas
of the body

48. A physician calls from an outlying hospital that his patient has passed a large, white, round worm with
pointed ends that is about 8 inches long. He is concerned this could be Echinococcus but the only parasite
that matches this description is Ascaris lumbricoides. Which of the following is false regarding Ascaris
lumbricoides?
A. Most infected humans are asymptomatic
B. Large number of larvae passing through the lung can cause asthma type symptoms
C. Large numbers of adult worms in the gut can cause obstruction
D. The fertilized embryonated egg passed in the stool requires a period of time to embryonate before it
becomes infectious
E. Heavy infection has been associated with rectal prolapse

49. In the 1920s, The rockerfeler foundation funded a physician to go throughout the Pacific Islands to
decrease the incidence of hookworm. Each of the following but one would help decrease the incidence of the
disease. Which one would not make any change in incidence of Ancylostoma duodenale or Necator
americanus?
 A. Wearing shoes
B. Washing hands after using the bathroom
C. Using latrines for defacation
D. Treating those found to be infected
E. Establishing sewage treatment facilities

50. T. Saginata and T. solium are similar in many ways, but T. soium is more dangerous. Which of the following
makes T. solium more dangerous?
A. It has an armed scolex
B. It It has fewer uterine branches than T. saginata
C. Man can be infected as an intermediate host by eating the eggs from T. solium
D. The cyst or larvae form ingested from pork is more potent than the cyst from beef
E. It produces more eggs than T. saginata

51. 22 year old female is found to have a large multiloculated cyst of the pelvis that is removed and found to
be due to Echinococcus granulosus. This is most unusual since most cysts occur in the liver or lung. Which of
the following is false regarding Echinococcus granulosus?
A. The diagnosis in humans can be made by looking for the eggs in human stool
B. Dogs are the definitive host
C. Sheep are intermediate hosts
D. Humans are incidental hosts
E. Humans contract disease from eating the eggs excreted in dog feces

52. A student returns from a student teaching assignment. On the way home she swam in lake Malawi. She
is found to have schistosomiasis. Which one is bad advice?
A. In risk areas, don’t swim in fresh water rivers or lakes
B. Swimming in chlorinated pools is safe
C. Swimming in ocean salt water is safe
D. Toweling off vigorously after contact with potentially contaminated water decreases your risk
E. Wading in water up to your knees is safe for brief periods of time

53. A chinese male has had right upper quadrant pain for the past 10 years. Workup for gallbladder disease
with an ultrasound shows small linear organisms. O&P exam reveals the ovoid, flask shaped egg of C. sinensis.
Which of the following statements is false regarding C. sinensis?
A. It is also called oriental liver fluke
B. Man is a definitive host?
C. This infection can best be treated with surgical removal of the gallbladder?
D. There are two intermediate hosts-the snail and the fish
E. Long-term infection has been associated with cholangiocarcinoma ( cancer of the bile duct)

54. Chagas disease is especially feared in Latin America because of its threat to the heart and parasympathetic
nervous system and the lack of an effective drug for the symptomatic later stages. Your patient is planning to
reside in a Venezuelan village for 1-2 years. Which one of the following suggestions would be of special value
for avoiding Chagas disease?
A. Boil or treat all of your drinking water
 B. Sleep under a bed net
C. Do not keep domestic pets in your house
D. Never walk barefoot in the village compound
E. Do not eat lettuce or other raw vegetables or unpeeled fruit.

55. An 18 year old male complain of abdominal pain, bloating, frequent loose stools, and loss of energy. He
returned a month ago from 3-week hiking and camping trek. The trek involved only high-elevation hiking,
since he flew in and out of the 12,000 ft starting point. Which of the following is an important consideration
for the diagnosis?
A. Exposure to high level UV radiation
B. The source and purification of water
C. The use of insect repellents while hiking
D. The degree of contact with villagers en route
E. The degree of contact with villagers en route

56. Several villagers known to eat pork during celebrations were reported to be suffering from an outbreak
of epileptiform seizures. One of the first things you should investigate is
A. The prevalence of Ascaris infections in the population
B. The presence of trypanosoma gondii in cats
C. The presence of trpanosoma brucei gambiense in the villagers
D. The presence of Taenia eggs in the drinking water
E. The presence of adult Taenia solium in the pigs

57. 6 year old boy was brought to the dermatologist fro skin lesions-burrows in the skin was noted with
intense itching. The lesions are noted on his trunk, arms, thighs and buttocks. Lindane 1% lotion was applied
on the lesions followed by thorough washing after 8 hours.the lesions disappeared after a few days. Your
diagnosis will be:
A. Dermatophytosis
B. Sporotrichosis
C. Tinea versicolor
D. Scabies

58. Staphylococcus aureus causes a broad range of human diseases some by endotoxin release and some by
direct organ invasion. Which one of the following is direct organ invasion:
A. Scalded skin syndrome
B. Toxic shock syndrome
C. Gastroenteritis (food poisoning)?
D. Septic Arthritis

59. Which of the following statements is not true regarding tetanus

A. Trismus is a common manifestation
B. In a patient with serious wounds and is uncertain about his immunization status it is recommended
that both toxoid and immune globulin be given
 C. Neonatal tetanus develops after passage through a contaminated birth canal
D. If given early enough after exposure, human tetanus immune globulin can modify the course of the
disease significantly

60. Which of the following would be considered a hallmark of SLE:

A. SLE is an arthus reaction
B. Vasculitis and antinuclear antibody
C. A linear deposition of imunoglobulin in the glomerular basement membrane occurs with nephritis
D. Rheumatoid factor is rarely present

61. E. coli become pathogenic of virulence factors. Of the following which is not considered a virulence factor:
A. Mineral interaction-adherence with pili and ability to invade intestinal cells
B. Production of H2S
C. Endotoxin and exotoxin production
D. Iron binding siderophore

62. Genital ulcer syndrome are cause by variety organisms including the following, EXCEPT:
A. H. Ducreyi
B. N. Gonorrhea
C. Herpes simplex virus
D. T. Pallidum

63. Which one is the smallest known free living organisms:

A. Griseofulvin
B. Mycoplasma
C. Rickettsiae
D. Chlamydia

64. Which of the following antifungal is an imidazole that is used orally or topically on systemic or superficial
infections:
A. Griseofulvin
B. Ketoconazole
C. Amhotericin B
D. Nystatin

65. Which of the following statements regarding primary syphillis is not true:
A. Darkfiled exam for the treponema is positive
B. Primay syphillis may appear 10 to 60 days after exposure
C. There is an indolent single ulcer, indurate, painless
D. The spirochete is limited to the primary site

66. The mycobacteria are etiologic agents for a number of chronic infections. Which of the following
statements is not true of mycobacteria.
A. They obligate aerobe
B. They are acid fast
 C. Their cell envelop contain mostly protein with no lipid content
D. They are facultative intracellular parasites

67. The localization and distribution of the skin findings seen in herpes zoster are distinctive, unilateral, does
not cross the midline, and localized to single dermatome a single sensory ganglion. The most common sites
are the thoracic nerve and:
A. Ophthalmic nerve (V1)
B. Trigeminal nerve (V2)
C. Mandibular nerve (V3)
D. Glossopharyngeal nerve

68. Ulcer of the ileum over enlarged Peyers patches are a characterisitc finding in:
A. Tuberculosis of the intestine
B. Shigella dysentery
C. Typhoid fever
D. Gastroenteritis

69. HIstorically, there are six “classical” infectious childhood exanthem that have been recognized. Four of
which are viral. The numbers were provided in the year 1905. which of the following numerical diseases and
viruses are matched up incorrectly?
A. First disease-measles
B. Second disease- scarlet fever
C. 4th disease- SSSS
D. Fifth disease- roseola infantum

70. The cause of antigenic drift of influenza viruses is:

A. Mixing of double strended DNA genome
B. Re-assortment of genome during mixed interaction
C. Accumuated point mutations in hemmaglutinin gene
D. Phenotypic masking

71. Laryngeal papillomatosis is commonly associated to this human papilloma virus serotype:
A. HPV 1 and 4
B. HPV 6 and 11
C. HPV 16 and 18
D. HPV 8 and 10
72. The following are inclusion bodies with the disease that it causes. Which of the following is mismatched
pair?
A. Babes ernstbodies-diphtheria
B. Henderson peterson bodies-herpes simplex
C. Leventhal colle lilie bodies- herpes simplex
D. Guamieri bodies-small pox
73. A child after consuming food in the party complain of vomiting and diarrhea within 1-5 hours. Most
probably he has got the infection due to:
A. S. Aureus
B. Streptococcus
C. C. Perfringens
D. C. Botulinum

74. Which of the following statements regarding Creudzfeldt-Jakob disease is true?

A. Creudzfelt-Jakob disease is primarily a disease of young adults
B. Creudfelt-Jakob disease is called the animal form of spongiform encephalopathy
C. Creudfelt-Jakob disease is readily inactivated by protease and nucleases
D. Creudfelt-Jakob disease is characterzed by dementia with subsequent coma and death

75. Pertussis is a communicable pediatric disease. Which state is communicability greatest?

A. Incubation period
B. Convalescent stage
C. Paroxysmal stage
D. Catarrhal stage

76. The following statements refer to endotoxin. Which statement is not true?
A. Listeria monocytes can produce endotoxin
B. Endotoxin is commonly preffred to as lipopolysaccharide
C. Endotoxin is produced exclusively by gram negative bacteria
D. It is heat stable compared to the more heat labile exotoxin

77. VIruses largely lack metabolic machinery of their own to generate energy or to synthesize
A. Protein
B. Carbohdrate
C. Alcohol
D. All of these

78. Which of the following viruses belong to family Flaviviridae?

A. Rubella virus
B. Yellow fever virus
C. Hepatitis virus
D. All of these

79. Which of the following viruses shows transfrmation of infected cells?

A. Hepatitis B virus
B. Human T cell Lymphotrophic virus type 1
C. EBV
D. AOTA
80. Which of the following statements is not true of viruses?
A. Viruses have been succesfully grown in pure cultures in test tubes
B. All viruses are obligatory intracellular parasites
B. All viruses have either DNA or RNA as their genetic material
C. Viruses probably arise from small fragments of cellular chromosomes

81. Which of the following viruses belong/s to family calciviridae?

A. Hepatitis B virus
B. Hepatitis D virus
C. Hepatitis E virus
D. All of these

82. Enzyme neuraminidase is carried by which of the following viruses?

A. Human Immunodeficiency virus
B. EBV
C. Influenza virus
D. Adenovirus

83. A viral protein that is thought to induce tumors by binding to a cellular tumor suppressor protein is
A. Adenovirus E1A
B. Epstein- Barr nuclear antigen proteins
C. Hepatitis B virus e protein
D. Human Immunodeficiency virus gag protein

84. A virus that infects a lyses progenitor erythroid cells causing aplastic crises in patients with hemolytic
anemia is
A. California encephalitis virus
B. EBV
C. Parvovirus B19
D. Yellow fever virus

85. The nanogram level of antigen in serum is detected by

A. Dot blot test
B. ELISA
C. Fluorescent antibody staining
D. Protein-protein hybridization test

86. Disinfection of day care center play tables with 70% ethanol is likely to affect the viability of
A. Cytomegalovirus
B. Parainfluenza virus
C. RSV
D. Rotavirus
87. The monospot test is based on
A. Destruction of Dowey cells
B. Heterophil antibodies
C. Syncitia inhibition
D. Viral capsid antigen antibodies

88. Localized viral disease

A. Is a major feature of congenital viral infections
B. Is associated with a pronounced viremia
C. Can be associated with carrier individuals
D. May have systemic clinical features such as fever

89. The first viral- induced defence mechanism in a nonimmunce individual is the
A. Generation of cytotoxic T lypmphocytes
B. Production of interferon
C. Synthesis of lymphokines
D. Synthesis of neutralizing antibodies

90. A killed vaccine is

A. Jeryl Lynn mumps virus
B. Enders measles vaccine
C. Salk poliovirus vaccine
D. Oka Vaicella-zoster vaccine

91. Persistent virus infections

A. Are usually confined to the initial site of infection
B. Are preceded by acute clinical disease
C. Elicit a poor antibody response
D. May involve infected carrier individuals

92. An RNA virus that has a nuclear phase to its replication process is
A. Coronavirus
B. Rhabdovirus
C. Retrovirus
D. Togavirus

93. Host-cell tRNAs are involved in the genome replication of

A. Influenza A virus
B. Retroviruses
C. RSV
D. Rhinoviruses

94. Linear stranded DNA is the genetic material of

 A. Calciviruses
B. Flaviviruses
C. Papillomaviruses
D. Parvoviruses

95. Passive immunixation is available for protection from

A. Influenza A virus
B. Hepatitis A virus
C. Parainfluenza type 2 virus
D. Rubella virus

96. Amantadine inhibits

A. Influenza A and B virus hemagglutinin binding activity
B. Influenza A virus M2 protein activity?
C. Inflenza A and B virus neuraminidase activity
D. Influenza B virus RNA-dependent RNA polymerase activity

97. HTLVs
A. Are asociated with leukemias
B. Are defective RNA tumor viruses
C. Carry tyrosine protein kinase oncogenes
D. Synthesize early proteins that interact with p53Rb

98. The eclipse period of a one-viral multiplication curve is defined as the period of time between the
A. Uncoating and assembly of the virus
B. Start of the infection and the first appearance of extracellular virus
C. Start of the infection and the first appearance of intracellular virus
D. Start of the infection and uncoating of the virus

99. Clinical viral disease

A. Is most frequently due to toxin production
B. Usually follows virus infection
C. Can result without infection of host cells
D. Is associated with target organs in most disseminated viral infections

100. Fungal cells that produce by budding are seen in the infected tissues of patients with:
A. Tinea corporis, tinea unguium, and tinea vesicolor
B. Candidiasis, cryptococcosis, and spirotrichosis
C. Mycetoma, candidiasis, and mucormycosis
D. Sprotrichosis, mycetoma, and aspergillosis