Physician's Licensure Exam. for Micro-para

1.

A patient complains of an “itching rash” on her abdomen. On examination, the lesions were found to be red, circular; with a vesiculated border and a healing central area. The most appropriate laboratory procedure to make a diagnosis is a: A. Potassium hydroxide mount of skin scrapings B. Giemsa stain for multinucleated cells C. Fluorescent antibody stain of the vesicle fluid D. Four-fold rise in antibody titer against the organism

14.

A laboratory technician has isolated an organism that grows in blood agar, forms round, smooth, pale yellow colonies surrounded by a narrow area of hemolysis, ferments mannitol, and is both catalase- and coagulase-positive. This organism is: A. Streptococcus pyogenes B. Staphylococcus aureus C. Staphylococcus epidermidis D. Staphylococcus saprophyticus

2.

During the first week of the disease Leptospirosis, the most reliable way to detect the presence of the causative agent is: A. Culturing the urine B. Examination of cerebrospinal fluid C. Culturing of blood D. Culturing of kidney tissue

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3.

A hospital worker is found to have hepatitis B surface antigens. Subsequent test reveal the presence of e Antigen as well. The worker most likely is: A. Infective and has active hepatitis B. Infective but does not have active hepatitis C. Not infective D. Evincing a biologic false-positive test for hepatitis

Cultures of two neomycin-sensitive strains of Escherichia coli are mixed and cultured in the presence of neomycin. After 2 hours, the mixture is plated on neomycin-containing agar. A few neomycin-resistant colonies grow. The emergence of these resistant strains most likely resulted from: A. Conjugation B. Spontaneous mutation C. Transduction D. Transformation

16.

An obstetrician sees a pregnant patient who was exposed to rubella virus in eighteenth week of pregnancy. She does not remember getting a rubella vaccination. The best immediate course of action is to: A. Terminate pregnancy B. Order a rubella antibody titer to determine immune status C. Administer rubella immune globulin D. Administer rubella vaccine

17.

A nurse develops clinical symptoms consistent with hepatitis. She recalls sticking herself with a needle approximately 4 months before after drawing blood from a patient. Serologic tests for HBsAg, antibodies to HBsAg, and hepatitis A virus (HAV) are all negative; however, she is positive for IgM core antibody. The nurse: A. Does not have hepatitis B B. Has hepatitis A C. Is in the “window” phase D. Has hepatitis C

18.

There are millions of cases of leprosy (Hansen’s disease) worldwide, but predominantly in Asia and Africa. The clinical spectrum of Hansen’s disease is best characterized by: A. Immunologic anergy B. Chronic pneumonitis C. Peripheral neuritis D. Erythematous lesions

19.

A 6-year old girl presents to the clinic with scaly patches on the scalp. Primary smears and culture of the skin and hair were negative. A few weeks later, she returned and found to have inflammatory lesions. The hair fluoresce under Wood’s light and primary smears of skin and hair contained septate hyphae. On speaking with the parents, it was discovered that there were several pets in the household. Which of the following is the most likely agent?: A. Microsporum audouinii B. Microsporum canis C. Trichophyton tonsurans D. Epidermophyton floccosum

20.

One of the most remarkable aspects of human immune system is its diversity, that is, the ability to recognize a wide range of antigens and to mount a specific antibody response. This is called clonal selection. At the cellular level, which of the following is primarily responsible for such specificity?: A. Cyctotoxic T cells B. Hypervariable regions in domains of B cells C. Specific T cell receptors D. Memory cells

21.

Relative to the primary immunological response, secondary and later booster responses to a given hapten-protein complex can be associated with which of the following?: A. Lower titers of antibody B. Decreased antibody avidity for the original hapten-protein complex C. Increased antibody affinity for the hapten D. Antibodies that are less efficient in preventing specific disease

22.

Which one of the following best describes the mode of action of endotoxin?: A. Degrades lecithin in cell membranes B. Inactivation of elongation factor-2 C. Blocks release of acetyl choline D. Causes the release tumor necrosis factor

23.

The major role of T cells in the immune response includes: A. Recognition of epitopes presented with MHC molecules B. Complement fixation C. Phagocytosis D. Production of antibodies

24.

A culture of skin lesions from a patient with pyoderma (impetigo) shows numerous colonies surrounded by a zone of beta hemolysis on a blood agar plate. A Gram-stained smear shows gram-positive cocci. If you found the catalase test to be negative, which one of the following organisms would you most probably have isolated?: A. Streptococcus pneumoniae B. Staphylococcus aureus C. Staphylococcus epidermidis D. Streptococcus pyogenes

25.

Five hours after eating fried rice at a restaurant a 24-year old woman and her husband both developed nausea, vomiting and diarrhea. This is most likely due to: A. Clostridium perfringens B. Escherichia coli C. Bacillus cereus D. Salmonella enteritidis

4.

A patient’s serum yields a positive RPR & a negative FTA. These results most likely indicate: A. Reactive for syphilis B. False negative FTA due to low sensitivity of the test C. Biological false-positive RPR due to cross-reacting antibodies D. Patient in remission for syphilis

5.

A positive ELISA test for HIV-1 & a Western blot test with bands at p24 & gp41 most likely indicate: A. False-positive ELISA & inconclusive Western blot B. Positive ELISA & Western blot; indicating HIV infection C. False positive ELISA & Western blot D. Lack of HIV infection

6.

A Staphylococcus produces a fibrin clot in the tube coagulase test, but not in the slide coagulase test. This organism: A. Produces only free coagulase & is most likely Staphylococcus aureus B. Produces only bound coagulase & is most likely Staphylococcus aureus C. Is most likely Staphylococcus epidermidis because of the negative slide test D. Is most likely Staphylococcus epidermidis since the slide test in unreliable

7.

If you start out with a population density of 200 CFU/ml of a bacterium that divides every 20 minutes, what will be the population density at the end of two hours, assuming the cells are in the log phase of growth: A. 1200 CFU/ml B. 26 CFU/ml C. 3200 CFU/ml D. 2006 CFU/ml

8.

The presence of low levels of IgG but not IgM antibodies to rubella virus in the newborn suggests: A. Presence of maternal antibodies B. Susceptibility to rubella virus infection C. Congenital infection D. Persistent infection

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13.

Despite feeling healthy, a fourth-year medical student has developed a positive PPD skin test after three years of negative results. The most likely interpretation of this result would be that the student has: A. Reacted as a result of a BCG vaccine given in childhood B. An HIV infection which may give a false-positive PPD test C. Secondary tuberculosis as a result of the activation of a long standing primary infection D. Been exposed to a person with active tuberculosis and has developed a primary tuberculosis infection Penicillin is added to a culture of a Gram-positive rod. Twelve hours later, the number of bacteria has increased, and the organisms have assumed a round configuration. The most likely explanation for these observations is that the: A. Concentration of penicillin was insufficient B. Organism carries a mutated transpeptidase C. Organism is deficient in autolytic activity D. Organism secretes penicillin A 35-year old migrant worker is admitted to the hospital with a high fever and malaise. When he started feeling weak 3 days ago, he checked his temperature and found it to be slightly elevated. Over the last 3 days, he has felt progressively worse and his temperature has reached 39.4ºC. The resident on call in the emergency room observes a scanty maculopapular rash on the patient’s trunk. The patient mentions that another worker in his group has been sick with similar symptoms. Which one of the following tests would most likely yield a diagnosis: A. Blood cultures B. Methylene blue staining of a fecal extract C. Serologic tests for mumps virus, rubella virus, coxsackie viruses and echovirus D. Stool cultures Which one of the following procedures is best for decontaminating a heatsensitive reusable piece of equipment?: A. Ethylene oxide gas sterilization B. Pasteurization C. Soaking in 3% hydrogen peroxide D. Soaking in alcohol An alginate-producing, aerobic, oxidase-positive, Gram-negative bacillus is isolated from the sputum of a patient with cystic fibrosis. This organism is likely to be: A. Bacteroides fragilis B. Escherichia coli C. Klebsiella pneumoniae D. Pseudomonas aeruginosa

26.

Escherichia coli has two major porins located in the outer membrane. The function of porins is: A. Stabilization of the mesosome B. Metabolism of phosphorylated intermediates C. Transfer of small molecules through the outer membrane D. Serologic stabilization of the O antigen

27.

A recently hired laboratory technologist forgets the iodine-fixation step while performing a Gram’s stain on a strain of Staphylococcus. The most likely result is that the organisms would: A. Appear pink B. Appear blue C. Be colorless D. Wash off the slide

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37.

Your patient is a woman with vaginal discharge. You suspect on clinical grounds, that it may be due to Candida albicans. Which of the following statements is true?: A. A Gram stain of the discharge should reveal an encapsulated yeast cells B. Culture of the discharge on Sabouraud’s agar should produce a white mycelium with aerial conidia C. To identify the organism, you should determine whether germ tubes are produced D. Dematiaceous, septated hyphae should be seen together with the yeast cells Fungal cells that reproduce by budding are seen in the infected tissues of patients with: A. Candidiasis, Cryptococcosis, and Sporotrichosis B. Mycetoma, Candidiasis, and Mucormycosis C. Tinea corporis, Tinea unguium, and Tinea versicolor D. Sporotrichosis, Mycetoma, and Aspergillosis Bacteriologic examination of the cerebrospinal fluid (CSF) of a 6-year old girl with suspected meningitis results in the isolation of a Gram-negative diplococcus that grows in chocolate agar and is oxidase positive. Which type of antibacterial should be selected for the treatment of this patient?: A. cause misreading of bacterial messenger RNA B. inactivate DNA-dependent RNA polymerase C. inhibit peptidoglycan cross-linking D. inhibit DNA gyrase A 22-year old woman developed urinary tract infection during her honeymoon. At the time she sought medical advice, she was febrile and complained of painful urination and flank pain. Her urine appeared “cloudy.” Urine culture yields a lactose-fermenting, indole-positive, Gram-negative bacillus. The infectiveness of the organism responsible for this urinary tract infection is associated with specific: A. exotoxins B. P fimbriae C. K antigens D. plasmids The survival of Mycobacteria after ingestion by macrophages is attributed to: A. bacterial inhibition of complement activation via the alternative pathway B. bacterial inhibition of phagolysosome formation and interference with endosomal acidification C. the poor immunogenecity of the cell wall glycolipids D. the bacterium’s rapid escape from the endosome into the cytoplasm of infected cells A Gram-negative bacterium is isolated from a patient’s cerebrospinal fluid (CSF). It grows on enriched chocolate agar but does not grow on blood agar except adjacent to a streak of staphylococci. The organism is most probably: A. Neisseria meningitidis B. Neisseria gonorrheae C. Haemophilus influenzae D. Listeria monocytogenes A gardener pricked his toe while cutting rose bushes. Four days later a pustule that changed to an ulcer developed on his toe. Then 3 nodules formed along the local lymphatic drainage. The most likely agent is: A. Sporothricum schenckii B. Trichophyton rubrum C. Aspergillus fumigatus D. Candida albicans A 24-year old construction worker, who has had four injections of the DPT vaccine in his first year of life and boosters at ages 5 & 19, received a deep laceration while excavating a building’s foundation. The preferred method of treatment would be: A. An aminoglycoside antibiotic B. Human tetanus immunoglobulin, because it will stimulate his anamnestic response C. Equine tetanus immune globulin, because it will passively immunize him. D. Tetanus toxoid, because it will stimulate his anamnestic response A Gram stain from the purulent drainage of a synovial fluid reveals numerous gram-negative diplococci. The organism grew on chocolate agar and Thayer Martin medium but failed to grow on blood agar or MacConkey agar. Further testing revealed the organism to be oxidase positive with positive utilization of glucose. All other carbohydrates were negative. The beta lactamase result was positive. The organism is most likely: A. Streptococcus pneumoniae B. Neisseria gonorrheae C. Neisseria meningitidis D. Moraxellal catarrhalis Beta-hemolytic streptococci were isolated from the throat culture of a 15-year old male. Select the best group of tests to identify this organism: A. Bacitracin and SXT B. Bacitracin and CAMP C. Bile esculin and PYRase D. Optochin and CAMP

38.

Salmonella has been isolated as a source of contamination in an outbreak of gastroenteritis associated with eggs. Which of the following reactions is correct for this genus?: A. H2S positive, urease negative, non-motile B. H2S positive, urease negative, motile C. H2S negative, urease positive, motile D. H2S positive, urease positive, non-motile

39.

An organism isolated from an anaerobic blood agar was subcultured onto both aerobic blood agar, which was incubated aerobically and anaerobic blood agar, which was incubated anaerobically. After 48 hours, growth was evident only on the anaerobic blood agar plate. This organism is most likely: A. An obligate aerobe B. An obligate anaerobe C. A facultative anaerobe D. Capnophilic

40.

As compared to a primary response, a typical anamnestic response yields: A. About the same antibody level but the level persists longer B. More antibody but the level is lower to develop C. A much higher antibody level that also persists longer D. A higher antibody level that declines much more rapidly

41.

Most by: A. B. C. D.

polar compounds cross the outer membrane of Gram negative bacteria Simple diffusion through the lipid bilayer Diffusion through porins Facilitated diffusion via specific carriers Active transport using ATP in the periplasm

42.

Individual prokaryotic cells grow: A. Slowly at first, then more rapidly B. At a constant rate throughout the cell cycle C. Rapidly at first, then more slowly D. In brief spurts, interspersed with periods of non-growth

43.

In terms of temperature optimums for growth, which group encompasses the human pathogens?: A. Psychrophile B. Mesophile C. Thermophile D. Hyperthermophile

44.

Pili contribute to bacterial invasiveness by: A. Helping pathogens attach to host cells B. Inhibiting phagocytosis C. Dissolving the extracellular matrix D. Inhibiting phagosome-lysosome fusion

45.

The symptom of diffuse, watery diarrhea that produces a relatively clear stool containing mucus flecks (rice water stool) is most closely associated with an infection caused by: A. Escherichia coli B. Shigella dysenteriae C. Vibrio cholerae D. Campylobacter jejuni

46.

A clinical problem has emerged concerning infections after prosthetic heart valve insertion or other cardiac procedures with methicillin-resistant strains of: A. Staphylococcus epidermidis B. Serratia marcescens C. Streptococcus salivarius D. Enterococcus faecalis

47.

Shigella sonnei is differentiated from the other species by: A. Its ability to ferment lactose B. Its positive phenylalanine deaminase reaction C. Its negative oxidase reaction D. Its ability to demonstrate motility at 42ºC

48.

The optimal specimen for the recovery of Bordetella pertussis is: A. Coughed sputum B. Blood C. Anterior nares swab D. Nasopharyngeal swab

49.

A gram-negative bacillus was recovered from the urine of a child with a history of recurrent urinary tract infections. The organism was oxidase negative, lactose negative, urease positive, and motile. The most likely identification of this agent would be: A. Proteus mirabilis B. Escherichia coli C. Pseudomonas aeruginosa D. Enterobacter aerogenes

50.

The enzyme produced by Helicobacter pylori that appears to be important for survival of the organism in the stomach is: A. Protease B. Urease C. Adenylate cyclase D. Alkaline phosphatase

51.

A microaerophilic curved rod, which frequently causes enteritis in humans, resides in the intestinal and reproductive tracts of animals: A. Vibrio cholerae B. Salmonella choleraesuis C. Shigella flexneri D. Campylobacter jejuni

52.

The most appropriate method for sterilizing a bacteriologic medium is: A. Autoclave B. Ethylene oxide application C. Filtration D. Use of dry heat

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54.

Urease production by enteric bacteria involved with urinary tract infections is clinically significant because: A. The enzyme destroys the epithelial lining of the bladder B. Products of urease activity cause an alkalinization of the urine and precipitation of calcium and magnesium phosphates C. The enzyme facilitates migration of bacteria into the kidneys D. The enzyme is required for adherence of bacteria to uroepithelial cells The highest incidence of meningococcal infection occurs in which age group?: A. 0 to 6 months of age B. 6 to 24 months of age C. 2 years to 5 years of age D. 5 years to 21 years of age Page 9 of 17

55.

The agent for artificial immunization against Clostridium tetani consists of: A. Purified capsular antigen B. Purified cell-wall protein C. An attenuated live organism D. A toxic protein treated with formaldehyde

56.

An individual experiences severe diarrhea after eating sushi in a restaurant. The most probable cause of the problem is: A. Salmonella enteritidis B. Campylobacter jejuni C. Vibrio parahaemolyticus D. Shigella sonnei

57.

The lowest amount of antibiotic that results in 99.9% in vitro killing of the organism is the: A. Minimal bacteriostatic concentration B. Serum bactericidal level C. Serum peak level D. Minimal bactericidal concentration

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60.

Propionibacterium acnes were isolated in one tube of a set of three blood cultures. The other two tubes revealed no growth and no organisms were seen on the Gram stain. This most likely indicates: A. Septicemia from the organism B. Failure to inoculate the negative bottles properly with blood C. Skin contamination from improper disinfection before venipuncture D. None of the above The iodine stain for the identification of Chlamydia trachomatis stains: A. The glycogen in the inclusion brown B. The periplasmic space purple C. The cell membrane brown D. The DNA in the inclusion purple An infant was seen in the emergency room with symptoms of neuromuscular weakness and constipation. The diagnosis of infant botulism was confirmed by the demonstration of toxin in the child’s stool. The child most likely contracted the disease by: A. Ingestion of spores that germinated in the intestine B. A puncture wound with contaminated household item C. Ingestion of preformed toxin found in a contaminated jar of pureed vegetables D. Inhalation of contaminated fomites

61.

Each of the following statements correctly describes the mycoplasmas, EXCEPT: A. They contain both DNA and RNA B. They do not have a cell wall C. They cannot replicate on their own D. They are the smallest free living organisms known

62.

The synergistic action of sulfonamides and trimethoprim is related to which of the following? A. Inhibition of beta-lactamase B. Inhibition of sequential steps in tetrahydrofolate synthesis C. Altered penicillin-binding proteins D. Inhibition of DNA gyrase

63.

The characterization of spirochetes relies primarily on: A. Metabolic end products B. Cell wall constituents C. Carbohydrate degradation D. Morphology

64.

Chronic carriers, persons who remain infected with an organism for long periods, are typically associated with the dissemination of: A. Salmonella typhi B. Corynebacterium diphtheriae C. Streptococcus pneumoniae D. Bordetella pertussis

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66.

A college student got a summer job working at a marina. While working on one of the outboard motors on a rental boat, he received several lacerations on his right forearm. No medical treatment was sought at the time of the injury but after several weeks he noted that the lesions were not healing and sought the opinion of his physician. A biopsy of one of the lesions showed it to be a cutaneous granulomatous condition. Given the history, which of the following microorganisms would most likely be the etiologic agent in this case?: A. Vibrio vulnificus B. Pseudomonas aeruginosa C. Mycobacterium marinum D. Nocardia asteroids A microbiology student noticed that a Fluid Thioglycollate culture broth was very turbid at the surface and turbid throughout the rest of the tube. She can conclude that the: A. Organisms cannot tolerate oxygen B. Organisms are aerobes C. Organisms should be put in a candle jar D. Organisms are facultative anaerobes

67.

All of the DNA elements carried within a bacterium – whether plasmid, a cloned fragment of DNA carried by a vector, or the chromosome – must share which of the following?: A. Common promoter sequences B. Common ribosome binding sites C. Bacterial origins for DNA replication D. Common repressor binding sequences

68.

Serologic diagnosis is an important tool in infectious disease treatment because: A. It detects the presence of the specific antigen B. It is useful even if the etiologic agent is difficult or impossible to isolate C. It is a reflection of current infection D. It is effective earlier in infection than any type of direct culture

69.

Fungal cultures should be held and observed for growth for at least: A. 72 hours B. 1 week C. 1 month D. 2 months

70.

A laboratory contaminant that produced blue-green growth and microscopically showed branching septate hyphae, large, flask-shaped vesicles, phialides, uniserated heads and parallel chains of conidia covering the upper half of the vesicle is most likely: A. Rhizopus B. Aspergillus C. Absidia D. Penicillium

71.

Which of the following is NOT appropriate when discussing cultures of blood for the recovery of bacteria? A. No more than 3 cultures should be drawn in one day B. Should be drawn before the expected fever spike C. Cultures are incubated aerobically and anaerobically D. Collect 5 ml of blood for optimal recovery of pathogen

72.

When clinical specimens are being processed for the recovery of Mycobacterium tuberculosis, the generally recommended method for digestion and decontamination of the sample is: A. Sodium hypochlorite B. Trisodium phosphate C. N-acetyl-L-cysteine D. Potassium hydroxide

73.

Effective vaccines presently in use against meningococcal disease contain which of the following as the primary immunizing agent?: A. heat-killed bacilli B. lipopolysaccharide C. major outer-membrane protein D. capsular polysaccharide

74.

The mycobacteria are described as “acid-fast” because: A. The organisms cannot be stained with acidic dyes B. The organisms are rapidly decolorized with acid-alcohol C. Once stained, the organisms cannot be decolorized with acid-alcohol D. The organisms are easily stained with acidic dyes

75.

You are growing bacterial cells in culture and notice that the cells do not look very healthy. After some checking you discover that there is a lot of lactic acid in the culture fluid. What is probably wrong with this culture?: A. Too much sugar is in the medium B. Ethyl alcohol is being produced in excess C. The cells do not have enough oxygen D. Glycolysis is being inhibited

76.

What is the cause of anemia associated with ancylostomiasis?: A. Bone marrow depression caused by parasitic invasion B. Vitamin B12 deficiency caused by competitive absorption by the parasite C. Malabsorption of folic acid as a result of chronic diarrhea D. Persistent iron loss

77.

A child who plays in dirt contaminated with human and pet feces is susceptible to which of the following set of parasites?: A. Ascaris lumbricoides, Trichuris trichiura, Trichinella spiralis, Wuchereria bancrofti B. Loa loa, Capillaria philippinensis, Enterobius vermicularis, Trichinella spiralis C. Strongyloides stercoralis, Toxocara canis, Ascaris lumbricoides, Necator americanus D. Ancylostoma braziliense, Trichuris trichiura, Trichinella spiralis, Necator americanus

78.

A scolex is recovered in human feces after the patient is treated with medication. The scolex bears four cup-shaped suckers. This parasite is. A. Diphyllobothrium latum B. Echinococcus granulosus C. Taenia saginata D. Hymenolepis nana

79.

While examining a fecal specimen, Isospora belli is suspected. The technologist would expect to see: A. Cysts containing sporozoites B. Oocysts that are acid fast C. Cysts with red blood cell inclusions D. Spores that are acid fast

80.

You have decided to move to the Great Lakes area of the United States to become a sheepherder. You will be a hermit, enjoying a completely selfsustained life by the edge of a lake with your sheepdog and sheep. Which of the following sets of Platyhelminthes are you most likely to contract?: A. Fasciola hepatica, Paragonimus westermani, Taenia solium B. Schistosoma mansoni, Echinococcus granulosus, Clonorchis sinensis C. Fasciolopsus buski, Diphyllobothium latum, Schistosoma japonicum D. Fasciola hepatica, Echinococcus granulosus, Diphyllobothrium latum

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82.

Fly larvae were recovered from an open wound on the arm of a nursing home patient. This finding is called: A. Facultative myiasis B. Intestinal myiasis C. Mechanical myiasis D. Obligate myiasis An 8-year old girl with respiratory symptoms comes to the emergency room. Her mother tells the physician that her daughter has been more clumsy than usual over the past 3 days. On physical examination, an engorged tick is found on the child’s neck. Her temperature is 37ºC, and her complete blood count levels are normal. These symptoms suggest that the child has: A. Babesiosis B. Colorado tick fever C. Lyme disease D. Tick paralysis

D.

Babesiosis

94.

Initial gastritis followed by hypereosinophilia and vasculitis, and ultimately myositis, are symptoms of clinical cases of which of the following: A. Cysticercosis B. Sparganosis C. Trichinosis D. Visceral larva migrans

95.

Disseminated intravascular coagulation resulting in decreased microcirculation and tissue anoxia is responsible for the severe renal and cerebral manifestations of: A. Amebic meningoencephalitis B. Malignant malaria C. Neonatal toxoplasmosis D. Urinary schistosomiasis

83.

Recovery in human feces of a 7 mm-long gravid proglottid containing eight lateral branches indicates infection with: A. Diphyllobothrium latum B. Taenia solium C. Echinococcus granulosus D. Taenia saginata

96.

Ulcerative colitis describes the intestinal lesions seen in clinical cases of which of the following?: A. Ascariasis B. Amebiasis C. Giardiasis D. Enterobiasis

84.

A patient with AIDS returned from Thailand with acute diarrhea. The stool revealed an oval organism that was acid-fast and fluoresced blue under ultraviolet light. The most likely identification of this organism is: A. Giardia B. Toxoplasma C. Cyclospora D. Cryptosporidium

97.

The modified acid-fast stain is most often used in parasitology to identify: A. Protozoan cysts and trophozoites B. Helmonth eggs C. Plasmodium D. Cryptosporidium and other Coccidia

98.

The observation of embryonic flame cell activity is recommended to demonstrate the viability of the eggs of: A. Clonorchis sinensis B. Fasciola hepatica C. Schistosoma japonicum D. Taenia solium

99.

Enterobius vermicularis infection is usually diagnosed by: A. Finding adult worm in feces B. Finding larvae in feces C. Finding eggs in the feces D. Finding eggs in the perianal specimens

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86.

A newspaper correspondent has diarrhea for 2 weeks after an assignment in Quezon province. You might expect to have: A. Schistosomiasis B. Toxoplasmosis C. Visceral larva migrans D. Giardiasis A retired Air Force colonel has had abdominal pain for 2 years. He makes yearly visits to his hometown in Leyte where he enjoys wading with bare feet into streams. Which of the following should be in your differential diagnosis?: A. Trichinosis B. Schistosomiasis C. Visceral larva migrans D. Giardiasis

87.

A woman from Mindanao complains of having paroxysmal attacks of chills, fever, and sweating; these attacks last a day or two at a time and recur every 36 to 48 hours. Examination of a stained blood specimen reveals ring-like and crescent-like forms within red blood cells. The infecting organism is most likely: A. Plasmodium falciparum B. Plasmodium vivax C. Babesia microti D. Wuchereria bancrofti

88.

A 56-year old missionary in Mindanao is in acute renal failure. Two months earlier, the patient had been diagnosed with malaria and treated with Chloroquine. Recrudescence occurred after the first month of therapy. The recent deterioration in his kidney function followed a febrile crisis during which the patient noted that his urine was very dark. The most likely cause for this patient’s acute renal failure is: A. acute dehydration B. bilirubin toxicity C. deposition of immune complexes in the glomeruli D. massive intravascular hemolysis

89.

A pear-shaped flagellate with an undulating membrane extending one-half the length of its body with four recurrent flagella but no anterior flagellum was recovered from a urine specimen. This is most likely: A. Giardia lamblia B. Trichomonas hominis C. Trichomonas vaginalis D. Trichomonas tenax

90.

A 3-year old girl was admitted to the hospital with severe emaciation and anemia secondary to a long term bloody diarrhea. While hospitalized, she experienced several episodes of rectal prolapse. Numerous white worms were seen attached to the surface of the prolapsed rectal mucosa. This patient most probably has: A. Diphyllobothrium latum B. Necator americanus C. Enterobius vermicularis D. Trichuris trichiura

91.

An ameba isolated from a patient with keratitis has spiny pseudopods, welldefined ectoplasm and endoplasm, and no flagellar phase noted. It is most likely: A. Iodamoeba B. Cryptosporidium C. Naegleria D. Acanthamoeba

92.

The host where the asexual or larval phase of the parasite occurs is known as the: A. Incidental host B. Intermediate host C. Definitive host D. Carrier

93.

Finding intraerythrocytic trophozoite, schizont and gametocyte stages in stained thin blood smears during febrile periods is the usual means of diagnosis of which of the following?: A. Malaria B. Toxoplasmosis C. Visceral leishmaniasis

100. Which of the following findings in a peripheral blood smear is especially associated with tissue-invading helminths but may also be found in a variety of allergic conditions and other diseases?: A. Anemia B. Eosinophilia C. Leucopenia D. Neutropenia