Medical Bacteriology & Entomology 2021/2022 Q&A – 29 MCQs | Kenya MBChB

29 Year 2: Microbiology exam questions on Medical Bacteriology & Entomology 2021/2022 Q&A for medical students. Includes MCQs, answers, explanations and

This MCQ set contains 29 questions on Medical Bacteriology & Entomology 2021/2022 Q&A in the Year 2: Microbiology unit. Each question includes the correct answer and a detailed explanation for active recall and exam preparation.

Q1: Which one of the following is a complication of streptococcus pharyngitis? A) Rheumatic fever

  1. A. Pseudomembrane blockage
  2. B. Tubercle formation
  3. C. Meningococcemia
  4. D. Waterhouse-Friderichsen syndrome Answer: A) Rheumatic fever

Correct answer: A – Pseudomembrane blockage

Rheumatic fever is a post-infectious autoimmune complication of Group A Streptococcus (S. pyogenes) pharyngitis. It occurs 2-4 weeks after untreated strep throat due to molecular mimicry between streptococcal M protein and cardiac myosin, leading to carditis, arthritis, and other manifestations. ---

Q2: The presence of a pseudomembrane is a result of: A) Strep throat

  1. A. Meningitis
  2. B. Scarlet fever
  3. C. Diphtheria
  4. D. Psittacosis Answer: D) Diphtheria

Correct answer: A – Meningitis

Diphtheria toxin produced by Corynebacterium diphtheriae causes local tissue necrosis and inflammation, leading to formation of a characteristic gray-white pseudomembrane in the throat that can obstruct airways. This fibrinous exudate is pathognomonic for diphtheria. ---

Q3: A paroxysm is a associated with : A) Fever; meningitis

  1. A. Rapid-fire cough; meningitis
  2. B. Fever; pneumonia
  3. C. Headache; pertussis
  4. D. Rapid-fire cough; pertussis Answer: E) Rapid-fire cough; pertussis

Correct answer: A – Rapid-fire cough; meningitis

Paroxysmal cough is the hallmark of pertussis (whooping cough) caused by Bordetella pertussis. The characteristic paroxysm consists of rapid-fire coughing fits followed by a high-pitched "whoop" during inspiration, often accompanied by vomiting. ---

Q4: The Mantoux test is used to identify: A) TB exposure

  1. A. Q fever
  2. B. Ornithosis
  3. C. Pertussis
  4. D. Meningitis Answer: A) TB exposure

Correct answer: A – Q fever

The Mantoux test (tuberculin skin test) uses purified protein derivative (PPD) injected intradermally to detect delayed-type hypersensitivity response indicating previous exposure to Mycobacterium tuberculosis or BCG vaccination. Induration ≥10mm in normal individuals suggests TB exposure. ---

Q5: This bacterial species is the most common cause of "typical" pneumonia: A) H. influenzae

  1. A. S. pneumoniae
  2. B. M. pneumoniae
  3. C. L. pneumophila
  4. D. B. pertussis Answer: B) S. pneumoniae

Correct answer: A – S. pneumoniae

Streptococcus pneumoniae (pneumococcus) is the leading cause of community-acquired pneumonia in adults, causing classic "typical" pneumonia with sudden onset, high fever, productive cough with rusty sputum, and lobar consolidation on chest X-ray. ---

Q6: To treat patients who have ingested botulism toxin, large doses of must be administered: A) Antibiotic

  1. A. Aspirin
  2. B. Pepto-Bismol
  3. C. Antitoxin
  4. D. Electrolytes Answer: D) Antitoxin

Correct answer: A – Aspirin

Botulism antitoxin (equine-derived antiserum) neutralizes circulating botulinum toxin and prevents progression of paralysis. It must be administered early as it cannot reverse existing nerve damage but prevents further toxin binding to nerve terminals. ---

Q7: The organism Clostridium perfringens multiplies in foods only under conditions: A) Aerobic

  1. A. Freezing
  2. B. Anaerobic
  3. C. Saline
  4. D. Permissive Answer: C) Anaerobic

Correct answer: A – Freezing

Clostridium perfringens is an obligate anaerobe that multiplies rapidly in foods under anaerobic conditions. Its spores survive cooking and germinate when oxygen is excluded, leading to rapid multiplication in improperly stored cooked foods. ---

Q8: A spore-forming, motile rod that can cause foodborne illness in a diarrheal or emetic form is Bacillus: A) Anthracis

  1. A. Abortus
  2. B. Enterocolitica
  3. C. Cereus
  4. D. Botulinum Answer: D) Cereus

Correct answer: A – Abortus

Bacillus cereus causes two forms of food poisoning: diarrheal syndrome (8-16 hours after ingestion, watery diarrhea) and emetic syndrome (1-6 hours, nausea and vomiting). It's commonly associated with rice dishes and forms heat-resistant spores. ---

Q9: Woolsorter disease applies to the form of : A) Inhalation; tularemia

  1. A. Toxic; myonecrosis
  2. B. Intestinal; anthrax
  3. C. Inhalation; anthrax
  4. D. Ingested; leptospirosis Answer: D) Inhalation; anthrax

Correct answer: A – Toxic; myonecrosis

Woolsorter disease is pulmonary (inhalation) anthrax historically seen in workers processing contaminated wool, hair, or hides. Bacillus anthracis spores are inhaled, germinate in alveolar macrophages, and cause severe pneumonia with high mortality if untreated. ---

Q10: Which one of the following describes the mode of action of tetanospasmin? A) It inhibits muscle contraction

  1. A. It damages and lyses red blood cells
  2. B. It disrupts cell tissues
  3. C. It inhibits muscle relaxation
  4. D. It lyses white blood cells Answer: D) It inhibits muscle relaxation

Correct answer: A – It damages and lyses red blood cells

Tetanospasmin cleaves synaptobrevin proteins in inhibitory neurons, preventing release of GABA and glycine neurotransmitters. This blocks muscle relaxation signals, resulting in sustained muscle contractions and spastic paralysis characteristic of tetanus. ---

Q11: Salpingitis is associated with and can lead to : A) Syphilis; gumma formation

  1. A. Gonorrhea; sterility
  2. B. Chlamydia; ophthalmia
  3. C. Chancroid; soft chancre
  4. D. Gonorrhea; pharyngitis Answer: B) Gonorrhea; sterility

Correct answer: A – Gonorrhea; sterility

Salpingitis (fallopian tube inflammation) is commonly caused by ascending Neisseria gonorrhoeae infection. Chronic inflammation leads to scarring and tubal occlusion, resulting in infertility or increased risk of ectopic pregnancy. ---

Q12: Ophthalmia is associated with what two STDs? A) Syphilis and chlamydia

  1. A. Gonorrhea and chlamydia
  2. B. Syphilis and chancroid
  3. C. Syphilis and gonorrhea
  4. D. Chlamydia and chancroid Answer: B) Gonorrhea and chlamydia

Correct answer: A – Gonorrhea and chlamydia

Neonatal ophthalmia (conjunctivitis) is primarily caused by Neisseria gonorrhoeae and Chlamydia trachomatis transmitted from infected mothers during delivery. Both can cause severe purulent conjunctivitis that may lead to blindness if untreated. ---

Q13: Toxin-generated S. aureus diseases resulting from contact include: A) Purpuric fever

  1. A. Scalded skin syndrome
  2. B. Toxic shock syndrome
  3. C. Pseudomembranous colitis
  4. D. Both B and C are correct Answer: E) Both B and C are correct

Correct answer: A – Scalded skin syndrome

Staphylococcus aureus produces exfoliative toxins causing staphylococcal scalded skin syndrome (SSSS) and toxic shock syndrome toxin-1 (TSST-1) causing toxic shock syndrome. Both are toxin-mediated diseases that can result from skin contact or colonization. ---

Q14: A 22-year-old woman who works in a plant nursery presents with fever and cough for 2 months, 5 kg weight loss, bilateral upper lobe infiltrates with cavities, and acid-fast bacilli in sputum. The likely means of infection acquisition is: A) Sexual activity

  1. A. Ingesting microorganisms in food
  2. B. Contaminated hand rails on public transportation
  3. C. Handling potting soil
  4. D. Breathing aerosolized droplets containing the microorganism Answer: E) Breathing aerosolized droplets containing the microorganism

Correct answer: A – Ingesting microorganisms in food

This presentation is classic for pulmonary tuberculosis caused by Mycobacterium tuberculosis. TB is transmitted via airborne droplet nuclei containing viable bacteria. The patient's occupation and clinical findings suggest respiratory transmission, not soil contact. ---

Q15: A 65-year-old woman with a central venous catheter develops fever and multiple blood cultures positive for Staphylococcus epidermidis with biofilm formation. Which statement about this infection is correct? A) The biofilm is likely to wash off the catheter

  1. A. Extracellular polysaccharide production inhibits S. epidermidis growth
  2. B. S. epidermidis in biofilm are more susceptible to antimicrobials due to decreased metabolism
  3. C. Quorum-sensing increases antimicrobial susceptibility
  4. D. Complex molecular interactions make antimicrobial therapy difficult, likely requiring catheter removal Answer: E) Complex molecular interactions make

Correct answer: A – Extracellular polysaccharide production inhibits S. epidermidis growth

S. epidermidis biofilms on catheters are highly resistant to antimicrobials due to decreased metabolic activity, altered gene expression, and physical barrier effects of the extracellular matrix. Catheter removal is often necessary for cure. ---

Q16: The first microorganism to satisfy Koch's postulates (in the late 19th century) was: A) Treponema pallidum

  1. A. Stenotrophomonas maltophilia
  2. B. Mycobacterium leprae
  3. C. Bacillus anthracis
  4. D. Neisseria gonorrhoeae Answer: D) Bacillus anthracis

Correct answer: A – Stenotrophomonas maltophilia

Robert Koch first demonstrated his postulates using Bacillus anthracis in 1876, proving it was the causative agent of anthrax. This established the germ theory of disease and the scientific method for linking specific pathogens to specific diseases. ---

Q17: Which of the following statements about lipopolysaccharide is correct? A) It interacts with macrophages and monocytes yielding release of cytokines

  1. A. The toxic component is the O side chain
  2. B. It forms holes in red blood cell membranes yielding hemolysis
  3. C. It causes hypothermia
  4. D. It causes paralysis Answer: A) It interacts with macrophages and monocytes yielding release of cytokines

Correct answer: A – The toxic component is the O side chain

Lipopolysaccharide (endotoxin) binds to CD14/TLR4 receptors on macrophages and monocytes, triggering release of inflammatory cytokines (TNF-α, IL-1, IL-6) that cause fever, hypotension, and other septic shock symptoms. The toxic component is lipid A, not the O antigen. ---

Q18: Which of the following best describes the mechanism of action of diphtheria toxin? A) Forms pores in red blood cells causing hemolysis

  1. A. Degrades lecithin in eukaryotic cell membranes
  2. B. Causes release of tumor necrosis factor
  3. C. Inhibits elongation factor 2
  4. D. Causes increased adenylate cyclase activity Answer: D) Inhibits elongation factor 2

Correct answer: A – Degrades lecithin in eukaryotic cell membranes

Diphtheria toxin ADP-ribosylates elongation factor 2 (eEF2), permanently inactivating it and halting protein synthesis in eukaryotic cells. This leads to cell death and the characteristic local tissue necrosis and systemic toxicity of diphtheria. ---

Q19: Certain microorganisms are never considered members of normal flora and are always considered pathogens. Which organism fits this category? A) Streptococcus pneumoniae

  1. A. Escherichia coli
  2. B. Mycobacterium tuberculosis
  3. C. Staphylococcus aureus
  4. D. Neisseria meningitidis Answer: C) Mycobacterium tuberculosis

Correct answer: A – Escherichia coli

M. tuberculosis is a true (obligate) pathogen that always causes disease when it infects humans and is never part of normal flora. The other organisms can be found as normal flora in certain body sites and cause opportunistic infections. ---

Q20: Which one of the following genera is the ODD one out in terms of pathogen transmission? A) Fannia

  1. A. Musca
  2. B. Blatta
  3. C. Bulinus
  4. D. None of the above Answer: D) Bulinus

Correct answer: A – Musca

Bulinus is a freshwater snail that serves as an intermediate host for Schistosoma haematobium (biological vector), while Fannia, Musca, and Blatta are arthropods that primarily serve as mechanical vectors of pathogens through contamination. ---

Q21: Which of the following diseases can be effectively controlled by the use of acaricides? A) Leishmaniasis

  1. A. Amoebiasis
  2. B. Katayama fever
  3. C. Q-fever
  4. D. Sleeping sickness Answer: D) Q-fever

Correct answer: A – Amoebiasis

Q-fever is transmitted by ticks (Ixodes species), which are arachnids (mites and ticks) controlled by acaricides. Leishmaniasis is transmitted by sandflies, Katayama fever by snails, sleeping sickness by tsetse flies (all insects), and amoebiasis is not vector-borne. ---

Q22: Which one of the following genera is a biological vector of scrub typhus pathogens? A) Glossina

  1. A. Blatta
  2. B. Simulium
  3. C. Leptotrombidium
  4. D. Dermacentor Answer: D) Leptotrombidium

Correct answer: A – Blatta

Leptotrombidium mites (chiggers) are the biological vectors of Orientia tsutsugamushi, the causative agent of scrub typhus. The mites serve as both vector and reservoir, with transovarial transmission maintaining the pathogen in mite populations. ---

Q23: Which of the following pathogens can be transovarially transmitted by its biological vector? A) Entamoeba histolytica

  1. A. Onchocerca volvulus
  2. B. Loa loa
  3. C. Orientia tsutsugamushi
  4. D. Wuchereria bancrofti Answer: D) Orientia tsutsugamushi

Correct answer: A – Onchocerca volvulus

Orientia tsutsugamushi (scrub typhus) is maintained in Leptotrombidium mite populations through transovarial transmission from infected female mites to their offspring, making the mites both vector and reservoir host. ---

Q24: Which of the following is the BEST treatment for scabies? A) Metronidazole

  1. A. Amphotericin B
  2. B. Sodium stibogluconate
  3. C. Benzyl benzoate
  4. D. Praziquantel Answer: D) Benzyl benzoate

Correct answer: A – Amphotericin B

Benzyl benzoate is a topical scabicide effective against Sarcoptes scabiei mites causing scabies. It kills adult mites and eggs when applied to the entire body. Other options treat different parasites: metronidazole for protozoa, amphotericin B for fungi, sodium stibogluconate for leishmaniasis, praziquantel for helminths. ---

Q25: Which of the following reagents can be used in the diagnosis of mites infection? A) Liquid iodine

  1. A. Liquid crystal violet
  2. B. Liquid safranin
  3. C. Liquid tetracycline
  4. D. Blood agar Answer: A) Liquid iodine

Correct answer: A – Liquid crystal violet

Liquid iodine can be applied to skin suspected of scabies infection to visualize burrows created by Sarcoptes scabiei mites. The iodine stains the burrows dark brown, making them more visible for diagnosis. This is a simple diagnostic technique for scabies. ---

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