38 clinical MCQs in Microbiology. Which of the following is the odd one out in terms of its mode of transmission?. Kenya, Africa and global revision.
Q1. Which of the following is the odd one out in terms of its mode of transmission?
Answer: Vibrio cholerae
Explanation: Vibrio cholerae, Entamoeba histolytica, and Rotavirus are all transmitted through the fecal-oral route (contaminated water/food). Thelazia species (eyeworms) are transmitted by flies that feed on lacrimal secretions, making it the odd one out. ---
Q2. Which one of the following is larviparous?
Answer: Glossina species
Explanation: Larviparous insects give birth to live larvae rather than laying eggs. Tsetse flies (Glossina species) are larviparous, producing one larva at a time that pupates immediately after birth. ---
Q3. Argasid ticks have
Answer: Multiple hosts
Explanation: Argasid (soft) ticks are multi-host ticks that can feed on different hosts throughout their life cycle and can take multiple blood meals at each life stage. ---
Q4. Ixodid ticks have how many nymphal stages?
Answer: One
Explanation: Ixodid (hard) ticks have a single nymphal stage in their life cycle: egg → larva → nymph → adult. ---
Q5. Traps for Aedes mosquitoes are composed of
Answer: Aedes mosquitoes
Explanation: Aedes mosquitoes are attracted to contrasting black and white patterns. Ovitrap designs often use black containers with white interiors or black and white striped patterns. ---
Q6. Traps for Glossina species are composed of
Answer: Black and blue colors
Explanation: Tsetse flies (Glossina species) are attracted to blue and black colors. Standard tsetse traps use blue cloth with black panels to attract the flies effectively. ---
Q7. Blackwater fever is due to presence of which species in the environment?
Answer: Blackwater fever
Explanation: Blackwater fever is a severe complication of falciparum malaria characterized by massive hemolysis and dark urine. It's associated with Plasmodium falciparum infection transmitted by Anopheles mosquitoes. ---
Q8. Hepatitis B virus has been associated with
Answer: Cimex species
Explanation: While not definitively proven, bed bugs (Cimex species) have been investigated as potential mechanical vectors for Hepatitis B virus, though human-to-human transmission remains the primary route. ---
Q9. Snails are both first and second intermediate hosts of
Answer: Echinostoma ilocanum
Explanation: Echinostoma ilocanum uses snails as both first and second intermediate hosts in its complex life cycle, unlike other flukes that use different intermediate hosts. ---
Q10. How can millipedes cause medical problems?
Answer: Spraying defensive secretions
Explanation: Millipedes defend themselves by secreting toxic chemicals (hydrogen cyanide, quinones) that can cause skin irritation, burns, and eye damage in humans. ---
Q11. Holometabolous insects have
Answer: 4 life stages
Explanation: Holometabolous insects undergo complete metamorphosis with four distinct stages: egg, larva, pupa, and adult. Examples include flies, beetles, and butterflies. ---
Q12. Rift Valley fever is mainly transmitted by
Answer: Rift Valley fever virus
Explanation: Rift Valley fever virus is primarily transmitted by Aedes mosquitoes, particularly Aedes mcintoshi and Aedes ochraceus in flood-water breeding sites. ---
Q13. Autogenous insects
Answer: Lay eggs without mating
Explanation: Autogenous insects can develop their first batch of eggs without taking a blood meal, using nutrient reserves from their larval stage. This is different from anautogenous insects that require blood meals. ---
Q14. Parthenogenesis is a type of
Answer: Parthenogenesis
Explanation: Parthenogenesis is a form of asexual reproduction where offspring develop from unfertilized eggs, essentially creating genetic clones of the parent. ---
Q15. Which insects are included in order Blattaria?
Answer: Cockroaches
Explanation: Order Blattaria (now called Blattodea) includes cockroaches and termites. Lice belong to Phthiraptera, flies to Diptera, and beetles to Coleoptera. ---
Q16. The best mode of malaria control is
Answer: Integrated vector management
Explanation: Integrated vector management combines multiple control strategies (bed nets, treatment, environmental management, etc.) and is considered the most effective approach for sustainable malaria control. ---
Q17. A 70-year-old man with diverticulosis experiences sudden severe left lower quadrant pain and fever. Surgery reveals a ruptured diverticulum with an abscess. The most likely bacteria to be found in the abscess are
Answer: Mixed normal gastrointestinal flora
Explanation: Diverticular abscesses typically contain mixed anaerobic and aerobic bacteria from normal colonic flora, including Bacteroides, E. coli, Enterococcus, and other enteric bacteria. ---
Q18. Antimicrobial therapy can allow proliferation of resistant colonic bacteria. Which species can proliferate and produce a toxin causing diarrhea?
Answer: difficile
Explanation: C. difficile is relatively resistant to many antibiotics and can overgrow when normal flora is suppressed. It produces toxins A and B that cause antibiotic-associated colitis. ---
Q19. Which microorganism can be part of normal vaginal flora and cause meningitis in newborns?
Answer: Group B streptococci
Explanation: Streptococcus agalactiae (Group B Strep) is normal vaginal flora in ~25% of women but can cause serious infections in newborns, including meningitis, pneumonia, and sepsis. ---
Q20. Dental plaque and periodontal disease represent what type of physiological process?
Answer: Biofilm formation
Explanation: Dental plaque is a classic example of biofilm formation where bacteria adhere to tooth surfaces and produce extracellular matrix, leading to periodontal disease. ---
Q21. Which microorganism is closely associated with dental caries?
Answer: S. mutans
Explanation: S. mutans is the primary causative agent of dental caries. It produces acids from sugar metabolism that demineralize tooth enamel and produces sticky glucans that help it adhere to teeth. ---
Q22. Streptococcus pneumoniae can be normal flora in 5-40% of people. At what anatomic site?
Answer: Nasopharynx
Explanation: S. pneumoniae commonly colonizes the nasopharynx asymptomatically. Colonization rates are highest in children and can lead to invasive disease under certain conditions. ---
Q23. Resident flora is commonly found in the
Answer: Urethra
Explanation: The distal urethra contains resident flora, primarily Staphylococcus epidermidis and other coagulase-negative staphylococci. The other sites listed are normally sterile. ---
Q24. Resident flora is absent from the
Answer: Lungs
Explanation: Synovial fluid in healthy joints is sterile. The other sites normally contain resident flora, though the lungs have minimal flora in healthy individuals. ---
Q25. A 65-year-old woman post-surgery with central line becomes febrile. Blood and line tip cultures grow gram-positive organisms that are ovoid and reproduce by budding. The most likely organism is
Answer: Candida albicans
Explanation: The description of ovoid organisms reproducing by budding describes yeast. Candida albicans commonly causes catheter-related bloodstream infections, especially in patients on broad-spectrum antibiotics. ---
Q26. The most likely portal of entry for the organism in Question 25 is
Answer: During placement of the central line
Explanation: Central line-associated bloodstream infections typically occur through contamination during insertion or through the catheter hub during maintenance. ---
Q27. A housewife develops double vision, difficulty talking, dry mouth, and descending paralysis after eating home-canned green beans. The diagnosis is
Answer: Botulism
Explanation: Classic botulism presentation: descending flaccid paralysis starting with cranial nerves, associated with home-canned foods. Botulinum toxin blocks acetylcholine release. ---
Q28. Which is an important virulence factor of Bacillus anthracis?
Answer: Protective antigen
Explanation: Protective antigen is a component of anthrax toxin that binds to host cells and facilitates entry of lethal factor and edema factor, the toxic components. ---
Q29. A motorcyclist with leg trauma develops fever, swollen leg with crepitus, hemolysis, and pale, shining skin. The most likely organism is
Answer: Clostridium perfringens
Explanation: This describes gas gangrene: crepitus (gas in tissues), hemolysis, and characteristic pale, shining skin. C. perfringens is the most common cause. ---
Q30. For the patient in Question 29, what is responsible for the hemolysis?
Answer: Lecithinase
Explanation: C. perfringens alpha toxin (lecithinase) is a phospholipase that breaks down cell membrane phospholipids, causing massive hemolysis and tissue necrosis. ---
Q31. The incubation period for inhalational anthrax can be up to
Answer: 6 weeks
Explanation: Inhalational anthrax has a variable incubation period that can extend to 6 weeks or more, depending on spore dose and host factors. Most cases occur within 1-7 days. ---
Q32. A food commonly associated with Bacillus cereus food poisoning is
Answer: Fried rice
Explanation: B. cereus food poisoning is classically associated with fried rice that has been kept warm for extended periods, allowing spore germination and toxin production. ---
Q33. Tetanus toxin blocks the release of
Answer: Inhibitory glycine and γ-aminobutyric acid
Explanation: Tetanospasmin blocks release of inhibitory neurotransmitters (glycine and GABA) from Renshaw cells, causing unopposed muscle contraction and spastic paralysis. ---
Q34. A man with a puncture wound develops jaw spasms and generalized muscle spasms triggered by noise. The diagnosis is
Answer: Tetanus
Explanation: Classic tetanus: puncture wound, trismus (lockjaw), generalized muscle spasms triggered by stimuli, and opisthotonus (arching of back). Patient remains alert and conscious. ---
Q35. Culex species are major vectors of which disease?
Answer: Lymphatic filariasis
Explanation: Culex mosquitoes, particularly Culex quinquefasciatus, are the primary vectors for Wuchereria bancrofti, the most common cause of lymphatic filariasis. These mosquitoes become infected when taking blood meals from infected humans and transmit microfilariae through subsequent feeding. ---
Q36. Onchocerca volvulus is mainly transmitted by
Answer: Anopheles mosquitoes
Explanation: Simulium species (blackflies) are the exclusive vectors of Onchocerca volvulus, causing onchocerciasis (river blindness). These flies breed in fast-flowing, well-oxygenated water bodies, explaining why the disease is associated with river systems in endemic areas. ---
Q37. Fresh water snails serve as intermediate hosts for
Answer: Freshwater snails
Explanation: Freshwater snails are obligatory intermediate hosts for Schistosoma blood flukes. Different snail genera host specific Schistosoma species: Biomphalaria (S. mansoni), Bulinus (S. haematobium), and Oncomelania (S. japonicum). The parasites undergo crucial developmental stages within these snails. ---
Q38. The primary mechanism of tetanus toxin action involves
Answer: Blocking acetylcholine release
Explanation: Tetanus toxin (tetanospasmin) cleaves synaptobrevin, preventing the release of inhibitory neurotransmitters GABA and glycine from Renshaw cells. This results in uncontrolled muscle contractions and spastic paralysis characteristic of tetanus.