38 clinical MCQs in Microbiology. A gram-positive coccus isolated from a wound shows golden-yellow colonies on blood agar bu. Kenya, Africa and global r...
Q1. A gram-positive coccus isolated from a wound shows golden-yellow colonies on blood agar but is coagulase negative. The most likely organism is
Answer: Staphylococcus saprophyticus
Explanation: S. saprophyticus can produce yellow pigment but is coagulase negative, unlike S. aureus which is coagulase positive. This organism is commonly associated with urinary tract infections in young women. ---
Q2. A patient with "rice water" stool most likely has infection with
Answer: Vibrio cholerae
Explanation: Rice water stool (watery with flecks of mucus resembling water in which rice has been washed) is characteristic of cholera caused by V. cholerae. ---
Q3. Which organism can grow at refrigeration temperature (4°C)?
Answer: Listeria
Explanation: Listeria is psychrophilic and can multiply at refrigeration temperatures (4°C), making it a significant food safety concern. ---
Q4. A 25-year-old sexually active female presents with urinary tract infection. The organism that is coagulase-negative and novobiocin resistant is
Answer: S. saprophyticus
Explanation: S. saprophyticus is novobiocin resistant and causes UTI in young sexually active women. S. epidermidis is novobiocin sensitive. ---
Q5. The "string of pearls" appearance on Loeffler serum medium is characteristic of
Answer: Bacillus anthracis
Explanation: B. anthracis shows string of pearls appearance when grown in the presence of penicillin on Loeffler medium due to the formation of round bodies along the bacilli chain. ---
Q6. A neonate develops meningitis. CSF culture grows gram-negative bacilli with K1 capsular antigen. The organism is
Answer: Escherichia coli
Explanation: E. coli with K1 capsular antigen is the most common cause of neonatal meningitis. ---
Q7. "Medusa head" colonies on blood agar are produced by
Answer: anthracis
Explanation: B. anthracis produces characteristic medusa head colonies due to chaining of bacilli with irregular edges and comma-shaped projections. ---
Q8. Which test differentiates Staphylococcus from Streptococcus?
Answer: Staphylococcus
Explanation: Staphylococcus is catalase positive while Streptococcus is catalase negative. ---
Q9. A patient develops pseudomembranous colitis after prolonged antibiotic therapy. The causative organism is
Answer: difficile
Explanation: C. difficile produces toxins A and B causing antibiotic-associated pseudomembranous colitis when normal gut flora is disrupted. ---
Q10. "Chinese letter" or "V and L shaped" arrangement is seen in
Answer: Corynebacterium diphtheriae
Explanation: C. diphtheriae shows characteristic angular arrangement resembling Chinese letters due to snapping division. ---
Q11. A burn patient develops green-blue pus with a fruity odor. The organism is
Answer: Pseudomonas
Explanation: Pseudomonas produces pyocyanin (blue-green pigment) and has a characteristic grape-like or fruity odor. ---
Q12. The CAMP test is positive for
Answer: Streptococcus agalactiae
Explanation: Group B Streptococcus (S. agalactiae) shows enhanced hemolysis (arrowhead-shaped zone) when grown near S. aureus on blood agar. ---
Q13. Which organism produces black colonies on bismuth sulfite agar?
Answer: S. typhi
Explanation: S. typhi produces hydrogen sulfide (H2S) which reacts with bismuth sulfite to form black colonies. ---
Q14. A patient presents with flaccid paralysis and descending weakness. The organism that causes this by blocking acetylcholine release is
Answer: Clostridium botulinum
Explanation: C. botulinum toxin blocks acetylcholine release at neuromuscular junctions causing flaccid paralysis. ---
Q15. "Swarming" motility on blood agar is characteristic of
Answer: Proteus species
Explanation: Proteus shows swarming motility creating concentric waves on agar due to highly active flagella. ---
Q16. A gram-negative coccus that ferments maltose but not glucose is
Answer: None of the above
Explanation: Neisseria species ferment glucose first. N. gonorrhoeae ferments only glucose; N. meningitidis ferments both glucose and maltose. ---
Q17. "Elek test" is used to detect toxigenicity of
Answer: Corynebacterium diphtheriae
Explanation: Elek immunoprecipitation test detects diphtheria toxin production. ---
Q18. Which organism produces "boxcar" shaped gram-positive rods?
Answer: Clostridium perfringens
Explanation: C. perfringens appears as large, rectangular, boxcar-shaped gram-positive rods. ---
Q19. A patient develops hemolytic uremic syndrome (HUS) after eating undercooked hamburger. The organism is
Answer: Escherichia coli O157:H7
Explanation: EHEC O157:H7 produces Shiga toxin causing hemorrhagic colitis and HUS. ---
Q20. "Drumstick" or "tennis racket" appearance of spores is seen in
Answer: Clostridium tetani
Explanation: C. tetani has terminal round spores giving a drumstick appearance. ---
Q21. The most common cause of acute bacterial meningitis in adults is
Answer: S. pneumoniae
Explanation: S. pneumoniae is the leading cause of bacterial meningitis in adults. ---
Q22. A stool sample shows gram-negative curved rods with "gull wing" or "S" shape. The organism is
Answer: Campylobacter jejuni
Explanation: Campylobacter has characteristic S-shaped or gull wing morphology and darting motility. ---
Q23. Which organism is urease positive and causes "alkaline tide" in urine?
Answer: Proteus
Explanation: Proteus produces urease which splits urea to ammonia, raising urine pH and promoting struvite stone formation. ---
Q24. "Nagler reaction" is positive for
Answer: Clostridium perfringens
Explanation: Nagler test detects lecithinase (alpha toxin) production by C. perfringens. ---
Q25. A patient with infective endocarditis has blood culture showing catalase negative, gram-positive cocci resistant to optochin and not lysed by bile. The organism is
Answer: Enterococcus
Explanation: Enterococcus is optochin resistant and bile insoluble, distinguishing it from S. pneumoniae. ---
Q26. "Quellung reaction" is used to identify capsule of
Answer: All of the above
Explanation: Quellung reaction (capsular swelling test) can identify capsules of any encapsulated bacteria using specific antisera. ---
Q27. Which organism causes "woolsorter's disease"?
Answer: Bacillus anthracis
Explanation: Woolsorter's disease is inhalational anthrax from B. anthracis spores. ---
Q28. A comma-shaped gram-negative rod showing "shooting star" motility in hanging drop is
Answer: Vibrio cholerae
Explanation: V. cholerae shows rapid darting or shooting star motility due to its single polar flagellum. ---
Q29. "Widal test" detects antibodies against
Answer: Salmonella typhi
Explanation: Widal test detects antibodies against O and H antigens of S. typhi in typhoid fever. ---
Q30. Which organism produces "currant jelly" sputum?
Answer: Klebsiella pneumonia
Explanation: Klebsiella pneumonia produces thick, bloody, mucoid sputum resembling currant jelly. ---
Q31. "McFadyean reaction" showing pink-staining capsule is diagnostic for
Answer: Bacillus anthracis
Explanation: McFadyean staining shows a pink/purple capsule around blue B. anthracis bacilli. ---
Q32. A patient develops gas gangrene after a crushing injury. The organism most likely responsible is
Answer: perfringens
Explanation: C. perfringens produces alpha toxin causing myonecrosis with gas production. ---
Q33. Which organism shows "tumbling motility" at 25°C but not at 37°C?
Answer: Listeria monocytogenes
Explanation: Listeria exhibits tumbling motility at room temperature (20-25°C) but motility is reduced at 37°C. ---
Q34. "Satellite phenomenon" on blood agar indicates
Answer: Staphylococcus aureus providing factors for Haemophilus
Explanation: H. influenzae grows as satellite colonies around S. aureus, which provides V factor (NAD). ---
Q35. A patient with facial nerve palsy, meningitis, and rash has CSF showing gram-negative diplococci. The organism is
Answer: N. meningitidis
Explanation: N. meningitidis causes meningitis with petechial rash and appears as gram-negative kidney bean-shaped diplococci. ---
Q36. "Double zone hemolysis" on blood agar is characteristic of
Answer: Clostridium perfringens
Explanation: C. perfringens shows an inner zone of complete beta-hemolysis and an outer zone of incomplete hemolysis. ---
Q37. A diabetic patient develops malignant external otitis. The organism is
Answer: P. aeruginosa
Explanation: P. aeruginosa causes invasive external otitis in diabetic patients, which can extend to the temporal bone. ---
Q38. Which organism is both oxidase and catalase positive?
Answer: P. aeruginosa
Explanation: P. aeruginosa is both oxidase and catalase positive. Enterobacteriaceae are typically oxidase negative.