Special Bacteriology

1. Food poisoning has occurred due to ingestion of fried rice, most likely contaminated with
the following organism:
A. Bacillus cereus
B. Staphylococcus aureus
C. Clostridia botulinum
D. Bacillus anthracis
E. Bacillus subtilis
2. Which one of the following statements concerning B. anthracis organism is correct?
A. It may be spread in a body via lymphatic or blood stream and cause septicemia
B. It has a strong endotoxin that can cause shock like state after antibiotic
administration
C. It can produce potent neurotoxins that results in nerve system
D. It can be transmitted from human to human by an insect vector
E. It can cause latent infection and can be re-activated after several
3. “Medusa head” colonies on nutrient agar is seen when the diagnosis is developed of:
A. Anthrax
B. Plague
C. Leptospirosis
D. Syphilis
E. Gas gangrene
4. A vaccine is available against anthrax, which is:
A. Live attenuated strain produced by culturing
at non-optimal temperature
B. Live attenuated strain produced by passage
through the organisms of unsusceptible
animals
C. Polysaccharide capsule
D. Highly virulent heat-killed whole organism
E. Peptidoglycan of the cell wall
5. What of the following paired properties are the important virulence determinants of B.
anthracis?
A. Edema and necrotizing toxin
B. Flagella and capsule
C. Exotoxin and endotoxin
D. Adhesive pili and hyalorunidase
E. All of the above
6. The "string of pearl" colonies on nutrient agar are produced when which of the following
organisms is growing on penicillin-containing medium?
A. Bacillus
B. Staphylococcus
C. Mycobacteria
D. Corynebacterium
E. Clostridia
7. Which of the following clinical forms of anthrax most likely has a poor prognosis?
A. Pulmonary anthrax
B. Cutaneous anthrax
C. Latent anthrax
D. Intestinal anthrax
E. Secondary anthrax
8. Which one of the followings is the major reservoir for B. anthracis infection?
 A. Spores in soil
B. Spores in a bodies ofunsusceptible animals
C. Vegetative organisms in blood of susceptible
animals
D. Spores in human blood
E. Vegetative cells in soil
9. Which one of the followings zoonotic disease has NO arthropod vector?
A. Anthrax
B. Lyme disease
C. Endemic relapsing fever
D. Plague
E. Epidemic typhus
10. What organism produces a frequently misdiagnosed food poisoning associated with fried
rice?
A. Bacillus cereus
B. Clostridium perfringens
C. Bacillus subtilis
D. Bacillus anthracis
E. Clostridium botulinum
11. Which one of the listed below bacteria paired with a mode of transmission is correct?
A. Leptospira interrogans-infected urine
B. Borrelia burgdorferi-flea bite
C. Borrelia recurrentis-water aerosol
D. Borrelia duttoni-louse-bite
E. Treponema pallidum-skin-to-skin contact
12. The cause of the relapses in relapsing fever is:
A. Reduction in antibody immune response
B. Development of the antibiotic resistance of
the pathogen
C. Changing in pathogen’s antigens
D. Late release of the exotoxins
E. Reduction in cell-mediated immune response
13. Each of the following statements about Weil’s disease is correct, except:
A. It can be transmitted from animals to humans
by tick bite
B. It is caused by Leptospira interrogans
C. It can be diagnosis by serogroup-specific
microagglutination test
D. It is a zoonotic disease
E. It is the most severe clinical form of
leptospirosis
14. The lab test which can be used to distinguish epidemic and endemic relapsing fever is:
A. Animal inoculation test
B. VDRL test for regain antibody
C. Serological test for IgM antibody
D. Culture of Borrelia using ordinary culture
media
E. Demonstration of the antigenic structure of
bacteria
15. Which of the following diseases is not a zoonotic disease?
 A. Endemic relapsing fever
B. Epidemic relapsing fever
C. Leptospirosis
D. Lyme disease
E. Plaque
16. Which one of the following statement regarding Lyme disease is correct?
A. Ticks are the principle mode of transmission of the disease
B. There is no vaccine available for human protection
C. The causative agent is a small gram-positive rod
D. The basis for diagnosis is culturing of the organism on chocolate agar
E. It is caused by Borrelia recurrentis
17. Spirochete that does not have an animal reservoir is:
A. Borrelia recurentis
B. Leptospira biflexa
C. Borrelia burgdorferi
D. Borrelia duttoni
E. Leptospira interrogans

18. Alternate periods with fever along with the periods without fever are characteristic for the disease
caused by:
A. Borrelia recurentis B. Leptospira biflexa С. Borrelia burgdorferi
D. Treponema carateum E. Leptospira interrogans
19. For which of the following disease vaccine are available for human protection?
A. Lyme disease
B. Endemic relapsing fever
C. Venereal syphilis
D. Non venereal syphilis
E. Epidemic relapsing fever
20. Spirochetes are stained with:
A. Giemsa stain B. Gram-stain C. Ziehl-Neelsen stain
D. Indian ink E. All of the above F. silver impregnation
21. The virulence of S. pneumoniae is primarily due associated with the presence of:
A. polysaccharide capsule
B. lecithinase
C. cell wall teichoic acids
D. M protein
E. peptidoglycan
22. What is the most probable source of the organism in an outbreak of sepsis caused by
Staphylococcus aureus in the newborn nursery?
A. nose
B. colon
C. throat
D. vagina
E. urethra
23. A culture of skin lesion from a patient with impetigo shows colonies with beta-hemolysis on
a blood agar. If these gram-positive cocci found to be catalase-negative, which of the
following organisms is the most probable cause of disease?
A. Streptococcus pyogenes
B. Streptococcus faecalis
C. Staphylococcus aureus
D. Staphylococcus epidermidis
E. Streptococcus pneumonia
24. The coagulase test for plasma clotting is used to distinguish:
A. Staph. aureus from Staph. epidermidis
B. Strptococcus pyogenes from Staphylococcus epidermidis
C. Str. pyogenes from Str. faecalis
D. Staph. aureus from Neisseria meningitidis
E. Str. pneumoniae from Str. pyogenes
25. Which one of the followings is considered a main virulence factor of Staphylococcus
aureus?
A. an alpha-hemolysin
B. a heat-labile neurotoxin
C. endotoxin
D. resistance to novobiocin
E. pilli
26. The patient has subacute endocarditis caused by the viridans group of streptococci.
Which site is most likely the source of the organism?
A. oropharynx
B. colon
C. urethra
D. skin
E. all of the above
27. Two hours after a dinner of potato salad and roast turkey the family of four experience
vomiting and diarrhea. Which one of the following organisms is most likely to cause the
symptoms?
A. Staphylococcus aureus
B. Salmonella enteritidis
C. Escherichia coli
D. Neisseria meningitides
E. Streptococcus pyogenes
28. Each of the following statements concerning Staph. aureus is correct EXCEPT:
A. Endotoxin is an important pathogenicity factor
B. The coagulase test is positive
C. Can produce several types of exotoxins
D. Penicillinase-resistant penicillins should be used for treatment
E. Gram-positive cocci in grape-like clusters
29. Which one of the followings is considered an important virulence factor of Streptococcus
pyogenes?
A. streptolysins O and S
B. capsule
C. endotoxin
D. an alpha-hemolysin
E. pilli
30. Staphylococcal scalded skin syndrome typically seen in infants and in children below 5
years is due to the production of:
A. exfoliative toxin
B. erythrogenic toxin
C. enterotoxin A
D. coagulase
E. leucocidin
31. A key characteristic of the etiological agent of bacillary dysentery is:
A. production of a potent cytotoxin responsible for invasiveness
B. the organism is found mainly in animals
C. strict localization of the pathogen in the small intestine
D. the organism is transmitted by droplet aerosol
E. it is a member of normal flora of the human body
32. Blood and leukocytes are seen frequently in the stool during:
A. shigellosis
B. salmonellae food poisoning
C. traveler’s diarrhea
D. staphylococcal food poisoning
E. disbacteriosis
33. The predominant virulence factor of Shigella dysenteriae is a (an):
A. enterotoxin/cytotoxin
B. polysaccharide capsule
C. flagella
D. potent endotoxin
E. plasmid mediated antibiotic resistance factor
34. A 30-yer-old woman developed watery diarrhea, little vomiting, nausea, and low-grade
fever on the airplane when she was returning from vacation in the Middle East. A stool
culture reveals only lactose-positive colonies on MacConkey agar. Which one of the
following organisms is the most likely to be the cause?
A. Escherichia coli
B. Klebsiella pneumonia
C. Shigella flexneri
D. Salmonella paratyphi A
E. Salmonella enteritidis
35. Which one of the following organisms causes bloody diarrhea, is non-motile, does not
ferment lactose and does not produce H2S:
A. Shigella flexnery
B. Shigella sonnei
C. Salmonella typhi
D. Salmonella enteritidis
E. Escherichia coli
36. Which one of the following exotoxins can kill Vero cells in culture?
A. shiga-toxin of Shigella dysenteriae
B. endotoxin of all Enterobacteriaceae
C. toxic shock syndrome toxin of S. aureus
D. heat-labile enterotoxin of E. coli
E. heat-stable enterotoxin of E. coli
37. Which one of the following organisms is the most common cause of urinary tract
infections in humans?
A. Escherichia coli
B. Streptococcus pyogenes
C. Klebsiella pneumonia
D. Pseudomonas aeruginosa
E. Staphylococcus aureus
38. Factors responsible for the pathogenicity of E. coli include all of the following EXCEPT:
A. lipoteichoic acid adhesins
B. capsular (K) antigen
C. heat-labile enterotoxin
D. heat-stable enterotoxin
E. endotoxin
39. Which one of the following agent of enteric illnesses has the lowest 50% infective dose
(ID50)?
A. Shigella sonnei
B. Salmonella typhi
C. Enterotoxigenic Escherichia coli
D. Salmonella typhimurium
E. Enterophatogenic Escherichia coli
40. A 5-year-old girl develops bloody diarrhea and no vomiting 3 days after visiting her
friend’s birthday. Stool culture on Endo’s agar grows both lactose-positive and
lactose-negative rods with Gram-negative stain reaction. Which one of the following
organisms is the most likely to be the cause?
A. Klebsiella pneumonia
B. Staphylococcus aureus
C. Shigella flexneri
D. Clostridium difficile
E. Salmonella cholerasuis
41. A 50-year-old woman returned from Peru, where there was an epidemic of cholerae. She
now has multiple episodes of diarrhea, characterized as:
A. Watery diarrhea without blood, no PMNs in the stool, and no organisms in the blood culture
B. Watery diarrhea without blood, no PMNs in the stool, and growth of curved Gram-negative
rods in the blood culture
C. Bloody diarrhea, PMNs in the stools, and growth of curved Gram-negative rods in the blood
culture
D. Bloody diarrhea, PMNs in the stools, and no organisms in the blood culture
E. All of following episodes can occur
42. Which one of the following exotoxins can stimulate hypersecretion of fluids and
electrolytes?
A. choleragen of V. cholerae
B. shiga-toxin of Shigella dysenteriae
C. shiga-like toxin of EHEC
D. endotoxin of all gram-negative rods
E. heat-stable toxin of ETEC
43. The predominant virulence factor of V. cholerae is a (an):
A. phage-mediated exotoxin
B. polysaccharide capsule
C. flagella
D. enterotoxin with cytotoxicity
E. plasmid- mediated antibiotic resistance factor
44. A 55-year-fishman who was working on his boat in the waters of the Black Sea
developed rapid progressive cellulites, of the right leg, high fever and chill. Which one of
the following organisms is the most likely to be the cause?
A. Vibrio vulnificus
B. Shigella dysenteriae
C. Salmonella paratyphi A
D. Vibrio cholerae
E. E. coli
45. Vibrio cholerae can be classified into how many serotypes on the base of O-Ag:
A. 139 (O1-O139)
B. (Ogava, Inaba, Hikojima)
C. (El Tor and Classical)
D. It can not be classified because it is antigenically homogenous
E. It can not be classified because it does not have O-Ag
46. Each of the following statements concerning exotoxin is correct, EXCEPT:
 A. Diphtheria toxin production is under
chromosomal genes control
B. Cholera toxin acts by stimulating adenylate
cyclase
C. Diphtheria is caused by an exotoxin that
inhibits protein synthesis by inactivating an
elongation factor-2
D. Diphtheria toxin is a major virulence factor of
C. diphtheriae
E. Botulinistic and tetanus exotoxins are both
neurotoxins
47. Toxigenicity of Corynebacterium diphtheriae strains can be detected by all of the
following methods, EXCEPT:
A. Antibiotic sensitivity testing
B. In vivo bioassay subcutaneous or
intracutaneous test in guinea-pigs
C. Gel precipitation test (Elek’s test)
D. Polymerase chain reaction (PCR)
E. Tissue culture test for demonstration of
diphtheria toxin cytotoxicity
48. The site of C. diphtheriae infection may be :
A. All of the followings
B. Laryngeal or nasal
C. Otitic or conjunctival
D. Genital
E. Cutaneous
49. Based on the cultural (colonies’ morphology) and biochemical properties C. diphtheriae
isolates can be classified into:
A. Four biovars (mitis, gravis, intermedius,
belfanti)
B. Two biovars (classical and eltor)
C. Two clinical forms (toxic and nontoxic)
D. Three serological groups (I, II, III)
E. Four phagovars
50. A 5 year-old boy has malaise, sore throat and a low-grade fever. On examination a
pseudomembrane firmly adhered to respiratory tissues was found and it was difficult to
dislodge it without making the underlying tissues bleed. Which one of the organisms is
most likely cause of the disease?
A. Gram-positive pleomorphic rods in palisade arrangement demonstrating metachromatic
nature
B. Gram-positive thick rods with subterminal spores
C. Gram-positive cocci arranged in short chains
D. Gram-negative curved highly motile rods
E. Long spiral-shaped rods that cannot be Gram-stained
51. The A portion of diphtheria exotoxin:
 A. Interferes with protein synthesis by
inactivating elongation factor II
B. Attaches to the membrane of a susceptible
cells
C. Attaches to the 30S ribosome
D. Attaches 50 S ribosome
E. Blocks neurotransmission at peripheral
cholinergic synapses by preventing release of
the acetylcholine
52. Each of the following statements concerning Corynebacterium diphtheriae is correct
EXCEPT:
A. Major virulence factor responsible for clinical
manifestation is an endotoxin
B. C. diphtheria is a gram-positive rod that does
not form spores
C. Toxin production is depend on the organism’s
being lysogenized by a bacteriophage
D. Antitoxin should be used to treat patients with
diphtheria
E. Vaccine against diphtheria containing toxoid
53. Methods for demonstration of C. diphtheriae strains toxigenicity are:
A. Gel precipitation test (Elek’s test)
B. Studying of sugar fermentation patterns
C. Microscopic examination of smears stained
with methylene blue to observe typical
arrangement
D. Serotyping and phagotyping of isolates
E. Neutralization (Nagler’s) test on egg-yolk
agar
54. A 10 year-old boy was admitted to a hospital and non-toxigenic mild respiratory
diphtheria was diagnosed. On tellurite agar the colonies appear small, round, convex, and
black. Which one of the C. diphtheriae biovars is the most likely cause of the disease?
A. Mitis
B. Gravis
C. Intermedius
D. Belfanti
E. All of them
55. Complications in patients with severe diphtheria is due to which of the following virulence
factors:
A. The release of exotoxin that inhibits protein synthesis in different type of cells
B. The release of endotoxin during the autolysis of organisms
C. The high specificity of surface bacterial antigens to respiratory epithelium
D. The presence of unique chemical composition of the cell wall
E. The presence of long-term bacteremia within recovery period
56. Mycoplasmas are different from most other bacteria in that they have no:
A. Cell membrane
B. Nucleic acid
C. Flagella
D. Proteins
E. Cell wall
 57. A 25-year-old man complains of a urethral discharge. Gram stain of discharge reveals
neutrophils but no bacteria. Which one of the listed organisms is more likely to cause
discharge?
A. Chlamydia trachomatis
B. Treponema pallidum
C. Mycoplasma pneumoniae
D. Candida albicans
E. Coxiella burnetii
58. Obligate intracellular parasites that form elementary bodies is:
A. Chlamydia pneumoniae
B. Ricketsia rickettsii
C. Mycoplasma pneumoniae
D. Mycobacterium leprae
E. Mycobacterium tuberculosis
59. Each of the following statements concerning chlamydial genital tract infections is correct,
EXCEPT:
A. Infection can be diagnosed by finding antichlamydial antibody in a serum
specimen
B. Infection can persist after administration of penicillin
C. Symptomatic infection can be associated with cervical discharge
D. There is no vaccine against this infection
E. It is the cause of lymphogranuloma venereum
60. Most cases of nongonococcal urethritis are caused by:
A. Chlamydia trachomatis
B. Treponema pallidum
C. Neisseria gonorrhoeae
D. Escherichia coli
E. Streptococcus pyogenes

Special Virology
1. A young adult male appeared HIV-negative on routine laboratory tests three weeks after the
suspicious sexual contact. A doctor suggested that the patient had “window’’ period. Which one
of the following tests will be the best, most cost-efficient test to order?

A. PCR for viral RNA B. CD4 counts C. ELISA for anti-HIV

antibody

D. HIV culture E. T4/T8 ratio

2. HIV and HTLV-1 share all the following characteristics EXCEPT:

A. They are oncogenic B. They are RNA viruses

C. They are enveloped viruses D. They have reverse transcriptase enzyme

 E. They infect T lymphocytes

3. Reverse transcriptase is:

A. RNA dependent DNA polymerase B. DNA ligase

C. DNA dependent RNA polymerase D. Integrase

E. DNA dependent DNA polymerase

4. The commonly used screening test for Human Immunodeficiency virus is:

A. ELISA test B. Weil-Felix test C. Western blot test

D. VDRL test E. Hemagglutination test

5. Commonest mode of AIDS transmission in the world is:

A. Sexual B. Intravenous drug abuse C. Vertical transmission

D. Indirect contact E. Blood transfusion

6. During the “Window” period of patient with HIV the lab tests results are as follows:

A. . Both ELISA and WB are negative B. Western Blot (WB) for antibody is

negative

C. ELISA for antibody is D. PCR is negative E. All are negative

negative

7. The gene coding for HIV enzymes is:

A. pol B. tat C. gag D. env E. vif

8. ELISA test when compared to Western blot technique is:

A. More sensitive, less specific B. More sensitive, more specific

 C. Less sensitive, more specific D. Less sensitive, less specific

E. They are equal in both specificity and sensitivity

9. Each of the following statements concerning HIV is correct EXCEPT:

A. The presence of antibodies that neutralize B. There is antigenic diversity in the viral

HIV is evidence that an individual is protected surface glycoproteins

against HIV-induced disease

C. The opportunistic infections seen in AIDS D. Transmission of HIV in adults occurs

are primarily the result of an immunity loss primarily by the transfer of blood or semen

E. The T cell CD4 protein is the receptor for the virus

10. Each of the following statements about HIV is correct EXCEPT:

A. The virion contains DNA-dependent RNA B. HIV is an RNA virus

polymerase

C. Saquinavir inhibits HIV-protease activity D. HIV replicate through DNA-intermediate

E. Zidovudine inhibits transcription of HIV

11. Each of the following statements about HIV is correct EXCEPT:

A. Acyclovir inhibits replication of HIV B. HIV is an enveloped virus

C. The virion contains RNA-dependent DNA D. A DNA copy of the HIV genome integrates

polymerase into host cell DNA

E. Saquinavir inhibits HIV-protease activity

12. HIV has a high mutation rate due to imprecise operation of its:
A. Reverse transcriptase B. Protease C. Dismutase

D. Integrase E. Ribonuclease H
 13. Which of the following viruses causes hemorrhagic fever and break-bone disease, which
is life threatening?
A. Dengue virus B. Yellow fever virus C. HBV

D. Rubella virus E. Rabies virus

14. All of the following statements about arboviruses are TRUE, EXCEPT that:
A. Flavi- and Togaviruses have negative B. Bunyaviruses differ in their structure and

ssRNA genome replicative cycle

C. They have wide host range D. They can grow in arthropod vector

E. One of the major clinical manifestations of arbovirus infections is encephalitis

15. Which description of the arbovirus infections diagnosis is LESS accurate:

A. IgG antibody is of high diagnostic value when detected in serum, taken after the
onset of the disease
B. Neutralizing and hemagglutination inhibition antibody can be detected by serological
reaction
C. Viruses can be recovered by intracerebral inoculation of mice
D. IgM is of high diagnostic value
E. Genetic methods can be used to detect viral genome in clinical specimens

16. Which of the following viruses causes jaundice and can be life threatening?
A. Yellow fever virus B. Rubella virus C. Rhinovirus

D. Rabies virus E. Measles

17. Which of the statement concerning epidemiology of arbovirus infections is NOT correct?
A. Hantavirus hemorrhagic fever with renal syndrome and pulmonary syndrome is
tick born
B. Alphavirus equine encephalitis is mosquito-borne
C. Arboviruses have wide host range
D. Bunyavirus Crimean-Congo hemorrhagic fever is tick-borne
E. Arboviruses cause typical zoonotic diseases

18. All of the following diseases are mosquito borne, EXCEPT:

A. Russian (European) B. Japanese encephalitis

encephalitis

C. Dengue fever D. EE encephalitis E. Yellow fever

19. After returning from Africa, a woman develops an illness characterized by high fever, black
vomits, proteinuria and jaundice. She is most likely to have:
A. Yellow fever virus B. Rubella virus C. Dengue

D. Equine encephalitis E. Scrub typhus

20. Alphavirus cause which one of the following diseases?

A. Western equine B. Japanese C. Russian /European

encephalitis encephalitis encephalitis

D. St. Louis encephalitis E. Crimean-Congo haemorrhagic fever

21. What is NOT TRUE about both rubella and measles viruses?

A. Their virions contain RNA polymerase B. They are RNA viruses

C. They both have a single antigenic type D. They are transmitted by respiratory route

E. Rubella but not measles infections of pregnant women cause teratogenic effect

22. Each of the following statements concerning rubella vaccine is correct, EXCEPT:

A. The vaccine contains whole-killed virion B. The vaccine prevents the spread of virulent

virus

C. The vaccine induces neutralizing D. The vaccine is trivalent or monovalent

antibodies

E. Vaccination promotes both humoral and cellular immune responses

23. Which of the statements about rubella is correct?

A. Women who have had no history of apparent rubella may have neutralizing
antibody in sera
B. The disease can be arthropod borne
C. In young children rubella usually cause very severe disease with serious
complications
D. Acyclovir is effective in the treatment of congenital rubella
E. A patient in incubation period is not infective

24. Congenital abnormalities is MOST LIKELY will be seen in which of the following
infections occurred in early pregnancy?
 A. Rubella virus B. Rabies virus C. Rhinovirus

D. Yellow fever virus E. RSV virus

25. A pregnant patient has been exposed to rubella virus in the 18th week of gestation.
She has no history of rubella and no records of vaccination at childhood. The best
course of action would be:
A. Check her antibody titer serologically B. Suggest termination of pregnancy

C. Vaccinate her immediately D. Administrate rubella immune serum

E. Assure her that no problems exist because she past the first trimester of pregnancy

26. German measles (rubella) infection is best described by which of the following statements?
A. Onset is abrupt with fever, rash and B. Vesicular rashes are characteristic

lymphadenopathy

C. Incubation period is long, 4 to 5 weeks D. Koplik’s spots are characteristic

E. German measles (rubella) and measles (rubeola) are caused by the same virus

27. Each of the following statements concerning rabies vaccine is correct, EXCEPT:
A. The vaccine contains live attenuated virus B. The vaccine is monovalent

C. The vaccine is used for post exposure D. The vaccine contains whole-killed

prophylaxis virion

E. It is usually used in combination with passive immunization

28. What is NOT TRUE about both rabies and influenza viruses?
A. They are usually transmitted by respiratory B. Their virions contain RNA polymerase

route

C. They are enveloped viruses D. They both have a negative-sense RNA

E. Killed vaccines are available for both viruses

 29. A 6-year-old boy was bitten by a dog about the face and neck. What strategy will be
used for immunization?
A. Use hyper immune serum and active B. Use hyper immune serum only

immunization

C. Use active immunization only D. Use active immunization, if the antibody

level is low use hyper immune serum

E. All of the followings are correct strategies for post exposure immunization

30. Which one of the following viruses causes encephalitis, but killed inactivated vaccine
is available for postexposure prophylaxis?
A. Rabies virus B. Measles virus C. Varicella-zoster virus

D. Mumps virus E. Herpes simplex virus

type1

31. Each of the following statements concerning rabies virus is correct, EXCEPT:
A. The virus has positive-sense RNA which is B. The virus has lipoprotein envelope

infectious embedded with viral-specific G proteins

C. Reproduction of the virus occurs in cytoplasm D. The assembled virions release by budding

E. The virion contains RNA-dependent RNA polymerase to start mRNA transcription

32. Mail hunters were attacked by a fox and got several scratches and bites on their hands
and legs. They failed to catch or shoot the animal. What should be done as a
postexposure prophylaxis?
A. Use human rabies immune serum and human B. Wash wounds with detergent and inject

diploid cell vaccine for immunization rabies immune globin

C. Try to check whether an animal it is rabid or D. Give human diploid cell vaccine

not

E. Clean wounds with soap and give antibiotic treatment

33. A young woman that had received a complete course of vaccination against hepatitis B one
year ago developed fever with anorexia, and after two days jaundice appeared. The results of
ELISA tests are: HAV-IgM-negative, HAV-IgG-positive, HBs-Ag-negative, HBs-IgG-positive,
HBc-Ag-negative, HCV-Ab-positive. What is the most probable conclusion?
A. She has had hepatitis A in the past, and now she has hepatitis C

B. She is having hepatitis A now, and she has been infected with hepatitis B and C in the
past

C. She has had hepatitis A in the past, and now she has hepatitis B, and she never has had
hepatitis D. The disease is most probably of non-infectious etiology

E. She is having hepatitis B now, and she has been infected with hepatitis B and C in the
past

34. Individuals vaccinated with the HBsAg vaccine would be protected from infection by:

A. Hepatitis B and delta B. Hepatitis B virus only C. Hepatitis C virus only

viruses

D. Hepatitis D virus only E. Hepatitis A virus only

35. Hepatitis A virus infection is BEST will be diagnosed with which of the following methods?
A. IgM antibodies in serum B. Culture from blood C. Isolation from

stool

D. Microscopic examination of E. Isolation from bile

feaces

36. The serological marker of acute Hepatitis B infection is:

A. HBsAg + HBeAg B. HBsAg C. HBsAg + Core antibody

D. HBcAg E. HBsAg and anti-HBs antibody

37. Which one of the following viruses contains a partially double-stranded DNA?
A. Hepatitis B. Hepatitis C C. Enterovirus D. Hepatitis E. Coxsackievirus

B 72 D
38. All of the following are true about Hepatitis C virus EXCEPT:
A. It is defective B. It contains an envelope C. It may cause chronic liver

damage

D. It is an RNA E. It is primary cause of transfusion associated hepatitis

virus

39. All following viruses are oncogenic, EXCEPT:

A. Hepatitis A virus B. Herpes simplex type 2 virus C. HHV 8

D. EBV E. Hepatitis B virus

40. The commonest cause of infectious viral hepatitis is:

A. Hepatitis type A virus B. Hepatitis type B virus C. Hepatitis type C virus

D. Cytomegalovirus E. Hepatitis type G virus

41. A recent Hepatitis B infection is confirmed by the demonstration in serum of:

A. anti-HBc IgM antibodies B. HBcAg C. HBsAg

D. Anti-HBs antibodies E. HBe-Ag and anti-HBe antibody

42. Each of the following statements concerning hepatitis E virus is correct, EXCEPT:
A. It is oncogenic and can cause hepatocellular carcinoma
B. It causes more severe disease in pregnant women
C. The initial site of viral replication is gastro-intestinal tract
D. It is transmitted by fecal-oral route
E. It is naked RNA virus

43. A hospital nurse is found to have HBs antigen in blood. Subsequent test reveal the presence
of HBe antigen as well. The nurse most probably
A. Has active hepatitis and is highly infective
B. Does not have active hepatitis but It is highly infective
C. Is not infective
D. Is evincing a false positive test for hepatitis
E. Has both hepatitis B and C

44. All of the following statements regarding HCV are true, EXCEPT:
A. Chronic HCV infection is not associated with hepatocellular carcinoma
B. It often occurs in posttransfusion patients
C. IV drug users are at risk of HCV infection
D. 30 to 50% of cases progress to chronic liver disease
 E. Blood products should be tested for antibody to HCV

45. Nonenveloped virus with single-stranded, positive polarity RNA is:

A. Poliovirus B. Adenovirus C. Influenza virus

D. Parainfluenza virus E. Measles virus

46. Which one of the following vaccines could safely be given to an immunocompromised
individual?
A. IPV (Salk) B. OPV Sabin) C. Measles D. Mumps E. Rubella

47. Which one of the following strategies will induce lasting mucosal immunity to
poliovirus?
A. Oral vaccination with live vaccine B. Oral administration of poliovirus immune

globin

C. Parenteral vaccination with live vaccine D. Parental administration of poliovirus

immune globin

E. Intramuscular vaccination with inactivated vaccine

48. Virus is shed in feces during which of the following infections:

A. Herpangina B. Smallpox C. Influenza

D. Parainfluenza type 2 E. Chickenpox

49. Introduction of a naked viral genome in the cytoplasm is infectious (leads to a productive
infection) with which virus?
A. Poliovirus B. Mumps virus C. Influenza virus

D. Parainfluenza virus E. Adenovirus

50. Poliovirus infections are subclinical in what percentage of population?

A. 90% B. 10% C. 20% D. 50% E. 1%

51. Poliovirus vaccine is correctly described by all of the following statements, EXCEPT:
A. The Sabin vaccine could not cause disease B. It is a polyvalent preparation

in humans

C. The Salk vaccine contains D. The Sabin vaccine is a live attenuated virus

formalin-inactivated virus

E. Active virus is excreted in the feces of Sabin-vaccine immunized individuals

52. Each of the following statements regarding poliovirus and its vaccine is correct,
EXCEPT:
A. Pathogenesis of poliovirus involves the death of sensory neurons
B. Poliovirus is transmitted by the fecal-oral route
C. The live attenuated vaccine contains all three serotypes of the virus
D. In 1% of the infections it can cause paralytic disease
E. Culture method is commonly used for poliovirus diagnosis

53. Most common manifestations of coxsackievirus type B infection are all of the followings,
EXCEPT:
A. Herpangina B. Myocarditis and pericarditis C. Paralytic diseases

D. Encephalitis and meningitis E. Pleurodynia and respiratory diseases

54. Which one of the following statements concerning poliovirus infection is correct?
A. The virus replicates in the gastrointestinal B. A skin test is available to determine prior

tract exposure to the virus

C. Congenital infection of the fetus is an D. Amantadine is an effective preventive agent

important complication

E. Poliovirus is one of the most common cause of respiratory diseases

55. Each of the following statements concerning mumps is correct, EXCEPT:

A. Mumps orchitis in children prior to puberty often causes sterility
B. It is paramyxovirus with single-stranded RNA genome
C. Meningitis is a recognized complication of mumps
D. During mumps pancreas can be affected
E. The virus spreads through the bloodstream to various internal organs

56. Examination of the 10-year old patient reveals fever and bilateral parotitis. A clinical
diagnosis of mumps was developed. Which one of the following tests is the BEST to
confirm a clinical diagnosis of acute mumps disease?
A. A 4-fold rise to in antibody titer to B. A history of exposure to a mumps case

mumps surface antigen

C. Orchitis in young adult male D. Syncytia formation in virus-infected cells

E. A positive skin test

57. Each of the following statements concerning subacute sclerosing panencephalitis is

correct, EXCEPT:
A. Complete virions bud from the nerve cells membranes
B. Aggregates of helical nucleocapsids are found in infected cells
C. Disease is caused by Defective (mutant) measles virus
D. Measles antibodies are found in cerebrospinal fluid
E. Slowly progressive deterioration of brain function occurs
58. A 3-year-old child has a temperature of 38.30C; discrete vesiculoulcerative lesions
(Koplik’s sports) are noted on the mucous membrane of the mouth. The most probable
diagnosis is:
A. Measles B. Scarlet fever C. Herpangina

D. Mumps E. Rubella

59. Laryngotracheobronchitis is most likely can be seen in which of the following infections :
A. Parainfluenza virus type B. Influenza virus C. Respiratory syncytial

1-3 virus

D. Mumps E. Measles

60. Each of the following statements concerning respiratory syncytial virus (RSV) is correct,
EXCEPT:
A. RSV does not spread in a host via B. RSV induces formation of multinucleated giant

viremia cells

C. RSV may cause pneumonia in D. RSV has a single stranded RNA genome

children

E. RSV infection can be effectively treated with acyclovir

61. An infection in 7-year old child started with mild cold-like symptoms, “seal bark” cough
and then it results in subglottal swelling. Which of the following organisms is most likely
can cause croup syndrome?
A. . Parainfluenza virus type B. Parainfluenza type 4 C. Respiratory syncytial

1-3 virus
 D. Measles E. Mumps

62. What statement about characteristic feature of measles virus is NOT CORRECT?
A. Measles virus usually causes local infection in upper respiratory tract
B. It is enveloped single-stranded RNA virus showing no neuraminidase activity
C. The important complication of measles virus infection is encephalitis
D. The certain strains of the measles virus can be attenuated by culture under non
optimal temperature
E. Measles virus strains are serologically homogenous

63. Orthomyxoviruses are correctly described by all of the following statements, EXCEPT:
A. Being classified into the same family with B. Type can be identify according to

parainfluenza virus ribonucleoprotein

C. Having a segmented genome D. Being of three antigenic types

E. Having RNA as their genome

63. Which one of the following statements about antigenicity of influenza virus is not
correct?
A. The main protein involved in antigenic drift is ribonucleoprotein
B. The antigenic shift causes major antigenic changes in the influenza virus that
results in pandemics
C. Antigenic shift can affect both hemagglutinin and neuraminidase
D. The only influenza A virus can undergo antigenic shift
E. Matrix protein is not involved in an antigenic changing

65. The feature of the influenza virus that contributes MOST to the antigenic variation of the
virus is:
A. Segmented nucleic acid B. High G + C content, which augments

binding to nucleoprotein

C. Helical structure of the nucleocapsid D. The purified nucleic acid of the virus is

non-infectious

E. Presence of two types of surface glycoproteins

66. Influenza virus A has all of the following features, EXCEPT:

A. A non-segmented genome B. Negative stranded RNA

 C. A lipid envelope of cellular origin D. A helical capsid

E. Hemagglutinin and neuraminidase spikes embedded on its surface

67. The principle reservoir for the antigenic shift variants of influenza appears is :

A. Animals, especially pigs, horses, ducks B. Non immune population

C. People in isolated communities D. Soil, especially in the tropics

E. Sewage as well as open waters, contaminated with organic substances

68. Which one of the following statements concerning treatment and prevention of influenza
virus disease is not correct?
A. Influenza inactivated vaccine aid to produce cell-mediated immune response against
surface glycoproteins
B. Influenza vaccine contains an inactivated whole virions or purified glycoproteins
C. Influenza inactivated vaccine aid to produce neutralizing antibodies against surface
glycoproteins
D. Recombinant and live attenuated influenza vaccines undergo clinical trials
E. The immunity induced by vaccination is subtype specific

69. Cytomegalovirus infections are treated most efficiently with:

A. Ganciclovir B. Ribavirin C. Azidothymidine

D. Amantadine E. Remantadine

70. Epstein-Barr virus is associated with all of the following, EXCEPT:

A. Multiple sclerosis B. Latent infection C. Burkitt’s lymphoma

D. Infectious mononucleosis E. Nasopharyngeal carcinoma

71. Which one of the following outcome is MOST common following a primary herpes
simplex virus infection?
A. Establishment of latent infection. B. Persistent asymptomatic viremia

C. Persistent cytopathic effect in infected cells D. Complete eradication of virus and

virus-infected cells
E. Hypersensitivity reaction to herpes simplex

antigens

72. Herpesviruses usually establish a latent infection in which part of the body?
A. Nerve ganglia B. Liver C. Intestine

D. Eyes E. Gall bladder

73. All of the followings are associated with cytomegalovirus EXCEPT:

A. Heterophil antibodies B. Inclusion bodies C. Subclinical infection

D. Latency E. Congenital disease

74. Which one of the following viruses is a leading cause of congenital malformations,
no vaccine available?
A. Cytomegalovirus B. Varicella-zoster virus C. Herpes simplex virus type 2

D. Herpes simplex virus type 1 E. Epstein-Barr virus

75. In humans, the causative agent of infectious mononucleosis (EBV) primarily infects:
A. B lymphocytes B. Heart muscle cells C. Sensory neurons

D. Cells of the intestinal epithelium E. Cells lining the alveoli

76. Which one of the following viruses causes painful vesicular rash along the course of a
thoracic nerve?
A. Varicella-zoster virus B. Cytomegalovirus C. Herpes simplex virus type 1

D. Epstein-Barr virus E. Herpes simplex virus type 2

77. Which one of the following statements about genital herpes (HSV-2) is NOT correct?
a. Recurrent disease episodes due to reactivation of latent HSV-2 are usually
more severe than the primary episodes
b. HSV-2 causes vesicular lesions in the genital area
c. Multinucleated giant cells with intranuclear inclusions are found in the lesions
d. Primary episodes are usually more severe than the recurrent episodes due to
reactivation of latent HSV-2 disease
e. Genital herpes may be transmitted in the absence of apparent lesions

78. During herpesviruses replication:

A. Viral regulatory proteins and enzymes are B. Late transcription takes place in the

made in immediate early phase cytoplasm

C. Viral capsid proteins mediate cell D. Viral envelope is derived from the

attachment cytoplasmic membrane

E. DNA is replicated by host cell DNA polymerase

79. A 60- year-old mail patient received several blood transfusions during the surgical
operation. He did well for 2 weeks, but then developed fever, vomiting, diarrhea.
Liver biopsy revealed intranuclear inclusion bodies. Which organism is the cause of
the disease?
A. Cytomegalovirus B. Adenovirus C. Hepatitis A virus

D. Parainfluenza virus E. Influenza virus

80. A 25-year-old man has developed sore throat with no exudates a day before
examination, and enlargement of cervical lymph nodes. A throat culture appeared
negative for beta-hemolytic streptococci. A heterophil antibody test for agglutination
of sheep erythrocytes by patient’s serum appeared to be positive. What is the most
probable pathogen cause disease?
A. Epstein-Barr virus B. Polio virus C. Influenza virus

D. Measles virus E. Cytomegalovirus