MICROBIOLOGY

PYQ CHALLENGE
A 29-year-old primigravida at 31 weeks of gestation presents with fever
(38.9°C), diffuse myalgia, nausea, and watery diarrhea for three days after
attending a family picnic where she consumed refrigerated soft cheese
and deli meats. She is otherwise healthy. Blood cultures grow small
Gram-positive coccobacilli that demonstrate tumbling motility at 25°C,
narrow β-hemolysis on blood agar, and growth at 4°C. Placental
ultrasound reveals fetal distress. Which virulence factor is primarily
responsible for allowing this organism to survive intracellularly by
escaping from the phagolysosome?

A. Internalin A
B. ActA protein
C. Listeriolysin O
D. Phospholipase C
Q. A 28-year-old pregnant woman at 32 weeks' gestation presents with
fever, myalgia, and diarrhea for 3 days. Blood cultures yield small
Gram-positive bacilli showing tumbling motility at room temperature.
The organism grows at 4°C and demonstrates β-hemolysis on blood
agar. Which virulence factor is primarily responsible for escape of the
organism from the phagolysosome?

A. Streptolysin O
B. Listeriolysin O
C. Pneumolysin
D. Alpha toxin
Q. An 18-year-old college freshman is admitted with septic shock, diffuse
purpura, and meningitis. Blood cultures grow encapsulated Gram-negative
diplococci. Despite appropriate antibiotic therapy, complement studies
reveal absent total hemolytic complement activity (CH50) with markedly
reduced membrane attack complex formation. His younger brother had
meningococcal meningitis at age 15. Which host defense mechanism is
most specifically impaired in this patient?

A. Opsonization by C3b

B. Classical pathway activation

C. Formation of transmembrane pores on bacterial membranes

D. Neutrophil respiratory burst

Q.A 19-year-old college student develops fever, headache, neck
stiffness, and petechial rash. CSF examination reveals neutrophilic
pleocytosis, low glucose, and elevated protein. Gram stain
demonstrates Gram-negative kidney-shaped diplococci. Which
virulence factor allows the organism to evade complement-mediated
killing?

A. Protein A
B. IgA protease
C. M protein
D. Exfoliative toxin
Q. A 58-year-old man with uncontrolled diabetes mellitus develops
facial pain, black nasal discharge, rapidly progressive periorbital
swelling, and ophthalmoplegia two weeks after recovering from
severe COVID-19. MRI reveals invasion of the ethmoid sinus and orbit.
Histopathological examination shows broad ribbon-like aseptate
hyphae branching at right angles. The causative fungus belongs to
which group?

A. Aspergillus

B. Mucorales

C. Candida

D. Fusarium
Q.A diabetic farmer presents with rapidly progressive orbital swelling
following COVID19 infection. Nasal biopsy reveals broad, aseptate
hyphae branching at right angles. The causative organism belongs to:

A. Aspergillus
B. Candida
C. Mucorales
D. Dermatophytes
Q. A 65-year-old diabetic patient with prolonged ICU stay develops
ventilator-associated pneumonia. Sputum culture grows
oxidase-positive, non-lactose fermenting Gram-negative bacilli
producing blue-green pigment and a fruity odor. Which toxin
inhibits protein synthesis by ADP-ribosylating elongation factor-2?

A. Endotoxin

B. Exotoxin A

C. Pyocyanin

D. Elastase
Q.A patient with prolonged fever undergoes blood culture. The isolate
is oxidase-positive, non-lactose fermenting, motile, and produces
blue-green pigment with fruity odor. The organism is:

A. Burkholderia pseudomallei
B. Pseudomonas aeruginosa
C. Vibrio cholerae
D. Proteus mirabilis
Q. A pharmaceutical company manufactures an intravenous monoclonal
antibody preparation that loses biological activity above 45°C.
Quality-control testing confirms that the final product must remain sterile
and free of viable bacteria without altering tertiary protein structure. Which
processing method best achieves this objective?

A. Dry heat at 160°C

B. Steam under pressure

C. Gamma irradiation

D. Membrane filtration through a 0.22-µm filter

Q. A microbiology laboratory needs to sterilize culture media containing
glucose and proteins that would be denatured by high temperatures.
Which sterilization technique is most appropriate?

A. Hot air oven

B. Autoclaving

C. Tyndallization

D. Filtration
Q. A biotechnology company engineers Escherichia coli to produce
recombinant insulin. During large-scale fermentation, nutrient depletion
and accumulation of acidic metabolic by-products halt the increase in
viable cell numbers. Transcriptional analysis demonstrates marked
upregulation of genes involved in oxidative stress resistance, DNA
repair, and alternative sigma factor–mediated survival pathways. The
bacterial culture is most likely in which growth phase?

A. Lag phase

B. Exponential phase

C. Stationary phase

D. Death phase
Q.A microbiologist inoculates bacteria into a nutrient-rich broth. During
one phase of growth, the number of viable organisms remains constant
because the rate of cell division equals the rate of cell death. Which
phase is this?

A. Lag phase

B. Log phase

C. Stationary phase

D. Decline phase
Q. A biotechnology company develops a recombinant protein that
selectively enhances expression of protein kinase R (PKR),
2',5'-oligoadenylate synthetase, and MHC class I molecules in
virus-infected cells. Treated cells demonstrate marked inhibition of
viral protein synthesis and increased recognition by cytotoxic T
lymphocytes. Which endogenous cytokine normally produces these
effects?

A. IL-4

B. IL-2

C. IFN-α

D. IL-10
Q. A 46-year-old veterinarian presents with a painless black eschar on his
forearm after handling livestock. Culture of the lesion grows large
Gram-positive rods that form spores under nutrient-limited conditions.
Molecular studies identify a plasmid encoding edema factor, lethal factor,
and protective antigen. Investigators create a mutant strain lacking
protective antigen and inoculate cultured macrophages. Compared with
the wild-type strain, the mutant organism is unable to deliver edema
factor and lethal factor into host cells. Which function is normally
performed by protective antigen?

A. ADP-ribosylation of elongation factor-2

B. Formation of a transmembrane pore for toxin entry

C. Cleavage of SNARE proteins

D. Activation of adenylate cyclase

Q. A 4-month-old infant develops paroxysmal coughing followed by
posttussive emesis. PCR confirms Bordetella pertussis. Laboratory studies
reveal marked lymphocytosis. The causative toxin ADP-ribosylates the
α-subunit of an inhibitory G protein. Which intracellular change is expected
in respiratory epithelial cells?

A. Decreased cAMP production

B. Persistent inhibition of adenylate cyclase

C. Increased intracellular cAMP

D. Decreased intracellular calcium

Q. A laboratory combines heat-killed encapsulated pneumococci with live
nonencapsulated bacteria. The resulting bacterial population becomes
encapsulated and virulent. Which bacterial property enabled this genetic
change?

A. Conjugation

B. Transduction

C. Transformation

D. Binary fission
Q. A patient with prolonged hospitalization develops bacteremia caused by
Enterococcus faecium. The organism is resistant to vancomycin. Genetic
analysis demonstrates replacement of the terminal D-alanine-D-alanine
sequence of peptidoglycan precursors with D-alanine-D-lactate. Which
process is directly inhibited by vancomycin under normal circumstances?

A. DNA replication

B. RNA transcription

C. Cell wall cross-linking

D. Protein elongation
Q. A 19-year-old college student develops low-grade fever, dry cough, and
headache. Chest radiograph shows diffuse interstitial infiltrates. Cold
agglutinin testing reveals antibodies that react with erythrocytes at low
temperatures. The causative organism differs from typical bacteria
because it lacks?

A. Ribosomes

B. DNA

C. Cell wall

D. Plasma membrane
Q. A 22-year-old woman presents with dysuria and mucopurulent
cervical discharge. Nucleic acid amplification testing confirms
Chlamydia trachomatis. The organism cannot replicate
independently outside host cells. Which developmental form is
responsible for attachment and entry into epithelial cells?

A. Reticulate body

B. Elementary body

C. Spore

D. Trophozoite
Q. A 56-year-old man with poorly controlled diabetes develops fever, night
sweats, weight loss, and hemoptysis. Lung biopsy demonstrates
granulomas containing numerous acid-fast bacilli despite recruitment of
macrophages. Molecular analysis shows the organism produces a lipid
that prevents phagosome maturation. Which bacterial molecule is
responsible?

A. Endotoxin
B. M protein
C. Lipoarabinomannan
D. Protein A
Q. One toxin causes watery diarrhea by increasing intracellular cAMP.
Another toxin causes paralysis by preventing acetylcholine release. A third
toxin causes pharyngeal necrosis by stopping protein synthesis. Which
combination correctly matches toxins with mechanisms?

A. Cholera — cAMP increase; Botulinum — SNARE cleavage; Diphtheria —

EF-2 inhibition

B. Cholera — EF-2 inhibition; Botulinum — cAMP increase; Diphtheria — SNARE

cleavage

C. Cholera — DNA damage; Botulinum — ribosomal inhibition; Diphtheria —

cAMP increase

D. Cholera — calcium release; Botulinum — DNA inhibition; Diphtheria —

membrane destruction
Q.A 42-year-old HIV-positive patient presents with chronic headache.
India ink preparation of CSF reveals encapsulated budding yeast. The
principal virulence factor is?

A. Melanin production only

B. Polysaccharide capsule
C. Protein A
D. Cord factor
Q.A patient develops severe watery diarrhea after consuming
contaminated seafood. Stool microscopy shows comma-shaped
Gram-negative bacilli with darting motility. The enterotoxin acts by?

A. Inhibiting 60S ribosome

B. Activating adenylate cyclase through Gs protein
C. Blocking acetylcholine release
D. Inhibiting protein kinase
Q. A patient with prosthetic valve endocarditis has repeated blood
cultures positive for coagulase-negative Staphylococcus. Which
property best explains persistence of infection?

A. Coagulase production

B. Capsule formation

C. Biofilm formation

D. Lecithinase production
Q.A child presents with pseudomembranous pharyngitis. Albert
staining of the organism demonstrates metachromatic granules. The
toxin acts by?

A. ADP-ribosylation of EF2

B. Activation of adenylate cyclase

C. Cleavage of SNARE proteins

D. Inhibition of DNA gyrase

Q. A microbiologist performs Ziehl–Neelsen staining on sputum.
Acid-fast bacilli are identified. The acid-fastness is due to:

A. Lipopolysaccharide

B. Mycolic acid

C. Teichoic acid

D. Lipoteichoic acid
Q.A patient develops severe diarrhea after prolonged clindamycin
therapy. Stool toxin assay is positive. The causative organism
produces:

A. Heat-labile toxin

B. Cholera toxin

C. Toxin A and Toxin B

D. Shiga toxin
Q.A patient with infective endocarditis undergoes blood culture.
Colonies exhibit alpha hemolysis and are optochin resistant. The
organism is?

A. Streptococcus pneumoniae

B. Viridans streptococci

C. Enterococcus faecalis

D. Staphylococcus epidermidis
Q. A patient presents with recurrent gastric ulcers. Gastric biopsy
demonstrates curved Gram-negative bacilli producing abundant
urease. Which virulence factor facilitates colonization?

A. Protein A

B. Flagella

C. Catalase

D. Capsule
Q. A patient with fever, thrombocytopenia, and elevated liver enzymes
has an eschar over the trunk. Weil–Felix test is positive with OXK
antigen. The causative organism is:

A. Rickettsia rickettsii

B. Orientia tsutsugamushi

C. Coxiella burnetii

D. Rickettsia prowazekii