ENT
2 questionsMost commonly used tuning fork in ear examination?
Hearing loss of 65dB, what is the grade of deafness?
NEET-PG 2013 - ENT NEET-PG Practice Questions and MCQs
Question 721: Most commonly used tuning fork in ear examination?
- A. 128 Hz
- B. 256 Hz
- C. 512 Hz (Correct Answer)
- D. 1024 Hz
Explanation: ***512 Hz*** - The **512 Hz tuning fork** is the most commonly recommended and used for auditory tests like **Rinne** and **Weber** because its vibratory decay is slow enough to allow adequate testing, and it falls within the **speech frequency range**. - Its frequency is optimal for assessing both **bone conduction** and **air conduction** without introducing confusing overtones or being too low to be felt as a vibration rather than heard as a tone. *128 Hz* - A **128 Hz tuning fork** produces a strong vibratory sensation and is primarily used for **neurological examinations** to test **vibration sense**, not typically for ear examinations. - Its low frequency can be easily perceived as a **tactile vibration** through bone, making it less ideal for purely auditory assessment. *256 Hz* - While it falls within the audible range, a **256 Hz tuning fork** is less commonly used than 512 Hz for standard hearing tests. - Its vibratory tone may have a faster decay and might not provide as clear a distinction for **bone conduction** as the 512 Hz fork. *1024 Hz* - A **1024 Hz tuning fork** is a higher frequency tone, which may decay too quickly for accurate **Rinne and Weber tests**, especially when assessing subtle differences in hearing. - While audible, its higher pitch can be less representative of the critical **speech frequencies** typically evaluated in basic hearing screenings.
Question 722: Hearing loss of 65dB, what is the grade of deafness?
- A. Mild
- B. Moderate
- C. Severe
- D. Moderately severe (Correct Answer)
Explanation: ***Moderately severe*** - A hearing loss of **65 dB** falls within the range defined as moderately severe. - The moderately severe range typically spans from **56 dB to 70 dB** in conventional audiometric classifications. *Mild* - **Mild hearing loss** is characterized by a threshold between **26 dB and 40 dB**. - Individuals with mild hearing loss may struggle with soft sounds or speech in noisy environments. *Moderate* - **Moderate hearing loss** is defined by a threshold between **41 dB and 55 dB**. - This level of loss causes difficulty understanding normal conversation without amplification. *Severe* - **Severe hearing loss** is characterized by a threshold between **71 dB and 90 dB**. - Individuals with severe hearing loss often require powerful hearing aids or other assistive listening devices.
Microbiology
8 questionsWhich of the following statements regarding resistance of penicillin in Staphylococcus aureus is false?
Which of the following bacteria can be identified using phage typing?
Which of the following is called Preisz-Nocard bacillus?
Darting motility which occurs in V.cholerae, also found in -
Patient came from Nagaland and shows positive test with OXK antigen. Diagnosis is?
Which of the following stimulate adenylate cyclase with G-protein coupled action ?
Which MRSA strain type is most commonly associated with hospital-acquired infections?
Which is the most common bacterial organism causing bacterial upper respiratory tract infections (including sinusitis, otitis media, and pharyngitis) in adults?
NEET-PG 2013 - Microbiology NEET-PG Practice Questions and MCQs
Question 721: Which of the following statements regarding resistance of penicillin in Staphylococcus aureus is false?
- A. Methicillin resistance is due to alterations in penicillin-binding proteins (PBPs).
- B. Penicillinase production is mediated by plasmids.
- C. Hospital strains predominantly produce a unique type of penicillinase. (Correct Answer)
- D. Penicillinase production can be transmitted by transduction.
Explanation: ***Hospital strains predominantly produce a unique type of penicillinase*** - This statement is **false** because hospital strains do not produce a truly "unique type" of **penicillinase** compared to community strains. - **Penicillinase (beta-lactamase)** is a common resistance mechanism found across various *S. aureus* strains, not exclusive to hospital environments. *Methicillin resistance is due to alterations in penicillin-binding proteins (PBPs)* - This statement is **true** as **MRSA** resistance involves the **mecA gene** encoding **PBP2a**. - **PBP2a** has low affinity for **beta-lactam antibiotics**, allowing cell wall synthesis despite antibiotic presence. *Penicillinase production is mediated by plasmids* - This statement is **true** because **penicillinase genes** are typically located on **plasmids**. - **Plasmids** facilitate horizontal transfer of resistance genes between bacterial populations. *Penicillinase production can be transmitted by transduction* - This statement is **true** as **transduction** via **bacteriophages** can transfer resistance genes. - **Plasmid-borne penicillinase genes** can spread through this horizontal gene transfer mechanism.
Question 722: Which of the following bacteria can be identified using phage typing?
- A. Salmonella (Correct Answer)
- B. Streptococcus
- C. Shigella
- D. Pseudomonas
Explanation: ***Salmonella*** - **Phage typing** is the most classical and widely used method for subtyping *Salmonella* species based on their susceptibility to specific bacteriophages. - This technique is extensively used in **epidemiological tracking** of outbreaks, particularly for *Salmonella typhi* and *S. enteritidis*, allowing differentiation of strains within the same species. - **Most commonly associated organism** with phage typing in clinical microbiology and medical education. *Streptococcus* - While phage typing was historically used for *Streptococcus pyogenes* (Group A Streptococcus), it has largely been replaced by **molecular typing methods** and is not the primary association when phage typing is mentioned. - *Streptococcus* species are typically identified through **Gram staining**, **catalase tests**, **hemolysis patterns** on blood agar, and **serological methods** (Lancefield grouping). *Shigella* - **Phage typing** is not routinely used for *Shigella* identification or subtyping in clinical practice. - **Serotyping** and **molecular methods** like pulse-field gel electrophoresis (PFGE) or whole genome sequencing are the standard approaches for *Shigella* differentiation. *Pseudomonas* - While **phage typing** has been used for *Pseudomonas aeruginosa* in research and outbreak investigations, it is not the primary or most commonly cited example of phage typing in medical education. - Routine identification relies on **culture characteristics** (pigment production, oxidase positive), **biochemical tests**, and **molecular methods**.
Question 723: Which of the following is called Preisz-Nocard bacillus?
- A. C. diphtheriae
- B. C. pseudotuberculosis (Correct Answer)
- C. M. tuberculosis
- D. Mycoplasma
Explanation: ***C. pseudotuberculosis*** - This bacterium is historically known as the **Preisz-Nocard bacillus**, named after its discoverers. - It is an important pathogen in animals, causing conditions like **caseous lymphadenitis** in sheep and goats. *C. diphtheriae* - This bacterium causes **diphtheria** and is known for producing a potent **exotoxin** that can lead to systemic complications. - It forms a characteristic **pseudomembrane** in the throat and is not associated with the Preisz-Nocard designation. *M. tuberculosis* - This is the causative agent of **tuberculosis** in humans, primarily affecting the lungs. - It is known for its **acid-fast staining** property and a complex pathogenesis involving granuloma formation. *Mycoplasma* - This genus includes bacteria that lack a **cell wall**, making them resistant to many common antibiotics. - They are known for causing various infections, including **atypical pneumonia** and genitourinary tract infections, but are not referred to as the Preisz-Nocard bacillus.
Question 724: Darting motility which occurs in V.cholerae, also found in -
- A. Campylobacter jejuni (Correct Answer)
- B. Bacillus anthracis
- C. Shigella
- D. Pneumococcus
Explanation: ***Campylobacter jejuni*** - *Campylobacter jejuni* is well-known for its **rapid, corkscrew-like motility**, often described as **darting motility**, which is a key characteristic for its identification. - This characteristic movement is due to its **polar flagella** and helps the bacterium penetrate the intestinal mucosa. *Shigella* - *Shigella* species are notable for being **non-motile**, a crucial feature distinguishing them from other enterobacteriaceae. - Their lack of flagella and motility prevents them from exhibiting darting or any other form of self-propulsion. *Bacillus anthracis* - *Bacillus anthracis* is typically described as **non-motile** in its vegetative form. - While other *Bacillus* species can be motile, *B. anthracis* lacks the flagella necessary for darting motility. *Pneumococcus* - *Pneumococcus* (Streptococcus pneumoniae) is a **non-motile** bacterium. - It does not possess flagella and therefore cannot exhibit darting or any other type of active movement.
Question 725: Patient came from Nagaland and shows positive test with OXK antigen. Diagnosis is?
- A. Trench fever
- B. Scrub typhus (Correct Answer)
- C. Endemic typhus
- D. Epidemic typhus
Explanation: ***Scrub typhus*** - A **positive Weil-Felix test** for the **OXK antigen** is highly suggestive of scrub typhus, particularly if the patient is from an endemic region like Nagaland. - Scrub typhus is caused by **_Orientia tsutsugamushi_**, transmitted by **chiggers** (larval mites), often presenting with fever and an **eschar**. *Trench fever* - Caused by **_Bartonella quintana_** and transmitted by the **human body louse**. - It does not typically show a positive Weil-Felix test for the OXK antigen. *Endemic typhus* - Also known as **murine typhus**, it is caused by **_Rickettsia typhi_** and transmitted by **fleas** (e.g., rat flea). - While it causes a positive Weil-Felix test, it usually involves the **OX19 antigen**, not OXK. *Epidemic typhus* - Caused by **_Rickettsia prowazekii_** and transmitted by the **human body louse**. - It yields a positive Weil-Felix test for the **OX19 and OX2 antigens**, but typically not for OXK.
Question 726: Which of the following stimulate adenylate cyclase with G-protein coupled action ?
- A. Shiga toxin
- B. Cholera toxin (Correct Answer)
- C. Diphtheria toxin
- D. Pseudomonas toxin
Explanation: ***Cholera toxin*** - Cholera toxin is a **G-protein-activating toxin** that irreversibly activates **adenylate cyclase**. - This leads to increased intracellular levels of **cAMP**, causing excessive fluid secretion into the intestinal lumen and severe diarrhea. *Shiga toxin* - Shiga toxin acts by inactivating the **60S ribosomal subunit**, thereby inhibiting protein synthesis in eukaryotic cells. - Its primary effect is **cytotoxicity**, not direct stimulation of adenylate cyclase. *Diphtheria toxin* - Diphtheria toxin inhibits **protein synthesis** by inactivating **elongation factor-2 (EF-2)** through ADP-ribosylation. - This toxin specifically targets host cells, leading to cellular death and tissue damage. *Pseudomonas toxin* - **Exotoxin A** produced by *Pseudomonas aeruginosa* also inhibits **protein synthesis** by ADP-ribosylating and inactivating **EF-2**, similar to diphtheria toxin. - It does not directly affect adenylate cyclase activity.
Question 727: Which MRSA strain type is most commonly associated with hospital-acquired infections?
- A. Phage type 83A
- B. Phage type 85
- C. Phage type 84
- D. Phage type 80/81 (Correct Answer)
Explanation: ***Phage type 80/81*** - This **phage type**, particularly **epidemic methicillin-resistant *Staphylococcus aureus* (EMRSA) 15 and 16**, is historically and currently the most common cause of **hospital-acquired MRSA infections** worldwide. - It rapidly diversified and spread globally, becoming a significant nosocomial pathogen. *Phage type 83A* - While this phage type has been associated with **MRSA outbreaks**, it is not the most common strain type globally for hospital-acquired infections. - Its prevalence is more regional and sporadic compared to the widespread dominance of EMRSA 15/16. *Phage type 84* - **Phage type 84** is not widely recognized as a predominant strain associated with the majority of **hospital-acquired MRSA infections**. - Other, more virulent and successful clonal types have outcompeted it to become the most prevalent. *Phage type 85* - Similar to other less common types, **phage type 85** does not represent the major lineage responsible for the bulk of **hospital-acquired MRSA cases**. - The landscape of MRSA epidemiology is dominated by a few highly successful clonal complexes, of which 80/81 is a prime example.
Question 728: Which is the most common bacterial organism causing bacterial upper respiratory tract infections (including sinusitis, otitis media, and pharyngitis) in adults?
- A. Staphylococcus aureus
- B. Haemophilus influenzae
- C. Streptococcus pyogenes
- D. Streptococcus pneumoniae (Correct Answer)
Explanation: ***Streptococcus pneumoniae*** - *Streptococcus pneumoniae* is the **most common bacterial pathogen** causing upper respiratory tract infections overall, including **bacterial sinusitis**, **otitis media**, and **community-acquired pneumonia**. - It is a frequent colonizer of the nasopharynx and leads to infection when host immunity is compromised. - Accounts for the highest burden of bacterial URTIs when considering all anatomical sites. *Haemophilus influenzae* - *Haemophilus influenzae* (particularly non-typeable strains) is the **second most common** cause of bacterial sinusitis and otitis media in adults. - While significant, it is less prevalent overall than *S. pneumoniae* across all URTI types. *Staphylococcus aureus* - *Staphylococcus aureus* primarily causes **skin and soft tissue infections** and device-related infections. - It is **not a common primary pathogen** in typical acute bacterial URTIs, though it may cause secondary infections or colonize the anterior nares. *Streptococcus pyogenes* - *Streptococcus pyogenes* (Group A Streptococcus) is the **most common cause of bacterial pharyngitis** (strep throat) in adults. - However, when considering the **full spectrum of bacterial URTIs** (pharyngitis, sinusitis, otitis media), *S. pneumoniae* has a broader overall impact and higher prevalence across multiple sites.