NEET-PG 2017 - Microbiology Practice Questions

Q: The following plate shows *H. influenzae* colonies. Which of the following is responsible for the phenomenon shown? (Recent NEET Pattern 2016-17)

V factor. ***V factor*** - The phenomenon depicted is **satellitism**, where *Haemophilus influenzae* grows as satellite colonies around a streak of *Staphylococcus aureus* on blood agar. - This occurs because *S. aureus* lyses red blood cells and releases **V factor (NAD - nicotinamide adenine dinucleotide)**, which is an essential growth factor that *H. influenzae* requires but cannot synthesize. - While *H. influenzae* requires both **X factor (hemin)** and **V factor (NAD)**, the satellitism phenomenon specifically demonstrates the role of **V factor** provided by *S. aureus*. - X factor is already available throughout the blood agar from lysed RBCs, so the enhanced growth specifically around *S. aureus* colonies is due to the **V factor** produced by the bacteria. *X factor* - **X factor (hemin)** is present throughout the blood agar medium from lysed red blood cells, so it does not explain the specific satellite growth pattern around *S. aureus* colonies. - Both X and V factors are required for growth, but the satellitism pattern demonstrates V factor dependency specifically. *PRP antigen* - **PRP (polyribosylribitol phosphate)** is the capsular polysaccharide of *Haemophilus influenzae* type b (Hib) and is a virulence factor. - It is not a growth factor and plays no role in the satellitism phenomenon. *All of the above* - Incorrect, as only **V factor** is responsible for the satellitism phenomenon shown in the image. - PRP antigen is not a growth factor, and X factor is already uniformly distributed in blood agar.

Q: All are true about the organism whose colonies are shown below except:

Warm agglutinin production. ***Warm agglutinin production*** - This is the **EXCEPTION** - Mycoplasma pneumoniae produces **COLD agglutinins**, not warm agglutinins - **Cold agglutinins** are IgM antibodies that agglutinate red blood cells at temperatures below 37°C and are a characteristic feature of **Mycoplasma pneumoniae** infection - **Warm agglutinins** are associated with autoimmune hemolytic anemia, not Mycoplasma infections - This is the FALSE statement, making it the correct answer in this EXCEPT question *Mulberry shaped colony* - **TRUE statement** - Mycoplasma colonies have a characteristic **"fried egg" or mulberry appearance** with a dense central zone and a flat peripheral zone - This distinctive colony morphology is due to the organisms growing into the agar surface while spreading on top - This is a key identifying feature of Mycoplasma species on culture media *Lack cell wall* - **TRUE statement** - Mycoplasma are unique among bacteria in that they **completely lack a cell wall** - This absence of cell wall makes them resistant to **beta-lactam antibiotics** (penicillins, cephalosporins) that target cell wall synthesis - The lack of cell wall also contributes to their **pleomorphism** (variable shape) and osmotic fragility - Their cell membrane contains **sterols**, which is unusual for prokaryotes *Divide by binary fission* - **TRUE statement** - Mycoplasma reproduce by **binary fission**, the standard method of bacterial reproduction - Despite lacking a cell wall, they still undergo typical prokaryotic cell division - They are the **smallest self-replicating organisms** capable of independent growth

Q: A 35-year-old patient presents to the OPD 24 hours after a fight with a stranger in which he was bitten. GCS is 15/15 and following injury is noted on left forearm. He complains of extreme pain and tenderness in the injury. Swab from the injury was plated in chocolate agar and incubated in 10% carbon dioxide for 48 hours. Small colonies with pitting appearance were noted. Which of the following organism is responsible?

Eikenella corrodens. ***Eikenella corrodens*** - The context of a **human bite wound** and the characteristic **pitting of agar** by bacterial colonies are classic identifiers for *Eikenella corrodens*. - This organism is a common inhabitant of the **oral flora** and is frequently implicated in infections resulting from human bites. *Flavobacterium meningosepticum* - This organism is more commonly associated with **nosocomial infections**, particularly in newborns and immunocompromised patients, and severe infections like meningitis or sepsis, not typically human bite wounds. - While it can grow on chocolate agar, its colonial morphology does **not typically involve pitting** of the agar. *Capnocytophaga gingivalis* - This organism is also part of the normal oral flora and can cause infections related to human bites, especially in immunocompromised individuals. - However, while it can grow on chocolate agar, it characteristically exhibits **gliding motility** and ferments carbohydrates, but does not typically cause the striking **pitting** seen with *Eikenella corrodens*. *Streptobacillus moniliformis* - *Streptobacillus moniliformis* is associated with **rat bite fever** (Haverhill fever if contracted through contaminated food or water) and not typically human bite wounds. - It often produces **"fried egg" colonies** with a dense center and a lacy edge, which is distinct from the pitting observed here.

Q: The following organism shown leads to development of:

Syphilis. ***Syphilis*** - The image displays **spirochetes**, which are characteristic of *Treponema pallidum*, the causative agent of **syphilis**. - **Syphilis** is a sexually transmitted infection that progresses through primary, secondary, latent, and tertiary stages. *Leptospirosis* - Caused by **Leptospira** species, which are also spirochetes but typically have hooked ends and are associated with exposure to contaminated water or animal urine. - Symptoms include fever, headaches, muscle aches, and occasionally severe conditions like Weil's disease (jaundice, renal failure, hemorrhage). *Lyme disease* - Caused by **Borrelia burgdorferi**, another spirochete transmitted by **ticks**. - Characterized by an expanding rash (**erythema migrans**), flu-like symptoms, and can lead to arthritis, neurological problems, and cardiac issues if untreated. *Relapsing fever* - Caused by various species of **Borrelia**, transmitted by **lice or ticks**. - Characterized by recurrent episodes of fever, headache, and muscle pain due to antigenic variation of the bacteria.

Q: All are correct about the organism shown in the image except: (Recent NEET Pattern 2016-17)

Pneumonic plague is the predominant presentation. **Pneumonic plague is the predominant presentation** - **Bubonic plague** is the most common form of plague, accounting for approximately 80-90% of cases. - While pneumonic plague is highly dangerous and can be transmitted person-to-person, it is **not the predominant clinical form** globally. *Safety pin appearance* - The image shows bipolar staining, which gives *Yersinia pestis* its characteristic **"safety pin" appearance** under microscopy. - This is a classic diagnostic feature when stained with **Giemsa or Wayson stain**. *Direct immunofluorescence for F1 antigen in sputum* - **F1 antigen** is a major virulence factor of *Yersinia pestis* and is produced in large quantities by the bacterium. - **Direct immunofluorescence (DIF)** for detecting F1 antigen in patient samples like sputum is a rapid and specific diagnostic method for plague, especially pneumonic plague. *Doxycycline is used for prophylaxis in house-hold contacts of pneumonic plague* - Due to the high transmissibility and severity of pneumonic plague, **post-exposure prophylaxis (PEP)** is crucial for close contacts. - **Doxycycline** is a recommended antibiotic for PEP alongside other options like ciprofloxacin or levofloxacin.

Q: The following two phase culture system is used for diagnosis of: (Recent NEET Pattern 2016-17)

Undulant fever. ***Undulant fever*** - The image depicts a **two-phase culture system** (specifically, a Castaneda bottle or similar), which is characteristic for the isolation of *Brucella* species. - *Brucella* causes **brucellosis**, also known as **undulant fever**, due to its characteristic waxing and waning fever pattern. *Relapsing fever* - Relapsing fever is caused by **spirochetes** (*Borrelia* species), which are typically diagnosed by **blood smear microscopy** during febrile episodes. - These organisms are **difficult to culture** using standard laboratory media, and a two-phase system is not routinely employed for their diagnosis. *Pontiac fever* - Pontiac fever is a mild, self-limiting form of **legionellosis**, caused by *Legionella pneumophila*. - Diagnosis typically involves detecting *Legionella* **antigen in urine** or culturing from respiratory secretions on specialized media like **buffered charcoal yeast extract (BCYE) agar**, not a two-phase system. *Pel-Ebstein fever* - Pel-Ebstein fever is a rare, periodic fever pattern associated with **Hodgkin lymphoma**. - It is a **symptom of a malignancy**, not an infectious disease, and therefore does not involve culture systems for diagnosis.

Q: All are correct about the condition shown in the image except:

Aspirated material shows LCL bodies. ***Correct: Aspirated material shows LCL bodies*** - **"LCL bodies" is NOT a recognized diagnostic term** for lymphogranuloma venereum (LGV) - The aspirated material from buboes in LGV shows **Chlamydia trachomatis elementary bodies and reticulate bodies**, along with inflammatory cells - This is the EXCEPTION as it is an incorrect statement about LGV *Incorrect: Groove sign of LGV* - The **groove sign is a classic clinical feature** of LGV - Formed by enlarged inguinal lymph nodes above and below the inguinal (Poupart's) ligament, creating a characteristic depression - This is a TRUE statement about LGV *Incorrect: Most common cause of this infection is L2 biovar* - LGV is caused by **Chlamydia trachomatis serovars L1, L2, and L3** - **L2 serovar is the most prevalent cause** of LGV infections worldwide - This is a TRUE statement about LGV *Incorrect: Females develop esthiomene* - **Esthiomene is a late complication** of chronic untreated LGV in females - Characterized by progressive genital elephantiasis, ulceration, and destruction of vulvo-perineal tissues - Results from persistent lymphatic obstruction and chronic inflammation - This is a TRUE statement about LGV

Q: Which organism is incriminated in causing the following lesions? (Recent NEET Pattern 2016-17)

Streptococcus pyogenes. ***Streptococcus pyogenes*** - The image depicts **impetigo**, characterized by crusted lesions, often found on the face. - **Streptococcus pyogenes** (Group A Streptococcus) is a common cause of impetigo, either alone or in combination with *Staphylococcus aureus*. *Streptococcus pneumoniae* - *Streptococcus pneumoniae* is primarily associated with **respiratory tract infections**, such as pneumonia and otitis media, not skin lesions like impetigo. - While it can cause invasive diseases, its primary presentation is typically not superficial skin infections. *Enterococcus* - *Enterococcus* species are common inhabitants of the normal **gastrointestinal flora** and are frequently implicated in **urinary tract infections**, endocarditis, and hospital-acquired infections. - They are generally not a primary cause of impetigo or similar superficial skin infections. *Staphylococcus aureus* - While *Staphylococcus aureus* is a very common cause of **impetigo**, the question asks for "the organism" as if there is only one most specific answer without providing other context, suggesting **Streptococcus pyogenes** as a highly relevant primary pathogen, especially if non-bullous impetigo is implied by the crusted appearance. - *S. aureus* often presents with **purulent lesions** (e.g., boils, carbuncles) and bullous impetigo with fluid-filled blisters which eventually rupture and crust.

Q: Which of the following organisms is incriminated in a patient of left sided endocarditis involving the mitral valve? (Recent NEET Pattern 2016-17)

Streptococcus viridans. ***Streptococcus viridans*** - This group of bacteria is the **most common cause** of **subacute infective endocarditis** on native, previously damaged valves, particularly the mitral valve. - They typically colonize the oral cavity and can enter the bloodstream after dental procedures or poor oral hygiene, leading to seeding of cardiac valves. *Candida albicans* - *Candida albicans* is a common cause of **fungal endocarditis**, which typically presents as a more subacute or chronic illness and can occur in immunocompromised individuals or those with indwelling catheters. - While it can affect the mitral valve, it is less common than bacterial causes, especially in the context of left-sided endocarditis unless specific risk factors (e.g., intravenous drug use, prosthetic valves, prolonged antibiotic use) are present. *Enterococci* - **Enterococcal endocarditis** often occurs in older patients, those with underlying genitourinary or gastrointestinal tract pathology, or healthcare-associated infections. - While they can affect native or prosthetic valves, they are not the most common cause of native valve endocarditis involving the mitral valve in the general population. *Pseudomonas* - **Pseudomonas endocarditis** is typically associated with **intravenous drug use** and commonly affects the **tricuspid valve** (right-sided endocarditis). - While it can involve left-sided valves, it is less frequent in the absence of intravenous drug use compared to *Streptococcus viridans*.

Q: A patient walking barefoot during his morning walk has developed a swelling in the foot. What is the probable diagnosis?

Madura foot. **Madura foot (Correct Answer)** - **Madura foot**, or mycetoma, is a **chronic granulomatous infection** often acquired through minor skin trauma, such as walking barefoot on contaminated soil - Classic presentation: **localized swelling, draining sinuses, and grain formation** - The image shows a **swollen foot** with signs of chronic infection, consistent with the progressive nature of Madura foot affecting subcutaneous tissues and eventually bone - Endemic in tropical regions including India, making this the most likely diagnosis given barefoot walking *Staphylococcus aureus (Incorrect)* - While *S. aureus* can cause various skin infections and swelling, it typically presents with **acute infections** (abscesses, cellulitis, folliculitis) - A **chronic, localized swelling with potential sinus tracts** that progresses over time is less typical for uncomplicated *S. aureus* infections - The context of barefoot walking on soil is more suggestive of fungal or actinomycotic infections *Botryomycosis (Incorrect)* - **Botryomycosis** is a rare chronic bacterial infection that causes granulomas and abscesses, often with "grains" similar to mycetoma - Typically caused by bacteria like *Staphylococcus aureus* or *Pseudomonas aeruginosa*, **not typically acquired directly from soil** - Though it presents with granulomas and "grains," the context of walking barefoot and the endemic nature of mycetoma in India makes Madura foot more likely *Tetanus (Incorrect)* - **Tetanus** is a severe neurological condition caused by the toxin of *Clostridium tetani*, entering through wounds - Presents with **muscle spasms, rigidity, and lockjaw** (trismus) - Does **not cause localized swelling or chronic granulomatous lesions** as shown in the image - Wrong clinical presentation entirely

Question 1

The following plate shows *H. influenzae* colonies. Which of the following is responsible for the phenomenon shown? (Recent NEET Pattern 2016-17)

Accepted Answer

V factor

Answer

X factor

Answer

All of the above

Answer

PRP antigen

Question 2

All are true about the organism whose colonies are shown below except:

Accepted Answer

Warm agglutinin production

Answer

Mulberry shaped colony

Answer

Lack cell wall

Answer

Divide by binary fission

Question 3

A 35-year-old patient presents to the OPD 24 hours after a fight with a stranger in which he was bitten. GCS is 15/15 and following injury is noted on left forearm. He complains of extreme pain and tenderness in the injury. Swab from the injury was plated in chocolate agar and incubated in 10% carbon dioxide for 48 hours. Small colonies with pitting appearance were noted. Which of the following organism is responsible?

Accepted Answer

Eikenella corrodens

Answer

Flavobacterium meningosepticum

Answer

Capnocytophaga gingivalis

Answer

Streptobacillus moniliformis

Question 4

The following organism shown leads to development of:

Accepted Answer

Syphilis

Answer

Leptospirosis

Answer

Lyme disease

Answer

Relapsing fever

Question 5

All are correct about the organism shown in the image except: (Recent NEET Pattern 2016-17)

Accepted Answer

Pneumonic plague is the predominant presentation

Answer

Safety pin appearance

Answer

Direct immunofluorescence for F1 antigen in sputum

Answer

Doxycycline is used for prophylaxis in house-hold contacts of pneumonic plague

Question 6

The following two phase culture system is used for diagnosis of: (Recent NEET Pattern 2016-17)

Accepted Answer

Undulant fever

Answer

Relapsing fever

Answer

Pontiac fever

Answer

Pel-Ebstein fever

Question 7

All are correct about the condition shown in the image except:

Accepted Answer

Aspirated material shows LCL bodies

Answer

Groove sign of LGV

Answer

Most common cause of this infection is L2 biovar

Answer

Females develop esthiomene

Question 8

Which organism is incriminated in causing the following lesions? (Recent NEET Pattern 2016-17)

Accepted Answer

Streptococcus pyogenes

Answer

Streptococcus pneumoniae

Answer

Enterococcus

Answer

Staphylococcus aureus

Question 9

Which of the following organisms is incriminated in a patient of left sided endocarditis involving the mitral valve? (Recent NEET Pattern 2016-17)

Accepted Answer

Streptococcus viridans

Answer

Candida albicans

Answer

Enterococci

Answer

Pseudomonas

Question 10

A patient walking barefoot during his morning walk has developed a swelling in the foot. What is the probable diagnosis?

Accepted Answer

Madura foot

Answer

Staphylococcus aureus

Answer

Botryomycosis

Answer

Tetanus

NEET-PG 2017 — Microbiology