NEET-PG 2013 - Microbiology Practice Questions

Q: What is the primary use of the Hybridoma technique?

Monoclonal antibodies. ***Monoclonal antibodies*** - The **hybridoma technique** is primarily used to produce **monoclonal antibodies (MAbs)**, which are highly specific antibodies derived from a single B-cell clone. - These antibodies recognize a **single epitope** on an antigen, providing exceptional specificity and uniformity. - The technique involves **fusing a B-lymphocyte** (antibody-producing cell) with a **myeloma cell** (immortal cancer cell) to create a hybridoma that continuously produces identical antibodies. - This is the **gold standard** for producing large quantities of identical, highly specific antibodies for diagnostic and therapeutic use. *Specific antibodies* - While monoclonal antibodies are indeed specific, this term is **too vague** and could refer to any antibody with specificity, including polyclonal antibodies. - **Polyclonal antibodies** are also specific but are produced through conventional immunization, not the hybridoma technique. - The defining characteristic of the hybridoma technique is that it produces **monoclonal** (single clone) antibodies, not just "specific" ones. *Antigen* - An **antigen** is a molecule that elicits an immune response and is used to immunize animals during antibody production. - However, antigens are the **input** for antibody production, not the **product** of the hybridoma technique. *Cytokines* - **Cytokines** are signaling molecules involved in immune cell communication and regulation. - They are not produced by the hybridoma technique, which is specifically designed for **antibody production**.

Q: An adolescent male developed vomiting and diarrhea 1 hour after having food from a restaurant. The most likely pathogen is?

Staphylococcus aureus. ***Staphylococcus aureus*** - The rapid onset of symptoms (within 1 hour) strongly suggests **pre-formed toxin ingestion**, which is characteristic of *Staphylococcus aureus* food poisoning. - While the typical incubation period is **1-6 hours** (average 2-4 hours), onset within 1 hour can occur with **high toxin loads** in contaminated food. - **Vomiting** is often the predominant symptom, occurring shortly after consuming contaminated food, which distinguishes it from other bacterial causes. *Clostridium perfringens* - Onset of symptoms caused by *Clostridium perfringens* is typically **8-16 hours** after ingestion, which is much longer than observed here. - It primarily causes **diarrhea and abdominal cramps** due to toxin production in the intestine, with minimal vomiting. *Vibrio parahaemolyticus* - Symptoms usually appear **4-96 hours** (average 12-24 hours) after consuming contaminated seafood, which is a longer incubation period than described. - It typically causes **watery diarrhea**, abdominal cramps, nausea, and occasional vomiting, but not within 1 hour. *Salmonella* - The incubation period for *Salmonella* infection is typically **6-72 hours** (average 12-36 hours), making it highly unlikely for symptoms to appear within 1 hour. - **Diarrhea, fever, and abdominal cramps** are common with *Salmonella*, but rapid-onset vomiting from pre-formed toxin is not its mechanism.

Q: Which of the following bacteria is known to exhibit antigenic variation?

Borrelia. ***Borrelia*** - *Borrelia* species, particularly *Borrelia burgdorferi* (causing **Lyme disease**), are known for extensive **antigenic variation** of their outer surface proteins (Osps), especially OspC. - This variation helps the bacteria evade the host's immune response, contributing to persistent infection. *Yersinia* - While *Yersinia* species produce various virulence factors, including proteins that interfere with immune cell function, they are not primarily known for the type of rapid and extensive **antigenic variation**seen in *Borrelia*. - Their immune evasion strategies often involve modifying host cell signaling pathways and resisting phagocytosis. *Bordetella* - *Bordetella pertussis*, causative agent of **whooping cough**, varies its expression of adhesins and toxins through **phase variation**, which is a form of phenotypic switching. - However, this is distinct from the frequent and sequential changes in surface antigens (antigenic variation) observed in *Borrelia*. *Brucella* - *Brucella* species are **intracellular pathogens** that primarily evade the immune system by surviving and replicating within host cells. - They do not typically engage in significant **antigenic variation** of their surface components as a primary immune evasion mechanism.

Q: Most common organism causing ventilator associated pneumonia -

Pseudomonas. ***Pseudomonas*** - **Pseudomonas aeruginosa** is one of the most common causes of **ventilator-associated pneumonia (VAP)**, particularly in **late-onset VAP** (≥5 days) and in patients with prolonged mechanical ventilation, prior antibiotic exposure, or underlying lung disease. - Its ability to form **biofilms** and its intrinsic antibiotic resistance contribute to its prevalence in hospital-acquired infections. - Along with **Staphylococcus aureus** (especially MRSA), Pseudomonas is consistently among the leading causes of VAP in ICU settings. *Legionella* - **Legionella** is a less common cause of VAP and is typically associated with contaminated water sources, manifesting as **Legionnaires' disease**. - It usually causes severe, rapidly progressive pneumonia and is often harder to culture than other bacteria. *Pneumococcus* - **Streptococcus pneumoniae (Pneumococcus)** is the most common cause of **community-acquired pneumonia (CAP)**, but it is less frequently implicated in VAP. - While it can cause severe pneumonia and may be seen in **early-onset VAP**, its incidence in late-onset VAP is lower compared to Gram-negative rods like Pseudomonas. *Coagulase negative staphylococcus* - **Coagulase-negative Staphylococci** (e.g., *Staphylococcus epidermidis*) are common **contaminants** in cultures and primarily cause device-related infections, such as those associated with central venous catheters. - They are rarely a primary cause of VAP, as they typically have low virulence in the respiratory tract.

Q: Which fungus is commonly known as golden yellow jelly fungus?

Tremella mesenterica. ***Tremella mesenterica*** - This fungus is commonly referred to as **golden yellow jelly fungus** or **witch's butter** due to its distinctive golden-yellow, gelatinous, and brain-like appearance. - It is a **jelly fungus** that typically grows on dead hardwood branches, especially after rain, and is known for its pliable, quivering texture. *T. tonsurans* - This refers to **Trichophyton tonsurans**, a dermatophytic fungus primarily known for causing **tinea capitis** (ringworm of the scalp). - Its common name relates to its effect on hair, causing breakage and a "black dot" appearance, rather than a golden yellow, jelly-like form. *Epidermophyton floccosum* - This is a dermatophytic fungus that specifically causes infections of the **skin and nails**, particularly **tinea pedis** (athlete's foot) and **tinea cruris** (jock itch). - It does not produce a fruiting body and is not described as a jelly-like fungus. *T. mentagrophytes* - This refers to **Trichophyton mentagrophytes**, another common dermatophyte responsible for various superficial fungal infections, including **tinea pedis**, **tinea corporis**, and **tinea unguium**. - Its clinical presentation is not that of a golden yellow jelly fungus.

Q: Maximum density of microfilariae in blood is reported to be between -

11 pm to 2 am. ***11 pm to 2 am*** - This period aligns with the **nocturnal periodicity** of *Wuchereria bancrofti* and *Brugia malayi* microfilariae, which are the most common causes of filariasis. - The microfilariae migrate to the **peripheral circulation** during these hours, making it the optimal time for blood smear collection for diagnosis. *9 pm to 11 pm* - While still within the active period for microfilarial migration, the **peak density** is generally observed slightly later. - Blood drawn during this time might show microfilariae, but in lower concentrations compared to the peak. *8 pm to 10 pm* - This timing is generally a little too early to consistently capture the **highest microfilarial load** in nocturnal periodic infections. - The microfilariae are still in the process of migrating from deeper tissues to the peripheral blood. *2 am to 5 am* - By this time, the microfilarial density in the peripheral blood of **nocturnal periodic species** usually starts to decline. - While some microfilariae may still be present, the count would likely be lower than during the earlier peak hours.

Q: Empyema thoracis is most commonly caused by which organism

Streptococcus pneumoniae. ***Streptococcus pneumoniae*** - This is the **most common cause of empyema thoracis**, accounting for **40-70% of all cases** in most published series - It is the leading cause of **community-acquired pneumonia** that progresses to parapneumonic effusion and empyema - The pneumococcal infection leads to **inflammatory exudation** into the pleural space, which can progress through exudative, fibrinopurulent, and organizing phases to form frank empyema - Remains the most frequent causative organism across all age groups in community-acquired empyema *Staphylococcus aureus* - An important but **less common cause** of empyema, accounting for approximately 10-20% of cases - More frequently seen in **specific clinical contexts**: post-influenza pneumonia, hospital-acquired infections, hematogenous spread, and pediatric empyema - Causes **severe, necrotizing infections** with abscess formation and is associated with higher morbidity - While clinically significant, it is **not the most common** overall cause *Pseudomonas* - *Pseudomonas aeruginosa* is primarily associated with **nosocomial empyema** in hospitalized patients - Risk factors include **ventilator-associated pneumonia**, immunosuppression, and **cystic fibrosis** - Accounts for a small percentage of empyema cases overall *Mycobacterium* - *Mycobacterium tuberculosis* causes **tuberculous empyema**, a chronic condition with characteristic **thick pleural fluid** and caseous material - Important in regions with high TB prevalence but represents a distinct entity from acute bacterial empyema - Not a common cause of acute pyogenic empyema in most settings

Q: The most common cause of meningitis in children aged 5 yrs is-

S. pneumoniae. ***S. pneumoniae*** - **_Streptococcus pneumoniae_** (Pneumococcus) is the **most common cause of bacterial meningitis** in children aged 5 years and older, as well as in adults. - Widespread vaccination has reduced its incidence but it remains a significant pathogen. *H. influenzae* - **_Haemophilus influenzae_ type b (Hib)** was a major cause of meningitis in young children, but its incidence has **drastically decreased** due to the routine **Hib vaccine**. - Without vaccination, it would still be a significant cause in this age group, but with high vaccine coverage, it is less common than _S. pneumoniae_. *Staphylococcus* - **_Staphylococcus aureus_** and other staphylococcal species are **less common causes of meningitis** in otherwise healthy children. - They are more typically associated with meningitis following **neurosurgery**, trauma, or in immunocompromised patients. *E.coli* - **_Escherichia coli_** is a common cause of **neonatal meningitis** (in infants less than 3 months old), often acquired during passage through the birth canal. - It is **rarely a cause of meningitis** in children aged 5 years.

Q: XDR-TB is defined as resistance to which of the following drug combinations?

Fluoroquinolones plus INH plus rifampicin plus amikacin. **Fluoroquinolones plus INH plus rifampicin plus amikacin** - **Extensively drug-resistant tuberculosis (XDR-TB)** is defined by resistance to the most effective anti-TB drugs: **isoniazid (INH)**, **rifampicin**, any **fluoroquinolone**, and at least one of the three injectable second-line drugs (**amikacin**, **kanamycin**, or **capreomycin**). - This combination signifies a substantial therapeutic challenge due to limited treatment options and a high risk of treatment failure. *INH plus rifampicin* - Resistance to **INH** and **rifampicin** defines **multidrug-resistant tuberculosis (MDR-TB)**, which is a precursor to XDR-TB but not XDR-TB itself. - While serious, MDR-TB is not as extensively resistant as XDR-TB, as it doesn't include resistance to fluoroquinolones and second-line injectables. *Fluoroquinolones plus INH plus amikacin* - This combination is incomplete for the definition of XDR-TB because it omits **rifampicin** from the core definition. - XDR-TB specifically requires resistance to both **INH** and **rifampicin** (defining MDR-TB), in addition to resistance to a fluoroquinolone and one of the injectable second-line drugs. *Fluoroquinolones plus rifampicin plus kanamycin* - This combination is also incomplete for the definition of XDR-TB as it omits **isoniazid (INH)**, which is one of the two most crucial first-line drugs that characterize MDR-TB. - XDR-TB builds upon MDR-TB's resistance to both INH and rifampicin.

Q: What is the most common cause of acute tonsillitis?

Group A beta-hemolytic streptococci. ***Group A beta-hemolytic streptococci*** - **Group A Streptococcus (GAS)**, specifically *Streptococcus pyogenes*, is the most frequent bacterial cause of **acute tonsillitis** and pharyngitis, especially in school-aged children. - Infection can lead to complications such as **rheumatic fever** and **post-streptococcal glomerulonephritis** if not appropriately treated. *Streptococcus pneumoniae* - While *S. pneumoniae* is a common cause of **otitis media**, **sinusitis**, and **pneumonia**, it is less commonly the primary cause of acute tonsillitis. - It typically causes respiratory infections involving the lower airways or adjacent structures rather than primarily tonsillar inflammation. *H. Influenza* - *Haemophilus influenzae* is a significant pathogen for **otitis media**, **epiglottitis**, and **meningitis**, particularly in unvaccinated children. - It is not a common primary cause of acute tonsillitis, which is predominantly bacterial or viral. *Staphylococcus aureus* - *Staphylococcus aureus* is often associated with **skin and soft tissue infections**, as well as more serious conditions like **sepsis** and **endocarditis**. - Although it can cause pharyngeal infections, it is an infrequent cause of acute tonsillitis compared to Group A Streptococcus.

Question 1

What is the primary use of the Hybridoma technique?

Accepted Answer

Monoclonal antibodies

Answer

Antigen

Answer

Specific antibodies

Answer

Cytokines

Question 2

An adolescent male developed vomiting and diarrhea 1 hour after having food from a restaurant. The most likely pathogen is?

Accepted Answer

Staphylococcus aureus

Answer

Clostridium perfringens

Answer

Vibrio parahaemolyticus

Answer

Salmonella

Question 3

Which of the following bacteria is known to exhibit antigenic variation?

Accepted Answer

Borrelia

Answer

Yersinia

Answer

Bordetella

Answer

Brucella

Question 4

Most common organism causing ventilator associated pneumonia -

Accepted Answer

Pseudomonas

Answer

Legionella

Answer

Pneumococcus

Answer

Coagulase negative staphylococcus

Question 5

Which fungus is commonly known as golden yellow jelly fungus?

Accepted Answer

Tremella mesenterica

Answer

T. tonsurans

Answer

Epidermophyton floccosum

Answer

T. mentagrophytes

Question 6

Maximum density of microfilariae in blood is reported to be between -

Accepted Answer

11 pm to 2 am

Answer

9 pm to 11 pm

Answer

8 pm to 10 pm

Answer

2 am to 5 am

Question 7

Empyema thoracis is most commonly caused by which organism

Accepted Answer

Streptococcus pneumoniae

Answer

Pseudomonas

Answer

Staphylococcus aureus

Answer

Mycobacterium

Question 8

The most common cause of meningitis in children aged 5 yrs is-

Accepted Answer

S. pneumoniae

Answer

Staphylococcus

Answer

E.coli

Answer

H. influenzae

Question 9

XDR-TB is defined as resistance to which of the following drug combinations?

Accepted Answer

Fluoroquinolones plus INH plus rifampicin plus amikacin

Answer

INH plus rifampicin

Answer

Fluoroquinolones plus INH plus amikacin

Answer

Fluoroquinolones plus rifampicin plus kanamycin

Question 10

What is the most common cause of acute tonsillitis?

Accepted Answer

Group A beta-hemolytic streptococci

Answer

Streptococcus pneumoniae

Answer

H. influenzae

Answer

Staphylococcus aureus

NEET-PG 2013 — Microbiology