Medical Microbiology
Exam Answer Key
Course Introduction
Medical Microbiology is a fundamental course that explores the biology, ecology, and pathogenic mechanisms of microorganisms that impact human health. The course covers major groups of medically important bacteria, viruses, fungi, and parasites, emphasizing the ways they cause disease, evade host defenses, and are transmitted. Students will gain an understanding of diagnostic laboratory techniques, antimicrobial therapies, and preventive strategies, as well as the development of resistance and emerging infectious diseases. By integrating clinical cases and real-world scenarios, the course prepares students to apply microbiological principles to the diagnosis, treatment, and prevention of infectious diseases in medical practice.
Recommended Textbook
Clinical Immunology and Serology A Laboratory Perspective 3rd Edition by Christine Dorresteyn
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22 Chapters
562 Verified Questions
562 Flashcards
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Chapter 1: Introduction and Natural Immunity
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49 Verified Questions
49 Flashcards
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Sample Questions
Q1) If a slide test for CRP is positive,what does this indicate?
A) It is a nonspecific indicator of inflammation.
B) Patient has lupus.
C) Patient is immunocompromised.
D) Patient has a strep infection.
Answer: A
Q2) What is the function of the acute phase protein haptoglobin?
A) acts as an opsonin
B) forms clots
C) binds hemoglobin
D) acts as a chemotaxin
Answer: C
Q3) All of the following are part of the process of phagocytosis EXCEPT:
A) formation of a phagosome
B) creation of hypochlorite radicals
C) formation of fibrin clots
D) outflowing of cell cytoplasm
Answer: C
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3
Chapter 2: Lymphoid System
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Sample Questions
Q1) Which of the following would be considered a primary lymphoid organ?
A) spleen
B) lymph nodes
C) tonsils
D) bone marrow
Answer: D
Q2) The germinal center of a lymph node is made up primarily of which type of cell?
A) B cells
B) T cells
C) dendritic
D) macrophages
Answer: A
Q3) Which cells are responsible for killing virally infected host cells and tumor cells?
A) CD4 T cells
B) CD8 T cells
C) B cells
D) eosinophils
Answer: B
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4
Chapter 3: Nature of Antigens and Major Histocompatibility Complex
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Sample Questions
Q1) A macromolecule that is capable of eliciting an immune response in an immunocompetent host is called a(an):
A) antigen
B) antibody
C) hapten
D) acute phase reactant
Answer: A
Q2) Another name for antigenic determinant is:
A) immunogen
B) epitope
C) antibody
D) polysaccharide
Answer: B
Q3) A 50 kDa protein from a bacterial cell that has numerous different epitopes would be called:
A) hapten,but not antigen
B) hapten and antigen
C) antigen,but not immunogen
D) immunogen and antigen
Answer: D
Page 5
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Chapter 4: Antibody Structure and Function
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Sample Questions
Q1) Which of the following immunoglobulins is found in only trace amounts in the serum?
A) IgM
B) IgG
C) IgD
D) IgA
Q2) Which of the following pairings of immunoglobulin and a property are true?
A) IgA: crosses the placenta
B) IgG: most abundant in serum
C) IgM: immunoglobulin produced by a T cell
D) IgE: major immunoglobulin of secondary response
Q3) The function of IgD is to:
A) protect the newborn
B) activate complement
C) protect the mucosa
D) bind antigen as a B-cell surface receptor
Q4) When papain is used to cleave antibody molecules,what are the products?
A) 2 Fab and Fc
B) two L chains and two H chains
C) VL,CL,VH,and CH
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Chapter 5: Cytokines
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Sample Questions
Q1) What is one of the main activities of interleukin-4 (IL-4)?
A) downregulation of the immune response
B) increased production of neutrophils
C) generation of TH2 cells
D) protecting cells from viral invasion
Q2) All of the following are actions of interleukin-1 EXCEPT:
A) increased synthesis of acute phase reactants
B) attraction of white cells to the area
C) increased production of IgE
D) acts as an endogenous pyrogen
Q3) The main target of interleukin-3 is:
A) antigen-activated B cells
B) antigen-activated T cells
C) macrophages
D) stem cells
Q4) When multiple cytokines act on the same cell,by definition they have:
A) pleiotropy
B) redundancy
C) synergism
D) antagonism
Page 7
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Chapter 6: Complement System
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Sample Questions
Q1) A deficiency in complement component C2 would result in:
A) increased vascular permeability
B) hereditary angioedema
C) severe infections with encapsulated bacteria
D) immune complex disease
Q2) Lack of the complement components C5-C* may result in which disease?
A) hereditary angioedema
B) paroxysmal nocturnal hemoglobinuria
C) atherosclerosis
D) meningitis
Q3) Which immunoglobulin(s)help(s)initiate the classic complement pathway?
A) IgA and IgD
B) IgM only
C) IgG and IgM
D) IgG only
Q4) Which factor is unique to the lectin pathway?
A) factor B
B) C1q
C) mannose-binding protein
D) factor I
Page 8
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Chapter 7: Safety and Specimen Preparation
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Sample Questions
Q1) Which of the following applies to recapping of needles?
A) It can be done carefully as long as gloves are worn.
B) A sheath can be placed back on the needle with the other hand.
C) Transport needles back to the lab for disposal.
D) Never manually recap a needle.
Q2) Which of the following is part of the federal Occupational Exposure to Bloodborne Pathogens Standard Act ?
A) All employees must practice universal precautions at all times.
B) Only workers who come in contact with patients need to wear gloves.
C) Taking a cup of coffee into the lab is okay as long as it doesn't spill.
D) A blood spill can be mopped up at the end of the day.
Q3) When a staphylococcal infection is passed between patients due to health-care workers not washing their hands,this represents an example of:
A) lack of chemical hygiene
B) a sharps hazard
C) the chain of infection
D) a specimen transport problem
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9
Chapter 8: Precipitation Reactions
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Sample Questions
Q1) In which of the following zones is a false-negative reaction likely?
A) prozone
B) zone of equivalence
C) postzone
D) all of the above
Q2) In the Mancini endpoint method of RID:
A) The diameter is proportional to the log of the concentration of antigen.
B) The squared diameter is proportional to the concentration of antigen.
C) The squared diameter is proportional to the log of the concentration of antigen.
D) The diameter is directly proportional to the concentration.
Q3) When antibody combines with a particulate antigen,this is classified as which type of reaction?
A) precipitation
B) agglutination
C) flocculation
D) turbidity
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Chapter 9: Agglutination
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Sample Questions
Q1) Which of the following would enhance an agglutination reaction?
A) polyethylene glycol (PEG)
B) high ionic strength saline
C) running the reaction at 4C
D) running the reaction at a high pH
Q2) The process by which particulate antigens such as cells aggregate to form larger complexes when specific antibody is present is called:
A) sensitization
B) precipitation
C) agglutination
D) flocculation
Q3) A serological test that uses red blood cells coated with exogenous antigens such as bacterial polysaccharides as a method to detect patient antibodies against that exogenous antigen is called:
A) latex agglutination
B) hemagglutination
C) neutralization
D) complement fixation
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Chapter 10: Labeled Immunoassays
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Sample Questions
Q1) Components of a competitive immunoassay include all of the following EXCEPT:
A) labeled analyte
B) means of detection of the label
C) solid-phase antibody
D) standard different from the analyte
Q2) In which of the following testing situations is there a direct relationship between the amount of bound label and the amount of patient antigen present?
A) competitive RIA using labeled antigen
B) competitive EIA using labeled antigen
C) noncompetitive EIA using a second labeled antibody
D) any of the above
Q3) Pregnancy testing is based on an early increase in which hormone?
A) human chorionic gonadotropin
B) luteinizing hormone
C) thyroid-stimulating hormone
D) follicle-stimulating hormone
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Chapter 11: Molecular Techniques
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Sample Questions
Q1) Restriction endonucleases used in DNA analysis are characterized by all of the following EXCEPT:
A) They cut at very specific sites.
B) They produce a pattern unique to each individual.
C) They occur naturally in bacteria.
D) They cleave both DNA and RNA.
Q2) Which type of RNA is used to directly translate the DNA code into making functional proteins?
A) transfer RNA
B) ribosomal RNA
C) messenger RNA
D) probe RNA
Q3) What is meant by semi-conservative replication of DNA?
A) Only part of the molecule is reproduced at one time.
B) Each strand is the template for another strand.
C) One copy is the same and another copy is different.
D) DNA uses RNA to make new copies.
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Chapter 12: Flow Cytometry and Laboratory Automation
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Sample Questions
Q1) The expression of cell surface markers is determined in the flow cytometer by which of the following?
A) chemiluminescence
B) fluorescence
C) optical density
D) radioactivity
E) scatter
Q2) In most flow cytometers,labeled cells:
A) scatter the light and absorb fluorescence
B) absorb fluorescence and emit electronic impulses
C) scatter the light and emit fluorescence
D) absorb both fluorescence and light
Q3) What is meant by "gating" in flow cytometry?
A) the chromatic arrangement of cellular populations
B) process by which one cell population adheres to another population
C) an electronic window separating subpopulations of cells
D) an electronic device measuring all populations of cells
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14
Chapter 13: Hypersensitivity
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Sample
Questions
Q1) A 5-year-old girl was rushed to the emergency department because she was having trouble breathing.She had been playing at the park when she fell down and her face and neck started to swell up.One of her friends thought that the girl might have been stung by a bee because a bee was flying around them and shortly before the girl fell to the ground,she had screamed.The girl had a large red bump on her cheek.This girl has:
A) Bruton's hypogammaglobulinemia
B) type I diabetes
C) type I hypersensitivity
D) type IV hypersensitivity
Q2) Complement is responsible for tissue damage in which of the following reactions?
A) immediate hypersensitivity
B) type III hypersensitivity
C) delayed hypersensitivity
D) anaphylaxis
Q3) Complement is responsible for tissue damage in which of the following reactions?
A) immediate hypersensitivity
B) cytotoxic reactions
C) delayed hypersensitivity
D) anaphylaxis
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Page 15
Chapter 14: Autoimmunity
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Sample Questions
Q1) An autoimmune disease characterized by pain and progressive destruction of the joints,weight loss,morning stiffness,and presence of an antibody directed against IgG best describes:
A) rheumatoid arthritis
B) lupus
C) hemolytic disease of the newborn
D) hemolytic anemia
Q2) A disease characterized by hypoactivity of the thyroid with weight gain and a sluggish metabolism due to destruction of thyroglobulin best describes:
A) Graves' disease
B) Hashimoto's thyroiditis
C) myasthenia gravis
D) rheumatoid arthritis
Q3) The characteristic ANA pattern produced by antibody to DNA-histone complex is:
A) homogeneous
B) peripheral
C) speckled
D) nucleolar
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Chapter 15: Immunoproliferative Diseases
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Sample Questions
Q1) What is the interpretation of the following patient results? (normal values)WBC = 7.0 th/uL (5.0-10.0 th/uL),with 89% blasts; CD3 = 10% (60-80%); CD5 = 9% (60-80%); CD10 = 89% (< 1%); CD4 = 6% (30-65%); CD20 = 0% (5-20%); CD34 = 94% (< 1%); CD8 = 3% (10-40%); kappa = 0% (3-15%); lambda = 0% (2-10%); CD19 = 90% (5-20%).
A) normal
B) B-cell acute leukemia
C) T-cell acute leukemia
D) B-cell chronic leukemia
E) T-cell chronic leukemia
Q2) What is the interpretation of the following patient results? (normal values)WBC = 25.0 th/uL (5.0-10.0 th/uL),with 78% blasts; CD3 = 83% (60-80%); CD5 = 90% (60-80%); CD10 = 2% (< 1%); CD4 = 85% (30-65%); CD20 = 1% (5-20%); CD34 = 0% (< 1%); CD8 = 87% (10-40%); kappa = 1% (3-15%); lambda = 0% (2-10%); CD19 = 2% (5-20%).
A) normal
B) B-cell acute leukemia
C) T-cell acute leukemia
D) B-cell chronic leukemia
E) T-cell chronic leukemia
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Page 17
Chapter 16: Immunodeficiency Disease
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Sample Questions
Q1) Which disease may be expected to show an IgM spike on an electrophoretic pattern?
A) hypogammaglobulinemia
B) multicystic kidney disease
C) Waldenström's macroglobulinemia
D) Wiskott-Aldrich syndrome
Q2) Which of the following statements about severe combined immunodeficiency (SCID)are true?
A) may be associated with a signal transduction defect
B) is accompanied by hypergammaglobulinemia
C) patients can be vaccinated with live virus
D) occurs only in males
Q3) A 6-month-old baby has suffered from recurrent bacterial infections.Flow cytometry results indicate a lack of B cells but presence of normally functioning T cells.Which is the most likely diagnosis?
A) SCID
B) common variable hypogammaglobulinemia
C) DiGeorge syndrome
D) Bruton's agammaglobulinemia
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Chapter 17: Transplantation Immunology
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Sample Questions
Q1) Which test would be best to determine the actual genotype in an HLA matching?
A) enzyme-linked immunosorbent assay
B) serological testing
C) polymerase chain reaction
D) flow cytometry
Q2) When a complement-dependent cytotoxicity test was performed using standard antibodies to HLA A1,A3,B2,and B11,the following microscopic results were obtained: a majority of blue cells were seen with anti-A1,A3,and B11.Based on these results,what is the phenotype of the donor cells?
A) HLA A1,B11
B) HLA B2 only
C) HLA A1,A3,B11
D) cannot be determined from these results
Q3) A 25- year-old female is in kidney failure and needs a transplant.She is A positive and HLA A1A3/B5B7/C2C9/DR4DR8.Which of the following donors would be the best match?
A) her brother,who is B positive and HLA A1A3/B7B5/C2C9/DR8DR4
B) her sister,who is A positive and HLA A3A4/B7B9/C2C3/DR4DR7
C) her mother,who is AB positive and HLA A1A4/B9B5/C9C3/DR8DR7
D) an unrelated donor who is A positive and HLA A6A3/B5B7/C3C10/DR2DR9
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Chapter 19: Tumor Immunology
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Sample Questions
Q1) Which of the following bacterial enzymes causes the release of lysosomal contents into the cytoplasm of the phagocytic cell,leading to the death of the cell?
A) protein H
B) leukocidin
C) M protein
D) IgA protease
Q2) All of the following are tests used to identify Helicobacter pylori EXCEPT:
A) polymerase chain reaction
B) urease
C) enzyme immunoassay
D) DNase
Q3) What is the main reason testing for cold agglutinins is no longer recommended to diagnose infection with Mycoplasma pneumonia?
A) It is difficult to perform.
B) False-positives may be caused by certain viruses.
C) Very few people develop anti-I antibodies.
D) It requires expensive instrumentation.
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Chapter 20: Serologic and Molecular Detection of Bacterial
Infections
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Sample Questions
Q1) The most likely reason for the development of an IgE antibody response in humans is:
A) protection against helminth infections
B) protection against bacterial diseases
C) protection against viruses
D) protection against allergens
Q2) In an individual with AIDS,what is the most likely reason for a toxoplasmosis infection that invades the central nervous system?
A) The host produces a lot of antibody.
B) Cysts in the tissue become reactivated.
C) The individual ingests contaminated water.
D) The parasite has acquired new surface proteins.
Q3) A host's immunological response to parasites includes all of the following EXCEPT:
A) formation of IgG,IgM,and IgA antibodies
B) production of cytokines
C) gamma-interferon production by natural killer cells
D) sequestering the parasite in host cells
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Chapter 21: Serologic and Molecular Detection of Bacterial
Infections
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Sample Questions
Q1) Which of the following is a confirmatory test for syphilis?
A) rapid plasma reagin
B) fluorescent antibody (FTA)
C) VDRL
D) all of the above
Q2) The RPR and VDRL tests differ from each other in which of the following ways?
A) method for reading or visualizing the reaction
B) specificity of antibody detected
C) specificity of antigen detected
D) principle for detecting antigen-antibody complexes
Q3) At which stage of syphilis is the RPR the most sensitive?
A) primary
B) secondary
C) tertiary
D) latent
Q4) Which best describes the antibody known as reagin?
A) It occurs only in the disease syphilis.
B) It is tested for using charcoal and cardiolipin.
C) It is found in all patients with primary syphilis.
D) It is antibody directed against IgG.
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Chapter 22: Serology of Parasitic and Fungal Infections
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Sample Questions
Q1) Which is the first detectable antibody in serum after infection with hepatitis B?
A) anti-HBs
B) anti-HBe
C) anti-Hbc
D) all are detectable at the same time
Q2) A 14-year-old boy presents to the physician complaining of sore throat,fatigue,and fever for the last week.A monotest was performed and was reported as positive.This boy has:
A) infectious mononucleosis
B) streptococcal pharyngitis
C) acute glomerulonephritis
D) common cold
Q3) In the routine diagnosis of hepatitis C virus,which type of laboratory test should be ordered first?
A) antigen detection in liver biopsy
B) antibody detection in blood
C) viral culture of stool
D) viral culture of biliary drainage
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Chapter 23: Spirochete Diseases
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Sample Questions
Q1) A 25-year-old male presents to the public health clinic complaining of flu-like symptoms.The man has been an IV drug user and prostitute for the last 5 years.HIV antibody screening is positive.Subsequently,antibodies are found to have specificity for p24,gp120,p31,and gp41.This patient has:
A) current HIV infection
B) indeterminate HIV infection
C) lack of HIV infection
D) infection with some other virus
Q2) Which is most likely a positive Western blot result for infection with HIV?
A) band at p24
B) band at gp60
C) bands at p24 and p31
D) bands at p24 and gp120
Q3) A patient has serum tested for HIV antibodies by ELISA,and the test is positive.The patient's serum is retested in duplicate with two more positive results.What should be done next?
A) Patient is diagnosed with acute HIV infection.
B) Serum is tested for antibodies against hepatitis C virus.
C) HIV Western blot assay is performed on patient's serum.
D) Results mean that patient had HIV in the past but not now.
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