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Questions and Answers
In a serial dilution agglutination test, what phenomenon is observed when there is an excess of antibody relative to antigen?
In a serial dilution agglutination test, what phenomenon is observed when there is an excess of antibody relative to antigen?
Which of the following is NOT a characteristic of innate immunity?
Which of the following is NOT a characteristic of innate immunity?
Which cell type is NOT considered an antigen-presenting cell (APC)?
Which cell type is NOT considered an antigen-presenting cell (APC)?
Which cytokine is predominantly produced by Th1 CD4+ T cells and is involved in activating macrophages and NK cells?
Which cytokine is predominantly produced by Th1 CD4+ T cells and is involved in activating macrophages and NK cells?
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What is the primary mechanism of action of cytotoxic T cells?
What is the primary mechanism of action of cytotoxic T cells?
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Bruton's disease is characterized by a deficiency in which of the following?
Bruton's disease is characterized by a deficiency in which of the following?
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Which of the following is a characteristic microscopic finding in tuberculosis?
Which of the following is a characteristic microscopic finding in tuberculosis?
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What is the primary purpose of the Interferon Gamma Release Assay (IGRA) in the context of the provided information?
What is the primary purpose of the Interferon Gamma Release Assay (IGRA) in the context of the provided information?
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In cases of viral encephalitis, which clinical feature is described as characteristic?
In cases of viral encephalitis, which clinical feature is described as characteristic?
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Which of the following is the most common cause of viral encephalitis overall?
Which of the following is the most common cause of viral encephalitis overall?
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What is the primary mode of transmission for Nipah virus?
What is the primary mode of transmission for Nipah virus?
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What is the recommended duration of the intensive phase of treatment for tuberculosis, according to the provided data?
What is the recommended duration of the intensive phase of treatment for tuberculosis, according to the provided data?
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Which of the following tests is used to detect Rifampicin resistance in Mycobacterium tuberculosis?
Which of the following tests is used to detect Rifampicin resistance in Mycobacterium tuberculosis?
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What is the primary method of post-exposure prophylaxis (PEP) for rabies, besides wound management?
What is the primary method of post-exposure prophylaxis (PEP) for rabies, besides wound management?
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A patient presents with fever, a rash, and Koplik spots. Which disease is most likely?
A patient presents with fever, a rash, and Koplik spots. Which disease is most likely?
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Which of the following is the most common etiological agent of parasitic encephalitis?
Which of the following is the most common etiological agent of parasitic encephalitis?
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Which type of pseudopodia is characteristic of Acanthamoeba?
Which type of pseudopodia is characteristic of Acanthamoeba?
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What is the primary diagnostic method for Progressive Multifocal Leukoencephalopathy (PML) in immunocompromised patients?
What is the primary diagnostic method for Progressive Multifocal Leukoencephalopathy (PML) in immunocompromised patients?
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What is the typical age range for children affected by Progressive Multifocal Leukoencephalopathy (PML)?
What is the typical age range for children affected by Progressive Multifocal Leukoencephalopathy (PML)?
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Which free-living amoeba is associated with a chronic form of encephalitis, often granulomatous, and also keratitis, particularly in contact lens users?
Which free-living amoeba is associated with a chronic form of encephalitis, often granulomatous, and also keratitis, particularly in contact lens users?
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Which amoebic infection is characterized by acute primary amoebic meningoencephalitis (PAM)?
Which amoebic infection is characterized by acute primary amoebic meningoencephalitis (PAM)?
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What is the recommended treatment for Naegleria infections?
What is the recommended treatment for Naegleria infections?
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What is the typical clinical presentation of most poliomyelitis cases?
What is the typical clinical presentation of most poliomyelitis cases?
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Which of the following statements is true regarding the transmission of free-living amoebae?
Which of the following statements is true regarding the transmission of free-living amoebae?
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Which amoeba exhibits bilobed nuclei and normal pseudopodia?
Which amoeba exhibits bilobed nuclei and normal pseudopodia?
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According to the Modified Jones criteria, which set of findings would be considered as major criteria for diagnosing Acute Rheumatic Fever (ARF)?
According to the Modified Jones criteria, which set of findings would be considered as major criteria for diagnosing Acute Rheumatic Fever (ARF)?
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A patient presents with a history of ARF, and now displays a fever of 38.6°C, arthralgia, and a CRP of 4 mg/dL. According to the Modified Jones criteria, how many of the minor criteria for low risk patients are present?
A patient presents with a history of ARF, and now displays a fever of 38.6°C, arthralgia, and a CRP of 4 mg/dL. According to the Modified Jones criteria, how many of the minor criteria for low risk patients are present?
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What is the first-line treatment for Acute Rheumatic Fever (ARF) according to the information provided?
What is the first-line treatment for Acute Rheumatic Fever (ARF) according to the information provided?
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Which stage of HIV disease is characterized by the presence of oral candidiasis that can be removed by rubbing?
Which stage of HIV disease is characterized by the presence of oral candidiasis that can be removed by rubbing?
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Which of the following is classified as an AIDS-defining illness (Stage 4) according to provided information?
Which of the following is classified as an AIDS-defining illness (Stage 4) according to provided information?
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Which of the following best describes the mechanism of action of botulinum toxin?
Which of the following best describes the mechanism of action of botulinum toxin?
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What is the primary pathological effect of tetanospasmin?
What is the primary pathological effect of tetanospasmin?
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Which lab diagnostic method is preferred for detection of poliovirus in stool samples?
Which lab diagnostic method is preferred for detection of poliovirus in stool samples?
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What is the main difference between the effects of botulinum and tetanus toxins on muscle contraction?
What is the main difference between the effects of botulinum and tetanus toxins on muscle contraction?
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Which of the following correctly describes the timing of fractional inactivated polio vaccine (fIPV) doses?
Which of the following correctly describes the timing of fractional inactivated polio vaccine (fIPV) doses?
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Which of the following is the most common cause of native valve infective endocarditis?
Which of the following is the most common cause of native valve infective endocarditis?
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Which of these clinical features is NOT associated with infective endocarditis?
Which of these clinical features is NOT associated with infective endocarditis?
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What type of culture medium is used for identifying Clostridium botulinum?
What type of culture medium is used for identifying Clostridium botulinum?
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In the context of poliovirus prophylaxis, what does OPV (Sabin) refer to?
In the context of poliovirus prophylaxis, what does OPV (Sabin) refer to?
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Apart from the use of antitoxin, what other medication may be used in the treatment of botulism?
Apart from the use of antitoxin, what other medication may be used in the treatment of botulism?
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Flashcards
Prozone Phenomenon
Prozone Phenomenon
The phenomenon where excess antibody concentration in a sample causes reduced or no agglutination, despite the presence of antigen. It occurs due to the formation of small, soluble antibody-antigen complexes that are not visible.
Post-Zone Phenomenon
Post-Zone Phenomenon
The phenomenon where excess antigen concentration in a sample causes reduced or no agglutination, despite the presence of antibody. It occurs due to the formation of small, soluble antibody-antigen complexes that are not visible.
Innate Immunity
Innate Immunity
The immune response present by birth, providing immediate but non-specific defense against pathogens. It is the first line of defense, acting within 3-4 hours, and lacks memory.
Acquired Immunity
Acquired Immunity
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Cell-mediated Immunity (CMI)
Cell-mediated Immunity (CMI)
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Humoral Immunity (HI)
Humoral Immunity (HI)
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Antigen Presenting Cells (APCs)
Antigen Presenting Cells (APCs)
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Pancarditis
Pancarditis
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Polyarthritis
Polyarthritis
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High ESR
High ESR
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Stage 3 HIV
Stage 3 HIV
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Wasting Syndrome
Wasting Syndrome
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Interferon gamma release assay (IGRA)
Interferon gamma release assay (IGRA)
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LJ culture
LJ culture
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Mantoux test
Mantoux test
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Viral Encephalitis
Viral Encephalitis
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Rabies
Rabies
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Measles
Measles
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Herpes simplex virus (HSV-1) encephalitis
Herpes simplex virus (HSV-1) encephalitis
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Japanese Encephalitis
Japanese Encephalitis
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Progressive multifocal leukoencephalopathy (PML)
Progressive multifocal leukoencephalopathy (PML)
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Primary Amoebic Meningoencephalitis (PAM)
Primary Amoebic Meningoencephalitis (PAM)
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Leukoencephalopathy (PML)
Leukoencephalopathy (PML)
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Naegleria fowleri
Naegleria fowleri
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Acanthamoeba
Acanthamoeba
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Balamuthia mandrillaris
Balamuthia mandrillaris
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Sappinia
Sappinia
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Temporal Lobe Encephalitis
Temporal Lobe Encephalitis
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Viral Myelitis (Poliomyelitis)
Viral Myelitis (Poliomyelitis)
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Granulomatous Amoebic Encephalitis (GAE)
Granulomatous Amoebic Encephalitis (GAE)
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Liposomal Amphotericin B
Liposomal Amphotericin B
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Infective Endocarditis
Infective Endocarditis
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Acute Rheumatic Fever
Acute Rheumatic Fever
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Blood & Systemic Infections
Blood & Systemic Infections
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Osler's Nodes
Osler's Nodes
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Roth's Spots
Roth's Spots
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Janeway Lesions
Janeway Lesions
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Native Valve Infective Endocarditis
Native Valve Infective Endocarditis
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Malaria
Malaria
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Trypanosomiasis
Trypanosomiasis
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Leishmaniasis
Leishmaniasis
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Study Notes
General Microbiology
- Topics covered include general microbiology, hospital infection control, immunology, and laboratory diagnosis of infections (bacterial, fungal, viral, and parasitic).
- The sections cover the central nervous system, cardiovascular system (infections of the heart and bloodstream/lymphatic infections), respiratory system, genitourinary system, gastrointestinal and hepatobiliary system, skin, subcutaneous and musculoskeletal system, and miscellaneous infections.
- Page numbers for each section are provided.
Microscopy & Staining
- Kary Mullis invented the polymerase chain reaction (PCR).
- Eva Engvall (with Peter Perlman) developed enzyme-linked immunosorbent assays (ELISA).
- Microscopy techniques detect organism morphology (killed) and motility (live). Hanging drop is used for live motility observation.
- Microscopy helps visualize motility: Bright field, darkfield, and phase contrast microscopes.
- Darkfield microscopes utilize special condensers.
- Phase microscopes use phase plates.
Microbiology Staining
- Gram Stain: Crystal violet/Gentian violet/methyl violet for primary staining.
- Mordant: Gram's iodine.
- Decolorization: Ethanol/Acetone is used to decolorize the cells.
- Counter-stain: Saffranin/Dilute carbol fuchsin.
- Acid-Fast Stain: Uses concentrated carbol fuchsin followed by acid-alcohol decolorization. Counter-stain with methylene blue. Acid-fast organisms retain the primary stain.
- Different microorganisms have varying staining characteristics as determined by cell walls, and these differences are critical to identification.
Culture & Molecular Methods
- Culture Media:
- Simple (nutrient agar)-appearance: white-grey colonies, exceptions yellow pigment, bluish-green pigment.
- Enriched media (blood agar) - Normal appearance: no zone surrounding colonies, exceptions: a-hemolysis (partial), b-hemolysis (complete), and double zone/target hemolysis.
- Differential media (MacConkey agar): Only Gram negative organisms grow.
Microbiology: Enrichment & Transport Media
- Enrichment media inhibits commensals in specimens like stool samples.
- Types: Selenite F broth, Tetrathionate broth, Alkaline peptone water.
- Transport media: Cary Blair media (best for all stool pathogens). Buffered glycerol saline (for all except vibrio and Campylobacter). Thioglycollate broth (for all except vibrio and Campylobacter).
Culture Identification (Biochemical Tests)
- Catalase Test: +ve: bubble, -ve: no bubble.
- Oxidase Test: +ve: blue colour, -ve: no blue colour.
- Urease Test: +ve : pink color, -ve : no pink color.
- The results from these tests help identify specific microorganisms.
Molecular Method: PCR
- Steps: Nucleic acid extraction, nucleic acid amplification in thermocycler, and nucleic acid detection.
- Uses: Diagnostic and prognostic tests (detecting genes, monitoring response).
- Modifications: Conventional PCR (detects DNA only), Real-time RT-PCR (detects DNA & RNA), Semiautomated, and Automated Realtime RT-PCR
Antimicrobial Susceptibility Testing (AST)
- Phenotypic method: • Kirby Bauer disk diffusion (MHA). • Zone of inhibition: present: antibiotic sensitive; absent: antibiotic resistant. • MIC: minimum inhibitory concentration.
Antimicrobial Susceptibility Testing (AST) :
- Gram Stain: To visualize bacteria cell structure/shape
- Special Stain: For bacterial classification.
- Culture: To isolate bacteria/fungi on specific media.
- Biochemical Tests: For identification.
- Molecular Testing: For specific detection of virulence or resistance genes.
Immunology
- Superantigens: Presented by APC to T-cell, activate T-cells and release cytokines.
- Antibodies: Proteins produced by plasma cells, different classes (IgG (highest serum concentration), IgA, IgM, IgD, IgE). fixing complement (acquired immunity).
- Antigen-Antibody Reactions: Precipitation, neutralization, and agglutination reactions use to detect antigens & antibodies.
- Immunity: Innate and acquired immunity (cell-mediated and humoral).
Immunodeficiency Disorders
- Humoral IDD: Bruton's, X-linked (BTK gene mutation). Leads to no B cells / B - cell defect.
- Cellular IDD: Di George, X-linked (ILR gene mutation), Ataxia-Telangiectasia (ATM gene mutation). Lacking a specific type or a number of immune cells.
- X-linked: WAS gene > No WASP protein, AR: ADA gene.
- Phagocytic IDD: Defect in phagocytic process.
- All these are hereditary, acquired or immunodeficiency syndromes/disease - causing defects in immune responses / lack of specific immune cells.
Hypersensitivity & Transplant Immunology
- Types of Hypersensitivity: Type 1 (Allergic), Type 2 (Cytotoxic), Type 3 (Immune complex), Type 4 (Delayed).
- Transplant Immunity: Types of graft rejection (hyperacute, acute, and chronic), and graft vs. host disease.
Laboratory Diagnosis of Infections (Bacterial & Fungal)
- Bacterial Classification: Gram-positive (cocci, bacilli), Gram-negative (cocci, bacilli, coccobacilli, spirochetes), special groups (mycoplasma, chlamydia).
- High Yield Points: Capsulated, anaerobic, intracellular types, and non-cultivable.
Laboratory Diagnosis of Infections (Viral & Parasitic)
- Viral Classification: DNA (enveloped, non-enveloped), RNA (enveloped, non-enveloped)
- Other RNA enveloped viruses: Orthomyxo, Filo, Arena, Bunya, Delta, and Paramixo.
- Other RNA Non-enveloped viruses: Picornavirus and Calicivirus.
- Lab Diagnosis: Molecular methods (PCR), and immunological methods (Ag/Ab detection).
Central Nervous System (CNS) Infections
- Common organisms: Bacterial (meningitis, encephalitis, and myelitis) and viral/parasitic (encephalitis)
- Acute Bacterial Meningitis: Etiology (pneumococcus, meningococcus, H. influenzae b, listeria), and Laboratory diagnosis (CSF, microscopy).
- Chronic Bacterial Meningitis: Etiology (mycobacterium tuberculosis), Lab diagnosis.
- Viral encephalitis: Etiology (measles, rabies, Japanese encephalitis, HSV-1, Nipah).
- Parasitic Encephalitis: Etiology (Naegleria, Acanthamoeba)
Cardiovascular System (Infections of Heart)
- Infective endocarditis: Inflammation of endocardium (Native valve > prosthetic valve).
- Acute rheumatic fever: Non-suppurative complication of Group A streptococcal pharyngitis
- Clinical Features: Osler's nodes, Roth's spots, Janeway lesions, vascular phenomenon, microbiological evidence, predisposing factor (valvular disease).
- Diagnosis: Modified Duke's Criteria (Major vs. Minor).
- Treatment: Penicillin, Vancomycin, Gentamycin, Rifampicin.
Cardiovascular System: Bloodstream and Lymphatic Infections
- HIV Disease: Structure, WHO staging (stages 1-4), opportunistic infection.
- Investigations: Antibody detection (ELISA, Western blot), rapid tests, and Criteria for diagnosis.
- Window period: Anti-bodies are not detected (3 wks - 3 months).
- Viral Hemorrhagic Fever (VHF): Etiology (Arenavirus: Lassa, Flavivirus: KFD, Dengue, YF, Filovirus: Ebola, Marburg, Bunya virus : Hanta, Crimean-Congo fever virus).
Skin, Subcutaneous, and Musculoskeletal System
- Bacterial Infections: Staphylococcus aureus, Streptococcus pyogenes, Streptococcus agalactiae, Bacillus anthracis, Clostridium perfringens.
- Viral Infections: Herpes viruses (HHV-1, HHV-2, HHV-3).
- Fungal Infections: Malassezia, dermatophyte infections (Tinea capitis, Tinea corporis, Tinea cruris, Tinea pedis).
Miscellaneous Infections
- Bacterial Toxin Related Diseases: Diseases caused by bacterial toxins (e.g., Clostridium botulinum, Clostridium tetani, Bacillus anthracis).
- Bacterial Vector-Transmitted Diseases: Yersinia pestis (plague), Borrelia burgdorferi (Lyme disease), Borrelia recurrentis (endemic relapsing fever). Rickettsia (typhus, spotted fever). Prion diseases (CJD).
Gastrointestinal and Hepatobiliary System
- Helicobacter pylori: Causes peptic ulcer and gastric carcinoma.
- Bacterial Gastroenteritis (GE): Types of toxins (pre-formed toxins and post-formed toxins)
- Viral Gastroenteritis: Viruses implicated that produce Gastroenteritis
- Protozoal Gastroenteritis: Organisms (Balantidium coli, Entamoeba histolytica, Giardia lamblia, Cryptosporidium, Cyclospora).
Genitourinary System
- Genital Ulcerative Diseases: Granuloma inguinale, Chancroid, Syphilis, Lymphogranuloma venereum (LGV)
- Vaginitis: Caused by Trichomonas vaginalis, Candida albicans, and Gardnerella vaginalis.
- Urethritis: Gonococcal urethritis and non-gonococcal urethritis.
- Cystitis: Etiology (Klebsiella, Proteus, Enterococci).
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Description
Test your knowledge on key concepts in immunology with this quiz. Questions cover topics such as antibody-antigen interactions, innate immunity, antigen-presenting cells, and diseases like Bruton's disease and tuberculosis. Perfect for students looking to solidify their understanding of immunological principles.