HS 202 Microbiology & Parasitology (Lec) PDF

Microbiology & Parasitology (Lec) HS 202 September 26, 2023 E01...

Microbiology & Parasitology (Lec) HS 202 September 26, 2023 E01 REMINDERS This Chika was only based on the memory of participating students, so some questions here are already paraphrased or are incomplete. Feedback was provided for this exam. Blind memorization of the answers in this Chika is highly discouraged. The purpose of this compilation is to give you an idea of how questions will appear in future exams and to help you evaluate your mastery of the topics. This should not be used as a substitute for transes and book. DO NOT SHARE OR REPRODUCE THIS DOCUMENT IN ANY WAY OUTSIDE OF THE CHIKA SYSTEM. Failure to do so may result in complete eviction from the system. Number of Items: 100 QUESTIONS 1. INTRODUCTION TO MICROBIOLOGY Lecturer: Dr. de Paz-Silava No. Question Answer and Rationale 1 Which of the following is not a B. Candida albicans bacteria? A. Streptococcus pneumoniae Candida albicans is a fungus. B. Candida albicans C. Clostridium botulinum Choices A, C, and D are bacteria. D. Helicobacter pylori 2 In SARS-CoV-2, the protein usually A. Binding and Entry used in vaccine development is the spike protein. Antibodies developed The spike protein helps SARS-CoV-2 invade cells by facilitating attachment against the spike protein inhibit which and penetration of the virus. This process is congruent with the binding and step of the virus life cycle? entry part of the virus life cycle. [E01-T01-Introduction to Microbiology p. 2] A. Binding and Entry B. Translation C. Transcription D. Assembly and Release 3 The presence of a lipid structure that C. Envelope coats a virion is used as a basis for classifying viruses. This structure is The envelope is made of lipids. called a/an? A. Capsid Choice A is a protein coat. B. Glycoproteins Choice B are proteins that determine the specificity of interaction C. Envelope of a virus and facilitates attachment and penetration of the host D. Ribosome cell. Choice C are protein structures involved in translation. [E01-T01-Introduction to Microbiology p. 2] 4 Prion diseases affect: C. Both humans and animals A. Humans only B. Animals only Prion diseases can affect both humans and animals and are sometimes C. Both humans and animals spread to humans by infected meat products. [E01-T01-Introduction to Microbiology p. 2] D. Neither humans nor animals 5 The protein that prions are made of is A. True found throughout the body, even in healthy people and animals, and is The protein that prions are made of is found throughout the body, even in encoded by the host’s DNA. healthy people and animals, and is encoded by the host's chromosomal DNA. E02 CG A2 1 of 22  A. True [E01-T01-Introduction to Microbiology p. 2] B. False 6 Which of the following is not found in C. Nuclear membrane prokaryotic cells? A. Nucleus Refer to the table below [E01-T01-Introduction to Microbiology p. 3] : B. Endoplasmic Reticulum C. Nuclear membrane D. Cell wall 7 What structure differentiates D. Cell wall gram-positive from gram-negative cells? Gram positive: Single thick layer of peptidoglycan above the cell membrane A. Nucleus that allows retention of the primary stain (e.g. Crystal violet). B. Endoplasmic reticulum C. Cell membrane Gram negative: Thin layer of peptidoglycan sandwiched between the D. Cell wall surface and plasma membrane that cannot retain the primary stain (e.g. Crystal violet) after decolorization. [E01-T01-Introduction to Microbiology p. 3] 8 If a fungus grows as a single cell, it is B. Yeast called a A. Colony Yeast: If a fungus grows simply as a single cell B. Yeast Mold: If mycelial growth occurs [E01-T01-Introduction to Microbiology p. 4] C. Mold D. Hyphae 9 A 30 year old man had a fungal A. Tinea unguium infection in his toenails. He most likely has: Tinea infections refer to common dermatologic fungal infections A. Tinea unguium Tinea capitis: affects the scalp B. Tinea corporis Tinea corporis: affects the arms, legs, and trunk C. Tinea cruris Tinea manuum: affects the hands and palm area D. Tinea capitis Tinea pedis (athlete’s foot): affects the feet Tinea faciei: affects the face Tinea barbae: affects facial hair Tinea cruris (jock itch): affects the groin area Tinea unguium: affects the fingernails and toenails [E01-T01-Introduction to Microbiology p. 5] 10 A 30 year old man had a fungal B. Tinea corporis infection on his left arm. He most likely has: Tinea infections refer to common dermatologic fungal infections A. Tinea unguium Tinea capitis: affects the scalp B. Tinea corporis Tinea corporis: affects the arms, legs, and trunk C. Tinea cruris Tinea manuum: affects the hands and palm area D. Tinea capitis Tinea pedis (athlete’s foot): affects the feet Tinea faciei: affects the face Tinea barbae: affects facial hair E02 CG A2 2 of 22  Tinea cruris (jock itch): affects the groin area Tinea unguium: affects the fingernails and toenails [E01-T01-Introduction to Microbiology p. 5] 2. FUNDAMENTALS OF BACTERIOLOGY Lecturer: Dr. Lota, MD, MHPed 11 Which part of the bacterial cell is also A. Periplasmic space known as the “bag of enzymes”? A. Periplasmic space The periplasmic space can be thought of as a “bag of enzymes” that can B. Outer membrane Degrade macromolecules C. Plasma membrane Protect against toxic intruders D. Cytoplasm Gather (bind) essential nutrients and deliver to transport proteins [E01-T02, Fundamentals of Bacteriology, p. 5] 12 An unknown organism with thick A. Gram stain is purple peptidoglycan, no capsule, and no flagella has which of the following Capsules and flagella are present in either type of bacteria, but a thick characteristics: peptidoglycan is characteristic of Gram-positive bacteria that stains purple. A. Gram stain is purple B. Gram stain is pink Choice B occurs when in Gram-negative bacteria which have a thin C. Has K antigen peptidoglycan layer. D. Has an outer membrane Choice C is also known as a capsular polysaccharide that some bacteria produce [ScienceDirect]. Choice D is characteristic of Gram-negative bacteria [E01-T02, Fundamentals of Bacteriology, p. 5] 13 A pathogenic organism has lipid A. A. Septic Shock What would be the most likely presentation in a severely ill patient? Lipid A is a component of the lipopolysaccharide of the outer membrane of A. Septic Shock Gram-negative bacteria. Lipopolysaccharides, such as Lipid A, are potent B. Food Poisoning endotoxins and immunogenic agents. The release of lipid A can trigger a C. Necrotizing Fasciitis host immune response, such as a pro-inflammatory cytokine storm, that D. Bacterial Meningitis results in septic shock[Di Piro, 1990] Choice B is usually caused by Salmonella, Clostridium perfringens, Campylobacter, and Staphylococcus aureus[CDC.gov] Choice C is most commonly caused by group A Streptococcus[CDC.gov] Choice D is caused by a pathogen that varies among age groups 14 Under the electron microscope, an C. Spirochetes unknown bacteria showed movement through the axial filament. What is the The axial filament is composed of bundles of fibrils that arise at the ends of most probable organism involved? the cell beneath the outer sheath and spiral around the cell. Spirochetes A. Staphylococcus move by flexing and spinning movements using the axial filament[E01-T02, p.4] B. Streptococcus C. Spirochetes D. Enterobacteriaceae 15 What structure allows the passage of C. Integral Proteins solutes across the cell membrane? A. Phospholipids Integral proteins have many functions including the passage of solutions B. Porins across the cell membrane through pumps and carrier or channel transport C. Integral Proteins proteins. D. Teichoic Acids Choice A contributes to the semipermeability of the cell E02 CG A2 3 of 22  membrane. Choice B are found in the outer membrane of Gram-negative bacteria which permit passage of molecules[E01-T02, p.5] Choice D are found in Gram-positive bacteria which mediate passage of cations and provide antigenic specificity[E01-T02, p. 5] 16 An unknown bacteria has shown to A. Plasmid integrate an extrachromosomal DNA structure into another bacterial cell Plasmids are small, circular, double-stranded DNA molecules. They are that leads to gene replication during extrachromosomal genetic material that can be transferred through cell division. What is this structure? conjugation, transformation, or transduction [E01-T02, p. 8] A. Plasmid B. Annamoxosomes C. Histone Proteins D. Chlorosomes 17 In a solid media, an organism was B. Peroxidase found to grow near the surface. What enzyme would allow this type of Oxygen concentration is relatively higher near the surface of a media as growth? compared to within or near the bottom of the media. During oxygen A. Streptokinase respiration, harmful reactive oxygen species (ROS), such as hydrogen B. Peroxidase peroxide, are produced. Peroxidase can break down ROS and protect the C. Hyaluronidase organism from oxidative damage[Nóbrega & Pauleta, 2019]. D. Coagulase 18 The process where a bacterium A. Transduction transfers DNA to another bacterium through a bacteriophage is called: Choice B involves the transfer of naked DNA[E01-T02, p. 11] A. Transduction Choice C requires direct cell-to-cell contact[E01-T02, p. 11] B. Transformation Choice D occurs when genetic material is deliberately introduced C. Conjugation through the creation of pores on the cell membrane[E01-T02, p.11] D. Transfection 19 What characteristic of the endospore A. High amount of calcium dipicolinate allows it to tolerate adverse conditions? Endospores can survive extreme heat, lack of water, and exposure to many A. High amount of calcium toxic chemicals and radiation due to low water content and large amount of dipicolinate calcium dipicolinate[E01-T02, p.8] B. Thick peptidoglycan layer C. Inner cortex D. Adequate amount of water 20 In what part of the growth curve do D. Stationary you expect to find smaller cells with different complement of enzymes and Stationary Phase[E01-T02, p.10] fewer ribosomes? “Period of equilibrium” - Number of microbial deaths balances A. Exponential number of new cells B. Log Metabolic activity slows down C. Lag Period of equilibrium D. Stationary Cells are smaller than log phase 21 Gram-positive bacteria are C. Presence of teichoic acids characterized by the presence of: A. An overall hydrophobic cell wall B. An outer membrane envelope E02 CG A2 4 of 22  C. Presence of teichoic acids D. Thin layers of peptidoglycan [E01-T02, p.6] 22 Which of the following is CORRECT A. Capsules do not contribute to growth and multiplication about bacterial capsules? A. Capsules do not contribute to The glycocalyx is a structure external to the cell wall. There are two types: growth and multiplication capsule and slime. They play a role in bacterial virulence, specifically by: B. Capsules are essential for cell Protecting the cell from phagocytosis survival in artificial culture Allowing the cell to attach to various surfaces C. Capsules are composed of Providing a source of nutrition murein Inhibiting movement of nutrients from cell wall D. Capsules are primarily for the Preventing dehydration anchorage of flagella It does not play a role in the growth or multiplication of the bacterial cell. Choice C: Capsules are composed of polysaccharides / polypeptides Choice D: Cell walls serve as anchorage for flagella [E01-T02, p.3] 23 What are the essential components of D. D-glutamic acid the cross linkages of the cell wall that assists in the strength and shape of The components of cross linkages are D-glutamic acid, D-alanine, and the bacteria? Meso-diaminopimelic acid (DAP). A. N-acetylglucosamine B. N-acetylmuramic acid Choices A and B are components of peptidoglycan. [E01-T02, p.5] C. D-butyric acid D. D-glutamic acid 3. FUNDAMENTALS OF MYCOLOGY Lecturer: Dr. Batac 24 Fungi are traditionally named based on D. Teleomorph their _______ state. A. Asexual Many fungi bear 2 names: one designating their sexual stage and the other B. Imperfect their asexual stage E02 CG A2 5 of 22  C. Progenitor E.g. Histoplasma capsulatum (anamorph) or Ajellomyces capsulatus D. Teleomorph (teleomorph) Often, this is because the anamorphic and teleomorphic stages were described and named at different times by different scientists without the connection between them being recognized. Both names are valid, but that of the teleomorph phase name should take precedence[E01-T03, p. 6] 25 COVID-19-associated mucormycosis, D. Asexual spores are released when sporangium is ruptured popularly known as “black fungus infection” are caused by fungi with which of the following characteristics The black fungi associated with COVID-19 belong to a phylum that produces A. Sexual spores are found on sexual spores known as zygospores, Subphylum Mucoromycotina. Those top of sporangiophore that produce sporangiospores as asexual spores, produce zygospores as B. Their sexual spores are sexual spores.[2026 Booster] produced inside a sac-like structure C. Asexual spores are borne naked on specialized structures D. Asexual spores are released when sporangium is ruptured 26 Which of the following are spherical C. Chlamydospore spores formed from the thickening of a hyphal cell at the cross walls? Spherical conidia formed by the thickening of a hyphal cell A. Ascospore Released when the surrounding hypha fractures[E01-T03, p. 7] B. Zygospore C. Chlamydospore D. Basidiospore 27 Which of the following describes a B. Diploid spore zygospore? A. Asexual spore Zygospore [E01-T03, p. 7] B. Diploid spore Diploid spores formed when hyphae of two opposite strains (+ and C. Within a sac -) fuse and create a diploid zygote that swells and becomes D. Formed inside a club-shaped covered by strong, spiny walls cell Germinates when wall is disrupted and conditions are suitable 28 Which phylum of fungi has the most A. Ascomycota number of medically-relevant species? A. Ascomycota Phylum Ascomycota [E01-T03, p. 9] B. Basidiomycota Contains the most number of fungi that are medically-relevant C. Mucoromycota ○ Examples: Pneumocystis, Candida, Aspergillus, Penicillium, D. Enteromophthoromycota Sporothrix ○ Dermatophytes ○ Endemic fungi 29 A 13 y/o male presented with B. Narrow hyphae with parallel walls erythematous, scaly, annular plaques over his arms and trunk. If a cutaneous Choice B is characteristic of cutaneous mycoses such as Tinea mycosis is suspected, what do you corporis[E01-T03, p. 10] expect to see under the microscope after a KOH smear? Choices A and C are characteristics of superficial mycoses, such as A. Short hyphae with balled-up Ptyriasis versicolor. E02 CG A2 6 of 22  spores B. Narrow hyphae with parallel walls C. Hyphae that do not cross cell membranes D. All of the above 30 If Aspergillus sp. is the causative agent, D. Acute angle branching hyphae what is the typical description of fungal structures in tissue on histopathology? A. Oval budding yeast cells B. Broad, ribbon-like hyphae C. Wide angle branching hyphae D. Acute angle branching hyphae H&E Stain of Aspergillus with Acute-Angle Branching of Dichotomous Hyphae [E01-T03, p. 13] 31 What is true of the advantages of B. More sensitive than KOH smear histopathology as lab work-up for deep fungal infections? Advantages and Disadvantages of Histopathology [E01-T03, p. 13] A. Rapid B. More sensitive than KOH smear C. Does not require experienced staff to interpret results D. Can provide full identification of the etiological agent 32 What is the primary component of the A. Ergosterol fungal cell membrane? A. Ergosterol Ergosterol is the main component of fungal cell membrane [E01-T03, p. 2] B. Cholesterol C. Methylsterol D. Dinosterol 33 Which of the following contents of D. Cycloheximide fungal culture media controls the growth of saprobic fungi? Cycloheximide inhibits growth of saprobic fungi, but does not inhibit growth A. Neopeptone of dermatophytes and other endemic fungi [E01-T03, p. 14] B. Glucose C. Chloramphenicol D. Cycloheximide E02 CG A2 7 of 22 34 A 17 y.o. male came to you with a B. Narrow hyphae (NOT SURE) complaint of an “itching rash”. On examination, you find an erythematous Cutaneous mycosis or “Buni” caused by Tinea corporis dermatophytes. annular plaque with central clearing. Pigmented, long, straight or curved filamentous structures are found under You suspect cutaneous mycosis. What the microscope [E01-T03, p. 10] would you expect on microscopy? A. Short hyphae with ball B. Short hyphae with ball sporangia = spaghetti and meatball appearance - sporangia for Superficial mycosis “An-an” by Pityriasis versicolor B. Narrow hyphae C. Spores found inside and outside hairshaft - Tinea capitis dermatophyte C. Spores found inside and (scalp fungal infection) [E01-T03, p. 10] outside hair shaft 35 Which of the following is TRUE of B. Their cross-walls allow isolation of cellular structures coenocytic hyphae? A. Their cross-walls are Coenocytic fungi are aseptate. They have imperforate, sparse to none septa perforated in hyphae allowing for the isolation of cytoplasmic material [E01-T03, p. 4] B. Their cross-walls allow isolation of cellular structures C. They possess many cross-walls separating one cell from another D. Exchange of cytoplasmic material easily occurs between cross-walls 36 Which best describes yeast cells? A. Reproduce by budding A. Reproduce by budding B. Produce wooly colonies Yeast cells produce round, pasty or mucoid colonies. Their buds C. Produce a mat-like structure (blastoconidia) can elongate to form hyphae. known as a mycelium D. They are released into the air Choices B, C, and D are produced by molds. Molds have a sporangium or a upon rupture of a saclike saclike structure that ruptures to produce sporangiospores (asexual spores) structure [E01-T03, p. 3-4] 37 In nature, dimorphic fungi exist as: B. Molds A. Yeast B. Molds Dimorphism is a form of adaptation of the fungus to the host environment. C. Blastoconidia Fungi can exist as mold in the environment and yeast in the host. D. Pseudohyphae Mnemonic: MOLD in the COLD; YEAST in the BEAST [E01-T03, p. 5] 38 Which of the following is classified as C. Blastomyces dermatitidis an endemic fungus? A. Rhizopus oryzae Endemic mycoses include [E01-T03, p. 5]: B. Aspergillus niger Histoplasma C. Blastomyces dermatitidis Blastomyces D. Cryptococcus neoformans Paracoccidiodes Coccidioides Choice A is a fungus that can cause black mucormycosis[E01-T03, p. 1] Choice B is also known as black mold, a common contaminant of food. Choice D can cause meningitis to immunocompromised individuals [E01-T03, p. 3] E02 CG A2 8 of 22  4. FUNDAMENTALS OF VIROLOGY Lecturer: Dr. de Paz-Silava, MD, PhD 39 Which of the following is false about C. Bacteriophages are the most common viruses in eukaryotic cells viruses? A. They are microscopic Bacteriophages do not infect eukaryotic cells. They infect bacteria which intracellular parasites are prokaryotes. B. They are non living outside their host cells C. Bacteriophages are the most common viruses in eukaryotic cells 40 Which of the following is NOT a part of C. ATPase the viral structure? A. Capsids ATPase is not a typical component of viruses. Viruses do not possess their B. Envelope own ATPase enzymes; instead, they rely on the host cell's machinery for C. ATPase energy production and other cellular processes. [E01-T04-Fundamentals of Virology p. 1] D. Envelope 41 Surface glycoproteins of virions usually A. Attachment and entry function in: A. Attachment and entry Surface glycoproteins mediate attachment of viruses to target cells through B. Reverse transcription a cellular receptor. Attachment leads to the fusion of the viral membrane C. Genome replication and host membrane allowing for viral entry into the cell. [E01-T04-Fundamentals of D. Translation Virology p. 3] 42 - For numbers 38-42, arrange the steps 42. D 46 in the viral life cycle from A to E: 43. C 38. Virion assembly 44. B 39. Translation of viral proteins 45. A 40. Transcription of viral genes 46. E 41. Attachment and entry 42. Budding Refer to lectures on Introduction to Microbiology and Fundamentals of Virology E02 CG A2 9 of 22 47 If a scientist wants to test viral viability C. Visualization of cytopathic effect and infectivity in an isolated virus, the best way to test it is through? Cells often grow in a monolayer fashion. However, when viral infection is A. Detection of viral proteins present, cells develop multiple layers and even detach[Feedback 2023] B. Detection of viral genetic material Infection by cytocidal viruses is usually associated with changes in cell C. Visualization of cytopathic morphology, in cell physiology and sequential biosynthetic events. Many of effect these changes are necessary for efficient virus replication. D. Visualization through electron microscopy The changes in cell morphology caused by infecting virus are called cytopathic effects (CPE). Common examples are rounding of the infected cell, fusion with adjacent cells to form a syncytia (polykaryocytes), and the appearance of nuclear or cytoplasmic inclusion bodies. Inclusion bodies may represent either altered host cell structures or accumulations of viral components. [Albrecht et al., 1996] 48 The gap in the genome is removed by C. Hepatitis B Virus converting the whole genome to dsDNA and removing the protein and Hepatitis B virus is an example of a Class VII: Gapped DNA virus. mRNA. [E01-T04-Fundamentals of Virology p. 7-8] A. Rotavirus B. HIV C. Hepatitis B Virus D. SARS-CoV-2 E. Influenza Virus 49 (+) ssRNA is synthesized from the D. SARS-CoV-2 dsRNA genome through the viral A. Rotavirus [Feedback] polymerase. The (+) ssRNA strand is used as template to make new dsRNA SARS-CoV-2 is part of Coronaviridae which are classified as (+)ssRNA genome viruses. To make more genomes, (+) strand is copied to a (-) strand to make A. Rotavirus more (+) strands which is done by a viral polymerase that has been B. HIV translated from RNA genome [E01-T04-Fundamentals of Virology] C. Hepatitis B Virus D. SARS-CoV-2 Among the dsRNA viruses, only Rotavirus has PH importance. E. Influenza Virus E02 CG A2 10 of 22 50 (+) ssRNA is copied to (-) ssRNA to D. SARS-CoV-2 make more (+) ssRNA strands which are then packaged into virions SARS-CoV-2 is a coronavirus with a (+) ssRNA genome [E01-T04-Fundamentals of A. Rotavirus Virology] B. HIV C. Hepatitis B Virus D. SARS-CoV-2 E. Influenza Virus 51 A (-) ssRNA copy is made from the (+) B. HIV ssRNA genome through reverse transcriptase. A dsDNA proviral HIV is under Retroviridae which are (+) ssRNA viruses with DNA genome is made from the (-) ssRNA Intermediates. They use reverse transcriptase to convert (+) ssRNA to a (-) copy. The dsDNA proviral genome is DNA [E01-T04-Fundamentals of Virology] used as a template to make more (+) ssRNA genome. A. Rotavirus B. HIV C. Hepatitis B Virus D. SARS-CoV-2 E. Influenza Virus 52 A (+) ssRNA copy is made from the (-) E. Influenza Virus ssRNA genome. The (+) ssRNA copy is used as a template to make more (-) The influenza virus is classified under Orthomyxoviridae which are (-) ssRNA ssRNA genome viruses. (-) ssRNA viruses carry virus polymerases (RdRp) in the virion, A. Rotavirus which are used to make (+) ssRNA. (+) RNA is also used as the template to B. HIV make more (-) RNAs for new virions [E01-T04-Fundamentals of Virology] C. Hepatitis B Virus D. SARS-CoV-2 E. Influenza Virus 5. FUNDAMENTALS OF IMMUNOLOGY Lecturer: Dr. Climacosa 53 The first line of defense of the immune B. Innate Immunity system is: A. Cellular Immunity Innate immunity, also called natural immunity or native immunity, is the first B. Innate Immunity line of defense of the immune system. It is ready to recognize and eliminate C. Adaptive Immunity microbes and dead cells [E01-T05, p. 1]. D. Humoral Immunity 54 The basis for vaccination is the B. Adaptive Immunity immune system’s capability for memory and specificity, which is the Adaptive immunity is specific for the pathogen and confers protective function of the immunity to reinfection with the same pathogen. This capability for memory A. Innate immunity and specificity is the basis for vaccination. [E01-T01-Introduction to Microbiology p. 6] B. Adaptive immunity C. Cytokine D. Complement 55 The substance that is recognized by A. Antigen the immune system and induces the production of antibodies is called the: Antigens are any nonself substance that can interact with immune cells or A. Antigen components. Recognition of such triggers the body’s immune response. B. Cytokine [E01-T05-Fundamentals of Immunology, p. 3] E02 CG A2 11 of 22  C. Complement D. Biomarker Definitions for other choices: Cytokine: molecules that communicate among cells of the immune system [E01-T05-Fundamentals of Immunology, p. 3] Complement: activation of this system leads to the formation of the Membrane Attack Complex (MAC) [E01-T05-Fundamentals of Immunology, p.5] Biomarker: (short for biological marker) is an objective measure that captures what is happening in a cell or an organism at a given moment [National Institute of Environmental Health Sciences, 2023] 56 Statement A: Innate immunity B. Only Statement B is TRUEFeedback responds quickly because it has diverse pattern recognition receptors Statement B: Adaptive immunity takes a longer time to act but it recognizes highly specific antigens A. Only Statement A is TRUE B. Only Statement B is TRUE C. Both statements are TRUE [E01-T05-Fundamentals of Immunology] D. Both statements are FALSE Statement A is false as “the innate immune system recognizes microorganisms via a limited number of germline-encoded pattern-recognition receptors (PRRs).”[Akira et al., 2006] 57 Statement A: Lysozyme in tears is A. Only Statement A is correct bactericidal as it cleaves glycosidic bonds in bacterial cell walls Statement B is incorrect because parietal cells produce hydrochloric acid in the stomach Statement B: Chief cells produce hydrochloric acid contributing to the antibacterial environment of the stomach A. Only Statement A is TRUE B. Only Statement B is TRUE C. Both statements are TRUE D. Both statements are FALSE 58 Statement 1: The alternative D. Both statements are false. complement pathway is activated by antibody bound to antigen. The classical complement pathway is activated by antibody binding to antigen. The alternative complement pathway is activated by recognition of Statement 2: C3b and C5b are certain PAMPs. The MBL (Mannose Binding Lectin) pathway is activated by inflammatory mediators that recruit mannose or any carbohydrate moiety that can be considered as other leukocytes in the site of PAMP[E01-T05-Fundamentals of Immunology p. 5] infection. C3a and C5a promote leukocyte recruitment to the infection site. C3b tags A. Only Statement A is TRUE the pathogen to be phagocytosed by macrophages. C5b interacts with B. Only Statement B is TRUE C6-9 to form the Membrane Attack Complex (MAC) that causes cell C. Both statements are TRUE lysis[E01-T05-Fundamentals of Immunology p. 5] D. Both statements are FALSE 59 Statement A: Eosinophils contain major B. Only Statement B is true. acidic protein against helminthic E02 CG A2 12 of 22  infections Eosinophils secrete major basic protein against helminthic infections [E01-T05-Fundamentals of Immunology p. 3] Statement B: Kupffer cells in the liver and microglial cells in the brain are Tissue resident macrophages: tissue resident macrophages Brain: Microglial cells Liver: Kupffer cells A. Only Statement A is TRUE Lungs alveolar macrophages B. Only Statement B is TRUE Heart: Myocardial macrophages [E01-T05-Fundamentals of Immunology p. 3] C. Both statements are TRUE D. Both statements are FALSE 60 Statement A: NK cells recognize injured C. Both statements are true. and infected cells and can induce them to undergo apoptosis NK cells recognize virus-infected cells and respond by killing them, specifically induce death of the infected cells to prevent the spread of the Statement B: Type 1 IFN can inhibit viral virus [E01-T05-Fundamentals of Immunology p. 5] synthesis of proteins in virus-uninfected neighboring cells Type 1 IFN is a cytokine released by infected cells that are detected by neighboring uninfected cells, which serve as warning for the uninfected to A. Only Statement A is TRUE increase their defenses by inhibiting viral replication thru inducing an B. Only Statement B is TRUE antiviral state: C. Both statements are TRUE ↓ protein synthesis D. Both statements are FALSE ↓ viral gene expression Viral RNA degradation[E01-T05-Fundamentals of Immunology p. 5] 61 What is the most effective activator of C. IgM the classical complement pathway? A. IgD IgM is the most effective complement activator. The classical complement B. IgG pathway is elicited when IgM, as well as certain IgG subclasses, bind to C. IgM antigens [E01-T05-Fundamentals of Immunology p. 7] D. IgE E. IgA 62 TGF-Beta induces the production and E. IgA secretion of which antibody? A. IgD B. IgG C. IgM D. IgE E. IgA [E01-T05-Fundamentals of Immunology p. 9] 63 Which antibody triggers mast cell D. IgE degranulation? A. IgD B. IgG C. IgM E02 CG A2 13 of 22  D. IgE E. IgA [E01-T05-Fundamentals of Immunology p. 9] 64 Which antibody is the most effective B. IgG opsonin for phagocytosis by neutrophils? Opsonization marks the antigen for killing via phagocytosis. Antibodies (e.g. A. IgD IgG) can serve as opsonins when they bind the pathogen and facilitate B. IgG phagocytosis [E01-T05-Fundamentals of Immunology p. 10] C. IgM D. IgE E. IgA 65 Which antibody can activate the lectin E. IgA pathway of the complement system? A. IgD IgA is involved in the activation of complement by the lectin pathway or by B. IgG the alternative pathway [E01-T05-Fundamentals of Immunology p. 7] C. IgM D. IgE E. IgA 66 The following are examples of live C. Rabies attenuated vaccines EXCEPT: A. BCG Rabies is an inactivated vaccine. Other inactivated vaccines include B. Rubella cholera, influenza, HepA, plague, IPV, and zika [E01-T05-Fundamentals of Immunology p. 15] C. Rabies D. Polio 67 At 12 months a fully immunized child D. 4 Doses of hepatitis B vaccine should have: A. 1 dose polio NOTE: Correct answer should be NOTA B. 2 doses BCG C. 3 doses measles Fully immunized child by their 12th month: D. 4 doses HepB 1 dose BCG at birth 1 dose Hepatitis at birth E02 CG A2 14 of 22  3 doses pentavalent vaccine (DPT-Hib-HepB) 3 doses oral polio vaccine (OPV) 1 dose of measles or MMR vaccine [E01-T02, Fundamentals of Immunology, pp. 17] 68 Which of the following accurately D. Provide semipermeable membrane describes plasma membranes? A. Are the same in all cells The plasma membrane is a phospholipid bilayer that functions as a B. Inhibit integral protein selectively permeable barrier [E01-T02, Fundamentals of Bacteriology, pp. 6-7] attachment C. Made exclusively from lipids D. Provide semipermeable membrane 69 What is false regarding the Major D. MHC I presents peptide antigens from endocytosed extracellular Histocompatibility Complex? protein A. Also called Human Leukocyte Antigen MHC II presents endocytosed extracellular proteins. MHC I is for intracellular B. Mutations in MHC can lead to pathogens or cytosolic proteins [E01-T05, Fundamentals of Immunology, p. 7] autoimmunity C. MHC II is exclusively found in antigen presenting cells D. MHC I presents peptide antigens from endocytosed extracellular protein 70 Which of the following is TRUE about B. TH17 cells, when dysregulated can lead to autoimmunity helper T cells? A. TH1 cells combat extracellular TH1 cells combat intracellular, not extracellular, pathogens. TH2 cells secrete fungal pathogens by activating IL-4, IL-5, and IL-13. Treg cells are activated by both IL-10 and TGF-β. macrophages Therefore, B is correct. [E01-T05, Fundamentals of Immunology, p. 10] B. TH17 cells, when dysregulated, can lead to autoimmunity C. TH2 cells secrete IL-2 to activate eosinophils to fight helminthic infections D. Treg cells are activated by IL-10 to suppress immune responses E02 CG A2 15 of 22  6. INTRODUCTION TO MEDICAL PARASITOLOGY Lecturer: Dr. Belizario, Jr. 71 The type of host in a case where wild C. Paratenic Host (AKA Transport Host) boar (baboy damo) act as “carrier” host of Paragonimus westermani Host that carries the parasite around, but in which no development occurs. A. Definitive Host Infective stage of Paragonimus westermani is the metacercariae that lives in B. Intermediate Host the muscle of the pig. When the pig is eaten raw or insufficiently cooked, C. Paratenic Host the consumer may be infected. [E01-T06, Fundamentals of Parasitology, p. 3] D. D. None of the Above 72 Which of the following best describes A. Definitive Host "Where the adult parasites live?" A. Definitive Host Host in which the parasite reaches sexual maturity. [E01-T06, Fundamentals of B. Intermediate Host Parasitology, p. 2] C. Paratenic Host D. D. None of the Above 73 Which of the following best describes B. Intermediate Host "Anopheles spp. in the life cycle of Plasmodium spp. that causes malaria? Host in which the parasite goes through preliminary development and where A. Definitive Host infective forms are generally obtained B. Intermediate Host C. Paratenic Host D. None of the Above (CDC, 2020) 74 Identify the type of vector: B. Phoretic vector (AKA Mechanical Vector) Cockroaches carrying Ascaris and Trichuris eggs Vector that is not essential in the life cycle but carries the parasite [E01-T06, A. Biologic vector Fundamentals of Parasitology, p. 3] B. Phoretic vector C. Both A and B D. Neither A nor B 75 Identify the type of vector: Aedes A. Biologic Vector poecilus in the life cycle of Wuchereria bancrofti causing bancroftian filariasis Vector that is essential in the life cycle. W. bancrofti needs mosquitoes for A. Biologic vector them to be infectious. [E01-T06, Fundamentals of Parasitology, p. 3] B. Phoretic vector C. Both A and B D. Neither A nor B E02 CG A2 16 of 22  7. SOIL-TRANSMITTED HELMINTHS Lecturer: Dr. Belizario, Jr. 76 Which of the following can lead to C. Both A and B pulmonary signs and symptoms? A. Ascariasis Ascaris lumbricoides causes Loeffler’s syndrome which manifest as allergies B. Hookworm Infection during the pulmonary phase. Other manifestations include lung infiltration, C. Both A and B asthmatic attacks, edema of the lips, pneumonia-like symptoms, vague D. Neither A nor B abdominal pain, and eosinophilia. Hookworms (Necator americanus and Ancylostoma duodenale) cause pulmonary symptoms and Leoffler’s syndrome due to pulmonary migration. [EO1-T07] 77 Which of the following can lead to : A. Ascariasis Intestinal obstruction as a possible complication In superinfection, older and younger worms of Ascaris form a bolus A. Ascariasis (perforation of bowel wall). The patient presents with abdominal pain and B. Hookworm Infection the abdomen also feels like it has a tennis ball[E01-T06] C. Both A and B D. Neither A nor B 78 Which of the following is diagnosed C. Both A and B through Kato-Katz method A. Ascariasis Kato-Katz is a general technique/method that utilizes stool samples of B. Hookworm Infection approximately 40-50 mg, in catching parasitic infection. It has a higher C. Both A and B chance of catching parasitic infection than direct microscopy[E01-T06] D. Neither A nor B 79 Which parasite is being described: A. Ascaris Erratic Behavior/ Migration A. Ascaris Adult Ascaris worms do not cling to the intestinal mucosa, rather they move B. Trichuris or swim to resist peristalsis and can exhibit erratic migration. Ascaris worms C. Hookworm can travel up the GI tract and into accessory organs[EO1-T07] D. All of the above 80 Which parasite is being described: B. Trichuris Abdominal pain and rectal prolapse A. Ascaris Trichuris trichiura clinical consequences include abdominal pain, diarrhea, B. Trichuris dysentery (bloody stool - when there is a deep wound in the colon), and C. Hookworm rectal prolapse. [EO1-T07] D. All of the above 81 The following are true statements B. There is a need to do stool examination on high-risk individuals so about soil-transmitted helminthiasis in that individuals who need to be treated will be identified. the Philippines EXCEPT: A. Soil-transmitted helminthiasis Deworming involves periodic treatment with anti-helminthics without remains as a major public previous individual diagnosis to all at-risk people living in endemic areas for health problem in the morbidity control. Mass drug administration involves provision of drugs even Philippines, which is without diagnostic examination. [EO1-T07] considered by the WHO as a high population, high burden, high priority country B. There is a need to do stool examination on high-risk individuals so that individuals who need to be treated will be E02 CG A2 17 of 22  identified C. Direct fecal smear is not the best diagnostic procedure D. All deworming drugs for ages 1-18 years old are provided by the DOH 82 Generally, in helminthic infections, the D. Sex of the parasite degree of pathologic changes, signs and symptoms depend on all of the Choice A affects the presenting symptoms. If the brain is the site of following, EXCEPT: infection, meningeal irritation and neurologic symptoms may be A. Site of infection present while if the site of infection is the intestines, abdominal B. Intensity of infection pain and other GI symptoms may be present. C. Host nutritional status Choice B, also known as worm burden, refers to the number of D. Sex of the parasite worms per infected person. Higher worm burden generally leads to more adverse symptoms. Choice C can affect infection tolerance, which is the ability of a host to limit the health effects of a given parasite load. Malnutrition is attributed to lower infection tolerance, causing more adverse effects. [EO1-T07] 83 Which of the following is more C. Ancylostoma ceylanicum commonly seen in animals and is therefore a zoonotic parasite? Ancylostoma ceylanicum can infect both animals and humans, making it a A. Trichuris trichiura zoonotic parasite. [Kladkempetch, D., Tangtrongsup, S., Tiwananthagorn, S. (2020). Ancylostoma B. Ancylostoma duodenale ceylanicum: The Neglected Zoonotic Parasite of Community Dogs in Thailand and Its Genetic Diversity among Asian Countries. Animals (Basel). Nov 19;10(11):2154. doi: 10.3390/ani10112154. PMID: 33228101; PMCID: PMC7699415.] C. Ancylostoma ceylanicum D. None of the above 84 For surveillance of soil-transmitted C. Kato katz method helminthiasis, control programs the best diagnostic procedure In terms of sensitivity: Mini-FLOTAC > 3-sample Kato-Katz > 2-sample KK > recommended by WHO is: 1- sample KK > Direct fecal smear A. Direct fecal smear + Kato thick smear B Direct fecal smear is of value only when the infection is quite heavy. It may B. Kato thick smear not detect the parasite in light infections. The Kato thick or Kato-Katz C. Kato katz method method may increase detection rates since more stools are examined using D. Formalin ether/ethyl acetate these techniques. The Kato-Katz technique may also provide quantitative concentration technique diagnosis by determining the intensity of infection in terms of number of helminth eggs per gram of feces. [EO1-T07] 85 Which of the following is NOT C. It does not cause opportunistic infection; CORRECT concerning Strongyloides stercoralis Choice A: Tissue-invasive helminthic parasites cause marked A. It causes marked eosinophilia; eosinophilia. B. It has a free-living phase in Choice B: Parasitic cycle: Filariform larvae in contaminated soil soil; penetrate human skin when skin contacts soil and migrate to the C. It does not cause small intestine. opportunistic infection; Choice C: S. stercoralis is the major causative agent of D. None of those mentioned strongyloidiasis in humans. Its life cycle is complex, alternating between free-living and parasitic cycles, and involving autoinfection. The rhabditiform larvae can either be passed in the stool or can become filariform larvae, resulting in autoinfection. [EO1-T07] E02 CG A2 18 of 22  8. ARTHROPODS OF MEDICAL AND PUBLIC HEALTH IMPORTANCE Lecturer: Dr. Bertuso 86 What is the name of the vector with B. Aedes albopictus straight white markings on the thorax? A. Aedes aegypti B. Aedes albopictus C. Anopheles flavirostris D. Mansonia uniformis 87 What are the municipalities in Palawan D. Kalayaan and Aborlan declared to be free from active transmission of malaria? Bataraza, Quezon, Rizal, Brooke’s Point, and Safronio Española, are A. Bataraza and Quezon municipalities in Palawan with active transmission [E01-T08, p. 5]. B. Rizal and Brooke's Point C. Safronio Espanola and Bataraza D. Kalayaan and Aborlan 88 The larvae of this mosquito lie parallel A. Anopheles flavirostis on the surface water or water table when at rest The larvae of A. flavirostis lie parallel to the surface water when at rest. A. Anopheles flavirostris B. Aedes aegypti Choices B, C, D lie perpendicular[Lecture Slides] C. Culex tritaeniorhynchus D. Aedes poecilus 89 The natural cycle of Japanese A. Amplifying Host encephalitis virus involves rice-field-breeding mosquitoes and Pigs serve as amplifying hosts for Culex tritaeniorhynchus, a small mosquito domestic pigs. The pigs serve as that is a vector for Japanese Encephalitis [Chapter 6: Arthropods and Mollusks of Medical _____ of the virus: Importance - Medical Parasitology in the Philippines, p. 309] A. Amplifying host B. Definitive host C. Intermediate host D. Reservoir host 90 Which vector is present when D. Anopheles flavirostris bancroftian filariasis and malaria are endemic in one community? A. Aedes aegypti B. Mansonia uniformis C. Aedes albopictus D. Anopheles flavirostris E02 CG A2 19 of 22  [E01-T08, page 2] 91 The larva of this arthropod breeds in C. Mansonia bonneae swampy ditches and rivers with floating vegetation Mansonia bonnae breeds in swampy and forested areas, ditches, canal, A. Anopheles flavirostris ponds and rivers with floating vegetation B. Aedis poecilus C. Mansonia bonneae Choice A: Anopheles flavirostris breeds in clear, slow flowing partly D. Aedes albopictus shaded streams and springs & clear ponds and pools in forest Choice B: Aedis poecilus breeds are axiled breeders (banana, abaca) Choice D: Aedes albopictus often breeds in small, often man-made bodies of water, largely present in urban private areas. [E01-T08, page 7], Stefopoulou et al., 2018] 92 Mr. XY, a 23 year old man, consulted his C. Scabies doctor and complained about a six week history of a rash which is worse Tiny burrows sometimes are seen on the skin; these are caused by the on his hands and upper torso. Intense female scabies mite tunneling just beneath the surface of the skin. These itching and slight pain was experienced burrows appear as tiny raised and crooked (serpiginous) grayish-white or particularly at night. Visible tunnel in skin-colored lines on the skin surface [CDC, 2020] whitish to greyish color appears on his skin. Mr. XY is worried that he could give “it” to his family. What would be your diagnosis? A. Pulicosis B. Pediculosis C. Scabies D. Cimicosis 93 A 17-year-old male was brought to the C. Scorpion poisoning emergency room complaining of breathlessness, cough, and chest pain Sulfhydryl group is a component of Scorpion’s venom which may produce associated with cold sweating, neurotoxic effects including: numbness at site of sting, itching sensations of excessive salivation and vomiting. nose, mouth, throat, excessive salivation and vomiting, rapid perspiration, Three hours before the hospital restlessness, involuntary sweating, and muscular spasms [E01-T08-Arthropods of admission, he was seen working in his Medical and Public Health Importance, p. 13] rock garden. The patient had no significant past history and no other predisposed cardiac risk factor. The E02 CG A2 20 of 22  patient reported that he was ‘bitten’ by an organism with a long tail. What would be your diagnosis? A. Wasp poisoning B. Pederin poisoning C. Scorpion poisoning D. Cantharidin poisoning 94 Which species of cockroach prefers to D. Blattella germanica breed in cool dark places? A. Periplaneta americana Five most common cockroach domestic pests: B. Blatta orientalis Periplaneta americana: American cockroach, 30-40mm C. Supella longipalpa Blattella germanica: German cockroach, breed in cool places, D. Blattella germanica 15-20mm Blatta orientalis: Oriental cockroach, 30-33mm Supella longipalpa: Brown-banded cockroach, 15-20mm Neostylopyga rhombifolia: Harlequin cockroach, can be bought as a pet or fed to tarantulas and scorpions [E01-T08-Arthropods of Medical and Public Health Importance, p. 8] 95 The following diseases are transmitted A. Murine typhus by Pediculus humanus humanus, EXCEPT: Pediculus humanus humanus (body louse) can transmit bacterial infections, A. Murine typhus leading to epidemic typhus, relapsing fever, and trench fever. Murine typhus B. Trench fever is spread by fleas [E01-T08-Arthropods of Medical and Public Health Importance, p. 9-10] C. Relapsing fever D. Epidemic typhus 96 Which of the following species exhibits D. Dermatobia specific myiasis? A. Fannia Dermatobia exhibits specific or primary myiasis, wherein the species require B. Musca hosts for larval development. C. Calliphora D. Dermatobia A and B exhibit accidental or pseudomyiasis, wherein the species has no requirement or preference for development in a host. C exhibits semispecific myiasis, wherein flies the species normally lays eggs in decaying animal or vegetable matter. Other examples of semispecific myiasis include Sarcophaga (flesh fly) and Lucilia (green bottle fly). [E01-T08-Arthropods of Medical and Public Health Importance, p. 8] 97 Which of the following venoms is B. Sulfhydryl specific to scorpion? A. Melittin Components of scorpion’s venom are serotonin and sulfhydryl groups [E01-T08, E02 CG A2 21 of 22  B. Sulfhydryl p. 13]. C. Pederin D. Acetylcholine 98 Which of the following strategies most B. Case management likely cannot prevent dengue transmission? Key strategy for dengue control is still vector control (through 5S)[E01-T08, p. 3] A. Use of aerosol spray B. Case management C. Removal of vector breeding sites D. Space spraying 99 Which of the following control B. Indoor residual spraying measures is recommended for the vectors of filariasis and malaria? Indoor residual spraying (IRS) was recommended in 2002 as vector A. Ova trapping intervention/strategies for malaria [E01-T08, p. 6] B. Indoor residual spraying C. Larviciding D. Source Reduction 100 Which of the following is an example of C. 1 and 3 cyclo-propagative transmission? 1. Malaria Plasmodium falciparum in the mosquito Anopheles causes malaria, which is 2. Elephantiasis an example of cyclo-propagative [E01-T08, p. 1]. 3. African trypanosomiasis 4. Filariasis A. 1, 2, 3, and 4 B. 1, 2, and 3 C. 1 and 3 D. 2 and 4 101 Which of the following is an example of D. 2 and 4 cyclo-developmental transmission? 1. Japanese encephalitis Filarial worm in lymphatic filariasis or elephantiasis is cyclo-developmental 2. Elephantiasis [E01-T08, p. 1]. 3. Malaria 4. Filariasis A. 1, 2, 3, and 4 B. 1, 2, and 3 C. 1 and 3 D. 2 and 4 END OF EXAM E02 CG A2 22 of 22