MICROBIOLOGY

PYQ 2016 -22

@PJS
 General Microbiology
General Bacteriology ,Sterilisation & Disinfection
Long Question
1. Define disinfection? What are the properties of an ideal disinfectant? Enumerate the
type of disinfectant and an an example of each ? Write risk categories of medical
devices according to Spaulding classification?
2. Enumerate different physical methods of sterilisation. Write the principle of autoclave,
it’s working condition and various sterilisation control.
3. Differentiate between Gram positive and Gram negative bacteria . Describe both cell
wall with labelled diagram.
4. Enumerate methods of genetic transfer in bacteria.
Short note
1. Bacterial growth curve.
2. Anaerobic culture methods.
3. Role of conjugation in spreading antimicrobial resistance.
4. Koch’s postulates
5. plasma sterilisation
6. Difference between exotoxin and endotoxin
7. Pasturization
8. Bacterial capsule and Bacterial spore
9. Negative staining method
10. Plasmid
11. National vector born disease control program (NVBDCP)
12. Transformation and Transduction
13. Difference between mutational and transferable drug resistance
14. Anaerobic culture
15. Autoclave efficiency test
16. Louis pasture
Short Question
1. What is enriched media? Give two examples?
2. Write two contribution of Louis Pasteur?
3. Draw a labelled diagram of bacterial endospore?
4. Draw a labelled diagram of cell wall of a Gram negative bacteria?
5. Who is known as father of chemotherapy? Mention two of his contributions.
6. What is biofilm? Give two example of biofilm producing bacteria.
7. What is enrichment media? Give two example of enrichment med.
8. Name two Gram negeti cocci.
9. Name the stain used for demonstration of polychromatic granules of diphtheria.
10. Name two culture media for mycobacterium tuberculosis.
11. Who is known as father of antiseptic surgery? Mention two of his contributions.
12. Iatrogenic infection.
13. Mention two pigment producing bacteria.
14. Two bacteria giving positive reaction in Urease test.
15. L forms
16. Write the importance of indole test.
17. What is selective media? Name two selective media.
18. Name two zoonotic diseases.
19. Enumerate different methods of genetic transfer.
20. Name Two bacteria showing swarming.
21. Name two bacteria showing satellitism.
22. DOTS
23. What is transport media? Give two examples of transport media.
24. Bacterial intracytoplasmic inclusion.
25. Two methods of demonstration of flagella.
26. Name two organism producing exotoxin.
27. Rapid urease test
28. Mannitol salt agar medium
29. Principles of Gram staining
30. Central Dogma of molecular biology
31. Name two microorganisms that do not meet criteria of Koch’s postulation.
32. What is indicator media ? Give two examples.
33. What is differential stain? Give two examples.
34. Cold sterilisation,two agents used for cold sterilisation.
35. Name two phenol derivative used as disinfectants.
36. Name the scientist who developed PCR?
37. Lawn culture
38. Mention two organisms causing food poisoning within 6hrs of ingestion of food
products.
39. Diagram of embryonated hen’s egg
 General Virology
Long Question
1. Fungi causing opportunistic mycoses. Describe lab diagnosis of candida infection.
Short note
1. Draw a labelled diagram of bacteriophage. Name 4 DNA and 4 RNA viruses.
2. Inclusion bodies
3. Prion
4. EBV
5. Interferons
6. Primary cell culture of virus
7. Methods of isolation of virus
8. Viral hemagglutination and elution
9. Stages of replication of virus
10. Enumerate viral vaccines
Short Question
1. Any two examples of prion disease?
2. Name two and two retroviruses.
3. Viral symmetry
4. Slow virus infection

General Mycology
Short note
1. Mycotoxin
2. Aspergillus
3. Dimorphic fungi
Short Question
1. Name two dimorphic fungi.
2. Mention the scientific name of capsulated fungus.
3. Name 2 culture media for fungi.
4. Name two species of Candida.
5. Pseudohyphae
6. Name two culture media used for fungus
7. Name two fungus causing opportunistic infection.
8. Mention two fungus which divide by budding.
9. Name two fungi causing mycotoxicosis.
10. Name two fungi causing otomycosis.
General Parasitology
Short Question
1. Name Parasites entered through skin.
2. Name different opportunistic parasitic infections.
 Hospital Associated Infections
Short note
1. What are the different types of HAIs? Mention the standard precautions to be followed
to prevent HAIs.
2. Post exposure prophylaxis following needle stick injury.
3. Write various aspect of confidentiality of a patient to be maintained in a laboratory?
4. Prevention of surgical site infection.
5. Efficiency test for disinfectants.
6. Biomedical waste management
Short Question
1. Categories of biomedical waste according to biomedical waste management rule
2016?
2. Enumerate WHO’s “my five moments of hand hygiene” ?
3. What are the codes of biochemical waste according to BMW management rule 2016?
4. Define hospital acquired infection? Give two examples.
5. Enumerate any two bacterial etiological agents of ventilator associated pneumonia.
6. Enumerate various personal protective equipment used as infection control measure.
7. Name two bacteria used as sterilisation control.
8. Mention the temperature and holding period required for hot air ovan.
9. Define tyndallization.
10. Enumerate themethod by which endoscopes are sterilised?
11. Filtration
 Immunity
Long Question
1. Enumerate the different complement activation pathways? Write briefly about classical
pathway of complement activation with suitable flowchart?Enumerate regulators of
complement pathway?
2. Define and classify hypersensitivity mentioning examples of each type. Write in details
about type 1 or 3 or 4 hypersensitivity.
3. What is antibody? Describe various classes of antibody with labelled diagram.
4. Define antigen-antibody reaction,precipitation,flocculation & Mention briefly
application.
Short notes
1. Type 1 or 4 hypersensitivity reaction.
2. Agglutination reaction
3. passive agglutination test
4. Difference between active and passive immunity.
5. Autoimmunity
6. ELISA
7. Live alternated vaccine
8. Structure of immunoglobulin
9. Adjuvant
10. Prozone phenomenon
11. Superantigen
12. Hapten
13. Schwartz an reaction
14. Coombs test
Short Question
1. Define agglutination reaction? Give two examples?
2. Write two difference between primary and secondary immune response?
3. Herd immunity
4. Four uses of ELISA
5. Heterophile antigen
6. Draw a labelled diagram of MHC class 1 molecule .
7. What is RA factor? Briefly mention it’s role in rheumatoid arthritis.
8. Name two primary immunodeficiency diseases.
9. Name the immunoglobulin which crosses placenta.
10. Name two super antigen.
11. Secretory antibody
12. Antigenicity
13. Two example of complement fixation test
14. Two example of artificial active immunity
15. Two application of monoclonal antibody
16. Mention the type of immune response of our body in response to antigen.
17. Name the cell involved in delayed type of hypersensitivity reaction.
 CVS
Long Question
1. A 30 yr old has complaint of fever since 10 days. On examination she has a typical
step ladder Pyrex is,looks very toxic,coated tounge, blanching rose spots over trunk
and soft splenomegaly and pulse rate was 60/min. (A) What is the most probable
diagnosis? (B) Write the lab diagnosis of the condition? (C) What is the prophylaxis
against this condition?
2. A 25 yr old male with hostory of multiple sex partner is admitted with complaint of
unexplained fever,progressive loss of weight,persistent diarrhoea and generalised
lymphadenopathy for the past 6 months. (A) What is the most probable diagnosis and
how you arrived at? (B) Draw a labelled diagram of the causative organism?
(C) Discuss the lab diagnosis of the above condition?
3. Enumerated various rickettsial disease? What is the causative agent and vector of
Scrub typhus? Enumerate the different modalities of diagnosis of Scrub typhus? Add
a note on Weil-Felix test?
4. Mention etiological agents,pathogenesis and lab diagnosis of infective endocarditis.
5. Enumerate common Arbo viruses transmitted by mosquito in India. Describe briefly
lab diagnosis of Dengue fever.
Short notes
1. Different strategies in diagnosis of HIV as prescribed by NACO ?
2. Laboratory diagnosis of malaria?
3. Mycotoxicosis?
4. Lab diagnosis of enteric fever?
5. Lab diagnosis of falciparum malaria?
6. Complications of falciparum malaria.
7. NVBDCP
8. Black water fever
9. Botulinum toxin
10. Weil-Felix test
11. Enumerate two non typhoidal Salmonella and infection produced by them.
12. Multi drug resistant Salmonella typhi.
13. Draw a labelled diagram of HIV virus.
14. PKDL
15. Widal rest
16. Germ tube test
17. HACEK
18. Scrub typhus
19. Candidiasis
20. Blood picture of falciparum malaria.
21. Typhoid vaccine
22. Viral haemorrhaging fever
Short Questions
1. Vector and infective form of visceral leishmaniasis?
2. Enumerate the serotype of Dengue virus?
3. Enumerate the predisposing factor for candidemia ?
4. Write the lab diagnosis of acute rheumatic fever
5. Write two helminth causing anemia?
6. What is PKDL.
7. What is Roman’s sign? Mention it’s etiological agents.
8. Name diseases produced by Salmonella typhi.
9. Name two non trepanomal spirochaetes.
10. Name two Rickettsia transmitted by ticks.
11. Name two opportunitistic viruses associated with AIDS.
12. Weil’s disease
13. Aetiological agent and vector of Epidemic Typhus.
14. Mention two co-receptor for fusion of HIV to gain access into host cell.
15. Mention any two fungi causing opportunistic infection in AIDS.
16. Mention two tests done for diagnosis of HIV in infants.
17. Infective form of malaria parasite.
18. Q fever
19. Window period
20. P24 antigen
21. Utility of QBC assay in parasitic infection.
22. Enumerate important disease caused by Salmonella.
23. Enumerate infection caused by Candida albicans.
24. Neil-Mooser reaction
25. NS1 antigen
26. Oral typhoid vaccine
27. Name two Haemoparasites
28. Name the two common filariasis worms.
 GIT
Long Question
1. A 10 yr old girl suffered from increased frequency of stools mixed with blood and
mucus along with painful defecation(tenesmus) and suffered abdominal cramp after
attending a summer [Link] has also fever of 38.4 degree C. Five to six other
children also have complained of same type of illness. (A) Write the differential
diagnosis of the condition? (B) Write the route of transmission? (C) Enumerate the lab
diagnosis?
2. Mention etiological agents,pathogenesis and lab diagnosis of diarrhoea.
Short notes
1. The mechanism of action of cholera toxin in producing diarrhoea?
2. Write the pathogenesis of cholera?
3. Halophilic vibrio
4. Spontaneous bacterial peritonitis
5. Free living amoeba
6. TSST
7. Traveller’s diarrhoea
8. Difference between classical and El-Tor Vibrio.
9. Occult filariasis
10. Lab diagnosis of Cholera.
11. Enumerate types of [Link]
12. Toxic shock syndrome
13. Infant botulism
14. Cholera toxin
15. Common character of enterobacteriaceae.
Short Question
1. Enumerate opportunistic intestinal coccidian parasite?
2. Difference between rhabditiform larva of hookworm and strongyloides ?
3. What are the identifying features of fertilized egg of Ascaris lumbricoides?
4. Name infective form of amoebiasis.
5. Name two Trematoda .
6. Name two coccidian parasites.
7. Name two nematodes transmitted by feco -oral route.
8. Mention the IMVIC reaction for [Link].
9. Enumerate any two highly selective medium for Shigella.
10. Enumerate any two virus causing acute gastroenteritis.
11. Two causative agents of dysentery.
12. Name two coccidian parasites.
13. Name two virus transmitted faeco orally.
14. Vi antigen
15. Name two parasites where fish acts as intermediate host.
16. Enrichment medium of vibrio cholera
17. Name two differences between cyst odes and trematodes.
18. Name two viviparous nematodes.
19. Write the scientific name of Dwarf tapeworm and Beef tapeworm.
20. Mention the infective form of hook worm.

Hepato-billiary
Long Question
1. A 55 yr old male presented with history of loss of apetite, malaise and jaundice of2
month durations. On examination there was a icterus hepatomegaly and tenderness in
the right hypochondriac region. He gave a history of several blood transfusion in the
past. (A) What is the most probable etiological agent? (B) What is the lab diagnosis to
diagnose the condition? (C) Write about adult vaccination schedule against this
agent?
Short notes
1. Write briefly on amoebic liver abscess ?
2. What are the hepatic and extra hepatic complications of Hepatitis B virus infection?
3. Larva migrans
4. Hydatid cyst
5. Describe the structure of HBV. Write the serological markers of HBV infection.
6. Casoni test
Short Question
1. Write example of faeco- orally transmitted hepatitis?
2. What is the vaccination schedule of Hepatitis B in adults?
3. What is the etiological agent of Q fever? Mention it’s mode of transmission.
4. Enumerate the various antigen of Hepatitis B virus.
5. Enumerate any two bacterial and parasitic etiological agents of cholangitis.
6. Name two parasite causing hyadatid disease.
 Skin
Long Question
1. A30 yr male was admitted to surgery IPD after 3days of a crush injury to the left leg
following a road accident. The wound had been managed in a nearby hospital
immediately after accident. On examination the wound was discharging foul smelling
serosanguinous secretion. The leg was swollen with skin discolouration and bulbous
eruptions. On palpation gas bubbles in muscle planes were felt. What is the clinical
condition? Write etiopathogenesis and lab diagnosis of the condition.
Short notes
1. Gas gangrene
2. Dermatophytes
3. cutaneous anthrax
4. Subcutaneous mycoses
5. Rhinosporidiosis
6. Classify streptococci and name the disease produced by streptococci.
7. Coagulate
8. Nagler reaction
9. Enumerate the causative agent of Mycetoma foot.
10. Hide-porter’s disease
11. CAMP test
12. Staphylococcal toxins
13. Epidermophyton
14. Sporotrichosis
15. Lepromin test
16. Streptokinase
Short Question
1. Two complications of varicella infection?
2. Agents causing cutaneous larva migrans?
3. Name two agent causing viral exenthema?
4. Write mode of transmission and clinical manifestation of chicken pox.
5. Mention the causative agent and clinical manifestation of scarlet fever.
6. Mention the dose scheduled and route of administration of MMR vaccine .
7. Name two catalase negative Gram negative cocci.
8. Name two bacteria causing gas gangrene.
9. Which bacteria shows M’Fadyean’s reaction?
10. Enumerate different types of specimen collected for diagnosis of leprosy.
11. Enumerate post streptococcal sequelae.
12. Enumerate any two fungi causing superficial mycoses .
13. Usefulness of lepromin test
14. Tzanck smear
15. Two fungi causing piedra
16. Oral thrus
17. Penicillium marneffei
18. Two organism involved in Eumyecetoma.
19. ECHO
 Respiratory system
Long Question
1. A 25 yr old man complained of progressive weakness and weight loss of 7kg since 3
months. It was associated with intermittent fever, chills and cough with expectoration.
During questioning he also told about appearance of blood streaks in his sputum and
loss of apetite. There was no chest pain or breathlessness. On examination,vitals were
stable. Chest X ray revealed multi lobar infiltrates. (A) Write the most probable
diagnosis with its etiological agent? (B) What is the most appropriate sample in this
case and how many sample to be Collected? (C) write about the grading of
microscopy under national program in India for this disease? (D) What is the role of
vaccine for this disease?
2. Enumerate virus causing respiratory infections? Define antigenic shift and antigenic
drift? Write briefly about lab diagnosis of influenza?
3. A 7 yr old male child having high grade fever, sever throat pain, unable to swallow, He
was looking toxic. On examination of throat a white coloured patch was found in
pharyngeal wall which started bleeding when it was touched. His parents could not
give history of immunisation. What is the clinical condition? Write etiopathogenesis
and lab diagnosis of the condition.
4. Enumerate bacteria causing pneumonia. Briefly describe lab diagnosis of community
acquired pneumonia of bacterial origin.
5. Classify mycobacteria. Describe the pathogenesis and lab diagnosis of pulmonary
tuberculosis.
Short notes
1. SARS-CoV 2
2. pulmonary anthrax
3. MDR-TB
4. Mantoux test
5. Quellung reaction
6. Satellitism
7. Elek’s gel precipitation test
8. RNTCP
9. Anti streptolysin O
 Short Question
1. Antigenic shift
2. Mechanism of diphtheria toxin

fi
3. Enumerate two rapidly growing mycobacteria?
4. What is the causative agent of whooping cough? Write national immunisation
schedule to prevent it.
5. Causative agent of atypical pneumonia.
6. Draw a labelled diagram of SARS-CoV-2 virus.
7. What are the virulence factor of pseudomonas aeruginosa ?
8. Which component of Mycobacterium responsible for its acid fastness?
9. Enumerate two special stain for staining metachromatic of C. diptheriae.
10. Causative agents and manifestations of pulmonary Aspergillosis.
11. Photochromogens
12. Describe two non suppurative complications of S. pyogenes infection.
13. Diseases caused by streptococcus pyogenes.
14. Staining methods used in detection of pneumocystis jiroveceii.
15. Afla toxin
16. Name two trematodes infecting respiratory system.
17. Name the vaccine used for diphtheria in National Immunisation Programme and
mention the time of administration.
18. Quellong phenomenon
SARS-CoV-2 is a novel coronavirus identi ed in December 2019 in Wuhan, China.
It causes Coronavirus Disease 2019 (COVID-19).
• Member of Betacoronavirus genus,
Transmission
• Primarily via respiratory droplets, aerosols, and fomites.
• Incubation period: 2–14 days.
Clinical Features
Inhalation of virus
• Ranges from asymptomatic infection to severe
⬇ pneumonia and ARDS.
Binding of Spike protein ACE2 receptor • Symptoms: fever, cough, sore throat, myalgia, loss of
taste/smell, dyspnea.
(alveolar epithelial cells) • Complications: ARDS, multi-organ failure,
⬇ thromboembolism, cytokine storm.
Viral entry & replication inside host cells
⬇
Direct cytopathic effect cell injury

⬇
Innate & adaptive immune activation
⬇
Cytokine storm (IL-6, TNF-α, etc.)
⬇
Diffuse alveolar damage ARDS

⬇
Endothelial injury + coagulation activation microthrombosis

⬇
Multiorgan dysfunction
 CNS
Long Question
1. A 7 yr old female child has symptoms of fever and semiconsciousness. On
examination there is a stiff neck and purpurin , non-blanching rashes over the body.
A special tap done,and turbid fluid was cool and sent for lab evaluation. Gram stain
of the CSF showed plenty of pus cells and few Gram negetive diplococci.
(A) What is the most probable etiological agent? (B) What are the virulence factors of
the organism? (C) What are the risk factors for acquiring this organism? (D) Write a
note on its prophylaxis? (D) Write the significance of Gram stain in this condition? (E)
What are the culture media and incubation condition to isolate the probable
diagnosis?
Short notes
1. Primary amoebic meningitis-encephalitis
2. Aseptic meningitis
3. Lab diagnosis of Cryptococcal meningitis.
4. Vaccination schedule and route of administration of Japanese Encephalitis B virus
vaccine.
5. Rabies vaccine
6. Cysticercus cellulosae
7. Polio vaccine
Short Question
1. Two virulence factor of Gonococcus?
2. Name two causes of neonatal pyogenic meningitis?
3. Mention the current vaccination schedule for polio under national immunisation
program.
4. Mention any two varieties of Rabies vaccine commercially available in India.
5. Toxin released by [Link]
6. Two viral causes of encephalitis.
7. Name two capsulated organism causing meningitis.
8. Two free living amoeba causing CNS infection.
9. Prophylaxis of tetanus.
10. Japanese encephalitis
 Urogenital tract and STDs
Long Question
1. A 20 yr old female presented with four day history of increased frequency of urination,
dysuria, lest flank pain and fever. On physical examination she had a temperature of
38.8 degree C and left costovertebral angle tenderness. (A) Write the most probable
diagnosis with its most common etiological agent ? (B) Describe the specimen
collection? (C) Define significant bacteriuria? (D) What is asymptomatic bacteriuria and
what is its clinical significance?
2. A 40 yr old male presented with ulcer over theshaft of external genitalia since 20
days. On examination non-tender ,indurated ulcer covered with thick indurated
bilateral painless inguinal lymphadenopathy which is rubbery consistency and non-
matted were seen . He gave history contact with sex worker two month back. (A) What
is the most probable diagnosis and it’s etiological agent? (B) Enumerate different
stages of disease? (C) Lab diagnosis of the disease?
3. A 28 yr old lady presented to OPD with burning micturation,increased frequency and
lower abdominal pain since two days. Microscopy of unsound urine revealed more
than 10 pus cell per high power field. What is the clinical condition? Write probable
etiological agents,pathogenesis and lab diagnosis of the condition.
4. Enumerate viruses causing STD. Mention the lab diagnosis.
Short notes
1. Lymphogranuloma venerum.
2. Trichomonas vaginalis-clinical manifestation and lab diagnosis?
3. Non gonococcal urethritis
4. Dienes phenomenon
5. VDRL
6. Significant bacteriuria
7. Trichomonas vaginalis
Short question
1. Name two agents causing non-gonococcal urethritis?
2. Name two diseases produced by Chlamydia.
3. Enumerate two standard test done for Syphillis.
4. Anti swarming agents
5. Two bacterial causes of STD.
6. Asymptomatic bacteriuria
7. TPHA
 fi
Viruses Causing STDs

1. Human Immunode ciency Virus (HIV-1, HIV-2)

• Disease: Acquired Immunode ciency Syndrome (AIDS)

2. Herpes Simplex Virus (HSV-1, HSV-2)

• Disease: Genital herpes

3. Human Papilloma Virus (HPV)

• Disease: Genital warts (Condyloma acuminata),cervical cancer

4. Hepatitis B Virus (HBV)

• Disease: Hepatitis, chronic carrier state, hepatocellular
carcinoma

5. Hepatitis C Virus (HCV) (less common, possible sexual

transmission)

6. Molluscum Contagiosum Virus (MCV, a Poxvirus)

• Disease: Molluscum contagiosum (pearly papules)

7. Cytomegalovirus (CMV) (transmitted sexually among other

routes)

8. Epstein–Barr Virus (EBV) (rare, but can be sexually transmitted

through oral-genital contact)
 fi
Laboratory Diagnosis

1. HIV

fi
• Screening: ELISA, Rapid antibody tests, p24 antigen
• Con rmation: Western blot, Line immunoassay

fl
• Molecular: RT-PCR for HIV RNA (viral load), CD4 count for monitoring

fi
2. HSV (1 & 2)
• Direct detection: Tzanck smear (multinucleated giant cells – obsolete, nonspeci c)
• Culture: Viral isolation in cell culture
• Antigen detection: DFA (direct uorescent antibody)
• Molecular: PCR (gold standard)
• Serology: HSV type-speci c IgG/IgM

3. HPV
• Cytology: Pap smear (koilocytes)
• Molecular: PCR for HPV DNA, Hybrid capture assay
• Histopathology: Warty lesions, dysplasia

4. HBV
• Serology: HBsAg (infection marker), HBeAg (infectivity), Anti-HBs (immunity), Anti-HBc IgM
fi
(acute infection)
• Molecular: HBV DNA PCR (viral load)

5. HCV
• Serology: Anti-HCV antibody (ELISA)
• Molecular: HCV RNA PCR (con rmatory, viral load)

6. Molluscum Contagiosum Virus

• Clinical: Characteristic umbilicated papules
• Microscopy: Henderson–Patterson bodies (large eosinophilic cytoplasmic inclusions) on
biopsy
• Molecular: PCR (rarely needed)

7. Cytomegalovirus (CMV)
• Histology: Owl’s eye inclusion bodies
• Antigen detection: pp65 antigen test
fi
• Molecular: PCR for CMV DNA
• Serology: CMV IgM (recent infection), IgG (past exposure)

8. Epstein–Barr Virus (EBV)

• Heterophile antibody test: Monospot test
• Serology: EBV-speci c antibodies (VCA IgM/IgG, EBNA)
• Molecular: PCR for EBV DNA
 Miscellaneous
Short notes
1. Bioterrorism
2. Malignant otitis externa
3. Lab diagnosis of Brucellosis ?
4. Bubonic plague
5. Stalactite growth
Short Question
1. Two example of oncogenic DNA virus?
2. Causative agent of Black Death?
3. Clinical manifestation of plague?
4. What are EBV associated malignancy?

1. Two examples of oncogenic DNA viruses?

• Human Papilloma Virus (HPV 16, 18) Cervical cancer.
• Epstein–Barr Virus (EBV) Burkitt’s lymphoma, nasopharyngeal carcinoma.
(Also: HBV, HHV-8/Kaposi’s sarcoma virus).

2. Causative agent of Black Death?

• Yersinia pestis (caused the plague pandemic in medieval Europe).

3. Clinical manifestation of plague?

• Bubonic plague: Painful lymphadenopathy (buboes), fever, chills.
• Septicemic plague: DIC, gangrene (“Black Death”), shock.
• Pneumonic plague: Hemorrhagic pneumonia, highly contagious, fatal if untreated.

4. EBV associated malignancy?

• Burkitt’s lymphoma
• Nasopharyngeal carcinoma
• Hodgkin’s lymphoma (mixed cellularity type)
• Post-transplant lymphoproliferative disorders
1. Bioterrorism
• De nition: Deliberate release of biological agents (bacteria, viruses,
toxins) to cause illness or death in humans, animals, or plants.
• Category A agents (highest risk, CDC): Bacillus anthracis (Anthrax),
Clostridium botulinum toxin, Yersinia pestis (Plague), Variola virus (Smallpox),
Francisella tularensis (Tularemia), Viral hemorrhagic fevers (Ebola, Marburg).
• Features of agents: Easily disseminated, high mortality, panic-inducing,
require special preparedness.
• Response: Rapid detection, isolation, prophylaxis/vaccination,
fi
biosafety measures.

2. Malignant Otitis Externa

• De nition: Aggressive, necrotizing infection of the external auditory
canal, spreading to skull base.
• Etiology: Pseudomonas aeruginosa (most common).

fl
• Predisposition: Elderly diabetics, immunocompromised.
• Clinical: Severe ear pain, otorrhea, granulation tissue at canal, cranial
nerve palsy in severe cases.
• Diagnosis: Culture (Pseudomonas), imaging (CT/MRI for bone
involvement).
• Treatment: Long course of antipseudomonal antibiotics (cipro oxacin),
surgical debridement if needed.

3. Lab Diagnosis of Brucellosis

• Specimen: Blood, bone marrow, CSF, lymph node aspirate.
• Direct methods:
• Culture: Blood/bone marrow culture (Castaneda’s biphasic medium).
• Microscopy: Gram-negative coccobacilli (rarely useful).
• Serology:
• Standard agglutination test (SAT): Detects antibodies.
• ELISA: IgM, IgG.
• Molecular: PCR for Brucella DNA.
 fi
4. Bubonic Plague
• Agent: Yersinia pestis (Gram-negative bacillus).
• Transmission: Flea bite (Xenopsylla cheopis), rodents are
reservoir.

fi
• Clinical features:
• Sudden fever, chills, malaise.
• Painful, enlarged lymph nodes (buboes) commonly
inguinal.
• May progress to septicemia, pneumonia (secondary plague).
• Diagnosis: Smear bipolar “safety pin” bacilli (Wayson stain),
culture, PCR, serology.
• Treatment: Streptomycin, gentamicin, doxycycline.

5. Stalactite Growth
• De nition: Characteristic growth pattern of Brucella abortus in
broth culture.
• Appearance: Floccules of bacteria hanging downward from
surface like stalactites.
• Diagnostic signi cance: Helpful presumptive clue for Brucella
in culture.