Which of the following organisms is most commonly associated with urinary tract infections?
A. Klebsiella pneumoniae
B. Shigella flexneri
C. Salmonella typhi
D. Escherichia coli
Answer: D
A major distinguishing feature between Salmonella and Shigella on TSI agar is:
A. Lactose fermentation
B. Urease activity
C. H2S production
D. Citrate utilization
Answer: C
Which organism is often linked to traveler's diarrhea?
A. Salmonella typhi
B. Shigella flexneri
C. Escherichia coli (ETEC)
D. Klebsiella pneumoniae
Answer: C
What is the mode of transmission of Shigella?
A. Inhalation
B. Blood transfusion
C. Fecal-oral
D. Sexual contact
Answer: C
Which of the following is a lactose fermenter?
A. Salmonella
B. Klebsiella
C. Shigella
D. Yersinia
Answer: B
Which E. coli pathotype is associated with bloody diarrhea and hemolytic uremic syndrome (HUS)?
A. ETEC
B. EPEC
C. EHEC
D. EAEC
Answer: C
Which organism causes typhoid fever?
A. Shigella sonnei
B. Klebsiella pneumoniae
C. Escherichia coli
D. Salmonella typhi
Answer: D
Which of the following organisms produces mucoid colonies on MacConkey agar?
A. Salmonella
B. Shigella
C. Klebsiella
D. E. coli
Answer: C
Which one is a facultative intracellular pathogen?
A. E. coli
B. Klebsiella
C. Salmonella
D. Shigella
Answer: C
Which organism causes bacillary dysentery with frequent, small-volume bloody stools?
A. E. coli (ETEC)
B. Shigella dysenteriae
C. Salmonella typhimurium
D. Klebsiella pneumoniae
Answer: B
Which Enterobacteriaceae is most associated with hospital-acquired pneumonia?
A. Salmonella
B. E. coli
C. Klebsiella pneumoniae
D. Shigella
Answer: C
Which organism is commonly transmitted through contaminated poultry and eggs?
A. Klebsiella
B. Shigella
C. Salmonella
D. E. coli
Answer: C
Which of the following grows colorless colonies on MacConkey and black centers on XLD?
A. Shigella
B. Salmonella
C. Klebsiella
D. E. coli
Answer: B
Which E. coli strain is responsible for HUS and is sorbitol-non fermenting?
A. ETEC
B. EHEC (O157:H7)
C. EAEC
D. EPEC
Answer: B
A lactose-fermenting, indole-positive Gram-negative rod most likely indicates:
A. E. coli
B. Klebsiella
C. Salmonella
D. Shigella
Answer: A
A 5-year-old presents with bloody diarrhea. Non-motile, non-lactose fermenter identified. Likely
organism?
A. E. coli
B. Shigella
C. Salmonella
D. Klebsiella
Answer: B
A woman develops UTI after catheterization; indole-positive, lactose fermenter found. Likely cause?
A. E. coli
B. Shigella
C. Salmonella
D. Klebsiella
Answer: A
A malnourished child with rose spots and high fever. Likely diagnosis?
A. Shigella
B. Klebsiella
C. Salmonella typhi
D. E. coli
Answer: C
Diabetic alcoholic with pneumonia and currant jelly sputum. Most likely organism?
A. E. coli
B. Shigella
C. Klebsiella pneumoniae
D. Salmonella
Answer: C
Child with seizures, bloody diarrhea, and HUS. Sorbitol-negative strain found. Cause?
A. EPEC
B. EHEC (O157:H7)
C. EAEC
D. ETEC
Answer: B
Hospital patient’s sputum reveals mucoid pink colonies on MacConkey agar. Pathogen?
A. Shigella
B. E. coli
C. Klebsiella
D. Salmonella
Answer: C
Burn patient develops sepsis from lactose fermenter, capsule-producer. Likely cause?
A. E. coli
B. Klebsiella pneumoniae
C. Shigella
D. Salmonella
Answer: B
Traveler with rice-water-like diarrhea; culture shows heat-stable/heat-labile toxins. Likely cause?
A. EHEC
B. ETEC
C. EPEC
D. EAEC
Answer: B
Infant with watery diarrhea and failure to thrive; lactose fermenter, non-motile Gram-negative rods.
A. E. coli (EPEC)
B. Shigella
C. Klebsiella
D. Salmonella
Answer: A
Stool sample reveals non-lactose fermenter, H2S-negative, motile rods. Likely diagnosis?
A. Shigella
B. Salmonella
C. Klebsiella
D. E. coli
Answer: B
Which Gram-positive cocci grow in clusters?
A. Streptococcus
B. Neisseria
C. Staphylococcus
D. Enterococcus
Answer: C
Which of the following is coagulase-positive?
A. Staphylococcus epidermidis
B. Streptococcus pyogenes
C. Staphylococcus aureus
D. Streptococcus pneumoniae
Answer: C
Which test is commonly used to differentiate Staphylococcus from Streptococcus?
A. Catalase test
B. Coagulase test
C. Oxidase test
D. Indole test
Answer: A
Streptococcus species are arranged in:
A. Clusters
B. Chains or pairs
C. Spirals
D. Tetrads
Answer: B
Which organism causes impetigo, boils, and abscesses?
A. Streptococcus pyogenes
B. Staphylococcus aureus
C. Streptococcus pneumoniae
D. Enterococcus faecalis
Answer: B
The most likely cause of hospital-acquired infections from catheters:
A. Streptococcus pyogenes
B. Staphylococcus epidermidis
C. Streptococcus pneumoniae
D. Staphylococcus aureus
Answer: B
Which Gram-positive cocci is optochin-sensitive and has a capsule?
A. Streptococcus pyogenes
B. Streptococcus pneumoniae
C. Staphylococcus aureus
D. Staphylococcus epidermidis
Answer: B
Which of the following causes toxic shock syndrome?
A. Streptococcus pneumoniae
B. Staphylococcus aureus
C. Streptococcus viridans
D. Enterococcus faecalis
Answer: B
A Gram-positive cocci that grows on Mannitol Salt Agar (MSA) and ferments mannitol is:
A. Streptococcus pyogenes
B. Staphylococcus aureus
C. Streptococcus pneumoniae
D. Enterococcus
Answer: B
A patient develops sepsis after catheter insertion. The isolate is coagulase-negative, catalase-positive.
Most likely cause?
A. Streptococcus pyogenes
B. Staphylococcus epidermidis
C. Staphylococcus aureus
D. Streptococcus pneumoniae
Answer: B
A 70-year-old man has pneumonia with rust-colored sputum. Gram stain shows lancet-shaped cocci in
pairs. Diagnosis?
A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Streptococcus pyogenes
D. Enterococcus
Answer: B
A young woman has fever, rash, and hypotension after using tampons. Blood culture grows coagulase-
positive Staphylococcus. Likely toxin?
A. Streptolysin
B. Pyrogenic exotoxin
C. Toxic shock syndrome toxin (TSST-1)
D. Pneumolysin
Answer: C
A child has red, scaly skin that peels. Swab shows coagulase-positive Gram-positive cocci. Likely disease?
A. Impetigo
B. Scarlet fever
C. Scalded skin syndrome
D. Erysipelas
Answer: C
A heart patient develops endocarditis after dental work. Blood cultures grow alpha-hemolytic
Streptococcus. Likely organism?
A. S. pyogenes
B. S. pneumoniae
C. S. viridans
D. S. epidermidis
Answer: C
A newborn develops meningitis. CSF shows Gram-positive cocci in chains, catalase-negative. Likely
cause?
A. Streptococcus agalactiae (Group B)
B. Streptococcus pneumoniae
C. Staphylococcus aureus
D. Staphylococcus epidermidis
Answer: A
Which of the following best defines Multidrug-Resistant TB (MDR-TB)?
A. TB resistant to any two antibiotics
B. TB resistant to Rifampicin only
C. TB resistant to Isonazid and Rifampicin
D. TB resistant to second-line drugs
Answer: C
A patient diagnosed with pulmonary TB is not responding to first-line treatment after 2 months. What is
the next appropriate step?
A. Increase dose of rifampicin
B. Repeat sputum microscopy and perform drug susceptibility testing
C. Switch to second-line drugs immediately
D. Prescribe antibiotics for pneumonia
Answer: B
Which method increases sensitivity for TB detection in sputum by concentrating the bacilli?
A. Cold staining
B. Heat fixation
C. Sodium hypochlorite (bleach) digestion and centrifugation
D. Direct smear from saliva
Answer: C
In a TB control program, why is a “spot–morning–spot” sample collection strategy recommended?
A. It reduces sample contamination
B. It improves sputum quality
C. It increases the chance of detecting TB bacilli
D. It minimizes patient visits
Answer: C
Which of the following symptoms is most specific to pulmonary TB?
A. Shortness of breath
B. Productive cough lasting more than 2 weeks
C. Headache and vomiting
D. Abdominal pain
Answer: B
A lab technician finds 7 AFB in 100 oil immersion fields of a patient’s sputum smear. How should this be
reported?
A. +
B. ++
C. Report as “7 AFB/100 fields”
D. +++
Answer: C
Which of the following increases the risk of developing MDR-TB?
A. Overuse of antibiotics in general
B. Taking first-line drugs irregularly or incompletely
C. Living in cold climate
D. Having a low hemoglobin level
Answer: B
What is the primary route of transmission of Mycobacterium tuberculosis?
A. Contaminated food
B. Fecal-oral route
C. Airborne droplets from cough/sneeze
D. Sexual contact
Answer: C
Which group is at highest risk for TB reactivation?
A. Healthy adults
B. Children under 5
C. HIV-positive individuals
D. Pregnant women
Answer: C
In a rural health center with limited resources, what is the most practical test for TB diagnosis?
A. Chest CT scan
B. Direct sputum smear microscopy
C. Blood culture
D. Xpert MTB/RIF only
Answer: B
A patient suspected of TB submitted sputum. Ziehl-Neelsen stain was negative. What next?
A. Report as negative
B. Use Gram stain
C. Examine additional specimens
D. Discard the sample
Answer: C
Gram-stained smear shows intracellular Gram-negative diplococci. Most likely organism?
A. Neisseria gonorrhoeae
B. Streptococcus pneumoniae
C. Escherichia coli
D. Staphylococcus aureus
Answer: A
An old bacterial culture stains Gram-negative though it was Gram-positive. Reason?
A. Incorrect stain
B. Over-decolorization
C. Old iodine solution
D. Aging culture
Answer: D
A thick Gram smear causes what error?
A. False gram-negative
B. False gram-positive
C. No visible organisms
D. Over-decolorization
Answer: B
In capsule staining, what replaces water for rinsing?
A. Ethanol
B. Copper sulfate
C. Acetone
D. Lugol’s iodine
Answer: B
Bleach-treated sputum improves AFB detection because:
A. Fixes smear
B. Increases fluorescence
C. Concentrates bacilli
D. Promotes growth
Answer: C
Water directly poured on heat-fixed CSF smear during rinse can cause:
A. Lysis
B. Dark staining
C. Smear loss
D. Enhanced violet stain
Answer: C
Why is alcohol fixation preferred for intracellular bacteria detection?
A. Faster fixation
B. Preserves leukocytes
C. Better contrast
D. Reduces evaporation
Answer: B
Overheating Ziehl-Neelsen stain causes:
A. Under-staining
B. Crystal artifact
C. Counterstain loss
D. Low background stain
Answer: B
Why is steaming done in spore staining with malachite green?
A. Fixes smear
B. Activates counterstain
C. Increases spore wall permeability
D. Destroys vegetative cells
Answer: C
