1.

2.

Which of the following chemical antimicrobial agents acts by denaturing

proteins?
a) Halogens.
b) Alcohols.
c) Peroxygens.
d) Biguanides.
e) Aldehydes.
Complication that is mostly associated with chloramphenicol:
a) Anaphylactic shock.
b) Deafness.
c) Nephrotoxicity.
d) Permanent staining of teeth.
e) Bone marrow depression.

3.

One of the bacterial virulence factors is the ability of adherence to the

host cells, which is achieved by:
a) Coagulase enzyme.
b) Glycocalyx.
c) Ig A protease.
d) Lipopolysaccharide.
e) Leukocidin.

4.

Siderophores are bacterial products which contribute in the bacterial

virulence through its ability to:
a) Adhere to host cell.
b) Compete for iron.
c) Elicit inflammatory response.
d) Invade the host cell.
e) Resist host immune defense.

5.

The most common mode of transmission of infections in health care

settings is:
a) Contact.
b) Vehicle.
c) Airborne.
d) Vector.
e) Droplet.

6.

Which of the following best describes hospital acquired infection?

a) Infections which are of exogenous source.
b) Infection that is neither present nor incubated at the time of hospital
admission.
c) Infection that occurs after hospital discharge.
d) Infection that occurs immediately before hospital admission.

e) Infection that is incubated on hospital admission.

7.

8.

Nosocomial acquired Methicillin Resistant Staphylococcus aureus

( MRSA) strains are treated by:
a) Cloxacillin.
b) Clindamycin
c) Trimethoprim- sulphamethoxazole.
d) Gentamycin.
e) Vancomycin.

A 67- year old man diagnosed clinically as cellulitis. Catalase- negative, hemolytic Gram- positive cocci are isolated from his blood culture. Which
virulence factor of the causative organism enabled it to cause this invasive
disease?
a) Streptolysin.
b) P fimbriae.
c) M protein.
d) F protein.
e) Streptokinase.

9.

Antistreptolysin O titre of 120 Todds units is:

a) Normal.
b) Diagnostic of rheumatic fever.
c) Diagnostic of Streptococcus pyogenes skin infection.
d) Diagnostic of acute glomerulonephritis.
e) Indication for long term penicillin therapy.

10.

Pneumcocci are classified according to:

a) Coagulase enzyme production.
b) Cell wall carbohydrate antigen.
c) Capsular polysaccharide substance.
d) Endopigment production.
e) Sugar fermentation.

11.

A 3 year old child presents with a high fever, vomiting, photophobia and
stiff neck. Gram stained smear of sediment from cerebrospinal fluid showed
Gram negative cocci. What is the best way to prevent this disease in the
classmates of the case ?
a) Vaccinate them with live attenuated bacterial vaccine.
b) Give them rifampin antibiotic.
c) Culture their throat swabs and give antibiotic according to the isolated
.organism.
d) Vaccinate them with killed bacterial vaccine.
e) Give them I.V. third generation cephalosporin.

12.

A 55 year- old diabetic man develops multiple abscesses in his back. They
were drained, and culture revealed Gram positive cocci. Which of the
following virulence character is responsible for this kind of lesion?
a) Endotoxin.
b) Epidermolytic toxin A.
c) Protein A.
d) Coagulase enzyme.
e) Hyaluronidase enzyme.

13.

A two years old boy is suffering from recurrent otitis media. Lymphocytic
count is normal. He is reactive to tuberculin testing . The most likely
defective immune cells are:
a) T lymphocytes.
b) B lymphocytes.
c) Neutrophils.
d) Eosinophils.
e) Mast cells.
----Correct answer is b as the boy suffers from otitis media (pyogenic
infection) and the Lymphocytic count is normal as B lyphocytes represents
only 15 -20 % of the total lymphocytic count
------a) is wrong because He is reactive to tuberculin testing.
------c) is wrong because Neutrophils defect is characterized by granuloma
formation &defective wound healing
-----d)and e) are wrong because Mast cells are not concerned in immune
response against pyogenic infections they are mainly involved in defence
against heliminthes.

14.

Your patient is in the emergency room stung by a bee about 15 minutes

ago. She says that a few minutes after being stung, she had short breath and
urticarial rash appears in several places on her skin. Which one of the
following is the most likely immunological mechanism for these clinic al
findings?
a) Sensitized helper T cells releasing large amounts of IL-2.
b) Immune complex consisting of IgG and hapten precipitated in the lungs
and skin.
c) Activated macrophages producing large amounts of tumor necrosis factor.
d) IgE coated mast cells releasing histamine and leukotrienes.
e) Membrane attack complexes with complement activation damaging cells
in the lung and skin.

15.

A 20 years old female presented to the emergency room with tachycardia,

dyspnea and severe weakness. She gave a history of penicillin intake 2 days

ago. On clinical examination she was hypotensive and had obvious pallor
with elevated bilirubin levels and markedly decreased RBCs count. The
pathogenesis of this condition is:
a) Congenital.
b) Cytotoxic antibodies against RBCs coated with foreign antigen.
c) IgE against RBCs.
d) Viral infection.
e) Toxaemia.
16.

Which of the following statements can define Ignorance as a

mechanism of peripheral self-tolerance?
a) A state of metabolic arrest in absence of co-stimulation.
b) Release of inhibitory cytokines by T regulatory lymphocytes.
c) Sequestration of auto-antigens behind cellular or vascular barriers.
d) Clonal deletion of auto-reactive lymphocytes.
e) Lack of T cells to auto-reactive B cells.

17.

A 32 years old hospitalized man had a bone marrow transplantation

(BMT) 2 weeks ago, the donor was his sister, that was his 3rd time to have
BMT from her as treatment of leukemia. He developed rash, diarrhea and
pneumonitis. The most likely diagnosis for his condition is:
a) Hyperacute graft rejection.
b) Acute graft rejection.
c) Chronic graft rejection.
d) Delayed hypersensitivity.
e) Graft versus host disease.

18.

Which of the following tests is used to assess the compatibility between

the donor and recipient regarding class II MHC compatibility?
a) Mixed lymphocyte reaction.
b) Blast transformation test.
c) NBT dye reduction test.
d) Cytotoxic T-lymphocyte assay.
e) Migration inhibition test.

19.

In which way an antibody can serve in escape mechanisms of a tumour

evading the immune response?
a) Decreasing expression of MHC class I molecules on tumour cells.
b) Coating tumour specific antigens and masking them from T cytotoxic
cells.
c) Activation of classical complement pathway.
d) Mediating antibody mediated opsonisation of tumour by phagocytes.
e) Mediating antibody dependent cell mediated cytotoxicity.

20.

21.

Interleukin-2 beneficial effectiveness in tumour immunotherapy is

through:
a) Passive immunisation for tuberculosis.
b) Induction of the production of neutralizing antibody.
c) Non-specific stimulation of the immune system.
d) Activation of alternative complement pathway.
e) B cells differentiation to plasma cells.
The protein coat which surrounds the nucleic acid of the virus is called:
a) Capsomere.
b) Capsid.
c) Cell wall.
d) Envelope.
e) Nucleocapsid.
22.What does viral envelop confer to the virion?
a) Antigenicity
b) Infectivity
c) Pathogenicity
d) Unstability
e) Symmetry.

----Correct answer is d asThe lipid bilayer envelope of these

viruses is relatively sensitive to heat, and detergents, therefore
these viruses are easier to sterilize than non-enveloped
viruses,they have limited survival outside host environments,
and typically must transfer directly from host to host.
-----a) is wrong because The antigenicity of viruses mainly
resides in
the viral proteins that form the viral capsid,
non enveloped viruses retain antigenicity though they dont
have envelop
Only sometimes the antigenicity of enveloped viruses
resides in the
exposed proteins and glycoproteins that are anchored in
the viral lipid membrane.
------b) is wrong because Viral genome is responsible for infectivity

-----c) is wrong because factors that contribute to the virulence (pathogenicity) of a

particular strain of virus are intracellular survival , Ability to combat host defense
mechanisms, and Ability to produce temporary or permanent damage in the host

.------e) is wrong because The arrangement of the protein capsomeres gives

the virus its symmetry
23.Which of the following agents is frequently used in preparation of viral
vaccines?
a) Alcohol.
b) Chlorine.
c) Ether.
d) Formaldhyde.
e) Iodine.
?What is a prion .24
a) Infectious particle composed solely of proteins
b) Host DNA enclosed in a capsid
c) Single molecule of circular RNA without coat or envelope
d) Virus that infects bacteria
e) Viral particle that cant replicate without helper virus
25.PCR is used in diagnosis of viral infection to detect:
a) Antiviral antibodies.
b) Viral nucleic acid.
c) Viral antigens.
d) Viral inclusion bodies.
e) Viral enzymes.
26.A 25 year old woman was presented to her physician with low grade fever,
headache, painful genital vesicles and enlarged inguinal lymph nodes.
Examination of stained scraping from genital lesions revealed multinucleated
giant cells and intranuclear inclusion bodies. What is the expected course of
this disease?
a) Blood dissemination.
b) Complete recovery.
c) Chronic infection.
d) Complication in the form of encephalitis.
e) Latency with periodic reactivation.
27.A 19 year old man came to your clinic complaining of sore throat, swollen
cervical lymph nodes and fever. On examination temperature was 39 C. The
tonsils and cervical lymph nodes were markedly enlarged. Blood examination
showed absolute lymphocytosis with 10% atypical lymphocytes and positive
heterophil antibody test. What is the most likely causative organism?

a)
b)
c)
d)
e)

Cytomegalovirus.
Epstein- Barr virus.
Human herpes virus type 7.
Streptococcus hemolyticus group A.
Staphylococcus aureus.

28.A seven days old baby was presented to you with rash, low birth weight,
microcephaly, brain calcification and hepatosplenomegaly. How did the baby
acquire this disease?
a) Blood transfusion.
b) Breast feeding.
c) Contact with secretions in birth canal.
d) Direct contact with health care worker.
e) Transplacental.
29. Which of the following diseases is caused by human herpes virus-6
( HHV-6)?
a) Shingles.
b) Infectious mononucleosis.
c) Kaposi's Sarcoma.
d) Oral leukoplakia.
e) Roseola Infantum.
30.A 65-year-old man complained of sharp, burning pain in one side of his
back. Severity of pain was not related to physical activity. On examination
the area of pain revealed patches of erythema with clusters of vesicles
distributed to skin innervated by one dorsal root ganglion. What is the most
likely cause of this man illness?
a) Primary infection with Varicella zoster.
b) Primary infection with Herpes simplex virus type 2.
c) Primary infection with human herpes virus-6.
d) Reactivation of Varicella zoster latent infection.
e) Reactivation of Herpes simplex virus type 2 latent infection.