May 21, 2013
ICMR 2012 Preparation
2. All of the following statements about the M-protein of Group A Streptococci are correct EXCEPT:
A. The amino terminal portion (distal portion) is variable, accounting for over 80 distinct serotypes.
B. M proteins allow streptococci to resist phagocytosis.
C. Antibodies to M protein confer type-specific immunity.
D. M protein is the major virulence factor of Group A streptococci.
E. M protein is the major constituent of the capsule of Group A streptococci.
Show answer
Correct Answer: E
3. A 12 year old boy presents with acute onset of sore throat, fever to 38.9 degrees C and painful anterior cervical lymphadenopathy. On exam the pharynx is red and swollen and the tonsils are covered with yellow-white exudate. The child also has halitosis. Which of the following non-suppurative complications are of concern?
A. Sinusitis
B. Acute rheumatic fever alone
C. Acute glomerulonephritis alone
D. Acute rheumatic fever and acute glomerulonephritis
E. Scarlet fever alone
Show answer
Correct Answer: D
4. Which of the following statements about Group B streptococci (Streptococcus agalactiae) is not correct?
A. They are important causes of toxic strep syndrome.
B. They are frequent colonizers of the female genital tract.
C. Screening for this pathogen during pregnancy has reduced the incidence of neonatal sepsis.
D. These organisms are b-hemolytic.
E. They are important causes of urinary tract infections and bacteremia in elderly and diabetic adults.
Show answer
Correct Answer: A
5. Which of the following statements about the 23-valent pneumococcal vaccine is not correct?
A. It is a protein-conjugated, polysaccharide vaccine.
B. It is poorly immunogenic in young children and immunocompromised hosts.
C. It is routinely recommended for immune competent adults and children >2 yrs. of age at risk for serious pneumococcal disease.
D. It protects against the major serotypes of pneumococci causing infection.
E. An adult with asplenia would be a candidate for this vaccine.
Show answer
Correct Answer: A
6. What is the O antigen of Enterobacteriaceae?
A. Cell surface polysaccharide
B. A channel controlling substance taken into the organism.
C. A flagellar protein
D. A peptidoglycan matrix important for cellular rigidity
E. Cell wall lipopolysaccharide
Show answer
Correct Answer: E
7. All Enterobacteriaceae share all of the following characteristics EXCEPT:
A. Ferment glucose
B. Reduce nitrates to nitrites
C. Oxidase positive
D. Gram negative
E. Rod-shaped (bacilli)
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Correct Answer: C
8. Which of the following virulence factors of E. coli is important for attachment to host epithelial cells in the pathogenesis of urinary tract infections?
A. Aerobactin
B. Alpha hemolysin
C. Urease
D. K1 antigen
E. Pili
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Correct Answer: E
9. This urinary pathogen "swarms" across agar surfaces and may cause bladder and renal calculi (stones).
A. Citrobacter freundii
B. Enterobacter aerogenes
C. Serratia marcescens
D. Klebsiella oxytoca
E. Proteus mirabilis
Show answer
Correct Answer: E
10. Which of the following statements regarding Enterotoxigenic E. coli are CORRECT?
A. They are important causes of traveler's diarrhea.
B. Transmission occurs from ingestion of contaminated food and water.
C. Disease is caused by production of one or both of two types of enterotoxins.
D. None of the above are correct.
E. All of the above are correct.
Show answer
Correct Answer: E
11. R factors:
A. Are small plasmids which encode resistance to only one type of antibiotic
B. Contain plasmid elements (replication origins, incompatibility determinants, etc.) that were widespread in the pre-antibiotic era
C. Represent genetically engineered cloning vectors which have escaped into pathogenic bacteria
D. All of the above are correct
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Correct Answer: B
12. Movement of DNA from one bacteria to another through a tubular bridge or pilus:
A. Conjugation
B. Transposition
C. Transfection
D. Transduction
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Correct Answer: A
13. Which statement describing the potential advantages of DNA technologies over conventional culture-based methods is not true?
A. Greater stability of samples during transport
B. Potentially more sensitive detection
C. More complete and accurate determination of organism resistance to antibiotics
D. More rapid than culture
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Correct Answer: C
14. The polymerase chain reaction (PCR):
A. Has been adapted for accurate quantification of viruses
B. May yield false positive results when amplicons contaminate clinical samples
C. Offers detection sensitivity which often but not always exceeds that of culture
D. All of the above
Show answer
Correct Answer: D
15. Which of the following is not one of Koch's postulates?
A. The organism is regularly found in lesions of the disease
B. The organism can be isolated from diseased tissues in pure culture on artificial media
C. Inoculation of this pure culture produces a similar disease in experimental animals
D. Treatment of the disease with a broad spectrum oral antimicrobial dependably eradicates the organism and cures the disease
Show answer
Correct Answer: D
Thanx for the information.
hope these questions will be helpful in exam
thanks for nice questions for ICMR exam
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The following properties render a substance immunogenic:
A) high molecular weight
B) chemical complexity
C) sufficient stability and persistence after injection
D) All of the above.
E) All of the above are essential but not sufficient. -
The protection against smallpox afforded by prior infection with cowpox represents
A) antigenic specificity.
B) antigenic cross-reactivity.
C) enhanced viral uptake by macrophages.
D) innate immunity.
E) passive protection. -
Converting a toxin to a toxoid
A) makes the toxin more immunogenic.
B) reduces the pharmacologic activity of the toxin.
C) enhances binding with antitoxin.
D) induces only innate immunity.
E) increases phagocytosis. -
Haptens
A) require carrier molecules to be immunogenic.
B) react with specific antibodies when homologous carriers are not employed.
C) interact with specific antibody even if the hapten is monovalent.
D) cannot stimulate secondary antibody responses without carriers.
E) all of the above. -
An immunologic adjuvant is a substance that
A) reduces the toxicity of the immunogen.
B) enhances the immunogenicity of haptens.
C) enhances hematopoiesis.
D) enhances the immune response against the immunogen.
E) enchances immunologic cross-reactivity. -
An antibody made against the antigen tetanus toxoid (TT) reacts with it even when the TT is denatured by disrupting all disulfide bonds. Another antibody against TT fails to react when the TT is similarly denatured. The most likely explanation can be stated as follows:
A) The first antibody is specific for several epitopes expressed by TT.
B) The first antibody is specific for the primary amino acid sequence of TT, whereas the second is specific for conformational determinants.
C) The second antibody is specific for disulfide bonds.
D) The first antibody has a higher affinity for TT.
Answers To Review Questions
1. E All of the properties are essential but not sufficient, since, for immunogenicity, the substance must be foreign to the immunized individual.
2. B The protection against smallpox provided by prior infection with cowpox is an example of antigenic cross-reactivity. Immunization with cowpox leads to the production of antibodies capable of reacting with smallpox because the two viruses share several identical, or structurally similar, determinants.
3. B Conversion of a toxin to a toxoid is performed in order to reduce the pharmacologic activity of the toxin, so that sufficient toxoid can be injected to induce an immune response.
4. E Haptens are substances, usually of low molecular weight and univalent, that, by themselves, cannot induce immune responses (primary or secondary), but can do so if conjugated to high-molecular-weight carriers. The haptens can and do interact with the induced antibodies, without it being necessary that they be conjugated to the carrier.
5. D An immunologic adjuvant is a substance that, when mixed with an immunogen, enhances the immune response against that immunogen. It does not enhance cross-reactivity, nor does it enhance hematopoiesis. An adjuvant does not enhance the immune response against a hapten, which requires its conjugation to an immunogenic carrier to induce a response against the hapten. The adjuvant has no relevance to possible toxicity of an immunogen.
6. B Antibodies can recognize single epitopes formed by primary sequence structures or secondary, tertiary, and quaternary conformational structures. Denaturing a protein by disrupting disulfide bonds generally destroys conformational determinants. Therefore it is likely that the first antibody reacts with a primary amino acid sequence determinant that is present on both native and denatured TT, while the second antibody sees a conformational determinant only on native TT.
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Which of the following generally does not apply to bone marrow (a primary lymphoid organ) and secondary lymphoid organs?
A) cellular proliferation
B) differentiation of lymphocytes
C) cellular interaction
D) antigen-dependent response
E) None of the above. -
Which of the following apply uniquely to secondary lymphoid organs?
A) presence of precursor B and T cells
B) circulation of lymphocytes
C) terminal differentiation
D) cellular proliferation
E) All of the above. -
Which of the following does not apply to "innate" immune mechanisms?
A) absence of specificity
B) activation by a stimulus
C) involvement of multiple cell types
D) a memory component -
Which of the following is the major function of the lymphoid system?
A) innate immunity
B) inflammation
C) phagocytosis
D) acquired immunity
E) None of the above. -
Removal of the bursa of Fabricius from a chicken results in
A) a markedly decreased number of circulating T lymphocytes.
B) anemia.
C) delayed rejection of skin graft.
D) low serum levels of antibodies in serum.
E) all of the above.
F) none of the above. -
The germinal centers found in the cortical region of lymph nodes and the peripheral region of splenic periarteriolar lymphatic tissue
A) support the development of immature B and T cells.
B) function in the removal of damaged erythrocytes from the circulation.
C) act as the major source of stem cells and thus help to maintain hematopoiesis.
D) provide an infrastructure that on antigenic stimulation contains large populations of B lymphocytes and plasma cells.
E) are the sites of NK-cell differentiation. -
Which of the following is correct?
A) NK cells proliferate in response to antigen.
B) NK cells kill their target cells by phagocytosis and intracellular digestion.
C) NK cells are a subset of polymorphonuclear cells.
D) NK-cell killing is extracellular.
E) NK cells are particularly effective against certain bacteria.
Answers to Review Questions
1. D Cellular proliferation, differentiation of lymphocyte, and cellular interactions can take place in bone marrow (or bursa of Fabricius). However, antigen-dependent responses occur in the secondary lymphoid organs, such as the spleen and lymph nodes.
2. C Terminal differentiation of B cells into plasma cells occurs only in secondary lymphoid organs, such as the spleen and lymph nodes. Circulation of lymphocytes and cellular proliferation (but not antigen-dependent responses of terminal differentiation) also take place in the primary lymphoid organs, such as the bursa of Fabricius, or its equivalent, and the thymus. The bone marrow is the site where pluripotential stem cells differentiate into precursor B and T cells.
3. D Innate immunity has none of the antigenic specificity exhibited by acquired immunity. It is activated by such stimuli as the invasion of the foreign particles into the body. Innate immunity involves multiple cell types, such as those of the monocytic series (macrophages) and those of the granulocytic series (neutrophils, eosinophils, etc.).
4. D The major function of the lymphoid system is the recognition of foreign antigen by lymphocytes, which leads to the acquired immune response. Functions such as phagocytosis and inflammation do not necessarily require the lymphoid system, and they constitute part of innate immunity.
5. D Removal of the bursa of Fabricius from a chicken results in low levels of antibodies in serum, since this organ serves as a primary lymphoid organ in which B lymphocytes (which eventually synthesize and secrete antibodies) undergo maturation. The removal of the organ will not result in a marked decrease in the number of circulating T lymphocytes, nor will it result in anemia, characterized by a marked decrease in erythrocyte count, since erythrocytes undergo maturation outside the bursa. Bursectomy has no effect on rejection of skin grafts.
6. D On antigenic stimulation, the germinal centers contain large populations of B lymphocytes undergoing mitosis and plasma cells secreting antibodies. Virgin immunocompetent lymphocytes are developed in the primary lymphoid organs, not in the secondary lymphoid organs, such as the spleen and lymph nodes. Germinal centers do not participate in the removal of damaged erythrocytes, nor are they a source of stem cells; the latter are found in the bone marrow.
7. D NK cells are large granular lymphocytes. Their number does not increase in response to antigen. Their killing is extracellular, and their target cells are virus-infected cells or tumor cells. They are not particularly effective against bacterial cells.
List of infectious diseases in Humans
SOURCE OF DISEASE
Acinetobacter infections
Actinomyces israelii, Actinomyces gerencseriae and Propionibacterium propionicus
African sleeping sickness (African trypanosomiasis)
AIDS (Acquired immunodeficiency syndrome)
HIV (Human immunodeficiency virus)
Anaplasma genus
Arcanobacterium haemolyticum infection
Aspergillus genus
Astrovirus infection
Astroviridae family
Babesia genus
Bacillus cereus infection
multiple bacteria
Bacterial vaginosis (BV)
multiple bacteria
Bacteroides infection
Bacteroides genus
Baylisascaris infection
Baylisascaris genus
BK virus infection
Blastocystis hominis infection
Borrelia infection
Borrelia genus
Botulism (and Infant botulism)
Clostridium botulinum; Note: Botulism is not an infection by Clostridium botulinum but caused by the intake of botulinum toxin.
Brucella genus
Burkholderia infection
usually Burkholderia cepacia and other Burkholderia species
Calicivirus infection (Norovirus and Sapovirus)
Caliciviridae family
Campylobacter genus
Candidiasis (Moniliasis; Thrush)
usually Candida albicans and other Candida species
usually Group A Streptococcus and Staphylococcus
Chagas Disease (American trypanosomiasis)
Chlamydophila pneumoniae infection
usually Fonsecaea pedrosoi
Clostridium difficile infection
Coccidioides immitis and Coccidioides posadasii
Colorado tick fever (CTF)
Colorado tick fever virus (CTFV)
Common cold (Acute viral rhinopharyngitis; Acute coryza)
usually rhinoviruses and coronaviruses.
Creutzfeldt-Jakob disease (CJD)
CJD prion
Crimean-Congo hemorrhagic fever (CCHF)
Crimean-Congo hemorrhagic fever virus
Cryptosporidium genus
Cutaneous larva migrans (CLM)
usually Ancylostoma braziliense; multiple other parasites
Cytomegalovirus infection
Dengue viruses (DEN-1, DEN-2, DEN-3 and DEN-4) – Flaviviruses
Ebolavirus (EBOV)
Echinococcus genus
Ehrlichia genus
Enterobiasis (Pinworm infection)
Enterococcus infection
Enterococcus genus
Enterovirus infection
Enterovirus genus
Erythema infectiosum (Fifth disease)
Exanthem subitum (Sixth disease)
Human herpesvirus 6 (HHV-6) and Human herpesvirus 7 (HHV-7)
Fasciola hepatica and Fasciola gigantica
Fatal familial insomnia (FFI)
FFI prion
Filarioidea superfamily
Food poisoning by Clostridium perfringens
multiple
Fusobacterium infection
Fusobacterium genus
Gas gangrene (Clostridial myonecrosis)
usually Clostridium perfringens; other Clostridium species
Gerstmann-Sträussler-Scheinker syndrome (GSS)
GSS prion
Burkholderia mallei
Gnathostoma spinigerum and Gnathostoma hispidum
Granuloma inguinale (Donovanosis)
Group A streptococcal infection
Group B streptococcal infection
Haemophilus influenzae infection
Hand, foot and mouth disease (HFMD)
Enteroviruses, mainly Coxsackie A virus and Enterovirus 71 (EV71)
Hantavirus Pulmonary Syndrome (HPS)
Helicobacter pylori infection
Hemolytic-uremic syndrome (HUS)
Escherichia coli O157:H7, O111 and O104:H4
Hemorrhagic fever with renal syndrome (HFRS)
Bunyaviridae family
Herpes simplex virus 1 and 2 (HSV-1 and HSV-2)
Hookworm infection
Ancylostoma duodenale and Necator americanus
Human bocavirus infection
Human bocavirus (HBoV)
Human granulocytic anaplasmosis (HGA)
Human metapneumovirus infection
Human metapneumovirus (hMPV)
Human papillomavirus (HPV) infection
Human papillomavirus (HPV)
Human parainfluenza virus infection
Human parainfluenza viruses (HPIV)
Hymenolepis nana and Hymenolepis diminuta
Epstein-Barr Virus Infectious Mononucleosis (Mono)
Epstein-Barr Virus (EBV)
Influenza (flu)
Orthomyxoviridae family
unknown; evidence supports that it is infectious
multiple
Kingella kingae infection
Kuru prion
Lassa virus
Legionellosis (Legionnaires' disease)
Legionellosis (Pontiac fever)
Leishmania genus
Mycobacterium leprae and Mycobacterium lepromatosis
Leptospira genus
Lyme disease (Lyme borreliosis)
usually Borrelia burgdorferi and other Borrelia species
Lymphatic filariasis (Elephantiasis)
Wuchereria bancrofti and Brugia malayi
Lymphocytic choriomeningitis virus (LCMV)
Plasmodium genus
Marburg hemorrhagic fever (MHF)
Measles virus
Melioidosis (Whitmore's disease)
multiple
usually Metagonimus yokagawai
Microsporidia phylum
Molluscum contagiosum virus (MCV)
Murine typhus (Endemic typhus)
numerous species of bacteria (Actinomycetoma) and fungi (Eumycetoma)
parasitic dipterous fly larvae
Neonatal conjunctivitis (Ophthalmia neonatorum)
most commonly Chlamydia trachomatis and Neisseria gonorrhoeae
(New) Variant Creutzfeldt-Jakob disease (vCJD, nvCJD)
vCJD prion
usually Nocardia asteroides and other Nocardia species
Onchocerciasis (River blindness)
Paracoccidioidomycosis (South American blastomycosis)
usually Paragonimus westermani and other Paragonimus species
Pasteurella genus
Pediculosis capitis (Head lice)
Pediculosis corporis (Body lice)
Pediculosis pubis (Pubic lice, Crab lice)
Pelvic inflammatory disease (PID)
multiple
Pertussis (Whooping cough)
Pneumocystis pneumonia (PCP)
multiple
Prevotella infection
Prevotella genus
Primary amoebic meningoencephalitis (PAM)
usually Naegleria fowleri
Progressive multifocal leukoencephalopathy
Streptobacillus moniliformis and Spirillum minus
Respiratory syncytial virus infection
Respiratory syncytial virus (RSV)
Rhinovirus infection
Rickettsial infection
Rickettsia genus
Rift Valley fever (RVF)
Rift Valley fever virus
Rocky mountain spotted fever (RMSF)
Rotavirus infection
Salmonella genus
SARS (Severe Acute Respiratory Syndrome)
Schistosoma genus
multiple
Shigellosis (Bacillary dysentery)
Shigella genus
Smallpox (Variola)
Variola major or Variola minor
Staphylococcus genus
Staphylococcus genus
Taenia genus
Tetanus (Lockjaw)
Tinea barbae (Barber's itch)
usually Trichophyton genus
Tinea capitis (Ringworm of the Scalp)
usually Trichophyton tonsurans
Tinea corporis (Ringworm of the Body)
usually Trichophyton genus
Tinea cruris (Jock itch)
usually Epidermophyton floccosum, Trichophyton rubrum, and Trichophyton mentagrophytes
Tinea manuum (Ringworm of the Hand)
usually Hortaea werneckii
Tinea pedis (Athlete’s foot)
usually Trichophyton genus
Tinea unguium (Onychomycosis)
usually Trichophyton genus
Tinea versicolor (Pityriasis versicolor)
Malassezia genus
Toxocariasis (Ocular Larva Migrans (OLM))
Toxocara canis or Toxocara cati
Toxocariasis (Visceral Larva Migrans (VLM))
Toxocara canis or Toxocara cati
Trichuriasis (Whipworm infection)
usually Mycobacterium tuberculosis
Ureaplasma urealyticum infection
Venezuelan equine encephalitis
Venezuelan equine encephalitis virus
multiple viruses
White piedra (Tinea blanca)
Yersinia pseudotuberculosis infection
Mucorales order (Mucormycosis) and Entomophthorales order (Entomophthoramycosis)
Thanx alot for the questions.Can you please suggest some guideline to study the pathogenic diseases???I have come to know that the above mentioned portion covers a major part of question paper for icmr...
1. Major inventions
2. science branches
3. vaccines- diseases
4. diseases- their caustive agents