FINAL EXAMINATION

SEPTEMBER 2017 SEMESTER

COURSE : CLINICAL MICROBIOLOGY

COURSE CODE : MLS 3233
DURATION : 2 HOURS 30 MINUTES
FACULTY : ENGINEERING AND LIFE SCIENCES
DEPARTMENT : HEALTH SCIENCES
PROGRAMME : BACHELOR IN MEDICAL LABORATORY SCIENCE
(HONS) – HS402 & HS403
LECTURER : MDM. NORHATIAH BINTI MD. LIAS

INSTRUCTIONS TO CANDIDATES

This paper consists of three (3) sections:

Section A – 20 questions (objective questions)

Section B – 5 questions (short answer questions)
Section C – 3 questions (essay questions)

Answer all questions in Section A and B and two questions in Section C.

All answers of:

Section A must be written in OMR objective paper provided.

Section Band Section C must be written in answer booklet provided.
The answer for each question must start on a new page.

Candidates are NOT ALLOWED to bring any unauthorized items into the exam
hall except with the permission of your invigilator.

Do Not Open the Question Paper Until Instructed

This Question Paper Consists of Seven (7) Printed Pages

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SECTION A: OBJECTIVE QUESTIONS (20 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. How are the non-coagulase staphylococcal identified?

(A) catalase test

(B) mannose fermentation
(C) grow on salt tolerance agar
(D) susceptibility to novobiocin

2. Beta-hemolytic streptococci is responsible for

(A) meningitis
(B) pneumoniae
(C) scalded skin syndrome
(D) streptococcal pharyngitis

3. An encapsulated bacterium can be virulent because the capsule

(A) act as endotoxin

(B) resists phagocytosis
(C) interferes cell metabolism
(D) secrete enzymes degrading tissue

4. The most common bacteria cause urinary tract infection (UTI) is

(A) Escherichia coli

(B) Proteus mirabilis
(C) Klebsiella pneumoniae
(D) Staphylococcus saprophyticus

5. Neurotoxin is responsible for symptoms caused by

(A) Bacillus anthracis

(B) Clostridium tetani
(C) Listeria monocytogenes
(D) Corynebacterium diphtheriae

6. A microscopic examination of patient’s sputum reveals Gram-positive cocci and

appears alpha hemolysis on blood agar. Which of the following is the
recommended step for further identification?

(A) catalase test

(B) Lancefield grouping
(C) optochin sensitivity test
(D) pyrrolidonyl aminopeptidase (PYR) test
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7. Group A and Group B streptococci can be distinguished by susceptibility test of

antibiotic

(A) optochin
(B) bacitracin
(C) novobiocin
(D) streptomycin

8. Laboratory diagnosis for invasive or intracellular pathogen is mostly rely on

(A) biochemical test

(B) bacteria isolation
(C) molecular identification
(D) histopathology observation

9. A useful test to identify Enterobactericea is

(A) serology test

(B) biochemical test
(C) microscopic examination
(D) antimicrobial susceptibility test

10. Microscopic examination of a patient’s blood culture shows very small Gram
negative coccobacilli bacteria. These bacteria require X and V factor to grow in
CO2 incubator. The most likely bacteria isolated is

(A) Haemophilus ducreyi

(B) Campylobacter jejuni
(C) Haemophilus influenza
(D) Haemophilus parainfluenzae

11. A patient with nausea, vomiting and diarrhea within 5 hours after eating most
likely has

(A) cholera
(B) shigellosis
(C) Escherichia coli gastroenteritis
(D) staphylococcal food poisoning

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12. Choose the MISMATCHED pair of selective medium and the respective
bacteria.

Medium Bacteria
(A) Thiosulfate-citrate-bile salts-sucrose Vibrio cholera
(B) Buffered charcoal yeast extract Legionella pneumophila
(C) Thayer Martin chocolate agar Haemophilus influenzae
(D) Ashdown/Francis medium Bukholderia pseudomalleI

13. Which of the following statement is TRUE about influenza (flu)?

(A) Influenza is caused by corona virus family.

(B) Infection cause colds and severe acute respiratory syndrome (SARS).
(C) Vaccines are not available for older adults and other high-risk groups.
(D) Antigenic variation and genetic exchange lead to the appearance of new
strains.

14. The following pathogens cause urogenital infection EXCEPT

(A) Toxoplasma gondii

(B) Trichomonas vaginalis
(C) Chlamydia trachomatis
(D) Mycoplasma genitalium

15. Serology tests are useful for diagnosis of

I. syphilis
II. gonorrhea
III. leptospirosis
IV. Lyme disease

(A) I, II and III

(B) I, II and IV
(C) I, III and IV
(D) I, II, III and IV

16. Mycobacterium leprae is different from M. tuberculosis due to

I. bacteria culture
II. acid fast staining
III. mode of transmission
IV. clinical manifestation

(A) I and II
(B) I and III
(C) I and IV
(D) III and IV
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17. Which of the following are cancer-causing viruses?

I. Hepatitis virus
II. Epstein-Barr virus
III. Human papilloma virus
IV. Herpes simplex virus 1 (HSV-1)

(A) I, II and III

(B) I, II and IV
(C) I, III and IV
(D) I, II, III and IV

18. A patient presents with hemorrhagic fever, headache, malaise and joint pain. NS 1
antigen and Ig M were detected in his blood. What is your diagnosis?

(A) relapsing fever

(B) dengue virus fever
(C) Japanese encephalitis
(D) chikungunya virus fever

19. Which of the following diseases are common in acquired immunodeficiency

syndrome (AIDS) patient?

I. Malaria
II. Candidiasis
III. Pneumocystis
IV. Cryptosporidiosis
(A) I, II and III
(B) I, II and IV
(C) II, III and IV
(D) I, II, III and IV

20. Which of the following helminth cause gastrointestinal disease?

I. Brugia malayi
II. Taenia saginata
III. Fasciola hepatica
IV. Ascaris lumbricoides
(A) I and II
(B) I and III
(C) II and IV
(D) III and IV

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SECTION B: SHORT ANSWER QUESTIONS (40 MARKS)

ANSWER ALL QUESTIONS

1. Outline an appropriately specimen collection for laboratory diagnostic test.

(7 Marks)

2. Briefly explain the mechanism of pathogenic bacteria to overcome the host

resistance and immunity. (6 Marks)

3. Stool sampel Z : watery diarrhea with rice water stool appearance

Figure 1

a. Name the most likely pathogen isolated from stool sample Z in figure 1.
(1 Marks)

b. Outline the process of stool sample Z in figure 1 for laboratory diagnosis.

(4 Marks)

c. Provide TWO (2) other pathogens that can cause bacterial gastroenteritis.
(2 Marks)

4. Briefly describe disease caused by Mycobacterium tuberculosis and the method

of bacteria identification. (10 Marks)

5. Define the following term provided with an example:

i. Prion disease
ii. Latent infection
iii. Nosocomial infection
iv. Sexual transmitted disease
v. Multiple drug resistance organism

(10 Marks)

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SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question 1

Describe major pathogens causing bacterial meningitis with their laboratory diagnosis
provided.
(20 Marks)

Question 2

Distinguish between blood and urine sample processing for laboratory diagnosis of
clinically relevant bacteria.
(20 Marks)

Question 3

Discuss the pathogens causing pneumonia included their clinical manifestation,

pathogenicity, and laboratory diagnosis.
(20 Marks)

END OF QUESTION PAPER

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