PHAR-6126-01 Medical Microbiology Chicago State University School of Pharmacy
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Free PHAR-6126-01 Medical Microbiology Chicago State University School of Pharmacy Questions
1.
Which of the following antibiotics is NOT an anti-metabolite?
- Quinolones
- Dapsone
- Trimethoprim
- Sulfonamides
Explanation
Explanation
Correct Answer: A) Quinolones
Quinolones are not anti-metabolites. They work by inhibiting bacterial DNA gyrase and topoisomerase IV, directly interfering with DNA replication — this is a nucleic acid synthesis inhibition mechanism, not antimetabolic activity.
Dapsone, Trimethoprim, and Sulfonamides are all true anti-metabolites. They interfere with folate synthesis at different enzymatic steps — sulfonamides and dapsone inhibit dihydropteroate synthase, while trimethoprim inhibits dihydrofolate reductase — ultimately starving bacteria of folate needed for nucleotide synthesis.
Correct Answer: A) Quinolones
Quinolones are not anti-metabolites. They work by inhibiting bacterial DNA gyrase and topoisomerase IV, directly interfering with DNA replication — this is a nucleic acid synthesis inhibition mechanism, not antimetabolic activity.
Dapsone, Trimethoprim, and Sulfonamides are all true anti-metabolites. They interfere with folate synthesis at different enzymatic steps — sulfonamides and dapsone inhibit dihydropteroate synthase, while trimethoprim inhibits dihydrofolate reductase — ultimately starving bacteria of folate needed for nucleotide synthesis.
2.
Which of the following bacteria causes disease by penetrating and replicating in cells lining the colon?
- Shigella
- Klebsiella
- Salmonella
- Yersinia
Explanation
Explanation
Correct Answer: A) Shigella
Shigella is the classic example of an enteroinvasive pathogen that causes disease specifically by invading and replicating within the epithelial cells lining the colon. It penetrates the colonic mucosa, escapes the phagosome, replicates in the cytoplasm, and spreads cell-to-cell using actin-based motility, triggering intense inflammation and causing bloody dysentery.
Klebsiella does not invade colonic epithelium and primarily causes pneumonia and urinary tract infections. Salmonella invades small intestinal epithelium (not the colon specifically) and is transported to deeper tissues. Yersinia invades Peyer's patches in the terminal ileum, not the colon.
Correct Answer: A) Shigella
Shigella is the classic example of an enteroinvasive pathogen that causes disease specifically by invading and replicating within the epithelial cells lining the colon. It penetrates the colonic mucosa, escapes the phagosome, replicates in the cytoplasm, and spreads cell-to-cell using actin-based motility, triggering intense inflammation and causing bloody dysentery.
Klebsiella does not invade colonic epithelium and primarily causes pneumonia and urinary tract infections. Salmonella invades small intestinal epithelium (not the colon specifically) and is transported to deeper tissues. Yersinia invades Peyer's patches in the terminal ileum, not the colon.
3.
Which of the following is atypical bacteria?
- Staph
- Mycobacteria
- Chlamydia
- Strep
- Nocardia
Explanation
Explanation
Correct Answer: C) Chlamydia
Chlamydia is the classic example of an atypical bacterium. It is an obligate intracellular pathogen that cannot synthesize its own ATP (energy parasite), does not Gram stain reliably, cannot be cultured on standard bacteriological media, and has a unique biphasic life cycle (elementary body and reticulate body). These features place it firmly in the "atypical" category alongside Mycoplasma and Rickettsia.
Staph and Strep are typical gram-positive cocci that culture readily on standard media. Mycobacteria, while having an unusual waxy cell wall, are classified separately as acid-fast bacteria, not atypical in the same clinical sense. Nocardia is a gram-positive filamentous bacterium, also not classified as atypical.
Correct Answer: C) Chlamydia
Chlamydia is the classic example of an atypical bacterium. It is an obligate intracellular pathogen that cannot synthesize its own ATP (energy parasite), does not Gram stain reliably, cannot be cultured on standard bacteriological media, and has a unique biphasic life cycle (elementary body and reticulate body). These features place it firmly in the "atypical" category alongside Mycoplasma and Rickettsia.
Staph and Strep are typical gram-positive cocci that culture readily on standard media. Mycobacteria, while having an unusual waxy cell wall, are classified separately as acid-fast bacteria, not atypical in the same clinical sense. Nocardia is a gram-positive filamentous bacterium, also not classified as atypical.
4.
The following bacteria escape phagocytosis by resistance to lysosomal enzymes EXCEPT:
- Ehrlichia
- Legionella
- Chlamydia
- Salmonella
- Coxiella
Explanation
Explanation
Correct Answer: D) Salmonella
Salmonella does not escape phagocytosis specifically by resisting lysosomal enzymes. Instead, Salmonella survives inside macrophages by preventing phagosome-lysosome fusion using its Salmonella Pathogenicity Islands (SPI) — a different mechanism from lysosomal enzyme resistance.
Ehrlichia, Legionella, Chlamydia, and Coxiella all survive intracellularly by actively resisting or evading lysosomal degradation — either by preventing phagolysosome formation or by being inherently resistant to lysosomal enzyme activity — making them true examples of lysosomal enzyme-resistant intracellular pathogens.
Correct Answer: D) Salmonella
Salmonella does not escape phagocytosis specifically by resisting lysosomal enzymes. Instead, Salmonella survives inside macrophages by preventing phagosome-lysosome fusion using its Salmonella Pathogenicity Islands (SPI) — a different mechanism from lysosomal enzyme resistance.
Ehrlichia, Legionella, Chlamydia, and Coxiella all survive intracellularly by actively resisting or evading lysosomal degradation — either by preventing phagolysosome formation or by being inherently resistant to lysosomal enzyme activity — making them true examples of lysosomal enzyme-resistant intracellular pathogens.
5.
Which of the following statements is TRUE for STDs?
- Rates are rapidly declining
- Use of Viagra has helped
- The incidence is a tip of the iceberg
- Highest rates are in white males
- All of the above are correct
Explanation
Explanation
Correct Answer: C) The incidence is a tip of the iceberg
STD incidence being described as "a tip of the iceberg" is a well-recognized public health truth — the majority of STD cases go undiagnosed, unreported, or asymptomatic, meaning the true burden of infection in the population is far greater than reported numbers suggest.
STD rates have not been rapidly declining — globally and in the U.S. they have been rising. The use of Viagra (sildenafil) has actually been associated with increased STD transmission due to increased sexual activity among older populations. The highest STD rates are not in white males — epidemiological data consistently shows disproportionately higher rates among Black and Hispanic populations and young people.
Correct Answer: C) The incidence is a tip of the iceberg
STD incidence being described as "a tip of the iceberg" is a well-recognized public health truth — the majority of STD cases go undiagnosed, unreported, or asymptomatic, meaning the true burden of infection in the population is far greater than reported numbers suggest.
STD rates have not been rapidly declining — globally and in the U.S. they have been rising. The use of Viagra (sildenafil) has actually been associated with increased STD transmission due to increased sexual activity among older populations. The highest STD rates are not in white males — epidemiological data consistently shows disproportionately higher rates among Black and Hispanic populations and young people.
6.
Laboratory diagnosis of syphilis includes which of the following?
- VDRL
- Darkfield microscopy
- TRUST
- Direct fluorescent antibody (DFA-TP)
- All of the above are correct
Explanation
Explanation
Correct Answer: E) All of the above are correct
Syphilis caused by Treponema pallidum is diagnosed through a combination of methods. VDRL (Venereal Disease Research Laboratory) and TRUST (Toluidine Red Unheated Serum Test) are both non-treponemal serological tests used for screening and monitoring treatment response. Darkfield microscopy allows direct visualization of the motile spirochetes from chancre exudate and is the gold standard for primary syphilis diagnosis. DFA-TP (Direct Fluorescent Antibody – T. pallidum) is a treponemal-specific test used to directly identify the organism in lesion specimens.
All four methods are established and recognized laboratory diagnostic tools for syphilis, making E the correct and complete answer.
Correct Answer: E) All of the above are correct
Syphilis caused by Treponema pallidum is diagnosed through a combination of methods. VDRL (Venereal Disease Research Laboratory) and TRUST (Toluidine Red Unheated Serum Test) are both non-treponemal serological tests used for screening and monitoring treatment response. Darkfield microscopy allows direct visualization of the motile spirochetes from chancre exudate and is the gold standard for primary syphilis diagnosis. DFA-TP (Direct Fluorescent Antibody – T. pallidum) is a treponemal-specific test used to directly identify the organism in lesion specimens.
All four methods are established and recognized laboratory diagnostic tools for syphilis, making E the correct and complete answer.
7.
Which of the following is/are NOT gram-negative rods?
- Nocardia
- Klebsiella
- Pseudomonas
- Proteus
- E. coli
Explanation
Explanation
Correct Answer: A) Nocardia
Nocardia is not a gram-negative rod. It is a gram-positive, filamentous, branching bacterium belonging to the Actinobacteria group. It is weakly acid-fast and has a fungi-like appearance, as covered in earlier questions.
Klebsiella, Pseudomonas, Proteus, and E. coli are all classic gram-negative rods (bacilli) and are important members of the Enterobacteriaceae or non-fermenting gram-negative rod families.
Correct Answer: A) Nocardia
Nocardia is not a gram-negative rod. It is a gram-positive, filamentous, branching bacterium belonging to the Actinobacteria group. It is weakly acid-fast and has a fungi-like appearance, as covered in earlier questions.
Klebsiella, Pseudomonas, Proteus, and E. coli are all classic gram-negative rods (bacilli) and are important members of the Enterobacteriaceae or non-fermenting gram-negative rod families.
8.
Which patients are NOT at greatest risk for H. influenzae-caused disease?
- Have had FLU vaccine
- Having inadequate levels of protective antibodies
- Having depleted complement
- Undergone splenectomy
Explanation
Explanation
Correct Answer: A) Have had FLU vaccine
Patients who have received the Hib (Haemophilus influenzae type b) vaccine are NOT at greatest risk — they are protected. It is important to note that the flu (influenza) vaccine does not protect against H. influenzae, but the Hib vaccine specifically does. The question implies prior vaccination as a protective factor, placing this group at lowest risk.
Patients with inadequate protective antibodies, depleted complement, and those who have undergone splenectomy are all at significantly increased risk. H. influenzae is an encapsulated organism, and the body's primary defense against encapsulated bacteria relies on opsonization via antibodies and complement, and clearance by the spleen — deficiency in any of these leaves the patient highly vulnerable to invasive disease.
Correct Answer: A) Have had FLU vaccine
Patients who have received the Hib (Haemophilus influenzae type b) vaccine are NOT at greatest risk — they are protected. It is important to note that the flu (influenza) vaccine does not protect against H. influenzae, but the Hib vaccine specifically does. The question implies prior vaccination as a protective factor, placing this group at lowest risk.
Patients with inadequate protective antibodies, depleted complement, and those who have undergone splenectomy are all at significantly increased risk. H. influenzae is an encapsulated organism, and the body's primary defense against encapsulated bacteria relies on opsonization via antibodies and complement, and clearance by the spleen — deficiency in any of these leaves the patient highly vulnerable to invasive disease.
9.
Bioterrorism causes death of the following:
- People
- Animals
- Plants
- A and B are correct
- A, B, and C are correct
Explanation
Explanation
Correct Answer: E) A, B, and C are correct
Bioterrorism is defined as the deliberate release of biological agents — including bacteria, viruses, or toxins — to cause harm. Its targets are not limited to humans alone. Bioterrorism agents can be specifically weaponized to kill people (e.g., anthrax, smallpox), animals (e.g., foot-and-mouth disease, anthrax in livestock), and plants (e.g., wheat rust, rice blast fungus used as agro-bioterrorism). Attacks on animals and crops are sometimes called "agrobioterrorism" and can devastate food security and economies.
All three categories are recognized targets, making E the most complete and correct answer.
Correct Answer: E) A, B, and C are correct
Bioterrorism is defined as the deliberate release of biological agents — including bacteria, viruses, or toxins — to cause harm. Its targets are not limited to humans alone. Bioterrorism agents can be specifically weaponized to kill people (e.g., anthrax, smallpox), animals (e.g., foot-and-mouth disease, anthrax in livestock), and plants (e.g., wheat rust, rice blast fungus used as agro-bioterrorism). Attacks on animals and crops are sometimes called "agrobioterrorism" and can devastate food security and economies.
All three categories are recognized targets, making E the most complete and correct answer.
10.
Select the INCORRECT statement about mycobacterial cell wall:
- Lipids, glycolipids, and peptide-glycolipids are present
- Transport protein and porins constitute 15% of the weight
- There is no outer membrane
- Basic structure is typical of gram-negative bacteria
- Lipid components comprise 60% of the weight
Explanation
Explanation
Correct Answer: D) Basic structure is typical of gram-negative bacteria
This statement is incorrect. The mycobacterial cell wall is unique and does not follow a typical gram-negative pattern. While mycobacteria do not stain well with the Gram stain and have a complex outer layer, their cell wall architecture — built around a peptidoglycan core covalently linked to arabinogalactan and an outer layer of mycolic acids — is distinctly different from gram-negative bacteria and constitutes its own structural category.
The other statements are correct: the mycobacterial cell wall is rich in lipids, glycolipids, and peptide-glycolipids; transport proteins and porins do constitute a smaller fraction of wall weight; there is no classical outer membrane like in gram-negatives; and the extraordinarily high lipid content (approximately 60% of cell wall weight), primarily mycolic acids, accounts for mycobacteria's acid-fastness, impermeability, and resistance to many antibiotics.
Correct Answer: D) Basic structure is typical of gram-negative bacteria
This statement is incorrect. The mycobacterial cell wall is unique and does not follow a typical gram-negative pattern. While mycobacteria do not stain well with the Gram stain and have a complex outer layer, their cell wall architecture — built around a peptidoglycan core covalently linked to arabinogalactan and an outer layer of mycolic acids — is distinctly different from gram-negative bacteria and constitutes its own structural category.
The other statements are correct: the mycobacterial cell wall is rich in lipids, glycolipids, and peptide-glycolipids; transport proteins and porins do constitute a smaller fraction of wall weight; there is no classical outer membrane like in gram-negatives; and the extraordinarily high lipid content (approximately 60% of cell wall weight), primarily mycolic acids, accounts for mycobacteria's acid-fastness, impermeability, and resistance to many antibiotics.
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