Naegler's reaction is due to:
Disruption of which of the following oropharyngeal commensals predisposes to candidiasis?
Primary complex of M bovis involves:
Brill-Zinsser disease is a recrudescent form of which infection?
Listeria escapes from phagosomes (phagolysosomes) due to:
Which bacteria can grow even in the presence of antiseptics?
A chronic alcoholic is presenting with clinical features of meningitis. Most likely organism to grow on CSF culture:
Bartonella quintana causes:
Which immunoglobulin does Protein A of Staphylococcus aureus bind to?
Which type of DNase produced by Streptococcus is known to be the most antigenic in humans?
NEET-PG 2015 - Microbiology NEET-PG Practice Questions and MCQs
Question 61: Naegler's reaction is due to:
- A. Lecithinase (Correct Answer)
- B. Coagulase
- C. Hyaluronidase
- D. None of the options
Explanation: ***Lecithinase*** - The **Naegler reaction** is a bacterial identification test used to detect the production of **lecithinase** (also known as alpha-toxin) by certain bacteria, particularly *Clostridium perfringens*. - This enzyme hydrolyzes **lecithin** (a lipid found in egg yolk), resulting in a visible opaque precipitate around the bacterial colonies on egg yolk agar. *Coagulase* - **Coagulase** is an enzyme produced by some bacteria (e.g., *Staphylococcus aureus*) that causes the coagulation of blood plasma. - While it is an important virulence factor, it is not involved in the **Naegler reaction**. *Hyaluronidase* - **Hyaluronidase** is an enzyme that breaks down **hyaluronic acid**, a component of connective tissue, facilitating the spread of bacteria. - It is often referred to as a **spreading factor** but is not detected by the **Naegler reaction**. *None of the options* - This option is incorrect because **Lecithinase** is directly responsible for the **Naegler reaction**.
Question 62: Disruption of which of the following oropharyngeal commensals predisposes to candidiasis?
- A. Staphylococcus
- B. Streptococcus (Correct Answer)
- C. Lactobacillus
- D. Haemophilus influenzae
Explanation: ***Streptococcus*** - **Streptococcus** species, particularly *S. sanguinis* and *S. mitis*, are major commensals in the oral cavity that **inhibit the growth of *Candida albicans*** through competition for nutrients and production of antimicrobial substances. - Disruption of this normal **streptococcal flora**, often by broad-spectrum antibiotics, creates an environment where *Candida albicans* can proliferate, leading to candidiasis. *Staphylococcus* - **Staphylococcus** species are primarily skin and nasal commensals; while *S. aureus* can be found in the oral cavity, it is not a primary competitor against *Candida* in the same way as streptococci. - Their presence or absence is not typically a direct predisposing factor for oral candidiasis compared to the dominant streptococcal flora. *Lactobacillus* - **Lactobacillus** species are common in the gastrointestinal tract and vagina, where they maintain an acidic environment that inhibits pathogen growth; however, they are less dominant in the oropharynx as a defense against *Candida*. - While beneficial for overall host health, their disruption in the oral cavity does not typically precipitate candidiasis as directly as that of the **streptococcal flora**. *Hemophilus influenzae* - *Haemophilus influenzae* is a common inhabitant of the **upper respiratory tract** and can be an opportunistic pathogen, but it is not known to have a significant role in directly inhibiting *Candida* growth in the oropharynx. - Its presence or absence in the commensal flora in the oral cavity does not typically influence the development of candidiasis.
Question 63: Primary complex of M bovis involves:
- A. Tonsil and skin
- B. Tonsil and intestine (Correct Answer)
- C. Tonsil and lung
- D. Skin and Intestine
Explanation: ***Tonsil and intestine*** - *Mycobacterium bovis* is primarily transmitted through **consumption of contaminated milk and dairy products**, making the **alimentary tract** the main route of infection - The primary complex (Ghon complex) involves the **initial site of infection plus regional lymph nodes** - In alimentary tuberculosis, the organisms enter through the **intestinal mucosa** (Peyer's patches) or **tonsillar tissue**, creating foci with associated mesenteric or cervical lymphadenopathy - Both tonsils and intestines are part of the **alimentary system**, representing the typical primary complex for M. bovis in humans *Tonsil and lung* - This incorrectly combines **two different routes of entry** (alimentary and respiratory) - A primary complex involves a **single portal of entry**, not multiple unrelated organ systems - While M. bovis can rarely cause pulmonary TB through inhalation, this would create a separate lung + hilar node complex, not a combined tonsil-lung complex *Tonsil and skin* - **Skin involvement** requires direct inoculation through cuts or abrasions and does not form a primary complex with tonsillar infection - These represent different portals of entry and would not occur together as a primary complex *Skin and Intestine* - **Skin infection** by M. bovis is rare and requires occupational exposure with direct inoculation (e.g., veterinarians, butchers) - This incorrectly pairs two different routes of infection that would not form a single primary complex
Question 64: Brill-Zinsser disease is a recrudescent form of which infection?
- A. Recrudescence of R prowazekii infection (Correct Answer)
- B. Recrudescence of R typhi infection
- C. None of the options
- D. Recrudescence of Coxiella burnetii infection
Explanation: **Recrudescence of R prowazekii infection** - Brill-Zinsser disease is a **late-onset complication** of **epidemic typhus**, caused by *Rickettsia prowazekii*. - It occurs years after the initial infection, due to **reactivation of dormant bacteria** in the body. *Recrudescence of R typhi infection* - *Rickettsia typhi* causes **murine typhus**, but its recrudescent form is not referred to as Brill-Zinsser disease. - Murine typhus is typically a **milder disease** compared to epidemic typhus. *Recrudescence of Coxiella burnetii infection* - *Coxiella burnetii* causes **Q fever**, which can have a chronic form but is not a recrudescence of a typhus infection. - Q fever presents with different clinical manifestations, such as **endocarditis** or **hepatitis**, not typically a rash or neurological symptoms seen in typhus. *None of the options* - This option is incorrect because the specific recrudescent form described in the question clearly points to *Rickettsia prowazekii*.
Question 65: Listeria escapes from phagosomes (phagolysosomes) due to:
- A. Opacity associated protein (OAP)
- B. Caspases
- C. Cell membrane adhesion molecules
- D. beta-hemolysin (Correct Answer)
Explanation: ***beta-hemolysin*** - *Listeria monocytogenes* produces **listeriolysin O (LLO)**, a **beta-hemolysin**, which is a pore-forming toxin that lyses the phagosomal membrane. - This allows the bacteria to escape into the host cell cytoplasm, thus **avoiding destruction** by lysosomal enzymes and neutralizing the microbicidal environment. *Caspases* - **Caspases** are a family of proteases that play essential roles in programmed cell death (apoptosis) and inflammation. - While bacteria can manipulate host cell apoptosis, caspases themselves are **host enzymes** and do not directly confer resistance to phagosome destruction. *Cell membrane adhesion molecules* - **Adhesion molecules** facilitate bacterial attachment to host cells and internalisation, but they do not directly provide a mechanism for **escaping the phagosome** once internalised. - Examples include internalins, which are involved in bacterial entry into cells. *Opacity associated protein (OAP)* - **Opacity associated proteins (OAPs)** are primarily associated with *Neisseria gonorrhoeae* and are involved in adherence to host cells and evasion of the immune response. - They are not a mechanism for **phagosomal escape** or directly related to *Listeria's* intracellular survival.
Question 66: Which bacteria can grow even in the presence of antiseptics?
- A. Staphylococcus
- B. Streptococcus
- C. E. coli
- D. Pseudomonas (Correct Answer)
Explanation: ***Pseudomonas*** - **Pseudomonas aeruginosa** is unique among common bacteria in its ability to not just survive but actually **grow in the presence of antiseptics**. - It can multiply in **quaternary ammonium compounds**, **chlorhexidine solutions**, and even **distilled water** due to minimal nutritional requirements. - Resistance mechanisms include **efflux pumps**, **biofilm formation**, and **low outer membrane permeability** that exclude many antiseptic agents. - This characteristic makes it a notorious cause of **hospital-acquired infections** and contaminant of disinfectant solutions. *Staphylococcus* - While some strains like **MRSA (methicillin-resistant Staphylococcus aureus)** are resistant to many antibiotics, they are generally **susceptible to common antiseptics**. - Standard antiseptics like alcohols, iodophors, and chlorhexidine effectively kill Staphylococcus species. *Streptococcus* - **Streptococcus species** are generally **susceptible to most common antiseptics and disinfectants**. - They are known for causing infections like strep throat and cellulitis but do not exhibit antiseptic resistance. *E. coli* - **Escherichia coli** is typically **susceptible to standard antiseptic agents**. - While some strains can be antibiotic-resistant, their resistance mechanisms do not generally extend to antiseptics, unlike **Pseudomonas**.
Question 67: A chronic alcoholic is presenting with clinical features of meningitis. Most likely organism to grow on CSF culture:
- A. Streptococcus pneumoniae (Correct Answer)
- B. Neisseria meningitidis
- C. Escherichia coli
- D. Listeria monocytogenes
Explanation: ***Streptococcus pneumoniae*** - **Chronic alcoholism** is a significant risk factor for **pneumococcal infections**, including meningitis, due to impaired immune function. - **S. pneumoniae** is the most common cause of **bacterial meningitis** in adults, especially in those with underlying conditions like alcoholism. *Neisseria meningitidis* - While a common cause of meningitis, especially in **young adults** and crowded settings, it is not specifically associated with chronic alcoholism as a primary risk factor like *S. pneumoniae*. - **Meningococcal meningitis** often presents with a **petechial rash**, which is not mentioned in the clinical scenario. *Escherichia coli* - **E. coli meningitis** primarily affects **neonates** and **elderly** or immunocompromised individuals, usually associated with healthcare-acquired infections. - It is not a typical cause of community-acquired meningitis in an otherwise healthy adult alcoholic. *Listeria monocytogenes* - **Listeria monocytogenes** is a known cause of meningitis in **immunocompromised individuals**, **neonates**, and **elderly** people, often linked to contaminated food. - While chronic alcoholism does impair immunity, *S. pneumoniae* is a more frequently encountered pathogen in this specific population for meningitis.
Question 68: Bartonella quintana causes:
- A. Trench fever (Correct Answer)
- B. Scrub typhus
- C. Epidemic typhus
- D. Endemic typhus
Explanation: ***Trench fever*** - **Bartonella quintana** is the causative agent of **trench fever**, a louse-borne disease historically common during wartime. - Symptoms include **recurrent fevers**, headache, bone pain (especially in the shins), and rash. *Scrub typhus* - Scrub typhus is caused by **Orientia tsutsugamushi**, a rickettsial bacterium, not Bartonella. - It is transmitted by **chiggers** and characterized by a rash, fever, and eschar at the bite site. *Epidemic typhus* - Epidemic typhus is caused by **Rickettsia prowazekii** and is also louse-borne. - It presents with sudden high fever, severe headache, and a maculopapular rash that spares the face, palms, and soles. *Endemic typhus* - Endemic typhus (murine typhus) is caused by **Rickettsia typhi** and is transmitted by **rat fleas**. - Its symptoms are generally milder than epidemic typhus, including fever, headache, and a truncal rash.
Question 69: Which immunoglobulin does Protein A of Staphylococcus aureus bind to?
- A. IgA
- B. IgG (Correct Answer)
- C. IgD
- D. IgE
Explanation: ***IgG*** - **Protein A** of *Staphylococcus aureus* binds to the **Fc region** of IgG antibodies. - This binding mechanism helps *S. aureus* in **evading opsonization** and phagocytosis by interfering with the host immune response. *IgA* - IgA is primarily found in **mucosal secretions** and its primary role is in mucosal immunity. - Protein A does not preferentially bind to IgA; instead, some bacteria produce specific **IgA proteases** to cleave and inactivate IgA. *IgD* - IgD is found mostly on the surface of **B lymphocytes** and its main role is in B cell activation. - Protein A does not have a significant binding affinity for IgD. *IgE* - IgE is involved in **allergic reactions** and defense against parasites. - Protein A does not bind to IgE; binding to IgE is typically mediated by specific IgE receptors on mast cells and basophils.
Question 70: Which type of DNase produced by Streptococcus is known to be the most antigenic in humans?
- A. DNase C
- B. DNase D
- C. DNase A
- D. DNase B (Correct Answer)
Explanation: ***DNase B*** - **DNase B** is the most **antigenic** of the four DNases (A, B, C, D) produced by *Streptococcus pyogenes*. - Antibodies against DNase B are commonly measured as anti-DNase B titers in the diagnosis of **streptococcal infections** and their sequelae, like **acute rheumatic fever** and **post-streptococcal glomerulonephritis**, especially when ASO titers are negative. *DNase A* - While *Streptococcus pyogenes* produces **DNase A**, it is not considered the most antigenically potent or clinically relevant for antibody testing in humans. - Its antigenicity is generally **lower** than that of DNase B in response to streptococcal infection. *DNase C* - **DNase C** is another deoxyribonuclease produced by *Streptococcus pyogenes*. - Similar to DNase A, it does not elicit as strong or as consistent an **antibody response** in human infections compared to DNase B. *DNase D* - **DNase D** is the fourth type of deoxyribonuclease produced by *Streptococcus pyogenes*. - Its **antigenicity** in humans is less pronounced and less diagnostically significant than that of **DNase B**.