n Am I B I A U n IVE RS ITV OF SCIEnCE AnD TECH n 0 LOGY FACULTY OF HEALTH AND APPLIED SCIENCES DEPARTMENT OF HEALTH SCIENCES QUALIFICATION: BACHELOR OF BIOMEDICAL SCIENCES QUALIFICATION CODE: SOBBMS LEVEL: 7 COURSE CODE: MMB220S COURSE NAME: MEDICAL MICROBIOLOGY 2 SESSION: November 2016 PAPER: THEORY DURATION: 3 HOURS MARKS: 130 FIRST OPPORTUNITY EXAMINATION PAPER EXAMINER(S) Mrs Fredrika Engelbrecht MODERATOR: Mr Munyaradzi Mukesi INSTRUCTIONS 1. Answer ALL the questions. 2. Write clearly and neatly. 3. Number the answers clearly. THIS QUESTION PAPER CONSISTS OF 5 PAGES (Including this front page)
SECTION A (30) QUESTION 1 [10] Assess the following statements and decide whether they are true or false. Write only the number of the question and next to it TRUE for a true statement and FALSE for a false statement, and give a reason for calling a statement FALSE. 1.1 The presence of lgm antibodies may indicate that it is an active or ("new"} 1.2 Pseudomembrane colitis is associated with the organism Clostridium perfringens. 1.3 Synergy is the utilisation of a combined effect of antibiotics for therapeutic success. 1.4 The reverse CAMP test is done for the identification of Streptococcus. 1.5 An OrthoNitroPhenyl-beta-D-Galactopyranoside test differentiates between lactose fermenters and non-lactose fermenters. 1.6 The Weii-Felix test is used for the diagnosis of a Proteus species QUESTION 2 [10] Choose the correct answer and report only the suitable letter next to the relevant question number. 2.1 Septicaemia can be defined as: 2.2 A} Overwhelming bacterial invasion of the bloodstream from a focus of B) lntermitted presence of bacteria in the blood due to obstruction of an C) Bacteria present in the blood in very low levels after dental work. D) Bacteria present in the blood of a patient and usually not life threatening. The antimicrobial substance to distinguish between S.agalactiae and 5. pyogenes is: A} Optochin. B) Bacitracin. C) Penicillin. D) Novobiocin. 2.3 The sample required for diagnosing the causative organism for infective endocarditis is a: A} Nasopharyngeal swab. B) Blood culture. C) Heparin tube with blood. D) Tissue biopsy. Page 1 of 4
2.4 Thayer Martin agar is a selective medium for: A) Moraxella catarrhalis. B) Nocardia species. C) Haemophillus influenza. D) Neisseria gonorrhoeae. 2.5 Actinomycosis A) Is associated with urinary tract infections. B) Are commensals of the gastro-intestinal tract. C) Arises when resident bacteria of the mouth are introduced into the tissues. D) Is identified using the CAMP test. 2.6 2.7 2.8 2.9 lmipenem belongs to the antibiotic groups of: A) Monobactams. B) Cephalosporins. C) Carbapenims. D) Aminoglycosides. Which of the following diseases is characterised by an irritating cough that may become paroxysmal in about 1-2 weeks? A) Tetanus. B) Bronchitis. C) Diphtheria. D) Pertusis. The following organism ferments lactose when grown on MacConkey agar A) Neisseria spp. B) E. coli. C) Pseudomonas aeruginosa. D) Aeromonas spp. Staphylococcus epidermidis infection is associated with: A) Open wounds. B) Deep tissue abscesses. C) Prosthetic devices. D) Chronic conditions like alcoholism. 2.10 The following antimicrobial agent can be classified as a protein synthesis inhibitor: A) Macrolide. B) Carbapenim. C) Quinolone. D) Vancomycin. Page 2 of 4
QUESTION 3 [10] 3.1 A patient presents with symptoms of meningitis. 3.1.1 What specimen do you expect to receive? 3.1.2 Describe the results you would expect for a presumptive N. meningitidis infection which would also be indicative for starting chemotherapy. [5] 3.2 Match the following organism with its serogroup: 3.2.1 S. boydii A) Serogroup A 3.2.2 S. dysenteriae B) Serogroup B 3.2.3 S. flexneri C) Serogroup C 3.2.4 S.sonnei D) Serogroup D [4] SECTION B (50) QUESTION 4 4.1 Illustrate the expected Gram results for the following organism : 3.1.1 Neisseria meningitides 3.1.2 Listeria monocytogenes 3.1.3 Pseudomonas aeroginosa 3.1.4 Campylobacter species 3.1.5 Clostridium perfringens [23] 4.2 Differentiate between C. perfringens and C. tetanus under the following headings: Gram reactivity, spores, haemolysis, motility, lecithinase production and glucose fermentation. [12 x X= 6] 4.3 Point out the 4 forms of Salmonellosis that manifest in man, and explain each form mentioned. QUESTION 5 5.1 Your weekly quality control on the antimicrobial disks in use is out of range. Recommend what the technologist in charge should do. [27] [5] 5.2 Illustrate by means of a labelled picture what a positive CAMP test will look like. [5] Page 3 of 4
5.3 I FIQ. 23 2! s G 0 @ 32 16 8 4 2 1 119/ml cefazolin 0 0 0 0 @ @ 32 16 8 4 2 1 119/ml ampicillin @ @ @ @ @ @ 8 4 2 1 0.5 0.25 119/ml ciprolloxacin 0 0 0 0 0 0 5.3.1 Would you be able to report the information seen in the above slide to the doctor? Justify your answer. [3] 5.3.2 Interpret and report the results according to the reactions seen on the slide. 5.4 Compose a standard operating procedure to ensure the successful isolation of Brucella melitensis from an infected patient. SECTION C (SO) QUESTION 6 6.1 Justify why it is difficult to treat and completely recover from Lyme's disease. [SO] 6.2 6.3 Discuss the RPR test in the identification of syphilis. Evaluate the illustration below and explain what is happening and give an example where each of these could occur. [6] [9] 6.4 6.5 Predict the pathogenesis and clinical manifestation of secondary syphilis. Design a flow chart for the identification of Gram positive cocci. [8] [20] TOTAL: 130 MARKS Page 4 of 4