Microbiology Test Part 1

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You are asked to speak to a 27 year old patient who is pregnant for the first time. She is
concerned as her friend recently gave birth and the baby was found to have profound hearing
loss. Her friend was told this was due to an infection whilst she was pregnant. What is the most
common infective cause of congenital hearing loss?

A) Toxoplasmosis

B) Rubella

C) Cytomegalovirus

D) Mycobacteria

E) Zika

2) What epithelium cell type lines the ureters?

A) Squamous

B) Cuboidal

C) Columnal

D) Transitional

E) Pseudostratified Columnar

3) Which of the following is a double stranded RNA virus?

A) Parvovirus B19

B) Rotavirus

C) EBV

D) CMV

E) Herpes Simplex type 2

What is the approximate risk of HIV transmission during a single episode of vaginal unprotected
sexual intercourse with a known HIV positive person?

A) 0.01%

B) 0.05%

C) 0.1%

D) 0.5%

E) 1.0%

5) What is the incubation period for CMV?

A) 2‐3 days

B) 5‐12 days

C) 2‐3 weeks

D) 3‐12 weeks

E) 3‐6 months

6) What is the prevalence of HIV in the UK obstetric population?

A) 0.5 per 1000 live births

B) 2 per 1000 live births

C) 1 per 10,000 live births

D) 2 per 10,000 live births

E) 5 per 10,000 live births

A 29 year old patient who is 22 weeks pregnant seeks your advice as she was recently exposed
to chickenpox. Regarding fetal varicella syndrome (FVS) which of the following statements is
correct regarding maternal varicella infection?

A) FVS may result if there is maternal varicella infection within the 1st 20 weeks gestation

B) FVS may result if there is maternal varicella infection within the 1st 6 weeks gestation

C) FVS may result if there is maternal varicella infection within the last 6 weeks gestation

D) FVS may result if there is maternal varicella infection within the 5 days prior to labour

E) FVS may result if there is maternal varicella infection at any time during pregnancy

A 35 year old lady is seen in clinic for IVF counselling. She reports having bloody watery
diarrhoea for the past 5 days and a fever up to 39oC. A day or two earlier she had takeaway
chicken that tasted "funny". Which gram negative rod is likely to be responsible?

A) Salmonella

B) Helicobacter

C) Listeria

D) Camplylobacter

E) Escherichia coli

9) HPV genotypes 6 and 11 are associated with which of the following?

A) Herpes Simplex

B) MCV 1 pox virus

C) Streptococcus pyogenes

D) Varicella Zoster

E) Parvovirus B19

10)

You are asked to see a 42 year old women due to pelvic pain and PV discharge. She had IUCD
fitted for emergency contraception 4 years ago. You send swabs. The microscopy reveals
sulphur granules. What is the likely causative organism?

A) Actinomyces israelii

B) Gardnerella vaginalis

C) Chlamydia trachomatis

D) Mycoplasma hominis

E) Group B Streptococcus

11) What family of virus does Rubella belong to?

A) Parvoviruses

B) Poxviruses

C) Togaviruses

D) Retroviruses

E) Reoviruses

12)

You are asked to see a 33 year old women who is 16 weeks pregnant. She complains of frothy
yellow vaginal discharge and vaginal soreness. A wet smear is sent and microscopy reveals
Trichomoniasis. What percentage of women with trichomoniasis infection have the classic
frothy yellow PV discharge?

A) 2%

B) 5%

C) 20%

D) 50%

E) 70%

13) What is the primary causative organism in Bacterial Vaginosis?

A) Gardnerella vaginalis

B) Escherichia Coli

C) Mycoplasma hominis

D) Chlamydia trachomatis

E) Actinomyces israelii

14) What is the primary host for Toxoplasma Gondii?

A) Sheep

B) Rodents

C) Cats

D) Humans

E) Cattle

15) Which of the following is a DNA virus?

A) Hepatitis A

B) Hepatitis B

C) Hepatitis C

D) Hepatitis D

E) Hepatitis E

16)

You are asked to review a 24 year old women in A&E. She delivered by C‐section following
failed vaginal delivery 3 weeks earlier. She complains of lower abdominal and renal angle pain
and has also noticed an offensive smelling vaginal discharge over the past 2‐3 days. Her
observations are:
T: 38.1°C
BP: 100/60
HR: 92
RR 20
She tells you she is not breastfeeding and has no known drug allergies.
What is the most appropriate option regarding her antimicrobial management?

A) 7 days oral trimethoprim 200mg BD

B) 7 days oral doxycycline 100mg BD

C) Send urgent blood cultures, take vaginal swabs and routine bloods. Await initial results prior to initiating antimicrobial therapy.

D) Intravenous piperacillin and tazobactam. Dose as per patients weight and duration determined by clinical response

E) Intravenous cefuroxime 750mg TDS duration determined by clinical respons

17) What is the causative organism of Toxoplasmosis?

A) Toxoplasma pallidum

B) Treponema pallidum

C) Toxoplasma Gondii

D) Toxoplasma vivax

E) Borrelia

18) Which group of beta haemolytic streptococci is associated with chorioamnioitis?

A) A

B) B

C) C

D) F

E) G

19) Regarding the image of the oocyte below what is the name given to the part labelled F

A) Corona Radiata

B) Cytoplasm

C) Perivitelline Space

D) Vitelline Membrane

E) Zona Pellucida

20)

What percentage of women develop antibodies to Human Papilloma Virus (HPV) following
infection?

A) 5%

B) 25%

C) 50%

D) 75%

E) 99%

21) What is the incubation period for Rubella?

A) 2‐3 days

B) 5‐6 days

C) 5‐9 days

D) 12‐23 days

E) 2‐6 weeks

22) Which of the following is a single stranded DNA virus?

A) Varicella Zoster

B) Parvovirus B19

C) Rubella

D) CMV

E) Rotavirus

23)

A 24 year old female patient undergoes an STI screen due to development of dysuria 5 days
earlier. The results are positive for chlamydia infection. With regard to contact tracing what is
the recommended action regarding tracing and informing sexual partners in this case?

A) All sexual partners past 4 weeks

B) All sexual partners past 6 weeks

C) All sexual partners past 4 months

D) All sexual partners past 6 months

E) Last sexual partner should be informed and tested

24)

What is the tubal factor infertility rate following a single episode of Pelvic Inflammatory
disease?

A) 1‐2%

B) 5%

C) 12.5%

D) 25%

E) 50%

25) Which of the following describes Toxoplasma Gondii?

A) intracellular bacterium

B) facultative aerobic bacterium

C) motile spirochete

D) double stranded DNA virus

E) intracellular protozoan

26)

A 32 year old patient develops painful ulcerated genital lesions and inguinal lymphadenopathy.
She is 32 weeks pregnant. You suspect genital herpes and send swabs. Which of the following is
appropriate management according to the 2014 BASHH/RCOG guidelines?

A) Send bloods to check antibody status. If this supports this is a first episode genital HSV then patient should be advised to have C‐section delivery

B) Give Aciclovir 400mg TDS orally for 5 days

C) No medical treatment required

D) Admit for intravenous Aciclovir for 5 days

E) Give Aciclovir 800mg 5 times daily for 5 days

27) Which of the following is an RNA virus?

A) Herpes Simples type 1

B) Varicella Zoster

C) Cytomegalovirus

D) Rubella

E) Hepatitis B

28)

A 24 year old patient who is 14 weeks pregnant has her urine dipped during an antenatal visit.
This shows leucocytes ++ and nitrites ++. You suspect a UTI and send a urine sample for culture.
According to NICE guidance which of the following is most appropriate treatment option?

A) No treatment until culture result received

B) Trimethoprim 200mg BD for 3 days

C) Trimethoprim 200mg BD for 7 days

D) Nitrofurantoin 50mg QDS for 7 days

E) Amoxicillin 500mg TDS for 7 days

29)

A 26 year old patient known to have Group B Streptococcus (GBS) on vaginal swab is being
admitted for elective C‐section delivery. She is penicillin allergic. What intrapartum antiobiotic
treatment is advised?

A) No treatment

B) IV Clindamycin 900 mg 8 hourly

C) IV Ciprofloxacin 750mg 12 hourly

D) IV Ciprofloxacin 750mg 12 hourly

E) Oral doxycycline 200mg 12 hourly

30)

According to the UK NSC and NICE which of the following should NOT be screened for during
routine antenatal care?

A) Syphilis

B) Hepatitis B

C) Hepatitis C

D) HIV

E) Asymptomatic bacteriuria

31)

A 24 year old patient decides to take a Chlamydia screening test whilst in the GP surgery. He is
asymptomatic. The results are positive for chlamydia infection. His partner attends for testing
and wants to know the risk of contracting Chlamydia. What is the risk of chlamydia infection
following intercourse with an asymptomatic chlamydia positive partner?

A) 5‐10%

B) 25%

C) 40%

D) 65%

E) >90%

32)

A patient has been referred to clinic following diagnosis of a Gumma. What stage of syphilis
infection is this?

A) Primary

B) Secondary

C) Tertiary

D) Early Latent

E) Late Latent

33) HPV genotypes 6 and 11 are associated with which of the following?

A) Herpes Simplex

B) MCV 1 pox virus

C) Streptococcus pyogenes

D) Varicella Zoster

E) Parvovirus B19

34) Which of the following describes Neisseria Gonorrhoeae?

A) Gram Positive Bacilli

B) Gram Positive Cocci

C) Gram Negative Bacilli

D) Gram Negative Cocci

E) Spirochaetes

35)

A 26 year old patient known to have Group B Streptococcus (GBS) on vaginal swab is going into
labour. A normal vaginal delivery is planned. She is penicillin allergic. What intrapartum
antiobiotic treatment is advised?

A) No treatment

B) IV Clindamycin 900 mg 8 hourly

C) IV Ciprofloxacin 750mg 12 hourly

D) IV Clarithromycin 500mg 12 hourly

E) Oral doxycycline 200mg 12 hourly

36) HPV genotypes 6 and 11 are associated with which of the following?

A) High grade squamous intraepithelial lesions of the cervix (HSIL)

B) Low grade squamous intraepithelial lesions of the cervix (LSIL)

C) Cervical intraepithelial neoplasia (CIN) 3

D) Squamous cell carcinoma penis

E) Cervical intraepithelial neoplasia (CIN) 2

37) Which of the following is the causative organism in Syphilis infection?

A) Propionibacterium propionicus

B) Gardnerella vaginalis

C) Ureaplasma

D) Borrelia burgdorferi

E) Treponoma Pallidum

38) In type 2 necrotising fasciitis what is the most likely causative organism?

A) Clostridia Perfringens

B) Clostridia Tetani

C) Staphylococcus aureus

D) Streptococcus viridans

E) Streptococcus pyogenes

39)

When is the highest risk of maternal‐fetal transmission of Toxoplasma Gondii during
pregnancy?

A) 0‐10 weeks

B) 10‐16 weeks

C) 10‐24 weeks

D) 24‐26 weeks

E) 26‐40 weeks

40) Regarding the image of the oocyte below what is the name given to the part labelled A

A) Zona Pellucida

B) Plasma Membrane

C) Perivitelline Space

D) Vitelline Membrane

E) Corona Radiata

41) What virus family does HIV belong to?

A) Togaviridae

B) Herpesviridae

C) Parvoviridae

D) Retroviridae

E) Flaviviridae

42)

The RCOG define septic shock as the persistence of hypoperfusion despite adequate fluid
replacement therapy. What is the mortality rate in patients with septic shock?

A) 5%

B) 10%

C) 20%

D) 35%

E) 60%

43)

According to the UK NSC and NICE which of the following should be screened for during routine
antenatal care?

A) Syphilis

B) Chlamydia

C) Hepatitis C

D) Group B streptococcus

E) CMV

44) What type of virus is the Rubella virus?

A) Single stranded RNA (ssRNA)

B) Double stranded RNA (dsRNA)

C) Retrovirus

D) Single stranded DNA (ssDNA)

E) Double stranded DNA (dsDNA)

45)

You are asked to review a patient in ITU. They have undergone extensive tissue debridement
for gas gangrene. What is the causative organism of gas gangrene?

A) Group A streptococcus

B) Streptococcus pyogenes

C) Clostridia perfringens

D) Clostridia tetani

E) Staphylococcus aureus

46) HPV genotypes 6 and 11 are associated with which of the following?

A) Herpes Simplex

B) MCV 1 pox virus

C) Streptococcus pyogenes

D) Varicella Zoster

E) Parvovirus B19

47)

Which of the following infections is most commonly associated with an increased risk of ectopic
pregnancy?

A) Neisseria Gonorrhoea

B) Chlamydia trachomatis

C) Gardnerella vaginalis

D) Group B streptococcus

E) Mycoplasma hominis

48) Which species of candida is the most common cause of genital candida infection in pregnancy?

A) Candida milleri

B) Candida albicans

C) Candida glabrata

D) Candida rugosa

E) Candida parapsilosis

49)

Which of the following is the most common cause of abnormal vaginal discharge in patients of
childbearing age?

A) Candida albicans

B) Chlamydia trachomatis

C) Neisseria gonorrhoeae

D) Bacterial vaginosis

E) Trichomonas vaginalis

50) Which of the following is a gram positive obligate anaerobe?

A) Staphlococcus

B) Streptococcus

C) Clostridia

D) Bacteroides

E) Prevotella

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