Minkerd_megold_angol 201

MEDICAL MICROBIOLOGY SHORT ANSWER QUESTIONS
These basic questions will be included in the mid-semester tests (in addition to simple- choice and multiple-choice questions) and in the written entry test of the Final Examination in the Department of Medical Microbiology. We would like to emphasize some important aspects about these questions and answers. It is important to realize that learning only this material does not give sufficient knowledge for the tests and examinations. These questions are not to be used to start learning, rather for measuring your knowledge. However, after a certain amount of learning, students may use this material for self-testing, and also for identifying dark areas of their knowledge. The teacher correcting the tests can give 1 point for each answer. As these are basic questions, only completely good answers will be accepted. However, after careful consideration, the teacher may give a point for an answer which is 75-80 % good. On the other hand, if the student writes bad answer(s) in addition to good answers for a question, the teacher may refuse to give the point, depending on the severity of the mistake. If you find any mistakes in the questions or answers, or you think that there may be additional good answers given to a question, please write me, preferably in e-mail (Dr. Veress György: veregy@med.unideb.hu). We cannot accept any complaints regarding these Dr. György Veress Associate Professor Academic advisor ____________________________________________________________________

GENERAL MICROBIOLOGY
1.
Describe the colour (in a Gram stained smear) of Gram positive and Gram negative bacteria, respectively!
Gram positives: dark blue/purple
Gram negatives: red/pink
Describe the 3 important parts of the bacterial lipopolysaccharide! lipid A + core polysaccharide + O-specific (polysaccharide) side chain
Which 2 roles are attributed to bacterial pili (fimbriae)? adhesion; conjugation (sex fimbriae)
Mention a bacterium and its virulence factor that is encoded by a lysogenic bacteriophage!
Corynebacterium diphtheriae – diphtheria toxin
Streptococcus pyogenes – erythrogenic toxin
Specify 2 genera containing obligate intracellular pathogens! Chlamydia, Rickettsia, (Coxiella, Ehrlichia)
Mention at least 5 possible transmission ways of infections! respiratory droplets (infectious aerosol)
faecal-oral
direct contact (such as sexual)
fomites (inanimate objects)
blood
vectors (blood-sucking arthropods)
List the possible shapes of bacteria. Write one example per category. coccus (spherical): Staphylococcus, Streptococcus
rod: Clostridium, Corynebacterium, Gram negative rods
curved rod: Vibrio
helical: Spirochetes (Treponema, Borrelia, Leptospira)
What are the essential components of bacterial cells? Specify at least 3! cytoplasm, nucleoid (genome), cell membrane, (cell wall)
Vector is an arthropod that transmits infection from human to human, or from animal to
human
examples. tick – Lyme disease; louse – epidemic typhus; mosquito – malaria
10. What is a reservoir? Write an example. The normal host of a pathogen (human or animal) serving as a continuous source of
infection to other hosts (such as humans).
Salmonella typhi – human; Yersinia pestis - rodents
11. Mention 3 reliable methods of sterilization! autoclaving, hot air oven, gamma-radiation, filtration (fluids), gas sterilisation
(not acceptable: boiling, pasteurisation, UV!)
alcohols; aldehydes (alkylating agents); phenol derivatives; detergents;
chlorine + iodine = oxidising agents
Mention a group of antimicrobial drugs that act on the bacterial ribosome and usually
has bactericidal effect!
aminoglycosides
14. Describe precisely what toxoid means! Inactivated bacterial exotoxin that is not toxic but immunogenic
15. Mention 2 broad-spectrum (effective against both Gram positive and Gram negative bacteria) penicillin derivatives.
ampicillin, amoxicillin, piperacillin, azlocillin, mezlocillin
16. Mention an antifungal and an antibacterial drug that alter the function of the cell membrane! antifungal: Amphotericin B, azoles; antibacterial: polymyxins 17. What are the possible mechanisms of acquired penicillin resistance of bacteria? Mention at least 3 mechanisms!
1. beta-lactamase production
2. PBP (target) alteration
3. reduced permeability
4. active efflux
18. Mention a drug belonging to macrolides! erythromycin, spiramycin, roxithromycin, clarithromycin, azithromycin
19. Mention 2 drugs belonging to aminoglycosides! streptomycin, gentamycin, tobramycin, amikacin…
20. Mention 2 groups of antimicrobial drugs that act on the 30 S subunit of the bacterial ribosome!
aminoglycosides, tetracyclines
21. Mention 3 groups of antibacterial drugs inhibiting bacterial cell wall synthesis!
penicillins, cephalosporins, carbapenems, monobactams, glycopeptides
22. Which part of the bacterial cell carries the endotoxin? Outer membrane of Gram negative bacteria
23. What role is attributed to the bacterial capsule in the infectious process? antiphagocytic effect, adhesion
24. Mention 2 infectious diseases that are transmitted to humans by tick bites! tick-borne encephalitis; Lyme-disease; tularemia; Rocky-Mountain spotted fever;
recurrent fever (Borrelia recurrentis) etc.
25. Which type of hypersensitivity is involved in the tuberculin test? late type (type IV)
26. Mention 2 bacterial infectious diseases that can be prevented or treated by passive transfer of specific immunoglobulins!
prevention: tetanus
treatment: diphtheria, botulism, tetanus
27. What do the vaccine(s) against diphtheria and tetanus contain? Diphtheria and tetanus toxoid
28. What does the vaccine against pertussis contain? Previously: killed bacteria
Currently: acellular vaccine (toxoid + other purified proteins)
29. What does the vaccine against tuberculosis (BCG) contain? live attenuated Mycobacterium bovis (Bacille Calmette-Guerin)
30. What is the nature of antigen in the vaccines used to prevent infections by Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis?
capsular polysaccharide (either alone or conjugated to a carrier protein)

31. Mention 2 bacterial exotoxins that are neurotoxic!
tetanus toxin, botulinum toxin

32.
Specify the 4 groups of bacterial vaccines according to the nature of the antigen!
a., live, attenuated vaccines
b., killed bacterial vaccines
c., toxoid vaccines
d., subunit vaccines (capsular polysaccharide or purified protein)

33. What is the mechanism of action of lysozyme? Where is lysozyme found in the host?
It destroys bacterial cell wall peptidoglycan by hydrolysing the glycosyl bonds
between NAM (N-acetylmuramicacid) and NAG (N-acetylglucosamine). It occurs in
tear, saliva, respiratory secretions.

34. Which Gram negative organelles or structures are associated with the O, H and K
antigens, respectively?
O- LPS, H-flagella, K-capsule

35. Mention 2 bacterial exotoxins that act by ADP ribosylation!
Diphtheria toxin, cholera toxin, pertussis toxin

36. Describe the rules of collecting native urine for culturing bacteria! Describe also the
conditions for keeping the specimen before sending it to the laboratory!
A midstream specimen, taken preferably in the morning, after thorough cleaning of
the external genital area. Keep it up to 1 h at room temperature or up to 24 h at +4
oC.

37. Describe the rules of collecting hemoculture specimens!
It is recommended to obtain 3 specimens (with at least 30 min. between the specimens).
The specimens should be preferably taken before fever spikes (during rising fever),
from fresh peripheral venipuncture sites. If possible, both aerobic and anaerobic
bottles should be used (3 x 2 bottles altogether). The site of venipuncture and the plug of
the bottle containing the medium must be properly disinfected. The amount of blood
injected to the bottle should be about 10 % of the liquid medium.

38. Mention two clinical specimens that are heavily contaminated with bacteria belonging
to the normal body flora!
throat and nasal secretions, faeces, vaginal secretions.

39. Mention at least three of the physiological effects of septic shock (characterized by the
presence of large amount of bacterial endotoxin in the blood)!
fever, hypotension, disseminated intravascular coagulation (DIC), complement
activation, impaired organ perfusion, hypoglycaemia

40. What pathogenic role is attributed to lysogenic conversion?
Lysogenic conversion: transfer of genes from one bacterium to another by lysogenic
bacteriophages. The bacteria may gain exotoxins (diphtheria toxin, Streptococcus
pyogenes erythrogenic toxin), or the structure of LPS epitopes may be altered (Shigella,
Salmonella).
41. Describe the principle of acid fast staining procedures! Mycobacteria contain a high amount of special lipids called mycolic acids. They can be
stained by hot carbol-fuchsin, but they resist decolourisation with acid-alcohol, so they
remain red. All other cells are stained blue by the counter stain (methylene blue).
42. Mention 2 non-essential bacterial organelles that enhance bacterial virulence! Describe how their function contributes to pathogenicity!
Capsule: antiphagocytic effect, adhesion to tissues
Fimbriae: binding to tissues
Flagellae: spreading the bacteria

43. Mention a differentiating culture medium and describe which groups of bacteria are distinguished on the mentioned medium!
Eosin-methylene blue (EMB) agar: Inhibits Gram positive bacteria and inhibits the
swarming of Proteus. Differentiates between lactose fermenters and non-fermenters.
Lactose fermenters produce high amounts of acids, which is indicated as dark blue
colonies by eosin and methylene blue.
McConkey agar: Inhibits Gram positive bacteria by bile salts and crystal violet. It
differentiates between lactose fermenters and non-fermenters. Lactose fermentation is
indicated by neutral red. Lactose fermenters form pink to red colonies, while non-
fermenters form colourless colonies.
44. Describe the definition for facultative anaerobic bacteria! They are able to grow and metabolize both in the presence and in the absence of
oxygen. In aerobic conditions they perform respiration, in anaerobic condition, they
perform fermentation.

45. Mention 4 extracellular enzymes of bacterial origin functioning as virulence factors!
coagulase, streptokinase (fibrinolysine), streptodornase (DNase), hyaluronidase, IgA
protease, collagenase, elastase, urease

46. What is the difference between prevalence and incidence of an infectious disease?
It can be differentiated in chronic diseases. Prevalence: total number of diseases (per
100,000 people). Incidence: number of new cases in a year (per 100,000 people).
47. What is the difference between mortality and lethality of a disease? Mortality: total number of deaths caused by the disease in a population (usually 100,000
people). Lethality: rate of death (in percent) among patients suffering from the disease.

48. Mention 2 groups of disinfectants acting on the microbial membrane structures!
a., (cationic) detergents (quaternary ammonium-compounds);
b., phenol compounds (cresol, hexachlorophene, chlorohexidine)
c., alcohol (ethanol, isopropanol)

49. Describe the principle of the Kirby-Bauer (disk diffusion) method used to determine
antibiotic sensitivity!
Disks impregnated with different antibiotics are placed on the surface of appropriate agar
media that has been inoculated with the bacterium isolated from the patient. After
overnight incubation, the antibiotics diffusing from the discs may cause zones of
inhibition around the discs. The size of the zone should be compared to standards to
determine antibiotic sensitivity.

50. Explain the purpose for using beta-lactamase inhibitors in antibacterial therapy!
Combination of beta-lactamase inhibitors (such as clavulanic acid or sulbactam) with
beta-lactamase sensitive penicillins (such as amoxicillin or ampicillin) can overcome
resistance mediated by many but not all beta-lactamases.

51. What are the main advantages and disadvantages of live attenuated vaccines as
Advantages: induce not only serum antibodies but also cellular immunity and local IgA
antibodies. Some may be applied orally. Usually fewer doses are needed.
Disadvantages: Attenuated strains may revert to virulent in rare cases. They may cause
disease in immunosuppressed patients. Live attenuated microbes are usually heat
sensitive and must be refrigerated.

52. Mention 4 groups of antibiotics which have bactericidal effects!
penicillins, cephalosporins, aminoglycosides, fluoroquinolons etc.

53. Which antibiotics inhibit bacterial DNA gyrase enzyme?
nalidixic acids, fluoroquinolons

54. What is the mode of action of the antibiotics sulfonamides and thrimethoprim,
They inhibit the synthesis of folic acid. Sulfonamides: inhibit the synthesis of dihidro-
folate (they are PABA analogues). Trimethoprim: inhibition of dihidrofolate-reductase.

55. What is the mode of action of the antibiotic vancomycin?
Inhibits cell wall synthesis in Gram positive bacteria by blocking transpeptidation.

56. Mention 4 groups of antibiotics inhibiting protein synthesis of bacteria!
Aminoglycosides, tetracyclines, chloramphenicol, macrolides, lincosamides

57. Regarding the joint effects of 2 antibiotics, what does synergism mean?
The effect of the two drugs together is significantly higher than the sum of the effects
of the two drugs acting separately.

58. Regarding the joint effects of 2 antibiotics, what does antagonism mean?
The effect of the two drugs together is significantly lower than the effect of the more
effective drug alone.
Selective inhibition of the growth of the microorganism without damage to the host.
In other words: the drug is highly toxic to the bacteria, but not toxic (or have very low
toxicity) to the human host.
60. How can one identify the different surface antigens of Gram negative bacteria? with slide agglutination tests using antibodies of known specificity
61. What is the mechanism of action of diphtheria toxin? Inhibition of protein synthesis in eukaryotic cells by ADP-ribosylation of ribosomal
EF-2 (elongation factor-2)
62. What is the mechanism of action of tetanus toxin? It causes spastic paralysis by blocking the release of inhibitory neurotransmitters
(glycine) in synapses
63. What roles can be attributed to specific antibodies in antibacterial immunity? Specify at least 3!
a. neutralisation of exotoxins and enzymes
b. complement-dependent bacteriolysis (Gram-negatives)
c. opsonisation (helping phagocytosis)
d. interfering with attachment of bacteria to mucosal surfaces
64. Starting from a fixed smear, specify the main steps of Gram stain in the appropriate order! 1. Crystal violet 2. Lugol solution (iodine) 3. Differentiation: ethanol wash 4. Counterstaining: safranin or fuchsin (wash with tap water after each step) 65. Starting from a fixed smear, specify the main steps of the acid-fast stain (Ziehl-Neelsen) 1. Stain with carbol-fuchsin (with heating) 2. Differentiation: wash with acid-ethanol 3. Counterstaining with methylene-blue (wash with tap water after each step) 66. What is the difference between agglutination and precipitation? Both are serological reactions where specific binding of the antigen with the antibody
directly results in a reaction visible by the naked eye. The difference is in the nature of the
antigen. Agglutination: particulate antigen (RBC, bacteria, latex particles).
Precipitation: antigen is in solution before the reaction.
67. What does titer mean in serological tests? The highest dilution of the serum sample that gives a positive reaction in the test.
68. How can one differentiate between past and current infections in serological tests? Current infections are indicated by: either IgM class specific antibodies or, in the case of
paired serum specimens (taken from the same patient at least 7-10 days apart), a
significant (at least 4-fold) rise in the titer of specific antibodies.
Specify the main steps of an ELISA test in which we detect antibodies from patients’ serum samples using known antigens!
1. Binding antigen to plastic surface (in wells of a 96-well plate)
2. Adding diluted serum sample (specific antibodies bind to the antigen)
3.Adding conjugate (secondary antibody conjugated with an enzyme)
4. Adding the substrate of the enzyme, reading the colour reaction.
70. How can one determine the minimal inhibitory concentration of an antibiotic to a bacterial isolate?
Inoculate the bacterial isolate into a series of test tubes containing 2-fold dilution series of
the drug. After overnight incubation, the lowest concentration of drug that prevents
visible growth of the organism is the MIC.
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CLINICAL BACTERIOLOGY
1.
Mention 5 diseases that can be caused by Staphylococcus aureus! Impetigo, furunculus, pneumonia, osteomyelitis, food poisoning etc.
Mention 2 toxin-mediated staphylococcal diseases! toxic shock syndrome (TSS), scalded skin syndrome, food poisoning
Mention 3 toxic products produced by Staphylococcus aureus! TSST (toxic shock syndrome toxin), enterotoxin, exfoliatin, leukocidins, hemolysins

4. Which is the most virulent species of Staphylococcus?
S. aureus
Which enzymatic virulence factor is characteristic exclusively for Staphylococcus aureus?
coagulase
How can we identify the source of infection in a staphylococcal food poisoning? by phage typing
Which antibacterial drug is the first choice in serious infections caused by methycillin resistant Staphylococcus aureus (MRSA) strains?
glycopeptides (vancomycin, teicoplanin)
In which disease is Staphylococcus saprophyticus considered an obligate pathogen! cystitis in young women
Which cell constituents determine the group-specific, and the type specific antigens of Streptococcus pyogenes, respectively?
group specific: C- polysaccharide
type specific: M protein
Mention 3 enzymes produced by Streptococcus pyogenes that enhance the spread of the bacterial infection in the body!
Streptokinase (fibrinolysin), hyaluronidase, streptodornase (DNAse)
List 3 diseases caused by Streptococcus pyogenes in the skin or in subcutaneous tissues!
impetigo (pyoderma), cellulitis, erysipelas, fasciitis, myositis
Mention a toxin-mediated streptococcal disease, specify the name of the toxin and its mechanism of action!
Scarlet fever - erythrogenic toxin – superantigen causing capillary destruction
Glomerulonephritis, rheumatic fever, erythema nodosum, chorea minor.
14. Which product of Streptococcus pyogenes has a major pathogenic role in poststreptococcal diseases?
M protein: may induce hypersensitivity reactions
How long does immunity against scarlet fever exist? Which immune effector mechanism is involved?
Life-long immunity. Antitoxic antibodies are involved.
What is the drug of first choice in Streptococcus pyogenes infection? Penicillin-G
What is the patomechanism of post-streptococcal rheumatic fever? type II hypersensitivity (cytotoxic antibodies)
What is the patomechanism of post-streptococcal glomerulonephritis? type III hypersensitivity (immune complexes)
Which Streptococcus species plays major role in the meningitis of newborn babies? Group B Streptococcus (S. agalactiae)
What is (are) the major causative agent(s) for subacute bacterial endocarditis? Viridans streptococci
What are the characteristics of Enterococci that can be used in their identification? D group polysaccharide antigen; tolerance to bile and hydrolysis of esculin (BEA
medium: bile esculin agar); growth in the presence of 6,5 % NaCl
What are the specific morphologic features of Streptococcus pneumoniae? Gram positive diplococcus, lancet shape, capsule.
Mention 3 diseases that can be caused by Streptococcus pneumoniae! Pneumonia, meningitis, sinusitis, otitis media, sepsis, (ulcus serpens corneae)
What fast diagnostic procedure can be used in acute Neisseria gonorrhoeae infection? Demonstration of bacteria (intracellular in PMNs) from urethral discharge by Gram
or methylene blue stain; PCR amplification of bacterial DNA
What kind of immunity develops after Neisseria gonorrhoeae infection? Partial immunity of short duration; no protection from reinfection
Specify at least 2 of the most important manifestations of disseminated gonorrhoeal infections!
arthritis, skin eruptions, (endocarditis, meningitis)
What is the major manifestation of Neisseria gonorrhoeae infection in newborns? How can it be prevented?
Blenorrhoea (ophtalmia) neonatorum, silver acetate eye drops or erythromycin
ointment
Mention at least 3 major virulence factors of Neisseria gonorrhoeae! pilus, outer membrane proteins, LOS (lipooligosaccharide), IgA protease
Mention at least 2 major virulence factors of Neisseria meningitidis! polysaccharide capsule, LPS, IgA protease
What is the site of entry of Neisseria meningitidis infection? What diseases are caused by this bacterium?
The site of entry is the nasopharynx (transmitted by airborne droplets).
Meningococcemia (characterized by skin lesions), and acute (purulent) bacterial
meningitis.
What kinds of prophylactic measurements are available against Neisseria meningitidis infections?
Chemoprophylaxis: rifampin or ciprofloxacin.
Vaccination: capsular polysaccharide (types A, C, Y and W135). No vaccine against
type B!
Which rapid diagnostic methods can be used in the presumptive diagnosis of purulent bacterial meningitis?
Gram or methylene blue stain of CSF sediment
Demonstration of bacterial capsular antigens by latex agglutination (from CSF)
Which capsular serotype is included in the vaccine against Haemophilus influenzae? 34. Which are the portals of entry of Bacillus anthracis? Skin, lungs, gastrointestinal tract
Mention 3 important bacteria involved in nosocomial (hospital-acquired) infections! Staphylococcus aureus, Enterococcus faecalis, Pseudomonas aeruginosa, Escherichia
coli
Mention four E. coli pathogenetic groups involved in enteric diseases! Enteropathogenic E. coli (EPEC)
Enterotoxic E. coli (ETEC)
Enteroinvasive E. coli (EIEC)
Enterohemorrhagic E. coli (EHEC)
Enteroaggregative E. coli (EAggEC)
What are the most important extraintestinal infections caused by E. coli? Mention at least 3 of them!
urinary tract infections, neonatal meningitis, nosocomial wound infections
38. The most frequent causative agent of urinary tract infections is: Escherichia coli
Which 2 diseases are caused by E. coli O157:H7? hemorrhagic colitis +/- HUS (hemolytic uraemic syndrome)
What is the reservoir of Salmonella typhi? humans (with disease, or healthy carriers)
41. Which bacteria cause most frequently typhoid fever and enteric fever, respectively? Salmonella typhi (typhoid)
Salmonella paratyphi A, B, C (enteric fever)

42. When typhoid fever is suspected, what kinds of clinical samples should be used to isolate
the causative agent in the first 2 weeks of the disease?
Blood, (bone marrow)
43. What is the route of infection in Salmonella gastroenteritis? Ingestion of contaminated food (such as eggs, cream, mayonnaise, creamed foods, etc.)
containing a sufficient number of Salmonella.

44. Which antibacterial drugs should be administered in gastroenteritis caused by
Salmonella?
Antibiotics are not usually necessary unless the infection is generalised. In case of
extraintestinal infection (very young, very old or immunosuppressed patients):
ampicillin, gentamicin, trimethoprim/sulfamethoxazole, or ciprofloxacin.

45. List the 4 Shigella species causing human disease!
Shigella dysenteriae, S. flexneri, S. boydii, S. sonnei
46. Mention 2 bacterial species belonging to different genera that cause bacillary dysentery Shigella dysenteriae, (Shigella flexneri, Shigella boydii, Shigella sonnei), enteroinvasive
E. coli (EIEC)
47. Mention 3 bacterial species belonging to different genera that cause enteritis or enterocolitis!
Campylobacter jejuni, Escherichia coli, Salmonella enteritidis, Shigella, Yersinia
enterocolitica
Mention 2 bacteria causing intestinal infections which have animal reservoirs! Salmonella (not Typhi and Paratyphi!), Campylobacter jejuni, Yersinia
enterocolitica, Listeria monocytogenes, E. coli O157
49. What are the modes of transmission for the 2 different epidemiologic forms of plague? - Bubonic plague is transmitted by the bite of infected rat fleas from rats to humans.
- Primary pneumonic plague spreads directly from human to human via respiratory
droplets.
What are the possible portals of entry of Francisella tularensis? Specify at least 4! tick bite, mucous membranes, skin abrasions, resp. tract, gastroint. tract
51. How do humans acquire brucellosis? Where do the bacteria replicate in the human body? Via contaminated milk products or through skin abrasions (contact with animals).
Organisms spread to the mononuclear phagocytes of the reticuloendothelial system
(lymph nodes, liver, spleen, bone marrow).
What are the reservoirs of the different Brucella species, respectively? B. abortus: cattle
B. melitensis: goat, sheep
B. suis: swine
53. What is the mechanism of action of cholera toxin? Cholera toxin activates the adenylate cyclase enzyme in cells of the intestinal mucosa
leading to increased levels of intracellular cAMP, and the secretion of large amount of
water, Na+, K+, Cl-, and HCO -
3 into the lumen of the small intestine.
54. What is the principle of the treatment for cholera? Rapid intravenous or oral replacement of the lost fluid and ions. (Administration of
isotonic maintenance solution should continue until the diarrhea ceases.) In severe cases:
administration of tetracycline (in addition to rehydration).
55. Mention 4 diseases caused by Haemophilus influenzae! purulent meningitis
epiglottitis (obstructive laryngitis)
otitis media and sinusitis
pneumonia
(cellulitis, arthritis)
56. Which disease is caused by Haemophilus ducreyi? Chancroid (soft chancre or ulcus molle)
57. What can serve as source of infections caused by Pseudomonas aeruginosa? Pseudomonas species are normally present in the environment and can be isolated from
the skin, throat, and stool of some healthy persons. They often colonize hospital food,
sinks, taps, mops, and respiratory equipment.
58. Mention 4 diseases that are frequently caused by Pseudomonas aeruginosa! urinary tract infections
wound infections (burns)
pneumonia, sepsis (immunosupression)
otitis externa
Mention at least 3 drugs which may be effective to treat infections caused by Pseudomonas aeruginosa!
certain penicillins: piperacillin/tazobactam combination
a 3rd generation cephalosporin: ceftazidim
a 4th generation cephalosporin: cefepime
certain aminoglycosides: gentamycin, tobramycin, amikacin
carbapenems: imipenem, meropenem
60. Which 2 diseases are caused by Legionella pneumophila? - legionellosis, legionnairs’ disease (atypical pneumonia)
- Pontiac fever (mild, flu like illness without pneumonia)
61. List 3 important virulence factors of Bordetella pertussis! filamentous hemagglutinin, pertussis toxin, adenylate-cyclase toxin, tracheal
cytotoxin
62. Mention 3 bacterium species causing food poisoning! Staphylococcus aureus, Bacillus cereus, Clostridium perfringens, Clostridium
botulinum, Vibrio parahaemolyticus, (Salmonella serotypes causing enterocolitis)
63. Which bacterium has the highest germ number in the colon? Bacteroides fragilis
64. Mention 4 bacterial genera that are obligate anaerobes! Clostridium, Bacteroides, Prevotella, Porphyromonas, Fusobacterium, Actinomyces,
Bifidobacterium, Peptostreptococcus, Propionibacterium
65. Which is the most important gas gangrene Clostridium? What is its main virulence factor? Clostridium perfringens
alpha-toxin (lecithinase)
66. Mention 3 Clostridium species causing gas gangrene! How are they acquired? Clostridium perfringens, C. novyi, C. septicum, C. histolyticum, C. tertium, C.
bifermentans, C. sporogenes
The site of infection is usually a wound that comes into contact with Clostridium spores
that germinate in an anaerobic environment.
67. How can be tetanus prevented in patients who have wounds possibly contaminated with C. tetani spores?
Wound should be cleaned and debrided; tetanus toxoid booster injection given;
tetanus immunoglobulin (TETIG) in previously unvaccinated patients and in case of
heavy contamination of wound; penicillin may be added prophylactically
68. What are the main symptoms of tetanus infection? Specify at least 3! Spastic paralysis: muscle spasms; lockjaw(trismus), rhisus sardonicus (grimace of the
face), opisthotonus (spasm of the back); respiratory paralysis
69. What is the mechanism of action of the botulinus toxin? Blocks release of acetylcholine in peripheral nerve synapses;
flaccid paralysis: diplopia (double vision), dysphagia (difficulty to swallow),
dysphonia (hoarseness), respiratory paralysis.
71. What kind of therapy is used to treat botulism? Treatment: respiratory support + trivalent antitoxin
72. Explain whether or not antibiotic treatment is useful in botulism! Not, because antibiotics are not effective against preformed toxins.
73. What diseases may be associated with Helicobacter pylori? Specify at least 3! Gastritis, peptic and duodenal ulcers, gastric carcinoma, MALT lymphoma
74. What is the most important virulence factor of Corynebacterium diphtheriae? Diphtheria toxin
75. What is the mechanism of action of the diphtheria toxin? Inhibits protein synthesis. Inhibits peptide elongation in eukaryotic ribosomes by
ADP ribosylation of EF-2 (elongation factor-2)
76. How long does immunity against diphtheria exist? Which immune effector mechanism is involved?
Antitoxic antibodies, long lasting immunity
77. Which assays should be done in the lab in order to prove diphtheria? Smears of the throat swab should be stained with methylene blue or Neisser stain;
bacteria are cultured on Löffler’s or tellurite (Clauberg) medium; toxin production
must be demonstrated by agar precipitation ( ELEK-test)
78. What feature of Mycobacteria make them acid fast? The cell envelope contains a high amount (60 – 70 %) of complex lipids: mycolic acid,
cord factor. Once the cells are stained (by carbol-fuchsin) they resist decolorisation by
acid-ethanol.
79. Mention 2 atypical Mycobacterium species! M. kansasii, M. marinum, M. avium-intracellulare complex, M. fortuitum-chelonei
complex

80. How can one demonstrate the presence of Mycobacterium tuberculosis in clinical samples?
Acid-fast staining (Ziehl-Neelsen)
Culture on selective media (Löwenstein-Jensen agar, liquid BACTEC medium)
PCR amplification of bacterial DNA
81. Why is multi-drug therapy used for tuberculosis? To prevent the overgrowth of drug-resistant mutants during the long treatment
period (if bacteria resistant to one drug emerge, they are most probably inhibited by
the other drugs).
82. What is the main immune defense mechanism against Mycobacterium tuberculosis? activated macrophages
83. Mention 3 antituberculotic drugs that are of first choice against Mycobacterium tuberculosis!
isoniazid (INH), pyrazinamid, rifampin, (ethambutol, streptomycin)
What disease is caused by Mycobacterium avium-intracellulare? What patients are characteristically susceptible to infection?
It causes TB, especially in immunosuppressed patients (such as AIDS patients).
What is the reservoir of Mycobacterium tuberculosis? What is the reservoir of atypical Mycobacteria? environment (soil, water)
87. What are the 2 distinct forms of leprosy? Tuberculoid, lepromatous forms
88. Mention 3 Gram-negative bacteria belonging to different genera causing zoonosis! Brucella, Francisella tularensis, Yersinia pestis, Pasteurella
89. Mention 2 Gram-positive bacteria belonging to different genera causing zoonosis! Listeria monocytogenes, Bacillus anthracis, Erysipelothrix rhusiopathiae
90. Mention 3 bacterial species belonging to different genera that are frequent causes of urinary tract infections!
E. coli, Klebsiella, Proteus, Pseudomonas aeruginosa, Enterococcus faecalis
91. Mention one aerobic and one anaerobic bacterium of the normal flora of the skin! aerobic: Staphylococcus epidermidis anaerobic: Propionobacterium acnes Give two genuses for each category of bacteria! Gram positive aerobic: Staphylococcus, Streptococcus, Bacillus, Corynebacterium,… Gram positive anaerobic: Clostridium, Actinomyces, Propionibacterium, Lactobacillus Give two genuses for each category of bacteria! Gram negativ aerobic: Vibrio, Neisseria, Haemophilus… Gram negativ anaerobic: Bacteroides, Prevotella, Porphyromonas, Veillonella… Give 2 genuses for each category of bacteria! Gram positive coccus: Staphylococcus, Streptococcus Gram negative coccus: Neisseria, Veillonella Gram positive rod: Clostridium, Bacillus Give 2 genuses for each category of bacteria! Gram negative rod: E. coli, Salmonella, Shigella Spirochetes: Treponema, Borrelia, Leptospira Describe the color and the shape of Clostridia in a Gram stained smear of gas gangrene exudate!
Gram positive (dark blue) rod
(it usually does not form spores in vivo)
Mention 2 antibiotics which can be used in the empirical treatment against Gram negative obligate anaerobic bacteria!
Metronidazol, amoxicillin + clavulanic acid, imipenem
Which 3 bacterial species are the most important causative agents of neonatal (< 1 month of age) meningitis?
Streptococcus agalactiae, E. coli, Listeria monocytogenes
Which 3 bacterial species are the most important causative agents of meningitis among babies (> 1 month of age) and children?
Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae
What is the causative agent of febris undulans (undulant fever)? Brucellae
What is the precise definition of bacterial food poisoning? Acute disease, usually with vomiting and diarrhea, caused by preformed toxins
produced by bacteria contaminating the food. The period between consumption of food
and the appearance of symptoms is short (< 4-6 hours).
What are the main symptoms in the different stages of syphilis? Primary syphilis: nontender ulcer (hard chancre)
Secondary lesions: maculopapular rash on skin, and condylomata lata on mucous
membranes
Tertiary stage: granulomas (gummas), central nervous system involvement (tabes
dorsalis, paralysis progressiva), cardiovascular lesions (aortitis, aorta aneurysm)
When syphilis is diagnosed in the lab, which antigens are used in the non-treponemal and in the specific treponemal antibody tests, respectively?
Non-treponemal antibody tests: cardiolipin
Specific treponemal antibody tests: Treponema pallidum
Which are the two different kinds of antibodies which may indicate syphilis? Give examples for tests demonstrating them!:
Reagin (nonspecific antibody) – RPR, VDRL (flocculation tests)
Immobilisin (specific antibody) – TPHA (T. pallidum hemagglutination), FTA-ABS
(fluorescent treponemal assay – with antibody absorption), TPI (T. pallidum
immobilisation test),
What is the advantage and disadvantage of the FTA-ABS syphilis serologic test compared to the VDRL test?
Specific (treponemal) tests such as FTA-ABS are more specific, but they can not be used
to follow the efficacy of treatment (because the specific antibodies persist even after
effective eradication of bacteria)
What is the drug of first choice in the treatment of syphilis? penicillin G
What is the reservoir and what is the vector for Borrelia recurrentis? Reservoir: human; vector: louse
What is used for the laboratory diagnosis of relapsing fever? Direct demonstration of bacteria from peripheral blood smear by microscopy (Giemsa
stain or dark field illumination)
What is the first characteristic symptom of Lyme disease? What is the causative agent?
Erythema (chronicum) migrans. Borrelia burgdorferi.
Mention 2 antibacterial drugs that are of first choice in early stage Lyme disease? Tetracyclines, amoxicillin, cefuroxim
Which symptoms are characteristic for the early and the late phases of disease by Borrelia burgdorferi?
Early: erythema chronicum migrans
Late: arthritis, cardiac (myocarditis, pericarditis) and neurological involvement
(meningitis, peripheral neuropathies)
What is the reservoir of Leptospira interrogans? rodents, household animals (dog, swine etc.)
Mention 2 obligate intracellular bacterial genuses! Rickettsia, Chlamydia, (Coxiella, Ehrlichia)
Mention 4 bacteria causing atypical pneumonia! Chlamydia pneumoniae
Chlamydia psittaci
Coxiella burnetii
Mycoplasma pneumoniae
Legionella pneumophila
What diseases are caused by Rickettsia prowazekii? Louse-borne epidemic typhus
Recurrent form: Brill-Zinsser disease
Mention an antibacterial drug active against rickettsial infections! Tetracycline, chloramphenicol
What are the reservoir and vector of Rickettsia prowazekii infections? reservoir: human; vector: louse
What are the reservoir and vector of Rickettsia typhi infections? reservoir: rodents; vector: flea
What is the causative agent of epidemic typhus? Rickettsia prowazekii
How can be Chlamydiae and Rickettsiae cultivated? These are obligate intracellular bacteria, can be cultured in experimental animals,
embryonated eggs, and cell culture
Mention an antibacterial drug active against chlamydial infections! Tetracycline, erythromycin, azithromycin

List the serotypes of Chlamydia trachomatis and the diseases caused by them! Types A,B and C: trachoma (chronic conjunctivitis)
Types D-K: genital tract infections (NGU, PID), inclusion conjunctivitis
Types L1-L3: lymphogranuloma venereum (STD)

123.
Mention an antibacterial drug effective against Mycoplasma pneumoniae infections! Erythromycin, azythromycin, tetracycline
Why are penicillins not effective against Mycoplasma pneumoniae infections? Because of the absence of a cell wall, penicillins are ineffective (penicillins inhibit cell
wall synthesis)
It is based on the cross-reaction of an antigen present in many rickettsiae with the O
antigen polysaccharide found in certain Proteus vulgaris strains (OX19 OX2, OXK).
The test is a tube agglutination test in which these Proteus strains are used as antigens to
demonstrate antibodies from the patient’s serum sample.
Mention 4 bacteria frequently causing sexually transmitted diseases (STD)! Treponema pallidum, Neisseria gonorrhoeae, Haemophilus ducreyi, Chlamydia
trachomatis, (Calymmatobacterium granulomatis)
Which bacterial species can cause hepatitis (jaundice)? Leptospira interrogans
Mention 2 bacteria causing aseptic (serous) meningitis! Treponema pallidum, Leptospira interrogans, Borrelia burgdorferi
Mention a bacterial pathogen which eludes the host immune response by frequent antigenic changes!
Borrelia recurrentis, Neisseria gonorrhoeae
What is the causative agent of febris recurrens (recurrent fever)? Borrelia recurrentis

MYCOLOGY

The same species is capable of existing in two morphological forms (yeast or mold),
depending upon enviromental conditions (temperature, nutrients).
Which are the 4 fungal species causing systemic infections? Coccidioides immitis, Histoplasma capsulatum, Blastomyces dermatitidis, Paracoccidioides
brasiliensis
Mention 3 species causing opportunistic fungal infections! Candida albicans, Cryptococcus neoformans, Aspergillus fumigatus, Mucor spp., Rhizopus
spp.
Mention 3 diseases caused by dermatophytons! Tinea corporis, tinea capitis, onychomycosis, tinea barbae
Mention 3 fungal genera belonging to the dermatophytons! Trichophyton, Microsporum, Epidermophyton
What is the route of transmission of Sporothrix schenkii? Traumatically introduced into the skin.
Mention a Candida infection associated with mucosal surfaces! Soor, vulvovaginitis
Which species is the most important causative agent of fungal meningitis? Cryptococcus neoformans
Mention 3 manifestations of Candida albicans infections that are characteristic in AIDS patients?
generalised oral candidiasis (GOC), oesophagitis, endocarditis
What are the different forms of pulmonary aspergillosis? 1. Aspergillus ball (in preformed cavities)
2. invasive aspergillosis (in immunosuppression)
3. allergic bronchopulmonary aspergillosis
What is the usual source of infection in systemic mycoses? What is the usual site of entry of fungi causing systemic mycoses? respiratory tract (inhalation)
Which morphological form of Coccidioides immitis can be found in the human body? spherule
Which human pathogenic fungus has a capsule? Cryptococcus neoformans

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PARASITOLOGY
1.
Mention a worm species for which ab ano ad os auto-reinfection is characteristic in childhood!
Enterobius vermicularis
Mention 2 worm species that migrate through the human lungs in the larval stage! Ascaris lumbricoides
Ancylostoma duodenale
Necator americanus
Strongyloides stercoralis
Which 2 protozoa may infect the human foetus transplacentally? Toxoplasma gondii
Plasmodium species
What is the laboratory diagnosis of malaria? Giemsa-stained blood smears. Thick smear is used to screen for the agent, thin smear is
used to identify the species.
How long is the erytrocytic cycle of Plasmodium vivax and P. ovale? How long is the erytrocytic cycle of Plasmodium malariae? What is the causative agent of malignant malaria? Plasmodium falciparum
Mention an antimalarial drug active against hypnozoites! Primaquin
How can one diagnose the African sleeping sickness disease? Giemsa-stained blood smears are used for direct demonstration
Serology may be helpful

10.
What are the causative agents of African sleeping sickness? Trypanosoma brucei gambiense and rhodesiense
Microscopic demonstration of E. histolytica cysts and trophozoites from feces
How can one diagnose Trichomonas vaginalis infection? Direct demonstration of protozoa in wet mount or stained smear of clinical specimens
(vaginal, urethral or prostatic secretions).
How can one diagnose intestinal taeniasis? Demonstration of characteristic proglottis and eggs (ova) in faeces.
How can one diagnose Hymenolepis infection? Demonstration of eggs (ova) in faeces
Demonstration of eggs (ova) in faeces
Demonstration of eggs (ova) in faeces
How can one diagnose Enterobius infection? Demonstration of eggs (ova) recovered from perianal skin (Scotch tape technique). Not
from feces!
Mention 4 tissue infecting filarial nematodes! Wuchereria bancrofti
Loa loa
Oncocerca volvulus
Dracunculus medinensis
How is human Fasciola hepatica infection acquired? By eating aquatic vegetation containing encysted larvae
(Rarely: by eating raw sheep liver containing adult worms)
What disease is caused if humans are infected per os with Taenia solium eggs? human cysticercosis (encysted larvae in brain, eyes, etc.)
How is human Trichinella spiralis infection acquired? By eating raw or undercooked meat containing encysted larvae
Mention 2 protozoa that are susceptible to metronidazol! Entamoeba histolytica
Giardia lamblia
Trichomonas vaginalis
What are the 3 modes of transmission for human Toxoplasma gondii infection? Eating undercooked meat containing tissue cysts,
Contact with cat feces containing oocysts
Transplacental transmission
Mention 2 helminths whose larvae enter the human body by penetratring the intact skin!
Schistosoma
Ancylostoma duodenale
Necator americanus
Strongyloides stercoralis
Which developmental form of Echinococcus granulosus can occur in humans? Hydatid cyst
What is the definitive (ultimate) host of Echinococcus granulosus? Which species are the causative agents of malaria? Plasmodium vivax, P. ovale, P. malariae, P. falciparum
What is the definitive (ultimate) host of Plasmodium species? female Anopheles mosquito
What are the definitive, and the intermediate hosts of Taenia saginata, respectively? definitive host: human
intermediate host: cattle
What is the infectious form of Strongyloides stercoralis? filariform larva
What is the infectious form of Trichuris trichiura? embryonated egg
Which form of Taenia saginata is infectious for humans? cysticercus (in beef)
Is autoreinfection possible in Ascaris lumbricoides infection? If yes, when? No, the eggs must mature in the soil for several days to become infectious
(embryonated)
Is autoreinfection possible in Strongyloide stercoralis infection? If yes, when? yes, in immunosuppression (for example: AIDS)
Is autoreinfection possible in Enterobius vermicularis infection? If yes, when? yes, the eggs become infectious in a few hours, and ab ano ad os autoinfection may
occur (especially in children)
___________________________________________________________________________
VIROLOGY
1.
Which virus family is characterized by a single-stranded DNA genome? Parvoviridae
Which virus family is characterized by a double-stranded RNA genome? Reoviridae
Which viruses are susceptible to acyclovir? What is the mechanism of effect of the drug?
alpha herpesviruses – HSV1, HSV2, VZV; inhibitor of viral DNA polymerase and
DNA chain terminator
Explain why acyclovir is selectively toxic to cells infected by alpha-herpesviruses! These viruses encode their own thymidine kinase enzymes, which are needed for
activation (phosphorylation) of the drug. Cellular thymidine kinase does not activate
the drug.
In which cells do Herpes simlex viruses establish latent infection? Sensory ganglion cells (trigeminal or sacral ganglia)
What is the possible, late complication (years after acute infection) of the childhood chickenpox?
Herpes zoster (shingles)
7. What are the possible consequences of fetal infections caused by B19 parvovirus? fetal death or hydrops fetalis
Which isotype of antigen-specific immunoglobulins in the newborn's blood indicates a congenital infection?
IgM
What diseases do cytomegalovirus cause in congenital infections? cytomegalic inclusion disease – spontaneous abortion, CNS damage (deafness, blindness,
mental retardation), hepatosplenomegaly, jaundice
What diseases do cytomegalovirus cause in immunocompetent persons? mononucleosis infectiosa (heterophil-antibody negative)
Mention 2 diseases that cytomegalovirus can cause in immune compromised persons! pneumonia, chorioretinitis, colitis
Which antiviral drug is active against cytomegalovirus infection? Ganciklovir, (foscarnet, cidofovir)
Describe the heterophil antibody test used in Epstein-Barr virus diagnostics! Paul-Bunnel test – in mononucleosis caused by EBV, the serum of the patient
agglutinates sheep red blood cells
Which virus causes exanthema subitum (roseola infantum)? Which virus causes erythema infectiosum? Human parvovirus B19
Reverse transcription is involved in the replication of which DNA virus? Hepadnaviridae – HBV
What is the mechanism of antigenic shift in influenza viruses? reassortment of genome segments
Which antigens of the influenza virus are recognized by neutralizing antibodies? Hemagglutinin, neuraminidase
Which virus(es) is(are) susceptible to amantadine? Influenza A virus
What is the possible late complication of measles infection (several years after the acute infection)?
SSPE – subacute sclerosing panencephalitis
What is the portal of entry of the viruses belonging to Paramyxoviridae? Respiratory tract – aerosol infection
Which age group is mostly affected by respiratory syncitial (RS) virus infection? babies (6 week – 6 month old)
What are the possible complications of adulthood mumps virus infection? Specify at least 2 of them!
Orchitis, meningitis, pancreatitis
What is the route of infection of rabies virus? How does rabies virus spread in the infected body?
By the bite of a rabid animal, (rarely by infectious aerosol)
spread of the virus in the host – along the axons
What medication does a person need after exposure to rabies virus? Active immunization – human diploid cell vaccine (killed virus)
and passive immunization – rabies immune globulin
What is the portal of entry of polioviruses? Which areas of the central nervous system are affected by poliovirus infection?
oropharynx and gastrointestinal tract
damage in motor neurons in the anterior horn of the spinal cord + brain stem
Which viruses belong to the Enterovirus genus? Polioviruses, coxsackie A and B viruses, echoviruses, enteroviruses 68 - 71
Mention 4 diseases caused by Coxsackie viruses! febrile rashes, herpangina, myocarditis, pericarditis, meningitis, pleurodynia, hand-
foot-and-mouth disease
What disease do rotaviruses cause? At which age? gastroenteritis in young children
List the 3 antigens of hepatitis B virus against which antibodies may develop during or after the acute phase of infection?
HBsAg, HBeAg, HBcAg
Which hepatitis B-specific antibody is never present in chronic hepatitis? Anti-Hbs
What are the main modes of transmission of HBV (hepatitis B virus) infection? sexual contact; perinatally from mother to newborn; by blood or blood product
What are the 2 serological markers that are necessary and sufficient to prove acute hepatitis B virus infection?
HBsAg, Anti-HBc IgM
Describe the active and passive prophylaxis against hepatitis B! active immunization: recombinant HBsAg vaccine
passive immunization: HBIG (hepatitis B immune globulin)
Which hepatitis viruses are acquired orally? Which hepatitis viruses are acquired via parenteral routes? HBV, HCV, HDV, (HGV)
Mention 4 diseases that can be caused by adenoviruses! pharyngitis, pharyngoconjunctival fever, acut respiratory disease, bronchitis,
atypical pneumonia, hemorrhagic cystitis, gastrointestinal infection
Kuru, Creutzfeldt-Jacob disease, Gerstmann-Straussler-Scheinker syndrome, fatal
familial insomnia
What are the serious complications of HSV infection in newborns? disseminated infections, encephalitis, skin, eye, mouth infection
Mention 3 DNA virus families containing no envelope!
Parvoviridae, Papovaviridae, Adenoviridae
Mention 3 DNA virus families containing envelope! Herpesviridae, Hepadnaviridae, Poxviridae
Mention 3 RNA virus families containing no envelope!
Picornaviriade, Caliciviridae, Reoviridae
Mention 3 RNA virus families containing envelope! Orthomyxoviridae, Paramyxoviridae, Rhabdoviridae, etc.
What is the portal of entry of mumps virus? Upper respiratory tract
Mention at least two viruses capable of causing pneumonia. RSV, influenza virus A and B, parainfluenza virus, adenovirus, coronavirus (SARS),
metapneumovirus,
What is the causative agent of subacute sclerosing panencephalitis (SSPE)? Measles virus
What is(are) the nature(s) of antigen(s) in the combined vaccine against measles, German measles and mumps?
live attenuated viruses
What is the nature of antigen in the rabies vaccine for human use? killed virus
Which viral variants are included in the human influenza vaccine? The vaccine contains 2 influenza A strains (H3N2, H1N1) and 1 influenza B strain.
What is the nature of antigen in the vaccine against hepatitis B? Subunit vaccine, containing HBsAg
What is(are) the nature(s) of antigens in the vaccines against poliovirus? IPV: inactivated polio vaccine: killed viruses (types 1, 2 and 3)
OPV: oral polio vaccine: live attenuated viruses (types 1, 2 and 3)

52. What is the causative agent of PML (progressive multifocal leucoencephalopathy)?
JC virus (Polyomaviridae)
53. Which influenza virus types are characterised by antigenic shift? influenza A
54. Which influenza virus types are characterised by antigenic drift? Influenza A and B
55. What is the nature of the immune response in diseases caused by prions? There is no immune response, as prions are self proteins.
56. Mention at least 3 diseases caused by herpes simplex viruses (HSV1, HSV2)! oropharyngeal herpes (gingivostomatitis, herpes labialis), keratoconjunctivitis,
encephalitis, herpes genitalis
57. What are the possible consequences of fetal infections caused by rubella virus? Specify at least 3 of them!
Congenital malformations involving the heart (patent ductus arteriosus, septum
defects), the eyes (cataract, glaucoma) and the brain (deafness, mental reardation).
58. Which ifluenza A subtypes cause most human infections currently? H1N1, H3N2
Which are the two most important targets of antiretroviral chemotherapy? HIV reverse transcriptase and protease
60. Mention 3 nucleoside type reverse transcriptase inhibitors used in the therapy of AIDS! azidothymidine (zidovudine), dideoxyinozine (didanosine), dideoxycytidine
(zalcitabine), stavudine, lamivudine, abacavir
61. Mention 2 non nucleoside type reverse transcriptase inhibitors used in the therapy of AIDS!
nevirapine, delavirdine, efavirenz
62. Mention 2 protease inhibitors used in the therapy of AIDS! indinavir, saquinavir, ritonavir, nelfinavir, amprenavir
63. What is the principle of the „highly active antiretroviral therapy” (HAART) currently used in the treatment of AIDS!
Combination of two nucleoside reverse transcriptase inhibitors (such as zidovudine
and lamivudine) and a protease inhibitor (such as indinavir). Or combination of two
nucleoside reverse transcriptase inhibitors (such as zidovudine and lamivudine) and
a nonnucleosid reverse transcriptase inhibitor (such as efavirenz).
2 NRTI + PI/NNRTI
What are the criteria to classify a virus as robovirus? Write an example, too! Robovirus: rodent reservoir (rodent-borne)
Arenaviridae – Lassa, Junin, Machupo, LCM virus; Bunyaviridae – Hantaan virus,
Puumala virus, Sin Nombre virus; Filoviridae – Marburg, Ebola virus
What are the criteria to classify a virus as arbovirus? Write an example, too! Arbovirus: arthropode vector (arthropode-borne);
Flaviviridae – yellow fever, Dengue-fever; Bunyaviridae – Rift-valley fever, Crimean-
Congo hemorrhagic fever; etc.
Which hepatitis virus infections increase the risk of hepatocellular carcinoma? HBV, HCV, HDV
Which virus can cause haemorrhagic fever with hepatitis and nephritis? yellow fever virus
Describe the 2 different epidemiological cycles of yellow fever! Jungle yellow fever: reservoir: monkeys; vector: Haemagogus mosquitos; humans:
accidental hosts
Urban yellow fever: reservoirs: humans; vectors : Aedes aegypti mosquitos
How can we prevent tick borne encephalitis? Active immunization: killed virus vaccine, passive: specific immune globulin
Which viruses can cause human tumors? Mention at least 4! HPV, EBV, HHV-8, HBV, HCV, HTLV
Mention 3 opportunistic infections characteristic for AIDS! Viruses: HSV-1, HSV-2, VZV, HCMV, EBV, HHV-8, HPV
Protozoa: Toxoplasma gondii, Pneumocystis carinii
Bacteria: Mycobacterium tuberculosis, atypical Mycobacteria, Salmonella septicaemia
Fungi: Candida, Cryptococcus neoformans
Describe the principals of the laboratory diagnosis of HIV infection! Demonstration of antiviral antibodies.
Presumptive diagnosis: ELISA
Verification: Western-blot assay
Mention three sexually transmittable viral infections! HPV, HSV-1, HSV-2, HIV, HBV, HCV, molluscum contagiosum
Mention two viruses capable of getting through the placenta. Rubella virus, HCMV, parvovirus B19, HIV, HTLV-1
Mention 2 viral infections whose preventive strategy involves passive immunization! Rabies, tick-borne encephalitis, HBV, VZV, measles
List three viruses capable of causing (meningo)encephalitis! Rabies, HSV, VZV, tick-borne encephalitis, Japanese B encephalitis, eastern and
western equine encepahalitis, mumps, poliovirus, coxsackie virus, echovirus

77.
What is the nature(s) of antigen in the vaccine against yellow fever? Live attenuated virus (17D strain)

78.
What disease does Epstein-Barr virus cause? What are the Epstein-Barr virus associated tumors?
Mononucleosis infectiosa (heterophil positive)
Nasopharyngeal carcinoma, Burkitt’s lymphoma, other B-cell lymphomas
79. Mention 3 types of human cancers caused by EBV? Nasopharyngeal carcinoma, Burkitt’s lymphoma, other B-cell lymphomas
80. What type of human cancer is caused most frequently by HHV8? Kaposi’s sarcoma
81. What types of human cancers are caused by high-risk HPV types? genital cancers, most importantly cervical cancer

Source: http://www.mikrobiologia.deoec.hu/upload/deoecmikrobi/document/GM_Short_answer_questions_2011_2012_1.pdf