VISION 2019 MISSION MD*MS*DNB MICROBIOLOGY

MICROBIOLOGY AIIMS PICTURE BASED QUESTIONS

1. Identify the following organism? (NOV 2017)

a) Mycobacterium tuberculosis
b) Corynebacterium diphtheriae
c) Actinomycetes
d) Nocardia

Answer: a) Mycobacterium tuberculosis

Mycobacterium tuberculosis: Acid-fast stain. Long-red rods of M.

tuberculosis are in a blue background

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Corynebacterium diphtheria –Chinese letter arrangement, club-shaped”

gram-positive rod, typical V- or L-shaped corynebacteria

Nocardia asteroids: Modified acid-fast positive filaments

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ACTINOMYCETES - gram positive bacilli 'antler-like branching'

(filamentous branching). Modified acid fast negative (Nocardia acid fast +)

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2. Identify the organism (MAY 2017)

a) Nocardia species
b) Actinomyces species
c) Mycobacterium tuberculosis
d) Mycobacterium leprae

Answer: a) Nocardia species

Branching, filamentaous organism, weakly acid fast

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3. Gram staining of the scrapings of a genital ulcer is given. The causative

organism is (MAY 2017)

a) Klebsiella granulomatis
b) Hemophilus ducreyi
c) Neisseria gonorrhea
d) Chlamydia trachomatis

Answer: a) Klebsiella granulomatis

Picture shows Donovan bodies

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Neisseria gonorrheae – intracellular gram-negative diplococci

Hemophius ducreyi – small, gram-negative rods occur in strands (School of

fish appearance)

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4. Identify the organism in the Gram staining slide picture (NOV 2016)

a) Staphylococcus aureus
b) Neisseria gonorrhoeae
c) Streptococcus pneumoniae
d) Haemophilus influenzae

Answer: b) Neisseria gonorrhoeae

Picture shows intracellular – gram negative diplococci

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Staphylococcus aureus - forming Streptococcus pyogenes -

Grape like clusters forming chains

Hemophilus influenzae: Gram negative pleomorphic cocco-bacilli

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5. Following Foley’s catheterization, a patient in ICU developed urinary

tract infection. Catheter tip was sent for culture and grown on blood
agar. The blood agar picture after 24-hours is given. The most likely
agent causing UTI is (NOV 2016)

a) Escherichia coli
b) Proteus mirabilis
c) Pseudomonas aeruginosa
d) Klebsiella pneumoniae

Answer: b) Proteus

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6. A picture of silver impregnation technique is given. Identify the

Spirochete (NOV 2016)

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a) Spirillum minus
b) Leptospira interrogans
c) Treponema pallidum
d) Borellia recurrentis

Answer: b) Leptospira interrogans

Treponema – thin, delicate, regular Borellia – large, irregular, wide

spirals at regular intervals open coils

Leptospira – large number of closely wound spirals, hooked ends

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Treponema

Borrelia burgdoferi

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Leptospira interogans

7. The gram stained smear shown below is most consistent with? (MAY
2016)

a) Staphylococcus aureus
b) Streptococcus pyogenes
c) Streptococcus pneumoniae
d) Neisseria gonorrhoeae
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Answer: c) Streptococcus pneumoniae

Picture shows Gram positive cocci in pairs

Pneumococci – in pairs Enterococci – in short chains or

pairs at an angle

Quellung reaction Draughtsman/Carron coin

(Capsular swelling) appearance of pneumococci
colonies

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8. A 22-year old girl is bought to the casualty with history of fever,

confusion and neck stiffness for 2 days. A purpuric rash is on her
extremities (see picture). BP 70/50 mmHg. Lumbar puncture sample
shows a cloudy CSF with TLC 4200 cells/mm3 with 91% neutrophils,
protein: 198 mg/dl, glucose: 21 mg/dl. The causative organism is a (MAY
2016)

a) Gram positive diplococcus (lanceolate), catalase negative, optochin

sensitive
b) Gram positive cocci in chains, catalase negative, bacitracin sensitive
c) Gram negative diplococcus, ferments glucose and maltose
d) Gram negative diplococcus (kidney bean shaped), oxidase positive

Answer: c) Gram negative diplococcus, ferments glucose and maltose

This is a characteristic rash in meningococcal meningitis caused by Neisseria
meningitidis which is a Gram negative diplococcus, ferments glucose and
maltose
A – Streptococcus pneumoniae
B – Streptococcus pyogenes
D – Neisseria gonorrhoeae

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9. A patient is diagnosed with brain abscess. Nasal biopsy is taken and

stained. Identify the organism and the stain used (NOV 2015)

a) Cryptococcus, India ink

b) Nocardia, Gram stain
c) Streptococcus, Gram stain
d) Staphylococcus, Gram stain

Answer: b) Nocardia, Gram stain

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10. Gram staining of scrapings of a genital ulcer is shown. Identify the

organism (NOV 2015)

a) Hemophilus ducreyi
b) Neisseria gonorrhea
c) Chlamydia trachomatis
d) Klebsiella granulomatis

Answer: a) Hemophilus ducreyi

Picture shows characteristic school of fish appearance

11. A farmer presented with cervical lymphadenopathy with multiple

discharging sinuses. HPE of the lymph node is shown. Which of the following
stain is used for the diagnosis of the patient? (NOV 2015)
a) Grams stain
b) AFB stain
c) PAS stain
d) Methenamine silver

Answer: a) Gram stain

Material from suspected cases is shaken with sterile water in a tube. Sulphur
granules settle to the bottom and may be removed
with a Pasteur pipette. Granules crushed between two glass slides are stained by
the Gram and Ziehl–Neelsen (modified by using 1% sulphuric acid for
decolorization) methods, which reveal the Gram-positive mycelia and the zone of
radiating acid-fast clubs

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12. Identify the virus? (NOV 2017)

a) HIV
b) Hepatitis B virus
c) Influenza
d) Herpes simplex

Answer: b) Hepatitis B virus

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Hepatitis B virus replication

• The infectious virion attaches to cells and becomes uncoated In the
nucleus, the partially double-stranded
viral genome is converted to covalently closed circular double-stranded
DNA (cccDNA).
• The cccDNA serves as template for all viral transcripts, including a 3.5-kb
pregenome RNA.
• The pregenome RNA becomes encapsidated with newly synthesized
HBcAg. Within the cores, the viral polymerase synthesizes by reverse
transcription a negative-strand DNA copy.
• The polymerase starts to synthesize the positive DNA strand, but the
process is not completed.
• Cores bud from the pre-Golgi membranes, acquiring HBsAg-containing
envelopes, and may exit the cell. Alternatively, cores may be reimported
into the nucleus and initiate another round of replication in the same
cell.

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13. Which causative organism is responsible for this disease? (NOV 2017)

a) Coxsackie virus
b) Human herpes virus
c) Pox virus
d) Molluscum contagiosum

Answer: a) Coxsackie virus

Hand foot and mouth disease
• After an incubation period of 4–6 days, patients with hand-foot-and-
mouth disease present with fever, anorexia, and malaise;
• These manifestations are followed by the development of sore throat
and vesicles on the buccal mucosa and often on the tongue and then by
the appearance of tender vesicular lesions on the dorsum of the hands,
sometimes with involvement of the palms.

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• About one-third of patients also have lesions on the palate, uvula, or

tonsillar pillars, and one-third have a rash on the feet (including the
soles) or on the buttocks
• The disease is highly infectious, with attack rates of close to 100%
among young children.
• The lesions usually resolve in 1 week.
• Most cases are due to coxsackievirus A16 or enterovirus 71

14. Life cycle of a human pathogen is given below. All of the following are
true regarding the pathogen except (NOV 2015)

a) Segmented genome
b) Incubation period 1 – 3 days
c) Pigs act as hosts
d) Pandemic is caused by all serotypes

Answer: d) Pandemic is caused by all serotypes

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A – Orthomyxo viruses have segmented genome

B – IP 18-72 hours
C - Influenza A: broad host range - water-based wild birds, humans, horses and
swine
D – Pandemics are caused by Influenza A virus

15. Identify the disease from the life cycle given below (NOV 2015)

a) Japanese encephalitis
b) Influenza
c) Dengue
d) Chikungunya

Answer: a) Japanese encephalitis

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16. A female from Himachal Pradesh presented with verrucous lesions

growth the skin with the following microscopic finding; Identify the
agent? (NOV 2017)

a) Blastomycosis
b) Pheohyphomycosis
c) Sporotrichosis
d) Chromoblastomycosis

Answer: d) Chromoblastomycosis
The diagnostic brownish, melanized sclerotic cells (4–12 m diameter)
are evident

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Chromoblastomycosis – Copper penny bodies

Chromoblastomycosis - Wartlike lesions with crusting abscesses

extend along the lymphatics

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17. A male with history of thorn prick presents with the following lesions in
the leg. Diagnosis.

a) Blastomycosis
b) Sporotrichosis
c) Pheohyphomycosis
d) Chromoblastomycosis

Answer: b) Sporotrichosis

Pictures shows - ulcers along lymphatic channels

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18. Lung biopsy of a neutropenic patient shows the following organism on

staining. Identify the organism? (NOV 2017)

a) Aspergillus
b) Mucor
c) Penicillium
d) Rhizopus

Answer: a) Acute angled branching Aspergillus

Picture shows typical acute-angled, Y-shaped (dichotomous) branching
septate hyphae

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Mucormycosis – aseptate, broad, ribbon like hyphae, right angled branching

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19. A known HIV infected patient develops diarrhea. Fecal examination

shows Isospora belli. He was treated with TMP-SMX. Diarrhea subsided
but fever persisted. Bone marrow examination showed the following
picture with an intracellular fungi. Which of the following not true? (NOV
2017)

a) It cannot be grown in SDA

b) Spores are the infective form
c) It is an intracellular pathogen
d) Does not cause disseminated disease

Answer: d) Does not cause disseminated disease

Diagnosis: Histoplasmosis

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20. A known case of HIV/AIDS presents with neck pain, fever, nausea and
vomiting. He succumbed to the illness. Autopsy is done. Pictures of section of
brain and HPE are given. Most likely causative agent (Nov 2016)
a) Cryptococcus neoformans
b) Echinococcus multilocularis
c) Herpes simplex virus
d) Toxoplasma gondii

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Answer: a) Cryptococcus neoformans

Section of the brain in a case of Cryptococcosis demonstrates the

characteristic cystic lesions. Special staining methods reveal the
structure of Cryptococcus, which is spherical, surrounded by an external
capsule

21. Identify the following egg? (NOV 2017)

a) Entamoeba dispar
b) Giardia Lamblia
c) Balantidium coli
d) Entamoeba histolytica

Answer: c) Balantidium coli

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Giardia lamblia Trichomonas vaginalis –

(cyst & trophozoite) trophozoite

Entamoeba histolytica

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Eggs of Schistosoma
S mansoni – lateral S. hematobium – terminal S japonicum – spine
spine spine rudimentary

22. The life-cycle given below belongs to (MAY 2017)

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a) Entamoeba histolytica
b) Balantidium coli
c) Ancylostoma duodenale
d) Enterobius vermicularis

Answer: a) Entamoeba histolytica

23. A 23-year old patient presents with history of abdominal pain and dysentery.
Histopathologic picture of colonic biopsy specimen is given. Most likely
diagnosis (MAY 2016)

a) Enterobiasis
b) Giardiasis
c) Intestinal amoebiasis
d) Bacterial diarrhea

Answer: c) Intestinal amoebiasis.

The picture shows trophozoites of E histolytica

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24. A 24-year old young male presents with persistent diarrhea and loss of
weight. Examination reveals signs of moderate dehydration such as dry
tongue and loss of skin turgor. Endoscopic is performed and biopsy is sent
for HPE. Most likely diagnosis (Nov 2016)

a) Whipple’s disease
b) Giardiasis
c) Entamoeba histolytica
d) Helicobacter pylori

Answer: b) Giardiasis
The picture shows trophozoite of Giardia lamblia

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25. The following picture shows various stages of development of (NOV 2015)

a) Plasmodium vivax
b) Plasmodium malariae
c) Plasmodium falciparum
d) Plasmodium ovale

Answer: a) Plasmodium vivax

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The number of developmental stages of P vivax and P falciparum are 30.

➢ P vivax – Schuffner’s dots are seen in infected erythrocytes
➢ P falciparum – Banana shaped gametocytes in stage 27-30

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The number of developmental stages of P malaria and P ovale are 30.

➢ P malariae – band forms (stage 10, 13)

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26. An adolescent girl is brought with fever and chills for 3 days. Examination
reveals signs of dehydration (positive skin pinch test and dry oral mucosa).
Peripheral blood smear picture is given below. Identify the species of
malarial parasite (NOV 2016)

a) Plasmodium vivax
b) Plasmodium falciparum
c) Plasmodium malariae
d) Plasmodium ovale

Answer: b) Plasmodium falciparum

More than one ring in one RBC and accole forms (rings at the margin of RBC) are
characteristic of falciparum malaria

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27. The life cycle given below refers to (MAY 2017)

a) Fasciola hepatica
b) Fasciola buski
c) Clonorchis sinensis
d) Paragonimus westermani
e)

Answer: a) Fasciola hepatica

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28. The following picture of an egg belongs to (MAY 2017)

a) Ascaris lumbricoides
b) Enterobius vermicularis
c) Necator americanus
d) Trichuris trichura

Answer: c) Necator americanus

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29. Which of the following statement regarding the intestinal nematode in the
picture given below is correct? (NOV 2016)

a) Adult worm is present in small intestine

b) Adult worm grows 1-2 m in length
c) Eggs become infective in 10 days
d) Drug of choice is triclabendazole
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Answer: c) Eggs become infective in 10 days

Image of Trichuris trichura
*Eggs become infective after 3 weeks of maturation in soil (JAWETZ); 15 to 30
days (CDC.gov); 10-14 days (medscape.com)

30. Picture of microscopic wet mount of stool sample is given. True statement
regarding the helminth (MAY 2016)
a) The infective stage of the parasite is the Rhabditiform larva
b) Females are parthenogenic
c) Transmitted through consumption of contaminated food and water
d) Drug of choice – thiabendazole

Adult free-living Strongyloides stercoralis alongside a rhabtidiform

larvae

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Answer: c) Females are parthenogenic

31. The following statement is true regarding the helminth whose egg is given
below (MAY 2016)

a) Acquired by consumption of improperly cooked pork

b) Causes transient self-limiting infection in human
c) Both adult and larval stages are seen in human
d) Drug of choice is thiabendazole/albendazole

Answer: c) Both adult and larval stages are seen in human

It is an egg of Tenia solium

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32. A young woman presents with progressive dyspnea for 3 months. A

cavitatory lesion was detected in the right lower lobe of the lung and
lobectomy was performed. Histopathological picture is given. Most likely
cause of the disease and the number of layers seen in the wall (NOV 2015)

a) Echinococcus with 3 layers

b) Strongyloides with 2 layers
c) Paragonimus with 3 layers
d) Cysticercosis with 2 layers

Answer: a) Echinococcus with 3 layers

C – Paragonimus eggs are found in lungs; after extensive search, we could not
find the number of layers in paragonimus lung cyst
D - Cysticercus cyst contains 3 layers

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33. Microscopic picture of stool sample of a patient is given. What is the mode of
transmission of the parasite? (NOV 2015)

a) Feco-oral transmission
b) Ingestion of undercooked beef
c) Penetration by filariform larvae
d) Penetration by rhabditiform larvae

Answer: a) Feco-oral transmission

Picture shows egg of trichuris

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34. Identify the species of microfilaria (NOV 2015)

a) Brugia malayi
b) Wuchereria bancrofti
c) Loa loa
d) Onchocerca volvulus

Answer: a) Brugia malayi

Sheathed microfilaria (WITH MNEMONICS)

1 Loa loa: tip of tail (1a) with several nuclei;
2 Wuchereria bancrofti: tip of tail (2a) without nuclei
3 Brugia malayi: tip of tail (3a) with two nuclei
Unsheathed microfilaria
4 Mansonella perstans: tip of tail (4a) rounded with densely packed nuclei, often
in several rows reaching nearly to the tip of the tail;
5 Mansonella ozzardi: tip of tail (5a) pointed, tip free of nuclei

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Mnemonic: She (Sheathed mf) is a

Lovely (Loa)
Beautiful (Brugia)
Woman (Wuchereria)
Bankrupt means nothing (Bancrofti has no nuclei in the tip)
Brugia - B is the second letter, Hence two nuclei at the tip
The other Sheathed mf is Loa which contains several nuclei at its tip
For Unsheathed remember PR & OP
PR - Perstans, Round tip, several nuclei
OP - Ozzardi, Pointed tip, no nuclei (O for zero)

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