PAST YEAR QUESTIONS

PAST YEAR QUESTIONS & ANSWERS

Note from Webmaster: Use the back button of the browser to return to this page. The answers provided to the questions listed below are by no means absolute in terms of both factual accuracy or consistency. They are merely suggested answers offered in the hope of providing a structural framework from which students are able to derive a better idea on how to approach these questions. Please use them at your own discretion.

MCQs

1. Viruses

2. Bacteria

3. Parasites

4. Antibiotics

Professionals & Supplementaries

2002 (Main):

1. Describe briefly the infections caused by Mycobacterium tuberculosis. Discuss the laboratory diagnosis, treatment and prevention of infections caused by this organism.

2. A patient presents with headache, fever, neck stiffness and photophobia.

(i) Discuss the investigations you would like to perform, and the interpretation of the results.

(ii) List the bacterial causes of meningitis; describe the patient group(s) in which each is most likely to occur.

(iii) Discuss the treatment and prevention measures applicable to such patients adn their contacts.

3. Name the viruses that can give rise to exanthemata (skin and mucosal rash). Describe the transmission, clinical features, laboratory diagnosis and prevention of ONE of the viral exanthemata named.

2001 (Main):

1. Describe the clinical presentations and laboratory diagnosis of malaria. Comment on the use of chloroquine and quinine in the prevention and management of this infection.

2. Discuss the clinical presentations, laboratory diagnosis, prevention and treatment of varicella-zoster virus infections.

3. Give a brief account of the bacteriology of the streptococci and enterococci. What diseases do they cause, how are they diagnosed in the laboratory and how are they treated?

2000 (Main):

1. Describe the epidemiology and clinical features of infections caused by Neisseria gonorrhoea. What are the diagnostic methods and antibiotic treatment available?

2. Write short notes on nosocomial infections. What are the means available for the prevention and control of such infections?

3. Describe the diagnosis of human immunodeficiency virus infections. What are the tests used, whom do you test and what are the important issues for testing?

2000 (Supplementary):

1. Describe the virology and epidemiology of hepatitis B virus. What are the diseases caused by it, and what measures are available for its control?

2. Describe the laboratory diagnosis of infections caused by Staphylococcus aureus. Discuss the diseases caused by this organism, and their treatment.

3. Discuss the use of vaccines for the prevention of infectious diseases. What are the vaccines available, when do you use them for general population, and for special groups, e.g. travellers, healthcare workers.

1999 (Main):

1. A male, aged 15 yrs had a bicycle accident which injured his spleen causing bleeding which necessitated surgical removal of his spleen. What effect will the loss of the spleen have on this person’s resistance to infections? Discuss the measures you would recommend for this person and the advice you would give to him and his parents.

2. Discuss the diagnostic value of a midstream specimen of urine in establishing the aetiology of urinary tract infections. How can contamination during collection be minimised in males and females. Comment on other specimens which can be used in establishing the aetiology of such infections.

3. Discuss the management of a nurse who has just sustained an accidental injury from a needle she used to give an intramuscular injection to a man aged ?? years. What measures could be adopted to prevent future similar incidents and their potential consequences?

1999 (Supplementary):

1. Performing a Gram stain on a clinical sample may give useful information on ē cause of a patient’s illness and may guide initial antibiotic therapy. Discuss ē use of this stain applied to :

(a) a sample of CSF.

(b) a sputum sample.

2. Discuss the diseases caused by Streptococcus pyogenes (group A streptococcus). Include notes on ē laboratory diagnosis of the infection, and on treatment.

3. Write brief notes on any 4 of ē following topics :

(a) serological diagnosis of syphilis.

(b) toxoplasmosis.

(d) bacterial capsules.

(e) poliomyelitis.

1998 (Main):

1. Discuss the epidemiology and clinical features of infections caused by Chlamydia trachomatis. What diagnostic methods and antibiotic treatments are available?

2. Discuss the virology and natural history of infections caused by hepatitis B virus. What measures are available to control ē transmission of the virus?

3. Discuss the significance of ē increase in antibiotic resistance. What are the problems that are likely to arise and what measures may be taken to control the emergence of such resistance?

1998 (Supplementary):

1. Describe briefly two common microbial agents of community-acquired pneumonia. Discuss ē epidemiology, clinical features, diagnostic methods, treatment and control of these infections.

2. Discuss infections caused by herpes simplex viruses under ē following headings:

(a) types of infections.

(b) predisposing factors.

(d) treatment and prevention.

3. What are the bacteria which commonly cause urinary tract infections? What are the problems faced in obtaining an accurate microbiological confirmation of the clinical diagnosis? What are the solutions available to these problems?

1997 (Main):

1. Emerging and re-emerging infectious diseases are an increasing problem worldwide. Discuss the relevance of emerging and re-emerging infectious diseases to public health in Singapore, giving examples.

2. Compare and contrast the biological characteristics of two of the following pairs, giving examples where appropriate:

(a) live, attenuated and killed, inactivated viral vaccines.

(b) dengue and Japanese encephalitis.

(d) epizootic and enzootic diseases.

3. Briefly discuss the diagnostic value of expectorated sputum in establishing the aetiology of infections of the lower respiratory tract. Briefly comment on the alternative specimens which may prove useful in establishing the aetiology of such infections.

1997 (Supplementary):

1. Describe the epidemiology, pathogenesis and control of chickenpox.

2. Discuss infections caused by Candida albicans under the following headings:

(a) types of infection.

(b) predisposing factors.

3. What microorganisms may produce acute pharyngitis? Discuss the microbiological investigations and clinical management of this condition.

1996 (Main):

1. Give an account of the pathogenic mechanisms employed by microbes in the causation of disease. How does the host's immune system attempt to overcome these pathogenic mechanisms?

2. What are the common causes of bacterial food poisoning? Fifty school children were admitted for diarrhea and vomiting 3 hours after a meal at the school canteen. Describe how you would investigate the cause and source of the outbreak.

3. Give an account of infections transmitted via blood and blood products. How can health workers protect themselves from acquiring such infections?

1995 (Main):

1. What are the principal opportunistic pathogens which cause infections in AIDS patients? Discuss the disease manifestations they cause. What does this group of pathogens and their manifestations tell us about the host defence mechanisms which are protective in the normal host? (Use 5 or 6 of the most important pathogens for the latter discussion, and compare this group of pathogens with the most common infections in non-compromised patients).

2. Tuberculosis is said to be making a comeback with a vengeance. What are the main causes for this? Briefly describe for this disease:

(a) the pathogenesis,

(b) the laboratory diagnosis,

(d) the principles of chemoprophylaxis

3. Answer parts (a) and (b).

(a) Write short notes on:

(i) Poliomyelitis vaccination.

(ii) Western blot in HIV diagnosis.

(b) Give two main reasons why malaria continues to be a serious problem in many areas. Briefly discuss the chemotherapy and chemoprophylaxis of this disease.

1995 (Supplementary):

1. What are the main sexually transmitted diseases caused by bacteria? Describe the characteristics of the organisms that cause them and how you would detect them in the laboratory.

2. Write short notes on antimicrobial resistance with reference to:

(a) Tuberculosis

(b) Malaria

3. What are the principles of proper antibiotic usage? Name three important classes of antibiotics, give a specific example of each and indicate its main use in clinical practice.

1994 (Main):

1. An AIDS patient presents with severe diarrhoea. You are provided with his stool specimen for investigation. What are the pathogens you may expect? Describe how you would proceed to look for them.

2. What infection does Pseudomonas pseudomallei cause? How would it manifest clinically? Discuss its epidemiology, laboratory diagnosis, and management.

3. Answer parts (a) and (b):

(a) List the viral vaccines that are currently available for use, giving the nature of the vaccine.

(b) Starting from known epidemiological data of hepatitis B infection in Singapore, give the rationale for a vaccination programme that you would develop for its prevention.

1994 (Supplementary):

1. How are streptococci differentiated? Discuss the diseases caused by each of these groups and the mechanisms responsible for the cause of these diseases.

2. Discuss gonococcal urethritis, including clinical features, laboratory diagnosis, treatment, complications and prevention.

3. Write short notes on:

(a) Chicken pox

(b) Herpes simplex

1993 (Main):

1. (a) Influenza A virus sometimes cause worldwide outbreaks known as pandemics. Briefly describe the virological characteristics of this virus, particularly its genomic and antigenic structure as well as ecology, in relation to its ability to cause pandemics.

(b) Rubella virus infection is often a benign febrile disease. However, it can cause congenital malformations in the foetus or newborn when pregnant women are infected during their early trimesters. Briefly discuss the most appropriate strategy to control congenital rubella syndrome.

2. (a) What are the common causes of pyogenic meningitis?

(b) Describe the laboratory diagnosis of pyogenic meningitis including the collection and transport of specimens. Also briefly comment on the relative usefulness of microscopy, culture, serology, and rapid tests in identifying the microorganisms that you listed.

3. (a) Tabulate the microorganisms that cause acute and chronic pneumonia.

(b) Briefly describe specimen collection and laboratory diagnosis of pneumonia in:

(i) an infant, and

(ii) a patient with AIDS.

1993 (Supplementary):

1. Describe the pathogenesis, clinical manifestations, mode of transmission, diagnosis and prevention of diseases resulting from dengue virus infection.

2. Describe the principal groups into which the Beta-haemolytic streptococci are divided, and give an account of the diseases with which they are associated.

3. Infective endocarditis is an infection which produces vegetation in endocardium, usually involving a heart valve, septal defect or mural endocardium. Without therapy the disease is usually fatal.

(a) Briefly describe the mechanisms by which bacteria are able to produce the disease and their correlation with the main clinical features.

(b) Briefly describe the diagnostic procedures and the therapeutic measures for this disease.

1992 (Main):

1. Describe the common causes of diarrhoea in children. How do they present clinically, and how can the etiological diagnosis be established?

2. Describe the disease caused by Neisseria gonorrhoeae. How is the diagnosis made? What appropriate antibiotics would you recommend, and what advice would you give for follow-up?

3. Describe the laboratory diagnosis of human immunodeficiency virus infection. What are the tests used, whom do you test and what are the important issues involved in testing?

1992 (Supplementary):

1. What common diseases are caused by Pseudomonas aeruginosa? Describe the laboratory diagnosis, management and prevention of these infections.

2. Write an essay on the hepatitis viruses, with reference to their general features, clinical and laboratory diagnosis, treatment and prevention of infection.

3. Describe the clinical and microbiological features, laboratory diagnosis and management of urinary tract infection.

1991 (Main):

1. What human infections are caused by Chlamydia trachomatis? Briefly describe each of them and say how they may be diagnosed and treated?

2. How does Clostridium tetani cause pathology in man? Discuss the epidemiology and describe its diagnosis, treatment and prevention.

3. Write on:

(a) Type 1 (Anaphylactic) hypersensitivity including sensitization, cells involved and mediators.

(b) Type 4 (Delayed) hypersensitivity including antigen recognition, effector cells, effector mechanisms and role of cytokines.

1991 (Supplementary):

1. Name the bacteria that cause enteric fever. How may a tentative clinical diagnosis of typhoid fever be confirmed in the laboratory? Name three antimicrobials that have been used successfully in its treatment, and discuss its control.

2. Compare and contrast the following:

(a) bacterial exotoxins and endotoxins, giving examples.

(b) rheumatic fever and acute glomerulonephritis.

3. (a) The macrophage is an important cell in the defence of the body. Discuss the role of macrophages in immunological processes.

(b) Write short notes on IgA.

1990 (Main):

1. Compare and contrast the epidemiology and treatment of infections due to salmonellas and shigellas, excluding the enteric fevers. Add a description of the laboratory diagnosis of these conditions.

2. Are hospital acquired (nosocomial) infections important? In answering this question say something about the more common types of these infections, where in the hospital they are fond, and why. Mention the bacteria most commonly involved.

3. Describe the life-cycle of the protozoan parasite, Entamoeba histolytica, and relate this to the transmission and control of the infection.

1990 (Supplementary):

1. Describe Escherichia coli and the range of infections it may cause. Say how these may be diagnosed in the laboratory.

2. How does Vibrio cholerae produce pathology in man? Discuss the diagnosis, treatment and prevention of cholera.

3. Describe the life cycle of Plasmodium falciparum and mention how it differs from Plasmodium vivax.

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