PAPER1

Q A 9-year-old female child presented to the cardiology OPD with swollen, red, and/or tender
joints, which migrates from one joint to another (knees, ankles, hips, and elbows) over a period
of hours. The child had an abnormal gait. She also complained of painless, small, mobile lumps
beneath the skin overlying bony prominences, particularly of the hand's feet, and elbows. On
auscultation, murmur was heard over the mitral valve area. ECG showed prolongation of P-R
interval. On inquiry, it was found that the child had an episode of sore throat 3 weeks back.

a. What is the probable clinical diagnosis and its etiological agent?

b. Describe the diagnostic criteria used for this condition.
C. How will you prevent the recurrence of such episodes?
Clinical case acute rheumatic fever

Q The newly hospitalized patient had a 2-week history of high-grade fever(step ladder pattern),
abdominal pain, loss of appetite, watery diarrhea, back pain, and generalized body aches. Blood
culture is the most accurate test for the diagnosis of typhoid fever. Blood culture was positive
and showed sensitivity to ciprofloxacin and other drugs.

A) What is the most probable etiological diagnosis?

B) Describe the pathogenesis of this condition
C) Mention sample collection and laboratory diagnosis in detail.
D) Add a note on treatment and vaccination available for this clinical condition clinical case-
ENTERIC FEVER
Q A 23-year-old is presented to the emergency department (ED) three days prior to admission
with a two-day history of fever (104F/40C), chills, headache, neck stiffness, productive cough,
nausea, and diffuse myalgias. At that time, he denied photophobia, rash, abdominal pain, and
diarrhea. On exam, he was found to be tachycardic (119 beats per minute [bpm]) and febrile
(101.4F/38.5C).
A) What is the etiological agent and how is this disease transmitted ?
B) What is the typical clinical presentation and pathogenesis of this condition?
C) How will you confirm the diagnosis?
D) How will you manage this clinical condition?
Clinical case leptospirosis
Q. A 25-year-old male with history of multiple sex partners is admitted with complaints of
unexplained fever, progressive loss of weight, persistent diarrhea and generalized
lymphadenopathy for the past 6 months.

a. What is the most probable diagnosis?

b. Discuss the pathogenesis and laboratory diagnosis of the above condition
c. ART guideline 2021

Q Sakshi a 24-year-old female came to casualty with complaint of high-grade fever, severe joint
pain, back pain and myalgia. Gradually, she developed petechial rashes over the body. On
examination, she was found to have jaundice, hepatomegaly and a low platelet count
(30,000/cmmm). A torniquet test done over the cubital fossa demonstrated 21 petechial spot
/square inch area. On inquiry, she told that she had been bitten by the mosquitoes.
A) What is the clinical diagnosis and how is this disease transmitted?
B) What are the typical clinical presentation and pathogenesis of this condition?
C) How will you confirm the diagnosis
Clinical case dengue

Q A 29-year-old Indian tourist had to break her return journey from Indonesia as she developed
dengue hemorrhagic fever. She appeared to have been infected on Bali. Serological investigation
revealed very high antibody Titres against dengue virus types 1 and 3 and a moderately high titer
against type 4 virus in the serum sample collected two weeks after onset of disease. In the
sample taken 14 weeks after onset only more normalized antibody Titres against type 1 and type
3 remained detectable.
A. What is the clinical diagnosis and how is this disease transmitted?
B. What are the typical clinical presentation and pathogenesis of this condition?
C. How will you confirm the diagnosis
Clinical case dengue
Q A 54-year-old male from Lucknow presented with fever, chills and rigor for a duration of four
days. The patient developed convulsions prior to admission. He was started on ceftriaxone by a
private medical practitioner but did not Improve. On physical examination, muscle tone and
tendon reflexes were reduced. Anemia and splenomegaly were present. The blood sample was
collected for peripheral blood smear examination which showed accole form, multiple ring forms
and crescent shaped gametocytes inside RBCs.
a. What is the etiological agent based on history?

b. Write briefly about the life cycle of the etiological agent.

C. Describe the pathogenesis, clinical manifestations and complications produced.
d. What are the various diagnostic modalities?
e. How will you treat this condition?

Case Study Falciparum Malaria

Q A 20-year-old female from Tamil Nadu, presented with high-grade fever which rises every third
day with associated chills and rigor. Her blood sample was subjected to a rapid diagnostic test
which revealed bands near pLDH line and control line, but no band near the HRP-II antigen line.
a. What is the probable etiological agent based on history?
b. Describe a note on epidemiology of this clinical condition.
c. What are the various diagnostic modalities?

d. How will you treat this condition?

Case Study Vivax Malaria
Q . A 31-year-old man from Bihar presented with splenomegaly,anemia, and fever. The bone
marrow aspirate collected was subjected to Giemsa staining which revealed amastigotes filled
within a macrophage.

a. Identify the etiological agent and the clinical diagnosis.

b. Write briefly about the life cycle of the etiological agent.
C. Describe the pathogenesis and clinical manifestations produced.
d. What are the various diagnostic modalities?

e. How will you treat this condition?

Case – kala azar
Q A 30-year-old female from a village of Patna came to the hospital with history of fever on and
off for the past one year and recently developed unilateral swelling of the left lower limb. Her
blood sample was sent for peripheral blood smear examination which revealed microfilariae, 240
µm in length, tail tip pointed free of nuclei.
a. What is the etiological diagnosis?
b. Write briefly about the life cycle, laboratory diagnosis and treatment of this clinical condition.

Case Study Lymphatic Filariasis

Q. A 25-year-old HIV-infected male presents to the clinic with history of high-grade fever and
altered mental status. On examination, his blood pressure was found as 90/60 mm Hg, and
respiratory rate was increased to 27 per minute. Blood cultures yielded creamy white colonies
which on Gram stain revealed gram-positive oval budding yeast cells with pseudo hyphae.
a. What is the clinical diagnosis and the likely etiological agent?
b. Name the risk factors predisposing this clinical condition.
C. What are the other clinical manifestations caused by this organism?

d. Describe the laboratory diagnosis of this clinical condition in detail.

Case Study Candidemia
Q. A middle-aged immunocompromised patient presents with complaints of pain during
swallowing. She describes it as a burning sensation that radiates to her back every time she
swallows. Oral examination reveals creamy white patches on the oral mucosa. The wet mount
microscopy of the scraping obtained from the patches.
a. What is the clinical diagnosis and the likely etiological agent?
b. Name the risk factors predisposing this clinical condition.
C. What are the other clinical manifestations caused by this organism?

d. Describe the laboratory diagnosis of this clinical condition in detail

Case Study Candidemia

Q1 A 6-year-old boy developed severe watery diarrhea (12-15 times) and vomiting since 2 days.
Stool collected has a rice water type of appearance. On inquiry, it was found that two other
members of same family and few children of the same locality also suffered from similar
presentation last week.

Q2In an outpatient department, a 2-year-old child presented with tenesmus, abdominal pain and
passage of bloody diarrhea with mucus, eight times for the past 2 days.

Case Study 1. Cholera 2. Shigellosis

In both case scenarios, stool specimens were collected in sterile containers and sent for
microscopy, and culture.
a. What is your probable clinical diagnosis?
b. What are the etiological agents, pathogenesis and clinical manifestations?
c. Describe the laboratory diagnosis in detail.
d. What are the treatment modalities according to the etiological agents?

Q. A 2 years old male child from with chief complaint of loose watery stools was admitted by his
mother to a tertiary hospital. Five days prior to the admission, onset of the disease with three
episodes (approximately 100 ml each) of non-foul smelling loose watery (yellow) stools was
observed with moderately severe dehydration. However, it was observed that the patient was
playful and with a good appetite. He was given 1 pack per day rehydration solution hence, the
episode reduced to one time. One night prior to admission, an increase in bowel movement
frequency was noted. The stool color changed to yellowish to greenish with mucus. Patient also
had 3 episodes of non-projectile vomiting (approximately 30 ml/ episode) irrelevant to the food
intake timings.
a. What is your probable clinical diagnosis?
b. What are the etiological agents, pathogenesis and clinical manifestations?
c. Describe the laboratory diagnosis in detail.
d. What are the treatment modalities according to the etiological agents?

Case study – vibrio cholera

Q 30 year old man was admitted to emergency ward with severe diarrhea and dehydration. He
also had hypokalemia and hypovolemia. The stool sample collected had rice water appearance
and hanging drop preparation showed darting motility of the bacteria.

(a) What is the most probable cause of this disease?

(b) Write its pathogenesis.
(c) Add a note on laboratory diagnosis
Case study vibrio cholera

Q A group of patients presented to the emergency department with chief complaints of fever,
vomiting and diarrhea. All of them had attended a birthday party 4-6 hours back.
a. What is your probable clinical diagnosis?
b. What are the etiological agents, pathogenesis and clinical manifestations?

C. Describe the laboratory diagnosis in detail.

d. What are the treatment modalities according to the etiological agents?
Case study food poisoning
Q A catheterized bedridden patient complained of fever and suprapubic pain. A urine routine
examination was done to look for catheter- associated urinary tract infection
A) Etiology of urinary tract infection
B) Laboratory diagnosis done in UTI
C) Describe six pathotypes of diarrheagenic E coli
D) Various properties of enterotoxin of E.coli
Case study UTI

Q A 12-year-old boy presented with bloody diarrhea with mucus and pus cells, colicky abdominal
pain, fever, and prostration. The wet mount examination of the stool sample was performed
which showed trophozoites of 5-20 µm, actively motile, with finger-like pseudopodia.
a. What is the etiological diagnosis?

b. Describe the pathogenesis and clinical manifestations produced.

C. What are the various diagnostic modalities?
d. How will you treat this condition?
Case- intestinal amoebiasis
Q . A 5-year-old boy presented with acute abdominal pain, nausea and vomiting. On
examination, the child was malnourished. The stool microscopy revealed bile stained oval eggs
with a thick albumin coat. Identify the etiological agent. Briefly discuss about life cycle,
pathogenesis and laboratory diagnosis of this clinical condition.
CLINICAL CASE ASCARIES

Q A 35-year-old male presented with history of loss of appetite, malaise and jaundice of 2
months duration. On examination, there was icterus, hepatomegaly and tenderness in the right
hypochondriac region. He gave a history of blood transfusion in the past. On laboratory
examination, he was found to be positive for HBsAg.
a. What is the most probable etiological diagnosis?
b. Discuss in detail about the various laboratory diagnosis of this condition.
C. How will you prevent the transmission of this infection?
CLINICAL DIAGNOSIS HEPATITIS

Q A 35-year-old female patient was brought to the emergency department with complaints of
sudden episode of high-grade fever and acute pain in the right hypochondrium. She had a
history of dysentery and jaundice for the last two months. Ultrasound scan of the abdomen
revealed enlarged liver with acute peritonitis. Pus aspirated from liver was thick chocolate brown
in color. Microscopy of liver pus revealed necrotic hepatocytes without any pus cells.
a. Identify the clinical condition and the probable causative agent.

b. What are the complications seen in this condition?

C. What are the various diagnostic modalities?
Case Study Amoebic Liver Abscess
2. A 28-year-old men presented with complaints of pain in the right hypochondrium. USG
revealed a single space occupying cystic lesion in the right lobe of the liver. The cyst was
removed surgically and subjected to histopathological examination, which revealed three layered
cyst wall with attached brood capsules. Identify the clinical condition. Briefly discuss the life
cycle, pathogenesis and laboratory diagnosis of the same.

CASE- HYDATID DISEASE

Q A 32-year-old newspaper reporter with no significant past medical history presents to your
office complaining of a 2-day history of fevers, diffuse myalgias, and severe pharyngitis. He also
complains of vomiting and bloody diarrhea that began this morning. He has marked edema of
the posterior pharynx, as well as a nonpruritic maculopapular eruption over his chest and back.
He has not had recent travel overseas, exposure to pets, or recent outdoor recreational
activities. He received an influenza vaccination earlier this year. He states that two of his
coworkers have been absent from work and had been referred by the Tribune’s health insurance
provider to your office for evaluation. Two of your practice partners confirm that recently they
each have seen a worker from the Tribune who presented with fevers, diffuse myalgias, and
pharyngitis. One patient was a 40-year-old editor with a history of diabetes. Her most prominent
findings on presentation were conjunctivitis, facial flushing, and new onset of nondependent
edema. Initially, she was sent home with close follow-up. The other
Clinical case - viral hemorrhagic fever

short questions

Q gram staining
Q Anaerobic culture methods
Q polymerase chain reaction
Q Real time PCR
Q Name various methods of horizontal gene transfer. Discuss in detail about mechanism of
conjugation.
Q Conjugation

Q Blotting technique
Q Mechanism of antibiotic resistance
Q Mutational and transferable drug resistance
Q Antimicrobial susceptibility testing method

Q Anti-microbial agents classification

Q Various modes of transmission of infection.
Q Mechanism of bacterial pathogenesis
Q Difference between exotoxins and endotoxin

Q Discuss in detail laboratory diagnosis of viral infection

Q Replication of virus
Q define immunity. Describe in detail about the properties and mediators of innate immunity.
Q Difference between innate and acquired immunity
Q difference between active and passive immunity

Q auto immunity
Q Factor influencing immunogenicity
Q Define antibody. Describe in detail about the structure and function of various types of
antibodies.
Q Monoclonal antibodies and their application
Q function of immunoglobulin
Q You are counselling a new mother about the importance of breastfeeding. Which antibody
that is maximally present in breast milk? Explain that antibody and its type .

Q Enumerate the properties and types of antigen antibody reaction Describe in detail about
principle ,type and application of ELISA?
Q. Describe in detail about the principle, types and application of agglutination reaction?
Q What is complement? Explain in detail about classical complement pathway. List various
effector function of complement.
Q MHC molecule
Q A newborn diagnosed with a hepatoblastoma is planned for liver transplantation, her father is
found to be an HLA match and he donates part of liver. What type of transplantation is
described here ? Write type of transplantation
Q Describe in detail about the mechanism of cell- mediated immune response
Q describe in detail about the mechanism of antibody-mediated immune response Q Define and
classify hypersensitivity reactions . Write in detail about type IV hypersensitivity reaction.

Q various type of hypersensitivity reactions

Q immune complex mediated hypersensitivity reaction
Q Define autoimmunity. Classify various autoimmune disease and briefly explain various
mechanism involved in the development of autoimmunity with suitable example

Q Chronic granulomatous disease

Q Wiskott- aldrich syndrome
Q monoclonal antibodies
Q live vaccine vs killed vaccine
Q passive immunoprophylaxis

Q Define PUO mention the etiological agent and laboratory diagnosis of PUO. Describe the Types
of bloodstream infection
Q Bacteremia and its type
Q infection causing anemia

Q Laboratory diagnosis of a clinically suspected case of sepsis

Q NACO guideline to prevent neonatal HIV
Q Diagnosis of HIV in Window period
Q NACO strategy for HIV diagnosis

Q Diagnosis of pediatric HIV

Q dengue haemorrhagic fever
Q ELISA
Q Molecular method for dengue
Q difference between chikungunya and dengue
Q Complications of falciparum malaria.
Q Life cycle of malaria parasite
Q prophylaxis against malaria

Q Babesia
Q Persistent and chronic Diarrhea
Q Nontyphoidal salmonella
Q pathogenesis of shigellosis

Q Bacillary dysentery
Q pathogenesis and clinical manifestation of shigella
Q lab diagnosis of shigella
Q enterohemorrhagic E coli (EHEC)

Q Laboratory diagnosis done in UTI

Q Describe six pathotypes of diarrheagenic E coli
Q Prophylaxis against cholera
Q halophilic vibrio
Q clinical manifestation and laboratory diagnosis of vibrio cholera

Q gardner and venkatraman classification of V.cholera.

Q Rotavirus gastroenteritis
Q List the viral agents causing gastroenteritis. Describe in detail pathogenesis and clinical
manifestation of viral gastroenteritis.
Q Prevention of rotavirus
Q laboratory diagnosis of Helicobacter pylori
Q Clostridioides difficile infection
Q Infections caused by Microsporidia.

Q Balantidiasis
Q Entero-test (or string test)
Q giardiasis
Q difference between amoebic dysentery and bacillary dysentery
Q laboratory diagnosis of intestinal amoeba
Q Briefly describe the life cycle, and laboratory diagnosis of intestinal taeniasis.

Q Briefly describe the life cycle, pathogenesis of strongy- loidiasis.

Q Briefly describe the life cycle, pathogenesis of enterobiasis
Q life cycle and laboratory of ascariasis
Q eggs of ascariasis

Q difference between taenia saginata and taenia solium

Q life cycle and laboratory diagnosis of intestinal taeniasis
Q Yellow fever vaccine.
Q Laboratory diagnosis of hepatitis C virus.

Q Prophylaxis of hepatitis b
Q laboratory diagnosis of hepatitis B
Q The first year MBBS students are given hepatitis B vaccination. Discuss the composition of the
vaccine and the vaccine schedule. How will you ensure that the students are protected against
hepatitis B, following vaccination?

Q Viral markers of hepatitis B

Q laboratory diagnosis of amoebic liver abscess
Q life cycle echinococcus granulosa
Q cutaneous larva migrans
Q write name of organisms in HACEK group
Q write in tabulate form difference between all species of plasmodium

Very short questions

Q selective media
Q Catalase test
Q OXIDASE TEST

Q CAMP test
Q IMViC TEST
Q triple sugar iron (TSI) test
Q interferons

Q inclusion bodies
Q herd immunity
Q Disk diffusion method
Q superantigen

Q Indirect immunofluorescence assay

Q Immuno chromatographic test
Q Chemiluminescence immunoassay (CIA)
Q WESTERN BLOT

Q Nagler's reaction
Q ELISPOT TEST
Q major histocompability antigen
Q cytokines
Q difference between t cell and b cell

Q HLA complex
Q Antigen – presenting cell (APCs)
Q Role of CMI
Q type 1 hypersensitivity
Q type 2 hypersensitivity
Q type 3 hypersensitivity
Q type 4 hypersensitivity
Q wheal and flare response

Q Mantoux test
Q Contact dermatitis
Q BCG VACCINE
Q Toxoid vaccine
Q cold chain
Q inactivated or killed vaccine

Q Live attenuated vaccine

Q graft versus host reaction
Q types of graft Rejection
Q Widal test

Q. Q-fever
Q Rocky Mountain Spotted fever
Q Post-kala-azar dermal leishmaniasis.
Q African sleeping sickness.

Q Chagas' disease.
Q Histoplasmosis.
Q Blastomycosis.
Q Travelers' diarrhea
Q Whipples disease

Q Bacillus cereus food poisoning.

Q Food botulism
Q draw cascade of classical complement pathway
Q write causative agent of food poisoning with incubation period >16 hrs
Q lab diagnosis of capsulate fungi
Q draw diagram of egg of taenia

Paper2
Long question
Q The discharge from an infected wound was cultured and the Gram-stained smear of the
isolated organism is given below. On performing further tests, the organism was found to be
catalase and coagulase-positive.

A. Identify the organism

B. List the infection caused by this organism
C. List the virulence factors of this organism
D. Briefly discuss the laboratory diagnosis

Case study abscess

Q The specimen obtained by performing incision and drainage of a breast abscess was sent for
culture on nutrient agar. Microscopy of the isolated organism revealed gram-positive cocci
arranged in clusters.
A. Identify the organism
B. List the infection caused by this organism
C. List the virulence factors of this organism
D. Briefly discuss the laboratory diagnosis

CLINICAL CASE STAPH AUREUS

Q A college student with a history of intravenous drug abuse presents with a fever for the last 3
weeks. Echocardiography is performed which reveals large friable vegetations on the cusps of
the tricuspid valve.

A. Identify the organism

B. List the infection caused by this organism
C. List the virulence factors of this organism
D. Briefly discuss the laboratory diagnosis

CLINICAL CASE INFECTIVE ENDOCARDITIS

Q Dakshita , a 3-year-old girl from Mangaluru presented tender, bright red, subcutaneous
swelling on malar area of the face with indurated peau d'orange texture of involved skin along
with fever and chills. A clinical diagnosis of cellulitis was made. The culture of the aspirated pus
revealed beta-hemolytic pinpoint colonies.
a. What is the most likely etiologic agent?
b. Describe the virulence factors and the other clinical manifestations produced by the
etiological agent?
c. Briefly discuss the laboratory diagnosis of this clinical condition.
Case streptococcal erysipelas

Q . An elderly diabetic lady presented with swelling and pain of her right leg following a skin
biopsy. She was febrile at the time of examination and hemorrhagic bullae with necrosis of the
surrounding skin were noted on her leg.
a. What is the most likely etiologic agent?

b. Describe the virulence factors and the other clinical manifestations produced by the
etiological agent?
c. Briefly discuss the laboratory diagnosis of this clinical condition.

Q Sujay, a 25-year-old male was admitted 6 days after a crush injury to his right leg
following a road traffic accident. He had been treated by a local village quack. On
examination, the wound, which was bandaged with soiled gauze, appeared to be
heavily contaminated with soil, the local muscles appeared to have been crushed,
there was edema and pain at the site and crepitus was felt on palpation.

a. What is the clinical condition? List the etiological agents responsible for this
condition.

b. Describe in detail the pathogenesis of this condition.

c. Describe in detail the laboratory diagnosis of this condition.

Case- trichophytum rubrum

Q A young girl presented with complaints of severe abdominal pain and watery
diarrhea eight hours after consuming meat at a restaurant. A stool sample was
sent for culture and the isolated organism showed this appearance on litmus milk
fermentation.

a. What is the most likely etiologic agent?

b. Describe the virulence factors and the other clinical manifestations produced by
the etiological agent?

c. Briefly discuss the laboratory diagnosis of this clinical condition.

Clinical case food poisoning

Q. A farmer presented to the outpatient department with history of papulovesicular lesion over
the neck region, which later on developed into a coal-black, necrotic wound for the past 3 to 4
days. After being examined, the doctor sent a tissue from that necrotic area to the laboratory.
Gram staining revealed gram-positive rod shaped bacilli arranged in chains.
Case Study Cutaneous Anthrax

a. What is the clinical diagnosis and causative agent?

b. Describe pathogenesis and various forms of clinical presentation of this infection.
C Mention the laboratory investigations to confirm the diagnosis.

Q A 9-year-old boy had developed multiple painful vesicles over the lips and buccal mucosa. His
parents revealed that two children of his school had a similar presentation few days back.
Scrapings taken from the lesion demonstrated presence of multinucleated giant cell (Tzanck
cell).

a. What is the most probable diagnosis?

C How is this infection diagnosed in the laboratory?
b. List the other agents causing this type of infection
Clinical case varicella
Q

1. A child presents with vesicular rashes, which appeared first on the face and
trunk, spread rapidly to involve flexor surfaces; sparing distal part of the limbs.
Rashes are bilateral and diffuse in distribution, appear in multiple crops. Fever
appears with each crop of rashes. What is the clinical diagnosis? Discuss about the
prevention of this disease.

2. A child presents with rashes, starts behind the ears and then spread over body.
On examination, bluish white spots were seen in buccal mucosa. What is the
clinical diagnosis? Discuss about the prevention of this disease.
3. A child presented with dome-shaped, pink pearly wart like lesions (2-5 mm size)
on face, umbilicated, with a dimple at the center. What is the clinical diagnosis?
Discuss its clinical presentation, laboratory diagnosis and treatment of this clinical
condition.

Case Studies 1. Chickenpox, 2. Measles, 3. Molluscum

Q A 21-year-old male, throughout the body had developed characteristic well-

demarcated annular or ring-shaped pruritic scaly skin lesions with central clearing
and raised edges. The culture of the skin scraping done on Sabouraud's dextrose
agar reveals velvety colonies with red pigment on the reverse. Microscopy of the
culture isolate reveals plenty of tear drop-shaped microconidia and few, long,
pencil-shaped macroconidia.

a. What is clinical diagnosis and what is the most likely etiological agent?

b. Describe the various clinical manifestations produced by this organism.

C Add a note on the laboratory diagnosis of this condition.

Case trichophyton rubrum

Q A 7-month-old boy was admitted with fever, lethargy,Productive cough with purulent sputum
and shortness of breath. On examination, dull note on percussion and consolidation on
auscultation were noted. Sputum and blood specimens were obtained and sent for
bacteriological culture.
a. What is the clinical diagnosis and the etiologicAL agents?
b. discuss the pathogenesis clinical presentation, laboratory diagnosis and treatment of this
clinical condition

Q A child aged 7 years with high grade fever, toxic, pain in the throat, inability to
swallow was brought to the casualty. On examination, a white patch was found on
the fauces, which started bleeding when touched. No history of immunization is
available.
a. What is the clinical diagnosis?

b. Name the etiological agent causing this clinical condition.

C. Write in detail pathogenesis and laboratory diagnosis of this condition.

d. Discuss the management of this condition.

clinical case pneumonia

2. A 5-year-old girl child was brought to the ENT OPD with history of sore throat
and fever for 2 days. On examination, she was febrile and her throat examina- tion
revealed pustules over the tonsils. Her throat

swab was sent to the microbiology laboratory, which

revealed ẞ-hemolytic pin point colonies on blood agar.

a. What is the probable clinical diagnosis and etiolo- gical agent causing this
clinical condition?

b. List the infections caused by this organism.

c. How will confirm the diagnosis in the laboratory?

d. How will you manage this case?

Clinical case diptheria

Q A father brought his 9-year-old unimmunized child to the pediatric OPD with
complaints of fever, sore throat and difficulty in swallowing.

a. What is the probable clinical diagnosis and etiolo- gical agent causing this
clinical condition?

b. List the infections caused by this organism.

c. How will confirm the diagnosis in the laboratory?

d. How will you manage this case?

Clinical case membranous tonsilitis

Q patient has complains of fever with chills. A throat examination reveals swollen
glands and a thick, whitish membrane over his tonsils.

a. What is the probable clinical diagnosis and etiolo- gical agent causing this
clinical condition?

b. List the infections caused by this organism.

c. How will confirm the diagnosis in the laboratory?

d. How will you manage this case?

Clinical case streptococcal pharyngitis

Q 1. Supriya, A 4-year-old girl from Bhubaneswar was brought to the emergency

room by her parents due to an acute onset of fever, productive cough and
dyspnea for past 2 days. Physical examination revealed dull note on percussion.
Direct examination of the sputum revealed plenty of pus cells and gram- positive,
lanceolate-shaped diplococci surrounded by a halo.

a. What is your clinical diagnosis of this condition and the most likely etiologic
agent?

b. How will you confirm the etiological agent in the laboratory?

C. Describe the virulence factors and pathogenesis of the etiological agent.

d. How will you manage this clinical condition?

Ans pneumococcal pneumonia

Q A 49-year-old man presented with high-grade fever, cough and shortness of

breath. On examination, he was febrile, tachypneic and tachycardic. A chest X-ray
was performed which showing right lobe consolidation suggestive of lobar
pneumonia.

a. What is your clinical diagnosis of this condition and the most likely etiologic
agent?

b. How will you confirm the etiological agent in the laboratory?

C. pathogenesis of the etiological agent.

d. How will you manage this clinical condition?

Clinical case pneumonia

Q Anshul a 25 year old male was admitted to the hospital with complaint of low
grade fever, loss of weight and appetite and chronic cough with expectoration for
past 6 months. Sputum examination revealed long, slender and beaded acid-fast
bacilli.

Case Study Pulmonary Tuberculosis

a. What is your provisional diagnosis?

b. Describe the pathogenesis of this condition.

C. Mention the laboratory diagnosis in detail.

d. Mention briefly about drug resistance that can occur in this etiological agent.

Q In early 2018, a 62-year-old debilitated man from Maharashtra presented with

symptoms of severe upper respiratory tract infection. He had a history of exposure
to a patient having similar condition. Nasopharyngeal swab collected was sent to
the reference laboratory for real time PCR which revealed

Case Study Influenza

A. that causative agent as influenza A/H1N1. a. What is the mechanism of

emergence of this particular strain of the virus?

b. Describe the pathogenesis, mode of trans- mission and laboratory diagnosis of

the causative agent.

C. Add a note on the epidemiological impact of the recent 2018 epidemic in India
produced by this causative agent.

d. What are the preventive measures available for this condition?

Q A 12-year-old boy is brought to the OPD with complaints of headache and
drowsiness since 2 days. He had a history of fever, ear pain, and difficulty in
swallowing for 1 week. On examination, you see the following. Brudzinki's sign is
positive.

A What is your provisional diagnosis?

b. Describe the pathogenesis of this condition.

C. Mention the laboratory diagnosis in detail.

d. write about its vaccine and vaccine schedule

CLINICAL CASE MUMPS

Q A 55-year-old patient (without wearing any mask) with complaints of dry cough,
sore throat and fever visited a hospital. The security guided him to go to the
casualty. The resident doctor (without mask) took history, examined the patient.
His throat swab was sent for COVID-19 testing which came positive. Subsequently
the security and the resident doctor were also turned positive for COVID-19.

a. Identify the infection control breaches.

b. Discuss the laboratory diagnosis of this disease.

c. Discuss the infection control measures to prevent the transmission of this

infection.

Q A patient with HIV presented complaining of cough and progressively worsening

breathing difficulty. Chest X-ray showed bilateral interstitial infiltrates. The findings
of microscopic examination of his bronchoalveolar lavage showing black coloured
cysts resembling crushed ping pong balls .

A Which is the most probable causative organism?

B laboratory diagnosis

CLINICAL CASE PNEUMOCYSTIS PNEUMONIA

Q A young lady complains of recurrent rhinitis, nasal discharge and bilateral nasal
blockage for two years. She has a history of allergic rhinitis. On rhinoscopy,
multiple ethmoidal polyps with mucosal thickening and impacted secretions are
seen in both the nasal cavities. A tissue biopsy is taken and sent for culture, which
on microscopic examination shows philaides are arranged in single row and
conidia arise from the upper third vesicle andare hyaline

A Which is the most probable causative organism?

B laboratory diagnosis

Ans- aspergillosis fumigatus

Q A 8-year-old girl was admitted to the hospital with complaints of high-grade

fever, headache, vomiting, altered mental status, seizure and neck rigidity. CSF
sample was collected by lumbar puncture in a sterile container and sent to the
laboratory for biochemical analysis, direct microscopic test, culture and sensitivity
testing.

a. What is the probable clinical diagnosis?

b. What are the etiological agents, pathogenesis and clinical manifestations of this
disease?

C. Describe the laboratory diagnosis in detail?

d. What are the treatment modalities according to the etiological agents?

CLINICAL CASE MENINGITIS

Q 3-5 days following a bullet injury, a person developed trismus followed by

muscle pain and stiffness, back pain, and difficulty in swallowing. Excised tissue
bits from the necrotic depths of the wound revealed gram- positive bacilli with
terminal and spherical spores.

Case Study Tetanus

a. What is the probable diagnosis of this clinical condition?

b. Describe in detail the pathogenesis and clinical manifestations, laboratory

diagnosis of this condition.

C. Add a note on vaccination to prevent this condition

Q Alisha, A 4-year-old girl from Bhubaneswar was brought to the emergency room
by her parents due to an acute onset of fever, neck rigidity and altered sensorium
for the past 2 days. Physical examination showed that when her neck was passively
flexed, her legs also flexed (positive Brudzinski's sign). Direct examination of the
CSF showed gram-positive, lanceolate-shaped diplococci surrounded by a clear
halo.

a. Identify the clinical diagnosis of this condition and the most likely etiologic
agent?

b. How will you confirm the etiological diagnosis in the laboratory?

CLINICAL CASE PNEUMOCOCCAL MENINGITIS

Q A 9-week-old baby named Sweety was brought to the emergency room with
weakness in her right leg. On examination, her right leg appeared flaccid, and no
deep tendon reflex or Babinski reflex can be elicited, although sensation was
intact. The tone, movement, sensation, and reflexes of her other limbs were
normal. Her immunization records were up to date according to the National
Immunization Schedule of India. CSF demonstrates elevated protein with normal
glucose levels. Fecal sample was collected and then sent to the referral center
where the poliovirus is identified as a vaccine strain (not the "wild-type" strain) of
poliovirus type-1 was isolated.

a. What is the probable diagnosis of this clinical condition?

B. Add a note on laboratory diagnosis

c. mention the types of vaccine available against etiological agent

CLINICAL CASE POLIO

Q . Mr Michel, a 25-year-old Australian visited his local doctor complaining of

difficulty in swallowing liquids, loss of appetite and restlessness. He had a travel
history to India one month back and did mention being bitten by a street dog in
Puducherry.

Case Study Rabies Encephalitis

a. What is the most probable etiological diagnosis?

b. Draw a labeled diagram of the morphology of the causative agent of this
condition.

C. Discuss the laboratory diagnosis.

d. Name the vaccines available for human use.

Q A 55-year-old person reactive for HIV, presented with altered mental status,
seizures, sensory abnormalities. The bone marrow aspirate collected was sent for
Giemsa stain which revealed crescent shaped tachyzoites (6 x 2 µm in size).

a. Identify the etiological agent and diagnose the clinical condition.

b. Write briefly about the life cycle of the etiological agent.

C. What are the various diagnostic modalities?

d. How will you treat this condition?

ANS TOXOPLASMA ENCEPHALITIS

Q A 25-year-woman had developed mucopurulent discharge, followed by

development of dysuria and urethral irritation. She had a history of multiple sexual
partners. Microscopy of the urethral swab revealed sterile pyuria and presence of
compact inclusion bodies which are later stained by Lugol's iodine.

Case Study Genital Chlamydiasis

a. What is the most probable etiological diagnosis?

b. What are the other manifestations produced by the causative agent?

C. How is this infection diagnosed in the laboratory?

Q A patient who was hospitalized with a severe anemia in the Internal Medicine Clinic
for one week is presented. The patient had fatigue, paleness and dizziness for one
Month and approximately 12 kg weight lost for four mounths before admission.. Severe
iron deficiency anemia was diagnosed in the patient by laboratory analyses. . In the
Parasitology Laboratory, stool microscopy of the patient revealed numerous ova of
hookworm.
Briefly discuss about life cycle, pathogenesis and laboratory diagnosis
Short question
Q toxic shock syndrome

Q MRSA (Methicillin – resistant staphylococcus)

Q Necrotizing fasciitis.

Q Virulence factors produced by Streptococcus pyogenes.

Q Suppurative Infections caused by Streptococcus pyogenes.

Q non-suppurative complications of Streptococcus pyo-genes infection

Q LABORATORY DIAGNOSIS OF LEPROSY

Q LEPROMATOUS LEPROSY

Q EPIDEMOLOGY OF LEPROSY
Q List the non-venereal treponematoses and their etiological agents. Discuss the epidemiology
and clinical manifestations seen in yaws.
Q Kinyoun stain of sputum from a man with cough with expectoration showed red colored
filamentous bacilli. Describe the pathogenesis and laboratory diagnosis of this condition
Q Describe the pathogenesis and lab diagnosis of erythema migrans

Q Discuss the clinical manifestations and laboratory diagnosis of sporotrichosis.

Q pathogenesis and clinical types of Dermatophytes

Q mucocutaneous candidiasis

Q pathogenesis and laboratory diagnosis of community acquired pneumonia

Q DPT vaccines.

Q Streptococcal pharyngitis.

Q Epidemiology of diphtheria

Q Diphtheroids

Q Pneumococcal vaccines.
Q Pulmonary anthrax.

Q Laboratory diagnosis and prevention of H. influenzae pneumonia

Q BCG vaccine.

Q MDR-TB.

Q Nontuberculous mycobacteria infections

Q Your neighbour is worried about a scar on her

Q 5-month-old daughter's left arm to prevent tuberculosis and other mycobacterial infections
. She tells you the child has received all vaccines on time.

Identify vaccine , its strain and vaccine schedule

Q Classification of NON tuberculous mycobacteria infection

Q Virulence factors of Bordetella pertussis

Q laboratory diagnosis of pertussis

Q vaccination against pertussis

Q VIRULENCE FACTOR AND LABORATORY DIAGNOSIS OF PSEUDOMONAS

AERUGINOSA

Q Mumps.

Q H1N1 2009 pandemic flu

Q A 9-month year old child brought to the OPD for MMR vaccine what type of
vaccine it is and strain of vaccine?

Q Laboratory diagnosis of COVID 19

Q Structure of SARS-CoV-2

Q healthcare-settings for COVID-19

Q Pathogenesis of COVID-19 disease.

Q mucormycosis

Q pneumocystis pneumonia (PcP)

Q Brain abscess
Q encephalitis

Q chronic meningitis

Q acute encephalitis syndrome

Q Write briefly about pathogenesis and laboratory diagnosis of listeriosis.

Q Write briefly about clinical manifestations and laboratory diagnosis of

tuberculous meningitis

Q Difference between N.Meningitis and N. gonorrhoeae

Q differences between pyogenic, tuberculous and viral meningitis

Q PREVENTION OF TETANUS AFTER INJURY

Q Vaccines for Japanese B encephalitis.

Q Prion diseases.

Q Post-exposure prophylaxis against rabies.

Q CRYPTOCOCCAL MENINGITIS

Q CEREBRAL MALARIA

Q AFRICAN SLEEPING SICKNESS

Q LIFE CYCLE OF TOXOPLASMA GONDII

Q Laboratory diagnosis of syphilis

Q Gonorrhea

Q Lymphogranuloma venereum

Q Nongonococcal urethritis

Q Bacterial vaginosis

Q Trichomonas vaginalis

Q difference between gonococcal urethritis and non gonococcal urethritis.

Q Congenital toxoplasmosis.

Q Congenital rubella syndrome.

Q Congential cytomegalovirus infection.

Q Congenital varicella syndrome.

Q Neonatal herpes.

Q Zika virus disease.

QMechanism of viral oncogenesis.

Q Epstein-Barr virus associated malignancies.

Q Human papillomavirus associated malignancies.

Q Categories of biomedical waste

Q Disposal methods available for biomedical waste
Q type of containers used for disposal of biomedical waste
Q steps of biomedical waste management

Q MODES OF TRANSMISSION OF HEALTHCARE- ASSOCIATED PATHOGENS.

Q PREVENTION OF HEALTHCARE-ASSOCIATED INFECTIONS
Q HOSPITAL INFECTION CONTROL COMMITEE (HICC)
Q HAND HYGIENE

Q STANDARD PRECAUTION
Q list the major types of health care associated infections. Discuss briefly the pathogenesis of
CAUTI AND CRBSI?
Q care bundle approach for prevention of device associated infection
Q prevention of surgical site infection
Q. Define sterilization and disinfection. Describe principle and uses of steam sterilizer
Q what are chemical sterilant. Discuss their application in healthcare settings.
Q type of disinfectants

Q membrane filters
Q autoclave
Q Ethylene oxide (ETO) STERILIZER
Q Intermediate level disinfectant (heat based method)
Q difference between taenia solium and taenia saginata
Very short questions
Q Laboratory diagnosis of gas gangrene.

Q non-sporing anaerobe
Q Nagler's reaction
Q TREATMENT OF LEPROSY
Q DIFFERENCE BETWEEN LEPROMATOUS LEPROSY AND TUBERCULOID LEPROSY

Q DIFFERENCE BETWEEN LEPRA REACTION TYPE 1 AND TYPE 2

Q LEPRA REACTIONS
Q Cutaneous leishmeniasis
Q guniea worm infection

Q Enumerate the organisms with oncogenic potential

Q Cutaneous larva migrans
Q Piedra
Q rhinosporidiosis
Q Penicillium marneffei infection.

Q Mycetoma
Q acute laryngotracheobrochitis (Croup)
Q vincent angina
Q pleural effusion
Q the End TB Strategy (WHO)
Q Anti tubercular drug
Q tuberculin skin test
Q BACTEC MGIT

Q whole cell pertussis vaccines

Q clinical manifestation of pertusis
Q MELIOIDOSIS
Q MEDICALLY IMPORTANT NON-FERMENTERS
Q Epidemiology of COVID-19.
Q Vaccine for COVID-19

Q VDRL test
Q polio vaccine
Q polio eradication
Q coxsackievirus

Q Acute bacterial conjunctivitis (ABC).

Q Ophthalmia neonatorum.
Q Ocular viral infections.
Q Ocular fungal infections.

Q Acanthamoeba keratitis.
Q Ocular toxoplasmosis.
Q Acute suppurative otitis medi
Q Paragonimiasis
Q aspergillosis

Q Clinical types of human plague.

Q Rat-bite fever.
Q Tularemia.
Q Bite wound infection