---

1) Streptococcus pyogenes:

Choose 2 of the following options.

   a) is alpha-haemolytic when grown on blood agar;

   b) is the commonest cause of acute pharyngitis;

   c) can be cultured from heart valves in acute rheumatic fever;

   d) is a frequent cause of cellulitis;

   e) is always susceptible to penicillin.

---

2) Immunoglobulin M:

Choose 2 of the following options.

   a) is a glycoprotein;

   b) comprises 75% of the total serum immunoglobulins;

   c) has a pentameric structure;

   d) plays a major role in the defence against parasites;

   e) is the only immunoglobulin to actively cross the placenta.

---

3) In viral meningitis:

Choose 4 of the following options.

   a) the overall mortality is less than pyogenic meningitis;

   b) the CSF cellular response is predominantly lymphocytic;

   c) CSF glucose concentrations may be markedly decreased;

   d) examination of throat swabs and faecal samples may aid diagnosis;

   e) there is a seasonal peak in incidence during the summer months.

---

4) Cell-mediated immunity is important in the immune response to:

Choose 3 of the following options.

   a) Mycobacterium tuberculosis;

   b) herpes viruses;

   c) tetanus;

   d) diphtheria;

   e) Chlamydia trachomatis.

---

5) In bacterial endocarditis:

Choose 4 of the following options.

   a) infection involving the mitral valve is commoner than that involving the tricuspid valve;

   b) enterococcal infection may follow gastrointestinal manipulation such as surgery or endoscopy;

   c) second infection with the same species of bacterium does not occur;

   d) coagulase negative staphylococci are commonly associated with infections on prosthetic valves;

   e) infection with Staphylococcus aureus is associated with intravenous drug abuse.

---

6) The following viral infections can be prevented by vaccination:

Choose 3 of the following options.

   a) hepatitis A;

   b) hepatitis B;

   c) hepatitis C;

   d) mumps;

   e) Epstein-Barr virus.

---

7) In pyogenic brain abscess:

One answer only.

   a) infection frequently follows on from acute pyogenic meningitis;

   b) Staphylococcus aureus abscesses often occur following haematogenous (blood borne) infection;

   c) surgery is not usually indicated;

   d) anaerobes are infrequently isolated;

   e) Streptococcus pneumoniae is a common cause.

---

8) penicillin:

Choose 3 of the following options.

   a) is a beta-lactam compound;

   b) is bactericidal against susceptible bacteria;

   c) cannot be given intravenously;

   d) is not active against Gram negative bacteria;

   e) is a useful agent for the therapy of syphilis.

---

9) Sterilisation may be achieved by the following chemical agents:

Choose 2 of the following options.

   a) glutaraldehyde;

   b) ethylene oxide;

   c) chlorhexidine gluconate;

   d) dipicolinic acid;

   e) quaternary ammonium compounds.

---

10) Streptococcus pneumoniae:

Choose 3 of the following options.

   a) is the commonest cause of community acquired pneumonia in adults;

   b) is "bile soluble";

   c) is not found as part of the normal upper respiratory tract flora in humans;

   d) is usually susceptible to metronidazole;

   e) is frequently isolated from clinical specimens in cases of acute sinusitis and acute otitis media.