Vulvovaginal candidiasis is commoner in pregnancy and in diabetes mainly because:

Vaginal glucose and glycogen rise

Vaginal pH becomes strongly alkaline

Oestrogen suppresses neutrophil numbers

Lactobacilli multiply faster than usual

Mycology: fungal diseases

45 Kerala PSC Lab Technician Gr II practice questions on Mycology: fungal diseases, part of Microbiology. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
Under the microscope, which feature separates a grain of eumycetoma from one of actinomycetoma?
1. AColour of the grain
2. BWidth of the filaments in it
3. CShape of the grain
4. DSize of the grain
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Answer: B · Width of the filaments in it
Eumycetoma grains contain true fungal hyphae, broad (about 2 to 5 µm), septate and often with swollen cells at the edge. Actinomycetoma grains contain actinomycete filaments under 1 µm wide, which are gram-positive and may be partly acid-fast. Grain colour helps to suggest the species but both groups include black, white and yellow grains. The distinction decides treatment: antibacterial drugs for actinomycetoma, antifungals with surgery for eumycetoma.
- A: Colour suggests the species but does not separate the two groups.
- C: Grains of both groups may be round or lobed.
- D: Grain size overlaps widely between the two groups.
Question 2 · Hard
A young man in Kerala who bathes in a village pond has a soft, bleeding nasal polyp. Histology shows large thick-walled sporangia full of endospores, and repeated cultures are sterile. The diagnosis is:
1. ACutaneous sporotrichosis
2. BRhinosporidiosis
3. CNasal mucormycosis
4. DNasal aspergillosis
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Answer: B · Rhinosporidiosis
Rhinosporidium seeberi causes friable, strawberry-like polyps of the nose and conjunctiva and is linked to bathing in stagnant water; it is common in Kerala, Tamil Nadu and Sri Lanka. Its sporangia, up to 300 µm across, are packed with endospores and are seen directly in tissue sections or in a crushed smear. It cannot be cultured on any routine medium, so sterile cultures support rather than exclude the diagnosis. Treatment is surgical excision, as the lesion often recurs.
- A: Sporotrichosis affects skin and lymphatics after a thorn prick.
- C: Mucormycosis destroys tissue rapidly and shows broad aseptate hyphae, not sporangia with endospores.
- D: Aspergillus grows readily in culture and shows septate hyphae.
Question 3 · Easy
Copper-penny (sclerotic) bodies in a skin biopsy point to which infection?
1. ACandidiasis
2. BEumycetoma of the foot
3. CSporotrichosis
4. DChromoblastomycosis
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Answer: D · Chromoblastomycosis
Chromoblastomycosis is a subcutaneous infection by pigmented soil fungi such as Fonsecaea pedrosoi, implanted by minor injury. In tissue they appear as thick-walled, brown, septate cells about 5 to 12 µm across, called sclerotic or copper-penny bodies. The lesions are warty, slowly spreading plaques, usually on the leg or foot of a barefoot worker. Mycetoma instead discharges grains, and sporotrichosis forms a chain of nodules.
- A: Candidiasis shows budding yeasts with pseudohyphae.
- B: Eumycetoma shows grains made of fungal filaments.
- C: Sporotrichosis shows scanty cigar-shaped yeasts in tissue.
Question 4 · Medium
Vulvovaginal candidiasis is commoner in pregnancy and in diabetes mainly because:
1. AVaginal pH becomes strongly alkaline
2. BOestrogen suppresses neutrophil numbers
3. CVaginal glucose and glycogen rise
4. DLactobacilli multiply faster than usual
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Answer: C · Vaginal glucose and glycogen rise
Oestrogen in pregnancy and high blood glucose in diabetes both raise the glycogen and free sugar available in the vaginal epithelium, which Candida uses to grow and adhere. The yeast then overgrows the normal flora and causes itching with thick white discharge. A Gram-stained smear and a KOH mount of the discharge show budding cells with pseudohyphae. Control of blood sugar reduces repeated attacks.
- A: The vaginal pH stays acid; Candida tolerates acid well.
- B: Oestrogen does not lower the neutrophil count.
- D: Lactobacilli restrain Candida rather than encouraging it.
Question 5 · Easy
Tinea unguium is a dermatophyte infection of which site?
1. AScalp
2. BTrunk
3. CNails
4. DGroin
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Answer: C · Nails
The tineas are named after the site: unguium the nails, capitis the scalp, cruris the groin, corporis the trunk, pedis the feet and barbae the beard area. In tinea unguium the nail becomes thick, discoloured and crumbly, and nail clippings with subungual debris are the specimen. Trichophyton rubrum is the commonest agent in India. Nails need longer KOH clearing and up to 4 weeks of culture.
- A: Scalp infection is tinea capitis.
- B: Infection of the trunk is tinea corporis.
- D: Groin infection is tinea cruris.
Question 6 · Easy
How is sporotrichosis usually acquired?
1. AA prick from a thorn or splinter
2. BA mosquito bite
3. CInhaling spores from soil
4. DDrinking pond water
Answer and explanation in LearnFree account
Question 7 · Medium
How does invasive pulmonary aspergillosis differ from an aspergilloma?
1. AThe fungus grows only in old cavities
2. BThe patient has high IgE and wheezing
3. CThe fungus invades lung tissue and vessels
4. DThe fungus forms grains in the sputum
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Question 8 · Medium
An adult with no obvious risk factor has repeated oral thrush. The laboratory should suggest testing for:
1. ATuberculosis
2. BHepatitis A
3. CTyphoid fever
4. DHIV infection
Answer and explanation in LearnFree account
Question 9 · Hard
A man with uncontrolled diabetes and ketoacidosis has a black crust on the palate and orbital swelling. A KOH mount of debrided tissue shows broad, ribbon-like hyphae with few septa branching at wide angles. Which agent is most likely?
1. ACandida tropicalis
2. BAspergillus flavus
3. CRhizopus species
4. DTrichophyton rubrum
Answer and explanation in LearnFree account
Question 10 · Easy
All of the following are dermatophyte genera EXCEPT:
1. AMalassezia
2. BMicrosporum
3. CTrichophyton
4. DEpidermophyton
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Question 11 · Medium
Mucormycosis produces a black, dead eschar on the palate or nose mainly because the hyphae:
1. ASecrete a toxin that dissolves the cartilage
2. BInvade blood vessels and cause infarction
3. CProduce a black melanin pigment
4. DForm a crust of dried spores
Answer and explanation in LearnFree account
Question 12 · Medium
Compared with anthropophilic dermatophytes, zoophilic species such as Microsporum canis usually cause human lesions that are:
1. AMilder, chronic and more slowly spreading
2. BLimited to the nails
3. CConfined to the groin and feet
4. DMore inflamed, sometimes with a kerion
Answer and explanation in LearnFree account
Question 13 · Easy
All of the following are subcutaneous mycoses EXCEPT:
1. APityriasis versicolor
2. BChromoblastomycosis
3. CSporotrichosis
4. DMycetoma
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Question 14 · Easy
A 35-year-old man with AIDS and a CD4 count of 60/µL has had headache and fever for 2 weeks. Which fungus is the most likely cause of his meningitis?
1. ARhizopus arrhizus
2. BCandida albicans
3. CAspergillus fumigatus
4. DCryptococcus neoformans
Answer and explanation in LearnFree account
Question 15 · Medium
Why do broad-spectrum antibiotics predispose a patient to candidiasis?
1. AThey make Candida produce toxins
2. BThey turn Candida into a mould
3. CThey kill bacteria that keep Candida in check
4. DThey damage the patient's neutrophils
Answer and explanation in LearnFree account
Question 16 · Hard
A 32-year-old farmer has had a painless, hard swelling of the right foot for 4 years. Several sinuses discharge pus with small black grains, and crushed grains show broad (2-5 µm) septate hyphae. The most likely agent is:
1. ANocardia brasiliensis
2. BActinomadura madurae
3. CMadurella mycetomatis
4. DSporothrix schenckii
Answer and explanation in LearnFree account
Question 17 · Easy
Allergic bronchopulmonary aspergillosis occurs mainly in patients with:
1. ANeutropenia after chemotherapy
2. BDiabetic ketoacidosis
3. CAsthma or cystic fibrosis
4. DAn old tuberculous cavity
Answer and explanation in LearnFree account
Question 18 · Easy
Tinea pedis is commonly known as:
1. AAthlete's foot
2. BJock itch
3. CMadura foot
4. DBarber's itch
Answer and explanation in LearnFree account
Question 19 · Medium
Along which structures does Sporothrix schenckii spread to form a line of nodules up the forearm?
1. ATendon sheaths
2. BPeripheral nerves
3. CLymphatic vessels
4. DSuperficial veins
Answer and explanation in LearnFree account
Question 20 · Hard
A 40-year-old man on chemotherapy for acute leukaemia has been neutropenic for 3 weeks. He develops fever and haemoptysis, and serum galactomannan is raised. A KOH mount of BAL fluid shows narrow septate hyphae branching at acute angles. The most likely agent is:
1. ARhizopus arrhizus
2. BAspergillus fumigatus
3. CCandida albicans
4. DCryptococcus neoformans
Answer and explanation in LearnFree account
Question 21 · Hard
A 6-year-old boy who plays with a new kitten has a boggy, pus-filled swelling on the scalp with hair loss. Plucked hairs fluoresce bright green under Wood's lamp, and a KOH mount shows small spores coating the outside of the hair shafts. The most likely agent is:
1. AMicrosporum canis
2. BEpidermophyton floccosum
3. CTrichophyton tonsurans
4. DTrichophyton violaceum
Answer and explanation in LearnFree account
Question 22 · Easy
An aspergilloma (fungus ball) usually forms in:
1. AThe pleural space after pneumonia
2. BThe normal alveoli of healthy adults
3. CAn old lung cavity, such as healed TB
4. DThe maxillary sinus of diabetics only
Answer and explanation in LearnFree account
Question 23 · Hard
A 28-year-old diabetic woman has vulval itching and a thick, white, curdy vaginal discharge. Vaginal pH is 4.2 (normal 3.8-4.5), the whiff test with KOH is negative, and a saline wet mount shows budding yeast cells with pseudohyphae but no clue cells or motile organisms. The most likely diagnosis is:
1. ATrichomoniasis
2. BGonococcal cervicitis
3. CVulvovaginal candidiasis
4. DBacterial vaginosis
Answer and explanation in LearnFree account
Question 24 · Medium
A man with tinea pedis develops itchy vesicles on his palms, but scrapings from the hands show no fungus. These lesions are:
1. ATinea manuum from spread
2. BContact with a contaminant mould
3. CAn id (dermatophytid) reaction
4. DEarly cutaneous candidiasis
Answer and explanation in LearnFree account
Question 25 · Medium
The classic triad of mycetoma is:
1. AItching, scaling and hair loss
2. BLymph node chain, ulcer and fever
3. CFever, cough and haemoptysis
4. DSwelling, sinuses and discharging grains
Answer and explanation in LearnFree account

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Mycology: fungal diseases

Under the microscope, which feature separates a grain of eumycetoma from one of actinomycetoma?

A young man in Kerala who bathes in a village pond has a soft, bleeding nasal polyp. Histology shows large thick-walled sporangia full of endospores, and repeated cultures are sterile. The diagnosis is:

Copper-penny (sclerotic) bodies in a skin biopsy point to which infection?

Vulvovaginal candidiasis is commoner in pregnancy and in diabetes mainly because:

Tinea unguium is a dermatophyte infection of which site?

How is sporotrichosis usually acquired?

How does invasive pulmonary aspergillosis differ from an aspergilloma?

An adult with no obvious risk factor has repeated oral thrush. The laboratory should suggest testing for:

A man with uncontrolled diabetes and ketoacidosis has a black crust on the palate and orbital swelling. A KOH mount of debrided tissue shows broad, ribbon-like hyphae with few septa branching at wide angles. Which agent is most likely?

All of the following are dermatophyte genera EXCEPT:

Mucormycosis produces a black, dead eschar on the palate or nose mainly because the hyphae:

Compared with anthropophilic dermatophytes, zoophilic species such as Microsporum canis usually cause human lesions that are:

All of the following are subcutaneous mycoses EXCEPT:

A 35-year-old man with AIDS and a CD4 count of 60/µL has had headache and fever for 2 weeks. Which fungus is the most likely cause of his meningitis?

Why do broad-spectrum antibiotics predispose a patient to candidiasis?

A 32-year-old farmer has had a painless, hard swelling of the right foot for 4 years. Several sinuses discharge pus with small black grains, and crushed grains show broad (2-5 µm) septate hyphae. The most likely agent is:

Allergic bronchopulmonary aspergillosis occurs mainly in patients with:

Tinea pedis is commonly known as:

Along which structures does Sporothrix schenckii spread to form a line of nodules up the forearm?

A 40-year-old man on chemotherapy for acute leukaemia has been neutropenic for 3 weeks. He develops fever and haemoptysis, and serum galactomannan is raised. A KOH mount of BAL fluid shows narrow septate hyphae branching at acute angles. The most likely agent is:

A 6-year-old boy who plays with a new kitten has a boggy, pus-filled swelling on the scalp with hair loss. Plucked hairs fluoresce bright green under Wood's lamp, and a KOH mount shows small spores coating the outside of the hair shafts. The most likely agent is:

An aspergilloma (fungus ball) usually forms in:

A man with tinea pedis develops itchy vesicles on his palms, but scrapings from the hands show no fungus. These lesions are:

The classic triad of mycetoma is: