Gonorrhea MCQs With Answer

Gonorrhea MCQs With Answer — This concise, keyword-rich introduction helps B. Pharm students master clinical, microbiological, and pharmacological aspects of gonorrhea. Focused on Neisseria gonorrhoeae epidemiology, pathogenesis, diagnosis (Gram stain, NAAT, culture), treatment guidelines, and emerging antibiotic resistance, these MCQs reinforce drug mechanisms, dosing, adverse effects, and stewardship principles relevant to pharmacy practice. Expect questions on laboratory media, virulence factors, complications like PID and DGI, and public-health reporting. Each item promotes critical thinking for dispensing, counseling, and antimicrobial selection. Ideal for exam prep, revision, and clinical decision-making skills. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. Which organism is the primary causative agent of gonorrhea?

• Streptococcus pyogenes
• Neisseria gonorrhoeae
• Escherichia coli
• Chlamydia trachomatis

Correct Answer: Neisseria gonorrhoeae

Q2. What is the typical Gram stain appearance of Neisseria gonorrhoeae from urethral discharge?

• Gram-positive cocci in chains
• Gram-negative intracellular diplococci
• Gram-positive bacilli
• Acid-fast bacilli

Correct Answer: Gram-negative intracellular diplococci

Q3. Which selective medium is classically used to culture N. gonorrhoeae?

• MacConkey agar
• Thayer-Martin (modified) medium
• Blood agar
• Sabouraud dextrose agar

Correct Answer: Thayer-Martin (modified) medium

Q4. What is the most sensitive diagnostic test for urogenital gonorrhea in noninvasive specimens?

• Gram stain
• Nucleic acid amplification test (NAAT)
• Culture only
• Complement fixation

Correct Answer: Nucleic acid amplification test (NAAT)

Q5. Which virulence factor allows N. gonorrhoeae to adhere to mucosal epithelium?

• Endotoxin
• Pili (fimbriae)
• Capsular polysaccharide
• Spore formation

Correct Answer: Pili (fimbriae)

Q6. Which characteristic explains N. gonorrhoeae immune evasion leading to recurrent infections?

• Antigenic variation of surface proteins
• Permanent capsule formation
• Production of exotoxin A
• High sporulation rate

Correct Answer: Antigenic variation of surface proteins

Q7. Which syndrome is a common complication of untreated gonorrhea in females?

• Rheumatic fever
• Pelvic inflammatory disease (PID)
• Glomerulonephritis
• Bronchiectasis

Correct Answer: Pelvic inflammatory disease (PID)

Q8. Which medication is recommended as first-line empirical therapy for uncomplicated gonorrhea by recent guidelines?

• Ceftriaxone (intramuscular)
• Penicillin G (oral)
• Tetracycline (oral)
• Ciprofloxacin (oral)

Correct Answer: Ceftriaxone (intramuscular)

Q9. What is the mechanism of action of ceftriaxone against N. gonorrhoeae?

• Inhibition of 30S ribosomal subunit
• Inhibition of cell wall synthesis by binding PBPs
• Inhibition of DNA gyrase
• Disruption of folate synthesis

Correct Answer: Inhibition of cell wall synthesis by binding PBPs

Q10. What major resistance mechanism is seen in N. gonorrhoeae against beta-lactams?

• Ribosomal methylation
• Alteration of penicillin-binding proteins (PBPs)
• Efflux pump for macrolides only
• Inactivation by chloramphenicol acetyltransferase

Correct Answer: Alteration of penicillin-binding proteins (PBPs)

Q11. Which test result supports diagnosis of disseminated gonococcal infection (DGI)?

• Positive NAAT from synovial fluid
• Negative blood cultures and NAATs from mucosal sites
• High antistreptolysin O titer
• Positive tuberculin skin test

Correct Answer: Positive NAAT from synovial fluid

Q12. Which ocular prophylaxis is recommended for newborns to prevent gonococcal ophthalmia neonatorum in many countries?

• Topical erythromycin ointment
• Topical tetracycline drops
• Topical ciprofloxacin gel
• Topical amphotericin drops

Correct Answer: Topical erythromycin ointment

Q13. Coinfection with which organism is commonly screened for along with gonorrhea?

• Mycobacterium tuberculosis
• Chlamydia trachomatis
• Staphylococcus aureus
• Treponema pallidum

Correct Answer: Chlamydia trachomatis

Q14. Which laboratory enzyme test is typically positive for N. gonorrhoeae?

• Coagulase
• Oxidase
• Indole

Correct Answer: Oxidase

Q15. For a patient allergic to ceftriaxone (severe immediate reaction), what is an appropriate management step?

• Use high-dose oral penicillin
• Consult infectious disease specialist for alternative regimen
• Administer ceftriaxone after desensitization without consultation
• Ignore allergy and treat as usual

Correct Answer: Consult infectious disease specialist for alternative regimen

Q16. Which DNA-based test advantage makes NAAT preferred over culture?

• Lower sensitivity
• Higher cost and complexity
• Higher sensitivity and ability to use noninvasive specimens
• Requires viable organisms

Correct Answer: Higher sensitivity and ability to use noninvasive specimens

Q17. What pharmacokinetic property of ceftriaxone is clinically useful for single-dose therapy?

• Short half-life requiring multiple daily doses
• High oral bioavailability
• Long half-life allowing single intramuscular dose
• Extensive hepatic first-pass metabolism

Correct Answer: Long half-life allowing single intramuscular dose

Q18. Which laboratory specimen is recommended for NAAT testing in suspected pharyngeal gonorrhea?

• Urine sample
• Pharyngeal swab
• Blood culture
• Stool sample

Correct Answer: Pharyngeal swab

Q19. Which antibiotic class historically used for gonorrhea has seen widespread resistance and is no longer recommended empirically in many regions?

• Third-generation cephalosporins
• Fluoroquinolones
• Macrolides
• Aminoglycosides

Correct Answer: Fluoroquinolones

Q20. Which lipid component of the outer membrane of N. gonorrhoeae contributes to inflammatory response?

• Lipooligosaccharide (LOS)
• Peptidoglycan monomer
• Lipoprotein A
• Polysaccharide capsule

Correct Answer: Lipooligosaccharide (LOS)

Q21. What is a common symptom of urethral gonorrhea in males?

• Painless vaginal discharge
• Purulent urethral discharge and dysuria
• Generalized rash without local symptoms
• Hematuria in all cases

Correct Answer: Purulent urethral discharge and dysuria

Q22. Which public health action is essential after diagnosing a confirmed case of gonorrhea?

• Ignore contacts
• Partner notification and treatment
• Discontinue reporting to health authorities
• Recommend home remedies only

Correct Answer: Partner notification and treatment

Q23. Which mechanism confers macrolide resistance in bacteria and is a consideration for gonococcal therapy?

• Mutations in 23S rRNA leading to decreased macrolide binding
• Beta-lactamase production
• Increased uptake through porins
• Inhibition of efflux pumps

Correct Answer: Mutations in 23S rRNA leading to decreased macrolide binding

Q24. Which dissemination manifestation is characteristic of DGI?

• Localized cellulitis only
• Tenosynovitis, dermatitis, and migratory arthritis
• Chronic cough and hemoptysis
• Hepatosplenomegaly as sole sign

Correct Answer: Tenosynovitis, dermatitis, and migratory arthritis

Q25. Which molecular target is inhibited by fluoroquinolones in susceptible bacteria?

• DNA gyrase and topoisomerase IV
• Cell wall PBPs
• 30S ribosomal subunit
• RNA polymerase

Correct Answer: DNA gyrase and topoisomerase IV

Q26. Which patient counseling point is important after treating gonorrhea?

• Resuming sexual activity immediately is safe
• Abstain from sexual activity until treatment completion and partner treatment
• There is no need to inform partners
• Antibiotics protect against all STIs indefinitely

Correct Answer: Abstain from sexual activity until treatment completion and partner treatment

Q27. For test-of-cure in uncomplicated urogenital gonorrhea after ceftriaxone therapy, when is NAAT recommended if symptoms persist?

• Within 24 hours
• Approximately 1 week after therapy
• At least 2 weeks after therapy if symptoms persist
• Never recommended

Correct Answer: At least 2 weeks after therapy if symptoms persist

Q28. Which drug interaction concern exists with azithromycin when used in combination with other medications?

• Strong CYP3A4 induction decreasing other drug levels
• QT prolongation risk when combined with other QT-prolonging drugs
• Severe nephrotoxicity with acetaminophen
• Universal antagonism with beta-lactams

Correct Answer: QT prolongation risk when combined with other QT-prolonging drugs

Q29. Which sample is preferred for NAAT in symptomatic men with urethritis?

• First-catch urine specimen
• Midstream clean-catch urine after voiding for 1 hour
• Blood sample
• Stool sample

Correct Answer: First-catch urine specimen

Q30. Which of the following is TRUE regarding gonorrhea vaccine development?

• A licensed, highly effective vaccine exists
• Vaccine development is challenging due to antigenic variation
• Vaccines are unnecessary due to low incidence
• Live-attenuated vaccines are standard

Correct Answer: Vaccine development is challenging due to antigenic variation

Q31. Which biochemical trait differentiates Neisseria gonorrhoeae from N. meningitidis in clinical practice?

• Both cannot be differentiated biochemically
• Pathogenic sites and some carbohydrate utilization patterns differ
• N. gonorrhoeae ferments maltose strongly
• N. meningitidis is not oxidase positive

Correct Answer: Pathogenic sites and some carbohydrate utilization patterns differ

Q32. Which adverse effect is commonly associated with ceftriaxone therapy?

• Severe ototoxicity
• Biliary sludging or gallbladder precipitation in neonates
• Hyperpigmentation of skin
• Permanent tendon rupture

Correct Answer: Biliary sludging or gallbladder precipitation in neonates

Q33. Which stewardship principle is most relevant when treating suspected gonorrhea empirically?

• Use the broadest possible spectrum indefinitely
• Prescribe guideline-recommended first-line agents and confirm with testing when possible
• Avoid testing and treat only symptomatic partners
• Reserve antibiotics for severe cases only

Correct Answer: Prescribe guideline-recommended first-line agents and confirm with testing when possible

Q34. Which molecular change can lead to reduced susceptibility to extended-spectrum cephalosporins in gonococcus?

• Point mutations in gyrA only
• mtrR promoter mutations and penA mosaic alleles
• Loss of cell wall entirely
• Acquisition of plasmid-encoded macrolide methylase

Correct Answer: mtrR promoter mutations and penA mosaic alleles

Q35. Which phenotype does N. gonorrhoeae display on Gram stain of cervical swab from an infected woman?

• Intracellular gram-positive cocci
• Intracellular gram-negative diplococci
• Long branching filaments
• Yeast cells with pseudohyphae

Correct Answer: Intracellular gram-negative diplococci

Q36. What is the role of ocular erythromycin prophylaxis in newborns?

• Treats congenital syphilis
• Prevents gonococcal conjunctivitis in neonates
• Prevents neonatal herpes simplex
• Cures maternal gonorrhea during delivery

Correct Answer: Prevents gonococcal conjunctivitis in neonates

Q37. Which laboratory measure is required when using cultures for antimicrobial susceptibility testing of N. gonorrhoeae?

• Viable organism isolates and standardized MIC testing methods
• Only NAAT data is sufficient for susceptibility
• No need for standardized inoculum
• Susceptibility testing is never performed

Correct Answer: Viable organism isolates and standardized MIC testing methods

Q38. Which patient population is at high risk for asymptomatic gonorrhea and requires screening?

• Monogamous older adults with no risk factors
• Sexually active adolescents and young adults with multiple partners
• Infants exclusively
• Patients with no sexual history

Correct Answer: Sexually active adolescents and young adults with multiple partners

Q39. Which treatment adjustment is recommended for a patient with uncomplicated gonorrhea weighing ≥150 kg?

• Give same fixed dose for all weights
• Increase ceftriaxone dose (e.g., 1 g IM) per guidelines
• Avoid ceftriaxone entirely
• Switch to oral penicillin VK

Correct Answer: Increase ceftriaxone dose (e.g., 1 g IM) per guidelines

Q40. Which of the following is a common lab finding in disseminated gonococcal infection?

• High antibody titers to Epstein-Barr virus
• Elevated inflammatory markers and positive cultures from sterile sites
• Consistent negative NAAT from all mucosal sites
• Hypoglycemia as hallmark

Correct Answer: Elevated inflammatory markers and positive cultures from sterile sites

Q41. Which drug is sometimes used as alternative therapy for gonorrhea when cephalosporins cannot be used and isolates show susceptibility?

• Oral azithromycin alone
• Ciprofloxacin if susceptibility confirmed by testing
• Tetracycline empirically
• Amphotericin B

Correct Answer: Ciprofloxacin if susceptibility confirmed by testing

Q42. What is the recommended management for sexual partners of a patient diagnosed with gonorrhea?

• No action required for partners
• Notify, test, and treat partners from the preceding 60 days or most recent partner
• Treat only if symptomatic
• Recommend herbal remedies for partners

Correct Answer: Notify, test, and treat partners from the preceding 60 days or most recent partner

Q43. Which laboratory feature helps differentiate gonococcal from non-gonococcal urethritis on smear in men?

• Presence of intracellular gram-negative diplococci suggests gonococcal urethritis
• Lack of neutrophils indicates gonococcal infection
• Yeast indicates gonococcus
• Presence of acid-fast bacilli suggests gonococcus

Correct Answer: Presence of intracellular gram-negative diplococci suggests gonococcal urethritis

Q44. Which molecular test limitation must pharmacists understand when counseling patients about NAAT?

• NAAT cannot detect nonviable organisms and always confirms resistance
• NAAT detects nucleic acid and may remain positive for a short time after successful treatment
• NAAT always yields culture results
• NAAT is unaffected by specimen type

Correct Answer: NAAT detects nucleic acid and may remain positive for a short time after successful treatment

Q45. Which statement about gonorrhea antimicrobial resistance surveillance is correct?

• Surveillance is unnecessary because resistance is stable
• Active surveillance guides empirical therapy and public health responses
• Only viral STIs require surveillance
• Resistance data do not influence guidelines

Correct Answer: Active surveillance guides empirical therapy and public health responses

Q46. Which adverse effect is most associated with fluoroquinolones and relevant to counseling?

• Tendonitis and tendon rupture risk
• Severe hypoglycemia in all patients
• Permanent hearing loss in infants
• Immediate anaphylaxis in majority

Correct Answer: Tendonitis and tendon rupture risk

Q47. Which pharmacodynamic parameter is most relevant for beta-lactam activity against N. gonorrhoeae?

• Peak/MIC ratio only
• Time above MIC (time-dependent killing)
• AUC/MIC only for aminoglycosides
• Post-antibiotic effect only

Correct Answer: Time above MIC (time-dependent killing)

Q48. Which lab practice reduces false-negative culture results for gonorrhea?

• Poor temperature control during transport
• Immediate placement of swabs in appropriate transport medium and prompt incubation
• Use of nonselective media at room temperature for several days
• Delaying processing for 7 days

Correct Answer: Immediate placement of swabs in appropriate transport medium and prompt incubation

Q49. Which clinical sign in neonates suggests possible gonococcal infection acquired during birth?

• Congenital heart murmur
• Profuse purulent conjunctivitis within days of birth
• Neonatal acne only
• Delayed milestones at 1 month without eye findings

Correct Answer: Profuse purulent conjunctivitis within days of birth

Q50. From a B. Pharm perspective, why is understanding gonorrhea pharmacotherapy important?

• Pharmacists never interact with STI patients
• Pharmacists advise on drug selection, dosing, interactions, adverse effects, and public-health considerations
• Only physicians need to know pharmacotherapy details
• Pharmacists should only sell OTC remedies

Correct Answer: Pharmacists advise on drug selection, dosing, interactions, adverse effects, and public-health considerations

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