Mycobacterial Infections Practice Exam
2026/2027 | 103 Board-Style Questions on
Tuberculosis, MAC, NTM, Drug-Resistant
TB, and HIV Co-Infection with Detailed
Explanations
Description:
Master mycobacterial diseases for your 2026/2027 infectious disease boards. 103 high-
yield MCQs covering TB treatment (RIPE, MDR-TB, BPaL), MAC pulmonary and
disseminated disease, NTM skin infections, PPD/IGRA interpretation, and IRIS. Each
answer includes a clinical explanation.
Download the complete 2026/2027 exam paper now and pass with confidence.
,Mycobacterial Infections Exam 2026/2027: TB, MAC, NTM (103
Q&A)
Subject: Infectious Diseases / Pulmonary Medicine
Topic: Mycobacterial Infections (NTM, TB, and Related Syndromes)
Exam Type: Multiple Choice Questions (MCQs) for Study Guides, Exam Prep, and Digital
Learning
Section 1: Mycobacterium avium complex (MAC) – Pulmonary Infections
Question 1
A middle-aged Caucasian patient with a history of chronic obstructive pulmonary disease,
alcohol use disorder, and cigarette smoking presents with an indolent respiratory illness.
Which clinical presentation of MAC infection is most likely?
A. MAC lymphadenitis
B. Disseminated MAC
C. Pulmonary MAC infection with underlying lung disease
D. Buruli ulcer
Answer: C
Explanation: Patients with pre-existing structural lung disease (e.g., COPD, bronchiectasis,
prior tuberculosis) who develop MAC typically present with an indolent, cavitary upper lobe
disease resembling tuberculosis. Risk factors include smoking, alcohol use, and underlying
lung pathology.
Question 2
A previously healthy, nonsmoking woman over 50 years of age is found to have a chronic
cough and variable sputum production. Imaging reveals small nodules and cylindrical
bronchiectasis. Which MAC infection pattern is most consistent with this presentation?
A. Classical cavitary MAC
B. MAC lymphadenitis
C. Nodular bronchiectatic MAC
D. Disseminated MAC
Answer: C
,Explanation: The nodular bronchiectatic form of pulmonary MAC typically affects older
women without underlying lung disease (often referred to as “Lady Windermere syndrome”).
Chest CT shows small nodules and cylindrical bronchiectasis, usually in the right middle lobe
and lingula.
Section 2: Extrapulmonary MAC and Other NTM Syndromes
Question 3
Which patient population is most commonly affected by MAC lymphadenitis?
A. Elderly immunocompromised adults
B. Children aged 1–5 years
C. Adolescents with cystic fibrosis
D. Young adult smokers
Answer: B
Explanation: MAC lymphadenitis is predominantly a disease of immunocompetent children
between 1 and 5 years of age, presenting as unilateral, nontender submandibular
lymphadenopathy with overlying skin that may range from pink to violaceous.
Question 4
A young adult develops a painless, indurated ulcer on the lower extremity after exposure to
stagnant water. Which organism is the most likely cause?
A. Mycobacterium marinum
B. Mycobacterium ulcerans
C. Mycobacterium abscessus
D. Mycobacterium chelonae
Answer: B
Explanation: Mycobacterium ulcerans causes Buruli ulcer, a necrotizing skin and soft tissue
infection often associated with swampy or stagnant water environments in tropical regions.
, Question 5
Which two rapidly growing mycobacteria are classically associated with tattoo-related
cutaneous infections?
A. Mycobacterium marinum and Mycobacterium kansasii
B. Mycobacterium tuberculosis and Mycobacterium bovis
C. Mycobacterium abscessus and Mycobacterium chelonae
D. Mycobacterium ulcerans and Mycobacterium fortuitum
Answer: C
Explanation: Outbreaks of skin and soft tissue infections following tattoo procedures have
been linked to rapidly growing nontuberculous mycobacteria, particularly Mycobacterium
abscessus and Mycobacterium chelonae, often due to contaminated ink or water.
Question 6
A patient presents with a chronic skin nodule on the elbow after cleaning a fish tank. The
most likely diagnosis is:
A. Buruli ulcer
B. Swimming pool granuloma
C. MAC lymphadenitis
D. Disseminated MAC
Answer: B
Explanation: Mycobacterium marinum causes “swimming pool granuloma” or fish tank
granuloma, typically presenting as nodular or ulcerative skin lesions after exposure to
contaminated fresh or salt water.
Question 7
Which group of NTM species most commonly causes nodular skin lesions with purplish
discoloration, abscesses, septic arthritis, and osteomyelitis?
A. MAC, M. kansasii, M. xenopi
B. M. abscessus, M. chelonae, M. fortuitum, M. ulcerans
C. M. tuberculosis, M. bovis, M. africanum
D. M. leprae, M. lepromatosis
Answer: B
2026/2027 | 103 Board-Style Questions on
Tuberculosis, MAC, NTM, Drug-Resistant
TB, and HIV Co-Infection with Detailed
Explanations
Description:
Master mycobacterial diseases for your 2026/2027 infectious disease boards. 103 high-
yield MCQs covering TB treatment (RIPE, MDR-TB, BPaL), MAC pulmonary and
disseminated disease, NTM skin infections, PPD/IGRA interpretation, and IRIS. Each
answer includes a clinical explanation.
Download the complete 2026/2027 exam paper now and pass with confidence.
,Mycobacterial Infections Exam 2026/2027: TB, MAC, NTM (103
Q&A)
Subject: Infectious Diseases / Pulmonary Medicine
Topic: Mycobacterial Infections (NTM, TB, and Related Syndromes)
Exam Type: Multiple Choice Questions (MCQs) for Study Guides, Exam Prep, and Digital
Learning
Section 1: Mycobacterium avium complex (MAC) – Pulmonary Infections
Question 1
A middle-aged Caucasian patient with a history of chronic obstructive pulmonary disease,
alcohol use disorder, and cigarette smoking presents with an indolent respiratory illness.
Which clinical presentation of MAC infection is most likely?
A. MAC lymphadenitis
B. Disseminated MAC
C. Pulmonary MAC infection with underlying lung disease
D. Buruli ulcer
Answer: C
Explanation: Patients with pre-existing structural lung disease (e.g., COPD, bronchiectasis,
prior tuberculosis) who develop MAC typically present with an indolent, cavitary upper lobe
disease resembling tuberculosis. Risk factors include smoking, alcohol use, and underlying
lung pathology.
Question 2
A previously healthy, nonsmoking woman over 50 years of age is found to have a chronic
cough and variable sputum production. Imaging reveals small nodules and cylindrical
bronchiectasis. Which MAC infection pattern is most consistent with this presentation?
A. Classical cavitary MAC
B. MAC lymphadenitis
C. Nodular bronchiectatic MAC
D. Disseminated MAC
Answer: C
,Explanation: The nodular bronchiectatic form of pulmonary MAC typically affects older
women without underlying lung disease (often referred to as “Lady Windermere syndrome”).
Chest CT shows small nodules and cylindrical bronchiectasis, usually in the right middle lobe
and lingula.
Section 2: Extrapulmonary MAC and Other NTM Syndromes
Question 3
Which patient population is most commonly affected by MAC lymphadenitis?
A. Elderly immunocompromised adults
B. Children aged 1–5 years
C. Adolescents with cystic fibrosis
D. Young adult smokers
Answer: B
Explanation: MAC lymphadenitis is predominantly a disease of immunocompetent children
between 1 and 5 years of age, presenting as unilateral, nontender submandibular
lymphadenopathy with overlying skin that may range from pink to violaceous.
Question 4
A young adult develops a painless, indurated ulcer on the lower extremity after exposure to
stagnant water. Which organism is the most likely cause?
A. Mycobacterium marinum
B. Mycobacterium ulcerans
C. Mycobacterium abscessus
D. Mycobacterium chelonae
Answer: B
Explanation: Mycobacterium ulcerans causes Buruli ulcer, a necrotizing skin and soft tissue
infection often associated with swampy or stagnant water environments in tropical regions.
, Question 5
Which two rapidly growing mycobacteria are classically associated with tattoo-related
cutaneous infections?
A. Mycobacterium marinum and Mycobacterium kansasii
B. Mycobacterium tuberculosis and Mycobacterium bovis
C. Mycobacterium abscessus and Mycobacterium chelonae
D. Mycobacterium ulcerans and Mycobacterium fortuitum
Answer: C
Explanation: Outbreaks of skin and soft tissue infections following tattoo procedures have
been linked to rapidly growing nontuberculous mycobacteria, particularly Mycobacterium
abscessus and Mycobacterium chelonae, often due to contaminated ink or water.
Question 6
A patient presents with a chronic skin nodule on the elbow after cleaning a fish tank. The
most likely diagnosis is:
A. Buruli ulcer
B. Swimming pool granuloma
C. MAC lymphadenitis
D. Disseminated MAC
Answer: B
Explanation: Mycobacterium marinum causes “swimming pool granuloma” or fish tank
granuloma, typically presenting as nodular or ulcerative skin lesions after exposure to
contaminated fresh or salt water.
Question 7
Which group of NTM species most commonly causes nodular skin lesions with purplish
discoloration, abscesses, septic arthritis, and osteomyelitis?
A. MAC, M. kansasii, M. xenopi
B. M. abscessus, M. chelonae, M. fortuitum, M. ulcerans
C. M. tuberculosis, M. bovis, M. africanum
D. M. leprae, M. lepromatosis
Answer: B
