Clinical Laboratory Science
Mock Exam
Course Introduction
Clinical Laboratory Science is an interdisciplinary field focused on the analysis of bodily fluids and tissues to aid in the diagnosis, treatment, and prevention of disease. Students will learn comprehensive laboratory techniques such as hematology, microbiology, immunology, and clinical chemistry, while gaining expertise in operating advanced diagnostic equipment and ensuring accuracy and safety in testing procedures. The course emphasizes critical thinking, problem solving, and quality assurance, preparing graduates to work as essential members of the healthcare team in hospitals, research laboratories, and public health settings.
Recommended Textbook
Bailey and Scotts Diagnostic Microbiology 12th Edition by Betty A. Forbes
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Page 2
Chapter 1: Microbial Taxonomy
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Sample Questions
Q1) The proper way to indicate that a bacterium has been moved from one genus (Pseudomonas) to another genus (Burkholderia) would be
A)Burkholderia (Pseudomonas) cepacia.
B)Pseudomonas (Burkholderia ) cepacia
C)Burkholderia (Pseudomonas) cepacia
D)Pseudomonas (Burkholderia ) cepacia.
Answer: C
Q2) A bacterium that has been moved from one genus (Pseudomonas) to another genus (Burkholderia) would be correctly noted as
A)Pseudomonas (Burkholderia).
B)Burkholderia (Pseudomonas).
C)Pseudomonas, formerly Burkholderia.
D)Burkholderia, formerly Pseudomonas.
Answer: B
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Chapter 2: Bacterial Genetics Metabolism and Structure
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Q1) A DNA sequence that encodes for a specific product (RNA or protein) is defined as a A)gene.
B)genome.
C)nucleotide.
D)deoxyribonucleic acid.
Answer: A
Q2) The mechanism for ATP production in which high-energy phosphate bonds produced by the central metabolic pathways are donated to adenosine diphosphate (ADP) to form ATP is
A)substrate level phosphorylation.
B)fermentative metabolism.
C)oxidative phosphorylation.
D)aerobic respiration.
E)anaerobic respiration.
Answer: A
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4
Chapter 3: Host-Microorganism Interactions
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Q1) IgG is
A)the first antibody produced when an invading microorganism is initially encountered.
B)the antibody that is associated with various parasitic infections.
C)the antibody that is secreted in various body fluids and primarily protects those body surfaces lined with mucous membranes.
D)the second antibody produced when an invading microorganism is initially encountered and the most abundant.
Answer: D
Q2) Proper handwashing and hygiene by hospital staff is essential in preventing what type of infections?
A)Chronic infections
B)Latent infections
C)Acute infections
D)Nosocomial infections
Answer: D
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Chapter 4: Laboratory Safety
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Q1) Certain procedures require the use of a biological safety cabinet.These include
A)processing specimens suspected of containing mycobacteria.
B)manipulation of all moldlike fungi.
C)all virology procedures.
D)manipulation of respiratory secretions.
E)all of the above.
Q2) The most effective antiseptic agent against HBV and HIV and therefore the antiseptic of choice in laboratories where these agents are likely found is
A)70% ethanol.
B)a phenol compound.
C)absolute ethanol.
D)10% bleach.
Q3) Optimal protection of specimen, personnel, and environment is accomplished with which class of biological safety cabinet?
A)Class I
B)Class II
C)Class III
D)Class IV
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6
Chapter 5: Specimen Management
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Q1) Accurate and rapid presumptive identification
A)can many times provide valuable information to clinicians in the early stages of disease.
B)can many times be accomplished by simple procedures in the laboratory.
C)can sometimes shorten hospitalization time and save money.
D)may save lives of infectious disease patients.
E)All of the above are correct.
Q2) Holding media such as Stuart's medium and Amie's medium are used
A)to maintain the viability of microorganisms present in a specimen.
B)to support the growth and multiplication of any pathogenic organisms present.
C)to prevent clotting of specimens such as blood, bone marrow, and synovial fluid.
D)All of the above are true.
Q3) Specimens for microbiologic studies should be
A)transported to the laboratory within 30 minutes of collection.
B)contained in specimen containers that are leak-proof.
C)transported within sealable, leak-proof, plastic bags with a separate section for paperwork.
D)clearly marked with a biohazard label.
E)All of the above are correct.
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Page 7
Chapter 6: Role of Microscopy
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Q1) Magnifications in excess of 100,000´ are achieved by which type of microscopy?
A)Bright-field microscopy
B)Electron microscopy
C)Dark-field microscopy
D)Phase contrast microscopy
E)All of the above are correct.
Q2) The fluorochrome stain that can be used to study fungus is
A)calcofluor white.
B)acridine orange.
C)auramine.
D)immunofluorescence.
Q3) Which of the following statements is true concerning dark-field microscopy?
A)This type of microscopy is used in some laboratories to detect spirochetes.
B)The condenser does not allow light to pass directly through the specimen but directs the light to hit the specimen at an oblique angle.
C)This technique involves the alteration of microscopic technique rather than the use of dyes or stains to achieve contrast.
D)All of the above are correct.
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Chapter 7: Traditional Cultivation and Identification
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Q1) Which category of media can be described as containing one or more agents that are inhibitory to all organisms except those being sought?
A)Enrichment
B)Supportive
C)Selective
D)Differential
Q2) Which type of media is designed to support the growth of a wide range of microorganisms?
A)Selective
B)Supportive
C)Differential
D)Definitive
Q3) A selective medium is designed especially to
A)support the growth of a wide range of microorganisms.
B)distinguish microorganisms based on certain growth characteristics.
C)support the growth of one group of organisms, but not another, by containing antimicrobials, dyes, or alcohol.
D)enhance the growth of pathogens and discourage the growth of commensals.
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9
Chapter 8: Nucleic Acid-Based Analytic Methods for
Microbial Identification and Characterization
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Q1) Target nucleic acid amplification (PCR) methods are based on
A)the ability of two nucleic acid strands that have complementary base sequences to specifically bond with each other and form a double-stranded molecule.
B)detecting phenotypic traits not detectable by conventional strategies.
C)the principles of complementary nucleic acid hybridization with those of nucleic acid replication that are applied repeatedly through numerous cycles.
D)determining the exact nucleotide sequence of a gene or gene fragment obtained from an organism.
Q2) Complementary nucleic acid hybridization is coupled with nucleic acid replication and applied repeatedly through numerous cycles.
A)Hybridization
B)Sequencing
C)Amplification (PCR)
D)Genotypic
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10
Chapter 9: Immunochemical Methods Used for Organism
Detection
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Q1) The major advantage of immunofluorescent microscopy assays is that
A)extensive training is not necessary.
B)it serves as an excellent way to preserve the reaction for referral and archiving.
C)they allow visual assessment of the adequacy of a specimen.
D)fluorescent microscopes are easily accessible to most laboratories.
Q2) The difference between latex agglutination and coagglutination is
A)the type of particle used to carry the antibody.
B)the type of target organism involved.
C)that coagglutination is less specific but more sensitive.
D)coagglutination can be used for direct antigen detection but not latex agglutination.
Q3) The precipitin test that involves antigen and antibody diffusing toward each other, producing a visible precipitin band at the point at which they meet is referred to as A)double immunodiffusion.
B)counterimmunoelectrophoresis.
C)particle agglutination.
D)enzyme immunoassay.
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Chapter 10: Serologic Diagnosis of Infectious Diseases
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Q1) Antibody-mediated immune responses produced by specific proteins are generated by
A)lymphocytes of the T (thymus-derived) class.
B)lymphocytes of the B (bone marrow-derived) class.
C)neutrophils.
D)basophils.
Q2) The antibody that has 10 antigen-binding sites is
A)IgG.
B)IgA.
C)IgM.
D)IgE.
Q3) The difference between latex agglutination and coagglutination is
A)the type of particle used to carry the antibody.
B)the type of target organism involved.
C)that coagglutination is less specific but more sensitive.
D)coagglutination can be used for direct antigen detection but not latex agglutination.
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12
Chapter 11: Principles of Antimicrobial Action Resistance
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Q1) Polymyxin B
A)Cell wall synthesis inhibition
B)Cell membrane function inhibition
C)Protein synthesis inhibition
D)DNA and RNA synthesis inhibition
Q2) Bacterial resistance to beta-lactams may be mediated by
A)enzymatic destruction of the antibiotics.
B)altered antibiotic targets.
C)decreased intracellular uptake of the drug.
D)All of the above are correct.
Q3) Vancomycin
A)Cell wall synthesis inhibition
B)Cell membrane function inhibition
C)Protein synthesis inhibition
D)DNA and RNA synthesis inhibition
Q4) Rifampin
A)Cell wall synthesis inhibition
B)Cell membrane function inhibition
C)Protein synthesis inhibition
D)DNA and RNA synthesis inhibition
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Chapter 12: Laboratory Methods and Strategies for
Antimicrobial Susceptibility Testing
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Q1) Staphylococcal resistance to oxacillin is used to determine and report resistance to A)vancomycin.
B)aminoglycosides.
C)cephalosporins.
D)amikacin.
Q2) Criteria for establishing a bacterial isolate as clinically significant include A)cultivation of the organism from a clinical specimen.
B)detection and/or the abundance of the organism on direct specimen Gram stain in the presence of white blood cells.
C)predominance of the organism in specimen cultures.
D)its antimicrobial susceptibility results.
Q3) A haze of bacterial growth within a more clearly defined zone of inhibition may be observed when testing A)aminoglycosides.
B)sulfonamides.
C)penicillins.
D)cephalosporins.
E)All of the above are correct.
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Chapter 13: Staphylococcus, Micrococcus, and Similar Organisms
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Q1) In clinical isolates, the most likely identification of a coagulase-positive, catalase-positive, gram-positive cocci that is penicillin-resistant would be
A)Staphylococcus aureus.
B)Staphylococcus intermedius.
C)Stomatococcus luteus.
D)Micrococcus aureus.
Q2) The tube coagulase test
A)detects bound coagulase.
B)detects extracellular coagulase.
C)is performed on slide coagulase-positive isolates to confirm this positive result.
D)requires citrated reagent plasma.
Q3) The most frequent agent of nosocomial bacteremia is
A)catalase-negative micrococci.
B)coagulase-positive staphylococci.
C)catalase-negative stomatococci.
D)coagulase-negative staphylococci.
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Page 15
Chapter 14: Streptococcus, Enterococcus, and Similar Organisms
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Q1) Not only normal flora of humans and animals, this genus of bacteria contains agents of important diseases such as rheumatic fever, glomerulonephritis, and exudative pharyngitis.
A)Staphylococcus
B)Streptococcus
C)Enterococcus
D)Micrococcus
Q2) Optochin, PYR, bile solubility, esculin, and 6.5% NaCl are tests most likely performed on a/an
A)alpha-hemolytic streptococcus.
B)beta-hemolytic streptococcus.
C)nonhemolytic streptococcus.
D)All of the above are correct.
Q3) A vancomycin-resistant cocci is likely not
A)Pediococcus.
B)Leuconostocs.
C)streptococci.
D)lactobacilli.
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Chapter 15: Bacillus and Similar Organisms
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Q1) Induction of capsule formation by B.anthracis can be accomplished with A)5% sheep blood agar.
B)PLET agar.
C)bicarbonate agar.
D)urea agar.
E)All of the above are correct.
Q2) Suspect spore-forming gram-positive bacilli that are hemolytic, motile, and penicillin-resistant and that produce a wide zone of lecithinase on egg yolk agar can be identified as
A)Corynebacterium diphtheriae.
B)Bacillus anthracis.
C)Bacillus cereus.
D)Corynebacterium jeikeium.
Q3) Suspect spore-forming gram-positive bacilli that are nonhemolytic, nonmotile, and penicillin-susceptible, and that produce a wide zone of lecithinase on egg yolk agar can be identified as
A)Corynebacterium diphtheriae.
B)Bacillus anthracis.
C)Bacillus cereus.
D)Corynebacterium jeikeium.
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Chapter 16: Listeria, Corynebacterium, and Similar Organisms
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Q1) A catalase-positive, gram-positive bacillus that is not acid-fast, does not branch, and does not form spores could possibly belong to which group of bacteria?
A)Corynebacterium
B)Bacillus
C)Actinomyces
D)Mycobacterium
Q2) Primary inoculation to a Loeffler slant, overnight incubation, and subculture of any growth to cystine-tellurite blood agar is no longer recommended for recovery of
A)Corynebacterium diphtheriae.
B)Bacillus anthracis.
C)Bacillus cereus.
D)Corynebacterium jeikeium.
Q3) A bacterium described as being coryneform has which type of morphology?
A)Short rods with rounded ends arranged singly, in "palisades" of parallel cells
B)Short rods in pairs that remain connected after cell division to form V or L shapes
C)Bacilli that resemble and are often referred to as Chinese letters
D)All of the above are correct.
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Page 18
Chapter 17: Erysipelothirix, Lactobacillus, and Similar Organisms
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Q1) A catalase-negative, non-spore-forming, non-branching, gram-positive rod that produces hydrogen sulfide when inoculated into TSI agar is most likely
A)Corynebacterium
B)Bacillus
C)Actinomyces
D)Erysipelothrix
Q2) A catalase-negative, non-spore-forming, gram-positive rod that is not acid-fast could possibly belong to which group of bacteria?
A)Corynebacterium
B)Bacillus
C)Actinomyces
D)Erysipelothrix
Q3) Erysipelothrix can be described as
A)catalase-negative
B)not acid-fast
C)not branching
D)non-spore-forming
E)All of the above are correct.
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Chapter 18: Nocardia, Streptomyces, Rhodococcus, Oerskovia,
and Similar Organisms
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Q1) Nocardia spp.cause which of the following types of infections in immunocompetent individuals?
A)Urinary tract infections
B)Disseminated infections
C)Skin abscesses or cellulites
D)Invasive pulmonary infections
Q2) The organism that has been most commonly associated with human disease, particularly in immunocompromised patients, such as those infected with human immunodeficiency virus (HIV) is
A)Rhodococcus.
B)Gordonia.
C)Tsukamurella.
D)Streptomyces.
Q3) Non-acid-fast aerobic actinomycetes include A)Nocardia.
B)Rhodococcus.
C)Streptomyces.
D)Gordona.
E)All of the above are correct.
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Chapter 19: Enterobacteriaceae
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Q1) Choose the bacterial family that is best described as catalase-positive, oxidase-negative, gram-negative bacilli that are facultative anaerobes and most of which reduce nitrates to nitrites.
A)Enterobacteriaceae
B)Micrococcaceae
C)Pseudomonas
D)Haemophilus
Q2) The gram-negative bacillus that can be described as oxidase-negative, nitrate-positive, indole-negative, citrate-positive, methyl red-positive, urease-negative,
H S-positive is
A)Klebsiella pneumoniae.
B)Proteus vulgaris.
C)Salmonella enteritidis.
D)Escherichia coli.
E)Shigella sonnei.
Q3) Alkaline slant, acid butt, no H S
A)Salmonella species
B)Escherichia coli
C)Proteus species
D)Pseudomonas species
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Chapter 20: Acinetobacter, Stenotrophomonas, and Other Organisms
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Q1) Differentiation of S.maltophilia and Burkholderia cepacia is best accomplished by A)the oxidase test.
B)maltose and glucose medium.
C)tyrosine-enriched heart infusion agar.
D)All of the above are correct.
Q2) The primary drug of choice for infections caused by S.maltophilia is A)a beta-lactam agent in combination with an aminoglycoside.
B)trimethoprim-sulfamethoxazole.
C)ticarcillin/clavulanic acid.
D)chloramphenicol.
Q3) Plump coccobacilli that tend to resist alcohol decolorization and may be mistaken for Neisseria spp.are
A)Bordetella spp.
B)S.maltophilia.
C)Acinetobacter spp.
D)P.oryzihabitans.
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Page 22
Chapter 21: Pseudomonas, Burkholderia, and Similar Organisms
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Q1) Excluding Enterobacteriaceae, name the second most common gram-negative bacilli encountered in clinical specimens.
A)Pseudomonas
B)Burkholderia
C)Ralstonia
D)Vibrio
Q2) A convenient and reliable identification scheme for P.aeruginosa involves the following conventional tests:
A)Oxidase, TSI slant, growth at 42° C on Mueller-Hinton agar or trypticase soy agar
B)Catalase, LIA slant, growth at 42° C on Mueller-Hinton agar or trypticase soy agar
C)Oxidase, TSI slant, growth at 24° C on Mueller-Hinton agar or trypticase soy agar
D)Catalase, TSI slant, growth at 42° C on sheep blood agar or blood trypticase soy agar
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Chapter
Organisms
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Q1) The natural habitat of Achromobacter sp.can best be described as
A)the mucous membranes of animals.
B)the gastrointestinal tract of humans and other animals.
C)the natural environment.
D)the genitourinary tract of animals.
Q2) Choose the habitat of the bacterium Ochrobactrum anthropi.
A)Environmental only, not human flora
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
E)Environmental and human flora
Q3) Choose the habitat of the bacterium Psychrobacter immobilis.
A)Environmental only, not human flora
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
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Chapter
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Q1) Choose the habitat of the bacterium Chryseobacterium.
A)Environmental
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
Q2) Choose the habitat of the bacterium Agrobacterium.
A)Environmental
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
Q3) The natural habitat of Chryseobacterium sp.can best be described as
A)the mucous membranes of animals.
B)the gastrointestinal tract of humans and other animals.
C)the natural environment.
D)the genitourinary tract of animals.
Q4) Choose the habitat of the bacterium Sphingobacterium.
A)Environmental
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
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Chapter 24: Alcaligenes, Bordetella Nonpertussis,
Comamonas, and Similar Organisms
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Q1) The organism most frequently associated with various infections in humans is A)Bordetella.
B)Oligella.
C)Achromobacter.
D)Roseomonas.
Q2) The mode of transmission of Bordetella bronchiseptica can best be described as A)person to person contact.
B)exposure to contaminated water.
C)inhalation of contaminated air.
D)close contact with animals.
Q3) Myroides is
A)oxidase-positive, motile, and rapid urease-positive.
B)urease-positive and has a fruity odor.
C)resistant to vancomycin and will grow on MacConkey agar and at 42° C.
D)nonmotile and both urea- and phenylalanine deaminase-positive.
Q4) The mode of transmission of Achromobacter denitrificans can best be described as A)person to person contact.
B)exposure to contaminated water.
C)contaminated fluids or medical solutions.
D)close contact with animals.
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Chapter 25: Vibrio, Aeromonas, Plesiomonas Shigelloides, and
Chromobacterium Violaceum
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Q1) The primary habitat for Vibrio spp is
A)fresh water.
B)the upper respiratory tract of various mammals.
C)brackish or marine water.
D)the soil and water environment.
Q2) Transmission of Vibrio spp.to humans is by
A)exposure of disrupted skin and mucosal surfaces to contaminated animal hides.
B)ingestion of contaminated seafood or water.
C)inhalation of contaminated air.
D)close contact with carriers of the organism.
Q3) Transmission of Plesiomonas shigelloides to humans is by
A)exposure of disrupted skin and mucosal surfaces to contaminated animal hides.
B)ingestion of contaminated seafood or water.
C)inhalation of contaminated air.
D)close contact with carriers of the organism.
Q4) Transmission of and Chromobacterium violaceum to humans is by
A)exposure of disrupted skin and mucosal surfaces to contaminated animal hides.
B)ingestion of contaminated seafood or water.
C)inhalation of contaminated air.
D)close contact with carriers of the organism.
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Chapter 26: Sphingomonas Paucimobilis and Similar Organisms
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Q1) Acidovorax spp.can be described as
A)oxidase-negative, glucose-fermenting, gram-negative bacilli that grow on MacConkey agar.
B)oxidase-positive, glucose-oxidizing, gram-negative bacilli that fail to grow on MacConkey agar.
C)oxidase-positive, glucose-fermenting, gram-negative bacilli that grow on MacConkey agar.
D)oxidase-positive, non-glucose-utilizing, gram-negative bacilli that do not grow on MacConkey agar.
Q2) Sphingobacterium spp.can be described as
A)oxidase-negative, glucose-fermenting, gram-negative bacilli that grow on MacConkey agar.
B)oxidase-positive, glucose-oxidizing, gram-negative bacilli that fail to grow on MacConkey agar.
C)oxidase-positive, glucose-fermenting, gram-negative bacilli that grow on MacConkey agar.
D)oxidase-positive, non-glucose-utilizing, gram-negative bacilli that do not grow on MacConkey agar.
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Page 28
Chapter 27: Moraxella
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Q1) Differentiation of Moraxella nonliquefaciens and M.osloensis can best be done by testing for
A)the ability to utilize acetate.
B)the ability to liquefy serum.
C)glucose utilization tests.
D)growth on MacConkey agar.
Q2) In Gram-stained preparations, Moraxella lincolnii will appear as
A)either gram-negative coccobacilli or short, broad rods that tend to resist decolorization and may appear gram-variable.
B)gram-negative cocci in pairs or short chains.
C)coccobacilli or medium-sized rods.
D)coccobacilli that may appear in chains.
E)either coccobacilli or short, straight rods.
Q3) The species of Moraxella that is most commonly associated with human infections, primarily of the respiratory tract, is
A)Moraxella catarrhalis.
B)Moraxella lacunata.
C)Moraxella canis.
D)Moraxella atlantae.
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Page 29
Chapter 28: Eikenella Corrodens and Similar Organisms
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Q1) Of the asaccharolytic, oxidase-positive bacilli that do not grow on MacConkey agar, which one is among the HACEK group of bacteria known to cause subacute bacterial endocarditis?
A)Eikenella corrodens
B)Weeksella virosa
C)Pseudomonas maltophilia
D)Sphingomonas paucimobilis
E)All of the above are correct.
Q2) Of the asaccharolytic, oxidase-positive bacilli, which bacterial species can be recognized in culture by its bleachlike odor?
A)Eikenella corrodens
B)Weeksella virosa
C)Pseudomonas maltophilia
D)Sphingomonas paucimobilis
E)All of the above are correct.
Q3) Eikenella corrodens can be easily recognized in culture by which characteristic?
A)Its pink pigmentation
B)Its grapelike odor
C)Its large spreading colony morphology
D)Its bleachlike odor
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Chapter 29: Pasteurella and Similar Organisms
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Q1) Although most other clinically relevant gram-negative bacilli are intrinsically resistant to penicillin, it is the drug of choice for infections involving
A)Sphingomonas paucimobilis.
B)Eikenella corrodens.
C)Pasteurella multocida.
D)Weeksella virosa.
E)All of the above are correct.
Q2) Which of the following bacterial species is part of animal flora and is transmitted to humans during close animal contact, including bites?
A)Sphingomonas paucimobilis
B)Eikenella corrodens
C)Pasteurella multocida
D)Weeksella virosa
E)All of the above are correct.
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Chapter 30: Actinobacillus, Kingella, Cardiobacterium,
Capnocytophaga, and Similar Organisms
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Q1) Actinobacillus actinomycetemcomitans can be distinguished from Capnocytophaga hominis by
A)its negative test for catalase.
B)its positive test for lactose fermentation.
C)its positive test for catalase.
D)its negative test for indole.
E)All of the above are correct.
Q2) Actinobacillus actinomycetemcomitans can be distinguished from Kingella spp by A)its negative test for catalase.
B)its positive test for lactose fermentation.
C)its positive test for catalase.
D)its negative test for oxidase.
E)All of the above are correct.
Q3) Of the following organisms, which can be described as slow or poorly growing, are capnophiles, and will not grow on MacConkey agar?
A)Actinobacillus actinomycetemcomitans
B)Kingella denitrificans
C)Cardiobacterium hominis
D)Capnocytophaga gingivalis
E)All of the above are correct.
Page 32
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Chapter 31: Haemophilus
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Q1) Very short bacilli occasionally seen as filamentous forms
A)H. haemolyticus
B)H. influenzae biotype aegypticus
C)H. influenzae
D)H. segnis
E)H. parainfluenzae
Q2) The major difference between infections caused by type b H.influenzae and those infections caused by nontypeable strains is that
A)infections caused by type b H.influenzae are often systemic and life- threatening.
B)infections caused by other Haemophilus spp.occur much less frequently.
C)the number of type b H.influenzae infections has been greatly reduced.
D)All of the above are correct.
E)None of the above are correct.
Q3) Chancroid is the sexually transmitted disease caused by A)Haemophilus influenzae.
B)H.ducreyi.
C)H.aphrophilus.
D)H.parainfluenzae.
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Chapter 32: Bartonella and Afipia
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Q1) Trench fever, bacteremia, endocarditis, chronic lymphadenopathy, and bacillary angiomatosis can be caused by A)Afipia felis.
B)Rochalimaea quintana.
C)Bartonella clarridgeiae.
D)Bartonella henselae.
Q2) Bacteremia, endocarditis, bacillary angiomatosis, cat-scratch disease, and peliosis hepatitis can all be caused by A)Afipia felis.
B)Rochalimaea quintana.
C)Bartonella clarridgeiae.
D)Bartonella henselae.
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34
Chapter 33: Campylobacter, Arcobacter, and Helicobacter
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Q1) Campylobacter spp.can sometimes be detected by direct Gram stain examination of fecal sample, which would reveal many
A)large, faintly staining gram-negative bacilli.
B)small, curved or seagull-winged gram-negative bacilli.
C)small gram-negative coccobacilli.
D)plump, faintly staining gram negative bacilli.
Q2) Making sure that all foods derived from animal sources are thoroughly cooked, all milk is pasteurized, and all drinking water is chlorinated are ways to avoid becoming infected with
A)Helicobacter.
B)Arcobacter.
C)Enterobacter.
D)Campylobacter.
Q3) Virulence determinants of Helicobacter pylori include A)motility.
B)urease enzyme.
C)adhesions.
D)All of the above are correct.
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Chapter 34: Legionella
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Q1) Specimens for culture recovery of Legionella should be inoculated to A)BCYE (buffered charcoal yeast extract).
B)Regan-Lowe agar.
C)Löwenstein-Jensen.
D)blood and chocolate agars.
Q2) Organisms belonging to the genus Legionella are
A)gram-positive diplococci.
B)gram-positive diphtheroid bacilli.
C)gram-negative coccobacilli.
D)faintly staining, thin gram-negative bacilli.
Q3) A febrile and pneumonic illness first named in 1976 by scientists at the Centers for Disease Control and Prevention (CDC) who were investigating an epidemic of pneumonia among Pennsylvania State American Legion members attending a convention in Philadelphia is known as A)Philadelphia pneumonia.
B)legionnaires' disease.
C)tuberculosis.
D)rheumatic fever.
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Chapter 35: Brucella
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Q1) Facultative, intracellular parasitic bacteria are those which are A)able to be cultured with or without oxygen but in cell cultures only.
B)able to exist in both intracellular and extracellular environments.
C)able to be cultured only with oxygen and in cell cultures.
D)can only be cultured inside living organisms like mice.
Q2) The serum agglutination test (SAT) detects antibodies to A)Brucella abortus.
B)B.melitensis.
C)B.suis.
D)All of the above are correct.
Q3) A nonmotile, urease- and nitrate-positive, strictly aerobic gram-negative coccobacillus is most likely A)Bordetella.
B)Moraxella.
C)Kingella.
D)Acinetobacter.
E)Brucella.
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Chapter 36: Bordetella Pertussis and Bordetella
Parapertussis
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Q1) Pertussis (whooping cough) is an epidemic disease that is a highly contagious, acute infection of the upper respiratory tract caused by A)Brucella species.
B)Bordetella species.
C)Pasteurella species.
D)Francisella species.
Q2) The mode of transmission of Bordetella pertussis can best be described as
A)person-to-person contact.
B)exposure to contaminated water.
C)inhalation of contaminated air.
D)close contact with animals.
Q3) During the catarrhal stage of pertussis, symptoms are A)a runny nose and mild cough.
B)severe and violent coughing.
C)vomiting and "whooping" as air is rapidly inspired into the lungs past the swollen glottis.
D)lymphocytosis and fever.
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Page 38
Chapter 37: Francisella
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Q1) Tularemia, characterized by glandular, ulceroglandular, oculoglandular, oropharyngeal, systemic, and pneumonic presentations is caused by A)Brucella species.
B)Bordetella species.
C)Pasteurella species.
D)Francisella species.
Q2) One of the most common laboratory-acquired infections that is caused by a Biosafety Level 2 pathogen is caused by A)Bordetella pertussis.
B)Francisella tularensis.
C)Pasteurella multocida.
D)Staphylococcus aureus.
E)All of the above are correct.
Q3) F.philomiragia differs from F.tularensis in that it
A)is oxidase-positive.
B)is hydrogen sulfide-positive.
C)hydrolyzes gelatin.
D)grows in 6% sodium chloride.
E)All of the above are correct.
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Page 39
Chapter 38: Streptobacillus Moniliformis and Spirillum
Minus
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Q1) Rat-bite fever, or Haverhill fever, characterized by acute onset of chills, fever, headache, vomiting, and often severe joint pains and a rash on the palms, soles of the feet, and other extremities is caused by
A)Streptobacillus moniliformis.
B)Brucella abortus.
C)Bordetella species.
D)Pasteurella species.
Q2) The name given to rat-bite fever when the illness is acquired by ingestion of the bacterium is
A)Sodoku.
B)Haverhill fever.
C)Monillic fever.
D)Monillic gastritis.
Q3) Rat-bite fever caused by Spirillum minus can be differentiated from that caused by Streptobacillus moniliformis by
A)chills, fever, headache, vomiting, and often severe joint pains.
B)a granulomatous lesion.
C)septic arthritis.
D)endocarditis.
Page 40
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Chapter 39: Neisseria and Moraxella Catarrhalis
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Q1) Gonococci require for growth which of the following nutrients?
A)Arginine
B)Hypoxanthine
C)Uracil
D)IsoVitaleX
Q2) Thayer-Martin, Martin-Lewis, and New York City media were all developed for the selective isolation of which organism?
A)Moraxella catarrhalis
B)Neisseria meningitidis
C)Neisseria gonorrhoeae
D)All of the above are correct.
Q3) Which type of test has the advantage of being able to test for Chlamydia trachomatis and Neisseria gonorrhoeae from the same specimen at the same time?
A)Culture
B)Molecular assays
C)Enzyme-linked immunosorbent assay (ELISA)
D)All of the above are true.
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Chapter 40: Overview and General Considerations
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Q1) Cervical swab
A)Acceptable
B)Not acceptable
Q2) Urine via percutaneous aspiration
A)Acceptable
B)Not acceptable
Q3) The final fill of the anaerobe jar prepared by the evacuation-replacement method consists of
A)20% to 30% nitrogen, 5% to 10% hydrogen, and 70% to 80% CO .
B)80% to 90% oxygen, 5% to 10% hydrogen, and 5% to 10% CO .
C)80% to 90% nitrogen, 5% to 10% hydrogen, and 5% to 10% CO .
D)80% to 90% nitrogen, 5% to 10% oxygen, and 5% to 10% CO .
Q4) Tissue biopsy taken from a puncture wound
A)Acceptable
B)Not acceptable
Q5) Urine via catheter
A)Acceptable
B)Not acceptable
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Chapter 41: Laboratory Considerations
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Q1) The primary plating media for inoculating a wound aspirate for anaerobic culture may include
A)anaerobic blood agar.
B)laked kanamycin-vancomycin blood agar.
C)aerobic 5% sheep blood agar.
D)thioglycollate.
E)All of the above are correct.
Q2) Porphyromonas spp.
A)Kanamycin, colistin, and vancomycin-resistant and grow in 20% bile
B)bile-sensitive, kanamycin-resistant, catalase-negative and indole-negative
C)fluoresce brick red or brown to black pigment
D)reduces nitrate and requires formate and fumarate for growth in broth culture
E)sensitive to kanamycin and fluoresce a chartreuse color
Q3) The most likely identification of a bile resistant, kanamycin, colistin, and vancomycin-resistant anaerobic gram-negative bacilli is
A)nonpigmented Prevotella.
B)Porphyromonas spp.
C)Bacteroides fragilis group.
D)Fusobacterium spp.
E)Bacteroides ureolyticus.
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Chapter 42: Mycobacteria
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Q1) The specimen of choice for detecting tuberculous pulmonary mycobacterial disease is
A)spontaneously produced sputum.
B)gastric lavage.
C)transtracheal aspiration.
D)bronchoscopy.
Q2) The presence of what in CSF is thought to be diagnostic of tuberculous meningitis?
A)Mononuclear leukocytes and acid-fast bacilli
B)Acid-fast bacilli
C)Tuberculostearic acid
D)Increased protein and decreased glucose
E)All of the above are correct.
Q3) The specimen of choice for detecting urinary tract mycobacterial disease is
A)a single clean-catch midstream urine sample.
B)a 24-hour timed urine sample.
C)three daily clean-catch midstream urine samples.
D)a biopsy of the suspected site.
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Chapter 43: Obligate Intracellular and Nonculturable Bacterial Agents
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Q1) Rickettsia can be described as
A)fastidious extracellular parasites that multiply by binary fission in the cytoplasm of host cells.
B)fastidious obligate intracellular parasites that multiply by binary fission in the nucleus of host cells.
C)hardy obligate intracellular parasites that multiply by budding in the cytoplasm of host cells.
D)fastidious obligate intracellular parasites that multiply by binary fission in the cytoplasm of host cells.
Q2) A prokaryote that differs from most other bacteria with respect to its very small size and obligate intracellular parasitism is
A)Rickettsia.
B)Ehrlichia.
C)Calymmatobacterium.
D)Coxiella.
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Chapter 44: Cell Wall-Deficient Bacteria: Mycoplasma and Ureaplasma
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Q1) Definitive identification of Mycoplasma pneumoniae is accomplished by which technique?
A)Hemadsorption of guinea pig erythrocytes
B)Traditional biochemical tests such as indole and oxidase
C)Direct detection methods such as PCR or ELISA
D)All of the above are correct.
Q2) Definitive identification of which of the following organisms is accomplished by hemadsorption techniques?
A)Chlamydia trachomatis
B)Mycoplasma hominis
C)Mycoplasma pneumoniae
D)Ureaplasma urealyticum
Q3) The natural habitat of Mycoplasma sp., which causes infectious disease in humans, can best be described as
A)the mucous membranes of humans.
B)the aquatic environment.
C)the natural environment.
D)the genitourinary tract of animals.
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Chapter 45: The Spirochetes
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Q1) Systemic symptoms such as fever, weight loss, malaise, and loss of appetite can be present along with a widespread rash can be seen in patients suffering from
A)primary syphilis.
B)secondary syphilis.
C)tertiary syphilis.
D)terminal stage syphilis.
Q2) Compared to other spirochetes, Borrelia can be described as
A)long, more slender, with hooked ends.
B)somewhat thicker with fewer and looser coils.
C)long, more slender, with tight coils.
D)somewhat thicker than treponemes with fewer and looser coils.
Q3) A stage of venereal syphilis characterized by tissue destruction, central nervous disease, cardiovascular abnormalities, eye disease, and granuloma-like lesions is known as
A)primary syphilis.
B)secondary syphilis.
C)tertiary syphilis.
D)quaternary syphilis.
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Chapter 46: Laboratory Methods for Diagnosis of Parasitic
Infections
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Q1) The specimen of choice for diagnosing infection with Leishmania spp is A)feces.
B)blood smear.
C)liver tissue.
D)CSF.
Q2) Trichinella spiralis
A)Rectal tape prep
B)Tissue biopsy
C)Sputum
D)Feces
E)Blood smear
Q3) The eggs of which intestinal parasite are not commonly found in feces and must be detected by other diagnostic techniques?
A)Giardia lamblia
B)Cryptosporidium parvum
C)Clonorchis sinensis
D)Enterobius vermicularis
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Page 48
Chapter 47: Laboratory Methods in Basic Mycology
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Q1) Aerial mycelia are those that serve what main purpose?
A)Nutrient absorption and water exchange
B)Penetration of host cells
C)Transfer of genetic material from cell to cell
D)Give rise to fruiting bodies from which asexual spores are borne
Q2) The genus Trichophyton is characterized by
A)large spindle-shaped, rough-walled macroconidia with thick walls that contain 4 to 15 septa and small club-shaped microconidia.
B)predominate spherical, teardrop-shaped or club-shaped microconidia and smooth, club-shaped, thin-walled macroconidia with 8 to 10 septa borne singly at the terminal ends of hyphae or on short conidiophores.
C)numerous smooth, thin-walled, club-shaped, multiseptate macroconidia, which are rounded at the tip and are borne singly on a conidiophore or in groups of two or three, no microconidia, and numerous chlamydoconidia.
D)spherical, teardrop-shaped microconidia and rough, club-shaped, thick-walled macroconidia with 8 to 10 septa borne on short conidiophores.
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Chapter 48: Laboratory Methods in Basic Virology
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Q1) The term primary cell line refers to
A)those lines that cannot be subcultured more than once or twice to avoid decreased receptivity to viral infection.
B)those lines that remain virus-sensitive through not more than 10 subcultures.
C)those lines that remain virus-sensitive through 20 to 50 subcultures.
D)those lines that can be subcultured and remain sensitive to virus infections indefinitely.
Q2) Influenza A and B viruses can be detected in clinical specimens using A)cell culture.
B)shell vial assay.
C)enzyme immunoassay.
D)FA staining methods.
E)All of the above are correct.
Q3) Urine specimens are most likely collected for the detection of A)varicella zoster virus.
B)herpes simplex virus.
C)cytomegalovirus.
D)rotavirus.
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Chapter 49: Bloodstream Infections
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Q1) Transient bacteremia
A)Condition wherein fungi are present in blood, occurring primarily in immunosuppressed patients and in those with serious or terminal illness
B)The action of bacteria being carried, usually to all organs of the host, where they may grow, invade normal tissue, and produce toxic products
C)A temporary, incidental presence of bacteria in the bloodstream
D)The situation in which organisms are released into the bloodstream at a noncontinuous rate
E)Infections that originate within the cardiovascular system
Q2) A factor that contributes to the initiation of bloodstream infections is
A)immunosuppressive agents.
B)broad-spectrum antibiotics that suppress the normal flora.
C)invasive procedures.
D)prolonged survival of debilitated and seriously ill patients.
E)All of the above are correct.
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Chapter 50: Infections of the Lower Respiratory Tract
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Q1) Streptococcus pneumoniae is detected as the most common agent of lower respiratory tract infections among
A)previously healthy patients 2 months of age to 5 years old.
B)adults younger than 30 years of age.
C)community-acquired pneumonia in adults.
D)children of school age.
Q2) The most common etiologic agent of community-acquired pneumonia in adults is
A)Mycoplasma pneumoniae.
B)Chlamydophila pneumoniae.
C)Streptococcus pneumoniae.
D)Klebsiella pneumoniae.
Q3) Evaluation of the quality of the sputum specimen sent to the laboratory for bacterial culture is best done by
A)measuring the amount of mucous found.
B)checking for mucous or blood.
C)examining microscopically via Gram-stained smear for leukocytes.
D)examining microscopically via Gram-stained smear for squamous epithelial cells.
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Chapter 51: Upper Respiratory Tract Infections and Other
Infections of the Oral Cavity and Neck
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Q1) An inflammation of the nasal mucous membrane or lining caused mostly by viruses and characterized by fever, increased mucous secretions, inflammatory edema of the nasal mucosa, sneezing, and watery eyes is called A)epiglottitis.
B)pharyngitis.
C)Vincent's angina.
D)rhinitis.
Q2) An inflammation of the mucous membranes of the oral cavity caused mostly by herpes simplex virus is called A)laryngitis.
B)pharyngitis.
C)Vincent's angina.
D)stomatitis.
E)thrush.
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Chapter 52: Meningitis and Other Infections of the Central
Nervous
Systems
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Q1) The most common source of infection in the central nervous system is
A)hematogenous spread.
B)infections at other sites such as otitis media.
C)organisms gaining access because of anatomic defects in central nervous system structures.
D)bacteria that are able to travel along nerves leading to the brain.
Q2) Organisms may gain access to the central nervous system (CNS) by which route?
A)Hematogenous spread
B)Spread from infections at other sites, such as otitis media
C)Anatomic defects in central nervous system structures
D)Travel along nerves leading to the brain
E)All of the above are correct.
Q3) An inflammation of the brain parenchyma usually a result of viral infection is called A)meningoencephalitis.
B)aseptic meningitis.
C)encephalitis.
D)pleocytosis.
E)meningitis.
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Chapter 53: Infections of the Eyes, Ears, and Sinuses
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Q1) Keratitis
A)An acute infection of the orbital contents most often caused by bacteria
B)Inflammation of the lacrimal canal
C)Infection of the lacrimal gland characterized by pain of the upper eyelid with erythema
D)Infection of the cornea
Q2) Trachoma
A) Haemophilus influenzae and S. pneumoniae
B) Bacteria, viruses, and occasionally lice
C) S. aureus, S. pneumoniae, and P. aeruginosa
D) Any bacterium, including those considered to be primarily saprophytic
E) Chlamydia
F) Actinomyces or Propionibacterium
G) S. aureus, Streptococcus pyogenes, and S. pneumoniae
Q3) Orbital cellulitis
A)An acute infection of the orbital contents most often caused by bacteria
B)Inflammation of the lacrimal canal
C)Infection of the lacrimal gland characterized by pain of the upper eyelid with erythema
D)Infection of the cornea
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Chapter 54: Infections of the Urinary Tract
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Q1) Cystitis
A)Infection of the terminal portion of the lower urinary tract
B)The isolation of a specified quantitative count of bacteria in an appropriately collected urine specimen obtained from a person without symptoms or signs of urinary infection
C)Infection of the bladder
D)Dysuria, frequency, and urgency but yielding fewer organisms than 105 colony-forming units of bacteria per milliliter (CFU/mL) urine on culture
E)Inflammation of the kidney parenchyma, calices (cup-shaped division of the renal pelvis), and pelvis
Q2) The most frequent cause of uncomplicated community-acquired urinary tract infections is
A)Staphylococcus saprophyticus.
B)Klebsiella spp.
C)Escherichia coli.
D)Proteus.
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Chapter 55: Genital Tract Infections
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Q1) The predominant organism in vaginal secretions from normal women of reproductive age is
A)lactobacilli.
B)Streptococcus agalactiae.
C)Enterobacteriaceae.
D)staphylococci.
Q2) A culture performed on a vaginal specimen collected from a 38-year-old woman would likely grow primarily
A)group B beta-hemolytic streptococci.
B)staphylococci and corynebacteria.
C)lactobacilli, Enterobacteriaceae, streptococci, staphylococci.
D)Gardnerella vaginalis, Prevotella spp., peptostreptococci, and Mobiluncus spp.
Q3) An infection that results when cervical microorganisms travel upward to the endometrium, fallopian tubes, and other pelvic structures and produce inflammatory conditions such as endometritis, salpingitis, peritonitis, or abscesses is called
A)chorioamnionitis.
B)bartholinitis.
C)cervicitis.
D)pelvic inflammatory disease.
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Page 57
Chapter 56: Gastrointestinal Tract Infections
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Q1) The normal flora of the adult large bowel consists predominantly of A)anaerobic species.
B)Staphylococcus.
C)Enterococcus.
D)Enterobacteriaceae.
Q2) Campy-thioglycollate broth serves which purpose when used in the bacterial fecal culture?
A)Evaluation of general flora and predominant species
B)Selection of enteric pathogens such as Salmonella, Aeromonas, and others
C)Inhibition of normal flora and select for enteric pathogens
D)Enrichment for enteric pathogens such as Salmonella and others
Q3) Sheep blood agar serves which purpose when used in the bacterial fecal culture?
A)Evaluation of general flora and predominant species
B)Selection of enteric pathogens such as Salmonella, Aeromonas, and others
C)Inhibition of normal flora and select for enteric pathogens
D)Enrichment for enteric pathogens such as Salmonella and others
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Chapter 57: Skin, Soft Tissue, and Wound Infections
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Q1) Necrotizing fasciitis
A)Extensive necrosis of muscle caused by infectious agents
B)Infection of the fascia overlying muscle groups, often with involvement of the overlying soft tissue
C)A slowly progressive infection of the subcutaneous tissue with associated ulceration of portions of the overlying skin
D)A chronic gangrenous condition of the skin most often encountered as a postoperative complication, particularly after abdominal or thoracic surgery
Q2) Progressive bacterial synergistic gangrene
A)Extensive necrosis of muscle caused by infectious agents
B)Infection of the fascia overlying muscle groups, often with involvement of the overlying soft tissue
C)A slowly progressive infection of the subcutaneous tissue with associated ulceration of portions of the overlying skin
D)A chronic gangrenous condition of the skin most often encountered as a postoperative complication, particularly after abdominal or thoracic surgery
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Marrow, and Solid Tissues
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Q1) Most cases of peritonitis in patients on continuous ambulatory peritoneal dialysis are caused by
A)Staphylococcus epidermidis and S.aureus.
B)Escherichia coli.
C)Klebsiella pneumoniae.
D)Streptococcus spp.
E)viral agents.
Q2) Proper technique for processing clotted body fluids sent to the laboratory for fungal culture is
A)grinding them in a mortar and pestle or glass tissue grinder.
B)placing small amounts of whole material from the clot directly onto media.
C)centrifugation with glass beads.
D)filtration under pressure.
Q3) The most common etiologic agent of septic arthritis in adults younger than 30 years of age is
A)Neisseria gonorrhoeae.
B)Staphylococcus aureus.
C)Haemophilus influenzae.
D)Streptococcus agalactiae.
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Chapter 59: Laboratory Physical Design, Management, and Organization
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Q1) Performance of a new molecular procedure alongside the methodology known as the "gold standard" is validating which characteristic?
A)Accuracy
B)Precision
C)Sensitivity
D)Specificity
Q2) The percentage of individuals with the particular disease for which the test is used in whom positive test results are found is called
A)accuracy.
B)precision.
C)sensitivity.
D)specificity.
Q3) The percentage of test results that are correctly identified by the test is called A)accuracy.
B)precision.
C)sensitivity.
D)specificity.
E)efficiency.
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Chapter 60: Quality in the Clinical Microbiology Laboratory
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Q1) Continuous quality assurance in the microbiology laboratory includes
A)monitoring personnel performance and providing education.
B)instrument maintenance and monitoring.
C)checking the performance of media, reagents, and other products.
D)All of the above are correct.
Q2) Positive patient outcomes produced through quality management programs in the microbiology laboratory are
A)reduced hospitalization time.
B)reduced cost of stay.
C)reduced turn-around time for diagnosis of infection.
D)appropriate antimicrobial therapy.
E)All of the above are correct.
Q3) Long-term storage (>1 year) of stock aerobic and anaerobic bacteria can be accomplished by
A)subculture onto trypticase soy agar (TSA) slants.
B)freezing at 70° C.
C)storing them on blood agar plates at 37° C.
D)All of the above are correct.
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Chapter 61: Infection Control
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Q1) Microorganisms are spread in hospitals through
A)direct contact in contaminated food or intravenous solutions.
B)indirect contact from patient to patient on the hands of health care workers.
C)inhalation of droplets.
D)vector-borne contact.
E)All of the above are correct.
Q2) An infection acquired by a hospitalized patient that was not present when they entered the hospital is referred to as
A)an autonomous infection.
B)a nosocomial infection.
C)an opportunistic infection.
D)septic introduction.
Q3) A phenotypic technique that examines the ability of bacteriophages (viruses capable of infecting and lysing bacterial cells) to attack certain strains is called A)biotyping.
B)antibiograms.
C)serotyping.
D)bacteriocin typing.
E)bacteriophage typing.
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Chapter 62: Sentinel Laboratory Response to Bioterrorism
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Q1) The act of using microorganisms to intentionally harm the civilian population is referred to as
A)biosecurity.
B)biocrime.
C)microterrorism.
D)bactiterrorism.
Q2) The difference between an overt and a covert bioterrorism event is that
A)a covert event is one that is carried out against undercover agents.
B)a covert event is announced and an overt event is not announced.
C)an overt event is announced and a covert event is not announced.
D)an overt event is one that is carried out in the air.
Q3) Bioterrorism is a term used to describe
A)the act of using horrific events to deliver harm to living beings.
B)the act of using microorganisms to intentionally harm the civilian population.
C)the act of using microorganisms to wage war in peace time.
D)the act of using living beings to wage war in peace time.
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