Clinical Microbiology
Exam Answer Key
Course Introduction
Clinical Microbiology explores the fundamental principles and practical applications of microbiology in a clinical setting, focusing on the identification, characterization, and diagnosis of pathogens responsible for human diseases. The course covers bacterial, viral, fungal, and parasitic organisms, emphasizing laboratory techniques used for detection and antimicrobial susceptibility testing. Students learn about host-pathogen interactions, mechanisms of disease transmission, infection control, and the clinical relevance of emerging infectious agents. In addition, the course highlights the interpretation of laboratory results, the role of microbiology in patient care, and strategies for effective infection prevention and public health management.
Recommended Textbook
Bailey and Scotts Diagnostic Microbiology 12th Edition by Betty A. Forbes
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Chapter 1: Microbial Taxonomy
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Q1) 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
Q2) The most basic taxonomic group that can be defined as a collection of bacterial strains that share many common physiologic and genetic features is A)genus.
B)species.
C)class.
D)kingdom.
E)order.
Answer: B
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Chapter 2: Bacterial Genetics Metabolism and Structure
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Q1) Genetic change in bacteria is accomplished by A)mutation.
B)genetic recombination.
C)gene exchange between bacteria.
D)All of the above are correct.
Answer: D
Q2) The term used when oxidative phosphorylation uses final electron acceptors other than oxygen is
A)substrate level phosphorylation.
B)fermentative metabolism.
C)oxidative phosphorylation.
D)aerobic respiration.
E)anaerobic respiration.
Answer: E
Q3) All genes within an organism comprise that organism's A)chromosome. B)genome.
C)nucleotide.
D)deoxyribonucleic acid. Answer: B
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Chapter 3: Host-Microorganism Interactions
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Q1) The first antibody produced when an invading microorganism is initially encountered is
A)IgG.
B)IgA.
C)IgM.
D)IgE.
Answer: C
Q2) A human infection that results from a microorganism that primarily infects animal populations is referred to as
A)an accidental infection.
B)a zoonotic infection.
C)a secondary infection.
D)a vector infection.
Answer: B
Q3) Swelling, redness, heat, and pain are all manifestations of A)nosocomial infection.
B)inflammation.
C)bacterial colonization.
D)coagulation.
Answer: B
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Chapter 4: Laboratory Safety
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Q1) 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.
Q2) The agency that published guidelines known as Universal Precautions to reduce the risk of disease transmission in laboratories is
A)DHEC.
B)OSHA.
C)CDC.
D)EPA.
Q3) Biosafety Level 4 agents
A)include those that are the common agents of infectious disease.
B)require only standard good laboratory technique.
C)include Mycobacterium tuberculosis, M.gordonae, and Brucella.
D)require the use of maximum containment facilities.
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Chapter 5: Specimen Management
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Q1) Microaerophiles grow best in
A)ambient air, which contains 21% oxygen (O ) and a small amount (0.03%) of carbon dioxide.
B)increased concentrations of CO (5% to 10%) and approximately 15% O .
C)Five percent to 10% hydrogen (H ), 5% to 10% CO , 80% to 90% nitrogen (N ), and 0% O .
D)Reduced O (5% to 10%) and increased CO (8% to 10%).
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) 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.
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Chapter 6: Role of Microscopy
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Q1) The fluorochrome stain that can be used to detect mycobacteria is A)calcofluor white.
B)acridine orange.
C)auramine.
D)immunofluorescence.
Q2) A mordant that is applied after the primary stain to chemically bond the alkaline dye to the bacterial cell wall is
A)safranin.
B)crystal violet.
C)Gram's iodine.
D)Gram's decolorizer.
Q3) In the Kinyoun acid-fast staining method, ___________ replaces __________ in the primary stain solution.
A)increased phenol; heat
B)heat; increased phenol
C)mycolic acid; heat
D)carbolfuchsin; phenol
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Chapter 7: Traditional Cultivation and Identification
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Q1) Which type of media is designed to support the growth of one group of organisms, but not another, by containing antimicrobials, dyes, or alcohol?
A)Selective
B)Nutritive
C)Differential
D)Definitive
Q2) The role of the agar ingredient in culture medium is to
A)provide a nutritional base for bacterial metabolism.
B)solidify the medium and provide a stable culture surface.
C)sterilize the medium and prevent contamination.
D)All of the above are correct.
Q3) Which category of media can be described as containing nutrients that support growth of most nonfastidious organisms without giving any particular organism a growth advantage?
A)Enrichment
B)Supportive
C)Selective
D)Differential
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Chapter 8: Nucleic Acid-Based Analytic Methods for
Microbial Identification and Characterization
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Q1) The probe in the hybridization assay can be described as
A)originating from the unknown organism to be detected or identified.
B)a "reporter" molecule that chemically forms a complex with the single-stranded probe DNA.
C)originating from an organism of known identity.
D)All of the above are correct.
Q2) Two nucleic acid strands (a probe and a target) that have complementary base sequences specifically bond with each other and form a double-stranded molecule.
A)Hybridization
B)Sequencing
C)Amplification (PCR)
D)Genotypic
Q3) 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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Chapter 9: Immunochemical Methods Used for Organism
Detection
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Q1) The immunochemical test that involves antigen present in a specimen binding to the combining sites of the antibody exposed on the surfaces of latex beads is referred to as
A)double immunodiffusion.
B)counterimmunoelectrophoresis.
C)particle agglutination.
D)enzyme immunoassay.
Q2) 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.
Q3) A test procedure that applies a specific fluorescent dye-antibody complex to a slide to which the patient specimen has been applied is referred to as
A)a solid-phase enzyme immunoassay.
B)a direct fluorescent antibody test.
C)an indirect fluorescent antibody test.
D)a radioimmunoassay.
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Chapter 10: Serologic Diagnosis of Infectious Diseases
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Q1) The study of the diagnosis of disease by measuring antibody levels in serum is called A)immunology.
B)immunohematology.
C)serology.
D)immunocytology.
Q2) Antibodies that function by attaching to the surface of pathogens and making the pathogens more amenable to ingestion by phagocytic cells are called A)opsonizing antibodies.
B)neutralizing antibodies.
C)complement-fixing antibodies.
D)chemotaxic antibodies.
Q3) Antibodies that function by attaching to the surface of pathogens and contributing to their destruction by the lytic action of complement are called A)opsonizing antibodies.
B)neutralizing antibodies.
C)complement-fixing antibodies.
D)chemotaxic antibodies.
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Chapter 11: Principles of Antimicrobial Action Resistance
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Q1) Antimicrobial agents that usually kill target organisms are said to be
A)bactericidal.
B)antibiotic.
C)bacteriostatic.
D)All of the above are correct.
Q2) Antimicrobial resistance resulting from the normal genetic, structural, or physiologic state of a microorganism is referred to as
A)intrinsic resistance.
B)inherent resistance.
C)microorganism mediated resistance.
D)All of the above are correct.
Q3) 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.
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Chapter 12: Laboratory Methods and Strategies for Antimicrobial Susceptibility Testing
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Q1) Enterococcal high-level gentamicin resistance predicts resistance to A)vancomycin.
B)aminoglycosides.
C)cephalosporins.
D)amikacin.
Q2) The MIC result recorded in antimicrobial testing can be defined as
A)the maximum concentration of antimicrobial agent that should be used for optimal therapy.
B)the minimum concentration of antimicrobial agent that should be used for optimal therapy.
C)the lowest antimicrobial agent concentration that completely inhibits visible bacterial growth.
D)the highest antimicrobial agent concentration that completely inhibits visible bacterial growth.
Q3) Growth on the oxacillin agar screen means that a patient should be treated with A)oxacillin.
B)methicillin.
C)vancomycin.
D)cephalosporins.
E)chloramphenicol.
14
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Chapter 13: Staphylococcus, Micrococcus, and Similar Organisms
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Q1) The resident human flora staphylococcus that is more likely to cause infections in compromised hosts such as cancer patients is
A)Staphylococcus saprophyticus.
B)Staphylococcus aureus.
C)Staphylococcus epidermidis.
D)Staphylococcus intermedius.
Q2) This virulent and important human pathogen can also be recovered from the nares, perineum, and other skin sites of healthy people, especially in the hospital setting.
A)Micrococcus luteus
B)Staphylococcus intermedius
C)Staphylococcus aureus
D)All Micrococcaceae
Q3) The species of Staphylococcus that is one of the most important human pathogens is
A)Staphylococcus luteus.
B)Staphylococcus aureus.
C)Staphylococcus mucilaginosus.
D)Staphylococcus intermedius.
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Chapter 14: Streptococcus, Enterococcus, and Similar Organisms
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Q1) Generally speaking, nutritionally variant streptococci require what ingredient not found in most conventional media?
A)Vitamin B6.
B)Nalidixic acid and its components
C)NAD enrichment
D)Blood or blood products
Q2) A vancomycin-resistant cocci is likely not
A)Pediococcus.
B)Leuconostocs.
C)streptococci.
D)lactobacilli.
Q3) Streptococcus pneumoniae can be described as
A)susceptible to bile and optochin.
B)alpha hemolytic.
C)a major cause of bacterial meningitis.
D)often carrying an antiphagocytic capsule.
E)All of the above are true.
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Chapter 15: Bacillus and Similar Organisms
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Q1) Media that can be used for isolation of Bacillus anthracis include
A)Thayer-Martin agar.
B)5% sheep blood agar.
C)MacConkey agar.
D)CNA blood agar.
Q2) Induction of sporulation by Bacillus sp.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.
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 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.
Q2) Patients who are immunocompromised and pregnant women should avoid eating soft cheeses such as Mexican-style, feta, brie, Camembert, and blue-veined cheese to prevent
A)foodborne listeriosis.
B)staphylococcal food poisoning.
C)gastric gangrene.
D)salmonella infection.
Q3) The organism that exhibits characteristic end-over-end tumbling motility when incubated in nutrient broth at room temperature for 1 to 2 hours is
A)Listeria monocytogenes.
B)Corynebacterium diphtheriae.
C)Bacillus anthracis.
D)Bacillus cereus.
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Chapter 17: Erysipelothirix, Lactobacillus, and Similar Organisms
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Q1) 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
Q2) Large, squamous epithelial cells with numerous attached pleomorphic gram-variable or gram-negative coccobacilli and rods are typical elements of a wet mount and Gram stain of vaginal secretions from a patient who has A)bacterial vaginosis caused by Gardnerella vaginalis.
B)large numbers of large gram-positive rods.
C)large numbers of polymorphonuclear leukocytes.
D)All of the above are correct.
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.
Page 19
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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) Nocardia spp.form branched filaments that extend into the air that are called
A)surface hyphae.
B)substrate hyphae.
C)aerial hyphae.
D)topical hyphae.
Q3) Nocardia spp.cause which of the following types of infections in immunocompromised individuals?
A)Mycetoma
B)Lymphocutaneous infections
C)Skin abscesses or cellulites
D)Invasive pulmonary infections
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Chapter 19: Enterobacteriaceae
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Q1) Enterotoxigenic and enteroinvasive are terms often linked to which of the following bacterial species?
A)Escherichia coli
B)Salmonella enteritidis
C)Shigella sonnei
D)Yersinia pestis
E)All of the above are correct.
Q2) Acid slant, acid butt, no H S
A)Salmonella species
B)Escherichia coli
C)Proteus species
D)Pseudomonas species
Q3) The major etiologic agent of urinary tract infections is
A)Escherichia coli.
B)Shigella species.
C)Salmonella species.
D)Vibrio species.
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Chapter 20: Acinetobacter, Stenotrophomonas, and Other Organisms
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Q1) The natural habitat of Acinetobacter 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) An organism that can be described as oxidase-negative, MacConkey agar-positive, glucose nonfermenter is likely
A)Escherichia.
B)Pseudomonas.
C)Acinetobacter.
D)Moraxella.
Q3) For more serious infections caused by Acinetobacter spp., such as pneumonia or bacteremia, effective treatment may require the use of
A)multiple rounds of penicillin or similar antibiotic.
B)a beta-lactam agent in combination with an aminoglycoside.
C)repeated high level doses of gentamycin.
D)single-drug therapy in combination with a steroid.
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Chapter 21: Pseudomonas, Burkholderia, and Similar Organisms
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Q1) 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
Q2) All Brevundimonas, Burkholderia, Ralstonia, Pseudomonas, and Acidovorax share which of the following characteristics?
A)Oxidase-positive
B)Utilize glucose oxidatively
C)Able to grow on MacConkey agar
D)None of the above are correct.
E)All of the above are correct.
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Chapter 22: Achromobacter, Rhizobium, Ochrobactrum, and Similar
Organisms
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Q1) Choose the habitat of the bacterium Paracoccus yeei.
A)Environmental only, not human flora
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
Q2) The most common type of infection caused by both Rhizobium radiobacter and Ochrobactrum anthropi is
A)peritonitis.
B)endocarditis.
C)meningitis.
D)bacteremia .
Q3) 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
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Chapter
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Q1) Valid susceptibility testing methods are not available for A)Enterobacteriaceae.
B)Chryseobacterium.
C)Pseudomonas.
D)Staphylococcus.
Q2) Choose the habitat of the bacterium Sphingobacterium.
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 Empedobacter.
A)Environmental
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
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Comamonas, and Similar Organisms
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Q1) Pertussis (whooping cough), an epidemic disease, 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) B.bronchiseptica is
A)oxidase-positive, motile, and rapid urease-positive.
B)indole-positive, nonmotile, 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.
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.
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Chapter 25: Vibrio, Aeromonas, Plesiomonas Shigelloides, and
Chromobacterium Violaceum
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Q1) 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.
Q2) The primary habitat for Plesiomonas shigelloides and Chromobacterium violaceum is
A)fresh water.
B)the upper respiratory tract of various mammals.
C)brackish or marine water.
D)the soil and water environment.
Q3) Profuse watery diarrhea ("rice water stools"), leading to dramatic fluid loss, severe dehydration, and hypotension that frequently leads to death, is the hallmark of which toxin activity?
A)Cholera toxin (CT)
B)Enteric endotoxin
C)Shiga toxin
D)Toxin A
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Chapter 26: Sphingomonas Paucimobilis and Similar Organisms
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Q1) Oxidase-positive, glucose-positive, (oxidatively) gram-negative bacilli that cannot grow on MacConkey agar include
A)Pseudomonas.
B)Vibrio.
C)Stenotrophomonas.
D)Sphingomonas.
Q2) Sphingomonas 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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Chapter 27: Moraxella
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Q1) Differentiation of Neisseria elongata subsp.glycolytica from other Moraxella species 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 elongata appears 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) Differentiation of Moraxella lacunata from other Moraxella species 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.
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Page 29
Chapter 28: Eikenella Corrodens and Similar Organisms
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Q1) Valid susceptibility testing methods are not available for A)Enterobacteriaceae.
B)Pseudomonas.
C)Eikenella.
D)Staphylococcus.
Q2) Of the asaccharolytic, oxidase-positive bacilli that do not grow on MacConkey agar, which one is generally associated with mixed infections resulting from bites or clenched-fist wounds?
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 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.
Q2) 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.
Q3) Kingella spp.can be distinguished from Neisseria 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.
Page 32
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Chapter 31: Haemophilus
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Q1) Coccobacilli or small rods
A)H. haemolyticus
B)H. influenzae biotype aegypticus
C)H. influenzae
D)H. segnis
E)H. parainfluenzae
Q2) Pleomorphic rods
A)H. haemolyticus
B)H. influenzae biotype aegypticus
C)H. influenzae
D)H. segnis
E)H. parainfluenzae
Q3) Long, slender rods
A)H. haemolyticus
B)H. influenzae biotype aegypticus
C)H. influenzae
D)H. segnis
E)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) A common characteristic of the bacterial species Bartonella henselae and Afipia felis is
A)both are believed to cause cat-scratch disease.
B)the ability to grow on chocolate agar but not very well on routine blood (trypticase soy agar with 5% sheep blood) and not at all on MacConkey agar.
C)that primary isolation from clinical specimens is best accomplished using special cultivation conditions.
D)All of the above are correct.
E)None of the above are correct.
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Chapter 33: Campylobacter, Arcobacter, and Helicobacter
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Q1) Organisms belonging to the genus Campylobacter are
A)gram-positive diplococci.
B)gram-positive diphtheroid bacilli.
C)gram-negative curved bacilli.
D)gram-negative straight-sided 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) Parenteral therapy can be defined as that which
A)must be approved and given by a parent under close supervision.
B)is not taken through the alimentary canal.
C)is taken orally.
D)is taken in the form of suppositories.
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Chapter 34: Legionella
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Q1) 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.
Q2) 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.
Q3) To cultivate Legionella in the laboratory, a medium supplemented with what ingredient(s) is necessary?
A)L-cysteine
B)Blood and cysteine
C)Dopa-cysteine
D)Nicotinic adenine
E)All of the above are correct.
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Chapter 35: Brucella
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Q1) The serum agglutination test (SAT) fails to detect antibodies to A)Brucella abortus.
B)B.melitensis.
C)B.suis.
D)B.canis.
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) Persons considered at greatest risk for contracting brucellosis are A)dairy farmers.
B)livestock handlers.
C)slaughterhouse employees.
D)veterinarians.
E)All of the above are correct.
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Chapter 36: Bordetella Pertussis and Bordetella
Parapertussis
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Q1) 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.
Q2) During the paroxysmal stage of pertussis, symptoms are A)a runny nose and mild cough.
B)severe and violent coughing.
C)neutrocytosis and fever.
D)lymphadenitis.
Q3) 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.
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Chapter 37: Francisella
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Q1) Organisms belonging to the genus Francisella are
A)gram-positive diplococci.
B)gram-positive diphtheroid bacilli.
C)gram-negative coccobacilli.
D)gram-negative bacilli.
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-negative.
B)is hydrogen sulfide-positive.
C)does not hydrolyze gelatin.
D)does not grow in 6% sodium chloride.
E)All of the above are correct.
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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) Moraxella catarrhalis may be described as A)oxidase-positive.
B)a glucose utilizer.
C)a major cause of venereal disease.
D)often carrying an antiphagocytic capsule.
E)All of the above are true.
Q2) Determination of carbohydrate utilization patterns for differentiation of Neisseria spp.and M.catarrhalis is best done by
A)48- to 72-hour incubation of inoculated cystine trypticase soy agar (CTA) with 1% dextrose, maltose, lactose, and sucrose.
B)oxidative-fermentative (OF) medium with dextrose, maltose, lactose, and sucrose.
C)heavy inoculation of buffered, low-peptone substrate with dextrose, maltose, lactose, and sucrose.
D)carbohydrate testing strips.
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Chapter 40: Overview and General Considerations
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Q1) Aspiration of peritoneal fluid using a needle and syringe
A)Acceptable
B)Not acceptable
Q2) Bronchial washing collected with double lumen plugged catheter
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) Cervical swab
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) Nonpigmented Prevotella
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
Q2) The most likely identification of an anaerobic gram-positive coccus that is resistant to metronidazole is
A)Streptococcus.
B)Peptostreptococcus.
C)Leptotrichia.
D)Peptococcus.
E)Finegoldia.
Q3) The ethanol shock or heat shock test will separate which two bacteria?
A)Clostridium perfringens and Clostridium ramosum
B)Clostridium and Bifidobacterium
C)Actinomyces and Bifidobacterium
D)Eubacterium and Eggerthella
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Page 43
Chapter 42: Mycobacteria
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Q1) The fluorochrome method of staining Mycobacterium
A)is more sensitive than the conventional carbolfuchsin stains.
B)enables the smear to be initially examined at lower magnifications.
C)results in a higher yield of positive smears.
D)will substantially reduce the amount of time needed for examining smears.
E)All of the above are correct.
Q2) Characteristics that are found in the bacteria called Mycobacterium are
A)a cell wall that contains N-glycolylmuramic acid and a very high lipid content.
B)resists staining with commonly used basic aniline dyes.
C)resist decolorization by acidified alcohol.
D)slow growth as compared to most other human pathogenic bacteria.
E)All of the above are correct.
Q3) Sodium hydroxide, Zephiran-trisodium phosphate, N-acetyl-L-cysteine-NaOH, and oxalic acid are associated with
A)methods of cultivating mycobacterium in vitro.
B)digestion and decontamination of specimens for mycobacterial studies.
C)identification of clinically significant Mycobacterium.
D)antimicrobial susceptibility testing of mycobacterial species.
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44
Chapter 43: Obligate Intracellular and Nonculturable Bacterial Agents
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Q1) Of the following organisms, which can be described as fastidious obligate intracellular parasites that multiply by binary fission in the cytoplasm of host cells and which infect humans as accidental hosts in most cases?
A)Rickettsia
B)Chlamydia
C)Calymmatobacterium
D)Coxiella
Q2) The extracellular, metabolically inert, infective form of the Chlamydia is called the A)reticulate body.
B)elementary body.
C)replicate body.
D)initial body.
Q3) 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) Media that can be used for isolation of Mycoplasma include
A)Thayer-Martin agar with vitamin K.
B)5% sheep blood and IsoVitaleX.
C)beef or soybean protein with serum and fresh yeast extract.
D)Hemin and NAD supplements.
Q2) 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.
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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Page 46
Chapter 45: The Spirochetes
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Q1) A destructive lesion of the gums also known as acute necrotizing ulcerative gingivitis that is caused by oral spirochetes as well as other bacteria is known as
A)Vincent's disease.
B)primary syphilis.
C)chancre disease.
D)Weil's disease.
Q2) The most severe illness associated with leptospires, with symptoms caused by liver, kidney, and/or vascular dysfunction with lethal pulmonary hemorrhage and sometimes death is called
A)icteric leptospirosis.
B)anicteric leptospirosis.
C)Vincent's disease.
D)syphilis.
Q3) 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.
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Chapter 46: Laboratory Methods for Diagnosis of Parasitic
Infections
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Q1) Naegleria fowleri
A)Feces
B)Blood smear
C)Vaginal secretions
D)CSF
E)Skin scraping
Q2) An amoebic trophozoite that can be described as 12 to 15 microns, with no nuclear peripheral chromatin, a large karyosome, and coarsely granular and highly vacuolated cytoplasm would most likely be
A)Entamoeba histolytica.
B)E.coli.
C)Iodamoeba bütschlii.
D)E.hartmanni.
Q3) A red blood cell parasite that can be described as infecting younger RBCs, having Schüffner's dots, presenting in all stages, and having 12 to 24 merozoites would most likely be
A)Plasmodium malariae.
B)Plasmodium vivax.
C)Plasmodium falciparum.
D)Babesia microti.
Page 48
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Chapter 47: Laboratory Methods in Basic Mycology
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Q1) Molds that have no pigmentation within the hyphae nor the spores are referred to as
A)hyaline molds.
B)pauciseptate molds.
C)dematiaceous molds.
D)nigraceous molds.
Q2) In most instances the most definitive means for identification of clinically significant molds is
A)the growth rate.
B)colonial morphologic features such as color and texture.
C)microscopic morphologic features such as shape, method of production, and arrangement of spores.
D)biochemical reactions.
Q3) A white fungus is growing on fungal medium with cycloheximide and chloramphenicol additives on which nail scrapings were inoculated.Which fungi is likely growing?
A)Dermatophytes
B)Zygomycetes
C)Dimorphic fungi
D)Dematiaceous fungi
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Chapter 48: Laboratory Methods in Basic Virology
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Q1) Successful cultivation of virus in the laboratory includes
A)incubation of the culture immediately at 30° C.
B)allowing the virus to adsorb to the cell monolayer for at least 2 to 4 hours.
C)removing the inoculum and culture medium after the initial adsorption period and replacing it with fresh maintenance medium.
D)adding new growth medium periodically.
E)All of the above are correct.
Q2) The most pathogenic of the hemorrhagic fever viruses, this group of long filamentous viruses include Marburg and Ebola.
A)Coronaviruses
B)Bunyaviruses
C)Caliciviruses
D)Filoviruses
Q3) Viruses can be stored by
A)freezing at 20°C.
B)freezing in liquid nitrogen.
C)inoculating to continuous cell lines such as HEp-2.
D)refrigeration at 2° to 6°C.
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Chapter 49: Bloodstream Infections
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Q1) Mycotic aneurysm
A)Infections that result from bacteria entering the blood circulation through the lymphatic system from another site of infection
B)An infection of the endocardium that is most commonly caused by bacteria
C)A web of platelets, fibrin, inflammatory cells, and entrapped organisms that deposits on damaged cardiac endothelium
D)An intravascular infection that causes inflammatory damage and weakening of an arterial wall, causing a bulging of the arterial wall that can eventually rupture
E)An inflammation of a vein wall that is then seeded with organisms, thereby establishing a primary site of infection.
Q2) In the case of infants and small children, how much blood can usually be drawn for bacterial culture?
A)No more than 10 mL
B)1 to 5 mL
C)0.5 mL
D)1 mL
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Chapter 50: Infections of the Lower Respiratory Tract
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Q1) The most common etiologic agent of lower respiratory tract infection among adults younger than 30 years of age is
A)Chlamydophila pneumoniae.
B)Mycoplasma pneumoniae.
C)Streptococcus pneumoniae.
D)Haemophilus influenzae.
Q2) 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.
Q3) One of the most common etiologic agents of lower respiratory tract infection among previously healthy patients 2 months of age to 5 years old is
A)Chlamydophila pneumoniae.
B)Mycoplasma pneumoniae.
C)Streptococcus pneumoniae.
D)respiratory syncytial virus.
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Chapter 51: Upper Respiratory Tract Infections and Other
Infections of the Oral Cavity and Neck
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Q1) A potentially life-threatening disease because the patient's airway can become completely obstructed, epiglottitis is usually caused by the bacterium
A)Haemophilus influenzae, type B.
B)Corynebacterium diphtheriae.
C)Streptococcus pyogenes.
D)type A influenza virus.
Q2) Epiglottitis
A)Influenza virus, parainfluenza virus, rhinovirus, and other viruses
B)Influenza virus, parainfluenza virus, Mycoplasma
C)Haemophilus influenzae
D)Streptococcus pyogenes
E)Anaerobes including Fusobacterium, Bacteroides, and anaerobic cocci
F)Herpes simplex virus
G)Candida spp.
H)Mixed bacteria with spirochetes
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Chapter 52: Meningitis and Other Infections of the Central
Nervous
Systems
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Q1) The outermost layer of membranes surrounding the brain and spinal column is called
A)dura mater.
B)meninges.
C)arachnoid.
D)pia mater.
Q2) The innermost membrane layer surrounding the brain and spinal column is called A)dura mater.
B)meninges.
C)arachnoid.
D)pia mater.
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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Page 54
Chapter 53: Infections of the Eyes, Ears, and Sinuses
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Q1) Blepharitis
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
Q2) Orbital cellulitis
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
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Chapter 54: Infections of the Urinary Tract
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Q1) Asymptomatic bacteriuria
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) Mucosal antibacterial properties, a valvelike mechanism, host immune responses, and defensins are all host defense mechanisms found in the A)digestive tract.
B)upper respiratory tract.
C)urinary tract.
D)genital tract.
E)lower respiratory tract.
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Chapter 55: Genital Tract Infections
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Q1) Prostatitis
A)Anaerobic and polymicrobic infections originating from normal genital flora
B)Chlamydia trachomatis
C)Gardnerella, Prevotella spp., Porphyromonas spp., peptostreptococci, Mobiluncus spp.
D)Neisseria gonorrhoeae
E)N. gonorrhoeae and C. trachomatis
F)Escherichia coli and other enterics
G)Mumps virus
Q2) The predominant organisms in vaginal secretions from normal prepubescent girls and postmenopausal women are
A)lactobacilli.
B)Streptococcus agalactiae.
C)Enterobacteriaceae.
D)staphylococci.
Q3) Infections that are acquired during sexual activity are referred to as
A)endogenous infections.
B)pyelonephritis
C)Exogenous infections.
D)Upper tract infections.
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Page 57
Chapter 56: Gastrointestinal Tract Infections
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Q1) MacConkey 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
Q2) The normal flora of the adult large bowel consists predominantly of
A)anaerobic species.
B)Staphylococcus.
C)Enterococcus.
D)Enterobacteriaceae.
Q3) Stool received for routine culture in most clinical laboratories in the United States should be examined for the presence of at least
A)Campylobacter, Salmonella, and Shigella spp.
B)Salmonella and Shigella spp.
C)Campylobacter and Vibrio.
D)Salmonella, Shigella, and Vibrio.
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Chapter 57: Skin, Soft Tissue, and Wound Infections
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Q1) An abnormal passage between two organs or leading from an internal organ to the body surface is known as a A)fistula.
B)sinus tract.
C)necrotizing fascia. D)decubitus.
Q2) Chronic undermining ulcer
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) 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.
Q2) 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.
Q3) 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.
Page 60
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Chapter 59: Laboratory Physical Design, Management, and Organization
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Q1) The percentage of test results that are correctly identified by the test is called A)accuracy.
B)precision.
C)sensitivity.
D)specificity.
E)efficiency.
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 ability of the test under study to match the results of a standard test commonly known as the "gold standard" is A)accuracy.
B)precision.
C)sensitivity. D)specificity.
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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) Criteria that should be considered for rejection of specimens include
A)missing or inadequate information such as clinical diagnosis, current drug treatment, or other helpful facts.
B)illegible physician name.
C)improperly collected or stored specimen.
D)requests of multiple tests on one specimen.
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) A phenotypic technique of typing microbial strains that consists of analyzing unique biologic or biochemical characteristics of the organism of interest is called A)biotyping.
B)antibiograms.
C)serotyping.
D)bacteriocin typing.
E)bacteriophage typing.
Q2) The classification of a surgical wound as "dirty" refers to
A)the lack of cleanliness of the surgical instruments.
B)surgery wounds done in emergency settings where cleansing was not done.
C)a surgical wound that has become grossly infected.
D)the large number of contaminating organisms at the wound site.
Q3) 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.
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Chapter 62: Sentinel Laboratory Response to Bioterrorism
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Q1) 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.
Q2) The act of using microorganisms to intentionally harm the civilian population is referred to as
A)biosecurity.
B)biocrime.
C)microterrorism.
D)bactiterrorism.
Q3) 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.
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