
Course Introduction
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Course Introduction
Clinical Microbiology explores the roles of microorganisms in human health and disease, focusing on the detection, identification, and characterization of pathogenic bacteria, viruses, fungi, and parasites. The course covers diagnostic laboratory techniques, antimicrobial susceptibility testing, infection control strategies, and the epidemiology of infectious diseases. Students learn how clinical microbiology supports patient care and public health, with practical applications in diagnosing infections and guiding appropriate therapeutic interventions.
Recommended Textbook
Bailey and Scotts Diagnostic Microbiology 12th Edition by Betty A. Forbes
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2
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Q1) Taxonomy can be described as
A)a consistent means to classify, name, and identify organisms.
B)the common language in science that minimizes confusion about names.
C)the naming system that allows scientific attention to center on more important issues and phenomena.
D)playing a central role in providing accurate and timely diagnosis of infectious diseases.
E)All of the above are true.
Answer: E
Q2) A collection of bacterial strains that share many common physiologic and genetic features can be defined as A)genus.
B)species.
C)class.
D)kingdom.
E)order.
Answer: B
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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) Recombination is defined as
A)the change of the bacterial genotypes through the exchange of DNA from one cell to another.
B)an internal change in the original nucleotide sequence of a gene or genes within an organism's genome.
C)the process by which genetic elements such as plasmids and transposons excise from one genomic location and insert into another.
D)the uptake of free DNA from the environment and recombination with the recipient's homologous DNA.
Answer: A
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Q1) Infectious processes that develop quickly are referred to as A)chronic infections.
B)latent infections.
C)acute infections.
D)nosocomial infections.
Answer: C
Q2) IgM 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: A
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Q1) Mouth pipetting
A)should be done only if necessary and with extreme care.
B)can save valuable time and should be done whenever quick results are needed.
C)is done only when material is not expected to pose a biological hazard.
D)should not be done in any circumstance in the clinical laboratory.
Q2) Biosafety Level 1 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.
Q3) Procedures such as grinding, mincing, vortexing, and preparing smears
A)are hazardous and should be done wearing gloves and gown protection.
B)create aerosol droplets and should be performed only in an approved biosafety cabinet.
C)should be avoided with specimens known to contain infectious agents.
D)produce a spill hazard and should be done over an absorptive mat.
E)All of the above are correct.
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Q1) Definitive identification of clinically significant isolates
A)is always necessary and should be carried out by the laboratory at all times.
B)is desirable in most cases but sometimes limited identification may be necessary and helpful.
C)is often not cost effective and should be done only when requested by the attending physician.
D)is not necessary in most cases and should not be done routinely by the laboratory.
Q2) Reduced O (5% to 10%) and increased CO (8% to 10%) is the environmental condition that best suits which type of organism?
A)Aerobes
B)Anaerobes
C)Capnophiles
D)Microaerophiles
Q3) Direct examinations such as the Gram stain serve what purpose?
A)To assess the quality of the specimen
B)To give the physician an early indication of what may be wrong with the patient
C)To guide the workup of the specimen
D)All of the above are correct.
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Q1) The fourth step in the Gram stain is the application of the A)safranin.
B)crystal violet.
C)Gram's iodine.
D)Gram's decolorizer.
Q2) 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
Q3) The fluorochrome stain that can be used to detect mycobacteria is A)calcofluor white.
B)acridine orange.
C)auramine.
D)immunofluorescence.
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Q1) Which type of media is designed to support the growth of a wide range of microorganisms?
A)Selective
B)Supportive
C)Differential
D)Definitive
Q2) Ambient air, which contains 21% oxygen (O ) and a small amount (0.03%) of carbon dioxide (CO ), is the environmental condition that best suits which type of organism?
A)Aerobes
B)Anaerobes
C)Capnophiles
D)Microaerophiles
Q3) 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.
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9

Microbial Identification and Characterization
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Q1) Nucleic acid sequencing 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.
D)determining the exact nucleotide sequence of a gene or gene fragment obtained from an organism.
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
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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 modification of the Ouchterlony method that speeds up migration of an antigen and antibody by applying an electrical current is referred to as A)double immunodiffusion.
B)counterimmunoelectrophoresis.
C)particle agglutination.
D)enzyme immunoassay.
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Q1) The precipitin test that is widely used for detecting antibodies against fungal infection is referred to as A)double immunodiffusion.
B)counterimmunoelectrophoresis.
C)particle agglutination.
D)enzyme immunoassay.
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) The antibody that is predominantly found in tears, saliva, and intestinal secretions is A)IgG.
B)IgA.
C)IgM.
D)IgE.
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Q1) The mechanism of acquired, high-level resistance to vancomycin involves
A)enzymatic destruction of the antibiotics.
B)altered antibiotic targets.
C)decreased intracellular uptake of the drug.
D)the production of altered cell wall precursors that do not bind the antibiotic with sufficient avidity.
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) Antimicrobial agents that inhibit bacterial growth but generally do not kill the organism are known as A)bactericidal.
B)antibiotic.
C)bacteriostatic.
D)All of the above are correct.
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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) 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) Bactericidal tests should be performed
A)for every clinically significant organism isolated from a clinical specimen.
B)to evaluate antimicrobials usually considered to be bacteriostatic.
C)for severe and life-threatening infections.
D)All of the above are correct.

Page 14
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Q1) The most frequent agent of nosocomial bacteremia is
A)catalase-negative micrococci.
B)coagulase-positive staphylococci.
C)catalase-negative stomatococci.
D)coagulase-negative staphylococci.
Q2) 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.
Q3) Isolates of coagulase-negative Staphylococcus from urinary tract infections can be presumptively identified as S.saprophyticus based on A)penicillin susceptibility.
B)novobiocin resistance.
C)penicillin resistance.
D)novobiocin susceptibility.
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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) CAMP factor is produced by
A)Enterococcus faecalis.
B)Streptococcus pneumoniae.
C)Streptococcus pyogenes.
D)Streptococcus agalactiae.
E)viridans streptococci.
Q3) The major etiologic agent of bacterial endocarditis in the United States is
A)Enterococcus faecalis.
B)Streptococcus pneumoniae.
C)Streptococcus pyogenes.
D)Streptococcus agalactiae.
E)viridans streptococci.
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Q1) 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.
Q2) 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.
Q3) 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.
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Q1) 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.
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) 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.
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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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Q1) 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.
Q2) Nocardia have as part of their cell wall peptidoglycan
A)mesodiaminopimelic acid (DAP).
B)arabinose.
C)galactose.
D)All of the above are correct.
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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Q1) Acid slant, acid butt, no H S
A)Salmonella species
B)Escherichia coli
C)Proteus species
D)Pseudomonas species
Q2) MacConkey-sorbitol agar is useful for detecting pathogenic strains of
A)Escherichia coli.
B)Shigella species.
C)Salmonella species.
D)Vibrio species.
Q3) Which of the following bacteria are etiologic agents of foodborne gastroenteritis in the United States?
A)Shigella species
B)Salmonella species
C)Yersinia enterocolitica
D)Escherichia coli
E)All of the above are correct.
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21

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Q1) 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.
Q2) 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.
Q3) 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.
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Q1) Production of exotoxin A, which kills host cells by inhibiting protein synthesis, and production of several proteolytic enzymes and hemolysins that destroy cells and tissue are factors that contribute to pathogenicity of
A)Pseudomonas aeruginosa.
B)Burkholderia cepacia.
C)Ralstonia pickettii.
D)Burkholderia mallei.
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.
Q3) The disease referred to as melioidosis is caused by A)Pseudomonas aeruginosa.
B)Ralstonia pickettii.
C)Burkholderia mallei.
D)Burkholderia pseudomallei.

Page 23
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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 Psychrobacter immobilis.
A)Environmental only, not human flora
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
Q3) Valid susceptibility testing methods are not available for A)Enterobacteriaceae.
B)Achromobacter.
C)Pseudomonas.
D)Staphylococcus.
Q4) Choose the habitat of the bacterium Rhizobium radiobacter.
A)Environmental
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
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Q1) Among the yellow-pigmented, oxidase-positive, glucose oxidizers that are occasionally encountered in human specimens are
A)Chryseobacterium meningosepticum.
B)Flavobacterium meningosepticum.
C)Sphingobacterium spiritivorum.
D)Empedobacter brevis.
E)All of the above are correct.
Q2) Valid susceptibility testing methods are not available for
A)Enterobacteriaceae.
B)Chryseobacterium.
C)Pseudomonas.
D)Staphylococcus.
Q3) 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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Q1) 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.
Q2) Gram stain morphology, motility, and flagellar placement are important identifying characteristics of
A)Chryseobacterium.
B)Flavobacterium.
C)Pseudomonas.
D)Bordetella.
Q3) Psychrobacter phenylpyruvicus can be described as
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.
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Q1) 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
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) 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.
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Q1) 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.
Q2) 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.
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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 atlantae 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) 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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Q1) 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.
Q2) 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.
Q3) Valid susceptibility testing methods are not available for A)Enterobacteriaceae.
B)Pseudomonas.
C)Eikenella.
D)Staphylococcus.
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Q1) 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.
Q2) 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.
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Q1) Actinobacillus actinomycetemcomitans can be distinguished from H.aphrophilus 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) Which of the following bacterial species is a nonvirulent part of human and animal flora and is transmitted to humans during trauma such as bites or dental work?
A)Sphingomonas paucimobilis
B)Weeksella virosa
C)Pasteurella multocida
D)Actinobacillus
E)All of the above are correct.
Q3) 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.
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Q1) Short to medium-length bacilli
A)H. haemolyticus
B)H. influenzae biotype aegypticus
C)H. influenzae
D)H. segnis
E)H. parainfluenzae
Q2) Slender or coccobacillary
A)H. haemolyticus
B)H. influenzae biotype aegypticus
C)H. influenzae
D)H. segnis
E)H. parainfluenzae
Q3) Growth of most Haemophilus species in culture is enhanced by A)incubation at 33° to 35° C.
B)high humidity.
C)5% to 10% carbon dioxide (CO ).
D)enriched special media.
E)All of the above are correct.
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Q1) 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.
Q2) 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.
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Q1) The majority of human infections with Campylobacter species are caused by
A)direct contact with carriers of the bacterium.
B)contamination of food, milk, or water with animal feces.
C)multiplication of the organism in food products.
D)direct contact with persons infected with the bacterium.
Q2) 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.
Q3) 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.
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Q1) 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.
Q2) 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.
Q3) 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.
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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) Organisms belonging to the genus Brucella are
A)gram-positive diplococci.
B)gram-positive diphtheroid bacilli.
C)gram-negative coccobacilli.
D)gram-negative bacilli.
Q4) 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.
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Q1) 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.
Q2) 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.
Q3) 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.
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Q1) 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.
Q2) 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.
Q3) To cultivate Francisella in the laboratory, a medium supplemented with what ingredient(s) is necessary?
A)Cysteine and cystine
B)Blood and cysteine
C)Dopa-cysteine
D)Nicotinic adenine
E)All of the above are correct.
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Q1) The name given to rat-bite fever when the illness is caused by acquired S.minus is A)Sodoku.
B)Haverhill fever.
C)Monillic fever.
D)Monillic gastritis.
Q2) Sodoku, characterized by swollen lymph nodes, chills, fever, headache, vomiting, and often severe joint pains, a rash on the palms, soles of the feet, and other extremities, and a granulomatous lesion is caused by
A)Streptobacillus moniliformis.
B)Spirillum minus.
C)Bordetella species.
D)Pasteurella species.
Q3) 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.
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Q1) Presumptive identification of an oxidase-positive, gram-negative diplococcus on Thayer-Martin medium from genital sites of a 6-year-old female as Neisseria gonorrhoeae
A)provides the physician with quick and reliable results at minimal cost.
B)should be confirmed with a repeat culture.
C)may sometimes be incorrect and should not be reported.
D)should only be done when venereal disease is suspected.
Q2) Choose the genus that is best described as oxidase-positive, gram-negative cocci that are normal flora of the respiratory and other mucosal surfaces, and that often form diplococci.
A)Haemophilus
B)Stomatococcus
C)Staphylococcus
D)Neisseria
Q3) M.catarrhalis may be differentiated from the gonococci and meningococci based on
A)its growth on blood agar at 22° C.
B)its growth on nutrient agar at 35° C.
C)the reduction of nitrate to nitrite.
D)its production of DNAse.
E)All of the above.
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Q1) Aspiration of peritoneal fluid using a needle and syringe
A)Acceptable
B)Not acceptable
Q2) Expectorated sputum
A)Acceptable
B)Not acceptable
Q3) During specimen collection, an important thing to remember when handling a collection device with an oxygen-free atmosphere is
A)to take care not to tip the container.
B)to hold the collected specimen in the refrigerator until processing.
C)to hold the collected specimen in the incubator until processing.
D)to avoid opening the container in an aerobic atmosphere.
Q4) When activating a hydrogen and CO generator system used for creating an anaerobic atmosphere, indications that the catalyst and generator envelope are functioning properly include
A)production of heat within a few minutes.
B)development of moisture on the walls of the jar.
C)a change in color of the methylene blue or resazurin indicator.
D)All of the above are correct.
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Q1) Fusobacterium 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
Q2) Optimal recovery and identification of anaerobic bacteria in clinical specimens occurs when
A)the initial incubation period is at 35° to 37° C for 48 hours.
B)plates are incubated for at least 3 days before discarding as negative.
C)the initial incubation period is at 35° to 37° C for 24 hours.
D)thioglycollate broth can be inspected daily for 3 days.
Q3) The primary plating medium for inoculating anaerobic specimens includes
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.
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Q1) The mycobacterial species that occur in humans and belong to the M.tuberculosis complex include
A)M.tuberculosis, nontuberculous mycobacteria, M.bovis, and M.africanum.
B)M.tuberculosis, M.gordonae, M.bovis BCG, and M.africanum.
C)M.tuberculosis, M.bovis, M.avium, and M.intracellulare.
D)M.tuberculosis, M.bovis, M.bovis BCG, and M.africanum.
Q2) In identification of mycobacterial isolates, the Tween 80 test involves A)an enzyme that is able to produce Tween 80 from certain ingredients found in the medium.
B)a lipase that is able to hydrolyze polyoxyethylene sorbitan monooleate into oleic acid and polyoxyethylated sorbitol.
C)the metabolism of niacin to nicotinic acid by enzymatic action.
D)testing the isolate for susceptibility to Tween 80.
Q3) The system of classification based on growth rate and colonial pigmentation is called
A)Bergey's.
B)scotochromogenic.
C)Runyon.
D)carotenoid.
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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) Diagnosis of C.trachomatis is done by which methodology?
A)Cytology
B)Culture
C)Direct detection of antigen or nucleic acid
D)Serologic testing
E)All of the above are correct.
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Q1) 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
Q2) 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.
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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Q1) A self-limiting illness and the most common clinical syndrome associated with leptospires that includes fever, headache, myalgia, and aseptic meningitis in the immune stage is called
A)icteric leptospirosis.
B)anicteric leptospirosis.
C)Weil's disease.
D)syphilis.
Q2) A stage of venereal syphilis characterized by fever, weight loss, malaise, loss of appetite, and a widespread rash is known as
A)primary syphilis.
B)secondary syphilis.
C)late syphilis.
D)tertiary 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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Q1) The specimen of choice for diagnosing infection with Leishmania spp is A)feces.
B)blood smear.
C)liver tissue.
D)CSF.
Q2) Trypanosoma cruzi
A)Feces
B)Blood smear
C)Vaginal secretions
D)CSF
E)Skin scraping
Q3) Strongyloides stercoralis
A)Rectal tape prep
B)Tissue biopsy
C)Sputum
D)Feces
E)Blood smear
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Q1) Large, usually multiseptate and club- or spindle-shaped spores are called A)microconidia.
B)macroconidia.
C)conidiophores.
D)phialides.
Q2) The genus Microsporum 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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Q1) Long-term storage of a specimen for viral culture for more than 6 days should include
A)holding specimen at 4°? C.
B)holding specimen at -70° C.
C)diluting or emulsifying in viral transport medium and holding at -70° C.
D)holding specimen at 20° C.
Q2) The major form of control of viral diseases has been
A)vaccination.
B)immune prophylaxis.
C)antiviral chemotherapeutic agents.
D)eradication.
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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Q1) Septicemia
A)A lipopolysaccharide comprising part of the cell wall structure of gram-negative bacteria that has a strong effect on several physiologic functions during septicemia
B)A condition in which bacteria or their products (toxins) are causing harm to the host
C)The syndrome in which bacteremia causes disease, characterized by fever, acute respiratory distress, shock, renal failure, intravascular coagulation, and tissue destruction
D)Infections that result from bacteria entering the blood circulation through the lymphatic system from another site of infection
Q2) Infective endocarditis, mycotic aneurysm, suppurative thrombophlebitis, and intravenous, catheter-associated bacteremia are
A)within the vascular system.
B)caused by organisms that are present in the bloodstream at a fairly constant rate.
C)continuous bacteremias.
D)extremely serious and considered life-threatening.
E)All of the above are correct.
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Q1) The most common etiologic agents of lower respiratory tract disease among previously healthy patients 2 months of age to 5 years old are
A)respiratory syncytial viruses.
B)human metapneumoviruses.
C)parainfluenza, influenza, and adenoviruses.
D)All of the above are correct.
Q2) Of the various types of specimens collected to diagnose respiratory infections, which one is acceptable for detection of anaerobic agents?
A)Tracheostomy aspirates
B)Bronchial washings
C)Gastric aspirates
D)Transtracheal aspirates
E)All of the above are correct.
Q3) Adenoviruses are one of the most common etiologic agents of lower respiratory tract infection 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.
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Q1) Rhinitis
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
Q2) 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.
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Q1) The innermost membrane layer surrounding the brain and spinal column is called A)dura mater.
B)meninges.
C)arachnoid.
D)pia mater.
Q2) A collective term used for the three layers of membranes surrounding the brain and spinal column is A)dura mater.
B)meninges.
C)arachnoid.
D)pia mater.
Q3) An increase of lymphocytes and other mononuclear cells (pleocytosis) in the CSF and negative bacterial and fungal cultures is referred to as A)meningoencephalitis.
B)aseptic meningitis.
C)encephalitis.
D)pleocytosis.
E)meningitis.
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Q1) 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
Q2) The most common etiologic agents in acute otitis media in children include
A)Klebsiella pneumococci.
B)Haemophilus influenzae.
C)Streptococcus agalactiae.
D)Moraxella catarrhalis.
Q3) Canaliculitis
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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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 common etiologic agent in uncomplicated community-acquired urinary tract infection is
A)Escherichia coli.
B)Klebsiella spp.
C)Staphylococcus saprophyticus.
D)Streptococcus pyogenes.
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Q1) Epididymitis
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) An organism that many women carry as part of their normal genital microbial flora that may be transmitted to the neonate during childbirth is
A)Staphylococcus.
B)Escherichia coli.
C)Streptococcus agalactiae.
D)Gardnerella vaginalis.
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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Q1) The transport medium that best preserves the viability of most intestinal bacterial pathogens is
A)buffered glycerol.
B)a rectal culture swab.
C)Cary-Blair.
D)Campy-thioglycollate broth.
Q2) Selenite 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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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) Myositis
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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Q1) 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.
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) 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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Q1) The percentage of true-positive test results based on the prevalence of the disease in the population studied is referred to as A)accuracy.
B)predictive value negative.
C)sensitivity.
D)specificity.
E)predictive value positive.
Q2) The reproducibility of a test when it is run (repeated) several times 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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Q1) 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.
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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Q1) 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.
Q2) 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.
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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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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