Clinical Microbiology
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Course Introduction
Clinical Microbiology explores the role of microorganisms in human disease, focusing on the identification, characterization, diagnosis, and management of infectious agents. The course covers the fundamental principles of bacteriology, virology, mycology, and parasitology as they relate to human health. Students will learn laboratory techniques for isolating and identifying pathogens, understand mechanisms of pathogenicity and host responses, and examine antimicrobial therapies and resistance. Emphasis is placed on clinically relevant case studies, current diagnostic methods, infection control, and the critical role of the clinical laboratory in patient care.
Recommended Textbook
Microbiology Fundamentals A Clinical Approach 3rd Edition by Marjorie Kelly Cowan
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Chapter 1: Introduction to Microbes and Their Building
Blocks
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Q1) As Ms.Smith progresses with her plan of care,the RN provides education regarding beneficial applications of microbes.Scientists use microbes to produce drugs,hormones,and enzymes.This type of biotechnology involves the transfer of foreign genetic material into a microbe,a process called ________.
A)recombinant DNA technology
B)gene therapy
C)bioremediation
D)polymerase chain reaction
Answer: A
Q2) Which of the following statements is incorrect regarding the relationship between humans and microbes?
A)The majority of microorganisms that colonize humans are pathogenic
B)Microorganisms are benefited from their colonization of humans,whereas humans are unaffected by the relationship
C)Humans are colonized by bacteria and fungi,but not viruses
D)Not only do the majority of colonizing bacteria cause no harm to humans,the relationship is beneficial for both microbe and human host
Answer: D
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Page 3
Chapter 2: Tools of the Laboratory: Methods for the
Culturing and Microscopic Analysis of Microorganisms
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Q1) A microbiologist must culture a patient's feces for intestinal pathogens.Which of the following would likely be present in selective media for analyzing this fecal specimen?
A)NaCl
B)Sheep red blood cells
C)Bile salts
D)Thioglycollic acid
E)Peptone
Answer: C
Q2) All of the following pertain to the fluorescence microscope except ________.
A)it uses electrons to produce a specimen image
B)it is a type of compound microscope
C)it requires the use of dyes like acridine and fluorescein
D)it is commonly used to diagnose certain infections
E)it requires an ultraviolet radiation source
Answer: A
Q3) Mixed cultures are also referred to as contaminated cultures.
A)True
B)False
Answer: False
4
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Chapter 3: Bacteria and Archaea
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Q1) Endospores of certain bacterial species can enter tissues in the human body,germinate,and cause an infectious disease.
A)True
B)False
Answer: True
Q2) The cell ________ can be composed of three layers: the cytoplasmic membrane,the cell wall,and the outer membrane.
A)glycocalyx
B)envelope
C)pathogenic package
D)slime coat
E)None of the choices is correct.
Answer: B
Q3) A bacterial genus that has waxy mycolic acid in the cell walls is ________.
A)Mycobacterium
B)Mycoplasma
C)Streptococcus
D)Corynebacterium
E)Salmonella
Answer: A
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Chapter 4: Eukaryotic Cells and Microorganisms
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Sample Questions
Q1) An organelle that is a stack of flattened,membranous sacs and functions to receive,modify,and package proteins for cell secretion is the ________.
A)mitochondria
B)lysosome
C)Golgi apparatus
D)chloroplast
E)endoplasmic reticulum
Q2) The best definition of endosymbiosis is ________.
A)A photosynthetic bacterial cell and an aerobic bacterial cell fused to become a larger,eukaryotic cell
B)A eukaryotic cell ingested a bacterial cell and the organelles fused producing a larger cell
C)A pre-eukaryotic cell was infected by a prokaryote,and symbiosis between the two cell types gave rise to the modern-day eukaryotic cell
D)A DNA virus,a bacteria and a photosynthetic prokaryote fused to form a nucleus,a chloroplast and a mitochondria
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Chapter 5: Viral Structure and Multiplication
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Q1) Which of the following occurs during assembly of an enveloped virus?
A)Nucleocapsid is formed.
B)New viral nucleic acid is formed.
C)Viral spikes insert in host cell membrane.
D)A nucleocapsid is formed and viral spikes insert in host cell membrane.
E)All of the choices occur.
Q2) It is necessary to culture viruses both in vivo and in vitro so that vaccines can be developed,analysis of viral genomes can be made and viruses in clinical specimens can be identified.
A)True
B)False
Q3) A patient undergoing chemotherapy for cancer develops an infection with cytomegalovirus,conclusively diagnosed by the presence of "owl's eye" viral nuclear inclusions in a liver biopsy. This is an example of a(n) ________.
A)cytopathic effect by cytomegalovirus
B)immune response by the host
C)cytomegalovirus becoming a provirus
D)transformation of the host cell by cytomegalovirus
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Chapter 6: Microbial Nutrition and Growth
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Q1) Microorganisms require small quantities of ________ for enzyme function and maintenance of protein structure.
A)carbon
B)macronutrients
C)water
D)growth factors
E)trace elements
Q2) The term chemoheterotroph refers to an organism that ________.
A)uses CO for its carbon source
B)must obtain inorganic compounds for its energy source
C)gets energy from sunlight
D)gets energy by oxidizing chemical compounds
E)does not need a carbon source
Q3) Which of the following is not a major element of a microbial cell?
A)Copper
B)Carbon
C)Hydrogen
D)Nitrogen
E)Oxygen
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Page 8
Chapter 7: Microbial Metabolism
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Q1) Catabolic reactions are coupled with ATP ________,whereas anabolic reactions are coupled with ATP ________.
A)synthesis; hydrolysis
B)hydrolysis; synthesis
C)amphibolism; repression
D)deamination; beta oxidation
Q2) The organism is found to grow throughout the entire tube of broth media.Which of the following terms best describes the oxygen requirement of this organism?
A)Obligate aerobe
B)Microaerophile
C)Facultative anaerobe
D)Obligate anaerobe
Q3) In the electron transport chain,the collective,captured energy released by electrons is used to phosphorylate ________.
A)ATP
B)ADP
C)pyruvic acid
D)oxygen
E)NAD
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Page 9
Chapter 8: Microbial Genetics and Genetic Engineering
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Sample Questions
Q1) Amplification of DNA is accomplished by ________.
A)polymerase chain reaction
B)DNA sequencing
C)gene probes
D)southern blot
E)western blot
Q2) All of the following pertain to nitrogenous bases except ________.
A)form pairs by hydrogen bonding
B)guanine pairs with uracil
C)adenine pairs with thymine
D)cytosine and thymine are pyrimidines
E)they are only present in the form of purines
Q3) DNA photolyase,in the presence of visible light,can repair DNA damage due to ultraviolet radiation.
A)True
B)False
Q4) Repressible operons are normally turned on in the cell.
A)True
B)False
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Chapter 9: Physical and Chemical Control of Microbes
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Q1) The RN utilizes an alcohol-based hand cleanser with friction rub when his hands are not visibly dirty.Which of the following terms appropriately describes the type of antimicrobial control provided by alcohol-based hand cleansers?
A)Sterilization
B)Disinfection
C)Decontamination
D)Antisepsis
Q2) The alcohol wipe before an injection is an example of ________.
A)antisepsis
B)disinfection
C)sterilization
D)decontamination
E)virilization
Q3) When a control agent targets the metabolic processes of microbial cells,active younger cells typically die more rapidly than older cells.
A)True
B)False
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11
Chapter 10: Antimicrobial Treatment
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Q1) The Kirby-Bauer test uses an agar surface,seeded with the test bacterium,to which small discs containing a specific concentration of several drugs are placed on the surface.
A)True
B)False
Q2) A ratio of the dose of a drug that is toxic to humans versus the minimum effective dose for that pathogen is assessed to predict the potential for toxic drug reactions.This is called the ________.
A)Kirby-Bauer
B)antibiogram
C)E-test
D)MIC
E)therapeutic index (TI)
Q3) An example of an antibacterial drug with high selective toxicity would be one that
A)targets the synthesis of the bacterial cell wall
B)targets the permeability of the cell membrane
C)targets DNA replication
D)targets RNA transcription
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Page 12
Chapter 11: Interactions Between Microbes and Humans
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Q1) The term infection refers to
A)microorganisms colonizing the body.
B)contact with microorganisms.
C)contact with pathogens.
D)pathogens penetrating host defenses.
E)None of the choices are correct.
Q2) The virus that causes rabies,and the rhinovirus that causes the common cold are both considered true pathogens; the degree of pathogenicity is determined by their
A)virulence
B)protein coat
C)envelope
D)infectivity
Q3) Animals that participate in the life cycles of pathogens and transmit pathogens from host to host are ________.
A)fomites
B)aerosols
C)mechanical vectors
D)droplet nuclei
E)biological vectors
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Chapter 12: Host Defenses I: Overview and Nonspecific Defenses
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Q1) Which of the following fluid compartments is not a partner in immune function?
A)Bloodstream
B)Extracellular fluid
C)Lymphatic system
D)Intracellular fluid
Q2) The term ________ is given to any foreign substance that stimulates a specific immune system response.
A)antibody
B)allergen
C)antigen
D)foreign body
E)None of the choices are correct.
Q3) Overuse of disinfectants and antiseptics,as well as antibiotics,can result in inflammatory diseases stemming from an inadequate microbiome.
A)True
B)False
Q4) Certain complement components stimulate inflammation and phagocytosis.
A)True
B)False
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Chapter 13: Host Defenses II: Specific Immunity and Immunization
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Q1) Immunotherapy is the ________.
A)use of antitoxins
B)use of immune serum globulin
C)conferring of passive immunity
D)administering of preformed antibodies
E)All of the choices are correct.
Q2) Antibodies directed to alloantigen from one organism often cross-react with an alloantigen from another organism.
A)True
B)False
Q3) High titers of specific antibodies are components of ________.
A)specific immune globulin (SIG)
B)gamma globulin
C)immune serum globulin (ISG)
D)attenuated vaccines
E)toxoids
Q4) After secreting antibodies during an immune response,plasma cells then differentiate into memory cells.
A)True
B)False
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Chapter 14: Disorders in Immunity
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Q1) The patient's clinical status and lab values will be closely monitored for two weeks following his transplant.If he experiences graft rejection,what type of cells will be primarily responsible?
A)T memory cells
B)Natural killer cells
C)T cytotoxic cells
D)T helper cells
Q2) What could result when grafted tissue such as bone marrow contains passenger lymphocytes?
A)Host rejection of graft
B)Graft versus host disease
C)Formation of autoantibodies
D)Hypogammaglobulinemia
E)None of the choices are correct.
Q3) Systemic anaphylaxis can quickly result in airway blockage,shock,and death.
A)True
B)False
Q4) Food allergies include gastrointestinal symptoms and often hives.
A)True
B)False
Page 16
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Chapter 15: Diagnosing Infections
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Sample Questions
Q1) Animals are required for the cultivation of ________.
A)Treponema pallidum
B)Pseudomonas
C)Streptococcus
D)Salmonella
E)Clostridium
Q2) Which test is the confirming test for people who initially tested antibody-positive in the screening ELISA test for HIV?
A)Immunochromatography
B)Western blot
C)Immunelectrophoresis
D)Radioimmunoassay (RIA)
E)Weil-Felix
Q3) Serological testing always involves reactions between specific antibody and antigen.
A)True
B)False
Q4) The Weil-Felix test is used for diagnosing salmonellosis.
A)True
B)False
Page 17
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Chapter 16: Infectious Diseases Affecting the Skin and Eyes
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Q1) This febrile disease with a rash has a pathogen that can cross the placenta and cause serious fetal damage.
A)Croup
B)Mumps
C)Influenza
D)Measles (rubeola)
E)Rubella
Q2) Which of the following is not true of bacterial conjunctivitis?
A)Transmitted through both direct and indirect contact
B)Can be caused by Streptococcus pyogenes or Streptococcus pneumoniae
C)Treatment is with a broad-spectrum topical antibiotic
D)Has a clear discharge
E)Can be caused by Staphylococcus aureus,Haemophilus influenzae,or Neisseria gonorrhoeae
Q3) Based upon the patient's symptoms,the most likely diagnosis is ________.
A)smallpox
B)chickenpox
C)shingles
D)measles
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Chapter 17: Infectious Diseases Affecting the Nervous System
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Q1) Which of the following is a sign of meningitis?
A)Headache
B)Stiff neck
C)White blood cells in cerebrospinal fluid
D)Fever
E)All of the choices are correct.
Q2) The concept of "immunologically privileged" explains why the CNS ________.
A)has a greater immune response than the rest of the body
B)has a reduced immune response compared to the rest of the body
C)has a completely different set of immune responses
D)has more MHC markers than other tissues
E)All of the choices are correct.
Q3) Serological testing on the patient's cerebral spinal fluid confirms a diagnosis of polio.What is the best treatment modality?
A)Antibiotics and fever control
B)Acyclovir and pain control
C)Immunization and respiratory support
D)Pain control and respiratory support
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Chapter 18: Infectious Diseases Affecting the
Cardiovascular and Lymphatic Systems
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Q1) Malaria may be prevented by ________.
A)using bed nets sprayed with insecticide
B)eliminating standing water
C)taking prophylactic drugs
D)decreasing the mosquito population
E)All of the choices are correct.
Q2) Which of the following is a hemorrhagic fever?
A)Yellow fever
B)Ehrlichiosis
C)Q fever
D)Rocky Mountain spotted fever
E)None of the choices are correct.
Q3) The common causative agent of acute endocarditis is ________.
A)Staphylococcus aureus
B)Streptococcus pneumoniae
C)Streptococcus pyogenes
D)Neisseria gonorrhoeae
E)All of the choices are correct.
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Chapter 19: Infectious Diseases Affecting the Respiratory Systems
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Q1) The bright red rash and fever of scarlet fever are due to ________.
A)enterotoxins
B)hemolysins
C)toxic shock syndrome toxin
D)exfoliative toxin
E)erythrogenic toxin
Q2) Which of the following is not true of Streptococcus pyogenes?
A)Group A streptococcus
B)Gram positive
C)Forms spores
D)Sensitive to bacitracin
E)Beta hemolytic
Q3) Formation of a pseudomembrane in the back of the throat is seen in ________.
A)diphtheria
B)pharyngitis
C)tuberculosis
D)pertussis
E)SARS
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Chapter 20: Infectious Diseases Affecting the
Gastrointestinal Tract
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Q1) Which of the following is incorrect regarding the microbiome of the stomach?
A)The high acid content of the stomach prevents any microbes from colonizing the organ.
B)Researchers for the Human Microbiome Project revealed the molecular signatures of over 100 microbial species in the stomach.
C)Microbes including Staphylococcus,Clostridium and Bacillus are known to be part of the stomach microbiome.
D)Helicobacter pylori,the organism known to cause stomach ulcers and cancer,is a known member of our stomach microbiome.
Q2) All of the following are components of the digestive tract except the ________.
A)kidneys
B)large intestine
C)mouth
D)esophagus
E)rectum
Q3) The only body fluid that can transmit hepatitis B virus is blood.
A)True
B)False
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Chapter 21: Infectious Diseases Affecting the Genitourinary System
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Q1) Which of the following is not a defense of the genitourinary tract?
A)Flushing action of urine
B)Lysozyme
C)IgA
D)IgG
E)Mucus secretions
Q2) Which of the following are characteristics that can be utilized to distinguish between vaginitis and vaginosis?
A)Causative agent
B)Presence of vaginal inflammation
C)Presence of discharge
D)All of the choices are correct.
Q3) Which of the following is not true of prostatitis?
A)Caused by GI tract biota
B)Can be chronic or acute
C)The specific agent is easy to determine
D)Patients may be very ill with the acute form
E)Accompanied by pain and frequent,difficult urination
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Chapter 22: One Health: the Interconnected Health of the Environment, humans,
and Other Animals
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Q1) In which step of water purification does water move through sand beds and activated charcoal?
A)Chlorination
B)Aeration and settling
C)Sedimentation
D)Storage
E)Filtration
Q2) Use of a trickling filter that sprays wastewater over rocks coated with biofilms which aerobically degrade organic matter is an example of the ________.
A)primary phase of wastewater treatment
B)secondary phase of wastewater treatment
C)tertiary phase of wastewater treatment
Q3) Backyard composting in either a pile or a bin is generally an ________ process.
A)aerobic
B)anaerobic
Q4) Coliforms,used as indicator bacteria,are gram-negative bacteria that ferment lactose and produce gas.
A)True
B)False
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