Diagnostic Microbiology
Exam Answer Key
Course Introduction
Diagnostic Microbiology explores the principles and methods used to identify, isolate, and characterize microorganisms relevant to human health. The course covers specimen collection, laboratory techniques such as staining, culturing, and molecular diagnostics, and the interpretation of results for the diagnosis of bacterial, viral, fungal, and parasitic infections. Emphasis is placed on the application of these techniques in clinical and public health settings, understanding antimicrobial susceptibility testing, and the role of diagnostic microbiology in disease control and prevention.
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) Colonial morphology, color, and smell would belong to a microorganism's group of A)genotypic characteristics.
B)taxonomic characteristics.
C)phenotypic characteristics.
D)subspecies characteristics.
Answer: C
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
Q3) Choose the binomial name that is correctly written.
A)Escherichia coli
B)Escherichia coli.
C)Escherichia coli..
D)Escherichia Coli
Answer: A
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Chapter 2: Bacterial Genetics Metabolism and Structure
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Q1) In gene regulation and control, repression is defined as
A)an internal change in the original nucleotide sequence of a gene or genes within an organism's genome.
B)the mechanism in which genes are induced only when the substrate to be degraded by enzymatic action is present.
C)the change of the bacterial genotypes through the exchange of DNA from one cell to another.
D)the mechanism of genetic control in which genes are not transcribed and therefore are not expressed in the presence of those target products in sufficient supply.
Answer: D
Q2) The mechanism of genetic control in which genes are induced only when the substrate to be degraded by enzymatic action is present is called A)repression.
B)mutation.
C)transduction.
D)induction.
Answer: D
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Chapter 3: Host-Microorganism Interactions
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Q1) The antibody that is secreted in various body fluids and primarily protects those body surfaces lined with mucous membranes is A)IgG.
B)IgA.
C)IgM.
D)IgE.
Answer: B
Q2) Cells that ingest and destroy bacteria and other foreign particles are called A)phagocytes.
B)polymorphonuclear leukocytes.
C)neutrophils.
D)macrophages.
E)All of the above are correct.
Answer: E
Q3) Which immune system cells destroy infected or malignant host cells?
A)B lymphocytes
B)T lymphocytes
C)Natural killer cells
D)Neutrophils
Answer: C
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Chapter 4: Laboratory Safety
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Q1) Biosafety Level 2 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.
Q2) Class III biological safety cabinets
A)sterilize the air within the cabinet as it passes over the material in the cabinet.
B)protect the environment from contamination by biologic agents by filtering the air as it is exhausted from the cabinet.
C)are enclosed completely and have gloves that enable the worker to manipulate the material in the cabinet.
D)are often called laminar flow hoods.
E)All of the above are correct.
Q3) 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.
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Chapter 5: Specimen Management
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Q1) Rejection of inappropriately collected or transported specimens
A)is the sole responsibility of the laboratory and should be done without regard to physician requests.
B)should be initiated by laboratory personnel but approved by nursing or physician staff responsible for the care of the patient.
C)is not in the best interest of patient care and should not be considered appropriate.
D)is the responsibility of nursing staff and should not be an issue for laboratory personnel.
Q2) The best anticoagulant that can be used to prevent clotting of specimens such as blood, bone marrow, and synovial fluid that are submitted for recovery of all types of microorganisms is
A)sodium polyanethol sulfonate (SPS).
B)heparin.
C)citrate.
D)EDTA (ethylenediaminetetraacetic acid).
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Chapter 6: Role of Microscopy
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Q1) The first step in the Gram stain is the application of the primary stain A)safranin.
B)crystal violet.
C)Gram's iodine.
D)Gram's decolorizer.
Q2) The second step in the Gram stain is the application of the A)safranin.
B)crystal violet.
C)Gram's iodine.
D)Gram's decolorizer
Q3) The third step in the Gram stain is the application of the A)safranin.
B)crystal violet.
C)Gram's iodine.
D)Gram's decolorizer.
Q4) 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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Chapter 7: Traditional Cultivation and Identification
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Q1) Which type of media is designed to distinguish microorganisms on the basis of certain growth characteristics?
A)Selective
B)Nutritive
C)Differential
D)Definitive
Q2) A differential medium is designed especially to
A)support the growth of a wide range of microorganisms.
B)distinguish microorganisms on the basis of certain growth characteristics.
C)support the growth of one group of organisms, but not another, by containing antimicrobials, dyes, or alcohol.
D)enhance the growth of pathogens and discourage the growth of commensals.
Q3) A supportive medium is designed especially to
A)support the growth of a wide range of microorganisms.
B)distinguish microorganisms on the basis of certain growth characteristics.
C)support the growth of one group of organisms, but not another, by containing antimicrobials, dyes, or alcohol.
D)enhance the growth of pathogens and discourage the growth of commensals.
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Chapter 8: Nucleic Acid-Based Analytic Methods for
Microbial Identification and
Characterization
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Q1) The target 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) 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.
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) 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.
Q2) The difference between latex agglutination and coagglutination is
A)the type of particle used to carry the antibody.
B)the type of target organism involved.
C)that coagglutination is less specific but more sensitive.
D)coagglutination can be used for direct antigen detection but not latex agglutination.
Q3) The 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.
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Chapter 10: Serologic Diagnosis of Infectious Diseases
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Q1) A method that uses an electrical current to speed up migration of an antigen and antibody is referred to as A)double immunodiffusion.
B)counterimmunoelectrophoresis.
C)particle agglutination.
D)enzyme immunoassay.
Q2) The antibody that is predominantly found in tears, saliva, and intestinal secretions is A)IgG.
B)IgA.
C)IgM.
D)IgE.
Q3) Antibody-mediated immune responses produced by specific proteins are generated by
A)lymphocytes of the T (thymus-derived) class.
B)lymphocytes of the B (bone marrow-derived) class.
C)neutrophils.
D)basophils.
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Chapter 11: Principles of Antimicrobial Action Resistance
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Q1) Vancomycin
A)Cell wall synthesis inhibition
B)Cell membrane function inhibition
C)Protein synthesis inhibition
D)DNA and RNA synthesis inhibition
Q2) Bacterial resistance to beta-lactams may be mediated by
A)enzymatic destruction of the antibiotics.
B)altered antibiotic targets.
C)decreased intracellular uptake of the drug.
D)All of the above are correct.
Q3) Polymyxin B
A)Cell wall synthesis inhibition
B)Cell membrane function inhibition
C)Protein synthesis inhibition
D)DNA and RNA synthesis inhibition
Q4) Tetracycline
A)Cell wall synthesis inhibition
B)Cell membrane function inhibition
C)Protein synthesis inhibition
D)DNA and RNA synthesis inhibition
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Chapter 12: Laboratory Methods and Strategies for
Antimicrobial Susceptibility Testing
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Q1) The decision to perform susceptibility testing depends on A)the clinical significance of a bacterial isolate.
B)the predictability of a bacterial isolate's susceptibility to the antimicrobial agents most commonly used against them.
C)availability of reliable standardized methods for testing the isolate.
D)All of the above are correct.
Q2) The difference between the serum bactericidal test and the minimum bactericidal concentration test is that
A)the medium used is patient's serum.
B)the source of the antibiotic used in testing is the patient's own serum that contains the therapeutic antimicrobial agent(s) that the patient has been receiving.
C)the antibacterial impact of factors other than the antibiotics also are observed.
D)All of the above are correct.
Q3) Enterococcal resistance to ampicillin predicts resistance to A)vancomycin.
B)aminoglycosides. C)cephalosporins. D)amikacin.
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Chapter 13: Staphylococcus, Micrococcus, and Similar Organisms
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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) Choose the group of bacteria that is described as catalase-positive, gram-positive cocci that grow facultatively anaerobic and that form grapelike clusters.
A)Neisseria
B)Rothia (stomatococci)
C)Staphylococcus
D)Micrococcus
Q3) 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.
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Chapter 14: Streptococcus, Enterococcus, and Similar Organisms
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Q1) 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.
Q2) Development of acute rheumatic fever and subsequent valvular heart disease are problems that may be encountered by patients infected with A)Enterococcus faecalis.
B)Streptococcus pneumoniae.
C)Streptococcus pyogenes.
D)Streptococcus agalactiae.
E)viridans streptococci.
Q3) CAMP factor is produced by
A)Enterococcus faecalis.
B)Streptococcus pneumoniae.
C)Streptococcus pyogenes.
D)Streptococcus agalactiae.
E)viridans streptococci.
Page 16
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Chapter 15: Bacillus and Similar Organisms
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Q1) Induction of capsule formation by B.anthracis can be accomplished with A)5% sheep blood agar.
B)PLET agar.
C)bicarbonate agar.
D)urea agar.
E)All of the above are correct.
Q2) 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 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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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) A catalase-positive, gram-positive bacillus that is not acid-fast, does not branch, and does not form spores could possibly belong to which group of bacteria?
A)Corynebacterium
B)Bacillus
C)Actinomyces
D)Mycobacterium
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) 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.
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) 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
Page 19
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Chapter 18: Nocardia, Streptomyces, Rhodococcus, Oerskovia,
and Similar Organisms
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Q1) The group of bacteria that can be described as being normal inhabitants of soil and water, and primarily responsible for the decomposition of plant material is
A)Rhodococcus.
B)Nocardia.
C)Gordonia.
D)Tsukamurella.
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) The organism that has been most commonly associated with human disease, particularly in immunocompromised patients, such as those infected with human immunodeficiency virus (HIV) is
A)Rhodococcus.
B)Gordonia.
C)Tsukamurella.
D)Streptomyces.
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Chapter 19: Enterobacteriaceae
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Q1) Choose the bacterial family that is best described as catalase-positive, oxidase-negative, gram-negative bacilli that are facultative anaerobes and most of which reduce nitrates to nitrites.
A)Enterobacteriaceae
B)Micrococcaceae
C)Pseudomonas
D)Haemophilus
Q2) The serotype O157:H7 of which of the following bacterial species is associated with a serious diarrheal illness with high mortality rates among some populations?
A)Escherichia coli
B)Shigella species
C)Salmonella species
D)Vibrio species
Q3) Acid slant, acid butt, no H S
A)Salmonella species
B)Escherichia coli
C)Proteus species
D)Pseudomonas species
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Chapter 20: Acinetobacter, Stenotrophomonas, and Other Organisms
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Q1) Of the following species, which are widely distributed in nature and hospital environments?
A)Pseudomonas luteola
B)Acinetobacter spp.
C)Pseudomonas oryzihabitans
D)Bordetella trematum
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) The disease referred to as melioidosis is caused by A)Pseudomonas aeruginosa.
B)Ralstonia pickettii.
C)Burkholderia mallei.
D)Burkholderia pseudomallei.
Q2) Of the species of Burkholderia, which is the one most commonly found in clinical specimens?
A)Burkholderia ralstonia
B)Burkholderia pseudomallei
C)Burkholderia mallei
D)Burkholderia cepacia
Q3) Which best describes the source of Burkholderia cepacia infections?
A)Plants, soil, and water
B)Medical devices medical solutions
C)Contaminated foods
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) 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 Paracoccus yeei.
A)Environmental only, not human flora
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
Q3) Choose the habitat of the bacterium Psychrobacter immobilis.
A)Environmental only, not human flora
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
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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Chapter
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Q1) Choose the habitat of the bacterium Sphingobacterium.
A)Environmental
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
Q2) 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.
Q3) Choose the habitat of the bacterium Empedobacter.
A)Environmental
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
Q4) Choose the habitat of the bacterium Agrobacterium.
A)Environmental
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
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Q1) The mode of transmission of Bordetella bronchiseptica can best be described as A)person to person contact.
B)exposure to contaminated water.
C)inhalation of contaminated air.
D)close contact with animals.
Q2) The mode of transmission of Achromobacter denitrificans can best be described as A)person to person contact.
B)exposure to contaminated water.
C)contaminated fluids or medical solutions.
D)close contact with animals.
Q3) Which statement best describes the habitats of Achromobacter, Alcaligenes, and Bordetella?
A)The habitats are limited to the upper respiratory tract of various mammals.
B)The habitats vary from the soil and water environment to the upper respiratory tract of various mammals.
C)The habitats are limited to the soil and water environment.
D)The habitats are limited to the mucous membranes of humans and animals.
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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) Aeromonas 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 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.
Q3) Transmission of and Chromobacterium violaceum to humans is by
A)exposure of disrupted skin and mucosal surfaces to contaminated animal hides.
B)ingestion of contaminated seafood or water.
C)inhalation of contaminated air.
D)close contact with carriers of the organism.
Page 27
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Chapter 26: Sphingomonas Paucimobilis and Similar Organisms
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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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Chapter 27: Moraxella
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Q1) 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.
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.
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Chapter 28: Eikenella Corrodens and Similar Organisms
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Q1) 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
Q2) Valid susceptibility testing methods are not available for
A)Enterobacteriaceae.
B)Pseudomonas.
C)Eikenella.
D)Staphylococcus.
Q3) 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.
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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) 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.
Q2) Actinobacillus actinomycetemcomitans can be distinguished from Capnocytophaga hominis by
A)its negative test for catalase.
B)its positive test for lactose fermentation.
C)its positive test for catalase.
D)its negative test for indole.
E)All of the above are correct.
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Chapter 31: Haemophilus
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Sample Questions
Q1) Growth of H.ducreyi in culture requires
A)incubation at 33° to 35° C.
B)high humidity.
C)increased CO .
D)special media.
E)All of the above are correct.
Q2) Of the following media, which provides the factors necessary for the growth of Haemophilus spp.?
A)5% sheep blood agar
B)Brain heart infusion agar
C)Chocolate agar
D)Nutrient agar
E)All of the above are correct.
Q3) Among H.influenzae strains, group designations (e.g., type b) are based on A)flagellar antigens.
B)capsular characteristics.
C)cell wall antigens.
D)infectious capabilities.
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33
Chapter 32: Bartonella and Afipia
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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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34
Chapter 33: Campylobacter, Arcobacter, and Helicobacter
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Q1) Curved, microaerophilic, gram-negative rods, with most species having strong urease activity and the majority of which colonize mammalian stomachs or intestines describes which group of bacteria?
A)Campylobacter
B)Helicobacter
C)Arcobacter
D)Enterobacte
Q2) 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.
Q3) Antimicrobial therapy for H.pylori infection consists of A)metronidazole.
B)bismuth.
C)tetracycline.
D)All of the above.
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Chapter 34: Legionella
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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) Organisms belonging to the genus Legionella are
A)gram-positive diplococci.
B)gram-positive diphtheroid bacilli.
C)gram-negative coccobacilli.
D)faintly staining, thin gram-negative bacilli.
Q3) 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) A nonmotile, urease- and nitrate-positive, strictly aerobic gram-negative coccobacillus is most likely A)Bordetella.
B)Moraxella.
C)Kingella.
D)Acinetobacter.
E)Brucella.
Q3) 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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Chapter 36: Bordetella Pertussis and Bordetella
Parapertussis
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Q1) Acceptable specimens for detection of Bordetella pertussis are A)throat swabs.
B)sputum.
C)nasopharyngeal aspirates.
D)anterior nose swab.
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) 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.
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Chapter 37: Francisella
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Sample Questions
Q1) Tularemia, characterized by glandular, ulceroglandular, oculoglandular, oropharyngeal, systemic, and pneumonic presentations is caused by A)Brucella species.
B)Bordetella species.
C)Pasteurella species.
D)Francisella species.
Q2) 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.
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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Page 39
Chapter 38: Streptobacillus Moniliformis and Spirillum
Minus
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Q1) 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.
Q2) 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.
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Chapter 39: Neisseria and Moraxella Catarrhalis
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Q1) Collection and handling of specimens for the detection of Neisseria gonorrhoeae should optimally include
A)charcoal-treated nontoxic swabs.
B)immediate inoculation to appropriate medium.
C)carbon dioxide-enriched atmosphere.
D)All of the above are correct.
Q2) Using charcoal-treated nontoxic swabs and immediate inoculation to appropriate medium and a carbon dioxide-enriched atmosphere describe specimen collection and handling requirements for which organism?
A)Moraxella catarrhalis
B)Neisseria meningitidis
C)Neisseria gonorrhoeae
D)All of the above are correct.
Q3) Neisseria gonorrhoeae can be described as A)oxidase positive.
B)a glucose utilizer.
C)a major cause of venereal disease.
D)a producer of penicillin-inactivating beta-lactamase enzyme.
E)All of the above are true.
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Page 41
Chapter 40: Overview and General Considerations
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Q1) 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.
Q2) Feces in a sterile specimen cup
A)Acceptable
B)Not acceptable
Q3) Pre-reduced, anaerobically sterilized (PRAS) media
A)are produced, packaged, shipped, and stored under anaerobic conditions.
B)have a short shelf life of only 2 weeks.
C)enable the culture to be incubated in the regular incubator under aerobic conditions.
D)All of the above are correct.
Q4) Nasopharyngeal swab
A)Acceptable
B)Not acceptable
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Chapter 41: Laboratory Considerations
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Q1) Fecal cultures for isolation of Clostridium difficile are plated on
A)anaerobic blood agar.
B)laked kanamycin-vancomycin blood agar.
C)aerobic 5% sheep blood agar.
D)cycloserine cefoxitin fructose agar.
E)All of the above are correct.
Q2) In a clinical specimen, sulfur granules strongly indicate the presence of which anaerobe?
A)Actinomyces spp.
B)Propionibacterium spp.
C)Eubacterium nodatum
D)All of the above are correct.
Q3) The media used for isolating the anaerobic agent of bacteremia may include A)thioglycollate.
B)Schaedler's broth.
C)thiol broth.
D)None of the above are correct.
E)All of the above are correct.
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43
Chapter 42: Mycobacteria
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Sample Questions
Q1) Large numbers of a poorly stained, beaded, gram-positive bacilli in a sputum specimen might be which bacterium?
A)Klebsiella pneumoniae
B)Mycobacterium spp.
C)Streptococcus pneumonia
D)Actinomyces spp.
Q2) Specimens for Mycobacterium studies that require concentration, decontamination, or liquefaction include
A)CSF and other body fluids.
B)sputum.
C)urine.
D)swabs and wound aspirates.
E)All of the above are correct.
Q3) A positive tuberculin skin test, or PPD test, is characterized by A)erythema and induration.
B)redness and rash.
C)swelling and erythema.
D)edema and rash.
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44
Chapter 43: Obligate Intracellular and Nonculturable Bacterial Agents
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Q1) The organisms in the genus Chlamydia can be described as
A)having a replicative form called the reticulate body.
B)having an intracellular infective form called the elementary body.
C)having an extracellular, metabolically inert, infective form.
D)All of the above are true.
Q2) The intracellular growth, or replicative form, of the Chlamydia is called the A)reticulate body.
B)elementary body.
C)replicate body.
D)initial body.
Q3) Of the following organisms, which has a unique developmental life cycle including a replicative form, the reticulate body, and an extracellular, metabolically inert, infective form, the elementary body?
A)Rickettsia
B)Chlamydia
C)Ehrlichia
D)Coxiella
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Page 45
Chapter 44: Cell Wall-Deficient Bacteria: Mycoplasma and Ureaplasma
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Q1) Definitive identification of Mycoplasma pneumoniae is accomplished by which technique?
A)Hemadsorption of guinea pig erythrocytes
B)Traditional biochemical tests such as indole and oxidase
C)Direct detection methods such as PCR or ELISA
D)All of the above are correct.
Q2) 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.
Q3) Which of the following agents lacks a cell wall and is the smallest known free-living form?
A)Chlamydia
B)Mycoplasma
C)Rickettsia
D)Coxiella
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Chapter 45: The Spirochetes
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Q1) The most common vector-borne disease in North America and Europe transmitted by the bite of Ixodes ticks is caused by
A)Leptospira interrogans.
B)Borrelia burgdorferi.
C)Treponema carateum.
D)Rickettsia rickettsii.
Q2) Compared to other spirochetes, Treponema can be described as
A)long, more slender, with hooked ends.
B)somewhat thicker with fewer and looser coils.
C)long, more slender, with tight coils.
D)somewhat thicker than treponemes with fewer and looser coils.
Q3) Nontreponemal antibodies are those that
A)are produced against antigens of the organisms themselves.
B)are those that are produced by infected patients against components of mammalian cells.
C)are those that are produced by the organism that cause the systemic destruction of the disease.
D)are also called reaginic antibodies.
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Chapter 46: Laboratory Methods for Diagnosis of Parasitic
Infections
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Sample Questions
Q1) The Schistosoma species with a prominent lateral spine is
A)Schistosoma japonicum.
B)Schistosoma haematobium.
C)Schistosoma mansoni.
D)Schistosoma westermani.
Q2) Naegleria fowleri
A)Feces
B)Blood smear
C)Vaginal secretions
D)CSF
E)Skin scraping
Q3) The concentration part of the O&P (ova and parasite) examination
A)requires freshly passed, unpreserved stool.
B)is designed to allow detection of protozoan cysts, coccidian oocysts, microsporidial spores, and helminth eggs and larvae.
C)is examined microscopically at low, high dry, and oil immersion magnifications.
D)is designed to facilitate identification of intestinal protozoa.
E)All of the above are correct.
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Chapter 47: Laboratory Methods in Basic Mycology
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Q1) Microconidia can be defined as
A)conidia that have divided into many smaller conidia.
B)large, usually multiseptate and club- or spindle-shaped spores.
C)large, elbow-shaped, rough-walled spores.
D)small, unicellular, round, elliptical, or pyriform.
Q2) Immunocompromised patients, particularly those who have uncontrolled diabetes mellitus and those who are receiving prolonged corticosteroid, antibiotic, or cytotoxic therapy, are at greatest risk of developing infection with A)dermatophytes.
B)Zygomycetes.
C)dimorphic fungi.
D)dematiaceous fungi.
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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Page 49
Chapter 48: Laboratory Methods in Basic Virology
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Sample Questions
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) 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.
Q3) Viral capsids are composed of many individual subunits called A)capsomeres.
B)virions.
C)capsules.
D)nucleocapsids.
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Chapter 49: Bloodstream Infections
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Q1) Extravascular bloodstream infections
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) The most common portal of entry for bacteremia is
A)the genitourinary tract.
B)the respiratory tract.
C)an abscess.
D)a surgical wound infection.
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Chapter 50: Infections of the Lower Respiratory Tract
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Q1) 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.
Q2) Respiratory syncytial virus is 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.
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) Most cases of pharyngitis occur during the colder months and are primarily caused by
A)Streptococcus pyogenes.
B)viruses.
C)Streptococcus pneumoniae.
D)Staphylococcus aureus.
Q2) Vincent's angina
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) Large, fluid-filled spaces within the brain are called A)the choroid plexus.
B)ventricles.
C)meninges.
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) A condition characterized by concomitant meningitis that occurs with encephalitis is called
A)meningoencephalitis.
B)aseptic meningitis.
C)encephalitis.
D)pleocytosis.
E)meningitis.
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Chapter 53: Infections of the Eyes, Ears, and Sinuses
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Sample Questions
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) Keratitis
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) The most frequent cause of uncomplicated community-acquired urinary tract infections is
A)Staphylococcus saprophyticus.
B)Klebsiella spp.
C)Escherichia coli.
D)Proteus.
Q2) The term acute urethral syndrome is used to describe a syndrome of symptoms that include
A)greater than 105 CFU/mL of urine, dysuria, and frequent urination.
B)dysuria, frequency, and urgency but that yields fewer organisms than 105 CFU/mL urine on culture.
C)fever and flank pain, dysuria, vomiting, diarrhea, chills, increased heart rate, and lower abdominal pain.
D)dysuria, frequency, and urgency along with tenderness and pain over the area of the bladder.
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Chapter 55: Genital Tract Infections
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Q1) Infections that are acquired during sexual activity are referred to as
A)endogenous infections.
B)pyelonephritis
C)Exogenous infections.
D)Upper tract infections.
Q2) Vaginitis
A)Inflammation of the vaginal mucosa resulting in abnormal discharge and an offensive odor or itching
B)A polymicrobial type of vaginitis characterized by mild perivaginal irritation and a foul-smelling discharge
C)An infection of the uterus and its contents during pregnancy.
D)A mild to severe inflammation of the testicles that is generally acquired by blood-borne dissemination of viruses such as the mumps virus
Q3) Proper design of a urogenital swab designed expressly for collection of urethral discharge should include what feature?
A)Made of charcoal treated cotton or rayon
B)Made of antibiotic treated calcium alginate
C)Shaft made of wood and not flexible
D)All of the above are correct.
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Page 57
Chapter 56: Gastrointestinal Tract Infections
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Q1) GN 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
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) 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
Q2) The most reliable specimen for determining the etiology of ulcers and nodules are
A)from the base of the ulcer or nodule.
B)those collected following removal of overlying debris.
C)those collected by surgical biopsy of deep tissues.
D)those collected without contact with the superficial layers of the lesion.
E)All of the above are correct.
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Chapter
Marrow, and Solid Tissues
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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.
Page 60
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Chapter 59: Laboratory Physical Design, Management, and Organization
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Q1) The percentage of individuals who do not have the particular disease being tested and in whom negative test results are found is called A)accuracy.
B)precision.
C)sensitivity.
D)specificity.
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 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) 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) 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.
Q3) 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.
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Chapter 61: Infection Control
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Q1) 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.
Q2) 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.
Q3) A phenotypic technique that examines an organism's susceptibility to bacterial peptides (proteins) is called A)biotyping.
B)antibiograms.
C)serotyping.
D)bacteriocin typing.
E)bacteriophage typing.
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Chapter 62: Sentinel Laboratory Response to Bioterrorism
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Q1) The 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.
Q2) 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.
Q3) The act of using microorganisms to intentionally harm the civilian population is referred to as
A)biosecurity.
B)biocrime.
C)microterrorism.
D)bactiterrorism.
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