Infectious Disease Diagnostics
Exam Solutions
Course Introduction
This course provides a comprehensive overview of infectious disease diagnostics, emphasizing the principles and applications of various laboratory techniques used to detect and identify pathogenic microorganisms. Students will explore both traditional methods, such as culture and microscopy, and advanced molecular techniques, including PCR and next-generation sequencing. Topics include specimen collection and handling, diagnostic algorithm development, antimicrobial susceptibility testing, point-of-care diagnostics, and the interpretation of laboratory results in a clinical context. The course also discusses emerging infectious diseases, quality assurance in diagnostic laboratories, and the impact of diagnostic innovations on patient care and public health.
Recommended Textbook
Bailey Scotts Diagnostic Microbiology 13th Edition by Patricia Tille
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Chapter 1: Microbial Taxonomy
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Q1) Taxonomy can be described as a system that:
A) classifies, names, and identifies microorganisms in a consistent manner.
B) classifies microorganisms, based on their genetic makeup.
C) classifies microorganisms, based on their phenotypic makeup.
D) classifies microorganisms, based on their cellular and colonial traits.
Answer: A
Q2) An example of an organism's genotypic characteristic is its:
A) macroscopic morphologic structure.
B) microscopic morphologic structure.
C) nucleic acid composition.
D) antigenic properties.
Answer: C
Q3) Which binomial name 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) Teichoic acids, mycolic acids, peptidoglycan, and disaccharide-pentapeptide subunits are all building blocks of which bacterial structure?
A) Outer cell membrane
B) Flagella
C) Inner cell membrane
D) Cell wall
Answer: D
Q2) A pathway that generates ATP by substrate-level phosphorylation that does not require oxygen and produces various end products, including alcohols, acids, carbon dioxide, and hydrogen, is:
A) substrate-level phosphorylation.
B) fermentative metabolism.
C) oxidative phosphorylation.
D) aerobic respiration.
Answer: B
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Chapter 3: Host-Microorganism Interactions
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Q1) A human infection that results from a microorganism that primarily infects animal populations is referred to as a(n)_________ infection.
A) accidental
B) zoonotic
C) secondary
D) vector
Answer: B
Q2) IgM is the:
A) first antibody produced when an invading microorganism is initially encountered.
B) antibody that is associated with various parasitic infections.
C) antibody that is secreted in various body fluids and primarily protects those body surfaces lined with mucous membranes.
D) second antibody produced when an invading microorganism is initially encountered and the most abundant.
Answer: A
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Chapter 4: Laboratory Safety
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Q1) Information concerning a chemical product's health hazards, toxicity, and disposal procedures is:
A) found in the manufacturer's material safety data sheets (MSDS).
B) found on the product label.
C) proprietary information and only released at the manufacturer's discretion.
D) obtained through the manufacturer's technical support division; acquiring access to that information is the responsibility of the laboratory worker.
Q2) 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.
Q3) A cleaning solution used on the laboratory bench top to kill bacteria that are potentially harmful to humans would be called a(n):
A) surfactant.
B) disinfectant.
C) biocide.
D) antiseptic.
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Chapter 5: Specimen Management
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Q1) 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
Q2) Direct examinations such as the Gram stain serve what purpose?
A) To determine the organism's genetic makeup
B) To give the physician an early indication of what may be wrong with the patient
C) To determine the type of flora in the throat and stool specimens
D) To determine the organism's colonial morphologic features
Q3) Which type of media is designed to support the growth of one group of organisms, but not another, by containing antimicrobials, dyes, or alcohol?
A) Selective
B) Nutritive
C) Differential
D) Definitive
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Chapter 6: Role of Microscopy
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Q1) Contrast in microscopy is most commonly achieved by:
A) changing objectives for various specimens.
B) increasing the resolution or resolving power.
C) staining techniques.
D) adding a blue filter to the light path.
Q2) The most critical 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 fluorochrome stain used to study a fungus is:
A) calcofluor white.
B) acridine orange.
C) auramine.
D) immunofluorescence.
Q4) Magnifications in excess of 100,000 ´ are achieved by ________ microscopy?
A) bright-field
B) electron
C) dark-field
D) phase-contrast
Page 8
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Chapter 7: Traditional Cultivation and Identification
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Q1) Which of the following organisms grows best at 42º C?
A) Streptococcus pneumonia
B) Haemophilus influenza
C) Neisseria gonorrhoeae
D) Campylobacter jejuni
Q2) Which medium can be described as a nutritionally rich medium used to grow various microorganisms, either as a broth or as an agar, with or without added blood?
A) Chocolate
B) Colistin, nalidixic acid (CNA) blood
C) Brain-heart infusion (BHI)
D) Thioglycollate
Q3) A positive pyrrolidonyl arylamidase (PYR)test was observed on a species of Enterococcus.What color should be observed for this reaction?
A) Purple
B) Red
C) Green
D) Pink
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Chapter 8: Nucleic Acid-Based Analytic Methods for
Microbial Identification and Characterization
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Q1) The enzyme that has the ability to synthesize DNA from ribonucleic acid (RNA)is called:
A) DNA polymerase.
B) RNAse.
C) helicase.
D) reverse transcriptase.
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 deoxyribonucleic acid (DNA).
C) originating from an organism of known identity with a known sequence.
D) the enzyme needed to elongate the strand.
Q3) The enzyme that is commonly used for primer extensions in the PCR method works best at what temperature?
A) 25º C
B) 56º C
C) 72º C
D) 94º C
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Chapter 9: Immunochemical Methods Used for Organism
Detection
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Q1) Monoclonal antibodies are those that:
A) react with many different types of antigens.
B) react with many species of bacteria within the same genus.
C) are produced by the offspring of a single hybrid cell.
D) can be produced from many different species of host organisms.
Q2) A positive latex agglutination test was observed in a sample containing Cryptococcus neoformans.The specimen of choice to identify this pathogen is:
A) urine.
B) blood.
C) stool.
D) cerebrospinal fluid (CSF).
Q3) A modification of the Ouchterlony method that speeds up the 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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Chapter 10: Serologic Diagnosis of Infectious Diseases
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Q1) The presence of which of the following antibodies usually indicates a recent or an active infection?
A) Immunoglobulin (Ig) G
B) IgA
C) IgM
D) IgE
Q2) For an accurate diagnostic of a current infection, acute and convalescent sera should reflect a(n)_____ in the patient's antibody titer of _____ doubling dilutions.
A) decrease; two
B) increase; two
C) decrease; four
D) increase; four
Q3) Antibody-mediated immune responses produced by specific proteins are generated by:
A) lymphocytes of the T class.
B) lymphocytes of the B class.
C) neutrophils.
D) basophils.
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Chapter 11: Principles of Antimicrobial Action and Resistance
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Q1) Rifampin
A)Cell wall synthesis inhibition
B)Cell membrane function inhibition
C)Protein synthesis inhibition
D)DNA and ribonucleic acid (RNA) synthesis inhibition
Q2) Polymyxin B
A)Cell wall synthesis inhibition
B)Cell membrane function inhibition
C)Protein synthesis inhibition
D)DNA and ribonucleic acid (RNA) synthesis inhibition
Q3) Antimicrobial agents that inhibit bacterial growth but generally do not kill the organism are known as:
A) bactericidal.
B) antibiotic.
C) bacteriostatic.
D) antagonistic.
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Chapter 12: Laboratory Methods and Strategies for
Antimicrobial Susceptibility Testing
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Q1) Enterococcal resistance to ampicillin predicts resistance to: A) vancomycin.
B) aminoglycoside.
C) cephalosporin.
D) amikacin.
Q2) Bactericidal tests should be performed:
A) for every clinically significant organism isolated from a clinical specimen.
B) to evaluate antimicrobial agents usually considered to be bacteriostatic.
C) for severe and life-threatening infections.
D) on all gram-positive and gram-negative organisms, whether or not they are clinically significant.
Q3) An important requirement for appropriate inoculum preparation in susceptibility testing includes the use of a(n):
A) pure culture.
B) inoculum that matches the severity of the infection.
C) single isolated colony.
D) variety of colony types.
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Chapter 13: Staphylococcus Micrococcus and Similar Organisms
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Q1) Which organism is catalase positive, coagulase negative, pyrrolidonyl arylamidase (PYR)positive, susceptible to novobiocin, urease negative, and beta hemolytic on sheep blood agar?
A) Staphylococcus epidermidis
B) S. saprophyticus
C) S. cohnii
D) S. haemolyticus
Q2) In clinical isolates, the most likely identification of coagulase-positive, catalase-positive, gram-positive cocci that are penicillin resistant would be:
A) Staphylococcus aureus.
B) Staphylococcus intermedius.
C) Stomatococcus luteus.
D) Micrococcus aureus.
Q3) The slide coagulase test is a rapid screening test for the production of:
A) clumping factor.
B) free coagulase.
C) extracellular coagulase.
D) catalase.
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Chapter 14: Streptococcus Enterococcus and Similar Organisms
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Q1) The CAMP factor is produced by:
A) Enterococcus faecalis.
B) Streptococcus pneumoniae.
C) S. pyogenes.
D) S. agalactiae.
Q2) The development of glomerulonephritis is a problem that may be encountered by patients infected with:
A) Enterococcus faecalis.
B) Streptococcus pneumoniae.
C) S. pyogenes.
D) S. agalactiae.
Q3) Streptococcus pneumoniae can be described as:
A) resistant to bile and optochin.
B) beta-hemolytic.
C) catalase-positive.
D) often carrying an antiphagocytic capsule.
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Chapter 15: Bacillus and Similar Organisms
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Q1) Suspect spore-forming, gram-positive Bacillus species that is nonhemolytic, nonmotile, and penicillin-susceptible and that produces a wide zone of lecithinase on egg yolk agar can be identified as:
A) Corynebacterium diphtheria.
B) Bacillus anthracis.
C) Bacillus cereus.
D) Corynebacterium jeikeium.
Q2) Which of the following types of anthrax occurs after ingesting the spores and affects the abdominal or oropharyngeal area? (Patients usually die from toxemia and overwhelming sepsis.)
A) Cutaneous
B) Pulmonary
C) Gastrointestinal
D) Bubonic
Q3) Induction of capsule formation by B.anthracis can be accomplished with _____ agar.
A) 5% sheep blood
B) PLET acetate
C) bicarbonate
D) urea
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Chapter 16: Listeria Corynebacterium and Similar Organisms
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Q1) Quality control is set up on urea media.Which two organisms should be used to determine the validity of the media?
A) C. ulcerans and C. diphtheria (subsp. mitis)
B) C. diphtheria (subsp. gravis) and C. diphtheria (subsp. intermedius)
C) C. ulcerans and C. pseudotuberculosis
D) C. diphtheria (subsp. belfanti) and C. diphtheria (subsp. gravis)
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) Bacteria described as being coryneform have which of the following morphologic features?
A) Squared rods with squared ends arranged in pairs
B) Short gram-positive cocci in branching chains
C) Resemble and are often referred to as Chinese letters
D) Long branching gram-positive bacilli
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Chapter 17: Erysipelothrix Lactobacillus and Similar Organisms
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Q1) Which organism is nonhemolytic on 5% sheep blood agar but hemolytic on human blood?
A) Weissella confusa
B) Arcanobacterium haemolyticum
C) Lactobacillus spp.
D) Gardnerella vaginalis
Q2) A catalase-negative, non-spore-forming, nonbranching, gram-positive rod that produces hydrogen sulfide when inoculated into triple sugar iron (TSI)agar is most likely:
A) Corynebacterium.
B) Bacillus.
C) Actinomyces.
D) Erysipelothrix.
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
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Chapter 18: Nocardia Streptomyces Rhodococcus and Similar Organisms
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Q1) Which partially acid-fast, gram-positive, and branching filamentous bacteria appear dry and white to creamy to orange with rhizoid edges on routine agar and are urea-positive and resistant to lysozyme?
A) Tsukamurella
B) Gordonia
C) Actinomadura
D) Dermatophilus
Q2) 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.
Q3) Non-acid-fast aerobic actinomycetes include:
A) Nocardia.
B) Rhodococcus.
C) Streptomyces.
D) Gordona.
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Chapter 19: Enterobacteriaceae
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Q1) A green colony with a black center was isolated and presumptively identified as a Salmonella spp.The organism was serotyped with polyvalent antisera; however, the antisera tested negative for all antigens.What is the next course of action?
A) Regrow the organism on sheep blood agar, and serotype again the next day.
B) Make a suspension, and heat to 100º C for 10 minutes.
C) Make a suspension, and place on ice for 30 minutes.
D) Report the organism out as a nontypable Salmonella spp.
Q2) Which of correct for the description "acid slant, acid butt, no H S"?
A) Salmonella spp.
B) Escherichia coli
C) Proteus spp.
D) Pseudomonas spp.
Q3) An organism that appears red with a black center on XLD agar is lactose-_____ and H S-_____.
A) positive; positive
B) positive; negative
C) negative; positive
D) negative; negative
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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) Differentiation of Stenotrophomonas maltophilia and Burkholderia cepacia is best accomplished by:
A) the oxidase test.
B) maltose and glucose medium.
C) tyrosine-enriched heart infusion agar.
D) nitrate reduction.
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 a similar antibiotic.
B) a beta-lactam agent in combination with an aminoglycoside antibiotic.
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) Which best describes the source of Burkholderia cepacia infections?
A) Rice paddles
B) Medical devices
C) Oropharynx of animals
D) Rodents
Q2) The disease referred to as melioidosis is caused by which one of the following?
A) Pseudomonas aeruginosa
B) Ralstonia pickettii
C) Burkholderia mallei
D) Burkholderia pseudomallei
Q3) Not including organisms in the Enterobacteriaceae family, the second most common gram-negative bacilli encountered in clinical specimens are:
A) Pseudomonas.
B) Burkholderia.
C) Ralstonia.
D) Vibrio.
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Chapter 22: Rhizobium, Ochrobactrum, and Similar Organisms
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Q1) Although validated susceptibility testing methods do not exist for this group of organisms, in vitro data suggest that certain cephalosporins and aminoglycosides are effective against which one of the following groups of organisms?
A) Ochrobactrum anthropi
B) Shewanella putrefaciens
C) Paracoccus yeei
D) Rhizobium radiobacter
Q2) Which of the following organisms is oral and respiratory flora of animals and is transmitted by bites or scratches from dogs and cats?
A) Achromobacter group
B) Alcaligenes xylosoxidans
C) Paracoccus yeei
D) Centers for Disease Control and Prevention (CDC) group EF-4b
Q3) Which two organisms should be used to determine the validity of the nitrate reduction test?
A) Achromobacter and Alcaligenes
B) Psychrobacter and Rhizobium
C) CDC group Ic and CDC group O-3
D) CDC group OFBA-1c and Shewanella
Page 24
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Q1) The natural habitat of the bacterium Sphingobacterium is:
A) environment.
B) animal oral and respiratory flora.
C) environment, cold climates.
D) human normal flora.
Q2) Which organism's virulence is due to protease and gelatinase production, which causes the destruction of host cells and tissues?
A) Bergeyella zoohelcum
B) Elizabethkingia meningoseptica
C) Chryseobacterium indologenes
D) Agrobacterium spp.
Q3) On Gram stain, which organism appears thin in the center and thicker at the ends?
A) Agrobacterium yellow group
B) CDC groups EO-3 and EO-4
C) Elizabethkingia meningoseptica
D) Empedobacter brevis
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Chapter 24: Alcaligenes, Bordetella Nonpertussis,
Comamonas, and Similar Organisms
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Q1) The biochemical description of Bordetella 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 at 42° C.
D) nonmotile and both urea-positive and phenylalanine deaminase-positive.
Q2) Quality control is set up to determine the validity of cetrimide agar.Which two organisms should be used?
A) Bordetella bronchiseptica and Cupriavidus pauculus
B) Achromobacter denitrificans and Alcaligenes faecalis
C) Achromobacter piechaudii and Bordetella bronchiseptica
D) Centers for Disease Control and Prevention (CDC) Alcaligenes-like group 1 and Cupriavidus pauculus
Q3) Pertussis (whooping cough), an epidemic disease, is a highly contagious, acute infection of the upper respiratory tract caused by the _________ species.
A) Brucella
B) Bordetella
C) Pasteurella
D) Francisella
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Chapter 25: Vibrio, Aeromonas, Chromobacterium, and Related Organisms
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Q1) A vibriostatic test using 0/129 (2,4-diamino-6,7-diisopropylpteridine)-impregnated disks differentiates vibrio cells, which are susceptible, and _________, which are resistant.
A) Enterobacteriaceae
B) Plesiomonas spp.
C) aeromonads
D) Chromobacterium spp.
Q2) The selective medium, thiosulfate citrate bile salts sucrose (TCBS)agar, is especially formulated for isolating what pathogen from stool cultures?
A) Vibrio
B) Salmonella
C) Shigella
D) Plesiomonas
Q3) Which organism appears green on TCBS agar and is halophilic?
A) V. cholerae
B) V. harveyi
C) V. fluvialis
D) V. vulnificus
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Chapter 26: Sphingomonas Paucimobilis and Similar Organisms
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Q1) Oxidase-positive, glucose-positive, (oxidatively)gram-negative bacilli that cannot grow on MacConkey agar include:
A) Pseudomonas.
B) Vibrio.
C) Stenotrophomonas.
D) Sphingomonas.
Q2) Which of the following statements best describes the habitats of Acidovorax, Sphingobacterium, and Sphingomonas?
A) Habitats are limited to the upper respiratory tract of various mammals.
B) Habitats are unknown.
C) Habitats are limited to the soil and water environment.
D) Habitats are limited mostly to water sources.
Q3) A yellow-pigmented, gram-negative rod on blood agar that is oxidase-positive, motile by wet mount, and has the ability to oxidize glucose, xylose, and sucrose is most likely which of the following?
A) Treponema
B) Leptospira
C) Borrelia
D) Sphingomonas
Page 28
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Chapter 27: Moraxella and Related Organisms
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Q1) 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.
Q2) In Gram-stained preparations, Moraxella lacunata 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.
Q3) Testing for differentiation of Moraxella nonliquefaciens and M.osloensis can best be performed by:
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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Chapter 28: Eikenella and Similar Organisms
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Q1) Eikenella corrodens can be easily recognized in culture by its:
A) pink pigmentation.
B) grapelike odor.
C) large spreading colonial morphologic characteristic.
D) bleachlike odor.
Q2) Of the asaccharolytic, oxidase-positive bacilli that do not grow on MacConkey agar, which one of the following organisms 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
Q3) Which of the following organisms is negative for catalase, indole, and arginine dihydrolase tests and pits the agar on a sheep blood agar plate?
A) Eikenella corrodens
B) Weeksella virosa
C) Pseudomonas maltophilia
D) Sphingomonas paucimobilis
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Chapter 29: Pasteurella and Similar Organisms
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Q1) Quality control should be performed on which two organisms to determine the validity of the nitrate reduction test?
A) Pasteurella aerogenes and Pasteurella dagmatis
B) Mannheimia haemolytica and Pasteurella pneumotropica
C) Pasteurella multocida and Suttonella indologenes
D) Pasteurella canis and Pasteurella bettyae
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.
Q3) Which of the following bacterial species is part of animal flora and transmitted to humans during close animal contact, including bites?
A) Sphingomonas paucimobilis
B) Eikenella corrodens
C) Pasteurella multocida
D) Weeksella virosa
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Chapter 30: Actinobacillus, Aggregatibacter, Kingella,
Cardiobacterium, Capnocytophaga, and Similar Organisms
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Q1) Which antimicrobial regimen should be administered to a patient suspected of having endocarditis as a result of infection with Cardiobacterium hominis?
A) Chloramphenicol and tetracycline
B) Erythromycin and ciprofloxacin
C) Ampicillin and ceftriaxone
D) Penicillin, with or without an aminoglycoside agent
Q2) To test the validity of catalase reagent, which two organisms should be used?
A) Aggregatibacter actinomycetemcomitans and Kingella kingae
B) Cardiobacterium hominis and Aggregatibacter aphrophilus
C) Kingella denitrificans and Kingella kingae
D) Actinobacillus suis and Actinobacillus ureae
Q3) Which yellow-pigmented organism exhibits gliding motility that grows best at 35º C and in conditions with increased carbon dioxide (CO )but cannot grow in ambient air?
A) Actinobacillus
B) Capnocytophaga
C) Cardiobacterium
D) Kingella
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Chapter 31: Haemophilus
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Q1) In a phenomenon known as satelliting, tiny colonies of Haemophilus spp.may be observed growing on sheep blood agar close to colonies of bacteria that can produce:
A) hemin.
B) NAD.
C) vitamin K.
D) cystine.
Q2) 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.
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 (CO2).
D) enriched special media.
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33
Chapter 32: Bartonella and Afipia
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Q1) Trench fever, bacteremia, endocarditis, chronic lymphadenopathy, and bacillary angiomatosis can be caused by:
A) Afipia felis.
B) Bartonella quintana.
C) B. clarridgeiae.
D) B. henselae.
Q2) Although molecular methods are available, such as polymerase chain reaction (PCR)for identifying the Bartonella species, limitations exist.One limitation to testing is the specificity of:
A) probes.
B) polymerases.
C) primers.
D) restriction enzymes.
Q3) Of the clinically significant Bartonella species, which is transmitted via a fleabite with the reservoir being rats?
A) B. bacilliformis
B) B. henselae
C) B. elizabethae
D) B. clarridgeiae
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34
Chapter 33: Campylobacter, Arcobacter, and Helicobacter
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Q1) Antimicrobial therapy for Helicobacter pylori infection consists of:
A) penicillin, gentamycin, and imipenem.
B) clindamycin, ceftriazone, and carbapenem.
C) metronidazole, bismuth salt, and tetracycline.
D) azithromycin alone.
Q2) Curved, microaerophilic, gram-negative rods, with most species having strong urease activity and the majority of which colonize mammalian stomachs or intestines, describe which group of bacteria?
A) Campylobacter
B) Helicobacter
C) Arcobacter
D) Enterobacter
Q3) 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.
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35
Chapter 34: Legionella
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Q1) The medium or media of choice used to recover Legionella is:
A) buffered charcoal yeast extract (BCYE).
B) Regan-Lowe agar.
C) Löwenstein-Jensen medium.
D) blood and chocolate agars.
Q2) A direct immunofluorescent antibody (DFA)test was performed on a sputum sample that yielded a positive test.The organism grew on BCYE medium and was a thin gram-negative, faintly staining bacillus.What is the drug of choice for this organism?
A) Fluoroquinolones
B) Erythromycin
C) Penicillin
D) Aminoglycosides
Q3) To cultivate Legionella in the laboratory, a medium supplemented with what ingredient(s)is necessary?
A) L-cysteine and iron
B) Blood and cysteine
C) Dopa-cysteine
D) Nicotinic adenine
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Chapter 35: Brucella
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Q1) Individuals considered at greatest risk for contracting brucellosis are:
A) dairy farmers.
B) fishermen.
C) prison guards.
D) those working with exotic birds.
Q2) Facultative, intracellular parasitic bacteria are those that are able to:
A) be cultured with or without oxygen but in cell cultures only.
B) exist in both intracellular and extracellular environments.
C) be cultured only with oxygen and in cell cultures.
D) be cultured only inside living organisms such as mice.
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) The animal reservoir for Brucella melitensis is:
A) cattle.
B) sheep or goats.
C) swine.
D) dogs.
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Chapter 36: Bordetella Pertussis, Bordetella Parapertussis, and
Related Species
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Q1) Which of the following toxins contributes to the virulence of Bordetella pertussis and works by hemolyzing red cells and activating cyclic adenosine monophosphate, which inactivates several types of host immune cells?
A) Endotoxin
B) Pertussis toxin
C) Tracheal cytotoxin
D) Adenylate cyclase toxin
Q2) The mode of transmission of Bordetella pertussis can best be described as:
A) person-to-person contact.
B) exposure to contaminated water.
C) inhalation of contaminated air.
D) close contact with animals.
Q3) Pertussis (whooping cough)is an epidemic disease that is a highly contagious, acute infection of the upper respiratory tract caused by the:
A) Brucella spp.
B) Bordetella spp.
C) Pasteurella spp.
D) Francisella spp.
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Chapter 37: Francisella
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Q1) Which assay is available to identify Francisella tularensis serologically?
A) Complement fixation
B) Direct fluorescent antibody test
C) Immunodiffusion assays
D) Enzyme-linked immunosorbent assays (ELISAs)
Q2) Francisella 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.
Q3) The specimen of choice to collect in suspected cases of Francisella tularensis is: A) blood.
B) cerebrospinal fluid (CSF).
C) lymph nodes.
D) urine.
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Chapter 38: Streptobacillus Moniliformis and Spirillum
Minus
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Q1) Which of the following causes Sodoku, which is 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?
A) Streptobacillus moniliformis
B) Spirillum minus
C) Bordetella spp.
D) Pasteurella spp.
Q2) Which of the following cause rat-bite fever, or Haverhill fever, which is characterized by acute onset of chills, fever, headache, vomiting, and often severe joint pains, as well as a rash on the palms, soles of the feet, and other extremities?
A) Streptobacillus moniliformis
B) Brucella abortus
C) Bordetella spp.
D) Pasteurella spp.
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Chapter 39: Neisseria and Moraxella Catarrhalis
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Q1) Organisms belonging to the genus Neisseria are:
A) gram-positive diplococci.
B) gram-negative diplococci.
C) gram-negative coccobacilli.
D) gram-negative bacilli.
Q2) The JEMBEC transport system for Neisseria spp.provides an atmosphere with increased _________ to keep the organism viable during transport.
A) hydrogen (H2)
B) carbon dioxide (CO2)
C) nitrogen (N2)
D) nitrate (NO3)
Q3) MTM, Martin-Lewis (ML), and New York City (NYC)media were all developed for the selective isolation of which organism?
A) Moraxella catarrhalis
B) Neisseria meningitidis
C) N. gonorrhoeae
D) N. mucosa
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Chapter 40: Overview and General Considerations
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Q1) Egg-yolk agar
A)Isolates of Prevotella and Bacteroides spp.
B)Inhibits gram-negative rods
C)Is nonselective; supports the growth of facultative anaerobes and aerobes
D)Determines lecithinase and lipase production of Clostridia and Fusobacteria
E)Is selective for Clostridium difficile
Q2) Percutaneous lung aspirate is:
A) acceptable.
B) not acceptable.
Q3) Expectorated sputum is:
A) acceptable.
B) not acceptable.
Q4) Feces in a sterile specimen cup is:
A) acceptable.
B) not acceptable.
Q5) Tissue biopsy taken from a puncture wound is:
A) acceptable.
B) not acceptable.
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Chapter 41: Overview of Anaerobic Organisms
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Q1) The most likely identification of a bile-resistant, kanamycin-resistant, colistin-resistant, and vancomycin-resistant anaerobic gram-negative bacilli is:
A) nonpigmented Prevotella.
B) Porphyromonas spp.
C) Bacteroides fragilis group.
D) Fusobacterium spp.
Q2) The most likely identification of an anaerobic gram-negative bacilli that will fluoresce brick red or has a brown-to-black-pigment is:
A) nonpigmented Prevotella.
B) Porphyromonas spp.
C) Bacteroides fragilis group.
D) Fusobacterium spp.
Q3) The most likely identification of kanamycin-sensitive and anaerobic gram-negative bacilli that fluoresce a chartreuse color is:
A) Fusobacterium spp.
B) nonpigmented Prevotella.
C) Bacteroides ureolyticus.
D) Porphyromonas spp.
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43
Chapter 42: Mycobacteria
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Q1) The specimens of choice for detecting urinary tract mycobacterial disease are:
A) single clean-catch midstream urine samples.
B) 24-hour timed urine samples.
C) three daily clean-catch midstream urine samples.
D) biopsies of the suspected site.
Q2) Acid-fast smears should be examined carefully by scanning at least ________ oil immersion fields.
A) 100
B) 200
C) 300
D) 400
Q3) The recent emergence of epidemic multidrug-resistant strains of Mycobacterium tuberculosis, in conjunction with the end of the downward trend of reported cases of tuberculosis in the United States, has been largely attributed to:
A) human immunodeficiency virus (HIV) epidemic.
B) ineffective treatment regimens.
C) political factors.
D) shortened treatment regimens.
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Chapter 43: Obligate Intracellular and Non-culturable Bacterial Agents
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Q1) A Weil-Felix test was performed on serial dilutions from a patient bitten by a tick.The results obtained were positive for OX-19 and negative for OX-2 and OX-K.Based on these findings, the organism can be identified as:
A) Rickettsia rickettsii.
B) Orientia tsutsugamushi.
C) Rickettsia prowazekii.
D) Rickettsia typhi.
Q2) The most common sexually transmitted bacterial pathogen and a major cause of pelvic inflammatory disease (PID)is:
A) Rickettsia rickettsii.
B) Chlamydia trachomatis.
C) Klebsiella granulomatis.
D) Coxiella burnetii.
Q3) Which of the following vectors transmit scrub typhus?
A) Lice
B) Ticks
C) Fleas
D) Chiggers
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Chapter 44: Cell Walldeficient Bacteria: Mycoplasma and Ureaplasma
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Q1) Caution should be taken when culturing blood in suspected cases of Mycoplasma infections since the organism is inhibited by which anticoagulant commonly found in commercial blood culture media?
A) Ethylenediaminetetraacetic acid (EDTA)
B) Sodium polyanethol sulfonate (SPS)
C) Heparin
D) Sodium citrate
Q2) Incorporation of urea into media is used to enhance the detection of which organism?
A) Ureaplasma urealyticum
B) Mycoplasma pneumonia
C) M. hominis
D) M. genitalium
Q3) The natural habitat of Mycoplasma spp., which causes infectious disease in humans, can best be described as the:
A) mucous membranes of humans.
B) aquatic environment.
C) natural environment.
D) genitourinary tract of animals.
Page 46
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Chapter 45: The Spirochetes
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Q1) Treponemal antibodies are those that are:
A) produced against antigens of the organisms themselves.
B) produced by infected patients against components of mammalian cells.
C) produced by the organism that causes the systemic destruction of the disease.
D) also called reaginic antibodies.
Q2) The Centers for Disease Control and Prevention (CDC)recommendations for testing in suspected cases of Lyme disease are to screen with ______ and confirm with
A) RPR; FTA-ABS
B) enzyme-linked immunosorbent assay (ELISA); immunofluorescent antibody (IFA)
C) IFA; immunoblotting
D) ELISA; TP-PA
Q3) A patient has a reactive RPR result and a positive FTA-ABS test.The drug of choice to treat this infection is:
A) penicillin G.
B) tetracycline.
C) clindamycin.
D) erythromycin.
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Chapter 46: Laboratory Methods for Diagnosis of Parasitic
Infections: Overview
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Q1) Which of the following is currently the only fixative available that does not contain formalin, polyvinyl alcohol (PVA), or mercury?
A) Merthiolate-iodine-formalin (MIF)
B) Sodium acetate-acetic acid-formalin (SAF)
C) ECOFIX
D) TOTAL-FIX
Q2) A bone marrow aspirate is examined for the presence of parasites from a patient who has been traveling in Latin America for several months and who came in contact with a triatomid bug.Which parasite will most likely be identified?
A) Trypanosoma cruzi
B) Dientamoeba fragilis
C) Fasciola hepatica
D) Chilomastix mesnili
Q3) The specimen of choice to collect in suspected cases of Paragonimus infection is:
A) sputum.
B) blood.
C) urine.
D) stool.
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Chapter 47: Intestinal Protozoa
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Q1) A patient has amebic colitis.A microscopic examination reveals the following: 18 microns in diameter
Fine granules
Centrally located karyosome
Cytoplasm with a "ground glass" appearance
RBC inclusions
This protozoan can be identified as:
A) Entamoeba dispar.
B) E. histolytica.
C) E. hartmanni.
D) E. coli.
Q2) Highly active antiretroviral therapy (HAART)is the most effective prophylaxis and treatment in patients with acquired immunodeficiency syndrome (AIDS)with which type of infection?
A) Cyclospora
B) Sarcocystis
C) Cryptosporidium
D) Toxoplasma
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Page 49
Chapter 48: Blood and Tissue Protozoa
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Q1) In Trypanosoma brucei rhodesiense trypanosomiasis infections, CNS invasion occurs early.The disease progresses rapidly, and death may occur before extensive CNS involvement.Inflammation of which organ is more common and severe with this disease form?
A) Kidney
B) Lungs
C) Liver
D) Heart
Q2) The vector Glossina palpalis group transmits the Trypanosoma brucei gambiense organism.The diagnostic stage is the:
A) amastigote.
B) epimastigote.
C) trypomastigote.
D) promastigote.
Q3) P.ovale
A)Normal shape and size
B)Normal shape; size may be normal or slightly smaller
C)1.5 to 2.0 times larger than normal; oval to normal
D)60% of cells are larger than normal and oval
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Page 50
Chapter 49: Other Protozoa
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Q1) Tissues suspected of containing Acanthamoeba cysts can be observed using various stains.A cyst that stains black has most likely been stained with the __________ stain.
A) methenamine silver
B) periodic acid-Schiff (PAS)
C) Giemsa
D) Wright
Q2) Tachyzoites
A)Crescent-shaped
B)Oocysts from cat feces
C)Tissue cysts
Q3) Laboratory diagnosis of Trichomonas gondii is confirmed by:
A) Giemsa stain.
B) tissue culture.
C) serologic testing.
D) Western blot.
Q4) Sporozoites
A)Crescent-shaped
B)Oocysts from cat feces
C)Tissue cysts
Page 51
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Chapter 50: Intestinal Nematodes Roundworms
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Q1) Direct penetration of which of the following worms results in tissue damage at the site of attachment, blood loss, and an acute gastrointestinal phase demonstrated by an increased eosinophilia?
A) Whipworm
B) Pinworm
C) Threadworm
D) Hookworm
Q2) The infective larvae of the parasite Strongyloides stercoralis penetrate the skin and migrate through the circulatory system to the heart and lungs.The organism enters the bronchial tree and is then swallowed, entering the digestive tract, where the organism matures into an adult worm.This parasite is classified as which type of infection?
A) Pinworm
B) Threadworm
C) Whipworm
D) Hookworm
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Chapter 51: Tissue Nematodes Roundworms
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Q1) A definitive diagnosis can be made in a Trichinella infection on the basis of which of the following findings?
A) Presence of adult worms in the feces
B) Identification of encysted larvae through muscle biopsy
C) Presence of cutaneous larvae migrans in the skin
D) Identification of unembryonated eggs in the feces
Q2) Systemic involvement is rare in infection caused by Ancylostoma braziliense or A.caninum; however, pneumonitis may occur.The antihelminthic therapy used to treat this infection is:
A) ivermectin or thiabendazole.
B) metronidazole or thiabendazole.
C) mebendazole or ivermectin.
D) albendazole or diethylcarbamazine.
Q3) Snails
A)Dracunculus medinensis
B)Parastrongylus cantonensis
C)Trichinella spp.
D)Parastrongylus costaricensis
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Chapter 52: Blood and Tissue Filarialnematodes
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Q1) A 36-year-old man who has been traveling through the orient is experiencing a tender region in the inguinal region.A blood film is made, and sheathed microfilariae with four to five subterminal nuclei and two terminal nuclei in the tail are identified using Giemsa stain.The organism is most likely:
A) Wuchereria bancrofti.
B) Onchocerca volvulus.
C) Loa loa.
D) Brugia malayi.
Q2) A Giemsa stain is performed on an eye exudate on a patient with calabar swelling, eosinophilia, and a recent travel history to Africa.Loa loa is suspected; however, the sheath in the adult worm recovered does not stain.Which one of the following statements explains this discrepancy?
A) The worm recovered is not Loa loa.
B) The specimen should have been stained with trichrome stain.
C) The Giemsa stain is most likely expired.
D) No discrepancy is present. The sheath does not stain with Giemsa stain.
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Chapter 53: Intestinal Cestodes
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Q1) The mode of infection for which of the following organisms is the ingestion of cysticercoid in an infected arthropod or by the direct ingestion of the egg? Autoinfection may also occur.
A) Diphyllobothrium latum
B) Hymenolepis nana
C) Taenia saginata
D) Taenia solium
Q2) The Taenia solium organism, which causes cysticercosis and can grow to be 1.5 to 8 meters long, contains 7 to 13 lateral uterine branches along the proglottid.The intermediate host is:
A) dogs.
B) cats.
C) pigs.
D) cattle.
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Chapter 54: Tissue Cestodes
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Q1) Hydatid disease is associated with which tapeworm?
A) Taenia solium
B) Echinococcus granulosus
C) Spirometra mansonoides
D) Echinococcus multilocularis
Q2) Epileptic seizures, headaches, and mental disturbances all result from infection with the Taenia solium organism.The definitive diagnosis is based on:
A) positive direct fluorescent antibody test.
B) observance of eggs in the stool.
C) positive India ink stain.
D) identification of cysts in tissue.
Q3) In Echinococcus granulosus infections, the hydatid cysts usually occur in which organ?
A) Stomach
B) Brain
C) Intestines
D) Liver
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Chapter 55: Intestinal Trematodes
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Q1) The life-cycle stages of the intestinal trematodes after the eggs are shed from the body via feces is best described as:
A) cercariae, miracidium larva, metacercariae, and redia.
B) redia, metacercariae, cercariae, and miracidium larva.
C) miracidium larva, redia, cercariae, and metacercariae.
D) metacercariae, miracidium larva, cercariae, and redia.
Q2) The adult form of the fluke, Fasciolopsis buski, is elongated in shape and ranges from 20 to 75 mm long and 8 to 20 mm wide with an oral sucker at the anterior and a ventral sucker approximately midway to the posterior.The reservoir host for the fluke is:
A) snails.
B) birds.
C) rodents.
D) dogs.
Q3) The intermediate host of the Platyhelminthes is freshwater: A) fish.
B) snails.
C) crabs.
D) crayfish.
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Chapter 56: Liver and Lung Trematodes
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Q1) Chinese liver fluke
A)Opisthorchis viverrini
B)Fasciola spp.
C)Clonorchis (Opisthorchis) sinensis
D)Paragonimus westermani
Q2) Sheep liver fluke
A)Opisthorchis viverrini
B)Fasciola spp.
C)Clonorchis (Opisthorchis) sinensis
D)Paragonimus westermani
Q3) The adult worm of Fasciola measures 2 to 5 cm by 0.8 to 1.3 cm with a cephalic cone at the anterior end that contains the oral sucker.The drug of choice to treat Fasciola infections is:
A) praziquantel.
B) bithionol.
C) albendazole.
D) benzimidazole.
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Chapter 57: Blood Trematodes
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Q1) A large lateral spine is characteristic of which Schistosoma egg?
A) S. mansoni
B) S. japonicum
C) S. haematobium
D) S. mekongi
Q2) Rodents, marsupials, and nonhuman primates are all reservoirs for which Schistosoma species?
A) S. japonicum
B) S. haematobium
C) S. mansoni
D) S. intercalatum
Q3) The eggs of the blood fluke Schistosoma haematobium range from 110 to 170 microns long by 40 to 70 microns wide and have a sharp, pointed terminal spine.In which specimen is this organism most likely found?
A) Ascites fluid
B) Sputum
C) Bile
D) Urine
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Chapter 58: Overview of Fungal Identification Methods and Strategies
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Q1) A 16-year-old male teenager is diagnosed with a fungal infection of his foot, which he acquired at the gym.This infection would most likely be classified as a(n)_______ mycosis.
A) superficial
B) subcutaneous
C) systemic
D) opportunistic
Q2) A 59-year-old patient with cancer who was receiving high doses of chemotherapy developed a secondary lung infection that was identified as a fungus.The organism disseminated, which ultimately was fatal to the patient.The organism isolated from sputum exhibited septate hyphae that were dichotomous.The organism is most likely which of the following?
A) Candida
B) Cryptococcus
C) Aspergillus
D) Zygomycetes
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Chapter 59: Hyaline Molds, Mucorales Zygomycetes,
Dermatophytes, and Opportunitistic and Systemic Mycoses
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Q1) Budding yeast resembling a "mariner's wheel"
A)Blastomyces dermatitidis
B)Coccidioides immitis
C)Histoplasma capsulatum
D)Paracoccidioides brasiliensis
E)Penicillium marneffei
F)Sporothrix schenckii
Q2) A pulmonary fungus ball and external otomycosis and onychomycosis are all infections caused by which genera?
A) Fusarium
B) Penicillium
C) Paecilomyces
D) Aspergillus
Q3) A hair perforation test is performed using Trichophyton mentagrophytes and T.rubrum.The expected results are:
A) positive for both organisms.
B) positive for T. rubrum and negative for T. mentagrophytes.
C) positive for T. mentagrophytes and negative for T. rubrum.
D) negative for both organisms.
Page 61
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Chapter 60: Dematiaceous Melanizedmolds
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Q1) Black-grain mycetoma
A)Exophiala jeanselmei
B)Pseudallescheria boydii
C)Piedraia hortae
D)Hortaea werneckii
E)Alternaria
Q2) Mycetoma is a subcutaneous infection that involves the lower extremities but may also occur in any part of the body.Swelling, purplish discoloration, and tumorlike deformities of the subcutaneous tissue are all symptoms associated with mycetoma.Which organism can cause this disease?
A) Bipolaris spp.
B) Exserohilum spp.
C) Pseudallescheria boydii
D) Exophiala dermatitidis
Q3) Which dematiaceous fungus causes a condition known as chromoblastomycosis?
A) Pseudallescheria boydii
B) Hortaea werneckii
C) Phialophora spp.
D) Exophiala jeanselmei
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Page 62
Chapter 61: Opportunistic Atypical Fungus: Pneumocystis
Jiroveci
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Q1) The cell membrane of Pneumocystis jirovecii contains _______ rather than _______, which differentiates it from other fungi.
A) sterols; cholesterol
B) ergosterol; sterols
C) cholesterol; ergosterol
D) sitosterol; sterols
Q2) In patients who do not have HIV, which underlying condition is considered a risk factor for acquiring PCP?
A) Malaria
B) Cystic fibrosis
C) Cytomegalovirus
D) Myasthenia gravis
Q3) Which type of molecular assay has been developed to identify Pneumocystis jirovecii but is not yet available in commercial kits?
A) Nucleic acid sequence-based amplification (NASBA)
B) Strand displacement amplification (SDA)
C) Transcription-mediated amplification (TMA)
D) Real-time polymerase chain reaction (PCR)
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Chapter 62: The Yeasts
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Q1) The most commonly isolated yeast in clinical specimens is:
A) Candida albicans.
B) C. tropicalis.
C) C. dubliniensis.
D) C. krusei.
Q2) A fungal infection found mostly in the tropics and temperate regions is characterized by the development of soft, yellow or pale-brown aggregations around hair shafts in the axillary, facial, genital, and scalp regions.The fungus that would most likely be isolated is:
A) Candida.
B) Malassezia.
C) Cryptococcus.
D) Trichosporon.
Q3) A patient with diabetes is experiencing creamy patches on his tongue and mucous membranes.Cultures are performed, and yeast is recovered.His diagnosis is most likely: A) paronychia.
B) onychomycosis.
C) candidemia.
D) thrush.
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Chapter 63: Anti-fungal Susceptibility Testing, Therapy, and Prevention
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Q1) A patient who is positive for the human immunodeficiency virus (HIV)is diagnosed with a Cryptococcus neoformans infection.The attending resident prescribed Griseofulvin; however, the patient's condition did not seem to improve.Which one of the following statements explains this discrepancy?
A) The dose should be increased to penetrate the blood-brain barrier.
B) Nystatin, which would have been more effective, should have been prescribed.
C) Griseofulvin is not effective against C. neoformans; therefore the therapy should be changed.
D) Potassium iodide is the therapy of choice, not griseofulvin.
Q2) Inhibits protein synthesis
A)Amphotericin B
B)Griseofulvin
C)5-Fluorocytosine
D)Echinocandin
E)Azole
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Chapter 64: Overview of the Methods and Strategies in Virology
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Q1) The cytomegalovirus (CMV)produces cytopathic effects (CPE)in diploid fibroblast cells in an average of 7 days.The results are available within 16 hours using which type of assay?
A) Conventional cell culture
B) Shell vial
C) Paired sera
D) Western blot
Q2) Stool
A)Varicella zoster virus
B)Enterovirus
C)Human papilloma virus (HPV)
D)Parainfluenza virus
E)CMV
Q3) Amie's, Leibovitz-Emory, and Stuart's are all types of:
A) cell lines.
B) cell culture media.
C) automated systems.
D) transport media.
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Chapter 65: Viruses in Human Disease
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Q1) Macropapular rash
A)Yellow fever
B)Dengue fever
C)West Nile virus
D)Hepatitis C
Q2) A 24-year-old woman is diagnosed with human papillomavirus (HPV)after having her annual Papanicolaou (Pap)smear.She was not vaccinated with the Gardasil vaccine.Which serotypes of the virus does she need to be concerned about that demonstrate the greatest risk for developing cervical cancer?
A) 12 and 14
B) 13 and 15
C) 16 and 18
D) 17 and 19
Q3) The term used to describe a virus that causes a global outbreak of serious illness of which little natural immunity exists and that has sustained person-to-person transmission is:
A) epidemic.
B) pandemic.
C) endemic.
D) widespread.
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Chapter 66: Antiviral Therapy, Susceptibility Testing, and Prevention
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Q1) Lamivudine
A)HSV
B)Influenza A
C)Hepatitis B virus (HBV)
D)Respiratory syncytial virus (RSV)
E)HIV
Q2) When performing antiviral susceptibility testing, a standard inoculum must be used.If the inoculum quantity is too large, then the isolate will appear:
A) susceptible.
B) intermediate.
C) resistant.
D) indeterminate.
Q3) Inhibits viral plaque formation.
A)Phenotypic assay
B)Plaque reduction assay
C)Du assay
D)Flow cytometry
E)Genotypic susceptibility assay
F)Pyrosequencing
68
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Chapter 67: Bloodstream Infections
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Q1) A 36-year-old emergency medical technician (EMT)is exposed to a patient with brucellosis.Blood cultures are drawn from the EMT and reported as negative after 1 week.Which of the following statements explains this discrepancy?
A) The blood culture system is most likely not correctly functioning.
B) Brucella does not grow in the blood.
C) The blood culture bottles are most likely expired.
D) The blood should have been incubated for a minimum of 3 weeks.
Q2) The possibility of an abscess should be considered if this bacterial group is isolated in the blood:
A) Clostridium septicum.
B) Bacteroides fragilis.
C) Streptococcus anginosus.
D) Aeromonas hydrophila.
Q3) The most common portal of entry for bacteremia is:
A) the genitourinary tract.
B) the respiratory tract.
C) an abscess.
D) the biliary tract.
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69
Chapter 68: Infections of the Lower Respiratory Tract
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Q1) The most common etiologic agent of lower respiratory tract infection among adults younger than 30 years of age is:
A) Chlamydophila pneumoniae.
B) Mycoplasma pneumoniae.
C) Streptococcus pneumoniae.
D) Haemophilus influenzae.
Q2) The sputum of a patient with acquired immunodeficiency syndrome (AIDS)is stained with Kinyoun carbolfuchsin stain.Which organism would test positive using this stain?
A) Streptomyces spp.
B) Pneumocystis jiroveci
C) Staphylococcus aureus
D) Cryptosporidium spp.
Q3) Evaluation of the quality of the sputum specimen sent to the laboratory for bacterial culture is best performed by:
A) measuring the amount of mucus found.
B) checking for mucus or blood.
C) microscopically examining the Gram-stained smear for leukocytes.
D) microscopically examining the Gram-stained smear for squamous epithelial cells.
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Chapter 69: Upper Respiratory Tract Infections and Other
Infections of the Oral Cavity and Neck
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Q1) Pharyngitis
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) An infection of the pharynx that is normally called sore throat, whose presentation includes erythematous and swollen tissue and which is characterized by inflammatory exudates, vesicles, and mucosal ulceration or by nasopharyngeal lymphoid hyperplasia, is:
A) laryngitis.
B) epiglottitis.
C) pharyngitis.
D) Vincent angina.
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Page 71
Chapter
Nervous System
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Q1) A condition characterized by concomitant meningitis that occurs with encephalitis is called:
A) meningoencephalitis.
B) aseptic meningitis.
C) encephalitis.
D) pleocytosis.
Q2) Infection within the subarachnoid space or throughout the pia mater and the arachnoid membrane is referred to as:
A) meningoencephalitis.
B) aseptic meningitis.
C) encephalitis.
D) meningitis.
Q3) A collective term used for the three layers of membranes surrounding the brain and spinal column is the:
A) dura mater.
B) meninges.
C) arachnoid.
D) pia mater.
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Chapter 71: Infections of the Eyes, Ears, and Sinuses
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Q1) Orbital cellulitis
A)Acute infection of the orbital contents most often caused by bacteria
B)Inflammation of the lacrimal canal
C)Infection of the lacrimal gland characterized by pain of the upper eyelid with erythema
D)Infection of the cornea
Q2) The organism that can be encountered in the conjunctival sac and that exists as indigenous flora is:
A) Staphylococcus epidermidis.
B) Bacteroides fragilis.
C) Staphylococcus aureus.
D) Moraxella lacunata.
Q3) Blepharitis
A)Haemophilus influenzae and Streptococcus pneumoniae
B)Bacteria, viruses, and occasionally lice
C)Staphylococcus aureus, S. pneumoniae, and Pseudomonas aeruginosa
D)Any bacterium, including those considered to be primarily saprophytic
E)Chlamydia
F)Actinomyces and Propionibacterium
G)S. aureus and Streptococcus pyogenes
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Chapter 72: Infections of the Urinary Tract
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Q1) Cystitis
A)Infection of the terminal portion of the lower urinary tract
B)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 a specimen yielding fewer organisms than 105 CFU/mL urine on culture
E)Inflammation of the kidney parenchyma, calices (cup-shaped division of the renal pelvis), and pelvis
Q2) The most frequent cause of uncomplicated community-acquired urinary tract infections is:
A) Staphylococcus saprophyticus.
B) Klebsiella spp.
C) Escherichia coli.
D) Proteus.
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Chapter 73: Genital Tract Infections
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Q1) An infection of the uterus and its contents during pregnancy is called:
A) PID.
B) bartholinitis.
C) cervicitis.
D) chorioamnionitis.
Q2) An infection of the vaginal mucosa resulting in an abnormal discharge and offensive odor or itching is referred to as:
A) chorioamnionitis.
B) bartholinitis.
C) cervicitis.
D) vaginitis.
Q3) The predominant organisms in vaginal secretions from normal prepubescent girls and postmenopausal women are:
A) lactobacilli.
B) Streptococcus agalactiae.
C) Enterobacteriaceae.
D) staphylococci.
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Chapter 74: Gastrointestinal Tract Infections
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Q1) 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 selection of enteric pathogens
D) Enrichment for enteric pathogens such as Salmonella and others
Q2) Gram-negative 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 selection of enteric pathogens
D) Enrichment for enteric pathogens such as Salmonella and others
Q3) Cultures for isolation of Campylobacter jejuni and Campylobacter coli should be incubated in:
A) a capnophilic atmosphere at 42° C and examined at 24 and 48 hours.
B) a microaerophilic atmosphere at 35° C and examined at 24 and 48 hours.
C) regular room air at 35° C and examined at 48 and 72 hours.
D) a microaerophilic atmosphere at 42° C and examined at 24 and 48 hours.
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Chapter 75: Skin, Soft Tissue, and Wound Infections
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Q1) A patient is diagnosed with gas gangrene in the skin as a result of bullous lesions associated with sepsis.The Gram-stain reaction and morphologic features of the most probable pathogen causing this infection is:
A) gram-positive cocci.
B) gram-positive bacilli.
C) gram-negative coccobacilli.
D) gram-negative bacilli.
Q2) Folliculitis, furuncles, and carbuncles are localized abscesses either in or around hair follicles.Which organism is the most common etiologic agent for all three infections?
A) Pseudomonas aeruginosa
B) Staphylococcus epidermidis
C) Escherichia coli
D) Staphylococcus aureus
Q3) The most predominant anaerobe isolated in animal bites is:
A) Veillonella spp.
B) Clostridium spp.
C) Prevotella spp.
D) Fusobacterium spp.
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Marrow, and Solid Tissues
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Q1) The 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) The most common etiologic agent of septic arthritis accounting for approximately 70% of infections is:
A) Streptococcus pyogenes.
B) Haemophilus influenza.
C) Staphylococcus aureus.
D) Streptococcus mitis.
Q3) Pericardial fluid may be inoculated in blood culture broth and processed as a blood culture, provided the broth contains which anticoagulant?
A) Heparin
B) Ethylenediaminetetraacetic acid (EDTA)
C) Citrate
D) Coumadin
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Chapter 77: Quality in the Clinical Microbiology Laboratory
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Q1) Defining the process from the patient's perspective, which is what the patient knowingly pays for, or the attributes of service
A)Value
B)Value stream
C)Flow
D)Pull
E)Continuous improvement
Q2) Occurring continuously through the remaining value-added steps
A)Value
B)Value stream
C)Flow
D)Pull
E)Continuous improvement
Q3) Eliminating redundant motion, recognizing waste, and identifying what creates value from the patient's perspective is considered which type of process?
A) Lean methodology
B) Total Quality Management
C) Continuous Quality Improvement
D) Performance Improvement
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Chapter 78: Infection Control
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Q1) A phenotypic technique that examines the ability of bacteriophages, which are viruses capable of infecting and lysing bacterial cells, to attack certain strains is:
A) biotyping.
B) antibiograms.
C) bacteriocin typing.
D) bacteriophage typing.
Q2) A phenotypic technique that examines an organism's susceptibility to bacterial peptides (proteins)is:
A) biotyping.
B) antibiograms.
C) serotyping.
D) bacteriocin typing.
Q3) The classification of a surgical wound as dirty refers to a:
A) lack of cleanliness of the surgical instruments.
B) surgical wound in an emergency setting in which the cleansing protocol was not followed.
C) surgical wound that has become grossly infected.
D) large number of contaminating organisms at the wound site.
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Chapter 79: Sentinel Laboratory Response to Bioterrorism
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Q1) The difference between an overt and a covert bioterrorism event is that a(n):
A) covert event is one that is carried out against undercover agents.
B) covert event is announced, and an overt event is not announced.
C) overt event is announced, and a covert event is not announced.
D) overt event is one that is carried out in the air.
Q2) The act of using microorganisms to harm the civilian population intentionally is referred to as:
A) biosecurity.
B) biocrime.
C) microterrorism.
D) cactiterrorism.
Q3) Bioterrorism is a term used to describe the act of using:
A) horrific events to deliver harm to living beings.
B) microorganisms to harm the civilian population intentionally.
C) microorganisms to wage war in peacetime.
D) living beings to wage war in peacetime.
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