Microbial Pathogenesis
Midterm Exam
Course Introduction
Microbial Pathogenesis explores the mechanisms by which microorganisms, including bacteria, viruses, fungi, and parasites, cause disease in humans and other hosts. The course covers the molecular and cellular strategies pathogens employ to invade hosts, evade immune responses, and establish infections. Students will study host-pathogen interactions, virulence factors, microbial toxins, and the genetic regulation of pathogenic traits. The course also discusses the epidemiology of infectious diseases, methods of diagnosis, and current approaches to treatment and prevention. By integrating foundational concepts with recent research advances, Microbial Pathogenesis provides a comprehensive understanding of how microorganisms contribute to disease processes.
Recommended Textbook
Bailey Scotts Diagnostic Microbiology 13th Edition by Patricia Tille
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Page 2
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) A bacterium that has been moved from one genus (Pseudomonas)to another genus (Burkholderia)would be correctly noted as which one of the following?
A) Pseudomonas (Burkholderia)
B) Burkholderia (Pseudomonas)
C) Pseudomonas, formerly Burkholderia
D) Burkholderia, formerly Pseudomonas
Answer: B
Q3) Which binomial name is correctly written?
A) Staphylococcus Aureus
B) staphylococcus aureus
C) Staphylococcus aureus
D) Staphylococcus aureus.
Answer: C
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Page 3
Chapter 2: Bacterial Genetics, Metabolism, and Structure
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Q1) Miniature chromosomes composed of several genes in double-stranded, closed, circular structures are called:
A) transposons.
B) insertion sequences.
C) plasmids.
D) chromatoids.
Answer: C
Q2) The pathway of metabolism that involves a series of electron transfers from reduced carrier molecules such as NADH and NADPH to a terminal electron acceptor is:
A) substrate-level phosphorylation.
B) fermentative metabolism.
C) oxidative phosphorylation.
D) aerobic respiration.
Answer: C
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4
Chapter 3: Host-Microorganism Interactions
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Q1) A bacterium that normally colonizes the skin gains access through a laceration and causes infection.This type of infection is classified as:
A) nosocomial.
B) opportunistic.
C) nonpathogenic.
D) immunogenic.
Answer: B
Q2) Infectious processes that quickly develop are referred to as _________ infections.
A) chronic
B) latent
C) acute
D) nosocomial
Answer: C
Q3) Swelling, redness, heat, and pain are all manifestations of: A) nosocomial infection.
B) inflammation.
C) bacterial colonization.
D) coagulation.
Answer: B
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Page 5
Chapter 4: Laboratory Safety
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Q1) Working with biosafety Level 3 agents requires:
A) U.S. Department of Agriculture (USDA) credentials and a postgraduate degree in microbiology or a related field.
B) laboratory design features that control air movement.
C) personnel to wear protective clothing and devices and enter a decontaminating chamber before leaving.
D) workers to have blood samples routinely tested to rule out infection or contamination.
Q2) The autoclave sterilizes material by:
A) applying dry heat at high temperatures and pressure.
B) infusing gaseous chemicals that kill organisms.
C) applying moist heat at high temperatures and increased pressure.
D) cleaving protein bonds found in most biological agent cell walls.
Q3) 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.
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Chapter 5: Specimen Management
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Q1) Colonies of Streptococcus pneumoniae appear alpha-hemolytic on blood agar media.Which one of the following statements explains this discrepancy?
A) The lot of blood agar may be expired.
B) Something may be wrong with the strain of S. pneumoniae since it should be beta-hemolytic on blood agar.
C) Something may be wrong with the strain of S. pneumoniae; it should be gamma-hemolytic on blood agar.
D) No discrepancy is present. S. pneumoniae should be alpha-hemolytic on blood agar.
Q2) Reduced O (5% to 10%)and increased CO (8% to 10%)produce an environmental condition that best suits which type of organism?
A) Aerobes
B) Anaerobes
C) Capnophiles
D) Microaerophiles
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Chapter 6: Role of Microscopy
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Q1) Bacterial cells with thick peptidoglycan and numerous teichoic acid cross-linkages are Gram stained.The organisms stain pink.Which one of the following statements explains this discrepancy?
A) The bacterial cells were most likely not heat-fixed to the slide.
B) The bacterial cells were subjected to the decolorizer too long and were overdecolorized.
C) The lot of Gram-stain reagent is most likely expired.
D) No discrepancy exists; cells with this composition stain pink on Gram stain.
Q2) The fluorochrome stain used to study a fungus is:
A) calcofluor white.
B) acridine orange.
C) auramine.
D) immunofluorescence.
Q3) 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.
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Chapter 7: Traditional Cultivation and Identification
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Q1) To read the hemolytic reaction accurately on a blood agar plate, the technologist must:
A) hold the plate up to the light, and observe the plate with the light coming from behind.
B) hold the plate under the light, and observe the plate with the light coming from the top.
C) hold the plate over a white background.
D) examine the plate using reflected and transmitted light.
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) The role of the agar ingredient in culture medium is to:
A) provide a nutritional base for bacterial metabolism.
B) solidify the medium and provide a stable culture surface.
C) sterilize the medium and prevent contamination.
D) support the growth of only pathogenic organisms.
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Chapter 8: Nucleic Acid-Based Analytic Methods for
Microbial Identification and Characterization
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Q1) Target nucleic acid amplification (polymerase chain reaction [PCR])methods are based on:
A) the ability of two nucleic acid strands that have complementary base sequences to bond specifically with each other and form a double-stranded molecule.
B) detecting phenotypic traits not detectable by conventional strategies.
C) the principles of complementary nucleic acid hybridization with those of nucleic acid replication that are repeatedly applied through numerous cycles.
D) determining the exact nucleotide sequence of a gene or gene fragment obtained from an organism.
Q2) Which enzyme recognizes a specific nucleotide sequence (~4-8 nucleotides in length)and catalyzes the digestion of the nucleic acid at that site, causing a break in the DNA strand?
A) Ligase
B) Gyrase
C) Helicase
D) Endonuclease
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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 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.
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 test procedure that applies a specific fluorescent dye-antibody complex to a slide to which the patient specimen has been applied is referred to as a(n):
A) solid-phase enzyme immunoassay.
B) direct fluorescent antibody test.
C) indirect fluorescent antibody test.
D) radioimmunoassay.
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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 the migration of an antigen and antibody is referred to as:
A) double immunodiffusion.
B) counterimmunoelectrophoresis.
C) particle agglutination.
D) enzyme immunoassay.
Q2) The study of the diagnosis of disease by measuring antibody levels in serum is called:
A) immunology.
B) immunohematology.
C) serology.
D) immunocytology.
Q3) A Western blot assay was performed, and bands were observed at p24, p41, and gp120/160 (kilodaltons).The organism can be identified as:
A) herpes simplex virus.
B) human immunodeficiency virus (HIV).
C) Borrelia burgdorferi.
D) Treponema pallidum.
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Chapter 11: Principles of Antimicrobial Action and Resistance
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Q1) Staphylococcus aureus is a gram-positive organism that produces the enzyme beta-lactamase, which renders certain types of antibiotics inactive.The mode of action that is prevented in certain antibiotics sensitive to this enzyme is:
A) cell wall synthesis.
B) protein synthesis to the 30S ribosomal subunit.
C) protein synthesis to the 50S ribosomal subunit.
D) deoxyribonucleic acid (DNA) synthesis.
Q2) The mechanism of acquired, high-level resistance to vancomycin involves:
A) enzymatic destruction of the antibiotic.
B) altered antibiotic targets.
C) decreased intracellular uptake of the drug.
D) production of altered cell wall precursors that do not bind the antibiotic with sufficient avidity.
Q3) Ciprofloxacin
A)Cell wall synthesis inhibition
B)Cell membrane function inhibition
C)Protein synthesis inhibition
D)DNA and ribonucleic acid (RNA) synthesis inhibition
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Chapter 12: Laboratory Methods and Strategies for
Antimicrobial Susceptibility Testing
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Q1) Staphylococcal resistance to oxacillin is used to determine and report resistance to: A) vancomycin.
B) aminoglycoside.
C) cephalosporin.
D) amikacin.
Q2) Growth on the oxacillin agar screen means that a patient should be treated with which antibiotic?
A) Oxacillin
B) Methicillin
C) Vancomycin
D) Cephalosporin
Q3) Enterococcal resistance to ampicillin predicts resistance to: A) vancomycin.
B) aminoglycoside.
C) cephalosporin.
D) amikacin.
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14
Chapter 13: Staphylococcus Micrococcus and Similar Organisms
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Q1) The tube coagulase test:
A) detects bound coagulase.
B) detects extracellular coagulase.
C) is performed on slide coagulase-positive isolates to confirm a positive result.
D) requires citrated reagent plasma.
Q2) Which group of bacteria is described as catalase positive and is gram-positive cocci that grow facultatively anaerobic and form grapelike clusters?
A) Neisseria
B) Rothia (stomatococci)
C) Staphylococcus
D) Micrococcus
Q3) The species of Staphylococcus, which is one of the most important human pathogens, is:
A) S. lentus.
B) S. aureus.
C) S. mucilaginosus.
D) S. intermedius.
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Chapter 14: Streptococcus Enterococcus and Similar Organisms
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Q1) What name is given to the type of hemolysis that produces complete hemolysis and a clearing of the medium?
A) Beta hemolysis
B) Gamma hemolysis
C) Alpha hemolysis
D) Kappa hemolysis
Q2) The colonial morphologic features of this organism resemble a donut as it ages, and it has a polysaccharide capsule that is responsible for its virulence.What two characteristics describe this organism?
A) Beta-hemolytic and susceptible to optochin
B) Alpha-hemolytic and bile solubility-negative
C) Gamma-hemolytic and resistant to optochin
D) Alpha-hemolytic and bile solubility-positive
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) Which of the following is described as a spore-forming, gram-positive Bacillus that is beta-hemolytic, motile, Voges-Proskauer (VP)-positive, and citrate-positive and causes two types of food poisoning as a result of toxin release?
A) Corynebacterium diphtheria
B) Bacillus anthracis
C) Bacillus cereus
D) Corynebacterium jeikeium
Q2) Media that can be used for isolating Bacillus anthracis include:
A) Thayer-Martin agar.
B) 5% sheep blood agar.
C) MacConkey agar.
D) Columbia blood agar with colistin-nalidixic acid (CNA).
Q3) Enzyme-linked immunosorbent assays (ELISAs)are available that can serologically identify which Bacillus species?
A) B. cereus
B) B. subtilis
C) B. thuringiensis
D) B. anthracis
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17
Chapter 16: Listeria Corynebacterium and Similar Organisms
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Q1) The organism that exhibits characteristic end-over-end tumbling motility when incubated in nutrient broth at room temperature for 1 to 2 hours is:
A) Listeria monocytogenes.
B) Corynebacterium diphtheriae.
C) Bacillus anthracis.
D) Bacillus cereus.
Q2) The isolation of a small gram-positive, catalase-positive rod with a narrow zone of beta hemolysis isolated from blood or CSF should be used as strong presumptive evidence for:
A) listeriosis.
B) diphtheria.
C) pertussis.
D) tetanus.
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
Page 18
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Chapter 17: Erysipelothrix Lactobacillus and Similar Organisms
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Q1) To test the validity of TSI media, quality control should be performed using which two organisms?
A) Gardnerella and Lactobacillus
B) Erysipelothrix and Gardnerella
C) Propionibacterium and Lactobacillus
D) Actinomyces and Arcanobacterium
Q2) Clue cells are associated with which gram-positive bacilli?
A) Gardnerella vaginalis
B) Lactobacillus
C) Erysipelothrix rhusiopathiae
D) Arcanobacterium haemolyticum
Q3) A gram-positive bacillus identified as Lactobacillus is isolated in large quantities from the urine of a 16-year-old female.Based on this information, the patient should receive which antibiotic?
A) Penicillin
B) Tetracycline
C) Vancomycin
D) No antibiotics should be administered.
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Chapter 18: Nocardia Streptomyces Rhodococcus and Similar Organisms
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Q1) The organism that has been most commonly associated with human disease, particularly in patients who are immunocompromised, such as those infected with human immunodeficiency virus (HIV), is:
A) Rhodococcus.
B) Gordonia.
C) Tsukamurella.
D) Streptomyces.
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) Nocardia spp.form branched filaments that extend into the air that are called _____ hyphae.
A) surface
B) substrate
C) aerial
D) topical
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Chapter 19: Enterobacteriaceae
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Q1) MacConkey-sorbitol agar is useful for detecting pathogenic strains of:
A) Escherichia coli.
B) Shigella spp.
C) Salmonella spp.
D) Vibrio spp.
Q2) The major etiologic agent of urinary tract infections is:
A) Escherichia coli.
B) Shigella spp.
C) Salmonella spp.
D) Vibrio spp.
Q3) A patient bitten by a flea developed a painful bubo at the site of the bite.The drug of choice for this organism is:
A) ampicillin.
B) gentamycin.
C) streptomycin.
D) ciprofloxacin.
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21
Chapter 20: Acinetobacter, Stenotrophomonas, and Other Organisms
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Q1) Plump coccobacilli that tend to resist alcohol decolorization and may be mistaken for Neisseria spp.are:
A) Bordetella spp.
B) Stenotrophomonas maltophilia.
C) Acinetobacter spp.
D) Pseudomonas oryzihabitans.
Q2) A bronchoscopy was performed on a patient who later developed a nosocomial infection as a result of the procedure.The organism recovered from his lung was a nonlactose fermenter that oxidized glucose and maltose, was lysine decarboxylase-positive, and was motile.The organism is most likely which one of the following?
A) Bordetella parapertussis
B) Saccharolytic Acinetobacter
C) Pseudomonas luteola
D) Stenotrophomonas maltophilia
Q3) Which organism is often isolated in the sputum of patients with cystic fibrosis?
A) Acinetobacter spp.
B) Bordetella trematum
C) Burkholderia gladioli
D) Stenotrophomonas maltophilia
Page 22
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Chapter 21: Pseudomonas, Burkholderia, and Similar Organisms
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Q1) An organism described as oxidase-positive, (K/NC)on TSI media, growth at 42° C, and produces a bright bluish-green pigment on Mueller-Hinton agar is most likely:
A) Pseudomonas aeruginosa.
B) Ralstonia pickettii.
C) Burkholderia mallei.
D) Burkholderia pseudomallei.
Q2) Which species of Burkholderia is the one most commonly found in clinical specimens?
A) Burkholderia ralstonia
B) Burkholderia pseudomallei
C) Burkholderia mallei
D) Burkholderia cepacia
Q3) Which two organisms should be used to determine the validity of urea agar for quality control purposes?
A) Pseudomonas fluorescens and Burkholderia cepacia complex
B) Ralstonia mannitolilytica and Acidovorax delafieldii
C) Brevundimonas diminuta and Brevundimonas vesicularis
D) Brevundimonas vesicularis and Ralstonia pickettii
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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) The most common type of infection caused by both Rhizobium radiobacter and Ochrobactrum anthropi is:
A) peritonitis.
B) endocarditis.
C) meningitis.
D) bacteremia.
Q3) 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
Page 24
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Q1) Which organism is indole- and gelatin-positive but does not have the ability to oxidize mannitol?
A) Sphingobacterium multivorum
B) CDC group O-1
C) Empedobacter brevis
D) Elizabethkingia meningoseptica
Q2) The natural habitat of Chryseobacterium sp.can best be described as the:
A) mucous membranes of animals.
B) gastrointestinal tract of humans and other animals.
C) natural environment.
D) genitourinary tract of animals.
Q3) 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.
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Chapter 24: Alcaligenes, Bordetella Nonpertussis,
Comamonas, and Similar Organisms
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Q1) The organism most frequently associated with various infections in humans is:
A) Bordetella.
B) Oligella.
C) Achromobacter.
D) Roseomonas.
Q2) Achromobacter, Alcaligenes, and Bordetella are all:
A) urea-positive.
B) oxidase-negative.
C) nonglucose utilizers.
D) lactose fermenters.
Q3) 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.
Q4) The biochemical description of Myroides is:
A) oxidase-positive, motile, and rapid urease-positive.
B) urease-positive and has a fruity odor.
C) resistant to vancomycin and will grow on MacConkey agar at 42° C.
D) nonmotile and both urea-positive and phenylalanine deaminase-positive.
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Chapter 25: Vibrio, Aeromonas, Chromobacterium, and Related Organisms
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Q1) Vibrio cholera and V.alginolyticus appear what color on TCBS agar?
A) Green
B) Black
C) Yellow
D) Blue
Q2) Which organism appears green on TCBS agar and is halophilic?
A) V. cholerae
B) V. harveyi
C) V. fluvialis
D) V. vulnificus
Q3) Colonies growing on modified cefsulodin-irgasan-novobiocin (CIN)agar appear to be either Aeromonas spp.or Yersinia enterocolitica.Which test should be performed to differentiate between these two organisms?
A) String test
B) Sucrose fermentation
C) Glucose fermentation
D) Oxidase
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Chapter 26: Sphingomonas Paucimobilis and Similar Organisms
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Q1) 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
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) When performing quality control on motility media, which of the following organisms should be used?
A) Acidovorax facilis and Sphingomonas spp.
B) Centers for Disease Control and Prevention (CDC) group IIc and CDC group IIe
C) CDC group Iii and Sphingobacterium mizutaii
D) CDC group IIh and Acidovorax facilis
Page 28
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Chapter 27: Moraxella and Related Organisms
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Q1) The species of Moraxella that is most commonly associated with human infections, primarily of the respiratory tract, is:
A) M. catarrhalis.
B) M. lacunata.
C) M. canis.
D) M. atlantae.
Q2) True cocci, such as most Neisseria spp.and Moraxella (Branhamella)catarrhalis, can be differentiated from morphologically similar Moraxella species by:
A) comparing the penicillin susceptibility testing results of the bacteria.
B) subjecting the bacterium to noninhibitory concentrations of penicillin.
C) identifying the resistance of Moraxella to many beta-lactam antimicrobial agents.
D) performing the deoxyribonucleic acid (DNA) test.
Q3) The virulence of this organism(s), which is transmitted via a dog bite, is attributed to:
A) protease production.
B) various toxins.
C) hemolysins.
D) something unknown.
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Chapter 28: Eikenella and Similar Organisms
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Q1) 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
Q2) 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.
Q3) Quality control performed on indole reagent should be performed on which two organisms?
A) Eikenella corrodens and Methylobacterium spp.
B) Weeksella virosa and Bergeyella zoohelcum
C) Bergeyella zoohelcum and Escherichia coli
D) Eikenella corrodens and Weeksella virosa
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Chapter 29: Pasteurella and Similar Organisms
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Q1) An organism that causes infection as a result of a dog or cat bite was tested for catalase, resulting in a positive reaction.What could be the possible source of the error?
A) The catalase reagent could be expired.
B) This organism is normally negative for catalase; therefore a mutation may have occurred.
C) A false-positive result occurred because of the catalase production of the red blood cells in the 5% sheep blood agar.
D) No error is present. This organism is catalase-positive.
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.
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Chapter 30: Actinobacillus, Aggregatibacter, Kingella,
Cardiobacterium, Capnocytophaga, and Similar
Organisms
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Q1) Which of the following biochemical reactions identifies an organism associated with blood, bone, and joint infections in young children?
A) Positive catalase, positive nitrate reduction, and positive indole
B) Negative catalase, positive nitrate reduction, and positive indole
C) Negative catalase, negative nitrate reduction, and positive indole
D) Negative catalase, negative nitrate reduction, and negative indole
Q2) 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
Q3) 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
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Chapter 31: Haemophilus
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Q1) Isolates from an ear swab that are gram-negative coccobacilli grow on chocolate agar in CO but not blood agar, require both X and V factors for growth, and are nonhemolytic on rabbit or horse blood may be identified as:
A) Haemophilus parainfluenzae.
B) H. ducreyi.
C) H. aphrophilus.
D) H. influenzae.
Q2) 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.
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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Chapter 32: Bartonella and Afipia
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Q1) Bartonella spp.are usually detected by the examination of biopsy using which stain?
A) Gram stain
B) Wright stain
C) Trichrome stain
D) Warthin-Starry silver stain
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) 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.
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Chapter 33: Campylobacter, Arcobacter, and Helicobacter
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Q1) 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.
Q2) Virulence determinants of Helicobacter pylori include:
A) proteases.
B) urease enzyme.
C) hemolysins.
D) exotoxins.
Q3) A gram-negative, spiral-shaped organism is isolated from a stool sample that was hippurate-positive, catalase-positive, susceptible to nalidixic acid, and resistant to cephalothin.The organism can be identified as:
A) Campylobacter coli.
B) C. jejuni subsp. doylei.
C) C. jejuni subsp. jejuni.
D) C. fetus subsp. fetus.
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35
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) 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
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Chapter 35: Brucella
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Q1) The animal reservoir for Brucella melitensis is:
A) cattle.
B) sheep or goats.
C) swine.
D) dogs.
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) Although in vitro susceptibility testing is not reliable, which regimen of antibiotics is recommended for Brucella infections?
A) Penicillin and azithromycin
B) Ampicillin and gentamycin
C) Doxycycline and rifampin
D) Gentamycin and vancomycin
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Chapter 36: Bordetella Pertussis, Bordetella Parapertussis, and
Related Species
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Q1) 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.
Q2) If real-time polymerase chain reaction (PCR)is performed on a Bordetella isolate, then it must be noted that this type of swab is unacceptable for collection because of the presence of which of the following inhibitory factors?
A) Dacron
B) Cotton
C) Rayon
D) Calcium alginate
Q3) Because of its longer shelf life, the medium of choice to cultivate Bordetella spp.is:
A) buffered charcoal yeast extract (BCYE).
B) thiosulfate citrate bile salts sucrose (TCBS) agar.
C) Bordet-Gengou agar.
D) Regan-Lowe agar.
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Chapter 37: Francisella
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Q1) 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.
Q2) To cultivate Francisella in the laboratory, a medium supplemented with which of the following ingredient(s)is necessary?
A) Cysteine and cystine
B) Blood and cysteine
C) Dopa-cysteine
D) Nicotinic adenine
Q3) 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)
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Chapter 38: Streptobacillus Moniliformis and Spirillum
Minus
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Q1) The name given to rat-bite fever when the illness is acquired by the ingestion of the bacterium is:
A) Sodoku.
B) Haverhill fever.
C) monillic fever.
D) monillic gastritis.
Q2) Rat-bite fever caused by Spirillum minus can be differentiated from that caused by Streptobacillus moniliformis by:
A) chills, fever, headache, vomiting, and often severe joint pains.
B) a granulomatous lesion.
C) septic arthritis.
D) endocarditis.
Q3) 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.
Page 40
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Chapter 39: Neisseria and Moraxella Catarrhalis
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Q1) The gram-negative coccus that can be described as oxidase-positive, glucose-negative, maltose-negative, sucrose-negative, lactose-negative, and DNase-positive is:
A) Neisseria meningitidis.
B) Moraxella catarrhalis.
C) N. cinerea.
D) N. gonorrhoeae.
Q2) The determination of carbohydrate utilization patterns for the differentiation of Neisseria spp.and M.catarrhalis is best performed by:
A) incubation of inoculated cysteine trypticase soy agar (CTA) with 1% dextrose, maltose, lactose, and sucrose for 48 to 72 hours.
B) oxidative-fermentative (OF) medium with dextrose, maltose, lactose, and sucrose.
C) heavy inoculation of buffered, low-peptone substrate with dextrose, maltose, lactose, and sucrose.
D) carbohydrate testing strips.
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Chapter 40: Overview and General Considerations
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Q1) The indicator used to determine whether anaerobic conditions are achieved in an anaerobic jar is:
A) phenol red.
B) bromothymol blue.
C) methylene blue.
D) methyl red.
Q2) To isolate anaerobic gram-positive organisms, which of the following media should be used?
A) Anaerobic blood agar
B) Cycloserine cefoxitin fructose agar (CCFA)
C) Laked kanamycin-vancomycin (LKV) blood agar
D) Anaerobic phenylethyl alcohol agar (PEA)
Q3) Tissue biopsy taken from a puncture wound is:
A) acceptable.
B) not acceptable.
Q4) An acceptable specimen for anaerobic culture is:
A) nasopharyngeal swab.
B) tissue obtained at biopsy.
C) small bowel contents.
D) catheterized urine.
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Chapter 41: Overview of Anaerobic Organisms
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Q1) 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.
Q2) A diabetic patient has developed gas gangrene of the right foot.The most likely anaerobe causing this infection is:
A) Clostridium tetani.
B) C. perfringens.
C) C. botulinum.
D) C. difficile.
Q3) The most likely identification of an anaerobic gram-positive bacillus that produces spores is:
A) Bifidobacterium.
B) Eubacterium.
C) Eggerthella.
D) Clostridium.
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43
Chapter 42: Mycobacteria
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Q1) Under what circumstance might slow-growing mycobacteria appear to produce colonies in a few days?
A) When the inoculum is too heavy
B) When subcultured to an enriched medium
C) When incubated at slightly warmer temperatures
D) When kept in the light
Q2) Negative mycobacterial cultures are reported final and the cultures are discarded after what period?
A) 7 days
B) 2 weeks
C) 4 weeks
D) 8 weeks
Q3) Fluorescent staining is more sensitive than conventional carbolfuchsin stains.What counterstain is used during the procedure?
A) Methylene blue
B) Crystal violet
C) Potassium permanganate
D) Auramine-rhodamine
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44
Chapter 43: Obligate Intracellular and Non-culturable Bacterial Agents
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Q1) A prokaryote that differs from most other bacteria with respect to its very small size and obligates intracellular parasitism is:
A) Rickettsia.
B) Ehrlichia.
C) Calymmatobacterium.
D) Coxiella.
Q2) Which of the following vectors transmit scrub typhus?
A) Lice
B) Ticks
C) Fleas
D) Chiggers
Q3) Binary fission within vacuoles divides which of the following forms of Chlamydia?
A) RB
B) EB
C) Replicate body
D) Initial body
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Chapter 44: Cell Walldeficient Bacteria: Mycoplasma and Ureaplasma
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Q1) 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
Q2) The definitive identification of which of the following organisms is accomplished by hemadsorption techniques?
A) Chlamydia trachomatis
B) Mycoplasma hominis
C) Mycoplasma pneumoniae
D) Mycoplasma genitalium
Q3) Which of the following Mycoplasma species is associated with individuals who are positive for human immunodeficiency virus (HIV), is capable of invading human cells, and can modulate the immune system?
A) M. pneumoniae
B) M. genitalium
C) M. hominis
D) M. fermentans
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Chapter 45: The Spirochetes
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Q1) A destructive lesion of the gums, also known as acute necrotizing ulcerative gingivitis, that is caused by oral spirochetes and other bacteria is known as:
A) Vincent's disease.
B) primary syphilis.
C) chancres.
D) Weil syndrome.
Q2) A nontreponemal flocculation serologic test in which soluble antigen particles are coalesced to form larger particles that are visible as clumps when they are aggregated by antibody is called the __________ test.
A) nontreponemal flocculation (NTF)
B) FTA-ABS
C) VDRL
D) TP-PA
Q3) Isoluminol-antigen conjugate
A)TP-PA
B)MHA-TP
C)PaGIA
D)Enzyme immunoassay (EIA)
E)Magnetic beads
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Page 47
Chapter 46: Laboratory Methods for Diagnosis of Parasitic
Infections: Overview
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Q1) Some strains of leishmaniae have reservoir hosts, including dogs and wild rodents.Transmission is via the bite of a:
A) tsetse fly.
B) tick.
C) sandfly.
D) triatomid bug.
Q2) The eggs of which of the following intestinal parasites are not commonly found in feces and must be detected by other diagnostic techniques?
A) Giardia lamblia
B) Cryptosporidium parvum
C) Clonorchis sinensis
D) Enterobius vermicularis
Q3) A urine sample from a 26-year-old woman is examined, and an organism is observed that displays "jerky" motility.This organism is classified as a(n):
A) amebae.
B) coccidia.
C) flagellate.
D) ciliate.
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Chapter 47: Intestinal Protozoa
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Q1) The Isospora belli organism, which contains two sporocysts with four sporozoites each, is recovered from fecal specimens and has also been implicated in traveler's diarrhea.The drug of choice to treat infection caused by I.belli is:
A) trimethoprim-sulfamethoxazole combination.
B) tetracycline.
C) albendazole.
D) flagyl.
Q2) The peripheral chromatin, which contains fine granules that are uniform in size and are evenly distributed, can be found in which one of the following protozoa?
A) Endolimax nana
B) Iodamoeba butschlii
C) Entamoeba coli
D) Entamoeba histolytica
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Chapter 48: Blood and Tissue Protozoa
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Q1) T.brucei gambiense
A)Anopheles mosquito
B)Tsetse fly
C)Sandfly
D)Reduviid bug
Q2) Stage I of trypanosomiasis characteristically involves systemic trypanosomiasis infection without central nervous system (CNS)involvement.Lymphadenopathy is also a feature of this disease.The trypomastigotes of which protozoa are involved?
A) Trypanosoma cruzi
B) T. rangeli
C) T. brucei rhodesiense
D) T. brucei gambiense
Q3) Cerebral malaria is considered to be the most serious complication and major cause of death with which species of Plasmodium spp.?
A) P. vivax
B) P. falciparum
C) P. ovale
D) P. malariae
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Chapter 49: Other Protozoa
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Q1) Primates, as well as dogs, sheep, and horses, have died of central nervous system (CNS)infections with which organism?
A) Naegleria fowleri
B) Acanthamoeba spp.
C) Toxoplasma gondii
D) Balamuthia mandrillaris
Q2) Bradyzoites
A)Crescent-shaped
B)Oocysts from cat feces
C)Tissue cysts
Q3) The troph of the motile Trichomonas vaginalis organism measures 7 to 23 microns long and 5 to 15 microns wide.The recommended treatment of choice for this urogenital infection is:
A) tetracycline.
B) metronidazole.
C) penicillin.
D) ketoconazole.
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Chapter 50: Intestinal Nematodes Roundworms
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Q1) Löffler syndrome is associated with which roundworm infection?
A) Strongyloides stercoralis
B) Ancylostoma duodenale
C) Trichostrongylus spp.
D) Ascaris lumbricoides
Q2) 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
Q3) A short buccal capsule, large bulb on the esophagus, and prominent genital primordium are all characteristics of which worm?
A) Trichuris trichiura
B) Capillaria philippinensis
C) Strongyloides stercoralis
D) Ascaris lumbricoides
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Chapter 51: Tissue Nematodes Roundworms
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Q1) Humans acquire infection with Trichinella tissue nematode by ingesting undercooked meat that contains the infective encysted larvae.In which tissue do these larvae encyst?
A) Brain
B) Meninges
C) Myocardium
D) Striated muscle
Q2) Swine
A)Dracunculus medinensis
B)Parastrongylus cantonensis
C)Trichinella spp.
D)Parastrongylus costaricensis
Q3) A child is believed to have a Toxocara cati infection in his eye, which he acquired after playing with a stray cat for several weeks.A serum titer was performed, which revealed a titer of 1:8.This laboratory value can be interpreted as:
A) normal.
B) insignificant.
C) diagnostic.
D) negative.
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Page 53
Chapter 52: Blood and Tissue Filarialnematodes
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Q1) 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.
Q2) A skin snip is performed, and microfilariae with tapered tails, no nuclei, and unsheathed are microscopically observed.The recommended therapy for this infection is:
A) ivermectin.
B) diethylcarbamazine.
C) antihistamines.
D) mebendazole.
Q3) The definitive host and reservoir for Wuchereria bancrofti is:
A) mosquito.
B) microfilaria.
C) humans.
D) tabanid fly.
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Chapter 53: Intestinal Cestodes
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Q1) 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.
Q2) The double-pored tapeworm, Diphyllobothrium caninum, consisting of many small proglottids, measures 10 to 70 cm in length as an adult.The scolex contains four suckers and an armed rostellum.The intermediate host in which infective cysticercoids develop is the:
A) dog.
B) cat.
C) flea.
D) human.
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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) The Taenia multiceps tapeworm is 5 to 6 cm long and consists of 200 to 250 segments.It has four suckers in its scolex and a proboscis with 22 to 32 hooks arranged in two rows.This organism causes which condition?
A) Coenurosis
B) Cysticercosis
C) Hydatid disease
D) Sparganosis
Q3) 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.
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Chapter 55: Intestinal Trematodes
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Q1) The intermediate host of the Platyhelminthes is freshwater:
A) fish.
B) snails.
C) crabs.
D) crayfish.
Q2) A 36-year-old man who has traveled for several weeks in the orient is experiencing abdominal pain and diarrhea with a large amount of mucus.A Heterophyes heterophyes egg measuring 28 by 15 microns is identified in the stool.The treatment of choice for this intestinal trematode is:
A) metronidazole.
B) chloroquine.
C) albendazole.
D) praziquantel.
Q3) 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.
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Page 57
Chapter 56: Liver and Lung Trematodes
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Q1) Which second intermediate host ingests the cercariae of Clonorchis and Opisthorchis?
A) Snail
B) Crustacean
C) Copepod
D) Freshwater fish
Q2) The eggs of Paragonimus mexicanus measure approximately 80 microns by 40 microns, are unembryonated and operculated, and have thick shells that are brownish yellow.An individual with this infection has most likely traveled to which endemic area?
A) Japan
B) Africa
C) New Guinea
D) South America
Q3) Southeast Asian liver fluke
A)Opisthorchis viverrini
B)Fasciola spp.
C)Clonorchis (Opisthorchis) sinensis
D)Paragonimus westermani
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Chapter 57: Blood Trematodes
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Q1) An egg of the organism of Schistosoma mansoni is isolated from the feces of an adult man who has been traveling in Africa.An unoperculated egg with a large lateral spine is recovered.The patient is administered the standard dose of praziquantel; however, his infection does not improve.Which one of the following statements explains this discrepancy?
A) Metrifonate should have been administered.
B) Bilarcil is the drug of choice for this type of infection.
C) Steroids should have been initially administered.
D) A larger dose may be required to be effective against this organism.
Q2) The only intermediate host required in the life cycle of blood flukes is a:
A) copepod.
B) crustacean.
C) freshwater snail.
D) freshwater fish.
Q3) A large lateral spine is characteristic of which Schistosoma egg?
A) S. mansoni
B) S. japonicum
C) S. haematobium
D) S. mekongi
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Page 59
Chapter 58: Overview of Fungal Identification Methods and Strategies
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Q1) Urea agar is set up for quality control purposes using two Trichophyton spp.-T.mentagrophytes and T.rubrum.After the appropriate amount of incubation, both organisms are negative.Which one of the following statements explains this discrepancy?
A) The medium is most likely expired.
B) These two Trichophyton spp. are poor choices for quality control.
C) The phenol red indicator is not working because both organisms are positive for urea.
D) No discrepancy is present; both organisms are negative for urease activity.
Q2) Which phylum exhibits both a teleomorph and an anamorph form?
A) Ascomycota
B) Basidiomycota
C) Deuteromycota
D) Zygomycota
Q3) The mode of transmission for most of the dimorphic fungi is:
A) inoculation.
B) inhalation.
C) arthropod.
D) blood.
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Chapter 59: Hyaline Molds, Mucorales Zygomycetes,
Dermatophytes, and Opportunitistic and Systemic Mycoses
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Q1) 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.
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) Nonbudding, thick-walled spherule
A)Blastomyces dermatitidis
B)Coccidioides immitis
C)Histoplasma capsulatum
D)Paracoccidioides brasiliensis
E)Penicillium marneffei
F)Sporothrix schenckii
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Chapter 60: Dematiaceous Melanizedmolds
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Q1) Black piedra
A)Exophiala jeanselmei
B)Pseudallescheria boydii
C)Piedraia hortae
D)Hortaea werneckii
E)Alternaria
Q2) Conidiophores bear a chain of large brown conidia, resembling a drumstick, and contain both horizontal and longitudinal septa.
A)Phialophora
B)Fonsecaea
C)Alternaria
D)Bipolaris
E)Cladosporium
F)Culvaria
G)Exophiala
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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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 therapy has decreased the incident of pneumocystis infection in patients with human immunodeficiency virus or acquired immunodeficiency syndrome (HIV/AIDS)?
A) Metronidazole
B) Trimethoprim-sulfamethoxazole combination
C) Aminoglycosides with fluconazole
D) Highly active antiretroviral therapy (HAART)
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Chapter 62: The Yeasts
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Q1) Encapsulated yeast is identified in the cerebrospinal fluid (CSF)of a patient with AIDS.The most likely stain or reagent used to identify this organism is:
A) potassium hydroxide (KOH).
B) calcofluor white.
C) lactophenol cotton blue.
D) India ink.
Q2) Which yeast identification system uses chromogenic substrates to assess specific enzyme activity usually detected within 4 hours?
A) Vitek
B) MicroScan
C) API-20C AUX
D) Uni-Yeast-Tek
Q3) Agar medium overlaid with olive oil will enhance the growth of which organism?
A) Malassezia
B) Candida
C) Trichosporon
D) Cryptococcus
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Chapter 63: Anti-fungal Susceptibility Testing, Therapy, and Prevention
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Q1) Is a glucan synthesis inhibitor
A)Amphotericin B
B)Griseofulvin
C)5-Fluorocytosine
D)Echinocandin
E)Azole
Q2) The Reference Method for Broth Dilution Antifungal Susceptibility Testing of Filamentous Fungi; Approved Standard (M38-A)describes the guidelines for antifungal susceptibility testing for molds.The suspension must be standardized with a spectrophotometer.Susceptibility testing is determined by which method?
A) Disk diffusion
B) Microdilution
C) Broth dilution
D) Immunodiffusion
Q3) 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) Some viruses have the ability to stimulate uncontrolled growth of the host cells, resulting in cancer.Which virus has oncogenic properties?
A) Measles
B) Papilloma
C) Retroviruses
D) Influenza
Q2) Stool
A)Varicella zoster virus
B)Enterovirus
C)Human papilloma virus (HPV)
D)Parainfluenza virus
E)CMV
Q3) Blood
A)Adenovirus
B)HSV
C)HBV
D)Arbovirus
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Page 66
Chapter 65: Viruses in Human Disease
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Q1) Shingles
A)Herpes simplex virus (HSV) type 1
B)HSV type 2
C)Zoster
D)Varicella
E)Epstein-Barr virus (EBV)
F)CMV
G)Human herpesvirus (HHV) 8
Q2) One of the most pathogenic hemorrhagic fever viruses belongs to the _________ family.
A) Filoviridae
B) Flaviviridae
C) Papovaviridae
D) Picornaviridae
Q3) Hand-foot-mouth
A)Coxsackie A
B)Coxsackie B
Q4) Herpangina
A)Coxsackie A
B)Coxsackie B
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Chapter 66: Antiviral Therapy, Susceptibility Testing, and Prevention
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Q1) Inhibits viral plaque formation.
A)Phenotypic assay
B)Plaque reduction assay
C)Du assay
D)Flow cytometry
E)Genotypic susceptibility assay
F)Pyrosequencing
Q2) Saquinavir
A)HSV
B)Influenza A
C)Hepatitis B virus (HBV)
D)Respiratory syncytial virus (RSV)
E)HIV
Q3) Point mutations in the hemagglutination (HA)or neuraminidase (NA)genes during viral ribonucleoprotein (RNP)replication give rise to new strains.This mechanism is known as the antigenic:
A) drift.
B) shift.
C) re-assortment.
D) modification.
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Chapter 67: Bloodstream Infections
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Q1) A 76-year-old man with intermittent fevers has blood cultures drawn three times.The second set is positive and grew out of a Corynebacterium spp.This organism is considered:
A) pathogenic.
B) virulent.
C) a contaminant.
D) normal flora.
Q2) If tachyzoites are found circulating in blood, then the infection would be classified as a:
A) parasitemia.
B) bacteremia.
C) viremia.
D) fungemia.
Q3) Brucella infections usually result in which type of bacteremia?
A) Transient
B) Intermittent
C) Continuous
D) Spontaneous
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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) Respiratory syncytial virus is one of the most common etiologic agents of lower respiratory tract infection among:
A) previously healthy patients 2 months to 5 years of age.
B) adults younger than 30 years of age.
C) community-acquired pneumonia in adults.
D) school-age children.
Q3) Mycoplasma pneumoniae is detected as the most common agent of lower respiratory tract infection among:
A) previously healthy patients 2 months to 5 years of age.
B) adults younger than 30 years of age.
C) community-acquired pneumonia in adults.
D) school-age children.
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Chapter 69: Upper Respiratory Tract Infections and Other
Infections of the Oral Cavity and Neck
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Q1) Stomatitis
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) Epiglottitis
A)Influenza virus, parainfluenza virus, rhinovirus, and other viruses
B)Influenza virus, parainfluenza virus, Mycoplasma
C)Haemophilus influenzae
D)Streptococcus pyogenes
E)Anaerobes including Fusobacterium, Bacteroides, and anaerobic cocci
F)Herpes simplex virus
G)Candida spp.
H)Mixed bacteria with spirochetes
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Chapter 70: Meningitis, Encephalitis, and Other Infections of
the Central Nervous System
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Q1) Proper storage of cerebrospinal fluid (CSF)sent to the laboratory for bacterial culture includes:
A) refrigeration for up to 23 hours.
B) freezing at 70° C.
C) incubation at 35° C.
D) freezing at temperatures above 70° C.
Q2) 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.
Q3) An increase of lymphocytes and other mononuclear cells (pleocytosis)in the CSF and negative bacterial and fungal cultures is referred to as:
A) meningoencephalitis.
B) aseptic meningitis.
C) encephalitis.
D) pleocytosis.
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Chapter 71: Infections of the Eyes, Ears, and Sinuses
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Q1) 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.
Q2) 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
Q3) The most common etiologic agents in acute otitis media in children include:
A) Klebsiella pneumococci.
B) Haemophilus influenzae.
C) Streptococcus agalactiae.
D) Moraxella catarrhalis.
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Page 73
Chapter 72: Infections of the Urinary Tract
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Q1) The term acute urethral syndrome is used to describe a syndrome of symptoms that include:
A) greater than 105 colony-forming units of bacteria per milliliter (CFU/mL) of urine, dysuria, and frequent urination.
B) dysuria, frequency, and urgency but a specimen yielding 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.
Q2) The resident microflora that can colonize the bladder and other structures of the urinary tract are:
A) Enterobacteriaceae.
B) yeast.
C) Propionibacterium acnes.
D) Corynebacteria.
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Chapter 73: Genital Tract Infections
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Q1) Bacterial vaginosis
A)Anaerobic and polymicrobic infections originating from normal genital flora
B)Chlamydia trachomatis
C)Gardnerella, Prevotella spp., Porphyromonas spp., Peptostreptococcus spp.,
Mobiluncus spp.
D)Neisseria gonorrhoeae
E)Neisseria gonorrhoeae and Chlamydia trachomatis
F)Escherichia coli and other enteric organisms
G)Mumps virus
Q2) Large amounts of epithelial cells, many of which are covered by tiny gram-variable rods and coccobacilli, and the absence of inflammatory cells in vaginal discharge are signs of:
A) pelvic inflammatory disease (PID).
B) bartholinitis.
C) cervicitis.
D) bacterial vaginosis.
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Chapter 74: Gastrointestinal Tract Infections
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Q1) Campylobacter thioglycollate 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
Q2) 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
Q3) 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
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Chapter 75: Skin, Soft Tissue, and Wound Infections
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Q1) 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
Q2) Myositis
A)Extensive necrosis of muscle caused by infectious agents
B)Infection of the fascia overlying muscle groups, often with the involvement of the overlying soft tissue
C)Slowly progressive infection of the subcutaneous tissue with associated ulceration of portions of the overlying skin
D)Chronic gangrenous condition of the skin most often encountered as a postoperative complication, particularly after abdominal or thoracic surgery
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Chapter
Marrow, and Solid Tissues
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Q1) 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
Q2) Most cases of peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD)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 accounting for approximately 70% of infections is:
A) Streptococcus pyogenes.
B) Haemophilus influenza.
C) Staphylococcus aureus.
D) Streptococcus mitis.
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Chapter 77: Quality in the Clinical Microbiology Laboratory
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Q1) Protocol for testing susceptibility test systems include testing _____ consecutive days.
A) daily for 7
B) bi-weekly for 30
C) every other day for 14
D) with use for 20
Q2) Define, measure, analyze, improve, and control (DMAIC)are the basis for which new concept?
A) Total Quality Management
B) Continuous Quality Improvement
C) Performance Improvement
D) Six Sigma
Q3) In addition to recording the lot number, date received, condition received, and expiration date, antisera should be:
A) discarded after each use.
B) frozen upon arrival.
C) dated when opened.
D) tested by the supervisor first before anyone uses it.
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Chapter 78: Infection Control
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Q1) An infection acquired by a hospitalized patient that was not present when he or she entered the hospital is referred to as a(n)_____ infection.
A) autonomous
B) nosocomial
C) opportunistic
D) septic
Q2) 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.
Q3) A phenotypic technique of typing microbial strains that consists of analyzing unique biologic or biochemical characteristics of the organism of interest is: A) biotyping.
B) antibiograms.
C) serotyping.
D) bacteriophage typing.
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Chapter 79: Sentinel Laboratory Response to Bioterrorism
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Q1) The act of using microorganisms to harm the civilian population intentionally is referred to as:
A) biosecurity.
B) biocrime.
C) microterrorism.
D) cactiterrorism.
Q2) If a pinpoint colony on blood agar after 24 hours of incubation is isolated, and if the colony is oxidase-, urease-, and indole-negative and also exhibits bipolar staining on Gram stain, then the suspect bioterror agent is most likely:
A) Bacillus anthracis.
B) Francisella tularensis.
C) Brucella spp.
D) Yersinia pestis.
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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