Microbial Pathogenesis Practice
Questions
Course Introduction
Microbial Pathogenesis explores the mechanisms by which microorganisms cause disease in humans and animals. This course examines the molecular interactions between pathogenic microbes bacteria, viruses, fungi, and parasites and their hosts, focusing on strategies pathogens use to invade, evade immune responses, and cause cellular damage. Major topics include virulence factors, host-pathogen interactions, microbial toxins, mechanisms of host defense, and approaches to diagnosing, treating, and preventing infectious diseases. Students gain a foundational understanding of pathogen biology and its relevance to medicine and public health.
Recommended Textbook
Bailey and Scotts Diagnostic Microbiology 12th Edition by Betty A. Forbes
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Chapter 1: Microbial Taxonomy
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Sample Questions
Q1) A collection of bacterial strains that share many common physiologic and genetic features can be defined as
A)genus.
B)species.
C)class.
D)kingdom.
E)order.
Answer: B
Q2) Taxonomy can be described as
A)a consistent means to classify, name, and identify organisms.
B)the common language in science that minimizes confusion about names.
C)the naming system that allows scientific attention to center on more important issues and phenomena.
D)playing a central role in providing accurate and timely diagnosis of infectious diseases.
E)All of the above are true.
Answer: E
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Chapter 2: Bacterial Genetics Metabolism and Structure
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Q1) A DNA sequence that encodes for a specific product (RNA or protein) is defined as a A)gene.
B)genome.
C)nucleotide.
D)deoxyribonucleic acid.
Answer: A
Q2) The term used when oxidative phosphorylation uses oxygen as the terminal electron acceptor is
A)substrate level phosphorylation.
B)fermentative metabolism.
C)oxidative phosphorylation.
D)aerobic respiration.
E)anaerobic respiration.
Answer: D
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4
Chapter 3: Host-Microorganism Interactions
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Q1) Infectious processes that develop quickly are referred to as A)chronic infections.
B)latent infections.
C)acute infections.
D)nosocomial infections.
Answer: C
Q2) Cells that ingest and destroy bacteria and other foreign particles are called A)phagocytes.
B)polymorphonuclear leukocytes.
C)neutrophils.
D)macrophages.
E)All of the above are correct.
Answer: E
Q3) Which immune system cells destroy infected or malignant host cells?
A)B lymphocytes
B)T lymphocytes
C)Natural killer cells
D)Neutrophils
Answer: C
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Page 5
Chapter 4: Laboratory Safety
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Sample Questions
Q1) The agency that published a guide to hazardous waste reduction is A)DHEC.
B)OSHA.
C)CDC.
D)EPA.
Q2) Optimal protection of specimen, personnel, and environment is accomplished with which class of biological safety cabinet?
A)Class I
B)Class II
C)Class III
D)Class IV
Q3) Minimal protection of specimen and personnel is accomplished with which class of biological safety cabinet?
A)Class I
B)Class II
C)Class III
D)Class IV
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Chapter 5: Specimen Management
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Q1) Microaerophiles grow best in
A)ambient air, which contains 21% oxygen (O ) and a small amount (0.03%) of carbon dioxide.
B)increased concentrations of CO (5% to 10%) and approximately 15% O .
C)Five percent to 10% hydrogen (H ), 5% to 10% CO , 80% to 90% nitrogen (N ), and 0% O .
D)Reduced O (5% to 10%) and increased CO (8% to 10%).
Q2) Which type of media is designed to support the growth of a wide range of microorganisms?
A)Selective
B)Nutritive
C)Differential
D)Definitive
Q3) Capnophiles grow best in
A)ambient air, which contains 21% oxygen (O ) and a small amount (0.03%) of carbon dioxide.
B)increased concentrations of CO (5% to 10%) and approximately 15% O .
C)Five percent to 10% hydrogen (H ), 5% to 10% CO , 80% to 90% nitrogen (N ), and 0% O .
D)Reduced O (5% to 10%) and increased CO (8% to 10%).
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Chapter 6: Role of Microscopy
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Q1) In microscopy, resolution can be defined as
A)the magnification power.
B)the extent to which detail in the magnified object is maintained.
C)the ability of objects to stand out from the background.
D)All of the above are correct.
Q2) The third step in the Gram stain is the application of the A)safranin.
B)crystal violet.
C)Gram's iodine.
D)Gram's decolorizer.
Q3) Magnifications in excess of 100,000´ are achieved by which type of microscopy?
A)Bright-field microscopy
B)Electron microscopy
C)Dark-field microscopy
D)Phase contrast microscopy
E)All of the above are correct.
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8
Chapter 7: Traditional Cultivation and Identification
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Q1) Which medium can be described as containing bile salts and dyes (bromthymol blue and acid fuchsin) to selectively slow the growth of most nonpathogenic gram-negative bacilli found in the gastrointestinal tract and allow Salmonella spp.and Shigella spp.to grow?
A)Thayer-Martin
B)MacConkey
C)PEA (phenylethyl alcohol)
D)Hektoen
Q2) 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
Q3) Which category of media would blood agar best fit?
A)Selective
B)Differential
C)Selective and differential
D)Supportive only
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Chapter 8: Nucleic Acid-Based Analytic Methods for
Microbial Identification and Characterization
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Q1) Complementary nucleic acid hybridization is coupled with nucleic acid replication and applied repeatedly through numerous cycles.
A)Hybridization
B)Sequencing
C)Amplification (PCR)
D)Genotypic
Q2) Nucleic acid sequencing methods are based on
A)the ability of two nucleic acid strands that have complementary base sequences to specifically bond with each other and form a double-stranded molecule.
B)detecting phenotypic traits not detectable by conventional strategies.
C)the principles of complementary nucleic acid hybridization with those of nucleic acid replication.
D)determining the exact nucleotide sequence of a gene or gene fragment obtained from an organism.
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Chapter 9: Immunochemical Methods Used for Organism
Detection
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Sample Questions
Q1) A modification of the Ouchterlony method that speeds up migration of an antigen and antibody by applying an electrical current is referred to as
A)double immunodiffusion.
B)counterimmunoelectrophoresis.
C)particle agglutination.
D)enzyme immunoassay.
Q2) Polyclonal antibodies are those that
A)react with many different types of antigens.
B)react with many species of bacteria within the same genus.
C)react with many different antigens of one specific organism.
D)can be produced from many different species of host organisms.
Q3) 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)react with many different antigens of one specific organism.
D)can be produced from many different species of host organisms.
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Chapter 10: Serologic Diagnosis of Infectious Diseases
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Q1) The immunochemical test that involves the agglutination of an artificial carrier particle with antigen bound to its surface with antibody present in a specimen is referred to as
A)double immunodiffusion.
B)counterimmunoelectrophoresis.
C)particle agglutination.
D)enzyme immunoassay.
Q2) Antibody-mediated immune responses produced by specific proteins are generated by
A)lymphocytes of the T (thymus-derived) class.
B)lymphocytes of the B (bone marrow-derived) class.
C)neutrophils.
D)basophils.
Q3) For accurate diagnostic of current infection, acute and convalescent sera should reflect a/an
A)decrease in the patient's antibody titer of two doubling dilutions.
B)increase in the patient's titer of two doubling dilutions.
C)decrease in the patient's antibody titer of four doubling dilutions.
D)increase in the patient's titer of four doubling dilutions.
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Page 12
Chapter 11: Principles of Antimicrobial Action Resistance
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Q1) Rifampin
A)Cell wall synthesis inhibition
B)Cell membrane function inhibition
C)Protein synthesis inhibition
D)DNA and RNA synthesis inhibition
Q2) Bacterial resistance to beta-lactams may be mediated by
A)enzymatic destruction of the antibiotics.
B)altered antibiotic targets.
C)decreased intracellular uptake of the drug.
D)All of the above are correct.
Q3) Antimicrobial resistance resulting from the normal genetic, structural, or physiologic state of a microorganism is referred to as
A)intrinsic resistance.
B)inherent resistance.
C)microorganism mediated resistance.
D)All of the above are correct.
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Chapter 12: Laboratory Methods and Strategies for Antimicrobial Susceptibility Testing
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Q1) Chromogenic cephalosporins are used to test for A)the action of beta-lactamase inhibitors.
B)intrinsic resistance to beta-lactam drugs by decreased intracellular uptake of the drug.
C)the production of beta-lactamase by the infecting organism.
D)intrinsic resistance to beta-lactam drugs by altered antibiotic targets.
Q2) Detection of the haze produced by some resistant staphylococci and enterococci against methicillin and vancomycin can best be accomplished by A)using reflected light.
B)using transmitted light.
C)placing the medium under the light rather than in front of it.
D)microscopy.
Q3) In the disk diffusion method of antimicrobial susceptibility testing, what is the standard agar base medium for testing most bacterial organisms?
A)5% blood agar
B)Mueller-Hinton agar
C)Mueller-Hinton broth
D)Brain heart infusion broth
E)Any of the above can be used.
Page 14
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Chapter 13: Staphylococcus, Micrococcus, and Similar Organisms
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Q1) The staphylococcus that is more likely to cause uncomplicated urinary tract infections in nonhospitalized hosts, especially sexually active young women, is
A)Staphylococcus saprophyticus.
B)Staphylococcus aureus.
C)Staphylococcus epidermidis.
D)Staphylococcus intermedius.
Q2) The tube coagulase test
A)detects bound coagulase.
B)detects extracellular coagulase.
C)is performed on slide coagulase-positive isolates to confirm this positive result.
D)requires citrated reagent plasma.
Q3) Isolates of coagulase-negative Staphylococcus from urinary tract infections can be presumptively identified as S.saprophyticus based on
A)penicillin susceptibility.
B)novobiocin resistance.
C)penicillin resistance.
D)novobiocin susceptibility.
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Page 15
Chapter 14: Streptococcus, Enterococcus, and Similar Organisms
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Q1) Generally speaking, nutritionally variant streptococci require what ingredient not found in most conventional media?
A)Vitamin B6.
B)Nalidixic acid and its components
C)NAD enrichment
D)Blood or blood products
Q2) The bacterial species that can be described as able to hydrolyze hippurate, beta hemolytic, a major cause of neonatal meningitis and sepsis, and producer of the CAMP factor is
A)Enterococcus faecalis.
B)Streptococcus pneumoniae.
C)Streptococcus pyogenes.
D)Streptococcus agalactiae.
E)viridans streptococci.
Q3) Optochin, PYR, bile solubility, esculin, and 6.5% NaCl are tests most likely performed on a/an
A)alpha-hemolytic streptococcus.
B)beta-hemolytic streptococcus.
C)nonhemolytic streptococcus.
D)All of the above are correct.
Page 16
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Chapter 15: Bacillus and Similar Organisms
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Q1) Induction of sporulation by Bacillus sp.can be accomplished with A)5% sheep blood agar.
B)PLET agar.
C)bicarbonate agar.
D)urea agar.
E)All of the above are correct.
Q2) Media that can be used for isolation of Bacillus anthracis include
A)Thayer-Martin agar.
B)5% sheep blood agar.
C)MacConkey agar.
D)CNA blood agar.
Q3) Suspect spore-forming gram-positive bacilli that are nonhemolytic, nonmotile, and penicillin-susceptible, and that produce a wide zone of lecithinase on egg yolk agar can be identified as
A)Corynebacterium diphtheriae.
B)Bacillus anthracis.
C)Bacillus cereus.
D)Corynebacterium jeikeium.
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Chapter 16: Listeria, Corynebacterium, and Similar Organisms
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Q1) The organism that exhibits characteristic end-over-end tumbling motility when incubated in nutrient broth at room temperature for 1 to 2 hours is
A)Listeria monocytogenes.
B)Corynebacterium diphtheriae.
C)Bacillus anthracis.
D)Bacillus cereus.
Q2) Patients who are immunocompromised and pregnant women should avoid eating soft cheeses such as Mexican-style, feta, brie, Camembert, and blue-veined cheese to prevent
A)foodborne listeriosis.
B)staphylococcal food poisoning.
C)gastric gangrene.
D)salmonella infection.
Q3) 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
Page 18
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Chapter 17: Erysipelothirix, Lactobacillus, and Similar Organisms
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Q1) A catalase-negative, non-spore-forming, gram-positive rod that is not acid-fast could possibly belong to which group of bacteria?
A)Corynebacterium
B)Bacillus
C)Actinomyces
D)Erysipelothrix
Q2) Erysipelothrix can be described as
A)catalase-negative
B)not acid-fast
C)not branching
D)non-spore-forming
E)All of the above are correct.
Q3) Large, squamous epithelial cells with numerous attached pleomorphic gram-variable or gram-negative coccobacilli and rods are typical elements of a wet mount and Gram stain of vaginal secretions from a patient who has
A)bacterial vaginosis caused by Gardnerella vaginalis.
B)large numbers of large gram-positive rods.
C)large numbers of polymorphonuclear leukocytes.
D)All of the above are correct.
Page 19
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Chapter 18: Nocardia, Streptomyces, Rhodococcus, Oerskovia,
and Similar Organisms
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Q1) Nocardia spp.cause which of the following types of infections in immunocompetent individuals?
A)Urinary tract infections
B)Disseminated infections
C)Skin abscesses or cellulites
D)Invasive pulmonary infections
Q2) Partially acid-fast aerobic actinomycetes include
A)Nocardia.
B)Rhodococcus
C)Gordona
D)Tsukamurella
E)All of the above are correct.
Q3) 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.
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Chapter 19: Enterobacteriaceae
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Q1) The gram-negative bacillus that can be described as oxidase-negative, nitrate-positive, indole-negative, citrate-positive, methyl red-positive, urease-negative, H S-positive is
A)Klebsiella pneumoniae.
B)Proteus vulgaris.
C)Salmonella enteritidis.
D)Escherichia coli.
E)Shigella sonnei.
Q2) Alkaline slant, acid butt, no H S
A)Salmonella species
B)Escherichia coli
C)Proteus species
D)Pseudomonas species
Q3) The swarming gram-negative bacillus that can be presumptively identified based on a positive indole test is
A)Klebsiella pneumoniae.
B)Proteus vulgaris.
C)Enterobacter aerogenes.
D)Escherichia coli.
E)Shigella sonnei.
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Chapter 20: Acinetobacter, Stenotrophomonas, and Other Organisms
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Q1) For more serious infections caused by Acinetobacter spp., such as pneumonia or bacteremia, effective treatment may require the use of
A)multiple rounds of penicillin or similar antibiotic.
B)a beta-lactam agent in combination with an aminoglycoside.
C)repeated high level doses of gentamycin.
D)single-drug therapy in combination with a steroid.
Q2) The natural habitat of Acinetobacter sp.can best be described as
A)the mucous membranes of animals.
B)the gastrointestinal tract of humans and other animals.
C)the natural environment.
D)the genitourinary tract of animals.
Q3) An organism that can be described as oxidase-negative, MacConkey agar-positive, glucose nonfermenter is likely
A)Escherichia.
B)Pseudomonas.
C)Acinetobacter.
D)Moraxella.
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Page 22
Chapter 21: Pseudomonas, Burkholderia, and Similar Organisms
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Q1) Excluding Enterobacteriaceae, name the second most common gram-negative bacilli encountered in clinical specimens.
A)Pseudomonas
B)Burkholderia
C)Ralstonia
D)Vibrio
Q2) An organism described as oxidase-positive, TSI slant with an alkaline/no change, good growth at 42° C, and producing bright bluish green pigment on Mueller-Hinton agar is most likely
A)Pseudomonas aeruginosa.
B)Ralstonia pickettii.
C)Burkholderia mallei.
D)Burkholderia pseudomallei.
Q3) Which best describes the source of Burkholderia cepacia infections?
A)Plants, soil, and water
B)Medical devices medical solutions
C)Contaminated foods
D)None of the above are correct.
E)All of the above are correct.
Page 23
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Chapter 22: Achromobacter, Rhizobium, Ochrobactrum, and Similar
Organisms
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Q1) Choose the habitat of the bacterium Ochrobactrum anthropi.
A)Environmental only, not human flora
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
E)Environmental and human flora
Q2) Valid susceptibility testing methods are not available for
A)Enterobacteriaceae.
B)Achromobacter.
C)Pseudomonas.
D)Staphylococcus.
Q3) Choose the habitat of the bacterium Rhizobium radiobacter.
A)Environmental
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
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24
Chapter 23: Chryseobacterium, Sphingobacterium, and Similar Organisms
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Q1) Choose the habitat of the bacterium Empedobacter.
A)Environmental
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
Q2) Among the yellow-pigmented, oxidase-positive, glucose oxidizers that are occasionally encountered in human specimens are
A)Chryseobacterium meningosepticum.
B)Flavobacterium meningosepticum.
C)Sphingobacterium spiritivorum.
D)Empedobacter brevis.
E)All of the above are correct.
Q3) Choose the habitat of the bacterium Chryseobacterium.
A)Environmental
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
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Comamonas, and Similar Organisms
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Q1) Pertussis (whooping cough), an epidemic disease, is a highly contagious, acute infection of the upper respiratory tract caused by A)Brucella species.
B)Bordetella species.
C)Pasteurella species.
D)Francisella species.
Q2) The mode of transmission of Achromobacter denitrificans can best be described as A)person to person contact.
B)exposure to contaminated water.
C)contaminated fluids or medical solutions.
D)close contact with animals.
Q3) Gram stain morphology, motility, and flagellar placement are important identifying characteristics of
A)Chryseobacterium.
B)Flavobacterium.
C)Pseudomonas.
D)Bordetella.
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26
Chapter 25: Vibrio, Aeromonas, Plesiomonas Shigelloides, and
Chromobacterium Violaceum
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Q1) 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
Q2) Profuse watery diarrhea ("rice water stools"), leading to dramatic fluid loss, severe dehydration, and hypotension that frequently leads to death, is the hallmark of which toxin activity?
A)Cholera toxin (CT)
B)Enteric endotoxin
C)Shiga toxin
D)Toxin A
Q3) Transmission of Plesiomonas shigelloides to humans is by
A)exposure of disrupted skin and mucosal surfaces to contaminated animal hides.
B)ingestion of contaminated seafood or water.
C)inhalation of contaminated air.
D)close contact with carriers of the organism.
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Chapter 26: Sphingomonas Paucimobilis and Similar Organisms
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Q1) Sphingomonas spp.can be described as
A)oxidase-negative, glucose-fermenting, gram-negative bacilli that grow on MacConkey agar.
B)oxidase-positive, glucose-oxidizing, gram-negative bacilli that fail to grow on MacConkey agar.
C)oxidase-positive, glucose-fermenting, gram-negative bacilli that grow on MacConkey agar.
D)oxidase-positive, non-glucose-utilizing, gram-negative bacilli that do not grow on MacConkey agar.
Q2) Oxidase-positive, glucose-positive, (oxidatively) gram-negative bacilli that cannot grow on MacConkey agar include A)Pseudomonas.
B)Vibrio.
C)Stenotrophomonas.
D)Sphingomonas.
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Chapter 27: Moraxella
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Q1) In Gram-stained preparations, Moraxella lincolnii will appear as
A)either gram-negative coccobacilli or short, broad rods that tend to resist decolorization and may appear gram-variable.
B)gram-negative cocci in pairs or short chains.
C)coccobacilli or medium-sized rods.
D)coccobacilli that may appear in chains.
E)either coccobacilli or short, straight rods.
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.
E)either coccobacilli or short, straight rods.
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Chapter 28: Eikenella Corrodens and Similar Organisms
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Q1) Of the asaccharolytic, oxidase-positive bacilli that do not grow on MacConkey agar, which one is among the HACEK group of bacteria known to cause subacute bacterial endocarditis?
A)Eikenella corrodens
B)Weeksella virosa
C)Pseudomonas maltophilia
D)Sphingomonas paucimobilis
E)All of the above are correct.
Q2) Of the asaccharolytic, oxidase-positive bacilli, which bacterial species can be recognized in culture by its bleachlike odor?
A)Eikenella corrodens
B)Weeksella virosa
C)Pseudomonas maltophilia
D)Sphingomonas paucimobilis
E)All of the above are correct.
Q3) Valid susceptibility testing methods are not available for
A)Enterobacteriaceae.
B)Pseudomonas.
C)Eikenella.
D)Staphylococcus.
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Chapter 29: Pasteurella and Similar Organisms
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Q1) Although most other clinically relevant gram-negative bacilli are intrinsically resistant to penicillin, it is the drug of choice for infections involving
A)Sphingomonas paucimobilis.
B)Eikenella corrodens.
C)Pasteurella multocida.
D)Weeksella virosa.
E)All of the above are correct.
Q2) Which of the following bacterial species is part of animal flora and is transmitted to humans during close animal contact, including bites?
A)Sphingomonas paucimobilis
B)Eikenella corrodens
C)Pasteurella multocida
D)Weeksella virosa
E)All of the above are correct.
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Chapter 30: Actinobacillus, Kingella, Cardiobacterium,
Capnocytophaga, and Similar Organisms
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Q1) Capnocytophaga hominis can be distinguished from Haemophilus aphrophilus by
A)its negative test for catalase.
B)its positive test for lactose fermentation.
C)its positive test for indole.
D)its negative test for oxidase.
E)All of the above are correct.
Q2) Actinobacillus actinomycetemcomitans can be distinguished from Capnocytophaga hominis by
A)its negative test for catalase.
B)its positive test for lactose fermentation.
C)its positive test for catalase.
D)its negative test for indole.
E)All of the above are correct.
Q3) Kingella spp.can be distinguished from Neisseria spp.by
A)its negative test for catalase.
B)its positive test for lactose fermentation.
C)its positive test for catalase.
D)its negative test for oxidase.
E)All of the above are correct.
Page 32
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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 seen growing on sheep blood agar very close to colonies of bacteria that can produce A)hemin.
B)nicotine adenine dinucleotide (NAD).
C)vitamin K.
D)cysteine.
Q2) Although a useful test in the past, the particle agglutination assay for detection of H.influenzae type b capsular polysaccharide antigen is no longer reliable due to A)insufficiently high concentration of the organisms in clinical infections.
B)Lack of sensitivity and specificity of the test procedure.
C)Frequent use of antimicrobial therapy before collection of the specimen.
D)Increased use of H.influenzae type b vaccination.
Q3) Pleomorphic rods
A)H. haemolyticus
B)H. influenzae biotype aegypticus
C)H. influenzae
D)H. segnis
E)H. parainfluenzae
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Chapter 32: Bartonella and Afipia
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Q1) Bacteremia, endocarditis, bacillary angiomatosis, cat-scratch disease, and peliosis hepatitis can all be caused by A)Afipia felis.
B)Rochalimaea quintana.
C)Bartonella clarridgeiae.
D)Bartonella henselae.
Q2) A common characteristic of the bacterial species Bartonella henselae and Afipia felis is
A)both are believed to cause cat-scratch disease.
B)the ability to grow on chocolate agar but not very well on routine blood (trypticase soy agar with 5% sheep blood) and not at all on MacConkey agar.
C)that primary isolation from clinical specimens is best accomplished using special cultivation conditions.
D)All of the above are correct.
E)None of the above are correct.
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Chapter 33: Campylobacter, Arcobacter, and Helicobacter
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Q1) Organisms belonging to the genus Campylobacter are
A)gram-positive diplococci.
B)gram-positive diphtheroid bacilli.
C)gram-negative curved bacilli.
D)gram-negative straight-sided bacilli.
Q2) The majority of human infections with Campylobacter species are caused by
A)direct contact with carriers of the bacterium.
B)contamination of food, milk, or water with animal feces.
C)multiplication of the organism in food products.
D)direct contact with persons infected with the bacterium.
Q3) Curved, microaerophilic, gram-negative rods, with most species having strong urease activity and the majority of which colonize mammalian stomachs or intestines describes which group of bacteria?
A)Campylobacter
B)Helicobacter
C)Arcobacter
D)Enterobacte
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Chapter 34: Legionella
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Q1) To cultivate Legionella in the laboratory, a medium supplemented with what ingredient(s) is necessary?
A)L-cysteine
B)Blood and cysteine
C)Dopa-cysteine
D)Nicotinic adenine
E)All of the above are correct.
Q2) 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.
Q3) Specimens for culture recovery of Legionella should be inoculated to
A)BCYE (buffered charcoal yeast extract).
B)Regan-Lowe agar.
C)Löwenstein-Jensen.
D)blood and chocolate agars.
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Chapter 35: Brucella
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Q1) Persons considered at greatest risk for contracting brucellosis are
A)dairy farmers.
B)livestock handlers.
C)slaughterhouse employees.
D)veterinarians.
E)All of the above are correct.
Q2) The serum agglutination test (SAT) detects antibodies to A)Brucella abortus.
B)B.melitensis.
C)B.suis.
D)All of the above are correct.
Q3) A nonmotile, urease- and nitrate-positive, strictly aerobic gram-negative coccobacillus is most likely
A)Bordetella.
B)Moraxella.
C)Kingella.
D)Acinetobacter.
E)Brucella.
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Chapter 36: Bordetella Pertussis and Bordetella
Parapertussis
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Q1) During the paroxysmal stage of pertussis, symptoms are
A)a runny nose and mild cough.
B)severe and violent coughing.
C)neutrocytosis and fever.
D)lymphadenitis.
Q2) 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) Acceptable specimens for detection of Bordetella pertussis are A)throat swabs.
B)sputum.
C)nasopharyngeal aspirates.
D)anterior nose swab.
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Chapter 37: Francisella
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Q1) Tularemia, characterized by glandular, ulceroglandular, oculoglandular, oropharyngeal, systemic, and pneumonic presentations is caused by A)Brucella species.
B)Bordetella species.
C)Pasteurella species.
D)Francisella species.
Q2) F.philomiragia differs from F.tularensis in that it
A)is oxidase-negative.
B)is hydrogen sulfide-positive.
C)does not hydrolyze gelatin.
D)does not grow in 6% sodium chloride.
E)All of the above are correct.
Q3) One of the most common laboratory-acquired infections that is caused by a Biosafety Level 2 pathogen is caused by A)Bordetella pertussis.
B)Francisella tularensis.
C)Pasteurella multocida.
D)Staphylococcus aureus.
E)All of the above are correct.
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Page 39
Chapter 38: Streptobacillus Moniliformis and Spirillum
Minus
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Q1) The name given to rat-bite fever when the illness is caused by acquired S.minus is A)Sodoku.
B)Haverhill fever.
C)Monillic fever.
D)Monillic gastritis.
Q2) 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) Rat-bite fever, or Haverhill fever, characterized by acute onset of chills, fever, headache, vomiting, and often severe joint pains and a rash on the palms, soles of the feet, and other extremities is caused by
A)Streptobacillus moniliformis.
B)Brucella abortus.
C)Bordetella species.
D)Pasteurella species.
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Chapter 39: Neisseria and Moraxella Catarrhalis
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Q1) Moraxella catarrhalis can be described as a
A)gram-positive diplococcus.
B)gram-negative diplococcus.
C)gram-negative coccobacillus.
D)gram-negative bacillus.
Q2) Which statement is true regarding the pathogenesis of N.meningitidis?
A)N.meningitidis is a leading cause of fatal bacterial meningitis.
B)Virulence factors include pili, capsule formation, and endotoxin.
C)Disseminated intravascular coagulation (DIC) and thrombocytopenia are complications of infection.
D)Petechiae (rash) may be associated with meningitis and bacteremia.
E)All of the above are true.
Q3) Generally speaking, Neisseria require what ingredient found in some conventional culture media?
A)Vitamin B6
B)Nalidixic acid and its components
C)Vitamin B12
D)Blood or blood products
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Chapter 40: Overview and General Considerations
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Q1) Bronchial washing collected with double lumen plugged catheter
A)Acceptable
B)Not acceptable
Q2) Urine via percutaneous aspiration
A)Acceptable
B)Not acceptable
Q3) Pre-reduced, anaerobically sterilized (PRAS) media
A)are produced, packaged, shipped, and stored under anaerobic conditions.
B)have a short shelf life of only 2 weeks.
C)enable the culture to be incubated in the regular incubator under aerobic conditions.
D)All of the above are correct.
Q4) Aspiration of peritoneal fluid using a needle and syringe
A)Acceptable
B)Not acceptable
Q5) Rectal swab
A)Acceptable
B)Not acceptable
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Chapter 41: Laboratory Considerations
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Q1) Optimal recovery and identification of anaerobic bacteria in clinical specimens occurs when
A)the initial incubation period is at 35° to 37° C for 48 hours.
B)plates are incubated for at least 3 days before discarding as negative.
C)the initial incubation period is at 35° to 37° C for 24 hours.
D)thioglycollate broth can be inspected daily for 3 days.
Q2) The media used for culturing a blood specimen for anaerobes may include
A)anaerobic blood agar.
B)Schaedler's broth.
C)5% sheep blood agar.
D)laked kanamycin-vancomycin blood agar.
E)All of the above are correct.
Q3) The ethanol shock or heat shock test will separate which two bacteria?
A)Clostridium perfringens and Clostridium ramosum
B)Clostridium and Bifidobacterium
C)Actinomyces and Bifidobacterium
D)Eubacterium and Eggerthella
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Page 43
Chapter 42: Mycobacteria
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Q1) Optimal conditions for most mycobacterial cultures are
A)25° to 30° C in the dark in an atmosphere of 2% carbon dioxide and high humidity.
B)35° C in the dark in an atmosphere of 5% to 10% carbon dioxide and high humidity.
C)35° C in the dark in a microaerophilic atmosphere of 10% carbon dioxide and high humidity.
D)32° C in the dark in an atmosphere of decreased carbon dioxide and increased humidity.
Q2) The first test that is always performed on organisms growing on solid or liquid mycobacterial media is
A)the niacin test.
B)an acid-fast stain.
C)a Gram stain.
D)a broth test.
Q3) On Gram stain, mycobacteria appear as
A)slender, well-stained gram-positive bacilli.
B)poorly stained, beaded, gram-positive bacilli.
C)gram-variable to gram-positive bacilli.
D)partially invisible gram-negative bacilli.
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Page 44
Chapter 43: Obligate Intracellular and Nonculturable Bacterial Agents
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Q1) The extracellular, metabolically inert, infective form of the Chlamydia is called the A)reticulate body.
B)elementary body.
C)replicate body.
D)initial body.
Q2) The organisms in the genus Chlamydia can be described as A)having a replicative form called the reticulate body.
B)having an intracellular infective form called the elementary body.
C)having an extracellular, metabolically inert, infective form.
D)All of the above are true.
Q3) The most common sexually transmitted bacterial pathogen and a major cause of pelvic inflammatory disease is
A)Rickettsia.
B)Chlamydia.
C)Calymmatobacterium.
D)Coxiella.
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Chapter 44: Cell Wall-Deficient Bacteria: Mycoplasma and Ureaplasma
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Q1) Media that can be used for isolation of Mycoplasma include
A)Thayer-Martin agar with vitamin K.
B)5% sheep blood and IsoVitaleX.
C)beef or soybean protein with serum and fresh yeast extract.
D)Hemin and NAD supplements.
Q2) Which of the following agents lacks a cell wall and is the smallest known free-living form?
A)Chlamydia
B)Mycoplasma
C)Rickettsia
D)Coxiella
Q3) The natural habitat of Mycoplasma sp., which causes infectious disease in humans, can best be described as
A)the mucous membranes of humans.
B)the aquatic environment.
C)the natural environment.
D)the genitourinary tract of animals.
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Page 46
Chapter 45: The Spirochetes
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Q1) A widely used nontreponemal serologic test is the A)VDRL.
B)PPR.
C)FTA-ABS.
D)MHA-TP.
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
A)NTF (nontreponemal flocculation).
B)FTA-ABS (fluorescent treponemal antibody absorption) test.
C)VDRL (Venereal Disease Research Laboratory) test.
D)TP-PA (T.pallidum particle agglutination) test.
Q3) A stage of venereal syphilis characterized by tissue destruction, central nervous disease, cardiovascular abnormalities, eye disease, and granuloma-like lesions is known as
A)primary syphilis.
B)secondary syphilis.
C)tertiary syphilis.
D)quaternary syphilis.
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Page 47
Chapter 46: Laboratory Methods for Diagnosis of Parasitic
Infections
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Q1) The most common larvae found in stool specimens is A)Ascaris lumbricoides.
B)Strongyloides stercoralis.
C)Paragonimus westermani.
D)Naegleria fowleri.
Q2) Iodamoeba bütschlii
A)Rectal tape prep
B)Tissue biopsy
C)Sputum
D)Feces
E)Blood smear
Q3) Toxoplasma gondii
A)Feces
B)Blood smear
C)Vaginal secretions
D)CSF
E)Skin scraping
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Page 48
Chapter 47: Laboratory Methods in Basic Mycology
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Q1) Molds that have pigmentation within the hyphae or the spores are referred to as A)hyaline molds.
B)pauciseptate molds.
C)dematiaceous molds.
D)nigraceous molds.
Q2) The presence of large, round or oval, multiply budding yeast cells, which resemble a "mariner's wheel," usually indicates infection with A)Coccidioides immitis.
B)Blastomyces dermatitidis.
C)Histoplasma capsulatum.
D)Paracoccidioides brasiliensis.
Q3) The tubular outpouching that occurs in some yeast cells without constriction at its base is referred to as A)pseudohyphae.
B)a germ tube.
C)ascospore.
D)a bud scar.
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49
Chapter 48: Laboratory Methods in Basic Virology
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Q1) The specimen of choice for detecting rotavirus is a A)throat swab.
B)urine sample.
C)bronchoalveolar wash.
D)feces sample.
Q2) Influenza A and B viruses can be detected in clinical specimens using A)cell culture.
B)shell vial assay.
C)enzyme immunoassay.
D)FA staining methods.
E)All of the above are correct.
Q3) In general, specimens collected for detection of virus should be A)placed in ice and transported to the laboratory at once.
B)frozen until processing occurs.
C)processed within 1 to 2 days of collection.
D)inoculated into cell culture at the bedside.
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Chapter 49: Bloodstream Infections
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Q1) Intravascular bloodstream infections
A)Condition wherein fungi are present in blood, occurring primarily in immunosuppressed patients and in those with serious or terminal illness
B)The action of bacteria being carried, usually to all organs of the host, where they may grow, invade normal tissue, and produce toxic products
C)A temporary, incidental presence of bacteria in the bloodstream
D)The situation in which organisms are released into the bloodstream at a noncontinuous rate
E)Infections that originate within the cardiovascular system
Q2) Infective endocarditis, mycotic aneurysm, suppurative thrombophlebitis, and intravenous, catheter-associated bacteremia are
A)within the vascular system.
B)caused by organisms that are present in the bloodstream at a fairly constant rate.
C)continuous bacteremias.
D)extremely serious and considered life-threatening.
E)All of the above are correct.
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Chapter 50: 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) Evaluation of the quality of the sputum specimen sent to the laboratory for bacterial culture is best done by
A)measuring the amount of mucous found.
B)checking for mucous or blood.
C)examining microscopically via Gram-stained smear for leukocytes.
D)examining microscopically via Gram-stained smear for squamous epithelial cells.
Q3) Streptococcus pneumoniae is detected as the most common agent of lower respiratory tract infections among
A)previously healthy patients 2 months of age to 5 years old.
B)adults younger than 30 years of age.
C)community-acquired pneumonia in adults.
D)children of school age.
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52
Chapter 51: Upper Respiratory Tract Infections and Other
Infections of the Oral Cavity and Neck
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Q1) Also called acute necrotizing ulcerative gingivitis, or trench mouth, this condition is a mixed bacterial-spirochetal infection of the gingival edge.
A)Laryngitis
B)Laryngotracheobronchitis
C)Epiglottitis
D)Pharyngitis
E)Vincent's angina
Q2) Most cases of pharyngitis occur during the colder months and are primarily caused by
A)Streptococcus pyogenes.
B)viruses.
C)Streptococcus pneumoniae.
D)Staphylococcus aureus.
Q3) Infection of the buccal (cheek) mucosa, tongue, or oropharynx by Candida spp.is called
A)pharyngitis.
B)Vincent's angina.
C)rhinitis.
D)stomatitis.
E)thrush.
Page 53
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Chapter 52: Meningitis and Other Infections of the Central
Nervous
Systems
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Q1) A collective term used for the three layers of membranes surrounding the brain and spinal column is
A)dura mater.
B)meninges.
C)arachnoid.
D)pia mater.
Q2) Proper storage of CSF sent to the laboratory for bacterial culture includes
A)refrigeration for up to 23 hours.
B)freezing at 70° C.
C)incubation (35° C).
D)freezing at temperatures above 70° C.
E)All of the above are correct.
Q3) Large, fluid-filled spaces within the brain are called
A)the choroid plexus.
B)ventricles.
C)meninges.
D)pia mater.
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Page 54
Chapter 53: Infections of the Eyes, Ears, and Sinuses
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Q1) Dacryoadenitis
A)An acute infection of the orbital contents most often caused by bacteria
B)Inflammation of the lacrimal canal
C)Infection of the lacrimal gland characterized by pain of the upper eyelid with erythema
D)Infection of the cornea
Q2) What is the proper specimen for culture and identification of the agent of acute sinusitis?
A)Aspirated material that has been collected by puncture of the maxillary sinus
B)Drainage material found in the upper respiratory passages that has been collected with a swab
C)Coughed up sinus drainage collected in a sterile cup
D)All of the above are correct.
Q3) Orbital cellulitis
A)An acute infection of the orbital contents most often caused by bacteria
B)Inflammation of the lacrimal canal
C)Infection of the lacrimal gland characterized by pain of the upper eyelid with erythema
D)Infection of the cornea
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Page 55
Chapter 54: 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 CFU/mL of urine, dysuria, and frequent urination.
B)dysuria, frequency, and urgency but that yields fewer organisms than 105 CFU/mL urine on culture.
C)fever and flank pain, dysuria, vomiting, diarrhea, chills, increased heart rate, and lower abdominal pain.
D)dysuria, frequency, and urgency along with tenderness and pain over the area of the bladder.
Q2) Mucosal antibacterial properties, a valvelike mechanism, host immune responses, and defensins are all host defense mechanisms found in the A)digestive tract.
B)upper respiratory tract.
C)urinary tract.
D)genital tract.
E)lower respiratory tract.
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Chapter 55: Genital Tract Infections
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Q1) Orchitis
A)Inflammation of the vaginal mucosa resulting in abnormal discharge and an offensive odor or itching
B)A polymicrobial type of vaginitis characterized by mild perivaginal irritation and a foul-smelling discharge
C)An infection of the uterus and its contents during pregnancy.
D)A mild to severe inflammation of the testicles that is generally acquired by blood-borne dissemination of viruses such as the mumps virus
Q2) An organism that many women carry as part of their normal genital microbial flora that may be transmitted to the neonate during childbirth is A)Staphylococcus.
B)Escherichia coli.
C)Streptococcus agalactiae.
D)Gardnerella vaginalis.
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Chapter 56: Gastrointestinal Tract Infections
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Q1) GN Broth serves which purpose when used in the bacterial fecal culture?
A)Evaluation of general flora and predominant species
B)Selection of enteric pathogens such as Salmonella, Aeromonas, and others
C)Inhibition of normal flora and select for enteric pathogens
D)Enrichment for enteric pathogens such as Salmonella and others
Q2) Selenite broth serves which purpose when used in the bacterial fecal culture?
A)Evaluation of general flora and predominant species
B)Selection of enteric pathogens such as Salmonella, Aeromonas, and others
C)Inhibition of normal flora and select for enteric pathogens
D)Enrichment for enteric pathogens such as Salmonella and others
Q3) MacConkey agar serves which purpose when used in the bacterial fecal culture?
A)Evaluation of general flora and predominant species
B)Selection of enteric pathogens such as Salmonella, Aeromonas, and others
C)Inhibition of normal flora and select for enteric pathogens
D)Enrichment for enteric pathogens such as Salmonella and others
Q4) XLD agar serves which purpose when used in the bacterial fecal culture?
A)Evaluation of general flora and predominant species
B)Selection of enteric pathogens such as Salmonella, Aeromonas, and others
C)Inhibition of normal flora and select for enteric pathogens
D)Enrichment for enteric pathogens such as Salmonella and others
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Chapter 57: Skin, Soft Tissue, and Wound Infections
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Q1) Myositis
A)Extensive necrosis of muscle caused by infectious agents
B)Infection of the fascia overlying muscle groups, often with involvement of the overlying soft tissue
C)A slowly progressive infection of the subcutaneous tissue with associated ulceration of portions of the overlying skin
D)A chronic gangrenous condition of the skin most often encountered as a postoperative complication, particularly after abdominal or thoracic surgery
Q2) Progressive bacterial synergistic gangrene
A)Extensive necrosis of muscle caused by infectious agents
B)Infection of the fascia overlying muscle groups, often with involvement of the overlying soft tissue
C)A slowly progressive infection of the subcutaneous tissue with associated ulceration of portions of the overlying skin
D)A chronic gangrenous condition of the skin most often encountered as a postoperative complication, particularly after abdominal or thoracic surgery
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Chapter
Marrow, and Solid Tissues
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Q1) Proper technique for processing clotted body fluids sent to the laboratory for fungal culture is
A)grinding them in a mortar and pestle or glass tissue grinder.
B)placing small amounts of whole material from the clot directly onto media.
C)centrifugation with glass beads.
D)filtration under pressure.
Q2) Most cases of peritonitis in patients on continuous ambulatory peritoneal dialysis are caused by
A)Staphylococcus epidermidis and S.aureus.
B)Escherichia coli.
C)Klebsiella pneumoniae.
D)Streptococcus spp.
E)viral agents.
Q3) The most common etiologic agent of septic arthritis in adults younger than 30 years of age is
A)Neisseria gonorrhoeae.
B)Staphylococcus aureus.
C)Haemophilus influenzae.
D)Streptococcus agalactiae.
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Chapter 59: Laboratory Physical Design, Management, and Organization
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Q1) The percentage of true-positive test results based on the prevalence of the disease in the population studied is referred to as A)accuracy.
B)predictive value negative.
C)sensitivity.
D)specificity.
E)predictive value positive.
Q2) The percentage of test results that are correctly identified by the test is called A)accuracy.
B)precision.
C)sensitivity.
D)specificity.
E)efficiency.
Q3) The reproducibility of a test when it is run (repeated) several times is called A)accuracy.
B)precision.
C)sensitivity.
D)specificity.
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Chapter 60: Quality in the Clinical Microbiology Laboratory
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Q1) Continuous quality assurance in the microbiology laboratory includes
A)monitoring personnel performance and providing education.
B)instrument maintenance and monitoring.
C)checking the performance of media, reagents, and other products.
D)All of the above are correct.
Q2) Criteria that should be considered for rejection of specimens include
A)missing or inadequate information such as clinical diagnosis, current drug treatment, or other helpful facts.
B)illegible physician name.
C)improperly collected or stored specimen.
D)requests of multiple tests on one specimen.
E)All of the above are correct.
Q3) Long-term storage (>1 year) of stock aerobic and anaerobic bacteria can be accomplished by
A)subculture onto trypticase soy agar (TSA) slants.
B)freezing at 70° C.
C)storing them on blood agar plates at 37° C.
D)All of the above are correct.
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Chapter 61: Infection Control
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Q1) Microorganisms are spread in hospitals through
A)direct contact in contaminated food or intravenous solutions.
B)indirect contact from patient to patient on the hands of health care workers.
C)inhalation of droplets.
D)vector-borne contact.
E)All of the above are correct.
Q2) A phenotypic technique of typing microbial strains that consists of serologic typing of bacterial or viral antigens, such as bacterial cell wall antigens of the organism of interest, is called
A)biotyping.
B)antibiograms.
C)serotyping.
D)bacteriocin typing.
E)bacteriophage typing.
Q3) An infection acquired by a hospitalized patient that was not present when they entered the hospital is referred to as
A)an autonomous infection.
B)a nosocomial infection.
C)an opportunistic infection.
D)septic introduction.
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Chapter 62: Sentinel Laboratory Response to Bioterrorism
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Q1) The act of using microorganisms to intentionally harm the civilian population is referred to as
A)biosecurity.
B)biocrime.
C)microterrorism.
D)bactiterrorism.
Q2) The difference between an overt and a covert bioterrorism event is that
A)a covert event is one that is carried out against undercover agents.
B)a covert event is announced and an overt event is not announced.
C)an overt event is announced and a covert event is not announced.
D)an overt event is one that is carried out in the air.
Q3) Bioterrorism is a term used to describe
A)the act of using horrific events to deliver harm to living beings.
B)the act of using microorganisms to intentionally harm the civilian population.
C)the act of using microorganisms to wage war in peace time.
D)the act of using living beings to wage war in peace time.
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