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Pathogenic Microbiology Practice Exam - 1245 Verified Questions

Page 1


Pathogenic Microbiology Practice Exam

Course Introduction

Pathogenic Microbiology explores the biology, diversity, and mechanisms of microorganisms responsible for causing disease in humans. This course covers the principles of microbial pathogenesis, including the interaction between host defenses and bacterial, viral, fungal, and parasitic pathogens. Students investigate how pathogens invade, evade immune responses, and produce disease, as well as methods for diagnosis, prevention, and treatment of infectious diseases. Emphasis is placed on the molecular mechanisms of virulence, the epidemiology of infectious diseases, and the role of public health interventions in controlling outbreaks.

Recommended Textbook

Bailey Scotts Diagnostic Microbiology 14th Edition by Patricia Tille

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78 Chapters

1245 Verified Questions

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Page 2

Chapter 1: Microbial Taxonomy

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Sample Questions

Q1) The most basic taxonomic group that can be defined as a collection of bacterial strains that share many common physiologic and genetic features is:

A)genus.

B)species.

C)class.

D)kingdom.

Answer: B

Q2) An example of an organism's genotypic characteristic is its:

A)macroscopic morphologic structure.

B)microscopic morphologic structure.

C)nucleic acid composition.

D)antigenic properties.

Answer: C

Q3) Species identification is based on all of the following except:

A)DNA-DNA Hybridization.

B)16sRNA sequencing.

C)Cell wall composition.

D)Colonial pigmentation.

Answer: D

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Page 3

Chapter 2: Bacterial Genetics, metabolism, and Structure

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Sample Questions

Q1) The mechanism for adenosine triphosphate (ATP)production in which high-energy phosphate bonds produced by the central metabolic pathways are donated to adenosine diphosphate (ADP)to form ATP is:

A)substrate-level phosphorylation.

B)fermentative metabolism.

C)oxidative phosphorylation.

D)aerobic respiration.

Answer: A

Q2) Transduction is defined as the:

A)change of the bacterial genotypes through the exchange of DNA from one cell to another.

B)internal change in the original nucleotide sequence of a gene or genes within an organism's genome.

C)process by which genetic elements such as plasmids and transposons excise from one genomic location and insert into another.

D)mechanism that is mediated by viruses,by which DNA from two bacteria may come together in one cell,thus allowing for recombination.

Answer: D

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4

Chapter 3: Host-Microorganism Interactions

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Sample Questions

Q1) The complement system serves to:

A)increase blood flow to the area of infection and can also effectively wall off the infection through the production of barrier substances.

B)attract and enhance the activities of phagocytes.

C)provide substances secreted by one type of cell,which have substantial effects on the antiinfective activities of other cells.

D)ingest and destroy microorganisms.

Answer: B

Q2) IgE is the:

A)first antibody produced when an invading microorganism is initially encountered. B)antibody that is associated with various parasitic infections.

C)antibody that is secreted in various body fluids and primarily protects those body surfaces lined with mucous membranes.

D)second antibody produced when an invading microorganism is initially encountered and the most abundant.

Answer: B

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Chapter 4: Laboratory Safety

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Sample Questions

Q1) The laboratory receives a bloody,tissue contaminated surgical forceps.Upon removal the laboratory should dispose of the instrument by:

A)placing in the biohazard container.

B)placing in a sharps container.

C)sending back to surgery for disposal.

D)ensuring proper return to surgery for chemical sterilization.

Q2) A new laboratory assistant was asked to disinfectant the laboratory bench where specimens are received and processed.The laboratory assistant used concentrated bleach to wipe down the laboratory bench.The discrepancy in this situation is:

A)the laboratory assistant forgot to rinse the laboratory bench after disinfecting it.

B)the laboratory assistant failed to wash the laboratory bench with soap prior to applying the bleach.

C)the laboratory assistant failed to use diluted 10% bleach,thinking that concentrated solution will result in improved disinfection of the bench.

D)the laboratory assistant followed proper procedure and there is no discrepancy.

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Chapter 5: Specimen Management

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Q1) The microbiology laboratory receives a genital culture from a 28-year-old female.The specimen direct Gram stain reveals,gram-positive cocci in clusters and gram-negative cocci in chains.The microbiologist inoculates a sheep blood agar plate,a chocolate agar plate,a modified thayer martin plate and a LIM Broth (selective enrichment for group B streptococci).The second shift microbiologist identifies the discrepancy and must take corrective action.The discrepancy indicates:

A)there is no discrepancy noted.

B)the preliminary Gram stain was erroneously reported.

C)the microbiologist should cancel this order and reorder a genital screen for group B streptococci.

D)the microbiologist should report out the results from the cultures when growth is evident.

Q2) Holding media,such as Stuart's medium and Amie's transport medium,are used to:

A)maintain the viability of microorganisms present in a specimen.

B)support the growth and multiplication of any pathogenic organisms that are present.

C)prevent clotting of specimens such as blood,bone marrow,and synovial fluid.

D)allow pathogenic organisms to grow while nonpathogenic organisms die.

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Chapter 6: Role of Microscopy

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Sample Questions

Q1) When reporting a direct smear from a primary specimen,it is important to note all of the following except:

A)white blood cells.

B)squamous epithelial cells.

C)artifacts.

D)prominent cell shapes and arrangements.

Q2) 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.

Q3) The fluorochrome stain used to study a fungus is:

A)calcofluor white.

B)acridine orange.

C)auramine.

D)immunofluorescence.

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Page 8

Chapter 7: Traditional Cultivation and Identification

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Sample Questions

Q1) Clinical sensitivity in the microbiology laboratory refers to:

A)positive results from patients known to have an infection or disease.

B)percentage of positive results from all patients tested.

C)percentage of patient's that test negative known to have an infection or disease.

D)none of the above answers are correct.

Q2) Colonial morphology that appears as a "checker" or dipped in the middle with raised edges is termed:

A)flat.

B)convex.

C)umbilicate.

D)variable.

Q3) When streaking for isolation and utilizing semi-quantitative methods,the numbers of colonial growth in successive quadrants correlates directly with:

A)the microbiologist's streaking technique.

B)the relative amount of organism present in the original specimen.

C)the ability of the organism to grow on the media.

D)the type of incubation conditions.

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Chapter 8: Nucleic Acid-Based Analytic Methods for

Microbial Identification and Characterization

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Sample Questions

Q1) Complementary nucleic acid hybridization,which is coupled with nucleic acid replication and applied repeatedly through numerous cycles,is based on which of the following methods?

A)Hybridization

B)Sequencing

C)Amplification (PCR)

D)Genotypic

Q2) If a patient sample contains 8 copies of viral DNA,predict how many DNA copies would be present following three rounds of PCR amplification.

A)16

B)24

C)32

D)64

Q3) The optimal way to detect PCR amplicons is to use which stain?

A)Methylene blue

B)Malachite green

C)Bromothymol blue

D)Ethidium bromide

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Chapter 9: Overview of Immunochemical Methods Used for Organism Detection

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Sample Questions

Q1) 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.

Q2) Cell-mediated immune responses,such as attacking and killing microorganisms or host cells that are damaged or infected,are carried out by:

A)lymphocytes of the thymus-derived (T)class.

B)lymphocytes of the bone marrow-derived (B)class.

C)neutrophils.

D)nasophils.

Q3) Elevations of which of the following antibodies may indicate a parasitic infection?

A)IgG

B)IgA

C)IgM

D)IgE

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Chapter 10: Principles of Antimicrobial Action Resistance

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Sample Questions

Q1) Antibiotic resistance resulting from altered cellular physiologic structure caused by changes in a microorganism's usual genetic makeup is known as __________ resistance.

A)intrinsic

B)inherent

C)acquired

D)environmentally mediated

Q2) Antimicrobial resistance resulting from the normal genetic,structural,or physiologic state of a microorganism is referred to as ________ resistance.

A)intrinsic

B)inherent

C)microorganism-mediated

D)clinical

Q3) Antimicrobial agents that inhibit bacterial growth but generally do not kill the organism are known as:

A)bactericidal.

B)antibiotic.

C)bacteriostatic.

D)antagonistic.

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Chapter 11: Laboratory Methods and Strategies for

Antimicrobial Susceptibility Testing

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Sample Questions

Q1) A D-test is set up on a S.aureus isolate.There was no zone around the Erythromycin disk and the zone of inhibition around the clindamycin disk adjacent to the erythromycin disk was interpreted as susceptible.Thus,the resistance mechanism for the erythromycin is due to:

A)altered target.

B)increased efflux.

C)decreased porin channels.

D)degradative enzymes.

Q2) MIC endpoints can be reported results obtained by the following conventional AST methods<b> <u>EXCEPT</b></u>:

A)agar dilution.

B)automated broth dilution.

C)disk Diffusion.

D)E-test.

Q3) Enterococcal high-level gentamicin resistance predicts resistance to:

A)vancomycin.

B)aminoglycosides.

C)cephalosporins.

D)levofloxacin.

Page 13

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Chapter 12: Staphylococcus, Micrococcus, and Similar Organisms

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Sample Questions

Q1) Which virulent and important human pathogen can also be recovered from the nares,perineum,and other skin sites of healthy people,especially in the hospital setting?

A)Micrococcus luteus

B)S.intermedius

C)S.aureus

D)All Micrococcaceae

Q2) Quality control should be performed on which two organisms to determine the validity of the oxidase reagent?

A)S.aureus and S.epidermidis

B)S.epidermidis and Enterococcus

C)Aerococcus and Enterococcus

D)Micrococcus and Aerococcus

Q3) Which of the following methods combines nucleic acid amplification testing and mass spectrometry (MS)for identification of S.aureus and MRSA?

A)Serodiagnosis

B)CHROMagar

C)The Xpert MRSA/SA test

D)PCR/ESI-MS

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Chapter 13: Streptococcus, Enterococcus, and Similar Organisms

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Sample Questions

Q1) When performing the CAMP test,what bacteria is steaked down the middle?

A)S.epidermidis

B)Staphylococcus aureus

C)S.pyogenes

D)E.faecalis

Q2) The development of glomerulonephritis is a problem that may be encountered by patients infected with:

A)E.faecalis.

B)S.pneumoniae.

C)S.pyogenes.

D)S.agalactiae.

Q3) Bacitracin,CAMP factor,PYR,and hippurate are tests most likely performed on a(n)_______ Streptococcus.

A) alpha-hemolytic

B) beta-hemolytic

C) gamma-hemolytic

D)non-hemolytic

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Chapter 14: Bacillus and Similar Organisms

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Sample Questions

Q1) A patient diagnosed with B.anthracis is allergic to penicillin.Which antibiotic can be given that will be therapeutically effective?

A)Ampicillin

B)Ciprofloxacin

C)Imipenem

D)Vancomycin

Q2) Which of the following is described as a spore-forming,gram-positive Bacillus that is -hemolytic,motile,Voges-Proskauer (VP)-positive,and citrate-positive and causes two types of food poisoning as a result of toxin release?

A)C.diphtheria

B)B.anthracis

C)B.cereus

D)C.jeikeium

Q3) 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).

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Chapter 15: Listeria Corynebacterium and Similar Organisms

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Sample Questions

Q1) A cerebrospinal fluid (CSF)culture was performed on a newborn in distress.After overnight incubation,small gram-positive bacilli with a soft zone of -hemolysis grew on sheep blood agar.Based on this information,what results would be expected on the following tests: hippurate;Christie,Atkins,Munch-Petersen (CAMP);and motility?

A)Negative hippurate,positive CAMP,and negative motility

B)Positive hippurate,negative CAMP,and positive motility

C)Positive hippurate,positive CAMP,and positive motility

D)Negative hippurate,negative CAMP,and negative motility

Q2) A 13-year-old girl presented to her physician complaining of being tired,having a mild sore throat and fever.She appears to have a grey coating on her tonsils when examined by the physician.The most logical etiologic agent associated with the patient's illness is:

A)Streptococcal pharyngitis.

B)diphtheriae.

C)scarlet fever.

D)Tonsillitis.

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17

Chapter 16: Erysipelothrix, Lactobacillus, and Similar Organisms

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Sample Questions

Q1) Clue cells are associated with which gram-positive bacilli?

A)G.vaginalis

B)Lactobacillus

C)Erysipelothrix rhusiopathiae

D)A.haemolyticum

Q2) Which organism is nonhemolytic on 5% sheep blood agar but hemolytic on human blood?

A)Weissella confusa

B)A.haemolyticum

C)Lactobacillus spp.

D)G.vaginalis

Q3) The wet mount and Gram stain of vaginal secretions from a patient who has bacterial vaginosis caused by Gardnerella vaginalis will reveal large:

A)squamous epithelial cells with numerous attached pleomorphic gram-variable or gram-negative coccobacilli and rods.

B)numbers of large gram-positive rods.

C)numbers of polymorphonuclear leukocytes.

D)pleomorphic gram-negative rods with many leukocytes.

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Chapter 17: Nocardia, Streptomyces, Rhodococcus, Oerskovia,

and Similar Organisms

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Q1) Nocardia spp.form branched filaments that extend into the air that are called _____ hyphae.

A)surface

B)substrate

C)aerial

D)topical

Q2) Which partially acid-fast,gram-positive,and branching filamentous bacteria appear dry and white to creamy to orange with rhizoid edges on routine agar and are urea-positive and resistant to lysozyme?

A)Tsukamurella

B)Gordonia

C)Actinomadura

D)Dermatophilus

Q3) A chronic,granulomatous infection of subcutaneous tissues,which is caused by aerobic actinomycetes resulting in tissue swelling and draining sinus tracts,is referred to as:

A)actinomycetoma.

B)infectious granulomas.

C)lymphocytoma.

D)Actinomadura.

Page 19

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Chapter 18: Enterobacteriaceae

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Sample Questions

Q1) For the most part,all Enterobacteriaceae are positive for which biochemical reactions?

A)Glucose,oxidase,and catalase

B)Glucose,indole,and oxidase

C)Glucose,reduce nitrates to nitrites,and oxidase

D)Glucose,catalase,and reduce nitrates to nitrites

Q2) This organism,belonging to the family Enterobacteriaceae,grows best at 25°C to 30°C.Domestic and wild rats and other animals can carry this organism.What is the medium of choice?

A)MacConkey agar

B)Xylose-lysine-deoxycholate (XLD)agar

C)Cefsulodin-irgasan-novobiocin (CIN)agar

D)Hektoen enteric (HE)agar

Q3) MacConkey-sorbitol agar is useful for detecting pathogenic strains of:

A)E.coli.

B)Shigella spp.

C)Salmonella spp.

D)Vibrio spp.

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Chapter 19: Acinetobacter, Stenotrophomonas, and Other Organisms

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Q1) Which organism may be mistaken for a lactose fermenter on MacConkey agar because of colonies exhibiting a purple hue on the media?

A)Acinetobacter spp.

B)P.luteola

C)S.maltophilia

D)Bordetella holmesii

Q2) Which organism is often isolated in the sputum of patients with cystic fibrosis?

A)Acinetobacter spp.

B)B.trematum

C)Burkholderia gladioli

D)S.maltophilia

Q3) Plump coccobacilli that tend to resist alcohol decolorization and may be mistaken for Neisseria spp.are:

A)Bordetella spp.

B)S.maltophilia.

C)Acinetobacter spp.

D)P.oryzihabitans.

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Page 21

Chapter 20: Pseudomonas, Burkholderia, and Similar Organisms

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Sample Questions

Q1) Which organism exhibits bipolar staining on the Gram stain,which resembles a "safety-pin" appearance?

A)B.mallei

B)B.pseudomallei

C)B.diminuta

D)B.vesicularis

Q2) What condition is most likely when P.fluorescens,P.putida,or P.stutzeri,Brevundimonas spp. ,and Ralstonia spp.are isolated from respiratory specimens?

A)Person-to-person transmission should be suspected.

B)Specimens come from immunocompetent individuals.

C)The isolated bacteria may not represent a significant pathogen.

D)The patient is in need of a lung transplant.

Q3) Not including organisms in the Enterobacteriaceae family,the most common gram-negative bacilli encountered in clinical specimens are:

A)Pseudomonas.

B)Burkholderia.

C)Ralstonia.

D)Vibrio.

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Chapter 21: Achromobacter, Rhizobium, Ochrobactrum, and

Similar Organisms

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Q1) Which two organisms should be used to determine the validity of the nitrate reduction test?

A)Ochrobactrum and Alcaligenes

B)Psychrobacter and Rhizobium

C)CDC group Ic and CDC group O-3

D)CDC group OFBA-1c and Shewanella

Q2) Which nonlactose-fermenting organism,that rarely causes human infection,grows poorly at 35°C;however,grows optimally between 20°C and 25°C?

A)Psychrobacter pulmonis

B)A.xylosoxidans

C)R.radiobacter

D)S.putrefaciens

Q3) The most common type of infection caused by both R.radiobacter and Ochrobactrum anthropi is:

A)peritonitis.

B)endocarditis.

C)meningitis.

D)bacteremia.

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Chapter

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Q1) A patient receiving hemodialysis began spiking a fever shortly after his treatment.Blood cultures were drawn and grew out the following gram-negative rods that were indole positive with variable results for urea,nitrate reduction,and gelatin.The organism is most likely:

A)E.meningoseptica.

B)E.brevis.

C)CDC group O-1.

D)Chryseobacterium spp.

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) On Gram stain,which organism appears thin in the center and thicker at the ends?

A)Agrobacterium yellow group

B)CDC groups EO-3 and EO-4

C)E.meningoseptica

D)E.brevis

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Chapter 23: Alcaligenes, Bordetella Nonpertussis,

Comamonas, and Similar Organisms

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Q1) Gram-stain morphologic features,motility,and flagellar placement are important identifying characteristics of:

A)Chryseobacterium.

B)Flavobacterium.

C)Pseudomonas.

D)Bordetella.

Q2) The biochemical description of B.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.

Q3) 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 24: Vibrio, aeromonas, Plesiomonas Shigelloides, and

Chromobacterium Violaceum

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Q1) The drug of choice to treat patients with V.cholerae is:

A)tetracycline.

B)ceftazidime.

C)imipenem.

D)aztreonam.

Q2) Which of the following species of Aeromonas is oxidase-positive,sucrose-positive,and can decarboxylate ornithine?

A) A.caviae

B)Allium schubertii

C)Aeromonas hydrophila

D)A.veronii biovar veronii

Q3) Which organism,which is oxidase positive,does not grow on TCBS agar,has the ability to decarboxylate lysine and ornithine but cannot utilize arginine,and would have the following colonial characteristics on sheep blood agar and MacConkey agar?

A) -Hemolytic and is a nonlactose fermenter

B) -Hemolytic and is a lactose fermenter

C) -Hemolytic and is a nonlactose fermenter

D) -Hemolytic and is a nonlactose fermenter

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Chapter 25: Sphingomonas Paucimobilis and Similar Organisms

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Q1) This bacterium is unique in that it does not possess a flagellum but is motile by gliding motility.

A)Acidovorax spp.

B)Sphingobacterium spp.

C)Spingomonas spp.

D)Pseudomonas spp.

Q2) Although no definitive guidelines are available for the treatment of Sphingomonas paucimobilis infections,which antibiotic appears to have potential activity against this organism?

A)Penicillin

B)Ttrimethoprim-sulfamethoxazole combination

C)Amoxicillin and Flagyl

D)Isoniazid and Imipenem

Q3) Oxidase-positive,glucose-positive (oxidatively)gram-negative bacilli that cannot grow on MacConkey agar include:

A)Pseudomonas.

B)Vibrio.

C)Stenotrophomonas.

D)Sphingomonas.

Page 27

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Chapter 26: Moraxella

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Q1) Which of the following tests can be performed to differentiate the two subspecies of Neisseria elongata and glycolytica?

A)Catalase

B)Nitrate reduction

C)DNase

D)Growth in nutrient broth

Q2) The commensal Neisseria spp.are often confused with pathogenic gram-negative diplococci.A simple test utilizing a blood agar plate and an antibiotic disk resulting in elongation of the cells assists in the differentiation of these organisms.Which antibiotic disk is utilized in this application?

A)Cephalosporin

B)Vancomycin

C)Penicillin

D)Metronidazole

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Chapter 27: Eikenella Corrodens and Similar Organisms

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Q1) E.corrodens can be easily recognized in culture by its:

A)pink pigmentation.

B)grapelike odor.

C)large spreading colonial morphologic characteristic.

D)bleachlike odor.

Q2) Of the asaccharolytic,oxidase-positive bacilli that do not grow on MacConkey agar,which one of the following organisms is generally associated with mixed infections resulting from bites or clenched-fist wounds?

A)Eikenella corrodens

B)Weeksella virosa

C)Pseudomonas maltophilia

D)Sphingomonas paucimobilis

Q3) Quality control performed on indole reagent should be performed on which two organisms?

A)E.corrodens and Methylobacterium spp.

B)W.virosa and Bergeyella zoohelcum

C)B.zoohelcum and Escherichia coli

D)E.corrodens and W.virosa

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Chapter 28: Pasteurella and Similar Organisms

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Q1) Which of the following bacterial species is part of animal flora and transmitted to humans during close animal contact,including bites?

A)S.paucimobilis

B)Eikenella corrodens

C)P.multocida

D)W.virosa

Q2) 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.

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Chapter 29: Actinobacillus, Kingella, Cardiobacterium,

Capnocytophaga, and Similar Organisms

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Q1) To test the validity of catalase reagent,which two organisms should be used?

A)A.actinomycetemcomitans and Kingella kingae

B)C.hominis and A.aphrophilus

C)K.denitrificans and K.kingae

D)Actinobacillus suis and Actinobacillus ureae

Q2) 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

Q3) A.actinomycetemcomitans can be distinguished from A.aphrophilus by its:

A)negative test for catalase.

B)positive test for lactose fermentation.

C)positive test for catalase.

D)negative test for oxidase.

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Chapter 30: Haemophilus

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Q1) Although a useful test in the past,the particle agglutination assay for the detection of H.influenzae,type b,capsular polysaccharide antigen is no longer reliable because of:

A)insufficiently high concentration of the organisms in clinical infections.

B)a lack of sensitivity and specificity of the test procedure.

C)the frequent use of antimicrobial therapy before collecting the specimen.

D)the increased use of H.influenzae,type b,vaccination.

Q2) With one exception,species of the genus Haemophilus require which of the following media ingredients for in vitro growth?

A)Vitamin K and hemin

B)Hemin and nicotine adenine dinucleotide (NAD)

C)Vitamin K and NAD

D)Hemin and cysteine

Q3) 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.

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Chapter 31: Bartonella and Afipia

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Q1) Bacteremia,endocarditis,bacillary angiomatosis,cat-scratch disease,and peliosis hepatis can all be caused by:

A)Afipia felis.

B)Bartonella quintana.

C)B.clarridgeiae.

D)B.henselae.

Q2) Bartonella spp.are usually detected by the examination of biopsy using which stain?

A)Gram stain

B)Wright's stain

C)Trichrome stain

D)Warthin-Starry silver stain

Q3) Trench fever,bacteremia,endocarditis,chronic lymphadenopathy,and bacillary angiomatosis can be caused by:

A)A.felis.

B)B.quintana.

C)B.clarridgeiae.

D)B.henselae.

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Chapter 32: Campylobacter, Arcobacter, and Helicobacter

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Q1) Which of the following genes may attribute to the virulence of H.pylori by encoding for outer membrane proteins that mediate adherence to a specific blood group antigen on the surface of gastric epithelial cells?

A)babA

B)iceA

C)cagA

D)vacA

Q2) Curved,microaerophilic,gram-negative rods,with most species having strong urease activity and the majority of which colonize mammalian stomachs or intestines,describe which group of bacteria?

A)Campylobacter

B)Helicobacter

C)Arcobacter

D)Enterobacter

Q3) Virulence determinants of H.pylori include:

A)proteases.

B)urease enzyme.

C)hemolysins.

D)exotoxins.

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Chapter 33: Legionella

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Q1) Who is at most risk to develop legionnaires' disease?

A)65-year-old transplant recipient

B)14 year old swimming in a lake

C)90 year old living in an apartment complex

D)Newborn baby to a mother infected with hepatitis

Q2) A direct immunofluorescent antibody (DFA)test was performed on a sputum sample that yielded a positive test.The organism grew on BCYE medium and was a thin gram-negative,faintly staining bacillus.What is the drug of choice for this organism?

A)Fluoroquinolones

B)Erythromycin

C)Penicillin

D)Aminoglycosides

Q3) To cultivate Legionella in the laboratory,a medium supplemented with what ingredient(s)is necessary?

A)L-cysteine and iron

B)Blood and cysteine

C)Dopa-cysteine

D)Nicotinic adenine

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Chapter 34: Brucella

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Q1) Individuals considered at greatest risk for contracting brucellosis are:

A)dairy farmers.

B)fishermen.

C)prison guards.

D)those working with exotic birds.

Q2) The animal reservoir for Brucella melitensis is:

A)cattle.

B)sheep or goats.

C)swine.

D)dogs.

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 35: Bordetella Pertussis and Bordetella

Parapertussis

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Q1) A nasopharyngeal aspirate is cultured on Bordet-Gengou agar,and growth is observed.The colonies are also subjected to a direct fluorescent antibody (DFA)stain,which is also positive.On the basis of these findings,the antimicrobial therapy that should be administered to the patient is:

A)azithromycin.

B)gentamycin.

C)streptomycin.

D)imipenem.

Q2) The mode of transmission of B.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) During the paroxysmal stage of pertussis,symptoms are:

A)runny nose and mild cough.

B)severe and violent coughing.

C)neutrocytosis and fever.

D)lymphadenitis.

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Chapter 36: Francisella

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Q1) Which assay is available to identify F.tularensis serologically?

A)Complement fixation

B)Direct fluorescent antibody test

C)Immunodiffusion assays

D)Enzyme-linked immunosorbent assays (ELISAs)

Q2) Francisella philomiragia differs from F.tularensis in that it:

A)is oxidase-negative.

B)is hydrogen sulfide-positive.

C)does not hydrolyze gelatin.

D)does not grow in 6% sodium chloride.

Q3) The specimen of choice to collect in suspected cases of Francisella tularensis is: A)blood.

B)cerebrospinal fluid (CSF).

C)lymph nodes.

D)urine.

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Chapter 37: Streptobacillus Moniliformis and Spirillum

Minus

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Q1) Which of the following cause rat-bite fever,or Haverhill fever,which is characterized by acute onset of chills,fever,headache,vomiting,and 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.

Q2) 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.

Q3) A patient has an infection caused by S.moniliformis.Which of the following is the preferred antibiotic choice?

A)Penicillin

B)Tetracycline

C)Streptomycin

D)All of the above

Page 39

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Chapter 38: Neisseria and Moraxella Catarrhalis

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Q1) The second most commonly reported sexually transmitted infection in the United States,according to the CDC,is:

A)M.catarrhalis.

B)N.gonorrhoeae.

C)N.meningitidis.

D)HIV.

Q2) N.gonorrhoeae is spread by:

A)person-to-person nosocomial spread by respiratory droplets.

B)person-to-person spread by sexual contact.

C)from infected mother to newborn during birth.

D)B and C only.

Q3) Which statement is true regarding the pathogenesis of N.cinerea?

A)N.cinerea 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)N.cinerea is commonly encountered as a contaminant in clinical specimens.

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Chapter 39: Overview and General Considerations

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Q1) Tissue biopsy taken from a puncture wound is:

A)Is acceptable,however an aspirate would not contain contaminating flora

B)Is acceptable,and is the optimal specimen for anaerobic culture

C)Is unacceptable,due to the high level of potential contaminating flora

D)Is unacceptable,because the sample is not considered anaerobic

Q2) Egg-yolk agar

A)Isolates of Prevotella and Bacteroides spp.

B)Inhibits gram-negative rods

C)Is nonselective;supports the growth of facultative anaerobes and aerobes

D)Determines lecithinase and lipase production of Clostridia and Fusobacteria

E)Is selective for Clostridium difficile

Q3) Rectal swab is:

A)acceptable.

B)not acceptable.

Q4) Bronchial washing collected with a double lumen-plugged catheter is:

A)acceptable.

B)not acceptable.

Q5) Urine via catheter is:

A)acceptable.

B)not acceptable.

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Chapter 40: Laboratory Considerations

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Q1) The most likely identification of a bile-sensitive,kanamycin-resistant,catalase-negative,and indole-negative anaerobic gram-negative bacilli is:

A)nonpigmented Prevotella.

B)Porphyromonas spp.

C)Bacteroides fragilis group.

D)pigmented Prevotella.

Q2) Optimal recovery and identification of anaerobic bacteria in clinical specimens occurs when:

A)the initial incubation period is at 35°C 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°C to 37°C for 24 hours.

D)thioglycollate broth can be inspected daily for 3 days.

Q3) Pigmented Prevotella

A)Are kanamycin-resistant,colistin-resistant,and vancomycin-resistant and grow in 20% bile

B)Are bile-sensitive,kanamycin-resistant,catalase-negative,and indole-negative

C)Fluoresce brick red or have a brown-to-black pigment

D)Reduces nitrate,and requires formate and fumarate for growth in broth culture

E)Are sensitive to kanamycin,and fluoresce a chartreuse color

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Chapter 41: Mycobacteria

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Q1) The specimen of choice for detecting mycobacterium in a skin lesion or wound is a:

A)swab placed in Amie's transport medium or Stuart's medium.

B)needle aspiration.

C)skin scraping.

D)swab placed in anaerobic conditions.

Q2) In the identification of mycobacterial isolates,the niacin test involves the:

A)accumulation of niacin in the medium in which the organism is growing.

B)metabolism of niacin to nicotinic acid by enzymatic action.

C)testing of the isolate for susceptibility to niacin.

D)utilization of niacin in metabolic pathways to produce nicotinic acid.

Q3) The stain that does not require heating the slide for better penetration of stain into the mycobacterial cell wall is known as the:

A)Kinyoun's.

B)Ziehl-Neelsen.

C)immunofluorochrome.

D)carbolfuchsin.

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Page 43

Chapter 42: Obligate Intracellular and Non-culturable Bacterial Agents

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Q1) Of the following organisms,which can be described as a fastidious obligate intracellular parasite that multiplies by binary fission in the cytoplasm of host cells and infects humans as accidental hosts in most cases?

A)Rickettsia

B)Chlamydia

C)Calymmatobacterium

D)Coxiella

Q2) Of the following organisms,which has a unique developmental life cycle including a replicative form,the reticulate body (RB),and an extracellular,metabolically inert,infective form,the elementary body (EB)?

A)Rickettsia

B)Chlamydia

C)Ehrlichia

D)Coxiella

Q3) Which of the following vectors transmit scrub typhus?

A)Lice

B)Ticks

C)Fleas

D)Chiggers

44

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Chapter 43: Cell Walldeficient Bacteria: Mycoplasma and Ureaplasma

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Q1) Caution should be taken when culturing blood in suspected cases of Mycoplasma infections since the organism is inhibited by which anticoagulant commonly found in commercial blood culture media?

A)Ethylenediaminetetraacetic acid (EDTA)

B)Sodium polyanethol sulfonate (SPS)

C)Heparin

D)Sodium citrate

Q2) Media that can be used for the 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 nicotinamide-adenine-dinucleotide (NAD)supplements.

Q3) Quality control is set up to test urea agar.M.genitalium and M.hominis are used;however,both organisms are negative for urease activity.Which one of the following statements explains these findings?

A)The urea agar is most likely expired.

B)The incubation time is most likely abbreviated.

C)A technical error has occurred.

D)These two organisms are poor choices for quality control of urea agar.

Page 45

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Chapter 44: The Spirochetes

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Q1) A self-limiting illness and the most common clinical syndrome associated with leptospirae that includes fever,headache,myalgia,and aseptic meningitis in the immune stage is called:

A)icteric leptospirosis.

B)anicteric leptospirosis.

C)Weil's disease.

D)syphilis.

Q2) A test that uses gelatin particles sensitized with T.pallidum subsp.pallidum antigens to detect specific antitreponemal antibodies in patient serum is called the __________ test.

A)RPR

B)FTA-ABS

C)VDRL

D)TP-PA

Q3) Long,slender,helically curved,gram-negative bacilli with tight coils are identified as belonging to which species?

A)Treponema

B)Leptospira

C)Borrelia

D)Coxiella

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Chapter 45: Overview of the Methods and Strategies in Parasitology

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Q1) The specimen of choice to collect in suspected cases of Paragonimus infection is: A)sputum.

B)blood.

C)urine. D)stool.

Q2) A 17-year-old male with a severe eye infection admits that he does not clean his contact lenses as often as he should.His eye infection is most likely the result of which parasite?

A)Toxoplasma gondii

B)Isospora belli

C)Strongyloides stercoralis

D)Acanthamoeba spp.

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 46: Intestinal Protozoa

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Q1) E.coli,a protozoan that ranges from 15 to 25 µm in diameter,can contain up to eight nuclei in mature cysts.How would the karyosome expect to appear on a stained slide?

A)Small,usually compact

B)Large,usually compact

C)Small,irregularly shaped

D)Large,not compact

Q2) When cooking meat,an internal temperature of ____°C must be reached to kill organisms such as Toxoplasma and Sarcocystis.

A)38

B)48

C)58

D)68

Q3) Which of the following nonpathogenic protozoa has a very large glycogen vacuole in its cyst form and measures approximately 5 to 20 µm in diameter?

A)E.coli

B)I.butschlii

C)E.dispar

D)E.nana

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Chapter 47: Blood and Tissue Protozoa

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Q1) T.brucei gambiense

A)Anopheles mosquito

B)Tsetse fly

C)Sandfly

D)Reduviid bug

Q2) In T.brucei rhodesiense trypanosomiasis infections,CNS invasion occurs early.The disease progresses rapidly,and death may occur before extensive CNS involvement.Inflammation of which organ is more common and severe with this disease form?

A)Kidney

B)Lungs

C)Liver

D)Heart

Q3) The most frequent clinical signs of chronic Chagas disease involve the enlargement of which organ?

A)Heart

B)Liver

C)Spleen

D)Lung

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Page 49

Chapter 48: Protozoa From Other Body Sites

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Q1) The Acanthamoeba organism is motile and has spinelike pseudopods,a single round nucleus in the cyst form,and a large karyosome in the nucleus of the troph.An estimated 70% of clinical cases of Acanthamoeba keratitis are misdiagnosed as __________ keratitis.

A)bacterial

B)fungal

C)prion

D)viral

Q2) Bradyzoites

A)Crescent-shaped

B)Oocysts from cat feces

C)Tissue cysts

Q3) Trichomoniasis is the primary nonviral sexually transmitted disease worldwide.One complication of this infection is:

A)keratitis.

B)endometritis.

C)meningitis.

D)appendicitis.

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Chapter 49: Intestinal Nematodes

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Q1) A 36-year-old man entered the emergency department with bleeding and weight loss several weeks after returning from a trip to South America.A stool sample was taken and microscopically examined.Barrel-shaped eggs with bipolar plugs were observed.The organism can be identified as:

A)T.trichiura.

B)A.duodenale.

C)N.americanus.

D)S.stercoralis.

Q2) A short buccal capsule,large bulb on the esophagus,and prominent genital primordium are all characteristics of which worm?

A)T.trichiura

B)Capillaria philippinensis

C)S.stercoralis

D)A.lumbricoides

Q3) Löffler syndrome is associated with which roundworm infection?

A)S.stercoralis

B)Ancylostoma duodenale

C)Trichostrongylus spp.

D)A.lumbricoides

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Page 51

Chapter 50: Tissue Nematodes

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Q1) 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.

Q2) Copepods

A)Dracunculus medinensis

B)Parastrongylus cantonensis

C)Trichinella spp.

D)Parastrongylus costaricensis

Q3) Crabs

A)Dracunculus medinensis

B)Parastrongylus cantonensis

C)Trichinella spp.

D)Parastrongylus costaricensis

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52

Chapter 51: Blood Nematodes

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Q1) Brugia spp.

A)Tabanid fly

B)Biting midges

C)Anopheles mosquito

D)Black fly

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) L.loa

A)Tabanid fly

B)Biting midges

C)Anopheles mosquito

D)Black fly

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Chapter 52: Intestinal Cestodes

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Q1) The mode of infection for which of the following organisms is the ingestion of cysticercoid in an infected arthropod or by the direct ingestion of the egg? Autoinfection may also occur.

A)D.latum

B)Hymenolepis nana

C)Taenia saginata

D)Taenia solium

Q2) A stool specimen is examined,and the following characteristics are observed: ·15 to 18 lateral branches on each side

·Scolex with four suckers

·No hooklets

The intermediate hosts of this tapeworm are:

A)cattle.

B)humans.

C)cats.

D)swine.

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Chapter 53: Tissue Cestodes

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Q1) Hydatid disease is associated with which tapeworm?

A)T.solium

B)Echinococcus granulosus

C)Spirometra mansonoides

D)Echinococcus multilocularis

Q2) Epileptic seizures,headaches,and mental disturbances all result from infection with the Taenia solium organism.The definitive diagnosis is based on:

A)positive direct fluorescent antibody test.

B)observance of eggs in the stool.

C)positive India ink stain.

D)identification of cysts in tissue.

Q3) In E.granulosus infections,the hydatid cysts usually occur in which organ?

A)Stomach

B)Brain

C)Intestines

D)Liver

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55

Chapter 54: Intestinal Trematodes

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Q1) The Heterophyes heterophyes worm,which has a genital sucker that surrounds the genital pore,has a variety of reservoir hosts including dogs,cats,and birds and a second intermediate host of freshwater: A)snails.

B)fish.

C)crabs.

D)shrimp.

Q2) The intermediate host of the Platyhelminthes is freshwater: A)fish.

B)snails.

C)crabs.

D)crayfish.

Q3) The adult form of the fluke,Fasciolopsis buski,is elongated in shape and ranges from 20 to 75 mm long and 8 to 20 mm wide with an oral sucker at the anterior and a ventral sucker approximately midway to the posterior.The reservoir host for the fluke is: A)snails.

B)birds.

C)rodents.

D)dogs.

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Chapter 55: 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) Sheep liver fluke

A)O.viverrini

B)Fasciola spp.

C)C.(Opisthorchis)sinensis

D)P.westermani

Q3) Chinese liver fluke

A)O.viverrini

B)Fasciola spp.

C)C.(Opisthorchis)sinensis

D)P.westermani

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Chapter 56: Blood Trematodes

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Q1) Rodents,marsupials,and nonhuman primates are all reservoirs for which Schistosoma species?

A)S.japonicum

B)S.haematobium

C)S.mansoni

D)Schistosoma intercalatum

Q2) An egg of the organism of S.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.

Q3) A large lateral spine is characteristic of which Schistosoma egg?

A)Schistosoma mansoni

B)Schistosoma japonicum

C)S.haematobium

D)Schistosoma mekongi

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Chapter 57: Overview of Fungal Identification Methods and Strategies

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Q1) A 29-year-old patient with acquired immunodeficiency syndrome (AIDS)is suspected of having a C.neoformans infection in the cerebrospinal fluid (CSF).A CSF specimen is collected and set up on cycloheximide agar.In addition,an India ink stain is set up.The India ink stain reveals encapsulated yeast;however,3 weeks later,the cycloheximide agar is negative.Which one of the following statements explains this discrepancy?

A)The India ink result is most likely false positive.

B)The ingredients in the cycloheximide agar most likely inhibited the growth of the organism.

C)C.neoformans is rarely recovered from CSF;therefore the cycloheximide result is accurate.

D)The India ink stain is most likely contaminated.

Q2) Colonies are isolated 4 days after incubation from a skin infection that disseminated in a burn victim.A fungal infection is suspected.Which of the following is a possible organism that may be identified?

A)Epidermophyton floccosum

B)Fusarium spp.

C)Cladosporium spp.

D)Microsporum audouinii

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Chapter 58: Hyaline

Molds, Zygomycetes, Dermatophytes, and Opportunistic and Systemic Mycoses

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Q1) The slow-growing organism Trichophyton rubrum produces a flat or heaped-up colony,generally white to reddish with a cottony or velvety surface.The cherry-red color is best observed on the reverse side of the colony.This organism is capable of infecting which of the following?

A)Hair and nails

B)Skin and nails

C)Hair and skin

D)Hair,skin,and nails

Q2) 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.

Q3) Which dermatophyte usually fluoresces yellow-green under a Wood's lamp?

A)Microsporum gypseum

B)Trichophyton verrucosum

C)Microsporum audouinii

D)Epidermophyton floccosum

Page 60

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Chapter 59: Dematiaceious Molds

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Q1) Mycetoma is a subcutaneous infection that involves the lower extremities but may also occur in any part of the body.Swelling,purplish discoloration,and tumorlike deformities of the subcutaneous tissue are all symptoms associated with mycetoma.Which organism can cause this disease?

A)Bipolaris spp.

B)Exserohilum spp.

C)Pseudallescheria boydii

D)Exophiala dermatitidis

Q2) Macroscopic examination of granules from lesions of mycetoma reveals them to be white to yellow and 0.2 to 2 mm in diameter.Microscopically,the granules consist of loosely arranged,intertwined septate hyaline hyphae cemented together.Which organism can cause a mycetoma infection?

A)Fonsecaea spp.

B)E.dermatitidis

C)Cladosporium spp.

D)P.boydii

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Chapter 60: Opportunistic Atypical Fungus: Pjirovecii

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Q1) 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

Q2) Which form is considered diagnostic in the life cycle of Pneumocystis jirovecii?

A)Bradyzoite

B)Trophozoite

C)Sporocyte

D)Cyst

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 61: The Yeasts

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Q1) Agar medium overlaid with olive oil will enhance the growth of which organism?

A)Malassezia

B)Candida

C)Trichosporon

D)Cryptococcus

Q2) Creamy,white patches

A)Trichosporon spp.

B)C.albicans

C)M.furfur

D)C.neoformans

Q3) A patient with leukemia is diagnosed with a Candida infection after receiving several doses of chemotherapy.The most likely yeast causing the infection is:

A)C.albicans.

B)C.parapsilosis.

C)C.tropicalis.

D)Candidametapsilosis.

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Chapter

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Q1) Binds microtubular proteins

A)Amphotericin B

B)Griseofulvin

C)5-Fluorocytosine

D)Echinocandin

E)Azole

Q2) A patient is diagnosed with an invasive Aspergillosis infection.The antifungal therapy that should be administered is:

A)nystatin.

B)griseofulvin.

C)amphotericin B.

D)fluconazole.

Q3) Alters membrane permeability

A)Amphotericin B

B)Griseofulvin

C)5-Fluorocytosine

D)Echinocandin

E)Azole

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Chapter 63: Overview of the Methods and Strategies in Virology

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Q1) Hemadsorption

A)RSV

B)HIV

C)CMV

D)Adenovirus

E)HSV

F)Pediatric respiratory virus

G)Hepatitis B virus (HBV)

H)Influenzas A and B

Q2) Respiratory

A)Adenovirus

B)HSV

C)HBV

D)Arbovirus

Q3) A 2-year-old girl is suspected of having a rotavirus infection.The specimen of choice to collect to identify the agent is:

A)stool.

B)blood.

C)urine.

D)throat.

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Chapter 64: Viruses in Human Disease

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Q1) Carcinoma

A)Yellow fever

B)Dengue fever

C)West Nile virus

D)Hepatitis C

Q2) Which of the following patterns of markers is a normal immune response after recovery from a hepatitis B viral (HBV)infection?

A)Negative hepatitis B surface antigen (HBsAg);negative hepatitis B core antibody (anti-HBcAb);and negative hepatitis B surface antibody (anti-HBsAb)

B)Positive HBsAg;negative anti-HBcAb;and negative anti-HBsAb

C)Positive HBsAg;positive HBeAg (hepatitis Be antigen);and negative anti-HBsAb

D)Negative HBsAg;positive anti-HBcAb;and positive anti-HBsAb

Q3) Lymphocytic choriomeningitis (LCM)and Lassa fever are considered which type of virus?

A)Adenovirus

B)Papillomavirus

C)Picornavirus

D)Arenavirus

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Chapter 65: Antiviral Therapy Susceptibility Testing and Prevention

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Q1) Lamivudine

A)HSV

B)Influenza A

C)Hepatitis B virus (HBV)

D)Respiratory syncytial virus (RSV)

E)HIV

Q2) Emtricitabine

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 66: Bloodstream Infections

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Q1) Patients receiving lipid-supplemented parenteral nutrition are at risk for developing fungemia caused by which organism?

A)Histoplasma capsulatum

B)Malassezia furfur

C)Coccidioides immitis

D)Candida albicans

Q2) The BACTEC automated blood culture system detects organisms by monitoring a rise in carbon dioxide (CO )levels using which type of sensor?

A)Fluorescence

B)Colorimetric

C)Isotopic

D)Saponin

Q3) Which virus found in the blood involves infecting certain T lymphocytes and possibly macrophages?

A)Cytomegalovirus (CMV)

B)Epstein-Barr virus (EBV)

C)Rubella virus

D)Human immunodeficiency virus (HIV)

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68

Chapter 67: Infections of the Lower Respiratory Tract

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Q1) The nasal hairs,convoluted passages,and mucous lining of the nasal turbinates:

A)nonspecifically protect the respiratory tract from infection.

B)promote colonization of normal bacterial flora.

C)can aid adherence by potentially harmful bacteria.

D)reduce colonization of normal bacterial flora.

Q2) The sputum of a patient with acquired immunodeficiency syndrome (AIDS)is stained with Kinyoun's carbolfuchsin stain.Which organism would test positive using this stain?

A)Streptomyces spp.

B)Pneumocystis jiroveci

C)S.aureus

D)Cryptosporidium spp.

Q3) Of the various types of specimens collected to diagnose respiratory infections,which one is acceptable for the detection of anaerobic agents?

A)Tracheostomy aspirates

B)Bronchial washings

C)Gastric aspirates

D)Transtracheal aspirates (TTA)

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69

Chapter 68: Upper Respiratory Tract Infections and Other

Infections of the Oral Cavity and Neck

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Q1) Clinical specimens from suspected cases of epiglottitis should be plated at least to _______ agar(s).

A)sheep blood

B)sheep blood and chocolate

C)Regan-Lowe

D)charcoal horse blood

Q2) Infection of the buccal (cheek)mucosa,tongue,or oropharynx by Candida spp.is:

A)pharyngitis.

B)Vincent angina.

C)rhinitis.

D)thrush.

Q3) Thrush

A)Influenza virus,parainfluenza virus,rhinovirus,and other viruses

B)Influenza virus,parainfluenza virus,Mycoplasma

C)H.influenza

D)S.pyogenes

E)Anaerobes including Fusobacterium,Bacteroides,and anaerobic cocci

F)Herpes simplex virus

G)Candida spp.

H)Mixed bacteria with spirochetes

Page 70

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Chapter 69: Meningitis and Other Infections of the Central

Nervous

Systems

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Q1) 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.

Q2) Specialized secretory cells centrally located in the brain in the third and fourth ventricles that produce CSF are called the:

A)choroid plexus.

B)ventricles.

C)meninges.

D)pia mater.

Q3) The most common source(s)of infection in the central nervous system (CNS)is(are): A)hematogenous spread.

B)infections at other sites such as otitis media.

C)organisms gaining access because of anatomic defects in CNS structures.

D)bacteria that are able to travel along nerves leading to the brain.

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Page 71

Chapter 70: Infections of the Eyes ears and Sinuses

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Q1) Canaliculitis

A)H.influenzae and S.pneumoniae

B)Bacteria,viruses,and occasionally lice

C)S.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 S.pyogenes

Q2) Dacryoadenitis

A)Acute infection of the orbital contents most often caused by bacteria

B)Inflammation of the lacrimal canal

C)Infection of the lacrimal gland characterized by pain of the upper eyelid with erythema

D)Infection of the cornea

Q3) 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.

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Chapter 71: Infections of the Urinary Tract

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Q1) Asymptomatic bacteriuria

A)Infection of the terminal portion of the lower urinary tract

B)Isolation of a specified quantitative count of bacteria in an appropriately collected urine specimen obtained from a person without symptoms or signs of urinary infection

C)Infection of the bladder

D)Dysuria,frequency,and urgency,but a specimen yielding fewer organisms than 105 CFU/mL urine on culture

E)Inflammation of the kidney parenchyma,calices (cup-shaped division of the renal pelvis),and pelvis

Q2) The most frequent cause of uncomplicated community-acquired urinary tract infections is:

A)S.saprophyticus.

B)Klebsiella spp.

C)E.coli.

D)Proteus.

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Chapter 72: Genital Tract Infections

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Q1) Proper design of a urogenital swab expressly intended for the collection of urethral discharge should include what feature?

A)Charcoal-treated cotton or rayon

B)Antibiotic-treated calcium alginate

C)Non flexible Shaft of wood and not flexible

D)Dacron-tipped swabs

Q2) 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)N.gonorrhoeae and C.trachomatis

F)E.coli and other enteric organisms

G)Mumps virus

Q3) The flora of the female genital tract:

A)consists primarily of staphylococci,corynebacteria,and Neisseria.

B)consists primarily of Enterobacteriaceae,streptococci,and staphylococci.

C)consists primarily of S.agalactiae and staphylococci.

D)varies with the pH and estrogen concentration of the mucosa.

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Chapter 73: Gastrointestinal Tract Infections

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Q1) The normal flora of the adult large bowel consists predominantly of:

A)anaerobic species.

B)Staphylococcus.

C)Enterococcus.

D)Enterobacteriaceae.

Q2) Cultures for isolation of Campylobacter jejuni and Campylobacter coli should be incubated in:

A)a capnophilic atmosphere at 42°C and examined at 24 and 48 hours.

B)a microaerophilic atmosphere at 35°C and examined at 24 and 48 hours.

C)regular room air at 35°C and examined at 48 and 72 hours.

D)a microaerophilic atmosphere at 42°C and examined at 24 and 48 hours.

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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Page 75

Chapter 74: Skin soft Tissue and Wound Infections

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Q1) An abnormal passage between two organs or leading from an internal organ to the body surface is known as a:

A)fistula.

B)sinus tract.

C)necrotizing fascia. D)decubitus.

Q2) The causative agents of lumpy jaw are:

A)Clostridium spp.

B)Bacteroides spp.

C)Prevotella spp.

D)Actinomyces spp.

Q3) If a Wood's lamp examination of skin lesions reveals a golden-yellow fluorescence,then what superficial mycoses are expected?

A)Malassezia furfur

B)Trichosporon spp.

C)Candida albicans

D)Cryptococcus neoformans

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Chapter 75: Normally Sterile Body Fluids, Bone and Bone

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) Human bites and animal bites caused by ________ and _________,respectively,can ultimately lead to an underlying bone infection.

A)Eikenella corrodens;Actinomyces spp.

B)Pasteurella multocida;Peptostreptococcus spp.

C)Prevotella spp. ;S.aureus

D)E.corrodens;P.multocida

Q3) A 68-year-old man has an osteomyelitis infection as a result of bacteremia.The most common etiologic agent found in this infection is:

A)Haemophilus spp.

B)S.aureus.

C)Pseudomonas aeruginosa.

D)Fusobacterium necrophorum.

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Chapter 76: Quality in the Clinical Microbiology Laboratory

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Q1) Challenging the wasted steps and eliminating all of the waste

A)Value

B)Value stream

C)Flow

D)Pull

E)Continuous improvement

Q2) 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.

Q3) Clinicians should always be notified of "panic values," that is,potentially life-threatening results.An example of a panic value is a(n):

A)elevated thyroid level.

B)positive urine culture.

C)positive blood culture.

D)elevated sodium level.

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Chapter 77: 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 an organism's susceptibility to bacterial peptides (proteins)is:

A)biotyping.

B)antibiograms.

C)serotyping.

D)bacteriocin typing.

Q3) 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:

A)biotyping.

B)antibiograms.

C)serotyping.

D)bacteriophage typing.

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Chapter 78: Sentinel Laboratory Response to Bioterrorism

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Q1) In the three-tier Laboratory Response Network,confirmed bioterrorism agents should be sent to which laboratory?

A)Clinical

B)Sentinel

C)Reference

D)National

Q2) The act of using microorganisms to harm the civilian population intentionally is referred to as:

A)biosecurity.

B)bio crime.

C)microterrorism.

D)cactiterrorism.

Q3) 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.

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