BOC MLT MICROBIOLOGY #2
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| 167) A gastroenterologist submits a gastric biopsy from a patient with a peptic ulcer. To obtain presumptive evidence of Helicobacter pylori, a portion of the specimen should be added to which media? a. urea broth b. tetrathionate c. selenite d. trypt | show 🗑
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| 168) A 4 yr. old boy is admitted to the hospital with suspected meningitis. He has not had most of the childhood vaccines. The suspected pathogen is: a. Listeria monocytogenes b. Haemophilus influenzae c. Streptococcus agalactiae d. Neisseria meningit | show 🗑
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| 171) A gram stain of a touch prep from a gastric biopsy shows gram-negative bacilli that are slender and curved. The most likely pathogen is: a. Burkholderia cepacia b. Corynebacterium urealyticum c. Helicobacter pylori d. Pasteurella multocida | show 🗑
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| show | b. Haemophilus influenzae
b (Haemophilus influenzae is recovered on chocolate agar.
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| show | d. growth at 42 C
(Pseudomonas aeruginosa grows at 42 C, but this temperature is inhibitory for other Pseudomonas species.)
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| show | a. optimal growth at 42 C
a (Campylobacter jejuni will grow at 37 C, but prefers 42 C. It is oxidase and catalase positive and motile.)
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| show | a. 6% O2, 10%-15% CO2, 85%-90% nitrogen
a (Campylobacter is microaerophilic, and requires a decreased oxygen and increased carbon dioxide atmosphere for growth.)
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| 178) Haemophilus influenzae is most likely considered normal indigenous flora in the: a. oropharynx b. female genital tract c. large intestine d. small intestine | show 🗑
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| show | d. beta-lactamase enzyme
(The beta-lactamase enzyme produced by Haemophilus influenzae inactivates the antibiotics that have a beta-lactam ring in their structure, such as penicillins and cephalosporins.)
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| 180) An isolate on chocolate agar from a patient with epiglottitis was suggestive of Haemophilus species. Additional testing showed that the isolate required NAD for growth and was nonhemolytic. The organism is most likely Haemophilus: | show 🗑
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| show | c. bone marrow
c (Bone marrow is considered the most sensitive specimen for the recovery of Brucella.)
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| 185) A gram negative bacillus with bipolar staining was isolated from a wound infection caused by a bite from a pet cat | show 🗑
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| show | . Aeromonas hydrophila
(Enterobacteriaceae, such as E coli, Serratia and Enterobacter, are oxidase negative. The only selection that is oxidase positive is Aeromonas. It is associated with wounds contaminated with water.)
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| show | d. culture was not incubated long enough
d (Media for isolation of Legionella should be incubated at 35 - 37 C for at least 7 days.)
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| 191) Which characteristic best differentiates Acinetobacter species from Moraxella species? a. production of indophenol oxidase b. growth on MacConkey agar c. motility d. susceptibility to penicillin | show 🗑
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| show | a. growth at 42 C, pyocyanin production, gelatinase production
a (Growth at 42 C and pyocyanin production are classic tests for the identification of Pseudomonas aeruginosa. Gelatin hydrolysis separates Pseudomonas putida [negative] from Pseudomonas fluo
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| show | a. a media with cysteine such as BYCA
a (Francisella tularensis is the causative agent of tularemia. It has a specific growth requirement for cysteine.)
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| show | d (Buffered charcoal yeast extract agar is recommended for culture of specimens for Legionella.)
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| 197) A community hospital microbiology lab is processing significant numbers of stool cultures because of an outbreak of diarrhea following heavy rains and flooding in the country. A media that should be incorporated in the plating protocol is: | show 🗑
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| show | d. oxidase
d (Both organisms are gram-negative bacilli and grow on MacConkey agar. Neither ferments glucose. Stenotrophomonas is oxidase negative, while most other nonfermenters are oxidase positive.)
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| show | d. take extra safety precautions for possible Brucella
d (Brucella causes undulant fever and is a cause of fever of unknown origin. It is slow growing, and is associated with laboratory-acquired infections. It is also a potential agent of bioterrorism. S
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| show | c. carbon dioxide
c (Neisseria gonorrhoeae requires an enhanced CO2 atmosphere for optimal growth.)
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| 204) Assuming the agent isolated from a patient's spinal fluid produces a positive oxidase test, the most likely diagnosis is: a. tuberculosis meningitis b. meningococcal meningitis c. viral meningitis d. pneumococcal meningitis | show 🗑
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| show | c. genitourinary tract
c (Based on the biochemicals listed the most likely identification of the organism is Neisseria gonorrhoeae. N gonorrhoeae is most commonly isolated from the genitourinary tract.)
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| show | d. organism requires CO2 for growth
d (Neisseria gonorrhoeae requires an enhanced carbon dioxide atmosphere for optimal growth.)
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| show | . Moraxella catarrhalis
b (The Neisseria species listed all ferment several carbohydrates, Moraxella catarrhalis is biochemically inert and does not ferment carbohydrates.)
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| show | b. Neisseria gonorrhoeae
b (One of the less commonly used methods for identification of Neisseria gonorrhoeae grown in culture is coagglutination.)
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| 209) Clinical resistance to penicillin correlates most frequently with beta-lactamase production in: a. Neisseria gonorrhoeae b. Neisseria meningitidis c. Streptococcus agalactiae d. Streptococcus pyogenes | show 🗑
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| show | d. tetramethyl-phenylenediamine
d (Since all Neisseria species are oxidase positive, they possess the enzyme to oxidize tetramethyl-phenylenediamine.)
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| 211) The diagnosis of Neisseria gonorrhoeae in females is best made from: a. clinical history b. an endocervical culture c. a gram stain of cervical secretions d. examination for clue cells | show 🗑
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| show | c. lactose degradation
c (Both Neisseria meningitidis and N lactamica produce acid from maltose and grow on modified Thayer martin agar. N lactamica ferments lactose, N meningitidis does not.)
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| show | d. hydrolysis of carbohydrates
d (Of the choices provided, only fermentation of carbohydrates provides definitive identification of Neisseria gonorrhoeae.)
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| show | b. oxidase positive and glucose positive, maltose negative
b (Neisseria gonorrhoeae is oxidase positive and ferments glucose but not maltose.)
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| show | b. carbohydrate negative (asaccharolytic)
b (Moraxella catarrhalis is an oxidase- positive gram-negative diplococcus that is usually beta-lactamase positive. It does not ferment carbohydrates.)
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| show | b. Neisseria meningitidis
b (Waterhouse-Friederichsen syndrome is a known complication of severe Neisseria meningitidis infection.)
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| show | . potassium tellurite
d (Media containing potassium tellurite is used for the recovery of Corynebacterium diphtheriae.)
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| 220) Which organism commonly causes food poisoning by consumption of foods containing excessive populations of organisms or preformed enterotoxin? | show 🗑
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| 222) The best procedure to differentiate Listeria monocytogenes from Corynebacterium species is: a. catalase b. motility at 25 C c. motility at 35 C d. Gram stain | show 🗑
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| show | c. a positive toxigenicity test
(In order to determine if an isolate of Corynebacterium diphtheriae produces toxin, testing for the presence of diphtheria toxin must be performed using methods such as the Elek test or PCR.)
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| show | d. H2S production
d (Erysipelothrix rhusipathiae is the only gram-positive bacillus that produces hydrogen sulfide when inoculated into triple sugar iron agar.)
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| show | d. esculin positive
d (Listeria may be confused with some streptococci because Listeria is beta- hemolytic and is capable of hydrolyzing esculin.)
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| 227) A branching gram-positive, partially acid-fact organism is isolated from a bronchial washing on a 63 yr. old woman receiving chemotherapy. The organism does not hydrolyze casein, tyrosine or xanthine. The most likely identification is: | show 🗑
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| 228) The characteristic that is most commonly associated with the presence of strict anaerobic bacteria and can be taken as presumptive evidence of their presence in a clinical specimen is the: | show 🗑
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| show | b. begin organism identification
b (A probable anaerobe is the only organism growing so the microbiologist can proceed with identification.)
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| 231) Anaerobic infections differ from aerobic infections in which of the following? a. they usually respond favorably with aminoglycoside therapy b. they usually arise from exogenous sources c. they are usually polymicrobic d. Gram stains of specimens | show 🗑
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| show | b. 10^3 CFU/mL
The Infectious Disease Society of America consensus definition of cystitis is greater than or equal to 1,000 CFU/mL of a uropathogen.)
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| show | d. oropharyngeal flora
In this specimen, >25 epithelial cells per low power field is an indicator of poor specimen quality, and the bacteria present are representative of oropharyngeal flora.)
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| A diabetic foot swab from a 82-year-old woman - neutrophils, no squamous epithelial cells - gram-negative bacilli - gram-positive cocci in chains sheep blood/ agar plates routinely used for wound cultures, the technologist might also process a(n): | show 🗑
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| show | d. Columbia CNA, MacConkey
d (Columbia CNA agar is a selective medium used for the isolation of gram- positive organisms.
MacConkey agar is a selective and differential medium used for the isolation of gram-negative organisms
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| show | b. too many organisms in the inoculum
b (To ensure the reproducibility of disk diffusion testing, the inoculum must be standardized. [too many organisms], zone sizes would be smaller than expected and appear falsely resistant.)
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| 48) Which of the following antibiotics would routinely be tested and reported for isolates of Pseudomonas aeruginosa? a. penicillin b. erythromycin c. clindamycin d. gentamicin | show 🗑
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| 65) A sputum specimen is received for culture and Gram stain. The Gram stained smear from this specimen is seen in the image (total magnification 100x): The technologist's best course of action would be to: | show 🗑
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| show | d. <2 mg/mL
GENTAMICIN:64,32,16,8,4,2
The well with the lowest concentration of antibiotic displaying no growth is read as the minimum inhibitory concentration [MIC].)
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| show | b. oxacillin disk diffusion
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| 234) Acceptable specimens for the culture of anaerobic bacteria that cause disease include: a. abscesses b. gingival swabs c. skin swabs d. vaginal swabs | show 🗑
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| 235) Propionibacterium acnes is most often associated with: a. normal oral flora b. post-antibiotic diarrhea c. tooth decay d. blood culture contamination | show 🗑
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| 236 The etiologic agent of botulism is: a. highly motile b. non-spore-forming c. Clostridium perfringens d. an exotoxin producer | show 🗑
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| show | a. Clostridium tetanus
a (Corynebacterium species and Propionibacterium species do not produce spores, and Bacillus is an aerobic organism.)
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| show | b. Clostridium perfringens
Clostridium perfringens is a spore-forming anaerobe organism.)
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| 240) The reverse CAMP test, lecithinase production, double zone hemolysis, and Gram stain morphology are all useful criteria in the identification of: a. Clostridium perfringens b. Streptococcus agalactiae c. Propionibacterium acnes d. Bacillus anthra | show 🗑
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| show | b. Clostridium septicum
Clostridium septicum forms subterminal spores.)
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| show | . demonstration of toxin in the patient's serum
a (Botulism infection is confirmed by reference laboratories such as the CDC by demonstrating toxin in serum, feces, gastric contents or vomitus.)
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| show | c. CCFA: yellow, ground glass colonies
CCFA is also differential-fermentation of lactose produces classic colony morphology for this organism.)
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| show | c. set up egg yolk agar plate
(The Gram stain and double zone of hemolysis are characteristics of Clostridium perfingens. C perfingens is lecithinase positive on the egg yolk agar test for lecithinase and lipase.)
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| show | d. Bacteroides
Bacteroides species are anaerobic, gram-negative bacilli.)
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| 257) A control strain of Clostridium should be used in an anaerobe jar to assure: a. that plate media is working b. that an anaerobic environment is achieved c. that the jar is filled with a sufficient number of plates d. that the indicator strip is c | show 🗑
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| show | a. macroscopic characteristics and microscopic morphology
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| show | c. include media that have cycloheximide and chloramphenicol added to inhibit bacterial organisms and saprophytic fungi
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| show | d. Histoplasma capsulatum
d (Histoplasma capsulatum is most frequently transmitted by inhalation.)
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| show | b. calcofluor white
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| show | a. Cryptococcus neoformans
a (Cryptococcus neoformans is a cause of meningitis in immunocompromised patients, and produces a polysaccharide capsule.)
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| 266) The formation of germ tubes presumptively identifies: a. Candida tropicalis b. Candida parapsilosis c. Candida glabrata d. Candida albicans | show 🗑
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| 267) An HIV-positive patient began to show signs of meningitis. A spinal fluid was collected and cultured for bacteria and fungus. A budding, encapsulated yeast was recovered. Which organism is consistent with this information? | show 🗑
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| show | c. India ink
(Cryptococcus may not stain well on Gram stain. Rapid identification is important when yeast is detected in CSF, the presence of capsules seen in an India ink preparation would be presumptive for C neoformans.)
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| India ink: no encapsulated yeast cells - cryptococcal antigen: negative - urea: negative - germ tube: negative What should the technologist do next to identify | show 🗑
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| 273) The recovery of some Cryptococcus species may be compromised if the isolation media contains: a. cycloheximide b. gentamicin c. chloramphenicol d. penicillin | show 🗑
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| 278) The most sensitive test for the initial diagnosis of cryptococcal disease is: a. India ink b. Gram stain c. cryptococcal antigen d. Giemsa stain | show 🗑
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| 279) Which of the following statements concerning the germ tube test is true? | show 🗑
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| show | b. culture conversion to yeast form
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| show | d. Coccidioides immitis
(The arthroconidia of Coccidioides immitis are highly infectious; cultures must be handled with care to minimize aerosols.)
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| 285) Which of the following is a dimorphic fungus? a. Sporothrix schenckii b. Candida albicans c. Cryptococcus neoformans d. Aspergillus fumigatus | show 🗑
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| show | a. lactophenol cotton blue
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| show | c. zygomycete
c (Zygomycetes grow rapidly and fill the dish with cotton candy-like growth.)
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| show | d. eschar biopsy
d (Mucormycosis is an aggressive infection where biopsy, curettage or fine-needle aspiration is essential for diagnosis.)
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| show | a. inhalation
a (Inhalation is a common mode of transmission for fungal spores. Specimens for fungal culture should be processed in a biological safety cabinet to minimize the potential for aerosol spread.)
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| 304) A sputum specimen received at 8 AM for an Acid Fast smear reveals acid-fast bacilli. This specimen was concentrated by the NALC-sodium hydroxide method and inoculated on 2 Lowenstein-Jensen slants and held for 8 weeks at 35C in 5%-10% CO2. No growth. | show 🗑
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| 305) The preferred carbon source for mycobacteria is: a. glycerol b. glucose c. fatty acids d. casein hydrolysate | show 🗑
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| show | b. Lowenstein-Jensen, Middlebrook 7H11, Lowenstein-Jensen Gruft
b (Lowenstein-Jensen is an egg-based medium, 7811 is an agar-based medium, and Lowenstein-Jensen Gruft is a selective egg-based medium.)
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| 311) Which of the following reagents should be used as a mucolytic, alkaline reagent for digestion and decontamination of a sputum for mycobacterial culture? a. N-acetyl-L-cystine and NaOH b. NaOH alone c. zephiran-trisodium phosphate d. oxalic acid | show 🗑
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| 312) The function of N-acetyl-L-cysteine in the reagent for acid-fast digestion-decontamination procedure is to: a. inhibit growth of normal respiratory flora b. inhibit growth of fungi c. neutralize the sodium hydroxide d. liquefy the mucus | show 🗑
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| 313) When staining acid-fast bacilli with Truant auramine-rhodamine stain, potassium permanganate is used as a: a. decolorizing agent b. quenching agent c. mordant d. dye | show 🗑
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| show | d (If exposed to light, agar-based media such as 7H11 may release formaldehyde, which is toxic to mycobacteria.)
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| show | d. oxalic acid
d (The oxalic acid method is superior to alkali methods for processing specimens contaminated with Pseudomonas.)
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| 316) An AFB broth culture is positive for acid-fast bacilli at 1 week while the agar slant shows no growth. The most likely explanation for this is: | show 🗑
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| show | d. process all specimens in a biological safety hood
(Specimens processed for mycobacterial culture must be processed in a biological safety cabinet to minimize aerosol transmission of the organism.)
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| show | d. carbol fuchsin
d (Mycobacteria form stable complexes with Kinyoun carbol fuchsin.)
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| show | b. type of water vegetation consumed
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| show | a. 4 suckers
(The scolex of Taenia saginata is square with 4 suckers and no hooks.)
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| show | d. Paragonimus westermani, Hymenolepis nana
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| show | a. Taenia solium
a (Humans may become infected with Taenia solium by either ingesting the larval form or ova. If ova are ingested the parasite cannot complete the life cycle, and cysticerci encyst in various tissues including the brain.)
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| show | c. a scotch tape preparation from the perianal region
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| show | b. cellophane tape preparation
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| 380) Multifocal brain lesion in AIDS patients is commonly caused by: a. Toxoplasma gondii b. Pneumocystis jiroveci c. Cryptosporidium parvum d. Giardia lamblia | show 🗑
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| 373) Artifacts found in a stool specimen that can be confused with ova or cysts are: a. partially digested meat fibers b. degenerated cells from the gastrointestinal mucosa c. dried chemical crystals d. pollen grains | show 🗑
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| 371) A cell culture line used for the recovery of Chlamydia trachomatis from clinical specimens is: a. HeLa 229 b. Hep- 2 c. BHK-21 d. McCoy | show 🗑
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| 363) Mycoplasmas differ from other bacteria in that they: a. do not cause disease in humans b. cannot grow in artificial inanimate media c. lack cell walls d. are not serologically antigenic | show 🗑
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| 362) Chlamydial infections have been implicated in: a. urethritis and conjunctivitis b. gastroenteritis and urethritis c. neonatal pneumonia and gastroenteritis d. neonatal meningitis and conjunctivitis | show 🗑
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| 361) Psittacosis is transmissible to man via contact with: a. insects b. birds c. cattle d. dogs | show 🗑
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| 360) Relapsing fever in humans is caused by: a. Borrelia recurrentis b. Brucella abortus c. Leptospira interrogans d. Spirillum minus | show 🗑
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| 352) Colds and other acute respiratory diseases are most often associated with: a. Epstein-Barr virus b. adenovirus c. coxsackie B d. reovirus | show 🗑
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| show | b. herpes simplex
b (Herpes simplex virus is the most common cause of fatal sporadic encephalitis in the United States.)
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| 350) The genus of virus associated with anogenital warts, cervical dysplasia and neoplasia is: a. herpes simplex virus b. papillomavirus c. cytomegalovirus d. coxsackierus | show 🗑
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