MLT ASCP BOC MICROBIOLOGY
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1) Proper media for culture of a urethral discharge from a man include: a. sheep blood and phenylethyl alcohol agars b. eosin methylene blue and sheep blood agars d. chocolate agar and modified Thayer Martin agar | show 🗑
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) A sheep blood agar plate inoculated with 0.001 mL of urine grows 70 colonies of Staphylococcus aureus. How many colony forming units per mL of urine should be reported: a. 70 b. 700 c. 7000 d. 70000 | show 🗑
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3) The lowest concentration of antibiotic that inhibits growth of a test organism is the : a. minimum inhibitory concentration b. serum inhibitory concentration c. minimum bactericidal titer d. minimum inhibitory titer | show 🗑
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5) The steam autoclave method of sterilization: a. uses 15 lbs. of pressure for 15 minutes b. utilizes dry heat for 20 minutes c. produces a minimum temp of 100 C d. requires a source of ethylene oxide | show 🗑
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6) The expected colony count in a suprapubic urine from a healthy individual is: a. 0 CFU/mL b. 100 CFU/mL c. 1,000 CFU/mL d. 100,000 CFU/mL | show 🗑
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7) An aspirate of a deep wound was plated on blood agar plates and incubated aerobically and anaerobically. At 24 hrs. there was growth on both plates. This indicates that the organism is a: a. nonfermenter b. obligate anaerobe d. facultative anaerobe | show 🗑
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9) A penicillin resistant Neisseria gonorrhoeae produces: a. alpha-hemolysin b. beta-lactamase c. enterotoxin d. coagulase | show 🗑
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10) Which selective medium is used for the isolation of gram-positive microorganisms? a. Columbia CNA with 5% sheep blood b. trypticase soy agar with 5% sheep blood c. eosin methylene blue d. modified Thayer-Martin | show 🗑
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11) The most sensitive substrate for the detection of beta-lactamases is: a. penicillin b. ampicillin c. cefoxitin d. nitrocefin | show 🗑
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13) An Enterococcus isolated from multiple blood cultures in a patient with endocarditis should be: a. screened for high level aminoglycoside resistance b. checked for tolerance c. assayed for serum antimicrobial activity | show 🗑
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14) In the Kirby-Bauer disk diffusion susceptibility test, which variable is critical when testing Pseudomonas species for antibiotic susceptibility to aminoglycosides? a. incubation temp b. duration of incubation c. cation content of media d. depth o | show 🗑
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show | d. use of cefoxitin for testing
d (Cefoxitin is used as a surrogate for mecA-mediated oxacillin resistance in S aureus.
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show | c. the depth of the media was too thin
If the depth of the media is < 4 mm, this may be associated with excessively large zones and false-positive susceptibility results
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18) 3 sets of blood cultures were obtained from an adult patient with fever and suspected endocarditis. The aerobic bottle of one set had growth of Staphylococcus epidermidis at 5 days of incubation. This indicates that: | show 🗑
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19) In order to isolate Campylobacter coli/jejuni the fecal specimen should be: | show 🗑
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21) Which type of microscope would be most useful in examining viruses and the structure of microbial cells? a. electron b. phase-contrast c. dark-field d. bright-field | show 🗑
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22) After satisfactory performance of daily disk diffusion susceptibility quality control is documented, the frequency of quality control can be reduced to: a. twice a week b. every week c. every other week d. every month | show 🗑
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show | b. decreased
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show | d. catalysts that have become inactivated after repeated use
d (The 2 most common causes of failure of the Gas Pak system is a defective gasket in the jar lid that allows escape of gas from inside the jar and inactivated catalyst pellets.)
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26) Which of the following specimen requests is acceptable? a. feces submitted for anaerobic culture b. Foley catheter tip submitted for aerobic culture c. rectal swab submitted for direct smear for gonococci d. urine for culture of acid-fast bacilli | show 🗑
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show | c. pleural fluid, brain abscess
c (Materials collected from sites not harboring indigenous flora [sterile body fluids, abscess exudate and tissue] should be cultured for anaerobic bacteria.
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28) A liquid fecal specimen from a 3 month old infant is submitted for microbiological exam. In addition to culture on routine media for Salmonella and Shigella, this specimen should be routinely: | show 🗑
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show | c. chocolate agar plate
c (Enriched media such as chocolate agar has no inhibitory effects on bacterial growth and contains additional nutrients that support the growth of fastidious organisms such as H influenzae and Neisseria.)
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31) Which of the following is the most appropriate specimen source and primary media battery? | show 🗑
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32) Which of the following in the most appropriate organism and media combination? | show 🗑
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34) Upon review of a sputum Gram stain, the technician notes that the nuclei of all of the neutrophils present in the smear are staining dark blue. The best explanation for this finding is: a. the slide was inadequately decolorized with acetone/alcohol | show 🗑
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35) When performing a Kovac indole test, the substrate must contain: a. indole b. tryptophan c. ornithine d. paradimethylaninobenzaldehyde | show 🗑
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show | b. beta-galactosidase
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show | c. differential
(Differential media contain compounds, often carbohydrates, that provide a presumptive identification based on colony color or a precipitate around the colony.
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42) Which of the following methods is inadequate for the detection of vancomycin-intermediate S aureus? a. broth macrodilution b. agar dilution c. gradient diffusion d. disk diffusion | show 🗑
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show | c. zones of larger diameter would result
c (A delay of more than 15 minutes between placing the disks on an inoculated plate and incubation permits excess prediffusion of the antimicrobial agent from the disk. This would result in a larger than expected
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show | c. cephalothin
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show | b. penicillin
b (Penicillin inhibits penicillin binding proteins that are essential to peptidoglycan [cell wall] synthesis
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47) Which of the following organisms does not require susceptibility testing to the antimicrobial indicated when isolated from a clinically significant source? | show 🗑
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49) Which of the following must be incubated in a microaerophilic environment for optimal recovery of the organism? a. Campylobacter jejuni b. Escheria Coli c. Pseudomonas aeruginosa d. Proteus mirabilis | show 🗑
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show | d. thiosulfate citrate bile salts agar
d (TCBS is a highly selective and differential medium for the recovery of most Vibrio species including V parahaemolyticus.
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show | a. Skirrow medium
a (Skirrow medium is an enriched selective blood agar medium used for the isolation of Campylobacter from specimens with mixed flora
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53) Tests for beta-lactamase production in Haemophilus influenzae: a. are not commercially available b. include tests that measure a change to an alkaline pH c. should be performed on all blood and CSF isolates | show 🗑
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show | c. charcoal and yeast extract
c (Buffered charcoal yeast extract medium is a specialized enrichment medium for the isolation of Legionella. The nutritive base includes yeast extract. Charcoal is added to the medium as a detoxifying agent.)
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55) The best medium for culture of Bordetella pertussis is: a. Regan-Lowe agar b. cystine blood agar c. Martin Lewis agar d. Ashdown agar | show 🗑
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56) The best medium for culture of Francisella tularensis is: a. Bordet-Gengou medium b. cystine glucose blood agar c. Loeffler medium d. charcoal selective medium | show 🗑
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show | a. sheep blood agar
a (Sheep blood agar is preferred because clear-cut patterns of hemolysis are obtained.
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59) The ability to detect oxacillin resistant staphylococcus aureus may be enhanced by: | show 🗑
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show | c. a syringe filled with pus, obtained before administration of antibiotics
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show | b. rejected as unacceptable
Anaerobic bacteria do not cause pharyngitis. The most common cause of pharyngitis is Streptococcus pyogenes.
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show | b. cycloheximide
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64) Production of beta-lactamase is inducible in which of the following: a. Haemophilus influenzae b. Staphylococcus aureus c. Corynebacterium diphtheriae d. Streptococcus pyogenes | show 🗑
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70) When using a control stain of Staphylococcus aureus, the tech notice that the zone around the oxacillin disk is too small. Which of the following is the most likely explanation? | show 🗑
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show | d. Moraxella osloensis
d (Moraxella osloensis is a gram-negative coccobacillus that is often plump and occurs in pairs and demonstrates a morphology similar to Neisseria.
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show | d. nitrofurantoin
d (Certain antimicrobials, such as nitrofurantoin and norfloxacin, are used only or primarily to treat urinary tract infections. These agents should not be reported for pathogens recovered from other sites of infection.)
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78) Which of the following combinations is useful for confirming the presence of extended spectrum beta-lactamases of E coli? a. ampicillin + cefepime b. cefoxitin + penicillin c. ceftrazidime + clavulanic acid d. cefpodoxime + cefotaxime | show 🗑
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show | b. the volume of blood cultured
b (The volume of blood collected is the single most important variable in the recovery of organisms in patients with bloodstream infections.
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84) A vaginal/rectal swab is collected from a pregnant patient to screen for group B streptococcus colonization. What is the best medium to use for specimen inoculation? a. blood agar b. LIM broth c. CNA agar d. thioglycollate broth | show 🗑
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87) To quality control the autoclave, a vial of Bacillus stearothermophilus is autoclaved and should they be: a. inoculated to blood agar b. incubated at 37 C c. inoculated to chocolate agar d. incubated at 56 C | show 🗑
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show | c. bacterial suspension was not diluted to the proper concentration
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89) Which of the following combinations of organisms would be appropriate as controls to test the functions listed? | show 🗑
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90) A urine Gram stain shows gram-positive cocci in clusters. The organism tested catalase positive. To speciate this organism from culture, the technician should perform a coagulase test and a/an: | show 🗑
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91) The Gram stain from a blood culture shows gram-positive cocci in chains. No growth occurs on blood agar plates incubated both aerobically and anaerobically. Additional testing should be done to detect the presence of: | show 🗑
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92) Viridans streptococci can be differentiated from Streptococcus pneumoniae by: a. alpha hemolysis b. morphology c. catalase reaction d. bile solubility | show 🗑
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show | b. coagulase
b (Coagulase is the biochemical test used to distinguish S aureus [positive] from coagulase-negative staphylococci [negative].)
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show | c. Streptococcus pneumoniae
c (Optochin susceptibility is used to differentiate S pneumoniae, which are susceptible, from other alpha-hemolytic streptococci, which are resistant.)
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show | c. pneumococci
c (Optochin susceptibility is used to differentiate S pneumoniae, which are susceptible from other alpha-hemolytic streptococci, which are resistant.)
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96) Which 2 diseases are usually preceded by infection with beta-hemolytic streptococci? a. rheumatic fever, undulant fever b. glomerulonephritis, rheumatic fever c. rheumatic fever, tularemia d. glomerulonephritis, undulant fever | show 🗑
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show | c. causes one type of bacterial food poisoning
c (Staphylococcus aureus produces an enterotoxin that is associated with short- incubation food poisoning.)
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98) A gamma-hemolytic Streptococcus that blackens bile esculin agar but does not grow in 6.5% NaCl broth is most likely: a. group B Streptococcus b. Enterococcus c. group D Streptococcus d. Streptococcus pneumoniae | show 🗑
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99) Gram stain examination from a blood culture bottle show dark blue, spherical organisms in clusters. Growth on sheep blood agar shows small, round, pale yellow colonies. Further tests should include: | show 🗑
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100) Gram-positive cocci in chains are seen on a Gram stain from a blood culture. The organism grows as a beta-hemolytic colony. Further tests that could be performed include: | show 🗑
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101) "Nutritionally deficient" streptococci are: a. enterococci b. group D nonenterococci c. cell wall-deficient streptococci d. in the genera Granulicatella and Abiotrophia | show 🗑
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show | a. perform a Streptococcus group typing
(The colony description and biochemical results presented describe Streptococcus agalactiae. The identification of this organism is confirmed by streptococcus antigen typing.)
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03) A beta-hemolytic streptococcus that has been isolated from an ear culture grows up to the edge of a 0.04 unit bacitracin disk. Which of the following tests would help to determine if the organism is Enterococcus? | show 🗑
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show | c. group B streptococci
c (All of the organisms listed are potential causes of meningitis. Group B Streptococcus is associated with neonatal meningitis and meningitis in the elderly.)
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105) An important cause of acute exudative pharyngitis is: a. Staphylococcus aureus (beta-hemolytic) b. Streptococcus pneumoniae c. Streptococcus agalactiae d. Streptococcus pyogenes | show 🗑
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show | d. Staphylococcus epidermidis
(Staphylococcus epidermidis is the most common cause of prosthetic valve endocarditis.)
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show | c. growth of 6,800 colonies/mL of a Streptococcus species, esculin hydrolysis and NaCl growth test to follow
c (The number of colonies isolated is multiplied by 100 when a 0.01 mL loop is used for inoculation. Gram-positive, catalase negative cocci are i
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109) Children who have infections with beta-hemolytic streptococci can develop: a. acute pyelonephritis b. acute glomerulonephritis c. chronic glomerulonephritis d. nephrosis | show 🗑
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110) A gram-positive coccus isolated from a blood culture has the following characteristics: optochin susceptibility: negative bacitracin susceptibility: negative bile esculin hydrolysis: negative hippurate hydrolysis: Positive catalase: negative | show 🗑
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111) A beta-hemolytic streptococci that is bacitracin-sensitive and CAMP-negative is: a. group B b. group A c. beta-hemolytic, not group A, B or D d. beta-hemolytic, group D | show 🗑
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show | c. group B Streptococcus Agalactiae
c (Group B streptococci [Streptococcus agalactiae] are resistant to bacitracin and CAMP test positive.)
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113) Group B, beta-hemolytic streptococci may be distinguished from other hemolytic streptococci by which of the following procedures? a. latex antigen typing b. growth in 6.5% NaCl broth c. growth on esculin medium d. bacitracin susceptibility | show 🗑
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114) It is important to differentiate between Enterococcus and group D streptococci because: | show 🗑
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115) Streptococcus pneumoniae can be differentiated best from the viridans group of streptococci by: a. Gram stain b. the type of hemolysis c. colonial morphology d. bile solubility | show 🗑
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116) Characteristically, enterococci are: a. unable to grow in 6.5% NaCl b. relatively resistant to penicillin c. sodium hippurate positive d. bile esculin negative | show 🗑
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show | d. do a tube coagulase test to confirm the slide test
d (Staphylococcus aureus are usually beta-hemolytic. Some strains may not produce bound coagulase detected by the slide coagulase test. A tube coagulase is performed to detect free coagulase and sho
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show | c. hydrolysis of sodium hippurate
c (Of the biochemicals listed only hydrolysis of sodium hippurate will differentiate Streptococcus agalactiae [positive] from S pyogenes [negative].)
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show | c. coagulase production
c (Coagulase production is the primary biochemical used to differentiate S aureus from other coagulase-negative staphylococci.)
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show | c. Streptococcus pyogenes
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show | c. latex antigen typing
c (The most likely organism isolated from this specimen is Streptococcus agalactiae. Polysaccharide antigen typing will confirm the identification of S agalactiae and differentiate it from other beta-hemolytic streptococci.)
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show | a. 2 - 6 hrs.
a (Staphylococcus aureus produces an enterotoxin that is associated with food poisoning. Symptoms typically appear within 2 - 6 hours.)
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123) During the past month, Staphylococcus epidermidis has been isolated from blood cultures at 2 - 3 times the rate from the previous year. The most logical explanation for the increase in these isolates is that: | show 🗑
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125) A yellow colony from a wound culture tested catalase-positive and coagulase-negative. The organism gram-positive cocci in clusters. Which of the following tests should differentiate between a coagulase-negative Staphylococcus and Micrococcus? | show 🗑
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show | d. CAMP test and S agalactiae
d (The question describes the CAMP test, which is positive for Streptococcus agalactiae.)
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show | d. Enterococcus faecalis
d (Enterococcus is positive for the bile esculin test while Streptococcus pyogenes and staphylococci are negative.)
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129) Infection of the urinary tract is most frequently associated with: a. Staphylococcus aureus b. Escherichia coli c. Enterococcus faecalis d. Serratia marcescens | show 🗑
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show | c. sorbitol
c (Sorbitol replaces lactose in MacConkey. E coli 0157:H7 does not ferment sorbitol, whereas other species of E coli are positive for fermentation of sorbitol. This makes the media a good screen for 0157:H7.)
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show | d. reduce nitrate to nitrite
d (Members of Enterobacteriaceae are oxidase negative, ferment glucose, and reduce nitrate to nitrite.)
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132) Which one of the following genera is among the least biochemically reactive members of the Enterobacteriaceae? a. Proteus b. Pseudomonas c. Citrobacter d. Shigella | show 🗑
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133) Which one of the following gram-negative bacilli ferments glucose? a. Alcaligenes faecalis b. Pseudomonas cepacia c. Acinetobacter lwoffii d. Yersinia enterocolitica | show 🗑
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134) A sputum culture from an alcoholic seen in the ER grows gray, mucoid, stringy colonies on SBA. The isolate grows readily on MacConkey agar and forms mucoid, dark pink colonies. The colonies yield the following test results: | show 🗑
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show | c. Salmonella typhimurium
c (Salmonella is the only distractor that produces H2S. Also, Klebsiella and E coli produce acid/acid reactions in TSI.)
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show | d. Shigella dysenteriae
d (Salmonella produce H2S in TSI and Yersinia produces an acid slant and acid butt. Shigella fits this biochemical profile.)
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show | b. Escherichia coli
b (E coli can produce several different types of toxins that result in different gastroenteritis manifestations.)
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show | b. nonmotile
b (The biochemical characteristic that best fits Shigella is that it is nonmotile. Shigella are urease negative and oxidase negative. Shigella are lactose nonfermenters.)
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142) A gram-negative bacillus has been isolated from feces, and the confirmed biochemical reactions fit those of Shigella. The organism does not agglutinate in Shigella antisera. What should be done next? | show 🗑
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143) Biochemical reactions of an organism are consistent with Shigella. A suspension is tested in antiserum without resulting agglutination. However, after 15 mins. of boiling, agglutination occurs in group D antisera. The Shigella species is | show 🗑
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show | d. Yersinia pestis
d (Yersinia pestis is classically described as having a "safety pin" appearance on Wayson stain. This patient's presentation is classic for bubonic plague.)
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show | c. 67,000 CFU/mL Enterobacter cloacae
TSI: Acid/Acid,oxidase: negative,motility: positive,indole:negative,citrate: positive,VP: positive,lysine decarboxylase: negative,ornithine decarboxylase: positive,urea: negative
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show | a. it is oxidase positive
a (Enterobacteriaceae ferment glucose and are oxidase negative.
However, it was moved to the Enterobacteriaceae family despite its positive oxidase reaction.)
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155) The stock cultures needed for quality control testing of motility are: a. Salmonella typhimurium / Escherichia coli b. Escherichia coli / Pseudomonas aeruginosa d. Klebsiella pneumoniae / Escherichia coli | show 🗑
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show | c. Escherichia coli / Pseudomonas aeruginosa
c (Of the organisms listed only Pseudomonas aeruginosa is oxidase positive.)
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157) The stock cultures needed for quality control testing of phenylalanine deamination activity are: a. Escherichia coli / Klebsiella pneumoniae b. Salmonella typhimurium / Escherichia coli d. Proteus mirabilis / Escherichia coli | show 🗑
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158) The stock cultures needed for quality control testing of deoxyribonuclease (DNase) production are: a. Salmonella typhimurium / Escherichia coli b. Escherichia coli / Pseudomonas aeruginosa d. Serratia marcescens / Escherichia coli | show 🗑
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159) Quality control of the spot indole test requires the use of ATCC cultures of: a. Pseudomonas aeruginosa / Proteus mirabilis b. Salmonella typhi / Shigella sonne d. Escherichia coli / Enterobacter cloacae | show 🗑
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show | a. Haemophilus influenzae
a (Haemophilus influenzae requires X and V factors. Sheep blood agar supplies X factor, and the staphylococci produce V factor, so colonies grow around staph colonies.)
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show | d. Pseudomonas aeruginosa
(Pseudomonas aeruginosa produces the blue-green pigment, pyocyanin.)
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162) A nonfermenting gram-negative bacillus is isolated from a wound. The nitrate and oxidase are strongly positive. The growth on SBA has a grape-like odor. The organism is: | show 🗑
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163) A small, gram-negative bacillus is isolated from an eye culture. It grows only on chocolate agar and is oxidase-variable. The most likely organism is: a. Acinetobacter lwoffii b. Haemophilus influenzae c. Stenotrophomonas maltophilia | show 🗑
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show | d. 42 C
d (Campylobacter jejuni/coli grow better at 42 C than 37 C and other organisms in the colon are inhibited at this high temperature)
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show | a. nasopharyngeal aspirate
a (Respiratory syncytial virus [RSV] infected the ciliated respiratory epithelium of the upper respiratory tract. A nasopharyngeal swab or aspirate is the optimal specimen for RSV recovery.)
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show | b. intranuclear inclusions
b (In tissue smears or biopsy specimens, the presence of virally infected cells is indicated by intranuclear or intracytoplasmic inclusions.)
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show | b. inhibits bacterial and fungal growth
b (Antibiotics and antifungal agents are added to viral transport medium to inhibit the growth of bacteria and fungus.)
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show | . Mycobacterium fortuitum
a (Rapidly growing mycobacteria such as Mycobacterium fortuitum may be <10% acid fast and may not stain with fluorochrome.)
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show | . DNA probe
(Mycobacterium avium and M intracellulare have the same biochemical pattern, but can be differentiated by the use of DNA probes.)
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show | b. exposed to light for 1 hour
b (Pigment production is controlled by an oxygen-dependent, light-inducible enzyme in photochromogenic mycobacteria.)
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show | c. Lowenstein-Jensen medium
c (Lowenstein-Jensen is an egg-based medium used to isolate AFB. The other media are not used for the isolation of AFB.)
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334) In a suspected case of Hansen disease (leprosy), a presumptive diagnosis is established by: | show 🗑
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show | a. photochromogens
a (Photochromogens produce nonpigmented colonies only when grown in darkness, but pigmented colonies after exposure to light.)
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332) The mycobacteria that produce a deep yellow or orange pigment both in the dark and light are: a. photochromogens b. scotochromogens c. nonchromogens d. rapid growers | show 🗑
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show | . rifampin
a (Primary drugs for the treatment of Mycobacterium tuberculosis include isoniazid, rifampin, pyrazinamide, and ethambutol.)
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show | b. nucleic acid amplification
(Several commercial PCR tests are available that identify Mycobacterium tuberculosis from positive respiratory specimens.)
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show |
b. bovis
(Mycobacterium tuberculosis can remain viable but dormant in macrophages for many years.)
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show | c. capacity to withstand intracellular digestion by macrophages
c (Mycobacterium tuberculosis can remain viable but dormant in macrophages for many years.)
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show | d. carbol fuchsin
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