Professional Documents
Culture Documents
SIMPLE COMPLETIONS
Give the BEST answer for the following questions:
1. A Gram stain prepared from an inoculum of S. aureus is overdecolorized. After the
completion of the Gram stain procedure, the resulting smear will show:
A. Purple cocci -in chains
B. Purple cocci in clusters
C. Red cocci in clusters
D. Red bacilli
E. Red cocci in chains
2. Salmonella is easily recognized in the laboratory for its ability to produce on TSI medium.
A. Indole
B. Urease
C. H2S
D. Lactose
E. Citrate
The following clinical specimen has to be sent to the laboratory for immediate processing:
A. Blood
B. CSF
C. Hair samples
D. Stool
E. Urine
4. A sputum exudate reveals lancet-shaped, gram-positive cocci arranged. in pairs. This
morphology is characteristic of:
A. Streptococcus pyogenes
B. Staphylococcus epidermidis
C. Streptococcus pneumoniae
D. Klebsiella pneumoniae
E. Enterococcus faecalis
5. The ability to clot blood plasma (coagulase +) is one of the most reliable laboratory
criteria available for the identification of:
A. Escherichia coli
B. Streptococcus pyogenes
C. Staphylococcus aureus
D. Haemophilus influenzae
E. Streptococcus agalactiae
Page
1
12. Group A Streptococcus growing on a blood agar plate, shows which of the following:
A. Alpha hemolysis, a clear zone surrounding the colonies
B. Alpha hemolysis, a green zone surrounding the colonies
C. Beta-hemolysis, a clear zone surrounding the colonies
D. Beta-hemolysis, a green zone surrounding the colonies
E. Gamma-hemolysis a clear zone surrounding the colonies
13. Colonies of Neisseria turn purple when a redox dye is applied. The color change is
indicative of the activity of the enzyme:
A. Beta-galactosidase
B. Oxidase
C. Urease
D. DNase
E. Lysine Decarboxylase
14. The only major category of infectious diseases with which Enterobacteriaceae members
have not been definitively associated is that of:
A. Urinary tract infections
B. Respiratory tract infections
C. Skin and soft tissue infections
D. Sexually transmitted infections
E. Systemic infections
15. Group D streptococci, when present, could most likely be recovered from a stool sample
if the primary inoculum was streaked on:
A. CNA agar
B. MacConkey agar
C. Xylose Lysine Decarboxylase agar
D. EMB agar
E. none of the above
16. The detection of the 13-lactamase enzyme is primarily valuable in infections caused by:
A.Streptococcus pyogenes
B. Streptococcus agalactiae
C. Nocardia asteroides
D. Hemophilus influenzae
E. Klebsiella pneumoniae
17. You are conducting an epidemiologic survey for the detection of upper respiratory carriers of
Group A. The optimal type of specimen to be obtained for culture is:
A. A throat swab
B. Saliva
C. A buccal cavity swab
D. Sputum
E. None of the above
Page
3
18. What is the time interval required for laboratory identification and antibiotic susceptibility
testing of common, pathogenic, gram positive cocci?
A. 24 hours
B. 48 hours
C. 72 hours
D. 4 days
E. 5 days
19. Once isolated in the laboratory, Staphylococcus can be easily distinguished from
Streptococcus on the basis of:
A. The catalase reaction
B. The oxidase reaction
C. The lactose fermentation reaction
D. The glucose fermentation reaction
E. The colony pigmentation reaction
20. A Kirby-Bauer susceptibility test, and a beta-lactamase detection test are indicated if an
organism isolated from an infected wound turns out to be:
A. Streptococcus agalactiae
B. Streptococcus pyogenes
C. Staphylococcus aureus
D. Alpha-hemolytic streptococcus
21. The use of chemical agents on skin or living tissue to inhibit or eliminate microbes is
known as:
A. Sterilization
B. Antisepsis
C. Disinfection
D. Pasteurization
E. Cleansing
22. Which of the following will make a sputum a "Q0" specimen?
A. Saliva contaminated the specimen
B. The specimen did not contain enough neutrophils
C. The specimen contained too many squamous cells
D. All of the above statements
23. You obtain a blood specimen from a patient who is being treated with IV penicillin.
Pathogenic microorganisms can still be isolated from this patient's blood cultures if.
A The lab incubates the cultures longer than usual
B. The cultures are incubated at a higher temperature than usual
C. The cultures are shaken for one hour prior to incubation
D. You alert the laboratory that the patient received antibiotics before you collected the
specimens
Page
4
MATCHING
Match the BEST possible answer with each question. Answers can be used once, more than
once, or not at all.
QUESTIONS 24-28
24._____ Microorganism that grows in the presence of O2
25. _____Microorganism that grows in the absence of O2
26. _____Medium used to distinguish between bacterial species or groups.
27. _____ Medium containing substances that stimulate a single organism or groups of
organisms to grow more readily.
28. _____ Medium that allows the growth of certain bacteria while inhibiting the growth of
others.
(A) Anaerobic
(B) Selective
(C) Differential
(D) Enriched
(E) Aerobic
QUESTIONS 29-31
29. _____ Mycobacterium tuberculosis
30. _____ Encapsulated microorganisms
31. _____ Enterobacteriaceae
(A) Rapid agglutination test
(B) Kinyoun stain
(C) India Ink
(D) Bile-esculin and 6.5% salt medium
(E) Carbohydrate fermentation
QUESTIONS 32-36
For each diagnostic procedure, select the most appropriate laboratory result.
32. _____ Differentiation of Group D enterococci from Group D non-enterococci.
33. _____ Differentiation of Streptococcus agalactiae from other streptococci.
Page
5
49. _____ A urine culture result showing 106 CFU/ml indicates a urinary tract infection.
PART II - LECTURE EXAM, QUESTIONS 51-150
MATCHING:
For each medium list below, select the BEST. lettered response. Answers may be used once,
more than once, or not at all.
QUESTIONS 50-52:
A. Brucella abortus
B. Brucella suis
C. Brucella melitensis
50. _____Causes mild disease with rare suppurative complications.
51. _____Is associated with destructive lesions and a prolonged course of infection.
52. _____ Is the most common cause of brucellosis, causing severe disease with a
high incidence of serious complications.
QUESTIONS 53-56:
For Legionella,
A. Presumptive Identification.
B. Definitive Identification.
53. _____ Demonstration of a typical colonial morphology.
54. _____ Specific staining with fluorescein-labeled antibodies.
55. _____ Gram stain showing weakly staining, pleomorphic, thin, gram-negative bacilli.
56. _____ NA hybridization tests.
SIMPLE COMPLETIONS:
Each of the questions or incomplete statements in this group is followed by four or five
suggested answers or completions. Select the one which is BEST in each case and mark the
corresponding letter on the answer sheet.
57. Which of the following factors is NOT important for establishment of meningococcal
disease due to Neisseria meningitidis?
A. the ability of N. meningitidis to colonize the nasopharynx.
B. the production of siderophores for iron scavenging.
C. systemic spread without antibody-mediated phagocytosis.
Page
7
Questions 58-60: A patient presents with small skin lesions on the trunk and lower extremities.
In some cases, these-have coalesced to form larger hemorrhagic lesions. The patient
complains of an abrupt, severe headache and fever.
58. You culture the cerebrospinal fluid, expecting to find:
A. gram negative cocci clustered as grapes.
B. gram positive rods within phagocytes.
C. gram negative diplococci associated with polymorphonuclear leukocytes.
D. gram negative, comma-shaped bacilli.
59. You question the patient about close contacts, recommending that previously exposed
persons:
A. leave the country.
B. be vaccinated.
C. be examined for a purulent urethral discharge.
D. Initiate prophylactic sulfonamide or rifampin therapy.
60. The bacterium responsible for the symptoms described above may also cause:
A. Waterhouse-Friderichsen Syndrome.
B. Toxic Shock Syndrome.
C. Reye's Syndrome.
D. Swimmer's Itch.
61. Legionella are able to avoid intracellular killing because:
A. They multiply only extracellularly.
B. They inhibit phagolysosomal fusion.
C. Once they penetrate the cell by endocytosis, they immediately kill host cells by
secreting proteolytic enzymes, phosphatases, lipases, and nucleases.
D. Humoral immunity, not cellular immunity, is the principle host defense response.
62. Among renal transplant and adult cancer patients, Listeria monocytogenes is the leading
cause of:
A. tonsillitis
B. otitis media
C. conjunctivitis
D. sinusitis
E. bacteria meningitis
63. Recovery from and immunity to listeriosis depend on the development of:
A. an effective IgG response by the host.
B. an effective IgA response by the host.
C. an effective IgM response by the host.
D. an effective cell-mediated immune response by the host.
E. an effective humoral and cell-mediated immune response by the host.
Page
8
Page
9
Page
11
Page
13
95. Which Escherichia coli type is most like Shigella in its virulence plasmid and mode of
infection:
A. EHEC
B. EPEC
C. EAggEC
D. ETEC
E, EIEC
96. Which organism is most likely to be isolated from septicemic blood?
A. EAggEC
B. Shigella flexnerii
C. EIEC
D. Salmonella enteriditis
97. Which of the following species, among Enterobacteriaceae, is the most common cause
of urinary tract infection?
A. Escherichia coli
B. Salmonella typhimurium
C. Salmonella typhi
D. Shigella sonnei
98. Hemolytic uremic syndrome is a sequela to infection with which type of E. coli?
A. ETEC
B. EHEC
C. EIEC
D. EPEC
E. all of the above
99. Zoonotic infections are those that humans acquire from non-human animals. Which of
the following is most associated with zoonotic infections?
A. ETEC
B. Chlamydia trachomatis
C. Yersinia pestis
D. Shigella flexneri
100. Klebsiella pneumoniae exhibits which distinguishing virulence characteristic?
A. abscess formation
B. the presence of a capsule
C. a characteristic toxin
D. strongly invasive property
101. Generally, Enterobacteriaceae DO NOT exhibit:
A. motility
B. nitrate reductase
C. gram-negative bacilli
D. cytochrome oxidase
Page
14
E. glucose fermentation
102. Healthy adult travelers visiting Peru are cautioned against eating uncooked vegetables
and unpeeled fruits, and against drinking unbottled water. However, they are already
resistant to cholera because of:
A. a gastric barrier, due to stomach acids.
B. the gamma globulin shots they received before their trip.
C. their ability to avoid contaminated food due to its acidic smell.
D. their consumption of large prophylactic amounts of bicarbonates.
Questions 103-104: The mayor of a small Gulf Coast town called the local hospital microbiology
lab and asked for an identification of the infectious agent that was causing an outbreak of
gastroenteritis in the town. A rumor has been spreading of a cholera epidemic and everyone is
worried about its effect on the local economy, which is based on tourism.
103. The microbiologist is aware that the gastroenteritis outbreak is associated with the
consumption of raw seafood at a local restaurant. She considers it may be due to a
number of vibrios EXCEPT:
A. V. parahaemolyticus
B. V. alginolyticus
C. V. cholerae non 01
D. V. Jluvialis
104. To determine to which species the infectious agent belongs, the microbiologist performs
some tests on colonies cultured from stool samples. These tests include the following EXCEPT:
A. growth on thiosulfate-citrate-bile-sucrose (TCBS) agar
B. fermentation of sucrose
C. growth at different NaCl concentrations
D. serotyping based on somatic O antigens
105. The pathogenic mechanisms that make Helicobacter pylori the causative agent of gastritis
include the following EXCEPT:
A. urease production
B. invasive abilities
C. motility
D. microaeophilism
106. Campylobacter jejuni gastroenteritis is associated with consumption of contaminated
water or foods which include the following EXCEPT:
A. milk
B. chicken
C. clams
D. hamburger
Page
15
113. One characteristic that distinguishes the elementary body from the reticulate body cell
type of Chlamydia is that only the elementary body:
A. is infectious.
B. is capable of cell division.
C. is osmotically fragile.
D. contains ribosomes.
E. is bacterial in origin.
114. The metabolically active stage in the chlamydial life cycle is the:
A. lysosome.
B. exocytic particle.
C. elementary body.
D. cytoadsorption body.
E. reticulate body.
115. All but one statement is true of Mycobacterium tuberculosis. Which one is UNTRUE?
A. Obligate aerobe
B. Produces few, if any toxins
C. Grows rapidly compared with a staphylococcus
D. Requires an enriched media
E. DNA probes are useful in identification
116. Which one of the following is the greatest risk factor for tuberculosis?
A. middle aged adult
B. Scandinavian
C. alcoholism
D. stockbroker
E. female
117. The one most reliable procedure in the definitive diagnosis of pulmonary tuberculosis is:
A. acid-fast stain
B. PPD skin test
C. culture of sputum
D. chest x-ray
E. histology of a biopsy
118. Which one of the following statements is UNTRUE?
Droplet nuclei:
A. are the chief means of transmitting pulmonary infection with tuberculosis.
B. are usually produced by coughing or sneezing.
C. may float in air for several hours.
D. are not an important source of infection in the emergency center of city/county
hospitals.
E. become small enough to bypass the normal upper airway defenses.
Page
17
119. The most common source of infection for Mycobacterium tuberculosis in the U.S. is:
A. sputum
B. urine
C. wound
D. milk
E water
120. Which of the following is TRUE of non-tuberculous mycobacteria?
A. positive skill tests are rare.
B. person-to-person spread occurs commenly.
C. clinical illness is more common in the immunocompromised host.
D. does not grow in soil.
E. never produces pigment.
121. Those with AIDS (Acquired Immunodeficiency Syndrome) are most likely to have a
severe infection with which one of the following organisms?
A. Actinomyces israelii.
B. Mycobacterium marinum.
C. Mycobacterium avium-intracellulare.
D. Mycobacterium smegmatis.
E. Nocardia asteroides.
122. Assuming a positive skin test, who has the highest risk for illness with M tuberculosis?
A. a patient with AIDS whose roommate recently has been diagnosed with cavitary
pulmonary tuberculosis
B. males over 45
C. normal chest x-ray
D. a patient treated for 9 months with INH and Rifampin
E. a 40-year old male with a partial gastrectomy
123. Which of the following statements is UNTRUE?
The tuberculin skin test:
A. is positive at 15 mm in duration or greater.
B. may be falsely negative in severe immunocompromised.
C. may be falsely positive in those with hepatitis.
D. positive in about six weeks after becoming infected with the organism.
E. done with a purified protein derivative (PPD) of killed organisms.
124. Of the organisms listed below, which one is the MOST frequent colonizer of
endoscopes, respirators and other hospital equipment?
A. Hemophilus influenzae
B. Klebsiella pneumoniae
C. Pseudomonas aeruginosa
D. Enterobacter aerogenes
E. Streptococcus pyogenes
Page
18
TRUE OR FALSE
Choose the best possible answer. A = True; B = False
125. _____ The Gram stain is the method of choice for diagnosis of Neisseria that
is isolated from mucosal surfaces other than the conjunctiva and the male
urethra.
126. _____ Generation of variant pilin forms by Neisseria spp. naturally occurs
through intragenic recombination.
OUESTIONS 127-130: The following drugs are antifolates:
127. _____ trimethoprim.
128. _____ gentamicin
129. _____ ciprofloxacin
130. _____ aztreonam
131. _____ Antibiotic resistance is an important clinical problem in day care centers.
132. _____ Antibiotic resistance is an important clinical problem in animal feed lots. 133. _____ Bacteroides fragilis elaborates endotoxin and can cause a syndrome
nearly identical to the septic shock due to aerobic gram-negative bacilli.
134. _____ Bacteroides fragilis is commonly found in mixed anaerobic/aerobic
bacterial infections that arise from bowel flora, because Bacteroides
fragilis quantitatively accounts for the majority of Bacteroides species
found in bowel flora.
135. _____ Although Clostridium tetani are frequently seen when they infect
puncture wounds, they are difficult to identify because of variable
staining characteristics and the absence of spores seen in clinical
specimens.
QUESTION 136: A woman had an illegal abortion, developed an infection of her uterus, and
was also noted to be severely anemic and jaundiced.
136. _____ This clinical presentation could be due to infection by a Clostridium perfringens
elaborating an alpha toxin.
137. _____ Vancomycin has cidal activity against gram-positive anaerobes.
138. _____ A candle jar does NOT generate an environment to support the growth of extremely
oxygen sensitive (e.o.s.) organisms.
Page
19
139. _____ Gas noted grossly on the x-ray of an infected foot of a diabetic patient might mean
the presence of infecting Clostridium species, but more likely indicates gas produced by
facultative Enterobacteriaceae.
140. _____ Clostridium docile causes food poisoning because it produces an enterotoxin that
causes a secretory diarrhea that lasts only 24-36 hours.
141. _____ Actinomycosis can be strongly suspected based on the findings of "sulphur granules"
in a clinical specimen.
142. _____ Lymphogranuloma venereum (LGV) is caused by Chlamydia trachomatis.
143. _____ Interstitial pneumonia in neonates is caused by Chlamydia pneumonia acquired via
an infected maternal birth canal.
144. _____ Replacement of electrolytes is the hallmark of therapy for diarrhea, especially for
severe cases of cholera.
145. _____ Shigella serotyping is based on O and H antigens.
146. _____ Pseudomonas aeruginosa is commonly isolated from the respiratory secretions of
patients with cystic fibrosis.
147. _____ Antibiotic resistance is an important clinical problem in animal feed lots.
Page
20
ANSWERS:
1. C
2. C
3. B
4. C
5. C
6. D
7. B
8. A
9. D
10. B
11. D
12. C
13. B
14. D
15. A
16. D
17. A
18. B
19. A
20. C
21. B
22. D
23. A
24. E
25. A
26. C
27. D
28. B
29. B
30. C
31. E
32. D
33. C
34. E
35. B
36. A
37. A
38. A
39. B
40. A
41. A
42. B
43. B
44. A
45. B
46. B
47. A
48. A
49. A
50. A
51. B
52. C
53. A
54. B
55. A
56. B
57. B
58. C
59. D
60. A
61. B
62. E
63. D
64. E
65. D
66. D
67. B
68. D
69. C
70. B
71. C
72. A
73. A
74. B
75. B
76. C
77. B
78. B
79. C
80. B
81. D
82. B
83. D
84. D
85. A
86. B
87. C
88. B
89. C
90. C
91. B
92. B
93. D
94. B
95. E
96. D
97. A
98. B
99. C
100.
101.
102.
103.
104.
105.
106.
107.
108.
109.
110.
111.
112.
Page
21
B
D
A
B
D
B
C
D
B
A
E
E
C
113.
114.
115.
116.
117.
118.
119.
120.
121.
122.
123.
124.
125.
126.
127.
128.
129.
130.
131.
132.
133.
134.
135.
136.
137.
138.
139.
140.
141.
142.
143.
144.
145.
146.
147.
A
E
C
C
C
D
A
C
C
A
C
C
B
A
A
B
B
B
A
A
A
B
B
A
A
A
A
B
A
A
B
A
B
A
A