Final Review Flashcards
A McFarland standard of 0.5 corresponds to a bacterial count of: a. 1.5x10(6) b. 1.0x10(8) c. 1.5x10(8) d. 1.0x10(4)
c. 1.5x10(8)
The mode of action of erythromycin and azithromycin is: a. inhibition of protein synthesis b. inhibition of nucleic acid c. inhibition of cell wall d. alters the cell membrane
a. inhibition of protein synthesis
Quality control records for media and reagents should be maintained a minimum of: a. one year b. three years c. two years d. five years
c. two years
True or False: It is not necessary to perform quality control on user prepared MacConkey plates because it is exempt.
False
The spectrum of activity for aminoglycosides is: a. gram positive aerobic bacteria b. gram negative aerobic bacteria c. gram negative anaerobic bacteria d. aerobic gram positive and gram negative bacteria e. all of the above
d. aerobic gram positive and gram negative bacteria
True of False: Proficiency testing in the microbiology lab will evaluate the accuracy of personnel and procedures
True
Supplemental testing of Enterococcus spp. for detection of high level resistance to which class of antimicrobials would demonstrate if synergy with ampicillin is possible? a. glycopeptides b. fluroquinolones c. macrolides d. aminoglycosides
d. aminoglycosides
All of the following antimicrobials are usually effective against gram negative bacterial except: a. imipenem b. levofloxacin c. vancomycin d. gentamicin
c. vancomycin
Specimens for bacterial culture were submitted from a burn patient. The culture grew a non lactose fermenting gram negative rod identified as P. aeruginosa. Disk diffusion testing was performed with the following results. Ampicillin=16mm Cefazolin=16mm Levofloxacin=23mm Ticarcillin/Clavulanic Acid=18mm Use these CLSI interpretations to determine which category is indicated. LVX is _____ AM is _____ CZ is _____ TIM is _____
LVX - Susceptible AM - Resistant CZ - Intermediate TIM - Intermediate
Growth of Enterococcus faecalis on a vancomyin agar screen plate would indicate that the organism is a. susceptible to vancomycin b. A beta-lactamase producer c. resistant to vancomycin d. resistant to all beta-lactamase
c. resistant to vancomycin
A reference lab has performed a rare manual macrodilution MIC test. Based on the growth in these tubes, what is the MIC value of the antimicrobial? a. 8.0 mcg/ml c. 16.0 mcg/ml d. 8.0 mcg/ml e. 4.0 mcg/ml
d. 8.0 mcg/ml
In order to determine the MBC in the previous question you would: a. Subculture tubes 8.0-256 b. Subculture tubes 0.5-4.0 c. Subculture all tubes d. Interpret the MBC as 8.0 mcg/ml e. Interpret the MBC as 16.0 mcg/ml
a. Subculture tubes 8.0-256
An isolate of E. coli was found to be ESBL positive, as a result it should be reported as resistant to: a. aminoglycosides b. vancomycin c. levofloxacin d. cephalosporins
d. cephalosporins
The use of ATCC reference organisms when performing quality control on established procedures will confirm the following: a. exempt and non exempt b. validity and reliability c. preliminary vs. final results d. proper collection and transport
b. validity and reliability
This test uses the patient’s own serum and can be used to monitor antimicrobic therapy as well as the effects of antibodies and complement. a. disk diffusion b. SBC (SBT) c. MIC (MBC) d. beta-lactamase
b. SBC (SBT)
Providing detailed instruction to nurses for proper specimen collection will effect this area of quality assessment: a. postanalytical b. analytical c. continuous daily monitoring d. preanalytical e. proanalytical
d. preanalytical
True or False: A large disk diffusion zone size will correspond to a low MIC value
True
The action of this antimicrobial in the class of Fluoroquinolones is generally bacteriocidal: a. levofloxacin b. vancomycin c. cephazolin d. erythromycin
a. levofloxacin
When performing routine AST quality control, after the initial 20 day testing period, all labs are required to test their systems: a. daily b. monthly c. weekly d. only when new lot numbers are received
c. weekly
Reference bacterial organisms are available through which of the following sources? a. CLIA b. ATCC c. CLSI d. TQM
b. ATCC
Antimicrobial resistance resulting from the normal genetic, structural, or physiologic state of a microorganism is defined as: a. antagonistic b. bacteriocidal c. acquired d. intrinsic
d. intrinsic
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Which of the following will define test performance, reagent preparation, quality control and results reporting as well as display signature by the microbiology supervisor? a. patient reports b. Q-Probes c. Benchmarks d. standard operating procedure manual
d. standard operating procedure manual
Which bacterial combinations represent the most appropriate quality control organisms when testing a new lot number of catalase test reagent. a. Strep agalactiae and Strep pyogenes b. Staph aureus and Strep pyogenes c. Staph aureus and Staph saprophyticus d. Staph aureus and Staph epi
b. Staph aureus and Strep pyogenes
The testing method demonstrated here will confirm an organism’s resistance to: a. pencillins b. carbapenams c. glycopeptides d. aminogylcosides
b. carbapenams
The MIC value of Oxacillin (OX) when read from this microdilution plate is: a. >4.0 mcg/ml b. 4.0 mcg/ml c. 2.0 mcg/ml d. .5 mcg/ml
a. >4.0 mcg/ml
Which of the following is not an example of intrinsic antibiotic resistance? a. klebsiella va. ampicillin b. staph vs. oxacillin c. E. coli vs. vancomycin d. Pseudomonas vs. trimethorprim and sulfonamides
b. staph vs. oxacillin
True or False: A Mueller Hinton Agar with a depth of 3.5mm will result in zone sizes that are falsely resistant.
False
In recording the results of a microdilution tray, you notice a slight haze is present in all the trimethoprim-sulfa wells. You would record the result as: a. resistant b. susceptible c. intermediate d. invalid
b. susceptible
What is the interpretation for Ampicillin (AM) based on following MIC interpretive standards: >=1.0 mcg/ml: susceptible 2-4 mcg/ml: intermediate >=8 mcg/ml: resistant a. susceptible b. intermediate c. resistant d. unable to interpret
a. susceptible
Preanalytical instructions to patient providers in clinics should indicate that which specimen may be refrigerated? a. sputum b. urine c. CSF d. urogenital swab
b. urine
When performing disk diffusion QC, only one disk out of twelve is out of range. What is the most likely explanation? a. inoculum is too light b. bad disk c. inoculum is too heavy d. mixed culture
b. bad disk
True or False: Panic values should be called immediately to the first available health care worker.
False
True or False: Quality assurance is associated with those external activities that ensure positive patient outcomes
True
Microbiology turnaround time can be defined as the elapsed time between: a. specimen receipt in the lab and reporting of final results b. specimen collection and reporting of final results c. specimen collection and reporting of preliminary gram stain results d. specimen receipt in the lab and initial culture set up
a. specimen receipt in the lab and reporting of final results
3 appropriate organisms to use when performing QC on a new lot of API 20E test systems would be: a. Enterococcus sp., E. coli and Staphylococcus sp b. Klebsiella sp., Haemophilus sp. and Enterococcus sp c. Pseudomonas sp., E. coli, and Neisseria spp d. E. coli, Klebsiella pneumoniae, Proteus mirabilis
d. E. coli, Klebsiella, Proteus mirabilis
True or False: Daily review by the microbiology supervisor of AST results that have been reported is an analytic function
False
True or False: An isolate of Staph aureus is determined to be resistant to Linezolid by MIC method. This antimicrobial (Linezolid) is the most appropriate for treatment.
False
Disk diffusion testing was performed on an isolate of P. aeruginosa from a urine culture. Numerous colonies were observed within the zone of this antimicrobial. What is the most probable cause? a. media was too thick b. media was too thin c. inoculum too heavy d. resistant mutants
d. resistant mutants
Most antimicrobials are cleared by which organ? a. kidney b. pancreas c. lymphatics d. liver
d. liver
True or False: Commercially prepared media are always exempt from quality control testing.
False
Penicillin susceptibility in isolates of Streptococcus pneumoniae can be determined using the following disk diffusion: a. penicillin b. methicilin c. oxacillin d. ampicillin
c. oxacillin
Which of these criteria is not used by the laboratory in determining if antimicrobial susceptibility testing will be performed: a. drugs of choice b. clinical significance c. status of patient’s immune system d. reliable standardized methods for testing
c. status of the patient’s immune system
Quality control for AST disk diffusion was performed and it was noted that numerous zone sizes were too small. The test was repeated with a new lot number of mueller hinton agar and all zone sizes were within an acceptable range. Which is the best explanation for the unacceptable zones? a. media was too thick b. media was too thin c. inoculum too light d. resistant mutants
a. media was too thick
Resistance of Staphylococus to methicillin, penicillin and other beta lactams may be detected by testing with this predictor drug: a. methicillin b. cefazolin c. oxacillin d. vancomycin
c. oxacillin
Protein synthesis is the principal mode of action of which of these antimicrobial pairs. a. erythromycin and ampicillin b. gentamycin and vancomycin c. gentamycin and erythromycin d. vancomycin and levofloxacin
c. gentamycin and erythromycin
Direct beta-lactamase testing may be performed by using a/an: a. cephalosporin (cefinase) disk b. oxacillin c. etest d. disk diffusion
c. etest
The zone of inhibition of disk A, is most likely to correspond to which of the following MIC results. a. 64mcg/ml b. 2.0 mcg/ml c. 1.0 mcg/ml d. <0.5 mcg/ml
a. 64 mcg/ml
Indicate only the criteria that are a part of the CLSI guidelines for AST. (This is an all or nothing question) a. length of incubation for testing b. medium type c. number of antimicrobials to be reported d. McFarland Standard (inoculum) e. age range of patient with infection f. concentration of antimicrobial begin tested
a. length of incubation for testing b. medium type d. McFarland Standard (inoculum) f. concentration of antimicrobial being tested
When the activity of a combination of antimicrobials is substantially greater than the activity of the single most active one. The effect is: a. antagonistic b. synergistic c. bacteriostatic d. indifferent
b. synergistic
Extended spectrum beta lactamase (ESBL) testing will be useful as a part of the AST of: a. enterobacteriaceae b. Streptococcus spp. c. Staphylococcus spp. d. Enterococcus spp.
a. Enterobacteriaceae
The ‘D’ test will test for the resistance of which antimicrobial among S. aureus isolates. a. vancomycin b. clindamycin c. oxacillin d. linezolid
b. clindamycin
Ampicillin treatment will acheive adequate levels in: a. blood b. urine c. CSF d. A and B e. A and C f. A, B, and C
f. A, B, and C
The microorganism responsible for Rocky Mountain Spotted Fever is: a. chlamydia trachomatis b. coccidiodes immitis c. histoplasma capsulatum d. rickettsia rickettsii
d. rickettsia rickettsii
True or False: Molds produce fluffy, cottony, wooly or powdery colonies on media and can be identified by the morphology of conidia and their arrangement on their hyphae.
True
This organism is the etiological (causative) agent of the most common STD in the United States: a. chlamydia trachomatis b. cryptococcus neoformans c. treponema pallidum d. candida albicans e. histoplasma capsulatum
a. chlamydia trachomatis
This extracellular, infective form that resembles a gram negative bacillus is part of the life cycle of Chlamydia trachomatis. a. host cell b. elementary body c. blastoconidia d. conidia
b. elementary body
The budding cells of candida albicans, consisting of a mother and daughter cell, may be described as: a. pseudohyphae b. hyphae c. elementary bodies d. blastoconidia
d. blastoconidia
The etiological agent of lyme disease is: a. rickettsia rickettsii b. chlamydia trachomatis c. treponema pallidum d. borrelia burgdorferi e. coccidiodes immitis
d. borrelia burgdorferi
This fungal organism is implicated in a clip of a case study on blackboard last week from monsters inside me. It causes valley fever. a. Rhizopus sp. b. Candida albicans c. Aspergillus fumigatus d. Microsporum canis e. Histoplasma capsulatum f. Coccidiodes immitis
f. Coccidiodes immitis
A request was submitted for the direct examination of skin tissue for the presence of fungi. Which is the best staining method to utilize? a. gram stain b. calcofluor white c. India ink d. darkfield e. lactophenol blue
b. calcofluor white
True or False: Room temperatures greater than 85 degrees F will increase the reactivity of RPR results
True
This organism can be described as: a. zygomycete b. dimorphic c. dermatophyte d. yeast
a. zygomycete
Yeast produce asexually by the production of these structures. a. arthroconidia b. blastoconidia c. pseudohyphae d. chlamydoconidia
b. blastoconidia
Bird (Niger) seed agar is useful in the identification of which of the following? a. C. neoformans b. C. albicans c. C. immitis d. S. schenckii
a. C. neoformans
Treponemes may be detected in material from skin lesions using this staining method. a. gram stain b. calcofluor white c. india ink d. darkfield
d. darkfield
The media that would not be used for the primary recovery of fungi is: a. SABHI agar b. dermatophyte test medium c. cornmeal agar d. brain-heart infusion agar
c. cornmeal agar
True or False: Candida sp., other than albicans, will not have germ tubes but may have pseudohyphae, with constrictions between the parent cell and the pseudohyphal projections
True
Chronic localized fungal infections that result from traumatic implantation are described as: a. subcutaneous b. systemic c. opportunistic d. cutaneous
a. subcutaneous
These colonies were observed on SABHI media at 25 and 35 degrees C. The ID is most likely: a. Histoplasma capsulatum b. Candida albicans c. Aspergillus fumigatus d. Microsporum canis
b. Candida albicans
This organism is implicated in allergic reactions. Rarely causes human infections. a. H. capsulatum b. Penicillium sp. c. Rhizopus sp. d. M. canis
b. Penicillium sp.
True or False: An organism that appears as yeast at 25C and as a mould at 25C can be described as dimorphic.
False
All of the following are necessary for mold identification except: a. Microscopic morphology b. API 20C Aux c. Macroscopic/colony morphology d. growth rate
b. API 20C Aux
The formation of these germ tubes indicates the organism is: a. C. neoformans b. C. tropicalis c. C. immitis d. C. albicans
d. C. albicans
A good selective, primary media to recover Microsporum canis from a scalp sample would be: a. bird seed agar b. Sab dex - SABHI c. Dermatophyte test media d. Cornmeal
c. Dermatophyte test media
A colony from a positive blood culture had the following gram stain. A germ tube was performed and was positive after 5 hours. The germ tube results should be reported as: a. unable to interpret, repeat b. negative - not likely C. albicans c. positive - likely C. albicans
a. unable to interpret, repeat
Infections with Candida albicans are generally considered: a. systemic b. subcutaneous c. superficial d. opportunistic
d. opportunistic
Which of these is not a feasible diagnostic test to diagnose Rocky Mountain Spotted Fever. a. Serology b. PCR c. Immunohistology d. Culture
d. Culture
Which of the following is a dimorphic fungi? a. H. capsulatum b. C. albicans c. C. neoormans d. A. fumigatus e. M. canis
a. H. capsulatum
All of the following are associated with Chlamydia trachomatis infection except: a. meningitis b. pelvic inflammatory disease c. ocular trachoma d. Lymphogranuloma venereum (LGV)
a. Meningitis
True or False: A patient was diagnosed with syphillis based on a positive FTA-ABS test. After successful treatment the FTA-ABS results will return to negative.
False
The method of choice to diagnose Cryptococcal meningitis in US hospitals is: a. calcafluor stain b. india ink stain c. germ tube production d. capsular antigen detection
d. capsular antigen detection
Laboratory workers should always work under a biological safety hood when working with cultures of: a. C. albicans b. C. immitis c. C. neoformans d. Candida species (other than albicans)
b. C. immitis
Based on colony morphology, this organism can be described as: a. Hyaline b. Yeast-like c. Dematiaceous d. Bacterial
c. Dematiaceous
A reactive RPR confirms the presence of this in the serum: a. Treponemal antibody b. Syphillis antigen c. Hemagglutinins d. Reaginic antibody
d. Reaginic antibody
The appropriate specimen to collect for recovery of this organism is: a. Feces b. Skin scrapings c. Blood d. Urine
b. Skin scrapings
The required culture media for Mycoplasma pneumonie is: a. brain heart infusion b. sheep blood agar c. biphasic SP-4 d. SABHI
c. biphasic SP-4
The rounded structures attached to the ends of the pseudohyphae were seen on cornmeal agar of a culture of candida albicans. They are: a. chlamydoconidia b. hyphae c. germ tubes d. conidiophores
a. chlamydoconidia
This organism is implicated in severe infections of nasal mucosa, face, sinus and brain. a. Aspergillus b. Penicillium sp. c. Coccidiodes sp. d. Rhizopus sp.
d. Rhizopus sp.
Chlamydia trachomatis is suspected in a male being seen in the ER. A urine specimen is collected. Which is the most appropriate test to order? a. Chlamydia culture b. Serology (IgM) c. Nucleic Acid Amplification (PCR/AMPA) d. Fluorescent antibody (DFA)
c. Nucleic Acid Amplification (PCR/AMPA)
All of these organism are associated with infection by inhalation, except: a. Coccidiodes immitis b. Aspergillus fumigatus c. Candida albicans d. Histoplasma capsulatum
c. Candida albicans
These microscopic structures are best demonstrated using this media: a. inhibitory mold agar b. bird seed agar c. cornmeal agar d. dermatophyte test media
c. cornmeal agar
This colony has been isolated from a skin culture. Microscopic features can best be seen by performing. a. germ tube test b. india ink preparation c. darkfield exam d. lactophenol cotton blue wet mount
d. lactophenol cotton blue wet mount
True or False: Mycoplasmas differ from other bacteria because they have no cell wall.
True
What is the organism or appropriate reservoir or vector responsible for transmission to humans. Microsporum canis
dogs and cats
What is the organism or appropriate reservoir or vector responsible for transmission to humans. Cryptococcus neoformans
pigeons and other birds
What is the organism or appropriate reservoir or vector responsible for transmission to humans. Borrelia burgdorferi
ticks
What is the organism or appropriate reservoir or vector responsible for transmission to humans. Treponema pallidum
Humans
What is the organism or appropriate reservoir or vector responsible for transmission to humans. Coccidiodes immitis
vegetation (living or dead) soil
What is the organism or appropriate reservoir or vector responsible for transmission to humans. Rickettsia rickettsii
Ticks
What is the organism or appropriate reservoir or vector responsible for transmission to humans. Histoplasma capsulatum
bats and/or birds
A sputum specimen was collected from a patient undergoing treatment for leukemia, necrotizing infiltrates are observed on chest x-rays. Bacterial and fungal cultures are ordered. Dark green fuzzy colonies were observed on sab-dex (SABHI) agar and Czapek-Dox agar within 7 days. The lactophenol stain shown below reveals hyaline septate hyphae with distinct conidial heads and flask shaped vesicles arranged on upper 2/3 of vesicle. Numerous microconidia are seen. This causative organism is most likely _____. a. Rhizopus sp. b. candida albicans c. aspergillus fumigatus d. microsporum canis e. histoplasma capsulatum f. coccidiodes immitis
c. aspergillus fumigatus
A patient is admitted to the hospital with fever and a very stiff neck. He is in treatment for complications of AIDS. A CSF culture is taken and growth of smooth, mucoid, white colonies are observed in 2 days. Gram stain - budding yeast cells, no pseudohyphae germ tube - negative urease - positive bird seed agar - brown colonies What is the most likely etiological agent? What CSF test should be ordered?
Cryptococcus neoformans Cryptococcal antigen
A 29 year old male is being seen by his family physician with complaints of fever, malaise and loss of appetite. He also informs him of a painless ulcer on his genitalia that has since healed. The following lab results are obtained: Fungus culture - negative serology for lyme disease - negative DNA probe (nucleic acid) for Chlamydia antigen - pending RPR - positive 1:8 titer FTA-ABS - positive The patient’s symptoms are most likely the result of infection with:
Treponema pallidum
A mother of 2, in her 2nd trimester of pregnancy is being seen by her doctor for a respiratory ailment that has led to symptoms of dissemenated infection. X-rays of her lungs revealed obvious tissue damage. A detailed history revealed she had spent 2 weeks with her sister in Arizona. Cultures, serology, and nucleic acid tests were ordered: Routine Bacterial Culture - normal respiratory flora mycology cultures - fluffy white mold in 4 days DNA probe result - pending Performance of a lactophenol blue stain of the mold (in the BSC) revealed the following structures: barrel shapped alternate arthroconidia separated by disjunctor cells. What is the presumptive ID?
Coccidiodes immitis
This organism produces a chronic granulomatous infection that begins in the lung and eventually invades the reticuloendothelial system. It must be handled with extreme caution. The microscopic preparation indicates the organism is:
Histoplasma capsulatum
Identify the elements that are part of the life cycle of Chlamydia trachomatis. Indicate only the elements that are included. a. elementary body b. lysis c. flagella d. persistent body e. multiplication f. insertion disks g. spores
a. elementary body b. lysis d. persistent body e. multiplication
The Weil Felix test is a presumptive test for diagnosis of: a. Histoplasmosis b. Rocky Mountain Spotted Fever c. Syphillis d. Cryptococcal meningitis e. Zygomycosis
b. Rocky Mountain Spotted Fever
Three examples of antifungal agents are: a. ampicillin, tetracycline and fluconazole b. Itraconazole, trimetroprim-sulfa, and penicillin c. ketaconazole, fluconazole and ciprofloxacin d. fluconazole, amphotericin b and ketoconazole
d. fluconazole, amphotericin B and ketoconazole
An outbreak of diarrhea was linked to visitors of a community swimming pool. Red oocysts were seen on modified acid fast stains from several of the stool specimens collected. The likely etiological agent is: a. Plasmodium malariae b. entamoeba histolytica c. cryptosporidium parvum d. Taenia solium
c. cryptosporidium parvum
Identify this organism found on a trichrome smear of a PVA preserved stool specimen from a patient with chronic diarrhea. a. E. vermicularis ova b. Cryptosporidum oocyst c. E. histolytica trophozoite d. E. histolytica cyst
d. E. histolytica cyst
The vector responsible for the spread of this organism is the: a. tick b. reduvid (triatomid) bug c. Mosquito d. Black fly
b. reduvid bug
True or False: Herpes Simplex 1 is primarily associated with genital lesions
False
This organism is a major cause of amoebic dysentary worldwide: a. E. coli b. E. histolytica c. G. lamblia d. Cryptosporidium parvum
b. E. histolytica
The proper specimen to collect when Plasmodium infection is suspected is: a. peripheral blood b. feces c. urine d. sputum
a. peripheral blood
The vector responsible for the spread of malaria is the: a. Tsetse fly b. Reduvid bug c. Mosquito d. Black fly
c. Mosquito
Avian strains of this virus in domestic and wild birds have led to worldwide pandemics: a. rotavirus b. cytomegalovirus c. mycobacterium avium complex d. influenza virus e. herpes simplex virus
d. influenza virus
Select the distinguishing feature of the trophozoite stage of entamoeba histolytica a. large karysome b. presence of red blood cells c. greater than 4 nuclei d. flagella
b. presence of red blood cells
Enterobius vermicularis is most likely to be recovered from this type specimen: a. peripheral blood b. perineal scotch tape prep c. urine d. feces e. skin lesion
b. perineal scotch tape prep
True or False: Nocardia asteroides infection can be acquired by inhalation
True
This organism is the causative agent of shingles. a. cytomegalovirus b. varicella zoster virus c. herpes simplex virus d. respiratory synctial virus
b. varicella zoster virus
This method of identification is rapid and provides the most accurate speciation of mycobacterium. a. growth on Lowenstein Jensen agar b. growth on middlebrook agar c. kinyoun stain d. DNA (molecular) ID e. runyon grouping f. MGIT
d. DNA (molecular) ID
Which of these is not a step in viral replication? a. maturation b. release c. penetration d. reactivation e. assembly
d. reactivation
True or False: Varicella zoster infection may be diagnosed by collection of respiratory or cutaneous samples.
True
True or False: Vaccination is effective in the prevention Varicella Zoster viral infections
True
Which organism is not a protozoa? a. cryptosporidium parvum b. trichuris trichuria c. giardia lamblia d. entamoeba histolytica
b. trichuris trichuria
Characteristic symptoms of infection with this organism involve perianal, perineal andvaginal itching and irritation. a. taenia species b. cryptosporidium parvum c. giardia lamblia d. enterobius vermicularis e. trypanosoma cruzi
d. enterobius vermicularis
The staining procedure used in the preparation is: a. kinyoun b. modified acid fast c. giemsa d. trichrome
d. trichrome
Which stage of this protozoa is represented in this image? a. cyst b. ova c. trophozoite d. oocyst e. larval
c. trophozoite
Infection with this organism occurs by ingesting embryonated eggs in soil. a. enterobius vermicularis b. trypanasoma cruzi c. giardia lamblia d. trichuris trichuria e. ascaris lumbricoides
d. trichuris trichuria
A patient collected a stool specimen for ova and parasites at home in a sterile cup. It is delivered to the lab the next day. Is it appropriate for testing? a. Yes, if it is refrigerated b. Yes, if it is kept at room temperature c. No, it is not appropriate
c. No, it is not appropriate
Viral transport media is most appropriate for the transport of numerous specimens for viral culture, except: a. respiratory secretions b. tissues c. stool d. peripheral blood
d. peripheral blood
This virus is a protypical latent DNA virus with a lifelong integration of viral DNA into human host cells. Infection produces oral and ocular lesions. a. respiratory synctial virus b. cytomegalovirus c. herpes simplex virus d. influenza virus e. rabies virus
c. herpes simplex virus
Which of these parasites is a cestode? a. taenia solium b. enterobius vermicularis c. trichuris trichuria d. cryptosporidium parvum
a. taenia solium
True or False: Viral specimens in transport media may be held in the regrigerator for up to 5 days.
True
Infection with this organism is associated with newborns infected in utero as well as immunocomprised patients. a. respiratory syncytial virus b. cytomegalovirus c. mycobacterium avium complex d. influenza virus e. herpes simplex virus
b. cytomegalovirus
A common etiologic agent of bronchiolitis and pneumonia in infants and children is: a. mycobacterium avium complex b. respiratory syncytial virus c. varicella zoster virus d. cytomegalovirus e. plasmodium malariae
b. respiratory syncytial virus
This image of a gram stain (A) and modified acid fast stain (B) of a sputum specimen indicate infection with: a. influenza A b. E. coli c. Cryptosporidium parvum d. Nocardia asteroides e. mycobacterium avium complex
d. Nocardia asteroides
The most appropriate specimen to collect when CMV is suspected is: a. nasopharyngeal secretions b. stool c. CSF d. urine e. blood
e. blood
Identification of trypanasoma cruzi is possible with this specimen: a. feces b. peripheral blood c. urine d. CSF
b. peripheral blood
Which staining procedure is commonly used to identify the pictured organism: a. kinyoun b. modified acid fast c. giemsa d. trichrome
b. modified acid fast
Indicate whether the viruses are RNA or DNA viruses: Cytomegalovirus
DNA
Indicate whether the viruses are RNA or DNA viruses: Influenza virus
RNA
Indicate whether the viruses are RNA or DNA viruses: Herpes Simplex Virus
DNA
Indicate whether the viruses are RNA or DNA viruses: Respiratory Syncytial Virus
RNA
Infection with this organism is usually associated with ingestion of infected water, food or soil. a. giardia lamblia b. cryptosporidium parvum c. ascaris lumbricoides d. hookworm e. diphylobothrium latum
c. ascaris lumbricoides
The organism used to manufacture the BCG vaccine is: a. mycobacterium bovis b. mycobacterium avium complex c. mycobacterium tuberculosis d. mycobacterium africanum e. mycobacterium gordonae
a. mycobacterium bovis
Viral transport media containing penicillin, gentamycin and amphotericin is used to collect and transport specimens for viral culture because this medium: a. enables rapid viral growth during the transport time b. inhibits bacterial and fungal growth c. destroys non pathogenic viruses d. inhibits complement fixing antibodies
b. inhibits bacterial and fungal growth
True or False: Lowenstein-Jensen is an egg based medium for the transport of viral cultures.
False
Which microscope/staining method is best when Cestodes are suspected? a. trichrome b. modified acid fast stain c. iodine wet mount d. giemsa stain
c. iodine wet mount
A 5 year old girl recently emigrated from Asia with bloody diarrhea and abdominal pain is seen by a pediatrician. She has lost 3 lbs. Further exam reveals anemia and a prolasped rectum. A stool culture and ova and parasite screen are ordered. The iodine wet mount of a concentrated stool specimen shows a light brown staining oval organism (ova) with two terminal polar plugs. What is the causative organism? a. giardia lamblia b. entamoeba histolytica c. trichuris trichuria d. plasmodium malariae
c. trichuris trichuria
A 12 year old child from a rural community is presented to the ER with gastrointestinal distress. A mild eosinophilia is noted on the CBC as well as a slight increase in liver enzymes. A stool culture and screen for ova and parasites was ordered. The stool culture is negative for any pathogens. The trichrome stain shows numerous spherical organisms (cysts) 12-15 microns. They contain 1-4 nuclei with a central karysome and evenly distributed peripheral chromatin. Elongated chromatoidal bodies with blunt ends are noted. Which organism is responsible for this illness? a. giardia lamblia b. entamoeba histolytica c. trichuirs trichuria d. mycobacterium avium complex
b. entamoeba histolytica
A 60 year old man presents to the ER with fever and persistant cough. An exam and history reveals that he is homeless and has had a productive cough with bloody sputum for 3 weeks. The patient is put in isolation and lab tests are ordered. Results are: PPD - positive viral cultures - pending routine bacterial culture - normal respiratory flora mycobacterial kinyoun stain -red bacilli mycobacterial culture - pending Which organism is most likely causing this illness. a. mycobacteium avium complex b. mycobacterium tuberculosis c. cryptosporidium parvum d. enterobius vermicularis
b. mycobacterium tuberculosis
A 6 year old is seen by her physician with complaints of stomach cramps and diarrhea. A history indicates that she lives in a rural area and has recently been on a trip with her family to water country. An ova and parasite exam revealed the following: trichrome smear - negative concentrated stool - negative modified acid fast stain - red spherical bodies (oocysts) What is causing her illness? a. cryptosporidum parvum b. enterobius vermicularis c. taenia species ova d. rotavirus
a. cryptosporidum parvum
A 46 year old man is seen by a physician after a 2 week illness. He complains of stomach cramps, weight loss and loss of appetite. A history of his diet and habits reveals he is a lover of sushi and frequents sushi bars in the city. A stool culture is negative. O&P exam reveals a recovery of numerous proglottids and the following ova. His infections is caused by: a. giardia lamblia b. entamoeba histolytica c. d. latum d. plasmodium malariae
c. d. latum
Mycobacterium which are scotochromogens: a. form pigment only in the presence of light b. form pigment with or without light c. grow rapidly in the presence of light d. form no pigment with or without light
b. form pigment with or without light
All of the following are characteristic of rapidly growing NTM, except a. cause skin and soft tissue infections b. may grow at 25 degrees C c. growth appears on solid media after 7 days d. may be acquired from environmental sources
c. growth appears on solid media after 7 days
Infection with this nonphotochromogen is associated with natural water sources and primarily infects AIDS patients and those with other immunocompromising conditions. a. mycobacterium avium complex b. mycobacterium tuberculosis c. enterobius vermicularis d. herpes simplex virus e. influenza virus
a. mycobacterium avium complex
This direct AFB smear of a sputum indicates a possible infection with which organism? a. M. avium complex b. Plasmodium malariae c. cryptosporidium parvum d. cytomegalovirus
a. M. avium complex
A systemic viral infection in a transplant patient is most likely: a. respiratory syncytial virus b. cytomegalovirus c. M. avium complex d. influenza virus
b. cytomegalovirus
The specimen processing step for sputum which releases mycobacteria from mucin and cells is: a. decontamination b. staining c. liquefication d. concentration
c. liquefication
Mycobacterium tuberculosis is spread by: a. sexual transmission b. mosquitoes c. coughs and sneezes d. blood transfusion
c. coughs and sneezes
True or False: A photochromogen will not show pigment with or without light.
False
True or False: Specimens suspected of containing M. tuberculosis should be handled in biosafety level 2 or 3 cabinet.
True
Identify this “fluke” found in Africa and America. It is associated with water sources and may cause swimmer’s itch. Diagnosis is made from eggs in the feces. a. taenia saginata b. hookworm c. schistosoma mansoni d. ascaris lumbricoides
c. schistosoma
Identify this agent of cystercercosis: a. giardia lamblia b. entamoeba histolytica c. trichuris trichuria d. taenia species
d. taenia species
Infection with this organism is transmitted by the deer fly and may migrate from the skin to the conjunctiva and the bridge of the nose. a. trypanasoma cruzi b. Loa Loa c. Wuchereria bancrofti d. schistosoma
b. Loa Loa
Infection with this organism is usually associated with contact with infected water and sewage. a. roundworm b. pinworm c. whipworm d. hookworm
d. hookworm
A patient presents to the ER with acute bronchitis. The best specimen to collect is: a. sputum b. nasopharyngeal swab c. throat swab d. blood
a. sputum
A urine specimen in a sterile cup is received in the lab for culture, if processing is delayed the best storage place is: a. refrigerator b. 35 degree C incubator c. room temperature in the micro lab d. freezer
a. refrigerator
Potential bioterrorism organisms and toxins are considered to be: a. sentinel organisms b. non-pathogenic c. select agents d. nosocomial
c. select agents
True or False: Use of monoclonal antibodies increases the specificity of immunoassays.
True
Large amounts of epithelial cells, many of which are covered by tiny gram variable rods and coccobacilli, and the absence of inflammatory cells in vaginal discharge is a sign of: a. pelvic inflammatory disease b. bartholinitis c. cervicitis d. bacterial vaginosis
d. bacterial vaginosis
The total number of bottles usually collected in each febrile episode is: a. 12 b. 4 c. 8 d. 2
b. 4
A urinalysis performed at Patient First revealed the presence of leukocyte esterase and nitrite, the urine culture is most likely to grow: a. no organisms b. candida albicans c. pseudomonas aeruginosa d. E. coli
d. E. coli
In the PCR procedure, this step releases the nucleic acid from the target organism or the clinical specimen that contains the target organism. a. thermal cycling b. hybridization c. extraction d. sequencing
c. extraction
The principle methodology of the Bact/alert blood culture system involves: a. detection of the organism’s growth rate b. measuring the CO2 content by fluorescence c. detection of changes in temperature d. measuring the CO2 content by colorimeter
d. measuring the CO2 content by colorimeter
The gram stain of a good quality sputum specimen for bacterial culture should contain: a. 10 epi cells/lpf c. >10 WBC/lpf d. <10 epi cells/hpf
a. <10 epi cells/lpf
If a .001 ml calibrated loop is used to culture a urine, each colony on the blood plate will equal: a. 1 organism/ml (cfu/ml) b. 10 organisms/ml (cfu/ml) c. 100 organisms/ml (cfu/ml) d. 1000 organisms/ml (cfu/ml)
d. 1000 organisms/ml (cfu/ml)
In the MALDI-TOF technique identification profiles are a result of detecting ____ in a flight tube and creating a protein spectrum. a. ions b. lasers c. colonies d. DNA
a. ions
Infection of the bladder is known as: a. urethritis b. cystitis c. acute urethral syndrome d. pyelonephritis
b. cystitis
Rapid latex testing for C. neoformans in CSF will detect: a. intracellular yeast cells b. cryptococcal DNA c. polysaccharide capsular antigens d. fungal enzymes
c. polysaccharide capsular antigens
The main role of a sentinel (level A) lab is: a. rule out and refer suspicious organisms b. rule out or confirm the identity of critical organisms c. analyze suspicious environmental samples d. archive and perform sophisticated molecular tests
a. rule out and refer suspicious organisms
Monoclonal and/or poly clonal antibodies are used in all of the following methodologies except: a. latex agglutination b. direct immunofluorescent assay c. polymerase chain reaction d. enzyme immunoassay
c. polymerase chain reaction
Which methodology uses RBC, hemolysis, may take up to 48 hours to complete and is usually done in reference labs? a. western blot b. ELISA c. latex agglutination d. complement fixation
d. complement fixation
True or False: Signs of bacteremia may include fever, chills, hyperventilation, skin lesions, DIC and shock.
False
Proper storage of CSF for routine bacterial culture includes: a. refrigeration for up to 23 hours b. freezing at -70C c. incubation (35C) d. freezing at temperatures above 70C e. all of the above are correct
c. incubation (35C)
A blood culture has flagged positive in the Bactec instrument. After removal of the bottle the next step should be: a. notify the physician that the patient has a positive blood culture b. plate the bottle to solid media and incubate for 24 hours c. observe the bottle for hemolysis d. perform and read the gram stain
d. perform and read the gram stain
A patient with an undrained hepatic abscess has grown E. coli from a set of blood cultures, this is likely to be: a. transient bacteremia b. intermittent bacteremia c. continuous bacteremia d. contamination
b. intermittent bacteremia
The methodology shown here for the detection of RSV or group A streptococcus is a. latex agglutination b. membrane based ELISA c. western blot d. immunofluorescent assay
b. membrane based ELISA
The transport medium that best preserves the viability of the most intestinal bacterial pathogens is: a. buffered glycerol b. a rectal culture swab c. Cary-Blair d. campy-thioglycollate broth
c. Cary-Blair
Detecting specific antibodies by electrophoretic separation (see image) to confirm the diagnosis of HIV can be done by: a. Western blot b. ELISA c. latex agglutination d. complement fixation e. immunofluorescent assay
a. Western blot
Thoracentesis is a procedure which will result in the collection of: a. induced sputum b. bladder urine c. bronchial washing d. transtracheal sputum e. pleural fluid f. peripheral blood
e. pleural fluid
The best anticoagulant for blood cultures is: a. sodium citrate b. sodium polyanethol sulfonate c. heparin d. EDTA
b. sodium polyanethol sulfonate
This is the most effective infection control procedure: a. standard precautions b. using PPE c. hand washing d. bagging used linen
c. hand washing
A .001 ml calibrated loop was used to plate this urine to a blood agar plate. What is the best estimate of the colony count? a. 100,000 org/ml
d. >100,000 org/ml
The toxin produced by V. cholera that results in an outpouring of electrolytes and fluid into the intestinal lumen is a/an a. cytotoxin b. neurotoxin c. invasive toxin d. enterotoxin
d. enterotoxin
Which of these infections is least likely to be nosocomial? a. post surgical wound with E. coli b. blood culture with MRSA c. streptococcal meningitis d. candida albicans in the urinary tract
c. streptococcal meningitis
True or False: Enterohemorrhagic E. coli infections can be diagnosed by the detection of the Shiga-toxin
True
XLD agar serves which purpose when used in the bacterial fecal culture? a. evaluation of general flora and predominant species b. selection of enteric pathogens such as salmonella, aeromonas, and others c. inhibition of normal flora and selection for enteric pathogens d. enrichment for enteric pathogens such as salmonella and others
c. inhibition of normal flora and selection for enteric pathogens
Which method involves a staining technique with an endpoint that will be observed as a bright apple green when utilizing specialized microscopy? a. latex agglutination b. immunofluorescent assay c. polymerase chain reaction d. enzyme immunoassay
b. immunofluorrescent assay
In the PCR assay, the nucleic acid strand from the known organism is the: a. amplicon b. probe c. hybrid d. extractor
b. probe
True or False: Lower respiratory specimens are not appropriate specimens for anaerobic culture.
False
True or False: An infection control measure for a patient on contact precautions would include a monitored negative pressure room.
False
The most common nosocomial or hospital acquired infections are: a. urinary tract b. pneumonia c. surgical site d. bloodstream
a. urinary tract
Which media combination is most appropriate when performing routine plating of lower respiratory cultures. a. blood, chocolate, and BYCE agars b. blood, MacConkey and Thayer Martin agars c. Blood, chocolate and MacConkey agars d. blood, chocolate and anaerobic agars
c. blood, chocolate and MacConkey agars
Which preventative measures are appropriate for a patient with an infection that is transmitted by larger airborne droplets that cannot travel more than 3 feet? a. segregation from other patients b. signage for the door c. requiring masks d. negative air pressure rooms e. a and c only f. a, b, and c g. a, b, c, and d h. a and b only
F. a, b, and c
Proper disinfection of the site when a blood culture is being collected includes: a. 70% alcohol only b. iodine only c. 70% alcohol then iodine d. iodine then 70% alcohol
c. 70% alcohol then iodine
The minimum equipment required by a sentinel lab in the LRN network is: a. class 2 BSC b. class 3 BSC c. class 4 BSC d. splash shield
d. splash shield
The gram stain of an organism suspicious for B. anthracis is: a. large bipolar gram negative rods b. small gram negative coccobacilli c. large gram positive rods d. small gram positive rods e. large gram positive cocci
c. large gram positive rods
Endocarditis is an example of this type of bacteremia. a. transient b. intermittent c. contaminated d. continuous
d. continuous
Nosocomial spread of MRSA infections usually results from this type of contact: a. direct b. airborne c. droplets d. indirect e. vectors
d. indirect
Pathogenic organisms elicit the production of these substances, resulting in an immune response: a. antibodies b. antigens c. probes d. enzymes
a. antibodies
The Vitek instrument can provide the following information: a. identification of fastidious organisms b. detection of positive blood cultures c. detection of specific bacterial antigens d. antimicrobial susceptibility patterns
d. antimicrobial susceptibility patterns
The ability of two complementary nucleic acid strands to bond and form a double stranded molecule is known as: a. extraction b. thermal cycling c. hybridization d. lydroysis
c. hybridization
Which of the following methods can be applied using both immunochemical and serological procedures: a. PCR b. ELISA c. Complement fixation d. hybridization
b. ELISA
Proper ‘clean catch’ urine sample collection technique should include: a. sterile cotton swabs b. prior cleansing of area c. catheterization d. needle aspiration e. all of the above
b. prior cleansing of area
True or False: Haemophilus influenzae is a major cause of epiglottis
True
An organism was isolated from a blood culture. The gram stain was suspicious of Bacillus species. As a sentinel lab, indicate which test result will or will not help rule out a diagnosis of B. anthracis. Catalase positive
will not rule out
An organism was isolated from a blood culture. The gram stain was suspicious of Bacillus species. As a sentinel lab, indicate which test result will or will not help rule out a diagnosis of B. anthracis. motile
will rule out
An organism was isolated from a blood culture. The gram stain was suspicious of Bacillus species. As a sentinel lab, indicate which test result will or will not help rule out a diagnosis of B. anthracis. non motile
will not rule out
An organism was isolated from a blood culture. The gram stain was suspicious of Bacillus species. As a sentinel lab, indicate which test result will or will not help rule out a diagnosis of B. anthracis. catalase negative
will rule out
An organism was isolated from a blood culture. The gram stain was suspicious of Bacillus species. As a sentinel lab, indicate which test result will or will not help rule out a diagnosis of B. anthracis. beta hemolysis
will rule out
An organism was isolated from a blood culture. The gram stain was suspicious of Bacillus species. As a sentinel lab, indicate which test result will or will not help rule out a diagnosis of B. anthracis. small flat colonies
will rule out
An organism was isolated from a blood culture. The gram stain was suspicious of Bacillus species. As a sentinel lab, indicate which test result will or will not help rule out a diagnosis of B. anthracis. large raised colonies
will not rule out
An organism was isolated from a blood culture. The gram stain was suspicious of Bacillus species. As a sentinel lab, indicate which test result will or will not help rule out a diagnosis of B. anthracis. gamma hemolysis
will not rule out
If Bacillus anthracis cannot be ruled out by a sentinel lab, the next step is to: a. refer the organism to the state or public health lab for further ID b. notify the CDC c. continue to test the organism with API or Vitek d. notify the physician that B. anthracis has been isolated
a. refer the organism to the state or public health lab for further ID
Indicate whether the following blood culture results most likely represent a Pathogen or Contaminant. Growth of coagulase negative Staph in 1 out of 4 bottles
contaminant
Indicate whether the following blood culture results most likely represent a Pathogen or Contaminant. growth of bacteroides fragilis in 1 anaerobic bottle
pathogen
Indicate whether the following blood culture results most likely represent a Pathogen or Contaminant. growth of staph sureus in 3 out of 4 bottles
pathogen
Indicate whether the following blood culture results most likely represent a Pathogen or Contaminant. growth of E. coli, S. epi and Enterococcus in 1/4 bottle
contaminant
A serology test is ordered to evaluate the possibility of a recent infection with Aspergilus. The time sensitive specimen/s to collect would be: a. acute serum b. first morning urine c. convalescent serum d. a and c only e. a and b only f. a, b and c
d. a and c only
What is the proper transmission precaution that should be followed for: Mycobacterium tuberculosis in the lower respiratory tract
airborne precautions
What is the proper transmission precaution that should be followed for: meningitis caused by Neisseria meningitidis
droplet precautions
What is the proper transmission precaution that should be followed for: Clostridium difficile
contact precautions
What is the proper transmission precaution that should be followed for: Bordetella pertussis (whooping cough)
droplet precautions
Indicate which organisms (non vaccine strains) are select agents or are not select agents: Bacillus anthracis
Select agent
Indicate which organisms (non vaccine strains) are select agents or are not select agents: C. perfringens
Not a select agent
Indicate which organisms (non vaccine strains) are select agents or are not select agents: V. cholera
Not a select agent
Indicate which organisms (non vaccine strains) are select agents or are not select agents: Ebola virus
Select agent
Indicate which organisms (non vaccine strains) are select agents or are not select agents: Smallpox virus
Select agent
Indicate which organisms (non vaccine strains) are select agents or are not select agents: Francisella tularensis
Select agent
Indicate which organisms (non vaccine strains) are select agents or are not select agents:Yersinia enterocolitica
Not a select agent
Indicate which organisms (non vaccine strains) are select agents or are not select agents: Rickettsia rickettsii
Select agent
