MICRO EXAMS Flashcards
1
Q
A single ASO titer is considered to be moderately elevated if the titer is at least _____ Todd units in a child.
A
320 Todd Units
2
Q
In addition to Enterococcus faecalis, which other streptococci will grow in 6.5% salt broth?
A
Group B streptococci
3
Q
When streaking a throat culture on 5% sheep blood agar, stabbing the agar plate provides enhanced detection for:
A
Streptolysin O - subsurface hemolysis
4
Q
Susceptibility testing performed on quality control organisms using a new media lot number yielded zone sizes that were too large for all antibiotics tested. The testing was repeated using media from a previously used lot number, and all zone sizes were acceptable. Which of the following best explains the unacceptable zone sizes?
A
The depth of the media was too thin
5
Q
In a disk diffusion susceptibility test, which of the following can result if disks are placed on the inoculated media and left at room temperature for an hour before incubation?
A
Zones of larger diameter would result
6
Q
Gram stain examination from a blood culture bottle shows dark blue, spherical organisms in clusters. Growth on sheep blood agar shows small, round, pale yellow colonies. Further tests should include:
A
Catalase production and coagulase test
7
Q
Which of the following tests should be used to differentiate Staphylococcus aureus from Staphylococcus intermedius?
A
Acetoin
8
Q
Streptolysin O:
A
Antigenic
9
Q
Neufeld reaction Quellung capsular swelling replaced by
A
Molecular test
10
Q
Tumbling motility is characteristic of:
A
Listeria
11
Q
Peptococcus and Peptostreptococcus are both:
A
Anaerobic gram-positive cocci
12
Q
Propionobacteria are:
A
Anaerobic gram-positive rods
13
Q
Transgrow is a transport medium for:
A
Gonococci and meningococci
14
Q
The unique chemical structure of the cell wall of Mycobacterium spp. is associated with the presence of:
A
N-glycolylmuramic acid and an increase in lipid content
15
Q
The heat resistance of bacterial spores, such as those of Bacillus anthracis, is partly attributable to their dehydrated state and partly to the presence of large amounts of:
A
Calcium dipicolinate
16
Q
The use of 0.1% fuchsin substituted for safranin in the Gram-stain procedure may enhance the visibility of the organisms:
A
Legionella
17
Q
The Schaeffer–Fulton stain can be used for demonstration of:
A
Spores
18
Q
The Schaeffer–Fulton stain can be used for demonstration of:
A
Spores
19
Q
The Leifson stain can be used for demonstration of:
A
Flagella
20
Q
Which statement correctly describes the mode of action of the antibiotic listed for modified Thayer-Martin medium?
A
Nystatin inhibits fungi and molds
21
Q
Select the medium best suited for the recovery of Yersinia enterocolitica from a patient with gastroenteritis:
A
Cefsulodin–Irgasan–Novobiocin (CIN) agar
22
Q
Which procedure is appropriate for culture of genital specimens in order to recover Chlamydia spp.?
A
Inoculate cycloheximide-treated McCoy cells
23
Q
PYR test
A
pyrrolidonyl arylamidase
24
Q
Substrate of PYR
A
L-pyrrolidonyl-B-naphthylamide
25
Skin test for Pneumococcal antibodies
Francis test
26
Assoc disease of S.bovis
Gastrointestinal malignancy
27
Special agar for nutritional variant streptococci
Agar with Cysteine or Pyridoxal Vitamin B6
28
Satelliting streptococci
Thiol requiring streptoco
1. Strep adjacens
2. Strep defectivus
29
Satellitism: dew drop
Staph streak test
H.influenzaw around S.aereus
30
Factor to convert immunoglobulin value from mg/dL to g/L:
0.01
31
Anaerobe
• 0-0% - O2
• 5-10% - CO2
• 5-10% - H2
• 80-90% - N2
32
Capnophilic
• O2 - 15%
• CO2 - 5-10%
33
Capnophilic
• O2 - 15%
• CO2 - 5-10%
34
Microaerophile
• O2 - 10%
35
Aerobic
• O2 - 21%
• CO2 - 0.03%
36
Seventy (70) % recirculated to the cabinet work area through HEPA; 30% balance can be exhausted through HEPA back into the room or to outside through a canopy unit:
*
BSC Class II: A1
37
Thirty (30) % recirculated, 70% exhausted. Exhaust cabinet air must pass through a dedicated duct to the outside through a HEPA filter:
BSC Class II: B1
38
CSF specimens must be transported in the laboratory:
Less than 15mins
39
Cerebrospinal fluid from a febrile 25-year-old man with possible meningitis is rushed to the laboratory for a stat Gram stain and culture. While performing the Gram stain, the technologist accidentally spills most of the specimen. The smear shows many neutrophils and no microorganisms. Since there is only enough CSF to inoculate one plate, the technologist should use a:
Chocolate agar plate: 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.
40
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:
Novobiocin susceptibility: Between CoNs agad mga staph. S.aereus- Coag +
Novobio S - S.epid
Novobio R - S.sapro
41
Which of the following tests should be used to differentiate Staphylococcus aureus from Staphylococcus intermedius?
Acetoin: imvic
42
Streptolysin O:
Oxygen labile
Antigenic
Non surface
43
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?
LIM broth (Todd-Hewitt broth with colistin and nalidixic acid): The swab(s) should be inoculated into a selective broth medium such as LIM broth (Todd-Hewitt broth with colistin and nalidixic acid). The use of vaginal/rectal swabs and selective broth medium greatly increases the recovery of GBS.
44
In addition to Enterococcus faecalis, which other streptococci will grow in 6.5% salt broth?
Group B streptococci
45
Xylose lysine deoxycholate (XLD) agar is a highly selective medium used for the recovery of which bacteria?
Enterobacteriaceae from gastrointestinal specimens:
XLD agar is selective for gram-negative coliforms because of a high concentration (0.25%) of deoxycholate, which inhibits gram-positive bacteria.
46
SITUATION: A group of elementary students became ill after eating undercooked ground beef prepared in the school cafeteria. The suspected pathogen, E. coli serotype 0157:H7, is usually recovered using which of the following media?
MacConkey agar with sorbitol
47
A positive Simmons citrate test is seen as a:
Blue color in the medium after 24 hours of incubation at 35°C
48
Which of the following reagents is added to detect the production of indole?
p-Dimethylaminobenzaldehyde
49
Fever, abdominal cramping, watery stools, and fluid and electrolyte loss preceded by bloody stools 2–3 days before is characteristic of shigellosis but may also result from infection with:
Campylobacter spp.
50
A liquid fecal specimen from a three-month-old infant is submitted for microbiological examination. In addition to culture on routine media for Salmonella and Shigella, this specimen should be routinely:
Examined for the presence of Campylobacter sp
51
Enterobacter sakazakii can best be differentiated from Enterobacter cloacae by which of the following characteristics?
Yellow pigmentation and negative sorbitol fermentation
52
Which single test best separates Klebsiella oxytoca from K. pneumoniae?
Indole
53
Three blood cultures taken from a 30-year-old cancer patient receiving chemotherapy and admitted with a urinary tract infection grew lactose-negative, motile, gram-negative rods prior to antibiotic therapy. Given the following biochemical reactions, which is most likely organism?
Proteus vulgaris
54
Which tests are most appropriate to differentiate between Pseudomonas aeruginosa and Pseudomonas putida?
Mannitol, nitrate reduction, growth at 42°C
55
Which Pseudomonas is usually associated with a lung infection related to cystic fibrosis?
P. aeruginosa
56
Which of the listed Pseudomonas spp. is associated with the following virulence factors: exotoxin A, endotoxins, proteolytic enzymes, antimicrobial resistance, and production of alginate?
P. aeruginosa
57
A blood culture bottle with macroscopic signs of growth is Gram stained and the technician notes small, curved gram-negative bacilli resembling “gull wings.” It is subcultured to blood and chocolate agar, and incubated aerobically and anaerobically. After 24 hours, no growth is apparent. The next step should be to:
Subculture the bottle, and incubate in microaerophilic conditions
58
A gastroenterologist submits a gastric biopsy from a patient with a peptic ulcer. To obtain presumptive evidence of Helicobacter pylori, a portion of the specimen should be added to which media?
Urea broth
59
Which group of tests best differentiates Helicobacter pylori from C. jejuni?
Urease, nitrate, and hippurate hydrolysis
60
Smooth gray colonies showing no hemolysis are recovered from an infected cat scratch on blood and chocolate agar but fail to grow on MacConkey agar. The organisms are gram-negative pleomorphic rods that are both catalase and oxidase positive and strongly indole positive. The most likely organism is:
Pasteurella spp.
61
Which of the following plates should be used in order to identify Haemophilus haemolyticus and Haemophilus parahaemolyticus?
Horse blood agar and Mueller–Hinton agar with X and V strips
62
Which Haemophilus species is difficult to isolate and recover from genital ulcers and swollen lymph nodes?
H ducreyi
63
A gram-negative, fastidious bacillus that has been isolated from air-conditioning towers:
Legionella pneumophila
64
“Chocolate cake” or “burnt chocolate” smell
Proteus spp.
65
Fruity or grapelike smell, corn tortilla-like odor:
Pseudomonas aeruginosa
66
Fruity or grapelike smell, corn tortilla-like odor:
Pseudomonas aeruginosa
67
Musty or mushroom odor:
Pasteurella multocida
68
Smell of ammonium cyanide (almond-like):
Chromobacterium violaceum
69
Oxidase and urease positive:
B. bronchiseptica
70
Oxidase negative, urease positive
B. parapertussis
71
Semisolid transport media such as Amies, Stuart, or Cary–Blair are suitable for the transport of swabs for culture of most pathogens except:
Specimens for culture of N. gonorrhoeae are best if plated immediately or transported in a medium containing activated charcoal to absorb inhibitory substances that hinder their recovery.
72
Putrescine is an alkaline amine product of which bacterial enzyme?
Ornithine
Putrescine is the amine product of the decarboxylation of ornithine.
73
Which of the following organisms are transmitted to animals and humans after a tick bite?
Ehrlichia and Anaplasma spp.
74
The manganous chloride–urea test is used for the identification of which organism?
Ureaplasma urealyticum
U. urealyticum is the only human mycoplasma that hydrolyzes urea. The manganous chloride–urea test utilizes manganous chloride (MnCl2) in the presence of urea. Urease produced by the organism hydrolyzes the urea to ammonia.
75
Which test is the most reliable for the detection of Mycoplasma pneumoniae in serum and for the confirmation of diagnosis?
EIA testing and direct antigen testing
Adults may fail to produce an IgM response especially in recurrent infections, so the best confirmatory approach is a combination of EIA and direct antigen testing.
76
Which organism typically produces “fried-egg” colonies on agar within 1–5 days of culture from a genital specimen?
Mycoplasma hominis
77
Primary atypical pneumonia is caused by:
Mycoplasma pneumoniae
A common cause of respiratory tract illness, M. pneumoniae, generally causes a self-limited infection (3–10 days) and usually does not require antibiotic therapy. M. pneumoniae can be cultured from the upper and lower respiratory tracts onto specially enriched (diphasic) media, but is most frequently diagnosed by the change in antibody titer from acute to convalescent serum using enzyme immunoassay or other serological methods.
78
Which is the test of choice for the confirmation of Chlamydia trachomatis infection in urine?
PCR is both sensitive and specific and may be performed on urine.
79
Which procedure is appropriate for culture of genital specimens in order to recover Chlamydia spp.?
Inoculate cycloheximide-treated McCoy cells
80
Routine laboratory testing for Treponema pallidum involves:
Serological analysis
81
The diagnostic method most commonly used for the identification of Lyme disease is:
Serology
Serological analysis using immunofluorescence or an enzyme immunoassay is the method of choice for diagnosis of Lyme disease.
82
Which of the following Mycobacterium spp. would be most likely to grow on a MacConkey agar plate?
M. chelonae–fortuitum complex
Mycobacteria growing on MacConkey agar are usually nonpathogens. M. chelonae and M. fortuitum are both nonpathogenic rapid growers that will grow on MacConkey agar (with no crystal violet) within 5 days.
83
Which of the following Mycobacterium species is diagnosed by means other than culture?
M. leprae
M. leprae and M. microti are different from all other mycobacteria because they cannot be cultured in vitro.
84
Which mycobacterium is associated with Crohn’s disease?
M. paratuberculosis
85
Which mycobacterium is associated with Crohn’s disease?
M. paratuberculosis
86
Which nonpathogenic Mycobacterium specie is isolated most often from clinical specimens and is called the “tapwater bacillus”?
M. gordonae
87
Which M. avium complex (MAC) organism is the most frequently isolated mycobacterium from AIDS patients?
M. avium
88
Which of the following Mycobacterium spp. is best differentiated by the rapid hydrolysis of Tween 80?
M kansaii
89
Growth inhibition by thiophene-2-carboxylichydrazide (T2H) is used to differentiate M. tuberculosis from which other Mycobacterium sp.:
M. bovis
90
Which organism, associated with tuberculosis in cattle, causes tuberculosis in humans, especially in regions where dairy farming is prevalent?
Mycobacterium bovis
91
All of the following Mycobacterium spp. produce the enzyme required to convert niacin to niacin ribonucleotide except:
M. tuberculosis
92
A gram-positive (gram-variable), beaded organism with delicate branching was recovered from the sputum of a 20-year-old patient with leukemia. The specimen produced orange, glabrous, waxy colonies on Middlebrook’s agar that showed partial acid-fast staining with the modified Kinyoun stain. What is the most likely identification?
Nocardia spp.
93
Establishing the pathogenicity of a microorganism isolated from a child’s throat and identified as Corynebacterium diphtheriae would depend upon:
A positive toxigenicity test
In order to determine if an isolate of Corynebacterium diphtheriae produces toxin, testing for the presence of diphtheria toxin must be performed using methods such as Elek test or PCR.
94
Methods other than packaged microsystems used to identify anaerobes include:
Gas–liquid chromatography (GLC)
Anaerobic bacteria can be identified by analysis of metabolic products using gas–liquid chromatography. Results are evaluated along with Gram staining characteristics, spore formation, and cellular morphology in order to make the identification.
95
Identification of Clostridium tetani is based upon:
Clinical findings
The culture and Gram stain of the puncture wound site usually does not produce any evidence of C. tetani. The diagnosis is usually based upon clinical findings, which are characterized by spastic muscle contractions, lockjaw, and backward arching of the back caused by muscle contraction.
96
Which spore type and location is found on Clostridium tetani?
Round, terminal spores
97
Which mechanism is responsible for botulism in infants caused by Clostridium botulinum?
Ingestion of spores in food or liquid
98
The classic form of foodborne botulism is characterized by the ingestion of:
Preformed toxin in food
99
Which of the following organisms will display lipase activity on egg yolk agar?
LIPASE + C. botulinum, C. sporogenes and C. novyi.
100
Feather-edged colonies usually surrounded by zone of green discoloration; produces a highly characteristic, fruity odor resembling apples or strawberries:
Alcaligenes faecalis
101
Which method is most useful for confirmation that a culture isolate is Group B streptococcus?
Direct hybridization
102
Salmonella-Shigella (SS) Agar is a modification of:
DCA
103
Possible cause of bulky or frothy stool:
Pancreatic disorder
104
Fruity or grapelike smell, corn tortilla-like odor:
P. aeroginosa
105
Fruity or grapelike smell, corn tortilla-like odor:
P. aeroginosa
106
Smell of ammonium cyanide (almond-like):
Chromobacterium violaceum
107
A gram-negative diplococcus that grows on modified Thayer-Martin medium can be further confirmed as Neisseria gonorrhoeae if it is:
Oxidase positive and glucose positive, maltose negative
108
Known as Koch' bacillus
Mycobacterium tuberculosis
109
What is thr virulence factor of M. tb?
Cord factor
110
Serpentine cords
M.tb
111
Granulomatos lesions seen xray surrounded by fibroid cells
Ghon cells
112
Skin test for TB
Purified protein derivative
Mantoux test
113
Mantoux tuberculin test diameter of induration
5-10mm
114
What is the meaning of DOTS
Direct observed treatment strategy
115
Detection rate of mtb dots
70%
116
Cure rate of mtb
85%
117
Specimens of mtb (SB CUP)
Sputum
Blood
CSF
Urine
3Ps : pericardial, pleural, pericarditis
118
Specimens of mtb (SB CUP)
Sputum
Blood
CSF
Urine
3Ps : pericardial, pleural, pericarditis
119
AFB grading NATIONAL standard
REPORT: No seen AFB/300 fields
0
120
1-9 AFB seen/100 fields
+n
121
10-99 afb per 100 fields
1+
122
1-10 AFB/50 fields
2+
123
>10 AFB per field NATIONAL GRADING
3+
124
National TB GRADING
1 OR MORE per OIF
3+ (numerous)
125
National grading: TB association
10 or more per slide
2+ (few)
126
Digesting/mucolytic agent of MTB lab diagnosis
NALC - N-acetyl-L-cystein
127
Decontaminant for mycobacterium
2-4% NaOH
128
Other decontam and digestant of mycobacterium spp
1. Trisodiun phosphate benzalkonium chloride (Zephraim)
2. Dithiothreitol and NaOH
129
Inhibitory of normal flora in egg based agar medium
Malachite green
130
Media used for M.bovis highly concentrated of Malachite green
Petragnani
131
Agar medium based in mycobacterium clear media for AST
Middlebrooke 7H10, 7H11
132
Liquid medium for Mycobacterium
Middlebrooke 7H9/7H12
133
Specimen for IGRA
Heparinized whole blood
134
PCR BASED NAAT for detection of MTB from sputum. Detects rifampicin resistance
GeneXpert
135
Rapid growers Mycobacterium
(PFaSC)
Mycobacterium
• phlei
• fortuitum
• smegmatid
• chelonei
136
Yellow bacillus, causes pneumonia
A photochromogens (MASK)
M.kansasii (mas☆K)
137
Photochromogen (MASK)
AGENT of swimming pool granuloma growth at 30°C
M.marinum (☆M- ask)
M -marinum
A - asiaticum
S - simiae
K - kansasii
138
A scotochromogen (SSX Gordon)
Causes scrofola : urease positive
M. scrofulaceum
139
A scotochromogen (SSX Gor)
Known aa the tap water bacillus
M.gordonae
140
A nonphotochrom causes Lady Windermere syndrome
M.avium
141
Mycobacterium causes pneumonia in HIV patients
M.avium-intracellulare complex
142
Nonphotochrom mycobacterium known as inert bacillus, causes Buruli Ulcers
M.ulcerans
143
Nonphotochrom known as Raddish bacillilus
M.terrae-triviale
144
Hansens disease
M.leprae
145
What is the specimen of leprosy?
Tissue juice earlobe/nasal scrapping
146
Test for M.leprae
1. Fernandez test (early)- 2days
2. Mitsuda (late) - 3-4 weeks
147
Niacin accumulation test is between what mycobacterium
Yellow (+) - M.tuberculosis
Negative(-) M.bovis
148
Most useful biochem test for M.kansasii
Tween 80 HOH (pneumoniae)
(-) M.avium intracellulare: HIV pneumonia
149
Positive isolates in pyrazinamidase
MTB and M.marinum
(-) M.bovis snd M.kansasii
150
The mycobacterium susceptible in T2H Test
M.bovis
M.tb (R)
151
Tropheryma whipplei disease
Whipples disease
152
Which M. avium complex (MAC) organism is the most frequently isolated mycobacterium from AIDS patients?
M.avium
153
A gram-positive branching filamentous organism recovered from a sputum specimen was found to be positive with a modified acid-fast stain method. What is the most likely presumptive identification?
Nocardia
154
A CSF sample obtained from a 2-week old infant with suspected bacterial meningitis grew gram-negative rods on blood and chocolate agars. The following results were noted:
MacConkey agar = No growth
Glucose (open) OF = +
Glucose (closed) OF = Neg
Indole = +
Motility = Neg
42° C growth = Neg
ONPG = +
Urease = Neg
Catalase = +
Oxidase = +
Pigment = Yellow
Chryseobacterium meningosepticum
155
Anaerobic gram-negative rods were recovered from the blood of a patient after gallbladder surgery. The bacteria grew well on agar containing 20% bile, but were resistant to kanamycin and vancomycin. What is the most likely identification?
B. fragilis is the most often isolated gram-negative anaerobic bacillus. It is resistant to many antibiotics. A good screening agar is a 20% bile plate that does not support the growth of Prevotella spp. or Porphyromonas spp.
156
Large gram-positive bacilli (boxcar shaped) were recovered from a blood culture taken from a 70-year-old female diabetic patient. The following results were recorded:
Aerobic growth = Neg
Anaerobic growth = +
Spores = Usually absent (requires enhancement)
Lecithinase = +
Motility = Neg
Hemolysis = β (double zone)
GLC (volatile acids) = acetic acid and butyric acid
Clostridium perfringens
C. perfringens is an anaerobic gram-positive rod that is often isolated from the tissue of patients with gas gangrene (myonecrosis). Spore production is not usually seen with this organism, which may also stain gram negative.
157
A Haemophilus spp., recovered from a throat culture obtained from a 59-year-old male patient undergoing chemotherapy, required hemin (X factor) and NAD (V factor) for growth. This species also hemolyzed horse erythrocytes on blood agar. What is the most likely species?
H. haemolyticus
H. haemolyticus requires both X and V factors for growth and lyses horse erythrocytes.
158
A Haemophilus spp., recovered from a throat culture obtained from a 59-year-old male patient undergoing chemotherapy, required hemin (X factor) and NAD (V factor) for growth. This species also hemolyzed horse erythrocytes on blood agar. What is the most likely species?
H. haemolyticus
H. haemolyticus requires both X and V factors for growth and lyses horse erythrocytes.
159
A patient with a human bite wound on the
right forearm arrived at the clinic for treatment. The wound was inflicted 36 hours earlier, and a culture was taken by the physician on duty. After 48 hours, the culture results were:
Gram-stain smear = Gram-negative straight, slender rods
Chocolate agar plate = “Pitting” of the agar by small, yellow, opaque colonies
Oxidase = +
Motility = Neg
Glucose = +
Growth in increased CO2 = +
160
Eikenella corrodens
E. corrodens is part of the normal flora of the human mouth and typically “pits” the agar. This organism is capnophilic (needing increased CO2).
A patient with a human bite wound on the
right forearm arrived at the clinic for treatment. The wound was inflicted 36 hours earlier, and a culture was taken by the physician on duty. After 48 hours, the culture results were:
Gram-stain smear = Gram-negative straight, slender rods
Chocolate agar plate = “Pitting” of the agar by small, yellow, opaque colonies
Oxidase = +
Motility = Neg
Glucose = +
Growth in increased CO2 = +
161
Eikenella corrodens
E. corrodens is part of the normal flora of the human mouth and typically “pits” the agar. This organism is capnophilic (needing increased CO2).
A patient with a human bite wound on the
right forearm arrived at the clinic for treatment. The wound was inflicted 36 hours earlier, and a culture was taken by the physician on duty. After 48 hours, the culture results were:
Gram-stain smear = Gram-negative straight, slender rods
Chocolate agar plate = “Pitting” of the agar by small, yellow, opaque colonies
Oxidase = +
Motility = Neg
Glucose = +
Growth in increased CO2 = +
162
A sputum culture from a 13-year-old cystic fibrosis patient grew a predominance of short, gram-negative rods that tested oxidase negative. On MacConkey, chocolate, and blood agar plates, the organism appeared to have a lavender-green pigment. Further testing showed:
Motility = +
Glucose = + (oxidative)
Lysine decarboxylase = +
DNase = +
Maltose = + (oxidative)
Esculin hydrolysis = +
Stenotrophomonas maltophilia
S. maltophilia is the third most frequently isolated nonfermentative gram-negative rod in the clinical laboratory. Cystic fibrosis patients are at greater risk for infections because of previous antimicrobial treatment and recurrent pneumonia and because some strains may be colonizers.
163
Bartonella quintana has been known to cause:
Trench fever
ROCHALIMEA/BARTONELLA QUINTANA: TRENCH FEVER
Trench fever, caused by B. quintana, was largely considered a disease of the past. Clinical manifestations of trench fever range from a mild influenza-like headache and bone pain to splenomegaly (enlarged spleen) and a short-lived maculopapular rash.
164
For nonspecific staining of Rickettsia the recommended stain is:
Gimenez stain
Direct microscopic examination for Rickettsia organisms is possible using such stains as Giemsa, Machiavello, or Gimenez. The recommended procedure is the nonspecific Gimenez stain, which colors the organisms a brilliant red against a green background.
165
The causative agent of endemic or murine typhus is:
Rickettsia typhi
Murine typhus is transmitted to humans by fleas infected with Rickettsia typhi. Prevalent in the southern U.S., it is primarily a disease of rodents and is sometimes transmitted to humans. Control of disease outbreaks is related to rodent (rat) control and the related rat flea population.
166
The mild type of typhus fever that is caused by recrudescence of an initial attack of epidemic typhus is known as:
Brill-Zinsser disease
167
Transmission of Orientia tsutsugamushi is associated with what vector?
Chiggers
O. tsutsugamushi
Scrub typhus
Vector: chiggers
168
Which triad of symptoms is associated with rickettsial infections?
Fever, headache, and rashRickettsias are suspected when the triad of fever, headache, and rash is the primary clinical manifestation in patients with an exposure to insect vectors.
Infections caused by these organisms may be severe and are sometimes fatal.
169
Which serovar of Chlamydia trachomatis causes lymphogranuloma venereum?
L1
trachomatis serovars L1, L2, L2b, and L3 are invasive causing LGV, in contrast to C. trachomatis serovars A-K, leaving the mucosa to spread to the regional lymph nodes.
170
Corneal scrapings are collected and examined microscopically using a direct fluorescent test to detect inclusion bodies for the diagnosis of infection caused by:
Chlamydia trachomatis,
a leading cause of blindness, can be detected in corneal scrapings of suspected cases of trachoma and inclusion conjunctivitis.
171
Chlamydia trachomatis causes which of the following?
Inclusion conjunctivitis
Chlamydia trachomatis is the causative agent of inclusion conjunctivitis, trachoma, and genital tract infections, including lymphogranuloma venereum
172
Spirochetes often detected in the hematology laboratory, even before the physician suspects the infection, are:
Borrelia spp.
are often seen on Wright’s-stained smears of peripheral blood as helical bacteria with 3–10 loose coils. They are gram negative but stain well with Giemsa’s stain.
173
Spirochetes often detected in the hematology laboratory, even before the physician suspects the infection, are:
Borrelia spp.
are often seen on Wright’s-stained smears of peripheral blood as helical bacteria with 3–10 loose coils. They are gram negative but stain well with Giemsa’s stain.
174
Borrelia burgdorferi, a spirochete transmitted by Ixodes dammini in the northeastern U.S., is the etiologic agent of:
Lyme disease
175
Borrelia burgdorferi, a spirochete transmitted by Ixodes dammini in the northeastern U.S., is the etiologic agent of:
Lyme disease
176
The etiologic agent of epidemic relapsing fever is Borrelia recurrentis, which is commonly transmitted by:
Lice
The human body louse, Pediculus humanus, is the vector for Borrelia recurrentis. Pathogenic species not only have specific vectors but also well-defined geographical distributions.
177
During the first week of leptospirosis, the most reliable way to detect the presence of the causative agent is by the direct:
Culturing of blood
Leptospira spp. are most reliably detected during the first week of illness by the direct culturing of a blood sample. The media of choice are Fletcher semisolid and Stuart liquid medium, both of which are supplemented with rabbit serum.
178
Serious congenital infections are associated with:
Treponema pallidum subsp. pallidum
Hutchinson's triad: a triad of symptoms that comprises Hutchinson's (notched) teeth, interstitial keratitis, and deafness and occurs in children with congenital syphilis
Syphilis is caused by Treponema pallidum subsp. pallidum. Congenital syphilis occurs when a pregnant woman has a septicemia, and the spirochetes cross the placenta and infect the fetus. Infection can affect fetal development and cause premature birth or fetal death, or the pregnancy may go to term. Following in utero infection, the infant is most often born with lesions characteristic of secondary syphilis; perinatal death is not an uncommon consequence of infection.
179
Detection of antibody against cardiolipin is useful for the diagnosis of which of the following diseases?
Syphilis
Cardiolipin is a tissue lipid produced as a byproduct of treponemal infection. Nontreponemal tests for syphilis take advantage of antibodies made to cardiolipin. The most commonly used tests are the rapid plasma reagin (RPR) for serum and the Venereal Disease Research Laboratory (VDRL) for cerebrospinal fluid.
180
Spirillum minus also causes rat-bite fever in humans and is referred to as:
Sodoku
Spirillum minus also causes rat-bite fever in humans and is referred to as sodoku. The clinical signs and symptoms are similar to those caused by Streptobacillus moniliformis, except that arthritis is rarely seen in patients with sodoku and swollen lymph nodes are prominent; febrile episodes are also more predictable in sodoku.
181
“Lumpy jaw” is caused by:
Actinomyces israelii
LOCK JAW: C. tetani
LUMPY JAW: Actinomyces
182
Sulfur granules in a clinical specimen indicate the presence of:
Actinomyces spp.
Direct examination and the macroscopic presence in purulent exudate of “sulfur granules,” which reveal gram-positive filaments when crushed, is diagnostic for an infection with Actinomyces spp.
183
Which Nocardia sp. causes more than 80% of human infections?
N. asteroides
Infections caused by Nocardia spp. can occur in immunocompetent and immunocompromised individuals. N. asteroides, N. brasiliensis, and N. otitidiscaviarum are the major causes of these infections, with N. asteroides causing greater than 80% of infections.
184
Which actinomycete is partial acid-fast, has extensive aerial hyphae, and is lysozyme resistant?
Nocardia sp.
185
Which organisms may stain partially acid-fast when stained with a modified acid-fast stain?
If the modified acid-fast stain results are positive, the isolate is a probable partially acid-fast aerobic actinomycete (i.e., Nocardia, Rhodococcus, Tsukamurella, or Gordonia sp).
186
Susceptibility to thiophene-2-carboxylicacid hydrazide (T2H) is characteristic of which of the following mycobacteria?
M. bovis
187
Growth inhibition by thiophene-2-carboxylichydrazide (T2H) is used to differentiate M. tuberculosis from which other Mycobacterium specie?
M. bovis
188
Mycobacterium fortuitum, a rapidly growing Mycobacterium, grows on MacConkey agar in 5 days. Which other species of Mycobacterium is able to demonstrate growth within the same time period on MacConkey agar?
M. chelonei
The MacConkey agar used for mycobacteria identification is a different formulation than that used for enterics, in that crystal violet is omitted. A MacConkey agar plate is inoculated with a 7-day broth culture of the test organism. The inoculated plate is then incubated at 37°C. Plates are checked for growth at 5 days, and if no growth is detected, they are checked daily until day 11, at which time they are discarded as negative. M. fortuitum and M. chelonei are the only mycobacteria able to grow on MacConkey agar in 5 days.
189
A slowly growing, orange-pigmented, acid-fast bacillus was isolated from a cervical lymph node of a child with symptoms of cervical adenitis. The most likely etiologic agent in this case would be:
Mycobacterium scrofulaceum
190
Which of the following is a fluorescent stain for mycobacteria?
Auramine-rhodamine
Auramine-rhodamine is a fluorescent stain used to visualize the mycobacteria. The bacteria retain the stain and will appear bright yellow against a black background.
Because it is easier to see the bacilli, this stain is more sensitive than a fuschin-based stain (e.g., Ziehl-Neelsen).
191
Mycobacteria can be examined by using the:
Kinyoun stain
Acid-fast bacilli can be demonstrated in stained smears of clinical material using the Ziehl-Neelsen or Kinyoun acid-fast stains. The Kinyoun carbol-fuchsin method uses a higher concentration of phenol in the primary stain to accelerate the staining process. Therefore, unlike the Ziehl-Neelsen stain, the Kinyoun stain does not need to be heated.
192
Which of the following media would not be routinely used to culture Mycobacterium spp.?
Chocolate agar
193
Mycobacteria have a large amount of a component in their cell wall that other bacteria lack. That component is:
Lipids
Mycobacteria characteristically possess a high lipid content, unlike gram-positive cocci and gram-negative bacteria. The high lipid content acts to protect these organisms from dehydration and the lethal effects of alkali, various germicides, alcohol, and acids. Thus, these bacteria do not stain well with the Gram stain, and an acid-fast staining technique must be used.
194
Pregnant women and immunocompromised patients should avoid eating which of the following foods to prevent Listeria infection?
Feta cheese
The general population should always properly wash raw vegetables and thoroughly cook vegetables and meat to prevent listerosis.
195
A 1-week-old newborn develops meningitis. Short, gram-positive rods are isolated. History reveals that the mother had eaten unpasteurized cheese from Mexico during pregnancy, and she recalled having a flu-like illness. Which of the following is the most likely etiologic microorganism?
Listeria monocytogenes
Listeria multiplies both extra-cellularly and intracellularly, but under most circumstances, a competent immune system eliminates Listeria. As expected, listeriosis is seen in the very young and the very old, and in people with compromised immune systems.
196
A Gram stain of organisms of Loeffler agar showed pleomorphic gram-positive bacilli. The organism should be subcultured to:
Potassium tellurite
Media containing potassium tellurite is used for the recovery of Corynebacterium diphtheriae
197
Symptoms of C. botulinum food poisoning include double vision, inability to speak, and respiratory paralysis. These symptoms are consistent with:
Ingestion of a neurotoxin
198
Symptoms of C. botulinum food poisoning include double vision, inability to speak, and respiratory paralysis. These symptoms are consistent with:
Ingestion of a neurotoxin
199
A fastidious gram-negative bacillus was isolated from a case of periodontal disease, which upon darkfield examination was noted to have GLIDING MOTILITY. The most likely identification of this etiologic agent would be:
Capnocytophaga
Capnocytophaga spp. are fermentative gram-negative bacteria that inhabit the oral cavity of humans. These organisms have been identified as a cause of disease in the oral cavity, and in compromised hosts they have been implicated in systemic disease isolated from cerebrospinal fluid, pleural fluid, and pulmonary secretions. The gliding motility is best observed during the log phase of growth and can be demonstrated by darkfield microscopy and on sheep blood agar by the production of concentrically spreading growth around primary colonies.
200
An environmental sampling study of respiratory therapy equipment produced cultures of a yellow, nonfermentative (at 48 hours), gram-negative bacillus from several of the nebulizers, which would most likely be species of:
Chryseobacterium spp.
are ubiquitous in the environment and are especially associated with moist soil and water. Chryseobacterium (formerly Flavobacterium) meningosepticum, a known nosocomial pathogen, has been implicated in outbreaks of meningitis in hospitals and is associated with the use of contaminated respiratory therapy equipment.
201
Which of the following is NOT required for growth of Streptobacillus moniliformis?
Cystine
Streptobacillus moniliformis is a gram-negative bacillus that requires media containing blood, serum, or ascites fluid as well as incubation under carbon dioxide (CO2) for isolation from clinical specimens. This organism causes rat-bite fever and Haverhill fever in humans.
202
When Streptobaccilus moniliformis is acquired by ingestion, the disease is called:
Haverhill fever
Streptobacillus moniliformis is a gram-negative bacillus that requires media containing blood, serum, or ascites fluid as well as incubation under carbon dioxide (CO2) for isolation from clinical specimens. This organism causes rat-bite fever and Haverhill fever in humans.
203
Which of the following conditions is viewed as a risk factor for systemic disease caused by Pasteurella multocida subsp. multocida?
Liver cirrhosis
P. multocida subsp. multocida is most commonly encountered in clinical specimens. Reported virulence factors for this subspecies include lipopolysaccharide, cytotoxin, six serotypes of the antiphagocytic capsule, surface adhesins, and iron-acquisition proteins.
204
The best medium for culture of Francisella tularensis is:
Cystine glucose blood agar
Francisella tularensis is fastidious and not readily recovered in culture. Cysteine blood glucose agar is an enriched medium with beef heart infusion, peptones, glucose and rabbit blood. It also includes cystine, which is required by F. tularensis for growth.
205
Media used to support growth of Legionella pneumophila should contain which of the following additives?
Charcoal and yeast extract
206
Milk has classically been the primary food associated with the transmission of some diseases, especially for those diseases of cattle transmissible to humans, such as:
Brucellosis
Brucella infects cattle and may be transmitted to humans by the ingestion of contaminated milk or other dairy products. Milk is able to support the growth of many clinically significant microorganisms, which may often be ingested in unpasteurized dairy products.
207
Fever of unknown origin in a farmer who raises goats would most likely be caused by which of the following organisms?
Brucella melitensis
Brucella are small, aerobic, Gram-negative coccobacilli. Of the four well-characterized species of Brucella, only one—B. melitensis—characteristically infects both goats and humans. Brucellosis may be associated with gastrointestinal and neurologic symptoms, lymphadenopathy, splenomegaly, hepatitis, and osteomyelitis.
208
Which of the following characteristics best differentiates Bordetella bronchiseptica from Alcaligenes species?
Rapid hydrolysis of urea
209
Colonies that are said to resemble "droplets of mercury" are characteristic of:
Bordetella pertussis
Bordetella pertussis is the etiologic agent of pertussis, or whooping cough. On Bordet-Gengou or Regan-Lowe agars, the organism forms small, round colonies that resemble mercury droplets. A nasopharyngeal swab is recommended as the optimal specimen for the recovery of this agent.
210
The best medium for culture of Bordetella pertussis is:
Regan-Lowe agar
211
A positive hippurate hydrolysis is a characteristic of:
Campylobacter jejuni
212
Which of the following has been recognized in postinfectious complications of a Campylobacter jejuni infection?
Guillain-Barré syndrome
213
The optimal incubator temperature for isolation of the Campylobacter jejuni/coli group is:
42C
214
Which of the following media can be used to culture Campylobacter jejuni?
Skirrow medium
215
All of the following organisms require X and V factors, except:
Aggregatibacter aphrophilus
H. aphrophilus is the only species that does not require X or V factors.
H. aphrophilus is an uncommon cause of endocarditis and is the H member of the HACEK group of bacteria associated with slowly progressive (subacute) bacterial endocarditis.
216
Into which genus have Haemophilus aphrophilus and Haemophilus paraphrophilus been recently reclassified?
Aggregatibacter
Haemophilus aphrophilus and Haemophilus paraphrophilus have been reclassified as a single species based on multilocus sequence analysis.
Aggregatibacter aphrophilus now includes both the hemin-dependent and hemin-independent isolates.
217
An unimmunized, 2-year-old boy presents with drooling from the mouth, elevated temperature, and enlarged tonsils. During attempts at intubation, no gray-white membrane is observed but the epiglottis appears “beefy” red and edematous. Which of the following is the most likely organism?
Haemophilus influenzae
218
The porphyrin (D-ALA) test was devised to detect strains of Haemophilus capable of:
Synthesis of hemin
219
Which organism has large, smooth, glistening colonies with a lavender pigment and smells like ammonia?
Stenotrophomonas maltophilia
Large, smooth, glistening colonies with uneven edges and lavender-green to light purple pigment; greenish discoloration underneath growth; ammonia smell
220
If present, a characteristic that is helpful in separating Pseudomonas aeruginosa from other members of the Pseudomonas family is:
Growth at 42ºC
Pseudomonas aeruginosa grows at 42˚C but this temperature is inhibitory for other Pseudomonas species
221
Which organisms are plump coccobacilli that may resist decolorization and may be mistaken for Neisseria spp?
Acinetobacter spp
Acinetobacter spp. are plump coccobacilli that tend to resist alcohol decolorization; they may be mistaken for Neisseria spp.
222
A wound (skin lesion) specimen obtained from a newborn grew predominantly β-hemolytic colonies of gram-positive cocci on 5% sheep blood agar. The newborn infant was covered with small skin eruptions that gave the appearance of a “scalding of the skin.” The gram-positive cocci proved to be catalase positive. Which tests should follow for the appropriate identification?
Coagulase, glucose fermentation, DNase
S. aureus is the cause of “scalded skin” syndrome in newborn infants. The production of a potent exotoxin (exfoliatin) causes the epidermis to slough off, leaving the newborn’s skin with a red, raw texture
or a burned, scalded look.
223
An isolate of Staphylococcus aureus was cultured from an ulcer obtained from the leg of a diabetic 79-year-old female patient. The organism showed resistance to methicillin. Additionally, this isolate should be tested for resistance or susceptibility to:
Vancomycin
MRSA isolates are usually tested for susceptibility or resistance to vancomycin, a glycopeptide.
224
A 65-year-old female outpatient was requested by her physician to submit a 24-hour urine specimen for protein and creatinine tests. He also requested testing for mycobacteria in the urine. Should the microbiology laboratory accept this 24-hour specimen for culture?
No, the specimen is unsuitable for the recovery of mycobacteria
225
To read the hemolytic reaction on a blood agar plate accurately, the technologist must hold the plate up to the light and observe the plate with:
Transmitted light
226
Staphylococcus aureus toxin which disrupts the smooth muscle in blood vessels and is toxic to erythrocytes, leukocytes, hepatocytes, and platelets:
Alpha toxin
Most strains of S. aureus produce ALPHA toxin, which disrupts smooth muscle in blood vessels and is toxic to erythrocytes, leukocytes, hepatocytes, and platelets.
227
Composition of McFarland standard:
1% sulfuric acid and 1.175% barium chloride
McFarland turbidity standards, prepared by mixing 1% sulfuric acid and 1.175% barium chloride to obtain a solution with a specific optical density, are commonly used.
228
The 0.5 McFarland standard, which is commercially available, provides an optical density comparable to the density of a bacterial suspension of:
1.5 x 10 8th CFU/mL
229
Bone marrow toxicity is the major side effect associated with:
Chloramphenicol
230
Monobactams
Inhibits cell wall synthesis
231
Interferes with folic acid pathway by binding the enzyme dihydropteroate synthase:
Sulfonamides
232
Media employ some factor (or factors) that allows colonies of one bacterial species or type to exhibit certain metabolic or culture characteristics that can be used to distinguish it from other bacteria growing on the same agar plate:
Differential media
233
Moderate growth; growth is out to the third quadrant:
3+
Numbers of organisms present can subse- quently be graded as 4+ (many, heavy growth) if growth is out to the fourth quadrant, 3+ (moderate growth) if growth is out to the third quadrant, 2+ (few or light growth) if growth is in the second quadrant, and 1+ (rare) if growth is in the first quadrant
234
CSF collected from a shunt
BAP, CAP, THIO
CSF
BA, CA (Routine)
BA, CA, thio (Shunt)
235
An outbreak of Staphylococcus aureus has occurred in a hospital nursery. In order to establish the epidemiological source of the outbreak, the most commonly used typing method is:
Pulsed-field gel electrophoresis
The most commonly used method to determine the relatedness of 2 or more bacterial strains is pulsed-field gel electrophoresis.
236
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:
There has been a break in proper skin preparation before drawing blood for culture
Appropriate skin antisepsis is the most important factor in preventing contaminated blood cultures. Staphylococcus epidermidis is a common blood culture contaminant because it is a common inhabitant of the skin.
237
In a quality control procedure on a new batch of Mueller-Hinton plates using a stock culture of Staphylococcus aureus (ATCC 25923), all the disk zone sizes are too small. The most likely reason for this is that the:
Bacterial suspension was not diluted to the proper concentration
Quality control zone sizes that are too small could indicate that the organism inoculum is too high, plate were poured too thick or that the potency of the antibiotic disks is too low.
238
To quality control the autoclave, a vial of Bacillus stearothermophilus is autoclaved and should than be:
Incubated at 56C
Bacillus stearothermophilus is commonly used as an indicator organism for the appropriate functioning of autoclaves.
Unlike most Bacillus species, B. stearothermophilus grows at 56˚C.
239
Which of the following is the most important variable in the recovery of organisms in patients with bacteremia?
The volume of blood cultured
The volume of blood collected is the single most important variable in the recovery of organisms in patients with bloodstream infections.
240
Quality control results for disk diffusion susceptibility tests yield the following results: aminoglycoside zones too small and penicillin zones too large. This is most likely due to the:
pH of Mueller-Hinton agar being too low
Mueller-Hinton Agar used for disk diffusion is standardized at pH 7.2 to 7.4.
241
Which of the following tests is used to monitor bactericidal activity during antimicrobic therapy in cases of endocarditis?
Schlichter
The serum bactericidal, or Schlichter test can be used to assess the activity of patient’s serum when they are receiving long term therapy for endocarditis or osteomyelitis. High titers of antibacterial activity in the serum suggest adequate dosing, a non-tolerant isolate or normal elimination of the antibiotic.
242
A 21-year-old patient presents with pharyngitis. A throat swab is collected and submitted for anaerobic culture. This specimen should be:
Rejected as unacceptable
Many anaerobic bacteria are commensal flora in the oropharynx. Anaerobic bacteria do not cause pharyngitis. The most common cause of pharyngitis is Streptococcus pyogenes. Other causes include Arcanobacterium haemolyticum, Corynebacterium diphtheriae, Neisseria gonorrhoeae and viruses.
243
A 21-year-old patient presents with pharyngitis. A throat swab is collected and submitted for anaerobic culture. This specimen should be:
Rejected as unacceptable
Many anaerobic bacteria are commensal flora in the oropharynx. Anaerobic bacteria do not cause pharyngitis. The most common cause of pharyngitis is Streptococcus pyogenes. Other causes include Arcanobacterium haemolyticum, Corynebacterium diphtheriae, Neisseria gonorrhoeae and viruses.
244
A patient exhibits fever, chills, abdominal cramps, diarrhea, vomiting, and bloody stools 10 to 12 hours after eating. Which organisms will most likely grow from this patient’s stool culture?
E. coli O157:H7 or Shigella spp.
Both E. coli O157:H7 and Shigella spp. are invasive and cause bloody stools.
245
The primary isolation of Neisseria gonorrhoeae requires:
Neisseria gonorrhoeae requires an enhanced CO2 atmosphere for optimal growth.
246
Characteristics of the HACEK group of bacteria include:
Requirement of 5 to 10% CO2 for growth
The HACEK group of organisms are gram negative bacilli that require increased CO2 for growth.
247
A child was bitten on the arm by her sibling and the resulting would grew a slender gram-negative bacilli that has the following characteristics:
Eikenella corrodens
“Pitting of agar” and the bleach smell of the colonies are hallmark characteristics of Eikenella corrodens
248
Acinetobacter lwoffii differs from Neisseria gonorrhoeae in that the former:
Will grow on MacConkey and EMB media
Both organisms are gram negative, Neisseria gonorrhoeae is fastidious and does not grow on MacConkey or EMB agar, but Acinetobacter does. Neisseria is oxidase positive and Acinetobacter is oxidase negative.
249
In the optochin (ethylhydrocupreine hydrochloride) susceptibility test, if there is a zone of inhibition of 19 to 30 mm surrounding the disk following overnight incubation at 37°C, the colony most likely consists of:
Pneumococci
250
Which of the following is the most appropriate specimen source and primary media battery?
Endocervical - chocolate, Martin Lewis
Chocolate agar and chocolate agar based selective media (Martin Lewis) are routinely used for the recovery of Neisseria gonorrhoeae from genital specimens.
251
CSF from a febrile 25-year-old man with possible meningitis is rushed to the laboratory for a stat Gram stain and culture. While performing the Gram stain, the technologist accidentally spills most of the specimen. The smear shows many neutrophils and no microorganisms. Since there is only enough CSF to inoculate one plate, the technologist should use a:
Chocolate agar plate
252
Which biochemical tests should be performed in order to identify colorless colonies growing on MacConkey agar (swarming colonies on blood agar) from a catheterized urine specimen?
Indole, phenylalanine deaminase, and urease
253
Direct spread of pneumonic plague disease occurs by which route?
Inhalation of contaminated airborne droplets
254
Nutritionally variant streptococci (NVS) require specific thiol compounds, cysteine, or the active form of vitamin B6. Which of the following tests supplies these requirements?
Staphylococcal cross-streak test
255
Which organism is the most often recovered gram-positive cocci (catalase negative) from a series of blood cultures obtained from individuals with endocarditis?
Enterococcus faecalis
256
Resistance to which drug categorizes a strain of Staphylococcus aureus as methicillin-resistant Staphylococcus aureus (MRSA)?
Oxacillin
Oxacillin is the drug used to screen staphylococci for resistance to antibiotics having the β-lactam ring. Included in this group are penicillin, cephalosporin, monobactam, and carbapenem. MRSA defines strains of staph that are resistant to all of these antibiotic groups. MRSA strains are treated with vancomycin or oxazolidinone
257
During childbearing years, the normal flora of the vagina is predominantly:
Lactobacillus
258
Stains the cell wall of fungi:
Calcofluor white
259
What step in the Gram stain distinguishes between gram-positive and gram-negative organisms?
Decolorization using alcohol or acetone
260
What is the stain that binds to the nucleic acid of organisms but does not discriminate between gram-positive or gram-negative organisms called?
Acridine orange stain
The fluorochrome acridine orange binds to nucleic acid. This staining method can be used to confirm the presence of bacteria in blood cultures when Gram stain results are difficult to interpret or when the presence of bacteria is highly suspected but none are detected using light microscopy.
261
Patient preparation for fungal culture:
Wipe nails or skin with 70% alcohol
NOTE:
PATIENT PREPARATION: Nails or skin: wipe with 70% alcohol
FOR MICROSCOPY/VISUALIZATION OF FUNGAL ELEMENTS: KOH
262
Cerebrospinal fluid from a febrile 25-year-old man with possible meningitis is rushed to the laboratory for a stat Gram stain and culture. While performing the Gram stain, the technologist accidentally spills most of the specimen. The smear shows many neutrophils and no microorganisms. Since there is only enough CSF to inoculate one plate, the technologist should use a:
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.
263
For ova and parasites (O&P), collect ____ specimens every other day at a minimum for outpatients.
Three specimens
264
Unpreserved stool should be transported to the laboratory in:
Less than 1 hour at room temperature
265
For patient preparation, wipe abscess with:
Sterile saline or 70% alcohol
266
This cabinet is selected if radioisotopes, toxic chemicals, or carcinogens will be used:
Biological safety cabinet class IIB
267
The exhaust air in class ___ cabinets is discharged outside the building.
Biological safety cabinet class IIB
The exhaust air in class IIB cabinets is discharged outside the building.
A class IIB cabinet is selected if radioisotopes, toxic chemicals, or carcinogens will be used
268
Cabinet is self-contained, and 70% of the air is recirculated:
Biological safety cabinet class IIA
269
Cabinets allow room (unsterilized) air to pass into the cabinet and around the area and material within, sterilizing only the air to be exhausted:
Biological safety cabinet class I
270
Filtration of air is accomplished using high-efficiency particulate air (HEPA) filters designed to remove organisms _______ μm from isolation rooms, operating rooms, and biologic safety cabinets (BSCs).
Larger than 0.3 um
Filtration of air is accomplished using high-efficiency particulate air (HEPA) filters designed to remove organisms larger than 0.3 μm from isolation rooms, operating rooms, and biologic safety cabinets (BSCs).
271
Safest method to ensure that no infective materials remain in samples or containers when disposed:
Incineration is the most common method of treating infectious waste. Hazardous material is literally burned to ashes at temperatures of 870° to 980°C. Incineration is the safest method to ensure that no infective materials remain in samples or containers when disposed.
272
Genes encoded in extrachromosomal genetic elements, such as PLASMIDS and TRANSPOSONS, may be transferred by:
Conjugation
In addition to chromosomal DNA, genes encoded in extrachromosomal genetic elements, such as plasmids and transposons, may be transferred by conjugation.
273
Synthesis of protein
Replication - duplication of DNA
Transcription - synthesis of RNA from a DNA template
Translation - synthesis of protein
274
Synthesis of RNA from a DNA template:
Replication - duplication of DNA
Transcription - synthesis of RNA from a DNA template
Translation - synthesis of protein
275
Which 2 diseases are usually preceded by infection with beta-hemolytic streptococci?
Glomerulonephritis, rheumatic fever
