Review Cards - Microbiology Flashcards

Question

Biosafety levels - Level IV - risk

Answer 1

those that pose a high risk of life-threatening disease -may be transmitted by aerosols -no vaccine or therapy

Answer 2

-class III BSC -full-body, air-supplied positive pressure suit -independent unit with specialized ventilation & waste management to prevent release into environment

Answer 3

easily disseminated or transmitted from person to person

Answer 4

high mortality, potential for major public health impact

Answer 5

2nd highest

Answer 6

moderately easy to disseminate

Answer 7

moderate illness, low death rate

Answer 8

3rd highest

Answer 9

could be engineered for mass dissemination

Answer 10

high morbidity/mortality, major public health impact

Answer 11

Category A

Answer 12

Category A

Answer 13

Category A

Answer 14

Category A

Answer 15

Category A

Answer 16

Category A

Answer 17

Category B

Answer 18

Category B

Answer 19

Category B

Answer 20

Category B

Answer 21

Category B

Answer 22

Category B

Answer 23

Category B

Answer 24

Category B

Answer 25

Category B

Answer 26

Category B

Answer 27

Category B

Answer 28

Category B

Answer 29

Category B

Answer 30

Category B

Answer 31

Category B

Answer 32

Category C

Answer 33

Category C

Answer 34

-autoclave -most widely utilized in clinical labs -15 lb of pressure for 15 min (for media) -121*C/250*F -Kills spores -may not kill prions

Answer 35

-not reliable -spores may not be killed

Answer 36

-used in food industry to kill foodborne pathogens -doesn't sterilize -liquid is heated to 71.7*C for 15 minutes

Answer 37

-used when steam may damage or fail to penetrate -2 hours at 170*C -kills spores

Answer 38

-used to sterilize inoculating loops & biomedical wastes

Answer 39

-used to sterilize liquids that are thermolabile (e.g., urea broth) -HEPA air filters are used in BSC

Answer 40

UV light wavelengths in the 200-320 nm range are used for surface disinfection both in the lab and patient rooms

Answer 41

-ethyl & isopropyl (70-80%) frequently used as antiseptics & disinfectant -does NOT kill spores

Answer 42

-sodium hypochlorite (household bleach) -one of the most effective agents against HIV & HBV -10% solution -CAN kill spores

Answer 43

-effective against most vegetative cells other than mycobacteria -used for cold sterilization of items damaged by heat, e.g., inhalation therapy equipment, equipment with optical lenses such as endoscopes

Answer 44

3%-6% solution used as disinfectant

Answer 45

-iodophors (e.g., providone-iodine) release iodine slowly & are less irritating & nonstaining -effective skin disinfectant -used with alcohol on skin prior to collection of blood for blood culture

Answer 46

0.5%-3% solution for disinfecting -does NOT kill spores

Answer 47

-effective against wide range of vegetative bacteria -NOT effective against spores, mycobacteria, or non-enveloped viruses -used to disinfect floors, walls, furniture

Answer 48

widely used in hospitals to sterilize materials that can't withstand steam

Answer 49

Aspirates preferred to swabs. Anaerobic transport system to eliminate O2.

Answer 50

25*C **do not refrigerate**

Answer 51

Storage not recommended, process immediately

Answer 52

Amies transport medium with charcoal, JEMBEC plates, Gono-Pak, BioBag (best to inoculate medium directly)

Answer 53

25*C **don’t refrigerate**

Answer 54

Transport media - e.g., Cary-Blair transport medium (has high pH and sodium thioglycollate added) I’d specimen can’t be cultured within 2 hrs of collection

Answer 55

4*C -best to process without delay -refrigeration may kill *Shigella*

Answer 56

Depending on procedures to be performed: polyvinyl alcohol (PVA), 10% formalin, sodium acetate-acetic acid-formalin (SAF), merthiolate-iodine-formalin (MIF), others without formaldehyde or mercury (e.g., Ecofix, Parasafe)

Answer 57

Can hold formed specimens at 4*C -soft or liquid specimens should be examined immediately or preserved

Answer 58

Transport tubes with boric acid-glycerol if specimen can’t be processed within 2 hrs of collection

Answer 59

4*C for not more than 24 hrs

Answer 60

Collect during acute phase of infection (2-3 days) -use viral transport medium (VTM)

Answer 61

4*C -for delay >24 hrs, freeze at -70*C

Answer 62

1. Anaerobes 2. *Chlamydia* 3. *Haemophilus influenzae* 4. *Neisseria gonorrhoeae* 5. *Neisseria meningitidis* 6. *Salmonella* 7. *Shigella* 8. *Shigella* 9. *Streptococcus pneumoniae* 10. Viruses 11. Parasites

Answer 63

Function: primary dye Outcome: stains all bacteria purple

Answer 64

Function: mordant Outcome: reacts with crystal violet to form a complex that incorporates into peptidoglycan

Answer 65

Function: decolorizer Outcome: removes crystal violet from gram-negative (neg) bacterial cells

Answer 66

Function: counterstain Outcome: stains gram-negative bacterial cells pink

Answer 67

Thick peptidoglycan layer with teichoic acid & lipoteichoic acid. -teichoic acid cross-links prevent decolorization in Gram stain

Answer 68

Stained by crystal violet. Color in gram stain: purple

Answer 69

Thin peptidoglycan layer covered with proteins, phospholipids, & lipopolysaccharides. -decolorizing agent causes increased permeability of lipid-rich cell wall -primary stain (crystal violet) washes out

Answer 70

Thin peptidoglycan layer covered with proteins, phospholipids, & lipopolysaccharides. -decolorizing agent causes increased permeability of lipid-rich cell wall -primary stain (crystal violet) washes out

Answer 71

Stained by safranin. Color in gram stain: pink

Answer 72

-supports growth of most non-fastidious bacteria

Answer 73

enrichment

Answer 74

enrichment

Answer 75

enrichment

Answer 76

enrichment

Answer 77

selective and differential

Answer 78

selective and differential

Answer 79

selective and differential

Answer 80

selective and differential

Answer 81

-contains added growth factors, e.g., blood, vitamins, yeast extract

Answer 82

-contains additives such as dyes, bile salts, alcohols, acids, or antibiotics to inhibit growth of certain bacteria (e.g., gram pos)

Answer 83

-contains compounds that allow certain bacteria (or even species) to be visually differentiated (e.g., lactose fermentation, hydrogen sulfide [H2S], production)

Answer 84

-enrichment -differential

Answer 85

-most non-fastidious bacteria

Answer 86

tryptic soy agar with 5% sheep blood -allows differentiation of hemolysis

Answer 87

enrichment

Answer 88

fastidious organisms including *Haemophilus* & *Neisseria*

Answer 89

supplies X (hemin) & V (NAD) factors -incubate in 5% CO2

Answer 90

gram-positive cocci (GPC), especially from wound & stool culture

Answer 91

Colistin & nalidixic acid suppress most gram-negative (GN) -contains 5% sheep blood but should not be used to observe hemolytic reactions.

Answer 92

gram-positive cocci (GPC) & anaerobic gram-negative rods (GNR)

Answer 93

Phenylethyl alcohol inhibits enteric GNR -contains 5% sheep blood

Answer 94

enrichment & selective

Answer 95

fastidious and non-fastidious organisms (anaerobes included)

Answer 96

useful for culturing streptococci, pneumococci, and meningococci

Answer 97

vancomycin VRE = vancomycin-resistant enterococci

Answer 98

selective & differential

Answer 99

enteric gram negative rods (GNR)

Answer 100

-eosin & methylene blue inhibit gram positive (GP) -LF = green-black or purple -E.coli = green metallic sheen -NLF = colorless or light purple

Answer 101

selective & differential

Answer 102

enteric gram negative rods (GNR)

Answer 103

-bile salts & crystal violet inhibits most GP -LF = pink -NLF = colorless

Answer 104

*E. coli* 0157:H7

Answer 105

-Doesn't ferment sorbitol = colorless colonies -Some labs have stopped using because non-0157 serotypes can be pathogens

Answer 106

selective & differential

Answer 107

*Salmonella* & *Shigella* in stool

Answer 108

-Bile salts, bromothymol blue, & acid fuchsin inhibit normal GI flora -Nonpathogens = orange to salmon pink -NLF = green to blue-green -H2S pos colonies = black precipitate

Answer 109

selective & differential

Answer 110

*Salmonella* & *Shigella* in stool

Answer 111

-Deoxycholate inhibits many GNR & GP -4 types of colonies: 1. yellow (e.g., *E. coli*) 2. yellow with black centers (e.g., some *Proteus* species) 3. colorless or red colonies (e.g., *Shigella*) 4. red colonies with black centers (e.g., *Salmonella*) -Some shigellae may be inhibited. -Some salmonellae may not produce H2S

Answer 112

*Salmonella & Shigella* in stool

Answer 113

-brilliant green & bile salts inhibit other enterics. -*Salmonella & Shigella* DO NOT ferment lactose - colorless colonies -*Salmonella* produces H2S (black center)

Answer 114

*Salmonella* & *Shigella*

Answer 115

other non-pathogenic enterics

Answer 116

enrichment

Answer 117

*Campylobacter* from stool, wound cultures

Answer 118

Campy-selective agar after overnight incubation at 4*C

Answer 119

Enrichment & selective

Answer 120

*Campylobacter* from stool

Answer 121

Incubate plates in 5% CO2 at 42*C

Answer 122

Vancomycin Colistin Nystatin Trimethoprim (TMP)

Answer 123

inhibit growth of normal genital flora -some *N. gonorrhoeae* may be inhibited

Answer 124

incubate in increased CO2

Answer 125

similar to Thayer-Martin, but different antibiotics - inhibits YEAST better

Answer 126

incubate in increased CO2

Answer 127

incubate in increased CO2

Answer 128

Some *N. gonorrhoeae* are inhibited by antibiotics. Genital mycoplasmas will grow.

Answer 129

Contains antibiotics to inhibit gram positive & gram negative bacteria and yeast

Answer 130

For transportation & growth of *N. gonorrhoeae*

Answer 131

Plates contain *Neisseria*-selective medium & come with resealable polyethylene bag & CO2-generating tablet. --NO need to transfer to a culture plate.

Answer 132

1. Modified Thayer-Martin (MTM) 2. Martin-Lewis 3. New York City medium (NYC) 4. GC-LECT 5. JEMBEC plates

Answer 133

Differential medium for isolation of *Corynebacterium diphtheriae*

Answer 134

*C. diphtheriae* produces dark grey to black colonies.

Answer 135

Enrichment medium for *C. diphtheriae*

Answer 136

promotes development of metachromatic granules

Answer 137

selective differential medium for *C. diphtheriae*

Answer 138

*Corynebacterium* spp. produce gray to black colonies due to reduction of tellurite. -*C. diphtheriae* colonies are surrounded by a brown halo.

Answer 139

-selective for *Salmonella* -inhibits most others

Answer 140

*S. typhi* colonies are black, surrounded by metallic sheen. -others are light green -Some salmonellae may be inhibited

Answer 141

Selective medium for *Yersinia enterocolitica*, *Aeromonas*, & *Plesiomonas shigelloides*

Answer 142

-Crystal violet inhibits most gram negatives. -Novobiocin inhibits gram positive cocci -Cefsulodin inhibits most gram positives & gram negatives

Answer 143

*Y. enterocolitica* ferments mannitol, appears as red "bull's-eye" colonies surrounded by colorless halo.

Answer 144

Enrichment media for recovery of *Vibrio* from stool

Answer 145

-Alkaline pH suppresses commensals -Subcultured to thiosulfate citrate bile salts sucrose (TCBS)

Answer 146

Selective for *Vibrio*

Answer 147

inhibits most bacteria

Answer 148

-*V. cholerae* ferments sucrose, produces yellow colonies -*V. parahaemolyticus* & *V. vulnificus* DO NOT ferment sucrose; usually produce blue-green colonies

Answer 149

Selective enrichment medium for isolation of *Bordetella pertussis*

Answer 150

-Potato-glycerol-based medium enriched with blood. -Contaminants inhibited by methicillin.

Answer 151

*Bordetella* colonies resemble mercury droplets.

Answer 152

"Cough plate."

Answer 153

Selective for *B. pertussis*

Answer 154

Charcoal agar supplemented with horse blood, cephalexin, & amphotericin B.

Answer 155

Enrichment medium for isolation of *Legionella*

Answer 156

-Yeast extract & L-cysteine enhance growth of *Legionella*. -Charcoal absorbs toxic compounds.

Answer 157

Selective & differential for *G. vaginalis*

Answer 158

Incubate in increased CO2 for 48 hours.

Answer 159

*G. vaginalis* colonies are beta hemolytic.

Answer 160

Detect emerging antibiotic-resistant pathogens such as extended-spectrum beta-lactamase (ESBL) - producing *E.coli*, methicillin-resistant *Staphylococcus aureus* (MRSA), and carbapenemase-producing *Enterobacteriaceae*

Answer 161

Chromogens are released if specific enzymes produced by target organism are present.

Answer 162

-Growth -No growth -Growth

Answer 163

-No growth -No growth -Growth

Answer 164

-Growth -Growth -Growth

Answer 165

-No growth -Growth -No growth

Answer 166

-No growth -Growth -Growth

Answer 167

1. *Campylobacter* (10-15% CO2) 2. *Haemophilus* (5-10% CO2) 3. *Helicobacter* (5-10% CO2) 4. *Moraxella catarrhalis* (5% CO2) 5. *Mycobacterium* (5-10% CO2) 6. Pathogenic *Neisseria* (5-10% CO2)

Answer 168

-green zone around colony; may be narrow or wide -partial lysis of RBCs -*Streptococcus pneumoniae* & viridans streptococci

Answer 169

-clear zone around colony; may be narrow or wide -complete lysis of RBCs -Group A strep (GAS), group B strep (GBS), *Listeria monocytogenes*

Answer 170

-no zone of hemolysis -no lysis of RBCs -*Enterococcus faecalis*

Answer 171

gram positive cocci - usually in clusters

Answer 172

1-3 mm round smooth convex glistening opaque entire edge butyrous (butter-like)

Answer 173

-catalase positive -fermentative -modified oxidase (microdase) negative -resistant to bacitracin -Matrix-assisted laser desorption ionization-time of flight (MALD-TOF) mass spectrometry routinely used for ID of isolates

Answer 174

skin mouth pharynx vagina urethra GI tract

Answer 175

facultative anaerobe

Answer 176

Grows on most non-selective media

Answer 177

salt tolerant

Answer 178

Causes suppurative cutaneous infections, toxic shock syndrome, food poisoning

Answer 179

gram positive cocci - usually in clusters

Answer 180

-most are beta hemolytic (small zone) -may be golden

Answer 181

-coagulase positive -ferments mannitol (yellow color with mannitol salt agar (MSA)) -usually DNase positive

Answer 182

85-90% resistant to penicillin

Answer 183

-strains are common -methicillin resistance is mediated by the mecA gene or its homologs and is the most important resistance mechanism

Answer 184

B. *S. aureus*

Answer 185

-opportunistic pathogen -causes nosocomial infections due to contamination of inserted or implanted medical devices

Answer 186

gram positive cocci - usually in clusters

Answer 187

-white to slightly yellow -usually non-hemolytic

Answer 188

-coagulase negative -grows on MSA but does NOT ferment mannitol -sensitive to novobiocin

Answer 189

B. *S. epidermidis*

Answer 190

-UTI in young sexually active females -Urethritis & prostatitis in males

Answer 191

gram positive cocci - usually in clusters

Answer 192

-white to slightly yellow -non-hemolytic

Answer 193

-coagulase negative -resistant to novobiocin -may ferment mannitol

Answer 194

C. novobiocin sensitivity -*S. epidermidis* is sensitive to novobiocin -*S. saprophyticus* is resistant to novobiocin -*S. saprophyticus may or may not ferment mannitol; S. epidermidis does NOT ferment mannitol. -Both are coagulase negative

Answer 195

Only when coagulase-negative staphylococci (CNS) are isolated from the urine of a female.

Answer 196

-usually non-pathogenic -found in environment and on skin & mucous membranes

Answer 197

Large gram positive cocci in pairs or tetrads (predominant arrangement)

Answer 198

-often pigmented (bright yellow, orange, pink, tan) -high-domed colonies

Answer 199

-catalase positive -coagulase negative -oxidative -Modified oxidase (microdase) positive -most urease positive -resistant to furazolidone & lysostaphin (in contrast to most staphylococci)

Answer 200

B. modified oxidase (microdase)

Answer 201

usually grow aerobically

Answer 202

Micrococcus luteus Micrococcus lylae

Answer 203

1. Catalase 2. Coagulase 3. Slide agglutination tests for *S. aureus* 4. MSA 5. Rapid latex and hemagglutinin assays 6. MALDI-TOF

Answer 204

Enzyme catalase converts 3% hydrogen peroxide (H2O2) to oxygen & water. Immediate bubbling.

Answer 205

Staphylococcus & micrococcus are catalase positive

Answer 206

Bubbles after 20-30 seconds are NOT considered a positive reaction. Catalase from RBCs in blood agar may produce weak bubbles.

Answer 207

Enzyme coagulase causes coagulation (tube test) or agglutination (slide test) in plasma.

Answer 208

*S. aureus* is coagulase positive.

Answer 209

Slide test is a screening test - detects bound coagulase (clumping factor). -If negative, a tube test should be performed - detects free coagulase. **Largely replaced by latex agglutination tests**

Answer 210

Agglutination of latex beads coated with fibrinogen & antibodies to protein A (protein in cell wall of *S. aureus*).

Answer 211

*S. aureus* positive

Answer 212

Most labs report positive organisms as *S. aureus*.

Answer 213

Fermentation of mannitol results in color change from pink to yellow.

Answer 214

*S. aureus* positive

Answer 215

They all can grow on MSA.

Answer 216

because other species ferment mannitol

Answer 217

Latex agglutination slide-card tests to detect coagulase and/or protein A associated with *S. aureus* & MRSA

Answer 218

*S. aureus* positive

Answer 219

High sensitivity but relatively low specificity. -May get false-positive with coagulase-negative staph.

Answer 220

A type of mass spectrometry good for analyzing biomolecules like peptides, lipids, and saccharides.

Answer 221

Rapid and specific ID of staphylococci and other catalase-positive cocci.

Answer 222

ID of staphylococci at species levels is >97% but lower for coagulase-negative staph.

Answer 223

Oval gram positive cocci in chains & pairs

Answer 224

-<1mm -white to gray -translucent or semi-opaque -variable hemolysis

Answer 225

Catalase negative -differentiates for staph

Answer 226

Facultative anaerobes

Answer 227

-require enriched media -chaining best in broth cultures

Answer 228

-causes 90% of strep infections -Strep sore throat -rheumatic fever -glomerulonephritis -scarlet fever -erysipelas -puerperal sepsis -impetigo

Answer 229

oval gram positive cocci in chains

Answer 230

-pinpoint -grayish white -translucent -usually beta hemolytic (wide zone)

Answer 231

-sensitive to bacitracin -pyrrolidonyl aminopeptidase (PYR) positive

Answer 232

*S. pyogenes*

Answer 233

O2-stable streptolysin S & O2-labile streptolysin O.

Answer 234

Immunoassay for Lancefield group A or MALDI-TOF

Answer 235

-normal flora of female genital tract -most common cause of neonatal septicemia & meningitis

Answer 236

oval gram positive cocci in chains

Answer 237

-slightly larger than GAS -gray-white -narrow zone of diffuse beta hemolysis -may be non-hemolytic

Answer 238

-resistant to bacitracin -sodium hippurate positive -CAMP positive

Answer 239

Vaginal & rectal swabs collected from pregnant women at 35-37 weeks gestation

Answer 240

Inoculated in selective broth, e.g., LIM, GBS broth

Answer 241

Nucleic acid amplification tests (NAATs)

Answer 242

-colonizes upper respiratory tract of some children -most common cause of community acquired pneumonia -major cause of otitis media & meningitis in adults -infects sinuses and eyes

Answer 243

-football-shaped (lancet-shaped) gram positive cocci -usually in pairs -may be single or in short chains -frequently encapsulated

Answer 244

-round -translucent -glistening -dome-shaped when young -central depression with age (umbilicate) due to autolysis -Alpha hemolytic -Encapsulated strains are mucoid

Answer 245

-bile solubility positive -sensitive to optochin

Answer 246

MALDI-TOF can be used

Answer 247

-normal flora of upper respiratory tract but can cause pharyngitis (throat infection)

Answer 248

oval gram positive cocci in clusters & pairs

Answer 249

beta-hemolytic

Answer 250

-resistant to bacitracin -PYR positive

Answer 251

Indistinguishable from pharyngitis caused by *S. pyogenes*.

Answer 252

-normal in oral, respiratory, & GI mucosa -opportunistic pathogens -frequent cause of subacute bacterial endocarditis, bacteremia, sepsis, and abscesses.

Answer 253

gram positive cocci in chains

Answer 254

-alpha hemolytic (*S. mitis* group) -non-hemolytic (*S. salivarius* and *S. bovis* group) -beta-hemolytic (*S. anginosus* group)

Answer 255

-*S. mutans* group - ferments sorbitol -Bile solubility negative -*S. bovis* is bile esculin positive

Answer 256

-normal in mouth, GI tract, & male genital tract -causes nosocomial UTI, wound infections, endocarditis, & bacteremia

Answer 257

oval gram positive cocci in pairs, chains

Answer 258

*E. faecium* - alpha or non-hemolytic -Some strains of *E. faecalis* may be beta-hemolytic

Answer 259

-catalase negative -hydrolyzes esculin -grows in 6.5% NaCl broth -PYR positive

Answer 260

Vancomycin -VRE are a significant public health concern. -VRE fecal surveillance culture is often done for early detection

Answer 261

chromogenic agar

Answer 262

1. Bacitracin disk 2. MALDI-TOF 3. PYR test 4. CAMP test 5. Hippurate hydrolysis 6. Slide agglutination tests

Answer 263

Zone of inhibition after overnight incubation = susceptibility to bacitracin

Answer 264

-Group A strep susceptible -Group B strep resistant

Answer 265

-also known as A disk -performed on SBA -no longer recommended because some groups C & G are susceptible -replaced by PYR & serogrouping by latex agglutination

Answer 266

A type of mass spectrometry good for identifying biomolecules like peptides, lipids, and saccharides.

Answer 267

Reliable for *S. pyogenes*, *S. agalactiae*, & *S. pneumoniae*

Answer 268

If PYR is hydrolyzed = red color after addition of color developer

Answer 269

group A strep are positive

Answer 270

bacitracin disk test

Answer 271

Group B strep produces extracellular protein that enhances hemolysis of beta-hemolytic *S. aureus* on SBA

Answer 272

group B strep is positive

Answer 273

-unknown is streaked perpendicular to a streak of beta-lysin producing *S. aureus*. -incubated in ambient air overnight -FALSE POSITVE in CO2 -Arrowhead hemolysis - where inoculum lines meet -Disk containing beta-lysin can be used instead of *S. aureus*

Answer 274

A drop of beta-lysin on colonies on SBA. -only requires 20 minute incubation

Answer 275

1. Hippurate hydrolysis 2. Slide agglutination tests

Answer 276

Organisms that produce hippuricase (hippurate hydrolase) hydrolyze sodium hippurate to benzoate & glycine.

Answer 277

group B strep positive

Answer 278

Alternative to CAMP. -2 hr test available

Answer 279

Latex particles coated with group-specific antibodies agglutinate in the presence of bacterial antigens.

Answer 280

Organisms agglutinate in corresponding antisera

Answer 281

groups A, B, C, D, F, G strep, & *S. pneumoniae*

Answer 282

1. Optochin disk 2. Bile solubility

Answer 283

Zone of inhibition >=14 mm with 6-mm disk OR >=16 mm with 10-mm disk = susceptibility to optochin

Answer 284

-*S. pneumoniae* susceptible -Viridans strep resistant

Answer 285

-also known as P disk -contains ethylhydrocupreine hydrochloride -Method: Placed on lawn of inoculum on SBA. Plates incubated overnight in CO2. If zone of inhibin is <14 mm, ID organisms as *S. pneumoniae* only if bile soluble.

Answer 286

Bile salts (e.g., sodium deoxycholate) causes lysis of some organisms

Answer 287

*S. pneumoniae* positive

Answer 288

-can be performed in broth or on colony -POS = clearing of broth or disappearance of colony -results in 30 seconds or less

Answer 289

-resistant to penicillin -susceptible to cephalosporin & vancomycin

Answer 290

-resistant to all beta-lactams (penicillin, ampicillin, and cephalosporin)

Answer 291

-universally susceptible to penicillin, cephalosporins, vancomycin

Answer 292

Susceptible to penicillin, cephalosporins, vancomycin

Answer 293

variable - may be done when isolated from baby

Answer 294

-increasingly resistant to penicillin -Susceptible to vancomycin

Answer 295

*E. faecium* -usually resistant to penicillin & several other commonly used antibiotics -most are susceptible to vancomycin *E. faecium -vancomycin resistant (VRE)

Answer 296

usually contaminants

Answer 297

-large with square ends -may be in chains -oval, central to subterminal spores that aren't swollen -looks like bamboo -spores may not be seen in direct smear

Answer 298

-large spreading beta-hemolytic colonies with irregular edges (MEDUSA HEAD) -whitish gray -may be pigmented

Answer 299

-catalase positive -most are motile

Answer 300

Must rule out *B. anthracis* -often done via PCR

Answer 301

-one of the most highly pathogenic microorganisms -causes anthrax -contracted from contaminated hides, wool, meat

Answer 302

-large with square ends -may be in chains -oval, central to subterminal spores that aren't swollen -looks like bamboo -spores may not be seen in direct smear

Answer 303

-large -adherent -NON-HEMOLYTIC -flat to slightly convex -irregular border -GROUND GLASS appearance -comma shaped projections -stands up like BEATEN EGG WHITE when touched with loop

Answer 304

-NON-HEMOLYTIC (beta-hydrolysis rules out) -catalase positive -NON-MOTILE -capsules are seen in CSF & blood smears

Answer 305

Most strains are susceptible to penicillin.

Answer 306

-often environmental contaminant -can cause focal & systemic infections, food poisoning

Answer 307

-large with square ends -may be in chains -oval, central to subterminal spores that aren't swollen -looks like bamboo -spores may not be seen in direct smear

Answer 308

-large -adherent -HEMOLYTIC -flat to slightly convex -irregular border -GROUND GLASS appearance -comma shaped projections -stands up like BEATEN EGG WHITE when touched with loop

Answer 309

-hemolytic -motile

Answer 310

-normal on skin & mucous membranes -opportunistic pathogen

Answer 311

-irregular -slightly curved -non-paralleled sides -CLUB-SHAPED ends -if taken from fluid, they can arrange in PALLISADES or clusters with angular V-shaped forms

Answer 312

-facultative anaerobes -grow on most media

Answer 313

DIPTHEROIDS - because they resemble *C. diphtheriae*

Answer 314

-catalase positive -non-motile

Answer 315

Diphtheria

Answer 316

-irregular -slightly curved -non-paralleled sides -CLUB-SHAPED ends -if taken from fluid, they can arrange in PALLISADES or clusters with angular V-shaped forms

Answer 317

-Tindale agar: gray-black colonies with brown halos -Cystine tellurite agar: black colonies

Answer 318

-catalase positive -non-motile -toxin producing

Answer 319

-demonstration of toxin production PCR or MALDI-TOFF are used for ID but must be followed up with ELEK immunoprecipitation test to confrim toxin production

Answer 320

-closely releated to *C. diphtheriae* -also contains the TOX gene and can cause diphtheriae

Answer 321

hospital-acquired pathogen

Answer 322

-irregular -slightly curved -non-paralleled sides -CLUB-SHAPED ends -if taken from fluid, they can arrange in PALLISADES or clusters with angular V-shaped forms

Answer 323

Same as other commensal corynebacteria

Answer 324

-catalase positive -rapid sucrose urea (RSU) negative

Answer 325

multidrug resistant (MDR)

Answer 326

C. *C. jeikeium*

Answer 327

-able to cross the placenta and can infect the fetus causing preterm labor and other complications resulting in fetal loss up to 24% -meningitis & septicemia in newborns & immunocompromised -food poisoning with mortality ranges up to 50%

Answer 328

-parallel sides -rounded ends -coccobacillary -singles or short chain arrangement

Answer 329

-tiny colonies with narrow zone of indistinct beta hemolysis -translucent, gray

Answer 330

-catalase positive -hippurate hydrolysis positive -esculin positive -CAMP positive (hemolysis looks like SHOVEL, not arrowhead) -TUMBLING motility on wet mount -UMBRELLA growth in motility agar at room temperature but not at 35*C.

Answer 331

-grows from 0.5*C-45*C -cold enrichment may be used -catalase differentiates from group B strep -motility (tumbling) differentiates from diphtheroids (non-motile) -MALDI-TOF can be used for ID

Answer 332

-immunocompetent: skin infection -immunocompromised: invasive pulmonary & disseminated infections

Answer 333

-aerobic actinomycetes -fine branching filaments with fragmentation -often beaded

Answer 334

-slow growing -SBA: --wrinkled --dry --crumbly --chalky white to orange-tan --beta hemolytic

Answer 335

-catalase positive -partially ACID FAST -SULFUR granules

Answer 336

*N. brasiliensis* *N. pseudobrasiliensis* *N. abscessus*

Answer 337

*Nocardia* isolates may be identified and reported at "complex" or "group" level.

Answer 338

-gram negative DIPLOCOCCI (GNDC) OR single COFFEE-BEAN shaped

Answer 339

-aerobic OR facultative -pathogens are CAPNOPHILIC

Answer 340

-catalase positive -oxidase positive

Answer 341

-gonorrhea -salpingitis -ophthalmia of newborn

Answer 342

-intracellular & extracellular GNDC --diagnostic in urethral discharge from symptomatic males --culture confirmation required for females

Answer 343

-requires increased CO2 -usually does NOT grow on SBA -grows on CHOC & *Neisseria*-selective media -colonies are small, grayish white or tan -may look like mixed culture

Answer 344

-oxidase positive -carbohydrate utilization: GLUCOSE only

Answer 345

-susceptible to drying & cold -culture used for presumptive ID -definitive ID: monoclonal antibodies -NAATs can be used on male urine specimens with high sensitivity but should NOT be used with oropharyngeal, rectal, ocular, or pediatric patients

Answer 346

-normal flora in upper respiratory tract -always pathogenic when recovered from usually sterile body fluids such as blood or CSF -common cause of meningitis in young adults

Answer 347

-intracellular & extracellular GNDC -a gram stain of CSF is required for all cases of suspected bacterial meningitis sent to the lab

Answer 348

-grows on SBA, CHOC, & *Neisseria*-selective media -colonies are grey, convex, glistening, & occasionally mucoid

Answer 349

-carbohydrate utilization: GLUCOSE & MALTOSE -O-nitrophenyl-beta-D-galactopyranoside (ONPG) NEGATIVE

Answer 350

-normal in upper respiratory tract -rarely cause disease

Answer 351

-grow on SBA & CHOC at RT -grow on nutrient agar at 35*C -some grow on *Neisseria*-selective media -DO NOT require increased CO2 -may be pigmented

Answer 352

varies with species

Answer 353

-not speciated if from respiratory tract -must differentiate from pathogenic *Neisseria* when isolated on selective media or from normally sterile body site -*N. lactamica* is easily confused with *N. meningitidis* but *N. lactamica* acidifies lactose in addition to glucose

Answer 354

-normal in upper respiratory tract -causes respiratory infections in young, old, & immunocompromised -causes otitis media & sinusitis in children

Answer 355

-grows on SBA & CHOC -some may grow at RT &/or on *Neisseria*-selective media -"HOCKEY PUCK colonies" - colonies can be pushed over agar surface with a loop

Answer 356

-catalase positive -oxidase positive -carbohydrate utilization: NEG for all sugars -ONPG negative -DNase positive -butyrate esterase positive

Answer 357

DNase & butyrate esterase differentiate from *Neisseria* spp.

Answer 358

Non-spore-forming GNRs

Answer 359

Non-spore-forming GNRs

Answer 360

facultative anaerobes

Answer 361

most are large, dull, gray, non-hemolytic

Answer 362

-lactose fermenters = pink -non-lactose fermenters = colorless

Answer 363

-ferment GLUCOSE -oxidase negative -most reduce nitrates to nitrites -most are catalase positive

Answer 364

1. Oxidase 2. nitrate reduction 3. carbohydrate fermentation 4. ONPG 5. H2S production 6. Triple sugar iron (TSI) agar 7. Indole 8. Methyl red (MR) 9. Voges-Proskauer (VP) 10. Citrate 11. Urease 12. Phenylalanine deaminase (PD) 13. Decarboxylase reactions 14. motility

Answer 365

tetramethyl-para-phenylenediamine dihydrochloride reacts with cytochrome C to produce a blue or purple color

Answer 366

Positive = blue or purple color

Answer 367

-good test to differentiate Enterobacterales from non-fermenters -false positive from iron-containing wire - use platinum or wooden stick

Answer 368

If organism reduces nitrates to nitrites, a RED color develops when sulfanic aicd & *N,N*-dimethyl-L-naphthylamine added

Answer 369

Positive = red, OR no color after addition of zinc dust

Answer 370

If no color develops (red = pos), zinc dust is added. It reduces nitrates. -RED color AFTER zinc dust = presence of nitrates (NEG REACTION) -NO COLOR after zinc dust means nitrates reduces to N2 or NO2 (POS REACTION)

Answer 371

when carbohydrate is fermented, acidic end products cause color change in pH indicator

Answer 372

with phenol red indicator = change from red to yellow

Answer 373

-frequently tested carbohydrates are glucose, lactose, sucrose, mannose, sorbitol, mannitol, xylose, adonitol, cellobiose, dulcitol, trehalose -All Enterobacterales ferment GLUCOSE

Answer 374

ONPG is changed to orthonitrophenol by beta-galactosidase

Answer 375

positive = yellow

Answer 376

-test for slow lactose fermentation -helpful in differentiating *Citrobacter* (positive) from most *Salmonella* (negative).

Answer 377

-organisms that possess H2S-producing enzymes produce colorless H2S gas from sulfur containing compounds -H2S reacts with iron salt in medium to form black ferrous sulfide

Answer 378

black precipitate

Answer 379

-sulfur-containing compounds = sodium thiosulfate, cystine, methionine -good test to differentiate *Salmonella* (H2S positive) from *Shigella* (H2S negative).

Answer 380

sugar fermentation produces acid = changes color of pH indicator

Answer 381

Yellow = acid (A) Pink = alkaline (K) Pink butt = glucose NOT fermented Yellow butt = glucose fermented Pink slant = lactose/sucrose NOT fermented Yellow slant = lactose and/or sucrose fermented Black precipitate = H2S produced Bubbles = gas production

Answer 382

-contains 0.1% glucose, 1% lactose, 1% sucrose, phenol red, sodium thiosulfate, iron salt -leave cap slightly loose -record as slant/butt, e.g., K/A [some record NC = no change (for pink butt] -Kligler iron agar (KIA) is same except NO sucrose

Answer 383

-tryptophanase deaminates tryptophan = indole produced -Kovacs reagent (paradimethylaminobenzaldehyde) forms pink-colored complex with indole

Answer 384

positive = pink

Answer 385

-commercially available -need source of tryptophan -use colonies from SBA or CHOC agar, not MAC -positive = blue -*E. coli* & *Proteus vulgaris* are positive

Answer 386

-acid products formed when glucose is metabolized by mixed acid fermentation pathway -color changes pH indicator

Answer 387

positive = red color after addition of MR (pH indicator)

Answer 388

acetoin is produced from alternate pathway for glucose metabolism

Answer 389

positive = red color when alphanaphthol & KOH added

Answer 390

organisms that are VP positive are usually MR negative & vice versa

Answer 391

if organism can use citrate as sole source of carbon, pH increases, and pH indicator changes color

Answer 392

positive = green to blue, or growth

Answer 393

false negative if cap is NOT loose

Answer 394

*Klebsiella* & *Enterobacter* are positive

Answer 395

-urease breaks down to urea -ammonia released, pH increased, pH indicator changes color

Answer 396

positive = yellow to pink

Answer 397

*Proteus* & *Morganella*

Answer 398

PD deaminates phenylalanine to phenylpyruvic acid, which reacts with ferric chloride to produce a green color.

Answer 399

positive = green color after addition of ferric chloride

Answer 400

-*Proteus* -*Providencia* -*Morganella*

Answer 401

if organism has enzyme to decarboxylate amino acid (e.g., ornithine, lysine, arginine), pH increases, pH indicator changes color -Ornithine decarboxylase (ODC)

Answer 402

positive = yellow to purple

Answer 403

motile organisms grow away from stab line in motility medium

Answer 404

positive: -movement away from stab line OR -hazy appearance throughout medium after overnight incubation

Answer 405

most Enterobacterales are positive, EXCEPT *Klebsiella* & *Shigella*

Answer 406

Differentiates: -*Klebsiella* (neg) from *Enterobacter* (pos) AND -*Shigella* (neg) from *Salmonella* (pos)

Answer 407

-somatic antigen -cell wall -lipopolysaccharide, heat stable -used for serological grouping of *Salmonella* & *Shigella*

Answer 408

-flagellar antigen -flagella -proteins, heat labile -used to serotype *Salmonella*

Answer 409

-capsular antigen -capsule -polysaccharide, heat labile, may mask O antigen; removed by heating -role in preventing phagocytosis = increased virulence -Vi antigen is K antigen produced by *S. typhi*

Answer 410

-UTI -septicemia -neonatal sepsis -meningitis -diarrhea (some)

Answer 411

-lactose -gas -indole -MR -motility

Answer 412

-H2S -VP -citrate -PD -urease

Answer 413

C. *E. coli*

Answer 414

A. *E. coli*

Answer 415

green metallic sheen

Answer 416

-lactose positive -dry colony on MAC -oxidase negative -indole positive

Answer 417

-does NOT ferment sorbitol -colorless colonies on SMAC

Answer 418

-dysentery (shigellosis) -most communicable of bacterial diarrheas -found primarily in crowded or substandard conditions, e.g., day-care centers, jails, prisons

Answer 419

-lactose -gas -H2S -citrate -PD -urease -motility

Answer 420

-blood -mucus -neutrophils

Answer 421

*S. dysenteriae*

Answer 422

*S. sonnei*

Answer 423

O antigens

Answer 424

A, B, C, D

Answer 425

*Escherichia*

Answer 426

-Typhoid (enteric) fever -bacteremia -enterocolitis

Answer 427

-H2S -MR -motility -lysine decarboxylase (LDC)

Answer 428

-lactose -indole -VP -PD -urease -ONPG

Answer 429

-Vi antigen -only trace H2S -citrate negative

Answer 430

-grouped by O antigens (e.g., A, B, C) -serotyped by H antigens (e.g., 1, 2)

Answer 431

-diarrhea -hemorrhagic colitis -hemolytic uremic syndrome (HUS) -most common cause of renal failure in children in the US -may be fatal, especially in young or elderly

Answer 432

-undercooked meat -raw milk -apple cider

Answer 433

toxins (verotoxins or Shiga toxins)

Answer 434

RBCs but usually no segmented neutrophils

Answer 435

-most common isolate of group -pathogen most often isolated from bloody stools

Answer 436

ID genes that code for toxins

Answer 437

-traveler diarrhea -diarrhea in infants

Answer 438

contaminated food or water

Answer 439

no segmented neutrophils or RBCs

Answer 440

profuse, watery stool

Answer 441

detect toxins or toxin genes

Answer 442

-bloody diarrhea -dysentery-like -usually in young children in areas of poor sanitation

Answer 443

contaminated food or water

Answer 444

invasiveness

Answer 445

-segmented neutrophils -RBCs -mucus

Answer 446

-diarrhea in infants -major pathogen in infants in developing countries

Answer 447

formula & food contaminated with fecal material

Answer 448

adherence-attachment

Answer 449

no segmented neutrophils or RBCs

Answer 450

watery diarrhea with mucus

Answer 451

-diarrhea in developing countries -chronic diarrhea in HIV-infected patients

Answer 452

nosocomial & community acquired

Answer 453

adherence-attachment

Answer 454

-diarrhea & UTI -most common in children in developing countries

Answer 455

little known about epidemiology

Answer 456

adherence-attachment

Answer 457

-pneumonia -UTI -septicemia -Carbapenem-resistant -significant pathogen in both community and hospital settings

Answer 458

-lactose -gas -VP -citrate -urease (slow)

Answer 459

-H2S -indole -MR -PD -motility -ODC

Answer 460

colonies are usually mucoid

Answer 461

similar to *K. pneumoniae* EXCEPT indole positive

Answer 462

-motility -ODC

Answer 463

-nosocomial infections -UTI is most common site of infection

Answer 464

-gas -H2S -MR -citrate -motility -ONPG

Answer 465

-VP -PD -LDC

Answer 466

lactose variable

Answer 467

-ONPG -LDC

Answer 468

-opportunistic -can cause bacteremia, wound, and GI infections -environmental risk factors include exposure to brackish water or undercooked fish

Answer 469

-gas -H2S -indole -MR -motility

Answer 470

-lactose -VP -citrate -PD -urease

Answer 471

positive indole

Answer 472

-opportunistic & nosocomial infections -UTI -respiratory tract infection (RTI) -wound infections

Answer 473

-VP -ONPG -ODC -citrate -motility -gas

Answer 474

-H2S -indole -MR -PD

Answer 475

colonies may be mucoid

Answer 476

-nosocomial infections from contaminated medical devices and instruments

Answer 477

-ODC -VP -sucrose

Answer 478

-oxidase -H2S -indole

Answer 479

frequently antibiotic resistant (intrinsic and plasma-based)

Answer 480

-opportunistic pathogen -UTI (indwelling catheters) -ocular -GI tract in children

Answer 481

-VP -citrate -motility

Answer 482

-lactose -H2S -indole -PD -urease

Answer 483

red pigment

Answer 484

-UTI -wound infections -septicemia

Answer 485

-H2S -MR -PD -urease -motility

Answer 486

-swarming -burned chocolate odor

Answer 487

*P. mirabilis* - indole negative *P. vulgaris* - indole positive

Answer 488

A/A - because of sucrose fermentation

Answer 489

-mainly nosocomial infections -UTI -wound infections

Answer 490

-indole -MR -PD -urease (weak) -motility -ODC

Answer 491

-lactose -H2S -VP -citrate

Answer 492

-UTI -diarrhea

Answer 493

-indole -MR -citrate -PD -motility

Answer 494

-lactose -H2S -VP

Answer 495

*P. rettgeri* is urease positive

Answer 496

*P. stuartii*

Answer 497

-MR -urease -ONDC

Answer 498

-lactose -H2S -VP (variable) -citrate -PD

Answer 499

-gram negative coccobacilli -bipolar staining

Answer 500

motile at 25*C but NOT 35*C

Answer 501

-CIN agar is selective -incubate 48 hours -red "BULL'S EYE" colonies surrounded by colorless halo

Answer 502

*Y. pestis*

Answer 503

-*Shigella* -*Edwardsiella* -*Salmonella* -*Citrobacter* (some) -*Serratia* -*Proteus* -*Morganella* -*Providencia* -*Yersinia*

Answer 504

-*Edwardsiella* -*Salmonella* -*Citrobacter* -*Proteus*

Answer 505

-*Klebsiella* -*Enterobacter* -*Serratia*

Answer 506

-*Proteus* -*Morganella* -*Providencia* -*Klebsiella* (slow)

Answer 507

-*Proteus* -*Morganella* -*Providencia rettgeri* -some species of *Citrobacter*

Answer 508

-*Shigella* -*Klebsiella* -*Yersinia* (motile at 22*C)

Answer 509

flat, dry pink colony with darker pink halo

Answer 510

K/A, gas, H2S

Answer 511

red, yellow, or colorless with or without black centers

Answer 512

A/A or K/A, gas, with or without H2S

Answer 513

-colorless at 24 hrs -may become pink at 48 hrs

Answer 514

red, yellow, or colorless with or without black centers

Answer 515

K/A, gas, H2S

Answer 516

red with black center

Answer 517

pink, mucoid

Answer 518

pink, may be mucoid

Answer 519

-colorless at first, turning pink -*S. marcescens* may have red pigment at RT

Answer 520

yellow or colorless

Answer 521

-K/A (*P. mirabilis) -A/A (*P. vulgaris) -gas, H2S

Answer 522

colorless, may swarm

Answer 523

yellow or colorless, with or without black centers

Answer 524

red or colorless

Answer 525

yellow or colorless

Answer 526

Yellow/orange

Answer 527

colorless to peach

Answer 528

yellow or colorless

Answer 529

obligate aerobes

Answer 530

K/K - they do NOT ferment carbohydrates

Answer 531

may be oxidizers or non-oxidizers (asaccharolytic)

Answer 532

either open tube pos/closed tube neg (oxidizer) OR open tube neg/closed tube neg (non-oxidizer)

Answer 533

grow in 24-48 hours

Answer 534

appear as non-lactose-fermenters

Answer 535

-most are oxidase positive -differentiates from Enterobacterales

Answer 536

resistant to a variety of antibiotics

Answer 537

-usually not normal flora-important cause of nosocomial infections, e.g., burn, wound, RTI, UTI, bacteremia -causes SWIMMER'S EAR & contact lens KERATITIS -predominant respiratory pathogen in patients with CYSTIC FIBROSIS

Answer 538

-long, thin, pale-staining GNR -slightly pointed or rounded ends

Answer 539

SBA: -flat spreading colonies -usually beta hemolytic -dull gray or blue-green -METALLIC SHEEN Grows on MAC & EMB (lactose neg)

Answer 540

-oxidase positive -catalase positive -motile -grows at 42*C -GRAPE-LIKE odor -only non-fermenter to produce PYOCYANIN (4% don't) -also produces pyoverdin (fluorescent pigment) -resistant to many antibiotics

Answer 541

-part of normal flora of skin, pharynx in some -opportunistic pathogen -nosocomial infections, e.g., UTI, pneumonia, septicemia, meningitis -2nd to *P. aeruginosa* in frequency -most common = *A. baumannii*

Answer 542

-pleomorphic gram-negative coccobacilli (GNCB) in singles, pairs, short chains -can be confused with *N. gonorrhoeae*, *Moraxella* -may retain crystal violet in broths & direct smears & be confused with GPC

Answer 543

-can grow on most media, including MAC -some produce purplish colonies (might be mistaken for lactose fermenter)

Answer 544

-oxidase negative (differentiates from *N. gonorrhoeae*) -catalase positive -non-motile -resistant to many antibiotics

Answer 545

-NOT part of normal flora -common cause of wound infections from agricultural machinery -colonizes immunocompromised patients -common in hospital -nosocomial infections, e.g., pneumonia

Answer 546

straight or slightly curved slender GNR in singles or pairs

Answer 547

SBA: -large, non-hemolytic -may be light yellow -agar may have lavender-green discoloration in areas of heavy growth Grows on MAC

Answer 548

-most often oxidase negative -catalase positive -motile -rapid oxidation of maltose -weaker oxidation of glucose -AMMONIA odor -resistant to many antibiotics -disk diffusion can give false results -broth dilution recommended

Answer 549

-most common cause of bacterial diarrhea -sources of infection: chickens, raw milk, pets

Answer 550

-curved, slender, gram negative rods -“GULL WING-shaped” -loose spirals -S shaped -stain faintly

Answer 551

-microaerophilic & capnophilic -grow on CAMPY-BAP at 42*C in increased CO2 (can grow at 37*C; normal enteric flora inhibited by 42*C incubation) -slow growing - hold plate 3 days -NAATs can be used for faster ID

Answer 552

-DARTING CORKSCREW motility -oxidase positive -catalase positive -hippurate hydrolysis positive

Answer 553

-similar to *C. jejuni*, but less severe -usually foodborne

Answer 554

-curved, slender GNR -“GULL WING-shaped” -loose spirals -S shaped -stain faintly

Answer 555

-microaerophilic & capnophilic -grow on CAMPY-BAP at 42*C in increased CO2 (can grow at 37*C; normal enteric flora inhibited by 42*C incubation) -slow growing - hold plate 3 days -NAATs can be used for faster ID

Answer 556

-hippurate hydrolysis NEGATIVE -a MALDI-TOF can be used to differentiate from *C.jejunu*

Answer 557

-causes bacteremia in immunocompromised & elderly -uncommon stool isolate

Answer 558

-curved, slender, gram negative rods -“GULL WING-shaped” -loose spirals -S shaped -stain faintly

Answer 559

-most often isolated in blood cultures -hold for 2 weeks -inhibited on Campy agar -grows on routine media at 37*C but NOT at 42*C

Answer 560

-oxidase positive -catalase positive -hippurate hydrolysis NEGATIVE

Answer 561

-gastritis -duodenal & peptic ulcers -possible risk factor for gastric carcinoma

Answer 562

-curved, slender, GNR

Answer 563

-grows on non-selective media incubated at 37*C in same atmosphere as Campy -does NOT grow at 42*C -slow growing

Answer 564

-rarely cultured -rapid urease tests on gastric biopsy, urea breath test, histology, PCR, serology, and ELISA all can be used for ID

Answer 565

-Cholera (acute diarrhea, dehydration, electrolyte imbalance) -transmitted by contaminated water, seafood -uncommon in the US, but may be seen in coastal areas

Answer 566

-small, COMMA-shaped GNR in direct smears -straight pleomorphic GNR in culture

Answer 567

-non-halophilic (doesn’t require NaCl for growth) -grows on SBA, CHOC, MAC (NLF) -large yellow colonies on TCBS (ferments sucrose) -alkaline peptone water can be used for enrichment

Answer 568

-“RICE WATER” stools -oxidase positive -serological ID with anti sera to O ag. -01 & 0139 strains cause epidemics -01 strains are divided into 2 serotypes (Inaba and Ogawa) and 2 biotypes (El Tor and classical)

Answer 569

-2nd most serious type of vibrio infection -causes primary septicemia and wound infections most often following consumption of raw oysters -patients usually have preexisting conditions such as liver disease or immunosuppression -seen in the US

Answer 570

Straight or curved GNR

Answer 571

-HALOPHILIC (salt-loving, requires addition of sodium) -most are green on TCBS; some are yellow -May look like enteric on MAC because some are lactose positive

Answer 572

-oxidase positive -motile

Answer 573

-most common cause of bacterial foodborne intestinal infection in Asia -contaminated seafood -water-associated wound infections -seen in US

Answer 574

straight or curved GNR

Answer 575

-requires 1% NaCl for growth -grows on SBA, MAC (NLF) -blue-green colonies on TCBS (doesn’t ferment sucrose)

Answer 576

-oxidase positive -motile

Answer 577

-gastroenteritis & wound infections, often related to aquatic exposure -septicemia -meningitis

Answer 578

straight or curved GNR with rounded ends

Answer 579

-grows on routine media -most are beta-hemolytic on SBA -NLF on MAC -does NOT grow on TCBS -CIN agar & APW can be used for selective isolation

Answer 580

-oxidase positive -motile -NAATs and MALDI-TOF can be used for ID

Answer 581

-gastroenteritis from contaminated water or seafood -bacteremia & meningitis in immunocompromised & neonates

Answer 582

pleomorphic GNR in singles, pairs, short chains, or long filaments

Answer 583

-grows on SBA, CHOC -most grow on MAC, appear as NLF -does NOT arrow on TCBS

Answer 584

-biochemical & antigenic similarities to *Shigella* -oxidase positive -motile

Answer 585

-normal flora of upper respiratory tract -causes: sinusitis, otitis media, pneumonia, bronchitis, often in elderly & immunocompromised -type b - common cause of pneumonia & meningitis in children where Hib vaccine not available

Answer 586

-small, pleomorphic GNCB to long filaments -capsules may be seen

Answer 587

-grows on CHOC in 5-10% CO2 -medium for optimum recovery should contain at least 10 mcg/mL of free X and V factors -translucent, moist, tannish colonies -encapsulated strains form larger & more mucoid colonies -MOUSY or BLEACH-like odor -may demonstrate SATELLITISM with staph on SBA

Answer 588

-porphyrin & porphobilinogen negative -NAATs can be used to detect from CSF, plasma, serum, and whole blood

Answer 589

-both cause conjunctivitis (pink eye) -*H. influenzae* biotype *aegyptius* also causes Brazilian purpuric fever

Answer 590

-small, pleomorphic GNCB to long filaments -capsules may be seen

Answer 591

-grows on CHOC in 5-10% CO2 -medium for optimum recovery should contain at least 10 mcg/mL of free X and V factors -translucent, moist, tannish colonies -encapsulated strains form larger & more mucoid colonies -MOUSY or BLEACH-like odor -may demonstrate SATELLITISM with staph on SBA

Answer 592

-characteristics are similar to *H. influenzae* -difficult to differentiate unless molecular methods are employed

Answer 593

-normal flora of upper respiratory tract -low incidence of pathogenicity

Answer 594

small, pleomorphic GNCB to long filaments

Answer 595

colonies are larger, dry, & tannish

Answer 596

*H. parainfluenzae*

Answer 597

-NEVER normal flora -causes chancroid (STD) -rare

Answer 598

-small GNCB -bipolar staining -may resemble SCHOOL OF FISH or RAILROAD TRACKS

Answer 599

difficult to culture without the use of many growth factors in the media (can identify by PCR)

Answer 600

-X factor? YES -V factor? YES -hemolysis? NO -porphyrin/delta-ALA? NO

Answer 601

-X factor? NO -V factor? YES -hemolysis? NO -porphyrin/delta-ALA? YES

Answer 602

-X factor? YES -V factor? YES -hemolysis? YES -porphyrin/delta-ALA? NO

Answer 603

-X factor? NO -V factor? YES -hemolysis? YES -porphyrin/delta-ALA? YES

Answer 604

-X factor? YES -V factor? NO -hemolysis? NO -porphyrin/delta-ALA? NO

Answer 605

-trench fever -relapsing fever -bacteremia -endocarditis -CAT-SCRATCH disease

Answer 606

gram-negative pleomorphic rods

Answer 607

-not practical -takes 9-40 days to grow -requires heme for growth

Answer 608

-identify by nucleic acid technique

Answer 609

-whooping cough in children and adults -DTaP vaccine is available

Answer 610

small GNCB

Answer 611

grows on Bordet-Gengou & Regan-Lowe (charcoal, horse's blood) after 3-7 days

Answer 612

MALDI-TOF or agglutination with specific antibodies for ID

Answer 613

-Brucellosis (undulent fever) -from unpasteurized milk or contact with infected goats, cows, hogs, dogs

Answer 614

tiny, faintly staining GNCB

Answer 615

-most often isolated from blood cultures or biopsies of reticuloendothelial (RE) tissue -blood cultures incubated in increased CO2 for 3 weeks -culture is not sensitive

Answer 616

-oxidase positive -catalase positive -urease positive -potential bioterrorism agent -reportable disease -slide agglutination test with specific antibodies used for ID

Answer 617

-Tularemia (rabbit fever) -human infected by tick or handling infected animal

Answer 618

-pale staining, small, pleomorphic, INTRACELLULAR GNCB with bipolar staining

Answer 619

-grows on special media enriched with glucose & cystine (e.g., blood cystine glucose agar), Thayer-Martin (TM), & BCYE -small, transparent colonies after 3 days

Answer 620

-level 3 pathogen -direct fluorescent antibody methods for ID -send to public health lab for confirmation

Answer 621

-normal flora of female genital tract -associated with bacterial vaginosis (BV) when it & anaerobic GNR are predominant & *Lactobacillus* is absent -linked to maternal & neonatal infections, bacteremia, rarely UTI

Answer 622

small, pleomorphic gram-variable rods

Answer 623

-not recommended for diagnosis of BV -grows on SBA, PEA, CNA, human blood Tween (HBT) agar, V agar -produces diffuse beta hemolysis only on media containing human blood -requires increased CO2 & 48-72 hour incubation

Answer 624

-catalase negative -oxidase negative -tests for Dx of BV: CLUE CELLS (vaginal epithelial cells covered with gram-variable rods), whiff test (10% KOH added to vaginal secretion => fish-like odor)

Answer 625

-Legionnaire disease -Pontiac fever -found in water (e.g., air conditioners, shower-heads, whirlpools) -contracted by inhalation of aerosol

Answer 626

small, pleomorphic, weakly staining GNR (sometimes filamentous)

Answer 627

-grows on BCYE in 3-4 days -pale yellow-green fluorescence with WOOL LAMP

Answer 628

-oxidase positive -ID by immunofluorescent stain or agglutination methods -MALDI-TOF can also be used

Answer 629

-contracted by bite or scratch of cat or dog or contact with infected carcass -wound & soft tissue infection

Answer 630

pleomorphic GNCB with bipolar staining

Answer 631

-grows on SBA & CHOC, but NOT MAC -MUSTY odor

Answer 632

-oxidase positive -catalase positive -indole positive -weak oxidase reaction after 30 minutes of being characteristic of *Pasteurella* -MALDI-TOF can also be used for ID

Answer 633

Acceptable

Answer 634

Acceptable

Answer 635

Acceptable

Answer 636

Acceptable

Answer 637

Acceptable

Answer 638

Acceptable

Answer 639

Acceptable

Answer 640

Acceptable

Answer 641

Acceptable

Answer 642

Unacceptable

Answer 643

Unacceptable

Answer 644

Unacceptable

Answer 645

Unacceptable

Answer 646

Unacceptable

Answer 647

Unacceptable

Answer 648

-non-selective enrichment medium that grows obligate & facultative anaerobes -contains yeast extract, L-cysteine, hemin, & vitamin K

Answer 649

-selective differential medium for *Baceteroides fragilis* -bile salts & gentamicin act as inhibitors -*B. fragilis* colonies are black with dark halos due to esculin hydrolysis

Answer 650

enrichment medium that grows obligate & facultative anaerobes

Answer 651

selective medium that grows obligate anaerobes & GP facultative anaerobes

Answer 652

-selective & differential for *Clostridium difficile* -*C. diff* colonies are yellow due to fermentation of fructose -Chartreuse fluorescence

Answer 653

-for determination of lecithinase & lipase production by clostridia & fusobacteria

Answer 654

-selective medium for isolation of anaerobic GNRs, especially *Bacteroides* & *Prevotella* -also known as laked blood kanamycin-vancomycin (LKV) agar

Answer 655

-selective medium: —inhibits enteric GNRs —grows obligate anaerobes & GP facultative anaerobes

Answer 656

-all-purpose medium that supports growth of most aerobes & anaerobes; can be used as backup broth to detect organisms present in small numbers or anaerobes -THIO acts as a reducing agent -Growth: —aerobes grow at the top —strict anaerobes grow at the bottom —facultative anaerobes grow throughout -store at RT -boil & cool before use

Answer 657

-gram reaction; morphology; presence, location, & shape of spores -some GN anaerobes stain faintly with safranin; extend time of counter staining to 3-5 minutes or use 0.1% basic fuchsin -some GP anaerobes, e.g., *Clostridium*, May stain pink

Answer 658

-which media organism grows on -pigmentation -hemolysis -colony morphology

Answer 659

-kanamycin, vancomycin, & colistin disks help differentiate anaerobes & ensure that over-decolorized *Clostridium* is not misidentified as GNR -the disk is placed on the first quadrant of the plate; after incubation , observe if organism is susceptible or resistant

Answer 660

-presumptive ID, e.g., fluorescence; catalase; spot indole; urease; motility; sodium polyanethanol sulfonate (SPS), nitrate, & bile disks; lecithinase, lipase, & proteolytic reaction on EYA

Answer 661

-test tubes containing variety of media inoculated & incubated in anaerobic environment -reaction leads to change in pH -expensive & time consuming -largely replaced by multitest systems

Answer 662

-detect preexisting enzymes -panels or cards are inoculated & incubated in room air -color changes are read in 4 hours -code number obtained & ID determined from code book -only contains codes for most commonly isolated anaerobes

Answer 663

-analysis of metabolic end products or cellular fatty acids -not frequently used

Answer 664

-DNA extracted from organism, amplified by PCR, sequenced on automated sequencer -nucleotide sequence compared with known sequences in database

Answer 665

-extremely sensitive method requiring little sample volume for ID -the mass spectra generated are compared to known databases

Answer 666

-normal flora on skin & in mouth, intestines, female genital tract -most commonly isolated & most pathogenic anaerobic GPC -associated with skin infections, decubitus ulcers, septic arthritis, bone infection following orthopedic surgery, oral & female genital tract infections, bacteremia

Answer 667

-GPC in singles, pairs, retreads, clusters -resembles staph

Answer 668

-small colonies -May take 48 hours to grow -catalase negative -indole negative -resistant to SPS

Answer 669

-normal flora on skin& mouth, GI, & genitourinary (GU) tracts -mixed infections of skin, soft tissues, GI tract, female genital tract, bones, joints, lungs, brain

Answer 670

-tiny GPC in chains -resembles strep

Answer 671

-small gray-white colonies in 24-48 hours -SWEET odor -sensitive to SPS

Answer 672

-normal on skin & in GI & GU tracts -associated with obstetric & gynecological infections

Answer 673

-yellow colonies -MUSTY odor -resistant to SPS -indole positive

Answer 674

-GPC in pairs, short chains, tetrads, clusters -some strains decolorize easily and can be confused with gram-negative anaerobes

Answer 675

-normal inhabitants of mucosal surfaces throughout the body -infects brain, face, lungs, genitals

Answer 676

-short or long gram-positive rods (GPR) -branched or unbranched -BANDED appearance -can break into club-shaped rods resembling diphtheroids

Answer 677

-sulfur granules may be seen in discharge -crush & stain to reveal characteristic gram-stain morphology -“MOLAR TOOTH” colonies

Answer 678

-botulism due to ingestion of toxin in inadequately cooked or improperly canned foods -infant botulism due to ingestion of spores in honey -wound botulism from injection drug use

Answer 679

-GPR with oval subterminal spores

Answer 680

-reportable disease -toxin testing at public health labs

Answer 681

-antibiotic-associated diarrhea -pseudomembranous colitis

Answer 682

-thin GPR -May form chains -rare oval subterminal spores

Answer 683

-yellow GROUND GLASS colonies on CCFA -usually not cultured -must demonstrate toxin production -toxins A & B -tissue culture molecular methods or enzyme immunoassay (EIA) to confirm

Answer 684

-normal in GI tract -causes gas gangrene -most common bacterial cause in US -can produce more than 16 different toxins and is classified by toxinotype

Answer 685

-large GPR with BLUNT ends in chains -“BOX CARS” -tendency to stain gram negative -usually no spores seen

Answer 686

-most commonly isolated *Clostridium* -double zone of beta hemolysis on SBA

Answer 687

-causes tetanus -deep wounds infected with soil

Answer 688

-GPR with swollen terminal spores -“DRUMSTICK” -“TENNIS RACQUET” -becomes gram-negative after 24 hours

Answer 689

-rare in US because of DTap vaccine but common worldwide -lab confirmation rarely required

Answer 690

-normal skin flora -common contaminant of blood cultures -causes acne -infections associated with artificial joints, cathethers, shunts, artificial heart valves -keratitis -bacteremia -endocarditis

Answer 691

-CLUB-shaped, pleomorphic GPR -diphtheroid-like

Answer 692

-most common anaerobic GPR -catalase positive -indole positive

Answer 693

-normal in mouth, GI tract -predominant & beneficial flora of vagina during reproductive years -produces lactic acid, maintains vaginal pH -absence in vagina predisposes to BV & yeast infections -rare cause of endocarditis, septicemia in immunocompromised -

Answer 694

-pleomorphic, long, thin, non-spore-forming GPR, often in chains -chains of rods in THIO

Answer 695

-aerotolerant anaerobes -grow better under anaerobic conditions -colonies vary greatly -may resemble *S. viridans* -catalase negative

Answer 696

-normal flora of upper respiratory tract, GI & GU tracts -usually in mixed culture -can cause infections in immunocompromised

Answer 697

-tiny GNDC in pairs, clusters, short chains -can resemble *Neisseria*

Answer 698

-may show weak red fluorescence under UV light -does NOT grow on KVLB -usually doesn't reduce nitrates

Answer 699

-main anaerobic organism recovered from intraabdominal infections -also causes endocarditis -more virulent and antibiotic resistant than most other anaerobes

Answer 700

pleomorphic, pale, irregularly staining GNR

Answer 701

-resistant to bile -hydrolyzes esculin -turns BBE brown

Answer 702

-pulmonary infections -brain abscesses -oral lesions

Answer 703

-GNR -*F. nucleatum* is long & thin with tapered ends (SPINDLE-shaped)

Answer 704

-indole positive -most fluoresce CHARTREUSE (green-yellow) under UV light

Answer 705

head, neck, & pleuropulmonary infections

Answer 706

-slow growing -brown to black on SBA -some fluoresce brick-red to orange under UV light -doesn't grow on KVLB

Answer 707

head, neck, & pleuropulmonary infections

Answer 708

-slow growing -some are pigmented -brown to black on SBA & KVLB -some fluoresce brick-red to orange under UV light -doesn't grow on BBE

Answer 709

-non-recirculating ventilation system -negative air pressure -BS-2 for non-aerosol-producing activities -BS-3 for manipulation of cultures and susceptibility testing -electric incinerators instead of flames to sterilize wire loops -slide-warming trays instead of flames to fix slides -tuberculocidal disinfectants to clean equipment & BSC (1:10 dilution of household bleach) -UV light in BSC (only when not in use) -annual testing of employees for exposure

Answer 710

Sputum & other specimens with normal flora such as gastric lavage, urine, feces

Answer 711

Tissue or body fluids collected aseptically

Answer 712

-sodium hydroxide (NaOH) - digestant and decontaminant -*N*-acetyl-L-cysteine/NaOH - NALC is a liquefying agent -benzalkonium chloride -oxalic acid

Answer 713

-cell walls have a high lipid content (mycolic acids) -difficult to stain -resist decolorization by acid alcohol (acid-fast) -gram stain poorly -use carbolfuchsin or fluorochrome acid-fast stains

Answer 714

-agar-based (Middlebrook 7H10 & 7H11) -egg-based (Löwenstein-Jensen, Petragnani, American Thoracic Society) -liquid (Middlebrook 7H9) -combination of a solid-based medium & a liquid-based medium recommended for primary isolation

Answer 715

35*C in 5-10% CO2 (EXCEPTION: if *M. marinum*, *M. ulcerans*, or *M. haemophilum* suspected, incubate at 25-30*C)

Answer 716

-slow -on solid media, most require 2-6 weeks incubation -rapid growers = 2-3 days -more rapid growth in liquid media

Answer 717

-liquid broth inoculated -placed in blood culture instrument for automatic or continuous monitoring -growth indicated by consumption of O2 or production of CO2 -Vitek MS is FDA approved & provides fast turnaround time

Answer 718

-colony morphology -growth rate -optimum temp for growth -photoreactivity -biochemical tests -smear microscopy -nucleus acid hybridization -PCR -automated DNA sequencing -MALDI-TOF

Answer 719

-Primary stain: Carbolfuchsin -Decolorizer: acid alcohol -Counterstain: methylene blue

Answer 720

-Primary stain: carbolfuchsin -Decolorizer: acid alcohol -Counterstain: methylene blue

Answer 721

-Primary stain: auramine-rhodamine -Decolorizer: acid alcohol -Counterstain: potassium permanganate OR acridine orange

Answer 722

-red, slightly curved, beaded rods (2-8 um) -blue background

Answer 723

-red, slightly curved, beaded rods (2-8 um) -blue background

Answer 724

yellow-orange rods against a dark background

Answer 725

-requires heat -examine at least 300 OI fields -wipe lens after positive smears to avoid cross-contamination & false positives -can be modified for improved detection by adding cytospin and Triton processing

Answer 726

-cold stain -examine at least 300 OI fields -wipe lens after positive smears to avoid cross-contamination & false positives

Answer 727

-more sensitive & faster than carbolfuchsin -can examine at 250X -read immediately or store at 2-8*C in dark to avoid fading -examine at least 300 fields -POSITIVE should be confirmed with carbolfuchsin stain -rapid 2 minute stain now available

Answer 728

cause human tuberculosis

Answer 729

Most predominant: -*M. tuberculosis* -*M. bovis* -*M. africanum* -*M. microti* Others: -*M. canetti* -*M. pinnipedii*

Answer 730

-some cause pulmonary infection similar to TB but not transmitted person to person -usually in immunocompromised -contracted from environment (soil, water)

Answer 731

-*M. avium* -*M. intracellulare* -*M. kansaii* -*M. malmoense* -*M. chelonae* -*M. xenopi* -*M. gordonae*

Answer 732

-slow growth -average recovery time by conventional methods is 21 days -rough, dry, buff-colored (no pigmentation) colonies -serpentine cording on smear from culture -niacin & nitrate positive -68*C catalase negative

Answer 733

causes disease similar to *M. tuberculosis* and is treated accordingly

Answer 734

-resistant to pyrazinamide -Bacille Calmette-Guerin (BCG) is attenuated strain used in vaccine in some parts of the world -causes false-pos purified protein derivative (PPD) test

Answer 735

-causes lung infection -disseminated disease in immunocompromised

Answer 736

-spread by respiratory droplets -endemic in equatorial Africa -rare in the US

Answer 737

-most common NTM to cause lung disease in US -most common systemic bacterial infection in AIDS patients -cervical lymphadenitis in children

Answer 738

-*M. avium* and *M. intracellulare* most commonly cause lung disease -contracted from environment

Answer 739

-skin, joint, bone, lung infections in immunocompromised -lymphadenitis in children

Answer 740

-requires hemin for growth -grows Best at 28-30*C

Answer 741

-chronic infection of skin& subcutaneous tissue -Buruli ulcers

Answer 742

-endemic in tropics -3rd most common mycobacterial disease after TB & leprosy -grows best at 30*C -molecular techniques aid ID

Answer 743

-2nd common NTM to cause lung disease -causes skin& soft tissue infections, lymphadenitis -can disseminate in immunocompromised

Answer 744

-often found in tap water -photochromogen -can ID by 16sRNA probe

Answer 745

skin infections

Answer 746

-contracted from swimming pools, aquariums -grows best at 28-30*C -photochromogen

Answer 747

-rare but associated with chronic respiratory infection

Answer 748

-difficult to treat due to multi drug resistance (MDR) -high mortality & morbidity

Answer 749

rarely causes infection (lab contaminant)

Answer 750

-“tap-water bacillus” -scotochromogen (does not require light to produce pigment)

Answer 751

-in water, soil, dust -contaminant of medical devices -skin & soft tissue infections -lung infections in those with chronic lung disease, e.g., cystic fibrosis -disseminated infection in immunocompromised

Answer 752

-rapid grower -tap water reservoir

Answer 753

-disseminated cutaneous infections in immunocompromised -infections of lungs, bone, CNS, prosthetic heart valves

Answer 754

Rapid grower

Answer 755

-rapid grower -common in environment -weakly gram positive -stains with carbolfuchsin, but may not with fluorescent stain

Answer 756

infection of skin, soft tissues, IV & injection sites, surgical wounds

Answer 757

Leprosy (Hansen disease)

Answer 758

-endemic in Southern hemisphere -<100 cases per year in US -most cases in Texas, California, Louisiana, Hawaii, Puerto Rico -armadillos may be reservoir -doesn’t grow on artificial media -can be grown in footpads of mice & armadillos -Dx by acid-fast stain of tissue -less acid fast than *M. tuberculosis*

Answer 759

-most common STD bacterial infection in US -trachoma -lymphogranuloma venereum -non-gonococcal urethritis -pelvic inflammatory disease -pneumonia & conjunctivitis in newborns

Answer 760

-Giemsa stain -direct fluorescent antibody stain -NAATs (most common)

Answer 761

-obligate intracellular parasite -need epithelial cells for culture -wooden swabs are toxic -NAAT preferred for genital and first-catch urine specimens -commercial systems available for simultaneous detection of *M. gonorrhoeae*

Answer 762

3rd most common cause of acute RTI

Answer 763

serological or molecular tests are method of choice

Answer 764

-obligate intracellular parasite -risk factor for Guillain-Barre syndrome

Answer 765

-Psittacosis ("PARROT FEVER") -rare in the US

Answer 766

serological or molecular tests

Answer 767

-obligate intracellular parasite -spread by BIRDS

Answer 768

Relapsing fever

Answer 769

-Giemsa-or Wright-stained blood smears -thrombocytopenia is common

Answer 770

-transmitted by ticks & lice -there are over 20 species in the relapsing fever *Borrelia* group but *B. recurrentis* causes the most cases

Answer 771

-Lyme disease (erythema chronicum migrans, neurological & cardiac abnormalities, arthritis)

Answer 772

-grows on modified Kelly medium -ELISA is most common method

Answer 773

*Ixodes* tick

Answer 774

*Borrelia burgdorferi* (Lyme disease)

Answer 775

-doesn't grow on artificial media -darkfield microscopy, fluorescent stain -serology (EIA) is most common method

Answer 776

Weil disease (infectious jaundice, leptospirosis)

Answer 777

-PCR or serological tests -can culture: growth = turbidity below surface of semisolid media such as Ellinghausen-McCullough-Johnson-Harris (EMJH) -hold cultures for 13 weeks

Answer 778

-zoonotic disease -transmitted by urine of infected animal -organism in blood & CSF during first week, then urine -common in tropical regions

Answer 779

primary atypical pneumonia (walking pneumonia)

Answer 780

-smallest free-living cells -LACK CELL WALL -pleomorphic -not visible by Gram staining -difficult to grow -culture rarely performed -may take 21 days or more -usually Dx by serology

Answer 781

urogenital tract disease

Answer 782

-only species that will grow on SBA & CHOC but may require 4 days -PINPOINT translucent colonies easily overlooked -"FRIED-EGG" colonies seen with stereomicroscope after staining with methylene blue -serological methods available

Answer 783

urogenital tract disease

Answer 784

-granular brown appearance on A8 agar because of urease production -serological methods available

Answer 785

-Rocky mountain spotted fever -rickettsial pox -epidemic typhus -murine typhus -scrub typhus

Answer 786

-don't grow on artificial media -grow in lice, ticks, tissue culture, eggs -usually Dx by serology -immunohistologic & molecular methods available

Answer 787

-obligate intracellular parasite -transmitted by ticks, mites, lice, fleas -Rocky mountain spotted fever is most common rickettsial infection in the US - caused by *R. rickettsii* -BSL-3 biohazard

Answer 788

-usual Dx by NAATs and serology -IFA and imaging available

Answer 789

-obligate intracellular parasite -zoonotic disease -found in cattle, sheep, goats -highly contagious -BSL-3 biohazard -reportable disease -potential bioterrorism agent

Answer 790

Ehrlichiosis

Answer 791

-morulae (clusters of organisms that resemble blackberry) in WBCs -usual Dx by serology, molecular amplification, and blood smear examination

Answer 792

-obligate intracellular parasites -infects WBCs -transmitted by ticks -disease similar to Rocky Mountain spotted fever

Answer 793

-SBA -CHOC -*Streptococcus*-selective agar may be used

Answer 794

-alpha & gamma strep -commensal *Neisseria* -CNS -diphtheroids -*S. pneumoniae* -*Candida*

Answer 795

-GAS (*S. pyogenes*)

Answer 796

-stab streaking to detect beta strep that only produce streptolysin-O -direct antigen tests for GAS -negative result should be cultured

Answer 797

-SBA -CHOC -MAC

Answer 798

-CNS -non-beta hemolytic strep -diphtheroids -commensal *Neisseria* -*Haemophilus* -yeast -ASPIRATES: none

Answer 799

-*S. pneumoniae* -*H. influenzae* -*S. aureus* -Enterobacterales -*Pseudomonas* -*M. catarrhalis* -*C. albicans*

Answer 800

-gram stain -acceptable sputum: --<10 epi cells/LPF -->25 seg. neutrophils/LFP -NOTE: neutropenic patients may not produce seg. neutrophils

Answer 801

-SBA -MAC Use 0.01 mL or 0.001 mL calibrated loop

Answer 802

-clean catch: few skin flora -catheterized or aspirate: NONE

Answer 803

-*E. coli* -*Klebsiella* -*Enterobacter* -*Proteus* -*Pseudomonas* -*S. aureus* -*S. saprophyticus* -CNS -GBS

Answer 804

-rapid screen for UTI: 1 or more bacteria/OI field on Gram stain of uncentrifuged urine -low counts are significant in catheterized urines & aspirates -3 or more organisms with none predominant = probable contamination

Answer 805

-SBA -MAC -EMB -XLD or HE -Campy blood -possible CIN and/or TCBS

Answer 806

-anaerobes -Enterobacterales -enterococci -strep -yeast

Answer 807

-*Salmonella* -*Shigella* -*Campylobacter* -diarrheagenic *E. coli* -*Aeromonas* -*Plesiomonas* -*Y. enterocolitica* *Vibrio*

Answer 808

-seg. neutrophils = invasive diarrhea; e.g., *Salmonella*, *Shigella*, *Campylobacter*, EIEC, *C. difficile* -no seg. neutrophils = enterotoxin-mediated diarrhea; e.g., ETEC, *Vibrio* -RBCs with EHEC

Answer 809

-SBA -CHOC -MAC -Thayer-Martin -add THIO & anaerobic media for tissue & aspirates

Answer 810

-Urethra: CNS, diphtheroids -Vagina, pre-pubescent/postmenopausal: yeast, GNR, GPC -Vagina, reproductive years: *Lactobacillus*, PGC -Surgical/aspirates: NONE

Answer 811

-*N. gonorrhoeae* -*C. albicans* -GBS -*S. aureus* -Surgical/aspirates: also anaerobes

Answer 812

Gram stain

Answer 813

-SBA -CHOC -MAC -some add THIO

Answer 814

-GBS (infants) -*Listeria* (infants, elderly) -*H. influenzae* (unimmunized children) -*N. meningitidis* -*S. pneumoniae -GNR Any isolate is significant.

Answer 815

-use tube 2 -handle STAT -DO NOT refrigerate -use of cytocentrifuge to concentrate specimen increases sensitivity of Gram stain -ID all isolates

Answer 816

-most labs inoculate an aerobic & anaerobic bottle -some use 2 aerobic bottles, no anaerobic

Answer 817

NONE -common contaminants: CNS, *Micrococcus*, alpha strep, diphtheroids, *Cutibacterium*

Answer 818

any isolate potentially significant -GPC are most common

Answer 819

-skin prep: 80-95% ethanol or isopropyl alcohol followed by povidone-iodine or tincture of iodine -optimum volume: adult, 20 mL; child, 1 mL per year of life -blood-to-broth ratio: 1:5 to 1:10 -usually draw 2 sets in 24 hours -automated systems used for monitoring -growth indicated by consumption of O2 or production of CO2 -Gram stain & subculture required for ID

Answer 820

-SBA -CHOC -MAC -surgical, aspirate, or tissue: add anerobic blood, KVLB, THIO

Answer 821

-CNS -diphtheroids -*Cutibacterium* -surgical, aspirate, or tissue: NONE

Answer 822

-*S. aureus* -beta-hemolytic strep -Enterobacterales -*P. aeruginosa* -surgical, aspirate, or tissue: also anaerobes -human bite: alpha-hemolytic strep, *S. aureus*, *S. pyogenes*, *Eikenella corrodens*, anaerobes

Answer 823

Gram stain

Answer 824

-SBA -CHOC

Answer 825

-CNS -diphtheroids -*Cutibacterium*

Answer 826

-*H. influenzae* -*S. pneumoniae* -*S. aureus* -Enterobacterales -*Pseudomonas*

Answer 827

-Gram stain - if POS, call -Keratitis = EMERGENCY - loss of eye can occur

Answer 828

-SBA -CHOC -MAC

Answer 829

normal skin flora

Answer 830

-*S. pneumoniae* -*H. influenzae* -GAS -*M. catarrhalis* -*S. aureus* -*Pseudomonas*

Answer 831

Gram stain

Answer 832

-*Campylobacter* -*Vibrio* -*Aeromonas* -*Plesiomonas*

Answer 833

-*Escherichia coli* -*Salmonella* -*Shigella* -*Yersinia*

Answer 834

-Penicillin V -Penicillin G

Answer 835

inhibit cell wall synthesis

Answer 836

-narrow -GPs other than staph -some GN

Answer 837

-beta-lactam -bactericidal -allergic reaction common side effect

Answer 838

-methicillin -oxacillin -ampicillin -carbenicillin -piperacillin

Answer 839

inhibit cell wall synthesis

Answer 840

-broader spectrum of activity than natural penicillins -GPs (not MRSA) & GNs

Answer 841

-beta-lactam -bactericidal -penicillinase-resistant penicillins = oxacillin, methicillin, nafcillin, cloxacillin, dicloxacillin -drug class of choice for STAPH infections

Answer 842

-cephalexin -cefotoxin -ceftriaxone -cefepime

Answer 843

inhibit cell wall synthesis

Answer 844

-GPs & GNs -each generation has broader spectrum of activity than previous

Answer 845

-beta-lactam -bactericidal

Answer 846

inhibit cell wall synthesis

Answer 847

-widest spectrum -GPs & GNs, including *P. aeruginosa* & anaerobes, but NOT MRSA or VRE

Answer 848

-beta-lactam -bactericidal -reserved for IV use in serious infections

Answer 849

inhibit cell wall synthesis

Answer 850

-*P. aeruginosa* & other GNR -low activity against GPs & anaerobes

Answer 851

-beta-lactam -bactericidal

Answer 852

Vancomycin

Answer 853

inhibit cell wall synthesis

Answer 854

-GPs -drug of choice for MRSA -some strain of *Enterococcus* are now resistant (VRE)

Answer 855

-bactericidal -used for serious infections

Answer 856

-erythromycin -clarithromycin -azithromycin

Answer 857

inhibit RNA-dependent protein synthesis

Answer 858

-GPs & some GNs -intracellular organisms -atypical mycobacteria

Answer 859

bacteriostatic

Answer 860

-tetracycline -doxycycline

Answer 861

-tetracycline -doxycycline

Answer 862

inhibit protein synthesis

Answer 863

-GPs & GNs -intracellular organisms -spirochetes -MRSA -VRE

Answer 864

-bacteriostatic -used less often than B-lactams -NOT given to children or pregnant women due to staining of teeth, abnormal bone growth

Answer 865

-gentamycin -tobramycin -amikacin

Answer 866

inhibit protein synthesis by binding irreversibly to 30S ribosomal subunit

Answer 867

-used primarily for GNs (including *P. aeruginosa*) -ineffective against anaerobes

Answer 868

-bactericidal -toxic to kidneys & ears -only used to treat serious GN infections

Answer 869

-Sulfamethoxazole (SMZ) -Trimethoprim (TMP)

Answer 870

inhibit folic acid synthesis

Answer 871

broad spectrum of activity against Enterobacterales

Answer 872

-bacteriostatic -used primarily for UTI

Answer 873

-ciprofloxacin -levofloxacin -ofloxacin

Answer 874

inhibit DNA synthesis

Answer 875

broad spectrum

Answer 876

-bactericidal -used to treat serious infections -ciprofloxacin used for anthrax

Answer 877

clindamycin

Answer 878

inhibit protein synthesis

Answer 879

-GPC (including MRSA) -anaerobes

Answer 880

-GPC (including MRSA) -anaerobes

Answer 881

one of the most effective antibiotics against ANAEROBES but resistance is increasing

Answer 882

-rapidly grow aerobes & facultative anaerobes -NOT for slow growers, anaerobes, or fastidious organisms (except with modifications)

Answer 883

-18-24 hour pure culture -1.5 x 10^8 CFU/mL -compare to 0.5 McFarland standard -too heavy = smaller zones/false resistant -too light = larger zones/false susceptible

Answer 884

-Mueller-Hinton (MH) agar -swab entire surface evenly to achieve solid lawn of growth

Answer 885

-store in refrigerator or freezer in sealed, desiccated container -warm to RT before use -check expiration dates -place within 15 minutes of inoculation -no more than 12 per 150-mm plate

Answer 886

-within 15 minutes of disk placement -inverted -ambient air -35*C for 16-18 hours -<16 hours = increased zone, false susceptible ->18 hours = decreased zone, false resistant EXCEPTION: MRSA may require 24 hours

Answer 887

-*Streptococcus*: use MH supplemented with 5% sheep blood; incubate in 5-7% CO2 -*Haemophilus*: use *Haemophilus* test medium (HTM); incubate in 5-7% CO2

Answer 888

-routine: measure zones from back side of plate using ruler or calipers -media containing blood: read from top with lid removed

Answer 889

-sparse growth: repeat with standardized inoculum -mixed culture: repeat with pure inoculum -colonies within zone: subculture & retest -slight growth in zone for TMP & sulfonamides: disregard -swarming of *Proteus* into zone: ignore

Answer 890

resistant, intermediate, or susceptible based on zone of inhibition in mm

Answer 891

-test QC strains of *E.coli*, *S.aureus*, *P.aeruginosa*, *Enterococcus faecalis* for 20-30 consecutive days -if results are acceptable, frequency may be reduced to weekly if all other guidelines are followed

Answer 892

-standard inoculum added to serial dilutions of antibiotics & incubated -MIC = least amount of antibiotic (highest dilution) that prevents visible growth -can be done in tubes, microtiter trays, or automated systems

Answer 893

-clear tubes from MIC are subcultured to agar -MBC = concentration of antibiotic that results in 99.9% decrease in CFU per mL

Answer 894

-detects enzyme that cleaves beta-lactam ring, rendering penicillin & cephalosporins ineffective -test *Haemophilus*, *N.gonorrhoeae*, *Moraxella* -bacteria applied to moistened disk impregnated with cephalosporin nitrocefin (Cefinase disk) -RED color if beta-lactam ring is broken, i.e., organism produces beta-lactamase

Answer 895

-test with oxacillin disk instead of penicillin disk -more sensitive in detecting resistance -Mueller-Hinton with 5% sheep blood inoculated with organism -oxacillin sick (1 mcg) placed -incubated overnight in 5-7% CO2 -zone of inhibition >=20 mm = susceptible to penicillin -zone of inhibition <20 mm = perform MIC

Answer 896

-oxacillin used as class representative for penicillinase-resistant penicillins -organism resistant to it is resistant to all -oxacillin screen plate: Mueller-Hinton with 4% NaCl & oxacillin (6 mcg/mL) inoculated & incubated overnight -any growth = resistant -not suitable for testing CNS -CLSI recommends cefoxitin disk diffusion method for both *S.aureus* & CNS

Answer 897

-for detection of VRE -brain-heart infusion agar plus 6 mcg vancomycin/mL inoculated & incubated overnight -growth = resistance -can also be used for * S.aureus*

Answer 898

-plastic strip containing concentration gradient placed on inoculum lawn on Mueller-Hinton plate & incubated overnight -MIC = point where border or growth inhibition intersects strip -useful for testing fastidious organisms such as *S.pneumoniae*, other strep, *H. influenzae*, & anaerobes

Answer 899

-to detect inducible clindamycin resistance in MRSA isolated that are resistant to erythromycin & susceptible to clindamycin on initial testing -erythromycin & clindamycin disks placed 15-26 mm apart on Mueller-Hinton agar inoculated with organism -after overnight incubation, flattened zone between disks (D-shaped zone of inhibition aground clindamycin disk) means erythromycin induces clindamycin resistance = clindamycin reported as resistant -similar procedure for beta-hemolytic strep except Mueller-Hinton with sheep blood used & disks placed 12 mm apart

Answer 900

-broth with various dilutions of antibiotics are inoculated & incubated -growth is determined by photometry, turbidity, or fluorescence, depending on system

Answer 901

-walk-away capability -LIS interface -generation of institutional antibiograms -epidemiology reportz

Answer 902

-accuracy -short TAT -frees tech for other duties

Answer 903

-only for rapidly growing organisms -not all microorganisms are in databases

Answer 904

-spore test weekly (*B. stearothermophilus* -must reach 121*C/15 psi

Answer 905

check for accuracy annually

Answer 906

check airflow annually

Answer 907

check rpm every 6 months

Answer 908

check CO2 & temperature daily

Answer 909

check for anaerobiosis with methylene blue strip each use (white = no O2; blue = O2)

Answer 910

clean & adjust 4 times per year

Answer 911

daily checks of incubators, heating blocks, water baths, refrigerators, freezers

Answer 912

must be checked against reference thermometer from National Bureau of Standards

Answer 913

document routine function checks, preventive maintenance service -maintain for life of instrument

Answer 914

control slide weekly (*E. coli* & *S.aureus*)

Answer 915

most are tested each day of use with positive & negative controls

Answer 916

-most are exempt from retesting if purchased from manufacturer who follows CLSI guidelines -obtain & retain statement of QC -retesting required for CHOC, selective media for *Neisseria* & *Campylobacter*

Answer 917

-must be reviewed & signed annually by lab director -changes must be approved & signed by lab director -obsolete procedures must be removed & retained for 2 years

Answer 918

verification on hiring & annually

Answer 919

-test unknowns exactly as patient specimens -must maintain an average score of 80% -document corrective action

Answer 920

-30 minutes -trophozoites (trophs), helminth eggs, larvae

Answer 921

-1 hour -trophs, helminth eggs, larvae

Answer 922

-24 hours -cysts, helminth eggs, larvae

Answer 923

-1-3 for routine workup -patients should submit 3 stool specimens, one every other day

Answer 924

-antibiotics -antiseptics -barium -laxatives -mineral oil -soap -water -urine

Answer 925

-PVA -5-10% formalin -MIF -SAF Formed stools may be refrigerated for 1-2 days

Answer 926

-on fresh liquid stools -to observe motility of trophs

Answer 927

-1% D'Antoni or Lugol iodine -to observe nuclei of cysts -trophs will be killed

Answer 928

to concentrate parasites & separate from fecal debris

Answer 929

-Formalin-ethyl acetate -recovers eggs, larvae, cysts

Answer 930

-33% zinc sulfate -specific gravity 1.18 -parasites float to top -may miss operculated eggs, unfertilized *Ascaris*

Answer 931

-for Dx of protozoa -PVA fixed or fresh specimen -iron hematoxylin or trichrome stain

Answer 932

-round -fine, even peripheral chromatin -small, delicate, central karyosome

Answer 933

-10-60 um, average 20 um -1 nucleus -delicate, finely granular cytoplasm -ingested RBCs -seldom contains bacteria -single, long, finger-like pseudopod -directional motility

Answer 934

-round -10-20 um -2-4 nuclei -10% have cigar-shaped chromatoid bodies -may have glycogen vacuoles

Answer 935

-causes acute amebic dysentery -can cause extraintestinal amebiasis

Answer 936

*Entamoeba histolytica*

Answer 937

-EIA for antigen detection -molecular testing available

Answer 938

-round -fine, even peripheral chromatin -small, delicate, central karyosome

Answer 939

-5-12 um -1 nucleus -delicate, finely granular cytoplasm -ingests bacteria -single, long, finger-like pseudopod -directional motility

Answer 940

-round -5-9 um -2-4 nuclei -10% have cigar-shaped chromatoid bodies -may have glycogen vacuoles

Answer 941

non-pathogenic

Answer 942

-coarse, irregular peripheral chromatin -eccentric karyosome

Answer 943

-15-50 um -coarse cytoplasm with many vacuoles & ingested bacteria -short, blunt, multiple pseudopods -sluggish non-directional motility

Answer 944

-round -10-35 um -2-8 nuclei -occasional chromatoid bodies with splintered ends -may have glycogen vacuoles

Answer 945

non-pathogenic

Answer 946

-no peripheral chromatin -large, irregular karyosome

Answer 947

-2-12 um -single nucleus -finely granular vacuolated cytoplasm -blunt pseudopods -sluggish, non-progressive motility

Answer 948

-5-10 um -round to oval -usually 4 nuclei -no chromatoid bodies -may have poorly defined glycogen mass

Answer 949

non-pathogenic

Answer 950

*Endolimax nana*

Answer 951

-no peripheral chromatin -large karyosome surrounded by layer of small granules

Answer 952

-8-20 um -coarsely granular cytoplasm with vacuoles & bacteria -blunt pseudopod -sluggishly progressive motility

Answer 953

-5-20 um -ovoid -1 nucleus -prominent glycogen vacuole -"Iodine cyst"

Answer 954

non-pathogenic

Answer 955

*Iodamoeba butschlii*

Answer 956

up to 4, pushed to the side

Answer 957

-round -6-40 um -large central body

Answer 958

-uncertain -does cause diarrhea, fever, abdominal pain, & vomiting

Answer 959

*Blastocystis hominis*

Answer 960

-5-15 um -80% have 2 nuclei -no peripheral chromatin -karyosome is mass of 4-8 granules

Answer 961

-rarely observed -contains 2 nuclei, each with a large karyosome, in the center of the cell

Answer 962

-fecal-oral -oral-anal

Answer 963

only visible with an electron microscope

Answer 964

-pear-shaped -10-20 um -2 nuclei with large central karyosomes -4 pairs of flagella -anterior & ventral sucking disks -2 axostyles -2 median bodies -"Old man in glasses" -FALLING LEAF motility

Answer 965

-ovoid -8-19 um -thick double wall -cytoplasm shrinks away from cell wall -2-4 nuclei at anterior end -median bodies & axostyles

Answer 966

ingestion of cyst in contaminated water, oral-anal, pets

Answer 967

-patient swallows capsule attached to string -string withdrawn after 4 hours and mucus is examined -antigen detected

Answer 968

-6-24 um -broad anterior, tapering posterior -3 flagella at anterior -1 flagella posterior -spiral groove running length of body -prominent cytostome bordered by fibrils -single nucleus at anterior -stiff rotary motility

Answer 969

-6-10 um -round with bulge at anterior -single large nucleus -hourglass-shaped cytostome & prominent fibrils -"Lemon cyst"

Answer 970

ingestion of cyst

Answer 971

-6-14 um -prominent axostyle extending through posterior -4 anterior flagella -undulating membrane entire length of body along costa -1 oval nucleus with small karyosome -rotary motion

Answer 972

ingestion of fecally contaminated material

Answer 973

-5-18 um -4 anterior flagella -undulating membrane that extends half the body

Answer 974

*Trichomonas vaginalis*

Answer 975

-wet mount (jerky motility) -culture -rapid antigen tests -PCR

Answer 976

-ovoid -usually 40-50 um, but can reach 200 um -covered with cilia -funnel-shaped cytostome -macronucleus & micronucleus -vacuoles -rapid rotary motion

Answer 977

-round -45-65 um -thick refractile cell wall -no cilia

Answer 978

ingestion of cyst

Answer 979

*Balantidium coli* (*Neobalantidium coli*)

Answer 980

*Balantidium coli* (*Neobalantidium coli*)

Answer 981

*Balantidium coli* (*Neobalantidium coli*)

Answer 982

ingestion of oocysts in fecally contaminated food or water

Answer 983

-oocysts in feces -30 x 12 um -transparent -stain well with iodine -1-2 sporoblasts

Answer 984

-anorexia -nausea -abdominal pain -diarrhea -possible malabsorption

Answer 985

-ingestion of oocysts from food or water contamination with animal feces -oral/anal route -direct contact with infected individual or animal

Answer 986

-modified acid-fast stain of feces -red spherical bodies 3-6 um -4 sporozoites -immunoassay kits

Answer 987

indistinguishable by routine microscopy

Answer 988

-chronic diarrhea in immunocompromised or those with AIDS -acute self-limited diarrhea in immunocompetent

Answer 989

contaminated food & water

Answer 990

-oocysts in direct wet mount -8-10 um -variable staining with modified acid-fast stain -autofluorescence under UV light -bright blue at 365 nm -mint green at 450-490 nm -antigen-based immunoassay kits during outbreaks -PCR

Answer 991

prolonged diarrhea

Answer 992

ingestion of spores

Answer 993

-histology on tissue using acid-fast and periodic acid-schiff (PAS) stains -chromotrophic stains also

Answer 994

-causes prolonged diarrhea -can disseminate Opportunistic pathogen, mainly in AIDS patients.

Answer 995

related to fungi

Answer 996

ingestion of infective egg

Answer 997

-undeveloped eggs in feces -barrel-shaped ovum -50 x 23 um -brown or yellow -clear plug at either end

Answer 998

eggs require a developmental period in warm soil before infective

Answer 999

eosinophilia

Answer 1000

ingestion of infective egg

Answer 1001

-ovoid ovum -50 x 20 um -1 side flattened -colorless -larva inside

Answer 1002

itching when adult female migrates out of anus at night to deposit eggs

Answer 1003

cellophane tape prep taken early in the morning when the patient first wakes

Answer 1004

skin penetration or ingestion of filariform larva

Answer 1005

-ovoid ovum -40 x 60 um -colorless -contains segmented embryo 2- to 8-cell stage surrounded by clear outer zone

Answer 1006

New World hookworm

Answer 1007

-severe allergic itching can develop - "Ground itch" -eosinophilia -can lead to anemia

Answer 1008

through lungs

Answer 1009

skin penetration or ingestion of filariform larva

Answer 1010

-ovoid ovum -40 x 60 um -colorless -contains segmented embryo 2- to 8-cell stage surrounded by clear outer zone

Answer 1011

Old World hookworm

Answer 1012

-skin penetration by filariform larva -sexual transmission -autoreinfection

Answer 1013

-rhabditiform larvae -200-250 um long x 16 um in diameter -short buccal cavity -large bulb in esophagus -prominent genital primordium

Answer 1014

Threadworm

Answer 1015

through lungs

Answer 1016

-duodenal aspirates and/or Enterotest -serology (EIA)

Answer 1017

hookworm larvae

Answer 1018

can disseminate & be fatal

Answer 1019

eosinophilia

Answer 1020

ingestion of infective ovum

Answer 1021

Fertilized ovum: -ovoid -50-75 um x 40-60 um -yellow to brown -granular yolk -clear zones at either end -may have mammillated covering or be decorticated Nonfertilized ovum: -larger & more elongated -thinner shell -no concentric clear zones -can be mammillated or decorticated

Answer 1022

*Ascaris lumbricoides*

Answer 1023

*Trichuris*

Answer 1024

eggs require several weeks in soil to become infective

Answer 1025

through lungs

Answer 1026

earthworms

Answer 1027

-anus -mouth -nose

Answer 1028

eosinophilia

Answer 1029

-tetragonal -4 cup-shaped suckers -no hooklets

Answer 1030

-longer than wide -15-30 uterine branches per side -irregularly alternating genital pores

Answer 1031

-spherical -35-45 um -yellow or brown -thick radially striated shell

Answer 1032

ingestion of larva in undercooked beef

Answer 1033

ova in feces

Answer 1034

beef tapeworm

Answer 1035

-4 cup-shaped suckers -2 rows of hooklets around rounded rostellum

Answer 1036

-longer than wide -7-13 uterine branches per side -regularly alternating genital pores

Answer 1037

-spherical -35-45 um -yellow or brown -thick radially striated shell

Answer 1038

ingestion of larva in undercooked pork

Answer 1039

ova in feces

Answer 1040

pork tapeworm

Answer 1041

C. *Taenia solium*

Answer 1042

cysticercosis

Answer 1043

-almond shaped -lateral groove on each side -no hooklets

Answer 1044

-wider than long -central rosette-shaped uterus

Answer 1045

-ovoid -45-70 um -yellow-brown -operculum -small knob at posterior

Answer 1046

1st: crustacean 2nd: fish

Answer 1047

ingestion of larva in undercooked freshwater fish

Answer 1048

ova in feces

Answer 1049

Broad fish tapeworm

Answer 1050

vitamin B12 deficiency

Answer 1051

ingestion of fecal material from infected dog or cat

Answer 1052

radiologic ID of cysts in organs (liver/lungs) -can also ID with serology

Answer 1053

-diamond-shaped -4 suckers -single row of hooklets around short rostellum

Answer 1054

-wider than long -uterine branches obliterated by eggs -3 ovoid irregularly spaced testes

Answer 1055

-round -40 um -colorless -2 distinct walls -slight bulge at each pole of inner wall with 4-8 hair-like polar filaments

Answer 1056

ingestion of eggs in feces of infected mice/rats

Answer 1057

ova in feces

Answer 1058

Dwarf tapeworm

Answer 1059

2.5-4 cm long

Answer 1060

*Hymenolepis nana*

Answer 1061

*Hymenolepis nana*

Answer 1062

ingestion of metacercariae on aquatic plants

Answer 1063

-ova in feces -135 x 80 um -yellow-brown -thin shell -small operculum -granular contents evenly distributed -clear zone between shell & yolk

Answer 1064

large intestinal fluke

Answer 1065

bowel mucosal ulcers

Answer 1066

ingestion of metacercariae on aquatic plants

Answer 1067

Similar to *F. buski*: -ova in feces -135 x 80 um -yellow-brown -thin shell -small operculum -granular contents evenly distributed -clear zone between shell & yolk

Answer 1068

Sheep liver fluke

Answer 1069

ingestion of metacercariae in raw, undercooked, dried, salted, or pickled fish

Answer 1070

-bile ducts -gallbladder -pancreatic ducts

Answer 1071

-ova in feces -29 x 16 um -bulbous -opercular shoulders -small comma-shaped protuberance at posterior -thick shell with tiny spines -ciliated miracidium inside

Answer 1072

Chinese liver fluke

Answer 1073

ingestion of undercooked crabs or crayfish

Answer 1074

-ova in feces or bloody sputum -80-120 um x 48-60 um -yellow-brown -thick shelled -flattened operculum

Answer 1075

Oriental lung fluke

Answer 1076

skin penetration

Answer 1077

intestinal venules

Answer 1078

-ova in feces -elongated -155 x 65 um -pronounced lateral spine

Answer 1079

Blood fluke

Answer 1080

skin penetration

Answer 1081

intestinal venules

Answer 1082

-ova in feces or rectal biopsy -ovoid -90 x 70 um -minute lateral spine

Answer 1083

Blood fluke

Answer 1084

skin penetration

Answer 1085

bladder venules

Answer 1086

-ova in concentrated urine -elongated -140 x 60 um -terminal spine

Answer 1087

Blood fluke

Answer 1088

*Schistosoma haematobium*

Answer 1089

malignant malaria

Answer 1090

36-48 hours

Answer 1091

not enlarged

Answer 1092

-ring forms (trophs) -gametocytes

Answer 1093

quartan malaria

Answer 1094

not enlarged

Answer 1095

ovale malaria

Answer 1096

-sometimes enlarged -frequently oval with ragged margins -Schuffner dots

Answer 1097

tertian malaria

Answer 1098

44-48 hours

Answer 1099

-enlarged -Schuffner dots

Answer 1100

not seen in peripheral blood

Answer 1101

sausage- or crescent-shaped

Answer 1102

-high mortality -medical emergency

Answer 1103

-rarely fatal -band-shaped trophs -similar morphology to newly emerging *P. knowlesi* species - differentiate by symptoms and PCR

Answer 1104

-least common -rarely fatal -may cause relapses

Answer 1105

*P. ovale*

Answer 1106

-most common -rarely fatal -may cause relapses

Answer 1107

*P. vivax*

Answer 1108

-swimming in contaminated water -inadequately disinfected contact lenses

Answer 1109

trophozoites and cysts from brain or skin biopsy or corneal scraping

Answer 1110

-granulomatous amebic encephalitis (GAE) -ulcerative acanthamoeba keratitis in contact lens wearers Usually in immunocompromised or debilitated

Answer 1111

swimming in contaminated ponds or streams

Answer 1112

-stained smears of culture material -trophs in CSF

Answer 1113

primary amebic meningoencephalitis (PAM)

Answer 1114

Anopheles mosquito

Answer 1115

-Wright-stained thick & thin blood smears -draw blood just before paroxysm -rapid immunochromatographic dipsticks for antigen detection and fluorescent DNA/RNA stained films also used

Answer 1116

-tick bite -blood transfusion

Answer 1117

-Wright-stained thick & thin blood smears -parasites in RBCs -2-4 um -trophozoites are usually pear-shaped, usually in pairs (most common) or tetrads

Answer 1118

-ingestion of undercooked meat or oocysts from cat feces -transplacental -organ transplants

Answer 1119

-serological tests -ELISA -PCR

Answer 1120

causes birth defects

Answer 1121

major cause of encephalitis

Answer 1122

flagellate

Answer 1123

sand flies

Answer 1124

amastigote forms in WBCs & cells of the RE system

Answer 1125

obligate intracellular parasite

Answer 1126

Kalaazar, cutaneous & mucocutaneous leishmaniasis

Answer 1127

flagellate

Answer 1128

-*T. brucei gambiense* & *T. brucei rhodesiense*: tsetse fly -*T. cruzi*: reduviid or kissing bug

Answer 1129

-*T. brucei gambiense* & *T. brucei rhodesiense*: trypomastigote in blood, lymph nodes, CSF -*T. cruzi*: trypomastigote in blood; amastigote in RE cells, myocardium, CNS

Answer 1130

East African sleeping sickness

Answer 1131

West African sleeping sickness

Answer 1132

Chagas disease -found in Southern US

Answer 1133

nematode (in dogs/cats)

Answer 1134

ingestion of eggs from dog/cat feces

Answer 1135

serological tests

Answer 1136

visceral & ocular larva migrams (toxocariasis)

Answer 1137

undercooked pork -bear

Answer 1138

-larvae encysted in muscle -serological tests (ELISA)

Answer 1139

-eosinophilia -edema of upper eyelids -fever -myalgia

Answer 1140

-microfilariae in blood -Giemsa-stained thick & thin smears

Answer 1141

chronic infection causes elephantiasis (lymphatic filariasis)

Answer 1142

-microfilariae in blood -Giemsa-stained thick & thin smears

Answer 1143

elephantiasis

Answer 1144

Mango fly (*Chrysops*)

Answer 1145

-microfilariae in blood -Giemsa-stained thick & thin smears

Answer 1146

African eye worm

Answer 1147

-microfilariae from skin snips or aspirates of fibrous nodules on body

Answer 1148

River blindness

Answer 1149

-skin -hair -nails

Answer 1150

makes fungal elements more visible

Answer 1151

-tissues -sputum -body fluids -skin scrapings -corneal scrapings

Answer 1152

fluorescent stain, optimal fluorescence occurs with UV excitation

Answer 1153

microscopic exam of fungal culture

Answer 1154

-lactic acid = preserves -phenol = kills -cotton blue = stains

Answer 1155

gram positive

Answer 1156

*Nocardia* (partially acid-fast)

Answer 1157

CSF sediment if *Cryptococcus* is suspected

Answer 1158

halos around yeast due to wide capsule -insensitive -direct antigen test preferred

Answer 1159

blood & bone marrow

Answer 1160

*Histoplasma*

Answer 1161

1. Sabouraud dextrose agar (SDA) 2. SDA with antibiotics 3. Brain-heart infusion agar 4. Inhibitory mold agar 5. Dermatophyte test medium

Answer 1162

1. Potato dextrose agar 2. Cornmeal agar with Tween 80 3. Urea agar 4. Birdseed agar (niger seed or caffeic agar) 5. Chromogenic agar

Answer 1163

-general medium -pH 5.6 inhibits bacteria -grows most molds & yeasts -can also be made with glucose (SGA)

Answer 1164

-antibiotics inhibit fungal contaminants & bacteria -dermatophytes & most fungal pathogens grow

Answer 1165

-used for the isolation of all fungi including fastidious dimorphic fungi -10% sheep blood is added for enrichment -antibiotics can be added to make the medium selective by inhibiting bacteria

Answer 1166

-for recovery of fungi from specimens contaminated with bacteria -contains chloramphenicol & gentamicin to inhibit bacteria -more sensitive than SDA

Answer 1167

-for recovery of dermatophytes from skin, hair, and nails -turn agar from yellow to red -antibiotics added to inhibit bacteria

Answer 1168

-stimulates sporulation of molds -good for slide cultures

Answer 1169

-allows for enhanced formation of hyphae, blastospores, & chlamydoconidia, to differentiate *Candida* species -*C. albicans* produces chlamydospores

Answer 1170

detects urease for presumptive ID of *Cryptococcus* and *Trichophyton*

Answer 1171

-isolation of *Cryptococcus* species -black-brown colonies in 4-7 days

Answer 1172

-allows rapid ID and detection -contains chromogenic substrates hydrolyzed by species-specific enzymes

Answer 1173

-skin -hair -rarely nails

Answer 1174

-large -spindle or cylinder shaped -thick walled -multi-septate -rough -spiny -borne singly on short conidiophores

Answer 1175

-few or absent -small, club shaped

Answer 1176

-ectothrix hair invasion -some species cause hair to fluoresce under UV light

Answer 1177

direct microscopic examination

Answer 1178

-*M. canis* -*Nannizzia gypsea* -*M. audouinii*

Answer 1179

-hair -skin -nails

Answer 1180

-rare -pencil shaped -multiseptate -thin walled -smooth -borne singly on conidiophore

Answer 1181

-predominant -spherical, tear shaped, or clavate

Answer 1182

-hair infections endothrix or ectothrix -hair usually doesn't fluoresce

Answer 1183

may have spirals, nodular bodies, chlamydospores, faviform mycelia

Answer 1184

red on reverse side

Answer 1185

-*T. mentagrophytes* -*T. rubrum* -*T. tonsurans*

Answer 1186

*T. tonsurans and *M. audouinii*

Answer 1187

-skin -sometimes nails -rarely hair

Answer 1188

-club shaped -septate -thin walled -smooth -borne in singles or clusters of 2-3 per conidiophore

Answer 1189

*E. floccosum* is the only species

Answer 1190

-colony characteristics on SGA and microscopic morphology -MALDI-TOF

Answer 1191

blastomycosis

Answer 1192

-white to gray-brown colony -hyaline, septate hyphae with small oval conidia borne singly at tips of conidiophores -"Lollipops"

Answer 1193

-8-15 um -round, thick walled -single bud connected by wide neck

Answer 1194

Ohio & Mississippi River valleys

Answer 1195

farmers - contract from soil

Answer 1196

-begins in lungs -may become systemic

Answer 1197

paracoccidioidomycosis

Answer 1198

resembles *Blastomyces*: -white to gray-brown colony -hyaline, septate hyphae with small oval conidia borne singly at tips of conidiophores -"Lollipops"

Answer 1199

-10-30 um -round, double walled -multiple buds pinched at attachment -"Mariner's wheel"

Answer 1200

-Brazil -Argentina -S. Mexico

Answer 1201

-begins in lungs -can become systemic

Answer 1202

Valley fever

Answer 1203

-fluffy or powdery white to gray-tan colonies -barrel-shaped arthrospores

Answer 1204

-spherule -20-80 um -contains numerous endospores

Answer 1205

California and fixed desert of Southwest US

Answer 1206

diagnosed more in males than females (15:1 ratio)

Answer 1207

-spores are inhaled or contaminate injured skin -affects respiratory tract 1st -can spread to other organs

Answer 1208

arthrospores

Answer 1209

serological tests

Answer 1210

Histoplasmosis

Answer 1211

-silky, white to gray-tan colonies -thick-walled spherical macroconidia, 7-16 um, surrounded by finger-like projections -"Tuberculate chlamydospores"

Answer 1212

-1-4 um -round to oval -intracellular in phagocytes of blood or bone marrow

Answer 1213

Ohio & mississippi River valleys

Answer 1214

(Soil saprophyte) -grows best in soils enriched with bird or bat droppings

Answer 1215

acute pulmonary disease (esp. dangerous to immunocompromised) -predilection for RE system

Answer 1216

Sporotrichosis (rose gardener's disease)

Answer 1217

-white to yellow colonies -clusters of pear-shaped conidia at tips of conidiophores -"flowers"

Answer 1218

-gram positive -cigar-shaped cells -usually not seen in direct smears unless by immunofluorescence

Answer 1219

Mississippi & Missouri River valleys

Answer 1220

-rose bushes -barberry bushes -sphagnum moss -mulch

Answer 1221

farmers or florists -introduced by trauma, usually to the hand

Answer 1222

spread along lymphatics

Answer 1223

-thrush (mouth) -vulvovaginitis -diaper rash -onychomycosis (nails) -paronychomycosis (cuticles) -endocarditis -meningitis -UTI -pulmonary infections -candidemia

Answer 1224

grows on SBA, EMB (spider-like projections), SDA

Answer 1225

gram positive cells, 2-4 um

Answer 1226

blastoconidia or pseudohyphae (no constrictions)

Answer 1227

produces germ tubes

Answer 1228

produces round terminal chlamydospores

Answer 1229

chromogenic agar

Answer 1230

-GI tract -mucocutaneous areas

Answer 1231

-onychomycosis (nails) -esophagitis

Answer 1232

-serological (antigen & antibody) -nucleic acid tests

Answer 1233

-vaginitis -UTI -GI -pulmonary -systemic infections

Answer 1234

blastoconidia produced randomly along pseudohyphae

Answer 1235

may produce constricted germ tubes (true germ tubes lack constrictions)

Answer 1236

immunosuppressed

Answer 1237

-UTI -systemic infections

Answer 1238

-no true- or pseudomycelium -small budding cells only

Answer 1239

fluconazole

Answer 1240

*C. glabrata*

Answer 1241

-endocarditis -ocular

Answer 1242

-forms true/pseudophyphae -does not produce germ tube

Answer 1243

fluconazole

Answer 1244

uncommon cause of wound infections & oral thrush

Answer 1245

forms hockey stick-shaped arthroconidia

Answer 1246

lung infections that can disseminate to brain

Answer 1247

-irregularly sized -spherical -surrounded by a capsule

Answer 1248

maroon to brown-black colonies

Answer 1249

-bird & bat droppings -decaying vegetation -fruit -milk

Answer 1250

capsule seen in about 50% of cases

Answer 1251

disseminated cryptococcosis

Answer 1252

Tinea versicolor

Answer 1253

-oval or bottle-shaped budding yeast -3-8 um in diameter -characteristic collar between mother & daughter cells

Answer 1254

chains of short, slightly curved septate hyphae may be seen

Answer 1255

KOH prep of skin scrapings

Answer 1256

atypical interstitial plasma cell pneumonia (PCP)

Answer 1257

cysts are 4-12 um spheres with intracystic bodies

Answer 1258

can't be cultured

Answer 1259

histopathological staining

Answer 1260

-preterm infants -immunocompromised

Answer 1261

-common lab contaminant -propensity to attack vascular system of immunocompromised -rapidly spreading -often fatal

Answer 1262

-mature within 4 days -"Lid lifter" -FRONT: dense cotton candy-like growth, white at first, turning gray or yellow-brown -REVERSE: white

Answer 1263

-Hyphae: large, broad, nonseptate -produces horizontal stolons that attach by rhizoids -sporangiophores in clusters opposite rhizoids -terminate in dark, round sporangia containing sporangiospores

Answer 1264

-common lab contaminant -propensity to attack vascular system of immunocompromised -rapidly spreading -often fatal

Answer 1265

-mature within 4 days -"Lid lifter" -FRONT: dense cotton candy-like growth, white at first, turning gray -REVERSE: white

Answer 1266

-Hyphae: large, broad, nonseptate -produces horizontal stolons -sporangiophores in clusters or branched -NO rhizoids -terminate in dark, round sporangia containing sporangiospores

Answer 1267

*A. fumigatus*

Answer 1268

-common contaminant -can cause invasive infection, colonization, toxicosis, allergy

Answer 1269

-mature within 3 days -FRONT: fluffy, granular, or powdery texture; white at first, then color depends on species: *A. fumigatus* - white to blue-green *A. niger* - black *A. flavus* - yellow to green *A. terreus* - tan to cinnamon -REVERSE: white, goldish, or brown

Answer 1270

-septate hyphae, branching at 45* angle -unbranched conidiophore arises from foot cell -expands into large, spherical vesicle covered with phialides that produce chains of round conidia

Answer 1271

hyaline mold

Answer 1272

-can be a contaminant -can cause mycetoma, corneal & nail infections

Answer 1273

-mature within 5 days -FRONT: white, spreading, moist, colorless; becomes cottony with gray top -REVERSE: yellow or rose

Answer 1274

-small, hyaline, septate hyphae -unbranched phialides -oblong, 1- to 2-celled conidia in clusters at tips of phialides

Answer 1275

hyaline mold

Answer 1276

-can be a contaminant -can cause eye, skin, nail, systemic infections

Answer 1277

-mature within 4 days -FRONT: white & cottony, developing a pink or violet center -REVERSE: light

Answer 1278

-septate hyphae -unbranched conidiophores -large, canoe-shaped, multiseptate macroconidia -small 1- to 2-celled oval or cylindrical conidia in singles or clusters on simple conidiophores

Answer 1279

hyaline mold

Answer 1280

-can be a contaminant -can cause keratitis, external ear infections, endocarditis with artificial heart valves

Answer 1281

-matures within 4 days -FRONT: white at first; becomes powdery, blue-green with white border -REVERSE: usually white

Answer 1282

-septate hyphae -branched or unbranched conidiophores -"brush-like" -flask-shaped phialides bearing unbranched chains of round conidia

Answer 1283

Dematiaceous

Answer 1284

-can be contaminant -can cause subcutaneous infection

Answer 1285

-mature within 5 days -FRONT: gray-white & wooly at first; becomes green-black or brown with light border -REVERSE: black

Answer 1286

-dark septate hyphae -conidiophores of variable length, sometimes branched -large brown, drumstick-shaped conidia with transverse & longitudinal septations, in singles or chains

Answer 1287

Dematiaceous

Answer 1288

non-pathogenic

Answer 1289

-mature within 7 days -FRONT: green-brown or black with velvety nap; becomes heaped & slightly folded -REVERSE: black

Answer 1290

-dark septate hyphae -dark branching conidiophores producing 2 or more chains of oval brown conidia

Answer 1291

Dematiaceous

Answer 1292

-can be a contaminant -can cause sinusitis, keratitis

Answer 1293

-mature within 5 days -FRONT: dark olive green to brown or black with pink-gray wooly surface -REVERSE: black

Answer 1294

-dark septate hyphae -simple or branched conidiophores, bent where conidia attach -large, 4-celled, curved conidia -central cell is larger & darker

Answer 1295

-*Histoplasma capsulatum* *Cryptococcus neoformans* -*Candida* spp. -*Blastomyces dermatitidis* -*Malassezia furfur*

Answer 1296

-*Cryptococcus neoformans* -*Coccidioides* spp. -*Histoplasma capsulatum* -*Candida* spp.

Answer 1297

-*Trichophyton* -*Microsporum*

Answer 1298

-*Trichophyton* -*Epidermophyton* -*Candida* -*Aspergillus*

Answer 1299

-*Candida* -*Aspergillus* -*Rhizopus* -*Mucor* -*Penicillium* -*Blastomyces dermatitidis* -*Coccidioides* spp. -*Paracoccidioides brasiliensis* -*Histoplasma capsulatum* -*Sporothrix schenckii*

Answer 1300

-*Candida* -*Trichophyton* -*Microsporum* -*Epidermophyton*

Answer 1301

*Candida albicans*

Answer 1302

-*Candida* -*Blastomyces dermatitidis* -*Coccidioides* spp. -*Histoplasma capsulatum* -*Cryptococcus neoformans*

Answer 1303

*Candida albicans*

Answer 1304

1. virion 2. nucleocapsid 3. nucleic acid 4. capsid 5. envelope

Answer 1305

complete virus particle

Answer 1306

nucleic acid & capsid

Answer 1307

-DNA or RNA -single- or double-stranded -linear or circular

Answer 1308

-protein coat that encloses genetic material -may be helical (rod-like) or icosahedral (cuboid) -composed of protein subunits called capsomers -protects nucleic acid -enables virus to attach to & enter host cell

Answer 1309

-outer membrane surrounding capsid in some viruses -aids in attachment to host cell -viruses without called naked nucleocapsids

Answer 1310

attachment of virus to host cell receptor

Answer 1311

virus enters host cell by direct penetration, endocytosis (entering in a vacuole), or fusion with cell membrane

Answer 1312

-eclipse: several hours during which virions can't be detected -synthesis: mRNA is produced; directs synthesis of viral particles

Answer 1313

-loss of capsid -genome enters cytoplasm (most RNA viruses) or nucleus (most DNA viruses)

Answer 1314

-genetic material assembled into protein coat-virions migrate to cytoplasmic membrane -released by budding off, leaking out, or lysing host cell with enzymes

Answer 1315

-adenoviruses ->60 serotypes divided into subgroups

Answer 1316

-mild respiratory, urinary tract, GI, & eye infections -can cause highly contagious pink eye (conjunctivitis)

Answer 1317

Hepatitis B

Answer 1318

-Herpes simplex viruses (HSV-1, HSV-2) -Varicella-zoster virus (VZV) -Epstein-Barr virus (EBV) -Cytomegalovirus(CMV) -Human herpesviruses 6-8

Answer 1319

-Herpes simplex viruses (HSV-1, HSV-2): oral, genital, neonatal, & ocular herpes, HSV encephalitis -Varicella-zoster virus (VZV): Chicken pox (varicella), shingles (zoster) -Epstein-Barr virus (EBV): infectious mononucleosis -Cytomegalovirus(CMV): infections in newborns & immunocompromised -Human herpesviruses 6-8: Roseola, Kaposi sarcoma

Answer 1320

Human papilloma virus (HPV)

Answer 1321

warts, including genital warts that are linked to cervical cancer

Answer 1322

Parvovirus B19

Answer 1323

Fifth disease (erythema infectiosum)

Answer 1324

-Lymphocyte choriomeningitis virus (LCM) -Lassa fever virus

Answer 1325

-LCM: aseptic meningitis or meningoencephalitis -Lassa fever virus: Lassa fever

Answer 1326

Astrovirus

Answer 1327

gastroenteritis in children, elderly, and immunocompromised

Answer 1328

Hantavirus (Sin Nombre virus)

Answer 1329

Hantavirus pulmonary syndrome (HPS)

Answer 1330

Noroviruses

Answer 1331

most common cause of infectious gastroenteritis in the US

Answer 1332

Coronavirus

Answer 1333

-severe acute respiratory syndrome (SARS) -cold-like infections -pediatric diarrhea -COVID-19

Answer 1334

-Marburg -Ebola

Answer 1335

hemorrhagic fever

Answer 1336

hemorrhagic fever

Answer 1337

-Yellow fever virus -Japanese encephalitis virus -dengue virus -West Nile virus -Zika virus (Note: above viruses are arboviruses - arthropod-borne viruses) -Hepatitis C virus (HCV)

Answer 1338

-Yellow fever virus: yellow fever -Japanese encephalitis virus: Japanese encephalitis -dengue virus: dengue fever -West Nile virus: West Nile virus infection -Zika virus: Zika (Note: above viruses are arboviruses - arthropod-borne viruses) -Hepatitis C virus (HCV): Hepatitis C

Answer 1339

Influenzae A, B, & C

Answer 1340

Influenzae

Answer 1341

-Measles virus -Mumps virus -Parainfluenza virus -Respiratory syncytial virus (RSV) -Human metapneumovirus (HMPV)

Answer 1342

-Measles virus: measles (rubeola) -Mumps virus: mumps -Parainfluenza virus: RTI in children -Respiratory syncytial virus (RSV): RTI in infants, elderly, immunocompromised -Human metapneumovirus (HMPV): RTI

Answer 1343

-Enteroviruses (polioviruses, coxsackieviruses A & B, echoviruses, enteroviruses) -Hepatitis A virus (HAV) -Rhinovirus

Answer 1344

-Enteroviruses (polioviruses, coxsackieviruses A & B, echoviruses, enteroviruses): Polio, hand-foot-mouth disease, aseptic meningitis, others -Hepatitis A virus (HAV): Hepatitis A -Rhinovirus: common cold

Answer 1345

Rotavirus: most common cause of gastroenteritis in infants & children

Answer 1346

-HIV-1, HIV-2 -Human T-lymphotropic viruses (HTLV-1, HTLV-2)

Answer 1347

-HIV-1, HIV-2: AIDS -Human T-lymphotropic viruses (HTLV-1, HTLV-2): T-cell leukemia & lymphoma, tropical spastic paraparesis

Answer 1348

Rabies virus

Answer 1349

Rabies virus: rabies

Answer 1350

-Rubella virus -Eastern, Western, & Venezuelan equine encephalitis viruses

Answer 1351

-Rubella virus: rubella (German measles) -Eastern, Western, & Venezuelan equine encephalitis viruses: Eastern, Western, & Venezuelan encephalitis

Answer 1352

-CSF -throat swab -stool -brain tissue -blood

Answer 1353

-Enteroviruses -HSV -arboviruses

Answer 1354

-conjunctival swab -corneal scraping

Answer 1355

-HSV -adenoviruses

Answer 1356

-genital swab -vesicle swab or fluid -lesion biopsy

Answer 1357

-stool -rectal swab

Answer 1358

Adults: noroviruses, adenoviruses, enteroviruses Infants/children: rotavirus, adenoviruses

Answer 1359

-nasal aspirate -throat swab -nasopharyngeal swab -bronchoalveolar lavage -lung biopsy

Answer 1360

-Influenzae A & B -parainfluenza virus -adenoviruses -RSV -HMPV -rhinovirus -enteroviruses -coronavirus

Answer 1361

vesicle fluid or scrapings

Answer 1362

-HSV -VZV -measles -rubella -enterovirus -parvovirus B19

Answer 1363

-HSV -VZV -measles -rubella -enterovirus -parvovirus B19

Answer 1364

-adenoviruses -HSV -CMV

Answer 1365

during acute phase (1st 3-5 days)

Answer 1366

site of infection, entry & exit sites

Answer 1367

sterile, leak-proof, nonbreakable

Answer 1368

-dacron -rayon -other polyester tips -plastic or aluminum shafts -calcium alginate, cotton, wood are inhibitory for some viruses

Answer 1369

-VTM -Amies -Stuart transport media (NOT required for blood, CSF, or urine)

Answer 1370

-deliver immediately -if not possible, keep at 2-8*C & deliver within 2 hours -EXCEPTION: keep whole blood at room temperature

Answer 1371

-best to process upon arrival -if not possible, hold at 2-8*C for up to 48 hours ->48 hours, freeze at -70*C (not recommended)

Answer 1372

microscopic examination of specimen for viral cytopathic effect (CPE)

Answer 1373

-rarely used -labor intensive, expensive

Answer 1374

-fluorescent-labeled antibody added to patient cells fixed to slide -if viral antigen present, antibody binds -fluorescence seen with fluorescent microscope

Answer 1375

solid-phase & membrane ELISAs

Answer 1376

-rapid modification of conventional cell culture -detection in 1-2 days -specimen centrifuged onto monolayer of cells growing on coverslip -coverslips stained with viral-specific immunofluorescent conjugate -used primarily by reference labs

Answer 1377

-PCR -real-time PCR -branched DNA -nucleic acid hybridization -faster & more sensitive than cell culture -can detect multiple viruses simultaneously

Answer 1378

-detects antibodies in serum -presence of antibodies isn't always indicative of current infection -useful in evaluating immune status or diagnosing -alternatively, can detect antigen from swabbed site

Answer 1379

B. the use of calcium alginate swab for *Chlamydia*

Answer 1380

C. CHOC agar

Answer 1381

C. *Salmonella* & *Shigella*

Answer 1382

A. *Pseudomonas aeruginosa*

Answer 1383

B. *Proteus vulgaris*

Answer 1384

C. *Haemophilus influenzae*

Answer 1385

A. modified oxidase (microdase)

Answer 1386

D. oxacillin

Answer 1387

C. *Trichomonas vaginalis*

Answer 1388

B. skin and nails