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Micro Flashcards Unit 3

1) A fungal specimen isolated from the bone marrow of a patient with a pulmonary infection showed tuberculate macroconidia at 30C and yeastlike cells at 36C. Indentify the most likely dimorphic fungi with these characteristics.

Trichophyton mentagrophytes

2) A yeast-like organism was isolated form a sputum specimen. On cornmeal agar, this yeast produced mycelia with thick-walled terminal chlamydoconidia. This organism is most likely:

Candida albicans

3) Thick-walled yeast cells bearing sibgle buds attached by a broad base are observed in an aspirated clinical specimen. The organism is most likely:

Blastomyces dermatitidis

4) Crust form a cauliflower-like lesion on the hand microscopically exhibited brown spherical bodies. After 3 weeks incubation at room temperature, a black mold grew on Sabouraud’s agar. Microscopic examination revealed cladosporium, phialophora and acrotheca sporulation. The most probable identification is:

Fonsecaea pedrosoi

5) In order to prove a yeast is dimorphic, which of the following tests is performed?

Incubate yeast subculture at 37C

6) Antimicrobial agents that inhibit bacterial growth but generally do not kill the organism are known as

bacteriostatic

7) Antimicrobial agents that usually kill target organisms are said to be

bactericidal

8) Antimicrobial resistance resulting from the normal genetic, structural, or physiologic state of a microorganism is referred to as ________ resistance.

intrinsic

9) Antibiotic resistance resulting from altered cellular physiologic structure caused by changes in a microorganism’s usual genetic makeup is known as __________ resistance.

acquired

10) Staphylococcus aureus is a gram-positive organism that produces the enzyme beta-lactamase, which renders certain types of antibiotics inactive. The mode of action that is prevented in certain antibiotics sensitive to this enzyme is:

cell wall synthesis

11) The mechanism of acquired, high-level resistance to vancomycin involves

production of altered cell wall precursors that do not bind the antibiotic with sufficient avidity

12) Mycoplasmas are organisms without cell walls. Which antimicrobial agents would be ineffective in treating infections involving this bacterium?

Penicillin

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13) Klebsiella spp. were isolated from a sputum sample, and susceptibility testing was performed. The isolates were sensitive to several antibiotics; however, they were resistant to ampicillin. Which one of the following statements explains this discrepancy?

No discrepancy is present; Klebsiella spp. are normally resistant to ampicillin

14) What is the mode of action for Vancomycin? Cell wall synthesis inhibition15) What is the mode of action for Polymyxin B? Cell membrane function inhibition16) What is the mode of action for Tetracycline? Protein synthesis inhibition17) What is the mode of action for Ciprofloxacin? DNA and ribonucleic acid (RNA)

synthesis inhibition18) The primary goal of antimicrobial susceptibility

testing is to:Determine whether the pathogen is capable of expressing resistance to the potential choices of antimicrobial agents

19) Up-to-date tables that list potential antimicrobial agents to include in batteries for testing against particular organisms or organism groups are published by the:

Clinical and Laboratory Standards Institute (CLSI).

20) The minimum inhibitory concentration (MIC) result recorded in antimicrobial testing can be defined as the:

Lowest antimicrobial agent concentration that completely inhibits visible bacterial growth.

21) A bacterial suspension of 1.5 x 108 colony-forming units (CFUs)/mL is comparable with which standard inoculum?

0.5

22) In the disk diffusion method of antimicrobial susceptibility testing, what is the standard agar base medium used for testing most bacterial organisms?

Mueller-Hinton agar

23) As a result of the organism going through several doubling generations of growth before inhibition, a haze of bacterial growth occurs on the agar around the disk. This phenomenon, which should be ignored, can be observed when testing which class of antibiotics?

Sulfonamides

24) Detection of the haze produced by some resistant staphylococci and enterococci against methicillin and vancomycin can best be accomplished by:

Using transmitted light

25) The minimal bactericidal concentration (MBC) test involves:

99.9% reduction in CFUs/mL, compared with the organism concentration in the original inoculum.

26) The serum bactericidal test (SBT) involves: Using patient serum to detect bacteriostatic and bactericidal activity and the antibacterial impact of factors other than the antibiotics.

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27) The antibiotic nitrofurantoin is effective against both gram-positive and gram-negative bacteria. This antibiotic is effective against which type of specimen?

Urine

28) An important requirement for appropriate inoculum preparation in susceptibility testing includes the use of a(n):

Pure culture

29) In the microdilution broth dilution method, the interpretive criteria for the susceptible, intermediate, or resistant categories are based on the:

Correlations of the MIC with serum achievable levels for the antimicrobial agent, particular resistance mechanisms, and successful therapeutic outcomes.

30) The concentrations in a broth dilution test that separate the categories of susceptible, intermediate, and resistant are called:

Breakpoints.

31) Chromogenic cephalosporins are used to test for: production of beta-lactamase by the infecting organism.

32) Growth on the oxacillin agar screen means that a patient should be treated with which antibiotic?

Vancomycin

33) Staphylococcal resistance to oxacillin is used to determine and report resistance to:

Cephalosporin.

34) Enterococcal high-level gentamicin resistance predicts resistance to:

Aminoglycoside.

35) Enterococcal resistance to ampicillin predicts resistance to: Cephalosporin.

36) Bactericidal tests should be performed: For severe and life-threatening infections

37) Daptomycin, whose mode of action is to inhibit cell membrane function, is ineffective against which organism?

Escherichia coli

38) Fungal Infections are generally acquired via which route?

Inhalation of spores

39) What is an example of a Dimorphic Fungus? Coccidoides40) Which Phylum exhibits both a Telemorph and an

Anamorph form?Ascomycota

41) A 16-year-old male teenager is diagnosed with a fungal infection of his foot, which he acquired at the gym. This infection would most likely be classified as a(n) ______ mycosis.

Superficial

42) A 59-year-old patient with cancer who was receiving high doses of chemotherapy developed a secondary lung infection that was identified as a fungus. The organism disseminated, which ultimately was fatal to the patient. The organism isolated from sputum exhibited septate hyphae that were dichotomous. The organism is most likely _______.

Aspergillus

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43) Blood cultures are collected from a 36-year-old paitent suspected of having a disseminated fungal infection. History reveals that she was exposed to bird droppings and may have inhaled the conidia. What is the best blood culture system to use to ensure optimal recovery of this pathogen?

Isolator System

44) The optimal temperature and length of time toIncubate a sample suspected of containing aDermatophyte is ____°C for ____ days.

30; 21

45) A 29-year old patient with acquired immunodeficiency syndrome (AIDS) is suspected of having a Cryptococcus neoformansinfection in the cerebrospinal fluid (CSF). A CSF specimen is collected and set up on cycloheximide agar. In addition an India ink stain is set up. The India ink stain reveals encapsulated yeast; however 3 weeks later, the cylcoheximide afar is negative. Explain the discrepancy?

The ingredients in the cycloheximde agar most likely inhibited the growth of the organism.

46) If a fungal colony is described as rugose, then it means that the colony______

Furrows radiate out from the center.

47) Microscopically, this fungus apprears barrel shaped with thick walls

Anthroconidia

48) All mold cultures and clinical samples should always be handled in a Class _____ level biosafety cabinet.

II

49) An example of a thermally monomorphic mold is Epidermophyton50) A septate hyphae is microscopically observed using

cotton blue. Which organism can be ruled out as the cause of infection on the basis of this information?

Rhizopus

51) The mode of transmission for most of the dimorphic fungi is

Inhalation

52) What type of fungal media is ideal for the recovery of the organisms such as Microsporum and Trichophyton?

Mycosel Agar

53) Urea is set up for quality control purposes using two Trichophyton spp. T. mentagrophytes and T. rubrum. After the appropriate amount of incubation, both organisms are negative. Explain the discrepancy

The medium is most likely expired

54) Which stain requires the use of a fluorescent microscope?

Calcofluor white

55) A-28-year-old woman was gardening when a rose thorn pricked her finger, which later became infected. A sample is taken of the exudate and sent to the microbiology laboratory. Small, round, cigar-shaped structures are microscopically observed. She is most likely infected with which type of fungi?

Sporothrix schenkii

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56) Colonies are isolated 4 days after incubation from a skin infection that disseminated in a burn victim. A fungal infection is suspected. What is a possible organism that may be identified?

Fusarium

57) A capsule and phenoloxidase melanin synthesis are virulence factors contributing to the pathogenicity of the organism _____.

Cryptococcus neoformans

58) Unbranched sporangiophores with rhizoids that appear opposite the point where the stolon arises at the base of the sporangiophore best describes?

Rhizopus

59) Which genus is involved in infections of the skin and nails only?

Epidermophyton

60) The term used to describe ringworm of the nail is: Tinea unguium61) The slow-growing organism Trichophyton rubrum

produces a flat or heaped-up colony, generally white to reddish with a cottony or velvety surface. The cherry-red color is best observed on the reverse side of the colony. This organism is capable of infecting which area of the body?

Hair, skin, and nails

62) A hair perforation test is performed using Trichophyton mentagrophytes and T. rubrum. The expected results are:

positive for T. mentagrophytes and negative for T. rubrum

63) Which Trichophyton spp. grows slowly (14 to 30 days) and best at 35° to 37° C? In addition, enriched media with thiamine and inositol enhance its growth.

T. verrucosum

64) Trichophyton schoenleinii causes a condition that is characterized by the formation of yellowish cup-shaped crusts or scutulae, considerable scarring of the scalp, and sometimes permanent alopecia. This organism is usually recovered in _____ days.

30

65) Which dermatophyte usually fluoresces yellow-green under a Wood’s lamp?

Microsporum audouinii

66) A fungus is recovered from a nail scrapping. Microscopic examination reveals numerous smooth, thin-walled, club-shaped, multiseptate macroconidia; however, microconidia are absent. The organism can be identified as:

Epidermophyton floccosum

67) A pulmonary fungus ball and external otomycosis and onychomycosis are all infections caused by?

Aspergillus

68) Which rapidly growing Aspergillus spp. (2 to 6 days) best describes a mold that produces a fluffy-to-granular, white-to–blue green colony?

Fumigatus

69) Which organism produces mostly shades of green or blue-green colonies? Microscopically, hyphae are hyaline and septate and produce brushlike conidiophores.

Penicillium

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70) An organism was isolated after growing 26 days. Colonial morphologic appearance revealed heaped, wrinkled, moist, and yeastlike colonies. As the culture aged, colonies became covered with short aerial mycelium that turned from tan to brown. This organism is most likely:

P. brasiliensis

71) Which two assays should be used together for detecting antibodies toward Blastomyces dermatitidis, Histoplasma capsulatum, and Coccidioides immitis?

Complement fixation and immunodiffusion

72)Coccidioides immitis Nonbudding, thick-walled spherule73) Histoplasma capsulatum Small, round-to-oval yeast cells; 2

to 5 microns in diameter74) Paracoccidioides brasiliensis Budding yeast resembling a

“mariner’s wheel75) Penicillium marneffei Yeastlike cells with internal cross

walls76) Sporothrix schenckii Cigar-shaped yeast cells77) Blastomyces dermatitidis Single bud connected to the parent

cell by broad base78) Mycetoma is a subcutaneous infection that involves

the lower extremities but may also occur in any part of the body. Swelling, purplish discoloration, and tumorlike deformities of the subcutaneous tissue are all symptoms associated with mycetoma. Which organism can cause this disease?

Pseudallescheria boydii

79) An agricultural worker is punctured by a tool used in the field. An infection, characterized by the development of a papule that is similar to a cauliflower appearance, develops. The worker is most likely suffering from which type of infection?

Chromoblastomycosis

80) Macroscopic examination of granules from lesions of mycetoma reveal them to be white to yellow and 0.2 to 2 mm in diameter. Microscopically, the granules consist of loosely arranged, intertwined septate hyaline hyphae cemented together. Which organism can cause a mycetoma infection?

Pseudallescheria boydii

81) Which dematiaceous fungus causes a condition known as chromoblastomycosis?

Phialophora spp.

82) Exophiala jeanselmei causes what disease? Black-grain mycetoma83) Pseudallescheria boydii causes what disease? White-grain mycetoma84) Piedraia hortae causes what disease? Black piedra85) Hortaea werneckii causes what disease? Tinea nigra86) Alternaria causes what disease? Sinusitis87) The microscopic characteristics of Phialophora are… This fundus exhibits cup- or flask-

shaped collarette.

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88) The microscopic characteristics of Fonsecaea are… Conidial heads with a sympodial arrangement of conidia exhibit primary conidia giving rise to secondary conidia.

89) The microscopic characteristics ofAlternaria are…

Conidiophores bear a chain of large brown conidia, resembling a drumstick, and contain both horizontal and longitudinal septa.

90) The microscopic characteristics of Bipolaris are… Conidiophores are bent at the locations where conidia are attached; conidia are sympodially arranged and are oblong to fusoid in shape.

91) The microscopic characteristics of Cladosporium are…

Conidia are usually single celled and exhibit prominent attachment scars (disjunctors).

92) The microscopic characteristics of Culvaria are… Conidia are arranged sympodially, golden brown, multicelled, and curved with a central swollen cell.

93) The microscopic characteristics of Exophiala are… Feltlike, filamentous colonies produce dematiaceous hyphae and conidiophores that are cylindrical and have a tapered tip.

94) Which form is considered diagnostic in the life cycle of Pneumocystis jirovecii?

Cyst

95) The cell membrane of Pneumocystis jirovecii contains _______ rather than _______, which differentiates it from other fungi.

cholesterol; ergosterol

96) Which therapy has decreased the incident of pneumocystis infection in patients with human immunodeficiency virus or acquired immunodeficiency syndrome (HIV/AIDS)?

Highly active antiretroviral therapy (HAART)

97) In patients who do not have HIV, which underlying condition is considered a risk factor for acquiring PCP?

Cystic fibrosis

98) Which type of molecular assay has been developed to identify Pneumocystis jirovecii but is not yet available in commercial kits?

Real-time polymerase chain reaction (PCR)

99) In general, yeast reproduce asexually by the formation of:

blastoconidia

100) The most commonly isolated yeast in clinical specimens is:

Candida albicans

101) Cryptococcus neoformans is widely distributed in nature, and aerosolization is a prerequisite to most infections. This organism is most often associated with exposure to:

pigeon excreta

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102) A patient with diabetes is experiencing creamy patches on his tongue and mucous membranes. Cultures are performed, and yeast is recovered. His diagnosis is most likely:

thrush

103) A patient with leukemia is diagnosed with a Candida infection after receiving several doses of chemotherapy. The most likely yeast causing the infection is:

C. tropicalis.

104) A patient with acquired immunodeficiency syndrome (AIDS) notices skin lesions on his back that have begun to ulcerate. Upon physical examination, his physician also notices hepatomegaly that is most likely caused by hepatitis. The physician prescribes antifungal therapy to prevent the dissemination of which of the following yeasts?

C. neoformans

105) A fungal infection found mostly in the tropics and temperate regions is characterized by the development of soft, yellow or pale-brown aggregations around hair shafts in the axillary, facial, genital, and scalp regions. The fungus that would most likely be isolated is:

Trichosporon.

106) Tinea versicolor is a skin infection characterized by superficial brownish scaly areas most often on the trunk, arms, or shoulders. Which type of replacement therapy places patients at risk for developing this type of skin infection?

Lipid

107) Encapsulated yeast is identified in the cerebrospinal fluid (CSF) of a patient with AIDS. The most likely stain or reagent used to identify this organism is:

India ink.

108) Agar medium overlaid with olive oil will enhance the growth of which organism?

Malassezia

109) Blood cultures are drawn on a patient suspected of having a fungemia. Positive cultures reveal the presence of chlamydoconidia on cornmeal agar. In addition, the yeast is germ-tube positive. The most likely identification of the fungal agent is:

C. albicans.

110) Determining urease activity and growth on niger seed agar is helpful in determining which type of yeast?

Cryptococcus neoformans

111) Which yeast identification system uses chromogenic substrates to assess specific enzyme activity usually detected within 4 hours?

MicroScan

112) If cornmeal agar is set up and chlamydoconidia are produced, the organism is most likely:

C. albicans.

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113) Match the organisms with its characteristics in the columns 1 - 4

OrganismsTrichosporon spp. 3Candida albicans 4Malassezia furfur 2Cryptococcus neoformans 1

Characteristics1. Polysaccharide capsule2. Spaghetti and meatball morphologic appearance3. White piedra4. Creamy, white patches

114) The agency that provides documents and sets standards for antifungal susceptibility testing is the:

Laboratory Standards Institute (CLSI)

115) The Reference Method for Broth Dilution Antifungal Susceptibility Testing of Filamentous Fungi; Approved Standard (M38-A) describes the guidelines for antifungal susceptibility testing for molds. The suspension must be standardized with a spectrophotometer. Susceptibility testing is determined by which method?

Microdilution

116) A patient is diagnosed with an invasive Aspergillosis infection. The antifungal therapy that should be administered is:

amphotericin B

117) A patient who is positive for the human immunodeficiency virus (HIV) is diagnosed with a Cryptococcus neoformans infection. The attending resident prescribed Griseofulvin; however, the patient’s condition did not seem to improve. Which one of the following statements explains this discrepancy?

Griseofulvin is not effective against C. neoformans; therefore the therapy should be changed

118) Know the Antifungal agent with its mode of actiona. Amphotericin Bb. Griseofulvinc. 5-Fluorocytosined. Echinocandine. Azole

a. Alters membrane permeabilityb. Binds microtubular proteinsc. Inhibits protein synthesisd. Is a glucan synthesis inhibitore. Interferes with ergosterol synthesis

119) If a virus is referred to as naked, it means it lacks which structure?

Envelope

120) The function of the glycoprotein spike on some viruses is to

stabilize attachment for the lipid envelope

121) Some viruses have the ability to stimulate uncontrolled growth of the host cells, resulting in cancer. Which virus has oncogenic properties?

Papilloma

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122) Which type of swab is not suitable for the collection of a viral specimen as a result of its ability to interfere with certain tests?

Calcium alginate

123) The specimen of choice to collect in suspected cases of respiratory syncytial virus (RSV) is:

nasopharyngeal

124) A 2-year-old girl is suspected of having a rotavirus infection. The specimen of choice to collect to identify the agent is:

stool

125) The appropriate temperature in which to store specimens for viral isolation is ____º C.

4

126) Amie’s, Leibovitz-Emory, and Stuart’s are all types of:

transport media

127) The cytomegalovirus (CMV) produces cytopathic effects (CPE) in diploid fibroblast cells in an average of 7 days. The results are available within 16 hours using which type of assay?

Shell vial

128) Which assay is the current recommended method of detection in most laboratories for influenzas A and B viruses?

Reverse transcriptase polymerase chain reaction (RT-PCR)

129) If Negri bodies are identified in brain tissue through cytologic means, then the virus is identified as a(n):

rabies virus

130) The most used EIA for antigen detection that uses a solid phase and membrane is used for detecting which virus?

Respiratory syncytial virus (RSV)

131) The enzyme-linked virus-inducible system (ELVIS) uses a cloned beta-galactosidase gene that is expressed only when cells are infected with what virus?

HSV

132) Which enzyme is incorporated into the master mix in the PCR reaction?

Deoxyribonucleic acid (DNA) polymerase

133) To detect immunoglobulin M (IgM) antibodies in an acute phase, blood should be collected in _____ days after the onset of infection.

7 to 14

134) From what part of the body is the Varicella zoster virus most commonly isolated?

Skin and mucous membranes

135) From what part of the body is Enterovirus most commonly isolated?

Stool

136) From what part of the body is Human papilloma virus (HPV) most commonly isolated?

Genital

137) From what part of the body is parainfluenza virus most commonly isolated?

Nasopharyngeal

138) From what part of the body is CMV most commonly isolated?

Urine

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139) Which of the following is a property of RSV?1. pp65 protein2. Surface antigen3. MRC-5 cell lines4. p24 protein5. Hemadsorption6. R-Mix cells7. HEp-2 culture cells8. Adenovirus serotypes 40 and 41

HEp-2 culture cells

140) Which of the following is a property of HIV?1. pp65 protein2. Surface antigen3. MRC-5 cell lines4. p24 protein5. Hemadsorption6. R-Mix cells7. HEp-2 culture cells8. Adenovirus serotypes 40 and 41

p24 protein

141) Which of the following is a property of CMV?1. pp65 protein2. Surface antigen3. MRC-5 cell lines4. p24 protein5. Hemadsorption6. R-Mix cells7. HEp-2 culture cells8. Adenovirus serotypes 40 and 41

pp65 protein

142) Which of the following is a property of Adenovirus?

1. pp65 protein2. Surface antigen3. MRC-5 cell lines4. p24 protein5. Hemadsorption6. R-Mix cells7. HEp-2 culture cells8. Adenovirus serotypes 40 and 41

Adenovirus serotypes 40 and 41

143) Which of the following is a property of HSV?1. pp65 protein2. Surface antigen3. MRC-5 cell lines4. p24 protein5. Hemadsorption6. R-Mix cells7. HEp-2 culture cells8. Adenovirus serotypes 40 and 41

MRC-5 cell lines

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144) Which of the following is a property of Pediatric respiratory virus?


R-Mix cells

145) Which of the following is a property of Hepatitis B virus (HBV)?


Surface antigen

146) Which of the following is a property of Influenzas A and B?


Hemadsorption

147) Which of the following is the appropriate cell line for HEp-2 culture cells?

1. Primary cell line2. Diploid cell line3. Continuous cell line

Continuous cell line

148) Which of the following is the appropriate cell line for Monkey kidney cells?


Primary cell line

149) Which of the following is the appropriate cell line for Fibroblast cells?


Diploid cell line

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150) Where in the body does one obtain a specimen for Adenovirus?

Respiratory

151) Where in the body does one obtain a specimen for HSV?

Vesicular

152) Where in the body does one obtain a specimen for HBV?

Blood

153) Where in the body does one obtain a specimen for Arbovirus?

Cerebrospinal fluid (CSF)

154) List these six steps of viral replication in order of appearance.AssemblyUncoatingAttachmentReleaseSynthesisPenetration

AttachmentPenetrationUncoatingSynthesisAssemblyRelease

155) Adenoviruses are responsible for causing diseases such as keratoconjunctivitis, pneumonia, hemorrhagic cystitis, and gastroenteritis in children. Transmission is usually via:

respiratory secretions

156) Lymphocytic choriomeningitis (LCM) and Lassa fever are considered which type of virus?

Arenavirus

157) Hantavirus classified in the Bunyaviridae family is transmitted via:

rodent excreta

158) A 45-year-old man living in the western United States begins experiencing headache, fever, and body aches, which he attributes to the flu. His symptoms, however, become worse, and he later develops kidney disease and acute respiratory failure. He is most likely infected with which virus?

Hantavirus

159) A 36-year-old woman is on a cruise ship and later develops nausea, abdominal pain, vomiting, and diarrhea. She is most likely suffering from which virus?

Norovirus

160) Severe acute respiratory syndrome (SARS) has what characteristic structures when visualized under an electron microscope?

Crownlike surface projections

161) One of the most pathogenic hemorrhagic fever viruses belongs to the _________ family.

Filoviridae

162) This hemorrhagic fever causes disease in humans and nonhuman primates such as chimpanzees, gorillas, and monkeys. It is identified in the laboratory using which type of assay?

Reverse-transcriptase polymerase chain reaction (PCR)

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163) A 37-year-old man traveling through South America has a sudden onset of fever, severe headache, and chills. A macropapular rash develops on his trunk, which then spreads to his face and extremities. The vector transmitting this disease is most likely:

mosquitos

164) Which of the following patterns of markers is a normal immune response after recovery from a hepatitis B viral (HBV) infection?

Negative HBsAg; positive anti-HBcAb; and positive anti-HBsAb

165) Hemagglutinin and neuraminidase are surface glycoproteins associated with what family of viruses?

Orthomyxoviridae

166) The term used to describe a virus that causes a global outbreak of serious illness of which little natural immunity exists and that has sustained person-to-person transmission is:

pandemic

167) Which cell line has demonstrated a consistent season-to-season isolation frequency of influenza viruses?

Primary monkey kidney

168) A 24-year-old woman is diagnosed with human papillomavirus (HPV) after having her annual Papanicolaou (Pap) smear. She was not vaccinated with the Gardasil vaccine. Which serotypes of the virus does she need to be concerned about that demonstrate the greatest risk for developing cervical cancer?

16 and 18

169) An 8-month-old female infant is admitted to the emergency department in respiratory distress on Christmas Eve. A nasopharyngeal aspirate is obtained and sent to the laboratory on ice for analysis. The most probable organism that would be isolated is:

respiratory syncytial virus (RSV)

170) Which of the following highly contagious viruses is a single-stranded ribonucleic acid (RNA) virus with a helical capsid and envelope and is transmitted by coming in contact with respiratory secretions?

Measles

171) Characteristics of which virus consist of a double-stranded genome and virions that appear as oval, brick-shaped structures of 200 to 400 nm in length? In addition, the World Health Organization (WHO) eradicated this virus in 1980.

Smallpox

172) What is the characteristic of Yellow fever? Black vomit173) What is the characteristic of Dengue fever? Macropapular rash174) What is the characteristic of West Nile virus? Fever and leucopenia175) What is the characteristic of Hepatitis C? Carcinoma176) What is the symptom of Herpes simplex virus

(HSV) type 1?cold sore

177) What is the symptom or disease state of HSV type 2?

Genital lesions

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178) What is the symptom or disease state of Zoster? Shingles179) What is the symptom or disease state of Varicella? Chickenpox180) What is the symptom or disease state of Epstein-

Barr virus (EBV)?Burkitt lymphoma

181) What is the symptom or disease state of CMV? Congenital disease182) What is the symptom or disease state of Human

herpesvirus (HHV) 8?Kaposi sarcoma

183) What is the corresponding Picornavirus for Coxsackie A?

Hand-foot-mouth

184) What is the corresponding Picornavirus for Coxsackie B?

Myocarditis

185) When performing antiviral susceptibility testing, a standard inoculum must be used. If the inoculum quantity is too large, then the isolate will appear:

Resistant

186) Which type of assay uses a variety of endpoint measurements to determine whether the virus is inhibited by the antiviral drug or is demonstrating drug resistance?

Phenotypic

187) The recombinant virus assay (RVA) uses which type of amplification methodology?

Reverse transcription polymerase chain reaction (RT-PCR)

188) Point mutations in the hemagglutination (HA) or neuraminidase (NA) genes during viral ribonucleoprotein (RNP) replication give rise to new strains. This mechanism is known as the antigenic:

Drift

189) If a physician prescribes Tamiflu to a patient, the patient is most likely infected with which virus?

Influenza

190) The only virus that has been globally eradicated is: Smallpox191) In the 1920s, an instrument known as an “iron

lung” was developed to fight breathing difficulties associated with which infection?

Poliomyelitis

192) At the end of the 2008-2009 influenza season, 100% influenza A H3N2 and the novel 2009 influenza A H1N1 were resistant to:

Adamantane

193) What is true regarding phenotypic assay: Inhibits viral DNA synthesis194) What is true regarding plaque: Inhibits viral plaque formation195) What is true regarding du assay: Viable cells take up neutral red dye196) What is true regarding flow cytometry: Quantifies the amount of viruses

infected in cells197) What is true regarding genotypic susceptibility

assay:Detects resistance genes

198) What is true regarding pyrosequencing: Quantifies sequence variation199) The possibility of an abscess should be considered

if this bacterial group is isolated in the blood:Streptococcus anginosus

200) Patients receiving lipid-supplemented parenteral nutrition are at risk for developing fungemia caused by which organism?

Malassezia furfur

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201) If tachyzoites are found circulating in blood, then the infection would be classified as a:

parasitemia

202) Which virus found in the blood involves infecting certain T lymphocytes and possibly macrophages?

Human immunodeficiency virus (HIV)

203) Brucella infections usually result in which type of bacteremia?

Continuous

204) A patient who has an existing heart condition has dental surgery but neglects to inform her dentist of this disorder. She later develops endocarditis as a consequence of the procedure. Which of the following organisms most likely caused endocarditis?

Streptococcus mutans

205) The most common portal of entry for bacteremia is: the genitourinary tract206) A consequence of sepsis is disseminated

intravascular coagulation (DIC), which is characterized by numerous small blood vessels becoming clogged with clotted blood and bleeding as a result of the depletion of coagulation factors. Although any circulating pathogen can cause DIC, it is most often a consequence of ________ sepsis.

gram-negative

207) In the case of infants and small children, how much blood is usually drawn for bacterial culture?

1 to 5 mL

208) A 26-year-old woman who has a Gardnerella vaginalis infection becomes immunocompromised, which causes the organism to enter the bloodstream. She has several fever spikes; therefore blood cultures are drawn and placed in blood culture media containing sodium polyanethol sulfonate (SPS). After 5 days of incubation, the blood cultures are negative. Which of the following statements explains this discrepancy?

G. vaginalis is usually inhibited by this anticoagulant, making recovery difficult

209) The BACTEC automated blood culture system detects organisms by monitoring a rise in carbon dioxide (CO2) levels using which type of sensor?

Fluorescence

210) Saponin, polypropylene glycol, SPS, and ethylenediaminetetraacetic acid (EDTA) are all components in which blood culture system?

Lysis centrifugation system

211) A 76-year-old man with intermittent fevers has blood cultures drawn three times. The second set is positive and grew out of aCorynebacterium spp. This organism is considered:

a contaminant

212) A 36-year-old emergency medical technician (EMT) is exposed to a patient with brucellosis. Blood cultures are drawn from the EMT and reported as negative after 1 week. Which of the following statements explains this discrepancy?

The blood should have been incubated for a minimum of 3 weeks

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213) Granulicatella spp. and Abiotrophia spp. are dependent on which nutritional additive for optimal growth?

Vitamin B6

214) The most common etiologic agent of lower respiratory tract infection among adults younger than 30 years of age is:

Mycoplasma pneumoniae

215) One of the most common etiologic agents of lower respiratory tract infection among previously healthy patients 2 months to 5 years of age is:

respiratory syncytial virus

216) One of the most important uses of the Gram stain of expectorated sputum received for routine bacteriologic culture is to:

evaluate the quality of the specimen

217) Of the various types of specimens collected to diagnose respiratory infections, which one is acceptable for the detection of anaerobic agents?

Transtracheal aspirates (TTA)

218) Pneumonia in children is most commonly caused by:

parainfluenza virus

219) The most common etiologic agent of community-acquired pneumonia in adults is _____ pneumoniae.

Streptococcus

220) The nasal hairs, convoluted passages, and mucous lining of the nasal turbinates:

nonspecifically protect the respiratory tract from infection

221) One of the most common causes of bacterial pneumonia in school-age children (5 to 14 years of age) is:

Mycoplasma pneumoniae

222) Mycoplasma pneumoniae is detected as the most common agent of lower respiratory tract infection among:

adults younger than 30 years of age

223) Respiratory syncytial virus is one of the most common etiologic agents of lower respiratory tract infection among:

previously healthy patients 2 months to 5 years of age

224) Adenoviruses are one of the most common etiologic agents of lower respiratory tract infection among:

previously healthy patients 2 months to 5 years of age

225) Evaluation of the quality of the sputum specimen sent to the laboratory for bacterial culture is best performed by:

microscopically examining the Gram-stained smear for squamos epithelial cells

226) The most common cause of community-acquired pneumonia in adults, regardless of age, is:

Streptococcus pneumoniae

227) The sputum of a patient with acquired immunodeficiency syndrome (AIDS) is stained with Kinyoun carbolfuchsin stain. Which organism would test positive using this stain?

Cryptosporidium spp

228) Epiglottitis is a potentially life-threatening disease because the patient’s airway can become completely obstructed (blocked) if not treated. Which bacterium usually causes this disease?

Haemophilus influenzae type B

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229) Most cases of pharyngitis occur during the colder months and are primarily caused by:

viruses.

230) Clinical specimens from suspected cases of epiglottitis should be plated at least to _______ agar(s).

sheep blood and chocolate

231) An inflammation of the mucous membranes of the oral cavity caused mostly by herpes simplex virus is:

stomatitis.

232) An infection of the epiglottis and other soft tissues above the vocal cords, whose presentation typically includes fever and difficulty in swallowing because of the pain, drooling, and respiratory obstruction with inspiratory stridor, is:

epiglottitis

233) Also called acute necrotizing ulcerative gingivitis or trench mouth, which condition is a mixed bacterial spirochetal infection of the gingival edge?

Vincent angina

234) A relatively common illness in young children, primarily those younger than 3 years of age, whose presentation includes variable fever, inspiratory stridor (difficulty in moving enough air through the larynx), hoarseness, and a harsh, barking, nonproductive cough, is:

laryngotracheobronchitis

235) An infection of the pharynx that is normally called sore throat, whose presentation includes erythematous and swollen tissue and which is characterized by inflammatory exudates, vesicles, and mucosal ulceration or by nasopharyngeal lymphoid hyperplasia, is:

pharyngitis

236) Infection of the buccal (cheek) mucosa, tongue, or oropharynx by Candida spp. is:

thrush.

237) Inflammation of the larynx that is usually associated with the common cold or influenza syndromes and that is caused almost exclusively by viruses is:

laryngitis.

238) An inflammation of the nasal mucous membrane or lining caused mostly by viruses and characterized by fever, increased mucous secretions, inflammatory edema of the nasal mucosa, sneezing, and watery eyes is:

rhinitis.

239) Inflammation of the mucous membranes of the oral cavity caused mostly by herpes simplex virus

Stomatitis

240) Infection of the epiglottis and other soft tissues above the vocal cords whose presentation typically includes fever and difficulty swallowing because of the pain, drooling, and respiratory obstruction with inspiratory stridor

Epiglottitis

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241) Mixed bacterial spirochetal infection of the gingival edge that is also called acute necrotizing ulcerative gingivitis or trench mouth

Vincent angina

242) Relatively common illness in young children, primarily those younger than 3 years of age, whose presentation includes variable fever, inspiratory stridor (difficulty in moving enough air through the larynx), hoarseness, and a harsh, barking, nonproductive cough

Laryngotracheobronchitis

243) Infection of the pharynx normally called sore throat whose presentation includes erythematous and swollen tissue and the possible observation of either inflammatory exudates, vesicles, and mucosal ulceration or nasopharyngeal lymphoid hyperplasia

Pharyngitis

244) Infection of the buccal (cheek) mucosa, tongue, or oropharynx by Candida spp.

Thrush

245) Inflammation of the larynx usually associated with the common cold or influenza syndromes and caused almost exclusively by viruses

Laryngitis

246) Inflammation of the nasal mucous membrane or lining caused mostly by viruses and characterized by fever, increased mucous secretions, inflammatory edema of the nasal mucosa, sneezing, and watery eyes

Rhinitis

247) Influenza virus, parainfluenza virus, rhinovirus, and other viruses

Rhinitis

248) Influenza virus, parainfluenza virus, Mycoplasma Laryngotracheobronchitis249) Haemophilus influenzae Epiglottitis250) Herpes simplex virus Stomatitis251) Candida spp. Thrush252) Mixed bacteria with spirochetes Vincent angina

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