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292 Cards in this Set
- Front
- Back
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the aseptic collection of blood culture req that the skin be cleansed with
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70% alcohol and then 2% iodine or an iodophor
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when cleansing the skin with alcohol and then iodine for the collection of BC, the iodine, should remain intact on the skin for at least
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60 sec
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what is the purpose of adding 0.025% - 0.050% sodium polyanethol sulfonate (SPS) to nutrient broth media for the collection of BC
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it inhibits phagocytosis & complement
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a flexible CA+ alginate nasopharyngeal swab is the collection device of choice for recovery of which org in the naso
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corynebacterium diphtheriae
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semisolid transport media such as Amies, Stuart, or Cary Blair are suitable for the transport of swab for culture of most patho except
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a. enterobacteriaceae
b. n. gonorrhoeae c. campylobacter fetus d. strep pneumoniae **N. gonorrhoeae |
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select the method of choice for recovery of ANA bacteria from deep abscess
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needle aspirate after surface decontamination
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select the primary and differential media of choice for recovery of most fecal patho
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HE, Mac, Campy, colistin - nalidixic acid (CNA) agars
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select the media of choice for recovery of Vibrio cholerae from a stool sp
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thiosulfate citrate bile sucrose (TCBS) agar and alkaline peptone water (APW) broth
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colistin nalidixic acid agar (CNA) is used primarily for the recovery of
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S. aureus
CNA inhibits CNO, but isolate GPO |
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in the US, most BAP are prepared w. 5 or 10% red blood cells
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sheep
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allow of the following are appropriate when attempting to isolate N. gon from genital sp except
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1. transport the genital swab in charcoal transport medium
2. plate the sp on MTM (modified thayer martin) medium 3. plate the sp on NYC or Martin Lewis agar |
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CA & MTM agar used for the recovery of
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Haemophilus sp & N. gonorrhoeae, respectively
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cycloserine-cefoxitin-fructose agar (CCFA) is used for recovery of
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c. difficile
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deoxycholate agar (DCA) is useful for the isolation of
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enterobacteriaceae
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xylose lysin deoxycholate (XLD) agar is highly selective medium used for the recovery of which bacteria
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enterobacteriaceae from the GI specimens
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a sheep blood agar plate is used as a primary isolation medium when all the following org are to be recovered from the wound sp is
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1. beta hemolytic strep
2. coagulase + staph ( 3. proteus & e. coli 4. psedumonas spp & acinetobacter spp |
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prereduced & vit K1 supplemented BAP recommended isolation media for
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1. bacteroides
2. peptostreptococcus 3. Clostridium sp |
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which procedure is appropriate for culture of genital sp in order to recover Chlamydia spp
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inoculate cyclo--hexi--mide-- treated McCoy cells
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CSF should be culture immediately, but if delay the sp should be
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incubated at 37c and culture asap
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the most sensitive method for the detection of b-lactamase is bacteria is by the use of
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chromogenic cephalosporin
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the breakpoint of antimicrobal drug refers to
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the level of drug that is achievable in serum
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which of the following variables may change the results of MIC
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1. inculum size
2. incubation time 3. growth rate of bacteria all of the above |
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according to KB std antimicrobial susceptibility testing method, what should be done when interpreting the zone of a motile, swarming org such as Proteus spp
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the swarming area should be ignored
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which class of antibiotics is used for the treatment of serious GN infections as well as infection w/ Mycobacterium tuberculosis
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aminoglycosids (inhibits Protein synthz)
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enterobacteriaceae common test rtx (4)
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ferm glucose
nitrate ---> nitrite mobile OX -- |
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biochemically, the enterobacteriaceae are GNR that
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ferments glucose
reduces nitrate to nitrite OX -- |
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the ortho-nitrophenyl-B-galactropyranoside (ONPG) test is most useful when differentiating
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Shigella spp ( -- ONPG) from
strains of E. coli (+ ONPG) |
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the Voges Proskauer test detects which end product of glucose fermentx
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acetoin
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at which pH odes the methyl red (MR) test become positive
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4.5
$4.50 |
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a positive Simmons citrate test is seen as a
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blue color in the medium after 24 hours incubation at 35c
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in the test for urease production, ammonie reacts to form which produce
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ammonium carbonate = alkalinization
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which of the following reagents is added to detect the production of indole
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p-dimethyl--amino--benz--aldhyde
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decarboxylation of the A/A lysine, ornithin & arginine results the formation of
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amines
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lysine iron agar (LIA) showing a purple slant & blackended butt indicates
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Salmonella sp
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Putrecine is an alkaline product of which bacterial emz
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orinithine decarboxylase
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which genera are + for phenylalanine deaminase
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Morganella
Providencia & Proteus |
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Kliger iron agar (KIA) differs from triple sugar iron (TSI) in the
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use of sucrose in the medium
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which genera of the enterobacteriaceae are known for cz diarrhea & are considered enteric pathogen (4)
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escherichia, salm/shigella and yersinia
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care must be taken when id'g biochem isolated of Shigella because sero cross rtx occurr with
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E.coli
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which sp of Shigella is most commonly ass w/ diarrheal dz in the US
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s. sonnei (sony has diarrheal)
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which of the following test best diff Shigella from E.coli
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E.coli:
Lactose + IN + ONPG + Motility Shigella Lactose - NLF IN -- ONPG -- Nonmotile |
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which genera of Enterobacteriaceae are usually nonmotile at 36c (3)
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Shigella
Klebsiella Yersinia |
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fever, abdominal cramping, water stolls & fluid + e-lytes loss preceded by blood stools 2-3 days before is characteristics of shigellosis but may also result from infection w/
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Campylobacter spp
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cold enrichment of feces (incubated at 4c) in phosphate buffered saline prior to subculture onto enteric media enhances the recovery of (2)
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Y. entercoliticia & Listeria monocytogen
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which group of tests, along w. colonial morph on primary media, aids most in the rapid ID of the Enterobacteriaceae
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IN
OX -- (all Enterobacteriaceae all NEG) Mac BAP |
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a routine complete stool culture procedure should inc media for the isolation of E.coli O157:H7 as well as (5)
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Salmonella
Shigella Yersinia Campy S. aureus |
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which grp of tests best ID the Morganella & Proteus genera
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Motility +
Urease + Phenylalanine deaminase + |
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which gro of test best diff Enterobacter aerogenes and Edwardsiella tardia
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H2S production
Sucrose fementation IN VP |
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what are the reactions for the following: Enterobacter aerogenes and Edwardsiella tardia
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E. tarda
H2S + IN + E. aerogenes Sucrose + IN + (<20%) VP + Citrate + |
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Enterobacter sakazakii can be best diff from Enterobacter cloacae by
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yellow pigmentation & negative sorbitol fermentation
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members of the genus Cedecae are best diff by Serratia sp by which test results
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Negative DNase
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which of the following org is often confused w/ Salmonella sp biochemically & on plate media
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Citrobacter freundii
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GNR recovered from catheterized urine sample from a nursing home patient. the lactose negative isolated tested positive for indole, urease, ornithine decarboxylase & phenylalanine deaminase & negative for H2S. the most probable ID is
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Morganella spp
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which single test best seperates Klebsiella oxytoca and K. pneumoniae
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K. oxytoca: Indole +
K. pneumoniae: Indole -- |
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which of the following org, found in normal fecal floral, may be mistaken biochem for the genus Yersinia
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Proteus spp
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why might it be necessary for both pink (lactose +) and colorless (lactose --) colonies from an initial stool cult on MAC agar be subcult and test further for poss patho
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pathogenic E.coli can be lactose or lactose --
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which agar is used for routine stool cult is the medium of choice for the isolation of Yerisnia strains from stool spp
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Mac agar
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which org is something mistake for Salmonella & will agglutinate in Salmonella polyvalent antiserum
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C. freundii strains
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a blood stool from a 26YOW w/ 3 days of severe diarrhea showed the following results at 48 hours after being plated on the following media
1. MAC: NLF 2. HE: blue green colonies 3. CAMP agar & C. diff agar: NG 4. clear colonies from MAC tested negative for OX, IN, Urease, motility, and H2S |
Shigella spp
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which of the following org are generally positive for B-galactosidase
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E. coli
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in the Kauffmann-White schema, the combined anigens used for sero ID for the Salmonella spp are
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O, Vi, and H antigens
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the drug of choice for treatment of infections w/ Enterobacteriacae are
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Aminoglycosides
STX Third generation Cephalosprins |
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the Shiga like toxin (verotoxin) is produced mainly by which Enterobacteriaceae
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E. coli
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infection cause by Y. petsis are rare in the US, those cases that do occur are most frequently located in what region
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Southwest states:
New Mex, AZ and CA |
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IMVIC reactions for
E.coli S. typhi Y. enterocolitica P. vulgaris |
E.coli ++00
S. typhi 0+00 Y. enterocolitica V+00 P. vulgaris ++00 |
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the majority of clinical lab w/ a microbiology department should have the capability of serotyping which patho Enterobacteriaceae
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E. coli 0157:H7, Salmonella spp, Shigella spp
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direct spread of pneumonic plague disease occured by which route
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inhalation of contaminated airborne droplets (bubonic plague & pneumonic plaque both infection are caused by members of Enterobacteriaceae family, Yersinia pestis
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what are the most appropriate screening tests to presumptively diff & ID the nonfermentative gram negative bacilli (NFB) from the Enterobacteriaceae
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Oxidase
TSI nitrate reduction growth on MAC |
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presumptive tests used for ID of the Pseudomonas spp are
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Oxidase
OF: oxidation fermentations Glucose (open) OF glucose (sealed) Motility Pigment production |
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which test are most appropriate to diff between Pseudomonas. aeruginosa & Pseudomonas putida
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Mannitol
Nitrate reduction Growth on 42c |
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which test group diff Acinteobacter baumannii from P. aeruginosa
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Oxidase
Motility NO3 reduction |
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in addition to motility, which test best diff Acinetobacter spp and Alcaligenes spp
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Oxidase
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the most noted diff between P. aeruginosa and S (X.) maltophilia are
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Oxidase
42c growth Polar tuff of flagella |
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which Pseudomonas is usually ass w/ lung infection related to cystic fibrosis
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mucoid P. aeruginosa
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a nonfermenter recovered from an eye wound is
OX + Motile w/ polar monotrichous flagella Growth at 42c colonies are dry, wrinkled or smooth, buff to light brown in color, and are difficult to remove from the agar. in which DNA homology should this org be placed |
P. stutzeri
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which org is ass w/ immunodeficiency syndromes & melioidosis (a glanders like disease in Southeast Asia and northern Australia)
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Burkholderia (P) pseudomallei aka Vietnamese time bomb
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which biochem tests are needed to diff Burkholderia (P). cepacia from S. (X) maltohilia
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pigment on BAP, Oxidase, DNase
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Alcaligenes faecalis (formerly A. odorans) is distinguished from Bordetella bronchiseptica with which test
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urease (rapid)
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Falvobacterium spp are easily distinguished from Acinetobacter spp by which of the following two test
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Oxidase
growth of MAC |
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a GNCB was recovered on CA from the CSF of an immunosuppressed patient. the org was nonmotile & positive for indophenol oxidase but failed to grow on MAC agar. the org was highly susceptible to penicillin, the most probably ID is
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M. lacunata (implicated in infections inv immunosuppressed patients)
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centrimide agar is used as a selective isolation agar for which org
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Pseudomonas aeruginosa
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a yellow pigment producing org that is
OX + nonmotile does not grow on MAC is |
Flavobacterium meningospecticum
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which reagents is are used to develope the red color indicative of a positive reaction in the nitrate reduction test
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sulfanilic acid & alpha naphthylamine
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Flavobacterium spp and B (P). cepacia are easily diff by which test
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motility
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a 15 year old female complained of a severe eye irritation after removing her soft contact lens. a swab of the infected right eyes was obtained. the culture was plated on BAP and MAC. at 24 hour, growth on GNR
- cytochrome oxidase + - MH sensitivity plate showed a bluish green "lawn" of growth that proved highly resistant to most of the antibiotics test except amikacin, tobramycin & ciprofloxacin. the most likely ID is |
Pseudomonas aeruginosa is an opportuistic org that is not part of the human NF. contact lens solution contaminiation, eye injury, or contact lens eye trauma are factors that contribute to P. aeruinosa eye infection
- blue green pigment on MH is the highly resistant nature to antitbiotics aid in its ID |
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which of the Pseudomonas spp below is ass w/ the following virulence factors:
exotoxin A endotoxins proteolytic emz antimicrobial resistant production of alginate |
P. aeruginosa
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a 20 year old horse groomer exhibited a "glanders-like" infection. his history indicated that he has suffered several open wounds on his hands 2 weeks before the swelling of his lymphs nodes. a GNR was recovered from the BC that grew well on BAP & MAC. most of the biochem were negative, inc the cytochrome oxidase --. what is the most likely ID
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Burkholderia mallei (ox negative)
vs Burkholderia pseudomallei (ox +) |
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a Vietnam war vet presented w/ "glanders-like" infection (melioidosis). several BC produced GNR that were
cytochrome OX + oxidized glucose & xylose & grew 42c. the most likely org is |
Burkholderia pseudomallei (ox +)
vs Burkholderia mallei (ox negative) |
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cytochrome ox +
nonfermentative GNR was recovered from the stool of a cystic fibrosis (CF) patient. the isolated produced wet (mucoidy) colonies on the BAP, which ID is the most likely |
P. aeruoginosa
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a visitor to S. America who returned w/ diarrhea is suspected of being infected w/ V. cholera. select the best medium for recovery & ID of this org
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TCBS agar
(yellow + and string test +) |
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which atmospheric condtx is needed to recover Campylobacter spp from sp inoculated onto the campy selected agar at 35-37 and 42c
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5% O2
10% CO2 85% N2 |
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which group of tests best diff Heliobacter pyloir from C. jenjuni
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H. pylori is found in sp from gastric secretion & biopsies & ahs been implicated as a cause of gastric ulcers. it is found only in the mucus secreting epi cells of the stomach.
Both H. pylori + C. jejuni are CAT -- OX + however, Helicobacter spp are Urease +, which diff them from Campy |
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which of the following test should be done first in order to diff Aeromonas spp from the Enterobacteriaceae
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Ox
Aeromonas spp OX + and known for acute diarrheal dz, cellultis & wound infection Enterobacteriaceae OX -- |
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which is the best rapid test to diff Plesiomonas shigelloides from Shigella spp on selective enteric agar
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Oxidase
Plesiomonas shigelloides OX + Shigella spp OX -- |
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which is the best two tests to diff A. hydrophilia from Plesiomonas shigelloides
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DNase and VP
A. hydrophilia DNase + VP + Plesiomonas shigelloides DNase - & VP - |
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which genus (in which most spp are oxidase & CAT +) of small GNCB is ass mainly w/ animals but may cause endocarditis, bacteremia, and wound & dental infections in human
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Actinobacillus (A. actino--myce--tem-comitas)
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which of the following test may be used to diff Cardiobacterium hominis from Actinobacillus spp
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Indole
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Kingella kingae can best diff from Eikenella corrodens using which medium
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Sheep blood agar cause K.kingae stains produce a narrow zone of beta hemolysis on BAP sim to that of GRP B Strep
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Kingella kingae is usually ass w/ which type of infection
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endocarditis
KK are GNCB or plump looking rods, NF of upper respiratory & urogential tracts of human - infection is seen primarily in patient having underlying heart dz, poor oral hygiene, or iaitrogenic mucosal ulceration (ex: radiation therapy) |
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cultures obtain from a dog bite would produced yellow, tan and slightly pink colonies on BAP & CA w/ a margin of fingerlike projection appearing as a film around the colonies. given the following results, which is the most likely org?
OX + CAT + growth on MAC Motility = negative |
Capnocytophaga spp (C. canimorsus or C. cynodegmi)
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smooth gray colonies showing no hemolysis are recovered from an infected cat scratch on BAP & CA but fail to grow on MAC. the org is GN pleomorphic rods that are both
CAT + OX + strongly IN + the most likely org is |
Pasturella (P. multocida)
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which media should be used to recover Bordetella pertussis from the nasopharyngeal spp
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Bordet Gengou agar
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which medium is recommended for the recovery of Brucella spp from blood and bone marrow sp
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Biphasic Catenada bottles w/ Brucella broth
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Brucella spp causes
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undulant fever and is responsibile for many cases of fever of unknown origin. Brucella spp are faculative intracellular org & grow very slowly, usually 4-6 weeks for recovery. B. melitensis is the most frequently recovered spp
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in addition to CO2, req & biochem characteristics of Brucella melitensis & Brucella abortus are diff by growth on media containing which 2 dyes
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basic fuchsin & thionin
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which of the following amino acids are req for growth of Francisella tularensis
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Cysteine & cystineon CA because it contain X factor and is supplemented w/ growth enrichment
F. tularensis is a fastidious GNR that is best recovered from lymph nods aspirates & tissue biopsies. OX -- Nonmotile |
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which medium is best for recovery of Legionella pneumophila from clinical sp
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Buffered charcoal yeast extract (CYE) agar
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H. influenza which req X & V factors to growth, can be diff from subspp H. aegyptius by which two tests
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IN & Xylose
H. influenza IN + xylose + H. aegyptius IN -- xylose -- |
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Haemophilus spp that req the V factor (NAD) are easily removed on which agar palte
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Chocolate agar
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which of the following product is responsible for satellite growth of Haemophilus spp around the colonies of Stap & Neisseria spp on BAP
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NAD (V factor)
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which of the following plates should be used in order to ID Haemophilus haemoluticus & Haemophilius parahaemolyticus
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horse blood agar
NH agar w/ X & V strips |
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the majority of H. influ infections are caused by which of the following capsular serotypes
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B
this strain appears to contain a virulence factoring making it resistant to phagocytosis and intracellular killing by neutrophils |
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which Haemophilius spp is generally ass w/ endocarditis
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H. aphrophilus
does not req either X or V factor for growth and is diff from the other Haem spp by its ability to produce acid from lactose and positive gamma aminolevulinic acid (ALA) |
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which Haemophilius spp is difficult to isolate and recover from genital ulcers and swollen lymph nodes
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H. ducreyi
req exogenes X factor and are referred to "soft chancres" |
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which of the following is characteristic of strain of Haemophilius influenzae that are resistant to ampicillin
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production of B lactamase emz
roughly 20% of H. influ strains produce B lactamase which hydrolyses and inactivates the B lactam ring of ampicillin and penicillin |
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Beta-lactamases are enzymes
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produced by some bacteria and are responsible for their resistance to beta-lactam antibiotics like penicillins, cephalosporins (are relatively resistant to beta-lactamase), cephamycins, and carbapenems (ertapenem).
These antibiotics have a common element in their molecular structure: a four-atom ring known as a beta-lactam. The lactamase enzyme breaks that ring open, deactivating the molecule's antibacterial properties. |
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the delta-ALIA test (for porphyrins) is confirmatory procedure for which test used for ID of Haemphillus spp
|
X factor
|
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the test used most often to seperate the Micrococcaeae family from Streptococcaceae family is
|
Catalase
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Micrococcaeae and Staph spp are diff by which test
|
Fementation of glucose (OF tube)
Staph: Open tube (oxidation) + Close tube (fementx) + Micrococcus spp Open tube (oxidation) + Close tube (fementx) -- |
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Lysostaphin (antibiotic disc) is used to diff Staph from which other genus
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Micrococcus
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which of the following test is used routinely to ID S. aureus
|
slide coag test
tube coat test latex aggltx |
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which of the following emz contributes to the virulence of S. aureus
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hyaluronidase & b-lactamase
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toxic shock syndrome is attributed to infection w/
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s. aureus
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which Staph spp in addition to S. aureus also produces coagulase
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S. intermedius (TC +)
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Staph epidermidis (coagulase negative) is recovered from which sources (3)
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proesthetic heard valves
intravenous catheters urinary tract |
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slime production is ass w/ which staph spp
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S. epi (adhension to plastic catheters & prostheses)
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strains of Staph spp resistant to B-lactam antibiotics by std disk diffusion & broth microdilution susceptibility methods are called
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heteroresistant -- which means two subpopulation in a culture, one that is susceptible and the other is resistant to antibiotics
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S. sap is best diff from S. epi by resistance to
|
5 ug of novobiocin
S. sap = resistant S. epi = SSSSSSSS |
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which of the following test should be used to diff S. aureus and S. intermedius
|
Acetoin aka VP test
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urine culture from the catheter of 18yof patient produced more than 100,000 col/mL on CNA plate. colonies
CAT + tube and slide COAG -- the best single test for ID is |
novobiocin susceptibility
S. epi = S S. sap = RRRRRRR |
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Staph spp recovered from a would (cellulitis) was
slide COAG test -- negative for NOV resistance the next test needed for ID is |
Tube coag test
Beta hemolysis on BAP Mannitol salt agar plate |
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Furazolidw (furoxone) susceptibility is a test used to diff
|
Staph sp (S) from
Micrococcus sp (R) |
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Bacitracin resistance (0.04 unit) is used to diff
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Staph sp (R) from
Micrococcus sp (S) |
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Streptococcus spp exhibit which of the following properties
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faculative ANA
OX -- CAT -- |
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which group of Streptococci is isolated with erthrogenic toxin production
|
Grp A (also causes Scarlet fever & scarlatiniform rash)
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a fourfold rise in titer to which antibiotics is the best indicator of a recent infection w/ grp A beta hemolytic strep
|
Anti-streptolysin O
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Bacitracin A disks (0.04 unit) are used for the presumptive ID for which grp of Beta hemolytic streptococci
|
grp AAAAAAAAAAAA
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Trimethroprim-sulfamethoxazole (SXT) disks are used along w/ bacitracin disks to diff which strep
|
beta Hemolytic streptococci
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what are the following rtx for Grp A, Grp B and nonA, nonB grp for Bacitracin and SXT
|
Grp A
Bact = S, SXT = R Grp B Bact = R, SXT = R NonA,NonB grp Bact = R, SXT = S |
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a false positive CAMP test for the presumptive ID for grp B strep may occur if the plate is incubated in
|
candle jar or CO2 incubator
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which test is used to diff the Viridians strep from Grp D strep and enterococci
|
bile esculin test
Viridin = BET -- Grp D sterp = BET + |
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the bile solubility test cause the lysis of
|
Streptococcus pneumoniae colonies on the BAP
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S. pneumoniae and the viridan streptococci can be diff by which test
|
Optochin disk test, 5 ug/mL or less
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the salt tolerance test (6.5 salt broth) is used to presumptively id
|
E. faecalis
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in addition to Enterococcus faecalis, which other strep will grow in 6.5 salt broth
|
Grp BBBB strep
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the quellung test is used to ID which Strep spp
|
S. pneumoniae
|
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the L-pyrrolidonyl-B-napthylamide (PYR) hydrolysis test is presumptive test for which strep
|
Grp A and D (enterococcus) streptococci
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nutritionally varian streptococci (NVS) req specific thiol compound, cysteine or the active form of vit B6, which of the following test supplies these requirements
|
Staphylococcal cross streak test
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which two test best diff S. bovis (grp D streptococcus, nonenterococcus) from Streptococcus salivarius
|
starch hydrolysis and acid production mannitol
|
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variation in colony types seen w/ fresh isolated of N. gonorrohoeae and sometimes w/ Neiseeria meningitidis are the results of (3)
|
mx nutritional requirments
pili on the cell surface use of transport medium |
|
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GN dipolococci recovered from an MTM plate and giving a OX + test can be presumptively id as
|
N. gonorrhoease
N. meningitidis N. lactamica (nonpatho) |
|
|
Nonpatho Moraxella spp capable of growing on selective media for Neisseria can be diff from Neisseria spp by which test
|
10 unit penicillin test
Moraxella spp: CAT + OX + |
|
|
a GS of urethral discharge from a man showing extracellular and intracellular GN dipolococci w/ segmented neutrophils is a presumptive of
|
N. gonorrhoeae
|
|
|
the B-galacosidase test aids in the ID of w/ Neisseria spp
|
N. lactamica
|
|
|
Cystine tryptic digest (CTA) media used for ID of Neisseria spp should be inoculated and culture in
|
a non CO2 incubator
at 35c for up 72 hours |
|
|
a large GP spore forming rod growing on BAP as large, raised, beta hemolytic, colonies that spread & appear as frosted green gray glass is most likely
|
Bacillus spp
|
|
|
Bacillus anthracis and Bacillus cereus can best be diff by which test
|
motility
beta hemolytic on BAP |
|
|
which of the sp of choice for proof of food poisoning by Bacillus cereus
|
food
Bacillus cereus is NF of stool |
|
|
a suspected Bacillus antracis culture obtained from a would specimen produced colonies that may have many outgrowth (Medusa head appearance) but were not Beta hemolytic on BAP, which test should be performed next
|
penicillin 10 unit susceptibility test
|
|
|
which of the following tests should be performed for initial diff of Listeria monocytogens from Grp B strep
|
GS
motility at RT CAT |
|
|
a nonspore forming, slender GPR forming palisades and chains was recovered from a vaginal cult and grew well on tomato juice agar, the most likely ID is
|
Lactobaillus spp
|
|
|
a Cornybacterium spp recovered from a throat culture is considered a patho when it produces (3)
|
- a pseudomembrane of the oropharynx
- exotoxin - gray black colonies w/ brown halo on Tinsdale's agar |
|
|
a presumptive diagnosis of Gardnerella vaginalis can be made using which of the following findings
|
OX and CAT
- plemorphic bacilli heavily colonized on vaginal epithelium - hippurate hydrolysis test |
|
|
a GP branching filamentous org recovered from sputum sp was found to be positive w/ a modified acid fast stain method -- what is the most likely presumptive id
|
Nocardia spp (AFS ++++)
Bacillus, Corynebacterium and Listeria AFS negative -- |
|
|
routine lab testing for T. pallidum invo
|
sero analysis
|
|
|
spirochetes often detected in the hematology lab, even before the doc suspect the infection, are
|
Borrelia spp
are often seen on Wright stained smear on peripheral blood as helical bacteria w/ 3-10 loose coils. they are GN but stain well w/ Giemsa stain |
|
|
which of the following org is the cause of Lyme disease
|
Borrelia burgdorferi
infected by deer tick 2 rodents & causes: acute arthritis & meningitis |
|
|
the diagnostic method most commonly used for the ID of Lyme disease is
|
serology
|
|
|
primary atypical pneumonia is caused by
|
Mycoplasma pneumoniae
|
|
|
which org typically produces "fried eggs" colonies on agar w/in 1-5 days of culture from a genital sp
|
Mycoplasma hominis
|
|
|
the manganous chloride urea test is used for ID of which org
|
Ureaplasma urealyticum (NF in genital area, but can also cause lots of problems)
urease + |
|
|
a GP/GV beaded org with delicate branching was recovered from the sputum of 20 yo patient w/ leukemia. the specimen produced organ, glabrous, waxy colonies on Middlebrook's agar that showed partial acid fast staining w/ the modified Kinyoun stain/ what is it?
|
Nocardia = musty basement odor, opportunistic patho
|
|
|
a direct smear from a naso swab stained w/ Loeffler methylene blue stain showed various letters shapes and deep blue, metachromatic granules. the most likely ID is
|
Corynebacterium spp
|
|
|
which of the following is the best, rapid, nonculture test to perform when Gardnerella vaginalis is suspected in a patient w/ vaginosis
|
10% KOH test
|
|
|
obligate ANA, faculative ANA and microAE are terms referring to bacteria req
|
decrease O2
|
|
|
which of the following most affects the oxidation reduction potential (Eh or redox potentional) of media of ANA bacteria
|
pH
|
|
|
which of the following is the medium of choice for selective recovery of GN ANA
|
Kanamycin vancomycin (KV) agar
|
|
|
ANA bacteria are routinely isolated of all of the following types of infections
|
lung & brain abscesses, dental infections
no UTI infections |
|
|
methods other than packaged microsystems used to ID ANA include
|
gas liquid chromatography (GLC)
|
|
|
which broth is used for the cultivation of ANA bacteria in order to detect the volatile fatty acids as an aid to ID
|
prereduced peptone yeast extract glucose (PYG)
|
|
|
a GP spore forming bacillus growing on sheep blood agar ANA produces a double zone of beta hemolysis and lecithinase +
|
Closteridium perfringens
|
|
|
egg yolk agar is used to detect which emz produced by Clostridium spp
|
Lecithinase
|
|
|
which of the following org will display lipase activity on egg yolk agar (3)
|
Clostridium: botulinum, sporogenes, novyi (A)
|
|
|
which spore type and location is found on Clostridium tetani
|
round terminal spores (racquet)
|
|
|
which mechx is responsible for botulism in infants caused by Clostridium botulinum
|
ingestion of spores in food or liquid
|
|
|
the classic form of foodborne botulism is characterized by the ingestion of
|
preformed toxin in food
confirmation of botulism is made by demo of toxin in the serum, gastric and stool spp infants: breast milk or honey |
|
|
which test is performed in order to confirm an infection w/ Clostridium botulinum
|
toxin neutralization
|
|
|
which Clostridium spp causes pseudomembranous colitis or antibiotic ass colitis
|
C. difficile
|
|
|
ID of Clostridium tetani is based upon
|
clinical finding: spastic muscle contraction, lockjaw, backward arching of the back caused by muscle contraction. difficult to culture/GS
|
|
|
obligate ANA GNR that do not form spores grow well in 20% bile and are resistant to penicillin 2 unit disks are most likely
|
Bacteroides spp
|
|
|
which Bacteroides spp is noted for "pitting" of the agar and sensitive to penicillin 2 unit disks
|
B. urealyticus
pitting U---RE |
|
|
which GNR produce black pigment and brick red fluorescence when exposed to an ultraviolet light source
|
Porphyromonas spp and Prevotella spp
|
|
|
the following characteristics of obligate ANA GNR
1. GS: long slender rods w/ pointed ends 2. colony: "dry bread crumbs" or fried egg appearance" 3. penicillin 2 unit disk test: susceptible |
Fusobacterium spp
|
|
|
all of the following genera are ANA cocci that stain GP
|
Peptococcus spp
Peptostreptococcus spp Streptococcus sp Veillonella (GNC) |
|
|
the GPR nonspore forming ANA most frequently recovered from BC as a contaminant are
|
Proprionibacterium acnes
NF in skin, naso, gen |
|
|
which Clostridium sp is most often recovered from a wound infection with gas gangrene
|
C. perfringens
|
|
|
GS of a smear taken from the periodontal pocket of a 30 yom, w/ poor dental hygiene showed sulfur granules containing GPR (short diphtheroids and some unbranched filaments). colonies in BAP resembles "molar teeth" in formation. the most likely org is
|
Actinomyces israelii
|
|
|
antimicrobial susceptibility testing of ANA is done by which of the following methods
|
microtube broth dilution
|
|
|
the best sp for recovery of the mycobacteria from a sputum sample is
|
first morning specimen
|
|
|
what concentration of sodium hydroxide (NaOH) is used to prepare a working decontamination solution for the processing of not normally sterile spp for mycobacteria
|
4% NaOH
|
|
|
which of the most appropriate nonselective medium for recovery of mycobacteria from a heavily contaminated spp
|
Petragnani's agar
|
|
|
mycobacteria stained by Ziehl Neelsen or Kinyoun methods with methylene blue couterstain as seen microscopically A
|
bright red rods against a blue background
|
|
|
acid fast staining of a smear prepared from a digested sputum showed slender, slightly curved, beaded, red mycobacterial rods. growth of Middlebrook 7H10 slants produced buff colored microcolonies w/ a serpentine pattern after 14 days at 37c. Niacin and nitrate reduction tests were positive what is the probably presumptive
|
Mycobacterium tuberculosis
|
|
|
which org, ass w/ tuberculosis in cattle, causes tuberculosis in humans, esp in regions where dairy farming is prevalent
|
Mycobacterium bovis
|
|
|
which of the following org are used as controls for rapid growers and slow growers
|
Mycobacterium fortuitum and Mycobacterium tuberculosis
|
|
|
which of the following mycobacterium spp produce pigmented colonies in the dark (is a scotochromogen)
|
Mycobacterium szulgai
|
|
|
Scotochromogenic bacteria develop
|
pigment in the dark or in the light
|
|
|
mycobacterium kansaii is photochromogen producing
|
yellow pigment following exposure to light and red beta carotene crystals after long incubation periods
|
|
|
all the following mycobacterium are ass w/ skin infections
|
M. marinum
M. heamophilum, and M. ulcerans |
|
|
all the following Mycobacterium spp produce the emz req to convert niacin to niacin ribonucleotide (3)
|
M. kanasaii
M. avium intracellulare complex M. szulgai |
|
|
the catalase test for mycobacteria diff from the use for other types of bacteria by using
|
30% H2O2 and
10% Tween 80 |
|
|
all the following Mycobacterium spp produce the emz req to convert niacin to niacin ribonucleotide except
|
M. tuberculosis
|
|
|
growth inhibition by thiophene-2-carboxylic hydrazide (T2H) is used to diff M. tuberculosis from which other Mycobacterium spp
|
M. bovis
|
|
|
which of the following Mycobacterium spp s best diff by the rapid hydrolysis of Tween 80
|
M. kansaii (neutral color red, positive = pink)
|
|
|
mycobacteria isolated from the water system of hospital grew at 42c. colonies on the LJ medium were not pigmented after exposure to light and were negative for niacin accumulation & nitrate reduction, the most likely ID is
|
Mycobacterium xenopi
|
|
|
causes pulmonary infection resembling M. tuberculosis and is frequently isolated from pat w/ underlying disease such as alcoholism, AIDS, diabetes or malignancy. often recovered from contaminated water system & hot water taps
|
Mycobacterium xenopi
|
|
|
the urease test is needed to diff Mycobacterium scrofulaceum from which of the following mycobacteria
|
M. gordonae
|
|
|
a lab provides the following services for ID of mycobacterium
According to the American Thoracic Society's definition of level of service this lab is 1. acid fast staining of clinical sp 2. inoculation of cultures 3. shipment of positive cultures to reference lab for ID |
level I
are those that grow mycobacteria and perform acid fast stains but do not ID M. tuberculosis |
|
|
a lab provides the following services for ID of mycobacterium
According to the American Thoracic Society's definition of level of service this lab is: level II |
lab perform all of the functions of level I lab and also ID M. tuberculosis
|
|
|
a lab provides the following services for ID of mycobacterium
According to the American Thoracic Society's definition of level of service this lab is: level III |
lab ID all mycobacteria sp from clinical sp and perform drug susceptibility test on all spp
|
|
|
according to the college of american pathologists guidelines, which services for mycobacteria would be performed by level II lab
|
acid fast staining, inoculation and referral to a reference lab
|
|
|
which nonpathogenic Mycobacterium spp is isolated most often from clinical spp and is called the "tapwater bacillus"
|
M. gordonae
|
|
|
which of the following drugs are first line antibiotics used to treat classic tuberculosis for which susceptibility testing is performed by the disk diffusion method on 7H11 agar plates
|
isonicotinic acid hydrazide (INH)
rifampin ethambutol |
|
|
how long should M. tuberculosis positive cultures be kept by the lab after ID and antibiotic susceptibility testing have been performed
|
6-12 months
|
|
|
according to the reporting standards of American Lung Ass, one or more acid fast bacilli per oil immersion field are reported as
|
Numerous or 3+
|
|
|
which of the following Mycobacterium spp would be most likely to grown on MAC
|
M. chelonae-fortuitum complex
nonpatho |
|
|
rapid methods for ID classic infection w/ M. tuberculosis inc
|
gas liquid chromatography
nucleic acid probes acid fast smears |
|
|
all of the following are example of appropriate specimen for the recovery of fungi
|
tissue biospy
CSF aspirate of culture but NOT swab |
|
|
for which clinical spp is the KOH direct mount techx for examination of fungal elements used
|
skin
|
|
|
the India ink stain is used as presumptive test for the presence of which org
|
Crytococcus neoformans in CSF
|
|
|
cutaneous disease inv skin, hair, nails usually indicate infection w/
|
dermatophyte
|
|
|
which is the first step to be performed in the ID of an unknown yeast isolate
|
germ tube test
|
|
|
an isolate produced a constriction that was interpreted a positive germ test, but C. albicans was ruled out when confirmatory test were performed. which of the following fungi is the most likely ID
|
C. tropicalis
forms a pseudohyphae that resemble true germ tubes by producing a constriction at the point of the origin of the yeast cell |
|
|
cornmeal agar w/ Tween 80 is used to identify which characteristic of unknown yeast isolate
|
hypahe (true & pseudo)
blastospores + arthrospores chlamydospores |
|
|
blastospores (blastoconidia) are the beginning of which structure
|
pseudohyphae
|
|
|
which of the following yeast emz is detected using birdseed (nigar seed) agar
|
phenol oxidase
|
|
|
which of the following yeasts is characteristically positive for germ tube production
|
C. albicans
are the only yeast that produce germ tubes w/in 1-3 hours of incubation at 37c |
|
|
Arthrospore (arthroconidia) production is used to differentitate which two yeasts isolates
|
Trichosporon pullulans and Crytococcus neoformans
|
|
|
the urease test, niger seed agar test and the germ tube test are all used for the presumptive ID of
|
C. neoformans
|
|
|
which of the following yeasts produces only blastospores on cornmeal Tween 80 agar
|
Crytococcus spp
|
|
|
Ascospores are formed by which yeast isolate
|
Saccharymyces cerevisiae
|
|
|
chlamydospore production is demo by which Candida species
|
C. albicans
|
|
|
carbohydrate assimilation tests are used for the ID of yeast isolates by inoculating media
|
free of carbohydrates
|
|
|
dimorphic molds are found in infected tissues in which form
|
yeast phase
|
|
|
the mycelial form of which dimorphic mold produces thick walled, rectangular, or barrel shaped alternate arthrocondidia
|
Coccidioides immitis
|
|
|
the yeast form of which dimorphic fungus appears as oval or elongated cigar shapes
|
Sporothrix schenckii
|
|
|
the mycelial form of Histoplasma capsulatum seen on the agar resembles
|
Sepedonium spp
|
|
|
the yeast form of which dimorphic mold shows a large parent yeast cell surrounded by smaller budding yeast cells
|
Paracoccidioides brasiliensis
|
|
|
which group of molds can be rules out when septate hyphae are observed in a culture
|
zygomycetes
|
|
|
tinea versicolor is a skin infection caused by
|
Malassezia furfur
|
|
|
which of the following structures is invaded by the genus Trichophyton
|
hair, nails, skin
|
|
|
an org culture from the skin produces colonies displaying a cherry red color on Sabouraud dextrose agar after 3-4 weeks and teardrops shaped microonidia along the side of the hyphae. the most likely ID is
|
Trichopyton rubrum
|
|
|
which Microsporum sp cause an epidemic form of tinea capitis in children
|
Microsporum audouinii
|
|
|
microscopic exam of a fungus culture from a patient w/ athlete's foot showed large, smooth walled, club shape macroconidia appearing singly or in clusters of two or three from the tups of short conidiophores. the colonies did not produce microconidia, what is it
|
Epidermmophyton spp
|
|
|
which Trichophyton species causes the favus type of tinea capitis seen in the Scandinavian countries and in the Appalachian region of the US
|
T. schoenleinii
|
|
|
the Hair Baiting test is used to diff which two spp of Trichophyton that produces red colonies on the Sabouraud agar plates
|
T. mentagrophytes and T. rubrum
|
|
|
a mold that produces colonies w/ a dark brown, green black, or black appearance of both the surface and reverse side is classified as
|
Dematiaceous mold
|
|
|
a rapidly growing hyaline mold began as a white colony but soon developed a black "pepper" effect on the agar surface. the older colony produced a black matte, making it resemble a dematiaceous mold. what am I
|
Aspergillus niger
|
|
|
which dematiaceous mold forms flask shaped phialides, each w/ a flask shapped collarette
|
Phialophora spp
|
|
|
which Aspergillus sp recoveries from sputum or bronchial mucus, the most common cause of pulmonary aspergillosis
|
A. fumigatus
|
|
|
a hylaine mold recovered from a patient w/ AIDS produced rose colored colonies w/ lavendar centers on Sabouraud dextrose agar, microscopic exam showed multiseptate macroconidia appearing as sickles or canoes. what am i
|
Fusarium spp
|
|
|
material from a fungus ball infection produced colonies w/ a green surface on Sab agar in 5 days at 30c. microscopic exam showed clubshaped vesicles w/ sporulation only from the top half of the vesicle. this hyaline mold is most probably which Aspergillus spp
|
A. fumigatus
|
|
|
a rapid growing nonseptate mold produced colonies w/ a gray surface resembling cotton candy that covered the entire plate. microscopic exam revealed sporrangiosphores arising btwn, not opposite, the rhizoids and producing pear shaped sporangia, what am i
|
Absidia spp
|
|
|
a BM sample obtained from an immunocomp pat revealed small intracellular cells using Wright's stain prep. growth on Sab of a mold plates at 25c and yeast phase at 37c designated the organism as dimorphic. the mold phase produce a thick, spherical tuberculated macroconidia, what am i
|
Histoplasma capsulatum
|
|
|
a lung biopsy obtained from immunocomp pat showed many "cup shaped" cysts (gray to black) in a foamy exudate (green background) w/ Gomori methenamine silver (GMS) stain. the org cannot be cultured because it does not grow on routine culture media for molds. the pat was di w/ pneumoniae that resisted antibiotics treatment, what am I
|
Pneumocystis carinii
most recently classified as a fungus but formerly a PA, is best recovered by bronchoalveolar lavage in immunocomp pat |
|
|
upon direct exam of a sputum sp, serveral spherules were notes that contained endospores. growth on Sab showed aerial mycelial elements. the septate hyphae produced barrel shaped arthroconidia. what am I
|
Coccidioides immitis
|
|
|
a BM sp was obtain from immumo pat who test positive for AIDS. the org grew rapid at 3 days showing a mold form at 25c, displaying conidiophores w/ 4 ot 5 terminal metulae w/ each having 4 to 6 phialides. the conidia at the end of the phialides were oval and in short chains. they appear as a fan or broom when viewing under 10 and 40x. at 37c, the yeast form grew more slowly, showing conidia that formed hyphal elements breaking at the septa to produce oval arthroconidia, this thermo dimorphic mold is
|
Penicillium marneffei
|
|
|
classification of viruses is made by
|
nucleic acid comptx
|
|
|
which virus is the most common etiological agent of viral respiratory dz in infants and children
|
RSV
|
|
|
the most common viral sybdrome of pericarditis myocarditis and pleurodynia (pain upon breathing) is caused
|
Coxsackie B virus
|
|
|
which of the following viruses is implicated along w/ Epstien Barr virus as a cause of IM
|
CMV cytomegalovirus
|
|
|
the most common cause of viral pneumonia in adults are
|
influenza and adenovirus (also causes conjunctivitis, keratitis, cystitis, and gasteroenteritis)
|
|
|
which virus belonging to the Reoviridae group causes gastroenteritis in infants and young children but an asymptomatic infection for adults
|
Rotavirus (implicated in both nosocomial infections & epidemic gastroenteritis)
|
|
|
a very small single stranded DNA virus that causes a ferbrile illness w/ a rash and is called the 5th childhood disease after rubeola, rubella, varicella, roseola is...
|
Parvovirus B19
|
|
|
Hep B can transmit
|
acupuncture, tattoos, sexual contact
|
|
|
which virus is ass w/ venereal and respiratory tract warts and produces lesions of skin and mucous membrane
|
Papillomavirus
|
|
|
which virus has been implicated in adult gasteroenteritis resulting from ingestion of contaminated good (esp shellfish) and water
|
Norwalk like viruses
|
|
|
a clinical test used for the detection and Id of viral infection other than culture is (3)
|
hemaggulatix
hemadsorption viral antigen detection |
|
|
which techx is most widely used for the confirmation of infection w/ HIV-1
|
Western blot (immunoblot) assay
|
|
|
a 13 yo boy was admitted to the hospital w/ a diagnosis of viral encephalitis. history reveals that the boy harbored wild raccoons from a nearby woods, what is the best method to determine if the boy has contracted rabies
|
request immunofluorescent test for antigen in cutaneous nervous obtained by nuchal biopsy of the patient
|
|
|
a 65 yow was admitted w/ acute respiratory distress, fever, myalgia, and headache. Influ A or B was suspected after ruling out bacteria pneumonia. which of the following method could be used to confirm Influ infection
|
1. influ virus cult in Madin Darby canine kidney
2. Hemaggltx-inhibition test for antibodies in the patient's serum 3. Direct exam of nasal epithelium for virus using fluorescent antibody stain |
|
|
the most rapid definitive DI of a genital herpes simplex (HSV-2) infection in a 20 yom is made by which method
|
direct immunofluorescence test for viral antigen in vesicle fluid
|
|
|
a 20 yof college student complained of a sore throat and extreme fatigue. the doc noted lymphadenopathy and ordered a rapid test for IM, antibodies were negative. BC = neg as were serological test for Influ A and B, HIV I, CMV, hep B, and antistreptolysin O, what would be the next line of viral testing to est DI
|
Epstein barr
|
|
|
a 60 yom gardener from NY was hospitalized w/ flu like symptoms and eventually DI w/ encephalitis. while working in his garden, he noticed several dead birds around his bird feeder. the region was known to be heavily infested w/ mosquitoes. what is the illness
|
West Nile virus
|
|
|
a 30 yom was a contractor and building inspector in the southeastern US, complain of difficult breathing and was admitted to the hospital w. severe respiratory dz. the doc noted a high fever and cough, 2 days before the patient has inspect an old warehouse, abandoned and infested w/ rodents. the patient was given IV antibiotics, but 2 days into their therapy the pneumonia worsened and he dev pulmonary edema. what org is the suspect
|
Hantavirus (transmitted by rodent, deer mouse) DI is usually made using an IGM ELISA assy
|
|
|
a 3 yof was admitted following a 2 day visit w/ relatives over the xmas holidays. vomitting and diarrhea left the child severely dehydrated. no other members of the family were affected. all BC = negative, stool sample should be tested for which virus
|
Rotavirus
|
|
|
a 25yom patient was DI w/ HIV-1 by emz immunoassay, testing positive twice and the DI was confirmed w/ Western blot testing, which lab testing should be performed prior to initiating antiviral therapy (3)
|
1. quant plasma virus concentration (viral load testing)
2. quan of CD4 lymphocytes 3. phenotype/genotype resistance testing |
|
|
a 6 month old male infant was hospitalized with a respiratory infection. he was DI w/ apnea and bronchiolitis. further testing reveals congenital heart dz. BC = neg for S. pneuomoniae and H. influ, what future testing should be done
|
RSV
|
|
|
a young male hunter encountered a fox in his path during walking in the woods. the fox was staggering but appeared nonthreatening. the man tried to avoid contact but was attack and bitten on the leg. the bite broke skin but was not deep. wildlife officials were unable to locate the fox for testing, what procedure should take place next
|
administration of hyperimmune antirabies globulin and rabies vaccine
|
|
|
a 40 yof experienced a respiratory infection after returning home from a visit from China. a rapid onset of pneumonia in the lower respiratory area prompt the doc to place her in isolation, she was DI: SARS (severe acute respiratory syndrome), and placed on a respirator, what type of testing should be done next
|
molecular techx and cell culture
|
|
|
a pregnant 25 yof w/ genital lesions delivered a premature newborn w/ complications. the baby test negative for bacterial infection (cult of blood and urine). antigen testing of the baby's urine proved negative for Grp B Strep and neg Strep pneumoniae. the mother tested negative for bacterial STD and for Grp B strep. the baby was treated w/ acyclovir and failed to survive. what was the cause of death
|
Herpes simplex virus
|
|
|
a young father of two small children complained of a rash on the torso of his body. the children has been DI w/ chickenpox and confined to their home. the father has experience chickenpox as a child and knew he did not have the same rash as his children, what is the likely rash
|
Varicella zoster virus
|
