N © « © wll 82% aml 8:33 am @ https://www.medialabinc.net @ : % You did not provide an answer to this question. The parts of the prototypical bacterium in the image to the right are identified below. Which of the following is incorrectly identified? The correct answer is highlighted below 5 a) myfh RN © 4 F wl 82% al 8:33 am @ https://www.medialabinc.net @ : B - cell wall A - cytoplasmic membrane E - nuclear material F - flagellum Feedback The correct answer is A - cytoplasmic membrane. A is representing pili and D is representing the cytoplasmic membrane. The cell wall is correctly depicted by B, the nuclear material is correctly depicted by E and the flagellum is correctly depicted by F. These are all structures that are typically found on bacteria, regardless of morphology. Bacteria are prokaryotic, meaning they have a single chromosome (nuclear material) that is not enclosed in a nuclear membrane.RN © « © will 82% olne N © « F wl 82% Gl 8:33 am The top image shows a 5-day-old colony grown on blood agar and incubated at 30° C. It has a delicate cobweb-like, gray-white mycelium. Note the dark gray discoloration on the upper margin where hemoglobin pigment has been absorbed. This colony was recovered from the needle biopsy of a lung nodule that developed three months after a 45-year-old businessman returned from a business trip in Southern California. The definitive identification can be made microscopically from the observation of the distinctive hyphae as presented in the lactophenol blue mount shown in the bottom image. From these observations, select the presumptive identification of this isolate from the choices listed below. The correct answer is highlighted below Histoplasma capsulatum Coccidioides immitis Blastomyces dermatitidisN © « © wll 82% aml 8:32 am ie Illustrated in the left tube of this photograph is a positive Voges Proskauer reaction (left tube). The red pigment is produced from the reactions of: The correct answer is highlighted below Alpha naphthol with acetoin (dimethyl carbinol) Alpha naphthol with diacetyl Potassium hydroxide with acetoin (dimethyl carbinol) 5 a) myN © «« © wll 82% al 8:32 am The reactions observed in this Kligler lron Agar slant (left) and Christensen’'s urease slant (right) provide the presumptive identification of: The correct answer is highlighted below Citrobacter freundii Edwardsiella tarda Salmonella typhimurium Proteus mirabilisfh N © «« F wl 82% Mam 8:32 am @ https://www.medialabinc.net @ : % You did not provide an answer to this question. Which of the following is necessary to test for in order to detect patients in the "window" period of a hepatitis B infection? The correct answer is highlighted below HBsAg Anti-HBs Anti-HBe Anti-HBcfh RN © 4 F atl 82% dal 8:32 am @ https://www.medialabinc.net @ : Wepre wonmeCUU: The correct answer is highlighted below HBsAg Anti-HBs Anti-HBe Anti-HBc Feedback The correct answer is anti-HBc. HBs antigen appears first, but is often cleared before symptoms appear. Anti-HBs appears after acute hepatitis symptoms disappear. Anti-HBe appears around the same time as anti- HBs peaks, which is after acute hepatitis symptoms disappear. 5 a) myfh N © « © wl 82% Mam 8:32 am *% You did not provide an answer to this question. A 3-year old girl was brought to the ER with a temperature of 103°F, lethargy, and cervical rigidity. Three tubes of cloudy CSF were delivered to the Lab, and preliminary test results showed: WBC: 4,500/uL Differential: 88% neutrophils Glucose: 15 mg/dL 12% lymphocytes Protein: 140 mg/dL Gram stain: No organisms observed From these results, what preliminary diagnosis SHOULD the physician consider? The correct answer is highlighted below Brain tumor Bacterial meningitis Viral meningitis Subdural hematoma Feedback 5N © « © wll 82% aml 8:32 am question. Each of the following statements regarding Rickettsiaceae are correct EXCEPT: The correct answer is highlighted below Serodiagnosis using enzyme immunoassay or indirect immunofluorescence methods are preferred over the Weil-Felix reaction to diagnosis rickettsial disease. Most cases of ehrlichiosis are transmitted by the Lone Star tick. Rickettsia rickettsii is the agent of Rocky Mountain spotted fever. Rocky mountain spotted fever is almost always geographically restricted to the Rocky mountain region.N © « © wl 82% aml 8:32 am Cy wy Questions % You did not provide an answer to this question. An organism isolated from the spinal fluid of a newborn produced small, grayish, slightly translucent beta-hemolytic colonies on sheep blood agar. A Gram stain of the colony showed small Gram-positive rods that look like diphtheroids. The organism is MOST likely: The correct answer is highlighted below Corynebacterium diphtheriae Erysipelothrix rhusiopathiae Listeria monocytogenes Streptococcus agalactiae 5 a)N © « © wll 82% aa 8:31 am Question 9 of 100 Ou Questions % You did not provide an answer to this question. The organism that is a strict anaerobe, non- motile, gram-negative bacillus, occurring in abscesses and associated with peritonitis is MOST likely: The correct answer is highlighted below Haemophilus spp. Bordetella spp. Bacteroides spp. Brucella spp.N © «« © wll 82% aa 8:31 am Complete hemolysis of sheep blood agar as demonstrated by the image below would be seen in which of the following catalase-negative isolates? The correct answer is highlighted below Streptococcus pneumoniae Streptococcus pyogenesN © « © ll 82% aa 8:31 am All of the following statements about blood cultures are correct EXCEPT? The correct answer is highlighted below A specific amount of blood is required to fill blood culture bottles to optimize the growth and detection of bacteria. If two separate sets (two bottles each set) of blood cultures are requested, draw them both from the same site at the same time. Prior to performing the venipuncture, allow the cleansing agent to air dry completely on the skin to ensure sterilization of the venipuncture site. If two separate sets (two bottles each set) of blood cultures are requested, it is recommended toN © « © wll 82% aa 8:31 am % You did not provide an answer to this question. A fusiform-shaped, Gram negative, oxidase negative bacillus that produces colonies with marginal finger-like projections was recovered from the oral cavity of a patient with periodontal disease. The most likely identification is: The correct answer is highlighted below Capnocytophaga canimorsus Capnocytophaga ochracea Actinobacillus actinomycetemcomitans Eikenella corrodensfh N © «« F wl 82% Ham 8:31 am % You did not provide an answer to this question. Why is Mycobacterium tuberculosis not seen on gram stained smears? The correct answer is highlighted below Mycobacterium tuberculosis stains gram positive, just too light to identify. Mycobacterium tuberculosis is too small to visualize in a gram stain. Mycobacterium tuberculosis has a waxy coating on its surface which prevents gram stain penetration. Mycobacterium tuberculosis have an impervious nucleocapsid. FeedbackN © « © wll 82% am 8:30 am A 34-year-old female was seen in the dermatology clinic for some lesions on her fingers that had not responded to topical antimicrobial therapy. A tissue biopsy was sent for histological examination, routine culture, acid-fast bacilli (AFB) culture, and fungal culture. There was no growth on any culture, but AFB were seen in the histological preparations. The tissue culture for AFB had been incubated at both 35°C and 32°C, in liquid media and on media with hemoglobin added for several weeks. What is the most likely diagnosis of her skin lesions? The correct answer is highlighted below Buruli's ulcer Swimming pool granuloma Leprosy AIDS% You did not provide an answer to this question. What is the unique colony morphology feature of Rhodotorula growing on Sabouraud Dextrose Agar (SDA)? The correct answer is highlighted below Rugose (wrinkled) colonies Filamentous colonies Green/blue pigment Pink-red/orange pigment FeedbackN © « © wll 83% aml 8:30 am % You did not provide an answer to this question. Host cells (e.g., white blood cells, epithelial cells) will appear what color on a properly stained Gram stain? The correct answer is highlighted below Violet Pink Orange They do not pick up either stain and will appear colorlessJ) ey Rs J Home Questions L2ETo 4 No % You did not provide an answer to this question. Which of the following is a characteristic of Francisella tularensis? The correct answer is highlighted below Tiny, weak-staining, gram-negative coccobacilli Oxidase and urease positive Subcultures grow easily and quickly on sheep blood agar (SBA) Tiny, gram-positive rodsN © « © wll 83% aml 8:30 am Question 18 of 100 S co ° 5 Home Questions 12ETo 4 Na % You did not provide an answer to this question. Which of the following microorganisms is LEAST likely to produce a capsule or slime layer? The correct answer is highlighted below Escherichia coli Klebsiella pneumoniae Streptococcus pneumoniae Pseudomonas aeruginosana N © rv ail) 83% ll 8:30 am Consider the following regarding infection with Mycobacterium tuberculosis. Each response is correct EXCEPT: The correct answer is highlighted below The typical route of transmission for primary tuberculosis is person to person contact via inhalation of infectious aerosols. Although primary tuberculosis is considered a respiratory tract disease, the infection may also affect other organs, such as the heart, lymph nodes, and central nervous system. A positive purified protein derivative (PPD) test always indicates the presence of active tuberculosis disease. Individuals with latent tuberculosis have no signs of infection and areN © 4 © wil 83% Gl 8:30 am s ~ Pe &, @ I ‘ “f we % ’ The bacterial species shown on the blood agar 5 a) myN © « © wll 83% aml 8:29 am 8 e 3 * * %e YY : The bacterial species shown on the blood agar plate illustrated in the photograph was recovered from a blood culture of a patient with fever. The most likely source of infection is which of the following? The correct answer is highlighted below Urinary tract Respiratory tract Indwelling catheter Cutaneous wound 5 a)RN © « 7 wll 83% aml % You did not provide an answer to this question. pv Illustrated in this image is a field of view 5 (a) oliA ro N © «« meskes Illustrated in this image is a field of view microscopically observed on a Scotch-tape preparation. Based on the morphology and presentation of these ova, an identification of Enterobius vermicularis can be made. The optimum time to obtain Scotch-tape samples of peri-anal skin to recover these ova is: The correct answer is highlighted below Immediately after waking Prior to waking Between 10:00 A. M. and 2:00 P. M. Between midnight and 2:00 A. M.N ©: CR Lr —_— — Questions Nt 20um Gas. The cyst as illustrated in the photograph was observed in a permanently stained smear of a stool specimen. Making a presumptive identification would be difficult because of the poor quality of the stain and the lack of internal detail. From the multiple-choice answers listed below, select the most likely cause for the poor staining quality observed in this cyst. The correct answer is highlighted belowN © « F wll 83% Ml 8:29 am — The cyst as illustrated in the photograph was observed in a permanently stained smear of a stool specimen. Making a presumptive identification would be difficult because of the poor quality of the stain and the lack of internal detail. From the multiple-choice answers listed below, select the most likely cause for the poor staining quality observed in this cyst. The correct answer is highlighted below Weak staining solution Inadequate stool fixation Insufficient time of staining Selection of wrong staina N © «« © wll 83% Gal 8:29 am @ https://www.medialabinc.net, ©) % You did not provide an answer to this question. Which fungal culture media is used for the primary recovery of pathogenic fungi exclusive of dermatophytes? The correct answer is highlighted below Inhibitory mold agar Potato flake agar Mycosel agar (SABHI) Sabouraud Dextrose withRN © x F wll 83% Gl 8:29 am Which of the following choices represents the characteristic indicator, fermentable sugar(s), and bacteriostatic agent(s) that are present in MacConkey agar respectively? The correct answer is highlighted below Phenol red / lactose, sucrose, and xylose / sodium desoxycholate and bile salts Eosin Y and methylene blue / lactose and sucrose / Eosin Y and methylene blue Bromothymol blue / lactose, salicin and sucrose / bile salts Neutral red / lactose / bile salts and crystal violet Feedback MacConkey agar contains neutral red, which is a 5 a) my% You did not provide an answer to this question. Which of the following species of hyaline molds produce conidia in chains? The correct answer is highlighted below Scopulariopsis species Gliocladium species Acremonium species Candida species Feedbackna) N © « © wll 83% aml 8:28 am % You did not provide an answer to this question. The production of polar germ tubes is a characteristic that is associated with which of these dematiaceous fungi? The correct answer is highlighted below Alternaria species Phialophora verrucosa Bipolaris species Curvularia species Feedbacka N © «« © wl 83% Hl 8:28 am % You did not provide an answer to this question. Stenotrophomonas maltophilia and Burkholderia cepacia share each of the following characteristics EXCEPT: The correct answer is highlighted below Decarboxylation of lysine Cytochrome oxidase activity Production of colonies with a yellow pigment Good growth on MacConkey agarh RB © d« F wll 83% Gl 8:28 am © lat © The image shows a variety of colony elevations. Which colony elevation description matches with figure B in the image? The correct answer is highlighted below High Convex or Dome Low Convex Flat Raised Feedback pe)na) N © « © wll 83% aml 8:28 am Low Convex Flat Raised Feedback Elevation is observed in colonies by tilting the culture plates and looking at the side of the colony to view how the colony is raised off the agar plate. Figure B shows a flat colony as there is not much elevation shown off the surface. High Convex or Dome is shown in Figure A. The colony has a high elevation off the agar surface and is dome-shaped. Low Convex is shown in Figure C. The colony elevation is a bit lower but still rather convex, or round in shape. Raised is shown in Figure D. The colony is not rounded, so it is not convex, and is only slightly elevated off the media surface. Other colony elevations include umbilicate, which has a central depression in the colony, and umbonate which as a central elevation in the colony.na) N © « © wll 83% aml 8:28 am @ https://www.medialabinc.net, ©) % You did not provide an answer to this question. Which of the following microorganisms is associated with foodborne illness contracted from oysters and clams? The correct answer is highlighted below Listeria monocytogenes Escherichia coli 0157:H7 Salmonella enteriditidis Vibrio vulnificusna) N © « © wl 83% aml 8:28 am The diagnosis of diphtheria must be confirmed by: The correct answer is highlighted below Observing metachromatic granules in a methylene blue stain of an oropharyngeal swab Recovering Corynebacterium diphtheriae in culture Performing a biochemical identification of a culture isolate Determining that a culture isolate is a toxin producing strain Feedback In a case of suspected diphtherial pseudomembranous pharyngitis, although microscopic observation of a Gram stain of an oropharyngeal swab may reveal a predominancea N © «« © wall 83% Gal 8:28 am ry ee CYP ay yay Question 31 of 100 % You did not provide an answer to this question. What is the most likely identification of a rapidly growing hyaline mold that began as a white colony and later develops a black "pepper" effect on the agar surface? As the colony aged it produced jet black, powdery colonies which then caused it to resemble a dematiaceous mold. The correct answer is highlighted below Penicillium notatum Aspergillus niger Paecilomyces spp. Scopulariopsis spp. 5 a)% You did not provide an answer to this question. Which of the following statements represents alpha hemolysis on 5% sheep blood agar? The correct answer is highlighted below No visible effect on blood Green area around bacteria; incomplete hemolysis Clear area around bacteria; complete hemolysis Clear area around bacteria; incomplete hemolysisN © «« F wl 83% Mam 8:27 am Question 33 of 100 Q AS Questions Bria. The colonies growing on the surface of this 5% sheep blood agar plate, with B-hemolysis, were recovered from a throat swab of a 19-year-old girl with acute pharyngitis. Gram stain revealed 5 a) mya BR © sd« F wll 83% Gl 8:27 am @ https://www.medialabinc.net @ : The colonies growing on the surface of this 5% sheep blood agar plate, with B-hemolysis, were recovered from a throat swab of a 19-year-old girl with acute pharyngitis. Gram stain revealed club-shaped Gram positive bacilli with rudimentary branching. What is this species? The correct answer is highlighted below Arcanobacterium hemolyticum Streptococcus pyogenes Listeria monocytogenes Corynebacterium pseudodiphtheriticumN © «« F wall 84% Gal 8:27 am % You did not provide an answer to this question. From the viruses listed below, select the one that is transmitted from birds to humans through a mosquito vector. The correct answer is highlighted below Hepatitis A virus Rotavirus West Nile virus CytomegalovirusN © «« F wall 84% Gal 8:27 am Question 35 of 100 S co ° 5 Home Questions 12ETo 4 Na % You did not provide an answer to this question. Which of the following organisms causes thrush? The correct answer is highlighted below Cryptococcus neoformans Aspergillus spp. Candida albicans Nocardia neoformansN © « © wall 84% Gal 8:27 am Oe > The adult fluke related to the 100 pm ovum, as illustrated in the image shown, most commonly inhabits the lung parenchyma. The ovum, as may be observed in a sputum specimen, has a smooth, slightly thickened shell with a prominent shouldered operculum as seen at the left lower end. A developing larva is observed within, retracting from the inner margin of the shell leaving a clear space. Infections with this fluke are endemic in the orient, in West Africa, in South and Central America and may be observed in patients elsewhere after travel to one of these regions. Humans become infected afterna N © « © wll 84% aa 8:27 am shouldered operculum as seen at the left lower end. A developing larva is observed within, retracting from the inner margin of the shell leaving a clear space. Infections with this fluke are endemic in the orient, in West Africa, in South and Central America and may be observed in patients elsewhere after travel to one of these regions. Humans become infected after ingestion of poorly cooked crab meat or crayfish contaminated with metacercariae. Intermittent chest pain, and cough with occasional spitting up of blood (hemoptysis) may be experienced after infection. From the choices below, select the trematode species related to this ovum. The correct answer is highlighted below Clonorchis sinensis Fasciola hepatica Fasciolopsis buski Paragonimus westermaniN © « © wll 84% aml 8:27 am Question 37 of 100 S co ° c Home Questions 12ETo 4 Na % You did not provide an answer to this question. Which of the following Mycobacterium species is closely associated with infections in HIV positive patients? The correct answer is highlighted below M. ulcerans M. avium-intracellulare complex M. simiae M. bovisRN © « © wll 84%iA ro Pest cb Lo N © « Illustrated in the top photograph is the appearance of a 4-day old fugal colony cultured from a “ringworm” cutaneous infection. Although the appearance of the colony may suggest a presumptive identification, microscopic mounts prepared from the surface hyphae must be examined, as observed in the lacto-phenol blue stained tease mount in the bottom photomicrograph. With these observations, select from the multiple choices the identification of this dermatophyte. The correct answer is highlighted below Microsporum canis Trichophyton mentagrophytes Epidermophyton floccosum Microsporum gypseumfh N © «« F wl 84% Gl 8:26 am @ https://www.medialabinc.net @ : sty) 39 of 100 % You did not provide an answer to this question. Which one of the following parasites migrates through the circulation (blood) before maturing in the portal venous system? The correct answer is highlighted below Schistosoma mansoni Enterobius vermicularis Taenia saginata Trichuris trichiuraRN © * F ll 84% al % You did not provide an answer to this question. vw Mh, & Illustrated in this photomicrograph of a gastric biopsy specimen are a few thin, curved and S- shaped bacteria (arrows). This picture is suspicious for Helicobacter pylori. An additional test helpful in confirming this identification is: The correct answer is highlighted below Indoxyl acetate 5 (a)N © F stl 84% Ham 8:26 am Illustrated in this photomicrograph of a gastric biopsy specimen are a few thin, curved and S- shaped bacteria (arrows). This picture is suspicious for Helicobacter pylori. An additional test helpful in confirming this identification is: The correct answer is highlighted below Indoxyl acetate Rapid urease Hippurate hydrolysis Growth at 42° C 5 a)fh N © « © wll 84% aml 8:26 am The federal government has categorized critical biological agents into three groups: A, B, and C. Why are the agents in category A classified as the highest-priority? The correct answer is highlighted below These organisms cause moderate morbidity and low mortality. These organisms could be engineered for mass dissemination at some future date. These organisms can be easily disseminated or transmitted person- to-person. The organisms are not easily disseminated and do not cause high morbidity rates. Feedback The federal government has categorized criticalN © « F wl 84% Mam 8:26 am From the list of fungal species, select the one for which optimum recovery in a laboratory culture requires the use of an enriched agar base such as inhibitory mold agar, SABHI (Sabouraud's dextrose agar + heart infusion agar), or brain- heart infusion with cycloheximide and chloramphenicol. The correct answer is highlighted below Aspergillus terreus Cryptococcus neoformans Blastomyces dermatitidis Fusarium species Feedback Blastomyces dermatitidis is the correct answer because as one of the dimorphic fungi, this species would require one of the selective media% You did not provide an answer to this question. The transmission of which of the following organisms is associated with the guano of bats? The correct answer is highlighted below Blastomyces dermatitidis Histoplasma capsulatum Coccidioides immitis Paracoccidioides brasilensis Feedbackfh N © « © wll 84% aa 8:26 am Questions % You did not provide an answer to this question. A Staphylococcus species recovered from a blood culture was found to produce acid from sucrose and maltose and showed alkaline phosphatase activity. The Staphylococcus was also coagulase negative. The same organism was also found in a culture from the central line tip. The most likely identification is: The correct answer is highlighted below Staphylococcus saprophyticus Staphylococcus schleiferi Staphylococcus epidermidis Staphylococcus aureusN © F wl 84% Mam 8:25 am & A patient is seen at his physician's office for scaling, flat lesions on his back that are irregular with white blotches of discoloration (top image). The bottom image shown is of a tease mount taken from the skin and stained with Periodic Acid Schiff, which reveals narrow fungal hyphae (arrows) along with 3 — 5 um in diameter, irregular sized spherical budding yeast cells, a presentation often referred to as “spaghetti and meatballs”. Which fungi is the most likely cause of infection? The correct answer is highlighted below Wickerhamomyces anomalus Malassezia furfur Aureobasidium pullulans Saccharomyces cerevisiae FeedbackN © « F wl 84% Mam 8:25 am arland Equivalence Turbidit al Comparison Card ll The McFarland Comparison Card shown in the illustration is used to: The correct answer is highlighted below Perform susceptibility testing Standardize concentrations of organisms Q.C. broth media Determine MICsfh N © « F wll 84% aa 8:25 am @ https://www.medialabinc.net @ : % You did not provide an answer to this question. The laboratory test most commonly used to establish a definitive diagnosis of primary syphilis is: The correct answer is highlighted below Rapid plasma reagin (RPR) Recovery of spirochetes via culture Direct fluorescent antibody test Fluorescent treponemal antibody A dn oe tinRN © 4 F atl 84% Gaal 8:25 m Question 48 of 100 3 A Questions a ww = « . a ae atts ne Mine ad 8 Gi Illustrated in the high power view of an H & E- stained tissue section isa Srenulorna involvingfh N © « © wll 84% aml 8:25 0m @ https://www.medialabinc.net @ : Illustrated in the high power view of an H & E- stained tissue section is a granuloma involving the wall of the large intestine. Based on the observation of a sharp spike projecting from the cyst shell (arrow), what is the identification of this parasitic egg? The correct answer is highlighted below Schistosoma japonicum Clonorchis sinensis Schistosoma mansoni Schistosoma haematobiumna N © « F will 84% aa 8:25 0m @ https://www.medialabinc.net @ : Questions % You did not provide an answer to this question. x B > All of the following nematodes are consistent with the 50 pm ovum illustrated in this image aAll of the following nematodes are consistent with the 50 pm ovum illustrated in this image EXCEPT one. Select the genus and species of the nematode whose ovum is NOT consistent with the image. The correct answer is highlighted below Strongyloides stercoralis Enterobius vermicularis Ancylostoma duodenale Necator americanush RN © « F wil 84% Gal 8:24 am @ https://www.medialabinc.net @ : % You did not provide an answer to this question. a stan - Pe ae ea ee P C a eb a is, . ie ns, , The bacterial species illustrated in these photographs was recovered from septic peritoneal fluid of a patient undergoing 5 (a) olN © « A wil 84% Ga 8:24 am The bacterial species illustrated in these photographs was recovered from septic peritoneal fluid of a patient undergoing continuous peritoneal dialysis. The most likely identification is: The correct answer is highlighted below Micrococcus luteus Staphylococcus aureus Staphylococcus cohnii Staphylococcus epidermidisRN © « F wil 84% Gaal 8:24 am % You did not provide an answer to this question. In the upper bi-plate i image are shown coloniesna) N © « © wil 84% aa 8:24 am In the upper bi-plate image are shown colonies growing on MacConkey (left), and on blood agar (right). Relatively large confluent gray white colonies are observed growing on blood agar, while smaller smooth convex colonies with a deep red pigmentation are growing on MacConkey agar. Note that the pigment is confined to the colonies growing on MacConkey agar that does not diffuse into the adjacent agar. In follow-up to making a presumptive identification, observe that the colonies growing on the DNase agar in the lower image (right) show a positive reaction with clearing of the adjacent agar, compared to the growth of a negative control growing in the streak lines to the left. From these observations, select from the multiple choices the presumptive identification of this isolate. The correct answer is highlighted below Proteus vulgaris Serratia marcescens Providencia stuartiina) N © « © wil 84% aa 8:24 am + fDract. co .f4nn Question 52 of 100 % You did not provide an answer to this question. Which of the following statements about Gram- positive bacteria is TRUE? The correct answer is highlighted below They resist acetone-alcohol decolorization They are always decolorized by acetone-alcohol They resist staining by crystal violet They readily stain with safranin in the Gram stainna) N © « © wil 84% aa 8:24 am @ https://www.medialabinc.net @ : % You did not provide an answer to this question. Rocky Mountain spotted fever (RMSF) is transmitted by the bite of a tick infected with: The correct answer is highlighted below Coxiella burnetti Borrelia burgdorferi Borrelia recurrentis Rickettsia rickettsiine N © « © wll 85% aa 8:23 am The type of sporulation of the dematiaceous mold that is illustrated in this photomicrograph is called: The correct answer is highlighted below Acrotheca Rhinocladiella Birds on a fence AcropetalN © « © wll 85% aml 8:23 am Illustrated in this photograph, reading from left to right, are biochemical reactions for indole, Voges Proskauer, Simmons citrate, and Christensen's urea. The bacterial species providing the best fit for the reactions illustrated is: The correct answer is highlighted below Salmonella typhimurium Citrobacter koseri Klebsiella oxytoca Enterobacter cloacaena N © «« © wl 85% Hl 8:23. am Smooth gray-white, convex, glistening non- hemolytic colonies were observed growing on the surface of anaerobic blood agar after 48 hours. This isolate was obtained from a nasal swab specimen. Short Gram positive bacilli in short chains and in diphtheroidal-like clusters were observed on Gram stain. Spot test results included a positive catalase and a negative indole reaction. This organism was presumptively identified as Cutibacterium (Propionibacterium) acnes. With this presumptive identification, select from the multiple choices what the next step should be. The correct answer is highlighted below Set up biochemical reactions to confirm the identification Refer the culture to a reference laboratory for confirmation Report with added comment: “probable contaminant” Retain isolate as part of a routinena) N © « © wll 85% aml 8:23 am Minimum inhibitory concentration (MIC) susceptibility tests should be performed against other beta lactam antibiotics for Streptococcus pneumoniae isolates from blood cultures and other sterile body fluids. The reason for this is due to an emerging resistance against penicillin and other beta lactam antibiotics. However, there is one antibiotic that is used to treat drug resistant Streptococcus pneumonia infections and MIC results should be questioned when a resistant susceptibility is found. Which of the following antibiotics does Streptococcus pneumonia still remain sensitive? The correct answer is highlighted below Cefotaxime Ceftriaxone Vancomycin Tetracyclinea N © « F wall 85% Gal 8:23 am What is the purpose of the iodine that is used in the Gram stain procedure? The correct answer is highlighted below It is the primary stain that is used in the Gram stain procedure. Fixes the crystal violet to the cellular components of gram-positive bacteria. Allows the counterstain to permeate the gram-negative bacteria. It is the dye that stains gram negative bacteria so that they appear pink. Feedback The correct answer is it fixes the crystal violet to the cellular components of gram-positive bacteria. lodine that is used in the Gram stain procedure; © @« 7 al 85% amna N © « © wll 85% aml 8:22 am @ https://www.medialabinc.net @ : Pena WN | G9) Illustrated in the top photograph is a 4-day-old white to cream-colored colony with a yeast-like background, but with the surface having a delicate silk-like consistency. Such colonies may be recovered as a contaminant in laboratory cultures. The identification is illustrated in a cornmeal agar mount shown in the bottom photograph. From these observations, the MOST likely identification of this yeast-like isolate is: The correct answer is highlighted below Trichosporon beigelii Aureobasidium pullulans Geotrichum candidum Phaeoannelomyces werneckiine N © « © wll 85% aml 8:22 am Which statement about assays for the antigenic detection of both Clostridium difficile toxins A and B is TRUE? The correct answer is highlighted below The antigenic assays give rapid results. The assays can only detect simultaneous production of toxin A and toxin B. The assays provide a high level of sensitivity. Assays that detect toxin A alone will detect all clinically significant strains. Feedback The correct answer is the antigenic assays give rapid results.na) N © © wl 85% Gl 8:22 am % You did not provide an answer to this question. An India Ink preparation is used to identify: The correct answer is highlighted below Crystals in synovial fluid Cryptococcus neoformans in CSF Bacteria in CSF WEBCs in synovial fluid Feedback India ink preparation performed on spinal fluid isna N © « © wll 85% aml 8:22 am % You did not provide an answer to this question. Which of the following Hepatitis viruses is (are) transmitted through the fecal oral route and may be implicated in infections transmitted through contaminated food and water? The correct answer is highlighted below Hepatitis A Hepatitis A and Hepatitis B Hepatitis C Hepatitis B and Hepatitis Cna) N © « © wl 85% Gl 8:22 am @ https://www.medialabinc.net @ : % You did not provide an answer to this question. What is the primary target of HIV? The correct answer is highlighted below Heart Neutrophils B-cell lymphocytes Helper T-cell lymphocytes© all 85% Ml 8:22 am oe | 1-26) NEG \ delta Aminolevulinic Acid Disk os Which of the following organisms would show as negative for the testing shown in the image? The correct answer is highlighted below Haemophilus parainfluenzae Haemophilus influenzae Haemophilus parahaemolyticus Haemophilus aphrophilusCome ey yay % You did not provide an answer to this question. A coagulase test should be performed to differentiate between which of the following? The correct answer is highlighted below Staphylococcus species and Streptococcus species Micrococcus species and Streptococcus species S.aureus and coagulase negative staphylococci Streptococcus pyogenes and Streptococcus agalactiaeN © « F wall 85% Gal 8:21 am % You did not provide an answer to this question. Which type of healthcare occupational exposure has the greatest risk of HIV transmission? The correct answer is highlighted below Percutaneous injury Mucous membrane exposure Abraded skin exposure None of the aboveN © « F wall 85% Gal 8:21 am % You did not provide an answer to this question. Bordet-Gengou potato infusion agar is the medium of choice for the recovery of which one of the following organisms? The correct answer is highlighted below Bordetella pertussis Corynebacterium diphtheriae Haemophilus influenzae Neisseria meningitidisN © © wn! 85% Gl 8:21 am The organism cultured on the Lowenstein- Jensen agar slant shown in the image to the right is most likely: The correct answer is highlighted below Cryptococcus Chlamydia Mycobacteria Listeria 5N © © wn) 85% Ml 8:21 am % You did not provide an answer to this question. Which one of the following fungi is MOST likely to be seen in skin infection of burn patients? The correct answer is highlighted below Sporothrix schenckii Aspergillus niger Fusarium sp. Alternaria sp. 5N © @ © wn) 85% Gil 8:21 am The ONPG (ortho-nitrophenyl-Beta-D- galactopyranoside) test is used to: The correct answer is highlighted below Separate Gram positive cocci based on production of catalase. Separate late lactose fermenters from lactose negative bacteria based on the production of beta- galactosidase. Differentiate alpha hemolytic streptococci based on bile solubility. Differentiate Gram negative bacilli based on cytochrome oxidase production. Feedback Structurally like lactose, ONPG is useful in the detection of late or slow lactose fermenters. 5 a) myQuestions % You did not provide an answer to this question. From the following molds, which one is considered an obligate pathogen, causing infections in persons who were previously healthy? The correct answer is highlighted below Aspergillus fumigatus Rhizopus species Blastomyces dermatitidis Mucor speciesN © «« © wil 85% aa 8:20 am + % You did not provide an answer to this question. MacConkey agar contains all of the following except : The correct answer is highlighted below Penicillin Bile salts Lactose Crystal violetN © «« © wil 85% aa 8:20 am % You did not provide an answer to this question. The susceptibility of a bacterium to each drug on a sensitivity plate using antibiotic disks is demonstrated by the diameter of the zone of: The correct answer is highlighted below Inhibition Resistance Beta hemolysis Gamma hemolysis© dx A a! 85% Gal 8:20 am The hyaline mold colony represented in the composite picture is approximately 8 days old. The most likely genus is: The correct answer is highlighted below Coccidiodes Rhizopus Penicillium Trichophyton 5N © « © wil 85% aa 8:20 am % You did not provide an answer to this question. Which culture agar combinations below will be MOST sufficient for routine urine culture investigations? The correct answer is highlighted below 5% sheep blood and Chocolate 5% sheep blood and MacConkey 5% sheep blood and Thayer-Martin MacConkey and Eosin MethyleneN © «« © wil 85% aa 8:20 am % You did not provide an answer to this question. The tubes shown in this photograph reading from left to right are Kligler Iron Agar (KIA), tryptophane broth for detecting indole and 5 a) myN © « © wil 85% aa 8:20 am The tubes shown in this photograph reading from left to right are Kligler Iron Agar (KIA), tryptophane broth for detecting indole and Simmor's citrate. The KIA tube shows an entirely yellow slant and butt, the indole tube shows a layer of red color, and the Simmon's citrate tube is green in color. Of the bacterial species listed, the one most likely to produce the reactions observed is: The correct answer is highlighted below Shigella flexneri Escherichia coli Klebsiella oxytoca Enterobacter aerogenes 5 a)N © « F wil 85% aa 8:20 am nan, ye ae Question 77 of 100 % You did not provide an answer to this question. Which Enterobacteriaceae are non-lactose fermenters on MacConkey (MAC) agar, have green colonies with black centers on Hektoen enteric (HE) agar, and on xylose-lysine- deoxycholate (XLD) agar will have red colonies with black centers? The correct answer is highlighted below Proteus spp. Edwardsiella spp. Salmonella spp. Shigella spp. 5N © « © wil 85% al 8:19 am question. Which one of the following combinations of organisms would be appropriate positive and negative controls to verify the specific test functions listed? The correct answer is highlighted below Beta hemolysis - Escherichia coli and Streptococcus pyogenes Catalase - Staphylococcus aureus and Staphylococcus epidermidis Hydrogen sulfide production — Proteus mirabilis and Salmonella typhi Indole — Escherichia coli and Klebsiella pneumonia Feedback Escherichia coli and Klebsiella pneumoniae are 5 a) myfh N © « © wil 85% al 8:19 am % You did not provide an answer to this question. The following are described as rapid growing, opportunistic fungi that are differentiated based on the presence of sporangiospores, the shape of the columella, presence or absence of rhizoids, and the location of the rhizoids on the stolon. The correct answer is highlighted below Aspergillus species Penicillium species Mucorales species Dermatophyte speciesfh N © « © wil 86% aml 8:19 am Questions % You did not provide an answer to this question. What organism matches the tissue morphological features of separate hyphae, 5-10 um in diameter that exhibit dichotomous branching? The correct answer is highlighted below Aspergillus species Histoplasma capsulatum Blastomyces species Coccidioides speciesh RN © x © wil 86% Gl 8:19 am @ https://www.medialabinc.net @ : 1estion 31 of 100 % You did not provide an answer to this question. Which of the following organisms is a cause of cutaneous infections? The correct answer is highlighted below Nocardia brasiliensis Nocardia cyriacigeorgica Nocardia farcinica Gordonia bronchialisfh N © « © wil 86% aml 8:19 am Questions % You did not provide an answer to this question. A mixture of Gram positive and Gram negative bacteria may be present within the same field of a slide of all of the following EXCEPT: The correct answer is highlighted below Mixed wound infections Urine sediment from a mid-stream catch specimen Expectorated sputum specimen Sterile cerebrospinal fluidfh N © « © wil 86% aml 8:19 am @ https://www.medialabinc.net @ : % You did not provide an answer to this question.N © « © wn! 86% Gl 8:19 am Slide Coagulase Purulent material is obtained from a carbuncle and submitted for bacterial culture. Many Gram positive cocci and white blood cells were seen on direct smear (top right image). Colonies on blood agar are, smooth and gold/yellow surrounded by a narrow zone of beta hemolysis (top left image). Coagulase tests are shown in the bottom images. The slide coagulase test is negative, but the tube coagulase test is positive. The probable presumptive identification is: The correct answer is highlighted below Micrococcus luteus Staphylococcus aureus Staphylococcus epidermidis Staphylococcus saprophyticusfh N © « © wil 86% aml 8:19 am @ https://www.medialabinc.net, ©) % You did not provide an answer to this question. The dark brown, wooly to velvety surface of the colony shown in th image to the right suggests a dematiaceous fungi. What additional feature would suggest recovery of one of the agents of chromomycosis, rather than one of thea © dx 7 a! 86% Gal 8:19 am The dark brown, wooly to velvety surface of the colony shown in th image to the right suggests a dematiaceous fungi. What additional feature would suggest recovery of one of the agents of chromomycosis, rather than one of the phaeohyphomycetes? The correct answer is highlighted below A velvety appearance of the surface mycelium. A delay in growth beyond five days. Dark brown to black staining of the reverse side of the colony. Distinct outer border with dark staining of the colony margin. 5 a) myna) N © « © wll 86% aml 8:19 am @ https://www.medialabinc.net @ : % You did not provide an answer to this question. Which one of the following organisms is typically urease negative: The correct answer is highlighted below Klebsiella Escherichia Proteus HaemophilusN © « A wil 86% Gal 8:18 am SX]N © «« © wil 86% aml 8:18 4m - This image shows a gram-positive, catalase negative coccus on sheep blood agar (beta- hemolytic). Please note the reactions with bacitracin (A) and trimethoprim sulfamethoxazole (SXT) disks seen on the right side of the agar plate. On the left side of the agar, a beta lysin-producing Staphylococcus aureus is streaked perpendicular to the unknown organism. What is the presumptive identification of this organism? The correct answer is highlighted below Streptococcus agalactiae Streptococcus dysgalactiae Staphylococcus lugdunensis Streptococcus pyogenesN © « © wil 86% aml 8:18 am @ https://www.medialabinc.net @ : % You did not provide an answer to this question. The detection of a distinct odor is often helpful in the presumptive identification of bacterial culture isolates. Which bacterial species produces a distinctive odor of grapes? The correct answer is highlighted below Proteus mirabilis Staphylococcus aureus Pseudomonas aeruginosaN © « F wll 86% al 8:18 am @ https://www.medialabinc.net @ : Question 38 ery .Y.. % You did not provide an answer to this question. A positive CAMP reaction and hippurate hydrolysis are key in identifying which beta- hemolytic streptococci? The correct answer is highlighted below Group B Group A Group F Viridans 5N © « F wll 86% al 8:18 am @ https://www.medialabinc.net @ : Questioll oY Ul TUU % You did not provide an answer to this question. Isolation and detection of Gardnerella vaginalis from vaginal secretions is improved by which of the following? The correct answer is highlighted below Utilization of human blood agar Incubation at 35-37° C ambient air Cold enrichment Utilization of Thayer-Martin agara N © © wl 86% Hl 8:18 am @ https://www.medialabinc.net @ : % You did not provide an answer to this question. 130 um Illustrated in the close-in high power microscopic view is a large spherical ovum measuring 130 um as it may appear in a mount of fecal material. These ova often have a brown staining that suggests passage through a biliary duct on itsN © « F wll 86% al 8:18 am @ https://www.medialabinc.net @ : Illustrated in the close-in high power microscopic view is a large spherical ovum measuring 130 um as it may appear in a mount of fecal material. These ova often have a brown staining that suggests passage through a biliary duct on its way through the large intestine. Identifying characteristics include a thin, smooth shell and an indistinct, flat, non-shouldered operculum (blue lines). Based on the appearance of this ovum, select from the multiple choices the correct presumptive identification. The correct answer is highlighted below Fasciola hepatica Schistosoma haematobium Clonorchis sinensis Paragonimus westermania N © « F wll 86% al 8:18 am @ https://www.medialabinc.net @ : % You did not provide an answer to this question. Two sputum specimens were submitted to the Microbiology laboratory for culture. A Gram stained smear was evaluated for each specimen prior to culturing. The fields that are shown in these images are representative of the 20 - 30 low power fields (Ipf) that were examined. Which one of the two results represents a sputum specimen that is acceptable for culturing? The correct answer is highlighted below Gram stain A Gram stain B Both are acceptable for culturing Neither are accepted for culturingBR © sd« 7 wall 86% Gil 8:17 am @ https://www.medialabinc.net @ “N © dx oe slob loa PAT an all Illustrated in the upper image is the anterior portion of a nematode filariform larva with a short buccal cavity. The ovum illustrated in the lower image is also part of the life cycle of this nematode. With these observations, what presumptive identification can be made from the parasite species listed below? The correct answer is highlighted below Ancylostoma duodenale Necator americanus Strongyloides stercoralis Trichostrongylus spp.na) N © © al 86% Gl 8:17 am @ https://www.medialabinc.net @ : Ye) a toy eee} % You did not provide an answer to this question. All of the following Mycobacterium species will cause tuberculosis, EXCEPT? The correct answer is highlighted below Mycobacterium bovis Mycobacterium africanum Mycobacterium leprae Mycobacterium microtiN © « © wl 86% Gl 8:17 am The curved, multi-celled, dark brown staining macroconidia divided by transverse septa that can be observed in the photomicrograph on the right is characteristic of which of the following species of dematiaceous fungi? The correct answer is highlighted below Bipolaris species Alternaria species 5 a)fh N © « F wall 86% Gal 8:17 am @ https://www.medialabinc.net 3 g = The curved, multi-celled, dark brown staining macroconidia divided by transverse septa that can be observed in the photomicrograph on the right is characteristic of which of the following species of dematiaceous fungi? The correct answer is highlighted below Bipolaris species Alternaria species Curvularia species Cladophialophora species 5 a)fh N © «« © wll 86% aml 8:17 am @ https://www.medialabinc.net @ : % You did not provide an answer to this question. All of the following choices are acceptable specimens for anaerobic culture, EXCEPT? The correct answer is highlighted below Throat swab Tissue biopsy Abscess aspirate Synovial fluidfh N © «« © wll 86% aml 8:17 am @ https://www.medialabinc.net @ : % You did not provide an answer to this question. Which organism will infect humans and a wide range of host animals? The correct answer is highlighted below Mycobacterium canettii Mycobacterium microti Mycobacterium mungi Mycobacterium bovisa BR © sd« 7 wll 86% Gl 8:16 am % You did not provide an answer to this question. Illustrated in the image of a Wright-stained peripheral blood smear is a developing intra- erythrocyte schizont. In review of this presentation, select from the multiple choices listed below the Plasmodium species represented by the image as shown. The correct answer is highlighted below 5 a) oO!N © « © all 87% Gl 8:16 am @ https://www.medialabinc.net @ : The correct answer is highlighted below Plasmodium falciparum Plasmodium malariae Plasmodium vivax Plasmodium ovale Feedback Plasmodium vivax is the correct selection. Note in the background that the non-infected erythrocytes are approximately of normal size and have normal pigmentation. However, the erythrocyte in which the schizont is developing is distinctly enlarged amid a pale cytoplasm. The additional observation distinctive for the P. vivax schizont is the presence of greater than 12 nuclear segments (in this presentation, 14). Plasmodium falciparum is an incorrect response.N © « © wll 87% aml 8:16 am @ https://www.medialabinc.net @ : MU BN er ere yun schizont is the presence of greater than 12, nuclear segments (in this presentation, 14). Plasmodium falciparum is an incorrect response. Developing schizonts are rarely observed in peripheral blood smears in P falciparum infections. The only malarial forms observed are the early ring forms, often involving many erythrocytes, and distinctive crescent-shaped gametocyts. Plasmodium malariae is an incorrect response. P malariae developing schizonts have no more than 12 nuclear segments arranged in the form of a rosette surrounding a central aggregate of malarial pigment. The invaded erythrocytes are not enlarged and have normal pigmentation. Schuffners dots are absent. Plasmodium ovale is an incorrect response. P. ovale schizonts virtually fill the entire infected cell. Much malarial pigment and scattered Schuffner's dots are seen in the cytoplasm. There are 8 nuclear segments. The infected erythrocytes with the ring form trophozoites are slightly enlarged and are distinctly oval in outline and are normochromic. P. ovale is rarely encountered as a human infection.% You did not provide an answer to this question. The following statements regarding the cell cytotoxicity neutralization assay (CCNA) for Clostridiodes (formerly Clostridium) difficile are correct EXCEPT? The correct answer is highlighted below Detects toxin B in stool samples Detects cytopathic effect on human cells Provides rapid results Procedure is complexN © « © wll 87% aml 8:14 0m % You did not provide an answer to this question. Parasites which can be found in urinary sediment include all of the following EXCEPT: The correct answer is highlighted below Enterobius vermicularis Trichomonas vaginalis Plasmodium malariae Schistosoma haematobiumN © « © wll 87% aml 8:14 0m @ https://www.medialabinc.net @ : Finalize % You did not provide an answer to this question. Each of the following organisms may possess extended-spectrum beta-lactamase (ESBL) activity except: The correct answer is highlighted below Escherichia coli Klebsiella oxytoca Proteus mirabilis Pseudomonas aeruginosa