Pathology Laboratory Techniques
Textbook Exam Questions
Course Introduction
Pathology Laboratory Techniques is a comprehensive course focused on the fundamental and advanced laboratory methods used in pathology for the diagnosis of diseases. Students are introduced to the principles of specimen collection, histopathological processing, staining, and microscopic examination of tissues. The course covers the use of various laboratory instruments, immunohistochemistry, molecular techniques, and quality control measures essential for accurate results. Emphasis is placed on safety protocols, proper documentation, and interpretation of findings, equipping students with practical skills necessary for laboratory work in medical and research settings.
Recommended Textbook
Bailey and Scotts Diagnostic Microbiology 12th Edition by Betty A. Forbes
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Chapter 1: Microbial Taxonomy
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Q1) Taxonomy can be described as
A)a consistent means to classify, name, and identify organisms.
B)the common language in science that minimizes confusion about names.
C)the naming system that allows scientific attention to center on more important issues and phenomena.
D)playing a central role in providing accurate and timely diagnosis of infectious diseases.
E)All of the above are true.
Answer: E
Q2) The most basic taxonomic group that can be defined as a collection of bacterial strains that share many common physiologic and genetic features is A)genus.
B)species.
C)class.
D)kingdom.
E)order. Answer: B
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Chapter 2: Bacterial Genetics Metabolism and Structure
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Q1) Mutation is defined as
A)the change of the bacterial genotypes through the exchange of DNA from one cell to another.
B)an internal change in the original nucleotide sequence of a gene or genes within an organism's genome.
C)the process by which genetic elements such as plasmids and transposons excise from one genomic location and insert into another.
D)the uptake of free DNA from the environment and recombination with the recipient's homologous DNA.
Answer: B
Q2) The enzymes that add nucleotide bases to each growing daughter strand in the replication process are called
A)replication enzymes.
B)DNA polymerases.
C)insertion sequence enzymes.
D)transcriptases.
Answer: B
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Chapter 3: Host-Microorganism Interactions
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Q1) The complement system serves to
A)increase blood flow to the area of infection and can also effectively wall off the infection through the production of barrier substances.
B)attract and enhance the activities of phagocytes.
C)provide substances secreted by one type of cell that have substantial effects on the antiinfective activities of other cells.
D)All of the above are correct.
Answer: B
Q2) IgG is
A)the first antibody produced when an invading microorganism is initially encountered. B)the antibody that is associated with various parasitic infections.
C)the antibody that is secreted in various body fluids and primarily protects those body surfaces lined with mucous membranes.
D)the second antibody produced when an invading microorganism is initially encountered and the most abundant.
Answer: D
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Chapter 4: Laboratory Safety
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Q1) The autoclave sterilizes material by
A)applying dry heat at high temperatures and pressure.
B)infusing gaseous chemicals that kill organisms.
C)applying moist heat at high temperatures and increased pressure.
D)cleaving protein bonds found in most biological agent cell walls.
Q2) Class I biological safety cabinets
A)sterilize the air within the cabinet as it passes over the material in the cabinet.
B)protect the environment from contamination by biologic agents by filtering the air as it is exhausted from the cabinet.
C)are enclosed completely and have gloves that enable the worker to manipulate the material in the cabinet.
D)are often called laminar flow hoods.
E)All of the above are correct.
Q3) Biosafety Level 4 agents
A)include those that are the common agents of infectious disease.
B)require only standard good laboratory technique.
C)include Mycobacterium tuberculosis, M.gordonae, and Brucella.
D)require the use of maximum containment facilities.
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Chapter 5: Specimen Management
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Q1) Direct examinations such as the Gram stain serve what purpose?
A)To assess the quality of the specimen
B)To give the physician an early indication of what may be wrong with the patient
C)To guide the workup of the specimen
D)All of the above are correct.
Q2) Accurate and rapid presumptive identification
A)can many times provide valuable information to clinicians in the early stages of disease.
B)can many times be accomplished by simple procedures in the laboratory.
C)can sometimes shorten hospitalization time and save money.
D)may save lives of infectious disease patients.
E)All of the above are correct.
Q3) Aerobes grow best in
A)ambient air, which contains 21% oxygen (O ) and a small amount (0.03%) of carbon dioxide.
B)increased concentrations of CO (5% to 10%) and approximately 15% O .
C)Five percent to 10% hydrogen (H ), 5% to 10% CO , 80% to 90% nitrogen (N ), and 0% O .
D)Reduced O (5% to 10%) and increased CO (8% to 10%).
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Chapter 6: Role of Microscopy
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Q1) The fluorochrome stain that can be used to detect mycobacteria is A)calcofluor white.
B)acridine orange.
C)auramine.
D)immunofluorescence.
Q2) The second step in the Gram stain is the application of the A)safranin.
B)crystal violet.
C)Gram's iodine.
D)Gram's decolorizer
Q3) In the Kinyoun acid-fast staining method, ___________ replaces __________ in the primary stain solution.
A)increased phenol; heat
B)heat; increased phenol
C)mycolic acid; heat
D)carbolfuchsin; phenol
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Chapter 7: Traditional Cultivation and Identification
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Q1) Which category of media would MacConkey agar best fit?
A)Selective
B)Differential
C)Selective and differential
D)Supportive only
Q2) The role of the agar ingredient in culture medium is to
A)provide a nutritional base for bacterial metabolism.
B)solidify the medium and provide a stable culture surface.
C)sterilize the medium and prevent contamination.
D)All of the above are correct.
Q3) What name is given to the type of hemolysis that produces complete hemolysis and a clearing of the medium?
A)Beta hemolysis
B)Gamma hemolysis
C)Alpha hemolysis
D)Kappa hemolysis
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Chapter 8: Nucleic Acid-Based Analytic Methods for
Microbial Identification and Characterization
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Q1) Two nucleic acid strands (a probe and a target) that have complementary base sequences specifically bond with each other and form a double-stranded molecule.
A)Hybridization
B)Sequencing
C)Amplification (PCR)
D)Genotypic
Q2) Advantages of the amplification methods are
A)ability to detect nonviable organisms.
B)ability to detect organisms that are difficult to cultivate.
C)ability to detect more quickly those organisms that grow slowly.
D)ability to quantitate infectious agent burden directly in specimens.
E)All of the above are correct.
Q3) The probe in the hybridization assay can be described as
A)originating from the unknown organism to be detected or identified.
B)a "reporter" molecule that chemically forms a complex with the single-stranded probe DNA.
C)originating from an organism of known identity.
D)All of the above are correct.
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Chapter 9: Immunochemical Methods Used for Organism
Detection
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Q1) Monoclonal antibodies are those that A)react with many different types of antigens.
B)react with many species of bacteria within the same genus.
C)react with many different antigens of one specific organism.
D)can be produced from many different species of host organisms.
Q2) A modification of the Ouchterlony method that speeds up migration of an antigen and antibody by applying an electrical current is referred to as
A)double immunodiffusion.
B)counterimmunoelectrophoresis.
C)particle agglutination.
D)enzyme immunoassay.
Q3) The immunochemical test that involves antigen present in a specimen binding to the combining sites of the antibody exposed on the surfaces of latex beads is referred to as
A)double immunodiffusion.
B)counterimmunoelectrophoresis.
C)particle agglutination.
D)enzyme immunoassay.
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Chapter 10: Serologic Diagnosis of Infectious Diseases
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Q1) The presence of this antibody usually indicates recent or active infection.
A)IgG
B)IgA
C)IgM
D)IgE
Q2) Neutralizing antibodies are
A)those that function by attaching to the surface of pathogens and contributing to their destruction by the lytic action of complement.
B)those that function by binding to and blocking surface receptors for host cells.
C)those that function by attaching to the surface of pathogens and making the pathogens more amenable to ingestion by phagocytic cells.
D)those that function by attaching to the surface of pathogens and contributing to their destruction by chemotaxis.
Q3) For most pathogens, to be diagnostic of current infection, there must be
A)a decrease in the patient's antibody titer of two doubling dilutions.
B)an increase in the patient's titer of two doubling dilutions.
C)a decrease in the patient's antibody titer of four doubling dilutions.
D)an increase in the patient's titer of four doubling dilutions.
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Chapter 11: Principles of Antimicrobial Action Resistance
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Q1) The mechanism of acquired, high-level resistance to vancomycin involves
A)enzymatic destruction of the antibiotics.
B)altered antibiotic targets.
C)decreased intracellular uptake of the drug.
D)the production of altered cell wall precursors that do not bind the antibiotic with sufficient avidity.
Q2) Antimicrobial resistance resulting from the normal genetic, structural, or physiologic state of a microorganism is referred to as
A)intrinsic resistance.
B)inherent resistance.
C)microorganism mediated resistance.
D)All of the above are correct.
Q3) Mycoplasmas are organisms without cell walls.Which antimicrobials would be ineffective in treating infections involving this bacterium?
A)Tetracycline
B)Aminoglycosides
C)Penicillin
D)Rifampin
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Chapter 12: Laboratory Methods and Strategies for Antimicrobial Susceptibility Testing
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Q1) The primary goal of antimicrobial susceptibility testing is to
A)determine whether the pathogen is capable of expressing resistance to the potential choices of antimicrobial agents.
B)determine the extent of an organism's intrinsic resistance.
C)determine in vivo whether the administered antibiotic is killing the pathogen.
D)All of the above are correct.
Q2) The minimal bactericidal concentration (MBC) test involves
A)a continuation of the procedure for conventional broth dilution testing.
B)subculturing the clear tubes of a completed broth dilution test.
C)99.9% reduction in CFU/mL compared with the organism concentration in the original inoculum.
D)All of the above are correct.
Q3) Detection of the haze produced by some resistant staphylococci and enterococci against methicillin and vancomycin can best be accomplished by A)using reflected light.
B)using transmitted light.
C)placing the medium under the light rather than in front of it.
D)microscopy.
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Chapter 13: Staphylococcus, Micrococcus, and Similar Organisms
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Q1) The resident human flora staphylococcus that is more likely to cause infections in compromised hosts such as cancer patients is
A)Staphylococcus saprophyticus.
B)Staphylococcus aureus.
C)Staphylococcus epidermidis.
D)Staphylococcus intermedius.
Q2) The first identification test performed on a clinical isolate of gram-positive, catalase-positive cocci would likely be the
A)penicillin test.
B)Gram stain.
C)oxidase test.
D)coagulase test.
Q3) The tube coagulase test
A)detects bound coagulase.
B)detects extracellular coagulase.
C)is performed on slide coagulase-positive isolates to confirm this positive result.
D)requires citrated reagent plasma.
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Chapter 14: Streptococcus, Enterococcus, and Similar Organisms
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Q1) The bacterial species that can be described as able to hydrolyze hippurate, beta hemolytic, a major cause of neonatal meningitis and sepsis, and producer of the CAMP factor is
A)Enterococcus faecalis.
B)Streptococcus pneumoniae.
C)Streptococcus pyogenes.
D)Streptococcus agalactiae.
E)viridans streptococci.
Q2) Differentiation of the pleomorphic strains of streptococci and the similar corynebacteria or lactobacilli can be best accomplished by
A)examination of Gram stain of colony.
B)vancomycin susceptibility testing.
C)serologic testing.
D)examination of morphology following growth in thioglycollate broth.
Q3) Streptococcus pneumoniae can be described as
A)susceptible to bile and optochin.
B)alpha hemolytic.
C)a major cause of bacterial meningitis.
D)often carrying an antiphagocytic capsule.
E)All of the above are true.
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Chapter 15: Bacillus and Similar Organisms
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Q1) Suspect spore-forming gram-positive bacilli that are hemolytic, motile, and penicillin-resistant and that produce a wide zone of lecithinase on egg yolk agar can be identified as
A)Corynebacterium diphtheriae.
B)Bacillus anthracis.
C)Bacillus cereus.
D)Corynebacterium jeikeium.
Q2) Media that can be used for isolation of Bacillus anthracis include A)Thayer-Martin agar.
B)5% sheep blood agar.
C)MacConkey agar.
D)CNA blood agar.
Q3) Induction of capsule formation by B.anthracis can be accomplished with A)5% sheep blood agar.
B)PLET agar.
C)bicarbonate agar.
D)urea agar.
E)All of the above are correct.
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Chapter 16: Listeria, Corynebacterium, and Similar Organisms
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Q1) A catalase-positive, gram-positive bacillus that is not acid-fast, does not branch, and does not form spores could possibly belong to which group of bacteria?
A)Corynebacterium
B)Bacillus
C)Actinomyces
D)Mycobacterium
Q2) The organism that exhibits characteristic end-over-end tumbling motility when incubated in nutrient broth at room temperature for 1 to 2 hours is
A)Listeria monocytogenes.
B)Corynebacterium diphtheriae.
C)Bacillus anthracis.
D)Bacillus cereus.
Q3) Primary inoculation to a Loeffler slant, overnight incubation, and subculture of any growth to cystine-tellurite blood agar is no longer recommended for recovery of
A)Corynebacterium diphtheriae.
B)Bacillus anthracis.
C)Bacillus cereus.
D)Corynebacterium jeikeium.
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Chapter 17: Erysipelothirix, Lactobacillus, and Similar Organisms
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Q1) Large, squamous epithelial cells with numerous attached pleomorphic gram-variable or gram-negative coccobacilli and rods are typical elements of a wet mount and Gram stain of vaginal secretions from a patient who has
A)bacterial vaginosis caused by Gardnerella vaginalis.
B)large numbers of large gram-positive rods.
C)large numbers of polymorphonuclear leukocytes.
D)All of the above are correct.
Q2) A catalase-negative, non-spore-forming, non-branching, gram-positive rod that produces hydrogen sulfide when inoculated into TSI agar is most likely
A)Corynebacterium
B)Bacillus
C)Actinomyces
D)Erysipelothrix
Q3) Erysipelothrix can be described as
A)catalase-negative
B)not acid-fast
C)not branching
D)non-spore-forming
E)All of the above are correct.
Page 19
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Chapter 18:
Nocardia, Streptomyces,
Oerskovia, and Similar Organisms
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Q1) Nocardia spp.cause which of the following types of infections in immunocompromised individuals?
A)Mycetoma
B)Lymphocutaneous infections
C)Skin abscesses or cellulites
D)Invasive pulmonary infections
Q2) Nocardia spp.form branched filaments that extend along the agar surface that are called
A)surface hyphae.
B)substrate hyphae.
C)aerial hyphae.
D)topical hyphae.
Q3) Non-acid-fast aerobic actinomycetes include
A)Nocardia.
B)Rhodococcus.
C)Streptomyces.
D)Gordona.
E)All of the above are correct.
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Chapter 19: Enterobacteriaceae
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Q1) Enterotoxigenic and enteroinvasive are terms often linked to which of the following bacterial species?
A)Escherichia coli
B)Salmonella enteritidis
C)Shigella sonnei
D)Yersinia pestis
E)All of the above are correct.
Q2) The gram-negative bacillus that can be described as oxidase-negative, nitrate-positive, indole-negative, citrate-positive, methyl red-positive, urease-negative,
H S-positive is
A)Klebsiella pneumoniae.
B)Proteus vulgaris.
C)Salmonella enteritidis.
D)Escherichia coli.
E)Shigella sonnei.
Q3) The major etiologic agent of urinary tract infections is
A)Escherichia coli.
B)Shigella species.
C)Salmonella species.
D)Vibrio species.
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Chapter 20: Acinetobacter, Stenotrophomonas, and Other Organisms
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Q1) The primary drug of choice for infections caused by S.maltophilia is A)a beta-lactam agent in combination with an aminoglycoside.
B)trimethoprim-sulfamethoxazole.
C)ticarcillin/clavulanic acid.
D)chloramphenicol.
Q2) An organism that can be described as oxidase-negative, MacConkey agar-positive, glucose nonfermenter is likely
A)Escherichia.
B)Pseudomonas.
C)Acinetobacter.
D)Moraxella.
Q3) The natural habitat of Acinetobacter sp.can best be described as A)the mucous membranes of animals.
B)the gastrointestinal tract of humans and other animals.
C)the natural environment.
D)the genitourinary tract of animals.
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Chapter 21: Pseudomonas, Burkholderia, and Similar Organisms
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Q1) Of the species of Burkholderia, which is the one most commonly found in clinical specimens?
A)Burkholderia ralstonia
B)Burkholderia pseudomallei
C)Burkholderia mallei
D)Burkholderia cepacia
Q2) The disease referred to as melioidosis is caused by
A)Pseudomonas aeruginosa.
B)Ralstonia pickettii.
C)Burkholderia mallei.
D)Burkholderia pseudomallei.
Q3) An organism described as oxidase-positive, TSI slant with an alkaline/no change, good growth at 42° C, and producing bright bluish green pigment on Mueller-Hinton agar is most likely
A)Pseudomonas aeruginosa.
B)Ralstonia pickettii.
C)Burkholderia mallei.
D)Burkholderia pseudomallei.
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Chapter 22: Achromobacter, Rhizobium, Ochrobactrum, and Similar
Organisms
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Q1) The natural habitat of Achromobacter sp.can best be described as
A)the mucous membranes of animals.
B)the gastrointestinal tract of humans and other animals.
C)the natural environment.
D)the genitourinary tract of animals.
Q2) Choose the habitat of the bacterium Ochrobactrum anthropi.
A)Environmental only, not human flora
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
E)Environmental and human flora
Q3) Valid susceptibility testing methods are not available for
A)Enterobacteriaceae.
B)Achromobacter.
C)Pseudomonas.
D)Staphylococcus.
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Q1) Valid susceptibility testing methods are not available for
A)Enterobacteriaceae.
B)Chryseobacterium.
C)Pseudomonas.
D)Staphylococcus.
Q2) Choose the habitat of the bacterium Chryseobacterium.
A)Environmental
B)Animal oral and respiratory flora
C)Environmental, cold climates
D)Human normal flora
Q3) Among the yellow-pigmented, oxidase-positive, glucose oxidizers that are occasionally encountered in human specimens are
A)Chryseobacterium meningosepticum.
B)Flavobacterium meningosepticum.
C)Sphingobacterium spiritivorum.
D)Empedobacter brevis.
E)All of the above are correct.
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Chapter 24: Alcaligenes, Bordetella Nonpertussis,
Comamonas, and Similar Organisms
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Q1) B.bronchiseptica is
A)oxidase-positive, motile, and rapid urease-positive.
B)indole-positive, nonmotile, and has a fruity odor.
C)resistant to vancomycin and will grow on MacConkey agar and at 42° C.
D)nonmotile and both urea- and phenylalanine deaminase-positive.
Q2) The organism most frequently associated with various infections in humans is A)Bordetella.
B)Oligella.
C)Achromobacter.
D)Roseomonas.
Q3) Which statement best describes the habitats of Achromobacter, Alcaligenes, and Bordetella?
A)The habitats are limited to the upper respiratory tract of various mammals.
B)The habitats vary from the soil and water environment to the upper respiratory tract of various mammals.
C)The habitats are limited to the soil and water environment.
D)The habitats are limited to the mucous membranes of humans and animals.
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Chapter 25: Vibrio, Aeromonas, Plesiomonas Shigelloides, and
Chromobacterium Violaceum
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Q1) Transmission of Vibrio spp.to humans is by
A)exposure of disrupted skin and mucosal surfaces to contaminated animal hides.
B)ingestion of contaminated seafood or water.
C)inhalation of contaminated air.
D)close contact with carriers of the organism.
Q2) The primary habitat for Vibrio spp is
A)fresh water.
B)the upper respiratory tract of various mammals.
C)brackish or marine water.
D)the soil and water environment.
Q3) Transmission of Aeromonas spp.to humans is by
A)exposure of disrupted skin and mucosal surfaces to contaminated animal hides.
B)ingestion of contaminated seafood or water.
C)inhalation of contaminated air.
D)close contact with carriers of the organism.
Q4) The primary habitat for Aeromonas spp.is
A)fresh water.
B)the upper respiratory tract of various mammals.
C)brackish or marine water.
D)the soil and water environment.
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Chapter 26: Sphingomonas Paucimobilis and Similar Organisms
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Q1) Which statement best describes the habitats of Acidovorax, Sphingobacterium, and Sphingomonas?
A)The habitats are limited to the upper respiratory tract of various mammals.
B)The habitats are unknown.
C)The habitats are limited to the soil and water environment.
D)The habitats are limited mostly to water sources.
Q2) Sphingobacterium spp.can be described as
A)oxidase-negative, glucose-fermenting, gram-negative bacilli that grow on MacConkey agar.
B)oxidase-positive, glucose-oxidizing, gram-negative bacilli that fail to grow on MacConkey agar.
C)oxidase-positive, glucose-fermenting, gram-negative bacilli that grow on MacConkey agar.
D)oxidase-positive, non-glucose-utilizing, gram-negative bacilli that do not grow on MacConkey agar.
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Chapter 27: Moraxella
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Q1) In Gram-stained preparations, Moraxella elongata appears as
A)either gram-negative coccobacilli or short, broad rods that tend to resist decolorization and may appear gram-variable.
B)gram-negative cocci in pairs or short chains.
C)coccobacilli or medium-sized rods.
D)coccobacilli that may appear in chains.
E)either coccobacilli or short, straight rods.
Q2) In Gram-stained preparations, Moraxella lacunata will appear as
A)either gram-negative coccobacilli or short, broad rods that tend to resist decolorization and may appear gram-variable.
B)gram-negative cocci in pairs or short chains.
C)coccobacilli or medium-sized rods.
D)coccobacilli that may appear in chains.
E)either coccobacilli or short, straight rods.
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Chapter 28: Eikenella Corrodens and Similar Organisms
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Q1) Of the asaccharolytic, oxidase-positive bacilli, which bacterial species can be recognized in culture by its bleachlike odor?
A)Eikenella corrodens
B)Weeksella virosa
C)Pseudomonas maltophilia
D)Sphingomonas paucimobilis
E)All of the above are correct.
Q2) Eikenella corrodens can be easily recognized in culture by which characteristic?
A)Its pink pigmentation
B)Its grapelike odor
C)Its large spreading colony morphology
D)Its bleachlike odor
Q3) Of the asaccharolytic, oxidase-positive bacilli that do not grow on MacConkey agar, which one is generally associated with mixed infections resulting from bites or clenched-fist wounds?
A)Eikenella corrodens
B)Weeksella virosa
C)Pseudomonas maltophilia
D)Sphingomonas paucimobilis
E)All of the above are correct.
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Chapter 29: Pasteurella and Similar Organisms
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Q1) Which of the following bacterial species is part of animal flora and is transmitted to humans during close animal contact, including bites?
A)Sphingomonas paucimobilis
B)Eikenella corrodens
C)Pasteurella multocida
D)Weeksella virosa
E)All of the above are correct.
Q2) Although most other clinically relevant gram-negative bacilli are intrinsically resistant to penicillin, it is the drug of choice for infections involving
A)Sphingomonas paucimobilis.
B)Eikenella corrodens.
C)Pasteurella multocida.
D)Weeksella virosa.
E)All of the above are correct.
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Chapter 30: Actinobacillus, Kingella, Cardiobacterium,
Capnocytophaga, and Similar Organisms
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Q1) Actinobacillus actinomycetemcomitans can be distinguished from Kingella spp by
A)its negative test for catalase.
B)its positive test for lactose fermentation.
C)its positive test for catalase.
D)its negative test for oxidase.
E)All of the above are correct.
Q2) Capnocytophaga hominis can be distinguished from Haemophilus aphrophilus by
A)its negative test for catalase.
B)its positive test for lactose fermentation.
C)its positive test for indole.
D)its negative test for oxidase.
E)All of the above are correct.
Q3) Actinobacillus actinomycetemcomitans can be distinguished from Capnocytophaga hominis by
A)its negative test for catalase.
B)its positive test for lactose fermentation.
C)its positive test for catalase.
D)its negative test for indole.
E)All of the above are correct.
Page 32
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Chapter 31: Haemophilus
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Q1) Of the following media, which provides the NAD necessary for the growth of Haemophilus spp.?
A)5% sheep blood agar
B)Brain heart infusion agar
C)Chocolate agar
D)Nutrient agar
E)All of the above are correct.
Q2) Growth of H.ducreyi in culture requires
A)incubation at 33° to 35° C.
B)high humidity.
C)increased CO .
D)special media.
E)All of the above are correct.
Q3) In a phenomenon known as satelliting, tiny colonies of Haemophilus spp.may be seen growing on sheep blood agar very close to colonies of bacteria that can produce A)hemin.
B)nicotine adenine dinucleotide (NAD).
C)vitamin K.
D)cysteine.
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Page 33
Chapter 32: Bartonella and Afipia
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Q1) A common characteristic of the bacterial species Bartonella henselae and Afipia felis is
A)both are believed to cause cat-scratch disease.
B)the ability to grow on chocolate agar but not very well on routine blood (trypticase soy agar with 5% sheep blood) and not at all on MacConkey agar.
C)that primary isolation from clinical specimens is best accomplished using special cultivation conditions.
D)All of the above are correct.
E)None of the above are correct.
Q2) Bacteremia, endocarditis, bacillary angiomatosis, cat-scratch disease, and peliosis hepatitis can all be caused by
A)Afipia felis.
B)Rochalimaea quintana.
C)Bartonella clarridgeiae.
D)Bartonella henselae.
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Chapter 33: Campylobacter, Arcobacter, and Helicobacter
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Q1) The majority of human infections with Campylobacter species are caused by
A)direct contact with carriers of the bacterium.
B)contamination of food, milk, or water with animal feces.
C)multiplication of the organism in food products.
D)direct contact with persons infected with the bacterium.
Q2) Parenteral therapy can be defined as that which A)must be approved and given by a parent under close supervision.
B)is not taken through the alimentary canal.
C)is taken orally.
D)is taken in the form of suppositories.
Q3) Organisms belonging to the genus Campylobacter are
A)gram-positive diplococci.
B)gram-positive diphtheroid bacilli.
C)gram-negative curved bacilli.
D)gram-negative straight-sided bacilli.
Q4) Antimicrobial therapy for H.pylori infection consists of A)metronidazole.
B)bismuth.
C)tetracycline.
D)All of the above.
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Chapter 34: Legionella
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Q1) Specimens for culture recovery of Legionella should be inoculated to
A)BCYE (buffered charcoal yeast extract).
B)Regan-Lowe agar.
C)Löwenstein-Jensen.
D)blood and chocolate agars.
Q2) To cultivate Legionella in the laboratory, a medium supplemented with what ingredient(s) is necessary?
A)L-cysteine
B)Blood and cysteine
C)Dopa-cysteine
D)Nicotinic adenine
E)All of the above are correct.
Q3) A febrile and pneumonic illness first named in 1976 by scientists at the Centers for Disease Control and Prevention (CDC) who were investigating an epidemic of pneumonia among Pennsylvania State American Legion members attending a convention in Philadelphia is known as
A)Philadelphia pneumonia.
B)legionnaires' disease.
C)tuberculosis.
D)rheumatic fever.
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Chapter 35: Brucella
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Q1) Organisms belonging to the genus Brucella are
A)gram-positive diplococci.
B)gram-positive diphtheroid bacilli.
C)gram-negative coccobacilli.
D)gram-negative bacilli.
Q2) The serum agglutination test (SAT) fails to detect antibodies to A)Brucella abortus.
B)B.melitensis.
C)B.suis.
D)B.canis.
Q3) A nonmotile, urease- and nitrate-positive, strictly aerobic gram-negative coccobacillus is most likely A)Bordetella.
B)Moraxella.
C)Kingella.
D)Acinetobacter.
E)Brucella.
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Chapter 36: Bordetella Pertussis and Bordetella
Parapertussis
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Q1) Acceptable specimens for detection of Bordetella pertussis are A)throat swabs.
B)sputum.
C)nasopharyngeal aspirates.
D)anterior nose swab.
Q2) Pertussis (whooping cough) is an epidemic disease that is a highly contagious, acute infection of the upper respiratory tract caused by A)Brucella species.
B)Bordetella species.
C)Pasteurella species.
D)Francisella species.
Q3) During the catarrhal stage of pertussis, symptoms are A)a runny nose and mild cough.
B)severe and violent coughing.
C)vomiting and "whooping" as air is rapidly inspired into the lungs past the swollen glottis.
D)lymphocytosis and fever.
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Chapter 37: Francisella
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Q1) F.philomiragia differs from F.tularensis in that it
A)is oxidase-negative.
B)is hydrogen sulfide-positive.
C)does not hydrolyze gelatin.
D)does not grow in 6% sodium chloride.
E)All of the above are correct.
Q2) F.philomiragia differs from F.tularensis in that it
A)is oxidase-positive.
B)is hydrogen sulfide-positive.
C)hydrolyzes gelatin.
D)grows in 6% sodium chloride.
E)All of the above are correct.
Q3) To cultivate Francisella in the laboratory, a medium supplemented with what ingredient(s) is necessary?
A)Cysteine and cystine
B)Blood and cysteine
C)Dopa-cysteine
D)Nicotinic adenine
E)All of the above are correct.
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Page 39
Chapter 38: Streptobacillus Moniliformis and Spirillum
Minus
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Q1) Rat-bite fever, or Haverhill fever, characterized by acute onset of chills, fever, headache, vomiting, and often severe joint pains and a rash on the palms, soles of the feet, and other extremities, is caused by
A)Bordetella species.
B)Brucella abortus.
C)Spirillum minus.
D)Pasteurella species.
Q2) Sodoku, characterized by swollen lymph nodes, chills, fever, headache, vomiting, and often severe joint pains, a rash on the palms, soles of the feet, and other extremities, and a granulomatous lesion is caused by
A)Streptobacillus moniliformis.
B)Spirillum minus.
C)Bordetella species.
D)Pasteurella species.
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Chapter 39: Neisseria and Moraxella Catarrhalis
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Q1) The bacterial species that can be described as oxidase-positive, glucose-positive, maltose-negative, sucrose-negative, lactose-negative, and a major cause of venereal disease is
A)Neisseria meningitidis.
B)Neisseria gonorrhoeae.
C)Streptococcus pyogenes.
D)Streptococcus agalactiae.
E)Viridans streptococcus.
Q2) Presumptive identification of a gram-negative diplococcus on chocolate agar from eye or ear cultures that is oxidase-positive and that hydrolyzes tributyrin can be made as
A)Neisseria meningitidis.
B)Neisseria cinerea.
C)Moraxella catarrhalis.
D)Neisseria gonorrhoeae.
Q3) Gonococci require for growth which of the following nutrients?
A)Arginine
B)Hypoxanthine
C)Uracil
D)IsoVitaleX
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Chapter 40: Overview and General Considerations
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Q1) Actinomyces spp., Bifidobacterium spp., and Clostridium spp.can be described as
A)aerotolerant organisms that can grow in the presence of either reduced or atmospheric oxygen but grow best under microaerobic conditions.
B)strictly anaerobic organisms that cannot grow in the presence of either reduced or atmospheric oxygen but grow only under anaerobic conditions.
C)microaerophilic organisms that can grow in the presence of either reduced or atmospheric oxygen but grow best under anaerobic conditions.
D)facultatively anaerobic organisms that grow in the presence or absence of atmospheric oxygen.
Q2) Urine via percutaneous aspiration
A)Acceptable
B)Not acceptable
Q3) Rectal swab
A)Acceptable
B)Not acceptable
Q4) Cervical swab
A)Acceptable
B)Not acceptable
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Chapter 41: Laboratory Considerations
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Q1) The most likely identification of an anaerobic gram-positive coccus that is resistant to metronidazole is
A)Streptococcus.
B)Peptostreptococcus.
C)Leptotrichia.
D)Peptococcus.
E)Finegoldia.
Q2) Nonpigmented Prevotella
A)Kanamycin, colistin, and vancomycin-resistant and grow in 20% bile
B)bile-sensitive, kanamycin-resistant, catalase-negative and indole-negative
C)fluoresce brick red or brown to black pigment
D)reduces nitrate and requires formate and fumarate for growth in broth culture
E)sensitive to kanamycin and fluoresce a chartreuse color
Q3) Complete identification of anaerobes is
A)relatively inexpensive for the average clinical laboratory.
B)complicated and often requires several different testing methods.
C)performed in most average clinical laboratories.
D)necessary in most cases to ensure adequate treatment.
E)All of the above are correct.
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Page 43
Chapter 42: Mycobacteria
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Q1) The type of specimen collected for mycobacterial studies that must be neutralized with 10% sodium carbonate is
A)spontaneously produced sputum.
B)gastric lavage.
C)transtracheal aspiration.
D)bronchial lavage.
Q2) The mycobacterial species that occur in humans and belong to the M.tuberculosis complex include
A)M.tuberculosis, nontuberculous mycobacteria, M.bovis, and M.africanum.
B)M.tuberculosis, M.gordonae, M.bovis BCG, and M.africanum.
C)M.tuberculosis, M.bovis, M.avium, and M.intracellulare.
D)M.tuberculosis, M.bovis, M.bovis BCG, and M.africanum.
Q3) Known to cause an inflammatory bowel disease referred to as Johne's disease in cattle, sheep, and goats, this organism has been isolated from the bowel mucosa of patients with Crohn's disease.
A)M.paratuberculosis
B)M.avium-intracellulare
C)M.phlei
D)M.lepraemurium
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Page 44
Chapter 43: Obligate Intracellular and Nonculturable Bacterial Agents
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Q1) Of the following organisms, which has a unique developmental life cycle including a replicative form, the reticulate body, and an extracellular, metabolically inert, infective form, the elementary body?
A)Rickettsia
B)Chlamydia
C)Ehrlichia
D)Coxiella
Q2) The organisms in the genus Chlamydia can be described as
A)having a replicative form called the reticulate body.
B)having an intracellular infective form called the elementary body.
C)having an extracellular, metabolically inert, infective form.
D)All of the above are true.
Q3) Diagnosis of C.trachomatis is done by which methodology?
A)Cytology
B)Culture
C)Direct detection of antigen or nucleic acid
D)Serologic testing
E)All of the above are correct.
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Chapter 44: Cell Wall-Deficient Bacteria: Mycoplasma and Ureaplasma
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Q1) Which of the following agents lacks a cell wall and is the smallest known free-living form?
A)Chlamydia
B)Mycoplasma
C)Rickettsia
D)Coxiella
Q2) The natural habitat of Mycoplasma sp., which causes infectious disease in humans, can best be described as
A)the mucous membranes of humans.
B)the aquatic environment.
C)the natural environment.
D)the genitourinary tract of animals.
Q3) Media that can be used for isolation of Mycoplasma include
A)Thayer-Martin agar with vitamin K.
B)5% sheep blood and IsoVitaleX.
C)beef or soybean protein with serum and fresh yeast extract.
D)Hemin and NAD supplements.
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Page 46
Chapter 45: The Spirochetes
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Q1) A test that utilizes gelatin particles sensitized with T.pallidum subsp.pallidum antigens to detect specific antitreponemal antibodies in patient serum is called A)RPR (rapid plasma reagin) test.
B)FTA-ABS (fluorescent treponemal antibody absorption) test.
C)VDRL (Venereal Disease Research Laboratory) test.
D)TP-PA (T.pallidum particle agglutination) test.
Q2) A widely used nontreponemal serologic test is the A)VDRL.
B)PPR.
C)FTA-ABS.
D)MHA-TP.
Q3) A nontreponemal flocculation serologic test in which soluble antigen particles are coalesced to form larger particles that are visible as clumps when they are aggregated by antibody is called A)NTF (nontreponemal flocculation).
B)FTA-ABS (fluorescent treponemal antibody absorption) test.
C)VDRL (Venereal Disease Research Laboratory) test.
D)TP-PA (T.pallidum particle agglutination) test.
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Chapter 46: Laboratory Methods for Diagnosis of Parasitic
Infections
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Q1) Naegleria fowleri
A)Feces
B)Blood smear
C)Vaginal secretions
D)CSF
E)Skin scraping
Q2) Entamoeba histolytica
A)Feces
B)Blood smear
C)Vaginal secretions
D)CSF
E)Skin scraping
Q3) The concentration part of the O&P (ova and parasite) examination
A)requires freshly passed, unpreserved stool.
B)is designed to allow detection of protozoan cysts, coccidian oocysts, microsporidial spores, and helminth eggs and larvae.
C)is examined microscopically at low, high dry, and oil immersion magnifications.
D)is designed to facilitate identification of intestinal protozoa.
E)All of the above are correct.
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Chapter 47: Laboratory Methods in Basic Mycology
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Q1) The fungal element that is produced when buds elongate and fail to dissociate is referred to as a A)pseudohyphae.
B)germ tube.
C)ascospore.
D)bud scar.
Q2) Features of the fungi as a group include the following:
A)the presence of chitin in the cell wall.
B)the absence of ergosterol in the cell membrane.
C)reproduction by means of transduction and germination.
D)autotrophic nature.
E)All of the above are correct.
Q3) A fungus culture is growing a mold that has unbranched sporangiophores with rhizoids that appear at the base of the sporangiophore at the point where the stolon arises.This fungus should be identified as
A)Cunninghamella.
B)Absidia.
C)Mucor.
D)Rhizopus.
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Page 49
Chapter 48: Laboratory Methods in Basic Virology
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Q1) In general, specimens collected for detection of virus should be
A)placed in ice and transported to the laboratory at once.
B)frozen until processing occurs.
C)processed within 1 to 2 days of collection.
D)inoculated into cell culture at the bedside.
Q2) The specimen of choice for detecting rotavirus is a A)throat swab.
B)urine sample.
C)bronchoalveolar wash.
D)feces sample.
Q3) To avoid transplacental infection followed by congenital defects, which series of serologic tests is often performed during pregnancy?
A)Toxoplasma, rubella, cytomegalovirus, and herpes simplex virus
B)Toxoplasma, rubella, varicella-zoster virus, and herpes simplex virus
C)Rubella, cytomegalovirus, varicella-zoster virus, and herpes simplex virus
D)Rubella, cytomegalovirus, herpes simplex virus, and papilloma virus
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Chapter 49: Bloodstream Infections
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Q1) Transient bacteremia
A)Condition wherein fungi are present in blood, occurring primarily in immunosuppressed patients and in those with serious or terminal illness
B)The action of bacteria being carried, usually to all organs of the host, where they may grow, invade normal tissue, and produce toxic products
C)A temporary, incidental presence of bacteria in the bloodstream
D)The situation in which organisms are released into the bloodstream at a noncontinuous rate
E)Infections that originate within the cardiovascular system
Q2) The most common portal of entry for bacteremia is
A)the genitourinary tract.
B)the respiratory tract.
C)an abscess.
D)a surgical wound infection.
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Chapter 50: Infections of the Lower Respiratory Tract
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Q1) Evaluation of the quality of the sputum specimen sent to the laboratory for bacterial culture is best done by
A)measuring the amount of mucous found.
B)checking for mucous or blood.
C)examining microscopically via Gram-stained smear for leukocytes.
D)examining microscopically via Gram-stained smear for squamous epithelial cells.
Q2) The nasal hairs, convoluted passages, and mucous lining of the nasal turbinates
A)nonspecifically protect the respiratory tract from infection.
B)promote colonization of normal bacterial flora.
C)can aid adherence by potentially harmful bacteria.
D)All of the above are correct.
Q3) Of the various types of specimens collected to diagnose respiratory infections, which one is acceptable for detection of anaerobic agents?
A)Tracheostomy aspirates
B)Bronchial washings
C)Gastric aspirates
D)Transtracheal aspirates
E)All of the above are correct.
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52
Chapter 51: Upper Respiratory Tract Infections and Other
Infections of the Oral Cavity and Neck
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Q1) Epiglottitis
A)Influenza virus, parainfluenza virus, rhinovirus, and other viruses
B)Influenza virus, parainfluenza virus, Mycoplasma
C)Haemophilus influenzae
D)Streptococcus pyogenes
E)Anaerobes including Fusobacterium, Bacteroides, and anaerobic cocci
F)Herpes simplex virus
G)Candida spp.
H)Mixed bacteria with spirochetes
Q2) Infection of the buccal (cheek) mucosa, tongue, or oropharynx by Candida spp.is called
A)pharyngitis.
B)Vincent's angina.
C)rhinitis.
D)stomatitis.
E)thrush.
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Chapter 52: Meningitis and Other Infections of the Central
Nervous
Systems
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Q1) The innermost membrane layer surrounding the brain and spinal column is called A)dura mater.
B)meninges.
C)arachnoid.
D)pia mater.
Q2) The most common source of infection in the central nervous system is A)hematogenous spread.
B)infections at other sites such as otitis media.
C)organisms gaining access because of anatomic defects in central nervous system structures.
D)bacteria that are able to travel along nerves leading to the brain.
Q3) A collective term used for the three layers of membranes surrounding the brain and spinal column is A)dura mater.
B)meninges.
C)arachnoid.
D)pia mater.
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Page 54
Chapter 53: Infections of the Eyes, Ears, and Sinuses
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Q1) Canaliculitis
A) Haemophilus influenzae and S. pneumoniae
B) Bacteria, viruses, and occasionally lice
C) S. aureus, S. pneumoniae, and P. aeruginosa
D) Any bacterium, including those considered to be primarily saprophytic
E) Chlamydia
F) Actinomyces or Propionibacterium
G) S. aureus, Streptococcus pyogenes, and S. pneumoniae
Q2) Orbital cellulitis
A)An acute infection of the orbital contents most often caused by bacteria
B)Inflammation of the lacrimal canal
C)Infection of the lacrimal gland characterized by pain of the upper eyelid with erythema
D)Infection of the cornea
Q3) Canaliculitis
A)An acute infection of the orbital contents most often caused by bacteria
B)Inflammation of the lacrimal canal
C)Infection of the lacrimal gland characterized by pain of the upper eyelid with erythema
D)Infection of the cornea
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Chapter 54: Infections of the Urinary Tract
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Q1) Cystitis
A)Infection of the terminal portion of the lower urinary tract
B)The isolation of a specified quantitative count of bacteria in an appropriately collected urine specimen obtained from a person without symptoms or signs of urinary infection
C)Infection of the bladder
D)Dysuria, frequency, and urgency but yielding fewer organisms than 105 colony-forming units of bacteria per milliliter (CFU/mL) urine on culture
E)Inflammation of the kidney parenchyma, calices (cup-shaped division of the renal pelvis), and pelvis
Q2) The resident microflora that can colonize the bladder and other structures of the urinary tract is
A)Enterobacteriaceae.
B)yeasts.
C)Propionibacterium acnes.
D)All of the above are correct.
E)None of the above are correct.
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Chapter 55: Genital Tract Infections
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Q1) Epididymitis
A)Anaerobic and polymicrobic infections originating from normal genital flora
B)Chlamydia trachomatis
C)Gardnerella, Prevotella spp., Porphyromonas spp., peptostreptococci, Mobiluncus spp.
D)Neisseria gonorrhoeae
E)N. gonorrhoeae and C. trachomatis
F)Escherichia coli and other enterics
G)Mumps virus
Q2) Proper design of a urogenital swab designed expressly for collection of urethral discharge should include what feature?
A)Made of charcoal treated cotton or rayon
B)Made of antibiotic treated calcium alginate
C)Shaft made of wood and not flexible
D)All of the above are correct.
Q3) Infections that are acquired during sexual activity are referred to as
A)endogenous infections.
B)pyelonephritis
C)Exogenous infections.
D)Upper tract infections.
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Page 57
Chapter 56: Gastrointestinal Tract Infections
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Q1) XLD agar serves which purpose when used in the bacterial fecal culture?
A)Evaluation of general flora and predominant species
B)Selection of enteric pathogens such as Salmonella, Aeromonas, and others
C)Inhibition of normal flora and select for enteric pathogens
D)Enrichment for enteric pathogens such as Salmonella and others
Q2) The normal flora of the adult large bowel consists predominantly of A)anaerobic species.
B)Staphylococcus.
C)Enterococcus.
D)Enterobacteriaceae.
Q3) Campy-thioglycollate broth serves which purpose when used in the bacterial fecal culture?
A)Evaluation of general flora and predominant species
B)Selection of enteric pathogens such as Salmonella, Aeromonas, and others
C)Inhibition of normal flora and select for enteric pathogens
D)Enrichment for enteric pathogens such as Salmonella and others
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Chapter 57: Skin, Soft Tissue, and Wound Infections
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Q1) Meleney's ulcer
A)Extensive necrosis of muscle caused by infectious agents
B)Infection of the fascia overlying muscle groups, often with involvement of the overlying soft tissue
C)A slowly progressive infection of the subcutaneous tissue with associated ulceration of portions of the overlying skin
D)A chronic gangrenous condition of the skin most often encountered as a postoperative complication, particularly after abdominal or thoracic surgery
Q2) Progressive bacterial synergistic gangrene
A)Extensive necrosis of muscle caused by infectious agents
B)Infection of the fascia overlying muscle groups, often with involvement of the overlying soft tissue
C)A slowly progressive infection of the subcutaneous tissue with associated ulceration of portions of the overlying skin
D)A chronic gangrenous condition of the skin most often encountered as a postoperative complication, particularly after abdominal or thoracic surgery
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Marrow, and Solid Tissues
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Q1) Most cases of peritonitis in patients on continuous ambulatory peritoneal dialysis are caused by
A)Staphylococcus epidermidis and S.aureus.
B)Escherichia coli.
C)Klebsiella pneumoniae.
D)Streptococcus spp.
E)viral agents.
Q2) Proper technique for processing clotted body fluids sent to the laboratory for fungal culture is
A)grinding them in a mortar and pestle or glass tissue grinder.
B)placing small amounts of whole material from the clot directly onto media.
C)centrifugation with glass beads.
D)filtration under pressure.
Q3) The most common etiologic agent of septic arthritis in adults younger than 30 years of age is
A)Neisseria gonorrhoeae.
B)Staphylococcus aureus.
C)Haemophilus influenzae.
D)Streptococcus agalactiae.
Page 60
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Chapter 59: Laboratory Physical Design, Management, and Organization
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Q1) The reproducibility of a test when it is run (repeated) several times is called A)accuracy.
B)precision.
C)sensitivity.
D)specificity.
Q2) The ability of the test under study to match the results of a standard test commonly known as the "gold standard" is
A)accuracy.
B)precision.
C)sensitivity.
D)specificity.
Q3) Performance of a new procedure several times on the same sample and evaluating the range of test results would be validating which characteristic?
A)Accuracy
B)Precision
C)Sensitivity
D)Specificity
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Page 61
Chapter 60: Quality in the Clinical Microbiology Laboratory
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Q1) Criteria that should be considered for rejection of specimens include
A)missing or inadequate information such as clinical diagnosis, current drug treatment, or other helpful facts.
B)illegible physician name.
C)improperly collected or stored specimen.
D)requests of multiple tests on one specimen.
E)All of the above are correct.
Q2) Long-term storage (>1 year) of stock aerobic and anaerobic bacteria can be accomplished by
A)subculture onto trypticase soy agar (TSA) slants.
B)freezing at 70° C.
C)storing them on blood agar plates at 37° C.
D)All of the above are correct.
Q3) Positive patient outcomes produced through quality management programs in the microbiology laboratory are
A)reduced hospitalization time.
B)reduced cost of stay.
C)reduced turn-around time for diagnosis of infection.
D)appropriate antimicrobial therapy.
E)All of the above are correct.
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Chapter 61: Infection Control
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Q1) A phenotypic technique of typing microbial strains that consists of analyzing antimicrobial susceptibility patterns of the organism of interest is called A)biotyping.
B)antibiograms.
C)serotyping.
D)bacteriocin typing.
E)bacteriophage typing.
Q2) A phenotypic technique of typing microbial strains that consists of serologic typing of bacterial or viral antigens, such as bacterial cell wall antigens of the organism of interest, is called A)biotyping.
B)antibiograms.
C)serotyping.
D)bacteriocin typing.
E)bacteriophage typing.
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63
Chapter 62: Sentinel Laboratory Response to Bioterrorism
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Q1) The difference between an overt and a covert bioterrorism event is that
A)a covert event is one that is carried out against undercover agents.
B)a covert event is announced and an overt event is not announced.
C)an overt event is announced and a covert event is not announced.
D)an overt event is one that is carried out in the air.
Q2) The act of using microorganisms to intentionally harm the civilian population is referred to as
A)biosecurity.
B)biocrime.
C)microterrorism.
D)bactiterrorism.
Q3) Bioterrorism is a term used to describe
A)the act of using horrific events to deliver harm to living beings.
B)the act of using microorganisms to intentionally harm the civilian population.
C)the act of using microorganisms to wage war in peace time.
D)the act of using living beings to wage war in peace time.
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