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13 Dec 2019

potato-blood-glycerol agar is the recommended culture medium for the recovery of

a. bordetella pertussis, b. cardiobacterium hominis, c. rhodococcus equi, d. brucella suis, e. vibrio vulnifcus

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Related questions

1. An organism, observed on direct Gram stain from a clinical specimen, does not grow on blood or chocolate agars incubated at 35°C in CO2. This can be explained by all of following statements except

a. the organism is an anaerobe.

b. the organism is dead due to previous antibiotic therapy.

c. the organism requires nicotinamide adenine dinucleotide for growth.

d. the organism is fastidious and is not being provided the growth factor it needs.

2. The laboratory should be notified in advance when the physician suspects Francisella tularensis because the organism is

a. fastidious and requires special medium.

b. infectious for laboratory personnel.

c. not culturable.

d. a and b.

e. b and c.

3. The HACEK organisms share all of the following characteristics except

a. gram-negative coccobacilli that are oxidase and catalase positive.

b. slow growing and stimulated by carbon dioxide.

c. part of the normal oral flora.

d. causative agents of bacterial endocarditis.

4. Legionella pneumophila and Francisella tularensis share the characteristic of

a. being easily identified by biochemical testing.

b. a requirement for cysteine to grow in culture.

c. the necessity for the use of Gimenez stain rather than Gram stain to visualize.

d. having an animal reservoir.

5. Legionella pneumophila and Francisella tularensis share all of the following characteristics except

a. poor Gram staining properties.

b. ability to cause pneumonia.

c. ability to diagnose infection with detection of serum antibodies.

d. fluorescence of colonies.

6. A blood culture isolate that stains as pleomorphic gram-negative coccobacillus and only grows on chocolate agar should be

a. identified using the ALA test.

b. identified using the ALA and horse blood agar tests.

c. presumptively identified under BSL 2 conditions.

d. identified using X and V factor disks and horse blood agar.

7. Which of the following organisms requires factor X only on initial isolation but loses the requirement on subculture?

a. Aggregatibacter actinomycetemcomitans

b. Eikenella corrodens

c. Francisella tularensis

d. Aggregatibacter aphrophilus

8. Haemophilus ducreyi is unique among the genus because it requires

a. factors X and V.

b. no factors.

c. heme only.

d. NAD only.

9. Streptobacillus moniliformis is most easily isolated from blood cultures because it requires _____ for growth.

a. heme

b. serum

c. cysteine

d. 1% α-ketoglutarate

10. A 57-year-old male farmer sees his physician complaining of fever, night sweats, and lethargy that come and go over the past three months. The patient’s history reveals that he raises sheep for wool and meat and goats for milk. The physician suspects undulant fever. What is the optimal specimen(s) for culture of this suspected organism?

a. Blood

b. Bone marrow

c. Lymph node biopsy

d. All of the above

e. B and C

11. A microbiologist processes a specimen for culture using a buffered charcoal yeast extract agar plate. What was the original specimen used for inoculation of this agar plate?

a. Blood

b. Lower respiratory specimen

c. Nasopharyngeal

d. Urine

12. A nasopharyngeal swab containing ciliated epithelial cells is the best specimen for the recovery of the organism that causes

a. whooping cough.

b. undulant fever.

c. rat bite fever.

d. legionnaire’s disease.

13. What is the clinical significance of ALA-positive, gram-negative coccobacilli in a sputum culture?

Normal flora

Potential pathogen

Significant if it is hemolytic on horse blood agar

Further testing is needed to assess significance

14. A small, slender, gram-negative rod was recovered from the blood cultures of a patient following root canal surgery. At 48 hours, the following results were observed:

BAP and CHOC agars: small gray colonies that tend to pit the agar

MAC agar: no growth

Odor upon opening the agar plates: bleach-like

This organism will also be

a. catalase and oxidase positive.

b. catalase positive and oxidase negative.

c. catalase and oxidase negative.

d. catalase negative and oxidase positive.

15. A pleomorphic gram-negative coccobacillus is isolated from the blood cultures of 58-year-old male who had recent dental surgery. His history is significant for rheumatic fever as a child. The organism only grows on chocolate agar. It should be tested using

a. ALA.

b. X and V factor disks.

c. ALA and horse blood agar.

d. X and V factors and horse blood agar.

16. The virulence of Bordetella pertussis is related to its

a. toxin’s ability to paralyze ciliated epithelial cells.

b. ability to hide in the reticuloendothelial system.

c. easy dissemination.

d. ability to live inside white blood cells.

17. Infection due to Brucella spp. is often slow to develop, long term, and displaying periodicity. This can be explained by the organism’s ability to

a. colonize the upper respiratory tract prior to infection.

b. travel and hide in the reticuloendothelial system.

c. cause infection as the vaccine wanes in adults.

d. change its surface antigens.

18. A 10-year-old male gave mouth-to-mouth resuscitation to his pet guinea pig, which proceeded to bite him on the lip. The guinea pig did not survive. Two days after the guinea pig’s funeral, the boy became ill with fever, chills, joint pain, and a rash. What organism should the physician suspect based on the patient’s history?

a. Brucella spp.

b. Francisella tularensis

c. Streptobacillus moniliformis

d. Eikenella corrodens

19. You and your best friend get into a fist fight. Your knuckles are torn and bleeding afterwards. What organism are you likely to isolate if your wounds become infected?

a. Kingella kingae

b. Eikenella corrdens

c. Aggregatibacter aphrophilus

d. Cardiobacterium hominis

20. Epiglottitis, a severe life-threatening infection occurring in non-vaccinated infants and children, is most commonly caused by

a. a pleomorphic gram-negative coccobacillus that is ALA positive and horse blood agar positive.

b. a gram-negative coccobacillus that is identified by direct fluorescent antibody and slide agglutination tests.

c. a gram-negative coccobacillus that is best identified by a rise in antibody titer in serum samples drawn two weeks apart.

d. a pleomorphic gram-negative coccobacillus that requires X and V factors and is horse blood agar negative.

21. An organism isolated from the swab of purulent eye drainage shows no fluorescence on the ALA test. The horse blood agar displays no hemolysis. This organism should be reported as

a. Haemophilus influenzae.

b. H. aegyptius.

c. H. influenzae or H. aegyptius, biochemically similar.

d. H. parainfluenzae.

22. Because of the nature of the profession, a veterinarian is at increased risk of acquiring

1. Brucella spp.

2. Aggregatibacter actinomycetemcomitans

3. Francisella tularensis

4. Streptobacillus moniliformis

5. Eikenella corrodens

a. 1, 2, 4, and 5

b. 1, 3, and 4

c. 2, 3, and

d. 3 and 4

The epiglottis acts as a

voice box.

filter for microorganisms and debris.

cover over the larynx.

producer of mucus.

ANSWER:

(Level 1, Objective 1)

Collectively, the nose, oral cavity, pharynx, epiglottis, and larynx make up the

nasopharynx.

oropharynx.

laryngopharynx.

upper respiratory system.

ANSWER:

(Level 1, Objective 1)

The cilia present on cells of the lower respiratory system function by:

trapping microorganisms and foreign debris.

propelling microorganisms and particles out.

preventing colonization by potential pathogens.

all of the above.

ANSWER:

(Level 1, Objective 2)

The most common causative agent of a swollen and painful oropharynx is

Streptococcus pyogenes.

Arcanobacterium haemolyticum.

Corynebacterium diphtheriae.

Rhinovirus.

ANSWER:

(Level 1, Objective 3)

Infections associated with cystic fibrosis are due to inflammation of the:

bronchi.

bronchioles.

lungs.

alveoli.

ANSWER:

(Level 1, Objective 3)

A physician sends a nasal washing for viral culture. This specimen is

unacceptable because it is contaminated with upper respiratory flora.

acceptable as long as it contains epithelial cells.

unacceptable if it is for the detection of influenza or respiratory syncytial viruses.

acceptable if it has a thick consistency and is yellow or green in color.

ANSWER:

(Level 2, Objective 4)

A patient is unable to produce adequate sputum for routine, acid-fast, and fungal cultures. The physician may attempt to obtain a/an

induced sputum.

transtracheal aspirate.

bronchoalveolar lavage.

pleural fluid.

ANSWER:

(Level 1, Objective 4)

9. Two throat swabs are received from a 6-year-old female with orders for a rapid screen for group A Streptococcus. One swab is tested using the group A Streptococcus rapid screen, and it is negative. The second swab is used to inoculate

a. sheep blood agar.

b. chocolate agar.

c. no culture is necessary.

d. a and b.

ANSWER:

(Level 1, Objective 6)

Which of the following disease states requires the addition of selective and/or differential medium to ensure recovery of potential pathogens from the respiratory system?

Pertussis

Cystic fibrosis

Laryngitis

a and b

all of the above

ANSWER:

(Level 2, Objective 6)

11. A throat culture provides the following results:

Moderate growth of alpha-hemolytic, catalase-negative, optochin-susceptible, gram-positive diplococci

Heavy growth of alpha-hemolytic, catalase-negative, optochin-resistant, gram-positive cocci

Heavy growth of gamma-hemolytic, oxidase-positive, glucose- and maltose­-positive, gram­ diplococci

You would report

moderate growth of Streptococcus pneumoniae and heavy growth of normal upper respiratory flora.

heavy growth of Streptococcus pneumoniae and heavy growth of normal upper respiratory flora.

heavy growth of Neisseria meningitidis and heavy growth of normal upper respiratory flora.

heavy growth of normal upper respiratory flora.

ANSWER:

(Level 3, Objective 7)

Yeast colonies in a sputum culture are considered significant when they

are present.

comprise 25% of the organisms present.

comprise 50% of the organisms present.

comprise 75% of the organisms present.

ANSWER:

(Level 1, Objective 7)

13. An 8-year-old male presents with a red and sore throat. The rapid group A Streptococcus screen is negative, and a sheep blood agar is inoculated. At 24 hours, there are no beta-hemolytic colonies present and moderate growth of normal upper respiratory flora. At 48 hours, the same culture results are present. Which of the following statements does not explain these results?

a. His sore throat is due to Haemophilus influenzae, and it will not grow on blood agar.

b. The culture was taken very early in the infection.

c. The patient received treatment prior to specimen collection.

d. The causative agent is not bacterial.

ANSWER:

(Level 2, Objective 8)

17. A quantitative bronchial alveolar lavage culture requires:

1. sheep blood agar.

2. chocolate agar.

3. 0.01 mL pipette.

4. 0.001 mL pipette.

a. 1 and 3

b. 1, 3, and 4

c. 2, 3, and 4

d. 2 and 4

ANSWER:

(Level 1, Objective 9)

18. A bronchial washing is plated to a BCYE. This agar should be examined under a laminar flow hood due to the potential for recovery of Legionella pneumophila and

a. Bordetella pertussis.

Francisella tularensis.

mould.

Pneumocystis jiroveci.

ANSWER:

(Level 2, Objective 9)

20. A physician submits a sputum with a culture request for Legionella. Select the growth medium that should be used to cultivate this organism.

a. 7H10

b. TCBS

c. BCSA

d. BCYE

ANSWER:

(Level 1, Objective 6)

2. A76-year-old man with atherosclerosis had been previously admitted for abdominal aneurysm and resection of the perirenal aorta. He had several follow-up admissions over the next year for postoperative wound infections, with accompanying bacteremia, alternating between Pseudomonas aeruginosa, vancomycin-resistant Enterococcus faecium, and Candida glabrata. On his final admission, blood cultures were positive, with numerous gram-positive cocci in pairs and chains in the smear, but subculture of the bottle showed no growth aerobically with increased CO2 on blood agar or chocolate agar or anaerobically on Brucella agar. QUESTIONS a) What is this organism and what would you do to grow it? b) To control infection, screening for vancomycin resistance in enterococci on selected hospitalized patients is important. What is a cost-effective screening method? c) Many genera of gram-positive cocci are catalase negative, but only a few are vancomycin-resistant. Name these genera, and indicate how they can be differentiated from vancomycin-resistant enterococci.

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