1. Gray to black colonies on Cystine
diptheriae causative agent of diptheria (CTBA) produce gray to black
tellurite blood agar characterize which
of the following gram (+) bacilli?
A. Listeria monocytogenes
B. Bacillus anthracis
C. Corynebacterium diphtheriae
D. none of these
2. A gram (+), catalase positive beta
hemolytic organism that shows
tumbling motility in a wet preparation is
most
likely
A. Erysipelothrix thusiopathiae
B. Listeria monocytogenes
C. Corynebacterium diphtheriae
D. Bacillus anthracis
3. on Leoffler’s serum, C. diphtheriae
produces:
A. black colonies with brown halo
B. beta hemolytic colonies
C. black colonies
D. enhanced metachromatic granule
formation
4. Bacillus cereus has been implicated
in which of the following?
A. gastroenteritis
B. home canned good intoxication
C. antibiotic associated diarrhea
D. meningitis
5. The most popular egg-based
medium used for growth of
Mycobacteria is
A. Lowenstein Jensen medium
B. Wallenstein medium
C. Petragnani
D. Middlebrook 7H10
-C.
colonies
-Selective media for C. diptheriae and the inhibitor is potassium tellurite,
-Tinsdale media can be used, black colonies with brown halo
-Leoffler`s serum, enhance pleomorphism & granules formation specifically
babes ernts
-B. anthracis – PLET – polymyxin lysosome EDTA thallous acetate, Non
hemolytic and non motile
-Consider signifact, this is a bioterrorism agent.
-L. monocytogenes – can tolerate cold enrichment – grwth @ 4 degress
celcius for several week.
-L. monocytogenes - tumbling motility is unique to this only, tumbling can
be called end over end. Hanging drop a presumptive test
-C. diptheriae (non motile) and L. monocytogenes – Beta hemolytic
-B. anthracis - gamma, non motile
-E. rhusiopathiae - alpha or gamma , non motile
>Aka kleb leoffler`s bacillus
>x-y-v formation, pallisade (side by side arrangement), picket fence,
Chinese letter- pleomorphic, babes Ernst granules (stored food),
>much granules – m. tuberculosis
>black colonies – CTBA
>black colonies with brown halo – tinsdale media
>Diarrheal type, more diarrhea than vomiting
>Emetic type, vice versa of diarrheal type.
>Home canned good intoxication caused by Clostridium botulinum
>Antibiotic associated diarrhea or pseudomembranous colitis caused by C.
difficile
>Neonatal minigitis – s. agalactiae, grp b hemolytic strep
>Adult bacterial - s. pneumoniae
>Elderly meningitis and immunecomproised – L monocytogenes
>9 – 29yrs old N. minigitis
>Less than 5 yrs old. H. influenzae
>LJM, Wallenstein medium and petragani are conventional media,
disadvantage is pro long time of growth,
>Mycobacterium are slow growing,
>Non selectice are egg based and opaque media, cannot use to detect
pigmentation
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6. The best procedure (s) to
differentiate B. anthracis from other
non-pathogenic Bacillus spp. include
motility &
hemolysis production because B.
anthracis is
A. Non-motile & beta hemolytic
B. motile & non-hemolytic
C. motile & beta hemolytic
D. non-motile & non-hemolytic
7. Which of the following characteristics
apply to the Enterobacteriaceae
family?
A. Glucose fermentation
B. lack of oxidase
C. Nitrate reduction
D. all of these
8. Infection with which of the following
organisms is most likely to lead to a
condition simulating acute
appendicitis?
A. Klebsiella pneumoniae
B. Yersinia pestis
C. Yersinia enterocolitica
D. Salmonella
9. Spontaenous abortion or stillbirth
during pregnancy may result from an
infection with:
A. E. coli
B. S. aureus
C. L. monocytogenes
D. E. rhusiopathiae
>Anthracis(most significant) causes anthrax that is an animal disease
transmitted to humans, cereus can caused food poisoning, contaminated
fried rice, and subtilis common lab contaminant, used as indicator of oven,
subtilis varneger biological indicator of oven, are the significant sp.
>Anthracis is a non motile and gamma hemolytic
>Cereus and subtilis are motile and beta hemolytic
>Enterobacteriaceae family are glucose fermenter, lack oxidase and
nitrate reduction, gram negative enteric bacilli, facultative anaerobe,
cytochrome oxidase neg except plesiomonas. P. shigelloides oxidase pos.
nitrate reduction pos except erwinia and pantoea, positive blood agar large
gray colonies with variable hemolysis, most are motile except klebsiella,
shigella and y. pestis
>cute appendicitis simulating is caused by y. enterocolitica
k. pneumoniae can cause UTI and community acquire pneumonia
y. pestis – plague (bubonic, septicemic and pneumonic) gram negative
bacilli, acquired thru flea bite
bubonic plague- swelling of axilla and groin lymph nodes, can progress to
fatal bacterimia (septic plague)
pneumonic plague – consequence of bacteremic plague
>salmonella sp.
Gastroenteritis and diarrhea – s. serotype typhi and s. serotype enteritidis
Bacteremia – s. serotype cholerasuis
Enteric fever – s. serotyope typhi
Yersinia enterocolitica causes enterocolitis or pseudoappendicular
syndrome.
>E. rhusiopathiae – skin infection called erysipeloid, occupational hazard,
can caused skin infection among those handling meat poulty and fish
>S aureus – toxin (food poisoning , scalded skin syndrome, TSS) and non
toxin (boils, carbuncles and bullous impetigo) mediated diseases
>E.coli – a normal flora of GIT, number 1 cause of UTI
>L. monocytogenes
>Food poisoning – coleslaw and soft cheese
>Meningitis – fetus/newborn & immunocompromised adults
>Spontaneous abortion
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10. A gram positive, non-spore forming
rod is isolated from a wound on a
farmer’s finger. Produced no change in
Catalase test, Blackening along the
stab line in TSI and on gelatin media,
no liquefaction but (+) “bottle brush”
growth.
This organism is identified as:
A. Erysipelothrix
B. Lactobacillus
C. Pneumococci
D. Listeria
11. A key identification characteristic of
C. perfrigens is its:
A. Double hemolysis
B. production of central spores
C. (+) lipase reaction
D. ability to produce beta lactamase
12. The pathogenicity of C. tetani and
C. botulinum is due to their ability to
A. Produce neurotoxin
B. produce spores
C. resist stomach acids
D. A & B only
13. ____ are slow growing
Mycobactreia which may be pigmented
when grown in the dark and when
exposed to light
and re-incubated, the pigment does not
intensify
A. Photochromogens
B. Scotochromogens
C. Non-photochromogens
D. rapid growers
>A gram pos non spore forming rod, catalase neg, blackening along the
stab line in TSI and on gelatin media no liquefaction but pos bottle brush
growth is Erysipelothrix
>Lactobacillus is H2s neg, in implicated with any of the disease since it is a
normal flora, highly pleomorphic (can assume different forms), with diff
colony morphology, and alpha hemolytic. It is a catalase, indole neg.
>Lactobacillus acidophillus a vaginal flora and can b notes in PAP`s
stained smears
>Pneumococci - is a gram pos cocci, dome shaped colonies after 24hrs
and crater like/ nail head colonies after 24hrs, bile solubility and Neufeld
quellung pos, optochin S, alpha hemolytic
>Listeria – umbrella like growth on agar surface, beta hemolytic, H2s neg,
and tumbling motility.
 Clostridium perfringens a.k.a GAS GANGRENE BACILLUS- causes
gas gangrene & myonecrosis
To detect
 Demonstration of Target Hemolysis on BAP
(colony surrounded by INNER BETA & OUTER ALPHA
hemolysis)
 (+) REVERSE CAMP TEST
 media: BAP
known organism: S. agalactiae (+) result: arrow head zone
of enhanced beta hemolysis
 Stormy fermentation of Milk - LITMUS MILK TEST
 Lecithinase (+) - can be demonstrated using Nagler's plate or
EGG YOLK AGAR (+) EYA - opaque yellow halo around the
colonies (+) Nagler's. - zone of precipitation around the
colonies on the side of plate without antitoxin
 "Box car" morphology; subterminal spores
 Neurotoxic Clostridium:
 C. tetani – “ Tetanospasmin” – blocks neurotransmitters causing SPASTIC
PARALYSIS = LITTLE MOVEMENT
 LOCK JAW – Risus sardonicus
 C. botilunum - Flaccid paralysis. = NO MOVEMENT OR UNRESPONSIVE
 MOTT - Mycobacterium other than tuberculosis
 NTM - Non Tuberculous Mycobacterium
 Runyoun's classification
> PHOTOCHROMOGENS – pigmented when expose to light
Mycobacterium marinum
Mycobacterium kansasii
M. simiae
M. Asiaticum
> NON-PHOTOCHROMOGENS – non-pigmented
M. xenopi; M. ulcerans
Mycobacterium haemophilum ; Mycobacterium gastri
Mycobacterium avium - intracellulare complex (MAI)
Mycobacterium terrae complex (M. terrae, M. triviale & M.
chromogenicum)
Mycobacterium
>Scotochromogen – pigmented in the dark and when exposed
to light
Mycobacterium scrofulaceum
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14. Which biochemical test used in the
identification of Mycobcteria requires
heavy growth of the test organism,
extraction of metabolite and the
generation of a yellow color as a
positive reaction?
A. Tellurite reduction
B. Nitrate reduction
C. Niacin test
D. Urease production
15. Growth on Mac Conkey agar
without crystal violet may be
suggestive of which of the following
organsims?
A. M. avium-intracellulare complex
B. M. fortuition-chelonae complex
C. M. terrae complex
D. M. tubuerculosis-bovis complex
16. When examining an AFB smear, if
8 AFB were noted in every field after
examining at least 50 fields. How
should
we report this?
A. 2+
B. 3+
C. 1+
D. +n
17. In the Guinea Pig lethal test for
toxin detection, which is reported as a
(+) result?
A. Death of unprotected guinea pig
B. Death of protected guinea pig
C. Death of both protected &
unprotected guine pigs
D. Survival of both test animals
18. Which reagent(s) is(are) used to
detect end product of the Vogues
Proskauer test?
A. 10% ferric chloride
B. 5% alpha naphthol & 40% KOH
C. KOVAC’s or Ehrlich’s
D. methyl red
Mycobacterium szulgai
Mycobacterium gordonae
Mycobacterium thermoresistible
Mycobacterium flavescens
>Rapid Growers – can develop colonies to 3-5 days
M. fortuitum and M. chelonei are:
Mycobacterium smegmatis
Mycobacterium phlei
M. mucogenicum
 All are biochem test for genus Mycobacterium.
 Tellurite reduction – (+) development of Black
 Nitrate reduction – initial (+) RED ; after addition of zinc : no color change
 Urease production - Red
 Mac Conkey agar – selective differential media for gram negative
enteric bacilli; contains crystal
violet as inhibitor.
 M. fortuitum -chelonai complex = rapid growers
 + growth on Mac Conkey agar with crystal violet
 Both are ARYLSULFATASE test +
 M. foruitum - + iron uptake, Nitrate reduction
 M. chelonai – (-) iron uptake, Nitrate reduction.
NUMBER OF AFB seen | Report
0 -----------------------------No AFB seen in 300 visual fields
+n -----------------------------1-9/100 fields
1+ -----------------------------10-99/100 fields
2+ -----------------------------1-10/IOF in at least 50 visual fields
3+ -----------------------------More than 10 AFB/OIF in at least 20 visual fields
 Inoculate to CTBA – cystine tellurite blood agar
 + grey to black colonies
 Perform Toxigenecity test
 Animal Inoculation – In vivo test
 Modified Elek’s – In vitro test
 VP test – IMVIC - to detect ability of organism to produce
acetyl methyl carbinol or “acetoin”
 MEDIA – MRVP broth or Clark Lubbs broth
 Reagents : 40% KOH and 5% alpha-naphthol ( Barritt’s
method)
 40% KOH with creatine and 5% alpha-naphthol (Coblentz
method)
+ Pink to RED COLOR
 KOVAC’s or Ehrlich’s – use in INDOLE test (IMVIC)
 Chemical name of Kovac’s – paradimethylaminobenzaldehyde
 Methyl Red indicator – Methyl Red Test
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  10% Ferric Chloride – used in Deaminase test using
Phenylalanine agar or Tryptophan agar
 Deaminase test = for identification of Proteus-Providencia and
Morganella
 + result with Phenylalanine = green
 + result with Tryptophan agar – brown

19. non-fermenters produce what Carbohydrate fermentation test

reaction in TSI
A. Alkaline slant, alkaline or neutral butt
B. Alkaline slant, alkaline butt
C. Acid slant, acid butt
D. Alkaline slant, acid butt
 Media : TSI dispensed as Butt and Slant
 Composition: 10 parts lactose, 10 parts sucrose, 1 part glucose
 pH indicator: Phenol Red
 H2S indicator: Sodium thiosulfate, Ferric ammonium sulfate
Possible results:
 In an ACID pH ( YELLOW ) = A, in ALKALINE RED = K
 H2S production – Blackening
 Gas production: Splitting of media; pulling away of media;
cracks on media
 KLIGLER’s IRON AGAR – same components as TSI but no
sucrose.

Color: Slant/Butt Report Interpretation Classification of

result as inoculated
organism
RED/RED K/K No sugar was Non-fermenter
fermented
RED/YELLOW K/A Only 1 sugar Non-lactose
(glucose) was fermenter
fermented
YELLOW/YELLOW A/A 2-3 sugars were Lactose
fermented; fermenter
Glucose +,
Lactose and/or
sucrose +
20. If the (-) nitrate reduction test does
not change color following the addition  Nitrate Reduction
of powdered zinc, how is it reported  Sodium nitrate broth
A. Positive  After incubation we add: n-n dimethyl-l-naphthylamine
B. Doubtful sulfanilic acid
C. Negative  To confirm a (-) result we add: Zinc dust/powder
D. Do not report  Initial positive result (+) Red, (-) no color change
 After adding zinc (+) no color change, (-) RED
21. Which of the following tests best NOTE: Shigella & E. coli are both : H2S, Urease, MRVP, and Citrate (-)
differentiates Shigella species from E.
coli? Shigella E. coli
Lactose (-) NLF (+) LF (Rapid)
A. Hydrogen sulfide, VP, citrate, and Indole (-) (+)
urease ONPG (-) (+)
Motility NM M
B. Lactose, indole, ONPG, and
motility

C. Hydrogen sulfide, MR, citrate, and

urease

D. Gas, citrate, and VP

22. In the grouping of Shigella Species Lactose

organisms, agglutination by Group C A Shigella dysenteriae/ -
antisera indicates that the specie is Shiga Bacillus
A. S. dysenteriae B Shigella -
B. S. boydii
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C. S. flexneri flexneri/Strong’s
D. S. sonnei Bacillus
C Shigella boydii / New -
Castle Manchester
Bacillus
D Shigella sonnei / - / LLF
Duval’s Bacillus
NOTE: All Shigella species are NON-LACTOSE FERMENTER except for
Shigella sonnei/Duval’s Bacillus (LLF)

23. Which statement correctly They are pathogenic due to their plasmid (Confers resistance to
describes the antigens of antibiotics)
Enterobacteriaceae?
A. The O antigen is heat labile Some of them possess antigens that can be used to identify other groups
B. The O antigen is located on the
cell wall O or Somatic K or Envelope H Flagellar Antigen
C. The Vi antigen is an example of a Antigen / Cell wall Antigen / capsular
flagellar antigen Antigen antigen
D. The K antigen is also known as the Heat-stable Heat-labile Heat-labile
somatic antigen For E. coli there are Consist of capsular Protein in nature
164 types of O polysaccharide Found in the
antigen & specific flagellum; used for
types maybe With K antigens: Salmonella
associated with a  Klebsiella Serotyping
particular disease.  E. coli
Used for E. coli ad  Salmonella
Shigella Serotyping Vi antigen:
Serotype 0111  S. typhi
Causes diarrhea in
infants
Serotype 0157
Verotoxin production

24. Which of the following culture NOTE: Traditionally to do Kirby Bauer Test we use Mueller Hinton Agar
media can be utilized for antibiotic
susceptibility testing of  Middlebrook 7H10 – a clear media
Mycobacterium?  Wallenstein and ATS media – egg-based media, opaque media

A. Middlebrook 7H10
B. Wallenstein
C. ATS media
D. all of these

25. Uninoculated TSI and Simmon
Citrate agar appears ______________.
A. orange & yellow
B. Red & green
TSI – media used to detect carbohydrate fermentation = og. RED
Indicator: PHENOL RED – Acid pH = YELLOW – Alkaline pH = RED
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C. Red & yellow Simon Citrate Agar – media used for citrate utilization test = og. GREEN
D. Orange & green
(+) BLUE : (-) GREEN

Color change is due to the incorporated pH indicator = BROMTHYMOL

BLUE

26. The general characteristics of the
members of the family
Enterobacteriaceae include the
following except
A. reduce nitrate to nitrite
B. ferment glucose
C. produce CO2 gas
D. produce indophenol oxidase
NOTE: Members of family Enterobacteriaceae are cytochrome oxidase
NEGATIVE (Unable to produce enzyme oxidase)
(+) for Endophenol Oxidase:
 Moraxella catarrhalis – ability to produce endophenol oxidase
- Gram negative cocci, considered as normal flora
- It can cause Otitis Media
- Assacharolytic/Non-assacharolytic (Do not ferment any sugar)
- “Hockey Puck” colonies – colonies that can be pushed to the
other side of that plate but can still remain intact.

27. Which of the following organisms is ONPG TEST(O-nitrophenyl-beta-d-galactopyranoside)

ONPG negative?
A. Shigella dysenteriae
B. Citrobacter freundii
C. Escherichia coli
D. Enterobacter aerogenes
- It is used to detect late lactose fermenters
- To differentiate citrobacter which are ONPG (+) from Salmonella
which are ONPG (-)
- Salmonella are ONPG (-) except S. arizonae
- May be carried out using ONPG broth/disk (+) result : YELLOW

ONPG POSITIVE ONPG NEGATIVE

Escherichia coli Proteus spp.
Klebsiella spp Salmonella spp.
Yersinia enterocolitica Shigella spp.
Enterobacter spp. Providencia
Citrobacter spp. Yersinia pestis
Shigella sonei Morganella
Hafnia alvei Yersinia pseudotuberculosis
Salmonella arizonae
28. When inoculated with Klebsiella Simmon Citrate agar/medium
pneumoniae and incubated for 24
hours, the Simmons citrate medium will – is the required media for citrate utilization test, it is part of a
appear biochemical test which is the IMViC TEST
A. green - It is a tube media dispensed as SLANT (Incubate, no reagent, only
B. yellow change in color
C. blue - Indicator BROMTHYMOL BLUE (Green to Blue)
D. purple - Result: (+) BLUE : (-) GREEN
- E.G. Klebsiella pneumonia (+)

29. The pH indicator in Christensen’s  BROMCRESOL PURPLE – indicator in Decarboxylase Test

urea agar is  NEUTRAL RED – indicator in Mac Conkey Agar (Selectiver media
A. bromcresol purple for Enterobacteriaceae) and CIN media (Selective for Yersinia
B. neutral red enterocolitica)
C. phenol red
 METHYL RED Indicator – used in Methyl Red Test (IMViC)
D. methyl red
 UREA AGAR- used to perform urease test to detect (PROTEUS,
PROVIDENCIA, & MORGANELLA) we do not use an indicator
because the media is already incorporated by PHENOL RED

30. Kovac’s reagent containing p-  Detection of AMMONIA – UREASE TEST which uses Urea Agar
dimethylaminobenzaldehyde is added w/ an indicator PHENOL RED
to detect the production of  Detection of ACETOIN – product in VOGUES PROSKAUER TEST
A. ammonia – uses MRVP broth w/ an indicator ALPHA NAPHTHOL & KOH
B. acetoin
 HYDROGEN PEROXIDE – required reagent in catalase test
C. H2O2
D. indole (Detect organism that produce enzyme catalase)
 Detection of INDOLE – INDOLE TEST – inoculates in SIM or
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31. Sputum samples may contain
normal flora and other contaminating
organisms, so samples must be
A. digested with N-acetyl-L cysteine
B. decontaminated with 2% NaOH
C. digested with trisodium phosphate
D. decontaminated with dithiotreitol
32. A required component in media for
Mycobacterium is
A. cysteine & cystine
B. whole egg
C. hemoglobin
D. none of these
33. Which of the following is not a
component of Kligler iron agar?
A. ferrous ammonium citrate
B. 2% peptone
C. phenol red
D. 1% sucrose
34. The strain of Escherichia coli
responsible for hemorrhagic colitis is
typically
A. lactose +, sorbitol 0
B. lactose 0, sorbitol +
C. lactose +, sorbitol +
D. lactose 0, sorbitol 0
Tryptophan broth with KOVAC’s or Erlich’s reagent
Sputum is often submitted to the lab for MYCOBACTERIUM detection. It is
a NON-STERILE SPECIMEN.1st STEP upon receiving spp. sample:
- classify if STERILE or NON-STERILE
2nd STEP:
IF STERILE- centrifuge immediately
IF NON-STERILE- perform DIGESTION (to liquify mucus) and
DECONTAMINATION (to remove contaminants and normal flora)
* Kinanglan ta kakson gid una ang normal flora kay ang
MYCOBACTERIUM, SLOW GROWERS sila. Basi ma unahan pa sya
tubo sang normal flora thus causing erroneous results.
*N-acetyl-L-Cysteine (NALC) and 2% NaOH are the gold standard for
DIGESTION AND DECONTAMINATION
*Trisodium Phosphate and Benzalkonium Chloride (Zeniphran)-
recommended when Pseudomonas is present
*Dithiotreitol and 2% NaOH- commonly known as SPUTULYSIN
* 4% NaOH
- MUCOLYTIC and ANTIBACTERIAL
- Strongly ALKALINE
-Cysteine and Cystine is required for the growth of FRANCISELLA
(tularensis), isolated in BCGA (Blood Cystine Glucose Agar)
- Hemoglobin is for ‘blood-loving’ spp, Haemophilus. Requires X and V
factors
- for Mycobacterium, we can use: Lowenstein-Jensen, Petragnani’s
Medium, ATS, Wallenstein, Dorset Egg Medium. The media should
contain WHOLE EGG.
Kligler Iron Agar is used to detect CARBOHYDRATE FERMENTATION,
same as TSI, contains the same components with TSI except for 1%
SUCROSE
There are two SEROTYPES of E. coli
- UPEC/NPEC- Uro/Nephropathogenic E. coli-(causes UTI), uro/nephro-
ihi
- Enterovirulent /Diarrheagenic E. coli- associated with diarrhea
DIARRHEAGENIC/ENTEROVIRULENT E. COLI
1. ETEC (ENTEROTOXIGENIC)- can cause PROFUSE/SEVERE diarrhea
that is CHOLERA LIKE due to production of TOXIN.
2. EIEC (ENTEROINVASIVE)- can cause bloody diarrhea that is
SHIGELLA LIKE due to its ability to invade the bowel mucosa
3. EPEC (ENTEROPATHOGENIC)- non-toxigenic and non-invasive but
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 can CAUSE DIARRHEA in infants (INFANTILE DIARRHEA)

4. EAEC (ENTEROAGGREGATIVE)- acute and persistent diarrhea in

children and adults

5. EHEC (ENTEROHEMORRHAGIC), VEROTOXIC, SHIGA TOXIN

PRODUCING- can cause SEVERE BLOOD DIARRHEA due to its ability
to produce VEROTOXIN, example is E. coli 0157:H7

6. DAEC (DIFFUSELY ADHERENT)- constitutes the 6th grp in the

diarrheagenic E. coli, can cause diarrhea in otherwise healthy patients

* All E. coli are LACTOSE (+), pink purple colonies on Mac Conkey Agar

* Sa E. coli 0157:H7, we use SORBITOL MAC CONKEY AGAR, same as

the usual Mac Conkey but instead of LACTOSE, SORBITOL is used to all
serotypes of E. coli, SORBITOL (+) except 0157:H7.

* Positive sa SMAC, pink-purple colonies. (-) is colorless. All E. coli

serotypes kay pink-purple sa SMAC, except 0157:H7

35. Which of the following tests best SHIGELLA A. COLI

differentiate Shigella spp. from E. coli?
1. lactose LACTOSE - +
2. indole
3. motility INDOLE - +
4. citrate
MOTILITY - +
A. 1 and 3
B. 2 and 4 CITRATE - -
C. 1, 2, and 3
D. 1, 2, 3, and 4

36. Cefsulodin-irgasan-novobiocin agar CIN contains (Selective media for Yersinia)

is the best medium for the isolation of
A. Proteus spp. - Mannitol, Peptone, Yeast
B. Edwardsiella spp.
- NEUTRAL RED (INDICATOR)
C. Serratia spp.
D. Yersinia spp. - Crystal Violet; Cefsulodin; Irgasan; Novobiocin (INHIBITORS para nd
maka tubo iban, Yersinia lang gid)

- Y. enterocolitica- “bull’s eye colonies” (when inoculated sa CIN)

For A,B and C, we can use Mac Conkey, XLD, Hektoen, EMB, any media
intended for ENTEROBACTERICIAE

37. An isolate from a bloody stool - Campylobacter is incorrect kay MOTILE and OXIDASE (+) , not a
tested negative for oxidase, indole, member of ENTEROBACTERICIAE. Classified as STOOL PATHOGEN,
urea, motility, and H2S. The most likely shows DARTING MOTILITY.
identification is
A. Campylobacter spp. - Salmonella is incorrect kay MOTILE kag H2S positive sya.
B. B. Klebsiella spp.
C. Salmonella spp. - Klebsiella is incorrect, kay H2S, Non-motile, Indole negative, PERO
D. Shigella spp. IT WILL NOT CAUSE BLOODY DIARRHEA, UTI sya kag
PNEUMONIA.

38. The Shiga-like toxin is produced ETEC (ENTEROTOXIGENIC)- can cause PROFUSE/SEVERE diarrhea
mainly by which E. coli serotype? that is CHOLERA LIKE due to production of TOXIN.
A. ETEC
B. EHEC EIEC (ENTEROINVASIVE)- can cause bloody diarrhea that is SHIGELLA
C. EPEC LIKE due to its ability to invade the bowel mucosa
D. EAEC
EPEC (ENTEROPATHOGENIC)- non-toxigenic and non-invasive but can
CAUSE DIARRHEA in infants (INFANTILE DIARRHEA)

EAEC (ENTEROAGGREGATIVE)- acute and persistent diarrhea in

children and adults

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39. Given the following results, which is
the most likely organism? IMViC =
00++; H2S = 0; urease = 0; LOA = ++0;
PAD = 0; gelatinase = +; DNAse = +
A. Enterobacter cloacae
B. Proteus vulgaris
C. Klebsiella pneumoniae
D. Serratia marcescens
40 Which of the following biochemical
reactions would differentiate
Citrobacter spp. from most Salmonella
spp.?
A. ONPG +, LDC 0
B. ONPG 0, LDC 0
C. ONPG +, LDC +
D. ONPG 0, LDC +
41. Which of the following is not a
characteristic of Salmonella serotype
typhi?
A. produces H2S
B. LDC positive
C. citrate negative
D. produces gas from glucose
42. Which of the following
characteristics is typical for Escherichia
coli?
A. colorless colonies on MacConkey
agar
B. pink, nonhemolytic colonies on BAP
C. yellow colonies on XLD agar
D. green colonies with black centers on
HEA
EHEC (ENTEROHEMORRHAGIC), VEROTOXIC, SHIGA TOXIN
PRODUCING- can cause SEVERE BLOOD DIARRHEA due to its ability
to produce VEROTOXIN, example is E. coli 0157:H7
DAEC (DIFFUSELY ADHERENT)- constitutes the 6th grp in the
diarrheagenic E. coli, can cause diarrhea in otherwise healthy patients
Key biochem results are GELATINASE and DNASE
- All of the choices are included in the family of ENTEROBACTERICIAE,
and sa dira na family, ISA LANG ANG DNASE (+) and that is Serratia
marcescens.
- Besides pa sna, ang isa ka unique characteristic pagid sa Serratia kay ga
produce sya RED PIGMENT “PRODIGIOSIN”
A. Cloacae P. Vulgaris K. pneumoniae
H2S - + -
PAD - + -
LOA -/+/+ -/-/- +/-/-
Urease +/- + +
ONPG TEST- O-nitrophenyl-beta-d-galactopyranoside
* used to detect late lactose fermenters
* to differentiate Citrpbacter which are ONPG (+) from Salmonella which
are ONPG (-)
* Salmonella are ONPG (-) except arizonae
* may be carried out using ONPG broth/disk (+) result: YELLOW
Genus Salmonella
- Species: S. enterica (human pathogen) & S. bongori (animal
pathogen)
- S. enterica has several subspecies ; S. enterica subsprecies
enterica
- S. enterica subsp enterica has several serotypes, the primary
indentifiable serotype is S. serotype typhi
- S. serotype typhi has Vi antigen - typhoid fever
E. Coli - rapid lactose fermenter ; marker for fecal contamination
>Mac Conkey:
-CHO: lactose;
-inhibitor: crystal violet & bole salts;
-indicator: neutral red
-Lactose fermenter: pink-purple
-Non lactose fermenter: colorless
> XLD:
-contains CHO: xylose, lactose, sucrose ;
-nhibitor: socium deoxycholate & bile salts;
-indicator: phenol red
-Fermenter: yellow
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43. A gram negative enteric bacilli
whose colonies tend to “string” when
lifted using inoculating loop
A. E. coli
B. K. pneumoniae
C. E. aerogenes
D. none of these
44. Which of the following does not
produce a positive citrate reaction?
A. Shigella boydii
B. Citrobacter freundii
C. Serratia marcescens
D. Enterobacter aerogenes
45. A positive indole reaction is
characteristic of
A. Klebsiella pneumoniae
B. Serratia marcescens
C. Proteus vulgaris
D. Yersinia pestis
46. Which Enterobacter species
produces a yellow pigment?
A. E. taylorae
B. E. aerogenes
C. E. gergoviae
D. C. sakazakii
47. Which of the following organisms is
urease negative?
A. Providencia rettgeri
B. Salmonella typhi
C. Proteus mirabilis
D. Enterobacter gergoviae
-Non fermenter: colorless or red (produced by those that do not
ferment any sugar)
>HEA:
- CHO: lactose, salicin, sucrose
- inhibitor: Bile salts
- Indicator: bromthymol blue
- Fermenter: yerllow
- non fermenter: green
- E. coli, Klebsiella & Enterobacter: Yellow
- Most pathogens ferment 1 or 2 sugars: bright orange to salmon pink
- Yersinia spp. : salmon colored colonies
Corrections for choices above:
A. colorless colonies on MacConkey agar -it is a lactose fermenter so it will
produce pink - purple colonies
B. pink, nonhemolytic colonies on BAP - on BAP they develop Large gray
colonies with varid hemolysis
D. green colonies with black centers on HEA - E. coli is a lactose
fermenter ; Produces yellow colonies
part of bacterial cells responsible for mucoid colonies is the capsule,
K. pneumoniae has a polysaccharide capsule. String test (+) hyperviscous
Citrate utilization test is part of IMVIC test. It is utilized to test the ability of
organism to use citrate as the only carbon source.
- Positive result: Blue
- Negative result: Green
P. vulgaris - indole (+)
- indole test - SIM media, Tryptophan broth
- KOVAC’s - paradimethyl aminobenzaldehyde
- to detect enzyme “tryptophanase”
- Positive REsult: REd ring
- Negative REsilt : no color development
Yellow pigment (+)
- Necrotizing colitis often due to powdered milk formula
> Urease test
- useful in the identification of PPM (proteus-providencia-morganella)
- based on the ability of the organism to convert urea to ammonia thru the
action of the enzyme urease
- PPM are regarded as RAPID UREASE PRODUCERS
- slow urease (+) ; (+) after 4 hours are (KEY-SC) = Klebsiella,
Enterobacter, Yersinia, Serratia, Citrobacter
- media is Christensen Urea Agar/ Urea Broth
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 - indicator: phenol red

(+) result: pink/red

(-) result: yellow

48. The selective nature of bismuth -Bismuth sulfate agar - selective for salmonella spp.
sulfite agar is attributed to -Inhibitor: bismuth sulfite & brilliant green
A. ammonium sulfite -Salmonella - Black
B. sodium metabisulfate
C. bile salts
D. brilliant green

49. The ability of an organism to > Deaminase test

deaminate phenylalanine in
phenylalanine agar is determined using
A. 1% alpha naphthol
B. 2N sodium carbonate
C. 2% sulfanilamide
D. 10% ferric chloride
- useful in the indication of PPM, these are the only deaminase (+) enterica
- uses lysine, tryptophan or phenilalanine
- PAD + overnight cultire + 10% Ferric Chloride
- (+) result with phenylalanine agar: Green
- (+) result with tryptophan agar: Brown

>correction for choices :

A. 1% alpha naphthol - VP test (5% alpha naphthol)

B. 2N sodium carbonate - used in arylsulfatase test (to identify species

under mycobacterium)

C. 2% Sulfanilamide - used in nitrate reductioon test

50. A K/A TSI reaction with gas and
H2S production would be produced by
the following organisms except
A. Salmonella enterica
B. Proteus spp.
C. Shigella spp.
D. Citrobacter spp.
-all choices are non lactose fermenters
-shigella is H2S (-)
>TSI reactions:
-K/K H2S (-) - Pseudomonas, Burkholderia (non fermenters)
-K/A H2S (-) - Providencia, Morganella, Shigella
-K/A H2S & Gas (+) - Salmonella, Proteus, Arizonae, S. freundii, E. tarda

-A/A H2s (-) & Gas (+) - Klebsialla, Escherichia, Enterobacter

51. In general, the Enterobacter ODC - Ornithine Decarboxylase (+)

species are
A. ODC positive ADH - Arginine Dihydrolase (+)
B. ADH positive
Enterobacter:
C. urease positive
D. H2S positive  (+) Lactose, Capsule (Mucoid colonies), plasmid
 HEA and XLD - Yellow colonies
 Infection is usually associated with contaminated medical devices

Capsule - Antiphagocytic

Plasmid - Carries or encodes antibiotic resistance genes

52. Which of the following is noted for a Niacin test - Required media is LJ medium
positive result for niacin accumulation?
A. M. tuberculosis Reagent: Strip impregnated with cyanogen bromide
B. M. bovis
(+) yellow
C. M. fortuitum-chelonae
D. M. avium-intracellulare

53. What is the ratio of lactose/sucrose TSI ingredients: used in CHO fermentation test
to glucose in triple sugar iron agar?
A. 1:10 Enzymatic digest of casein
B. 1:1
Enzymatic digest of animal tissue
C. 10:1
D. 2:1
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 Yeast enriched peptone

Dextrose - 1 part

Lactose - 10 parts

Sucrose - 10 parts (not present in KIA)

54. Which of the following is not a Anaerogenic E. coli - also known as inactive E. coli; lactose (-)
characteristic of the anaerogenic E. coli
(Alkalescens dispar)?
A. does not produce gas
B. H2S negative
C. lactose positive
D. non-motile
55. Which of the following Shigella Shigella - Shigellosis or Bacillary Dysentery; Intestinal pathogen
species does not ferment mannitol?
A. S. dysenteriae  (+) endotoxin and invasive - Bloody diarrhea
B. S. flexneri
C. S. sonnei S. dysenteriae produces neurotoxin in addition to the endotoxin
D. S. boydii
 (-) Catalase test and manitol

S. sonnei - LLF; ONPG (+)

56. Which of the following C. ulcerans - Bovine mastitis

Corynebacterium species is associated
with chronic urinary tract infections C. pseudotuberculosis - Lymphadenitis
bacteremia in
C. pseudodiphtheriticum (Hoffman's Bacillus) - Throat flora, Endocarditis
immunocompromised host?
A. C. urealyticum C. minutissimun - Erythrasma
B. C. pseudodiphtheriticum
C. C. pseudotuberculosis C. urealyticum - UTI; Catalase and urease (+)
D. none of these
C. jeikium (JK bacillus) - Prosthetic heart valve infection

57. The Corynebacterium species Non-lipophilic:

whose growth is enhanced in the
presence of lipids  C. ulcerans
1. C. jeikeium  C. pseudotuberculosis
2. C. diphtheriae  C. pseudodiphtheriticum
3. C. urealyticum
4. C. pseudotuberculosis Lipophilic:
A. 1 & 3
B. 2 & 4  C. urealyticum
C. 1,2 & 3  C. jeikium
D. 1,2,3 & 4
E. none of
these

58. Which of the following tests detects Indole test - detect enzyme tryptophanase
the production of pyruvic acid from
glucose fermentation? Malonate test - detect ability of organism to use malonate as carbon
A. indole source
B. methyl red
C. malonate  Indicator: Bromthymol blue
D. oxidase  (+) Blue
 (-) Yellow

Oxidase test - detect presence of cytochrome activity in organisms; for

identification of oxidase (-) Enterobacteriaceae

 (+) Purple
 (-) Absense of color

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 MR - detect ability of organism to produce acid when glucose is
metabolized

59. The following media can be used to H2S indicator: Ferric ammonium citrate
detect hydrogen sulfide production
except LIA - H2S production, deamination and decarboxylation
A. LIA
HEA - Selective differential media
B. HEA
C. SIM SIM - H2S production, Indole production and Motility
D. MAC CONKEY
Mac Conkey agar - selective differential media

60. A positive Decarboxylase test - ability of the organism to remove carboxyl group from
decarboxylation/dihydrolation reaction specific amino acid through the release of the enzyme decarboxylase
is indicated by what color on Moeller’s
broth? There are 3 amino acids that can be used:
A. red
B. yellow Amino Acid: Carboxyl
C. purple
 Lysine - Cadaverine
D. pink
 Ornithine - Putrescine
 Arginine - Citrulline

Media: Moeller's broth

 Bromcresol purple (indicator) + amino acid + 1% glucose

 Tubes are overlaid with mineral oil
 (+) Purple
 (-) Yellow
 Use of mineral oil - Act as oxygen barrier

61. Choose the LDC, ODC, and ADH Genus Klebsiella:

reactions of Klebsiella species.
A. +++
B. ++0 -Rapid Lactose Fermenter = TSI A/A
C. +00 - Non-Motile
D. 0++ - Inhabitation of nasopharynx and GIT
- Can cause a variety of infections i.e. UTI, pneumonia
- Species:
 K. pneumoniae – encapsulated
 K. oxytoca
 K. rhinscleromatis & K. ozanae
 Chronic infections: atrophic rhinitis & rhinoscleroma
DECARBOXYLASE TEST
1. Use of Moeller’s broth
 Uses bromcresol purple as indicator and 1% glucose as CHO
 (+) result: purple while (-) result: yellow
 Use of mineral oil – to act as oxygen barrier
2. LIA – Lysine Iron Agar
LIA contains:
Bromcresol purple, Glucose, Lysine, Ferric ammonium sulfate and
sodium thiosulfate

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 (SLANT) DEAMINASE TEST: (+) red/burgundy; (-) purple

(BUTT) DECARBOXYLASE TEST: (+) purple; (-) yellow

DEAMINASE TEST

1. Use of tryptophan agar on phenylalanine agar and use of 10%

ferric chloride
Phenylalanine (+) GREEN
Tryptophan (-) BROWN
Color of Report it Interpretation Possible
Slant/ Butt as: Organism
Purple/Purple K/K (-) DEAM/ (+) Salmonella
DECAR
Purple/Yellow K/A (-) DEAM & Shigella
DECAR
Red/ Yellow A/A (+) DEAM/ (-) P-P-M
DECAR

62. Which LIA reaction correlates with  Brown color in Tryptophan agar ( Deaminase Test) = POSITIVE
a brown color in tryptophan agar and a
 Yellow in Moeller’s broth ( Decarboxylase Test ) = NEGATIVE
yellow color in Moeller’s broth
containing lysine?
A. K/K
B. R/A
C. K/A
D. A/A

63. Which of the following biochemical Genus Providencia

reactions characterize Providencia  Most commonly associated with UTI
stuartii?
A. urease +, citrate 0  Deaminase (+); NLF; both are citrate (+)
B. urease 0, citrate 0  Species:
C. urease +, citrate + Providencia rettgeri: urease (+)
D. urease 0, citrate +
Providencia stuartii: urease (V) greater probability of (+)

64. Which of the following does not Morganella morganii:

characterize Morganella morganii?  Normal GIT flora
A. lactose negative
B. LDC positive  Deaminase and Urease (+)
C. citrate negative  Isolated from stools of patients with diarrhea
D. PAD positive  Lysine & Arginine (-);Ornithine (+)
 NLF and Motile

65. The agent of plague is transmitted Plague

to man through bites of  Bubonic – septicemic/bacteremia – Pneumonic
A. rodents
B. ticks
C. fleas
D. mites

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66. Which of the following genera is
characterized by rapid urease activity
and typical swarming motility on BAP?
A. Proteus
B. Providencia
C. Yersinia
D. Hafnia
67. Which of the following Enterobacter
species produces bull’s eye colonies
on CIN medium?
A. Y. pestis
B. Y. enterocolitica
C. Y. pseudotuberculosis
D. Plesiomonas spp
68. The organism known for its stormy
fermentation and double zone of beta
hemolysis under anaerobic conditions
causes
A) Botulism
B) Gas gangrene
C) Pseudomembranous colitis
D) Tetanus
E) None of these
69. Which of the following amino acids
are used in the test for decarboxylase
A) Cadaverine, putrescine, ornithine
B) Ornithine, arginine, cadaverine
C) Lysine, arginine, ornithine
D) Arginine, putrescine, cadaverine
Genus Yersinia:
 Slow urease (+)
 Mac Conkey agar: colorless – peach
 HEA: salmon
 XLD: yellow/colorless
 Can grow at 4-43 degC
Genus Hafnia:
 NLF and delayed citrate activity
Genus Proteus & Providencia – Rapid Urease (+) and Deaminase (+)
Genus Proteus:
 NLF; colorless colonies with burnt chocolcate/ burnt gun powder
odor
 “swarming on BAP”
 Source of antigens for Weil Felix Test
(OX2, OX19- P. vulgaris and OXK – P. mirabilis)
Y. pestis
 Stalactite pattern on broth – clumps of cells adhering to 1 side of
tube
 5% SBA – pinpoint colonies (24hrs); cauliflower app at 48hrs
 “hammered copper colonies”
Plesiomonas shigelloides – a fresh water inhabitant, gastroenteritis in
children
 TRIO profile of Lysine Ornithine and Arginine
 (-) Dnase
Botulism/ Home Canned Good Intoxication = Clostridium botulinum
Tetanus = Clostridium tetani
Dx: observation of terminal swollen spores & observation of
clinical symptom “Risus Sardonicus”
 Toxins: Toxin A: Enterotoxin and Toxin B – Cytotoxin
 Diagnose is usually thru: Cytotoxin detection thru immunoassays
 Specimen:
Freshly passed stool- liquid/unformed stools for culture & toxin
assay
Formed stool/rectal swab: to detect carrier state
 Media: (CCFA) Cycloserine Cefoxitine Fructose agar
 On CCFA, C. difficile develops colonies with Horse Stable or Barn
Yard odor
 On BAP – the organism is said to fluoresce CHARTREUSE
C. perfringes – Gas gangrene/ Myonecrosis
 Double/target hemolysis
 Reverse CAMP test
 Lecithinase (+)
 Litmus milk-stormy fermentation milk
DECARBOXYLASE TEST
- Based on the ability of the organisms to remove carboxyl group
from specific amino acid thru release of the enzyme
decarboxylase
- There are 3 amino acids that can be used:
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70. The biochemical test performed on
gram (+) bacillus were consistent with
C. Diphtheriae. As a definitive test, the
laboratory scientist should now
A) perform an ELEK to determine
whether the organism produce
exotoxin
B) subculture the organism on Cystine
tellurite blood agar and examine for
black colonies
C) prepare a methylene blue stain and
examine for metachromatic granules
D) gram stain the isolate and observe
for its pleomorphic morphology
71. All of the following growth
characteristics are true of Bacillus
anthracis except:
A. inverted fir tree pattern on gelatin
media
AMINO ACID CARBOXYL
LYSINE CADAVERINE
ORNITHINE PUTRESCINE
ARGININE CITRULLINE
C & D are correct because we do staining to detech the organism.
 Staining is a preliminary step to identify a particular organism.
 If presence of organism is suspected we place it in gram stain the
isolate (to place in a suitable media to allow suitable growth)
B is incorrect because CTBA (Cystine Tellurite Blood Agar) is used as
primary isolation media.
 B C D is not definitive test for C.diphtheriae
Corynebacterium diphtheriae
 Gram (+), non-spore forming bacilli, pleomorphic rod (can assume
different forms),
 Microscopy: “palisade (organism is arrange side by side), picket-
fence, Chinese letter & xyv formation”
 Beta hemolytic on BAP
 CTBA - appears gray to black colonies
Tinsdale – appears black colonies with gray halo
Leoffler’s serum – used to enhance granules
Note! if (+) growth on all selective media. TOXIGENECITY test) must be
done (to detech if the organism that is isolated is the toxigenic type)
 Causes Diphtheria due to diphtheria toxin
 Toxigenecity Test
 Modefied Elek’s – In Vitro Test
1. Prepare agar/plated media
2. Place strip that contains antitoxin
3. Allow media to solidify
4. Inoculate for negative control single streak? (1 on the
picture)
5. Inoculate for test organism single streak (number 2 on
the pic).
Came from the growth on CTBA, Tinsdale
Take note! Inoculate organism parallel to the negative control.
6. Inoculate for positive control (number 3 on pic)
7. Positive result shows development of lines of
precipitation
 Animal Inoculation – In Vivo Test (discuss on previous slide)
If all biochem test is positive for C. diphtheriae next step is to perform
toxigenicity test.
Types of C. diphtheriae
A. Toxigenic – responsible for the disease diphtheria due to
diphtheria toxin
Non toxigenic - do not cause diphtheria
Bacillus anthracis
 Considered most significant specie in the genus bacillus because
it is a bioterrorism agaent
 Non-motile & Gamma hemolytic (uniquec to B. anthracis)
 Microscopy: Disjointed bamboo fishing rod
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B. colonies appearing like “comet tail”
C. colonies with beaten egg white
consistency
D. none of these
 Gram stain: Box Car morphology because of the square ends (not
unique to B. anthracis including C. perfringens)
 BAP: Medusa/Lion head colonies. Also describe as comet tail
appearing or “cut glass appearance”
 On plated medias it produces tenacious (malapot) “beaten egg
white” consistency
 On tube/gelatin media (semi solid media) it forms “inverted Fir
Tree or Inverted Pine tree pattern”
 Selective media is PLET (Polymyxin lysosome EDTA Thallous
acetate)
 Shows “string like pattern” because of its resistance to Penicillin
(observe under microscope)
 (+) Lecithinase test – Egg yolk agar (media)
 (+) Opaque zone around the colonies
- B. anthracis can produce enzyme lecithinase.
- Cause anthrax due to virulence factors
 Virulence factors
a. D-agglutimate capsule (capsule not polysaccharide in
nature)
b. Ability to produce exotoxin with 3 components:
1. Lethal factor
2. Edema factor
3. Protective antigen

72.Which of the following set of Clostridium perfingens

tests/procedures must be done to - Organism that causes Gas gangrene/Myonecrosis
positively identify the agent of Gas - Causative agent of gas gangrene is the spore forming c.
Gangrene? perfingens
1. Perform litmus milk test – Stormy fermentation of milk
A. Litmus milk test; CAMP test; 2. Demonstration of target/double hemolysis – done by inoculating
Demonstration of target hemolysis on BAP
B. Reverse CAMP test; Observation of 3. Reverse CAMP Test (+)
subterminal spores; demonstration of 4. Lecithinase (+)
target hemolysis a. Nuglers plate?
C. Litmus Milk test; Demonstration b. Egg yolk agar
of double hemolysis; Reverse CAMP  Camp test - to detect s. agalactiae
test  Observation of subterminal spores – not definitive for c. perfingens
D. Lecithinase test; Reverse CAMP
test; demonstration of terminal spores
73. Which of the following anaerobic Motility Lecithinase Lipase Lactose Glucose
gram + spore forming rods are motile C. - + - + +
but lecithinase and lipase negative? perfingens
1. C. perfringens C. + - + - +
2. C. tetani botulinum
3. C. botulinum
4. C. difficile C. tetani + _ _ _ _
+ - - - +
A. 1 & 3 C. difficile
B. 2 & 4 All are saccharolytic (+ for sugars) except: C tetani & C.
C. 1,2 & 3 septicum.
D. 1,2,3 & 4 Swarming (+) Anaerobe: C. tetani & C. septicum.
E. none Note!
 Proteus produces swarming but it is facultative
anaerobe & gram (-) bacilli
 C. tetatni produces swarming anaerobe & gram (+)
74. All of the following are saccharolytic Clostridium tetani
anaerobic gram + spore forming rods - Nonsaccharolytic (-) for sugars
EXCEPT
A. C. perfringens
B. C. tetani
C. C. botulinum
D. C. difficile

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75. An unknown isolate that had  Erysipelothrix rhusiopathiae
developed umbrella like growth on agar - If inoculated on gelatin media it show bottle brush like/test tube
surface of gelatin medium is likely to be brush like or pipe cleaner pattern of growth
A. B. anthracis - ability to produce large amounts of H2S on TSI (H2S +)
B. L. monocytogenes  Listeria monocytogenes
C. E. rhusiopathiae - Develop umbrella like growth on agar surface of gelatin medium
D. none of these (not distinct)
- Tumbling /end over end motility at room temp. (distinct)

76. Bovine mastitis can be attributed to Corynebacterium diphtheriae is considered significant

which of the following Corynebacterium  C. ulcerans – acquired through contact with infected animal or
species? consumption of unpasteurized milk/milk products
A. C. minutissimum  C. minutissimum - Erythrasma
B. C. pseudotuberculosis Corynebacterium Bovine mastitis
C. C. ulcerans ulcerans
D. C. jeikeium Corynebacterium Lymphadenitis
pseudotuberculosis
Corynebacterium Throat flora
pseudoodiphtherinticum Endocarditis
Aka Hoffman’s Bacillus
Corynebacterium Erythrasma (skin
minutissimum infection affecting
inguinal in axillary
region
Corynebacterium UTI
urealyticum Catalase &
urease (+)
Corynebacterium Prosthetic heart
jeikium valve infection
Aka JK Bacillus
77. Which genera is likely if the Non- spore forming & non-branching bacilli
following results are obtained: Motility Catalase Motility Esculin H2S
(+); H2S (-); Catalase & Esculin (+) test in
A. Corynebacterium TSi
B. Erysipelothrix Corynebacterium + - V -
C. Listeria Listeria + + + -
D. Gardnerella Erysipelothrix - - - +
Gardenella - - - -
vaginalis
78. In which of the following media that  Lowenstein media & Wallenstein medium
when used will allow observation of - Classified as egg-based medium (opaque media cannot detect
pigment production? pigment production)
A. Middlebrook 7H10  Middlebrook 7H10
B. Wallenstein Medium C. Lowenstein - Agar based is a clear media used to detect pigment production
Media > All three are used in isolating Mycobacterium
D. All of these

79. Which of the following differential T2H/TCH susceptibility (Thiopene-2-carboxylic hydrazide)

tests may be done for M. tuberculosis  M. tuberculosis – resistant
and M. bovis?  M. bovis – susceptibe
1. T2H susceptibility Nitrate reduction
2. Niacin Test - M. tuberculosis (+)
3. Nitrate Reduction - M. bovis (-)
Niacin test
A. 1 & 2 - M. tuberculosis (+)
B. 2 & 3 - M. bovis (-)
C. 1 & 3 All three test is useful in differentiating M. tuberculosis (+) & M. bovis (-)
D. 1,2 & 3
E. none of these

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80. The color change that may indicate  Rusty brown color ((+) result)
a positive Niacin accumulation - Iron uptake test
A. rusty brown color - Uses ferric ammonium citrate
B. pink - Lowenstein media
C. black  Pink
D. yellow a. Arylsulfatase test (uses Phenolphthalein media; 2N sodium
carbonate)
b. Tween 80 hydrolysis test (uses neutral red as indicator)
- Rapid tween (+) M. kansaii
10 days (+) M. tuberculosis
 Black
- Tellurite Reduction Test (based on the ability of certain
mycobacteria to reduce tellurite salts to metallic tellurium (good
test to detech M. Aviium?)
 Yelow
- Niacin test
> All three are biochem test are used to detech Mycobacterium genus

81. All of the following are true M. leprae “Hansen’s bacillus”

concerning M. leprae except
A. non-cultivable but viability can be  cigar packet appearance
maintained using testicular chancre  Fite Faraco method – hematoxylin (counter stain)
of rabbits  Leprosy (chronic disease) lasts for several years
B. Microscopically forms the so-called
“cigar packet” arrangement 2 types of leprosy:
C. can be best visualized using Acid
 Tuberculoid type/paucibacillary- usually benign & least contagious
Fast Staining using Fite Faraco method
 Lepromatous type/multibacillary- the type that becomes malignant
D. can infect skin, mucous membranes
and peripheral nerves Basis of diagnosis clinical symptoms

 Skin sores or lesions that do not heal after several weeks

 Skin lumps and bumps that can be disfiguring
 Numbness of the skin because of damage to the nerves under the
skin
 Muscle weakness

M. leprae is non-cultivable/cultureable but..

To maintain viability of M. leprae we use:

 Mice foot pads or foot pads of Armadillo

T. pallidum (syphilis) – testicular chancre of rabbits (culture)

82. Enteroinvasive E. coli (EIEC) may E. coli 2 major serotypes:

produce infection similar to which of the
following?  UPEC- uropathogenic E.coli
A. Bacillary Dysentery  NPEC- non-pathogenic E.coli
B. typhoid fever
C. typhus fever Enteroinvasive E. coli (EIEC) – bloody diarrhea (shigella like)(comparable
D. none of these to)(shigellosis)

 Typhoid fever- Salmonella serotype typhi

 Typhus fever- Rickettsia spp.

83. Bacillus anthracis is a medically

important spore-forming rod that may
EXTERNAL
cause the disease "anthrax" in animals
INTERNAL
and humans. What are the two
Cutaneous Anthrax Pulmonary Anthrax Intestinal Anthrax
important virulence factors of this
(most common, least (least common, most
organism?
severe) severe)
A. capsule & enterotoxins
Black Eschar Woolsorte’s disease Ingestion of
B. exotoxins & enterotoxins
Ragpicker’s disease improperly cooked
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C. endotoxin & capsule
D. capsule & exotoxin
84. Which of the following can cause
infections in humans through a
puncture wound and ultimately enter
the CNS
releasing a potent neurotoxin that could
later cause muscle paralysis?
A. Bacillus anthracis
B. Clostridium botulinum
C. Clostridium tetani
D. Bacillus ceresu
85. A 50 years old patient who had his
kidney transplant 6 months ago visited
the hospital with pneumonia like
symptoms for 2 months, the infection
was similar to tuberculosis. The chest
x-ray examination revealed a typical
feature of tuberculosis infection. A
photochromogenic (orange pigment
when exposed to UV light) acid-fast rod
bacterium was isolated from the
sputum sample. The identified bacteria
is:
A. M. avium
B. M. kansasii
C. M. ulcerans
D. M. leprae
86. The nitrate reduction test is one of
the primary biochemical tests in
identifying M. tuberculosis, which of the
following biochemical test is useful in
the identification of lipase producing M.
kansasii?
A. Tween 80 Hydrolysis Test
B. Niacin test
C. Tellurite Reduction
D. Arylsulfatase test
87. Which type of E. coli infection can
be severe with life-threatening
consequences such as hemolytic
uremic
syndrome?
A. ETEC
B. EPEC
Hide Porter’s disease infected meat
(Acquired thru)
Inhilation of spores
while handling wool.
Bacillus anthracis
 most significant bacillus (agent of bioterrorism)
 named as such because it can cause ANTHRAX acquired thru
contact with infected animals & animal products
VIRULENCE FACTORS are:
1) D-glutamate capsule
2) Ability to produce exotoxin with 3 components (a lethal factor, an
edema factor, and protective antigen)
Clostridium tetani – (tetanus) symptoms is risus sardonicus triggered by
lockjaw
Bacillus cereus – sporeformer implicated in cases of food poisoning
Clostridium botulinum
 neurotoxic organism and can cause paralysis but not implicated in
cases of wound infection.
 Causes fatal type of food poisoning
 M.leprae – not classified under Runyon’s causes leprosy- a
disease affecting the skin, mucuos membrane & peripheral nerves
 M.ulcerans – classified as NON-PHOTOCHROMOGEN; causes
BURULI ULCERS
 M.avium non-photochromogen but regarded as #1 NTM to cause
TB in immunocompromised host i.e HIV(+) patients
 M.kansasii - PHOTOCHROMOGEN; #2 NTM to cause TB in
those with AIDS ; Rapid Tween Hydrolysis (+)
RUNYON’S CLASSIFICATION
 Photochromogens – pigmented when exposed to light
 Scotochromogens – pigmented in the dark and when exposed to
light
 Nonphotochromogens – unable to develop pigment
 Rapid Growers – can produce colonies/growth in 3-5 days
Niacin test & Arylsulfatase test- negative in M.kansasii
Tellurite Reduction- variable result in M.kansasii
Tween 80 Hydrolysis Test – (rapid) M.kansasii can be noted in 3-6 days
All choices are classified as diarrhea genic or enterovirulent E. coli.
all can cause diarrhea
ETEC
 Causes profuse/severe watery diarrhea cholera like
 “Traveller’s diarrhea
 Can produce toxin
EPEC
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C. EHEC  causes diarrhea in infant (non-toxigenic & non-invasive)
D. EIEC  Infantile diarrhea
EIEC
 causes bloody diarrhea similar to some shigella specie because it
is invasive (can invade bowel/intestinal mucosa)
EHEC/Vero Toxic E. coli (VTECT/STEC)
 shiga toxin like producing E. coli that causes severe blood
diarrhea due to production of potent toxin Vero Toxin.
 Infection can lead to hemorrhagic colitis & hemolytic uremic
syndrome
 Life threatening
 Most significant
88. Which of the following members of Serratia
Family Enterobacteriaceae is noted for  Procude a red pigment called prodigiosin
its production of a red pigment called  Genus is noted to produce number of enzyme
prodigiosin? a. Dnase (+)
A. Klebsiella b. Lipase (+)
B. Enterobacter c. Gelatinase (+)
C. Serratia Klebsiella
D. Shigella  Unique is the deposition of capsule
 Known to produce mucoid colonies
 Non motile
& Shigella
 Non motile (unique)
 Intestinal pathogen
 Invasive that results to bloody diarrhea
Enterobacter sakazakii/Chronobacter sakazakii
 Produce yellow pigment that intensifies at room temp.

89. Green colonies with black center Hektoen Enteric Agar

developing on Hektoen Enteric Agar is  Selective (gram (-) enteric bacilli)
most likely which of the following  Differential media differentiates fermenter (develops yellow
species? colonies) to non-fermenters (develops green colonies) due to
A. E. coli bromthymol blue as indicator
B. Salmonella spp. E. coli
C. Shigella spp.  Lactose fermenter
D. K. pneumoniae  Yellow colonies on HEA
 H2S (-) do not produce blackening on media
K. pneumoniae
 Lactose fermenter
 Yellow colonies on HEA
 H2S (-) do not produce blackening on media
Salmonella
 Non lactose fermenter
 Green colonies on HEA
 H2S (+)
Shigella
 Non lactose fermenter
 Green colonies on HEA
 H2S (-)

90. Choose the incorrect pair between Malonate utilization test

biochemical test & positive result  Blue (+)
A. Malonate utilization Test – blue  Green (-)
B. Vogues-Proskauer Test – pink to red  Bromthymol blue as an indicator
color Vogues-Proskauer Test
C. Phenylalanine Deaminase Test –  Pink to red color (+)
yellow  Part of IMViC
D. Lysine Decarboxylase test – purple  Use alpha-naphthol & KOH
Lysine decarboxylase test
 Purple (+)
 2 medias use in decarboxylase test
1) LIA
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 2) Moeller’s broth
Deaminase Test
 To detect Proteus-Providencia & Morganella
 3 medias used
1) Phynelalanine agar – green (+)
2) Tryptophan – brown (+)
3) LIA – burgundy/red (+)

91. Cold enrichment of feces 4 types of bacteria (temperature)

(incubation at 4°C) in phosphate-
buffered saline prior to subculture
onto enteric media enhances the
recovery of:
A. Enterotoxigenic E. coli
B. Salmonella paratyphi
C. Hafnia alvei
D. Y. enterocolitica
Psychrophilic – COLD LOVING – able to grow between 0-20 degC
Mesophilic – Able to grow at MODERATE temperature 20-40 degC
Thermophilic – HEAT LOVING
Thermoduric – Not growing well at high temperature but can withstand
exposure to high temperature
Many bacteria are MESOPHILIC, it is the reason why the incubator is
set at 35 to 37 degC
Listeria monocytogenes – Gram (+) bacilli that can also tolerate cold
enrichment

92. Bromthymol blue is used as XLD – Phenol red

indicator in which of the following Mac Conkey and SSA – Neutral red
media? TSI – Phenol red
1. XLD
Bromthymol blue is used as indicator in HEA, Malonate and Citrate
2. Mac Conkey Agar
3. SSA utilization test
4. TSI

A. 1 & 3
B. 2 & 4
C. 1,2 & 3
D. 1,2,3 & 4
E. none of these

93. Members of Family
Enterobacteriaceae are primarily
classified on the basis of
A. Mannitol fermentation
B. Lactose fermentation
C. catalase & Oxygen reaction
D. B & C only
Mannitol fermentation – To classify species in the Genus Staphylococcus
S. aureus Mannitol (+) while S. epidermidis and S. saprophyticus (CoNS)
are Mannitol (-)
Catalase and Oxygen – To differentiate the SPORE FORMING GENERA:
Bacillus and Clostridium
Catalase (+) and Aerobic – Genus Bacillus
Catalase (-) and generally Anaerobic – Genus Clostridium

94. Which of the following enteric bacilli
can produce growth appearing as
clumps of cells adhering to one side of
the
tube forming the so-called “stalactite
pattern”?
A. Yersinia pestis
B. Yersinia enterocolitica
C. Klebsiella pneumoniae D. Proteus
mirabilis
Y. enterocolitica – BULL’S EYE COLONIES (pink colonies with red center)
on CIN
K. pneumoniae – Mucoid colonies that tend to STRING because of
capsule
Proteus mirabilis – colonies with BURNT GUN/BURNT CHOCOLATE
odor; swarming on BAP
Y. pestis – FLOCCULENT GROWTH or STALACTITE growth in Liquid
media
- hammered copper colonies (shiny or glistening colonies) on BAP in 48
hours, bioterrorism agent, plague agent

95. Which of the following can be used MAC – SOR – Mac Conkey – Sorbitol is a Mac Conkey agar without
as selective enrichment for growth of LACTOSE but with SORBITOL; used to detect E. coli serotype O157:H7
Salmonella spp? (specific example of EHEC) is said to be Lactose (+) but Sorbitol (-)
A. MAC-SOR
BGA (Brilliant Green Agar) – Selective isolation media for Salmonella
B. BGA
C. Alkaline Peptone water except S. typhi
D. Selenite Broth Indicator (BGA) – Phenol Red
Alkaline Peptone Water – Enrichment media for the genus Vibrio

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96. CIN medium contains
_____________as fermentable CHO
and ______________as indicator.
A. lactose; phenol red
B. mannitol; phenol red
C. mannitol; neutral red
D. Lactose; neutral red
97. Clostridium difficile is most
commonly identified thru
A. demonstration of cytotoxin
B. isolation of organism in stool culture
C. detection of hemolysis on BAP
D. all of these
98. Colorless growth on Mac Conkey
agar and colonies with burnt gun
powder odor characterize which of the
following
species?
A. Providencia rettgeri
B. B. Proteus vulgaris
C. Morganella morganii
D. Plesiomonas shigeloides
99. All of the following Mycobacterium
species can cause skin infections
EXCEPT:
A. M. marinum
B. M. ulcerans
C. M. haemophilum
D. M. kansasii
100. The Mycobacterium species most
likely to be isolate from hot water
system of hospital and can grow when
incubated at 42 degC.
A. M. marinum
B. M. ulcerans
C. M. haemophilum
D. M. xenopi
Selenite Broth – Selective enrichment media for Salmonella and Shigella
XLD – May contain lactose as one of the fermentable CHO and phenol
red as indicator
MSA – contains mannitol and phenol red
Mac Conkey Agar – Contains Lactose as CHO and neutral red as
indicator
*XLD and Mac Conkey are SELECTIVE – DIFFERNTIAL MEDIA for
gram negative enteric bacilli
*MSA – Is for Staphylococcus aureus
CIN – contains mannitol, neutral red as indicator and novobiocin
C. difficile is classified as gram (+), spore former
-Causes Pseudomembranouscolitis/antibiotic associated diarrhea
-Produces Toxin A (Enterotoxin) and Toxin B (Cytotoxin)
-Detection is usually thru CYTOTOXIN DETECTION (Toxin b) thru
immunoassays
BAP – Fluorescence chartreuse – Yellow fluorescence
CCFA – Colonies with horse stable or barn yard odor
C. difficile is culturable but seldom use
Morganella spp. Providencia spp.
Mac Conkey NLF and COLORLESS NLF and COLORLESS
HEA COLORLESS COLORLESS
XLD RED/COLORLESS YELLOW/COLORLESS
Plesiomonas shigelloides – BAP Shiny, opaque colonies, non – hemolytic
Mac Conkey – LF or NLF (not commonly used)
M. kansasii – potentially pathogenic; can cause chronic pulmonary
disease
M. marinum – cause skin infection (swimming pool granuloma/fish tank
granuloma)
M. ulcerans – cause skin infection (buruli ulcer)
M. haemophilum – also an agent of skin infection
M. marinum – swimming pool granuloma/fish tank granuloma = classified
as photochromogen
M. ulcerans – Buruli ulcer/Bairnsdale ulcer = classified as Non –
photochromogen
M. haemophilum – Disseminated disease, cutaneous disease in
immunocompromised
M. xenopi – “bird’s nest appearing colonies” on cornmeal agar (media for
fungi particularly candida albicans)
- causes pulmonary disease
- this is the mycobacterium species that can be isolated or most likely to be
recovered from hot water systems of hospitals
- transmitted via aerosols
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