MLS

046 Prepared by: Ebuña, MJCP

D. Candida albican
MYCOLOGY AND VIROLOGY
MODULE 1: Basic Concepts of Myclogy
MODULE 2: Principles of Fungous Disease
1. Blastoconidia are the beginning of which structures?
1. Identify if the following are fungal virulence factor or not.
A. Arthroconidia B. Germ tubes
Place a checkmark if correct, or cross mark if not.
C. Pseudohyphae D. True hyphae
a.____ motility
2. Dimorphich molds are found in infected tissue in which
b.____ capsule formation
form?
c.____ dimorphism
A. Mold phase B. Yeast phase
d.____ growth at RT
C. Encaspsulated D. Latent
e.____ size of fungal spores
3. Which group of molds can be ruled out when septate
2. Classify the following mycoses according to anatomical
hyphae are observed in a culture?
sites: superficial, dermatophytosis, subcutaneous, systemic
A. Dematiaceous B. Zygomycetes
and opportunistic.
C. Dermatophytes D. Dimorphic molds
a. Tinea capitis _____________________
4. Fungi that undergo asexual reproduction are term:
b. Tinea nigra _____________________
A. Imperfect B. Aseptate
c. Histoplasmosis _____________________
C. Perfect D. Septate
d. Cryptococcus mengitis _____________________
5. A fungus that reproduces sexually is called a/an:
e. Oral candidiasis _____________________
A. Anamorph B. Holomorph
f. Chromomycosis _____________________
C. Teleomorph D. Synanamorph
g. Coccidioidomycosis _____________________
6. The following are characteristics of yeast, EXCEPT
h. Black Piedra _____________________
A. Round or oval cells
i. Sporotrichosis _____________________
B. Form cottony or fluffy colonies
j. Pityriasis versicolor _____________________
C. Reproduce by budding
D. Unicellular
MODULE 3: Laboratory Methods for Fungal Infections
7. Fungi that have both yeast and mold forms in the same
1. For which clinical specimens is the potassium hydroxide
culture are:
direct mount technique for examination of fungal elements
A. Dimorphic fungiB. Hyaline fungi
used?
C. Dematiaceous fungi D. Polymorphic fungi
A. Skin B. Blood
8. The following fungal classes exhibit both asexual and
C. CSF D. Bone marrow
sexual modes of reproduction, EXCEPT
2. Which of the following is MOST OFTEN used to prepare
A. Basidiomycetes B. Deuteromycetes
a slide from as plate culture of a dermatophyte for
C. Ascomycetes D. Zygomycetes
microscopic observation?
9. Which among the following is NOT a product of fungal
A. Lactophenol cotton blue B. Iodine solution
sexual reproduction?
C. Potassium hydroxide D. Gram stain
A. Ascospores B. Sporangiospores
3. The India ink stain is used as a preservative test for the
C. Basiodiospores D. Zygospores
presence of which organism?
10. An organism that demonstrates budding yeast cells with
A. Aspergillus niger in blood
wide capsules in an India ink preparation of spinal fluid is
B. Histoplasma capsulatum in CSF
most probably____.
C. Cryptococcus neoformans in CSF
A. Cryptococcus neoformans
D. Candida albicans in blood or other body fluids
B. Blastomyces dermatitidis
C. Histoplasma capsulatum
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4. What is the first step to be performed in the identification A. Yeast, pseudohyphae, and true hyphae
of an unknown yeast isolate? B. Filaments with lots of arthroconidia
A. Gram stain smear B. Catalase test C. Clusters of round fungal cells with short, curbed, septate
C. India ink stain D. Germ tube test hyphae.
5. The Gram stain is usually not applied to most fungal D. Cigar-shaped yeasts
species since it may obscure internal structures, EXCEPT 2. Malassezia furfur can identified diagnostically by:
for: A. “spaghetti and meatballs” mx appearance
A. Aspergillus B. Candida B. Brwon, 2-celled yeast appearance
C. Blastomyces D. Cryptococcus C. SDA culture w/ olive oil
6. Fungi are poorly stained or too sparse to be detected by D. A,B, and C
route stains. However, _______ and ________ can be used 3. Predisposing factors to tinea flava include _____.
since neither the internal contents nor the capsular material A. Malnutrition
is stained by them. B. Excessive perspiration
A. Calcoflour and rhodamine dye C. Corticosteroids treatment
B. PAS and methenamine silver D. A, B, and C.
C. Eosin and hematoxylin 4. In tinea nigra, the brown lesions ______.
D. PAS and Gram stain A. Resemble a AgNO3 stain
7. Which of these stains is considered as the best stain to B. Resemble melanoma
detect fungal elements in tissue sections? C. Are darkest at the central palm area
A. Acid fast stain B. Methenamine silver stain D. A, B, and C.
C. Calcoflour white stain D. Periodic acid Schiff stain 5. Tinea nigra palmaris is caused by _______.
8. Which microscopic method is preferred to examine nails, A. Cladosporium werneckii
skin, or hair? B. Exophiala werneckii
A. Saline mount B. India ink C. Hortaea werneckii
C. KOH preparation D. Giemsa stain D. A, B, and C
9. Which of the following techniques best maintains the 6. Which of these organisms is the usual cause of white
microscopic morphology of the fungus? piedra?
A. Tease mount B. Slide culture A. Malassezia furfur B. Piedraiae hortae
C. Cellophane preparation D. India ink C. Microsporum canis D. Trichosporum beigelii
10. Gram stain examination of a CSF specimen indicates the 7. Identify this superficial fungus: hyphae are dark brown
presence of yeast-like cells with gram positive granular and closely septate; arthroconidia and chlamydospores are
inclusions. Which of the following techniques should be used present.
next to assist in the identification of this organism? A. Exophiala werneckii B. Malassezia furfur
A. 10% KOH C. Piedraia hortae D. Trichosporon beigelii
B. India ink 8. Lipid such as olive oil are needed to grow this fungus in
C. Lactophenol cotton blue culture.
D. Periodic acid-Schiff A. Exophiala werneckii B. Malassezia furfur
C. Piedraia hortae D. Trichosporon beigelii
MODULE 4: Superficial Fungi 9. A neonatal blood culture collected through a catheter
1. A patient has spotchy hypopigmentation on the chest and grows a small yeast. Microscopically, the yeast appears
back with only slight itchiness. What is most likely to be seen round at one end, with a budlike structure on a broad base
on a KOH mount of the skin scrapping?

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at the other end. Growth is enhanced around olive oil- 6. Which Trichophyton species causes the favus type of tinea
saturated discs. The organism isolated is _________. capitis?
A. Candida tropicalis B. Malassezia furfur A. T. verrucosum B. T. tonsurans
C. Candida lipolytica D. Malassezia pachydermis C. T. violaceum D. T. schoenleinii
10. Depigmentation in pityriasis versicolor is due to: 7. The Hair Baiting Test is used to differentiate which two
A. High concentration of dicarboxylic acid species of Trichophyton that produce red colonies on
B. Excessive perspiration Sabouraud agar plates?
C. Erosion of stratum corneum A. T. mentagophytes and T. rubrum
D. A, B, and C B. T. tonsurans and T. violaceum
C. T. tonsurans and T. schoenleinii
MODULE 5: Dermatophytes D. T. verrucosum and T. rubrum
1. Cutaneous disease involving skin, hair, and nails usually 8. In a direct examination of a KOH wet mount of a nail
indicates an infection with a/an ___________ specimen, E. floccosum could be detected as ____
A. Dimophic fungus B. Zygomycetes A. Arthroconidia B. Macroconidia
C. Dermatophyte D. Candida species C. Blastoconidia D. Microconidia
2. Which of the following structures is invaded by the genus 9. A fungus infecting only the skin and nails typically
Trichophyton? produces in culture _____
A. Hair B. Nails A. Spindle-shaped, hyaline, echinulate macroconidia and
C. Skin D. A, B, and C microcnidia
3. Which Microsporum species causes an epidemic form of B. Cylindrical or club-shaped, smooth, thin-walled
tinea capitis in children? macroconidia and microcnidia
A. Microsporum canis C. Many microconidia in clusters or along the hyphae
B. Microsporum gypseum D. Largem thin-walled, club-shaped macroconidia without
C. Microsporum audouinii microconidia
D. A, B, and C 10. A 4-year-old child’s hair is falling out in platelets. The
4. An organism cultured from the skin produces colonies hair flourences when subjected to the UV light from a
displaying a cherry-red color on SDA after 3-4 weeks and Wood’s lamp. When the hair is cultured, a white cottony
teardrop-shaped microconidia along the sides of the hyphae. mold grows at 25 C on potato dextrose agar.
The most likely identification is _______ Microscopically, rare microconidia, septate hyphae, and
A. Tricophyton rubrum terminal chlamydospores are seen. Macroconidia are absent.
B. Trichophyton schoenleinii The mould fails to grow on polished rice grains. The
C. Trichophyton tonsurans causative agent is ________
D. Trichophyton violaceum A. Microsporum audouinii
5. Microscopic examination of a fungus cultured from a B. Microsporum gypseum
patient with athlete’s foot showed large, smoothed-walled, C. Trichophyton mentagrophytes
club shaped macroconidia appearing singly or in clusters of D. Trichophyton rubrum
two to three from the tips of short conidiosphores. The
colonies did not produce microconidia. What is the most MODULE 6: Subcutaneous Fungi
likely identification? 1. Chromomycosis is a slowly granulomatous infection that
A. Trichophyton spp. B. Epidermophyton spp. is caused by _______
C. Alternaria spp. D. Microsporum spp. A. Fonsecaea B. Cladosporium
C. Phialophora D. A, B, and C

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2. Which is TRUE regarding Madurella mycetomatis? 1. The India ink stain is used as a presumptive test for the
A. Causes Madura foot presence of which organism?
B. Dematiaceous fungi A. Aspergillus niger in blood
C. Produces brown pigmented colonies B. Cryptococcus neoformans in CSF
D. A, B, and C C. Histoplasma capsulatum in CSF
3. Which of the following subcutaneous mycoses can also be D. Candida albicans in blood or body fuids
caused by Actinomycetes? 2. An isolate from CSF growing on cornmeal-agar produces
A. Chromomycosis B. Sporotrichosis the following structures:
C. Mycetoma D. A, B, and C Blastoconidia – Positive Pseudohyphae- Negative
4. ________ will form germ tubes when incubated in water Chlamydoscpores- Negative Arthroconidia – Neg
at 25 C for 24 hours. Which test should be performed next?
A. Alternaria B. Curvularia A. Birdseed agar and urease
C. Bipolaris D. Exophiala B. India ink and germ tube
5. Chains of more than 30 blastoconidia are microscopically C. Germ tube and glucose
demonstrated by _______ D. A, B, and C
A. Alternaria B. Cladosporium 3. Which of the following yeast enzymes is detected using
C. Fonsecaea D. Phialophora birdseed (niger seed) agar?
6. The following are agents of white grain mycetoma A. Phenol oxidase B. Urease
EXCEPT _______ C. Catalase D. Nitrate reductase
A. Acremonium B. Fusarium 4. A germ tube-negative, pink yeast isolate was recovered
C. Curvularia D. Pseudallescheria from the respiratory secretions and urine of a patient with
7. Which medium is best to enhance the cleistothecium AIDS. Given the following results, what is the most likely
production of Pseudallescheria boydii? identification?
A. Potato flake agarB. Potato carrot agar Cornmeal Tween Agar
C. Potato dextrose agar D. Sabouraud’s dextrose agar Blastoconidia-Positive Pseudohyphae-Negative
8. Optimal antifugal treatment for mycetoma is _____ Arthroconidia- Negative Urease- Positive
A. Amphotericin B B. Miconadazole A. Candida albicans B. Cryptococcus spp.
C. Ketoconazole D. SSKI C. Rhodotorula spp. D. Trichosporon spp.
9. Infection with Sporothrix schenckii is an occupational 5. A rapidly growing hyaline mld began as a white colony
hazard for gardeners. The portal of entry for this organism but soon developed a black “pepper” effect on the agar
is via which of the following routes? surface. The older colony produced a black matte, making it
A. Lymphatic system B. Respiratory tract resemble a dermatiaceous mold. What is the most likely
C. Mucous membranes D. Skin identification?
10. A section of tissue from the foot of a person assumed to A. Penicillium notatum B. Paecilomyces spp.
have eumycotic mycetoma shows a white, lobulated granule C. Aspergillus niger D. Scopulariopsis spp.
composed of fungal hyphae. Which of the following is the 6. Which Aspergillus species, recovered from sputum or
most likely pathogen? bronchial mucus, is the most common cause of pulmonary
A. Acremonium B. Madurella aspergillosis?
C. Actinomyces D. Pseudallascheria A. A. niger B. A. fumigatus
C. A. flavus D. A, B, and C
MODULE 7: Opportunistic Fungi 7. A hyaline mold recovered from a patient with AIDS
produced rose-colored colonies with lavender centers on

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Sabouraud dextrose agar. Microscopic examination showed A. Candida tropicalis

multiseptate macroconidia appearing as sickles or canoes. B. Cryptococcus neoformans
What Is the most likely identification? C. Candida kefyr (pseudotropicalis)
A. Fusarium spp. B. Exphiala spp. D. Candida albicans
C. Wangiella spp. D. Phialophora spp. 14. Chlamydospore production is demonstrated by which
8. Material from a fungus-ball infection produces colonies Candida species?
with a green surface on SDA in 5 days at 30 C. Microscopic A. Candida glabrata B. Candida albicans
examination showed club-shaped vesicles with sporulation C. Candida krusei D. Candida tropicalis
only from the top half of the vesicle. This hyaline mold is 15. Carbohydrate assimilation test are used for the
most probably which Aspergillus spp? identification of yeast isolates by inoculating media ______
A. A. niger B. A. flavus A. Free of carbohydrates
C. A. fumigatus D. A. terreus B. Free of niger seed
9. A rapidly growing nonseptate mold produced colonies C. Containing carbohydrates
with a gray surface resembling cotton candy that covered D. Containing yeast extract
the entire plate. Microscopic examination revealed 16. Yeast recovered from the urine of a catheterized patient
sporangiosphores arising between, not opposite, the rhizoids receiving chemotherapy for cancer gave the following
and producing pear-shaped sporangia. What is the most results:
likely identification? Cornmeal Tween Agar
A. Absidia spp. B. Rhizopus spp Germ Tube – Positive Arthroconidia – Negative
C. Penicillium spp. D. Aspergillus spp. Pseudohyphae – Pos Chlamydospores – Pos
10. A lung biopsy obtained from an immunocompromised Blastoconidia – Pos
patient showed many “cup-shaped” cyst (gray to black) in a What further testing is necessary?
foamy exudate (green background) using Gomori A. Carbohydrates assimilation and urease
methenamine silver (GMS) stain. The organism cannot be B. Nitrate reductase and carbohydrate fermentation
cultured because it does not grow on routine culture media C. Urease and Niger seed
for molds. The patient was diagnosed with pneumonia that D. No further testing is needed for identification
resisted antibiotic treatment. The most likely identification is 17. Which of the following types of Candida albicans
_____ infection is commonly acquired from an exogenous source?
A. Pneumocystis jiroveci A. Diaper rash B. Perianal infection
B. Scopulariopsis spp. C. Neonatal thrush D. UTI
C. Aspergillus fumigatus 18. The most useful finding for prompt, presumptive
D. Rhizopus spp. identification of C. albicans is its ______
11. What is the first step to be performed in the A. Failure to assimilate sucrose
identification of an unknown yeast isolate? B. Production of Chlamydospores
A. Gram stain smear B. Catalase test C. “Feathering” on EMB
C. India ink stain D. Germ tube test D. Production of germ tubes
12. Cornmeal agar with Tween 80 is used to identify which 19. Which of the following is likely to be found in clinical
characteristics of an unknown yeast isolate? specimens as normal microflora and as clinically-significant
A. Hyphae (true and pseudo) B. Chlamydospores isolate?
C. Blastconidia and arthroconidia D. A, B, and C A. Aspergillus niger
13. Which of the following yeast is characteristically positive B. Penicillium marneffei
for germ tube production? C. Paracoccidioides brasiliensis

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D. Candida albicans 40*. At 37 C, the yeast form grew more slowly, showing
20. Candida albicans and Candida dubliniensis both can conidia that formed hyphal elements breaking at the septa to
produces germ tubes. Which of the following tests will produce oval arthroconidia. This thermo-dimorphic mold is
differentiate them? most likely____
A. Gram stain B. Growth at 42 C A. Paecilomyces spp. B. Penicillium marneffei
C. KNO3 assimilation test D. Urease test C. Rhizomucor spp. D. Aspergillus fumigatus
5. A thermally dimorphic fungus shows a filamentous mold
MODULE 8: Systemic Fungi from with tuberculae macroconidia at room temperature,
1. The mycelial form of which dimorphic mold produces and a yeast form above 35 C. Which organism best fits this
thick-walled, rectangular, or barrel-shaped alternate description?
arthroconidia? A. Histoplasma capsulatum
A. Coccidioides immitis B. Paracoccidioides brasiliensis
B. Sporothrix schenckii C. Candida albicans
C. Histoplasma capsulatum D. Coccidioides immitis
D. Blastomyces dermatitidis 6. Identify the dimorphic fungus that typically has a tissue
2. A bone marrow sample obtained from an phase in which the large mother cells have one to a dozen
immunocompromised patient revealed small intracellular narrow-necked buds and a slowly growing mycelial form
cells using a Wright’s stain preparation. Growth on with intercalary chlamydoconidia and coiled hyphae.
Sabouraud-dextrose agar plates of a mold at 25 C and a A. Blastomyces dermatitidis
yeast phase at 37 C designates the organism as dimorphic. B. Coccidioides immitis
The mold phase produced thick, spherical tuberculated C. Histoplasma capsulatum
macroconidia. What is the most likely identification? D. Paracoccidioides brasiliensis
A. Histoplasma capsulatum 7. In tissue infected with Histoplasma capsulatum _______
B. Sepedonium spp. A. The hyphae usually invade blood vessels
C. Sporothrix schenckii B. Encapsulated yeast cells are typical
D. Coccidioides immitis C. Tuberculate macroconidia are typical
3. Upon direct examination of a sputum specimen, several D. The fungus is usually intracellular
spherules were noted that contained endospores. Growth on 8. Identify the dimorphic fungus that typically has a tissue
Sabouraud-dextrose agar showed aerial mycelial elements. phase in which the large mother cells have on to a dozen
The septate hyphae produced barrel-shaped arthroconidia. narrow-necked buds and a slowly growing mycelial form
What is the most likely identification? with intercalary chlamydoconidia and coiled hyphae.
A. Penicillium marneffei A. Blastomyces dermatitidis
B. Scopulariopsis spp. B. Coccidioides immitis
C. Cryptococcus neoformans C. Histoplasma capsulatum
D. Coccidioides immitis D. Paracoccidioides brasiliensis
4. A bone marrow specimen was obtained from an 9. A KOH preparation of repiratory secretions of a 78 year
immunocompromised patient who tested positive for HIV. old man reveals large, spherical, thick-walled yeast cells 8 to
The organism grew rapidly at 3 days showing a mold from 15 mm in diameter, usually with a single bud that is
(at 25 C), displaying conidiophores with four to five terminal connected to the patient cell by a broad base. Which fungus
metulae with each having four to sex phialides. The conidia will likely be isolated from the culture?
at the end of the phialides were oval and in short chains. A. Coccidioides immitis
They appear as a fan or broom when viewing under 10* and B. Blastomyces dermatitidis

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C. Histoplasma capsulatum
D. Paracoccidioides brasiliensis
10. A mold is isolated in the laboratory that displays a
velvety, gray-green colony morphology. On microscopic
evaluation, flash-shaped conidiospores arranged in a
brushlike formation are seen. The most likely organism is
which of the following?
A. Penicillium sp.
B. Acremonium sp.
C. Paecilomyces sp.
D. Scopulariopsis sp.