SSESSION 19

1. A Routine laboratory testing for Treponema pallidum involves _______________________.

A. Culturing C. Acid-fast staining
B. Serological analysis D. Gram staining

2. The Spirochetes often detected in the hematology laboratory, even before the physician suspects the
infection, are: _____________.
A. Borrelia spp C. Leptospira spp.
B. Treponema spp. D. A, B, and C

3. The axial fibrils of spirochetes most closely resemble which bacterial structure?
A. Cell membrane C. Pilus
B. Flagellum D. Sporangium

4. Which of the following organisms is the cause of Lyme disease________________.

A. Treponema pallidum C. Babesia microti
B. Neisseria meningitidis D. Borrelia burgdorferi

5. The diagnostic method most commonly used for the identification of Lyme disease is _________.
A. Serology C. Gram stain
B. Culture D. Acid-fast stain

6. Following a hike in the woods, a young male noted a tick on his ankle. He removed the tick, but 2
weeks later noticed a circular, bull’s eye rash at the site of the bite. Which specimen(s) should be
obtained to establish a diagnosis of Lyme borreliosis?
A. Lymph node biopsy, skin scraping C. Hair, fingernails
B. Blood, CSF, and skin biopsy D. Saliva, sputum

7. During the first week of leptospirosis, the most reliable way to detect the presence of the causative
agent is by _________.
A. Culturing of blood C. Examination of blood
B. Culturing of urine D. Examination of cerebrospinal fluid

8. Which of the following is not true of the VDRL test?

A. False-positive tests are more frequent than with the FTA-ABS test.
B. The antibody titer will decline if the patient is adequately treated.
C. Inactivated Treponema pallidum serves as the antigen
D. The test is usually positive in secondary syphilis.

9. In A helicoidal, flexible organism was demonstrated in a blood smear. This motile organism was
approximately 12 um long, approximately 0.1 um wide, and had semicircular hooked ends. The
description of this organism corresponds most closely to the morphology of ___________________.
A. Borrelia C. Leptospira
B. Leptonema D. Treponema

10. Which of the following is not correct regarding spirochetes?

A. Motility is via axial filaments.
B. Spirochetes are gram positive.
C. They are visualized best using dark field or phase optics
D. Those associated with human disease are 0.1-0.5 um in diameter and 5-30 um in length

SESSSION 20

1. Primary atypical pneumonia is caused by ______________________.

A. Streptococcus pneumoniae C. Klebsiella pneumoniae
B. Mycoplasma pneumoniae D. Mycobacterium tuberculosis

2. Which organism typically produces “fried-egg” colonies on agar within 1–5 days of culture from a
genital specimen?
A. Mycoplasma hominis C. Leptospira interrogans
B. Borrelia burgdorferi D. Treponema pallidum

3. The manganous chloride–urea test is used for the identification of which organism?
A. Mycoplasma pneumoniae C. Mycoplasma hominis
B. Ureaplasma urealyticum D. A, B, and C

4. Which test is the most reliable for the detection of Mycoplasma pneumoniae in serum and for the
confirmation of diagnosis?
A. EIA testing and direct antigen testing C. Culture on SP4 glucose broth with arginine
B. Cold agglutinin testing using Group O RBCs D. Complement fixation

5. Which of the following is true about mycoplasmas?

A. Resistant to penicillin C. Easily stained using the Gram stain
B. Not able to survive extracellularly D. Grow on routine nonselective culture media

6. The recommended medium for the recovery of Mycoplasma pneumoniae from clinical specimens
is________.
A. Charcoal yeast extract medium C. Middlebrook
B. Fletcher semisolid medium D. SP4agar

7. Which of the following Mycoplasmataceae has not been connected with human genital infections?
A. Mycoplasma genitalium C. Mycoplasma pneumoniae
B. Mycoplasma hominis D. Ureaplasma urealyticum

8. Colonies said to have the appearance of a "fried egg" are characteristic of ______________.
A. Ehrlichia chaffeensis C. Mycoplasma hominis
B. Mycoplasma genitalium D. Ureaplasma urealyticum.

9. A screening test for the identification of Mycoplasma pneumoniae isolates is the __________.
A. Acid-fast stain C. Lysis of red blood cells
B. Gram stain D. Catalasetest

10. A genital specimen is inoculated into 10 B broth. After overnight incubation, an alkaline reaction is
noted without turbidity. What is the most likely explanation?
A. pH change due to molecules in the clinical specimen C. Presence of Mycoplasma hominis
B. Presence of Mycoplasma genitalium D. Presence of Ureaplasma urealyticum
SESSION 21

1. Which of the following organisms are transmitted to animals and humans after a tick bite?
A. Leptospira C. Neisseria sicca
B. Chlamydia and Mycoplasma spp. D. Ehrlichia and Anaplasma spp.

2. Identify the following bacterium and specimen pairing that is mismatched (specimen not appropriate
for isolation).
A. Chlamydophila psittaci: fecal swab C. Chlamydia trachomatis: endocervical swab
B. Chlamydia trachomatis: first voided urine D. Chlamydia pneumoniae: throat swab or sputum

3. Chlamydophila psittaci infections in humans most commonly result after exposure to infected
__________.
A. Amphibians C. Avians
B. Arthropods D. Mammalians

4. Which of the following is not true of Coxiella burnetii?

A. It is an obligate intracellular parasite
B. It is transmitted from animals to humans by inhalation
C. A rash appears first on the extremities and then on the trunk.
D. Is the etiologic agent of Q fever, which may be acute or chronic

5. Corneal scrapings are collected and examined microscopically using a direct fluorescent test to detect
inclusion bodies for the diagnosis of infection caused by ___________________.
A. Chlamydia trachomatis C. Mycoplasma hominis
B. Ehrlichia chaffeensis D. Rickettsia prowazekii

6. Which of the following is not true about Chlamydophila (Chlamydia) pneumoniae?

A. Common agent of lower respiratory tract infection
B. Humans become infected from animal reservoirs.
C. Tetracycline and erythromycin are effective treatments
D. Research has found an association with artherosclerosis

7. What is the reference method for detection of Chlamydia trachomatis in cases of sexually transmitted
disease?
A. Tissue culture C. DNA-amplification techniques
B. Nonculture El A methods D. Culture on modified Thayer-Martin agar

8. Human infection with the causative agent of Q fever is acquired by ______________.

A. Inhalation of infectious material C. The bite of a body louse
B. The bite of a mite (chigger) D. The bite of the arthropod Phlebotomus

9. For nonspecific staining of Rickettsia the recommended stain is __________.

A. Gimenez stain C. Gram stain
B. Gomori silver stain D. Kinyoun stain
10. The mild type of typhus fever that is caused by recrudescence of an initial attack of epidemic typhus
is known as ______.
A. Brill-Zinsser disease C. Sao Paulo typhus
B. Q fever D. Tsutsugamushi disease

SESSION 22

1. Which organism, associated with tuberculosis in cattle, causes tuberculosis in humans, especially in
regions where dairy farming is prevalent?
A. Mycobacterium avium–intracellulare complex C. Mycobacterium marinum
B. Mycobacterium kansasii D. Mycobacterium bovis

2. Which of the following organisms are used as controls for rapid growers and slow growers?
A. Mycobacterium fortuitum and Mycobacterium tuberculosis
B. Mycobacterium avium-intracellulare complex and Mycobacterium tuberculosis
C. Mycobacterium chelonei and Mycobacterium fortuitum
D. Mycobacterium kansasii and Mycobacterium tuberculosis

3. Which of the following Mycobacterium spp. produce(s) pigmented colonies in the dark (is a
scotochromogen)?
A. M. szulgai C. M. tuberculosis
B. M. kansasii D. A, B, and C

4. Which All of the following mycobacteria are associated with skin infections except
_________________.
A. Mycobacterium marinum C. Mycobacterium ulcerans
B. Mycobacterium haemophilum D. Mycobacterium kansasii

5. Which nonpathogenic Mycobacterium species is isolated most often from clinical specimens and is
called the “tapwater bacillus”?
A. M. kansasii C. M. leprae
B. M. avium–intracellulare complex D. M. gordonae

6. Which of the following drugs are first-line antibiotics used to treat classic tuberculosis for which
susceptibility testing is performed by the disk diffusion method on Middlebrook 7H10 or 7H11 agar
plates?
A. Ampicillin, penicillin, streptomycin, and carbenicillin
B. Ampicillin, penicillin, and methicillin
C. Vancomycin, methicillin, and carbenicillin
D. Isonicotinic acid hydrazide (INH), rifampin, ethambutol, and pyrazinamide

7. Which of the following Mycobacterium spp. would be most likely to grow on a MacConkey agar plate?
A. M. chelonae–fortuitum complex C. M. marinum
B. M. ulcerans D. M. avium–intracellulare complex

8. Individuals showing a positive purified protein derivative (PPD) skin test for M. tuberculosis are
usually ________.
A. Infective C. Latently infected
B. Symptomatic of pulmonary disease D. Falsely positive

9. Which two mycobacteria commonly isolated from subcutaneous skin have an optimal growth
temperature of 30°C?
A. M. haemophilum and M. ulcerans C. M. gordonae and M. avium
B. M. kansasii and M. xenopi D. M. simiae and M. avium

10. Which M. avium complex (MAC) organism is the most frequently isolated mycobacterium from AIDS
patients?
A. M. avium C. M. scrofulaceum
B. M. intracellulare D. M. bovis

11. The best specimen for recovery of the mycobacteria from a sputum sample is _____________,
A. First morning specimen C. 12-hour pooled specimen
B. 10-hour evening specimen D. 24-hour pooled specimen

12. Which is the most appropriate nonselective medium for recovery of mycobacteria from a heavily
contaminated specimen?
A. Löwenstein–Jensen agar C. Petragnani’s agar
B. Middlebrook 7H10 agar D. American Thoracic Society medium

13. Mycobacteria stained by the Ziehl–Neelsen or Kinyoun methods with methylene blue counterstain
are seen microscopically as ___________.
A. Bright red rods against a blue background C. Orange-red rods against a black background
B. Bright yellow rods against a yellow background D. Bright blue rods against a pink background

14. All of the following Mycobacterium spp. produce the enzyme required to convert niacin to niacin
ribonucleotide EXCEPT _________________.
A. M. kansasii C. M. avium–intracellulare complex
B. M. tuberculosis D. M. szulgai

15. The catalase test for mycobacteria differs from that used for other types of bacteria by using
_______.
A. 1% H2O2 and 10% Tween 80 C. 10% H2O2 and 0.85% saline
B. 3% H2O2 and phosphate buffer, pH 6.8 D. 30% H2O2 and 10% Tween 80

16. Growth inhibition by thiophene-2-carboxylic hydrazide (T2H) is used to differentiate M. tuberculosis

from which other Mycobacterium species?
A. M. bovis C. M. kansasii
B. M. avium–intracellulare complex D. M. marinum

17. The urease test is needed to differentiate Mycobacterium scrofulaceum from which of the following
mycobacteria?
A. M. gordonae C. M. avium–intracellulare complex
B. M. kansasii D. M. bovis

18. Which mycobacterium of the MTB complex fails to grow in culture and has a characteristic
“croissant-like” morphology in stained smears?
A. M. africanum C. M. bovis
B. M. microti D. M. leprae

19. Rapid methods for identifying classic infection with M. tuberculosis include ________________.
A. Gas–liquid chromatography C. Acid-fast smears
B. Nucleic acid probes D. A, B, and C

20. Which of the following Mycobacterium spp. would be most likely to grow on a MacConkey agar
plate?
A. M. chelonae–fortuitum complex C. M. marinum
B. M. ulcerans D. M. avium–intracellulare complex

SESSION 23

1. Obligate anaerobes, facultative anaerobes, and microaerophiles are terms referring to bacteria that
require ______,
A. Increased nitrogen C. Increased O2
B. Decreased CO2 D. Decreased O2

2. Anaerobic bacteria are routinely isolated from all of the following types of infections EXCEPT
____________.
A. Lung abscesses C. Dental infections
B. Brain abscesses D. Urinary tract infections

3. A gram-positive spore-forming bacillus growing on sheep-blood agar anaerobically produces a double

zone of β- hemolysis and is positive for lecithinase. What is the presumptive identification?
A. Bacteroides ureolyticus C. Clostridium perfringens
B. Bacteroides fragilis D. Clostridium difficile

4. Egg yolk agar is used to detect which enzyme produced by Clostridium species?
A. Lecithinase C. Catalase
B. Lipase D. Oxidase

5. Which spore type and location is found on Clostridium tetani?

A. Round, terminal spores C. Ovoid, subterminal spores
B. Round, subterminal spores D. Ovoid, terminal spores

6. Which mechanism is responsible for botulism in infants caused by Clostridium botulinum?

A. Ingestion of spores in food or liquid C. Virulence of the organism
B. Ingestion of preformed toxin in food D. Lipase activity of the organism

7. The classic form of foodborne botulism is characterized by the ingestion of ________________.

A. Spores in food C. Toxin H
B. Preformed toxin in food D. A, B, and C

8. All of the following genera are anaerobic cocci that stain gram positive EXCEPT ________________.
A. Peptococcus spp. C. Streptococcus spp.
B. Peptostreptococcus spp D. Veillonella spp
9. The gram-positive non–spore-forming anaerobic rods most frequently recovered from blood cultures
as a contaminant are ___________.
A. Propionibacterium acnes C. Staphylococcus intermedius
B. Clostridium perfringens D. Veillonella parvula

10. Gram stain of a smear taken from the periodontal pockets of a 30-year-old man with poor dental
hygiene showed sulfur granules containing gram-positive rods (short diphtheroids and some
unbranched filaments). Colonies on blood agar resembled “molar teeth” in formation. The most likely
organism is _______________.
A. Actinomyces israelii C. Staphylococcus intermedius
B. Propionibacterium acnes D. Peptostreptococcus anaerobius

11. Which of the following is the medium of choice for the selective recovery of gram-negative
anaerobes?
A. Kanamycin–vancomycin (KV) agar C. Cycloserine–cefoxitin–fructose agar (CCFA)
B. Phenylethyl alcohol (PEA) agar D. THIO broth

12. Which broth is used for the growth of anaerobes in order to detect volatile fatty acids as an aid to
identification?
A. Prereduced peptone–yeast extract–glucose (PYG) C. Gram-negative (GN) broth
B. THIO broth D. Selenite (SEL) broth

13. Which of the following organisms will display lipase activity on egg yolk agar?
A. Clostridium botulinum C. Clostridium novyi (A)
B. Clostridium sporogenes D. A, B, and C

14. Identification of Clostridium tetani is based upon ______________.

A. Gram stain of the wound site C. Blood culture results
B. Anaerobic culture of the wound site D. Clinical findings

15. Obligate anaerobic gram-negative bacilli that do not form spores grow well in 20% bile and are
resistant to penicillin 2-unit disks are most likely ___________.
A. Porphyromonas spp. C. Fusobacterium spp.
B. Bacteroides spp. D. Prevotella spp.

16. Which gram-negative bacilli produce black pigment and brick red fluorescence when exposed to an
ultraviolet light source?
A. Porphyromonas spp. and Prevotella spp. C. Bacteroides spp. and Fusobacterium spp.
B. Fusobacterium spp. and Actinomyces spp. D. A, B, and C

17. Which Bacteroides spp. is noted for “pitting” of the agar and is sensitive to penicillin 2-unit disks?
A. B. vulgatus C. B. thetaiotaomicron
B. B. ovatus D. B. ureolyticus

18. The following characteristics of an obligate anaerobic gram-negative bacilli best describe which of
the listed genera? Gram stain: long, slender rods with pointed ends; colonial appearance: dry bread
crumbs or “fried-egg” appearance; penicillin 2-unit disk test: susceptible.
A. Bacteroides spp. C. Prevotella spp
B. Fusobacterium spp. D. Porphyromonas spp.

19. Antimicrobial susceptibility testing of anaerobes is done by which of the following methods?
A. Broth disk elution C. Microtube broth dilution
B. Disk agar diffusion D. β-Lactamase testing

20. Which test is performed in order to confirm an infection with Clostridium botulinum?
A. Toxin neutralization C. Lipase test
B. Spore-forming test D. Gelatin hydrolysis test