Home Laboratory Quizzes The Quizzes about Bacteriology – Part 2

The Quizzes about Bacteriology – Part 2

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Bacteriology Quiz Part 2 (20 test)

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Part 1 | Part 2 | Part 3 | Part 4 | Part 5


1. The laboratory reports that the Venereal Disease Research Laboratory (VDRL) test performed on the above patient is reactive at a dilution of 1:4 (4 dils). The patient also reports to you that he has recently been diagnosed with hepatitis A. Which one of the following is most appropriate next step in management?

a. Order a confirmatory test such as the fluorescent treponemal antibody (FTA) test
b. Order a rapid plasma reagin (RPR) test
c. Perform a spinal tap to rule out central nervous system (CNS) syphilis
d. Repeat the VDRL test
e. Report this patient to the health department, as he has syphilis

2. In the same patient from the previous vignette, which of the following test combinations for syphilis is most appropriate?

a. FTA-Abs (IgG)/FTA-Abs (IgM)
b. RPR/culture of the lesion
c. RPR/FTA-Abs
d. Treponema pallidum hemagglutination (TPHA)/microhemagglutination—Treponema pallidum (MHTP) tests

3. Assume that the same patient from the previous vignette absolutely denies any contact, sexual or otherwise, with a person who had syphilis. Also assume that both the RPR and the FTA-Abs are positive on this patient. Which of the following tests could be used to show that this patient probably does not have syphilis?

a. Frei test
b. MHTP test
c. Quantitative RPR
d. Treponema pallidum immobilization (TPI) test

4. A patient is hospitalized after an automobile accident. The wounds become infected, and the patient is treated with tobramycin, carbenicillin, and clindamycin. Five days after antibiotic therapy was initiated, the patient develops severe diarrhea and pseudomembranous enterocolitis. Antibiotic-associated diarrhea and the more serious pseudomembranous enterocolitis can b caused by which of the following organisms?
a. Bacteroides fragilis
b. Clostridium difficile
c. Clostridium perfringens
d. Clostridium sordellii
e. Staphylococcus aureus

5. A 2-year-old child has a fever, stiff neck, and is irritable. Gram stain smear of spinal fluid reveals gram-negative, small pleomorphic coccobacillary organisms. What is the most appropriate procedure to follow in order to reach an etiological diagnosis?

a. Culture the spinal fluid in chocolate agar, and identify the organism by growth factors
b. Culture the spinal fluid in mannitol-salt agar
c. Perform a catalase test of the isolated organism
d. Perform a coagulase test with the isolate
e. Perform a latex agglutination (LA) test to detect the specific antibody in the spinal fluid

6. A patient complains to his dentist about a draining lesion in his mouth. A Gram stain of the pus shows a few gram-positive cocci, leukocytes, and many-branched gram-positive rods. Branched yellow sulfur granules are observed by a microscope. Which of the following is the most likely cause of the disease?

a. Actinomyces israelii
b. Actinomyces viscosus
c. Corynebacterium diphtheriae
d. Propionibacterium acnes
e. Staphylococcus aureus

7. A 39-year-old primigravid Caucasian female lawyer develops premature rupture of membranes at 35 weeks of gestation. She develops fever up to 103°F, and the amniotic fluid reveals a group B Streptococcus. Which of the following is the best option to reduce Group B streptococcal infection in her fetus?

a. Identification of possible high-risk births
b. Intravenous penicillin administered at least 4 hours before delivery
c. Screening of pregnant female at the first office visit, usually during the first trimester
d. Screening of pregnant female in the last trimester
e. Use of a polysaccharide vaccine

8. A 1-week-old neonate presents to the pediatric emergency room with fever, irritability, poor feeding, and a bulging anterior fontanelle. Lumbar puncture is performed, and the cerebrospinal fluid (CSF) grows group B Streptococcus. Which of the following is the most likely pathogenic mechanism?

a. Complement C5a, a potent chemoattractant, activates polymorphonuclear neutrophils (PMNs)
b. In the absence of a specific antibody, opsonization, phagocyte recognition, and killing do not proceed normally
c. The alternative complement pathway is activated
d. The streptococci are resistant to penicillin

9. A man who has a penile chancre appears in a hospital’s emergency service. The VDRL test is negative. Which of the following is the most appropriate course of action?

a. Perform dark-field microscopy for treponemes
b. Perform a Gram stain on the chancre fluid
c. Repeat the VDRL test in 10 days
d. Send the patient home untreated
e. Swab the chancre and culture on Thayer-Martin (TM) agar

10. A clinically depressed farmer complains of extreme weakness, a daily rise and fall in fever, and night sweats. Small gram-negative rods are isolated from blood cultures after a 2-week incubation period. Which of the following organisms is the most likely etiologic agent?

a. Brucella melitensis
b. Campylobacter jejuni
c. Francisella tularensis
d. Salmonella enteritidis
e. Serratia marcescens

11. An outbreak occurs in a community where the water supply is contaminated. Multiple patients experience nausea and vomiting as well as profuse diarrhea with abdominal cramps; stools are described as “rice water.” Curved, gram-negative rods are isolated on a sulfate-citrate-bilesucrose agar. In the treatment of patients who have cholera, the use of a drug that inhibits adenyl cyclase would be expected to have which of the following characteristics?

a. Block the action of cholera toxin
b. Eradicate the organism
c. Increase fluid secretion
d. Kill the patient immediately
e. Reduce intestinal motility

12. A box of ham sandwiches with mayonnaise, prepared by a person with a boil on his neck, is left out of the refrigerator for the on-call interns. Three doctors become violently ill approximately 2 hours after eating the sandwiches. Which of the following is the most likely cause?

a. Clostridium perfringens toxin
b. Coagulase from S. aureus in the ham
c. Penicillinase given to inactivate penicillin in the pork
d. Staphylococcus aureus enterotoxin
e. Staphylococcus aureus leukocidin

3. A 34-year-old diabetic truck driver notices maceration of the web space of his toes on the right foot. Two days later he has a temperature of up to 100°F, exquisite tenderness, erythema, and swelling of the right leg. Culture exudate from the foot yields S. aureus. Which of the following often complicates treatment of S. aureus infection with penicillin?

a. Allergic reaction caused by staphylococcal protein
b. Inability of penicillin to penetrate the membrane of S. aureus
c. Lack of penicillin-binding sites on S. aureus
d. Production of penicillin acetylase by S. aureus
e. Production of penicillinase by S. aureus

14. Two of 3 family members have dinner at a local restaurant and, within 48 hours, start experiencing double vision, difficulty in swallowing and speaking, and breathing problems. These symptoms are consistent with which of the following?

a. Activation of cyclic AMP
b. Endotoxin shock
c. Ingestion of a neurotoxin
d. Invasion of the gut epithelium by an organism
e. Secretion of an enterotoxin

15. A clinical research group attempting to develop an improved Neisseria meningitidis vaccine is granted approval to gather volunteers for a clinical trial. Part of the volunteer evaluation is to sample bacteriologically for normal oral flora Neisseria. They find that almost all of the participants have several commensal species as part of their upper respiratory tract (URT) flora. Which of the following statements accurately describes the significance of these bacteria?

a. As a part of the normal flora, Neisseria provide a natural immunity in local host defense
b. As a part of the respiratory flora, they are the most common cause of acute bronchitis and pneumonia
c. Commensal bacteria stimulate a cell-mediated immunity (CMI)
d. Commensal Neisseria in the upper respiratory tract impede phagocytosis by means of lipoteichoic acid
e. Normal flora, such as nonpathogenic Neisseria, provides effective nonspecific B-cell-mediated humoral immunity

16. A family routinely consumes unpasteurized milk, claiming “better taste.” Several members experience a sudden onset of crampy abdominal pain, fever, and profuse bloody diarrhea. Campylobacter jejuni is isolated and identified from all patients. Which of the following is the treatment of choice for this type of enterocolitis?

a. Ampicillin
b. Campylobacter antitoxin
c. Ciprofloxacin
d. Erythromycin
e. Pepto-Bismol

17. An unimmunized, 2-year-old boy presents with drooling from the mouth, elevated temperature, and enlarged tonsils. During attempts at intubation, no gray-white membrane is observed but the epiglottis appears “beefy” red and edematous. Which of the following is the most likely organism?

a. Haemophilus haemolyticus
b. Haemophilus influenzae
c. Klebsiella pneumoniae
d. Mycoplasma pneumoniae
e. Neisseria meningitidis

18. A 70-year-old female patient is readmitted to a local hospital with fever and chills following cardiac surgery at a major teaching institution. A gram-positive coccus grows within 24 hours from blood taken from the patient. Initial tests indicate that this isolate is resistant to penicillin. Which of the following is the most likely identification?

a. Enterococcus species
b. Group A Streptococcus
c. Group B Streptococcus
d. Neisseria species
e. Streptococcus pneumoniae

19. Further testing of the patient in the previous question reveals that the isolate possesses the group D antigen, and is not β-lactamasepositive, but is resistant to vancomycin. Which of the following is the most likely identification of this isolate?

a. Enterococcus casseliflavus
b. Enterococcus durans
c. Enterococcus faecalis
d. Enterococcus faecium
e. Streptococcus pneumoniae

20. Which of the following is the treatment of choice for the isolate in Question 19?

a. Ciprofloxacin
b. Gentamicin
c. Gentamicin and ampicillin
d. Rifampin
e. No available treatment

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