Microbiology Module 4 Study Questions
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Questions and Answers

How is M. tuberculosis usually transmitted?

  • Puncture of the skin
  • Inhalation of aerosols (correct)
  • Ingestion of spore
  • Eating/drinking contaminated food/water

    • Which of the following is TRUE regarding a positive TB skin test? Select all that apply.

  • Indicates the individual may have latent tuberculosis (correct)
  • Positive test = no skin changes
  • Indicates the individual has been exposed to MTB (correct)
  • Indicates the individual could have active tuberculosis (correct)
  • Positive test = red indurated area (correct)

    • Which of the following are TRUE regarding interferon-gamma release assays? Select all that apply.

  • Less subjective to reader bias and errors (correct)
  • This test is not affected by the BCG vaccine
  • Testing requires a blood sample (correct)
  • Performed by injecting a small amount of tuberculin into the skin
  • Testing helps differentiate latent from active tuberculosis (correct)

    • What is the appearance of mycobacteria in gram-stained smears?

    <p>Stain very poorly - if at all</p> Signup and view all the answers

    What is the recommended specimen collection procedure for SPUTUM samples (for Mycobacterial cultures)?

    <p>1 morning sample</p> Signup and view all the answers

    What is the recommended specimen collection procedure for URINE samples (for Mycobacterial cultures)?

    <p>1 morning sample</p> Signup and view all the answers

    Match the specimen with it's corresponding processing procedure.

    <p>CSF = Decontaminate specimen &amp; inoculate 2 sets of media (30°C &amp; 35°C) Sputum = No decontamination - Centrifuge &amp; inoculate media Urine = Decontaminate specimen before inoculating media Pleural fluid = Decontaminate specimen before inoculating media Skin/Wound for <em>M. marinum</em> = No decontamination - Centrifuge &amp; inoculate media</p> Signup and view all the answers

    How should gastric aspirates be handled if they cannot be processed within 4 hours?

    <p>Add N-acetyl-L-cystine to the specimen</p> Signup and view all the answers

    Which mycobacteria are rapid growers? Select all that apply.

    <p><em>M. fortuitum-chelonae</em></p> Signup and view all the answers

    How fast does a rapid grower grow?

    <p>Less than 7 days</p> Signup and view all the answers

    How can a laboratory's contamination rate be used to evaluate its decontamination procedure?

    <p>If the contamination rate is too HIGH, the decontamination process is not strong enough</p> Signup and view all the answers

    What is the function of the following reagents?

    <p>N-acetyl-L-cysteine = Decontaminating agent 2% NaOH = Mucolytic agent</p> Signup and view all the answers

    What are the requirements for storing Middlbrook agar? Select all that apply.

    <p>Store in the dark</p> Signup and view all the answers

    Indicate if the Mycobacteria media is egg-based or agar-based.

    <p>Lowenstein-Jensen (LJ) = Agar-based Middlebrook 7H10 = Egg-based Petragnani = Egg-based Mitchison 7H11 = Egg-based American Thoracic Society (ATS) = Agar-based</p> Signup and view all the answers

    Match the group with it's corresponding pigment production.

    <p>Photochromogen = No pigment in light; no pigment in dark Scotochromogen = Pigment in light; Pigment in dark Nonchromogen = Pigment in light; No pigment in dark</p> Signup and view all the answers

    Match each test with it's corresponding POSITIVE result. Answers may be used more than once or not at all.

    <p>Arylsufatase = Yellow Catalase - 68°C = Green Catalase - Semiquantitative = No color change Iron Uptake = Rust color Niacin = Red Pyrazinamidase = No Growth Tween 80 = Growth Special MacConkey = No bubbles = Bubble column &lt; 45mm</p> Signup and view all the answers

    Match each organism with it's corresponding description.

    <p><em>M. tuberculosis</em> = • Rapid growers • Arylsufatase (+) • Growth on Special MacConkey <em>M. bovis</em> = • Buff, rough colonies • Niacin (+) • Nitrate (+) <em>M. kansasii</em> = • Scotochromogen • Non-pathogenic • Water contaminant <em>M. marinum</em> = • Photochromogen • &quot;Swimming pool granuloma&quot; • Grows at 30°C and 37°C <em>M. gordonae</em> = • Photochromogen • Causes a pulmonary disease • Nitrate (+) • Tween 80 (+) <em>M. haemophilum</em> = • Causes tuberculosis • Niacin (-) • T2H sensitive <em>M. avium complex</em> = • Nonchromogen • Slow grower • Requires X factor for growth • Grows at 30°C and 37°C <em>M. fortuitum-chelonae-abscessus complex</em> = • Nonchromogen • Slow grower • Negative for most biochemical tests</p> Signup and view all the answers

    M. gordonae is a clinically significant isolate.

    <p>False</p> Signup and view all the answers

    What is the typical incubation condition & time for Mycobacterial cultures?

    <p>Incubate at 35-37°C in Air; Hold plates for 8 weeks</p> Signup and view all the answers

    What additional step(s) should be taken when setting up a soft tissue/wound specimen for Mycobacterial culture? Select all that apply.

    <p>A plate containing hemin (CHOC) should be added to the media panel</p> Signup and view all the answers

    What does a POSITIVE result look like for a Ziehl-Neelsen or Kinyoun stain?

    <p>Red rods</p> Signup and view all the answers

    What is the purpose of potassium permanganate in the fluorochrome acid fast stain?

    <p>Quenches the background fluorescence</p> Signup and view all the answers

    Positive and negative control smears should be included with each batch when performing acid fast stains.

    <p>True</p> Signup and view all the answers

    Which of the following are dimorphic fungi? Select all that apply.

    <p>Coccidioides immitis</p> Signup and view all the answers

    Which of the following is TRUE regarding dimorphic fungi?

    <p>Yeast form at 37°C - Mold form at 30°C</p> Signup and view all the answers

    With respect to Malassezia furfur, what special type of media should be used to culture for this organism?

    <p>Media supplemented with lipids</p> Signup and view all the answers

    With respect to Malassezia furfur, what type of patient is at risk for systemic disease?

    <p>Patients on long-term antimicrobial therapy</p> Signup and view all the answers

    Which disorder does Malassezia furfur cause?

    <p>Tinea versicolor</p> Signup and view all the answers

    What is the recommended specimen collection procedure for SPUTUM samples (for Mycology cultures)?

    <p>1 morning sample</p> Signup and view all the answers

    Pencillium species is always a lab contaminant and is not known to cause disease.

    <p>False</p> Signup and view all the answers

    Which test is more reliable in diagnosing cryptococcal meningitis?

    <p>Cryptococcal antigen test</p> Signup and view all the answers

    Cycloheximide inhibits the growth of Cryptococcus.

    <p>False</p> Signup and view all the answers

    What is the gram stain reaction for Nocardia?

    <p>Gram positive branching rods</p> Signup and view all the answers

    Which organism shares a similar gram stain reaction as Nocardia?

    <p>Actinomyces israelii</p> Signup and view all the answers

    Which stain can be used to help differentiate Nocardia from other organisms?

    <p>Modified Acid Fast</p> Signup and view all the answers

    What disease does Pneumocystis jirovecii typically cause?

    <p>Pneumonia</p> Signup and view all the answers

    Select the stains that are helpful in visualizing Histoplasma capsulatum and Pneumocystis jirovecii in specimen smear. Select all that apply.

    <p>Periodic-Acid Schiff (PAS) stain</p> Signup and view all the answers

    Match the dermatophyte with it's corresponding macroconidia description.

    <p>Epidermophyton = Spindle shaped Trichophyton = Beaver tail or club shaped Microsporum = Pencil shaped</p> Signup and view all the answers

    Match the following organisms with it's corresponding description.

    <p>Blastomyces dermatidis = Closed fist formation Histoplasma capsulatum = Yeast phase: Broad based budding, double walled Coccidioides immitis = Mold phase: Alternating arthrospores Sporothrix schenckii = Mold phase: Tuberculate macroconidia Penicillium species = Yeast phase: Cigar shaped yeast cells Aspergillus species = Open fist formation</p> Signup and view all the answers

    What is the typical incubation condition & time for Mycology cultures?

    <p>Incubate at 35-37°C in Air; Hold plates for 8 weeks</p> Signup and view all the answers

    How many stool specimens should be submitted for "Ova & Parasite" exams? How often should they be collected?

    <p>3 stool samples - collected every 2-3 days</p> Signup and view all the answers

    What are Charcot-Leyden crystals?

    <p>Degradation products of eosinophils</p> Signup and view all the answers

    Indicate which protozoan stage is found in each type of stool.

    <p>Liquid stools = Cysts Formed stools = Trophozoites</p> Signup and view all the answers

    Match the parasitic infection with the best specimen needed for diagnosis. Answers may be used more than once.

    <p>Pinworm = Urine/Genital Extraintestinal amebiasis = Serum Primary Amebic Encephalitis = Stool Malaria = CSF Dysentery = Blood Chagas Disease = Sticky paddle prep Trichomoniasis = Urine/Genital</p> Signup and view all the answers

    How should the following specimens be handled/processed?

    <p>Liquid fecal specimen for motile trophozoites = Reject and request new specimen Liquid fecal specimen for &quot;Ova &amp; Parasites&quot; = Prepare a wet mount and examine within 30 minutes of collection Fecal specimen with urine = Examine within 30 minutes of collection - Place in preservatives if unable to examine immediately Fecal specimen with barium = Examine within 30 minutes of collection - Place in preservatives if unable to examine immediately Fecal specimen with mineral oil = Examine within 30 minutes of collection - Place in preservatives if unable to examine immediately Urine or vaginal secretions for Trichomonas vaginalis = Examine within 30 minutes of collection - Place in preservatives if unable to examine immediately</p> Signup and view all the answers

    Which procedure(s) is/are appropriate for specimens placed in PVA preservative? Select all that apply?

    <p>Permanent stained smear</p> Signup and view all the answers

    Which procedure(s) is/are appropriate for specimens placed in FORMALIN preservative? Select all that apply?

    <p>Permanent stained smear</p> Signup and view all the answers

    Match the procedure with it's intended purpose.

    <p>Saline wet mount prepared from fresh specimen = Detection and identification of helminths &amp; protozoa Permanent stained smear of fecal specimen = Detection and identification of protozoa lodine wet mount (from concentrated specimen) = Detecting motile trophozoites</p> Signup and view all the answers

    Match the Plasmodium species with it's corresponding key characteristics.

    <p><em>P. vivax</em> = • Crescent-shaped gametocytes • Multiple rings in RBCs common • Double chromatin dots in ring forms <em>P. malariae</em> = • Enlarged RBCs infected • Schuffner's dots • Schizont contains 12-14 merozoites <em>P. falciparum</em> = • Produces &quot;band&quot; forms • Schizont has rosette appearance • Schizont contains 6-12 merozoites</p> Signup and view all the answers

    Which Plasmodium Species causes the most severe malaria?

    <p>P. falciparum</p> Signup and view all the answers

    Match the organism with the appropriate stain used for detection/identification.

    <p>Plasmodium = Trichrome/Iron Hematoxylin stain Cryptosporidium species = Wrights/Giemsa stain Entamoeba species = Acid Fast Stains Giardia = Acid Fast Stains Ascaris lumbricoides = Acid Fast Stains Trypanosoma brucei = Acid Fast Stains</p> Signup and view all the answers

    Match the organism with the disease it typically causes.

    <p>Acanthamoeba species = Nonpathogen Giradia intestinalis = Keratitis Naegleria fowleri = Diarrhea Stronglyoides stercoralis = Primary amebic encephalitis Trichomonas hominis = Diarrhea Entamoeba coli = Diarrhea</p> Signup and view all the answers

    Match the organism with it's parasitic classification.

    <p>Entamoeba histolytica = Cestode Giradia intestinalis = Flagellate Strongyloides stercoralis = Nematode Trichomonas vaginalis = Ciliate Trichinella spiralis = Amoebae Balantidium coli = Trematode Paragonimus westermani = Trematode Hymenolepis nana = Cestode Ascaris lumbricoides = Nematode</p> Signup and view all the answers

    Study Notes

    Module 4 Study Questions

    • Question 1: Transmission of M. tuberculosis

      • Inhalation of aerosols
      • Puncturing the skin
      • Eating/drinking contaminated food/water

    • Question 2: Positive TB Skin Test

      • A positive test shows a red, indurated (hardened) area.
      • A positive test does not involve any skin changes.
      • A positive test indicates exposure to Mycobacterium tuberculosis (MTB).
      • A positive test suggests the individual might have active tuberculosis or latent tuberculosis

    • Question 3: Interferon-gamma release assays (IGRA)

      • Performed using a blood sample.
      • Less prone to error based on the reader's subjectivity
      • Effective in distinguishing latent from active tuberculosis.
      • Not affected by the BCG vaccine

    • Question 4: Gram-stained appearance of mycobacteria

      • Gram-positive rods
      • Poor staining performance

    • Question 5: SPUTUM sample collection procedure for Mycobacterial cultures -Three-five morning (3-5) samples over a week

    • Question 6: URINE sample collection procedure for Mycobacterial cultures -Three-five morning (3-5) samples over a week

    • Question 7: Specimen processing procedures

      • CSF: Decontaminate specimen & inoculate 2 sets of media (30°C & 35°C)
      • Sputum: No decontamination. Centrifuge & inoculate media

    • Question 8: Handling gastric aspirates -Neutralize specimen with sodium bicarbonate -Store in a refrigerator, if not processed within four hours

    • Question 9: Rapid-growing mycobacteria -M. abscessus -M. fortuitum-chelonae

    • Question 10: Time for rapid-growing mycobacterial growth -Less than 3 days.

    • Question 11: Evaluation of decontamination procedures -High contamination rate indicates a weak decontamination process

    • Question 12: Function of reagents -N-acetyl-L-cysteine: Decontaminating agent -2% NaOH: Mucolytic agent

    • Question 13: Middlbrook Agar storage requirements:

      • Store in the dark. Avoid light.
      • Incubate plates in air, not CO2

    • Question 14: Mycobacterial media types -Lowenstein-Jensen (LJ) media is agar-based. -Middlebrook 7H10 media is egg-based. -Petragnani media is egg-based. -Mitchison 7H11 media is egg-based. -American Thoracic Society (ATS) media is egg-based

    • Question 15: Pigment production by groups (Matching)

    • Question 16: Positive test results (Matching)

    • Question 17: Organism descriptions (Matching)

    • Question 18: Clinical significance of M. gordonae -True, M. gordonae is clinically significant

    • Question 19: Mycobacterial culture incubation -Incubate at 35-37°C in air, hold plates for 8 weeks.

    • Question 20: Additional steps for soft-tissue specimen culture -Add a fungal culture plate (PDA or SAB media) and a plate containing hemin (CHOC media.) -Incubate all plates at 30°C

    • Question 21: Ziehl-Neelsen or Kinyoun stain positive result -Red rods

    • Question 22: Potassium permanganate in fluorochrome stain: -Used to stain the background blue

    • Question 23: Positive and negative controls in acid-fast stains -True

    • Question 24: Dimorphic fungi -Blastomyces dermatitidis -Coccidioides immitis -Histoplasma capsulatum

    • Question 25: Dimorphic fungi growth conditions -Yeast form at 37°C, mold form at 25°C or 30°C

    • Question 26: Malassezia furfur culture media -Media supplemented with lipids.

    • Question 27: Malassezia furfur and systemic disease risk -Patients on long-term antimicrobial therapy.

    • Question 28: Malassezia furfur causes (Matching/disease associated with organism)

    • Question 29: SPUTUM collection procedure for mycology cultures -3–5 morning samples over a week (3-5)

    • Question 30: Penicillium species and disease -Penicillium species is not known to cause diseases. -This is false

    • Question 31: Testing for cryptococcal meningitis -Cryptococcal antigen test

    • Question 32: Effect of cycloheximide on Cryptococcus -Cycloheximide inhibits Cryptococcus growth -This is true

    • Question 33: Gram stain reaction for Nocardia -Gram-positive branching rods.

    • Question 34: Organism also sharing similar gram stain reaction with Nocardia -Actinomyces israelii

    • Question 35: Stain for identifying Nocardia -Modified Acid Fast stain

    • Question 36: Disease caused by Pneumocystis jirovecii -Pneumonia

    • Question 37: Stains for visualizing Histoplasma capsulatum and Pneumocystis jirovecii -GMS stain and KOH

    • Question 38: Dermatophyte macroconidia descriptions (Matching)

    • Question 39: Organism descriptions (Matching)

    • Question 40: Incubation conditions for mycology cultures -Incubate at 35-37°C in air; hold plates for 8 weeks.

    • Question 41: Stool samples for Ova and Parasite exams -Two stool samples, one day apart.

    • Question 42: Charcot-Leyden crystals -Degradation products of eosinophils

    • Question 43: Protozoan stages in different stool types -Liquid stools: Cysts. Forme stools: Trophozoites

    • Question 44: Parasitic infection and best specimen for diagnosis (Matching)

    • Question 45: Handling of specimen-related questions (Procedures and processing guidelines for specimen handling and collection)

    • Question 46: Specimens with PVA preservative -Permanent stained smear.

    • Question 47: Specimens and appropriate staining (Matching and procedures for specimens in formalin and other preservatives)

    • Question 48: Intended purposes of procedures (Matching: Procedures and what they do to specimens and diagnoses)

    • Question 49: Plasmodium species characteristics (Matching)

    • Question 50: Plasmodium species causing most severe malaria -Plasmodium falciparum

    • Question 51: Organism and appropriate stain (Matching: organisms and stains based on visual determination)

    • Question 52: Organisms and diseases they cause (Matching)

    • Question 53: Parasitic classification of organisms (Matching)

    • Question 54: Organism descriptions (Matching)

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