Micro CD&R Module #4 - Study Questions PDF

Module #4 Study Questions Question 1 How is M. tuberculosis usually transmitted? Choose at least one correct answer A Eating/drinking contaminated food/water B Ingestion of spore C Puncture of the skin D Inhalation of aerosols Question 2 Which of the following is TRUE re...

Module #4 Study Questions Question 1 How is M. tuberculosis usually transmitted? Choose at least one correct answer A Eating/drinking contaminated food/water B Ingestion of spore C Puncture of the skin D Inhalation of aerosols Question 2 Which of the following is TRUE regarding a positive TB skin test? Select all that apply. Choose at least one correct answer A Positive test = red indurated area B Positive test = no skin changes C Indicates the individual has been exposed to MTB D Indicates the individual could have a active tuberculosis E Indicates the individual may have latent tuberculosis Question 3 Which of the following are TRUE regarding interferon-gamma release assays? Select all that apply. Choose at least one correct answer A Performed by injecting a small amount of tuberculin into the skin B Less subjective to reader bias and errors C Testing helps differentiate latent from active tuberculosis D Testing requires a blood sample E This test is not affected by the BCG vaccine Question 4 What is the appearance of mycobacteria in gram-stained smears? Choose at least one correct answer 0 A Gram positive cocci 0 B Gram positive rods 0 C Gram negative cocci 0 D Gram negative rods 0E Stain very poorly - if at all Question 5 What is the recommended specimen collection procedure for SPUTUM samples (for Mycobacterial cultures)? Choose at least one correct answer 0A 1 morning sample 0B 3 samples (in one day) 0C 3-5 morning samples (over a week) 0D 2 samples (in the late aftenoon) Question 6 __) ( What is the recommended specimen collection procedure for URINE samples (for Mycobacterial cultures)? Choose at least one correct answer 0A 1 morning sample 0B 3 samples (in one day) 0C 3-5 morning samples (over a week) 0D 2 samples (in the late aftenoon) Question 7 Match the specimen with it's corresponding processing procedure. Prompt Answer Decontaminate specimen & inoculate 2 sets of media (30oC & 35oC) 01 CSF 02 Sputum No decontamination - Centrifuge & inoculate media  Urine Decontaminate specimen before inoculating media 03 Pleural fluid 04 Skin/Wound for M. marinum 05 Question 8 How should gastric aspirates be handled if they cannot be processed within 4 hours? Choose at least one correct answer 0A Neutralize specimen with sodium bicarbonate 0B Store specimen in a refrigerator 0C Request a new specimen 0D Add N-acetyl-L-cystine to the specimen Question 9 Which mycobacteria are rapid growers? Select all that apply. Choose at least one correct answer 0A M. tuberculosis 0B M. abscessus 0C M. gordonea 0D M. bovis 0E M. marinum 0F M. fortuitum-chelonae Question 10 How fast does a rapid grower grow? Choose at least one correct answer A Less than 3 days 0 B Less than 7 days 0 C 2 weeks 0 D More than 2 weeks 0 Question 11 How can a laboratory’s contamination rate be used to evaluate its decontamination procedure? Choose at least one correct answer 0 A If the contamination rate is too HIGH, the decontamination process is too vigorous 0 B If the contamination rate is too HIGH, the decontamination process is not strong enough Question 12 _ ( _____,,) What is the function of the following reagents? Prompt Answer 01 N-acetyl-L-cysteine Decontaminating agent 02 2% NaOH Mucolytic agent Question 13 __) ( What are the requirements for storing Middlbrook agar? Select all that apply. Choose at least one correct answer 0A Store in light 0B Store in the dark 0C Incubate plates in air 0D Incubate plates in CO2 Question 14 Indicate if the Mycobacteria media is egg-based or agar-based. Prompt Answer 01 Lowenstein-Jensen (LJ) Agar-based 02 Middlebrook 7H10 Egg-based 03 Petragnani 04 Mitchison 7H11 05 American Thoracic Society (ATS) Question 15 Match the group with it's corresponding pigment production. Prompt Answer  0 1 Photochromogen No pigment in light; no pigment in dark 0 2 Scotochromogen Pigment in light; Pigment in dark 0 3 Nonchromogen Pigment in light; No pigment in dark Question 16 Match each test with it's corresponding POSITIVE result. Answers may be used more than once or not at all. Prompt Answer 01 Arysulfatase Green Catalase - 68oC 02 Yellow 03 Catalase - Semiquantitative No color change 04 Iron Uptake Rust color 05 Niacin Red 06 Pyrazinamidase No growth 07 Tween 80 Growth 08 Special MacConkey No bubbles Bubble column > 45mm Bubbles Bubble column < 45mm Question 17 Match each organism with it's corresponding description. Prompt Answer 01 M. tuberculosis Rapid growers Arylsufatase (+) Growth on Special MacConkey 02 M. bovis Buff, rough colonies Niacin (+) Nitrate (+) 03 M. kansasii Scotochromogen Non-pathogenic Water contaminant  0 4 M. marinum Photochromogen "Swimming pool granuloma" Grows at 30oC and 37oC 0 5 M. gordonae Photochromogen Causes a pulmonary disease Nitrate (+) Tween 80 (+) 0 6 M. haemophilum Causes tuberculosis Niacin (-) T2H sensitive 07 M. avium complex Nonchromogen Requires X factor for growth Grows at 30oC and 37oC 08 M. fortuitum-chelonae-abscessus complex Nonchromogen Slow grower Negative for most biochemical tests Question 18 (_____~ ) M. gordonae is a clinically significant isolate. 0A True 0B False Question 19 What is the typical incubation condition & time for Mycobacterial cultures? Choose at least one correct answer Incubate at 35-37oC in Air; Hold plates for 8 weeks 0A Incubate at 30oC in CO2; Hold plates for 4 weeks 0B Incubate at 30oC in Air; Hold plates for 4 weeks 0C Incubate at 35-37oC in CO2; Hold plates for 8 weeks 0D Question 20 What additional step(s) should be taken when setting up a soft tissue/wound specimen for Mycobacterial culture? Select all that apply. Choose at least one correct answer 0A A fungal culture plate (PDA or SAB) should be added to the media panel 0B A plate containing hemin (CHOC) should be added to the media panel Incubate all plates at 30oC 0C  Set up 2 set of media plates - incubate at 30oC and 37oC 0D 0E Perform an extra decontamination procedure on the specimen Question 21 0.25 points What does a POSITIVE result look like for a Ziehl-Neelsen or Kinyoun stain? Choose at least one correct answer 0A Blue rods 0B Red rods 0C Green rods 0D Fluorescence Question 22 0.25 points What is the purpose of potassium permanganate in the fluorochrome acid fast stain? Choose at least one correct answer 0A Stains the background blue 0B Stains the mycobacteria red 0C Causes mycobacteria to fluoresce 0D Quenches the background fluorescence Question 23 0.25 points Positive and negative control smears should be included with each batch when performing acid fast stains. 0A True 0B False Question 24 1 point Which of the following are dimorphic fungi? Select all that apply. Choose at least one correct answer A Blastomyces dermatitidis 0 B Aspergillus species 0 C Coccidioides immitis 0 D Histoplasma capsulatum 0  0 E Epidermophyton species 0 F Sporothrix schenkii 0 Paracoccidioides G 0 H Malassezia furfur Question 25 0.25 points (._________,) Which of the following is TRUE regarding dimorphic fungi? Choose at least one correct answer 0 A Yeast form at 37°C - Mold form at 30°C 0B Yeast form at 37°C - Mold form at 37°C 0C Yeast form at 30°C - Mold form at 37°C 0D Yeast form at 30°C - Mold form at 30°C Question 26 0.25 points With respect to Malassezia furfur, what special type of media should be used to culture for this organism? Choose at least one correct answer 0A Blood agar 0B Media supplemented with cycloheximide 0C Media supplemented with lipids 0D Potato dextrose agar (PDA) Question 27 0.25 points (._________,) With respect to Malassezia furfur, what type of patient is at risk for systemic disease? Choose at least one correct answer 0A The organism is nonpathogenic 0B Patients on long-term antimicrobial therapy 0C Patients on lipid therapy 0D Teenagers Question 28 0.25 points (._________,) Which disorder does Malassezia furfur cause? Choose at least one correct answer 0 Fungal keratitis A 0 B Tinea corporis 0 C Black piedra 0 D Tinea versicolor Question 29 0.25 points What is the recommended specimen collection procedure for SPUTUM samples (for Mycology cultures)? Choose at least one correct answer 0 A 1 morning sample 0B 3 samples (in one day) 0C 3-5 morning samples (over a week) 0D 2 samples (in the late aftenoon) Question 30 0.25 points Penicillium species is always a lab contaminant and is not known to cause disease. 0A True 0B False Question 31 _____) 0.25 points (~ Which test is more reliable in diagnosing cryptococcal meningitis? Choose at least one correct answer 0A India Ink prep 0B Gram stain smear 0C Cryptococcal antigen test 0D Fungal culture Question 32 0.25 points Cycloheximide inhibits the growth of Cryptococcus. 0A True 0B False Question 33 0.25 points What is the gram stain reaction for Nocardia? Choose at least one correct answer 0 A Gram positive coccobacilli 0 B Gram negative bacilli 0 C Gram positive branching rods 0 D Gram negative filamentous rods Question 34 __ ( 0.25 points ) Which organism shares a similar gram stain reaction as Nocardia? Choose at least one correct answer 0A Streptococcus pneumoniae 0B Actinomyces israelii 0C Histoplasma capsulatum 0D Clostridium perfringens Question 35 (__ 0.25 points ) Which stain can be used to help differentiate Nocardia from other organisms? Choose at least one correct answer 0A Calcofluor White 0B Kinyoun 0C Modified Acid Fast 0D KOH Question 36 (__ 0.25 points ) What disease does Pneumocystis jirovecii typically cause? Choose at least one correct answer 0A Abscess/wounds 0B UTI 0C Meningitis  0D Pneumonia Question 37 0.5 points Select the stains that are helpful in visualizing Histoplasma capsulatum and Pneumocystis jirovecii in specimen smear. Select all that apply. Choose at least one correct answer 0A Gram stain 0B Gomori Methenamine Silver (GMS) stain 0C Wright's stain 0D KOH 0E Periodic-Acid Schiff (PAS) stain 0F Calcofluor White Question 38 0.25 points Match the dermatophyte with it's corresponding macroconidia description. Prompt Answer Epidermophyton Spindle shaped 01 Trichophyton Beaver tail or club shaped 02 Microsporum Pencil shaped 03 Question 39 1 point Match the following organisms with it's corresponding description. Prompt Answer Blastomyces dermatidis Closed fist formation 01 Histoplasma capsulatum Yeast phase: Broad based budding, double walled 02 Coccidioides immitis Mold phase: Alternating arthrospores 03 4 Sporothrix schenckii Mold phase: Tuberculate macroconidia 0 5 Penicillium species Yeast phase: Cigar shaped yeast cells 0 6 Aspergillus species Open fist formation 0 Question 40 0.25 points What is the typical incubation condition & time for Mycology cultures? Choose at least one correct answer o 0 A Incubate at 35-37 C in Air; Hold plates for 8 weeks Incubate at 30oC in CO2; Hold plates for 4 weeks 0 B Incubate at 30oC in Air; Hold plates for 4 weeks 0 C Incubate at 35-37oC in CO2; Hold plates for 8 weeks 0 D Question 41 __ ( 0.25 points ) How many stool specimens should be submitted for “Ova & Parasite” exams? How often should they be collected? Choose at least one correct answer 0A 1 stool sample 0B 2 stool samples - 1 day in between collection 0C 2 stool samples - collected once a week 0D 3 stool samples - collected every 2-3 days Question 42 (__ 0.25 points ) What are Charcot-Leyden crystals? Choose at least one correct answer 0A Degradation products of PMNs 0B Degradation products of nucleic acids 0C Degradation products of eosinophils 0D Degradation products of RBCs Question 43 (__ 0.25 points ) Indicate which protozoan stage is found in each type of stool. Prompt Answer 01 Liquid stools Cysts 02 Formed stools Trophozoites Question 44 1 point Match the parasitic infection with the best specimen needed for diagnosis. Answers may be used more than once. Prompt Answer 0 1 Pinworm Urine/Genital 0 2 Extraintestinal amebiasis Serum 0 3 Primary Amebic Encephalitis Stool 04 Malaria CSF 05 Dysentery Blood 06 Chagas Disease Sticky paddle prep 07 Trichomoniasis Question 45 1.25 points How should the following specimens be handled/processed? Prompt Answer 01 Liquid fecal specimen for motile trophozoites Reject and request new specimen 02 Liquid fecal specimen for “Ova & Parasites” Prepare a wet mount and examine within 30 minutes of collection 03 Fecal specimen with urine Examine within 30 minutes of collection - Place in preservatives if unable to examine immediately 04 Fecal specimen with barium 05 Fecal specimen with mineral oil 06 Urine or vaginal secretions for Trichomonas vaginalis Question 46 0.25 points (~______,) Which procedure(s) is/are appropriate for specimens placed in PVA preservative? Select all that apply. Choose at least one correct answer 0A Permanent stained smear 0B Direct microscopic exam 0C Concentration procedure Question 47 0.25 points Which procedure(s) is/are appropriate for specimens placed in FORMALIN preservative? Select all that apply. Choose at least one correct answer 0A Permanent stained smear 0B Direct microscopic exam C Concentration procedure 0 Question 48 0.5 points Match the procedure with it's intended purpose. Prompt Answer Saline wet mount prepared from fresh specimen Detection and identification of helminths & protozoa 01 Permanent stained smear of fecal specimen Detection and identification of protozoa 02 Iodine wet mount (from concentrated specimen) Detecting motile trophozoites 03 Question 49 (..__________,) 0.25 points Match the Plasmodium species with it's corresponding key characteristics. Prompt Answer P. vivax Crescent-shaped gametocytes 01 Multiple rings in RBCs common Double chromatin dots in ring forms P. malariae Enlarged RBCs infected 02 Schuffner’s dots Schizont contains 12-14 merozoites P. falciparum Produces “band” forms 03 Schizont has rosette appearance Schizont contains 6-12 merozoites Question 50 (..__________,) 0.25 points Which Plasmodium species causes the most severe malaria? Choose at least one correct answer A P. vivax 0 B P. ovale 0 C P. malariae 0 D 0 P. falciparum Question 51 1 point Match the organism with the appropriate stain used for detection/identification. Prompt Answer 01 Plasmodium Trichrome/Iron Hematoxylin stain 02 Cryptosporidium species Wrights/Giemsa stain 03 Entamoeba species Acid Fast Stains 04 Giardia 05 Ascaris lumbricoides 06 Trypanosoma brucei Question 52 1 point Match the organism with the disease it typically causes. Prompt Answer 01 Acanthamoeba species Nonpathogen 02 Giradia intestinalis Keratitis 03 Naegleria fowleri Diarrhea 04 Stronglyoides stercoralis Primary amebic encephalitis 05 Trichomonas hominis 06 Entamoeba coli Question 53 2 points Match the organism with it's parasitic classification. Prompt Answer 01 Entamoeba histolytica Cestode 02 Giradia intestinalis Flagellate 03 Strongyloides stercoralis Nematode 04 Trichomonas vaginalis Ciliate 05 Trichinella spiralis Amoebae  Balantidium coli Trematode 06 Paragonimus westermani 07 Hymenolepis nana 08 Ascaris lumbricoides 09 Question 54 0.5 points Match the organism with it's corresponding description. Prompt Answer Giradia intestinalis Nucleus: Usually eccentric karyosome, Clumpy peripheral chromatin 01 Troph: Heavily vaculated cytoplasm, Sluggish motility Cyst: 1- 8 nuclei Entamoeba histolytica Nucleus: Small central karyosome, Evenly distributed peripheral 02 chromatin Troph: Purposeful motility, May contain RBCs Cyst: 1-4 nuclei Entamoeba coli Troph: 2 nuclei, bilateral symmetry 03 Cyst: 2-4 nuclei Falling leaf motility