MMSC 438 FINAL EXAM REVIEW QUESTIONS
When drawing blood cultures for a 5-year-old, the correct blood volume (according to
ASM) is _______.
A. Based upon the child's weight.
B. 1 mL for each year of life of the child.
C. 10 to 20 mL of blood per bottle to assure positive rate of 99%.
D. Any volume is sufficient since blood is more concentrated in children. - Answer -A.
Based upon the child's weight.
A patient presents with acute onset of signs and symptoms consistent with endocarditis.
The patient has a history of IV drug abuse. An echocardiogram demonstrates
vegetations on the mitral valve. The most likely pathogen is:
A. Cryptococcus neoformans
B. Escherichia coli
C. Treponema pallidum
D. Staphylococcus aureus - Answer -D. Staphylococcus aureus
What is the single most important variable for positive blood culture detection?
A. Blood volume
B. Incubation time
C. Time of collection
D. Prep of venipuncture site - Answer -A. Blood volume
A 24-year-old female is diagnosed with gonorrhea and the physician also suspects
chlamydia. The correct treatment is
A. Amoxicillin.
B. Ceftriaxone.
C. Cefixime and amoxicillin.
D. Ceftriaxone and azithromycin. - Answer -D. Ceftriaxone and azithromycin.
Three sets of blood cultures (6 bottles) are drawn from a car accident patient in the
emergency department. One aerobic bottle demonstrates a positive signal in a
continuous monitoring system at 24 hours. Gram stain reveals Gram-positive cocci in
clusters, which are catalase positive, and produced non-hemolytic colonies on a sheep
blood agar plate. Which of the following is the most likely explanation for these findings?
A. Septicemia due to Staphylococcus aureus
B. Septicemia due to Bacteroides fragilis group
C. Contamination due to staphylococci
D. Contamination due to fecal biota - Answer -C. Contamination due to staphylococci
Which of the following is a common principle of continuous monitoring blood culture
systems?
A.The amount of ATP produced is measured by determining changes over time
comparing to bottle background levels at primary reading.
,B. The amount of LPS is measured and monitored over time comparing to bottle
background levels at primary reading.
C. The amount of CO2 produced is measured by determining changes over time
comparing to bottle background levels at primary reading.
D. The amount of O2 produced is measured by determining changes over time
comparing to bottle background levels at primary reading. - Answer -C. The amount of
CO2 produced is measured by determining changes over time comparing to bottle
background levels at primary reading.
A 2-year-old patient with a history of leukemia is admitted to the hospital with a
diagnosis of possible sepsis. A set of blood cultures is collected, and after 11 hours on
the automated system, both aerobic and anaerobic bottles are positive. Gram stain
reveals rare coccobacilli. The next step is to:
A. Call the physician
B. Report findings to the laboratory manager
C. Reincubate the bottles
D. Recollect the blood cultures - Answer -A. Call the physician
Pelvic inflammatory disease in women is most frequently caused by:
A. Chlamydia trachomatis and Neisseria gonorrhoeae.
B. Treponema pallidum subsp. pallidum and human papillomavirus.
C. Streptococcus agalactiae and herpes simplex virus.
D. Candida albicans and Trichomonas vaginalis. - Answer -A. Chlamydia trachomatis
and Neisseria gonorrhoeae.
A known risk factor for subacute bacterial endocarditis due to alpha-streptococci
viridans group:
A. Oral broad=spectrum antimicrobial agents
B. Prolonged use of an indwelling bladder catheter
C. Oral trauma, e.g., tooth extraction
D. Puncture wound contaminated with soil - Answer -C. Oral trauma, e.g., tooth
extraction
A diabetic woman was previously treated with penicillin for strep throat and now
presents with a genital discharge. The most likely causative agent is:
A. Treponema pallidum
B. Herpes simplex virus
C. Candida albicans
D. Klebsiella granulomatis - Answer -C. Candida albicans
An elderly man enters the emergency department with gradual onset of signs and
symptoms suggestive of subacute endocarditis. After 48 hours, a blood culture bottle
from the patient is flagged by the continuous monitoring system as positive. Gram stain
demonstrates Gram-positive cocci and subculture reveals small alpha-hemolytic
colonies. Which of the following is the most likely cause of the infection?
A. Staphylococcus epidermidis
, B. Streptococcus pyogenes
C. Staphylococcus aureus
D. Viridans streptococci - Answer -D. Viridans streptococci
A dark-field examination of genital lesions would be most helpful in diagnosing:
A. Syphilis.
B. Gonorrhea.
C. Genital warts.
D. Genital herpes. - Answer -A. Syphilis.
Pertaining to the collection of blood for a blood culture:
A. It is sufficient to only use rubbing alcohol at the venipuncture site.
B. It is appropriate to draw through an arterial catheter.
C. Always draw blood above an IV.
D. Collect both aerobic and anaerobic bottles. - Answer -D. Collect both aerobic and
anaerobic bottles.
Granuloma inguinale is caused by:
A. Treponema pallidum subsp. Pallidum
B. Haemophilus ducreyi
C. Klebsiella granulomatis
D. Human papillomavirus - Answer -C. Klebsiella granulomatis
Chancroid is caused by:
A. Gardnerella vaginalis
B. Chlamydia trachomatis
C. Haemophilus ducreyi
D. Human papillomavirus - Answer -C. Haemophilus ducreyi
Lymphogranuloma venereum is caused by:
A. Treponema pallidum subsp. pallidum
B. Chlamydia trachomatis
C. Klebsiella granulomatis
D. Human papillomavirus - Answer -B. Chlamydia trachomatis
When collected properly, which specimens should never contain normal microbiota?
A. Blood and urethral
B. Blood and CSF
C. CSF and vaginal
D. Vaginal and urethral - Answer -B. Blood and CSF
Which of these is an abscess that extends more deeply into the subcutaneous tissue
and may have multiple draining sites?
A. Carbuncle
B. Folliculitis
C. Furuncle
When drawing blood cultures for a 5-year-old, the correct blood volume (according to
ASM) is _______.
A. Based upon the child's weight.
B. 1 mL for each year of life of the child.
C. 10 to 20 mL of blood per bottle to assure positive rate of 99%.
D. Any volume is sufficient since blood is more concentrated in children. - Answer -A.
Based upon the child's weight.
A patient presents with acute onset of signs and symptoms consistent with endocarditis.
The patient has a history of IV drug abuse. An echocardiogram demonstrates
vegetations on the mitral valve. The most likely pathogen is:
A. Cryptococcus neoformans
B. Escherichia coli
C. Treponema pallidum
D. Staphylococcus aureus - Answer -D. Staphylococcus aureus
What is the single most important variable for positive blood culture detection?
A. Blood volume
B. Incubation time
C. Time of collection
D. Prep of venipuncture site - Answer -A. Blood volume
A 24-year-old female is diagnosed with gonorrhea and the physician also suspects
chlamydia. The correct treatment is
A. Amoxicillin.
B. Ceftriaxone.
C. Cefixime and amoxicillin.
D. Ceftriaxone and azithromycin. - Answer -D. Ceftriaxone and azithromycin.
Three sets of blood cultures (6 bottles) are drawn from a car accident patient in the
emergency department. One aerobic bottle demonstrates a positive signal in a
continuous monitoring system at 24 hours. Gram stain reveals Gram-positive cocci in
clusters, which are catalase positive, and produced non-hemolytic colonies on a sheep
blood agar plate. Which of the following is the most likely explanation for these findings?
A. Septicemia due to Staphylococcus aureus
B. Septicemia due to Bacteroides fragilis group
C. Contamination due to staphylococci
D. Contamination due to fecal biota - Answer -C. Contamination due to staphylococci
Which of the following is a common principle of continuous monitoring blood culture
systems?
A.The amount of ATP produced is measured by determining changes over time
comparing to bottle background levels at primary reading.
,B. The amount of LPS is measured and monitored over time comparing to bottle
background levels at primary reading.
C. The amount of CO2 produced is measured by determining changes over time
comparing to bottle background levels at primary reading.
D. The amount of O2 produced is measured by determining changes over time
comparing to bottle background levels at primary reading. - Answer -C. The amount of
CO2 produced is measured by determining changes over time comparing to bottle
background levels at primary reading.
A 2-year-old patient with a history of leukemia is admitted to the hospital with a
diagnosis of possible sepsis. A set of blood cultures is collected, and after 11 hours on
the automated system, both aerobic and anaerobic bottles are positive. Gram stain
reveals rare coccobacilli. The next step is to:
A. Call the physician
B. Report findings to the laboratory manager
C. Reincubate the bottles
D. Recollect the blood cultures - Answer -A. Call the physician
Pelvic inflammatory disease in women is most frequently caused by:
A. Chlamydia trachomatis and Neisseria gonorrhoeae.
B. Treponema pallidum subsp. pallidum and human papillomavirus.
C. Streptococcus agalactiae and herpes simplex virus.
D. Candida albicans and Trichomonas vaginalis. - Answer -A. Chlamydia trachomatis
and Neisseria gonorrhoeae.
A known risk factor for subacute bacterial endocarditis due to alpha-streptococci
viridans group:
A. Oral broad=spectrum antimicrobial agents
B. Prolonged use of an indwelling bladder catheter
C. Oral trauma, e.g., tooth extraction
D. Puncture wound contaminated with soil - Answer -C. Oral trauma, e.g., tooth
extraction
A diabetic woman was previously treated with penicillin for strep throat and now
presents with a genital discharge. The most likely causative agent is:
A. Treponema pallidum
B. Herpes simplex virus
C. Candida albicans
D. Klebsiella granulomatis - Answer -C. Candida albicans
An elderly man enters the emergency department with gradual onset of signs and
symptoms suggestive of subacute endocarditis. After 48 hours, a blood culture bottle
from the patient is flagged by the continuous monitoring system as positive. Gram stain
demonstrates Gram-positive cocci and subculture reveals small alpha-hemolytic
colonies. Which of the following is the most likely cause of the infection?
A. Staphylococcus epidermidis
, B. Streptococcus pyogenes
C. Staphylococcus aureus
D. Viridans streptococci - Answer -D. Viridans streptococci
A dark-field examination of genital lesions would be most helpful in diagnosing:
A. Syphilis.
B. Gonorrhea.
C. Genital warts.
D. Genital herpes. - Answer -A. Syphilis.
Pertaining to the collection of blood for a blood culture:
A. It is sufficient to only use rubbing alcohol at the venipuncture site.
B. It is appropriate to draw through an arterial catheter.
C. Always draw blood above an IV.
D. Collect both aerobic and anaerobic bottles. - Answer -D. Collect both aerobic and
anaerobic bottles.
Granuloma inguinale is caused by:
A. Treponema pallidum subsp. Pallidum
B. Haemophilus ducreyi
C. Klebsiella granulomatis
D. Human papillomavirus - Answer -C. Klebsiella granulomatis
Chancroid is caused by:
A. Gardnerella vaginalis
B. Chlamydia trachomatis
C. Haemophilus ducreyi
D. Human papillomavirus - Answer -C. Haemophilus ducreyi
Lymphogranuloma venereum is caused by:
A. Treponema pallidum subsp. pallidum
B. Chlamydia trachomatis
C. Klebsiella granulomatis
D. Human papillomavirus - Answer -B. Chlamydia trachomatis
When collected properly, which specimens should never contain normal microbiota?
A. Blood and urethral
B. Blood and CSF
C. CSF and vaginal
D. Vaginal and urethral - Answer -B. Blood and CSF
Which of these is an abscess that extends more deeply into the subcutaneous tissue
and may have multiple draining sites?
A. Carbuncle
B. Folliculitis
C. Furuncle
