Micro-Specimen Collection, Media, and Methods

Question 1

1. The aseptic collection of blood cultures requires
   that the skin be cleansed with:
   A. 2% iodine and then 70% alcohol solution
   B. 70% alcohol and then 2% iodine or an
   iodophor
   C. 70% alcohol and then 95% alcohol
   D. 95% alcohol only

Answer 1

B. 70% alcohol and then 2% iodine or an
iodophor

Question 2

2. When cleansing the skin with alcohol and then
   iodine for the collection of a blood culture, the
   iodine (or iodophor) should remain intact on
   the skin for at least:
   A. 10 sec
   B. 30 sec
   C. 60 sec
   D. 5 min

Answer 2

C. 60 sec

Question 3

3. What is the purpose of adding 0.025%–0.050%
   sodium polyanetholsulfonate (SPS) to nutrient
   broth media for the collection of blood cultures?
   A. It inhibits phagocytosis and complement
   B. It promotes formation of a blood clot
   C. It enhances growth of anaerobes
   D. It functions as a preservative

Answer 3

A. It inhibits phagocytosis and complement

Question 4

4. A flexible calcium alginate nasopharyngeal swab
   is the collection device of choice for recovery of
   which organism from the nasopharynx?
   A. Staphylococcus aureus
   B. Streptococcus pneumoniae
   C. Corynebacterium diphtheriae
   D. Bacteroides fragilis

Answer 4

C. Corynebacterium diphtheriae

Question 5

5. Semisolid transport media such as Amies, Stuart,
   or Cary–Blair are suitable for the transport of
   swabs for culture of most pathogens except:
   A. Neisseria gonorrhoeae
   B. Enterobacteriaceae
   C. Campylobacter fetus
   D. Streptococcus pneumoniae

Answer 5

A. Neisseria gonorrhoeae

Question 6

6. Select the method of choice for recovery of
   anaerobic bacteria from a deep abscess.
   A. Cotton fiber swab of the abscess area
   B. Skin snip of the surface tissue
   C. Needle aspirate after surface decontamination
   D. Swab of the scalpel used for débridement

Answer 6

C. Needle aspirate after surface decontamination

Question 7

7. Select the primary and differential media of choice
   for recovery of most fecal pathogens.
   A. MacConkey, blood, birdseed, and Campylobacter
   (Campy) agars
   B. Hektoen, MacConkey, Campy, colistin–nalidixic
   acid (CNA) agars
   C. CNA and Christensen urea agars and
   thioglycollate media
   D. Blood, Campy, Mueller–Hinton agars,
   and thioglycollate media

Answer 7

B. Hektoen, MacConkey, Campy, colistin–nalidixic
acid (CNA) agars

Question 8

8. Select the media of choice for recovery of Vibrio
   cholerae from a stool specimen.
   A. MacConkey agar and thioglycollate media
   B. Thiosulfate–citrate–bile–sucrose (TCBS) agar
   and alkaline peptone water (APW) broth
   C. Blood agar and selenite-F (SEL) broth
   D. CNA agar

Answer 8

B. Thiosulfate–citrate–bile–sucrose (TCBS) agar
and alkaline peptone water (APW) broth

Question 9

9. Colistin–nalidixic acid agar (CNA) is used
   primarily for the recovery of:
   A. Neisseria species
   B. Enterobacteriaceae
   C. Pseudomonas aeruginosa
   D. Staphylococcus aureus

Answer 9

D. Staphylococcus aureus

Question 10

10. In the United States, most blood agar plates
    are prepared with 5% or 10% red blood cells
    (RBCs) obtained from:
    A. Sheep
    B. Horses
    C. Humans
    D. Dogs

Answer 10

A. Sheep

Question 11

11. All of the following are appropriate when
    attempting to isolate N. gonorrhoeae from a
    genital specimen except:
    A. Transport the genital swab in charcoal transport
    medium
    B. Plate the specimen on modified Thayer–Martin
    (MTM) medium
    C. Plate the specimen on New York City or
    Martin–Lewis agar
    D. Culture specimens in ambient oxygen at 37°C

Answer 11

D. Culture specimens in ambient oxygen at 37°C

Question 12

12. Chocolate agar and modified Thayer–Martin agar
    are used for the recovery of:
    A. Haemophilus spp. and Neisseria spp., respectively
    B. Haemophilus spp. and N. gonorrhoeae,
    respectively
    C. Neisseria spp. and Streptococcus spp., respectively
    D. Streptococcus spp. and Staphylococcus spp.,
    respectively

Answer 12

B. Haemophilus spp. and N. gonorrhoeae,
respectively

Question 13

13. Cycloserine–cefoxitin-fructose agar (CCFA) is
    used for the recovery of:
    A. Yersinia enterocolitica
    B. Yersinia intermedia
    C. Clostridium perfringens
    D. Clostridium difficile

Answer 13

D. Clostridium difficile

Question 14

14. Deoxycholate agar (DCA) is useful for the
    isolation of:
    A. Enterobacteriaceae
    B. Enterococcus spp.
    C. Staphylococcus spp.
    D. Neisseria spp.

Answer 14

A. Enterobacteriaceae

Question 15

15. Xylose lysine deoxycholate (XLD) agar is a highly
    selective medium used for the recovery of which
    bacteria?
    A. Staphylococcus spp. from normal flora
    B. Yersinia spp. that do not grow on Hektoen agar
    C. Enterobacteriaceae from gastrointestinal
    specimens
    D. Streptococcus spp. from stool cultures

Answer 15

C. Enterobacteriaceae from gastrointestinal
specimens

Question 16

16. A sheep blood agar plate is used as a primary
    isolation medium when all of the following
    organisms are to be recovered from a wound
    specimen except:
    A. β-Hemolytic streptococci and coagulase-positive
    staphylococci
    B. Haemophilus influenzae and Haemophilus
    parainfluenzae
    C. Proteus spp. and Escherichia coli
    D. Pseudomonas spp. and Acinetobacter spp.

Answer 16

B. Haemophilus influenzae and Haemophilus
parainfluenzae

Question 17

17. Prereduced and vitamin K1-supplemented blood
    agar plates are recommended isolation media for:
    A. Mycobacterium marinum and Mycobacterium
    avium intracellulare
    B. Bacteroides, Peptostreptococcus, and Clostridium spp.
    C. Proteus spp.
    D. Enterococcus spp.

Answer 17

B. Bacteroides, Peptostreptococcus, and Clostridium spp.

Question 18

18. Which procedure is appropriate for culture
    of genital specimens in order to recover
    Chlamydia spp.?
    A. Inoculate cycloheximide-treated McCoy cells
    B. Plate onto blood and chocolate agar
    C. Inoculate into thioglycollate (THIO) broth
    D. Plate onto modified Thayer–Martin agar within
    24 hours

Answer 18

A. Inoculate cycloheximide-treated McCoy cells

Question 19

19. Specimens for virus culture should be transported
    in media containing:
    A. Antibiotics and 5% sheep blood
    B. Saline and 5% sheep blood
    C. 22% bovine albumin
    D. Antibiotics and nutrient

Answer 19

D. Antibiotics and nutrient

Question 20

20. Cerebrospinal fluid (CSF) should be cultured
    immediately, but if delayed the specimen
    should be:
    A. Refrigerated at 4°C to 6°C
    B. Frozen at –20°C
    C. Stored at room temperature for no longer
    than 24 hours
    D. Incubated at 37°C and cultured as soon as
    possible

Answer 20

D. Incubated at 37°C and cultured as soon as
possible

Question 21

21. The most sensitive method for the detection
    of β-lactamase in bacteria is by the use of:
    A. Chromogenic cephalosporin
    B. Penicillin
    C. Oxidase
    D. Chloramphenicol acetyltransferase

Answer 21

A. Chromogenic

Question 22

22. The breakpoint of an antimicrobial drug refers to:
    A. The amount needed to cause bacteriostasis
    B. A minimum inhibitory concentration (MIC) of
    16 μg/mL or greater
    C. A MIC of 64 μg/mL or greater
    D. The level of drug that is achievable in serum

Answer 22

D. The level of drug that is achievable in serum

Question 23

23. Which of the following variables may change the
    results of an MIC?
    A. Inoculum size
    B. Incubation time
    C. Growth rate of the bacteria
    D. All of these options

Answer 23

D. All of these options

Question 24

24. According to the Kirby–Bauer standard
    antimicrobial susceptibility testing method,
    what should be done when interpreting the zone
    size of a motile, swarming organism such as a
    Proteus species?
    A. The swarming area should be ignored
    B. The results of the disk diffusion method are
    invalid
    C. The swarming area should be measured as the
    growth boundary
    D. The isolate should be retested after diluting to a
    0.05 McFarland standard

Answer 24

A. The swarming area should be ignored

Question 25

25. Which class of antibiotics is used for the treatment of serious gram-negative infections as well as infections with Mycobacterium tuberculosis? A. Cephalosporins B. Penicillins C. Tetracyclines D. Aminoglycosides

Answer 25

D. Aminoglycosides

Question 26

26. Select the medium best suited for the recovery of Yersinia enterocolitica from a patient with gastroenteritis. A. Hektoen agar B. Cefsulodin–Irgasan–Novobiocin (CIN) agar C. Blood agar D. Eosinmethylene blue agar

Answer 26

B. Cefsulodin–Irgasan–Novobiocin (CIN) agar

Question 27

27. A suspected case of plague requires which of the following procedures in order to confirm Yersinia pestis? A. Collection of multiple sets of blood cultures B. Incubation of blood cultures at both 28°C and 35°C C. Culture aspirates from bubos to MacConkey agar at room temperature D. All of these options

Answer 27

D. All of these options

Question 28

28. SITUATION: Abdominal pain, fever, vomiting, and nausea prompted an elderly male to seek medical attention. A watery stool specimen producing no fecal leukocytes or erythrocytes was cultured and grew a predominance of gram-negative fermentative bacilli. The colonies were beta-hemolytic on blood agar and cream colored on MacConkey agar. The colonies were both oxidase and catalase positive. What is the most likely identification? A. Aeromonas hydrophilia B. Escherichia coli C. Salmonella spp. D. Shigella spp.

Answer 28

A. Aeromonas hydrophilia

Question 29

29. SITUATION: Several attendees of a medical conference in the Gulf coast area became ill after frequenting a seafood restaurant. A presumptive identification of Vibrio cholera was made after stool specimens from several subjects grew clear colonies on MacConkey agar and yellow colonies on TCBS agar. Which key tests would help eliminate Aeromonas and Plesiomonas spp.? A. Mannitol fermentation, Na+ requirement B. Oxidase, motility C. Oxidase, nitrate D. Hemolysis on blood agar, catalase

Answer 29

A. Mannitol fermentation, Na+ requirement

Question 30

30. SITUATION: A group of elementary students became ill after eating undercooked ground beef prepared in the school cafeteria. The suspected pathogen, E. coli serotype 0157:H7, is usually recovered using which of the following media? A. XLD agar B. MacConkey agar C. MacConkey agar with sorbitol D. Hektoen agar

Answer 30

C. MacConkey agar with sorbitol