MV Flashcards by MS ICA

The most useful finding for prompt, presumptive identification of C. albicans is its:

Failure to assimilate sucrose
Feathering on EMB
Production of chlamydospores
Production of germ tubes

Production of germ tubes

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Essentially all strains of Candida albicans produce germ tubes within 2 hours of incubation at 37°C in serum.

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Germ tube formation is seen with which two yeasts?

C. albicans, C. neoformans
C. albicans, C. parapsilosis
C. glabrata, C. parapsilosis
C. albicans, C. dubliniensis

C. albicans, C. dubliniensis

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The formation of arthroconidia is not an important characteristic in the identification of:

Coccidioides
Geotrichum
Trichosporon
Sporothrix

Sporothrix

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Sporothrix is the sole member of the list that does not produce arthroconidia.

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A black pigment produced by colonies growing on bird seed agar is due to:

Urease
Phenol oxidase
Sucrose assimilation
Arthroconidia production

Phenol oxidase

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Phenol oxidase breaks down the substrate found in niger seeds producing melanin. This result is characteristic of C. neoformans.

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What are the optimal temperature and incubation time before a fungal blood culture is reported as negative?

37°C; 21 days
37°C; 7 days
30°C; 21 days
30°C; 7 days

30°C; 21 days

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Which group of molds can be ruled out when septate hyphae are observed in a culture?

Dematiaceous
Zygomycetes
Dermatophytes
Dimorphic molds

Zygomycetes

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Tinea versicolor is a skin infection caused by:

Malassezia furfur
Trichophyton rubrum
Trichophyton schoenleinii
Microsporum gypseum

Malassezia furfur

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M. furfur has a worldwide distribution and causes a superficial, brownish, dry, scaly patch on the skin of light-skinned persons and lighter patches on persons with dark skin.

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Dry, horny, platelike lesions or SCALES are associated with:

Dermatophytes (tinea)
Sporothrix schenckii
Mycobacterium marinum
Varicella-zoster virus

Dermatophytes (tinea)

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Adding specimen scrapings to 10% KOH to show the presence of SCLEROTIC BODIES that resemble COPPER PENNIES is useful in the diagnosis of:

Chromoblastomycosis
Phaeohyphomycosis
Mycetomas
Zygomycosis

Chromoblastomycosis

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A thermally dimorphic fungus shows a filamentous mold form with TUBERCULATE MACROCONIDIA at room temperature, and a yeast form above 35°C. Which organism best fits this description?

Histoplasma capsulatum
Paracoccidioides brasiliensis
Candida albicans
Coccidioides immitis

Histoplasma capsulatum

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The yeast form of which dimorphic mold shows a large parent yeast cell surrounded by smaller budding yeast cells?

Paracoccidioides brasiliensis
Sporothrix schenckii
Coccidioides immitis
Histoplasma capsulatum

Paracoccidioides brasiliensis

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P. brasiliensis yeast forms are sometimes seen as a “mariner’s wheel” because multiple budding cells completely surround the periphery of the parent cell.

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A 2-month-old infant in good health was scheduled for a checkup at the pediatrician’s office. After arriving for the appointment, the mother noted white patches on the baby’s tongue and in his mouth. The baby constantly used a pacifier. What is the most likely organism causing the white patches?

Cryptococcus neoformans
Candida albicans
Aspergillus fumigatus
None of these options

Candida albicans

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An India ink test was performed on CSF from an HIV-infected male patient. Many encapsulated yeast cells were seen in the centrifuged sample. Further testing revealed a positive urease test and growth of brown colonies on niger-seed agar. The diagnosis of meningitis was caused by which yeast?

Candida albicans
Cryptococcus neoformans
Cryptococcus laurentii
Candida tropicalis

Cryptococcus neoformans

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Immunocompromised patients are at risk for invasion of Cryptococcus neoformans. The polysaccharide capsule of C. neoformans is not recognized by phagocytes, which allow patients with impaired cell-mediated immunity to become readily infected with C. neoformans.

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The appearance of Koplik spots in the oral mucosa of patients is characteristic of infection with what viral agent?

Hepatitis
Measles
Rabies
Smallpox

Measles

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Koplik spots are diagnostic for measles infection and represent necrotic vesicles with a white center surrounded by erythema.

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Kaposi sarcoma is associated with infection by:

Adenovirus
Cytomegalovirus
Hepatitis E vims
Human herpes virus 8

Human herpes virus 8

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Kaposi sarcoma, a relatively common cancer in patients with AIDS, has been linked to human herpes virus 8.

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Negri bodies may be found in brain tissue of humans or animals infected with:

Adenovirus
Filovirus
Measles virus
Rabies virus

Rabies virus

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Rabies is a neurotropic virus that causes extensive destruction in the brain. Negri bodies are seen in the cytoplasm of large ganglion cells and are demonstrated by Seller’s stain. Rabies in humans or lower animals can be diagnosed by demonstration of these characteristic inclusions.

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The virus associated with warts is:

Flavivirus
Morbillivirus
Mumps virus
Papillomavirus

Papillomavirus

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The etiologic agents for the numerous benign cutaneous and mucosal lesions known as warts are the human papillomaviruses (HPVs).

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A dehydrated 25-year-old male patient was admitted to the hospital with SYMPTOMS SIMILAR TO THOSE OF CHRONIC FATIGUE SYNDROME. Serological testing proved negative for recent streptococcal infection, Epstein–Barr virus, and hepatitis. Which of the following viral serological tests should help with a possible diagnosis?

CMV
Echovirus
Respiratory syncytial virus
Measles virus

CMV

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Collection of specimens from cutaneous vesicles for detection of these viruses may require a TZANCK SMEAR:

CMV and EBV
HSV and VZV
JC and BK polyomavirus
HBV and HCV

HSV and VZV

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Transient aplastic crisis can occur with:

Parvovirus B19
West Nile virus
Cytomegalovirus
Epstein Barr virus

Parvovirus B19

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The filovirus that has a characteristic “shepherd’s hook” morphology when viewed by electron microscopy is:

Ebola Zaire virus
Ebola Reston virus
Ebola Sudan virus
Marburg virus

Marburg virus

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Slow but continuing replication of damaged virus in the brain gives rise to SUBACUTE SCLEROSING PANENCEPHALITIS:

Measles virus
Mumps virus
Parainfluenza virus
Respiratory syncytial virus (RSV)

Measles virus

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Subacute sclerosing panencephalitis (defective measles virus infection of CNS).

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Most common cause of ASEPTIC MENINGITIS, an inflammation of the brain parenchyma:

Arenavirus
Cytomegalovirus
Enterovirus
Herpes simplex virus 2

Enterovirus

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A 3-year-old female was admitted to the hospital following a 2-day visit with relatives over the Christmas holidays. Vomiting and diarrhea left the child severely dehydrated. No other members of the family were affected. All bacterial cultures proved negative. A stool sample should be tested for which virus?

Adenovirus
CMV
Hepatitis D
Rotavirus

Rotavirus

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Which of the following viruses is implicated along with Epstein–Barr virus as a cause of infectious mononucleosis? Cytomegalovirus (CMV) Coxsackie A virus Coxsackie B virus Hepatitis B virus

Cytomegalovirus (CMV) Feedback CMV infection in a previously healthy individual causes a self-limited mononucleosis syndrome

A very small, single-stranded DNA virus that causes a febrile illness with a rash and is called the fifth childhood disease after rubeola, rubella, varicella, and roseola is: Rotavirus Adenovirus type 40 Coxsackie A virus Parvovirus B19

Parvovirus B19 Feedback Parvovirus causes a fever and characteristic “slapped cheek” rash in young children. Adults are usually immune, but immunocompromised persons may exhibit an arthritis or anemia (the virus infects immature RBCs in the bone marrow).

All of the following are examples of appropriate specimens for the recovery of fungi except: Tissue biopsy CSF Aspirate of exudate Swab

Swab Specimens for fungal culture must be kept in a moist, sterile environment. Swabs that are dried out or submitted with insufficient material on them should be rejected.

What are the optimal temperature and incubation time before a FUNGAL BLOOD CULTURE is reported as negative? 37°C; 21 days 37°C; 7 days 30°C; 21 days 30°C; 7 days

30°C; 21 days

For which clinical specimens is the KOH direct mount technique for examination of fungal elements used? Skin CSF Blood Bone marrow

Skin A solution of 10% KOH is used for contaminated specimens such as skin, nail scrapings, hair, and sputum to clear away background debris that may resemble fungal elements.

Which group of molds can be ruled out when septate hyphae are observed in a culture? Dematiaceous Zygomycetes Dermatophytes Dimorphic molds

Zygomycetes Zygomycetes commonly recovered from clinical specimens are Rhizopus spp. and Mucor spp. Both display ASEPTATE HYPHAE, while the other groups above display septate hyphae.

Tinea versicolor is a skin infection caused by: Malassezia furfur Trichophyton rubrum Trichophyton schoenleinii Microsporum gypseum

Malassezia furfur

Cutaneous mycoses are fungal infections that involve: Hair Skin Nails All of the above

All of the above

A Wood’s lamp is used to detect fluorescing hairs in which dermatophyte? M. audouinii M. canis M. gypseum M. audouinii, M. canis

M. audouinii, M. canis M. audouinii: fluoresce yellow-green under a Wood’s lamp, no growth in rice medium M. canis :bright yellow-green under a Wood’s lamp, growth in rice medium

Which test can be used to differentiate T. mentagrophytes from T. rubrum? Fluorescence using a Wood’s lamp In vitro hair perforation Red color on reverse side of colony Gram staining

In vitro hair perforation T. mentagrophytes: positive hair baiting and urease test T. rubrum: negative hair baiting and urease test

Adding specimen scrapings to 10% KOH to show the presence of SCLEROTIC BODIES that resemble copper pennies is useful in the diagnosis of: Chromoblastomycosis Phaeohyphomycosis Mycetomas Moniliasis

Chromoblastomycosis

Which of the following is a fungus known to cause chromoblastomycosis? Bipolaris spp. Cladosporium spp Cryptococcus spp. Candida spp.

Cladosporium spp CHROMOBLASTOMYCOSIS: Cladosporium, Phialophora, and Fonsecaea spp.

Sickle- or boat-shaped macroconidia on cornmeal agar are characteristic of: Alternaria spp. Aspergillus spp. Penicillium spp. Fusarium spp

Fusarium spp

A hyaline mold recovered from a patient with AIDS produced rose-colored colonies with lavender centers on Sabouraud dextrose agar. Microscopic examination showed multiseptate macroconidia appearing as SICKLES OR CANOES. What is the most likely identification? Fusarium spp. Wangiella spp. Exophiala spp. Phialophora spp.

Fusarium spp.

All of the following are medically dimorphic fungi EXCEPT: Histoplasma capsulatum Blastomyces dermatitidis Coccidioides immitis Aspergillus niger

Aspergillus niger

Dimorphic molds are found in infected TISSUE in which form? Mold phase Yeast phase Encapsulated Latent

Yeast phase

Which fungus is most often acquired by traumatic implantation into the skin? Histoplasma capsulatum Sporothrix schenckii Coccidioides immitis Penicillium marneffei

Sporothrix schenckii Humans acquire the infection (sporotrichosis) through trauma (thorns, splinters), usually to the hand, arm, or leg. The infection is an occupational hazard for farmers, nursery workers, gardeners, florists, and miners; it is commonly known as “ROSE GARDENER’S DISEASE.”

Which dimorphic fungus may be contracted by people who clean chicken coops? Blastomyces dermatitidis Histoplasma capsulatum Coccidioides immitis Paracoccidioides brasiliensis

Histoplasma capsulatum Numerous cases of histoplasmosis have been reported in people who clean out an old chicken coop or barn that has been undisturbed for long periods and in individuals who work in or clean areas that have served as roosting places for starlings and similar birds. SPELUNKERS (i.e., cave explorers) are commonly exposed to the organism when it is aerosolized from bat guano in caves.

The yeast form of which dimorphic fungus appears as oval or elongated CIGAR SHAPES? Coccidioides immitis Sporothrix schenckii Histoplasma capsulatum Blastomyces dermatitidis

Sporothrix schenckii

The yeast form of which dimorphic mold shows a large parent yeast cell surrounded by smaller budding yeast cells? Paracoccidioides brasiliensis Sporothrix schenckii Coccidioides immitis Histoplasma capsulatum

Paracoccidioides brasiliensis P. brasiliensis yeast forms are sometimes seen as a “MARINER’S WHEEL” because multiple budding cells completely surround the periphery of the parent cell.

A bone marrow sample obtained from an immunocompromised patient revealed small intracellular cells using a Wright’s stain preparation. Growth on Sabouraud–dextrose agar plates of a mold phase at 25°C and a yeast phase at 37°C designates the organism as dimorphic. The mold phase produced thick, spherical TUBERCULATED MACROCONIDIA. What is the most likely identification? Histoplasma capsulatum Sepedonium spp. Sporothrix schenckii Coccidioides immitis

Histoplasma capsulatum

The mycelial form of Histoplasma capsulatum seen on agar resembles: Sepedonium spp. Penicillium spp. Sporothrix spp. Coccidioides spp

Sepedonium spp. Sepedonium spp. are saprophytic molds that do not have a yeast phase and produce large spherical TUBERCULATE MACROCONIDIA like H. capsulatum.

The mycelial form of which dimorphic mold produces thick-walled, rectangular, or barrel-shaped alternate ARTHROCONIDIA? Coccidioides immitis Sporothrix schenckii Histoplasma capsulatum Blastomyces dermatitidis

Coccidioides immitis

Upon direct examination of a sputum specimen, several SPHERULES were noted that contained endospores. Growth on Sabouraud–dextrose agar showed aerial mycelial elements. The septate hyphae produced barrel-shaped ARTHROCONIDIA. What is the most likely identification? Penicillium marneffei Scopulariopsis spp. Cryptococcus neoformans Coccidioides immitis

Coccidioides immitis

What is the FIRST STEP to be performed in the identification of an unknown yeast isolate? Gram stain smear India ink stain Catalase test Germ tube test

Germ tube test

Germ tube formation is seen with which two yeasts? C. albicans, C. neoformans C. albicans, C. parapsilosis C. glabrata, C. parapsilosis C. albicans, C. dubliniensis C. glabrata, C. dubliniensis

C. albicans, C. dubliniensis The germ tube test is the most generally accepted and economical method used in the clinical laboratory to identify yeasts. Approximately 80% of the yeasts recovered from clinical specimens are C. albicans, and the germ tube test usually provides sufficient identification of the organism within 3 hours. Another Candida species, C. dubliniensis, has been shown to also produce germ tubes. Although C. dubliniensis is infrequently encountered in clinical specimens, supplemental biochemical or morphologic testing may be needed to differentiate it from C. albicans. C. tropicalis produces what have been called “pseudo–germ tubes,” which are constricted at the base or point of germ tube origin on the yeast cell.

Chlamydospore production is demonstrated by which Candida species? C. glabrata C. krusei C. albicans C. tropicalis

C. albicans C. albicans may be identified by the production of GERM TUBES or CHLAMYDOCONIDIA

What type of stain is best used to detect Candida in bloodstream infections? Gram stain Acridine orange Methylene blue Calcofluor white

Acridine orange Acridine orange (AO) staining proved particularly helpful in the early detection of candidemia—one third of all microorganisms missed by Gram stain of instrument-positive bottles were yeasts detected by AO staining.

An India ink test was performed on CSF from an HIV-infected male patient. Many encapsulated yeast cells were seen in the centrifuged sample. Further testing revealed a positive urease test and growth of brown colonies on Niger-seed agar. The diagnosis of meningitis was caused by which yeast? Candida albicans Cryptococcus neoformans Cryptococcus laurentii Candida tropicalis

Cryptococcus neoformans

Which of the following yeast enzymes is detected using birdseed (NIGER SEED) agar? Phenol oxidase Catalase Urease Nitrate reductase

Phenol oxidase Most isolates of C. neoformans produce phenol oxidase when grown on birdseed medium, producing BROWN TO BLACK PIGMENTED COLONIES.

Which of the following organisms is/are partially or completely inhibited by media containing CYCLOHEXIMIDE? Cryptococcus spp. Candida krusei Aspergillus niger All of the above

All of the above Pathogenic fungi, such as C. neoformans complex, Candida krusei and other Candida spp., Trichosporon spp., P. boydii, and Aspergillus spp., are partially or completely inhibited by cycloheximide.

A lung biopsy obtained from an immunocompromised patient showed many “cup-shaped” cysts (gray to black) in a foamy exudate (green background) using Gomori methenamine silver (GMS) stain. The organism cannot be cultured because it does not grow on routine culture media for molds. The patient was diagnosed with pneumonia that resisted antibiotic treatment. The most likely identification is? Pneumocystis jiroveci (carinii) Histoplasma capsulatum Sporothrix schenckii Scopulariopsis spp.

Pneumocystis jiroveci (carinii) Pneumocystis jiroveci (carinii), most recently classified as a fungus but formerly as a parasite, is best recovered by bronchoalveolar lavage or induced sputum in immunocompromised patients. Open lung biopsy sample was the specimen of choice before the AIDS epidemic. Gomori methenamine silver stain is used to identify the organism; it stains the cyst form but not the trophozoites.

A 65-year-old male with HIV presents to the emergency department with night sweats, a nonproductive cough, and a low-grade fever. Pneumocystis pneumonia (PCP) is suspected. Which of the following is the best specimen for diagnostic staining for Pneumocystis jiroveci? Urine Sputum Bronchoalveolar lavage fluid Blood Nasopharyngeal swab

Bronchoalveolar lavage fluid Respiratory specimens from the deep portions of the lung, such as bronchoalveolar lavage fluid (BALF), are best for detection of P. jiroveci.

Which of the following is not a step involved in virus replication? Attachment Mitosis Penetration Release

Mitosis STEPS IN VIRAL REPLICATION 1. Attachment (adsorption) 2. Penetration 3. Uncoating 4. Macromolecular synthesis 5. Viral assembly 6. Release

In the virus laboratory, most manipulation of viruses occurs at what safety level? Biosafety Level 1 Biosafety Level 2 Biosafety Level 3

Biosafety Level 2

Classification of viruses is made by: Complement fixation serology Electron microscopy Nucleic acid composition Cellular inclusion bodies

Nucleic acid composition True viruses have nucleic acid that is either RNA or DNA, and this serves as the basis for initial classification.

Which of the following viruses is predominantly associated with respiratory disease and epidemics of KERATOCONJUNCTIVITIS? Adenovirus Molluscum contagiosum virus Norwalk virus Rotavirus

Adenovirus

The type of cell culture that best supports the growth of cytomegalovirus is: HeLa cells HEp-2 cells Human fibroblast cells Primary monkey kidney (PMK) cells

Human fibroblast cells

What is the primary cause of STOMATITIS, inflammation of the mucous membranes of the oral cavity? Herpes simplex virus Klebsiella spp. Candida spp. Enterobacteriaceae

Herpes simplex virus Stomatitis is an inflammation of the mucous membranes of the oral cavity. Herpes simplex virus is the primary agent of this disease, in which multiple ulcerative lesions are seen on the oral mucosa.

Parvovirus B19

Transient APLASTIC CRISIS can occur with: Parvovirus B19 West Nile virus CMV EBV

Parvovirus B19

Which virus is associated with venereal and respiratory tract WARTS and produces lesions of skin and mucous membranes? Polyomavirus Poxvirus Adenovirus Papillomavirus

Papillomavirus

An immunocompromised patient was admitted to the hospital with a diagnosis of HEMORRHAGIC CYSTITIS. Which combination of virus and specimen would be most appropriate to diagnose a viral cause of this disorder? BK virus—urine Human papilloma virus—skin Hepatitis B virus—serum Epstein–Barr virus—serum

BK virus—urine

John Cunningham (JC) virus is associated with: Hemorrhagic cystitis Progressive multifocal leukoencephalopathy

Progressive multifocal leukoencephalopathy BK VIRUS: Hemorrhagic cystitis JC VIRUS: Progressive multifocal leukoencephalopathy

MOLLUSCUM CONTAGIOSUM VIRUS is a member of the: Adenoviruses Herpes viruses Papovaviruses Pox viruses

Pox viruses

Kaposi sarcoma is associated with infection by: Adenovirus Cytomegalovirus Hepatitis E vims Human herpes virus 8

Human herpes virus 8

Which virus is the most common etiological agent of viral respiratory diseases in infants and children? Respiratory syncytial virus (RSV) Measles virus Coxsackie A virus Coxsackie B virus

Respiratory syncytial virus (RSV)

The three respiratory agents most often responsible for causing CROUP in pediatric patients are: Parainfluenza, RSV, and rhinovirus Influenza A, RSV, and parainfluenza 3 Coronavirus, RSV, and rhinovirus Parainfluenza, RSV, and metapneumovirus

Parainfluenza, RSV, and metapneumovirus CROUP: Inflammation of upper airways (larynx, trachea) with respiratory obstruction, often caused by virus infections in children.

SUBACUTE SCLEROSING PANENCEPHALITIS is defective ______ virus infection of CNS. Measles Mumps Polio Rabies

Measles

Mumps is characterized by an infection of the: Central nervous system Parotid glands (salivary gland) Pancreas Thymus

Parotid glands (salivary gland)

What virus traditionally causes viral parotitis? Influenza virus Parainfluenza virus Rhinovirus Mumps virus

Mumps virus

Most common cause of ASEPTIC MENINGITIS, an inflammation of the brain parenchyma, and have been isolated from more than 40% of patients with this disease: CMV HIV Rotavirus Enteroviruses

Enteroviruses

The etiologic agents of many common colds are RNA viruses that grow better at 33°C than at 37°C. These viruses are: Adenoviruses Orthomyxoviruses Paramyxoviruses Rhinoviruses

Rhinoviruses

The most common viral syndrome of pericarditis, myocarditis, and pleurodynia (pain upon breathing) is caused by: Herpes simplex virus Respiratory syncytial virus Epstein–Barr virus Coxsackie virus

Coxsackie virus

Which virus belonging to the Reoviridae group causes gastroenteritis in infants and young children but an asymptomatic infection in adults? Coxsackie B virus Rotavirus Respiratory syncytial virus Rhabdovirus

Rotavirus

Which virus has been implicated in ADULT GASTROENTERITIS resulting from ingestion of contaminated food (especially shellfish) and water? Norwalk-like viruses Rotavirus Hepatitis C virus Coronavirus

Norwalk-like viruses

Which virus has been implicated in ADULT GASTROENTERITIS resulting from ingestion of contaminated food (especially shellfish) and water? Norwalk-like viruses Rotavirus Hepatitis C virus Coronavirus

Norwalk-like viruses

NEGRI BODIES may be found in brain tissue of humans or animals infected with: Adenovirus Filovirus Measles virus Rabies virus

Rabies virus

The coronavirus SARS epidemic resulted in many cases and deaths. What is the primary route of transmission of human coronaviruses? Fecal–oral Respiratory Blood Perinatal mother-to-infant Sexual activity

Respiratory

Coronavirus infections in humans usually cause a common cold syndrome. However, a recent outbreak of SARS was characterized by pneumonia and progressive respiratory failure. The prevention of these diseases can be accomplished by: A subunit vaccine A cold-adapted live-attenuated vaccine The antiviral drug amantadine Infection control measures, including isolation and wearing of protective gear The antiviral drug acyclovir

Infection control measures, including isolation and wearing of protective gear

Based on sequence analysis and serologic assays, the most likely origin of the SARS coronavirus is which of the following? Recombination between a human and an animal coronavirus that created a new virus Jump of an animal coronavirus into humans Mutation of a human coronavirus that resulted in increased virulence Acquisition of human cellular genes by a human coronavirus via recombination that allowed viral evasion of the host immune response

Jump of an animal coronavirus into humans The SARS virus probably originated in a nonhuman host, most likely bats, was amplified in palm civets, and was transmitted to humans in live animal markets. Chinese horseshoe bats are natural reservoirs of SARS-like coronaviruses.

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