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INSTAND 427 Mykobakteriendiagnostik - Empfindlichkeitsprüfung von nichttuberkulösen Exam

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INSTAND 427
Mykobakteriendiagnostik -
Empfindlichkeitsprüfung von
nichttuberkulösen
Mykobakterien Exam

,INSTAND 427 Mykobakteriendiagnostik - Empfindlichkeitsprüfung von nichttuberkulösen Mykobakterien Exam




Question 1
Identify the statement requiring a technical correction. I. “Detektion des erm(41)-Gens
und Nachweis einer induzierbaren Makrolidresistenz (insb. beim Mycobacterium
abscessus-Komplex)” II. “Detektion von Mutationen im rrs-Gen
(Aminoglykosidresistenz)” III. “Anwendung und Limitationen validierter Breakpoints
(Grenzwerte nach CLSI M24 oder EUCAST)”
A. Statement II.
B. No correction is required.
C. Statement I.
D. Statement III.


Correct Answer: B
Full Explanation:
Detektion des erm(41)-Gens und Nachweis einer induzierbaren Makrolidresistenz (insb. beim
Mycobacterium abscessus-Komplex). Detektion von Mutationen im rrs-Gen (Aminoglykosidresistenz).
Anwendung und Limitationen validierter Breakpoints (Grenzwerte nach CLSI M24 oder EUCAST). Each
note retains its appropriate expression, so none requires correction.


Question 2
Two descriptions are complete and one retains a gap. I. “Anforderungen und Kriterien
des INSTAND-Ringversuchs (Probenidentifikation, ____)” II. “Kulturelle Anzuchtverfahren
in Flüssig- und Festmedien (z. B. MGIT, Lowenstein-Jensen-Medium)” III. “Interne
Qualitätskontrolle (IQK) unter Verwendung definierter Referenzstämme” Which
expression completes the remaining gap?
A. z. B. MGIT, Lowenstein-Jensen-Medium
B. und Infektionswege
C. IQK
D. korrekte MHK-Bestimmung und Resistenzkategorisierung


Correct Answer: D
Full Explanation:
Anforderungen und Kriterien des INSTAND-Ringversuchs (Probenidentifikation, korrekte
MHK-Bestimmung und Resistenzkategorisierung). Kulturelle Anzuchtverfahren in Flüssig- und
Festmedien (z. B. MGIT, Lowenstein-Jensen-Medium). Interne Qualitätskontrolle (IQK) unter
Verwendung definierter Referenzstämme. The remaining gap requires its own context-specific term,
not an expression borrowed from either completed description.




Questions and explanations Page 2

,INSTAND 427 Mykobakteriendiagnostik - Empfindlichkeitsprüfung von nichttuberkulösen Mykobakterien Exam




Question 3
For this review, workstream I addresses “Grundlagen und Taxonomie der
Nichttuberkulösen Mykobakterien (NTM)”, including “Klassifikation und Differenzierung
der Mykobakterien (Abgrenzung zum Mycobacterium tuberculosis-Komplex und
Mycobacterium leprae)”; workstream II addresses “Methoden der
Empfindlichkeitsprüfung (In-vitro-Resistenztestung)”, including
“Agar-Dilutionsverfahren”. Which assignment covers the two stated responsibilities
without replacing either one?
A. I and II: Agar-Dilutionsverfahren.
B. I: Agar-Dilutionsverfahren; II: Klassifikation und Differenzierung der Mykobakterien (Abgrenzung
zum Mycobacterium tuberculosis-Komplex und Mycobacterium leprae).
C. I: Klassifikation und Differenzierung der Mykobakterien (Abgrenzung zum Mycobacterium
tuberculosis-Komplex und Mycobacterium leprae); II: Agar-Dilutionsverfahren.
D. I and II: Klassifikation und Differenzierung der Mykobakterien (Abgrenzung zum Mycobacterium
tuberculosis-Komplex und Mycobacterium leprae).


Correct Answer: C
Full Explanation:
Within Grundlagen und Taxonomie der Nichttuberkulösen Mykobakterien (NTM), the relevant
consideration is Klassifikation und Differenzierung der Mykobakterien (Abgrenzung zum
Mycobacterium tuberculosis-Komplex und Mycobacterium leprae). Within Methoden der
Empfindlichkeitsprüfung (In-vitro-Resistenztestung), the relevant consideration is
Agar-Dilutionsverfahren. Covering both responsibilities requires retaining both of the stated
considerations rather than duplicating one.


Question 4
For the topic “Langsam wachsende NTM”, an assessment addresses z. B. Mycobacterium
avium-Komplex [MAC], Mycobacterium kansasii, Mycobacterium xenopi, Mycobacterium
marinum. For “Anforderungen an Probengewinnung, Transport und Lagerung”, what
additional consideration is required rather than repeating the first?
A. Replace both topics with Langsam wachsende NTM.
B. z. B. Mycobacterium avium-Komplex [MAC], Mycobacterium kansasii, Mycobacterium xenopi,
Mycobacterium marinum
C. Treat z. B. Mycobacterium avium-Komplex [MAC], Mycobacterium kansasii, Mycobacterium xenopi,
Mycobacterium marinum as the definition of both topics.
D. Sputum, Bronchialsekret, Biopsien, Punktionsflüssigkeiten, Blutkulturen


Correct Answer: D
Full Explanation:
Langsam wachsende NTM is associated with z. B. Mycobacterium avium-Komplex [MAC],
Mycobacterium kansasii, Mycobacterium xenopi, Mycobacterium marinum. Anforderungen an
Probengewinnung, Transport und Lagerung is associated with Sputum, Bronchialsekret, Biopsien,
Punktionsflüssigkeiten, Blutkulturen. A complete comparison retains the separate consideration
attached to the second topic.




Questions and explanations Page 3

, INSTAND 427 Mykobakteriendiagnostik - Empfindlichkeitsprüfung von nichttuberkulösen Mykobakterien Exam




Question 5
Evaluate the accuracy of each completed technical statement. I. “Interne
Qualitätskontrolle (IQK) unter Verwendung definierter Referenzstämme” II.
“Identifizierung auf Speziesebene (z. B. Clarithromycin, Azithromycin, Ethambutol,
Rifampicin, Rifabutin, Amikacin, Moxifloxacin, Linezolid)” III. “Qualitätskriterien für
Isolate vor der Empfindlichkeitsprüfung (Reinkultur, Ausschluss von Kontaminationen,
IQK)”
A. Statements I and III only.
B. Statement II only.
C. Statement I only.
D. Statements I and II only.


Correct Answer: C
Full Explanation:
Interne Qualitätskontrolle (IQK) unter Verwendung definierter Referenzstämme. Testsubstanzen für
langsam wachsende NTM (z. B. Clarithromycin, Azithromycin, Ethambutol, Rifampicin, Rifabutin,
Amikacin, Moxifloxacin, Linezolid). Qualitätskriterien für Isolate vor der Empfindlichkeitsprüfung
(Reinkultur, Ausschluss von Kontaminationen, Identifizierung auf Speziesebene). Check each
statement independently; a correct term in one context does not validate a different term in another.


Question 6
For this review, workstream I addresses “Methoden der Empfindlichkeitsprüfung
(In-vitro-Resistenztestung)”, including “Detektion des erm(41)-Gens und Nachweis einer
induzierbaren Makrolidresistenz (insb. beim Mycobacterium abscessus-Komplex)”;
workstream II addresses “Dokumentation, Befundung und Qualitätsmanagement”,
including “Fehlerquellen, Ursachenanalyse und Troubleshooting bei abweichenden oder
unklaren Testergebnissen”. The review of “Detektion des erm(41)-Gens und Nachweis
einer induzierbaren Makrolidresistenz (insb. beim Mycobacterium abscessus-Komplex)” is
complete, but “Fehlerquellen, Ursachenanalyse und Troubleshooting bei abweichenden
oder unklaren Testergebnissen” has not been addressed. Which status statement is
justified?
A. The first stated responsibility has been addressed; the second remains open.
B. Neither stated responsibility has been addressed.
C. Both stated responsibilities have been addressed.
D. The second stated responsibility has been addressed; the first remains open.


Correct Answer: A
Full Explanation:
Within Methoden der Empfindlichkeitsprüfung (In-vitro-Resistenztestung), the relevant consideration
is Detektion des erm(41)-Gens und Nachweis einer induzierbaren Makrolidresistenz (insb. beim
Mycobacterium abscessus-Komplex). Within Dokumentation, Befundung und Qualitätsmanagement,
the relevant consideration is Fehlerquellen, Ursachenanalyse und Troubleshooting bei abweichenden
oder unklaren Testergebnissen. Evidence of completion for one consideration is not evidence that
the other has been reviewed.




Questions and explanations Page 4

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