Microbiology Exam Chamberlain - Predictor
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595. Additional history reveals that she has had several serious infections with this organism
previously. On the basis of this, which one of the following is the MOST likely predisposing
factor?
(A) She is HIV antibody positive.
(B) She is deficient in CD8-positive T cells.
(C) She is deficient in one of the late-acting complement components.
(D) She is deficient in antigen presentation by her macrophages. –
Correct Answer :594 (B)
595 (C)
CASE 2. Your patient is a 70-year-old man with a long history of smoking who now has a fever
and a cough productive of greenish sputum. You suspect pneumonia, and a chest X-ray confirms
your suspicion.
596. If a Gram stain of the sputum reveals very small gram-negative rods and there is no growth
on a blood agar but colonies do grow on chocolate agar supplemented with NAD and heme,
which one of the following bacteria is the MOST likely cause?
(A) Chlamydia pneumoniae
(B) Legionella pneumophila
(C) Mycoplasma pneumoniae
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(D) Haemophilus influenzae –
Correct Answer :D
CASE 3. Your patient is a 50-year-old woman who returned yesterday from a vacation in Peru,
where there is an epidemic of cholera. She now has multiple episodes of diarrhea.
597. Of the following, which one is MOST compatible with cholera?
(A) Watery diarrhea without blood, no polys in the stool, and growth of curved gram- negative
rods in the blood culture
(B) Watery diarrhea without blood, no polys in the stool, and no organisms in the blood culture
(C) Bloody diarrhea, polys in the stool, and growth of curved gram-negative rods in the blood
culture
(D) Bloody diarrhea, polys in the stool, and no organisms in the blood culture –
Correct Answer :B
CASE 4. Your patient is a 55-year-old man who is coughing up greenish blood-streaked sputum.
For the past 2 weeks, he has had fever and night sweats. He thinks he has lost about 10 pounds.
On physical examination, there are crackles in the apex of the right lung, and a chest X-ray shows
a cavity in that location.
598. Of the following, which one is the LEAST likely finding?
(A) Gram stain of the sputum shows no predominant organism.
(B) Culture of the sputum on blood agar shows no predominant organism.
(C) Culture of the sputum on Löwenstein-Jensen medium shows tan colonies after incubation for
4 weeks.
(D) Rapid plasma reagin test reveals the causative organism. –
Correct Answer :D
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CASE 5. Your patient is a 5-year-old girl with bloody diarrhea and no vomiting. There is no history
of travel outside of San Francisco. Stool culture grows both lactose-positive and lactose-negative
colonies on EMB agar.
599. Of the following organisms, which one is MOST likely to be the cause?
(A) Shigella sonnei
(B) Salmonella typhi
(C) Campylobacter jejuni
(D) Helicobacter pylori –
Correct Answer :A
CASE 6. Your patient is a 25-year-old woman with acute onset of pain in her left lower quadrant.
On pelvic examination, there is a cervical exudate and tenderness in the left adnexa. You
conclude that she has pelvic inflammatory disease (PID) and order laboratory tests.
600. Of the following, which one is the LEAST informative laboratory result?
(A) Gram stain of the cervical exudate shows gram-negative diplococci within polys.
(B) Culture of the cervical exudate on Thayer-Martin agar shows oxidase-positive colonies.
(C) Fluorescent-antibody test shows cytoplasmic inclusions.
(D) Complement fixation test shows a rise in antibody titer. –
Correct Answer :D
CASE 7. Your patient is a 22-year-old man with fever, fatigue, and a new diastolic murmur. You
suspect endocarditis and do a blood culture.
601. Which of the following statements is LEAST accurate?
(A) If he had dental surgery recently, one of the most likely organisms to grow would be a
viridans group streptococcus.
(B) If he is an intravenous drug user, one of the most likely organisms to grow would be Candida
albicans.
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(C) If he had colon surgery recently, one of the most likely organisms to grow would be
Enterococcus faecalis.
(D) If he has a prosthetic aortic valve, one of the most likely organisms to grow would be
Streptococcus agalactiae.
In fact, none of the above organisms grew in the blood culture. What did grow was a gram-
positive coccus arranged in clusters. When sub-cultured on blood agar, the colonies were
surrounded by a zone of clear hemolysis, and a coagulase test was positive.
602. In view of –
Correct Answer :601 (D)
602 (A)
CASE 8. Your patient is a 70-year-old woman who had a hysterectomy for carcinoma of the
uterus 3 days ago. She has an indwelling urinary catheter in place and now has a fever to 39°C,
and the urine in the collection bottle is cloudy. A Gram stain of the urine specimen shows many
neutrophils and gram-positive cocci in chains. You also do a urine culture.
603. Which one of the following is the MOST likely set of findings on the urine culture?
(A) β-Hemolytic colonies that are bacitracin-sensitive
(B) α-Hemolytic colonies that are optochin-sensitive
(C) Nonhemolytic colonies that grow in 6.5% sodium chloride
(D) Nonhemolytic colonies that grow only anaerobically –
Correct Answer :C
CASE 9. Your patient is a 27-year-old woman who was treated with oral ampicillin for cellulitis
caused by Streptococcus pyogenes. Several days later, she developed bloody diarrhea. You
suspect that she may have pseudomembranous colitis.
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