MEDICAL TECHNOLOGY

BACTERIOLOGY

1. A diabetic foot swab from a 82-year-old woman with recurrent infections is submitted for culture.
The Gram stain reveals:
- many neutrophils, no squamous epithelial cells
- many gram-negative bacilli
- many gram-positive cocci in chains
The physician requests that all pathogens be worked up. In addition to the sheep blood and MacConkey
agar plates routinely used for wound cultures, the technologist might also process a(n)
a. CNA agar plate
b. chocolate agar plate
c. XLD agar plate
d. chopped meat glucose
2. A gram-negative diplococci showed the following results

Maltose Fermentation : Negative

Glucose Fermentation : Positive

Oxidase : Positive

Lactose Fermentation : Negative

Which of the following is the most probable organism?

a. Neisseria gonorrhoeae
b. Moraxella catarrhalis
c. Neisseria meningitidis
d. Neisseria lactamica
3. A nonbranching non-spore-former gram-positive rod was isolated from a culture and showed the
following results

Catalase : Positive

Motility : +

Bile Esculin Hydrolysis : +

CAMP : +

What is the most probable genus of the microorganism?

a. Corynebacterium
b. Listeria
c. Bacillus
d. Erysipelothrix
4. The enterics that are classified rapid lactose fermenters are due to which of the following?
a. Lactose Permease
b. Beta-galactosidase
c. Beta-lactamase
d. Phosphatase
5. A gram-positive rod was isolated and has the following characteristics

Aerobe

Spore Former

Motile

Beta-Hemolytic

What is the most probable organism?

a. Bacillus cereus
b. Bacillus anthracis
c. Clostridium difficile
d. Clostridium botulinum
6. Gram-positive cocci in chains are seen on a gram stain from a blood culture. The organism grow as a
beta-hemolytic colony. Further tests were performed and yielded the following results

Catalase : Negative

Bacitracin : Susceptible

PYR : Positive

a. Streptococcus pyogenes
b. Streptococcus agalactiae
c. Staphylococus auerus
d. Enterococcus faecalis
7. MacConkey media for screenicng suspected cases of verotoxin producing E. coli must contain:
a. Indole
b. Sorbitol
c. Citrate
d. Lactose
8. A sputum culture from an alcoholic patient grows mucoid, stringy colonies on Sheep blood agar. The
isolate grows readily on MacConkey agar and froms mucoid dark pink colonies. The colonies yield the
following results

ONPG +

Indole +

Glucose +

Oxidase –

Citrate +

VP +

The organism is most likely

a. Edwardsiella tarda
b. Klebsiella pnuemoniae
c. Klebsiella oxytoca
d. Proteus vulgaris
9. What are the most appropriate screening tests to presumptively differentiate and identify the
nonfermentative gram-negative bacilli (NFB) from the Enterobacteriaceae?
a. Catalase, decarboxylation or arginine, growth on blood agar
b. Motility, Urease, Morphology on Blood Agar
c. Oxidase, TSI, nitrate reduction, growth on MacConkey agar
d. Oxidase, indole, and growth on blood agar
10. Which tests are most appropriate to differentiate between Pseudomonas aeruginosa and Pseudomonas
putida?
a. Oxidase, motility, Pyoverdin
b. Oxidase, Motility, lactose
c. Oxidase, ONPG, Dnase
d. Mannitol, Nitrate Reduction, Growth on 42 degrees Celsius
11. A community hospital microbiology laboratory is processing significant numbers of stool cultures because
of an outbreak of diarrhea following heavy rains and flooding in the country. A media that should be
incorporated in the plating protocol is:
a. CNA for Listeria
b. MacConkey with Sorbitol of E. coli O157:H7
c. Mannitol Salt Agar for Enterococcus
d. TCBS for Vibrio
12. Which of the following tests best differentiates Salmonella and Citrobacter
a. KCN, Malonate, Beta-galactosidase, Lysine Decarboxylation
b. Dulcitol, Citrate, Indole, H2S Production
c. Lactose, Adonitol, KCN, Motility
d. Lysine Decarboxylase, Lactose, Sucrose, Malonate, Indole
13. A catalse negative non-branching nonsporeforming gram positive rod was isolated. The following are the
possible organisms EXCEPT:
a. Erysiphelothrix
b. Arcanobacterium
c. Gardnerella vaginalis
d. Corynebacterium
14. Which of the following reagents should be used as a mucolytic, alkaline reagent for digestion and
decontamination of sputum for mycobacterial culture?
a. N-acetyl-L-Cystine and NaOH
b. NaOH alone
c. Zephiran-Trisodium Phosphate
d. Oxalic Acid
15. Which reagent(s) is (are) used to develop the red color indicaive of a positive reaction for nitrate
reduction test?
a. Sulfanillic Acid and a-naphthylamine
b. O-nitrophenyl-B-D-Galactopyranoside
c. Ehrlich’s and Kovac’s
d. Kovac’s Reagent
16. While swimming in a lake near his home,a young boy cut his foot and an infection developed. The culture
grew a nonfastidious gram-negative oxidase positive beta hemolytic motile bacilli that produced
Deoxyribonuclease. The most like identification is :
a. Enterobacter cloacae
b. Aeromonas hydrophilia
c. Serratia marcescens
d. Escherichia coli
17. A microbiologist is reading plates from a sputu culture. On the sheep blood agar, she observed flat
spreading colones with metallic sheen. On cetrimide agar, she observed fluorescent green color in the
medium with clear colonies. On MacConkey, she observed medium clear colonies. What is the most likely
organisms?
a. P. fluorescens
b. P. putida
c. P. aeruginosa
d. P. stutzeri
18. Which test group best differentiates Acinetobacter baumannii from P. aeruginosa?
a. Oxidase, motility, NO3 reduction
b. MacConkey growth, 37°C growth, catalase
c. Blood agar growth, oxidase, catalase
d. Oxidase, TSI, MacConkey growth
19. A nonfermenter recovered from an eye wound is oxidase positive, motile with polar monotrichous flagella,
and grows at 42°C. Colonies are dry, wrinkled or smooth, buff to light brown in color, and are difficult to
remove from the agar. In which DNA homology group should this organism be placed?
a. Pseudomonas stutzeri
b. Pseudomonas fluorescens
c. Pseudomonas alcaligenes
d. Pseudomonas diminuta
20. Chryseobacterium spp. are easily distinguished from Acinetobacter spp. by which of the following two
tests?
a. Oxidase, growth on MacConkey agar
b. Oxidase and OF (glucose)
c. TSI and urea hydrolysis
d. TSI and VP
21. What is the culture media of choice for the agent of Whooping Cough
a. Regan-Lowe Agar
b. Bordet-Gengou Agar
c. Blood agar with 10% horse blood
d. Chocolate Agar with 5% Carbon Dioxide
22. The only spirochetal disease in which the organisms are visible in blood with bright-field microscopy
a. Weil’s Disease
b. Syphillis
c. Relapsing Fever
 d. Leptospirosis
23. Which of the following clean catch urine culture colony counts indicates the patient likely has a urinary
tract infection?
a. 10^1 CFU/mL
b. 10^2 CFU/mL
c. 10^5 CFU/mL
d. No growth
24. Which of the following specimen is ideal during the acute phase (first week) of leptospirosis?
a. Blood and Urine
b. Urine and Peritoneal Fluid
c. Blood and CSF
d. Urine and Stool
25. Which of the following is not true?
a. Bacillus anthracis – non hemolytic colonies on BAP
b. Streptococcus spp. – Vines on surface of thioglycollate broth
c. Diptheroids –dry, rough colonies with umbonate center growing on BAP
d. Klebsiella spp. – large mucoid colonies on MacConkey
26. A catalase positive, gram positive short rod was recovered from the blood of a prenatal patient. The
organism appeared on 5% sheep blood agar as white colonies surrounded by a small zone of beta-
hemolysis. The following tests were performed

Motility : = (tumbling on wet prep)

Umbrella-shaped on semisolid agar

Glucose fermenter

Esculin +

VP +

a. Listeria monocytogenes
b. Streptococcus pyogenes
c. Streptococcus agalactiae
d. Lactobacillus spp.
27. A yellow pigment–producing organism that is oxidase positive, nonmotile, and does not grow on
MacConkey agar is:
a. Acinetobacter baumannii
b. Acinetobacter lwoffii
c. Burkholderia cepacia
d. Chryseobacterium meningosepticum
28. A yellow pigment–producing organism that is oxidase positive, motile, and grows on MacConkey agar
is:
a. Acinetobacter baumannii
b. Acinetobacter lwoffii
c. Burkholderia cepacia
d. Chryseobacterium meningosepticum
29. If a male is infected with Neisseria gonorrhoeae, what would be the results of the Gram stain?
a. Many PMNs (some with gram negative intracellular diplococci) and gram negative diploccocci
b. Many mononuclear white blood cells and a gram negative cocci
c. Few WBC, many RBC, gram negative rods
d. Many PMNs (some with gram negative intracellular rods) and gram negative rods
30. A Vietnam War veteran presented with a “glanders-like” infection (melioidosis). Several blood cultures
produced gram-negative rods that were positive for cytochrome oxidase, oxidized glucose and xylose,
and grew at 42°C. What is the most likely organism?
a. Stenotrophomonas maltophilia
b. Burkholderia mallei
c. Burkholderia pseudomallei
d. Acinetobacter spp.
31. What is the characteristic odor produced by Pasteurella multocida
a. Chlorine-bleach-like odor
b. Fish-like odor
c. Earthy odor
 d. Mousy odor
32. A gram-negative bacilli was isolated on a patient suspected with endocarditis. The colonies pitted the
agar. The following tests were performed

Oxidase : + Catalase : -

Indole : + LDC : -

What is the most probable organism?

a. Eikenella corrodens
b. Aggregatibacter aprophilus
c. Kingella kingae
d. Cardiobacterium hominis
33. A patient presented with diarrhea and could only point out soft-bolled egg as the most probable food
which may have cause his condition. Which statement would be most appropriate in securing a reliable
diagnosis?
a. The patient is suffering from shigellosis and will demonstrate lactose fermenting colonies in
MacConkey agar which are nonmotile, H2S negative and deaminase negative.
b. The patient is likely suffering from Typhoid fever. Stool enrichment and culture Is necessary to
demonstrate nonlactose fermenting colonies which will be H2S positive, and motile.
c. it is highly probable that the patient is infected with enteroinvaslve E.coli and blood culture is
necessary to confirm etiologic agent of diarrhea.
d. HUS will likely follow the course of infection and will be confirmed by a positive blood culture.
34. In the outlined group of organisms, which does not belong to the group and why? Klebsiella, Proteus,
Salmonella, Yersinia
a. Klebsiella does not belong because it ls the only lactose fermenting organisms in the group.
b. Proteus does not belong because it is the only one in the group with a characteristic macroscopic
appearance
c. Yersinia does not belong because It ls the only one in the group with a characteristic microscopic
morphology.
d. all the mentioned statements are true for the organisms mentioned.
35. An anaerobic, spore-forming, non-motlle, gram-positive bacillus isolated from a deep wound of the legs
is most probably
a. Francisella tularensis
b. Clostridium perfringens
c. Bacillus subtillis
d. Bacillus anthracis
36. An organism isolated for the surface of a skin burn is found to produce a diffusible green pigment on a
blood agar plate. Further studies of the organism would most likely show the organism to be:
a. Staphylococcus aureus
b. Serratia marcescens
c. Flavobacterium meningosepticum
d. Pseudomonas aeruginosa
37. Media used for the recovery of Legionella pneumophila must contain
a. X & V factors
b. Hemin and Vitamin K
c. Charcoal and Yeast Extract
d. Dextrose and Laked Blood
38. A sputum specimen from an 89-year-old male patient with suspected bacterial pneumonia grew a
predominance of gram-positive cocci displaying alpha-hemolysis on 5% sheep blood agar. The colonies
appeared donut-shaped and mucoidy and tested negative for catalase. The most appropriate tests for a
final identification are:
a. Coagulase, glucose fermentation, lysostaphin
b. Optochin, bile solubility, PYR
c. Penicillin, bacitracin, CAMP
d. Bile esculin, hippurate hydrolysis
39. Which group of tests best differentiates Helicobacter pylori from C. jejuni?
a. Catalase, oxidase, and Gram stain
b. Catalase, oxidase, and nalidixic acid sensitivity
c. Catalase, oxidase, and cephalothin sensitivity
d. Urease, nitrate, and hippurate hydrolysis
40. A stool sample is sent to the laboratory for culture to rule out Clostridium difficile. What media should
the microbiologist use and what is the appearance of the organisms on this media?
a. BBE: colonies turn black
b. Brucella agar: red pigmented colonies
c. CCFA: yellow, ground glass colonies
d. CNA: double zone hemolytic colonies
41. Which of the following products is responsible for satellite growth of Haemophilus spp. around colonies
of Staphylococcus and Neisseria spp. on sheep blood agar?
a. NAD
b. Hemin
c. Indole
d. Oxidase
42. In a positive decarboxylase test, the medium changes from
a. Purple to yellow to purple
b. Purple to yellow
c. Yellow to purple
d. Yellow to purple to yellow
43. Which of the following tests should be done first in order to differentiate Aeromonas spp. from the
Enterobacteriaceae?
a. Urease
b. OF Glucose
c. Oxidase
d. Catalase
44. Which is the best rapid test to differentiate Plesiomonas shigelloides from a Shigella species on selective
enteric agar?
a. Oxidase
b. Indole
c. TSI
d. Urease
45. The majority of Haemophilus influenzae infections are caused by which of the following capsular
serotypes?
a. a
b. b
c. c
d. d
46. >100,000 CPU/mL of a gram-negative bacilli were isolated On MacConkey from a urine specimen.
Biochemical results are as follows:

Glucose : Acid and Gas Produced

Indole : Negative

Urea : Positive

H2S : Positive

The organism is most likely:

a. Morganella morganii
b. Proteus mirabilis
c. Proteus vulgaris
d. Providencia stuartii
47. Which Haemophilus species is generally associated with endocarditis?
a. H. influenzae
b. H. aprophilus
c. H. ducreyi
d. H. haemolyticus
48. A small, gram-negative coccobacillus recovered from the CSF of a 2-year-old child gave the following
results:

Indole + Requires X & V Non-hemolytic Urease +

Which of the following is the most likely identification?

 a. Haemophilus parainfluenzae
b. Haemophilus influenzae
c. Haemophilus ducreyi
d. Haemophilus aprophilus
49. A 4-year-old is admitted with symptoms of meningitis, and a Gram stain of the cerebrospinal fluid
reveals small, pleomorphic, gram-negative coccobacilli. After 24 hours incubation at 35 C, small, moist,
gray colonies, which are oxidase variable, are found on the chocolate agar plate only. Which of the
following biochemical data would be consistent with this isolate?
a. CTA dextrose: positive / CTA maltose: positive / ONPG: negative
b. sodium hippurate hydrolysis: positive / A disc: negative / CAMP test: positive
c. X factor: no growth / V factor: no growth / XV factor: growth / horse blood: no hemolysis
d. catalase: positive / esculin hydrolysis: positive / methyl red: positive / "umbrella" motility at
room temperature
50. The δ-ALA test (for porphyrins) is a confirmatory procedure for which test used for identification of
Haemophilus species?
a. X factor requirement
b. V factor requirement
c. Urease production
d. Indole production
51. A gram stain of organisms on Loeffler agar showed pleomorphic gram-positive bacilli must be
subcultured into
a. BAP
b. CAP
c. MacConkey
d. Potassium Tellurite
52. The most meaningful laboratory procedure in confirming the diagnosis of clinical botulism is:
a. demonstration of toxin in the patient's serum
b. recovery of Clostridium botulinum from suspected food
c. recovery of Clostridium botulinum from the patient's stool
d. Gram stain of suspected food for gram-positive, sporulating bacilli
53. Which organism commonly causes food poisoning by consumption of foods containing excessive
populations of organisms or preformed enterotoxin?
a. Salmonella enteritidis
b. Shigella sonnei
c. Bacillus cerues
d. Escherichia coli
54. Fluid from a cutaneous black lesion was submitted for routine bacterial culture. After 18 hours of
incubation at 35°C there was no growth on MacConkey agar, but 3+ growth on sheep blood agar. The
colonies were nonhemolytic, nonmotile, 4-5mm in diameter and of-white with a ground glass
appearance. Each colony had an irregular edge with comma-shaped outgrowths that stood up like
"beaten egg whites" when gently lifted with an inoculating needle. A Gram stain of a typical colony
showed large, gram positive rectangular bacilli. The organism is *most* likely:
a. Clostridium perfringens
b. Bacillus cereus
c. Bacillus anthracis
d. Aeromonas hydrophilia
55. Susceptibility testing is performed on a Staphylococcus aureus isolate from a blood culture with the
following results:
- oxacillin: resistant
- cefazolin: susceptible
- clindamycin: susceptible
- erythromycin: susceptible
- trimethoprim/sulfamethoxazole: susceptible
- vancomycin: susceptible
What should the technologist do next?
a. ceftriaxone should be reported instead of cefazolin
b. clindamycin should be tested for inducible resistance prior to reporting
c. the trimethoprim/sulfamethoxazole result should be removed since all S aureus are resistan
d. the cefazolin result should be changed to resistant since the oxacillin result is resistant