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Mycology: Hyaline and Dematiaceous Fungi


Elmer W. Koneman, MD

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Course Instructions
Welcome! Please proceed through this course by clicking on the arrows in the upper right or text links on the lower left of the page. Monitor your progress with the Table of Contents, and return to your Student Homepage by clicking on the Home icon. Your progress will be saved automatically as you proceed through the course. If you exit the course, you can continue from where you left off, even if you use a different computer. As you progress through the course, you may find knowledge assessment questions that cover the material you've read so far. These practice questions are not graded or recorded.

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Course Instructions
Welcome! Please proceed through this course by clicking on the arrows in the upper right or text links on the lower left of the page. Monitor your progress with the Table of Contents, and return to your Student Homepage by clicking on the Home icon. Your progress will be saved automatically as you proceed through the course. If you exit the course, you can continue from where you left off, even if you use a different computer. As you progress through the course, you may find knowledge assessment questions that cover the material you've read so far. These practice questions are not graded or recorded.

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Course Info
This course carries the following continuing education credits:
q

P.A.C.E. Contact Hours: 1.50 hour(s) Course Number: 578-004-08 Florida Board of Clinical Laboratory Science CE - General (Microbiology/Mycology/Parasitology): 1.50 hour(s)

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Hyaline Molds

Ungraded Practice Question


Match each hyaline mold from the drop-down list to its corresponding colony and microscopic description. The mold colonies are illustrated in the image on the right. Select the correct match for each item from the drop-down box Choose
6 Colony in upper left quadrant (orange sphere);

micoscopic description: Multi-celled, sickle-form macro spherical shape); microscopic description: Dark, elliptical conidia each supported by a conidiophore ("lollipops") microscopic description: Chains of spherical conidia produced from branching phialides.

Choose

6 Colony in upper right quadrant (grayish-brown

Choose

6 Colony in bottom left quadrant (lilypad-like shape);

Choose

6 Colony in bottom right quadrant (green sphere with

yellow inner circle); microscopic description: Tight clusters of spherical conidia held by finger-like phialides.

Hyaline Molds

Ungraded Practice Question


Match each hyaline mold from the drop-down list to its corresponding colony and microscopic description. The mold colonies are illustrated in the image on the right. Select the correct match for each item from the drop-down box Choose
6 Fusarium

species

Colony in upper left quadrant (orange sphere); micoscopic description: Multi-celled, sickleform macro Colony in upper right quadrant (grayish-brown spherical shape); microscopic description: Dark, elliptical conidia each supported by a conidiophore ("lollipops") Colony in bottom left quadrant (lilypad-like shape); microscopic description: Chains of spherical conidia produced from branching phialides. Colony in bottom right quadrant (green sphere with yellow inner circle); microscopic description: Tight clusters of spherical conidia held by finger-like phialides.
Page 6 of 61

Choose

6 Scedosporium

apiospermum

Choose

6 Penicillium

species

Choose

6 Gliocladium

Copyright 2011 by MediaLab, Inc. All rights reserved.

Feedback The description of "tight clusters of spherical conidia held by finger-like phialides" is the microscopic description for Gliocladium, the colony of which typically appears as a "green lawn" that extends from border to border across the Petri dish. "Multi-celled, sickle-form macroconidia" is the description for Fusarium species, which produces colonies with a distinctive rose red or purple red pigmentation (upper left). "Dark, elliptical conidia each supported by a conidiophore ('lollipops')" is characteristic of Scedosporium apiospermum. The grayish-brown appearance of the typical colony is due to the production of darkly pigmented spores as the colony matures. "Chains of spherical conidia produced from branching phialides" is descriptive of Penicillium species, which typically produces green, granular, rugose colonies.

Hyaline Molds

Ungraded Practice Question


Match each hyaline mold from the drop-down list to its corresponding microscopic and colony description. The microscopic appearance of the molds are illustrated in the image on the right. Select the correct match for each item from the drop-down box Choose
6 Microscopic description: Flower-like appearance (Image

in the upper left quadrant) Colony description: Green granular colony with a white peripheral apron (Image in the upper right quadrant) Colony description: Gray-white, cottony growth rapidly filling the Petri dish (Image in the lower left quadrant) Colony description: "Green lawn" colony covering the surface of the Petri dish flowers (Image in the lower right quadrant) Colony description: White, smooth colony with a low downy surface

Choose

6 Microscopic description: Stem with bulbous extensions

Choose

6 Microscopic description: Cluster on green background

Choose

6 Microscopic description: Blue cluster of what look like

Hyaline Molds

Ungraded Practice Question

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Match each hyaline mold from the drop-down list to its corresponding microscopic and colony description. The microscopic appearance of the molds are illustrated in the image on the right. Select the correct match for each item from the drop-down box Choose
6 Aspergillus

fumigatus

Microscopic description: Flower-like appearance (Image in the upper left quadrant) Colony description: Green granular colony with a white peripheral apron Microscopic description: Stem with bulbous extensions (Image in the upper right quadrant) Colony description: Gray-white, cottony growth rapidly filling the Petri dish Microscopic description: Cluster on green background (Image in the lower left quadrant) Colony description: "Green lawn" colony covering the surface of the Petri dish Microscopic description: Blue cluster of what look like flowers (Image in the lower right quadrant) Colony description: White, smooth colony with a low downy surface

Choose

6 Zygomycetes

Choose

6 Trichoderma

species

Choose

6 Beuveria

species

Feedback The description of a "gray-white, cottony growth rapidly filling the Petri dish" is characteristic of the Zygomycetes, of which Cunninghamella species is the representative in this exercise. The microscopic features include aseptate hyphae and the production of spherical sporangioles from the surface of a spherical vesicle. Of the hyaline molds listed in this exercise, "a white, smooth colony with a low downy surface" is consistent with Beuveria species, demonstrated by the loose clusters of tiny conidia, each attached by a "zig zag" conidiophore. The hyaline mold in this exercise corresponding to a "green granular colony with a white peripheral apron" is the most consistent with Aspergillus fumigatus, microscopically characterized by the production of chains of conidia from a single row of phialides along the top half of a club-shaped vesicle. A "green lawn" colony covering the surface of the Petri dish points to Trichoderma species among the fungi listed in this exercise, featured microscopically by the production of tight clusters or balls of spherical conidia supported by long, tapered conidiophores.

Hyaline Molds

Ungraded Practice Question

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Match each hyaline mold from the drop-down list to its corresponding colony and microscopic description. The mold colonies are illustrated in the image on the right. Select the correct match for each item from the drop-down box Choose
6 Upper left image

Multi-celled, rough walled macroconidia with a tapered terminal cell Dense aggregates of echinulate, brown-black conidia Loose clusters of elliptical conidia arranged in a "diphtheroid" pattern Chains of large, lemon-shaped annelloconidia

Choose Choose

6 Upper right image 6 Lower left image

Choose

6 Lower right image

Hyaline Molds

Ungraded Practice Question


Match each hyaline mold from the drop-down list to its corresponding colony and microscopic description. The mold colonies are illustrated in the image on the right. Select the correct match for each item from the drop-down box Choose
6 Microsporum canis Upper left image

Multi-celled, rough walled macroconidia with a tapered terminal cell Upper right image Dense aggregates of echinulate, brownblack conidia Lower left image Loose clusters of elliptical conidia arranged in a "diphtheroid" pattern Lower right image Chains of large, lemon-shaped annelloconidia

Choose

6 Aspergillus niger

Choose

6 Acremonium

species

Choose

6 Scopulariopsis

species

Feedback The description of "loose clusters of elliptical conidia arranged in a 'diphtheroid' pattern" is characteristic of Acremonium species, which is represented by the smooth, pastel rose pigmented colony. "Multi-celled, rough walled macroconidia with a tapered terminal cell" describes the macroconidia of Microsporum canis, the colony of which is usually cottony white with a lemon yellow apron. "Chains of large, lemon-shaped annelloconidia" describes the microscopic features of Scopulariopsis species, the colony of which is buffbrown with distinctive radial rugae.

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"Dense aggregates of echinulate, brown-black conidia" describes Aspergillus niger, the colony of which is a peppered brown-black on the surface and gray-white on the reverse.

Hyaline Molds

Ungraded Practice Question


Match each of the names of the fungi listed in the left column with its most likely associated disease listed in the right column. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Chronic sinusitis 6 Otitis externa 6 Mycotic keratitis 6 Tinea pedis

Hyaline Molds

Ungraded Practice Question


Match each of the names of the fungi listed in the left column with its most likely associated disease listed in the right column. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Scedosporium apiospermum Chronic sinusitis 6 Aspergillus niger 6 Fusarium species 6 Trichophyton rubrum

Otitis externa Mycotic keratitis Tinea pedis

Feedback Of the diseases listed in this exercise, Fusarium species is the most likely associated with mycotic keratitis. Trichophyton rubrum is a dermatophyte that commonly causes an itching, scaling skin infection of the feet, known as tinea pedis. Scedosporium apiospermum is commonly associated with sinusitis. Although Aspergillus niger can also be associated with sinusitis in the form of a fungus ball infection, in the context of this exercise, it is the only agent listed that typically causes otitis externa.

Hyaline Molds
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Ungraded Practice Question


Match each of the names of the hyaline molds listed with the environmental conditions or natural objects with which it is most likely associated. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Stale bread 6 Hospital construction 6 Shared bath towels 6 Fermenting stored grain

Hyaline Molds

Ungraded Practice Question


Match each of the names of the hyaline molds listed with the environmental conditions or natural objects with which it is most likely associated. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Mucor species 6 Aspergillus niger

Stale bread Hospital construction

6 Epidermophyton floccosum Shared bath towels 6 Fusarium species

Fermenting stored grain

Feedback Although other hyaline fungi may be found growing on stale bread, of those listed in this exercise, Mucor species is the most likely incriminated. Aspergillus niger is one of the more frequent molds that contaminate laboratory cultures during times of hospital construction. Fusarium species commonly grow in fermenting stored grains, producing aflotoxins that can affect any livestock for which the grain may be used as feed. Epidermophyton floccosum, along with other dermatophytes, may be transmitted from person to person through the use of shared bath towels where spore-infected skin scales are present in profusion.

Hyaline Molds
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Ungraded Practice Question


Match the names of each of the species of hyaline molds listed with the appropriate category. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Aspergillus fumigatus 6 Gliocladium species 6 Acremonium species 6 Scopulariopsis species

Hyaline Molds

Ungraded Practice Question


Match the names of each of the species of hyaline molds listed with the appropriate category. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Conidia in chains

Aspergillus fumigatus

6 Conidia in clusters Gliocladium species 6 Conidia in clusters Acremonium species 6 Conidia in chains

Scopulariopsis species

Feedback Aspergillus species and Scopulariopsis species develop conidia in chains, while the conidia of Gliocladium species and Acremonium species are gathered in tight and loose clusters respectively.

Hyaline Molds

Ungraded Practice Question


Match the names of each of the species of hyaline molds listed with the appropriate category. Select the correct match for each item from the drop-down box Choose Choose Choose
6 Syncephalastrum species 6 Pseudallescheria boydii 6 Aspergillus nidulans (telemorph)

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Choose

6 Mucor species

Hyaline Molds

Ungraded Practice Question


Match the names of each of the species of hyaline molds listed with the appropriate category. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Spores in sporangia

Syncephalastrum species

6 Spores in cleistothecia Pseudallescheria boydii 6 Spores in cleistothecia Aspergillus nidulans (telemorph) 6 Spores in sporangia

Mucor species

Feedback The Zygomycetes, including Syncephalastrum species and Mucor species, typically produce conidia within sack-like sporangia. Of the molds listed in this exercise, Syncephalastrum species produces spores in special cylindrical-shaped sporangia called mesosporangia, and Mucor species develops spores within spherical sporangia; therefore, both of these should be associated with the first category, spores in sporangia. Cleistothecia are bag like structures containing smaller structures called asci within which ascospores are produced. These are sexual or telomorphic structures that are characteristic of ascosporogenous fungi including Pseudallescheria boydii and certain strains of Aspergillus species, including Aspergillus nidulans.

Hyaline Molds

Ungraded Practice Question


Match the names of each of the species of hyaline molds listed with the appropriate taxonomic category. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Microsporum nanum 6 Trichophyton schoenleinii 6 Epidermophyton floccosum 6 Cunninghamella species

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Hyaline Molds

Ungraded Practice Question


Match the names of each of the species of hyaline molds listed with the appropriate taxonomic category. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Dermatophyte Microsporum nanum 6 Dermatophyte Trichophyton schoenleinii 6 Dermatophyte Epidermophyton floccosum 6 Zygomycete

Cunninghamella species

Feedback Microsporum nanum, Trichophyton schoenleinii and Epidermophyton floccosum are all species of dermatophytes. Cunninghamella species are zygomycetes.

Hyaline Molds

Ungraded Practice Question


Match the names of each of the fungi listed below into the appropriate category indicating the classification of infection with which it is most commonly associated. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Aspergillus fumigatus 6 Blastomyces dermatitidis 6 Rhizopus species 6 Acremonium species

Hyaline Molds

Ungraded Practice Question


Match the names of each of the fungi listed below into the appropriate category indicating the classification of infection with which it is most commonly associated.
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Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Opportunistic pathogen Aspergillus fumigatus 6 Obligate pathogen

Blastomyces dermatitidis

6 Opportunistic pathogen Rhizopus species 6 Opportunistic pathogen Acremonium species

Feedback Most of the hyaline molds are opportunistic pathogens, causing infections only in patients with underlying immunologic, metabolic or hematologic disorders. Aspergillus fumigatus commonly causes infections in patients who are debilitated, immunosuppressed or leukopenic. Rhizopus species is an opportunistic pathogen that may cause invasive infections in patients with diabetes mellitis. Acremonium species is less commonly a pathogen, but may cause post traumatic keratitis and mycetoma. Blastomyces dermatitidis can cause infections in patients who were previously healthy; therefore, it is an obligate pathogen.

Hyaline Molds

Ungraded Practice Question


The microscopic features shown in this photomicrograph is of a fungus commonly associated with: Please select the single best answer j k l m n Zygomycosis j k l m n Aspergillosis j k l m n Dermatophytosis j k l m n Pseudallescheriosis

Hyaline Molds

Ungraded Practice Question


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The microscopic features shown in this photomicrograph is of a fungus commonly associated with: Please select the single best answer j k l m n Zygomycosis j k l m n Aspergillosis j k l m n Dermatophytosis j k l m n Pseudallescheriosis

Feedback The microscopic features of the fungus seen here, namely, a conidiophore that terminates in a vesicle with a single row of phialides giving rise to chains of conidia, is characteristic of Aspergillus fumigatus, the most common agent of human aspergillosis. The zygomycetes produce fruiting heads with a vesicle-like columella; however, spores are borne within sack-like sporangia rather than in chains. None of the dermatophytes produce vesicles or chains of conidia. Pseudoallescheria boydii produces single celled microconidia and some other species of Pseudoallescheria produce sack-like cleistothecia containing ascospores.

Hyaline Molds

Ungraded Practice Question


Based on the structures observed in this photomicrograph, the most probable species of the fungus recovered from an induced sputum specimen is: Please select the single best answer j k l m n Aspergillus fumigatus j k l m n Aspergillus niger j k l m n Aspergillus nidulans j k l m n Aspergillus flavus

Page 16 of 61 Copyright 2011 by MediaLab, Inc. All rights reserved.

Hyaline Molds

Ungraded Practice Question


Based on the structures observed in this photomicrograph, the most probable species of the fungus recovered from an induced sputum specimen is: Please select the single best answer j k l m n Aspergillus fumigatus j k l m n Aspergillus niger j k l m n Aspergillus nidulans j k l m n Aspergillus flavus

Feedback Shown by the red arrow is a vesicle of Aspergillus species, with the production of irregular chains of conidia from phialides that are hidden. The yellow arrow points to a cleistothecium, the telomorphic form that may be produced in clinical isolates by certain strains. Of the Aspergillus species listed, Aspergillus nidulans would be the most likely species with the potential for producing cleistothecia in culture isolates from clinical specimens. In addition, the amorphic fruiting head does not correspond to any of the other species listed. A. fumigatus produces a distinct single row of phialides, not seen in this photomicrograph, and both Aspergillus flavus and Aspergillus niger sporulate from phialides distributed around the entire circumference of the vesicle.

Hyaline Molds

Ungraded Practice Question


Illustrated in this photograph is a "green lawn" colony of Gliocladium species. The other hyaline mold that produces this type of colony is: Please select the single best answer j k l m n Trichoderma species j k l m n Paecilomyces species j k l m n Aspergillus flavus j k l m n Rhizopus species

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Hyaline Molds

Ungraded Practice Question


Illustrated in this photograph is a "green lawn" colony of Gliocladium species. The other hyaline mold that produces this type of colony is: Please select the single best answer j k l m n Trichoderma species j k l m n Paecilomyces species j k l m n Aspergillus flavus j k l m n Rhizopus species

Feedback Gliocladium species and Trichoderma species are the two hyaline molds that produce this border to border, green lawn colony without a distinct margin. Although both Paecilomyces species and Aspergillus flavus may produce green colonies, they always have a margin, usually with a distinct white apron at the outer margins of new growth. Rhizopus species also produces a "lawn" like colony that extends from border to border in the Petri dish; however, it never produces a green pigment.

Hyaline Molds

Ungraded Practice Question


The fungus illustrated in this photomicrograph was recovered from an induced sputum specimen from a 74 year old man with chronic obstructive pulmonary disease. This isolate is most likely: Please select the single best answer j k l m n The cause of chronic bronchitis j k l m n The cause of invasive pulmonary disease j k l m n The cause of allergic bronchopulmonary disease j k l m n A contaminant

Page 18 of 61 Copyright 2011 by MediaLab, Inc. All rights reserved.

Hyaline Molds

Ungraded Practice Question


The fungus illustrated in this photomicrograph was recovered from an induced sputum specimen from a 74 year old man with chronic obstructive pulmonary disease. This isolate is most likely: Please select the single best answer j k l m n The cause of chronic bronchitis j k l m n The cause of invasive pulmonary disease j k l m n The cause of allergic bronchopulmonary disease j k l m n A contaminant

Feedback The microscopic features shown here represent Scopulariopsis species. In most instances, particularly if a patient does not have underlying immunologic or hematologic disease, Scopulariopsis species should be considered a contaminant when recovered from a sputum specimen. However, if there is clinical or X-ray evidence of mycotic pulmonary infection, additional daily induced sputum specimens should be obtained. If Scopulariopsis species or any other hyaline mold is recovered from two or more successive specimens, its potential as a pathogenic agent should be considered. Scopulariopsis species have been reported as the agents of pulmonary fungus ball infections in patients with preexistent cavities and as a cause of pneumonia in patients with leukemia. Invasive pulmonary disease by this agent has not been reported.

Hyaline Molds

Ungraded Practice Question


The dermatophytic fungus shown is in this photomicrograph, recovered from a ringworm lesion of the skin of the back of the hand of an 8 year old boy, was most likely contracted from: Please select the single best answer j k l m n A commonly used bath towel j k l m n Soil in the back yard j k l m n A classmate

Page 19 of 61 Copyright 2011 by MediaLab, Inc. All rights reserved.

Hyaline Molds

Ungraded Practice Question


The dermatophytic fungus shown is in this photomicrograph, recovered from a ringworm lesion of the skin of the back of the hand of an 8 year old boy, was most likely contracted from: Please select the single best answer j k l m n A commonly used bath towel j k l m n Soil in the back yard j k l m n A classmate

Feedback The photomicrograph illustrates a macroconidium of Microsporum gypseum. M. gypseum is a geophilic fungus that is endemic in the soil. Human to human transfer, either directly or through the use of a common towel, is quite unlikely with M. gypseum.

Hyaline Molds

Ungraded Practice Question


An Aspergillus species was recovered from a sputum specimen of a patient with X-ray evidence of fungal pneumonia. Microscopic examination did not permit a species identification. A small amount of vegetative mycelium was removed and a direct mount prepared. The features indicated by the red arrows in this image are associated with which Aspergillus species? Please select the single best answer j k l m n Aspergillus fumigatus j k l m n Aspergillus flavus j k l m n Aspergillus terreus j k l m n Aspergillus clavatus

Page 20 of 61 Copyright 2011 by MediaLab, Inc. All rights reserved.

Hyaline Molds

Ungraded Practice Question


An Aspergillus species was recovered from a sputum specimen of a patient with X-ray evidence of fungal pneumonia. Microscopic examination did not permit a species identification. A small amount of vegetative mycelium was removed and a direct mount prepared. The features indicated by the red arrows in this image are associated with which Aspergillus species? Please select the single best answer j k l m n Aspergillus fumigatus j k l m n Aspergillus flavus j k l m n Aspergillus terreus j k l m n Aspergillus clavatus

Feedback Illustrated in this photomicrograph are the spherical, microconidia attached to the vegetative hyphae, a feature unique to Aspergillus terreus. The other Aspergillus species listed in this exercise do not produce these vegetative structures.

Hyaline Molds

Ungraded Practice Question


The hyaline mold illustrated in this photomicrograph can be identified as: Please select the single best answer j k l m n Trichoderma species j k l m n Acremonium species j k l m n Fusarium species j k l m n Gliocladium species

Page 21 of 61 Copyright 2011 by MediaLab, Inc. All rights reserved.

Hyaline Molds

Ungraded Practice Question


The hyaline mold illustrated in this photomicrograph can be identified as: Please select the single best answer j k l m n Trichoderma species j k l m n Acremonium species j k l m n Fusarium species j k l m n Gliocladium species

Feedback All of the species listed in this exercise produce microconidia that aggregate in clusters rather than form chains. The clusters of conidia with Gliocladium species are supported by multiple conidiophores as shown in this photomicrograph, much as the cupped fingers would support a tennis ball. The microconidia of both Fusarium species and Acremonium species are loosely held, are elongated and arrange in an Oriental letter pattern. The conidia of both Gliocladium species and Trichoderma species are spherical and aggregate in tight clusters or balls. The conidia clusters of Trichoderma species are supported by single, tapered phialides that extend laterally from the hyphae.

Hyaline Molds

Ungraded Practice Question


The differentiation between Aspergillus species and Scedosporium species may be difficult when only hyphal elements are observed in stained tissue sections. It is important to obtain a culture to make this differentiation when possible because Scedosporium species, in contrast to Aspergillus species, tend to be resistant to: Please select the single best answer j k l m n Amphotericin B j k l m n The imidazoles j k l m n Flucytosine j k l m n Tolnaftate

Page 22 of 61 Copyright 2011 by MediaLab, Inc. All rights reserved.

Hyaline Molds

Ungraded Practice Question


The differentiation between Aspergillus species and Scedosporium species may be difficult when only hyphal elements are observed in stained tissue sections. It is important to obtain a culture to make this differentiation when possible because Scedosporium species, in contrast to Aspergillus species, tend to be resistant to: Please select the single best answer j k l m n Amphotericin B j k l m n The imidazoles j k l m n Flucytosine j k l m n Tolnaftate

Feedback Since amphotericin B is the antifungal drug most frequently administered empirically in cases of suspected deep and invasive mycoses, it is important to know which fungal agents may have innate resistance to this drug. Most strains of Scedosporium species are resistant to amphotericin B, and administration of one of the imidiazoles is recommended. Most strains of both Aspergillus species and Scedosporium species are resistant to flucytosine; therefore, this agent would not be recommended in the treatment of infections with either of these agents. Tolnaftate is a topical antifungal agent, which would not be appropriate in the treatment of any deep tissue fungal infection.

Hyaline Molds

Ungraded Practice Question


A dermatophyte that produces thin-walled, two or three-celled macroconidia, and no microconidia, most likely belongs to the genus: Please select the single best answer j k l m n Microsporum j k l m n Trichophyton j k l m n Epidermophyton j k l m n Ajellomyces

Hyaline Molds

Ungraded Practice Question


A dermatophyte that produces thin-walled, two or three-celled macroconidia, and no microconidia, most likely belongs to the genus:

Page 23 of 61 Copyright 2011 by MediaLab, Inc. All rights reserved.

Please select the single best answer j k l m n Microsporum j k l m n Trichophyton j k l m n Epidermophyton j k l m n Ajellomyces

Feedback One of the key characteristics in the identification of Epidermophyton floccosum is the inability of this dermatophyte to produce microconidia. Two to four-celled, club-shaped macroconidia are produced, usually in clusters of two or three. Both Microsporum species and Trichophyton species produce microconidia, the latter genus in profusion. The genus Ajellomyces does not belong to the dermatophytes; rather is the telomorphic or perfect form of Blastomyces dermatitidis. It produces telomorphic ascocarps that contain ascospores.

Hyaline Molds

Ungraded Practice Question


The spores produced by telomorphic forms of Aspergillus glaucus are: Please select the single best answer j k l m n Conidia j k l m n Ascospores j k l m n Sporangiospsores j k l m n Chlamydospores

Hyaline Molds

Ungraded Practice Question


The spores produced by telomorphic forms of Aspergillus glaucus are: Please select the single best answer j k l m n Conidia j k l m n Ascospores j k l m n Sporangiospsores
Page 24 of 61 Copyright 2011 by MediaLab, Inc. All rights reserved.

j k l m n Chlamydospores

Feedback The telomorphic forms of Aspergillus glaucus, and other ascosporogenous Aspergillus species, are cleistothecia that contain asci within which are produced ascospores that aggregate in groups of four or eight. The amorphic sack-like pycnidia, produced by Phoma species, among others, contain conidia. Sporangiospores are produced within sacklike sporangia, the amorphic fruiting heads of the Zygomycetes. Chlamydospores are derived from the vegetative hyphae and are not contained within any confined structure.

Hyaline Molds

Ungraded Practice Question


The bare fruiting heads shown here, characteristic of Aspergillus niger, demonstrate a spherical vesicle with phialides positioned around the entire circumference of the surface. The other Aspergillus species that also sporulates circumferentially is: Please select the single best answer j k l m n Aspergillus terreus j k l m n Aspergillus fumigatus j k l m n Aspergillus flavus

Hyaline Molds

Ungraded Practice Question

Page 25 of 61 Copyright 2011 by MediaLab, Inc. All rights reserved.

The bare fruiting heads shown here, characteristic of Aspergillus niger, demonstrate a spherical vesicle with phialides positioned around the entire circumference of the surface. The other Aspergillus species that also sporulates circumferentially is: Please select the single best answer j k l m n Aspergillus terreus j k l m n Aspergillus fumigatus j k l m n Aspergillus flavus

Feedback The fruiting heads of Aspergillus flavus are described as having a central spherical vesicle covered on all surfaces by a double row of sterigmata, consisting of a primary row of metulae and a secondary row of phialides, giving rise to short chains of conidia. Aspergillus clavatus also demonstrates sporulation from the entire surface; however, the vesicles are much larger and typically club-shaped. The phialides of both Aspergillus fumigatus and Aspergillus terreus are derived from the top portion of the vesicle, and not in the circumferential arrangement as shown here.

Hyaline Molds

Ungraded Practice Question


A dull white fungus, turning mouse gray on maturity, was recovered from material aspirated from a bone cyst in the upper femur. Based on the microscopic appearance as seen in a lactophenol blue mount of a portion of the colony, the most likely identification is: Please select the single best answer j k l m n Scedosporium apiospermum j k l m n Scedosporium prolificans (inflatum) j k l m n Sepedonium species j k l m n Chrysosporium species

Page 26 of 61 Copyright 2011 by MediaLab, Inc. All rights reserved.

Hyaline Molds

Ungraded Practice Question


A dull white fungus, turning mouse gray on maturity, was recovered from material aspirated from a bone cyst in the upper femur. Based on the microscopic appearance as seen in a lactophenol blue mount of a portion of the colony, the most likely identification is: Please select the single best answer j k l m n Scedosporium apiospermum j k l m n Scedosporium prolificans (inflatum) j k l m n Sepedonium species j k l m n Chrysosporium species

Feedback Each of the species of fungus listed in this exercise produce single conidia supported by individual conidiophores. The "mouse gray" appearance of the colony suggests that the isolate may be a Scedosporium species, which indeed it is. The flask-shaped swelling in the conidiophore, as illustrated in this photomicrograph, is characteristic of Scedosporium prolificans. The other fungal species listed in this exercise do not form these flask-shaped conidiogenous cells, rather produce straight conidiophores.

Hyaline Molds

Ungraded Practice Question


The "birds on a fence" arrangement of uniform-sized, tear-shaped microconidia is characteristic of: Please select the single best answer j k l m n Trichophyton tonsurans j k l m n Trichophyton mentagrophytes j k l m n Trichophyton rubrum j k l m n Trichophyton verrucosum

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Hyaline Molds

Ungraded Practice Question


The "birds on a fence" arrangement of uniform-sized, tear-shaped microconidia is characteristic of: Please select the single best answer j k l m n Trichophyton tonsurans j k l m n Trichophyton mentagrophytes j k l m n Trichophyton rubrum j k l m n Trichophyton verrucosum

Feedback The intended answer is Trichophyton rubrum. Note the tiny microconidia in a "birds on the fence" arrangement along the hyphal strand transversing the field of view (yellow arrows). Two pencil-shaped, smooth walled macroconidia are seen in the lower left field of view (red arrows). Trichophyton tonsurans may also produce conidia arranged like "birds on the fence"; however, they are irregular in size, with many large club- and balloon-shaped forms present. "Birds on a fence" microconidia may also be seen with Trichophyton mentagrophytes; however, this is not a constant feature, and is always accompanied by the more typical conidia in clusters. Although usually in small quantities, Trichophyton verrucosum may produce microconidia. However, they are irregularly arranged with little tendency to line up along the hyphae. Antler hyphae and string bean macroconidia are characteristic of this species.

Hyaline Molds

Ungraded Practice Question


Illustrated in this photomicrograph are fruiting heads of Trichoderma species. Note the single, long, tapered phialides (red arrows), extending laterally from either side of the hyphae, one of the key identifying features of this fungus. Another hyaline mold that produces long tapered phialides is: Please select the single best answer j k l m n Penicillium species j k l m n Paecilomyces species j k l m n Beaveria species

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Hyaline Molds

Ungraded Practice Question


Illustrated in this photomicrograph are fruiting heads of Trichoderma species. Note the single, long, tapered phialides (red arrows), extending laterally from either side of the hyphae, one of the key identifying features of this fungus. Another hyaline mold that produces long tapered phialides is: Please select the single best answer j k l m n Penicillium species j k l m n Paecilomyces species j k l m n Beaveria species

Feedback The production of long, tapered phialides is one of the key identifying features of Paecilomyces species, in contrast to Penicillium species, in which the ends of the phialides are blunt. The phialides of Beauveria species are geniculate, forming a zig-zag pattern.

Hyaline Molds

Ungraded Practice Question


Illustrated here is a single conidium of Microsporum canis. Note that the hilar cell appears fractured (shorter red arrow), where it was released from the stolon. Macroconidia having this so-called "break-away" cell are termed: Please select the single best answer j k l m n Ascospsores j k l m n Dictyospores j k l m n Aleureospores j k l m n Arthrospores

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Hyaline Molds

Ungraded Practice Question


Illustrated here is a single conidium of Microsporum canis. Note that the hilar cell appears fractured (shorter red arrow), where it was released from the stolon. Macroconidia having this so-called "break-away" cell are termed: Please select the single best answer j k l m n Ascospsores j k l m n Dictyospores j k l m n Aleureospores j k l m n Arthrospores

Feedback By definition, an aleureospore is one that becomes detached by the lysis or fracture of the wall of the attachment cell. Ascospores are single-celled spores formed within sack-like structures called asci. Dictyospsores are multi-celled macroconidia separated by both longitudinal and transverse septa. A dictyospore may in fact be an aleureospore if it becomes detached by a fractured cell; however, this is not its definition. Arthrospores are thick, rectangular spores that are derived directly from the vegetative hyphae at points of septation.

Hyaline Molds

Ungraded Practice Question


The hyaline saprobic fungus that has microscopic features similar to the mold form of Histoplasma capsulatum is: Please select the single best answer j k l m n Chrysosporium species j k l m n Malbranchia species j k l m n Sepedonium species j k l m n Scopulariopsis species

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Hyaline Molds

Ungraded Practice Question


The hyaline saprobic fungus that has microscopic features similar to the mold form of Histoplasma capsulatum is: Please select the single best answer j k l m n Chrysosporium species j k l m n Malbranchia species j k l m n Sepedonium species j k l m n Scopulariopsis species

Feedback Sepedonium species and the mold form of Histoplasma capsulatum share the common microscopic feature of producing large, spherical, single-celled macroconidia that characteristically are covered with echinulations. Scopulariopsis also produces conidia that may be roughened when mature; however, they are arranged in chains. Chrysosporium also produces single conidia; however, they are more elliptical and not roughened. Malbranchia produces rectangular-shaped, alternately staining arthroconidia that have thickened, smooth walls.

Hyaline Molds

Ungraded Practice Question


The hyaline saprobic fungus that has microscopic features similar to the mold form of Coccidioides immitis is: Please select the single best answer j k l m n Malbranchia species j k l m n Geotrichum species j k l m n Trichosporon species j k l m n Microsporum canis

Hyaline Molds

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Ungraded Practice Question


The hyaline saprobic fungus that has microscopic features similar to the mold form of Coccidioides immitis is: Please select the single best answer j k l m n Malbranchia species j k l m n Geotrichum species j k l m n Trichosporon species j k l m n Microsporum canis

Feedback Malbranchia species share the production of alternate staining arthroconidia as a common feature with the mold form of Coccidioides immitis. Both Geotrichum species and Trichosporon species produce rectangular-shaped arthroconidia; however, they are regularly rather than alternately staining. Additionally, the arthroconidia of Geotrichum may produce germ tubes from one corner and the arthroconidia of Trichosporon species may produce blastoconidia from adjacent corners, features not shared by either Malbranchia species or Coccidioides immitis. The hyphae of Microsporum canis, as seen in direct KOH mounts of skin scales, may break up into arthroconidia; however, they are much narrower in dimension and do not share the alternate staining characteristics.

Hyaline Molds

Ungraded Practice Question


Several saprophytic, hyaline molds have microscopic characteristics that mimic the mold forms of the dimorphic fungi (Histoplasma capsulatum, Blastomyces dermatitidis, etc.). Each of the following can be used to differentiate the saprophytic from the dimorphic fungi except: Please select the single best answer
o j k l m n Conversion of the mold form to the yeast form at 37 C incubation

j k l m n Ability of the dimorphic fungi to grow on cycloheximide-containing culture media j k l m n Differential growth profiles on Trichophyton differential agars j k l m n Positive reactions for the dimorphic fungi in commercially available nucleic acid probe assays.

Hyaline Molds

Ungraded Practice Question


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Several saprophytic, hyaline molds have microscopic characteristics that mimic the mold forms of the dimorphic fungi (Histoplasma capsulatum, Blastomyces dermatitidis, etc.). Each of the following can be used to differentiate the saprophytic from the dimorphic fungi except: Please select the single best answer
o j k l m n Conversion of the mold form to the yeast form at 37 C incubation

j k l m n Ability of the dimorphic fungi to grow on cycloheximide-containing culture media j k l m n Differential growth profiles on Trichophyton differential agars j k l m n Positive reactions for the dimorphic fungi in commercially available nucleic acid probe assays.

Feedback Trichophyton differential agars are not intended to differentiate dimorphic from saprophytic fungi and the differences in growth profiles would not be helpful in making this separation. The dimorphic fungi can be converted to a yeast form by incubation at body temperature, will grow in culture media containing cycloheximide, and will show positive reactions in antigen specific nucleic acid probe assays. All of these procedures can be used to differentiate the saprophytic hyaline mold from the dimorphic fungi.

Hyaline Molds

Ungraded Practice Question


The most helpful feature in differentiating the Zygomycetes from the other hyaline molds in the clinical mycology laboratory is: Please select the single best answer j k l m n Rapid growth rate j k l m n The production of spores within sporangia j k l m n The production of rhizoids j k l m n The formation of aseptate hyphae

Hyaline Molds

Ungraded Practice Question


The most helpful feature in differentiating the Zygomycetes from the other hyaline molds in the clinical mycology laboratory is: Please select the single best answer j k l m n Rapid growth rate
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j k l m n The production of spores within sporangia j k l m n The production of rhizoids j k l m n The formation of aseptate hyphae

Feedback The production of spores within sporangia is unique to the Zygomycetes. Although the production of rhizoids and the formation of aseptate hyphae are characteristics of the Zygomycetes, these are not constant characteristics for all species or at all times during maturation. Only Rhizopus and Absidia species regularly produce rhizoids and occasional septations can be seen in the hyphae of each of the Zygomycetes as the colonies mature, particularly in the sporangiophores. Although the rate of growth of the Zygomycetes is among the more rapid among the fungi, many strains of Aspergillus species and other hyaline fungi may also grow within the 2-3 day period.

Dematiaceous Molds

Ungraded Practice Question


Match each of the names of the fungal species listed with the corresponding identifying structures illustrated in the photomicrographs: Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 A 6 B 6 C 6 D

Dematiaceous Molds

Ungraded Practice Question

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Match each of the names of the fungal species listed with the corresponding identifying structures illustrated in the photomicrographs: Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Stemphylium species A 6 Curvularia species 6 Bipolaris species 6 Alternaria species

B C D

Feedback Stemphylium species microscopically are characterized by the production of dark brown, oblong or broadly elliptical, multi-celled, muriform conidia that are supported by a straight conidiophore (so-called "bale of cotton on a stick") (upper left). Bipolaris species produce smooth-walled, oblong-shaped, multi-celled conidia (lower left) with the individual cells surrounded and separated by a sac-like wall called a distosepta that is not part of the cell wall. The macroconidia are borne sympodially from bent, geniculate conidiophores. The macroconidia of Curvularia species have cells separated by true septa extending from the cell wall. The multi-celled, dark brown, macroconidia are bow- or boomerang-shaped due to overgrowth of the central cells (upper right). The macroconidia of Alternaria species are muriform, are elongated and drumstick shaped, and are connected together in chains, with the blunt end of one conidium attached to the narrow end of another (lower right).

Dematiaceous Molds

Ungraded Practice Question


Match the names of each of the fungal species listed in the drop-down box with the corresponding identifying structures illustrated in the photomicrographs: Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Upper left 6 Upper right 6 Lower left 6 Lower right

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Dematiaceous Molds

Ungraded Practice Question


Match the names of each of the fungal species listed in the drop-down box with the corresponding identifying structures illustrated in the photomicrographs: Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Epicoccum species 6 Ulocladium species

Upper left Upper right

6 Exserohilum species Lower left 6 Nigrospora species

Lower right

Feedback Exserohilum species produce long, pencil-shaped, multi-celled macroconidia in which the individual cells are separated by a sac-like wall that is not part of the outer cell wall; structures called distosepta (lower left). The distinguishing feature, as reflected in the genus name, is the distinct nipple-like extension from the hilar cell, which serves as a point of attachment to the conidiophore. Nigrospora species microscopically produce single-celled, jet black, globose conidia, each supported by a short pedicle with a swollen base (lower right). Epicoccum species can be recognized microscopically by the production of dark brown, club-shaped, multi-celled muriform macroconidia that are attached laterally either directly from the hyphae or from short conidiophores and aggregate in tight clusters (upper left). Ulocladium produces subglobose, muriform macroconidia that are borne sympodially from bent, geniculate conidiophores (upper right).

Dematiaceous Molds

Ungraded Practice Question

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A presumptive identification of the four genera of slower growing pathogenic dematiaceous molds can be made by observing specific types of conidiation. Match the names of the species of dematiaceous pathogenic fungi with the corresponding microscopic features illustrated in the photomicrographs: Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Upper left 6 Upper right 6 Lower left 6 Lower right

Dematiaceous Molds

Ungraded Practice Question


A presumptive identification of the four genera of slower growing pathogenic dematiaceous molds can be made by observing specific types of conidiation. Match the names of the species of dematiaceous pathogenic fungi with the corresponding microscopic features illustrated in the photomicrographs: Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Phialophora verrucosum Upper left 6 Cladosporium carrionii 6 Exophiala jeanselmei 6 Fonsecaea pedrosoi

Upper right Lower left Lower right

Feedback Phialophora type sporulation, typical of Phialophora verrucosum, is characterized by short urn-shaped phialides, each with a narrow mouth from which spherical conidia in tight ball-like aggregates are released (upper left). The cladosporium type sporulation, represented in the upper right photomicrograph by Cladosporium carrionii in this exercise, is characterized by the production of uniform-sized, oval or elliptical-shaped conidia that are produced in chains from the tips of branching conidiophores. Dark staining scars or collarettes are seen connecting adjacent conidia. Exophiala jeanselmei (lower left) produces long tapered phialides from the tips of which are released oval to elliptical conidia that aggregate in loose clusters or fall down the sides of the phialides. The sporulation in the lower right photomicrograph, characteristic of Fonsecaea pedrosoi, is acrotheca in type, characterized by the production of short chains of elliptical conidia borne radially from the sides of hyphae.

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Dematiaceous Molds

Ungraded Practice Question


Match the name of each dematiaceous fungus listed in the drop-down box with its most likely disease. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Brain abscess 6 Chronic sinusitis 6 Chromomycosis 6 Subcutaneous Phaeohyphomycotic cyst

Dematiaceous Molds

Ungraded Practice Question


Match the name of each dematiaceous fungus listed in the drop-down box with its most likely disease. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Cladosporium trichoides (Xylohypha

bantianum)

Brain abscess Chronic sinusitis Chromomycosis Subcutaneous Phaeohyphomycotic cyst

6 Bipolaris species 6 Phialophora verrucosum 6 Phialophora richardsiae

Feedback Of the answers listed in this exercise, Bipolaris species is most commonly associated with sinusitis. Although both Phialophora verrucosum and Phialophora richardsiae can be involved in subcutaneous mycetomas, the latter is more commonly associated with the formation of phaeohyphomycotic cysts. Cladosporium trichoides, currently named Xylohypha bantianum, is the most common isolate of this group of fungi from cases of mycotic cerebral abscess. Phialophora verrucosum among the group of fungi listed in this exercise, is the more likely agent of the exophytic cutaneous lesions called chromomycosis.

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Dematiaceous Molds

Ungraded Practice Question


Match the name of each fungal species listed with its most likely corresponding morphologic features. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Polar germ tubes 6 Dictyospores 6 Urn-shaped phialides 6 Black yeast colony

Dematiaceous Molds

Ungraded Practice Question


Match the name of each fungal species listed with its most likely corresponding morphologic features. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Bipolaris species 6 Alternaria species

Polar germ tubes Dictyospores

6 Phailophora verrucosum Urn-shaped phialides 6 Aureobasidium pullulans Black yeast colony

Feedback Alternaria species is characterized by the production of drum stick-shaped multi-celled, muriform macroconidia called dictyospores. The identifying characteristic of Aureobasidium pullulans is the production of a black yeast-like colony. Bipolaris species receives its genus name from the production of germ tubes extending from both sides of a conidium that has been incubated in an aqueous environment for several hours. The production of urn-shaped phialides is characteristic of Phialophora verrucosum.

Dematiaceous Molds

Ungraded Practice Question


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Match the name of each fungal species listed in the drop-down box with its most likely corresponding morphologic feature. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Hilar cell extension 6 Sporodochium 6 Rhinocladiella type sporulation 6 Macroconidia with enlarged center cells

Dematiaceous Molds

Ungraded Practice Question


Match the name of each fungal species listed in the drop-down box with its most likely corresponding morphologic feature. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Exserohilum species Hilar cell extension 6 Epicoccum species

Sporodochium

6 Fonsecaea pedrosoi Rhinocladiella type sporulation 6 Curvularia species

Macroconidia with enlarged center cells

Feedback Certain strains of Fonsecaea pedrosoi produce the rhinocladiella type of sporulation, in which single-celled oval to elliptical conidia are borne sympodially from the sides and tips of straight phialides. The macroconidia of Curvularia species are multi-celled and divided by transverse septa. Overgrowth of the central cells results in a boomerang shape. Excerohilum species are characterized by the production of nipple-like extension from the hilar cell. The dark-staining, muriform macroconidia of Epicoccum species are produced from the sides of the hyphae in compact clusters, an arrangement known as a sporodochium.

Dematiaceous Molds

Ungraded Practice Question


Match the names of each of the fungi listed with its appropriate category. Select the correct match for each item from the drop-down box
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Choose Choose Choose Choose

6 Phialophora verrucosa 6 Alternaria species 6 Exophiala species 6 Cladosporium species

Dematiaceous Molds

Ungraded Practice Question


Match the names of each of the fungi listed with its appropriate category. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Conidia in clusters Phialophora verrucosa 6 Conidia in chains

Alternaria species

6 Conidia in clusters Exophiala species 6 Conidia in chains

Cladosporium species

Feedback The conidia of Phialophora verrucosa and Exophiala species are produced within phialides that extrude the conidia in tight, ball-like clusters. The large, drum stick-shaped muriform macroconidia of Alternaria species are arranged in short chains; the small, elliptical conidia of Cladosporium species are arranged in both long and short, branching chains.

Dematiaceous Molds

Ungraded Practice Question


Match the names of each of the fungi listed with its appropriate category depending upon whether the multi-celled macroconidia are divided by both longitudinal and transverse septa (dictyospores); or, are divided by only transverse septa. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Exserohilum species 6 Epicoccum species 6 Curvularia species 6 Ulocladium species

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Dematiaceous Molds

Ungraded Practice Question


Match the names of each of the fungi listed with its appropriate category depending upon whether the multi-celled macroconidia are divided by both longitudinal and transverse septa (dictyospores); or, are divided by only transverse septa. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Transverse septa Exserohilum species 6 Dictyospores

Epicoccum species

6 Transverse septa Curvularia species 6 Dictyospores

Ulocladium species

Feedback Dictyospores are multi-celled muriform macroconidia in which the cells are divided by both longitudinal and transverse septa. Epicoccum species and Ulocladium species each produce this type of macroconidium. Of the fungi listed in this exercise, Curvularia, and Exserohilum produce multi-celled macroconidia in which the individual cells are divided by transverse septa only.

Dematiaceous Molds

Ungraded Practice Question


Match the names of each of the fungi listed with its appropriate category indicating the degree of pathogenicity. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Alternaria species 6 Fonsecaea pedrosoi 6 Phialophora verrucosa 6 Bipolaris species

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Dematiaceous Molds

Ungraded Practice Question


Match the names of each of the fungi listed with its appropriate category indicating the degree of pathogenicity. Select the correct match for each item from the drop-down box Choose Choose Choose Choose
6 Usually not pathogenic Alternaria species 6 Usually pathogenic 6 Usually pathogenic

Fonsecaea pedrosoi Phialophora verrucosa

6 Usually not pathogenic Bipolaris species

Feedback It may be concluded that there is no truly non pathogenic fungus as any species may cause an infection in severely immunocompromised patients. However, some fungi have more innate capabilities of causing infections than others. Of the fungi listed in this exercise, Fonsecaea pedrosoi and Phialophora verrucosa, each serving as agents of chromomycosis, are generally considered "pathogenic" species. Alternaria species and Bipolaris species are usually not pathogenic, but may cause opportunistic infections in debilitated patients, commonly sinusitis from the inhalation of spore-laden dust; or, subcutaneous mycetomas where spore-infected vegetative material has been traumatically inoculated into the skin.

Dematiaceous Molds

Ungraded Practice Question


The fungal species most likely associated with the granulomatous infection seen in this photomicrograph, illustrating segmented, dark brown-staining grains with a giant cell is: Please select the single best answer j k l m n Phialophora verrucosum j k l m n Scedosporium apiospermum j k l m n Sporothrix schenckii j k l m n Exserohilum species

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Dematiaceous Molds

Ungraded Practice Question


The fungal species most likely associated with the granulomatous infection seen in this photomicrograph, illustrating segmented, dark brown-staining grains with a giant cell is: Please select the single best answer j k l m n Phialophora verrucosum j k l m n Scedosporium apiospermum j k l m n Sporothrix schenckii j k l m n Exserohilum species

Feedback The segmented dark-staining grains seen in this photomicrograph are most commonly seen in cases of chromomycosis. Of the fungal species listed in this exercise, only Phialophora verrucosum is associated with chromomycosis and has the capability of producing the grains seen in the photograph. Although Scedosporium apiospermum may cause mycetoma and produce grains, they are soft, gray white and not segmented. Sporothrix schenckii is the agent of subcutaneous sporotrichosis, an infection that may result in granulomatous inflammation with the presence of multi-nucleated giant cells; however, grains or granules are not formed. Exserohilum species are soil dematiaceous molds that rarely may be involved in subcutaneous mycetomas; however, it is not associated with chromomycosis and does not produce grains.

Dematiaceous Molds

Ungraded Practice Question


The infrequently encountered mold that is represented by the photomicrograph begins as a gray-white colony that blackens with maturity as the hyphae become darkened and single, globose, black conidia are produced. This fungus can be identified as: Please select the single best answer j k l m n Pseudallescheria boydii j k l m n Nigrospora species j k l m n Scopulariopsis brumptii j k l m n Stemphilium species

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Dematiaceous Molds

Ungraded Practice Question


The infrequently encountered mold that is represented by the photomicrograph begins as a gray-white colony that blackens with maturity as the hyphae become darkened and single, globose, black conidia are produced. This fungus can be identified as: Please select the single best answer j k l m n Pseudallescheria boydii j k l m n Nigrospora species j k l m n Scopulariopsis brumptii j k l m n Stemphilium species

Feedback Each of the fungal species listed here produces colonies that may darken with maturity; however, only Nigrospora species produce the single, globose, black conidia described in the question. The anamorphic conidia of Pseudallescheria boydii are also produced singly and darken with maturity; however, are small and never turn "black". The conidia of Scopulariopsis brumptii are lemon-shaped, annelloconidia arranged in chains and the macroconidia of Stemphylium species, although borne singly, are multi-celled and muriform in appearance.

Dematiaceous Molds

Ungraded Practice Question

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The multi-celled conidia of this dematiaceous mold are divided into cells by what are called distosepta (pseudosepta), indicating that the individual cells are surrounded by a sac-like wall that is distinct from the outer cell wall of the conidium. The identification of this mold is: Please select the single best answer j k l m n Curvularia species j k l m n Exserohilum species j k l m n Stemphilium species j k l m n Bipolaris species

Dematiaceous Molds

Ungraded Practice Question


The multi-celled conidia of this dematiaceous mold are divided into cells by what are called distosepta (pseudosepta), indicating that the individual cells are surrounded by a sac-like wall that is distinct from the outer cell wall of the conidium. The identification of this mold is: Please select the single best answer j k l m n Curvularia species j k l m n Exserohilum species j k l m n Stemphilium species j k l m n Bipolaris species

Feedback The multi-celled macroconidia shown in this photomicrograph are those of Bipolaris species. Note the thickened, sac-like structures surrounding the central, spherical cells. These are in contrast to the distinct septa derived from the cell wall as seen with Curvularia species. Exserohilum species also produce macroconidia with distosepta; however, in contrast to the macroconidia of Bipolaris species, they are long and pencil-shaped and show a prominent nipple-like protrusion from the hilar cell, which serves as the point of attachment to the hyphae. Stemphylium species produce multi-celled, muriform, macroconidia separated by both longitudinal and transverse septa (dictyospores).

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Dematiaceous Molds

Ungraded Practice Question


The oval or curved multi-celled, dark-staining macroconidia divided by transverse septa only is characteristic of: Please select the single best answer j k l m n Drechslera species j k l m n Curvularia species j k l m n Exserohilum species j k l m n Alternaria species

Dematiaceous Molds

Ungraded Practice Question


The oval or curved multi-celled, dark-staining macroconidia divided by transverse septa only is characteristic of: Please select the single best answer j k l m n Drechslera species j k l m n Curvularia species j k l m n Exserohilum species j k l m n Alternaria species

Feedback The boomerang-shaped macroconidia of Curvularia species are divided by transverse, true septations only. The curved or boomerang effect is caused by overgrowth of the central cells (arrows). The macroconidia of Exserohilum species also have cells divided by transverse septa only, although the septa are false and are called distosepta because they are not derived from the cell walls. These conidia are also long and pencil-shaped and have a prominent nipple like protrusion from the hilar cell. The macroconidia of Drechslera species are muriform and show both longitudinal and transverse septation. The drum stick-shaped macroconidia of Alternaria species also are divided by both longitudinal and transverse septa.

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Dematiaceous Molds

Ungraded Practice Question


The type of sporulation of the dematiaceous mold that is illustrated in this photomicrograph is called: Please select the single best answer j k l m n Acrotheca j k l m n Rhinocladiella j k l m n Birds on a fence j k l m n Acropetal

Dematiaceous Molds

Ungraded Practice Question


The type of sporulation of the dematiaceous mold that is illustrated in this photomicrograph is called: Please select the single best answer j k l m n Acrotheca j k l m n Rhinocladiella j k l m n Birds on a fence j k l m n Acropetal

Feedback The production of single conidia in succession both laterally and around the tip of a straight phialide is called the rhinocladiella type of sporulation, characteristic of Fonsecaea pedrosoi. Acrotheca type sporulation is also produced by F. pedrosoi; however, is characterized by the production of short chains of elliptical conidia in a circular arrangement from the tips of branching phialides.

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The "birds on a fence" arrangement of microconidia, characteristic of Trichophyton rubrum, is somewhat reminiscent of the rhinocladiella type sporulation except that the conidia are more loosely held and alternate more from one side of the hyphae to the other. (T. rubrum is a hyaline rather than a dematiaceous fungus.) Acropetal is the term referring to a type of sporulation where chains of conidia are formed with each new daughter cell produced from the previous one, leaving the oldest cell at the base of the chain. This type of sporulation is characteristic of Aspergillus species and Penicillium species.

Dematiaceous Molds

Ungraded Practice Question


Of the following dematiaceous fungi, the black, suede-like colony illustrated here, reaching no larger than the size of a dime after 7 days incubation, most likely can be identified as: Please select the single best answer j k l m n Curvularia species j k l m n Alternaria species j k l m n Fonsecaea species j k l m n Nigrospora species

Dematiaceous Molds

Ungraded Practice Question

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Of the following dematiaceous fungi, the black, suede-like colony illustrated here, reaching no larger than the size of a dime after 7 days incubation, most likely can be identified as: Please select the single best answer j k l m n Curvularia species j k l m n Alternaria species j k l m n Fonsecaea species j k l m n Nigrospora species

Feedback The dematiaceous molds can be broadly separated into two major groups: the agents of chromomycosis that grow more slowly, maturing only after 7 days or more of incubation, and the more rapidly growing species that most commonly are clinically insignificant commensals or contaminants when recovered from clinical specimens, but in rare situations may cause opportunistic infections called phaeohyphomycosis. Of the species of dematiaceous fungi listed in this exercise, only Fonsecaea species fits the slow growth characteristics indicated in the question. All others listed will produce relatively large, mature colonies within 7 days of incubation.

Dematiaceous Molds

Ungraded Practice Question


The dematiaceous colony illustrated here grew to a diameter of 3 - 4 cm in 5 days. The dematiaceous fungus that can be ruled out is: Please select the single best answer j k l m n Phialophora verrucosum j k l m n Exserohilum species j k l m n Alternaria species j k l m n Ulocladium species

Dematiaceous Molds

Ungraded Practice Question


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The dematiaceous colony illustrated here grew to a diameter of 3 - 4 cm in 5 days. The dematiaceous fungus that can be ruled out is: Please select the single best answer j k l m n Phialophora verrucosum j k l m n Exserohilum species j k l m n Alternaria species j k l m n Ulocladium species

Feedback Of the species of dematiaceous fungi listed in this exercise, all grow rapidly, forming mature colonies within 5-7 days of incubation, except for Phialophora verrucosum, one of the agents of chromomycosis, which grows more slowly, producing colonies no more than 1 cm in diameter after 7 days incubation. The dematiaceous molds can be broadly separated into two major groups: the agents of chromomycosis that grow more slowly, maturing only after 7 days or more of incubation, and the more rapidly growing species that most commonly are clinically insignificant commensals or contaminants when recovered from clinical specimens. However, in rare situations, they may cause opportunistic infections called phaeohyphomycosis.

Dematiaceous Molds

Ungraded Practice Question


The dematiaceous fungus that may produce both acrotheca and rhinocladiella types of sporulation is: Please select the single best answer j k l m n Fonsecaea pedrosoi j k l m n Exophiala jeanselmei j k l m n Phialophora richardsiae j k l m n Aureobasidium pullulans

Dematiaceous Molds

Ungraded Practice Question


The dematiaceous fungus that may produce both acrotheca and rhinocladiella types of sporulation is: Please select the single best answer j k l m n Fonsecaea pedrosoi
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j k l m n Exophiala jeanselmei j k l m n Phialophora richardsiae j k l m n Aureobasidium pullulans

Feedback The four genera of slowly growing dematiaceous molds that cause chromomycosis and mycetoma can be differentiated by their unique forms of sporulation. Of these, Fonsecaea pedrosoi is the only species that may exhibit each of the various types of sporulation. The acrotheca and rhinocladiella forms of sporulation are unique to this species and predominate in most strains. Acrotheca type sporulation appears as single or short chains of elliptical conidia that come off the hypha circumferentially, much as the hooks on a hat rack. Rhinocladiella type sporulation consists of single conidia festooned on either side of a straight conidiophore. Exophiala jeanselmei produces a long tapered phialide with clusters of elliptical conidia at the tip. Phialophora richardsiae produces flask-shaped phialides that terminate in a flat saucer-like lip which supports clusters of conidia. Aureobasidium pullulans produces large, dark, arthroconidia-like thickenings of the hyphae at points of septation, from which bud off small, elliptical hyaline microconidia.

Dematiaceous Molds

Ungraded Practice Question


Saprophytic Cladosporium species may be difficult to differentiate from Cladosporium trichoides (Xylohypha bantianum) in culture as both produce chains of conidia separated by distinct scars or dysjuncters. Each of the following characteristics of Cladosporium trichoides are helpful in separating the two except: Please select the single best answer j k l m n Slow growth rate j k l m n Neurotropism in animal experiments
o j k l m n Ability to grow at 43 C

j k l m n Conversion to a yeast form

Dematiaceous Molds

Ungraded Practice Question


Saprophytic Cladosporium species may be difficult to differentiate from Cladosporium trichoides (Xylohypha bantianum) in culture as both produce chains of conidia separated by distinct scars or dysjuncters. Each of the following characteristics of Cladosporium trichoides are helpful in separating the two except: Please select the single best answer
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j k l m n Slow growth rate j k l m n Neurotropism in animal experiments


o j k l m n Ability to grow at 43 C

j k l m n Conversion to a yeast form

Feedback Neither saprophytic Cladosporium species nor Cladosporium trichoides (Xylohypha bantianum) convert to yeast forms; this is not a differential characteristic and therefore is the correct answer. Xylohypha bantianum, formerly called Cladosporium trichoides, has a special nitch with the dematiaceous pathogenic fungi in being selectively associated with cerebral abscesses; therefore, its definitive laboratory identification may be important. This neurotropism in humans has also been demonstrated in experimental animals. The ability to grow at 43C and to liquify gelatin are two additional characteristics by which X. bantianum can be differentiated from saprophytic Cladosporium species.

Dematiaceous Molds

Ungraded Practice Question


The black yeast colony illustrated in this photograph may represent any of the following dematiaceous molds except: Please select the single best answer j k l m n Phaeoannellomyces wernickii j k l m n Exophiala jeanselmei (young colony) j k l m n Scopulariopsis brumptii j k l m n Aureobasidium pullulans

Dematiaceous Molds

Ungraded Practice Question

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The black yeast colony illustrated in this photograph may represent any of the following dematiaceous molds except: Please select the single best answer j k l m n Phaeoannellomyces wernickii j k l m n Exophiala jeanselmei (young colony) j k l m n Scopulariopsis brumptii j k l m n Aureobasidium pullulans

Feedback Of the fungal species listed in this exercise, Scopulariopsis brumptii is the only one that does not have a yeast form during any part of its growth cycle. Aureobasidium pullulans and Phaeoannellomyces wernickii characteristically produce black yeasts throughout their maturation process. The young colonies of Exophiala jeanselmei may appear as a black yeast, being microscopically identical to P. wernickii.

Dematiaceous Molds

Ungraded Practice Question


The chain of conidia illustrated in this photomicrograph, with the deep-staining truncated bases, are called annelloconidia, and are most characteristic of: Please select the single best answer j k l m n Cladosporium species j k l m n Scopulariopsis brumptii j k l m n Alternaria species j k l m n Aureobasidium pullulans

Dematiaceous Molds

Ungraded Practice Question

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The chain of conidia illustrated in this photomicrograph, with the deep-staining truncated bases, are called annelloconidia, and are most characteristic of: Please select the single best answer j k l m n Cladosporium species j k l m n Scopulariopsis brumptii j k l m n Alternaria species j k l m n Aureobasidium pullulans

Feedback The dematiaceous variant of Scopulariopsis species is called Scopulariopsis brumptii. True to the genus, conidiation is through the production of chains of relatively large lemon-shaped conidia, with thicker, more darkly staining truncated bases, representing scars or annellides. Therefore, they are called annelloconidia. Cladosporium species also produce conidia in chains with darker staining dysjunctors between the cells. However, these conidia are relatively small and elliptical in shape. The conidia of Alternaria species are also in chains; however, they are quite large and muriform in type, with multiple cells divided by both longitudinal and transverse septation. Aureobasidium pullulans produces tiny, hyaline microconidia that bud from the thickened arthroconidia-like segments of the hyphae.

Dematiaceous Molds

Ungraded Practice Question


In this photomicrograph are observed several background dematiaceous hyphae within which is seen a long, flask-shaped, tapered phialide (arrow) that has a flat saucer-like terminus. This feature is most characteristic of: Please select the single best answer j k l m n Phialophora verrucosa j k l m n Phialophora richardsiae j k l m n Exophiala jeanselmei j k l m n Scopulariopsis brumptii

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Dematiaceous Molds

Ungraded Practice Question


In this photomicrograph are observed several background dematiaceous hyphae within which is seen a long, flask-shaped, tapered phialide (arrow) that has a flat saucer-like terminus. This feature is most characteristic of: Please select the single best answer j k l m n Phialophora verrucosa j k l m n Phialophora richardsiae j k l m n Exophiala jeanselmei j k l m n Scopulariopsis brumptii

Feedback The microscopic structures that are described in the question and are illustrated in the photomicrograph are characteristic of Phialophora richardsiae. Exophiala jeanselmei produces a long, slender, tapered phialide that may appear roughened at the tip where the rings or annellides have formed. The conidia of Scopulariopsis brumptii are lemon-shaped and have a flat, truncated base, rather than the open phialides seen with these other species.

Dematiaceous Molds

Ungraded Practice Question


The disease with which the dematiaceous fungus illustrated in this photomicrograph is most likely associated is: Please select the single best answer j k l m n Chronic sinusitis j k l m n Brain abscess j k l m n Invasive pulmonary mycosis j k l m n Subcutaneous mycetoma

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Dematiaceous Molds

Ungraded Practice Question


The disease with which the dematiaceous fungus illustrated in this photomicrograph is most likely associated is: Please select the single best answer j k l m n Chronic sinusitis j k l m n Brain abscess j k l m n Invasive pulmonary mycosis j k l m n Subcutaneous mycetoma

Feedback The dematiaceous fungus illustrated in this photomicrograph has the microscopic characteristics of Curvularia species. Curvularia species are most commonly considered as laboratory contaminants or commensals; however, of the diseases listed in this exercise, they may occasionally cause sinusitis in patients with underlying disease. Brain abscesses are more commonly caused by Cladosporium (Xylohypha) bantianum. Invasive pulmonary mycosis is a rare condition for any of the dematiaceous fungi and subcutaneous mycetomas would be more likely caused by Exophiala or Phialophora species, although Curvularia species in rare instances could cause mycetoma if spore-contaminated vegetative material had been directly inoculated into the deep skin.

Dematiaceous Molds

Ungraded Practice Question

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The dematiaceous conidium illustrated in this photomicrograph was obtained from a tiny portion of dark colony that grew to maturity in six days. Spores incubated in a saline mount for four hours developed germ tubes from both terminal cells. The features observed confirm the identification of: Please select the single best answer j k l m n Drechslera species j k l m n Curvularia species j k l m n Bipolaris species j k l m n Exserohilum species

Dematiaceous Molds

Ungraded Practice Question


The dematiaceous conidium illustrated in this photomicrograph was obtained from a tiny portion of dark colony that grew to maturity in six days. Spores incubated in a saline mount for four hours developed germ tubes from both terminal cells. The features observed confirm the identification of: Please select the single best answer j k l m n Drechslera species j k l m n Curvularia species j k l m n Bipolaris species j k l m n Exserohilum species

Feedback The genus name Bipolaris is derived from its characteristic production of germ tubes on either end of the cell upon incubation in water or physiologic saline for a few hours. The closely related Drechslera species also produce germ tubes upon incubation; however, they are single and emerge only from the hilar cell at a right angle. The conidia of Curvularia species and Exserohilum species do not produce germ tubes of any type when incubated in an aqueous atmosphere.

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Dematiaceous Molds

Ungraded Practice Question


The chief microscopic feature possessed by Ulocladium species by which it can be differentiated from the close look-alike Stemphilium species is: Please select the single best answer j k l m n Dematiaceous septate hyphae j k l m n The production of annelloconidia in chains j k l m n The production of dictyospores j k l m n The presence of geniculate conidiophores

Dematiaceous Molds

Ungraded Practice Question


The chief microscopic feature possessed by Ulocladium species by which it can be differentiated from the close look-alike Stemphilium species is: Please select the single best answer j k l m n Dematiaceous septate hyphae j k l m n The production of annelloconidia in chains j k l m n The production of dictyospores j k l m n The presence of geniculate conidiophores

Feedback In any given culture, it is often difficult to differentiate Ulocladium species from Stemphylium species, to the extent that these may represent variants of the same species. The chief differential features between the two is the production of bent or geniculate conidiophores by Ulocladium species, while the conidia of Stemphylium species are borne from the tips of straight conidiophores (so called a "bale of cotton" on a stick). The problem arises when both forms of sporulation occur in the same culture. In such instances, one can only judge the species by which of these two forms of sporulation predominate. The other features listed in this exercise will not differentiate the two species, as both have dematiaceous, septate hyphae and neither produce muriform macroconidia (dictyospores) or conidia in chains.

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Dematiaceous Molds

Ungraded Practice Question


The etiologic agent of the superficial skin infection tinea niger palmaris (plantaris) is: Please select the single best answer j k l m n Phaeoannellomyces wernickii j k l m n Aureobasidium pullulans j k l m n Cladosporium trichoides (Xylohypha bantianum) j k l m n Scopulariopsis brumptii

Dematiaceous Molds

Ungraded Practice Question


The etiologic agent of the superficial skin infection tinea niger palmaris (plantaris) is: Please select the single best answer j k l m n Phaeoannellomyces wernickii j k l m n Aureobasidium pullulans j k l m n Cladosporium trichoides (Xylohypha bantianum) j k l m n Scopulariopsis brumptii

Feedback The black yeast, now called Phaeoannellomyces wernickii, the cause of tinea nigra palmaris, has had a number of name changes through the years, previously being included at one time or another in genera Cladosporium, Dematium, and Exophiala. The current genus name, Phaeoannellomyces (dark fungus producing annellides) derives from the microscopic appearance in young cultures of the two-celled, spindle-shaped yeast cells that are divided centrally by a distinct, dark brown or black dysjunctor or scar known as an annellide. As the colony matures, a distinct dematiaceous mycelium develops often producing fruiting bodies similar to those produced by members of the genus Exophiala. Some mycologists believe that Phaeoannellomyces wernickii is a synanamorph of Exophiala species.

Page 60 of 61 Copyright 2011 by MediaLab, Inc. All rights reserved.

Page 61 of 61 Copyright 2011 by MediaLab, Inc. All rights reserved.

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