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For Coccidioides immitis

1. Please provide the name(s) of the disease(s) caused by this organism.

2. Please mark all the characteristics that are applicable to this organism. (more than one answer)

Gram +

Gram -

Acid Fast +

Acid Fast -

Endospore Forming

Non-Endospore Forming

Motile

Non-Motile

Catalase +

Catalase -

Aerobic

Facultative Anaerobe

Anaerobic

Microaerophile

Not Applicable

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Patrina Schowalter
Patrina SchowalterLv2
29 Sep 2019
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Related questions

1. An organism, observed on direct Gram stain from a clinical specimen, does not grow on blood or chocolate agars incubated at 35°C in CO2. This can be explained by all of following statements except

a. the organism is an anaerobe.

b. the organism is dead due to previous antibiotic therapy.

c. the organism requires nicotinamide adenine dinucleotide for growth.

d. the organism is fastidious and is not being provided the growth factor it needs.

2. The laboratory should be notified in advance when the physician suspects Francisella tularensis because the organism is

a. fastidious and requires special medium.

b. infectious for laboratory personnel.

c. not culturable.

d. a and b.

e. b and c.

3. The HACEK organisms share all of the following characteristics except

a. gram-negative coccobacilli that are oxidase and catalase positive.

b. slow growing and stimulated by carbon dioxide.

c. part of the normal oral flora.

d. causative agents of bacterial endocarditis.

4. Legionella pneumophila and Francisella tularensis share the characteristic of

a. being easily identified by biochemical testing.

b. a requirement for cysteine to grow in culture.

c. the necessity for the use of Gimenez stain rather than Gram stain to visualize.

d. having an animal reservoir.

5. Legionella pneumophila and Francisella tularensis share all of the following characteristics except

a. poor Gram staining properties.

b. ability to cause pneumonia.

c. ability to diagnose infection with detection of serum antibodies.

d. fluorescence of colonies.

6. A blood culture isolate that stains as pleomorphic gram-negative coccobacillus and only grows on chocolate agar should be

a. identified using the ALA test.

b. identified using the ALA and horse blood agar tests.

c. presumptively identified under BSL 2 conditions.

d. identified using X and V factor disks and horse blood agar.

7. Which of the following organisms requires factor X only on initial isolation but loses the requirement on subculture?

a. Aggregatibacter actinomycetemcomitans

b. Eikenella corrodens

c. Francisella tularensis

d. Aggregatibacter aphrophilus

8. Haemophilus ducreyi is unique among the genus because it requires

a. factors X and V.

b. no factors.

c. heme only.

d. NAD only.

9. Streptobacillus moniliformis is most easily isolated from blood cultures because it requires _____ for growth.

a. heme

b. serum

c. cysteine

d. 1% α-ketoglutarate

10. A 57-year-old male farmer sees his physician complaining of fever, night sweats, and lethargy that come and go over the past three months. The patient’s history reveals that he raises sheep for wool and meat and goats for milk. The physician suspects undulant fever. What is the optimal specimen(s) for culture of this suspected organism?

a. Blood

b. Bone marrow

c. Lymph node biopsy

d. All of the above

e. B and C

11. A microbiologist processes a specimen for culture using a buffered charcoal yeast extract agar plate. What was the original specimen used for inoculation of this agar plate?

a. Blood

b. Lower respiratory specimen

c. Nasopharyngeal

d. Urine

12. A nasopharyngeal swab containing ciliated epithelial cells is the best specimen for the recovery of the organism that causes

a. whooping cough.

b. undulant fever.

c. rat bite fever.

d. legionnaire’s disease.

13. What is the clinical significance of ALA-positive, gram-negative coccobacilli in a sputum culture?

Normal flora

Potential pathogen

Significant if it is hemolytic on horse blood agar

Further testing is needed to assess significance

14. A small, slender, gram-negative rod was recovered from the blood cultures of a patient following root canal surgery. At 48 hours, the following results were observed:

BAP and CHOC agars: small gray colonies that tend to pit the agar

MAC agar: no growth

Odor upon opening the agar plates: bleach-like

This organism will also be

a. catalase and oxidase positive.

b. catalase positive and oxidase negative.

c. catalase and oxidase negative.

d. catalase negative and oxidase positive.

15. A pleomorphic gram-negative coccobacillus is isolated from the blood cultures of 58-year-old male who had recent dental surgery. His history is significant for rheumatic fever as a child. The organism only grows on chocolate agar. It should be tested using

a. ALA.

b. X and V factor disks.

c. ALA and horse blood agar.

d. X and V factors and horse blood agar.

16. The virulence of Bordetella pertussis is related to its

a. toxin’s ability to paralyze ciliated epithelial cells.

b. ability to hide in the reticuloendothelial system.

c. easy dissemination.

d. ability to live inside white blood cells.

17. Infection due to Brucella spp. is often slow to develop, long term, and displaying periodicity. This can be explained by the organism’s ability to

a. colonize the upper respiratory tract prior to infection.

b. travel and hide in the reticuloendothelial system.

c. cause infection as the vaccine wanes in adults.

d. change its surface antigens.

18. A 10-year-old male gave mouth-to-mouth resuscitation to his pet guinea pig, which proceeded to bite him on the lip. The guinea pig did not survive. Two days after the guinea pig’s funeral, the boy became ill with fever, chills, joint pain, and a rash. What organism should the physician suspect based on the patient’s history?

a. Brucella spp.

b. Francisella tularensis

c. Streptobacillus moniliformis

d. Eikenella corrodens

19. You and your best friend get into a fist fight. Your knuckles are torn and bleeding afterwards. What organism are you likely to isolate if your wounds become infected?

a. Kingella kingae

b. Eikenella corrdens

c. Aggregatibacter aphrophilus

d. Cardiobacterium hominis

20. Epiglottitis, a severe life-threatening infection occurring in non-vaccinated infants and children, is most commonly caused by

a. a pleomorphic gram-negative coccobacillus that is ALA positive and horse blood agar positive.

b. a gram-negative coccobacillus that is identified by direct fluorescent antibody and slide agglutination tests.

c. a gram-negative coccobacillus that is best identified by a rise in antibody titer in serum samples drawn two weeks apart.

d. a pleomorphic gram-negative coccobacillus that requires X and V factors and is horse blood agar negative.

21. An organism isolated from the swab of purulent eye drainage shows no fluorescence on the ALA test. The horse blood agar displays no hemolysis. This organism should be reported as

a. Haemophilus influenzae.

b. H. aegyptius.

c. H. influenzae or H. aegyptius, biochemically similar.

d. H. parainfluenzae.

22. Because of the nature of the profession, a veterinarian is at increased risk of acquiring

1. Brucella spp.

2. Aggregatibacter actinomycetemcomitans

3. Francisella tularensis

4. Streptobacillus moniliformis

5. Eikenella corrodens

a. 1, 2, 4, and 5

b. 1, 3, and 4

c. 2, 3, and

d. 3 and 4

Part III – The Physician
June 5th
ree weeks had passed. e swelling was still present and it had become even more di cult for Margo to move
her nger. In addition, the amount of uid oozing from the wound had increased, suggesting that the medication hadn’t worked. It was now time to visit a local physician. Following the advice of a neighbor, Margo set up an o ce appointment with Dr. Chan, an internist. After the usual battery of questions, Dr. Chan sent in the nurse to collect a specimen from Margo’s nger. Dr. Chan mentioned to Margo that the specimen would be sent o to the regional hospital laboratory for analysis and that he would provide her with another prescription for Ke ex, which she should continue to take until test results came back.
June 15th
e test results arrived in Dr. Chan’s o ce on June 15th and were as follows: • No yeast or fungal elements were noted
• Gram-stain reaction: no organisms seen
• Culture of anaerobes and aerobes @48 hours yielded no growth
• Enrichment culture results: moderate growth on day 5 of an acid-fast bacterium (AFB). o Growth identi ed as Mycobacterium fortuitum by the Florida State Laboratory.
Armed with a microbial identi cation, Dr. Chan prescribed Doxycycline and Bactrim to be taken for four months. Dr. Chan also mentioned that the isolated organism was known to be found in tap water. Consequently, Margo planned to ask her condo community why an organism that could cause so much pain would be living in the water that was coming out of her faucets. And although she was annoyed to learn of the source of the organism, at least she could take some comfort in the fact that she nally had an accurate diagnosis and that by taking her medicine she could fully recover from her injury and start to enjoy her new home.
Questions
1. Compare and contrast aerobes and anaerobes. Why were no microbes noted upon aerobic and anaerobic culture?
2. Investigate the properties and characteristics of M. fortuitum. Where is this organism typically found (reservoirs)?
3. Why must the acid fast stain be performed to identify organisms of the genus Mycobacterium?
4. Why did Dr. Chan prescribe two antibiotics rather than only one?
5. How does doxycycline kill bacteria (cellular target)?
6. Why were the antibiotics prescribed for an extended period (4 months)?
7. No organisms were noted upon Gram staining, yet the enrichment culture yielded M. fortuitum after several days. Provide an explanation.

Highlight or bold the answer you select for multiple choice or type in your answer in the blank space provided.

1. Which of the following is not true of the nervous system?

Consists of central and peripheral systems

(b) Central nervous system is composed of brain and spinal cord

(c) Ganglia are part of brain

(d) Meninges are membranes that cover brain and spinal cord

(e) Normally free of microbes

2. Which of the following is a common cause of meningitis in nonimmunized young children?

(a) Streptococcus pneumoniae

(b) Escherichia coli

(c) Staphylococcus

(d) Haemophilus influenzae

(e) None of the above

3. A complication of infection with this organism (Waterhouse-Friderichsen syndrome) can occur if the organism becomes widely distributed in the body, leading to endotoxin shock and death. The organism is:

(a) Haemophilus influenzae type A

(b) Neisseria meningitidis

(c) Haemophilus influenzae type B

(d) Streptococcus pneumoniae

(e) Listeria monocytogenes

4. Which of the following bacterial meningitis diseases currently is the most common type in the U.S., with increased incidences in infants and in the 15- to 24-year-old age group, and has three types or strains of the infectious microbe?

(a) Haemophilus meningitis

(b) Listeriosis

(c) Streptococcus meningitis

(d) Meningococcal meningitis

(e) a and c

5. Before development of a vaccine against this microbe, the disease it caused accounted for two-thirds of bacterial meningitis cases during the first year of life but is still the number one leading cause of mental retardation in patients who survive serious disease due to permanent central nervous system disorders. What is the microorganism?

(a) Haemophilus influenzae type B

(b) Haemophilus influenzae type A

(c) Neisseria meningitidis

(d) Streptococcus pneumoniae

(e) Listeria monocytogenes

6. Which of the following bacteria that may cause meningitis is Gram-positive and therefore does not cause endotoxin shock in infected individuals?

(a) Escherichia coli

(b) Neisseria meningitidis

(c) Listeria monocytogenes

(d) Haemophilus influenzae type B

(e) None of these

7. Avid swimmers and hot tub enthusiasts sometimes acquire an opportunistic infection caused by Naegleria fowleri that results in a meningoencephalitis. This organism is a (an):

(a) Protist

(b) Helminth

(c) Bacteria

(d) Amoeba

(e) a and d

8. Which of the following in NOT true about listeriosis?

(a) Foodborne transmission is the most common source of infection.

(b) It is a leading cause of bacterial meningitis today.

(c) It is responsible for many cases of fetal damage and death.

(d) It is sometimes acquired as a zoonosis.

(e) Individuals with impaired immune systems are highly susceptible to this disease.

9. Viral meningitis is usually always fatal if untreated, unlike bacterial meningitis, which is always self-limiting and nonfatal. True or false?

10. Which of the following is acid-fast and causes Hansen's disease?

(a) Mycobacterium tuberculosis

(b) Clostridium tetani

(c) Neisseria meningitidis

(d) Haemophilus influenzae

(e) Mycobacterium leprae

11. An immunofluorescent antibody test (IFAT) has replaced the older test for the presence of inclusions in neurons (Negri bodies) for the detection of infections caused by:

(a) Neisseria meningitidis

(b) Enteroviruses

(c) Mumps virus

(d) Rabies virus

(e) Haemophilus influenza

12. The viruses that cause encephalitis are most likely to be:

(a) Togaviruses

(b) Enteroviruses

(c) Mumps virus

(d) Rabies virus

(e) Hepatitis viruses

13. What do the following viral encephalitis diseases have in common: eastern equine encephalitis, western equine encephalitis, Venezuelan equine encephalitis, St. Louis encephalitis, West Nile fever?

(a) They are all caused by the same virus.

(b) They are have the horse as a common intermediate host.

(c) They are all transmitted into the body through the bite of an infected mosquito.

(d) Birds are never involved in the life cycle of the viruses that cause these diseases.

(e) Both a and d.

14. The only bacterium known to damage peripheral nerves is:

(a) Naegleria fowleri

(b) Mycobacterium leprae

(c) Streptococcus pneumoniae

(d) Neisseria meningitidis

(e) Haemophilus influenzae

15. All of the following are true about Clostridium tetani, the causative agent of tetanus, EXCEPT:

(a) They are spore-forming rods.

(b) They are part of the normal bowel microflora of horses, cattle, and humans.

(c) They produce a powerful exotoxin that mediates the disease.

(d) Their toxin elicits muscle stiffness, spasms, and paralysis in the victim.

(e) They require oxygen to survive.

16. A vaccine that was developed in 1933 has proven effective in reducing the incidence of disease caused by:

(a) Clostridium botulinum

(b) Mycobacterium leprae

(c) Clostridium tetani

(d) Streptococcus pneumoniae

(e) Listeria monocytogenes

17. The most common form of disease caused by Clostridium botulinum is:

(a) Infant

(b) Wound

(c) Lung, following exposure to aerosols

(d) Foodborne

(e) None of these

18. The endospores of this organism are the most heat-resistant known; it is:

(a) Clostridium tetani

(b) Clostridium botulinum

(c) Mycobacterium leprae

(d) Streptococcus thermicos

(e) Listeria monocytogenes

19. All of the following are true about Clostridium botulinum, the causative agent of botulism, EXCEPT:

(a) Their ability to form toxin depends on infection with a bacteriophage.

(b) They can produce one of eight different toxins, all of which cause human disease.

(c) They produce the most potent toxin known.

(d) Although their endospores are highly heat-resistant, their toxin can be inactivated by only a few minutes' boiling.

(e) All of the above are true.

20. All of the following are true about poliomyelitis EXCEPT:

(a) Most poliovirus infections are inapparent or mild and nonparalytic.

(b) Polio can be caused by three strains of picornaviruses.

(c) The Salk vaccine contains live, attenuated polioviruses while the Sabin vaccine contains formalin-inactivated polioviruses.

(d) Transmission is by the fecal-oral route and pharyngeal secretions.

(e) Poliomyelitis has afflicted man for thousands of years.

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