Micro 60 Flashcards


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1

A neutropenic patient with sinusitis develops onychomycosis and necrotic lower-extremity lesions. Which fungus should be suspected?

A. Candida albicans

B. Cryptococcus neoformans

C. Fusarium species

D. Pneumocystis jirovecii

C. Fusarium species

2

Why are clinical signs and symptoms alone usually insufficient for identifying a fungal infection?

A. Fungal diseases are always asymptomatic

B. Findings rarely distinguish the cause

C. Fungi never produce inflammation

D. Symptoms occur only after culture

B. Findings rarely distinguish the cause

3

Processing of which microbial specimen is generally least affected by a short delay?

A. Fungi

B. Viruses

C. Bacteria

D. Parasites

A. Fungi

4

What is generally considered to be among the most rapid and cost-effective means of diagnosing fungal infections?

A. Antibody sequencing

B. Fungal genome mapping

C. Animal inoculation

D. Direct microscopic examination

D. Direct microscopic examination

5

Which stain binds fungal cell walls and produces fluorescence?

A. Calcofluor white

B. Giemsa stain

C. India ink

D. Gram stain

A. Calcofluor white

6

Calcofluor white improves fungal visualization through which effect?

A. Dissolves the fungal capsule

B. Stains intracellular iron

C. Makes cell walls fluoresce

D. Produces dark-field contrast

C. Makes cell walls fluoresce

7

A bone marrow specimen contains suspected intracellular Histoplasma yeast. Which stain is especially useful?

A. Acid-fast stain

B. Giemsa stain

C. Calcofluor white

D. India ink

B. Giemsa stain

8

Which specimen can be examined with Giemsa for intracellular Histoplasma?

A. Nail clippings

B. Bronchoalveolar lavage

C. Peripheral blood smear

D. Cerebrospinal fluid only

C. Peripheral blood smear

9

Besides peripheral blood, Giemsa may detect Histoplasma in which specimen?

A. Stool culture

B. Bone marrow

C. Hair shafts

D. Corneal scrapings

B. Bone marrow

10

Calcofluor white stain detects fungi primarily by binding to which fungal component?

A. Ergosterol
B. Capsule polysaccharide
C. Melanin
D. Chitin
E. β-D-glucan in serum

D. Chitin

11

Which preparation may also reveal Histoplasma yeast with Giemsa?

A. Touch preparation of tissue

B. Serum electrophoresis

C. Urine antigen strip

D. Nail potassium hydroxide mount

A. Touch preparation of tissue

12

Which stain is commonly used to detect Pneumocystis jirovecii cysts?

A. Giemsa

B. India ink

C. Gomori methenamine silver

D. Acid-fast stain

C. Gomori methenamine silver

13

GMS staining for Pneumocystis jirovecii is usually performed on which specimens?

A. Respiratory specimens

B. Nail specimens

C. Blood cultures

D. Skin scrapings

A. Respiratory specimens

14

Which diagnostic method is generally considered most sensitive for fungal infection?

A. Clinical examination

B. Serum microscopy

C. Skin testing

D. Isolation in culture

D. Isolation in culture

15

Why is fungal culture diagnostically valuable?

A. It demonstrates fungal isolation

B. It detects host antibodies

C. It measures inflammatory cytokines

D. It stains fungal capsules

A. It demonstrates fungal isolation

16

Fastidious dimorphic fungi commonly require which culture supplement?

A. Bile salts

B. Blood

C. Urea

D. Charcoal

B. Blood

17

Which organisms commonly require blood-containing fungal media?

A. Candida and Cryptococcus

B. Aspergillus and Fusarium

C. Histoplasma and Blastomyces

D. Mucor and Rhizopus

C. Histoplasma and Blastomyces

18

A nonselective fungal medium could best be described at supporting which organisms?

A. Dermatophytes

B. Rapid yeasts and molds

C. Fastidious dimorphic fungi

D. Rapid and slow-growing fungi

D. Rapid and slow-growing fungi

19

Why might a laboratory use nonselective fungal media?

A. It supports broad fungal recovery

B. It suppresses every opportunist

C. It identifies Candida by color

D. It prevents mold sporulation

A. It supports broad fungal recovery

20

What is the purpose of cycloheximide in fungal media according to the provided material?

A. Enhances fungal fluorescence

B. Prevents opportunistic fungal growth

C. Stimulates dimorphic conversion

D. Increases yeast pigmentation

B. Prevents opportunistic fungal growth

21

Which medium assists with identification of different Candida species?

A. Blood agar

B. Sabouraud broth

C. CHROMagar

D. MacConkey agar

C. CHROMagar

22

Most medically important fungi grow optimally within which temperature range?

A. 4°C to 10°C

B. 15°C to 20°C

C. 37°C to 42°C

D. 25°C to 30°C

D. 25°C to 30°C

23

A culture produces smooth, pasty, opaque colonies. Which fungal form is most likely?

A. Dermatophyte mold

B. Yeastlike fungus

C. Mucorales mold

D. Filamentous basidiomycete

B. Yeastlike fungus

24

Which colony appearance most strongly indicates a mold?

A. Small translucent colonies

B. Smooth mucoid colonies

C. Large filamentous colonies

D. Pasty opaque colonies

C. Large filamentous colonies

25

Mold colonies can vary substantially in which characteristics?

A. Texture, color, and topography

B. Capsule, motility, and flagella

C. Hemolysis, odor, and spores

D. Antibody, antigen, and genome

A. Texture, color, and topography

26

PNA FISH can rapidly distinguish individual yeast species from which specimen?

A. Fixed skin tissue

B. Blood culture

C. Nail scraping

D. Bronchoalveolar lavage

B. Blood culture

27

PNA FISH differentiates yeast species by targeting which molecules?

A. Cell-wall glucans

B. Capsular proteins

C. Specific RNA sequences

D. Membrane ergosterol

C. Specific RNA sequences

28

What is the first major step of MALDI-TOF fungal identification?

A. Extract fungal proteins

B. Amplify fungal DNA

C. Stain fungal capsules

D. Measure serum antibodies

A. Extract fungal proteins

29

After protein extraction during MALDI-TOF, what occurs next?

A. Proteins enter animal tissue

B. Specimen is cultured indefinitely

C. Antibodies are added

D. Specimen is spotted with matrix

D. Specimen is spotted with matrix

30

What does MALDI-TOF generate from the fungal proteins?

A. Fluorescent cell-wall image

B. Mass spectral pattern

C. Viral RNA sequence

D. Antibody-titer curve

B. Mass spectral pattern

31

How is the MALDI-TOF spectrum used for identification?

A. Compared with reference spectra

B. Tested for erythrocyte binding

C. Converted into fungal RNA

D. Examined for yeast budding

A. Compared with reference spectra

32

MALDI-TOF can be particularly helpful in identifying species from which genus?

A. Pneumocystis

B. Histoplasma

C. Aspergillus

D. Microsporum

C. Aspergillus

33

Which fungal cell-wall marker can be measured in several invasive mycoses?

A. Galactomannan

B. 1,3-β-glucan

C. 1,3-α-glucan

D. Lipopolysaccharide

B. 1,3-β-glucan

34

Detection of 1,3-β-glucan may support infection by which yeast?

A. Cryptococcus neoformans

B. Candida species

C. Malassezia furfur

D. Sporothrix schenckii

B. Candida species

35

Detection of 1,3-β-glucan may support infection by which mold?

A. Rhizopus species

B. Mucor species

C. Aspergillus species

D. Fusarium species

C. Aspergillus species

36

Detection of 1,3-β-glucan may support which pulmonary infection?

A. Pneumocystis jirovecii pneumonia

B. Pulmonary cryptococcosis

C. Invasive mucormycosis

D. Pulmonary blastomycosis

A. Pneumocystis jirovecii pneumonia

37

Elevated serum D-arabinitol suggests which infection?

A. Pulmonary aspergillosis

B. Localized dermatophytosis

C. Disseminated candidiasis

D. Pulmonary histoplasmosis

C. Disseminated candidiasis

38

In which specimen is D-arabinitol measured for disseminated candidiasis?

A. Serum

B. Sputum

C. Nail tissue

D. Cerebrospinal fluid

A. Serum

39

Elevated D-mannitol in bronchoalveolar lavage suggests which disease?

A. Disseminated candidiasis

B. Cryptococcal meningitis

C. Pulmonary aspergillosis

D. Cutaneous fusariosis

C. Pulmonary aspergillosis

40

Which specimen is tested for D-mannitol during suspected pulmonary aspergillosis?

A. Serum

B. Urine

C. Bone marrow

D. Bronchoalveolar lavage fluid

D. Bronchoalveolar lavage fluid

41

A patient with diabetic ketoacidosis develops invasive fungal sinusitis. Which organism is most likely?

A. Candida albicans

B. Rhizopus species

C. Sporothrix schenckii

D. Malassezia furfur

B. Rhizopus species

42

Why is a short transport delay less harmful for fungal specimens?

A. Fungi replicate during transport

B. Fungi resist all temperature changes

C. Fungi remain viable at 4°C

D. Fungi require no living organisms

C. Fungi remain viable at 4°C

43

For how long may fungal specimens remain refrigerated without major viability loss?

A. A short period

B. Several months

C. One full year

D. Indefinitely

A. A short period

44

What is the preferred diagnostic approach for gastrointestinal fungal infection?

A. Serum antibody testing

B. Stool fungal culture

C. Urine antigen testing

D. Biopsy with histopathology

D. Biopsy with histopathology

45

Which specimen is commonly obtained to diagnose Pneumocystis jirovecii pneumonia?

A. Bronchoalveolar lavage

B. Peripheral blood smear

C. Urine sediment

D. Nail scraping

A. Bronchoalveolar lavage

46

Which invasive procedure may also diagnose Pneumocystis jirovecii infection?

A. Bone marrow aspiration

B. Skin punch biopsy

C. Lung biopsy

D. Lumbar puncture

C. Lung biopsy

47

Which stain commonly demonstrates Pneumocystis jirovecii cysts?

A. Mucicarmine stain

B. Methenamine silver stain

C. Acid-fast stain

D. India ink

B. Methenamine silver stain

48

Which antibody-based method can detect Pneumocystis jirovecii?

A. Fluorescent monoclonal antibody

B. Latex cryptococcal antigen

C. Heterophile antibody test

D. Direct Coombs test

A. Fluorescent monoclonal antibody

49

Which stain detects Pneumocystis trophic and intracystic forms?

A. Mucicarmine stain

B. Calcofluor white

C. Giemsa stain

D. Gram stain

C. Giemsa stain

50

Mucicarmine staining is used to demonstrate which fungal structure?

A. Aspergillus conidia

B. Histoplasma yeast nuclei

C. Pneumocystis cyst walls

D. Cryptococcal capsular material

D. Cryptococcal capsular material

51

Which organism has a capsule highlighted by mucicarmine?

A. Cryptococcus neoformans

B. Rhizopus species

C. Candida glabrata

D. Sporothrix schenckii

A. Cryptococcus neoformans

52

Cycloheximide may be added to which fungal medium?

A. MacConkey agar

B. Brain heart infusion agar

C. Chocolate agar

D. Lowenstein-Jensen medium

B. Brain heart infusion agar

53

What is the purpose of cycloheximide in fungal culture media

A. Promote capsule production

B. Detect antifungal resistance

C. Suppress rapid fungal contaminants

D. Induce yeast conversion

C. Suppress rapid fungal contaminants

54

Cycloheximide particularly inhibits which contaminating organisms?

A. Rapid yeasts and molds

B. Fastidious dimorphic fungi

C. Intracellular Histoplasma yeast

D. Encapsulated cryptococcal yeast

A. Rapid yeasts and molds

55

Which organism requires olive oil for optimal culture recovery?

A. Candida albicans

B. Cryptococcus neoformans

C. Malassezia furfur

D. Pneumocystis jirovecii

C. Malassezia furfur

56

CHROMagar may rapidly assess susceptibility to which antifungal drug?

A. Amphotericin

B. Fluconazole

C. Flucytosine

D. Caspofungin

B. Fluconazole

57

What is the first step when identifying an unknown fungal isolate?

A. Distinguish yeast from mold

B. Perform antifungal susceptibility testing

C. Sequence the fungal genome

D. Measure serum fungal antigen

A. Distinguish yeast from mold

58

What is the classical method for identifying a mold isolate?

A. Colony odor

B. Serum antibody testing

C. Microscopic morphology

D. Urine antigen testing

C. Microscopic morphology

59

Which test detects the cryptococcal polysaccharide capsular antigen?

A. Trehalose test

B. Latex agglutination test

C. Germ-tube test

D. Urease breath test

B. Latex agglutination test

60

Latex agglutination for Cryptococcus detects which target?

A. Capsular polysaccharide antigen

B. Fungal ribosomal RNA

C. Cell-wall β-glucan

D. Yeast mitochondrial protein

A. Capsular polysaccharide antigen

61

Which specimens are commonly tested for Histoplasma antigen?

A. Sputum and stool

B. CSF and saliva

C. Urine and serum

D. Nails and hair

C. Urine and serum

62

A patient with suspected disseminated histoplasmosis needs rapid antigen testing. Which specimen is appropriate?

A. Nail clipping

B. Urine sample

C. Corneal scraping

D. Hair shaft

B. Urine sample

63

Which hyphal morphology characterizes Mucor and Rhizopus?

A. Narrow septate hyphae

B. Broad nonseptate hyphae

C. Budding encapsulated yeast

D. Pseudohyphae with blastoconidia

B. Broad nonseptate hyphae

64

How do Mucor and Rhizopus hyphae typically branch?

A. At acute angles

B. At narrow parallel angles

C. At wide irregular angles

D. Without visible branching

C. At wide irregular angles

65

Which combined morphology suggests Mucorales infection?

A. Broad, irregular, nonseptate hyphae

B. Narrow, septate, acute branches

C. Encapsulated budding yeast

D. Intracellular tiny yeasts

A. Broad, irregular, nonseptate hyphae

66

Which fungus appears as cigar-shaped yeast at 37°C?

A. Blastomyces dermatitidis

B. Sporothrix schenckii

C. Histoplasma capsulatum

D. Coccidioides immitis

B. Sporothrix schenckii

67

The cigar-shaped tissue form of Sporothrix develops at what temperature?

A. 20°C

B. 25°C

C. 30°C

D. 37°C

D. 37°C

68

According to the cited study, MycAssay Pneumocystis was evaluated using which specimen?

A. Bronchoalveolar lavage

B. Serum

C. Urine

D. Bone marrow

A. Bronchoalveolar lavage

69

Which test can detect Candida at 1 CFU/mL?

A. PNA FISH

B. T2Candida

C. CHROMagar

D. Latex agglutination

B. T2Candida

70

Which specimen is recommended for antigen detection in Histoplasma infection of the bloodstream according to the diagnostic table?

A. Cerebrospinal fluid
B. Bone marrow aspirate
C. Urine
D. Skin scraping
E. Corneal biopsy

C. Urine

71

Which specimen is specifically recommended for Cryptococcus antigen testing in central nervous system infection?

A. Serum only
B. Spinal fluid
C. Urine
D. Bone marrow aspirate
E. Skin biopsy

B. Spinal fluid

72

Which specimen collection method is recommended for mucosal lesions of the skin and mucous membranes?

A. Sterile aspirate
B. Saline swab
C. Punch biopsy only
D. Venipuncture
E. Skin scraping

B. Saline swab