Clinical Lab Practice Quiz For Module 2

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  • 1/222 Questions

    Which specimen collection procedure is best for identifying nasopharyngeal microbes?

    • Swab or wash
    • Blood culture
    • Sputum culture
    • “Whiff” test
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About This Quiz

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Clinical Lab Practice Quiz For Module 2 - Quiz

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  • 2. 

    When obtaining a specimen for a suspected lower respiratory infection, what collection technique is BEST?

    • Obtain sputum sample from pt at the end of the day

    • Obtain a sputum sample from the pt at the beginning of the day

    • Obtain a throat swab sample from the pt

    • Obtain a throat wash sample from the pt

    Correct Answer
    A. Obtain a sputum sample from the pt at the beginning of the day
    Explanation
    The best collection technique for obtaining a specimen for a suspected lower respiratory infection is to obtain a sputum sample from the patient at the beginning of the day. This is because sputum produced in the morning tends to be more concentrated and contains a higher number of microorganisms, making it easier to detect any potential infection. Collecting the sample at the beginning of the day also allows for better identification and testing of the microorganisms present, leading to more accurate diagnosis and treatment.

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  • 3. 

    A 1 y/o male is presented to you with flaccid paralysis and shows signs of intoxication. His mother explains that she routinely mixes his formula with honey in order to “build up his immune system”. Which of the following microbes BEST meets this pt’s signs/symptoms?

    • Bacillus Cereus

    • Streptococcus pyogenes

    • Escherichia coli (EHEC)

    • Clostridium botulinum

    • Staphylococcus aureus

    Correct Answer
    A. Clostridium botulinum
    Explanation
    Clostridium botulinum is the best microbe that meets the patient's signs and symptoms. This bacterium is known to cause flaccid paralysis and can produce a toxin that leads to intoxication. The patient's ingestion of honey mixed with formula may have exposed him to the spores of Clostridium botulinum, which can grow and produce the toxin in the intestinal tract. This can result in symptoms such as flaccid paralysis and signs of intoxication.

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  • 4. 

    Which of the following special considerations should be taken when submitting a viral specimen for analysis?

    • Viruses require living cells and must be transported in a Viral Transport Medium with antibiotics/antifungals

    • Viruses must be transported via a dark collection tube as they are anaerobic

    • Viruses must be transported via a collection tube which contains a 10% saline solution

    • Viruses do not require special considerations

    Correct Answer
    A. Viruses require living cells and must be transported in a Viral Transport Medium with antibiotics/antifungals
    Explanation
    Viruses require living cells to survive and replicate. Therefore, when submitting a viral specimen for analysis, it is important to transport the virus in a Viral Transport Medium that contains antibiotics/antifungals. This medium helps to maintain the viability of the virus during transportation and prevents the growth of bacteria or fungi that could potentially contaminate the specimen.

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  • 5. 

    Which of the following infections yields flank pain, nausea, fever?

    • Cystitis

    • Pyelonephritis

    • Lower UTI

    • Prostatitis

    Correct Answer
    A. Pyelonephritis
    Explanation
    Pyelonephritis is the correct answer because it is an infection of the kidneys, which can cause flank pain. Nausea and fever are also common symptoms of pyelonephritis. Cystitis refers to a bladder infection and may cause urinary symptoms but not necessarily flank pain. Lower UTI is a general term that includes infections of the bladder and urethra, which may cause urinary symptoms but not specifically flank pain. Prostatitis refers to an infection of the prostate gland and may cause urinary symptoms, but flank pain is not typically associated with it.

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  • 6. 

    Which of the following would not require a urine culture prior to treatment of a patient with UTI?

    • Uncomplicated Cystitis

    • Uncomplicated Pyelonephritis

    • Complicated Cystitis

    • Uncomplicated Prostatitis

    Correct Answer
    A. Uncomplicated Cystitis
    Explanation
    Uncomplicated cystitis typically presents with symptoms of a lower urinary tract infection (UTI) in otherwise healthy individuals. It is usually caused by a common pathogen, such as Escherichia coli, and can be effectively treated with empirical antibiotics without the need for a urine culture. In contrast, uncomplicated pyelonephritis, complicated cystitis, and uncomplicated prostatitis may have more severe symptoms, involve upper urinary tract or prostate infections, and may require a urine culture to guide appropriate antibiotic treatment.

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  • 7. 

    24 y/o sexually active female presents to the clinic with a frothy green discharge. You perform a wet prep microscopy of a vaginal swab taken from the pt and discover several motile organisms in the specimen. Which microbe can you expect to be present?

    • Gardnerella vaginalis

    • Candida albicans

    • Trichomonas vaginalis

    • Haemophilus ducreyi

    • Neisseria gonorrhea

    Correct Answer
    A. Trichomonas vaginalis
    Explanation
    Trichomonas vaginalis is the correct answer because it is a sexually transmitted parasite that commonly causes frothy green discharge in women. It can be identified on wet prep microscopy by the presence of motile organisms in the vaginal swab. Gardnerella vaginalis is associated with bacterial vaginosis and typically presents with a thin, grayish-white discharge. Candida albicans is a yeast infection that causes a thick, white discharge. Haemophilus ducreyi is the causative agent of chancroid, which presents with painful genital ulcers. Neisseria gonorrhea is a bacterial infection that can cause a yellowish discharge.

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  • 8. 

    Which of the following microbes is causal to Syphilis?

    • Treponema pallidum

    • Calymmatobacterium

    • Haemophilus ducreyi

    • Herpes Simplex

    • Lymphogranuloma Venereum

    Correct Answer
    A. Treponema pallidum
    Explanation
    Treponema pallidum is the causal microbe of Syphilis. Syphilis is a sexually transmitted infection caused by this bacterium. It is a spirochete bacteria that can be transmitted through sexual contact or from mother to child during pregnancy. Treponema pallidum infects the genital area, mouth, or rectum, and if left untreated, can lead to serious complications such as neurological damage, cardiovascular problems, and even death. Therefore, identifying Treponema pallidum as the causal microbe of Syphilis is crucial for diagnosis and treatment of the disease.

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  • 9. 

    Which of the following is a common sign of tertiary(Late) Syphilis?

    • Painless Chancres

    • Neurosyphilis

    • Rash

    • Lymphadenopathy

    Correct Answer
    A. Neurosyphilis
    Explanation
    Neurosyphilis is a common sign of tertiary (late) syphilis. Tertiary syphilis is the third stage of syphilis, which occurs when the infection is left untreated for a long time. Neurosyphilis refers to the involvement of the central nervous system by the syphilis bacteria. It can cause various neurological symptoms such as cognitive impairment, psychiatric symptoms, and sensory abnormalities. Therefore, neurosyphilis is a significant indicator of late-stage syphilis.

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  • 10. 

    27 y/o female presents to your clinic with voluminous watery diarrhea resembling “rice water” with a foul fishy smell. Which of the following microbes BEST meets this pt’s signs/symptoms?

    • Vibrio cholera

    • Bacillus Cereus

    • Escherichia coli (EHEC)

    • Staphylococcus aureus

    • Salmonella enteritidis

    Correct Answer
    A. Vibrio cholera
    Explanation
    The patient's presentation of voluminous watery diarrhea resembling "rice water" with a foul fishy smell is characteristic of Vibrio cholera infection. Vibrio cholera is a bacterium that causes cholera, a severe diarrheal disease. Cholera is known for its watery diarrhea, which can be profuse and lead to dehydration. The "rice water" appearance of the diarrhea is due to the presence of mucus and epithelial cells in the stool. The foul fishy smell is a result of the bacterial toxins produced by Vibrio cholera. Therefore, Vibrio cholera is the best match for the patient's signs and symptoms.

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  • 11. 

    A Tzanck smear is a diagnostic test to detect which type of microbes?

    • HSV, VZV

    • MRSA

    • Fungi

    • Cancer

    Correct Answer
    A. HSV, VZV
    Explanation
    A Tzanck smear is a diagnostic test used to detect the presence of the herpes simplex virus (HSV) and varicella-zoster virus (VZV). This test involves collecting a sample from a skin lesion and examining it under a microscope to look for characteristic changes in the cells caused by these viruses. The test helps in the diagnosis of conditions such as herpes and chickenpox, which are caused by HSV and VZV respectively.

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  • 12. 

    The facility where you are assigned for Phase 2 has a BSL3 equipped lab for mycobacteria. In order to maximize this resource, when is the best time to collect a specimen from a pt whom you suspect to have active TB?

    • There is no such thing as a BSL3 equipped lab for mycobacteria.

    • As TB is diurnal and is most active in the evening, collect a sputum sample after 2000

    • Mycobacterial specimens are best when collected in the morning

    • Mycobacterial specimens are best when collected after the pt eats

    Correct Answer
    A. Mycobacterial specimens are best when collected in the morning
    Explanation
    The best time to collect a mycobacterial specimen, such as for suspected active TB, is in the morning. This is because mycobacteria, including TB, tend to be more concentrated in the respiratory tract in the morning due to overnight accumulation. Collecting the specimen in the morning increases the chances of detecting the bacteria and improving diagnostic accuracy.

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  • 13. 

    Interpret the following serological results: HBsAg (+), IgM anti-HBc (+), IgM anti-HAV (-), Anti-HCV (-)

    • Hep B Acute

    • Heb B resolved, Hep C resolved

    • Hep A acute

    • Hep B resolved

    Correct Answer
    A. Hep B Acute
    Explanation
    The given serological results indicate the presence of HBsAg and IgM anti-HBc, which are markers for acute Hepatitis B infection. The absence of IgM anti-HAV and Anti-HCV suggests that the patient does not have acute Hepatitis A or Hepatitis C infections. Therefore, the correct interpretation of the serological results is Hepatitis B Acute.

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  • 14. 

    Interpret the following serological results: HBsAg (-), IgM anti-HBc (-), IgM anti-HAV (-), Anti-HCV (-), ALT 2000 (normal is 45)

    • Hep B Acute

    • No Hep infection, possible liver pathology

    • Hep A acute

    • Hep B resolved, possible liver pathology

    Correct Answer
    A. No Hep infection, possible liver pathology
    Explanation
    Based on the given serological results, it can be concluded that there is no Hepatitis infection detected as HBsAg, IgM anti-HBc, IgM anti-HAV, and Anti-HCV are all negative. However, the elevated ALT level of 2000 suggests possible liver pathology. Therefore, the interpretation of the serological results is that there is no Hepatitis infection present, but there may be some underlying liver pathology causing the high ALT level.

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  • 15. 

    Which of the following is not associated with the LOWER respiratory tract?

    • Bronchi

    • Pharynx

    • Lungs

    • Alveoli

    Correct Answer
    A. Pharynx
    Explanation
    The pharynx is not associated with the lower respiratory tract. The lower respiratory tract consists of the bronchi, lungs, and alveoli, which are involved in the process of breathing and gas exchange. The pharynx, on the other hand, is part of the upper respiratory tract and serves as a passage for air and food. It connects the nasal cavity and mouth to the larynx and esophagus. Therefore, the pharynx is not directly involved in the lower respiratory tract.

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  • 16. 

    Sinusitis or “sinus ostia” normally follows what type of infection?

    • Lower respiratory infection

    • Upper respiratory infection

    • Lymph node infection

    • Herpes Simplex

    Correct Answer
    A. Upper respiratory infection
    Explanation
    Sinusitis, or inflammation of the sinuses, typically occurs as a result of an upper respiratory infection. Upper respiratory infections are commonly caused by viruses, such as the common cold or influenza, which can lead to inflammation and congestion in the nasal passages and sinuses. This inflammation can block the sinus openings, causing a buildup of mucus and leading to sinusitis. Therefore, the correct answer is upper respiratory infection.

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  • 17. 

    A pt receives a titer test with a 1:30 ratio of IgM. If you perform a second titer test on this pt in 5 days, what ratio is needed to confirm an ACUTE infection?

    • 1:10

    • 1:90

    • 1:100

    • 0.120

    Correct Answer
    A. 0.120
  • 18. 

    21 y/o male presents to clinic with burning on urination and purulent discharge. Which microbe do you suspect is causal to the pt’s infection?

    • Neisseria gonorrhea

    • Proteus mirabilis

    • Klebsiella

    • Staphylococcus saprophyticus

    • Enterococcus

    Correct Answer
    A. Neisseria gonorrhea
    Explanation
    The symptoms described by the patient, including burning on urination and purulent discharge, are consistent with a sexually transmitted infection. Neisseria gonorrhea is a common cause of such infections, especially in young sexually active individuals. It is a gram-negative bacterium that primarily infects the genital tract and can lead to complications if left untreated. Therefore, Neisseria gonorrhea is the most likely microbe responsible for the patient's infection.

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  • 19. 

    Upon performing a wet prep microscopy of a 22 y/o female pt with definitive STI symptoms other than a malodorous grayish-white discharge, you discover several “Clue Cells”. What microbe can you expect to be present?

    • Gardnerella vaginalis

    • Candida albicans

    • Chlamydia trachomatis

    • Haemophilus ducreyi

    • Neisseria gonorrhea

    Correct Answer
    A. Gardnerella vaginalis
    Explanation
    Clue cells are epithelial cells that have a stippled appearance due to the presence of bacteria on their surface. They are typically seen in cases of bacterial vaginosis, which is commonly caused by Gardnerella vaginalis. Therefore, the presence of clue cells indicates the likelihood of Gardnerella vaginalis being the microbe responsible for the symptoms in the patient.

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  • 20. 

    In a congenital case of bronchiectasis, what primary disease is generally the cause?

    • Lupus

    • Smoking

    • Cystic Fibrosis

    • Hashimoto’s

    Correct Answer
    A. Cystic Fibrosis
    Explanation
    Cystic fibrosis is a genetic disorder that affects the production of mucus in the body, leading to the accumulation of thick, sticky mucus in the airways. This can result in recurrent infections and inflammation, causing damage to the bronchial tubes and leading to bronchiectasis. Therefore, in cases of congenital bronchiectasis, cystic fibrosis is generally the primary disease that causes it.

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  • 21. 

    The Epstein Barr Virus is commonly associated with what other type of infection?

    • Mononucleosis

    • Influenza

    • Parasitic Pneumonia

    • Severe Acute Respiratory Disease (SARS)

    Correct Answer
    A. Mononucleosis
    Explanation
    The Epstein Barr Virus is commonly associated with mononucleosis. Mononucleosis, also known as mono or the "kissing disease," is a viral infection that causes fatigue, sore throat, swollen lymph nodes, and fever. Epstein Barr Virus is a member of the herpes virus family and is transmitted through saliva, making it commonly spread through kissing or sharing drinks or utensils. It primarily affects teenagers and young adults and can cause symptoms that last for several weeks or even months.

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  • 22. 

    Which of the following is NOT a relevant clinical question when Dx diarrhea?

    • Timing of disease

    • Frequency

    • Chromatography of urine

    • Level of hydration

    Correct Answer
    A. Chromatography of urine
    Explanation
    The question is asking for a clinical question that is not relevant when diagnosing diarrhea. The timing of the disease, frequency, and level of hydration are all important factors to consider when diagnosing diarrhea. However, chromatography of urine is not directly related to the diagnosis of diarrhea. Urine chromatography is typically used to analyze the composition of urine and detect any abnormalities or specific substances present. While it may be useful in other medical conditions, it is not directly relevant to diagnosing diarrhea.

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  • 23. 

    Which of the following microbes is NOT a common cause of bacterial diarrhea?

    • Salmonella

    • Campylobacter

    • Isospora belli

    • Clostridium perfringens

    Correct Answer
    A. Isospora belli
    Explanation
    Isospora belli is not a common cause of bacterial diarrhea. It is actually a parasite that causes an intestinal infection called isosporiasis. Bacterial diarrhea is usually caused by bacteria such as Salmonella, Campylobacter, and Clostridium perfringens.

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  • 24. 

    All of the following are macroscopic characteristics EXCEPT which of the following?

    • Consistency

    • Color

    • PH

    • Quantity

    Correct Answer
    A. pH
    Explanation
    This question is asking for the macroscopic characteristic that is not included in the given options. The options Consistency, Color, and Quantity are all macroscopic characteristics that can be observed and measured. However, pH is not a macroscopic characteristic, but rather a measure of the acidity or alkalinity of a substance. Therefore, pH is the correct answer.

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  • 25. 

    During a physical exam of a 39 y/o male, you discover costovertebral angle tenderness in the pt. Which of the following infections is MOST LIKELY the cause of his pain?

    • Cystitis

    • Pyelonephritis

    • Lower UTI

    • Splenomegaly

    • Prostatitis

    Correct Answer
    A. Pyelonephritis
    Explanation
    Pyelonephritis is the most likely cause of the patient's pain because costovertebral angle tenderness is a classic sign of kidney infection. Pyelonephritis is an infection of the kidneys, usually caused by bacteria ascending from the bladder. It commonly presents with symptoms such as fever, flank pain, and urinary symptoms. The presence of costovertebral angle tenderness indicates inflammation and infection in the kidneys, supporting the diagnosis of pyelonephritis. Cystitis refers to a bladder infection, lower UTI refers to a urinary tract infection that can involve the bladder or urethra, splenomegaly refers to an enlarged spleen, and prostatitis refers to inflammation of the prostate gland. These conditions are less likely to cause the specific symptom of costovertebral angle tenderness.

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  • 26. 

    22 y/o male present to the clinic 2 weeks after you Dx him with Syphilis complaining of a palmar rash. What stage of Syphilis is the symptom considered to be attributed to?

    • Primary

    • Secondary

    • Latent

    • Acute

    Correct Answer
    A. Secondary
    Explanation
    The symptom of a palmar rash in a patient with syphilis is considered to be attributed to the secondary stage of the disease. In the secondary stage, which typically occurs a few weeks to a few months after the initial infection, a rash may develop on the palms of the hands and the soles of the feet. This rash is usually not itchy and may be accompanied by other symptoms such as fever, sore throat, swollen lymph nodes, and fatigue. The secondary stage is characterized by the spread of the infection throughout the body.

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  • 27. 

    Which of the following infections is commonly observed via a Pap smear?

    • HIV

    • HPV

    • Herpes

    • Syphilis

    Correct Answer
    A. HPV
    Explanation
    A Pap smear is a test used to screen for cervical cancer. Human papillomavirus (HPV) is the most common cause of cervical cancer, so it is commonly observed via a Pap smear. HIV, herpes, and syphilis are not typically detected through a Pap smear.

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  • 28. 

    26 y/o pt presents to clinic with coughing, rhinorrhea, and low grade fever. Which of the following do you suspect?

    • Viral Pharyngitis

    • Bacterial Pharyngitis

    • Diphtheria

    • N gonorrhea

    Correct Answer
    A. Viral Pharyngitis
    Explanation
    Based on the symptoms described (coughing, rhinorrhea, and low-grade fever), it is likely that the patient is experiencing a viral infection rather than a bacterial or sexually transmitted infection. Viral Pharyngitis is the most probable diagnosis as it is a common viral infection characterized by inflammation and soreness in the throat. This condition typically presents with symptoms similar to those described by the patient. Bacterial Pharyngitis, Diphtheria, and N. gonorrhea are less likely as they are associated with different symptoms and risk factors.

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  • 29. 

    Which of the following infections is attributed to the toxins produced by Corynebacterium diphtheria?

    • Laryngotracheobronchitis (Croup)

    • Epiglottitis

    • Diphtheria

    • Pertussis

    Correct Answer
    A. Diphtheria
    Explanation
    Diphtheria is caused by the toxins produced by Corynebacterium diphtheria. This bacterial infection primarily affects the throat and upper respiratory tract, leading to the formation of a thick grayish membrane in the throat, which can obstruct breathing. It can also cause other complications, such as heart and nerve damage. Laryngotracheobronchitis (Croup), Epiglottitis, and Pertussis are caused by different pathogens and have different clinical presentations.

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  • 30. 

    A qualitative fecal fat analysis was performed yielding a positive result. What specific kind of condition could cause this result?

    • Ulcerative colitis

    • Intestinal inflammation

    • Ingestion of red meat

    • Malabsorption

    • Stool pH >8.0

    Correct Answer
    A. Malabsorption
    Explanation
    Malabsorption can cause a positive result in a qualitative fecal fat analysis. Malabsorption refers to the inability of the digestive system to properly absorb nutrients, including fats, from food. This can be caused by various conditions such as celiac disease, Crohn's disease, pancreatic insufficiency, or certain infections. When there is malabsorption of fats, they are not properly digested and absorbed, leading to an increase in fecal fat levels, which can be detected in the analysis. Therefore, malabsorption is the specific condition that could cause a positive result in this case.

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  • 31. 

    Continuing this elongated reasoning, other than a blood culture, what other specimen would BEST yield a correct diagnosis in the pt above if he were infected with Strep?

    • Stool culture

    • Throat swab

    • Skin scraping

    • Wood’s lamp

    Correct Answer
    A. Throat swab
    Explanation
    A throat swab would be the best specimen to yield a correct diagnosis in the patient if he were infected with Strep. Strep infections commonly affect the throat, causing symptoms such as sore throat and difficulty swallowing. By taking a throat swab, healthcare providers can collect a sample from the back of the patient's throat and test it for the presence of Streptococcus bacteria. This can help confirm the diagnosis of a Strep infection and guide appropriate treatment. Stool culture, skin scraping, and Wood's lamp are not typically used to diagnose Strep infections.

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  • 32. 

    The RIBA assay is a _______ test for Hep C

    • Screening

    • Confirmatory

    • Negatory

    • Sensitive

    Correct Answer
    A. Confirmatory
    Explanation
    The RIBA assay is a confirmatory test for Hep C. This means that it is used to confirm the presence of Hep C antibodies in a person's blood after a positive screening test. The RIBA assay is highly specific and accurate in confirming the presence of Hep C infection, making it an important tool in the diagnosis and management of the disease.

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  • 33. 

    Which of the following microbes is the MOST prevalent in female urinary tract infections (first occurrence)?

    • Pseudomonas

    • Staphylococcus

    • E. Coli

    • Klebsiella

    • Treponema pallidum

    Correct Answer
    A. E. Coli
    Explanation
    E. Coli is the most prevalent microbe in female urinary tract infections (UTIs) because it is a common bacterium found in the gastrointestinal tract and can easily travel from the anus to the urethra. The short urethra in females makes it easier for E. Coli to reach the bladder and cause an infection. Additionally, E. Coli has adhesive properties that allow it to attach to the urinary tract walls, further contributing to its prevalence in UTIs.

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  • 34. 

    Which of the following microbes is most commonly associated with Bacterial vaginosis?

    • Gardnerella vaginalis

    • Calymmatobacterium

    • Candida albicans

    • Chlamydia trachomatis

    • Neisseria gonorrhea

    Correct Answer
    A. Gardnerella vaginalis
    Explanation
    Gardnerella vaginalis is the most commonly associated microbe with Bacterial vaginosis. Bacterial vaginosis is a condition characterized by an imbalance in the vaginal microbiota, leading to an overgrowth of certain bacteria. Gardnerella vaginalis is one of the main bacteria involved in this condition. It can cause symptoms such as vaginal discharge, odor, and itching. Treatment usually involves antibiotics to restore the balance of bacteria in the vagina.

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  • 35. 

    24 y/o sexually active female presents with intense perivaginal itching, perivaginal burning and observed “cottage cheese” texture lining vaginal wall. Which of the following BEST represents the pt’s signs/symptoms?

    • Urethritis

    • Cervicitis

    • Candidiasis

    • Bacterial Vaginosis

    Correct Answer
    A. Candidiasis
    Explanation
    The patient's symptoms of intense perivaginal itching, perivaginal burning, and the presence of a "cottage cheese" texture lining the vaginal wall are indicative of candidiasis. Candidiasis, also known as a yeast infection, is caused by an overgrowth of the fungus Candida. It commonly presents with symptoms such as itching, burning, and a thick, white, cottage cheese-like discharge. This is a common infection in sexually active females and can be treated with antifungal medications.

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  • 36. 

    Which of the following is considered a syphilis screening test?

    • Dark field microscopy

    • VDRL

    • MHA-TP

    • TP-PA

    Correct Answer
    A. VDRL
    Explanation
    VDRL (Venereal Disease Research Laboratory) is considered a syphilis screening test. It is a blood test that detects the presence of antibodies produced by the body in response to the bacteria that causes syphilis. The test is commonly used to screen for syphilis infection in individuals, and if the result is positive, further confirmatory tests are done to confirm the diagnosis. Dark field microscopy, MHA-TP, and TP-PA are not screening tests for syphilis, but rather confirmatory tests used to confirm the diagnosis in individuals with positive screening tests.

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  • 37. 

    Treponemal and Nontreponemal testing is done to Dx which of the following infections?

    • Chancroid

    • Syphilis

    • Herpes Simplex

    • Hep C

    Correct Answer
    A. Syphilis
    Explanation
    Treponemal and Nontreponemal testing is done to diagnose syphilis. Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. Treponemal testing detects antibodies specifically produced in response to the infection, while Nontreponemal testing detects antibodies that are produced in response to a variety of treponemal infections, including syphilis. Therefore, both types of testing are used together to confirm the diagnosis of syphilis. Chancroid, Herpes Simplex, and Hep C are not specifically diagnosed using Treponemal and Nontreponemal testing methods.

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  • 38. 

    Which of the following infections arises after a 7-10 day incubation of the microbe? Some symptoms often include a “whooping cough”, vomiting and exhaustion?

    • Laryngotracheobronchitis (Croup)

    • Epiglottitis

    • Diphtheria

    • Pertussis

    Correct Answer
    A. Pertussis
    Explanation
    Pertussis, also known as whooping cough, is the correct answer. Pertussis is caused by the bacterium Bordetella pertussis and has an incubation period of 7-10 days. It is characterized by severe coughing fits, often followed by a "whooping" sound when trying to breathe in. Other symptoms can include vomiting and exhaustion. Laryngotracheobronchitis (Croup) is a viral infection that affects the upper airway, while epiglottitis is a bacterial infection that causes inflammation of the epiglottis. Diphtheria is a bacterial infection that affects the throat and nose.

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  • 39. 

    If a pt presents with loose, fatty, malodourous stool, which microbe is MOST likely the causative agent?

    • Cryptosporidium parvum

    • Salmonella

    • Shigella

    • Giardia lamblia

    • Staphylococcus aureus

    Correct Answer
    A. Giardia lamblia
    Explanation
    Giardia lamblia is the most likely causative agent for a patient presenting with loose, fatty, malodorous stool. Giardia lamblia is a protozoan parasite that commonly causes gastrointestinal infection, known as giardiasis. The symptoms of giardiasis include diarrhea, abdominal pain, bloating, and foul-smelling stools, which align with the patient's presentation. Cryptosporidium parvum is another protozoan parasite that can cause similar symptoms, but giardiasis is more common. Salmonella and Shigella are bacteria that typically cause bloody diarrhea and are less likely to present with fatty stools. Staphylococcus aureus is a bacteria that can cause food poisoning but does not typically cause loose, fatty stools.

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  • 40. 

    25 y/o female presents to your clinic with 102F, bloody diarrhea, and abdominal pain in the lower right quadrant. The pt recalls that her last meal was menudo at a Mexican restaurant on the River Walk. You initially suspect appendicitis, but notice in the pt’s SurgHx she had an appendectomy at age 5. Given this information, which of the following microbes BEST meets this pt’s signs/symptoms?

    • Vibrio cholera

    • Yersinia enterocolitica

    • Staphylococcus aureus

    • Salmonella enteritidis

    • Recurrent Ghost Appendicitis Syndrome

    Correct Answer
    A. Yersinia enterocolitica
    Explanation
    The patient's symptoms of bloody diarrhea, abdominal pain in the lower right quadrant, and a recent meal of menudo at a Mexican restaurant on the River Walk suggest a possible foodborne infection. Yersinia enterocolitica is a bacterium commonly associated with food poisoning, particularly from consumption of contaminated pork products. It can cause symptoms similar to appendicitis, such as abdominal pain in the lower right quadrant. Therefore, Yersinia enterocolitica is the best microbe that meets the patient's signs and symptoms.

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  • 41. 

    19 y/o female presents to your clinic with severe diarrhea, projectile vomiting, abdominal pain and 100F. The pt lives in a barracks room with 5 other roommates. Given these signs/symptoms, which of the following microbes do you suspect?

    • Hep A

    • Norovirus

    • Rotavirus

    • Giardia

    Correct Answer
    A. Norovirus
    Explanation
    Based on the given symptoms of severe diarrhea, projectile vomiting, abdominal pain, and low-grade fever, along with the patient living in close quarters with 5 other roommates, the most likely microbe causing these symptoms is Norovirus. Norovirus is highly contagious and can spread easily in crowded places such as barracks rooms. It is known to cause gastroenteritis, which is characterized by symptoms like diarrhea and vomiting. Hepatitis A, Rotavirus, and Giardia can also cause similar symptoms, but the close living conditions and the rapid onset of symptoms point towards Norovirus as the most likely culprit.

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  • 42. 

    55 y/o male pt presents to the clinic with pain in lower abdomen, testicles, penis and blood in his semen. Which of the following is a possible DDx given these symptoms?

    • Cystitis

    • Pyelonephritis

    • Lower UTI

    • Prostatitis

    Correct Answer
    A. Prostatitis
    Explanation
    Prostatitis is a possible differential diagnosis (DDx) for a 55-year-old male patient presenting with pain in the lower abdomen, testicles, penis, and blood in his semen. Prostatitis refers to the inflammation of the prostate gland, which can cause symptoms such as pain and discomfort in the lower abdomen and genital area. It can also lead to blood in the semen. Other conditions like cystitis, pyelonephritis, and lower urinary tract infection (UTI) may cause similar symptoms, but prostatitis specifically involves inflammation of the prostate gland.

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  • 43. 

    Of the following microbes, which would yield a positive Amine “whiff” test?

    • Gardnerella vaginalis, Candida albicans, & Treponema pallidum

    • Haemophilus ducreyi, Herpes Simplex, Candida albicans

    • Trichomonas vaginalis, Gardnerella vaginalis

    • Calymmatobacterium, Treponema pallidum

    Correct Answer
    A. Trichomonas vaginalis, Gardnerella vaginalis
    Explanation
    Trichomonas vaginalis and Gardnerella vaginalis would yield a positive Amine "whiff" test. This is because these microbes are associated with bacterial vaginosis, a condition characterized by an overgrowth of certain bacteria in the vagina. One of the diagnostic criteria for bacterial vaginosis is the presence of a fishy odor, which is detected during the Amine "whiff" test. Therefore, if Trichomonas vaginalis or Gardnerella vaginalis is present, the test would be positive.

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  • 44. 

    23 y/o female presents with vaginal pruritus and soreness. Physical examination shows the presence of malodorous gray white discharge. Vaginal pH is >4.5 , amine test is positive. What is your presumptive Dx?

    • Vaginosis

    • Urethritis

    • Cervicitis

    • Treponema pallidum

    Correct Answer
    A. Vaginosis
    Explanation
    The correct answer is Vaginosis. Vaginosis is a condition characterized by vaginal inflammation and an imbalance of the normal vaginal flora. Symptoms include vaginal itching, soreness, and a malodorous gray-white discharge. The elevated vaginal pH (>4.5) and positive amine test are indicative of bacterial vaginosis. Urethritis refers to inflammation of the urethra, cervicitis refers to inflammation of the cervix, and Treponema pallidum is the bacterium that causes syphilis.

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  • 45. 

    Which of the following specimens is best suited to test for Otis Media?

    • Nasopharyngeal swab

    • Nasal Wash

    • Throat swab

    • Ear cultures are not necessary

    Correct Answer
    A. Ear cultures are not necessary
    Explanation
    Ear cultures are not necessary because Otis Media, also known as middle ear infection, is primarily diagnosed based on symptoms and physical examination findings. Ear cultures are typically not needed to confirm the diagnosis of Otis Media. Instead, a medical professional can usually identify the condition by examining the ear using an otoscope and assessing the patient's symptoms, such as ear pain, fever, and hearing loss.

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  • 46. 

    Which of the following is a recurrent destruction and widening of the large airways generally causal to recurrent inflammation?

    • Bronchitis

    • Pharyngitis

    • Empyema

    • Bronchiectasis

    Correct Answer
    A. Bronchiectasis
    Explanation
    Bronchiectasis is a condition characterized by the recurrent destruction and widening of the large airways, which leads to chronic inflammation. This inflammation can cause the airways to become permanently damaged and lose their ability to clear mucus effectively. Symptoms of bronchiectasis include coughing up large amounts of mucus, shortness of breath, and recurrent respiratory infections. Pharyngitis, on the other hand, refers to inflammation of the pharynx, while bronchitis is the inflammation of the bronchial tubes. Empyema is the accumulation of pus in the pleural cavity of the lungs.

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  • 47. 

    29 y/o pregnant female presents to your clinic with 103F, nausea, diarrhea, and other flu-like symptoms. She explains that the last thing she remembers eating was a ham sandwich with a side of hotdog flavored ice cream. Which of the following microbes BEST meets this pt’s signs/symptoms?

    • Listeria monocytogenes

    • Escherichia coli (EHEC)

    • Staphylococcus aureus

    • Clostridium perfringens

    Correct Answer
    A. Listeria monocytogenes
    Explanation
    The correct answer is Listeria monocytogenes. Listeria monocytogenes is a bacterium that can cause flu-like symptoms, such as fever, nausea, and diarrhea. It is commonly associated with foodborne illnesses, especially from contaminated deli meats and unpasteurized dairy products. In this case, the patient's symptoms and history of consuming a ham sandwich suggest a possible infection with Listeria monocytogenes.

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  • 48. 

    21 y/o AD female arrives to Sick Call with c/c of lower back pain and dysuria. You suspect some sort of upper urinary tract pathology. What test should you run to confirm your suspicions?

    • Utilizing a catheter, retrieve specimen from the pt and run a urine culture

    • Obtain a “clean catch” urine specimen from the pt and run a urine culture

    • Obtain a wet mount specimen and perform a saline wet prep microscopy

    • Utilizing a swab, obtain a specimen from the pt’s external uretheral meatus and run a urine culture

    Correct Answer
    A. Obtain a “clean catch” urine specimen from the pt and run a urine culture
    Explanation
    To confirm suspicions of upper urinary tract pathology, obtaining a "clean catch" urine specimen and running a urine culture is the appropriate test. This method ensures that the urine sample is free from contaminants and provides an accurate representation of the patient's urinary tract. A urine culture can identify any bacterial growth, indicating a urinary tract infection or other upper urinary tract pathology. This test helps in diagnosing the cause of the patient's symptoms and determining the appropriate treatment.

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  • 49. 

    Twenty-four hours after ordering x2 blood cultures on a febrile patient, the lab contacts you to let you know that 1 out of the 4 bottles flagged positive. Preliminary gram stain: GPC. What can you suspect from these results?

    • Suspected endocarditis

    • Confirmed endocarditis

    • Possible cross-contamination of samples

    • Suspected bacteremia

    Correct Answer
    A. Possible cross-contamination of samples
    Explanation
    Possible cross-contamination of samples can be suspected based on the given results. Since only 1 out of the 4 bottles flagged positive and the preliminary gram stain showed GPC (Gram-Positive Cocci), it suggests that there may have been contamination during the collection or processing of the samples. This means that the positive result may not be due to an actual infection, but rather due to external factors. Further testing and evaluation would be needed to confirm the presence of endocarditis or bacteremia.

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