What is used for Oxacillin Screens?
MH + oxacillin
MH + 4% NaCl + oxacillin
MH with Sheep blood + 4% NaCl + oxacillin
MH with sheep blood + Oxacillin
What is used in a vancomycin screen?
BHI + vanc
BHI + vanc + 4% NaCl
MH + vanc + 4% NaCl
MH + vanc
If the MIC is 0.08ug/mL for a staphylococcus aureus organism, how should we report this?
report as resistant
report as susceptible
it is not relevant
confirm susceptibility with penicillin zone edge test
Which of these are associated with infection control significant VRE organisms?
vanC gene
vanA and VanB gene
yellow pigment of colonies
motility observed on wet prep
what should you expect to see on an MRSA select II agar?
magenta colonies
no growth
blue colonies
growth if it is MRSA
growth if it is MSSA
What additional testing should you do if you see growth on MRSA select II agar?
staphaurex
tube coagulase
PBP2' agglutination
oxacillin screen
vancomycin screen
oxidase
What are the next steps for growth on a brilliance VRE?
gram stain and catalase
gram stain
gram stain and oxidase
what do you expect to see with an VRE organism?
gram positive cocci in chains and pairs
catalase negative
PYR positive
DNase positive
What are the next steps after PYR is performed on a VRE suspect?
vitek GPI
vitek AST
penicillin screen
What will grow on a BEAA plate?
staphylococcus species
enterobacteriacaea species
haemophilus species
enterococcus species
A penicillin zone edge test will give a edge.
Penicillin zone edge test is more sensitive for detection.
A negative penicillin zone edge test will have a beach edge.
when do we call ICP (infection control practitioner)?
isolated a super bug i.e. MRSA
isolated GC
isolated S.pneumoniae
Methicillin Staphylococcus aureus (MRSA) isolated. Please follow procedures. Further report to follow.
How do we differentiate between a class A ESBL and a class C ESBL?
Phenotypic confirmatory testing
PYR
Staphaurex
Bile Esculin hydrolysis
Class A ESBL organisms are inhibited by?
beta-lactamase inhibitors
clavulanic acid
penicillins
clindamycin
What classifies a class A ESBL?
potentiation when combined with clavulanic acid
susceptible to cefoxitin
resistance to cefoxitin
zone of >15mm on cefoxitin
class C ESBLs are resistant to 3rd generation cephalosporins, clavulanic acid and cephamycins such as cefoxitin.
SPICE group are intrinsically resistant to ampicillin, cephalosporins and cefoxitin.
What antibiotics are used in PCT?
cefotaxime
cefotaxime + clavulanic acid
ceftazidime
ceftazidime + clavulanic acid
cefoxitin
vancomycin + clavulanic acid
ampicillin + clavulanic acid
ampicillin
vancomycin
Escherichia coli class ESBL. Please follow procedures.
SPICE organisms are;
Serratia spp.
pseudomonas aeruginosa
indole positive proteus (morganella and providencia spp.)
citrobacter spp.
enterobacter spp.
Which antibiotics are reported as resistant with a class A ESBL?
all beta-lactam drugs
carbapenems
cephamycin
beta-lactam inhibitor combinations
Which antibiotics are not reported as resistant for a class A ESBL?
cephamycins
penicillin
oxacillin
Bacterial meningitis in neonates can be caused by
Group B streptococcus
E.coli
Listeria monocytogenes
Neisseria meningitidis
Bacterial meningitis in infants 6 months to 5 years old can be caused by?
Haemophilus influenza type b
Streptococcus pneumoniae
Bacterial meningitis in older children and adults can be caused by?
Group B Streptococcus
What is normal skin flora?
Bacillus spp
Corynebacterium spp. diphtheroids, urea negative
coagulase negative Staphylococcus species except for S. lugdunensis
Proprionibacterium spp
Alpha hemolytic streptococcus
Nonpathogenic Neisseria spp
Bacteroides spp
Enterobacteriaceae spp
For an aerotolerance test, what disks do you use for a GPC?
bile
SPS
For an aerotolerance test, what disks would you use for a GNB?
You must report AST for superficial ear and eye isolates.
When do you use a NYC plate?
When GC is requested by doctor
When GC is seen on the direct gram stain on day 1
When the patient is under 2 weeks old
When GPDC is seen on the direct gram stain on day 1
Bodily fluids such as CSF or tympanocentesis fluid will contain some normal flora.
What organism is this? oxidase+, nitrate reduced to nitrite, GNDC, strict aerobic, on BA-sm, grey, NH, dry
Moraxella catarrhalis
Neisseria meningitis
Neisseria gonorrhoeae
What organism is this? sm GNB, facultative anaerobe, oxidase-, on BA - ppt, grey, and NH, need V factor
Haemophilus parainfluenza
Haemophilus influenzae
What organism is this? sm GNB, facultative anaerobe, oxidase+, on BA - ppt, grey, and NH, need X and V factor
Haemophilus parainfluenzae
What organism is this? strict anaerobe, large GPB, double zone hemolysis, reverse camp+, catalase-
Clostridium perfringens
Clostridium spp
what organism is this? large GPB, large tan colonies, BH, motile at RT and 35 degrees
corynebacterium spp
What organism is this? sm GNB, on BA-med grey NH, catalase+, strict anaerobe
Bacteriodes spp
Enterobacteriacaea spp
What organism is this? facultative, sm GPB, urea negative, on BA-sm white NH
Corynebacterium diphtheroid
Corynebacterium ulcerans
What causes the Hand, Foot and Mouth Disease?
Enterovirus
Hentavirus
Parvovirus
Rubivirus
What is the role of micro RNA?
keeps latent virus-infected cells alive
it is a part of prions
RNA codes for micro proteins
A 55-year old make just returned from a trip from Saudi Arabia. He was rushed to the ER with symptoms of acute respiratory illness. His condition rapidly progressed to pneumonitis and multi-organ failure. This patient has:
Tularemia
Cat Scratch disease
Rat bite fever
MERS
Rocky Mountain spotted fever
What animals have been found to be carriers of MERS?
Bat
Rabbit
Camel
All of the above
Camel and Bats
Which of these viruses causes MERS?
Hantavirus
Coronavirus
Lentivirus
What is the gold standard for laboratory diagnosis of Rocky Mountain Spotted Fever?
Culture
Clinical presentation
Immunofluorescence
PCR
A 22-year old female was hiking in the Rocky Mountains. A few days later she had a headache, fever and flat pink macules on her trunk and ankles. The lab found Rickettsii rickettsia. What is the vector of this infection?
Mosquito
Tick
Black fly
Rat
What is the Gram stain and motility of the Rickettsii rickettsia infection?
GPB, motile
GPB, non-motile
GNB, motile
GNB, non-motile
What is the atmospheric preference of Brucella?
facultative anaerobe
strict anaerobe
strict aerobe
capnophile
strict aerobe and capnophile
Which of the following is NOT ta type of Brucella species?
Brucella suis
Brucella canis
Brucella abortus
Brucella melitensis
Brucella tigris
What clinical manifestation of Brucellosis?
arthritis
valve endocarditis
malta fever
Bieber fever
arthritis and malta fever
What is the gold standard diagnostic test for leptospirosis?
microscopic agglutination test (MAT)
MALDI
Latex agglutination
What does leptospirosis look like under dark-field microscopy?
tumbling motility
long bacilli
question mark/interrogation points
branching bacilli
A patient presents with meningoencephalitis with multi system involvement (jaundice, kidney failure). Chemistry results reveal elevated kidney and liver enzymes. Culturing the organism proved to be difficult. What bacterial disease is suspected?
Brucellosis
Leptospirosis
Plague
Which organism causes the plague?
Francisella tularensis
Leptospira interrogans
Yersinia pestis
Bartonella henselae
What is the main reservoir for the organism responsible for the plague?
birds
deer ticks
fleas of rats
cats
Which of the following correctly describes the Gram stain of the organism responsible for the plague?
GNB with 'safety pin' appearance
GPC pairs
Filamentous GPB
large GPB with subterminal spores
What organism causes Rat Bite Fever?
Pseudomonas aeruginosa
Capnocytophaga canimorsus
Streptobacillus moniliformis
Pasteurella multocida
What is the virulence factor of Streptobacillus moniliformis?
inhibits phagocytosis
convert to D form allowing it to survive in the host
convert to L form allowing it to survive in the host
secretes pyogenic toxin
none of the above
Which of the following is a characteristic feature of Streptocbacillus moniformis?
molar tooth
fried egg
dry, hockey puck
medusa head
no distinct characteristic
Laboratory diagnosis of hantavirus includes the following techniques except?
IgM antibody detection
Viral culture
Rising IgG antibody titre
Immunohistochemistry
Which zoonotic microorganism is associated with potentially fatal pulmonary symptoms which have been described as a sensation of ‘tight band around chest’ or ‘pillow over the face’?
Zika virus
What is the primary strategy for preventing hantavirus infection?
Usage of insect repellent
Avoidance of contact with feral cats
Improved water quality and sanitation
Avoidance of pigeon droppings
Rodent control in and around the home
Which of the following causes microcephaly in infants?
Zika Virus
Cytomegalovirus
Rubella
None of the above
Which of the following is not a mode of transmission for Zika virus?
Mosquito bite
Airborne
Sexual contact
Infected mother to child
Blood transfusion
What condition can be associated with Zika virus?
Malaria
West Nile Fever
Yellow Fever
Guillain-Barre Syndrome
Chikungunya
Bartonella henselae is the specific cause of:
Beaver fever
Cat Scratch Disease
Rocky Mountain Spotted Fever
Zika
A patient presents lack of appetite, wounds with lesions and has a history of working at an animal shelter. Biopsy of the lesion shows GNB but no growth or cultures was seen after 24 hours. What is the best reason for this?
Organism is an anaerobe
Organism is a slow grower
Organism requires special media
Organism is a capnophile
What is not a symptom of Cat Scratch Disease?
Papule or Pustule at bite on scratch site
Lymphadenpathy
Anorexia for 1-3 weeks
Tissue necrosis at wound area
Which form of oropharyngeal tularemia causes photophobia?
Pneumonic form
Oculoglandular form
Systemic typhoidal form
Exudative form
A patient at a clinic showed fevers, chills and headache. A swab of the lesions was sent for culture and sensitivity. After questioning, it was determined the patient was an avid rabbit hunter. The Gram showed GNB organism intracellularly in reticuloendothelial cells. It grew only aerobically and grew on special media containing iron and cysteine. What probable disease could have caused the infection?
Rocky Mountain Spotted fever
What organism causes Tularemia?
Neisseria species
Legionella
Francisella
Salmonella
Scabies
itching
rash
Sarcoptes scabiei
Cutaneous Leishmaniasis
self limiting
sandfly
Herpes
latent, lifelong infection
neuronal ganglia
Type 1 - cold sores
Type 2 - sexually transmitted infections
Varicella zoster
chicken pox
shingles
highly contagious, rash, red spots
Fifth Disease
Parvovirus B19
slapped cheek
Actinomyces
sulphur granules
anaerobe
acid fast negative
chronic, granulomatous infectious disease
Nocardia
ubiquitous in nature
aerobic
GPB, branching
modified acid fast positive
BA- white, chalky, dry, smooth
Madura Foot
Nocardia and S.aureus
Madurella mycetomi, Actinomadura, others
outdoor labourers
no person to person transmission
All of them
Tinea versicolor
Malassezia furfur
superficial skin infection
lipid loving fungus
spaghetti and meatballs under the microscope
Bacillus anthracis
dormant spore form can survive for long periods of time and in harsh conditions
highly lethal
transmitted by inhalation, ingesting and contact with skin lesions
glutamic acid capsule - evades phagocytosis
lethal factor + edema factor + protective factor = becomes active
eschar - black ulcerative skin lesion
GPB with subterminal spores, aerobic, non-motile, NH, Cat+
Mycobacteria
thin bacilli, non-motile, aerobe
N-glucolymuramic acid and mycolic acids in cell wall
acid fast positive
Mycobacterium leprae
mainly affects skin and nerves
claw hand and drop foot
Tuberculoid and Lepromatous form
not highly contagious
all of the above
what is rhabdomyolysis?
breakdown of skeletal muscle
overproduction of collagen
inflammation or swelling of muscles
how are diabetic patients affected in muscle disorders?
vascular insufficiency
poor blood supply
antibiotic ineffectiveness
insulin deficiency
increased in glucose makes them more prone
Osteomyelitis:
pyogenic organisms
occurs rapidly in children
occurs rapidly in adults
S.aureus is the most common cause
in children under 2, spreads into the diaphysis
Capnocytophaga canimorsus:
GNB
zoonotic
treat with cephalosporins
common in asplenic patients
all except for 'treat with cephalosporin'
Pasteurella multocida:
dog bites
can cause osteomyelitis or endocarditis
GPB
spot indole +
septic arthritis:
inflammation of synovial membrane
damage to cartilage
examining the joint fluid is diagnostic
this is not real
mild and preventable
what can cause septic arthritis?
S.aureus
Peptostreptococcus
Brucella
Reactive arthritis:
non-infectious inflammatory joint disease
GAS
GBS
what do we make note of when inspecting synovial fluid?
volume
color
odor
turbidity
protein content
glucose content
WBC
Osteoarthritis:
the most common form of arthritis
thinning of cartilage
synovial hypertrophy
in both male and females
all of the options
Artificial arthritis:
biofilm formation
difficult to treat
normal skin flora is agent
cannot treat, will result in amputation
what can cause bacterial conjunctivitis?
Neisseria spp
S. pneumoniae
S. aureus
Candida spp
anaerobes
cause of viral conjunctivitis?
herpes simplex type 1 and 2
adenovirus
HIV
hentavirus