Turgeon: Clinical Laboratory Science, 9th Edition
Chapter 16: Introduction to Medical Microbiology
Student Review Questions
MULTIPLE CHOICE
1. A sputum specimen is received in the laboratory for orders to culture and stain for the bacteria
that causes tuberculosis. Which stain would be used?
a. Gram stain
b. Acid-fast stain
c. Supravital stain
d. Wright stain
ANS: B
The Gram stain separates bacteria into two groups based on their cell wall structure and staining
characteristics as either gram positive (purple) or gram negative (pink). In addition to these two
staining characteristics observation of morphologic features, cell shape and cellular arrangement
is noted. The acid-fast stain is used mainly to detect organisms that cause tuberculosis.
2. A patient is seen by their physician for a wound that has not been healing properly for the past
week. The patient states that they are in the garden quite frequently and when pruning their rose
bushes, the thorns sliced their finger. The physician examines the wound and wants to rule out
the possibility of a fungal infection. What protocol should the laboratory follow to culture the
specimen to assure if fungal elements are present, and that they will grow?
a. The media used to culture the wound specimen should contain antibiotics to inhibit normal
flora organisms.
b. The laboratory needs to put the specimen in the freezer until the supervisor arrives.
c. The laboratory needs to culture the specimen to regular media used for wound cultures.
d. The laboratory needs to place the swab in the incubator and then culture in the morning when
more staff are available.
ANS: A
Many specimens collected for fungal identification will be contaminated with bacteria or rapidly
growing fungi. Therefore the media used should contain antibiotics to inhibit these organisms
and allow the pathogens to grow. The selection of the required specimen, along with collection
techniques is directly related to the diagnosis of fungal infections. It is extremely important that
specimens be appropriately collected from the proper site so that the fungi are recovered. It is
Copyright © 2023, Elsevier Inc. All Rights Reserved.
Student Review Questions 15-2
also important that a specimen for fungal studies be transported to the laboratory as quickly as
possible. Because many pathogenic fungi grow slowly, any delay in transporting or processing a
specimen can compromise the quality of the specimen and the eventual prospects of isolating the
causative organism.
3. A technologist removes a culture plate from the incubator and notices that the colonies of the
bacteria seem to have swarmed all over the plate indicating motility. Which bacteria may be
presumptively identified by this feature?
a. Escherichia coli
b. Staphylococcus aureus
c. Proteus vulgaris
d. Streptococcus pyogenes
ANS: C
Visible colonial characteristics that may be used for identification of the bacteria that include the
type of bacteria may spread or swarm across the media, for example, Proteus vulgaris, which
indicates that they are motile.
4. A culture plate contains a colony of bacteria that the technologist has identified as either
Staphylococcus sp. or Streptococcus sp. Which is a quick enzyme test that will differentiate the
two organisms?
a. Bile esculin agar
b. Bile solubility test
c. Catalase test
d. Coagulase test
ANS: C
The catalase test is a reaction that measures the presence of the enzyme catalase that converts
hydrogen peroxide into oxygen and water. This test is often used to differentiate staphylococci
from streptococci. All staphylococci are catalase positive and will produce oxygen gas. The
genus Streptococcus does not produce catalase and consequently is catalase negative, producing
no visible bubbling or lack of oxygen gas.
5. A group of college students is seen in the nurse’s office for what appears to be a wound
infection. The group of students state that over the weekend they stayed with friends that had a
hot tub that may have not been cleaned recently before they got in. What may be the most likely
bacteria identified in their wound cultures?
a. Pseudomonas aeruginosa
Copyright © 2023, Elsevier Inc. All Rights Reserved.
Student Review Questions 15-3
b. Klebsiella pneumoniae
c. Streptococcus pneumonia
d. Enterococcus sp.
ANS: A
Pseudomonas aeruginosa is often identified associated with infections from exposure in a hot
tub, whirl pool, or swimming pool.
6. A technologist needs to perform antibiotic susceptibility testing on a urine culture containing
E. coli. Which media needs to be used for antibiotic testing using the disk diffusion procedure?
a. Blood agar
b. Mueller-Hinton agar
c. Trypticase soy agar
d. MacConkey agar
ANS: B
For antimicrobial susceptibility testing, Mueller-Hinton agar plates are used. The plates should
be stored in the refrigerator until used and should be checked periodically.
7. A 5-year-old male is seen in the emergency room for abdominal pain and diarrhea over the
past week. He has recently immigrated with his family from Africa and the physician wants to
rule out a parasitic infection. Which specimen would need to be collected?
a. Wound
b. Stool
c. Synovial fluid
d. Cerebral spinal fluid
ANS: B
Identification of intestinal parasites, particularly protozoa, requires that specific collection
protocol be followed in order to properly identify the organism. A single stool specimen may not
be sufficient to isolate an intestinal parasite, for example, because many intestinal parasitic
organisms shed eggs or cysts intermittently. The recommended protocol is to collect three stool
samples 1 or 2 days apart, but all within a 10-day period, to provide optimal detection of
intestinal parasites. The patient has come from a poorly developed country with poor sanitation
and has had diarrhea. A stool specimen would rule out a parasitic infection causing his
symptoms.
8. A technologist pulls a respiratory culture from the incubator. When looking at the plates, there
Copyright © 2023, Elsevier Inc. All Rights Reserved.
Student Review Questions 15-4
is no growth on the blood agar plate but small tan colonies on the chocolate agar plate. The
colonies are suspicious for which type of bacteria?
a. Streptococcus pneumoniae
b. Streptococcus pyogenes
c. Haemophilus sp.
d. Staphylococcus aureus
ANS: C
Chocolate agar is an enrichment medium that promotes the growth of fastidious bacteria.
Chocolate agar is prepared by adding blood to a nutrient base medium, then gently heating the
preparation. The heat lyses the red blood cells, causing the medium to turn brown, thus the name
“chocolate.” This gives a richer medium than ordinary blood agar, releasing hemin (X factor) and
nicotinamide adenine dinucleotide (NAD, or V factor) from the red blood cells to enhance
growth. The X and V growth factors are required for the growth of some fastidious organisms,
such as Haemophilus spp.
9. A technologist is working on a stool culture and observes green colonies with a black center on
the Hektoen enteric agar plate. This would indicate which type of pathogen found in the stool?
a. Shigella sp.
b. Salmonella sp.
c. E. coli
d. Campylobacter sp.
ANS: B
Hektoen enteric (HE) agar is a selective and differential media for the isolation of enteric
pathogens such as Salmonella and Shigella spp. Colonies of Salmonella, an H2S producer, will
appear green or transparent with black centers, and Shigella, a non-H2S producer, will appear
green or transparent.
10. A technologist is working on a blood culture that is suspected of containing Candida
albicans. Which would be a rapid test to identify this yeast?
a. India ink
b. Gram stain
c. KOH preparation
d. Germ tube
ANS: D
Copyright © 2023, Elsevier Inc. All Rights Reserved.
Student Review Questions 15-5
The germ-tube test is a simple rapid test utilized to identify Candida albicans. This test is based
on the ability of C. albicans to produce germ tubes from their yeast cells when placed in 0.5 mL
of sheep or rabbit serum and incubated at 35°C for no longer than 3 hours.
Copyright © 2023, Elsevier Inc. All Rights Reserved.