1. Cornmeal agar with Tween 80 is used to identify which characteristic of an unknown yeast isolate?

A. Hyphae (true and pseudo)

B. Blastoconidia and arthroconidia

C. Chlamydospores

D. All of these options

2. The mycelial form of which dimorphic mold produces thick-walled, rectangular, or barrel-shaped
alternate arthroconidia?

A. Coccidioides immitis

B. Sporothrix schenckii

C. Histoplasma capsulatum

D. Blastomyces dermatitidis

3. Dimorphic molds are found in infected tissue in which form?

A. Mold phase

B. Yeast phase

C. Encapsulated

D. Latent

4. A blood agar plate inoculated with sputum from a patient with diabetes mellitus grew very few
bacterial flora and a predominance of yeast. Given the following results, what is the most likely
identification of the yeast isolate?

CORNMEAL TWEEN 80 AGAR

Germ tube = Neg Pseudohyphae = +

Arthroconidia = Neg Blastoconidia = + (arranged along pseudohyphae)

Chlamydospores = Neg

A. Candida tropicalis

B. Candida kefyr (pseudotropicalis)

C. Trichosporon cutaneum

D. Geotrichum candidum

5. Which group of molds can be ruled out when septate hyphae are observed in a culture?

A. Dematiaceous

B. Zygomycetes

C. Dermatophytes

D. Dimorphic molds

6. Which of the following structures is invaded by the genus Trichophyton?

A. Hair

B. Nails

C. Skin

D. All of these options

7. An organism cultured from the skin produces colonies displaying a cherry-red color on Sabouraud
dextrose agar after 3-4 weeks and teardrop-shaped microconidia along the sides of the hyphae. The
most likely identification is:

A. Trichophyton rubrum

B. Trichophyton tonsurans

C. Trichophyton schoenleinii

D. Trichophyton violaceum

8. A bone marrow sample obtained from an immunocompromised patient revealed small intracellular
cells using a Wright's stain preparation. Growth on Sabouraud-dextrose agar plates of a mold phase at
25°C and a yeast phase at 37°C designates the organism as dimorphic. The mold phase produced thick,
spherical tuberculated macroconidia. What is the most likely identification?

A. Histoplasma capsulatum

B. Sepedonium spp.

C. Sporothrix schenckii

D. Coccidioides immitis

9. A lung biopsy obtained from an immunocompromised patient showed many "cup-shaped" cysts
(gray to black) in a foamy exudate (green background) using Gomori methenamine silver (GMS) stain.
The organism cannot be cultured because it does not grow on routine culture media for molds. The
patient was diagnosed with pneumonia that resisted antibiotic treatment. The most likely
identifification is?

A. Pneumocystis jirovecci (carinii)

B. Histoplasma capsulatum

C. Sporothrix schenckii

D. Scopulariopsis spp.

10. Upon direct examination of a sputum specimen, several spherules were noted that contained
endospores. Growth on Sabouraud-dextrose agar showed aerial mycelial elements. The septate
hyphae produced barrel-shaped arthroconidia. What is the most likely identification?

A. Penicillium marneffffei

B. Scopulariopsis spp.

C. Cryptococcus neoformans

D. Coccidioides immitis

11. Tinea versicolor is a skin infection caused by:

A. Malassezia furfur

B. Trichophyton rubrum

C. Trichophyton schoenleinii

D. Microsporum gypseum

12. Which Microsporum species causes an epidemic form of tinea capitis in children?

A. Microsporum canis

B. Microsporum audouinii

C. Microsporum gypseum

D. All of these options

13 colony but soon developed a black "pepper' effect on the agar surface. The older colony produced a
black matte, making it resemble a dematiaceous mold. What is the most likely identification?

A. Penicillium notatum

B. Aspergillus niger

C. Paecilomyces spp.

D. Scopulariopsis spp.

14. A mold that produces colonies with a dark brown, green-black, or black appearance of both the
surface and reverse side is classified as a:

A. Dematiaceous mold

B. Dermatophyte

C. Hyaline mold

D. Dimorphic fungus

15. The Hair Baiting Test is used to differentiate which two species of Trichophyton that produce red
colonies on Sabouraud agar plates?

A. T. mentagrophytes and T. rubrum

B. T. tonsurans and T. schoenleinii

C. T. tonsurans and T. violaceum

D. T. verrucosum and T. rubrum

16. Microscopic examination of a fungus cultured from a patient with athlete's foot showed large,
smooth-walled, club-shaped macroconidia appearing singly or in clusters of two to three from the tips
of short conidiophores. The colonies did not produce microconidia. What is the most likely
identification?

A. Trichophyton spp.

B. Alternaria spp.

C. Epidermophyton spp.

D. Microsporum spp.

17. Which dematiaceous mold forms flask-shaped phialides, each with a flask-shaped collarette?

A. Phialophora spp.

B. Exophiala spp.

C. Wangiella spp.

D. All of these options

18. hyaline mold recovered from a patient with AIDS produced rose-colored colonies with lavender
centers on Sabouraud dextrose agar. Microscopic examination showed multiseptate macroconidia
appearing as sickles or canoes. What is the most likely identification?

A. Fusarium spp.

B. Wangiella spp.

C. Exophiala spp.

D. Phialophora spp
19. Material from a fungus-ball infection produced colonies with a green surface on Sabouraud agar in
5 days at 30°C. Microscopic examination showed club-shaped vesicles with sporulation only from the
top half of the vesicle. This hyaline mold is most probably which Aspergillus spp.?

A. A. niger

B. A. fumigatus

C. A. fiflavus

D. A. terreus

20. An India ink test was performed on CS from an HIV-infected male patient. Many encapsulated
yeast cells were seen in the centrifuged sample. Further testing revealed a positive urease test and
growth of brown colonies on niger-seed agar. The diagnosis of meningitis was caused by which yeast?

A. Candida albicans

B. Cryptococcus neoformans

C. Cryptococcus laurentii

D. Candida tropicalis

21. A bone marrow sample obtained from an immunocompromised patient revealed small
intracellular cells using a Wright's stain preparation. Growth on Sabouraud-dextrose agar plates of a
mold phase at 25°C and a yeast phase at 37°C designates the organism as dimorphic. The mold phase
produced thick, spherical tuberculated macroconidia. What is the most likely identification?

A. Histoplasma capsulatum

B. Sepedonium spp.

C. Sporothrix schenckii

D. Coccidioides immitis

22. A lung biopsy obtained from an immunocompromised patient showed many "cup-shaped" cysts
(gray to black) in a foamy exudate (green background) using Gomori methenamine silver (GMS) stain.

The organism cannot be cultured because it does not grow on routine culture media for molds. The
patient was diagnosed with pneumonia that resisted antibiotic treatment. The most likely
identification is?

A. Pneumocystis jirovecci (carinii)

B. Histoplasma capsulatum

C. Sporothrix schenckii

23. Upon direct examination of a sputum specimen, several spherules were noted that contained
endospores. Growth on Sabouraud-dextrose agar showed aerial mycelial elements. The septate
hyphae produced barrel-shaped arthroconidia. What is the most likely identification?

A. Penicillium marneffffei

B. Scopulariopsis spp.

C. Cryptococcus neoformans

D. Coccidioides immitis

24. A bone marrow specimen was obtained from an immunocompromised patient who tested positive
for HIV. The organism grew rapidly at 3 days showing a mold form (at 25°C), displaying conidiophores
with four to fifive terminal metulae with each having four to six phialides. The conidia at the end of
the phialides were oval and in short chains. They appear as a fan or broom when viewing under
10REland
40 At 37°C, the yeast form grew more slowly, showing conidia that formed hyphal elements breaking
at the septa to produce oval arthroconidia. This thermodimorphic mold is most likely:

A. Paecilomyces spp.

B. Penicillium marneffffei

C. Rhizomucor spp.

D. Aspergillus fumigatus

25. SITUATION: After a vacation to the Southwestern United States, a midwesterner complained of
flulike symptoms with fever, chills, nonproductive cough, and chest pain. Microscopic exam of sputum,
cleared with KOH, revealed large, thick-walled spherules containing endospores. Upon culture, the
mold phase showed septate hyphae and alternating barrel-shaped arthroconidia. Which organism is
most likely the cause of this pneumonia?

A. Coccidioides immitis

B. Histoplasma capsulatum

C. Paracoccidioides brasiliensis

D. Penicillium marneffffei

26. A thermally dimorphic fungus shows a filamentous mold form with tuberculate macroconidia at
room temperature, and a yeast form above 35°C. Which organism best fits this description?

A. Histoplasma capsulatum

B. Paracoccidioides brasiliensis

C. Candida albicans

D. Coccidioides immitis

27. Blastoconidia are the beginning of which structures?

A. Arthroconidia

B. Germ tubes

C. Pseudohyphae

D. True hyphae

28. Which of the following yeasts is characteristically positive for germ tube production?

A. Candida tropicalis

B. Candida kefyr (pseudotropicalis)

C. Cryptococcus neoformans

D. Candida albicans

29. Arthroconidia production is used to differentiate which two yeast isolates?

A. Candida albicans and Candida dubliniensis

B. Trichosporon cutaneum and Cryptococcus neoformans

C. Candida albicans and Candida tropicalis

D. Saccharomyces cerevisiae and Candida glabrata

30. The urease test, niger seed agar test, and the germ tube test are all used for the presumptive
identification of:

A. Rhodotorula rubra
B. Cryptococcus neoformans

C. Trichosporon cutaneum

D. Candida albicans

31. All of the following are medically dimorphic fungi except:

a. Histoplasma capsulatum

b. Blastomyces dermatitidis

c. Coccidioides immitis

d. Aspergillus niger

32. Cutaneous mycoses are fungal infections that involve:

a. Hair

b. Skin

c. Nails

d. All of the above

33. Which fungus is most often acquired by traumatic implantation into the skin?

a. Histoplasma capsulatum

b. Sporothrix schenckii

c. Coccidioides immitis

d. Penicillium marneffei

34. What are the optimal temperature and incubation time before a fungal blood culture is reported
as negative?

a. 37°C; 21 days

b. 37°C; 7 days

c. 30°C; 21 days

4. 30°C; 7 days

35. What is a disadvantage of using the tease mount?

a. The preparation cannot be preserved.

b. Lactophenol cotton blue stains uniformly.

c. Conidia may be disrupted in the preparation.

d. Contamination is possible.

36. Which of the following organisms is/are partially or completely inhibited by media containing
cycloheximide?

a. Cryptococcus spp.

b. Candida krusei

c. Aspergillus niger

d. All of the above

37. Which stain uses a bleaching agent for fungal detection?

a. Gram stain
o. Lactophenol cotton blue

c. Calcofluor white

a. India ink

38. Which criterion applies to the identification of Histoplasma capsulatum?

a. Red pigment on cornmeal agar

b. Produces yeast form at 25°C and mold form at 36°C

c. Slow-growing fungus (1 to 4 weeks)

d. All of the above

39. Which test can be used to differentiate T. mentagrophytes from T. rubrum?

a. Fluorescence using a Wood's lamp

b. In vitro hair perforation

c. Red color on reverse side of colony

d. Pyriform microconidia

40. Tinea capitis is caused by which dermatophyte?

a. T. tonsurans

b. M. audouinii

6. M. canis

d. All of the above

41. Microsporum infection involves:

la. Hair, skin, and nails

b. Hair and skin

e. Skin and nails

d. None of the above

42. A Wood's lamp is used to detect fluorescing hairs in which dermatophyte?

a. M. audouinii

b. M. canis

c. M. gypseum

d. a and b

43. Sickle- or boat-shaped macróconidia on cornmeal agar are characteristic of:

a. Alternaria spp.

b. Aspergillus spp.

c. Penicillium spp.

d. Fusarium spp.

44. Which of the following produces rhizoids?

a. Mucor spp. ab. Rhizopus spp.

c. Trichophyton spp.

d. Microsporum spp.
45. Which dimorphic fungus is found in the Missouri River valley?

a. Blastomyces dermatitidis

b. Histoplasma capsulatum

c. coccidioides immitis

d. paracoccidioides brasiliensis

46. which demorphhic fungus may be contracted by people who clean chicken cops?

a. Blastomyces dermatitidis

6. Histoplasma capsulatum

c. Coccidioides immitis

d. Paracoccidioides brasiliensis

47. In the virus laboratory, most manipulation of viruses occurs at what safety level?

a. Biosafety Level 1

b. Biosafety Level 2

c. Biosafety Level 3

d. No biosafety is needed; manipulations are done on the bench.

48. What pH indicator is added to the cell culture growth medium to monitor pH changes?

a. Eagle's minimum essential medium

b. Fetal bovine serum

c. Earle's balanced salt solution

d. Phenol red

49. Unlike with other herpes viruses, asymptomatic shedding does not occur with this virus, therefore
detection is always significant:

a. Herpes simplex virus type 1

b. Herpes simplex virus type 2

c. Varicella-zoster virus

d. Cytomegalovirus

50. An example of a virus that exhibits latency is:

a. Adenovirus

b. Respiratory syncytial virus

c. Cytomegalovirus

d. Herpes simplex virus

51. Respiratory specimens are best collected with what type of swabs?

a. Calcium alginate swabs

b. Dacron- or polyester-tipped swabs

c. Swabs with cotton tips or wooden shafts

d. All of the above are acceptable

52. The best laboratory test for detecting astrovirus is:

a. EIA

b. IFA

c. RT-PCR

d. EM

53. R-mix shell vials are best used to detect what virus?

a. Enterovirus

b. Norovirus

c. Respiratory viruses (e.g., influenza, RSV)

d. Rhinovirus

54. The macromolecular synthesis in the virus infectious cycle:

a. is the process by which structural proteins, genomes, and sometimes enzymes are assembled into
virions

b. includes the production of nucleic acid and protein polymers

c. releases the viral genome before the viral nucleic acid is delivered to its intracellular site of replication

d. all of the above

55. CMV is best detected in which type of specimen?

a. Blood or urine

b. Nasal swab

c. Throat or nasopharyngeal swab

d. Vesicle fluid or scraping

56. Sin nombre virus is best detected in which type of specimen?

a. Nasal swab

b. Stool

c. Serum for antibody testing

d. Brain biopsy

57. Rhinovirus is best detected in which type of specimen?

a. Throat or nasopharyngeal swab

b. Nasal swab

c. Bronchial lavage

d. CSF

58. Which instrument is used to detect CPE in cell culture?

a. Fluorescent microscope

b. Electron microscope

c. Biologic safety cabinet

d. Inverted light microscope

59. An example of the cells used for primary cell culture type is:

a. Rhesus monkey kidney cells

b. Lung fibroblast cells

c. HeLa cells

d. Human epidermoid carcinoma cell

60. Which family of viruses produces one of the most lethal hemorrhagic fevers?

a. Bunyaviridae

b. Filoviridae

c. Flaviviridae

d. Arenaviridae

61. Apulmonary syndrome, refered to as hanta pulmonary syndrome, that often results in death s

carried in the excreta of:

a. Bats

b. Cats

c. Mice

d. Birds

62. The type of influenza A virus most often associated with greatest human morbidity and mortality
is:

a. Influenza A 2009 pam H1N1

b. Influenza A seasonal H1N1

c. Influenza A seasonal H3N2

d. Influenza A H1N2

63. The three respiratory agents most often responsible for causing croup in pediatric patients are:

a. Parainfluenza, RSV, and rhinovirus

b. Influenza A, RSV, and parainfluenza 3

c. Coronavirus, RSV, and rhinovirus

d. Parainfluenza, RSV, and metapneumovirus

64. The filovirus that has a characteristic "shepherd's hook" morphology when viewed by electron
microscopy is:

a. Ebola Zaire virus

b. Ebola Reston virus

c. Ebola Sudan virus

d. Marburg virus

65. Which of the following factors does not contribute to the rapid spread and transmission of
noroviruses?

a. Transmission by the fecal-oral route

b. Nucleic acid segmented genome

c. Low infectious dose required for infection

d. High environmental stability of the virus

66. Congenital infections passed from mother to infant often are a cause of severe disease. Which viral
agents are responsible for causing congenital infections? (Select all that apply.)

a. Rubella virus and CMV

b. Enterovirus and herpes virus

c. Coronavirus and CMV

d. Epstein-Barr virus and CMV

67. Rotaviruses are most readily detected using which type of laboratory testing?

a. Cell culture with IFA confirmation

b. Cell culture using hemadsorption

c. Nucleic acid testing by PCR or RT-PCR

d. Serology testing for antigen détection

68. Brown patches on the palm of the hand or the sole of the foot are caused by:

a. Cladosporium spp.

b. Exophiala spp.

c. Hortae werneckii

d. Acremonium spp.

69. Adding specimen scrapings to 10% KOH to show the presence of sclerotic bodies that resemble
copper pennies is useful in the diagnosis of:

a. Chromoblastomycosis

b. Phaeohyphomycosis

c. Mycetomas

d. Zygomycosis

70. Which of the following is the causative agent of black grain mycetoma?

a. Exophiala jeanselmei

b. Curvularia spp.

c. Madurella mycetomatis

d. All of the above

71. Which of the following is a fungus known to cause chromoblastomycosis?

a. Curvularia spp.

b. Acremonium spp.

c. Bipolaris spp.

d. Cladosporium spp.

72. Which laboratory test may be used to differentiate Exophiala jeanselmei from Exophiala
dermatitidis?

a. Urea

b. Growth at 42°C

c. Esculin

d. Germ tube
73. A 65-year-old male with HIV presents to the emergency department with night sweats, a
nonproductive cough, and a low-grade fever. PCP is suspected. Which of the following is the best
specimen for diagnostic staining for Pneumocystis jiroveci?

a. Urine

b. Sputum

c. Bronchial alveolar lavage fluid

d. Blood

e. Nasopharyngeal swab

74. Which of the following is not a virulence factor of Candida spp.?

a. Phospholipases

b. Chlamydospore production

C. Aspartyl proteases

d. Hydrophobicity

e. Hyphae formation

75. Which method has improved the isolation of Candida spp. from positive blood cultures?

a. API 20 C AUX

b. Vitek

C. CHROMagar

d. PNA FISH kit

e. Germ tube test

76. The specimen needed to isolate Trichosporon spp. is:

a. Urine

b. Tissue biopsy

c. Hair clippings

d. Skin scrapings

e. CSF

77. A bulldozer operator became ill while working on a hew highway in the San Joaquin Valley. He
developed chest pain, anorexia, headache and general malaise and myalgia with fever. Chest x-ray
showed pneumonic infiltrate and a single, well-defined nodule in the left lower lobe. His leukocyte
count and sedimentation rate were slightly elevated. Although no fungus was seen in direct
examination of a sputum specimen, processing included a culture on Sabouraud's dextrose agar with
chloramphenicol and cycloheximide. Within 3 days at 28°C, this culture produce moist, grayish growth,
and a white aerial mycelium began to develop. If this fungus was the cause of infection, it was most
probably be:

a. A. fumigatus

b. B. dermatitidis

C. neoformans

d. H. capsulatum

78. A subcutaneous fungal infection characterized by the development of necrotic ulcers may follow
direct inoculation of fungal spores into the skin. The causative fungus may be cultured as a small yeast
form at 36°C and as a mold at room temperature with delicate hyphae and conidia. This disease is
a. Blastomycosis

b. Chromomycosis:

c. Mycetoma

d. Sporotrichosis

e. Tinea

79. A yeast-like fungus was isolated from sputum. No hyphae were produced in morphology agar. It
was negative for nitrate assimilation and positive for inositol assimilation and produced urease at
37°C. these findings are typical of

a. C. krusei

b. C. terreus

c. C. neoformans

d. T. beigelli

e. G. candidum

80. This is due to cutaneous inoculation of fungus from penetrating injury with a spore.

a. Blastomycosis

b. Sporotrichosis

c. Coccidioidomycosis

d. Histoplasmosis

e. Paracoccidioidomycosis

81. Large, one-celled, smooth to tuberculate macroconidia and smooth or echinulate microconidia are
typical of mycelial phase growth of

a. B. dermatitidis

b. C. immitis

c. H. capsulatum

d. P. brasiliensis

e. S. schenckii

82. Which of the following types of C. albicans infection is commonly acquired from an exogenous
source?

a. Diaper rash

b. Neonatal thrush

c. Perianal infection

d. Urinary tract infection

e. Vulvovaginitis

83. The most useful finding for prompt, presumptive identification of C. albicans is its

a. Failure to assimilate sucrose

b. "feathering" in EMB

c. Production of chlamydoconidia

d. Production of germ tubes

e. Production of pseudohyphae

84. Culture of C. immitis can be seen as

a. Fluffy white to brownish white colored mold

b. Brown to black with a greasy-looking appearance

C. Colony starts waxy and become wooly after 7-10 days

d. White cottony mycelial growth

e. White to slightly tan, smooth colony

85. Name the dimorphic fungus that typically has a tissue phase in which the large mother cells have
one to a dozen narrow-necked buds and a slow-growing mycelial form with intercalary
chlamydoconidia and coiled hyphae

a. B. dermatitidis

b. C. immitis

c. H. capsulatum

d. P. brasiliensis

e. S. schenckii

86. An immunodiffusion test has been useful for diagnosis and prognostic evaluation of one important
mycosis. Two precipitin lines have been recognized as significant in this test; the m line, which is found
early in infection and in persons who have recovered from the disease, and the h line, which generally
indicates active infection. The antigen used in this test is

a. Aspergillin

b. Coccidioidin

c. Histoplasmin

d. Sporotrichin

e. None of the above

87. Which of the organisms is the usual cause of white piedra?

A. Trichosporon beigelii

B. Microspourum canis.

C. Piedraia hortai

D. Malassezia furfur

88. Which dermatophyte has large, multicelled, spindle-shaped macroconicida and fluoresce green-
yellow?

A. E. floccosum

B. T. rubrum

C. M. canis

D. None of the above

89. Which of the following dermatophytes are differentiated by the hair baiting test?

A. Candida labicans and C. neoformans

B. M. canis and M. audouinii

C. T. tonsurans and T. schoeleinii

D. T. mentagrphytes and T. rubrum

90. Fungal infection of the hair and scalp:

A. Piedraia hortae

В. Hortae werneckii

C. Phialophora

D. None of the above

91. A tinea infection is commonly referred to as:

A. Pityriasis

B. Piedra

C. Ringworm

D. All of the above

92. Which of the following is/are anthropophilic?

A. M. audouinii

B. M. canis

C. M. gypseum

D. All of the above

93. Which of these dermatophytes fluoresce under wood's lamp?

A. T. rubrum

B. T. tonsurans

C. M. canis

D. E. floccosum

94. Which of the following fungi forms thin-walled, clavate multiseptate macroconidia?

A. T. mentagrophytes

B. Epidermophyton floccosum

C. Microsporum gypseum

D. None of the above

95. In rice agar medium, these fungi produced apple-green fluorescence on ectothrix hair:

A. M. audouinii

B. M. canis

C. M. equinum

D. M. gypseum

96. It is the second most common cause of epidemic tinea capitis in adults:

A. M. gypseum

B. T. tonsurans

C. T. metagrophytes

D. None of the above

97. Primary culture media for the growth of fungi:

A. DTM

B. SDA

C. Commeal agar

D. Rice medium agar

98. Which of the following is a dimorphic fungus?

A. Sporothrix schenkii

B. Cryptococcus neojormans

C. Nocardia asteroides

D. Candida albicans

99. Distinctive homothallic, multicellular macroconidia with echinulate or rough walls.

A. Trichophyton spp

B. Epidermophyton

C. Microsporum spp

D. Trichosporon

100. Characterized by superficial, brownish, scaly areas on light-skinned individual:

A. Tinea versicolor

B. Tinea nigro

C. Malassezia furfur

D. Aand C