Question 1

What is the most common clinical manifestation associated with continuous bacteremia?

Accepted Answer

A)  Meningitis 
B)  Pleurisy 
C)  Encephalitis 
D)  Endocarditis 
A)  Meningitis 
B)  Pleurisy 
C)  Encephalitis 
D)  Endocarditis D

Question 2

Lipopolysaccharide in gram-negative bacteria and the lipoteichoic acid and peptidoglycan in gram-positive bacteria cause which of the following to be released in the human body?

Accepted Answer

A)  Tumor necrosis factor (TNF) 
B)  Interleukin (IL)-1 
C)  IL-6 
D)  All of the above 
A)  Tumor necrosis factor (TNF) 
B)  Interleukin (IL)-1 
C)  IL-6 
D)  All of the above D

Question 3

Which of the following has been suggested as a biomarker of fungal sepsis?

Accepted Answer

A)  C-reactive protein 
B)  Procalcitonin 
C)  (1-3)-$\beta$-D-Glucan 
D)  All of the above 
A)  C-reactive protein 
B)  Procalcitonin 
C)  (1-3)-$\beta$-D-Glucan 
D)  All of the above C

Question 4

All of the following factors are associated with an unfavorable outcome in bacteremia, except

Accepted Answer

A)  surface wound or abscess. 
B)  polymicrobial bacteremia. 
C)  presence of malignancy. 
D)  acquired immunodeficiency syndrome. 
A)  surface wound or abscess. 
B)  polymicrobial bacteremia. 
C)  presence of malignancy. 
D)  acquired immunodeficiency syndrome.

Question 5

What is the principle of a continuous monitoring blood culture system?

Accepted Answer

A)  The amount of CO2 produced is measured as a growth index and compared with a threshold. 
B)  The amount of increased lipopolysaccharide is measured and compared against the null value. 
C)  The pH of the media is continuously measured to check for bacterial metabolic by-products. 
D)  An optical monitor records the number of bacteria and records the growth. 
A)  The amount of CO2 produced is measured as a growth index and compared with a threshold. 
B)  The amount of increased lipopolysaccharide is measured and compared against the null value. 
C)  The pH of the media is continuously measured to check for bacterial metabolic by-products. 
D)  An optical monitor records the number of bacteria and records the growth.

Question 6

A vaccine is available to prevent septicemia and invasive infections, particularly in children, caused by this organism.

Accepted Answer

A)  Haemophilus influenzae 
B)  Klebsiella pneumoniae 
C)  Escherichia coli 
D)  Streptococcus agalactiae 
A)  Haemophilus influenzae 
B)  Klebsiella pneumoniae 
C)  Escherichia coli 
D)  Streptococcus agalactiae

Question 7

Abnormal conditions that may indicate the presence of bacteremia include all the following, except

Accepted Answer

A)  disseminated intravascular coagulation (DI
C) . 
B)  thrombocytopenia. 
C)  coagulopathy. 
D)  anemia. 
A)  disseminated intravascular coagulation (DI
C) . 
B)  thrombocytopenia. 
C)  coagulopathy. 
D)  anemia.

Question 8

All of the following organisms are noted colonizers of indwelling catheters, except

Accepted Answer

A)  coagulase-negative staphylococci. 
B)  Streptococcus pyogenes. 
C)  Staphylococcus aureus. 
D)  Enterococcus spp. 
A)  coagulase-negative staphylococci. 
B)  Streptococcus pyogenes. 
C)  Staphylococcus aureus. 
D)  Enterococcus spp.

Question 9

What underlying condition predisposes a person to a polymicrobial bacteremia?

Accepted Answer

A)  Intravenous drug use 
B)  Burns 
C)  Gastrointestinal tract sources 
D)  All of the above 
A)  Intravenous drug use 
B)  Burns 
C)  Gastrointestinal tract sources 
D)  All of the above

Question 10

Meningitis following bacteremia and septicemia are often associated with Neisseria meningitidis and

Accepted Answer

A)  Streptococcus pneumoniae. 
B)  Escherichia coli. 
C)  Pseudomonas aeruginosa. 
D)  Staphylococcus aureus. 
A)  Streptococcus pneumoniae. 
B)  Escherichia coli. 
C)  Pseudomonas aeruginosa. 
D)  Staphylococcus aureus.

Question 11

Sodium polyanetholsulfonate (SPS) performs all the following functions in the blood culture bottles, except

Accepted Answer

A)  anticoagulation. 
B)  prevention of phagocytosis. 
C)  act as a bacterial nutrient. 
D)  inactivate certain antimicrobials. 
A)  anticoagulation. 
B)  prevention of phagocytosis. 
C)  act as a bacterial nutrient. 
D)  inactivate certain antimicrobials.

Question 12

Bacteremia with this organism often leads to endocarditis, osteomyelitis, septic arthritis, hepatic abscess, or pyomyositis.

Accepted Answer

A)  Streptococcus pneumoniae 
B)  Escherichia coli 
C)  Staphylococcus aureus 
D)  Pseudomonas aeruginosa 
A)  Streptococcus pneumoniae 
B)  Escherichia coli 
C)  Staphylococcus aureus 
D)  Pseudomonas aeruginosa

Question 13

Which of the following is an example of a primary bacteremia source?

Accepted Answer

A)  An infected heart valve 
B)  A case of pneumonia 
C)  A patient with hepatitis 
D)  A wound abscess 
A)  An infected heart valve 
B)  A case of pneumonia 
C)  A patient with hepatitis 
D)  A wound abscess

Question 14

When drawing blood for blood cultures in a child younger than age 10 years, how much blood should be drawn?

Accepted Answer

A)  1% of total blood volume 
B)  5 mL 
C)  2 mL 
D)  1 mL for children younger than 2 years old, 3 mL for children younger than 7 years old, and 5 mL for children up to 10 years old 
A)  1% of total blood volume 
B)  5 mL 
C)  2 mL 
D)  1 mL for children younger than 2 years old, 3 mL for children younger than 7 years old, and 5 mL for children up to 10 years old

Question 15

What condition results when there is a procedural manipulation of a body site containing normal microbiota, causing those bacteria to enter the bloodstream?

Accepted Answer

A)  Continuous bacteremia 
B)  Intermittent bacteremia 
C)  Septic shock 
D)  Transient bacteremia 
A)  Continuous bacteremia 
B)  Intermittent bacteremia 
C)  Septic shock 
D)  Transient bacteremia

Question 16

Septi-Chek is which type of blood culture system?

Accepted Answer

A)  Continuous-monitoring blood culture system 
B)  Lysis-centrifugation blood culture system 
C)  Aerobic-anaerobic blood culture system 
D)  Biphasic broth-slide system 
A)  Continuous-monitoring blood culture system 
B)  Lysis-centrifugation blood culture system 
C)  Aerobic-anaerobic blood culture system 
D)  Biphasic broth-slide system

Question 17

What condition leads to most cases of bacteremia arising from intraabdominal infections?

Accepted Answer

A)  Pleurisy 
B)  Cholecystitis 
C)  Peritonitis 
D)  Irritable bowel syndrome 
A)  Pleurisy 
B)  Cholecystitis 
C)  Peritonitis 
D)  Irritable bowel syndrome

Question 18

A patient receiving chemotherapy for leukemia has developed a fever causing the physician to request blood cultures times three. Each set of cultures grows an $\alpha$-hemolytic streptococcal organism. What is the most likely explanation for these results?

Accepted Answer

A)  The patient probably has an infection with $\alpha$-hemolytic strep. 
B)  The blood cultures were contaminated with skin biota 
C)  The blood cultures were probably contaminated in the laboratory. 
D)  The patient probably has an infection with Bacillus spp. 
A)  The patient probably has an infection with $\alpha$-hemolytic strep. 
B)  The blood cultures were contaminated with skin biota 
C)  The blood cultures were probably contaminated in the laboratory. 
D)  The patient probably has an infection with Bacillus spp.

Question 19

Separate venipunctures were performed to collect three sets of blood cultures from a patient with an artificial heart valve. The first and third sets grew a gram-positive pleomorphic rod in 1 of 2 bottles while the second set had no growth in either bottle. What is the most likely explanation for these findings?

Accepted Answer

A)  The patient probably has an infection with Clostridium spp. 
B)  The blood cultures were contaminated with skin biota. 
C)  The blood cultures were probably contaminated in the laboratory. 
D)  The patient probably has an infection with Bacillus spp. 
A)  The patient probably has an infection with Clostridium spp. 
B)  The blood cultures were contaminated with skin biota. 
C)  The blood cultures were probably contaminated in the laboratory. 
D)  The patient probably has an infection with Bacillus spp.

Question 20

If a patient with a bacteremia is receiving appropriate antimicrobial therapy for a known infection but is not responding to treatment, how does the physician find out if another organism is causing the problem?

Accepted Answer

A)  Redraw the blood cultures. 
B)  Redraw the blood cultures using an antimicrobial removal device. 
C)  Switch the patient to another agent that will resolve the clinical symptoms. 
D)  Perform hemodialysis to remove the organisms from the patient's blood. 
A)  Redraw the blood cultures. 
B)  Redraw the blood cultures using an antimicrobial removal device. 
C)  Switch the patient to another agent that will resolve the clinical symptoms. 
D)  Perform hemodialysis to remove the organisms from the patient's blood.

Exam 36: Bacteremia and Sepsis

What is the most common clinical manifestation associated with continuous bacteremia?

Lipopolysaccharide in gram-negative bacteria and the lipoteichoic acid and peptidoglycan in gram-positive bacteria cause which of the following to be released in the human body?

Which of the following has been suggested as a biomarker of fungal sepsis?

All of the following factors are associated with an unfavorable outcome in bacteremia, except

What is the principle of a continuous monitoring blood culture system?

A vaccine is available to prevent septicemia and invasive infections, particularly in children, caused by this organism.

Abnormal conditions that may indicate the presence of bacteremia include all the following, except

All of the following organisms are noted colonizers of indwelling catheters, except

What underlying condition predisposes a person to a polymicrobial bacteremia?

Meningitis following bacteremia and septicemia are often associated with Neisseria meningitidis and

Sodium polyanetholsulfonate (SPS) performs all the following functions in the blood culture bottles, except

Bacteremia with this organism often leads to endocarditis, osteomyelitis, septic arthritis, hepatic abscess, or pyomyositis.

Which of the following is an example of a primary bacteremia source?

When drawing blood for blood cultures in a child younger than age 10 years, how much blood should be drawn?

What condition results when there is a procedural manipulation of a body site containing normal microbiota, causing those bacteria to enter the bloodstream?

Septi-Chek is which type of blood culture system?

What condition leads to most cases of bacteremia arising from intraabdominal infections?

A patient receiving chemotherapy for leukemia has developed a fever causing the physician to request blood cultures times three. Each set of cultures grows an α\alphaα -hemolytic streptococcal organism. What is the most likely explanation for these results?

If a patient with a bacteremia is receiving appropriate antimicrobial therapy for a known infection but is not responding to treatment, how does the physician find out if another organism is causing the problem?

Bacterial Cell Structure, Physiology, Metabolism, and Genetics

Hostparasite Interaction

The Laboratory Role in Infection Control

Control of Microorganisms

Performance Improvement in the Microbiology Laboratory

Specimen Collection and Processing

Microscopic Examination of Materials From Infected Sites

Use of Colony Morphology for the Presumptive Identification of Microorganisms

Biochemical Identification of Gram-Negative Bacteria

Immunodiagnosis of Infectious Diseases

Applications of Molecular Diagnostics

Antimicrobial Agent Mechanisms of Action and Resistance Mechanisms

Antimicrobial Susceptibility Testing

Staphylococci

Streptococcus, Enterococcus, and Other Catalase-Negative, Gram-Positive Cocci

Aerobic Gram-Positive Bacilli

Neisseria Species and Moraxella Catarrhalis

Haemophilus, Hacek, Legionella, and Other Fastidious Gram-Negative Bacilli

Enterobacteriaceae

Vibrio, Aeromonas, and Campylobacter Species

Nonfermenting and Miscellaneous Gram-Negative Bacilli

Anaerobes of Clinical Importance

The Spirochetes

Chlamydia, Rickettsia, and Similar Organisms

Mycoplasma and Ureaplasma

Mycobacterium Tuberculosis and Nontuberculous Mycobacteria

Medically Significant Fungi

Diagnostic Parasitology

Clinical Virology

Agents of Bioterror and Forensic Microbiology

Biofilms: Architects of Disease

Upper and Lower Respiratory Tract Infections

Skin and Soft Tissue Infections

Gastrointestinal Infections and Food Poisoning

Infections of the Central Nervous System

Urinary Tract Infections

Genital Infections and Sexually Transmitted Infections

Infections in Special Populations

Zoonotic Diseases

Ocular Infections

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A patient receiving chemotherapy for leukemia has developed a fever causing the physician to request blood cultures times three. Each set of cultures grows an $\alpha$ -hemolytic streptococcal organism. What is the most likely explanation for these results?