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Quality control of antimicrobial susceptibility tests involves:


A) performing antimicrobial susceptibility tests on organisms using the Clinical and Laboratory Standards Institute (CLSI) charts to interpret the results.
B) using organisms grown from patient cultures to test the reactivity of the antimicrobial drugs.
C) testing standard reference strains that have defined antimicrobial susceptibility (or resistance) to the drugs tested.
D) none of the above.

E) C) and D)
F) B) and C)

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What is the most widely used supplementary quality control measure for antimicrobial susceptibility testing?


A) b-Lactamase testing
B) Use of antibiograms to verify results generated on patient isolates
C) Correlation of clinical outcomes with laboratory findings
D) None of the above

E) B) and D)
F) B) and C)

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What is the principle of the Etest?


A) Turbidimetry
B) Establishing an antimicrobial density gradient in agar
C) Carbon dioxide concentration
D) Redox indicator system

E) None of the above
F) B) and C)

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What broth is recommended in the tube dilution minimal inhibitory concentration (MIC) tests?


A) Trypticase soy
B) Mueller-Hinton
C) Columbia
D) Cooked meat

E) A) and D)
F) None of the above

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In this type of antimicrobial susceptibility test, a McFarland 0.5 standardized suspension of bacteria is swabbed over the surface of a Mueller-Hinton agar plate, and paper disks containing single concentrations of each antimicrobial agent are placed onto the inoculated surface.What is the name of this test?


A) Kirby-Bauer
B) MIC
C) Breakpoint
D) Agar dilution

E) B) and C)
F) None of the above

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A microbiology technologist is performing a b-lactamase test on a staphylococci isolated from a hospitalized patient.The test was negative, so the technologist reported out in vitro antimicrobial susceptibility test results for b-lactam antibiotics.After 2 days, the patient was not improving and the physician changed the patient's antibiotic to an aminoglycoside.The patient showed improvement immediately.Why was the b-lactamase test on the staphylococci negative, when the organism produced b-lactamase?


A) The test was a false negative-the organism really did produce b-lactamase, but it did not react with the test.
B) Staphylococci must be exposed to the b-lactam agent before it will produce a positive test result.
C) The test was a false positive-the organism reacted with the test, but it did not produce a b-lactamase.
D) The staphylococci on the plate were more than 24 hours old and false-negative test results can occur when an "old" organism is used.

E) B) and C)
F) A) and B)

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Because the identity of the bacterial isolate is often unknown at the time the susceptibility testing is performed, it may include drugs that are inappropriate for reporting.What does the microbiologist do when this occurs?


A) A drug should not be indiscriminately reported because results may be misleading.
B) If the drug is tested, the results are reported because the microbiologist does not know what antibiotic was prescribed to the patient.
C) The microbiologist reports this immediately to the microbiology supervisor because this is a wasteful practice.
D) The microbiologist only reports on the drugs to which the bacteria are sensitive.

E) B) and D)
F) A) and D)

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What McFarland standard provides turbidity comparable to that of a bacterial suspension containing approximately 1.5 ´ 10⁸ CFU/mL?


A) 1.0
B) 1.5
C) 0.5
D) 2.0

E) All of the above
F) B) and C)

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When would it be appropriate for an institution to routinely test group C agents?


A) For urinary tract infections
B) If a particular institution routinely encounters large numbers of isolates resistant to group A and group B agents
C) For blood cultures
D) If a particular institution routinely encounters large numbers of isolates susceptible to group A and group B agents

E) A) and B)
F) C) and D)

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What is generated by analysis of individual susceptibility results on isolates from a particular institution in a defined period and represents the percentage of isolates of a given species that is susceptible to the antimicrobial agents commonly tested against the species?


A) Historical antibiogram
B) Laboratory workload report
C) Infection control committee report
D) Cumulative antibiogram

E) All of the above
F) B) and C)

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On a breakpoint panel, when two concentrations are tested and no growth is present in either well, the isolate is:


A) susceptible.
B) resistant.
C) intermediate.
D) none of the above.

E) B) and D)
F) B) and C)

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What is a mechanism for ensuring the testing personnel are proficient in their tasks?


A) Supervisory review of reported results
B) Self-assessment checklists
C) Periodic competency testing through proficiency surveys
D) All of the above

E) All of the above
F) A) and B)

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A 12-year-old girl goes to the doctor complaining of a sore throat, fever, headache, and general malaise.The doctor does a quick strep test that is positive for group A b-hemolytic Streptococcus.No antibiotic testing is needed because Streptococcus is:


A) universally susceptible to penicillin.
B) universally susceptible to erythromycin.
C) not treated in throat cultures.
D) not considered a pathogen in the throat.

E) B) and C)
F) A) and D)

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All of the following techniques are used to measure the amount of antimicrobial agent in the serum except:


A) biologic assays.
B) immunoassays.
C) chromatographic assays.
D) bioluminescence assays.

E) A) and C)
F) A) and B)

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What is the storage temperature for frozen panels?


A) 0° C
B) -20° to -70° C
C) -75° to -100° C
D) 273 K

E) B) and D)
F) C) and D)

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How many hours of incubation are necessary for the antimicrobial susceptibility test run on the BD Phoenix?


A) 6 to 8 hours
B) 8 to 12 hours
C) 12 to 18 hours
D) 24 hours

E) A) and D)
F) All of the above

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All of the following steps are taken to verify the results from an atypical antibiogram except:


A) reexamining the disk diffusion plate, or minimal inhibitory concentration (MIC) tray, to ensure that results were properly interpreted.
B) checking earlier reports to see whether the particular patient previously had an isolate with an atypical antibiogram.
C) calling around to other hospitals to see if they are encountering the same organism with that same antibiogram.
D) repeating the test, if necessary.

E) B) and D)
F) B) and C)

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In this method of antimicrobial susceptibility testing, specific volumes of various concentrations of antimicrobial solutions are dispensed into premeasured volumes of molten and cooled agar, which is subsequently poured into standard Petri dishes.Organisms are inoculated onto the plate.What type of antimicrobial susceptibility testing is this?


A) Macrodilution
B) Broth dilution
C) Disk diffusion
D) Agar dilution

E) B) and C)
F) A) and C)

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What principle do most current automated antimicrobial susceptibility instruments use to read growth?


A) Turbidimetric detection
B) Turbidity suppression
C) Hydrolysis of a fluorogenic growth substrate
D) Carbon dioxide concentration

E) A) and D)
F) All of the above

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A drug will generally inhibit multiplication of the bacteria so that the patient's immune defense mechanisms are no longer overwhelmed when:


A) all the debris and necrotic cells are removed.
B) the drug concentration exceeds the MIC for the microbe.
C) the patient is not infected with a gram-negative rod.
D) two synergistic drugs are used to kill the bacteria.

E) A) and B)
F) B) and C)

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