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Which of the following species of hyaline molds produce conidia in chains?

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Scopulariopsis species
Gliocladium species
Acremonium species

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Scopulariopsis species develop conidia in chains, while the conidia of Gliocladium

species and Acremonium species are gathered in tight and loose clusters respectively.

Question Difficulty: Level 6

 

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Under a Woods’ lamp, infected hair strands from several children with tinea capitis
showed green fluorescence, and subsequent cultures grew fungi with aerial mycelia
and terminal chlamydospores. These isolates are most likely:

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Candida albicans
Epidermophyton floccosum
Microsporum audouinii
Microsporum gypseum
Trichophyton rubrum

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Microsporum audouinii is a causative agent of tinea capitis and shows a green

fluorescence. This fungus is a slow-grower with a culture morphology of aerial
mycelia and terminal chlamydospores. Colonies also show a gray/tan/cream surface
color while the reverse color is typically peach or flesh-colored.
 Question Difficulty: Level 7
 

  

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Which one of the following fungi is MOST likely to be found as a common saprobe
and as a cause of keratitis?

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Sporothrix schenckii
Cladosporium
Fusarium
Alternaria

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Fusarium can be found as a common saprobe and as a cause of keratitis. Fusarium

colonies are most commonly fast-growing and may or may not have a cottony aerial
mycelium. Fusarium typically produce both macroconidia and microconidia from thin
phialides. Macroconidia and microconidia are both hyaline. Chlamydoconidia may or
may not be present.

Question Difficulty: Level 7

 

  

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What is the MOST likely identification of an encapsulated yeast in a blood culture

bottle from a patient with septicemia with the following additional culture
information?:

Failure to produce germ tubes

Urease positive
Produced brown pigment on bird seed agar

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 Candida albicans
Candida pseudotropicalis
Cryptococcus neoformans
Torulopsis glabrata
Saccharomyces cerevisiae

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Cryptococcus neoformans is the MOST likely identification of the encapsulated yeast

in this question. C. neoformans is urease +, and grows brown colonies on birdseed
agar. In addition, India ink stain can also be used for Cryptococus spp. identification.

Question Difficulty: Level 4

 

  

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The photomicrograph on the right illustrates single conidia in succession both

laterally and around the tip of a straight phialide. This type of sporulation,
characteristic of certain species of dematiaceous mold, is called:

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Acrotheca
Acropetal
 Rhinocladiella

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The production of single conidia in succession both laterally and around the tip of a
straight phialide is called the rhinocladiella type of sporulation, characteristic of
Fonsecaea pedrosoi.

Acrotheca type sporulation is also produced by F. pedrosoi; however, is characterized

by the production of short chains of elliptical conidia in a circular arrangement from
the tips of branching phialides.

Acropetal is the term referring to a type of sporulation where chains of conidia are
formed with each new daughter cell produced from the previous one, leaving the
oldest cell at the base of the chain. This type of sporulation is characteristic of
Aspergillus species and Penicillium species.

Question Difficulty: Level 6

 

  

  

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Which of the yeasts listed below is known as brewer's or baker's yeast?

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Rhodotorula rubra
Cryptococcus albidus
Saccharomyces cerevisiae
Hansenula anomala

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Saccharomyces cerevisiae is known as brewer's or baker's yeast, as it is used in the

fermentation stages of beer and bread making.

None of the other yeasts that are listed are used in beer or bread making.

Question Difficulty: Level 4

 

  

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All of the following observations are consistent with the laboratory identification of
Cryptococcus neoformansexcept:

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Colonies that appear mucoid on primary isolation culture medium

Negative urease test
Cornmeal agar morphology displaying spherical, irregular cells with no
pseudohyphae
Presence of capsular material
Tan-brown pigment on bird seed agar

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Cryptococcus neoformans would produce a rapidly positive urease test. All the
remaining observations are consistant with the laboratory identification of C.
neoformans.

Upon observing mucoid appearing colonies on a primary isolation culture medium,

perform a rapid urease test and set up a cornmeal agar preparation.

If the urease test is rapidly positive, observe the cornmeal agar morphology. If
pseudohyphae are absent, and particularly if the yeast cells are spherical, irregular in
size and widely separated (presence of capsular material), inoculate the surface of a
bird seed agar plate with a small portion of the unknown colony.

If a brown pigment is produced within 48-72 hours, a definitive identification of

Cryptococcus neoformans can be made.

Question Difficulty: Level 6

 

  

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The yeast forms of which of the following species of dimorphic fungi (represented in
the image on the right) can be described as large yeast cells with multiple buds that
are attached by narrow necks, giving the appearance of a "mariner's wheel"?

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Sporothrix schenkii
Paracoccidioides brasiliensis
Blastomyces dermatitidis

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Paracoccidioides brasiliensis produces large yeast cells approximately the same size
as those of Blastomyces dermatitidis (10 - 15 µm), except multiple buds are attached
by narrow necks, giving the appearance of a "mariner's wheel."

The yeast form of Blastomyces dermatitidis is a thick-walled yeast cell that

characteristically produces a single bud attached by a broad base.

The yeast forms of Sporothrix schenckii are elongated cells that have been called
"cigar bodies."

Question Difficulty: Level 5

 

  

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Which of the following fungal infections is endemic in the southwestern US desert

regions?
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Histoplasmosis
Blastomycosis
Coccidioidomycosis
Sporotrichosis

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Coccidioidomycosis is strictly endemic in the southwestern US desert regions.

The geographic distribution of blastomycosis in the United States tends to be centered

more in the upper Mississippi river drainage system and adjacent tributaries.

Histoplasmosis is more concentrated in the lower Mississippi river valley and

adjacent tributaries and, sporotrichosis has a broad geographic distribution, sparing
only the higher western mountainous regions.

Question Difficulty: Level 6

 

  

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Of the molds that are listed, which is considered an obligate pathogen, causing
infection in persons who were previously healthy?

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Aspergillus fumigatus
Rhizopus species
Blastomyces dermatitidis

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Blastomyces dermatitidis can cause infections in patients who were previously

healthy; therefore, it is an obligate pathogen.

Most of the hyaline molds are opportunistic pathogens, causing infections only in
patients with underlying immunologic, metabolic or hematologic disorders.
Aspergillus fumigatus commonly causes infections in patients who are debilitated,
immunosuppressed or leukopenic. Rhizopus species is an opportunistic pathogen that
may cause invasive infections in patients with diabetes mellitus.

Question Difficulty: Level 6

 

  

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Dematiaceous molds can be broadly separated into two major groups; the agents of
chromomycosis and clinically insignificant commensals or contaminants. The agents
of chromomycosis grow: more slowly than; more rapidly than; or generally at the
same rate as the clinically insignificant commensals or contaminants?

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more slowly than

more rapidly than
generally at the same rate as

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The dematiaceous molds can be broadly separated into two major groups: the agents
of chromomycosis that grow more slowly, maturing only after 7 days or more of
incubation, and the more rapidly growing species that most commonly are clinically
insignificant commensals or contaminants when recovered from clinical specimens,
but in rare situations may cause opportunistic infections called phaeohyphomycosis.

Question Difficulty: Level 5

 

  

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Within three days at 28 ºC a sputum specimen placed on Sabouraud’s dextrose agar

with chloramphenicol and cycloheximide produced moist, grayish growth, with a
white aerial mycelium, the organism is MOST likely:

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 Aspergillus fumigatus
Blastomyces dermatitidis
Coccidioides immitis
Cryptococcus neoformans
Histoplasma capsulatum

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C. immitis is a dimorphic fungus which can be isolated from sputum specimens of

infected individuals. When grown on Sabouraud's agar at 25o it grows as a mold with
white aerial mycelium in about 3 to 5 days. C. immitis is known to produce
arthroconidia which are "barrel-shaped" after 1 to 2 weeks of growth.

Question Difficulty: Level 8

 

  

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What is the most likely identification of a rapidly growing hyaline mold that began as
a white colony and later develops a black "pepper" effect on the agar surface. As the
colony aged it produced a black matte making it resemble a dematiaceous mold.

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Penicillium notatum
Aspergillus niger
Paecilomyces spp.
Scopulariopsis spp.

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Aspergillus niger is a rapidly growing hyaline mold that began as a white colony and
later develops a black "pepper" effect on the agar surface. A. niger is toxic and
pathogenic, as it has been known to cause lung mycosis in man.

Question Difficulty: Level 4

 
  

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Which one of the following fungi is MOST likely to be found as a common saprobe
and as a cause of keratitis?

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Sporothrix schenckii
Cladosporium
Fusarium
Alternaria

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Fusarium can be found as a common saprobe and as a cause of keratitis. Fusarium

colonies are most commonly fast-growing and may or may not have a cottony aerial
mycelium. Fusarium typically produce both macroconidia and microconidia from thin
phialides. Macroconidia and microconidia are both hyaline. Chlamydoconidia may or
may not be present.

Question Difficulty: Level 7

 

  

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The type of sporulation illustrated in this photomicrograph of a dematiaceous fungus
is:

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Rhinocladiella
Acrotheca
Cladosporium
Phialophora

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The production of dark, elliptical conidia in branching chains with the conidia
separated by a delicate black scar or dysjunctor is characteristic of the cladosporium
type sporulation.

In rhinocladiella type sporulation, the conidia are borne from either side of a straight
conidiophore in a picket fence arrangement. Acrotheca type sporulation is somewhat
similar to the cladosporium type except that the chains are quite short and the conidia
are derived circumferentially from the hyphae, much as the hooks on a hat rack.

Phialophora type sporulation involves the production of vase-like phialides with a

distinct mouth from which spherical or slightly elliptical conidia are produced in
clusters.

Question Difficulty: Level 6

 

  

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MOST pathogens enter the body through:

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Eyes
GI tract
Lungs
Mucous membranes
Skin abrasions
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Most pathogens enter the body through mucous membranes. Mucous membranes are
tissues that line body cavities and internal organs that are exposed to the external
environment such as the throat, nose, mouth, urethra, ears, eyelids, rectum, and
vagina. Mucous is secreted by the mucous membranes and glands to help protect from
infection.

Question Difficulty: Level 5

 

  

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Which of the following molds is classified as a zygomycete?

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Microsporum nanum
Cunninghamella species
Trichophyton schoenleinii
Epidermophyton floccosum

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Cunninghamella species are zygomycetes. Microsporum nanum, Trichophyton

schoenleinii and Epidermophyton floccosum are all species of dermatophytes.

Question Difficulty: Level 7

 

  

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?What is the identifying characteristic of Aureobasidium pullulans

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The production of a black yeast-like colony

The production of polar germ tubes

The production of urn-shaped phialides

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The identifying characteristic of Aureobasidium pullulans is the production of a black yeast-

like colony

Question Difficulty: Level 7

==========

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The segmented, dark-staining grains seen in this photomicrograph are most

commonly seen in cases of chromomycosis. Which of the fungal species listed below
is known to cause this disease?

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Scedosporium apiospermum
 Phialophora verrucosum
Sporothrix schenckii

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The segmented dark-staining grains seen in this photomicrograph are most commonly
seen in cases of chromomycosis. Of the fungal species listed in this exercise, only
Phialophora verrucosum is associated with chromomycosis and has the capability of
producing the grains seen in the photograph.

Although Scedosporium apiospermum may cause mycetoma and produce grains, they
are soft, gray white and not segmented.

Sporothrix schenckii is the agent of subcutaneous sporotrichosis, an infection that may

result in granulomatous inflammation with the presence of multi-nucleated giant cells;
however, grains or granules are not formed.

Question Difficulty: Level 7