TB or Not TB
Parasite Paradise
Gram Slammers
Yeast of Your Worries
Going Viral
Resistance is NOT Futile
Boss Level=Final Jeopardy
100
What is the definition of scotochromogenic mycobacteria?
Develop yellow or orange pigment in the dark or after exposure to light
100
This wet mount is from a liver aspirate. What is the identification of this organism?
Echinococcus (hooklets)
100
What color would your Gram stain be if you forgot the iodine step?
Gram-positive organisms will stain pink.
100
What kind of stain is Calcofluor white, and what part of the fungus does it stain?
Fluorescent; chitin
100
Which respiratory virus is a DNA virus?
Adenovirus
100
Name the following antimicrobial susceptibility testing methods:
(have to get all 3 right for 100 points)
A. disk diffusion; B. gradient diffusion; C. broth microdilution
200
What is the most common acid-fast bacteria found as laboratory/environmental contaminant?
M. gordonae
200
29 yo female immigrant from Ecuador presenting with a skin lesion of the outer thigh which appeared 3 months ago. What is the organism (genus level)?
Leishmania (Viannia) braziliensis species complex
200
What liquid media do we use to help select for Group B Strep at UW, and what color does this media turn if positive?
Carrot Broth; orange indicates positive for GBS
200
You see colonies growing on CGB agar and see this on an India-ink stain. Name this organisms (genus and species).
Cryptococcus gattii
200
Which MMR series virus has a childhood vaccination series with a protective lifetime efficacy of ≥97%, causes a maculopapular rash & Koplik spots in the mouth, and induces a high spiking fever?
Measles Virus
200
________ has broad-spectrum anaerobic activity with the least resistance
Metronidazole
300
What is the optimal growth temperature of M. marinum?
30 C
300
Which Plasmodium species causes a milder infection compared to others?
P. ovale
300
You see this cellular morphology on the Gram stain and small growth on both aerobic and anaerobic plates, leading you to think about the aerotolerant Clostridium species. Name all 3 species
Clostridium carnis
Clostridium tertium
Clostridium histolyticum
300
Name the emerging Candida species we screen patients for, and which antifungal is 90% of US isolates resistant to?
C. auris; fluconazole
300
At what point in the CDC HIV testing algorithm is NAAT testing recommended?
When HIV-1 vs HIV-2 antibody differentiation immunoassay results are indeterminant.
300
What is the mechanism of action of Glycopeptides and the spectrum of activity?
A major class of antibiotics that inhibit bacterial cell wall synthesis by binding to the end of the peptidoglycan, interfering with transpeptidation. Antimicrobial activity against almost all types of Gram-positive organisms including MRSA although their spectra of activity tend to be limited to Gram-positive organisms.
400
What is the most common AFB causing cervical lymphadenitis in children?
M. avium complex
400
28yo male from Mauritania with gross hematuria, mild eosinophilia, and calcified bladder. What is the cause of his symptoms (genus & species)?
Schistosoma haematobium
400
This medium selects for Nesseria species from other normal microbiota, and name one of the selective antimicrobials.
Thayer Martin (or Modified Thayer Martin) or Martin Lewis agar
Vancomycin (inhibits Gram +), colistin (inhibits Gram -), Nystatin (inhibit yeast), trimethoprim (inhibit Proteus swarming)
400
Which species of mold are lipophilic and may need an olive oil overlay on the culture media to help it grow?
Malassezia species
400
List out different components of 4th generation HIV testing.
4th Generation: 3rd Gen assay design + HIV-1 p24 Ag detection
• Detects HIV-1 (Groups M and O), and HIV-2 IgG and IgM antibody
• Detects HIV-1 p24 antigen to detect infection about 7 days earlier than third-generation tests
400
Name the ‘Big five’ carbapenemases accounting for >97% of Carbapenem-resistant Enterobacteriaceae (CRE).
KPC, OXA-48, IMP, VIM, and NDM
500
Which NTM is highly antibiotic-resistant and most commonly associated with surgical infections following cosmetic procedures?
M. abscessus
500
What is the primary vector for transmission of this disease caused by the parasite seen in this blood smear?
Deer tick Ixodes scapularis
500
What testing do we do to R/O Brucella and what results would you expect for Brucella? (Gram stain and 3 Biochemicals)
Gram stain: small GNCB
Catalase positive, Oxidase positive, Urease positive
500
Which genus of mould produces macroconidia like this with fluffy white colonies?
Microsporum
500
What is the possible interpretation of the Hepatitis B testing results shown here?
Chronic HBV infection
500
A Karius Test returns a result of Enterococcus faecium along with detection of the Van A/B resistance genes, but Vancomycin tests “susceptible” when cultured in vitro. What could explain this?
The Van A/B genes may have a mutation rendering them ineffective for resistance to Vancomycin, or there may be a mixed population of bacteria. The standard AST results should not be released and should be carefully explained to the patient care team.
500
A 58yo male presents to the ED with a 3-day history of subjective fevers, chills, and a skin ulcer on his thumb. He reports that he had recently spent several days on a landscaping project in rural Arkansas, where he was clearing brush and handling vegetation. He denies any recent travel or exposure to ticks. Blood cultures flagged positive for the organism shown in the Gram stain below. Tiny, grey-white, opaque colonies grew on chocolate agar after 48 hours. The organism is weakly positive for catalase and negative for oxidase and urease. What is the organism? 
Francisella tularensis