1. You receive plates from a respiratory specimen that exhibit no growth on a blood agar plate and growth of small gray colonies on a chocolate plate. You perform a gram stain, which reveals small, pleomorphic gram-negative rods. Based on these results you conclude that this organism is a Haemophilus species. To further subtype the organism, you test for factor requirements and hemolysis. The next day, you examine the plate and based on the growth, you determine the organism is H. influenzae. What growth pattern most closely resembles the expected findings for this organism?

2. You receive a proficiency test unknown in your microbiology lab. You are told the specimen is from a wound, so you plate the specimen onto your four standard agars. Pictured are the colonies on MacConkey agar. Based on these findings, you perform an indole test and find that it is positive. What is the MOST LIKELY organism?

3. In preparation for an upcoming laboratory inspection, you are reviewing your quality control procedures in the microbiology department. You have a list of atypical bacteria-antibiotic resistance profiles that are posted and should alert the technicians to perform confirmatory testing. Which of the following bacteria-antibiotic resistance combinations is INCORRECT and should prompt retesting by another method to confirm resistance?

4. Which spiral bacterium has hooks at both ends?

5. You finalize a report from a skin wound as no growth after 5 days. The clinician calls and he is concerned that the specimen was not cultured correctly, as he was certain there was adequate material upon collection. He states that the patient had an abscess on the thigh and upon drainage, there was 25ml of purulent fluid expressed from the lesion. Following the drainage, a swab culture was taken for microbiology. The clinician sent the swab for gram stain, aerobic and anaerobic cultures. Your BEST response to address the clinicianʼs concern is:

6. You receive a respiratory specimen in the laboratory that is labeled bronchial washing and has been obtained by bronchoscopy. As standard procedure in your lab, you culture the specimen to a blood and buffered charcoal yeast extract plate. On the third day, you examine the plates and notice colonies growing that you would describe as having a ground-glass appearance. You perform a Gram stain and see tiny gram-negative rods. There is no growth on the blood plate. What is the MOST LIKELY organism growing on the BCYE plate?

7. You isolate a Staphylococcus aureus on a specimen from a wound. You test for Erythromycin susceptibility and find that the organism is resistant. You perform a D-test disk diffusion test to evaluate clindamycin inducible resistance. Based on the results pictured, can you treat this patientʼs infection with clindamycin?

8. You isolate an Enterococcus faecium from a urine specimen. Standard susceptibility testing is performed. What is the MOST IMPORTANT antibiotic pattern to look for initially?

9. You receive a cultured specimen on a MacConkey plate. Based on the growth pictured, you perform an oxidase test, which is positive. What is the BEST organism identification for this specimen?

10. A urine specimen from a middle aged female is received in the lab and grows small white colonies on sheep blood agar that are coagulase negative and positive for catalase. The Gram stain reveals Gram-positive cocci in clusters. The organism is plated onto a Mueller-Hinton agar and a Novobiocin disc is placed onto the plate. The next morning, the plate is examined and shows no zone of inhibition. What is the MOST LIKELY organism growing on this plate?