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American Society of Microbiology ABMM Sample Questions:

1. A patient with a history of travel to a developing country presents with chronic diarrhea, abdominal pain, and weight loss. Stool examination reveals the presence of cysts containing four nuclei and chromatoidal bars with rounded ends. The MOST likely causative organism is:

A) Giardia lamblia
B) Entamoeba histolytica
C) Cyclospora cayetanensis
D) Cryptosporidium parvum

2. A clinical microbiology laboratory is performing quality control on antimicrobial susceptibility testing. The zone diameter for Escherichia coli ATCC 25922 tested against ciprofloxacin is consistently smaller than the acceptable range published by CLSI. The MOST likely cause of this discrepancy is:

A) Inoculation with a bacterial suspension that is too dense
B) Incubation at an incorrect temperature
C) All of the above
D) Use of expired antibiotic disks

3. A traveler returning from a tropical region presents with fever, chills, and jaundice. Peripheral blood smear reveals the presence of ring-shaped parasites within erythrocytes. Further laboratory testing shows a positive result for Plasmodium falciparum histidine-rich protein 2 (HRP2). The MOST appropriate treatment for this patient is:

A) Amphotericin B
B) Mebendazole
C) Metronidazole
D) Primaquine and a blood schizonticide (e.g., artemisinin-based combination therapy)

4. A patient presents with a chronic cough, weight loss, and night sweats. Chest X-ray shows cavitarylesions in the upper lobes. Sputum is acid-fast positive. Drug susceptibility testing reveals resistance to isoniazid but susceptibility to rifampin, ethambutol, and pyrazinamide. The MOST appropriate treatment regimen should include:

A) Isoniazid, ethambutol, and pyrazinamide
B) Isoniazid, rifampin, pyrazinamide, and ethambutol
C) Isoniazid and rifampin
D) Rifampin, ethambutol, and pyrazinamide

5. A clinical microbiology laboratory is performing antimicrobial susceptibility testing on a Streptococcus pneumoniae isolate recovered from a patient with meningitis. The isolate shows reduced susceptibility to penicillin (MIC = 2 µg/mL). The MOST likely mechanism for this reduced susceptibility is:

A) Production of beta-lactamase enzymes that hydrolyze penicillin.
B) Increased activity of efflux pumps that actively remove penicillin from the cell.
C) Alterations in the penicillin-binding proteins (PBPs) that reduce their affinity for penicillin.
D) Modification of the peptidoglycan structure, preventing penicillin binding.

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