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American Society of Microbiology ABMM Sample Questions:

1. A 55-year-old male with a history of poorly controlled diabetes mellitus develops a necrotizing fasciitis of his left lower extremity following a minor abrasion sustained while gardening. Initialcultures of the wound reveal a polymicrobial flora, including Gram-positive cocci in chains and Gram-negative bacilli. Over the next 48 hours, despite broad-spectrum antibiotic therapy, the patient's condition deteriorates, and new bullae with hemorrhagic fluid appear. Gram stain of this fluid now predominantly shows large, Gram-positive bacilli with subterminal spores. Which of the following virulence factors is MOST likely contributing to the rapid tissue destruction observed in this patient?

A) Lecithinase (alpha-toxin)
B) Lipopolysaccharide (LPS)
C) Exotoxin B (SpeB)
D) Protein A

2. A patient with severe combined immunodeficiency (SCID) develops a progressive respiratory illness.
Bronchoalveolar lavage fluid is examined using direct fluorescent antibody (DFA) staining, which reveals numerous cysts of Pneumocystis jirovecii. The cysts appear:

A) Large and multinucleated with prominent endospores.
B) Oval-shaped with a thin wall and internal nuclei.
C) Cup-shaped or helmet-shaped with internal structures.
D) Small and round with a thick wall, containing sporozoites.

3. A traveler returning from sub-Saharan Africa presents with cyclical fevers, chills, and sweats. A Giemsa- stained peripheral blood smear reveals multiple ring forms within red blood cells, some applique forms, and occasional banana-shaped gametocytes. No Schüffner's dots or red blood cell enlargement is observed. Which Plasmodium species is the most likely cause?

A) Plasmodium ovale
B) Plasmodium vivax
C) Plasmodium malariae
D) Plasmodium falciparum

4. The direct fluorescent antibody (DFA) test is commonly used for the rapid detection of which respiratory pathogen directly from nasopharyngeal specimens?

A) Bordetella pertussis
B) Mycoplasma pneumoniae
C) Legionella pneumophila (serogroup 1 in sputum)
D) Influenza virus

5. A patient with a history of recurrent urinary tract infections caused by Escherichia coli develops a new infection. The urine isolate is resistant to trimethoprim-sulfamethoxazole. The MOST common mechanism of resistance to this antibiotic combination in E. coli involves:

A) Increased production of para-aminobenzoic acid (PABA).
B) Expression of efflux pumps that specifically target trimethoprim and sulfamethoxazole.
C) Enzymatic inactivation of trimethoprim and sulfamethoxazole.
D) Mutations in the genes encoding dihydrofolate reductase and dihydropteroate synthase.

Solutions: