MICROBIOLOGY PRACTICAL.

University exam

Question 1:

A; identify the sterile container labeled A1. List 3 uses

B; identify the instrument labeled A2.What is the use of the instrument?

Answer.

A/ Universal bottle and its uses are;

-collection of specimen
-biochemical test
-culturing of organisms
B/ Wire loop it’s used for inoculation

Question 2:

A; identify the material inside the test tube labeled B1. What are its uses?

B; the bottle labeled B2 contains transport media, what is the use of the transport
media?

a./sterile swabbing stick, is used for the collection specimen collection

b. / Stuart’s transport media it contains buffer to maintain the PH and salts

It is used for temporary storage of specimen being transported to the lab for
cultivation and it maintains the viability of all organisms in the specimen without
affecting their concentration.

Question 3:

A; identify the media labeled C.

B; what is the category of the media?

C; list 2 contents

Answer

a. / blood agar

b. / the category of the media differential or general media

c. / the contents are

- Sheep blood or horse blood

-peptone agar
Question 4:

A; identify the media labeled D

B; the category of the media is selective media, mention 2 contents that makes it
selective

Answer

a. / Mac Conkey medium

b. / the two main contents are

-bile salt

-crystal violet

-neutral red

Question 5:

A; identify the media labeled E

B; what is the use of this media

C; list four content of this media

Answer

a. / TCBS media it can act as both selective and differential media

b./ it’s used to culture vibro cholera

c./ the main contents of the media

- thiosulphate

- Citrate

-bile

-sucrose

Question 6:

A; identify the media labeled F

B; what is the difference of this media and blood agar?

C; what organism will grow in this media but not in the blood agar?

Answer

a./ chocolate agar

b./ the difference of this media with blood agar is

-heated blood

-X and V factor

c./ used to culture Neisseria meningitis and hamophilus influenza

Question 7:

The media labeled G is the selective media for common pathogenic enteric
bacteria responsible for enteritis

A; identify the media

B; list two organisms which can be cultivated in this media.

Answer

a./ SSA agar (salmonella shigella agar)

b./ the organisms that can grow in this media are

-salmonella spp

-shigella spp

Question 8:

The broth labeled H is used as enrichment media in isolation of enteric

pathogenic bacteria

A; identify the broth

B; mention the organism which is enriched with this broth

Answer

A,/ salenite F broth ( its contents involves casein enzymic hydrolysate, lactose
and sodium phosphate)

c./ salmonella spp

Question 9:

Bar attendant from Mwanza city with multiple sexual partners underwent HIV
rapid tests. The results are given in the test labeled l1 and l2

A; interpret the results?

B; do you need the confirmatory test?

Answer

a./

Question 10:

The CSF from immunocompromised patient was stained on the slide labeled J and
examined.

A; describe what you see

B; what is the name of the stain?

C; what is the additional test will you do to confirm the diagnosis?

a./ capsulated budding yeast

b./ india ink stain

c./ the additional tests involves

 - urease test and latex agglutination test

Question 11

The peripheral smear of the patient with high graded fever was negative for
malaria parasite, but was positive for bacterial infection

A; identify the organisms seen on the slide K

B; what is the drug of choice of the organisms seen

C; how is the organisms transmitted?

Answer

a./ borrelia spp

b./ tetracycline

c./ the organism involved

- body louse, pediculus humanis var coporis

- soft tick, ornithodorus mobatu

NB. Body-louse-recurrentis diseases; lyme disease (budgoferi) and Relapsing

fever( recurrentis)

Treatment;

• Doxycycline or amoxycillin

• Penicillin for ceftriaxone

• aminoglycosides
Question 12

The patient who had dinner in Chinese Hotel, presented with acute water
diarrhea associated with vomiting. The organism was stained and examined under
oil immersion

A; describe what you see on the slide labeled L

B; what are likely organisms?

C; what other disease can be caused with this organism?

Answer

a./ gram positive rods in chains and purple coloured

b./ the organisms are

-bacillus cereus

- clostridium pefringes
c./ gas gangrene for clostridium perfringes

Question 13

The 27 year old male presented with urethral discharge, the culture of discharge
in the special media was stained in the slide labeled M

A; describe what you see

B; mention two types of media which can be used to culture the organisms seen
on slide M

C; what is the drug of choice of the organisms?

Answer

a./ gram negative diplococci pink coloured

b./ the types of media involves Thayer Martin agar ( it contain Vancomycin,
Nystatin, and cholestin trimethoprime they inhibit other organisms so favours
neisseria meningtidis)

and Muller Hinton agar

Question 14

The sputum from the patient with 2 weeks duration of cough was stained, the
results are seen in the slide labeled N

A; describe what you have seen on the slide?

B; what is the name of the stain?

C; what is the name of the counter stain used in this slide?

D; what is the other stain technique and principle can be used to diagnose the
organisms?

Answer

a./ red rods with blue back ground, so they are acid fast bacilli

b./ ZIEHL NEELSEN STAIN

c./ the conter stains are methylene blue or Malachite green

d./ other techniques are;

- kinyon stain, flouresence stain, modified ZN stai and Auramine stain

-principle;

the lipid capsule of the AFB organisms takes up carbolfuschin and resist
decolourization with dilute acid, the lipid capsule of the mycobacterium is waxy at
room temp 25 degree centigrade and successful penetration by the aquease
based staining solution is prevented.
Question 15

The isolate of the pregnant woman with UTI was stained and examined

A; describe what you have seen on the slide labeled O

B; list 4 likely organisms

C .What is most likely organism?

Answer.

a./ garm negative rods with pink colour

the likely organisms are

- Escherichia coli
- Klebsiella pneumonia
- Enterobacter spp
- Serratia spp
- Proteus vulgaris

c./ the likely organism is E. coli

Question 16

The culture with the pus from the patient with pyomyositis is seen on plate P1
and slide labeled P2

A; describe the colonies seen on the plate P1

B; list 2likely genera

C; what is the drug of choice

Answer

a./ white colonies, smooth, small with no hemolysis

b./ S. saprophyticus and S. epidermidis

c./ the drug of choice is vancomycin

Question 17

The culture from the patient with cellulitis is seen on the plate labeled Q

A; describe the colonies seen.

B; is the organism seen staphylococcus or streptococcus? Use the material given

to answer the question.

C; what is the addition test will you do to identify the specie?

Answer

a./ whitish colonies with no hemolysis

b./ staphylococcus proved by catalase positive

c./ the additional test is coagulase test,where by they are coagulase negative and
Novobiacin
Question 18

The blood culture from the neonate gave the results seen on the plate labeled R

A; describe the colonies

B; list 3 likely organisms

C; why are the colonies pink?

Answer

a./ the colonies are pink means they are lactose fermenters, they are convex and
smooth

b./ the likely organisms are

- klebsiella spp

- E. coli

-enterobacter spp

c./ the colonies are pink because there is lactose fermentation

Question 19
The sputum culture from the patient with hospital acquired pneumonia gave the
result seen on the plate labeled S

A; describe the colonies

B; list 4 likely genera

Answer

a./ convex, smooth, foul smell, non lactose fermentation

b./ the species involves

- pseudomonas spp

- proteus spp

- salmonella spp

-serratia spp

Question 20

The stool sample from the patient with acute watery diarrhea (rice water like)
was inoculated on the enrichment broth labeled T1 and then to the special media
labeled T2

A; what is the name of the enrichment broth?

B; describe the colonies

C; what is likely organism

D; what additional test will you do to confirm the isolate?

Answer

a./ alkaline peptone water

b./ the colour changes from green to golden yellow colonies are medium sized,
coma shaped at the microscope, gram negative

c/ vibrio cholera

b./ the addition test are biotyping and serotyping Biotype determined by
chemical reactions

• Biotypes of O1 are classical and Eltor

• Serotypes- inaba, ogawa, hikojima

• antigen –Hikojima( ABC)

Ogawa (A&B)

Inaba ( A&C)

Serogroups-O1

O139

Question 21

The culture results from the patient with UTI infection is seen on the plate labeled
U1, indole test was done the result are seen on the botthe labeled U2.

A; describe the colonies

B; interpret the biochemical result seen on the bottle labeled U2

C; identify the organism to specie level

Answer
a./ whitish, swaming ( its only on blood agar but not CLED due Pynylethyl alcohol
inhibit swaming but enhace isolatin to get pure colonies), small and foul smell

b./ the biochemical results are

-Indole test is negative because no red ring

- motility positive

-Hydrogen sulphide gas production

c./ the organism is Proteus mirabilis

Question 22

The organisms seen on the plate V1 are from the patient with pyelonephritis. The
TSI was done as seen in tube labeled V2, urease test in the bottle V3.

A; describe the colonies

B; interpret TSI and urease results.

C; what are likely organisms

Answer

a./ the colonies have small size, foul smell,, non lactose fermenter with swaming

b./ TSI: black colouration due to utilization of amino acids containing sulphur

-urease positive
- citrate negative

_SIM; motility positive, black ppt are formed due to sulpur production, no indole
production hence no utilization of tryptophan

- The organism is Proteus spp

Question 23

The organisms seen on plate W1 were isolated from the patient from Burn unit,
the TSI result is seen on tube labeled W2, the oxidase was done the result not
given

A; describe the colonies

B; interpret the TSI results

C; what is the oxidase result?

D; what is the genus of the organism isolated

Answer

a./ cream or greenish colonies, medium sized, foul smell, non lactose fermenter

b./ TSI; alkaline slant and alkaline butt

c./ it is oxidase positive

b./ pseudomous spp, the drugs used can be penicillin, Aminoglyceride

Question 24

The stool from the patient with dysentery gave results seen on the plate X1, TSI
on the tube X2 and motility results seen on the bottle X3

A; what is likely organism

B; interpret motility results

C; what is the drug of choice?

Answer

a./ shigella dysenrty

b./ motility test is negative

c./ the drug of choice is Ciprofloxacin

Question 25

The culture of MSU from 23 year old female gave results of significant bactariuria
seen on the plate Y1, indole test is seen on the bottle Y2 and citrate test on the
bottle Y3

A; what is the organism responsible for UTI

B; what is the principle of indole test?

C; what is the drug of choice, if this lady has in ICU for 2 weeks

Answer

a./ E. coli
B./ it involves the indole production after the organism utilize Tryptophan amino
acid by Tryptophanase enzyme released by the organism, the confirmation by
Kovac’s Reagent which is added to the media, so if the indole is present red colour
is formed at the surface.

c./ the drug of choice CARBAPINERM, MEROPENEM and IMEPENEM

Question 26

G; gentamicin sensitive > 12mm

Am; ampicillin sensitive > 20mm

Ci; ciprofloxacin sensitive > 18mm

Ca; ceftazidime sensitive > 20mm

Ac; augmentin sensitive > 20mm

Cf; ceftriaxone sensitive > 20mm

A; interpret susceptibility results seen on the plate labeled Z

B; what is the drug of choice if the patient is 8 years old?

C; what is demonstrated between CRO-AMC-CA

Answer

a./ ceftriaxone

b./ is imepene and ciprofloxacin

b./ its ESBL

Question 27

The sputum from the immunocompetent patient with lobar pneumonia gave
results seen on the plate labeled 1a, TSI is seen on the tube labeled 1b, citrate
test on the bottle 1c and indole on the bottle 1d

A; describe the colonies on the plate 1a

B; interpret the biochemical results

C; what is likely the organism?

Answer

a./ mucoid colonies, lactose fermenter, pink coloured

b/ TSI ; acid butt and acid slant

citrate agar; citrate positive

SIM; indole negative

b./ klebsiella spp

Question 28

The sample labeled E1 was obtained from 25 year old man with swollen ankle
joint. The gram stain is seen on the slide labeled E2.

A; describe what is seen on the slide E1.

B; what is likely specimen? Give one most likely reason

C; what is the the likely organism causing infection in this patient?

Answer

a./ gram positive colonies

b./ pus

c./ staphylococcus aures

Question 29

Media labeled G is selective for the common pathogen causing diarrhea infection
in children from developing countries

A; identify the media labeled G

B; what organism can be grown in this media

C; list 2 component of this media that makes it selective

a./ CCDA agar (charcoal cephaperozone deoxycholate Agar)

b./ campylobacterspp, and Helicobacter

note;Identification test- urease test and Skirrow’s media- it contain

polymixin,vancomycin& septrin

c./ two components are

- cephaperozone

-amphotericin B

- charcoal

- bile salt
Question 30

A; describe the colonies seen on plate labeled S1.

B; is the organism catalase positive or negative?

C; list 3 common diseases that can be caused by the organism

Answer

a./ golden yellow colonies, B hemolysis

b./ it is catalase positive

c./ the 3 common diseases are

_ pyogenic infection such as Endocarditis

-toxic shock syndrome

-food poisoning

Question 31

The 5 year old boy presented with history of blood diarrhea and fever. Stool
sample was taken and inoculated on the broth labeled B1 and then subcultured
on selective agar plate B2.

A; list 2 types of likely broth that can be used

B; why is it necessary to inoculate on broth B1 before subculture

C; describe the colonies seen on the plate B2

Answer

a./broth are – selenite F and Tetrathionate Broth

 • b./ its placed at inoculated at broth B1 since its selective and enriched
media, so Necessity of inoculation in Broth is to inhibit the growth of
other normal flora and to favour the growth of the pathogenic species.

c./ the agar B2 is SSA agar the colonies are Blackish, Non lactose Fermenter

Question 32

The urine sample H2, was obtained from the 25 year old pregnant woman with
lower abdominal pain, using loop it was inoculated on the media labeled H3

A; identify the media labeled H2

B; does this patient has significant bacteriuria

C; what is most likely the organism?

Answer

a./ CLED agar( the contents are bromothymol blue, L-cystine, tryptone, lactose,
powder and peptones)

b./ yes

b./ E. coli, Klebsiella spp and enterobacter

Question 33
A; identify the media labeled Z1

B; how is this media solidified?

C; list 3 components of the media.

a./ L J media

b./ its mainly due to coagulation of eggs albumin

c./ the main contents are

-malachites green, coagulated egg, glycerol, potato flower and mineral salts
such as Nacl,potassium thiosulphate, sodium

Question 34

The throat swab was taken from the patient with sore throat and inoculated on
the plate labeled J. (SXT= co-trimoxazole, BA= bacitracin)

A; describe the colonies

B; what is most likely the organism

C; what is most likely the drug of choice

Answer

a./ Hemolytic colonies,Resistant to septrin and Sensitive to bacitracin

b./ Streptococcus pyogenes

c./ treatment of choice

• Rx- Pen-V mild streptococcal infection

• Severe-X-pen

• Allergy -erythromycin
Question 35

The plate labeled K1 has been inoculated with sputum from the 80 year old
patient with fever and productive cough. OP= optochin

A; what is most likely the organism, give one reason

B; list 2 common other diseases that can be caused by the organism in children

C; how can infection with this organism be prevented

Answer.
a./ since it is Optochin sensitive there for it is Streptococcal pneumoniae

b./ the diseases are Meningitis,Otitis media and Pharyngitis

c./ can be prevented by Vaccine.

But also by the following

• Penicillin/erythromycin

• Severe-Penicillin G

• For PRSP- Vancomycin(penicillin resistant streptococcal pneumoniae)

Question 36

The blood culture from the neonate gave the results seen on the biochemical test
labeled U1, U2, U3, and U4
A; interpret biochemical results?

B; identify the organism isolated from the blood of a neonate

C, what are the principles of biochemical labeled U2

Question 37

The organism seen on the plate V1 are from the CSF from the patient with
meningitis, biochemical test are seen on V1, V2, V3, V4 and V5

A; describe the colonies

B interpret the biochemical results

C; what is likely the organism?

D; what is the most likely age of the patient?

Question 38

The biochemical test of the urine sample from the patient with colicky loin pain
are seen on W1, W2, W3, and W4

A; interpret the results

B; what is the most likely organism

C; what is the principle of W2

D; what is likely the cause of colicky pain?

Answer
a./ H2s produced,Indole –ve ,Urease +ve and Citrate –ve

b/ Proteus mirabilis

c./ TSI principle;

-triple sugar iron contains the following which are ferrous sulphate, glucose 0.1%,
sucrose 1%, and lactose 1%. The agar contains the two main regions which are
slant( well oxygenated) and butt (poorly oxygenated).

- if lactose is fermented so produces large amount of acid that turns the slant and
butt from red to yellow

_if lactose is not fermented, but small amount of glucose, butt will be yellow and
slant will be red ( neutral or alkaline)

-if neither lactose nor glucose is fermented , both butt and slant remains red
(neutral)

-if Hydrogen sulphide is produced, the black color of ferrous sulphate is seen

d./ the cause of colicky pain is Renal stone

Question 39

The swab from the ear of the baby was positive for the organism seen on the
plate Y and biochemical Y1, Y2, Y3 and Y4

A describe the colonies seen on the plate

B; what is most likely the organism

C; mention 2 antibiotics of choice for this patient.

Answer

a./ Colonies- non lactose fermenter, oxidase +ve

b./ Organism; Pseudomonas

c./ antibiotics are

• neomycin

• Gentamycin

• Ticarcillin / piperacillin +gentamycin

Question 40

The susceptibility of staphylococcus aureus isolated from aspirate of the knee

joint is seen plate AA.

A; interpret the results

B; what is likely the mechanism of the resistance,

ans; penicillinase binding protein alteration or B- lactamase protection enzyme

so it binds to the b- lactam ring of penicillin, hence preventing binding of
penicillin to the cell wall of the bacteria.

C; what is the drug of choice?

E; erythromycin S >20mm

Da; clindamycin s >18mm

P; penicillin s >29mm
Ox; Oxacillin s > 18mm

Fox; Cefoxitin s > 23mm

Va; vancomycin s > 15mm

Question 41

The blood culture from the patient with fever is positive for organism seen on the
plate FF, biochemical test are seen on FF1, FF2, FF3 and FF4

A; what is likely organism

B; list 3 other specimens that can be used

C; what is the most like drug of choice in our setting?

D ; how is the organism transmitted?

Answer

a./ salmonella spp

b. / bone marrow, stool and urine

c./ ciprofloxacin and ceftriaxone

d/ is transmitted by fecal oral route.