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American Society of Microbiology ABMM Sample Questions:

1. The azole class of antifungal agents (e.g., fluconazole, voriconazole) exerts its effect primarily by inhibiting which fungal-specific enzyme involved in membrane synthesis?

A) Chitin synthase
B) Squalene epoxidase
C) Lanosterol 14-alpha-demethylase
D) Beta-(1,3)-glucan synthase

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

3. Acyclovir is a commonly used antiviral agent effective against Herpes Simplex Virus (HSV) and Varicella- Zoster Virus (VZV). Its selective toxicity relies on which initial step for activation within infected cells?

A) Direct inhibition of viral RNA polymerase activity
B) Monophosphorylation primarily by viral thymidine kinase
C) Phosphorylation by host cell mitochondrial kinases
D) Blocking viral entry through competitive inhibition of cellular receptors

4. An immunocompromised patient develops a disseminated fungal infection. Blood cultures are negative, but a serum galactomannan assay is strongly positive. A CT scan of the chest reveals multiple nodular lesions with a halo sign. Bronchoalveolar lavage (BAL) fluid is analyzed by PCR, yielding a positive result for Aspergillus fumigatus. The halo sign observed on the CT scan is primarily attributed to:

A) Formation of thick-walled cysts containing fungal conidia.
B) A hypersensitivity reaction in the lung parenchyma.
C) Angioinvasion by Aspergillus hyphae leading to localized hemorrhage and necrosis.
D) Extensive granuloma formation surrounding fungal hyphae.

5. In a clinical microbiology laboratory, quality control testing of Mueller-Hinton agar used for disk diffusion susceptibility testing involves checking the zone sizes for E. coli ATCC 25922, S. aureus ATCC 25923, and
P. aeruginosa ATCC 27853. What is the primary purpose of including P. aeruginosa ATCC 27853 in this QC?

A) To assess the performance of agents primarily active against Gram-positive organisms
B) To verify the performance of cell wall active agents like penicillin
C) To confirm the correct pH of the agar medium
D) To ensure appropriate concentration of calcium and magnesium ions affecting aminoglycoside activity

Solutions: