| The colonies shown in the blood agar (upper) and MacConkey agar (lower) biplate are a 24 hour growth from an aerobic blood culture bottle that became positive at 12 hours after inoculation. The appearance of the colonies on MacConkey agar rules out the following two bacterial species: | View Page |
| The reactions seen in the portion of the API strip shown in the photograph, effectively rules out Escherichia coli. | View Page |
| Clinical isolates of Escherichia coli and Klebsiella pneumoniae may possess ESBL activity. Therefore, clinical laboratories should be screening all clinically significant isolates of these two species. | View Page |
| ESBL Activity Illustrated is the picture of the surface of a disk diffusion test including a ceftazidime disk (left) and a combintation ceftazidime/clavulanic acid disk (right).Observe in the photograph that the zone of inhibition around the the combination ceftazidime/clavulanic acid disk (right) is at least 5 mm larger than around the clavulanic acid disk (left).This observation that the presence of clavulanic acid, a beta-lactamase inhibitor, has resulted in such a large increase in the zone of inhibition indicates that an extended spectrum beta lactamase (ESBL)is being produced.When an organism is producing an ESBL, the susceptibility to individual cephalosporins cannot be predicted, thus requiring that each drug must be tested individually.It may be important to detect ESBL-producing stains of K. pneumoniae and E. coli as treatment failure may occur if the wrong cephalosporin is selected. | View Page |
| Extended Spectrum Beta Lactamases In follow-up to the observations of the ESBL screening test, the following antibiotic susceptibility profile was later reported:
Ampicillin = R;
Cefazolin = R;
Cefoxitin 1 = S;
Ciprofloxacin 0.25 = S;
Gentamicin 1 = S;
Ceftazidime 32 = R;
Imipenem The susceptibility of the 2nd generation drug cefoxitin, with resistance of the 1st generation cefazolin and the 3rd generation ceftazidime, is another way in addition to the screening test in which ESBL activity may be detected.
It is recommended that clinical microbiologists check the antibiotic susceptibility profiles for possible ESBL activity of clinically significant isolates of K. pneumoniae and E. coli.Most automated systems have built in methods for automatically detecting an ESBL isolate, or provide an "alert" that such a strain may be present. | View Page |
| The ELISA method may be used to detect: | View Page |
| The avoidance of laboratory diagnosis techniques that utilize water is recommended for the identification of which of these parasites? | View Page |
| A specimen suspected of containing which organism may be cultured by placing it on an agar plate seeded with gram negative rods? | View Page |
| This suspicious form, recovered from a stool sample, measures 30 µm in diameter. | View Page |
| This suspicious form, seen in a stool sample, measures 10 µm in diameter. | View Page |
| This suspicious form measures 13 µm and was recovered from a stool sample. | View Page |
| This suspicious form, found in a stool sample, measures 15 µm. | View Page |
| Recovered in a stool sample, this suspicious form measures 7 µm. | View Page |
| This suspicious form, found in stool, measures 25 µm. | View Page |
| This suspicious form, found in stool, measure 10 µm. | View Page |
| This suspicious form, which was recovered in stool specimen and measures 32 µm, is responsible for which of the following diseases? | View Page |
| Match each pictured parasite with its corresponding associated condition: | View Page |
| Entamoeba, Endolimax, and Iodamoeba are members of which of subphylum? | View Page |
| Which of the following parasites typically survive human stomach juices? | View Page |
| The protozoa are classified and placed in groups based on which of the following criteria? | View Page |
| Match each protozoal trophozoite listed below with its corresponding pictured cyst form: | View Page |
| Match each amebic cyst listed here with its respective trophozoite form pictured: | View Page |
| Match each parasite listed here with its corresponding optimal specimen type from which it may be recovered: (Answers may be used more than once.) | View Page |
| Which of the following parasites resembles Entamoeba histolytica but lack ingested red blood cells in the trophozoite form? | View Page |
| Match each parasite listed here with its respective means of locomotion: (Answers may be used more than once.) | View Page |
| The largest protozoan known to infect humans is: | View Page |
| The nuclei of which of the following parasites lack peripheral chromatin? | View Page |
| Arrange these parasites in order by general relative size from smallest to largest: | View Page |
| Match each parasite listed here with its corresponding typical nuclear appearance: | View Page |
| Match each pair of parasites listed here with the key morphologic characteristics that help to distinguish between them: | View Page |
| Arrange the following parasites in decreasing order (from large to small) based on relative size: | View Page |
| Match each parastie with the most common maximum number of nuclei present in the mature cyst form: (Answers may be used more than once.) | View Page |
| Label the morphologic structures on this parasite form: | View Page |
| Label the morphologic structures on this parasite form: | View Page |
| A 43 year old female presented to her doctor for a routine check-up. Her only complaint was that she had been experiencing watery stools that occasionally contained pus and blood. Examination revealed tenderness in her abdomen. A stool for parasite study was sent to the lab. Two suspicious forms were seen. The oblong form on measured 53 µm by 60 µm whereas the rounder form measured 45 µm by 37 µm. Use the pulldown boxes to identify each picture: | View Page |
| A 12 year old female went to her doctor for her yearly back-to-school check-up. She was in good health and was asymptomatic at the time of the examination. Due to the increased incidence of parasites in the area, the doctor ordered a stool for parasite examination as part of the routine physical testing. Multiple suspicious forms, measuring approximately 9 µm each were seen. Which of the following is most likely the identification of these forms? | View Page |
| A 17 year old female went to her doctor complaining of diarrhea. With the exception of seasonal allergies, she was in relatively good health. Patient history was unremarkable. A stool was submitted for culture and parasite examination. The culture was reported out as "no enteric pathogens isolated." This suspicious form was seen on wet preparation and permanent stain. It measures 27 µm. This patient is most likely suffering from which of the following conditions: | View Page |
| A stool was received in the laboratory for parasitic examination on a 49 year old female who just returned from missionary work in numerous third world countries around the world. The patient had been suffering from mild diarrhea over the past two weeks. These two suspicious forms were seen. Form 1 measures a mere 6 µm whereas form 2 measures 35 µm. Label these two forms: | View Page |
| I measure 15 µm and am found in stool. | View Page |
| I reside in the mouth where, when present, I measure approximately 17 µm. | View Page |
| I measure 12 µm and am found in stool. | View Page |
| I am found in stool and may be easily mistaken for "junk." I measure 12 µm. | View Page |
| I am 12 µm in size and reside in stool. I may be easily missed since I tend to "blend-in" with fecal debris. | View Page |
| I measure 45 µm and am found in stool. | View Page |
| I am found in stool and measure 45 µm. | View Page |
| The Enterotest may be used to recover which of the following parasites? | View Page |
| Match each amebic cyst with its respective name: | View Page |
| This suspicious form, which measures 20 µm, was recovered in sigmoidoscopic material. Name that parasite! | View Page |