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American Society of Microbiology ABMM Sample Questions:

1. Which pattern on a Kirby-Bauer disk diffusion plate, showing resistance of Staphylococcus aureus to erythromycin but susceptibility to clindamycin with a flattening of the clindamycin zone adjacent to the erythromycin disk (D-zone test positive), indicates inducible clindamycin resistance?

A) Indicates the strain should be reported as clindamycin susceptible
B) Indicates the strain possesses an erm gene and should be reported as clindamycin resistant
C) Indicates the strain is tolerant to clindamycin
D) Indicates the strain possesses the msrA gene

2. A patient with a history of neutropenia following chemotherapy develops a severe pneumonia.
Bronchoalveolar lavage fluid reveals the presence of hyaline, septate hyphae with frequent dichotomous branching at acute angles. Culture yields a filamentous fungus that produces conidiophores with a vesicle bearing phialides that release chains of conidia. The MOST likely genus is:

A) Mucor
B) Fusarium
C) Rhizopus
D) Aspergillus

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

4. A patient with a history of travel to a rural area develops a febrile illness with myalgias and thrombocytopenia. Laboratory testing reveals the presence of morulae within circulating leukocytes. The MOST likely diagnosis is:

A) Babesiosis
B) Ehrlichiosis
C) Lyme disease
D) Anaplasmosis

5. Vancomycin resistance in Enterococcus faecium, mediated by the vanA gene cluster, results from:

A) Enzymatic inactivation of vancomycin by phosphorylation
B) Modification of the drug target from D-alanyl-D-alanine to D-alanyl-D-lactate
C) Decreased outer membrane permeability to vancomycin
D) Efflux pump overexpression removing vancomycin from the cell

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