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American Society of Microbiology ABMM Sample Questions:

1. According to the current CDC-recommended laboratory algorithm for diagnosing HIV infection in adults and children aged >18 months, what is the recommended initial screening test?

A) HIV-1/HIV-2 antigen/antibody combination immunoassay
B) HIV-1 p24 antigen assay only
C) HIV-1/HIV-2 antibody differentiation immunoassay
D) HIV RNA nucleic acid test (NAT)

2. A patient with a history of intravenous drug use develops a bloodstream infection with Enterococcus faecalis.
Antimicrobial susceptibility testing reveals resistance to vancomycin. The MOST likely mechanism of vancomycin resistance in Enterococcus involves:

A) Increased expression of efflux pumps that actively transport vancomycin out of the cell.
B) Alteration of the ribosomal target site, preventing vancomycin binding to the ribosome.
C) Production of enzymes that inactivate vancomycin.
D) Modification of the peptidoglycan precursor, reducing vancomycin binding.

3. Histopathological examination of lung tissue from an immunocompromised patient reveals large (8-15 µm), spherical yeast cells with thick, refractile walls and characteristic single, broad-based budding. These findings are most suggestive of infection with:

A) Coccidioides immitis/posadasii
B) Paracoccidioides brasiliensis
C) Histoplasma capsulatum
D) Blastomyces dermatitidis

4. A patient presents with a chronic, non-healing skin ulcer in a tropical region. Microscopic examination of a biopsy reveals amastigotes within macrophages. Culture of the biopsy on Novy-MacNeal-Nicolle (NNN) medium yields flagellated promastigotes. The MOST likely diagnosis is cutaneous leishmaniasis caused by:

A) Leishmania donovani
B) Leishmania tropica or Leishmania major
C) Trypanosoma cruzi
D) Trypanosoma brucei gambiense

5. 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

Solutions: