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American Society of Microbiology ABMM Sample Questions:

1. An elderly patient in a long-term care facility develops a localized outbreak of painful vesicles along a dermatome. Tzanck smear of a vesicle reveals multinucleated giant cells. The MOST likelycausative agent is:

A) Orf virus
B) Herpes simplex virus type 1
C) Coxsackievirus
D) Varicella-zoster virus

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

3. 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) Rhizopus
B) Aspergillus
C) Fusarium
D) Mucor

4. A patient with HIV infection and a low CD4+ T-cell count presents with fever, weight loss, and cough. Chest X-ray shows diffuse interstitial infiltrates. Sputum induction reveals oval yeast cells with narrow-based budding. The MOST likely diagnosis is:

A) Pneumocystis pneumonia
B) Tuberculosis
C) Histoplasmosis
D) Cryptococcosis

5. Microscopic examination of a Calcofluor white stained sputum sample from an immunocompromised patient with suspected invasive pulmonary infection reveals septate hyphae that branch dichotomously at acute (approximately 45°) angles. Conidial structures are observed, showing conidiophores arising from a specialized foot cell, terminating in a flask-shaped vesicle that bears phialides only on the upper two-thirds (uniseriate arrangement). Chains of small, round conidia are produced. This morphology is most characteristic of:

A) Rhizopus arrhizus
B) Aspergillus flavus
C) Aspergillus fumigatus
D) Fusarium solani

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