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American Society of Microbiology ABMM Sample Questions:

1. A patient with HIV infection and a CD4+ T-cell count below 100 cells/µL presents with headache, fever, and altered mental status. CSF analysis reveals elevated protein and low glucose. India ink stain is negative.
Cryptococcal antigen test of the CSF is positive. The MOST appropriate initial treatment is:

A) Fluconazole
B) Caspofungin
C) Voriconazole
D) Amphotericin B and flucytosine

2. A foodborne outbreak is suspected after several individuals who attended a potluck dinner develop nausea, vomiting, and abdominal cramps within 1-6 hours of eating. No fever or diarrhea is reported. The MOST likely bacterial toxin involved is:

A) Shiga toxin
B) Clostridium perfringens enterotoxin
C) Botulinum toxin
D) Staphylococcal enterotoxin

3. A patient with HIV infection and a CD4+ T-cell count of 30 cells/µL develops progressive multifocal leukoencephalopathy (PML). The causative agent of PML is:

A) JC virus (JCV)
B) Epstein-Barr virus (EBV)
C) Cytomegalovirus (CMV)
D) Human herpesvirus 6 (HHV-6)

4. A clinical microbiology laboratory is monitoring the emergence of resistance to colistin in Gram-negative bacteria. Resistance to colistin is often mediated by modifications of the bacterial lipopolysaccharide (LPS).
The genetic basis for acquired colistin resistance most commonly involves:

A) Mutations in genes encoding enzymes that modify the lipid A component of LPS.
B) Alterations in the outer membrane porin proteins, reducing colistin uptake.
C) Production of enzymes that directly inactivate the colistin molecule.
D) Acquisition of genes encoding efflux pumps that specifically target colistin.

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

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