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American Society of Microbiology ABMM Sample Questions:

1. A patient returning from a hiking trip in a Lyme disease-endemic area presents with a unilateral facial nerve palsy, headache, and neck stiffness. Serological testing for Borrelia burgdorferi by ELISA is positive, but a Western blot shows only IgM bands. The MOST appropriate interpretation of these results is:

A) The patient has a co-infection with another tick-borne pathogen causing a non-specific IgM response.
B) The patient has early Lyme disease, and the IgM response is characteristic of recent infection.
C) The patient has chronic Lyme disease with a persistent IgM response.
D) The patient has a false-positive ELISA result, and Lyme disease is unlikely.

2. A research laboratory is investigating the mechanism of action of a novel antiviral compound. In vitro studies demonstrate that the compound effectively inhibits the replication of a specific enveloped RNA virus. Further analysis reveals that the compound does not interfere with viral entry, genome replication, or protein synthesis. However, electron microscopy of infected cells treated with the compound shows an accumulation of viral glycoproteins within the endoplasmic reticulum and Golgi apparatus, with a significant reduction in the release of infectious virions. The MOST likely target of this antiviral compound is:

A) Viral protease responsible for polyprotein cleavage
B) Viral RNA-dependent RNA polymerase
C) Viral glycoprotein trafficking and maturation
D) Host cell membrane fusion machinery

3. A patient with HIV infection and a very low CD4+ T-cell count develops a disseminated infection with a fungus that is commonly found in pigeon droppings. The MOST likely causative agent is:

A) Saccharomyces cerevisiae
B) Cryptococcus neoformans
C) Candida glabrata
D) Cryptococcus gattii

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

5. A patient with a history of chronic lung disease develops a severe pneumonia. Bronchoalveolar lavage fluid reveals the presence of numerous cysts containing multiple nuclei, which stain positively with silver stains but poorly with Gram stain. The patient's CD4+ T-cell count is within the normal range. The MOST likely causative organism and the preferred treatment are:

A) Blastomyces dermatitidis; itraconazole.
B) Pneumocystis jirovecii; trimethoprim-sulfamethoxazole.
C) Paragonimus westermani; praziquantel.
D) Histoplasma capsulatum; amphotericin B followed by itraconazole.

Solutions: