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American Society of Microbiology ABMM Sample Questions:

1. A 30-year-old female who recently returned from a hiking trip in the northeastern United States presents to her physician with a two-week history of a slowly expanding, erythematous rash with central clearing on her thigh. She also reports intermittent fatigue, arthralgias, and mild headache. Serological testing reveals a positive IgM and IgG response to Borrelia burgdorferi. Which of the following mechanisms is MOST significant in the pathogenesis of the clinical manifestations observed in this patient?

A) Intracellular replication within macrophages leading to disseminated infection
B) Evasion of phagocytosis through a thick polysaccharide capsule
C) Production of potent exotoxins leading to direct tissue damage
D) Induction of a strong pro-inflammatory cytokine response by the host

2. A research laboratory is investigating the mechanisms of viral latency in herpes simplex virus type 1 (HSV-
1). During latency in sensory neurons, the viral genome exists as a circular episome. Whichof the following viral gene products is thought to play a crucial role in maintaining this latent state and preventing viral gene expression?

A) Immediate-early (IE) proteins such as ICP4 and ICP27.
B) Late (L) proteins such as structural glycoproteins.
C) Early (E) proteins such as thymidine kinase and DNA polymerase.
D) Latency-associated transcripts (LATs).

3. An immunocompromised patient develops a disseminated fungal infection. Blood cultures are negative, but a serum galactomannan assay is strongly positive. A CT scan of the chest reveals multiple nodular lesions with a halo sign. Bronchoalveolar lavage (BAL) fluid is analyzed by PCR, yielding a positive result for Aspergillus fumigatus. The halo sign observed on the CT scan is primarily attributed to:

A) A hypersensitivity reaction in the lung parenchyma.
B) Extensive granuloma formation surrounding fungal hyphae.
C) Angioinvasion by Aspergillus hyphae leading to localized hemorrhage and necrosis.
D) Formation of thick-walled cysts containing fungal conidia.

4. A patient with a history of chronic sinusitis develops a severe invasive fungal infection involving the nasal sinuses and extending into the orbit. Tissue biopsy reveals broad, aseptate hyphae with irregular branching.
The patient is diabetic and acidotic. The MOST likely causative organism belongs to the genus:

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

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

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