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American Society of Microbiology ABMM Sample Questions:

1. A previously healthy 28-year-old female develops a severe, watery diarrhea after attending a picnic where she consumed potato salad that had been left unrefrigerated for several hours. Stool culture reveals numerous Gram-positive bacilli. Further biochemical testing shows the organism is beta-hemolytic on blood agar and produces a heat-stable enterotoxin. The MOST likely causative agent is:

A) Bacillus cereus
B) Staphylococcus aureus
C) Vibrio cholerae
D) Clostridium difficile

2. A patient with AIDS develops a disseminated fungal infection. Blood cultures grow a yeast that produces pseudohyphae and terminal chlamydospores on cornmeal agar. The patient's CD4+ T-cell count is below 50 cells/µL. The MOST likely causative organism is:

A) Cryptococcus neoformans
B) Pneumocystis jirovecii
C) Candida albicans
D) Aspergillus fumigatus

3. Vancomycin resistance in Enterococcus faecium, mediated by the vanA gene cluster, results from:

A) Enzymatic inactivation of vancomycin by phosphorylation
B) Modification of the drug target from D-alanyl-D-alanine to D-alanyl-D-lactate
C) Efflux pump overexpression removing vancomycin from the cell
D) Decreased outer membrane permeability to vancomycin

4. A patient develops a febrile illness with a diffuse petechial rash after a camping trip. Serological testing reveals a four-fold rise in antibody titer to Rickettsia rickettsii. The vector responsible for transmitting this organism is a:

A) Mosquito
B) Tick
C) Flea
D) Louse

5. Which of the following bacterial genera inherently possesses D-alanyl-D-lactate peptide subunits in its peptidoglycan precursors, conferring natural, high-level resistance to vancomycin?

A) Leuconostoc
B) Streptococcus
C) Staphylococcus
D) Enterococcus (e.g., E. gallinarum, E. casseliflavus carrying vanC)

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