A 10 year old child was subjected to Mantoux test (with tuberculin). 48 hours later a papule up to 8 mm in diameter appeared on the site of tuberculin injection. What type of hyperesponsiveness reaction has developed after tuberculin injection?

Correct Answer: A

Rationale: The correct answer is A: Hyperresponsiveness reaction type IV. This type of reaction, also known as delayed-type hypersensitivity, is characterized by the activation of T lymphocytes and macrophages, leading to inflammation at the site of antigen exposure. In the case of the Mantoux test, the appearance of a papule 48 hours later indicates a delayed hypersensitivity reaction mediated by T cells. Choice B: Reaction of Arthus phenomenon type is incorrect as this type of reaction involves immune complexes forming in the blood vessels leading to tissue damage, which is not the mechanism seen in the Mantoux test reaction. Choice C: Reaction of serum sickness type is incorrect as this type of reaction involves the formation of immune complexes in the blood leading to systemic symptoms like fever, rash, and joint pain, which is not typically seen in the Mantoux test reaction. Choice D: Atopic reaction is incorrect as atopic reactions involve IgE antibodies and mast cell degranulation, which are not the mechanisms

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pyogenes. This bacterium is known to cause sore throat and fever, commonly referred to as strep throat. Gram's stain showing Gram-positive cocci in chains is characteristic of Streptococcus species. Streptococcus pyogenes is a beta-hemolytic bacterium that forms chains and is a common cause of bacterial pharyngitis. Staphylococcus aureus (B) is a Gram-positive cocci that forms clusters, not chains. Neisseria gonorrhoeae (C) is a Gram-negative diplococcus and is not associated with sore throat. Enterococcus faecalis (D) is a Gram-positive cocci that can cause infections but is not typically associated with sore throat.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Adenoviruses are DNA viruses, so choices B and C (ssRNA and DNA) are incorrect. 2. Adenoviruses have a middle-sized, naked icosahedral capsid, making choice A the correct description. 3. Choice D is incorrect as adenoviruses do have specific characteristics, making "None of the above" an inaccurate option. In summary, the correct answer A is supported by the fact that adenoviruses have a middle-sized, naked icosahedral capsid and contain double-stranded DNA. Choices B, C, and D are incorrect as they do not align with the characteristics of adenoviruses.

Correct Answer: A

Rationale: Step 1: Rubella virus belongs to the Togaviridae family, which typically exhibits icosahedral symmetry. Step 2: Icosahedral symmetry refers to a structure with 20 equilateral triangular faces, which is characteristic of many viruses, including rubella. Step 3: Therefore, choice A is correct as rubella virus indeed has icosahedral type of symmetry. Summary: - Choice B is incorrect as rubella virus is an ssRNA virus, not ssDNA. - Choice C is incorrect as rubella virus does have an envelope derived from the host cell membrane. - Choice D is incorrect as rubella virus does have glycoprotein spikes on its surface.

Correct Answer: B

Rationale: The correct answer is B: Enable bacterial adherence to surfaces. Bacterial capsules are a protective layer outside the cell wall that helps bacteria adhere to surfaces and evade host immune responses. This allows bacteria to colonize and infect host tissues. A: Enhancing bacterial motility is typically associated with flagella, not capsules. C: Bacterial DNA replication is not directly affected by capsules. D: Bacterial capsules do play a role in protecting bacteria from desiccation by providing a barrier against drying out. However, the primary function is enabling adherence to surfaces.

Correct Answer: B

Rationale: The correct answer is B: For HIV. Pneumocystis pneumonia in a young man with CD4+ cells less than 200/mm3 is highly suggestive of HIV infection. HIV weakens the immune system, leading to opportunistic infections like pneumocystis pneumonia. Testing for HIV is crucial for diagnosis and appropriate management. Explanation for other choices: A: Testing for ureaplasma urealyticum is not indicated in this case as the symptoms and CD4+ cell count point towards an HIV-related infection. C: Testing for Treponema pallidum (syphilis) is not relevant in the context of a young man with pneumocystis pneumonia and low CD4+ cell count. D: Testing for Neisseria gonorrhoea is not appropriate in this scenario as the symptoms and CD4+ cell count suggest an underlying HIV infection rather than a bacterial sexually transmitted infection.

Correct Answer: A

Rationale: The correct answer is A: Neisser staining method. Neisser staining method is used to stain diphtheria bacilli, which appear as blue rods with thickenings at the poles. The rationale is that Neisser staining specifically targets and highlights the characteristics of the diphtheria bacilli. Incorrect choices: B: Gram staining is not specific for diphtheria bacilli and does not show the characteristic blue rods with thickenings at the poles. C: Ziehl-Neelsen staining is used for acid-fast bacteria like Mycobacterium tuberculosis, not for diphtheria bacilli. D: Loeffler staining is used for diphtheria bacilli but does not produce blue rods with thickenings at the poles as seen in this case.

Correct Answer: A

Rationale: The correct answer is A: Helicobacter pylori. This bacterium is the most likely causative agent of gastric ulcers. Here's the rationale: 1. Helicobacter pylori is commonly associated with gastric ulcers. 2. It is a gram-negative bacterium that grows on chocolate agar and is oxide reductase-positive. 3. The slow growth on the fifth day is characteristic of H. pylori. 4. Campylobacter jejuni and Campylobacter fetus are not typically associated with gastric ulcers. 5. Mycoplasma hominis is a bacterium that lacks a cell wall and is not commonly found in gastric ulcers.

Correct Answer: A

Rationale: The correct answer is A: Entamoeba histolytica. This is because the presence of cysts with four nuclei is characteristic of Entamoeba histolytica, a protozoan parasite that causes amoebic dysentery. Entamoeba histolytica cysts contain four nuclei, distinguishing them from other pathogens. Giardia lamblia and Trichomonas vaginalis are not associated with cysts containing four nuclei. Balantidium coli is a ciliated protozoan that does not typically form cysts with multiple nuclei. In summary, the unique feature of four nuclei in the cysts points towards Entamoeba histolytica as the most likely causative agent of the diarrhea in this patient.