A 16-year-old adolescent was vaccinated with DTP. In eight days there was stiffness and pain in the joints, subfebrile temperature, urticarial skin eruption, enlargement of inguinal, cervical lymph nodes and spleen. What kind of allergic reaction is observed?

Correct Answer: D

Rationale: The correct answer is D: Hypersensitivity of delayed type. The symptoms described occur 5-10 days after exposure to the antigen, consistent with a delayed hypersensitivity reaction. This type of reaction involves T cells and is characterized by cell-mediated immune response, leading to inflammation and tissue damage. Choices A, B, and C are incorrect because they are associated with different mechanisms of allergic reactions. Immunocomplex reactions (choice A) involve antigen-antibody complexes depositing in tissues, immediate hypersensitivity reactions (choice B) involve IgE-mediated mast cell degranulation, and cytotoxic reactions (choice C) involve antibodies targeting specific cells for destruction.

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: Polyclonal antibodies are produced by different B cells, each recognizing a different epitope on an antigen. Therefore, they can respond to multiple antigens. This diversity in recognition allows polyclonal antibodies to bind to various targets, making option A true. Options B, C, and D are incorrect as they do not accurately reflect the nature of polyclonal antibodies' ability to recognize multiple antigens.

Correct Answer: A

Rationale: The correct answer is A: Pseudomonas aeruginosa. P. aeruginosa is a Gram-negative rod that is a lactose non-fermenter commonly associated with deep tissue infections. It is an opportunistic pathogen known for its ability to cause infections in immunocompromised individuals. P. aeruginosa is often resistant to multiple antibiotics and can form biofilms, making it difficult to treat. Summary of why other choices are incorrect: B: Escherichia coli is a Gram-negative rod that ferments lactose and is commonly found in the gastrointestinal tract. It is not typically associated with deep tissue infections. C: Salmonella typhi is a Gram-negative rod that causes typhoid fever, primarily affecting the gastrointestinal system, not deep tissue infections. D: Shigella dysenteriae is a Gram-negative rod that causes bacillary dysentery, which primarily affects the gastrointestinal tract and does not typically cause deep tissue infections.

Correct Answer: B

Rationale: The correct answer is B: Mycobacterium leprae. This microorganism can only be cultured in the footpads of mice or a species of armadillo due to its specific growth requirements. Mycobacterium tuberculosis (choice A) can be cultured in various culture media in the laboratory. Neisseria gonorrhoeae (choice C) can be cultured on selective media like Thayer-Martin agar. Mycoplasma (choice D) can be cultured in cell cultures or specialized media. Therefore, the unique growth pattern of Mycobacterium leprae makes it the correct answer.

Correct Answer: D

Rationale: The correct answer is D because there is specific prophylaxis available for influenza, such as the flu vaccine. Choice A is incorrect as influenza viruses are not spherical, they are typically pleomorphic. Choice B is incorrect because hemagglutinin and neuraminidase are indeed antigenically variable, contributing to the need for annual flu vaccines. Choice C is incorrect as the susceptibility of the population to influenza viruses can vary depending on factors such as immunity and vaccination status.

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. This bacterium is the most likely causative agent based on the description of Gram-positive cocci in pairs with a capsule. S. pneumoniae is known for its characteristic morphology and the presence of a capsule, which helps in evading the immune system. It commonly causes pneumonia, especially in patients with a productive cough and fever. Incorrect choices: B: Klebsiella pneumoniae typically presents with a mucoid capsule and is associated with pneumonia in immunocompromised individuals. C: Neisseria meningitidis is a Gram-negative diplococcus and is more commonly associated with meningitis and septicemia. D: Staphylococcus aureus is a Gram-positive cocci, but it does not typically present in pairs with a capsule and is more commonly associated with skin and soft tissue infections.

Correct Answer: A

Rationale: The correct answer is A: yeast and molds. Yeast and molds can resist acidic pH due to their ability to maintain a stable internal pH through various mechanisms such as ion transport and cell wall composition. Bacteria, including E. coli, are generally more sensitive to acidic conditions. Choice D is incorrect as yeast and molds are known to thrive in acidic environments.

Correct Answer: D

Rationale: The correct answer is D: Chocolate agar. Neisseria meningitidis is a fastidious organism that requires enriched media for growth. Chocolate agar contains heat-treated blood that provides essential nutrients for the growth of N. meningitidis. The other choices, A: Levine agar, B: Lowenstein-Jensen agar, and C: TCBS agar, do not provide the specific nutrients required for the growth of N. meningitidis. Therefore, only choice D, Chocolate agar, supports the growth of N. meningitidis due to its enriched composition.