A 16-year-old boy from the rural area entered the technical school. During a regular Mantoux test, it turned out that this boy had a negative reaction. What tactics should the doctor choose as the most rational in this case?

Correct Answer: D

Rationale: The correct answer is D: BCG vaccination. BCG vaccination is recommended for individuals with a negative Mantoux test result, especially in countries where tuberculosis is prevalent. This vaccination can help provide protection against tuberculosis. Choice A is incorrect because repeating the Mantoux test in a month is unnecessary since the boy already had a negative reaction. Choice B is incorrect as serodiagnosis of tuberculosis is not the first-line approach for diagnosis, especially in this scenario. Choice C is incorrect because urgent isolation is not necessary based solely on the Mantoux test result. Isolation is typically reserved for individuals with active tuberculosis.

Correct Answer: A

Rationale: The correct answer is A: Bacillus anthracis. The black, painless carbuncle with peripheral vesicular rash is characteristic of cutaneous anthrax. Microscopy showing non-motile Gram-positive rods with a capsule aligns with Bacillus anthracis. The other choices can be eliminated: B: Staphylococcus aureus does not typically form a black lesion or have a capsule. C: Clostridium perfringens causes gas gangrene, not the described lesion. D: Bacillus subtilis is not associated with the specific clinical presentation mentioned.

Correct Answer: C

Rationale: Rationale: Choice C is correct because Staphylococcus epidermidis, Escherichia coli, and Enterococcus spp. are common causative agents of nosocomial infections due to their presence on the skin, in the gut, and in healthcare settings. S. aureus and L. monocytogenes (Choice A) are also important pathogens but are less common in nosocomial infections. Enterobacteriaceae (Choice B) are a large family of bacteria that can cause infections but are not as commonly associated with nosocomial infections compared to the organisms in Choice C. The correct answer (Choice C) encompasses pathogens commonly found in healthcare settings, making it the most suitable option.

Correct Answer: C

Rationale: The correct answer is C: Obligate anaerobes. These bacteria cannot survive in the presence of oxygen as they lack the necessary enzymes to detoxify reactive oxygen species. Obligate aerobes (A) require oxygen, facultative anaerobes (B) can grow with or without oxygen, and aerotolerant anaerobes (D) can survive in the presence of oxygen but do not utilize it for growth.

Correct Answer: B

Rationale: The correct answer is B: Borrelia burgdorferi. Borrelia burgdorferi is the bacteria responsible for causing Lyme disease. It is transmitted to humans through the bite of infected black-legged ticks. Treponema pallidum causes syphilis, Leptospira interrogans causes leptospirosis, and Rickettsia rickettsii causes Rocky Mountain spotted fever. Borrelia burgdorferi is specifically associated with Lyme disease due to its transmission through tick bites and the characteristic symptoms it causes.

Correct Answer: D

Rationale: The correct answer is D because antigens can be composed of lipids, proteins, or polysaccharides. Antigens are molecules that can elicit an immune response in the body. They can be diverse in their chemical composition, leading to the recognition and response by the immune system. Therefore, the correct choice is D as antigens can be any of these chemical components. Choices A, B, and C are incorrect because they each represent a possible chemical composition of antigens, but the flexibility of antigens to be made up of any of these components makes D the most accurate choice.

Correct Answer: B

Rationale: The correct answer is B: IgM. IgM antibodies are the first type of antibodies produced in response to an infection, indicating an active or recent infection. In the case of a rubella virus infection in a fetus, IgM antibodies can be detected in the umbilical cord blood, confirming the presence of the virus. IgA antibodies are mainly found in mucosal areas, IgG antibodies indicate past infection or immunity, and IgD antibodies play a role in B cell activation but are not typically detected in this context.

Correct Answer: A

Rationale: The correct answer is A: Picornaviridae. Picornaviruses, such as enteroviruses, are commonly found in the feces of infected individuals. Therefore, their presence in water indicates fecal contamination and the need for additional purification. B: Herpesviridae are not typically associated with fecal contamination. C: Flaviviridae are mainly transmitted through arthropods like mosquitoes, not fecal contamination. D: Retroviridae, including HIV, are not typically excreted in high levels in feces and are not indicators of fecal contamination.

Correct Answer: C

Rationale: The correct answer is C: High amount of mycolic acids. Mycobacteria are characterized by their unique cell wall composition, which includes a high amount of mycolic acids. Mycolic acids provide the bacteria with resistance to environmental stresses and are crucial for their pathogenicity. Polysaccharides (A) are not a prominent component of mycobacterial cell walls. While lipids (B) are present in mycobacterial cell walls, mycolic acids are the predominant lipid. Proteins (D) are also present but are not the defining feature of mycobacterial cell walls. Therefore, the correct answer is C due to the significant role mycolic acids play in the structure and function of mycobacterial cell walls.