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: B

Rationale: The correct answer is B: ELISA test for IgM anti-HAV in serum and HAV-Ag in stools. This test is the most reliable for detecting acute hepatitis A infection because IgM antibodies are produced early in the infection, indicating an active infection. Detection of HAV antigen in stools also confirms active viral shedding. A: Western blot assay for IgG anti-HAV in serum is not the most reliable for acute infection detection as IgG antibodies are produced later in the infection and indicate past exposure or immunity. C: ELISA test for IgG anti-HAV in serum is not the most reliable for acute infection detection as IgG antibodies are produced later in the infection and indicate past exposure or immunity. D: None of the above is incorrect as option B is the most appropriate choice for detecting acute hepatitis A infection.

Correct Answer: B

Rationale: The correct answer is B: Vibrio cholerae. Cholera is caused by Vibrio cholerae, a gram-negative bacterium that produces a toxin leading to severe watery diarrhea. Shigella dysenteriae causes dysentery, not cholera. Salmonella enterica causes salmonellosis, not cholera. Clostridium perfringens is associated with food poisoning, not cholera. In summary, Vibrio cholerae is the correct answer because it is the specific bacterium known to cause cholera, while the other choices are associated with different diseases.

Correct Answer: B

Rationale: The correct answer is B: Motility. Bacterial flagella function in providing motility to bacteria, allowing them to move towards nutrients or away from harmful substances. Flagella are long, whip-like appendages that rotate to propel the bacteria through their environment. Incorrect choices: A: Protein synthesis - Bacterial flagella are not involved in protein synthesis. C: Adhesion to surfaces - While some bacteria use flagella for attachment, their main function is not adhesion. D: DNA replication - Flagella do not play a role in DNA replication, which occurs in the bacterial cell's nucleus.

Correct Answer: A

Rationale: Step 1: Gram-negative bacillus indicates P. aeruginosa, known for causing wound infections. Step 2: Semi-transparent mucous colonies of blue-green color with a pearlescent appearance are characteristic of P. aeruginosa. Step 3: Specific odor of violets or jasmine is a unique feature of P. aeruginosa. Therefore, the correct answer is A: P. aeruginosa. Summary: - B: P. vulgaris typically forms yellow colonies and doesn't have the characteristic odor. - C: S. aureus forms creamy white colonies, not blue-green, and has a distinct odor. - D: S. pyogenes forms grayish-white colonies and doesn't have the unique characteristics described.

Correct Answer: A

Rationale: The correct answer is A: Bacterial DNA. PCR analysis detects specific DNA sequences, so a positive result for H. pylori indicates the presence of the bacterial DNA in the gastric biopsy specimen. This method identifies the genetic material of the bacterium, not the bacterium itself (choice C) or its toxins (choice B). Additionally, PCR does not directly detect bacterial enzymes (choice D) but rather focuses on genetic material for accurate identification. Therefore, in this case, the detection of H. pylori in the PCR analysis points to the presence of bacterial DNA, confirming the etiology of peptic ulcer disease.

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.

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: D

Rationale: The correct answer is D because all three bacteria mentioned (Clostridium botulinum, Vibrio cholerae, and Escherichia coli) are capable of producing exotoxins that cause severe diarrhea. Clostridium botulinum produces botulinum toxin leading to botulism, Vibrio cholerae produces cholera toxin causing cholera, and some strains of Escherichia coli produce enterotoxins causing severe diarrhea. Choices A, B, and C alone are incorrect because each of them can produce exotoxins that cause severe diarrhea.