A 23-year old medical student arrives in the student health clinic complaining of difficult in swallowing, sore throat, and chills. Upon examination, she is found to be running a fever and has white patches on her tonsils. A throat swab is positive for streptococcus pyogenes (group A). A diagnosis of acute pharyngitis is made. Her past medical history is unremarkable except an anaphylactic reaction to cefaclor two years ago. Which of the following would be a safe alternative for treating?

Correct Answer: D

Rationale: The correct answer is D: Clindamycin. Clindamycin is a lincosamide antibiotic that is safe to use in patients with a history of anaphylaxis to beta-lactam antibiotics like cefaclor. Clindamycin is effective against streptococcus pyogenes and is a suitable alternative in this case. Amoxicillin (choice A) is a beta-lactam antibiotic similar to cefaclor and may cause a cross-reactive allergic reaction. Meropenem (choice B) is a carbapenem antibiotic and not typically used for acute pharyngitis. Cephalexin (choice C) is a cephalosporin antibiotic and may also cause cross-reactivity in patients with a history of anaphylaxis to cefaclor.

Correct Answer: A

Rationale: The correct answer is A (25-37 °C) because mesophilic bacteria thrive best at moderate temperatures typical of most environments, making 25-37 °C their optimum range. This range allows for optimal enzyme activity and growth. Choice B (55-65 °C) is incorrect as it is more suitable for thermophilic bacteria. Choice C (15-18 °C) is too low for mesophiles to thrive efficiently. Choice D (38-45 °C) is too high and is more suitable for thermophiles. Ultimately, the correct answer aligns with the typical temperature range where mesophilic bacteria are most active and abundant.

Correct Answer: A

Rationale: The correct answer is A: Complex. Poxviruses have a complex nucleocapsid symmetry due to their unique structure with multiple layers of proteins and genetic material. Isohedral symmetry (B) refers to a regular polyhedron shape, which is not characteristic of poxviruses. Helical symmetry (C) is found in viruses like tobacco mosaic virus, not poxviruses. "All of the above" (D) is incorrect because poxviruses do not exhibit isohedral or helical symmetry.

Correct Answer: C

Rationale: The correct answer is C: Fecal enterococcus. In a drugstore setting, finding a fecal-indicative microorganism like fecal enterococcus indicates a potential contamination from fecal matter, which poses a significant health risk. Staphylococcus aureus (Choice A) and α-haemolytic streptococcus (Choice D) are not typically indicative of fecal contamination. Colon bacillus (Choice B) is a common bacterium found in the gut but is not specifically indicative of fecal contamination. Therefore, choice C, fecal enterococcus, is the most appropriate microorganism indicating unsanitary conditions in a drugstore.

Correct Answer: A

Rationale: The correct answer is A: Neisseria meningitidis. This bacterium is a Gram-negative diplococcus commonly associated with meningitis. Neisseria meningitidis is a leading cause of bacterial meningitis in young adults and adolescents. It is known for causing fever, headache, and neck stiffness. The other choices, Streptococcus pneumoniae, Haemophilus influenzae, and Klebsiella pneumoniae, are not typically Gram-negative diplococci and are not commonly associated with the symptoms described. Streptococcus pneumoniae is a Gram-positive coccus, Haemophilus influenzae is a Gram-negative coccobacillus, and Klebsiella pneumoniae is a Gram-negative rod. Therefore, Neisseria meningitidis is the most likely causative agent in this scenario.