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: Cell-mediated immunity plays a crucial role in combating infections with intracellular pathogens by activating T cells to directly kill infected cells. Facultative and obligate intracellular pathogens, such as viruses and some bacteria, require cell-mediated immunity for effective clearance. Option A is correct due to the specificity of this immune response. Choices B, C, and D are incorrect as they are primarily associated with humoral immunity involving antibodies and not T cell responses against intracellular pathogens.

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: A

Rationale: The correct answer is A: Cytopathic effect. This is because polioviruses cause visible changes in infected cells, leading to cell damage and death, known as cytopathic effect. This is a key characteristic of viral infection. Choice B (Cytotoxic effect) is incorrect as it refers to the toxicity of a substance to cells, not the specific effect of polioviruses. Choice C (Cytolytic effect) is incorrect as it specifically refers to cell lysis, which is not the primary mechanism of poliovirus infection. Choice D (They Don't Change The Cell Cultures) is incorrect because polioviruses do indeed cause changes in cell cultures due to their cytopathic effect.

Correct Answer: C

Rationale: The correct answer is C: Chronic atrophic rhinitis. This infection is typical for the upper respiratory tract as it affects the nasal mucosa and sinuses. It is characterized by inflammation and atrophy of the nasal mucosa. Psittacosis (A) is a zoonotic infection transmitted from birds, affecting the lungs. Mycoplasma bronchitis (B) is a lower respiratory tract infection caused by Mycoplasma pneumoniae. Legionnaires disease (D) is a severe form of pneumonia caused by Legionella bacteria. Therefore, C is the correct answer as it specifically pertains to the upper respiratory tract.