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: C

Rationale: The correct answer is C: Treatment. Tularin is a specific immunizing agent used for the treatment of tularemia. The purpose of tularin administration in this patient is to provide a targeted treatment against the suspected tularemia infection. It helps the patient's immune system to recognize and fight against the bacteria causing the disease. Explanation for other choices: A: Allergy diagnostics - Tularin is not used for allergy diagnostics, as it is specifically indicated for tularemia treatment. B: Prognosis for the disease - Tularin is not used to predict the outcome of the disease but rather to treat the infection. D: Treatment evaluation - Tularin is not used for evaluating the effectiveness of treatment but for actively treating the tularemia infection.

Correct Answer: A

Rationale: The correct answer is A: Clostridia. Fusiform spore-forming microorganisms that stain violet-blue with Gram's stain are characteristic of Clostridia. Clostridia are anaerobic, rod-shaped bacteria known for their ability to form spores and cause diseases such as tetanus and botulism. Summary of other choices: B: Streptococci are spherical, not fusiform, and typically do not form spores. C: Spirochaete are spiral-shaped bacteria and do not typically form spores. D: Actinomycete are filamentous bacteria that do not typically form spores and do not stain violet-blue with Gram's stain.

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: 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.

Correct Answer: C

Rationale: The correct answer is C: S.aureus. Stomatitis is commonly caused by S.aureus due to its ability to form clusters of oval polymorphous Gram-positive microorganisms. S.aureus is known to colonize the oral mucous membrane and can cause infections, especially after prolonged antibiotic use. Explanation for other choices: A: С.albicans - Candida albicans is a fungus commonly associated with oral thrush, not typically causing stomatitis. B: C.perfringens - Clostridium perfringens is a bacterium associated with food poisoning and gas gangrene, not commonly causing stomatitis. D: S.pyogenes - Streptococcus pyogenes is known to cause strep throat and skin infections, but not typically associated with stomatitis.

Correct Answer: A

Rationale: The correct answer is A: Binding of IgE fixed to the mast cells. The Bezredka method involves injecting small, gradually increasing doses of the antigen (tetanus toxoid) to desensitize the body and prevent anaphylactic shock. This process works by binding the IgE antibodies fixed to mast cells, thereby reducing the release of allergic mediators like histamine. This prevents the cascade of events that lead to anaphylactic shock. Choice B (Blocking the mediator synthesis in the mast cells) is incorrect because the Bezredka method does not block mediator synthesis but rather prevents the release of mediators by binding IgE. Choice C (Stimulation of immune tolerance to the antigen) is incorrect as the Bezredka method does not primarily focus on inducing immune tolerance but rather on preventing anaphylactic reactions. Choice D (Stimulation of the synthesis of antigen-specific IgG) is incorrect because the Bezredka method targets IgE antibodies on mast cells

Correct Answer: C

Rationale: The correct answer is C: Direct flaming. Direct flaming is the simplest heat-related method to sterilize metal because it involves passing the metal through a flame to kill microorganisms. The high temperature of the flame effectively destroys any bacteria or spores present on the metal surface. Incineration (A) is not practical for sterilizing metal as it involves burning at extremely high temperatures. Autoclaving (B) uses steam under pressure to sterilize, which is effective but more complex than direct flaming. Indirect heating (D) is not an effective method for sterilizing metal as it does not directly expose the metal to high temperatures required for sterilization.

Correct Answer: B

Rationale: The correct answer is B: dermis. The papillary layer is located in the dermis, specifically at the junction with the epidermis. It contains capillaries, lymphatics, and sensory receptors, contributing to the skin's strength and elasticity. The epidermis (choice A) is the outermost layer of the skin, while the hypodermis (choice C) and subcutaneous layer (choice D) are deeper layers beneath the dermis, primarily composed of fat cells and connective tissue. Therefore, the papillary layer is part of the dermis, making choice B the correct answer.