A 38-year-old male complains of tonic tension of the masticatory muscles, so that he cannot open his mouth. 12 days before, he was bitten by an unknown dog. Objectively: there is pronounced tension and twitching of the masticatory muscles. What is the most likely diagnosis?

Correct Answer: A

Rationale: The correct answer is A: Tetanus. The symptoms of tonic tension of the masticatory muscles following a dog bite are indicative of tetanus, caused by the bacterium Clostridium tetani. The incubation period of tetanus is usually 3-21 days, consistent with the patient's history of being bitten 12 days ago. Tetanus toxin causes muscle stiffness and spasms, leading to the inability to open the mouth. Rabies (B) presents with hydrophobia and neurological symptoms. Hysteria (C) is a psychological condition. Trigeminal neuralgia (D) is characterized by severe facial pain, not muscle stiffness.

Correct Answer: A

Rationale: The correct answer is A: Mycolic acid. Ziehl-Neelsen method is used to stain acid-fast bacteria, such as Mycobacterium species. Mycolic acid in the cell wall of these bacteria resists decolorization, leading to red-colored bacilli on a blue background. Capsule, flagella, and endospores do not play a role in this staining property. Capsules are usually stained using special techniques, flagella are not typically visible with this stain, and endospores are stained using the Schaeffer-Fulton method.

Correct Answer: D

Rationale: The correct answer is D: All are correct. Culture of samples from the respiratory tract can identify specific pathogens, Immunofluorescence can detect viral antigens, and PCR can amplify and detect specific DNA/RNA sequences. Using all methods together provides a comprehensive approach for diagnosing respiratory tract infections. Culture alone may miss fastidious organisms, Immunofluorescence has limitations in sensitivity, and PCR requires specific primers. Therefore, combining these methods increases the likelihood of accurate diagnosis by covering a range of pathogens and improving sensitivity and specificity.

Correct Answer: A

Rationale: The correct answer is A: Sabouraud. Sabouraud agar is specifically designed for the cultivation of fungi and yeasts, making it ideal for identifying Candida species causing candidosis. It contains antibiotics to inhibit bacterial growth, promoting the growth of fungi. Endo, Loewenstein-Jensen, and Roux are not suitable for fungal cultures and are used for different purposes like bacterial isolation or mycobacterial cultures. Sabouraud agar is the best choice for confirming candidosis due to its fungal-selective properties.

Correct Answer: B

Rationale: The correct answer is B: 3.5 to 4.0 billion years. This range aligns with the oldest known fossils of prokaryotes found in ancient rocks. Fossils dating back to this time period provide evidence of early life forms on Earth. Choices A, C, and D are incorrect because they fall outside the established timeline based on scientific evidence and fossil records. A (4.0 to 5.0 billion years) is too early for the oldest prokaryote fossils, as it predates the formation of Earth's atmosphere suitable for life. C (2.5 to 3.0 billion years) and D (2.2 to 2.7 billion years) are too recent for the oldest prokaryote fossils, as life is believed to have originated much earlier.

Correct Answer: A

Rationale: The correct answer is A: Corynebacterium diphtheriae. The presence of rod-shaped bacteria with dark blue polar granules suggests the presence of Corynebacterium diphtheriae, the causative agent of diphtheria. This bacterium is known for causing sore throat and fever, and the characteristic appearance on smear helps identify it. Streptococcus pyogenes (Choice B) typically appears as chains of cocci and is associated with strep throat. Haemophilus influenzae (Choice C) is a small, pleomorphic Gram-negative coccobacillus and is more commonly associated with respiratory infections. Klebsiella pneumoniae (Choice D) is a Gram-negative bacillus and is not typically associated with sore throat and fever in children.

Correct Answer: B

Rationale: The correct answer is B: non-spore forming encapsulated gram-negative bacterium. Francisella tularensis is a non-spore forming bacterium, which rules out choices A and D. It is encapsulated, which eliminates choice C. The encapsulation of the bacterium helps it evade the host immune system, leading to its pathogenicity. This encapsulated bacterium is responsible for causing the zoonotic disease tularemia in humans.

Correct Answer: D

Rationale: Step 1: Formic acid is produced during fermentation by Actinomyces. Step 2: Actinomyces are known to produce organic acids like formic acid through fermentation. Step 3: Other choices like Streptococcus, Klebsiella, and Clostridium are not typically associated with formic acid production. Step 4: Actinomyces is the most likely candidate based on its fermentation capabilities. Summary: Actinomyces is the correct answer because it is known to produce formic acid during fermentation, while the other choices lack this specific metabolic function.

Correct Answer: C

Rationale: The correct answer is C: cytoplasmic membrane. The cytoplasmic membrane is the fluidlike portion of a cell that separates the cell's contents from the external environment. It regulates the passage of substances in and out of the cell, maintains cell shape, and provides protection. Rationale: 1. Cytosol (choice A) is the liquid component of the cytoplasm where organelles are suspended, not the fluidlike portion of the cell. 2. Nucleoplasm (choice B) refers to the liquid component of the nucleus, not the entire cell. 3. Inclusion (choice D) refers to non-living substances within the cell that are not considered the fluidlike portion. Summary: The cytoplasmic membrane is the correct answer as it encompasses the entire cell and is responsible for maintaining cell integrity and regulating transport. Choices A, B, and D are incorrect as they do not represent the fluidlike portion of the cell.