A 43 y.o. patient was admitted to the hospital with complaints of high temperature of the body and severe headache. On examination: carbuncle is revealed on the forearm. There are intense edema around it, insignificant pain, regional lymphadenitis. The patient is a worker of cattle-ranch. What disease is it necessary to think about first?

Correct Answer: D

Rationale: The correct answer is D: Erysipeloid. Erysipeloid is a bacterial infection caused by Erysipelothrix rhusiopathiae commonly found in animals like cattle. The patient's occupation as a cattle-ranch worker puts them at risk for this infection. Symptoms such as high body temperature, severe headache, carbuncle on the forearm with edema, and regional lymphadenitis are typical of erysipeloid. Anthrax (A) is more associated with skin lesions and severe systemic symptoms. Carcinoma of skin (B) presents differently with slow-growing skin lesions. Erysipelas (C) is a different bacterial infection characterized by red, swollen patches on the skin.

Correct Answer: C

Rationale: The correct answer is C: Polar placement of volutin granules. This feature is indicative of Corynebacterium diphtheria. Volutin granules are metachromatic granules found in the polar region of the bacterial cell, which is characteristic of this species. This feature helps differentiate it from other bacteria. Explanation: A: Fence-like position of the agent's cells is not a specific morphologic feature of Corynebacterium diphtheria. B: Spores that exceed cells in diameter is not a characteristic feature of Corynebacterium diphtheria. D: Presence of the capsule is not a distinguishing morphologic feature of Corynebacterium diphtheria. In summary, the polar placement of volutin granules is the most indicative feature for determining the type of agent as Corynebacterium diphtheria, making it the correct choice.

Correct Answer: A

Rationale: The correct answer is A: Neisseria meningitidis. This bacterium is a Gram-negative diplococcus commonly associated with meningitis. The patient's symptoms of fever, headache, and neck stiffness are classic signs of meningococcal meningitis. Neisseria meningitidis is known to cause outbreaks in crowded settings. Streptococcus pneumoniae (Choice B) is a common cause of bacterial meningitis but typically appears as Gram-positive cocci. Haemophilus influenzae (Choice C) can also cause meningitis but is more commonly seen in unvaccinated children. Klebsiella pneumoniae (Choice D) is a Gram-negative bacterium but is not a typical causative agent of meningitis.

Correct Answer: B

Rationale: The correct answer is B: focal. When a pathogen spreads from the original site to other tissues or organs, it is considered a focal infection. This term specifically refers to an infection that is localized to a specific area but can spread to other parts of the body. A: Local infection refers to an infection that is confined to a specific area without spreading to other tissues or organs. C: Natural is not a term commonly used to describe the spread of pathogens within the body. D: Acute refers to the rapid onset of a disease but does not specifically address the spread of pathogens from one site to another. In summary, the term "focal" best describes the scenario provided in the question, making it the correct answer.

Correct Answer: A

Rationale: The Burri-Gins staining technique is used to identify the presence of capsules around bacteria. Capsules are protective structures that some bacteria produce to evade the immune system. This technique stains the capsule, making it visible under a microscope. Therefore, the correct answer is A: Capsule formation. Incorrect: B: Spore formation - Spores are not typically identified using the Burri-Gins staining technique. C: Acid resistance - This property is not specifically identified by Burri-Gins staining. D: Alkali resistance - This property is not specifically identified by Burri-Gins staining.

Correct Answer: B

Rationale: The correct answer is B because the presence of calcium dipicolinate in bacterial spores helps protect their DNA from damage under harsh conditions. Calcium dipicolinate acts as a stabilizer, preserving the spore structure. Choice A is incorrect as bacterial spores have a tough protein coat, not a lipid-rich membrane. Choice C is incorrect as bacterial spores have very low metabolic activity. Choice D is incorrect as bacterial spores have low water content to prevent damage during harsh conditions.

Correct Answer: A

Rationale: The correct answer is A: Oxacillin. In AST for Gram-positive bacteria, the antibiotic panel typically includes oxacillin to determine if the bacterium is susceptible or resistant to beta-lactam antibiotics. Oxacillin is commonly used to test for methicillin resistance in Staphylococcus aureus. Tetracycline (B), Tobramycin (C), and Amikacin (D) are not typically included in the Gram-positive antibiotic panel. Tetracycline is more commonly used for Gram-negative bacteria, while Tobramycin and Amikacin are aminoglycosides usually tested in Gram-negative bacterial infections. Therefore, they are not appropriate choices for the Gram-positive antibiotic panel.

Correct Answer: B

Rationale: The correct answer is B: Salmonellosis. The description of microorganisms resembling a tennis racket indicates the presence of Salmonella typhi, which causes salmonellosis. Salmonella bacteria can appear like tennis rackets under a microscope due to their flagella. Botulism (A) is caused by Clostridium botulinum, which does not resemble a tennis racket. Cholera (C) is caused by Vibrio cholerae, which appears as curved rods under the microscope. Dysentery (D) is usually caused by bacteria like Shigella or Entamoeba histolytica, which do not resemble tennis rackets.

Correct Answer: D

Rationale: The correct answer is D because the flu vaccine mainly stimulates systemic immunity, not local immunity. Systemic immunity refers to the immune response throughout the body, while local immunity is specific to a certain area. Choice A is incorrect because the flu vaccine is indeed recommended. Choice B is incorrect as the flu vaccine can be a subunit vaccine, containing only specific antigens. Choice C is incorrect as the flu vaccine is typically administered parenterally, meaning through injection, nasal spray, or oral routes.