A 60-year-old patient was hospitalized to the surgical department because of infection caused by blue pus bacillus (Pseudomonas aeruginosa) which is sensative to penicillin antibiotics. Indicate which of the given penicillins has marked activity to the Pseudomonas aeruginosa?

Correct Answer: A

Rationale: The correct answer is A: Carbenicillin disodium. Carbenicillin is a semisynthetic penicillin that has marked activity against Pseudomonas aeruginosa. This is due to its extended spectrum of activity and increased stability against beta-lactamases produced by Pseudomonas aeruginosa. Carbenicillin is commonly used to treat infections caused by this bacterium. Choice B: Benzylpenicillin (Penicillin G) has limited activity against Pseudomonas aeruginosa. Choice C: Methicillin is not effective against Pseudomonas aeruginosa. Choice D: Oxacillin also has limited activity against Pseudomonas aeruginosa. In summary, Carbenicillin is the correct choice due to its marked activity against Pseudomonas aeruginosa compared to the other penicillins listed.

Correct Answer: B

Rationale: The correct answer is B because Q-fever is not transmitted only after ticks bite; it can also be transmitted through inhalation of contaminated aerosols. Rickettsia mooseri and Rickettsia provazekii can cause spotted fevers, making choice A correct. Mediterranean fever is associated with a recurrent pattern of fever, not maculopapular rash, making choice C incorrect. "None of the above" is not correct in this case as choice B is incorrect.

Correct Answer: D

Rationale: The correct answer is D: Helicobacter pylori. Helicobacter pylori is a known bacterium associated with causing duodenal ulcers. The presence of Gram-negative curved bacteria in the biopsy along with a highly positive rapid urease test is characteristic of H. pylori infection. Vibrio cholerae causes cholera, not duodenal ulcers. Campylobacter fetus is associated with gastroenteritis, not duodenal ulcers. Acinetobacter baumannii is a nosocomial pathogen, not typically associated with duodenal ulcers. In summary, the unique combination of findings in this case points towards H. pylori as the most likely cause of the disease.

Correct Answer: A

Rationale: The correct answer is A: Treponema. The characteristics described match Treponema pallidum, the causative agent of syphilis. Treponema has long, spiral shape with 8-12 regular coils. Leptospira (B) is a spirochete but has fewer coils and causes leptospirosis. Borrelia (C) is another spirochete but typically has irregular coils and causes Lyme disease. Vibrios (D) are curved rods and not spirochetes.

Correct Answer: D

Rationale: The correct answer is D: amensalism. Penicillin mold produces a substance that inhibits the growth of bacteria, but it does not benefit nor harm the bacteria directly. This relationship is characterized by one organism (the mold) negatively affecting another (the bacteria) without any benefit or harm to itself. In parasitism (A), one organism benefits at the expense of another. In mutualism (B), both organisms benefit from the relationship. In commensalism (C), one organism benefits while the other is unaffected. Therefore, the mold producing penicillin fits the definition of amensalism.

Correct Answer: A

Rationale: The correct answer is A: TRUE. Poxviruses are indeed DNA viruses that replicate in the cytoplasm. This is due to their complex structure that allows them to carry out their replication process in the cytoplasm of the host cell. Other choices are incorrect because poxviruses specifically replicate in the cytoplasm and do not require the nucleus for replication, ruling out choice B. Choice C is incorrect because poxviruses consistently replicate in the cytoplasm regardless of the situation. Choice D is incorrect as the correct answer is A.

Correct Answer: A

Rationale: Rationale for Correct Answer A (Diphtheria): 1. Thin yellow bacilli with dark brown grains on ends suggest Corynebacterium diphtheriae, characteristic of diphtheria. 2. Roman numeral five shape is typical of diphtheria bacilli. 3. Diphtheria causes sore throat and can spread in boarding schools. 4. Neisser staining method is used for diphtheria bacilli. Summary of Incorrect Choices: B: Scarlet fever is caused by Streptococcus pyogenes and presents with rash, not yellow bacilli. C: Listeriosis is caused by Listeria monocytogenes, not consistent with the described findings. D: Tonsillitis can be caused by various bacteria or viruses, but the specific characteristics described do not match.

Correct Answer: A

Rationale: The correct answer is A: Syphilis. The presentation of painless inguinal lymph nodes, along with a small-sized ulcer with thickened edges and a "laquer" bottom of greyish color on the genital mucous membrane, is classic for primary syphilis. The painless nature of the lymph nodes and the specific characteristics of the ulcer are key features of syphilitic infection. Primary syphilis is caused by the bacterium Treponema pallidum and typically presents with a single, painless ulcer known as a chancre. It is important to consider syphilis in the differential diagnosis of genital ulcers. Summary of other choices: B: Tuberculosis - Unlikely, as tuberculosis typically presents with pulmonary symptoms and does not cause genital ulcers. C: Lepra - Unlikely, as leprosy does not typically present with painless inguinal lymph nodes and the specific ulcer characteristics described. D: Trophic ulcer - Unlikely

Correct Answer: D

Rationale: The correct answer is D, Vancomycin, because it is not a beta-lactam antibiotic. Beta-lactam antibiotics contain a beta-lactam ring in their molecular structure, which Vancomycin lacks. Benzylpenicillin, Cephalosporin, and Monobactam all contain the beta-lactam ring, making them beta-lactam antibiotics. Vancomycin belongs to a different class of antibiotics called glycopeptides.