A blood culture from a patient with sepsis revealed Gram-negative diplococci. The organism was oxidase-positive and fermentative. What is the most likely causative agent?

Correct Answer: B

Rationale: The correct answer is B: Neisseria meningitidis. This is because Neisseria meningitidis is a Gram-negative diplococci that is oxidase-positive and fermentative. Neisseria gonorrhoeae (choice A) is also a Gram-negative diplococci but is not fermentative. Haemophilus influenzae (choice C) is not a diplococci and Moraxella catarrhalis (choice D) is oxidase-negative. Thus, Neisseria meningitidis fits all the criteria provided in the question, making it the most likely causative agent for the sepsis in this patient.

Correct Answer: B

Rationale: The correct answer is B: protein filaments made of flagellin. Bacterial flagella are composed of flagellin proteins arranged in helical filaments. This structure allows for movement and propulsion of bacteria. A: 9+2 microtubule arrangement is incorrect because this structure is typically found in eukaryotic flagella, not bacterial flagella. C: Lipid bilayer is incorrect as it is a structural component of cell membranes, not bacterial flagella. D: Peptidoglycan layer is incorrect as it is a component of bacterial cell walls, not flagella.

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: Delayed hypersensitivity reaction. In granuloma development in tuberculosis, macrophages present antigen to T cells, leading to a delayed hypersensitivity reaction. This triggers the recruitment of more macrophages and formation of granulomas. Antibody-dependent cytotoxicity (B) and complement-dependent cytotoxicity (C) involve antibodies and complement proteins in immediate hypersensitivity reactions, which are not the primary mechanisms in tuberculosis. Anaphylactic reaction (D) is an acute systemic allergic reaction mediated by IgE antibodies, not relevant to granuloma formation in tuberculosis.

Correct Answer: D

Rationale: The correct answer is D because bacteremia can be caused by a variety of bacteria including S.epidermidis, E.coli, S.aureus, P.aeruginosa, K.pneumoniae, and resident skin diphtheroids. Bacteremia refers to the presence of bacteria in the bloodstream, which can occur due to infections from various sources. Choices A and B include common bacteria known to cause bacteremia, while choice C refers to resident skin diphtheroids that can also enter the bloodstream under certain conditions. Therefore, the correct answer is D as it encompasses all the possible etiological causes of bacteremia.

Correct Answer: A

Rationale: Ribosomes are the target for antibiotics as they interfere with protein synthesis in bacteria. Aminoglycosides, tetracyclines, macrolides, and lincosamides all target ribosomes by inhibiting protein synthesis at different stages. Beta-lactam antibiotics target cell wall synthesis, not ribosomes. Antifolate compounds, quinolones, and raspicin target DNA synthesis and replication, not ribosomes. Therefore, the correct answer is A as it includes antibiotics that specifically target ribosomes for inhibiting bacterial protein synthesis.

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: B

Rationale: The correct answer is B: Shigella. On Endo agar, Shigella appears as colorless colonies due to its inability to ferment lactose. Shigella is a Gram-negative rod and is a common cause of diarrhea. Salmonella (A) and Escherichia coli (C) would typically produce pink colonies on Endo agar as they can ferment lactose. Proteus (D) is not commonly associated with diarrhea and would not be expected to grow on Endo agar.

Correct Answer: D

Rationale: Rationale: After a splenectomy, patients are at high risk of infections caused by encapsulated bacteria such as Streptococcus pneumoniae, Listeria monocytogenes, and Salmonella. The spleen plays a crucial role in the immune response against encapsulated bacteria, and its absence increases susceptibility to these specific pathogens. Therefore, all choices are correct as patients are at risk of infections from all three types of bacteria mentioned.