A child is presumably ill with diphtheria. A specimen of affected mucous membrane of his pharynx was taken for analysis. The smear was stained and microscopic examination revealed yellow rods with dark blue thickenings on their ends. What structural element of a germ cell was revealed in the detected microorganisms?

Correct Answer: A

Rationale: The correct answer is A: Volutin granules. Volutin granules are metachromatic granules that stain dark blue with methylene blue or Leishman stain. In diphtheria-causing bacteria, Corynebacterium diphtheriae, these granules are typically seen as yellow rods with dark blue thickenings on their ends when stained. Volutin granules are storage inclusions composed of polymetaphosphate that serve as an energy reserve for the bacteria. The presence of these granules in the detected microorganisms indicates the characteristic feature of Corynebacterium diphtheriae. Summary of other choices: B: Plasmids are extrachromosomal DNA molecules that are not typically visible on stained smears. C: Capsules are outer protective layers that are not visible on stained smears. D: Spores are reproductive structures formed by certain bacteria, not typically seen in Corynebacterium diphtheriae.

Correct Answer: B

Rationale: The correct answer is B: Uptake of naked DNA from the environment. Bacterial transformation is a process where bacteria take up free DNA from their surroundings and incorporate it into their own genome. This process is essential for genetic recombination and the acquisition of new traits. Plasmids are small DNA molecules that can be transferred between bacteria, but not necessarily through pili. Bacteriophages are viruses that infect bacteria and transfer their DNA, but this is not the primary mechanism of bacterial transformation. Binary fission is a method of bacterial reproduction, not related to the uptake of DNA.

Correct Answer: B

Rationale: The correct answer is B: Motility. Bacterial flagella function in providing motility to bacteria, allowing them to move towards nutrients or away from harmful substances. Flagella are long, whip-like appendages that rotate to propel the bacteria through their environment. Incorrect choices: A: Protein synthesis - Bacterial flagella are not involved in protein synthesis. C: Adhesion to surfaces - While some bacteria use flagella for attachment, their main function is not adhesion. D: DNA replication - Flagella do not play a role in DNA replication, which occurs in the bacterial cell's nucleus.

Correct Answer: A

Rationale: The correct answer is A: Neisseria meningitidis. This is because Neisseria meningitidis is a Gram-negative diplococcus that is oxidase-positive and fermentative. Neisseria gonorrhoeae is also a Gram-negative diplococcus, but it is not fermentative. Moraxella catarrhalis is oxidase-positive but not fermentative. Haemophilus influenzae is Gram-negative but is not a diplococcus, and it is not fermentative. Therefore, based on the characteristics provided in the question, Neisseria meningitidis is the most likely causative agent.

Correct Answer: D

Rationale: The correct answer is D, Late congenital syphilis. This is because the patient presents with Hutchinson's teeth, which are a characteristic feature of late congenital syphilis. Hutchinson's teeth are small, barrel-shaped teeth with a wider cervix and notched incisors. The patient's history of visual impairment and hearing aid use also support the diagnosis of late congenital syphilis, as these are common manifestations of this stage of the disease. Choice A, Primary syphilis, is incorrect because it typically presents with a painless sore at the site of infection, not dental abnormalities. Choice B, Early congenital syphilis, is incorrect as dental abnormalities in this stage are usually more severe, such as mulberry molars. Choice C, Neurosyphilis, is incorrect as it primarily affects the central nervous system and does not typically present with dental abnormalities.

Correct Answer: A

Rationale: The correct answer is A: Bordetella pertussis. Bordetella pertussis is the bacterium responsible for causing whooping cough, also known as pertussis. It produces toxins that damage the respiratory tract, leading to severe coughing fits. Haemophilus influenzae, Streptococcus pneumoniae, and Mycobacterium tuberculosis are not associated with whooping cough. Haemophilus influenzae can cause respiratory infections but not whooping cough. Streptococcus pneumoniae is known for causing pneumonia, and Mycobacterium tuberculosis causes tuberculosis, both different from whooping cough. Therefore, the correct answer is A as it is the specific bacterium linked to the disease in question.

Correct Answer: D

Rationale: The correct answer is D: components of the gram-negative cell wall. Bacterial endotoxins are lipopolysaccharides found in the outer membrane of gram-negative bacteria. They are released upon bacterial cell lysis and can cause severe immune responses. A: Proteins in the cell wall - This is incorrect because endotoxins are not proteins but rather lipopolysaccharides. B: Secreted into the environment - Endotoxins are not actively secreted but are released upon cell death or lysis. C: Components of the gram-positive cell wall - Gram-positive bacteria do not have an outer membrane with lipopolysaccharides, so endotoxins are not found in the gram-positive cell wall.

Correct Answer: A

Rationale: The correct answer is A: cultivating on artificial media and biochemical identification. This method is appropriate for diagnosing listeriosis because it allows for the isolation and growth of Listeria species on selective media, followed by biochemical tests to confirm the identity. Serological diagnosis with ELISA (choice B) is not as specific for Listeria and may yield false positives. Choice C, serological diagnosis with agglutination hype Widal, is not typically used for listeriosis diagnosis. Cultivating in cell cultures (choice D) is not the primary method for diagnosing listeriosis as it is less specific compared to cultivating on artificial media and biochemical identification.

Correct Answer: C

Rationale: The correct answer is C: Macrolides or fluoroquinolones. Legionella pneumophila is a bacterium that causes Legionnaires' disease, a severe form of pneumonia. Macrolides (like azithromycin) and fluoroquinolones (like levofloxacin) are the recommended first-line treatments due to their ability to penetrate into lung tissues where Legionella infects. Penicillins and cephalosporins (choice A) are not effective against Legionella as it is intracellular and resistant to these antibiotics. Ethambutol and isoniazid (choice B) are used to treat tuberculosis, not Legionella infections. Second and third generation cephalosporins (choice D) are also not effective against Legionella. Therefore, the best choice for treating Legionella pneumophila infections is macrolides or fluoroquinolones.