A child with a persistent sore throat and fever had a smear from the throat revealing rod-shaped bacteria with dark blue polar granules. What is the likely causative agent?

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: 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: destruction of the local blood supply. In osteomyelitis, the infection occurs in the bone, which has a relatively poor blood supply compared to soft tissues. This limited blood flow makes it challenging for antibiotics to reach the infection site effectively, hindering their ability to combat the infection. Destruction of the local blood supply restricts the delivery of antibiotics and immune cells to the infected bone, leading to poor treatment outcomes. Summary: - Option A is correct because the limited blood supply in bones hinders antibiotic delivery. - Option B is incorrect as denaturing by normal flora does not impact antibiotic reach to the infection site. - Option C is incorrect as inflammation and edema, while present, do not primarily hinder antibiotic delivery. - Option D is incorrect as excessive pus production does not directly impede antibiotic access to the infection site.

Correct Answer: C

Rationale: The correct answer is C: prions. Prions are misfolded proteins that can cause transmissible spongiform encephalopathies like Creutzfeldt-Jakob disease. Prions are not viruses like flavoviruses (A) or orthomyxoviruses (D). Virusoids (B) are small, circular, single-stranded RNA molecules that require a helper virus to replicate and are not associated with transmissible spongiform encephalopathies. Therefore, the correct answer is C as prions are the only choice that correctly links to the etiology of transmissible spongiform encephalopathies.

Correct Answer: D

Rationale: The correct answer is D because all the choices can contribute to hospital-acquired infections. New patients in the incubation period can spread infections, medical staff can inadvertently transmit infections, and contaminated medical instruments can also be a source of infections. Therefore, it is important to consider all these factors to prevent and control the spread of infections in a hospital setting.