A child with a sore throat had a throat smear revealing Gram-positive cocci in pairs with a capsule. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. The presence of Gram-positive cocci in pairs with a capsule is characteristic of Streptococcus pneumoniae. Step 1: Gram-positive cocci in pairs indicate a Streptococcus species. Step 2: The presence of a capsule suggests S. pneumoniae specifically. Summary: B: Staphylococcus aureus is a Gram-positive cocci but does not typically present in pairs with a capsule. C: Neisseria gonorrhoeae is a Gram-negative diplococcus, not a Gram-positive cocci. D: Klebsiella pneumoniae is a Gram-negative rod, not a cocci.

Correct Answer: D

Rationale: The correct answer is D. Escherichia coli, Salmonella enterica, and Pseudomonas aeruginosa all produce endotoxins that can lead to septic shock. Endotoxins are part of the outer membrane of Gram-negative bacteria and can trigger a systemic inflammatory response if released into the bloodstream. E. coli and Salmonella are common causes of bacterial infections that can lead to septic shock, while P. aeruginosa is a known opportunistic pathogen that can produce endotoxins. Therefore, all three bacteria can cause septic shock by releasing endotoxins. Choices A, B, and C are incorrect because each of these bacteria individually can produce endotoxins that contribute to the development of septic shock.

Correct Answer: A

Rationale: The correct answer is A: Obligate anaerobes. These bacteria can only survive in the absence of oxygen as they lack the enzymes needed for aerobic respiration. They typically use fermentation or anaerobic respiration for energy production. Incorrect choices: B: Facultative anaerobes can switch between aerobic and anaerobic metabolism based on oxygen availability. C: Obligate aerobes require oxygen for survival and cannot survive in anoxic conditions. D: Microaerophiles require low levels of oxygen for growth and are not capable of surviving in completely anoxic conditions.

Correct Answer: C

Rationale: The correct answer is C: cell wall composition. Gram staining differentiates bacteria based on the structure of their cell walls. It classifies bacteria into Gram-positive (thick peptidoglycan layer) and Gram-negative (thin peptidoglycan layer). This differentiation is crucial for identifying bacterial species and guiding treatment choices. Size and shape (choice A) are not specific to Gram staining. Presence of flagella (choice B) is related to bacterial motility, not Gram staining. Genetic material (choice D) is not directly assessed by Gram staining. Overall, the unique composition of the cell wall is the key factor in distinguishing bacteria through Gram staining.

Correct Answer: B

Rationale: The correct answer is B: Actinomycosis. Actinomyces is a gram-positive bacterium that forms sulfur granules (druses) with gram-positive coloring in the center and filamentous structures resembling cones with gram-negative coloring. This morphology is characteristic of Actinomyces species. Fusobacteriosis (choice A) typically presents with gram-negative rods. Staphylococcal osteomyelitis (choice C) is caused by gram-positive staphylococci, not Actinomyces. Anaerobic infections (choice D) can be caused by various bacteria, but the specific morphology described in the question matches Actinomyces, making choice B the correct answer.

Correct Answer: D

Rationale: The correct answer is D (A and B both). In viral multiplication, the presence of a specific cytopathic effect (CPE) in cell culture indicates viral replication. This is detected visually through changes in cell morphology. Additionally, immunofluorescence detection methods can be used to detect viral antigens within infected cells, confirming viral multiplication. Options C is incorrect as viral colonies are not typically used to detect viral multiplication in cell culture. Option B alone is not sufficient as it only focuses on immunofluorescence detection, while option A alone may not always be specific. Therefore, the combination of A and B provides a more comprehensive and accurate detection method for viral multiplication in cell culture.

Correct Answer: B

Rationale: The correct answer is B (2). During glycolysis, one glucose molecule is broken down into two molecules of pyruvate. In this process, a net gain of 2 ATP molecules is produced through substrate-level phosphorylation. Specifically, ATP is generated during the conversion of glyceraldehyde-3-phosphate to 1,3-bisphosphoglycerate and during the conversion of phosphoenolpyruvate to pyruvate. The other choices are incorrect because the net gain of ATP molecules in glycolysis is not 1, 3, or 4; it is 2 based on the specific enzymatic reactions involved in the pathway.

Correct Answer: B

Rationale: The correct answer is B: Corynebacterium diphtheriae. This bacterium produces a toxin that causes diphtheria. It forms a grayish membrane in the throat, leading to difficulty breathing. Bacillus anthracis (Choice A) causes anthrax, Streptococcus pneumoniae (Choice C) causes pneumonia, and Escherichia coli (Choice D) causes various infections but not diphtheria.

Correct Answer: A

Rationale: The correct answer is A: Oxidation. Phase I reactions in biotransformation involve introducing or unmasking functional groups through oxidation, reduction, or hydrolysis. Oxidation reactions typically involve the addition of an oxygen atom or removal of hydrogen atoms, making them common phase I reactions. In this process, enzymes like cytochrome P450 play a crucial role in catalyzing the oxidation reactions. Conjugation (B), acetylation (C), and glucuronidation (D) are all examples of phase II reactions, which involve the conjugation of the drug or metabolite with endogenous compounds to increase water solubility for excretion. These reactions typically follow phase I reactions and are not classified as phase I reactions in biotransformation.