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: 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: D

Rationale: The correct answer is D: Primaquine. Primaquine is used for individual chemoprophylaxis of malaria caused by Plasmodium vivax and Plasmodium ovale. It is effective in preventing the relapse of these malaria species by eliminating the liver forms of the parasites. Chingamin (A) is not a commonly used drug for malaria prophylaxis. Pyrantel (B) is an anthelmintic drug used for treating parasitic worm infections, not malaria. Pyrimethamine (Chloridinum) (C) is primarily used in combination with sulfadoxine for treating uncomplicated malaria, not for chemoprophylaxis.

Correct Answer: D

Rationale: Interferon delta is not a known type of interferon, making choice D incorrect. Interferon beta is indeed produced by fibroblasts (choice A), interferon alpha by leukocytes (choice B), and interferon gamma by lymphocytes (choice C). Each type of interferon is produced by specific cells in the immune system, contributing to the body's defense against viruses and other pathogens.

Correct Answer: A

Rationale: The correct answer is A: Clostridium botulinum. This bacterium produces the neurotoxin responsible for botulism. Clostridium perfringens is associated with gas gangrene, not botulism. Streptococcus pneumoniae causes pneumonia, and Neisseria gonorrhoeae causes gonorrhea, not botulism. Therefore, A is the correct choice.

Correct Answer: D

Rationale: Step 1: Mantoux test measures cell-mediated immunity response to tuberculosis. Step 2: A negative result means no significant immune response to TB antigens. Step 3: Option A is incorrect, as it refers to antitoxic immunity, not cell immunity. Step 4: Option B is incorrect, as it mentions antibodies, not cell-mediated immunity. Step 5: Option C is incorrect, as it states absence of antibodies, not cell immunity. Step 6: Option D is correct as it directly correlates with the purpose of Mantoux test.

Correct Answer: D

Rationale: The correct answer is D: Proteus vulgaris. This is because Proteus species are non-lactose-fermenting, Gram-negative rods that produce gas in nutrient broth. They are known to cause severe abdominal pain due to their ability to invade the intestinal mucosa. A: Salmonella enterica is a lactose-fermenting organism and typically does not produce gas in nutrient broth. B: Shigella dysenteriae is a lactose-negative organism but does not produce gas in nutrient broth. C: Escherichia coli is a lactose-fermenting organism and does not typically produce gas in nutrient broth. In summary, the presence of non-lactose-fermenting, gas-producing Gram-negative rods points towards Proteus vulgaris as the most likely causative agent of the severe abdominal pain.

Correct Answer: D

Rationale: The correct answer is D: Terminally. In Clostridium tetani, spores are located at the terminal end of the cell. This positioning helps the spores to be released easily when the cell lyses, aiding in the spread of the bacteria. Paracentrally (A) and centrally (C) would not be as efficient for spore release. Subterminally (B) is also incorrect as the spores are specifically located at the terminal end of the cell, not just near it.

Correct Answer: A

Rationale: Step-by-step rationale for choice A being correct: 1. Microscopic examination of discharge from infected organ allows direct visualization of bacteria causing the infection. 2. Microscopic examination of urine for organisms can help identify any bacteria present in the urinary tract. 3. Both methods are specific for diagnosing bacterial infections in the reproductive system. Summary: - Choice B is incorrect as biopsy is invasive and not typically used for diagnosing bacterial infections. - Choice C is incorrect as fecal samples and urine protein tests are not relevant for diagnosing bacterial infections in the reproductive system. - Choice D is incorrect as antibody agglutination and coagulation tests are not primary methods for diagnosing bacterial infections in the reproductive system.