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: Certainly! The correct answer is D because all three options (A, B, and C) can be analyzed in the diagnosis of sexually transmitted infections. Genital ulcer secretions can reveal the presence of pathogens causing STIs, lymph node punctate can indicate systemic infection, and serum can be tested for specific STI antibodies. Therefore, all these clinical specimens are essential for a comprehensive diagnosis of sexually transmitted infections. The other choices (A, B, C) are incorrect as they individually represent important specimens used in the diagnosis process.

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: A

Rationale: The correct answer is A. Benzylpenicillin sodium salt, also known as penicillin G, works by blocking the synthesis of peptidoglycan in the microbial cell wall. Peptidoglycan is crucial for the structural integrity of bacterial cell walls. By inhibiting its synthesis, penicillin disrupts the cell wall formation, leading to cell lysis and bacterial death. Choices B, C, and D are incorrect because penicillin does not target cytoplasm proteins, thiol enzymes, or RNA synthesis. Penicillin's primary mode of action is specifically related to interfering with bacterial cell wall synthesis.

Correct Answer: C

Rationale: The correct answer is C: Identification. Bacteria are studied by identification to determine their specific characteristics and differentiate between different species. Taxonomy (A) is the science of classification, not specific to bacteria. Classification (B) is the process of grouping organisms based on shared characteristics, not specific to bacteria. Nomenclature (D) is the naming system for organisms, not the primary method for studying bacteria. Therefore, identification (C) is the correct choice for studying bacteria.

Correct Answer: B

Rationale: The correct answer is B: septicemia. Septicemia specifically refers to the presence of bacteria in the bloodstream, leading to a systemic inflammatory response. Bacteremia (choice A) is simply the presence of bacteria in the blood without the systemic inflammatory response. Shock (choice C) is a state of circulatory collapse, often seen in severe septicemia. Bloodborne infection (choice D) is a general term for infections transmitted through the blood but does not specifically refer to the condition of bacterial multiplication causing toxicity.

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: 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: pertussis toxin. This toxin is the most important virulence factor of Bordetella pertussis because it plays a key role in causing the characteristic symptoms of whooping cough. Pertussis toxin interferes with the host's immune response, leading to inflammation and tissue damage in the respiratory tract. The other choices (A: the flagellum, C: P fimbriae, D: mannose-resistant adhesins) are important for bacterial attachment and colonization, but they do not directly contribute to the severity of the disease like pertussis toxin does.