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: A

Rationale: Step-by-step rationale: 1. Blue-green pigment + fruity odor are characteristic of Pseudomonas aeruginosa. 2. P. aeruginosa is a Gram-negative bacterium commonly associated with wound infections. 3. P. aeruginosa is known for its ability to produce pyocyanin (blue-green pigment) and a sweet, fruity odor. 4. Other choices like E. coli, K. pneumoniae, and P. mirabilis do not typically produce blue-green pigment or fruity odor. 5. Therefore, based on the characteristics observed, the likely causative agent is Pseudomonas aeruginosa. Summary of other choices: - Escherichia coli: Does not produce blue-green pigment or fruity odor. - Klebsiella pneumoniae: Does not typically produce blue-green pigment or fruity odor. - Proteus mirabilis: Does not produce blue-green pigment or fruity odor.

Correct Answer: A

Rationale: The correct answer is A: Clostridium perfringens. This bacterium is an anaerobic, Gram-positive rod that forms terminal spores and produces gas. It is commonly associated with wound infections and gas gangrene. Clostridium botulinum causes botulism and does not typically present with gas production. Bacillus anthracis is an aerobic, Gram-positive spore-forming bacterium causing anthrax. Clostridium tetani causes tetanus and does not produce gas. Thus, based on the characteristics described in the question, Clostridium perfringens is the most likely causative agent.

Correct Answer: B

Rationale: The correct answer is B: Gram-negative bacteria. Gram-negative bacteria have an outer membrane containing lipopolysaccharides (LPS). In the Gram staining technique, these bacteria appear pink/red due to the thin peptidoglycan layer, which allows the crystal violet stain to be washed out, revealing the safranin counterstain. Gram-positive bacteria (choice A) have a thick peptidoglycan layer but lack an outer membrane with LPS. Choice C is incorrect since only Gram-negative bacteria possess LPS in their outer membrane. Choice D is incorrect as all bacteria can be classified as either Gram-positive or Gram-negative based on their cell wall structure.

Correct Answer: A

Rationale: Rationale for correct answer (A: Escherichia coli): 1. Endo agar selects for Gram-negative bacteria. 2. Red colonies on Endo agar indicate lactose fermentation, characteristic of E. coli. 3. E. coli is a common cause of pneumonia, especially in immunocompromised patients. Summary of why other choices are incorrect: - B: Klebsiella pneumoniae: Typically forms mucoid colonies on agar. - C: Pseudomonas aeruginosa: Produces characteristic greenish-blue colonies on agar. - D: Proteus mirabilis: Does not typically ferment lactose, so would not produce red colonies on Endo agar.