A child with fever and a sore throat had a Gram-stained smear revealing Gram-positive cocci in chains. The bacteria were beta-hemolytic. What is the likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pyogenes. The presence of Gram-positive cocci in chains suggests a streptococcal infection. Beta-hemolysis indicates the production of a hemolysin that lyses red blood cells, a characteristic of Streptococcus pyogenes. This bacterium is known to cause strep throat and can present with fever and sore throat. Summary: - B: Streptococcus pneumoniae is a common cause of pneumonia but typically appears as lancet-shaped cocci, not in chains. - C: Staphylococcus aureus is a gram-positive cocci in clusters, not chains, and is not typically beta-hemolytic. - D: Enterococcus faecalis is a gram-positive cocci that are part of the normal gut flora and are not typically beta-hemolytic or found in chains.

Correct Answer: B

Rationale: The correct answer is B: Cannot induce infectious disease. Saprophytes are microorganisms that obtain nutrients from decaying organic matter and do not cause infectious diseases in humans. They play a vital role in the ecosystem by decomposing dead organisms. Choice A is incorrect because saprophytes do not cause typical infections. Choice C is incorrect because saprophytes do not cause chronic infections. Choice D is incorrect because saprophytes do not cause mixed infections involving multiple pathogens. Therefore, the correct answer is B as saprophytes do not induce infectious diseases.

Correct Answer: A

Rationale: The correct answer is A: Trichomonas tenax. Trichomonas tenax is a flagellated protozoan commonly found in the oral cavity and does not have a cyst stage. This organism typically inhabits the gingival crevices and can be identified in dental plaque samples. Entamoeba gingivalis (B) is an amoeba and does not have flagella. Balantidium coli (C) is a ciliated protozoan that infects the intestines, not the oral cavity. Giardia lamblia (D) is a flagellated protozoan that infects the intestines and has a distinct cyst stage. Therefore, the presence of flagellated protozoa without a cyst stage in dental plaque indicates Trichomonas tenax is likely present.

Correct Answer: C

Rationale: The correct answer is C: E + S = P. This notation represents the interaction between an enzyme (E) and a substrate (S) resulting in a product (P). Enzymes facilitate chemical reactions by binding to substrates and converting them into products. Choice A is incorrect because it does not include the enzyme in the reaction. Choice B is incorrect as it involves two substrates binding to the enzyme, not a substrate converting to a product. Choice D is incorrect as it shows two substrates reacting to form a product without involvement of an enzyme. Thus, choice C accurately represents the process of enzymatic reactions involving enzymes, substrates, and products.

Correct Answer: A

Rationale: The correct answer is A: Actinomycosis. This is a chronic bacterial infection caused by Actinomyces species. In this case, the description of dense yellow-green colored focus, white granules in purulent masses, and presence of fungal druses, plasma cells, xanthome cells, and macrophages all match the characteristics of actinomycosis. Actinomycosis typically presents with abscess formation containing sulfur granules, which are yellowish and granular. The other choices (B: Furuncle, C: Carbuncle, D: Syphilis) do not fit the clinical and histological features described in the question, making them incorrect options.

Correct Answer: A

Rationale: The correct answer is A: Gram-negative stain. Pseudomonas aeruginosa is a gram-negative bacterium, as indicated by the bluish-green pus color. This bacterium has an outer membrane that retains the crystal violet stain, making it appear pink/red after the counterstain with safranin in Gram staining. The other choices are incorrect because Pseudomonas aeruginosa does not typically form spores (B), has a rod-shaped morphology rather than a coccal form (C), and does not exhibit cell pairing (D).

Correct Answer: A

Rationale: The correct answer is A: Gram staining method. This method involves staining with gentian violet, followed by Lugol's solution, 96% alcohol decolorization, and counterstaining with safranin or water-magenta. This staining sequence allows for the differentiation of bacteria based on their cell wall composition. In the case of lobar pneumonia, the causative agent is typically a bacterium with a cell wall that retains the crystal violet stain after decolorization with alcohol, indicating a Gram-positive bacterium. Summary of Incorrect Choices: B: Ziehl-Nielsen staining is used for acid-fast bacteria like Mycobacterium tuberculosis, not for lobar pneumonia. C: Romanovsky staining is primarily used in the identification of blood cells and blood parasites, not for bacteria. D: Neisser staining is not a commonly used staining method in microbiology for bacterial identification.

Correct Answer: D

Rationale: The correct answer is D: TCBS. Thiosulfate-citrate-bile salts-sucrose (TCBS) agar is the most selective for Vibrio cholerae due to its high salt content, bile salts, and sucrose. Vibrio cholerae can grow well in alkaline conditions, which are provided by TCBS agar. MacConkey's agar (A) is selective for gram-negative bacteria, but not specifically for Vibrio cholerae. Chocolate agar (B) is a non-selective medium suitable for fastidious organisms. SS agar (C) is selective for Salmonella and Shigella species, not Vibrio cholerae.

Correct Answer: D

Rationale: The correct answer is D: Trichomonas tenax. Trichomonas tenax is a flagellated protozoan that is commonly found in the oral cavity, specifically in dental plaque. The description provided in the question matches the characteristics of Trichomonas tenax, such as unicellular structure, distinct layers in the cytoplasm, wide pseudopodia, and barely visible core. Entamoeba gingivalis (choice A) and Entamoeba histolytica (choice B) are amoebas, not flagellated protozoa, and they do not exhibit the characteristics described in the question. Lamblia (choice C) is also an incorrect choice as it is a different type of protozoan that does not match the description provided.