A child with fever and swollen lymph nodes had a Gram-stained smear revealing Gram-negative rods with a safety pin appearance. What is the causative agent?

Correct Answer: A

Rationale: The correct answer is A: Yersinia pestis. This bacterium causes the plague, which presents with fever and swollen lymph nodes. The safety pin appearance on Gram stain is characteristic of Yersinia pestis. B: Francisella tularensis causes tularemia, which presents differently and does not show safety pin appearance on Gram stain. C: Brucella abortus causes brucellosis, which does not typically present with the same symptoms as described in the question. D: Clostridium botulinum causes botulism, which does not show safety pin appearance on Gram stain and does not typically present with fever and swollen lymph nodes.

Correct Answer: A

Rationale: Subcutaneous mycoses are fungal infections that affect the skin, subcutaneous tissues, and bones. The correct answer is A: tropics, as these infections are more commonly found in warm and humid regions. Fungi that cause subcutaneous mycoses thrive in tropical climates due to the favorable conditions for their growth and transmission. Choices B, C, and D are incorrect because deserts (B) have dry conditions not conducive to fungal growth, forests of the Northern Hemisphere (C) have varying climates that may not support the specific fungi causing subcutaneous mycoses, and the Rocky Mountains (D) are not typically associated with the high humidity required for these infections.

Correct Answer: A

Rationale: The correct answer is A because a soft chancre is a type of sexually transmitted infection caused by the bacterium Haemophilus ducreyi. It presents as a painless ulcer on the genitals. The other choices are incorrect. B is incorrect because STIs can enter the body through various routes, not only the urogenital tract mucosa. C is incorrect because immunity to syphilis is not lifelong; reinfection is possible. D is incorrect because STIs can occur in any country regardless of social status or hygiene levels.

Correct Answer: A

Rationale: Step 1: Large, oval protozoa with a single nucleus and four flagella indicate Giardia lamblia. Step 2: Giardia lamblia is a flagellated protozoan causing diarrhea. Step 3: It has a distinct appearance under microscopy. Step 4: Entamoeba histolytica causes dysentery with no flagella. Step 5: Balantidium coli is a ciliated protozoan with a larger size. Step 6: Trichomonas vaginalis lacks a cyst stage and causes genitourinary infections.

Correct Answer: D

Rationale: The correct answer is D (All of the above) because different bacteria can cause pneumonia. Streptococcus pneumoniae is the most common cause of community-acquired pneumonia. Mycobacterium tuberculosis causes tuberculosis, which can lead to pneumonia. Pseudomonas aeruginosa is a common cause of hospital-acquired pneumonia. Therefore, all three bacteria can be responsible for causing pneumonia in different contexts. Choices A, B, and C are incorrect because each bacterium individually can cause pneumonia, so selecting only one option would not cover the full spectrum of bacterial causes of pneumonia.

Correct Answer: A

Rationale: The correct answer is A: Actinomycosis. This is supported by the presence of purulent foci with druses consisting of short rod-like elements attached to a homogenous center, which is characteristic of Actinomyces species. Actinomycosis commonly presents with granulation tissue and connective tissue formation. B: Tuberculosis does not typically present with druses containing short rod-like elements. C: Syphilis does not typically present with purulent foci or druses. D: Candidosis does not typically present with the described features of purulent fluxing and druses with short rod-like elements.

Correct Answer: D

Rationale: The correct answer is D: lyases. Lyases are enzymes that catalyze the breaking of chemical bonds without the addition of water. They can remove functional groups from substrates or add functional groups to double bonds without the use of water. A: Oxidoreductases involve the transfer of electrons. B: Transferases transfer functional groups from one molecule to another. C: Hydrolases catalyze the breaking of bonds by adding water.

Correct Answer: A

Rationale: The correct answer is A: 96% ethanol. In Gram's staining method, after applying gentian violet, Lugol's solution, and aqueous fuchsin, the next step is to use a decolorizing agent like 96% ethanol to wash away the excess stain from the Gram-negative bacteria. This step is crucial as it helps differentiate between Gram-positive and Gram-negative bacteria based on their cell wall properties. The other choices are incorrect because sulfuric acid is not used in Gram's staining method, methylene blue is typically used in other staining techniques like the simple stain, and carbolic fuchsin is not a standard reagent in the Gram's staining process.

Correct Answer: A

Rationale: The correct answer is A: Gin's stain method. Gin's stain method is specifically used to detect capsules of bacteria. This method involves staining the bacteria with crystal violet and copper sulfate, which highlights the capsules as a clear halo around the stained bacterial cells. Ziehl-Neelsen's stain is used for acid-fast bacteria like Mycobacterium tuberculosis, Neisser's stain is for detecting Neisseria species, and Gram's stain is for differentiating bacteria based on their cell wall composition (Gram-positive vs. Gram-negative). Therefore, choices B, C, and D are incorrect for this scenario.