A fecal sample from a patient with diarrhea revealed cysts with four nuclei. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Entamoeba histolytica. This is because the presence of cysts with four nuclei is characteristic of Entamoeba histolytica, a protozoan parasite that causes amoebic dysentery. Entamoeba histolytica cysts contain four nuclei, distinguishing them from other pathogens. Giardia lamblia and Trichomonas vaginalis are not associated with cysts containing four nuclei. Balantidium coli is a ciliated protozoan that does not typically form cysts with multiple nuclei. In summary, the unique feature of four nuclei in the cysts points towards Entamoeba histolytica as the most likely causative agent of the diarrhea in this patient.

Correct Answer: B

Rationale: The correct answer is B: For HIV. Pneumocystis pneumonia in a young man with CD4+ cells less than 200/mm3 is highly suggestive of HIV infection. HIV weakens the immune system, leading to opportunistic infections like pneumocystis pneumonia. Testing for HIV is crucial for diagnosis and appropriate management. Explanation for other choices: A: Testing for ureaplasma urealyticum is not indicated in this case as the symptoms and CD4+ cell count point towards an HIV-related infection. C: Testing for Treponema pallidum (syphilis) is not relevant in the context of a young man with pneumocystis pneumonia and low CD4+ cell count. D: Testing for Neisseria gonorrhoea is not appropriate in this scenario as the symptoms and CD4+ cell count suggest an underlying HIV infection rather than a bacterial sexually transmitted infection.

Correct Answer: A

Rationale: The correct answer is A because immunofluorescence slides are examined under a fluorescence microscope with a x100 oil immersion objective. This is because immunofluorescence relies on the detection of fluorescently labeled antibodies, which emit light when excited by a specific wavelength. Using a fluorescence microscope allows for visualization of these labeled antibodies at high magnification and resolution, enabling precise examination of cellular structures and protein localization. Choice B is incorrect as light microscopes are not suitable for visualizing fluorescence. Choice C is incorrect as electron microscopes use electrons, not light, for imaging, which is not compatible with immunofluorescence. Choice D is incorrect as there is a specific method for examining immunofluorescence slides.

Correct Answer: C

Rationale: The correct answer is C: Salmonella. This bacterium should be handled in a Biosafety Level 2 facility due to its potential to cause disease in humans. Salmonella is a pathogenic bacterium that can cause foodborne illnesses and infections. Handling it in a Biosafety Level 2 facility ensures proper containment and protection of personnel. A: Micrococcus luteus and B: Bacillus subtilis are common environmental bacteria that do not pose significant risks to human health, so they can be safely handled in lower biosafety levels. D: Staphylococcus epidermidis is a common skin commensal bacterium that is generally not considered highly pathogenic, so it does not require Biosafety Level 2 containment.

Correct Answer: A

Rationale: The correct answer is A: Neisser staining method. Neisser staining method is used to stain diphtheria bacilli, which appear as blue rods with thickenings at the poles. The rationale is that Neisser staining specifically targets and highlights the characteristics of the diphtheria bacilli. Incorrect choices: B: Gram staining is not specific for diphtheria bacilli and does not show the characteristic blue rods with thickenings at the poles. C: Ziehl-Neelsen staining is used for acid-fast bacteria like Mycobacterium tuberculosis, not for diphtheria bacilli. D: Loeffler staining is used for diphtheria bacilli but does not produce blue rods with thickenings at the poles as seen in this case.

Correct Answer: A

Rationale: The correct answer is A: Cell wall. Mycoplasma species lack a cell wall, making them unique among bacteria. This is because they have a flexible cell membrane that provides structural support instead of a rigid cell wall. The absence of a cell wall allows them to be pleomorphic and gives them resistance to certain antibiotics targeting cell wall synthesis. Plasma membrane (B), DNA (C), and ribosomes (D) are present in Mycoplasma species, so they are not the correct answer.

Correct Answer: B

Rationale: The correct answer is B: Salmonella enteritidis. In this case, the presence of Gram-negative rods producing gas in the blood culture indicates a likelihood of Salmonella infection, as it is a common cause of severe abdominal pain, vomiting, and gas production. Salmonella enteritidis is a known pathogen that can cause gastroenteritis and systemic infections. Escherichia coli (choice A) can also cause similar symptoms, but it is less likely to produce gas in blood culture. Clostridium perfringens (choice C) typically causes food poisoning with rapid onset and less likely to be isolated from blood cultures. Campylobacter jejuni (choice D) is associated with gastroenteritis but is less likely to cause systemic infections with gas-producing Gram-negative rods in blood culture.

Correct Answer: A

Rationale: The correct answer is A: epidermis. Langerhans cells are a type of immune cell found in the epidermis, the outermost layer of the skin. They play a crucial role in the defense against microbes by capturing and presenting antigens to activate the immune system. The dermis (B), hypodermis (C), and subcutaneous layer (D) are located deeper in the skin and do not contain Langerhans cells. Therefore, the epidermis is the correct location for these immune cells to carry out their defensive functions.

Correct Answer: A

Rationale: Step 1: Rubella virus belongs to the Togaviridae family, which typically exhibits icosahedral symmetry. Step 2: Icosahedral symmetry refers to a structure with 20 equilateral triangular faces, which is characteristic of many viruses, including rubella. Step 3: Therefore, choice A is correct as rubella virus indeed has icosahedral type of symmetry. Summary: - Choice B is incorrect as rubella virus is an ssRNA virus, not ssDNA. - Choice C is incorrect as rubella virus does have an envelope derived from the host cell membrane. - Choice D is incorrect as rubella virus does have glycoprotein spikes on its surface.