A patient was diagnosed with active focal pulmonary tuberculosis. What drug should be prescribed in the first place?

Correct Answer: A

Rationale: The correct answer is A: Isoniazid. Isoniazid is a first-line drug for treating active pulmonary tuberculosis due to its high efficacy and low toxicity. It works by inhibiting the synthesis of mycolic acids in the bacterial cell wall. Sulfalen, Cyclocerine, and Ethionamide are not first-line drugs for tuberculosis. Sulfalen is used for urinary tract infections, Cyclocerine for drug-resistant tuberculosis, and Ethionamide as a second-line drug for multidrug-resistant tuberculosis. Therefore, Isoniazid is the most appropriate initial choice for treating active focal pulmonary tuberculosis.

Correct Answer: B

Rationale: Fimbriae in bacteria are hair-like appendages that help in adhesion to surfaces. This is essential for colonization and infection. Fimbriae do not provide motility (flagella do), facilitate protein synthesis (ribosomes do), or help in endospore formation (specialized structures do). Adhesion is the primary function of fimbriae, allowing bacteria to stick to host cells or abiotic surfaces.

Correct Answer: B

Rationale: The correct answer is B: kidneys. The kidneys are the primary organs responsible for excreting drugs from the body through urine. They filter the blood and remove waste products, including drugs, through the process of urine formation. The lungs primarily excrete gases and volatile substances, not drugs. The small intestines are mainly involved in absorption of nutrients, not drug excretion. The spleen is part of the immune system and does not play a direct role in drug excretion.

Correct Answer: A

Rationale: The correct answer is A: Bacterial vaginosis (gardnerellosis). The presence of clue cells on the Gram-stained smears is characteristic of bacterial vaginosis. Clue cells are vaginal epithelial cells covered with bacteria, specifically Gardnerella vaginalis, which is the causative agent of bacterial vaginosis. The symptoms described by the patient - itching, burning, watery discharge with a fish-like smell - are classic signs of bacterial vaginosis. The absence of alterations in the cervix, uterus, and appendages rules out other sexually transmitted infections like chlamydiosis, gonorrhea, and trichomoniasis. Therefore, the most likely pathology in this case is bacterial vaginosis.

Correct Answer: D

Rationale: The correct answer is D: P.aeruginosa. This bacterium is commonly found in water and soil, making its presence in indoor air an indicator of poor sanitation. Step 1: P.aeruginosa is an opportunistic pathogen known to cause infections in hospitals. Step 2: Its presence in the air indicates potential contamination and poor air quality. Step 3: Regular monitoring of P.aeruginosa levels can help assess the effectiveness of sanitation measures. Summary: A, B, and C are not suitable indicators of air sanitation in an enclosed space as they are not typically associated with environmental contamination or poor air quality.

Correct Answer: B

Rationale: Step-by-step rationale: 1. Sodium is the major cation in the intracellular fluid. 2. It plays a crucial role in maintaining cell volume and transmitting nerve impulses. 3. Potassium is the major cation in the extracellular fluid, not intracellular. 4. Bicarbonate and sulfate are anions and not major cations in intracellular fluid. Summary: Choice B (sodium) is correct as it is the major cation in intracellular fluid, essential for various cellular functions. Choices A, C, and D are incorrect as potassium is extracellular, while bicarbonate and sulfate are anions and not predominant cations in intracellular fluid.

Correct Answer: C

Rationale: The correct answer is C because hemagglutinin of influenza viruses serves as an attachment molecule to the receptor of the target cell, facilitating viral entry. This is crucial for the virus to infect host cells. Choice A is incorrect because hemagglutinin is not part of the viral capsid but rather a surface protein. Choice B is incorrect as hemagglutinin is not directly involved in viral replication, but in host cell attachment. Choice D is incorrect as hemagglutinin is highly antigenic, triggering the host's immune response.

Correct Answer: B

Rationale: The correct answer is B because antigenic drift is not caused by the exchange of genetic information between animal and human influenza viruses. Antigenic drift is actually due to point mutations in the genes that encode for the surface proteins of the virus, leading to small changes in the antigens. These mutations can affect the hemagglutinin of both type A and B influenza viruses, making choices A and C correct. Choice D is incorrect because antigenic drift can occur in both type A and B influenza viruses, with type B being less prone to drift compared to type A.

Correct Answer: A

Rationale: The correct answer is A: Candida fungi. Candida fungi are known to cause oral thrush, characterized by whitish spots on the oral mucosa. The presence of gram-positive oval budding cells in the smear preparations is indicative of Candida species. Staphylococci (choice B) are gram-positive cocci, not oval budding cells. Sarcinae (choice C) are gram-positive bacteria that form cuboidal packets, not oval budding cells. Actinomycetes (choice D) are filamentous gram-positive bacteria, not oval budding cells like Candida fungi.