A patient was taken to a hospital with acute food poisoning caused by homemade canned mushrooms. The product analysis revealed some microorganisms that develop only in the absence of oxygen. What microorganisms caused the poisoning?

Correct Answer: A

Rationale: The correct answer is A: Obligate anaerobes. These microorganisms thrive in the absence of oxygen, as seen in the canned mushrooms where oxygen is limited. They produce toxins causing food poisoning. Facultative anaerobes (B) can survive with or without oxygen. Microaerophiles (C) require low levels of oxygen. Obligate aerobes (D) need oxygen to survive and would not be responsible for the poisoning in this case.

Correct Answer: B

Rationale: The correct answer is B: Jenner. Edward Jenner is credited with performing the first successful vaccination against smallpox in 1796. He used cowpox virus to inoculate individuals, leading to immunity against smallpox. Jenner's experiment laid the foundation for modern vaccination. Pasteur (A) is known for developing the germ theory of disease. Semmelweis (C) advocated for handwashing to prevent infections. Koch (D) identified the causative agents of several diseases but did not develop the smallpox vaccine.

Correct Answer: B

Rationale: The correct answer is B: Outer membrane containing lipopolysaccharides. Gram-negative bacteria have an outer membrane that contains lipopolysaccharides, which are important for protection and pathogenicity. This outer membrane is a unique feature of Gram-negative bacteria and is not present in Gram-positive bacteria, making it a key characteristic. A: Incorrect because Gram-negative bacteria have a thin peptidoglycan layer compared to Gram-positive bacteria. C: Incorrect because teichoic acids are a characteristic of Gram-positive bacteria, not Gram-negative bacteria. D: Incorrect because all bacteria, including Gram-negative bacteria, have a cell wall.

Correct Answer: A

Rationale: The correct answer is A: Tuberculin. In this clinical scenario, the patient presents with symptoms suggestive of tuberculosis, including chronic cough, night sweats, weight loss, and hemoptysis. The Mantoux test, also known as the tuberculin skin test, is used to screen for tuberculosis. Tuberculin, a purified protein derivative (PPD) derived from Mycobacterium tuberculosis, is injected intradermally. The test elicits a delayed-type hypersensitivity reaction in individuals who have been exposed to the organism in the past. A positive Mantoux test indicates exposure to tuberculosis and does not differentiate between active infection and prior exposure. Explanation for other choices: B: Measles - Measles is a viral infection that presents with a characteristic rash and fever, not consistent with the symptoms described in the case. C: Tetanus and diphtheria toxoids vaccine (Td) - Td vaccine is not used for tuberculosis screening and does not elicit

Correct Answer: A

Rationale: Rationale for Correct Answer A (Diphtheria): 1. Thin yellow bacilli with dark brown grains on ends suggest Corynebacterium diphtheriae, characteristic of diphtheria. 2. Roman numeral five shape is typical of diphtheria bacilli. 3. Diphtheria causes sore throat and can spread in boarding schools. 4. Neisser staining method is used for diphtheria bacilli. Summary of Incorrect Choices: B: Scarlet fever is caused by Streptococcus pyogenes and presents with rash, not yellow bacilli. C: Listeriosis is caused by Listeria monocytogenes, not consistent with the described findings. D: Tonsillitis can be caused by various bacteria or viruses, but the specific characteristics described do not match.

Correct Answer: A

Rationale: The correct answer is A: Helicobacterial infection. This is the most probable leading mechanism of disease development in this case because the patient's symptoms, such as heartburn, epigastric pain, food intolerance, and presence of a duodenal ulcer with a positive urease test, are classic signs of Helicobacter pylori infection. This bacterium colonizes the stomach lining, leading to inflammation and ulcer formation. The exacerbations in spring and autumn could be due to seasonal variations in immune response. Choice B: Dietary allergy is incorrect because the symptoms and findings in the patient are more indicative of an infectious etiology rather than an allergic reaction to specific foods. Choice C: Autoantibody production is unlikely as there are no indications of an autoimmune process in this case. Choice D: Reduced prostaglandin synthesis is not the leading mechanism as the symptoms and findings are more consistent with an infectious cause rather than a deficiency in prostaglandin synthesis.

Correct Answer: A

Rationale: The correct diagnosis is A: Syphilis. The spiral microorganisms described are characteristic of Treponema pallidum, the causative agent of syphilis. The thin and mobile bacteria with 8-12 regular coils match the morphology of Treponema pallidum. Leptospirosis is caused by Leptospira interrogans, which are thicker and have hook-like ends, different from the described bacteria. Lyme disease is caused by Borrelia burgdorferi, which has a different appearance than the thin, coiled bacteria in the smear. Relapsing fever is caused by Borrelia recurrentis, which typically have irregular coils, unlike the regular coils seen in the smear.

Correct Answer: D

Rationale: The correct answer is D: All are correct. Patients planned for treatment with monoclonal antibodies should be tested for HBV, HCV, and M. tuberculosis due to the risk of reactivation of these infections during treatment. HBV and HCV reactivation can lead to severe liver damage, while M. tuberculosis reactivation can cause serious respiratory complications. Testing for all three infections helps in identifying and managing any pre-existing infections to ensure patient safety during monoclonal antibody treatment. Choices A, B, and C are incorrect because each of these infections presents specific risks that need to be assessed before initiating monoclonal antibody therapy.

Correct Answer: D

Rationale: The correct answer is D, Vancomycin, because it is not a beta-lactam antibiotic. Beta-lactam antibiotics contain a beta-lactam ring in their molecular structure, which Vancomycin lacks. Benzylpenicillin, Cephalosporin, and Monobactam all contain the beta-lactam ring, making them beta-lactam antibiotics. Vancomycin belongs to a different class of antibiotics called glycopeptides.