A patient with a productive cough and fever had a sputum smear revealing Gram-positive cocci in clusters. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Staphylococcus aureus. Staphylococcus aureus is a Gram-positive cocci bacterium that forms clusters and commonly causes pneumonia with a productive cough and fever. It is frequently found in sputum smears in such cases. Streptococcus pneumoniae (B) is another common cause of pneumonia but typically appears in pairs or chains, not clusters. Neisseria meningitidis (C) is a Gram-negative diplococcus that causes meningitis, not pneumonia. Klebsiella pneumoniae (D) is a Gram-negative bacterium that can cause pneumonia but appears as Gram-negative rods, not Gram-positive cocci in clusters.

Correct Answer: B

Rationale: The function of bacterial pili is to aid in adhesion. Pili are hair-like structures on the bacterial surface that help the bacteria attach to surfaces or other cells. This adhesion is crucial for colonization and infection. Pili do not provide motility, as that is typically done by flagella. Bacteria form spores for survival under harsh conditions, and protein synthesis is carried out by ribosomes, not pili. Thus, the correct answer is B, aiding in adhesion.

Correct Answer: A

Rationale: The correct answer is A: TRUE. Poxviruses are indeed DNA viruses that replicate in the cytoplasm. This is due to their complex structure that allows them to carry out their replication process in the cytoplasm of the host cell. Other choices are incorrect because poxviruses specifically replicate in the cytoplasm and do not require the nucleus for replication, ruling out choice B. Choice C is incorrect because poxviruses consistently replicate in the cytoplasm regardless of the situation. Choice D is incorrect as the correct answer is A.

Correct Answer: B

Rationale: The correct answer is B: Order. The suffix -virales is used in virology to denote the order level in the taxonomy of viruses. Orders are higher taxonomic ranks compared to species, family, and genus. The suffix -virales is specifically assigned to virus orders, making choice B the correct one. The other choices (A, C, D) are incorrect because the suffix -virales does not apply to species, family, or genus in the taxonomic classification of viruses.

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: C

Rationale: The correct answer is C: Plague. Yersinia pestis is the bacterium responsible for causing the bubonic, septicemic, and pneumonic plague. The bacterium is transmitted to humans through infected flea bites or handling infected animals. Tonsillitis (A) is commonly caused by streptococcal bacteria, leprosy (B) is caused by Mycobacterium leprae, and rat fever (D) is another term for leptospirosis, caused by Leptospira bacteria.

Correct Answer: C

Rationale: The correct answer is C, as Gram-negative bacteria have a cell wall containing lipopolysaccharides. This outer membrane structure is unique to Gram-negative bacteria and plays a critical role in pathogenicity and immune response. Teichoic acid (choice A) is found in Gram-positive bacteria. The cell wall of Gram-negative bacteria is thinner than that of Gram-positive bacteria (choice B). The cell wall of Gram-negative bacteria is not composed entirely of peptidoglycan (choice D), as it also contains other components like lipopolysaccharides.

Correct Answer: A

Rationale: The correct answer is A, Exotoxin. Botulism is caused by the exotoxin produced by Clostridium botulinum bacteria. The symptoms described - diplopia, acute headache, deglutition disorder, hard breathing, muscle weakness - are all consistent with botulism due to the neurotoxic effects of the exotoxin. The exotoxin interferes with neurotransmission at the neuromuscular junction, leading to muscle paralysis and the symptoms mentioned. The other choices (B, C, D, E) are incorrect as they do not correspond to the pathogenic mechanism of botulism and do not explain the specific clinical manifestations observed in this case.

Correct Answer: A

Rationale: Step-by-step rationale for choice A being correct: 1. Penicillin allergy involves IgE antibodies binding to penicillin. 2. This triggers mast cell degranulation, releasing histamine. 3. Histamine causes allergic symptoms like rash, swelling. 4. This immune response characterizes Type I hypersensitivity reactions. Summary of other choices: B: Type II reactions involve antibody-mediated cell destruction, not seen in penicillin allergy. C: Type III reactions involve immune complex deposition, not typical in penicillin allergy. D: Type IV reactions are delayed hypersensitivity reactions, not immediate like penicillin allergy.