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?

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Question 1 of 9

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.

Question 2 of 9

The organisms to be identified have a nucleus surrounded by a nuclear membrane. Genetic material is concentrated predominantly in the chromosomes which consist of DNA strands and protein molecules. These cells divide mitotically. Identify these organisms:

Correct Answer: A

Rationale: Step-by-step rationale: 1. The presence of a nucleus with a nuclear membrane indicates eukaryotic cells. 2. Eukaryotes have genetic material in chromosomes made of DNA and proteins. 3. Mitotic division is characteristic of eukaryotic cells. 4. Therefore, the organisms described are eukaryotes. Summary: - Bacteriophages (B) are viruses that infect bacteria. - Prokaryotes (C) lack a nucleus and their genetic material is not organized into chromosomes. - Viruses (D) are not considered living organisms and do not have a nucleus or chromosomes.

Question 3 of 9

Fires from flammable metals require type __________ fire extinguishers.

Correct Answer: D

Rationale: The correct answer is D because fires from flammable metals require specialized Class D fire extinguishers designed to extinguish these unique types of fires. Class A, B, and C fire extinguishers are not suitable for flammable metal fires as they are designed for different types of materials and fire classes. Class A extinguishers are for ordinary combustibles, Class B for flammable liquids, and Class C for electrical fires. Therefore, Class D fire extinguishers are specifically designed for flammable metal fires, making them the correct choice for this scenario.

Question 4 of 9

In humans, the embryonic phase of development extends from fertilization to the end of week __________, after which the developing infant is called a fetus.

Correct Answer: C

Rationale: The correct answer is C: 8. The embryonic phase in humans lasts until the end of week 8. During this time, the major organs and structures of the body begin to form. After week 8, the developing organism is referred to as a fetus. Choice A (2) is too early for this transition to occur, Choice B (6) is also premature, and Choice D (12) is too late as the embryonic phase ends before week 12. Therefore, the correct answer is C (8) as it accurately reflects the timeline of embryonic development in humans.

Question 5 of 9

A 6-year-old boy is brought to the pediatrician by his mother, who complains of low-grade fever, chronic cough and night sweats in her child. She describes the cough as productive, producing white sputum that is sometimes streaked with blood. She also says that her son has lost some weight in the last month. His vital signs include blood pressure of 115/75 mm Hg, heart rate of 110/min., respiratory rate of 18/min. and temperature of 36,6°C. On physical examination, the patient is ill looking. Pulmonary auscultation reveals some fine crackles in the right upper lobe. The pediatrician suspects an active infection and performs Mantoux test. Intradermal injection of which of the following substances has been most likely used by pediatrician for screening test in this clinical case?

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

Question 6 of 9

A blood culture from a patient with sepsis revealed Gram-positive cocci in pairs. The bacteria were catalase-negative and alpha-hemolytic. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. This is because the bacterium is Gram-positive cocci in pairs, catalase-negative, and alpha-hemolytic, which are characteristic features of S. pneumoniae. The other choices can be ruled out based on specific characteristics: B) Staphylococcus aureus is catalase-positive, C) Enterococcus faecalis is gamma-hemolytic, and D) Neisseria gonorrhoeae is a Gram-negative diplococcus. Therefore, based on the given information, S. pneumoniae is the most likely causative agent of the sepsis.

Question 7 of 9

All statements about plasmids are correct except:

Correct Answer: C

Rationale: The correct answer is C because plasmids do not encode essential bacterial properties. They are non-essential, extra-chromosomal DNA molecules that can replicate independently within bacterial cells. Plasmids mainly contain genes for antibiotic resistance, genetic transfer, and other specific functions. Choice A is correct as many plasmids do carry antibiotic resistance genes. Choice B is also accurate as plasmids are indeed smaller, circular, and exist outside the bacterial chromosome. Choice D is true as plasmids can facilitate bacterial conjugation, allowing the transfer of genetic material between bacteria.

Question 8 of 9

During sanitary and bacteriological testing of water with the membrane filter technique there were revealed two red colonies on a membrane filter (Endo agar) through which 500 ml of water was filtred. Calculate the coli index and coli titer of the analyzed water:

Correct Answer: C

Rationale: The correct answer is C (coli index of 250 and coli titer of 4). The coli index is calculated by multiplying the number of colonies by the reciprocal of the volume filtered, which gives 2 colonies x (1/0.5 L) = 4. The coli titer is obtained by dividing the volume filtered by the number of colonies, which gives 0.5 L / 2 colonies = 0.25 L or 250 ml. This indicates the concentration of coliform bacteria in the water sample. Choice A (4 and 250) is incorrect because it has the correct coli index but the values are reversed for coli index and coli titer. Choice B (2 and 500) is incorrect as it provides the correct coli titer value but the values are reversed for coli index and coli titer. Choice D (500 and 2) is incorrect because it reverses the values for both coli index and coli titer.

Question 9 of 9

How is viral multiplication detected in cell culture?

Correct Answer: D

Rationale: The correct answer is D because viral multiplication in cell culture can be detected by observing a specific cytopathic effect (A) caused by viral infection in cells and by using an immunofluorescence detection method (B) to visualize viral antigens within the cells. Choice C, the characteristic type of viral colonies, is incorrect as viral multiplication is not typically detected by observing viral colonies in cell culture. Option D is the correct choice as both A and B methods are commonly used to detect viral multiplication in cell culture.

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