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: C

Rationale: The correct answer is C: Mycobacterium tuberculosis. This bacterium is responsible for causing tuberculosis as it specifically infects the lungs and can spread to other parts of the body. Mycobacterium leprae (A) causes leprosy, Streptococcus pneumoniae (B) causes pneumonia, and Clostridium botulinum (D) causes botulism, making them incorrect choices for tuberculosis. Mycobacterium tuberculosis has unique characteristics and mechanisms that enable it to cause tuberculosis, such as its ability to evade the immune system and form granulomas in the lungs.

Correct Answer: B

Rationale: The correct answer is B: Fimbriae. Fimbriae are short, hair-like appendages on the surface of bacteria that help in attachment to surfaces. They aid in colonization and biofilm formation. Flagella (A) are used for motility. Pili (C) are longer appendages used for conjugation and adherence to other cells. Capsules (D) are protective structures that aid in evading the host immune system, not necessarily for attachment.

Correct Answer: D

Rationale: The correct answer is D (All of the above) because all three bacteria (Clostridium botulinum, Escherichia coli, Salmonella enterica) are known to cause foodborne infections. Clostridium botulinum can lead to botulism, E. coli can cause various gastrointestinal illnesses, and Salmonella enterica is a common cause of food poisoning. Each bacterium has specific mechanisms that result in foodborne illnesses. Choices A, B, and C are incorrect because each bacterium mentioned is associated with causing foodborne infections, making them collectively the correct answer.

Correct Answer: D

Rationale: The correct answer is D, "All of the above." Staphylococcus aureus, Escherichia coli, and Neisseria meningitidis all produce endotoxins that can lead to septic shock. Endotoxins are part of the outer membrane of Gram-negative bacteria, such as E. coli and N. meningitidis, which can trigger a severe immune response leading to septic shock. S. aureus, a Gram-positive bacterium, produces toxins that can also contribute to septic shock. Therefore, all of these bacteria can produce endotoxins responsible for septic shock. Choices A, B, and C are incorrect because they only identify individual bacteria that produce endotoxins, whereas the correct answer encompasses all bacteria listed.