A patient with a severe sore throat had a throat smear revealing Gram-positive cocci in pairs with a capsule. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. The presence of Gram-positive cocci in pairs with a capsule is characteristic of Streptococcus pneumoniae. This bacterium is a common cause of bacterial pharyngitis, leading to a severe sore throat. Staphylococcus aureus (B) does not typically present in pairs or have a capsule. Neisseria meningitidis (C) is a Gram-negative diplococcus, not a Gram-positive cocci. Klebsiella pneumoniae (D) is a Gram-negative bacillus, not a cocci. Thus, based on the characteristics described in the question, Streptococcus pneumoniae is the most likely causative agent.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Clostridium botulinum is known for producing the neurotoxin causing botulism. 2. Botulinum toxin paralyzes muscles, leading to symptoms of botulism. 3. Clostridium tetani produces tetanus toxin causing muscle rigidity, not botulism. 4. Streptococcus pneumoniae causes pneumonia, not botulism. 5. Escherichia coli can cause food poisoning, but not botulism. Summary: Choice A is correct (Clostridium botulinum) due to its association with botulism and neurotoxin production. Choices B, C, and D are incorrect as they are associated with different diseases and toxins.

Correct Answer: D

Rationale: The correct answer is D: Proteus mirabilis. The patient's symptoms of lower abdominal pain, back pain, frequent/painful urination, and the presence of gram-negative oxidase-positive bacilli forming green mucoid colonies with a specific smell suggest a urinary tract infection caused by Proteus mirabilis. This bacterium is known for causing UTIs and is characterized by its swarming motility and distinctive odor. A: Pseudomonas aeruginosa is commonly associated with hospital-acquired infections but does not typically cause UTIs with the specific characteristics described. B: Mycoplasma pneumonia is a bacterium that causes respiratory infections, not UTIs. C: Str.pyogenes (Streptococcus pyogenes) is a common cause of strep throat and skin infections, not UTIs. D: Helicobacter pylori is associated with gastritis and peptic ulcers, not UTIs.

Correct Answer: D

Rationale: The correct answer is D: Blood. Normal flora refers to the microorganisms that naturally inhabit specific areas of the body. Blood is considered a sterile environment in healthy individuals, meaning it does not harbor any microorganisms under normal circumstances. In contrast, the intestine, skin, and vagina all have normal flora as they provide suitable environments for various microbial species to thrive. The presence of normal flora in these sites helps maintain a balance and protect against pathogenic invaders. Blood, being a vital and sterile fluid, is not meant to have any resident microbial populations.

Correct Answer: D

Rationale: The correct answer is D: IgM. IgM antibodies are the first type of antibodies produced by the immune system in response to an acute infection, such as Parvovirus B19. During the first 10-14 days of the infection, IgM antibodies are usually detectable in the blood, indicating a recent or ongoing infection. IgG antibodies (choice A) are produced later in the immune response and indicate past infection or immunity. IgA (choice B) is more commonly associated with mucosal immunity and may not be as prominent in the early stages of systemic infections. IgD (choice C) is primarily found on the surface of B cells and is involved in B cell activation but is not typically used as a marker for acute infections like IgM.

Correct Answer: A

Rationale: The correct answer is A: Clostridium perfringens. This bacterium fits all the characteristics mentioned: Gram-positive rods with spore formation, motile, and gas production in nutrient broth. Clostridium perfringens is known to cause gas gangrene, which aligns with the gas production in nutrient broth. Bacillus anthracis (B) causes anthrax and does not typically produce gas. Clostridium tetani (C) causes tetanus and does not form spores that are motile. Bacillus cereus (D) is a common cause of food poisoning and does not cause gas gangrene.

Correct Answer: A

Rationale: The correct answer is A: Tuberculin. The Mantoux test involves injecting tuberculin, a protein derivative of Mycobacterium tuberculosis, under the skin to check for a delayed hypersensitivity reaction in individuals exposed to TB. B: BCG vaccine is a live attenuated vaccine used for TB prevention, not for diagnostic testing. C: DTP vaccine is for diphtheria, tetanus, and pertussis, not TB. D: Tularinum is not a standard immunobiological preparation used for TB testing. Therefore, A is the correct choice for the Mantoux test.

Correct Answer: D

Rationale: The correct answer is D: sterols. Eukaryotic cytoplasmic membranes contain sterols, such as cholesterol, which provide stability and regulate fluidity. This is a key characteristic that distinguishes them from prokaryotic membranes. Cellulose (A) is a component of plant cell walls, not the cytoplasmic membrane. Starch (B) is a carbohydrate used for energy storage in plants. Chitin (C) is a component of fungal cell walls and arthropod exoskeletons, not found in eukaryotic cytoplasmic membranes.

Correct Answer: A

Rationale: The correct answer is A: Metronidazole. Metronidazole is the drug of choice for amebic dysentery as it effectively targets the protozoa causing the infection. It has good tissue penetration and high efficacy against Entamoeba histolytica. Pyrantel (B) is used for nematode infections, not amebiasis. Levamisole (C) is an anthelmintic for roundworms and not effective against amoebas. Bicillin-5 (D) is a penicillin antibiotic, which is not indicated for treating amebic dysentery.