A patient with a sore throat and fever had a throat smear stained with Gram's method, revealing Gram-positive cocci in chains. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pyogenes. This bacterium is known to cause sore throat and fever, commonly referred to as strep throat. Gram's stain showing Gram-positive cocci in chains is characteristic of Streptococcus species. Streptococcus pyogenes is a beta-hemolytic bacterium that forms chains and is a common cause of bacterial pharyngitis. Staphylococcus aureus (B) is a Gram-positive cocci that forms clusters, not chains. Neisseria gonorrhoeae (C) is a Gram-negative diplococcus and is not associated with sore throat. Enterococcus faecalis (D) is a Gram-positive cocci that can cause infections but is not typically associated with sore throat.

Correct Answer: D

Rationale: The correct answer is D, chemotherapy combined with surgical therapy. Actinomycosis is a bacterial infection that requires a combination of antibiotics to target the bacteria and surgery to remove abscesses or infected tissues. Antibiotics alone may not penetrate abscesses effectively. Waiting for self-clearance can lead to complications. Surgical treatment alone may not eradicate the infection entirely. Therefore, the most effective therapeutic plan is to combine chemotherapy to treat the infection systemically and surgery to remove localized infections.

Correct Answer: C

Rationale: The correct answer is C: Hepatitis A virus. This is because Hepatitis A virus is a non-enveloped virus, while choices A, B, and D are all enveloped viruses. Enveloped viruses have a lipid bilayer membrane surrounding their protein capsid, aiding in their ability to infect host cells. Hepatitis C, B, and D viruses all possess this lipid envelope, making them enveloped viruses. Hepatitis A virus, on the other hand, lacks this lipid envelope and is classified as a non-enveloped virus. Therefore, the correct answer is C.

Correct Answer: A

Rationale: The correct answer is A: Entamoeba histolytica. This is because the presence of cysts with four nuclei is characteristic of Entamoeba histolytica, a protozoan parasite that causes amoebic dysentery. Entamoeba histolytica cysts contain four nuclei, distinguishing them from other pathogens. Giardia lamblia and Trichomonas vaginalis are not associated with cysts containing four nuclei. Balantidium coli is a ciliated protozoan that does not typically form cysts with multiple nuclei. In summary, the unique feature of four nuclei in the cysts points towards Entamoeba histolytica as the most likely causative agent of the diarrhea in this patient.

Correct Answer: B

Rationale: The correct answer is B: For HIV. Pneumocystis pneumonia in a young man with CD4+ cells less than 200/mm3 is highly suggestive of HIV infection. HIV weakens the immune system, leading to opportunistic infections like pneumocystis pneumonia. Testing for HIV is crucial for diagnosis and appropriate management. Explanation for other choices: A: Testing for ureaplasma urealyticum is not indicated in this case as the symptoms and CD4+ cell count point towards an HIV-related infection. C: Testing for Treponema pallidum (syphilis) is not relevant in the context of a young man with pneumocystis pneumonia and low CD4+ cell count. D: Testing for Neisseria gonorrhoea is not appropriate in this scenario as the symptoms and CD4+ cell count suggest an underlying HIV infection rather than a bacterial sexually transmitted infection.

Correct Answer: A

Rationale: The correct diagnosis is A: Balantidiasis. The presence of large ciliated protozoa with a kidney-shaped macronucleus is characteristic of Balantidium coli, the causative agent of balantidiasis. The ciliated trophozoites of Balantidium coli are unique compared to the other choices. Giardiasis is caused by Giardia lamblia, which has flagella and not cilia. Amoebiasis is caused by Entamoeba histolytica, which lacks cilia. Trichomoniasis is caused by Trichomonas vaginalis, which also lacks cilia. Therefore, based on the specific morphology described, the correct diagnosis is Balantidiasis.

Correct Answer: C

Rationale: The correct staining technique for staining sputum smears from a tuberculosis patient is Ziehl-Neelsen staining. This technique uses a carbol fuchsin stain that specifically stains acid-fast organisms like Mycobacterium tuberculosis. The steps involved include staining with carbol fuchsin, decolorizing with acid-alcohol, counterstaining with methylene blue, and then examining under a microscope. This staining method is crucial for detecting the acid-fast bacilli characteristic of tuberculosis. Explanation for incorrect choices: A: Gram staining is used to differentiate bacteria into Gram-positive and Gram-negative, not suitable for acid-fast organisms like Mycobacterium tuberculosis. B: Giemsa staining is used for detecting parasites and certain types of white blood cells, not specific for acid-fast bacteria. D: Burry staining is not a recognized staining technique in microbiology for staining acid-fast organisms.

Correct Answer: A

Rationale: Step 1: Viruses can have either DNA or RNA, not both, hence they have only one type of nucleic acid. Step 2: The extracellular form of viruses is called virion, not viroid. Step 3: Viruses are obligate intracellular parasites, meaning they rely on host cells for replication. Step 4: Viruses are measured in nanometers, not micrometers. Therefore, the correct answer is A.

Correct Answer: C

Rationale: The correct answer is C because Rickettsia requires living cells for growth and replication. Chick embryos, cell cultures, and lab animals provide a suitable environment for Rickettsia isolation. Skin-allergy tests (A) and serological methods for proving antibodies (B) are not directly used for isolating Rickettsia as they do not support the growth of the bacteria. "None of the above" (D) is incorrect as option C involves the appropriate methods for isolating Rickettsia.