A patient with a sore throat and fever had a throat culture revealing Gram-positive cocci in chains. The bacteria were beta-hemolytic. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pyogenes. 1. Gram-positive cocci in chains suggest streptococci. 2. Beta-hemolytic activity indicates Streptococcus pyogenes. 3. Streptococcus pyogenes is commonly associated with sore throat (pharyngitis) and fever. 4. Streptococcus pneumoniae (choice B) is alpha-hemolytic and mainly causes pneumonia. 5. Enterococcus faecalis (choice C) is not typically associated with sore throat. 6. Staphylococcus aureus (choice D) is not commonly beta-hemolytic and is not a typical cause of pharyngitis.

Correct Answer: A

Rationale: The correct answer is A: Delayed hypersensitivity reaction. In granuloma development in tuberculosis, macrophages present antigen to T cells, leading to a delayed hypersensitivity reaction. This triggers the recruitment of more macrophages and formation of granulomas. Antibody-dependent cytotoxicity (B) and complement-dependent cytotoxicity (C) involve antibodies and complement proteins in immediate hypersensitivity reactions, which are not the primary mechanisms in tuberculosis. Anaphylactic reaction (D) is an acute systemic allergic reaction mediated by IgE antibodies, not relevant to granuloma formation in tuberculosis.

Correct Answer: B

Rationale: The correct answer is B: Chlamydia trachomatis. This is because Chlamydia trachomatis is an obligate intracellular bacterium that cannot be cultured on standard agar plates. The symptoms described by the patient, such as pain, burning at urination, and scarce secretion in the morning, are indicative of a possible chlamydial infection. Additionally, the fact that the urine cultures are sterile after 24 hours of incubation suggests that the causative agent is not a typical bacteria like Escherichia coli, Streptococcus pneumoniae, or Neisseria gonorrhoeae, which would normally grow on agar plates. Therefore, Chlamydia trachomatis is the most probable cause of this disease. Summary: A: Escherichia coli - Incorrect, as it is a common cause of urinary tract infections and would typically grow on agar plates. C: Streptococcus pneumoniae - Incorrect, as it is

Correct Answer: A

Rationale: Ribosomes are the target for antibiotics as they interfere with protein synthesis in bacteria. Aminoglycosides, tetracyclines, macrolides, and lincosamides all target ribosomes by inhibiting protein synthesis at different stages. Beta-lactam antibiotics target cell wall synthesis, not ribosomes. Antifolate compounds, quinolones, and raspicin target DNA synthesis and replication, not ribosomes. Therefore, the correct answer is A as it includes antibiotics that specifically target ribosomes for inhibiting bacterial protein synthesis.

Correct Answer: D

Rationale: The correct answer is D: Propionibacterium acnes. This bacterium is not a fungus, but a common skin bacteria. Fungal vaginitis is typically caused by Candida albicans or other fungal species, not by bacteria like Escherichia coli, Streptococcus agalactiae, or Klebsiella oxytoca. Propionibacterium acnes is not associated with vaginal infections, making it the correct answer in this context.

Correct Answer: B

Rationale: Step-by-step rationale for why choice B (Tuberculin is introduced) is correct: 1. Tuberculin test helps identify individuals with latent TB infection. 2. Negative skin-allergic samples suggest absence of active TB. 3. Introducing tuberculin can help confirm latent TB infection. 4. Antibiotics are not prescribed for negative skin-allergic samples. 5. Vaccines are not administered for TB diagnosis. Summary: - Choice A is incorrect as antibiotics are not prescribed for negative skin-allergic samples. - Choice C is incorrect as vaccines are not used for TB diagnosis. - Choice D is incorrect as introducing tuberculin is the appropriate step in this scenario.

Correct Answer: D

Rationale: The correct answer is D, "All of these." Monotrichous bacteria have a single flagellum at one end, amphitrichous have flagella at both ends, and peritrichous have flagella distributed all over the surface. The answer D is correct because it includes all these possibilities based on flagella location. Monotrichous is incorrect as it only refers to a single flagellum, amphitrichous is incorrect as it only refers to flagella at both ends, and peritrichous is incorrect as it only refers to flagella all over the surface. Therefore, the correct answer encompasses all these options.

Correct Answer: A

Rationale: The correct answer is A: Trichomonas vaginalis. Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis, a sexually transmitted infection characterized by inflammation of urogenital tracts. The description of big unicellular pyriform organisms with a sharp spike on the back end of their bodies, big nucleus, and undulating membrane matches the morphology of Trichomonas vaginalis. Trichomonas hominis and Trichomonas buccalis are different species that do not cause urogenital infections. Trypanosoma gambiense is a protozoan parasite causing African trypanosomiasis and does not match the described morphology or symptoms.

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pyogenes. 1. Gram-positive cocci in chains suggest streptococci. 2. Beta-hemolytic activity indicates Streptococcus pyogenes. 3. Streptococcus pyogenes is commonly associated with sore throat (pharyngitis) and fever. 4. Streptococcus pneumoniae (choice B) is alpha-hemolytic and mainly causes pneumonia. 5. Enterococcus faecalis (choice C) is not typically associated with sore throat. 6. Staphylococcus aureus (choice D) is not commonly beta-hemolytic and is not a typical cause of pharyngitis.