A patient with abdominal pain and diarrhea had a stool culture revealing non-lactose-fermenting, Gram-negative rods. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Shigella dysenteriae. Shigella causes dysentery, characterized by bloody diarrhea and abdominal pain. Shigella is a non-lactose-fermenting, Gram-negative rod. B: Salmonella typhi causes typhoid fever, not typically associated with abdominal pain and diarrhea. C: Escherichia coli, a common gut bacteria, can cause diarrhea but typically ferments lactose. D: Proteus vulgaris is not a common cause of gastrointestinal infection and is not typically associated with abdominal pain and diarrhea.

Correct Answer: A

Rationale: The correct answer is A because it specifies the commonly used parameters for autoclaving sterilization: 1.0 atm pressure, 120º C temperature, and 15-20 minutes duration. This combination ensures effective sterilization by providing the necessary heat and pressure for killing microorganisms. Rationale: 1. Pressure of 1.0 atm: Standard atmospheric pressure commonly used in autoclaving. 2. Temperature of 120º C: Optimal temperature for sterilization without causing damage to heat-sensitive materials. 3. Duration of 15-20 minutes: Time required for heat and pressure to penetrate and kill microorganisms effectively. Summary of Incorrect Choices: B: Incorrect temperature and duration, too high and long, may damage materials. C: Incorrect pressure and temperature, higher pressure and temperature not commonly used. D: Incorrect temperature, too high, can damage materials, and duration is longer than necessary.

Correct Answer: A

Rationale: The correct answer is A: Metronidazole. Anaerobic bacteria are sensitive to metronidazole due to its mechanism of action targeting their DNA. Metronidazole is often the drug of choice for treating infections caused by anaerobic bacteria. Gentamicin, Oxacillin, and Co-trimoxazole are not effective against anaerobes. Gentamicin is an aminoglycoside mostly used for aerobic bacteria, Oxacillin is a beta-lactam antibiotic effective against gram-positive bacteria, and Co-trimoxazole is a combination of sulfamethoxazole and trimethoprim mainly used for urinary tract infections and some respiratory infections.

Correct Answer: B

Rationale: The correct answer is B: Polymorphonuclear leukocyte. APCs are specialized immune cells that present antigens to T cells. B cells and dendritic cells are classic examples of APCs, as they can efficiently present antigens. Polymorphonuclear leukocytes, such as neutrophils, are not considered traditional APCs because they are primarily involved in phagocytosis and killing of pathogens rather than antigen presentation. Therefore, they do not play a significant role in initiating adaptive immune responses. The incorrect choices are A (B cell) and C (Dendritic cell) because they are both well-known antigen-presenting cells in the immune system. Choice D (All of the above) is incorrect because B cells and dendritic cells are indeed antigen-presenting cells.

Correct Answer: B

Rationale: The correct answer is B because Gram-negative bacteria have an outer membrane with lipopolysaccharides, which is a key characteristic used in Gram staining. This outer membrane is responsible for the pink/red color seen when stained with Gram stain. Choice A is incorrect because Gram-negative bacteria have a thin peptidoglycan layer. Choice C is incorrect because Gram-negative bacteria stain pink, not purple. Choice D is incorrect because all bacteria have a cell wall, but Gram-negative bacteria have a different structure compared to Gram-positive bacteria.

Correct Answer: C

Rationale: The correct answer is C: Protection against harsh conditions. Bacterial endospores are dormant structures produced by certain bacteria as a survival strategy under unfavorable conditions. They protect the bacterial DNA and other essential components from damage caused by heat, chemicals, desiccation, and radiation. Endospores do not directly participate in energy production (A), DNA replication (B), or protein synthesis (D). These functions are carried out by the active, vegetative form of the bacterial cell.

Correct Answer: D

Rationale: The correct answer is D because all three bacteria (Salmonella enterica, Escherichia coli, Pseudomonas aeruginosa) are known to produce endotoxins, specifically lipopolysaccharides in their cell walls. Endotoxins are released upon bacterial cell death and can trigger an immune response, leading to septic shock. Salmonella and E. coli are common causes of bacterial infections, while Pseudomonas is associated with nosocomial infections. Therefore, all of the above choices are correct in terms of producing endotoxins that can cause septic shock. Choices A, B, and C are incorrect individually because they do not encompass all the bacteria known to produce endotoxins that can lead to septic shock.

Correct Answer: A

Rationale: The correct answer is A: Chingamin (also known as Chloroquine). Chingamin is the drug of choice for chemoprophylaxis of malaria in regions with high risk. It is effective against Plasmodium falciparum, the most common malaria parasite. Chingamin is well-tolerated, affordable, and has a long track record of use. Sulfalen (Choice B) is not commonly used for malaria prophylaxis. Tetracycline (Choice C) is not recommended for malaria prophylaxis due to poor efficacy and resistance development. Metronidazole (Choice D) is not effective against malaria parasites.

Correct Answer: B

Rationale: The correct answer is B: CMV. Patients after allogeneic stem cell transplantation are monitored for CMV reactivation due to its potential to cause severe complications in immunocompromised individuals. CMV can lead to organ damage and even mortality in these patients. Monitoring for CMV reactivation allows for early detection and prompt intervention. Incorrect Choices: A: HAV - Hepatitis A virus reactivation is not commonly monitored in post-transplant patients. C: Rubella virus - Rubella is not a common concern for reactivation in this patient population. D: Measles virus - Measles reactivation is not typically monitored in these patients.