A patient with diarrhea had stool microscopy revealing flagellated protozoa with two nuclei. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Giardia lamblia. Giardia lamblia is a flagellated protozoan with two nuclei, known as the "falling leaf" appearance. It causes diarrhea in humans through ingestion of contaminated water or food. Entamoeba histolytica causes amoebic dysentery, characterized by bloody diarrhea and colitis. Trichomonas vaginalis is a sexually transmitted protozoan causing vaginal discharge but is not found in stool. Balantidium coli is a ciliated protozoan causing diarrhea but does not have flagellated forms.

Correct Answer: A

Rationale: Rationale: 1. Gram-positive cocci in pairs indicate Streptococcus pneumoniae. 2. Presence of a capsule points to S. pneumoniae as it has a polysaccharide capsule. 3. S. pneumoniae commonly causes sore throat. 4. Neisseria meningitidis, Haemophilus influenzae, and Klebsiella pneumoniae are not typically associated with sore throat.

Correct Answer: B

Rationale: The correct answer is B: Bacillus subtilis. Bacillus subtilis is a thermophilic bacterium capable of surviving in extreme heat due to its heat-resistant spores. It forms spores when exposed to unfavorable conditions, allowing it to withstand high temperatures. Escherichia coli (A), Staphylococcus aureus (C), and Clostridium botulinum (D) are mesophilic bacteria that do not have the same heat resistance mechanisms as Bacillus subtilis, making them unable to survive in extreme heat conditions.

Correct Answer: B

Rationale: The correct answer is B, Clostridium botulinum. This bacterium is capable of forming spores, which are dormant, resistant structures that help bacteria survive harsh conditions. Staphylococcus aureus (A), Escherichia coli (C), and Neisseria gonorrhoeae (D) do not form spores. Staphylococcus aureus is a gram-positive bacterium that does not produce spores. Escherichia coli is a gram-negative bacterium that also does not form spores. Neisseria gonorrhoeae is a gram-negative bacterium and does not have the ability to form spores. Therefore, the only bacteria among the options that can form spores is Clostridium botulinum.

Correct Answer: A

Rationale: Step 1: Streptococcus mutans is known for its ability to produce lactic acid, which contributes to the demineralization of tooth enamel, leading to dental caries. Step 2: Streptococcus pneumoniae is a common respiratory pathogen and not directly associated with dental caries. Step 3: Bacillus cereus is a foodborne pathogen and not typically found in the oral cavity or associated with dental caries. Step 4: Clostridium tetani causes tetanus, a neurological condition, and is not involved in the formation of dental caries. Summary: Choice A is correct as Streptococcus mutans is specifically linked to dental caries due to its acidogenic and aciduric properties. Choices B, C, and D are incorrect as they are not associated with dental caries.