A patient with pneumonia had a sputum smear stained by the Gram method revealing Gram-positive cocci in pairs. 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 indicates a bacterial morphology consistent with Streptococcus pneumoniae, a common cause of pneumonia. This bacterium is known to appear in pairs or short chains on Gram stain. Staphylococcus aureus (B) typically presents as clusters of Gram-positive cocci, Neisseria meningitidis (C) is a Gram-negative diplococcus, and Klebsiella pneumoniae (D) is a Gram-negative rod, making them less likely causative agents in this scenario.

Correct Answer: A

Rationale: The correct answer is A: Giardia lamblia. Giardia is a flagellated protozoa with two nuclei, causing diarrhea. It is commonly found in contaminated water sources. Entamoeba histolytica (B) causes amoebic dysentery with trophozoites in stool. Trichomonas vaginalis (C) causes sexually transmitted infections, not diarrhea. Balantidium coli (D) is a ciliated protozoa causing dysentery with ciliated trophozoites. Therefore, Giardia lamblia is the most likely causative agent in this case.

Correct Answer: C

Rationale: The correct answer is C. Prostatitis is inflammation of the prostate gland, leading to symptoms like painful urination, fever/chills, and weak urine flow. Painful urination is due to irritation of the urinary tract by the inflamed prostate. Fever/chills indicate an infection, common in prostatitis. Weak urine flow is due to obstruction caused by the inflamed prostate. Choice A is incorrect as muscle aches, sore throat, and swollen lymph nodes are not typical symptoms of prostatitis. Choice B is incorrect as painful joints and nausea are not characteristic symptoms. Choice D is almost identical to the correct answer but includes an extra symptom of painful joints, which is not associated with prostatitis.

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. This bacterium is the most likely causative agent because it is a Gram-positive cocci in pairs with a capsule, which matches the description provided. S. pneumoniae is a common cause of bacterial pharyngitis and can present with sore throat. Summary of other choices: B: Staphylococcus aureus is a Gram-positive cocci in clusters, not pairs, and is not typically associated with sore throat. C: Neisseria meningitidis is a Gram-negative diplococcus and more commonly causes meningitis or septicemia, not sore throat. D: Klebsiella pneumoniae is a Gram-negative rod bacterium, not a Gram-positive cocci, and is not a common cause of sore throat.

Correct Answer: A

Rationale: The correct answer is A because spores are heat-resistant and require high temperatures for destruction. Autoclaving at 121°C for 15-20 minutes ensures spore destruction due to the high pressure and temperature. Choice B (heating to 80°C) is insufficient to destroy spores. Choice C (boiling at 100°C for 10 minutes) is also inadequate as spores require higher temperatures for elimination. Choice D (None of them) is incorrect as autoclaving is the standard method for spore sterilization.

Correct Answer: D

Rationale: The correct answer is D: stereomicroscopes. These types of microscopes, also known as dissecting microscopes, are designed for observing larger objects like insects or worms. They have a lower magnification power compared to electron microscopes (A), which are used to observe smaller objects at a much higher resolution. Dark-field microscopes (B) are used for observing live and unstained samples with high contrast, not specifically for larger objects. Fluorescence microscopes (C) are used to observe specimens that fluoresce under specific wavelengths of light, not necessarily for large objects like insects or worms. Therefore, the most suitable choice for observing fairly large objects like insects or worms is stereomicroscopes.

Correct Answer: A

Rationale: The correct answer is A: Balantidium coli. Balantidium coli is a large ciliated protozoa with a kidney-shaped macronucleus, commonly found in the feces of individuals with dysentery symptoms. Its morphology matches the description given in the question, making it the most likely causative agent. Summary of other choices: B: Entamoeba histolytica - This is not the correct answer because Entamoeba histolytica is a small amoeba with no cilia and a different nucleus shape. C: Giardia lamblia - This is not the correct answer as Giardia lamblia is a flagellated protozoa with a pear-shaped nucleus, different from the description provided. D: Trichomonas hominis - This is not the correct answer as Trichomonas hominis is a flagellated protozoa with multiple flagella and an undulating membrane, which does not match the characteristics of the

Correct Answer: D

Rationale: The correct answer is D: mixed infection. In a mixed infection, multiple infectious agents establish themselves at the same site, leading to a complex and diverse infection. This type of infection can involve different types of pathogens such as bacteria, viruses, fungi, and parasites. It can be challenging to diagnose and treat due to the presence of multiple pathogens. A: Chronic infection refers to an infection that persists over a long period but is typically caused by a single pathogen. B: Necrotizing infection is characterized by rapid tissue destruction but does not necessarily involve multiple infectious agents. C: Fatal infection does not specify the presence of multiple infectious agents, it simply implies that the infection leads to death. In summary, the correct answer, mixed infection, is the only choice that specifically describes the scenario of multiple infectious agents establishing themselves at the same site.

Correct Answer: D

Rationale: The correct answer is D because virulent strains of Listeria monocytogenes exhibit multiple pathogenic factors. A: They do not have endotoxin-like substances, so this is incorrect. B: They are indeed facultative intracellular bacteria, aiding in their ability to survive and replicate inside host cells. C: They produce hemolysin, which helps them lyse red blood cells. Therefore, the correct answer is D, as all of the above statements are true for virulent strains of Listeria monocytogenes.