A patient with pneumonia had sputum cultured on Endo agar, revealing red colonies. The bacteria were Gram-negative rods. What is the most likely causative agent?

Correct Answer: A

Rationale: Rationale for correct answer (A: Escherichia coli): 1. Endo agar selects for Gram-negative bacteria. 2. Red colonies on Endo agar indicate lactose fermentation, characteristic of E. coli. 3. E. coli is a common cause of pneumonia, especially in immunocompromised patients. Summary of why other choices are incorrect: - B: Klebsiella pneumoniae: Typically forms mucoid colonies on agar. - C: Pseudomonas aeruginosa: Produces characteristic greenish-blue colonies on agar. - D: Proteus mirabilis: Does not typically ferment lactose, so would not produce red colonies on Endo agar.

Correct Answer: A

Rationale: The correct answer is A: Spores. The Ozheshko method is used to stain spores, which are resistant structures produced by certain bacterial species. By studying the smear of streptobacillus preparation under oil immersion, one can observe the presence of spores as distinct, oval bodies within the bacteria. Spores are important for bacterial survival in harsh conditions. Summary: B: Capsules are not typically stained using the Ozheshko method. Capsules are usually visualized using negative staining techniques. C: Flagella are not stained by the Ozheshko method. Flagella are visualized using special staining techniques like the flagella stain. D: Inclusions are not specifically stained by the Ozheshko method. Inclusions are often observed using techniques that highlight cellular structures or components.

Correct Answer: A

Rationale: The correct answer is A: Oxidation. Phase I reactions in biotransformation involve introducing or unmasking functional groups through oxidation, reduction, or hydrolysis. Oxidation reactions typically involve the addition of an oxygen atom or removal of hydrogen atoms, making them common phase I reactions. In this process, enzymes like cytochrome P450 play a crucial role in catalyzing the oxidation reactions. Conjugation (B), acetylation (C), and glucuronidation (D) are all examples of phase II reactions, which involve the conjugation of the drug or metabolite with endogenous compounds to increase water solubility for excretion. These reactions typically follow phase I reactions and are not classified as phase I reactions in biotransformation.

Correct Answer: A

Rationale: The correct answer is A: Shigella dysenteriae. This bacterium produces Shiga toxin, which inhibits protein synthesis by inactivating the ribosomes. Shigella dysenteriae is known to cause severe gastrointestinal infections. Choice B: Escherichia coli typically does not produce toxins that inhibit protein synthesis. E. coli strains may produce toxins that cause diarrhea. Choice C: Clostridium tetani produces tetanospasmin toxin, which affects the nervous system but does not inhibit protein synthesis. Choice D: Staphylococcus aureus produces toxins like enterotoxins and exotoxins but these toxins do not directly inhibit protein synthesis.

Correct Answer: B

Rationale: The correct answer is B because live vaccines can potentially revert to a virulent form, although this is extremely rare. This is due to the live attenuated virus in the vaccine potentially mutating back to a more dangerous form. Live vaccines are designed to be weakened but there is a small risk of reversion. Therefore, statement B is not correct. A: This statement is correct as immunocompromised individuals may have adverse reactions to live vaccines due to their weakened immune system. C: This statement is correct as microbes with many serotypes can make it challenging to develop a vaccine that covers all variations. D: This statement is correct as side effects to vaccination, although usually mild and temporary, can occur in some individuals.

Correct Answer: D

Rationale: The correct answer is D because the defense role of the skin is not related to lysozyme activity. Lysozyme is an enzyme found in tears, saliva, and mucus, not specifically in the skin. The skin's defense role is primarily related to its physical barrier function, low pH creating an acidic environment that inhibits microbial growth, secretion of antimicrobial peptides, and the activity of skin macrophages that phagocytose pathogens. Choices A, B, and C are true statements as they correctly describe different aspects of the skin's defense mechanisms.

Correct Answer: A

Rationale: The correct answer is A: Obligate anaerobes. These bacteria can only survive in the absence of oxygen as they lack the enzymes needed for aerobic respiration. They typically use fermentation or anaerobic respiration for energy production. Incorrect choices: B: Facultative anaerobes can switch between aerobic and anaerobic metabolism based on oxygen availability. C: Obligate aerobes require oxygen for survival and cannot survive in anoxic conditions. D: Microaerophiles require low levels of oxygen for growth and are not capable of surviving in completely anoxic conditions.

Correct Answer: A

Rationale: The correct answer is A: cryophiles. Psychrophiles are microorganisms that thrive in cold temperatures. The prefix "cryo-" means cold, which accurately describes the environment in which these organisms grow. Choice B, thermophiles, are organisms that thrive in high temperatures. Choice C, mesophiles, grow best at moderate temperatures. Choice D, psychrotrophs, are organisms that can grow at refrigeration temperatures but have an optimal growth temperature range different from psychrophiles.

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. This bacterium is a common cause of pneumonia and is characterized by being Gram-positive cocci arranged in pairs with a capsule, as described in the question. The presence of a capsule is a key characteristic of Streptococcus pneumoniae, distinguishing it from the other choices. Staphylococcus aureus (B) is a Gram-positive cocci, but it typically forms clusters, not pairs. Klebsiella pneumoniae (C) is a Gram-negative rod, not a Gram-positive cocci. Enterococcus faecalis (D) is a Gram-positive cocci, but it does not typically present with a capsule in the same way Streptococcus pneumoniae does.