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: C

Rationale: The most probable diagnosis for the homeless male with symptoms of roseolo-petechiae rash, hyperemia, tachycardia, splenomegaly, and euphoria is Leptospirosis. Leptospirosis is a bacterial infection commonly associated with exposure to contaminated water or soil, which is prevalent in homeless populations. The initial diagnosis of "influenza" fits with the flu-like symptoms. The appearance of roseolo-petechiae rash and other symptoms like hyperemia, tachycardia, splenomegaly, and euphoria are consistent with leptospirosis. The other choices can be ruled out: A) Typhus typically presents with headache, fever, and rash, but not the specific symptoms described. B) Alcoholic delirium is more likely with a history of alcohol abuse and presents with confusion, disorientation, and hallucinations. D) Abdominal typhoid presents with prolonged fever, abdominal pain

Correct Answer: B

Rationale: Step-by-step rationale: 1. Marburg virus is named after the German city Marburg where it was first identified in 1967. 2. Chikungunya virus is named after a village in Tanzania. 3. Measles virus got its name from the Middle English word "maselen" meaning "many little spots". 4. Epstein-Barr virus is named after Michael Epstein and Yvonne Barr, who discovered it. Summary: B is correct as it is directly named after the city of its discovery. A, C, and D are incorrect as they are named after other locations, characteristics, or discoverers.

Correct Answer: D

Rationale: The correct answer is D. Escherichia coli, Salmonella enterica, and Pseudomonas aeruginosa all produce endotoxins that can lead to septic shock. Endotoxins are part of the outer membrane of Gram-negative bacteria and can trigger a systemic inflammatory response if released into the bloodstream. E. coli and Salmonella are common causes of bacterial infections that can lead to septic shock, while P. aeruginosa is a known opportunistic pathogen that can produce endotoxins. Therefore, all three bacteria can cause septic shock by releasing endotoxins. Choices A, B, and C are incorrect because each of these bacteria individually can produce endotoxins that contribute to the development of septic shock.

Correct Answer: A

Rationale: Step-by-step rationale for choice A being correct: 1. Microscopic examination of discharge from infected organ allows direct visualization of bacteria causing the infection. 2. Microscopic examination of urine for organisms can help identify any bacteria present in the urinary tract. 3. Both methods are specific for diagnosing bacterial infections in the reproductive system. Summary: - Choice B is incorrect as biopsy is invasive and not typically used for diagnosing bacterial infections. - Choice C is incorrect as fecal samples and urine protein tests are not relevant for diagnosing bacterial infections in the reproductive system. - Choice D is incorrect as antibody agglutination and coagulation tests are not primary methods for diagnosing bacterial infections in the reproductive system.

Correct Answer: A

Rationale: The correct answer is A: Botulism. Botulism is caused by the toxin produced by Clostridium botulinum bacteria found in improperly preserved or canned foods. The symptoms described align with botulism, such as difficulty swallowing and breathing due to muscle paralysis. The tennis racket appearance seen under microscopy corresponds to the characteristic appearance of Clostridium botulinum spores. The other choices can be ruled out based on the clinical presentation and microscopy findings. Cholera typically presents with severe watery diarrhea, Nontyphoidal Salmonella infection with fever and gastrointestinal symptoms, and Typhoid fever with high fever and abdominal pain. Therefore, the most likely diagnosis in this case is botulism.

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: A

Rationale: The correct answer is A: Anatoxin. An anatoxin is a preparation that contains inactivated toxins produced by the anthrax-causing bacteria. By administering anatoxin, the population can develop immunity against the toxin without being exposed to the live bacteria. This specific prophylaxis approach helps prevent the development of anthrax infection by targeting the toxin itself. Summary: - Choice B (Inactivated vaccine) is incorrect because an inactivated vaccine typically contains killed or inactivated whole bacteria, not just the toxins. - Choice C (Chemical vaccine) is incorrect as there is no such thing as a chemical vaccine; vaccines are biological preparations. - Choice D (Genetically engineered vaccine) is incorrect because while vaccines can be genetically engineered, the specific term "genetically engineered vaccine" does not accurately describe the prophylaxis used against anthrax in this scenario.

Correct Answer: B

Rationale: The correct answer is B: Actinomycosis. Actinomyces is a gram-positive bacterium that forms sulfur granules (druses) with gram-positive coloring in the center and filamentous structures resembling cones with gram-negative coloring. This morphology is characteristic of Actinomyces species. Fusobacteriosis (choice A) typically presents with gram-negative rods. Staphylococcal osteomyelitis (choice C) is caused by gram-positive staphylococci, not Actinomyces. Anaerobic infections (choice D) can be caused by various bacteria, but the specific morphology described in the question matches Actinomyces, making choice B the correct answer.