A patient with pneumonia had sputum cultured, revealing Gram-negative diplococci. The bacteria were oxidase-positive and fermentative. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Neisseria meningitidis. This is because Neisseria meningitidis is a Gram-negative diplococcus that is oxidase-positive and fermentative. Neisseria gonorrhoeae is also a Gram-negative diplococcus, but it is not fermentative. Moraxella catarrhalis is oxidase-positive but not fermentative. Haemophilus influenzae is Gram-negative but is not a diplococcus, and it is not fermentative. Therefore, based on the characteristics provided in the question, Neisseria meningitidis is the most likely causative agent.

Correct Answer: C

Rationale: The correct answer is C: Acid-fast cell wall. Mycobacterium tuberculosis is characterized by its unique cell wall composition, containing high levels of mycolic acids which make it acid-fast. This property allows it to resist decolorization during acid-fast staining procedures. This distinguishes it from other bacteria. A: Producing spores is not a key feature of Mycobacterium tuberculosis. Spore formation is more commonly associated with bacterial species such as Bacillus and Clostridium. B: Mycobacterium tuberculosis is not Gram-negative. It is classified as acid-fast Gram-positive. D: Mycobacterium tuberculosis does not produce toxins as a key feature. Its pathogenicity is more closely related to its ability to evade host immune responses and persist in host tissues.

Correct Answer: A

Rationale: The correct answer is A: Yersinia pestis. Y. pestis is responsible for causing the plague, a severe infectious disease. This bacterium is transmitted via fleas from rodents to humans. It causes bubonic, septicemic, and pneumonic plague. Clostridium difficile causes gastrointestinal infections, Neisseria gonorrhoeae causes gonorrhea, and Pseudomonas aeruginosa can cause various infections but not the plague.

Correct Answer: C

Rationale: The correct answer is C: Escherichia coli. E. coli is a gram-negative bacterium, which means it has an outer membrane containing lipopolysaccharides (LPS), also known as endotoxins. Endotoxins are released when the bacterium is destroyed, causing an inflammatory response. Streptococcus pneumoniae (choice A) is a gram-positive bacterium and does not produce endotoxins. Clostridium tetani (choice B) produces exotoxins, not endotoxins. Staphylococcus aureus (choice D) is also a gram-positive bacterium and does not produce endotoxins. In summary, E. coli is the correct answer because it is a gram-negative bacterium that produces endotoxins, while the other choices are gram-positive bacteria that do not produce endotoxins.

Correct Answer: D

Rationale: The correct answer is D, "All of the above." Escherichia coli is the most common bacteria causing UTIs due to its ability to colonize the urinary tract. Salmonella enterica and Neisseria gonorrhoeae are not typically associated with UTIs. Therefore, by process of elimination, since A is correct, B and C are incorrect.