A patient with severe pneumonia had a sputum culture revealing Gram-negative rods that are non-lactose fermenters. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Pseudomonas aeruginosa. This is because Pseudomonas aeruginosa is a common Gram-negative rod that is a non-lactose fermenter and a common cause of severe pneumonia, especially in immunocompromised individuals. It is also known for its resistance to many antibiotics, making it difficult to treat. Summary of other choices: B: Escherichia coli is a lactose fermenter and is not commonly associated with severe pneumonia. C: Klebsiella pneumoniae is a lactose fermenter and is more commonly associated with pneumonia in alcoholics or debilitated patients. D: Enterobacter cloacae is a lactose fermenter and is not a common cause of severe pneumonia.

Correct Answer: D

Rationale: The correct answer is D: All are correct. Patients planned for treatment with monoclonal antibodies should be tested for HBV, HCV, and M. tuberculosis due to the risk of reactivation of these infections during treatment. HBV and HCV reactivation can lead to severe liver damage, while M. tuberculosis reactivation can cause serious respiratory complications. Testing for all three infections helps in identifying and managing any pre-existing infections to ensure patient safety during monoclonal antibody treatment. Choices A, B, and C are incorrect because each of these infections presents specific risks that need to be assessed before initiating monoclonal antibody therapy.

Correct Answer: C

Rationale: The correct answer is C: Mycobacterium tuberculosis. This bacterium is responsible for causing tuberculosis as it specifically infects the lungs and can spread to other parts of the body. Mycobacterium leprae (A) causes leprosy, Streptococcus pneumoniae (B) causes pneumonia, and Clostridium botulinum (D) causes botulism, making them incorrect choices for tuberculosis. Mycobacterium tuberculosis has unique characteristics and mechanisms that enable it to cause tuberculosis, such as its ability to evade the immune system and form granulomas in the lungs.

Correct Answer: A

Rationale: The correct answer is A: Pseudomonas aeruginosa. P. aeruginosa is known for producing a blue-green pigment called pyocyanin, which gives a characteristic color to the colonies. The fruity odor is due to the production of a compound called 2-aminoacetophenone by P. aeruginosa. These features are classic for P. aeruginosa and help differentiate it from other Gram-negative rods. Proteus mirabilis (B) typically does not produce blue-green pigment or fruity odor. Klebsiella pneumoniae (C) and Escherichia coli (D) also do not exhibit these specific characteristics associated with P. aeruginosa.

Correct Answer: A

Rationale: Osmosis is the correct answer because it is the process by which water molecules move across a semi-permeable membrane from an area of low solute concentration to an area of high solute concentration. This movement occurs passively, driven by the concentration gradient. Facilitated diffusion (B) involves the transport of specific molecules with the help of carrier proteins, not water. Phagocytosis (C) is a process where cells engulf solid particles, not water molecules. Exocytosis (D) is the process of releasing substances from a cell by fusion of vesicles with the cell membrane, not the transport of water across the membrane.

Correct Answer: B

Rationale: The correct answer is B because Q-fever is not transmitted only after ticks bite; it can also be transmitted through inhalation of contaminated aerosols. Rickettsia mooseri and Rickettsia provazekii can cause spotted fevers, making choice A correct. Mediterranean fever is associated with a recurrent pattern of fever, not maculopapular rash, making choice C incorrect. "None of the above" is not correct in this case as choice B is incorrect.

Correct Answer: B

Rationale: The correct answer is B: Mycobacterium leprae. This bacterium is responsible for causing leprosy, also known as Hansen's disease. Mycobacterium leprae specifically targets the skin, peripheral nerves, and mucosa of the upper respiratory tract. It is an acid-fast bacterium with a slow growth rate, making it difficult to culture in the laboratory. Streptococcus pyogenes (choice A) is responsible for various infections such as strep throat, Neisseria gonorrhoeae (choice C) causes gonorrhea, and Escherichia coli (choice D) is commonly found in the gut and can lead to various infections but not leprosy.

Correct Answer: D

Rationale: The correct answer is D because viral multiplication in cell culture can be detected by observing a specific cytopathic effect (A) caused by viral infection in cells and by using an immunofluorescence detection method (B) to visualize viral antigens within the cells. Choice C, the characteristic type of viral colonies, is incorrect as viral multiplication is not typically detected by observing viral colonies in cell culture. Option D is the correct choice as both A and B methods are commonly used to detect viral multiplication in cell culture.

Correct Answer: D

Rationale: The correct answer is D, Vancomycin, because it is not a beta-lactam antibiotic. Beta-lactam antibiotics contain a beta-lactam ring in their molecular structure, which Vancomycin lacks. Benzylpenicillin, Cephalosporin, and Monobactam all contain the beta-lactam ring, making them beta-lactam antibiotics. Vancomycin belongs to a different class of antibiotics called glycopeptides.