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: B

Rationale: The correct answer is B: Fimbriae. Fimbriae are short, hair-like appendages on the surface of bacteria that help in attachment to surfaces. They aid in colonization and biofilm formation. Flagella (A) are used for motility. Pili (C) are longer appendages used for conjugation and adherence to other cells. Capsules (D) are protective structures that aid in evading the host immune system, not necessarily for attachment.

Correct Answer: A

Rationale: The correct answer is A: Helicobacterial infection. This is the most probable leading mechanism of disease development in this case because the patient's symptoms, such as heartburn, epigastric pain, food intolerance, and presence of a duodenal ulcer with a positive urease test, are classic signs of Helicobacter pylori infection. This bacterium colonizes the stomach lining, leading to inflammation and ulcer formation. The exacerbations in spring and autumn could be due to seasonal variations in immune response. Choice B: Dietary allergy is incorrect because the symptoms and findings in the patient are more indicative of an infectious etiology rather than an allergic reaction to specific foods. Choice C: Autoantibody production is unlikely as there are no indications of an autoimmune process in this case. Choice D: Reduced prostaglandin synthesis is not the leading mechanism as the symptoms and findings are more consistent with an infectious cause rather than a deficiency in prostaglandin synthesis.

Correct Answer: A

Rationale: Rationale for Correct Answer A (Diphtheria): 1. Thin yellow bacilli with dark brown grains on ends suggest Corynebacterium diphtheriae, characteristic of diphtheria. 2. Roman numeral five shape is typical of diphtheria bacilli. 3. Diphtheria causes sore throat and can spread in boarding schools. 4. Neisser staining method is used for diphtheria bacilli. Summary of Incorrect Choices: B: Scarlet fever is caused by Streptococcus pyogenes and presents with rash, not yellow bacilli. C: Listeriosis is caused by Listeria monocytogenes, not consistent with the described findings. D: Tonsillitis can be caused by various bacteria or viruses, but the specific characteristics described do not match.

Correct Answer: B

Rationale: The correct answer is B: Catalase. Catalase is the enzyme responsible for breaking down hydrogen peroxide into water and oxygen. This process helps protect the bacteria from oxidative damage caused by hydrogen peroxide. Amylase (A), Lipase (C), and Protease (D) are enzymes that are not involved in breaking down hydrogen peroxide. Amylase is involved in breaking down starch, Lipase breaks down lipids, and Protease breaks down proteins. Therefore, they are not the correct enzymes for the given question.

Correct Answer: A

Rationale: The correct answer is A: Capsule. A capsule is a mucous structure tightly bound to the bacterial cell wall with distinct outer boundaries. This structure helps bacteria evade the host immune system, resist desiccation, and adhere to surfaces. In contrast, spores are resistant structures formed by certain bacteria for survival, filaments are long chains of bacterial cells, and ribosomes are cellular organelles responsible for protein synthesis. Therefore, based on the characteristics described in the question, the most appropriate choice is A: Capsule.

Correct Answer: A

Rationale: The correct answer is A because adaptive immunity is not mainly observed in the skin and mucous membranes. Adaptive immunity is a systemic response that involves specific immune cells and antibodies targeting specific pathogens. It develops immune memory (B), meaning it can recognize and respond faster upon re-exposure to the same pathogen. Adaptive immunity also has specificity (C), as it can target specific antigens. Lastly, adaptive immunity is not evolutionarily newer in comparison to innate immunity (D), as both systems have co-evolved to provide comprehensive protection against pathogens.

Correct Answer: B

Rationale: The function of bacterial pili is to aid in adhesion. Pili are hair-like structures on the bacterial surface that help the bacteria attach to surfaces or other cells. This adhesion is crucial for colonization and infection. Pili do not provide motility, as that is typically done by flagella. Bacteria form spores for survival under harsh conditions, and protein synthesis is carried out by ribosomes, not pili. Thus, the correct answer is B, aiding in adhesion.

Correct Answer: A

Rationale: The correct answer is A: TRUE. Poxviruses are indeed DNA viruses that replicate in the cytoplasm. This is due to their complex structure that allows them to carry out their replication process in the cytoplasm of the host cell. Other choices are incorrect because poxviruses specifically replicate in the cytoplasm and do not require the nucleus for replication, ruling out choice B. Choice C is incorrect because poxviruses consistently replicate in the cytoplasm regardless of the situation. Choice D is incorrect as the correct answer is A.