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, 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.

Correct Answer: C

Rationale: Rationale: Choice C is correct because immunomodulators can indeed be natural (e.g., cytokines) or artificial compounds (e.g., synthetic peptides). They work by modulating the immune response, enhancing or suppressing it as needed. Choice A is incorrect because immunomodulators can stimulate both humoral and cellular immune responses. Choice B is incorrect as isoniazid is primarily an antibiotic used to treat tuberculosis, not an immunomodulator. Choice D is incorrect because immunomodulators can have varying effects on the immune response, not just suppress it.

Correct Answer: A

Rationale: The correct answer is A: Obligate anaerobes. These microorganisms thrive in the absence of oxygen, as seen in the canned mushrooms where oxygen is limited. They produce toxins causing food poisoning. Facultative anaerobes (B) can survive with or without oxygen. Microaerophiles (C) require low levels of oxygen. Obligate aerobes (D) need oxygen to survive and would not be responsible for the poisoning in this case.

Correct Answer: D

Rationale: The correct answer is D, "None of the above," because viruses like Parotitidis (mumps), Rubella, and Influenza A are not typically associated with reactivation under immunosuppressive therapy. Reactivation is more commonly seen in latent viruses like herpesviruses (e.g., herpes simplex, varicella-zoster), cytomegalovirus, and Epstein-Barr virus. These viruses can remain dormant in the body and reactivate when the immune system is compromised. Therefore, the correct answer is D, as the viruses mentioned in choices A, B, and C do not fit the criteria for reactivation under immunosuppressive therapy.

Correct Answer: B

Rationale: The correct answer is B: Yersinia pestis. Y. pestis is the causative agent of plague, a serious infectious disease transmitted through fleas. It causes bubonic, pneumonic, and septicemic plague. Bordetella pertussis causes whooping cough, Rickettsia prowazekii causes epidemic typhus, and Treponema pallidum causes syphilis. Y. pestis is the correct answer because it is specifically associated with plague, making the other options incorrect.

Correct Answer: B

Rationale: The correct answer is B: K-antigen. H. Influenzae types are classified based on their capsular polysaccharides, which are known as K-antigens. The K-antigen is a major virulence factor and plays a crucial role in the pathogenicity of H. Influenzae. The other options (A, C, D) are not used to classify H. Influenzae types. Vi-antigen is related to Salmonella serotyping, O-antigen is characteristic of gram-negative bacteria such as Escherichia coli and Salmonella, and H-antigen is typically associated with flagellar antigens of bacteria like Salmonella and E. coli.

Correct Answer: A

Rationale: The correct answer is A: Treponema. The characteristics described match Treponema pallidum, the causative agent of syphilis. Treponema has long, spiral shape with 8-12 regular coils. Leptospira (B) is a spirochete but has fewer coils and causes leptospirosis. Borrelia (C) is another spirochete but typically has irregular coils and causes Lyme disease. Vibrios (D) are curved rods and not spirochetes.

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.