A sputum smear from a patient with pneumonia revealed Gram-positive cocci in pairs with pointed ends and capsules. What is the likely microorganism?

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. The description of Gram-positive cocci in pairs with pointed ends and capsules matches the morphology of S. pneumoniae. This bacterium is known to cause pneumonia, especially in individuals with underlying conditions like COPD. Staphylococcus aureus (B) typically appears in clusters, not pairs. Klebsiella pneumoniae (C) is a Gram-negative rod, not a cocci. Neisseria meningitidis (D) is a Gram-negative diplococcus, not a cocci. Hence, based on the morphology and clinical context, Streptococcus pneumoniae is the likely microorganism causing pneumonia in this patient.

Correct Answer: A

Rationale: The correct answer is A: Clostridium tetani. This bacterium is known for causing tetanus due to its ability to produce tetanospasmin, a neurotoxin that leads to the characteristic muscle stiffness and spasms seen in tetanus. Clostridium perfringens (Choice B) is associated with gas gangrene, Streptococcus pyogenes (Choice C) causes streptococcal infections, and Escherichia coli (Choice D) is known for causing various gastrointestinal infections. Therefore, Choices B, C, and D are incorrect as they are not the causative agents of tetanus.

Correct Answer: B

Rationale: The correct answer is B: Yersinia pestis. Yersinia pestis is the bacterium responsible for causing the plague, specifically the bubonic plague. It is transmitted through fleas and rodents. Escherichia coli (A) is a common gut bacterium, Clostridium difficile (C) causes antibiotic-associated diarrhea, and Staphylococcus aureus (D) is associated with skin infections, but they are not responsible for causing the plague.

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pyogenes. 1. Gram-positive cocci in chains: characteristic of Streptococcus species. 2. Catalase-negative: Streptococcus species are catalase-negative. 3. Beta-hemolytic: S. pyogenes is beta-hemolytic on blood agar. Therefore, S. pyogenes fits all these criteria. B: Streptococcus pneumoniae is catalase-negative but alpha-hemolytic, not beta-hemolytic. C: Enterococcus faecalis is catalase-negative, but not typically beta-hemolytic or in chains. D: Staphylococcus aureus is catalase-positive and not in chains.

Correct Answer: C

Rationale: The correct answer is C: Increased active efflux from the bacterial cell. This is the most important mechanism of tetracycline resistance because it involves the bacteria actively pumping out the antibiotic, reducing its intracellular concentration. This prevents tetracycline from effectively targeting bacterial ribosomes. Choice A is incorrect as tetracycline resistance typically involves active efflux rather than reduced influx. Choice B is incorrect because tetracycline resistance mechanisms do not primarily involve altered cell membrane components affecting passive influx. Choice D is also incorrect as tetracycline resistance mechanisms do not typically involve direct enzymatic inactivation of the antibiotic.

Correct Answer: A

Rationale: The correct answer is A: Pseudomonas aeruginosa. P. aeruginosa is a Gram-negative rod that is oxidase-positive and lactose non-fermenting. The positive oxidase test indicates the presence of cytochrome c oxidase, a characteristic of P. aerugin. E. coli is lactose fermenting. Salmonella and Shigella are also Gram-negative rods, but they are lactose fermenters, unlike the lactose non-fermenting P. aeruginosa.

Correct Answer: A

Rationale: The correct answer is A: Corynebacterium diphtheriae. The presence of rod-shaped bacteria with dark blue polar granules suggests the presence of Corynebacterium diphtheriae, the causative agent of diphtheria. This bacterium is known for causing sore throat and fever, and the characteristic appearance on smear helps identify it. Streptococcus pyogenes (Choice B) typically appears as chains of cocci and is associated with strep throat. Haemophilus influenzae (Choice C) is a small, pleomorphic Gram-negative coccobacillus and is more commonly associated with respiratory infections. Klebsiella pneumoniae (Choice D) is a Gram-negative bacillus and is not typically associated with sore throat and fever in children.

Correct Answer: B

Rationale: The correct answer is B: Syphilis. The Wasserman reaction is a test for syphilis, specifically for detecting antibodies against the bacterium Treponema pallidum. In a 30-year-old man with a markedly positive Wasserman reaction, it indicates an active syphilis infection. Brucellosis (Choice A) is not diagnosed using the Wasserman reaction. Poliomyelitis (Choice C) is a viral infection affecting the spinal cord, not diagnosed using the Wasserman reaction. Influenza (Choice D) is a respiratory viral infection, not associated with the Wasserman reaction.

Correct Answer: A

Rationale: Step 1: Gram-positive cocci in chains suggest Streptococcus species. Step 2: Catalase-negative eliminates Staphylococcus aureus. Step 3: Beta-hemolytic on blood agar matches Streptococcus pyogenes. Step 4: Streptococcus pyogenes is a common cause of sore throat (pharyngitis). Summary: A: Streptococcus pyogenes - Correct due to Gram-positive cocci in chains, catalase-negative, beta-hemolytic, and common cause of sore throat. B: Staphylococcus aureus - Incorrect due to catalase-positive. C: Streptococcus pneumoniae - Incorrect due to alpha-hemolytic. D: Enterococcus faecalis - Incorrect due to not being beta-hemolytic.