A stool sample from a patient with severe diarrhea revealed non-lactose-fermenting, Gram-negative rods on Endo agar. What is the likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Shigella dysenteriae. It is the likely causative agent because it is a non-lactose-fermenting, Gram-negative rod commonly associated with severe diarrhea. Shigella dysenteriae specifically causes bacillary dysentery. Other choices are incorrect because: B: Escherichia coli is a lactose-fermenting bacterium commonly found in the gut and not typically associated with severe diarrhea. C: Salmonella typhi causes typhoid fever, not severe diarrhea. D: Proteus mirabilis is a urease-positive bacterium associated with urinary tract infections, not severe diarrhea.

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. This bacterium is the most likely causative agent because it is a Gram-positive cocci in pairs with a capsule, which matches the description provided. S. pneumoniae is a common cause of bacterial pharyngitis and can present with sore throat. Summary of other choices: B: Staphylococcus aureus is a Gram-positive cocci in clusters, not pairs, and is not typically associated with sore throat. C: Neisseria meningitidis is a Gram-negative diplococcus and more commonly causes meningitis or septicemia, not sore throat. D: Klebsiella pneumoniae is a Gram-negative rod bacterium, not a Gram-positive cocci, and is not a common cause of sore throat.

Correct Answer: A

Rationale: The correct answer is A: Francisella tularensis. This bacterium is classified as a class A bioterrorism agent due to its high virulence and potential for mass casualties. It can cause tularemia, a severe and potentially fatal disease. The other choices, Hepatitis B, E. coli, and Bacillus subtilis, are not considered class A bioterrorism agents. Hepatitis B is a virus causing liver inflammation, E. coli is a common bacterium found in the gut, and Bacillus subtilis is a beneficial bacterium used in various industries. Therefore, Francisella tularensis is the correct choice based on its high pathogenicity and bioterrorism potential.

Correct Answer: D

Rationale: The correct answer is D: Yersinia enterocolitica. This bacterium can contaminate foods and grow at refrigerator temperatures due to its psychrotrophic nature. Yersinia enterocolitica is known to cause foodborne illnesses even when stored at cold temperatures. Shigella sonnei is a human pathogen transmitted through fecal-oral route, Campylobacter jejuni is typically found in poultry and causes food poisoning, and E. coli can cause foodborne illnesses but does not grow well at refrigerator temperatures.

Correct Answer: D

Rationale: The correct answer is D because it encompasses the true statements regarding the laboratory diagnosis of urinary tract infections. A: Bacteriuria of less than 10^5 can be significant in treated patients due to the development of antibiotic resistance. B: Staphylococcus aureus, Salmonella typhi, and Mycobacterium tuberculosis may be significant regardless of quantity due to their pathogenic nature. C: Leukocyturia indicates inflammation, and even a lower number of leukocytes can be clinically significant. Therefore, option D covers all these aspects making it the correct choice.

Correct Answer: D

Rationale: The correct answer is D: salmonellosis. Zoonotic diseases are those that can be transmitted from animals to humans. Salmonella is not directly transmitted from animals to humans, instead, it is typically transmitted through contaminated food or water. Brucellosis (A), undulant fever (B), and plague (C) are all zoonotic diseases that can be directly transmitted from animals to humans through various means. Therefore, salmonellosis does not fit the definition of a zoonotic disease, making it the correct answer.

Correct Answer: D

Rationale: The correct answer is D: Granulomatosis. The appearance of a 10 mm papule 48 hours after the Mantoux test indicates a delayed-type hypersensitivity reaction, which is characteristic of granulomatosis. This type of reaction involves activation of macrophages and T cells, leading to the formation of granulomas. Granulomas are organized collections of immune cells that wall off the antigen, in this case, the tuberculin antigen. A, B, and C are incorrect: A: Cellular cytotoxicity involves the destruction of target cells by immune cells such as cytotoxic T cells or natural killer cells. This mechanism is not associated with the delayed-type hypersensitivity reaction seen in granulomatosis. B: Anaphylaxis is a rapid and severe allergic reaction involving IgE-mediated release of histamine and other inflammatory mediators. This is not the mechanism underlying the delayed-type hypersensitivity reaction in the Mantoux test. C: Antibody-dependent cytotoxic

Correct Answer: A

Rationale: The correct answer is A: aspergillosis and candidiasis. Detection of galactomannan and free mannan is commonly used in diagnosing these fungal infections. Galactomannan is a component of the cell wall of Aspergillus species, while free mannan is associated with Candida species. This detection method helps in identifying these specific fungal infections accurately. B: Syphilis is caused by a bacterium, Treponema pallidum, and is not diagnosed using galactomannan or free mannan detection. C: Leptospirosis is a bacterial infection caused by the Leptospira species and is not diagnosed using galactomannan or free mannan detection. D: HIV infection is a viral infection caused by the human immunodeficiency virus and is not diagnosed using galactomannan or free mannan detection.

Correct Answer: A

Rationale: The correct answer is A: Neisser. Bacterial capsules can be stained using the Neisser staining method because it specifically targets the capsule, making it visible under a microscope. Neisser staining involves using a combination of acidic and basic dyes to highlight the capsule structure. This method helps differentiate the capsule from the bacterial cell, aiding in the identification and study of capsules. Choices B, C, and D are incorrect because Cleat and Müller staining methods are not commonly used for staining bacterial capsules, and "None of the above" is incorrect as Neisser staining is a valid method for capsule staining.