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: D

Rationale: The correct answer is D: mixed infection. In a mixed infection, multiple infectious agents establish themselves at the same site, leading to a complex and diverse infection. This type of infection can involve different types of pathogens such as bacteria, viruses, fungi, and parasites. It can be challenging to diagnose and treat due to the presence of multiple pathogens. A: Chronic infection refers to an infection that persists over a long period but is typically caused by a single pathogen. B: Necrotizing infection is characterized by rapid tissue destruction but does not necessarily involve multiple infectious agents. C: Fatal infection does not specify the presence of multiple infectious agents, it simply implies that the infection leads to death. In summary, the correct answer, mixed infection, is the only choice that specifically describes the scenario of multiple infectious agents establishing themselves at the same site.

Correct Answer: B

Rationale: The correct answer is B: peak effect. When drug receptors are maximally activated, it means the drug has reached its highest effectiveness, resulting in the peak effect. This occurs when the drug concentration is at its highest level in the body, leading to the maximum response. Threshold level (A) refers to the minimum amount of drug needed to produce a response. Cessation effect (C) is when the drug's effect wears off. Latency time (D) is the time it takes for the drug to start producing an effect. So, the peak effect best describes the scenario where drug receptors are maximally activated.

Correct Answer: C

Rationale: The correct answer is C: Thick peptidoglycan layer. Gram-positive bacteria have a thick peptidoglycan layer in their cell wall, which retains the crystal violet stain in the Gram staining process, leading to a purple color. This thick layer is a defining characteristic of Gram-positive bacteria. Rationale: A: Thin peptidoglycan layer is incorrect because Gram-positive bacteria have a thick peptidoglycan layer. B: Presence of an outer membrane is incorrect because Gram-positive bacteria lack an outer membrane. D: Presence of lipopolysaccharides is incorrect because lipopolysaccharides are typically found in the outer membrane of Gram-negative bacteria, not Gram-positive bacteria.

Correct Answer: C

Rationale: The correct answer is C: Clostridium perfringens. This bacterium is the causative agent of gas gangrene due to its ability to produce gas and toxins in anaerobic conditions. Clostridium tetani causes tetanus, Clostridium botulinum causes botulism, and Bacillus anthracis causes anthrax, not gas gangrene. Clostridium perfringens stands out as the correct choice based on its specific association with gas gangrene and its pathogenic mechanisms.

Correct Answer: A

Rationale: The correct answer is A: Giardia lamblia. Giardia is a flagellated protozoa with two nuclei, causing diarrhea. It is commonly found in contaminated water sources. Entamoeba histolytica (B) causes amoebic dysentery with trophozoites in stool. Trichomonas vaginalis (C) causes sexually transmitted infections, not diarrhea. Balantidium coli (D) is a ciliated protozoa causing dysentery with ciliated trophozoites. Therefore, Giardia lamblia is the most likely causative agent in this case.

Correct Answer: A

Rationale: Rationale: 1. Listeria monocytogenes is a Gram-positive bacterium known for causing foodborne illnesses. 2. Gram-negative bacteria have a different cell wall structure than Gram-positive bacteria, making choice A correct. 3. Choice B is incorrect as Listeria monocytogenes is not encapsulated or sporulating. 4. Choice C is incorrect as Listeria monocytogenes does have a cell wall. 5. Choice D is incorrect as Listeria monocytogenes is indeed a Gram-positive coccobacilli.

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: A

Rationale: The correct answer is A: Streptococcus pneumoniae. The presence of Gram-positive cocci in pairs indicates a bacterial morphology consistent with Streptococcus pneumoniae, a common cause of pneumonia. This bacterium is known to appear in pairs or short chains on Gram stain. Staphylococcus aureus (B) typically presents as clusters of Gram-positive cocci, Neisseria meningitidis (C) is a Gram-negative diplococcus, and Klebsiella pneumoniae (D) is a Gram-negative rod, making them less likely causative agents in this scenario.