After long-term antibiotic treatment a patient has developed whitish spots on the oral mucosa. Gram- positive oval budding cells were detected in the smear preparations. What causative agents were detected?

Correct Answer: A

Rationale: The correct answer is A: Candida fungi. Candida fungi are known to cause oral thrush, characterized by whitish spots on the oral mucosa. The presence of gram-positive oval budding cells in the smear preparations is indicative of Candida species. Staphylococci (choice B) are gram-positive cocci, not oval budding cells. Sarcinae (choice C) are gram-positive bacteria that form cuboidal packets, not oval budding cells. Actinomycetes (choice D) are filamentous gram-positive bacteria, not oval budding cells like Candida fungi.

Correct Answer: B

Rationale: The correct answer is B because the structure of the cytoplasmic membrane in gram-positive and gram-negative bacteria is fundamentally different. Gram-positive bacteria have a single-layered cytoplasmic membrane, while gram-negative bacteria have a double-layered cytoplasmic membrane with an additional outer membrane. This key difference is crucial for various functions such as antibiotic resistance and nutrient transport. Rationale for the incorrect choices: A: Gram-positive bacteria have a single-layered cytoplasmic membrane, not a double-layered one. C: Prokaryotes do have a cytoplasmic membrane, which is essential for maintaining cell integrity and regulating the passage of molecules. D: Gram-negative bacteria have a double-layered cytoplasmic membrane, not a three-layered one.

Correct Answer: A

Rationale: The correct answer is A because penicillins and cephalosporins inactivate transpeptidase activity of penicillin binding proteins, leading to disruption of bacterial cell wall synthesis. This mechanism makes them bactericidal, not bacteriostatic (choice B). Choice C is incorrect as penicillins and cephalosporins target cell wall synthesis, not the cytoplasmic membrane. Choice D is incorrect as option A is the correct statement.

Correct Answer: D

Rationale: The correct answer is D: Parenteral introduction of antitetanus serum. The symptoms described in the question, such as bilateral ptosis, mydriatic pupils, and difficulty reading, are indicative of tetanus infection. The source of infection could be the scratch on the knee, which allowed the tetanus bacteria to enter the body. The most appropriate therapy for tetanus is the administration of antitetanus serum to neutralize the tetanus toxin. Antibotulinic serum (choice A) is not appropriate as it is used for botulism, which presents differently. Disintoxication (choice B) is too general and does not address the specific cause of the symptoms. Antibiotics (choice C) are not effective in treating tetanus because it is caused by a toxin, not a bacterial infection. Therefore, the correct course of action is to administer antitetanus serum to the patient.

Correct Answer: B

Rationale: The correct answer is B: Within 24 hours. Rabies post-exposure prophylaxis should ideally be initiated as soon as possible after a potentially infectious bite to prevent the virus from spreading and causing symptoms. Immediate treatment is crucial to prevent the virus from reaching the central nervous system. Waiting beyond 24 hours increases the risk of the virus reaching the brain and becoming fatal. Choices A, C, and D are incorrect because waiting for 6 months, a week, or 2 weeks respectively would significantly delay treatment, allowing the virus to progress and potentially become untreatable.

Correct Answer: A

Rationale: The correct answer is A: Peroxidase and catalase. Peroxidase and catalase are enzymes that break down hydrogen peroxide into water and oxygen. Peroxidase helps in breaking down low levels of hydrogen peroxide, while catalase is crucial for breaking down high levels of hydrogen peroxide efficiently. This process is important for organisms to prevent damage from reactive oxygen species. Choices B, C, and D are incorrect: B: Oxygenase and hydroxylase are enzymes involved in different biochemical reactions and do not break down hydrogen peroxide. C: Cytochrome oxidase and cytochrome B5 are involved in electron transport chain reactions and not in breaking down hydrogen peroxide. D: Oxygenase and catalase are not correct as oxygenase is not involved in hydrogen peroxide breakdown, only catalase is.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Purple-stained diplococci suggest Gram-positive cocci. 2. Capsule presence is a characteristic of Streptococcus pneumoniae. 3. S. pneumoniae is known to form diplococci arrangements. 4. Therefore, the microorganism most likely present is Streptococcus pneumoniae. Summary: - B: Klebsiella pneumoniae is a Gram-negative rod, not a cocci. - C: Neisseria meningitidis is a Gram-negative diplococcus, not a capsule producer. - D: Escherichia coli is a Gram-negative rod, not a cocci or capsule producer.

Correct Answer: A

Rationale: The correct answer is A: Helicobacter pylori. This bacterium is a major cause of gastric ulcers by disrupting the balance between aggressive (acid, pepsin) and defensive (mucus, bicarbonate, prostaglandins) factors in the stomach lining. H. pylori infection leads to inflammation, weakening the protective mucosal barrier, making the stomach more susceptible to damage. Choices B, C, and D are defensive factors that help protect the stomach lining and prevent ulcer formation, so they do not contribute to the development of gastric ulcers.

Correct Answer: D

Rationale: The correct answer is D: rabbit fever. Tularemia is commonly known as rabbit fever due to the fact that it is often contracted through handling infected rabbits or other rodents. This zoonotic disease is caused by the bacterium Francisella tularensis. Scarlet fever (A) is a streptococcal infection characterized by a rash, not related to tularemia. Strep throat (B) is a bacterial infection caused by Streptococcus bacteria and is not associated with tularemia. Cat scratch fever (C) is caused by Bartonella henselae and typically transmitted through cat scratches or bites, not related to tularemia.