By what mechanism does MRSA achieve resistance to standard beta-lactam antibiotics?

Correct Answer: D

Rationale: The correct answer is D: Altered penicillin binding proteins. MRSA (Methicillin-resistant Staphylococcus aureus) achieves resistance to beta-lactam antibiotics, such as penicillin, by producing altered penicillin binding proteins that have reduced affinity for these antibiotics. This alteration prevents the antibiotics from binding to their target sites on the bacterial cell wall, thus rendering them ineffective. Choice A, extended spectrum beta-lactamases, are enzymes produced by some bacteria to break down beta-lactam antibiotics, but MRSA does not use this mechanism. Choice B, penicillin efflux pump, is a mechanism where bacteria pump out antibiotics from their cells, but this is not how MRSA develops resistance. Choice C, altered peptide sequence in peptidoglycan, does not directly relate to how MRSA resists beta-lactam antibiotics.

Correct Answer: C

Rationale: The correct answer is C because "Infectious disease" is a combination of both a clinical term (A) and a term expressing the possibility of developing certain symptoms in an infection (B). Infectious diseases are illnesses caused by pathogenic microorganisms, such as bacteria, viruses, parasites, or fungi, that can spread directly or indirectly from person to person. Therefore, the term encompasses both the clinical aspect of the disease and the potential symptoms that may manifest in an infected individual. Choices A and B alone do not fully capture the comprehensive definition of infectious disease, making C the correct answer. Choice D is incorrect as there is a correct answer in this case.

Correct Answer: B

Rationale: The correct answer is B: BKV. BK virus can cause hemorrhagic cystitis in immunocompromised patients by infecting the urinary tract. It primarily affects the renal tubular epithelial cells, leading to hemorrhagic cystitis. EBV (A) causes infectious mononucleosis, HSV1 (C) causes oral and genital herpes, and JCV (D) causes progressive multifocal leukoencephalopathy, none of which are associated with hemorrhagic cystitis.

Correct Answer: C

Rationale: The correct answer is C: Macrolides or fluoroquinolones. Legionella pneumophila is a bacterium that causes Legionnaires' disease, a severe form of pneumonia. Macrolides (like azithromycin) and fluoroquinolones (like levofloxacin) are the recommended first-line treatments due to their ability to penetrate into lung tissues where Legionella infects. Penicillins and cephalosporins (choice A) are not effective against Legionella as it is intracellular and resistant to these antibiotics. Ethambutol and isoniazid (choice B) are used to treat tuberculosis, not Legionella infections. Second and third generation cephalosporins (choice D) are also not effective against Legionella. Therefore, the best choice for treating Legionella pneumophila infections is macrolides or fluoroquinolones.

Correct Answer: D

Rationale: The correct answer is D: Fibers at the vertices of the icosahedron. Adenoviruses have fibers at the vertices of the icosahedron, which give them their distinctive pattern. These fibers help in attaching to host cells. Choices A, B, and C are incorrect because adenoviruses do not have a lipid envelope, helical capsid, or ssDNA. Adenoviruses have a non-enveloped icosahedral capsid and contain dsDNA. This makes choice D the correct answer as it specifically relates to the unique structural feature of adenoviruses.