Examination of a child revealed some whitish spots looking like coagulated milk on the mucous membrane of his cheeks and tongue. Analysis of smears revealed gram-positive oval yeast-like cells. What causative agents are they?

Correct Answer: A

Rationale: The correct answer is A: Candida. The whitish spots resembling coagulated milk on the mucous membranes are characteristic of oral thrush, a condition caused by Candida species. Candida is a gram-positive oval yeast-like fungus commonly found in the oral cavity. Staphylococci (B) are gram-positive cocci, not yeast-like cells. Diphtheria bacillus (C) causes diphtheria, not oral thrush. Actinomycetes (D) are filamentous bacteria, not yeast-like cells typically seen in oral thrush. Therefore, A is the correct answer based on the clinical presentation and microscopic findings.

Correct Answer: D

Rationale: The correct answer is D. Escherichia coli, Salmonella enterica, and Pseudomonas aeruginosa all produce endotoxins that can lead to septic shock. Endotoxins are components of the outer membrane of Gram-negative bacteria that can trigger a systemic inflammatory response, potentially leading to septic shock. E. coli and Salmonella are common causes of bacterial infections that can result in septic shock, while P. aeruginosa is known for causing infections in immunocompromised individuals. Therefore, since all three bacteria produce endotoxins that can lead to septic shock, the correct answer is D.Choices A, B, and C are incorrect because each of these bacteria individually produces endotoxins that can contribute to septic shock.

Correct Answer: C

Rationale: The correct answer is C: Escherichia coli. E. coli is the most common cause of acute cystitis. It typically presents with leukocytes and gram-negative bacilli in the urine. The green pigment production indicates pyocyanin, which is a characteristic of E. coli. Pseudomonas aeruginosa (A) can also produce green pigment, but it is less common in urinary tract infections. Proteus mirabilis (B) is associated with a swarming motility pattern on agar, not mucous colonies. Klebsiella pneumoniae (D) is associated with pneumonia and other respiratory infections, not cystitis.

Correct Answer: C

Rationale: The correct answer is C: Bacillus, Clostridium. Both Bacillus and Clostridium are known to form spores. Bacillus species produce endospores, which are resistant structures for survival in harsh conditions, while Clostridium species also form spores for protection and dispersal. The other choices are incorrect because Borrelia and Treponema are spirochetes and do not form spores, Bacteroides and Fusobacterium are anaerobic bacteria that do not produce spores, and Bordetella and Brucella are non-spore forming bacteria as well.

Correct Answer: B

Rationale: The correct answer is B: Gamma globulin, as it is not a primary immunodeficiency disease. Primary immunodeficiency diseases are genetic disorders that affect the immune system's ability to fight infections. A: Glanzmann-Riniker hypergammaglobulinemia is a rare primary immunodeficiency characterized by elevated levels of gammaglobulins. C: Variable hypogammaglobulinemia is a primary immunodeficiency disease where there are fluctuating levels of gammaglobulins. D: Bruton hypogammaglobulinemia, also known as X-linked agammaglobulinemia, is a primary immunodeficiency characterized by a lack of B cells and gammaglobulins. In summary, B is the correct answer as gamma globulin is not a primary immunodeficiency disease, whereas A, C, and D are all examples of primary immunodeficiency diseases affecting gammaglobulins levels.

Correct Answer: A

Rationale: The correct answer is A because significant bacteriuria is defined as having more than 10^5 cells in 1 ml of midstream morning urine. This concentration indicates a true infection rather than contamination. Choice B is incorrect because the amount of urine does not determine significant bacteriuria. Choice C is incorrect because even a single bacterium in urine does not necessarily indicate an infection. Choice D is incorrect because not all statements are correct; only choice A accurately defines significant bacteriuria based on the bacterial concentration in urine samples.

Correct Answer: D

Rationale: The correct answer is D: scanning electron microscope. A scanning electron microscope provides a three-dimensional image of a specimen by scanning a focused electron beam across the surface of the specimen, detecting the electrons that are emitted from the surface, and creating a detailed image. This is achieved through the detection of secondary electrons, backscattered electrons, and X-rays emitted from the specimen surface. A dark-field microscope (choice A) utilizes oblique lighting to enhance contrast and is not specifically designed to provide a 3D image. A transmission electron microscope (choice B) uses a beam of electrons transmitted through a specimen to create a 2D image at high magnification. A bright-field microscope (choice C) is a basic microscope that illuminates a specimen with uniform light and does not provide a 3D image like a scanning electron microscope does.

Correct Answer: A

Rationale: Step 1: Ziehl-Neelsen staining is a type of acid-fast staining used to detect acid-resistant bacteria like Mycobacterium species. Step 2: Acid-resistant bacteria have a high lipid content in their cell walls, making them resist decolorization with acid-alcohol. Step 3: Mycobacterium species, such as M. tuberculosis and M. leprae, are examples of acid-resistant bacteria. Step 4: Spores are not typically stained using Ziehl-Neelsen staining, making choice B incorrect. Step 5: Metachromatic bodies are stained using specific techniques like Albert's stain, not Ziehl-Neelsen staining, making choice C incorrect. Summary: Ziehl-Neelsen staining is specifically used for acid-resistant bacteria detection, making choice A the correct answer. Choices B and C are incorrect as they do not align with the purpose of Ziehl-Neelsen staining. Choice D is incorrect as Ziehl

Correct Answer: A

Rationale: The correct answer is A: Nystatin. Nystatin is an antifungal medication specifically used to treat candida infections. It works by disrupting the cell membrane of the fungus, leading to its death. Penicillin (B) is an antibiotic effective against bacterial infections, not fungal. Streptomycin (C) is also an antibiotic used for bacterial infections. Isoniazid (D) is used to treat tuberculosis, not candida infections. Therefore, Nystatin is the best choice for treating candida infections due to its antifungal properties.