For serological diagnostics of the whooping cough it was made large-scale reaction with parapertussis and pertussis diagnosticums. At the bottom of the test-tubes with diagnosticum of Bordetella parapertussis grain-like sediment formed. What antibodies have this reaction revealed?

Correct Answer: B

Rationale: Rationale: 1. The grain-like sediment indicates a precipitation reaction. 2. Precipitins are antibodies that cause precipitation reactions. 3. In serological diagnostics, precipitation reactions are used to detect specific antibodies. 4. Therefore, the reaction revealed in this scenario is due to the presence of precipitins. Summary: A: Bacteriolysins - These antibodies cause bacterial lysis, not precipitation. C: Antitoxins - These antibodies neutralize toxins, not involved in precipitation reactions. D: Opsonins - These antibodies enhance phagocytosis, not related to precipitation reactions.

Correct Answer: D

Rationale: The correct answer is D: Exanthematous rash. Erythema infectiosum, also known as fifth disease, is characterized by a distinctive rash on the cheeks that looks like a "slapped cheek." This rash then spreads to the rest of the body, resulting in a lace-like rash (exanthem). Swelling of salivary glands (choice A) is not a typical symptom of erythema infectiosum. Diarrhea (choice B) and hepatitis (choice C) are also not associated with this condition. Therefore, the most characteristic clinical symptom of erythema infectiosum is the exanthematous rash.

Correct Answer: C

Rationale: The correct answer is C: Actinomycosis. Actinomycosis is a chronic suppurative bacterial infection caused by Actinomyces species, which form sulfur granules in purulent masses surrounded by dense fibrous tissue. In this case, the presence of fungal druses, plasma cells, xanthoma cells, and macrophages in the histological examination is characteristic of actinomycosis. The clinical presentation of skin redness, swelling, and abscess formation in the neck area also aligns with actinomycosis. Choice A: Syphilis is caused by Treponema pallidum, presenting with a painless chancre at the site of infection, not skin redness and swelling in the neck area. Choice B: Carbuncle is a bacterial skin infection involving a group of hair follicles, typically on the back of the neck, not characterized by fungal druses or sulfur granules. Choice D: Leprosy

Correct Answer: B

Rationale: The correct answer is B: Facultative anaerobes. Facultative anaerobes can survive in both oxygen-rich and oxygen-poor environments by switching between aerobic and anaerobic metabolism. They have the flexibility to use oxygen if present but can also ferment in the absence of oxygen. Obligate anaerobes (A) cannot survive in the presence of oxygen, obligate aerobes (C) require oxygen for survival, and microaerophiles (D) require low levels of oxygen for growth, unlike facultative anaerobes.

Correct Answer: B

Rationale: The correct answer is B: Mefloquine. Mefloquine is a histoschizontocidal antimalarial drug commonly prescribed for prevention of malaria in travelers. It is effective against the liver stage of the malaria parasite, which is crucial for preventing the development of the disease. Chingamin (A) is not a commonly used antimalarial drug. Biseptol (C) is a combination antibiotic and is not effective against malaria parasites. Quinine (D) is primarily used for treating malaria, not preventing it, and it is not specifically histoschizontocidal.

Correct Answer: B

Rationale: The correct answer is B: Tuberculosis. The case describes a man with a perforation in the hard palate and features of caseous necrosis with granulation tissue, endovasculitis, and a cellular infiltration mainly of lymphocytes, epithelioid cells, and plasma cells. These findings are classic for tuberculosis infection, commonly seen in extrapulmonary sites like the oral cavity. Syphilis (choice A) typically presents with a painless ulcer and different histopathological features. Leprosy (choice C) presents with granulomas containing foamy macrophages. Scleroma (choice D) is caused by Klebsiella rhinoscleromatis and presents with chronic granulomatous inflammation.

Correct Answer: B

Rationale: The correct answer is B: 1971. OSHA, the Occupational Safety and Health Administration, was established in 1971 under the Occupational Safety and Health Act signed by President Richard Nixon. This act aimed to ensure safe and healthy working conditions for employees by setting and enforcing standards. Choices A, C, and D are incorrect as OSHA was not established in those years. Option A (1921) is too early, option C (1980) is after OSHA was already established, and option D (1985) is also too late. Therefore, the correct answer is B, 1971, as it aligns with the historical establishment of OSHA.

Correct Answer: C

Rationale: The correct answer is C because there is no obligatory vaccine for Neisseria meningitidis in Bulgaria. The rationale for this is that while vaccines are available for meningococcal disease, they are not mandatory in Bulgaria. Therefore, this statement is incorrect. A: This statement is correct as Waterhouse-Friderichsen syndrome can occur during meningococcemia due to rapid progression of the infection leading to adrenal gland failure. B: This statement is incorrect as Neisseria meningitidis is most common in infants, children, and adolescents, with a second peak in young adults. D: This statement is correct as Neisseria meningitidis is transmitted through respiratory secretions, such as coughing or kissing, especially in close contacts like household members or roommates.

Correct Answer: A

Rationale: The most likely causative agent in this case is Staphylococcus epidermidis. This conclusion can be drawn based on the characteristics provided: Gram-positive cocci in clusters, catalase-positive, and coagulase-negative. Staphylococcus epidermidis fits all these criteria. Explanation of other choices: - Staphylococcus aureus: Typically coagulase-positive, so it does not match the characteristics given. - Streptococcus pyogenes: Gram-positive cocci in chains, not clusters. Also, it is catalase-negative. - Enterococcus faecalis: Gram-positive cocci in pairs or chains, not clusters. Additionally, it is catalase-negative. Therefore, Staphylococcus epidermidis is the most likely causative agent based on the provided characteristics.