Gram-negative diplococci were isolated from a urethral discharge in a male patient with painful urination. What is the causative agent?

Correct Answer: A

Rationale: The correct answer is A: Neisseria gonorrhoeae. This bacterium is a gram-negative diplococci commonly associated with gonorrhea, which presents with symptoms like painful urination. Neisseria gonorrhoeae is known to infect the urethra in males. Escherichia coli, Proteus vulgaris, and Klebsiella pneumoniae are all gram-negative bacteria, but they are not typically associated with urethral discharge or gonorrhea. E. coli is commonly associated with urinary tract infections, Proteus vulgaris with wound infections, and Klebsiella pneumoniae with pneumonia and other respiratory infections. Therefore, based on the patient's symptoms and the characteristics of the bacteria, Neisseria gonorrhoeae is the most appropriate causative agent in this case.

Correct Answer: A

Rationale: The correct answer is A: Staphylococcus epidermidis. The presence of Gram-positive cocci in clusters, catalase-positive, and coagulase-negative characteristics indicate Staphylococcus species. Specifically, Staphylococcus epidermidis is a common skin commensal and a frequent cause of wound infections. Staphylococcus aureus is catalase-positive and coagulase-positive, making it less likely in this scenario. Streptococcus pyogenes and Enterococcus faecalis are both Gram-positive cocci but are catalase-negative, making them less likely causative agents.

Correct Answer: A

Rationale: The correct answer is A: Ziehl-Neelsen staining method. This method is used to detect acid-fast bacteria like Mycobacterium tuberculosis. Step-by-step rationale: 1. Acid-fast bacteria resist decolorization with acid-alcohol. 2. The red bacilli seen in the smear indicate acid-fast bacteria. 3. Ziehl-Neelsen stain uses carbol fuchsin to stain acid-fast bacteria red. 4. The blue background is likely the counterstain methylene blue. Incorrect choices: B: Gram stain is for categorizing bacteria into Gram-positive or Gram-negative, not specific for acid-fast bacteria. C: Giemsa stain is used for blood films and detecting parasites, not acid-fast bacteria. D: Neisser stain is not a standard microbiological staining method.

Correct Answer: A

Rationale: The correct answer is A: Type 1 hypersensitivity reaction. In this type of reaction, allergens trigger the production of IgE antibodies, leading to mast cell and basophil degranulation and release of inflammatory mediators like histamine. This causes immediate allergic symptoms. Seafood and eggs are common allergens that can elicit this response. B: Type 2 hypersensitivity reaction involves antibodies targeting cell surface or extracellular matrix antigens, leading to cell destruction or dysfunction. This is not the mechanism in seafood or egg allergies. C: Type 3 hypersensitivity reaction involves immune complex deposition in tissues, leading to inflammation and tissue damage. This is not the mechanism in seafood or egg allergies. D: Type 4 hypersensitivity reaction is cell-mediated and involves T cells causing inflammation and tissue damage. This is not the mechanism in seafood or egg allergies.

Correct Answer: C

Rationale: The correct answer is C: plasmids. Plasmids are nonchromosomal DNA molecules commonly found in bacterial cells, providing additional genetic material for bacteria. They are not essential for bacterial survival but can confer advantages such as antibiotic resistance. Endospores (A) are dormant bacterial structures resistant to harsh conditions. Transposons (B) are mobile genetic elements that can move within a genome. Prions (D) are misfolded proteins causing neurodegenerative diseases, not DNA molecules.

Correct Answer: B

Rationale: The correct answer is B: dermis. The papillary layer is located in the dermis, specifically at the junction with the epidermis. It contains capillaries, lymphatics, and sensory receptors, contributing to the skin's strength and elasticity. The epidermis (choice A) is the outermost layer of the skin, while the hypodermis (choice C) and subcutaneous layer (choice D) are deeper layers beneath the dermis, primarily composed of fat cells and connective tissue. Therefore, the papillary layer is part of the dermis, making choice B the correct answer.

Correct Answer: B

Rationale: The correct answer is B: Toxoplasmosis. Toxoplasmosis is caused by the protozoan Toxoplasma gondii. The rationale for this is that protozoa are single-celled organisms that can cause diseases in humans. Cat scratch disease (A) is caused by a bacterium, Bartonella henselae. Relapsing fever (C) is caused by the bacterium Borrelia recurrentis. Plague (D) is caused by the bacterium Yersinia pestis. Therefore, the only choice caused by a protozoan is toxoplasmosis, making it the correct answer.

Correct Answer: C

Rationale: The correct answer is C because chills, fever, and loss of consciousness are not typical symptoms of botulism. Botulism is characterized by descending, flaccid paralysis (choice A), dry mouth, difficulty swallowing, and speaking (choice B), and blurred vision, diplopia (choice D). These symptoms result from the neurotoxin produced by Clostridium botulinum, leading to muscle weakness and paralysis. Chills, fever, and loss of consciousness are more commonly associated with infections or other conditions, not botulism.

Correct Answer: C

Rationale: The correct answer is C: Treatment. Tularin is a specific immunizing agent used for the treatment of tularemia. The purpose of tularin administration in this patient is to provide a targeted treatment against the suspected tularemia infection. It helps the patient's immune system to recognize and fight against the bacteria causing the disease. Explanation for other choices: A: Allergy diagnostics - Tularin is not used for allergy diagnostics, as it is specifically indicated for tularemia treatment. B: Prognosis for the disease - Tularin is not used to predict the outcome of the disease but rather to treat the infection. D: Treatment evaluation - Tularin is not used for evaluating the effectiveness of treatment but for actively treating the tularemia infection.