Granulomas containing lymphocytes and macrophages were detected during analysis of skin biopsy material. Among macrophages there are large cells with fat inclusions, which contain microorganisms in spheric packages (Virchow's cells). The following disease is based on the described type of hypersensitivity:

Correct Answer: C

Rationale: The correct answer is C: Tuberculosis. Granulomas with lymphocytes and macrophages containing Virchow's cells (large cells with fat inclusions containing microorganisms) are classic findings in tuberculosis. Leprosy (A) typically presents with granulomas but with different histopathological features. Syphilis (B) does not usually form granulomas in the skin. Rhinoscleroma (D) is a chronic bacterial infection characterized by nodular lesions but does not typically involve Virchow's cells as seen in tuberculosis.

Correct Answer: A

Rationale: The correct answer is A: Gram-negative stain. Pseudomonas aeruginosa is a gram-negative bacterium, as indicated by the bluish-green pus color. This bacterium has an outer membrane that retains the crystal violet stain, making it appear pink/red after the counterstain with safranin in Gram staining. The other choices are incorrect because Pseudomonas aeruginosa does not typically form spores (B), has a rod-shaped morphology rather than a coccal form (C), and does not exhibit cell pairing (D).

Correct Answer: A

Rationale: The correct answer is A: Trichomonas tenax. Trichomonas tenax is a flagellated protozoan commonly found in the oral cavity and does not have a cyst stage. This organism typically inhabits the gingival crevices and can be identified in dental plaque samples. Entamoeba gingivalis (B) is an amoeba and does not have flagella. Balantidium coli (C) is a ciliated protozoan that infects the intestines, not the oral cavity. Giardia lamblia (D) is a flagellated protozoan that infects the intestines and has a distinct cyst stage. Therefore, the presence of flagellated protozoa without a cyst stage in dental plaque indicates Trichomonas tenax is likely present.

Correct Answer: A

Rationale: The correct answer is A: Metronidazole. Anaerobic bacteria are sensitive to metronidazole due to its mechanism of action targeting their DNA. Metronidazole is often the drug of choice for treating infections caused by anaerobic bacteria. Gentamicin, Oxacillin, and Co-trimoxazole are not effective against anaerobes. Gentamicin is an aminoglycoside mostly used for aerobic bacteria, Oxacillin is a beta-lactam antibiotic effective against gram-positive bacteria, and Co-trimoxazole is a combination of sulfamethoxazole and trimethoprim mainly used for urinary tract infections and some respiratory infections.

Correct Answer: B

Rationale: The correct answer is B: Penicillin. Penicillin is the drug of first choice for treating syphilis due to its effectiveness in eradicating the bacterium Treponema pallidum, which causes syphilis. It is the most reliable treatment with well-established efficacy. Gentamicin (A), ciprofloxacin (C), and chloramphenicol (D) are not recommended for treating syphilis as they are not effective against the specific bacteria causing the infection. Penicillin remains the gold standard for syphilis treatment.

Correct Answer: C

Rationale: The correct answer is C: Endospore. Endospores are dormant, tough, and non-reproductive structures formed by certain bacteria as a response to unfavorable conditions. They help bacteria survive harsh environments such as extreme temperatures, desiccation, and exposure to harmful chemicals. The other choices, Flagella (A), Capsule (B), and Pili (D), do not directly contribute to bacterial survival in adverse conditions. Flagella aid in bacterial movement, capsules provide protection from immune system attacks, and pili are involved in attachment to surfaces or other cells. Endospores are specifically designed for survival during unfavorable conditions, making them the correct choice in this scenario.

Correct Answer: B

Rationale: The correct answer is B: scalp. Tinea capitis is a fungal infection that specifically affects the scalp. This infection is caused by dermatophytes, which thrive in warm and moist environments. It typically presents with symptoms such as scaling, itching, and hair loss on the scalp. Choices A, C, and D are incorrect because tinea pedis (athlete's foot) affects the feet, oral thrush is a fungal infection of the mouth, and tinea manuum affects the hands. By process of elimination and understanding the specific characteristics of tinea capitis, we can determine that the scalp is the correct location for this fungal infection.

Correct Answer: A

Rationale: The correct answer is A: Clostridium perfringens. Gas gangrene is caused by Clostridium perfringens, a Gram-positive rod bacterium that produces spores. This bacterium is anaerobic and commonly found in soil, where it forms spores that can survive harsh conditions. Clostridium tetani causes tetanus, not gas gangrene. Bacillus anthracis causes anthrax, not gas gangrene. Clostridium botulinum causes botulism, not gas gangrene. Therefore, based on the characteristics of the microorganism described in the question, Clostridium perfringens is the correct identification.

Correct Answer: C

Rationale: The correct answer is C: Reaction type GRUBER. Agglutination reaction in GRUBER involves the clumping of particles due to specific antibodies binding to antigens on the surface. This reaction is commonly used in blood typing and serology tests. A: Western blot is a technique used to detect specific proteins in a sample, not related to agglutination. B: ELISA is an enzyme-linked immunosorbent assay used to detect antibodies or antigens, not based on agglutination. D: Ascoli ring test is a method to detect the presence of DNA in a sample, not related to agglutination.