Microscopic examination of cerebrospinal fluid revealed Gram-negative diplococci. The patient presented with fever, headache, and neck stiffness. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Neisseria meningitidis. This bacterium is a Gram-negative diplococcus commonly associated with meningitis. The patient's symptoms of fever, headache, and neck stiffness are classic signs of meningococcal meningitis. Neisseria meningitidis is known to cause outbreaks in crowded settings. Streptococcus pneumoniae (Choice B) is a common cause of bacterial meningitis but typically appears as Gram-positive cocci. Haemophilus influenzae (Choice C) can also cause meningitis but is more commonly seen in unvaccinated children. Klebsiella pneumoniae (Choice D) is a Gram-negative bacterium but is not a typical causative agent of meningitis.

Correct Answer: A

Rationale: The correct answer is A. Method of Ziel-Neelsen. This method uses a special stain (carbol fuchsin) to detect acid-fast organisms like Mycobacterium tuberculosis, the causative agent of tuberculosis. The staining procedure involves heating the slide to help penetrate the mycolic acid layer of the bacteria, making them resistant to decolorization by acid-alcohol. The red stained acid-fast bacilli stand out against the blue counterstain. This method is specific for identifying tubercle bacilli in sputum samples. Choice B: Method of Romanowsky-Giemsa is used for staining blood smears and is not suitable for detecting acid-fast bacilli in sputum. Choice C: Method of Gram is used for staining bacteria based on their cell wall composition and is not effective for identifying acid-fast bacilli like Mycobacterium tuberculosis. Choice D: Method of Neisser is not a specific staining method for acid-fast bacilli and is not suitable

Correct Answer: C

Rationale: The correct answer is C: Endospore. Endospores are highly resistant structures formed by certain bacterial species to withstand harsh conditions like desiccation. They contain a tough outer layer that protects the bacterial DNA and other essential components. Capsules (choice A) provide protection against host immune responses but not specifically against desiccation. Flagella (choice B) are used for bacterial motility. Pili (choice D) are involved in bacterial adhesion but do not protect against desiccation. Therefore, endospores are the most suitable choice for protecting against desiccation.

Correct Answer: D

Rationale: The correct answer is D. Botulism typically presents with symptoms such as dry mouth, difficulty swallowing, blurred vision, diplopia, and descending flaccid paralysis. Chills, fever, and loss of consciousness are not typical of botulism. Botulism is caused by a neurotoxin produced by Clostridium botulinum bacteria, which affects the nervous system leading to muscle weakness and paralysis, not fever or altered consciousness. Therefore, choice D is the correct answer.

Correct Answer: B

Rationale: The correct answer is B: Malaria. Fever developing 2 weeks post-blood transfusion is characteristic of malaria due to the incubation period of the parasite. Trypanosomiasis presents earlier, amebiasis usually causes GI symptoms, and toxoplasmosis typically manifests with flu-like symptoms. Malaria is the most likely cause based on the timing and clinical presentation.

Correct Answer: B

Rationale: The correct answer is B: Salmonellosis. The description of microorganisms resembling a tennis racket indicates the presence of Salmonella typhi, which causes salmonellosis. Salmonella bacteria can appear like tennis rackets under a microscope due to their flagella. Botulism (A) is caused by Clostridium botulinum, which does not resemble a tennis racket. Cholera (C) is caused by Vibrio cholerae, which appears as curved rods under the microscope. Dysentery (D) is usually caused by bacteria like Shigella or Entamoeba histolytica, which do not resemble tennis rackets.

Correct Answer: A

Rationale: The correct answer is A: Entamoeba histolytica. This protozoon is known to cause amoebic dysentery, presenting symptoms of weakness, intestinal pain, and indigestion. The presence of microbial cysts with four nuclei in fecal samples is characteristic of Entamoeba histolytica. These cysts are the infective form of the parasite and can cause severe invasive disease in the intestines. Incorrect choices: B: Entamoeba coli does not typically cause invasive disease or severe symptoms like those described in the question. C: Balantidium is a ciliated protozoan that causes balantidiasis, which presents differently from the symptoms described in the question. D: Trichomonad is a flagellated protozoan that typically infects the urogenital tract, not the intestine, and does not form cysts with four nuclei. In summary, the key clues in the question were the symptoms of weakness, intestinal pain,

Correct Answer: B

Rationale: The correct answer is B: peptidoglycan and calcium dipicolinate. Bacterial endospores are resistant structures formed by certain bacterial species under unfavorable conditions. Peptidoglycan provides structural support, while calcium dipicolinate aids in heat resistance. Lipid bilayers (choice A) are not a primary component. Capsular polysaccharides (choice C) are part of the bacterial capsule, not the endospore. Teichoic acid (choice D) is a component of the cell wall, not the endospore.

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. This bacterium is a common cause of pneumonia and is known to appear as Gram-positive cocci in pairs with a capsule. The presence of a capsule is a key characteristic of S. pneumoniae. Staphylococcus aureus (B) is a Gram-positive cocci but typically does not have a capsule. Neisseria meningitidis (C) is a Gram-negative diplococcus, not a Gram-positive cocci. Klebsiella pneumoniae (D) is a Gram-negative rod, not a Gram-positive cocci. Therefore, based on the staining pattern and the presence of a capsule, Streptococcus pneumoniae is the most likely causative agent in this case.