Microscopic examination of vaginal discharge revealed pear-shaped flagellated protozoa with an undulating membrane. What is the causative agent?

Correct Answer: A

Rationale: The correct answer is A: Trichomonas vaginalis. Trichomonas vaginalis is a sexually transmitted protozoan that causes trichomoniasis. The pear-shaped flagellated protozoa with an undulating membrane described in the question match the morphology of Trichomonas vaginalis. It is typically found in vaginal discharge of infected individuals. Giardia lamblia (B) is a different protozoan that causes giardiasis and has a distinct morphology of a teardrop shape with flagella. Trypanosoma brucei (C) causes African sleeping sickness and Leishmania donovani (D) causes visceral leishmaniasis, both of which have different morphologies and clinical presentations compared to Trichomonas vaginalis.

Correct Answer: D

Rationale: The correct answer is D: III, IV, V. 1. RNA viruses belong to Group III of the Baltimore classification system because their genetic material is single-stranded RNA. 2. They are also categorized under Group IV as they use reverse transcriptase to replicate their genetic material. 3. Finally, RNA viruses fall under Group V as they have an envelope derived from the host cell membrane. Therefore, options A, B, and C are incorrect as they do not include all the correct groups that RNA viruses belong to according to the Baltimore classification system.

Correct Answer: D

Rationale: The bacitracin sensitivity test is used to differentiate between different types of streptococci. Group A streptococci are sensitive to bacitracin, which means they will show inhibition around the bacitracin disk. This sensitivity is a characteristic feature of group A streptococci and helps in their identification. Staphylococci, pneumococci, and intestinal bacteria do not exhibit this sensitivity to bacitracin. Therefore, the correct answer is D: group A streptococci.

Correct Answer: D

Rationale: The correct answer is D, "All of the above," because all three bacteria (Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus) can cause urinary tract infections. E. coli is the most common causative agent of UTIs, followed by Staphylococcus aureus and occasionally Pseudomonas aeruginosa. Each of these bacteria has different virulence factors that enable them to infect the urinary tract. Therefore, it is important to consider all three options when diagnosing and treating UTIs. Choices A, B, and C are incorrect because each of those bacteria can individually cause UTIs, so the correct answer is D, as it encompasses all the possible causative agents.

Correct Answer: A

Rationale: The correct answer is A: Capsule. The capsule is a mucous structure tightly bound to the bacterial cell wall. It helps bacteria evade the host immune system and provides protection. The other choices are incorrect because: B) Spores are resistant structures formed by some bacteria for survival, C) Flagella are long, whip-like structures for movement, and D) Filaments are long, thin structures found in some bacteria.

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: A

Rationale: The correct answer is A: Clostridium botulinum. This bacterium produces the neurotoxin responsible for botulism. It thrives in anaerobic environments like improperly canned foods. Clostridium difficile (B) causes colitis, not botulism. Staphylococcus aureus (C) causes food poisoning but not botulism. Escherichia coli (D) can cause gastrointestinal illness but not botulism.

Correct Answer: D

Rationale: The correct answer is D: Erysipeloid. Erysipeloid is a bacterial infection caused by Erysipelothrix rhusiopathiae commonly found in animals like cattle. The patient's occupation as a cattle-ranch worker puts them at risk for this infection. Symptoms such as high body temperature, severe headache, carbuncle on the forearm with edema, and regional lymphadenitis are typical of erysipeloid. Anthrax (A) is more associated with skin lesions and severe systemic symptoms. Carcinoma of skin (B) presents differently with slow-growing skin lesions. Erysipelas (C) is a different bacterial infection characterized by red, swollen patches on the skin.

Correct Answer: D

Rationale: The correct answer is D: Pulmonary tuberculosis. The presence of red bacilli stained with Ziehl-Nielsen method indicates acid-fast bacteria, which are characteristic of Mycobacterium tuberculosis, the causative agent of tuberculosis. The size and appearance of the bacilli described match those of M. tuberculosis. Chronic pneumonia, along with the specific staining pattern, strongly suggests tuberculosis as the likely diagnosis. Explanation for other choices: A: Pneumococcal pneumonia is caused by Streptococcus pneumoniae, which would not show red bacilli on Ziehl-Nielsen staining. B: Pulmonary actinomycosis is caused by Actinomyces species, not acid-fast bacteria like M. tuberculosis. C: Pulmonary candidiasis is caused by Candida species, which are fungi and do not appear as red bacilli on staining.