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: Gram-negative coccobacillus. Francisella tularensis is a Gram-negative coccobacillus because it has a unique shape that is between a coccus (spherical) and a bacillus (rod-shaped) and it stains pink/red in the Gram staining process. It is important to note that it is not a coccus (choice B) or a Gram-positive bacterium (choice A). Choice C is too general and does not specify the coccobacillus shape of F. tularensis. So, the correct answer is D due to its specific characteristics as a Gram-negative coccobacillus.

Correct Answer: A

Rationale: The correct answer is A: Tetanus. Tetanus is caused by the bacterium Clostridium tetani, which produces a neurotoxin leading to muscle stiffness, including trismus (restricted mouth opening). The patient's history of a stab wound increases the likelihood of tetanus infection due to the spores entering the body through the wound. Incorrect Choices: B: Brucellosis does not typically present with trismus and is more commonly associated with fever, joint pain, and fatigue. C: Whooping cough presents with severe coughing fits but does not cause trismus. D: Wound anaerobic infection may cause localized symptoms at the wound site but is less likely to cause trismus compared to tetanus.

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: Pseudomonas aeruginosa. Pseudomonas aeruginosa is known for producing a blue-green pigment called pyocyanin, which is characteristic of its colonies. This bacterium is commonly associated with purulent infections, especially in immunocompromised patients. Proteus vulgaris (B) is not typically associated with blue-green pigment production. Bacillus subtilis (C) is not a common pathogen in wound infections. Klebsiella pneumoniae (D) does not produce blue-green pigment and is more commonly associated with respiratory infections. Therefore, based on the clinical presentation and pigment production, Pseudomonas aeruginosa is the most likely causative agent in this case.

Correct Answer: B

Rationale: The correct answer is Staphylococcus saprophyticus (choice B). This bacterium is a common cause of urinary tract infections in young women. It typically grows on blood agar without hemolysis and appears as Gram-positive cocci under the microscope. Proteus mirabilis (choice A) is known for urease production, causing alkaline urine. Staphylococcus aureus (choice C) is a common cause of skin and soft tissue infections, not urinary tract infections. Pseudomonas aeruginosa (choice D) is an opportunistic pathogen often seen in nosocomial infections, not typically associated with urinary tract infections in healthy individuals.

Correct Answer: D

Rationale: The correct answer is D: decimal reduction time. This term represents the time required at a specific temperature to kill 90% of a bacterial population. It is a key parameter in microbiology to determine the effectiveness of a given heat treatment. Generation time (A) refers to the time it takes for a population to double in size. Thermal death time (B) is the shortest time needed to kill all organisms at a specific temperature. Sterilization time (C) is a general term and does not specifically refer to the time required to kill 90% of the population.

Correct Answer: B

Rationale: The correct answer is B: Fluconazole. Rationale: 1. Candidiasis is a fungal infection, so an antimycotic agent is needed. 2. β-lactam antibiotics like ampicillin can lead to fungal overgrowth, necessitating an antimycotic. 3. Fluconazole is an antifungal agent effective against Candida species. 4. Streptomycin is an antibiotic, not an antifungal. 5. Phthalylsulfathiazole is an antibacterial sulfonamide, not an antifungal. 6. Ampicillin is an antibiotic, not an antifungal.

Correct Answer: D

Rationale: The correct answer is D because antigenic shift is a major change in the influenza virus where genetic material from different influenza viruses mix to create a new subtype. This is a large-scale change that results in a novel virus with a different antigenic composition. Option A and B are incorrect because antigenic shift does involve the exchange of genetic information between animal and human influenza A viruses, and it does occur when animal or avian influenza viruses of type A directly pass into the human population. Option C is incorrect because antigenic shift is not related to the recirculation of a previously circulating influenza strain.