Microscopy of a sputum smear revealed acid-fast bacilli stained red using the Ziehl-Neelsen method. What is the most likely diagnosis?

Correct Answer: A

Rationale: The presence of acid-fast bacilli stained red using the Ziehl-Neelsen method indicates a mycobacterial infection. Among the choices, tuberculosis is the most common mycobacterial infection affecting the lungs, presenting with acid-fast bacilli in sputum. Leprosy is caused by Mycobacterium leprae, but it typically does not show up in sputum smears. Diphtheria is caused by Corynebacterium diphtheriae, which is not acid-fast. Pneumonia is a general term for lung inflammation caused by various pathogens, not specifically mycobacteria. Therefore, the correct diagnosis is tuberculosis based on the microscopy findings.

Correct Answer: B

Rationale: Rationale: 1. The grain-like sediment indicates a precipitation reaction. 2. Precipitins are antibodies that cause precipitation reactions. 3. In serological diagnostics, precipitation reactions are used to detect specific antibodies. 4. Therefore, the reaction revealed in this scenario is due to the presence of precipitins. Summary: A: Bacteriolysins - These antibodies cause bacterial lysis, not precipitation. C: Antitoxins - These antibodies neutralize toxins, not involved in precipitation reactions. D: Opsonins - These antibodies enhance phagocytosis, not related to precipitation reactions.

Correct Answer: B

Rationale: The correct answer is B: Availability of cell-mediated immunity to tuberculosis. A negative Mantoux test indicates the presence of an immune response to the TB bacteria, as the test measures the body's delayed hypersensitivity reaction to TB antigens. This means the child has been exposed to TB in the past or has been vaccinated, resulting in the development of cell-mediated immunity against TB. Incorrect choices: A: No cell-mediated immunity to tuberculosis - This is incorrect as a negative Mantoux test actually indicates the presence of cell-mediated immunity. C: No antibodies to the tuberculosis bacteria - Mantoux test measures cell-mediated immunity, not antibody response. D: No anti-toxic immunity to tuberculosis - Mantoux test does not assess anti-toxic immunity, it specifically measures cell-mediated immunity.

Correct Answer: D

Rationale: The correct answer is D: interferes with protein synthesis. Cephalosporins are beta-lactam antibiotics that work by inhibiting bacterial cell wall synthesis, not protein synthesis. They are bactericidal and have a relatively broad spectrum of activity against various bacteria. Choice A, B, and C all describe characteristics of cephalosporins, making them incorrect options.

Correct Answer: C

Rationale: The correct staining technique for sputum smears obtained from a tuberculosis patient is Ziehl-Neelsen staining. This technique uses carbol fuchsin dye to stain the acid-fast bacteria, such as Mycobacterium tuberculosis, red. Here's a step-by-step rationale: 1. Ziehl-Neelsen staining is specifically designed to detect acid-fast bacteria like Mycobacterium tuberculosis. 2. Carbol fuchsin dye is used to penetrate the mycolic acid layer in the cell wall of the bacteria, making them resistant to decolorization. 3. Acid-alcohol is used as a decolorizer to remove the stain from non-acid-fast bacteria. 4. Methylene blue is used as a counterstain to visualize non-acid-fast bacteria in blue. Therefore, Ziehl-Neelsen staining is the most appropriate technique for identifying Mycobacterium tuberculosis in sputum smears. Other choices like Gram, Giemsa, and

Correct Answer: A

Rationale: The correct answer is A: Vibrio cholerae. This bacterium produces cholera toxin, an exotoxin that causes severe dehydration and diarrhea by increasing the secretion of electrolytes and water in the intestines. Vibrio cholerae is the causative agent of cholera, a disease characterized by profuse watery diarrhea. Choice B, Clostridium tetani, produces tetanospasmin causing tetanus, not dehydration or diarrhea. Choice C, Escherichia coli, can cause diarrhea but rarely severe dehydration. Choice D, Shigella dysenteriae, produces Shiga toxin leading to bloody diarrhea, not severe dehydration.

Correct Answer: A

Rationale: The correct answer is A: viruses. Viruses are always in a parasitic form of interaction with the individual because they cannot survive or reproduce outside of a host cell. They rely on host cells to replicate and cause harm. Non-pathogenic bacteria (choice B) do not always cause harm and can coexist with the individual. Facultative pathogenic bacteria (choice C) can switch between being beneficial and harmful. Therefore, the correct answer is A as viruses always rely on a host for survival and reproduction.

Correct Answer: B

Rationale: The correct answer is B: Tuberculosis. The case describes a man with a perforation in the hard palate and features of caseous necrosis with granulation tissue, endovasculitis, and a cellular infiltration mainly of lymphocytes, epithelioid cells, and plasma cells. These findings are classic for tuberculosis infection, commonly seen in extrapulmonary sites like the oral cavity. Syphilis (choice A) typically presents with a painless ulcer and different histopathological features. Leprosy (choice C) presents with granulomas containing foamy macrophages. Scleroma (choice D) is caused by Klebsiella rhinoscleromatis and presents with chronic granulomatous inflammation.

Correct Answer: B

Rationale: The correct answer is B because there are two types of herpes simplex virus: HSV-1 and HSV-2. HSV-1 typically causes oral herpes, while HSV-2 usually causes genital herpes. Choice A is incorrect because there is more than one type. Choices C and D are also incorrect as there are only two types of herpes simplex virus known to infect humans.