Microscopy of dental plaque revealed unicellular organisms. Their cytoplasm had two distinct layers, barely visible core, wide pseudopodia. The patient is most likely to have:

Correct Answer: D

Rationale: The correct answer is D: Trichomonas tenax. Trichomonas tenax is a flagellated protozoan that is commonly found in the oral cavity, specifically in dental plaque. The description provided in the question matches the characteristics of Trichomonas tenax, such as unicellular structure, distinct layers in the cytoplasm, wide pseudopodia, and barely visible core. Entamoeba gingivalis (choice A) and Entamoeba histolytica (choice B) are amoebas, not flagellated protozoa, and they do not exhibit the characteristics described in the question. Lamblia (choice C) is also an incorrect choice as it is a different type of protozoan that does not match the description provided.

Correct Answer: B

Rationale: The correct answer is B, Streptococcus pneumoniae. This bacterium is the classic causative agent of croupous pneumonia due to its ability to infect the lungs and cause inflammation. Streptococcus pneumoniae is a common pathogen known for causing pneumonia in both adults and children. It is characterized by the presence of a capsule that helps it evade the host immune system. Choice A, Chlamydia pneumoniae, is not the correct answer as it is more commonly associated with atypical pneumonia. Choice C, Mycoplasma pneumoniae, is also associated with atypical pneumonia and not croupous pneumonia. Choice D, Staphylococcus aureus, can cause pneumonia, but it is not the classic causative agent of croupous pneumonia.

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: 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: B

Rationale: The correct answer is B because in immune reactions, a large lattice is formed when antigens and antibodies are in optimal proportion. This optimal ratio allows for the formation of a strong antigen-antibody complex, leading to the aggregation of immune complexes into large lattice structures. When antibodies are in excess (choice A), there may not be enough antigens to form a stable lattice. Similarly, when antigens are in excess (choice C), there may be insufficient antibodies to form a strong lattice. Choice D is incorrect because the optimal proportion of antigens and antibodies is crucial for the formation of large lattices in immune reactions.

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pyogenes. The presence of Gram-positive cocci in chains suggests a streptococcal infection. Beta-hemolysis indicates the production of a hemolysin that lyses red blood cells, a characteristic of Streptococcus pyogenes. This bacterium is known to cause strep throat and can present with fever and sore throat. Summary: - B: Streptococcus pneumoniae is a common cause of pneumonia but typically appears as lancet-shaped cocci, not in chains. - C: Staphylococcus aureus is a gram-positive cocci in clusters, not chains, and is not typically beta-hemolytic. - D: Enterococcus faecalis is a gram-positive cocci that are part of the normal gut flora and are not typically beta-hemolytic or found in chains.

Correct Answer: D

Rationale: The correct answer is D: all of them. Malignant disease weakens the immune system, making individuals more susceptible to infections. Cytostatic therapy suppresses the immune system, increasing the risk of infections. Premature birth can lead to underdeveloped immune systems, making babies more prone to infections. Therefore, all three choices are risk factors for the development of infections. Other choices are incorrect because each individual risk factor listed contributes to an increased susceptibility to infections.

Correct Answer: D

Rationale: The correct answer is D: Trichomonas tenax. Trichomonas tenax is a flagellated protozoan that is commonly found in the oral cavity, specifically in dental plaque. The description provided in the question matches the characteristics of Trichomonas tenax, such as unicellular structure, distinct layers in the cytoplasm, wide pseudopodia, and barely visible core. Entamoeba gingivalis (choice A) and Entamoeba histolytica (choice B) are amoebas, not flagellated protozoa, and they do not exhibit the characteristics described in the question. Lamblia (choice C) is also an incorrect choice as it is a different type of protozoan that does not match the description provided.

Correct Answer: D

Rationale: The correct answer is D because all three bacteria (Salmonella enterica, Escherichia coli, Pseudomonas aeruginosa) are known to produce endotoxins, specifically lipopolysaccharides in their cell walls. Endotoxins are released upon bacterial cell death and can trigger an immune response, leading to septic shock. Salmonella and E. coli are common causes of bacterial infections, while Pseudomonas is associated with nosocomial infections. Therefore, all of the above choices are correct in terms of producing endotoxins that can cause septic shock. Choices A, B, and C are incorrect individually because they do not encompass all the bacteria known to produce endotoxins that can lead to septic shock.