On examination of a 6-year-old child the doctor noticed greyish film on the child's tonsils. Microscopy of the smear stained by Neisser method detected there Corynebacterium diphtheria. What morphologic feature was the most indicative for determining the type of the agent?

Correct Answer: C

Rationale: The correct answer is C: Polar placement of volutin granules. This feature is indicative of Corynebacterium diphtheria. Volutin granules are metachromatic granules found in the polar region of the bacterial cell, which is characteristic of this species. This feature helps differentiate it from other bacteria. Explanation: A: Fence-like position of the agent's cells is not a specific morphologic feature of Corynebacterium diphtheria. B: Spores that exceed cells in diameter is not a characteristic feature of Corynebacterium diphtheria. D: Presence of the capsule is not a distinguishing morphologic feature of Corynebacterium diphtheria. In summary, the polar placement of volutin granules is the most indicative feature for determining the type of agent as Corynebacterium diphtheria, making it the correct choice.

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: A

Rationale: The correct answer is A: Propionibacterium shermanii. This bacterium is used in the production of certain types of cheese, such as Swiss cheese, to create the characteristic holes and flavor. Propionibacterium produces carbon dioxide gas during fermentation, forming the holes in the cheese. Acetobacter aceti (B) is used in vinegar production. Giardia (C) is a parasite that causes gastrointestinal issues, not used in cheese production. Fusobacterium (D) is a type of bacteria associated with infections in humans, not used in cheese production.

Correct Answer: A

Rationale: The correct answer is A: Bacteriological. This method involves isolating and culturing the causative bacteria from the wound material to determine the species. This allows for further testing to confirm gaseous gangrene and identify the specific pathogen. Choice B: Allergic is incorrect as it pertains to immune responses, not identifying bacteria. Choice C: Bacterioscopic is incorrect as it refers to microscopic examination of bacteria, not species identification. Choice D: Serological is incorrect as it involves testing for antibodies in the blood, not identifying the causative agent directly.

Correct Answer: C

Rationale: The correct answer is C: Bacillus subtilis. Bacillus subtilis is known for its spore-forming ability, which is a survival mechanism to withstand harsh conditions. Spore formation allows the bacteria to become dormant and resistant to heat, chemicals, and radiation. Escherichia coli (A) is not known for spore formation. Staphylococcus aureus (B) does not form spores either. Listeria monocytogenes (D) is a pathogenic bacterium but does not typically form spores.

Correct Answer: B

Rationale: The correct answer is B because the presence of calcium dipicolinate in bacterial spores helps protect their DNA from damage under harsh conditions. Calcium dipicolinate acts as a stabilizer, preserving the spore structure. Choice A is incorrect as bacterial spores have a tough protein coat, not a lipid-rich membrane. Choice C is incorrect as bacterial spores have very low metabolic activity. Choice D is incorrect as bacterial spores have low water content to prevent damage during harsh conditions.

Correct Answer: D

Rationale: The correct answer is D because the flu vaccine mainly stimulates systemic immunity, not local immunity. Systemic immunity refers to the immune response throughout the body, while local immunity is specific to a certain area. Choice A is incorrect because the flu vaccine is indeed recommended. Choice B is incorrect as the flu vaccine can be a subunit vaccine, containing only specific antigens. Choice C is incorrect as the flu vaccine is typically administered parenterally, meaning through injection, nasal spray, or oral routes.

Correct Answer: D

Rationale: The correct answer is D: HIV. HIV is transmitted through direct contact with certain body fluids such as blood, semen, vaginal fluids, and breast milk. This direct contact route of transmission makes it different from the other choices. Salmonellosis is typically transmitted through contaminated food or water (not direct contact). Tularemia is usually transmitted through insect bites or contact with infected animals. Rubella is primarily transmitted through respiratory droplets. Therefore, HIV is the only option with a contact route of transmission.

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.