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: D

Rationale: The correct answer is D: Index of fecal coli-forms. Fecal coli-forms are bacteria found in the intestines of warm-blooded animals, including humans. Their presence in water indicates fecal contamination, which is a common source of hepatitis A transmission. Monitoring the index of fecal coli-forms can help identify potential sources of contamination and assess the risk of disease transmission. A: Number of coli-phages - Coli-phages are viruses that infect coliform bacteria and are not directly related to fecal contamination. B: Escherichia coli index - While E. coli is a type of coliform bacteria found in the intestines of warm-blooded animals, it alone may not be a reliable indicator of fecal contamination in water sources. C: Oxidability - Oxidability is a measure of the water's ability to react with oxygen and does not provide direct information about fecal contamination or the presence of pathogens like hepatitis A. In summary,

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: A

Rationale: The correct answer is A: Entamoeba histolytica. This protozoon is known to cause amoebic dysentery, presenting symptoms of weakness, intestinal pain, and indigestion. The presence of microbial cysts with four nuclei in fecal samples is characteristic of Entamoeba histolytica. These cysts are the infective form of the parasite and can cause severe invasive disease in the intestines. Incorrect choices: B: Entamoeba coli does not typically cause invasive disease or severe symptoms like those described in the question. C: Balantidium is a ciliated protozoan that causes balantidiasis, which presents differently from the symptoms described in the question. D: Trichomonad is a flagellated protozoan that typically infects the urogenital tract, not the intestine, and does not form cysts with four nuclei. In summary, the key clues in the question were the symptoms of weakness, intestinal pain,

Correct Answer: A

Rationale: Saddle nose is a condition where the bridge of the nose collapses, a characteristic feature of congenital syphilis. This occurs due to inflammation and destruction of cartilage. Syphilis is caused by the bacterium Treponema pallidum. CMV, Rubella, and Toxoplasmosis do not typically cause saddle nose. CMV can result in hearing loss, Rubella can lead to cataracts and heart defects, and Toxoplasmosis may cause hydrocephalus or chorioretinitis.

Correct Answer: B

Rationale: The correct answer is B: peptidoglycan and calcium dipicolinate. Bacterial endospores are resistant structures formed by certain bacterial species under unfavorable conditions. Peptidoglycan provides structural support, while calcium dipicolinate aids in heat resistance. Lipid bilayers (choice A) are not a primary component. Capsular polysaccharides (choice C) are part of the bacterial capsule, not the endospore. Teichoic acid (choice D) is a component of the cell wall, not the endospore.

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: 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.

Correct Answer: D

Rationale: The correct answer is D: tinea pedis. Athlete's foot is a fungal infection that affects the feet, specifically the skin between the toes and on the soles. "Tinea pedis" is the medical term for athlete's foot, with "tinea" meaning a fungal infection and "pedis" referring to the foot. A: tinea capitis refers to a fungal infection of the scalp, not the feet. B: tinea corporis refers to a fungal infection of the body, not specifically the feet. C: tinea versicolor refers to a fungal infection that causes discoloration of the skin, not typically on the feet. In summary, the other choices are incorrect because they refer to fungal infections affecting different parts of the body, whereas "tinea pedis" specifically refers to athlete's foot.