Patients after splenectomy are of high risk of infections caused by:

Correct Answer: D

Rationale: Rationale: After a splenectomy, patients are at high risk of infections caused by encapsulated bacteria such as Streptococcus pneumoniae, Listeria monocytogenes, and Salmonella. The spleen plays a crucial role in the immune response against encapsulated bacteria, and its absence increases susceptibility to these specific pathogens. Therefore, all choices are correct as patients are at risk of infections from all three types of bacteria mentioned.

Correct Answer: C

Rationale: The correct answer is C: young adults. Young adults are at a higher risk for sexually transmitted infections (STIs) due to factors such as engaging in risky sexual behaviors, lack of awareness, and inconsistent condom use. They are more likely to have multiple sexual partners and are less likely to seek regular STI screenings. Adolescents, while also at risk, may not make up almost half of all STI cases in the U.S. The elderly, on the other hand, are generally at a lower risk due to lower levels of sexual activity compared to young adults.

Correct Answer: A

Rationale: The correct answer is A: Amikacin sulfate. Pseudomonas aeruginosa is commonly resistant to many antibiotics, but aminoglycosides like Amikacin have good activity against it. Step 1: Identify the pathogen causing the infection. Step 2: Consider the antibiotic's spectrum of activity against the pathogen. Step 3: Choose an antibiotic with proven efficacy. Amikacin is a good choice due to its effectiveness against Pseudomonas. Choice B, Benzylpenicillin, is a penicillin which is not effective against Pseudomonas. Choice C, Cephazolin, is a cephalosporin with limited activity against Pseudomonas. Choice D, Erythromycin, is a macrolide which is not effective against Pseudomonas.

Correct Answer: A

Rationale: The correct answer is A: BCG. BCG vaccine is commonly used for tuberculosis prevention because it provides immunity against Mycobacterium tuberculosis. Mantoux is a test, not a vaccine. DTaP vaccine is for diphtheria, tetanus, and pertussis, not tuberculosis. Anatoxin is a type of toxoid vaccine, not used for tuberculosis prevention. BCG vaccine has been shown to be effective in preventing severe forms of tuberculosis in infants, making it the appropriate choice in this scenario.

Correct Answer: C

Rationale: The correct answer is C: Increased active efflux from the bacterial cell. This is the most important mechanism of tetracycline resistance because it involves the bacteria actively pumping out the antibiotic, reducing its intracellular concentration. This prevents tetracycline from effectively targeting bacterial ribosomes. Choice A is incorrect as tetracycline resistance typically involves active efflux rather than reduced influx. Choice B is incorrect because tetracycline resistance mechanisms do not primarily involve altered cell membrane components affecting passive influx. Choice D is also incorrect as tetracycline resistance mechanisms do not typically involve direct enzymatic inactivation of the antibiotic.

Correct Answer: D

Rationale: The correct answer is D: Propionibacterium acnes. This bacterium is not a fungus, but a common skin bacteria. Fungal vaginitis is typically caused by Candida albicans or other fungal species, not by bacteria like Escherichia coli, Streptococcus agalactiae, or Klebsiella oxytoca. Propionibacterium acnes is not associated with vaginal infections, making it the correct answer in this context.

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pyogenes. 1. Gram-positive cocci in chains: characteristic of Streptococcus species. 2. Catalase-negative: Streptococcus species are catalase-negative. 3. Beta-hemolytic: S. pyogenes is beta-hemolytic on blood agar. Therefore, S. pyogenes fits all these criteria. B: Streptococcus pneumoniae is catalase-negative but alpha-hemolytic, not beta-hemolytic. C: Enterococcus faecalis is catalase-negative, but not typically beta-hemolytic or in chains. D: Staphylococcus aureus is catalase-positive and not in chains.

Correct Answer: C

Rationale: The correct answer is Shigella (Choice C) because it matches the description of being Gram-negative rods and lactose non-fermenters. Shigella is a non-lactose fermenting, Gram-negative rod that typically produces colorless colonies on Endo agar. Salmonella (Choice A) and Escherichia coli (Choice B) are both lactose fermenters and would produce pink colonies on Endo agar. Proteus (Choice D) is also a lactose fermenter and would appear pink on Endo agar. Therefore, based on the characteristics provided, Shigella is the most likely microorganism in this scenario.

Correct Answer: A

Rationale: The correct answer is A because Gram-negative bacteria have a unique cell envelope structure consisting of a cytoplasmic membrane, a peptidoglycan layer, and an outer membrane. The cytoplasmic membrane is the innermost layer that separates the cytoplasm from the external environment. The peptidoglycan layer provides structural support to the cell. The outer membrane acts as an additional protective barrier and contains lipopolysaccharides. Choice B is incorrect because Gram-negative bacteria have an outer membrane in addition to the cytoplasmic membrane and peptidoglycan layer. Choice C is incorrect because Gram-negative bacteria have more than just a peptidoglycan layer in their cell envelope. Choice D is incorrect as the cell envelope of Gram-negative bacteria does have specific components.