The most important mechanism of tetracycline resistance is

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: B

Rationale: The correct answer is B: Neisseria meningitidis. This is because Neisseria meningitidis is a Gram-negative diplococci that is oxidase-positive and fermentative. Neisseria gonorrhoeae (choice A) is also a Gram-negative diplococci but is not fermentative. Haemophilus influenzae (choice C) is not a diplococci and Moraxella catarrhalis (choice D) is oxidase-negative. Thus, Neisseria meningitidis fits all the criteria provided in the question, making it the most likely causative agent for the sepsis in this patient.

Correct Answer: B

Rationale: The correct answer is B: Alpha-hemolytic streptococci. Streptococcus pneumoniae are classified as alpha-hemolytic streptococci based on their ability to partially break down red blood cells, causing a greenish discoloration on blood agar plates. This distinguishes them from beta-hemolytic streptococci, which completely break down red blood cells. Streptococcus pneumoniae are not resistant to bile (choice A), as they are bile soluble. They are not stained by the Ziehl-Neelsen staining method (choice C), which is used for acid-fast bacteria such as Mycobacterium tuberculosis. They are sensitive to optochin (choice D), which is a key differentiating factor in identifying them from other alpha-hemolytic streptococci.

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: B

Rationale: The correct answer is B: Precipitins. When a granular sediment forms at the bottom of the test-tubes, it indicates the formation of antigen-antibody complexes that are insoluble and precipitate out of the solution. Precipitins are antibodies that specifically react with antigens to form insoluble complexes. Agglutinins cause clumping of cells, opsonins enhance phagocytosis, and bacteriolysins lyse bacteria. These processes do not result in the formation of a granular sediment, making them incorrect choices in this context.

Correct Answer: B

Rationale: The correct answer is B: Staphylococcus aureus. This bacterium is commonly found in hospital environments due to its ability to colonize human skin and mucous membranes. It is a leading cause of hospital-acquired infections. Borrelia burgdorferi is mainly associated with Lyme disease transmitted by ticks, not commonly found in hospitals. Bacillus cereus is a foodborne pathogen, not typically prevalent in hospital settings. Staphylococcus haemolyticus is a coagulase-negative staphylococcus species, less pathogenic and less common in hospitals compared to Staphylococcus aureus.

Correct Answer: B

Rationale: The correct answer is B: Malarial plasmodiums. The description of crescent bodies with a pointed end, blue cytoplasm, and red nucleus corresponds to the characteristics of Plasmodium species seen in Romanovsky's stain. Plasmodium species are known to cause malaria and have distinct features like the ones described. Incorrect choices: A: Toxoplasmas - Toxoplasma gondii typically appear as tachyzoites or bradyzoites under staining, not crescent bodies. C: Dermotropic leishmania - Leishmania species appear as amastigotes in tissue smears, not crescent bodies. D: Viscerotropic leishmania - Similar to choice C, Leishmania species do not typically present as crescent bodies in stained specimens.

Correct Answer: A

Rationale: The correct answer is A: Trichomonas vaginalis. Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis, a sexually transmitted infection characterized by inflammation of urogenital tracts. The description of big unicellular pyriform organisms with a sharp spike on the back end of their bodies, big nucleus, and undulating membrane matches the morphology of Trichomonas vaginalis. Trichomonas hominis and Trichomonas buccalis are different species that do not cause urogenital infections. Trypanosoma gambiense is a protozoan parasite causing African trypanosomiasis and does not match the described morphology or symptoms.

Correct Answer: A

Rationale: The correct answer is A: Metronidazole. Rationale: 1. Metronidazole is the drug of choice for amebic dysentery due to its effectiveness against the causative agent, Entamoeba histolytica. 2. Metronidazole has good tissue penetration and is able to reach the site of infection in the gut. 3. It is a bactericidal drug that acts by disrupting the DNA structure of the parasite. 4. Metronidazole is well-absorbed orally and has minimal side effects. Summary of other choices: B: Furazolidonum - Not the drug of choice for amebic dysentery. It is primarily used for treating bacterial diarrhea. C: Levomycetin - Not effective against Entamoeba histolytica and not recommended for amebic dysentery. D: Phthalazol - Not commonly used for amebic dysentery treatment. Metronidazole is preferred due