There are several cases of children from boarding school suffering from sore throat. Microscopy of tonsil smears stained according Neisser method has revealed thin yellow bacilli with dark brown grains on their ends placed in the shape of Roman numeral five. What infection can be suspected in this case?

Correct Answer: A

Rationale: Rationale for Correct Answer A (Diphtheria): 1. Thin yellow bacilli with dark brown grains on ends suggest Corynebacterium diphtheriae, characteristic of diphtheria. 2. Roman numeral five shape is typical of diphtheria bacilli. 3. Diphtheria causes sore throat and can spread in boarding schools. 4. Neisser staining method is used for diphtheria bacilli. Summary of Incorrect Choices: B: Scarlet fever is caused by Streptococcus pyogenes and presents with rash, not yellow bacilli. C: Listeriosis is caused by Listeria monocytogenes, not consistent with the described findings. D: Tonsillitis can be caused by various bacteria or viruses, but the specific characteristics described do not match.

Correct Answer: D

Rationale: The correct answer is D, "None of the above," because viruses like Parotitidis (mumps), Rubella, and Influenza A are not typically associated with reactivation under immunosuppressive therapy. Reactivation is more commonly seen in latent viruses like herpesviruses (e.g., herpes simplex, varicella-zoster), cytomegalovirus, and Epstein-Barr virus. These viruses can remain dormant in the body and reactivate when the immune system is compromised. Therefore, the correct answer is D, as the viruses mentioned in choices A, B, and C do not fit the criteria for reactivation under immunosuppressive therapy.

Correct Answer: B

Rationale: The correct answer is B: Mycobacterium leprae. This bacterium is responsible for causing leprosy, also known as Hansen's disease. Mycobacterium leprae specifically targets the skin, peripheral nerves, and mucosa of the upper respiratory tract. It is an acid-fast bacterium with a slow growth rate, making it difficult to culture in the laboratory. Streptococcus pyogenes (choice A) is responsible for various infections such as strep throat, Neisseria gonorrhoeae (choice C) causes gonorrhea, and Escherichia coli (choice D) is commonly found in the gut and can lead to various infections but not leprosy.

Correct Answer: A

Rationale: The correct answer is A: Fluconazole. 1. Fluconazole is an antifungal agent effective against Candida species commonly causing candidiasis. 2. Streptomycin (B) is an antibiotic used for bacterial infections, not fungal. 3. Phthalylsulfathiazole (C) is an antibacterial agent, not antifungal. 4. Ampicillin (D) is a β-lactam antibiotic, which can actually contribute to fungal infections like candidiasis.

Correct Answer: A

Rationale: The correct answer is A: Helicobacterial infection. This is the most probable leading mechanism of disease development in this case because the patient's symptoms, such as heartburn, epigastric pain, food intolerance, and presence of a duodenal ulcer with a positive urease test, are classic signs of Helicobacter pylori infection. This bacterium colonizes the stomach lining, leading to inflammation and ulcer formation. The exacerbations in spring and autumn could be due to seasonal variations in immune response. Choice B: Dietary allergy is incorrect because the symptoms and findings in the patient are more indicative of an infectious etiology rather than an allergic reaction to specific foods. Choice C: Autoantibody production is unlikely as there are no indications of an autoimmune process in this case. Choice D: Reduced prostaglandin synthesis is not the leading mechanism as the symptoms and findings are more consistent with an infectious cause rather than a deficiency in prostaglandin synthesis.

Correct Answer: C

Rationale: The correct answer is C (coli index of 250 and coli titer of 4). The coli index is calculated by multiplying the number of colonies by the reciprocal of the volume filtered, which gives 2 colonies x (1/0.5 L) = 4. The coli titer is obtained by dividing the volume filtered by the number of colonies, which gives 0.5 L / 2 colonies = 0.25 L or 250 ml. This indicates the concentration of coliform bacteria in the water sample. Choice A (4 and 250) is incorrect because it has the correct coli index but the values are reversed for coli index and coli titer. Choice B (2 and 500) is incorrect as it provides the correct coli titer value but the values are reversed for coli index and coli titer. Choice D (500 and 2) is incorrect because it reverses the values for both coli index and coli titer.

Correct Answer: D

Rationale: The correct answer is D because fires from flammable metals require specialized Class D fire extinguishers designed to extinguish these unique types of fires. Class A, B, and C fire extinguishers are not suitable for flammable metal fires as they are designed for different types of materials and fire classes. Class A extinguishers are for ordinary combustibles, Class B for flammable liquids, and Class C for electrical fires. Therefore, Class D fire extinguishers are specifically designed for flammable metal fires, making them the correct choice for this scenario.

Correct Answer: D

Rationale: The correct answer is D: amensalism. Penicillin mold produces a substance that inhibits the growth of bacteria, but it does not benefit nor harm the bacteria directly. This relationship is characterized by one organism (the mold) negatively affecting another (the bacteria) without any benefit or harm to itself. In parasitism (A), one organism benefits at the expense of another. In mutualism (B), both organisms benefit from the relationship. In commensalism (C), one organism benefits while the other is unaffected. Therefore, the mold producing penicillin fits the definition of amensalism.

Correct Answer: A

Rationale: Ionizing radiation has enough energy to remove tightly bound electrons from atoms, creating charged particles (ions). UV light does not have enough energy to ionize atoms, making choice A the correct answer. Gamma rays, electron beams, and X-rays all have sufficient energy to cause ionization. Gamma rays are very high-energy electromagnetic radiation, electron beams are streams of high-energy electrons, and X-rays are high-energy electromagnetic radiation as well.