What preventive medications should be injected to a patient with open maxillofacial trauma provided that he has never got prophylactic vaccination before?

Correct Answer: C

Rationale: Step 1: Antitetanus serum is crucial for patients with open maxillofacial trauma to prevent tetanus infection from contaminated wounds. Step 2: Antibiotics are needed to prevent infection in the wound. Step 3: Antitetanus serum provides immediate passive immunity while antibiotics help combat potential infections. Step 4: Antitetanus immunoglobulin is not mentioned in the question and is not typically used for prophylaxis. Step 5: Anticonvulsive drugs are not preventive medications for maxillofacial trauma. Step 6: Diphtheria, tetanus, and pertussis vaccines are not specifically indicated for immediate prevention in this scenario.

Correct Answer: A

Rationale: The correct answer is A: Candida. The whitish spots resembling coagulated milk on the mucous membranes are characteristic of oral thrush, a condition caused by Candida species. Candida is a gram-positive oval yeast-like fungus commonly found in the oral cavity. Staphylococci (B) are gram-positive cocci, not yeast-like cells. Diphtheria bacillus (C) causes diphtheria, not oral thrush. Actinomycetes (D) are filamentous bacteria, not yeast-like cells typically seen in oral thrush. Therefore, A is the correct answer based on the clinical presentation and microscopic findings.

Correct Answer: C

Rationale: The correct answer is C: nosocomial infections. Nosocomial infections are infections acquired in healthcare settings. This term specifically refers to infections that occur during the course of receiving medical treatment. The other choices are incorrect because: A: Incidental infections do not necessarily occur in healthcare settings. B: Accidental infections is not a commonly used term in healthcare for infections acquired in healthcare settings. D: Secondary infections refer to infections that occur as a result of a primary infection, not specifically related to healthcare settings.

Correct Answer: D

Rationale: The correct answer is D: scanning electron microscope. A scanning electron microscope provides a three-dimensional image of a specimen by scanning a focused electron beam across the surface of the specimen, detecting the electrons that are emitted from the surface, and creating a detailed image. This is achieved through the detection of secondary electrons, backscattered electrons, and X-rays emitted from the specimen surface. A dark-field microscope (choice A) utilizes oblique lighting to enhance contrast and is not specifically designed to provide a 3D image. A transmission electron microscope (choice B) uses a beam of electrons transmitted through a specimen to create a 2D image at high magnification. A bright-field microscope (choice C) is a basic microscope that illuminates a specimen with uniform light and does not provide a 3D image like a scanning electron microscope does.

Correct Answer: A

Rationale: The correct answer is A: Lowestein-Jensen. This is because Lowestein-Jensen medium is specifically designed to cultivate Mycobacterium tuberculosis, providing necessary nutrients and conditions for its growth. Loefller's medium is not optimal for cultivating M. tuberculosis. Choice C (All of the above) is incorrect as not all the options listed are suitable for cultivating M. tuberculosis. Choice D (None of the above) is also incorrect as Lowestein-Jensen is indeed the recommended growth medium for this bacterium.

Correct Answer: A

Rationale: The correct answer is A: Neisseria meningitidis. This bacterium fits the description of Gram-negative diplococci that are oxidase-positive and fermentative. Neisseria meningitidis commonly causes pneumonia and meningitis. Choice B: Neisseria gonorrhoeae is also a Gram-negative diplococci but is not fermentative. Choice C: Moraxella catarrhalis is oxidase-positive but not fermentative. Choice D: Haemophilus influenzae is not fermentative and typically appears as pleomorphic rods, not diplococci.

Correct Answer: B

Rationale: The correct answer is B: serratia spp. This is because serratia spp. are not typically found in the normal skin microflora. Normal skin microflora primarily consist of bacteria such as diphtheroids, alpha-hemolytic streptococci, and epidermidis. Serratia spp. are more commonly associated with healthcare-associated infections rather than being a part of the skin's natural bacterial flora. Therefore, choice B is the correct answer. Choices A, C, and D are incorrect as they are commonly found in the normal skin microflora.

Correct Answer: A

Rationale: 1. Gram-positive cocci in clusters suggest Staphylococcus species. 2. Catalase-positive and coagulase-positive characteristics match with Staphylococcus aureus. 3. Staphylococcus aureus is a common cause of wound infections due to its virulence factors. 4. Other choices are incorrect: B) S. epidermidis is coagulase-negative and a common contaminant, C) S. pyogenes is catalase-negative, D) Enterococcus faecalis is not typically associated with wound infections.

Correct Answer: A

Rationale: The correct answer is A: Bacillus anthracis. Bacillus anthracis is the likely causative agent as it is a Gram-positive rod-shaped bacterium known to cause ulcerated lesions with associated fever and malaise. Anthrax typically presents with these symptoms and fits the description given in the question. Clostridium perfringens (Choice B) causes gas gangrene and typically presents with different symptoms. Clostridium tetani (Choice C) causes tetanus and is not associated with ulcerated lesions. Bacillus cereus (Choice D) is known for causing food poisoning and does not typically present with the symptoms described in the question.