Which of the following bacteria can produce endotoxins that cause septic shock?

Correct Answer: D

Rationale: The correct answer is D because all of the mentioned bacteria (Escherichia coli, Salmonella enterica, and Pseudomonas aeruginosa) are gram-negative bacteria that produce endotoxins in their cell walls. Endotoxins are released when the bacteria are destroyed, leading to the activation of the immune system and potentially causing septic shock. Escherichia coli and Salmonella enterica are common causes of gastrointestinal infections, while Pseudomonas aeruginosa is known for causing infections in immunocompromised individuals. Therefore, all three bacteria can produce endotoxins that contribute to septic shock. Choices A, B, and C are incorrect because each of these bacteria individually can produce endotoxins that lead to septic shock.

Correct Answer: B

Rationale: Rationale: The correct answer is B because virulence factors of bacteria are characteristics that enable them to cause disease. Colonization allows bacteria to establish and multiply in the host. Invasion refers to the ability to penetrate host tissues. Toxins are substances produced by bacteria that harm the host. Adhesion is crucial for bacteria to attach to host cells. A: Size and mutation are not typical virulence factors. Resistance is not directly related to causing disease. C: While toxins and evasion of body defenses are correct, motility and size are not universally considered virulence factors. D: Chemotaxis and fermentation are not primary virulence factors, unlike colonization and toxins.

Correct Answer: D

Rationale: Rationale: 1. Streptococcus pneumoniae is a common cause of bacterial pneumonia. 2. Mycobacterium tuberculosis can cause a type of pneumonia called tuberculosis. 3. Escherichia coli is not typically associated with pneumonia. 4. "All of the above" includes both Streptococcus pneumoniae and Mycobacterium tuberculosis, which are known to cause pneumonia. Therefore, D is the correct answer.

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 most likely diagnosis is A: Pneumonic plague. The patient's symptoms align with the presentation of pneumonic plague, caused by the bacterium Yersinia pestis. Symptoms include high fever, severe headache, dyspnea, cough with bloody sputum, and cyanosis. The characteristic bubonic plague lymphadenopathy may be absent in the pneumonic form. The patient's recent travel history to India also raises suspicion, as plague is endemic in some regions. The other choices can be ruled out based on the patient's symptoms and presentation. Miliary tuberculosis typically presents with diffuse miliary nodules on imaging. Influenza typically presents with more generalized symptoms and does not usually cause rusty sputum. Ornithosis is caused by Chlamydophila psittaci and usually presents with pneumonia-like symptoms after exposure to infected birds.

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: C

Rationale: The correct answer is C: cytoplasmic membrane. The cytoplasmic membrane is the fluidlike portion of a cell that separates the cell's contents from the external environment. It regulates the passage of substances in and out of the cell, maintains cell shape, and provides protection. Rationale: 1. Cytosol (choice A) is the liquid component of the cytoplasm where organelles are suspended, not the fluidlike portion of the cell. 2. Nucleoplasm (choice B) refers to the liquid component of the nucleus, not the entire cell. 3. Inclusion (choice D) refers to non-living substances within the cell that are not considered the fluidlike portion. Summary: The cytoplasmic membrane is the correct answer as it encompasses the entire cell and is responsible for maintaining cell integrity and regulating transport. Choices A, B, and D are incorrect as they do not represent the fluidlike portion of the cell.

Correct Answer: A

Rationale: The correct answer is A: Tetanus. The symptoms of tonic tension of the masticatory muscles following a dog bite are indicative of tetanus, caused by the bacterium Clostridium tetani. The incubation period of tetanus is usually 3-21 days, consistent with the patient's history of being bitten 12 days ago. Tetanus toxin causes muscle stiffness and spasms, leading to the inability to open the mouth. Rabies (B) presents with hydrophobia and neurological symptoms. Hysteria (C) is a psychological condition. Trigeminal neuralgia (D) is characterized by severe facial pain, not muscle stiffness.

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.