Correct Answer: D

Rationale: The correct answer is D because all three bacteria (Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae) can cause bacterial meningitis. Neisseria meningitidis is a common cause of meningococcal meningitis, Haemophilus influenzae can cause H. influenzae meningitis, and Streptococcus pneumoniae is a leading cause of pneumococcal meningitis. Therefore, all of the above choices are correct. The other choices are incorrect because each of the bacteria listed can independently cause bacterial meningitis, so none of them alone can be the sole correct answer.

Correct Answer: C

Rationale: The normal microflora plays a crucial role in defending against pathogens in the skin and mucus. This is because the skin and mucus act as physical barriers and the normal microflora outcompetes potential pathogens, preventing their colonization. In contrast, the circulatory system (A), hepatobiliary tract (B), and CNS (D) are not typically colonized by normal microflora, so they do not directly contribute to defense against pathogens in those areas.

Correct Answer: A

Rationale: The correct answer is A: Neisseria meningitidis. This is because Neisseria meningitidis is a Gram-negative diplococcus that is oxidase-positive and fermentative. Neisseria gonorrhoeae is also a Gram-negative diplococcus, but it is not fermentative. Moraxella catarrhalis is oxidase-positive but not fermentative. Haemophilus influenzae is Gram-negative but is not a diplococcus, and it is not fermentative. Therefore, based on the characteristics provided in the question, Neisseria meningitidis is the most likely causative agent.

Correct Answer: B

Rationale: The correct answer is B: Outer membrane with lipopolysaccharides. Gram-negative bacteria have an outer membrane that contains lipopolysaccharides, which play a role in pathogenicity and resistance to certain antibiotics. This outer membrane is a distinguishing feature of Gram-negative bacteria, as opposed to Gram-positive bacteria that have a thick peptidoglycan layer. Choices A, C, and D are incorrect because Gram-negative bacteria have a thin peptidoglycan layer, do have a cell wall (although it is different from Gram-positive bacteria), and do not contain teichoic acids.

Correct Answer: B

Rationale: The correct answer is B: IgM. IgM antibodies are the first type of antibodies produced in response to an infection, indicating an active or recent infection. In the case of a rubella virus infection in a fetus, IgM antibodies can be detected in the umbilical cord blood, confirming the presence of the virus. IgA antibodies are mainly found in mucosal areas, IgG antibodies indicate past infection or immunity, and IgD antibodies play a role in B cell activation but are not typically detected in this context.