Which of the following pathogenic mechanisms are not typical for autoimmune reactions?

Correct Answer: D

Rationale: The correct answer is D, Formation of CD4+ cells. In autoimmune reactions, CD4+ cells are actually involved in the immune response. Here's the rationale: 1. CD4+ cells are helper T cells that play a crucial role in activating other immune cells in autoimmune reactions. 2. Decreased functional activity of T-suppressors (Choice A) is typical in autoimmune reactions as it leads to unchecked immune responses. 3. Loss of tolerance for T-helpers and B-lymphocytes (Choice B) is common in autoimmune reactions, where the immune system mistakenly attacks self-cells. 4. Ag released by normally isolated tissues (Choice C) is a typical mechanism in autoimmune reactions where self-antigens trigger immune responses.

Correct Answer: C

Rationale: The correct answer is C: Actinomycosis. Actinomycosis is a chronic suppurative bacterial infection caused by Actinomyces species, which form sulfur granules in purulent masses surrounded by dense fibrous tissue. In this case, the presence of fungal druses, plasma cells, xanthoma cells, and macrophages in the histological examination is characteristic of actinomycosis. The clinical presentation of skin redness, swelling, and abscess formation in the neck area also aligns with actinomycosis. Choice A: Syphilis is caused by Treponema pallidum, presenting with a painless chancre at the site of infection, not skin redness and swelling in the neck area. Choice B: Carbuncle is a bacterial skin infection involving a group of hair follicles, typically on the back of the neck, not characterized by fungal druses or sulfur granules. Choice D: Leprosy

Correct Answer: C

Rationale: The correct answer is C: Staphylococcus aureus. This bacterium is commonly associated with hospital-acquired infections due to its ability to cause a wide range of infections and its resistance to multiple antibiotics. Staphylococcus aureus can cause skin infections, pneumonia, bloodstream infections, and surgical site infections, making it a significant threat in healthcare settings. Escherichia coli (choice A) is more commonly associated with foodborne illnesses. Clostridium difficile (choice B) is known for causing antibiotic-associated diarrhea. Bacillus anthracis (choice D) is primarily associated with anthrax infections, which are not typically acquired in hospital settings.

Correct Answer: C

Rationale: The correct answer is C because there is no obligatory vaccine for Neisseria meningitidis in Bulgaria. The rationale for this is that while vaccines are available for meningococcal disease, they are not mandatory in Bulgaria. Therefore, this statement is incorrect. A: This statement is correct as Waterhouse-Friderichsen syndrome can occur during meningococcemia due to rapid progression of the infection leading to adrenal gland failure. B: This statement is incorrect as Neisseria meningitidis is most common in infants, children, and adolescents, with a second peak in young adults. D: This statement is correct as Neisseria meningitidis is transmitted through respiratory secretions, such as coughing or kissing, especially in close contacts like household members or roommates.

Correct Answer: D

Rationale: The correct answer is D: Exanthematous rash. Erythema infectiosum, also known as fifth disease, is characterized by a distinctive rash on the cheeks that looks like a "slapped cheek." This rash then spreads to the rest of the body, resulting in a lace-like rash (exanthem). Swelling of salivary glands (choice A) is not a typical symptom of erythema infectiosum. Diarrhea (choice B) and hepatitis (choice C) are also not associated with this condition. Therefore, the most characteristic clinical symptom of erythema infectiosum is the exanthematous rash.

Correct Answer: B

Rationale: The correct answer is B: to sequester iron from the environment. Siderophores are molecules produced by bacteria to chelate and acquire iron, an essential nutrient for their growth and survival. By sequestering iron, bacteria can compete with host cells and other microbes for this vital resource. This enhances their ability to thrive and establish infections. Choices A, C, and D are incorrect because siderophores do not directly enhance antibiotic resistance, form capsules, or perform oxidative phosphorylation. These functions are unrelated to the primary role of siderophores in iron acquisition.

Correct Answer: C

Rationale: The correct answer is C: acetyl-CoA. Acetyl-CoA is the compound that combines with oxaloacetic acid at the beginning of the Krebs cycle to form citric acid. This step is essential for the cycle to proceed, making acetyl-CoA the correct choice. A: Citric acid is formed after acetyl-CoA combines with oxaloacetic acid, so it is a product of the reaction, not the compound that enters the cycle. B: Pyruvic acid is converted to acetyl-CoA in a separate process before entering the Krebs cycle. D: Phosphoglyceraldehyde is not involved in the Krebs cycle; it is a compound in glycolysis.

Correct Answer: C

Rationale: The correct answer is C: Helicobacter pylori. This bacterium is a well-known cause of peptic ulcers due to its ability to survive in the acidic environment of the stomach and produce enzymes that weaken the protective mucous layer of the stomach lining. Treponema pallidum (choice A) causes syphilis, Vibrio cholerae (choice B) causes cholera, and Escherichia coli (choice D) can cause various infections but is not a common cause of peptic ulcers. Therefore, Helicobacter pylori is the correct answer as it is specifically associated with peptic ulcer formation.

Correct Answer: A

Rationale: Adhesins in gram positive bacteria are typically carried out by surface structures such as lipoteichoic acids. These molecules help the bacteria adhere to host cells or tissues. Lipoteichoic acids are specific to gram positive bacteria and play a crucial role in initiating infections. Fimbriae, flagella, and short chain mycolic acids are not primarily responsible for adhesion in gram positive bacteria. Fimbriae are more commonly found in gram negative bacteria, flagella are involved in motility, and short chain mycolic acids are specific to mycobacteria. Therefore, the correct answer is A, lipoteichoic acids.