Correct Answer: C

Rationale: The correct answer is C: gram-negative bacteria have an outer membrane that acts as an extra barrier. This outer membrane in gram-negative bacteria contains lipopolysaccharides and porins, which restrict the entry of antibiotics like penicillin. The outer membrane acts as an additional layer of protection, making it harder for penicillin to penetrate and reach its target, the peptidoglycan layer. Choices A, B, and D do not directly address the specific mechanism of resistance seen in gram-negative bacteria. Choice A focuses on transpeptidase enzyme quantity, which is not the primary reason for penicillin resistance. Choice B refers to β-lactamase enzymes in the periplasmic space, which are actually enzymes that degrade penicillin and contribute to resistance, but this is not unique to gram-negative bacteria. Choice D mentions a thicker cell wall, which is a characteristic of gram-positive bacteria, not gram-negative bacteria.

Correct Answer: D

Rationale: The correct answer is D because a fourfold increase in titer in the second serum sample indicates a significant rise in specific antibodies, which is crucial for diagnosing viral infections accurately. This increase is considered significant in serologic reactions as it shows a strong antibody response to the virus. A: A threshold increase may not be substantial enough to confirm a diagnostic antibody response. B: Dismissing the increase in titer would overlook important diagnostic information. C: A twofold increase may not be as indicative of a strong antibody response compared to a fourfold increase.

Correct Answer: A

Rationale: The correct answer is A: Clostridia. Fusiform spore-forming microorganisms that stain violet-blue with Gram's stain are characteristic of Clostridia. Clostridia are anaerobic, rod-shaped bacteria known for their ability to form spores and cause diseases such as tetanus and botulism. Summary of other choices: B: Streptococci are spherical, not fusiform, and typically do not form spores. C: Spirochaete are spiral-shaped bacteria and do not typically form spores. D: Actinomycete are filamentous bacteria that do not typically form spores and do not stain violet-blue with Gram's stain.

Correct Answer: B

Rationale: The correct answer is B: Toxoplasmosis. Toxoplasmosis is caused by the protozoan Toxoplasma gondii. The rationale for this is that protozoa are single-celled organisms that can cause diseases in humans. Cat scratch disease (A) is caused by a bacterium, Bartonella henselae. Relapsing fever (C) is caused by the bacterium Borrelia recurrentis. Plague (D) is caused by the bacterium Yersinia pestis. Therefore, the only choice caused by a protozoan is toxoplasmosis, making it the correct answer.

Correct Answer: A

Rationale: The correct answer is A: Binding of IgE fixed to the mast cells. The Bezredka method involves injecting small, gradually increasing doses of the antigen (tetanus toxoid) to desensitize the body and prevent anaphylactic shock. This process works by binding the IgE antibodies fixed to mast cells, thereby reducing the release of allergic mediators like histamine. This prevents the cascade of events that lead to anaphylactic shock. Choice B (Blocking the mediator synthesis in the mast cells) is incorrect because the Bezredka method does not block mediator synthesis but rather prevents the release of mediators by binding IgE. Choice C (Stimulation of immune tolerance to the antigen) is incorrect as the Bezredka method does not primarily focus on inducing immune tolerance but rather on preventing anaphylactic reactions. Choice D (Stimulation of the synthesis of antigen-specific IgG) is incorrect because the Bezredka method targets IgE antibodies on mast cells