Young man is hospitalized in pulmonology with complaints of dry cough, fatigue and suffocations. The anamnesis and the lab tests lead to pneumocystis pneumonia. The CD4+ cells are less than 200/mm3. What test you will order:

Correct Answer: B

Rationale: The correct answer is B: For HIV. Pneumocystis pneumonia in a young man with CD4+ cells less than 200/mm3 is highly suggestive of HIV infection. HIV weakens the immune system, leading to opportunistic infections like pneumocystis pneumonia. Testing for HIV is crucial for diagnosis and appropriate management. Explanation for other choices: A: Testing for ureaplasma urealyticum is not indicated in this case as the symptoms and CD4+ cell count point towards an HIV-related infection. C: Testing for Treponema pallidum (syphilis) is not relevant in the context of a young man with pneumocystis pneumonia and low CD4+ cell count. D: Testing for Neisseria gonorrhoea is not appropriate in this scenario as the symptoms and CD4+ cell count suggest an underlying HIV infection rather than a bacterial sexually transmitted infection.

Correct Answer: B

Rationale: The correct answer is B: Vibrio cholerae. Cholera is caused by this specific bacterium due to its production of cholera toxin, leading to severe watery diarrhea. Shigella dysenteriae causes dysentery, Salmonella enterica causes salmonellosis, and Clostridium perfringens causes food poisoning, none of which present with the characteristic symptoms of cholera.

Correct Answer: B

Rationale: The correct answer is B: Pseudomonas aeruginosa. This bacterium is important for controlling air quality as it can degrade a wide range of organic compounds present in the air, helping to maintain a clean and healthy environment. Alpha and beta-hemolytic streptococci (Choice A) are not typically associated with air quality control. E. coli (Choice C) and Salmonella spp. (Choice D) are more commonly found in water and food sources, not air, making them incorrect choices for this question. Pseudomonas aeruginosa's ability to break down organic matter in the air makes it the most suitable option for maintaining sanitary air quality.

Correct Answer: C

Rationale: The correct staining technique for staining sputum smears from a tuberculosis patient is Ziehl-Neelsen staining. This technique uses a carbol fuchsin stain that specifically stains acid-fast organisms like Mycobacterium tuberculosis. The steps involved include staining with carbol fuchsin, decolorizing with acid-alcohol, counterstaining with methylene blue, and then examining under a microscope. This staining method is crucial for detecting the acid-fast bacilli characteristic of tuberculosis. Explanation for incorrect choices: A: Gram staining is used to differentiate bacteria into Gram-positive and Gram-negative, not suitable for acid-fast organisms like Mycobacterium tuberculosis. B: Giemsa staining is used for detecting parasites and certain types of white blood cells, not specific for acid-fast bacteria. D: Burry staining is not a recognized staining technique in microbiology for staining acid-fast organisms.

Correct Answer: C

Rationale: Rationale: C is the correct answer because antibodies formed against Mycobacterium tuberculosis are not protective. They do not efficiently clear the infection due to the bacterium's ability to evade the immune response by residing intracellularly in macrophages. Antibodies play a minimal role in controlling tuberculosis compared to cell-mediated immunity. Summary: A is incorrect because Mycobacterium tuberculosis does contain mycolic acid in its cell wall. B is incorrect because the pathogen can indeed live intracellularly in macrophages. D is incorrect as C is the correct answer.