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: A

Rationale: Step 1: Pear-shaped protozoa with two nuclei, four pairs of flagella, two axostyles, and a ventral adhesive disc match the characteristics of Giardia lamblia. Step 2: Giardia lamblia is commonly found in the duodenum and causes giardiasis. Step 3: Lamblia is the correct answer as it specifically matches all the described characteristics. Summary: B, Toxoplasma, is incorrect as it does not match the described features. C, Leishmania, does not have the specific characteristics mentioned. D, Intestinal trichomonad, does not match the detailed descriptions given.

Correct Answer: A

Rationale: The correct answer is A: Neutralization. In this scenario, the antibotulinic serum of types A, B, and E were introduced to neutralize the botulinum toxin in the test specimen. The serological reaction applied here involves the neutralization of the toxin by the specific antibodies present in the serum. This process prevents the toxin from causing harm to the mice. Summary of other choices: B: Precipitation - This involves the formation of insoluble complexes between antigen and antibody, not the specific neutralization seen in this case. C: Complement binding - This involves activation of the complement system leading to cell lysis, not the direct neutralization of toxin. D: Double immune diffusion - This technique is used to determine the presence of specific antibodies or antigens based on their diffusion patterns, not the neutralization of toxin as seen in this scenario.

Correct Answer: A

Rationale: The correct answer is A: Entamoeba histolytica. This is because the presence of cysts with four nuclei is characteristic of Entamoeba histolytica, a protozoan parasite that causes amoebic dysentery. Entamoeba histolytica cysts contain four nuclei, distinguishing them from other pathogens. Giardia lamblia and Trichomonas vaginalis are not associated with cysts containing four nuclei. Balantidium coli is a ciliated protozoan that does not typically form cysts with multiple nuclei. In summary, the unique feature of four nuclei in the cysts points towards Entamoeba histolytica as the most likely causative agent of the diarrhea in this patient.

Correct Answer: D

Rationale: The correct answer is D: Chocolate agar. Neisseria meningitidis is a fastidious organism that requires enriched media for growth. Chocolate agar contains heat-treated blood that provides essential nutrients for the growth of N. meningitidis. The other choices, A: Levine agar, B: Lowenstein-Jensen agar, and C: TCBS agar, do not provide the specific nutrients required for the growth of N. meningitidis. Therefore, only choice D, Chocolate agar, supports the growth of N. meningitidis due to its enriched composition.

Correct Answer: A

Rationale: Step 1: Rubella virus belongs to the Togaviridae family, which typically exhibits icosahedral symmetry. Step 2: Icosahedral symmetry refers to a structure with 20 equilateral triangular faces, which is characteristic of many viruses, including rubella. Step 3: Therefore, choice A is correct as rubella virus indeed has icosahedral type of symmetry. Summary: - Choice B is incorrect as rubella virus is an ssRNA virus, not ssDNA. - Choice C is incorrect as rubella virus does have an envelope derived from the host cell membrane. - Choice D is incorrect as rubella virus does have glycoprotein spikes on its surface.

Correct Answer: A

Rationale: The correct answer is A: Toxoplasmosis. Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii, which can be transmitted from mother to fetus during pregnancy, leading to congenital toxoplasmosis. This infection can result in stillbirth, multiple developmental defects, and intrauterine death. Leishmaniasis (B), Malaria (C), and Amebiasis (D) are caused by different parasites and do not typically lead to intrauterine death or developmental defects in the fetus.

Correct Answer: A

Rationale: Step-by-step rationale: 1. IgG is the most abundant immunoglobin in a normal healthy adult due to its long half-life and diverse functions. 2. It plays a crucial role in immune response by neutralizing pathogens and enhancing phagocytosis. 3. IgA is mainly found in mucosal areas, IgE is involved in allergic reactions, and IgD's function is not fully understood. 4. Therefore, IgG is the correct answer as it is the predominant immunoglobin in circulation, providing broad immune protection.

Correct Answer: B

Rationale: The correct answer is B: Capsule. Capsules are a protective layer outside the bacterial cell wall that helps bacteria evade phagocytosis by immune cells. The capsule inhibits phagocytic cells from engulfing the bacteria, making it difficult for them to be recognized and destroyed. A: Flagella - Flagella are not involved in protecting bacteria from phagocytosis. They are responsible for bacterial movement. C: Endospore - Endospores are dormant, resistant structures formed by some bacteria in response to harsh conditions. They do not directly protect against phagocytosis. D: Pili - Pili are hair-like structures used for adhesion and conjugation, not for protection against phagocytosis.