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: 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: A

Rationale: The correct answer is A: Clostridium perfringens. Clostridium perfringens is known to cause gas gangrene and is a Gram-positive rod that produces spores and gas in tissue infections. Clostridium tetani causes tetanus, not gas gangrene. Bacillus anthracis causes anthrax, not gas gangrene. Staphylococcus aureus is a Gram-positive cocci and does not produce spores or gas in the context of gas gangrene. Therefore, based on the characteristics of the microorganism isolated from the wound sample, Clostridium perfringens is the most likely causative agent.

Correct Answer: C

Rationale: The correct answer is C because Rickettsia requires living cells for growth and replication. Chick embryos, cell cultures, and lab animals provide a suitable environment for Rickettsia isolation. Skin-allergy tests (A) and serological methods for proving antibodies (B) are not directly used for isolating Rickettsia as they do not support the growth of the bacteria. "None of the above" (D) is incorrect as option C involves the appropriate methods for isolating Rickettsia.

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pyogenes. This bacterium is known to cause sore throat and fever, commonly referred to as strep throat. Gram's stain showing Gram-positive cocci in chains is characteristic of Streptococcus species. Streptococcus pyogenes is a beta-hemolytic bacterium that forms chains and is a common cause of bacterial pharyngitis. Staphylococcus aureus (B) is a Gram-positive cocci that forms clusters, not chains. Neisseria gonorrhoeae (C) is a Gram-negative diplococcus and is not associated with sore throat. Enterococcus faecalis (D) is a Gram-positive cocci that can cause infections but is not typically associated with sore throat.

Correct Answer: A

Rationale: The correct answer is A: Helicobacter pylori. This bacterium is the most likely causative agent of gastric ulcers. Here's the rationale: 1. Helicobacter pylori is commonly associated with gastric ulcers. 2. It is a gram-negative bacterium that grows on chocolate agar and is oxide reductase-positive. 3. The slow growth on the fifth day is characteristic of H. pylori. 4. Campylobacter jejuni and Campylobacter fetus are not typically associated with gastric ulcers. 5. Mycoplasma hominis is a bacterium that lacks a cell wall and is not commonly found in gastric ulcers.

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: B

Rationale: The correct answer is B: Herpangina. Coxsackie Viruses are known to cause Herpangina, which is characterized by sore throat, fever, and painful blisters in the mouth and throat. This is because Coxsackie Viruses typically infect the throat and mouth mucosa. Hemorrhagic conjunctivitis (A) is commonly caused by Adenoviruses, not Coxsackie Viruses. Mumps (C) is caused by the Mumps virus, a completely different virus. Poliomyelitis (D) is caused by the Poliovirus, not Coxsackie Viruses. Therefore, the correct answer is B as it aligns with the known pathogenicity of Coxsackie Viruses.

Correct Answer: B

Rationale: The correct answer is B: Contains single-stranded RNA with negative polarity. Measles virus is an enveloped virus with a single-stranded RNA genome that is negative-sense. This means it must first be transcribed into positive-sense RNA before it can be translated. Choice A is incorrect as the measles virus does have an outer envelope. Choice C is incorrect as measles virus belongs to the family Paramyxoviridae, not Togaviridae. Choice D is incorrect as measles virus can be grown on cell cultures, specifically on Vero cells.