Nokea
Each of the following statements about Neisseria meningitidis is correct, EXCEPT
- A. during meningococcemia Waterhouse-Friderichsen syndrome may be present
- B. Disease is most common in children younger than age 5
- C. There is an obligatory vaccine in Bulgaria
- D. infection is transmitted by respiratory secretions in close contacts
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.
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The bacterium that shows swarming on blood agar
- A. providencia stuartii
- B. providencia rettgeri
- C. Proteus mirabilis
- D. morganella morganii
Correct Answer: C
Rationale: The correct answer is C: Proteus mirabilis. This bacterium shows swarming on blood agar due to its ability to produce flagella and exhibit rapid and coordinated movement. Providencia stuartii and Providencia rettgeri are not known for swarming behavior on blood agar. Morganella morganii can exhibit swarming motility, but it is not as commonly associated with this characteristic compared to Proteus mirabilis, making C the most appropriate choice.
A 40-year-old man developed skin redness and swelling in the neck area, where eventually a small abscess appeared. On section the focus is dense and yellow-green colored, in the purulent masses there are white granules. Histologically there are fungal druses, plasma and xanthoma cells, and macrophages detected. Specify the most correct etiological name of this pathological process:
- A. Syphilis
- B. Carbuncle
- C. Actinomycosis
- D. Leprosy
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
When microorganisms enter the circulatory system through the lymphatic drainage and cause an infection, the condition is called:
- A. bacteremia
- B. septicemia
- C. microbemia
- D. viremia
Correct Answer: C
Rationale: The correct answer is C: microbemia. When microorganisms enter the circulatory system via the lymphatic drainage, the condition is specifically termed microbemia. This term focuses on the presence of microorganisms in the bloodstream.
Rationale:
1. Bacteremia (choice A) refers to the presence of bacteria in the bloodstream, not specifically microorganisms as a whole.
2. Septicemia (choice B) is a severe infection causing systemic inflammation due to the presence of pathogens or their toxins in the blood, not limited to microorganisms entering via lymphatic drainage.
3. Viremia (choice D) is the presence of viruses in the bloodstream, not a term used for microorganisms entering through the lymphatic drainage.
In summary, the term microbemia accurately describes the scenario of microorganisms entering the circulatory system through lymphatic drainage, making it the correct choice over the other options.
Which of the following organisms is a common cause of peptic ulcers?
- A. Treponema pallidum
- B. Vibrio cholerae
- C. Helicobacter pylori
- D. Escherichia coli
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.
Which of the following viruses can cause hemorrhagic cystitis?
- A. BK virus
- B. Enteroviruses
- C. Flaviviruses
- D. Coronaviruses
Correct Answer: A
Rationale: The correct answer is A: BK virus. BK virus is a common cause of hemorrhagic cystitis, especially in immunocompromised individuals. It infects the urinary tract, leading to inflammation and bleeding in the bladder. Enteroviruses, Flaviviruses, and Coronaviruses do not typically cause hemorrhagic cystitis. Enteroviruses usually cause respiratory and gastrointestinal infections, Flaviviruses are commonly associated with diseases like dengue fever and Zika virus, and Coronaviruses are known for causing respiratory illnesses such as COVID-19. Hence, the correct answer is A as it is the only virus among the options known to cause hemorrhagic cystitis.