Nokea
Microscopic examination of a smear from a chancre revealed spiral microorganisms. The bacteria were thin and mobile with 8-12 regular coils. What is the likely diagnosis?
- A. Syphilis
- B. Leptospirosis
- C. Lyme disease
- D. Relapsing fever
Correct Answer: A
Rationale: The correct diagnosis is A: Syphilis. The spiral microorganisms described are characteristic of Treponema pallidum, the causative agent of syphilis. The thin and mobile bacteria with 8-12 regular coils match the morphology of Treponema pallidum. Leptospirosis is caused by Leptospira interrogans, which are thicker and have hook-like ends, different from the described bacteria. Lyme disease is caused by Borrelia burgdorferi, which has a different appearance than the thin, coiled bacteria in the smear. Relapsing fever is caused by Borrelia recurrentis, which typically have irregular coils, unlike the regular coils seen in the smear.
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All statements about plasmids are correct except:
- A. Many plasmids contain genes that confer resistance to one or more antibiotics
- B. Are smaller, circular, extrachromosomal DNAs
- C. Plasmids encode essential bacteria properties
- D. Plasmids are responsible for the bacterial conjugation
Correct Answer: C
Rationale: The correct answer is C because plasmids do not encode essential bacterial properties. They are non-essential, extra-chromosomal DNA molecules that can replicate independently within bacterial cells. Plasmids mainly contain genes for antibiotic resistance, genetic transfer, and other specific functions. Choice A is correct as many plasmids do carry antibiotic resistance genes. Choice B is also accurate as plasmids are indeed smaller, circular, and exist outside the bacterial chromosome. Choice D is true as plasmids can facilitate bacterial conjugation, allowing the transfer of genetic material between bacteria.
Gram-negative bacteria have a cell wall that:
- A. contains teichoic acid
- B. is thicker than that of Gram-positive bacteria
- C. contains lipopolysaccharides
- D. is composed entirely of peptidoglycan
Correct Answer: C
Rationale: The correct answer is C, as Gram-negative bacteria have a cell wall containing lipopolysaccharides. This outer membrane structure is unique to Gram-negative bacteria and plays a critical role in pathogenicity and immune response. Teichoic acid (choice A) is found in Gram-positive bacteria. The cell wall of Gram-negative bacteria is thinner than that of Gram-positive bacteria (choice B). The cell wall of Gram-negative bacteria is not composed entirely of peptidoglycan (choice D), as it also contains other components like lipopolysaccharides.
A 32 year old patient complains about heartburn and dull pain in the epigastrium that appear 2-3 hours after meal. Exacerbations happen in spring and in autumn. The patient has food intolerance of eggs and fish. Objectively: stomach palpation reveals painfulness in the gastroduodenal area. Electrophasoduodenoscopy revealed a 5 mm ulcer on the anterior wall of duodenum. Urease test is positive. What is the most probable leading mechanism of disease development?
- A. Helicobacterial infection
- B. Dietary allergy
- C. Autoantibody production
- D. Reduced prostaglandin synthesis
Correct Answer: A
Rationale: The correct answer is A: Helicobacterial infection. This is the most probable leading mechanism of disease development in this case because the patient's symptoms, such as heartburn, epigastric pain, food intolerance, and presence of a duodenal ulcer with a positive urease test, are classic signs of Helicobacter pylori infection. This bacterium colonizes the stomach lining, leading to inflammation and ulcer formation. The exacerbations in spring and autumn could be due to seasonal variations in immune response.
Choice B: Dietary allergy is incorrect because the symptoms and findings in the patient are more indicative of an infectious etiology rather than an allergic reaction to specific foods.
Choice C: Autoantibody production is unlikely as there are no indications of an autoimmune process in this case.
Choice D: Reduced prostaglandin synthesis is not the leading mechanism as the symptoms and findings are more consistent with an infectious cause rather than a deficiency in prostaglandin synthesis.
Which one is not true for the adaptive immunity:
- A. Is mainly observed in the skin and mucous membranes
- B. Develops immune memory
- C. Has a specificity
- D. Evolutionary newer in comparison to the innate immunity
Correct Answer: A
Rationale: The correct answer is A because adaptive immunity is not mainly observed in the skin and mucous membranes. Adaptive immunity is a systemic response that involves specific immune cells and antibodies targeting specific pathogens. It develops immune memory (B), meaning it can recognize and respond faster upon re-exposure to the same pathogen. Adaptive immunity also has specificity (C), as it can target specific antigens. Lastly, adaptive immunity is not evolutionarily newer in comparison to innate immunity (D), as both systems have co-evolved to provide comprehensive protection against pathogens.
Gram-negative rods producing blue-green pigment and a fruity odor were isolated from a wound infection. What is the causative agent?
- A. Pseudomonas aeruginosa
- B. Proteus mirabilis
- C. Klebsiella pneumoniae
- D. Escherichia coli
Correct Answer: A
Rationale: The correct answer is A: Pseudomonas aeruginosa. P. aeruginosa is known for producing a blue-green pigment called pyocyanin, which gives a characteristic color to the colonies. The fruity odor is due to the production of a compound called 2-aminoacetophenone by P. aeruginosa. These features are classic for P. aeruginosa and help differentiate it from other Gram-negative rods. Proteus mirabilis (B) typically does not produce blue-green pigment or fruity odor. Klebsiella pneumoniae (C) and Escherichia coli (D) also do not exhibit these specific characteristics associated with P. aeruginosa.