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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Which of the following is characteristic of Gram-negative bacteria?
- A. Thick peptidoglycan layer
- B. Outer membrane containing lipopolysaccharides
- C. Presence of teichoic acids
- D. Absence of a cell wall
Correct Answer: B
Rationale: The correct answer is B: Outer membrane containing lipopolysaccharides. Gram-negative bacteria have an outer membrane that contains lipopolysaccharides, which are important for protection and pathogenicity. This outer membrane is a unique feature of Gram-negative bacteria and is not present in Gram-positive bacteria, making it a key characteristic.
A: Incorrect because Gram-negative bacteria have a thin peptidoglycan layer compared to Gram-positive bacteria.
C: Incorrect because teichoic acids are a characteristic of Gram-positive bacteria, not Gram-negative bacteria.
D: Incorrect because all bacteria, including Gram-negative bacteria, have a cell wall.
A patient who came to the doctor because of his infertility was administered to make tests for toxoplasmosis and chronic gonorrhoea. Which reaction should be performed to reveal latent toxoplasmosis and chronic gonorrhoea in this patient?
- A. RIHA - Reverse indirect hemagglutination assay
- B. RDHA - Reverse direct hemagglutination assay
- C. IFA - Immunofluorescence assay
- D. Immunoblot analysis
Correct Answer: C
Rationale: The correct answer is C: IFA - Immunofluorescence assay. Toxoplasmosis and chronic gonorrhea can be detected using serological tests like IFA. IFA detects specific antibodies in the patient's serum by using fluorescently labeled antibodies. This method is highly sensitive and specific for detecting both acute and latent infections.
Explanation of Incorrect Choices:
A: RIHA - Reverse indirect hemagglutination assay - This test is not commonly used for detecting toxoplasmosis or chronic gonorrhea.
B: RDHA - Reverse direct hemagglutination assay - This test is not typically used for these specific infections.
D: Immunoblot analysis - While Immunoblot analysis is a useful confirmatory test for certain infections, it is not the primary method for detecting toxoplasmosis or chronic gonorrhea.
Allergy to penicillin is an example of:
- A. Type I hypersensitivity reaction
- B. Type II hypersensitivity reaction
- C. Type III hypersensitivity reaction
- D. Type IV hypersensitivity reaction
Correct Answer: A
Rationale: Step-by-step rationale for choice A being correct:
1. Penicillin allergy involves IgE antibodies binding to penicillin.
2. This triggers mast cell degranulation, releasing histamine.
3. Histamine causes allergic symptoms like rash, swelling.
4. This immune response characterizes Type I hypersensitivity reactions.
Summary of other choices:
B: Type II reactions involve antibody-mediated cell destruction, not seen in penicillin allergy.
C: Type III reactions involve immune complex deposition, not typical in penicillin allergy.
D: Type IV reactions are delayed hypersensitivity reactions, not immediate like penicillin allergy.
There are several cases of children from boarding school suffering from sore throat. Microscopy of tonsil smears stained according Neisser method has revealed thin yellow bacilli with dark brown grains on their ends placed in the shape of Roman numeral five. What infection can be suspected in this case?
- A. Diphtheria
- B. Scarlet fever
- C. Listeriosis
- D. Tonsilitis
Correct Answer: A
Rationale: Rationale for Correct Answer A (Diphtheria):
1. Thin yellow bacilli with dark brown grains on ends suggest Corynebacterium diphtheriae, characteristic of diphtheria.
2. Roman numeral five shape is typical of diphtheria bacilli.
3. Diphtheria causes sore throat and can spread in boarding schools.
4. Neisser staining method is used for diphtheria bacilli.
Summary of Incorrect Choices:
B: Scarlet fever is caused by Streptococcus pyogenes and presents with rash, not yellow bacilli.
C: Listeriosis is caused by Listeria monocytogenes, not consistent with the described findings.
D: Tonsillitis can be caused by various bacteria or viruses, but the specific characteristics described do not match.
During sanitary and bacteriological testing of water with the membrane filter technique there were revealed two red colonies on a membrane filter (Endo agar) through which 500 ml of water was filtred. Calculate the coli index and coli titer of the analyzed water:
- A. 4 and 250
- B. 2 and 500
- C. 250 and 4
- D. 500 and 2
Correct Answer: C
Rationale: The correct answer is C (coli index of 250 and coli titer of 4). The coli index is calculated by multiplying the number of colonies by the reciprocal of the volume filtered, which gives 2 colonies x (1/0.5 L) = 4. The coli titer is obtained by dividing the volume filtered by the number of colonies, which gives 0.5 L / 2 colonies = 0.25 L or 250 ml. This indicates the concentration of coliform bacteria in the water sample.
Choice A (4 and 250) is incorrect because it has the correct coli index but the values are reversed for coli index and coli titer. Choice B (2 and 500) is incorrect as it provides the correct coli titer value but the values are reversed for coli index and coli titer. Choice D (500 and 2) is incorrect because it reverses the values for both coli index and coli titer.