Nokea
Which of the following infections are typical for the upper respiratory tract?
- A. Psittacosis
- B. Mycoplasma bronchitis
- C. Chronic atrophic rhinitis
- D. Legionnaires disease
Correct Answer: C
Rationale: The correct answer is C: Chronic atrophic rhinitis. This infection is typical for the upper respiratory tract as it affects the nasal mucosa and sinuses. It is characterized by inflammation and atrophy of the nasal mucosa. Psittacosis (A) is a zoonotic infection transmitted from birds, affecting the lungs. Mycoplasma bronchitis (B) is a lower respiratory tract infection caused by Mycoplasma pneumoniae. Legionnaires disease (D) is a severe form of pneumonia caused by Legionella bacteria. Therefore, C is the correct answer as it specifically pertains to the upper respiratory tract.
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An adult patient with type 2 diabetes attends the emergency room. He reported that two days ago he was accidentally injured in the left leg, but he did not seek medical care. At the time of examination, an infected wound was found, surrounded by a large area of inflammation with characteristic tissue crepitation on palpation and with foul odor. Blood (for hemoculture) and wound secretions were taken for microbiological testing. The microscopic examination reveals large Gram-positive bacteria, with centrally located spores. These bacteria were unable to grow in vitro at presence of oxygen. The most likely cause of this disease is:
- A. Clostridium tetani
- B. Clostridium perfringens
- C. Clostridium botulinum
- D. Clostridium difficile
Correct Answer: B
Rationale: The correct answer is B: Clostridium perfringens. In this case, the patient's presentation of infected wound with tissue crepitation, foul odor, and Gram-positive bacteria with centrally located spores that cannot grow in the presence of oxygen is indicative of gas gangrene caused by Clostridium perfringens. This anaerobic bacterium produces various toxins that lead to tissue destruction and gas production in the affected area. Clostridium tetani (choice A) causes tetanus, characterized by muscle stiffness and spasms. Clostridium botulinum (choice C) causes botulism, leading to muscle paralysis. Clostridium difficile (choice D) is associated with antibiotic-associated diarrhea. These choices are incorrect as they do not match the clinical presentation described in the question.
Agents associated with human disease but generally not a serious health risk are classified in which of the following risk groups?
- A. RG1
- B. RG2
- C. RG3
- D. RG4
Correct Answer: B
Rationale: The correct answer is B: RG2. RG2 is appropriate for agents associated with human disease that pose a moderate health risk. These agents may cause disease of varying severity, but generally do not result in serious health consequences. Other choices are incorrect because: A: RG1 is for agents not associated with disease in healthy adults, C: RG3 is for agents associated with serious or lethal human disease, and D: RG4 is for agents that pose a high risk of life-threatening disease and for which there are no treatments.
Which bacteria is responsible for causing the disease known as whooping cough?
- A. Clostridium botulinum
- B. Bordetella pertussis
- C. Streptococcus pneumoniae
- D. Neisseria meningitidis
Correct Answer: B
Rationale: The correct answer is B: Bordetella pertussis. This bacterium causes whooping cough by infecting the respiratory tract. It produces toxins that lead to severe coughing fits characteristic of the disease. Clostridium botulinum (A) causes botulism, Streptococcus pneumoniae (C) causes pneumonia, and Neisseria meningitidis (D) causes meningitis, not whooping cough. B. pertussis is the only bacterium specifically associated with whooping cough.
Microscopic examination of a microbial culture revealed fusiform spore-forming microorganisms that get violet-blue Gram's stain. What microorganisms were revealed?
- A. Clostridia
- B. Streptococci
- C. Spirochaete
- D. Actinomycete
Correct Answer: A
Rationale: The correct answer is A: Clostridia. Fusiform spore-forming microorganisms that stain violet-blue with Gram's stain are characteristic of Clostridia. Clostridia are anaerobic, rod-shaped bacteria known for their ability to form spores and cause diseases such as tetanus and botulism.
Summary of other choices:
B: Streptococci are spherical, not fusiform, and typically do not form spores.
C: Spirochaete are spiral-shaped bacteria and do not typically form spores.
D: Actinomycete are filamentous bacteria that do not typically form spores and do not stain violet-blue with Gram's stain.
A 23-year old medical student arrives in the student health clinic complaining of difficult in swallowing, sore throat, and chills. Upon examination, she is found to be running a fever and has white patches on her tonsils. A throat swab is positive for streptococcus pyogenes (group A). A diagnosis of acute pharyngitis is made. Her past medical history is unremarkable except an anaphylactic reaction to cefaclor two years ago. Which of the following would be a safe alternative for treating?
- A. Amoxicillin
- B. Meropenem
- C. Cephalexin
- D. Clindamycin
Correct Answer: D
Rationale: The correct answer is D: Clindamycin. Clindamycin is a lincosamide antibiotic that is safe to use in patients with a history of anaphylaxis to beta-lactam antibiotics like cefaclor. Clindamycin is effective against streptococcus pyogenes and is a suitable alternative in this case. Amoxicillin (choice A) is a beta-lactam antibiotic similar to cefaclor and may cause a cross-reactive allergic reaction. Meropenem (choice B) is a carbapenem antibiotic and not typically used for acute pharyngitis. Cephalexin (choice C) is a cephalosporin antibiotic and may also cause cross-reactivity in patients with a history of anaphylaxis to cefaclor.