Nokea
Which of the following is a phase I reaction in biotransformation?
- A. Oxidation
- B. Conjugation
- C. Acetylation
- D. Glucuronidation
Correct Answer: A
Rationale: The correct answer is A: Oxidation. Phase I reactions in biotransformation involve introducing or unmasking functional groups through oxidation, reduction, or hydrolysis. Oxidation reactions typically involve the addition of an oxygen atom or removal of hydrogen atoms, making them common phase I reactions. In this process, enzymes like cytochrome P450 play a crucial role in catalyzing the oxidation reactions.
Conjugation (B), acetylation (C), and glucuronidation (D) are all examples of phase II reactions, which involve the conjugation of the drug or metabolite with endogenous compounds to increase water solubility for excretion. These reactions typically follow phase I reactions and are not classified as phase I reactions in biotransformation.
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A patient with pneumonia had sputum cultured on Endo agar, revealing red colonies. The bacteria were Gram-negative rods. What is the most likely causative agent?
- A. Escherichia coli
- B. Klebsiella pneumoniae
- C. Pseudomonas aeruginosa
- D. Proteus mirabilis
Correct Answer: A
Rationale: Rationale for correct answer (A: Escherichia coli):
1. Endo agar selects for Gram-negative bacteria.
2. Red colonies on Endo agar indicate lactose fermentation, characteristic of E. coli.
3. E. coli is a common cause of pneumonia, especially in immunocompromised patients.
Summary of why other choices are incorrect:
- B: Klebsiella pneumoniae: Typically forms mucoid colonies on agar.
- C: Pseudomonas aeruginosa: Produces characteristic greenish-blue colonies on agar.
- D: Proteus mirabilis: Does not typically ferment lactose, so would not produce red colonies on Endo agar.
The patient has developed pain in the axillary area, rise of temperature developed 10 hours ago. On examination: shaky gait is marked, the tongue is coated by white coating. The pulse is frequent. The painful lymphatic nodules are determined in the axillary area. The skin is erythematous and glistering over the lymphatic nodules. What is the most probable diagnosis?
- A. Bubonic plague
- B. Acute purulent lymphadenitis
- C. Lymphogranulomatosis
- D. Tularemia
Correct Answer: D
Rationale: The most probable diagnosis is D: Tularemia. Tularemia is a bacterial infection caused by Francisella tularensis. The symptoms described align with tularemia, such as pain in axillary area, fever, shaky gait, coated tongue, frequent pulse, painful lymphatic nodules, and erythematous skin over nodules. The key features pointing towards tularemia are the presence of lymphadenitis in the axillary area and the erythematous, glistering skin over the nodules, which are characteristic of ulceroglandular tularemia. Bubonic plague (A) presents with painful, swollen lymph nodes called buboes but typically lacks the erythematous skin findings. Acute purulent lymphadenitis (B) usually presents with pus-filled lymph nodes but does not typically cause shaky gait or coated tongue. Lymphogranulomatosis (C) is a term for Hodgkin's lymphoma, which does not
A patient presented with a painful, swollen lymph node, and bacteremia. A Gram-negative rod with a characteristic safety pin appearance was observed. What is the causative agent?
- A. Yersinia pestis
- B. Clostridium tetani
- C. Brucella melitensis
- D. Pasteurella multocida
Correct Answer: A
Rationale: Step 1: Gram-negative rod with safety pin appearance indicates bipolar staining.
Step 2: Yersinia pestis is a Gram-negative rod causing bubonic plague.
Step 3: Y. pestis has bipolar staining due to its unique F1 capsule.
Step 4: The swollen lymph node and bacteremia are consistent with bubonic plague.
Step 5: Therefore, the correct answer is A: Yersinia pestis.
Summary:
- B: Clostridium tetani causes tetanus, not characterized by a safety pin appearance.
- C: Brucella melitensis causes brucellosis, not characterized by a safety pin appearance.
- D: Pasteurella multocida causes animal bites infections, not characterized by a safety pin appearance.
The primary target of beta-lactam antibiotics is:
- A. protein synthesis
- B. DNA replication
- C. cell wall synthesis
- D. folic acid synthesis
Correct Answer: C
Rationale: The primary target of beta-lactam antibiotics is cell wall synthesis. These antibiotics inhibit enzymes called penicillin-binding proteins, which are essential for building the bacterial cell wall. By disrupting cell wall synthesis, beta-lactam antibiotics weaken the cell wall, leading to bacterial cell lysis and death. Protein synthesis (Choice A), DNA replication (Choice B), and folic acid synthesis (Choice D) are not directly targeted by beta-lactam antibiotics, making them incorrect choices.
A child with a sore throat had a throat smear revealing Gram-positive cocci in pairs with a capsule. What is the most likely causative agent?
- A. Streptococcus pneumoniae
- B. Staphylococcus aureus
- C. Neisseria gonorrhoeae
- D. Klebsiella pneumoniae
Correct Answer: A
Rationale: The correct answer is A: Streptococcus pneumoniae. The presence of Gram-positive cocci in pairs with a capsule is characteristic of Streptococcus pneumoniae.
Step 1: Gram-positive cocci in pairs indicate a Streptococcus species.
Step 2: The presence of a capsule suggests S. pneumoniae specifically.
Summary:
B: Staphylococcus aureus is a Gram-positive cocci but does not typically present in pairs with a capsule.
C: Neisseria gonorrhoeae is a Gram-negative diplococcus, not a Gram-positive cocci.
D: Klebsiella pneumoniae is a Gram-negative rod, not a cocci.