Microbiology Basic and Clinical Principles Test Bank

Correct Answer: A

Rationale: The most likely diagnosis is A: Botulism. The symptoms, such as nausea, vomiting after eating canned vegetables, dry mucous membranes, muscular hypotonia, anisocoria, mydriasis, dysphagia, and dysarthria, are classic signs of botulism poisoning. Botulism is caused by the neurotoxin produced by Clostridium botulinum bacteria found in improperly canned or preserved food. The neurotoxin affects the nervous system, leading to symptoms like those described. Shigellosis (B), Salmonellosis (C), and Cholera (D) typically present with different symptoms such as diarrhea, fever, and abdominal pain, which are not seen in this patient.

Correct Answer: A

Rationale: The correct answer is A: Neisseria meningitidis. This is because Neisseria meningitidis is a Gram-negative diplococcus known to cause bacterial meningitis, presenting with fever, headache, and neck stiffness. It is a common cause of meningitis in young adults and teenagers. Streptococcus pneumoniae (B) is a Gram-positive bacteria and a common cause of bacterial pneumonia, not meningitis. Haemophilus influenzae (C) is a Gram-negative coccobacillus that can cause meningitis, but it is less common in adults. Klebsiella pneumoniae (D) is a Gram-negative bacillus known to cause pneumonia and urinary tract infections, not meningitis.

Correct Answer: D

Rationale: The correct answer is D: All are correct. Culture of samples from the respiratory tract can identify specific pathogens, Immunofluorescence can detect viral antigens, and PCR can amplify and detect specific DNA/RNA sequences. Using all methods together provides a comprehensive approach for diagnosing respiratory tract infections. Culture alone may miss fastidious organisms, Immunofluorescence has limitations in sensitivity, and PCR requires specific primers. Therefore, combining these methods increases the likelihood of accurate diagnosis by covering a range of pathogens and improving sensitivity and specificity.

Correct Answer: C

Rationale: The correct answer is C: Increased active efflux from the bacterial cell. This is the most important mechanism of tetracycline resistance because it involves the bacteria actively pumping out the antibiotic, reducing its intracellular concentration. This prevents tetracycline from effectively targeting bacterial ribosomes. Choice A is incorrect as tetracycline resistance typically involves active efflux rather than reduced influx. Choice B is incorrect because tetracycline resistance mechanisms do not primarily involve altered cell membrane components affecting passive influx. Choice D is also incorrect as tetracycline resistance mechanisms do not typically involve direct enzymatic inactivation of the antibiotic.

Correct Answer: B

Rationale: The correct answer is B: Chlamydia trachomatis. This is because Chlamydia trachomatis is an obligate intracellular bacterium that cannot be cultured on standard agar plates. The symptoms described by the patient, such as pain, burning at urination, and scarce secretion in the morning, are indicative of a possible chlamydial infection. Additionally, the fact that the urine cultures are sterile after 24 hours of incubation suggests that the causative agent is not a typical bacteria like Escherichia coli, Streptococcus pneumoniae, or Neisseria gonorrhoeae, which would normally grow on agar plates. Therefore, Chlamydia trachomatis is the most probable cause of this disease. Summary: A: Escherichia coli - Incorrect, as it is a common cause of urinary tract infections and would typically grow on agar plates. C: Streptococcus pneumoniae - Incorrect, as it is