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A 12-year-old male whose family recently emigrated from eastern Europe presents to the emergency room with a fever of 103.5F, a swollen neck (Figure A), difficulty breathing, and grayish-white membranes in the oropharynx (Figure B). Cultures were taken from the pharynx and the bacteria were found to be Gram-positive rods with metachromatic granules (Figure C). The toxin produced by this bacterium has which of the following mechanism of action?
Pertussis toxin inhibits the G-protein Gi alpha subunit via ADP ribosylation
Overactivates guanylate cyclase
Inactivates the 60S ribosomal subunit
Inactivates elongation factor 2
Cleaves SNARE proteins
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A 6-year-old male who recently immigrated to the United States from Asia is admitted to the hospital with dyspnea. Physical exam reveals a gray pseudomembrane in the patient's oropharynx along with lymphadenopathy. The patient develops myocarditis and expires on hospital day 5. Which of the following would have prevented this patient's presentation and decline?
Increased CD4+ T cell count
Secretory IgA against viral proteins
Increased IgM preventing bacterial invasion
Circulating IgG against AB exotoxin
Improved IgE release from mast cells
A 3-year-old male is brought to the ER with a sore throat and fever. Examination of the pharynx reveals a dark, inflammatory exudate. Cysteine-tellurite agar culture produces black, iridescent colonies. Microscopic features of the causal organism most likely include which of the following?
Serpentine growth patterns
Long, branching filaments
Kidney-bean shaped rod