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537 Unknown

A 49-year-old male, chronic alcoholic presented to ER with complaints of fever, progressive lethargy and confusion for 2-3 days. On examination, Hypotension Tachycardia Distended diffusely tender abdomen Positive fluid wave The doctor advised USG of the abdomen which revealed irregular outline of liver with coarsened echotexture with gross ascites. Paracentesis of the ascites was done and sent for examination which revealed, WBC count- 1000/ microL Neutrophils – 40% All of the following are true about the most common organisms causing the above condition except: –

AFerment glucose with acid production
BReduce nitrates to nitrites
COxidase negative
DPhenylalanine deaminase positive
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540 Unknown

A 50-year-old man presents with complaints of bilateral morning stiffness in his wrists and knees and painful joints on exercise. On physical examination, the joints are slightly swollen. The rest of the examination is unremarkable. His laboratory findings are also negative except for slight anemia, elevated erythrocyte sedimentation rate, and positive rheumatoid factor. X-ray of B/L knee was done. The patient was staed on weekly methotrexate to control the inflammation. What is the principle mechanism of action here?

AInhibition of Dihydrofolate reductase enzyme
BIncreased extracellular levels of adenosine
CInhibition of assembly of microtubules in neutrophils impairing chemotaxis
DInhibition of cyclooxygenase enzyme
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