A 12-year-old boy presents with nausea, frequent repeated vomiting that first occurred after eating canned vegetables. Objectively: the patient has dry mucous membranes, muscular hypotonia, anisocoria, mydriasis, dysphagia and dysarthria. What is the most likely diagnosis?

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: B

Rationale: The correct answer is B: Syphilis. The Wasserman reaction is a test for syphilis, specifically for detecting antibodies against the bacterium Treponema pallidum. In a 30-year-old man with a markedly positive Wasserman reaction, it indicates an active syphilis infection. Brucellosis (Choice A) is not diagnosed using the Wasserman reaction. Poliomyelitis (Choice C) is a viral infection affecting the spinal cord, not diagnosed using the Wasserman reaction. Influenza (Choice D) is a respiratory viral infection, not associated with the Wasserman reaction.

Correct Answer: A

Rationale: The correct answer is A: Metronidazole. Rationale: 1. Metronidazole is the drug of choice for amebic dysentery due to its effectiveness against the causative agent, Entamoeba histolytica. 2. Metronidazole has good tissue penetration and is able to reach the site of infection in the gut. 3. It is a bactericidal drug that acts by disrupting the DNA structure of the parasite. 4. Metronidazole is well-absorbed orally and has minimal side effects. Summary of other choices: B: Furazolidonum - Not the drug of choice for amebic dysentery. It is primarily used for treating bacterial diarrhea. C: Levomycetin - Not effective against Entamoeba histolytica and not recommended for amebic dysentery. D: Phthalazol - Not commonly used for amebic dysentery treatment. Metronidazole is preferred due

Correct Answer: A

Rationale: The correct answer is A: Trichomonas vaginalis. Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis, a sexually transmitted infection characterized by inflammation of urogenital tracts. The description of big unicellular pyriform organisms with a sharp spike on the back end of their bodies, big nucleus, and undulating membrane matches the morphology of Trichomonas vaginalis. Trichomonas hominis and Trichomonas buccalis are different species that do not cause urogenital infections. Trypanosoma gambiense is a protozoan parasite causing African trypanosomiasis and does not match the described morphology or symptoms.

Correct Answer: B

Rationale: The correct answer is B: Malarial plasmodiums. The description of crescent bodies with a pointed end, blue cytoplasm, and red nucleus corresponds to the characteristics of Plasmodium species seen in Romanovsky's stain. Plasmodium species are known to cause malaria and have distinct features like the ones described. Incorrect choices: A: Toxoplasmas - Toxoplasma gondii typically appear as tachyzoites or bradyzoites under staining, not crescent bodies. C: Dermotropic leishmania - Leishmania species appear as amastigotes in tissue smears, not crescent bodies. D: Viscerotropic leishmania - Similar to choice C, Leishmania species do not typically present as crescent bodies in stained specimens.