A 23 year old female patient complains about periodical chill and body temperature rise up to 40oC, sense of heat taking turns with profuse sweating. The patient has had already 3 attacks that came once in two days and lasted 12 hours. She has lived in Africa for the last 2 months. Liver and spleen are enlarged. In blood: erythrocytes - 2,5x1012/l. What is the most probable diagnosis?

Correct Answer: A

Rationale: The most probable diagnosis is A: Malaria. The patient's symptoms of periodic chills, high fever, and profuse sweating, along with living in Africa where malaria is endemic, strongly suggest malaria. The enlarged liver and spleen are consistent with malaria infection. The low erythrocyte count indicates hemolysis, a common feature of malaria. Spotted fever and sepsis do not typically present with the same pattern of symptoms and travel history as seen in this case. Haemolytic anaemia would not explain the patient's fever episodes and other symptoms. Therefore, based on the symptoms, travel history, and laboratory findings, malaria is the most likely diagnosis.

Correct Answer: A

Rationale: The correct answer is A: Giardia lamblia. This protozoan matches the description of the causative agent because it has two nuclei, four flagella, and a ventral adhesive disc. Giardia lamblia is commonly found in the duodenum and causes giardiasis. The other choices can be eliminated because Leishmania donovani causes visceral leishmaniasis, not the described symptoms. Entamoeba coli is a non-pathogenic amoeba found in the large intestine. Trypanosoma gambiense causes African trypanosomiasis and is transmitted by the tsetse fly, not matching the described characteristics.

Correct Answer: B

Rationale: The correct answer is B: Borrelia burgdorferi. Borrelia burgdorferi is the bacteria responsible for causing Lyme disease. It is transmitted to humans through the bite of infected black-legged ticks. Treponema pallidum causes syphilis, Leptospira interrogans causes leptospirosis, and Rickettsia rickettsii causes Rocky Mountain spotted fever. Borrelia burgdorferi is specifically associated with Lyme disease due to its transmission through tick bites and the characteristic symptoms it causes.

Correct Answer: A

Rationale: The correct answer is A: Anaerobic infection. The sudden deterioration, bursting pain, edema, foul appearance of wound, and presence of gas are indicative of gas gangrene caused by anaerobic bacteria like Clostridium perfringens. These bacteria thrive in low oxygen environments, such as deep wound tissues. The symptoms align with the classic presentation of gas gangrene, necessitating immediate surgical intervention. Choice B: Aerobic gram-negative, is incorrect because anaerobic bacteria, not aerobic gram-negative bacteria, are responsible for gas gangrene. Choice C: Putrid, is incorrect as it is a general term referring to foul-smelling decay and does not specify the type of infection. Choice D: Aerobic gram-positive, is incorrect as gas gangrene is typically caused by anaerobic bacteria, not aerobic gram-positive bacteria.

Correct Answer: B

Rationale: The correct answer is B: Uptake of naked DNA from the environment. Bacterial transformation is a process where bacteria take up free DNA from their surroundings and incorporate it into their own genome. This process is essential for genetic recombination and the acquisition of new traits. Plasmids are small DNA molecules that can be transferred between bacteria, but not necessarily through pili. Bacteriophages are viruses that infect bacteria and transfer their DNA, but this is not the primary mechanism of bacterial transformation. Binary fission is a method of bacterial reproduction, not related to the uptake of DNA.

Correct Answer: C

Rationale: Rifampicin is the correct answer because it is a first-line antibiotic for treating pulmonary tuberculosis. It has excellent bactericidal activity and penetrates well into lung tissues where the infection is located. Rifampicin is also known for preventing the development of resistance. Tetracycline (A) and Furasolidone (B) are not commonly used for tuberculosis treatment. Bactrim (D) is a combination of sulfamethoxazole and trimethoprim, not effective for tuberculosis treatment.

Correct Answer: D

Rationale: The correct answer is D: Lamblia. The cysts described match the characteristics of Giardia lamblia, a protozoan parasite. Giardia cysts are oval-shaped, 50-60 microns in diameter, and contain 2 nuclei (macronucleus and micronucleus). Giardia is commonly found in contaminated water sources and can cause gastrointestinal illness in humans. Incorrect choices: A: Toxoplasma - Toxoplasma gondii is a parasite that causes toxoplasmosis, transmitted through ingestion of contaminated food or water, but its cysts do not match the description given in the question. B: Amoeba - Amoebas are single-celled organisms, but they do not typically form cysts with visible nuclei as described. C: Balantidium - Balantidium coli is a ciliated protozoan that can cause dysentery in humans, but its cysts do not

Correct Answer: A

Rationale: The correct answer is A: Volutin granules. Volutin granules are metachromatic granules that stain dark blue with methylene blue or Leishman stain. In diphtheria-causing bacteria, Corynebacterium diphtheriae, these granules are typically seen as yellow rods with dark blue thickenings on their ends when stained. Volutin granules are storage inclusions composed of polymetaphosphate that serve as an energy reserve for the bacteria. The presence of these granules in the detected microorganisms indicates the characteristic feature of Corynebacterium diphtheriae. Summary of other choices: B: Plasmids are extrachromosomal DNA molecules that are not typically visible on stained smears. C: Capsules are outer protective layers that are not visible on stained smears. D: Spores are reproductive structures formed by certain bacteria, not typically seen in Corynebacterium diphtheriae.

Correct Answer: B

Rationale: The correct answer is B: Mycobacterium tuberculosis. Acid-fast bacteria have a unique cell wall component called mycolic acid, making them resistant to decolorization by acid-alcohol during staining. Mycobacterium tuberculosis is acid-fast, as it retains the stain due to its high lipid content. Streptococcus pyogenes (A), Clostridium perfringens (C), and Bacillus subtilis (D) do not possess mycolic acid in their cell walls, so they are not acid-fast.