A 23-year-old man developed a perforation in his hard palate, a dense formation with clear margins was detected in this area. After a surgery, microscopy of excised formation shows there a large focus of caseous necrosis surrounded with a granulation tissue with endovasculitis and a cellular infiltration consisting of lymphocytes and epithelioid cells with predominance of plasma cells. What is the most likely disease in this case?

Correct Answer: B

Rationale: The correct answer is B: Tuberculosis. The case describes a man with a perforation in the hard palate and features of caseous necrosis with granulation tissue, endovasculitis, and a cellular infiltration mainly of lymphocytes, epithelioid cells, and plasma cells. These findings are classic for tuberculosis infection, commonly seen in extrapulmonary sites like the oral cavity. Syphilis (choice A) typically presents with a painless ulcer and different histopathological features. Leprosy (choice C) presents with granulomas containing foamy macrophages. Scleroma (choice D) is caused by Klebsiella rhinoscleromatis and presents with chronic granulomatous inflammation.

Correct Answer: A

Rationale: The correct answer is A: Urogenital trichomoniasis. The presence of pyriform protozoa with a spine, flagella at their front, and an undulating membrane in a vaginal smear indicates Trichomonas vaginalis, the causative agent of urogenital trichomoniasis. Trichomonas vaginalis is sexually transmitted and causes vaginal discharge, itching, and inflammation. Lambliasis (choice B) is caused by Giardia lamblia, which is not characterized by the described features. Intestinal trichomoniasis (choice C) is caused by a different species, Tritrichomonas foetus, and presents with diarrhea in cattle. Toxoplasmosis (choice D) is caused by Toxoplasma gondii and typically affects the brain and other organs, not the genital tract.

Correct Answer: B

Rationale: The correct answer is B: Mefloquine. Mefloquine is a histoschizontocidal antimalarial drug commonly prescribed for prevention of malaria in travelers. It is effective against the liver stage of the malaria parasite, which is crucial for preventing the development of the disease. Chingamin (A) is not a commonly used antimalarial drug. Biseptol (C) is a combination antibiotic and is not effective against malaria parasites. Quinine (D) is primarily used for treating malaria, not preventing it, and it is not specifically histoschizontocidal.

Correct Answer: A

Rationale: Step 1: Initial diagnosis of influenza suggests a viral illness. Step 2: Presence of maculopapular petechial rash and high fever indicates a systemic infection. Step 3: Symptoms like euphoria, hyperemia, tachycardia, splenomegaly, and excitement are characteristic of epidemic typhus. Step 4: Face hyperemia, sclera reddening, and tongue tremor are specific to epidemic typhus. Step 5: Epidemic typhus is transmitted by body lice, which fits the scenario of a patient without permanent residence. Summary: - Delirium alcoholicum is unlikely due to the specific symptoms and lack of history of alcohol abuse. - Leptospirosis typically presents with jaundice and renal symptoms, not seen in this case. - Measles rash is different from the maculopapular petechial rash described.

Correct Answer: A

Rationale: The correct answer is A: Blue pus bacillus. Pseudomonas genus includes bacteria that commonly cause diseases in plants. Blue pus bacillus is a common name for Pseudomonas aeruginosa, a well-known bacterium that causes diseases in medicinal plants. Explanation: 1. Blue pus bacillus (Pseudomonas aeruginosa) is a member of the Pseudomonas genus known for causing diseases in plants. 2. Colon bacillus (Escherichia coli) belongs to the Enterobacteriaceae family, not the Pseudomonas genus. 3. Proteus is a genus of the Enterobacteriaceae family, not Pseudomonas. 4. Mycoplasma is a genus of bacteria that lack a cell wall and are not related to the Pseudomonas genus. In summary, the correct answer is A because it is a member of the Pseudomonas genus known for causing diseases in medicinal plants, while