A 30-year-old patient complains about having abdominal pain and diarrhea for five days; body temperature rise up to 37, 5oC along with chills. The day before a patient had been in a forest and drunk from an open water reservoir. Laboratory analyses enabled to make the following diagnosis: amebic dysentery. What is the drug of choice for its treatment?

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: B

Rationale: The correct answer is B: Alpha-hemolytic streptococci. Streptococcus pneumoniae are classified as alpha-hemolytic streptococci based on their ability to partially break down red blood cells, causing a greenish discoloration on blood agar plates. This distinguishes them from beta-hemolytic streptococci, which completely break down red blood cells. Streptococcus pneumoniae are not resistant to bile (choice A), as they are bile soluble. They are not stained by the Ziehl-Neelsen staining method (choice C), which is used for acid-fast bacteria such as Mycobacterium tuberculosis. They are sensitive to optochin (choice D), which is a key differentiating factor in identifying them from other alpha-hemolytic streptococci.

Correct Answer: A

Rationale: The correct answer is A: Amikacin sulfate. Pseudomonas aeruginosa is commonly resistant to many antibiotics, but aminoglycosides like Amikacin have good activity against it. Step 1: Identify the pathogen causing the infection. Step 2: Consider the antibiotic's spectrum of activity against the pathogen. Step 3: Choose an antibiotic with proven efficacy. Amikacin is a good choice due to its effectiveness against Pseudomonas. Choice B, Benzylpenicillin, is a penicillin which is not effective against Pseudomonas. Choice C, Cephazolin, is a cephalosporin with limited activity against Pseudomonas. Choice D, Erythromycin, is a macrolide which is not effective against Pseudomonas.

Correct Answer: C

Rationale: The correct answer is C: Flaviviridae. Dengue virus belongs to the Flaviviridae family because it is a flavivirus. Flaviviruses are a group of RNA viruses known to cause diseases in humans, such as dengue fever, Zika virus, and yellow fever. This family is characterized by its single-stranded, positive-sense RNA genome and enveloped virion structure. Hepadnaviridae (choice A), Parvoviridae (choice B), and Picornaviridae (choice D) are all different families of viruses that do not include the dengue virus. Hepadnaviridae includes hepatitis B virus, Parvoviridae includes parvoviruses, and Picornaviridae includes enteroviruses like poliovirus.

Correct Answer: A

Rationale: The correct answer is A: Neisseria meningitidis. Step 1: Gram-negative diplococci - characteristic of Neisseria species. Step 2: Oxidase-positive - Neisseria species are oxidase-positive. Step 3: Fermentative - Neisseria meningitidis is a fermentative bacterium. Therefore, Neisseria meningitidis is the most likely causative agent. Summary: - B: Neisseria gonorrhoeae is also a Neisseria species but is not fermentative. - C: Moraxella catarrhalis is oxidase-positive but not fermentative. - D: Haemophilus influenzae is not a Neisseria species and is not typically fermentative.

Correct Answer: A

Rationale: The correct answer is A: Pseudomonas aeruginosa. P. aeruginosa is a Gram-negative rod that is oxidase-positive and lactose non-fermenting. The positive oxidase test indicates the presence of cytochrome c oxidase, a characteristic of P. aerugin. E. coli is lactose fermenting. Salmonella and Shigella are also Gram-negative rods, but they are lactose fermenters, unlike the lactose non-fermenting P. aeruginosa.

Correct Answer: A

Rationale: The correct answer is A: Neisseria meningitidis. This is because Neisseria meningitidis is a Gram-negative diplococcus known to cause bacterial meningitis, presenting with fever, headache, and neck stiffness. It is a common cause of meningitis in young adults and teenagers. Streptococcus pneumoniae (B) is a Gram-positive bacteria and a common cause of bacterial pneumonia, not meningitis. Haemophilus influenzae (C) is a Gram-negative coccobacillus that can cause meningitis, but it is less common in adults. Klebsiella pneumoniae (D) is a Gram-negative bacillus known to cause pneumonia and urinary tract infections, not meningitis.

Correct Answer: B

Rationale: The capsule of Bacillus anthracis is made of polypeptide. This is because the capsule is composed of a protein-based material that surrounds the bacterium, providing protection and aiding in its virulence. Polysaccharides, lipids, and the absence of capsules are not characteristic of Bacillus anthracis' capsule structure, making choices A, C, and D incorrect, respectively.

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.