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: A

Rationale: The correct answer is A because Gram-negative bacteria have a unique cell envelope structure consisting of a cytoplasmic membrane, a peptidoglycan layer, and an outer membrane. The cytoplasmic membrane is the innermost layer that separates the cytoplasm from the external environment. The peptidoglycan layer provides structural support to the cell. The outer membrane acts as an additional protective barrier and contains lipopolysaccharides. Choice B is incorrect because Gram-negative bacteria have an outer membrane in addition to the cytoplasmic membrane and peptidoglycan layer. Choice C is incorrect because Gram-negative bacteria have more than just a peptidoglycan layer in their cell envelope. Choice D is incorrect as the cell envelope of Gram-negative bacteria does have specific components.

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. The description of Gram-positive cocci in pairs with pointed ends and capsules matches the morphology of S. pneumoniae. This bacterium is known to cause pneumonia, especially in individuals with underlying conditions like COPD. Staphylococcus aureus (B) typically appears in clusters, not pairs. Klebsiella pneumoniae (C) is a Gram-negative rod, not a cocci. Neisseria meningitidis (D) is a Gram-negative diplococcus, not a cocci. Hence, based on the morphology and clinical context, Streptococcus pneumoniae is the likely microorganism causing pneumonia in this patient.

Correct Answer: D

Rationale: The correct answer is D because all the choices can contribute to hospital-acquired infections. New patients in the incubation period can spread infections, medical staff can inadvertently transmit infections, and contaminated medical instruments can also be a source of infections. Therefore, it is important to consider all these factors to prevent and control the spread of infections in a hospital setting.

Correct Answer: C

Rationale: The correct answer is C: Increased active efflux from the bacterial cell. This is the most important mechanism of tetracycline resistance because it involves the bacteria actively pumping out the antibiotic, reducing its intracellular concentration. This prevents tetracycline from effectively targeting bacterial ribosomes. Choice A is incorrect as tetracycline resistance typically involves active efflux rather than reduced influx. Choice B is incorrect because tetracycline resistance mechanisms do not primarily involve altered cell membrane components affecting passive influx. Choice D is also incorrect as tetracycline resistance mechanisms do not typically involve direct enzymatic inactivation of the antibiotic.

Correct Answer: D

Rationale: Step-by-step rationale for why answer choice D is correct: 1. Coronaviruses can cause reinfections due to potential waning immunity. 2. Studies have shown cases of reinfections with different strains or within a short period. 3. This contradicts the notion that reinfections cannot be observed. Summary: A: Incorrect because some coronaviruses can cause lower respiratory tract infections. B: Incorrect as coronaviruses can exhibit varied symptomatology including asymptomatic cases. C: Incorrect as some coronaviruses like SARS can lead to severe pneumonia and complications.

Correct Answer: B

Rationale: The correct answer is B: Clostridium botulinum. This bacterium belongs to the Clostridium genus, known for its ability to produce endospores. Endospores are dormant, resistant structures that help bacteria survive harsh conditions. Staphylococcus aureus (A), Escherichia coli (C), and Neisseria gonorrhoeae (D) do not produce endospores. Staphylococcus aureus is a gram-positive bacterium known for causing various infections, but it does not form endospores. Escherichia coli is a gram-negative bacterium commonly found in the intestines of humans and animals, but it does not produce endospores. Neisseria gonorrhoeae is a gram-negative bacterium that causes the sexually transmitted infection gonorrhea, but it also does not form endospores.

Correct Answer: B

Rationale: The correct answer is B: Staphylococcus aureus. This bacterium is commonly found in hospital environments due to its ability to colonize human skin and mucous membranes. It is a leading cause of hospital-acquired infections. Borrelia burgdorferi is mainly associated with Lyme disease transmitted by ticks, not commonly found in hospitals. Bacillus cereus is a foodborne pathogen, not typically prevalent in hospital settings. Staphylococcus haemolyticus is a coagulase-negative staphylococcus species, less pathogenic and less common in hospitals compared to Staphylococcus aureus.

Correct Answer: A

Rationale: The correct answer is A: Mycolic acid in the cell wall. Mycolic acid is a unique component of the cell wall of Mycobacterium species, including the causative agent of tuberculosis. The Ziehl-Neelsen method uses acid-fast staining, where mycolic acid confers resistance to decolorization by acid-alcohol, causing the bacteria to retain the red stain. Choices B, C, and D are incorrect as capsules, flagella, and peptidoglycan layers do not directly contribute to acid-fast staining characteristic of Mycobacterium species.