A 33 year old patient was delivered to the infectious diseases department on the 7-th day of disease. He complained about great weakness, high temperature, pain in the lumbar area and leg muscles, icteritiousness, dark color of urine, headache. The acute disease started with chill, body temperature rise up to 40oC, headache, pain in the lumbar area and sural muscles. Icterus turned up on the 4th day, nasal and scleral haemorrhages came on the 5th day. Fever has lasted for 6 days. Diuresis - 200 ml. What is the most probable diagnosis?

Correct Answer: A

Rationale: The most probable diagnosis is Leptospirosis. The symptoms described align with the classic presentation of Leptospirosis, such as fever, muscle pain, headache, jaundice, and hemorrhages. The initial symptoms of chills, high fever, and muscle pain followed by jaundice and hemorrhages are characteristic of Leptospirosis. The presence of dark urine and low diuresis also point towards kidney involvement, which is common in Leptospirosis due to renal failure. Additionally, the patient's history of potential exposure to contaminated water or soil supports the diagnosis, as Leptospirosis is commonly transmitted through contact with infected animal urine. Summary of other choices: - Typhoid fever typically presents with sustained fever, abdominal pain, and constipation, not matching the symptoms described. - Virus A hepatitis usually presents with jaundice, but other symptoms such as muscle pain and hemorrhages are not typical. - Sepsis is a systemic response

Correct Answer: D

Rationale: The correct answer is D: Intestinal trichomonad. This protozoan matches the description provided, with pyriform shape, twin nuclei, four pairs of flagella, supporting filaments, and a suctorial disc. Lamblia (A) lacks flagella and supporting filaments. Toxoplasma (B) is an intracellular parasite with different morphology. Leishmania (C) belongs to a different class with no flagella or supporting filaments. In summary, the unique combination of features described in the question points to an intestinal trichomonad, making it the correct answer.

Correct Answer: D

Rationale: The correct answer is D because the treatment for Anthrax involves using antibiotics such as penicillins, tetracyclines, and macrolides to target the bacteria. Anti-anthrax gamma-globulins and immune-serum are used to provide passive immunity, but they are not the primary treatment. Therefore, options A, B, and C are incorrect as they do not encompass all the necessary components for treating Anthrax. Overall, using a combination of antibiotics and immune-based treatments like gamma-globulins and immune-serum provides a comprehensive approach to managing Anthrax infection.

Correct Answer: D

Rationale: The correct answer is D because all measures mentioned are important in preventing hospital-acquired infections. Isolating the source helps prevent the spread of infections. Isolating at-risk patients reduces their exposure. Increasing patient resistance to infections through proper hygiene and immunizations minimizes susceptibility. Each measure plays a crucial role in infection prevention, making all options correct.

Correct Answer: B

Rationale: The correct answer is B: Treponema pallidum. The scenario describes symptoms of primary syphilis, which is caused by Treponema pallidum. The presence of a painless ulcer (chancre) and enlarged inguinal lymph nodes are characteristic of syphilis. Dark field microscopic examination showing motile, curved spirochetes is highly specific for Treponema pallidum. Incorrect explanations: A: Chlamydia trachomatis typically causes urethritis or cervicitis, not painless ulcers. C: Neisseria gonorrhoeae causes gonorrhea, which presents with purulent discharge, not painless ulcers. D: Herpes simplex virus type 2 causes genital herpes, leading to painful ulcers and vesicles, not painless ulcers seen in syphilis.

Correct Answer: A

Rationale: The correct answer is A: Bacterial endospores. Bacterial endospores have a higher resistance to environmental stresses due to their unique structure, which includes a tough outer layer that protects the spore from harsh conditions such as heat, chemicals, and radiation. This protective layer allows endospores to remain dormant and survive in unfavorable environments until conditions improve. Summary: B: Fungal spores - While fungal spores can also survive in harsh conditions, they are generally not as resistant as bacterial endospores due to differences in their protective structures. C: Enveloped viruses - Enveloped viruses are susceptible to environmental stresses as their lipid envelope can easily be damaged by heat, chemicals, and other factors. D: Vegetative bacterial cells - Vegetative bacterial cells are more susceptible to environmental stresses compared to endospores, as they do not have the same level of protective mechanisms to survive in unfavorable conditions.

Correct Answer: B

Rationale: Bacillary dysentery is caused by the bacterium Shigella, hence it is also known as shigellosis. Shigella is the primary pathogen responsible for this infectious disease, leading to severe diarrhea with blood and mucus. Salmonellosis (A) is caused by Salmonella bacteria, not Shigella. Typhoid fever (C) is caused by Salmonella typhi, not Shigella. Campylobacteriosis (D) is caused by Campylobacter bacteria, not Shigella. Therefore, the correct answer is B because Shigella is the specific bacterium associated with bacillary dysentery.

Correct Answer: A

Rationale: The correct answer is A: Entamoeba histolytica. The presence of cysts with four nuclei is characteristic of Entamoeba histolytica, a protozoan parasite causing amoebic dysentery. It forms cysts with four nuclei before maturing into trophozoites. Balantidium coli (B) is a ciliated protozoan causing balantidiasis, not known for four-nuclei cysts. Giardia lamblia (C) forms cysts with two nuclei, causing giardiasis. Trichomonas hominis (D) is a non-pathogenic flagellate found in the human colon, not associated with four-nuclei cysts.

Correct Answer: A

Rationale: The correct answer is A: Mantoux test. The Mantoux test is used to detect tuberculosis infection by injecting a small amount of tuberculin under the skin and checking for a reaction. This test helps identify individuals who have been exposed to tuberculosis. The other choices are incorrect because: B: Schick test is used to determine immunity to diphtheria, not tuberculosis. C: Anthraxine test is used for anthrax, not tuberculosis. D: Burnet test is not a recognized medical test for tuberculosis.