A 45-year-old patient has foul-smelling diarrhea. Stool examination revealed large ciliated protozoa with a kidney-shaped macronucleus. What is the causative agent?

Correct Answer: A

Rationale: The correct answer is A: Balantidium coli. This large ciliated protozoa with a kidney-shaped macronucleus is characteristic of Balantidium coli, an intestinal parasite known to cause foul-smelling diarrhea in humans. Balantidium coli is the only option among the choices that fits this specific description. Entamoeba histolytica causes amoebic dysentery, Giardia lamblia causes giardiasis, and Trichomonas hominis is a non-pathogenic protozoa found in the intestinal tract. Therefore, based on the morphology described in the question, Balantidium coli is the correct causative agent.

Correct Answer: A

Rationale: The correct answer is A: Cytopathic effect. This is because polioviruses cause visible changes in infected cells, leading to cell damage and death, known as cytopathic effect. This is a key characteristic of viral infection. Choice B (Cytotoxic effect) is incorrect as it refers to the toxicity of a substance to cells, not the specific effect of polioviruses. Choice C (Cytolytic effect) is incorrect as it specifically refers to cell lysis, which is not the primary mechanism of poliovirus infection. Choice D (They Don't Change The Cell Cultures) is incorrect because polioviruses do indeed cause changes in cell cultures due to their cytopathic effect.

Correct Answer: A

Rationale: The correct answer is A: Toxoplasmosis. Toxoplasmosis is caused by the protozoan Toxoplasma gondii, which can be transmitted from mother to fetus during pregnancy leading to stillbirth and malformations. This parasite can cross the placenta and infect the fetus, causing severe complications. Leishmaniasis (B), Malaria (C), and Amebiasis (D) are not known to cause intrauterine death or malformations in the same way as Toxoplasmosis. Leishmaniasis is transmitted by sandflies, Malaria by mosquitoes, and Amebiasis by contaminated food or water.

Correct Answer: A

Rationale: The correct answer is A: Microscopy of blood smears. Malaria diagnosis is confirmed by identifying the Plasmodium parasite in a blood smear. This step is crucial as it directly visualizes the causative agent. The other choices are incorrect as they do not directly detect malaria parasites. B: Studying lymph node punctate is not specific for malaria. C: Urinalysis does not show malaria parasites. D: Studying cerebrospinal fluid is used to diagnose conditions affecting the brain and spinal cord, not malaria.

Correct Answer: C

Rationale: The correct answer is C: Streptococcus. Streptococcus pneumoniae is the most common etiological factor for community-acquired pneumonia in young adults. The symptoms described align with typical pneumococcal pneumonia presentation. Presence of pleural friction rub and infiltration in the X-ray support the diagnosis. The blood work showing elevated WBC count with a left shift (increased neutrophils and low lymphocytes) and elevated ESR is consistent with a bacterial infection. Legionella and Mycoplasma typically present with atypical pneumonia symptoms such as headache, confusion, and GI symptoms, which are not described in the case. Staphylococcus pneumonia is not a common cause of community-acquired pneumonia in young adults.

Correct Answer: A

Rationale: The correct answer is A: Balantidium coli. This large ciliated protozoa with a kidney-shaped macronucleus is characteristic of Balantidium coli, an intestinal parasite known to cause foul-smelling diarrhea in humans. Balantidium coli is the only option among the choices that fits this specific description. Entamoeba histolytica causes amoebic dysentery, Giardia lamblia causes giardiasis, and Trichomonas hominis is a non-pathogenic protozoa found in the intestinal tract. Therefore, based on the morphology described in the question, Balantidium coli is the correct causative agent.

Correct Answer: A

Rationale: The correct answer is A: Lamblia. The description matches the characteristics of Giardia lamblia - a protozoan parasite that causes giardiasis. The piriform bodies, 4 pairs of filaments, and two symmetrically located nuclei are specific to Giardia lamblia. It is important to differentiate it from the other choices. Dysentery ameba (choice B) typically has a single nucleus and lacks the specific characteristics described. Trichomonas (choice C) is a flagellated protozoan with different morphology and does not match the given description. Intestinal ameba (choice D) such as Entamoeba histolytica usually has a single nucleus and different body shape compared to the described organism.

Correct Answer: B

Rationale: The correct answer is B: Bordetella pertussis. This bacterium causes whooping cough by infecting the respiratory tract. It produces toxins that lead to severe coughing fits characteristic of the disease. Clostridium botulinum (A) causes botulism, Streptococcus pneumoniae (C) causes pneumonia, and Neisseria meningitidis (D) causes meningitis, not whooping cough. B. pertussis is the only bacterium specifically associated with whooping cough.

Correct Answer: A

Rationale: The correct answer is A: Bordetella pertussis. Whooping cough is caused by this bacteria, which specifically infects the respiratory tract. Bordetella pertussis produces toxins that lead to the characteristic symptoms of the disease. Haemophilus influenzae, Pseudomonas aeruginosa, and Streptococcus pneumoniae are not the causative agents of whooping cough. Haemophilus influenzae can cause respiratory infections, Pseudomonas aeruginosa is associated with hospital-acquired infections, and Streptococcus pneumoniae is a common cause of pneumonia and other respiratory infections, but none of these bacteria are responsible for whooping cough.