A 60-year-old patient was hospitalized to the surgical department because of infection caused by blue pus bacillus (Pseudomonas aeruginosa) which is sensative to penicillin antibiotics. Indicate which of the given penicillins has marked activity to the Pseudomonas aeruginosa?

Correct Answer: A

Rationale: The correct answer is A: Carbenicillin disodium. Carbenicillin is a semisynthetic penicillin that has marked activity against Pseudomonas aeruginosa. This is due to its extended spectrum of activity and increased stability against beta-lactamases produced by Pseudomonas aeruginosa. Carbenicillin is commonly used to treat infections caused by this bacterium. Choice B: Benzylpenicillin (Penicillin G) has limited activity against Pseudomonas aeruginosa. Choice C: Methicillin is not effective against Pseudomonas aeruginosa. Choice D: Oxacillin also has limited activity against Pseudomonas aeruginosa. In summary, Carbenicillin is the correct choice due to its marked activity against Pseudomonas aeruginosa compared to the other penicillins listed.

Correct Answer: D

Rationale: The correct answer is D: Helicobacter pylori. Helicobacter pylori is a known bacterium associated with causing duodenal ulcers. The presence of Gram-negative curved bacteria in the biopsy along with a highly positive rapid urease test is characteristic of H. pylori infection. Vibrio cholerae causes cholera, not duodenal ulcers. Campylobacter fetus is associated with gastroenteritis, not duodenal ulcers. Acinetobacter baumannii is a nosocomial pathogen, not typically associated with duodenal ulcers. In summary, the unique combination of findings in this case points towards H. pylori as the most likely cause of the disease.

Correct Answer: A

Rationale: The correct answer is A: C. perfringens. This is because Clostridium perfringens is a gram-positive, anaerobic, spore-forming bacterium commonly associated with food poisoning. It produces toxins that cause gastrointestinal symptoms. Proteus vulgaris (B) and P. mirabilis (C) are gram-negative bacteria not typically associated with food poisoning. Vibrio parahemolyticus (D) is a gram-negative bacterium causing seafood-related gastroenteritis, not spore-forming or anaerobic.

Correct Answer: A

Rationale: The correct answer is A: Isoniazid. Isoniazid is known to cause peripheral neuropathy as a side effect, especially with prolonged use. It can lead to symptoms such as numbness, tingling, and weakness in the toes and fingers due to its neurotoxic effects. Rifampicin (B) is less likely to cause neuropathy. Ciprofloxacin (C) is not typically associated with neuropathy. Sodium salt of benzylpenicillin (D) is an antibiotic but is not known to cause polyneuritis.

Correct Answer: C

Rationale: The correct answer is C: IFA - Immunofluorescence assay. Toxoplasmosis and chronic gonorrhea can be detected using serological tests like IFA. IFA detects specific antibodies in the patient's serum by using fluorescently labeled antibodies. This method is highly sensitive and specific for detecting both acute and latent infections. Explanation of Incorrect Choices: A: RIHA - Reverse indirect hemagglutination assay - This test is not commonly used for detecting toxoplasmosis or chronic gonorrhea. B: RDHA - Reverse direct hemagglutination assay - This test is not typically used for these specific infections. D: Immunoblot analysis - While Immunoblot analysis is a useful confirmatory test for certain infections, it is not the primary method for detecting toxoplasmosis or chronic gonorrhea.

Correct Answer: D

Rationale: The correct answer is D, Vancomycin, because it is not a beta-lactam antibiotic. Beta-lactam antibiotics contain a beta-lactam ring in their molecular structure, which Vancomycin lacks. Benzylpenicillin, Cephalosporin, and Monobactam all contain the beta-lactam ring, making them beta-lactam antibiotics. Vancomycin belongs to a different class of antibiotics called glycopeptides.

Correct Answer: B

Rationale: The correct answer is B: Helicobacter pylori. This bacterium is associated with stomach ulcers as it can survive in the acidic environment of the stomach and produce substances that weaken the stomach lining. Escherichia coli (A) is associated with foodborne illnesses, not ulcers. Bacillus cereus (C) causes food poisoning. Clostridium difficile (D) is associated with antibiotic-associated colitis, not ulcers. Therefore, Helicobacter pylori is the correct answer based on its specific association with stomach ulcers.

Correct Answer: B

Rationale: The correct answer is B because Q-fever is not transmitted only after ticks bite; it can also be transmitted through inhalation of contaminated aerosols. Rickettsia mooseri and Rickettsia provazekii can cause spotted fevers, making choice A correct. Mediterranean fever is associated with a recurrent pattern of fever, not maculopapular rash, making choice C incorrect. "None of the above" is not correct in this case as choice B is incorrect.

Correct Answer: A

Rationale: The correct answer is A: Obligate anaerobes. These microorganisms thrive in the absence of oxygen, as seen in the canned mushrooms where oxygen is limited. They produce toxins causing food poisoning. Facultative anaerobes (B) can survive with or without oxygen. Microaerophiles (C) require low levels of oxygen. Obligate aerobes (D) need oxygen to survive and would not be responsible for the poisoning in this case.