A 65 y.o. woman complains of complicated mouth opening following foot trauma 10 days ago. Next day she ate with difficulties, there were muscles tension of back, the back of the head and abdomen. On the third day there was tension of all muscle groups, generalized convulsions every 10-15 min. What is the most probable diagnosis?

Correct Answer: A

Rationale: The most probable diagnosis is Tetanus (Choice A) based on the symptoms described. Tetanus is characterized by muscle stiffness, difficulty opening the mouth (trismus), muscle spasms, and convulsions. The progression of symptoms from muscle tension to generalized convulsions every 10-15 min is classic for tetanus. Tetania (Choice B) is similar but typically presents with more subtle muscle contractions rather than convulsions. Meningoencephalitis (Choice C) presents with fever, headache, and altered mental status, not the muscle symptoms described. Hemorrhagic stroke (Choice D) presents with sudden onset neurological deficits like weakness or sensory changes, not the muscle symptoms described.

Correct Answer: C

Rationale: Correct Answer: C - Immunological tolerance to the pathogen Rationale: 1. Immunological tolerance is when the immune system does not mount a response against specific antigens to prevent autoimmunity. 2. In the context of infection, tolerance to the pathogen means the immune system does not recognize the pathogen as a threat and does not initiate a protective response. 3. This lack of response leaves the host vulnerable to infection as there is no specific immune defense mechanism activated against the pathogen. Summary of incorrect choices: A: Opsonic action of antibody - enhances phagocytosis of pathogens B: Viral neutralization by specific antibody - prevents viral entry into host cells D: Neutralization of protein exotoxin - prevents the harmful effects of toxins produced by pathogens.

Correct Answer: D

Rationale: The correct answer is D (All of the above). All three bacteria (Escherichia coli, Salmonella enterica, Pseudomonas aeruginosa) produce endotoxins that can lead to septic shock. Endotoxins are part of the outer membrane of Gram-negative bacteria and can trigger a strong immune response, leading to septic shock when released in large amounts. Escherichia coli and Salmonella enterica are common causes of bacterial septic shock, while Pseudomonas aeruginosa is known for its ability to produce endotoxins that contribute to severe infections and septic shock. Therefore, all three choices are correct in this context.

Correct Answer: C

Rationale: The correct answer is C: peritrichous. Peritrichous bacteria have flagella distributed all over the cell surface, providing motility in various directions. This allows them to move efficiently through their environment. Option A and D, lophotrichous, have flagella clustered at one or both ends of the cell, limiting movement to specific directions. Option B, amphitrichous, have flagella at both ends of the cell, also limiting movement compared to peritrichous bacteria. Therefore, peritrichous is the correct choice for bacteria with flagella distributed over the general cell surface.

Correct Answer: B

Rationale: The correct answer is B: Extracellular. Heparin works by inhibiting clotting factors in the blood outside of cells, preventing the formation of blood clots. It does not directly affect cellular, neuromuscular, or intracellular processes. By targeting extracellular factors, heparin effectively reduces the ability of blood to clot, making it an effective anticoagulant. The other choices are incorrect because heparin does not act on cellular, neuromuscular, or intracellular sites in the body to decrease blood clotting.

Correct Answer: B

Rationale: The correct answer is B: Bacillus subtilis. Bacillus subtilis is known for its ability to resist heat and radiation due to its formation of endospores, which are highly resistant structures that protect the bacterium from harsh environmental conditions. This resilience allows Bacillus subtilis to survive in extreme environments where other bacteria cannot. Explanation of other choices: A: Escherichia coli is not known for its exceptional resistance to heat and radiation. C: Pseudomonas aeruginosa is not particularly resistant to heat and radiation compared to Bacillus subtilis. D: Clostridium perfringens is not as well-known for its heat and radiation resistance as Bacillus subtilis.

Correct Answer: B

Rationale: The correct answer is B: psittacosis. Psittacosis is an infection caused by Chlamydia psittaci that primarily affects the lower respiratory tract, leading to pneumonia-like symptoms. Mycoplasma pneumoniae causes atypical pneumonia, not pharyngitis (Choice A). Chronic atrophic rhinitis (Choice C) and rhinoscleroma (Choice D) both affect the upper respiratory tract, not the lower respiratory tract. Psittacosis specifically targets the lower respiratory tract, making it the most appropriate answer.

Correct Answer: A

Rationale: The most probable diagnosis is Tetanus (Choice A) based on the symptoms described. Tetanus is characterized by muscle stiffness, difficulty opening the mouth (trismus), muscle spasms, and convulsions. The progression of symptoms from muscle tension to generalized convulsions every 10-15 min is classic for tetanus. Tetania (Choice B) is similar but typically presents with more subtle muscle contractions rather than convulsions. Meningoencephalitis (Choice C) presents with fever, headache, and altered mental status, not the muscle symptoms described. Hemorrhagic stroke (Choice D) presents with sudden onset neurological deficits like weakness or sensory changes, not the muscle symptoms described.

Correct Answer: C

Rationale: The correct answer is C: Epidemic. This term refers to the widespread occurrence of an infectious disease in a specific community or region at a particular time. In this scenario, the infection of many people with a known epidemiological link indicates a localized outbreak within a defined population. Explanation: 1. Epidemic specifically refers to a sudden increase in the number of cases of a disease above what is normally expected in a population. 2. The term "known epidemiological link" suggests a clear connection between the cases, indicating a common source or mode of transmission within a specific group. 3. Endemic (choice A) refers to the constant presence of a disease within a specific geographic area or population. 4. Pandemic (choice B) refers to a global outbreak of a disease that spreads across countries and continents. 5. Sporadic disease (choice D) refers to isolated cases that occur infrequently and without a clear pattern. In summary, an epidemic best describes the situation of many people being