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: D

Rationale: The correct answer is D: Mycoplasma. Mycoplasma is the only bacteria among the choices that have sterols in their cytoplasmic membrane. This feature helps stabilize their membrane structure due to the lack of a cell wall. Legionella (A), Bacillus (B), and Rickettsia (C) do not contain sterols in their cytoplasmic membrane. Legionella has a unique lipid composition, Bacillus has peptidoglycan in its cell wall, and Rickettsia is an intracellular parasite lacking sterols in its membrane.

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. This bacterium appears as purple-stained diplococci with pointed ends on Gram staining. S. pneumoniae is a common cause of pneumonia. It is encapsulated and has a lancet-shaped appearance, which is characteristic of the pointed ends seen in the staining. Staphylococcus aureus (B) typically appears as clusters of gram-positive cocci, not diplococci. Klebsiella pneumoniae (C) is a gram-negative rod, not a diplococci. Neisseria meningitidis (D) is a gram-negative diplococci but typically lacks the pointed ends seen in the staining of S. pneumoniae.

Correct Answer: A

Rationale: The correct answer is A: Metronidazole. It is the drug of choice for treating systemic amebiasis due to its high efficacy against Entamoeba histolytica. Metronidazole is well-absorbed, reaches therapeutic levels in the intestines, liver, and lungs, making it effective in treating the multi-organ involvement in this case. Choice B: Quiniofone is not a recommended treatment for amebiasis. Choice C: Tetracycline is not the first-line treatment for systemic amebiasis. Choice D: Quingamine is not a recognized drug for treating amebiasis.

Correct Answer: C

Rationale: Neonatal meningitis is commonly caused by E. coli K1 and group B streptococci due to their ability to cross the blood-brain barrier in newborns. E. coli K1 is a frequent cause in early-onset cases, while group B streptococci are common in late-onset cases. Neisseria meningitidis and streptococcus agalactiae are not as likely to cause neonatal meningitis. Listeria and shigella are also uncommon causes in neonates. Therefore, choice C is the most likely pair of organisms responsible for neonatal meningitis.

Correct Answer: A

Rationale: Step 1: Vibrio cholerae is a bacterium known to cause cholera, a foodborne illness transmitted through contaminated water. Step 2: Cholera outbreaks are often linked to unsanitary water sources, making Vibrio cholerae the correct choice. Step 3: Clostridium difficile causes gastrointestinal infections, not typically associated with contaminated water. Step 4: Mycobacterium tuberculosis causes tuberculosis, a respiratory disease, not related to foodborne illnesses. Step 5: Neisseria gonorrhoeae is a sexually transmitted bacterium, not linked to foodborne illnesses from contaminated water.

Correct Answer: B

Rationale: The correct answer is B because a supercapsid is a lipoprotein membrane that encloses the nucleocapsid, providing protection to the genetic material inside. This structure is distinct from the capsid which is the protein coat surrounding the nucleic acid. Choice A is incorrect as there is no shell located between the capsid and supercapsid. Choice C is incorrect as it describes the nucleocapsid itself, not the supercapsid. Choice D is incorrect as a protein envelope around the nucleic acid does not specifically refer to a supercapsid.

Correct Answer: C

Rationale: The correct answer is C: Escherichia coli. E.coli is the most common urinary tract pathogen due to its ability to adhere to and infect the urinary tract epithelium. It accounts for approximately 80-85% of urinary tract infections. It possesses specific virulence factors that enable it to colonize and cause infection in the urinary tract. Proteus mirabilis (A) is known for causing complicated UTIs, but it is less common than E.coli. Staphylococcus aureus (B) is not a common urinary pathogen. Pseudomonas aeruginosa (D) is more commonly associated with hospital-acquired infections, rather than community-acquired urinary tract infections.

Correct Answer: C

Rationale: The correct answer is C: Pili. Pili are bacterial structures involved in conjugation, which is the process of transferring genetic material between bacterial cells. Pili facilitate the physical contact between donor and recipient cells, allowing for the transfer of plasmids or other genetic material. Capsules (choice A) are involved in protection and adherence, not conjugation. Flagella (choice B) are responsible for bacterial motility. Fimbriae (choice D) are also involved in adherence but not in conjugation. Therefore, the correct answer is C as pili specifically play a crucial role in the process of conjugation.