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: B

Rationale: The correct answer is B (Urethra). Resident microflora are typically found in various parts of the body where they establish a stable population without causing harm. The urethra is one of the locations where resident microflora are commonly present, helping to maintain a healthy microbial balance and prevent pathogenic bacteria from colonizing the area. In contrast, choices A, C, and D are not typical locations for resident microflora. Blood is normally sterile, the lungs have a different microbial environment due to their exposure to the external environment, and the cerebro-spinal fluid is also typically sterile to prevent infections in the central nervous system.

Correct Answer: B

Rationale: Step 1: The description of microorganisms resembling tennis racket indicates Corynebacterium diphtheriae, the causative agent of diphtheria. Step 2: Diphtheria is a bacterial infection that can cause severe respiratory and systemic symptoms. Step 3: Botulism is caused by Clostridium botulinum, not tennis racket-shaped microorganisms. Step 4: Typhoid fever is caused by Salmonella typhi, which does not resemble tennis rackets. Step 5: Salmonellosis is caused by various Salmonella species, which also do not have the described tennis racket appearance.

Correct Answer: A

Rationale: The correct answer is A: Plague. The presence of ovoid Gram-negative bipolar-stained bacilli with a delicate capsule in the sputum is characteristic of Yersinia pestis, the causative agent of plague. Plague presents with symptoms like fever, chills, and cough. Plague is a zoonotic disease usually transmitted through fleas from rodents. The other choices (B: Tuberculosis, C: Leptospirosis, D: Brucellosis) can be ruled out based on the specific description of the bacteria in the sputum. Tuberculosis is caused by Mycobacterium tuberculosis, which is not Gram-negative. Leptospirosis is caused by Leptospira, which are spirochetes and not ovoid bacilli. Brucellosis is caused by Brucella species, which are small, coccobacilli and not ovoid bacilli.

Correct Answer: A

Rationale: Step 1: Treponema pallidum is a spirochete bacterium known to cause syphilis, a sexually transmitted infection. Step 2: Neisseria gonorrhoeae causes gonorrhea, not syphilis. Step 3: Chlamydia trachomatis is responsible for causing chlamydia, not syphilis. Step 4: Escherichia coli is commonly found in the gut and can cause gastrointestinal infections, not syphilis. Summary: Treponema pallidum is the correct answer as it is the specific bacterium associated with syphilis, while the other choices are responsible for different infections.

Correct Answer: A

Rationale: The correct answer is A: Vibrio cholerae. 1. Vibrio cholerae is a Gram-negative, comma-shaped bacterium known to cause cholera. 2. Shigella dysenteriae causes dysentery, not cholera. 3. Salmonella typhi causes typhoid fever, not cholera. 4. Campylobacter jejuni causes gastroenteritis, not cholera. Therefore, based on the symptoms presented and the characteristics of the bacterium, Vibrio cholerae is the most likely microorganism.

Correct Answer: A

Rationale: The correct answer is A: Chingamin. Chingamin is a type of antimalarial drug that is commonly used for individual prevention of malaria. It works by targeting the malaria parasite in the body, preventing its growth and spread. Rifampicin (B), Ampicillin (C), and Gentamicin (D) are not effective for preventing malaria as they are antibiotics that target bacterial infections, not parasitic infections like malaria. Therefore, Chingamin is the most appropriate choice for individual prevention of malaria due to its specific antimalarial properties.

Correct Answer: A

Rationale: The correct answer is A: Epidemic typhus. This disease is caused by the bacterium Rickettsia prowazekii, which is transmitted by body lice. The symptoms include high fever, body rash, and tiny wounds due to scratching. The presence of lice in the clothing suggests a possible lice-borne disease like epidemic typhus. Summary: - B: Tularemia is caused by the bacterium Francisella tularensis, transmitted through ticks, deer flies, and contact with infected animals. Lice are not involved in its transmission. - C: Scabies is a skin infestation caused by the mite Sarcoptes scabiei, leading to itching and skin rashes. It is not associated with high fever or lice infestation. - D: Malaria is caused by Plasmodium parasites, transmitted by infected mosquitoes. The symptoms differ from those described in the scenario, and lice are not involved in its

Correct Answer: D

Rationale: The correct answer is D: All of the above. Salmonella enterica, Clostridium botulinum, and Escherichia coli are all bacteria known to cause food poisoning. Salmonella causes symptoms like diarrhea and vomiting; Clostridium botulinum produces a toxin leading to paralysis; Escherichia coli can cause severe stomach cramps and bloody diarrhea. Therefore, selecting "All of the above" is correct because all three bacteria are commonly associated with foodborne illnesses. Choices A, B, and C on their own are incorrect as they each represent only one bacterium known to cause food poisoning, whereas the correct answer encompasses all three.