A child with fever and swollen lymph nodes had a Gram-stained smear revealing Gram-negative rods with a safety pin appearance. What is the causative agent?

Correct Answer: A

Rationale: The correct answer is A: Yersinia pestis. This bacterium causes the plague, which presents with fever and swollen lymph nodes. The safety pin appearance on Gram stain is characteristic of Yersinia pestis. B: Francisella tularensis causes tularemia, which presents differently and does not show safety pin appearance on Gram stain. C: Brucella abortus causes brucellosis, which does not typically present with the same symptoms as described in the question. D: Clostridium botulinum causes botulism, which does not show safety pin appearance on Gram stain and does not typically present with fever and swollen lymph nodes.

Correct Answer: A

Rationale: The correct answer is A: Genus Shigella. Shigella is known to be the causative agent of bacterial dysentery. It invades the intestinal lining, leading to symptoms like severe diarrhea and abdominal cramps. Salmonella (choice B) typically causes food poisoning, not dysentery. Klebsiella (choice C) is associated with pneumonia and urinary tract infections, not dysentery. "None of the above" (choice D) is incorrect as Shigella does belong to a specific genus responsible for bacterial dysentery.

Correct Answer: C

Rationale: Rationale: 1. Infectious process involves interactions between macro and microorganisms. 2. It is not limited to manifested diseases or typical symptoms. 3. The process can occur without leading to a full-blown infectious disease. 4. Choice C correctly captures the dynamic relationship between different organisms. Summary: - A: Incorrect - Infectious process is not solely about clinically manifested diseases. - B: Incorrect - Not all infectious diseases have typical symptoms. - D: Incorrect - Ambulatory form is a specific type, not encompassing all infectious processes.

Correct Answer: C

Rationale: The correct answer is C: Respiratory tract. The respiratory tract is likely the most frequently used portal of entry for pathogens because it is constantly exposed to the external environment and has a large surface area lined with mucous membranes that can trap and facilitate the entry of pathogens. Additionally, the respiratory tract serves as a direct pathway for pathogens to reach the bloodstream and other organs. Skin (choice A) is a physical barrier that can prevent pathogen entry, while the gastrointestinal tract (choice B) has acidic pH and enzymes that can kill many pathogens. Conjunctiva (choice D) is a less common portal of entry compared to the respiratory tract due to its smaller surface area and protective mechanisms such as tears.

Correct Answer: B

Rationale: The correct answer is B: Passive hemagglutination. In this test, red blood cells coated with Treponema antigens agglutinate in the presence of patient's serum antibodies. This indicates the presence of antibodies against Treponema, confirming the diagnosis. A: Immobilization test uses live Treponema to detect specific antibodies, but it is not commonly used for syphilis diagnosis. C: Precipitation test is not commonly used for syphilis diagnosis. D: Complement binding test is not specific for syphilis and is used more for autoimmune diseases. Therefore, passive hemagglutination is the most appropriate serological test in this case due to its specificity and relevance to the presentation of the patient.

Correct Answer: A

Rationale: The correct answer is A: Actinomycosis. This is supported by the presence of purulent foci with druses consisting of short rod-like elements attached to a homogenous center, which is characteristic of Actinomyces species. Actinomycosis commonly presents with granulation tissue and connective tissue formation. B: Tuberculosis does not typically present with druses containing short rod-like elements. C: Syphilis does not typically present with purulent foci or druses. D: Candidosis does not typically present with the described features of purulent fluxing and druses with short rod-like elements.

Correct Answer: A

Rationale: The correct answer is A: Entamoeba histolytica. This is because it is a protozoan parasite known to cause amoebic dysentery, presenting with chronic diarrhea and cysts with four nuclei in the stool sample. Giardia lamblia (B) causes giardiasis with trophozoites and cysts with two nuclei. Balantidium coli (C) is a ciliated parasite causing dysentery with large trophozoites. Trichomonas hominis (D) is a non-pathogenic flagellate often found in the human intestine. Thus, based on the specific characteristics of the cysts and clinical presentation, Entamoeba histolytica is the most likely causative agent.

Correct Answer: A

Rationale: The correct answer is A: Triatomine bug. Triatomine bugs, also known as "kissing bugs," are the specific carrier of the trypanosomes that cause Chagas disease. These bugs transmit the parasite through their feces, which contain the infectious forms of the trypanosomes. When the bug bites a human or animal, it defecates near the bite wound, allowing the parasites to enter the bloodstream through the broken skin. Mosquitoes (B) transmit diseases like malaria and dengue fever, not Chagas disease. Tsetse flies (C) are known for transmitting African trypanosomiasis (sleeping sickness), not Chagas disease. Cockroaches (D) are not known to transmit Chagas disease.

Correct Answer: D

Rationale: The correct answer is D because hospital-acquired infections can be caused by a variety of microorganisms, including opportunistic pathogens and obligate pathogens such as bacteria or viruses. Opportunistic microorganisms take advantage of weakened immune systems in hospital patients, while obligate pathogens are capable of causing infections in healthy individuals. Therefore, all the choices are correct in this context as they represent potential etiological causes of hospital-acquired infections.