A patient complains of acute spastic abdominal pain, frequent urge to defecate, liquid bloody feces with mucus. Laboratory analysis of fecal smear revealed inconstant in shape organisms with erythrocyte. What is the most likely diagnosis?

Correct Answer: A

Rationale: The correct answer is A: Amebiasis. Amebiasis is caused by the parasite Entamoeba histolytica, presenting with symptoms like acute abdominal pain, bloody diarrhea with mucus, and inconstant shape organisms seen in fecal smear. The presence of erythrocytes supports the diagnosis due to the parasite's ability to invade intestinal mucosa causing bleeding. Choice B (Lambliasis) presents with different symptoms like steatorrhea and fatigue. Choice C (Schistosomiasis) is mainly associated with liver and urinary symptoms. Choice D (Intestinal trichomoniasis) commonly presents with watery diarrhea and does not typically cause bloody stools. Therefore, based on the patient's symptoms and fecal smear findings, Amebiasis is the most likely diagnosis.

Correct Answer: A

Rationale: Step 1: The soil is low-contaminated according to the sanitary indicative value, which indicates that the contamination is recent. Step 2: The soil is contaminated according to coli titer, suggesting the presence of coliform bacteria typically found in fresh fecal matter. Step 3: The soil is low-contaminated according to the anaerobe titer (Cl. perfringens), which is an indicator of recent fecal contamination. Step 4: Based on the above steps, the correct answer is A: Fresh fecal contamination, as the presence of coliform bacteria and recent anaerobe titer levels point to recent fecal contamination. Summary: B: Old fecal contamination - Incorrect because the indicators suggest recent contamination. C: Insufficient intensity of soil humification - Incorrect as it is not related to the specific indicators mentioned in the question. D: Constant entry of organic protein contaminations - Incorrect as the indicators point towards fecal contamination, not protein

Correct Answer: D

Rationale: The correct answer is D: Imipenem. Imipenem is a carbapenem antibiotic effective against multiple-resistant microorganisms due to its broad spectrum and resistance to beta-lactamases. It is often used as a last resort for severe infections. Ampicillin (A) and Penicillin (B) are both beta-lactam antibiotics that are less effective against multiple-resistant microorganisms due to widespread resistance mechanisms. Augmentin (C) is a combination of amoxicillin and clavulanic acid, which may have limited efficacy against certain resistant strains but is not as effective as imipenem for treating infections caused by multiple-resistant microorganisms.

Correct Answer: A

Rationale: The Ziehl-Neelsen stain is specific for acid-fast bacteria like Mycobacterium tuberculosis. The bright red bacilli seen in the smear indicate the presence of acid-fast organisms, which is characteristic of Mycobacterium tuberculosis. Staphylococcus aureus, Clostridium tetani, and Escherichia coli are not acid-fast bacteria and would not be stained red using the Ziehl-Neelsen method. Therefore, the correct answer is A: Mycobacterium tuberculosis.

Correct Answer: D

Rationale: Certainly! The correct answer is D: Pertussis exotoxin. Pertussis toxin primarily affects the respiratory system causing whooping cough. It does not directly target the nervous system like the other toxins listed. Tetanospasmin causes muscle spasms, Diphtheria exotoxin affects the heart and nerves, and Botulinum exotoxin causes paralysis by blocking neurotransmitter release. Therefore, Pertussis exotoxin is the only toxin among the options that does not manifest with neurological symptoms.

Correct Answer: A

Rationale: The correct answer is A: Break down antibiotics like penicillin. Beta-lactamase is an enzyme produced by bacteria to inactivate beta-lactam antibiotics like penicillin by breaking the beta-lactam ring. This mechanism helps bacteria resist the antibiotic's effects. The other choices are incorrect because beta-lactamase does not enhance protein synthesis, facilitate DNA replication, or transport nutrients. It specifically targets and deactivates beta-lactam antibiotics, making choice A the most appropriate answer.

Correct Answer: A

Rationale: The correct answer is A: Salmonella enterica. This is because Salmonella are Gram-negative rods that do not ferment lactose, which fits the description in the question. Additionally, Salmonella is a common cause of severe abdominal pain and diarrhea. Shigella dysenteriae is a Gram-negative rod that also causes severe diarrhea but it does not share the characteristic of not fermenting lactose. Escherichia coli is a Gram-negative rod that does ferment lactose. Proteus vulgaris is also a Gram-negative rod but it is not commonly associated with severe abdominal pain and diarrhea, making it an unlikely causative agent in this scenario.

Correct Answer: D

Rationale: The correct answer is D: Adenovirus. Adenovirus commonly causes acute febrile pharyngitis and pharyngoconjunctival fever. Adenovirus is known to cause respiratory infections and can present with symptoms such as sore throat, fever, and conjunctivitis. VZV (Varicella-Zoster Virus) causes chickenpox and shingles, not these specific symptoms. Measles virus causes a systemic illness with characteristic rash, not typically pharyngitis. Rubella virus causes a mild febrile illness with rash, but not pharyngitis. Therefore, based on the clinical presentation described, adenovirus is the most likely cause.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Mycobacterium leprae is the correct answer because it is the bacterium responsible for causing leprosy. 2. Neisseria gonorrhoeae causes gonorrhea, not leprosy. 3. Escherichia coli is associated with gastrointestinal infections, not leprosy. 4. Staphylococcus aureus causes various skin infections, but not leprosy. In summary, Mycobacterium leprae is the correct choice because it is the specific bacterium known to cause leprosy, while the other options are associated with different diseases.