A patient presents with acute pain, swelling, and deformity of the ankle following a twisting injury. X-ray reveals a fracture involving the distal fibula with associated widening of the ankle mortise. Which type of ankle fracture is most likely?

Correct Answer: D

Rationale: A trimalleolar fracture is characterized by fractures involving the lateral malleolus (distal fibula), medial malleolus (distal tibia), and the posterior tubercle of the distal tibia. This fracture pattern results in instability of the ankle joint and is often associated with widening of the ankle mortise on X-ray. The deformity and swelling seen in this patient are indicative of a trimalleolar fracture and are typically caused by a high-energy injury, such as a forceful twisting motion. Treatment for trimalleolar fractures often involves surgical intervention to stabilize the ankle joint and restore normal function.

Correct Answer: A

Rationale: The clinical presentation of gross hematuria, flank pain, palpable abdominal mass, along with imaging findings of a large heterogeneous renal mass with necrosis and calcifications are highly suggestive of renal cell carcinoma (RCC). RCC is the most common type of kidney cancer in adults. The presence of necrosis and calcifications are characteristic features of RCC. Imaging modalities such as CT scans or MRI can confirm the diagnosis by showing the typical features of RCC, including a solid mass with areas of necrosis and calcifications. It is important to further evaluate this patient, likely with a biopsy, to confirm the diagnosis and determine the extent of the disease for appropriate management.

Correct Answer: C

Rationale: Prostatitis is characterized by inflammation of the prostate gland, leading to symptoms such as dysuria (painful urination), urinary frequency, urinary urgency, and perineal or pelvic pain. Prostate cancer, on the other hand, is characterized by the presence of malignant cells in the prostate gland and may not present with these typical symptoms. Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland that can cause urinary symptoms but is not typically associated with inflammation. Urethritis refers to inflammation of the urethra, which is a different condition and may present with symptoms such as painful urination and discharge from the urethra.

Correct Answer: C

Rationale: Cryptosporidium parvum is a protozoan parasite that commonly causes waterborne illness characterized by watery diarrhea, abdominal cramps, and nausea. This parasite is often transmitted through contaminated water sources such as streams or lakes. Laboratory tests identifying oocysts in the stool sample are indicative of Cryptosporidium infection. Giardia lamblia can also cause similar symptoms, but the presence of oocysts points more towards Cryptosporidium in this case. Entamoeba histolytica causes amoebic dysentery with bloody diarrhea and is usually associated with fecal-oral transmission through contaminated food or water. Cyclospora cayetanensis typically causes prolonged watery diarrhea and is associated with the ingestion of contaminated food or water.

Correct Answer: C

Rationale: The most likely causative agent in this scenario is Borrelia burgdorferi, which is the bacterium responsible for causing Lyme disease. The classic presentation of Lyme disease includes fever, malaise, and a skin lesion resembling a "bull's eye" rash, known as erythema migrans. This rash typically appears at the site of a tick bite. If left untreated, Lyme disease can progress to involve multiple organ systems and lead to more severe complications. Plasmodium falciparum is the causative agent of malaria, which typically presents with symptoms such as fever, chills, and fatigue, but it does not cause a "bull's eye" rash. Trypanosoma cruzi is the parasite responsible for Chagas disease, which presents with symptoms such as fever, swelling at the site of entry (typically the bite wound), and enlarged lymph nodes, but it does not