A patient presents with fever, chill and cough. From his sputum the ovoid Gram-negative bipolar- stained bacilli with a delicate capsule were secured. What is the most likely diagnosis?

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: 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: Thin mobile bacillus with central spore. This is because the causative agent of botulism, Clostridium botulinum, is a gram-positive bacillus that typically appears as a thin rod-shaped bacterium with a central endospore. This characteristic morphology is essential in the identification of Clostridium botulinum. A: Gram-positive bacillus with subterminal spore - This is incorrect as Clostridium botulinum typically has a central endospore, not a subterminal one. B: Thick gram-positive non-spore-forming bacillus - This is incorrect as Clostridium botulinum forms endospores, although they are not thick. C: Gram-positive bacillus with terminal spore - This is incorrect as the spore of Clostridium botulinum is typically central, not terminal.

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: Benzylpenicillin sodium salt. Benzylpenicillin is a beta-lactam antibiotic that inhibits the synthesis of bacterial cell walls by disrupting the formation of murein (peptidoglycan), leading to bacterial cell death. This mechanism specifically targets the causative agent of syphilis, Treponema pallidum. - Choice B: Bijochinol is not a known drug used to treat syphilis. - Choice C: Ciprofloxacin is a fluoroquinolone antibiotic that works by inhibiting bacterial DNA replication and is not the first-line treatment for syphilis. - Choice D: Azithromycin is a macrolide antibiotic that interferes with bacterial protein synthesis and is commonly used to treat other infections but is not the preferred treatment for syphilis.