A patient with a long history of chronic gastritis undergoes a gastroscopy, which detects an ulcer in the duodenum area. Microscopic examination of the tissue biopsy developed Gram-negative curved bacteria and the rapid urease activity test of the biopsy material was highly positive. The most likely cause of the disease is:

Correct Answer: D

Rationale: The correct answer is D: Helicobacter pylori. Helicobacter pylori is a known bacterium associated with causing duodenal ulcers. The presence of Gram-negative curved bacteria in the biopsy along with a highly positive rapid urease test is characteristic of H. pylori infection. Vibrio cholerae causes cholera, not duodenal ulcers. Campylobacter fetus is associated with gastroenteritis, not duodenal ulcers. Acinetobacter baumannii is a nosocomial pathogen, not typically associated with duodenal ulcers. In summary, the unique combination of findings in this case points towards H. pylori as the most likely cause of the disease.

Correct Answer: C

Rationale: The correct answer is C: Streptococcus pyogenes. This bacterium is commonly known as "flesh-eating bacteria" due to its ability to cause severe tissue destruction and necrotizing fasciitis. Streptococcus pyogenes produces toxins that break down skin and muscle tissues. Staphylococcus aureus (A) can cause skin infections but is not typically associated with necrotizing fasciitis. Staphylococcus epidermidis (B) is a normal skin flora and rarely causes infections. Propionibacterium acnes (D) is associated with acne and not known for causing tissue destruction. Therefore, the correct choice is Streptococcus pyogenes due to its unique ability to cause severe tissue damage and necrotizing fasciitis.

Correct Answer: C

Rationale: The correct answer is C: Mycobacterium tuberculosis. This bacterium is responsible for causing tuberculosis as it specifically infects the lungs and can spread to other parts of the body. Mycobacterium leprae (A) causes leprosy, Streptococcus pneumoniae (B) causes pneumonia, and Clostridium botulinum (D) causes botulism, making them incorrect choices for tuberculosis. Mycobacterium tuberculosis has unique characteristics and mechanisms that enable it to cause tuberculosis, such as its ability to evade the immune system and form granulomas in the lungs.

Correct Answer: C

Rationale: The correct answer is C (coli index of 250 and coli titer of 4). The coli index is calculated by multiplying the number of colonies by the reciprocal of the volume filtered, which gives 2 colonies x (1/0.5 L) = 4. The coli titer is obtained by dividing the volume filtered by the number of colonies, which gives 0.5 L / 2 colonies = 0.25 L or 250 ml. This indicates the concentration of coliform bacteria in the water sample. Choice A (4 and 250) is incorrect because it has the correct coli index but the values are reversed for coli index and coli titer. Choice B (2 and 500) is incorrect as it provides the correct coli titer value but the values are reversed for coli index and coli titer. Choice D (500 and 2) is incorrect because it reverses the values for both coli index and coli titer.

Correct Answer: A

Rationale: Rationale: Metronidazole is the drug of choice for treating lambliosis due to its effectiveness against Giardia lamblia, the parasite causing the infection. Metronidazole works by disrupting the DNA structure of the parasite, leading to its death. Erythromycin (choice B) is not effective against Giardia lamblia. Monomycin (choice C) and Chingamin (choice D) are not commonly used for treating lambliosis. Therefore, choice A, Metronidazole, is the correct medication for this patient.

Correct Answer: A

Rationale: The correct answer is A: Fluconazole. 1. Fluconazole is an antifungal agent effective against Candida species commonly causing candidiasis. 2. Streptomycin (B) is an antibiotic used for bacterial infections, not fungal. 3. Phthalylsulfathiazole (C) is an antibacterial agent, not antifungal. 4. Ampicillin (D) is a β-lactam antibiotic, which can actually contribute to fungal infections like candidiasis.

Correct Answer: C

Rationale: The correct answer is C: enterotoxigenic E. Coli (ETEC). ETEC adheres to the intestine wall and produces toxins, leading to symptoms like diarrhea. Shigella spp. invade intestinal cells, Salmonella spp. cause inflammation, and Helicobacter pylori infects the stomach lining. This makes them incorrect choices for bacteria adhering to the intestine wall and producing toxins.

Correct Answer: B

Rationale: The correct answer is B: Helicobacter pylori. This bacterium is associated with stomach ulcers as it can survive in the acidic environment of the stomach and produce substances that weaken the stomach lining. Escherichia coli (A) is associated with foodborne illnesses, not ulcers. Bacillus cereus (C) causes food poisoning. Clostridium difficile (D) is associated with antibiotic-associated colitis, not ulcers. Therefore, Helicobacter pylori is the correct answer based on its specific association with stomach ulcers.

Correct Answer: C

Rationale: Rationale: 1. Bacillus anthracis is a spore-forming bacterium that can survive for decades in the soil. 2. The spores are resistant to harsh conditions and can remain dormant for long periods. 3. This resilience allows Bacillus anthracis to persist in the old cattle burial ground for over 50 years. 4. Mycobacterium bovis, Brucella abortus, and Francisella tularensis are not known for long-term survival in soil. Summary: - Mycobacterium bovis, Brucella abortus, and Francisella tularensis do not have the spore-forming ability. - Mycobacterium bovis causes tuberculosis in cattle. - Brucella abortus causes brucellosis in cattle. - Francisella tularensis causes tularemia in animals and humans.