A patient with foul-smelling diarrhea had a stool sample showing large ciliated protozoa with a kidney-shaped macronucleus. What is the diagnosis?

Correct Answer: A

Rationale: The correct answer is A: Balantidiasis. The large ciliated protozoa with a kidney-shaped macronucleus described in the stool sample is consistent with Balantidium coli, the causative agent of balantidiasis. Balantidium coli is the only ciliated protozoan parasite that infects humans and presents with these specific characteristics. Giardiasis (B) is caused by Giardia intestinalis, which is flagellated, not ciliated. Amoebiasis (C) is caused by Entamoeba histolytica, which has an amoeboid shape, not ciliated. Trichomoniasis (D) is caused by Trichomonas vaginalis, which is a flagellated protozoan and does not have a kidney-shaped macronucleus. Hence, the correct diagnosis in this case is Balantidiasis.

Correct Answer: C

Rationale: The correct answer is C, Meat-peptone agar, as it provides a simple nutritive media for bacterial growth. This agar contains meat extract and peptone, which are good sources of nutrients for bacterial growth. Glucose broth (A) is a liquid medium with glucose but lacks other essential nutrients. Ascites (serum) agar (B) is a selective medium used for detecting pathogens in clinical samples. Blood agar (D) is a differential medium used to distinguish different types of bacteria based on hemolytic reactions. Meat-peptone agar is the simplest and most general-purpose medium among the options provided.

Correct Answer: D

Rationale: The correct answer is D because virulent strains of Listeria monocytogenes exhibit multiple pathogenic factors. A: They do not have endotoxin-like substances, so this is incorrect. B: They are indeed facultative intracellular bacteria, aiding in their ability to survive and replicate inside host cells. C: They produce hemolysin, which helps them lyse red blood cells. Therefore, the correct answer is D, as all of the above statements are true for virulent strains of Listeria monocytogenes.

Correct Answer: B

Rationale: Gas gangrene is caused by Clostridium perfringens due to its ability to produce gas in tissues leading to necrosis. Other choices are incorrect: A (C. difficile causes diarrhea), C (C. tetani causes tetanus), and D (incorrect as B is the causative agent).

Correct Answer: C

Rationale: The correct answer is C: Clostridium perfringens. This bacterium is the causative agent of gas gangrene due to its ability to produce gas and toxins in anaerobic conditions. Clostridium tetani causes tetanus, Clostridium botulinum causes botulism, and Bacillus anthracis causes anthrax, not gas gangrene. Clostridium perfringens stands out as the correct choice based on its specific association with gas gangrene and its pathogenic mechanisms.