A patient with suspected liver abscess was admitted to the surgical department. The patient had been staying for a long time on business in one of African countries and fell repeatedly ill with acute gastrointestinal disorders. What protozoal disease may the patient be now ill with?

Correct Answer: A

Rationale: Rationale: The correct answer is Amebiasis (choice A) because the patient's symptoms of acute gastrointestinal disorders and prolonged stay in an African country suggest exposure to Entamoeba histolytica, the causative agent of amebiasis. This protozoal infection commonly occurs in tropical regions, including Africa. Trypanosomosis (choice B) is caused by Trypanosoma species transmitted by tsetse flies, primarily found in sub-Saharan Africa. Leishmaniasis (choice C) is transmitted by sandflies and presents with skin lesions or visceral involvement, not acute gastrointestinal symptoms. Malaria (choice D) is caused by Plasmodium parasites transmitted by mosquitoes and typically presents with fever, not acute gastrointestinal disorders. Therefore, choices B, C, and D are incorrect based on the patient's clinical presentation and travel history.

Correct Answer: A

Rationale: The correct answer is A: CMV (Cytomegalovirus). CMV is the most common congenital infection worldwide due to its high prevalence and ability to be transmitted from mother to fetus during pregnancy. It can lead to serious complications such as hearing loss, developmental delays, and vision problems in newborns. Listeria monocytogenes (B) is a foodborne pathogen, not typically associated with congenital infections. Rubella Virus (C) can cause congenital rubella syndrome but is less common globally compared to CMV. Syphilis (D) can also be transmitted from mother to fetus, but its prevalence and impact on congenital infections are lower compared to CMV.

Correct Answer: D

Rationale: The correct answer is D, Kitt-Tarozzi medium. This medium is specifically designed for the isolation and cultivation of Clostridium tetani, the bacteria responsible for tetanus. The other options, Sabouraud agar, Endo agar, and Hiss medium, are not suitable for the growth of Clostridium tetani. Sabouraud agar is used for fungal cultures, Endo agar is a selective medium for enteric bacteria, and Hiss medium is used for the cultivation of anaerobic bacteria other than Clostridium tetani. Therefore, the Kitt-Tarozzi medium is the most appropriate choice for isolating and identifying the tetanus agent in this scenario.

Correct Answer: C

Rationale: The correct answer is C: Acid-fast cell wall. Mycobacterium tuberculosis is characterized by its unique cell wall composition, containing high levels of mycolic acids which make it acid-fast. This property allows it to resist decolorization during acid-fast staining procedures. This distinguishes it from other bacteria. A: Producing spores is not a key feature of Mycobacterium tuberculosis. Spore formation is more commonly associated with bacterial species such as Bacillus and Clostridium. B: Mycobacterium tuberculosis is not Gram-negative. It is classified as acid-fast Gram-positive. D: Mycobacterium tuberculosis does not produce toxins as a key feature. Its pathogenicity is more closely related to its ability to evade host immune responses and persist in host tissues.

Correct Answer: A

Rationale: The presence of acid-fast bacilli stained red against a blue background indicates mycobacteria, specifically Mycobacterium tuberculosis in this case. Ziehl-Neelsen staining is commonly used to detect tuberculosis. Diphtheria is caused by Corynebacterium diphtheriae, which does not stain with Ziehl-Neelsen. Pneumonia is a general term for lung infections caused by various pathogens. Leprosy is caused by Mycobacterium leprae, which requires special staining methods different from Ziehl-Neelsen.

Correct Answer: D

Rationale: The correct answer is D: components of the gram-negative cell wall. Bacterial endotoxins are lipopolysaccharides found in the outer membrane of gram-negative bacteria. They are released upon bacterial cell lysis and can cause severe immune responses. A: Proteins in the cell wall - This is incorrect because endotoxins are not proteins but rather lipopolysaccharides. B: Secreted into the environment - Endotoxins are not actively secreted but are released upon cell death or lysis. C: Components of the gram-positive cell wall - Gram-positive bacteria do not have an outer membrane with lipopolysaccharides, so endotoxins are not found in the gram-positive cell wall.

Correct Answer: D

Rationale: The correct answer is D, "All of the above." Clostridium botulinum produces botulinum toxin causing botulism, Vibrio cholerae produces cholera toxin leading to severe diarrhea, and certain strains of Escherichia coli produce toxins causing gastrointestinal illness. Therefore, all three bacteria are known for producing toxins that can cause severe gastrointestinal illness. Choices A, B, and C individually represent bacteria known for producing toxins that can cause severe gastrointestinal illness, making them incorrect individual choices.

Correct Answer: B

Rationale: The correct answer is B: ELISA test for IgM anti-HAV in serum and HAV-Ag in stools. This test is the most reliable for detecting acute hepatitis A infection because IgM antibodies are produced early in the infection, indicating an active infection. Detection of HAV antigen in stools also confirms active viral shedding. A: Western blot assay for IgG anti-HAV in serum is not the most reliable for acute infection detection as IgG antibodies are produced later in the infection and indicate past exposure or immunity. C: ELISA test for IgG anti-HAV in serum is not the most reliable for acute infection detection as IgG antibodies are produced later in the infection and indicate past exposure or immunity. D: None of the above is incorrect as option B is the most appropriate choice for detecting acute hepatitis A infection.

Correct Answer: B

Rationale: The correct answer is B: Biological oxidation. Haematrophic bacteria obtain energy through biological oxidation, where they break down organic compounds to generate ATP for cellular processes. This process involves the transfer of electrons from the substrate to an electron transport chain to produce energy. Heat production (A) is a byproduct of metabolism, not the primary way to obtain energy. In biosynthetic reactions (C), energy is utilized rather than generated. Cultivation in culture media (D) is a method of growing bacteria but does not directly provide energy. Therefore, the correct answer is B as it aligns with the metabolic process of haematrophic bacteria.