After a prolonged isoniazid treatment, the patient developed polyneuritis, paresthesia, memory disorders, and convulsions. What is the most likely mechanism of the described isoniazid side-effects?

Correct Answer: D

Rationale: The correct answer is D. Isoniazid inhibits pyridoxal phosphate synthesis, which is the active form of vitamin B6. Pyridoxal phosphate is essential for various enzymatic reactions, including neurotransmitter synthesis and myelin formation. Therefore, isoniazid-induced pyridoxal phosphate deficiency can lead to neurological symptoms like polyneuritis, paresthesia, memory disorders, and convulsions. A: Disruption of cell membrane synthesis - This is not the mechanism of isoniazid side-effects. B: Inhibition of protein synthesis - Isoniazid does not directly inhibit protein synthesis. C: Inhibition of RNA-synthesis - Isoniazid does not inhibit RNA synthesis; it affects vitamin B6 metabolism.

Correct Answer: A

Rationale: The correct answer is A: Kitt-Tarozzi. This medium contains blood and hemin, which are essential nutrients for the growth of anaerobes. Blood provides a source of iron, while hemin stimulates the growth of anaerobes. This combination creates an environment conducive for the isolation and identification of anaerobic organisms. B: Endo and C: Roux are selective media primarily used for the isolation of gram-negative bacteria and not specifically designed for anaerobes. D: Sabouraud's is a medium used for the cultivation of fungi, not anaerobes. In summary, Kitt-Tarozzi is the correct choice due to its specific nutrient composition that supports the growth of anaerobes, unlike the other options which are not suitable for this purpose.

Correct Answer: A

Rationale: The correct answer is A: Homemade canned meat. Botulism is often caused by consuming improperly canned or preserved foods, particularly meats. The spores of the Clostridium botulinum bacteria can grow in anaerobic conditions, such as those found in improperly canned foods, leading to the production of the botulinum toxin. The symptoms of botulism align with those characteristic of the patient's condition. Explanation of why the other choices are incorrect: B: Custard pastry from private bakery - Unlikely to be the cause of botulism as this type of food is not typically associated with the growth of Clostridium botulinum. C: Sour cream from local dairy factory - While dairy products can sometimes be sources of foodborne illness, botulism is not commonly associated with sour cream. D: Strawberries from suburban vegetable garden - Botulism is not typically transmitted through fresh fruits or vegetables, making this an unlikely source of infection.

Correct Answer: A

Rationale: The correct answer is A: Clostridium perfringens. Clostridium perfringens is a gram-positive spore-forming bacillus commonly found in soil. It produces hemolysis on blood agar, as described in the question. Clostridium botulinum is also a gram-positive spore-forming bacillus, but it does not typically cause hemolysis. Staphylococcus aureus is a gram-positive cocci, not a bacillus. Pseudomonas aeruginosa is a gram-negative bacterium, not a gram-positive spore-forming bacillus.

Correct Answer: A

Rationale: The correct answer is A: Syphilis. Hutchinson's triad is a classic presentation of congenital syphilis in children. Barrel-shaped incisors, parenchymatous keratitis, and deafness are key manifestations. Barrel-shaped incisors result from mulberry molars, a type of abnormal tooth. Parenchymatous keratitis is an inflammation of the cornea, a common ocular sign in congenital syphilis. Deafness can occur due to damage to the auditory nerve caused by the infection. Choices B, C, and D are incorrect as they do not typically present with the specific triad of symptoms seen in congenital syphilis.