After consumption some tinned meat a patient had diplopia, acute headache, deglutition disorder, hard breathing, muscle weakness. The diagnosis was botulism. What factor of pathogenicity are the clinic presentations of this disease connected with?

Correct Answer: A

Rationale: The correct answer is A, Exotoxin. Botulism is caused by the exotoxin produced by Clostridium botulinum bacteria. The symptoms described - diplopia, acute headache, deglutition disorder, hard breathing, muscle weakness - are all consistent with botulism due to the neurotoxic effects of the exotoxin. The exotoxin interferes with neurotransmission at the neuromuscular junction, leading to muscle paralysis and the symptoms mentioned. The other choices (B, C, D, E) are incorrect as they do not correspond to the pathogenic mechanism of botulism and do not explain the specific clinical manifestations observed in this case.

Correct Answer: A

Rationale: The correct answer is A: Syphilis. The presentation of painless inguinal lymph nodes, along with a small-sized ulcer with thickened edges and a "laquer" bottom of greyish color on the genital mucous membrane, is classic for primary syphilis. The painless nature of the lymph nodes and the specific characteristics of the ulcer are key features of syphilitic infection. Primary syphilis is caused by the bacterium Treponema pallidum and typically presents with a single, painless ulcer known as a chancre. It is important to consider syphilis in the differential diagnosis of genital ulcers. Summary of other choices: B: Tuberculosis - Unlikely, as tuberculosis typically presents with pulmonary symptoms and does not cause genital ulcers. C: Lepra - Unlikely, as leprosy does not typically present with painless inguinal lymph nodes and the specific ulcer characteristics described. D: Trophic ulcer - Unlikely

Correct Answer: B

Rationale: The correct answer is B: Dysenteric amoeba. 1. Dysenteric amoeba causes amoebiasis, which presents with symptoms like weakness, intestinal pain, and gastrointestinal disorders. 2. The presence of four-nucleus cysts in the feces indicates an infection with Entamoeba histolytica, the causative agent of amoebiasis. 3. Multiple-nucleus cysts are characteristic of Entamoeba histolytica, distinguishing it from other protozoa. 4. Lamblia (choice A), Balantidium (choice C), and Trichomonas (choice D) are not associated with four-nucleus cysts or the mentioned symptoms, making them incorrect choices.

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: D

Rationale: The correct answer is D: Sporozoites. Sporozoites are the infective stage of Plasmodium for the female Anopheles mosquito. Here's the rationale: After being transmitted to a human host through a mosquito bite, the sporozoites travel to the liver where they mature and reproduce asexually as merozoites (not the infective stage for mosquitoes). The merozoites then infect red blood cells, leading to symptoms like fever, headache, and shivering. During the blood stage, some merozoites develop into male and female gametocytes, which are not infective to mosquitoes. When a mosquito bites an infected person, it ingests gametocytes, which then develop into male and female gametes and fuse to form ookinetes. Ookinetes develop into oocysts in the mosquito's gut, releasing sporozoites that migrate to the salivary glands, ready to infect a new human host when the mosquito bites