An 18-year-old patient has enlarged inguinal lymph nodes, they are painless, thickened on palpation. In the area of genital mucous membrane there is a small-sized ulcer with thickened edges and "laquer"bottom of greyish colour. What is the most probable diagnosis?

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: 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: D

Rationale: The correct answer is D (All of the above) because all three bacteria (Clostridium botulinum, Escherichia coli, Salmonella enterica) are known to cause foodborne infections. Clostridium botulinum can lead to botulism, E. coli can cause various gastrointestinal illnesses, and Salmonella enterica is a common cause of food poisoning. Each bacterium has specific mechanisms that result in foodborne illnesses. Choices A, B, and C are incorrect because each bacterium mentioned is associated with causing foodborne infections, making them collectively the correct answer.

Correct Answer: B

Rationale: The correct answer is B: Ascomycota. Penicillin is produced by the mold Penicillium, which belongs to the phylum Ascomycota. Ascomycota is known for its sac-like structures called asci that contain ascospores. Penicillium produces penicillin as a defense mechanism against bacteria. Basidiomycota (A) are known for producing mushrooms, Zygomycota (C) includes bread molds like Rhizopus, and Deuteromycota (D) is a classification for fungi with no known sexual reproductive stage.

Correct Answer: C

Rationale: The correct answer is C: Survival. Bacterial spores are specialized structures that bacteria form to survive harsh conditions such as extreme temperatures or lack of nutrients. Spores are not used for protection against phagocytosis (A) as they are dormant structures and not actively involved in defense mechanisms. They are not for reproduction (B) as spores are a form of bacterial reproduction but not the primary purpose of spore formation. Spores do not serve as nutrient storage (D) as they are mainly used for survival during unfavorable conditions.

Correct Answer: A

Rationale: The correct answer is A: Helicobacterial infection. This is the most probable leading mechanism of disease development in this case because the patient's symptoms, such as heartburn, epigastric pain, food intolerance, and presence of a duodenal ulcer with a positive urease test, are classic signs of Helicobacter pylori infection. This bacterium colonizes the stomach lining, leading to inflammation and ulcer formation. The exacerbations in spring and autumn could be due to seasonal variations in immune response. Choice B: Dietary allergy is incorrect because the symptoms and findings in the patient are more indicative of an infectious etiology rather than an allergic reaction to specific foods. Choice C: Autoantibody production is unlikely as there are no indications of an autoimmune process in this case. Choice D: Reduced prostaglandin synthesis is not the leading mechanism as the symptoms and findings are more consistent with an infectious cause rather than a deficiency in prostaglandin synthesis.

Correct Answer: A

Rationale: The correct answer is A: Obligate anaerobes. These microorganisms thrive in the absence of oxygen, as seen in the canned mushrooms where oxygen is limited. They produce toxins causing food poisoning. Facultative anaerobes (B) can survive with or without oxygen. Microaerophiles (C) require low levels of oxygen. Obligate aerobes (D) need oxygen to survive and would not be responsible for the poisoning in this case.

Correct Answer: A

Rationale: Ionizing radiation has enough energy to remove tightly bound electrons from atoms, creating charged particles (ions). UV light does not have enough energy to ionize atoms, making choice A the correct answer. Gamma rays, electron beams, and X-rays all have sufficient energy to cause ionization. Gamma rays are very high-energy electromagnetic radiation, electron beams are streams of high-energy electrons, and X-rays are high-energy electromagnetic radiation as well.

Correct Answer: B

Rationale: The correct answer is B: Chlamydia trachomatis. Elementary bodies (EBs) and reticular bodies (RBs) are two distinct forms of Chlamydia trachomatis, a bacterium causing various infections. EBs are the infectious form, while RBs are the replicative form within host cells. Mycoplasma genitalium (choice A) lacks a cell wall and does not have these specific morphological forms. Rickettsia prowazekii (choice C) is an obligate intracellular bacterium but does not exhibit the elementary and reticular body forms characteristic of Chlamydia trachomatis. Therefore, the correct answer is B, as only Chlamydia trachomatis exhibits the elementary and reticular bodies.