An outbreak of food poisoning was recorded in an urban settlement. The illness was diagnosed as botulism on the grounds of clinical presentations. What foodstuffs should be chosen for analysis in the first place in order to confirm the diagnosis?

Correct Answer: A

Rationale: The correct answer is A: Tinned food. Botulism is often caused by the botulinum toxin produced by the bacterium Clostridium botulinum, which can be present in improperly canned foods. Analyzing tinned food allows for direct detection of the toxin or bacteria, confirming the diagnosis. Potatoes, pasteurized milk, and boiled meat are less likely sources of botulism compared to tinned food, making them less suitable for initial analysis in this case.

Correct Answer: D

Rationale: The correct answer is D, Late congenital syphilis. This is because the patient presents with Hutchinson's teeth, which are a characteristic feature of late congenital syphilis. Hutchinson's teeth are small, barrel-shaped teeth with a wider cervix and notched incisors. The patient's history of visual impairment and hearing aid use also support the diagnosis of late congenital syphilis, as these are common manifestations of this stage of the disease. Choice A, Primary syphilis, is incorrect because it typically presents with a painless sore at the site of infection, not dental abnormalities. Choice B, Early congenital syphilis, is incorrect as dental abnormalities in this stage are usually more severe, such as mulberry molars. Choice C, Neurosyphilis, is incorrect as it primarily affects the central nervous system and does not typically present with dental abnormalities.

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: C

Rationale: The correct answer is C: Visceral leishmaniasis. This disease is caused by the protozoan parasite Leishmania, which is transmitted by sandfly bites. The symptoms described in the question, such as enlarged liver and spleen, peripheral gland enlargement, and eathy colored skin, are characteristic of visceral leishmaniasis. Amebiasis (choice A) typically presents with gastrointestinal symptoms, Balantidiasis (choice B) is caused by a different parasite and presents with dysentery, and Lambliasis (choice D) is caused by Giardia lamblia and presents with diarrhea.

Correct Answer: A

Rationale: The most probable diagnosis is A: Malaria. The patient's symptoms of periodic chills, high fever, and profuse sweating, along with living in Africa where malaria is endemic, strongly suggest malaria. The enlarged liver and spleen are consistent with malaria infection. The low erythrocyte count indicates hemolysis, a common feature of malaria. Spotted fever and sepsis do not typically present with the same pattern of symptoms and travel history as seen in this case. Haemolytic anaemia would not explain the patient's fever episodes and other symptoms. Therefore, based on the symptoms, travel history, and laboratory findings, malaria is the most likely diagnosis.