Examination of duodenal contents revealed some pyriform protozoa with twin nuclei and four pairs of flagella. There were two supporting filaments between the nuclei and a suctorial disc on the ventral side. What representative of protozoa was revealed in this patient?

Correct Answer: D

Rationale: The correct answer is D: Intestinal trichomonad. This protozoan matches the description provided, with pyriform shape, twin nuclei, four pairs of flagella, supporting filaments, and a suctorial disc. Lamblia (A) lacks flagella and supporting filaments. Toxoplasma (B) is an intracellular parasite with different morphology. Leishmania (C) belongs to a different class with no flagella or supporting filaments. In summary, the unique combination of features described in the question points to an intestinal trichomonad, making it the correct answer.

Correct Answer: D

Rationale: The correct answer is D, "All of the above," because all three bacteria listed (Vibrio cholerae, Clostridium difficile, Escherichia coli) produce toxins that can cause severe gastrointestinal illness. Vibrio cholerae produces cholera toxin leading to severe diarrhea. Clostridium difficile produces toxins causing antibiotic-associated diarrhea. Escherichia coli can produce toxins such as Shiga toxin causing severe gastrointestinal symptoms. Therefore, all the options listed are correct in producing toxins that can result in severe gastrointestinal illness.

Correct Answer: A

Rationale: The correct answer is A: Helicobacter. Helicobacter pylori is the main causative agent of peptic ulcer disease and is characterized by its gram-negative arcuate bent shape and positive urease activity. Helicobacter pylori specifically colonizes the stomach mucosa and is associated with various gastrointestinal disorders. Spirochetes (choice B), spirilla (choice C), and Leptospira (choice D) are not typically associated with peptic ulcer disease or stomach mucosa infections, making them incorrect choices in this context.

Correct Answer: A

Rationale: The correct answer is A: Antibiotic. Brucellosis is a bacterial infection, and antibiotics are the primary treatment to target and eliminate the bacteria causing the disease. Antibiotics such as doxycycline and rifampin are commonly used for brucellosis treatment. Donor immunoglobulin (B) is not used to treat brucellosis as it is not caused by a deficiency in antibodies. Inactivated therapeutic vaccine (C) is used for prevention, not for treating active infections. Antitoxic serum (D) is used to neutralize toxins produced by bacteria, not to directly kill the bacteria themselves in cases like brucellosis.

Correct Answer: A

Rationale: Step 1: Gram-positive diplococci suggest a pneumococcal infection. Step 2: Catalase-negative indicates Streptococcus. Step 3: Alpha-hemolysis matches S. pneumoniae's characteristics. Therefore, Streptococcus pneumoniae is the most likely causative agent. Staphylococcus aureus (B) is catalase-positive, Neisseria meningitidis (C) is Gram-negative, and Klebsiella pneumoniae (D) is not diplococci or alpha-hemolytic.

Correct Answer: A

Rationale: The correct answer is A: Clostridium botulinum. This bacterium produces the botulinum neurotoxin, which causes paralysis by blocking the release of acetylcholine at neuromuscular junctions. Clostridium perfringens causes gas gangrene, not paralysis. Escherichia coli is associated with gastrointestinal infections, not paralysis. Staphylococcus aureus produces enterotoxins causing food poisoning, not paralysis. Therefore, Clostridium botulinum is the correct choice based on its well-known association with paralysis due to botulinum neurotoxin production.

Correct Answer: A

Rationale: The likely diagnosis is Meningococcal meningitis (Choice A) due to the presence of Gram-negative diplococci in the cerebrospinal fluid. Neisseria meningitidis is a Gram-negative diplococcus commonly associated with meningococcal meningitis. Fever, chills, and neck stiffness are classic symptoms of bacterial meningitis, and Neisseria meningitidis often presents with these symptoms. Pneumococcal meningitis (Choice B) is caused by Streptococcus pneumoniae, a Gram-positive organism. Haemophilus influenzae (Choice C) is also a Gram-negative organism but typically presents with a different clinical picture. Listeria monocytogenes (Choice D) is a Gram-positive rod and is more commonly associated with meningitis in neonates, elderly, and immunocompromised individuals.

Correct Answer: A

Rationale: The correct answer is A: Mantoux test. The Mantoux test is used to detect tuberculosis infection by injecting a small amount of tuberculin under the skin and checking for a reaction. This test helps identify individuals who have been exposed to tuberculosis. The other choices are incorrect because: B: Schick test is used to determine immunity to diphtheria, not tuberculosis. C: Anthraxine test is used for anthrax, not tuberculosis. D: Burnet test is not a recognized medical test for tuberculosis.

Correct Answer: C

Rationale: The correct answer is C: Prions. Prions are infectious proteins that lack nucleic acids, such as DNA or RNA, which are essential components of all other living organisms, including Archaea, Bacteria, and Viruses. Prions are unique in their ability to cause protein misfolding and aggregation in the brain, leading to various neurodegenerative diseases. The other choices (A: Archaea, B: Viruses, D: Bacteria) all contain nucleic acids in the form of DNA or RNA, making them distinct from prions. Therefore, C is the correct answer in this case.