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: A

Rationale: Rationale for Correct Answer A (Lamblia): 1. Pyriform protozoa with twin nuclei, four pairs of flagella, and a suctorial disc match the characteristics of Giardia lamblia. 2. The presence of two supporting filaments between the nuclei is a unique feature of Giardia lamblia. 3. Giardia lamblia is known to infect the duodenum and cause symptoms such as diarrhea and abdominal pain. Summary of Incorrect Choices: B: Toxoplasma - Toxoplasma gondii is not characterized by four pairs of flagella or supporting filaments in the nuclei. C: Leishmania - Leishmania species do not typically have the described morphology or location in the duodenum. D: Intestinal trichomonad - Intestinal trichomonads do not exhibit the specific features mentioned in the question, such as twin nuclei and supporting filaments.

Correct Answer: C

Rationale: The pertussis toxin inhibits the adenylate cyclase-mediated conversion of ATP to cyclic AMP, leading to decreased levels of cyclic AMP in the cell. This disrupts important cellular signaling pathways, affecting immune response and causing symptoms of pertussis. Choices A, B, and D are incorrect because the pertussis toxin does not directly affect protein synthesis, provoke overproduction of mucus in tracheal cells, or provoke release of electrolytes.

Correct Answer: A

Rationale: The correct answer is A: Vibrio cholerae. This bacterium is the likely causative agent because it is known to cause severe diarrhea, and it is characterized by its motile, comma-shaped Gram-negative rods. Vibrio cholerae produces cholera toxin, leading to profuse watery diarrhea. Shigella dysenteriae causes dysentery with bloody diarrhea, Salmonella typhi causes typhoid fever, and Escherichia coli can cause various types of diarrhea but typically does not have a comma shape.

Correct Answer: C

Rationale: Step-by-step rationale: 1. Shigella is a nonmotile bacterium. 2. This lack of motility is a key characteristic used to differentiate it from other enteric bacteria. 3. Nonmotile nature of Shigella helps it to cause infections by invading the intestinal epithelial cells. 4. Therefore, choice C is correct as Shigella is indeed nonmotile. Summary: A: Incorrect - Shigella does not produce hydrogen sulfide. B: Incorrect - Shigella does not ferment lactose. D: Incorrect - Shigella is not mannitol positive.

Correct Answer: D

Rationale: The correct answer is D (4) because biosafety levels range from 1 to 4, each corresponding to the level of containment required when handling different types of organisms. BSL-1 is for low-risk agents, while BSL-4 is for dangerous pathogens. Choice A (1) is incorrect as there are multiple levels, not just one. Choice B (2) and C (3) are incorrect as they do not account for all the levels of biosafety required for handling various organisms. Therefore, D is the correct answer as it encompasses the full range of biosafety levels.

Correct Answer: D

Rationale: The correct answer is D: Salmonella typhi. Typhoid fever is caused by the bacterium Salmonella typhi. This bacterium is responsible for causing the systemic infection that leads to symptoms such as high fever, abdominal pain, and diarrhea. Yersinia pestis (choice A) causes plague, Shigella dysenteriae (choice B) causes dysentery, and Escherichia coli (choice C) can cause various gastrointestinal infections, but not typhoid fever. Salmonella typhi specifically targets the intestines and is transmitted through contaminated food or water. Therefore, choice D is the correct answer for the cause of typhoid fever.

Correct Answer: B

Rationale: Transduction is the transfer of genetic material between bacterial cells with the help of a phage (virus). This process involves a phage infecting a bacterial cell, replicating inside it, and then transferring bacterial DNA along with phage DNA to another bacterial cell. This is different from transformation (choice A) which involves the uptake of naked DNA by a bacterial cell and plasmid transfer (choice C) which involves the transfer of small, circular DNA molecules. Therefore, the correct answer is B because it specifically describes the process of transduction in bacteria, while choices A and C describe different mechanisms of genetic transfer.

Correct Answer: A

Rationale: The most likely diagnosis is Reiter's syndrome. This is suggested by the presence of joint pain, fever, elevated ESR and CRP levels, and chlamydia infection. Reiter's syndrome is a reactive arthritis triggered by an infection elsewhere in the body, such as chlamydia. The patient's symptoms of joint pain and swelling, along with the positive chlamydia test, support this diagnosis. Rheumatic arthritis (Choice B) is not associated with chlamydia infection, making it less likely. Gout (Choice C) typically presents with elevated uric acid levels, which are normal in this case. Bechterew's disease (Choice D) primarily affects the spine and sacroiliac joints, not the sternoclavicular and knee joints as seen in this patient.

Correct Answer: C

Rationale: Rationale: 1. Helicobacter pylori is known for producing urease enzyme to neutralize stomach acid. 2. Urease enzyme converts urea into ammonia, buffering the acidic pH. 3. This adaptation allows H. pylori to survive in the acidic environment of the stomach. 4. Salmonella typhi, Escherichia coli, and Shigella flexneri do not produce urease. 5. Therefore, C is the correct answer based on the unique urease-producing capability of H. pylori.