Following treatment with a highly efficient anti-tuberculosis drug a 48-yearold female developed optic nerve neuritis, memory impairment, cramps. Which of these anti-TB drugs had the patient taken?

Correct Answer: D

Rationale: Step 1: The symptoms of optic nerve neuritis, memory impairment, and cramps are indicative of ethambutol toxicity. Step 2: Ethambutol is known to cause optic nerve toxicity leading to neuritis, as well as CNS toxicity causing memory impairment. Step 3: Ethambutol can also lead to peripheral neuropathy manifesting as cramps. Step 4: Isoniazid is associated with peripheral neuropathy and hepatotoxicity but not with optic nerve neuritis or memory impairment. Step 5: PASA is not commonly used for tuberculosis treatment and does not cause the described symptoms. Step 6: Rifampicin is known for hepatotoxicity and flu-like symptoms, but not specifically for optic nerve neuritis, memory impairment, or cramps. Summary: Ethambutol is the correct answer due to its known side effects of optic nerve toxicity, CNS toxicity, and peripheral neuropathy, which align with the presented symptoms. Ison

Correct Answer: D

Rationale: The correct answer is D: Trichomonas tenax. Trichomonas tenax is a flagellated protozoan that is commonly found in the oral cavity, specifically in dental plaque. The description provided in the question matches the characteristics of Trichomonas tenax, such as unicellular structure, distinct layers in the cytoplasm, wide pseudopodia, and barely visible core. Entamoeba gingivalis (choice A) and Entamoeba histolytica (choice B) are amoebas, not flagellated protozoa, and they do not exhibit the characteristics described in the question. Lamblia (choice C) is also an incorrect choice as it is a different type of protozoan that does not match the description provided.

Correct Answer: A

Rationale: The correct answer is A: Actinomycosis. This is a chronic bacterial infection caused by Actinomyces species. In this case, the description of dense yellow-green colored focus, white granules in purulent masses, and presence of fungal druses, plasma cells, xanthome cells, and macrophages all match the characteristics of actinomycosis. Actinomycosis typically presents with abscess formation containing sulfur granules, which are yellowish and granular. The other choices (B: Furuncle, C: Carbuncle, D: Syphilis) do not fit the clinical and histological features described in the question, making them incorrect options.

Correct Answer: B

Rationale: The correct answer is B: colonization. E. Coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa in the pharynx indicate colonization rather than being part of the normal resident flora. Colonization refers to the presence of these bacteria on body surfaces without causing harm. They are not considered normal flora in the pharynx but rather transient or opportunistic pathogens. Choice A is incorrect because these bacteria are not part of the normal resident flora of the pharynx. Choice C is incorrect as it implies that these bacteria are both normal flora and colonization, which is not accurate. Choice D is incorrect as there is evidence of bacterial presence, indicating colonization.

Correct Answer: A

Rationale: The correct answer is A: Mycobacterium tuberculosis. This bacteria is responsible for causing tuberculosis because it is the specific pathogen known to infect the lungs and other parts of the body, leading to the disease. Mycobacterium tuberculosis has unique cell wall components that allow it to evade the immune system and survive in the host. Neisseria meningitidis (B) causes meningitis, not tuberculosis. Salmonella enterica (C) causes food poisoning, not tuberculosis. Streptococcus pneumoniae (D) causes pneumonia, not tuberculosis. Therefore, the correct answer is A based on the specific characteristics and pathogenicity of Mycobacterium tuberculosis.

Correct Answer: B

Rationale: Protein A is a virulence factor specific to Staphylococcus aureus. This protein binds to the Fc region of immunoglobulins, inhibiting opsonization and phagocytosis. Therefore, the correct answer is B. Coagulase negative staphylococcus (choice A) does not produce Protein A. Micrococcus (choice C) is a different genus and does not possess Protein A. Choice D is incorrect because Protein A is indeed found in Staphylococcus aureus.

Correct Answer: A

Rationale: The correct answer is A: Gram staining method. This method involves staining with gentian violet, followed by Lugol's solution, 96% alcohol decolorization, and counterstaining with safranin or water-magenta. This staining sequence allows for the differentiation of bacteria based on their cell wall composition. In the case of lobar pneumonia, the causative agent is typically a bacterium with a cell wall that retains the crystal violet stain after decolorization with alcohol, indicating a Gram-positive bacterium. Summary of Incorrect Choices: B: Ziehl-Nielsen staining is used for acid-fast bacteria like Mycobacterium tuberculosis, not for lobar pneumonia. C: Romanovsky staining is primarily used in the identification of blood cells and blood parasites, not for bacteria. D: Neisser staining is not a commonly used staining method in microbiology for bacterial identification.

Correct Answer: C

Rationale: The correct answer is C: Tuberculosis. Granulomas with lymphocytes and macrophages containing Virchow's cells (large cells with fat inclusions containing microorganisms) are classic findings in tuberculosis. Leprosy (A) typically presents with granulomas but with different histopathological features. Syphilis (B) does not usually form granulomas in the skin. Rhinoscleroma (D) is a chronic bacterial infection characterized by nodular lesions but does not typically involve Virchow's cells as seen in tuberculosis.

Correct Answer: A

Rationale: The correct answer is A: Shigella dysenteriae. Shigella causes dysentery, characterized by bloody diarrhea and abdominal pain. Shigella is a non-lactose-fermenting, Gram-negative rod. B: Salmonella typhi causes typhoid fever, not typically associated with abdominal pain and diarrhea. C: Escherichia coli, a common gut bacteria, can cause diarrhea but typically ferments lactose. D: Proteus vulgaris is not a common cause of gastrointestinal infection and is not typically associated with abdominal pain and diarrhea.