From urine of a 14-year-old boy with the exacerbation of secondary obstructive pyelonephritis Pseudomonas aeruginosa was isolated with a titer of 1000000 microbes per 1 ml. Which antibiotic is most advisable to be administered in this case?

Correct Answer: A

Rationale: The correct answer is A: Ciprofloxacin. Pseudomonas aeruginosa is commonly resistant to Ampicillin, Cefazolinum, and Azithromycin. Ciprofloxacin is a fluoroquinolone antibiotic known for its efficacy against Pseudomonas aeruginosa. Its broad spectrum and ability to penetrate tissues make it the most advisable choice for treating secondary obstructive pyelonephritis caused by this pathogen.

Correct Answer: A

Rationale: The correct answer is A: Trichomonads. Trichomonads are pear-shaped protozoa, typically 6-13 micrometers long, with one nucleus, undulating membrane, and four flagella at the front. These characteristics match the description provided in the question. Trichomonads are commonly found in oral cavities and can cause gum infections like periodontosis. Summary: - B: Leishmania - Leishmania is a flagellated protozoan responsible for Leishmaniasis, not typically found in the oral cavity. - C: Amoebae - Amoebae are not pear-shaped and do not have the specific characteristics described in the question. - D: Balantidia - Balantidia are ciliated protozoa, not flagellated like trichomonads, and are not typically associated with gum infections.

Correct Answer: A

Rationale: The correct answer is A: Shigella dysenteriae. It is the likely causative agent because it is a non-lactose-fermenting, Gram-negative rod commonly associated with severe diarrhea. Shigella dysenteriae specifically causes bacillary dysentery. Other choices are incorrect because: B: Escherichia coli is a lactose-fermenting bacterium commonly found in the gut and not typically associated with severe diarrhea. C: Salmonella typhi causes typhoid fever, not severe diarrhea. D: Proteus mirabilis is a urease-positive bacterium associated with urinary tract infections, not severe diarrhea.

Correct Answer: B

Rationale: The correct answer is B: peak effect. When drug receptors are maximally activated, it means the drug has reached its highest effectiveness, resulting in the peak effect. This occurs when the drug concentration is at its highest level in the body, leading to the maximum response. Threshold level (A) refers to the minimum amount of drug needed to produce a response. Cessation effect (C) is when the drug's effect wears off. Latency time (D) is the time it takes for the drug to start producing an effect. So, the peak effect best describes the scenario where drug receptors are maximally activated.

Correct Answer: B

Rationale: The correct answer is B: Aminoglycosides. Aminoglycosides are antibiotics that act by binding to the 30S ribosomal subunit, disrupting protein synthesis in bacteria. This interaction affects the ribosomes directly, leading to inhibition of bacterial protein production. Penicillins (A) work by inhibiting cell wall synthesis, Sulfonamides (C) target folic acid synthesis, and Quinolones (D) inhibit DNA gyrase. These mechanisms do not directly affect the ribosomes, making them incorrect choices in this context.

Correct Answer: B

Rationale: The correct answer is B: Trichomonas vaginalis. Trichomonas vaginalis is a protozoan parasite that can survive and grow in low moisture conditions. It does not require a host cell and can thrive in moist environments, making it able to grow on substances with very low moisture content. Giardia lamblia (A), Balantidium coli (C), and Entamoeba histolytica (D) are all parasites that require a host to survive and reproduce, making them unable to grow on substances with very low moisture content. Trichomonas vaginalis is the only organism among the choices that fits the criteria of being able to grow on low moisture substances.

Correct Answer: B

Rationale: The correct answer is B: Legionella and Neisseria are both gram-negative aerobic rods and cocci. Legionella is a rod-shaped bacterium, while Neisseria is a diplococcus. Both are aerobic, meaning they require oxygen for growth. The other choices are incorrect because Legionella and Neisseria are not facultative anaerobes (A), spirochetes (C), or anaerobic cocci (D). Understanding the characteristics of these bacteria helps in differentiating and selecting the correct answer.

Correct Answer: C

Rationale: The correct answer is C: Measles serological test. This is because the clinical presentation of high fever, maculopapular rash, and Filatov-Koplik's spots on the buccal mucosa are classic symptoms of measles. The presence of Filatov-Koplik's spots is highly specific for measles. Performing a measles serological test will help confirm the diagnosis by detecting measles-specific antibodies in the blood. Incorrect choices: A: Mumps serological test - Mumps typically presents with parotitis (swelling of the parotid glands) and not with Filatov-Koplik's spots. B: Enteroviruses serological test - Enteroviruses do not typically cause Filatov-Koplik's spots or the classic triad of symptoms seen in measles. D: Influenza virus serological test - Influenza virus does not cause Filatov-Koplik's spots and the characteristic rash seen

Correct Answer: C

Rationale: The correct answer is C: ECHO virus infection. ECHO virus is transmitted via the fecal-oral route, meaning the virus is passed from feces to the mouth. This transmission occurs through contaminated food, water, or surfaces. Relapsed fever and spotted fever are generally transmitted by arthropod vectors like ticks. Pertussis, also known as whooping cough, spreads through respiratory droplets. Therefore, the fecal-oral route is not applicable to these diseases.