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: D

Rationale: The correct answer is D because virulent strains of Listeria monocytogenes exhibit multiple pathogenic factors. A: They do not have endotoxin-like substances, so this is incorrect. B: They are indeed facultative intracellular bacteria, aiding in their ability to survive and replicate inside host cells. C: They produce hemolysin, which helps them lyse red blood cells. Therefore, the correct answer is D, as all of the above statements are true for virulent strains of Listeria monocytogenes.

Correct Answer: A

Rationale: The correct answer is A: Haemolytic streptococci. Hemolytic streptococci are known to cause serious infections in humans, including strep throat and skin infections. These bacteria have the potential to spread rapidly and cause epidemics. Bacilli are a broad category of bacteria and not all are necessarily harmful. Micrococci are commonly found on human skin and are generally harmless. Yeast fungi are also commonly found in the environment and are not typically associated with causing epidemics. Therefore, the presence of hemolytic streptococci in the air of a pharmacy indicates a direct epidemic danger due to their pathogenic nature and potential to cause widespread infections.

Correct Answer: C

Rationale: Rationale: 1. Shigella invades and multiplies within the intestinal epithelial cells, causing inflammation and tissue damage locally. 2. It does not spread systemically, unlike Yersinia enterocolitica and Listeria monocytogenes. 3. Shigella's pathogenesis is focused on invasion and multiplication at the site of infection, leading to symptoms of dysentery. 4. Yersinia enterocolitica and Listeria monocytogenes can disseminate beyond the gastrointestinal tract, causing systemic infections. Summary: - A (Yersinia enterocolitica) and B (Listeria monocytogenes) are incorrect as they can generalize the infectious process. - C (Shigella) is correct as it mainly involves invasion and intraepithelial multiplication without spreading systemically.

Correct Answer: D

Rationale: The correct answer is D: stereomicroscopes. These types of microscopes, also known as dissecting microscopes, are designed for observing larger objects like insects or worms. They have a lower magnification power compared to electron microscopes (A), which are used to observe smaller objects at a much higher resolution. Dark-field microscopes (B) are used for observing live and unstained samples with high contrast, not specifically for larger objects. Fluorescence microscopes (C) are used to observe specimens that fluoresce under specific wavelengths of light, not necessarily for large objects like insects or worms. Therefore, the most suitable choice for observing fairly large objects like insects or worms is stereomicroscopes.

Correct Answer: D

Rationale: The correct answer is D: Granulomatosis. The appearance of a 10 mm papule 48 hours after the Mantoux test indicates a delayed-type hypersensitivity reaction, which is characteristic of granulomatosis. This type of reaction involves activation of macrophages and T cells, leading to the formation of granulomas. Granulomas are organized collections of immune cells that wall off the antigen, in this case, the tuberculin antigen. A, B, and C are incorrect: A: Cellular cytotoxicity involves the destruction of target cells by immune cells such as cytotoxic T cells or natural killer cells. This mechanism is not associated with the delayed-type hypersensitivity reaction seen in granulomatosis. B: Anaphylaxis is a rapid and severe allergic reaction involving IgE-mediated release of histamine and other inflammatory mediators. This is not the mechanism underlying the delayed-type hypersensitivity reaction in the Mantoux test. C: Antibody-dependent cytotoxic

Correct Answer: C

Rationale: Rationale: 1. Candida is a fungus commonly isolated from clinical specimens. 2. Sabouraud agar is the most suitable medium for Candida due to its low pH and high dextrose content. 3. Low pH inhibits bacterial growth, while dextrose promotes fungal growth. 4. Zeisler media, Chocolate agar, and Muller-Hinton agar are not specific for fungal isolation. Summary: - Zeisler media is used for anaerobic bacteria. - Chocolate agar is used for fastidious organisms like Haemophilus. - Muller-Hinton agar is for antibiotic susceptibility testing, not fungal isolation.

Correct Answer: B

Rationale: The correct answer is B: Cholera. Cholera is caused by Gram-negative curved rod-like bacteria called Vibrio cholerae, commonly found in contaminated water or food. The characteristic symptom of cholera is profuse watery diarrhea, which matches the patient's presentation. Typhoid fever (A) is caused by Salmonella typhi, which is not a curved rod-like bacteria. Diphtheria (C) is caused by Corynebacterium diphtheriae, a Gram-positive bacterium, and does not typically cause diarrhea. Intestinal form of plague (D) is caused by Yersinia pestis, which is not a curved rod-like bacteria and does not typically present with diarrhea.

Correct Answer: A

Rationale: The correct answer is A: Giardia lamblia. Giardia is a flagellated protozoa with two nuclei, causing diarrhea. It is commonly found in contaminated water sources. Entamoeba histolytica (B) causes amoebic dysentery with trophozoites in stool. Trichomonas vaginalis (C) causes sexually transmitted infections, not diarrhea. Balantidium coli (D) is a ciliated protozoa causing dysentery with ciliated trophozoites. Therefore, Giardia lamblia is the most likely causative agent in this case.