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: BCG vaccine. Step 1: BCG vaccine is specifically designed to protect against tuberculosis, making it the appropriate choice for newborns. Step 2: STI vaccine is for sexually transmitted infections, not tuberculosis. Step 3: EV vaccine is not a recognized vaccine. Step 4: DPT vaccine protects against diphtheria, pertussis, and tetanus, not tuberculosis. In summary, BCG vaccine is the correct choice as it targets tuberculosis specifically, while the other options are designed for different purposes.

Correct Answer: B

Rationale: The correct answer is B: Streptococcus mutans. This bacterium is associated with the formation of dental caries due to its ability to metabolize sugars and produce acids that demineralize tooth enamel. Streptococcus pneumoniae (choice A) is not typically associated with dental caries. Bacillus anthracis (choice C) causes anthrax, not dental caries. Clostridium botulinum (choice D) causes botulism, not dental caries. Streptococcus mutans' unique characteristics make it the correct choice for the bacteria associated with dental caries.

Correct Answer: D

Rationale: The correct answer is D. Staphylococcus aureus, Escherichia coli, and Clostridium difficile are all known for causing hospital-acquired infections. Staphylococcus aureus can cause skin infections and pneumonia. Escherichia coli can lead to urinary tract infections. Clostridium difficile is associated with gastrointestinal infections. Each of these bacteria has been linked to healthcare-associated infections due to their ability to spread in healthcare settings. Therefore, the correct answer is D. Choices A, B, and C are incorrect because each of these bacteria individually is known to cause hospital-acquired infections.

Correct Answer: A

Rationale: The correct answer is A: Brill's disease. Brill's disease is a relapse of typhus that occurs in patients who had typhus in their youth. The patient's history of having typhus at 15 years old is a key indicator. Brill's disease is characterized by symptoms such as rash, fever, and dizziness, which align with the patient's current presentation. Summary of other choices: B: Typhoid fever - While typhoid fever may present with similar symptoms to typhus, the patient's history of having typhus in the past makes this less likely. C: Measles - Measles does not typically present with dizziness, and the patient's history of typhus in the past is more indicative of Brill's disease. D: Rubella - Rubella does not typically cause dizziness, and the patient's history of typhus in the past points more towards Brill's disease.

Correct Answer: D

Rationale: The correct answer is D: Viscerotropic Leishmania. The presence of crescent-shaped bodies with pointed tips, blue cytoplasm, and red nuclei is characteristic of Leishmania species. Viscerotropic Leishmania causes visceral leishmaniasis, also known as kala-azar, which affects the internal organs. Toxoplasma typically presents as tachyzoites, not crescent-shaped bodies. Plasmodium malariae is a malaria parasite with different morphology. Dermatotropic Leishmania causes cutaneous leishmaniasis, not the visceral form indicated by the morphology described in the question.

Correct Answer: A

Rationale: The correct answer is A: Clostridium tetani. The presence of Gram-positive rods with terminal spores resembling drumsticks indicates Clostridium tetani, the causative agent of tetanus. This bacterium forms spores at one end, giving it a drumstick appearance under the microscope. Clostridium perfringens (B) and Clostridium botulinum (D) do not have terminal spores. Bacillus anthracis (C) forms spores but typically appears as a square-ended or bamboo stick shape. Therefore, based on the microscopy findings, Clostridium tetani is the most likely microorganism responsible for the wound infection.

Correct Answer: D

Rationale: The correct answer is D: commensalism. In commensalism, one organism benefits while the other is neither helped nor harmed. In this relationship, the waste product of one organism serves as a nutrient source for another without affecting the first organism. Mutualism (A) involves both organisms benefiting, competition (B) involves a struggle for resources, and synergism (C) involves cooperative interactions. Commensalism is the only choice where one organism benefits from the waste product of another without any impact on the producer.

Correct Answer: A

Rationale: The correct answer is A: Francisella tularensis. This bacterium is classified as a class A bioterrorism agent due to its high virulence and potential for mass casualties. It can cause tularemia, a severe and potentially fatal disease. The other choices, Hepatitis B, E. coli, and Bacillus subtilis, are not considered class A bioterrorism agents. Hepatitis B is a virus causing liver inflammation, E. coli is a common bacterium found in the gut, and Bacillus subtilis is a beneficial bacterium used in various industries. Therefore, Francisella tularensis is the correct choice based on its high pathogenicity and bioterrorism potential.