Microscopy of a smear from a patient with foul-smelling diarrhea revealed large ciliated protozoa with a kidney-shaped macronucleus. What is the diagnosis?

Correct Answer: A

Rationale: The correct diagnosis is A: Balantidiasis. The presence of large ciliated protozoa with a kidney-shaped macronucleus is characteristic of Balantidium coli, the causative agent of balantidiasis. The ciliated trophozoites of Balantidium coli are unique compared to the other choices. Giardiasis is caused by Giardia lamblia, which has flagella and not cilia. Amoebiasis is caused by Entamoeba histolytica, which lacks cilia. Trichomoniasis is caused by Trichomonas vaginalis, which also lacks cilia. Therefore, based on the specific morphology described, the correct diagnosis is Balantidiasis.

Correct Answer: C

Rationale: The correct answer is C: Salmonella. This bacterium should be handled in a Biosafety Level 2 facility due to its potential to cause disease in humans. Salmonella is a pathogenic bacterium that can cause foodborne illnesses and infections. Handling it in a Biosafety Level 2 facility ensures proper containment and protection of personnel. A: Micrococcus luteus and B: Bacillus subtilis are common environmental bacteria that do not pose significant risks to human health, so they can be safely handled in lower biosafety levels. D: Staphylococcus epidermidis is a common skin commensal bacterium that is generally not considered highly pathogenic, so it does not require Biosafety Level 2 containment.

Correct Answer: C

Rationale: Rationale: 1. Vibrio cholerae produces cholera toxin causing severe diarrhea. 2. Clostridium tetani causes tetanus, not diarrhea. 3. Clostridium botulinum causes botulism, not diarrhea. 4. Shigella dysenteriae causes dysentery, not typical diarrhea. Summary: A: Incorrect, causes tetanus. B: Incorrect, causes botulism. C: Correct, produces cholera toxin causing severe diarrhea. D: Incorrect, causes dysentery.

Correct Answer: B

Rationale: The correct answer is B: H antigen. Flagellar antigen is typically referred to as the H antigen in bacteria. Flagella are the whip-like structures used for movement in bacteria, and the H antigen is specifically associated with the flagella. The other choices (A: D antigen, C: K antigen, D: F antigen) are not related to flagella in bacteria and are commonly associated with other types of antigens in bacterial classification.

Correct Answer: D

Rationale: The correct answer is D: Relapsing fever. The description matches Borrelia species, the causative agent of relapsing fever. The thin, spiral-shaped microorganisms with pointed ends and specific length are characteristic of Borrelia. The number of coils and size mentioned also align with Borrelia morphology. Relapsing fever is transmitted by tick bites and manifests as recurring febrile episodes. Incorrect choices: A: Syphilis - Syphilis is caused by Treponema pallidum, which is not spiral-shaped. B: Trypanosomiasis - Trypanosomiasis is caused by Trypanosoma species, which are not spiral-shaped. C: Leptospirosis - Leptospirosis is caused by Leptospira species, which are not spiral-shaped and do not match the specific description provided.

Correct Answer: A

Rationale: The correct answer is A: Neisser staining method. Neisser staining method is used to stain diphtheria bacilli, which appear as blue rods with thickenings at the poles. The rationale is that Neisser staining specifically targets and highlights the characteristics of the diphtheria bacilli. Incorrect choices: B: Gram staining is not specific for diphtheria bacilli and does not show the characteristic blue rods with thickenings at the poles. C: Ziehl-Neelsen staining is used for acid-fast bacteria like Mycobacterium tuberculosis, not for diphtheria bacilli. D: Loeffler staining is used for diphtheria bacilli but does not produce blue rods with thickenings at the poles as seen in this case.

Correct Answer: C

Rationale: Rationale: C is the correct answer because antibodies formed against Mycobacterium tuberculosis are not protective. They do not efficiently clear the infection due to the bacterium's ability to evade the immune response by residing intracellularly in macrophages. Antibodies play a minimal role in controlling tuberculosis compared to cell-mediated immunity. Summary: A is incorrect because Mycobacterium tuberculosis does contain mycolic acid in its cell wall. B is incorrect because the pathogen can indeed live intracellularly in macrophages. D is incorrect as C is the correct answer.

Correct Answer: B

Rationale: The correct answer is B: Salmonella enteritidis. In this case, the presence of Gram-negative rods producing gas in the blood culture indicates a likelihood of Salmonella infection, as it is a common cause of severe abdominal pain, vomiting, and gas production. Salmonella enteritidis is a known pathogen that can cause gastroenteritis and systemic infections. Escherichia coli (choice A) can also cause similar symptoms, but it is less likely to produce gas in blood culture. Clostridium perfringens (choice C) typically causes food poisoning with rapid onset and less likely to be isolated from blood cultures. Campylobacter jejuni (choice D) is associated with gastroenteritis but is less likely to cause systemic infections with gas-producing Gram-negative rods in blood culture.

Correct Answer: D

Rationale: The correct answer is D because viruses are sensitive to interferon, a natural defense mechanism of the body against viral infections. Interferon helps to inhibit viral replication. A: Viruses are cell-free infectious particles, not living systems. B: Viruses are obligate intracellular parasites as they require host cells to replicate. C: Viruses can have either DNA or RNA as genetic material, which is a characteristic feature.