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: B

Rationale: The correct answer is B: For HIV. Pneumocystis pneumonia in a young man with CD4+ cells less than 200/mm3 is highly suggestive of HIV infection. HIV weakens the immune system, leading to opportunistic infections like pneumocystis pneumonia. Testing for HIV is crucial for diagnosis and appropriate management. Explanation for other choices: A: Testing for ureaplasma urealyticum is not indicated in this case as the symptoms and CD4+ cell count point towards an HIV-related infection. C: Testing for Treponema pallidum (syphilis) is not relevant in the context of a young man with pneumocystis pneumonia and low CD4+ cell count. D: Testing for Neisseria gonorrhoea is not appropriate in this scenario as the symptoms and CD4+ cell count suggest an underlying HIV infection rather than a bacterial sexually transmitted infection.

Correct Answer: B

Rationale: The correct answer is B: Transformation. Frederick Griffith discovered bacterial transformation, where genetic material can be transferred between bacteria. He observed this phenomenon while studying pneumonia-causing bacteria in 1928. Transformation is the process by which bacteria take up external DNA and incorporate it into their own genome. This discovery was crucial in understanding how genetic information can be transferred between organisms. Rationale for other choices: A: Translation - This term refers to the process of protein synthesis from mRNA, not relevant to Griffith's discovery. C: Transcription - This term refers to the process of synthesizing RNA from DNA, not related to Griffith's discovery. D: Conjugation - This term refers to the direct transfer of genetic material between bacterial cells through cell-to-cell contact, which is different from the phenomenon Griffith observed.

Correct Answer: B

Rationale: The correct answer is B: Agglutination. During a suspected plague outbreak, agglutination testing is used to quickly identify the antigen of the causative agent. In this test, specific antibodies are added to a sample containing the suspected antigen. If the antigen is present, it will clump together (agglutinate) with the antibodies, indicating a positive result. This method is rapid and efficient for identifying the presence of the plague-causing agent. Choice A: Precipitation involves the formation of a visible precipitate when antigen and antibody react, but it is not as quick or specific as agglutination for identifying the antigen in this scenario. Choice C: Passive hemagglutination is a variation of agglutination that uses red blood cells as carriers for antigens or antibodies. While it can be useful in certain situations, it is not typically the first choice for rapid identification of plague antigen. Choice D: Complement binding is a different type of

Correct Answer: D

Rationale: The correct answer is D: protozoan. Malaria is caused by Plasmodium parasites transmitted through the bite of infected female Anopheles mosquitoes. These parasites belong to the protozoa kingdom, not viruses (choice A), bacteria (choice B), or helminths (choice C). Protozoa have complex life cycles involving both mosquito and human hosts, leading to the development of malaria in humans. Other choices are incorrect as they do not align with the known etiology and characteristics of malaria.

Correct Answer: A

Rationale: The correct answer is A: endogenous infections. This term refers to infections caused by microorganisms that are normally present in or on the body. In the context of vaginal infections, an overgrowth of the normal flora can lead to an imbalance and result in infection. Choice B, chronic infections, does not specifically address the source of the infection. Choice C, iatrogenic infections, refers to infections caused by medical intervention, not normal flora overgrowth. Choice D, fatal infections, is incorrect as it does not describe the nature or source of the infection. In summary, the term "endogenous infections" accurately describes the scenario of vaginal infections caused by an overgrowth of normal flora.

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: BCG. Bacille Calmette-Guérin (BCG) vaccine is used for the prevention of tuberculosis. BCG is a live attenuated strain of Mycobacterium bovis that helps the immune system recognize and fight off tuberculosis bacteria. Specific anti-tuberculosis serum (A) is not used for prevention but for treatment. DTP (C) stands for diphtheria, tetanus, and pertussis vaccine, not specific for tuberculosis prevention. PPD (D) is a tuberculin skin test used for diagnosis, not prevention. Thus, BCG is the correct choice for tuberculosis prevention.

Correct Answer: D

Rationale: The correct answer is D: Chocolate agar. Neisseria meningitidis is a fastidious organism that requires enriched media for growth. Chocolate agar contains heat-treated blood that provides essential nutrients for the growth of N. meningitidis. The other choices, A: Levine agar, B: Lowenstein-Jensen agar, and C: TCBS agar, do not provide the specific nutrients required for the growth of N. meningitidis. Therefore, only choice D, Chocolate agar, supports the growth of N. meningitidis due to its enriched composition.