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: A

Rationale: The correct answer is A: Pseudomonas aeruginosa. P. aeruginosa is a Gram-negative rod that is a lactose non-fermenter commonly associated with deep tissue infections. It is an opportunistic pathogen known for its ability to cause infections in immunocompromised individuals. P. aeruginosa is often resistant to multiple antibiotics and can form biofilms, making it difficult to treat. Summary of why other choices are incorrect: B: Escherichia coli is a Gram-negative rod that ferments lactose and is commonly found in the gastrointestinal tract. It is not typically associated with deep tissue infections. C: Salmonella typhi is a Gram-negative rod that causes typhoid fever, primarily affecting the gastrointestinal system, not deep tissue infections. D: Shigella dysenteriae is a Gram-negative rod that causes bacillary dysentery, which primarily affects the gastrointestinal tract and does not typically cause deep tissue infections.

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: A

Rationale: The correct answer is A: Clostridium botulinum. Clostridium botulinum produces the botulinum toxin, which causes botulism. This bacteria thrives in anaerobic environments and can contaminate improperly canned foods. Clostridium tetani causes tetanus, not botulism. Staphylococcus aureus produces enterotoxins causing food poisoning, not botulism. Escherichia coli can cause food poisoning through various toxins, but not botulism. Therefore, the correct choice is Clostridium botulinum as it specifically produces the botulinum toxin responsible for botulism.

Correct Answer: A

Rationale: The correct answer is A: Anthroponoses. This term refers to diseases caused by specific human parasites that are transmitted directly from human to human. In this case, the source of parasite invasion is always a human host. This term specifically describes diseases caused by parasites that exclusively infect humans. Choice B: Zoonoses refers to diseases that can be transmitted from animals to humans. Choice C: Anthropozoonoses is a combination of zoonoses and anthroponoses, which is not applicable in this scenario. Choice D: Infections is a general term that does not specify the source or type of parasite causing the disease.

Correct Answer: B

Rationale: The correct answer is B: Contains single-stranded RNA with negative polarity. Measles virus is an enveloped virus with a single-stranded RNA genome that is negative-sense. This means it must first be transcribed into positive-sense RNA before it can be translated. Choice A is incorrect as the measles virus does have an outer envelope. Choice C is incorrect as measles virus belongs to the family Paramyxoviridae, not Togaviridae. Choice D is incorrect as measles virus can be grown on cell cultures, specifically on Vero cells.

Correct Answer: A

Rationale: The correct answer is A: Entamoeba histolytica. This is because the presence of cysts with four nuclei is characteristic of Entamoeba histolytica, a protozoan parasite that causes amoebic dysentery. Entamoeba histolytica cysts contain four nuclei, distinguishing them from other pathogens. Giardia lamblia and Trichomonas vaginalis are not associated with cysts containing four nuclei. Balantidium coli is a ciliated protozoan that does not typically form cysts with multiple nuclei. In summary, the unique feature of four nuclei in the cysts points towards Entamoeba histolytica as the most likely causative agent of the diarrhea in this patient.

Correct Answer: A

Rationale: Step 1: Pear-shaped protozoa with two nuclei, four pairs of flagella, two axostyles, and a ventral adhesive disc match the characteristics of Giardia lamblia. Step 2: Giardia lamblia is commonly found in the duodenum and causes giardiasis. Step 3: Lamblia is the correct answer as it specifically matches all the described characteristics. Summary: B, Toxoplasma, is incorrect as it does not match the described features. C, Leishmania, does not have the specific characteristics mentioned. D, Intestinal trichomonad, does not match the detailed descriptions given.

Correct Answer: A

Rationale: The correct answer is A: Hyperresponsiveness reaction type IV. This type of reaction, also known as delayed-type hypersensitivity, is characterized by the activation of T lymphocytes and macrophages, leading to inflammation at the site of antigen exposure. In the case of the Mantoux test, the appearance of a papule 48 hours later indicates a delayed hypersensitivity reaction mediated by T cells. Choice B: Reaction of Arthus phenomenon type is incorrect as this type of reaction involves immune complexes forming in the blood vessels leading to tissue damage, which is not the mechanism seen in the Mantoux test reaction. Choice C: Reaction of serum sickness type is incorrect as this type of reaction involves the formation of immune complexes in the blood leading to systemic symptoms like fever, rash, and joint pain, which is not typically seen in the Mantoux test reaction. Choice D: Atopic reaction is incorrect as atopic reactions involve IgE antibodies and mast cell degranulation, which are not the mechanisms