On the 15-th day after a minor trauma of the right foot a patient felt malaise, fatigability, irritability, headache, high body temperature, feeling of compression, tension and muscular twitching of his right crus. What disease can it be?

Correct Answer: A

Rationale: The correct answer is A: Tetanus. Tetanus is caused by the bacterium Clostridium tetani, which produces a toxin affecting the nervous system. Symptoms such as malaise, irritability, muscular twitching, and high body temperature are characteristic of tetanus due to muscle spasms and rigidity. The 15-day incubation period after trauma aligns with the typical onset of tetanus symptoms. Incorrect choices: B: Anaerobic gas gangrene - This condition usually presents with localized tissue necrosis and gas bubbles in the affected area, not systemic symptoms like malaise and headache. C: Erysipelas - This is a bacterial skin infection presenting with red, swollen patches, not the neurological symptoms seen in tetanus. D: Acute thrombophlebitis - This is a blood clot in a vein causing pain and swelling, not associated with the systemic symptoms and muscle twitching seen in tetanus.

Correct Answer: A

Rationale: The correct answer is A because a soft chancre is a type of sexually transmitted infection caused by the bacterium Haemophilus ducreyi. It presents as a painless ulcer on the genitals. The other choices are incorrect. B is incorrect because STIs can enter the body through various routes, not only the urogenital tract mucosa. C is incorrect because immunity to syphilis is not lifelong; reinfection is possible. D is incorrect because STIs can occur in any country regardless of social status or hygiene levels.

Correct Answer: A

Rationale: The correct answer is A because immunity in syphilis is nonsterile, meaning that individuals who have been infected may still carry the bacteria and be capable of transmitting the disease. This is due to the ability of the bacterium causing syphilis, Treponema pallidum, to evade the immune system by hiding within host cells. Option B, antitoxic, is incorrect because syphilis is not caused by a toxin produced by the bacteria, but rather by the bacterium itself. Option C, humoral, is also incorrect as syphilis immunity involves both humoral (antibody-mediated) and cell-mediated immune responses, not solely humoral immunity. Option D is incorrect as it includes all three options, whereas in reality, the immunity in syphilis is primarily nonsterile.

Correct Answer: A

Rationale: The correct answer is A: Kitt-Tarozzi medium. This medium is used for the primary inoculation of suture material suspected of causing tetanus. The rationale is that Kitt-Tarozzi medium contains the necessary nutrients to support the growth of Clostridium tetani, the bacterium responsible for tetanus. This medium is selective and helps in isolating the specific pathogen from the contaminated suture material. Summary of other choices: B: Endo agar is used for the isolation of Gram-negative bacteria from clinical and non-clinical samples. C: Sabouraud agar is used for the isolation of fungi and yeast. D: Egg-yolk salt agar is used for the detection of lipase-producing bacteria, particularly Staphylococcus aureus.

Correct Answer: D

Rationale: The correct answer is D: Hyaluronidase synthesis. Hyaluronidase is an enzyme produced by some pathogens to break down hyaluronic acid in the extracellular matrix, aiding their spread. This action does not directly counteract the immune system's mechanisms. Antigenic heterogeneity and mimicry can evade immune recognition. IgA proteases degrade IgA antibodies, impairing mucosal immunity. Therefore, D is the only choice not directly involved in counteracting the immune system.

Correct Answer: A

Rationale: The correct answer is A: Staphylococcus epidermidis. 1. Gram-positive cocci suggest a staphylococcal species. 2. Catalase-positive indicates it belongs to the Staphylococcus genus. 3. Coagulase-negative rules out Staphylococcus aureus. 4. Staphylococcus epidermidis is a common cause of infections in immunocompromised patients. Summary: - B: Staphylococcus aureus is coagulase-positive. - C: Streptococcus pneumoniae is a Gram-positive diplococci. - D: Neisseria meningitidis is a Gram-negative diplococci.

Correct Answer: D

Rationale: The correct answer is D because hospital-acquired infections can be caused by a variety of microorganisms, including opportunistic pathogens and obligate pathogens such as bacteria or viruses. Opportunistic microorganisms take advantage of weakened immune systems in hospital patients, while obligate pathogens are capable of causing infections in healthy individuals. Therefore, all the choices are correct in this context as they represent potential etiological causes of hospital-acquired infections.

Correct Answer: A

Rationale: The correct answer is A: Gin's stain method. Gin's stain method is specifically used to detect capsules of bacteria. This method involves staining the bacteria with crystal violet and copper sulfate, which highlights the capsules as a clear halo around the stained bacterial cells. Ziehl-Neelsen's stain is used for acid-fast bacteria like Mycobacterium tuberculosis, Neisser's stain is for detecting Neisseria species, and Gram's stain is for differentiating bacteria based on their cell wall composition (Gram-positive vs. Gram-negative). Therefore, choices B, C, and D are incorrect for this scenario.

Correct Answer: A

Rationale: The correct answer is A: Entamoeba histolytica. This is because it is a protozoan parasite known to cause amoebic dysentery, presenting with chronic diarrhea and cysts with four nuclei in the stool sample. Giardia lamblia (B) causes giardiasis with trophozoites and cysts with two nuclei. Balantidium coli (C) is a ciliated parasite causing dysentery with large trophozoites. Trichomonas hominis (D) is a non-pathogenic flagellate often found in the human intestine. Thus, based on the specific characteristics of the cysts and clinical presentation, Entamoeba histolytica is the most likely causative agent.