On the 5th day after a surgery for colon injury a patient complains of bursting pain in the postoperative wound, weakness, drowsiness, headache, fever up to 40oC. Objectively: the skin around the wound is swollen, there is gas crepitation. The wound discharges are scarce foul-smelling, of dark-gray color. What is the most likely diagnosis?

Correct Answer: A

Rationale: The correct answer is A: Anaerobic clostridial wound infection. The symptoms and signs described (bursting pain, weakness, drowsiness, fever, swollen skin, gas crepitation, foul-smelling dark-gray discharge) are classic for gas gangrene, caused by Clostridium perfringens. Gas gangrene is an anaerobic infection that thrives in devitalized tissue, such as postoperative wounds. The gas crepitation is due to gas production by the bacteria. Abscess (B) typically presents with localized swelling and fluctuance, not gas crepitation. Postoperative wound infection (C) may present with redness, warmth, and increased wound discharge but not the specific features mentioned. Erysipelas (D) is a superficial bacterial skin infection, typically caused by Streptococcus pyogenes, presenting with well-defined raised borders and redness.

Correct Answer: A

Rationale: Step 1: Streptococcus pyogenes is commonly known as Group A Streptococcus, which is the primary bacteria responsible for causing strep throat. Step 2: Staphylococcus aureus is not typically associated with strep throat but can cause skin infections and other illnesses. Step 3: Neisseria gonorrhoeae is the bacteria responsible for gonorrhea, a sexually transmitted infection, not strep throat. Step 4: Clostridium tetani causes tetanus, a bacterial infection that affects the nervous system and is not related to strep throat.

Correct Answer: A

Rationale: The correct answer is A: Malaria. The patient's travel history to an endemic area like Tajikistan, along with symptoms of fever with chills, sweating, and hepatosplenomegaly, are classic for malaria. The blood test results show anemia (low RBC and hemoglobin levels), which can occur in malaria due to hemolysis. The presence of eosinophils and lymphocytes are not typical for malaria, but the overall clinical picture fits. Infectious mononucleosis (choice B) typically presents with sore throat, lymphadenopathy, and atypical lymphocytosis, which are not seen in this case. Sepsis (choice C) is characterized by systemic inflammatory response syndrome and organ dysfunction due to infection, which does not align with the symptoms and findings in the case. Typhoid fever (choice D) usually presents with gradual onset of sustained fever, abdominal pain, headache, and constipation, which are not present in this patient

Correct Answer: A

Rationale: The correct answer is A: Isoniazid and rifampicin. These drugs are considered first-line treatment for tuberculosis due to their high efficacy and low toxicity. Isoniazid targets the cell wall of the tuberculosis bacteria, while rifampicin inhibits RNA synthesis. They are recommended by WHO as the first choice for treating tuberculosis. Choice B (Penicillin and erythromycin) is incorrect because these antibiotics are not effective against tuberculosis bacteria. Choice C (Trimethoprim and third generation cephalosporins) is incorrect because they are not considered first-line drugs for tuberculosis treatment. Choice D (All the listed above can be used depending on their resistance profile) is incorrect because only isoniazid and rifampicin are universally recognized as first-line drugs for tuberculosis regardless of resistance profile.

Correct Answer: A

Rationale: The correct answer is A: Chlamydia. Chlamydia lacks the essential enzymes for ATP synthesis and relies on host cell ATP. Enterococci, Rickettsia, and Staphylococci possess the necessary enzymes for ATP synthesis through cellular respiration. Chlamydia's inability to synthesize ATP makes it dependent on the host cell for energy production, distinguishing it from the other bacteria listed.

Correct Answer: C

Rationale: The Baltimore classification system categorizes viruses based on their genome type and replication strategy. It divides viruses into seven groups: Group I (dsDNA), Group II (ssDNA), Group III (dsRNA), Group IV (ssRNA(+)), Group V (ssRNA(-)), Group VI (ssRNA-RT), and Group VII (dsDNA-RT). Each group represents a distinct viral genome and replication method. Therefore, the correct answer is C. The other choices are incorrect because the Baltimore classification system specifically identifies viruses into seven groups, not four, five, or nine.

Correct Answer: A

Rationale: The correct answer is A: Amoxicillin. Amoxicillin is commonly used in combination therapy with metronidazole and bismuth compounds like De-Nol to eradicate Helicobacter pylori infection in children. Amoxicillin targets the bacterial cell wall synthesis, working synergistically with metronidazole to effectively eradicate the infection. Tetracycline (choice B) is not recommended in children under 8 years old due to potential tooth discoloration. Oleandomycin (choice C) is not commonly used for H. pylori infection. Biseptol (choice D) is a combination of sulfamethoxazole and trimethoprim, not typically used for H. pylori eradication.

Correct Answer: C

Rationale: The correct answer is C: Contaminated wounds. Tetanus is caused by the bacterium Clostridium tetani, which enters the body through breaks in the skin such as wounds or cuts. The bacteria produce a toxin that affects the nervous system, leading to muscle stiffness and spasms. Ingestion of contaminated food (choice A) is not a mode of transmission for tetanus. Inhalation of droplets (choice B) is more relevant for respiratory infections. Direct physical contact (choice D) is not the primary mode of transmission for tetanus as the bacteria need a portal of entry such as a wound to cause infection.

Correct Answer: B

Rationale: The correct answer is B: Proteus mirabilis. This bacterium is known to cause urinary tract infections (UTIs) and matches the description given in the question. Proteus mirabilis is a gram-negative rod-like bacterium that forms greenish mucoid colonies with a specific smell due to its production of urease enzyme. This enzyme leads to the formation of struvite crystals, which can cause painful and frequent urination. Pseudomonas aeruginosa (A) is not typically associated with UTIs. E.coli (C) is the most common cause of UTIs but does not match the specific description provided. Str.pyogenes (D) is a gram-positive bacterium and is not typically associated with UTIs.