The patient has developed pain in the axillary area, rise of temperature developed 10 hours ago. On examination: shaky gait is marked, the tongue is coated by white coating. The pulse is frequent. The painful lymphatic nodules are determined in the axillary area. The skin is erythematous and glistering over the lymphatic nodules. What is the most probable diagnosis?

Correct Answer: D

Rationale: The most probable diagnosis is D: Tularemia. Tularemia is a bacterial infection caused by Francisella tularensis. The symptoms described align with tularemia, such as pain in axillary area, fever, shaky gait, coated tongue, frequent pulse, painful lymphatic nodules, and erythematous skin over nodules. The key features pointing towards tularemia are the presence of lymphadenitis in the axillary area and the erythematous, glistering skin over the nodules, which are characteristic of ulceroglandular tularemia. Bubonic plague (A) presents with painful, swollen lymph nodes called buboes but typically lacks the erythematous skin findings. Acute purulent lymphadenitis (B) usually presents with pus-filled lymph nodes but does not typically cause shaky gait or coated tongue. Lymphogranulomatosis (C) is a term for Hodgkin's lymphoma, which does not

Correct Answer: C

Rationale: The most probable diagnosis for the homeless male with symptoms of roseolo-petechiae rash, hyperemia, tachycardia, splenomegaly, and euphoria is Leptospirosis. Leptospirosis is a bacterial infection commonly associated with exposure to contaminated water or soil, which is prevalent in homeless populations. The initial diagnosis of "influenza" fits with the flu-like symptoms. The appearance of roseolo-petechiae rash and other symptoms like hyperemia, tachycardia, splenomegaly, and euphoria are consistent with leptospirosis. The other choices can be ruled out: A) Typhus typically presents with headache, fever, and rash, but not the specific symptoms described. B) Alcoholic delirium is more likely with a history of alcohol abuse and presents with confusion, disorientation, and hallucinations. D) Abdominal typhoid presents with prolonged fever, abdominal pain

Correct Answer: C

Rationale: Toxoplasma gondii is a protozoan parasite known to cause toxoplasmosis. It belongs to the group of eukaryotic organisms called protozoans because it is a single-celled organism with complex cellular structures. Protozoans are characterized by their ability to move and perform essential functions independently. Algae (choice A) are photosynthetic eukaryotic organisms, fungi (choice B) are non-photosynthetic eukaryotes that include molds and yeasts, and helminths (choice D) are multicellular parasitic worms. Therefore, the correct answer is C because Toxoplasma gondii is a protozoan parasite.

Correct Answer: B

Rationale: The correct answer is B: presence of metachromatic granules. This is because Corynebacterium diphtheriae is known for containing metachromatic granules, which are characteristic of this species. These granules can be observed under a microscope and aid in the identification of the bacteria. Explanation of other choices: A: formation of spores - Corynebacterium diphtheriae does not form spores. Spore formation is more commonly seen in bacteria such as Bacillus and Clostridium species. C: production of coagulase - Coagulase production is a characteristic of Staphylococcus aureus, not Corynebacterium diphtheriae. D: beta-hemolysis on blood agar - Corynebacterium diphtheriae does not exhibit beta-hemolysis on blood agar. This type of hemolysis is more typical of Streptococcus pyogenes.

Correct Answer: B

Rationale: The correct answer is B: microvilli. Pili are hair-like structures found on the surface of some bacteria, while microvilli are microscopic cellular projections that increase surface area for absorption in cells like intestinal cells. Pili are involved in bacterial adhesion, while microvilli are important for nutrient absorption. Therefore, the correct answer is B. Incorrect choices: A: Fimbriae are short, thin appendages found on the surface of some bacteria, mainly used for adhesion. C: Cilia are hair-like structures found on the surface of some eukaryotic cells, often involved in movement or sensory functions. D: Flagella are long, whip-like appendages used for bacterial motility.

Correct Answer: D

Rationale: The correct answer is D: Proteus vulgaris. This is because Proteus species are non-lactose-fermenting, Gram-negative rods that produce gas in nutrient broth. They are known to cause severe abdominal pain due to their ability to invade the intestinal mucosa. A: Salmonella enterica is a lactose-fermenting organism and typically does not produce gas in nutrient broth. B: Shigella dysenteriae is a lactose-negative organism but does not produce gas in nutrient broth. C: Escherichia coli is a lactose-fermenting organism and does not typically produce gas in nutrient broth. In summary, the presence of non-lactose-fermenting, gas-producing Gram-negative rods points towards Proteus vulgaris as the most likely causative agent of the severe abdominal pain.

Correct Answer: C

Rationale: Rationale: Metronidazole is the drug of choice for systemic amebiasis due to its high efficacy against Entamoeba histolytica. It has good tissue penetration and can treat intestinal, liver, and lung involvement. Quiniofone (A) has limited use and is not recommended for amebiasis. Enteroseptol (B) is not effective against systemic amebiasis. Tetracycline (D) is not the first-line treatment for amebiasis and has limited efficacy against Entamoeba histolytica.

Correct Answer: A

Rationale: The correct answer is A: Tetanus. The patient's symptoms of muscle contractions, fever, and wound history suggest tetanus, caused by Clostridium tetani bacteria commonly found in soil. The spastic muscle contractions around the wound are classic for tetanus due to the neurotoxin produced by the bacteria. General weakness and headache are also common symptoms. B: Anthrax is unlikely as it presents with different symptoms such as skin lesions, respiratory symptoms, and gastrointestinal symptoms. C: Erysipelas is characterized by red, swollen patches on the skin, not consistent with the symptoms described. D: Gram-positive is not a specific diagnosis but a broad category of bacteria. Tetanus is caused by Clostridium tetani, which is a Gram-positive bacterium, but this choice does not provide a specific infection diagnosis.

Correct Answer: A

Rationale: The correct answer is A: Clostridium perfringens. This bacterium is an anaerobic, Gram-positive rod that forms terminal spores and produces gas. It is commonly associated with wound infections and gas gangrene. Clostridium botulinum causes botulism and does not typically present with gas production. Bacillus anthracis is an aerobic, Gram-positive spore-forming bacterium causing anthrax. Clostridium tetani causes tetanus and does not produce gas. Thus, based on the characteristics described in the question, Clostridium perfringens is the most likely causative agent.