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: A

Rationale: The correct answer is A because CSF (Cerebrospinal fluid) is the sample used for proving epidemic meningitis. It should be transported at 37°C to maintain its integrity. Blood and nasopharyngeal secretions are not typically used for diagnosing meningitis. Choice B, feces, is unrelated to the diagnosis of meningitis. Choice C, CSF transported at +4°C, is incorrect as it should be transported at 37°C to prevent degradation of the sample. Therefore, A is the correct choice for proving epidemic meningitis due to the specificity of the sample and the proper transport conditions.

Correct Answer: A

Rationale: The correct answer is A. Benzylpenicillin sodium salt, also known as penicillin G, works by blocking the synthesis of peptidoglycan in the microbial cell wall. Peptidoglycan is crucial for the structural integrity of bacterial cell walls. By inhibiting its synthesis, penicillin disrupts the cell wall formation, leading to cell lysis and bacterial death. Choices B, C, and D are incorrect because penicillin does not target cytoplasm proteins, thiol enzymes, or RNA synthesis. Penicillin's primary mode of action is specifically related to interfering with bacterial cell wall synthesis.

Correct Answer: A

Rationale: The correct answer is A: Oxidation. Phase I reactions in biotransformation involve introducing or unmasking functional groups through oxidation, reduction, or hydrolysis. Oxidation reactions typically involve the addition of an oxygen atom or removal of hydrogen atoms, making them common phase I reactions. In this process, enzymes like cytochrome P450 play a crucial role in catalyzing the oxidation reactions. Conjugation (B), acetylation (C), and glucuronidation (D) are all examples of phase II reactions, which involve the conjugation of the drug or metabolite with endogenous compounds to increase water solubility for excretion. These reactions typically follow phase I reactions and are not classified as phase I reactions in biotransformation.

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: B

Rationale: The correct answer is B: Gram-negative bacteria. Gram-negative bacteria have an outer membrane containing lipopolysaccharides (LPS). In the Gram staining technique, these bacteria appear pink/red due to the thin peptidoglycan layer, which allows the crystal violet stain to be washed out, revealing the safranin counterstain. Gram-positive bacteria (choice A) have a thick peptidoglycan layer but lack an outer membrane with LPS. Choice C is incorrect since only Gram-negative bacteria possess LPS in their outer membrane. Choice D is incorrect as all bacteria can be classified as either Gram-positive or Gram-negative based on their cell wall structure.

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: B

Rationale: Step-by-step rationale: 1. Filamentous spiral nucleocapsid is characteristic of Filoviridae, such as Ebola virus. 2. Linear unsegmented single strand (-) RNA is a key feature of Filoviridae genomes. 3. The lipid bilayer membrane of cellular origin is found in Filoviridae viruses. 4. Therefore, the correct answer is B (Filoviridae) due to the alignment of all three morphological features. Summary: - A (Picornaviridae): Has an icosahedral capsid, not filamentous spiral. - C (Orthomyxoviridae): Has a segmented genome, not linear unsegmented. - D (Togaviridae): Has a spherical capsid, not filamentous spiral.

Correct Answer: A

Rationale: The correct answer is A: Anatoxin. An anatoxin is a preparation that contains inactivated toxins produced by the anthrax-causing bacteria. By administering anatoxin, the population can develop immunity against the toxin without being exposed to the live bacteria. This specific prophylaxis approach helps prevent the development of anthrax infection by targeting the toxin itself. Summary: - Choice B (Inactivated vaccine) is incorrect because an inactivated vaccine typically contains killed or inactivated whole bacteria, not just the toxins. - Choice C (Chemical vaccine) is incorrect as there is no such thing as a chemical vaccine; vaccines are biological preparations. - Choice D (Genetically engineered vaccine) is incorrect because while vaccines can be genetically engineered, the specific term "genetically engineered vaccine" does not accurately describe the prophylaxis used against anthrax in this scenario.