While examining the feces of a patient with diarrhea, cysts with four nuclei were found. What protozoan is most likely causing the condition?

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Question 1 of 9

While examining the feces of a patient with diarrhea, cysts with four nuclei were found. What protozoan is most likely causing the condition?

Correct Answer: A

Rationale: The correct answer is A: Entamoeba histolytica. This protozoan causes amoebiasis, which presents with symptoms like diarrhea. The cysts with four nuclei found in the feces are characteristic of Entamoeba histolytica. This protozoan is known to cause invasive infection, leading to tissue destruction and ulcers in the intestines. Lamblia (choice B) typically presents with cysts containing two nuclei. Trichomonas (choice C) is a sexually transmitted parasite and does not form cysts. Balantidium (choice D) is a ciliated protozoan that does not have four nuclei in its cyst form.

Question 2 of 9

The Gram stain is used to differentiate bacteria based on:

Correct Answer: B

Rationale: The Gram stain differentiates bacteria based on cell wall structure. It classifies bacteria into Gram-positive (purple) and Gram-negative (pink) based on the presence of peptidoglycan in the cell wall. This method helps in identifying the bacterial species and determining appropriate treatment. Option A (Cell shape) is incorrect because the Gram stain focuses on cell wall composition, not cell shape. Option C (Flagella composition) is incorrect as the Gram stain does not assess flagella. Option D (Nutrient requirements) is incorrect as it does not relate to the purpose of the Gram stain.

Question 3 of 9

Which of the following diseases is transmitted by the fecal–oral route?

Correct Answer: B

Rationale: The correct answer is B: Peptic ulcer. Peptic ulcers are commonly caused by Helicobacter pylori bacteria, which can be transmitted through the fecal-oral route. This means that the bacteria from infected feces can be ingested through contaminated food or water, leading to the development of peptic ulcers in the gastrointestinal tract. Incorrect choices: A: Ehrlichiosis - Ehrlichiosis is a tick-borne disease transmitted through the bite of an infected tick, not through the fecal-oral route. C: Lyme disease - Lyme disease is also transmitted through the bite of an infected tick, specifically the black-legged tick. D: Tularemia - Tularemia is a bacterial disease typically transmitted through insect bites, handling of infected animals, or ingestion of contaminated water, not through the fecal-oral route.

Question 4 of 9

A 34-year-old male visited Tajikistan. After return, he complains of fever up to 40oC which occurs every second day and is accompanied by chills, sweating. Hepatosplenomegaly is present. Blood test results: RBC- 3x1012/l, b- 80 g/l, WBC- 4x109/l, eosinophils - 1%, stab neutrophils - 5%, segmented neutrophils - 60%, lymphocytes - 24%, monocytes - 10%, ESR - 25 mm/h. What is the provisional diagnosis?

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

Question 5 of 9

Bacteria causing bacillary dysentery can be isolated from the patient's blood:

Correct Answer: A

Rationale: Rationale: 1. Bacillary dysentery primarily affects the intestinal tract, not the bloodstream. 2. Bacteremia is rare in bacillary dysentery, as the infection is localized. 3. Isolating bacteria from the blood is not a typical diagnostic feature. 4. Therefore, the correct answer is A. Summary: Bacteria causing bacillary dysentery are not typically isolated from the patient's blood due to the localized nature of the infection. Choices B and C are incorrect as they suggest specific timeframes, which are not relevant to bacteremia in this context. Choice D is incorrect as bacteremia is not associated with bacillary dysentery.

Question 6 of 9

A 6-year-old child has duodenal ulcer. What antibacterial drug should be co-administered together with metronidazole and De-Nol in order to eradicate Helicobacter pylori infection?

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.

Question 7 of 9

Which of the following bacteria are unable to synthesize ATP?

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.

Question 8 of 9

The Baltimore classification system places viruses into __________ groups.

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.

Question 9 of 9

A centrifugate of urine sample obtained from patient with suspected renal tuberculosis was used to make a slide mount for microscopy. What method should be used to stain the slide and detect the causative agent?

Correct Answer: A

Rationale: The correct answer is A: Zielh-Neelsen stain. This stain is specifically used to detect acid-fast bacteria like Mycobacterium tuberculosis, the causative agent of renal tuberculosis. The staining process involves using carbol fuchsin to penetrate the mycolic acid layer of the bacterial cell wall, making it resistant to decolorization with acid-alcohol. This allows the red stained bacteria to be visualized under a microscope. Loeffler stain (B) is used for staining bacteria like diphtheria bacilli, Gram stain (C) is used for bacterial classification based on cell wall properties, and Aujeszky stain (D) is not a recognized staining method for detecting acid-fast bacteria.

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