Nokea
A child with foul-smelling diarrhea had trophozoites with two nuclei and flagella identified in stool microscopy. What is the causative agent?
- A. Giardia lamblia
- B. Entamoeba histolytica
- C. Trichomonas vaginalis
- D. Balantidium coli
Correct Answer: A
Rationale: The correct answer is A: Giardia lamblia. Giardia lamblia is a protozoan parasite that causes foul-smelling diarrhea with trophozoites having two nuclei and flagella in stool microscopy. The presence of flagella and two nuclei is characteristic of Giardia lamblia. Entamoeba histolytica (Choice B) causes amoebic dysentery with trophozoites containing ingested RBCs. Trichomonas vaginalis (Choice C) is a sexually transmitted protozoan causing vaginitis with a distinctive pear-shaped trophozoite. Balantidium coli (Choice D) is a ciliated protozoan causing diarrhea with trophozoites containing a single nucleus.
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In a bacteriological laboratory some bacterial smears had to be stained by Gram's method. For this purpose the following reagents were prepared: gentian violet, Lugol's solution, aqueous fuchsin solution. What other reagent is required?
- A. 96% ethanol
- B. 5% sulfuric acid
- C. Methylene blue solution
- D. Carbolic fuchsin
Correct Answer: A
Rationale: The correct answer is A: 96% ethanol. In Gram's staining method, after applying gentian violet, Lugol's solution, and aqueous fuchsin, the next step is to use a decolorizing agent like 96% ethanol to wash away the excess stain from the Gram-negative bacteria. This step is crucial as it helps differentiate between Gram-positive and Gram-negative bacteria based on their cell wall properties. The other choices are incorrect because sulfuric acid is not used in Gram's staining method, methylene blue is typically used in other staining techniques like the simple stain, and carbolic fuchsin is not a standard reagent in the Gram's staining process.
A patient being treated for tuberculosis is suffering from hearing deterioration. What drug causes this complication?
- A. Streptomycin
- B. Isonicotinic acid hydrazide (Isoniazid)
- C. Rifampicin
- D. Ethionamide
Correct Answer: A
Rationale: The correct answer is A: Streptomycin. Streptomycin is an aminoglycoside antibiotic used to treat tuberculosis that can cause hearing loss as a side effect. It is known to damage the cochlear and vestibular organs in the inner ear. The other choices, B: Isoniazid, C: Rifampicin, and D: Ethionamide, are not associated with causing hearing deterioration as a side effect. Isoniazid can rarely cause peripheral neuropathy, Rifampicin can lead to hepatotoxicity, and Ethionamide may cause gastrointestinal disturbances, but none of these drugs are known to specifically cause hearing loss.
The most rapid rate of drug absorption is achieved by __________ administration.
- A. on the skin
- B. intravenous
- C. intramuscular
- D. sublingual
Correct Answer: B
Rationale: The correct answer is B: intravenous administration. This route bypasses the first-pass metabolism, allowing the drug to directly enter the bloodstream for immediate distribution. In contrast, on the skin (A) and sublingual (D) routes have slower absorption rates due to barriers like skin layers or mucous membranes. Intramuscular (C) absorption is slower than intravenous due to slower perfusion rates in muscle tissues. Overall, intravenous administration provides the fastest and most direct route for drug absorption, making it the most rapid method.
Sanitary control is applied to monitor the quality of:
- A. Food, drinking water, restaurants, health care services and transport
- B. Food, drinking water
- C. Food, drinking water, restaurants and health care services
- D. Food, drinking water, and restaurants
Correct Answer: A
Rationale: The correct answer is A because sanitary control is crucial for monitoring the quality of a wide range of essential services to ensure public health and safety. Food safety, drinking water quality, cleanliness in restaurants, hygiene in healthcare settings, and transportation systems all fall under the purview of sanitary control. Therefore, option A is the most comprehensive and accurate choice.
Option B is incorrect because it does not include monitoring restaurants, health care services, and transport, which are important aspects of sanitary control. Option C is incorrect as it excludes transportation, an essential area that requires sanitary monitoring. Option D is incorrect as it does not cover health care services, which are critical for ensuring public health and safety.
A stool sample from a patient with chronic diarrhea revealed cysts with four nuclei. What is the most likely causative agent?
- A. Entamoeba histolytica
- B. Giardia lamblia
- C. Balantidium coli
- D. Trichomonas hominis
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.