Nokea
Etiological cause of bacteremia could be:
- A. S.epidermidis, E.coli, S. aureus
- B. P.aeruginosa, K. pneumoniae, E.coli
- C. Resident skin diphtheroids
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because bacteremia can be caused by a variety of bacteria including S.epidermidis, E.coli, S.aureus, P.aeruginosa, K.pneumoniae, and resident skin diphtheroids. Bacteremia refers to the presence of bacteria in the bloodstream, which can occur due to infections from various sources. Choices A and B include common bacteria known to cause bacteremia, while choice C refers to resident skin diphtheroids that can also enter the bloodstream under certain conditions. Therefore, the correct answer is D as it encompasses all the possible etiological causes of bacteremia.
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A sputum smear from a patient with pneumonia revealed Gram-positive cocci in pairs with pointed ends and capsules. What is the likely microorganism?
- A. Streptococcus pneumoniae
- B. Staphylococcus aureus
- C. Klebsiella pneumoniae
- D. Neisseria meningitidis
Correct Answer: A
Rationale: The correct answer is A: Streptococcus pneumoniae. The description of Gram-positive cocci in pairs with pointed ends and capsules matches the morphology of S. pneumoniae. This bacterium is known to cause pneumonia, especially in individuals with underlying conditions like COPD. Staphylococcus aureus (B) typically appears in clusters, not pairs. Klebsiella pneumoniae (C) is a Gram-negative rod, not a cocci. Neisseria meningitidis (D) is a Gram-negative diplococcus, not a cocci. Hence, based on the morphology and clinical context, Streptococcus pneumoniae is the likely microorganism causing pneumonia in this patient.
The infectious (non-sterile) immunity is:
- A. cross-reactivity of antibodies
- B. toxemia and formation of antitoxic antibodies
- C. persistence of infectious agent
- D. neutralization of infectious agent
Correct Answer: C
Rationale: The correct answer is C because infectious (non-sterile) immunity is achieved through the persistence of the infectious agent in the body, allowing the immune system to continuously recognize and combat the pathogen. This type of immunity provides long-lasting protection against future infections by the same agent.
Choice A (cross-reactivity of antibodies) is incorrect as it refers to the ability of antibodies to recognize similar antigens, not necessarily related to infectious immunity.
Choice B (toxemia and formation of antitoxic antibodies) is incorrect as it specifically relates to toxins produced by pathogens and the corresponding antibody response, not the persistence of the infectious agent itself.
Choice D (neutralization of infectious agent) is incorrect as it describes the process of antibodies binding to and inactivating pathogens, but it does not necessarily lead to long-term immunity through the persistence of the infectious agent.
A 28-year-old patient was hospitalized with preliminary diagnosis "influenza". Roseolous-petechial rash appeared on the 5th day of disease on the trunk. The temperature is 41oC. Hyperemia of face, reddening of scleras, tremor of tongue, tachycardia, splenomegaly are present. What is the most likely diagnosis?
- A. Epidemic typhus
- B. Measles
- C. Alcohol delirium
- D. Leptospirosis
Correct Answer: A
Rationale: The most likely diagnosis is Epidemic typhus (Choice A) based on the symptoms described. The presence of roseolous-petechial rash, high fever (41oC), hyperemia of face, reddening of scleras, tremor of the tongue, tachycardia, and splenomegaly are classic signs of epidemic typhus. The rash typically appears around the 5th day of the disease.
Summary:
- B: Measles typically presents with a maculopapular rash starting on the face and spreading downward. It doesn't usually present with tremor of the tongue or splenomegaly.
- C: Alcohol delirium is characterized by confusion, disorientation, and hallucinations due to alcohol consumption. It doesn't match the symptoms described.
- D: Leptospirosis presents with fever, muscle pain, and conjunctival suffusion. It doesn't typically present with the specific rash and trem
A wound culture grew Gram-negative rods that were oxidase-positive and lactose non-fermenters. What is the most likely microorganism?
- A. Pseudomonas aeruginosa
- B. Escherichia coli
- C. Salmonella typhi
- D. Shigella dysenteriae
Correct Answer: A
Rationale: The correct answer is A: Pseudomonas aeruginosa. P. aeruginosa is a Gram-negative rod that is oxidase-positive and lactose non-fermenting. The positive oxidase test indicates the presence of cytochrome c oxidase, a characteristic of P. aerugin. E. coli is lactose fermenting. Salmonella and Shigella are also Gram-negative rods, but they are lactose fermenters, unlike the lactose non-fermenting P. aeruginosa.
A 12-year-old boy presents with nausea, frequent repeated vomiting that first occurred after eating canned vegetables. Objectively: the patient has dry mucous membranes, muscular hypotonia, anisocoria, mydriasis, dysphagia and dysarthria. What is the most likely diagnosis?
- A. Botulism
- B. Shigellosis
- C. Salmonellosis
- D. Cholera
Correct Answer: A
Rationale: The most likely diagnosis is A: Botulism. The symptoms, such as nausea, vomiting after eating canned vegetables, dry mucous membranes, muscular hypotonia, anisocoria, mydriasis, dysphagia, and dysarthria, are classic signs of botulism poisoning. Botulism is caused by the neurotoxin produced by Clostridium botulinum bacteria found in improperly canned or preserved food. The neurotoxin affects the nervous system, leading to symptoms like those described. Shigellosis (B), Salmonellosis (C), and Cholera (D) typically present with different symptoms such as diarrhea, fever, and abdominal pain, which are not seen in this patient.