Nokea
When examining a patient presumptively diagnosed with food toxicoinfection, a doctor on duty has detected symptoms characteristic of botulism. The patient named the meals he ate the day before. What is the most probable cause of infection?
- A. Homemade canned meat
- B. Custard pastry from a private bakery
- C. Sour cream from a local dairy factory
- D. Strawberries from a suburban vegetable garden
Correct Answer: A
Rationale: The correct answer is A: Homemade canned meat. Botulism is caused by the Clostridium botulinum bacteria, which thrives in low-oxygen environments like improperly canned food. Homemade canned meat poses a higher risk of contamination as it may not have been processed correctly, allowing the bacteria to grow and produce toxins. Custard pastry, sour cream, and strawberries are less likely to cause botulism as they are not typically associated with the bacteria unless improperly handled or stored. Homemade canned meat is the most probable cause based on the characteristic symptoms of botulism and the conditions that favor the growth of Clostridium botulinum in canned food.
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Which of the following is a folate antagonist?
- A. Methyl Penicillin
- B. Trimethoprim
- C. Vancomycin
- D. Gentamicin
Correct Answer: B
Rationale: The correct answer is B: Trimethoprim. Trimethoprim is a folate antagonist that inhibits dihydrofolate reductase, an enzyme essential for folate metabolism in bacteria. This disrupts bacterial DNA synthesis, leading to bacteriostatic effects. Methyl Penicillin (A) is a beta-lactam antibiotic that interferes with bacterial cell wall synthesis. Vancomycin (C) inhibits cell wall synthesis by binding to D-Ala-D-Ala terminus of cell wall precursors. Gentamicin (D) inhibits bacterial protein synthesis by binding to the 30S subunit of the bacterial ribosome.
A scientist identifies a strand of RNA that can be directly used to code for important viral proteins during viral replication. What have they found?
- A. RNA major
- B. -RNA
- C. (+RNA)
- D. RNA minor
Correct Answer: C
Rationale: The correct answer is C: (+RNA). This indicates that the scientist found a positive-sense RNA strand that can be directly translated by host cell machinery to produce viral proteins. Positive-sense RNA can act as messenger RNA, allowing immediate protein synthesis during viral replication. Choice A (RNA major) and D (RNA minor) are not standard terms used to describe RNA strands in virology. Choice B (-RNA) indicates a negative-sense RNA strand, which requires transcription to form a complementary positive-sense strand before protein synthesis. Thus, the identification of a strand of RNA that directly codes for viral proteins aligns with the characteristics of a positive-sense RNA strand.
Antigenic variation is used by bacteria to:
- A. evade host immune responses
- B. increase antibiotic susceptibility
- C. increase peptidoglycan synthesis
- D. enhance motility
Correct Answer: A
Rationale: The correct answer is A: evade host immune responses. Antigenic variation allows bacteria to change their surface antigens, making it difficult for the host immune system to recognize and attack them effectively. This enhances the bacteria's ability to evade immune responses and establish infection.
B: Increase antibiotic susceptibility is incorrect because antigenic variation does not directly impact the susceptibility of bacteria to antibiotics.
C: Increase peptidoglycan synthesis is incorrect because antigenic variation is not related to the synthesis of peptidoglycan, which is a major component of the bacterial cell wall.
D: Enhance motility is incorrect because antigenic variation does not directly affect the motility of bacteria.
In summary, antigenic variation in bacteria primarily serves to help them evade host immune responses, making option A the correct answer.
Bacteria causing bacillary dysentery can be isolated from the patient's blood:
- A. There is no bacteremia
- B. During the second week of illness
- C. During the first week of illness
- D. None of the above
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.
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?
- A. Malaria
- B. Infectious mononucleosis
- C. Sepsis
- D. Typhoid fever
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