Nokea
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.
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While examining the feces of a patient with diarrhea, cysts with four nuclei were found. What protozoan is most likely causing the condition?
- A. Entamoeba histolytica
- B. Lamblia
- C. Trichomonas
- D. Balantidium
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.
A bacteriological laboratory received sputum sample of a patient suffering from tuberculosis. Bacterioscopic examination of smears and detection of tuberculosis bacillus can be realized by one of enrichment methods that involves processing of sputum only with solution of caustic soda. What is this method called?
- A. Homogenization
- B. Inactivation
- C. Flotation
- D. Filtration
Correct Answer: B
Rationale: The correct answer is B: Inactivation. In this method, the sputum sample is processed with a solution of caustic soda, which helps to kill any contaminants present and preserve the tuberculosis bacillus for microscopic examination. This step is crucial in ensuring accurate detection of the bacillus.
A: Homogenization involves breaking down the sample to make it uniform, but it does not necessarily involve using caustic soda for inactivation.
C: Flotation is a method used to separate different components based on their density and is not specific to inactivating tuberculosis bacillus.
D: Filtration involves passing a sample through a filter to separate particles based on size and is not related to inactivating the tuberculosis bacillus.
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.
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
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.