Correct Answer: A

Rationale: The most probable diagnosis is A: Malaria. The patient's symptoms of periodic chills, high fever, and profuse sweating, along with living in Africa where malaria is endemic, strongly suggest malaria. The enlarged liver and spleen are consistent with malaria infection. The low erythrocyte count indicates hemolysis, a common feature of malaria. Spotted fever and sepsis do not typically present with the same pattern of symptoms and travel history as seen in this case. Haemolytic anaemia would not explain the patient's fever episodes and other symptoms. Therefore, based on the symptoms, travel history, and laboratory findings, malaria is the most likely diagnosis.

Correct Answer: B

Rationale: The correct answer is B: Outer membrane with lipopolysaccharides. Gram-negative bacteria have an outer membrane that contains lipopolysaccharides, which play a role in pathogenicity and resistance to certain antibiotics. This outer membrane is a distinguishing feature of Gram-negative bacteria, as opposed to Gram-positive bacteria that have a thick peptidoglycan layer. Choices A, C, and D are incorrect because Gram-negative bacteria have a thin peptidoglycan layer, do have a cell wall (although it is different from Gram-positive bacteria), and do not contain teichoic acids.

Correct Answer: C

Rationale: The correct answer is C: Acid-fast cell wall. Mycobacterium tuberculosis is characterized by its unique cell wall composition, containing high levels of mycolic acids which make it acid-fast. This property allows it to resist decolorization during acid-fast staining procedures. This distinguishes it from other bacteria. A: Producing spores is not a key feature of Mycobacterium tuberculosis. Spore formation is more commonly associated with bacterial species such as Bacillus and Clostridium. B: Mycobacterium tuberculosis is not Gram-negative. It is classified as acid-fast Gram-positive. D: Mycobacterium tuberculosis does not produce toxins as a key feature. Its pathogenicity is more closely related to its ability to evade host immune responses and persist in host tissues.

Correct Answer: C

Rationale: The correct answer is C: To determine the antibiotic susceptibility of microorganisms. PCR is not suitable for determining antibiotic susceptibility as it is a technique used to amplify DNA/RNA, not to test for antibiotic resistance. To prove latent infection (A), PCR can be used to detect low levels of pathogens. For rapid diagnosis of infectious diseases (B), PCR is commonly used due to its sensitivity and specificity. To demonstrate DNA and RNA molecules (D), PCR is ideal as it can amplify and detect specific sequences. Therefore, choice C is incorrect as PCR is not designed for determining antibiotic susceptibility.

Correct Answer: C

Rationale: The correct answer is C: Macrolides or fluoroquinolones. Legionella pneumophila is a bacterium that causes Legionnaires' disease, a severe form of pneumonia. Macrolides (like azithromycin) and fluoroquinolones (like levofloxacin) are the recommended first-line treatments due to their ability to penetrate into lung tissues where Legionella infects. Penicillins and cephalosporins (choice A) are not effective against Legionella as it is intracellular and resistant to these antibiotics. Ethambutol and isoniazid (choice B) are used to treat tuberculosis, not Legionella infections. Second and third generation cephalosporins (choice D) are also not effective against Legionella. Therefore, the best choice for treating Legionella pneumophila infections is macrolides or fluoroquinolones.