A 25-year-old patient was delivered to an infectious diseases unit on the 3rd day of illness with complaints of headache, pain in lumbar spine and gastrocnemius muscles, high fever, chill. Objectively: condition of moderate severity. Scleras are icteric. Pharynx is hyperemic. Tongue is dry with dry brown coating. Abdomen is distended. Liver is enlarged by 2 cm. Spleen is not enlarged. Palpation of muscles, especially gastrocnemius muscles, is painful. Urine is dark in color. Stool is normal in color. The most likely diagnosis is:

Correct Answer: A

Rationale: The correct diagnosis is Leptospirosis. Leptospirosis presents with headache, fever, muscle pain, jaundice, and kidney involvement. The patient's symptoms of headache, lumbar and muscle pain, high fever, icteric scleras, and dark urine are classic for Leptospirosis. The enlarged liver could be due to liver involvement in the disease. The absence of splenic enlargement and normal stool color rule out malaria. Infectious mononucleosis typically presents with sore throat and lymphadenopathy, which are absent in this case. Viral hepatitis A may present with similar symptoms, but the presence of muscle pain and dark urine is more indicative of Leptospirosis. Therefore, based on the patient's symptoms and clinical findings, Leptospirosis is the most likely diagnosis.

Correct Answer: A

Rationale: Step-by-step rationale for choice A being correct: 1. Parvovirus B19 is a single-stranded DNA (ssDNA) virus. 2. The prefix "parvo-" indicates small size, characteristic of ssDNA viruses. 3. ssDNA viruses replicate in the host cell by converting their ssDNA genome into double-stranded DNA (dsDNA). 4. Therefore, the correct answer is A: Its genome consists of dsDNA. Summary of why other choices are incorrect: B: Parvovirus B19 is a non-enveloped virus, making choice B incorrect. C: Parvovirus B19 has a linear ssDNA genome, not segmented, making choice C incorrect. D: Parvovirus B19 has two structural proteins - VP1 and VP2, making choice D incorrect.

Correct Answer: A

Rationale: The correct answer is A: Capnophilic. Brucella requires a CO2 enriched atmosphere for cultivation, making it capnophilic. This is because Brucella is a microaerophilic bacterium that thrives in low oxygen conditions and elevated CO2 levels. Choice B (Facultative anaerobic) and D (Obligate aerobic) are incorrect as Brucella does not grow well under aerobic conditions. Choice C (Obligate anaerobic) is also incorrect as Brucella can grow in the presence of oxygen, although it prefers low oxygen environments.

Correct Answer: A

Rationale: The correct answer is A: Neisser staining method. Neisser staining method is used to stain diphtheria bacilli, which appear as blue rods with thickenings at the poles. The rationale is that Neisser staining specifically targets and highlights the characteristics of the diphtheria bacilli. Incorrect choices: B: Gram staining is not specific for diphtheria bacilli and does not show the characteristic blue rods with thickenings at the poles. C: Ziehl-Neelsen staining is used for acid-fast bacteria like Mycobacterium tuberculosis, not for diphtheria bacilli. D: Loeffler staining is used for diphtheria bacilli but does not produce blue rods with thickenings at the poles as seen in this case.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Adenoviruses are DNA viruses, so choices B and C (ssRNA and DNA) are incorrect. 2. Adenoviruses have a middle-sized, naked icosahedral capsid, making choice A the correct description. 3. Choice D is incorrect as adenoviruses do have specific characteristics, making "None of the above" an inaccurate option. In summary, the correct answer A is supported by the fact that adenoviruses have a middle-sized, naked icosahedral capsid and contain double-stranded DNA. Choices B, C, and D are incorrect as they do not align with the characteristics of adenoviruses.

Correct Answer: A

Rationale: The correct answer is A: Pseudomonas aeruginosa. P. aeruginosa is a Gram-negative rod that is a lactose non-fermenter commonly associated with deep tissue infections. It is an opportunistic pathogen known for its ability to cause infections in immunocompromised individuals. P. aeruginosa is often resistant to multiple antibiotics and can form biofilms, making it difficult to treat. Summary of why other choices are incorrect: B: Escherichia coli is a Gram-negative rod that ferments lactose and is commonly found in the gastrointestinal tract. It is not typically associated with deep tissue infections. C: Salmonella typhi is a Gram-negative rod that causes typhoid fever, primarily affecting the gastrointestinal system, not deep tissue infections. D: Shigella dysenteriae is a Gram-negative rod that causes bacillary dysentery, which primarily affects the gastrointestinal tract and does not typically cause deep tissue infections.

Correct Answer: C

Rationale: The correct answer is C: green monkeys. The Marburg virus was first identified in 1967 in Marburg and Frankfurt, Germany, after outbreaks in lab workers exposed to infected African green monkeys. These monkeys were imported from Uganda. The virus is believed to be originally endemic in certain species of African bats and is transmitted to humans through contact with infected animals. Choice A, laboratory rats, is incorrect as the virus did not originate from rats. Choice B, birds, and Choice D, wild turkeys, are also incorrect as there is no evidence linking these animals to the transmission of the Marburg virus.

Correct Answer: A

Rationale: The correct answer is A because the cytoplasmic membrane in bacteria is primarily composed of phospholipids, glycerol, and glycolipids. Phospholipids form the basic structure of the membrane, with glycerol serving as the backbone and glycolipids present on the outer surface. Lipopolysaccharides (choice B) are primarily found in the outer membrane of Gram-negative bacteria, not the cytoplasmic membrane. Choice C is incorrect because peptidoglycan is a component of the bacterial cell wall, not the cytoplasmic membrane. Choice D is incorrect as the cytoplasmic membrane in bacteria is indeed composed of phospholipids, glycerol, and glycolipids.

Correct Answer: B

Rationale: The correct answer is B: For HIV. Pneumocystis pneumonia in a young man with CD4+ cells less than 200/mm3 is highly suggestive of HIV infection. HIV weakens the immune system, leading to opportunistic infections like pneumocystis pneumonia. Testing for HIV is crucial for diagnosis and appropriate management. Explanation for other choices: A: Testing for ureaplasma urealyticum is not indicated in this case as the symptoms and CD4+ cell count point towards an HIV-related infection. C: Testing for Treponema pallidum (syphilis) is not relevant in the context of a young man with pneumocystis pneumonia and low CD4+ cell count. D: Testing for Neisseria gonorrhoea is not appropriate in this scenario as the symptoms and CD4+ cell count suggest an underlying HIV infection rather than a bacterial sexually transmitted infection.