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?

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

Correct Answer: B

Rationale: The correct answer is B: Chlamydia trachomatis. This is because Chlamydia trachomatis is an obligate intracellular bacterium that cannot be cultured on standard agar plates. The symptoms described by the patient, such as pain, burning at urination, and scarce secretion in the morning, are indicative of a possible chlamydial infection. Additionally, the fact that the urine cultures are sterile after 24 hours of incubation suggests that the causative agent is not a typical bacteria like Escherichia coli, Streptococcus pneumoniae, or Neisseria gonorrhoeae, which would normally grow on agar plates. Therefore, Chlamydia trachomatis is the most probable cause of this disease. Summary: A: Escherichia coli - Incorrect, as it is a common cause of urinary tract infections and would typically grow on agar plates. C: Streptococcus pneumoniae - Incorrect, as it is

Correct Answer: B

Rationale: The correct answer is B: Vibrio cholerae. Cholera is caused by Vibrio cholerae, a bacterium that infects the small intestine, leading to severe diarrhea and dehydration. This bacterium produces a toxin that causes the symptoms of cholera. A: Shigella dysenteriae causes dysentery, not cholera. C: Salmonella enterica causes food poisoning, not cholera. D: Escherichia coli can cause food poisoning but not cholera.

Correct Answer: B

Rationale: During latency, HSV1 exists as episomes in neurons. This is because HSV1 establishes a lifelong latent infection in sensory neurons, where the viral genome remains as a circular episome in the nucleus. This form allows the virus to persist in a dormant state, avoiding detection by the immune system. Choice A is incorrect as HSV1 does not integrate into the host chromosome. Choice C is incorrect as latency is a well-documented phenomenon for HSV1. Choice D is incorrect as the correct answer is B.

Correct Answer: A

Rationale: The correct answer is A: Vibrios. Vibrios are gram-negative curved bacteria that are motile and do not form spores or capsules. The description of the bacteria in the question fits the characteristics of Vibrios. Vibrios are commonly found in aquatic environments and some species can cause gastrointestinal infections in humans. B: Spirochetes are also gram-negative curved bacteria, but they are spiral-shaped and have unique axial filaments for motility. The description in the question does not match the characteristics of spirochetes. C: Clostridia are gram-positive, spore-forming bacteria. The question specifically states that the bacteria are gram-negative and do not form spores, ruling out Clostridia. D: Corynebacteria are gram-positive, non-spore-forming bacteria. The description in the question does not match the characteristics of Corynebacteria.

Correct Answer: C

Rationale: The correct answer is C: prions. Prions are misfolded proteins that can cause transmissible spongiform encephalopathies like Creutzfeldt-Jakob disease. Prions are not viruses like flavoviruses (A) or orthomyxoviruses (D). Virusoids (B) are small, circular, single-stranded RNA molecules that require a helper virus to replicate and are not associated with transmissible spongiform encephalopathies. Therefore, the correct answer is C as prions are the only choice that correctly links to the etiology of transmissible spongiform encephalopathies.

Correct Answer: A

Rationale: The correct answer is A: Trichomonas vaginalis. Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis, a sexually transmitted infection characterized by inflammation of urogenital tracts. The description of big unicellular pyriform organisms with a sharp spike on the back end of their bodies, big nucleus, and undulating membrane matches the morphology of Trichomonas vaginalis. Trichomonas hominis and Trichomonas buccalis are different species that do not cause urogenital infections. Trypanosoma gambiense is a protozoan parasite causing African trypanosomiasis and does not match the described morphology or symptoms.

Correct Answer: C

Rationale: The correct answer is C: the hydrolysis of the four-membered ring present in penicillin. Beta-lactamase enzyme catalyzes the hydrolysis of the four-membered beta-lactam ring present in penicillin, rendering the antibiotic ineffective against bacterial cell walls. This enzyme breaks the bond in the beta-lactam ring, thus inactivating the antibiotic. Incorrect choices: A: the final cross-linking reaction to form the bacterial cell wall - This is incorrect as beta-lactamase does not participate in the formation of bacterial cell walls. B: the biosynthesis of the penicillin structure from the amino acid valine and cysteine - This is incorrect as beta-lactamase is not involved in the biosynthesis of penicillin. D: the hydrolysis of the acyl side chain from penicillin structures - This is incorrect as beta-lactamase specifically targets the beta-lactam ring, not the

Correct Answer: B

Rationale: The capsule of Bacillus anthracis is made of polypeptide. This is because the capsule is composed of a protein-based material that surrounds the bacterium, providing protection and aiding in its virulence. Polysaccharides, lipids, and the absence of capsules are not characteristic of Bacillus anthracis' capsule structure, making choices A, C, and D incorrect, respectively.