A 33 year old patient was delivered to the infectious diseases department on the 7-th day of disease. He complained about great weakness, high temperature, pain in the lumbar area and leg muscles, icteritiousness, dark color of urine, headache. The acute disease started with chill, body temperature rise up to 40oC, headache, pain in the lumbar area and sural muscles. Icterus turned up on the 4th day, nasal and scleral haemorrhages came on the 5th day. Fever has lasted for 6 days. Diuresis - 200 ml. What is the most probable diagnosis?

Correct Answer: A

Rationale: The most probable diagnosis is Leptospirosis. The symptoms described align with the classic presentation of Leptospirosis, such as fever, muscle pain, headache, jaundice, and hemorrhages. The initial symptoms of chills, high fever, and muscle pain followed by jaundice and hemorrhages are characteristic of Leptospirosis. The presence of dark urine and low diuresis also point towards kidney involvement, which is common in Leptospirosis due to renal failure. Additionally, the patient's history of potential exposure to contaminated water or soil supports the diagnosis, as Leptospirosis is commonly transmitted through contact with infected animal urine. Summary of other choices: - Typhoid fever typically presents with sustained fever, abdominal pain, and constipation, not matching the symptoms described. - Virus A hepatitis usually presents with jaundice, but other symptoms such as muscle pain and hemorrhages are not typical. - Sepsis is a systemic response

Correct Answer: C

Rationale: The correct answer is C: Inhibits protein synthesis. Exotoxin of C. Diphtheriae acts by inhibiting protein synthesis in host cells. This disrupts cellular functions and leads to tissue damage. Choice A is incorrect because acetylcholine release is not affected. Choice B is incorrect as it does not involve neurotransmitters. Choice D is incorrect as the exotoxin does have a specific mechanism.

Correct Answer: D

Rationale: The correct answer is D: Proteus vulgaris. This is because Proteus species are non-lactose-fermenting Gram-negative rods that are known to produce gas in nutrient broths. Proteus vulgaris is commonly associated with urinary tract infections and can also cause abdominal infections. A: Salmonella typhi typically causes typhoid fever and is not known to produce gas in nutrient broths. B: Shigella dysenteriae is a causative agent of dysentery and does not typically produce gas in nutrient broths. C: Escherichia coli is a lactose-fermenting bacterium and does not fit the description of the organism in the stool culture.

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. This bacterium is the most likely causative agent for pneumonia in this case due to the presence of Gram-positive cocci in pairs with a capsule, which is a typical characteristic of S. pneumoniae. This pathogen is a common cause of community-acquired pneumonia and is known for its encapsulated morphology. Staphylococcus aureus (B) is a Gram-positive cocci but does not typically present in pairs with a capsule in pneumonia cases. Klebsiella pneumoniae (C) is a Gram-negative bacterium and does not match the description provided. Pseudomonas aeruginosa (D) is a Gram-negative bacterium that is not typically associated with Gram-positive cocci in pneumonia samples.

Correct Answer: D

Rationale: The correct answer is D: Non-tender chancre (ulcus durum). In the primary stage of syphilis, an individual typically develops a painless ulcer known as a chancre at the site of infection. This ulcer is usually firm, round, and clean with well-defined borders. It is important to note that it is non-tender, which distinguishes it from other skin conditions. This characteristic helps healthcare providers differentiate syphilis from other sexually transmitted infections. Explanation for other choices: A: Diffuse maculopapular rash - This is more commonly associated with secondary syphilis. B: Purulent exudation from the urethra - This is not a typical presentation of primary syphilis. C: Syphilitic granulomas (gummas) - Gummas typically develop in the tertiary stage of syphilis, not in the primary stage.

Correct Answer: D

Rationale: Step 1: Micellar growth refers to the apical prolongation of hyphae in fungi. Step 2: Fungi have a unique growth structure with hyphae extending at the tips. Step 3: This growth pattern allows fungi to expand and access nutrients. Step 4: Bacterial cells (A) do not exhibit micellar growth. Step 5: Parent and daughter cells in division have similar sizes, not different (B). Step 6: Viruses and rickettsia (C) do not display micellar growth.

Correct Answer: A

Rationale: Step 1: Mycobacterium leprae is the bacterium responsible for causing leprosy, a chronic infectious disease affecting the skin and nerves. Step 2: Neisseria gonorrhoeae causes gonorrhea, a sexually transmitted infection. Step 3: Streptococcus pneumoniae causes pneumonia and other respiratory infections. Step 4: Clostridium perfringens causes gas gangrene and food poisoning. Summary: A is correct as Mycobacterium leprae specifically causes leprosy, while B, C, and D cause different diseases unrelated to leprosy.

Correct Answer: A

Rationale: The correct answer is A: Bacillus anthracis. The presence of Gram-positive rods in chains with central spores on the Gram stain indicates Bacillus anthracis. This bacterium is known to cause severe pneumonia. Clostridium tetani does not typically cause pneumonia but rather tetanus. Streptococcus pneumoniae is a Gram-positive cocci, not rods. Klebsiella pneumoniae is a Gram-negative bacterium commonly associated with pneumonia, but it does not form central spores.

Correct Answer: A

Rationale: The correct answer is A because it lists the genera that belong to the family Reoviridae accurately. Orthoreovirus and Rotavirus are well-known genera within the family Reoviridae. Orbivirus is another genus belonging to the same family. Choice B is incorrect because Orthoretrovirus and Retrovirus are not part of the Reoviridae family. Orbfiloviridae is also not a valid genus within this family. Choice C is incorrect because Orthoretrovirus and Retrovirus are not part of the Reoviridae family. Orbivirus is the correct genus but the other two are inaccurate. Choice D is incorrect because Orthoretrovirus and Retrovirus are not part of the Reoviridae family. Orbarenaviridaefiloviridae is not a valid genus within Reoviridae.