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: B

Rationale: The correct answer is B: Agglutination reaction. This is the most suitable serological reaction for the quick determination of the antigen of the epizootic agent causing mass rodent deaths. In agglutination reaction, antibodies cause the clumping of antigens, allowing for easy visual detection of the presence of the specific antigen. This is efficient for rapid diagnosis in cases of suspected infectious diseases like plague. A: Precipitation reaction is more suitable for identifying soluble antigens, not for quick determination of a specific antigen in this scenario. C: Reaction of passive hemagglutination is used for measuring the presence of antibodies, not antigens. D: Bordet-Gengou test is a specific test for the identification of Bordetella pertussis bacterium, not suitable for this scenario.

Correct Answer: A

Rationale: The correct answer is A: Syphilitic granulomas (gummas). In the tertiary stage of syphilis, gummas, which are soft, tumor-like growths, can develop in various organs such as the skin, bones, liver, and brain. This stage typically occurs years after the initial infection and can lead to serious complications if left untreated. Purulent exudation from the urethra (B) is not specific to syphilis and may indicate other infections. Non-tender chancre (C) is characteristic of the primary stage of syphilis, not the tertiary stage. Diffuse maculopapular rash (D) is more commonly seen in the secondary stage of syphilis.

Correct Answer: C

Rationale: In anaphase, sister chromatids separate and move towards opposite poles of the cell. This is facilitated by the shortening of microtubules attached to the centromeres. Prophase is the phase where chromosomes condense and the nuclear envelope breaks down. Metaphase is when chromosomes align at the metaphase plate. Telophase is when the nuclear envelope reforms and chromosomes decondense. Therefore, anaphase is the correct phase for chromatid separation.

Correct Answer: A

Rationale: The correct answer is A: Klebsiella pneumoniae. This bacterium is commonly associated with pneumonia in elderly patients. Klebsiella pneumoniae is a Gram-negative, non-motile, rod-shaped bacterium that frequently causes pneumonia in individuals with underlying health conditions. It is known for its ability to produce a distinctive mucoid capsule. Pseudomonas aeruginosa (B) is more commonly associated with hospital-acquired infections, particularly in immunocompromised individuals. Escherichia coli (C) is a common cause of urinary tract infections but is less likely in this case due to the symptoms and sputum sample results. Haemophilus influenzae (D) is another common respiratory pathogen, but in this scenario, Klebsiella pneumoniae is the most likely causative agent based on the patient's age, symptoms, and the characteristics of the bacteria described in the sputum sample.

Correct Answer: D

Rationale: The correct answer is D because Cytomegalovirus infections are caused by human herpesvirus 5, also known as Human Herpesvirus 5 (HHV-5) or Cytomegalovirus (CMV). This virus belongs to the Herpesviridae family, genus Betaherpesvirinae. Options A, B, and C are incorrect as they do not correspond to the specific virus responsible for causing Cytomegalovirus infections.

Correct Answer: D

Rationale: The correct answer is D because all the options are essential for a PCR reaction. A: DNA segment is required as the template for amplification. B: Two oligonucleotide primers are needed to initiate DNA replication. C: Heat stable DNA polymerase (not just heat stable DNA) is crucial for withstanding the high temperatures during PCR. In summary, without any of these components, the PCR reaction cannot proceed effectively.

Correct Answer: A

Rationale: The correct answer is A: Teratogenesis. Teratogenesis refers to the process of abnormal development of the fetus leading to congenital defects due to exposure to harmful agents during pregnancy. In this case, toxoplasmosis infection during pregnancy can lead to teratogenesis, causing multiple congenital defects in the child. Other choices are incorrect because B: Cancerogenesis refers to the process of cancer formation, C: Recombination is a genetic process unrelated to congenital defects, and D: Chemical mutagenesis refers to mutations caused by chemical agents, not necessarily congenital defects.

Correct Answer: A

Rationale: Step 1: Small, curved Gram-negative bacilli with a monotrichous flagellum point towards a motile bacterium. Step 2: The absence of spores or capsules and preference for alkaline conditions further narrows down the possibilities. Step 3: Vibrio cholerae fits all criteria as it is a curved, motile, Gram-negative bacillus that thrives in alkaline environments. Summary: Escherichia coli is a facultative anaerobe, Salmonella and Shigella are non-flagellated, and all of them can form capsules or spores, unlike Vibrio cholerae.