A 47-year-old patient came to see a doctor on the 7th day of disease. The disease developed very fast: after the chill body temperature rose to 40oC and lasted up to 7 hours, then dropped abruptly, which caused profuse sweat. There were three such attacks occur in once in two days. Two days ago the patient arrived from Africa. Objectively: pale skin, subicteric sclera, significantly enlarged liver and spleen. What is the cause of fever attacks in this disease?

Correct Answer: A

Rationale: The correct answer is A: Erythrocytic schizogony. In this case, the patient most likely has malaria, specifically caused by Plasmodium falciparum. The fever attacks every 2 days (tertian fever) are characteristic of P. falciparum infection. The cycle of erythrocytic schizogony in P. falciparum is around 48 hours, leading to the recurring fever pattern. Choices B, C, and D are incorrect as tissue schizogony does not cause the characteristic fever pattern, exotoxins are not typically involved in malaria fever, and gametocytes do not directly cause fever attacks.

Correct Answer: D

Rationale: The correct answer is D: All of these. HBV, HCV, and HDV can all lead to chronic carrier states due to their ability to establish persistent infections in the liver. HBV can result in chronic hepatitis, cirrhosis, and even liver cancer. HCV can also lead to chronic hepatitis and liver damage. HDV is a defective virus that requires HBV for replication and can worsen the outcome of HBV infection, potentially leading to chronic liver disease. Therefore, all three viruses have the potential to cause chronic carrier states.

Correct Answer: C

Rationale: The correct hierarchical order for virus classification is order, family, subfamily, genus, species. This is because classification starts at a broader level (order) and narrows down to a more specific level (species). Order comes first to group viruses based on common characteristics, followed by family, which further categorizes them. Subfamily refines the classification, then genus groups similar viruses together, and species distinguishes different strains within a genus. Choice A is incorrect because it places genus before family, which is not the correct sequence. Choice B is incorrect as it starts with species, which is the most specific level. Choice D is incorrect because it places genus at the beginning, which is too specific for the hierarchical order.

Correct Answer: A

Rationale: The correct answer is A: Erythrocytic schizogony. In this case, the patient most likely has malaria, specifically caused by Plasmodium falciparum. The fever attacks every 2 days (tertian fever) are characteristic of P. falciparum infection. The cycle of erythrocytic schizogony in P. falciparum is around 48 hours, leading to the recurring fever pattern. Choices B, C, and D are incorrect as tissue schizogony does not cause the characteristic fever pattern, exotoxins are not typically involved in malaria fever, and gametocytes do not directly cause fever attacks.

Correct Answer: D

Rationale: The correct answer is D because nosocomial infections can be transmitted through various routes, including air droplets, fecal-oral mechanism, contact mechanism, and parenteral mechanism. Air droplets can carry infectious agents through the air, while contact with contaminated surfaces or individuals can spread infections. Fecal-oral transmission occurs through ingesting contaminated food or water. Parenteral transmission involves the introduction of pathogens directly into the bloodstream. Therefore, all the options listed in D are correct routes for transmission of nosocomial infections. Choices A, B, and C are incorrect because they do not encompass all possible routes of transmission for nosocomial infections.

Correct Answer: A

Rationale: The correct answer is A: viral DNA polymerase. This enzyme is essential for replicating the viral DNA during the herpesvirus life cycle. It catalyzes the synthesis of new DNA strands using the viral genomic template. Ribonucleotide reductase (B) is involved in nucleotide synthesis, but not directly in DNA replication. Neuraminidase (C) is an enzyme found in influenza viruses, not herpesviruses. Thymidine kinase (D) is an enzyme that phosphorylates thymidine, but its role is more related to nucleotide metabolism rather than viral DNA replication.

Correct Answer: B

Rationale: The correct answer is B: Endoplasmic reticulum. Prokaryotic cells lack membrane-bound organelles like the endoplasmic reticulum, which is present in eukaryotic cells. Prokaryotes do possess ribosomes for protein synthesis (A), a chromosome (C) for genetic material, and peptidoglycan (D) in their cell walls. The absence of endoplasmic reticulum is a key characteristic that distinguishes prokaryotic cells from eukaryotic cells.

Correct Answer: A

Rationale: The correct answer is A: Bordetella pertussis. This bacterium is known for causing whooping cough due to its ability to produce toxins that damage the respiratory tract, leading to severe coughing fits. Clostridium tetani causes tetanus, Haemophilus influenzae can cause respiratory infections but not whooping cough, and Staphylococcus aureus is more commonly associated with skin infections. Therefore, A is the correct choice based on its specific association with the disease in question.

Correct Answer: D

Rationale: The correct answer is D: Propionibacterium acnes. This bacterium plays a key role in acne formation by colonizing hair follicles, leading to inflammation and acne lesions. It produces fatty acids that contribute to the development of acne. Staphylococcus aureus (A) and Staphylococcus epidermidis (B) are not directly linked to acne. Streptococcus pyogenes (C) is associated with skin infections but not acne. In summary, Propionibacterium acnes is the primary bacterium responsible for acne due to its ability to induce inflammation and follicular blockages.