A patient returning from Congo republic a week ago is with fever, headache vomiting and diarrhea, Three days after his admission to the infectious ward, despite antibiotic therapy, severe hemorrhagic syndrome developed and as well as CNS involvement, The diagnosis is hemorrhagic fever. Which of these viruses can be a causative agent?

Correct Answer: C

Rationale: The correct answer is C: Ebola virus. The patient's symptoms align with Ebola virus infection, including fever, severe hemorrhagic syndrome, and CNS involvement. Ebola virus is known to cause hemorrhagic fevers with high mortality rates. A: SARS CoV causes Severe Acute Respiratory Syndrome, which typically presents with respiratory symptoms, not hemorrhagic fever. B: Lymphocytic choriomeningitis virus usually causes a mild illness with flu-like symptoms, not severe hemorrhagic syndrome. D: ECHO 9 virus is associated with aseptic meningitis, not hemorrhagic fever.

Correct Answer: D

Rationale: The correct answer is D. Escherichia coli, Salmonella enterica, and Pseudomonas aeruginosa all produce endotoxins that can lead to septic shock. Endotoxins are components of the outer membrane of Gram-negative bacteria that can trigger a systemic inflammatory response, potentially leading to septic shock. E. coli and Salmonella are common causes of bacterial infections that can result in septic shock, while P. aeruginosa is known for causing infections in immunocompromised individuals. Therefore, since all three bacteria produce endotoxins that can lead to septic shock, the correct answer is D.Choices A, B, and C are incorrect because each of these bacteria individually produces endotoxins that can contribute to septic shock.

Correct Answer: A

Rationale: The correct answer is A: Lowestein-Jensen. This is because Lowestein-Jensen medium is specifically designed to cultivate Mycobacterium tuberculosis, providing necessary nutrients and conditions for its growth. Loefller's medium is not optimal for cultivating M. tuberculosis. Choice C (All of the above) is incorrect as not all the options listed are suitable for cultivating M. tuberculosis. Choice D (None of the above) is also incorrect as Lowestein-Jensen is indeed the recommended growth medium for this bacterium.

Correct Answer: A

Rationale: The correct answer is A: Trichomonas vaginalis. Trichomonas vaginalis is a flagellated protozoan that causes trichomoniasis, a sexually transmitted infection commonly found in vaginal discharges. In this case, the presence of flagellates in the vaginal discharge aligns with the characteristics of Trichomonas vaginalis. Leishmania donovani causes leishmaniasis, transmitted by sandflies. Trypanosoma gambiense causes African sleeping sickness through the tsetse fly bite. Trihomonas hominis is a non-pathogenic flagellate found in the human intestine. Therefore, the correct choice is A due to the correlation between the flagellates found in the vaginal discharge and the characteristics of Trichomonas vaginalis.

Correct Answer: B

Rationale: The correct answer is B because the main target of the toxin produced by Vibrio cholerae is the epithelial cells of the small intestine. This toxin, known as cholera toxin, binds to the surface of these cells and disrupts their normal function, leading to the characteristic watery diarrhea seen in cholera. The other choices are incorrect because macrophages are not the main target, RBCs are not directly affected by the toxin, and the stomach epithelial cells are not specifically targeted by Vibrio cholerae toxin.

Correct Answer: A

Rationale: The correct answer is A: Bacillus anthracis. Bacillus anthracis is the likely causative agent as it is a Gram-positive rod-shaped bacterium known to cause ulcerated lesions with associated fever and malaise. Anthrax typically presents with these symptoms and fits the description given in the question. Clostridium perfringens (Choice B) causes gas gangrene and typically presents with different symptoms. Clostridium tetani (Choice C) causes tetanus and is not associated with ulcerated lesions. Bacillus cereus (Choice D) is known for causing food poisoning and does not typically present with the symptoms described in the question.

Correct Answer: A

Rationale: The correct answer is A: Nystatin. Nystatin is an antifungal medication specifically used to treat candida infections. It works by disrupting the cell membrane of the fungus, leading to its death. Penicillin (B) is an antibiotic effective against bacterial infections, not fungal. Streptomycin (C) is also an antibiotic used for bacterial infections. Isoniazid (D) is used to treat tuberculosis, not candida infections. Therefore, Nystatin is the best choice for treating candida infections due to its antifungal properties.

Correct Answer: A

Rationale: The correct answer is A: Listeria monocytogenes. This pathogen can cross the placenta and infect the fetus, leading to serious complications. Listeria can cause miscarriage, stillbirth, or severe neonatal infections. Staphylococcus aureus and Corynebacterium diphtheriae do not typically cross the placenta. Choice D is incorrect because Listeria monocytogenes can indeed be transmitted through the placenta, unlike the other pathogens listed.

Correct Answer: A

Rationale: Step-by-step rationale for why the correct answer is A (Cholera): 1. Gram-negative curved mobile monotrichous bacilli: Vibrio cholerae, the causative agent of cholera, fits this description. 2. Do not produce spores or capsules: Vibrio cholerae does not produce spores or capsules. 3. Require alkaline reaction (pH 8.5-9.5): Vibrio cholerae thrives in alkaline environments. 4. Enteric infection: Cholera is a classic example of an enteric infection transmitted through contaminated food or water. Summary of why other choices are incorrect: B: Shigellosis is caused by Shigella species, which are gram-negative, but they are not curved bacilli and do not require an alkaline pH. C: Typhoid fever is caused by Salmonella Typhi, which are gram-negative but are not curved bacilli and do not require an alkaline pH.