This 19-year old student was in his usual state of health until the evening prior to admission, when he went to bed with a headache. He told his mother that he felt feverish, and on the following morning his mother found him in bed, moaning and lethargic. He was brought to the emergency room, where he appeared toxic and drowsy but oriented. His temperature 40'C, his heart rate was 126/min, and his blood pressure was 100/60 mm Hg. His neck was supple. He had an impressive purpuric rash, not blanching, most prominent on the trunk, legs and wrists. His white blood cell count was 26,000/ul with 25% band forms. The platelet count was 80,000/ul.

Blood cultures were obtained, a lumbar puncture was performed, and the patient was begun on intravenous ceftriaxone. Cerebrospinal fluid (CSF) glucose, protein, and white blood cell count were normal, and CSF bacterial culture was negative. Blood cultures grew a Gram Negative diplococci.

1. What is the organism causing his illness? Is the finding of a normal CSF profile without evidence of meningitis commonly observed in infection with this organism? Explain.

2. Is this organism ever part of the normal oropharyngeal microbiota? Explain.

3. How is this disease spread? How can infection be prevented?

4. What is a purpuric rash, and which virulence factor plays a central role responsible for its appearance?

nucleus

would be most reasonable answer tbh

the scientific method.

an individual’s sex (i.e., whether they are a male or female) is determined by the sex chromosomes. most people have two sex chromosomes, one that is inherited from their mother and one that is inherited from their father. typically, females have two x chromosomes (xx) and males have one x chromosome and one y chromosome (xy). conditions caused by changes (“mutations”) in genes located on the x chromosome are considered x-linked.

x-linked recessive inheritance

most x-linked conditions are recessive. this means that in a person with two x chromosomes (most females), both copies of a gene (i.e., one on each x chromosome) must have a change or mutation whereas in a person with one x chromosome (most males), only one copy of a gene must have a mutation. a female with a mutation in one copy of a gene on the x chromosome is said to be a “carrier” for an x-linked condition. a male with a mutation in a gene on the x chromosome is typically affected with the condition. because females have two copies of the x chromosome and males have only one x chromosome, x-linked recessive diseases are more common among males than females. however, x-linked recessive diseases can occur in both males and females.

for x-linked recessive disorders, an unaffected carrier mother who has a mutation in a gene on the x chromosome can transmit either the x chromosome with this mutation or a “normal” x chromosome to her children. if the father is unaffected, none of her daughters will be affected and all of her daughters will be unaffected—since they will inherit at least one normal x chromosome from their father. however, each daughter will have a 50% chance of being an unaffected carrier like her mother and a 50% chance of both x chromosomes being normal.

it has to be understood that the sea water contains a huge amount of sodium and chlorine ions and if they enter the cell of the atlantic cod fish, the cell will shrivel and the fish will die. to avoid such a condition, the fish uses active transport for the purpose of removing the ions against the gradient.

explanation:

the atlantic cod is not a maritime osmoconformer. its native application of salts is less than that of the seawater it lives in. it is continually falling water from the gills to the ocean via osmosis.

countering that, the fish is going to be swallowing seawater. but since its internal collection of salts is lower than seawater, the fish will want to go free of excess salt, and since that's going upon a gradient, then active transport, requiring energy, must be used to pump out the salt. much marine fish use the organs to filter out the salt and these fish discharge very straight urine.