A 45 year old male is admitted to medical admission ward with a five day history of fever, joint pains and loss of appetite. The patient had consulted a general medical officer the first day of his fever and was given paracetamol and artemether. On the third day, the patient still had the said symptoms. The patient did not yet experience having serious health problems other than fever and nausea. He had no previous hospitalization. He then reports to you and you decide to order the following Lab tests which yield the respective results: Urinalysis : Colour: Yellow Specific Gravity: 1.020 Sugar: negative Protein: Negative Epithelial Cells: Occasional Red Blood Cells: 0-2 Pus Cells: 0-2 Urates/Phosphates: Occasional Hematology: White Blood Cells: 2.7 x 109/L Hemoglobin: 9.5 g/dL Hematocrit: 29 % Platelet Count: 125 x 109 /dL Liver Enzymes: AL: 100 IU/L AST: 98 IU/L Malaria Tests: Malarial parasites smear: Negative Malaria Rapid Tests: Negative I. Comment on the results and give possible explanation for abnormal results. II. What are the differentials? (mention 3) On the 9th day he develops a profuse non-productive cough with white sputum with blood spots noted and shallow and rapid respirations of 35/ minute. Lung auscultation reveals crackles. Abdominal exam also reveals moderate ascites. III. What is the pathophysiology of such findings? IV. How do you highly confirm this disease? V. How do you grade the severity of this disease? VI. How do you rule out the suspected diseases from the history? VII. What type of vector is involved?

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