A 37-year-old male was admitted to a hospital complaining of abdominal pain, difficulty in swallowing and breathing, constipation, and nausea. He developed respiratory failure and required endotracheal intubation and ventilation. Two days before, the patient consumed dried salted fish bought from an artisanal producer. Laboratory investigation for infectious pathogen was performed using Kitt-Tarozzi's method. Observation under a bright field microscopy revealed the presence of typical microorganisms with tennis racket appearance. Which of the following is the most likely diagnosis?

Correct Answer: A

Rationale: The correct answer is A: Botulism. Botulism is caused by the toxin produced by Clostridium botulinum bacteria found in improperly preserved or canned foods. The symptoms described align with botulism, such as difficulty swallowing and breathing due to muscle paralysis. The tennis racket appearance seen under microscopy corresponds to the characteristic appearance of Clostridium botulinum spores. The other choices can be ruled out based on the clinical presentation and microscopy findings. Cholera typically presents with severe watery diarrhea, Nontyphoidal Salmonella infection with fever and gastrointestinal symptoms, and Typhoid fever with high fever and abdominal pain. Therefore, the most likely diagnosis in this case is botulism.

Correct Answer: A

Rationale: The correct answer is A: Tetanus. The patient's symptoms of muscle contractions, fever, and wound history suggest tetanus, caused by Clostridium tetani bacteria commonly found in soil. The spastic muscle contractions around the wound are classic for tetanus due to the neurotoxin produced by the bacteria. General weakness and headache are also common symptoms. B: Anthrax is unlikely as it presents with different symptoms such as skin lesions, respiratory symptoms, and gastrointestinal symptoms. C: Erysipelas is characterized by red, swollen patches on the skin, not consistent with the symptoms described. D: Gram-positive is not a specific diagnosis but a broad category of bacteria. Tetanus is caused by Clostridium tetani, which is a Gram-positive bacterium, but this choice does not provide a specific infection diagnosis.

Correct Answer: C

Rationale: Rationale: 1. Pseudomonas aeruginosa is commonly found in hospital environments. 2. It is an opportunistic pathogen causing various nosocomial infections. 3. Its ability to develop resistance to antibiotics makes it a significant threat. 4. Corynebacterium diphtheriae causes diphtheria, not common nosocomial infections. 5. Shigella sonnei causes foodborne illness, not typically nosocomial infections. 6. "None of the above" is incorrect as Pseudomonas is indeed commonly associated with nosocomial infections.

Correct Answer: C

Rationale: The correct answer is C: Identification. Bacteria are studied by identification to determine their specific characteristics and differentiate between different species. Taxonomy (A) is the science of classification, not specific to bacteria. Classification (B) is the process of grouping organisms based on shared characteristics, not specific to bacteria. Nomenclature (D) is the naming system for organisms, not the primary method for studying bacteria. Therefore, identification (C) is the correct choice for studying bacteria.

Correct Answer: A

Rationale: The correct answer is A: Botulism. Botulism is a rare but serious illness caused by a toxin produced by the bacterium Clostridium botulinum. In this case, the patient's symptoms align with botulism due to the ingestion of homemade mushrooms. The symptoms of double vision, heavy breathing, paleness, widened pupils, swallowing difficulties, bradycardia, and constipation are all classic signs of botulism poisoning. The toxin affects the nervous system and can lead to paralysis. The other choices (B: Yersiniosis, C: Leptospirosis, D: Salmonellosis) do not match the patient's symptoms and history of consuming mushrooms, making them incorrect.

Correct Answer: B

Rationale: The correct answer is B: microvilli. Pili are hair-like structures found on the surface of some bacteria, while microvilli are microscopic cellular projections that increase surface area for absorption in cells like intestinal cells. Pili are involved in bacterial adhesion, while microvilli are important for nutrient absorption. Therefore, the correct answer is B. Incorrect choices: A: Fimbriae are short, thin appendages found on the surface of some bacteria, mainly used for adhesion. C: Cilia are hair-like structures found on the surface of some eukaryotic cells, often involved in movement or sensory functions. D: Flagella are long, whip-like appendages used for bacterial motility.

Correct Answer: C

Rationale: The correct answer is C: cell wall composition. Gram staining differentiates bacteria based on the structure of their cell walls. It classifies bacteria into Gram-positive (thick peptidoglycan layer) and Gram-negative (thin peptidoglycan layer). This differentiation is crucial for identifying bacterial species and guiding treatment choices. Size and shape (choice A) are not specific to Gram staining. Presence of flagella (choice B) is related to bacterial motility, not Gram staining. Genetic material (choice D) is not directly assessed by Gram staining. Overall, the unique composition of the cell wall is the key factor in distinguishing bacteria through Gram staining.

Correct Answer: A

Rationale: The correct answer is A: Clostridium perfringens. This bacterium is a Gram-positive rod that forms chains and produces gas due to its ability to ferment carbohydrates. It is also spore-forming, which helps it survive harsh conditions. Clostridium perfringens is commonly associated with severe tissue infections and gas gangrene. Choice B: Bacillus anthracis is also a spore-forming Gram-positive rod but is not typically associated with gas production or severe tissue infections. Choice C: Clostridium tetani is a spore-forming bacterium that causes tetanus, not severe tissue infections with gas production. Choice D: Pseudomonas aeruginosa is a Gram-negative bacterium and does not fit the description provided in the question.

Correct Answer: C

Rationale: The correct answer is C: urethra. Resident microflora refers to the normal, beneficial bacteria that inhabit a specific area of the body without causing harm. The urethra is one of the locations where resident microflora are commonly found. These bacteria play a vital role in maintaining a healthy balance and preventing harmful pathogens from colonizing the urethra. Blood (A), lung (B), and cerebro-spinal fluid (D) are not typical locations for resident microflora as these areas are usually sterile or have very limited microbial presence to prevent infections.