A 43-year-old cattle farm worker is brought to the surgeon with fever, malaise, and inflamed lesions on his hands and arms. He reports that about 2 weeks before his presentation at the hospital he noticed small, painless, pruritic papules that quickly enlarged and developed a central vesicle. The vesicles developed into erosion and left painless necrotic ulcers with black, depressed eschar. Gram's staining of the ulcer reveals gram-positive spore-forming bacilli. Which of the following diseases is the most likely cause of these findings?

Correct Answer: A

Rationale: The correct answer is A: Anthrax. The clinical presentation of painless necrotic ulcers with black eschar, along with the gram-positive spore-forming bacilli seen on Gram's staining, is classic for cutaneous anthrax. Anthrax is caused by Bacillus anthracis, which produces spores and can lead to skin lesions in individuals working with animals or animal products. Choice B, Chickenpox, typically presents with vesicular rash all over the body. Choice C, Syphilis, is caused by Treponema pallidum and does not present with the characteristic eschar seen in the patient. Choice D, Tularemia, caused by Francisella tularensis, presents with ulceroglandular lesions but lacks the black eschar characteristic of anthrax.

Correct Answer: B

Rationale: The correct answer is B because there are two types of herpes simplex virus: HSV-1 and HSV-2. HSV-1 typically causes oral herpes, while HSV-2 usually causes genital herpes. Choice A is incorrect because there is more than one type. Choices C and D are also incorrect as there are only two types of herpes simplex virus known to infect humans.

Correct Answer: A

Rationale: The correct answer is A because most bacteria can grow in both the presence and absence of oxygen. Some bacteria are aerobic and require oxygen for growth, while others are anaerobic and can grow in the absence of oxygen. Choice B is incorrect because not all bacteria grow in the absence of oxygen. Choice C is incorrect because not all bacteria are microaerophiles, which are bacteria that require a low level of oxygen for growth. Choice D is incorrect because most bacteria exhibit flexibility in their oxygen requirements.

Correct Answer: A

Rationale: The correct answer is A: Urogenital trichomoniasis. The presence of pyriform protozoa with a spine, flagella at their front, and an undulating membrane in a vaginal smear indicates Trichomonas vaginalis, the causative agent of urogenital trichomoniasis. Trichomonas vaginalis is sexually transmitted and causes vaginal discharge, itching, and inflammation. Lambliasis (choice B) is caused by Giardia lamblia, which is not characterized by the described features. Intestinal trichomoniasis (choice C) is caused by a different species, Tritrichomonas foetus, and presents with diarrhea in cattle. Toxoplasmosis (choice D) is caused by Toxoplasma gondii and typically affects the brain and other organs, not the genital tract.

Correct Answer: C

Rationale: The correct answer is C because disinfectants are non-selective and can harm a wide range of microbial cells. Disinfectants work by disrupting cell membranes, proteins, and nucleic acids, affecting both harmful and beneficial microorganisms. Choices A and B are incorrect because disinfectants are designed to be potent and non-selective. Choice D is incorrect because the effects of disinfectants are often permanent and irreversible on microbial cells.

Correct Answer: A

Rationale: The correct answer is A: Clostridium perfringens. This is because Clostridium perfringens is a Gram-positive rod bacterium that forms terminal spores. It is commonly associated with deep tissue infections and can cause gas gangrene. Bacillus anthracis (B) causes anthrax and does not typically form spores at the terminal end. Clostridium tetani (C) causes tetanus and Bacillus cereus (D) is more commonly associated with food poisoning. In this case, the presence of terminal spores along with the clinical presentation of a deep tissue infection points towards Clostridium perfringens as the most likely causative agent.

Correct Answer: C

Rationale: The correct answer is C: flagella. Flagella are whip-like structures that move fluid, mucus, or cells over the surface of a cell. They are longer and fewer in number compared to cilia, which are shorter and more numerous. Fimbriae are small, bristle-like structures that help bacteria attach to surfaces but do not move fluid. Microvilli are tiny projections that increase the surface area for absorption but do not have a role in moving fluid or cells. Therefore, flagella is the correct answer as it specifically fits the function described in the question.

Correct Answer: A

Rationale: The correct answer is A: Anthrax. The clinical presentation of painless necrotic ulcers with black eschar, along with the gram-positive spore-forming bacilli seen on Gram's staining, is classic for cutaneous anthrax. Anthrax is caused by Bacillus anthracis, which produces spores and can lead to skin lesions in individuals working with animals or animal products. Choice B, Chickenpox, typically presents with vesicular rash all over the body. Choice C, Syphilis, is caused by Treponema pallidum and does not present with the characteristic eschar seen in the patient. Choice D, Tularemia, caused by Francisella tularensis, presents with ulceroglandular lesions but lacks the black eschar characteristic of anthrax.

Correct Answer: B

Rationale: The correct answer is B: Acute purulent lymphadenitis. The symptoms described indicate an acute bacterial infection of the lymph nodes. The presence of painful lymph nodes, erythema, and shiny appearance of the skin overlying the nodes suggest an inflammatory process. The rise in temperature and frequent pulse indicate an active infection. The white-coated tongue may be a sign of systemic involvement. The shaky gait may indicate systemic toxicity. Bubonic plague (A) presents with buboes, not just painful lymph nodes. Lymphogranulomatosis (C) is a type of lymphoma and would not present with these acute bacterial infection symptoms. Anthrax (D) typically presents with a black eschar and is less likely in this context.