A Gram-stained smear from a wound revealed Gram-positive rods with terminal spores. The bacteria were anaerobic and produced gas. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Clostridium perfringens. This bacterium is an anaerobic, Gram-positive rod that forms terminal spores and produces gas. It is commonly associated with wound infections and gas gangrene. Clostridium botulinum causes botulism and does not typically present with gas production. Bacillus anthracis is an aerobic, Gram-positive spore-forming bacterium causing anthrax. Clostridium tetani causes tetanus and does not produce gas. Thus, based on the characteristics described in the question, Clostridium perfringens is the most likely causative agent.

Correct Answer: C

Rationale: The correct answer is C: Bacterial adhesion to the surface of the host cells, conjugation. Villi and cilia on the cell surface of pathogenic bacteria help in bacterial adhesion to host cells, facilitating the process of infection. Conjugation is the transfer of genetic material between bacterial cells, which can be aided by these structures. The other choices are incorrect because RNA exchange between cells (A) is typically facilitated by different structures like pili, inhibition of complement activity (B) is not related to the function of villi and cilia, and resistance to antibody opsonization (D) is usually achieved through other mechanisms such as capsule formation.

Correct Answer: D

Rationale: The correct answer is D, "All of the above." Bacterial meningitis can be caused by Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae. These bacteria are common pathogens associated with meningitis. Each of them can lead to serious infections in the brain and spinal cord. Neisseria meningitidis is known for causing meningococcal meningitis, Haemophilus influenzae is a common cause of H. influenzae meningitis, and Streptococcus pneumoniae is responsible for pneumococcal meningitis. Therefore, since all three bacteria can cause bacterial meningitis, the correct answer is D. Choices A, B, and C are incorrect because each of these bacteria individually can cause bacterial meningitis; it is not limited to just one specific type.

Correct Answer: D

Rationale: The most probable diagnosis is D: Tularemia. Tularemia is a bacterial infection caused by Francisella tularensis. The symptoms described align with tularemia, such as pain in axillary area, fever, shaky gait, coated tongue, frequent pulse, painful lymphatic nodules, and erythematous skin over nodules. The key features pointing towards tularemia are the presence of lymphadenitis in the axillary area and the erythematous, glistering skin over the nodules, which are characteristic of ulceroglandular tularemia. Bubonic plague (A) presents with painful, swollen lymph nodes called buboes but typically lacks the erythematous skin findings. Acute purulent lymphadenitis (B) usually presents with pus-filled lymph nodes but does not typically cause shaky gait or coated tongue. Lymphogranulomatosis (C) is a term for Hodgkin's lymphoma, which does not

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: B

Rationale: Step-by-step rationale: 1. Marburg virus is named after the German city Marburg where it was first identified in 1967. 2. Chikungunya virus is named after a village in Tanzania. 3. Measles virus got its name from the Middle English word "maselen" meaning "many little spots". 4. Epstein-Barr virus is named after Michael Epstein and Yvonne Barr, who discovered it. Summary: B is correct as it is directly named after the city of its discovery. A, C, and D are incorrect as they are named after other locations, characteristics, or discoverers.

Correct Answer: B

Rationale: The correct answer is B: pertussis toxin. This toxin is the most important virulence factor of Bordetella pertussis because it plays a key role in causing the characteristic symptoms of whooping cough. Pertussis toxin interferes with the host's immune response, leading to inflammation and tissue damage in the respiratory tract. The other choices (A: the flagellum, C: P fimbriae, D: mannose-resistant adhesins) are important for bacterial attachment and colonization, but they do not directly contribute to the severity of the disease like pertussis toxin does.

Correct Answer: A

Rationale: The correct answer is A because the secondary immune response is quicker due to memory B and T cells being already present from the primary response. These memory cells can quickly recognize and respond to the antigen upon re-exposure, leading to a faster and more efficient immune response. Choices B and C are incorrect as the secondary response produces more antibodies and requires fewer antigen stimulations. Choice D is also incorrect as the secondary response is faster than the primary response.

Correct Answer: B

Rationale: The correct answer is B because reinfection is indeed possible with rabies virus. Step 1: Reinfection occurs if a person is exposed to the virus again after initial infection. Step 2: Once infected, the virus can remain dormant in the body and become active upon re-exposure. Step 3: Therefore, it is essential to continue preventive measures even after initial immunization. Summary: Choices A, C, and D are incorrect because antibodies develop within 14-15 days post-immunization, HRIG is administered shortly after exposure, and a specific vaccination schedule is followed for rabies prophylaxis, respectively.