A patient has a necrotizing phlegmon of his lower extremity. A doctor suspects a gas gangrene. Microscopy reveals grampositive bacilli. In order to confirm the diagnosis further bacteriological tests should include inoculation of the material into the following nutrient medium:

Correct Answer: A

Rationale: The correct answer is A: Kitt-Tarozzi medium. This medium is specifically designed to culture Clostridium species, the causative agents of gas gangrene. Clostridium species are gram-positive bacilli that produce gas during their metabolism. Inoculating the material into Kitt-Tarozzi medium allows for the selective growth of Clostridium species, aiding in the confirmation of a gas gangrene diagnosis. Other choices are incorrect: B: Endo agar is used for the isolation of gram-negative enteric bacteria. C: Meat-peptone agar is a general-purpose medium and not specific for Clostridium species. D: Levine agar is used for the isolation of Salmonella and Shigella species, not Clostridium.

Correct Answer: D

Rationale: The correct answer is D, All of the above. Clostridium botulinum produces botulinum toxin causing botulism, Vibrio cholerae produces cholera toxin leading to severe diarrhea, and certain strains of Escherichia coli produce toxins causing gastrointestinal illness. Each bacterium has specific exotoxins that can result in severe gastrointestinal symptoms. Therefore, all three choices are correct in producing exotoxins that can cause severe gastrointestinal illness.

Correct Answer: B

Rationale: The correct answer is B: Fimbriae. Fimbriae are hair-like appendages found on the surface of bacteria that enable attachment to host cells. This attachment is crucial for establishing infection. Flagella (A) are used for movement, not attachment. Capsules (C) provide protection and help evade the host immune system, but do not directly facilitate attachment. Endospores (D) are dormant structures for survival, not for attachment to host cells. Fimbriae specifically aid in adherence to host cells, making them the correct choice in this context.

Correct Answer: A

Rationale: The correct answer is A: cytomegalovirus. CMV is the most common virus transmitted during pregnancy, leading to potential serious complications for the fetus. It can cause birth defects, hearing loss, and developmental delays. CMV is commonly spread through bodily fluids. HIV (B) can also be transmitted during pregnancy but is less common. Herpes simplex virus (C) can be transmitted but typically results in localized infection. Epstein-Barr virus (D) is not commonly transmitted during pregnancy.

Correct Answer: A

Rationale: The correct answer is A: Homemade canned meat. Botulism is caused by the Clostridium botulinum bacteria, which thrives in low-oxygen environments like improperly canned food. Homemade canned meat poses a higher risk of contamination as it may not have been processed correctly, allowing the bacteria to grow and produce toxins. Custard pastry, sour cream, and strawberries are less likely to cause botulism as they are not typically associated with the bacteria unless improperly handled or stored. Homemade canned meat is the most probable cause based on the characteristic symptoms of botulism and the conditions that favor the growth of Clostridium botulinum in canned food.

Correct Answer: A

Rationale: The correct answer is A: Mantoux test. The Mantoux test is used to screen for tuberculosis by injecting PPD intradermally. The presence of a delayed hypersensitivity reaction indicates prior exposure to Mycobacterium tuberculosis. The Schick test (B) is used to test for immunity to diphtheria, while the Dick test (C) is used to test for immunity to scarlet fever. Therefore, the correct use of PPD is in the Mantoux test for tuberculosis screening.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Warts are caused by human papillomavirus (HPV) due to its ability to infect the skin. 2. HPV infects the top layer of skin and causes the rapid growth of cells, leading to the formation of warts. 3. Herpesvirus (choice B) causes herpes, not warts. 4. HIV (choice C) weakens the immune system but does not directly cause warts. 5. Varicella-zoster virus (choice D) causes chickenpox and shingles, not warts. Summary: Choice A is correct as warts are primarily caused by HPV, which infects the skin cells. Choices B, C, and D are incorrect as they are associated with different viral infections that do not lead to the development of warts.

Correct Answer: C

Rationale: The correct answer is C: Anti-measles IgM. During acute measles infection, the body produces IgM antibodies specific to the measles virus. This indicates a recent or current infection. A: Anti-mumps IgM and B: Anti-rubella IgM are specific to mumps and rubella viruses, respectively, not measles. D: Anti-CMV IgM is specific to cytomegalovirus, not measles. In summary, choice C is correct because Anti-measles IgM is the specific antibody indicating acute measles infection, while the other choices are antibodies related to different viruses.

Correct Answer: C

Rationale: The correct answer is C: Obligate anaerobes cannot tolerate oxygen. They lack the enzymes needed to detoxify reactive oxygen species generated in the presence of oxygen. This makes them unable to survive in oxygen-rich environments. Choice A is incorrect because obligate anaerobes do not require oxygen to survive. Choice B is incorrect because obligate anaerobes specifically require the absence of oxygen. Choice D is incorrect because obligate anaerobes cannot even tolerate low levels of oxygen.