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: B

Rationale: The Gram stain differentiates bacteria based on cell wall structure. It classifies bacteria into Gram-positive (purple) and Gram-negative (pink) based on the presence of peptidoglycan in the cell wall. This method helps in identifying the bacterial species and determining appropriate treatment. Option A (Cell shape) is incorrect because the Gram stain focuses on cell wall composition, not cell shape. Option C (Flagella composition) is incorrect as the Gram stain does not assess flagella. Option D (Nutrient requirements) is incorrect as it does not relate to the purpose of the Gram stain.

Correct Answer: B

Rationale: The correct answer is B: Before antibiotic therapy is begun. Detecting penicillin-resistant, beta-lactamase-producing strains before antibiotic therapy is crucial to ensure proper treatment. If detected after therapy (choice A), it may lead to treatment failure. Detection during therapy (choice C) may result in delayed or ineffective treatment. Choice D is incorrect as early detection is essential for successful management.

Correct Answer: A

Rationale: Rationale: 1. Bacillary dysentery primarily affects the intestinal tract, not the bloodstream. 2. Bacteremia is rare in bacillary dysentery, as the infection is localized. 3. Isolating bacteria from the blood is not a typical diagnostic feature. 4. Therefore, the correct answer is A. Summary: Bacteria causing bacillary dysentery are not typically isolated from the patient's blood due to the localized nature of the infection. Choices B and C are incorrect as they suggest specific timeframes, which are not relevant to bacteremia in this context. Choice D is incorrect as bacteremia is not associated with bacillary dysentery.

Correct Answer: A

Rationale: The correct answer is A: Co-trimoxazole. This drug combination is the first-line treatment for toxoplasmosis due to its efficacy against Toxoplasma gondii. Co-trimoxazole consists of sulfamethoxazole and trimethoprim, which work synergistically to inhibit bacterial and protozoal folate synthesis, effectively treating toxoplasmosis. B: Itraconazole is an antifungal medication and not effective against toxoplasmosis. C: Mebendazole is an anthelmintic drug used for treating parasitic worm infections, not toxoplasmosis. D: Azidothimidine, also known as AZT, is used for treating HIV, not toxoplasmosis.

Correct Answer: A

Rationale: Flagella are the correct answer because they are long, whip-like structures that aid in bacterial movement towards or away from chemical stimuli. They rotate like propellers, allowing the bacterium to navigate its environment. Pili are used for attachment, not movement. Capsules are involved in protection and adherence, not chemotaxis. Fimbriae help in attachment to surfaces, not in movement towards stimuli.

Correct Answer: A

Rationale: The presence of rods with polar dark blue granules stained by Neisser's method indicates metachromatic granules consistent with Corynebacterium diphtheriae. The characteristic staining pattern is due to the presence of polar granules in the bacterial cells, a feature specific to Corynebacterium diphtheriae. Bacillus anthracis, Clostridium tetani, and Escherichia coli do not exhibit this staining pattern or morphology typical of Corynebacterium diphtheriae, making them incorrect choices.

Correct Answer: B

Rationale: The correct answer is B: Proteus mirabilis. This bacterium is known to cause urinary tract infections (UTIs) and matches the description given in the question. Proteus mirabilis is a gram-negative rod-like bacterium that forms greenish mucoid colonies with a specific smell due to its production of urease enzyme. This enzyme leads to the formation of struvite crystals, which can cause painful and frequent urination. Pseudomonas aeruginosa (A) is not typically associated with UTIs. E.coli (C) is the most common cause of UTIs but does not match the specific description provided. Str.pyogenes (D) is a gram-positive bacterium and is not typically associated with UTIs.

Correct Answer: B

Rationale: Step-by-step rationale for choice B being correct: 1. The conclusion should be based on evidence or observations. 2. "Doubtful" suggests uncertainty, indicating lack of definitive safety. 3. Choice A is too absolute without considering potential risks. 4. Choice C uses extreme language without proper evidence. 5. Choice D is overly definitive without considering varying levels of contamination. Therefore, choice B is the most reasonable conclusion.