A patient with a deep tissue infection had a wound culture revealing Gram-positive cocci in clusters. The bacteria were catalase-positive and coagulase-negative. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Staphylococcus epidermidis. The presence of Gram-positive cocci in clusters that are catalase-positive and coagulase-negative points towards coagulase-negative staphylococci like Staphylococcus epidermidis. Staphylococcus aureus is catalase-positive and coagulase-positive. Streptococcus pyogenes is catalase-negative. Enterococcus faecalis is catalase-negative and not typically seen in clusters. Therefore, the most likely causative agent in this scenario is Staphylococcus epidermidis.

Correct Answer: A

Rationale: The correct answer is A: Vibrio cholerae. This bacterium produces the cholera toxin, an enterotoxin that causes profuse watery diarrhea by disrupting the normal function of the intestines. Vibrio cholerae is specifically known for causing cholera, a severe diarrheal disease. Clostridium botulinum (B) produces botulinum toxin, causing botulism (paralysis, not diarrhea). Escherichia coli (C) can produce enterotoxins, but the question specifies a specific enterotoxin causing diarrhea, which is not a characteristic of all strains of E. coli. Streptococcus pneumoniae (D) is a common cause of respiratory infections but does not produce an enterotoxin causing diarrhea.

Correct Answer: C

Rationale: The correct answer is C: Adhesion and immune evasion. Bacterial capsules serve as a protective layer that aids in adhesion to surfaces and host cells, allowing bacteria to colonize and evade the immune system. This function is crucial for bacterial survival and pathogenicity. Choices A and D are incorrect because energy production and DNA replication are not primary functions of bacterial capsules. Choice B is incorrect because while bacterial capsules do provide some protection from desiccation, their primary function lies in adhesion and immune evasion.

Correct Answer: B

Rationale: The correct answer is B: Outer membrane with lipopolysaccharides. Gram-negative bacteria have an outer membrane containing lipopolysaccharides (LPS), which are important in pathogenesis and immune response. This feature is unique to Gram-negative bacteria, distinguishing them from Gram-positive bacteria (choice A). Teichoic acids (choice C) are found in the cell walls of Gram-positive bacteria, not Gram-negative. The statement in choice D, absence of a cell wall, is incorrect as all bacteria have a cell wall, although the composition may vary between Gram-negative and Gram-positive bacteria.

Correct Answer: D

Rationale: The correct answer is D: All of the above. - Streptococcus pneumoniae is a common cause of community-acquired pneumonia. - Mycobacterium tuberculosis can cause pulmonary tuberculosis, which can present as pneumonia-like symptoms. - Pseudomonas aeruginosa is an opportunistic pathogen that can cause pneumonia in immunocompromised individuals. Therefore, all three bacteria can cause pneumonia, making option D the correct choice. Options A, B, and C are incorrect because they each represent a bacterium that can cause pneumonia, so only selecting one of them would not encompass all common causes of pneumonia.