An adult patient with type 2 diabetes attends the emergency room. He reported that two days ago he was accidentally injured in the left leg, but he did not seek medical care. At the time of examination, an infected wound was found, surrounded by a large area of inflammation with characteristic tissue crepitation on palpation and with foul odor. Blood (for hemoculture) and wound secretions were taken for microbiological testing. The microscopic examination reveals large Gram-positive bacteria, with centrally located spores. These bacteria were unable to grow in vitro at presence of oxygen. The most likely cause of this disease is:

Correct Answer: B

Rationale: The correct answer is B: Clostridium perfringens. In this case, the patient's presentation of infected wound with tissue crepitation, foul odor, and Gram-positive bacteria with centrally located spores that cannot grow in the presence of oxygen is indicative of gas gangrene caused by Clostridium perfringens. This anaerobic bacterium produces various toxins that lead to tissue destruction and gas production in the affected area. Clostridium tetani (choice A) causes tetanus, characterized by muscle stiffness and spasms. Clostridium botulinum (choice C) causes botulism, leading to muscle paralysis. Clostridium difficile (choice D) is associated with antibiotic-associated diarrhea. These choices are incorrect as they do not match the clinical presentation described in the question.

Correct Answer: B

Rationale: The correct answer is B: Clostridium perfringens. In this case, the patient's presentation of infected wound with tissue crepitation, foul odor, and Gram-positive bacteria with centrally located spores that cannot grow in the presence of oxygen is indicative of gas gangrene caused by Clostridium perfringens. This anaerobic bacterium produces various toxins that lead to tissue destruction and gas production in the affected area. Clostridium tetani (choice A) causes tetanus, characterized by muscle stiffness and spasms. Clostridium botulinum (choice C) causes botulism, leading to muscle paralysis. Clostridium difficile (choice D) is associated with antibiotic-associated diarrhea. These choices are incorrect as they do not match the clinical presentation described in the question.

Correct Answer: A

Rationale: The correct answer is A because Staphylococcus aureus can develop resistance to penicillin over time due to the production of beta-lactamase enzymes. This resistance mechanism makes it no longer susceptible to penicillin. The other choices are correct: B) S. aureus can produce beta hemolysis, C) it produces various toxins like hemolysins, leucocidins, and enterotoxins, and D) it shows a positive catalase reaction due to the presence of catalase enzyme that converts hydrogen peroxide to water and oxygen.

Correct Answer: A

Rationale: The correct answer is A: Staphylococcus aureus. This bacterium is Gram-positive cocci in clusters, catalase-positive, and coagulase-positive. Staphylococcus aureus is a common pathogen causing abscesses. Streptococcus pyogenes (B) is Gram-positive cocci in chains, not clusters. Micrococcus luteus (C) is catalase-positive but coagulase-negative. Enterococcus faecalis (D) is catalase-negative and coagulase-negative.

Correct Answer: B

Rationale: The correct answer is B because a viral capsid is a protein coat that surrounds and protects the viral nucleic acid (DNA or RNA). It helps in the attachment of the virus to host cells and protects the genetic material during transmission. Choice A is incorrect because a viral capsid is composed of proteins, not an envelope. Choice C is incorrect because not all viruses have an outer membrane. Choice D is incorrect because a viral capsid is primarily made up of proteins, not lipids.