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: C

Rationale: The Gram stain process involves staining bacterial cells with crystal violet and iodine, followed by decolorization and counterstaining. The primary differentiation is based on the cell wall structure, distinguishing bacteria into Gram-positive (retain purple color) and Gram-negative (lose purple color). This classification is crucial in microbiology for treatment decisions as it correlates with different antibiotic susceptibilities. Choices A, B, and D are incorrect because the Gram stain process does not primarily focus on flagella, shape, or motility of bacteria.

Correct Answer: B

Rationale: The correct answer is B: Toxoplasmosis. Toxoplasmosis is caused by the protozoan Toxoplasma gondii. The rationale for this is that protozoa are single-celled organisms that can cause diseases in humans. Cat scratch disease (A) is caused by a bacterium, Bartonella henselae. Relapsing fever (C) is caused by the bacterium Borrelia recurrentis. Plague (D) is caused by the bacterium Yersinia pestis. Therefore, the only choice caused by a protozoan is toxoplasmosis, making it the correct answer.

Correct Answer: C

Rationale: The correct answer is C because chills, fever, and loss of consciousness are not typical symptoms of botulism. Botulism is characterized by descending, flaccid paralysis (choice A), dry mouth, difficulty swallowing, and speaking (choice B), and blurred vision, diplopia (choice D). These symptoms result from the neurotoxin produced by Clostridium botulinum, leading to muscle weakness and paralysis. Chills, fever, and loss of consciousness are more commonly associated with infections or other conditions, not botulism.

Correct Answer: A

Rationale: The correct answer is A: Cytopathic effect. This is because polioviruses cause visible changes in infected cells, leading to cell damage and death, known as cytopathic effect. This is a key characteristic of viral infection. Choice B (Cytotoxic effect) is incorrect as it refers to the toxicity of a substance to cells, not the specific effect of polioviruses. Choice C (Cytolytic effect) is incorrect as it specifically refers to cell lysis, which is not the primary mechanism of poliovirus infection. Choice D (They Don't Change The Cell Cultures) is incorrect because polioviruses do indeed cause changes in cell cultures due to their cytopathic effect.

Correct Answer: D

Rationale: The correct answer is D: rRNA. Bacterial ribosomes consist mainly of ribosomal RNA (rRNA), which plays a crucial role in protein synthesis. Ribosomes are composed of rRNA and proteins, with rRNA being the major component. rRNA serves as the structural and catalytic component of the ribosome, aiding in the binding of mRNA and tRNA during translation. Carbohydrates (A) and lipids (B) are not primary components of ribosomes, and DNA (C) is not found in ribosomes as they are involved in storing genetic information, not in protein synthesis.

Correct Answer: C

Rationale: Rationale: 1. Vaccinia is a laboratory product used in smallpox vaccination. 2. Variola is the virus that causes smallpox, not a laboratory product. 3. Monkeypox is a naturally occurring virus, not a laboratory product. 4. Cowpox can be found in nature and is used in vaccine production, but it is not a laboratory product like Vaccinia.

Correct Answer: D

Rationale: The correct answer is D because virulence refers to the degree of pathogenicity of a microorganism, which can vary and is not a constant characteristic. It can be measured using LD50, which is the lethal dose that kills 50% of the test population. Therefore, all the statements in options A, B, and C are true and collectively provide a comprehensive understanding of virulence.

Correct Answer: B

Rationale: The correct answer is B: Pseudomonas aeruginosa. P. aeruginosa is known for producing pyocyanin, a green pigment. This bacterium is commonly associated with infections in immunocompromised individuals. Staphylococcus aureus (choice A) produces golden-yellow pigments, not green. Escherichia coli (choice C) and Clostridium difficile (choice D) do not produce pyocyanin. Therefore, the correct choice is B based on the characteristic pigment produced by Pseudomonas aeruginosa.