On the 5th day after a surgery for colon injury a patient complains of bursting pain in the postoperative wound, weakness, drowsiness, headache, fever up to 40oC. Objectively: the skin around the wound is swollen, there is gas crepitation. The wound discharges are scarce foul-smelling, of dark-gray color. What is the most likely diagnosis?

Correct Answer: A

Rationale: The correct answer is A: Anaerobic clostridial wound infection. The symptoms and signs described (bursting pain, weakness, drowsiness, fever, swollen skin, gas crepitation, foul-smelling dark-gray discharge) are classic for gas gangrene, caused by Clostridium perfringens. Gas gangrene is an anaerobic infection that thrives in devitalized tissue, such as postoperative wounds. The gas crepitation is due to gas production by the bacteria. Abscess (B) typically presents with localized swelling and fluctuance, not gas crepitation. Postoperative wound infection (C) may present with redness, warmth, and increased wound discharge but not the specific features mentioned. Erysipelas (D) is a superficial bacterial skin infection, typically caused by Streptococcus pyogenes, presenting with well-defined raised borders and redness.

Correct Answer: B

Rationale: The correct answer is B: Corynebacterium diphtheriae. This bacterium produces a toxin that causes diphtheria by inhibiting protein synthesis, leading to the formation of a pseudomembrane in the throat. Bordetella pertussis causes whooping cough, Streptococcus pyogenes causes strep throat, and Neisseria meningitidis causes meningitis. Corynebacterium diphtheriae is the only bacterium among the choices known to cause diphtheria due to its specific toxin production.

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: 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.

Correct Answer: A

Rationale: The correct answer is A, Anthrax bacillus, because it has the widest infectious spectrum among the options provided. Anthrax bacillus can infect a wide range of hosts, including humans and various animals. It is known for its ability to survive in different environments and cause disease through various routes of exposure. In contrast, choices B, C, and D have more limited infectious spectra. Mumps virus primarily infects humans, the causative agent of gonorrhea mainly affects humans through sexual contact, and the rabies virus typically infects mammals through bites from infected animals. Therefore, Anthrax bacillus is the correct choice due to its broader range of hosts and modes of transmission compared to the other options.

Correct Answer: A

Rationale: The correct answer is A: Peritoneum. Normal flora refers to the microorganisms that naturally inhabit the human body without causing harm. The peritoneum is a sterile area, so it does not harbor normal flora. The urethra, vagina, and mouth all have normal flora due to their moist and warm environments, which provide an ideal habitat for microorganisms to thrive. The peritoneum, being a sterile cavity that houses organs like the stomach and intestines, does not have a natural microbial population like the other areas mentioned. Therefore, it does not contain normal flora.

Correct Answer: A

Rationale: The correct answer is A: Chlamydia. Chlamydia lacks the essential enzymes for ATP synthesis and relies on host cell ATP. Enterococci, Rickettsia, and Staphylococci possess the necessary enzymes for ATP synthesis through cellular respiration. Chlamydia's inability to synthesize ATP makes it dependent on the host cell for energy production, distinguishing it from the other bacteria listed.

Correct Answer: B

Rationale: The correct answer is B because viruses can indeed be cultured on hen embryos, cell cultures, and experimental animals in vitro. This method allows for the replication and study of viruses outside the host organism. Option A is incorrect as viral cultivation is possible in laboratory settings. Option C is incorrect because while viruses can be grown on nutrient media, it is not the only method. Option D is incorrect as viruses can be cultured in various types of cell cultures, not just human embryonic ones.

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.