Which of the following components is present in Gram-negative bacteria but not in Gram-positive bacteria?
Peptidoglycan
Flagella
Lipid A
Capsule
Pili
The Correct Answer is C
The bacterial cell envelope structure is the primary basis for the Gram stain classification. Gram-positive bacteria have a thick, multi-layered peptidoglycan wall containing teichoic acids. In contrast, Gram-negative bacteria have a much thinner peptidoglycan layer but possess an asymmetrical outer membrane. This outer membrane contains specialized molecules that act as a barrier to certain antibiotics and function as powerful endotoxins during systemic infections.
Rationale:
A. Peptidoglycan is found in both Gram-positive and Gram-negative bacteria. It is the structural polymer that provides the cell its shape and protects it from osmotic lysis. While the thickness varies significantly—thick in Gram-positive and thin in Gram-negative—it is a universal component of most eubacterial cell walls and thus not unique.
B. Flagella are complex protein structures used for motility and can be found on both Gram-positive and Gram-negative species. They are not a distinguishing feature of the cell wall type. The presence of flagella depends on the specific genus and species and their need to move toward nutrients or away from toxins.
C. Lipid A is the correct answer as it is the innermost component of the lipopolysaccharide (LPS) found exclusively in the outer membrane of Gram-negative bacteria. It acts as a potent endotoxin that triggers a massive immune response, potentially leading to septic shock. Gram-positive bacteria lack an outer membrane and therefore do not possess Lipid A.
D. A capsule is an organized layer of polysaccharides located outside the cell wall that can be present in either Gram-positive or Gram-negative bacteria. It serves as a virulence factor by helping the bacteria evade phagocytosis. Because it is found in diverse groups like Streptococcus (positive) and Klebsiella (negative), it is not a defining difference.
E. Pili (or fimbriae) are hair-like appendages used for attachment or genetic exchange (conjugation). While they were historically associated more with Gram-negative bacteria, many Gram-positive bacteria are now known to possess similar structures. Therefore, they are not a reliable exclusive component of Gram-negative organisms for the purpose of differential classification.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["3"]
Explanation
Step 1 is to express the percentage concentration as a decimal or ratio
0.005% = 0.005 ÷ 100
Result at this step = 0.00005
Step 2 is to calculate the weight of the active ingredient in grams
Weight (g) = Total weight × Concentration
60 × 0.00005 = 0.003
Result at this step = 0.003 g
Step 3 is to convert grams (g) to milligrams (mg)
mg = 0.003 × 1000
0.003 × 1000 = 3
Result at this step = 3
Step 4 is to round to the nearest whole number
3 = 3
Answer: 3
Correct Answer is B
Explanation
Hypercortisolism results from prolonged exposure to excessive levels of circulating glucocorticoids, often due to pituitary adenomas or exogenous steroid use. This hormonal imbalance causes profound metabolic derangements and systemic physical alterations. Common clinical features include centripetal obesity, hypertension, and dermal changes. Management focus includes identifying the etiological trigger and normalizing cortisol.
Rationale:
A. Upper body slenderness is the opposite of the clinical presentation seen in hypercortisolism. Patients typically exhibit centripetal obesity, which involves weight gain in the trunk and abdomen. The extremities often appear thin due to significant muscle wasting and the mobilization of peripheral structural proteins.
B. Facial puffiness with a moon-shaped appearance, known as moon facies, is a hallmark sign of Cushing syndrome. This occurs due to the redistribution of adipose tissue under the influence of chronic glucocorticoid excess. It is often accompanied by a "buffalo hump" in the dorsocervical region of the neck.
C. Thick skin is incorrect, as glucocorticoid excess leads to the inhibition of collagen synthesis and fibroblasts. This results in fragile skin that is abnormally thin and prone to easy bruising. Characteristic wide, purple striae often develop on the abdomen and thighs due to this dermal thinning.
D. Hypoglycemia is not characteristic; rather, hypercortisolism frequently leads to hyperglycemia and secondary diabetes mellitus. Cortisol stimulates gluconeogenesis and antagonizes the effects of insulin in peripheral tissues. This creates a state of insulin resistance, resulting in elevated blood glucose levels rather than a deficit.
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