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Micro question: Poliomyelitis; 1 A 3-year-old child has been taken to a pediatrician. He has no recent history of any diseases. Objective examination revealed no pathology of the internal organs. The child needs the routine immunization against the following disease: A. Poliomyelitis B. Diphtheria...

Micro question: Poliomyelitis; 1 A 3-year-old child has been taken to a pediatrician. He has no recent history of any diseases. Objective examination revealed no pathology of the internal organs. The child needs the routine immunization against the following disease: A. Poliomyelitis B. Diphtheria and tetanus C. Measles, rubella, parotitis D. Pertussis E.. Type B hepatitis 2- A 1,5 y.o. child fell ill acutely with high temperature 380C, headache, fatigue. The temperature declined on the fifth day, muscular pain in the right leg occured in the morning, there were no movements and tendon reflexes, sensitivity was reserved. What is the initial diagnosis? A. Polyomyelitis B. Viral encephalitis C. Polyartropathy D. Osteomyelitis E. Hip joint arthritis Tetanus 3- A patient consulted a dentist about limited (restricted) mouth opening (trismus). He has a history of a stab wound of the lower extremity. What infection may cause these symptoms? A. Tetanus B. Brucellosis C. Whooping cough D. Wound anaerobic infection E. Tularemia 4- A 47-year-old male patient consulted a dentist about difficult mouth opening (lockjaw or trismus). The patient has a history of a stab wound of the lower extremity. What infection can be manifested by these symptoms? A. Tetanus B. Brucellosis C. Whooping cough D. Anaerobic wound infection E. Tularemia 5- On the 15-th day after a minor trauma of the right foot a patient felt malaise, fatigability, irritability, headache, high body temperature, feeling of compression, tension and muscular twitching of his right crus. What disease can it be? A. Tetanus B. Anaerobic gas gangrene C. Erysipelas D. Acute thrombophlebitis E. Thromboembolism of popliteal artery 6- A 65 y.o. woman complains of complicated mouth opening following foot trauma 10 days ago. Next day she ate with difficulties, there were muscles tension of back, the back of the head and abdomen. On the third day there was tension of all muscle groups, generalized convulsions every 10-15 min. What is the most probable diagnosis? A. Tetanus B. Tetania C. Meningoencephalitis D. Hemorrhagic stroke E. Epilepsy 7- A 45-year-old patient complains of body temperature rise up to 40oC, general weakness, headache, painfulness and spastic muscle contractions around the wound in the shin. He received this wound 5 days ago when working in his garden. He requested no medical care back then. What wound infection can be suspected? A. Tetanus B. Anthrax C. Erysipelas D. Gram-positive E. Gram-negative 8- A 45-year-old patient complains of fever up to 40oC, general weakness, headache and spasmodic contraction of muscles in the region of a shin wound. The patient got injured five days ago when tilling soil and didn’t seek medical attention. What kind of wound infection can be suspected? A. Tetanus B. Anthrax C. Erysipelas D. Gram-positive E. Gram-negative 9- A 38-year-old male complains of tonic tension of the masticatory muscles, so that he cannot open his mouth. 12 days before, he was bitten by an unknown dog. Objectively: there is pronounced tension and twitching of the masticatory muscles. What is the most likely diagnosis? A. Tetanus B. Rabies C. Hysteria D. Trigeminal neuralgia E. Apyretic tetanus Measles 9- A 4-year-old girl died suddenly with symptoms of asphyxia. Autopsy revealed white spots on the buccal mucosa; large blotches of rash on the skin of face, trunk and extremities; conjunctivitis, edema with foci of necrosis on the laryngeal mucosa; giant-cell pneumonia on microscopy. What is the most likely diagnosis? A. Measles B. Scarlet fever C. Influenza D. Meningococcal infection E. Typhus 10- A child is 4 years old, has been ill for 5 days. There are complaints of cough, skin rash, to- 38,2oC, face puffiness, photophobia, conjunctivitis. Objectively: there is bright, maculo-papulous, in some areas confluent rash on the face, neck, upper chest. The pharynx is hyperemic. There are seropurulent discharges from the nose. Auscultation revealed dry rales in lungs. What is the most likely diagnosis? A. Measles B. Rubella C. Scarlet fever D. Adenoviral infection E. Enterovirus exanthema 11- A child, aged 4, has being ill for 5 days, suffers from cough, skin rash, t0- 38,2 °C, facial hydropy, photosensitivity, conjunctivitis. On the face, neck, upper part of the chest there is bright maculopapular rash with areas of merging. Hyperemic throat. Seropurulent nasal discharge. In lungs there are dry crackles. What is the most probable preliminary diagnosis? A. Measles B. Rubella C. Scarlet fever D. Adenovirus infection E. Enterovirus exanthema 12- Such presentations as catarrhal conjunctivitis, pharyngitis, laryngotracheo-bronchitis, white spots on the buccal mucosa in the region of lower premolar teeth, maculopapular rash on face, body and extremities are typical for the following disease: A. Measles B. Spotted fever C. Scarlet fever D. Meningococcal infection E. Influenza 13-. A 7 year old child had an acute onset of disease. Pediatrician stated that mucous membrane of face is hyperemic and covered with a lot of mucus. Mucous membrane of cheeks has whitish stains. Next day the child’s skin of face, neck, body was covered with coarsely-papular rash.What disease may be presumed? A. Measles B. Scarlet fever C. Diphteria D. Meningococcemia E. Allergic dermatitis 14. There is a 7-year-old child with complains of cough, lacrimation, rhinitis, skin rash, photophobia and three-day-long fever as high as 38oC. Physical examination has revealed the following: conjunctivitis; bright red maculopapular rash covering the skin of face, neck and torso; hyperemic pharynx; serous purulent secretions from the nose; dry rales in the lungs. What is the most probable diagnosis? A. Measles B. Scarlet fever C. Rubella D. Adenovirus infection E. Chicken pox 15-A 5-year-old child developed an acute disease starting from body temperature rise up to 38,5oC, running nose, cough and conjunctivitis. On the 4th day the child presented with maculo- papular rash on face. Body temparature rose again up to 39,2oC. Over the next few days the rash spread over the whole body and extremities. Mucous membrane of palate was hyperemic, there was whitish deposition on cheek mucous membrane next to molars. What is your provisional diagnosis? A. Measles B. Acute viral respiratory infection C. Yersinia D. Rubella E. Enterovirus diseases 16. A 3 year old child has been suffering from fever, cough, coryza, conjunctivitis for 4 days. He has been taking sulfadimethoxine. Today it has fever up to 39oC and maculopapular rash on its face. Except of rash the child’s skin has no changes. What is your diagnosis? A. Measles B. Allergic rash C. Rubella D. Scarlet fever E. Pseudotuberculosis Toxoplasmosis with multiple developmental defects. ‫א‬17- A woman delivered What protozoan disease might have caused the intrauterine death? A. Toxoplasmosis B. Leishmaniasis C. Malaria D. Amebiasis E. Lambliasis 18. A woman gave birth to a stillborn baby with numerous malformations. What protozoan disease could cause intrauterine death? A. Toxoplasmosis B. Leishmaniasis C. Malaria D. Amebiasis E. Lambliasis 19- A married couple applied to the genetic consultation in order to consult about their child with multiple abnormalities (microcephaly, idiocy etc). The woman has had an illnesses during her pregnancy but she didn’t take any teratogens or mutagens. The parents’ and the child’s karyotype is normal. Anamnesis study revealed that the family kept a cat. What gravidic disease caused the child’s abnormalities? A. Toxoplasmosis B. Leishmaniasis C. Dysentery D. Balantidiasis E. Trichomoniasis 20. A patient’s preliminary diagnosis is toxoplasmosis. What material was used for diagnostics of this disease? A. Blood B. Feces C. Urine D. Duodenal contents E. Sputum. Tuberculosis 21- Medical examination of the first-year pupils included Mantoux test. 15 pupils out of 35 had negative reaction. What actions should be taken against children with negative reaction? A. BCG vaccination B. Antitoxin vaccination C. Rabies vaccination D. Repeat Mantoux test E. Examination of blood serum 91. Planned mass vaccination of all newborn 5-7 day old children against tuberulosis plays an important role in tuberculosis prevention. In this case the following vaccine is applied: A. BCG B. Diphteria and tetanus toxoids and pertussis vaccine C. Diphtheria and tetanus anatoxin vaccine D. Adsorbed diphtheria vaccine E. – 92. For tuberculosis prevention the newborns got an injection of a vaccine. What vaccine was used? A. BCG B. Mantoux C. DTaP vaccine D. Anatoxin E. Oral polio vaccine (Sabin vaccine) 93. In a maternity hospital a newborn should receive vaccination against tuberculosis. What vaccine should be chosen? A. BCG vaccine B. STI vaccine C. EV vaccine D. DPT vaccine E. Tuberculin 94. There is a suspicion of active tuberculosis development in patient. The doctor has appointed Mantoux test to make a diagnosis. What immunobiological agent has to be administered? A. Tuberculine B. BCG vaccine C. DPT vaccine D. Tularin test E. DT vaccine 26 There are several cases of children from boarding school suffering from sore throat. Microscopy of tonsil smears stained according to Neisser method has revealed thin yellow bacilli with dark brown grains on their ends placed in the shape of Roman numeral five. What infection can be suspected in this case? A. Diphtheria B. Infectious mononucleosis C. Listeriosis D. Tonsillitis E. Scarlet fever 6. A sample taken from the pharynx of a patient with angina was inoculated on the blood-tellurite agar. This resulted in growth of grey, radially striated (in form of rosettes) colonies up to 4-5 mm in diameter. Microscopically there can be seen gram- positive rods with club-shaped ends arranged in form of spread fingers. What microorganisms are these? A. Corynebacteria diphtheriae B. Clostr. botulinum C. Diphtheroids D. Streptococci E. Streptobacilli 7. After inoculation of the material obtained from the pharynx of an angina patient onto the blood-tellurite agar, grey colonies could be observed. They were 4-5 mm in diameter, radially striated (in form of rosettes). Microscopical examination revealed gram-positive bacilli with clavate swollen ends arranged in form of wide-spread fingers. Identify these microorganisms: A. Diphtheria corynebacteria B. Clostr. botulinum C. Diphtheroids D. Streptococci E. Streptobacilli 8. Inoculum from pharynx of a patient ill with angina was inoculated into bloodtellurite agar. It resulted in growth of grey, radially striated (in form of rosettes) colonies 4-5 mm in diameter. Grampositive bacilli with clublike thickenings on their ends placed in form of spread wide apart fingers are visible by microscope. What microorganisms are these? A. Diphtheria corynebacteria B. Botulism clostridia C. Diphtheroids D. Streptococci E. Streptobacilli Autopsy of a dead 6-year-old child revealed a marked 32 edema of the soft tissues of neck and enlarged tonsils. Pharyngeal mucosa was covered with numerous dense whitish- yellow pellicles exposing deep ulcers after their removal. What infectious disease caused the death of the child? A. Diphtheria B. Parainfluenza C. Scarlet fever D. Whooping cough 32- While examining a patient an otolaryngologist noticed hyperaemia and significantly edematous tonsils with a grayish film upon them. Microscopical examination of this film revealed some gram-positive bacilli placed at an angle with each other. What disease might be suspected? A. Diphtheria B. Angina C. Scarlet fever D. Meningococcal nasopharyngitis E. Epidemic parotitis 33- There are several cases of children from boarding school suffering from sore throat. Microscopy of tonsil smears stained according Neisser method has revealed thin yellow bacilli with dark brown grains on their ends placed in the shape of Roman numeral five. What infection can be suspected in this case? A. Diphtheria B. Scarlet fever C. Listeriosis D. Tonsilitis E. Infectious mononucleosis Examination of a child revealed some whitish spots looking like coagulated milk on the mucous membrane of his cheeks and tongue. Analysis of smears revealed gram-positive oval yeast-like cells. What causative agents are they? A. Candida B. Staphylococci C. Diphtheria bacillus D. Actinomycetes E. Fusobacteria 4. During examination of a 3-month old infant a pediatrician revealed that the baby’s oral mucosa and tongue were covered with a thick white deposit. In the material taken from the affected site a bacteriologist revealed the presence of yeast fungi giving the reasons for suspecting a fungal infection which occurs most often in children of this age, namely: A. Candidiasis B. Favus C. Epidermophytosis D. Actinomycosis E. Trichophytia 5. Microscopic examination of a Gramstained scrape from patient’s tongue revealed oval, round, elongated chains of dark- violet gemmating cells. What disease can be caused by this causative agent? A. Candidosis B. Actinomycosis C. Diphtheria D. Staphylococcic infection E. Streptococcic infection 6. A 9 y.o. child has been taking antibiotics on account of bronchopneumonia for a long time. There appeared pain and burning in the area of mucous membrane of his lips and tongue. Objectively: mucous membrane of lips and tongue has caseous and grey plaques that can be easily removed by a spatula leaving hyperemia foci on their spot. Microscopic examination of the plaques revealed mycelium. What is the most probable diagnosis? A. Candidous cheilitis B. Exfoliative cheilitis C. Leukoplakia D. Contactant allergic cheilitis E. Manganotti’s cheilitis 7. After continuous treatment with antibiotics a patient got symptoms of stomatitis. Examination of specimens of oral mucous membrane revealed some oval polymorphous Gram- positive microorganisms arranged in clusters. What microorganism may be the cause of such manifestations? A. С.albicans B. C.perfringens C. S.aureus D. S.pyogenes E. H.pylori 8. After long-term antibiotic treatment a patient has developed whitish spots on the oral mucosa. Gram-positive oval budding cells were detected in the smear preparations. What causative agents were detected? A. Candida fungi B. Staphylococci C. Sarcinae D. Actinomycete E. Tetracocci A worker of a cattle farm consulted a surgeon about fever up to 40oC, headache, weakness. Objective examination of his back revealed hyperaemia and a dark red infiltration up to 5 cm in diameter with black bottom in the center and some pustules. What disease are these presentations typical for? A. Anthrax B. Plaque C. Tularemia D. Furuncle E. Abscess 7. A 43 y.o. patient was admitted to the hospital with complaints of high temperature of the body and severe headache. On examination: carbuncle is revealed on the forearm. There are intense edema around it, insignificant pain, regional lymphadenitis. The patient is a worker of cattle-ranch. What disease is it necessary to think about first? A. Anthrax B. Carcinoma of skin C. Erysipelas D. Erysipeloid E. Eczema 8. A 49-year-old countryman got an itching papule on the dorsum of his right hand. In the centre there is a vesicle with serosanginous exudate. Within the next 2 days the patient developed a painless edema of hand and forearm. On the 4th day the temperature rose to 38,5oC, in the right axillary region a large painful lymph node was found. One daybefore the onset of the disease the patient had examined a dead calf. What is the most likely diagnosis? A. Cutaneous anthrax B. Bubonic plague C. Carbuncle D. Lymphocutaneous tularemia E. Erysipelas 9. Quite often, the soil may contain a number of pathogenic microorganisms. The causative agents of the following disease may exist in the soil for a long time: A. Anthrax B. Diphtheria C. Viral hepatitis D. Pertussis E. Dysentery A female patient bitten by a stray dog came to a surgery. Wide lacerated wounds were localized on the patient’s face. What treatment-and prevention aid should be rendered in order to prevent rabies? A. Immunization with the antirabic vaccine B. Combined antibiotic therapy C. Hospitalization, injection of DTP D. Hospitalization, medical surveillance E. Urgent injection of normal gammaglobulin 5. A man who was bitten by the unknown dog applied to the surgeon. Wide ragged wounds were localized on the face. What curative-prophylactic aid should be given to prevent rabies? A. Start immunization with rabies vaccine B. Prescribe combined antibiotic therapy C. Immediate injection of DPT vaccine D. Hospitalize the patient and keep under the doctor’s supervision E. Immediately inject normal gamma globulin 6. Brain autopsy revealed an edema, hyperemia, and small hemorrhages in the medulla oblongata. Microscopically chromatolysis, hydropia and nerve cell necrosis are observed; within the cytoplasm of hippocampal nerve cells there are eosinophilic structures (Negri bodies) detected. What diagnosis corresponds with the described morphological signs? A. Rabies B. Encephalomyelitis C. Meningococcal meningitis D. Brucellosis E. Encephalitis A 34-year-old male visited Tajikistan. After return, he complains of fever up to 40oC which occurs every second day and is accompanied by chills, sweating. Hepatosplenomegaly is present. Blood test results: RBC- 3x1012/l, Нb- 80 g/l, WBC- 4x109/l, eosinophils - 1%, stab neutrophils - 5%, segmented neutrophils - 60%, lymphocytes - 24%, monocytes - 10%, ESR - 25 mm/h. What is the provisional diagnosis? A. Malaria B. Infectious mononucleosis C. Sepsis D. Typhoid fever E. Leptospirosis 47. A 23 year old female patient complains about periodical chill and body temperature rise up to 40oC, sense of heat taking turns with profuse sweating. The patient has had already 3 attacks that came once in two days and lasted 12 hours. She has lived in Africa for the last 2 months. Liver and spleen are enlarged. In blood: erythrocytes - 2,5x1012/l. What is the most probable diagnosis? A. Malaria B. Spotted fever C. Sepsis D. Haemolytic anaemia E. Leptospirosis 48. 2 weeks since the blood transfusion a recepient has developed fever. What protozoal disease can it be? Trypanosomiasis B. Malaria A. C. Amebiasis D. Toxoplasmosis E. Leishmaniasis