Children infectious diseases

1. 
   *Measles
   
2. 
   German measles
   
3. 
   Enterovirus infection
   
4. 
   Adenovirus infection
   
5. 
   Scarlet fever
   

14. 
    A 7 year old girl has mild form of varicella. Headache, weakness, vertigo, tremor of her limbs, ataxia, then mental confusion appeared on the 5th day of illness. Meningeal signs are negative. Cerebrospinal fluid examination is normal. How can you explain these signs?
    
    1. 
       Meningitis
       
    2. 
       Myelitis
       
    3. 
       Neurotoxic syndrome
       
    4. 
       Meningoencephalitis
       
    5. 
       *Encephalitis
       

15. 
    A 7-year-old child is sick for 2 weeks with running nose. The boy suffers with alimentary allergy. He applied to doctor due to purulent and bloody discharge from nose, maceration of nostrils and upper lip. Rhinoscopy results: whitish-grayish areas at nasal septum. Mucous membrane of pharynx is not changed. What is the most probable disease?
    
    1. 
       *Diphtheria of the nose
       
    2. 
       Allergic rhinitis
       
    3. 
       Sinusitis (maxillar sinus)
       
    4. 
       Rhinovirus
       
    5. 
       Adenovirus
       

16. 
    A 7-year-old girl suddenly fell ill with fever, headache, severe sore throat, vomiting. Tiny bright red rash had appeared on her reddened skin 3 hours later. It is more intensive in axillas and groins. Mucous membrane of oropharynx is hyperemied, on tonsils there are grayish patches. Submaxillary glands are enlarged and painful. What is the most likely diagnosis?
    
    1. 
       *Scarlet fever
       
    2. 
       Enteroviral infection
       
    3. 
       Rubella
       
    4. 
       Pseudotuberculosis
       
    5. 
       Measles
       

17. 
    A 9-year-old child is ill for 5 days. Physical examination: Conscious, inert. Puffy face. Catarrhal conjunctivitis, scleritis. Bright-red papulous middle-spotted skin rash on face and behind ears. Somewhere elements confluence. Diffuse hyperemia in pharynx. Soft palate shows enanthema. The child is not vaccinated. What is the most likely diagnosis?
    
    1. 
       *Measles
       
    2. 
       Allergic dermatitis
       
    3. 
       Pseudotuberculosis
       
    4. 
       Scarlet fever
       
    5. 
       Rubella
       

18. 
    A boy of 12 years is treated in the infectious department because of moderate form of scarlet fever. How many days a quarantine for his class will continue?
    
    1. 
       7 days
       
    2. 
       15 days
       
    3. 
       21 day
       
    4. 
       30 days
       
    5. 
       *it is not needed to impose a quarantine, only to do medical inspection of schoolboys
       

19. 
    A boy had the catarrhal signs, intoxication, on 5th day has appeared maculo-papulous exanthema behind the ears, on face, during a day it spreads on a neck, shoulders. Put your diagnosis.
    
    1. 
       Rubella
       
    2. 
       Pseudotuberculosis
       
    3. 
       meningococcal infection
       
    4. 
       *Measles
       
    5. 
       Infectious mononucleosis
       

20. 
    A boy has pseudotuberculosis for 3 weeks. Today, after the improvement, a temperature rose repeatedly, pain in joints and stomach appeared. Name the course of the disease in this case.
    
    1. 
       Prolonged, unsmooth with exacerbation
       
    2. 
       Subacute, unsmooth with exacerbation
       
    3. 
       acute, unsmooth with the relapse
       
    4. 
       *acute, unsmooth with exacerbation
       
    5. 
       Prolonged, unsmooth with the relapse
       

21. 
    A boy of 2 years is ill by infectious mononucleosis, severe form, unsmooth course, is treated in the hospital. What medicine is appointed in such case?
    
    1. 
       *glucocorticoids
       
    2. 
       antihistamines
       
    3. 
       Antibiotics
       
    4. 
       disaggregates
       
    5. 
       cytostatics
       

22. 
    A boy of 8 years is ill by infectious mononucleosis, severe form, unsmooth course, is treated in the hospital. What daily dose of prednisolone is given in such case?
    
    1. 
       0.5 - 0.8 mg/kg
       
    2. 
       0.8 - 1.0 mg/kg
       
    3. 
       1 - 1.5 mg/kg
       
    4. 
       *2.0- 2.5 mg/kg
       
    5. 
       2.5 - 5.0 mg/kg
       

23. 
    A boy, 15 years, has infectious mononucleosis a severe form, is treated in the hospital. A mother worries from what complications children die more frequent:
    
    1. 
       lymphadenitis
       
    2. 
       hemolytic anemia
       
    3. 
       *Break of spleen
       
    4. 
       thrombocytopenia
       
    5. 
       Paresis of cranial nerves
       

24. 
    A boy, 15 years, has infectious mononucleosis a severe form, complicated by thrombocytopenia. His mother very worries, is interested in frequency of lethal consequences. What doctor answers for her?
    
    1. 
       Lethality is high
       
    2. 
       *Lethality is low, only single cases
       
    3. 
       Lethality is absent
       
    4. 
       Lethality is high only among new-born
       
    5. 
       Lethality is high only in preschool age
       

25. 
    A boy, 15 years, is treated in the hospital because of infectious mononucleosis. A doctor diagnosed a concomitant bacterial infection. What from antibiotics is impossible to use for treatment in this case?
    
    1. 
       azythromicin
       
    2. 
       roxythromycin
       
    3. 
       amikacin
       
    4. 
       *Ampicillin
       
    5. 
       cefasolin
       

26. 
    A boy, 2 years, has infectious mononucleosis a severe form, complicated, is treated in the hospital. A mother worries from what complications children die more frequent:
    
    1. 
       *The CNS damage
       
    2. 
       lymphadenitis
       
    3. 
       hemolytic anemia
       
    4. 
       thrombocytopenia
       
    5. 
       Paresis of cranial nerves
       

27. 
    A boy, 2 years, is in the infectious department with the diagnosis of infectious mononucleosis. Indicate the possible mechanism of this disease transmission:
    
    1. 
       Fecaly-oral
       
    2. 
       *hemo-contact
       
    3. 
       Water
       
    4. 
       air-dust
       
    5. 
       Food
       

28. 
    A boy, 2years, not vaccinated, 2 weeks ago contacted with a patient with Rubella. Today his temperature rose to subfebrile. Indicate other signs of Rubella in prodromal period.
    
    1. 
       *Moderate intoxication and catarrhal signs, enanthem, increase of posterior cervical and occipital lymph nodes
       
    2. 
       Moderate intoxication and catarrhal sings, rashes on a skin
       
    3. 
       Expressed catarrhal signs, intoxication, enanthem, Koplick's spots
       
    4. 
       Moderate catarrhal signs, enanthem, rashes on a skin
       
    5. 
       Expressed intoxication, difficulty of the nasal breathing, increase of anterior and posterior cervical lymph nodes
       

29. 
    A boy, 3 years, with infectious mononucleosis, is treated in the hospital. What from the serological laboratory investigations will confirm the diagnosis in the late period?
    
    1. 
       Determination of the Ig M against viral capsid antigen (immune enzyme analysis)
       
    2. 
       *Determination of the Ig G against viral capsid and nuclear antigens (immune enzyme analysis)
       
    3. 
       Polymerase chain reaction
       
    4. 
       Reaction of hetero agglutination
       
    5. 
       Complete blood analysis
       

30. 
    A boy, 3 years, with infectious mononucleosis, is treated in the hospital. What from the serological laboratory investigations will confirm the diagnosis in the acute period?
    
    1. 
       *Determination of the Ig M against viral capsid antigen (immune enzyme analysis)
       
    2. 
       Determination of the Ig G against viral capsid and nuclear antigens (immune enzyme analysis)
       
    3. 
       Polymerase chain reaction
       
    4. 
       Reaction of hetero agglutination
       
    5. 
       Complete blood analysis
       

31. 
    A boy, 9 years, contacted with a brother, patient with Rubella. How many time after the contact a child cannot go to the rest camp?
    
    1. 
       11 days
       
    2. 
       14 days
       
    3. 
       17 days
       
    4. 
       *21 day
       
    5. 
       25 days
       

32. 
    A boy, aged of 9 years entered a clinic with a barking cough, hoarse voice, sub-febrile body temperature. During laryngoscopy the edema and hyperemia of epiglottis was noted. During latex-agglutination reaction a diphtheria toxin is exposed in serum. Diagnose is:
    
    1. 
       primary diphtheria of the larynx
       
    2. 
       secondary diphtheria of the larynx
       
    3. 
       *localized diphtheria of the larynx, dysphonia period
       
    4. 
       localized diphtheria of the larynx, stenotic period
       
    5. 
       spread diphtheria of the larynx, dysphonia period
       

33. 
    A child of 5 years complains of pain in his throat, fever. When examined at the 2nd day of illness, a rash was revealed. A scarlet fever was suspected. What morphology of the rash will be typical for scarlet fever?
    
    1. 
       *Pinpoint
       
    2. 
       Hemorrhagic ("Starry")
       
    3. 
       Vesiculous
       
    4. 
       Maculopapular
       
    5. 
       Nodular
       

34. 
    A child of 5 years on 2-day being in the surgical hospital has chickenpox. The day before he had appendectomy. Which of the following is correct as epidemiological measures?
    
    1. 
       *Place patient in Meltzer’s box
       
    2. 
       Urgent discharge
       
    3. 
       Isolate in a separate ward
       
    4. 
       Held in a room with children who previously suffered from chickenpox
       
    5. 
       Isolate by the glass screen up to 5 days from the onset of the last eruption
       

35. 
    A child of five years two weeks ago was in contact with the patient that had shingles (herpes zoster). The child became ill yesterday acutely. The body temperature is 38.7 ˚C, weakness, headache. The body has many, slightly pruritic papular rash elements, vesicles, isolated pustules, vesicles on the oral mucosa, conjunctiva. What is the diagnosis?
    
    1. 
       *Chickenpox
       
    2. 
       Strophulus
       
    3. 
       Impetigo
       
    4. 
       The tuberculosis skin lesions
       
    5. 
       Shingles (herpes zoster)
       

36. 
    A child of seven years had sore throat, fever up to 38.6 ˚C, single vomiting. The next day the body temperature is 37.2-38.5 °C. The doctor found pinpoint rash and diagnosed scarlet fever. Which of the following has been crucial for the diagnosis of scarlet fever?
    
    1. 
       *The prevalence of rash in the natural skin folds
       
    2. 
       White nasolabial triangle
       
    3. 
       Xerosis
       
    4. 
       White dermographism
       
    5. 
       Positive "pinch" symptom
       

37. 
    A child, 14 years, is treated in the infectious department from diphtheria. With the purpose of serological diagnostics the reaction of passive hemagglutination with paired sera in 2 weeks was done. What growth of specific antibodies titre has the diagnostic importance?
    
    1. 
       2 times
       
    2. 
       3 times
       
    3. 
       4 times
       
    4. 
       6 times
       
    5. 
       8 times
       

38. 
    A child of 2 years has measles. Name the evidence to administer antibiotics in this case.
    
    1. 
       Viral complications, presence of concomitant pathology
       
    2. 
       *Bacterial complications, severe disease
       
    3. 
       severe disease, croup syndrome with 1st degree stenosis.
       
    4. 
       severe, moderate disease
       
    5. 
       often ill, with decreased immunity child
       

39. 
    A complement binding reaction with measles diagnostic test is done to a child for confirmation of diagnosis. Indicate the diagnostic titer of antibodies.
    
    1. 
       1:40
       
    2. 
       1:80
       
    3. 
       1:160
       
    4. 
       There is the stable titre of antibodies in paired sera
       
    5. 
       *Growth 4 and more times in 2 weeks
       

40. 
    A child, 8 years, is treated in the infectious department from diphtheria. At examination the child is faded, adynamic. A skin is pale, gray, general cyanosis, hypotonic muscles. Consciousness is absent. Breathing is frequent, superficial, arrhythmic. Diagnose is:
    
    1. 
       diphtheria of the larynx, dysphonia period
       
    2. 
       diphtheria of the larynx, stenotic period, stenosis of the 1st degree
       
    3. 
       diphtheria of the larynx, stenotic period, stenosis of the 2nd degree
       
    4. 
       diphtheria of the larynx, stenotic period, stenosis of the 3rd degree
       
    5. 
       *diphtheria of the larynx, stenotic period, stenosis of the 4th degree
       

41. 
    To a child, 8 years, that for 2 weeks was treated in the hospital, pseudotuberculosis, non-smooth course, is diagnosed. What distinguishes exacerbation of the disease from the relapses?
    
    1. 
       *Growth of clinical symptoms after the period of improvement
       
    2. 
       Appearance of clinical symptoms after normalization of clinic-laboratory indexes
       
    3. 
       Growth of clinical symptoms without the improvement of the patient's state
       
    4. 
       Stable severe state of the patient
       
    5. 
       Gradual improvement of the patient's state up to the convalescence
       

42. 
    A child, aged 5, is ill with fever, vesicular rash mainly on the trunk and head skin. On the 8th day there appeared severe headache, ataxia, lethargy, movement discoordination, tremor of the extremities. On the second wave of the fever encephalitis is diagnosed. Complication of what decease can be encephalitis in this case?
    
    1. 
       *Chicken pox
       
    2. 
       Herpetic infection
       
    3. 
       Enterovirus infection
       
    4. 
       Measles
       
    5. 
       Rubella
       

43. 
    A fellow, 17 years, is treated because of pseudotuberculosis, that has acute smooth courser. Name, what is characteristically in this case?
    
    1. 
       Duration of the disease up to 1 month, presence of exacerbations, relapses, absence of complications
       
    2. 
       *Duration of the disease up to 1 month, absence of exacerbations, relapses, complications
       
    3. 
       Duration of the disease up to 1.5 months, absence of exacerbations, relapses, complications
       
    4. 
       Duration of the disease up to 1.5 months, presence of exacerbations, relapses, absence of complications
       
    5. 
       Duration of disease up to 3 months, absence of exacerbations, relapses, complications
       

44. 
    A girl 5 years is ill for 5 days. On a background of the catarrhal phenomena rashes have appeared today. Measles is suspected. What will differ rashes at this child from rashes at scarlet fever?
    
    1. 
       Absence of rashes concentration round joints, hyperemia and edema of the face, hands, feet
       
    2. 
       More large elements of rashes, concentration round joints, hyperemia and edema of the face, hands, feet
       
    3. 
       rashes are polymorphic (spots, papules, vesicles, crusts), appears in pushes
       
    4. 
       *Time of appearance, morphology, localization, stages, propensity to confluence, unchanged background of skin, pigmentation of rashes
       
    5. 
       rashes are rose, as small spots, during days covers all body, is disposed mainly on the unbend surfaces of extremities, back, buttocks
       

45. 
    A girl aged 10 years had infectious mononucleosis, two days ago she was discharged from the hospital. Indicate how long she must be on the dispensary observation:
    
    1. 
       1 month
       
    2. 
       3 months
       
    3. 
       6 months
       
    4. 
       9 months
       
    5. 
       *12 months
       

46. 
    A girl has pseudotuberculosis. Clinically: febrile temperature, moderate intoxication, enteritis, stomach-ache, rash all over the body. Liver +4 cm. Indicate the severity of the disease.
    
    1. 
       mild
       
    2. 
       *moderate
       
    3. 
       severe
       
    4. 
       Septic
       
    5. 
       Toxic
       

47. 
    A girl has pseudotuberculosis. Clinically: hyperpyrexia, expressed intoxication, meningeal syndrome, stomach-ache, hemorrhagic rash all over the body, polyarthritus, hepatitis. Indicate the severity of the disease.
    
    1. 
       mild
       
    2. 
       moderate
       
    3. 
       *severe
       
    4. 
       Toxic
       
    5. 
       Hypertoxic
       

48. 
    A girl has pseudotuberculosis. Clinically: subfebrile temperature, insignificant intoxication, rashes round the joints, in skin folds. Indicate the severity of disease.
    
    1. 
       Effaced
       
    2. 
       Subclinical
       
    3. 
       *mild
       
    4. 
       moderate
       
    5. 
       severe
       

49. 
    A girl of seven years had sore throat, fever up to 38.6 ˚C, single vomiting. The next day the body temperature is 37.2-38.5 °C. The doctor found pinpoint rash and diagnosed scarlet fever. The apartment is separate. There are no more children in the family. Where this girl could be treated?
    
    1. 
       *Treat at home
       
    2. 
       Hospitalized for 10-12 days
       
    3. 
       Hospitalized at least for 22 days
       
    4. 
       Hospitalized till the negative throat culture (b-hemolytic streptococcus)
       
    5. 
       Treat in hospital until the cessation of desquamation
       

50. 
    A girl of seven years has been ill chickenpox. Indicate the most likely source of infection:
    
    1. 
       *Grandpa, that had shingles (herpes zoster)
       
    2. 
       A neighbor, who had chicken pox a month ago
       
    3. 
       Mother with ARVI, herpes simplex
       
    4. 
       Toy from the varicella focus
       
    5. 
       A classmate, who ills chickenpox for 2 days
       

51. 
    A girl, 10 months, contacted with a brother who had measles. A passive prophylaxis was not done. What is the possibility of future disease in this child?
    
    1. 
       50%
       
    2. 
       70%
       
    3. 
       80%
       
    4. 
       95%
       
    5. 
       *100%
       

52. 
    A girl, 10 years, has pseudotuberculosis, typical form, that has smooth course. What auscultative changes from the heart are possible at the patient?
    
    1. 
       tachycardia, extrasystols
       
    2. 
       tachycardia, dullness of tones, systolic murmur in all points, is spread outside a heart
       
    3. 
       tachycardia, accent of ІІ tone, systolic murmur above an aorta
       
    4. 
       *bradycardia, sinus arrhythmia, dull tones, systolic murmur of functional character
       
    5. 
       bradycardia, systolic murmur that is conducted in all points of auscultation
       

53. 
    A girl, 2 years old, for four nights has paroxysms of cough, which ended by the whoop. What probable duration of the disease:
    
    1. 
       4 days;
       
    2. 
       5 days;
       
    3. 
       7 days;
       
    4. 
       25 days;
       
    5. 
       *14 days.
       

54. 
    A girl, 2 years old, for four nights has paroxysms of cough, which ended by the whoop. The small quantity of the transparent phlegm appeared after cough; one vomiting was noted. What is the probable diagnosis in this case?
    
    1. 
       Bronchiolitis;
       
    2. 
       Obstructive bronchitis;
       
    3. 
       *Whooping cough;
       
    4. 
       Pneumonia with obstructive syndrome;
       
    5. 
       Croup syndrome.
       

55. 
    A girl, 2 years, contacted with a brother who had measles. She with the purpose of measles prophylaxis has received immunoglobulin. A child visits preschool (kindergarten). What is term of quarantine for this girl?
    
    1. 
       9-17 days
       
    2. 
       11-17 days
       
    3. 
       14 days
       
    4. 
       17 days
       
    5. 
       *up to 21 day
       

56. 
    A girl, 5 years, is treated in the hematological department, received preparations of blood, contacted with a patient who had measles. Indicate duration of measles incubation period in this case.
    
    1. 
       Till 17 days
       
    2. 
       *Till 21 day
       
    3. 
       9-17 days
       
    4. 
       14 days
       
    5. 
       11-16 days
       

57. 
    A girl, aged 16 years, appealed to the policlinic for determination of the immune defense against diphtheria. What level of specific antibodies in a blood is protective?
    
    1. 
       0.02-0.03 IU/ml
       
    2. 
       0.03-0.05 IU/ml
       
    3. 
       0.05-0.07 IU/ml
       
    4. 
       0.07-0.09 IU/ml
       
    5. 
       *0.1-0.15 IU/ml
       

58. 
    A boy presents to physician with cramping pain in left side of the chest, general weakness, fever and headache that have appeared 2 days ago. In the morning skin rash on chest was noted. Physical examination: multiple aggregated vesicles filled with transparent fluid, 2-4 mm in diameter. Vesicles are situated on the erythematous and edematous base along 4-5 intercostals. What is the most likely diagnosis?
    
    1. 
       *Herpes zoster varicellosus
       
    2. 
       Pityriasis rosea
       
    3. 
       Streptococcal (Fox's) impetigo
       
    4. 
       Allergic dermatitis
       
    5. 
       Herpes simplex
       

59. 
    A month ago a child received second vaccination by DTP-vaccine and against poliomyelitis. When this boy should be revaccinated against whooping cough?
    
    1. 
       *Through 1 year after finished vaccination;
       
    2. 
       Through 1.5-2 years after finished vaccination;
       
    3. 
       Through 2.5 years after finished vaccination;
       
    4. 
       Through 3 years after finished vaccination
       
    5. 
       In 4 years
       

60. 
    A mother has addressed to physician with the girl, 5 years old. The mother complains of raised temperature in child and multiple vomiting. The disease has begun suddenly. During examination: dry lips, sclera injection, hyperemia of the pharynx, the tongue is covered by white coat, small point-like rash on neck, upper part of the trunk, in skin folds. The pulse is small, heart tones are deaf. The scarlet fever was diagnosed. What form of the scarlet fever has this child?