Children infectious diseases

*Measles.

Parainfluenza.

153. 
     The child, 9 years old, is ill for 6 days. He complains of increasing body temperature to 38 ºС, pain during swallowing, small maculous rash on neck, upper part of the trunk, skin folds. Objectively: pharyngeal and tonsillar hyperemia was founded, small point-like enanthema on soft palate. What laboratory investigation will confirm the Scarlet fever?
     
     1. 
        Thick smear of the blood.
        
     2. 
        Smears from the pharynx on viral parts.
        
     3. 
        Blood culture.
        
     4. 
        *The agglutination reaction to reveal the antigen in material.
        
     5. 
        The swab from nose and pharynx on bacillus Lefleri.
        

154. 
     The child, aged 3 months, was vaccinated against diphtheria, tetanus, whooping-cough, poliomyelitis, Ніb-infection. What interval is need before next vaccination against these diseases?
     
     1. 
        2 weeks
        
     2. 
        *1 month
        
     3. 
        5 months
        
     4. 
        6 months
        
     5. 
        12 months
        

155. 
     The child, aged 4 months, was vaccinated against diphtheria, tetanus, whooping-cough, poliomyelitis, Ніb-infection. What interval is need before next vaccination against these diseases?
     
     1. 
        2 weeks
        
     2. 
        *1 month
        
     3. 
        5 months
        
     4. 
        6 months
        
     5. 
        12 months
        

156. 
     The child, aged 5 months, was vaccinated against diphtheria, tetanus, whooping-cough, poliomyelitis, Ніb-infection. What interval is need before next vaccination against these diseases?
     
     1. 
        Not less than 3 months
        
     2. 
        Not less than 6 months
        
     3. 
        Not less than 9 months
        
     4. 
        *Not less than 12 months
        
     5. 
        Not less than 18 months
        

157. 
     The district pediatrician visited 9-month-old baby who is suffering from chicken pox, on the third day of illness. On examination were revealed vesicles on the skin of the trunk, extremities and oral mucosa, as well as crusts on his face, hyperemia of conjunctivas, and purulent discharge from the eyes. The body temperature is 38.5 ˚C. What conclusion has made the doctor?
     
     1. 
        *Moderate form of varicella, complicated by the bacterial infection
        
     2. 
        Typical moderate form of varicella
        
     3. 
        Typical severe form of varicella
        
     4. 
        Generalized form of varicella
        
     5. 
        Hemorrhagic form of varicella
        

158. 
     The girl, 7 years old, complains of pain in the throat, increasing of the body temperature to febrile, headache, and sickness. During objective examination: bright point-like rash on flexible surfaces of the limbs, lateral surface of the trunk, internal and back surfaces of the thighs, increased front-cervical lymphatic nodes, "blazing pharynx". The scarlet fever was diagnosed. What bacteria cause this disease?
     
     1. 
        Staphylococci
        
     2. 
        *Betha-haemolytic streptococci
        
     3. 
        Escherichia coli
        
     4. 
        Bacillus cereus
        
     5. 
        Gram-positive diplococci
        

159. 
     The home pediatrician during examination of the 14 years old girl, has noticed maculous rash on lateral surface of the body and lower part of the abdomen on hyperemied skin. The face is hyperemied with cyanosis, edema of the hands and feet. Name the diagnosis:
     
     1. 
        *Pseudotuberculosis.
        
     2. 
        Scarlet fever.
        
     3. 
        Erysipelas.
        
     4. 
        Tularemia.
        
     5. 
        Brucellosis.
        

160. 
     The home pediatrician during examination of the 9 years old boy put the diagnosis of pseudotuberculosis. Name the method, which is used for early diagnostic of the disease:
     
     1. 
        Bacteriological.
        
     2. 
        *Immune-enzyme.
        
     3. 
        Serological.
        
     4. 
        Cytological.
        
     5. 
        Cytochemical.
        

161. 
     The Physician is called to the boy, 5 years old. Patient is ill during 4 days: increased temperature to 38.2º С, rash has appeared on skin since the first day of the disease. During examination is noted polymorphic rash (the papules, vesicles, crusts) on the whole body, there are several vesicles with purulent content and hyperemia around them. What complication is possible?
     
     1. 
        Phlegmona
        
     2. 
        Furunculosis
        
     3. 
        *Pustulosis
        
     4. 
        Paronychia
        
     5. 
        Eczema
        

162. 
     Three weeks after acute tonsillitis the patient is still weak, inert, subfebrile, his retromaxillary lymph nodes are enlarged. Tonsils are flabby, stick together with arches, there are purulent plugs in lacunae. What is the most probable diagnosis?
     
     1. 
        Acute lacunar tonsillitis
        
     2. 
        *Chronic tonsillitis
        
     3. 
        Chronic pharyngitis
        
     4. 
        Tonsillar tumor
        
     5. 
        Perytonsillitis
        

163. 
     To pediatrician has addressed a boy, 10 years old, with complains of increased body temperature to 38.2 ºC, rash in the manner of red spots and papules on the skin. The physician has noticed the rash on lateral surface of the body and lower part of the abdomen. The face is hyperemied with cyanosis, edema of the neck, higher part of the thorax. Name the diagnosis:
     
     1. 
        Chickenpox.
        
     2. 
        *Pseudotuberculosis.
        
     3. 
        Measles.
        
     4. 
        Rubella.
        
     5. 
        Scarlet fever.
        

164. 
     To pediatrician has addressed a girl, 12 years old, who had increased body temperature to 38.2-39.4 ºC. In 5 days rash had appeared around knees and feet, and lower part of the abdomen, in skin folds. It looks like red spots and papules. Mild jaundice of the skin had appeared. Name the diagnosis.
     
     1. 
        Chickenpox.
        
     2. 
        *Pseudotuberculosis.
        
     3. 
        Measles.
        
     4. 
        Rubella.
        
     5. 
        Scarlet fever.
        

165. 
     To the 10 years old boy a tree-like keratitis is diagnosed. Unilateral expressed vascular injection of the eyeball is revealed, almost in the center of the cornea is fuzzy grayish turbidity, that takes the form of twigs with rough surface. What infection can cause such changes?
     
     1. 
        *Herpetic
        
     2. 
        Adenovirus
        
     3. 
        Measles
        
     4. 
        Chlamydia
        
     5. 
        Staphylococcal
        

166. 
     To the boy, patient with pseudotuberculosis, complete blood analysis is done. How will differ its results from complete blood analysis at infectious mononucleosis with the secondary tonsillitis?
     
     1. 
        leucopenia, lymphomonocytosis, appearance of atypical mononuclear cells,
        
     2. 
        leucopenia, lymphocytosis, plasmocytosis
        
     3. 
        leucocytosis, neutrophilia, eosynophilia, increased ESR
        
     4. 
        leucopenia, lymphocytosis, absence of atypical mononuclear cells
        
     5. 
        *neutrophilia, absence of atypical mononuclear cells
        

167. 
     To the child of 18 months re-vaccination against tetanus, diphtheria, whooping-cough was done. What recommendation does it follow to give to the parents in case the credible increase of temperature?
     
     1. 
        *paracethamol during 1 day
        
     2. 
        paracethamol during 3 days
        
     3. 
        Aspirin during 1 days
        
     4. 
        analgin during 1 day
        
     5. 
        analgin during 3 days
        

168. 
     To the child with the purpose of congenital Rubella confirmation virology research is performed. What environments and liquids need to be examined for this test?
     
     1. 
        Blood, saliva, cerebral-spinal fluid
        
     2. 
        Blood, saliva, urine, sweat
        
     3. 
        Blood, cerebral-spinal fluid, urine
        
     4. 
        *Blood, nasopharyngeal mucus, excrements, urine
        
     5. 
        Urine, excrements, saliva, sweat
        

169. 
     To the child with the purpose of Rubella confirmation hemagglutination retardation reaction is done with the rubella diagnostic test. When does it follow to repeat this research?
     
     1. 
        In 4 days
        
     2. 
        In 7 days
        
     3. 
        *In 10-14 days
        
     4. 
        In 3 weeks
        
     5. 
        In a month
        

170. 
     To the child with the purpose of Rubella confirmation hemagglutination retardation reaction is done with the rubella diagnostic test. Indicate the diagnostic titer of antibodies.
     
     1. 
        1:20
        
     2. 
        1:40
        
     3. 
        1:80
        
     4. 
        1:160
        
     5. 
        *Increase of titre in 4 and more times in paired sera
        

171. 
     To the child, 10 months old, with the purpose of measles' prophylaxis (he contacted with a sick brother) was injected specific immunoglobulin. What type of immunity has developed in this case?
     
     1. 
        *Specific, passive, with short duration
        
     2. 
        Specific, passive, with long duration
        
     3. 
        Specific, active, with long duration
        
     4. 
        Unspecific, passive, with short duration
        
     5. 
        Unspecific, passive, of long duration
        

172. 
     To the girl, patient with pseudotuberculosis, moderate degree, complete blood analysis is done. What results will be different from results in complete blood analysis at scarlet fever?
     
     1. 
        Increased number of plasmatic cells, normal ESR
        
     2. 
        monocytosis, normal ESR
        
     3. 
        Appearance of atypical mononuclear cells, increased ESR
        
     4. 
        leucocytosis, increased ESR
        
     5. 
        *No one
        

173. 
     To the healthy child, 1 year old, 3 days ago Mantoux test was performed. The result is negative. Together with what vaccination should be done vaccination against Chickenpox?
     
     1. 
        Against whooping cough, tetanus, diphtheria.
        
     2. 
        Against poliomyelitis.
        
     3. 
        *This vaccination is not obvious.
        
     4. 
        Against hepatitis В.
        
     5. 
        Against tuberculosis.
        

174. 
     What medicine is better to use to decrease the number of cough paroxysms in case of Whooping cough in 5 years old child?
     
     1. 
        *Buthamirat;
        
     2. 
        Glauvent;
        
     3. 
        Salbuthamol;
        
     4. 
        Instaril;
        
     5. 
        Libexin.
        

175. 
     What treatment is necessary to a 5 years old child who is suffering with uncomplicated whooping cough for 3 weeks?
     
     1. 
        *None of the above
        
     2. 
        Chloramphenicol
        
     3. 
        Glucocorticoid hormones
        
     4. 
        Erythromycin
        
     5. 
        Whooping cough immunoglobulin
        

176. 
     Which of the following should be taken (with the purpose of the Epidemic measures) in the rheumatologic department, where one child has chicken pox, in relation to other children, that previously had not suffered from chicken pox?
     
     1. 
        *Discharge or translocate them to an infectious "box" in 8 days
        
     2. 
        Urgent discharge
        
     3. 
        Urgently translocate them to Meltzer’s box
        
     4. 
        Held in a room with children who previously suffered from chickenpox
        
     5. 
        Do nothing
        

177. 
     A 1,5 y.o. child fell ill acutely with high temperature 38 °C, headache, fatigue. The temperature declined on the fifth day, muscular pain in the right leg occurred in the morning, there were no movements and tendon reflexes, sensitivity was reserved. What is the initial diagnosis?
     
     1. 
        Viral encephalitis
        
     2. 
        Hip joint arthritis
        
     3. 
        *Poliomyelitis
        
     4. 
        Polyartropathy
        
     5. 
        Osteomyelitis
        

178. 
     A 14-year-old patient on the 5th day of acute respiratory disease with high grade temperature complained of strong headache, systemic dizziness, sensation of double vision, paresis of right mimic muscles, tickling at swallowing. Diagnosis: Acute viral encephalitis. Determine the basic direction of the emergent therapy.
     
     1. 
        *Acyclovir
        
     2. 
        Glucocorticoids
        
     3. 
        Hemodesis
        
     4. 
        Cephtriaxon
        
     5. 
        Lasix
        

179. 
     A 15 years patient fell ill a week ago: body temperature rose up to 37.6 °C, there appeared a slight swelling on his neck. His illness was diagnosed as ARVI, cervical lymphadenitis. Treatment included erythromycin, hot compress on the neck. Than body temperature raised up to 39 ^oC, appeared headache, repeated vomiting, meningeal syndrome. What studies are necessary for the final diagnosis?
     
     1. 
        Complete blood count
        
     2. 
        Puncture of cervical lymph node
        
     3. 
        *Cerebrospinal puncture
        
     4. 
        Sputum test for secondary flora
        
     5. 
        Roentgenological examination of lungs
        

180. 
     A 3 year old boy fell ill abruptly: fever up to 39 ^oC, weakness, vomiting. Haemorrhagic rash of various size appeared on his lower limbs in 5 hours. Meningococcemia with infectious - toxic shock of the 1st degree was diagnosed. What medications should be administered?
     
     1. 
        *Chloramphenicol succinate and prednisone
        
     2. 
        Chloramphenicol succinate and interferon
        
     3. 
        Penicillin and prednisone
        
     4. 
        Ampicillin and immunoglobulin
        
     5. 
        Penicillin and immunoglobulin
        

181. 
     A 3 year old child fell ill acutely, body temperature rose up to 39.5 °C, the child became inert, there appeared recurrent vomiting, headache. Examination revealed positive meningeal symptoms. CSF is turbid, with high pressure, protein 1,8 g/l; Pandy reaction +++, sugar 2,2 mmole/l, chlorides - 123 mmole/l, cytosis is 2,35*10^9 (80% neutrophils, 20% lymphocytes). What is the most probable diagnosis?
     
     1. 
        Serous tuberculosis meningitis
        
     2. 
        Brain tumor
        
     3. 
        Serous viral meningitis
        
     4. 
        *Purulent meningitis
        
     5. 
        Subarachnoid hemorrhage
        

182. 
     A 5-year-old boy fell ill abruptly: fever up to 39.8 °C, recurrent vomiting, severe headache. Convulsions occur in 3 hours. Meningeal signs are positive. Pleocytosis of 2500 mainly polymorphonuclear cells, elevated protein concentration and normal glucose concentration were found in cerebrospinal fluid. What is your diagnosis?
     
     1. 
        *Purulent meningitis
        
     2. 
        Tuberculosis meningitis
        
     3. 
        Serous meningitis
        
     4. 
        Subarachnoid hemorrhage
        
     5. 
        Encephalitis
        

183. 
     A boy, 7 years old became ill 3 days ago: body temperature 39.6 °С, repeated vomiting, headache, weakness. On the 3rd day he couldn't close left eye, face asymmetry during speaking has appeared. The boy wasn't vaccinated. What disease is suspected?
     
     1. 
        *Poliomyelitis, pontine form
        
     2. 
        Poliomyelitis, bulbar form
        
     3. 
        Poliomyelitis, meningeal form
        
     4. 
        Facial nerve peripheral palsy
        
     5. 
        Facial nerve central palsy
        

184. 
     A child with meningococcus meningitis has been taking penicillin for 7 days. Last 4 days a body's temperature is normal. Meningeal signs are absent. When is it possible to cancel antibiotic therapy?
     
     1. 
        *If liquor cytosis is 50 or less, mainly due to lymphocytes
        
     2. 
        If liquor cytosis is 150, mainly due to lymphocytes
        
     3. 
        Right now
        
     4. 
        If leucocytosis and left neutrophilic shift are absent
        
     5. 
        If liquor cytosis is 100 or less, mainly due to neutrophils
        

185. 
     A girl 2 years became ill acutely from raising of temperature to 38.3 °С, catarrhal phenomena. During three days cough and cold were present. Then a temperature decreased, but the child could not stay. A doctor reveals limitation of movements, lowering of muscular tone in lower extremities. Sensitiveness is normal. Name previous diagnosis.
     
     1. 
        *Poliomyelitis
        
     2. 
        Osteomyelitis
        
     3. 
        Enteroviral infection
        
     4. 
        Rotaviral infection
        
     5. 
        Flu
        

186. 
     A girl, 4.5 years old, is treated in infectious department from meningococcal infection (generalized form), meningococcemia. Name, what examination must be done to determine specific antibody.
     
     1. 
        *Serological reaction.
        
     2. 
        The latex-agglutination reaction
        
     3. 
        The immune-electrophoresis reaction
        
     4. 
        The direct bacterioscopy of the blood.
        
     5. 
        Bacteriological examination of the blood.
        

187. 
     A girl, aged 10 months, is treated from meningococcal infection (generalized form). Choose the sign, which is not unfavorable at this disease:
     
     1. 
        Early age.
        
     2. 
        Early appearance and quick growth of the hemorrhagic rash.
        
     3. 
        Predominant localization of the rash on face and trunk.
        
     4. 
        Hypothermia.
        
     5. 
        *Presence of purulent meningitis.
        

188. 
     At 14 years fellow measles was complicated by meningoencephalitis. What features of this complication?
     
     1. 
        *Severe course, high lethality
        
     2. 
        Defeat of cerebellum, convalescence without the remaining phenomena
        
     3. 
        Defeat of cerebellum, central paralyses
        
     4. 
        Mild course, without the remaining phenomena
        
     5. 
        Development of purulent meningitis
        

189. 
     At a boy Rubella was complicated by meningoencephalitis. In what age such complication is more frequent?
     
     1. 
        In new-born
        
     2. 
        At infants
        
     3. 
        At the children of early age
        
     4. 
        In preschoolers
        
     5. 
        *In senior schoolers
        

190. 
     At a child 4 years suddenly the temperature of body rose to 39.5 °C. Head ache and repeated vomit appeared. In a hour a mother noticed the plural hemorrhagic rashes on buttocks and shins, which spread quickly. What is the previous diagnosis?
     
     1. 
        *Meningococcemia, fulminant form
        
     2. 
        Meningococcemia, infectious-toxic shock ІІ degree
        
     3. 
        Meningococcal meningitis
        
     4. 
        Meningococcal meningoencephalitis
        
     5. 
        Meningococcal meningitis and Meningococcemia
        

191. 
     Child 1.5 years, not vaccinated is ill for 4 days. The disease had begun from hyperthermia to 38.5 °C, weakness, mild catarrhal phenomena and liquid emptying. On a 5th day a temperature normalized, pain appeared in the muscles of feet with acute limitation of movements, lowering of tendon reflexes. Name previous diagnosis.
     
     1. 
        *Poliomyelitis
        
     2. 
        Acute intestinal infection
        
     3. 
        Acute encephalitis
        
     4. 
        URT infection
        
     5. 
        Osteomyelitis
        

192. 
     In entrance department of the infectious diseases hospital to the child, 5 years old, physician put diagnosis of meningococcal infection, meningococcemia. Indicate the start dose of the penicillin for meningococcemia treatment.
     
     1. 
        100 thous. IU/kg/day.
        
     2. 
        *200-300 thous. IU/kg/day.
        
     3. 
        500 thous. IU/kg/day.
        
     4. 
        800 thous. IU/kg/day.
        
     5. 
        1 mln. IU/kg/day.
        

193. 
     In entrance department of the infectious hospital to the boy, at the age of 2 years, the diagnosis of meningococcal infection, mixed form with infectious-toxic shock I degree, was put. Choose the sign, which is not typical for this case:
     
     1. 
        *Decrease of the arterial pressure below 80 mm.Hg.
        
     2. 
        Skin pallor.
        
     3. 
        Cool limbs.
        
     4. 
        Central hyperthermia.
        
     5. 
        Adequate urination.
        

194. 
     In the child with meningococcal infection (typical meningococcemia) typical hemorrhagic rash is localized especially on the skin of the buttocks, lower part of the abdomen. What is the most probable time of the rash beginning?
     
     1. 
        Simultaneously with increasing of the temperature.
        
     2. 
        Through 2-3 hours after increasing of the temperature.
        
     3. 
        *Through 5-15 hours after increasing of the temperature.
        
     4. 
        At the beginning of the 2nd day.
        
     5. 
        After 2 days.
        

195. 
     In a patient the disease has started acutely, with fever to 38 — 39 °C, weakness, acute headache, nausea, vomiting, pain all over the body, sleep disorders. On physical examination: hyperemia of face, neck, thorax. Meningeal signs are positive. 12 days ago the patient returned from the Siberia, from the forest. What is the most probable diagnosis?
     
     1. 
        *Tick-borne encephalitis
        
     2. 
        Omsk hemorrhagic fever
        
     3. 
        Pseudotuberculosis
        
     4. 
        Epidemic typhus
        
     5. 
        Influenza
        

196. 
     The boy, aged 3 years, had meningococcemia, uncomplicated form. Before the disease vaccination was performed outside of vaccination calendar. Indicate through what time after the disease is possible to continue vaccinations.
     
     1. 
        *1 month.
        
     2. 
        2 months.
        
     3. 
        6 months.
        
     4. 
        1 year.
        
     5. 
        Vaccination is impossible.
        

197. 
     The child is 3 years old. Meningococcal infection, generalized form, purulent meningitis was diagnosed. What changes in the general blood test are typical for this disease?
     
     1. 
        leucocytosis, lymphocytosis.
        
     2. 
        Leucopenia, neutrophilia, reduction of ESR.
        
     3. 
        *Elevation of ESR, leucocytosis, neutrophilia.
        
     4. 
        leucocytosis, aneosinophylia.
        
     5. 
        leukopenia, neutrophilia, atypical mononuclear cells.
        

198. 
     The child, 4 years old, is ill with meningococcal infection (meningococcemia), complicated by infectious-toxic shock. Choose the antibacterial medicine, which is reasonable to use for etiotrope therapy:
     
     1. 
        Penicillin.