Introduction into the Infectious Diseases. Infections with fecal-oral mechanism of transmission. Infections with droplet mechanism of transmission. Tests

Situational tasks

1. 
   3 patients were delivered with symptoms of fever, diarrhea and vomiting. Excrements are dark-green, without any pathological changes. All patients together took part in the preparation of food and have used eggs, meat, salad. The most likely diagnosis.
   
   1. 
      Cholera
      
   2. 
      Botulism
      
   3. 
      Dysbacteriosis
      
   4. 
      * Salmonellosis
      
   5. 
      Shigellosis
      
2. 
   A 30 y/o patient is seen on the 9th day of illness. The symptoms of illness had been building–up gradually with increasing of fever and intoxication. Roseolar rash has appeared on skin of stomach. The skin is pale, temperature 40°C, pulse 80/min, BP 100/65. The tongue is covered with sediments and abdomen is swollen. Spleen and liver are palpable. What symptom will be positive for this patient?
   
   1. 
      Symptom of Botkin
      
   2. 
      * Symptom of Padalka
      
   3. 
      Symptom of Kyl'dyushevsky
      
   4. 
      Symptom of Ortner
      
   5. 
      Symptom of Pasternatsky
      
3. 
   A 39 years old train conductor, is hospitalized on the 4th day of illness with complaints on headache, weakness, dizziness, increased perspiration, insomnia, chills. Hyperaemia of face with edema, and conjunctivitis have been observed. On a transitional fold of conjunctiva are present some petechias. On the skin of trunk, thorax, stomach, extremities intensive roseolopetechial rash was found. During examination there was tachycardia, BP – 100/60 mm of Hg, tremor of tongue were marked. The liver, and spleen, are enlarged. Patient is constipated for 3 days. Most credible diagnosis is:
   
   1. 
      * Epidemic typhus
      
   2. 
      Typhoid fever
      
   3. 
      Flu
      
   4. 
      Meningococcemia
      
   5. 
      Leptospirosis
      
4. 
   A child, 8 years old, has been ill for 9 days. Complaints of weakness, headache, insomnia. A temperature to – 38,5-39,5°C. The skin is pale. There are 3 roseolas on the skin of abdomen. A tongue is assessed. A liver and spleen is enlarged. What disease is the most probable?
   
   1. 
      Sepsis
      
   2. 
      Yersiniosis
      
   3. 
      Infectious mononucleosis
      
   4. 
      * Typhoid fever
      
   5. 
      Leptospirosis
      
5. 
   A Pakistani, 30 years old, is severely ill: with the complains of frequent diarrhea like rice water. Objectively: body temperature 35,4°C, skin of peripheral parts of the body cold to the touch, acrocyanosis, xerostomia, sharply decreased skin elasticity and turgor. What should be done to assess the degree of dehydration.
   
   1. 
      Measurement of central venous pressure
      
   2. 
      Determination of urea and creatinine in blood
      
   3. 
      Funduscopy
      
   4. 
      Plain X-ray film of abdomen
      
   5. 
      * Determination of specific gravity of blood plasma
      
6. 
   A patient A., 43 years old, is ill 2 weeks. The disease began from the increasing of temperature to 37,2°C, headache, decline of appetite, weakness. Then a temperature attained 39-40 °C. Objectively: the state is hard, on a question answers slowly. Adynamia. Pulse 80 in a min. BP is 100/60 mmHg. An abdomen is painless, flatulence, hepatosplenomegaly. Stool is of green colour. How long is it necessary to look after people who were in contact with this patient?
   
   1. 
      35 days
      
   2. 
      1 month
      
   3. 
      * 21 days
      
   4. 
      1 week
      
   5. 
      12 days
      
7. 
   A patient K., 26 years old, acted to permanent establishment on the 5th day of the disease with complaints for a high temperature, chill, dry cough. The disease began suddenly from getting up of temperature to 38,8 °C, chill, then a dry cough. Treated oneself as acute respiratory infection, took an analgesic, antihistaminic. Objectively: state of moderate severity, on skin of an abdomen are single roseollas, hepatosplenomegaly, diarrhea up to 4 times without admixtures. The most informative methods of diagnostics of this disease are:
   
   1. 
      Washing off from a pharynx for a virus
      
   2. 
      Passive hemaglutination reaction with О-, Н- and Vi-antigens
      
   3. 
      Clinical blood test
      
   4. 
      Reaction of Vidal
      
   5. 
      * Hemoculture
      
8. 
   A patient R., 23 years old, was hospitalized on the 4th day of disease, had a contact with a patient of typhoid fever. During hospitalization temperature of body – 37,8 °C, severe headache. A tongue is with a yellow coverings. A stomach is soft, painless, rumbling in an ileocecal corner. Liver +1 cm. Defecation is absent during 3 days. Hospitalized for an inspection on typhoid fever. What examination (laboratory diagnostic) do you suggest for this patient?
   
   1. 
      Urinoculture
      
   2. 
      Coproculture
      
   3. 
      * Hemoculture
      
   4. 
      Biliculture
      
   5. 
      Positive reaction with a typhoidal antigen 1:200
      
9. 
   A patient V., 23 years old, was hospitalized on the 6th day of the disease with complaints for a high temperature, chill, dry cough. The disease began suddenly from getting up of temperature to 39,7 °C, chill, then a dry cough. Treated oneself as ARI, took an analgesic, antihistaminic. Objectively: state of moderate severity, on an abdomen are single roseollas, hepatosplenomegaly, diarrhea up to 4 times without admixtures. What is the previous diagnosis?
   
   1. 
      Yersiniosis
      
   2. 
      * Typhoid fever
      
   3. 
      Brill‘s disease
      
   4. 
      Meningococcemia
      
   5. 
      Epidemic typhus
      
10. 
    A patient was hospitalised after 4 hours of consumption of raw eggs, complaining frequent vomiting, abdominal pain, mostly in the right iliac area and umbilical area. Objectively pale skin, dry tongue with grey coating, hypotension, tachycardia. What tests should be carried out to confirm the diagnosis.
    
    1. 
       General blood analysis
       
    2. 
       Parasitological examinations
       
    3. 
       Microscopic examination of stool
       
    4. 
       Biological test
       
    5. 
       * Coproculture
       
11. 
    A patient, 23 years old, appealed into the hospital on the 6th day of gradual development of illness, with complaints about severe headache in the back of head, parahypnosis, fever. Objectively: temperature 39,7 °C, Ps 84 per min. Face is pale, a tongue is dry, near a root covered with grey coverings. A stomach is swollen. Dullness of percussion sound is determined in a right iliac area. A liver and spleen are palpated. What day does a rash appear at this disease?
    
    1. 
       On the 12th day
       
    2. 
       On the 4th day
       
    3. 
       On the 5th day
       
    4. 
       On the 6th day
       
    5. 
       * On the 8th day
       
12. 
    A patient, 24 y/o, was hospitalized in infectious department on the 10th day of illness with complaints about a weakness, headache, absence of appetite, cough. Objectively: temperature of body 39,5 °C, pallor of skin. On the skin of stomach and chest some roseolas were found. There is hard breathing over the lungs with no rales. RR 20 / min. Pulse 80 /1 min. The liver edge is palpable 1 cm. below than costal arc. The spleen is enlarged a little. What is the diagnosis?
    
    1. 
       * Typhoid fever
       
    2. 
       Flu
       
    3. 
       Spotted fever
       
    4. 
       Brucellosis
       
    5. 
       Pneumonia
       
13. 
    A persons 28 y.o., became ill sharply, when a chill, feeling of heat, increase body temperature to 38,5 °C, spastic pain in a left hypogastria area, frequent liquid stool. The excrements have the appearance of bloody-mucous mass (lumps of mucus with the blood). At palpation: abdomen is painful in its left half, a spastic sigmoid colon. What is the previous diagnosis?
    
    1. 
       Amoebiasis
       
    2. 
       Escherichiosis
       
    3. 
       * Shigellosis
       
    4. 
       Balanthidiasis
       
    5. 
       Acute intestinal infection
       
14. 
    A plumber, 45 y/o., is hospitalized on the 7th day of fever. Objectively: t – 39,8 °C, somnolence (at night insomnia), adynamia, pallor of skin, Ps 78/min, BP 105/70 mmHg. Tongue is thickly assessed by the grey coverings with the imprints of teeth. Palpation: an abdomen is distended, a liver enlarged for 2 cm, and spleen for 1 cm below costal arc, in the right iliac area – the crepitating grumbles and hyperesthesia of skin. The defecation is absent for 2 days. What additional research should be performed for confirmation of diagnosis?
    
    1. 
       Spinal puncture
       
    2. 
       * Bacteriological research of blood
       
    3. 
       Analysis of myelogram
       
    4. 
       Colonoscopy
       
    5. 
       Research of blood for the markers of viral hepatitis
       
15. 
    A sick woman, 32 years, complains on diarrhea, headache, severe weakness, insomnia, dull pain in a right iliac area. It is a 8th day of illness. At a review: Т-39,8 °C, Рs – 86/min., BP – 90/60 mm Hg. It is dictoria of pulse. Skin is pale. Single roseollas are on the abdomen. Tongue is dry, assessed by the coverings, with the imprints of teeth on a lateral surface. Soft, dulling of percussion sound is determined in a ileocaecal area of abdomen. Hepatosplenomegaly, positive Blumberg’s symptom, neutrophilic leukocytosis. What changes will be at X-ray examination?
    
    1. 
       No changes
       
    2. 
       * Presence of air under a diaphragm
       
    3. 
       Presence of the exaggerated loops of intestine
       
    4. 
       Enlarged liver and spleen
       
    5. 
       Signs of impassability of intestine
       
16. 
    A vagabond 45 years old is hospitalized on the 7th day of fever. Objectively: t – 39,8 °C. He complaints for headache and insomnia. A patient is excited, talkative. Face is hyperemic. Rash mainly on the lateral surfaces of trunk, abundant, roseollar-patechial. Pulse is rapid. Enlarged liver and spleen. What is the previous diagnosis?
    
    1. 
       Typhoid fever
       
    2. 
       * Epidemic typhus
       
    3. 
       Paratyphoid B
       
    4. 
       Leptospirosis
       
    5. 
       Scarlet fever
       
17. 
    A woman D., 41 years, complains on diarrhea, headache, severe weakness, insomnia, dull pain in a right iliac area. It is a 8th day of illness. At a review: Т-39,8 °C, Рs – 86/min., AP – 90/60 mm Hg. It is dictoric pulse. Skin is pale. Single roseollas are on the abdomen. Tongue is dry, assessed by the coverings, with the imprints of teeth on a lateral surface. Soft, dulling of percutory sound is determined in a illeocaecal area of abdomen. Hepatosplenomegaly, positive Blumberg’s symptom, neutrophilic leukocytosis. What diagnosis is most reliable?
    
    1. 
       * Typhoid fever
       
    2. 
       Epidemic typhus
       
    3. 
       Sepsis
       
    4. 
       Megakaryoblastoma
       
    5. 
       Tuberculosis
       
18. 
    ?At a patient G., 41 years old, was a high temperature during 8 days, severe headache, constipation. Objectively: temperature of body 39,5 °C, pale, languid. Pulse 82 per a min, a tongue is dry, assessed by the brown coat. An abdomen is moderato exaggerated, painful in a right ileac area. A liver + 2 cm. What is the most credible diagnosis?
    
    1. 
       * Typhoid fever
       
    2. 
       Epidemic typhus
       
    3. 
       Flu
       
    4. 
       Appendicitis
       
    5. 
       Yersiniosis
       
19. 
    At patient Z., 40 years old, disease became suddenly: the temperature of body rose to 39 °C, pain appeared in a left ileac area, frequent stool was with blood and mucous. What preparation does need to give at primarily?
    
    1. 
       * Furazolidonum
       
    2. 
       Phtalazoium
       
    3. 
       Tetracyclinum
       
    4. 
       Biseptolum
       
    5. 
       Levomicetynum
       
20. 
    At sick P., 40 years old, the high temperature of body is marked during 8 days, great headache. Objectively: temperature – 39,5 °C, a patient is pale, languid, adynamic. Pulse 82 per a min. A tongue is dry, assessed a brown raid, on the skin of abdomen singles roseolas. A liver + 2 cm. What is the most credible diagnosis?
    
    1. 
       * Typhoid fever
       
    2. 
       Spotted fever
       
    3. 
       Sepsis
       
    4. 
       Tuberculosis
       
    5. 
       Brucellosis
       
21. 
    At sick, 32 years, on the 9th day of illness which began gradually, from slow growth of fever and intoxication, appeared 3 roseols on the skin of abdomen. Objectively: pale of skin, temperature – 40,4 °C, pulse 80 per a min, BP 100/65 mm Hg. A tongue is assessed, an abdomen is swollen, and the spleen and liver are palpated. Inspection what disease is it needed to conduct on above all things?
    
    1. 
       Spotted fever
       
    2. 
       * Typhoid fever
       
    3. 
       Measles
       
    4. 
       Scarlet fever
       
    5. 
       Sepsis
       
22. 
    At the inspection of persons who contact with patient with typhoid fever, stick of typhoid fever was found in urine. The reaction of Widal was negative. A patient considers himself healthy. What is your preliminary diagnosis?
    
    1. 
       Typhoid fever, latent period
       
    2. 
       Typhoid fever, relapse
       
    3. 
       Transitory bacteriocarriers of stick of typhoid fever
       
    4. 
       * Chronic bacteriocarriers of stick of typhoid fever
       
    5. 
       Any of the enumerated diagnoses is possible
       
23. 
    At the patient B., 25 years old, was diagnosed typhoid fever. On the 17th day of disease the temperature of body critically went down to the norm, a pallor color of skin increased. Consciousness is stored. Pulse 120 per a min, rhythmic. On the top of heart is systolic noise. Constipation. About what complication is it necessary to think?
    
    1. 
       * Bleeding
       
    2. 
       Perforation
       
    3. 
       Infectiously-toxic shock
       
    4. 
       Infectiously-allergic myocarditis
       
    5. 
       Pneumonia
       
24. 
    At the typical form of typhoid fever temperature of body rises like to stairs from a day to the day to 39-40 °C at the end of 1st week, in future during 10-14 days reposes approximately on this level, and then becomes remittent and, gradually going down, comes to the norm. How is such temperature curve named?
    
    1. 
       * The temperature curve as Vunderlihs
       
    2. 
       The temperature curve as Botkin
       
    3. 
       Temperature curve as Kildushevsky
       
    4. 
       Temperature curve as Ellers
       
    5. 
       Intermedium temperature curve
       
25. 
    At the typical form of typhoid fever, temperature of body rises like to stairs from a day to the day to 39-40 °C at the end of 1st week, and then slowly during 2-3 week gradually going down, comes to the norm. How is such temperature curve named?
    
    1. 
       The temperature curve as Vunderlihs
       
    2. 
       The temperature curve as Botkin
       
    3. 
       * Temperature curve as Kildushevsky
       
    4. 
       Temperature curve as Ellers
       
    5. 
       Intermedium temperature curve
       
26. 
    Disease started acutely with the complains of heavy watery diarrhea, vomiting, cramps in the lower extremities. Objectively: slow voice, shunken eyes, quick pulse, low blood pressure, decrease of urination, weak cardiac sounds. In liver and spleen no changes. Put the correct diagnosis.
    
    1. 
       Salmonellosis
       
    2. 
       Dysentery
       
    3. 
       Food poisoning
       
    4. 
       * Cholera
       
    5. 
       Typhoid fever
       
27. 
    Emergency ambulance deliveredin infectious hospital girl N., 17 years old, complaining of headaches, expressed general weakness, pain in epigastrium, repeated vomiting, diarrhea to 8 times a day greenish color. She was used 2 raw chicken eggs. Body temperature 39 °C, the tongue covered with white coat, moderately cramps, pain in abdomen and sigmoid area. The most likely diagnosis.
    
    1. 
       Acute appendicitis
       
    2. 
       Crohn’s disease
       
    3. 
       Shigellosis
       
    4. 
       Viral gastroenteritis
       
    5. 
       * Salmonellosis
       
28. 
    In 42 y.o. annual explorers the temperature of body rose to 39 °C. At the receipt patient is pale, tongue edematous, covered by the dirtily-brown raid, has clean edges and tag, and on sides imprints of teeth, pulling out of tongue is impaired and he trembles finely, bedside patient is smell of ammonia. On the front wall of abdomen monomorphic single roseollas. In a mouth cavity in place of hyperplasic lymphatic follicles of soft palate especially at front, appeared symmetric flat superficial oval form of ulcer by the diameter to 5 mm. Such ulcers are on tonsils. In case of such disease the convalescents are discharge after:
    
    1. 
       Triple bacteriological research of blood, excrement, urine, bile
       
    2. 
       * Triple bacteriological research of excrement, urines and once of the bile
       
    3. 
       Triple bacteriological research of excrement, urines and once of the blood
       
    4. 
       Triple bacteriological research of excrement, urine, bile
       
    5. 
       Triple bacteriological research of blood, urine, bile and once excrement
       
29. 
    In a hospital admited within 5 patients in 15 hours. All of them have similiar complains of mild diarrhea and vomiting developed ,diplopia, midriasis, visual disturbance, difficulty in swallowing, dry mouth, difficulty in breathing. All patients together joined in a dinner party, used different dishes, including meat, salad, canned mushroom. The most likely diagnosis.
    
    1. 
       Cholera
       
    2. 
       * Botulism
       
    3. 
       Thypus
       
    4. 
       Salmonellosis
       
    5. 
       Rotaviral gastroenteritis
       
30. 
    In a patient 30 years old, on the 9th day of illness disease began gradually, with slow growth of fever and intoxication, appeared unabundant roseollar rash on the skin of abdomen. Skin was pale, Т-40 °C, pulse-80 per a min, BP-100/65 mm Hg. A tongue is assessed, abdomen is distended, the spleen is enlarged, and liver is felt. What symptom will be positive?
    
    1. 
       Botkin’s symptom
       
    2. 
       * Padalka’s symptom
       
    3. 
       Kildushevsky‘s symptom
       
    4. 
       Оrtner’s symptom
       
    5. 
       Pasternatsky‘s symptom
       
31. 
    In a patient 35 y.o. stormily illness began from chills, increase of temperature to 39 C, vomits, pain in epigastria, and diarrhea with the watery stinking emptying. 6 hours prior to the disease ate a raw egg, fried potato with the braised meat, drank juice. Which pathogen probably caused the similar state?
    
    1. 
       Proteus
       
    2. 
       * Salmonella
       
    3. 
       Intestinal stick
       
    4. 
       Staphylococcus
       
    5. 
       C. perfringens
       
32. 
    In a patient A., 33 years old, with a diagnosis typhoid fever, on the 5th day of normal temperature appeared tachycardia and rozeol rash on the middle and lateral surfaces of abdominal. About what is it necessary to think?
    
    1. 
       Measles
       
    2. 
       Bleeding
       
    3. 
       Perforation
       
    4. 
       * Relapse of typhoid fever
       
    5. 
       Infectiously-allergic myocarditis
       
33. 
    In patient F., 25 years old, appeared a chill in 6 hours after breakfast (ate 2 row eggs), a temperature rose to 38,7 °C, pain appeared in 20 minutes in the peryumbilical region, nausea, frequent vomit, and yet in 30 minutes appeared frequent watery stool without pathological admixtures, green color. What diagnosis is most reliable?
    
    1. 
       Esheryhiosis
       
    2. 
       Shigellosis
       
    3. 
       Cholera
       
    4. 
       Ersiniosis
       
    5. 
       * Salmonellosis
       
34. 
    Induction centre of infectious hospital a patient entered at which during three weeks high fever 38-40 °C, head pain, weakness, insomnia. To the doctor did not speak, accepted antipyretics. Objectively: temperature of body 35,7 ?C, pulse 140 per 1 mines, BP 80/50 mm Hg. General state heavy. Skin and mucous membranes pale. A tongue is incrassate with the imprints of teeth, with a dirtily-brown raid, a tag and edges of tongue is clean. The abdomen is swollen. A liver and spleen is enlarged. There was defecation on a reception, in an excrement fresh blood. What is the fall-off of temperature of body and becoming more frequent of pulse related to?
    
    1. 
       Perforation
       
    2. 
       Acute poisoning medications
       
    3. 
       Infectiously toxic shock
       
    4. 
       Endometriosis of colon
       
    5. 
       * Bleeding
       
35. 
    One of methods of diagnostics of typhoid fever and paratyphoid fever is the selection of hemoculture. For that in a fever period sowing of blood from a vein on bilious bulione or Rappaport‘s media in correlation 1:10 is made. What volume of blood must be taken on the 2nd week of disease?
    
    1. 
       5 ml of blood
       
    2. 
       10 ml of blood
       
    3. 
       * 15 ml of blood
       
    4. 
       20 ml of blood
       
    5. 
       25 ml of blood
       
36. 
    One of methods of diagnostics of typhoid fever and paratyphoid fever is the selection of hemoculture. For that in a fever period sowing of blood from a vein on bilious bulione or Rappaport‘s media in correlation 1:10 is made. What volume of blood must be taken on the 1st week of disease?
    
    1. 
       0,5 ml of blood
       
    2. 
       * 10 ml of blood
       
    3. 
       15 ml of blood
       
    4. 
       20 ml of blood
       
    5. 
       25 ml of blood
       
37. 
    One of methods of diagnostics of typhoid fever and paratyphoid fever is the selection of hemoculture. For that in a fever period sowing of blood from a vein on bilious bulione or Rappaport‘s media in correlation 1:10 is made. What volume of blood must be taken on the 3nd week of disease?
    
    1. 
       5 ml of blood
       
    2. 
       10 ml of blood
       
    3. 
       15 ml of blood
       
    4. 
       * 20 ml of blood
       
    5. 
       25 ml of blood
       
38. 
    Pain in abdomen appeared at a patient with typhoid fever on the 19th day of disease, and was during 4 hours. Pulse – 100 per a min, rhythmic. A tongue is dry, assessed by wait coat. The abdomen is tense, does not take part in the act of breathing. Stool and urine was absent. About what complication is it necessary to think?
    
    1. 
       Appendicitis
       
    2. 
       Infectiously-toxic shock
       
    3. 
       Bleeding
       
    4. 
       * Perforation
       
    5. 
       Urolithiasis
       
39. 
    Patient 24 y.o., was hospitalized in the infectious department on the 10th day of disease with complains of general weakness, headache, poor appetite, cough. Objectively: body temperature 39,5 °C, pallor of skin. Adynamism. Single roseolas are present on the skin of anterior wall of the abdomen, thorax. Liver in palpate + 1 cm below the rib angle on the midclavicular line, spleen is palpate not significantly. What is he most possible diagnosis?
    
    1. 
       * Typhoid fever
       
    2. 
       Flu
       
    3. 
       Typhoid rash
       
    4. 
       Brucellosis
       
    5. 
       Pneumonia
       
40. 
    Patient 25 years, received complaints of double vision of the eyes, a decline of view, shortness of breath. Before the disease eat mushrooms home preservation. Objective: pallor, wide pupils with a weak reaction to light, dry mouth, a violation of swallowing, flatulence, delay of stool. What is preliminary diagnosis.
    
    1. 
       Leptospirosis
       
    2. 
       Yersinioz
       
    3. 
       * Botulism
       
    4. 
       Giardiasis
       
    5. 
       Salmonellosis
       
41. 
    Patient 27 years old, complains of headaches, weakness, pain in epigastric area, vomiting, diarrhea (9 times in a day; huge excrement, greenish colour). Before the appearance of disease he consumed raw eggs. Objectively: body temperature 38,8 °C. Tongue is white, pain in epigastric and umbilical region. The most likely diagnosis.