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

infectious-toxic shock

The seventh pandemic of cholera is caused by V cholera El Tor. It begans in 1961 on the Sulawesi island. However, to the epidemic of cholera arose up only in the countries of the third world. It is known that cholera is classic bacterial infection with the fecal-oral mechanism of transmission with the certain infectious dose of exciter. After the L.V. Hromashevsky factors of transmission of exciter of illness can be contaminated by them drinking-water, meal, hands. What is the basic factor of risk, that is instrumental in the such uneven division of morbidity on countries?

1. 
   Biological properties of exciter
   
2. 
   Climate of country
   
3. 
   * Social-economic conditions of population of country
   
4. 
   Immune status of population
   
5. 
   High development of industry and contamination of surrounding environment
   

To the district doctor a patient, complaints on abundant excretions from a nose, moderate headache, hearing loss, perversion of taste. On examination – dry of skin, nose excoriation, in a pharynx – mild hyperemia. Temperature of body is subfebrile. Pathological changes of internal organs are absent. Which acute respiratory viral infection carries the patient?

1. 
   Adenoviral infection
   
2. 
   Parainfluenza
   
3. 
   * Rhinoviral infection
   
4. 
   РC-infection
   
5. 
   Influenza
   

To the internist appealed patient with complaints of weakness, diarrhea. Rested on a south, where the cases of diarrhea were present. Objectively: t-36,4 °C, skin covers are clean, acrocyanosis, tongue is dry, abdomen is soft, painless, emptying abundant, watery, with the flakes of white color floating on a surface, without odor and admixtures. For clarification of diagnosis sowing on the Ressels medium was made. How will the color of medium change?

1. 
   From yellow to blue
   
2. 
   From yellow to green
   
3. 
   From green to yellow
   
4. 
   * From blue to yellow
   
5. 
   From blue to green
   

18 year old student was hospitalized to the infectious disease department on the 2nd day of disease with complaints on sore throat during swallowing. Objective status: t – 37,5 °C, light hyperemia and swelling of right tonsil, which is covered by gray-white color pellicle, slightly erected above the tonsil’s surface. The pellicle is easily removed by spatula, disclosing hemorrhagic ulcer with smooth bottom. What is the most possible diagnosis?

1. 
   Diphtheria of pharynx.
   
2. 
   * Plout-Vensan’s tonsillitis
   
3. 
   Lacunar tonsillitis
   
4. 
   Follicular tonsillitis
   
5. 
   Ulcerative-necrotic tonsillitis
   

35 years old patient A., came to the clinic on the third day of illness with complaints of drowsiness, sweat, headache, fever up to 38.5 °C. Reviewing physician found sore throat, splenomegaly, enlarged lymph nodes. Liver is not enlarged. Blood analysis – leukocytosis, lymphocytosis. What additional test should hold the patient for infectious mononucleosis?

1. 
   Byurne and Wright-Hadulson’s reaction
   
2. 
   ELISA-test, bacteriological test for tularemia
   
3. 
   Bacteriological test for diphtheria and typhoid fever
   
4. 
   * ELISA-test, bacteriological test for diphtheria
   
5. 
   Paul-Bunnel’s reaction and lymph node puncture
   

A 19-years-old patient became ill 5 days ago: subfebrile temperature, acquired voice, dry cough weakness. After hospitalization: t – 37,1 °C, but the state is heavy, pallor, expressed weakness, aphonia, noisy stenotic breathing, inciters indrawings of intercostal intervals, pulse-110 shots per min., frequency of breathings 36 per min., cyanosys of lips and nailes. Tonsills is covered by the greyish dense raid. Define strategy of intensive therapy:

1. 
   Tracheotomy, AVL, antitoxin
   
2. 
   Tracheotomy, AVL, toxoid, desintoxic therapy
   
3. 
   * Sedative, intubation, antitoxin, dexametazon, desintoxic therapy
   
4. 
   intubation, sedative, toxoid, penicillinum, desintoxic therapy
   
5. 
   sedative, oxygenotherapy, antitoxin i/v
   

A 32 years old patient appealed to a doctor on a background of fever and increase of temperature to 38.0 °C, pain in the right ear area, left side “deviation” appear during the next day. On examination: right side smoothed out frontal and occipital skinning folds, right eyelids fissure is wider than left, a mouth is overtighten to the left, a right eyebrow does not rise upwards, and a cheek “hyperemia”, xerostomia and violation of taste receptors on front 2/3 right halves of tongue. Herpetic blisters in right external auditory canal and auricle. What is the most possible diagnosis?

1. 
   * Hunt’s syndrome
   
2. 
   Post herpetic neuralgia of the I- and II- branches of right trifacial nerve
   
3. 
   Post herpetic neuralgia of all branches of right trifacial nerve
   
4. 
   Sludder’s syndrome
   
5. 
   Rosolimo-Меlkerson-Rozantalia syndrome
   

A 37 years old patient, 2 days ago a spot on a hand appeared, which for days grew into pustule with a black bottom, painless at touch, with the crown of daughters vesicles on periphery. There are painless edema on a hand and shoulder. Temperature rise to 39.0 °C, dizziness appeared. Pulse – 100 beats per min, AP – 95/60 mm Hg. BR – 30 per a minute. What is the most possible diagnosis?

1. 
   * Anthrax
   
2. 
   Plague
   
3. 
   Tularemia
   
4. 
   Brucellosis
   
5. 
   Herpes
   

A 40 years old scientist, became ill sharply with chill, temperature of body – 39.8 °C, severe headache, vomiting, pain in muscles. Did not went to the doctor, the state had become worse, hyperemia of sclera, appeared, on lips herpes with hemorrhagic maintenance, the nose-bleeding, skin and sclera, became icteric, urine color is of strong tea, diuresis 200 ml, an anacholia was not present. What is the most reliable source of infection?

1. 
   * Rats
   
2. 
   Cats
   
3. 
   Infected people
   
4. 
   Bacillocarrier
   
5. 
   Mosquito
   

A 70 years old sick person, after supercooling severy pain in the left half of head in the area of forehead and left eye appeared. 3 days ago the temperature of body increased to 37,6 °C, the blister of pouring out at the head and left overhead eyelid appeared. What disease can be diagnosed?

1. 
   * Herpetic ganglionitis
   
2. 
   Encephalitis
   
3. 
   Allergy
   
4. 
   Dermatitis
   
5. 
   Trifacial neuritis
   

A boy 11 years old, complaints about sickness at mastication, increasing of temperature to 37.1 °C, enlargment of parotid salivary glands . At the age of 8 years carried a paraflu infection. Objectively: in the region of right parotid salivary gland tubular sickly at palpation, a skin above it is not changed. A pharynx is moderate hyperemic, tonsils are not coated. What is your previous diagnosis?

1. 
   * Cytomegaloviral syaloadenitis
   
2. 
   Lymphadenitis
   
3. 
   Parotitis
   
4. 
   Infectious mononucleosis
   
5. 
   Cholylithiasis
   

A boy 6 years was in the close touch with a patient with diphtheria. What treatment-prophylactic measures need to be conducted, if vaccine anamnesis is unknown?

1. 
   Introduction of AWDT vaccine
   
2. 
   Antibacterial therapy
   
3. 
   Introduction of ADT-м to the toxoid
   
4. 
   * Antibacterial therapy and double introduction of ADT-м to the toxoid
   
5. 
   Antibacterial therapy and introduction of immunoprotein
   

A child 2 years carries a diphtherial croup. There was the stop of breathing on 2nd days of whey therapy. What was the reason of asphyxia?

1. 
   * Mechanical obturation by tapes
   
2. 
   Stenosis of larynx
   
3. 
   Anaphylaxis shock
   
4. 
   Whey illness
   
5. 
   Paresis of respiratory musculature
   

A female M., 24 years old came to the doctor with long-lasting fever, night sweat. Over the past three months, weight reduced by 7 kg. Low intention for sex. Objective examination found an increasing of all lymph nodes, hepatolienal syndrome. In the blood: Leucocyte – 2,2?109. What disease should be suspected?

1. 
   * HIV infection
   
2. 
   Lymphogranulomatosis
   
3. 
   Tuberculosis
   
4. 
   Infectious mononucleosis
   
5. 
   Sepsis
   

A girl, 18 years old, became ill sharply: indisposition, pain of head, pharyngalgia, t – 38,2 °C. To the doctor appealed only on the 3th day of illness. Objectively: on one of tonsills the crateriform ulcer covered by the chlor raid. During the direct backterioscopy of area of defeat found out exciters morphologically similar to spirohets sticks. What previous diagnosis?

1. 
   Aphthosis stomatitis
   
2. 
   Diphtheria
   
3. 
   * Quinsy of Vensan
   
4. 
   Herpetic quinsy
   
5. 
   Infectious mononucleosis
   

A girl, 6 years old, admitted to hospital with complaints on general weakness, increase of temperature, pain in a throat. Objectively: observed oropharyngeal mucous membrane is bright red, on tonsils – white covering, can take off easily and enlarged all groups of lymph nodes 1-3 cm in a diameter, dense and elastic in consistancy, not very painfull, are not soldered between themselves. Liver is enlarged till 3 cm, spleen - till 1 cm. In bloods - leykocytosis, plazmocytes – 20 %. What will be the credible diagnosis?

1. 
   Acute lympholeycosis
   
2. 
   * Infectious mononucleosis
   
3. 
   Angina
   
4. 
   Diphtheria
   
5. 
   Adenoviral infection
   

A patient 21 years old 4th day grumbles about a general weakness, moderate pharyngalgia fervescence, to 39°C. Did not treat oneself. Objectively: edema and cyanosys of mucus shell of otopharynx of left tonsill rough fibrinose raid which goes out on a palatal handle and tongue. Bloodstreaks appear at the attempt of removal by his spatula. Submandibular lymphatic knots are megascopic, more on the left side. What diagnosis is most credible?

1. 
   Paratonsill abscess
   
2. 
   Lacunar quinsy
   
3. 
   Quinsy of Vensan-Symanovskiy
   
4. 
   * Diphtheria of otopharynx
   
5. 
   Infectious mononucleosis
   

A patient 60 years old for 2 days has disturbed severe pain in a right arm. On 3rd day appeared blisters, pouring out as a chain on the skin of shoulder, forearm and brush. Sensitiveness in the area of pouring out is mionectic. What disease can be diagnosed?

1. 
   Dermatitis
   
2. 
   * Herpetic ganglionitis
   
3. 
   Neck-pectoral redicals
   
4. 
   Psoriasis
   
5. 
   Allergy
   

A patient A., 23 years old, hospitalized on the 2th day of disease with complaints about a weakness, pharyngalgias, that increase at swallowing, chill. State is moderate, temperature of body – 38.3 °C, a mouth opens freely, moderate hyperemia with small cyanosys of mucous in the throat, tonsils is megascopic, covered by the pellicles raids which spread on a wall pharynx and tongue. Increasing of neck lymphonodes. Pulse – 88 per 1 min, BP 120/60 mm of Hg. A liver and spleen are not megascopic. What is previous diagnosis:

1. 
   * Diphtheria of oropharynx
   
2. 
   Mycotic tonsillitis
   
3. 
   Simanovsky-Vensent’s tonsillitis
   
4. 
   Infectious mononucleosis
   
5. 
   Acute leucosis
   

A patient appealed to the doctor with complaints of difficulties in opening of the mouth. Two weeks ago fell down and head was hurt, did not have medication. At a review mouth opens on 1.5 cm, moderate expressed pain of muscles at the back of head. The paralysis of muscles of person, eyeballs, are more prominent. In a temporal area dry bloody crusts in the place of trauma. What are your diagnosis?

1. 
   Neuritis of facial nerve
   
2. 
   Throat abscess
   
3. 
   * Facial paralytic stupor of Rоsе
   
4. 
   Bulbar encephalitis
   
5. 
   Herpetic ganglionitis of knot of trifacial
   

A patient came with complaints about erosions of his penis. From anamnesis frequent appearance of similar rashes during a year is found out. Objectively: on a balanus are the grouped blisters and erosions of polycyclic outlines, with clear margin, soft during palpation. What is your diagnosis?

1. 
   * Recurrent congenital herpes
   
2. 
   Pemphigus vulgaris
   
3. 
   Primary syphillis
   
4. 
   Pyodermia
   
5. 
   Scabies
   

A patient D., 20 years old came to the infectious polyclinic with complaints of moderate pain in the throat, headache, general weakness, increasing of body temperature to 38.9 °C. He fells sick during 3 days. Objective examination: increasing inguinal lymph nodes, hepatosplenomegaly, subicteric sclera and skin, changes in the throat are typical for sore throats were found. Blood analysis – lymphogranulomatosis. What is probable diagnosis?

1. 
   * Infectious mononucleosis
   
2. 
   Tonsillitis
   
3. 
   Adenovirus infection
   
4. 
   Influenza
   
5. 
   Viral hepatitis
   

A patient D., yesterday in the evening delivered in the hospital due to high temperature of body, increasing pharyngalgia, pain lockjaw of masseters, nausea, vomits. At nasopharhyngoscopy by an otolaryngologist the moderate expressed hyperemia, edema, cyanosys of mucous membrane of left palatal tonsil, oral cavity and nasopharynx were found out. The surface of tonsil is covered by the raid of dirty-grey color pellicle which goes beyond his borders (in nasopharynx). Increasing of left submandibular lymphatic node of dense consistency was also found. The edema of hypoderm of neck reaches to the collar-bone. What is the described disease?

1. 
   * Hypertoxic diphtheria of nasopharynx
   
2. 
   Localized diphtheria of nasopharynx
   
3. 
   Subtoxic diphtheria of nasopharynx
   
4. 
   Widespread diphtheria of nasopharynx
   
5. 
   Lacunar tonsillitis
   

A patient is hospitalized in infectious permanent establishment: sharp beginning of disease, temperature 39,9 °C, moderate pharyngalgia, takes place edema, insignificant hyperemia with cyanosys of mucuses shells of otopharynx, on tonsills dense, brilliant, greyish color the raids placed as continuous pellicle, is heavily taken off, bare a surface, that bleeds. Submandibular lymphonoduss are moderatory megascopic. A patient must immediately do:

1. 
   Strokes with tonsills, nose or other areas for the exposure of diphtherial stick
   
2. 
   IFA
   
3. 
   * Microscopy (painting for Neyser)
   
4. 
   Haemoculture
   
5. 
   RDHA with a diphtherial diagnosticum
   

A patient N., 45 years old, complaints about headache, general weakness increasing of temperature, to 37.4 °C. In 2 days pain appeared in the pectoral region of spine with an irradiation in a right between scapular regions. After some time skin in this region turned red as a strip from a spine to the subarmpit line, and in 2 days red knots which through the set time grew into blisters with transparent maintenance appeared in this place. What is your diagnosis?

1. 
   * Herpes zoster
   
2. 
   Thoracal rediculopathy
   
3. 
   Neurology of intercostal nerves
   
4. 
   Neurology of superscapular nerve
   
5. 
   Herpetiform dermatitis
   

A patient X., 25 years old, was examined by a otolaryngologist on the 4th day of illness. Temperature of body – 38.1 °C. Complaints about indisposition, moderate pains in the throat. Objectively: a mouth opens fully. Mucous soft palate, handles, tongue, was swollen, insignificant hyperemia with cyanosis. Increasing of tonsills, covered by the grey dense raid. The raid is taken off free. The edema of neck is not present. Increasing of submandibular lymph nodes. What is most credible diagnosis?

1. 
   Lacunar tonsillitis
   
2. 
   Infectious mononucleosis
   
3. 
   Simanovsky-Vensent’s tonsillitis
   
4. 
   * Diphtheria of oropharynx
   
5. 
   Follicular tonsillitis
   

A patient, 13 years old, complaints on pain in a throat, body temperature rise till 38 °C. Objectively: hyperemia of skin, hyperpigmentation of oropharyngeal mucous , tonsils are enlarged in size, marked suppuration of follicles. During palpation enlarged posterior cervical and submandibular lymph nodes. Pulse 96 times/minute, spleen – under the edge of costal arc on 1 cm. About what disease it is necessary to think?

1. 
   * Infectious mononucleosis
   
2. 
   Follicular tonsillitis
   
3. 
   Typhoid fever
   
4. 
   Measles
   
5. 
   Acute respiratory disease
   

A patient, 22 years old, became ill sharply. History showed fever up to 38.2 °C with headache, repeated vomiting, olfactory and tastes hallucinations. Quickly got complex of meningeal symptoms, pyramidal paresis. The general epileptic attack and comatose state also developed. Neurolymph is with mixed lymphocytosis, cytochrome, single red corpuscles. What is previous diagnosis?

1. 
   Brain abscess
   
2. 
   Subdural empyema
   
3. 
   * Herpetic encephalitis
   
4. 
   Tumor of brain
   
5. 
   Encephalopathy
   

A sick person, 65 years old, complains of rash, pain in a subscapular region. Objectively: on a skin surface of the subscapular region present the arcwise rose-red filling out hearths some infiltrative, with clear scopes. On-the-spot hearths grouped vesicles with transparent maintenance. What preparation he should take?

1. 
   Suprastyn
   
2. 
   Prednisolone
   
3. 
   Biseptolum-480
   
4. 
   Loratidin
   
5. 
   * Laferon
   

A woman 65 years old the disease had beginning sharply from increase of temperature to 39.0 °C, weakness, and pain in the left part of thorax that increased with breathing motions. On 3rd day of disease vesicular breathing appeared after motion of rib on the left on a hyperemic background. Together with sick a grandchild lives 4 years. What measures of prophylaxis of disease need to be adopted?

1. 
   Vaccination
   
2. 
   Final disinfection
   
3. 
   Reception of specific immunoprotein
   
4. 
   * Isolation of patient
   
5. 
   Acyclovir administration
   

A woman C., during 3 days complaints about a general weakness, headache increasing of temperature to 39-40 °C, insignificant pharyngalgia. Her husband is sick with tonsillitis. Objectively: a skin is pale, cyanosis of lips. Hyperemia of mucous of oropharynx, increasing of tonsils. On the spot of tonsils there are continuous dense accented mother-of-pearl raids, which are taken off with great effort with bleading. Increasing of submandibular lymphatic nodes. Edema of the neck. AP 105/65 mm Hg. What is most credible diagnosis?

1. 
   Acute leucosis
   
2. 
   Lacunar tonsillitis
   
3. 
   Infectious mononucleosis
   
4. 
   * Diphtheria of oropharynx
   
5. 
   Adenoviral infection
   

An 18 years old patient, entered the hospital with complaints of headache, general weakness, raising the temperature to 37,5-38,0 °C for 6 days, a sore throat. Objective examination: increasing of all lymph nodes, 1-3 cm in diameter, flexible, megaloblastic not soliter together. Increasing of the liver size till 3 cm, spleen – 1 cm. Common blood analysis: leukocytosis, plasma cells – 15 %. What is preliminary diagnosis?

1. 
   Diphtheria
   
2. 
   Adenovirul infection
   
3. 
   Lacunar tonsillitis
   
4. 
   * Infectious mononucleosis
   
5. 
   Acute lympholucosis
   

At a 36 years old sick person, 4 days ago a rash appeared on a skin that is accompanied by itching. Swelling of stomach. Disturbed dull pain in right subcostal area had constipation. Day prior to it he ate the smoked meat. Atypical reactions appeared after the use of tomatoes, strawberry, chocolate. Objectively: on the skin of person, trunk, extremities are rashes. Level of general IgE in normal. What is most possible diagnosis?

1. 
   * Pseudoallergy
   
2. 
   Idiosyncrasy
   
3. 
   Food allergy
   
4. 
   Herpetic infection
   
5. 
   Chronic hives
   

At a child 4 years on the third day of disease the widespread form of diphtheria of nasopharynx is diagnosed. Preparation of specific therapy:

1. 
   macrolids per os
   
2. 
   Antibiotics of penicillin row i/m
   
3. 
   cortycosteroid
   
4. 
   * antidiphterial whey i/v
   
5. 
   antitoxic therapy
   

At a child 6 years with a diphtherial widespread croup the first dose of antidiphterial whey makes:

1. 
   * 40 AО
   
2. 
   15 AО
   
3. 
   20 AО
   
4. 
   80 AО
   
5. 
   60 AО
   

At a child with the catarrhal phenomena it is found out the increase of submandibular and back neck lymphatic knots, hyperplasia of tonsils with the magnificent raid of gum-blush on them as points and aits, presence of the single roseol-papular pouring out, increase of liver. Name a credible diagnosis.

1. 
   * Infectious mononucleosis
   
2. 
   Adenoviral infection
   
3. 
   Scarlet fever
   
4. 
   Measles
   
5. 
   German measles
   

At a girl, 22 years old, heavy form of diphtheria of otopharynx. Specific treatment is begun only on a 5th day from the beginning of disease, in the day of appeal of parents for medical help. The sick is instiled only in a maternity hospital. What complication of diphtheria is potentially dangerous?

1. 
   Stenotic laryngotracheitis
   
2. 
   Pneumotorax
   
3. 
   Meningoencephalitis
   
4. 
   Septicopyemia
   
5. 
   * Infectiously-toxic shock
   

At a patient by the method of specific laboratory diagnostics the confirmed noncommunicative form of diphtheria of otopharynx. Specific etiotropic treatment is appointed on the second day from the beginning of disease. Your attitude toward setting of antibiotics:

1. 
   Beside the purpose to appoint
   
2. 
   * Obligatory component of holiatry
   
3. 
   To appoint in the case of stratification of complications
   
4. 
   To appoint at presence of base-line and concomitant diseases
   
5. 
   To appoint in default of positive dynamics of local displays of diphtheria during three days
   

At a patient the dense darkly-grey raid covers tonsils is considerably megascopic and spreads for their scopes. Mucus shell bloodshot accented cyanochroic, was considerably swollen. Immediate medical measure:

1. 
   Ultraviolet irradiation of throat
   
2. 
   p0unction of perstonsillar space