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

Section of peritonsillar space

* Introduction of antidiphterial whey

Compress on a neck

At a patient which appealed to the district doctor with pharyngalgias, it is discovered at a review: temperature is subfebrile, moderate hyperemia of otopharynx, megascopic left tonsill, on him dense grey-white color raid which becomes separated from heavily, mucus bleeds under him. Megascopic littlesickly regional submandibular lymphonodus. Specify a previous diagnosis?

1. 
   Lacunar quinsy
   
2. 
   Quinsy of Symanovskyi-Plaut-Vensan
   
3. 
   Adenoviral infection
   
4. 
   * Noncommunicative diphtheria of otopharynx
   
5. 
   Infectious mononucleosis
   

At a patient which treats oneself stationary on an occasion the widespread form of diphtheria of otopharynx, on a background the positive dynamics of displays of illness appeared periodic hit of spoon-meat in a nose, voice acquired a nasal tint. During a review: hang-on of soft palate and absence of his motions at fonation. On-the-spot palatal tonsills tailings of grey raid for a gum-blush, perifocal edema. What complication of diphtheria at a patient?

1. 
   * Bilateral palatoplegia
   
2. 
   Peritonsillar abscess
   
3. 
   Postpharyngeal abscess
   
4. 
   Edema of Kvinke
   
5. 
   Peritonsillar abscess
   

At a patient, 17 years: tonsils, temperature 38,2 °C, generilized lymphadenopathy (the first multiplied neck lymphatic knots which are located along m. sternocleidomastoideus), small icterus hepatospleenomegaly. What exciter causes this disease?

1. 
   Herpesvirus I type
   
2. 
   Herpesvirus ІІ type
   
3. 
   Herpesvirus ІІІ type
   
4. 
   * Herpesvirus ІV type
   
5. 
   Herpesvirus V type
   

At a student 25 years on a background sharp development of illness is fervescence to 40 ?C, rapid growth of intoxication – a pharyngalgia appeared at swallowing. Objectively: oedematousness and hyperemia of mucuses shells of otopharynx and tonsills. On the tonsils there is raid of grey-white color, which is taken off by a spatula in the type of pellicle, that does not dissolve in water and is not ground by a spatula. In place of the taken tape off sanguifluousness. Suspected diphtheria of fauces. What most expedient medical tactic?

1. 
   * Obligatory hospitalization of patient and introduction of antidiphtheria whey
   
2. 
   Ambulatory treatment of patient and introduction of antidiphtheria whey
   
3. 
   Introduction of antidiphtheria whey
   
4. 
   Setting of antibiotics therapy ambulatory
   
5. 
   Hospitalization of patient in permanent establishment and setting of antibacterial therapy
   

At maintenance of call on a house a district paediatrician put to the sick child 5 years old, diagnosis “Acute lacunar tonsillitis”. Specify, who must carry out the laboratory inspection of patient and in what terms.

1. 
   Worker of SES upon receipt report
   
2. 
   A district medical sister is at once after determination of diagnosis
   
3. 
   Doctor pediatrician in 5 hours
   
4. 
   * Doctor pediatrician at once after determination of diagnosis
   
5. 
   District medical sister on a next day
   

At sick L, 35 years old, a diagnosis is set is diphtheria of pharynx, noncommunicative form. What first dose of antitoxic antidiphtheria whey is it necessary to appoint?

1. 
   120 thousand of AО
   
2. 
   80 thousand of AО
   
3. 
   * 30 thousand of AО
   
4. 
   50 thousand of AО
   
5. 
   150 thousand of AО
   

At sick person with the combined form of diphtheria of tonsills, larynx and front departments of nose on the 2nd day of stay in permanent establishment the state became worse: a weakness grew, pain appeared after a breastbone, vomiting. Objectively: patient is adinamic, pale, acrocyanosys. Pulse 54 per 1 min, weak filling. Cardiac tones are muffled, chaotic extrasystoles. BP is 80/40 mm Hg. Liver +3 cm. What complication arose up at a patient?

1. 
   Infectiously-toxic shock
   
2. 
   anaphilaxis shock
   
3. 
   cardiogenic shock
   
4. 
   * Early myocarditis
   
5. 
   Late myocarditis
   

At sick, that grumbled about the massive salivation, during the objective inspection it is found out gingivitis, separate rather yellow ulcers on tongue, mucus shell of cheeks, ash, moderate increase, and painful back neck lymphonoduses. What previous diagnosis?

1. 
   * Herpetic stpmatitis
   
2. 
   Diphtherial adenoiditis
   
3. 
   Infectious mononucleosis
   
4. 
   Abscess of epipharyngeal tonsill
   
5. 
   Herpetic quinsy
   

At the patient B., 35 years, after the disease which was accompanied by the fever and pharyngalgias, there were an odynophagia, dysarthria, weakness and violation of motions in hands and feet, hyporeflexia, violation of sensitiveness in extremities to the polyneurotic type. What disease does it follow to think about above all things?

1. 
   neuropathy of hypoglossus
   
2. 
   * Diphtherial polyneuropathy
   
3. 
   neuropathy of glossopharyngeus nerve
   
4. 
   Trunk encephalitis
   
5. 
   pseudobulbar syndrome
   

At the patient P, 20 years old, reconvalescent from heavy form of diphtheria in 10 days after excerption a general weakness pain and paresthesias appeared from permanent establishment (5th week from the beginning of disease), mainly in the distal departments of extremities. Independently can not be tricked into on feet. Objectively: considerable symmetric atrophy of muscles of extremities, especially – lower. To the tendon reflexes are mionectic. In a neurolymph is moderate pleocytosis is albumen-cellular dissociation. Your diagnosis?

1. 
   * Syndrome of Gienne-Barre
   
2. 
   Diphtherial polyneuropathy
   
3. 
   Poliomyelitis
   
4. 
   Transversal myelities
   
5. 
   Ascending paralysis of Landri
   

Child 3 years from having many children social-unprosperity family is ill 3 days. The disease began sharply, from the increase of temperature to 38,0 °C, barking cough hoarseness voice. In a dynamics on a background of subfebrile temperature a cough became soundless. At a review: the state is heavy, inciter shortness of breath with the indrawing of jugular fossula, cyanosys of nasolabial triangle, HR –160 per minute, tonsills filling out, hyperaemia accented cyanochroic. In the plan of differential diagnostics the most reliable is:

1. 
   Viral croup
   
2. 
   * Diphtherial croup
   
3. 
   Respirator chlamidiosis
   
4. 
   Infectious mononucleosis
   
5. 
   Epiglottiditis
   

Diagnostics of quinsy background on such criteria: epidemiologys information, sharp beginning, fever, tonsillitis, regional lymphadenitis, neutrophilic leycocytosys. What research must be conducted in an obligatory order by a patient with the diagnosis of quinsy?

1. 
   Selection from mucus of otopharynx haemolitic streptococcus
   
2. 
   Biochemical blood test
   
3. 
   * Strokes from otopharynx and nose on bacteria of diphtheria
   
4. 
   Hemoculture
   
5. 
   IFA
   

During the examination of a patient with pharyngalgias subfebrile temperature, moderate hyperemia of mouth, increasing of left tonsil with grey-white cover which becomes bleading during separation. Megascopic submandibular leftside lymphatic nodus. What is previous diagnosis?

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

During the examination of a patient, 17 years old, observe tonsilitis, body temperature 38,2 °C, generalized lymphadenopathy (cervical ltmph nodes, located along the m. sternocleidomastoideus), mild jaundice, hepatospleenomegaly. What is preliminary diagnosis?

1. 
   Tuberculosis of lymph nodes
   
2. 
   Bacterial tonsillitis
   
3. 
   Diphtheria
   
4. 
   * Infectious mononucleosis
   
5. 
   Lymphogranulematosis
   

In 18 years old patient, diphtheria of mouth pellicle severe form was diagnosed. On the 6th day of disease pain in the heart region, palpitation were appeared. Pulse – 120 per 1 min, systolic noise on apex of heart. On ECG is incomplete blockade of left leg of Giss bunch. What complication has developed?

1. 
   * Early infectious-toxic myocarditis
   
2. 
   Myocardial dystrophy
   
3. 
   Heart attack of myocardium
   
4. 
   Acute cardio-vessel insufficiency
   
5. 
   Stenosis of mitral valve
   

In a newborn, the septic state was accompanied with the increase of temperature to 40 oC which developed on 5th day, with pneumonia expressed intoxication: pallor, vomiting, shortness of breath, disturbance, cramps. Appeared rash (blisters with hemorrhages) on skin, mucous membrane of mouth cavity, throat and conjuctiva. The child suffers with congenital herpes. Lungs: difficult breathing and vesicular wheezing. Mild enlargement of liver. What is the most reliable diagnosis?

1. 
   * Herpetic infection
   
2. 
   Cytomegaloviral infection
   
3. 
   Chicken pox
   
4. 
   Rubella
   
5. 
   AIDS
   

In a policlinic the patient C., 18 years old, appealed with complaints about a moderate pharyngalgia, head pain, general weakness fervescence, to 38,9 °C. It is ill already three days. Objectively: it is found out megascopic back neck, and inguinal lymphatic knots, hepatospleenomegaly, subicterus scleroticas and skin, changes in a throat, characteristic for tonsils. At the hemanalysis – lymphomonocytosis. Credible diagnosis?

1. 
   * Infectious mononucleosis
   
2. 
   Follicle quinsy
   
3. 
   Adenoviral infection
   
4. 
   Flu
   
5. 
   Viral hepatitis
   

In a policlinic the patient C., 18 years old, appealed with complaints about a moderate pharyngalgia, head pain, general weakness fervescence, to 38,9 °C. It is ill already three days. Objectively: it is found out megascopic back neck, and inguinal lymphatic knots, hepatospleenomegaly, subicterus scleroticas and skin, changes in a throat, characteristic for tonsils. At the hemanalysis – lymphomonocytosis. Principles of treatment?

1. 
   Antibiotics, hepar protective preparations, antihistaminic
   
2. 
   Antiherpetic preparations, hepar protective preparations, antihistaminic
   
3. 
   * Antibiotics, preparations of interferon, hepar protective preparations
   
4. 
   Antibiotics, Antiherpetic preparations , antihistaminic
   
5. 
   Antibiotics, preparations of interferon, vitamins
   

In an epidemic cell rationally to organize verification of the state of immunity. The Use of RUHA allows to find out persons unimmune to diphtheria during a few hours. What minimum protective titre?

1. 
   1:10
   
2. 
   1:20
   
3. 
   * 1:40
   
4. 
   1:80
   
5. 
   1:160
   

In children with catarrhal phenomena revealed an increase of inframaxillary lymph nodes, tonsil hyperplasia with whitish soft touch on them in the form of points and islands, the presence of rare maculo-papular bulging out, increased liver and spleen. Identify the likely diagnosis?

1. 
   * Infectious mononucleosis
   
2. 
   Acute leukemia
   
3. 
   Measles
   
4. 
   Scarlet fever
   
5. 
   Chicken pox
   

In patient R., 34 years old with general intoxication and increased body temperature up to 38 ?C, appear pain in region of right auditory canal and next day distortion of face to the left side. Review: softening of frontal and nasal-mouth skin folds, right eyelid cleft is wider than left, mouth cavity turned left, right eyebrow doesn’t move upwards and cheek is strenght. Right xerophthalmia, xerotomia and disordered taste sensation on the surface of right anterior 2/3 half of tongue. Herpetic vesicles in right exterior auditory canal and auricle. What is the most possible diagnosis?

1. 
   Rossolimo-Melkerson-Rozental’s syndrome right side
   
2. 
   Postherpetic neuralgia of I-st and II-nd branch of right trigeminal nerve
   
3. 
   Postherpetic neuralgia of all 3 branches of right trigeminal nerve
   
4. 
   Sluder’s syndrome right side
   
5. 
   * Hant’s syndrome
   

Male patient, 22 years old, complains of sore throat, general weakness, headache. Objective status: fever 38 ?C, Ps 100 per min, pharyngeal mucosa is hyperemic, tonsils are swollen, porous, covered with layer, which is easily removed with spatula, without bleeding. What is the most possible diagnosis?

1. 
   Follicular tonsillitis
   
2. 
   * Lacunar tonsillitis
   
3. 
   Simanovsky-Vensan’s tonsillitis
   
4. 
   Infectious mononucleosis
   
5. 
   Localized dyphtheria of pharynx
   

Patient 18 years, entered permanent establishment with complaints about head pain, general weakness increase of temperatures, to 37,5–38,2 °C during 6 days, pharyngalgia. Objectively: all groups of lymphonoduses, 1-3 cm in a diameter, elastic, are megascopic, little sickly, not soldered between itself. A liver is megascopic on 3 sm, spleen – on 1 sm. In a blood is leycocytosis, plasmatic mews – 15 %. What group of herpes does the exciter of this illness belong to?

1. 
   Alpha
   
2. 
   Beta
   
3. 
   * Gamma
   
4. 
   Delta
   
5. 
   Teta
   

Patient 60 years old complain of pains in right hand which last for 2 days. On the 3rd day appeared vesicular chain-like rash on the skin of arm, forearm and fist. Sensitivity in the rash area is decreased. Which disease can be diagnosed?

1. 
   Dermatitis
   
2. 
   * Herpetic ganglionitis
   
3. 
   Neck-thorax radiculitis
   
4. 
   Psoriasis
   
5. 
   Allergy
   

Patient A., 17 years old, became ill gradually. A general weakness, fatigue, pain in throat, stomach-ache, nausea, was marked. He was hospitalized on the 5th day of illness. Objectively: body temperature 38 °C, increased cervical, cubital and axillary lymph nodes. Subecteric skin and sclera. Observed elements of spot-papul rash on a trunk. Raids on tonsils are loose, yellow, tongue coated by white covering, a stomach is moderately swollen, hepatospleenomegaly. In general blood – leucocytosis, neutrophyle shift to left, atypical mononuclears – 10 %, plasmatic cells – 10 %. What is preliminary diagnosis?

1. 
   * Infectious mononucleosis
   
2. 
   Yersyniosis
   
3. 
   Lacunar tonsillitis
   
4. 
   Viral hepatitis A
   
5. 
   Typho-paratyphoid disease
   

Patient A., 18 years old, is complaining about headache, weakness, high temperature, soar throat. Objectively: general lymphadenopaty,wit lymph nodes 1-3 cm in diameter, dense, elastic not painful and not combined between themselves. Hepatospleenomegaly was noticed. In blood there is leucocytosis, monocytes – 15 %. What is the diagnosis?

1. 
   * Infectious mononucleosis
   
2. 
   Adenoviral infection
   
3. 
   Tonislatis
   
4. 
   Diphtheria
   
5. 
   Acute leukemia
   

Patient A., 35 years old, came to the clinic on the third day of disease with complaints of drowsiness, sweat, headache, fever up to 38.5 °C. Reviewing physician found sore throat, splenomegaly, enlarged lymph nodes. Liver not enlarged. Blood analysis – leukocytosis, lymphomonocytosis. What is treatment for the patient?

1. 
   * Antibiotic, drugs interferon, hepatoprotectors
   
2. 
   Antihistamin, antiherpetic preparations hepatoprotectors
   
3. 
   Antibiotic, hepatoprotector, antihistamine
   
4. 
   Antibiotics, antihistamine, antiherpatic drugs
   
5. 
   Vitamins, antibiotics, drugs interferon
   

Patient A., complains of redness of the skin and edema on the right cheek. During a review: body temperature 38,7 °C, enlarged and painful right submandibular lymphatic nodes, the border between red and normal skin is sharp, present vesicles with dark content, palpation is painful. Your primary diagnosis?

1. 
   * Erysipelas, hemorrhagic form
   
2. 
   Anthrax, skin form
   
3. 
   Herpetic infection
   
4. 
   Varicella (chickenpox)
   
5. 
   Phlegmone of the cheek
   

Patient B, 29 years, appealed to the clinic with complaints about the increase of temperature bodies, pain of head, dull ache in joints, chill, pharyngalgia, that increased at swallowing. Objectively: hyperemia of otopharynx, tonsills are hyperaemic, hypertrophied, on both are necrotizing areas of darkly-grey color, after removing a layer by the layer of which the deep defect of mucus shell appeared with an uneven bottom, sickly regional lymphatic knots are megascopic. What illnesses is it necessary to conduct differential diagnostics with?

1. 
   Diphtheria
   
2. 
   Rabbit-fever
   
3. 
   Lupus
   
4. 
   Infectious mononucleosis
   
5. 
   * With all listed above
   

Patient B, after disease, which was accompanied by fever and sore throat, has signs of dysphagia, dysarthria, weakness of limb muscles, hypoaesthesia of polyneurotic type. What is the most possible diagnosis?

1. 
   Sublingual nerve neuropathy
   
2. 
   * Dyphtherial polyneuropathy
   
3. 
   Glossopharyngeal nerve neuropathy
   
4. 
   Encephalitis
   
5. 
   Bulbar syndrome
   

Patient B., 18 years old, entered infectious department with complaints about headache, general weakness increasing of temperature to 37.5-38.2 °C during 6 days, pharyngalgia. Objectively: all groups of lymphonodes are megascopic 1-3 cm in a diameter, elastic, littlesickly, not soldered between itself. A liver is megascopic on 3 cm, spleen – on 1 cm. Common blood analysis: atypical mononuclears – 15 %. What is reliable diagnosis?

1. 
   Acute lympholeukosis
   
2. 
   Adenoviral infection
   
3. 
   * Infectious mononucleosis
   
4. 
   Diphtheria
   
5. 
   Acute streptococcus tonsillitis
   

Patient B., 22 years, became ill sharply, when insignificant pharyngalgias appeared at swallowing, nasal voice. Objectively: on left tonsill and there is the pellicle raid on a handle. It is diagnosed: lacunar quinsy, appointed penicillinum and rinse 2 % by solution of soda. On the second day pellicles spread on a soft palate and tongue. On a neck the edema appeared to the collar-bone, voice nasal. Tones of heart are muffled, pulse 90 per min, BP is 95/65 mm HG. What most expedient medical tactic in this case?

1. 
   Antibiotics of group of penicillinum and diphtherial toxoid
   
2. 
   By the rinse 2 % by soda solution in combination with the peroral setting of erythromicinum
   
3. 
   Autohemotherapy, warming compresses and quartz
   
4. 
   Opening paratonsill cellulose
   
5. 
   * Antitoxic antidiphterial whey and benzylpenicillinum
   

Patient C., 16 years old, consulted to the infectious hospital on the 2nd day of diseases with complaints for a pain in throat at swallowing, increase of temperature. Objectively: body temperature 38,6 ?C, sharp hyperemia to the pharynx, edematous and loose tonsils, on both sides – purulent covering which can be taken off easily by spatula. By palpation painful enlarged submandibular lymph nodes. Pulse 114 times/minute. From epidemic anamnesis it is clear that the same symptoms had her boyfriend. Changes in other organs didn’t observe. What preliminary diagnosis can be suspected?

1. 
   * Lacunar tonsillitis
   
2. 
   Diphtheria of pharynx.
   
3. 
   Infectious mononucleosis.
   
4. 
   Influenza
   
5. 
   Scarlet fever
   

Patient D, 24 years old, grumbles about a general weakness, increase of t to 37,5°C, pharyngalgia, edema of neck. Objectively: the mucus shell of otopharynx was swollen, cyanochroic, tonsills is megascopic, covered by tapes, which spread for their scopes, is taken off heavily. What basic mechanism of development of this disease?

1. 
   Accumulation of unoxidized products
   
2. 
   Action of bacterial endotoxin
   
3. 
   Allergic
   
4. 
   Bacteriaemia
   
5. 
   * Action of bacterial exotoxin
   

Patient D., 20 years old, fell ill and went to infectious polyclinic cabinet with complaints of moderate pain in the throat, headache, general weakness, increased body temperature of 38.9 °C. Fells bed during three days. At examination: increasing of inguinal lymph nodes, hepatosplenomegaly, subicteric sclera and skin, changes in the throat are typical for sore throats. In the blood – lymphogranulomatosis. The principles of treatment are?

1. 
   * Antibiotics, interferons, hepatoprotectors
   
2. 
   Antihypertensives hepatoprotectors, antihistamines
   
3. 
   Antibiotics, hepatoprotectors, antihistamines
   
4. 
   Antibiotics, antihypertensives, antihistamine
   
5. 
   Antibiotics, interferones, vitamins
   

Patient D., 32 years, appealed on the third day with complaints about a sharp general weakness, change of voice, pharyngalgia. Objectively: dense pellicles occupy all surface of tonsills, tongue, handles; a hypoderm was swollen from both sides to the middle of neck. Cardiac activity is satisfactory: pulse 90 per min, BP is 95/65mm Hg; temperature of body 38,3 °C. Your diagnosis?

1. 
   Combined diphtheria
   
2. 
   Diphtheria of otopharynx, middling-heavy form
   
3. 
   Infectious mononucleosis, heavy form
   
4. 
   * Diphtheria of otopharynx, heavy form
   
5. 
   Diphtheria of nasopharynx, heavy form
   

Patient D., was hospitalized with complaints on fever, sore throat, trismus of masticator muscle, nausea, vomiting. Data of pharyngoscopy: moderate hyperemia, swelling, cyanosis of left tonsil and pharyngeal mucosa. Tonsil is covered with thick gray-white pellicle, which is spreading beyond the tonsil. On the left neck side big submandibular lymph node is palpable. Swelling of neck spreads to the clavicle. What form of disease has developed?

1. 
   Toxic dyphtheria of pharynx of the III degree
   
2. 
   Subtoxic dyphtheria of pharynx
   
3. 
   Localized dyphtheria of pharynx
   
4. 
   Spread dyphtheria of pharynx
   
5. 
   * Toxic dyphtheria of pharynx of the II degree
   

Patient K., 56 years old, during last 5 days has Herpes zoster with localization of the process on the right cheek and paraauricular region. Treating with herpevir. Today pain in the right eye appeared. During examination present of edema of eyelid and hyperemia of conjunctiva. What is the action of a physician?

1.