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Назва наукового напрямку (модуля): Семестр: 8 Situational tasks (Phthisiology) Опис: 4 course med Перелік питань: 1. A. * B. C. D. E. 2. A. B. C. D. * E. 3. A. B. * C. D. E. 4. A. B. C. D. * E. 5. A. * B. C. D. E. Set the proper diagnosis to the patient K. The upper right lung lobe reduced in volume with decreasing it’s transparency, but retaining airiness. The expressed interstitial changes are increasing toward to the root of the lung and to the large, irregular shapes, not intense focal shadows without clear contours . Right root increased in volume, with a clear polycyclic nonstructural outer loop The central lung cancer right-sided pneumonia infiltrative tuberculosis of upper lobe right lung focal tuberculosis disseminated tuberculosis The patient O. has right-side spontaneous pneumothorax. The outer contour of the lung that decreased projects on a region of the root of the lungs. What is the approximate degree of decreasing lungs? 2% 30% 45% 90% 55% In the patient R., with the bilateral fibro-cavernous tuberculosis revealed: proteinuria (1.32 g / l), erythrocyte uriya (07-05-10 at n / s), leucocyturia (06-08-12 at n / s). Which are the leading causes of these changes? chronic pulmonary heart amyloidosis of the internal organs TB intoxication Tuberculosis of kidney accompanying pyelonephritis The patient 22 years old are treated in a tuberculosis hospital with the infiltrative tuberculosis upper left lobe of the lung. From the age of 11 suffers from diabetes (type2), complicated by diabetic retinopathy. During the last 3 months he marks the reduction of daily insulin requirements from 40 to 35 units. On the background of anti-tuberculosis therapy, edema of the lower extremities appears in the patient. Which of the following tests can determine the cause of edema with the highest probability? test Zymnytskoho; the definition of protein spectrum of blood; urinalysis; determine the level of blood creatinine total blood The patient is observed in the group of 5.1 strokes keeping with a diagnosis of "dense foci and fibrosis of the upper right lobe of the lung," entered the hospital with such complaints as fever (38C) and dry cough. The beginning of disease was subacute,the patient connects symptoms with hypothermia. Radiological findings the homogeneous notintense eclipse without clear contours in the projection of C2, 3 case. Objectively-the percussion tone of the upper divisions of the right lung are blunting, wheezing isn’t listened clearly. What doctor’s tactic is the most appropriate to the patient? treatment within 2 weeks with antimicrobial drugs of a wide spectrum followed by X-ray control trial of over 1.5-2 months. TB drugs that do not affect the nonspecific microflora a course of intensive anti-tuberculosis therapy within 1.5-2 months Observation chemoprophylaxis 6. A. B. C. * D. E. 7. A. B. C. D. * E. 8. A. B. * C. D. E. 9. A. B. * C. D. E. 10. A. B. C. D. * The patient 20 year old has shortness of breath, pain in the right half of the chest, dry cough, fever to 38C, sweating, weakness. He has been sick about a month and noted a gradual increase of intoxication, and then pains and shortness of breath appeared. Previously, he considered himself healthy. Physicaly in the lower right chest was noted shortening of pulmonary tone, diminished bronhofoniya, voice trembling and breathing. For what disease this complaints and physical data are tipical? inflammation of lower zone of left lung atelectasis exudative pleurisy adhesive pleurisy selective spontaneous pneumothorax The patient 23 years old with no complaints . On physical examination pathology was undetected. Hemogram within normal limits. Radiography and tomography: in the third segment of the right lung in the basal zone not intense formation measuring 1.5 x 2.5 sm irregular configuration in a retort shape is defined. A possible diagnosis: lung cancer benign tumor tuberkuloma retention cysts infiltrative pulmonary tuberculosis The patient 53 year old entered the examination on the fibrous changes in a C6 right lung, the background is determined by the cavity from infiltrated walls. From history we know that about six months ago after cranial trauma with loss of consciousness shivering emerged , body temperature increased sharply, dry cough appeared. Body temperature is kept at 38-39,50 C level for a week. Improvements came after one-time discharge of a large amount of foul-smelling sputum, but full normalization condition hasn’t occurred. Coughing with purulent sputum and periodic subfebrile are still hurting the patient. What is the correct diagnosis in this patient? fibro-cavernous tuberculosis chronic lung abscess purulent cyst chronic pneumonia cirrhosis segment VI of right lung The patient 54 years old complains on a dry cough with little phlegm mucus, periodic subfebrile. Objectively - low power. Auscultation observed weakening of breathing over the left half of the chest. Radiologically increased pulmonary picture on the left, some narrowing of the left lung field, a slight shift to the left median shade. What resulted from the research can verify the diagnosis? analysis of sputum of atypical cells bronchoscopy ECG median tomography complete blood count The patient of '30 complains on a shortness of breath, pain in a right side, which increases during breathing, increased body temperature.He illed acutely before admission to a hospital. There were fever with chills, cough and then cough with the release of small quantities of rusty sputum . At objective examination observed blunting percussion sound over the basal divisions of the right lung, ibid auscultated bronchial breathing. What is the most likely diagnosis in this patient? infiltrative tuberculosis spontaneous pneumothorax pleural effusion lobar pneumonia E. lung cancer 11. The patient N. of '34 complains with a slight shortness of breath on exertion, cough with the release of small quantities of mucous sputum. Suffering from her childhood. The disease runs with periodic exacerbations, during which symptoms of intoxication, increased cough, increased sputum quantity, which acquires a purulent character. The general condition is moderate, diffuse cyanosis. Nail phalanges have the form of drum sticks, nails - watch glasses. lung There is relaxed breathing above the upper divisions of the right . Radiological deformation of the pulmonary picture is determined in the upper right of lobe , the background is determined by multiple thin-walled cavity. What is the most likely diagnosis in this patient? fibro-cavernous pulmonary tuberculosis cystic hypoplasia bullous emphysema bronchiectasis progressive degeneration of the lungs In the pleural aspirate of the patient C. revealed erythrocytes 5-6 in the field of view, neytrofils 80% limfotsyts - 20%,also mezothelian cells. Completely possible – it is: TB plevropneumonia heart insufficiency malignant process sarkoidosis In bioptate of lymphatic node was found a large number of neytrofils. - Completely possible it is: TB non specific inflammation lymphogranulomatosis sarcoidosis fungal lesions Which disease means the following picture: acute onset, fever - 39, weakness, chills, pain in the chest, cough with little phlegm, wheezing, a high white blood cell count, erythrocyte sedimentation rate: pneumonia A. B. * C. D. E. 12. A. B. * C. D. E. 13. A. B. * C. D. E. 14. A. * B. C. D. E. 15. A. B. * C. D. E. 16. A. abscess infiltrative tuberculosis Cancer sarcoidosis Patient C.,30 years old, worried about dyspnea, pain in the right side, which amplifies during breathing, fever, blunting percussion sound over the basal segment, where is also bronchial breath. Completely possible – it is: pulmonary infarction pneumonia pleuritis lung cancer sarkoidosis Patient of 39 years. Cough with phlegm, subfibrylitet, pain in the chest, food reduced. The weakening of breathing over the left half of the chest. On the x-ray – strengthening of the pulmonary picture, restriction of the left lung field, a shift to the left median shade. What method of examination is the most significant? sputum of atypical cells B. * C. D. E. 17. A. B. C. D. * E. 18. A. B. C. D. E. * 19. A. B. * C. D. E. 20. A. B. C. D. * E. 21. A. B. * C. D. E. 22. A. B. C. bronchoscopy Tomography respiratory function ultrasound The patient A.,with destructive tuberculosis, during the development of drug stability MBC to the most effective chemotherapy, the optimal method of treatment is: use chemotherapy drugs reserves + isoniazyd Reserve use of preparations Early treatment with intravenous introduction of isoniazidi Early treatment in combination with the intensive treatment - drugs of II line imposition an artificial pneumothoraxis In the patient B.,during the chemotherapy appeared: sleep disorders, depression,polyneuritis. This is due to admission: ryfampitsine pуrazinamide etionamid streptomycin izoniazyd A patient B. with tuberculosis, during the chemotherapy, appeared complaints of reduced vision, the presence of the nets before the eyes. Ophthalmologist found in violation of color feeling, idecrease of visual acuity. This is due to admission izoniazyd ethambutol streptomitsyn pirazynamid ryfampitsyn In the patient C. with first discovered infiltrative tuberculosis of upper lobe of right lung in phase of decayin,was detected by microscopy MBC in sputum. Choose the most rationally combination of chemotherapy for the first two months of treatment: izoniazyd + streptomitsyn +ryfampitsyn izoniazyd +ryfampitsyn + pirazynamid +streptomitsyn izoniazyd + ryfampitsyn +pirazynamid izoniazyd+ ryfampitsyn + pirazynamid+ streptomitsyn + ethambutol izoniazyd+ ryfampitsyn + ethambutol + streptomitsyn The patient F.,against chemotherapy disappeared appetite , which drug should be excluded from the treatment plan: streptomytsyn protyonamid rifampicin izoniazid kanamycin The patient D. with tuberculosis of the third category of intensive phase is always necessary to assign combination of: izoniazyd +ryfampitsyn izoniazyd + + ryfampitsyn+ streptomitsyn izoniazyd + streptomitsyn +pirazynamid D. * E. 23. A. B. C. D. * E. 24. A. B. C. * D. E. 25. A. B. C. * D. E. 26. A. B. C. * D. E. 27. A. izoniazyd+ ryfampitsyn + ethambutol +pirazynamid izoniazyd +ryfampitsyn + ethambutol After the main course of chemotherapy about tuberculosis intoxication, from the 3 category children and teenagers are translated: in 5.4 in 5.2 in 5.5 in 5.1 to 5.3 Patient B.,60 years old, arrived with complaints of weakness, growing dyspnea, subfibrylitet, pain in the upper chest, slight cough, hemoptysis. The disease began gradually. Leuk. - 9 * 10 ^ 9, ESR 42 mm / hr. Tuberculin test is negative.There is not MBC in the sputum . On the X-ray in a case of C3- large cavity irregularly rounded with thick, irregular wallthickness, internal contours are like bay. The most possible diagnosis isabscessed pneumonia cheesy pneumonia Cancer, which decays Acute abscess Circular infiltrate in the collapse phase Patient C.,49 years old,notes grueling dry cough, chest pain, hemoptysis,subfibrylity, catarrhal phenomena in the lungs is not listened. ESR - 48 mm / hr., Blood parameters are not changed, in the sputum the MBT was found only once. Radiological findings: in the case of C3,subpluevral, observed the formation of circular d.of 3.5 cm with clear but unevencontours, homogeneous structure. Diagnosis: Tuberkuloma Circular infiltration Peripheral cancer eosinophilic infiltration Asperhiloma Patient B.,53 years old,general condition is severe, pronounsed dry cough, chest pain, dyspnea, hemoptysis . In the lungs -dry scattered wheezing. ESR - 46 mm / hr., Leuk. - 9.8 x 10 ^ 9,Hb - 96 g / l, lymphocytes - 14%, Mantou test is negative. Radiological findings: the background of lymphangoitis ,more in mid-medial and inferior parts of the lungs, determined by multiple round shape and different size, with clear contours external pockets (a symptom of "small change").Diagnosis: disseminated tuberculosis Systemic lupus erythematosus metastatic cancer exogenous allergic alveolitis Silicosis Patient S., 45 years old. During X-ray examination about right-sided lower lobe pneumonia was found single, low-intensity fire to 1 cm in diameter in the C2 of the left lung . After cure of pneumonia due to focal tuberculosis of doubtful activity 3 months of chemotherapy was conducted. Dynamics of the process is not seen. The diagnosis of tuberculosis has been removed. After 2.5 years patient was examined again. The general condition is satisfactory, no complaints.On the X-ray in the left C2 observed rounded homogeneous shadow focus, medium intensity to 1.5 cm in diameter, small size of banky contours and surrounding tissue intact. The most possible diagnosis isfocal pulmonary tuberculosis (fibroznovohnyschevyy) B. C. * D. E. 28. A. * B. C. D. E. 29. A. B. C. D. * E. 30. A. B. C. D. * E. 31. A. B. * C. D. E. 32. A. B. Tuberkuloma of lung Peripheral cancer Benign tumor (hamartohondroma) Metabolic retykuloz (lipidoz) Which diseases in patients E. corresponds to the following X-ray picture? Mainly in corticalregions of the upper segment of the right lung determined by multiple focal shadows different size and intensity, irregular shape, without clear contours. Around them locally pulmonary picture moderately excessive and distorted by the reticulated type focal pulmonary tuberculosis focal pneumonia Peripheral cancer Sarcoidosis of lung Aspergillosis A “range” of tuberculin reaction is established in a 18-years old patient, Mantaex test with 2 TU PPD-L –a papule of 16mm in diameter. He complains of the general weakness, subfebrile temperature, promoted perspiration. The blood analysis\: L -9,2? 10 /l, ESR-26 mm/hr. No pathological changes in lungs is been revealed at roentgenological examination. What diagnosis is most reliable? Primary tuberculous complex Tuberculosis of intrathoracic lymphatic nodes Nidus lung tuberculosis Tuberculous intoxication Infiltrative tuberculosis A patient 23, has fallen ill acutely. He complains of the headache, dry cough, shortness of breath, the body temperature rising up to 39,0?C. Objectively\: his general state is difficult, cyanosis of lips, rales are not heard. The blood analysis\: L -12,6? 10 /l, ESR-16 mm/hr. Multiple small nidal shades of weak intensity are observed throughout the whole lung length on the inspection roentgenogram. Mantaex test with 2 TU PPD-L –a papule of 5mm in diameter. What clinical form of lung tuberculosis is found in a patient? Nidus Infiltrative Disseminated Miliary tuberculosis Caseous pneumonia A patient aged 43. FDT (21.01.2004) of the upper particle of the right lung (infiltrative), Destr +, MBT+ M- K+ Resist- HIST0, Cat1Cog1(2004), as to clinico-roentgenologicalal data was established. What phase is answered by abbreviation after effective treatment? infiltration sowing condensation decay suction A patient is 50-ty.He is on treatment in antitubercular dispensary with a diagnosis\: CT (15.02.2000) of upper particles of both lungs(fibrous-cavernous, phase of infiltration and sowing), Destr+,MBT+ M+ K+ Resist- ResistІІ0 HIST0, Cat4 cog1(2000). Roentgenologically decay cavities (in upper particles of lungs), multiple fresh nidi in both lungs, fibrous deformation of lung picture has been established in a patient. What phase of tubercular process is answered by the presence of multiple fresh nidi? Phase of decay Phase of condensation C. D. * E. 33. A. B. C. D. E. * 34. A. B. C. D. E. * 35. A. B. C. D. E. * 36. A. B. * C. D. E. 37. A. B. Phase of calcination Phase of sowing Phase of infiltration A patient, 36th. She was hospitalized into an antitubercular dispensary in connection with infiltrative changes with destruction in the upper particle of the right lung presence, which have been found on roentgenogram. Complains on weakness, subfebrile temperature of body, cough with sputum expectoration. No pathological changes from the respiratory organs have been revealed at physical examination. MBT+ have been in sputum analysis (bacteriologically). The diagnosis of lung tuberculosis has been established in a patient. What diagnosis formulation correct is? FDT (15.11.2004) (nidus), Destr+, MBT- M- K- HIST0, Cat3 cog4(2003). FDT (15.11.2004) of lungs (disseminated, the phase of infiltration), Destr-, MBT- K- HIST0, Cat3 cog4(2004). FDT (15.11.2004) of the middle particle of the right lung (infiltrative) Destr+, MBT- K+ HIST0, Cat3 cog4(2004). CT (3.12.1999) of the upper particle of the right lung (cirrhotic) Destr-, MBT- K- HIST0, Cat3 cog4(2003) FDT (15.11.2004) of the upper particle of the right lung (infiltrative) Destr+, MBT+ M- K+ Resist0 ResistІІ0 HIST0, Cat1 cog4(2004). A patient, 44. She complains of a cough with sputum expectoration, weakness, raising of body temperature. No changes from respiratory organs have been revealed at physical examination. Roentgenologically decay cavity with perifocal inflammation of lung tissue and nidi of sowing in both lungs has been found in S1,2 of the right lung. MBT are revealed in sputum. A diagnosis\: FDT (15.01.2004) of the upper particle of the right lung (infiltrative), Destr +, MBT+ M+ K+ Resist0 ResistІІ0 HIST0,Cat1cog1 (2004) has been established in a patient. What method of revealing tuberculosis mycobacterium is the answer to the abbreviation of M+? bacteriological biological culturally bacterioscopy method of sowing A rink-like shadow of 6 cm in diameter with thick walls in the upper part of the left lung, around which there are fibrous traces and nidal shadows at roentgenological examination in a 53-years old patient. MBT have been found in sputum. What form of lung tuberculosis is most reliable? Cirrhotic Infiltrative Disseminated Tuberculoma Fibrous-cavernous Each one tuberculosis patient can infect annually: 1-5 persons 10-15 persons 25-30 persons 35-40 persons 45-50 persons What term it should be expect results of culturally examination with a view to reveal MBT at using of hard eggs mediums? 2-5 days 10-14 days C. * D. E. 38. A. B. * C. D. E. 39. A. B. C. * D. E. 40. A. * B. C. D. E. 41. A. B. C. D. * E. 42. A. B. * C. D. E. 2-2.5 months 4-6 hours 20-30 days H was synthesized in the laboratory of: S.Waksman Fox R.Koch R.Roentgen R.Philip Multiple focal shades of weak and medium intensity in the upper and middle parts of lungs have been found at roentgenological examination in a 19-years old patient. MBT have been found in sputum. The blood analysis\: ESR-38 mm/hr. What diagnosis is most reliable? Lung infiltrative tuberculosis Nidus lung tuberculosis Disseminated lung tuberculosis Caseous pneumonia Fibrous-cavernous lung tuberculosis In the exposure of what changes in biopsy material is based histological confirmation of tubercular character of inflammation? Pirogov-Langerhans cells , caseous necrosis. Cells of foreign bodies, fibroblasts. A big amount of neutrophiles, colicvation necrosis. Proliferation of lymphocytes. Proliferation of poorly differentiated cells. Patient 37-ty, complains of the shortness of breath at walking, pain is in the area of heart. He is ill tuberculosis during 15 years. An intensive shade in the upper part of the left lung on inspection roentgenogram. The left root dislocation upwards, a shade of mediastinum is dislocated to the left. MBT have been found in sputum analysis. What clinical form of tuberculosis for a patient is marked? Fibrous-cavernous Infiltrative Caseous pneumonia Cirrhotic Tuberculoma Patient 33-th years. He complains of the body temperature rising up to 37,2?C, weakness, promoted perspiration, cough with sputum expectoration. Roentgenologically infiltrative shade with decay cavity in S1,2,3 of the right lung and nidi of sowing in S6 of healthy lung. Tuberculosis mycobacterium was found in sputum. The clinical diagnosis of tuberculosis was established in a patient. What diagnosis should be answered classification fully? FDT (12.01.2005) of the upper part of the right lung (infiltrative) Destr+, MBT+ M+ K+ HIST0, Cat1cog1(2005). FDT (12.01.2005) of the upper part of the right lung (infiltrative) Destr+, MBT+ M+ K+ Resist0 ResistІІ0 HIST0, Cat1cog1(2005). FDT (12.01.2005) (infiltrative), MBT+ M+ K+ HIST0, Cat1Cog1 (2005). FDT (12.01.2005) of the upper part of the right lung (infiltrative) MBT+ M+ K+ Resist+ ResistІІ0 HIST0, Cat1cog1 (2005). FDT (12.01.2005) of the upper part of the right lung (infiltrative) Destr+,Resist0 ResistІІ0 HIST0. 43. A. B. C. * D. E. 44. A. * B. C. D. E. 45. A. B. C. * D. E. 46. A. B. * C. D. E. 47. A. Patient 34th years. She is on treatment into an antitubercular dispensary. FDT (12.11.2004) of lungs (disseminated, the phase of infiltration and decay) Destr+, MBT+ M+ K+ Resist- ResistІІ0, Cat1 cog4(2004) has been established in a patient at hospitalization.. Roentgenologically multiple nidi in all pulmonary fields with decay cavities presence have been revealed in S1-2 of the left lung. MBT+ have been in sputum analysis. After the performed course of treatment during 4th months nidi in both lungs have resolved partly, bacteria excretion and sizes of caverns have decreased. How to estimate efficiency of treatment? Cessation of bacterial excretion Recovery Prolongation treatment Ineffective treatment Completed treatment Patient age 41 years. He is sick by fibrous cavernous pulmonary tuberculosis of the upper part of the right lung during 8 years. Mycobacteriums tuberculosis+. He feels good during last 2 year. Radiographic data\: the upper part of the right lung available thick cavern with fibrosis and perifocal inflammation. The upper part is narrow due fibrosis. Both lungs have focuses of semination. Shadow of mediastinum shifted right. What radiographic data are typical for fibrous cavernous pulmonary tuberculosis of the lungs? Caverns presence, well-defined fibrosis, focuses of semination. Caverns presence, perifocal inflammation. Perifocal inflammation, bronchogenic dissemination. Organs on mediastinum are shifted in the side of lesion. Intense dark patch, narrowed lung field. Patient aged 26. He complains of a weakness, subfebrile temperature, insignificant cough with sputum expectoration. FDT (16.12.2004) of lungs (disseminated, the phase of infiltration), Destr +, MBT+ M- K+ Resist- ResistІІ0 HIST0, Cog4 (2004), as to clinico-roentgenologicalal and laboratory data was established. What category does it follow to deliver a patient to? Cat 5 Cat 4 Cat 1 Cat 2 Cat 3 Patient of 35 years. He was hospitalized into an antitubercular dispensary in connection with changes which have been found in fluorography\: a shade about 1 cm in diameter of small intensity with vague contours has been revealed in S1 of the right lung. On tomogrami destruction is determined in the center of shade. MBT+ have been in sputum analysis (bacteriologically). A diagnosis of nidus lung tuberculosis has been established in a patient. What phases of nidus lung tuberculosis are representing changes which have been revealed on roentgenogram? Infiltration and sowing Infiltration and decay Suction and scarring Decay and sowing Condensation and suction Patient of 32, was on treatment in an antitubercular dispensary with a diagnosis\: FDT (16.06.2003) S1-2 of the left lung(infiltrative), Destr +, MBT+ M+ K+ Resist- ResistІІ0 HIST0, VNII Cat1cog2(2003). During 6 months a course of antimycobacterial therapy was performed in hospital. Then next 2 months he was treated ambulatory. At the present time excretion of bacteria has ceased in a patient, a cavern has scarred. How to define efficiency of treatment of this patient? completed treatment B. * C. D. E. 48. A. B. C. D. E. * 49. A. B. C. * D. E. 50. A. B. C. * D. E. 51. A. B. C. D. E. * 52. A. B. * C. D. E. 53. A. B. * C. D. E. 54. ineffective treatment Interrupted treatment Left recovery Patient of 31 years. At prophylactic examination nidal shade of small intensity with vague contours has been found in lateral zone of the under clavicle area of the right lung. What segment of lung should be noted in a clinical diagnosis? ІІІ X ІV VI II Single focal of small intensity with vague contours have been revealed in apexes segments of both lungs at prophylactic fluorographic examination in a 19-years old patient. What form of tuberculosis such changes are characteristic for? Infiltrative tuberculosis Tuberculoma Nidus lung tuberculosis Caseous pneumonia Disseminated lung tuberculosis The vaccine BCG was produced by: R.Koch S.Waksman A.Calmette and Guerin F. Seibert M.Linnykova The all number of tuberculosis patients in the world is: 3-5 mln 10-15 mln 20-30 mln 40-45 mln 50-60 mln The first antituberculosis dispansery world was founded by R.Koch R.Phylip A.Calmette and Guerin Abre F.G.Yanovsky Treatment of what state is most perspective and important from the epidemiological point of view? At first diagnosed tuberculosis without destruction. At first diagnosed tuberculosis with destruction. Relapse. Chronic tuberculosis. Primary tuberculosis. What changes in the number of leucocytes at the uncomplicated tuberculosis are the most typical? A. B. C. * D. E. 55. A. B. * C. D. E. 56. A. B. * C. D. E. 57. A. B. * C. D. E. 58. A. B. * C. D. E. 59. A. B. C. D. E. * 60. A. B. C. * D. E. 61. A. B. Expressed leucocytosis with a considerable bacillarnuclear shift, leukemia reaction Changes are not characteristic Moderate leucocytosis with an unsignificant bacillarnuclear shift Leucopenia Both leucopenia and leucocytosis is possible What changes of ESR at the uncomplicated tuberculosis are most characteristic? Accelerated up more than 60 mm on hour Changes are absent Reduction Accelerated up to 30 mm on hour Accelerated only in woman What changes of the urine at a lung tuberculosis which courses with expressed phenomena of intoxication are most characteristic? Moderate proteinuria, moderate leucocyturia, total macrohaematuria Moderate leucocyturia, single erythrocytes Significant proteinuria without changes in the number of leucocytes, initial macrohaematuria Pyuria, cylindruria, microhaematuria Total macrohaematuria with a pain syndrome What color is used for the revealing MBT? According to Gram According to Tsil-Nilsen According to Romanovskij-Gimza By fuxyne By methylene-blue What complication does specific belong to? Haemophthisis Chronic lung heart Atelectasis Larynx tuberculosis Amyloidosis What data clinical diagnosis formulation begin from? The process phase Clinical form Bacterial excretion Localization of process Type of tuberculous process What definition does atypical mycobacterium characterize most correct? There are unpathogenic mycobacteria for a human being They cause tuberculosis with atypical course They cause an illness, similar to tuberculosis, for persons with lowered immunity There are pathogenes of leprae There are changed mycobacteria under act of chemotherapy What definition of role of clinical blood examination in tuberculosis patients is most correct? It allows to define an etiologic diagnosis It has no importance C. * D. E. 62. A. B. C. * D. E. 63. A. B. C. D. E. * 64. A. B. * C. D. E. 65. A. B. C. * D. E. 66. A. B. * C. D. E. 67. A. B. C. * D. E. 68. A. * It allows to evaluate expressiveness of inflammatory and intoxication changes in an organism It form the basis of differential diagnostics It form the basis of working capacity examination What form of tuberculosis does primary belong to? Nodus Disseminated Tuberculosis of the unstated localization. Caseous pneumonia Infiltrative What form of tuberculosis is referring to primary? Disseminated Nidus Infiltrative Tuberculoma Tuberculosis of intrathoracic lymphatic nodes What formulation of clinical diagnosis of lung tuberculosis is not correct? FDT (16.06.2003) of the upper parts of both lungs (disseminated, the phase of infiltration), Destr+, MBT+ M+ K+ Resist0, HIST0, Cat1 cog2(2003). CT (12.02.2000) of the upper part of the right lung (fibrous-cavernous), Destr+, MBT+ K+ M+ Resist+(8,K), HIST0, haemophthisis, CLH, HI ІІA degree, Cat4 cog1(2000). TR (20.11.2003) of the lower part of the right lung (tuberculoma), Destr+, MBT- M- K-, HIST0, RI 1st degree, Cat2cog4(2003). Diabetes, І type, severe form. FDT (20.09.2003) (nidus, the phase of infiltration), MBT- M- K0, HIST0, Cat3 cog3(2003) State after the lobectomy of the upper part of the right lung (20.06.2003) on the occasion of tuberculoma of the upper part of the right lung in the decay phase, MBT(+). What information must not contain the classification of any illness according to the IKD-10? Clinical form of disease. Localisation of affection. Prognosis. Accompanimental diseases. Complication. What is the definition of primary tuberculosis? At first diagnosed tuberculosis. Initial signs of tuberculosis. Nondestructive tuberculosis. Tuberculosis which arose up just after infection. Tuberculosis with an affection of only one organ or system. What is the definition of secondary tuberculosis? Relapse of tuberculosis. Destructive tuberculosis. Tuberculosis which arose up long after an infection. Tuberculosis with the unfolded clinical picture. Generalized tuberculosis. What is the most probable distance at the infectioning by MBT by the aerogenic way? To 1,5 m B. C. D. E. 69. A. B. C. * D. E. 70. A. B. C. D. * E. 71. A. B. C. D. * E. 72. A. B. C. D. * E. 73. A. * B. C. D. E. 74. To 3,5 m To 4,5 m To 6 m To 10 m The “range” of tuberculin reaction was discovered in girl B. aged 9. Clinico-roentgenological and laboratory examinations revealed no pathological changes. Your tactics regarding with the girl.{ To repeat Mantoux test with 2 TU in a year To hospitalize to an antituberculous hospital To perform chemoprophylaxis with isoniazidum and vitamin B6 within 3 months The observation in an antituberculous dispensary for 1-2 years To consider the girl healthy and not to take any prophylactic measures The 11-year-old patient M. is diagnosed with tuberculin “turn”, Mantoux test with 2 TO – 16 mm infiltrate. Complaints for general asthenia, increased sweating. Blood analysis\: leuk. – 9,2x109/l, ESR – 26 mm/hour. Roentgenogram examination did not reveal pathologic alterations in the lungs. What diagnosis is the most probable one?{ Primary tuberculous complex Tuberculosis of intrathoracic lymphatic nodes Nidus lung tuberculosis Tuberculosis intoxication Infiltrative lung tuberculosis A 3-years old child reaction to Mantoux test with 2 TU – 7 mm infiltration, at the age of 4 – 3 mm. Postvaccinal seam of 4 mm. Define the character of tuberculin reaction.{ Infectious allergy A “range” of tuberculin testing The child is ill with tuberculosis Postvaccinal allergy Doubtful Mantoux reaction A 22-year-old patient fell ill acutely. Complaints for headache, dry cough, dyspnea, temperature rise up to 39,0? C. Objectively\: general condition is grave, lips cyanosis, rales are not heard. Blood analysis\: leuk. – 12x109/l, ESR – 16 mm/hour. Roengenogram\: the whole length of both lungs is full with multiple, small focal shadows of low intensity. Mantoux test – 5mm infiltrate. What clinical form of lungs tuberculosis does this patient have?{ Nidus Infiltrative Disseminated Miliary tuberculosis Caseous pneumonia A 5 years old boy K., had a “range” of tuberculin reaction. What examinations should be done?{ General clinical examination, inspection roentgenogram of the thoracic cage organs, general blood and urine test Koch’s testing, general blood and urine test Fluorography, general blood and urine test Tomography, smear examination from pharynx for MBT Fibrobronchoscopy, examination of contents from bronchi for MBT A patient 34, complains of the cough with sputum, weakness, raising of body temperature to 37,52?C, during 3 weeks, appetite loss, indisposition. No changes have been revealed at objective examination. What should be found out in a patient in the life anamnesis?{ A. B. C. * D. E. 75. A. B. * C. D. E. 76. A. B. * C. D. E. 77. A. B. C. D. E. * 78. A. B. * C. D. E. 79. A. B. C. Smoking Following the routine of work and rest Present the contact with tuberculosis patient Sport occupation Present the emotional labiality A patient 36, appeal to the doctor with complains of the weakness, cough with sputum, raising of body temperature to 37,2?C. Lung infiltrative tuberculosis was revealed in antitubercular dispensary after finish examination. It is known from anamnesis, that a patient was ill with arthritis, infectious hepatitis, tyreotoxicosis. Diabetes two years ago and glomerulonephrytis. What somatic disease is the risk factor of tuberculosis occurring?{ Glomerulonephritis Diabetes Thyreotoxicosis Infectious hepatitis Gaimoritis A patient 34, complains of the raising of body temperature to 37,5?C, appetite loss, indisposition, weakness, cough with sputum excretion up to 50 ml per day of slime character. The state of patient has worsened gradually, during a month. What disease in a patient can one suspect?{ Pneumonia Lung tuberculosis Lung abscess Bronchial asthma Chronic bronchitis A patient 31, complains of the weakness, insignificant cough with sputum. An inhomogeneous limited darkening sized more than 5cm. in the 81, 2 of the right lung has been revealed at roentgenologic examination. Lung infiltrative tuberculosis of the upper part of the right lung has been suspected. What most reliable auscultative data characterize will be observed above the lesion lungs section of mentioned localization?{ Moist rales Dry disseminated rales Vesicular breathing Amphoric respiration Absence of breathing A patient 43, is directed to antitubercular dispensary for finish examination and lung tuberculosis diagnosis confirmation. A patient complains of the raising of body temperature to 37,5?C, weakness, disposition to perspire, cough with sputum. What sputum characterized lung tuberculosis?{ Purulent with a stinking odor Slime Frothy Slime sputum of canary color Rusty A patient 44, complains of the weakness, periodical raising of body temperature to 37,7?C, cough with sputum expectoration more than 3 weeks. There are tuberculosis patients in a family. In what thorax areas can one reveal auscultative changes at objective examination of the patient most frequently? In the lower{part of lungs In the lower third of lungs In the area under scapular D. * E. 80. A. B. * C. D. E. 81. A. B. C. D. * E. 82. A. B. * C. D. E. 83. A. B. C. D. * E. 84. A. B. C. * D. E. In the area under clavicle In the axillary’s region A patient 53, is ill with tuberculosis during 3 month, complains of the cough with sputum excretion, raising of body temperature, weakness, shortness of breathe at physical tension. Amphoric respiration is heard above the right lung, in the area under clavicle at auscultation. What changes in lungs do such auscultative phenomenon at tuberculosis condition?{ Exudates A big cavern Lung atelectasis A small cavern Cirrhotic changes A patient of 43 is on treatment in tuberculosis dispensary with a diagnosis\: FDT (15.01.2004) of right lung’s upper part (focal) Destr-, Mbt - m- k- ,gist o, Cat 3 Cog1(2004). Roentgenological\: in S1,2 of right lung darkening was determined 1 centimeter in the diameter of weak intensity. What blood test is typical for patients with a tuberculosis? { RBC.- 4,6х1012, НЬ - 134 г/л, WBC - 28х109, E-17%, п- 3%, с -60%, Li-15%, Mo-5%, ESR - ЗО mm/hr. RBC.- 3,6х10, НЬ - 128 г/л, WBC - 15х109, п- 7%, с -53%, Li - 30%. Mo - 10%, ESR - 70 mm/hr. RBC.- 4,6х1012, НЬ - 136 г/л, WBC - 2,5х109, п- 1%, с -60%, Li - 29%, Mo - 10%, ESR - 40 mm/hr. RBC.- 4,2х1012, НЬ - 130 г/л, WBC - 9,5х109, п- 5%, с -67%, Li - 20%, Mo - 5%, ESR - 20 mm/hr. RBC.- 3,2х1012, НЬ - 120 г/л, WBC - 4,5х109, е- 20, п- 1% , с -49% , Li - 25%, Mo -5%, Blood sedimentation test-2 mm/hr A patient 5-year-old boy with primary tubercular complex, above the lower department of thorax in right side auscultate pleural friction rub. What do pathological changes we think about?{ Spontaneous pneumothorax. Dry pleurisy. Ecsudatical pleurisy. Pleuropneumonia. Pleural empyema. Patient 37, has been delivered on treatment into an antitubercular dispensary on the occasion of firstly diagnosed infiltrative tuberculosis of the upper part of the right lung. The intoxication syndrome is expressed. Which of cited complaints do intoxication syndrome at tuberculosis refer to?{ Haemophthisis, weakness, chest pain, cold, shortness of breathing Cough, sputum excretion, hectic temperature, chest pain Nausea, vomit, cough, pain in joints, indisposition Subfebrile temperature, weakness, appetite and weight loss, disposition to perspire Cough, sputum excretion, broken-sleep, headache, hoarseness of voice Patient 31, has been delivered on treatment into an antitubercular dispensary on the occasion of relapse of tuberculosis process. The presence of bronchi-lung-pleura syndrome has been determined in a patient at examination. What are characterized symptoms for this syndrome?{ The raising of body temperature, weakness, appetite loss, weight loss, disposition to perspire Cough, weakness, broken-sleep, headache, hoarseness of voice Cough, sputum presence, chest pain, haemophthisis, shortness of breathe Cough, weakness, hoarseness of voice, dry rales, shortening of percussion note Shortness of breathe, broken-sleep, moist rales, increasing voice tremor, indisposition 85. A. B. C. D. * E. 86. A. B. C. D. E. * 87. A. B. C. * D. E. 88. A. B. * C. D. E. 89. A. * B. C. D. E. 90. Patient 39, is on treatment into an antitubercular dispensary on the occasion of firstly diagnosed infiltrative tuberculosis of the upper part of the left lung in decay phase (lobit).No changes have been revealed at physical examination. How should patient breath right to improve informing of the auscultative method?{ To breathe frequently To breathe deeply To cough strongly To cough slightly and to do a deep breathe To breathe by opened mouth Patient R., 53. Roentgenologic examination showed in the upper segment of the left lung a ringlike shadow with a diameter of 5cm with thick walls and fibrous heaviness and focusness. Sputum contains MBT. What clinical picture is the most probable one?{ Lung cirrhotic tuberculosis Infiltrative lung tuberculosis Disseminated lung tuberculosis Lung tuberculoma Lung fibrous-cavernous tuberculosis Patient L., 24. Roentgenologic examination showed multiple focal shadows in upper and medial lungs segments of low and medium intensity. Sputum contains MBT. Blood analysis\: ESR – 38 mm/hour. What diagnosis is the most probable one?{ Infiltrative lung tuberculosis Nidus lung tuberculosis Disseminated lung tuberculosis Caseous pneumonia Lung fibrous-cavernous tuberculosis Patient of 21 went to tuberculosis dispensary with complaints about a weakness, indisposition, cough with sputum. On a survey rontgenography were discovered infiltrative changes on the upper part of right lung with the presence of cavity of disintegration. Using bacterioscopic method MBT were found in sputum.What amount of MBT should be found in 1 ml of sputum (at a revision 300 eyeshots)?{ 500. 5000. 1000. 100. 100000. Patient of 24 is on treatment in tuberculosis dispensary with a diagnosis\: FDT (2.02.2004) of right lung’s upper part (infiltrative, phase of disintegration and semination), Destr- mbt+ m- k+ Resist+ (N,R) resist O, GIST O, Cat4 Cog1(2004). The patient was appointed proper treatment\: H, R, S, Z. In two months during conducting roentgenological control positive dynamics was not seen. As a result of determination of MBT sensitiveness to untytuberculosis preparations was got in 2 months after patient’s receipt .What is the principal reason of treatment’s ineffectiveness?{ Existence of MBT’s resistance to untymycobacterial medications. Smoking. Periodic using of alcohol. Protracted reception of chemo medication. In the absence of fifth preparation. Patient of 28 years on a roentgenological inspection found out in the right lung under a collar-bone dark patch in a diameter to 1sm, small intensity with unclear contours. What type of pathological shade is certain in the woman?{ A. B. C. D. * E. 91. A. B. C. * D. E. 92. A. B. C. * D. E. 93. A. B. C. D. E. * 94. A. * B. C. D. E. focal Infiltrative . focal-infiltrative . Annular. Linear. Patient of 38 at a reception to tuberculosis dispensary complains about a weakness, promoted sweating, cough with sputum of mucus character. Roentgenological\: in S1,2 of left lung darkening of weak intensity with unclear contours was found. What kind of research should be done to confirm diagnosis tuberculosis?{ General blood test. Biochemical blood test. Sputum’s test on MBT. Immunological research of blood. Sputum’s test on the second flora. Patient of 31 is on treatment in tuberculosis dispensary with a diagnosis\: FDT (23.11.1997) of right lung’s upper part (Fibrosis - cavernous, phase of infiltration and semination), Mbt+ ,m- ,K+ resist+ (R,E) resist O, GIST O, Cat4 Cog4(2004).What kind of research should be primarily done to a patient?{ Histological Luminescent microscopy. Determine sensitiveness of MBT to chemo medication of the II row. Immunological research. Biological research. Patient of 37 went to the stationary section of tuberculosis dispensary with complaints about cough with sputum, weakness, temperature - 38,0°C, severe headache, nausea and vomit that does not bring a facilitation. A disease has begun gradually. Patient went to the therapeutist and then X-ray examination was made. As a result of examination small (1-2 mm in diameter) multiply nonintencive shades with unclear contours along lungs were determined. Patient was diagnosed\: a FDT (3.12.2003) of lungs (miliary in a phase of infiltration and disintegration), Destr+, Mbt+m-k+ rezist-rezistpo, GIST O Kat1kog4(2003). What kind of research will reliably confirm possibility tubercular meningitis’ development?{ Bacterial analysis of sputum. Immunologic research. Encephalography. Bacterioscopy of spinal liquid. Biochemical analysis of composition of spinal liquid. Patient of 41 grumbles about weakness, bad appetite and sleep, decline of body’s mass. Roentgenlogical\: in S1 infiltrative darkening was found out in a right lung. General analysis of blood\: Er.- 4,8х1012, Нb - 146 г/л, L - 8,5х109, E-3%, P-7%, s-66%, l-20%,m-4%, ESR - 22 mm/hr. What research should be done to a patient with the purpose to exposure MBT?{ Taking of washing liquid of bronchial tubes. Tomography. To take a Manta’s sample from 2 PPD-L. To explore sputum. To make immunological research. 95. A. B. C. D. * E. 96. A. B. C. * D. E. 97. A. B. C. * D. E. 98. A. B. C. D. * E. 99. A. B. * C. D. Patient of 44 complains about weakness, bad appetite, decline of body’s mass, subfebrile temperature (37,1°-37,4°C), pain in left side. During roentgenological examination in S 1-2 of a left lung limited microfocal disseminations has been determinated, to the bottom from the IV rib exudation. At bacterioscopic research of liquid MBT were not found.What research is optimum for confirmation of etiology of found changes for this patient?{ Examination of sputum. Making bronchoscopy. Immunologic research. Biopsy of pleura. Cytological research of exudation. Patient of 45 undergo a course of anmycobacterial medication treatment concerning FDT (12.12.1998) of left lung’s upper part (fibrocavernous, phase of infiltration and semination), Destr-+ Mbt+ M+ K+ reist 0, GISTO, Cat4 Cog4(2004). What research above all should be done to a patient to set an optimum combination of chemo medication?{ Determine a type of MBT. Determine presence of the second flora. Determine sensitiveness of MBT to anmycobacterial medication. To define massiveness of bacterioexcretion To define virulence of MBT. Patient of 46 underwent a course of medical treatment during 1 week. Patient was diagnosed\: ’ FDT (15.01.2004) (desemination, phase to infiltration and disintegration), Destr+, MBT+M+KOrezisto GISTO Cat1 Cog1(2004). MBT has been discovered by bacteriological method in 3 analyses. What is the most reliable reason that the record of K O was made in a diagnosis?{ analysis was not conducted. Kulturalniy Negative result of sputum’s sowing was got. Insufficient period for MBT’s growth Absence of MBT in sputum. Incorrect results of bacterioscopy. Patient of 48 is on treatment in tuberculosis dispensary concerning FDT (13.12.2003) of upper part of the right lung (infiltrative, phase of disintegration and semination ), Destr+ Mbt+ m+ k+ resist- , GIST O, Сat2 Сog4((2003). He does not use alcohol and narcotics and does not smoke. In spite of adequate chemotherapy (N,R,S,E) patient still has a progressive tuberculosis. On the control radiography the increasing of cavity disintegration and appearance of semination fires have been determined on a left lung. What kind of research should be done to a patient to determine possible reason of treatment’s ineffectiveness?{ General blood test. Biochemical blood examination. Koch’s test. Immunological research. Functions’ research of the external breathing. Sick women 34 years old. She grumbles about a cough with sputum, pain in the right part of thorax, weakness, increase body's temperature up to 37,8°C. On the survey sciagram of the right lung it is found out an area of unhomogeneous structure without clear contours. It was established the diagnosis\: tuberculosis What disease does have alike roentgenological signs?{ Bronchial asthma. Pneumonia. Cyst. Bronchitis. E. 100. A. B. C. D. * E. 101. A. B. C. D. E. * 102. A. B. C. * D. E. 103. A. * B. C. D. E. 104. A. B. C. D. * E. 105. A. B. lungs oedema. Sick men 36 years old. He is directed to the T.B. prophylactic center with a diagnos of tuberculosis. It was made more inspection and as a result were revealed destructive changes in the overhead particle of right lung. What roentgenological method of research was used for more inspection?{ Lateral sciagraphy. Bronchography. Radioxerography. Tomography. Fluorography. Sick woman 24 years old is directed to phthisiatrician, concerning changes, that were discovered on fluorogram (prophylactic inspection). We can see changes not very good, because they are hidden behind the collar-bone. What roentgenological research we need to use, to find out these changes?{ entgenography. Bronchography. Rentgenoscopy. Lateral sciagraphy. Sciagraphy with the maximal taking of collar-bone. Sick woman 40-ty years acted in to the T.B. prophylactic center complaining on a cough, weakness, decline of mass , cough with sputum. A differential diagnostic is conducted between infiltrative tuberculosis of upper particle of left lung and a cancer of lungs .What roentgenological method of research is optimum to confirm the diagnosis?{ Radioxerography. Bronchography. Computerized tomography. Pleurography. Rentgenoscopy. The patient of 47 years . He is on treatment in T.B. prophylactic center concerning the relapse of tuberculosis of the left lung (infiltrative tuberculosis). In patient's phlegm appear MBT but on a survey sciagram destructive changes are not determined. What roentgenological method of research should we use to find the source which excretes bacterias?{ Tomography. Bronchography. Spot-film sciagraphy. Rentgenoscopy. Lateral sciagraphy The Patient 38 years old. He is ill with cirrhotic tuberculosis of overhead particle of the right lung during 10 years. The patient is prepared to the operation. It is needed to define mobile of lower edge of lungs. What method of roentgenological research is used in this case?{ Tomography. Bronchography. Sciagraphy. Rentgenoscopy. NMR. The patient is 39 years. At a prophylactic inspection in infraclavicular region of right lung (lateral part of it) found out the area focal shade of small intensity. What segment of lung does the area belongs VIII. to?{ VI. C. D. E. * 106. A. B. C. D. * E. 107. A. B. C. D. * E. 108. A. B. C. * D. E. 109. A. B. * C. D. E. 110. A. B. C. * D. E. IV. V VII. The patient of 25 years acted into the T.B. prophylactic center complaining about a weakness, decline of appetite, cough with sputum. A survey sciagram was made, on which in the part of the left lung an annular shade is determined. Such character of shade is inherent for\:{ Hearth. Infiltration. Fibrosis. Disintegration of pulmonary tissue. Exudat accumulation. The patient of 38 years grumbles about the shortness of breath, weight in a right side increasing of body's temperature up to 39°C. On a survey sciagram found out the homogeneous intensive dark patch from the level of the IV rib to the diaphragm with an oblique high bound. Such roentgenological changes are inherent for\: { Pneumonia. Cancer. Eosinophylic infiltration. Exudatic pleurisy. Dry pleurisy. The patient of 51 years old, during 9 months was treated because of the infiltrative tuberculosis of the upper part of the right lung, decay phase, MBT (+). At X-ray examination\: the upper part of the right lung became smaller in volume, under the clavicle there’s a decay cavity 3 cm in diameter, the trachea is moved to the right, MBT (-). Define the form of tuberculosis.{ Cyrrhotic Caseuos pneumonia Fibrous-cavernous Infiltrative Nidus A 15 years old child lives with her parents and grandfather. Grandfather suffers from tuberculosis of the lungs (active form). The teenager is in constant contact with grandfather. The teenager should be revaccinated. What dose of BCG SSI should be given to patient in this case?{ 0,5 ml. 0,1 ml 0,25 ml 0,025 ml 0,05 ml. A 24 year old patient is diagnosed with tuberculosive meningitis. In the lungs lymphatic knots are observed. MBT is absent in cerebrospinal fluid. Which treatment should be prescribed to patient in acute phase?{ Isoniazid + Rifampicin + Pyrazinamide + Streptomycin Isoniazid + Rifampicin + Pyrazinamide + Ethambutol Isoniazid + Rifampicin + Pyrazinamide + Ethambutol + Streptomycin Isoniazid + Rifampicin + Pyrazinamide + Ethambutol Isoniazid + Rifampicin + Ethambutol + Streptomycin 111. A. B. * C. D. E. 112. A. B. C. D. * E. 113. A. * B. C. D. E. 114. A. B. C. * D. E. 115. A. B. C. D. E. * 116. A. B. A 26 year old patient suffers from diabetes of moderate degree. He became acutely ill. Temperature increased up to 40'С, complains of cough with small amount of mucous sputum, weakness, diaphoresis. On x-ray\\: observed darkening of the upper part of the right lung with small area of brighter spots and presence of low intensity shadows at the bottom of both lungs. What treatment of should be prescribed in acute phase?{ Isoniazid + Rifampicin+ Pyrazinamide+ Ethambutol Isoniazid + Rifampicin+ Ethambutol+ Pyrazinamide + Streptomycin Isoniazid + Streptomycin+ Ofloxacin + Ethambutol Isoniazid + Rifampicin+ Ethambutol+ Pyrazinamide + Ofloxacin Isoniazid + Rifampicin + Ethambutol A 27 years old patient has been diagnosed for the first time with caseous pneumonia of the right lung. MBT positive numerous times in sputum, sensitivity to all antituberculosis drugs is preserved. What treatment should be prescribed to patient in acute phase?{ Isoniazid + Rifampicin + Pyrazinamide + Ethambutol Isoniazid + Rifampicin + Pyrazinamide + Streptomycin Isoniazid + Rifampicin + Ethambutol + Streptomycin Isoniazid + Rifampicin + Pyrazinamide + Ethambutol + Streptomycin Isoniazid + Rifampicin + Pyrazinamide + Ethambutol+ Ofloxacin A 29 year old patient has been admitted with complaints of weakness, increased temperature up to 38 С, productive cough, decreased body weight. On x-ray\\: in the upper part of the right lung infiltrative changes are noted with destructive changes. MBT present in sputum. What treatment should be prescribed in acute phase?{ Isoniazid + Rifampicin + Streptomycin + Pyrazinamide Isoniazid + Rifampicin + Streptomycin Isoniazid + Rifampicin + Kanamycin + Pyrazinamide + Ethambutol Isoniazid + Rifampicin + Pyrazinamide + Ethambutol Isoniazid + Rifampicin + Ethambutol + Ethionamide A 3 months old child received BCG SSI vaccine. On the third day on the injection spot appeared infiltration of 8mm in diameter, after a pustule appeared which bursted and formed a 5mm ulcer. What should be the action of pediatrician?{ Apply Isoniazid powder to the wound. Apply Streptomycin to the wound. Patient should be under observation of pediatrician. Laboratory analysis. X-ray. A 4 months old child has been vaccinated with BCG vaccine at birth. In left axilla increased lymphatic node by 2cm,elastic, painless, no changes in skin. General state of the child is good, temperature 36.5oC. General blood analysis is within norm. The child has{ Unspecific lymphadenitis; Tuberculosis of the peripheral lymphatic node; Generalized infective tuberculosis; Normal reaction to vaccination; Post-vaccination lymphadenitis (complication). A 4 months old child has been vaccinated with BCG vaccine at birth. In left axilla increased lymphatic node by 2cm,elastic, painless, no changes in skin. General state of the child is good, temperature 36.5oC. General blood analysis is within norm. What treatment should be prescribed to patient?{ wide spectrum antibiotics; Prescribe Treatment with Isoniazid for 3 months; C. * D. E. 117. A. * B. C. D. E. 118. A. B. C. * D. E. 119. A. B. C. D. * E. 120. A. B. C. * D. E. 121. A. B. * C. D. E. Treatment with Isoniazid and Rifampicin for 3-6 months, compress with Rifampicin and Dimexide in distilled water; Desensibilizing therapy; No treatment is necessary only observation. A 4 year old child has been vaccinated with BCG vaccine five days after birth. Mantoux test 2 TO PPD has been negative for the past 3 years. Post vaccination scar 3 mm. What should be the action of pediatrician?{ Continue with yearly Mantoux tests. Repeat BCG SSI vaccination. Yearly conduct chemoprophylaxis. Repeat BCG SSI vaccination with a greater dose. Conduct x-ray examination. A 31 year old patient has been admitted to tuberculosis hospital with complaints of periodic increased body temperature up to 37,0'С, weakness. After x-ray and laboratory analysis the patient was diagnosed with tuberculosis(15.02.2005)of the upper right lung(acute infiltrative stage), Destr.-, MBT- М-К- Resist-,Histo 0, Cat3 Cog 4 (2005). What should be the treatment plan for the patient?{ Isoniazid + Rifampicin + Kanamycin Isoniazid + Rifampicin Isoniazid + Rifampicin + Streptomycin + Pyrazinamide Isoniazid + Rifampicin + Streptomycin + Pyrazinamide + Ethionamidum Isoniazid + Rifampicin + Ofloxacini A 38 years old patient has been suffering from fibro-cavernous lung tuberculosis for the past 6 years. Treatment with ethiotropic drugs is ineffective. Surgical treatment is contraindicated. He complains of high fever, weakness, productive cough, bloody sputum. MBT is present in sputum and resistant to streptomycin. What treatment should be prescribed to patient?{ Isoniazid + Rifampicin + Pyrazinamide + Ethambutol Isoniazid + Rifampicin + Pyrazinamide + Kanamycin Isoniazid + Rifampicin + Pyrazinamide + Ethionamide Isoniazid + Rifampicin + Pyrazinamide + Ethambutol + Ofloxacin Isoniazid + Rifampicin + Ethambutol + Kanamycin A 5 month old child hasn’t been vaccinated at birth due to birth trauma. Presently the child is healthy. What should be done?{ Vaccinate the infant at 6 months. Vaccinate the infant at 12 months. After test Montoux Vaccination is contraindicated Vaccinate the child when the weight is 15kg. A 43 years old patient during childhood has been exposed to a tuberculosis patient. During a routine x-ray in I segment of the right lung a 2cm moderate intensive darkening was noted with defined margins. In pre pulmonary tissue single low intensity shadows were noted. Patient has no complaints. Objectively no pathology. Blood analysis within norm, MBT absent. Given diagnosis\\: tuberculoma of the I segment of right lung, MBT - . What treatment should be prescribed in acute phase?{ Dissolving drugs Corticosteroids, immune-correctors Chest ultrasound Vitamin A Tissue Electrophoresis 122. A. B. C. * D. E. 123. A. B. * C. D. E. 124. A. B. C. * D. E. 125. A. B. C. D. * E. 126. A. B. C. D. * E. 127. A. B. A 45 year old patient has been diagnosed with fibro-cavernous lung tuberculosis. MBT present is sputum, which is resistant to Isoniazid and Streptomycin. What treatment should be prescribed in acute phase?{ Isoniazid + Rifampicin+ Pyrazinamide + Ethambutol Ftivazide+ Rifampicin + Pyrazinamide + Ofloxacin Rifampicin + Pyrazinamide + Ethambutol + Kanamycin Isoniazid + Rifampicin +Pyrazinamide +Streptomycin Isoniazid + Rifampicin +Ethambutol+ Ofloxacin A 46 years old patient has been suffering from cirrhotic tuberculosis of the left lung. Periodically bacterial discharge is observed. What treatment should be prescribed to patient in acute phase?{ Isoniazid + Rifampicin + Streptomycin Isoniazid + Rifampicin + Pyrazinamide + Ethambutol Isoniazid + Rifampicin + Ethambutol Isoniazid + Rifampicin + Pyrazinamide + Streptomycin Isoniazid + Pyrazinamide + Ethambutol + Streptomycin A 51 year old patient is an inpatient. Clinical diagnosis\: tuberculosis(12.01.2005)of the upper part of right lung (caseous pneumonia) Destr.+, MBT+ М+К+ Resist(Н)-,Histo 0, Cat 1 Cog 1 (2005) In order to obtain results of sensitivity to MBT patient has been under treatment with \\: Isoniazid + Rifampicin + Streptomycin + Pyrazinamide. What drug should be prescribed instead of Isoniazid?{ Rifabutin. Ftivazide Ofloxacin. Dassa Kanamycin A 55 year old patient has been diagnosed for the first time with fibro-cavernous tuberculosis of the lower lobe of the left lung. On x-ray decrease in size of lower left lobe, Mediastinum shifted to the left. In VI segment on the background of cirrhosis thickening of the wall of the cavity is noted in the lower lobe of the left lung small intensive shades are noted. MBT is present in sputum; sensitivity to all antituberculosis drugs is preserved. What treatment should be prescribed to patient in acute phase?{ + Rifampicin + Pyrazinamide + Ethambutol Isoniazid Isoniazid + Rifampicin + Pyrazinamide + Streptomycin Isoniazid + Rifampicin + Pyrazinamide Isoniazid + Rifampicin + Pyrazinamide + Ethambutol Isoniazid + Rifampicin + Pyrazinamide + Ofloxacin A 57 years old patient has been suffering from tuberculosis for the past 6 years. Two years ago he has been diagnosed with chronic lung tuberculosis (2.09.1994) ( fibro-cavernous, infiltrative phase), Destr.+, MBT+ М+К+ Resist(0)-,Histo 0, Cat 4 Cog 4 (2005). What treatment should be prescribed in acute phase?{ Isoniazid + Rifampicin + Streptomycin Isoniazid + Rifampicin + Streptomycin + Pyrazinamide Isoniazid + Rifampicin + Pyrazinamide + Ethambutol Isoniazid + Rifampicin + Streptomycin + Pyrazinamide + Ethambutol Isoniazid + Rifampicin + Kanamycin + Ethambutol A 8 year old child is on living with a father who suffers from lung tuberculosis, MBT (+). Mantoux test for the child is negative. What drug should be ordered for primary chemoprophylaxis for the child?{ Ethambutol. Pyrazinamide. C. D. E. * 128. A. B. C. * D. E. 129. A. B. C. D. * E. 130. A. B. C. D. * E. 131. A. * B. C. D. E. 132. A. * B. C. D. E. 133. A. B. C. * Rifampicin. Ethionamide. Isoniazide. A 7 year old child lives with his mother who suffers from tuberculosis. Mantoux test negative. What Chemoprophylactic therapy should be ordered for the child?{ Guarding. Repetitive. Secondary. Primary. Intensive. A 7 year old child was vaccinated at birth with BCG vaccine. When she was 4 months on the injection site a cold abscess appeared. A 2 months local treatment lead to disappearance of the abscess. At present the Mantoux test with 2 ТU PPD is negative.What should be done in this case? Revaccinate with BCG vaccine. Revaccinate with BCG-M vaccine. Prescribe chemoprophylaxis. Do not revaccinate, it is contraindicated. Perform X-ray. A 8 years old child is presently healthy. Mantoux 2 To test is negative. It is known that after receiving BCG vaccine at birth patient suffered from complication-lymphadenitis of the left axillary lymph node. What should be done in this case?{ Revaccinate with BCG vaccine. Do not revaccinate. Conduct chemoprophylaxis following with BCG vaccine. Do not revaccinate, once a year perform Mantoux 2 TO test. Revaccinate wirh BCG , followed by chemoprophylaxis. Family consisting of a husband and wife, husband has been diagnosed for the first time with destructive lung tuberculosis, MBT+. The wife has been examined and is healthy. What treatment should the wife undergo?{ Chemoprophylactic Isoniazid 0,3 g daily. Chemoprophylactic Rifampicin 0,6 g daily. BCG SSI vaccination. Chemoprophylactic Ethambutol 1,2 g. Treatment with three different antimycobacterial preparations. The health 1,5 month old child was not able to receive BCG at birth due to fever. What should be done ?{ Vaccinate with BCG M vaccine. Conduct mantoux test with 2 ТО. Conduct chemoprophylaxis. Admit patient for surveillance. Should be referred to a pediatrician. A patient P. has been diagnosed with\\: Infiltrated tuberculosis(22.03.04)of upper part of the lung(infiltrative), Destr+, MBT+ М +К + Resist-,Histo 0, Cat 1 Cog 1 (2004).\n What antimycobacterial treatment should be prescribed in acute phase of the disease?{ Isoniazid, Rifampicin, Pasque Acre, Streptomycin Isoniazid, Rifampicin, Pyrazinamide, Streptomycin, Ofoxacin. Isoniazid, Rifampicin, Streptomycin, Pyrazinamid. D. E. 134. A. B. * C. D. E. 135. A. B. * C. D. E. 136. A. B. * C. D. E. 137. A. B. * C. D. E. 138. A. B. C. D. E. * 139. Isoniazid, Rifampicin. Isoniazid, Rifampicin, Streptomycin. A patient P. is diagnosed with tuberculosis (І4.02.2005) of the upper right lung (fibro-cavernous, infiltrative phase), Destr.+, MBT+ М+К+ Resist(Н+К+Е+Z)-,Histo 0, Cat 2 Cog 4 (2005), In the upper part of the right lung a large cavern is present(6,0x7,0 cm). Patient has been offered surgical treatment. What surgical treatment should e performed in this case?{ Cavernotomy. Pulmonectomy Segmentectomy Lobectomy Cavernoplastics A patient C. with tuberculosis(4.11.2004) of lungs(Disseminative, infiltrative and destructive phase), Destr.+, MBT+ М+К+ Resist(0)-,Histo 0, Cat 1 Cog 4 (2005). Patient is being treated according to I category drugs\\: Isoniazid + Rifampicin + Streptomycin + Pyrazinamide. Patient abuses alcohol use. What non-specific patient should be prescribed to patient?{ Ambroksol Carsil Lidaza Trental Almagel After x-ray examination of a 43 year old patient it was noted that on second segment of the right lung small low intensity focal shadows moderate in size with unclear margins. Patient denies of any complaints. No pathologies objectively. Blood analysis is within norms. He was diagnosed with acute tuberculosis of the second segment of the right lung. Sputum test is negative. What treatment should be prescribed in acute phase?{ Isoniazid + Rifampicin Isoniazid + Rifampicin + Pyrazinamide+ Ethambutol Isoniazid + Streptomycin Isoniazid + Rifampicin +Ethambutol+ Pyrazinamide + Streptomycin Ethambutol + Pyrazinamide Infant has been vaccinated with BCG at the hospital. After 4 weeks on the area of injection a blue coloured 4mm infiltrate appeared. These changes are typical for ?\:{ Complication of BCG vaccine. Normal local allergic reaction to vaccination. Proper antiseptic measures were not followed during vaccination. Severe reaction to the vaccine. Subcutaneous injection of the vaccine . Infant was vaccinated in the hospital. A 5mm post-activation scar has appeared. At the age of 1, mantoux test resulted in 10mm induration during the first test and 6mm during the second test. How would you evaluate these results ?{ Chronic tuberculosis intoxication Tuberculosis infectivity Turn of tuberculosis test Early tuberculosis intoxication Post vaccination allergy. Infiltrative phase of primary tuberculosis complex of the middle lobe of the right lung was discovered in a 10 year old child. MBT negative(pneumonic stage). What therapy should be prescribed to the child in acute phase?{ A. * B. C. D. E. 140. A. B. * C. D. E. 141. A. B. * C. D. E. 142. A. B. C. D. E. * 143. A. B. C. * D. E. 144. A. B. * C. D. Isoniazid + Rifampicin + Pyrazinamide + Ethambutol Isoniazid + Rifampicin + Pyrazinamide + Kanamycin Isoniazid + Rifampicin + Pyrazinamide + Ethionamide Isoniazid + Rifampicin + Pyrazinamide + Ethambutol + Ofloxacin Isoniazid + Rifampicin + Ethambutol + Kanamycin For the past few weeks a 34 year old patient complains of weakness, increased temperature up to 38,1'С, cough with small amount of sputum. Upon x-ray examination it was determined that in VI segment in left lung a 4x4 cm darkening, with low intensity shadow with unclear borders. Infiltrative lung tuberculosis of the left lung was diagnosed. Bacterioscopically MBT positive. What therapy should be prescribed in acute phase ?{ Isoniazid + Rifampicin + Pyrazinamide Isoniazid + Rifampicin + Pyrazinamide + Ethambutol Isoniazid + Rifampicin + Pyrazinamide + Ethambutol + Streptomycin Isoniazid + Rifampicin + Pyrazinamide + Kanamycin Isoniazid + Rifampicin + Pyrazinamide + Ethionamide In (4.11.2005) a patient has been diagnosed with lung tuberculosis (disseminative, phase of infiltration and destruction), Destr.+, MBT+ М+К+ Resist-,Histo 0, Cat 1 Cog 4 (2004) Patient is currently under treatment of 1st category\\: Isoniazid + Rifampicin + Streptomycin + Pyrazinamide. Patient constantly abuses alcohol. What drug should be prescribed to patient for non specific therapy?{ Ambroksol. Thiotriazoline Lidaza. Trental Almagel In a 7 year old child, after 6 months after re-vaccination on the area of the BCG injection a 6 mm keloid scar is noted. Patient feels well. What action should be taken ?{ antimycobacterial Conduct chemoprophylaxis. Perform Mantoux test. Perform x-ray. Observe the child at an outpatient base according to category 5. On chest x-ray of a 26 year old patient it was noted that on II segment of the right lung low intensity shadows with unclear margins. Patients has no complaints. Objectively no pathologies noted. Blood analysis within physiological norm. MBT absent in sputum. Patient is diagnosed with tuberculosis. What therapy should be prescribed in acute phase? Isoniazid + Rifampicin+ Pyrazinamide Isoniazid + Rifampicin+ Kanamycin Isoniazid + Rifampicin+ Pyrazinamide + Ethambutol Isoniazid + Pyrazinamide + Ethambutol Rifampicin+ Kanamycin + Ethambutol+ Streptomycin Patient has been diagnosed with\: milliary tuberculosis (5.09.2005), ), Destr-, MBT- М -К Resist-,Histo 0, Cat 1 Cog 3 (2005) What scheme of treatment should be prescribed to patient in acute phase?{ Isoniazid + Rifampicin - Streptomycin+ Ethionamide. Isoniazid + Rifampicin + Streptomycin + Pyrazinamide+ Ethambutol. Rifampicin + Streptomycin + Ethambutol + Pyrazinamide. Isoniazid + Streptomycin+ Ethambutol + Pyrazinamide. E. 145. A. B. C. D. * E. 146. A. B. C. D. E. * 147. A. B. * C. D. E. 148. A. B. C. * D. E. 149. A. B. C. D. E. * 150. A. Еthambutol + Rifampicin + Ethambutol + Ethionamide. Patient has been diagnosed with\\: tuberculosis (8.01.2006) S2 (tuberculoma). Destr.+, MBT+ М+К+ Resist(0)-,Histo 0, Cat 1 Cog 1 (2006) After 2 months of treatment tuberculoma has increased in size to 5,5cm in diameter. Bacterial sections are constant. A patient is getting ready for surgery. What surgical intervention should be performed in this case?{ Pulmonectomy Lobectomy Bilobectomy Segmentectomy Resection of tuberculoma Patient is undergoing a treatment for the diagnosis of\\: tuberculus meningitis. Diagnosis is confirmed with presence of MBT in cerebrospinal fluid. The following treatment has been prescribed to patient\\: Isoniazid +Ethambutal, Rifampicin - per os, Streptomycin - Intramuscularly, Pyrazinamideper os. What drug should be introduced intraspinally during cerebrospinal puncture?{ Rifampicin Ethambutal Streptomycin Amikacin Streptomycin with calcium chloride complex What is the optimal scheme of treatment for antimycobacterial therapy in the beginning phase in patient with tuberculosis (05.09.2004)of the upper right lung (tuberculoma. Destr.-, MBT- М-КResist(0),Histo 0, Cat 2 Cog 4 (2005){ Isoniazid + Rifampicin + Streptomycin + Ofloxacin Isoniazid + Rifampicin + Pyrazinamide + Ethambutol Isoniazid + Streptomycin + Pyrazinamide Rifampicin + Streptomycin + Ethambutol Pyrazinamide + Kanamycin + Ethambutol What is the optimal time of treatment for antimycobacterial therapy for patient with tuberculosis(13.08.2003) of the upper part of left lung(acute, infiltrative phase), Destr.-, MBT- М-КResist(0)-,Histo 0, Cat 3 Cog 3 (2003) { 2 months. 4 months 6 months 8 months 10 months A female patient of 45 is disturbed with cough, temperature rise up to 37,5°Got ill six weeks ago after ”the flu”. In a 2 weeks treatment course for focal pneumonia, focal shadows in the upper segment of the right lung remained without any changes. What is the most probable diagnosis? Aspergilosis Lung cancer Eosiniphil infiltration Lingering pneumonia Nidus tuberculosis Nidal shades of medium intensity with vague contours were revealed on the left apex of a 20-years old youth during fluorographic examination. His general state is gooMantoux test with 2 TU – 19 mm infiltratYour preliminary diagnosis? Primary tuberculous complex. B. C. D. E. * 151. A. B. C. D. E. * 152. A. B. C. D. E. * 153. A. B. C. D. E. * 154. A. B. C. D. E. * 155. A. B. C. D. E. * Infiltrative tuberculosis. Disseminated tuberculosis. Lung tuberculoma. Focal tuberculosis. A group of shadows of small and medium intensity of 3-8 mm in diameter has been revealed in the upper part of the right lung in a patient of 25 years old on a fluorogoram. The patient’s state is satisfactory. Mantoux test with 2 TU – 16 mm infiltratWhat disease is the most probable one? Sarcoidosis Eosinophil infiltration Nidus pneumonia Peripheral lung cancer Nidus lung tuberculosis Small and average nidi of little intensity have been revealed on the apex of the right lung during fluorographic examination of a man aged During the last month he notes the decrease of the appetite, perspiration, inconsiderable cough. Prescribe of antimicobacterial therapy on the 1-st stage. Isoniazidum + pyrazinamidum Isoniazidum + rifampycinum + streptomycini + pyrazinamidum + ethambutolum. Isoniazidum + rifampycinum. Isoniazidum + rifampycinum + ethambutolum. Isoniazidum + rifampycinum + pyrazinamidum Patient V. suffers from tuberculosis for 17 years. Recent dyspnea aggravation, cough, new pain in the right intercostal area, in heart area, drowsiness, edema in lower extremities. What is the most probable complication? Spontaneous pneumotorax Lung atelectasis Amiloidosis of internal organs Tuberculosis of bronchi Chronic lung heart The patient M., 19 years old, got sick gradually: general weakness, the body temperature up to 37? C. She had been in contact with a patient suffering from tuberculosis. The tuberculous meningitis was suspected. Say, which one from the present symptoms is not typical for the tuberculous meningitis? Dyplopia Headache Gradual development of the disease Vomiting Normal body temperature A patient, 45years old, is diagnosed with tuberculous meningitis for the first time. The general condition is grave, the meningeal symptoms are sharply pronounced, the consciousness is shadowed. What is the total duration of the treatment of this patient? 1 month 3 months 5 months 7 months 12 months 156. A. B. C. D. E. * 157. A. B. C. D. E. * 158. A. B. C. D. E. * 159. A. B. C. D. E. * 160. A. B. C. D. E. * The teacher O., 28 years old, was treated during 10 months because FDTB (05.05.2003) of the upper part of the right lung (infiltration ), Destr+, MBT+M-C+, Resist-, HIST0, Cat1 Coh2(2003). The state became much better (the absence of MBT, the closing of the cavity of decay). What is the tactics for the employment? To be let to the previous work To continue the list of uncapacity to work up to 12 months and then to be let to work To direct to the MSEC to indicate the II invalid group To propose another job To direct to the MSEC to indicate the III invalid group A man of 48. The photoroengenologic examination showed multiple focuses of various dimensions of low and medium intensity with illegible contours in the upper segments of both lungs. The patient does not feel himself worse. Blood analysis: 8,2 x 109/l, ESR – 20 mm/hour. Which form of lungs tuberculosis does the patient have? Miliary Disseminated Nidus Infiltrate Disseminated (chronic) Patient at the age of 35 years has complains concerning cough with sputum, weakness, shortness of breath during minor activity. Three month ago was returned from correctional institutions. During medical examination right part of the thorax is narroweLags during breath. Mycobacteriums tuberculosis revealed bacterioscopy. Which clinic form of pulmonary tuberculosis was revealed in the patient? Tuberculoma. Focal tuberculosis. Tuberculous pleurisy. Disseminated pulmonary tuberculosis. Fibrous cavernous tuberculosis Patient (woman) at the age 36 year first diagnosed fibrous cavernous pulmonary tuberculosis, mycobacterium tuberculosis+, resist to ethambutol and streptomycin. Which combination of antimicobacterial agents is the most optimal? Isoniazid+rifampicin A+ thioacetazone+florimytcin. Isoniazid+kanamycin+PAS(A)(para-aminosalicylic acid)+ethionamide. Kanamycin+ethionamide+rifampicin+phthivazide. Isoniazid+cycloserine+protionamide+kanamycin. Rifampicin+isoniazid+kanamycin+pyrazinamide. Patient age 42 years. He is sick by fibrous cavernous pulmonary tuberculosis of the upper part of the right lung during 8 years. Mycobacteriums tuberculosis+. He feels good during last 2 year. Radiographic data: the upper part of the right lung available thick cavern with fibrosis and perifocal inflammation. The upper part is narrow due fibrosis. Both lungs have focuses of semination. Shadow of mediastinum shifted right.What radiographic data are typical for fibrous cavernous pulmonary tuberculosis of the lungs? Caverns presence, perifocal inflammation. Perifocal inflammation, bronchogenic dissemination. Organs on mediastinum are shifted in the side of lesion. Intense dark patch, narrowed lung field. Caverns presence, well-defined fibrosis, focuses of semination. 161. A. B. C. D. E. * 162. A. B. C. D. E. * 163. A. B. C. D. E. * 164. A. B. C. D. E. * 165. A. Patient age 33 years admitted to hospital with complains about weakness, decreasing of the appetite, hyper hydrosis, subfebrile temperature, cough with sputum. Tuberculosis of the left lung (infiltrative form) was revealed 3 year ago. The patient systematically broke treatment course, excessive used spirits, irregular took antimicobacterial medications. As a result patient has resistance of mycobacteriums tuberculosis to isoniazid and rifampicin and has formed fibrous cavernous tuberculosis of left lung.What reasons of forming fibrous cavernous tuberculosis in the patient? Disturbance of medical treatment. Alcohol abuse. I rregular take medicine. Resistance of mycobacteriums tuberculosis to isoniazid and rifampicin. All above. Patient age 42 years. He is sick by fibrous cavernous pulmonary tuberculosis during 8 years. Had irregular treatment. He has complains about intense pain in the left part of thorax, breathlessness. Objective: state of the patient is averagAbove left lung percussion data shows tympanitis, auscultatory - breath not auscultates. What complications of fibrous cavernous pulmonary tuberculosis arose in the patient? Bullous emphysema. Tuberculous atelectasis. Chronical cor pulmonale. Escudative pleurisy. Pneumothorax spontaneous. Patient`s (woman) age 52 years. She is sick by fibrous cavernous pulmonary tuberculosis during 15 years. She had irregular treatment. She admitted to hospital with complains about strong pain in the left part of the thorax during breathing, shortness of breath. Objective: state of the patient is averagLeft part of the lung lags during breathing, during percussion – tympanitis. Auscultatory breath very impaire What medical investigation need to do with patient at first for more accurate diagnosis? Medical investigation of respiratory function. Computer tomography. Bronchoscopy. Tomography. Radiography of organs of thorax. Patient (woman) age 54 years. She is sick by fibrous cavernous pulmonary tuberculosis during 15 years. She had irregular treatment. She admitted to hospital with complains about cough with bright-red blood with bubbles (total amount of the flowed blood near 250 milliliters) , shortnes of breath, weakness, giddiness, subfebrile temperature (low grade fever). During percussion above upper part of right lung is tympanic shade of lung sounDuring auscultation - bronchial respiration with different crepitations. Above other regions of lungs - diffused dry rales. Radiographic data: near S2 right lung defines cavity of disintegration with diameter 5.0 x 4.0 centimeters, upper part is reduced, right root pulled up. What complications of fibrous cavernous pulmonary tuberculosis Pneumothorax spontaneous. arose in the patient? Sputum with blood. Pulmonary edema. Chronical cor pulmonale. Pulmonary hemorrhage. Patient at the age of 49 years address to doctor with complains about weakness, decreasing of the appetite, hyper hydrosis, subfebrile temperature, cough with spew. Tuberculosis of the left lung was revealed 7 years ago. Patient had course of treatment in the hospital. Two year ago patient had relapse of diseasRadiographic data:both lungs fibrous changeUpper part of left lung has cavity with diameter 6 centimeters with area of perifocal inflammation.Upper part of right lung has some cavities..Spew has mycobacteriums tuberculosis+. What clinic form of tuberculosis resides such kind of radio data? Caseous pneumonia. B. C. D. E. * 166. A. B. C. D. E. * 167. A. B. C. D. E. * 168. A. B. C. D. E. * 169. A. B. C. D. E. * 170. Infiltrative form. Tuberculoma. Cirrhosis form Fibrous-cavernous form. Patient at the age of 56 years has fibrous cavernous pulmonary tuberculosis during 13 years. He admitted to hospital with complains about shortness of breath in quiet state, edema of legs. Objective: available diffusive cyanosis, increased liver on 4 centimeters, edema of legs. Above both lungs, in upper areas (against a background of hard breath) auscultates crepitation with middle bubbles. P8 – 100 per minute, arterial pressure 115/88 mm of mercury. Heart borders increased, present accent and separation of II sound above pulmonary artery. What complication arose in the patient? Pneumothorax spontaneous. Pulmonary hemorrhage. Spew with blood. Pulmonary edema. Chronical cor pulmonale. Patient`s age is 40 years. Has tuberculosis during 7 years. Two years ago got diagnosed fibrous cavernous pulmonary tuberculosis, mycobacterium tuberculosis+. Half year ago appeared progressive shortness of breath during physical activity. Now shortness of breath appears during rising on the second floor. Objective: respiration rate 24 per minute, pulse - 96 beats per minutHeart sounds speeded up, rhythmical. Above pulmonary artery auscultates accent of second sound. Liver during palpation not sickly, prominent from border of costal margin on 2 centimeters. What complication arose in the patient? Pneumothorax spontaneous. Pulmonary hemorrhage. Pulmonary edema. Spew with blood. Chronical cor pulmonale. Patient age is 40 years. Has fibrous cavernous pulmonary tuberculosis during 8 years. Last time has edema of legs. Urine examination shows: growing proteinuria, cylindruria, hyposthenuriWhat is the most probable reasons for changing in urine examination? Acute nephritis. Renal tuberculosis. Cystic disease. Chronic renal insufficiency. Amyloidosis. The prophylactic photoroentgenographic examination of a 25-year-old patient showed in segments 1-2 of the left lung focal shadows of low intensity without distinct contours. Mantoux test with 2 TO – 7 mm infiltratBlood analysis: leuk. – 9,9 x 109/l, ESR – 26 mm/hour. Which is the most probable diagnosis? Infiltrative lung tuberculosis Nidus pneumonia Lung cancer Eosiniphil infiltration Nidus lung tuberculosis Patient, Underwent 4-months treatment in a hospital because of infiltrate tuberculosis of the upper segment of the left lung in the phase of destruction. He is achieved, but in the place of the infiltrate a round 2 cm hole of medium intensity and with distinct exterior contours is formeWhat treatment method is most advisable at this phase? A. B. C. D. E. * 171. A. B. C. D. E. * 172. A. B. C. D. E. * 173. A. B. C. D. E. * 174. A. B. C. D. E. * 175. A. B. C. To recommend sanatoric treatment To use surgical intervention To carry out 1,5-2th months course of hormonotherapy To use means of popular medicine To continue the treatment with antimycobacterial preparations A man of 43, smoker, complains of cough with little sputum secretion, subfebrility, weight loss. With the suspect for the abcess-forming pneumonia was hospitalized into a diagnostic department. Roentgenogram: in the upper segment of the right lung – 4x4 cm round shadow with distinct exterior contour. Blood analysis: leuk. – 9,0 x 109/l, ESR – 19 mm/hour. Sputum analysis: leuk. – 8-12 in the vision fiel Mantoux test with 2 TO – 22 mm infiltrat.What is the most probable diagnosis? Peripheral lung cancer Abscess of lung Non-malignant tumor Aspergiloma Lung tuberculoma A man of 38 complains of pain in heart area, subfebrility, sweatness, weight loss. Pulse: 82 strokes/min., AP 110/75 mm m.Systolic murmur over the heart apex. Roentgenogram: focal shadows up to 5mm in diameter on both lungs apexes. What disease is the most probable one? Sarcoidosis Eosinophil infiltration Nidus lung tuberculosis Peripheral lung cancer Nidus pneumonia Female patient Z., 3Got ill with diabetes mellitus six years ago. The roentgenologic examination showed infiltrate shadow with enlightment in the center in the lower segment of the left lung. General condition of the patient is satisfactory. Blood analysis: leuk. – 10,5 x 109/l, ESR – 25 mm/hour. Mantoux test with 2 TO - positivWhat is the most probable diagnosis? Lung cancer Pneumonia Abscess of a lung Primary tuberculosis complex Infiltrative tuberculosis Patient K., Got ill acutely after a surgical operation for a stomach ulcer. Roentgenogram: massive infiltration of pulmonary tissue with several hollows of destruction in the upper segment of the right lung. Mantoux test with 2 TO – doubtful. Blood analysis: leuk. – 17,0 x 109/l, ESR – 52 mm/hour. MBT are found in sputum. What is the most probable form of lungs tuberculosis? Infiltrative Nidus Fibrous-cavernous Cirrhotic Caseous pneumonia A cloud-like darkening of the upper part of the right lung with a lightening in the center, to the left paracardially a group of small intensity nidi have been revealed during fluorographic examination of a female patient, 30, suffering from a stomach ulcer. A preliminary diagnosis. Lung tuberculoma. Fibrous cavernous tuberculosis. Caseous pneumonia. D. E. * 176. A. B. C. D. E. * 177. A. B. C. D. E. * 178. A. B. C. D. E. * 179. A. B. C. D. E. * 180. A. B. C. D. E. * Disseminated tuberculosis. Infiltrative tuberculosis. Haemoptysis appeared in a day after hyperinsolation of a girl of No pathologic changes were found in the lungs of fluorography six months ago. Damp middle-blistered rales are heard beneath the right clavicle, Mantoux test with 2 TU – 23 mm infiltratWhat changes in lungs can one think about? Spontaneous pneumothorax. Lung tuberculosis. Multiple nidi. Cirrhosis of a lung. Decay cavities. Plan a specific treatment to a patient with FDTB (03.03.2001) of the upper part of the right lung (caseous pneumonia), Destr+, MBT+M+C+, Resist-, HIST0, Cat1 Coh1(2001). The patient is 45, weight – 46 kg. His general condition is difficult. There is no accompanying pathology. Prescribe antimycobacterial preparations. Isoniazidum + rifampycinum + streptomycini. Isoniazidum + pyrazinamidum Isoniazidum + rifampycinum. Isoniazidum + rifampycinum + ethambutolum. Isoniazidum + rifampycinum + streptomycini + pyrazinamidum . Female patient, During the last five years has noted general weakness, cough, subfebrility; menstruations absence for three months. General roentgenogram: in the 2nd segment of the left lung – a round hole above 3cm in diameter of medium intensity. Mantoux test with 2 TO – 23 mm infiltratWhat is the most probable diagnosis? Aspergiloma Peripheral lung cancer Filled with a cyst Chondroma Lung tuberculoma A patient R., aged During the last four months – dry cough, general weakness, perspiration, subfebrile temperaturThere is a round formation of over 2 cm in diametre, of medium intensity in the second segment of the upper part of the right lung on a fluorogram. At the age of 20, the patient suffered from the infiltrative lung tuberculosis. The general blood analysis is within the norm. Mantoux reaction with 2 ТU – 15 mm infiltratA preliminary diagnosis. Primary tuberculous complex. Infiltrative tuberculosis. Disseminated tuberculosis. Focal tuberculosis. Lung tuberculom A female patient Z., A shadow with vague contours sized 4 cm, MBT(-) has been found in the right lung (1st segment) at a roentgenologic examination. After 3 months of antimycobacterial therapy a round focus, 2 cm in diametre, of homogeneous structure with clear contours forme A diagnosis after 3-months treatment. Primary tuberculous complex. Infiltrative tuberculosis. Disseminated tuberculosis. Focal tuberculosis. Lung tuberculoma. 181. A. B. C. D. E. * 182. A. B. C. D. E. * 183. A. B. C. D. E. * 184. A. B. C. D. E. * 185. A. B. C. D. E. * A round shadow with wave-like outer contours was found in the 3-rd segment of the left lung of a man of 60 during a fluorographic examination. There were single calcinates in the roots. ESR – 62 mm/hr. What illness can be suspected? Infiltrative tuberculosis. Disseminated tuberculosis. Lung tuberculom Focal tuberculosis. Periferal cancer. A female patient Z., 29, has been coughing for 2 years, with a small quantity of sputum, sometimes subfebrilitet. She did not apply for a medical carA week ago a heterogeneous round darkening 2,5 x 3,0 cm with clear contours and a strip of excentric lightening was found in the sixth segment. A preliminary diagnosis. Fibrous-cavernous tuberculosis. Infiltrative tuberculosis. Disseminated tuberculosis. Focal tuberculosis. Lung tuberculom In a patient S., 17, suffering from diabetes, a round shadow of 2,5 cm in diameter, of medium intensivity with vague outer contours and a path to the root was found in the second segment of the upper part of the right lung during fluorography. Mantoux test with 2 ТU – 24 mm infiltrate.A preliminary diagnosis. Fibrous-cavernous tuberculosis. Infiltrative tuberculosis. Disseminated tuberculosis. Caseous pneumonia. Lung tuberculom A patient 35, complains of the weakness, insignificant cough with sputum. An inhomogeneous limited darkening sized more than 5cm. in the 81, 2 of the right lung has been revealed at roentgenologic examination. Lung infiltrative tuberculosis of the upper part of the right lung has been suspecteWhat most reliable auscultative data characterize will be observed above the lesion lungs section of mentioned localization? Moist rales Dry disseminated rales Vesicular breathing Amphoric respiration Absence of breathing Fluorographic examination has been conducted for a patient 25, on the occasion of the complains of the raising of body temperature and cough, as a result of which darkening of small intensity of 4,0-5,0 cm in diameter with the destruction present has been revealed in the upper part of the right lung. MBT has been revealed in sputum. What rales will be the most characteristic for such changes in lungs? Disseminated rales Diffused single rales Moist and dry rales along lung lesion Moist rales in lower parts of lungs Local rales 186. A. B. C. D. E. * 187. A. B. C. D. E. * 188. A. B. C. D. E. * 189. A. B. C. D. E. * 190. A. B. C. D. E. * 191. A. B. A patient 35, appeal to the doctor with complains of the weakness, cough with sputum, raising of body temperature to 37,2?Lung infiltrative tuberculosis was revealed in antitubercular dispensary after finish examination. It is known from anamnesis, that a patient was ill with arthritis, infectious hepatitis, tyreotoxicosis. Diabetes two years ago and glomerulonephrytis. What somatic disease is the risk factor of tuberculosis occurring? Glomerulonephritis Thyreotoxicosis Infectious hepatitis Gaimoritis Diabetes Patient 38, is on treatment into an antitubercular dispensary on the occasion of firstly diagnosed infiltrative tuberculosis of the upper part of the left lung in decay phase (lobit).No changes have been revealed at physical examination. How should patient breath right to improve informing of the auscultative method? To breathe frequently To breathe deeply To cough strongly To breathe by opened mouth To cough slightly and to do a deep breathe A patient 40, is directed to antitubercular dispensary for finish examination and lung tuberculosis diagnosis confirmation. A patient complains of the raising of body temperature to 37,5?C, weakness, disposition to perspire, cough with sputum. What sputum characterized lung tuberculosis? Purulent with a stinking odor Frothy Slime sputum of canary color Rusty Slime Patient 30, has been delivered on treatment into an antitubercular dispensary on the occasion of firstly diagnosed infiltrative tuberculosis of the upper part of the right lung. The intoxication syndrome is expresseWhich of cited complaints do intoxication syndrome at tuberculosis refer to? Haemophthisis, weakness, chest pain, cold, shortness of breathe Cough, sputum excretion, hectic temperature, chest pain Nausea, vomit, cough, pain in joints, indisposition Cough, sputum excretion, broken-sleep, headache, hoarseness of voice Subfebrile temperature, weakness, appetite and weight loss, disposition to perspire Patient 32, has been delivered on treatment into an antitubercular dispensary on the occasion of relapse of tuberculosis process. The presence of bronchi-lung-pleura syndrome has been determined in a patient at examination. What are characterized symptoms for this syndrome? The raising of body temperature, weakness, appetite loss, weight loss, disposition to perspire Cough, weakness, broken-sleep, headache, hoarseness of voice Cough, weakness, hoarseness of voice, dry rales, shortening of percussion note Shortness of breathe, broken-sleep, moist rales, increasing voice tremor, indisposition Cough, sputum presence, chest pain, haemophthisis, shortness of breathe A patient 35, complains of the raising of body temperature to 37,5?C, appetite loss, indisposition, weakness, cough with sputum excretion up to 50 ml per day of slime character. The state of patient has worsened gradually, during a month. What disease in a patient can one suspect? Pneumonia Lung abscess C. D. E. * 192. A. B. C. D. E. * 193. A. B. C. D. E. * 194. A. B. C. D. E. * 195. A. B. C. D. E. * 196. A. B. Bronchial asthma Chronic bronchitis Lung tuberculosis A patient 55, is ill with tuberculosis during 3 month, complains of the cough with sputum excretion, raising of body temperature, weakness, shortness of breathe at physical tension. Amphoric respiration is heard above the right lung, in the area under clavicle at auscultation. What changes in lungs do such auscultative phenomenon at tuberculosis condition? Exudates Lung atelectasis A small cavern Cirrhotic changes A big cavern A patient 33, complains of the cough with sputum, weakness, raising of body temperature to 37,52?C, during 3 weeks, appetite loss, indisposition. No changes have been revealed at objective examination. What should be found out in a patient in the life anamnesis? Smoking Following the routine of work and rest Sport occupation Present the emotional labiality Present the contact with tuberculosis patient Female patient Z., 29 years old, was brought by an urgent medical service car to a regional tuberculous dispensary. She complains on cough, dyspnea, pain in the right half of the thorax. Objectively – wooden sound at percussion, auscultatively – the absence of breathing above the right half of the thorax. What is the most probable diagnosis? Lung infarction Lung atelectasis Exudative pleurisy Pleropneumonia Spontaneous pneumothorax A female patient K., 30, two years ago underwent treatment on the occasion of the FDTB (16.09.2002) of the first segment of the right lung (nidal tuberculoisis), Destr-, MBT-M-C-, HIST0, Cat3 Coh3(2002). 10 days ago a right-side purulent otitis was diagnosed. At the present time she complains of a terrible headache, vomiting, general weakness. She has difficulty in making a contact. Roentgenologically there are two nidal shadows of more than medium intensity in the first segment of the right lung. The liquor analysis: turbid, cytosis – 650 cells in 1 ml, neutrophiles – 85 %, lymphocytes – 15 %, sugar – 3,1 mmol/L, chlorides – 115 mmol/L. Your diagnosis. Serous meningitis Tuberculous meningitis Meningo-coccal meningitis “Meningism” Secondary purulent meningitis Patient, 62. Complaints of accessive cough, dyspnea, drop of appetite, weight loss for 10 kg. Contacted with his brother who is ill with tuberculosis of lungs. 6 months ago had a surgical operation because of cancer of the prostatic gland. Blood analysis: anemia, ESR – 65 mm/hour. Roentgenogram: multiple focal shadows (5-6 mm) with distinct contours in medial and especially in lower lungs segments. Your preliminary diagnosis. Disseminated lung tuberculosis Nidus lung tuberculosis C. D. E. * 197. A. B. C. D. E. * 198. A. B. C. D. E. * 199. A. B. C. D. E. * 200. A. B. C. D. E. * 201. A. B. C. D. Tromboembolism of branches of lung arteria Bilateral nidus pneumonia Carcinomatosis Patient, 35. Has been a drift miner for 10 years. Complains for dyspnea during physical load, cough with little of sputum. Normal body temperature. Rales in the lungs are not heard. Blood analysis: leuk. – 7,8 x 109/l, ESR – 8 mm/hour. Mantoux test with 2 TO – 10mm infiltrate. Roentgenogram: small focal shadows of high intensity with distinct contours on both sides, especially in the medial-lateral segments. What is the preliminary diagnosis? Small-nidal pneumonia Miliary tuberculosis Disseminated lung tuberculosis Carcinomatosis Pneumoconiosis Patient L., 35. The illness started acutely – with body temperature rise up to 39°C, cough with sputum secretion. Received antibiotics during a week time – no effect. Not numerous moist fine bubbling rales between the scapulae. Roengenogram: focuses of various dimensions with illegible contours along the whole extent of both lungs. Blood analysis: leuk. – 13,2 x 109/l, ESR – 45 mm/hour. Which is the most probable diagnosis? Bilateral nidal pneumonia Infarction-pneumonia Stagnation phenomena in lungs Caseous pneumonia Disseminated lung tuberculosis The patient, 34 years old, 8 years ago was treated because of the infiltrative tuberculosis of lung. Her state became much better. During the last 6 years the X-ray picture was stable. To what group of dispensary observation does she belong? 5.3 5.2 5.1 5.5 5.4 In a seven-years-old girl in 5 months after the revaccination, in the place of vaccine injection of BCG a swelling with cyanotic touch of skin appeared, at palpation – fluctuation. What is the postvaccinal complication? Lymphodenit Cyst Keloid seam Ulcer Cold abscesse At the 5 years old boy, who suffers from the tuberculosis of intrathoracic lymphatic nodes suddenly appeared coughing, pain behind the stern, shortness of breath, mild cyanosis of lip mucose. Body temperature is 38,4? C. Upon the upper part of the right lung there is the dulling of the percussion note, in the same place there is the weakened breathing. The most probable complication of the tuberculosis of intrathoracic lymphatic nodes. Exudative pleurisy Spontaneous pneumothorax Tuberculosis of bronchi Pleural empyema E. * 202. A. B. C. Atelectasis A girl of 7 years old, 2 months ago suffered from “influenza”, after which coughing, general weakness, decreased appetite, sweating appeared, the body temperature rose up to 37,5? C. At the percussion and auscultation pathological changes are not found. On the X-ray: the enlarged tracheobronchial and bronchopulmonal lymphatic nodes on the left side. Blood: leuc. 9,0 x 109/l, ESR – 22 mm/hour. Mantoux test with 2 TU – infiltrate of 17 mm. What is the most probable diagnosis? Sarcoidosis Lymphogranulomatosis Lymphosarcoma D. E. * 203. Central cancer Tuberculosis of intrathoracic lymphatic nodes A. Lymphogranulomatosis Unspecific adenopathy Sarcoidosis Tuberculosis of intrathoracic lymphatic nodes Lympholeucosis A boy of 6 complains for cough, poor appetite, sweating, temperature rise up to 37,5°C. Roentgenogram – on the left: enlarged bronchopulmonary lymph nodes with illegible exterior contours. Mantoux test with 2 TO – 15 mm infiltrate. Blood analysis: leuk. – 9,0 x 109/l, ESR – 30 mm/hour. The most probable diagnosis. Unspecific pneumonia Central cancer Tuberculosis of intrathoracic lymphatic nodes Lymphosarcoma Sarcoidosis Patient K., 53. Roentgenologic examination showed in the upper segment of the left lung a ringlike shadow with a diameter of 5cm with thick walls and fibrous heaviness and focusness. Sputum contains MBT. What clinical picture is the most probable one? Lung cirrhotic tuberculosis Infiltrative lung tuberculosis Disseminated lung tuberculosis Lung tuberculoma Lung fibrous-cavernous tuberculosis A 10-year-old patient M. is diagnosed with tuberculin “turn”, Mantoux test with 2 TO – 16 mm infiltrate. Complaints for general asthenia, increased sweating. Blood analysis: leuk. – 9,2x109/l, ESR – 26 mm/hour. Roentgenogram examination did not reveal pathologic alterations in the lungs. What diagnosis is the most probable one? Primary tuberculous complex Tuberculosis of intrathoracic lymphatic nodes Nidus lung tuberculosis Infiltrative lung tuberculosis Tuberculosis intoxication B. C. * D. E. 204. A. B. C. D. E. * 205. A. B. C. D. E. * 206. A. B. C. D. E. * Prophylactic examination of a 17-year-old boy revealed bilateral enlargement of bronchopulmonary lymph nodes. General condition – satisfactory, no complaints. No pathologic alterations were found at physiacal examination. Mantoux test with 2 TO – negative. General blood analysis – without any pathologic deviations. The most probable diagnosis. 207. B. C. Patient of 45 is on treatment in tuberculosis dispensary concerning FDT (13.12.2003) of upper part of the right lung (infiltrative, phase of disintegration and semination ), Destr+ Mbt+ m+ k+ resist- , GIST O, Сat2 Сog4((2003). He does not use alcohol and narcotics and does not smokIn spite of adequate chemotherapy (N,R,S,E) patient still has a progressive tuberculosis. On the control radiography the increasing of cavity disintegration and appearance of semination fires have been determined on a left lung. What kind of research should be done to a patient to determine possible reason of treatment’s ineffectiveness? General blood test. Biochemical blood examination. Koch’s test. Functions’ research of the external breathing. Immunological research. Patient of 36 is on treatment in tuberculosis dispensary with a diagnosis: FDT (23.11.1997) of right lung’s upper part (Fibrosis - cavernous, phase of infiltration and semination), Mbt+ ,m- ,K+ resist+ (R,E) resist O, GIST O, Cat4 Cog4(2004).What kind of research should be primarily done to a patient? Histological Luminescent microscopy. Immunological research. D. E. * Biological research. Determine sensitiveness of MBT to chemo medication of the II row. A. B. C. D. E. * 208. A.