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Infectious diseases in children (situational tasks, 6 year)
Опис:
6 year, Modul control
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A patient complained of general weakness, fever, painful rash on his trunk skin. He has been
suffering from this for 3 days. Objectively: lateral surface of trunk on the left is hyperemic and
edematic; there are some groups of vesicles with serous and haemorrhagic content. What is the most
probablezoster
diagnosis?
Herpes
Herpetiform Duhring's dermatosis
Contact allergic dermatitis
Microbial eczema
Contact dermatitis simplex
A 3 year old child has been suffering from fever, cough, coryza, conjunctivitis for 4 days. He has
been taking sulfadimethoxine. Today he has fever up to 39oC and maculopapular rash on his face.
Except of rash the child's skin has no changes. What is your diagnosis?
Scarlet fever
Rubella
Pseudotuberculosis
Measles
Allergic rash
A 7 year old girl had mild form of varicella. Headache, weakness, vertigo, tremor of her limbs,
ataxia, and then mental confusion had appeared on the 5th day of illness. Meningeal signs were
negative. Cerebrospinal fluid examination was normal. How can you explain these signs?
Meningitis
Myelitis
Neurotoxic syndrome
Meningoencephalitis
Encephalitis
A 2 year old girl has been ill for 3 days. Today she has low grade fever, mild catarrhal signs, slight
maculopapular rash on her buttocks and enlarged occipital lymph nodes. What is your diagnosis?
Measles
Adenoviral infection
Scarlet fever
Rubella
Pseudotuberculosis
A 36-year-old woman is on the 12-th week of her first pregnancy. In the past history she was treated
because of infertility. Recently she visited guests and contacted a child who developed rubella in 2
days after meeting. The woman doesn't remember whether she was infected with rubella before or
not. What is the adequate tactics?
Monitoring of the specific Ig G, Ig M
Acyclovir administration
Immune globulin injection
Interruption of the pregnancy
Interferon administration
A child, aged 5, is ill with fever, vesicular rash mainly on the trunk and scalp. On the 8th day has
appeared severe headache, ataxia, lethargy, movement discoordination, tremor of the extremities. On
the second wave of the fever encephalitis is diagnosed. Complication of what disease can be
encephalitis in this case?
Chicken pox
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Herpetic infection
Enterovirus infection
Measles
Rubella
A 4-year-old child on the 5th day of illness complains of cough, rash on the skin. Temperature is
38,2°C, face is puffy, photophobia, conjunctivitis. There is a bright papulomacular rash on the face,
neck, upper half of the chest. Pharynx is hyperemiated. There are serous and purulent discharge from
nose, ronchi in the lungs. What is your preliminary diagnosis?
Measles
Rubella
Enterovirus infection
Adenovirus infection
Scarlet fever
A 9-year-old child is ill for 5 days. Physical examination: сonscious, inert. Puffy face. Cataral
conjunctivitis, scleritis. Bright-red mid-size papulous-maculous skin rash on face and behind ears.
Diffuse hyperemia in pharynx. Soft palate shows enanthema. The child is not vaccinated. What is the
most likely diagnosis?
Measles
Allergic dermatitis
Pseudotuberculosis
Scarlet fever
Rubella
A 14-year-old adolescent on the second day of the disease with a sudden onset complains of a strong
headache in forehead and in the orbits, dull pain in the body, dry painful cough. His temperature is
39°C. Adynamic. Mucous membrane of oropharynx is "flaming", rales are not ausculated. What is
the most probable diagnosis?
Influenza
Parainluenza
Meningococcus infection
Pneumonia
Respiratory mycoplasmosis
A 15-year-old patient complains of pain in the right half of face, headache, and rise in temperature.
He is sick for 3 days, speaks that disease is due to being in cold. On physical exam: in the right half
of forehead there is inflammatory hyperemia, edema. Erosions with necrotic coating are on places of
vesicles. There are vesicles with inflammatory hyperemia along the border of the nodes. What
pathology is meant in this case?
Herpes zoster
Eczema
Lichen planus erythematosus
Dermatitis
Erysipelas
A man presents to physician with cramping pain in left side of the chest, general weakness, fever and
headache that have appeared 2 days ago. In the morning skin rash on chest is noted. Physical
examination: multiple aggregated vesicles filled with transparent fluid, 2-4 mm in diameter. Vesicles
are situated on the erythematous and edematous background along 4-5 intercostals. What is the most
likely diagnosis?
Herpes zoster varicellosus
Pityriasis rosea
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Streptococcal impetigo
Allergic dermatitis
Herpes simplex
A 7-year-old girl suddenly fell ill with fever, headache, severe sore throat, vomiting. Tiny bright red
rash appeared on her reddened skin 3 hours later. It is more intensive in axillas and groins. Mucous
membrane of oropharynx is hyperemied, on tonsils there are greyish exudates. Submaxillary
lymphnodes are enlarged and painful. What is the most likely diagnosis?
Scarlet fever
Enteroviral infection
Rubella
Pseudotuberculosis
Measles
A patient, aged 16, complains of headache, mainly in the frontal and temporal areas, superciliary
arch, appearing of vomiting at the peak of headache, pain during the eyeballs movement, joints pain.
On examination: excited, t° — 39°C, Ps - 110/min. Tonic and clones cramps. Uncertain meningeal
signs. What is the most likely diagnosis?
Influenza with cerebral edema manifestations
Parainfluenza
Adenovirus infection
Respiratory syncytial virus
Influenza, typical course
In infant aged 1 year on the third day of common cold at night has developed inspiratory stridor,
hoarse voice and barking cough. Physical examination revealed suprasternal and intercostals chest
retractions. There is a bluish skin discoloration. Moist is seen over the upper lip. The respiratory rate
is 52 per min and pulse — 122 bpm. The body temperature is 37,5°C. What disease does the infant
have?
Acute bronchiolitis with respiratory distress
Bronchopneumonia without complications
Acute epiglottitis
Acute infectious croup due to viral laryngotracheitis
Acute laryngitis
A 7 year old boy complains of general weakness, spastic pain in the lower parts of his abdomen,
mainly in the left iliac area, frequent defecations up to 18 times a day, feces contain admixtures of
mucus and blood. The illness began abruptly 3 days ago with chills, fever, and headache. General
condition is moderately severe, body temperature is 37,8oC. Sigmoid colon is spasmed and painful.
What is the most probable diagnosis?
Salmonellosis
Escherichiosis
Shigellosis
Nonspecific ulcerative colitis
Yersiniosis
A girl, aged 8, suddenly fell ill. Chills, sensation of heat, fever up to 38.5°C, intermitting pain in the
left iliac area, frequent liquid stool in the form of rectal spit have appeared. On palpation: the left part
of the abdomen is painful, spastic sigmoid colon. What is the most likely diagnosis?
Acute dysentery
Amebiasis
Escherichiosis
Non-specific ulcerative colitis
Malignant tumor of the large intestines
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A girl, aged 12, was delivered to the admission ward of a hospital on the 2nd day of illness in severe
condition. Examination has revealed body temperature 36,1oC, coarse features of the face, dry skin
that makes a fold, aphonia, convulsive twitching of some muscle groups. Acrocyanosis is present.
Heart sounds are dull, Ps is 102 bpm, BP is 50/20 mm Hg. Abdomen is soft, sunken, painless. Anuria
is presnt. Stool is liquid in form of rice water. What is the most probable diagnosis?
Cholera
Intestinal amebiasis
Escherichiosis
Acute dysentery
Salmonellosis
A patient has been in a hospital. The beginning of the disease was gradual: nausea, vomiting, dark
urine, аcholic stools, jaundice of the skin and sclera. The liver is enlarged on 3 cm. Jaundice
progressed on the 14th day of the disease. The liver decreased in size. What complication of viral
hepatitis caused deterioration of the patient's condition?
Infectious-toxic shock
Hepatic encephlopathy
Meningitis
Relapse of viral hepatitis
Cholangitis
A 13 years old boy who has hepatitis B complains of jaundice increase and bloody vomiting after diet
impairment and nervous stress. Physical examination: Ps 110 bmp, BP 80/50 mm Hg. The liver is
painful at palpation and is reduced in size. What complication is the most likely being observed?
Acute hepatic failure
Toxic-infectious shock
Haemolytic crisis
Acute adrenal failure
Acute renal failure
District doctor of rural medical department was called to a 12-year-old patient. While examining the
patient, the shigellosis was suspected. What document must the doctor fill in?
Urgent notification of infectious disease
Statistical coupon of final (precise) diagnosis
Abstract of outpatient medical card
Infectious disease report
Report addressed to Head of the village
A 10-year-old child is sick with chronic viral hepatitis B with marked activity of the process. Total
bilirubin —70 mcmol/L, direct – 26 mcmol/L, indirect — 44 mcmol/L. AST — 6.2 mmol/L, ALT —
4.8 mmol/L. What is the mechanism of transaminase level increase in this pati_ent?
Cytolysis of hepatocytes
Failure of bilirubin conjugation
Intrahepatic cholestasis
Hypersplenism
Failure of the synthetical function of the liver
A 15-year-old patient was hospitalized in severe condition with complaints of chills, high grade
temperature, dryness in the mouth, multiple vomiting, pain in the epigastrium, frequent watery,
foamy, dirty green color stool of unpleasant odor. The tongue and the skin are dry. BP — 80/40 mm
Hg. What first aid is necessary for the patient?
Intravenous injection of sodium soluti_ons
Hemosorbtion
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Sympathomimetics
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To prescribe polyglucin
Fresh-frozen plasma transfusion
In a boy the disease has started with acute onset. Frequent watery stools developed 6 hours ago. Then
vomiting took place. The body temperature is normal. On physical examination: boy's voice is
hoarse; eyes are deeply situated in the orbits. The pulse is frequent. Blood pressure is low. Anuria.
What is the preliminary diagnosis?
Cholera
Typhoid fever
Toxic food-borne infection
Salmonellosis
Dysentery
An 8-year-old boy fell ill acutely: fever, weakness, headache, abdominal pain, recurrent vomiting,
then diarrhea and tenesmus. Stools occur 12 times daily, are scanty, contain a lot of mucus, pus,
streaks of blood. His sigmoid colon is tender and thickened. What is your diagnosis?
Dysentery
Escherichiosis
Salmonellosis
Cholera
Staphylococcal gastroenteritis
A 12-year-old girl complains of dull right subcostal pain, nausea, decreased appetite. History: disease
has started with jaundice in 2 months after appendectomy. She was treated in an infectious hospital. 1
year later present complaints have developed. Physical examination: subicteric sclerae, enlarged firm
liver. What is your preliminary diagnosis?
Chronic viral hepatitis
Chronic cholangitis
Acute viral hepatitis
Calculous cholecystitis
Gilbert's disease
A male, aged 17, intravenous drug addict complains of weakness, moderate jaundice, sensation of
heaviness in the right hypochondrium. The patient's condition has aggravated gradually. Biochemical
tests: Total bilirubin – 48.2 mcmol/L; ALT – 3.0 mmoI/L. What examination will verify the
diagnosis?
Polymerase chain reaction (HCV -RNA)
Determination of HB antigen
Determination of ALT in dynamics
Ultrasound examination of liver
Computer tomography
A 14 y.o. patient was admitted to the gasteroenterology with skin itching, jaundice, discomfort in the
right subcostal area, generalized weakness. On examination: skin jaundice, traces of scratches, liver
is +5 cm; spleen is 6x8 cm. In blood: alkaline phosphatase — 3.0 mmol/(hour*L), general bilirubin
— 60 mcmol/L, cholesterol — 8.0 mmol/L. What is the leading syndrome in the patient?
Cytolytic
Asthenic
Mesenchymal inflammatory
Liver-cells insufficiency
Cholestatic
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A 15 year old patient fell ill a week ago: body temperature rose up to 37,6 oC, than appeared a slight
swelling on his neck. His illness was diagnosed as ARVI, cervical lymphadenitis. Treatment course
included erythromycin, hot compress on the neck. In course of treatment body tempearture rose up to
39oC, than appeared headache, repeated vomiting, meningeal syndrome. What studies are necessary
for the final diagnosis?
A.
B.
Complete blood count
Puncture of cervical lymph node
Cerebrospinal puncture
Sputum test for secondary flora
Roentgenological examination of lungs
A 3 year old boy fell ill abruptly: fever up to 39oC, weakness, vomitng. Haemorrhagic rash of
various size appeared on his lower limbs in 5 hours. Meningococcemia with infective - toxic shock of
the 1 degree was diagnosed. What medications should be administered?
Chloramphenicol succinate and prednisone
Chloramphenicol succinate and interferon
Penicillin and prednisone
Ampicillin and immunoglobulin
Penicillin and immunoglobulin
A child with meningococcus meningitis has been taking penicillin for 7 days. Last 4 days his body
temperature is normal. Meningeal signs are absent. When is it possible to cancel antibiotic?
If liquor cytosis is 50 or less, mainly due to lymphocytes
If liquor cytosis is 150, mainly due to lymphocytes
Right now
If leucocytosis and left neutrophil shift are absent
If liquor cytosis is 100 or less, mainly due to neutrophils
A 3 year old child became ill acutely, body temperature rose up to 39,5oC, the child became inert,
there appeared recurrent vomiting, headache. Examination revealed positive meningeal symptoms,
after this lumbal puncture was performed. Spinal fluid is turbid, outflows with high pressure, protein
concentration is 1.8 g/l; Pandy reaction is +++, sugar concentration is 2.2 mmol/l, chloride
concentration - 123 mmol/l, cytosis is 2.35*109 (80% of neutrophils, 20% of lymphocytes). What is
the most probable diagnosis?
Serous tuberculous meningitis
Brain tumour
Serous viral meningitis
Purulent meningitis
Subarachnoid haemorrhage
A 14-year-old boy on the 5th day of acute respiratory disease with high grade temperature has strong
headaches, systemic dizziness, sensation of double vision, paresis of mimic muscles on the right,
tickling why swallowing. Diagnosis is Acute viral encephalitis. Determine the basic direction of the
etiological therapy.
Acyclovir
Glucocorticoids
Hemodesis
Cephtriaxon
Lasix
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A 5-year-old boy fell ill abruptly: fever up to 39.8 °C, recurrent vomiting, severe headache.
Convulsions occur in 3 hours. Physician has found positive meningeal signs. Pleocytosis of 2500
cells mainly polymorphonuclear, elevated protein concentration and normal glucose concentration
was found in cerebrospinal fluid examination. What is your diagnosis?
Purulent meningitis
Tuberculous meningitis
Serous meningitis
Subarachnoidal hemorrhage
Encephalitis
A 1.5 y.o. child fell ill acutely with high temperature 38 °C, headache, fatigue. The temperature
declined on the fifth day, muscular pain in the right leg occured in the morning, there were no
movements and tendon reflexes, sensitivity was reserved. What is the initial diagnosis?
Viral encephilitis
Hip joint arthritis
Polyomyelitis
Polyartropathy
Osteomyelitis
A 14 year old patient complains of general weakness, dizziness, body temperature rise up to 37.5oC,
sore throat, neck edema, enlargement of submaxillary lymph nodes. Objectively: mucous membrane
of oropharynx is edematic and cyanotic, tonsils are enlarged and covered with films that spread
beyond the tonsils and cannot be easily removed. What is the leading mechanism of this illness'
development?
Action
of bacterial exotoxin
Accumulation of suboxidated products
Action of bacterial endotoxin
Allergic
Bacteriemia
Three weeks after acute angina the patient is still weak, inert, subfebrile, his retromaxillary lymph
nodes are enlarged. Tonsils are flabby, stick together with arches; there are purulent plugs in lacunae.
What is the most probable diagnosis?
Acute lacunar tonsillitis
Chronic tonsillitis
Chronic pharyngitis
Tonsillar tumour
Paratonsillitis
In the inhabited locality there is an increase of diphtheria morbidity during the last 3 years with
separate outbursts in families. What measure can effectively influence the epidemic process of
diphtheria and decrease the morbidity with diphtheria to single cases?
Immunization of the population
Disinfection in disease focus
Revealing of carriers
Early diagnostics
Hospitalization of patients
A 14 year old patient was admitted to a hospital with complains of headache, weakness, high
temperature, sore throat. Objectively: enlargement of all groups of lymph nodes was revealed. The
liver is enlarged on 3 cm, spleen - on 1 cm. In blood: leukocytosis, atypical lymphocytes - 15%.
What is the most probable diagnosis?
Angina
Adenoviral infection
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Diphtheria
Acute lymphoid leukemia
Infectious mononucleosis
A 15 year old girl complained of edema on her face and legs, rise of blood pressure up to 160/100
mm Hg and weakness. She fell ill 3 weeks after recovering from angina. Urinalysis data: protein 0.5
g/l, erythrocytes 17-20/field, leukocytes 2-3/field, erythrocyte casts. What treatment should be
initiated after specifying the diagnosis?
Ceftriaxone
Penicillin
Dipyridamol
Heparin
Ciprofloxacine
A 7-year-old child is sick for 2 weeks with running nose, was taking nasal drops. The boy suffers
with alimentary allergy. He applied to doctor due to suppurative and bloody discharges from nose,
maceration of nostrills and upper lip. Rhinoscopy results: there are whitish-greyish membranes at
nasal septum. Mucous membrane of oropharynx is not changed. What is the most probable disease?
Diphtheria of the nose
Allergic rhinitis
Sinusitis (maxillar sinus)
Rhinovirus
Adenovirus
A patient complains of intense pressing pain in the pharynx, mainly to the right, impossibility to
swallow even liquid food. The patient is sick for 5 days. His condition is severe. Body temperature is
38.9°C, it is difficult to talk, voice is constrained, and it is difficult to open the mouth. Submaxillary
glands to the right are painful, enlarged. What is the most probable diagnosis?
Peritonsillar abscess
Diphtheria
Vincent's disease
Pharyngeal tumor
Phlegmonous tonsillitis
A woman complains of high temperature up to 38 °C, mild pain in the throat during 3 days. On
examination: lymphatic nodes of the jaw angle are 3 cm, palatal tonsils are enlarged and coated with
grey membrane which spreads to the uvula and frontal palatal arches. What is the most probable
diagnosis?
Agranulocytosis
Vincent's angina
Oropharyngeal candidosis
Infectious mononucleosis
Pharyngeal dyphtheria
A 14 y.o. female presents with prolonged fever, nocturnal sweating. She's lost her weight on 7 kg
during the last 3 months. She had irregular sexual activity with different partners. On examination:
enlargement of all lymphnodes, hepatolienal syndrom. In blood: WBC — 2.2*109/L. What is the
most likely diagnosis?
Infectious mononucleosis
HIV-infection
Lymphogranulomatosis
Tuberculosis
Chroniosepsis
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A 16 y.o. female presents with prolonged fever, nocturnal sweating. She's lost her weight on 7 kg
during the last 3 months. HIV-infection was diagnosed. What preparations are used for prevention of
fungal infection?
Fluconazol, Orungal, Nisoral
Cytosar, Cormyctin, Lomycitin
Rubomycin, Bleomycin, Mytomycin С
Captopril, Enalapril
Isoniazid, Ftivazid, Pyrazinamid
The child, 3 years old, has measles. He is treated in infectious department. He visits kindergarten. On
what period it is necessary to impose the quarantine in the group, which visits this child if nobody of
them has received immunoglobulin for measles passive prevention?
On 4 days
On 10 days
On 17 days
On 21 days
Not, it is unnecessary
The child, 4 years old, is ill for 7 days. The body temperature is 36.8 ?С, once in a while productive
cough disturbs him. On the face and upper half of the trunk - pigmented rashes, on lower limbs
spotted-papulous rashes. Measles was diagnosed. What period of this disease has the patient?
Catarrhal
Exanthema
Pigmentation
Complications
Recovery
The child, 7 years old, is ill for the 5th day. He complains of rashes that appear on the nose bridge.
He became ill acutely, when the body temperature had increased to 38 ?С, rhinitis had appeared. On
the third day of the disease the temperature fell to 37 ?С. Objectively: the general condition is
moderate; the temperature is 38 ?С. The child is wilted, sleepiness. The face is puffy, conjunctional
hyperemia and edema is noted. The back pharyngeal wall is hyperemied. On soft palate - single small
rose spots. On cheeks - white spots with red corolla. The skin of the face and neck is covered by big
amount of small rose spots, places overflow, wrong form, on unchanged base. What diagnosis is the
Measles,
catarrhal period.
most probable?
Measles, the 1st day of the rashes period.
Measles, the 2nd day of the rashes period.
Measles, the 3rd day of the rashes period.
Measles, the 1st day of the pigmentation period.
The child, 3 years old, is ill during 3 days. His mother complains that child has high temperature (38
?C), headache, cough. The child could not look at light (appears tearing). Objectively: child is wilted;
congunctival hyperemia and edema are present. On cheeks and gums are present spots of gray-white
colour, surrounded by red bordering, sized as poppy grain. On soft palate is enanthema - in the
manner of small rose-red spots. What diagnosis is the most probable?
Influenza.
Parainfluenza.
Rubella.
Scarlet fever.
Measles.
A boy of 2years, not vaccinated, 2 weeks ago contacted with a Rubella patient. Today his
temperature rose to subfebrile. Indicate other signs of Rubella in prodromal period.
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Moderate intoxication and catarrhal signs, enanthema, increase of posterior cervical and occipital
lymph nodes
Moderate intoxication and catarrhal sings, rashes on a skin
Expressed catarrhal signs, intoxication, enanthem, Koplick's spots
Moderate catarrhal signs, enanthema, rashes on a skin
Expressed intoxication, difficulty of the nasal breathing, increase of anterior and posterior cervical
lymph nodes
At a girl the body temperature rises to 37.5?С. 17 days ago she contacted with a Rubella patient.
What changes on oral mucosa are typical for this child?
enanthem on a soft palate, the Koplick's spots
Hyperemia of the external orifice of the parotid salivary gland's channel
Catarrhal tonsillitis, grainulose back pharyngeal wall
maculous enanthem on a hard palate, herpangina
maculous enanthem on a soft palate, hyperemia of the throat
To the child with the purpose of innate Rubella confirmation virology research is performed. What
fluids need to be examined in this case?
Blood, saliva, cerebrospinal fluid
Blood, saliva, urine, sweat
Blood, cerebrospinal fluid, urine
Blood, nasopharyngeal mucus, excrements, urine
Urine, excrements, saliva, sweat
In a child, 9 years old, who has Chickenpox, on 7th day of the disease body temperature has
increased again to 39.2? С, headache vomiting, shaky gait, declaimed speech have appeared. During
examination remaining elements of the rash (crusts), nuchal rigidity are noted; the child is falling in
Romberg pose. What complication is possible?
Polyneuropathy.
Meningitis.
Meningoencephalitis.
Encephalomyelitis.
Ventriculitis.
The child, 4 years old, is ill for the 3rd day. On skin he has polymorphic rash: spots, papules,
vesicles, some of them have purulent content, crusts. Body temperature has increased. Chickenpox,
complicated by pyodermia was diagnosed. What from enumerated medicine should be prescribed to
this child?
Genthamycin.
Nifuroxazid.
Gancyclovir.
No one.
Laevomycetin.
The boy, 2 years old, became ill acutely. The disease has began from increasing of the temperature to
37.9? С, skin rash. On the third day physician has noted the rash on the face, hair part of the head,
trunk, hands, legs in the manner of spots, papules, vesicles with transparent content, crusts. What is
the probable diagnosis?
Herpes simplex.
Herpes zoster.
Rubella.
Chickenpox.
Lyell syndrome.
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D.
E. *
60.
In a child, 2 years old, with oral mucose damage as vesicles, that ruin, forming erosions, acompanied
by the pain, febril body temperature was diagnosed Herpetic stomatitis. What changes in complete
blood analyses are most probable?
Leucocytosis, lymphopenia.
Leucopenia, lymphocytosis.
Leucocytosis, neutrophylia.
Leucopenia, monocytosis.
Leucocytosis, monocytosis, atypical mononuclear cells.
The child, 3 years old, became ill acutely. Body temperature has increased to 37.8? С. small spots,
papules has appeared on the trunk, scalp, face. Next day new elements of the rash has appeared, old
elements has changed to vesicles, and some of them to crusts. It is known that two weeks ago the
child contacted with a sick person, who has a similar disease. What is the probable diagnosis?
Rubella
Chickenpox
Measles
Scarlet fever
Infectious mononucleosis
The boy, 4 years old, became ill acutely: subfebril temperature, small catarrhal phenomena, rash on
skin. The rash looks like firmly grouped papuls on the red base. On the 2nd day they changed for
small vesicles with the transparent content, localised along left trigeminal nerve branches. Herpes
Zoster was diagnosed. How long the ill person must be isolated?
the whole rash period + 15 days since the rash has appeared.
the whole rash period + 10 days since the rash has appeared.
the whole rash period + 5 days since the rash has appeared.
11 days.
21 days.
In a child, 6 years old, who has Herpetic infection, on the 6 day of the disease body temperature has
increased, the headache and vomiting has appeared. During examination “stiff neck” was fined.
Meningitis was diagnosed. What change in spinal fluid is the most probable?
Lymphocyte pleocytosis.
Neutrophyl pleocytosis.
Protein more than 1 g/l.
Normocytosis.
Glucose level is increased.
The child, 5 years old, became ill acutely, 3 days ago. The body temperature has increased to 38 ?С.
He was treated by home methods. In 3 days the patient was examined by family doctor. Pharyngeal
and tonsilar hyperemia, small point-like enanthema on soft palate were found. In skin folds, lateral
surface of the trunk and neck small maculous rash is present. Increased front-cervical lymphatic
nodes are palpated. What is the probable diagnosis?
Rubella.
Chickenpox.
Pseudotuberculosis.
Hemorrhagic purpura.
Scarlet fever.
The child, 9 years old, is ill for 6 days. He complains of increased body temperature to 38 ?С, pain
during swallowing, small maculous rash on neck, upper part of the trunk, skin folds. Objectively:
pharyngeal and tonsilar hyperemia, small point-like enanthema on soft palate were found. What
laboratory investigation will confirm the Scarlet fever?
A.
B.
C.
D. *
E.
61.
A.
B.
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.
Fat drop of the blood.
Smears from the pharynx for viral parts.
Blood culture.
The agglutination reaction to reveal the antigen in the material.
The swab from nose and pharynx for corinebacteria.
The boy is 6 years old. Suddenly 2 days ago his body temperature rose to 38 ?С, the general
condition become worse, the pain during swallowing has appeared. The patient was examined by
family doctor. Pharyngeal and tonsilar hyperemia, small point-like enanthema on soft palate were
found. In skin folds, lateral surface of the trunk and neck - small maculous rashes. Increased
front-cervical lymphatic nodes are palpated. The scarlet fever was diagnosed. When the child could
visit10th
the school?
On
day after the disease has begun.
On 15th day after the disease has begun.
On 20th day after the disease has begun.
On 22nd day after the disease has begun.
On 30th day after the disease has begun.
The girl, 7 years old, complains of pain in the throat, increasing of the body temperature to febrile,
headache, and sickness. During objective examination: bright point-like rash in skin folds, lateral
surface of the trunk, internal and back surfaces of the thighs, increased front-cervical lymphatic
nodes, "blazing pharynx". The scarlet fever was diagnosed. What bacteria cause this disease?
Staphylococci
group A -haemolytic streptococci
Escherichia coli
Bacillus cereus
Gram-positive diplococci
At a girl, 7 years, in a week after the discharge from the hospital, where she was treated because of
pseudotuberculosis, a temperature has increased, pain in knee-joints, nodular erythema have
appeared. Indicate the course of the disease.
Uneven with exacerbation
Uneven with complications
Uneven with the relapse
Uneven with exacerbation of chronic disease
Protracted
At a child passive hemagglutination reaction with pseudotubercular diagnosticum was done.
Pseudotuberculosis, atypical form, is diagnosed. Indicate the probable atypical forms of disease.
Effaced, asymptomatic, mononucleosis like
Catarrhal, combined, asymptomatic
Effaced, septic, catarrhal
Catarrhal, combined, mononucleosis like
Effaced, asymptomatic, catarrhal
2 children from the family are hospitalized to the infectious department. Pseudotuberculosis is
suspected. What measures does it follow to perform concerning contact persons (except for
prohibition to use raw products)?
Supervision during 2 weeks, 1 fecal culture
Supervision during 3 weeks, 1 fecal culture
Supervision during 3 weeks, 1 fecal culture, urine culture, throat culture
Supervision during 3 weeks, 2 fecal cultures
Supervision during 3 weeks, 1 fecal culture, urine culture
66.
A.
B. *
C.
D.
E.
67.
A.
B.
C. *
D.
E.
68.
A.
B.
C. *
D.
E.
69.
A. *
B.
C.
D.
E.
70.
A. *
B.
C.
D.
E.
71.
A.
B.
A 12 years old girl, who had increased body temperature to 38.2-39.4 ?C has addressed to
pediatrician. In 5 days a rash had appeared around knees and feet, and lower part of abdomen, in
skin folds. It looks like red spots and papules. Mild jaundice of the skin was noted. Name the
probable diagnosis.
Chickenpox.
Pseudotuberculosis.
Measles.
Rubella.
Scarlet fever.
A teenager, 17 years old, entered to infectious department. Diphtheria of the pharynx was diagnosed.
A firm, smooth membranes which cover the entire surface of tonsils, spread on the soft palate, uvula
were noted. Indicate the form of diphtheria.
Combined
Isolated
Spread
Localized insular
Localized membranous
A child of 14 years is treated in the infectious department because of diphtheria. The reaction of
passive hemagglutination with paired sera with 2 weeks interval was done. What growth of specific
antibodies titer has the diagnostic value?
2 times
3 times
4 times
6 times
8 times
A patient of 6 years had tonsillitis. There were membranes on tonsils. A district doctor took the swab
from the tonsils. In few days, obtaining a positive result, he directed a child to the hospital with
diagnosis of „Diphtheria" . What is the tactic of diphtheria antitoxic serum (DTA) treatment if
patient’s tonsills were free of membranes when he admited to the hospital.
DTA is not input
DTA is input in a dose of 15 thousand IU
DTA is input in a dose of 30 thousand IU
DTA is input in a dose of 60 thousand IU
DTA is input in a dose of 100 thousand IU
A girl, 7 years old, from the focus of diphtheria with complains of sore throat, subfebril body
temperature has entered to the infectious hospital. She was not vaccinated during last 6 years because
of contraindications. Diphtheria of the pharynx, insular form is suspected. What investigation will
prove the diagnosis as quickly as possible?
Bacterioscopy of the pharyngeal swab
General blood test
Fat drop
Bacteriological examination of the pharyngeal and nasal swab
Immune-enzyme reaction.
A boy, 7 years, has infectious mononucleosis. The increase of body temperature to 38.5? С, head
ache, lowering of appetite were present during last 2 weeks. Objective examination revealed edema
of the face, considerably enlarged neck lymph nodes, liver, spleen; purulent tonsillitis. Indicate the
disease severity.
compensated
subcompensated
C.
D. *
E.
72.
A.
B. *
C.
D.
E.
73.
A.
B.
C.
D.
E. *
74.
A.
B. *
C.
D.
E.
75.
A.
B. *
C.
D.
E.
76.
A. *
B.
C.
D.
E.
mild
moderate
severe
A boy, 3 years, with infectious mononucleosis, is treated in the hospital. What from the serological
laboratory investigations does it follow to do in the late period to confirm the diagnosis?
Determination of the Ig M against viral capsid antigen (immune enzyme analysis)
Determination of the Ig G against viral capsid and nuclear antigens (immune enzyme analysis)
Polymerase chain reaction
Reaction of heteroagglutination
Complete blood analysis
The child, 10 years old, complains of bloody secretions from the nose. He is ill for the 4th day. The
body temperature is 37.5? С. Crusts are present in the nasal cavity, more on the left; near nostrils
maceration is present. Bacterioscopy of the pharyngeal swab has revealed Gram-positive bacteria
with thickened ends, grouped in the manner of W, V, and X. What is the most probable diagnosis?
Adenoviral infection
Diphtheria of the pharynx
Rhinoviral infection
Foaring body of the nose
Diphtheria of the nose
Purulent exudates in lacunas were noticed in a child, who has infectious mononucleosis. That’s why
he starts antibacterial therapy. maculopapulous rash on trunk, extremities has appeared next day.
Which medicine can provoke rash in this case?
Benzylpenicillin
Ampicillin
Cefazolin
Cefalotin
Erythromycin
A boy of 6.5 years is ill for three days: subfebrile temperature, catarrhal changes in the pharynx,
insignificant increase of neck lymph nodes. Red maculous-papulous exanthema forming large
erythema which elevates above the skin has appeared on a background of the amoxicillin reception
on a trunk, extremities. In the blood analysis: leucopenia, lymphocytosis, and 10% of atypical
mononuclears. What infectious disease does it follow to differentiate with infectious mononucleosis
in this case?
Medicinal
allergy: hives
Measles
Rubella
URT infections
Pseudotuberculosis
A girl, 5 years old, is ill for 4 days. The disease has begun from high body temperature. Home
pediatrician has noted the edema of parotid, submandibular, sublingual salivary glands. Mumps was
diagnosed. Name type and form of the disease according to classification.
Typical, isolated.
Atypical, isolated.
Atypical, combined.
Typical, combined.
Atypical, subclinical.
77.
A.
B.
C.
D. *
E.
78.
A.
B.
C. *
D.
E.
79.
A.
B.
C.
D. *
E.
80.
A.
B.
C. *
D.
E.
81.
A.
B.
C.
D. *
E.
82.
A.
B.
C. *
D.
E.
In a boy, 7 years old, who has mumps, body temperature has increased to 39? С. A headache,
sleepiness, vomiting, nuchal rigidity have appeared. The child was hospitalized to the infectious
department. What changes in spinal fluid are probable?
Decreased liquor pressure.
Expressed neutrophyl pleocytosis.
Moderate neutrophyl pleocytosis.
Moderate lymphocyte pleocytosis.
Expressed lymphocyte pleocytosis.
A boy, 12 years old, has recovered from mumps, combined form (parotitis + orchitis). He was treated
at home: anti-inflammatory, antiviral, antihistamine, antibacterial medicine, was consulted by
urologist. Name the duration of dispensary observation by urologist for this child.
1 month.
2 months.
6 months.
2 years.
3 years.
The boy, three years old, awoke at night from paroxysmal cough: one for another exist the short
cough pushes, which ended by whistling inbreath (whoop). Name the disease period:
Incubation;
Prodromal;
Catarrhal;
Paroxysmal;
Permition.
A child’s face reddened, became cyanotic, tearing has appeared, tongue was brought forth outward
during cough paroxysm, which disturbs the child for the last three weeks. The paroxysm has ended
by cough with transparent phlegm and vomiting. Name the diagnosis:
Bronchiolitis;
Obstructive bronchitis;
Whooping cough;
Allergic bronchitis;
Bronchial asthma.
A girl, 4 years old, has paroxysms of spasmodic cough, which ended by the whoop for three nights
apart. The viscous transparent phlegm in a small amount has appeared after cough; one vomiting was
noted. What duration of the disease is probable?
3 days;
5 days;
7 days;
14 days;
20 days.
Mother has addressed to pediatrician with complains of spasmodic cough in a child. The cough
disturbs her child only at night. Whistling inspiration, periodical vomiting were noted during the
cough. “Whooping cough” was suspected. What changes in complete blood analysis are typical in
this case?
Leucocytosis
with neuthrophylia;
Leucopenia with lymphocytosis;
Leucocytosis with lymphocytosis;
Leucocytosis with lymphopenia;
Leucopenia with neuthropenia.
83.
A.
B.
C.
D. *
E.
84.
A.
B.
C. *
D.
E.
85.
A.
B.
C.
D.
E. *
86.
A.
B.
C. *
D.
E.
87.
A.
B.
C.
D.
E. *
88.
A.
B.
C.
The child of 2 years with meningococcal infection, is examined by the group of students together
with physician. Typical rash is present on skin of the whole body, especially on the buttocks, lower
limbs. Name, which sign is absent at meningococcal rash.
Hemorrhagic nature.
The elements are mildly increased above the level of the skin.
The necrosis in the centre.
Disappears at pressure.
It is possible to find meningococci in scraper
To the boy, 4 years old, was put the diagnosis of meningococcal infection (generalized form). The
child is treated in infectious department. What generalized form is the most often one?
Meningitis.
Meningococcemia.
Combined form (Meningococcemia + meningitis).
Meningoencephalitis.
Encephalitis.
The child, 4 years old, is ill with meningococcal infection (meningococcemia), complicated by
infectious-toxic shock. Choose the antibacterial medicine, which is reasonable to use for etiotrope
therapy:
Penicillin.
Erythromycin
Genthamycin
Karbenicillin
Chloramphenicol
A girl of 2 years became ill acutely from raising of temperature to 38.3 oС, catarrhal phenomena.
Cough and cold were present during three days. Then a temperature decreased, but a child could not
stay. A doctor reveals limitation of movements, lowering of muscular tone in lower extremities.
Sensitiveness is normal. Name previous diagnosis.
Osteomyelitis
Enterovirus infection
Poliomyelitis
Rotavirus infection
Flu
A child of 2.5 years, not vaccinated, was ill for 4 days. The disease had begun from hyperthermia to
38.5 oC, weakness, mild catarrhal phenomena and liquid emptying. On the 5th day the temperature
was normal, however much pains in the muscles of feet and acute limitation of movements,
decreased tendon reflexes had appeared. Name the preliminary diagnosis.
Acute intestinal infection
Acute encephalitis
URT infection
Osteomyelitis
Poliomyelitis
A child of 4 years had the fever and catarrhal signs for 3 days. On the 4th day a temperature become
normal, but a boy began to pull his left leg. A doctor suspected poliomyelitis. What form of the
disease is the most probable?
Bulbar
Abortive
Pontine
D. *
E.
89.
A.
B.
C.
D. *
E.
90.
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.
Spinal
Meningeal
The diagnosis of enteroviral infection was put to the child of 6 years. He complains of acute,
paroxysmal pain in his chest, which increases at cough, movements. Name the form of the disease.
pleurisy
paralytic form
myocarditis
epidemic myalgia
herpangina
The diagnosis of enteroviral infection was put to the child of 10 years. During objective examination:
his common state is satisfactory; a temperature is normal, languid monoparesis of extremities,
weakness of buttocks, thigh, and mimic muscles are present. Name the form of the disease.
summer flu
serous meningitis
paralytic form
epidemic myalgia
herpangina
The child of 7 years is ill for 2 days, complains of cold, dry cough, hyperemia of the face, pharynx,
and conjunctivitis. His smaller sister had signs of herpangina and diarrhea few days ago. Name the
probable diagnosis in his case.
Enteroviral infection, herpangina
Enteroviral infection, respiratory-catarrhal form
Measles, prodromal period
Herpetic infection
Adenoviral infection, pharyngocojunctival fever
The child is 7 years old. He has influenza for 5 days. The condition of the child has sharply
worsened. Breathing is 30 in 1 min.; cyanosis of perioral triangle; dullness of the lung sound, moist
tiny rales in lower parts of the lungs, more in the right, are present. What complication of influenza is
possible?
Croup syndrome
Pneumonia
Meningitis
Myocarditis
Obstructive bronchitis
The child, 2 years old, is treated from influenza. His condition suddenly became worse: the body
temperature has increased to 39.8 ?С, rough barking cough, hoarseness of the voice, expressed
inspiratory dyspnea have appeared. What complication of influenza has developed?
Pneumonia
Bronchiolitis
Croup syndrome
Obstructive bronchitis
Pharyngitis
The child is 10 years old. He has influenza for 4 days. The body temperature is 40.2 С. The child
complains of headache, expressed weakness, vomiting. Objectively: child is faded, positive
meningeal signs, denominated hemorrhagic syndrome. What form of influenza has this child?
Typical, catarrhal
Typical, subtoxic
Typical, toxic
D. *
E.
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.
E.
100.
Atypical, hypertoxic
Atypical, fulminant
The child is 2 years old. Mother complains of nasal congestion, dry cough, increasing of the body
temperature to 38 ?С in him. The breathing is rough, diffuse dry ronchi and moist tiny rales in both
lungs are auscultated. On chest x-ray – signs of emphysema. What is the most probable diagnosis?
Adenoviral infection
Rhinoviral infection
Influenza
Parainfluenza
Respiratory-syncitial infection
At a child the typical form of adenoviral infection is diagnosed clinically. At the inspection:
temperature of body 38,3-38,7?С, labored nasal breath because of mucous-purulent excretions in
lower nasal passages, moderate hyperemia and edema of soft palate, tonsils; back pharyngeal wall is
red with enlarged, bright follicles, moderately enlarged anterior and posterior cervical lymph nodes,
hepatosplenomegaly. Name diagnostic criterion, which is absent here to complete the diagnosis of
adenoviral infection.
Pneumonia.
Mesadenitis.
Conjunctivitis.
Encephalitis.
Nephritis.
The child, 1 year old, is treated in infectious department because of Parainfluenza. On the 2nd day of
the disease his condition became worse. The child is excited, inspiratory dyspnea, tachypnea,
tachycardia, cyanosis of the lips, tip of the nose and fingers, cool perspiration has appeared.
Intercostals’ involvement is noted at breathing. What degree of larynx stenosis is present?
I
II
III
IV
V
Child of 4 years during 5 days is treated because of acute dysentery, moderate degree. An effect from
the received therapy is insignificant; toxic and dyspepsia syndrome are continued. Choose the
adequate treatment.
To strengthen oral rehydration.
To apply parenteral rehydration therapy.
To give netylmycin 5 mg/kg per day.
To give immune modulators therapy.
To give enterosorbents.
At a child,10 months old, with the expressed signs of toxicosis with dehydration, the acute severe
dysentery is clinically suspected. Give feeding recommendations to his mother.
To decrease the usual volume of meal in the first 2-3 days on 40-50 %, the rejuvenation of meal.
Feed the child only by the strained breast milk.
Give the advantage to the sour-milk adapted mixtures.
Water-tea pauses during 6-12 hours, and further usual feeding.
Frequent feeding by small portions, as a child wants to eat.
At a child, 7 years, dysentery manifests with diarrhea 20-25 times per day, skin is pale, dry, with
reduced elasticity, temperature of the body is 38.9? С, repeated vomiting, paroxysmal pain in the
abdomen are present. What severity of the disease does this child have?
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.
C.
mild
moderate
severe
severe with predominance of local signs
severe with predominance of toxic signs
The child, 10 days old, has entered to the infectious department with mother’s complaints on
increasing the temperature to 38.7 ?С, repeated vomiting, porridge-consistence stools with green
mucus up to 5 times per day. There were some episodes of Salmonellosis in the maternal house.
Child’s heart tones are dull, 146 per minute. The abdomen is distended; the liver emerges from the
rib arch on 3 cm, spleen - on 1 cm. A purulent arthritis was diagnosed in the child in 3 days. What is
the most possible
diagnosis? form.
Salmonellosis,
gastrointestinal
Salmonellosis, typhoid form.
Salmonellosis, septic form.
Salmonellosis, influenza-like form.
Salmonellosis, dysentery-like form.
The boy, 4 years old, complains of abdominal pain, repeated vomiting, increased frequency of
defecation, liquid feces, high body temperature – 38 ?С. He is ill for 4 days. He entered to infectious
department because of poor condition (the appearing of blood in feces) . What investigation will
confirm the diagnosis?
Fecal culture (dysentery, typhoid, paratyphoid fever).
General blood test.
Bacteriological examination of cerebrospinal fluid.
Fat drop.
Bacteriological investigation of pharyngeal swab.
In family members of the 3 years old child, who used in food hamburgers, has appeared hemocolitis
with the normal body temperature. A hemorrhagic rash, and anuria has appeared on the third day of
the disease in this child. In general urinalysis erythrocyturia is present. About what intestinal
infection you should think first of all?
Shigellosis
Salmonellosis
Entheroinvasive Escherichiosis
Entherohemorrhagic Escherichiosis.
Typhoid fever
A boy of 1 year is ill for 3 days. Main syndromes are: toxic with hyperthermia; dyspeptic with
vomiting, «sprinkling» diarrhea (like rice-water); back pharyngeal wall is bright red; moderate signs
of dehydration are present. Put preliminary diagnosis.
Enterotoxigenic Escherichiosis
Enteropatogenic Escherichiosis
Cholera
Rotavirus infection
Enterovirus infection
A girl, 7 years old, complains of periodic colicky abdominal pain, increased frequency of defecation,
temperature 39.2 ?С. During objective examination painful sigmoid colon is revealed. Feces are
dark-green in a small amount, with much mucus. Anus is closed. Fecal culture was positive for
Sаlmоnеllа enteritidis. What disease must be differentiated from this form of salmonellosis?
Shigellosis.
Typhoid fever.
Escherichiosis.
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.
Acute appendicitis.
Staphylococcal enterocolitis.
In a child, 3 months old, the dyspepsia in the manner of the repeated vomiting, right after the meal,
and often (12 times per day) defecation has appeared. The child during examination is wilted,
moveless, big fontanel is sunken, skin is pale with marble tone, mucous membranes are dry, bright;
oliguria is present. Feces are liquid, bright-yellow with large amount of water. What infection is
possible?
Cholera
Shigellosis
Salmonellosis
Escherichiosis
Yersiniosis
The child, 5 years old, became ill acutely. The disease is connected with milk-products, because the
same clinical picture is present in the other members of the family, which used in food the same milk.
He complains of short hyperthermia, frequent liquid feces of the orange color with mucus and single
bloody mucus, colicky abdominal pain. During the treatment marked symptoms regressed. What
form of escherichiosis you can think about?
Entheropathogenic
Entheroinvasive
Entherotoxigenic
Entherohemorrhagic
Entheroadherrent
A boy of 6 months has repeated vomiting, appetite is absent. He is ill for 2 days. During examination:
malaise, skin is pale, lips are dry. Moderate thirst is present. Large fontanel is lower than skull bones.
Weight loss is 4 %. Body temperature is 38° C. Abdomen is soft, intestinal grumbling is present.
Feces are watery, colorless, 12 times per day. Urination was 8 times per day. What type of
dehydration has developed?
Isotonic
Hypertonic
Hypotonic
Moderate
Severe
A boy, 8 months old, has entered the infectious department. The disease had acute beginning. He
didn’t want to drink nothing; vomiting repeated. Objectively: body temperature is 35.5 ?C, skin and
mucus membranes are dry; large fontanel is lower than skull bones; extremities are cold; tachycardia
is present. In entrance room he became unconscious, tonic-clonic seizures has appeared. What fluids
does he need for the rehydration, in what correlation?
5% glucose, 0.9% NaCl, 1:2
5% glucose, 0.9% NaCl, 1:1
10% glucose, 0.45% NaCl, 2:1
5% glucose, 0.9% NaCl, Albumen 1:1:1
10% glucose, 0.45% NaCl, 3:1
The child, 8 years old, was treated because of the hepatitis В. He was discharged from the hospital on
35th day. Objectively: jaundice is absent; liver emerges below rib arc on 1.5 cm, with normal
elasticity. In biochemical blood test: total bilirubin is 18.39 mcmol/l, AST – 0.68, ALT – 0.72.
What is the duration of dispensary observation in tis case?
3 months.
6 months.
9 months.
D. *
E.
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.
12 months.
18 months.
The boy, 14 years old, was treated because of the hepatitis А, moderate degree. He is discharged
from the hospital in satisfactory condition. In biochemical blood test: total bilirubin is 15.39 mcmol/l;
AST – 0.72; ALT – 0.78. In what time it is necessary to repeate biochemical blood test?
In 1, 3, 6 months.
In 1, 2, 4 months.
In 1, 3, 6, 9 months.
In 2, 4, 6, 8 months.
In 1, 3, 6, 12 months.
In a boy, 8 years old, pediatrician has suspect pseudotuberculosis. For the specific antibodies
revealing on the second week of the disease was performed Indirect hemagglutination reaction.
Indicate the diagnostic titer of this reaction:
1:50.
1:80.
1:160.
1:200.
1:360.
The child, 8 years old, complains of pain in knee joints, weakness, jaundice of the skin and visible
mucous membranes, the rash on limbs, around joints. The spleen is enlarged to +2 cm and liver – to
+3 cm, moderately compacted. In biochemical blood test: total bilirubin is 98.26 mcmol/l; direct –
66.2; AST – 2.12; ALT – 2.65. Hepatitis В was diagnosed. What infectious disease must be
differentiated in this case?
Hepatitis А
Infectious mononucleosis
Pseudotuberculosis
Mechanical jaundice
Hemolytic anemia
A boy, 10 years old, has addressed to pediatrician with complains of body temperature 38.2 ?C, pain
in the right inguinal region, diarrhea, red spots and papules arround the knees. The face is
hyperemied with cyanosis, edema of the neck, upper part of the thorax. Peripheral lymph nodes are
enlarged. Y.entrocolitica was selected from his feces. Prescribe etiothrope treatment in this case.
chloramphenicol
cefotaxim
cefasoline
nifuroxasid
cefuroxim
2 children from a family are hospitalized in the infectious department, Yersiniosis is suspected. What
measures, does it follow to perform concerning contact persons (except for prohibition to use raw
products)?
Supervision during 2 weeks, measuring the temperature, skin, throat and feces inspection
Supervision during 3 weeks, measuring the temperature, skin, throat and feces inspection, 1
bacteriological fecal culture
Supervision during 3 weeks, 1 bacteriological fecal culture, urine culture, throat culture
Supervision during 3 weeks, 2 bacteriological fecal culture
Supervision during 3 weeks, 1 bacteriological fecal culture, urine culture
116.
A.
B.
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.
14-year-old teenager has HIV/AIDS, which is characterized by low number of CD4 cells and high
concentration of virus. Highly active antiretroviral therapy was appointed to him. One of the products
is nucleoside analog that inhibits viral reverse transcriptase, and is effective for HIV and Hepatitis B.
This drug is:
Acyclovir
Amantadine
Ribavirine
Sacvumavir
Lamivudine
In patient of 7 years submandibular, axillary and inguinal lymph nodes are increased. Lymph node
biopsy reveal marked follicular hyperplasia. HIV infection was diagnosed by PCR method. What
period of HIV infection is characterized by such clinical symptoms?
Incubation
The latent infection
The period of persistent generalized lymphadenopathy
Pre-AIDS
AIDS
A combination of drugs that suppress HIV reproduction were assigned to patient in the specialized
clinic. What group belong drugs that are obvious for the complex antiviral treatment?
Interleukins.
Broad-spectrum antibiotics.
Nucleoside analogs.
Antimicotic drugs.
Trimethoprime/sulfamethoxasolum.
A girl, 2.5 years old, is ill for 3 days. The body temperature was 38.6-39.7? С, pain in throat, labored
breathing by nose, without discharge from nostrils. Objectively: tonsils are increased, hyperemied,
without exudate, increased and moderately painful front- and posterior neck lymphatic nodes. Liver
emerges below rib arc on 2.5 cm, is mildly compacted, spleen emerges below rib arc on 1.5 cm. In
general blood test: L - 14.6х109/l, er - 3.69х1012 /l, Hb-116 g/l, eosynophyls - 2%, bands - 12%,
segments - 21%, lymphocytes - 50%, monocytes - 5%, atypical mononuclear cells -10%. What is the
probable diagnosis?
Adenoviral infection
Infectious mononucleosis
Viral hepatitis
Submandibular lymphadenitis
Mumps
The eight-year old child is ill for 6 days. He has increased body temperature to 38-39? C; increased
all groups of lymphatic nodes, especially posterior neck; tonsillitis, hepatosplenomegaly. Infectious
mononucleosis is suspected. What changes in the general blood test are possible?
Leucopenia, lymphocytosis.
Leucopenia, neutrophylia, atypical mononuclear cells.
Leucocytosis, lymphocytosis, atypical mononuclear cells.
Leucopenia, neutrophylia, monocytosis.
Leucopenia, neutrophylia.
What kind of immunity to rubella virus has breast-fed baby of 5 months if her mother at the age of 12
years had rubella?
Passive natural
Active artificial
C.
D.
E.
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. *
Active natural
Passive artificial
Immunity is absent
A child of 6 years old is invited to visit a doctor for booster vaccination against measles. The doctor
make the conclusion that the vaccine is contraindicated. What from listed below is a compelling
reason for this?
The presence of the measles antibodies in child’s blood
Positive Mantoux test
Acute viral hepatitis A 6 months ago
An intolerance of penicillin
Febrile convulsions in history
A doctor examining the child of 1 year 2 months because of the routine vaccination against measles
concluded that the child has temporary contraindication for 3 months. Which of the following was
the decisive argument for such contraindication?
The introduction to the child of immunoglobulins 1 month ago
Lack of child's weight 8%
Hyperemia and dry cheeks
Bow-legs deformity
Positive Mantoux test
In January the parents brought the child of 6 months in the vaccination room for routine DTP
vaccination (third). The doctor recommended to parents temporarily refrain from vaccination. Which
of the following was the reason of the contraindigation?
Influenza epidemic in the city
Insufficient weight gain of the child (deficit 5%)
Dentition
ARVI in the child 1 month ago
Increased body temperature to 37.6 oC after the previous vaccination
On the 2nd day after the DPT vaccination mother had seen at the injection site - in the upper outer
quadrant of buttocks - infiltration with hyperemia of the skin 2 cm in diameter; general condition of a
child is not violated. What is the most possible cause of infiltration?
Variant of normal vaccination process
All of the above
Wrong choice of injection site
Allergic reactions to vaccine components
Secondary bacterial infection
A child of seven years had sore throat, fever up to 38.6 ?C, single vomiting. On the next day the body
temperature is 37.2-38.5 °C. The doctor found pinpoint rash and diagnosed scarlet fever. Which of
the following has been crucial for the diagnosis of scarlet fever?
The prevalence of rash in the natural skin folds
White nasolabial triangle
Xerosis
White dermographism
Positive "pinch" symptom
A girl of seven years had sore throat, fever up to 38.6 ?C, single vomiting. The next day the body
temperature is 37.2-38.5 °C. The doctor found pinpoint rash and diagnosed scarlet fever. The
apartment is separate. There are no more children in the family. How this girl need to be treated?
Treated at home
B.
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.
Hospitalized for 10-12 days
Hospitalized at least for 22 days
Hospitalized till the negative throat culture (b-hemolytic streptococcus)
Treated in hospital until the cessation of desquamation
Examining a child of six years on the second day of illness a doctor saw multiple, very small rash
predominantly on the flexor surfaces of hands and feet. The body temperature is 38.4 ?C. The child
complains of sore throat. A scarlet fever was suspected. Which of the following will be crucial to
confirm the diagnosis of scarlet fever?
Localization of the rash
Scratches
Xerosis
White nasolabial triangle
White dermographism
A child of 5 years on 2-day being in the surgical hospital has chickenpox. The day before he had
appendectomy. Which of the following is appropriate for epidemiological purpose?
Place patient in Meltzer’s box
Urgent discharge of the patient
Isolate in a separate ward
Held in a room with children who previously suffered from chickenpox
Isolate by the glass screen up to 5 days from the onset of the last eruption
A schoolboy of 8 years is treated in the hepatitis department for 25 days. Today he has chicken pox.
One of the patients in another ward had herpes zoster 2 weeks before. It is also known that there were
cases of chickenpox in the school during last month. Name the source of infection for varicella in this
case. with herpes zoster
Patient
Neighbors in the ward
Classmates
Staff of the admission office
Medical personnel of the hepatitis department
A child of 2 years old fell ill acutely: body temperature increased to 39.5 ?C, he refuses to eat. He
had drunk hot milk before. At the oral mucosa have appeared thin-walled vesicles with a red rim that
quickly form as characteristic surface ulcers, which are prone to peripheral distribution. Oral mucosa
is edematous and hyperemic. Gums are inflamed and edematous. What diagnosis is the most likely in
a child?
Herpes of oral mucosa
Burn of oral mucosa
Thrush (oral candidiasis)
Chickenpox
An allergic reaction to cow's milk
To the district pediatrician children aged from the 3 months to 4 years come for vaccinations. What
vaccinations does it follow to do to the children of 3 months?
Hepatitis B
DTP + OPV + Ніb
DTaP +OPV + Ніb
DTP + IPV + Ніb
DTP + IPV + hepatitis B
133.
A. *
B.
C.
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.
In a child of 5 years (on the third day of chickenpox) body temperature is 39.3 ?C, remains a rash as
macula, vesicles, crusts without a definite localization; has appeared eruptions on the oral mucosa
and conjunctiva. The reason for the home visit was the appearance of rough barking paroxysmal
cough. How to interpret the changes in the child's condition on the third day of illness?
Croup syndrome in varicella
Pertussis
Joining of ARVI with symptoms of croup
Acute pneumonia
Aphthous stomatitis
Child of 3 months was brought for vaccination. His mother is ill with bronchial asthma, atopic form,
in childhood had the reactions on vaccinations. What vaccine does it follow to vaccinate the child
with the high risk of postvaccinal complications development?
Hepatitis B
DTP + OPV + Ніb
DTaP +OPV + Ніb
DTaP + IPV + Ніb
DTP + IPV + hepatitis B
The child was born in therm in a maternity hospital. A mother renounced from vaccinations, however
after the discharge from maternity hospital changed her mind. Indicate a vaccine and the dose which
it follows to apply.
0.25 dose BCG
0.3 dose BCG
0.5 dose BCG
1 dose BCG
1 dose BCG-M
The child was born in therm in a maternity hospital. A mother renounced from vaccinations, however
after the discharge from maternity hospital changed her mind. Indicate till what age vaccination
against tuberculosis is done without the previous Mantoux test:
to 2 weeks
to 1 month
to 2 months
to 3 months
to 6 months
A child, aged 3.5 years, was brought to the family doctor for vaccination out of the terms of schedule.
Indicate what test is necessary to do before vaccination:
Sulkowitch Test
Shtange Test
Thorn Test
Mantoux Test
Complete blood analysis
A pretherm child was born with body weight 1800 g, 34 weeks of gestation. When does this child
will be vaccinated against tuberculosis?
On 3-7th day of life
On 3-7th day of life in a half dose
In the age of 1 month
When his weight will be more than 2000 g
In the age of 2 months
139.
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.
E.
To the child, aged 6 months, which was born with temporal contraindications for vaccination, the
Mantoux test was done in child's policlinic. In 72 hours a district pediatrician find in the place of
test only 2 cm hyperemia. Indicate the tactic for vaccination against tuberculosis:
not to vaccinate
to vaccinate
to vaccinate only at presence of phtysiatrist consultation
to vaccinate in the hospital
to vaccinate only at presence of immunologist consultation
The child, aged 6 years, a week ago was vaccinated against diphtheria, tetanus, poliomyelitis,
measles, rubella, mumps. In his family a patient with tuberculosis is revealed. Indicate through what
term after the vaccination it is possible to do the Mantoux test:
on the next day
in 2 weeks
in 1 month
in 2 months
in 3 months
The child, aged 5 months, was vaccinated against diphtheria, tetanus, whooping-cough, poliomyelitis,
Ніb-infection. What interval is need before next boster vaccination against these diseases?
Not less than 3 months
Not less than 6 months
Not less than 9 months
Not less than 12 months
Not less than 18 months
The child, aged 3 months, was vaccinated against diphtheria, tetanus, whooping-cough, poliomyelitis,
Ніb-infection. What interval is need before next vaccination against these diseases?
2 weeks
1 month
5 months
6 months
12 months
At a child of 5 months, which came for vaccination according the calendar, in anamnesis was
postvaccinal complication in 4 months age. Indicate what vaccine is it follow to use for vaccination?
DTaP
DTP
DT
DT-m
D-m
To the child of 18 months fourth vaccination against tetanus, diphtheria, whooping-cough was done.
It is known from anamnesis that after the third one he had the febrile temperature. What
recommendation does it follow to give to his parents in this case?
paracethamol during 1 day
paracethamol during 3 days
aspirin during 1 day
analgin during 1 day
analgin during 3 days
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. *
B.
Child of 2 years old fell ill acutely: increased body temperature to 39.5 ?C, refuses to eat. He had
drunk hot milk before. At the oral mucosa have appeared thin-walled vesicles with a red rim that
quickly come to light with the formation of characteristic surface ulcers, which are prone to
peripheral distribution. Oral mucosa is edematous and hyperemic. Gums are inflamed and edematous.
What diagnosis is the most likely in a child?
Herpes of oral mucosa (thrush)
Burn of oral mucosa
Thrush (oral candidiasis)
Chickenpox
An allergic reaction to cow's milk
In a child 5 years of age (on the third day of chickenpox) body temperature is 39.3 ?C, remains a rash
as macula, vesicles, crusts without a definite localization; has appeared profuse eruption on the oral
mucosa and conjunctiva. The reason for the home visit was the appearance of rough barking
paroxysmal cough. How to interpret the changes in the child's condition on the third day of illness?
Croup syndrome in varicella
Pertussis
Joining of ARVI with symptoms of croup
Acute pneumonia
Aphthous stomatitis
A 10 years old girl today has been ill chickenpox. How many days she should not attend school (in
the no complicated course of the disease)?
9-10 days
2-4 days
5-7 days
10-14 days
15-20 days
A schoolboy of 8 years for 25 days is treated in the hepatitis department. Today he has been ill
chicken pox. One of the patients in another ward had zoster 2 weeks before. It is also known that last
month there have been cases of chickenpox in the school. Name the source of infection for varicella
in this case.
Patient
with herpes zoster
Neighbors in the ward
Classmates
Staff of the admission office
Medical personnel of the hepatitis department
During inspection of the 6-year old patient on the skin in the VI intercostal space along the anterior
and posterior axillary lines doctor found closely spaced vesicles of 0.3-0.5 cm, filled with transparent
content, with a tendency to cloudy, the body temperature is 37.5 ?C. What disease is the most likely
in this situation?
Herpes zoster
Measles
Chickenpox
Herpes simplex
Allergic rash
A child of 5 years on 2-day being in the surgical hospital has chickenpox. The day before he had
appendectomy. Which of the following is appropriate in epidemiological purposes?
Place patient in Meltzer’s box
Urgent discharge
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.
Isolate in a separate ward
Held in a room with children who previously suffered from chickenpox
Isolate by the glass screen up to 5 days from the onset of the last eruption
The district pediatrician visited 9-month-old baby who is suffering from chicken pox, on the third
day of illness. On examination were revealed vesicles on the skin of the trunk, extremities and oral
mucosa, as well as crusts on his face, hyperemia of conjunctivas, and purulent discharge from the
eyes. The body temperature is 38.5 ?C. What conclusion made the doctor?
Moderate form of varicella, complicated by the bacterial infection
Typical moderate form of varicella
Typical severe form of varicella
Generalized form of varicella
Hemorrhagic form of varicella
A child of five years two weeks ago was in contact with the patient that had shingles (herpes zoster).
The child became ill yesterday acutely. The body temperature is 38.7 ?C, weakness, headache, runny
nose. The body has many, slightly pruritic papular rash elements, vesicles, isolated pustules, vesicles
on the oral mucosa, conjunctiva. Your diagnosis?
Chickenpox
Strophulus
Impetigo
The tuberculosis skin lesions
Shingles (herpes zoster)
A child 5 years old complains of pain in his throat, fever. When examined at the 2nd day of illness, a
rash was revealed. A scarlet fever was suspected. What morphology of the rash will be typical for
scarlet fever?
Pinpoint
Hemorrhagic ("Starry")
Vesicles
Maculopapulous
Nodular
On the 2 nd day after the DPT vaccination mother had seen at the injection site - in the upper outer
quadrant of buttocks - infiltration with hyperemia of the skin 2 cm in diameter; general condition of a
child is not violated. What is the most possible cause of infiltration?
Variant of normal vaccination process
All of the above
Wrong choice of injection site
Allergic reactions to vaccine components
Lack of vaccination sites processing (secondary infection)