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85k 7years Class :Examination of Infectious Disease (A) Multiple choice (0.5 point/ each) 1.Which state is the most common occurrence during the course of infection? A. To clear out of organism B. Carrier state C. Covert infection D. Latent infection E. Overt infection 2.Which one is passive immunization? A.Typhoid vaccine B. P.P.D. C..Measles vaccine D. Diphtheria toxoid E.Tetanus antitoxin 3.Which virus belongs to DNA virus? A.HAV B.HEV C.HCV D.HDV E.HBV 4.What are the basic features of infectious disease? A. Infectivity,mode of transmission, immunity and epidemiologic features. B. Infectivity,immunity epidemicity and seasonal. C. Pathogen,immunity,infectivity and mode of transmission. D. Pathogen,immunity,infectivity and epidemiologic features. E. Infectivity,pathogen,immunity,epidemicity and susceptibility. 5.What is the principal measure to wipe out alimentary infectious diseases? A. isolation of source of infection. B. Treatment of source of infection. C. Protection of susceptible population. D. Cutting off the route of transmission. E. Observatoin of contactor. 6.HBsAg can not be detected in the serum of A. Patients with acute hepatitis B. B. Patients with chronic hepatitis B. C. Carriers of HBV. D. Persons who have received hepatitis B vaccines. E. Cirrhosis caused by hepatitis B virus. 7.Three factors of the infective process are: A.Source of infection,route of transmission,population of susceptibility. B.Dosage,pathogenicity and specific location of pathogen. C.Pathogen,vector and host. D.Pathogen,host and route of transmission. E.Pathogen,host and environment. Questions 8-11 A.IgG B.IgM C.IgA D.IgE E.IgD 8.r-globulin for prevention and treatment of infectious diseases contains: 9.The most significant antibody for the early diagnosis of infectious diseases is: 10.Which can pass through the placenta? 11.Major agglutinin in serum is: Questions 12-14 A.the first day B.the second day C.the fourth day D.the fifth day E.the sixth day 12.When does the rash of chickenpox appear after onset of the disease? 13.When does the rash of scarlet fever appear after onset of the disease? 14.When does the rash of typhus appear after onset of the disease? 15.Pathogens invade into the host and cause mild damage of the tissues. There are no clinical manifestations or only atypical symptoms and signs.But there are specific antibodies in the serum.This condition is called: A. To clear out pathogens. B. Latent infecton .C. Carrier state. D. Covert infection. E. Overt infection. 16.Which is correct in the following items? A.Most of chronic hepatitis in mild develop cirrhosis. B.There is not chronic hepatitis A. C.Hepatitis C can not develop cirrhosis. D.Chronic active hepatitis is only caused by HBV. E.Hepatocellular carcinoma is not related to HCV. 17.In acute fulminant hepatitis,the most significant clinical manifestation for diagnosis is: A.Progressive deep jaundice. B.Rapid shrink of the liver. C.The symptoms of C.N.S. D.Hemorrhagic tendency. E.Toxic intestinal tympanites. 18.The aim of using lactulose in fulminant hepatitis is: A. To increase the nutrition of liver. B. To supply the energy. C. To reduce the absorption of ammonia. D. To reduce the necrosis of liver cells. E. To increase the regeneration of liver cells. 19.A 18 year female was found HBsAg positive in health check up 2 years ago, but without symptoms and signs,and the liver functions were normal. In May this year, she was admitted for fever, weakness, vomiting and jaundice of sclera. ALT 1200U/L, TBil 167umol/L, anti-HAVIgM(+).Anti-HBc IgG(+) HBsAg(+).HBVDNA(-),The diagnosis may be: A. Acute hepatitis A(icteric type) and HBsAg chronic carrier. B. Chronic hepatitis B(mild degree). C. Chronic hepatitis B(morderate degree). D. Acute hepatitis A and acute hepatitis B. E. Acute hepatitis A and chronic hepatitis B(mild degree).. 20.The most common pathogen causing icteric hepatitis in children is: A.HAV. B.HBV. C.HCV. D.HEV. E.HDV. 21.The antibody protecting human body from hepatitis B is: A.Anti-HBs . B.Anti-HBcIgM. C.Anti-HBcIgG. D.Anti-DNA. E.Anti-HBe. 22.The patient with HBsAg(+) and HBeAg(+) has: A. No infectivity. B. Immunity. C. Inactive disease. D. Active disease. E. Infectivity. 23.The main route of transmission for hepatitis A is: A. By injection and blood transfusion. B. By droplets in the air. C. By saliva. D. By fecal-oral. E. By vertical transmission. 24.The most sensitive serum enzyme for diagnosing viral hepatitis is: A.AST. B.ALT. C..ALP. D. r-GT. E. LDH. 25.Human can not suffer from paragonimiasis by: A. Ingesting crayfish curd. B. Eating raw crabs and crayfishes. C. Drinking contaminated water. D. Eating raw meat of wild boar. E. Eating raw shrimps. 26.The chronic carrier of typhoid fever is that: A.The period of discharge of bacteria is no more than 1 month B.The period of discharge of bacteria is no more than 2 months C.The period of discharge of bacteria is no more than 3 months D.The period of discharge of bacteria is more than 3 months E.The period of discharge of bacteria is more than 6 months 27.What is the main factors that cause the sustained fever and toxic symptoms in typhoid fever? A.The typhoid bacilli multiply at local site and invade into blood constantly B.The typhoid bacilli multiply largely in blood C.The endotoxin released by typhoid bacilli acts upon the central of regulating temperature D.Delayed allergy E.The endogenous pyrogen released by macromononuclear cells in site of lesion A girl, 6 month old, high fever 3 days, the temperature 40 ℃, the typhoid bacilli was positive in blood culture, widal test :“H” and “O”were negative. 28.What disease did the child suffer from? A.The carrier of bacilli of typhoid fever B.Ambulatory type of typhoid fever C.The common type of typhoid fever D.The bacteremia of typhoid bacillI E.No infection of typhoid fever 29.What is the main complication of this disease? A Toxic hepatitis B. Toxic myocarditis C. Intestinal bleeding D. Intestinal perforation E. Bronchopneumonia 30.Which is the most significant manifestation of toxic bacillary dysentery? A. Onset abruptly B. Diarrhea C. High fever, coma and convulsion D. Shock in early time E. Respiratory failure 31.Chronic bacillary dysentery relates to the following factors, except for: A. The bacteria having a strong virulence B. Treating without thorougly and not in time C. Hypotrophy D. Chronic cholecystitis E. Intestinal parasitosis Questions 32~34: A.fever+abdominal pain +diarrhea+stool with pus and blood B.fever+ abdominal pain +diarrhea+stool like jams C.fever+ abdominal pain +diarrhea+watery stool D.no fever+ abdominal pain +diarrhea+watery stool E.no fever+no abdominal pain +diarrhea+watery stool 32.Ameba has: 33.Bacillary dysentery has: 34.Cholera has: 35.Since 1961,the pathogen of the 7th pandemic of cholera in the world is: A. Classical biotype B. EL-Tor biotype C. O139 biotype D. O137 biotype E. O157 biotype A female,22 years old, was hospitalized because violent diarrhea and profuse vomitting,no fever, no abdominal pain, the diarrhea is more than 10 times with a large amount of watery stool. 36.The diagnosis may be : A.Bacillary dysentery B.Poisoning of food C.Acute gastroenteritis D.Cholera E.Other 37.In order to make clinical diagnosis ,what is the first choice of the test? A.Blood routine B. Stool routine C. Smear of stool D. Culture of stool E. Culture of blood 38.According to <the prophylaxis and treatment laws of infectious disease of P.R of China>,when should this disease be reported to epidemic prevention station in town and in countryside: A. 3 hours and 6 hours B. 6 hours and 12 hours C.12 hours and 24 hours D. 24 hours and 48 hours E. <3 hours 39.which is the most important treating method to this patient? A. Injection of cirofloxacin B. Injection of 0.9%N.S C. Injection of 5%bicarbonas solution D. Injection of humorous E. Injection of dopamine 40.A patient, with intermittent fever for 20days,and parasitic protozoa were found in blood thick smear,the most obvious sign in the patient may be: A. Anemia B.Jaudice C. Hepatomegaly D. Splenomegaly E. Heroes simplex on lips 41.the common radical treating plan of malaria is: A. Chloroquine+Pyrimethamine B.Chloroquine+Primaquine C.Quinine+ Pyrimethamine D.Quinine+ Primaquine E.Quinine+ Pyrimethamine 42.Which is the drug , most easily causing the Black-Water Fever in malaria? A.Chloroquine B.Pyrimethamine C.Primaquine D.Artemisinine E.Quinine 43.The classical attacks of malaria appear in following patients except for: A. The early period of tertian malaria B. Malignant malaria C. Malaria of infant D. Malaria from infusion of blood E. The co-infection of different kinds of protozoa 44.Which change of blood picture is the most significant for the diagnosis of typhoid fever? A. Thrombocytopenia B. Leukocytosis+increased eosinophiles C. Leukopenia+decreased eosinophiles D. Lymphocytosis+ increased eosinophiles E. Lymphocytosis+decreased eosinophiles 45.The course of chronic bacillary dysentery is beyond: A.Two months B.Three months C.Six months D.One week E.One year 46.The first choice drug for treatment of typhoid fever is: A.Penecillin B.Ampicillin C.Ofloxacin D.Chloromycetin E.SMZco. 47.In bacillary dysentery,pathological changes are the most severe in: A. Cecum B. Lower part of ileum C. Sigmoid and rectum D. Ascending colon E. Descending colon 48.What is the vector of transmission of malaria: A.Pig B.Rat C.Anopheles minimus D.Anopheles Hyrcanus Sinensis E.Culex Tritaenio-rhynchus 49.The examinations of cholera don’t include: A. Direct observation of the stool B. Fecal smears C. Fecal culture D. Urine test E. Anti-bacterial agglutinin 50.In chronic carriers of typhoid fever ,the bacteria exist mainly in: A. Liver B. Spleen C. Lymphnodes of the intestine D. Gallbladder E. MPS 51.The most cardinal reason of bleeding in febrile period of EHF is: A. DIC B.Heparin-like substance increasing C.Thrombocytopenia and vascular injury D.Azotemia E.Coagulation factor decreasing 52. Which point is not true about poliomyelitis? A. Polio is an acute infectious disease caused by viruses. B. Most of cases are sporadic. C. Most of patients with Polio may develop into paralysis. D. This disease is often seen in children. E. Polio is a preventable disease. 53.which treatment is not available in the treatment of preparalytic period of patients with Polio? A. Rest in bed and nursing. B. Oral vitamin B and vitamin C. C. Muscular injection of ribavirin D. Using hot moist pack to muscles. E. Hydrocortisone may be used for severe patients. 54. The basic pathogenic change of EHF is: A.Inflammation of small blood vessels and inflammatory cell infiltration around blood vessels. B.Extensive lesions of general small blood vessels. C.Toxic damage of general capillaries. D.Damage of endothelial cells of blood vessels and lymphatics. E.Direct damage of endothelial cells of capillaries. 55.The main cause of early shock in EHF are : A. Infection. B. Blood plasma-losing C. Hypervolemia D. Hemorrhage E. Vomiting . 56. The patient had fever,lumbago,headache for three days. Pysical examination: drunken face , petechiae in axillary folds, chemosis, urine protein (+++), RBC 3-5/HP, WBC 4-6/HP, diagnosis may be: A. Typhoid fever B. Typhus C. Acute glumerulonephritis D. Epidemic hemorrhagic fever E. Leptospirosis 57. What is correct liquid supplement for patients with EHF in transitional stage of diuretic period : A. 1500ml/day B. 200ml/day C. 500~700ml/day D. Urine volume +500~700ml/day E. Urine volume+1000ml/day 58. A patient, ten years old ,was admitted to hospital for fever ,lethargy, headache for three days in 15, August. Physical examination: T 40℃, coma, neck stiffness, knee reflexes were hyperactive , Babinski’s sign (+), CSF: transparent, cell count 100 × 106/L, N 80%, L20%,protein:0.45g/L, glucose3.8mmol/L ,chloride:125mmol/L. blood routine examination: WBC 15 ×109/L, N 79%,L21%, which diagnosis most possibly be considered? A.Epidemic cerebrospinal meningitis B.Tuberculous meningitis C.Toxic bacillary dysentery D.Epidemic encephalitis B E. Leptospirosis 59. The main source of infection of epidemic encephalitis B is: A. Patients B. Carriers C. Swine D. Mosquitoes E. Rodents 60. The main vectors of transmission in encephalitis B is: A. Culex tritaeniorhynchus B. Mites C.Anophelets aconitus D. Anopheles hyrcanus sinensis E. Anopheles minimus 61. The pathological injury regions of poliomyelitis are mainly in: A. Nerve cells of brain B. Respiratory center C. Vasomotor center D. Motor neurons in anterior horn of spinal cord E. Motor neurons in posterior horn of spinal cord 62. The pathological diagnosis of EHF is mainly according to the item as follow, but excluding: A. Typical lesion of kidney B. Hemorrhage in right cardiac atrium C. Adenohypophysis lesion D. Retroperitoneal gelatinous edema E. Hemorrhage and necrosis of lungs 63. An male patient , 40 years old ,farmer was admitted for fever, headache, fatigue for 4 days. Physical examination: T 37℃, P 120 times/min, Bp 75/60 mmHg, with drunken face and petechia in chest and back skin. Physical examination of heart and lung were normal, abdominal tenderness (+).the most important examinations for this patient at this time were: A.Blood and urine routine examination B.DIC routine examination C.Blood culture D.X-ray examination of abdomen E.Smear and culture of bone barrow 64. the most possible diagnosis is: A. Leptospirosis B. Epidemic hemorrhagic fever C. Septicemia D. Leukemia E. Thrombopenia purpura 65. The most suitable treatment is: A. Atibiotics iv drop B. Dexamethason iv drop C. Vaso-active drug iv drop D. Supplement of blood volume E. Heparin iv drop 66. The pathological lesion regions of epidemic encephalitis B are principally in: A Cerebral cortex and spinal cord B. Spinal cord and oblongata medulla C. Midbrain and thalamus D. Cerebral cortex, midbrain and thalamus E. Cerebral cortex, oblongata medulla and spinal cord 67. The most common cause for convulsion of epidemic encephalitis B is: A. High fever B. Hypoxia C. Inflammation of cerebral parenchyma and brain edema D. Sputum obstruction E. Hyponatremic encephalopathy 68. Which item is false about pathologic changes of encephalitis B? A Swelling and necrosis of endothelial cell of blood vessel in CNS B Degeneration and necrosis of nerve cell C Neurogliocyte hyperplasia and inflammatory cell infiltration D Neuronophagia E. soften focuses of spinal cord 69. The cardinal sources of infection for flood or rain type of leptospirosis are: A. Pigs B. Dogs C. Patients D. Apodemus agrarius E. Rattus norvegicus 70. The patients with leptospirosis excrete pathogen by: A. Stool B. Urine C. Vomiting substance D. Blood E. Secretion of nose and pharynx 71. The leptospirosis is transmitted by mainly: A. Air borne B. Insect borne C. Direct contact transmission D. Food water borne E. Indirect contact transmission 72. The main cause of death of patients with icterohemorrhagic type of leptospirosis is: A Acute liver function failure B.Acute renal function failure C.Massive bleeding of intestine D.Pneumorrhagia E.Central respiratory failure A patient, 5 years old, was admitted to hospital for high fever, coma, convulsion for 2 days in 10 ,August. Physical examination: T 40 ℃ , P 90 times/min, Bp135/105mmHg, deep coma, his breathing was irregular, and the size of his two pupil was not same, neck stiffness (+), examinations of heart and lungs are normal, Babinski’s sign (+), blood routine examination: WBC 15×109/L, N 85%, L 15%. 73.The most possible diagnosis is: A Toxic bacillary dysentery, B Epidemic encephalitis B C Fulminant type of epidemic cerebrospinal meningitis D Meningoencephalitis type of leptospirosis E Brain type of malaria 74.For excluding toxic bacillary dysentery, the most simple and reliable method is: A. Stool culture B. Examination of CSF C. Stool routine examination D. Test of specific IM antibody E. Complement fixation test 75. Which item is false for disposal of the patient? A.20% mannitol iv drop B.To make spinal acupuncture at once for making correct diagnosis C.Physical cooling and subhibernation D.Lobelin iv E.Dexamethason iv drop 76.Which is the envelope of HIV : A.gp121 B.gp40 C.p24 D.p18 E.gp120 and gp41 77.Which belongs to the regulatory genes ? A.gag.pol.env B.rev.vif.tat C.vif.vpv.vpr D.vpx.vif.vpr E.Tat.rev.vpr 78.HIV-2 infection is mainly located in: A. Thailand B. U.S.A C. West Africa D. Japan E. Europe 79.Which can activate HIV ? A. TNF B. IL—2 C. LgG D. NK 11 E. CD4+ Tlymphocyte 80.How many years may the asymptomatic infection last after the infection of HIV? A.1year B.2~10years or more C.5~10years D.2~5years E.1~20years 81.The most common pulmonary infection is caused by. A. CMV B. TB C. pneumocystis carinii D. Mycobacteria.Avium E. EBV 82.Which is used for pneumocystis carinii pneumnia. A.pentamidine B.Bleomycin C.spiromycin D.clindamycin E.Gancyclovir 83.Which is used for cryptococcal meningitis A.pentamidine B.fluconazole C.spiromycin D. clindamycin E.VCR 84.Which can be the reservoirs of HIV A.CD4+lymphocyte B.lymphocyte C.NK D.Monophagocyte + E.CD8 lymphocyte 85.The specific sign of measles in the prodomal period is: A.fever B.catarrhea C.rash D.Koplik's spot E.strawberrry tongue 86.Pigmentation may be seen after rashes fade in: A.measles B.varicella C.rubella D.Scarlet fever E.typhoid fever 87.Desquamation can be seen in: A. epidemic cerebrospinal meningitis B. scarlet fever C. rubella D. Varicella E. Herpes zoster 88.Leukopenia is ususlly seen in : A.scarlet fever B.measles C.epidemic cerebropinal meningtis D.Bacillary dysentery E.Epidemic encephalitis B 89.The incubation period of SSPE is: A.2~17 years B.2~10 years C.1~2 years D.3 weeks E.3~5 years 90.The complication of scarlet fever is caused by: A.purulent lesion B.toxic lesion C.allergic lesion D.secondary infection E. Endotoxin 91.How many serotypes does erythrogenic toxin have: A. 19 B. 80 C. 5 D. 10 E. 7 92.The course of antibiotics given for scarlet fever is: A. 10~14 days B. one week C. two weeks D.7~10 days E. 3~5 days 93.Which can produce autolysin: A. Group A β-hemolytic streptococcus B Meningitis Neserria C. streptococus mitis D. staphylococcus aureus E. E. Coli 94.The main pathological factor of epidemic cerebrospinal meningitis is: A. hemolysin o.s. B. autolysin C. exotoxin D. streptokinase E. Endotoxin 95.Which is the first choice for epidemic cerebrospinal meningitis: A. AZT B. chloromycin C. ofloxacin D. Penicillin E. SD 96.Which is the first choice for intracranial hypertension: A. Dexamethasone B. Hydrocortisone C. 20% mannitol D. Heparin E. 654-2 97.What cause hairy leucoplakia: A. M avium infection B. candiasis C. viral infection D. toxoplasma infection E. Kaposi sarcoma 98.The main site of lesion for bacillary dysentery is: A sigmoid colon and rectum B. Terminal ileum C. Duodenum and jejiuaum D. Whole intestine E. Rectum 99.Which drug is the first choice for preventing malaria? A Quinine B. Chloroquine C. Pyrimethamine D.Primaquine E. Mefloquine 100.Which is type A infectious disease? A.Smallpox B.Rabies C.Poliomyelitis D.Cholera E.Scarlet fever Fill in blank (0.5point/each blank) 1.In bacillary dysentery, (1) turns to chronic easily, common in China. (2) is the more 2.HIV usually infect (3) and (4) , mainly infects (5) . 3.The cercaria of schistosoma japonica develops into adult worm in the (6) . 4.The first choice of pathogenic treatment of leptospirosis is (7) 、the common dose is (8) 、the first dose is (9) ,for preventing (10) . Simply Answer Question(3 point/each): 1.What is Koplik's spots and what are the clinical significances of it? 2.Please answer the clinical manifestation of pneumocystitis carinii pneumnia . 3.How many types are there for chronic stage of paragonimiasis? 4.Please simply answer the cardinal clinical manifestation and clinical types of common type of epidemic cerebrospinal meningitis. 5.What is the covert infection and its significance? Answer Question(5 point/each): l. what are the basic features of infection disease ? 2.Please describe in detail the clinical manifestation about acute icteric hepatitis. 3.What is principle of the radical treatment of malaria? please to indicate the reasons. 4.What is the definite criterion and considering criterion of cholera? 5.please answer the cardinal clinical manifestation in crisis period of epidemic encephalitis B. 6.please answer the therapical principle of oliguric period in HFRS. 85k 7years Class :Examination of Infectious Disease (A) Answer sheet Choice answer 1.C 2.E 3.E 11.B 12.A 13.B 21.A 22.E 23.D 31.A 32.B 33.A 41.B 42.C 43.D 51.C 52.C 53.C 61.D 62.E 63.A 71. E 72.B 73.B 81.C 82.A 83.B 91.C 92.B 93.B 4.D 14.D 24.B 34.E 44.C 54.B 64.B 74.C 84.A 94.E 5.D 15.D 25.E 35.B 45.A 55.B 65.D 75.B 85.D 95.D 6.D 7.A 8.A 16.B 17.C 18.C 26.D 27.C 28.C 36.D 37.C 38.B 46C 47.C 48.D 56.D 57.D 58.D 66.D 67.C 68.E 76.E 77.B 78.C 86.A 87.B 88.B 96.C 97.B 98.A 9.B 19.A 29.C 39.B 49.D 59.C 69.A 79.A 89.A 99.C 10.A 20.A 30.D 40.C 50.D 60.A 70.B 80.B 90.C 100.D Fill in blank (0.5 point) ⑴ S. flexneri ⑵ S. Sonnei (3) lymphocyte (4) nerve cells (5) CD4+ lymphocyte (6) liver (7) penicillin (8)400000u q6h or q8h、 (9) 50000u、(10) Herxheimer reaction Simply answer question:(3 point) 1.In 90% patients, It appears at 2th-3th day after onset , white and red circle rose, locates at buccal mucosa oppositing the 1th molar teeth,diammond about 0.5 -1.0 mm, like thrush in sever patient The early diagnosis base on it。 2. chronic cough,fever,tachypnea ,cyanosis,arterial oxygen pressure decrease ,moist rales occasionally, X-ray film resemble interstial pneumnia. 3.five types :lung type; abdominal type; brain—spinal cord type; subcutaneous nodule type; ubclinical type. 4.high fever, severe headache, vomiting, petechiae and ecchymosison skin and mucosa, signs of meningeal irritation. clinical types: prodromal period, septicemia period, meningitis period, convalescent period. 5.covert infection is also called subclinical infection. after invasion of pathogen it can’nt cause the damage of tissue and there are no any clinical manifestation even the biochemical changes. but it may cause specific immune reation and there is important significance in the prevention of infectious disease. Answer question (5 point) 1.1) Pathogen 2) Infectivity 3) Epidemiologic feature including sporadic occurrence, epidemic, pandemic, epidemic outbreak and seasinal destribution, regional distribution, sex, age, occupation. 2. 1) Preicteric period: ① The symptoms of digestive tract. ② The urine darkens. ③ 5-7 days. 2) Icteric period ① The jaundice appears on the skin,sclera. ② Subjective symptoms abate. ③Liver and spleen may be palpable. ④ Liver function is abnormal. ⑤ 2-6 weeks. 3)Convalescent period ① The jaundice and symptoms disappear gradually. Liver and spleen retract. ②Liver function return to normal. ③2weeks to 4 months. 3.chloroquine : 1g /d, for 3 day, p.o. it can kill merozoites and trophozoites in RBC, so may prevent attack.. primaquine: for 8day, p.o. it can kill microgametocytes , macrogametocytes and hypozoites, so may prevent relapse and transmission.4.Definite criterion: 1).Symptoms plus culture positive 2).In epidemiologic investigation, initial stool culture was positive, diarrhea existed before or after stool culture for 5 days. 3).In epidemic period ,the patient has typical symptoms but culture is negative, without any other explanting reasons. Considering criterion: 1).Having typical symptoms , the first patient is waiting for the result of culture. 2).In epidemic period, contact history (+), the patient suffers from diarrhea without any other explanting reasons. 5. (1) high fever: >40℃, sustained for 7~10 days. (2)altered consciousness: lethargy, confusion, delirium, stupor, semicoma, coma. (3)convulsion or twitch (4)respiratory failure: manifestation of central RF: cacorhythmic breathing (cheyne-stokes breathing, apnea) manifestation of peripheral RF: dyspnea, regular breathing(5)other symptoms & signs of CNS: meningeal irritations (neck stiffness,Kernigs & Brudzinskis signs positive) tendon reflexes from hyperactive to disappear, pathologic reflexes positive limbs paralysis. 6. 1)Stabilization of internal environment; (1) control of azotemia: Glucose 200g~300g/day (2) maintaining fluid-electrolyte balance: limitation of liquid: urine volume + 500~700ml electrolyte: K Na Cl (3) maintaining acid-base balance: (4) stabilization of blood pressure:2)diuresis: early phase 20%mannitol 125ml Furosemide 40~100mg/time 3)eccoprotic and phlebotomy: high blood volume syndrome, hyperkalemia, mannitol, magnesium, rhubarb. 4)dialysis therapy : BUN >28.56mmol/L BUN> 7.14mmol/L/day K > 6 mmol/L high blood volume syndrome blood dialysis. 85k 7 years Class :Examination of Infectious Disease (B) Multiple choice (0.5 point/ each) 1.The most cardinal reason of bleeding in febrile period of EHF is: A.DIC B. Heparin-like substance increasing C. Thrombocytopenia and vascular injury D. Azotemia E. Coagulation factor decreasing 2.which point is not true about poliomyelitis? A. Polio is an acute infectious disease caused by viruses. B. Most of cases are sporadic. C. Most of patients with Polio may develop into paralysis. D. This disease is often seen in children. E. Polio is a preventable disease. 3.which treatment is not available in the treatment of preparalytic period of patients with Polio? A.Rest in bed and nursing. B.Oral vitamin B and vitamin C. C.Muscular injection of ribavirin D.Using hot moist pack to muscles. E.Hydrocortisone may be used for severe patients. 4.The basic pathologic change of EHF is: A.Inflammation of small blood vessels and inflammatory cell infiltration around blood vessels. B.Extensive lesions of general small blood vessels. C.Toxic damage of general capillaries. D.Damage of endothelial cells of blood vessels and lymphatic vessels. E.Direct damage of endothelial cells of capillaries. 5.The main reasons for early shock in EHF are : A.Infection. B. Blood plasma-losing C.Hypervolemia D. Hemorrhage E.Vomiting . 6.The patient had fever,lumbago,headache for three days. physical examination: drunken face , petechiae in axillary folds , chemosis, urine protein (+++), RBC 3-5/HP, WBC4-6/HP,diagnosis may be: A.Typhoid fever C.Acute glumerulonephritis B.Typhus D.Epidemic hemorrhagic fever E.Leptospirosis 7.Which is the correct method of liquid supplement in transitional stage of patients with EHF: A. 1500ml/day B. 200ml/day C. 500~700ml/day D. Urine volume +500~700ml/day E. Urine volume+1000ml/day 8.A patient, ten years old ,was admitted to hospital in 15, August.the medical history is the following: fever ,lethargy, headache for three days Physical examination: T 40℃, coma, neck stiffness, knee reflexes were hyperactive ,Babinski‘s sign(+),CSF: transparent, cell count 100×106/L, N 80%,Na 125mmol/L, protein:0.45g/L,glucose 3.8mmol/L ,chloride: 79%,L 21%.blood routine examination: WBC 15 ×109/L, N 80%,L20%. which diagnosis is considered most possibly? A.Epidemic cerebrospinal meningitis B.Tuberculous meningitis C.Toxic bacillary dysentery D. Epidemic encephalitis B E. Leptospirosis 9.The main source of infection of epidemic encephalitis B is: A. Patients B. Carriers C. Swine D. Mosquitoes E. Rodents 10.The main vectors of transmission in encephalitis B is: A. Culex tritaeniorhynchus B. Mites C.Anophelets aconitus D. Anopheles hyrcanus sinensis E. Anopheles minimus 11.The pathological injury regions of poliomyelitis are mainly in: A Nerve cells of brain B. Respiratory center C. Vasomotor center D. Motor neurons in anterior horn of spinal cord E.Motor neurons in posterior horn of spinal cord 12. The pathological diagnosis of EHF is mainly according to the item as follow, but excluding: A.Typical lesion of kidney B.Hemorrhage in right cardiac atrium C.Adenohypophysis lesion D.Retroperitoneal gelatinous edema E.Hemorrhage and necrosis of lungs 13.An male patient , 40 years old ,farmer was admitted for fever, headache, fatigue for 4 days. Physical examination: T 37℃, P 120 times/min, Bp 75/60 mmHg, with drunken face and petechia in chest and back skin. Physical examination of heart and lung were normal, abdominal tenderness (+).the most important examinations for this patient at this time were: A.Blood and urine routine examination B.DIC routine examination C.Blood culture D.X-ray examination of abdomen E.Smear examination and culture of bone barrow 14.When the pupil don’t have the same size in the patients with fulminant type of epidemic cerebrospinal meningitis, which drug is the first choice: A. Antibiotics B. sedatives C. 654-2 D. steroid E.dehydrant 15.The source of infection for measles is: A.chronic viral carriers B. acute patients with measles C. convalescent patients with measles D.covert infection patients with measles E. patients with subacute sclerosing panencephalitis 16.The pathological lesion regions of epidemic encephalitis B are principally in: A.Cerebral cortex and spinal cord B. Spinal cord and oblongata medulla C. Midbrain and thalamus D.Cerebral cortex, midbrain and thalamus E. Cerebral cortex, oblongata medulla and spinal cord 17.The most common reason of convulsion for epidemic encephalitis B is: A.High fever B. Hypoxia C. Inflammation of cerebral parenchyma and brain edema D. Sputum obstruction E. Hyponatremic encephalopathy 18.Which item is wrong about pathologic changes of encephalitis B? A.Swelling and necrosis of endothelial cell of blood vessel in CNS B. Degeneration and necrosis of nerve cell C. Neurogliocyte hyperplasia and inflammatory cell infiltration D.Neuronophagia E. soften focuses of spinal cord 19.The infective period of measles is: A. From 5days before eruption to 5days after eruption B. From exposure to eruption C. From appearance of the koplik‘s spots to their disappearance D. From fever to eruption E. From the rash appearance to it‘s subsidence 20.The patients with leptospirosis discharge the pathogen by: A.Stool B. Urine C. Vomiting substance D.Blood E. Secretion of nose and pharynx 21.The leptospirosis is transmitted mainly by: A.Air borne B.Insect borne C.Direct contact transmission D.Food water borne E.Indirect contact transmission 22. The main reason for death of patients with icterohemorrhagic type of leptospirosis is: A.Acute liver function failure B.Acute renal function failure C.Severe bleeding of intestine C.Pneumorrhagia E.Central respiratory failure A patient, 5 years old, was admitted to hospital in 10, August. The medical history is : high fever, coma, convulsion for 2 days Physical examination: T 40℃, P 90 times/min, Bp135/105mmHg, deep coma, irregular breathing, and the size of both pupil was not same, neck stiffness (+), examinations of heart and lungs are normal, Babinski‘s sign (+), blood routine examination: WBC 15×109/L, N 85%, L 15%. 23.The most possible diagnosis is: A Toxic bacillary dysentery, B. Epidemic encephalitis B C. Fulminant type of epidemic cerebrospinal meningitis D. Meningoencephalitis type of leptospirosis E. Brain type of malaria 24.For excluding toxic bacillary dysentery, the most simple and reliable method is: A. Stool culture B. Examination of CSF C. Stool routine examination D. Test of specific IgM antibody E. Complement fixation test 25.Which disposal to the patient is wrong? A.20% mannitol iv drop B.To make spinal acupuncture at once for making correct diagnosis C.Physical cooling and subhibernation. D.Lobelin iv E.Dexamethason iv drop 26.The first change of CSF of fulminant type of epidemic cerebrospinal meningitis is: A.Cloudy appearance B.Cells elevation C.Protein elevation D.Sugar decrease E.Pressure raise 27.The first antibiotic drug chosen in treating shock type of fulminant epidemic cerebrospinal meningitis is: A. Sulfadiazine B. Penicillin C. Ampicillin D. Chloromycetin E. ceftriaxone 28.HIV infecfion is mainly located in: A.Thailand B.U.S.A C.Africa D.Japan E.Europe 29.Which cell is the target cell of HIV? A.CD8+ cells B.Mononuclear cells C.CTL D.NK cells E.CD4+ cells 30.How many years may the asymptomatic infecfion last After the infection of HIV ? A.1year B.20years C.2~10years or more D.2~15years E.1~20years 31.The most main route of transmission for AIDS is: A.Sexual contact B.Receiving blood and blood products C.Abuser of intravenous drug D.Receiving organs or tissues E.Eating uncooked food 32.Which drug is used for the treatment of pneumocystis carinii pneumnia. A.pentamidine B.Bleomycin C.spiromycin D.clindamycin E.Gancyclovir 33.Adhere to epithelial cell of group A -hemolytic streptococcus rely on: A.Protein M B.Thythrogenic toxin C.Lipoteichoic acid D.Hymolysins E.Hyaluronic acid 34.The common clinical manifestations of common form of epidemic cerebrospinal meningitis are: A.Obvious upper respiratory symptoms, headache, fever, petechiae, neck stiffness B.Abrupt onset, headache, vomiting, maculopapules on the skin, neck stiffness C.Abrupt onset, vague upper respiratory symptoms, fever, headache, petechiae in skin, neck stiffness D.Obvious symptoms of prodrome, headache, vomiting, petechiae, neck stiffness E.Abrupt onset, high fever, convulsions, hypotension, neck stiffness 35.The specific sign of measles in the prodromal period is: A.fever B.catarrhea C.rash D.Koplik’s spot E.strawberrry tongue 36.Pigmentation may be seen after rashes fade in: A.measles B.varicella C.rubella D.Scarlet fever E.typhoid fever 37.Desquamation can be seen in: A.epidemic cerebrospinal meninqitis B.scarlet fever C.rubella D.Varicella E.Herpes zoster 38.Leukopenia is ususlly seen in : A. scarlet fever B. measles C.epidemic cerebropinal meningtis D. Bacillary dysentery E. Epidemic encephalitis B 39.The incubation period of SSPE is: A.2~17 years B.2~10 years C.1~2 years D.3 weeks E.3~5 years 40.Which one is patient with AIDS: A.PGL B.PGL+ARS C.Anti-HIV(+) D.CD4+:CD8+ <1+ anti-HIV(+) E.Anti-HIV(+)+opportunistic infection or tumor 41.How many serotypes does erythrogenic toxin have: A.19 B.80 C.5 D.10 E.7 42.Which one is late complication of the scarlet fever: A.Otitis media B.Cellulitis C.Pharyngitis D.Septicemia E.Acute glomerulonephritis 43.Which form of epidemic cerebrospinal meningitis is the most dangerous: A.Common form B.Shock type of fulminant form C.Cerebromeningitis type of fulminant form D.Mixed type of fulminant form E.Chronic septicemic form 44.Main evidence of diagnosing scarlet fever is: A.Fever, eruption in 4th day from onset, petechiae or ecchymosis B.Fever, pharyngitis, congested gooseflesh, strawberry tongue and desquamation after rash C.Finding G- diplococci in petechiae D.In blood culture finding a-hemolytic streptococcus E.Pigmentation after rash 45.Which one of the shock type of fulminant epidemic cerebrospinal meningitis is incorrect: A.Violent chills, high fever, dizziness, headache and profound weakness B.Petechiae appearing on the extremities, and rapidly increasing in number and coalescing C.circulatory failure D.Normal CSF E.Obvious meningeal irritant signs 46.Main sources of infection of leptospirosis are: A.Patients and carriers of leptospires B.Rats and pigs C.Rats and patients D.Pigs and patients E.Dogs and cats 47.The evidence of making a correct diagnosis of poliomyelitis is: A.Features of paralysis B.Changes of CSF C.Menigeal irritation sign D.Impaired consciousness E.Not any above 48.Which clinical type of poliomyelitis is the most commom: A.Paralytic type B.Non-paralytic type C.Brain type D.Covert infection E.Abortive infection 49.Which drug is the first choic for preventing malaria? A.Quinine B.Chloroquine C.Pyrimethamine D.Primaquine E.Mefloquine 50.Which is type A of infectious disease? A.Smallpox B.Rabies C.Poliomyelitis D.Cholera E.Scarlet fever 51.Pathogen of the scartler fever is: A.group A – hemolytic streptococcus B.group A – hemolytic streptococcus C.group B – hemolytic streptococcus D.group A – hemolytic streptococcus E.group C – hemolytic streptococcus 52.Which one is passive immunization? A.Typhoid vaccine B.P.P.D. C.Measles vaccine D.Diphtheria toxoid E.Tetanus antitoxin 53.The most common complication of the measles is: A.heart failure B.encephalitis C.laryngitis D.bronchopneumonia E.secondary infection 54.The basic features of infectious disease are? A.Infectivity,mode of transmission, immunity and epidemiologic features. B.Infectivity,immunity epidemicity and seasonal. C.Pathogen,immunity,infectivity and mode of transmission. D.Pathogen,immunity,infectivity and epidemiologic features. E.Infectivity,pathogen,immunity,epidemicity and susceptibility. 55.What is the principal measure to wipe out alimentary infectious diseases? A. Isolation of source of infection. B. Patients therapy C. Protection of susceptible population. D. Cutting off the route of transmission. E. Observatoin of contactor. 56.HBsAg can not be detected in the serum of A. Patients with acute hepatitis B. B. Patients with chronic hepatitis B. C. Carriers of HBV. D. Persons who have received hepatitis B vaccines. E. Cirrhosis caused by hepatitis B virus. 57.Three factors of the infective process are: A. Source of infection,route of transmission,population of susceptibility. B. Dosage,pathogenicity and specific location of pathogen. C. Pathogen,vector and host. D. Pathogen,host and route of transmission. E. Pathogen,host and enviroment. Questions58-61 A.IgG B.IgM C.IgA D.IgE E.IgD 58.r-globulin for prevention and treatment of infectious diseases contains: 59.The most significant antibody for the early diagnosis of infectious diseases is: 60.Which can pass through the placenta? 61.Major agglutinin in serum is: Questions 62-64 A.the first day B.the second day C.the fourth day D.the fifth day E the sixth day 62.When does the rash of chickenpox appear after onset of the disease? 63.When does the rash of scarlet fever appear after onset of the disease? 64.When does the rash of typhus appear after onset of the disease? 65.Pathogens invade into the host and cause mild damage of the tissues.There are no clinical manifestations or only atypical symptoms and signs.But there are specific antibodies in the serum.This condition is called: A.To clear out pathogens. B.Latent infecton C.Carrier state. D.Covert infection. E.Overt infection. 66.Which is correct in the following items? A. Most of chronic hepatitis in mild degree edevelop cirrhosis. B.There is no chronic hepatitis A. C.Hepatitis C can not develop cirrhosis. D.Chronic active hepatitis is only caused by HBV. E.Hepatocellular carcinoma is not related to HCV. 67.In acute fulminant hepatitis,the most signigicant clinical manifestation for diagnosis is: A.Progressive deep jaundice. B.Rapid shrink of the liver. C.The symptoms of C.N.S. D.Hemorrhagic tendency. E.Toxic intestinal tympanites. 68.The aim of using lactulose in fulminant hepatitis is: A.To increase the nutrition of liver. B.To supply the energy. C.To reduce the absorption of ammonia. D.To reduce the necrosis of liver cells. E.To increase the regeneration of liver cells. 69. A 18 year female was found HBsAg positive in health check up 2 years ago,but without symptoms and signs,and the liver functions were normal. 1 week ago, she was admitted for fever, weakness, vomiting and jaundice of sclera. ALT 1200U/L,TBil 167umol/L , anti-HAV IgM(+),Anti-HBc IgG(+), HBsAg(+),HBVDNA(-) .The diagnosis may be: A. Acute hepatitis A(icteric type) and HBsAg chronic carrier. B. Chronic hepatitis B(mild degree). C. Chronic hepatitis B(moderate degree). D. Acute hepatitis A and acute hepatitis B. E. Acute hepatitis A and chronic hepatitis B(mild degree). . 70.The most common pathogen causing icteric hepatitis in children is: A.HAV. B.HBV. C.HCV. D.HEV. E.HDV. 71.The antibody protecting human body from hepatitis B is: A.Anti-HBs B.Anti-HBcIgM C.Anti-HBcIgG. D.Anti-DNA E.Anti-HBe. 72.The patient with HBsAg(+) and HBeAg(+) has: A.No infectivity. B. Immunity. C. Inactive disease. D.Active disease. E. Infectivity. 73.The main route of transmission for hepatitis A is: A.By injection and blood transfusion. B. By droplets in the air. C. By saliva. D.By fecal-oral. E. By vertical transmission. 74.The most sensitive serum enzyme for diagnosing viral hepatitis is: A.AST. B.ALT. C.ALP. D.r-GT. E.LDH. 75.Human can not suffer from paragonimiasis by: A. Ingesting crayfish curd. B. Eating raw crabs and crayfishes. C. Drinking contaminated water. D. Eating raw meat of wild boar. E. Eating raw shrimps. 76.The chronic carrier of typhoid fever is that: A.The period of discharge of bacteria is no more than 1 month B.The period of discharge of bacteria is no more than 2 months C.The period of discharge of bacteria is no more than 3 months D.The period of discharge of bacteria is more than 3 months E.The period of discharge of bacteria is more than 6 months 77.What is the main factors that cause the sustained fever and toxic symptoms in typhoid fever? A.The typhoid bacilli multiply at local site and invade into blood constantly B.The typhoid bacilli multiply largely in blood C.The endotoxin released by typhoid bacilli acts upon the central of regulating temperature D.Delayed allergy E.The endogenous pyrogen released by macromononuclear cells in site of lesion A girl, 6 month old, high fever 3 days, the temperature 40 ℃, the typhoid bacilli was positive in blood culture, widal test:“H” and “O”were negative. 78.What disease did the child suffer from? A.The carrier of bacilli of typhoid fever B. Ambulatory type of typhoid fever C. The common type of typhoid fever D.The bacteremia of typhoid bacillI E. No infection of typhoid fever 79.What is the main complication of this disease? A.Toxic hepatitis B. Toxic myocarditis C. Intestinal bleeding D.Intestinal perforation E. Bronchopneumonia 80.Which one is the most significant manifestation of toxic bacillary dysentery? A.Onset abruptly B. Diarrhea C. High fever,coma and convulsion D.Shock in early time E. Respiratory failure 81.Chronic bacillary dysentery relates to the following factors, except for: A.The bacteria having a strong virulence B.Treating without thorougly and not in time C.Hypotrophy D.Chronic cholecystitis E.Intestinal parasitosis Questions 82~84: A. fever+abdominal pain +diarrhea+stool with pus and blood B. fever+ abdominal pain +diarrhea+stool like jams C. fever+ abdominal pain +diarrhea+watery stool D. no fever+ abdominal pain +diarrhea+watery stool E. no fever+no abdominal pain +diarrhea+watery stool 82.Ameba dysentery has: 83.Bacillary dysentery has: 84.Cholera has: 85.Since 1961,the pathogen of the 7th pandemic of cholera in the world is: A.Classical biotype B.EL-Tor biotype C.O139 biotype D.O137 biotype E.O157 biotype A female,22 years old, was hospitalized because violent diarrhea and profuse vomitting,no fever, no abdominal pain, the diarrhea is more than 10 times with a large amount of watery stool. 86.The diagnosis may be : A.Bacillary dysentery B.Poisoning of food C.Acute gastroenteritis D.Cholera E.Other 87.In order to make clinical diagnosis ,what is the first choice of the test? A. Blood routine B. Stool routine C. Smear of stool D. Culture of stool E. Culture of blood 88.According to <the prophylaxis and treatment laws of infectious disease of P.R of China>,when should this disease be reported to epidemic prevention station in town and in countryside: A.3 hours and 6 hours B.6 hours and 12 hours C.12 hours and 24 hours D.24 hours and 48 hours E.<3 hours 89.which is the most important treatment to this patient? A.Injection of cirofloxacin B.Injection of 0.9%N.S C.Injection of 5%bicarbonas solution D.Injection of humorous E.Injection of dopamine 90.A patient, with intermittent fever for 20days,and parasitic protozoa were found in blood thick smear,the most obvious sign in the patient may be: A.Enlargement of lymph node B. Jaudice C. Hepatomegaly D.Splenomegaly E. Herpes simplex on lips 91.the common radical treating plan of malaria is: A.Chloroquine+Pyrimethamine B. Chloroquine+Primaquine C. Quinine+ Pyrimethamine D.Quinine+ Primaquine E. Quinine+ Pyrimethamine 92.Which is the drug most easily causing the Black-Water Fever in malaria? A.Chloroquine B.Pyrimethamine C.Primaquine D.Artemisinine E.Quinine 93.The classical attacks of malaria appear in following patients except for: A.The early period of tertian malaria B.Malignant malaria C.Malaria of infant D..Malaria from transfusion of blood E.The co-infection of different kinds of protozoa 94.Which change of blood picture is the most significant for the diagnosis of typhoid fever? A.Thrombocytopenia B.Leukocytosis+increased eosinophiles C.Leukopenia+decreased eosinophiles D.Lymphocytosis+ increased eosinophiles E.Lymphocytosis+decreased eosinophiles 95.The course of chronic bacillary dysentery is beyond: A.Two months B.Three months C.Six months D.One week E.One year 96.The first choice drug for treatment of typhoid fever is: A.Penecillin B.Ampicillin C.Ofloxacin D.Chloromycetin E.SMZco. 97.In bacillary dysentery,pathological changes are the most severe in: A.Cecum B. Lower part of ileum C. Sigmoid and rectum D.Ascending colon E.Descending colon 98.What is the vector of transmission of malaria: A.Pig B.Rat C.Anopheles minimus D.Anopheles Hyrcanus Sinensis E.Culex Tritaenio-rhynchus 99.The examinations of cholera don‘t include: A.Direct observation of the stool B. Fecal smears C. Fecal culture D.Urine test E. Anti-bacterial agglutinin 100.Evidence of making a definite diagnosis for epidemic cerebrospinal meningitis is: A.season B.high fever, headache, vomiting and petechiae C.signs and symptoms of cerebromeningitis D.find meningococcus in petechiae E.purulent CSF Fill in blank (0.5 point/each) 1.The mediated host of plasmodium.is (1) , the final host of plasmodium.is (2) . 2.Schistosoma japonica mainly parasite in (3) vein and (4) vein。 3.Clorchis Sinensis parasite in (5) of human ,the first choice drug for Clorchiasis Sinensis is (6) . 4.Poliovirus belongs to (7) family, virus, and can be distinguished in (10) (8) genus, which is types. (9) Simply answer question(3 point/each): 1.What are the clinical type of bacillary dysentery? 2.The high risk populations of AIDS. 3.Please answer the clinical manifestation of late stage of schistosomiasis japonica. 4.What is the conception of incubation period and it’s significance? 5.How to differentiate epidemic encephalitis B from toxic bacillary dysentery? Answer question(5 point/each): 1.What are the early clinical diagnosis criterion and definite diagnosis criterion of measles? 2.please to recount the mechanism of violet diarrhea and vomiting in cholera. 3.What are the route of transmission for viral hepatitis B? 4.Please describe in detail the three antigen-antibody systems of hepatitis B virus (HBV) and its significance. 5.What are the main treatment measures of fulminant type ofepidemic cerebrospinal meningitis? 6.Please try to describe the main changes of blood and urine routine examination in HFRS? 85k 7years Class :Examination of Infectious Disease (B) Answer sheet: Multiple choice answer: 1.C 2.C 3.C 4.B 5.B 6.D 7.D 8.D 9.C 10.A 11.D 12.E 13.A 14.E 15.B 16.D 17.C 18.E 19.A 20.B 21.E 22.B 23.B 24.C 25.B 26.E 27.B 28.C 29.E 30.C 31.A 32.A 33.C 34.C 35.D 36.A 37.B 38.B 39.A 40.E 41.C 42.E 43.D 44.B 45.E 46.B 47.E 48.D 49.C 50.D 51.A 52.E 53.D 54.D 55.D 56.D 57.A58.A 59.B 60.A 61.B 62.A 63.B 64.D 65.D 66.B 67.C 68.C 69.A 70.A 71.A 72.E 73.D 74.B 75.E 76.D 77.C 78.C 79.C 80.D 81.A 82.B 83.A 84.E 85.B 86.D 87.C 88.B 89.B 90.D 91.B 92.C 93.D 94.C 95.A 96.C 97.C 98.C 99.D 100.D Blank answer: (1)human (2) mosquito (3) inferior mesenteric (4) superior rectal hemorrhoid . (5)intrahepatic bile duct (6) pyquiton (7)picornaviridae (8)enterovirus (9)RNA. (10)three serum Simply Answer Question(3 point): 1. Acute bacillary dysentery: mild type , typical type, toxic type (shock form, brain form,mixed form); Chronic bacillary dysentery: chronic delayed type,chronic latent type,acute attack type 2.male homosexual; drug abusers; people who have multiplesexual parters; hemophilia patients, receipt of blood or blood products. 3. giant spleen type, hypersplenism; ascites type; colon granuloma type, abdominal pain ,diarrhea ,constipation even abdominal dullness,intestinal obstruction; dwarf type. 4.the period from invading of pathogen to appearing first symptom is called incubation period. To help diagnosis, to determine guarantine period. 5. Epidemic encephalitis B Toxicbacillary dysentery onset abrupt More abrupt CSF abnormal normal Stool examination Circulatory failure Meningeal irritation normal A lot of RBC,WBC — + + — <24h Answer question(5 point/each): 1.the early clinical diagnosis criterion: 1).Fever; 2).Catarrhal inflammation of URT; 3).Koplik’s spots; 4).anti-measles-IgM positive in blood definite diagnosis criterion: 1).Fever; 2).Catarrhal inflammation of URT; 3).Koplik’s spots; 4).anti-measles-IgM positive in blood 5).Maculopapular 2.Bacteria enter small intestine, then attach to brush border of epithelia cell and release choleragen which divide into A and B subunits. B subunit is binding subunit by specific receptor GM1, A subunit acts on intestinal membrane cell, actives adenyl cyclase that transform ATP into cAMP, than the later as a the second message r act on crypt cell to secrete a large amount of cl- 、H2o and HCO3 ,meanwhile intestinal membrane cells of villus reabsorb Na+ decreasingly. 3. 1)Humoral transmisson or parenteral transmisson.. 2) Mather to infant transmission or vertical transmission 3)Sexual contact transmission 4)Insect transmission 4. HBsAg-anti-HBs HBeAg-anti-HBe HBcAg-anti-HBc(IgM,IgG) 1)HBsAg including HBsAg, pre-s1, s2 antigen, they are the markers of infectivity. Anti-HBs is α kind of protective antibody. Anti-pre-s2 may have the action of clearing virus. 2) HBcAg is the marker of the replication of HBv. Anti-HBc IgM is α marker of acute infection and acute attack of chronic infection of HBV. Anti-HBc IgG is the marker of past infection of HBV. But high titer of anti-HBc IgG is α marker of low level replication of HBV. 3) HBeAg is α reliable indicater of active replication of HBV. 5.fulminant form: 1). Shock type: (1)pathogenic therapy: penicillin (2)anti-shock: replacement of fluid and correct acidosis. 654-2: 0.3~0.5mg/kg/time, 10~15 min. steroid:hydrocortisone: adult:100~150mg/day child: 8~10mg/kg/day, <3d. anti-DIC: heparin: 0.5~1mg/kg, 4~6h. protective organ: cardiotonic drugs 2) .meningoencephalitis type: pathogenic therapy: penicillin decrease intracranial hypertension; 20%mannitol:adult:1~2g/kg/time, child: 0.25g/k/time ,q4~6h steroid; dexamethason:10~20mg/time anti-respiratory failure; treatment of high fever and convulsion 6.Blood routine examination: WBC15~30×109/L , thrombocytopenia, heteromorphic lymphocyte increase Urine routine examination: proteinuria , hemoturia (RBC), cast, membranoid substance, large diffuse cell.