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Lesson

Rickettsia. Biological properties. Laboratory diagnostics of rickettsiosis. Serological diagnostics of the epidemic and endemic (murine) typhus, Q-fever.

1. Rocky Mountain Spotted Fever is caused by...

a. *rickettsia rickettsia

b. rickettsia prowazekii

c. coxiella burnetii

d. rickettsia typhi

2. Epidemic typhus is caused by(louse borne)

a. rickettsia typhi

b. salmonella typhi

c.* rickettsia prowazekii

d. shigella sp.

3. Each of the following statements concerning neisseriae is correct EXCEPT:

a. *Gram-positive bacilli that are obligate intracellular parasites of eukaryotic cells

b. Rickettsiaceae genus consists of two antigenically defined groups: spotted fever group and typhus group

c. Bacteria found in ticks, lice, fleas, mites, chiggers, and mammals.

d. These zoonotic pathogens cause infections that disseminate in the blood to many organs.

4. Determine the INCORRECT route of transmission for Rickettsia-infection:

a. Fecal – oral route by ingestion

b. Sexual intercourse

c. Parenteral

d. *By the bite of infected ticks or mites or by the feces of infected lice or fleas

Lesson

Pathogenic cocci. Staphylococci and streptococci. Morphology and biological properties. Laboratory diagnostics of suppurative and non-suppurative lesions caused by them.

1. Your patient has subacute bacterial endocarditis caused by a member of the viridans group ofstreptococci. Which one of the following sites is MOST likely to be the source of the organism?

A) Skin

B) Colon

C) *Oropharynx

D) Urethra

2. A culture of skin lesions from a patient with pyoderma (impetigo) shows numerous colonies surrounded by a zone of beta hemolysis on a blood agar plate. A Gram-stained smear shows gram-positive cocci. If you found the catalase test to be negative, which one of the following organisms would you MOST probably have isolated?

A) Streptococcus pyogenes

B) Staphylococcus aureus

C) *Staphylococcus epidermidis

D) Streptococcus pneumoniae

3. The coagulase test, in which the bacteria cause plasma to clot, is used to distinguish

A) Streptococcus pyogenes from Enterococcus faecalis

B) Streptococcus pyogenes from Staphylococcus aureus

C) *Staphylococcus aureus from Staphylococcus epidermidis

D) Staphylococcus epidermidis from Neisseria meningitides

4. Which one of the following is considered a virulence factor for Staphylococcus aureus?

A) A heat-labile toxin that inhibits glycine release at the internuncial neuron

B) An oxygen-labile hemolysin

C) Resistance to novobiocin

D) *Protein A that binds to the Fc portion of IgG

5. The MOST important contribution of the capsule of Streptococcus pneumoniae to virulence is

A) To prevent dehydration of the organisms on mucosal surfaces

B) *To retard phagocytosis by polymorphonuclear leukocytes

C) To inhibit polymorphonuclear leukocyte chemo taxis

D) To accelerate tissue invasion by its collage-nase-like activity

6. The MOST important way the host circumvents the function of the pneumococcal polysaccharide capsule is via

A) T lymphocytes sensitized to polysaccharide antigens

B) Polysaccharide-degrading enzymes

C) *Anticapsular antibody

D) Activated macrophages

7. Which one of the following is NOT a characteristic of the staphylococcus associated with toxic shock syndrome?

A) Elaboration of enterotoxin F

B) Coagulase production

A) Appearance of the organism in grapelike clusters on Gram-stained smear

C) *Catalase-negative reaction

8. Which one of the following is NOT an important characteristic of Streptococcus pyogenes?

A) *Protein A

B) M protein

C) Beta-hemolysin

D) Polysaccharide group-specific substance

9. Of the organisms listed below, which one is the MOST frequent bacterial cause of pharyngitis?

A) Staphylococcus aureus

B) Streptococcus pneumoniae

C) *Streptococcus pyogenes

D) Neisseria meningitides

10. Over 50 children at an elementary school became violently ill several hours after eating lunch. All of the affected children ate sweet rolls. They developed severe nausea and vomiting, and some additionally developed abdominal cramps and non-bloody diarrhea. All of the students felt much better by the following morning. Gram’s stain of a smear taken from the presumed source of the food poisoning shows abundant gram-positive cocci in grape-like clusters. Which of the following is the most likely causative agent?

A) Bacillus cereus

B) Escherichia coli

C) *Staphylococcus aureus

D) Streptococcus pneumoniae

E) Streptococcus pyogenes

11. A 32-year-old female presents with high fever (390C), shortness of breath and cough productive of pink sputum. She reports that she was well the previous night but awoke with a shaking chill which lasted 20 minutes. A gram stain of this patient’s sputum has demonstrated lancet-shaped gram-positive diplococci, surrounded by capsule. The most likely causative agent is

A) Staphylococcus aureus

B) Streptococcus pyogenes

C) *Streptococcus pneumoniae

D) Klebsiella pneumoniae

E) Yersinia pestis

12. Laboratory assistant isolated from pus spherical bacteria arranged in grape-like clusters in the smear. What group do these microorganisms belong to?

A – micrococci; B – streptococci;

C- *staphylococci; D- sarcina;

E- tetracocci; F- diplococci

13. Laboratory assistant isolated from nasopharyngeal mucus spherical bacteria arranged in chains in the smear. What group do these microorganisms belong to?

A – micrococci; B – *streptococci;

C- staphylococci; D- sarcina;

E- tetracocci; F- diplococci

14. Some bacteria can cause generalized infection due to ability to split host tissue and spread from the site of entry. Choose from the list invasion factors of pathogenic cocci:

A) Endotoxins

B) *Virulent enzymes

C) Adhesins

D) Exotoxins

E) Antiphagocytic factors

15. Which virulent factor of pathogenic cocci from following capable of splitting connective tissue of a host?

A) Plasmocoagulase

B) *Hyaluronidase

C) IgA protease

D) Fibrinolysine

E) Hemolysine

16. Which medium should be used to isolate and distinguish streptococci with hemolytic properties?

A) Meat-peptone gelatin

B) *Blood agar

C) Hiss media

D) Meat-peptone broth

E) Serum agar

17. Which nutrient medium is the most convenient to isolate pure culture staphylococci from the clinical sample?

A) Semisolid medium

B) *Solid medium

C) Liquid medium

D) Minimal medium

The bank of Krok-1 tests

1. Furuncle pus smear showed spherical microbes arranged in grape-like clusters. Name these microorganisms.

A. *Staphilococci.

B. Diplococci.

C. Micrococci.

D. Streptococci.

E. Tetracocci.

2. A child with the diagnosis of staphylococcal sepsis was admitted to a hospital. What nutrient medium should be used for patient's blood inoculation to isolate the causative agent of this disease?

A. Ploskirev's medium.

B. Meat peptone broth.

C. *Glucose peptone broth.

D.Buchin's medium.

E. Yolk-salt agar.

3. Feces of a child with enteritis are resuspended in isotonic solution of sodium chloride, and a suspension drop is applied onto selective medium: 10 % milk-salt or yolk-salt agar. What microorganisms are supposed to be isolated?

A. E. coli.

B. *Staphylococci.

C. Streptococci.

D.Klebsiella.

E. Enterococci.

4. A 55-year-old patient is hospitalized to a surgical department with suspicion of sepsis. Choose the specimen which should be obtained for examination.

A. Liquor.

B. *Blood.

C. Urine.

D.Pus.

E. Lymph node punctate.

5. Microbiology examinations are carried out in the neonatal department of a maternity hospital because of the suspicion of a hospital infection. S. aureus from several children and some things was isolated. What properties of isolated cultures should be examined to determine the source of infection?

A. Biochemical activity.

B. Chrornogenesis.

C. Antigenic structure.

D. *Phage type.

E. Antibiotic sensitivity.

6. Cases of suppurative postoperative complications caused by staphylococcus have increased in a surgical unit. Which test should be used to determine the source of infection?

A. Drugs susceptibility test.

B. Serotyping test.

C. Aggression enzymes determination.

D.Toxin production.

E. *Phage typing.

7. Cholecystic infection was caused by microorganisms of spherical oblong form situated in pairs or short chains. On the basis of biological properties the bacteria were referred to group D streptococci. What is their name?

A. β-hemolytic streptococci.

B. α-hemolytic streptococci.

C. Pyogenic streptococci.

D.*Enterococci.

E. Pneumococci.

8. Gram-positive diplococci were revealed during the examination of a patient's sputum. Which microorganism is the most likely to cause the disease?

A. Legionella pneumophila.

B. Neisseria meningitidis.

C. Klebsiella pneumoniae.

D. Mycoplasma pneumoniae.

E. *Streptococcus pneumoniae.

9. Microscopy of the sputum of a patient with croupous pneumonia revealed numerous Gram-positive lanceolate diplococci surrounded by a capsule. Name the most likely causative agent.

A. Chlamidia pneumoniae.

B. Klebsiella pneumoniae.

C. *Streptococcus pneumoniae.

D. Staphylococcus aureus.

E. Escherichia coli.

10. A 12-year-old boy after angina has rheumatic damage of heart. Every successive streptococcal infection worsens the condition of the patient. What preparation is expedient to use for the prevention of complications?

A. Streptococcic toxoid.

B. *Benzylpenicillin sodium salt.

C. Streptococcic bacteriophage.

D. Donor γ-globulin.

E. Autovaccine.

11. A doctor has suspected scarlet fever of a 2-year-old child with catarrh and skin rash. A small quantity of serum against streptococci erythrogenic toxin has been injected intracutaneously. In the place of injection the rash disappeared. What do reaction results indicate?

A. The whole doze of serum can be injected intravenously.

B. The child is hypersensitive to erythrogenic toxin.

C. The disease has been caused by a nonhemolytic streptococcus.

D.*The clinical diagnosis has proved to be true.

E. Immune system of the child is considerably impaired.

Lesson

Pathogenic Gram-negative cocci. Gonococci and meningococci. Biological characteristics and laboratory diagnostics of diseases.

1. Laboratory assistant isolated from spinal fluid samples Neisseria meningitidis (oval cocci arranged in pairs with adjacent sides concave in the smear). What morphological group do these microorganisms belong to?

A – micrococci; B – streptococci;

C- staphylococci; D- sarcina;

E- tetracocci; F- *diplococci

2. A 19-year-old male presents with dribble and painful urination (strangury), purulent discharge from urethra and subfebrile temperature. Two days ago he had sexual intercourse with his girlfriend without condom. Venereologist took discharge for microscopy. Which microscopic picture from following confirms diagnosis “gonorrhea”?

a. Gram-negative rods and leucocytes in the smear

b. Gram-positive cocci located within leucocytes and outside

c. *Gram-negative bean-shaped diplococci located free and within leucocytes

d. Spiral gram-negative bacteria

e. Gram-negative ovoid small rod located into epithelial cells

3. Which one of the following is NOT an important characteristic of either Neisseria gonorrhoeae or Neisseria meningitidis?

A. *Polysaccharide capsule

B. gA protease

C. M protein

D. Pili

4. Which nutrient medium is the most convenient to isolate pure culture Neisseria meningitidis from the clinical sample?

A. Meat-peptone agar

B. McConcy agar

C. Hiss media

D. Meat-peptone broth

E. *Serum agar

5. Laboratory assistant isolated from cervical samples Neisseria gonorrhoeae (oval cocci arranged in pairs with adjacent sides concave in the smear). What morphological group do these microorganisms belong to?

A – micrococci; B – streptococci;

C- staphylococci; D- sarcina;

E- tetracocci; F- *diplococci

6. Which nutrient medium is the most convenient to isolate pure culture Neisseria gonorrhoeae from the clinical sample?

a. Meat-peptone agar

b. McConcy agar

c. Hiss media

d. Meat-peptone broth

e. *Serum or ascitic agar

7. Each of the following statements concerning neisseriae is correct EXCEPT:

A) They are gram-negative diplococci

B) They produce IgA protease as a virulence factor

C) They are oxidase-positive

D) *They grow best under anaerobic conditions

8. Each of the following statements concerning Neisseria meningitidis is correct EXCEPT:

A) It is an oxidase-positive, gram-negative diplococcus

A) It contains endotoxin in its cell wall

B) *It produces an exotoxin that stimulates adenylate cyclase

C) It has a polysaccharide capsule that is antiphagocytic

9. A 19-year-old male presents with dribble and painful urination (strangury), purulent discharge from urethra and subfebrile temperature. Two days ago he had sexual intercourse with his girlfriend without condom. Venereologist took discharge for microscopy. Which microscopic picture from following confirms diagnosis “gonorrhea”?

A. Gram-negative rods and leucocytes in the smear

B. Gram-positive cocci located within leucocytes and outside

C. *Gram-negative bean-shaped diplococci located free and within leucocytes

D. Spiral gram-negative bacteria

E. Gram-negative ovoid small rod located into epithelial cells

The bank of Krok-1 tests

1. Pure culture of cocci-like microorganisms of urethral discharge was isolated from a patient with chronic urethritis. The culture fermented only glucose to acid in the standard Hiss' medium. Name the species of these microorganisms.

A. *Neisseria gonorrheae.

B. Neisseria meningitidis.

C. Staphylococcus aureus.

D. Streptococcus pyogenes.

E. Enterococcus faecalis.

2. Bacteriological examination of pus urethral discharge revealed Gram-negative bacteria of coffee beans shape, which fermented glucose to acid and were found in leukocytes. To what disease causative agents can they be referred?

A. Syphilis.

B. *Gonorrhea.

C.Venereal lymphogranulomatosis.

D.Soft chancre.

E. Leptospirosis.

3. Pus from urethra was inoculated onto special nutrient medium. Tender bluish colonies grew. Microscopical examination revealed Gram-negative bean-shaped diplococci. What disease do they cause?

A. Syphilis.

B. Chlamidiosis.

C. *Gonorrhea.

D. Tularemia.

E. Myeloidosis.

4. An ophthalmologist has suspected blennorrhea (gonococcal conjunctivitis) of a sick child with purulent keratoconjunctivitis. What methods of laboratory diagnostics should be used for the confirmation of the diagnosis?

A. Microscopic and serologic.

B. Serologic and allergic.

C. Biological and phage typing.

D. Biological and allergic.

E. *Microscopic and bacteriological.

5. During bacterioscopic examination of the purulent discharge from the uterus there were revealed Gram-negative bean-like diplococci situated in leukocytes and out of them. Which microorganism is the causative agent of the purulent inflammation of the uterus?

A. Chlamidia trachomatis.

B. *Neisseria gonorrhoeae.

C. Haemophilus vaginalis.

D.Trichomonas vaginalis.

E. Calymmatobacterium granulo-matis.

6. A sick woman has gonorrhea diagnosed on the basis of clinical symptoms. Which method is the most rational for confirmation of the diagnosis?

A. Precipitation test.

B. Infection of laboratory animals.

C. Test with bacteriophage.

D. Hemagglutination test.

E. *Microscopy of pathological material.

7. Urethral purulent discharge is inoculated onto special nutrient medium. There have grown tender bluish colonies. Microscopy has shown Gram-negative bean-shaped diplococci. What disease do they cause?

A. Chlamidiosis.

B. *Gonorrhea.

C. Syphilis.

D.Tularemia.

E.Toxoplasmosis.

8. A bacteriologist using a bacterioscopic test of nasopharynx mucus hasrevealed Gram-negative cocci that resemble coffee beans and are located in pairs or tetrads. Which microorganism was isolated by the bacteriologist?

A. Acinetobacter calcoaceticus.

B. Hemophilus ifluenzae.

C. Streptococcus pneumoniae.

D.Moraxella lacunata.

E. *Neisseria meningitidis.

9. A doctor has diagnosed meningococcal nasopharyngitis of a child with nasopharyngitis. What method of laboratory diagnostics is the most rational for diagnosis confirmation?

A. Serologic.

B. Biological.

C. *Bacteriological.

D. Microscopic.

E. Allergic.

10. From a child with cerebrospinal meningitis there was obtained muddy spinal fluid with numerous leukocytes. Which test should be used for express-diagnostics of the disease?

A. Complement fixation test.

B. Agglutination.

C. *Immunofluorescence test.

D. Hemagglutination.

E. Neutralization.

11. In a kindergarten children and personnel were examined with the purpose of detecting meningococcal carriers. What method of microbiological research should be used?

A. Allergic.

B. *Bacteriological.

C. Bacterioscopic.

D. Biological.

E. Serologic.

Lesson

Enterobacteria. Biological characteristics and classification of family. Characteristics of genera Escherichia, Shigella. Pathogenesis, laboratory diagnostics of coli-enteritis and bacterial dysentery.

1. Within a two-day period, a pediatrician in a rural community sees sixteen children between the ages of 2 and 6 with gastroenteritis. The illness began with a fever and abdominal pain. The diarrhea was initially watery, but in some patients, subsequently became mucoid and bloody. Three days before the onset of illness, all of the children had attended a picnic at a city park where they played in a wading pool later found to have an inadequate level of chlorination. Feces cultures performed on these children showed a nonmotile Gram negative rod that did not split lactose. Which of the following organisms is the most likely cause of the illness?

a. Enterohemorrhagic E.coli

b. Vibrio cholerae

c. *Shigella flexneri

d. Salmonella enteritidis

e. Yersinia enterocolitica

2. Five days after eating rare hamburgers at a cookout, a 46-year old man presents to his primary care physician with abdominal pains, nausea, and diarrhea. Stool culture grows translucent colonies of motile gram-negative bacteria on MacConkey agar which fermented glucose, maltose and mannitol with acid and gas formation. Which of the following organisms is the most likely cause of the illness?

a. *Enteropathogenic E.coli

b. Shigella sonnae

c. Salmonella enteritidis

d. Salmonella typhi

e. Proteus vulgaris

3. The pathogenesis of which one of the following organisms is MOST likely to involve invasion of the intestinal mucosa?

A) Vibrio cholerae

B) *Shigella sonnei

C) Enterotoxigenic Escherichia coli

D) Clostridium botulinum

4. Five hours after eating fried rice at a restaurant, a 24-year-old woman and her husband both developed nausea, vomiting, and diarrhea. Which one of the following organisms is the MOST likely to be involved?

A) Clostridium perfringens

B) *Enterotoxigenic Escherichia coli

C) Bacillus cereus

D) Salmonella typhi

5. Which medium should be used to isolate and distinguish bacteria based on their ability to split lactose?

a) Meat-peptone agar

b) Meat-peptone broth

c) Blood agar

d) Serum agar

e) *Endo agar or Ploskirev one

The bank of Krok-1 tests

1. A 7-year-old boy has been diagnosed a cholera-like disease (vomiting,profuse diarrhea). The feces of the patient were inoculated onto Endo medium, and homotypic crimson colonies with metallic sheen have grown. Which microorganism is the most likely to be the causative agent of the disease?

A. Shigella sonnei.

B. Salmonella enteritidis.

C. Yersinia enterocolitica.

D.*Escherichia coli, enterotoxigenic type.

E. Vibrio holera.

2. A patient complained of nausea, liquid blood-streaked stool with mucus, fever, general weakness. He was hospitalized to the infectious department of a hospital. A doctor suspected shigellosis. What method of laboratory diagnostics should be administered to confirm this diagnosis?

A. *Bacteriological.

B. Serologic.

C. Mycological.

D. Microscopic.

E. Test on laboratory animals.

3. Pure culture of bacteria isolated from a patient with symptoms of colitis was identified as Shigella genus according to morphological, cultural, and biochemical properties. Which test should be used for serological identification of this culture?

A. Inhibition of hemagglutination.

B. Complement fixation test.

C. Indirect hemagglutination.

D. Precipitation.

E. *Agglutination with diagnostic serums.

4. Stool culture revealed S. zonnei. What additional researches should be carried out to determine the source of infection?

A. Drugs susceptibility test.

B. *Phage typing test.

C. Precipitation reaction.

D. Complement-fixing reaction.

E. Neutralization reaction.

5. Feces culture of a patient with typical clinical picture of shigellosis did not reveal shigella due to early treatment with antibiotics. But antishigellosis antibodies titer in PHAT in pair serums increased by four times. What does it mean?

A. Vaccinal reaction.

B. Excludes shigellosis diagnosis.

C. The patient was ill with shigellosis before.

D.Nonspecific reaction.

E. *Confirms shigellosis diagnosis.

6. Feces bacteriological examination of a patient with enteric infection revealed Shigella sonnei. Choose the serological reaction, which was used for the identification of the obtained pure culture.

A. Complement fixation test.

B. Precipitation.

C. *Agglutination.

D. Neutralization.

E. Lysis test.

Lesson 41

Enterobacteria. Salmonella. Biological characteristics of Salmonella, causing typhoid and paratyphoid fevers. Pathogenesis and laboratory diagnostics of enteric and paratyphoid fevers.

1. Typhoid fever may be acquired from all these sources EXCEPT:

f. Contaminated water

g. Contaminated food

h. A cook who is an asymptomatic carrier

i. A person with acute infection due to low sanitation

j. *A animal with diarrhea

2. Choose from following the main method for early laboratory diagnostics of typhoid fever:

a. *Isolation of blood culture

b. Isolation of bile culture

c. Isolation of urine culture

d. Widal test

e. Microscopy of blood smear

3. A 35-year-old female presents in surgical department with gastrointestinal bleeding. Three weeks ago she suffered from flu-like disease with high temperature, intoxication, and headache. Surgeon suspects typhoid fever. Which method of laboratory diagnostics from following may confirm diagnosis at late stage of typhoid fever?

a. Isolation of blood culture

b. *Widal test and isolation of stool culture

c. Biological method

d. Microscopy of stained smear from feces

e. Precipitation test

4. For which one of the following enteric illnesses is a chronic carrier state MOST likely to develop?

a. Campylobacter enterocolitis

b. Shigella enterocolitis

c. Cholera

d. *Typhoid fever

5. Which one of the following organisms that infects the gastrointestinal tract is the MOST frequent cause of bacteremia?

a. Shigella flexneri

b. Campylobacter jejuni

c. Vibrio cholerae

d. *Salmonella typhi

The bank of Krok-1 tests

1. After inoculation of feces specimen from a patient with typhoid fever onto Endo medium colonies of different size and color — big red and medium colorless - have grown. Name the functional type of this medium.

A. Selective.

B. Enriched.

C. Special.

D. *Differential-diagnostic.

E. Universal (general purpose).

2. From the blood of a patient there was obtained the culture of typhoid fever pathogen. What cultural

properties are characteristic of this pathogen?

A. Hemolysis on blood agar.

B. Formation of red colonies with metallic luster on Endo medium.

C. Formation of colorless colonies on bismuth-sulfite agar medium.

D. *Formation of colorless colonies on Endo medium.

E. Formation of a gentle pellicle on alkaline peptone water.

3. Feces of a restaurant cook with out any clinical symptoms of disease are examined with the help of bacteriological methods. On bismuth-sulfite agar little black colonies with metallic sheen have grown. What microorganisms can it be?

A. *Salmonellae.

B. Shigellae.

C. Escherichiae.

D. Staphylococci.

E. Streptococci.

4. A diagnosticum (processed with tannin sheep erythrocytes adsorbed by Vi-antigen of Salmonella typhi) has been used for serologic diagnostics of typhoid carrying. Choose the reaction, in which this diagnosticum will be used.

A. Precipitation.

B. Hemagglutination.

C. Hemagglutination inhibition reaction.

D. *Indirect (passive) hemagglutination.

E. Complement fixation test.

5. Inspection of school dining-room staff for typhoid carrying has been carried out. There were revealed antibodies to Vi-antigen in the blood serum of the cook. Which test has been used?

A. Complement fixation test.

B. Widal's test.

C. *Indirect hemagglutination test.

D. Enzyme immunoassay.

E. Immunofluorescence test.

6. A patient with typhoid fever suspected was administered blood culture. It is rational because during the first week of enteric fever the following phenomenon is observed:

A. Toxinemia.

B. *Bacteremia.

C. Septicemia.

D. Septicopyemia.

E. Viremia.

7. A patient (has been feeling ill during 3 days) was hospitalized to an infectious clinic with typhoid fever preliminary diagnosed. What method should be used to confirm the diagnosis?

A. *Hemoculture.

B. Coproculture.

C. Urine culture.

D.Biliculture.

E. Roseola culture.

8. Pure culture was isolated from a patient with typhoid fever suspected. The culture was identified as S. typhi by morphologic, cultural, and biochemical characteristics. What investigation should be used for final identification of the causative agent?

A. Serodiagnosis.

B. *Seroidentification.

C. Allergic diagnostics.

D. Antibiotic-sensitivity test.

E. Phage typing.

9. A patient with complaints of a three days' fever, general weakness, insomnia, deterioration of appetite referred to a doctor. The doctor has suspected typhoid fever. What method of laboratory diagnostics is the most rational for confirmation of the diagnosis?

A. Myeloculture.

B. Coproculture.

C. Urine culture.

D.Spinal fluid culture.

E. *Hemoculture.

10. Widal's test is used for the serologic diagnostics of typhoid fever. What mechanism of antigens and antibodies interaction underlies it?

A. Hemolysis.

B. Precipitation.

C. Bacteriolysis.

D. *Agglutination.

E. Bacteria immobilization.

11. Blood of a patient with typhoid fever has been sent to a laboratory for detecting antibodies. Which serological reaction should be used?

A. Hemagglutination inhibition.

B. Precipitation.

C. Complement binding.

D. Passive hemagglutination.

E. *Agglutination.

12. A patient was hospitalized to aninfectious department on the 8th day of the disease complaining of headache, general weakness. Blood was taken for serological examination. Widal's reaction of agglutination appeared to be positive in dilution 1:200 with O-diagnosticum Salmonella typhi. What diagnosis can be made?

A. Cholera.

B. Shigellosis.

C. *Typhoid fever.

D. Leptospirosis.

E. Tuberculosis.

Lesson 42

Enterobacteria. Salmonella causing acute gastroenteritis. Biological features and classification. . Pathogenesis and laboratory diagnostics of acute gastroenteritis caused by Salmonella.

1. Which of the following bacteria belong/s to the family Enterobacteriaceae?

a. Staphylococcus.

b. Streptococcus.

c. Neisseria

d. *Salmonella

2. Which one of the following host defense mechanisms is the MOST important for preventing dysentery caused by Salmonella?

a. *Gastric acid

b. Salivary enzymes

c. Normal flora of the mouth

d. Alpha interferon

3. Which of the following serotypes of Salmonella can cause gastroenteritis?

a. S. enteritidis.

b. S. newport.

c. S. typhimurium.

d. *All of the above.

4. Which of the following media is/are selective for Salmonella?

a. Wilson and Blair's brilliant-green bismuth

sulphite agar medium.

b. Bile salt agar.

c. Thiosulphate citrate bile salt agar.

d. *All of the above.

5. Which of the following media serve/s as enrichment medium/media for Salmonella?

a) Tetrathionate broth.

b) Brilliant green tetrathionate broth.

c) Selenite-F broth.

d) *All of the above.

6. Which of the following serotypes of Salmonella is/are non-motile?

a) *S. gallinarum.

b) S. typhimurium.

c) S. typhi.

d) All of the above.

7. Gastroenteritis is caused by:

a. Staphylococcus

b. Escherichia

c. Salmonella

d. *All of the above .

The bank of Krok-1 tests

1. A 12-year-old boy with food poisoning suspected was hospitalized. Feces culture on Endo medium revealed numerous colorless colonies. Name the microorganism, which can be excluded from the number of possible causative agents of this disease.

A. Pseudomonas aeruginosa.

B. *Salmonella enteritidis.

C. Proteus vulgaris.

D.Escherichia coli.

E. Yersinia enterocolitica.

2. During the bacteriological examination of gastric washings of a patient with food poisoning pure culture of bacteria with such properties was isolated: Gram-negative motile rods which form colorless colonies on Endo medium. Which microorganism species is the most likely to be the cause of the disease?

A. *Salmonella.

B. Shigella.

C. Yersinia.

D. Escherichia.

E. Citrobacter.

3. There is registered an outbreak of food poisoning connected with eating confectionery products, which were kept at room temperature and for preparation of which duck's eggs were used. What microorganisms could have caused this disease?

A. Vibrio cholerae.

B. E.coli.

C. Staphylococci.

D. Legionella.

E. *Salmonella.

4. Identification of food toxical infection causative agent has shown that according to biochemical properties it belongs to Salmonella genus. What property of the causative agent testifies its specific belonging?

A. Pathogenicity for laboratory animals.

B. Phagotype.

C. Culture properties.

D. *Antigenic structure.

E. Morphologic and staining properties.

Lesson

Opportunistic enterobacteria: Klebsiella spp. and Proteus spp.Pseudomonas aeruginosa. Biological features. . Pathogenesis and laboratory diagnostics of opportunistic infections

1. Which of the following bacteria belong/s to the family Enterobacteriaceae?

a) Shigella.

b) Salmonella.

c) Klebsiella.

d) *All of the above.

2. Which of the following species is/are included in the genus Proteus?

a) Mirabilis.

b) Vulgaris.

c) Inconstans.

d) *All of the above.

3. Dienes phenomenon is used to determine the identity or non-identity of strains of:

a) *Proteus.

b) Salmonella.

c) Shigella.

d) Klebsiella.

4. Urinary tract infection caused by Proteus is more severe as compared to that caused by other bacteria due to:

a. *production of urease.

b. production of H2S.

c. production of lipase.

d. all of the above.

5. Which of the following pigments is diagnostic of Pseudomonas aeruginosa?

a. *Pyocyanin.

b. Pyoverdin.

c. Pyomelanin.

d. Pyorubrin

6. Swarming of Proteus strains on solid media can be inhibited by:

a) increasing the concentration of agar in the

medium.

a) incorporation of chloral hydrate in the medium.

b) *incorporation of sodium azide in the medium.

(d) all of the above methods.

7. Which of the following species/subspecies of Klebsiella produces indole?

a) K. pneumonias subspecies aerogene.s.

b) K. oxytoca.

c) *K. pneumoniae subspecies pneumoniae.

d) K. pneumoniae subspecies rhinoscleromalis.

8. Which of the following organisms is an opportunistic pathogen causing urinary tract and wound infections, and production of kidney stones?

a) Klebsiella pneumoniae.

b) Escherichia coli.

c) *Proteus vulgaris.

d) Citrobacter freundii.

9. Which of the following substances can be produced by strains of Pseudomonas aeruginosa?

a) Haemolysins.

b) Elastase.

c) Exotoxins A and S.

d) *All of the above.

Lesson

Pathogenic Vibrio. Biological properties of Vibrio cholerae. Laboratory diagnostics of cholera and other infections caused by pathogenic vibrio.

1. The colonies of Vibrio cholerae and V. parahaemolyticus can be differentiated on:

a) *thiosulphate-citrate-bile-sucrose agar.

b) alkaline bile salt agar.

c) MacConkey medium.

d) all of the above media.

2. Which of the following tests can differentiate between classical and El Tor biotypes of Vibrio cholerae?

a) Sensitivity to polymyxin B.

b) Agglutination of fowl RBCs.

c) Sensitivity to Mukerjee's group IV phage.

d) *All of the above.

3. The DNA coding for the production of cholera toxin in Vibrio cholerae is on the:

a) plasmid.

b) *chromosome.

c) phage.

d) transposon.

4. Which of the following bacteria is/are halophilic?

a. Vibrio parahaemolyticus.

b. V. cholerae.

c. V. vulnificus.

d. *All of the above.

5. Which of the following bacteria is/are associated with food poisoning due to consumption of sea fish?

a. *Vibrio parahaemolyticus.

b. V. alginolyticus.

c. V. vulnificus.

d. All of the above

6. Your patient is a 20-year-old woman with severe diarrhea that began yesterday. She has just returned from a 3-week trip to Peru, where she ate some raw shellfish at the farewell party. She now has watery diarrhea, perhaps 20 bowel movements a day, and is feeling quite weak and dizzy. Her stool is guaiac-negative, a test that determines whether there is blood in the stool. A Gram stain of the stool reveals curved gram-negative rods. Of the following organisms, which one is MOST likely to be the cause of her diarrhea?

a. Bacteroides fragilis

b. Campylobacter jejuni

c. Entamoeba histolytica

d. Helicobacter pylori

e. Shigella dysenteriae

f. *Vibrio cholerae

7. Which of the following tests can be used for the assay of cholera toxin?

a) Enzyme-linked immunosorbent assay.

b) Radioimmunoassay.

c) Morphological changes in Chinese hamster ovary cells.

d) *All of the above.

8. Which of the following vaccines is/are available for prophylaxis against cholera?

a) Killed whole organism vaccine.

b) Non-living oral В subunit-whole cell vaccine.

(c) Live vaccine

(d) * All of the above.

9. Cholera toxin resembles which of the following toxins?

a) *Labile toxin of Escherichia coli.

b) Stable toxin of E. coli.

c) Diphtheria toxin.

d) Tetanus toxin.

10.Your patient is a 30-year-old woman who was part of a tour group visiting a N. country. The day before leaving, several members of the group developed fever, abdominal cramps, and bloody diarrhea. Of the following, which one is the LEAST likely organism to cause this infection?

A) Shigella dysenteriae

B) Salmonella enteritidis

C) *Vibrio cholerae

D) Campylobacter jejuni

.

The bank of Krok-1 tests

1. Gram-negative comma-shaped bacteria are revealed in the feces of a patient with diarrhea. What properties should be studied with a microscope first of all to receive additional information about the revealed microbes?

A. Presence of spores.

B. Presence of a capsule.

C. *Motility.

D. Presence of volutin inclusions.

E. Presence of glycogen inclusions.

2. In the feces of a patient with acute gastroenteritis there were revealed motile, slightly curved Gram-negative rods, which grow onto alkaline 1% peptone water in the form of tender bluish pellicle. What

microorganisms have such properties?

A. Spirilla.

B. Spirochetes.

C. Clostridia.

D. Bacilli.

E. *Vibrios.

3. As a result of feces inoculation onto 1% alkaline peptone water after 8 hours' incubation with 37° C temperature a growth in the form of tender bluish pellicle was revealed. Microscopy revealed Gram-negative curved rods. What disease could these microorganisms cause?

A. Shigellosis.

B. Plague.

C. Typhoid fever.

D. Paratyphoid fever.

E. *Cholera.

4. A patient is hospitalized to an infectious department with cholera suspected. What basic method of research is necessary to use for the confirmation of the diagnosis?

A. Immunological.

B. *Bacteriological.

C. Biological.

D. Serologic.

E. Allergic.

5. Feces of a patient with cholera were delivered to a laboratory of extremely dangerous infections. What method of microbiological diagnostics is to be used to confirm or deny the diagnosis?

A. Virological.

B. Allergic.

C. Bacterioscopic.

D. Biological.

E. *Bacteriological.

6. From the vomit mass of a patient there were isolated very motile, slightly curved, Gram-negative rods which react positively with Inaba's diagnostic serum. What symptoms, most probably, will appear with the treatment absent?

A. Endotoxic shock.

B. Bacteremia.

C. *Fluid loss.

D.Skin rash.

E. Ulcerous damages of intestine.

7. A patient with complaints of repeated diarrhea and vomiting, pain in muscles of legs, general weakness, and vertigo is hospitalized to an infectious department. After examination a doctor

has previously diagnosed cholera. Which method of investigation of the specimen from the patient should be used for express-diagnostics ?

A. *Immunofluorescence test.

B. Agglutination test

C. Bacteriological.

D. Allergic.

E. Biological.

Lesson

Microorganisms causing zoonotic infections. Biological characteristics of Yersinia spp. Morphology and biological characteristics of Francisella tularensis.Pathogenesis and laboratory diagnostics of a plaque, enteric yersiniosis, pseudotuberculosis and tularemia.

1. In Yersinia pestis, capsule is best demonstrated in cultures grown at:

(a) 22°C.

b) 27°C.

c) *37°C.

d) 42°C.

2. Bipolar staining is characteristic of:

a) *Yersinia pestis.

b) Proteus mirabilis.

c) Pseudomonas aeruginosa.

d) all of the above.

3. Which of the following determine the pathogenicity of Yersinia pestis?

a) V and W antigens.

b) Fl envelope antigen.

c) Production of pigmented colonies on haemin containing media.

d) *All of the above.

4. Which of the following agents can cause plague?

a) *Yersinia pestis.

b) Y. pseudotubercitlosis.

c) Y. enterocolilica.

d) All of the above.

5. Plague is transmitted by:

a) sandflies.

b) *rat fleas.

c) mites.

d) ticks.

6. Sylvatic plague occurs in:

a) mice.

b) squirrels.

c) chipmunks.

d) *all of the above

.

7. Bubonic plague is transmitted by:

a) rat flea.

b) inhalation.

c) ingestion.

d) *all of the above routes.

8. Yersinia enterocolitica and Y. pestis can be differentiated on the basis of which of the following tests?

*Motility at 22°C.

Fermentation of sucrose and cellobiose.

Decarboxylation of ornithine.

All of the above.

9. The name 'black death' is given to which of the following diseases?

a) Tuberculosis.

b) Diphtheria.

c) *Plague.

d) AIDS.

10. Bubonic plague can be diagnosed in the laboratory by:

a) demonstration of gram-negative coccobacilli.

b) culture on blood agar.

c) inoculation in guinea-pigs.

d) *all of the above.

11. Which of the following vaccines is/are recommended for immunization against plague?

a. * Live.

b. Killed.

c. Subunit.

d. All of the above.

12. Which of the following diseases is/are caused by Yersinia enterocolitica in man?

a. *Gastroenteritis.

b. Mesenteric lymphadenitis.

c. Septicaemia.

d. All of the above.

13. Each of the following statements concerning plague is correct EXCEPT:

a. Plague is caused by a gram-negative rod that can be cultured on blood agar

b. Plague is transmitted to humans by flea bite

c. The main reservoirs in nature are small rodents

d. *Plague is of concern in many underdeveloped countries but has not occurred in the some countries since 1968

14. Pneumonic plague can be transmitted from man to man by:

a. *droplet infection.

b. inoculation.

c. ingestion.

d. all of the above routes

The bank of Krok-1 tests

1. Microscopical examination of the sputum of a patient with acute pneumonia preliminary diagnosed has shown chaotically located microorganisms of ovoid form up to 2 microns long, more intensively stained on the poles. What the most probable diagnosis can be made on the basis of this data?

A. *Pneumonic plague.

B. Streptococcal pneumonia.

C. Staphylococcal pneumonia.

D.Klebsiella pneumonia.

E. Diphtheria.

2. In a mountain settlement mass death of rodents was observed. Simultaneously the inhabitants of this area were ill. The illness was accompanied by the fast rise of body temperature up to 40° C, apparent intoxication, increase of inguinal lymph nodes. In the touch smears of cadaveric material Gram-negative bi-polarly stained ovoid rods were revealed. What microorganisms are the causative agents of this infectious disease?

A. Staphylococci.

B. *Causative agents of plague.

C. Causative agents of tularemia.

D. Causative agents of anthrax.

E. Clostridia.

Lesson

Microorganisms causing zoonotic infections. Brucella spp. Bacillus anthracis. Biological properties of microorganisms. Pathogenesis, laboratory diagnostics and specific prevention of brucellosis and anthrax.

1. Choose uncorrected statement about Brucella:

a. Are gram-negative rods

b. Are facultative intracellular parasites

c. *Produce exotoxin which promotes edema and swelling

d. Produce granulomatous nodules in spleen, kidney and liver

e. Are transmitted following contact with infected livestock

2. Which of the following Brucella spp. is/are capnophilic?

a. *B. abortus.

b. B. melitensis.

c. B. suis.

d. All of the above.

3. A 45-year-old male presents with a vesicular papule containing bloodstained fluid, surrounded by edematous and congested area. After one day several satellite lesions will appear but central lesion will be covered by a black eschar. Physician suggest anthrax based on this typical lesion which is named:

a. Chancre

b. *Malignant pustule

c. Typical furuncle

d. Erythema migrants

e. Roseola

4. In case described above laboratory confirmation of diagnosis may be done with the most common methods as following:

a. *Immunofluorescent microscopy and culture method

b. Serological test

c. Biological test and allergic test

d. Allergic skin test

e. Microscopy and serological test

5. For confirmation of diagnose brucellosis patient was performed skin test with brucellin. The name of test:

a. Mantoux test

b. *Burne test

c. Mitsuda test

d. Vidal test

6. Vaccination of cattle against brucellosis is done by:

a. *attenuated Brucella abortus vaccine.

b. attenuated B. melitensis vaccine.

c. attenuated B. ovis vaccine.

d. attenuated B. neotomae vaccine

7. Detect the major source of infection, caused by Brucella melitensis:

a. Cattle

b. Pigs

c. Dogs

d. *Goats

e. Sheep

8. A 35-year-old worker of wool factories presents with severe intoxication, fever, cough with hemorrhagic sputum, and shortness of breath. X-ray examination reveals lobar pneumonia and pleuritis. Microscopy of the stained smears from sputum demonstrates gram-positive large rods, arranged in pairs or in short chains and surrounded by capsules. The most likely pathogen may be:

a. *Bacillus anthracis

b. Klebsiella pneumonia

c. Streptococcus pneumonia

d. Yersinia pestis

e. Staphylococcus aureus

9. Common reservoir host/s of Brucella melitensis is/are:

a. *sheep and goats.

b. cattle.

c. pigs.

d. all of the above.

10. Human may be infected with Bacillus anthracis:

a. With contaminated animal milk and meat

b. By direct contact with infected animal

c. By inhalation of the spores

d. With contaminated animal raw

e. *All mentioned above

11.Which of the following Brucella spp. is most pathogenic for man?

a) *B. melitensis.

b) B. abortus.

c) B. suis.

d) B. canis

12. Brucellae are transmitted to humans by:

a) direct contact with animal tissues.

b) ingestion of contaminated meat.

c) ingestion of raw infected milk.

d) *all of the above.

The bank of Krok-1 tests

1. During the swing of flu epidemic a milkmaid referred to a doctor with complaints of high body temperature, general weakness, absence of appetite, pain in joints. During 10 days she has been having self-treatment for flu. The infectiologist suspected brucellosis. Using what reaction is it possible to diagnose brucellosis?

A. *Wright's.

B.Wassermann test.

C.Coombs test.

D.Widal'stest.

E. Ouchterlony test.

2. During a scheduled examination milkmaids had a Burnet's intracutaneus allergy test. This test is used to detect hypersensitivity to:

A. *Brucellin.

B. Tuberculin.

C. Old tuberculin.

D. Tularin.

E. Antraxin.

3. A patient with an infectious disease has positive skin-allergic Burnet's test. What diagnosis was confirmed by this test?

A. Q fever.

B. Tularemia.

C. Typhoid fever.

D. Salmonellosis.

E. *Brucellosis.

4. A patient with brucellosis has a positive Burnet's intracutaneus allergy test. Which immune system factor can induce inflammatory reaction in the site of brucellin introduction?

A. IgA.

B. *Sensitized T-lymphocytes.

C.IgE.

D.IgG.

E.IgD.

5. A child has brucellosis diagnosed. The child didn't have any contacts with sick animals. How could the infection get into the organism?

A. Via dirty hands.

B. Via dirty vegetables and fruit.

C. Via water.

D.*Via unpasteurized milk.

E. During injections.

6. During a biological test in touch smears from the organs of an animal streptobacteria surrounded with a capsule were revealed. It gives the basis to diagnose:

A. Tularemia.

B.*Anthrax.

C.Plague.

D. Brucellosis.

E.Croupous pneumonia.

7. A 34-year-old patient complained of carbuncle on his face. Examination revealed a painless thin edema of subcutaneous fatty tissue with a black eschar in the center, and vesicular eruption on the periphery. Microbiologic examination revealed nonmotile capsule-forming streptobacilli. What microorganisms are the causative agents of this disease?

A. *Bacillus anthracis.

B.Staphylococcus aureus.

C.Bacillus anthracoides.

D. Bacillus subtilis.

E.Bacillus megaterium.

8. The territory of the burial ground of cattle, which has not been used for more than 50 years, is planned for house building. However, soil examination has shown the presence of viable spores of

an especially dangerous disease causative agent. Name the microorganism which could have been preserved in soil during such a long time.

A. Yersinia pestis.

B.Francisella tularensis.

C.Brucella abortus.

D. *Bacillus anthracis.

E.Mycobacterium bovis.

9. A man referred to the reception ward of an infectious disease hospital, having received by mail an envelope with suspicious powder. The man was isolated, and the powder was sent to the laboratory for detecting the presence of anthrax causative agent's spores. Which is the fastest method of detecting these

microorganisms?

A. Isolation of pure culture.

B. Complement fixation test.

C. Precipitation in gel.

D. *Immunofluorescence test.

E. Neutralization test.

10. An extract of cattle-breading raw material was delivered to a laboratory from the area, where cases of anthrax among animals were noted. What serological reaction should be used for detecting anthrax causative agent antigens in the investigated specimen?

A. *Termoprecipitation.

B. Complement fixation test.

C. Indirect hemagglutination.

D. Radioimmunoassay.

E. Precipitation in agar.

11. In a laboratory for the examination of animal skins the precipitation test is used (Askoly test). The resultis: in some minutes after adding of the immune serum with skin extract an albescent ring formed. What does this result indicate?

A. *Presence of bacillus anthracis antigens.

B. Presence of Clostridium perfringens toxin.

C. Presence of brucellosis causative agent.

D.Presence of escherichia surface antigen.

E. Presence of salmonella Vi-antigen.

12. To check cattle-breeding raw material (leather, wool) for the presence of anthrax agent soluble thermostable antigen in water-salt extract from raw material is prepared. What reaction may be used for this purpose?

A. Neutralization.

B. Precipitation in agar.

C. Agglutination.

D. Indirect hemagglutination.

E. *Ring-precipitation.

Lesson

Medical-important clostridia. Biological characteristics Clostridium tetani and Clostridium botulinum. Pathogenesis, laboratory diagnostics and specific prevention of tetanus and botulism.

1.Choose obligate anaerobes among these bacteria.

a. Neisseria gonorrhoeae, Streptococcus pneumoniae

b. Mycobacterium tuberculosis, Micrococcacae

c. *Clostridium tetani, Clostridium botulinum

d. Bacillus anthracis, Brucella melitensis

e. Shigella dysenteriae, Salmonella typhi

2.Choose method of staining of bacterial spores, which are formed by C. tetani and C. botulinum:

a. Staining by mеthylene blue

b. *Staining by Aujesko’s method

c. Staining by Ziehl-Neelsen’s method

d. Staining by Gram method

e. Staining by crystal violet

3. Choose the nutrient media on which it is possible to grow anaerobic microorganisms:

a. Endo's and Lewin's media

b. Meat - pepton agar, meat - pepton broth

c. *Sugar - blood agar Zoessler, Kitt-Tarozzi's medium

d. The curtailed serum, meat-pepton gelatin

e. Blood agar, serum agar

4. The MOST important protective function of the antibody stimulated by tetanus toxoid is

a. To opsonize the Clostridium tetani

b. To prevent growth of the Clostridium tetani

c. To prevent adherence of the Clostridium tetani

d. *To neutralize the toxin of the Clostridium tetani

5. Laboratory assistant has to isolate Clostridium tetani, anaerobic sporeforming bacterium, from wound exudation. What will he do before inoculation of material into appropriate culture medium?

a. he filtrates the material through cellulose filter

b. *he heats the sample to kill asporogenous bacteria at 800C for 20 min

c. wound discharge should be frozen before inoculation to inhibit facultative anaerobes

d. he will not do anything before investigation

e. he heats the sample to kill vegetative forms bacteria at 600C for 5 min

6. It is possible to cultivate obligate anaerobes on the special medium under absence of air. The most reliable method to create anaerobic condition will be next:

a. usage of thermostat

b.* usage of anaerostat

c. by inoculation into solid media (pour agar culture)

d. usage of chemostat

7. Clostridium botulinum releases the most powerful biological poison which belongs to bacterial exotoxins. Choose from proposed list target cell for botulotoxin:

a. Epithelial cell of the gut

b. Muscle cell

c. *Motoneuron of central nervous system

d. Sensitive neuron of spinal cord

e. Inhibiting neuron of spinal cord

8. Special nutrient media on which it is possible to grow anaerobic microorganisms will be next:

a.*Zoessler, Kitt-Tarozzi's

b.Meat - peptone agar, meat - peptone broth

c.medium Endo's and Lewin's media

d.The curtailed serum, meat- peptone gelatin

e.Blood agar, serum agar

9. Medical important sporeforming bacteria belong to next genus:

a. Proteus

b. *Clostridia

c. Fusobacterium

d. Streptococcus

e. Escherihia

10. Each of the following statements concerning Clostridium tetani is correct EXCEPT:

a. It is a gram-positive, spore-forming rod

b. Pathogenesis is due to the production of an exotoxin that blocks inhibitory neurotransmitters

c. *It is a facultative organism; it will grow on a blood agar plate in the presence of room air

d. Its natural habitat is primarily the soil

11. Spores are necessary to bacteria for:

a. Survive into human and animal’s organism

b. Reproduction

c. *Survive in an external environment

d. Defense from fagocytosis

e. Defense from acid in stomack

The bank of Krok-1 tests

1. The causative agent of tetanus produces exotoxin with different biological action effects. What clinical symptoms can this toxin cause?

A. Disorders of vision.

B.*Lackjaw.

C.Diarrhea.

D.Skin rash.

E. Nausea.

2. A bacteriological laboratory conducts a research of canned meat for the presence of botulinum toxin. An extract from the researched material with antitoxic antibotulinic serum of A, B, E types was injected to the experimental group of mice. An extract without antitoxic serum was injected to the control group.

What serologic test has been used?

A. Complement fixation.

B. Precipitation.

C. *Neutralization.

D.Opsonophagocytic.

E.Double immune diffusion.

3. A patient with the previous diagnosis of botulism has been hospitalized. What serological reaction should be used to determine botulinum toxin in test specimens?

A. Complement fixation test.

B. Agglutination.

C. *Neutralization.

D.Precipitation.

E.Immunofluorescence test.

4. After eating canned mushrooms a patient has bulbar paralysis symptoms: ptosis, diplopia, aphonia, and dysphagia. Botulism was previously diagnosed. What test should be used to determine the toxin type?

A. *Neutralization.

B. Agglutination.

C. Precipitation.

D. Complement fixation test.

E. Immunofluorescence test.

5. A student, having eaten meat,tinned in domestic conditions, has symptoms of food poisoning, caused by Clostridium botulinum: diplopia, dysphrasia, respiratory paralysis. What caused such symptoms of botulism?

A. Enterotoxin secretion.

B. C. botulinum invasion into intestinal epithelium.

C. *Neurotoxin action.

D.Endotoxic shock.

E.Activation of adenylate cyclase.

6. Jerked fish, being the cause of food poisoning, has been delivered to a bacteriological laboratory. The sample was cultured under anaerobic condition. After inoculation into Kitt-Tarozzi medium a bacteriologist has revealed microorganisms akin to a tennis-racket. What disease do they cause?

A. Typhoid fever.

B. Salmonellosis.

C. Dysentery.

D.Staphylococcal toxic infection.

E.*Botulism.

Lesson

Anaerobic rods causing purulent wound infections and gas gangrene. Pathogenesis, laboratory diagnostics and specific prevention of gas gangrene and wound infections.

1. Each of the following statements concerning Clostridia is correct EXCEPT:

a. Pathogenic Clostridia are found both in the soil and in the normal flora of the colon

b. Antibiotic-associated (pseudomembranous) colitis is due to a toxin produced by Clostridium difficile

c. *Anaerobic conditions at the wound site are not required to cause tetanus, because spores will form in the presence of oxygen

d. Botulism, which is caused by ingesting preformed toxin, can be prevented by boiling food prior to eating

2. Each of the following statements concerning Clostridium perfringens is correct EXCEPT:

a. It causes gas gangrene

b. It causes food poisoning

c. It produces an exotoxin that degrades lecithin and causes necrosis and hemolysis

d. *It is a gram-negative rod that does not ferment lactose

3. Choose among these bacteria obligate anaerobes.

a. Neisseria gonorrhoeae, Streptococcus pneumoniae

b. Mycobacterium tuberculosis, Micrococcacae

c. *Clostridium perfringens Clostridium defficile

d. Bacillus anthracis, Brucella melitensis

e. Shigella dysenteriae, Salmonella typhi

4. Choose method of staining of bacterial spores, which are formed by C. perfringens:

a. Staining by mеthylene blue

b. *Staining by Aujesko’s method

c. Staining by Ziehl-Neelsen’s method

d. Staining by Gram method

e. Staining by crystal violet

5. Choose the nutrient media on which it is possible to grow anaerobic microorganisms:

a. Endo's and Lewin's media

b. Meat - pepton agar, meat - pepton broth

c. *Sugar - blood agar Zoessler, Kitt-Tarozzi's medium

d. The curtailed serum, meat-pepton gelatin

e. Blood agar, serum agar

6. Five days ago a 65-year-old woman with a lower urinary tract infection began taking ampicillin. She now has a fever and severe diarrhea. Of the organisms listed, which one is MOST likely to be the cause of the diarrhea?

a. *Clostridium difficile

b. Bacteroides fragilis

c. Proteus mirabilis

d. Bordetella pertussis

7. Each of the following statements concerning wound infections caused by Clostridium perfringens is correct EXCEPT:

a. An exotoxin plays a role in pathogenesis

b. Gram-positive rods are found in the exudate

c. *The organism grows only in human cell culture

d. Anaerobic culture of the wound site should be ordered

8. Specify the nutrients media on which it is possible to grow anaerobic microorganisms:

a. *Zoessler, Kitt-Tarozzi's

b. Meat - pepton agar, meat - pepton broth

c. medium Endo's and Lewin's media

d. The curtailed serum, meat- pepton gelatin

e. Blood agar, serum agar

The bank of Krok-1 tests

1. A patient injured in an accident has been suspected of probable development of anaerobic wound infection (gas gangrene). What is the most appropriate treatment before making a specific laboratory diagnosis?

A. Native plasma.

B. Toxoid.

C. Type specific immune serum.

D. *Polyvalent specific serum.

E. Placental γ-globulin.

Lesson

Corynebacterium diphtheria. Bordetella spp. Biological characteristics. Pathogenesis, laboratory diagnostics, specific therapy and prevention of diphtheria and whooping cough.

1. Which of the following species of Bordetella is the most important human pathogen?

a) *B. pertussis.

b) B. parapertussis.

c) В. bronchiseptica.

d) B. avium.

2. Which of the following media is employed most frequently for the isolation of Bordetella pertussis?

a) Blood agar.

b) Chocolate agar.

c) *Bordet-Gengou medium.

d) Nutrient agar.

3. Pertussis toxin is produced by:

a) *Bordetella pertussis.

b) B. parapertussis.

c) В. bronchiseptica.

d) all of the above.

4. The most infective stage in whooping cough is:

a) *catarrhal stage.

b) paroxysmal stage.

c) convalescent stage.

d) when the patient develops complications.

5. Which of the following methods is most suitable for culture of Bordetella pertussis?

a) Pernasal swab culture.

b) Postnasal swab culture.

c) *Cough plate method.

d) Sputum culture.

6. Which of the following factors act/s as virulence determinant/s for Bordetella pertussis?

a) Pertussis toxin.

b) Tracheal cytotoxin.

c) Filamentous hemagglutinin.

d) *All of the above.

7. A 5-years-old girl presents to her pediatrician with malaise, sore throat, fever and grey-white membranes over her tonsils and pharyngeal wall. History revealed that she had not received any of her childhood immunizations. Considering her history, the clinical picture is strongly suggestive of diphtheria.

a. The physician should (choose the best or correct answer):

b. *Treat after isolation and identification of toxigenic C.diphtheria

c. Treat after demonstration C.diphtheria in the nasopharynx smears stained by Gram

d. Immediately initiate treatment with penicillin or erythromycin

e. Passively administer antitoxin and initiate antibiotic therapy immediately

f. Confirm the diagnosis of diphtheria by serological testing

8. Which material should be collected for laboratory diagnostics?

a. Blood;

b. *Membraneous exudate

c. CSF

d. Sputum

e. Nasal secretions

9. The exotoxin of C.diphtheria

a. Increases cAMP levels by altering the regulation of adenylate cyclase

b. Is plasmid incoded

c. *Enzymatycally inactivates eukaryotic elongation factor 2

d. Can not be converted to an immunogenic toxoid

10. Specific prophylaxis is obligate measure, preventing diphtheria in childhood. Choose the preparation for prevention of diphtheria and write down the scheme of vaccination.

a. *DPT

b. Diphtheria toxoid

c. Antitoxic diphtheria serum (ADS)

d. BCG vaccine

11. Which medicines should be administered for specific treatment of diphtheria?

a. DPT vaccine

b. Antibiotics

c. Sulfonamides

d. Diphtheria toxoid

e. *Antitoxic diphtheria serum (ADS)

12. Choose the methods for laboratory diagnostics of diphtheria:

a. *Microscopy and culture

b. Microscopy and biological method

c. Allergic skin test and culture method

d. Serological and culture methods

The bank of Krok-1 tests

1. A patient was admitted to a clinic in grave condition, fever, heavy breathing. Preliminary diagnosis of diphtheria croup was made by the microscopy of throat specimen. What method of staining was used?

A. Peshkov's. D.*Neisser's.

B. Ziehl-Neelsen's.

C. Burri-Gins'. E. Ozheshko's.

2. In the smear from the tonsils of a patient with di phtheria suspected there have been revealed blue rods with thickenings on the ends. What method of staining has been used?

A. *Loeffler's.

B. Burri's.

C. Gins'.

D. Gram's.

E. Neisser's.

3. Among the children of a boarding school there are cases of angina. Microscopy of tonsil smears stained by Neisser method revealed yellow rods with dark-brown terminal granules arranged in the form of V, W, and X letters.What infection can be suspected in this case?

A. Infectious mononucleosis. D. Tonsillitis.

B. *Diphtheria.

C. Listeriosis. E. Scarlet fever.

4. Profilactic vaccination of a student's group was necessary because of a case of diphtheria. What preparation should be used to develop artificial active immunity?

A. *Diphtheria toxoid. D. Vaccine DPT (triple vaccine).

B. Antidiphtheritic serum.

C. Specific immunoglobulin. E. Inactivated vaccine.

5. To determine the toxigenicity of diphtheria causative agents isolated from patients, cultures are inoculated onto a Petri dish with nutrient agar on both sides of the centrally located filter paper strip sodden with antidiphtheric antitoxic serum. After cultures incubation in the agar between separate cultures and filter paper strip the sites of medium opacity are revealed. Which serological reaction has been carried out?

A. *Precipitation in gel. D. Ring-precipitation.

B. Coombs reaction.

C. Agglutination. E. Opsonization.

6. Pure culture of diphtheria corynebacteria is isolated from a patient. What serologic test should be used for detecting toxigenicity of the culture?

A. Agglutination. D. Hemagglutination inhibition.

B. *Precipitation in agar.

C. Complement fixation test. E. Passive hemagglutination.

7. Corynebacterium diphtheria was obtained from a sick child with diphtheria suspected. What research is necessary to be carried out to be convinced that this microbe causes diphtheria?

A. Agglutination test.

B. Staining by Burri-Giens' method.

C. Inoculation on blood agar.

D. Infecting a rabbit.

E. *Determining of toxigenicity

8. A girl of 7 with high temperature, complaints of pain in throat and general weakness has been hospitalized to the infectious department. The doctor has suspected diphtheria and has given the instruction to take material from the fauces for isolation of the pure culture of the pathogen. Which point is the most important for confirmation of the diagnosis «diphtheria»?

A. Detecting volutin granules in the causative agent.

B. *Toxigenicity test. C. Cystinase test.

D. Hemolytic activity of the causative agent. E. Phage typing.

9. A microorganism, isolated from a 5-year-old child's nasopharynx, is identical to Corynebacterium di phtheriae by morphological and biochemical properties, but doesn't form exotoxin. What process can make this microorganism toxigenetic?

A. Chromosome mutation.

B. Cultivation on telurite medium.

C. Passage through the organism of sensitive animals.

D. Cultivation in the presence of antitoxic serum.

E.*Phage conversion.

10. Examining a 6-year-olf child a doctor has noticed on pharyngeal tonsils a grayish "pseudoembrane". Attempt to remove it causes moderate bleeding. Bacterioscopy of tonsils swabs has shown Gram-positive club-shaped bacteria. What symptoms can appear within the next few days without specific treatment?

A. Very strong attack-like cough. D.Papular rash on skin.

B. Lungs edema. E.Intermittent fever.

C. *Toxic affection of the cardiac muscle, liver, kidneys.

11. Antitoxic serums are used for the prophylaxis and treatment of:

A. Gonorrhea.

B. Whooping cough.

C. Shigellosis.

D. *Diphtheria.

E. Tuberculosis.

12. In the pediatric department of an infectious clinic a boy had diphtheria diagnosed. Which preparation should be injected first of all?

A. *Diphtheritic antitoxin.

B. Diphtheritic anatoxin.

C. APDT.

D. ADT.

E. TABTe

13. It is necessary to carry out specific active prophylaxis of diphtheria of children in a kindergarten. What preparation should be used for this purpose?

A. *Toxoid.

B. Antibiotics.

C. Probiotics.

D. Corpuscular vaccine.

E. Immune serum.

14. In a kindergarten vaccination against pertussis is planned. Which preparation is used for the immunization?

A. Type specific serum.

B. BCG vaccine.

C. *APDT vaccine.

D. Normal γ-globulin.

E. ADT vaccine.

Lesson

Mycobacteria. Causative agents of tuberculosis and leprosy, their biological properties. Pathogenesis, laboratory diagnostics, specific prevention of diseases.

1. M. tuberculosis may be revealed with staining by:

A) *Ziehl-Neelsen

B) Gram

C) Burry

D) Neisser

E) Simple staining

2. What is BCG vaccine?

a. Alive vaccine from attenuated M.tuberculosis

b. *Alive vaccine from attenuated M.bovis

c. Inactivated complex vaccine from some mycobacteria

d. Chemical vaccine containing antigens of both M.tuberculosis and M.bovis

e. Alive vaccine from attenuated M.leprae

3. The Mantoux skin test

a. Should be read between 15 and 24 hrs

b. Is specific for Mycobacterium tuberculosis only

c. *Indicates past or present infection with Mycobacteria spp.

d. Will become negative following immunization

e. May give a false positive in immunocompromised persons

4. A 62-year-old man with diabetes presents with chronic cough, fever and weight loss. Chest X-ray reveals a consolidated mass in the anterior portion of the lower lobe. The Mantoux test is positive. Poorly stained, gram-positive rods were seen in the sputum.

A. The most likely causative agent will be: Mycobacterium tuberculosis ……………………………

B. What method of staining allows revealing acid-fast bacteria?. Ziehl-Neelsen. . . . . .

C. Which culture media should be used for isolation of causative agent from the sputum?

a) *Lowenstein-Jensen media

b) Blood agar

c) Charcoal blood agar

d) Tinsdale agar

e) MPA

5. Each of the following statements concerning Mycobacterium tuberculosis is correct EXCEPT:

A. After being stained with carbolfuchsin, M. tuberculosis resists decolorization with acid alcohol

B. M. tuberculosis has a large amount of mycolic acid in its cell wall

C. *M. tuberculosis appears as a red rod in Gram-stained specimens

D. M. tuberculosis appears as a red rod in acid-fast stained specimens

6. Which one of the following statements MOST accurately depicts the ability of the organism to be cultured in the laboratory?

A) Treponema pallidum from a chancre can be grown on a special artificial medium supplemented with cholesterol

B) *Mycobacterium leprae can be grown in the armadillo and the mouse footpad but not on any artificial media

C) Mycobacterium tuberculosis can be grown on enriched artificial media and produces visible colonies in 48-96 hours

D) Atypical mycobacteria are found widely in soil and water but cannot be cultured on artificial media in the laboratory

7. Acid-fast bacteria are poorly stained by Gram because their cell wall includes:

A) a lot amount of peptidoglycane

B) phosphor compounds

C) lipoproteins

D)* netral lipids, waxes, fat acids

E) a lot amount of water

8. Each of the following statements concerning Mycobacterium tuberculosis is correct EXCEPT:

A) Some strains isolated from individuals with previously untreated cases of tuberculosis are resistant to isoniazid

B) *M. tuberculosis contains a small amount of lipid in its cell wall and therefore stains poorly with the Gram stain

C) The organism grows slowly, often requiring 3-6 weeks before colonies appear

D) The antigen in the skin test is a protein extracted from the organism

9. Each of the following statements concerning Mycobacterium leprae is correct EXCEPT:

A) In lepromatous leprosy, large numbers of organisms are usually seen in acid-fast-stained smears

B) *The organism will grow on bacteriologic media in 3-6 weeks

C) Prolonged therapy (9 months or longer) is required to prevent recurrence

D) Skin tests for delayed hypersensitivity are useful diagnostically

The bank of Krok-1 tests

1. Microscopy of the sputum of a patient with an acute form of pulmonary tuberculosis is carried out to detect the causative agent of this disease. What method of staining is the most rational in this case?

A. Gram's.

B. *Ziehl —Neelsen's.

C. Burri —Gins'.

D. Romanowsky — Giemsa.

E. Neisser.

2. Sputum of a patient with tuberculosis was delivered to a laboratory. What method of staining should be used for detecting causative agents of tuberculosis?

A. Gram's.

B.*Ziehl — Neelsen's.

C. Burri —Gins'.

D. Romanowsky-Giemsa.

E. Neisser.

3. Centrifuge urine of a patient with renal tuberculosis suspected was used to prepare a smear. What method of staining should be used for pathogen detecting?

A. Loeffler's.

B. Burri.

C. Gram's.

D. *Ziehl-Neelsen's.

E. Romanovsky-Giemsa.

4. The sputum of a patient with tuberculosis was delivered to a bacteriological laboratory. What staining method should be used for microscopic examination of the smears for revealing tuberculosis mycobacteria?

A. Zdrodovsky's.

B. Bum's.

C. *Ziehl-Neelsen's.

D. Gram's.

E. Romanovsky-Giemsa.

5. In the sputum smear stained by Ziehl-Neelsen's method are revealed single or grouping red acid-fast rods. On nutrient, media first growth signs appear in 14 days. What species do the microorganisms belong to?

A. Yersinia pseudotuberculosis. D.Klebsiella rhinoscleromatis.

B. *Mycobacterium tuberculosis.

C. Histoplasma dubrosii. E.Coxiella burnettii.

6. Sputum examination by Price method revealed rod-shaped bacteria arranged in twisted ropes. Which substance leads to sticking of these bacteria and their above-mentioned growth?

A. Tuberculin. D. Tuberculostearic acid.

B. *Cord-factor.

C. Phosphatid. E. PPD.

7. A 6-year-old child with active tubercular process suspected had a diagnostic Mantoux test carried out. What immunobiological preparation was injected?

A. APDT vaccine.

B. BCG vaccine.

C. *Tuberculin.

D. Tularin.

E. ADT vaccine

8. Children had Mantoux test done in a kindergarten. What preparation was used?

A. *Tuberculin.

B. Brucellin.

C. Tularin.

D. Antraxin.

E. Toxoplasmin

9. A 16-year-old patient from the countryside has a negative Mantoux test. What should the doctor do?

A. *To give BCG injection.

B. To repeat the reaction in a month.

C. To carry out tuberculosis serodiagnosis.

D. To quarantine the young man from the collective urgently.

E. To conduct the accelerated tuberculosis diagnostics by Price method.

10 At school medical inspection of pupils has been carried out. The purpose was to select children for revaccination against tuberculosis. Which test has been used?

A. Burnet's.

B. Schick's.

C. Skin test with tularin.

D. *Mantoux.

E. Anthraxin skin test.

11. At a maternity hospital immunization of newborn children against tuberculosis has been carried out. What vaccine has been used?

A. Tetanus toxoid.

B. Diphtheritic toxoid.

C. BCG.

D. TABTe.

E.*APDT.

12. After complex examination of a patient lepra was diagnosed. Name the skin allergic test, which should be used to confirm the diagnosis.

A. Dick's.

B. Mantoux.

C. *Mitsuda's.

D. Coombs'.

E. Schick’s.

Lesson

Medical-important spirochetes. Biological characteristics of Treponema pallidum. Pathogenesis and laboratory diagnostics of syphilis.

1. Choose the correct statement about Spirochetes:

a.* the body of Spirochete consist of an axial filament and cytoplasm wound spirally around the filament;

b. they are gram-positive bacteria;

c. they produce spore:

d. they are acid-fast and poorly stained by Gram:

e. spirochetes are capsulated, non-motile bacteria

2. Choose the correct staining technique for Treponema pallidum revealing in the tissue:

a. by Gram

b. *by Morozov (silver impregnation);

c. by Ziehl-Neelsen;

d. by Neisser;

e. by Loeffler

3. Which of the following statements is true concerning congenital syphilis?

a. It has been eradicated in the world

b. It is effectively prevented by mother treating with penicillin

c. It is now seen only in association with neonatal HIV infection

d. It is incurable

e. *It does not arise if mother get a syphilis during last trimester of pregnancy

4. Each of the following statements concerning Treponema is correct EXCEPT:

a. *T. pallidum produces an exotoxin that stimulates adenylate cyclase

b. T. pallidum cannot be grown on conventional laboratory media

c. Treponemes are members of the normal flora of the human oropharynx

d. Patients infected with T. pallidum produce antibodies that react with beef heart cardio-lipin

5. Which of the following is the characteristic skin lesion of primary syphilis?

a. Condylomata

b. *Chancre

c. Gumma

d. Ecthyma gangrenosum

e. Erythema marginatum

6. Choose the correct statement about Spirochetes:

a. they contain teichoic acids in the cell wall;

b. they are readily stained with Gram;

d. *they are poorly stained and may be revealed with silver impregnation;

c. they produce spores;

e. they may be branched

7. Which of the following test is used for screening or presumptive serodiagnostics of syphilis?

a. *RPR test, VDRL test

b. Wassermann test

c. FTA, TPI, TPHA

d. Vidal test

e. precipitation test

The bank of Krok-1 tests

1. A patient with syphilis suspected has arrived to a hospital. What method should be used for detecting the causative agent in hard chancre?

A. Microscopy of material stained by Gram's method.

B. Isolation of pure culture. D. Wassermann test.

C. *Using dark-field microscopy. E. Agglutination test.

2. Microscopy of the specimen of a regional lymph node punctate stained by Romanowsky-Giemsa showed thin microorganisms with 12-14 regular curls and pointed ends of light rose color 10-13 micrometers long. What disease could this agent cause?

A. Relapsing fever.

B. Toxoplasmosis.

C. Leptospirosis.

D. *Syphilis.

E. Leishmaniasis.

3. A laboratory assistant has taken blood serum from a patient with preliminary diagnosed syphilis for the immune reaction based on detecting antibodies, which inhibit the motility of treponemes and lead to their death. What test has been used for diagnostics?

A. Complement fixation.

B. *Immobilization.

C. Agglutination.

D. Precipitation.

E. Neutralization.

4. To conduct syphilis serum diagnostics using the Wassermann test a laboratory doctor has prepared the following reagents: cardiolipidic antigen (ethanolic extract of lipids from a bull's cardiac muscle with cholesterol), hemolytic system, test serums, isotonic sodium chloride solution, and antigen of treponema

destroyed by ultrasound. What another ingredient should be used for this test?

A. *Complement.

B. Live treponema.

C. Sheep erythrocytes.

D. Diagnostic precipitating serum.

E. Diagnostic antiglobulin serum

5. A 30-year-old patient's Wassermann test is positive (++++). What infectious disease diagnostics is this test used for?

A. Brucellosis.

B.*Syphilis.

C. Tuberculosis.

D. Poliomyelitis.

E. Influenza.

Lesson

Pathogenic spirochetes. Characteristics of genera Leptospira and Borellia. Pathogenesis, laboratory diagnostics of relapsing fever, Lyme disease, and leptospirosis.

1. Choose the correct staining method for Borrelia spp. observation in the blood smear:

a. by Neisser;

b. by Gram

c. by Ziehl-Neelsen;

d. *by Romanovsky-Giemsa

e. by Loeffler

2. A 23-year-old women presents with a chief complaint of recurrent fever. Two weeks ago after returning from a camping trip in the wooded region, she experienced an abrupt onset of fever, malaise, and chills, which lasted several days. She then felt better and returned to her usual activities only to again the reappearance of fever and myalgia one week later. The most likely germ associated with her illness is:

a. Coxiell burnetti

b. Borrelia burgdorferi

c. *One of the tick-transmitted Borrelia

d. Salmonella typhi

c. Riccketsia typhi

3. Leptospirosis is transmitted to human from animal by:

a. direct contact

b. *contaminated with animal urine water or food

c. mosquitoes

d. ticks

e. air droplets

4. A 40-year-old male presents with fever, myalgia, jaundice, nose bleeding, malaise and nausea. Under examination physician reveals enlarged liver and spleen, painful kidney at palpation. The presumptive diagnosis is leptospirosis. Which method of laboratory diagnostics may confirm diagnose at first 5-7 days of disease?

a. *Microscopy and cultural

b. Microscopy and allergic skin test

c. Microscopy of urine sediment

d. biological method

e. serological method

5. Examining blood smear stained by Romanovsky-Giemsa laboratory assistant reveal purple-violet spiral microorganisms with 3-8 irregular loose coils and pointed ends. Which is following microorganisms was revealed?

a. *Borrelia spp.

b. Leptospira interrogans

c. Treponema pallidum

d. Spirillum minor

e. Spirochaeta buccalis

6. Lyme disease is transmitted to human from animal by:

a. direct contact

b. contaminated water

c. mosquitoes

d. *ticks

e. fleas

7. Choose the correct staining technique for Leptospira revealing in the tissue:

a. by Gram

b. *by Morozov (silver impregnation);

c. by Ziehl-Neelsen;

d. by Neisser;

e. by Loeffler

8. The characteristic skin lesion seen early in Borrelia burgdorferi infection is known as

a. malignant pustule

b. urticarial petechia

c. *erythema migrans (annular erythema)

d. chancroid

e. acrodermatitis atrophicans

9. Each of the following statements concerning spirochetes is correct EXCEPT:

a. Species of Treponema are part of the normal flora of the mouth

b. Species of Borrelia cause a tick-borne disease called relapsing fever

c. *The species of Leptospira that cause leptospirosis grow primarily in humans and are usually transmitted by human-to-human contact

d. Species of Treponema cause syphilis and yaws

The bank of Krok-1 tests

1. Microscopy of the blood smear stained by Romanovsky-Giemsa showed thin, bluish-violet filaments with 5-7 large curls 10-30 micrometers and more long. What disease can be characterized by such microscopic picture?

A. Leishmaniasis.

B. Syphilis.

C. Leptospirosis.

D. Toxoplasmosis.

E. *Relapsing fever.

2. To an infectious clinic a patient with preliminary diagnosed epidemic relapsing fever is hospitalized. What material, taken from the patient, is it necessary to examine first of all?

A. *Blood.

B. Urine.

C. Spinal fluid.

D. Feces.

E. Nasopharynx swab.

3. A patient with a periodically repeating fever is hospitalized to an infectious department. In blood specimen(a thick drop), stained by Romanovsky-Giemsa method, spiral microorganisms with sharp ends of blue-violet color are revealed. Which disease is caused by this agent?

A. *Relapsing fever.

B. Typhoid fever.

C. Malaria.

D. Epidemic typhus.

E. Leptospirosis.

4. A patient was hospitalized on the 5th day of illness with jaundice signs, pain in muscles, rigor, nose bleeding. A bacteriologist used dark-field microscopy. In the patient's blood there have been revealed motile spiral microorganisms. Name the causative agent.

A. Bartonella bacilloformis. D.*Leptospira interrogans

B. Borrelia duttoni.

C. Calymmatobacterium granulomatis. E. Rickettsia mooseri.

5. In the endemic region of leptospirosis the population is ill with this dangerous illness. What source of the infection is the most dangerous?

A. *Rodents.

B. Dairy products.

C. Cattle.

D. Meat products.

E. Ticks.

Lesson

Pathogenic Spirilla. Campylobacteria and helicobacteria. Morphology and biological properties. Laboratory diagnostics.

1. Campylobacter and Helicobacter can be differentiated on the basis of:

a. multiple sheathed flagella.

b. strong hydrolysis of urea.

c. *both of the above.

d. none of the above.

2. Which of the following species of Campylobacter is/are thermophilic?

a. С jejuni.

b. С соli.

c. С lari.

d. *All of the above.

3. Campylobacter jejuni produces diarrhoea by which of the following mechanism/s?

a. By production of a heat-labile enterotoxin.

b. By invasive property of the bacterium.

c. *Both of the above mechanisms.

d. None of the above mechanisms.

4. Which species of Campylobacter has the ability to hydrolyze sodium hippurate?

a. *C. jejuni.

b. C. coli.

c. С. fetus.

d. C. concisus.

5. Which of the following bacteria is/are microaerophilic?

a. Campylobacter jejuni.

b. Helicobacter pylori.

c. Mycobacterium.

d. *All of the above

6. Which of the following conditions is/are blamed to be caused by Helicobacter pylori?

a. Chronic active gastritis.

b. Duodenitis.

c. Peptic ulceration.

d. *All of the above.

7. Which of the following tests is/are useful in identification of Helicobacter pylori ?

a. Warthin-starry silver staining.

b. Biopsy urease test.

c. Urea breath test.

d. *All of the above.

8. Which of the following bacteria is/are urease positive?

a. Proteus mirabilis.

b. Klebsiella pneumoniae.

c. Helicobacter pylori.

d. *All of the above.

9. Which of the following bacteria has a single polar flagellum?

a. *Campylobacter jejuni.

b. Helicobacter pylori.

c. Mobilunciis curtisii.

d. Proleus vulgaris.

10. Diarrhea caused by which one of the following agents is characterized by the presence of fecal leukocytes?

a. *Campylobacter jejuni

b. Rotavirus

c. Clostridium perfringens

d. Enterotoxigenic Escherichia coli

The bank of Krok-1 tests

1. During fibrogastroscopy there was taken mucosa biopsy material in the site of the ulcer of a patient with stomach ulcer. In the Gram-stained touch smear there were revealed Gram-negative curved microorganisms. With the rest biopsy material u rease test had been made. This test was positive. What bacteria have been revealed?

A. Campylobacter jejuni.

B. Spirilla minor.

C. Shigella flexneri.

D. Treponema pallidum.

E. *Helicobacter pylori.

2. A doctor has suggested a patient to make bacteriological analysis to detect the causative agent of gastric ulcer. What microorganisms can be isolated?

A. Salmonellae.

B. Listeria.

C. Leptospires.

D. *Helicobacter pylori.

E. Shigellae.

3. A 28-year-old patient with moderate intoxication and bloody diarrhea is hospitalized. Stool culture revealed curved Gram-negative bacteria — microaerophils, catalase-positive, urease-posi-

tive, without spores and capsules, motile. Which bacteria are characterized by these properties?

A. Proteus mirabilis. D.*Helicobacter pylori.

B. Escherichia coli.

C. Haemophilus influenzae. E.Salmonella typhi.

Lesson

Pathogenic actinomycetes and fungi of genus Candida. Morphology and biological properties. Laboratory diagnostics of infections caused by them.

1. Members of the genus Candida reproduce by:

a. Arthrospore formation

b. Blastospore formation

c. Sexual spores

d. *Ascospore formation

e. Mycelial fragmentation

2. Your patient is a woman with a vaginal discharge. You suspect, on clinical grounds, that it may be due to Candida albicans. Which one of the following statements is LEAST accurate or appropriate?

a. A Gram stain of the discharge should reveal budding yeasts

b. *Culture of the discharge on Sabouraud's agar should produce a white mycelium with aerial conidia

c. To identify the organism, you should determine whether germ tubes are produced

d. You should ask her whether she is taking antibiotics

3. Each of the following statements concerning Actinomyces and Nocardia is correct EXCEPT:

a. A. israelii is an anaerobic rod found as part of the normal flora in the mouth

b. Both Actinomyces and Nocardia are branching, filamentous rods

c. N asteroides causes infections primarily in immunocompromised patients

d. *Infections are usually diagnosed by detecting a significant rise in antibody titer

4. Each of the following statements concerning Candida albicans is correct EXCEPT:

a. C. albicans is a budding yeast that forms pseudohyphae when it invades tissue

b. *C. albicans is transmitted primarily by respiratory aerosol

c. C. albicans causes thrush

d. Impaired cell-mediated immunity is an important predisposing factor to disease

5. A child was hospitalized to a clinic. On the mucous membrane of cheeks, palate, and tongue there was revealed white and yellowish fur typical of candidiasis. What material should be taken for examination?

a. *White exudates (plaques) from different sites of oral cavity

b. Hair and nails

c. Blood

d. Mucus from nasopharynx

e. Urine

6.A pediatrician examining a 3-month-old child has noticed that the mucous membrane of oral cavity and the tongue are covered with dense whitish fur. In the material taken from the site of affection a bacteriologist has revealed yeast. What mycosis will he suspect in this case?

a. Actynomycosis

b. Favus

c. Epydermophytia

d. *Candidiasis

e. Trichophytosis

7. The scraping of albescent fur from oral cavity mucous membranes was sent to a laboratory. The material was inoculated onto Sabouraud”s medium. Sour cream-like colonies” growth was revealed. Bacterioscopic method has shown short budding strings. What group of infections can we refer this disease to?

a. *Mycosis

b. Spirochetosis

c. Rickettsiosis

d. Mycoplasmosis

e. Chlamidiosis

The bank of Krok-1 tests

1. On the mucous membrane of cheeks and tongue of a child albescent stains were revealed. In the prepared smears Gram-positive oval yeast-like cells are found. What causative agent is this?

A. Corinebacterium diphtheriae.

B. Staphylococci.

C. *Fungi of Candida genus,

D. Actinomycetes.

E. Fusobacteria.

2. The scraping of albescent fur from oral cavity mucous membranes was sent to a laboratory. The material was inoculated onto Sabouraud's medium. Sour cream-like colonies' growth was revealed. Bacterioscopic method has shown short budding strings. What group of infections can we refer this disease to?

A. *Mycosis.

B. Spirochetosis.

C. Rickettsiosis.

D. Mycoplasmosis.

E. Chlamidiosis.

3. A pediatrician examining a 3-month-old child has noticed that the mucous membrane of the oral cavity and the tongue are covered with dense whitish fur. In the material taken from the site of affection a bacteriologist has revealed yeast. What mycosis will he suspect in this case?

A. Actinomycosis.

B. Favus.

C. Epidermophytia.

D. *Candidiasis.

E. Trichophytosis

4. A child was hospitalized to a clinic. On the mucous membrane of cheeks, palate, and tongue there was revealed white and yellowish fur typical of candidiasis. What material should be taken for examination?

A. *White exudates (plaques) from different sites of oral cavity.

B. Hair and nails.

C. Blood.

D. Mucus from nasopharynx.

E. Urine.

5. Candidosis of the oral cavity of a child is diagnosed. What preparation should be used for treatment?

A. Cifran.

B. Gentamycin.

C. Penicillin sodium salt.

D. Tetracycline hydrochloride.

E. *Nystatin.

6. Microscopy of the smear of vaginal discharges of a woman with chronic colpovaginitis revealed round and oval budding cells 3-6 micrometers in size.Name the fungal disease, which can be caused by these microorganisms.

A. Epidermophytium.

B. Coccidiosis.

C. *Candidosis.

D. Microsporia.

E. Cryptococcosis.

7. A pregnant woman complained of itching and genital tracts discharges. Bacterioscopy of vaginal discharges smear showed big Gram-positive oval oblong cells which form pseudomycelium. What is the most plausible causative agent of the disease?

A. Staphylococci.

B.*Fungi of Candida genus.

C. Streptococci.

D. Diplococci.

E. Sarcina.

Lesson

Pathogenic fungi. Classification and biological properties of medical-important fungi. Dermatophytes and fungi causing deep mycoses.. Laboratory diagnostics of candidosis and dermatophytosis.

1. Which one of the following fungi is MOST likely to be found within reticuloendothelial cells?

a. *Histoplasma capsulatum

b. Candida albicans

c. Cryptococcus neoformans

d. Sporothrix schenckii

2. You have made a clinical diagnosis of meningitis in a 50-year-old immunocompromised woman. A latex agglutination test on the spinal fluid for capsular polysaccharide antigen is positive. Of the following organisms, which one is the MOST likely cause?

a. Histoplasma capsulatum

b. *Cryptococcus neoformans

c. Aspergillus fumigatus

d. Candida albicans

3. Fungi often colonize lesions due to other causes.Which one of the following is LEAST likely to be present as a colonizer?

a. Aspergillus

b. Mucor

c. *Sporothrix

d. Candida

4. Each of the following statements concerning Cryptococcus neoformans is correct EXCEPT:

a. Its natural habitat is the soil, especially associated with pigeon feces

b. *Pathogenesis is related primarily to the production of exotoxin A

c. Budding yeasts are found in the lesions

d. The initial site of infection is usually the lung

5. Several fungi are associated with disease in immunocompromised patients. Which one of the following is the LEAST frequently associated?

a. Cryptococcus neoformans

b. Aspergillus fumigatus

c. *Malassezia furfur

d. Mucor species

6. Infection by a dermatophyte is MOST often as sociated with

a. Intravenous drug abuse

b. Inhalation of the organism from contaminated bird feces

c. *Adherence of the organism to perspirarior-moist skin

d. Fecal-oral transmission

7. Which one of the following is NOT a characteristic of histoplasmosis?

a. *Person-to-person transmission

b. Specific geographic distribution

c. Yeasts in the tissue

d. Mycelial phase in the soil

8. Each of the following statements concerning yeasts is correct EXCEPT:

a. Yeasts have chitin in their cell walls and ergosterol in their cell membranes

b. *Yeasts form ascospores when they invade tissue

c. Yeasts have eukaryotic nuclei and contain mitochondria in their cytoplasm

d. Yeasts produce neither endotoxin nor exotoxins

9. Each of the following statements concerning Histoplasma capsulatum is correct EXCEPT:

a. The natural habitat of H. capsulatum is the soil, where it grows as a mold

b. H. capsulatum is transmitted by airborne conidia, and its initial site of infection is the lung

c. Within the body, H. capsulatum grows primarily intracellularly within macrophages

d. *Infection does not elicit a cell-mediated immune response, and no skin test is available

10. Most fungi live as:

a. Animal parasites

b. Parasites of trees and other vegetation

c. *Saprophytes

d. Normal flora in man

11. Hair perforation test is positive in infection with:

a. Trichophyton

b. Microsporum

c. Epidermophyton

d. *All of the above

12. All of the following are dimorphic fungi except:

a. *Trychophyton

b. Cryptococcus

c. Coccidiodes

d. Histoplasma

13. Which of the following statements about host defenses against fungal infections is\are not correct

a. Antibody is not protective

b. *Leukocytes can kill fungi

c. Mild illness can confer protection against future infections

d. Interferon released from lymphocytes slows fungal infections

14. Opportunistic molds are all of them, EXEPT:

a. Candida albicans

b. Cryptococcus neoformans

c. Aspergillus fumigates

d. Malassezia furfur

e. *Trichophyton rubrum

15. Produces keratinolytic enzymes

a. Candida albicans

b. Cryptococcus neoformans

c. Aspergillus fumigates

d. Malassezia furfur

e. *Trichophyton rubrum

16. Superficial mycosis is caused by:

a. Candida albicans

b. Cryptococcus neoformans

c. Aspergillus fumigates

d. *Malassezia furfur

e. Trichophyton rubrum

17. Fungal dimorphism is:

a. An essential biological process for fungal reproduction

b. A non-essential biological process in teleomorphic growth

c. *A characteristic feature of dematiaceous molds

d. A virulence factor of Aspergillus fumigates

e. An adaptive response to an altered enviroment

18. All of the following are dimorphic fungi except:

a. *Trychophyton

b. Cryptococcus

c. Coccidiodes

d. Histoplasma

Lesson

The most medical-important protozoa. Causative agents of malaria and toxoplasmosis. Features of laboratory diagnostics of protozoan infections.

1.In malaria, the form of plasmodia that is transmitted from mosquito to human is called:

a. Sporozoite

b. *Gametocyte

c. Merozoite

d. Hypnozoite

2.Each of the following statements concerning Toxoplasma gondii is correct EXCEPT:

a. T gondii can be transmitted across the placenta to the fetus

b. T. gondii can be transmitted by cat feces

c. *T. gondii can cause encephalitis in immunocompromised patients

d. T. gondii can be diagnosed by finding trophozoites in the stool

3.Each of the following statements concerning malaria is correct EXCEPT:

a. The female Anopheles mosquito is the vector

b. Early in infection, sporozoites enter hepatocytes

c. Release of merozoites from red blood cells causes periodic fever and chills

d. *The principal site of gametocyte formation is the human gastrointestinal tract

4.Round forms of malaria protozoa that invade red blood cells are:

a. Sporosoites

b. Merosoites

c. Gametocytes

d. *Trophozoite

e. Oocyst

5.Male and female sexual cells of malaria protozoa forming in the blood of malaria patient are:

a. Sporosoites

b. Merosoites

c. *Gametocytes

d. Trophozoite

e. Oocyst

6.Toxoplasma gondii is the etiologic agent of

a. Kala-asar

b. Chagas’ disease

c. *Toxoplasmosis

d. Diarhea

e. Venereal infection

7.The infective forms of malaria protozoa that are injected into human by a mosquito are:

a. *Gametocytes

b. Trophozoite

c. Oocyst

d. Sporosoites

e. Merosoites

8.The two chemical agents most widely used to treat malaria are:

a. Penicillin and streptomycin

b. Chloramphenicol and ampicillin

c. *Chloroquine and primaquine

d. Tetracicline and penicillin

e. Vancomicin and cephalothin

9.Human malaria is caused by four species of

a. Tripanosoma

b. Leishmania

c. Toxoplasma

d. Balantidium

e. *Plasmodium

10. Transmitted by oocyst in stool of infected cat

a. Amebiasis

b. Hookworm infection

c. Enterobiasis

d. Cryptosporidiosis

e. *Toxoplasmosis

11.The condition\symptom that is most consistent with toxoplasmosis:

a. Eosinophilia

b. Liver abscess

c. Steatorrhea

d. *Chorioretinitis

e. Vaginitis

12.The procedure that is effective in revealing stages important in making a diagnosis of neonatal toxoplasmosis

a. Blood smear

b. Stool exam

c. *Serological test

d. Liver biopsy

e. Non of the above

13.Which disease is transmitted by mosquito bite?

a. *Malaria

b. Whipworm infection

c. Trichinosis

d. Gardiasis

e. Schistosomiasis

Lesson

The most medical-important protozoa. Causative agents of amebiasis, giardiasis, leshmaniasis, trypanosomiasis, and balantidiasis. Features of laboratory diagnostics of protozoan infections.

1. Which one of die following protozoa primarily infects macrophages?

a. Plasmodium vivax

b. *Leishmania donovani

c. Trypanosoma cruzi

d. Trichomonas vaginalis

2. Each of the following parasites has an intermediate host as part of its life cycle EXCEPT:

a. *Trichomonas vaginalis

b. P.falciparum

c. P.vivax

d. Toxoplasma gondii

3. Each of the following parasites is transmitted by mosquitoes EXCEPT:

a. Leishmania donovani

b. *Wuchereria bancrofti

c. Plasmodium vivax

d. Plasmodium falciparum

4. Amoebic dysentery in humans is caused by

a. G.lamblia

b. T.hominis

c. L.donovani

d. *E.histilitica

e. T.cruzi

5. Venereal infection is caused by

a. *T.vaginalis

b. L.donovani

c. G.lamblia

d. E.histolitica

e. T.cruzi

6. Laboratory diagnosis of a patient with a suspected liver abscess due to Entamoeba histolytica should include

a. *Stool examination and indirect hemagglutination test

b. Stool examination and blood smear

c. Indirect hemagglutination test and skin test

d. Xenodiagnosis and string test

7. Each of the following statements concerning G. lamblia is correct EXCEPT:

a. G. lamblia has both a trophozoite and a cyst stage in its life cycle

b. *G. lamblia is transmitted by the fecal-oral route from both human and animal sources

c. G. lamblia causes hemolytic anemia

d. G. lamblia can be diagnosed by the string test

8. Each of the following statements concerning Trichomonas vaginalis is correct EXCEPT:

a. T. vaginalis is transmitted sexually

b. T. vaginalis can be diagnosed by visualizing the trophozoite

c. T. vaginalis can be treated effectively with metronidazole

d. *T. vaginalis causes bloody diarrhea

9. Each of the following statements concerning Trypanosoma cruzi is correct EXCEPT:

a. T. cruzi is transmitted by the reduviid bug

b. T. cruzi occurs primarily in tropical Africa

c. T. cruzi can be diagnosed by seeing trypo-mastigotes in a blood smear

d. *T. cruzi typically affects heart muscle, leading to cardiac failure

10. Tripanosoma gambiense is the etiologic agent of

a. Kala-azar

b. *Chagas’ disease

c. African sleeping sickness

d. Diarrhea

e. Venereal infection

11. A protozoan-caused intestinal infections that is transmitted by ingestion of water or food contaminated by cists that the present in hog feces is:

a. *Balantidiasisi

b. Trihomoniasis

c. Cystitis

d. Trihinosis

e. Leishmaniosis

12. Each of the following statements concerning sleeping sickness is correct EXCEPT:

a. Sleeping sickness is caused by a trypanosome

b. Sleeping sickness is transmitted by tsetse flies

c. *Sleeping sickness can be diagnosed by finding eggs in the stool

d. Sleeping sickness occurs primarily in tropical Africa

13. Each of the following statements concerning kala-azar is correct EXCEPT:

a. Kala-azar is caused by Leishmania donovani

b. Kala-azar is transmitted by the bite of sandflies

c. *Kala-azar occurs primarily in rural Latin America

d. Kala-azar can be diagnosed by finding amastigotes in bone marrow

14. Amoebic dysentery in humans is caused by

a. G.lamblia

b. T.hominis

c. L.donovani

d. *E.histilitica

e. T.cruzi

15. The condition\symptom that is most consistent with trichomoniasis:

a. Eosinophilia

b. Liver abscess

c. Statorrhea

d. Chorioretinitis

e. *Vaginitis

The bank of Krok-1 tests

1 A woman with complaints characteristic of inflammatory process in vagina has referred to a gynecologist. Which protozoa can it be caused by?

A. *Trichomonas vaginalis.

B. Toxoplasma gondii.

C. Plasmodium malariae.

D. Entamoeba coli.

E. Lamblia intestinalis.

Lesson

Major tasks of the clinical microbiology. Normal microbiota of the human body. Pathologically changed microbiota, clinical appearance and laboratory revealing

1. Vaginal dysbacteriosis of a pregnant woman is diagnosed. What preparation should be prescribed in this case?

A. *Eubiotic

B. Bacteriphage

C. Interferon

D. Antidiotic

E. Polyvitamin

2. The major genera of Gram-negative anaerobic bacteria in the colon is:

A. *Escherichia

B. Klebsiella

C. Streptococcus

D. Candida

E. Proteus

3. The normal flora of the human body is composed mainly of:

A. *Bacteria

B. Protozoa

C. Viruses

D. Fungy

E. Algae

4. A patient, who has been taking antibiotics for a long time, has developed intestinal dysbacteriosis. What drug should be prescribed for restoration of normal microflora?

A. Sulfonamide

B. *Eubiotic

C. Interferon

D. Antimycotic

E. Nitrofurans

5. Which of the following statement is correct?

A. Before birth a healthy human fetus has acquired a normal flora

B. Under natural circumstance, the fetus first acquires microorganisms while passing down the birth canal

C. A child will eventually have a very different kind of normal flora from that of an adult person in the same environment

D. *The normal flora of the skin on a child would have the same mixture of the microbial species as the normal flora of the large intestine

6. A common bacterium that lives in the mouth is:

A. *Streptococcus salivarius

B. Staphylococcus aureus

C. Clostridium difficile

D. Escherichia coli

E. Propionibacteriun acnes

7. The major genera of Gram-positive anaerobic bacteria on the skin is:

A. Streptococcus

B. Escherichia

C. *Propionobacterim

D. Candida

E. Lactobacillus

The bank of Krok-1 tests

1. Vaginal dysbacteriosis of a pregnant woman is diagnosed. What preparation should be prescribed in this case?

A. Bacteriophage. D.*Eubiotic.

B. Antibiotic.

C. Interferon. E. Polyvitamin.

2. A patient, who has been taking antibiotics for a long time, has developed intestinal dysbacteriosis. What drugs should be prescribed for restoration of normal microflora?

A. Sulfonamide. D.Antimycotic.

B. *Eubiotics.

C. Interferon. E. Nitrofurans.

Lesson

Sanitary microbiology and virology, main principles. Sanitary-microbiological investigation of the water, soil and air.

1. During a sanitary-bacteriological tap water investigation the following results were obtained: the total amount of bacteria in 1.0 ml is 80, coli index is 3. How should the results of the investigation be evaluated?

A. *Quality of water is doubtful.

B. Water is polluted.

C. Water is eligible for drinking.

D. Quality of water is very doubtful.

E. Water is considerably polluted.

2. Sanitary-bacteriological investigation of water by the method of membranous filters detects two red colonies on a membranous filter (Endo medium), through which 500 ml of the explored water has been passed. What are the coli index and coli titer of the explored water?

A. *4 and 250.

B. 500 and 2.

C. 2 and 500.

D. 250 and 4.

E. 250 and 2.

3.Which of the following is soil bacteria?

A. *Bacillus subtilis.

B. Streptococcus pneumoniae

C. Vibrio cholera

D. Corynebacterium diphtheria

4. Which of the following is/are water-borne pathogen/s?

A. Hepatitis A virus.

B. Vibrio cholera.

C. Entamoeba hislolytica.

D. *All of the above.

5. Which of the following organisms can serve as indicator of fecal pollution of drinking water?

A. *Enterococcus faecalis

B. Bacillus subtilis.

C. Corynebacterium diphtheria.

D. Baccillus megaterium

6. In presumptive coliform count of water, it is considered satisfactory if the count is:

A. 0.

B. *1-3.

C. 4-10.

D. 10-15.

7. In operation theatre for dentist, bacterial count of air should not exceed:

A. *1 per foot3.

B. 10 per foot3.

C. 5 per foot3.

D. 50 per foot3

8. In operation theatres for surgery, bacterial count of air should not exceed:

A. 50 per foot3.

B. 10 per foot3.

C. 5 per foot3.

D. *1 per foot3

9. Besides coliforms, which other bacteria can serve as indicator organism/s for faecal pollution of water?

A. *Enterococci

B. Vibrio.

C. Staphylococci

D. Spreptococci

10. Sanitary-bacteriological water research is carried out to assess drinking water eligibility. What numerical symbol characterizes the amount of E.coli in one liter?

A. Perfringens titer.

B.*Coli index.

C. Coli titer.

D. Coli phage titer.

E. Total microbial amount.

11. Sanitary-microbiologic drinking water research is being carried out in a bacteriological laboratory. Total microbial amount appeared to be nearly 100. What microorganisms were taken into account?

A. Enteropathogenic bacteria and viruses.

B. Coliform bacteria.

C. Pathogenic for people and animals bacteria.

D. Opportunistic microorganisms.

E. *All bacteria, which have grown on nutrient medium.

12. Microbial amount of air in a hospital room appeared to be 1500 cells/m3. What groups of microorganisms were taken into consideration?

A. Bacteria and viruses — causative agents of respiratory infections.

B. *All bacteria, which have grown in nutrient medium.

C. Staphylococci and streptococci.

D. Hospital infection causative agents.

E. All pathogenic and opportunistic bacteria.

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