Вінницький національний медичний університет ім. М.І. …



* - наробки кафедри

(04) – 2004

(05) – 2005

(06) – 2006

(07) – 2007

(08) – 2008

Infections diseases with the syndrome of exanthema

Scarlet fever

1.* 6-year-old child. Complaints: Т - 38,9о С, headache, throat ache on swallowing, skin rash. 1st day of the disease: face is hyperemic, perioral area is pale. Pharynx - hyperemic, on tonsils there’s a coating, easily detached. Submandibular lymphatic nodes are enlarged, tender. On the flexor areas of the limbs and trunk there are dotted rash, not conglomerated on the hyperemic skin. What etiotropic medication is indicated in this case?

A. Lincomycin

B. Immunoglobulin

C. Polymixyn

D. Biseptolum

E. Penicillin

2.* 12-year-old child, 2nd day - throat ache, vomiting, punctuate pink rash on the neck, lateral parts of the trunk, inguinal folds, internal sides of the legs. Т- 39,7°С, perioral area without rash. In the pharynx there is a bright hyperemia, coating on the tonsils, tongue has white coating, the apex is “raspberry”, with papillae. What is the primary diagnosis?

A. Measles.

B. Rubella.

C. Scarlet fever

D. Pseudotuberculosis.

E. Chickenpox.

3.* 6 -year-old child. 2nd day. Complains on sore throat, twice vomiting. Т- 38,5°С, cheeks are bright pink, pallor perioral area, punctuate pink rash on the skin, mostly on the flexor surfaces of the limbs and in the folds. In the pharynx there’s bright hyperemia, tongue is coated. Scarlet fever is supposes. What antibiotic is preferable?

A. Cephasolin.

B. Penicillin.

C. Erythromycin.

D. Hentamycin.

E. Lincomycin.

4.* Girl 7 years old with complaints to rise in temperature in 38( With, a pain in joints (all over again in talocrural, then knee), for 3 weeks she was ill quinsy. Pallor, frequency breathing is expressed by 34/minutes. Borders of heart are expanded at the left systolic noise at top, the liver is increased on 3 see. Hemogram: Eryth. 3,2х1012/л, Нв 100 г/л, Leu 9,8х109/л, R.C.- 5, with – 55, l– 45, m – 4,ESR- 25 mm / hour. What etiological the factor of this disease?

A. Staphylococcus

B. Streptococcus

C. Klebsiela

D. Gonococci

E. Iersinea

5.* The patient with a fever, a pain in a throat at swallowing at objective inspection quinsy is diagnosed lacunar. What kind of treatment is necessary for appointing in the first turn?

A. Symptomatic therapy

B. Infusion therapy

C. Immunotherapy

D. Antibacterial therapy

E. Antihistamine therapy

6. (04, 07) A 7 y.o. girl fell ill abruptly: fever, headache, severe sore throat, vomiting. Minute bright red rash appear in her reddened skin in 3 hours. It is more intensive in axillae and groin. Mucous membrane of oropharynx is hyperemic. Greyish patches is on the tonsills. Submaxillary lymph nodes are enlarged and painful. What is your diagnosis?

A. Measles

B. Enteroviral infection

C. Scarlet fever

D. Rubella

E. Pseudotuberculosis

Measles

7.* 4-year-old child. 5th day. Complains on cough, rash appeared 2 days ago. Т - 38,2°С, pallor and edematic face, conjunctivitis, rhinitis, maculopapular rash behind the ears, upon the neck, on upper part of thorax, somewhere confluent. Pharynx is hyperaemic. Dry rhonchi in the lungs. What is the primary diagnosis?

A. Adenovirus infection.

B. Influenza.

C. Rubella.

D. Enterovirus infection.

E. Measles.

8.* 4-year-old. Fever 37,8°С, dry cough, conjunctivitis, rhinitis. Face is edematic, skin is without pathology. Pharynx bright, buccal mucosa is papular, near the molars there are little white spots (1х1 mm), surrounded by hyperemic area, do not detach. Measles is supposed. What period of the disease does child have?

A. Incubation.

B. Prodromal

C. Rash-period.

D. Pigmentation.

E. Residual.

9.* 7-year-old child. Complaints: Т - 37,7оС, dry cough, nasal respiration is disturbed. 4th day: Т- 39,5оС, behind the ears, on the face and neck there are maculopapular rash, some elements are confluent. Pharynx is hyperaemic, ananthema, on the cheek mucus there are a whitish spots; conjunctivitis. What is the primary diagnosis?

A. Scarlet fever

B. Rubella

C. Measles

D. Chickenpox

E. Meningococcal infection

10.* 5-year-old child, has got acutely sick; Т - 38о С, barking cough, sharp pain in eyes. 4th day of the disease: Т - 40оС, apathic, somnolence, barking cough, light fear. On the face, neck and upper parts of trunk bright-red maculopapular rash, confluent, on the pale skin. On the buccal mucosa anathema and little white spots. In the lungs – resonant breath. Child didn’t have vaccination, admits kinder garden, where there are other 5 non-vaccinated children. What is the primary diagnosis:

A. Meningococcal infection

B. Measles

C. Scarlet fever

D. Enterovirus infection

E. Rubella

11. * In the middle group in the kinder garden there is a case of measles. 3 children didn’t have this disease before and are non-vaccinated. Children are healthy; do not have contraindications for prophylaxis. What would you prefer to use for prophylaxis of measles for those children?

A. Anti-measles vaccination

B. Acyclovir

C. Immunoglobulin

D. Not to use specific prophylaxi

E. Interferon

12.* In family hostel the child was ill measles For what term it is necessary to isolate the sick child for the prevention (warning) of distribution of an infection?

A. Up to the fifth day from the beginning eruption

B. Up to he sixth day from the beginning eruption

C. Up to the tenth day from the beginning eruption

D. Up to the twelfth day from the beginning eruption

E. Up to the fifteenth day from the beginning eruption

13. * Child of 4 years old. 5-th day of illness. Complaints to cough, a rash on the skin. Т - 38,2( C, pallor and conjunctivitis. On the person, a neck, the top half of thorax bright it macula - papular, places a drain rash. A pharunx hiperemia. From a nose –serous-purulent separated. In easy - dry rattles. Your diagnosis?

A. German measles.

B. Adenovirus infection.

C. Scarlatina

D. Measles.

E. Enterovirus exanthema.

14.* Boy of 2 years was in touch with a girl, who had sick measles during catarrhal period. Antibodies were injected him. How long the incubatory period may last?

A. 7 days

B. 17 days

C. 28 days

D. 14 days

E. 21 day

15. *Child of 5 years old has got acutely sick, temperature raised up to 38.5(C, a cold, cough and conjunctivitis appeared. For 4-th day of illness has appeared it macula– papular rash on the body, new rise of temperature up to 39.2( C. Mucous membrane of the pallet is hyperemic, on a mucous membrane of cheeks opposite the molars - there are fine gray spots. Diagnose:

A. Rubela

B. Iersinios

C. ARVI

D. Measles

E. Enterovirus infection.

16.* Children’s preschool establishment some children simultaneously were ill measles. In this connection quarantine for the period of 21 day is established. His(its) duration is proved:

A. Minimal term of the incubatory period

B. Maximal term of the infectious period

C. Maximal term of the incubatory period

D. Medium term of the incubatory period

E. High virulence activator

17.* The child of 9 months old has got measles, in the first day of rash appearance he was hospitalized. His brother of 4 years old, who contacted with him did not have measles and was not vaccinated, due to the constant contra-indications of a general condition of his health. By what means of bellow listed actions it is possible to warn measles in this child?

A. Chemotherapy using

B. Vaccination

C. Using antibiotics

D. Gamma-globulinoprophylaxis

E. Fagoprophylaxis

18. (06,08) A 3 year old child has been suffering from fever, cough, coryza, conjunctivitis for 4 days. He has been taking sulfadimethoxin E. Today it has fever up to 39oC and maculopapular rash on its fac E. Except of rash the child's skin has no changes. What is your diagnosis?

A. Scarlet fever

B. Rubella

C. Pseudotuberculosis

D. Measles

E. Allergic rash

19. (04-05) A child, aged 4, has being ill for 5 days, suffers from cough, skin rash,

t0- 38,20С, facial hydropy, photosensitivity, conjunctivitis. On the face, neck, upper part of the chest there is bright maculopapular rash with areas of merging. Hyperemic throat. Seropurulent nasal discharge. In lungs there are dry crackles. What is the most probable preliminary diagnosis?

A. Scarlet fever

B. Enterovirus exanthema

C. Measles

D. Adenovirus infection

E. Rubella

20. *Measles in children is characterized by:

A. Maculopapular rash, conjunctivitis, rhinitis, high fever

B. Vesicular rash and high fever

C. Tonsillitis and conjunctivitis without rash

D. Hemorrhagic spots and meningeal signs

E. Tonsillitis, strawberry tongue and macular rash

Chickenpox

21.* 7-year-old child. Complaints: Т - 38,2о С, skin rash. Examination: on the face, scalp, trunk, and limbs – macules, papules, vesicles, crusts. Palms and feet are free from the rash. Pharynx is a bit hyperaemic, on the right arc – vesicle. The internal organ – without pathology. What is the primary diagnosis:

A. Herpes simplex

B. Smallpox

C. Chickenpox

D. Streptodermy

E. Allergic rash

22.* 10 -year-old child. 22nd day of the chickenpox he have got fever - 38°С, apatic, torpid. Speech is abnormal, vomiting, dizziness. Meningeal sings are negative. There are lots of crusts on the skin. Cerebrospinal fluid: transparent, pressure is increased. Cytosis - 62, lymphocytes – 98 %, neutrophils – 2 %, protein - 400 мg/L. Pandy reaction ++, Noone-Appelt +++. What is the primary diagnosis?

A. Chickenpox, typical severe form with smooth course.

B. Chickenpox, secondary encephalitis

C. Chickenpox, encephalitic reaction.

D. Mix-infection: Chickenpox + viral encephalitis of other etiology.

E. meningoencephalitis, not connected to the chickenpox

23.* 5 - year-old child, disease started with fever 37,5°С, on the abdomen, back, limbs, scalp there is macular rash. In several hours those macula became papules and vesicles with surrounding hyperemia, without infiltration. On the soft palate – two aphta. Intoxication isn’t severe. What is the primary diagnosis?

A. Chickenpox.

B. Measles.

C. Enterovirus infection.

D. Rubella.

E. Scarlet fever.

24.* Child 5 years has been sick for six day. Some deterioration of the general condition, the body temperature is increased up to 37,2 C(, an itching rash. At examination, fibrous parts of a head, a body, there is polymorphic rash as roseola, papula vesicles, pustule, scab superficial ulceres. Palms and soles are free from eruption. What disease is the most probable in this case?

A. Allergic a rash

B. Natural a smallpox

C. Chickenpox

D. Measles

E. Steven-Johns syndrome

25.* Sick child of 4 years old has been examined by district pediatrician. He has been sick for 3 days. Complaints: rise of a body temperature up to 39.9(C, itching of the skin, loss of appetite, eruption all over the body. During the examination: a skin is pale, on hairy parts of a head, a trunk, fine polymorphic eruptions: maculas, papulas, vesicles, crusts. What diagnosis is most probable in this case?

A. Naturale smallpox

B. Chickenpox

C. Streptococcal impetigo

D. Staphyloderma

E. Herpetic infection

26. * The child of 11 months has a slight indisposition, temperature 37.2(C, punctuate rash, which quickly disappears. Next day temperature 39( on the skin of a trunk and a head – there is a macula, papula and vesicle with the transparent contents, itching, soft, single-chamber, not grouped. Some of the rash elements quickly disappeared from the person’s hands with formation of crusts. Diagnose:

A. Naturale smallpox

B. Scarlatina

C. Impetigo

D. Generalized form of a simple herpes

E. Chickenpox

27.* Girl of 5 years old has got a chicken pox (moderate severity). For what term it is necessary to isolate the child?

A. From 10 days up to the beginning drying up eruption on a leather(skin).

B. For 17 days from the beginning of disease.

C. For 21 day from the moment of contact with the sick child.

D. For 9 days from the moment of occurrence of a rash.

E. For 7 days after the temperature is normal.

28.(06-08) A 7 y.o. girl has mild form of varicella. Headache, weakness, vertigo, tremor of her limbs, ataxia, then mental confusion appeared on the 5th day of illness. Meningeal signs are negative. Cerebrospinal fluid examination is normal. How can you explain these signs?

A. Myelitis

B. Meningoencephalitis

C. Encephalitis

D. Meningitis

E. Neurotoxic syndrome

29. * What is the typical rash for chickenpox?

A. Vesicular, polimorphic

B. Hemorrhagic spots

C. Macular spots, localized in the fossae and underarm

D. Maculopapular, confluent

E. Ulcers of the skin

Rubella

30.* 11-year-old child. Т - 37,8°С, marked enlargement and tenderness of the cervical lymphatic nodes. The same day appeared macular rash on the trunk and face. Buccal mucosa are without changing, moderate hyperemia in the pharynx. 2nd day t - 37,2°С, child feels better, but rash became even more severe, all over the body. Suboccippital lymph nodes are enlarged. What disease do you suppose?

A. Measles, mitigated form.

B. Enterovirus infection, exanthema.

C. Allergic rash.

D. Rubella, typical mild form.

E. Measles, typical mild form.

31.* During examination: on the mucous membrane of pharynx there enanthema, the increase postcervical and occipital lymph nodes, on all body spotty – papular rash is observed with

primary localization on a back, buttocks, unbending surfaces of exteremities.

What is the most probable diagnosis?

A. Stomatitis

B. Measles

C. Scarlatina

D. German measles

E. Enterovirus infection

32.* Child was born on 8-th month of pregnancy. At him(it) are revealed: microcephaly, cataract, intimate insufficiency. Mother of the child on 2-nd month of pregnancy was illing short rise of temperature up to was 37,5(With, increase in lymph nodes and small maculate rash on the person, a trunk and finitenesses which has passed in 3 days without the residual phenomena. What disease was transferred by mother?

A. Toxoplasmosis

B. Cytomegalovirus infection.

C. Herpetic infection.

D. Chlamidian infection.

E. Rubellа

33. (04, 05, 07,08) A 2 y.o. girl has been ill for 3 days. Today she has low grade fever, mild catarrhal presentations, slight maculopapular rash on her buttocks and enlarged occipital lymph nodes. What is your diagnosis?

A. Rubella

B. Adenoviral infection

C. Measles

D. Scarlet fever

E. Pseudotuberculosis

Acute intestinal infections

34.* 3-month-old child. Complaints: Т - 38,3оС, frequent watery stool, weight loss, vomiting. 3rd day of the disease. Т - 36,2оС, HR - 168, RR – 62/min. Skin is pale, grayish, dry, cold, marble-like. Facial features are sharpened, eyes are retracted. Big fontanelle is retracted. Tongue has white coating. Turgor is decreased. Abdomen is distended Stool is frequent, massive, watery. Urination is rare. Bilirubin - 27,4 mmol/L. The sevire condition is more like to be due to:

A. Acute respiratory failure

B. Toxicosis with exicosis

C. Acute renal failure

D. Neurotoxicosis

E. Encephalitic reaction

35.* A girl of 8 months is hospitalized in the infectious department, due to an acute intestinal infection. Which method from the list below helps to verify the diagnosis?

A. Bacteriological and virologic analyses of excrements.

B. Anamnesis.

C. Clinical attributes.

D. General analysis of blood.

E. Coprogramm

36.* Within a period of 2 days 30 children of different age groups from a children’s preschool institution got acutely sick with an intestinal infection. What way of transmission is the most authentic?

A. Contact

B. Water

C. Food

D. Inoculable

E. Air

Pseudotuberculosis

37.* 12 year-old child. Complaints: Т - 38-39о С, headache, abdominal pains. 4th day: skin rash in the pleats area – punctuate on the hyperemic background. Face, neck, hands, feet are edematic, cyanotic. Skin and sclera are subicteric. Pharynx is hyperemic, “raspberry tongue”, conjunctivitis and scleritis is observed. Ankles are edematic and painful. Lymphoadenopathy; liver + 3,5 cm, lien + 1 cm. Blood: leucocytes - 23,0 х 109/l, eosinophils – 4 %, s - 12 %, mature neutrophils – 71 %, lymphocytes – 10 %, monocytes – 3 %, ESR - 50 mm/h. Urine analysis - protein, red blood cells - 1-2, leucocytes - 10. Primary diagnosis:

A. Scarlet fever

B. Pseudotuberculosis

C. Viral hepatitis

D. Typhoid fever

E. Infectious mononucleosis

38.* Child 5 years. Was ill sharply. Т – 38,5С, pains in a throat and a stomach. In 3 days - a rash on a leather(skin). 4-th day of illness - a condition heavy. It is languid, pale. Plentiful small maculation rash on all body, condensed on the person, brushes and stops. Total hyperemia mucous a pharunx. "Crimson" language. Tones of heart deaf persons. A stomach painful (unhealthy). A chair liquid, 2 once a day, without impurity. Your diagnosis?

A. Scarlatina.

B. Pseudotuberculosis.

C. Staphilococcus infection with syndrome of scarlatina.

D. Measles

E. Enterovirus exanthema.

Typhoid fever

39.* 10-year-old child. 9th day of the disease. Complaints: malaise, apathy, headache, Т- 38,5-39,5оС. Examination: heavy condition, Т - 39,2о С. Apathy. Skin is pale, dry, single rosella are found in the abdominal area. Tongue is with greyish coating, with teeth prints. Heart sounds are muted, bradycardia, abdomen is distended, tender in the right iliac area. Liver + 3,5 cm, lien + 1,5 cm. Stool is liquid, 1-2 times a day. Blood: Leucocytes- 4,5 х 09/л, myelocytes - 8%, mature neutrophils - 26%, lymphocytes - 52%, monocytes- 14%, ESR - 26 mm/h. Primary diagnosis:

A. Meningococcal infection

B. Typhoid fever

C. Influenza

D. Enterovirus infection

E. Salmonellosis

40.* Child 8 years. Complaints to rise in temperature all the days long, a headache. For 9 day of illness slackness, temperature 39,8С is marked, the pallor, the inflated stomach, is palpated a liver and a spleen. On a stomach 4 elements of a spotty rash in the size 0.2 х 0.2 see. Your diagnosis?

A. Typhoid fever.

B. Sepsis

C. Pseudotuberculosis

D. Infected mononucleosis

E. Enteritis infection.

41.* What period during a belly typhus is the most dangerous to development complications on the part of a gastroenteric path?

A. First week

B. Second week

C. Third week

D. Fourth week

F. Fifth week

Salmonellosis

42.* 5 -year-old child. Complains on repeated vomiting. Т- 38,8°С, pallor, apatic, skin is without pathology. Tongue is dry, has white coating. Heart sounds are muted. Abdomen is distended, tender in the epigastric area, stool 6 times a day, watery, dark-green color with some mucus. What is your primary diagnosis?

A. Bacillar dysentery.

B. Yersiniosis.

C. Salmonellosis.

D. Escherichiosis.

E. Rotaviral infection.

43.* 3-month-old child has Salmonella typhimurium infection. 7th day: the condition became worse. Т - 39,0°С, repeated vomiting, bulged fontanelle. Meningitis is supposed. Hard respiration in the lungs, crackles, on the both sides, RR – 76/min, pulse - 152 per minute. Abdomen is distended. Stool is frequent, watery, dark-green. What form of the disease does child have?

A. Typhoid.

B. Dispepsic.

C. Septic.

D. Subclinical.

E. Without symptoms.

44.* Child 10 months. Complaints: Т - 39.6( With, a watery stool. 5-th day: Т - 38.7( simultaneously the child is weak, pale. The tongue is covered with a white coat. Tones of heart are muffled. The stomach is inflated, rumbling in area of umbilicus, departments of thick intestines are not changed. Watery stool, 5 times a day of dark green color as « marsh scum», with an impurity of transparent slime. Your diagnosis?

A. Acute dysentery.

B. Iersiniosis intestinal.

C. Escherihiosis.

D. Salmonellosis

E. Rotavirus infection.

45.* The child of 2 years has a fever of 38,5( with vomiting, dehydratation 2-3rd degree, stool is up to 10 times per day, excriments: watery, foamy, brown-green color. The mother has similar symptoms after the use of crude eggs. What is the most probable diagnosis?

A. Shigellosis

B. Salmonellosis

C. Campilobacteriosis

D. Rotavirus infection

E. Enterovirus infection

46.* A child of 3 months old is severely sick. He has a fever, dehydratation of the second degree, frequent vomiting, watery excrements of brown-green color. Clinical signs of hepatitis, pneumonia and meningitis are observed. Salmonella is detected in the blood. What clinical form of salmonellosis is the most probable?

A. Subclinical

B. tiphys-like

C. Gastritical

D. Enterocolitical

E. Septical

Dysentery

47.* 6 -year-old child. Complains on frequent watery stool, vomiting. 2nd day: malaise, t- 38,4°С, pulse 150 per min, abdomen is retracted, tender sigmoid is palpated, stool - 10 times a day, watery with blood and mucus. What is your primary diagnosis?

A. Salmonellosis.

B. Yersiniosis.

C. Typhoid fever.

D. Bacillar dysentery.

E. Amoeboid dysentery.

48.* 1,2-year-old child. Complains on frequent watery stool, vomiting, fever. 3rd day: fainting, fever 39,3°С, pallor, pulse 150 per min, RR 32per min, heart tones are muted, lungs without abnormalities, abdomen is retracted, painful on bowel palpation, anus is widen, stool 38 times a day, with blood, pus and mucus. Primary diagnosis is acute bacillary dysentery. What form is it?

A. Mildest.

B, Mild.

C. Moderate.

D. Severe.

E. Toxic.

49.* The child of 2 years is hospitalized in the infectious department. Complains of recent rise of body temperature up to 40( C, absence of appetite, vomiting. He has been sick for two days. The skin is pale, a tachycardia, tones of heart are weakened, expressed hemocolitis ("rectal spittle ", slime, pus, blood in excrements), loss of the direct gut, a "gaping" anus. What from the listed diagnoses is the most probable?

A. Proteose

B. Escherihios

C. Shigella

D. Klebsiella

E. Staphylococcus enterocolitis.

50.* Child 5 years, became acutely sick. Disease began from rise in temperature of a body to 38.5( with, a watery stool with plenty of muddy slime. During the time of defecation the child cries, is agitated and reddens. What disease is the most probable?

A. Shigelles

B. Salmonellosis

C. Ecsherishios

D. Staphylococcus enterocolitis

E. Virus diarrhea

51.* Child 6 years. Complaints of frequent watery stool, vomiting. For 2-nd day of illness weakness, temperature is 38.4(, pulse 150 per minute, a sunken stomach, watery stool 10 times per day with slime and greens, painful sigmoid is palpated. Your diagnosis?

A. Amebic a dysentery.

B. Salmonellosis

C.Iersiniosis intestinal.

D. Abdominal typhus.

E. Bacterial dysentery.

52.* Patient 5 years got sick suddenly. Complains of a pain in the stomach, complete loss of appetite, tenesmus, triple vomiting, rise in body temperature of a up to 38(C, with frequent (up to 10 times day) watery excrements with slime. Objectively: turgor of soft tissues is decreased. The abdomen at palpation is soft, but with painful spastic sigma. The liver extends 1,5 cm down from the costal arch. About what disease do you need to think?

A. Cholera

B. Acute appendicitis

C. Virus hepatites

D. Shigelles

E. Food toxicoinfection

53.* Child of 5 years old got acutely sick. The onset was a rise of body temperature up to 39,2( With, frequent vomiting. Complaints of spasmodic pains in the stomach, tenesmus, and frequent defecations: scanty, with plenty of slime, greens and blood streaks. During examination: sigma is spasmodic, painful at palpation. Diagnosis:

A. Cholera

B. Salmonellosis.

C. Acute appendicitis

D. Shigellosis

E. Rotavirus infection.

54. * 8 year – old boy fell ill acutely: fever, weakness, headache, abdominal pain, recurrent vomiting, then diarrhea and tenesmus. Stools occur 12 times daily, are scanty, contain a lot of mucus, pus, streaks of blood. His sigmoid gut is tenderness and hardened. What is your diagnosis?

A. Dysentery

B. Salmonellosis

C. Cholera

D. Staphylococcal gastroenteritis

E. Escherichiosis

55. * Dysentery is commonly characterised by:

A. High fever, vomiting, false urge to defecate, stool in the form of a spit mucus

B. Watery, yellow, profuse stool

C. Hepatosplenomegaly and diarrhea

D. “Typhoid status”

E. Pea-soup feces

Cholera

56. (04) A child fell abruptly ill. Frequent watery stool developed 6 hours ago. The body temperature is normal. Then vomiting took place. On physical examination: child 's voice is hoarse, eyes are deeply set in the orbits. The pulse is frequent. Blood pressure is low. There is no urine. What is the preliminary diagnosis?

A. Salmonellosis

B. Dysentery

C. Cholera

D. Toxic food-borne infection

E. Typhoid fever

Esherichiosis

57.* 4,5-month old child. Complaints are: subfebrile fever, frequent (8times a day), watery stool. 4th day: 37,4°С, stool liquid 6 times a day, orange colour, internal organs are without pathology. Has a good appetite. Blood: moderate leucocytosis, ESR - 10 mm/h. Stool analysis: fatty acids ++, soaps ±. From the stool was cultivated EPE 0111 – diagnosed Escherichiosis enteritis. What form of the disease does child have?

A. Subclinical.

B. Mild.

C. Moderate.

D. Severe.

E. Toxic.

58.* 9-month-old child. Complaints are: fever, vomiting, frequent, watery stool. 4th day: t - 37,8°С, apatic, appetite loss, abdomen is distended, stool 12 times a day, orange colour, watery, vomiting, no signs of dehydration. Internal organs are without changes. From stool was cultivated EPE 026. What form of Escherichiosis does patient have?

A. Subclinical.

B. Mild.

C. Moderate severity.

D. Severe.

E. Toxic.

59.* Child 4 months was ill 2 days ago when the temperature up to 37,6 has raised (increased)( with liquid excrements, aqueous, bright yellow color with lumps have appeared not digested food up to 20 times day, vomitting 2-3 times. At survey: a condition heavy, the child languid, a leather (skin) pale, dry, undertakes pleated, тургор fabrics is lowered. Big fontanel sinks down. Tones of heart are weakened, a tachycardia, the phenomena of a peripheral angiospasm are marked. Tachypnea. The stomach is increased in sizes, expressed wind. The liver, a spleen are not increased. Your diagnosis:

A. Enteropathogenic escherichios

B. Shigellosis

C. Salmonellosis

D. Intenstinal iersinios

E. Enteroinvasive escherichiosis.

60. *Characteristics of hypernatremic dehydration with Na+ in serum 170 meq/L and 10 percent loss of body weight include all the following EXCEPT

A. Low blood pressure

B. Convulsions

C. Thirst

D. Lethargy

E.Hyperirritability

Neuroinfections

Poliomyelitis

61.* 3-year-old child. Have got sick acutely. Т- 39°С, malaise, sweat. Nose is obstructed. Pharynx is hyperaemic. Abdominal pains. 2nd day – back pain. 4th day Т - 36,7°С, but can’t step on the right leg, left arm is “lash-like”, muscle tone and tendon reflexes in affected limbs are decreased. Sensation is saved. What is your primary diagnosis?

A. Meningococcal infection

B. Influenza

C. Polyneuritis

D. Encephalitis

E. Acute poliomyelitis

62* 5 -year-old child. Have got sick acutely. Т- 38,9°С, malaise. Catarrhal sings in the lungs. from the right side can’t close eye, nasolabial plica is smoothed, mouth retightened to the left, sensation is saved. Cerebrospinal fluidе: protein- 0,46 g/L, cytosis - 85 per 1 mkL, lymphocytes. What is your primary diagnosis?

A. poliomyelitis, pont form

B. Facial nerve palsy.

C. Encephalitis.

D. Influenza.

E. Purulent meningitis.

Meningococcal infection. Purulent meningitis. Serous meningitis.

63.* 4-month-old. Disease developed acutely, Т - 39,8о С, anxiety, vomiting, short convulsions. 2nd day of the disease: somnolence. The enlargement of the big fontanelle is observed. Hyperesthesia. On the legs and buttocks heamorrhagic rash with necrosis in the center. Pharynx is hyperemic. Heart sounds are muted, tachycardia. Revealed neck stiffness. CSF: cytosis - 1203, protein - 0,59 g/L, neutrophils – 88 %. What is the primary diagnosis:

A. Encephalitis

B. Influenza

C. Enterovirus infection

D. Measles

E. Meningococcal infection

64.* 3-year-old child, 1st day of the disease. Primary diagnosis: Meningococcal infection, generalized form, purulent meningitis. What drug is preferred to include in the management and in what dosage?

A. Penicillin, 500000 U/kg/per day

B. Penicillin 100000 U/ kg /per day

C. Lincomycin

D. Ampicillin 100000 U/kg /per day

E. Sulphadimezinum

65.* 1,8-month-old child. Acutely have got ill: Т - 39,2о С, malaise, sleeping disturbances, shudders, vomiting twice. 1st day of the disease. Pallor. Pharynx is hyperemic. Hypereathesia. Sever neck stiffness, positive Kernig’s and Brudzinski’s symptoms from both sides. CSF: cytosis - 2320, protein - 1,23 g/L, neutrophils - 95%, lymphocytes - 5%. Clinic and data of cerebrospinal fluid examination are characteristic for:

A. Brain tumour

B. Serous meningitis

C. Arachnoiditis

D. Purulent meningitis

E. Neurotoxicosis

66.* 7-year-old child. Complaints: Т- 39,3оС, headache, vomiting. 1st day of the disease. Skin is without changes. Pharynx is hyperaemic. Tongue is coated. Conjunctivitis, scleritis. Signs of neck stiffness. Positive Kernig’s sing on the right. CSF: cytosis - 340, lymphocytes - 87%, neutrophils - 13%, protein - 140 mg/L Clinic and CSF examination data are characteristic for:

A. Purulent meningitis

B. Arachnoiditis

C. Neurotoxicosis

D. Brain tumour

E. Serous meningitis

67* 5-month-old child. Have got sick acutely, Т - 39,2°С, malaise, vomiting, skin rash. 2nd day of the disease: somnolence, convulsion readiness, big fontanel is bulged and tensed. There is hemorrhagic, bluish-red rash with irregular shape and necrosis in the middle on the back, buttocks and thigh. The symptoms of meninges irritation are revealed. Cerebrospinal fluid: protein - 5,6 g/L, cytosis - 1235 per 1 mkL, neutrophils - 83%. What disease caused that?

A. Influenza

B. Viral meningoencephalitis.

C. Pneumococcus meningitis.

B. Tuberculous meningitis.

E. Meningococcal infection.

68.* 5-year-old child. Complains on headache, repeated vomiting, Т - 38,9°С. Examination: 2nd day of the disease: pallor, rests upon side, moans, vomiting. On buttocks, thighs and shanks there’s star-like haemorrhagic rash with necrosis in the center. Revealed the neck stiffness. Positive Kernig’s and Brudzinski’s signs. What is your primary diagnosis?

A. Influenza.

B. Meningococcal infection.

C. Enterovirus infection.

D. Haemorrhagic vasculitis

E. Viral meningoencephalitis

69.* Child 8 months, was admitted to the infectious hospital with the expressed phenomena intoxications: temperature 39.5( With, anxiety, repeated vomiting. Disease began suddenly 2 days ago. At survey the phenomena hyperesthesia are marked, anxiety, sharp "brain" shout, big fontanel is protruding, expressed rigidity muscles of a nape, FHR 180 in one minutes. What inspection most informatively for specification of the diagnosis of disease?

A. general analysis of blood

B. lumbar puncture

C. Biochemikal analysis of blood

D. Computer tomography

E. USE brain

70.* What doze of penicillin is used in the treatment of generalizated forms meningococcus infections – purulent meningitis?

A. 1 000000 ЕД/KG

B. 500 000 ЕД/KG

C. 100 000 ЕД/KG

D. 50 000 ЕД/KG

E. 10 000 ЕД/KG

71.* Child 7 months, has was admitted to infectious department with a diagnosis ARVI. A body temperature 39,9(With, it is restless, a skin pale, a pharunx hiperemia. In 5 hours has appeared star-shaped a rash on a skin of buttocks, the bottom finitenesses, dense to the touch, different the sizes. The tachycardia is marked, intimate tones are weakened. What diagnosis is most probable in this case?

A. Thrombocytopenia purple

B. Meningococcemia

C. Scarlatina

D. Purpura nervosa

E. Nettle-rash

72.* Child 3th years have been examined concerning sudden rise of temperature, occurrence symptoms of an intoxication and presence meningeal syndrome. The lumbal puncture was done. The spinal liquid cloudy, follows out under a high pressure, the maintenance of proteine - 1, 8g/l; reaction Pandy(++++), sugar - 2, 2mmole/l, chlorides - 123 mmole/l, cytos-2350 х106/л (80 %n, 20 % lym) . Diagnose:

A. Encephalitis

B. Meningitis virus.

C. Tuberculos meningitis.

D. Meningism

E. Purulent meningitis.

73.* before The body temperature of the healthy 3-years child increased up to 39.5(C. On the skin of buttocks, hands and legs, trunks hemorrhagic rash star-shaped forms, with necrosis in the center has appeared. The condition is severe; consciousness is absent, vomiting 2 times, pulse - 140 of times per mines, the BP – 75/45 mm hn/ст, oliguria , there are new elements of a rash. What from below listed antibiotics is necessary for appointing?

A. Ampicillini

B. Penicillini natrii salt

C. Gentamicini sulfate

D. Ceftriacsoni

E. Levomecitini succinatis

74.* Child 11 months was ill sharply from rise in temperature up to 39(With, slackness. In 8 hours plentiful spotty elements eruption on the bottom finitenesses, buttocks, a stomach have appeared. The amount of eruption quickly increased, some elements of it have got a character of hemorragis irregular-shaped, asymmetrically located, from 3 up to 5 mm, be dark - cherry color. A mucous membrane of a pharunx hyperemia on a back wall drinks purulent - mucous allocation. A tachycardia, tachypnea. Arterial blood pressure is normal. Verify the diagnosis:

A. Meningococcus infection, meningococcemia

B. Grippe with hemorrhagic syndrome.

C. Measles with hemorrhagic syndrome.

D. Hemorrhagic vasculitis (illness Shonlan-Genoh).

E. Thrombocytopenia purple (illness Verlgof)

75(08) A 3 year old child fell acutely ill, body temperature rose up to 39,5oC, the child became inert, there appeared recurrent vomiting, headache. Examination revealed positive meningeal symptoms, after this lumbal puncture was performed . Spinal fluid is turbid, runs out under pressure, protein concentration is 1,8 g/l; Pandy reaction is +++, sugar concentration is 2,2 millimole/l, chloride concentration - 123 millimole/l, cytosis is 2,35*109 (80% of neutrophils, 20% of lymphocytes). What is the most probable diagnosis?

A. Serous tuberculous meningitis

B. Brain tumour

C. Serous viral meningitis

D. Purulent meningitis

E. Subarachnoid haemorrhage

76(06) A 1,5 y.o. child fell seriously ill: chill, body temperature rise up to 40,10С, then rapid dropping to 36,20С, skin is covered with voluminous hemorrhagic rash and purple cyanotic spots. Extremities are cold, face features are sharpened. Diagnosis: meningococcosis, fulminant form, infection-toxic shock. What antibiotic must be used at the pre-admission stage?

A. Soluble Levomycetine succinate

B. Penicillin

C. Sulfamonometoxin

D. Lincomycin

E. Gentamycin

77 (04) A child with meningococcus meningitis has been taking penicillin for 7 days. During last 4 days a body temperature is normal. Meningitic signs are absent. When is it possible to cancel antibiotic?

A. If liquor cytosis is 100 or less, prevalence of neutrophils

B. If leucocytosis and left neutrophil shift are absent

C. If liquor cytosis is 100 or less, prevalence of lymphocytes

D. If liquor cytosis is 150, prevalence of lymphocytes

E. Immediately

78. * 5 year old boy fell ill abruptly: fever up to 39,8 C, recurrent vomiting, severe headache. Convulsions occur in 3 hours. Physician found out positive meningeal sign. Pleocytosis of 2500 cells chiefly polymorphonuclear cells, elevated protein concentration and normal glucosa concentration was found in cerebrospinal fluid examination.

A. Purulent meningitis

B. Serous meningitis

C. Tuberculous meningitis

D. Subarachnoidal hemorrhage

E. Encephalitis

79. * 3-year – old boy fell ill abruptly: fever up to 39 C, weakness, vomitng.Haemorrhagic rash of various size appear on his lower limbs in 5 hours.Meningococcemia with infective – toxic shock of 1 degree was diagnosed. What medications should be administered?

A. Chloramphenicol succinate and prednisone

B. Penicillin and prednisone

C. Penicillin and immunoglobulin

D. Chloramphenicol succinate and interferon

E. Ampicillin and immunoglobulin

Nonpolio Enteroviruses infections

80. * 14 -year-old child. Complaints: back pain. 5th day: Т - 37,5°С, apatic, pale. Heart sound are muted. Pharynx is hyperaemic. Lies on the back, revealed pain of lumbar muscles and lower part of the thorax. Movements in the limbs are without pathology, reflexes are without changing. Cerebrospinal fluid - normal. What is your primary diagnosis?

A. Meningitis.

B. Acute viral respiratory infection.

C. Enterovirus infection, pleuradinia.

D. Poliomyelitis.

E. Polyneuritis.

81.* 11 -year-old child. Complains on rash. 1st day-: Т- 37,2°С, on the trunk, face and limbs there is a maculopapular rash, the plicae are without rash. The nasal respiration is disturbed, nasal discharge. Pharynx: tonsils, soft palate and arcs are hyperaemic with vesicular anathema. Internal organs are without pathology. What is your primary diagnosis?

A. Measles.

B. Scarlet fever.

C. Yersiniosis.

D. Enterovirus infection.

E. Herpes infection.

Acute respiratory virus

Influenza

82.*4-year-old child. 1st day of the disease.. Complaints: headache, malaise, dry cough, nasal bleeding. Т - 39,9оС. Pallor. Conjunctivitis. Scleritis. Pharynx is hyperemic, dry, vessels of the palate are observed, punctuate heamorrhage. Tongue is coated. Resonant respiration in the lungs. Heart sounds are muted, tachycardia. What is the primary diagnosis:

A. Adenovirus infection

B. Influenza

C. Parainfluenza

D. Pertussis

E. Meningococcal infection

83.* 10-month-old child have got sick acutely, t - 38,5°С, cough. The condition became more severe at night, t - 40,5°С, apatic. In the paired serums – increased titer of Ab to Influenza in 6 times, to Adenovirus in 2 times. What is your primary diagnosis?

A. Diphtheria.

B. Influenza.

C. RS-infection

D. Foreign body in larynx.

E. Spasmophilia.

84.* 14 -year-old child has got fever 39,7°С, headache, eye pain, sleep disturbances. Examination: catarrhal conjunctivitis, scleritis. Skin is pale. Nasal respiration is disturbed. There is wide hyperemia, petechial spots on the soft palate in the pharynx. Influenza is supposed. What etiotropic drug should be administered?

A. Penicillin.

B. Biseptolum.

C. Immunoglobulin.

D. Sulfadimezimun.

E. Oseltamivir

85.* Girl 6 years within one year again was i. Illness has become complicated encephalitis. What main pathogenetic mechanism of occurrence of this complication?

A. Decrease protective forces of an organism.

B. Increase permeability of vessels.

C. Autoallergic reaction.

D. Edema and swelling of a brain.

E. Connection bacterial flora.

86.(06) Ambulace brought to the hospital a patient with acute respiratory viral infection. The illness began suddenly with temperature rise up to 39,90С. He complains of headache in frontotemporal lobes, pain in eyeballs, aching of the whole body, nose stuffiness, sore throat, dry cough. At home he had a nasal hemorrhage twice. What type of acute respiratory viral infection is it?

A. Influenza

B. Adenoviral infection

C. Parainfluenza

D. RS-infection

E. Enterovirus infection

87.(04-05) A patient, aged 16, complains of headache, mainly in the frontal and temporal areas, superciliary arch, appearing of vomiting at the peak of headache, pain during the eyeballs movement, joint's pain. On examination: excited, t0- 390С, Ps- 110/min. Tonic and clonus cramps. Uncertain meningeal signs. What is the most likely diagnosis?

A. Influenza with cerebral edema manifestations

B. Adenovirus infection

C. Respiratory syncytial virus

D. Influenza, typical disease duration

E. Parainfluenza

88. * The typical signs of croup, caused by influenza virus, are:

A. Inspiratory dyspnea, barking cough, high fever

B. Expiratory dyspnea, dry cough, normal temperature

C. Whooping cough

D. Conjunctivitis and coryza

E. Tachypnea with moist rales

Parainfluenza

89. *Child 2 years was ill sharply from rise in temperature up to 37,5( with, occurrences of a cold with insignificant allocation of slime, dry "barking" cough. For 2-nd day of illness at night the child has woken up for rough cough, hoarseness, noisy often breath with the complicated breath has quickly appeared. Involving intercostals intervals was marked, the auxiliary muscles took part in the certificate(act) breath. What is your diagnosis?

A. ARVI,croup

B. Diphtheria, croup.

C. Whooping cough

D. Foreign substance of respiratory ways.

E. Obstructive bronchitis.

90.* A 9-months-old child fell ill acutely(a child is vaccinated according with the schedule of immunization). The onset was marked by fever up to 37,5°C, dry "barking" cough. The condition has sharply worsened at night: began restless, barking cough, hoarseness, inspiratory a short wind; jugular fossa, subclavian fossa and intercostal retractions. The major cause of croup in children are:

A. Enteroviruses

B. Influenza viruses

C. Adenoviruses

D. Rinoviruses

E. Parainfluenza viruses

Adenovirae infections.

91.* Child 2 years was ill sharply from rise in temperature up to 37,5( with, occurrences of a cold with insignificant allocation of slime, dry "barking" cough. For 2-nd day of illness at night the child has woken up for rough cough, hoarseness, noisy often breath with the complicated breath has quickly appeared. Involving intercostals intervals was marked, the auxiliary muscles took part in the certificate(act) breath. Specify the diagnosis:

A. ARVI with a syndrome stenotic laryngotracheobronchitis

B. Diphtheria gloats.

C. Whooping cough

D. Foreign substance of respiratory ways.

E. Obstructive bronchitis.

92.* Child 9 months was ill sharply: the body temperature up to 37.8 has raised(increased)( with, has appeared cough and cold. For 3-rd day of illness at night the condition has sharply worsened: began restless, barking cough, hoarseness of a voice, inspiratory a short wind rushes, has appeared. It is diagnosed groats. What from activators gives a syndrome groats is more often?

A. Enterovirus

B. Virus of flu

C. Adenovirus

D. Rinovirus

E. Virus of parainfluenzia

93.* 2-years boy is delivered in a reception with complaints to a fever up to 39,5(С within 3 days. The child is active, scared. At survey it is marked hyperemia a pharunx, small inspiratory stridor. Actions of the doctor:

A. Examine nasopharynx and to take separated on crop

B. Prepare to intubation tracheas

C. Explore gases of arterial blood and catheterized a vein

D. Prescribe the roentgenogram of a thorax

E. Hospitalaze the child and to place it (him) in chamber with the raised (increased) humidity of air

Whooping cough

94.*,5-month-old child has pertussis, spasmatic period, has 25-30 cough attacks per day, convulsions, often apnea. What is severity form of pertussis?

A. Mild.

B. Middle.

C. Severe.

D. Toxic.

E. Hypertoxic.

95.* Child 3th years complain of cough, which on supervision of mother gradually amplifies within 11 days. For 12 day objectively: t - 37.1( With, a leather(skin) pale, a pharunx pure(clean). Under language a small ulcer. Often hoarse cough comes to an end allocation hyaline phlegm. In easy rigid breath, dry rattles. On the roentgenogram a horizontal arrangement of edges, increase of a transparency easy, expansion of root figure. In blood: Leu– 23.0х109/л, Э-1 %, »-3 %, Я-23 %, Ѕ-70 %, ј-3 %, SSE– 3 mm / hour. What diagnosis is most probable?

A. Tubercular bronchoadenitis

B. ARVI

C. Pneumonia

D. Whooping-cough

E. Measles

96.* Call terms revaccination against whooping cough? Through:

A. 1,5-2 year after the finished rate of vaccination

B. 12 month.

C. 6 month.

D. 3 month.

E. 5 years

97.* Child 3th years has been illing 10 days. Mother shows complaints to dry cough, amplifying at night, rise in temperature up to 37.5( S.Pri survey a pharunx hiperemia, on a bridle of language it is found out ulcer, during a fit of coughing the person reddens, eyes are poured by blood, cervical veins are swelled. The fit of coughing has ended bursting of viscous transparent phlegm. At research easy the box shade percuss sound is marked, at auscultation dry rattles are listened. What most probable diagnosis?

A. ARVI

B. Tracheobronhitis

C. oreign a body of the top respiratory ways

D. Tuberculosis intrachest lymph nodes

E. Wooping cough

98.* Child 3th years it is examined by the local pediatrist. Disturbs attack-like cough up to 17 attacks for a day he has been illing within 3 weeks. First disturbed dry cough mainly at night, subfebrile a body temperature. Symptomatic treatment of effect has not given. At the end of the next week cough has got attack-like character. The ulcer is marked puffy persons, dot haemorrhages in conjunctiva, on a bridle of language. In easy rigid breath, plentiful absent-minded rattles on all fields. The review fauces provokes a fit of coughing. What most probable diagnosis in this case?

A. Bronchial asthma

B. Obstructive bronchitis

C. Asthmatic bronchitis

D. Whooping cough

E. Stenosis laryngotracheobronhitis

99.* Child 2th years transfer wooping cough. For 30-th day of illness cough continues to carry attack-like character. What principle of dominates means duration of cough?

A. Beyond-cutoff braking

B. Summation

C. Irradiation

D. Inactivity

E. Vestige reactions

100*. Boy 3,5 years has transferred wooping cough. Frequency of fits of coughing makes 35 in day, number of reprises - up to 15, up to 5 fits of coughing come to an end vomitting with an output(exit) glassy phlegm. What preparation is applied to reduction of fits of coughing?

A. Pectusin

B. Mucaltin

C. Bromgecsin

D. Gentamecini sulfate

E. Aminasini

101.* Child 3th years complained of cough which gradually amplified. Temperature 36,7-37( S. At the 12-th day objectively: temperature 37,1( With, a skin pale. A mucous membrane fauces - light pink. On a bridle of language a small ulcer. Fits of coughing up to 20 in day which are characterized by a series cough pushes which the whistling breath follows are marked. The attack comes to an end allocation glassy phlegm. In easy rigid breath, dry rattles, sometimes damp. On the roentgenogram: horizontal position of the edges, the raised(increased) transparency easy, expansion of root figure. In blood: leukocytes - 23,0х109/л, Э-1 %, »-3 %, seg-24 %, l-70 %, м-3 %, SSE-3 mm / hour. What disease is the most probable?

A. Measles

B. ARVI with a syndrome of stenotic laryngotracheobronchitis

C. Wooping cough

D. Tuberculosis bronchoadenitis

E. Pneumonia

102.*The child of one month it is diagnosed wooping cough, an easy degree of severity. In family of 3 more children. The pediatrist insists on hospitalization of the sick chlid. Main causal it is:

A. Obligation hospitalization of patients wooping cough

B. Providing isolation of the patient

C. Providing the best leaving(care)

D. Providing intensive treatment

E. Big probability of clinical complications

Viral hepatitis

103.* 2,5-month-old child. Complaints: Т - 39,2о С, malaise, cancels breast-feeding, periodically agitation. 3rd day – sclera and skin are jaundiced, dark urine, pale stool. 4th day vomiting – with haematemesis, convulsions, consciousness disturbances. Abdomen is distended. Liver is near the edge of rib arch. Lien enlarged + 1,5 cm. Bilirubin - 234 mkmol/L, direct -182, ALT - 3,1 mmol/L/h., prothrombine index– 38 %. Found НВS Аg and delta virus. In the past history – pneumonia and blood transfusion. What is the primary diagnosis:

A. Encephalitis

B. Viral hepatitis В, heavy form

C. Viral hepatitis В + delta infection, malignant form

D. Viral hepatitis А

E. Atresy of biliary ducts

104.* 2-year-old. Complaints: malaise, appetite loss. 5th day – dark urine, pale stool. 6th - jaundice of skin and sclera, Т - 37,4о С, repeated vomiting. Liver enlarged + 7 cm, lien +2,5 cm. Heart sounds are muted, bradycardia. Child not active. Sleeping disturbances. Bilirubin - 220 mmol/L, direct - 176. Prothrombine - 60%. ALT - 6,4 IU. Found НВS Ag. In age 1,5 years child have had pneumonia, have got treatment in the hospital. What is the primary diagnosis:

A. Haemolytic anaemia

B. Viral hepatitis А

C. Toxic hepatitis

D. Viral hepatitis В

E. Obstructive jaundice

105.* 5 -year-old child. Complaints: Т - 38,7о С, vomiting, abdominal pain. 3rd day of the disease: malaise, skin and mucosa are without pathology. Tongue has white coating. Pharynx is clear. Abdomen is soft. Liver is enlarged + 2,5 cm. Faeces and urine are with normal colour. Child got in touch with person sick with viral hepatitis A and Scarlet fever 2 weeks ago. What examination do you prefer to found out the right diagnosis?

A. Smear from pharynx on haemolytic streptococcus

B. Urine analysis on bile pigments and urobilin

C. Blood on paired serums

D. Blood on aminotranspherases

E. Blood on bilirubin and fractions

106.* At the eldest group of the kinder garden in Kyev was a case of viral hepatitis A. 16 children didn’t have hepatitis A before. What do you prefer to use to prevent the viral hepatitis?

A. Vaccination

B. Interferon

C. Immunoglobulin

D. Remantadin

E. Not to use specific prophylaxis

107.* 5 -year-old child. The disease started with appetitie loss and vomiting, Т- 37,8°С. 5th day – dark urine, pale faeces, jaundiced sclera and skin, liver on 4 cm lower than rib arch, tender, concrete. Blood: ALT- 2,7 mmol/L, total bilirubin 150 mkmol/L, direct - 110, indirect - 40. What is the primary diagnosis?

A. Cholecystitis.

B. Viral hepatitis.

C. Infectious mononucleosis.

D. Leptospirosis with jaundice.

E. Obstructive jaundice.

108.* 10-month old child on the 5th day of the disease have got vomiting, denied meals, became anxious, doesn’t recognize parent, have got seizures, haemorrhagic rash, the jaundice appeared, the liver size became smaller, liver is soft on palpation. Т- 37,5 - 39,9°С. What caused the worsening?

A. Encephalitis.

B. Meningitis.

C. Sapasmophilia.

D. Liver coma.

E. Acute intestinal infection.

109.* Child 3 months was ill with rise in temperature up to 37,5( With, slackness, regurgitation , periodic anxiety. In 2 days have noticed, that urine leaves dark stain on the nappy excrement is not painted. At survey for 3-rd day it is revealed icteritiousnes skin, sclera, increase in a liver, a spleen. In a maternity hospital concerning hemolytic illnesses of newborns received hemotransfusions . What disease is the most probable?

A. Virus hepatitis A.

B. Hemolytic jaundice.

C. Conjugated jaundice.

D. Virus hepatitis C.

E.Atresia biliary ways.

110.* The child with a jaundice, hepatosplenomegaly, increase of hepatic tests establishes the typical, mild form of a virus hepatites of A. The main in treatment is:

A. Installation of infusion therapies

B. Prescription hepatoprotectors

C. Prescription antivirus preparations

D. Prescription glucocorticoids

E. Prescription bases - therapies (a mode, a diet, vitamins)

111.(06) An 8 y.o. boy was ill with B hepatitis one year ago. In the last 2 months he has complaints of undue fatiguability, sleep disorder, appetite loss, nausea, especially in the mornings. Skin isn't icterious, liver and spleen are 1 cm below the costal margins, painless. Alanine aminotransferase activity is 2,2 mcmol/L. How can this condition be estimated?

A. Biliary dyskinesia

B. Residual effects of old viral hepatitis type B

*C. Development of chronic hepatitis

D. Development of liver cirrhosis

E. Recurrance of viral hepatitis type B

Mumps

112.* 6 year-old child. 3rd day of the disease. Complaints: Т - 38,7оС, edema in the paraauricular areas, headache, tenderness during chewing. Examination: edema in the paraauricular areas, of elastic consistency, tender on palpation. Skin in those areas is not changed. Retromandibular fossa is whammed. Pharynx is normal. There’s edema and hyperemia around the Stenonov’s duct. Primary diagnosis:

A. Tumour of parotid gland

B. Mumps (epidemic parotitis)

C. Pharynx diphtheria, toxic form

D. Secondary parotitis

E. Salivary duct obstruction due to calculus

113*. 5-year-old child have got ill acutely, fever t - 39,7°С, repeated vomiting, dizziness, edema in the left parauricular area. 2nd day: t - 39,2°С, Tenderness in the paraumbilical area. Serum amylase: 16,4 IU/L. What is the primary diagnosis?

A. Enterovirus infection, pancreatitis.

B. Enterovirus infection, mesoadenitis.

C. Mumps, pancrestitis.

D. Purulent pancreatitis.

E. Acute cholecystitis.

114.* In kindergarten disease an epidemic parotitis is registered. What the longest duration of the incubatory period at an epidemic mumps?

A. 10 days

B. 15 days

C. 20-23 day

D. 30 days

E. More then 40 days

115.* Тhe child of 9 years defeat parotid gland, symptoms of the general intoxication has appeared. The doctor suspects parotitis an infection, appoints serologic test. What will be a diagnostic level of lumpsum research?

A. 1: 40

B. 1: 80

C. 1: 160

D.1: 200

E. 1: 120

116.* Family has two children: four and eight years. The senior child has an epidemic parotitis. What period of disease is the most dangerous for communication?

A. in first 5 days

B. on 6-7 day

C. later 8 days

D. with occurrences of clinical displays it is not infectious

E. the whole period of development of complications

117. * What signs are not typical for mumps?

*A. Redness of the tissue around the ear

B. Painful chewing

C. Red and edematous Stensen’s duct

D. The earlobe is pushed upward and out ward

E. Swelling of the tissue round the angle of the mandible

Helminthic invasion

118. *A 4-year old child attends the kindergarten. Complaints of the bad appetite, fatigue. Objective examination: skin and mucous membrane are pale, child is asthenic. In the hemogram: hypochromatic anemia 1st., leucomoide reaction, of the eosinophile type. What pathology must be excluded at first?

*A. helminthic invasion

B. Lymphoprolipherative process

C. Hypoplastic anemia

D. Duodenal ulcer

E. Atrophic gastritis

Diphtheria

119. * The diphtheria pseudomembrane is commonly:

*A. Whitish or dirty gray, tough and adhered to the mucous membrane

B. Yellow, friable, localized in the gland crypt

C. White colored, friable, can be removed easily

D. Yellow, localized beneath tonsillar mucous membrane

E. Black, friable

120. 10-year-old child. Complaints are fever - 38,2о С, sore throat while swallowing. The 2nd day – fever - 37,6оС, the swollen tonsils are observed in the pharynx, all over on the right tonsil extending to the palatoglossal arch, the upper and centre part of the left tonsil there is a grayish-white membrane is found, which is firmly adherent. The mucous around tonsils is hyperaemic, cyanotic; the submandibular lymphatic nodes are enlarged, a little painful. Taking into consideration the clinical features what medication is most sufficient for that patient?

A. Metronidazole

B. Biseptolum

C. Prednisolone

D. Antidiphtheric serum

E. Erythromycin

121. 2-year-old child. Complaints: cough, hoarseness, dyspnoe, Т - 37,4оС. The condition gradually became worse. 3rd day of the disease: Т - 37,2оС, inspiratory dyspnoe. Cough soundless, voice is aphonic cyanosis of the perioral area, acrocyanosis. Cold sweat. Anxious. Resonant breath in the lungs. What is the primary diagnosis:

A. Parainfluenza, stenotic laryngotracheobronchitis.

B. Larynx polyposis

C. Pertussis (spasmatic period)

D. Larynx diphtheria

E. Foreign body on the larynx

122. 12 -year-old child. Complains to sore throat. Т - 39°С. 3rd day: Т- 39,5°С, pallor, hypodynamics. Submandibular lymphatic nodes are enlarged - 2 cm, painless edema of cervical subcutaneous tissue up to the middle of the neck. Mucus membrane of tonsils and the palatoglossal arch is hyperaemic with cyanotic color, edemous. On the both tonsils, involving uvula from the left side there is a concrete grayish-white membrane, bulged, hardly detached, bleed. Heart sounds are muted. Your diagnosis?

A. Tonsils diphtheria, localized form.

B. Infectious mononucleosis.

C. Tonsils diphtheria, toxic form.

D. Mumps.

E. Necrotic tonsillitis.

123. 5-year-old child. Complains on throat aches when swallowing, Т - 38,5°С. 2nd day: Т- 37,8°С. Pharynx and tonsils are edematic, moderately hyperaemic, covered with gray membranes, elivated over mucosa, hardly detached, mucosa is cyanotic, hyperaemic, Submandibular lymphatic nodes are enlarged - 2 cm, painless. What disease is most likely with those clinical features?

A. Necrotic tonsillitis.

B. Paratonsillar abscess.

C. Infectious mononucleosis.

D. Tonsils diphtheria

E. Adenovirus infection.

124. 6,5-year-old child. Complains on difficulty breathing, pallor, Т - 38,2°С, soundless cough. Child didn’t have vaccinations. 4th day of the disease: sits, bents onward, pale, face is edematic, respiration is noisy, aspiratory dyspnoe, 48 per min, cough soundless. Throat mucosa is pale and cyanotic. Severe tachycardia. About what disease do you think?

A. Infectious mononucleosis.

B. Larynx diphtheria, croup.

C. Mumps.

D. Adenovirus infection.

E. Parainfluenza, stenotic laryngotracheobronchitis

125. Driving part in pathogenesis of diphtherias is:

A. Homeostasis violation

B. Bacteremia

C. Sensitization

D. Toxemia

E. Immunity violation

126. Disease of the 5 years old child started acutely with high temperature, single vomiting. On the second day of disease sore throat, a hoarseness voice has appeared, tonsils are greatly increased, pruinose dirty - gray color. During examination of the pharynx the unpleasant ordor is sensed. Submaxillary and cervical lymph nodes are increased, painful at palpation. Edema of cervical subcutaneous tissue of the neck. What is the most probable diagnosis?

A. Scarlatina

B. Phlegmonic paratonsillitis

C. Infectious mononucleosis

D. Lacunary quinsy

E. Toxic form of a diphtheria tonsil

127. Disease of 5 years old child began acutely with a high temperature, single vomiting. For the second day of disease the throat is sore, hoarseness of voice has appeared, tonsil are greatly increased of pruinose dirty - grey color. During examination of the pharynx the unpleasant ordor is sensed. Submaxillary and cervical lymph nodes are increased, painful at palpation. Edema of cervical subcutaneous tissue of the neck. What from the listed attributes is the basic at diagnostics of the toxic form of a diphtheria tonsil?

A. Hoarseness voices

B. Patch on tonsils

C. Stagnant hyperemia of tonsils

D. Impossibility to open a mouth

E. Edema hypodermic cellular tissue neck

128. Child of 3 years old the diagnosis is a diphtheria of tonsils, the toxic form is established. Has been sick for 2 weeks. What is the most severe complication can develop at the patient with the current of disease?

A. Violation of brain blood circulation

B. Paresis of the soft sky

C. Polyradiculoneuritis

D. Glomerylonefritis

E. Myocarditis

129. Child 6,5 years. Т – 38,2(С. 4-th day of the disease. Sits, having bent forward, pale. The person bloated. Inspiration is superficial, 48 per minute, aphonic, silent cough. Mucous membranes are pale -cyanotic. The tachycardia is expressed. Diagnose:

A. Diphteria throats, croup.

B. Foreign a body of a throat.

C. Whooping cough pneumonia.

D. Adenovirus an infection, croup.

E. Parainfluenzia groats.

130. In a child of 3 years old diphtheritic croup is diagnosed. Choose a method of specific treatment.

A. Antidiphtheric serum

B. Antibioticotherapy

C. Give antibodies

D. Glucocorticoid therapy

E. Infusion therapy

Herpes infections. Infections mononucleosis

Herpes infections

131. Child, 1 year 2 months, was ill sharply. T-38.8( With, staffiness in nose. In 2 days – a rash on lips and the person. Objectively: a condition heavy. Symptoms of an intoxication. On a leather(skin) of the person, around of a mouth, on lips, wings of a nose, a forward surface of a neck - groups closely sitting peaked vesicle on inflamed, hyperemia and a little infiltration site of a leather(skin). Submaxillary and occipital lymph nodes are increased up to 1 see. Your diagnosis?

A. Dartrous infection.

B. Streptococcal impetigo

C.Varicellous smallpox.

D. Infantile eczema

E. Heat rash

Infections mononucleosis

132. 8-year-old child, admitted to a hospital on 3rd day of the disease. Т- 38,0°С, respiration with rhonchi, hoarseness, the tonsils are covered with ivory coating, hardly detached, tonsils are hypertrophic II-III stage., But there is no surrounding edema. Lymphoadenopathy. Liver + 3,5 cm. Lien + 2,0 cm. Your primary diagnosis?

A. Diphtheria.

B. Adenovirus infection.

C. Infectious mononucleosis.

D. Lymphogranulomatosis

E. Leucosis.

133. Child with quinsy, increase in all groups lymphatic nodes, hepatosplenomegaly preliminary diagnosed infectious mononucleosis. What method needs to be used for acknowledgement(confirmation) of the diagnosis?

A. Bacteriological

B. Hematological

C. X-ray

D. Biochemical

E. Ultrasonic

134 The disease of a child began with rise in temperature, stuffiness in nose, increases cervical lymphatic nodes. The doctor prescribed ampicillin. On the 3-rd day of the disease: temperature 38,3( C, lacuna tonsillitis, spotty – papula rash all over the body, the liver and a spleen are increased. What is the disease of a child?

A. Measles.

B. Infections mononucleosis

C. Rubella.

D. Scarlatina

E. Pseudotuberculosis

135.(08) An 18 year old patient was admitted to a hospital with complaints of headache, weakness, high temperature, sore throat. Objectively: enlargement of all groups of lymph nodes was reveale D. The liver is enlarged by 3 cm, spleen - by 1 cm. In blood: leukocytosis, atypical lymphocytes - 15%. What is the most probable diagnosis?

A. Angina

B. Adenoviral infection

C. Diphtheria

D. Acute lymphoid leukosis

*E. Infectious mononucleosis

136. *The typical signs of infectious mononucleosis are:

A.Acute tonsillitis, lymphadenopathy and hepatosplenomegaly

B. Acute tonsillitis and swelling of the neck tissue

C. Acute tonsillitis and strawberry tongue

D Acute tonsillitis and coryza

E. Acute tonsillitis and conjunctivitis

Botulism

137(08) A 12 year old girl complains about abrupt weakness, nausea, dizziness, vision impairment. The day before she ate home-made stockfish, bee Examination revealed skin pallor, a scratch on the left knee, dryness of mucous membranes of oral pharynx, bilateral ptosis, mydriatic pupils. The girl is unable to read a simple text (mist over the eyes). What therapy would be the most adequate in this case?

A. Parenteral introduction of antibiotics

B. Parenteral introduction of polyvalent antibotulinic serum

C. Gastric lavage

D. Parenteral introduction of antitetanus serum

E. Parenteral disintoxication

Prophylactic immunization

138. Girl 8 years. Since 2th years suffers atopic dermatitis. At mum -polinosis. Inoculation was carried out(was spent) on an individual calendar. Has vaccination БЦЖ in a maternity hospital, І and ІІ AMTD, it is 3-multiple - poliomyelitis . What further plan of inoculations?

A. ATD +P/M, in 2 months reaction Mantu+БЦЖ, in 2 months vaccination reproach

B. AMTD +P/M, in 2 months reaction Mantu+БЦЖ

C. Measles +epidparotitis, in 2 months reaction Mantu+БЦЖ

D. Measles +epidparotitis

E. Combined vaccine (measles, epidparotitis, rubella)

139. The child of 6 years the body temperature up to 38 has raised(increased)(With, the headache disturbs, cold. It agrees a calendar of inoculations, to this day is planned to lead(carry out) revaccination against reproach. Tactics of the doctor?

A. Questions concerning vaccination to consider after recovery.

B.Give a measles vaccine.

C. Vaccinate the child right after normalization of a body temperature.

D. Give a vaccine and an antibody.

E. Give a measles vaccine together with anti-inflammatory and febrifugal preparations.

140. Child 12 months vaccinated according to a calendar with observance of terms immunizations. What inoculation needs to be made to the child at this age?

A. For virus hepatites

B.for diphtherias, wooping cough, tetanus

C. for tuberculosis

D. for poliomyelitis

E. for measles,mumps, rubella

141. Child 6 months, was born prematurely born and in a delivery room of any inoculations has not received. Against what infection of it(him) it is necessary to vaccinate the first of all?

A. Diphtheria

B. Tuberculosis

C. Polyomielit

D. Tetanus

E. Measles

142. According with a calendar of inoculations revaccination against rubella it is carried out (is spent) to teenagers in the age of 15 years. To it(her) are subject:

A. All, irrespective of a floor

B. Only boys

C. Only girls

D.Only patients with an immunodeficiency

E.All, who did not ill rubella

143. Child 14 years, frequently were ill, has arrived from a countryside on a new residence. The next inoculation on a calendar against a diphtheria and a tetanus has not received. What preparation it is necessary to lead(carry out) immunization?

A. AT-anatoxin

B. AwTD - adsorbed wooping cough-tetanus vaccine

C. ADT-anatoxin

D. AD -о-anatoxin

E. Td-anatoxin

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