Actual problems of infectious diseases and hiv infection
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Y. pestis is transmitted by:
Fly *Flea Tick Lice Bug What is the duration of incubation period of plague? 3 – 7 days 2 – 12 days *2 – 10 days 1 – 8 days 3 -15 days What form of plague is highly fatal? Skin Bubonic Intestinal *Pneumonic Septic What form of plague is most contagious? Skin Bubonic Intestinal *Pneumonic Septic What is the main etiotropical drug of plague treatment? Penicillin Amoxicillin *Streptomycin Biseptol Cefazolin What group of infectious diseases plague belong to according to L. Gromashevsky classification? Intestinal Respiratory tract *Blood Infection of external covers Transmissive Drugs of choice for the treatment of amoebae cyst carrier: Monomycinum Delagilum Tetracyclin * Furamid Ursosan Principles of treatment of patients with shigellosis. Diet Antibacterial drugs Correction of dysbacteriosis Detoxication therapy *All the above Largest nematode parasite is: Ascaris lumbricoides Necator americanus Ancilostoma duodenum *Dracunculus medinensis Trichinella spiralis Which of the following nematodes is ovoviviparous? Ascaris lumbricoides *Strongiloides stercoralis Ancilostoma duodenum Dracunculus medinensis Trichinella spiralis Which of the following nematodeslays unsegmented eggs? Ascaris lumbricoides Strongiloides stercoralis Ancilostoma duodenum *Trichuris trichiura Trichinella spiralis Which of the following nematodes is ovoviviparous? Ascaris lumbricoides *Strongiloides stercoralis Ancilostoma duodenum Dracunculus medinensis Trichinella spiralis Best site for taking biopsy for diagnosis of trichinellosis is: *Deltoid muscle Diaphragm Pectoralis major Liver Spleen Rectal prolapse is seen in infection with: Ascaris lumbricoides Strongiloides stercoralis Ancilostoma duodenum Dracunculus medinensis *Tricuris trichiura Disseminated systemic infection in AIDS patients is seen with: Ascaris lumbricoides *Strongiloides stercoralis Ancilostoma duodenum Dracunculus medinensis Trichinella spiralis “Larva currens” is the name given to the migranting larvae of: Ascaris lumbricoides *Strongiloides stercoralis Ancilostoma duodenum Dracunculus medinensis Trichinella spiralis Which of the following nematodes does not pass through lungs during its life cycle? Ascaris lumbricoides Strongiloides stercoralis *Tricuris trichiura Dracunculus medinensis Trichinella spiralis All the following parasites may cause B12 deficiency anaemia: *Diphyllobothrium latum Strongiloides stercoralis Tricuris trichiura Dracunculus medinensis Trichinella spiralis Eggs are passed in sputum in case of infection with: Clonorchis sinensis *Paragonimus westermani Ascaris lumbricoides Strongiloides stercoralis Trichinella spiralis Which of the following is not a hepatic trematode? Fasciola hepatica *Fasciolopsis buski Clonorchis sinensis Schistosoma haematobium All of the above Largest trematode is: Fasciola hepatica *Fasciolopsis buski Clonorchis sinensis Schistosoma haematobium Opisthorchis felineus Gynaecophoric canal is seen in case of male worm of: Ascaris lumbricoides Fasciolopsis buski Clonorchis sinensis *Schistosoma mansoni Opisthorchis felineus Pseudotubercurcles may be formed around the eggs of: *Schistosoma haematobium Fasciolopsis buski Clonorchis sinensis Schistosoma mansoni Opisthorchis felineus Carcinoma of urinary bladder is associated with which of the following parasites? Schistosoma japonicum *Schistosoma haematobium Clonorchis sinensis Schistosoma mansoni Opisthorchis felineus Flame cells are the organ of excretion in: *Trematodes Nematodes Cestodes Pectodes All of the above Convulsive seizures may be seen in infection with: Trypanosoma brucei gambiense Negleria fowleri *Paragonimus westermani Schistosoma mansoni Opisthorchis felineus Cercaria is the infective stage of: Schistosoma japonicum *Schistosoma haematobium Clonorchis sinensis Schistosoma mansoni Opisthorchis felineus Which of the following acts as the main reservoir of Balantidium coli infection in human beings? Man Monkey * Pig Cow Dog Which of the following is the largest protozoal parasite inhabiting the large intestine of man? Entamoeba histolitica Entamoeba coli *Balantidium coli Giardia lamblia All of the above Which of the following is characteristic of Balantidium coli trophozoite? Body covered with short cilia Two nuclei Two contractive vacuoles Numerous food vacuoles All of the above Toxoplasma gondii lives inside the: Lumen of small intestine Lumen of large intestine *Reticuloendothelial cells Red blood cells White blood cells During which trimestr pregnancy infection with Toxoplasma gondii is more severy? *First Second Third Second and third First and second Commonest manifestation of postnatally acquired infection with Toxoplasma gondii is: * Lymphadenopathy Pneumonitis Myocarditis Meningoencephalitis Bronchitis Drug used for the treatment of toxoplasmosis is: Pyrimethamine Sulphadiazine Spiramycin Clindamycin *All of the above Which is the infective form of the malaria parasite? Trophosoite Schizont Merozoite *Sporozoite All of the above Which of the following phases of malaria parasites brings on a clinical attack of malaria? Primary exoerythrocytic schizogony *Erythrocytic schizogony Gametogony Sporogony Secondary exoerythrocytic schizogony Resting stage of the malaria parasite is known as: Trophosoite Schizont *Hypnozoite Merozoite Sporozoite Ситуаційні Задачі For a man 25 years old, half-year ago there was a positive reaction on protien. Last 3 months are complaint with general weakness, fatigueability, somnolence, chest pain, during last 2 weeks developed anxiety, fear, depression, disorders of memory and aphasia, untidiness appeared 5 days ago. Set a diagnosis. Dementia of AIDS * Patient has еncephalopathy (AIDS-related complex) Organic psychosis Anxiously depressed syndrome for HIV infection Somatoform depression For a man 30 years old, it was discovered positive reaction on HIV half-year ago. Last 3 months complaints of general weakness, fatigueability, somnolence, chest pain. Last 2 weeks with anxiety, fear, depression, disorders of memory and aphasia, untidiness appeared 5 days ago. What is the treatment? Acylovir Cerebroprotector Antidepressants Neuroleptic * Zidovudin, didanosin For a patient 35 years old, after 4-months of treatment by isoniaside - аdynamia, icterus, pain in right hypochondric appeared. The liver is megascopic. In blood activity of enzymes of AlAT is increased in three times, AsAT in two times. Bilirubin of blood - 122 mcmol/l (conjugated - 82, unconjugated - 40). НBs-аntigen is not found out. What is the diagnos? Calculary cholecystitis Hepatocirrhosis Acute viral hepatitis Chronic active hepatitis * Toxic hepatitis HIV positive patient, 28 years old, drug addict, complaints of dyspnea, unproductive cough, fever with 37,5 °C for 2 months.Objectively: skin is pale, hyposthenic breathing in lungs, especially in lower lobe, short breathing 24 per min. Roentgenologic chromophilic bilateral infiltrations as “wings of butterfly”. What is the most effective treatment: Antibacterial preparations. Inhibitors of transcriptase Inhibitors of proteases. Inhibitors of transcriptase Transplantation of marrow. Inhibitors of transcriptase Antiviral gamma-globulin. Vitamins of A, C groups. Inhibitors of proteases * Inhibitors of proteases. Inhibitors of transcriptase. Antibacterial drugs In 2 months after returning from India, where she often drank unboiled water; the 23-year-old pregnant woman felt nauseated, strong general weakness, head acke appeared. Later the temperature of body rose to 38,6 °C, which stuck to within a week. icterus appeared on the 6th day, the general condition continued to worsen. On the 12th day of illness the general condition became severe. EuphoriA. Vomiting at night. Complete fastidium. Bright icterus, signs of hemorragic syndrome, tachycardiA. BP 110/60 mm Hg, body temperature 37,8 °C. The liver is insignificantly megascopic, soft, painfull, spleen +2 cm There is neutrophilic leykocytosis in general blood analysis. General bilirubinum of blood up to 570, to the line - 300, activity of ALAT is enhanceable in 100 times, timol test of 26 units., urea - 2,1 mmol/l. With most probability for a patient: Man 30 years old, drug addict, takes drugs intravenously. Has been taking drugs for 12 years Complaints of weakness, moderate icterus, weight in right subcostal region. The state became gradually worse. Biochemical indexes: general bilirubin 28,2 mcmol/l; ALAT 1,0, ASAT 0,8 . Will you define a diagnostic method which is expedient to conduct for establishment of etiologic diagnosis? Biopsy of liver * Polymerase chain reaction (PCR) Enzymes of liver Computer tomography Immunological tests On a background of prolonged treatment for an HIV patient, appeared ulcer on the mucous of mouth. During objective examination, the doctor found erosions on the mucous, hyperemic and filling out mucous of oral cavity, tongue without raid, with a smooth surface. About what complication is possible to think? Leptospirosis Acute herpes Stevens-Johnson syndrome * Candidos stomatitis Layel syndrome Patient P., 21 years old, complaints of diarhhea that lasts for one and a half months, changes sometimes, on emptying there are admixtures of blood and mucus, 13 kg loss of body mass, weakness, subfebrile temperature of body, recurrent herpes. It is discovered generalised lymphadenopathy, increase of liver size by 2 cm. Blood test: Er 4,4*1012 g/l, Hb 115 g/l, ESR - 15 mm/hr, L 10,0*109 g/l, е 2 %, b 6 %, n 61 %, s 17 %, m 3 %, atypical mononuclears 6 %. What is most credible diagnosis? Shigellosis * AIDS Infectious mononucleosis Salmonellosis Ameobiasis Sick O., 25 years old, complaints of considerable fatigue, fever up to 39 °C profuse sweating, lethargy. Objectively: all groups of peripheral lymphatic node are enlarged, candidiasis of oral cavity, herpetic pouring out with megascopic on lips. In the global analysis of blood: leucocytes 3,3*109 g/l, ESR – 15 mm/hr, B-lymphocyte 12 %, a decline of CD4 to 600/mm. What is most credible diagnosis is? Herpetic infection Malaria Urogenital chlamydia * HIV/AIDS Acute brucellosis Student L, 20 years old, complaints of considerable fatigue, fever up to 39 °C profuse sweating, lethargy. Objectively: all groups of peripheral lymphatic node are enlarged, candidiasis of oral cavity, herpetic pouring out with megascopic on lips. In the global analysis of blood: leucocytes of 6,2*109 g/l, ESR 15 mm/hr, B-lymp 12 %. What is most credible diagnosis is? Megakaryoblastoma Malaria * HIV/AIDS Urogenital chlamydiasis Brucellosis Patient T., 35 years old, appeared to the doctor on the 8th day of gradual development of illness with complaints of general weakness, rapid fatigue, dark color of urine. In the morning noticed an icterus. On examination temperature of body 36,8 °C. Found out the increasing of liver +3 sm. The changes of what laboratory index most informing at this illness? *AlAT Hemodiastases Protrombin index Cholesterol Alkaline phosphatase The sick complaints of a prolonged cough, more than half-year, rising temperature of body to 38 °C, enlargement of peripheral lymphnode, frequent herpetic wide-spread pouring out with considerable lowering of body mass. In іmmunogram correlation of T-helper to T-suppression is 0,3. It takes place because the infestant: Infects cells with the receptors of CD22 Induces proliferation of Т-helpers Induces proliferation of T-suppressors Infects cells from receptor CD8 * Infects cells from receptor CD4 HIV-positive patients, 28 years old, a former injecting drug user, complained of shortness of breath, nonproductive cough, temperature rise up to 37,5 °C for 2 months. Objective: pale skin, lungs auscultated respiratory depression, especially in lowback, dyspnea 24 for 1 min. Radiographically bilateral infiltrates in the form of “butterfly wings”. Choose the most effective approaches to treatment: Antbacterial drugs. Transcriptase inhibitors Protease inhibitors. Transcriptase inhibitor Bone marrow transplant. Transcriptase inhibitors Antiviral gamma globulin. Vitamins B, C. Protease Inhibitors E.* Protease inhibitors. Transcriptase inhibitors. Antibacterial drugs During influenza epidemic, a patient in the hospital arrived 43 years with complaints of fever above 38 °C, malaise, in the analysis of blood on the outpatient phase of the survey neutrophilic leukocytosis 12.0 * 109 g/L, a shift to the left, ESR 50 mm / hour. As it turned out, a fever with a few interruptions lasted for about 3 months, then lost 13 kg in body weight with normal appetite. Catarrhal symptoms are minor. Liver to 2 cm below the costal arch. Other abnormalities are not detected. What kind of disease should think of first? Flu Pneumonia Chronic hepatitis in the acute stage HIV infection *AIDS Patient was taken to a hospital after car accident in critical condition, caused by shock, bleeding. Before emergency blood transfusion in order to prevent HIV transmission everybody should consider: Health reasons The conclusion of the panel of doctors Agree of the patient (or his family) The results of a survey of emergency donor HIV (IHA) *All the above listed 33 years patient comes in with complaints of fever above 38 °C, and general malaise. As it turned out, a fever with a few interruptions lasted for about 2 months, then lost of body weight to 16 kg. Periodically bowel dysfunction. Palpable enlarged lymph nodes in the axillary regions on both sides of the neck. Other abnormalities are not detected. What changes would expect to find in the study of blood? Anemia Leukopenia Hypolymphemia Thrombocytopenia *All the above listed 33 years patient with complaints of fever above 38 °C, and general malaise. As it turned out, a fever with a few interruptions lasted for about 2 months, then lost of body weight to 16 kg. Periodically bowel dysfunction. Palpable enlarged lymph nodes in the axillary regions on both sides of the neck. Other abnormalities are not detected. What changes would expect to find in the study of blood? Leukopenia Decrease the number of CD4 Decrease immunoregulatory index Increase ESR *All the above listed 40 years sick with complaints of general weakness, sweating, wasting a 12 kg, often long-term diarrhea and recurrent respiratory infections. Objectively: generalized lymphadenopathy, oral candidiasis, fecal mucus and blood. B blood reduced the number of T-helper cells, T4/T8 less than 0.5. What is the most likely diagnosis? Dysentery Amebiaz *AIDS Tuberculosis Cytomegalovirus infection Student 20 years during the month has been concerned a significant fatigue, increased body temperature 39 °C, profuse perspiration, emaciation. Objective: increasing of all peripheral lymph nodes, oral candidiasis, herpes on lips. General blood analysis: leukocytes 3.3 x 109 / l, ESR 15 mm/hour, B-lymphocytes 12%. What additional test is helpful in diagnosis? Biological assay in guinea pigs Determination of the number of T-lymphocytes *Determination by IFA antibodies in response to antigens or RIA HIV Burne test Leukocyte migration inhibition test Patient 18 years intravenous drugs user, complaints of a cough lasting more than 4 months, Increasing of body temperature to 38 °C, treatment of “interstitial pneumonia” is not effective. There have been several episodes of widespread herpes, decreasing of body weight. The study will identify all immunograms authentic: Increasing of T4-helper lymphocytes Increase immunoregulatory index T4/T8 *Decrease the number of T4-helper lymphocytes Increase the absolute number of T lymphocytes Improving performance of delayed-type hypersensitivity Patient 18 years intravenous drugs user, complaints of a cough lasting more than 4 months, Increasing of body temperature to 38 °C, treatment of “interstitial pneumonia” is not effective. There have been several episodes of widespread herpes, decreasing of body weight. The study will identify all immunograms authentic: Increasing of T4-helper lymphocytes Increase immunoregulatory index T4/T8 *Reducing the number of T4-helper lymphocytes Increase the absolute number of T lymphocytes Improving performance of delayed-type hypersensitivity Patient 23 years old, fell ill at the end of summer, when the temperature rose to 37.2 °C, mild headache, and weakness. Up to 7 days of illness treated at the outpatient ARI. Condition worsened, admitted to hospital. The body temperature of 40 °C, a pale, severe weakness. Pulse 96 per 1 min, blood pressure 110 and 70 mm Hg. Tongue with imprints of teeth, the abdomen is soft, swollen, hepatosplenomegaly. Constipation. There is congestion and hyperplasia of the tonsils, on the surface of the right - the ulcer. What disease we may think about? Vincent-Simanovsky tonsillitis Herpangina *Necrotizing tonsillitis Kissing disease Angina Duge Patient 30 years after exposure to the earnings to consult a dermatologist complaining of rashes around the skin surface. Over the last three months have seen a sharp emaciation, weakness, constant low-grade fever. Presens what disease we will exam the patient? Syphilis TB infection *AIDS CMV infection Malignant neoplasms of the skin Patient B., 28, a prostitute, 2 years living in the Middle East. Admitted to hospital with complaints of weakness, cough, sputum gray, burning in the chest, shortness of breath, night chills, fever, sweating, pain in the joints. Patients lost of weight near 12 kg during 5 months, decreased appetite. On examination: the soft palate, temples, back of the throat covered by white raids. Lymphadenopathy. Hepatosplenomegaly. In the blood: anemia, leukocytosis, shift formula to myelocytes, lymphopenia, ESR 60 mm/hour. Your diagnosis? Visceral leishmaniasis *HIV infection. Pneumocyst pneumoniA. Esophageal candidiasis Brucellosis Lymphogranulomatosis Esophageal carcinoma Patient K., 29 years old, not vaccinated, complaints of the increasing temperature to 37,2 °C, headache, weakness, pain in the throat which increase with swallowing, acute disease began two days ago. Objectively: pale skin. Pulse 110 for 1 min. Heart sounds are muffled, especially the first one. Gentle systolic murmur. AP 100 and 65 mm Hg. Tonsils, soft palate, uvula swollen. On the surface of the tonsils, more to the right, pale-gray film, which spreads their borders, removed hard, dense. The regional lymph nodes are enlarged. Subcutaneous edema, which reaches to the middle of the neck. Specify the most likely diagnosis: *Diphtheria oropharynx Angina Kissing disease Paratonsillar abscess Acute leukemia A patient, 16 y.o., complaints of general weakness, fever, sore throat. Objectively: oropharyngeal mucosa bright red, the tonsils - white raids are removed easily, an increasing of all groups of lymph nodes, 1-3 cm in diameter, firm, elastic maloboleznennye, not welded together. The liver is enlarged by 3 cm, the spleen - 1 cm in blood leukocytosis, atypical mononuclear cells – 20 %. What is previous diagnosis? *Infectious mononucleosis Acute lymphocytic leukemia Acute streptococcal tonsillitis Diphtheria Adenovirul infection Patient G., 24, complaines of sore throat, fatigue. Temperature 38 °C. Pulse 96 per minute, flushing of the skin, hyperemia of mucous membranes of oropharynx. Enlargment of tonsills, friable. Palpable enlargement submandibular lymph nodes. Spleen + 1 cm. What method can confirm the diagnosis? Paul-Bunnel, Wright-Heddlson, Hoff-Bauer reactions *Paul-Bunnel, Lovrika-Volner, Hoff-Bauer reactions Paul-Bunnel, Wright-Heddlson, Lovrika-Volner reactions Paul-Bunnel, Burne, Hoff-Bauer reactions Paul-Bunnel, Hoff-Bauer, Wright-Heddlson, Lovrika-Volner reactions A patient 15 years old, was admitted to the hospital on the third day of illness with complaints of pain in the throat when swallowing, fever. The disease is linked to the use of raw molokA. On examination: body temperature of 38 °C, hyperemic pharynx, enlargement of right tonsill, swollen, with necrotising layering grayish-white color. Right neck lymph node on the size like a hen’s egg, mild painful, with clear contours, the skin over it is not changed. What is preliminary diagnosis? Lacunar tonsillitis Diphtheria of oropharynx Vincent-Simanovsky tonsillitis Duge-Strumpell tonsillitis *Tonsilar-bubonic form of tularemia The patient became ill 17 years after acute hypothermia: 39,5 ° C fever, headache and muscle pain, sharp pain in the throat when swallowing, aching pain. Hypertrophy of tonsils, bright red, in the gaps of the purulent deposit. Diagnosed as lacunar tonsillitis. What is most effective laboratory method of investigation in this case? Biochemical blood Microscopic examination of the pus gaps Immunological study of blood Biological research method *Bacteriological study of the content of gaps 28 years old patient complaints of increasing of lymph nodes during six months, progressive weakness, sweating, recurrent fevers to 38 °C. During several years has used drugs intravenously. Malnutrition, widespread seborrheic dermatitis, painless palpable enlarged cervical, axillary and inguinal lymph nodes of up to 2-2.5 cm What research is to assign at first? Lymph node biopsy Blood cultures *Blood test for antibodies to HIV Sternum puncture Examination of blood for antibodies to the Epstein-Barr virus A patient 30 years old, was taken to the infectious department by ambulance in serious condition. On examination: the temperature of 38,9 °C, the patient is exhausted, lethargic, pale skin, in the peripheral vein - injection marks. In the mouth - a lot of carious teeth, white attacks on the mucosA. By an increase in the axillary, inguinal, supraclavicular lymph nodes, not painful, not welded to the underlying fiber. In the lungs - breathing weakened, respiratory rate 30 per minute., Pulse 92 / Min., AD 100 and 65 mm Hg. Heart sound muffled, rhythmic, hepatosplenomegaly. In history - injecting drug user for 3 years. What is your diagnosis? Toxic hepatitis Sepsis Lymphogranulomatosis Brucellosis *AIDS A patient B., 18 years old, was admitted to hospital with complaints of headache, weakness, fever up to 37,5-38,2 °C for 6 days, the pain in the throat. Objective: increasing of all lymph nodes, 1-3 cm in diameter, flexible, not painfull, not welded together. The liver is enlarged by 3 cm, the spleen - 1 cm in blood leukocytosis, virotsity - 15%. Likely diagnosis? Tonsillitis Adenovirus infection *Infectious mononucleosis Diphtheria Acute lymphocytic leukemia Patient B., 22 years old, desperately ill, mild pain in the throat during swallowing, nasal voice. Objectively: the left tonsil and the arc is filmy coating. Diagnosed with lacunar tonsillitis, appointed penicillin and rinse 2% soda solution. Till the second day covers spread on the soft palate and uvulA. Swelling of the neck on to the collar bone, nasal voice. Muffled heart sounds, pulse 90 per minute. AP 95 and 65 mm Hg. What is the most expedient treatment in this case? Penicillin and diphtheria toxoid Rinse 2% soda solution in combination with erythromycin peroral Autohaemotherapy, hot compress and quartz tube Disclosure and drainage paratonsillar fiber *Antitoxic diphtheria serum and benzylpenicillin Patient B., 34 years old, complained of fever, headache, aching joints, fever, sore throat, worse when swallowing. Objectively: flushing of the oropharynx, tonsils hyperemic, hypertrophied, on both - the necrotic areas of dark gray color, which was formed after the delamination defect deep mucosa with bumpy bottom, enlarged and painful submandibular lymph nodes. Put the diagnosis? Diphtheria Tonsillitis Lacunar tonsillitis Vincent's angina *Necrotizing tonsillitis C. become sick gradually. There was general weakness, fatigue, sore throat, abdominal pain, and nauseA. Hospitalized on the 5th day of illness. Examination: body temperature 38 ° C, increased cervical, and submandibular lymph nodes. Skin or eyes subikterichny. There have been isolated maculo-papular rash all over body. The deposits on the tonsils, white-yellow, tongue coated with white covering, moderately distended abdomen, hepatosplenomegaly. In blood leukocytosis, neutrophilic left shift, atypical mononuclear cells 10 %, 10 % plasma cells. What is the preliminary diagnosis? Viral hepatitis A *Infectious mononucleosis Typhus, paratyphoid diseases Yersiniosis Lacunar tonsillitis The patient, age 20, complained of a sore throat when swallowing, weakness and headache on the 2nd day of the disease. OBJECTIVE: Temperature 39,0 ° C, the pulse 110 for 1 min, oropharyngeal mucosa hyperemic, tonsils enlarged in size, loose, covered with plaque that is easily removed, the surface after removal of the plaque does not bleed. What kind of disease is necessary to think about? Tularemia Diphtheria oropharynx -Vincent Angina Simanovsky Kissing disease * Acute streptococcal tonsillitis In infectious hospital, patients who present with acute onset of disease, temperature of 39,9 °C, mild sore throat, swelling, and redness with slight cyanosis of the mucous membranes of the oropharynx, the tonsils are dense, shiny, grayish deposits in the form of a continuous film, which hard to remove, exposing a bleeding surface. Submandibular lymph nodes were moderately enlarged. The patient should have what immediately performed: Swabs from the tonsils, nose or other areas to identify diphtheria bacilli (culture) ELISA * Microscopy (Neisser staining) Blood culture Serology (RPHA with diphtheria diagnostic tools) HIV-positive patient, 28 years old, a former injecting drug user, complained of shortness of breath, nonproductive cough, temperature rise to 37.5 °C for 2 months. OBJECTIVE: pale skin, lungs auscultated respiratory depression, especially in the lower parts of the posterolateral, dyspnea 24 for 1 min. Radiographically bilateral infiltrates in the form of "butterfly wings." Choose the most effective approaches to treatment: Antibacterials. Transcriptase inhibitors Protease inhibitors. Transcriptase inhibitors Bone marrow transplant. Transcriptase inhibitors Antiviral gamma globulin. Vitamins B, C. Protease inhibitors * Protease inhibitors. Transcriptase inhibitors. Antibacterials The 40 year-old driver is sick for two months - general weakness, sweating, lost 12 kg, often long-term diarrhea and recurrent respiratory infections. OBJECTIVE: generalized lymphadenopathy, oral candidiasis, fecal mucus and blood. In the blood, reducing the number of T-helper cells, T4/T8 less than 0.5. What is the most likely diagnosis? Dysentery Amebiasis * AIDS Tuberculosis Cytomegalovirus infection Gynecologist, during the operation emergency of a young woman accidentally hurt himself with a scalpel. After 3 days, a reply came from the laboratory with positive antibodies to HIV in the blood of a patient taken before surgery. Priority actions in respect of the operated physician: Debridement Immediate laboratory testing for HIV Post-exposure prophylaxis with antiretroviral drugs by the results of laboratory testing for HIV * post-exposure prophylaxis with antiretroviral drugs Observation Girl 8 years old, was admitted to hospital with complaints of general weakness, fever, sore throat. OBJECTIVE: oropharyngeal mucosa is bright red, the tonsils have white plaques which are removed easily, shows an increase in all groups of lymph nodes, 1-3 cm in diameter, firm, elastic slightly painful, not grouped together. The liver is increased by 3 cm, the spleen 1 cm in the blood - leukocytosis, plasma cells 20%. Likely diagnosis? Acute lymphocytic leukemia * Infectious mononucleosis Angina Diphtheria Adenovirus infection Female 24 years old, went to the doctor due to prolonged fever, night sweats. Over the past three months lost 7 kg. Was promiscuity. An objective study found an increase in all groups of lymph nodes, hepatoileal syndrome. Leukocytes-. 2.2 *109 / l. What disease should be suspected? Hroniosepsis Lymphogranulomatosis Tuberculosis Kissing disease * HIV infection Woman, 28 years old, complaining of general weakness, headache, fever up to 39-40 ° C, sore throat for 3-days. Her husband has strep throat. OBJECTIVE: pale skin, lips cyanotic. Hyperemia of oropharynx with cyanosis, swelling of tongue, palatine arches, tonsils. On the surface of the tonsils - solid thick white with pearl shade plaque, which are difficult to remove with a spatula, after removing plaque, mucosa bleeds. Enlarged submandibular lymph nodes. Swelling of the neck. TachycardiA. AP 105 and 65 mm Hg.. What is the most likely diagnosis? Acute leukemia Angina Kissing disease * Diphtheria oropharynx Adenovirus infection Patient N., 23, was hospitalized in infectious department and diagnosed with oropharyngeal diphtheriA. On examination, the tonsils of the throat have solid thick white with pearl shade plaque, which are difficult to remove with a spatula, after removing plaque, mucosa bleeds. When can the patient be discharged? After the disappearance of clinical symptoms After the disappearance of clinical symptoms and get a negative culture results mucus tonsils and nasal diphtheria at two-day intervals After the disappearance of clinical symptoms and get negative results of two bacteriology mucus tonsils and nasal diphtheria at a three-day intervals After the disappearance of clinical symptoms of diphtheria and get three negative results of bacteriological studies of mucus from the nose to the tonsils and diphtheria three-day intervals * After the disappearance of clinical symptoms of diphtheria and get negative results of two bacteriology mucus tonsils and nasal diphtheria at two-day intervals Patient K., 40 years old, complained of fever, night sweats, rapid weight loss, muscle aches, sore throat, joint pain, photophobia, recurrent diarrheA. On examination revealed generalized lymphadenopathy. Most likely the following diseases: Lymphogranulomatosis Tumor of the digestive system * AIDS Tuberculosis Salmonellosis Patient received a blood transfusion from an unverified voluntary donor. Remains of blood sent to the station of blood transfusion, where the examination of the donor antibodies to HIV. Your actions for recipient: Observation laboratory testing for HIV Emergency antibiotic * Post-exposure prophylaxis with antiretroviral drugs all the above After months of unsuccessful treatment for pneumonia in a 7-month-old baby antibodies to HIV was revealed. During pregnancy, the mother of the child was examined twice by HIV with negative results, the last at 24 weeks of pregnancy. Childbirth was without complications. Baby breastfeeding. What is the most likely route of HIV infection of the child: HIV-infected mother Vaginall birth Breast-feeding Parental interventions after birth * All the above After months of unsuccessful treatment for pneumonia in a 7-month-old baby antibodies to HIV was revealed. During pregnancy, the mother of the child was examined twice by HIV with negative results, the last at 24 weeks of pregnancy. Childbirth was without complications. Baby breastfeeding. What is the most likely route of HIV infection of the child: * HIV infection of the mother Laboratory examination of the child Parental interventions during treatment of pneumonia AIDS of the father All variants are possible . 7 -month old child with pneumonia had antibodies to HIV. During pregnancy, the mother of the child was examined twice by HIV with negative results, the last at 24 weeks of pregnancy. What is possible reasons of HIV of the mother: * HIV infection during pregnancy Presence of AIDS of the father Infection during care of a sick child Contamination during breast-feeding All variants are possible 7-month old child with pneumonia had antibodies to HIV. During pregnancy, the mother of the child was examined twice by HIV with negative results, the last at 24 weeks of pregnancy. What terms of final investigation of mother for presence of HIV infection: Negative screening result in the first trimester Negative screening result in the II trimester * A negative screening result after 28 weeks Negative screening result in I and II trimesters All variants are possible . Patient 37 years old, slower muscle and motor responses during 3 monthes have been developed, impaired memory for names, addresses, disrupting cognitive function, there was stiffness, drowsiness, sloppiness, indifference to others and to his state. Loss of weight 12 kg. Intermittent fever. Generalized lymphadenopathy. What is clinical diagnosis. Tuberculosis Herpes encephalitis * AIDS Syphilis Lymphocytic Leukemia 12 years old boy with catarrhal symptoms observed an increase of all groups of lymph nodes, injection of sclera, hyperplasia of the tonsills with white loose build-up on them in the form of islands, there are single roseolous-papular rash, increasing of liver and spleen. What additional research should be appointed? Ultrasound of the abdomen Puncture of the lymph nodes followed by microscopy * Blood on atypical mononuclear Blood culture RPHA with influenza viruses 96. 30 years old person, six months ago, was found positive for HIV. 3 months complaints of general weakness, fatigue, drowsiness, headache. 2 Weeks - anxiety, fearfulness, depression. 5 days ago, there were memory disorders and aphasia, tremor, impaired fine movements, myoclonus, sloppiness. What additional tests need to be carried out for the diagnosis of the nervous system? Ganciclovir Cerebroprotector Antidepressants Antipsychotics * Zidovudine, didanosine 97. 30 years old person, six months ago, was found positive for HIV. 3 months complaints of general weakness, fatigue, drowsiness, headache. 2 Weeks - anxiety, fearfulness, depression. 5 days ago, there were memory disorders and aphasia, tremor, impaired fine movements, myoclonus, sloppiness. What additional tests need to be carried out for the diagnosis of the nervous system? Ultrasound * Computer Tomography Doppler Blood analysis for HIV Pathophisiology study . The patient has been diagnosed with herpes zoster. A patient suffering from childhood diabetes, father and grandfather - asthmA. A few days ago, suffered food poisoning. 7 days took analgin due to headaches. Antibodies against HIVwas find. What factor has the greatest pathogenetic significance? *HIV-relative immune deficiency Food poisoning An allergic disease in relatives Diabetes Analgesics Sick C., 20 years old, was admitted to the hospital with complaints of the frequent emptying without stomach-ache, vomiting without nausea, pain in calf muscle. Objectively: Temperature of body is 36,2 oC. Skin is pale, cold, tongue is dry, voice is hoarsed. The stomach is pulled is not painful at palpation. Emptying resemble with “rice-water”. Are there what terms of discharge of patients from the hospital at such illness? A.*Triple negative results of bacteriological examination of excrements Double negative results of bacteriological examination of excrements Single negative result of bacteriological examination of excrements Single negative results of bacteriological examination of excrements and urine Double negative results of bacteriological examination of excrements and urine A sick 18 years, hospitalized in an infectious department with diagnosis of cholera, dehydration of IV degree. What measures are possible primarily? Oral rehydration by glucose solutions Tetracycline *Intravenous stream introduction of salt solutions Proceeding in the normal microflora of intestine Intravenous stream introduction of sodium chloride solution Patient B., 20 years, became ill acutely. The unexpected severe diarrhea appeared with frequent vomiting, with plenty of vomits. The patient arrived from a South-east Asia countries. He has temperature 36,1 oC during 3 weeks. Abdomen is pulled, not painful. Stool is a rice-water. What most reliable changes in blood will be present? Increasing amount of erytrocytes, leucocytes, relative closeness of plasma of blood, hyperkalemia, metabolic acidosis Decreasing of amount of erytrocytes, leucocytes, relative closeness of plasma of blood, hypokalemia, metabolic acidosis Decreasing of amount of erytrocytes, leucocytes, increase of relative closeness of plasma of blood, hyperkalemia, metabolic acidosis *Decreasing amounts of erytrocytes, leucocytes, relative closeness of plasma of blood, metabolic hypokalemic acidosis Increasing amount of erytrocytes, leucocytes, relative closeness of plasma of blood, hypokalemia, metabolic alkalosis A sick, 29 years, emptying watery stool repeatedly, frequent vomiting. Objectively: total cyanosis, dryness of mucous membrane, turgor of skin is decreased Temperature of body 35,2 oC. Pulse in radial artery is not determined. Tachypnea, musle spasm, urination is absent for 6 hours. What is the state of the patient? Dehydration of IV degree Dehydration of I degree Infectious-toxic shock Anaphylactic shock *Uncompensated hypovolemic shock Patient with complaints of a general weakness, diarrhoea appeared to the doctor. Objectively: temperature of body 36,4 oC, skin covers clean, acrocyanosis, tongue is dry, stomach is soft, not painful, emptying is abundant, watery, with the supernatant flakes of white color, odourless and admixtures. For clarification of diagnosis culture of stool was made on ResselyA. What is the color of culture chang? From blue to green From yellow to green From green to yellow From yellow to blue *From blue to yellow For a patient E., 37 years old, a disease began rapidly, 6 hours the frequent liquid emptying appeared onto the plain rise of normal temperature of body, vomit joined then. At an inspection: aphonia, eyes are hollow, pulse frequent, threadlike, low blood pressure cramps appeared in lower extremities. Liver and spleen are not enlarged. Choose preparations for starting etiotropic therapy. Tetracyclin, erythromycin, levomycetin, ciprofloxacin or imodium Erythromycin, levomycetin, benzylpenicillin or imodium Tetracyclin, erythromycin, levomycetin, benzylpenicillin or ofloxacin Tetracyclin, erythromycin, levomycetin, or bifi-form *Levomycetin, erythromycin or ciprofloxacin Citizen of Pakistan, 30 years became ill rapidly with frequent watery stool which appears like a rice water. Objectively: temperature of body 35.4 oC, skin is cold, acrocynosis, elasticity of skin and turgor is decreased. By what method may estimate the degree of dehydration? To examine an eyeballs To check central venous pressure To define the level of urea and creatinine in blood *To check the loss of blood plasma To check the pressure of blood For a patient E., 37 years, body weight of 70 kg, frequent liquid emptying appeared with rise of body temperature, frequent vomiting joined in later. At an inspection: aphonia, eyes are hollow, pulse with frequent threadlike, blood pressure is not determined, tachypnea, total cramps. Liver and spleen are not enlarged. What volume of salt solutions must be entered for primary rehydration? *7 L 3,5 L 5 L 10 L 2 L Sick C., 23 years, ill from 3 days after returning from IndiA. The disease has begun with the liquid emptying which looks like a watery, after wards joined with multiple vomiting, expressed weakness and cramps. The state progressively got worse and was admitted within 12 hour in an infectious hospital in a grave condition. The eyes of person is sharped, skin is cold, acrocynosis temperature of body 35,5 oC. Aphonia, cramps of hands and feet. The fold of skin falls out through abdomen. stomach is pulled in, no pain at palpation. Blood pressure is 70 and 30 mm of Hg. Pulse on radial artery is not determined, urination and emptying are not good. What is the most appropriate diagnosis? Intestinal echerihiosis Salmonellosis Shigellosis *Cholera Amebiasis, intestinal form Patient with cholera on a background treatment has signs of hyperkalemiA. What solution must be applied for futher rehydration therapy? Neohemodez *Disalt Chlosalt Polyhybrid Lactosalt Sick I., 25 years, returned from rest in Egypt. Early in the morning diarrhea began. Emptying each 1-1,5 hrs, abundant watery, without mucus and blood. Abundant vomiting also appeared. The temperature of body at first rise to 37,3 oC, afterwards became 35,5 oC, stomach-aches negative. Delivered in an infectious department. What is first aid? Treatment with sorbents Polyhybrid solution intravenous 5 % solution of glucose intravenous Fresh-frozen plasma intravenous *Salt solutions intravenous Sick, 20 year old, apeared to the hospital with complaints offrequent emptying without stomach-ache, vomit without nausea, pain in calve. Objectively: temperature of body – 36,2 oC. A skin is pale and cold, a tongue is dry, voice getting hoarse. A stomach is pulled in, painless, emptying like a “rice-water”. What are the criterias for discharging of the patient from the hospital? Double negative bacteriological examination of excrements Single negative bacteriological examination of excrements *Triple negative bacteriological examination of excrements Negative bacteriological examination of excrement and urine Double negative bacteriological examination of excrement and urine For a patient, the disease begun rapidly with a chill, increase of temperature to 39 oC, vomitting, pain in epigastrium, diarrhea with the watery stinking emptying. 6 hours before the disease he ate a raw egg, potato with the braised meat and drink juice. What exciter did cause the similar state probably? Shigella Collibacillus Campylobacter *Salmonella Citrobacter Patient C., 17 years old, worker in vegetable garden. Became sick 2 days ago. The disease is related to use of meal of dirty root crop. Disease begun with chill, fever of 38.1 oC, had pain in abdomen and in the muscles of all groups and joints, weakness, nauseA. Emptying is liquid, viscid, with a strong smell, ordinary color. At objective examination: sclera, conjunctivitis, hyperemia of soft palate, “raspberry” tongue. At palpation of abdomen – moderate pain in epigastrium and in right iliac areA. What will be the diagnosis? Cholera Dysentery Salmonellosis *Scarlet fever Viral hepatitis Patient with cholera has bradycardia, low blood pressure, weakness. What is most important factor in the given clinical situation? . Hypocalcemia Hypopotassium Hyponatremia Hypernatremia *Hyperpotassium Patient E, 47 years, became ill in 4 days after returning from Egypt. A disease begun with the liquid emptying which look like a watery kind afterwards, joined with frequent vomiting, expressed weakness and fatigue. The state progressively got worse and within 18 hrs was admitted in an infectious department in a very grave condition. The lines of person are strained, skin is cold, cyanosis, temperature of body 35.5 oC. Aphonia, cramps of hands and feet. The skin fold falls out through the abdomen. A stomach is pulled; no pain at palpation. Blood pressure is 70 and 30 mm of Hg. The pulse on radial artery is not determined, urination and emptying normal. Weight of patient at admission to the hospital was 60 kg. What is the degree of dehydration of the patient? I II *IV III It is not Sick X., which returned from vacations from Turkey within 5 hrs in the morning, diarrhea began. Emptying each 1-1.5 hrs, with abundant watery without mucus and blood. In future bloodless watery, abundant vomitting appeared through 12 hrs. The temperature of body at first rise to 37.5 oC afterwards became 35.7 oC is delivered in an infectious department. What disease did you suspect? Echeriosis Food poisoning| *Cholera Salmonellosis Balantidiasis Sick P., 25 years old, presents with frequent vomitting. Objectively: dryness of skin and mucous membranes, brief cramps in gastrocnemius muscles, the temperature of body is normal, voice is hoarsed, moderate tachycardia and hypotension. The compensated metabolic acidosis is marked. About what degree of dehydration is it possible to think? IV II *III I There is no dehydration An unconscious patient is delivered in the intensive department. Pale dark circles around eyes. Skin is cold with sticky sweat. Temperature of body 35,6 oC. Pulse 140/min and weak. Blood pressure is 40 /0 mm of Hg. Tongue is dry. Emptying is involuntary and “watery”, vomited twice. What infusion must be given as intensive therapy. Albumin Rheopoliglykin 5 % glucose solution *Polyionic salt solutions 10 % glucose solution A farmer O., 50 years old, hospitalized in a moderate condition with complaints of dryness in mouth, multiple vomitings, pain in the epigastriums and frequent watery stool. First aid to the patient is? Hypersaturated oxygen Transfusion of fresh-frozen plasma Tetracyclin *Intravenous introduction of salt solutions Introduction of polyhybrid Patient P, 35 years old, became ill within 2 days after returning from IndiA. A disease begun with appearance of liquid diarrhea which resembled a watery appearance, afterwards joined with multiple vomit, expressed weakness and fatigue. State progressively got worse and within 12 hrs delivered in an infectious department in a grave condition. The skin is cold, cyanosis, temperature of body 35.5 oC. Aphonia, cramps of hands and feet. A skin fold falls out from abdomen. The stomach is pulled in, no pain at palpation. Blood pressure is 70 and 30 mm of Hg. A pulse on a radial artery is not determined, urination and emptying are normal. Weight of patient at admission to the hospital was 80 kg. What volume of infusion solutions is needed for primary rehydration? 10 liters *8 liters 4 liters 6 liters 2 liters A patient L., who returned from Crimea, developed diarrhea at 5AM. Bowel movements are each 1-1.5 hrs, watery, without mucus and blood. In 12 hrs a single episode of vomiting developed. The temperature of body at first rise to 37.3 oC, stomach-aches is present. he was examined by the doctor of first-aid and delivered to an infectious isolation with the diagnosis of acute intestinal infection.Which disease is most probable for the patient? Intestinal echerihiosis . Salmonellosis Echeriosis Food poisoning *Cholera The ill patient in severe state was delivered to infectious department with no consciousness. Pale dark circles around eyes. Skin is cold, covered with sticky sweat. Temperature of body 35.6 oC. Pulse 140/min and weak.Blood pressure is 40 and 0 m of Hg. Tongue is dry. Emptying is involuntary and watery. Three times vomited like “fountain”.What is the state of the patient? Collapse Infectious toxic shock *Dehydrational shock Cereblral edema Intoxicated encephalopathy Patient T., 22 years old, appealed to the hospital with complaints of the frequent stool without the abdominal pain, vomits without nausea, pain in calves. Objectively: Т-36,2 °C. A skin is pale, cold, tongue dry, voice getting hoarse. An abdomen is pulled in, painless. Emptying remind a “rice-water”. What terms of extract of patients from a hospital at this illness? Non-permanent negative bacteriological research of excrement Double negative bacteriological research of excrement Double negative bacteriological research of excrement and urine Non-permanent negative bacteriological research of excrement and urine *Triple negative bacteriological research of excrement Patient N, 13 years old, hospitalized in the infectious department with a diagnosis of cholera, severe dehydration of Ш-ІV stage. What measures are primary? Setting of etiotropic antibacterial preparations Stream intravenous introduction of salts solutions Peroral rehydratation with glucose-salts solutions Renewal of normal microflora of intestine *Setting of enzyme preparations A patient J., 23 years old, became ill suddenly. Profuse diarrhea with frequent and large amount vomits. A patient arrived from one of countries of south-east Asia, where was near 3 weeks. T 36,1 °C. An abdomen is pulled in, painless. The stool has the appearance of rice-water. What most reliable changes will be in a blood? Decrease amount of erythrocytes, leucocytes, relative tightness of plasma of blood, hypopotassemia, metabolic acidosis. *Increase amount of erythrocytes, leucocytes, relative tightness of plasma of blood, hypopotassemia, metabolic acidosis. Decrease amount of erythrocytes, leucocytes, increase of relative tightness of plasma of blood, hyperpotassemia, metabolic acidosis. Increase amount of erythrocytes, leucocytes, relative tightness of plasma of blood, hyperpotassemia, metabolic acidosis. Increase amount of erythrocytes, leucocytes, relative tightness of plasma of blood, hipopotassemia, metabolic alkalosis. Patient C, 17 years old, became ill suddenly. Profuse diarrhea with frequent vomits without nosier. A patient arrived from south-east AsiA. Temperature – 36,1 °C. An abdomen is pulled in, painless. The stool has the appearance of rice-water. What diagnosis is most reliable? *Cholera Dysentery Salmonellosis Esheryhiosis Rotavirus gastroenteritis To the internist appealed patient with complaints of weakness, diarrheA. Rested on a south, where the cases of diarrhea were present. Objectively: t-36,4 °C, skin covers are clean, acrocyanosis, tongue is dry, abdomen is soft, painless, emptying abundant, watery, with the flakes of white color floating on a surface, without odor and admixtures. For clarification of diagnosis sowing on the Ressels medium was made. How will the color of medium change? From yellow to blue From yellow to green From green to yellow *From blue to yellow From blue to green The disease began sharply, 6 hours ago at a normal temperature appeared frequent liquid emptying, then vomit joined. At the inspection: voice is soundless, eyes reddish, pulse frequent, arterial pressure low, urine is not present, cramps appeared in lower extremities. The heart and lungs without changes. A liver and spleen are not enlarged. Choose preparations of ethiotropic therapy which can be used: Tetracycline, erythromycin, levomycetine, gentamycine, ofloxacine Erythromycine, evomycetine, gentamycine, ofloxacine, ciprofloxacin, imodium Tetracycline, erythromycine, levomycetine, benzyl-penicillin sodium salt, ofloxacine *Erythromycine, levomycetine, gentamycine, ofloxacine, ciprofloxacin Erythromycine, gentamycine, ofloxacine, ciprofloxacine, imodium The disease began sharply from diarrhea, that was accompanied by an abdominal pain. The act of defecation brought facilitation. Emptying of green color, abundant, foamy, with a strong unpleasant smell. Temperature of body is subfebrile. It is found out hyperemia and graininess of soft palate. In blood: leucopenia, eozinophiliA. Violations of water-electrolyte balance are moderate.Your diagnosis: Cholera Toxic food-borne infection Salmonelliosis Dysentery *Rotaviral gastroenteritis The seventh pandemic of cholera is caused by V. cholera El Tor. It begans in 1961 on the Sulawesi island. However, to the epidemic of cholera arose up only in the countries of the third world. It is known that cholera is classic bacterial infection with the fecal-oral mechanism of transmission with the certain infectious dose of exciter. What is the basic factor of risk, that is instrumental in the such uneven division of morbidity on countries? Biological properties of exciter Climate of country *Social-economic conditions of population of country Immune status of population High development of industry and contamination of surrounding environment Patient C., 36 years old, periodically goes on a business trip in Egypt, desperately ill. Complaints of the increasing body temperature up to 39,4 °C with chills and sweating, pain in the right under rib, emaciation. A slight jaundice. Increased liver density, painful. In blood neutrophils leukocytosis, increased ESR. When USD revealed multiple liver abscesses. What kind of illness need to think. Legionellosis Echinococcosis . Ascariasis Liver cancer with metastases *Amoebiasis Student A., 22 years old, ill for 3 weeks, a month after returning from Ethiopia: appeared abdominal pain, liquid excrement, abundant, up to 10 times per day, in the form of “raspberry jelly”, joined cramping in the abdomen, more right, growing in the bowel. Over time the disease has lost 6 kg body weight. Your diagnosis. *Intestinal amoebiasis Shigellosis Salmonellosis Tumor bowel Intestinal yersiniosis Patient K., 40 years old, had complained of fever, night sweating, a significant decrease in body weight, pain in muscles, throat, joints, photophobia, recurrent diarrheA. When inspection revealed a generalized lymphadenopathy. What is the most reliable diagnosis. *AIDS Lymphogranulomatos The tumor of the digestive system Tuberculosis Salmonellosis Patient C., 35 years old, the disease has started severe chills, raising the temperature to 39 °C, vomiting, pain in epigastric region, diarrhea with water-smelly bowel movement. Over 6 hours after eating raw eggs, potatoes with braised meat, drank juice. What kind of agent is likely to cause this condition. *Salmonella Vibrio cholera Enteric stick Campylobacter Shigella Patient C., 17 years old, working vegetable base. Acutely ill, 2 days ago. His illness is linked to eating dirty roots. The disease started with chills, body temperature increase to 38,1 °C, headache, pain in muscles and joints of all groups, weakness, nausea, Cramping in the stomach around the navel, in epigastrium, diarrhea up to 5 times. Excrements liquid, viscous, bed smell, normal colour. Objective inspection: scleritis, conjunctivitis, hyperemia of soft palate, “raspberry” tongue. In palpation of abdomen - the moderate morbidity in epigastrium. What is diagnosis. *Yersiniosis Dysentery Salmonellosis Cholera Viral hepatitis Patient 25 years, received complaints of double vision of the eyes, a decline of view, shortness of breath. Before the disease eat mushrooms home preservation. Objective: pallor, wide pupils with a weak reaction to light, dry mouth, a violation of swallowing, flatulence, delay of stool. What is preliminary diagnosis. Leptospirosis Yersiniosis *Botulism Giardiasis Salmonellosis Patient C., 22 years old, hospitalized in an infectious department complaining of chills, temperature increase to 38,5 °C, vomiting, pain in epigastrii, frequent stool. 7 hours before the disease, ate raw eggs, potatoes with braised meat, drink tomato juice. What kind of organism most likely to cause disease. Enterovirus *Salmonella Enteric stick Staphylococcus perfringens Emergency ambulance delivered in infectious hospital girl N., 17 years old, complaining of headaches, expressed general weakness, pain in epigastrium, repeated vomiting, diarrhea to 8 times a day greenish color. She was used 2 raw chicken eggs. Body temperature 39 °C, the tongue covered with white coat, moderately cramps, pain in abdomen and sigmoid areA. The most likely diagnosis. Acute appendicitis Crohn’s disease Shigellosis Viral gastroenteritis *Salmonellosis Patient L., 32 years old, was admitted to the infectious hospital complaining of chills, headache, expressed general weakness, cutting pain in epigastric, diarrheA. The temperature of 39 °C, repeated vomiting. Excrement abundant, greenish color, without pathological impurities. Over 4 hours to illnesses used the meat salad in the factory canteen. Which drugs will be most effective for the treatment of this patient. Antibotulism serum Salt and colloid solutions Sulfanilamides *Antibiotics Enterosorbent Patient B., 55 years old, was hospitalized in an infectious hospital with complaints of frequent vomiting, liquid excrements, abdominal pain, mainly in the right iliac area and epigastrium. Pale skin, dry tongue with a touch of gray, hypotension, tachycardiA. The doctor was suspected salmonellA. What laboratory test is need to perform. General blood analysis Parasytoscopy of blood smear Microscopy of stool *Coproculture Biologic test Patient C., 30 years old, was hospitalized with a preliminary diagnosis of salmonellosis. Body temperature – 40 °C, repeated vomiting, profused diarrheA. Hypotension (BP 55/30 mm Hg), expressed tachycardia (pulse to 120/min), face pale, pain mainly in right iliac area and epigastrium, hepatosplenomegaly were found. What treatment tactic will be most effective in this case. Glucocorticoids, crystalloid solutions, antibiotics, diuretics Cardiac glycosides, colloid solutions, antibiotics Sorbents, diuretics, desintoxication Dopamine, colloid solutions, antibacterial *Glucocorticoids, crystalloid solutions, antibiotics Patient F., 25 years old, was hospitalized in the infectious hospital with complaints of frequent vomiting, liquid stool, abdominal pain in epigastrium. Pale skin, dry tongue with a grey cover, hypotension, tachycardiA. The doctor was suspected salmonellA. What serologic study is need to perform. Microprecipitation reaction RA (Widal) *RIGA with Salmonella diagnosticum RIGA with Shigella diagnosticum and RA (Widal) with paired serum RKC Patient N., 22 years old, was admitted to the infectious office complaining of chills, headache, expressed general weakness, cutting pain in sigmoid area, diarrheA. The temperature of the body of 39,3 °C, vomiting. Faces watery. Patient was used the salad with sausage and eggs. For further diagnosis doctor was prescribed RIGA with salmonella diagnosticums. When it’s necessary to take blood for the investigation. At the 1st and 2nd days of illness Once in recovering period *At the end of the 1st week and after 7-10 days At the end of the 1st week and after 3-4 days Once in acute period Patient B., 32 years old, an employ of poultry was hospitalized with complaints of pain in abdomen, mostly in sigmoid area, fever up to 38,8 °C, nausea, vomiting, diarrhea with dark-green colour of stool, without any pathological changes. Skin and mucous membranes are dry, moderate tension in epigastric region and pain in the right iliac areA. The most likely diagnosis. Acute appendicitis Cholera Disbacteriosis *Salmonellosis Rotavirus gastroenteritis Three patients were delivered with symptoms of fever, diarrhea and vomiting. Excrements dark-green, without any pathological changes. All patients together took part in the preparation of food and have used eggs, meat salad. The most likely diagnosis. Cholera Botulism Dysbacteriosis *Salmonellosis Shigellosis Patient L., 33 years old, was admitted to the hospital with the complaints of untolarable pain in the abdomen, mostly in sigmoid region, fever up to 38,8 ?C, nausea, vomiting , diarrhea of dark-green colour in every1-1,5 hour, without admixture of blood and mucus. The condition progressively deteriorated, increasing hypotension, paleness, weak cardiac sounds, decreased intestinal peristalsis with moderate tension in epigastric region and pain in the right iliac region. What tactics of treatment? Glucocorticoids, infusion of salt solutions, antibiotics intravenously, diuretic Cardiac glycosides, infusion colloidal solution, antibacterial drugs Enterosorbents, diuretic, desintoxication therapy Mezaton 1% / in drops, infusion of salt solutions, antibacterial drugs orally *Glucocorticoids, infusion of salt solutions, antibiotics intravenously Patient 45 years old, became ill within 10 hours after consumption of grinded meat. Complaints of vomiting, pain in epigastric region, diarrhea of green color, increasing of temperature up to to 39 °C. During objective examination revealed that: patients general condition is sever, pain in the muscles of the lower limbs, pale face, acrocyanosis. Pulse 130 per min,. B.P 70/40 mm Hg. weak cardiac sounds, dry tongue, brown-whitecovering . abdomen cramps, painful iliac and epigastric regions. What is the most likely diagnosis. Shigellosis Cholera *Salmonellosis Viral gastroenteritis Eshericiosis Five patients during 15 hours were admited In a hospital. All of them have similiar complaints of mild diarrhea and vomiting developed ,diplopia, midriasis, visual disturbance, difficult swallowing, dry mouth, difficulty in breathing. All patients together joined in a dinner party, used different dishes, including meat, salad, canned mushroom. The most likely diagnosis. Cholera *Botulism Thypus Salmonellosis Rotaviral gastroenteritis Patient G., 24 years old, 6 hours after taking his breakfast with boiled eggs, a cup of coffee appeared chill, fever up to 38,8 °C, pain in left inguinal area, nausea,vomiting, rumbling in the stomach, then frequent diarrhea, feces copious, watery, mudy-green. What is the most likely diagnosis. Cholera Botulism *Salmonellosis Abdominal thypoid Shigellosis Patient, who was arrived from the Crimea, diarrhea appeared in an intervel of 1-1.5 hour. with copious watery increments, without admixtures of mucous and blood. He was admtted in an infectious dipartment with the diagnosis of “acute intestinal infection”. What laboratory tests are necessary to confirm the etoilogical diagnosis. General blood analysis Bacteriological blood analysis Microscopical analysis of stool *Coprogram The biological examination in mice Patient C. with complaints of diarrhea with mucous, stabing pain in epigastric area , rumbling in the stomach, fever. According to his anamnesis he took preserved milk, eggs, salad of fresh vegetables. What is the disease most likely. Shigellosis Yersiniosis *Salmonellosis Cholera Botulism Patient B., 38 years old, came to the admission department with the complaints of fever up to 38 °C, vomiting 4 times in a day, diarrhea up to 6 times in a day. Durin objective examination revealed that B.P 125/75 mm Hg, pulse 80 per min, abdomen is soft,painful in the right iliac and epigastric area .According to anamnesis he took salad of boiled eggs and sausage. What treatment should be started first. Antibotulism serum Intravenous antibiotics Washing of the stomach and intestine, rehydration therapy , glucocorticoids *Gastric lavage and washing of intestine, rehydraton therapy enterosorbents Treatment after getting of the laboratory test results Patient 27 years old, complaints of headaches, weakness, pain in epigastric area, vomiting, diarrhea (9 times in a day; huge excrement, greenish colour). Before the appearance of disease he consumed raw eggs. Objectively: body temperature 38,8 °C. Tongue is white, pain in epigastric and umbilical region. The most likely diagnosis. *Salmonellosis Cholera Dysentery Viral gastroenteritis Acute appendicitis Patient K., 30 years old, came with complaints of nausea, vomiting, pain in epigastrium and paraumbilical areA. High body temperature, pale skin, dry. tongue covered with whitish-gray coating. quick pulse, low blood pressure. 2 hours before the onset of symptoms of the disease he ate in cafe. What is the diagnosis most likely. Cholera Shigellosis Thypoid fever *Salmonellosis Meningitis Disease started acutely with the complaints of watery diarrhea, vomiting, cramps in the lower extremities. Objectively: slow voice, shunken eyes, quick pulse, low blood pressure, decrease of urination, weak cardiac sounds. In liver and spleen no changes. Put the correct diagnosis. Salmonellosis Dysentery Food poisoning *Cholera Typhoid fever A Pakistani, 30 years old, severly ill: with the complaints of frequent diarrhea like rice water. Objectively: body temperature 35,4 °C, skin of peripheral parts of the body cold to the touch, acrocyanosis, xerostomia, sharply decreased skin elasticity and turgor. What should be done to assess the degree of dehydration. Measurement of central venous pressure Determination of urea and creatinine in blood Funduscopy Plain X-ray film of abdomen *Determination of specific gravity of blood plasma Patient N., 30 years old, works in a restaurant, admitted to the hospital complaining of unbearable pain in the abdomen, increase of temperature 38,8 °C, nausea, vomiting, diarrhea of dark-green colour, He took eggs, mushrooms, canned food. Objective state: general condition is moderately sever, skin and mucous membranes are dry, pain in epigastric region. Name the disease. Shigellosis Yersiniosis *Salmonellosis Cholera Rotaviral infection Patient 35 years old with complaints of increasing of temperature to 39 °C with chill, vomiting, pain in epigastric region, diarrhea with foul smell, abdominal cramps. 6 hours before onset of the disease ate raw eggs, fried potatoes with grinded meat, drank juice. To clarify the diagnosis of serological diagnostic methods often used RNGA with the salmonella groupdiagnostic tools and RA (Vidal test) . When blood should take for the diagnostic procedures? In the first day of illness At the end of the first month In 1st week in 3-4 days *At the end of the 1st week from 7-10 days During admission to the hospital A patient was hospitalised after 4 hours of consumption of raw eggs, complaining frequent vomiting, abdominal pain, mostly in the right iliac area and umbilical areA. Objectively pale skin, dry tongue with gray coating, hypotension, tachycardiA. What tests should be carried out to confirm the diagnosis. General blood analysis Parasitological examinations Microscopic examination of stool Biological test *Coproculture Patient G., 22 years old, was hospitalised in an infectious department complaining of chills, stabing pain in epigastrium, diarrhea, temperature increased up to 39,6 °C, repeated vomiting. Feces copious, watery, without pathological changes. 4 hours before the onset of symptoms ate the meat, salad. What is the most appropriate drug to be prescribe. Antidiarrheal drugs Flouroquinolone group of antibiotics Sulfanilamide group of antibiotics Desintoxication therapy *Enterosorbents Patient K., 40 years old, was hospitalised with the diagnosis of intestinal infection. Complaints of general weakness, headache and diarrheA. Symptomes appeared suddenly 2 hours after consumption of cake with custard. Suddenly there were chills, nausea, profuse repeated vomiting, frequent diarrhea, abdominal pain and short-term loss of consciousness, temperature increased to 38,6 °C. The preliminary dianosis? Salmonellosis, localized form, gastroenteritis type *Salmonellosis, localized form gastroenterocolitis type Salmonellosis, localized form enterocolitis type Salmonellosis, generalized form Salmonellosis, nosoparasitic Patient K., 40 years old, hospitalised with the diagnosis of salmonellosis, with symptoms of rise of body temperature to 40 °C, repeated vomiting, diarrheA. Objectively: AP 60/20 mm Hg, pulse 120/minute, pale face, increased intestinal peristalsis, enlarged liver and spleen. What is the best treatment. *Glucocorticoids, desintoxication therapy, antibacterial drugs Diuretic, desintoxication therapy, antibacterial drugs Enterorsorbents, diuretic, detsintoxication therapy Glucocorticoids, diuretic, desintoxication therapy, antibacterial drugs Glucocorticoids, diuretic, antibacterial drugs Patient P., 36 years old, a farmer is seriously ill, with high temperature, having chills, headache, flatulence, nauseA. At present he is complaining of severe abdominal pain, diarrhea up to 15 times a day stool is liquid, smelly, with impurities mucous and blood. His eyes are sunken. The tongue is covered with white coating. On palpation- painful colon, increased liver. In blood – neutropil leukocytosis with a shift formula the left anemiA. On rectomanoscopy deep ulcers with irregular edges are observed, including along the folds. What is the diagnosis. Shigellosis *Balantidiasis Nonspecific ulcerous colitis Amoebiasis Colon tumor A 29 years old patient T. works on a pig farm. Shi was hospitalized with symptoms of balantidiasis. What would be the drug of choice. Benzylpenicillin Gentamycin Chloramphenicol *Monomycin Timogen A 63 years old villager,is gravely ill: increased body temperature, headache, nausea, vomiting, abdominal pain, diarrheA. The patient was not seeking mediacal attention, and was taking levomycetin. The condition had not improved, the frequency of bowel movements was 8-12 times a day. At present he is complaining of severe abdominal pain, diarrhea, general weakness. The stool is liquid, smelly, with mixture of puss and blood. The patient is exosted his eyes are sunken. His tongue is covered with white coating. In blood analys is leukocytosis and anemia observed. On rectomanoscopy detected ulcers with jagged edges. What is the most likely diagnosis. *Balantiasis Shigellosis Nonspecific ulcerative colitis Rotavirus gastroenteritis Colon tumor Patient C., 35 years old, the disease has started from severe chills, raising the temperature to 39 oC, vomiting, pain in epigastric region, diarrhea with water-smelly bowel movement. Over 6 hours after eating raw eggs, potatoes with braised meat, drank juice. What kind of agent is likely to cause this condition. *Salmonella Vibrio cholera Enteric stick Campylobacter Shigella Patient C., 17 years old, working at vegetable base. Acutely ill, 2 days ago. His illness is linked to eating dirty roots. The disease started with chills, body temperature increase to 38,1 oC, headache, pain in muscles and joints of all groups, weakness, nausea, Cramping in the stomach around the navel, in epigastrium, diarrhea up to 5 times. Excrements liquid, viscous, bed smell, normal colour. Objective inspection: scleritis, conjunctivitis, hyperemia of soft palate, “raspberry” tongue. In palpation of abdomen - the moderate morbidity in epigastrium. What is diagnosis. *Yersiniosis Dysentery Salmonellosis Cholera Viral hepatitis Patient 25 years, received complaints of double vision of the eyes, a decline of view, shortness of breath. Before the disease eat mushrooms home preservation. Objective: pallor, wide pupils with a weak reaction to light, dry mouth, a violation of swallowing, flatulence, delay of stool. What is preliminary diagnosis. Leptospirosis Yersiniosis *Botulism Giardiasis Salmonellosis Patient C., 22 years old, hospitalized in an infectious department complaining of chills, temperature increase to 38,5 oC, vomiting, pain in epigastrii, frequent stool. 7 hours before the disease, ate raw eggs, potatoes with braised meat, drink tomato juice. What kind of organism most likely to cause disease. Enterovirus *Salmonella Enteric stick Staphylococcus Cl. perfringens Emergency ambulance delivered in infectious hospital girl N., 17 years old, complaining of headaches, expressed general weakness, pain in epigastrium, repeated vomiting, diarrhea to 8 times a day greenish color. She was used 2 raw chicken eggs. Body temperature 39 °C, the tongue covered with white coat, moderately cramps, pain in abdomen and sigmoid areA. What is the most likely diagnosis. Acute appendicitis Crohn’s disease Shigellosis Viral gastroenteritis *Salmonellosis Patient L., 32 years old, was admitted to the infectious office complaining of chills, headache, expressed general weakness, cutting pain in epigastrii, diarrheA. The temperature of 39 °C, repeated vomiting. Excrement abundant, greenish color, without pathological impurities. Over 4 hours to illnesses used the meat salad in the factory canteen. Which drugs will be most effective for the treatment of this patient. Antibotulism serum Salt and colloid solutions Sulfanilamides *Antibiotics Enterosorbent Patient B., 55 years old, was hospitalized in an infectious hospital with complaints on frequent vomiting, liquid excrements, abdominal pain, mainly in the right iliac area and epigastrium. Pale skin, dry tongue with a touch of gray, hypotension, tachycardiA. The doctor was suspected salmonellA. What laboratory test is need to perform. General blood analysis Parasytoscopy of blood smear Microscopy of stool *Coproculture Biologic test Patient C., 30 years old, was hospitalized with a preliminary diagnosis of salmonellosis. Body temperature – 40 °C, repeated vomiting, profused diarrheA. Hypotension (BP 55/30 mm Hg), expressed tachycardia (pulse to 120/min), face pale, pain mainly in right iliac area and epigastrium, hepatosplenomegaly were found. What treatment tactic will be most effective in this case. Glucocorticoids, crystalloid solutions, antibiotics, diuretics Cardiac glycosides, colloid solutions, antibiotics Sorbents, diuretics, desintoxication Dopamine, colloid solutions, antibacterial *Glucocorticoids, crystalloid solutions, antibiotics Patient F., 25 years old, was hospitalized in the infectious hospital with complaints of frequent vomiting, liquid stool, abdominal pain in epigastrium. Pale skin, dry tongue with a grey cover, hypotension, tachycardiA. The doctor was suspected salmonellA. What serologic study is need to perform. Microprecipitation reaction RA (Widal) *RIGA with Salmonella diagnosticum RIGA with Shigella diagnosticum and RA (Widal) with paired serum RKC Patient N., 22 years old, was admitted to the infectious office complaining of chills, headache, expressed general weakness, cutting pain in sigmoid area, diarrheA. The temperature of the body of 39,3 °C, vomiting. Faces watery. Patient was used the salad with sausage and eggs. For further diagnosis doctor was prescribed RIGA with salmonella diagnosticums. When it’s necessary to take blood for the investigation. At the 1st and 2nd days of illness Once in recovering period *At the end of the 1st week and after 7-10 days At the end of the 1st week and after 3-4 days Once in acute period Patient B., 32 years old, an employ of poultry was hospitalized with complaints of pain in abdomen, mostly in sigmoid area, fever up to 38,8 oC, nausea, vomiting, diarrhea with dark-green colour of stool, without any pathological changes. Skin and mucous membranes are dry, moderate tension in epigastric region and pain in the right iliac areA. The most likely diagnosis. Acute appendicitis Cholera Disbacteriosis *Salmonellosis Rotavirus gastroenteritis Patient L., 33 years old, was admitted to the hospital with the complaints of untolarable pain in the abdomen, mostly in sigmoid region, fever up to 38,8 oC, nausea, vomiting , diarrhea of dark-green colour in every1-1,5 hour, without admixture of blood and mucus. The condition progressively deteriorated, increasing hypotension, paleness, weak cardiac sounds, decreased intestinal peristalsis with moderate tension in epigastric region and pain in the right iliac region. What tactics of treatment? Glucocorticoids, infusion of salt solutions, antibiotics intravenously, diuretic Cardiac glycosides, infusion colloidal solution, antibacterial drugs Enterosorbents, diuretic, desintoxication therapy Mezaton 1% / in drops, infusion of salt solutions, antibacterial drugs orally *Glucocorticoids, infusion of salt solutions, antibiotics intravenously Patient 45 years old, became ill within 10 hours after consumption of grinded meat. Complaints of vomiting, pain in epigastric region, diarrhea of green color, increasing of temperature up to to 39 °C. During objective examination revealed that: patients general condition is sever, pain in the muscles of the lower limbs, pale face, acrocyanosis. Pulse 130 per min,. B.P 70/40 mm Hg. weak cardiac sounds, dry tongue, brown-whitecovering . abdomen cramps, painful iliac and epigastric regions. What is the most likely diagnosis. Shigellosis Cholera *Salmonellosis Viral gastroenteritis Eshericiosis Patient U., who was arrived from the Crimea, diarrhea appeared in an intervel of 1-1.5 hour. with copious watery increments, without admixtures of mucous and blood. He was admtted in an infectious dipartment with the diagnosis of “acute intestinal infection”. What laboratory tests are necessary to confirm the etoilogical diagnosis. General blood analysis Bacteriological blood analysis Microscopical analysis of stool *Coprogram The biological examination in mice Patient C with complaints of diarrhea with mucous, stabing pain in epigastric area , rumbling in the stomach, fever. According to his anamnesis he took preserved milk, eggs, salad of fresh vegetables. What is the disease most likely. Shigellosis Yersiniosis *Salmonellosis Cholera Botulism Patient B., 38 years old, came to the admission department with the complaints of fever up to 38 °C, vomiting 4 times in a day, diarrhea up to 6 times in a day. Durin objective examination revealed that B.P 125/75 mm Hg, pulse 80 per min, abdomen is soft,painful in the right iliac and epigastric area .According to anamnesis he took salad of boiled eggs and sausage. What treatment should be started first. Antibotulism serum Intravenous antibiotics Washing of the stomach and intestine, rehydration therapy , glucocorticoids *Gastric lavage and washing of intestine, rehydraton therapy enterosorbents Treatment after getting of the laboratory test results Patient 27 years old, complaints of headaches, weakness, pain in epigastric area, vomiting, diarrhea (9 times in a day; huge excrement, greenish colour). Before the appearance of disease he consumed raw eggs. Objectively: body temperature 38,8 °C. Tongue is white, pain in epigastric and umbilical region. The most likely diagnosis. *Salmonellosis Cholera Dysentery Viral gastroenteritis Acute appendicitis Patient K., 30 years old, came with complaints of nausea, vomiting, pain in epigastrium and paraumbilical areA. High body temperature, pale skin, dry. tongue covered with whitish-gray coating. quick pulse, low blood pressure. 2 hours before the onset of symptoms of the disease he ate in cafe. What is the diagnosis most likely. Cholera Shigellosis Thypoid fever *Salmonellosis Meningitis Disease started acutely with the complaints of watery diarrhea, vomiting, cramps in the lower extremities. Objectively: slow voice, shunken eyes, quick pulse, low blood pressure, decrease of urination, weak cardiac sounds. In liver and spleen no changes. Put the correct diagnosis. Salmonellosis Dysentery Food poisoning *Cholera Typhoid fever Patient 35 years old with complaints of increasing of temperature to 39 °C with chill, vomiting, pain in epigastric region, diarrhea with foul smell, abdominal cramps. 6 hours before onset of the disease ate raw eggs, fried potatoes with grinded meat, drank juice. To clarify the diagnosis serological diagnostic methods often used. When blood should be taken for the diagnostic procedures? In the first day of illness At the end of the first month In 1st week in 3-4 days *At the end of the 1st week from 7-10 days During admission to the hospital A patient was hospitalised after 4 hours of consumption of raw eggs, complaining frequent vomiting, abdominal pain, mostly in the right iliac area and umbilical areA. Objectively pale skin, dry tongue with gray coating, hypotension, tachycardiA. What tests should be carried out to confirm the diagnosis. General blood analysis Parasitological examinations Microscopic examination of stool Biological test *Coproculture Patient G., 22 years old, was hospitalised in an infectious department complaining of chills, stabing pain in epigastrium, diarrhea, temperature increased up to 39,6 °C, repeated vomiting. Feces copious, watery, without pathological changes. 4 hours before the onset of symptoms ate the meat, salad. What is the most appropriate drug to be prescribe. Antidiarrheal drugs Flouroquinolone group of antibiotics Sulfanilamide group of antibiotics Desintoxication therapy *Enterosorbents Patient K., 40 years old, was hospitalised with the diagnosis of intestinal infection. Complaints of general weakness, headache and diarrheA. Symptomes appeared suddenly 2 hours after consumption of cake with custard. Suddenly there were chills, nausea, profuse repeated vomiting, frequent diarrhea, abdominal pain and short-term loss of consciousness, temperature increased to 38,6 °C. The preliminary dianosis? Salmonellosis, localized form, gastroenteritis type *Salmonellosis, localized form gastroenterocolitis type Salmonellosis, localized form enterocolitis type Salmonellosis, generalized form Salmonellosis, nosoparasitic Patient K., 40 years old, hospitalised with the diagnosis of salmonellosis, with symptoms of rise of body temperature to 40 °C, repeated vomiting, diarrheA. Objectively: AP 60/20 mm Hg, pulse 120/minute, pale face, increased intestinal peristalsis, enlarged liver and spleen. What is the best treatment. *Glucocorticoids, desintoxication therapy, antibacterial drugs Diuretic, desintoxication therapy, antibacterial drugs Enterorsorbents, diuretic, detsintoxication therapy Glucocorticoids, diuretic, desintoxication therapy, antibacterial drugs Young farmer was diagnosed with balantidiasis. Drugs of choice would be all except: Monomycin Ampicillin Aminarson *Gentamicin Metronidazole A patient complaints of severe abdominal pain, smelly watery diarrheA. with content of blood, . What kind of disease might be considered in the first place. Amoebiasis Rotaviral gastroenteritis Giardiasis *Balantidiasis Cholera Patient P., 36 years old, a farmer is seriously ill, with high temperature, having chills, headache, flatulence, nauseA. At present he is complaining of severe abdominal pain, diarrhea up to 15 times a day stool is liquid, smelly, with impurities mucous and blood. His eyes are sunken. The tongue is covered with white coating. On palpation- painful colon, increased liver. In blood – neutropil leukocytosis with a shift formula the left anemiA. On rectomanoscopy deep ulcers with irregular edges are observed, including along the folds. What is the diagnosis. Shigellosis *Balantidiasis Nonspecific ulcerous colitis Amoebiasis Colon tumor A 29 years old patient T. works on a pig farm. She was hospitalized with symptoms of balantidiasis. What would be the drug of choice. Benzylpenicillin Gentamycin Chloramphenicol *Monomycin Timogen A 63 years old villager,is gravely ill: increased body temperature, headache, nausea, vomiting, abdominal pain, diarrheA. The patient was not seeking mediacal attention, and was taking levomycetin. The condition had not improved, the frequency of bowel movements was 8-12 times a day. At present he is complaining of severe abdominal pain, diarrhea, general weakness. The stool is liquid, smelly, with mixture of puss and blood. The patient is exosted his eyes are sunken. His tongue is covered with white coating. In blood analys is leukocytosis and anemia observed. On rectomanoscopy detected ulcers with jagged edges. What is the most likely diagnosis. *Balantidiasis Shigellosis Nonspecific ulcerative colitis Rotavirus gastroenteritis Colon tumor Patient admitted in hospital with complaints of abdominal pain, increased body temperature, diarrheA. Stool is liquid, smelly, with mixture of mucus and blood. What kind of illness need to think about in the first place? *Balantidiasis Rotavirus gastroenteritis Food poisoning Amoebiasis Giardiasis Patient S., 53, a resident of the village, heavelly ill – common symptoms of intoxication, intestinal dysfunction excrements are smelly, with mucous and blood. Abdomen on palpation is soft, but painful along spazmotic sygmoid bovell. On rectoromanoscopy - ulcers in diameter up to 10-20 mm along the folds of mucous membrane, swelling, moist edge, surrounded by a zone of flushing, the bottom is covered hyperemia and necrotic masses. What kind of illness need to think about? *Balantidiasis Shigellosis Nonspecific ulcerous colitis Amoebiasis Colon tumor Student U. from India, 22, a month after returning home develops – liquid stool, weak abdominal pain. Over time of the disease has lost 6 kg. The next day heavy diarrhea 10 times a day, stool is like «raspberry jelly». Cramping in the abdomen growing in the bowel. The most likely diagnosis is: Bowel tumor Salmonellosis Shigellosis *Amoebiasis HIV/AIDS Patient F., 25 years old, was hospitalized complaining of diarrhea – 10-15 times per day. A month ago was returned from Central AsiA. The general condition of relatively satisfactory. The temperature of the body subfebrile. Abdomen soft. Stool is liquid, high-level clear scanty mucus and blood. What is the most likely diagnosis: *Amoebiasis Shigellosis Salmonellosis Tumor of bowel Enterohemorrhagic escherihiosis Patients with аmebiasis has been hospitalized. For specific therapy are used so-called, indirect and аmebiostic tissue, and preparations with universal action. What group does delagin belong to? *Tissue аmoebiostic Indirect аmoebiostic Lines of аmoebiostic Preparations with universal action Does not belong to anyone A student from Africa, 22 years old, liquid stool and weak stomach-aches appeared a month after returning from home. Lost of weight is 6 kg. Diarrhoe is abundant 10 times on a day, like “raspberry jelly”. Stomach-aches increase during defecation. What is most probable diagnosis? Tumor of intestine Salmonellosis Shigellosis *Amoebiasis HIV/AIDS Patient O., 25 years old, hospitalized with complaints off diarrhea up to 10-15 times a day. Month ago he returned from Middle AsiA. The general condition is relatively satisfactory. The temperature of body is subfebrile.A stomach is soft, pain after motion of colon. Emptying is liquid with the considerable admixtures of glassy mucous and blood. What is most probable diagnosis? *Amoebiasis Shigellosis Salmonellosis Tumor of intestine Enterohaemorrhagic esherihiosis Patient U., 36 years old, farmer, became ill gradually. Indispositions, tormina, diarrhea (stool was 8-12 times per day). He was in one of countries with a hot climate during last 2 month. Temperature – 36,9 °C. At palpation – pain in iliac areas. Stool is liquid, with the admixtures of glassy mucus, look like to „raspberry jelly”. What is primery diagnosis? *Amoebiasis Shigellosis Salmonellosis Tumor of intestine Enterohaemorrhagic esherihiosis Patient C., 46 years old, periodically visited Egypt for a business purpose, became acutely ill. Complaints of a fever of 38 °C, with chills and shevering, pain in right hypochorium. Insignificant icterus.Liver is enlarged,some hyperechogeninic area . In blood neutrophilic leucocytosis, increased ESR. Purulent abscesses of liver were found out during ultrasound examination . What is previous diagnosis? Legionellosis Echinnococcosis Ascaridosis Cancer of liver with metastases *Amebiasis Student, 22 years old fell ill within a month after return from EthiopiA.Dull stomach-ache appeared and liquid emptying. Emptying is abundant up to 10 times a day, as “raspberry jelly” excrement, stomach-ache that increase during defecation. In times of illness lost 6 kg of body weight. Your diagnosis will be? *Intestinal аmoebiasis Shigellosis Salmonellosis Tumor of intestine Intestinal esheriosis Patient O., 47 years old, became ill acutely. Periodically visits Uzbekistan for a business purpose. Complaints of a fever of 39,4 °C with chills and shivering, and pain in right hypochorium, cough with sputum. Skin with an earthy tint. Signs of rightsided pneumoniA.The liver and spleen are enlarged.In blood neutrophilic leucocytosis. On X-ray infiltration of pulmonary tissues is found, at ultrasound abdominal examination numerous abscesses are present in a liver. What disease is it necessary to think about? Echeriosis Alveolitis *Amebiasis Cancer of liver is with metastases in lungs Legionellosis Sick E., 21 years old, complaints of nausea, insignificant dull or rarely aggressive pain in a stomach. Appetite is decreased. Periodically presence of flatulence, grumbling in a stomach and semi-fluid emptying. Sick during about 6 month. The diagnosis of chronic cholecystitis was proposed. In examination pallor of skin, lowering of mass of body and signs of vegetative dystonia are found.On palpation pain in еpigastric area also found. What disease you will think about? *Giardiasis Salmonellosis Amebiasis Balantidiasis Intestinal esherihiosis Diagnosis of giardiasis is based on the discovering of cyst in fresh incandescence and vegetative forms in duodenal content. At diarhoea in incandescence can appear trophozoite on faecal microscopic examination and preparations with solution of Lugola and еоsin. Examination is more expedient to conduct 3-5 times at intervals 1-2 days. How to increase frequency of findings? *By application of the formalin-еpiniphrine enriching methods Cultivation in thermostat Cultivation in an anaerobic chamber By the method of floatation in bilious clear soup To sow on a nutrient medium A patient complaints of severe abdominal pain, smelly watery diarrheA. with content of blood. What kind of disease might be considered in the first place. Amoebiasis Rotaviral gastroenteritis Giardiasis *Balantidiasis Cholera Patient P., 36 years old, a farmer is seriously ill, with high temperature, having chills, headache, flatulence, nauseA. At present he is complaining of severe abdominal pain, diarrhea up to 15 times a day stool is liquid, smelly, with impurities mucous and blood. His eyes are sunken. The tongue is covered with white coating. On palpation- painful colon, increased liver. In blood – neutrophil leukocytosis with a shift formula the left with anemiA. On rectomanoscopy deep ulcers with irregular edges are observed, including along the folds. What is the diagnosis. Shigellosis *Balantidiasis Nonspecific ulcerous colitis Amoebiasis Colon tumor A 63 years old villager, is gravely ill: increased body temperature, headache, nausea, vomiting, abdominal pain, diarrheA. The patient was taking levomycetin. The condition had not improved, the frequency of bowel movements was 8-12 times a day. At present he is complaining of severe abdominal pain, diarrhea, general weakness. The stool is liquid, smelly, with mixture of puss and blood. The patient is exosted his eyes are sunken. His tongue is covered with white coating. In blood analys is leukocytosis and anemia observed. On rectomanoscopy detected ulcers with jagged edges. What is the most likely diagnosis. Colon tumor Shigellosis Nonspecific ulcerative colitis Rotavirus gastroenteritis *Balantidiasis A patient was admitted in hospital with complaints of abdominal pain, increased body temperature, diarrheA. Stool is liquid, smelly, with mixture of mucus and blood. What kind of illness need to think about in the first place? *Balantidiasis Rotavirus gastroenteritis Food poisoning Amoebiasis Giardiasis A patient was admited in permanent establishment with complaints of stomach-ache, fever and diarrheA. Stool is liquid, stinking, with the admixtures of pus and blood. About what disease it is necessary to think about? Food poisoning Rotaviral gastroenteritis *Balantidiasis Amebiosis Giardiasis Patient F, 53 years, habitant of a village, diseased acutely,the symptoms of general intoxication, dysfunction of bowels appeared, emptying became semi-fluid with the admixtures of pus and blood. The stomach at palpation is soft, morbid along belly and ascending colon with spasm. At rectoscopy are found ulcers with diameter upto 10-20 mm, located along the folds of mucus membrane, have fillings out, sharp edges places, surrounded by the area of hyperemia, bottom is covered by pus and necrotizing masses. What disease it is needed to think about? *Balantidiasis Shigellosis Idiopatic ulcerous colitis Amebiasis Intestinal cancer A villager, was admited with complaints of severe pain in a stomach, and diarrheA. The stool is liquid with mixtures of blood. About what disease it is possible to think about? Amebiosis Rotavirus gastroenteritis Gisrdiasis *Balantidiasis Cholera Sick P, 36 years, farmer, became acutely ill when the temperature of body rised. There were a chills, pain in chest, flatulence and nauseA. In the moment of admition grumbles about terminal diarrhoea with 15 times day. The stool is liquid, sticky with the admixtures of pus and blood. Tongue is covered with whitecovering. Stomach is distended, painfu colon, enlarged liver is palpable. In blood neutrophilic leucocytosis with the shift of formula to the left and anemiA. At a rectoscopy, deep ulcers with unequal, sharped areas which are placed along the folds was found. What disease will you think about? Shigellosis Ulcerous colitis *Balantidiasis Amebiasis Cancer of colon Patient O., 29 years old, farmer came to a doctor with the signs of balantidiasis and was hospitalized. What is the best etiotropic drug: Benzylpenicillin Gentamycin Laevomycitin *Monomycin Timogen 63 years old patient became ill suddenly. The temperature of body raised, the stomach-ache with nausea and vomiting and diarrhea were observed. The patient’s condition did not improve even after giving him Levomycitin for long time. The diarrhea had proceeded again 8-12 times a day and became liquid. On admition the patient complaints of diarrhea and general weakness.The excrement is liquid stinking with the admixtures of pus and blood. The persons face is emaciated, eyes are hollow. Tongue is covered by white stratification. The stomach is distended, peristalsis after bowel movments. In blood leucocytosis and anaemic. At a rectoscopy ulcers with sharped, uneven edges was found. What is the most probable diagnosis? *Amebiasis Shigellosis Idiopatic ulcerative colitis Rotavirus gastroenteritis Cancer of colon Sick E., 21 years old, complaints of nausea, insignificant dull or rarely aggressive pain in a stomach. Appetite is decreased. Periodically presence of flatulence, grumbling in a stomach and semi-fluid emptying. Sick during about 6 month. The diagnosis of chronic cholecystitis was proposed. In examination pallor of skin, lowering of mass of body and signs of vegetative dystonia are found.On palpation pain in еpigastric area also found. What disease you will think about? *Giardiasis Salmonellosis Amebiasis Balantidiasis Intestinal єcheriosis Diagnosis of giardiasis is based on the discovering of cyst in fresh incandescence and vegetative forms in duodenal content. Trophozoites can be find during faecal microscopic examination. Examination is more informative if it conducts 3-5 times with 1-2 days intervals. How is possible to increase the frequency of findings? *By application of the formalin-еpiniphrine enriching method Cultivation in thermostat Cultivation in an anaerobic chamber By the method of floatation in bilious clear soup To sow on a nutrient medium Veterinarian 57 years old, on the 3rd day of disease appealed to the doctor with complaints of headache, high temperature, pain in gastrocnemius muscles, icterus, dark urine and diminishing of its amount. Objectively: temperature of body is 38 °C, sclerotic big peteachia on overhead part of thorax, hepatospleenomegaly. Most reliable preliminary diagnosis will be: *Leptospirosis Brucellosis Viral hepatitis Pseudotuberculosis Trichinosis A sick P., 40 in 2 weeks after eating of uncooked pork, purchased at the elemental market, has sudden rise of temperature upto 40 °C, myalgias appeared, oedematous, papular rash on extremities and trunk and dry cough. Accepted aspirin. General blood test: leucocytes– 12*109 /l , eosinophilia– 40 %. What disease it is possible to think about? *Trichinosis Ascaridosis Leptospirosis Teniosis Allergic reaction Patient M., 32 years old, during a month has disturbing cough, increasing of temperature up to 38.0 °C. In anamnesis ascaridosis was found. On x-ray was found separate homogeneous infiltration without clear contour of bronchus. In blood test – еоsinophils 55 %. What is most probable diagnosis? *Eosinophil infiltration (Lefler syndrome) Plague Chronic bronchitis, acute phase Acquired pneumonia Tumour of lungs Woman 24, complaints of heaviness in the area of liver during 3 days, with an irradiation in the back. Signs of icterus are not present. Last menstruation – 5 weeks ago. Appointed ultrasonic research of abdominal region and small pelvis was, found marked progress uterogestation. Expansion of common biliary tract, inflammation of gall-bladder, bulge of its its wall, presence of crystal sediment, extended loops of small intestines are visualized. Investigation of colonoscopy found additional exogenic structures as a “ribbon”, which is displaced in intestine and changes form without distal acoustic shade. Most probable diagnosis is: *Ascaridosis Yüklə 3,17 Mb. Dostları ilə paylaş:
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