Children infectious diseases

Erythromycin.

Gentamicin.

Karbenicillin.

*Laevomycetin.

199. 
     The child, 5 years old, complains of: increasing of the body temperature to 39.5 ºС, shivering, headache, poor sleeping. What single dose of paracethamol should be given?
     
     1. 
        *0.01 g/kg
        
     2. 
        0.05 g/kg
        
     3. 
        0.1 g/kg
        
     4. 
        0.2 g/kg
        
     5. 
        0.5 g/kg
        

200. 
     The Child, aged 2 years, with meningococcal infection, is examined by the group of students together with physician. Name, which sign is not present at meningococcal rash:
     
     1. 
        Hemorrhagic nature.
        
     2. 
        The elements are mildly increased on the level of the skin.
        
     3. 
        The necrosis in the centre.
        
     4. 
        *Disappears at pressure.
        
     5. 
        In scraper is possible to find meningococcus.
        

201. 
     To the boy, 4 years old, was put the diagnosis of meningococcal infection (generalized form). The child is treated in infectious department. What generalized form of meningococcal infection is the most often one?
     
     1. 
        Meningitis.
        
     2. 
        Meningococcemia.
        
     3. 
        *Combined form (Meningococcemia + meningitis).
        
     4. 
        Meningoencephalitis.
        
     5. 
        Encephalitis.
        

202. 
     To the girl, 8 months old, the physician has put the diagnosis of meningococcal infection, mixed form with infectious-toxic shock II degree. The child is treated in resuscitation department of the infectious hospital. Choose the sign, which is not typical in this case:
     
     1. 
        Decrease of the arterial pressure.
        
     2. 
        *Bradycardia.
        
     3. 
        Pallor of the skin.
        
     4. 
        Acrocyanosis.
        
     5. 
        Small pulse.
        

203. 
     Child is 1 year. What antibiotic is it necessary to give him on a hospital stage of treatment in case of Meningococcal infection without the infectious-toxic shock?
     
     1. 
        *benzylpenicillin
        
     2. 
        ampicillini thryhidratis
        
     3. 
        rifampicin
        
     4. 
        ciprofloxacin
        
     5. 
        amoxyclav
        

204. 
     The child is 3.5 years. Admitted to the infectious ward on the 5th day of the disease with complaints on fever to 37.9 °C, the absence of active movements in the legs, inability to stand, walk. On examination: lower extremities are cold, hypersensitivity, positive symptoms of tension, he sits in a «tripod" pose, passive movements in the legs are complete, the sensitivity is normal. Name a diagnosis according to the classification.
     
     1. 
        *Polio, a typical spinal form
        
     2. 
        Polio, a typical bulbar form
        
     3. 
        Polio, a typical pontine form
        
     4. 
        Polio, a typical meningeal form
        
     5. 
        Polio, atypical abortive form
        

205. 
     A child of 2 years has entered to the infectious ward on the 5th day of the disease with complaints on fever to 37.9 °C, the absence of active movements in the legs, inability to stand, walk. On examination: lower extremities are cold, hypersensitivity, positive symptoms of tension, he sits in a "tripod" pose, passive movements in the legs are complete, the sensitivity is normal. Which period of poliomyelitis does this child have?
     
     1. 
        *Paralytic
        
     2. 
        Preparalytic
        
     3. 
        Recovery
        
     4. 
        Residual
        
     5. 
        Abortive
        

206. 
     The child is 4 years old. Entered the infectious department on the 6th day of the disease with complaints on fever to 37.9 °C, marked weakness, lack of active movements in the legs, inability to stand, walk. Polio, typical spinal form, paralytic period of moderate severity was diagnosed. What changes in the complete blood analysis are typical for this case?
     
     1. 
        *lymphocytosis, ESR acceleration
        
     2. 
        leucocytosis, accelerated erythrocyte sedimentation rate
        
     3. 
        lymphopenia, ESR acceleration
        
     4. 
        neutrophilia, eosynophilia, ESR acceleration
        
     5. 
        lymphocytosis, monocytosis, the appearance of atypical mononuclear cells
        

207. 
     Child is 6 years. Entered the infectious department on the 4th day of the disease with complaints on fever to 37.9 °C, marked weakness, lack of active movements in the legs, inability to stand, walk. Polio, typical spinal form was diagnosed. What changes in the cerebrospinal fluid are typical for this case?
     
     1. 
        *mild lymphocytic pleocytosis, protein-cell dissociation
        
     2. 
        changes are not characteristic (indicators are normal)
        
     3. 
        marked lymphocytic pleocytosis, cell-protein dissociation
        
     4. 
        the neutrophilic pleocytosis, cell-protein dissociation
        
     5. 
        moderate neutrophilic pleocytosis, protein-cell dissociation
        

208. 
     A boy of 7 years is acutely ill: fever increased to 39.6 °C, repeated vomiting, dizziness, muscular weakness are present. On the third day parents noticed absence of the right eyelids closing, distorted face during speaking. The boy is not immunized. What the family doctor has to do?
     
     1. 
        *Obviously send the patient to the infectious ward with 40 days isolation.
        
     2. 
        Obvious admission to the neurological department
        
     3. 
        Home treatment up to restore lost functions
        
     4. 
        Home treatment for 21 days
        
     5. 
        Hospitalization to the infectious ward, the introduction of specific serum
        

209. 
     A boy of 10 years is acutely ill: fever increased to 39.2 °C, repeated vomiting, dizziness, muscular weakness are present. On the third day parents noticed absence of the right eyelids closing, when speaking - distorted face. The boy is not immunized. What is the diagnosis?
     
     1. 
        *Polio, typical pontine form
        
     2. 
        Polio, typical spinal form
        
     3. 
        Polio, typical bulbar form
        
     4. 
        Polio, typical meningeal form
        
     5. 
        Polio, atypical abortive form
        

210. 
     A boy of 6 years is acutely ill: fever increased to 39.4 °C, repeated vomiting, dizziness, muscular weakness are present. On the third day parents noticed absence of the right eyelids closing, when speaking - distorted face. The boy is not immunized. What period of poliomyelitis has the child?
     
     1. 
        *Paralytic
        
     2. 
        Preparalytic
        
     3. 
        Recovery
        
     4. 
        Residual
        
     5. 
        Abortive
        

211. 
     A boy of 8 years is acutely ill: fever increased to 39.4 °C, repeated vomiting, dizziness, muscular weakness are present. On the third day parents noticed absence of the right eyelids closing, when speaking - distorted face. The boy is not immunized. Which diseases of the following it should not be differentiated?
     
     1. 
        *meningococcal disease
        
     2. 
        neuritis of the facial nerve
        
     3. 
        volume processes in the brain
        
     4. 
        viral encephalitis
        
     5. 
        enterovirus infection, polio-like form
        

212. 
     A boy of 5 years is acutely ill: fever increased to 39.8 °C, repeated vomiting, dizziness, muscular weakness are present. On the third day parents noticed absence of the right eyelids closing, when speaking - distorted face. The boy is not immunized. What is the severity of polio in this case?
     
     1. 
        *severe
        
     2. 
        mild
        
     3. 
        moderate
        
     4. 
        abortive form
        
     5. 
        unapparent form
        

213. 
     A child of 3.5 years is acutely ill: 3 days ago there was a fever 38,8 °C, and repeatedly vomiting, sore throat, on the third day there were rashes all over the body. On examination: a maculopapular rash all over the body, conjunctivas hyperemia, soft palate, the back of the throat, tonsils. On the mucosa of the soft palate and tonsils small papules and vesicles with a clear content are present. Put a preliminary diagnosis.
     
     1. 
        *Enterovirus infection
        
     2. 
        Adenovirus infection
        
     3. 
        Flu
        
     4. 
        Measles
        
     5. 
        Rubella
        

214. 
     A child of 4 years is acutely ill: 4 days ago there was a fever 38,5 °C, and repeatedly vomiting, sore throat, on the third day there were rashes all over the body. On examination: a maculopapular rash all over the body, conjunctivas hyperemia, soft palate, the back of the throat, tonsils. On the mucosa of the soft palate and tonsils small papules and vesicles with a clear content are present. Enterovirus infection is suspected. Indicate the form of the disease.
     
     1. 
        *Combined form: rash, herpangina
        
     2. 
        Combined form: rash, enteritis
        
     3. 
        Typical form: herpangina
        
     4. 
        Respiratory catarrhal form (summer flu)
        
     5. 
        Typical form: epidemic myalgia
        

215. 
     A child of 5 years is acutely ill: 4 days ago there was a fever 38,5 °C, and repeatedly vomiting, sore throat, on the third day there were rashes all over the body. On examination: a maculopapular rash all over the body, conjunctivas hyperemia, soft palate, the back of the throat, tonsils. On the mucosa of the soft palate and tonsils small papules and vesicles with a clear content are present. Enterovirus infection is suspected. Which study will confirm it in the early stages of the disease?
     
     1. 
        *the virusological swab from the pharynx by ELISA
        
     2. 
        serological method of paired sera
        
     3. 
        bacteriological smear from the oropharynx
        
     4. 
        detection of specific antibodies (Ig G) for enterovirus
        
     5. 
        blood smear (thick film)
        

216. 
     A child of 3.5 years is acutely ill: 3 days ago there was a fever 38,8 °C, and repeatedly vomiting, sore throat, on the third day there were rashes all over the body. On examination: a maculopapular rash all over the body, conjunctivas hyperemia, soft palate, the back of the throat, tonsils. On the mucosa of the soft palate and tonsils small papules and vesicles with a clear content are present. Enterovirus infection is suspected. What control measures should be undertaken if the child attended kindergarten?
     
     1. 
        *The patient should be isolated until recovery, contact persons are not isolated, daily inspection of contacts with a thermometry.
        
     2. 
        The patient should be isolated for 5 days, quarantine in the group for 21 days
        
     3. 
        The patient should be isolated for 10 days, quarantine in the group for 7 days
        
     4. 
        The patient should be isolated for 30 days, quarantine in the group for 14 days
        
     5. 
        The patient should be isolated for 5 days from the time of the last eruption, the contacts are not isolated
        

217. 
     A girl of 11 years, fell ill acutely: fever up to 39 °C, complains of the lateral chest pain attacks, and pain attacks in upper abdomen. The pain is intensified in deep breathing. On examination: conjunctivas hyperemia, vascular injection of the sclera, mild hyperemia of the soft palate and the posterior pharyngeal wall. Heart sounds are loud, heart rate is 100 per min. Percussion: clear lung sound. On auscultation - vesicular breathing, during the pain attack episode - the superficial, the breathing rate - 20 per min. Stomach is available for palpation, moderate muscular protection in the upper part, the symptoms of peritoneal irritation are negative. Put a preliminary diagnosis.
     
     1. 
        *epidemic myalgia
        
     2. 
        pleuropneumonia
        
     3. 
        dry pleurisy
        
     4. 
        syndrome of "acute abdomen"
        
     5. 
        leptospirosis
        

218. 
     Enterovirus infection was diagnosed to 10 years old patient. Objectively: general condition is satisfactory, the temperature is normal, paresis of the lower extremities, muscular weakness of buttocks, thighs, and facial muscles. Specify the form of the disease.
     
     1. 
        *Paralytic form
        
     2. 
        Epidemic myalgia
        
     3. 
        Summer flu
        
     4. 
        Serous meningitis
        
     5. 
        Herpangina
        

219. 
     Enterovirus infection was diagnosed to 6 years old patient. He complains of acute paroxysmal pain in the chest, which become worse when coughing and moving. Specify the form of the disease.
     
     1. 
        *epidemic myalgia
        
     2. 
        paralytic form
        
     3. 
        encephalomyocarditis
        
     4. 
        summer flu
        
     5. 
        enterovirus exanthema
        

220. 
     7 years old child is sick for 2 days. He complains of fever, dry cough, red face, sore throat, and conjunctivitis. His younger sister was hospitalized with symptoms of diarrhea and herpangina a few days ago. Put a preliminary diagnosis.
     
     1. 
        *Enterovirus infection, respiratory catarrhal form
        
     2. 
        Enterovirus infectious, herpangina
        
     3. 
        Measles prodrome
        
     4. 
        Herpes virus infection (stomatitis)
        
     5. 
        Adenovirus infection, pharyngoconjunctival fever
        

221. 
     A child of 7 years is acutely ill: fever increased to 39.7 °C, repeated vomiting, dizziness, muscular weakness are present. On the third day parents noticed absence of the right eyelids closing, when speaking - distorted face. The boy is not immunized. The child was hospitalized to neuroinfections department with a preliminary diagnosis of polio. A lumbar puncture was performed. Choose the most likely indicators of CSF.
     
     1. 
        *Transparent, cell count is 100 cells, 80% lymphocytes, protein is 0.45 g/l
        
     2. 
        Turbid, milky, cell count is 1200, 92% neutrophils, protein is 1.2 g/l
        
     3. 
        Transparent, yellowish, cell count 200, lymphocytes 72%, glucose 1.2 mmol/l
        
     4. 
        Red cell count is 150 (erythrocytes)
        
     5. 
        Transparent, cell count is 5, 100% lymphocytes, protein 0.045 g/l
        

222. 
     A child of 5 years is acutely ill: fever increased to 39.6 °C, repeated vomiting, dizziness, muscular weakness are present. Small papules and vesicles with a clear content are situated on the soft palate and tonsils. Meningeal signs are positive. Which indicators of spinal fluid are characteristic in this case?
     
     1. 
        *mild lymphocytic pleocytosis, protein-cell dissociation
        
     2. 
        changes are not characteristic (indicators are standard)
        
     3. 
        marked lymphocytic pleocytosis, cell-protein dissociation
        
     4. 
        the neutrophilic pleocytosis, cell-protein dissociation
        
     5. 
        moderate neutrophilic pleocytosis, protein and cell dissociation
        

223. 
     1.5 years child is ill for 1 week. Objectively: body temperature is 38.5º C, often moist cough, dyspnea at rest. On X-ray: lungs’ roots are broad, infiltrated, and in both sides are little shadows. What form of an acute pneumonia is this X-ray typical for?
     
     1. 
        Interstitial
        
     2. 
        *Bronchopneumonia
        
     3. 
        Monosegmental
        
     4. 
        Polysegmental
        
     5. 
        Croupose
        

224. 
     10-years child is ill for 4 days. He complains of subfebrile temperature, dry cough. Objectively: pallor of the skin, red cheeks, greater on right side. Percussion of lungs: on right sight dull sound in lowest part, and in axillar region. Auscultation: on right sight lower than angle of the scapula decrease of breathing, crepitating. What form of an acute pneumonia is possible in this case?
     
     1. 
        Bronchopneumonia
        
     2. 
        Monosegmental
        
     3. 
        Polysegmental
        
     4. 
        *Croupose
        
     5. 
        Interstitial
        

225. 
     15 y.o. female was admitted to thoracic surgery department with fever up to 40 °C, onset of pain in the side caused by deep breathing, cough with considerable quantity of purulent sputum and blood, with bad smell. What is the most likely diagnosis?
     
     1. 
        Complication of liver echinococcosis
        
     2. 
        Pulmonary tuberculosis
        
     3. 
        *Abscess of the lung
        
     4. 
        Actinomycosis of lungs
        
     5. 
        Bronchiectatic disease
        

226. 
     2 years old child has dry cough, dyspnea, body temperature is 37.5 °C. Percussion: clear pulmonary sound without dullness. Auscultation: dry whistling and different moist rales. In the peripheral blood: leucocytosis, eosynophilia, increased ESR. What disease is possible?
     
     1. 
        Acute simple bronchitis
        
     2. 
        *Obstructive bronchitis
        
     3. 
        Whooping cough
        
     4. 
        Acute pneumonia
        
     5. 
        Bronchial asthma
        

227. 
     5-years' old child was hospitalized because of destructive pneumonia. The bacteriological investigation from pleural cavity has found staphylococci. What antibacterial medicine is better to prescribe?
     
     1. 
        Penicillin
        
     2. 
        Ampicillin
        
     3. 
        *Ceftriaxon
        
     4. 
        Erythromycin
        
     5. 
        Gentamicin
        

228. 
     A 10-years boy complains of a headache, weakness, fever [temperature — 40 °C], vomiting. On physical examination: dyspnea, pale skin with a flush on a right cheek, right hemithorax respiratory movement delays, dullness on percussion of the lower lobe of the right lung, weakness respiration in this region. The abdomen is painless and soft by palpation. What disease has caused these symptoms and signs?
     
     1. 
        *Pneumonia croupose
        
     2. 
        Intestinal infection
        
     3. 
        Acute appendicitis
        
     4. 
        Acute cholecystitis
        
     5. 
        Influenza
        

229. 
     A 14-year-old adolescent on the second day of the disease complains of a strong headache in temples and in the area of orbits, pain in the legs, dry painful cough. His temperature is 39 °C. Adynamic. Mucous membrane of oropharynx is “flaming”, rales are not auscultated. What is the most probable diagnosis?
     
     1. 
        *Influenza
        
     2. 
        Parainfluenza
        
     3. 
        Meningococcus infection
        
     4. 
        Pneumonia
        
     5. 
        Respiratory mycoplasmosis
        

230. 
     A 14-year-old patient has been treated in a hospital. A fever of 39 °C, chest pain which is worsened by breathing; cough, brownish sputum appeared on the 7^th day of the treatment. Chest X-ray shows left lower lobe infiltrate. Which of the following is the treatment of choice for this patient?
     
     1. 
        *Cephalosporins of the III generation
        
     2. 
        Erythromycin
        
     3. 
        Streptomycin
        
     4. 
        Penicillin
        
     5. 
        Tetracycline
        

231. 
     A 16-year-old male was admitted to the hospital complaining of left-side chest pain on inspiration and dyspnea. On exam, t – 37 °C, Ps 92/min, RR of 24/min, vesicular breath sounds. There is a dry, granting, low-pitched sound heard in both expiration and inspiration in the left lower lateral part of the chest. What is the most likely diagnosis?
     
     1. 
        *Acute fibrinous pleurisy
        
     2. 
        Acute bronchitis
        
     3. 
        Pneumonia
        
     4. 
        Pneumothorax
        
     5. 
        Myocarditis
        

232. 
     A 16-year-old male was discharged from the hospital after having a community acquired pneumonia. He has no complaints. On physical exam: his temperature is — 36,6 °C, RR-18/min, Ps — 78 bpm, BP — 120/80 mm Hg. During auscultation there is harsh respiration in the lower part of the right lung. Roentgenological: infiltrative changes are absent, intensification of the pulmonary picture in the right lower lobe. How long should the doctor keep the patient under observation?
     
     1. 
        *12 months
        
     2. 
        1 month
        
     3. 
        3 months
        
     4. 
        Permanently
        
     5. 
        6 months
        

233. 
     A 3 month old infant is suffering from an acute segmental pneumonia. He has dyspnea (respiration rate – 80 per minute), paradoxical breathing, tachycardia, total cyanosis. Respiration / pulse ratio is 1:2. The heart dullness is of the normal size. Such signs characterize:
     
     1. 
        Congenital heart malformation
        
     2. 
        Myocarditis
        
     3. 
        Respiratory failure of II degree
        
     4. 
        Respiratory failure of I degree
        
     5. 
        *Respiratory failure of III degree
        

234. 
     A 5-year-old girl with the transitory T-system immunodeficiency has a right-sided pneumonia during 2 months. What course of pneumonia is in this case?
     
     1. 
        *Protracted
        
     2. 
        Acute
        
     3. 
        Reactivating
        
     4. 
        Chronic
        
     5. 
        Wavelike
        

235. 
     A 6 year old girl has an acute onset of fever up to 39 °C with chills, cough, and pain on respiration in the right side of her chest. On physical examination: HR – 120/min, BP- 85/45 mm Hg, RR- 36/min. There is dullness over the right lung on percussion. On X-ray: infiltrate in the right middle lobe of the lung. What is the diagnosis?
     
     1. 
        *Community-acquired lobar pneumonia of moderate severity
        
     2. 
        Acute pleurisy
        
     3. 
        Community-acquired bronchopneumonia
        
     4. 
        Acute lung abscess
        
     5. 
        Nosocomeal lobar pneumonia
        

236. 
     A 7-year-old boy has body temperature 39.4 °C, productive cough, intoxication. If breathing the right side is behind, a voice fremitus is stronger, short percussion sound, depressed breathing and bronhophonia over the right lung. The X-ray: a homogeneous infiltration of the right lung lower lobe. What is the diagnosis?
     
     1. 
        *Acute right-sided lobar pneumonia
        
     2. 
        Acute right-sided segmental pneumonia
        
     3. 
        Acute right-sided pleurisy
        
     4. 
        Acute right-sided pneumothorax
        
     5. 
        Acute right-sided interstitial pneumonia
        

237. 
     To a 8-month-old child is diagnosed atypical community-acquired Chlamydia trachomatis pneumonia. Select the best antibiotic.
     
     1. 
        *Macrolides of 2^nd generation
        
     2. 
        Macrolides of 1^st generation
        
     3. 
        Aminopenicilline
        
     4. 
        Cephalosporin of 2^nd generation
        
     5. 
        Aminoglycosides
        

238. 
     A 9 month-old baby has fever, cough, dyspnea. She is sick for 5 days after contact with ARVI patient. Condition of the child is severe. Temperature 38 °C, nasolabial triangle is cyanotic. BR 54 per 1 min, nostrils flaring during breathing. Percussion – a shortening of the sound below the right scapula angle, over the other sites – tympanic sound. On auscultation – fine bubbling moist rales on both sides, more on the right. What is the most likely diagnosis?