Children infectious diseases

1. 
   Salmonellosis
   
2. 
   Amebiasis
   
3. 
   *Dysentery
   
4. 
   Nonspecific ulcerative colitis
   
5. 
   Yersiniosis
   

283. 
     A 8-year-old boy fell ill acutely: fever, weakness, headache, abdominal pain, recurrent vomiting, then diarrhea and tenesms. Stools occur 12 times daily, are scanty, contain a lot of mucus, pus, blood. His sigmoid colon is tender and firm. What is your diagnosis?
     
     1. 
        *Dysentery
        
     2. 
        Escherichiosis
        
     3. 
        Salmonellosis
        
     4. 
        Cholera
        
     5. 
        Staphylococcal gastroenteritis
        

284. 
     A baby, aged 2 years, has a syndrome of malabsorbtion. On ECG: S-T segment depression, wave T inversion and high wave U. What is the cause of these changes?
     
     1. 
        *decreased level of potassium
        
     2. 
        decreased level of magnesium
        
     3. 
        increased level of potassium
        
     4. 
        decreased level of calcium
        
     5. 
        decreased level of sodium
        

285. 
     A boy of 10 years with complains of fever, for three days, general weakness, insomnia, worsening of appetite, appealed to the pediatrician. A doctor has suspected typhoid fever. What method of laboratory diagnostics most expediently confirm the diagnosis?
     
     1. 
        coproculture
        
     2. 
        urine culture
        
     3. 
        biliculture
        
     4. 
        *hemoculture
        
     5. 
        mieloculture
        

286. 
     A child, 1 year old, has rare vomiting after the meal, metheorism, defecation 12 times per day. Feces are yellow-orange, in a large amount, watery, with gases, and small quantity of transparent mucus. Put the most probable diagnosis.
     
     1. 
        Shigellosis
        
     2. 
        Salmonellosis
        
     3. 
        Yersiniosis
        
     4. 
        *Entheroinvasive Escherichiosis
        
     5. 
        Paratyphoid fever B
        

287. 
     A child, 5 years old, has dyspeptic syndrome, moderate intoxication syndrome, and abdominal pain. Salmonellosis was diagnosed. What changes in the general blood test are typical for this disease?
     
     1. 
        Leucopenia, aneosinophylia, lymphocytosis.
        
     2. 
        *Leucocytosis, neuthrophilia, ESR increasing.
        
     3. 
        Leucocytosis, lymphocytosis.
        
     4. 
        Leucopenia, neutrophlia, ESR decreasing.
        
     5. 
        Leucocytosis, lymphomonocytosis, atypical mononuclear cells.
        

288. 
     A girl, 7 years old, complains of periodic colicky abdominal pains, increased frequency of defecation, temperature 39.2 ºС. During objective examination is revealed painful sigmoid colon. Feces are dark-green in a small amount, with much mucus. Anus is closed. During feces bacteriological examination was found Sаlmоnеllа enteritidis. What disease must be differentiated from this form of salmonellosis?
     
     1. 
        *Shigellosis.
        
     2. 
        Typhoid fever.
        
     3. 
        Escherichiosis.
        
     4. 
        Acute appendicitis.
        
     5. 
        Staphylococcal enterocolitis.
        

289. 
     A girl, aged 12, in severe condition was delivered to the admission ward of a hospital on the 2nd day of illness. Examination revealed body temperature of 36,1 °C, acute features of face, dry skin, aphonia, convulsive twitching of some muscle groups. Acrocyanosis is present. Heart sounds are muffled, Ps is 102 bpm, AP is 50/20 mm Hg. Abdomen is soft, sealed, painless. Anuria is present. Stool is liquid in form of rice water. What is the most probable diagnosis?
     
     1. 
        *Cholera
        
     2. 
        Intestinal amebiasis
        
     3. 
        Escherichiosis
        
     4. 
        Acute dysentery
        
     5. 
        Salmonellosis
        

290. 
     A girl, aged 8, suddenly fell ill. There had appeared chills, sensation of heat, fever 38,5°C, intermitting pain in the left iliac area, frequent liquid stool in the form of rectal spit. On palpation: the left part of the abdomen is painful, sigmoid colon is spastic. What is the most likely diagnosis?
     
     1. 
        *Acute shigellosis
        
     2. 
        Cholera
        
     3. 
        Escherichiosis
        
     4. 
        Non-specific ulcerative colitis
        
     5. 
        Malignant tumor of the large intestine
        

291. 
     A male, aged 17, intravenous drug addict complains of weakness, moderate jaundice, sensation of heaviness in the right hypochondrium. The patient's condition aggravated gradually. Biochemical tests: Total bilirubin - 48,2 µmol/L; ALT - 3,0 mmol/h*L. What examination will verify the diagnosis?
     
     1. 
        *Polymerase chain reaction (HCV -RNA)
        
     2. 
        Determination of HB antigen
        
     3. 
        Determination of ALAT in dynamics
        
     4. 
        Ultrasound examination of liver
        
     5. 
        Computer tomography
        

292. 
     A patient is in a hospital. The beginning of the disease was gradual: nausea, vomiting, dark urine, clay-colored stools, jaundice of the skin and sclera. The liver was enlarged on 3 cm. Jaundice progressed on the 14th day of the disease. The liver decreased in size. What complication of viral hepatitis has developed?
     
     1. 
        Infectious-toxic shock
        
     2. 
        *Hepatonecrosis
        
     3. 
        Meningitis
        
     4. 
        Relapse of viral hepatitis
        
     5. 
        Cholangitis
        

293. 
     A patient is hospitalized in an infectious hospital on a 8th day of the disease with complaints on head ache, general weakness. For serological research a blood is taken. During Vidal's reaction it is positive in dilution 1 : 200 with О-diagnosticum of Salmonella typhi. What diagnosis can be put, basing on this test result?
     
     1. 
        Cholera
        
     2. 
        *Typhoid fever
        
     3. 
        Shigellosis
        
     4. 
        Leptospirosis
        
     5. 
        Tuberculosis
        

294. 
     A patient with suspicion on typhoid fever entered to the infectious hospital on the 3rd day of disease. What method of microbiological diagnostics does it follow to use?
     
     1. 
        Selection of coproculture.
        
     2. 
        *Selection of hemoculture.
        
     3. 
        Selection of urineculture.
        
     4. 
        Selection of biliculture.
        
     5. 
        Selection of mieloculture.
        

295. 
     A temperature rose at 2 years old child. Vomit and multiple diarrhea has appeared. After the use of fruit juices diarrhea aggravates and the patient's condition worsened. Which from the enumerated agents could be the cause of this disease?
     
     1. 
        enteroviruses
        
     2. 
        *rotaviruses
        
     3. 
        Escherichia coli
        
     4. 
        Salmonella
        
     5. 
        staphylococcus
        

296. 
     Among the children of junior group of preschool the repeated cases of intestinal infection are revealed. At fecal culture shigella revealed. Define tactic of doctor concerning contact persons.
     
     1. 
        Contacts examination with estimation of feces character.
        
     2. 
        Supervision during 3 days with measuring of the body temperature.
        
     3. 
        Bacteriological inspection of feces for 3 days.
        
     4. 
        Supervision after those children who has increased temperature for 5 days.
        
     5. 
        *Supervision after contacts for 7 days and bacteriological inspection of emptying.
        

297. 
     Among the children of the closed child's establishment the flash of acute dysentery is diagnosed. Among the children of what age category this disease is more frequent?
     
     1. 
        Children under 1 year.
        
     2. 
        *Children elder than 1 year.
        
     3. 
        Junior schoolboys.
        
     4. 
        Senior schoolboys.
        
     5. 
        In any age.
        

298. 
     Among the children of the closed child's establishment the flash of acute dysentery is diagnosed. Contact persons are subjects to the supervision during:
     
     1. 
        3 days and 1 bacteriological inspection of emptying
        
     2. 
        *7 days and 1 bacteriological inspection of emptying
        
     3. 
        7 days and 2 bacteriological inspection of emptying
        
     4. 
        14 days and 2 bacteriological inspection of emptying
        
     5. 
        14 days and 3 bacteriological inspection of emptying
        

299. 
     At a boy, 7 years, the cholera-like disease is revealed (vomits, watery diarrhea). At fecal culture same types of the colonies grew on the Endo environment: raspberry color, with metallic lustre. What microorganism is the most credible agent of this disease?
     
     1. 
        Shigella sonnei.
        
     2. 
        Salmonella enteritidis.
        
     3. 
        Yersinia enterocolitica.
        
     4. 
        *Escherichia coli, enterotoxigenic type.
        
     5. 
        vibrio cholera
        

300. 
     At a child of 1.5 year has developed the typical clinic of acute dysentery. Choose a sign which is most characteristic for the clinic of this disease at the children of early age.
     
     1. 
        Repeated vomits and frequent regurgitation.
        
     2. 
        Acute beginning from expressed toxic at the minimum diarrhea syndrome.
        
     3. 
        *colitic character of emptying.
        
     4. 
        Frequent tenesms, hollow abdomen and expressed colitic syndrome.
        
     5. 
        mild disease's duration with predominance of local signs.
        

301. 
     At a child with the acute enterocolitis escherichiosis is diagnosed. From determination of which antigen does it follow to begin serological authentication of parenteral escherichiosis?
     
     1. 
        K-antigen
        
     2. 
        M-antigen
        
     3. 
        *О-antigen
        
     4. 
        Н-antigen
        
     5. 
        В-antigen
        

302. 
     At a child with the expressed signs of toxicosis with dehydration the acute severe dysentery is clinically suspected. Give feeding recommendations to the mother of her sick 10 months old child.
     
     1. 
        *To decrease the usual volume of meal in the first 2-3 days on 40-50 %, to conduct the rejuvenation of the food.
        
     2. 
        Feed by the only strained breast milk.
        
     3. 
        At feeding to give advantage to the soul-milk adapted mixtures.
        
     4. 
        Water-tea pause during 6-12 hours, and farther usual feeding.
        
     5. 
        Frequent feeding by small portions, as a child wants to eat.
        

303. 
     At the child of 4 months an acute bacterial dysentery is diagnosed. Name antibiotics which apply in treatment of dysentery of moderate and severe degree at the children of this age:
     
     1. 
        penicillin
        
     2. 
        gentamicin
        
     3. 
        cefasolin
        
     4. 
        *cefotaxim
        
     5. 
        ciprofloxacin
        

304. 
     At the children of senior group of preschool (kindergarten) shigellosis is diagnosed. At careful collection of epidemiology anamnesis the food way of infection is proved. What from the representatives of shigella more frequent infects by such way?
     
     1. 
        Sh. Flexneri.
        
     2. 
        *Sh. Sonnei.
        
     3. 
        Sh. dysenteriaе Grigor'ev-Shiga.
        
     4. 
        Sh. dysenteriaе Larg-Sax.
        
     5. 
        Sh. boydiі.
        

305. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed the pathogenic E.coli are revealed. What morphological and tinctorial properties inherent to the representatives of these bacteria?
     
     1. 
        Gram-negative cocci
        
     2. 
        Gram-positive cocci
        
     3. 
        Gram-positive bacillus
        
     4. 
        *Gram-negative bacillus
        
     5. 
        Gram-negative spirochetes
        

306. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed the pathogenic E.coli are revealed. What from the pointed representatives of the E.coli family cause the dysentery-like disease at children elder 1 year and adults?
     
     1. 
        *enteroinvasive E.coli
        
     2. 
        enteropathogenic E.coli
        
     3. 
        enteroadhesive E.coli
        
     4. 
        enterohemolytic E.coli
        
     5. 
        E.coli, that belong to normal microbiocynosis of intestine
        

307. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed the pathogenic E.coli are revealed. What from the pointed representatives of the E.coli family cause the cholera-like diseases?
     
     1. 
        enteroinvasive E.coli
        
     2. 
        enteropathogenic E.coli
        
     3. 
        *enterotoxigenic E.coli
        
     4. 
        enterohemolytic E.coli
        
     5. 
        E.coli, that belong to normal microbiocynosis of intestine
        

308. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed the pathogenic E.coli are revealed. What from the pointed O-antigen factions causes serological specificity of E.coli?
     
     1. 
        Fats
        
     2. 
        Protein
        
     3. 
        Lipoproteins
        
     4. 
        *Polysaccharides
        
     5. 
        All answers are correct
        

309. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed from one of patients on the Endo environment E. coli was selected. How to differentiate relative-pathogenic E. coli from enteropathogenic ones:
     
     1. 
        after biochemical signs
        
     2. 
        *after the antigen structure
        
     3. 
        after the selection of endotoxin
        
     4. 
        after pathogenicity for animals
        
     5. 
        after firmness to the antibiotics.
        

310. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed from one of patients on the Endo environment E. coli was selected. At determination of the family belonging of enterobacteria take into account:
     
     1. 
        Breathing type
        
     2. 
        Food necessities
        
     3. 
        *Biochemical properties
        
     4. 
        Morphological properties
        
     5. 
        Cultural properties
        

311. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed from one of patients on the Endo environment E. coli was selected. Indicate the maximal term of delivery of selected in concervant feces, to the bacteriological laboratory:
     
     1. 
        2 hours
        
     2. 
        4 hours
        
     3. 
        6 hours
        
     4. 
        *12 hours
        
     5. 
        16 hours
        

312. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed from one of patients on the Endo environment E. coli was selected. What correlation must be possessed between feces and concervant?
     
     1. 
        1:50
        
     2. 
        1:25
        
     3. 
        1:10
        
     4. 
        *1:3
        
     5. 
        1:1
        

313. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed from one of patients on the Endo environment E. coli was selected. Indicate properties of enteropathogenic escherichia, determination of which more authentic will confirm the diagnosis:
     
     1. 
        *Serological
        
     2. 
        Biochemical
        
     3. 
        Morphological
        
     4. 
        Cultural
        
     5. 
        Biological
        

314. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed from one of patients on the Endo environment E. coli was selected. What result of serologic research testifies the etiology of disease?
     
     1. 
        Titre of specific antibodies in agglutination reaction 1: 20
        
     2. 
        Titre of specific antibodies in indirect hemagglutination reaction 1:40
        
     3. 
        Titre of antibodies in the reaction of precipitation 1:100
        
     4. 
        Titre of antibodies in the reaction of precipitation 1:200
        
     5. 
        *Fourfold growth of specific antibodies titre in paired sera selected in the dynamics of disease
        

315. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed from one of patients on the Endo environment E. coli was selected. Indicate its biochemical properties:
     
     1. 
        does not decompose lactose and saccharose.
        
     2. 
        *decomposes to acid and gas lactose, glucose, mannitol.
        
     3. 
        does not decompose mannitol and maltose.
        
     4. 
        rarefy gelatin.
        
     5. 
        does not restore nitrates to nitrites.
        

316. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed from one of patients on the Endo environment E. coli was selected. Material for research of colienteritis at children is:
     
     1. 
        *emptying, vomiting masses, swab from pharynx, nasopharynx.
        
     2. 
        blood.
        
     3. 
        spinal fluid.
        
     4. 
        urine.
        
     5. 
        bile.
        

317. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed from one of patients on the Endo environment E. coli was selected. Pathogenic serotypes of E. coli are identified:
     
     1. 
        by the reaction of precipitation.
        
     2. 
        by complement binding reaction.
        
     3. 
        by hemagglutination reaction.
        
     4. 
        by the reaction of neutralization.
        
     5. 
        *by the reaction of agglutination with the escherichia ОК-agglutinating sera.
        

318. 
     At the inspection of group of child's collective, where the flash of intestinal infection is exposed from one of patients on the Endo environment E. coli was selected. For speed-up authentication of pathogenic E. coli is used:
     
     1. 
        reaction of lysis.
        
     2. 
        complement binding reaction.
        
     3. 
        *immune fluorescence reaction.
        
     4. 
        reaction of precipitation.
        
     5. 
        reaction of neutralization.
        

319. 
     At the inspection on S. typhi carrying in the blood serum antibodies to the Vi-antigen are revealed. What from the enumerated reactions was used in this case?
     
     1. 
        Binding complement.
        
     2. 
        Vidal.
        
     3. 
        *Indirect hemagglutination.
        
     4. 
        Immune-enzyme analysis.
        
     5. 
        Immune fluorescence.
        

320. 
     Child of 4 years during 5 days is treated because of acute dysentery, moderate degree. An effect from the received therapy is insignificant; continue to be toxic and dyspepsia syndrome. Choose the adequate treatment.
     
     1. 
        To strengthen oral rehydration.
        
     2. 
        To apply parenteral rehydration therapy.
        
     3. 
        *To appoint netylmycine 5 mg/kg per day.
        
     4. 
        To apply immune modulators therapy.
        
     5. 
        To give enterosorbents in combined chart.
        

321. 
     District doctor of rural medical department was called to a 12-year-old patient. While examining the patient, the doctor suspected the dysentery. What document must the doctor issue?
     
     1. 
        *Urgent notification of infectious disease
        
     2. 
        Statistical coupon of final (precise) diagnosis
        
     3. 
        Abstract of outpatient medical card
        
     4. 
        Infectious disease report
        
     5. 
        Report addressed to Head of the village
        

322. 
     Fecal culture of 8 years child, who had typhoid fever 1.5 years ago was positive for Salmonella typhi. How to describe the patient's status?
     
     1. 
        *Carrying.
        
     2. 
        Dysbiosis.
        
     3. 
        Reinfection.
        
     4. 
        Superinfection.
        
     5. 
        Relapse.
        

323. 
     From feces of sick 6-month child, which was on the artificial feeding, the culture of E.coli with the antigen structure O-111 is selected. What diagnosis can be put?
     
     1. 
        *Colienteritis
        
     2. 
        Cholera-like disease.
        
     3. 
        Disease of urinary tract.
        
     4. 
        Meningitis of the new-born.
        
     5. 
        Dysentery-like disease.
        

324. 
     In a boy the disease started with acute onset. Frequent watery stools has appeared 6 hours ago. The body's temperature is normal. Then vomiting has appeared. On physical examination: boy's voice is hoarse, eyes are deeply set in the orbits. The pulse is frequent. Blood pressure is low. There was no urination. What is the preliminary diagnosis?
     
     1. 
        *Cholera
        
     2. 
        Typhoid fever
        
     3. 
        Toxic food-borne infection
        
     4. 
        Salmonellosis
        
     5. 
        Dysentery
        

325. 
     In a child, 2.5 years old, who was treated in pulmonological department because of double-sided bronchopneumonia, has increased body temperature on seventh day of the treatment to 39 ºС, has appeared diarrhea. Feces are fluid dirty-green. What physician has to do?
     
     1. 
        Leave the patient in the department, perform bacteriological examination of the feces.
        
     2. 
        Isolate the patient in separate ward in this department, prescribe the etiological treatment.
        
     3. 
        *Transport the patient in the infectious department, send priority message in sanitary station, and perform the bacteriological examination of this child and contacts.
        
     4. 
        Send priority message in sanitary station, perform the bacteriological examination of this child and contacts, and prescribe the etiological treatment.
        
     5. 
        Perform the bacteriological examination of this child, discharge him home for ambulatory treatment.
        

326. 
     In a child, 7 years old, dysentery reveals itself by often defecation to 20-25 times per day, skin is pale, dry, elasticity is reduced, the body temperature is 38.9 ºС, repeated vomiting, colicky pain are present. What is the disease's severity in this case?
     
     1. 
        Mild
        
     2. 
        Moderate
        
     3. 
        severe
        
     4. 
        severe degree with prevalence of toxicosis.
        
     5. 
        *severe degree with prevalence of the local manifestations.
        

327. 
     The boy, 3 months old, is treated in infectious department because of Salmonellosis, moderate degree, caused by Salmonellae typhimurium. Which etiological treatment is reasonable to use?