Faculative-anaerobic Nonsporeforming Gram-positive Rods: Corynebacteria. Causative Agents of Whooping Cough13.

354. A preliminary diagnosis of the patient is diphtheria. Bacterioscopy of the pharyngeal smear yields Gram-positive rods. What remedy is to be prescribed for treatment?

A. Antitoxic antidiphtheric serum.

B. Interferon.

C. DTP.

D. DTt.

E. Polyvalent serum.

355. A child of a large family got ill with diphtheria. What should be administered to other kids to prevent the spread of infection?

A. Antidiphtheric immunoglobulin.

B. Antidiphtheric serum.

C. DTP vaccination.

D. Vaccination by DT toxoid.

E. Vaccination by attenuated (live) vaccine.

356. Specific prophylaxis of diphtheria is scheduled in the kindergarten. What is the preparation of choice?

A. Toxoid.

B. Antibiotics.

C. Corpuscular vaccine.

D. Immunomodulators.

E. Serum.

357 Bacteriologist revealed Corynebacterium diphtheriae in the material obtained from a sick child initially diagnosed with diphtheria. What method of investigation will confirm or disprove the diagnosis?

A. Study of isolate for toxiginity.

B. Infecting of rabbits.

C. Agglutination test.

D. Burri-Gins staining.

E. Inoculation of the studied material on blood agar.

358. An outbreak of diphtheria was registered in one of the kindergartens. As it appeared, two of children who had been in contact with the sick, were not vaccinated against diphtheria. What preparation will be administered to the children for prophylaxis?

A. Specific antitoxic antidiphtheriс serum.

B. Diphtherial toxoid.

C. Interferon.

D. Lactobacterin.

E. DTP vaccine.

359. For prophylactics and treatment of what disease is antitoxic serum indicated?

A. Diphtheria.

B. Tuberculosis.

C. Dysentery.

D. Gonorrhea.

E. Whooping cough.

360. It is necessary to provide specific prophylaxis of diphtheria in the children’s group. What is the preparation of choice?

A. Toxoid.

B. Subunit vaccine.

C. Engineered vaccine.

D. Inactivated vaccine.

E. Attenuated (live) vaccine.

361. One of the children of the kindergarten got ill with diphtheria. What immunological remedy is to be administered for express prophylaxis of diphtheria?

A. Antitoxic serum.

B. Tetracycline.

C. Interferon.

D. Erythromycin.

E. DTP vaccine.

362. A patient had been burning with fever for ten days. A physician noted attacks of typical spasmodic cough and administered inoculation of pharyngeal sputum on casein-charcoal agar. What microorganism is suggestive to be identified in the sputum?

A. Causative agent of whooping cough.

B. Klebsiella.

C. Haemophilus influenzae.

D. Staphylococcus.

E. Listeria.

363. Toxiginic strains of Corynebacterium diphtheriae contain tox+ gene of prophage. Characterize prophage.

A. DNA phage, integrated into DNA bacteria.

B. Prophage, capable to replicate with bacterial cells.

C. DNA of prophage, replicated independently.

D. Prophage, destroying bacterial cells.

E. Auto phage.

364. A boy with catarrhal inflammation of trachea and bronchi is presented with the occasional attacks of cough. What nutrient agar is used to inoculate the studied material for isolation the pure culture of the causative agent of whooping cough?

A. Bordert-Gengou medium.

B. Endo agar.

C. MPA with bile.

D. Tumansky agar¹⁴.

E. Buchin agar.

365. Corynebacterium diphtheriae is identified in one of the personnel staff of the children’s group. Research of the causative agent for toxiginity showed that the strain produced exotoxin. What test was performed by bacteriologist to determine toxigenicity?

A. Agglutination reaction.

B. Ring test.

C. Immune fluorescent reaction.

D. Precipitation reaction in agar gel.

E. Complement fixation test.

366. Children of the kindergarten are scheduled for vaccination against whooping cough. What is the preparation of choice?

A. BCG vaccine.

B. Tipe-specific serum.

C. DT vaccine.

D. Donor γ (gamma) - globulin.

E. DTP vaccine.

367. Examining the patient, ETS specialist noted hyperemia and swelling of the tonsils covered with yellow-grayish coat. Microscopy of the swab revealed Gram-positive rods arranged angular to each other. What is the initial diagnosis of the disease?

A. Diphtheria.

B. Angina.

C. Scarlet fever.

D. Meningococcal nasopharyngitis.

E. Epidemic parotitis.

368. A patient presented to the clinic in poor condition, with high temperature and difficulty breathing. Bacterioscopic research of the swab allowed making an initial diagnosis of diphtherial croup. What method of staining was used by bacteriologist?

A. Neisser method.

B. Ziele-Nielson method.

C. Burri-Gins method.

D. Peshkov method.

E. Ojeshko method.

369. A child with diphtheria developed rash with itching on the skin within ten days after introduction of antidiphtherial serum. The child also complained of muscle pain and fever (38 ºC). What is likely to be the cause of the developed symptoms?

A. Serum disease.

B. Anaphylactic reaction.

C. Atopia.

D. Delayed hypersensitivity.

E. Contact allergy.

370. A patient was initially diagnosed with diphtheria. Microscopy of the patient’s material revealed rods of yellow-brown pigmentation with dark-blue thickenings at the ends. What method of staining was used?

A. Neisser method.

B. Leoffler method.

C. Ziele-Nielson method.

D. Kozlovsky method.

E. Romanovsky method.

371. A patient was initially diagnosed with diphtheria. Microscopy of the material revealed fine rods of yellow-brown pigmentation with dark-blue thickening at the ends (Neisser staining) as well as rods of blue color with blue thickening at the end (Leoffler staining). Rods were settled angular to each other. What was the conclusion based on microscopic findings?

A. Identification of pathogenic corynebacteria.

B. Absence of pathogenic corynebacteria.

C. Identification of Corynebacterium xerosis.

D. Identification of Corynebacterium pseudodiphtheriticum.

E. Identification of Mycobacterium tuberculosis.

372. Mucus from the pharynx of a sick child suspected of diphtheria is investigated under the microscope. Microscopy yields rods of yellow-brown pigmentation with dark-blue thickening at the end. What structural component of a microbial cell was identified?

A. Volutine.

B. Plasmids.

C. Capsules.

D. Spores.

E. Flagella.

373. A two-year-old child who had been in contact with the diphtherial sick person, was introduced a definite dose of toxin (1/40 MLD for sea pig) subcutaneously in the forearm. What is diphtherial toxin aimed to produce?

A. Antidiphtheric antitoxic immunity.

B. Active immunity.

C. Passive artificial immunity.

D. Allergic reaction.

E. Antidiphtheric antibacterial immunity.

374. Because of the increased morbidity rate of diphtheria it has become necessary to vaccinate a group of students. What preparation will be used to produce artificial active immunity?

A. Diphtheric toxoid.

B. Antidiphtheric serum.

C. Specific immunoglobulin.

D. DTP vaccine.

E. Inactivated vaccine.

375. To assure the necessity of vaccination against diphtheria, epidemiologist has to estimate the level of immunity of the personnel. What has he to do?

A. To determine the titer of antitoxins by PHAT.

B. To reveal bacteria carrier among the members of the collective.

C. To evaluate the level of antibodies against the causative agent of diphtheria.

D. To check medical documents dealing with the recorded vaccination against diphtheria.

E. To evaluate the immunity against the causative agent of diphtheria.

376. A pure culture of corynebacteria was isolated by bacteriologist during microscopy. What immunologic reaction was used by the specialist for identification of bacterial toxigenicity?

A. Reaction of precipitation in gel.

B. Reaction of agglutination.

C. Complement fixation test.

D. Hemagglutination inhibition test.

E. Pasive hemagglutination test.

377. Exotoxin is considered to be the basic factor of Corynebacteria diphtheriae pathogenicity. What immunologic reaction will be used by bacteriologist to evaluate the capability of bacteria to produce exotoxin?

A. Reaction of precipitation in gel.

B. Reaction of agglutination.

C. Complement fixation test.

D. Reaction of flocculation.

E. Reaction of thermal ring precipitation due to Ascoli.

378. Introduction of antidiphtherial serum is a part of therapy suggested to the patient. What is the initial diagnosis of the disease?

A. Diphtheria.

B. Angina.

C. Exacerbation of chronic tonsillitis.

D. Scarlet fever.

E. Anginoid form of tularemia.

379. A patient presented to the infectious department complaining of moderately sore throat. Objectively: elevated body temperature (39 ºC), slight hyperemia of the mucous membrane of the pharynx; tonsils are covered with yellow-gray coat that is followed by bleeding when it is stripped off. What is the initial diagnosis of the disease?

A. Diphtheria.

B. Angina.

C. Exacerbation of chronic tonsillitis.

D. Scarlet fever.

E. Anginoid form of tularemia.

380. A group of military men were immunized by associated vaccine containing toxoid of tetanus and diphtheria. Among the immunized there were revealed two bacteria carriers of toxigenic diphtherial bacillus. How can this episode be interpreted?

A. Diphtherial toxoid does not produce antimicrobial immunity.

B. Dose of vaccine was not enough for bacterial carriers.

C. Vaccine was of inadequate quality.

D. Identified causative agents of bacteria had different antigenic structure.

E. Immunized persons could have been contaminated by the causative agent of diphtheria before vaccination.

381. To evaluate the toxiginicity of the causative agent of diphtheria bacteriologist put a streak of filterable paper wetted with antitoxic antidiphtherial serum, next to it there was plated a pure culture of bacterium that looked like spots and tested toxigenic strain of bacteria. If the tested culture produces exotoxin, then:

A. Lines of precipitation become infused.

B. Lines of precipitation become crossed.

C. Zones of opacity.

D. Lines of precipitation are absent.

E. Rings of precipitation.

382. To evaluate the level of antidiphtherial immunity in a child, reaction of passive hemagglutination is suggested. What are erythrocytes sensibilized by to perform the reaction?

A. Diphtherial toxoid.

B. Diphtherial antitoxin.

C. Antigens of diphtherial bacillus.

D. Antidiphtheric serum.

E. Hemolitic serum.

383. A patient with diphtheria has to be introduced antitoxic serum immediately. What is the way to prevent anaphylactic shock, if the patient’s allergic response to the serum appears to be positive?

A. Serum should be introduced only after the organism of the patient is sensibilized due to Bezredky method.

B. Serum is not introduced.

C. Serum is introduced avoiding venous bloodstream.

D. Serum should be introduced through the skin.

E. Serum should be introduced simultaneously with the diphtherial toxoid.

384. To identify toxigenic strains of Corynebacterium diphtheriae pure cultures are plated on nutrient agar of Petri dish. In the centre there is a streak of filterable paper wetted with antitoxic serum, and on both sides pure cultures of Corynebacterium diphtheriae are inoculated. What is the type of reaction used by bacteriologist?

A. Reaction of precipitation in gel.

B. Coomb’s test.

C. Reaction of agglutination.

D. Reaction of thermal ring precipitation.

E. Reaction of opsonization.

385. A 7-year-old girl presented to the infectious department with high temperature, sore throat and general malaise. An initial diagnosis is "diphtheria". A swab from the pharynx is to be studied for isolation of pure culture of the causative agent. What method of research seems to be preferable to confirm the diagnosis?

A. Test for toxigenicity.

B. Identification of volutine granules in the causative agent.

C. Cistinase test.

D. Identification of hemolytic features of the causative agent.

E. Study of phagolisability.

386. DTP vaccine is used for effective prophylaxis of diphtheria, tetanus and whooping cough. What component of the vaccine protects the organism from the influence of the causative agent of whooping cough?

A. Inactivated Bordetella pertussis.

B. Exotoxin of whooping cough.

C. Attenuated (live) Bordetella pertussis.

D. Endotoxin of whooping cough.

E. Toxoid.