387. What nutrient agar will the studied material for identification of the causative agent of diphtheria be inoculated on?

A. Meat peptone agar.

B. Egg yolk agar.

C. Casein-charcoal agar.

D. Coagulated serum (Ru agar).

E. Differential-diagnostic Hiss media.

388. A 5-year-old boy presented to the hospital with the inflammation of the upper respiratory tract, attacks of cough that occurred under the influence of various specific and nonspecific stimuli. An initial diagnosis of whooping cough was made on the basis of obtained data. Sputum of the back palate of the pharynx had to be studied. What nutrient agar should be used by bacteriologist for isolation and identification of pure culture of the causative agent?

A. EMB agar.

B. Bordet-Gengou medium.

C. Endo agar.

D. Serum agar.

E. Tumansky agar.

389. Among the children of a boarding school there were registered some episodes of angina. The children were examined and the swab from the tonsils was taken for investigation by Neisser staining. Microscopy revealed rods of yellow-brown pigmentation with dark blue thickening at the end arranged like the letter "V". What preliminary diagnosis based on the obtained data can be made?

A. Infectious mononucleosis.

B. Listeriosis.

C. Tonsillitis.

D. Diphtheria.

E. Scarlet fever.

390. Toxin of diphtheria is produced particularly by the strains of Corynebacterium diphtheriae which:

A. Ferment glucose.

B. Are lysogenic ones.

C. Are biovar of mitis.

D. Ferment sucrose.

E. Do not have capsule.

391. What is the most frequent case of diphtheria nowadays?

A. Diphtheria of the eye.

B. Diphtheria of the ear.

C. Diphtheria of fauces.

D. Nasal diphtheria.

E. Diphtheria of a wound.

392. A patient presented to the hospital on the second day of illness complaining of severe headache, sore swallowing, fatigue and loss of appetite. The onset of the disease was acute, with the rise of body temperature to 39 °C. Tonsils became enlarged and coated with yellow-gray incrustation followed by bleeding on the attempt to strip it off. Neisser staining of the micropreparation revealed bacilli arranged angular to each other and with binary volutine granules. What is the causative agent of the disease?

A. Corynebacterium diphtheriae.

B. Legionella pneumophila.

C. Bordetella parapertussis.

D. Erysipelothrix rhusiopathiae.

E. Candida albicans.

393. A child diagnosed with diphtheria is presented to the hospital. What medication is of choice for specific therapy?

A. Diphtheria toxoid, antibiotics.

B. Kodivac vaccine, sulfonamides.

C. Antidiphtherial antitoxic serum, antibiotics.

D. DTP vaccine, DTt, Dt.

E. Diphtheria bacteriophage.

394. A patient is initially diagnosed with diphtheria of fauces. Bacteriologist isolated a pure culture with morphologic, tinctorial, cultural and biochemical properties typical for the causative agent of diphtheria. What method of research should be used to approve that it is a causative agent of diphtheria?

A. To determine the capability of bacteria to ferment starch.

B. To study proteolytic properties of bacteria.

C. To perform urease test.

D. To perform cistinase test.

E. To estimate toxigenicity of bacteria.

395. To estimate the activity of antitoxic antidiphtherial serum, which term of validity is over, bacteriologist performed the reaction based on the interaction of various doses of serum with the definite dose of diphtherial toxin or toxoid. What is the reaction called?

A. Reaction of precipitation.

B. Reaction of bacteriolyse.

C. Complement fixation test.

D. Reaction of hemagglutination.

E. Reaction of flocculation.

396. Bacterioscopic research of the material obtained from the fauces of the patient suspected of diphtheria revealed rod-shaped bacilli arranged in parallels. What aetiotropic remedy will be administered to the patient?

A. Interferon.

B. Eubiotic.

C. Bacteriophage.

D. Antibiotic.

E. Antitoxic antibacteriac serum.

397. Clinical signs of a sick child include elevated body temperature to 38 ºC, yellow-grayish fibrinolytic coat on the tonsils and adynamy. The child complains of a sore throat. An initial diagnosis of the disease is "diphtheria". Which of the following microbiological methods are likely to confirm the preliminary diagnosis?

A. Microscopic + skin allergic test.

B. Biological + serological.

C. Skin allergic test + serological.

D. Microscopic + bacteriological.

E. Microscopic + serological.

398. Exotoxin, processed by 0,4% of formalin solution at

t = 37-40 ºC within four weeks, is utilized for vaccination. Processed toxin loses its toxic properties completely, but preserves antigenic and immunogenic features. Ramon was the first to utilize such preparation in prophylaxis of diphtheria. What is this preparation called?

A. Toxoid.

B. Immunoglobulin.

C. Antitoxic serum.

D. Adjuvant.

E. Inactivated vaccine.

399. A 5-year-old girl complains of a sore throat and chills (body temperature is elevated to 38 ºC). Notifiable swelling of the neck and signs of general intoxication of the organism are observed. Tonsils are covered with yellow-greyish fibrinolytic coat joined firmly to the surrounding tissues and which is followed by bleeding on the attempt to strip it off. What initial diagnosis of the disease is likely to be suggested?

A. Diphtheria.

B. Scarlet fever.

C. Meningococcal nasopharyngitis.

D. Influenza.

E. Measles.

400. A family has got two kids. A 1-year-old child is manifested with spasmodic attacks of cough on the background of elevating body temperature. Typical clinical signs were observed in the older preschool child a month before. What method of diagnostics will allow the pediatrician to diagnose the disease in a younger child retrospectively?

A. Serological.

B. Bacteriological.

C. Biological.

D. Microscopic.

E. Molecular and biological.

401. Examining a 6-year-old child, a pediatrician revealed yellow-grayish fibrinolytic coat on the tonsils. A specimen of the sputum swabbed from the tonsils on the border of healthy and damaged areas was studied in the bacteriological laboratory by Neisser staining which revealed Corynebacterium diphtheriae in the micropreparation. Which of the morphological properties is the most important in identification of the causative agent of the disease?

A. Polar arranged volutine granules.

B. Localization of the causative agent inside macrophages.

C. Spores, diameter of which prevails the diameter of the cell.

D. Cells of the causative agent are arranged in the form of stockade.

E. Presence of capsule.

402. Tonsils of the fauces of a 6-year-old child are covered with yellow-grayish fibrinolytic coat followed by moderate bleeding on the attempt to strip it off. Neisser staining of the micropreparation revealed a number of Gram-positive bacteria like drumsticks with volutine inclusions on the poles. What symptoms can develop in the nearest time if specific treatment is not provided?

A. Toxic impairment of the cardiac muscle and kidneys.

B. Edema of the lungs.

C. Attacks of bad cough.

D. Papules on the skin.

E. Indigestion.

403. A group of children were vaccinated by diphtherial toxoid to prevent the development of diphtheria. Vaccination was provided due to all the requirements. A number of blood tests were performed to estimate the level of acquired postvaccinal antitoxic immunity. The research showed a small number of antitoxins. What is the reason of such findings?

A. Bad reaction of immune response genes to diphtheria toxoid.

B. The patients appeared to have contracted diphtheria before vaccination.

C. The patients had already been vaccinated by diphtheria toxoid.

D. The patients are sensibilized to diphtherial antigens.

E. The patients have got normal antibodies to diphtheria toxoid.

404. Microscopy of the material obtained from the patient diagnosed with diphtheria revealed bacilli with thickened ends. What method of staining was used by bacteriologist to identify volutine granules?

A. Neisser staining.

B. Gram staining.

C. Ojeshko method.

D. Ziehl-Neelsen method.

E. Burri-Gins method.

405. Condition of a sick child was characterized by attacks of spasmodic cough typical for whooping cough. Sputum of the fauces was sent to the laboratory. The studied material was plated on casein-carchcoal agar. Then it was cultivated in the thermostat within 72 hours at the t = 37 ºC and small humid colonies which looked like drops of mercury grew on the nutrient medium. What is the causative agent of the disease?

A. Bordetella pertussis.

B. Staphylococcus aureus.

C. Neisseria meningitides.

D. Haemophilus influenza.

E. Bordetella parapertussis.

406. A 6-year-old girl with angina was examined by the pediatrician and was initially diagnosed with diphtheria. Sputum of the tonsils had to be tested. What are morphological and tinctorial properties of the causative agent of diphtheria?

A. Gram-positive rods arranged angular to each other.

B. Gram-positive cocci arranged in chains.

C. Gram-negative cocci arranged in pairs.

D. Gram-negative rods arranged chaotically.

E. Gram-negative rods arranged in pairs.