417. What component of vaccine is used by a physician for prophylaxis and production of antidiphtherial antitoxic immunity?
A. Diphtheria toxoid.
B. A small dose of diphtheria toxin.
C. Diphtheria toxoid together with antidiphtherial serum.
D. Attenuated causative agent of diphtheria.
E. Inactivated causative agent of diphtheria.
418. A patient initially diagnosed with tonsillitis was presented to the hospital. A swab from the fauces had to be investigated. The studied material was inoculated on meat tellurite agar on which large (d = 3-4 mm) radial crossed colonies of gray pigmentation and cut wavy margin grew. Microscopy of the obtained material revealed Gram-positive rods with drumstick thickening at the end arranged in a shape of digital fingers. What species of bacteria was identified by bacteriologist?
A. Corynebacterium pseudodiphtheriticum.
B. Streptococcus pyogenes.
C. Bacillus anthracis.
D. Corynebacterium diphtheriae.
E
. Clostridium
botulinum.
Pathogenic Mycobacteria18
419. Microscopy of the sputum obtained from the patient diagnosed with chronic pneumonia was performed. The preparation was stained by Ziehl-Neelsen method which revealed rods of red pigmentation localized separately or in settlers. What diagnosis would you make?
А Pulmonary tuberculosis.
В. Pneumococcal pneumonia.
С. Pulmonary actinomycosis.
D. Pulmonary candidiasis.
Е. Influenza.
420. A patient is diagnosed with meningitis of unknown aetiology. Red bacilli were found in preparation made of cerebrospinal fluid and stained by Zeihl-Neelsen. What microorganisms are the ethnologic factors of meningitis?
А. Mycobacterium tuberculosis.
В. Streptococcus pyogenes.
С. Salmonella typhi.
D. Rickettsia prowazekii.
Е. Neisseria meningitidis.
421. A patient suspected of tuberculosis visited a doctor. What method of diagnostics has to be used?
А Microscopic (Zeihl-Neelsen stain).
В. Bacteriological (isolation of pure culture).
С. Serological (PHAT, to reveal specific antibodies).
D. Biological method.
Е. Mantoux test.
422. Mantoux test (intracutaneous test) was introduced to the children of the kindergarten. What preparation was used?
А Tuberculin.
В. Tularin.
С. Toxoplasmin.
D. Brucellin.
Е. Anthraxin.
423. For prevention of what infectious disease is attenuated (live) vaccine used?
А Tuberculosis.
В. Pertussis.
С. Diphtheria.
D. Tetanus.
Е. Botulism.
424. Scheduled medical check up of the residents of rural region revealed a 16-year-old boy with negative tuberculin skin test. What was the doctor’s decision?
А To vaccinate the boy with BCG19 vaccine.
В. To conduct express diagnostics by Price-method.
С. To repeat Mantoux test in a month.
D. To conduct serological diagnostics of tuberculosis.
Е. To isolate the boy from educational surrounding immediately.
425. A patient is suspected of tuberculosis. Microscopy of the puncture of knee joint did not reveal any microorganisms. What is the purpose of introducing the material obtained from the patient to laboratory animals?
А For biological method of diagnostics.
В. To study virulence of microorganisms.
С. To study reaction of immune system to introduction of infected material.
D. To study variability of microorganisms.
Е. To study pathogenesis of the disease.
426. Considerable number of vaccine preparations is used to produce active human immunity. What preparation contains attenuated (live) microorganisms?
А BCG vaccine.
В. TABTe vaccine.
С. DTP vaccine.
D. Salk vaccine.
Е. Hepatitis A vaccine.
427. What test can help to differentiate mycobacterium tuberculosis from other mycobacteria?
А Formation of niacin.
В. Staining by Zeihl-Neelsen method.
С. Formation of pigment.
D. Hydrolysis of phthyonic acid.
Е. Urease secretion.
428. Mantoux test was introduced to a child suspected of tuberculosis. Oedema, hyperaemia, and tenderness appeared in the region of allergen introduction 24 hours later. By what components is the reaction determined?
А Macrophages, T-lymphocytes and lymphokines.
В. Granulocytes, T-lymphocytes and IgG.
С. Plasmocytes, T-lymphocytes and lymphokines.
D. B-lymphocytes, IgM.
Е. Macrophages, B-lymphocytes, monocytes.
429. Price method of examination the patient’s sputum revealed red bacilli creating twisting shaft braces. What substance stipulates gluing microorganisms and their growth in a shape of serpentine cords?
А Cord-factor.
В. Alt-tuberculin.
С. Phthyonic acid.
D. Tuberculostearic acid.
Е. PPD (purified protein derivative).
430. Mantoux test was introduced to the school children of the 1st form. After their examination, the results of 15 out of 35 pupils appeared negative. What was the doctor’s decision?
А To vaccinate pupils with negative test with BCG vaccine.
В. To introduce antitoxic serum to pupils with negative test.
С. To vaccinate pupils with negative test with antirabic vaccine.
D. To repeat Mantoux test.
E. To examine blood serum of all the pupils.
431. Mantoux test was introduced to a 5-year-old child suspected of active form of tuberculosis. Mild hyperaemia was observed in the region of injection 30 minutes after performing the test. Hyperaemia disappeared in 24 hours. Estimate the results of the test.
А Test is negative.
В. Presence of postvaccinal immunity.
С. Active form of tuberculosis.
D. Latent form of tuberculosis.
E. Test is positive.
432. Mantoux test has to be introduced to a 6-year-old child suspected of active form of tuberculosis. What immunological preparation will be introduced?
А Tuberculin.
В. BCG vaccine.
С. DTP vaccine.
D. Tularine.
E. DT vaccine.
433. What method allows establishing the presence of cord factor in case of Mycobacterium tuberculosis?
А Growth of bacteria like serpentine cords in microculture.
В. Gram stain.
С Zeihl-Neelsen stain.
D. Phase-contrast microscopy.
E. Bacilli are arranged angularly to each other in the micropreparations.
434. Complex examination of the patient suggested the diagnosis of leprosy. What skin allergic test is of significant importance for making such a diagnosis?
А Mitsuda test.
В. Molony test.
С. Dick test20.
D. Coombs test.
E. Shick test.
435. Presence of lipid "cord-factor" in the cell wall of Mycobacterium tuberculosis prevents digestion of microorganisms by phagocytes. Which of the terms gives the most complete definition of it?
А Aggressiveness.
В. Pathogenicity.
С. Invasiveness.
D. Colonysative resistance.
E. Toxigenicity.
436. Mantoux test was introduced to a 14-year-old boy. The result was estimated in 72 hours: creation of the papule with the diameter of 3 mm. The former anamnesis read that last year the diameter of the papule was 15 mm. Insufficient number of what cells stipulated the changes?
А CD4-lymphocytes and macrophages.
В. B-lymphocytes and macrophages.
С. Eosinophils and mast cells.
D. T-inhibitors and T-helpers.
E. NK-cells and basophiles.
437. A healthy mature boy weighing 3500 g was born in the maternity home. What vaccine must be introduced to the child before discharge?
А BCG.
В. DTP.
С. Attenuated (live) poliomyelitis vaccine.
D. EV 76 vaccine.
E. Attenuated (live) influenza vaccine.
438. Mantoux test (with tuberculin) was introduced to a 10-year-old child. Papule of 8 mm in diameter was created 48 hours later in the place of injection. What type of hypersensitivity did the child develop?
А Delayed hypersensitivity (type IV).
В. Artus phenomenon.
С. Serum sickness.
D. Atopic reaction.
E. II type of hypersensitivity.
439. A patient is diagnosed with chronic pulmonary disease. Microscopy of the preparation obtained from the patient’s sputum and stained by Ziehl-Neelsen method revealed bacilli of red pigmentation. What properties of the infecting agent of tuberculosis were identified?
А Acid resistance.
В. Alkaline resistance.
С. Resistance to alcohol.
D. Sensitivity to acids.
E. Sensitivity to alkali.
440. Acute positive reaction on Mantoux test with tuberculin was first observed at the age of 7. What does it testify?
А Tuberculosis infection.
В. Infection of the child with Hansen bacillus21.
С. Previous vaccination with BCG vaccine.
D. Previous Mantoux test.
E. Tuberculosis.
441. Mantoux test was introduced to a child to make a conclusion about further vaccination. The result appeared to be negative. What did it testify?
А Absence of cellular immunity to causative agent of tuberculosis.
В. Presence of cellular immunity to causative agent of tuberculosis.
С. Absence of antibodies to causative agent of tuberculosis.
D. Absence of antitoxic immunity to causative agent of tuberculosis.
E. Presence of antibodies to causative agents of tuberculosis.
442. Initial diagnosis of the patient is tuberculosis. The sputum is to be investigated in the laboratory by Zeihl-Neelsen staining. What results of examination will testify the diagnosis?
А Thin red bacteria on the blue background.
В. Microorganisms with red nucleus and blue cytoplasm.
С. Red bacteria on the white background.
D. Violet bacteria forming chains.
E. Red bacteria on the green background.
443. A patient is diagnosed with the open form of pulmonary tuberculosis. Microscopy of the sputum was executed. What method of staining is worth being used?
А Gram stain.
С. Burri-Gins method.
В. Romanovsky-Giemsa staining.
D. Ziehl-Neelsen technique of staining.
E. Neisser’s method.
444. Micropreparation was made of centrifugated urine of the patient suspected of renal tuberculosis. What method of staining is worth being used?
А Burri-Gins stain.
В. Ziehl-Neelsen technique of staining.
С. Gram stain.
D. Leoffler’s stain.
E. Neisser’s stain.
445. Bright red bacilli located separately or in settlers and resistant to acids were identified in micropreparations made of the sputum and stained by Zeihl-Neelsen method. Pathological material created "serpentine cords" and grew slowly on cultural medium. First signs of their growth appeared in 10-15 days. Microorganisms did not produce spores and capsules. What species do the microorganisms belong to?
А. Yersinia pseudotuberculosis.
В. Mycobacterium tuberculosis.
С. Histoplasma duboisii.
D. Klebsiella rhinoscleromatis.
Е. Coxiella burnetii.
446. Mycobacterium wasn’t identified in micropreparation of the sputum obtained from the patient with tuberculosis. What method is preferable in bacterioscopic identification of the causative agent in the sputum?
А Methods of concentration of the studied material: centrifugation and floatating.
В. Biological method.
С. Inoculation on enriched medium.
D. Enzyme-linked immunosorbent assay.
Е. Serological method.
447. Mycobacterium wasn’t identified in micropreparation of the sputum obtained from the patient with tuberculosis. What methods can increase probability of bacterioscopic revealing of the causative agent in the sputum?
А Homogenization and floating.
В. Price method and Shkolnikova method.
C. Dark field microscopy.
D. Microscopy of micropreparation stained by Zeihl-Neelsen.
E. Microscopy of vital preparation.
448. Frequent bacterial infections have been observed in a 2-year-old child within two months. Tuberculin skin test is positive (4th type). What type of immune deficiency is it likely to be?
А Congenital T-cellular immunodeficiency.
В. Acquired immunodeficiency.
C. Congenital B-cellular immunodeficiency.
D. Congenital defection of T-suppressors.
E. Congenital total immunodeficiency.
449. Mantoux test was introduced to 35 pupils of the 1st form after they had been examined. 15 pupils responded positively. What specific factors stipulated positive reaction?
А Antibodies.
В. Leucocytes.
C. Erythrocytes.
D. T-lymphocytes.
E. B-lymphocytes.
450. A boy was vaccinated with BCG vaccine on the 5th day of life. Revaccination was administered at the age of 7. The results of what examination appeared to be reasonable for such decision?
А Tuberculin skin allegic test.
В. Study of titre of antitubercular antibodies.
C. Medical-genetic examination.
D. Bacterioscopy of the sputum.
E. X-ray examination of the lungs.
451. A 40-year-old man suffers from chronic kidney infection. An examination of ureal sediment revealed resistant to acids bacteria in a shape of fine a bit curved bacilli that didn’t grow on universal cultural media. On potato glycerine agar bacteria created dry wrinkled colonies with yellow-rose pigment. What group do those microorganisms belong to?
А. Mycobacterium.
В. Mycoplasma.
C. Chlamydia.
D. Trichomonas.
E. Gardnerella.
452. Bacteriologist proceded micropreparation of the sputum by 1% carbolic Zeihl fuchsine and then heated it three times till evaporation. Then he took off paper, plunged the micropreparation in a glass with 5% sulfuric acid and finally washed it out with water. After that the micropreparation was proceded by Loeffler’s blue. To identify what species of bacteria was such method used by bacteriologist?
А. Mycobacterium tuberculosis.
В. Staphylococcus aureus.
С. Streptococcus pneumoniae.
D. Streptococcus viridans.
Е. Klebsiella pneumoniae.
453. Bacterioscopy of the sputum, initially cultivated in the blood revealed bacilli arranged in a shape of "serpentine cords". What method of diagnosing tuberculosis was used?
А Method of microcultures (Price method).
В. Shkolnikova method.
С. Method of plaques.
D. Method of serial dilution.
Е. Cocks method.
454. Microscopy of the material obtained form the patient suspected of leprosy revealed bright red bacilli arranged in parallel groups (pack of cigars). What method of staining was used?
А Ziehl-Neelsen technique of staining.
В. Gram stain.
С. Loeffler’s stain
D. Neisser’s stain
Е. Romanovsky-Giemsa stain.
455. What remedy will be administered to the patient diagnosed with pulmonary tuberculosis?
А Isoniazid.
В. Penicillinum.
С. Erythromycin.
D. Tetracycline.
Е. Chloromphenicol.
456. A patient complained of persistent cough with purulent sputum. Bacteriologist revealed blue pigmented cocci and red thin curved rods at bacterioscopy of micropreparations stained by Zeihl-Neelsen. What microorganism is the causative agent of the disease?
А. Mycobacterium tuberculosis.
В. Actinomyces bovis.
С. Staphylococcus aureus.
D. Escherichia coli.
Е. Corynebacterium diphtheriae.
457. What is the aim of introducing Mantoux test with tuberculin intracutaneously to the pupils of the first form?
А To identify pupils subjective to revaccination with BCG vaccine.
В. For prophylaxis of tuberculosis.
С. To study immunity to causative agents of diphtheria.
D. To study the level of allergy or rickettsia.
Е. To identify pupils with epidemic parotitis.
458. In 1874 Gerhard Hansen described a causative agent of a very dangerous infectious chronic disease that was contracted only by humans. The disease is characterized by a prolonged incubation period and formation of infiltrate (leproma). What genus does the causative agent of this disease represent?
А. Mycobacterium.
В. Corynebacterium.
С. Enterobacter.
D. Actinomyces.
Е. Rickettsia.
459. Soil is not considered to be so favourable for the development of many pathologic bacteria, viruses, fungi, and protozoa. However, it is important for the transmission of some agents of infectious diseases. What microorganisms can survive in the soil for a long period of time?
А Mycobacterium tuberculosis.
В. Causative agents of plague.
С. Causative agents of cholera.
D. Causative agents of tularaemia.
Е. Shigella.
460. Initial diagnosis of the disease is "tuberculosis". Microscopy of the preparation made from the patient’s sputum was stained by Zeihl-Neelsen method. What characteristics of the causative agent were studied?
А Morphological and tinctorial.
В. Cultural and enzymic.
С. Pathogenic and virulent.
D. Biological and antigenic.
Е. Toxigenic and immunogenic.
461. To stain the micropreparation made from the patient’s sputum the following reagents were used: solution of Zeihl fuschine, methylene blue, and 5% solution of sulphuric acid. What method of staining was used?
А Zeihl-Neelsen technique of staining.
В. Burri-Gins method.
С. Gram method.
D. Peshkov method.
Е. Neisser’s method.
462. Sputum of the patient with tuberculosis was delivered to the bacteriological laboratory. One of the methods to reveal the causative agent of tuberculosis was enriching the sputum by means of caustic soda. What method was used?
А Homogenization.
В. Inactivation
С. Floating.
D. Filtration
Е. Sterilization.
463. Scheduled vaccination of newborns (on the 5th-7th day of life) plays a significant role in prophylaxis of tuberculosis. What test is used to monitor the effectiveness of vaccination against tuberculosis?
А Mantoux test with tuberculin.
В. Schick test.
С. Zacks test.
D. Allergic test.
Е. Dick test.
464. Immunity against tuberculosis is preserved after vaccination until there are live bacteria of the same strain in the organism. What is the type of immunity?
А Type-specific.
В. Humoral.
С. Nonsterile (infection immunity).
D. Innate.
Е. Crossed.
465. Introduction of Mantoux test to a child resulted in the production of papule, 10 mm in diameter, in the place of injection 48 hours later. What is the mechanism of producing hypersensitivity as a result of changes in the organism?
А Anaphylaxis.
В. Cellular cytotoxicity.
С. Granulematosis.
D. Antibody depending cytotoxicity.
Е. Immunocomplex cytotoxicity.
466. A patient is diagnosed with active form of focal pulmonary tuberculosis. What is the preparation of choice for treatment?
A. Cycloserinium.
B. Etionamide.
C. Isoniazid.
D. Ethoxide.
Е. Sulfaline.
467. Pupils of the first form were examined before revaccination against tuberculosis. What test was used?
A. Burne test.
В. Schick test.
C. Skin test with tularin.
D. Mantoux test.
E. Test with anthraxin.
468. Urine of the patient with renal tuberculosis was delivered to bacteriological laboratory, there it was proceeded on centrifuge and the obtained sediment was grown in 10% solution of sulphuric acid and then inoculated on potato-yolk medium. There was no growth of microorganisms on the medium 3 days later. What is the reason why microbes did not grow on the plate?
А Very slow growth of the causative agent.
В. The nutrient medium was not favorable for cultivation of bacteria.
С. Microorganisms died under procedure of bisulphuric acid.
D. Microorganisms remained in suprasedimental fluid.
Е. Microorganisms had to be activated in anaerobic conditions.
469. A patient is administered intracutaneous Mantoux test for diagnostics of tuberculosis. What can be dedicated in favour of Mantoux test?
А Infection of organisms with mycobacterium.
В. Natural resistance to tuberculosis.
С. Patient’s sensitivity to antibiotics.
D. Condition of acquired immunity against tuberculosis.
Е. Barrier functions of tissues and organs.
470. Bacteriologist used one of the methods for collection of mycobacteria and their more effective identification during microscopy. What method did he use?
А Floating.
В. Pure culture isolation.
С. Price method.
D. Biological method.
Е. Tuberculin skin test.
471. Sputum of the patient suspected of pulmonary tuberculosis was taken for isolation of Мycobacterium tuberculosis. What factor of pathogenecity of the causative agent is it possible to determine by Price method?
А ‘Cord-factor’.
В. Endotoxin.
С. Exotoxin.
D. Aggressiveness.
Е. Adhesiveness.
472. A patient is diagnosed with pulmonary tuberculosis. What antibiotic will be prescribed to the patient alongside with other antitubercular preparations?
А. Chloromphenicol.
В. Azytromycine
С. Rifampin.
D. Tetracycline.
Е
. Kefsol.
Causative Agents of Plaque, Tularemia,
Brucellosis and Anthrax22
473. Investigation of the patient’s sputum revealed minute Gram-negative rods (bacilli) of ovoid shape, with intense pigmentation at the poles. In micropreparation of broth culture microorganisms were arranged in chains. On inoculation of the sputum on MPA microorganisms performed R-type colonies. The causative agent of what disease is characterized by similar properties?
А. Causative agent of plague.
В. Causative agent of meningococcal nasopharingitis.
С. Causative agent of brucellosis.
D. Causative agent of shigellosis.
Е. Causative agent of streptococcal tonsillitis.
474. The content of a carbuncle of a patient suspected of anthrax was tested. Microscopy revealed microorganisms typical for B. anthracis. What signs are peculiar for these microorganisms?
А. Thick Gram-positive rods with cut endings surrounded by a capsule.
В. Gram-negative rods with bipolar staining.
С. Gram-negative rods with oval endings arranged in micropreparation chaotically.
D. Gram-negative slightly curved rods.
Е. Minute curved Gram-positive rods.
475. A patient complaining of fever is dignosed with enlarged lymphatic node (bubo). What serological reaction may confirm the diagnosis of tularemia?
А. Agglutination reaction with tularemia diagnosticum.
В. Agglutination reaction with tularin.
С. Widal test.
D. Wright’s test.
Е. Hemagglutination inhibition test.
476. One of the districts was registered with an episode of plague among golphers. Specific prophylaxis of plague in that district was performed 6 years before. What is necessary to be done in this case?
А. Inoculate the residents of the district by plague vaccine.
В. Inoculate the children by plague vaccine.
С. Inoculate the adults by plague vaccine.
D. Inoculate the healthcare workers and hunters by plague vaccine.
Е. Inoculate only hunters of the district by plague vaccine.
477. A physician suspected bubonic tularemia in the patient and sent the material obtained from the patient’s node for bacteriological investigation. What is the purpose of performing such bacteriological investigation?
А. The material will be introduced to the animals to isolate pure culture.
В. Pure culture will be isolated with the help of enriching the medium.
С. Isolated culture will be identified by antigen properties.
D. Pure culture will be identified on liquid nutrient medium.
Е. Pure culture will be isolated in solid media.
478. A child who had not been in contact with ill animals was diagnosed with brucellosis. How could the child have got infected?
А. Drinking nonpasterized milk.
В. During injection.
С. Through dirty hands.
D. Eating infected vegetables and fruits.
Е. Drinking contaminated water.
479. There were registered numerous deaths of rodents in the rural area. The rotten corpses of animals were delivered to the lab of extremely dangerous infections to confirm or deny a case of plague. What method had to be used to confirm the cause of animals' mortality?
А. Bacteriological.
В. Bacterioscopic.
С. Express method (IFT).
D. Serological (precipitation test).
Е. Biological.
480. The territory of the old cattle gravedigger that had not been used for more than 50 years was planned to be built with new houses. But the investigation of the soil revealed presence of live spores of the agent of extremely dangerous disease. Which microorganism is more likely to survive in the soil for such a long period of time?
А. Yersinia pestis.
В. Mycobacterium bovis.
С. Brucella abortus.
D. Bacillus anthracis.
Е. Francisella tularensis.
481. In one of the mountain villages there were registered numerous deaths of rodents and increased morbidity rate of the inhabitants. The patients were observed with rapid elevation of body temperature to 40 °C, noticeable intoxication, and enlargement of lymphatic nodes. In micropreparations of a dead body there were revealed Gram-negative ovoid rods with bipolar staining. What microorganisms are the causative agents of this infectious disease?
А. Staphylococci.
В. Agent of anthrax.
С. Clostridia.
D. Agent of tularemia.
Е. Agent of plague.