Nosocomial Infections28
625. Neonates’ morbidity rate of acute respiratory viral infections increased sharply in the neonatal department. What should be administered for treatment?
A. Interferon.
B. Influenzal ribosomal vaccine.
C. Influenzal vaccine for orally introductions.
D. Antibiotics.
E. Sulfonamides.
626. Urine microslide of the patient suffering from acute cystitis revealed leucocytes and considerable number of Gram-negative rods. On nutrient medium bacteria produce mucous colonies with green soluble pigment. What microorganisms are likely to cause the disease?
A. Pseudomonas aeruginosa.
B. Salmonella enteritidis.
C. Proteus mirabilis.
D. Escherichia coli.
E. Klebsiella pneumoniae.
627. Since internal nosocomial infection was suspected, neonatal department of the maternity hospital was monitored. Staphylococcus aureus was identified among the children as well as on certain objects used for neonatal care. What features of isolated culture made it possible to determine the origin of infection?
A. Identical phagotype.
B. Ability to pigment formation.
C. Generality of antigenic structure.
D. Results of biochemical activity.
E. Results of sensitivity to antibiotics.
628. What is the principle method of diagnosing opportunistic infections?
A. Bacteriological.
B. Method of express train-diagnostics.
C. Bacterioscopic.
D. Serological.
E. Biological.
629. Staphylococcus aureus was found at sour cream samples’ bacteriologic investigation. What way can etiologic importance of isolated culture be proved as the cause of food poisoning found among sour cream consumers group?
A. Identification of phagotype.
B. Revealing of enzyme plasmacoagulase.
C. Revealing hemolysin.
D. Definition of sugar properties.
E. Revealing enzyme lecithinase.
630. Nosocomial staphylococcal infection was suspected in surgical department; medical staff appeared to be the source of infection. What medium can be used to culture the medical staff nasopharyngeal materials in order to find pathogenic staphylococcal bacteria carriers?
A. Yolk-salt agar.
B. Endo agar.
C. Meat-peptone broth.
D. Triple sugar iron agar.
E. Blood agar.
631. To evaluate maternity hospital sanitary conditions, medical staff were tested for bacteria carrying. What microorganisms are extremely dangerous for those who come in contact?
A. Pathogenic staphylococcus.
B. Micrococci.
C. Escherichia coli.
D. Lactic bacteria.
E. Bifidobacteria.
632. What is the way of determination the source of staphylococcal infection in a department?
A. Definition of phagotypes.
B. Revealing hemolysin.
C. Definition of enzymes of aggression.
D. Definition of biotypes.
E. Definition of antibiotic resistance.
633. During bacteriological examination of the purulent material obtained from the burn wound, big plain decolorized mucous colonies with irregular margin grew on meat-peptone agar. Having been in sunshine for 24 hours, they produced green-blue water soluble pigment with honey or jasmine odor. Bacterioscopy revealed Gram-negative lophotrichi. Pathogen’s pure culture has natural resistance to the majority of antibiotics. What genus of bacterial culture was identified in the exudate?
A. Pseudomonas aeruginosa.
B. Proteus vulgaris.
C. Klebsiella ozaenae.
D. Streptomyces griseus.
E. Brucella abortus.
634. Investigation of low quality foodstuff revealed mobile Gram-negative bacilli. 18-hour cultivation on MPA created serpiginous growth of bacteria shaped like tender bluish film (phenomenon of swarming). Isolates didn’t ferment lactose, mannitol but fermented glucose, maltose and sucrose producing acid and gas, hydrogen sulphide and indole. It was proved bacteriologically that the identified bacteria were representatives of:
А. Proteus.
В. Escherichia.
С. Pseudomonas.
D. Salmonella.
Е. Shigella.
635. A case of anaerobic infection is observed in the hospital after scheduled surgical operation. What material is to be sent for bacterial examination to identify the cause of infection?
A. Dressing, sutural material (silk, catgut).
B. Urine.
C. Blood.
D. Slices of the damaged tissue.
E. Tissue liquid.
636. Postoperative wound complications rate increased in the surgical unit. Thus, pathogenic staphylococci 3А, 3С, 81 phagovar were isolated in patient’s wound egesta; in patient B. – the same phagovar. Investigation of the material obtained from the medical personnel, medical instruments of the surgical unit, rooms and air in the dressing room revealed various phagovars of staphylococci. Thus, staphylococci of 80 phagovar were revealed in the pharynx of an operational nurse; 3А, 3С, 81 phagovar in the nurse of intensive care unit; 79 phagovar − in a surgeon who operated the patient;72 phagovar in a junior nurse of a surgical unit; 83А phagovar of staphylococci in a dressing room; and 42Е phagovar of staphylococci on tools and instruments. Who of those examined is the source of infection for patients?
A. The nurse of intensive therapy unit.
B. The surgeon.
C. The operational sister.
D. The nurse of the dressing unit.
E. The junior sister of the operation block.
637. A nurse of the operation theater was diagnosed with Gram- positive cocci found in her nasopharynx during examination of the medical staff. Microorganisms were located in a bunch of grapes; on yolk-salt agar they created S-shaped colonies and were able to ferment mannitol in anaerobic conditions. What test will confirm that this is Staphylococcus aureus?
A. Plasma coagulase test.
B. Catalase test.
C. Urease test.
D. Gram stain.
E. Cistinase test.
638. Postoperative complications rate increased among the patients of the surgical department. It was found out that Staphylococcus aureus hospital strains circulate in the unit and an operational nurse appeared to be a carrier. In what material obtained from the carrier will S. aureus be found?
A. In nasopharyngeal washout.
B. In excrements.
C. In the blood.
D. In the urine.
E. In washouts of the hands.
639. It is known that if the patients are treated with antibiotics, bacteria become resistant to them. Resistance does not develop in case:
A. Permeability of cell membrane changes.
B. Antibiotic cooperates with a target and oppresses its functions.
C. Nonspecific targets are blocked.
D. Enzymes of hydrolysis are synthesized.
E. The structure of a target changes.
640. Bacteriological examination of pus obtained from postoperational wound identified pathogen which grew up on sugar-blood agar and created S-shaped black pigmented shining colonies of unpleasant odour within 7-10 days of anaerobic conditions. Microscopy of the specimen revealed Gram-negative rods with extensive polymorphism. What microorganism caused suppuration?
A. Bacteroides.
B. Clostridia.
C. Escherichia coli.
D. Veillonella.
E. Fusobacteria.
641. A patient was diagnosed with poliomyelitis. Bacteriological investigation of the patient’s urine revealed microorganisms which created colonies with yellow-green pigment and specific odour on meat-peptone agar. What microorganisms are identified?
A. Pseudomonads.
B. Proteus.
C. Klebsiella.
D. Escherichia.
E. Azotobacteria.
642. During nosocomial infectional episode staphylococci were isolated from the pharynx of a nurse. Microorganisms were not identical to the strain isolated from the patient, because of R-plasmid. What property can hospital strain receive as a result of conjugation with staphylococcus?
A. Resistance to antibiotics.
B. Synthesis of leucocydines.
C. Creation of rough colonies.
D. Fertility.
E. Production of enterotoxin.
643. A patient presented to the infectious department with clinical diagnosis of ozena. What serological test should be executed to confirm clinical diagnosis?
A. Complement fixation test.
B. Opsono-phagocytic reaction.
C. Neutralization test.
D. Precipitation test.
E. Hemagglutination test.
644. What causative agent is able to destroy mucous membranes causing inflammation of the internal organs, sepsis, producing blue-green pus and which is usually resistent to antibiotics?
A. Pseudomonas aeruginosa.
B. Proteus vulgaris.
C. Streptococcus mutans.
D. Staphylococcus aureus.
E. Escherichia coli.
645. Such opportunistic microorganisms as Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus epidermidis were isolated from different patients of the surgical department. What common structural component determines their pathogenicity?
A. Capsule.
B. Plasmids.
C. Spores.
D. Lipopolysaccharides of the cell wall.
E. Protective antigene.
646. A number of pathologic conditions are commonly associated with microbic factor: meningococcemia, acute pyelonephritis caused by klebsiella, sepsis caused by Escherichia coli, bad wound infection of protein etiology, and puerperal endometritis caused by undetermined enterobacterial etiology. What particulairity of pathogenesis is typical for all pathological processes?
A. Intoxication by lipopolysaccride endotoxin.
B. Intoxication by albuminous bacterial toxins.
C. Septic condition.
D. Presence of Gram-negative bacteria in the blood.
E. Septicemia with the development of allergic reactions.
647. Some of the patients of surgical unit simultaneously showed postoperative wound purulent inflammable complications. Bacteriological examination revealed staphylococcal culture isolated from all the patients’ material. Nosocomial infection episode was recorded. Which of the described features characterizes staphylococcus as nosocomial infection causative agent?
A. Polyresistency to antibiotics.
B. Isolation of exotoxin.
C. Isolation of enzymes of pathogenicity.
D. Widespread circulation.
E. Resistency to physical factors.
648. A female of a surgical department complains of backache and abdominal pain, pain at urination and frequent urination tenesmus. Urine’s bacterial examination identified Gram-negative oxydase-positive rodlike bacteria that created mucoid colonies of green pigmentation with specific odour. What microorganism caused the disease?
А. Pseudomonas aeruginosa.
В. Proteus mirabilis.
С. Escherichia coli.
D. Streptococcus pyogenes.
Е. Mycoplasma pneumoniаe.
649. A 65-year-old patient was admitted to hospital complaining of frequent urination with blood traces. A physician sent the patient’s urine for bacteriologic examination. Inoculation of specimen on meat-peptone agar produced big colonies with typical flower odour and greenish-blue pigmentation. Microscopy of the swab revealed Gram-negative rods. What is the causative agent of the inflammation of urogenital system?
А. Pseudomonas aeruginosa.
В. Еsсherichia coli.
С. Klebsiella ozaenae.
D. Hafnia alvei.
Е. Proteus vulgaris.
650. An episode of infection with clinical features of neonate pemphigus was recorded in the maternity home. Identical strains of staphylococci were isolated from the patients’ material. What toxin should be identified to confirm staphylococcal etiology of the episode?
A. Exfoliatin.
B. Enterotoxin.
C. β-lysin (Beta-lysin).
D. Endotoxin.
E. Factor of toxic shock.
651. Burns department patient suffers from purulent complication. The pus is of bluish-green color, indicating infection caused by Pseudomonas aeruginosa. What morphological feature is typical for this causative agent?
A. It is a Gram-negative bacillus.
B. It is spore forming.
C. It is a coccal form.
D. Cells are located in pairs.
E. It creates mycelium.
652. Standard staphylococcal bacteriophages were used to find the source of patients’ contamination with pathogenic staphylococci. What investigation of pure culture isolated from various sources was performed?
A. Phage typing.
B. Phage diagnostics.
C. Phage indication.
D. Phage therapy.
E. Phage identification.
653. Episode of enteric infection was registered in the therapeutic department. It was associated with the contaminated food that the patients had been fed with. It was hard to fight against the infection by antibiotic therapy. What causative agent of hospital infection was likely to cause the disease?
A. Salmonella.
B. Staphylococcus.
C. Streptococcus.
D. Blue pus bacillus (Pseudomonas aeruginosa).
E. Proteus.
654. An episode of nosocomial staphylococcal infection was registered in the maternity hospital. What method of investigation was preferable to identify the source of infection?
A. Phage typing.
B. Studying biochemical properties of the causative agent.
C. Studying toxin production.
D. Studying sensitivity of the causative agent to antibiotics.
E. Studying antigenic structure of the causative agent.
655. An episode of nosocomial infection was registered in burns department. Mobile Gram-negative rods were revealed in patients’ material obtained from the pus swabs and washouts of sanitary room’s surfaces. Causative agent was aerobic; it did not decompose lactose; while growing on meat-peptone agar it created blue-green pigmentation. What microorganism is likely to be a causative agent of nosocomial infection?
A. Pseudomonas aeruginosa.
B. Proteus vulgaris.
C. Salmonella typhimurium.
D. Escherichia coli.
E. Bacteroides melaninogenicus.
656. A patient, operated on urinary bladder cancer, showed increase of body temperature a day later. His condition worsened, pain in the lower part of the abdomen developed. Microscopic examination of ureal microslides identified leucocytes and a considerable number of Gram-negative rods. Mucous colonies grew up on nutrient medium producing green soluble pigmentation. What microorganism caused postoperative complication, in your opinion?
A. Pseudomonas aeruginosa.
B. Escherihia coli.
C. Klebsiella pneumoniae.
D. Proteus mirabilis.
E. Salmonella enteritica.
657. An episode of nosocomial infection was recorded in the surgical unit. Infection was characterized by frequent suppuration of postoperative wounds. Bacteriological investigation isolated aurococcus in the pus. What method is to be used to identify bacteria carrier among the medical staff of the surgical unit?
A. Phage typing.
B. Microscopic.
C. Serological identification.
D. Definition of sensitivity to antibiotics.
E. Biochemical identification.
658. A patient diagnosed with pyelonephritis is admitted to hospital. What material should be obtained from the patient for bacteriological investigation?
A. Last portion of urine.
B. Blood.
C. Bile.
D. Exudate from urethra.
E. Faecal mass.
659. One of the representatives of Enterobacteriaceae family forms a capsule both in microorganism and in nutrient medium, creating mucous colonies. It is also known that this microorganism is the causative agent of rhinoscleroma – chronic atrophic process of mucus of the upper respiratory tract. What genus is the causative agent representative of?
A. Klebsiella.
B. Salmonella.
C. Citrobacter.
D. Enterobacter.
E. Shigella.
660. While determining the cause of nosocomial infection episode, pure cultures of Staphylococcus aureus from the patients, medical staff and certain environmental objects were isolated. What examination should be carried out to determine isolated staphylococci identity and the source of nosocomial infection?
A. Phage typing.
B. Definition of biotype.
C. Serologic typing.
D. Definition of pathogenicity.
E. Infecting of animals.
661. Material (wound exudate) was cultured on dense nutrient medium and incubated for 18 hours at t = 37 ºС. Large flat colonies grew up on meat-peptone agar with marked blue-green pigment diffusing into agar and with intense odor. What microorganism grew up on the nutrient medium?
A. Pseudomonas.
B. Serratia.
C. Sarcine.
D. Staphylococcus.
E. Klebsiella.
662. Material obtained from the patient with maxillofacial injury and suppurative wound caused by Klebsiella pneumoniae was sent to bacteriological laboratory. What method of microbiological diagnostics was used to identify the cause of the disease?
A. Bacteriological.
B. Express method (Ascoli test).
C. Skin allergic test.
D. Biological method.
E. Serological (hemagglutination inhibition test).
663. Shigella sonnei was isolated from the patient’s faeces. What additional investigation should be performed to identify the source of infection?
A. Phage typing of the isolated pure culture.
B. Study of sensitivity to antibiotics.
C. Reaction of precipitation.
D. Complement fixation test.
E. Reaction of neutralization.
664. Having eaten cottage cheese, children of the kindergaten developed symptoms of nausea, vomiting, and diarrhoea. Microscopy of the preparation revealed Gram-positive microorganisms (golden staphylococcus). What is the suggestive method of identification the source of infection?
A. Phagotyping of isolated strains.
B. Determination of capability of strains to produce toxins.
C. Investigation of kitchen stuff.
D. Identification of antibodies in sick children.
E. Additional skin allergic test.
665. When the material from the burns wound was plated on meat-peptone agar, colonies of medium and small size with irregular margin, blue-greenish pigmentation and metallic sheen grew up. The culture produced odour typical for jasmine. What species of bacteria was identified due to its cultural properties?
A. Pseudomonas aeruginosa.
B. Escherichia coli.
C. Proteus vulgaris.
D. Staphylococcus aureus.
E. Clostridium perfringens.
666. A pure culture of facultative anaerobe was isolated in the material obtained from the patient with symptoms of food intoxication. The culture produced two types of colonies on meat peptone agar. H-type of bacterim created typical scrawling growth (phenomenon of digging). In unfavorable conditions (presence of phenol, bile acids, and acridine units) O-type of bacterium created large colonies with flat edges on meat peptone agar. Inoculation of bacterial culture in condensated water of slanting MPA (Shukevich method) produced typical scrawling growth like tender bluish film. What genus of bacteria is the isolated pure culture representative of?
A. Proteus.
B. Yersinia.
C. Klebsiella.
D. Salmonella.
E. Shigella.
667. To clear up the causes of saprogenous infection, inoculation of the material on nutrient agar is sometimes performed with a specific technique: the studied material is introduced into the condensated water of slanting MPA. The presence of bacteria is identified due to the typical scrawling growth – from the bottom to the upper surface of the nutrient medium. What microorganism is characterized by such particularity of growth?
A. Proteus.
B. Escherichia coli.
C. Blue pus bacillus (Pseudomonas aeruginosa).
D. Staphylococcus.
E. Enterococcus.
668. Meat sausage with unpleasant saprogenous odour was sent to bacteriological laboratory. Mobile Gram-negative rod-shaped bacteria were isolated in the studied material. Bacteria grew very quickly on MPA and produced phenomenon of swarming (when inoculated in condensated water of slanting MPA, bacterial culture produced typical scrawling growth like tender bluish film). What microorganism caused saprogenous biological decomposition of the studied material?
A. Proteus spp.
B. Escherichia coli.
C. Vibrio cholerae.
D. Salmomella spp.
E. Shigella spp.
