tests for VI grade students in Pedeiatric Infectious Diseases

1. What kind of rash is not typical for measles?

a) petechiaeb) vesicles c) macular-papular d) erythema on cheekse) a,b,df) a,b

2. Measles. Highlight the correct answer

а) Virus of measles penetrates under mucosal layer and reaches lymphatic tissue of the upper respiratory tract. This is the place of the virus primary multiplication b) virusemia happens in the first days of incubation period c) virus of measles has tropism to CNS and intestinal tract.d) all mentioned abovee) a.b

3. Typically measles starts from:

a) High temperature, conjunctivitis, inflammation of the upper respiratory tract, coryza, cugh b) cough, moderate feverc) moderate fever, scratch feeling in the throatd) all mentioned above is correct

4. The reservoir of the measles is not:

а) acute patient b) Patient with atypical form of measles c) all above is incorrectd) Chronic patient with panencephalitis

5. The transmission of measles virus is (which is correct):

a) parenteralb) fecal-oralc) with food d) air e) all above is correct

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6. Contagious index for Measles for non- immune people is:

a) 10-15%b) 100%. c) 1-2%d) 30-40%

7. Koplik spots, upper respiratory tract symptoms are typical for?

a) Varicellab) Rubellac)Measles d) Scarlet fever

8.Measles. What is incorrect?

a) In case of the contact with patient who has measles the immunization against it is contraindicated b) After 2 days from contact the vaccination still prevents from this disease c) Vaccination is contraindicated for patients with allergic dermatitis d) all above is incorrect

9. Diagnosis of the measles is confirmed:

a) by clinical and epidemiological data b) PCRc) serology d) all above is correct

10. During measles the patient is contagious:

а) All period of the diseases b) in prodrome periodc) 2 last days of the incubation period d) correct b,c,e e) during 1 week after appearance of disease

11. Vaccination against measles in Georgia is recommended at the age:

a) 6-9 mob) 18-24 mo

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c) 12 mo и 5 year d) not recommended.

12. Virus of measles has no tropism to:

a) CNSb) Bone and muscles c) Digestive tractd) Respiratory tract

13. Due the passive immunity infants do not usually acquire measles till the age:

a) up to 2 year b)up to 4 year c) up to 20 yeard) up to 4-6 mo

14. What is not typical for Rubella?

a) Enlarged lymphatic multiple nodesb) Petechiae c) punctulated rash (small size spots)d) Hyperemia of pharynx and mild inflammatory signs in it

15. What congenital defects may cause virus of Rubella?

a) heart valve defectsb)deafnessc) cataractd) all above

16. Not typical for Rubella is:

a) cough, fever, diarrheab) Fever, conjunctivitis, enteritisc) inflammation of upper respiratory tract, pleuritisd) punctulated rash (small size spots), stiff necke) all above

17. What kind of rash is typical for Rubella?

a) punctulated hemorrhagic rash

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b) punctulated rash (small size spots) on the unchanged skinc) Consolidating erythemad) punctuated rash (small size spots) on the hyperemic skin

18. In case of congenital Rubella the virus is isolated during the period:

a) 6 mob) 3-4 moc) up to 2 years (24 mo) d) up to 2 mo.

19. Specific prophylaxis for Rubella is not managed with

a) serumb) anatoxinc) all above

20. In which trimester of pregnancy Rubella is dangerous?

a) first trimesterb) second, third trimesterc) is dangerous in all trimesters d) Rubella is not dangerous in pregnancy

21. Which of the infections has incubation period less then 2 weeks?

a) Measlesb) Rubellac) Varicellad) Mumps

22. Which of the diseases is caused not by β-hemolytic Streptococcus Group A?

a) Scarlet feverb) erysipelasc) Reumatic feverd) Hepatitis

23. Scarlet fever is caused by:

a) meningococci

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b) staphylococcic) streptococcid) gonococci

24. Scarlet fever develops in case of:

a) absence of antibacterial immunity b) in any case when infected by GAS (Group A Strep infection)c) absence of antibacterial immunity, but presence of antitoxic immunity d) no antitoxic immunity

25. It is typical for Scarlet fever:

a) Peak of the morbidity at the age of 10-15 yearsb) season infection c) persistant antitoxic immunity after diseased) transplacental transmission of immunity e) all above

26. Scarlet fever Rash appears:

a) on the hairy part of the head and trunk b) step-by-step starting from the headc) on hyperemic skind) as hemorrhagic rash in the skin folds

27.After the acute phase of the streptococcal disease immunity may be:

a) antibacterial and antitocxis as well b) antitoxicc) no immunity develops d) antibacterial immunity

28. Highlight the incorrect answer (Scarlet fever):

a) Specific prophylaxis existsb) Patient is not contagious during after 24 houres of antimicrobial treatment c) no disinfection is needed in the nidus of infection

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29. Not typical for Scarlet fever is:

a) Purulent rash on the skin b) Leucopenia, lowering of ESR c) Local infection may become systemicd) fever of different types

30. Typical for Scarlet fever is:

a) Big hemorrhagic spotsb) pharyngitis, brown tonguec) large-lamellate desquamation on the fingers of toys and palmsd) Branny desquamation on the fingers of toys and palms

31. The antibiotic of choice in case of Scarlet fever is not:

a) sulphonamids, amynoglicosidsb) penicillinsc) macrolides

32. Highlight incorrect answer (Meningococcal infection):

The mechanism of transmission of infection isa) fecal-oral, sometime parenteral b) parenteral c) airborn infection, important is close contact with the infected person d)a,b

33. When the patient with meningococcal infection is already not contagious?

a) after 24- since antibiotic therapy b) after 2 days since initializing antibiotic therapyc) after 1 week since initializing antibiotic therapyd) after 10 days since initializing antibiotic therapy

34. Highlight correct approach for treatment of patient with meningococcal sepsis accompanied with shock :

a) Antibiotics and parenteral fluids, Control blood pressure b) corticosteroidsc) Lumbar puncture d) Investigation of fundus of eyes

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35. The appropriate approach to the treatment of bacterial meningitis:

a) dehydrationb) glycosides c) antibiotic therapy and corticosteroids in case of brain edema d) observation of patient

36. Highlight incorrect answer:

a) In case of meningococcal meningitis that nausea and vomiting is not connected with food ingestion and is fountain like b) Headache is rare in case of meningococcal meningitisc) hyperesthesia often accompanies meningococcal meningitis

37. Highlight incorrect answer for meningococcal infection:

a) meningococcal exotoxin is strong poisonb) shock due to meningococcal sepsis may be caused by necrosis of adrenal glandc) endotoxin plays the main role in the pathogenesis of meningococcal infection.

38. Meningococci grow on the following media (highlight correct answer):

a) animal or human protein and amonoacid containing media – chocolate agar, blood containing media Mueller-Hinton. b) sugar containing media.c) tellurite-containing media

39. In case of meningococcal sepsis sometimes it is reasonable sometime to make differential diagnosis with:

a) Measlesb) Scarlet fever c) iersiniosisd) thromocytic purpure) all above.

40. For the treatment of varicella in first 2 days could be used:

a) ribavirinb) rimantadinc) interferone

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d) acyclovire) non of above

41. Highlight the correct answer:

a) VZV virus causes only one varicellab) VZV virus is the same HSV and causes: varicella, Herpes Zoster and herpes labialisc)) VZV causes Zoster infection d) Non is correct

42. Highlight the most correct answer:

a) the mechanism of transmission of varicella is air and contact b) varicella is transmitted by skin contactc) varicella is transmitted by air and parenterally d) Varicella is airborn infection

43. What is the most typical for congenital varicella ?:

a) cataractb) Neurological and sensorial disturbances c) Atrophy of extremities and scars on the skind) all above

44.What kind of rash is not typical for varicella?

a) petechiae b) vesicularc) macula –papula d) erythema on the cheeks. t) а,c,d

45. Which of the listed antibiotics is not from macrolid group?

a) Amykacin b) Clarythromycin c) Azithromicind) Erythromycin

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46. Which of the listed antibiotics does not belong to cephalosporin’s of III generation?

a) Cefamezinb) Ceftriaxone c) Cefotaximd) Ceftibuten

47. Which of the listed antibiotic is not amynoglycoside?

a) erythromycin b) Tobramycinc) Amykacind) Gentamycin

48. Highlight the most correct answer:

a) For the treatment of Infectious diseases is used only etiological treatment b) For the treatment of Infectious diseases is used only pathogenetic therapyc) Strategy of the treatment of the patient with infectious diseases depends on the etiology, general condition of the patient, accompanying diseases and the age of the patient

49. For rehydration are used following fluids:a) Ringer-Lactatedb) Mannit c) Albumind) 40% Glucose

50. Highlight correct answer:

a) Fluid inside cell contains Na and outside cell fluid contains К. Their concentration in these places is equal b) Fluid inside cell contains К, fluid outside cell contains Na. Their concentration in these places is equal c) Fluid inside cell contains Na, fluid outside cell– K and chlorides d) Fluid inside cell contains К, fluid outside cell contains Na and chlorides

51. Effectiveness of antibacterial treatment depends on (highlight the incorrect answer ):

a) on the identification of the agent and sensitivity to the antibiotic b) Antibiotic is the drug of choice, its dosage is correct c) The length of the treatment depends on the etiology of diseases d) is administrated only when the diseases is chronic

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52. Which of the listed antibiotics belongs to penicillins?

a) Azythromicin b) Amykacin c) Cefalexind). Azlocillin

53. Which of the listed antibiotics belong to the IV generation of the cephalosporins?

a) Cefoperazone b) Cefuroximc) Cefepimd) Cefalexin.

54. To which group belongs Tobramycin?

a) Cephalosporinsb) Aminoglycosidesc) Macrolidsd) Penicillins

55. Which of the listed antibiotics does not belong to aminoglycosides?

f) Gentamycind) Chloramphenicol. c) Amycacind) Tobramycin

56. What are the contraindications for immunization with ММR vaccine?.

a) Acute febrile illness at the moment of the visit to physician b) Allergy (Quinke edema, anaphylactic shock)to the vaccine componentc) pregnancyd) all above

57. After immunization with OPV how long period does the virus persist in the organism?

a) in oropharynx during 1-2 weekb) it may be isolated from feces during 2 mo after vaccinationc) in immunocompromised patient OPV can be isolated long period d) all above.

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58. After vaccination with DTP a patient has fever 38,3°C. What is incorrect tactics for future vaccination?

a) Next DTP shot will contain half of a previous dose of vaccine b) Postpone next shot for several mo or refuse to vaccinate c) a,bd) Continue the schedule and in case of high fever to give antipyretics

59. Which of the antibiotics are not recommended for the treatment of pneumococcal infection as a monotherapy?

а) penicillinsb) cephalosporinsc) macrolidsd) aminoglycosides

60. Which of the antibiotics are not recommended for the systemic Staphylococcus aureus infection?

a) Oxacillinb) Cefazoline c) Vancomycin d) Nafcillin. e) Penicillin

61. When is Thrimethoprim-Sulphametoxazole not recommended?:

a) Severe anemia b) Pregnancy c) Newborn under 1 week of aged) all above is correct

62. Which of the listed antibiotics do not cause “red man syndrome”?

a) penicillinb) Chloramphenicolc) a,bd) vancomycin

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63. What should be done to prevent antibiotic resistance?

a) Do not use antibiotics in case of viral infectionb) if possible use antibiotic of narrow spectrumc) Patient should not start treatment with antibiotics himself d) all above

64. Which of the listed drugs may be used in case of severe RS infection?

a) ribavirin-aerosol b) ceftriaxon c) Amoxicillind) Ampicillin

65. The severe rapid dehydration in children is usualy caused by:

a) Shigellab) Rotavirus infection c) Chlamidiad) Staphilococci.

66. Which of the symptoms are typical for obstructive laryngitis?

a) stridor b) Rapid superficial breathingc) Noisy sound expirationd) Auscultative small bubble sounds in the lungs

67. Which of the part of Respiratory tract is usually involved in case of RSV?

a) tracheab) Larynx c) Epiglottitisd) Bronchioles

68. Which of the part of respiratory tract is usually affected by Influenza virus?

a) larynxb) Bronchioles c) Bronchid) Trachea

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69. Chemotherapy for Infectious diseases is defined as:

a) etiological treatmentb) pathogenetic treatment c) symptomatic treatment

70. Chemotherapy is:

a) antisepticsb) desinfectantsc) antimicrobials

71. Highlight incorrect answer: Against which mechanism/structure of the bacterial cell is targeted by antibiotic?

a) Protein synthesis of bacteria.b) Cytoplasm membrane c) Cell wall of bactria d) Capsular antigen of virus

72. When are antibiotics administered in case of scarlet fever?

a) In any case if the diagnosis of Scarlet fever is clear b) in complicated cases onlyc) in children under 1 year old d) in moderate and severe cases

73. Which of the antibiotics belong to semisynthetic penicillins

a) Ampicillinb) erythromicin c) Tobramycin d) Chloramphenicol

74. After vaccination against measles when is expected that antibody concentration may become detectable?

a) in couple of hoursb) in 1-2 days c) after 1 yeard) on 7-15 day after vaccinattion

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75. Highlight the incorrect answer for Scarlet fever and other Strep infections caused by Group A (GAS) and Group B (GBS):

a) In newborns these infections are rareb) transplacentarelly received immunity against Scarlet fever will protect children all their life c) In newborns strep diseases may be presented as sepsis (GBS). d) under 1 year of the age the clinical symptoms of Scarlet fever are presented mildly

76. The drug of choice for meningococcal infection is:

a) Ceftriaxonb) Streptomycinc) Erythromycind) Penicillin

77. Not recommended for the treatment of Influenza is:

a) Rimantadinb) Amantadinc) Streptomicin.

78. For the mild course of diarrhea caused by Salmonella basically is enough only:

a) rehydration b) antibioticsc) symptomatic treatment

79. What is appropriate decision in case of the bloody diarrhea?

a) postpone treatment until the bacteriology will be clear and then administer antibioticsb) rehydrate patient and administer symptomatic treatmentc) rehydrate patient and start antibiotic therapy

80. In what age is recommended to start polio vaccination in Georgia?

a) 3-mob) 2-mo c) 6-mod) 12 mo

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81. Which of the listed drugs still rarely are used for the treatment of infectious diseases?

a) phages b) serumc) antibiotics

82. For oral rehydration in the childhood are administered:

a) Solutions containing Glucose and Salt (NaCl)b) Colloid solutions c) Glucosed) Salty solutions

83. Which of the listed antibiotics are not recommended in case of the impaired haemopoiesis?

a) macrolidesb) amynoglycosides c) penicilinsd) chloramphenicol

84. Which of the listed antibiotics are not recommended before age of 6 years?

a) macrolidsb) chloramphenicolc) penicillinsd) tetracyclines

85.For what age the sixth diseases (sudden exanthema – ННV-6) is more frequent?

a) 1-6 mob) 6 - 18 moc) 4-5 years

86. The contraindications (temporary/constant) for immunization are not:

a) Acute febrile disease b) Fever > 38,5°Сc) Anorexia d) progressive neurological disease.

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87. Routs of transmission of ECHO and Coxsackie infection:

a) fecal-oralb) air-droplet c) all above

88. Highlight the correct answer:

a) enteroviral infections have variety of clinical forms of the disease b) for enteroviral infections typical is only inflammatory signs of respiratory tract c).the main target for the enteroviral infection are intestines

89. For enteroviral infections may be common:

a) Measles-like rash b) Rubella-like rashc) Scarlet fever like rashd) small rash with petechial elements e) all above

90. Routs of transmission of nosocomial infection:

a) householdb) airbornc) artificiald) all above

91. Nosocomial infections can be caused by:

a) S.aureus; E.coli.b) Herpes simplex; Ps. aeruginosa.c) Salmonellad) P.vulgarise) all above

92. Specific prophylaxis of Proteus infection is provided with:

a) live vaccineb) killed vaccinec) anatoxind) specific prophylaxis does not exist

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93. Pseudomonas aeruginosa is same as:

a) Bacilli producing "blue pus" b) Streptococcus pyogenesc) Staph aureus

94. Pseudomonas Infection frequently develops into diseases in the organism of:

a) Healthy personb) Severe patients with pneumonia, intestinal infections and sepsisc) Carriage d) Patients with viral infections

95. For the treatment of anaphylactic reaction first drug of choice is:

a) Corticosteroidsb) Diuretics c) Sol. Dextrose d) Epinephrine

96. For the Pseudomonas infection drug of choice are:

a) antibioticsb) vitaminsc) immunomodulating drugsd) non of listed above e) all above

97. Highlight the correct answer:

a) cholera causes epidemics b) cholera may cause pandemic c) cholera may be sporadic d) all above.

98. Cholera infection may be transmitted:

a) with waterb) with foodc) household d) all above is correct.

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99. Vibrio cholerae evolves:

a) endo-exotoxin b) exotoxinc) endotoxin

100. Treatment of eshcheriochiosis with severe dehydration and shock must be started:

a) i/v bolus salty solutions (Ringer Lactated or 0,9% NaCl) and further control of loss of the water and electrolytes b) i/v bolus salty solutions and diuretics c) detoxicationd) corticosteroids

101. For the treatment of systemic eshcheriochiosis (E.coli sepsis) following antibiotics are appropriate:

a) amynoglicosides b) cephalosporinsc) semisynthetic penicillinsd) all above

102. Salmonella has:

a) exotoxinb) endotoxinc) exo-endotoxin

103. Salmonella endotoxin has tropism to:

a) CNSb) Vegetative nervous system c) to all system listed above

104. The main pathogeneses chain in cholera is:

a) Intoxicationb) Dehydration and demineralization c) Allergic factor

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105. Why is cholera dangerous disease?

a) develops mild dehydration, but often is complicated with secondary florab) dehydration does not develop, bloody diarrhea is common hardly treated with antibioticsc) developes isoosmotic severe dehydration and algid

106. What is not typical for cholera:

a)discomfort and rumbling around umbilicus and lower part of the abdomen b) Pains, imperative defecation and tenesmus c) imperative defecation without tenesmus d) incoercible vomiting usually stared after diarrhea

107. Stool in case of cholera is:

a) With bloodb) Watery, like rice-water c) Watery, green with mucous

108. For the treatment of cholera is recommended:

a) Rehydrtation solutions (ORS, Ringer-Lactated, other)b) Antibacterial drugsc) All above

109. The source of rotavirus infection is: a) carrier of the virusb) Sick animal c) Patient with any form of the infection d) all above

110. Rotavirus causes: a) Impairment of the enterocytes of the small intestines b) Impairment of large and small intestines c). Impairment of stomach and distal part of small intestine

111. Typical for rotavirus infection is:

a) Acute start of disease b) Vomiting and watery diarrhea c) Pain in the stomach d) All above

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112. For the management of rotavirus infection are used:

a) Dehydration b) Antibioticsc) Rehydration d) Sulfonamides

113. In pathogenesis of Salmonella infection following plays role:

a) Endotoxinb) Exotoxinc) Live bacteria d) Live bacteria and endotoxin

114. In case of intestine form of salmonellosis differential diagnosis with (tick out a disease) is not usually needed:

a) Eshcherichiosisb) Staph enterocolitis c) Shigellosisd) Influenza

115. When is needed to apply antibiotics during Salmonellosis diseases?

a) in mild and moderate form of the disease b) in gastro-intestinal form of the disease c) In systemic Salmonellosis d) in all cases listed above

116. What is true for prophylaxis of Salmonella infection:

a) Anatoxin may stop this infectionb) Vaccine is useful in case of preventionc) No specific prophylaxis exists

117. Which of the following treatment is not needed in the case of the moderate form of Shigellosis?

a) antibacterial therapyb) oral rehydrtationc) parenteral feeding.

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118. Which of the antibiotics is not recommended for the treatment of Shigellosis in children?

a) Fusidin b) Semisynthetic penicillins c) Thrimethoprim-Sulfamethoxazole.

119. By which rout Shigellosis is not transmitted?:

a) Household b) with blood and blood productsc) food d) water

120. Which symptoms are not typical for Shigellosis?

a) rash on the skin b) pain in the abdomenc) tenesmusd) colitis (an stool with blood).

121. Highlight the correct answer for adenovirus infection:

a) is an acute respiratory viral infection b) typical is fever, inflammation mostly of the upper respiratory tract, conjunctivitis, enlargd lymph nodes c) may cause diarrhea, encephalitis d) all above is correct

122. Highlight the incorrect answer for adenovirus infection:

a) Maybe impaired upper and rarely lower respiratory tract b) never develops gastroenteritis c) typical is conjunctivitis d) all above is correct

123. For the diagnosis of adenoviral infection may be used following tests:

a) Virus isolated from cell culture (biological material from throat, eye, feces)b) IFA method may be useful c) all above is correct

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124. Adenovirus infection:

a) the source of infection is carrier or sick patient b) virus penetrates through mucous of upper respiratory tract, conjunctiva and intestines c) the disease starts acutely and different symptoms may join d) all above is correcte) all above is not correct

125. Highlight incorrect answer. Flu is

a) highly contagious disease b) chronic infectionc) viral infection d) infection accompanied by general intoxication, impairment of the respiratory tract and complications

126. The source of Influenza virus is:

a) arthropodab) chronic carrierc) sick patient

127. Influenza is transmitted (Highlight incorrect answer). a) At the end of incubation period b) From chronic carrier. c) When persisting in the organism couple of daysd) all period of fever

128.Typical for Influenza is:

a) pandemicb) seasonal peaks c) all age groups are involved d) all above

129. Influenza (highlight the correct answer):

a) Infection is airborne. Virus replicates in the epithelium of upper respiratory tractb) Local morphological changes reflect inflammatory process in upper respiratory tractc) Verusamia is followed by general intoxicationd) Often are vascular impairment like capillary and pre-capillar paresis e) all above is correct.

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130. The origin of the pneumonia during Influenza is :

a) sometimes viral onlyb) viral and microbial usuallyc) all above is correct

131. Incubation period for Influenza is:

a)1 weekb) From couple of hours to 3-4 days c) Not more then 1 day

132. Not typical for Influenza is:

a) Intoxication, fever b) Headache, muscle pains, eyeball pain c) Rash with pigmentation and desquamation. d) Inflammation in respiratory tract

133. Not helpful in the diagnostic of Influenza is: a) bacteriology b) virusological testsc) Radioimmunological Analysis d) Serology

134. Typical for Influenza is:

a) Abrupt initiation of symptomsb) General intoxication from the first day of diseasec) Inflammation in the upper respiratory tract d) Short course of the disease e) All above is typical

135. Highlight the correct answer:

a) The prognosis in Influenza often depends on the other somatic diseases and complication b) It is necessary to isolate patient in single ward during hospitalization c) Not complicated Influenza usually resolves and is benign d) Patients with any form of Influnza should be admitted to the Hospital

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136. Antibiotics in Influenza should be included to the treatment if:

a) Disease is complicated with bacterial flora b) For prophylaxis for the complications c) Always to prevent transmission of the infection from one person to another

137. Uncomplicated Influenza does not need: a) High calorie diet and increased fluid intake b) Symptomatic treatment, vitamins c) antibiotics

138. Influenza complicated with severe croup does not need

a) Increased humidity of the airb) Inhalation of epinephrine and corticosteroids c) Differentiate condition with epiglottis d) Application of sedative therapy

139. What is incorrect ?:

a) Carbapenems, meronem are drugs of choice for Enterobacteriaceae b) β-lactamases are produced only by Streptococcus family pathogensc) There are 4 known types of β-lactamases d) β-lactamases may be chromosomal and plasmid

140. What is incorrect?:

a) P. aeruginosa and Аcinetobacter are usually primary infections. Carriage of pathogens do not cause diseases if antibiotic prophylaxis is used b) These pathogens have non-predictable phenomena of resistance c) From non-fermentyzing Gram negative bacteria the main representatives are P. aeruginosa and Аcinetobacter.d) P. aeruginosa is the frequent cause of hospital infection especially in ICU

141. What types of mechanism of resistance is typical for P. aeruginosa?

a) Hyperproduction of chromosomal beta-lactamases b) Decreased permeability of the cell wall for antibiotics c) Active efflux d) All above is correcte) Non above is correct

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142. Which of the following statements is wrong?:

a) Resistance in P. aeruginosa develops shortly after the initiation of the treatment with one antibiotics, that is why combination of antibiotics will be more appropriate b) Acinetobacter spp are not virulent per se microorganisms and cause disease in the immunocompromised and severely ill patients who may need long course antibiotic therapy c) Antibiotic therapy helps to select resistant strains of Acinetobacter spp d) The initiation of treatment with antibiotics does not depend on chronicity of the disease, resistance of pathogens and previous applied antibiotics e) all above is wrong

143. What is true about de-escalation therapy?:

a) De-escalation is when wide spectrum of antibiotics is replaced by narrow spectrum antibiotic b) If the etiology of Infectious disease is discovered and antibioticogram is known de-escalation may be started c) Before starting de-escalation it is necessary to be sure that identified pathogen is the real etiology of the disease and not the colonizationd) All above is true e) Non above is correct.

144. Which statement is correct?:

a) Benzilpenicilline is not effective against Gram positive cocci, Gram negative cocci, Gram negative bacilli and Gram positive bacilli, spirochete and anaerobes b) Benzathin Benzylpenicillin (Bicillin 1) is the drug of choice in the treatment os Strep Pharyngitis in children under 5 years of age c) Oxacillin in 80-90%, is resistant to penicillinase produced by S. aureus, this is why antibiotic can be effective against Staph infections including MRSA

145. Highlight the correct answer:

a) he main indications for application of macrolides are: Non-hospital (community-aquired pneumonia)DiphtheriaPertussisSoft tissue infectionsChlamidiosisSpirochete infectionsb) Vancomycin and teichoplanin are glycopeptides

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c) Vancomicin and teichoplanin are narrow spectrum antibiotics and are active against staph infections including MRSA and S. epidermidis.d) all above is correct

146. Highlight incorrect answer:

a) chloramphenicol is antibiotic of wide spectrum of action b) chloramphenicol may act as bacteriastatic and bactericide drug c) chloramphenicol is effective against Gram positive cocci, Gram negative cocci, Gram negative bacilli, rickettsia, anaerobs d) chloramphenicol is not hepatotoxin drug d) Newborns have immature fermentative system of liver, this why chloramphenicol may cumulate in the organism and cause cardiotoxic effect, collapse, hart insufficiency. Patient is pale and syndrome is named Gray syndrome

147. Antibiotic adverse reactions may be:

a) Stivens-Johnson syndrome b) vasculitisc) feverd) Quincke edemae) hivesf) Non of mentioned aboveg) All above is correct

148. Contraindication for polyvalent inactivated Flu vaccine is:

a) Hypersensitivity to some components of the vaccine b) Hematological disease c) HIV infectiond) Age 6> monthse) Immunosuppressive therapy

149. Larynx stenosis may develop due to:

a) Allergyb) Larynx phlegmon c) Chemical burnsd) Foreign bodye) all above

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150. During which respiratory viral infections can develop croup?

a)Influenzab) Parainfluenzac) Adenoviral infectiond) All above

151. Typical for viral croup is:

a) Cough almost soundless, aphonic b) Expiratory distress c) Gruff voice and cough, stenotic breathingd) all above

152. Epiglottitis is same as:

a) Bacterial inflammation of epiglottisb) laryngotracheitisc) laryngotracheobronchitisd) .laryngitis

153. For uncomplicated croups treatment includes:

a) antibioticsb) sulphonamidesc) antibiotics and sulphonamidesd) none of mentioned above

154. For viral croup effective treatment includes:

a) inhalation of the humid hot steamb) inhalation of epinephrine and corticosteroidsc) Inhalation of broncholitics

155. For the treatment of viral croup recommended are:

a) sedationb) steam inhalation, antihistamine drugsc) O2, epinephrine inhalation

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156. What should be recommended for the treatment of viral croup if O2 does not bring a relief:

a) diazepamb) steroids, epinephrinec)antibiotics and antihistamines .

157. What may be differential diagnosis for the viral croup?:

a) Diphtheriab) Retropharyngeal abscessc) Foreign body d) Epiglottitise) All above

158. Patient has viral croup, what are recommendations for intubation and/or rtracheostomy?

a) When inhalation of O2 does not bring reliefb) When inhalation with epinephrine is not effectivec) When corticosteroids do not help d) all above together.

159. Highlight correct answer:

For parainfluenza:

a) the transmission root is air-droplet b) Infection is usually sporadic and sometimes are outbreaks in the communities c) this virus causes croup more often then other viruses d) all above is correct

160. For parainfluenza is typical:

a) pneumoniab) bronchitisc) bronchiolitisd) Laryngitis

161. How long does immunity against parainfluenza last?

a) around 1 yearb) immunity is short-term and disappears in the convalescence period c) immunity is long lasting and secondary cases are rare

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162. For parainfluenza incubation period is:

a) couple of houres b) 2-7 days c) 1 day

163. For parainfluenza typical is:

a) moderate intoxication b) Severe intoxicationc) No intoxicationd) often hypertoxic appearance

164. For parainfluenza is typical:

a) Gruff cough b) Cough with big amount of mucousc) dry coughd) Spasmatic attack of the cough

165. For viral croup is typical::

a) Sudden attackb) Benign course of the diseases if the condition is treated properlyc) Non of above.d) all above is true

166. In case of the treatment of parainfluenza recommended treatment usually includes

a) antibioticsb) inhalation of epinephrine, corticosteroidsc) sulphonamidesd) antipireticse) Ribavirin

167. For the treatment of the I degree of croup recommended are

a) Fresh air, O2

b)Intubation c) both answers correct

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d) both answers incorrect

168. Reoviral infection:

a) Accompanies usually with intoxication and hectic feverb) Patients have headache, anorexia, vomiting, low grade fever, hemorrhagic rashc) In infancy this infection may be complicated with pneumonia, aseptisc meningitis and myocarditis.

169. The source of RS-infection are:

a) wild animalsb) humanc) domestic animals d) all mentioned above

170. For RS-infection is typical:

a) bronchiolotis b) pharyngitisc) laryngitisd) rinitis

171.Rinoviral infection is :

a) CNS infectionb) infection of Gastrointestinal tract c) Infection of Soft tissuesd) Infection of upper respiratory tract

172. Rinovirus is:

a) Anthropnose infection b) Zoonosis c) anthropo-zonotic infection

173. Typical for rinovirus infection is:

a) fever and intoxication b) tonsillitisc)diarrhead) rinorrhea and cough

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174. For treatment of rinovirus infection is recommended:a) Antibioticsb) Steroidsc) Antihistaminesd) Non of mentioned above

175. For fifth disease (parvovirus B19) is typical:

a) slap in the face syndromeb) rash on the skin, lace –like rashc) all above

176. For fifth disease (parvovirus B19) treatment is recommended:

a) no specific reatment, just symptomatic b) antiviral drugsc) antibiotics

177. Sixth disease etiology is:a) virusb) bacteriac) rickettsia.

178. Clinical features of sixth disease include:

a) Fever 39-41°Сb) Febrile seizures c) Lymphadenitisг) All above.

179.Rash in Sixth disease appears usually (correct answer):

a) After the fever goes down b) On the peak of the feverc) During low grade fever

180. What kind of rash is typical for the sixth disease?:

a) punctulated b) macula-papular c) urthicaria

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181. Usually not needed for the differential diagnosis in sixth diseases is:

a) Henoсh- Schonlein b) Scarlet feverc) Measlesd) Infectious Mononucleosis

182. For the sudden exanthema recommended treatment is:

a)Antipiretics b) Antihistaminsc) Antibioticsd) Steroidse) rehydration

183. Can be BCG-vaccine used at the same day as other vaccine?

a) Yesb) NO

184. Which dosage of adrenalin will be appropriate to treat anaphylactic reaction after vaccination?:

a) 0,01 ml/kg b) 0,1 ml/kgc) 0,3 ml/kg for all ages.

185. Which immunity will be more long-lasting?

a) after alive vaccine b) after inactivated vaccine

186. Highlight the correct answer for meningococcemia:

a) Hypercoagulation is typical at the beginning of the diseases and thrombus are typical in the small vesicles . b) Hypercoagulation is typical at the last stage of the diseases c) Thrombosis of the large vesicles does not course gangrene of the fingers

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187. Correct for meningococcal systemic infection is:

a) In children seizures are often b) Seazures in adults develop in severe case of the disease c) Symptoms of the meningitis are more severe on II-III day if not treated. The rigidity may develop on the first dayd) Kernig symptom may accompany stiff neck in meningitis e) All above is correct

188. Correct for meningococcal meningitis is:

a) Unconsciousness in first hours of meningitis does not mean poor prognosis, is not dangerous and does not confirm severe course of the disease b) Specific position in the bed is typical for meningitis – the patent lays on the side, head is unflexed, extremities are flexed c) Disease in children under 1 year old is mild

189. When is recommended first shot for BCG in countries were this immunization is in the schedule?a) Right after birthb) after 2 mo after birthc) after 1 mo after birthd) Together with DTP.

190. Which age is appropriate for the starting vaccination against Diptheria, Tetanus and Pertussis?

а) 4 moб) right after birthв) 1,5- 2 moг) after 6 mo

191 Highlight incorrect answer.

a) Nosocomial infection needs appropriate antibiotics to be started right away after the diagnosis is made in order to prevent mortality and stay in the Hospital b) It is very important in nosocomial infection to choose correct antibiotics, length of treatment and dosages c) If antibiotic is started at the early stage of the treatment of nosocomial infection resistance will never developd) Doctors MUST know about the resistance in their Hospital and ICU to decide which antibiotics will be the most appropriate for the treatment of nosocomial infection

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192. Infection control includes:

a) Adequate washing of the hands and wear medical gloves if necessary b) Remove catheters and other unneeded devices timelyc) Non is correctd) All mentioned above is correct

193. Highlight incorrect answer:

a) UTI, pneumonia, are not at the top of the list of nosocomial infectionsb) Microbial resistance are the main problems of hospitals and already for out-patient facilities c) Pseudomonas aeruginosa, Enterobacter spp. Klebsiella pneumoniae, Escherichia coli often cause nosocomial infections

194. Which statement is correct?

a. No resistance to ciprofloxacin is noticed in last yearsb. Resistance in ICUs is frequent phenomenon because antibiotics are mostly used in this Unitsc. Last years Vancomycin-resistant S. aureus (VRSA) became a problem for Hospitalsd. Correct a,b e. Correct b,c

195. What is the most correct statment ?

«Good» antibiotic is: a. Which kills pathogen and is expensive and used i/vb. Which kills pathogen and is cheap and used per osc. Which kills pathogen, does not kill us d. Non is correct

196. The most correct answer

What are the targets for the action of antibiotic?

a. Synthesis of bacterial cell b. Synthesis of bacterial cell and cell proteinc. Synthesis of bacterial dna/rnad. All mentioned are targets for the action of the antibiotic

197. What is correct regarding bacteria resistance?

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a. bacteria modifies the target for antibiotics b. bacteria inactivates antibioticsc. bacteria has mechanism such as efflux of antibioticsd. Bacteria decreases permeability of the membrane for the antibiotice. correct a, bf. all answers are correctg. Nothing is correct

198. Which statement is wrong?

аa Enterobacteriaceae - the basic mechanism of resistance in this bacteria is not connected with production of beta-lactamases

b In the prevention of MRSA very important is hand washing and isolation of the patient c. If S aureus is resistant to oxacillin, it is resistant also to all beta-lactams

199. Which statement is correct?

a Necessary is to identify who of the staff is MRSA carrier in ICUb. Expanded spectrum beta-lactamases (ESBL) are localized often on plasmids c. Enterobacteriaceae, which produce ESBL are often resistant to aminoglicosydes and

fluiorocquinolones as welld. Enterobacteriaceae, which produce Expanded Spectrum Beta-lactamase are multiresistant e. Non is correctf. all is correct

200. Which answer is correct:?

2 doses of Influenza vaccine is needed:

a) All children from 6 mo to 3 yearsb) all patients with chronic diseases c) all patients who received 1 dose d) Non is correct

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