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tests for VI grade students in Pedeiatric Infectious Diseases

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


a) petechiae
b) vesicles
c) macular-papular
d) erythema on cheeks
e) a,b,d
f) a,b
2. Measles. Highlight the correct answer
) 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 above
e) a.b
3. Typically measles starts from:
a) High temperature, conjunctivitis, inflammation of the upper respiratory tract, coryza, cugh
b) cough, moderate fever
c) moderate fever, scratch feeling in the throat
d) all mentioned above is correct
4. The reservoir of the measles is not:
) acute patient
b) Patient with atypical form of measles
c) all above is incorrect
d) Chronic patient with panencephalitis
5. The transmission of measles virus is (which is correct):
a) parenteral
b) fecal-oral
c) 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) Varicella
b) Rubella
c)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) PCR
c) serology
d) all above is correct
10. During measles the patient is contagious:
) All period of the diseases
b) in prodrome period
c) 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 mo
b) 18-24 mo
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c) 12 mo 5 year
d) not recommended.
12. Virus of measles has no tropism to:
a) CNS
b) Bone and muscles
c) Digestive tract
d) 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 year
d) up to 4-6 mo
14. What is not typical for Rubella?
a) Enlarged lymphatic multiple nodes
b) 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 defects
b)deafness
c) cataract
d) all above
16. Not typical for Rubella is:
a) cough, fever, diarrhea
b) Fever, conjunctivitis, enteritis
c) inflammation of upper respiratory tract, pleuritis
d) punctulated rash (small size spots), stiff neck
e) 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 skin


c) Consolidating erythema
d) punctuated rash (small size spots) on the hyperemic skin

18. In case of congenital Rubella the virus is isolated during the period:
a) 6 mo
b) 3-4 mo
c) up to 2 years (24 mo)
d) up to 2 mo.
19. Specific prophylaxis for Rubella is not managed with
a) serum
b) anatoxin
c) all above
20. In which trimester of pregnancy Rubella is dangerous?
a) first trimester
b) second, third trimester
c) 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) Measles
b) Rubella
c) Varicella
d) Mumps
22. Which of the diseases is caused not by -hemolytic Streptococcus Group A?
a) Scarlet fever
b) erysipelas
c) Reumatic fever
d) Hepatitis
23. Scarlet fever is caused by:
a) meningococci
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b) staphylococci
c) streptococci
d) 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 years
b) season infection
c) persistant antitoxic immunity after disease
d) 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 head
c) on hyperemic skin
d) 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) antitoxic
c) no immunity develops
d) antibacterial immunity
28. Highlight the incorrect answer (Scarlet fever):
a) Specific prophylaxis exists
b) Patient is not contagious during after 24 houres of antimicrobial treatment
c) no disinfection is needed in the nidus of infection

29. Not typical for Scarlet fever is:


a) Purulent rash on the skin
b) Leucopenia, lowering of ESR
c) Local infection may become systemic
d) fever of different types
30. Typical for Scarlet fever is:
a) Big hemorrhagic spots
b) pharyngitis, brown tongue
c) large-lamellate desquamation on the fingers of toys and palms
d) Branny desquamation on the fingers of toys and palms
31. The antibiotic of choice in case of Scarlet fever is not:
a) sulphonamids, amynoglicosids
b) penicillins
c) macrolides
32. Highlight incorrect answer (Meningococcal infection):
The mechanism of transmission of infection is
a) 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 therapy
c) after 1 week since initializing antibiotic therapy
d) 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) corticosteroids
c) Lumbar puncture
d) Investigation of fundus of eyes
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35. The appropriate approach to the treatment of bacterial meningitis:


a) dehydration
b) 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 meningitis
c) hyperesthesia often accompanies meningococcal meningitis
37. Highlight incorrect answer for meningococcal infection:
a) meningococcal exotoxin is strong poison
b) shock due to meningococcal sepsis may be caused by necrosis of adrenal gland
c) 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) Measles
b) Scarlet fever
c) iersiniosis
d) thromocytic purpur
e) all above.
40. For the treatment of varicella in first 2 days could be used:
a) ribavirin
b) rimantadin
c) interferone
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d) acyclovir
e) non of above
41. Highlight the correct answer:
a) VZV virus causes only one varicella
b) VZV virus is the same HSV and causes: varicella, Herpes Zoster and herpes labialis
c)) 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 contact
c) varicella is transmitted by air and parenterally
d) Varicella is airborn infection
43. What is the most typical for congenital varicella ?:
a) cataract
b) Neurological and sensorial disturbances
c) Atrophy of extremities and scars on the skin
d) all above
44.What kind of rash is not typical for varicella?
a) petechiae
b) vesicular
c) macula papula
d) erythema on the cheeks.
t) ,c,d
45. Which of the listed antibiotics is not from macrolid group?
a) Amykacin
b) Clarythromycin
c) Azithromicin
d) Erythromycin

46. Which of the listed antibiotics does not belong to cephalosporins of III generation?
a) Cefamezin
b) Ceftriaxone
c) Cefotaxim
d) Ceftibuten
47. Which of the listed antibiotic is not amynoglycoside?
a) erythromycin
b) Tobramycin
c) Amykacin
d) 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 therapy
c) 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-Lactated
b) Mannit
c) Albumin
d) 40% Glucose
50. Highlight correct answer:
a) Fluid inside cell contains Na and outside cell fluid contains . Their concentration in these
places is equal
b) Fluid inside cell contains , 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 , 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) Cefalexin
d). Azlocillin
53. Which of the listed antibiotics belong to the IV generation of the cephalosporins?
a) Cefoperazone
b) Cefuroxim
c) Cefepim
d) Cefalexin.
54. To which group belongs Tobramycin?
a) Cephalosporins
b) Aminoglycosides
c) Macrolids
d) Penicillins
55. Which of the listed antibiotics does not belong to aminoglycosides?
f) Gentamycin
d) Chloramphenicol.
c) Amycacin
d) Tobramycin
56. What are the contraindications for immunization with R vaccine?.
a) Acute febrile illness at the moment of the visit to physician
b) Allergy (Quinke edema, anaphylactic shock)to the vaccine component
c) pregnancy
d) all above
57. After immunization with OPV how long period does the virus persist in the organism?
a) in oropharynx during 1-2 week
b) it may be isolated from feces during 2 mo after vaccination
c) 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 38,3C. 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,b
d) 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?
) penicillins
b) cephalosporins
c) macrolids
d) aminoglycosides
60. Which of the antibiotics are not recommended for the systemic Staphylococcus aureus
infection?
a) Oxacillin
b) 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 age
d) all above is correct
62. Which of the listed antibiotics do not cause red man syndrome?
a) penicillin
b) Chloramphenicol
c) a,b
d) vancomycin

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63. What should be done to prevent antibiotic resistance?


a) Do not use antibiotics in case of viral infection
b) if possible use antibiotic of narrow spectrum
c) 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) Amoxicillin
d) Ampicillin
65. The severe rapid dehydration in children is usualy caused by:
a) Shigella
b) Rotavirus infection
c) Chlamidia
d) Staphilococci.
66. Which of the symptoms are typical for obstructive laryngitis?
a) stridor
b) Rapid superficial breathing
c) Noisy sound expiration
d) Auscultative small bubble sounds in the lungs
67. Which of the part of Respiratory tract is usually involved in case of RSV?
a) trachea
b) Larynx
c) Epiglottitis
d) Bronchioles
68. Which of the part of respiratory tract is usually affected by Influenza virus?
a) larynx
b) Bronchioles
c) Bronchi
d) Trachea

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69. Chemotherapy for Infectious diseases is defined as:


a) etiological treatment
b) pathogenetic treatment
c) symptomatic treatment
70. Chemotherapy is:
a) antiseptics
b) desinfectants
c) 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 only
c) in children under 1 year old
d) in moderate and severe cases
73. Which of the antibiotics belong to semisynthetic penicillins
a) Ampicillin
b) erythromicin
c) Tobramycin
d) Chloramphenicol
74. After vaccination against measles when is expected that antibody concentration may become
detectable?
a) in couple of hours
b) in 1-2 days
c) after 1 year
d) 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 rare
b) 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) Ceftriaxon
b) Streptomycin
c) Erythromycin
d) Penicillin
77. Not recommended for the treatment of Influenza is:
a) Rimantadin
b) Amantadin
c) Streptomicin.
78. For the mild course of diarrhea caused by Salmonella basically is enough only:
a) rehydration
b) antibiotics
c) 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 antibiotics
b) rehydrate patient and administer symptomatic treatment
c) rehydrate patient and start antibiotic therapy
80. In what age is recommended to start polio vaccination in Georgia?
a) 3-mo
b) 2-mo
c) 6-mo
d) 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) serum
c) antibiotics
82. For oral rehydration in the childhood are administered:
a) Solutions containing Glucose and Salt (NaCl)
b) Colloid solutions
c) Glucose
d) Salty solutions
83. Which of the listed antibiotics are not recommended in case of the impaired haemopoiesis?
a) macrolides
b) amynoglycosides
c) penicilins
d) chloramphenicol
84. Which of the listed antibiotics are not recommended before age of 6 years?
a) macrolids
b) chloramphenicol
c) penicillins
d) tetracyclines
85.For what age the sixth diseases (sudden exanthema V-6) is more frequent?
a) 1-6 mo
b) 6 - 18 mo
c) 4-5 years
86. The contraindications (temporary/constant) for immunization are not:
a) Acute febrile disease
b) Fever > 38,5
c) Anorexia
d) progressive neurological disease.

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87. Routs of transmission of ECHO and Coxsackie infection:


a) fecal-oral
b) 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 rash
c) Scarlet fever like rash
d) small rash with petechial elements
e) all above
90. Routs of transmission of nosocomial infection:
a) household
b) airborn
c) artificial
d) all above
91. Nosocomial infections can be caused by:
a) S.aureus; E.coli.
b) Herpes simplex; Ps. aeruginosa.
c) Salmonella
d) P.vulgaris
e) all above
92. Specific prophylaxis of Proteus infection is provided with:
a) live vaccine
b) killed vaccine
c) anatoxin
d) specific prophylaxis does not exist

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93. Pseudomonas aeruginosa is same as:


a) Bacilli producing "blue pus"
b) Streptococcus pyogenes
c) Staph aureus
94. Pseudomonas Infection frequently develops into diseases in the organism of:
a) Healthy person
b) Severe patients with pneumonia, intestinal infections and sepsis
c) Carriage
d) Patients with viral infections
95. For the treatment of anaphylactic reaction first drug of choice is:
a) Corticosteroids
b) Diuretics
c) Sol. Dextrose
d) Epinephrine
96. For the Pseudomonas infection drug of choice are:
a) antibiotics
b) vitamins
c) immunomodulating drugs
d) 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 water
b) with food
c) household
d) all above is correct.

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99. Vibrio cholerae evolves:


a) endo-exotoxin
b) exotoxin
c) 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) detoxication
d) corticosteroids
101. For the treatment of systemic eshcheriochiosis (E.coli sepsis) following antibiotics are
appropriate:
a) amynoglicosides
b) cephalosporins
c) semisynthetic penicillins
d) all above
102. Salmonella has:
a) exotoxin
b) endotoxin
c) exo-endotoxin
103. Salmonella endotoxin has tropism to:
a) CNS
b) Vegetative nervous system
c) to all system listed above
104. The main pathogeneses chain in cholera is:
a) Intoxication
b) 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 flora
b) dehydration does not develop, bloody diarrhea is common hardly treated with antibiotics
c) 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 blood
b) 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 drugs
c) All above
109. The source of rotavirus infection is:
a) carrier of the virus
b) 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) Antibiotics
c) Rehydration
d) Sulfonamides
113. In pathogenesis of Salmonella infection following plays role:
a) Endotoxin
b) Exotoxin
c) 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) Eshcherichiosis
b) Staph enterocolitis
c) Shigellosis
d) 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 infection
b) Vaccine is useful in case of prevention
c) No specific prophylaxis exists
117. Which of the following treatment is not needed in the case of the moderate form of
Shigellosis?
a) antibacterial therapy
b) oral rehydrtation
c) 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 products
c) food
d) water
120. Which symptoms are not typical for Shigellosis?
a) rash on the skin
b) pain in the abdomen
c) tenesmus
d) 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 correct
e) all above is not correct
125. Highlight incorrect answer. Flu is
a) highly contagious disease
b) chronic infection
c) viral infection
d) infection accompanied by general intoxication, impairment of the respiratory tract and
complications
126. The source of Influenza virus is:
a) arthropoda
b) chronic carrier
c) 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 days
d) all period of fever
128.Typical for Influenza is:
a) pandemic
b) 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 tract
b) Local morphological changes reflect inflammatory process in upper respiratory tract
c) Verusamia is followed by general intoxication
d) 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 only
b) viral and microbial usually
c) all above is correct
131. Incubation period for Influenza is:
a)1 week
b) 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 tests
c) Radioimmunological Analysis
d) Serology
134. Typical for Influenza is:
a) Abrupt initiation of symptoms
b) General intoxication from the first day of disease
c) 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 air
b) 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) -lactamases are produced only by Streptococcus family pathogens
c) There are 4 known types of -lactamases
d) -lactamases may be chromosomal and plasmid

140. What is incorrect?:


a) P. aeruginosa and cinetobacter 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
cinetobacter.
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 correct
e) 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 colonization
d) 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)
Diphtheria
Pertussis
Soft tissue infections
Chlamidiosis
Spirochete infections
b) 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) vasculitis
c) fever
d) Quincke edema
e) hives
f) Non of mentioned above
g) 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 infection
d) Age 6> months
e) Immunosuppressive therapy
149. Larynx stenosis may develop due to:
a) Allergy
b) Larynx phlegmon
c) Chemical burns
d) Foreign body
e) all above

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150. During which respiratory viral infections can develop croup?


a)Influenza
b) Parainfluenza
c) Adenoviral infection
d) All above
151. Typical for viral croup is:
a) Cough almost soundless, aphonic
b) Expiratory distress
c) Gruff voice and cough, stenotic breathing
d) all above
152. Epiglottitis is same as:
a) Bacterial inflammation of epiglottis
b) laryngotracheitis
c) laryngotracheobronchitis
d) .laryngitis
153. For uncomplicated croups treatment includes:
a) antibiotics
b) sulphonamides
c) antibiotics and sulphonamides
d) none of mentioned above
154. For viral croup effective treatment includes:
a) inhalation of the humid hot steam
b) inhalation of epinephrine and corticosteroids
c) Inhalation of broncholitics
155. For the treatment of viral croup recommended are:
a) sedation
b) steam inhalation, antihistamine drugs
c) 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) diazepam
b) steroids, epinephrine
c)antibiotics and antihistamines .
157. What may be differential diagnosis for the viral croup?:
a) Diphtheria
b) Retropharyngeal abscess
c) Foreign body
d) Epiglottitis
e) All above
158. Patient has viral croup, what are recommendations for intubation and/or rtracheostomy?
a) When inhalation of O2 does not bring relief
b) When inhalation with epinephrine is not effective
c) 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) pneumonia
b) bronchitis
c) bronchiolitis
d) Laryngitis
161. How long does immunity against parainfluenza last?
a) around 1 year
b) 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 intoxication
c) No intoxication
d) often hypertoxic appearance
164. For parainfluenza is typical:
a) Gruff cough
b) Cough with big amount of mucous
c) dry cough
d) Spasmatic attack of the cough
165. For viral croup is typical::
a) Sudden attack
b) Benign course of the diseases if the condition is treated properly
c) Non of above.
d) all above is true
166. In case of the treatment of parainfluenza recommended treatment usually includes
a) antibiotics
b) inhalation of epinephrine, corticosteroids
c) sulphonamides
d) antipiretics
e) 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 fever
b) Patients have headache, anorexia, vomiting, low grade fever, hemorrhagic rash
c) In infancy this infection may be complicated with pneumonia, aseptisc meningitis and
myocarditis.
169. The source of RS-infection are:
a) wild animals
b) human
c) domestic animals
d) all mentioned above
170. For RS-infection is typical:
a) bronchiolotis
b) pharyngitis
c) laryngitis
d) rinitis
171.Rinoviral infection is :
a) CNS infection
b) infection of Gastrointestinal tract
c) Infection of Soft tissues
d) 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) tonsillitis
c)diarrhea
d) rinorrhea and cough
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174. For treatment of rinovirus infection is recommended:


a) Antibiotics
b) Steroids
c) Antihistamines
d) Non of mentioned above
175. For fifth disease (parvovirus B19) is typical:
a) slap in the face syndrome
b) rash on the skin, lace like rash
c) all above
176. For fifth disease (parvovirus B19) treatment is recommended:
a) no specific reatment, just symptomatic
b) antiviral drugs
c) antibiotics
177. Sixth disease etiology is:
a) virus
b) bacteria
c) rickettsia.
178. Clinical features of sixth disease include:
a) Fever 39-41
b) Febrile seizures
c) Lymphadenitis
) All above.
179.Rash in Sixth disease appears usually (correct answer):
a) After the fever goes down
b) On the peak of the fever
c) 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) Henoh- Schonlein
b) Scarlet fever
c) Measles
d) Infectious Mononucleosis
182. For the sudden exanthema recommended treatment is:
a)Antipiretics
b) Antihistamins
c) Antibiotics
d) Steroids
e) rehydration
183. Can be BCG-vaccine used at the same day as other vaccine?
a) Yes
b) NO
184. Which dosage of adrenalin will be appropriate to treat anaphylactic reaction after
vaccination?:
a) 0,01 ml/kg
b) 0,1 ml/kg
c) 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 day
d) 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 birth
b) after 2 mo after birth
c) after 1 mo after birth
d) Together with DTP.
190. Which age is appropriate for the starting vaccination against Diptheria, Tetanus and
Pertussis?
) 4 mo
) right after birth
) 1,5- 2 mo
) 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 develop
d) 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 timely
c) Non is correct
d) All mentioned above is correct
193. Highlight incorrect answer:
a) UTI, pneumonia, are not at the top of the list of nosocomial infections
b) 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 years
b. Resistance in ICUs is frequent phenomenon because antibiotics are mostly used in this Units
c. Last years Vancomycin-resistant S. aureus (VRSA) became a problem for Hospitals
d. 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/v
b. Which kills pathogen and is cheap and used per os
c. 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 protein
c. Synthesis of bacterial dna/rna
d. 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 antibiotics
c. bacteria has mechanism such as efflux of antibiotics
d. Bacteria decreases permeability of the membrane for the antibiotic
e. correct a, b
f. all answers are correct
g. Nothing is correct
198. Which statement is wrong?
a 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 ICU
b. Expanded spectrum beta-lactamases (ESBL) are localized often on plasmids
c. Enterobacteriaceae, which produce ESBL are often resistant to aminoglicosydes and
fluiorocquinolones as well
d. Enterobacteriaceae, which produce Expanded Spectrum Beta-lactamase are multiresistant
e. Non is correct
f. all is correct
200. Which answer is correct:?
2 doses of Influenza vaccine is needed:
a) All children from 6 mo to 3 years
b) all patients with chronic diseases
c) all patients who received 1 dose
d) Non is correct

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