Super Final pdf

AIRDROP Exam questions for 7th semester 2K23 4TH YR

Prepared by 3rd & 4th patok students
Maeked by -Ankit Akela
 Pink marked is corrected at the last moment

1. A patient became ill sharply. Severe pain of head, frequent vomits appeared in the morning.
Temperature of body rose to 39,9°C. Adopted febrifuge, however much the state got worse. Till
the evening patient lost consciousness. Excited, sharply expressed meningeal signs. What is
most reliable diagnosis?
a) Status typhosus in typhoid fever

b) Viral meningoencephalitis

c) Sepsis, infectious-toxic shock

d) Meningococcal infection, meningitis

e) Status typhosus in epidemic typhus

2. A patient C., 25 years old, fell suddenly ill. Every morning severe headache, frequent
vomiting, temperature of the body is 39,9°C. Adopted fatigue, then state got much worse. In the
evening lost of consciousness. Expressed muscles pains of back and head. Positive Кеrning’s
symptom. Leukocytes – 18,0x109/l. What is the most reliable diagnosis?
a) Flu

b) Epidemic typhus, typhus state

c) Viral menigoencephalitis

d) Sepsis, infectious-toxic shock

e) Bacterial menigoencephalitis

3. Among the students of PTU 2 cases of generalized form of meningococcal infection are
registered. What preparation does it follow to enter to the contact persons with the purpose of
urgent prophylaxis?
a) Normal immunoglobulin

b) Leukocytic interferon

c) Meningococcal vaccine

d) Meningococcal anatoxin

e) Bacteriophage

4. Which of the following symptoms characterize of mumps?

a) Punctuate rash (sporting rash)
b) Maculopapular rash
c) Vesicular rash
d) Swelling of parotid glands
5. What clinical periods are in measles?
a) Catarrh period, rash period, pigmentation period
b) Catarrh period, convulsive period, coma
c) Rash period, catarrh period, coma
d) Catarrh period, rash period, coma

6. Indicate the pathogenesis link that distinguishes the generalized form of salmonellosis from
gastrointestinal form:
a.penetration of salmonella into the mucous membrane of the small intestine;

b. intoxication;

c.bacteremia;

d.parenchymal diffusion of the pathogen.

7. What changes in peripheral blood are characteristic of infectious mononucleosis?

a. neutrophilic leukocytosis;

b. leukopenia with relative lymphocytosis;

c. leukocytosis, lymphocytosis, monocytosis, atypical mononuclear cells;

d. leukopenia, lymphocytosis, monocytosis.

8. Patient K., 39 years old, went to the clinic with complaints of a constant headache, high body
temperature, abdominal pain; cough infrequent and unproductive. Enlarged liver and spleen.
Sick for 6 days. Specify the probable diagnosis:
A. typhus

B. influenza

C. typhoid fever

G. salmonellosis

D. pneumonia

9. Patient E., 20 years old, went to the doctor on the 5th day of illness. Concerned about fever
from the 1st day of illness, weakness, fatigue, sore throat, coughing. I took aspirin and
sulfadimezin on my own. Against this background, on the 4th day of the disease appeared
epigastric severity, nausea, a sharp decrease in appetite, dark urine. Objectively: the patient is
lethargic, pale, moderate yellowness of the sclera and mucous membranes of the oral cavity. The
liver is palpated 1 cm below the costal arch. Pulse 64 in 1 min., BP - 100/60 mm Hg He lives in a
student dormitory, in a room of 4 people. Specify the most probable diagnosis:
A. infectious mononucleosis

B. adenovirus infection

C. viral hepatitis

D. toxic hepatitis
E. toxoplasmosis

10. The main signs of a common form of diphtheria:

A. swelling of the mucous membrane of the oropharynx

B. edema of the subcutaneous tissue of the neck in the submandibular region

C. the location of fibrinous deposits on the tonsils and on the mucous membrane of the oropharynx

D. the location of fibrinous deposits on the tonsils only

E. bright hyperemia of the mucous membrane of the oropharynx

11. The main clinical sign of toxic diphtheria is:

A. Tumor spread

B. an increase in regional lymph nodes

C. edema of the subcutaneous tissue of the neck D. damage to other parts of the upper respiratory tract

E. hyperthermia

12. The finding of large, multinucleated, clumps of cells in the bronchial secretions of a 2 year
old girl with acute bronchopneumonia suggests that this infection is caused by?
a. Bordetella pertusis
b. Epstein-Barr virus
c. Mycoplasma hominis
d. Rhinovirus
e. Respiratory syncytial virus (RSV)

13. All of the following methods are the common preventive measures taken to reduce the
transmission of respiratory infections during the flu season, Except?
a) Avoiding close contact with the infected persons

b) Providing flu vaccine to only the people who have respiratory illnesses

c) Covering the face and nose while sneezing and coughing

d) Maintaining clean hygiene habits, washing hands regularly

e) Using the disinfectants and sanitizers regularly

14. Which of the following pathogen is the most common cause of "bronchiolitis" in infants?
a) Respiratory Syncytial virus

b) Herpes simplex virus

c) Coxsackievirus

d) Rhinovirus
15. The influenza virus has complicated genetics mainly characterised by which of the
following?

a) Genetic reassortment amongst 8 genes

b) High levels of recombination

c) Rapid adsorption and fusion from without via a hydrophobic peptide

d) High fidelity RNA replicase enzyme

16.Antivirals can be used prophylactically or therapeutically in persons in which of the following

circumstances?
a) If administered within 4 days of clinical signs

b) If used within 48 hours of first clinical signs

c) Used for the obese

d) Used in children under the age of 2 years where high virus spread is noted

17. The summer-autumn rise in morbidity has

a) dysentery

b) flu

c) brucellosis

`d) meningococcal infection

18. Abdominal pain in the colitic form of dysentery:

a) constant, aching nature

b) appear only after the act of defecation

c) cramping, intensified before the act of defecation

d) sharp, "dagger"

19. The main method of individual prevention of shigellosis:

a) vaccination

b) compliance with the rules of personal hygiene

c) reception of dysentery bacteriophage

d) taking antibiotics

20.The main cause of diarrhea in rotavirus infection?

1) impaired fluid absorption due to malabsorption

2) increased intestinal motility

3) increased permeability of the intestinal mucosa

4) violation of the functioning of the adenylate cyclase system-cyclic adenosine monophosphate (cAMP)

21. Stool with rotavirus diarrhea?

1) muco-bloody

2) watery, abundant, like "rice broth"

3) foamy, yellowish color

4) watery, with "green"

22. The leading method of treatment of viral diarrhea?

1) antibiotic therapy 2) rehydration 3) immunomodulatory 4) detoxification

23. Abdominal pain with rotavirus gastroenteritis?

1) diffuse, all over the abdomen, indistinct

2) cramping, lower abdomen, intense

3) intense, in the upper abdomen, of a permanent nature

4) intense, in the right iliac region, often constant

24.A group of children with a preliminary clinical diagnosis of rotavirus gastroenteritis was
hospitalized in the children's infectious diseases department of the city hospital. What is the main
laboratory diagnostic principle used in this case?
A. Detection of viral antigen in the test material.

B. Detection of specific inclusions in cells.

C. Infection of chicken embryos.

D. Isolation of virus in cell cultures with subsequent identification.

+E. Infection of laboratory animals.

25. The clinic of laryngitis is characteristic mainly for:

1) adenovirus infection

2) flu

3) rhinovirus infection

4) rubella

5) parainfluenza

26. The development of the influenza pandemic is associated with:

1) by changing the virulent properties of the pathogen
2) the spread of a new serological subtype of the A+ virus
3) changes in the age structure of the population
4) increasing migration processes
5) changing climatic conditions
27. A rash with chickenpox is characterized by:
1) stage appearance

2) its appearance on a hyperemic skin background

3) the presence of false polymorphism

4) location along the course of nerve ending

28. Chickenpox virus:

1) tropen to hepatocytes

2) can persist for a long time in human cells, mainly in the nerve ganglia

3) they are found in the nasopharynx of a healthy person

4) is not detected in the blood of a chicken pox patient

5) does not overcome the transplacental barrier

29. Changes in peripheral blood during coronavirus infection:

1) thrombocytopenia

2) erythrocytosis

3) lymphocytosis atypical mononuclears

4) eosinophilia

5) thrombocytosis

30. Rare symptoms of coronavirus infection include:

1) fever;

2) shortness of breath;

3) diarrhea.

4) the presence of a rash on the trunk

5) rashes on the lip

31.Viral pneumonia with a complicated course of 2019-nCoV develops:

1) by the end of 8 days from the moment of the disease;

2) on the 15th day from the onset of the disease;

3) on the 6th day of the disease;

4) in 1-3 days from the onset of the disease;

5) by the 10th day of the disease.

32. What symptom is the basis for prescribing antibiotic therapy for acute respiratory viral
infection?
1) fever later than the third day of the disease

2) fever in the first three days of the disease

3) cough

4) catarrhal phenomena in the nasopharynx

5) deterioration of the general condition of the patient against the background of antiviral therapy

33.A 25-year-old primigravida presents at 34/40 with a 1-day history of fevers, rash, dry cough
and coryzal symptoms. She had recently moved to the UK and was uncertain of her childhood
vaccinations. On examination her temperature is 39 °C, and a generalized maculopapular rash
which is coalescent on her trunk. Some small cervical lymph nodes are palpable bilaterally.
There are small white spots on the buccal membrane beside her molars. She has bilateral
conjunctivitis. She is concerned about the risk to her baby. What are the possible adverse effects
that she should be made aware of?
A.Cataracts

B.Hydrops fetalis

C.Intrauterine death

D.No increased risk of fetal adverse outcome

E.Sensorineural deafness

34.A 52-year-old woman developed an encephalopathy and was admitted to her local intensive
care unit. On extensive questioning of her partner, a recent travel history and the course of her
illness were elicited. She had returned from a 3-week holiday to Bali where she had been bitten
by an apparently healthy Rhesus macaque. She had been vaccinated prior to travel with the
rabies vaccine, and received two intramuscular rabies boosters after the event. 2 weeks later she
had developed localized pain, redness and vesicular skin lesions near the site of the bite,
followed by localized numbness. Ataxia and diplopia ensued, with confusion, and then coma.
What intervention could have successfully prevented her illness?
A.Amoxicillin–clavulanic acid 625 mg TDS for 7 days

B.No intervention available

C.Rabies immunoglobulin infiltrated into the bite wound

D.Valaciclovir 1 g BD for 14 days

E.Wound irrigation for 5 minutes with scrubbing

35.An 8-year-old boy was admitted to a hospital with torrential rice water diarrhea. He was from
a rural area where there had been a recent outbreak of cholera associated with contaminated
drinking water supply. What is the mechanism of action of the cholera toxin?

A. ADP ribosylation of Elongation Factor 2

B. ADP ribosylation of inhibitory G proteins

C. ADP ribosylation of stimulatory G proteins

D. Formation of cation-selective pores in cell membranes

E. Zinc-dependent hydrolysis of phosphatidylcholine

36. A woman D., 41 years, complains on diarrhea, headache, severe weakness, insomnia, dull
pain in a right iliac area. It is a 8th day of illness. At a review: Т-39,8 °C, Рs – 86/min., AP –
90/60 mm Hg. It is dictoric pulse. Skin is pale. Single roseollas are on the abdomen. Tongue is
dry, assessed by the coverings, with the imprints of teeth on a lateral surface. Soft, dulling of
percutory sound is determined in ailleocaecal area of abdomen. Hepatosplenomegaly, positive
Blumberg’s symptom, neutrophilic leukocytosis. What diagnosis is most reliable?

a) Typhoid fever

b) Paratyphoid fever

c) Apendicitis
d) Salmonellosis

37.A man of 24 years old after eating dried pickle in few hours he had nausea, vomiting, severe
abdominal pain with diarrhea and sub febrile temperature. By physical examination were noticed
the pain around the umbilical. In blood were noticed increase neutrophil count and ESR. The
stool had greenish color. Primary diagnosis?
a) Salmonellosis

b) Typhoid fever

c) Shigella

d) E.coli

38.The 18 students were admitted to the infectious hospital during 1 day. All patients had similar
symptoms: nausea, vomiting, pain in stomach with frequent watery diarrhea. 10 patients had low
BP and convulsions of the legs. All patients had curds and sour cream in café for breakfast.
a) Cholera

b) Shigellosis

c) Salmonellosis

d) Botulism

39.This infectious disease is contracted when people eat or drink water that is contaminated by
the feces or urine of an infected person. There is a sudden onset of fever, a severe headache,
nausea, anorexia, and a slow heart rate. It may also be accompanied by a hoarse cough and
constipation or diarrhea. What is it?
a) Food poisoning
b) Salmonellosis
c) Pseudotuberculosis
d) Dysentery
e) Typhoid fever
40.The reason for the formation of bacteria carrier in typhoid fever is:
a)Virulence of the pathogen

b)Relapses of the disease

c)Reduced immunity response

d)Reduction of the duration of antibiotic therapy

e)Weak reparation processes in the intestine

41 A patient during a week had risen gradually temperature, appeared headache, general
weakness, appetite decreased. He appealed to the doctor on the 8th day of disease. Physical
examination: temperature 39,5°С, he gave short answers to the questions, skin pale, coated
tongue and fuliginosus, BP is 100/60 mm Hg, pulse rates 74 in min. Meteorism, there are few
rose spots on the skin of abdomen. Hepatosplenomegaly. Constipation. What is it?
a) Typhoid fever
b) Salmonellosis
c) E.coli
d) Malaria

42. The patient of 32 years appealed to the district internist on the 5th day of disease with
complaints for severe headache, general weakness, absence of appetite, sleeplessness,
temperature increase to 39,0°С in the day of appeal for medical help. Physical examination: pale
of skin. A tongue is coated by a greyish-white raid, imprints of teeth on sides. Pulse rate 78 min,
PB 110/60 mm of Hg. Meteorism, painless. Liver enlarge on a 1,5-2 cm. Tenderness of muscles
in the ileocecal area on palpation. Constipation during 2 days. Which tests of laboratory
diagnostics do you use for the confirm Typhoid fever on this day?
a) Widal test
b) Blood culture
c) Stool culture
d) Bile culture
e) Urine culture

43. A patient 36 years had disease during 3 weeks: gradual increase of temperature, from the 2th
week of disease temperature purchased undulating character, decline of activity, headache and
insomnia. He treated at home him-self from "Cold", but treatment was ineffective, and he was
directed to the hospital. Physical examination: skin pale, adynamic, temperature 400С, fuliginous
tongue, meteorism, tenderness of muscles in the ileocecal area on palpation. Liver enlarge on 2-3
cm. Spleen was palpated. In 2 days dizziness, sonitus, melena appeared after hospitalization.
BP 70/40 mm Hg, pulse rate 120 in min, temperature sudden was decreased to norm. Which
complication of Typhoid fever developed?
a) Spleen rupture
b) Intestinal bleeding
c) Infectious-toxic shock
d) Perforation of the intestinal wall e) Recurrence of disease

44. The patient Н. 22 years was delivered to the hospital by an ambulance. His condition was
severe, adynamic, drooping eyelids. Skin pale with a cyanotic tint, tonus of skeletal muscles was
decreased, sounds hearts were muffled, extrasystolie, pulse rate 130 in min, rate of breath 28 in
min, breathing superficial. The day before he eat the canned cucumbers in food. Other family
members have clinic of the food poisoning, disorders of sight. What it is?
 a) Salmonellosis

b) Dysentery

c) Botulism

d) Meningitis

e) Encephalitis

45.The patient К. 38 years, was admitted to the hospital with complaints on headache, dizziness,
general weakness, double vision. Later joined difficulty swallowing, dryness in mouth. On the
eve patient eat the canned fungi in food. By physical examination were found: mydriasis,
anisocoria, hoarse voice, slurred speech, dyspnoea and cyanosis. During breathing, the
intercostals muscles were retracted. What emergency treatment is required for the patient?
a) Detoxification

b) Artificial ventilation

c) Antibiotics

d) Spinal puncture e) Blood transfusion

46. A woman had eaten the piece of cake, which stood on a table during few hours. The common
condition became worse in 4 hours. Spastic stomach pain, nausea with a single vomiting
appeared. Skin is pale, tongue was white covered. Temperature of body did not rise, diarrhea has
not been observed.
a) Typhoid fever

b) Salmonella infection

c) Food poisoning

d) Paratyphoid fever B

47.Patient A.30 years old came to the hospital due to acute illness. His complaints were for
chills, fever to 38.5°C, nausea, vomiting, stinking stool 7 times, without any impurities, pain in
epigastrium and in the large intestine. For 10 hours before the illness he had eaten the duck
meat, which was stay in 12 hours at room temperature.
a) Typhoid fever

b) Salmonella infection

c) Botulism

d) Cholera

48. Which of the following statements is true about Reverse transcriptase-polymerase chain
reaction (RT-PCR)?
a) Very useful for mRNA quantitation
b) Highly specific assay than serology for certain virus detection
c) Low cost and easily available
d) Helps in the identification of virus strains

49. Paroxysms in the convulsive period with whooping cough are more often observed:
1. In the morning

2. During the day

3. In the evening

4. At night

50. The first signs of mumps:

1. Pain in the temporomandibular joint

2. Dry mouth

3. Pain in the parotid salivary gland

4. Decreased appetite

51. A 31-year-old woman who was diagnosed with pelvic inflammatory disease (PID) 3 days
earlier, presents with a one-day history of right upper quadrant pain and jaundice. You suspect
that this lady has developed perihepatitis (Fitz-Hugh-Curtis syndrome). What would be the best
initial treatment for this complication of PID?
a) Antibiotics
b) Interferon
c) Laparoscopic adhesiolysis
d) Steroids

52.Thirty-eight children consumed eatables procured from a picnic party. Twenty children developed
abdominal cramps followed by vomiting and watery diarrhoea 6-10 hours after the party. The most likely
etiology for the outbreak is:
A. Rotavirus infection
B. Entero-toxigenic E. coli infection
C. Staphylococcol toxin
D. Clostridium perfringens infection

53. Paramyxoviruses have all of the following properties, except?

a) Consists of a segmented genome
b) Envelope contains glycoprotein which has fusion activity
c) Has a negative RNA genome
d) Replicate in the cytoplasm
54. Which of the following pathogens cant cause respiratory infections in humans?
a) Respiratory syncytial virus
b) Parainfluenza virus
c) Measles virus
d) Rabies virus

55. Which of the following virus is not a common pathogen found in lower respiratory tract
infections?
a) Rhinovirus
b) Metapneumovirus
c) Influenza virus
d) Respiratory syncytial virus

56. Which of the following is an example of the natural hosts of the Mumps virus?
a) Pigs
b) Bats
c) Horses
d) Humans

57. Which of the following statements is not correct about the epidemiologic features of measles?
a) More than one serotype of the virus has been identified
b) Humans are the only reservoir
c) Infection confers lifelong immunity
d) Infection can be transmitted from mother to the fetus

58. Which of the following is not the common symptom of the mumps virus?
a) Fever
b) Muscle aches
c) Swollen salivary glands
d) Skin rashes
59. Which of the following statement about measles (Rubeola) and rubella (German measles) is
false?
a) Humans are the only host for the rubella virus
b) Rubeola virus infection is characterized by maculopapular rashes
c) Rubella virus causes swelling of salivary glands
d) Rubella can cause serious birth defects in babies born to infected mothers
60. Which of the following age group have been found to be most affected by the parainfluenza
virus?
a) Teenagers
b) Babies
c) Elder people
d) School-age children
61. Which of the following statements is correct about congenital rubella syndrome?
a) Children born to unvaccinated mothers are at higher risks
b) The infected newborns usually show mild symptoms
c) Ribavirin is a very effective drug for the treatment of the infection
d) All of the above
62. Which of the following are Not the other symptoms related to measles?
a) Red and watery eyes
b) Runny nose
c) High-grade fever
d) Enlarged salivary glands
63. Each of the following statements about the measles vaccine is correct, except?
a) The vaccine was first introduced in 1963
b) It is available only in a monovalent form
c) The vaccine can be introduced to the child as early as 12 months of age
d) The vaccine contains live, attenuated virus
64.Mumps virus can primarily infect which of the following organs?
a)Salivary glands
b) Limbs
c) Eyes
d) Ears
65. The first dose of MMR vaccine and varicella vaccine (VAR) is most effective for which of
the following age group of people?
a) 12 years and older

b) 12 months to 10 years old

c) Newborn and 6 months old

d) 60 years and older

66.Which of the following viral infection is most commonly associated with the varicella virus?
a) Yellow fever

b) Gangrene

c) Tuberculosis

d) Chickenpox

67.Children infected with the measles virus may die when symptoms worsen and become
chronic. Name the common complication that occurs if the chronic infection develops in infants
and children?
a) Kidney failure

b) Liver damage

c) Encephalitis

d) Paraplegia

68.Vaccination is only an important effective preventive method for mumps. Symptoms of the
mumps usually disappear within how many days after the initial infection?
a) 1 to 2 weeks

b) 1 month

c) 2 to 5 days

d) 4 to 8 weeks

69. The following bacteria are most often associated with acute neonatal meningitis
except:
1. Escherichia coli

2. Streptococcus agalactiae

3. Neisseria meningitidis

4. Listeria monocytogenes

70.The following statement about meningococcal meningitis are true except:

a. The source of infection is mainly clinical cases
b. The disease is more common in dry and cold months of the year
c. Chemoprophylaxis of close contacts of cases is recommended
d. The vaccines are not effective in children below 2 years of age
71.Xavier and Yogender stay in the same hostel of the same university, Zavier develops infection due to
group B meningococcus. After few days Yogender develops infection due to Group – C meningococcus.
Al the following are true statement except:
a.Educate students about meningococcal trans-mission and take preventive measures
b.Chemoprophylaxis to all against both group B and group C
c.Vaccine prophylaxis of contacts of Xavier
d.Vaccine prophylaxis of contacts of Yogendra

72. Which of the following is true regarding Neisseria meningitidis infection?

a) It is the most common cause of meningitis in children

b) All strains are uniformly sensitive to sulfonamides

c) In children less than 2 years the vaccine is not effective

d) In India, serotype B is the most common cause

In book of mci self assisment both a and c option is correct , mark answer wisely
73. Diagnostic criteria of acquired rubella?

a) pronounced signs of intoxication

b) pronounced catarrhal phenomena from the upper respiratory tract

c) fine-spotted rash with predominant localization - face, extensor surfaces of limbs, buttocks

d) Fever, tachycardia, coma

74. Nonspecific prevention of rubella includes:

a) identification and isolation of contacts with the patient for 21 days from the moment of separation

b) isolation of parents and children for 10 days at home

c) final disinfection

d) administration of gamma globulin to contact persons

75.The main clinical manifestations of the localized filmy form of oropharyngeal

diphtheria:

a) inspiratory dyspnea

b) barking cough

c) filmy patches of whitish-gray color on the tonsils

d) swelling of the subcutaneous cervical tissue

76. The group of lymph nodes that increases with infectious mononucleosis primarily?

a) axillary

b) inguinal

c) posterior neck

d) Internal

77. Upon contact with a patient with meningococcal infection in the family, the
following is carried out:

a) hospitalization of children of this family

b) double bacteriological examination of family members

c) single bacteriological examination of family members

d) vaccination for the whole family

78. To reliably confirm the diagnosis of meningococcal meningitis, it is necessary:

1. Oropharyngeal and nasal smear for meningococcus

2. Sowing blood for meningococcus

3. Bacterioscopy of a thick drop of blood

4. Bacterioscopy of the cerebrospinal fluid

5. Sowing liquor for meningococcus

79. The main link in the pathogenesis of diphtheria:

1. Exposure to Corynebacteria

2. Exposure to exotoxin

3. Sensitization of the patient's body

4. allergic reaction

80. The main cause of death of patients with fulminant forms of diphtheria:
1. Myocarditis

2. Paralysis of the respiratory muscles

3. Paresis of laryngeal muscles

4. Infectious and toxic shock

81. The most frequent residual phenomenon of meningococcal meningitis in children:

1. Hydrocephalus

2. Paresis of cranial nerves

3. Cardiovascular disorders

4. Asthenic syndrome

5. Hormonal disorders

82. The most common cause of croup in children:

1. The flu virus

2. Parainfluenza virus

3. Adenovirus

4. Mycoplasma

5. Streptococcus

83. The main cause of bronchiolitis in children of the 1st half of life:
1. Pneumocysts

2. Parainfluenza virus

3. Respiratory syncytial virus

4. Staphylococcus

5. Mycoplasma

84. Early complications of scarlet fever:

1. Otitis media, sinusitis, lymphadenitis

2. Purulent arthritis

3. Jade

4. Myocarditis

85. Indication for hospitalization for chickenpox:

1) all patients with chickenpox
2) adolescence

3) patients with mild forms of the disease

4) the presence of complications

86. With chickenpox meningoencephalitis in the cerebrospinal fluid?

1) neutrophil cytosis

2) lymphocytic cytosis

3) protein-cell dissociation

4) high sugar content

87. Antibiotics for chickenpox are prescribed:

1) all patients

2) with mixed infection: chickenpox + purulent complications

3) persons with immunodeficiency

4) children with a body weight deficit of more than 25%

88. In what cases can chickenpox in a newborn occur in a mild form?

1) in the presence of immunity received from the mother

2) if the child received acyclovir, zovirax preparations shortly before infection with chickenpox

3) if the mother did not have chickenpox

4) if he is born from twins

89. The source of infection in chickenpox can be:

1) a patient with a typical form of herpetic stomatitis

2) a patient with shingles

3) contact for chickenpox, on the first day of contact.

4) a patient with herpetic encephalitis

90. The differential diagnosis of scarlet fever should mainly be carried out with:
1) measles

2) pseudotuberculosis

3) enterovirus infection
4) infectious mononucleosis

91. Herpes zoster infections are characterized by rashes:

1) in the course of sensitive nerves

2) on the scalp

3) evenly over the whole body

4) on the hips and buttocks

92. Development of acute systemic illness due to the virulent microorganism invasion to the
blood stream from foci:
a) Septicemia

b) Bacteremia c) Sepsis

d) Viremia

93.Increasing resistance of immune system due to injection of killed or live microbe:

a)Immunization

b)Vaccination

c)Immune sera

d)Globulins

94.E. coli and other species of bacteria found in human intestines help him body do what?
a)Break down fats

b)Make vitamin K and B-complex vitamins

c) Absorb oxygen

d) Move waste material through the intestines

95.E.coli and other intestinal bacteria have what kind of relationship with human?
a) Parasitic

d) Paratyphoid fever B

b) Symbiotic

c) Nosotropic

d) Synergistic

96.Which infectious agent often associated with chronic pyelonephritis?

a) Proteus vulgaris
 b) Klebsiella pneumonia

c)Escherichia coli

d) Staphylococcus aureus

97.Choose the correct statement about Enterotoxigenic E.coli:

a) Is a common cause of traveler’s diarrhoea and hemolytic-uremic syndrome

b) Do cause the disease like Shigellosis

c) Pathogen spreads from animals

d) Often cause urinary tract infection

e) For development disease requires production of both toxins and pilin adhesions

98.Student, 22 years old fell ill within a month after return from Ethiopia.Dull stomach-ache
appeared and liquid emptying. Emptying is abundant up to 10 times a day, as “raspberry jelly”
excrement, stomach-ache that increase during defecation. In times of illness lost 6 kg of body
weight. Your diagnosis will be?
a) Intestinal amoebiosis

b) Shigellosis

c) Salmonellosis

d) Tumor of intestine

e) Intestinal echeriosis

99.A 24 years old engineer from Bishkek, has spent one month in India where he drunk unboiled
water. After arriving home he has become ill. He appeared to the doctor with complaints of
fever, weakness, pain in stomach, diarrhea - 12-15 times a day with mucous and blood (like
raspberry jelly stool). Physical examination: the state is relatively satisfactory, appetite became
worse, tongue is coated with white patches. On deep palpation of abdomen patient complaints of
pain especially in his right half and hypochodrium area. Liver and spleen are not changed. No
change was found in blood analysis. On rectoscopy clear mucous and hyperemia of mucous
membrane in rectum with ulceration in sigmoid colon were found. The stool test gave the growth
of pathogenic flora. What most probable pathology which predetermines such picture?
a) Strongyloidosis

b) Amebiasis

c) Ulcerative colitis

d) Balantidiasis

e) Food poisoning

100.To prevent diarrhoea, a vaccine is available against:

A. Adenovirus

B. Rotavirus

C. Enterovirus
 D.ECHO

101.Loperamide is not recommended in children below the age of:

A. 6 years

B. 8 years

C. 12 years

D.15 years

102. The most common site for amoebiasis is:

(a) Cecum

(b) Sigmoid colon

(c) Transverse colon

(d) Hepatic flexure

103. Choose the incorrect statement about amoebiasis:

(a) Causes dysentery

(b) Parasite of the small intestine

(c) Houseflies are mechanical carriers

(d) Symptoms include constipation, abdominal pain and cramp.

104. The bloody dysentery epidemics occurred in different parts of India during the 1980s.
Name the predominant pathogen identified during the dysentery outbreaks in India in the 2000s?
a) Shigella dysentery type 1

b) Shigella boydii

c) Shigella dysentery type 3

d) Shigella sonnei

105.Salmonella typhi and S.paratyphii are the two major pathogens that cause enteric fever.
Which of the following are Not the possible specimen taken for the routine diagnosis of the
disease?
a) Blood

b) Sputum

c) Feces

d) Urine

106. Which of the following culture media is not the selective media most commonly used for
the isolationof salmonellae and shigellae?
a)Deoxycholatcitrate-agar
b)Xylose-lysine-decarboxylaseagar
c)Salmonella–Shigella-agar
d) Potato dextrose agar

107.Which of the following Shigellaspp produces a heat-labile exotoxin that can affect both the
gut and central nervous system resulting in diarrhea and meningismus?
a)Shigella-sonnie
b)Shigella-dysenteriae type 1
c)Shigella-dysenteriae type 2
d) Shigella dysenteriae type 3

108.The rotavirus is an important cause of which of the following?

a) Respiratory infection in adults

b) Gastroenteritis in children

c) Diarrhoea and vomiting in adults

d) Cancer

109.How are rotaviruses predominately identified from clinical samples?

a) Electron microscopy

b) PT PCR

c) Antibody tests

d) Laboratory diagnosis not required

110. An 18-month-old boy presented with 4 days of sudden onset, severe watery diarrhea,
after 2 days of being nonspecifically unwell. He was passing stool approximately 15 times/day.
He had vomited for one day, but this then stopped. There was no blood in the stool. He was also
noted to have a dry cough and appeared to have coryzal symptoms. He had not had a wet nappy
for hours. He had stopped breast feeding at 12 months old.Onexamination, he was markedly
dehydrated, with a temperature of 38.5 °C and tachycardia. He required aggressive fluid
resuscitation. In addition to intravenous fluids or oral rehydration solutions, what agent would
improve his outcome?
A.Ascorbic acid

B. Cholecalciferol

C. Magnesium

D. Thiamine

E. Zinc

111.A 25-year-old primigravida presents at 34/40 with a 1-day history of fevers, rash, dry cough
and coryzal symptoms. She had recently moved to the UK and was uncertain of her childhood
vaccinations. On examination her temperature is 39 °C, and a generalized maculopapular rash
which is coalescent on her trunk. Some small cervical lymph nodes are palpable bilaterally.
There are small white spots on the buccal membrane beside her molars. She has bilateral
conjunctivitis. She is concerned about the risk to her baby. What are the possible adverse effects
that she should be made aware of?
A. Cataracts
B. Hydrops fetalis
 C. Intrauterine death
D. No increased risk of fetal adverse outcome
E. Sensorineural deafness

112.An 11-month-old boy developed a high fever. This was associated with malaise, irritability
and poor feeding. After 48 hours he developed a macular rash along his arms and legs. There
was extensive confluent blistering of the perineum, but otherwise the trunk and back were
spared. There were no lesions on his scalp. There were a number of perioral lesions, but no
lesions visible inside the mouth. Some of the lesions progressed into thin-walled vesicles
containing clear fluid. There were macules on the soles of his feet. The fever resolved 24 hours
after the rash appeared. The rash took 10 days to clear, but left no scars. 3 weeks later the skin on
his feet began to desquamate. He attended a nursery for 3 days a week. He had had his
vaccinations as per the UK schedule for his age. He had been born at full term and was meeting
his developmental milestones. He lived at home with two older siblings.
What is the most likely pathogen?
A. Adenovirus
B. Coxsackievirus A6
C. Echovirus
D. Herpes simplex virus 1
E. Varicella zoster virus

113.A 10-week-old infant was admitted to the pediatric intensive care unit with severe
bronchopneumonia requiring intubation and ventilation. She suffered repeated apneic attacks.
She had been born at full term by normal vaginal delivery, with no instrumentation. Her APGAR
scores had been 8 and 9 at 1 and 5 minutes respectively. She had received her 8-week
immunizations with DTaP/IPV/HiB, PCV, meningococcal B and rotavirus vaccines 1 week
before she became unwell. She lived at home with her parents, grandmother and two older
siblings. Initial investigations revealed a lymphocytosis. What microbiological findings would be
most consistent with this infection?
A. Bisected pearl colonies on charcoal cephalexin agar
B. Blue–grey colonies on Thayer Martin agar with vancomycin, colistin, nystatin
C. Grey colonies on Hoyle's agar with potassium tellurite
D. Colonies on buffered charcoal yeast extract agar with L cysteine which fluoresce yellow–
green under UV light
E. Growth around combined X+V disc only on nutrient agar

114. The influenza virus has complicated genetics mainly characterised by which of the
following?
a) Genetic reassortment amongst 8 genes

b) High levels of recombination

c) Rapid adsorption and fusion from without via a hydrophobic peptide

d) High fidelity RNA replicase enzyme

115. Antivirals can be used prophylactically or therapeutically in persons in which of the

following circumstances?
a) If administered within 4 days of clinical signs
b) If used within 48 hours of first clinical signs

c) Used for the obese

d) Used in children under the age of 2 years where high virus spread is noted

116. There are 57 serotypes of adenovirus currently recognised. Which has the most important
clinical impact?
a) Diarrhoea

b) Eye infections

c) Respiratory tract infections

d) Haemorrhagic cystitis

117.Treatment for bronchiolitis in a one year old, can include:

(a) Ribuvirin

(b) dexamethazone

(c) salbutamol

(d) antibiotics

118.In a three year old with stridor, the causes could include:
(a) croup, epiglottitis, asthma, retropharyngeal abscess, foreign body,

(b) epiglottitis, foreign body, trauma, asthma, retropharyngeal abscess

(c) trauma, croup, retropharyngeal abscess, foreign body

(d) asthma, croup, bronchiolitis, trauma

119.A 3-year-old male patient presented with sore throat, dry cough, shortness of breath and
fever beginning one week ago.Patient coughed continuously, each episode cough had lasted 5
to10 minutes, after coughing, patient had little white sputum and then stopping cough.
Respiratory rate 26. What confirmatory diagnosis will you suggest to this patient?
A.Completebloodcount
B.PCR
C.ELISA
D. None

120. A three-week-old previously healthy term baby girl was taken to the local GP with a one-
weekhistory of coughing and post-tussive vomiting. Numerous episodes of central cyanosis
andassociated lethargy and respiratory distress had occurred after the coughing fits. Whilst at the
GPshe had a further episode of respiratory distress post coughing that required facial oxygen
andtactile stimulation to recover. The day after her admission to hospital she experienced a
cardiac arrest secondary tohypoxia and apnoeas following an extensive coughing episode. She
was intubated and ventilated fora period of nine days and with a total hospital stay of 14 days.
What is the most appropriate pharmacological management for this case?
A.five-daуcourseofAzithromycin.
B.14dayscourseofTMX-SFX.
C.7DayscourseofClarithromycin.
D. 7-14 Days course of Erythromycin.

121. A mother, has brought her 10-month-old infant into the hospital. She mentions that the baby
has been unwell for several weeks, starting with what she thought was a cold, with a runny nose
and dry cough. However, in the past two weeks, a more definite cough has developed, and the
baby has had to be kept home from Day-care. When checking the baby’s history, you notice that
he has not received his standard childhood immunisations. When you mention this to the Mum,
she states that she is very “anti-vaccination due to all the toxic products that are included in
vaccines today”. What is time schedule of Pertussis vaccines in children?
A.1,2,3months
B.3,6,9month
C.2,4,6months
D. None

122. The patient was a 52-week-old male with a 10-day history of choking spells. The child's
spells began with repetitive coughing and progressed to his turning red and gasping for breath. In
the prior 2 days, he also had three episodes of vomiting in association with his choking spells.
His physical examination was significant for a pulse of 160 beats per min and respiratory rate of
72/min (both highly elevated). The child's chest radiograph was 15,500/Fl with 7-%
lymphocytes. What was the organism infecting this child?
A.B.Pertussis
BS.Pneumoniae
C.BothA&B
D.None
123. What is incubation period of pertussis?
A. 3-12 days

B. 2-3 days

C. 2 weeks

D. 1-5 days

124. A 4 yr old child , came with the complaints of coughing, sneezing, fever, lacrimation and he
has a classic spasm( paroxyms) of uncontrolled cough. Which of the following organisms is the
causative agent of the disease.
A. bordetella pertussis

B. bordetella para pertussis

C. hemophilus influenzae

D.adenovirus

125. 14-month-old male was admitted to hospital for a systemic disease which has been
showing some pulmonary complications and was confused with whooping cough. Later it was
realised that, this disease is related to CFTCR gene abnormality and is considered as differential
diagnosis of Whooping cough?
A.Cysticfibrosis
B.Pneumonia
C.Lunabscess
D. None

126. Children <2 years of age who were hospitalized with pertussis have shown a report of 27%
of a single complication of whooping cough. Which of the complication is most predominant in
case if whooping Cough?
A.Seizures
B.Encephalopathy
C.Apnea
D. Pneumonia

127. Your relative called you about their son having a consistent cough and increased
lacrimation for past 3 days and it was in episode of 5-10 mins. Their Child gasps for air
sometimes and local primary health care centre had diagnosed it as whooping cough. They are
seeking a right guidance from you, what will be your first advice?
A.Startmedications
B.Rusomemorelaboratorydiagnostics
C.Hospitalise
D. Let disease settle down itself

128. Most common complication of parapertussis in infant is:

a) Encephalopathy

b) Seizures

c) Epistaxis

d) Bronchopneumonia

129. Booster dose of parapertusis vaccine given at:

b)18-24 months

c) 24-36 months

d) None of the above

130. Parapertusis vaccine contraindicated in:

a) Epilepsy

b) Liver disease

c) Congenital heart disease

d) Worm infestation
131. A 2 year old immunized girl from hilly tribal area develop keratomalacia after a viral
infection which would have lead to development of the keratomalacia ?
a) Rubella

b)varicella

c) mumps

d) rubeola

132. Which of the following methods can be used to detect the rubella infection in the children.
a) T4 cell count

b)fetalhaemoglobin

c)IgM antibody in fetal blood

d)IgA antibody in fetal blood

133.A 3 months old child develop the complaints like cough dyspnoea Preauricular
lymphadenopathy was notice and low grade fever for 2- 3 days and maculopapular rash as
given in the picture .The diagnostic manifestation described that IgM level is increased and CSF
is also slightly increased what is possible infection that has raised to the child?
a) mumps

b) rubella

c) rubeola

d) infectious mononucleosis

134. A young boy Arush is brought to the OPD with a sore throat and a rash for past two days.
The rash started around the neck and then spread to the trunk and extreme ties. On examination
rash blanches on pressure. Tongue examination shows swollen papillae. Which of the following
toxin is responsible for this child's condition?
a) pyogenic exotoxin

b) Exfoliotoxin

c) enterotoxin

d) Panton valentine leukocidin

135. Which of the following is/are true about Varicella (chickenpox):

a) Pregnant women appear to be at greatest risk of severe disease late in the second

b) It may be acquired from people with shingles

c) It has a secondary infection rate of up to 90% in household contacts

d) Smoking is not a risk factor for severe disease or early in the third trimester
136. The risk to the foetus if the mother develops chickenpox in pregnancy:
a) Is 10% for congenital varicella syndrome up to 12 weeks

b) Is of herpes zoster in the second and third trimesters

c) is a 1 in 50 chance for the baby to develop a set of birth defects

d) Is substantially lower of congenital varicella syndrome after 20 weeks of pregnancy

137. Varicella vaccines:

a) Are live attenuated vaccines

b) Provide 98% protection against clinical chickenpox in children with a 2-doseschedule

c) Carry a high risk of transmission of chickenpox to close contacts of vaccines

d) Provide 90% protection against clinical chickenpox in adults a 2-dose schedule

138. Varicella zoster immunoglobulin:

a) Is prepared from pooled plasma from UK donors

b) Is recommended for at risk persons in contact with immunocompetent individuals with ophthalmic
shingles

c) Is recommended for those in a risk group with significant exposure even if they have detectable
varicella zoster antibodies

e) Is recommended for at risk persons exposed up to 5 days before the appearance of the chickenpox
rash

139. Varicella vaccine should not be given to:

a) Immunosuppressed patients

b) Pregnant women

c) Those with a confirmed anaphylactic reaction to neomycin or gelatine

d) Women who are breast feeding

e) Non-immune contacts within 3 days of exposure

140. Anu a preschool student presented with a fever and sore throat. she also had an acute onset
generalised erythematous rash with pastia lines over the antecubital fossa what is the most likely
diagnosis?
a) scarlet fever

b) ritter’s disease

c) kawasaki disease

d) urticaria pigmento
141. What is the first line treatment for scarlet fever?
a) penicillin

b) amoxicillin/ clavulanate

c) gentamicin

d) metronidazole

142. A 7 years old with a sore throat, fever, vomiting, headache and a rash is brought into the
office. the exam shows grey-white exudates on hyperemic tonsils and the entire pharynx is
erythematous. there is a papular , erythematous rash over the groin, axillae, and the cubital fossae
and is starting on the trunk. which of the following is the most likely diagnosis?
a) scarlet fever

b) measles

c) Enteroviral exanthem

d) kawasaki disease

143. Which of the following are characteristic symptoms of scarlet fever?

a) red rash, fever, and sore throat

b) excessive urination.,increased thirst and exhaustion

c) increased heart rate, low blood pressure and hyperventilating

d) heart failure, trouble breathing

144. Scarlet fever is most common in children aged __ years.

a) 2-10 years

b) above 16 year

c) both a and b correct

d) none of the above

145. Scarlet fever is often a complication of what comman ailment?

a) strep throat

b) measles

c) common cold

d) conjuctivitis

146. A child presents with a sore throat and fever. A rapid strep is positive and you begin
treatment she returns with an erythematous finely punctate rash beginning on the upper chest and
spreading to the entire body. red lines are seen in the skin folds of the neck, axillae, elbows,
groin and knees what is the most likely diagnosis?
a) scarlet fever

b) lyme disease

c) mononucleosis

d) secondary syphillis

147. Which of the following is the most common complication of mumps in children?
a). Orchitis

b). Conjunctivitis

c). Meningoencephalitis

d). Myocarditis

148. A 15-year-old patient presents with pyrexia, sore throat and bilateral parotitis. However, on
palpation of the parotids the saliva is clear, and there is no xerostomia. What is your most likely
diagnosis?
a) Measles

b) Mumps

c) Bacterial parotitis

d) Cytomegalovirus

149.Which of the following symptoms is more evident in children older than 1 year having
meningococcal infections?
a) Neck and back pain

b) Splotchy rash

c) Bulging fontanel

d) Malaise

150. Which of the following symptoms is evident of meningococcal infections in infants ?

a) Splotchy rash

b) Neck stiffness

c) Bulging fontanel

d) Nausea and vomiting

151. Which children are not at risk for meningococcal infections?

a) Low birth weight child

b) Normal birth weight child

c) Complement deficiency
d) Children who are not meningococcal vaccinated

152. Meningococcal conjugate vaccine (MenACWY) should be given to children aged between ?
a) 11-18 years

b) 2-3 years

c) 16-23years

d) 4-10 years

153. MenB vaccine should be given to children aged between?

a) 11-18 years

b) 4-10 years

c) 8-13 years

d)16-23 years

154. Disseminated intravascular coagulation is caused by:

a) Meningitis

b) Meningococcal pneumonia

c) Meningococcemia

d) None of the above

155. Which of the following differentiate meningococcus from gonococcus?

a) it is oxidase positive

b) it fermentes glucose

c) it fermentes maltose

d) it reduces nitrates

156. Which pathogen is the most common bacterial cause of meningitis?

a) pseudomonas aeriginosa

b) staphylococcal epidermis

c) enterobacteraerogens

d) streptococcus pneumonia

157. What is a not initial symptom of scarlet fever:

A. increase temperature

B. vomiting
C. bowel dysfunction

D. headache

158. Olga 3 years rose to 37,80С, cough, conjunctivitis, on the 5th day of the disease rose to 40
0
С and a rash behind the ears and on the face. Your diagnosis:
A. adenoviral infection

B. rubella

C. measles

D. Enterovirus rash

159. Indicator of severe pertussis is:

A. short bouts of coughing

B. long, frequent bouts of coughing

C. rhinitis

D. satisfactory general condition of the child

160. The differential diagnosis of glandular form of mumps infections are often carried out with:
A. suppurative parotitis

B. chickenpox

C. scarlet fever

D. measles

161. The features of mumps virus etiology of purulent parotitis:

A. skin over the surface of the parotid gland is snug but normal color

B. skin over the affected gland hyperemic

C. skin over gland hot to the touch

D. determined fluctuation

162. Symptom what distinguishes adenovirus infection from measles catarrhal period:
A. rise in body temperature

B. eyelid edema and conjunctivitis

C. puffy face

D. Filatov- Koplik spots

163. Choose clinical signs of the syndrome of croup:
A. aphonia

B. inspiratory dyspnea

C. cough

D. expiratory dyspnea

164. Specify the features characteristic of the syndrome of croup with ARI from diphtheria
croup:
A. aphonia

B. vomiting

C. catarrhal phenomena

D. rough barking cough

165.What type of E. coli is clinically similar to dysentery?

A. Enteropathogenic Escherichia coli
B. Enteroinvasive Escherichia coli
C. Enterotoxigenic Escherichia coli
D. Enterohemorrhagic Escherichia coli

166.A patient during a week had risen gradually temperature, appeared headache, general
weakness, appetite decreased. He appealed to the doctor on the 8th day of disease. Physical
examination: temperature 39,5°С, he gave short answers to the questions, skin pale, coated
tongue and fuliginosus, BP is 100/60 mm Hg, pulse rates 74 in min. Meteorism, there are few
rose spots on the skin of abdomen. Hepatosplenomegaly. Constipation. What is it?
a) Typhoid fever
b) Salmonellosis
c) E.coli
d) Malaria

167.The patient Н. 22 years was delivered to the hospital by an ambulance. His condition was
severe, adynamic, drooping eyelids. Skin pale with a cyanotic tint, tonus of skeletal muscles was
decreased, sounds hearts were muffled, extrasystolie, pulse rate 130 in min, rate of breath 28 in
min, breathing superficial. The day before he eat the canned cucumbers in food. Other family
members have clinic of the food poisoning, disorders of sight. What it is?
a) Salmonellosis

b) Dysentery

c) Botulism

d) Meningitis

e) Encephalitis

168.The patient К. 38 years, was admitted to the hospital with complaints on headache,
dizziness, general weakness, double vision. Later joined difficulty swallowing, dryness in mouth.
On the eve patient eat the canned fungi in food. By physical examination were found: mydriasis,
anisocoria, hoarse voice, slurred speech, dyspnoea and cyanosis. During breathing, the
intercostals muscles were retracted. What emergency treatment is required for the patient?
a) Detoxification

b) Artificial ventilation

c) Antibiotics

d) Spinal puncture e) Blood transfusion

169.This is an acute intestinal infection caused by a bacterium. Its incubation period is typically
1-5 days. Symptoms include an excessive, painless watery diarrhea and usually vomiting. There
may also be leg cramps. Severe dehydration and death can occur if not treated promptly. What is
it?
a) Food poisoning
b) Shigellosis
c) Cholera
d) Salmonella infection
e) Typhoid fever

170.Sick P., 25 years old, presents with frequent vomitting. Objectively: dryness of skin and
mucous membranes, brief cramps in gastrocnemius muscles, the temperature of body is normal,
voice is hoarsed, moderate tachycardia and hypotension. The compensated metabolic acidosis is
marked. About what degree of dehydration is it possible to think?
a) IV

b) II

c) III

d) I

e) There is no dehydration

171.Which one of the following virus cause hemorrhagic cystitis, diarrhea and conjunctivitis:
a) Adenovirus

b) Rotavirus

c) RSV

d) Rhinovirus

172.Patient L., 18 years old is sick with fever till 38 °C which proceeds 5 days. He has moderate
dry cough, common cold, badly opens eyes. On examination: edema on face, expressed
conjunctivitis with film raids. Mucous of pharynx is hyperemic, posterior wall of pharynx is
grainy. Internal organs are without pathology. What form of disease does the described picture
correspond to?
a) Viral conjunctivitis

b) Allergic dermatitis

c) Adenoviral infection
 d) Influenza

e) Rhinoviral infection

173.Which of the following antiviral effective at Rhinovirus infections intranasally:

a) Pleconaril

b) Interferon - alpha

c) Desloratadine

d) Ioratadine

174.Primary infection of Rhinovirus occurs in:

a) Conjunctiva

b) Nasopharynx

c) Nasal mucosa

d) Mouth

175.Where did the drug binds in VP1 for stabilizing protein capsid:
a) Amphipathic compound

b) Hydrophilic pocket

c) Hydrophobic pocket d) Lipophilic

176.Severe lower respiratory tract illness is seen in Rhinovirus as:

a) Bronchiolitis, pneumonia

b) Pneumonia, TB

c) Bronchiolitis, back pain d) Asthma and pneumonia

177.Most common organism which can contaminate crowded army camps:

a) Kleibsella

b) E.coli

c) Neisseria meningitides d) Staphylococcus

178.A 30years old man bought to emergency room with a 10hr history of a fever headache and
lethargy. Physical examination reveals very sick man, temp 39.5°C and petechial rash. The most
likely diagnosis is:
a) Urinary tract infection

b) Upper respiratory tract infection

c) Meningococcemia

d) Pneumonia

e) Migraine
179.In case of fulminant meningococcal infection is develops:
a) Brown Sequard syndrome

b) Wolf Parkinson White syndrome

c) Waterhouse Friderichsen syndrome

d) Lambert Eaton syndrome

180.Which main complication does not occur in Meningoencephalitis:

a) Hearing loss

b) Epilepsy

c) Loss of limbs amputation&vision loss

d) Left heart failure

181.Cytolysis of liver cells reflects the following biochemical tests for viral hepatitis:
a) Cholesterol

b) The level of total protein and protein fractions

of blood

c) The level of alanine aminotransferase and asparaginaminotransferazy

d)Thymol test

182.What are enzymes reflect cholestasis in viral hepatitis?

a) AlT

b) AsT

c) Cyclic amine phosphates

d) Alkaline phosphatase

183.Specify the typical changes in bilirubin and its fractions in viral hepatitis:
a) Direct bilirubin increase

b) Direct and indirect bilirubin increase

c) Indirect bilirubin increase

d) Direct bilirubin increase at moderately elevated indirect bilirubin

184.Which of the listed variants of the pre-icteric period is not characteristic for viral hepatitis A:
a) Arthralgic

b) Dyspeptic c) Catarrhal

d) Asthenic-vegetative e) Mixed
185.What changes in biochemical parameters are most characteristic for the anicteric form of
viral hepatitis A:
a) Hyperbilirubinemia

b) Increased transaminase levels

c) Increase in alkaline phosphatase d) Increased cholesterol

186.How many days the infectious period at measles?

a) 3-5 days
b) 1-2 days
c) 10 days d) 14 days

187.Which combination of symptoms is characteristic of cholera:

a. watery stools, absence of abdominal pains, nausea;

b. nausea, vomiting;

c. watery fetid stool;

d. greenish stool, diffuse abdominal pain.

188. The generalized form of salmonellosis from the localized one is distinguished by
symptoms:
a. vomiting;

b. abdominal pain;

c.loose stools;

d.hepatosplenomegaly.

189. What clinical symptoms are characteristic of a gastrointestinal form of salmonellosis?

a. nausea, vomiting, loose watery stools of a greenish color, diffuse abdominal pain, high fever;

b. vomiting without nausea, without abdominal pain, normal temperature;

c. cramping abdominal pains, scanty stools, high temperature;

d) abundant watery stools such as “rich broth” without abdominal pain, normal temperature.

190. Specify typical changes in the level of bilirubin and its fractions with viral hepatitis:
a. increase in the bound fraction;

b. an increase in the bound and free fractions to the same extent;

c. increase in free fraction;

d. an increase in the bound fraction with a moderate increase in free bilirubin.

191. What symptom of typhoid fever is absent in the first week of illness?
a. high temperature;

b. headache;

c. roseola rash;

d. weakness.

192. What combination of symptoms is characteristic for the onset of meningococcal meningitis?
a. gradual onset, headache, vomiting, loose stools; b. rapid fever, headache, vomiting without
abdominal pain;

c. high fever, vomiting, abdominal pain;

d high fever, headache, visual impairment.

193. The kindergarten teacher, 22 years old, has high fever, enlarged painful occipital lymph
nodes, a small spotty pink rash on the skin, plentiful, without a tendency to thicken, evenly
covers all areas of the skin, joint pain. Sick 2nd day. The condition is satisfactory. Specify the
most probable diagnosis:
A. measles

B. rubella

C. infectious mononucleosis

D. pseudotuberculosis

D. typhus

194. The main signs of a common form of diphtheria:

A. swelling of the mucous membrane of the oropharynx

B. edema of the subcutaneous tissue of the neck in the submandibular region

C. the location of fibrinous deposits on the tonsils and on the mucous membrane of the oropharynx

D. the location of fibrinous deposits on the tonsils only

E. bright hyperemia of the mucous membrane of the oropharynx

195. The main clinical sign of toxic diphtheria is:

A. Tumor spread

B. an increase in regional lymph nodes

C. edema of the subcutaneous tissue of the neck D. damage to other parts of the upper respiratory tract

E. hyperthermia

196. Which of the following disease are notifiable to WHO in Geneva under the International
Health Regulations:
A. Plague, polio and malaria

B. Cholera, influenza and yellow fever

C. Cholera, plague and polio

D. Cholera, plague and yellow fever

197. Typical features of botulism include:

a. circumoral parasthaesia
b. extensor plantars
c. diarrhoea
d. fever
e. post-tetanic potentiation on EMG (electromyography)

198. The finding of large, multinucleated, clumps of cells in the bronchial secretions of a 2 year
old girl with acute bronchopneumonia suggests that this infection is caused by:
a. Bordetella pertusis
b. Epstein-Barr virus
c. Mycoplasma hominis
d. Rhinovirus
e. Respiratory syncytial virus (RSV)

199. The most likely surgical emergency in infectious mononucleosis (IM) is:
A. Suppurative tonsillitis

B. Spinal abscess and cord compression

C. Catastrophic gastrointestinal bleed

D. Spontaneous rupture of spleen

200. A 22 year old female presents with a history of fever, A seventh nerve palsy, and cervical
lymphadenopathy. Additionally, she has a morbilliform rash that presented after a single dose of
Augmentin. She now has a seventh nerve palsy and worsening urinary incontinence. An IgM for
Infectious Mononucleosis is negative on two occasions 2 weeks apart. Her likeliest diagnosis is:
A. Infectious mononucleosis
B. T-cell lymphoma
C. Transverse myelitis
D. D. Staphylococcal shock syndrome

201. A 54-year old with a history of recurrent gut infections has grown Shigella and
campylobacter repeatedly in a background of dermatomyositis and is on azathioprine
maintenance. His best Investigation would be:
A. Muscle biopsy and myonecrosis
B. Bone marrow for aplastic anemia
C. Colonoscopy for colon cancer
D. D. HLA-DR link association for muscle atroph
202. A 47 year old man with alcoholic liver cirrhosis and ascites is admitted to hospital .He is
febrile with abdominal pain and delirium. Routine blood test show increased (wbc)and C-
reactive protein(CRP)WITH normal electrocyteand renal function.An ascites tap shows
500WBCs/µL and organisms visible on microscopy.what is the most likely organism?
A. Klebsiella pneumoniae

B. Escherichia coli

C. Enterobacteriaceae D. Streptococcus pneumoniae

E. Staphylococcus aureus

Answer: B
203. Which of the following is the most common organism isolated in SBP?
GRAM -VE ENTERIC ORGANISMS (E.COLI, KLEBESIELLA PNEUMONIAE)

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