c)Listeriosis, meningeal form, moderate severity+.

c)Listeriosis, meningeal form, moderate severity+.

d)Listeriosis, ocular-glandular form, of moderate severity.

e)Listeriosis, anginous-septic form, moderate severity.

23. The teenager is 16 years old, studying at the lyceum, where acute respiratory infections were registered. The disease started gradually. Complaints: runny nose, cough, subfebrile body temperature for 8 days, epigastric pain, loose stools 1-2 times. Objectively, the face is hyperemic, the sclera are injected, conjunctivitis, granularity of the posterior pharyngeal wall. Enlarged posterior and submandibular lymph nodes. Conjunctivitis is unilateral.

What is the correct diagnosis?

a) Flu

b)Parainfluenza

c)Adenovirus infection +++

d)Rhinovirus infection

e)Respiratory syncytial infection

24. A man of 25 years, came to the hospital. He became acutely ill. Complaints: increased body temperature up to 39°C, headache in the frontal area and orbits of the eyes, sore throat, nasal congestion, body aches, pain in the bones and joints. Objectively: hyperemia and puffiness of the face, injection of scleral vessels, dry cough, shortness of breath, tachycardia. In the lower parts of the lungs, weak breathing, dry wheezing. Pulse-92, respiratory rate-24, blood pressure-100/60 mm Hg. Hemogram: white blood cells-13.5 x 109/l, rod-shaped neutrophils-6%, segmental neutrophils-76%, monocytes-8%, lymphocytes-10%, ESR-15 mm / h.

What complication?

a) Pulmonary edema

b)Pneumonia+

c)Acute bronchitis

d)Heart failure

e)Respiratory failure

25. A 25-year-old man became acutely ill. Complaints: headache in the frontal area and orbits of the eyes, chills, aches in the body, in the bones and joints, sore throat, nasal congestion, fever up to 39C. Objectively: in the oropharynx - bright hyperemia. The face is flushed, puffy. Injection of scleral vessels. The nose is blocked. In the lungs, the breathing is hard, there is no wheezing. Heart tones are muted, tachycardia, pulse-98 beats per minute, blood pressure 100/60 mm Hg.

What is the correct diagnosis?

a) Influenza+

b)Rhinovirus infection

c)Parainfluenza

d)Enterovirus infection

e)Adenovirus infection

26. A young man of 15 years, came to the hospital. Complaints: chills for 3 days, headache, subfebrile fever, sore throat and along the trachea, rough barking cough. Objectively: hyperemia of the pharynx, tonsils are not enlarged. Breathing is rapid and difficult. There is a profuse serous discharge from the nose. The voice is hoarse. Heart tones are muted, pulse-82 beats per minute, blood pressure-100/60 mm Hg. The abdomen is soft, painless. Diuresis is normal.

What is the correct diagnosis?

a) Influenza

b)Parainfluenza+++

c)Adenovirus infection

d)Rhinovirus infection

e)Respiratory syncytial infection

27.The patient is 30 years old, fell ill with an increase in body temperature, weakness, malaise. There was a mottled rash all over the body, later new elements began to appear, the spots turned into vesicles, sometimes crusts. The rash has spread to the scalp. The neighbor's child had a similar infection.

What is the correct diagnosis?

a) Chickenpox+

b)Measles

c)Rubella

d)Scarlet fever

e)Meningococcal infection

28.A 36-year-old man is admitted to the hospital.

Complaints: uncontrollable vomiting, liquid stools and thirst.

On examination: body temperature - 36.0°C, lethargic. BP - 80/60 mmHg. Pulse 105 beats per minute. His voice is hoarse. Skin turgor reduced. The abdomen is sunken, painless. The stools are liquid, in the form of rice broth, odourless. Arrived from India 5 days ago.

What is the MOST appropriate treatment tactic?

a) Dehydration

b)Rehydration+

c)Vaccine therapy

d)Detoxification

e)Hemodynamic stabilization

29. Male, 20 years old, went to see his GP on the 1st day of illness. He became acutely ill 5 hours after eating lunch at the student canteen. Complaints: cramp-like abdominal pain, nausea, vomiting 3-4 times, frequent liquid stools. Examination: Body temperature 38ºC. Abdomen was not swollen, painful at palpation in epigastric and right iliac region. No intestinal spasm. BP - 110/70 mmHg. Pulse - 80 beats per minute. He urinated well. The stools were copious, mucousy, dark greenish, stinky.

What examination is necessary to clarify the diagnosis?

a)Coprogram

b)Urinalysis

c)Blood test

d)Feces for helminth eggs

e)Faeces for bacteriological culture+

30. A 28-year-old man was seen by a general practitioner on the 2nd day of illness.

Complaints: abdominal cramps, nausea, headache, liquid stool every 30 minutes, tenesmus, false urges.

On examination: body temperature - 37.5 ° C, BP - 100/60 mm Hg. On palpation there was pain in the left iliac area. The sigmoid colon is spasmodic. The stool is faecal, mucus with streaks of blood. Blood count: erythrocytes-4.0x10¹²/l, Hb -145g/l, leukocytes-11.4x10⁹/l, eosinophils-1, stab neutrophils-2, segmented neutrophils-75, lymphocytes-18, monocytes-5. Blood sedimentation rate - 17mm/h.

Which drug is the most appropriate to prescribe?

a) Meloflam

b)Penicillin

c)Erythromycin

d)Doxycycline+

e)Ciprofloxacin+

31. A 37-year-old man consulted a general practitioner on the 2nd day of his illness. Complaints: cramp-like abdominal pain, nausea, headache, liquid stool up to 10 times a day, cramps, false urges. On examination: body temperature - 39.5° C, BP - 110/70 mm Hg. On palpation there was pain in the left iliac area, sigmoid colon was spasmed. The stool is in the form of mucus with blood streaks. Blood count: erythrocytes-4.0x10¹²/l, Hb -145g/l, leukocytes-11.4x10⁹/l, eosinophils-1, stab neutrophils-2, segmented neutrophils-75, lymphocytes-18, monocytes-5. Blood sedimentation - 17mm/h.

What tests should be ordered to clarify the diagnosis?

a) General urinalysis

b)General blood test

c)Blood test for haemoculture

d)Fecal bacteriological examination+

e)Bacteriological testing of urine

32. A 28-year-old woman began to have an acute illness. A heavy watery faecal stool appeared and after a few hours it resembled "rice broth" without a faecalodour. On examination: body temperature normal, abdomen painless on palpation. Arrived from India a week ago, notes consumption of unboiled water. The doctor has made a preliminary diagnosis: Cholera.

Which method of laboratory diagnosis is the most appropriate?

a) Biological

b)Serological

c)Allergological

d)Immunoassay

e)Bacteriological+

33. A young woman, 25 years old, tests positive for pregnancy. Complaints: weakness, scratchy throat. Sixth day of illness. The first 3 days there was an abundant small dotty rash all over the body, which went away on its own. Objective findings: satisfactory condition, body temperature 37.0⁰°С. She was active. Occipital, posterior cervical lymph nodes were enlarged to the size of "peas", sensitive on palpation. Moderate hyperemia of oropharyngeal mucosa, tonsils behind the temples, enanthma, no plaque.

What is the MOST reliable examination to verify the diagnosis?

a) IgM ELISA for VEB infection

b)IgM ELISA with measles antigen

c)IgM ELISA with rubella antigen+

d)IgM ELISA with listeriosis antigen

e)IgM ELISA with yersinosis antigen

34. Female, 25 years old, 12-13 weeks pregnant, admitted to the allergology department on the 4th day of illness. Complaints: coarse cough, photophobia, weakness, rash, increased body temperature. Rash appeared on the face on the 4th day of the disease, then spread to the neck and chest. Objectively: condition was of medium severity, body temperature 39⁰ C, scleritis, conjunctivitis, oropharyngeal enanthema on the cheeks in the form of "semolina", facial and trunk skin was full of confluent papular rash in places.

What is the BEST course of action in establishing a probable diagnosis?

a) Discharge the patient

b)Leave the patient in the ward

c)Call in a gynaecologist for a consultation

d)Prescribe desensitization therapy

e)Isolate the patient, call in an infectious disease specialist+

35. Male, 20 years old, admitted to an infectious disease hospital. Complaints: coarse cough, photophobia, weakness, sore throat, rash, increased body temperature. He had been ill for 5 days and on the fourth day rash appeared on his face and then spread to the upper half of his torso. Objectively, the condition was of medium severity, body temperature 39⁰ C, scleritis, conjunctivitis, copious, in some places, confluent papular rash on the face and trunk, manna-like enanthema on the oropharynx.

What is the MOST reliable examination to confirm the diagnosis?

a) Precipitation reaction

b)Agglutination test

c)ELISA IgM antibodies to yersinosis antigen

d)ELISA IgM antibodies to measles antigen +

e)ELISA IgM antibodies to rubella antigen

36. An 18-year-old female patient was taken by an ambulance to the emergency room. Complaints: fever for 3 days, weakness, a slightly itchy rash. The patient took paracetamol on her own. Anamnesis: had measles in childhood, noted allergy to analgesics. Examination: Body temperature 39.3⁰С, facial skin, scalp, trunk, extremities with polymorphic (spotty-papulose, vesicular, crusty in places) rash. Two weeks ago, the girl was visiting relatives where her child had a similar infection.

Which medication is the most appropriate to prescribe?

a) Vitamins

b)Acyclovir

c)Antibiotics

d)Antipyretics+

e)Antifungals

37. A 20-year-old female student living in a dormitory went to the emergency room on the second day of illness. Complaints: fever during the day, weakness, a slightly itchy rash. Examination: Body temperature 39.30 С, facial skin, scalp, trunk, extremities polymorphic rash (spotty-papular, vesicular, crusty in some places). 2 weeks ago she visited her relatives where their child had a disease.

What is the MOST appropriate management tactic?

A) Refer to a day hospital

b)efer the patient to the community doctor

c)dvise and refer to a hostel

d) Hospitalize in an infectious disease hospital +

e) Refer the patient to an allergy unit

38. An 18-year-old girl has been admitted to an infectious disease ward. Complaints: weakness, fever, nausea, vomiting, dark urine, jaundice of the sclerae and skin. Had been ill for a week, thought she had a cold. Went to the doctor because of jaundice in skin. She is a college student and a friend is in an infectious disease hospital at the moment. Objectively: Condition is of medium severity, no nausea or vomiting. Appetite has appeared. Her skin was jaundiced. The abdomen is soft, sensitive in the right subcostal area. The liver is enlarged, of dense elastic consistency. The stool is acholic, the urine is dark.

What is the most informative indicator?

a) Sulmol test

b)Timol test

c)Transaminase levels

d)Bilirubin and fractions

e)Markers of viral hepatitis+

39. A 19 year old man had an ELISA test for viral hepatitis markers during a preventive check-up. The result is 'negative' for all markers.

What primary prevention option for viral hepatitis B should be recommended for this patient?

a) Avoid any manipulation

b)Give a gamma globulin injection

c)Wearing protective masks

d)Specific vaccination+

e)Drink only boiled water

40. A 42-year-old man comes to the health centre after an examination. He had no complaints. Objectively: no changes of internal organs and systems were detected. Results of the examination revealed: ELISA-anti-HCV (+), PCR-HCVRNA (+), viral load 2600000 IU/ml, virus genotype 1.

What is the MOST appropriate treatment?

a) Prescribe glucocorticosteroids

b)Observe and prescribe tests after 3 months

c)Prescribe nucleoside analogues for 48 weeks

d)Prescribe hepatoprotective and choleretic drugs

e)Prescribe peg interferon with ribavirin for 48 weeks +

41. A 35-year-old woman was admitted to the hospital on the 8th day of illness. Complaints: pronounced weakness, lack of appetite, nausea, vomiting up to 4-5 times a day, jaundice, skin itching, heaviness in the epigastric region and in the right subcostal area. A woman fell ill a week ago, when weakness, general malaise appeared, then appetite gradually reduced, nausea and vomiting occurred, on the 5th day of the disease she noticed darkening of urine, on the 6th day of the disease her feces became discoloured, and yesterday morning her relatives noticed jaundice of sclerosis, after dinner the nausea increased and vomiting became more frequent. The woman is admitted to hospital with a diagnosis of acute viral hepatitis B.

Which marker is most commonly used for the specific diagnosis of HBV?

a)HbsAg+

b)HBeAg

c)BcAg

d)Antibodies to HBsAg

e)Antibodies to HbeAg

42. A 30-year-old man has been admitted to hospital with the diagnosis: Acute viral hepatitis C.

What markers indicate the presence of acute viral hepatitis C?

a)anti HCV Ig M +

b)anti HCV total

c)anti HBcoreIg M

d)anti HBcoretotal

e)BsAg

43. A 35-year-old woman was admitted to the hospital on the 8th day of illness.

Complaints: pronounced weakness, lack of appetite, nausea, vomiting up to 4-5 times a day, jaundice, skin itching, heaviness in the epigastric region and in the right subcostal area.

A week ago weakness, general malaise appeared, then appetite gradually decreased, nausea and one-time vomiting occurred. On the 5th day of the illness she noticed a darkening of the urine. On the 6th day of the illness the faeces became discoloured. Yesterday morning relatives noticed jaundice of sclerae, in the afternoon nausea increased, vomiting became more frequent. The woman is admitted to hospital with a diagnosis of acute viral hepatitis B.

What marker for HBV indicates active viral replication in the blood?

a)HBsAg

b)HBeAg+

c)nti HDV

d)nti HB core total

e)nti HB core Ig M

44. A 35-year-old woman was admitted to the hospital on the 8th day of illness.

Complaints: pronounced weakness, lack of appetite, nausea, vomiting up to 4-5 times a day, jaundice, skin itching, heaviness in the epigastric region and in the right subcostal area.

What laboratory tests should be ordered to confirm the presence of hepatitis?

a) General urinalysis

b)Blood count

c)Transaminase determination

d)earch on serum immunoglobulin levels+

e)Examination of serum proteins and protein fractions

45. A 57 year oldzootechnician consulted a doctor on the 3rd day of illness.

Complaints: headache, fever, pain in the calf muscles, lower back pain, jaundice, dark urine and reduced quantity of urine.

Objectively: Body temperature 38.1°C, scleral vascular injection, petechial rash in the chest area, hepatosplenomegaly. Preliminarydiagnosis: Leptospirosis.

What is the MOST effective etiotropicdrug:

a) Sumamed

b)Claforan

c)Gentamicin

d)Penicillin+

e)Pefloxacin

46.A 57 year old zootechnician consulted a doctor on the 3rd day of illness.

Complaints: headache, fever, pain in the calf muscles, lower back pain, jaundice, dark urine and reduced quantity of urine.

Objectively: Body temperature 38.1°C, scleral vascular injection, petechial rash in the chest area, hepatosplenomegaly. Preliminary diagnosis: Leptospirosis.

What is the MOST informative method of examination?

a) Virological, biological

b)Virological, serological

c)Parasitological, biological

d)Bacteriological, biological

e)acteriological, serological+

47. A 57 year oldzootechnician consulted a doctor on the 3rd day of illness.

Complaints: headache, fever, pain in the calf muscles, lower back pain, jaundice, dark urine and reduced quantity of urine.

Objectively: Body temperature 38.1°C, scleral vascular injection, petechial rash in the chest area, hepatosplenomegaly. Preliminary diagnosis: Leptospirosis.

Which drug is used as a specific therapy for leptospirosis:

a) Antibiotics+

b)Corticosteroids

c)Fresh frozen plasma

d)Specific immunoglobulin

e)Normal human immunoglobulin

48. A 26-year-old woman was admitted to an infectious disease hospital on the 9th day of her illness.

Complaints: fever up to 39.0 °C, coughing, weakness, worsening of appetite, headache. Fever on all days. On examination: state of moderate severity. Body temperature 39.5 degrees. Skin was slightly jaundiced. The oropharynx showed hyperemia of the mucosa, enlarged tonsils, no purulent plaques. Submandibular and axillary lymph nodes were enlarged. There is vesicular breathing in the lungs. The abdomen is soft and painless. The liver protrudes from under the edge of the rib cusp by 2.0 cm. The urine was of normal colour and urine output was not decreased. The stools are liquid. Yersinosis is suspected.

What is the MOST effective etiotropic medicine?

a) Delagil

b)Decaris

c)Cefazolin+

d)Remantadine

e)Penicillin

49. A 26-year-old woman was admitted to an infectious disease hospital on the 9th day of her illness.

What is the MOST accurate method of diagnosis to confirm the diagnosis?

a) Сlinical

b)Epidemiological

c)Bacteriological +

d)Bacterioscopy

e)Clinical and epidemiological

50. A 35-year-old woman was admitted to hospital with suspected yersinosis. A laboratory examination was carried out.General blood count: leukocytes 5.9×109/l, stab neutrophils-4%, segmented nuclear neutrophils-46, eosinophils-1%, lymphocytes-42%, monocytes-7%, COE-12 mm/hr. Passive Haemagglutination reaction with Yersinia antigen 1:200. Stool bacteriological analysis: Yersinia enterocolitica.

What is the most effective etiotropic drug?

a) Delagil

b)Decaris

c)enicillin

d)urazolidone

e)yprofloxacin+

51. A 25-year-old woman became acutely ill with chills, vomiting twice, liquid stool, sore throat, pain in knee and elbow joints, body temperature increased to 39.2°C. On day 4 the urine became darker, the sclerae and skin jaundiced, a fine-pigmented "sock" and "glove" type rash appeared. The liver is enlarged and the tongue is crimson. Preliminary diagnosis: Yersinosis.

Which antibacterial agent should be prescribed?

a) Ceporin

b)Nistatin

c)Penicillin

d)Oxacillin

e) Cyprofloxacin+

52. A 40-year-old woman, a worker in a vegetable storage facility, came to the health centre. Complaints: high body temperature, sore throat, jaundice, abdominal pain, nausea, vomiting, liquid stools. Objectively: palpable enlarged peripheral lymph nodes, hepatomegaly. Yersinosis is suspected.

What tests should be ordered to confirm the diagnosis?

a) General blood test

b) Paul-Bunnel blood test

c) Blood for viral hepatitis markers

d) Blood for Agglutination test with leptospirosis antigen

e) Bacteriological analysis of blood, faeces, urine, pharyngeal smears for yersiniae+

53. A 25-year-old woman consulted a doctor for colpitis. After a clinical and laboratory examination the doctor made a preliminary diagnosis of Listeriosis.

Which method of examination is necessary to confirm the diagnosis?

a)Viological

b)Bacteriological+

c)Parasitological

d)Serological

e)Dermato-allergic

54. The woman is 26 years old. She is in hospital on day 5. Pregnancy 20-21 weeks, with a history of obstetric complications (2 spontaneous abortions). A woman has manifestations of colpitis, polyhydramnios. Her general blood test showed erythrocytes - 4.5×1012\L, hemoglobin - 123g/L, leukocytes - 5.6×109\L, sed rate - 17mm/hr. Vaginal smear - leukocytes 15-16 in pys. ELISA - Listeria specificity IgG. Passive hemagglutination reaction- anti-listeriosis antibodies in titer 1:100. Bacteriological analysis of vaginal mucus - L.monocytogenes isolated.

Which findings were decisive in making the diagnosis?

a) Obstetric history data

b)Listeria-specific IgG detection by ELISA

c)L.monocytogenes culture isolation from the vagina+

d)Inflammatory changes on vaginal smear microscopy

e)Detection of anti-listeriosis antibodies in 1:100 titer by PPGA

55. A 25-year-old man became acutely ill. Headache, pain in the frontal area of the head and the orbits of the eyes, chills, body aches, bone and joint pain, sore throat, nasal congestion and a body temperature of 39oC. Took teraflu, paracetamol but had no effect. He called an ambulance and was taken to the infectious diseases hospital. Examination on the 2nd day of illness: bright hyperemia in the oropharynx, facial hyperemia and puffiness, injection of sclerae vessels, stuffy nose. In the lungs, breathing is rigid, no rales. Cardiac tones muffled, tachycardia, heart rate 98ud/min, BP 100/60 mmHg. The abdomen is soft and painless.

Which examination would be most informative?

a) General blood test

b)General urinalysis

c)Pharyngeal smear for virology +

d)Pharyngeal smear for microflora

e)Biochemical blood test

56. A 24-year-old man was admitted to the hospital on day 2 of illness. Complaints: Headache in the frontal area and pain in the orbits of the eyes, sore throat, dry cough, aching pain in the muscles. Objective: Body temperature 39.5C. Mucous membranes of the oropharynx are brightly hyperemic, granularity of the posterior pharyngeal wall, injection of sclerae vessels is noted. There was a serous mucous discharge from the nose. The cough is dry and unproductive. The lungs have rigid breathing, no rales. Clear cardiac tones, tachycardia, heart rate-92 beats per minute, BP100/60 mm Hg. Abdomen was soft, painless. The patient was prescribed: cefazolin 1.0*3p/ml, glucose 5%-500.0 v/v, suprastin 1.0 v/ml, remantadine according to the scheme, throat rinse with furacilin.

What mistake was made in the prescription?

a) Antibiotics+

b)Detoxification

c)Desensitization

d)Throat rinse

e)Antiviral medication

57. A 26-year-old man became acutely ill, called an ambulance and was admitted to the hospital on the 2nd day of illness. Complaints: headache, runny nose, dry cough, sore throat, chest pain. Objectively: body temperature 38.80°C, pharyngeal mucosa brightly hyperemic, the back of the pharynx granular. Injection of the sclerae vessels is noted. The lungs had rigid breathing, no rales. Heart sounds are muffled, rhythmic, heart rate 88 bpm, BP 100/60 mmHg.

Which antiviral agent is the most appropriate to prescribe?

a)Acyclovir

b)nterferon

c)ycloferon

d)Oseltamivir+

e)Oxaline ointment

58. A 25-year-old woman (12-13 weeks pregnant) was admitted to the allergy department on the 4th day of her illness with complaints of a rough cough, photophobia, weakness, a rash on the body, and fever. The rash appeared on the 4th day of the disease, first on the face, then spread to the neck, chest. Objectively: the state of moderate severity, body temperature – 39C. Scleritis, conjunctivitis, in the oropharynx on the mucous membrane of the cheeks-enanthema in the form of "semolina". On the skin of the face, torso, there is a plentiful, sometimes draining spot-papular rash.

What is the correct diagnosis?

a) Measles+

b)Rubella

c)Yersineosis

d)Scarlet fever

e)Allergic dermatitis

59. The pregnant woman is 28 years old, the gestation period is 8-9 weeks. Complaints of weakness, fever, sore throat, heavy skin rash. He is ill for 3 days. On the 2nd day of the disease, the patient noticed a rash all over her body. Objectively: the condition is of moderate severity. Body temperature-37.7 C.On the trunk, limbs (more on the flexor surfaces) small spot-papular rash. Occipital lymph nodes are enlarged, moderately painful.

What is the correct diagnosis?

a) Measles

b)Rubella+

c)ersiniosis

d)Chickenpox

e)Allergic dermatitis

60. In the urology department, a patient with a diagnosis of "Orchoepididymitis" is treated. The patient has been ill for 20 days, and his body temperature has periodically increased to 38 C. At the beginning of the disease, against the background of an increase in body temperature, I noted soreness and swelling in the cheeks, a week ago I was worried about abdominal pain of a shingling nature, nausea, vomiting up to 5-6 times a day, diarrhea. 2 days ago, the body temperature increased again, yesterday he noticed soreness and swelling in the right testicle area.

What is the correct diagnosis?

a) Bacterial orchitis

b) Chlamydia

c)Mumps infection+

d)Testicular carcinoma

e)Acutebrucellosis

31. Юноша 17 лет, обратился к участковому врачу на 5-ый день болезни с жалобами на боли в горле, усиливающиеся при глотании, головную боль, тошноту, выраженную слабость, боли в суставах, потемнение мочи. При осмотре установлено: температура 38,5° С. кожные покровы, склеры субъиктеричны, пальпируются шейные и подчелюстные лимфоузлы, в зеве – гиперемия миндалины увеличены, в лакунах гнойный налет. Живот мягкий чувствительный правом подреберье, печень от края реберной дуги +2,0+2,5см плотноватый консистенции.

Какой НАИБОЛЕЕ вероятный диагноз у больного

a)Листериоз

b)Иерсиниоз

C)Лептоспироз

D)Вирусный гепатит

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