The specialist is a man who was taught, has been taught and was tested on what he had studied.
Sergey Nikolayev,
Candidate of Medical Sciences
ATTENTION OF READERS
Features of professional work of doctors oblige to apply by their preparation objective and informative methods of an estimation of knowledge and abilities. It is connected with the necessity of mastering by medical students at a level of judgment of great volume of the material making system of theoretical knowledge, and putting a basis for formation of practical skills. This feature of preparation of the future doctor also has obliged the Ministry of public health of Ukraine to enter into higher education system the state license examination”Krok-1. General medical training”.
Scientific researches testify that testing for the purpose of examination of the student can be considered as a method of estimation which answers the basic methodical criteria of quality and provides objectivity of process of training. Simultaneously testing – a data processing method about educational activity and their interpretation. This question is especially important, as, an estimation of the knowledge of the student according to the credit-rating-modular system should be standardized and unified enough.
External estimation of the quality of preparation of medical students on fundamental biomedical sciences is carried out by the Testing Center at МPH Ukraine and Krok-1 is spent in the form of the licensed examination”. The general medical training ”Medical microbiology, immunology and virology” – one of fundamental disciplines. The control of results of training of students strengthens internal motivation of teachers of each fundamental discipline to quality warranting.
Training, gives the chance to the teacher to reveal weak places in preparation of the expert, and – it is better for the student to understand, what themes demand completion.
The manual contains tests on microbiology (section ”Intestinal bacterial infections”), received from a database of the Center of testing of the professional competence of experts at the Ministry of public health of Ukraine for higher educational institutions ІІІ - ІV levels of accreditation and tests from booklets for previous years.
In the grant tests are grouped according to the basic intestinal infections, which students study on a practical training on private microbiology: causative agents of Escherichiosis, Shigellosis, Typhoid fever and Salmonellosis, Cholera, Campilobacteriosis and Helicobacteriosis, Botulism and Food intoxications. Each test contains only one correct or best answer which to the student is necessary to choose. The tests collected in the grant, will give the chance to the student to be prepared for delivery of license examination by ”Krok-1. General medical training”, since, the booklet which is received annually by the student for the examination, contains certain percent of tests from previous years. Also these tests will give the chance to the student to be prepared for examination on a practical training, the thematic module ”Intestinal bacterial infections” and the Module ІІ. ”Special microbiology”.
Today it is possible to ascertain that delivery by the student of the licensed examination ”Krok-1. General medical training” gives powerful motivation of studying of the discipline ”Microbiology, immunology and virology”.
Causative agents of Escherichiosis
1. Colon bacillus culture with the antigen structure O111 was isolated from the feces of a 6-month-old child, who was fed artificially. What diagnosis can be made to this patient?
+ Colienteritis.
– Gastroenteritis.
– Cholera-like disease.
– Food poisoning.
– Dysentery-like disease.
2. When a patient has dysbacteriosis which is followed by the development of ichorous flora (proteus, pseudomonads) and rise of pH in feces, it is necessary to prescribe to him biological preparations which will acidify the medium and manifest antagonistic action. What microorganisms are capable to perform these functions?
+ Bifidobacterium bifidum.
– Klebsiella.
– Azotobacter.
– Enterbacter.
– Serratia.
3. For the first inoculation of defecation the following is used:
– Blood agar.
– Triple sugar iron agar.
– Hiss media.
+ MacConkey’s agar (or eosin-methylene blue agar - EMB agar).
– Sugar broth.
4. When a xenogenetic antigen gets into a organism, synthesis of antibodies takes place. Which of the enumerated immunoglobulin penetrates through placenta providing the development of natural passive immunity of the neonate?
– Ig A.
– Ig D.
– Ig E.
+ Ig G.
– Ig M.
5. A bacteriologist isolated Flexner shigellosis agents type 2, Zonne shigellosis agents and enteropathogenic E. coli О55:К59 from a young patient. What is this type of infection called?
– Secondary infection.
+ Mixed infection.
– Bacteria carriage.
– Superinfection.
– Reinfection.
6. Information about microorganism sensitivity and its resistance to antibiotics with zones of growth and delay diameter is given in the antibiotic gram taken from bacteriological laboratory. By what method was the microorganism sensitivity to antibiotics revealed in the given case?
– By the method of serial dilutions in the thick nutrient medium.
+ By the method of diffusion into agar with standard disks application.
– By the method based on the colour change of the indicator when pH medium is changed.
– By the method of serial dilutions in the liquid nutrient medium.
– By the method based on the microorganisms enzymatic activity change.
7. E. coli serotype О78:К12 was isolated from the patient’s feces and its sensitivity to antibiotics was determined: for penicillin – growth delay zone of 8mm, for erythromycin – 9mm, for chloramphenicol – 10mm, for gentamycin – 12mm, for polymyxin – 25mm. Which antibiotic is most effective for the patient’s treatment?
– Penicillin.
– Erythromycin.
– Chloramphenicol.
– Gentamycin.
+ Polymyxin.
8. A child suspected to have colienteritis was taken to the infectious hospital. Colon bacillus was isolated from his feces. How can colon bacillus relation to pathogenic variants be determined?
– By the microscopy of coloured preparations.
– By the way of growth on the Endo agar.
– With the help of phage typing.
– On the basis of biochemical qualities study.
+ In agglutination reaction with O-sera.
9. When the feces of a four-month-old child with the symptoms of acute intestinal infection were bacteriologically investigated, some quantity of red colour colonies grew on the Endo agar. What kind of organisms might it be?
– Staphylococcus.
– Salmonella.
+ Escherichia.
– Streptococcus.
– Shigella.
10. A 1,5-year-old child has vomiting, diarrhea, elevated body temperature. His feces were investigated and plated on Endo agar. 18 hours later round, slightly convex red colonies with metallic sheen average size grew on the surface of the medium. What should be done with these colonies?
– Make the phage typing of the microorganisms.
+ Carry out the reaction of agglutination with polyvalent of OK-sera of pathogenic serogroups.
– Plate microorganisms on the Triple sugar iron agar.
– Make a preparation and stain it by Gram method.
– Determine the motility of the bacteria in the dark field.
11. During the outbreak of acute intestinal disease, the serotype of pathogenic colon bacillus was isolated from some sick children. In order to refer to the isolated culture as enteropathogenic E. coli, it is necessary to reveal the antigen О111 in it. How is it possible to reveal this antigen in the isolated culture?
+ To make the reaction of agglutination with the monovalent serum.
– To differentiate the antigens of bacteria by the method of immunoelectrophoresis.
– To use the method of drop micro-agglutination.
– To make agglutination reaction with the blood serum of the reconvalescent children.
– To use the specific precipitating serum against the mentioned antigen.
12. A 7-year-old boy has cholera-like disease (vomiting, profuse diarrhea). During the plating of the patient’s feces on Endo agar, similar colonies of crimson colour with metallic sheen appeared. What organism is likely to be the agent of the disease?
+ Enterotoxigenic Escherichia coli.
– Salmonella enterica.
– Yersinia enterocolitica.
– Shigella sonnei.
– NAG-vibrio (Non-Agglutinable vibrio).
13. A child with acute intestinal infection developed quickly the signs of dehydration and blood appeared in feces. The pediatrician suspected colienteritis. Which method should be used for enteric Escherichiosis diagnosis?
+ Bacteriological.
– Serological.
– Biological.
– Allergic.
– Microscopic.
14. Enterotoxigenic E. coli was isolated from the soil during the sanitary bacteriological inspection of the city rest zone. Its toxin stimulates the appearance of c-AMP (adenosine 3'5'-cyclic phosphate) and, as a result, the hypersecretion of water and salts in the intestines appeared. What disease can this microorganism most probably provoke?
+ Cholera-like Escherichiosis.
– Dysentery-like Escherichiosis.
– Urethra infection.
– Peritonitis.
– Enterotoxic shock.
15. Infants from the children’s home were registered with outbreak of intestinal infection with the signs of colienteritis. What investigation should be performed for the final identification of the isolated agent?
+ Study the antigenic properties of the agent.
– Study the sensitivity to antibiotics.
– Study the sensitivity to bacteriophages.
– Study the biochemical properties of the agent.
– Study the pathogenic ability of the agent.
16. The feces of a sick infant was sent to bacteriological laboratory for investigation and the enteropathogenic E. coli О55:К59 culture was isolated from it. On the basis of what properties can the isolated culture be referred to EPEC О55?
+ Antigen properties.
– Morphological properties.
– Cultural properties.
– Biochemical properties.
– Phagotype determination.
17. A 37-year-old patient developed intestinal dysbacteriosis after having been treated by antibiotics for a long period of time. What medicine should be administered to the patient to normalize the macro flora of the intestines?
+ Eubiotics.
– Sulfonamides.
– Bacteriophages.
– Autovaccine.
– Vitamins.
18. From the feces of a sick child was isolated a pure culture of pathogenic colon bacillus and it was identified by its antigen structure. The child was diagnosed with ”colienteritis”. What method of microbiological diagnostics was used to determine the serovar of the causative agent?
+ Bacteriological.
– Serological.
– Biological.
– Allergic.
– Microscopic.
19. A 6-month-old child developed severe disturbances of the intestine, diarrhea. The initial diagnosis was ”colienteritis”. What method is able to confirm the etiology of the disease?
+ Bacteriological.
– Serological.
– Biological.
– Allergic.
– Microscopic.
20. An 18-year-old male was followed by appendicitis as a result of endogenic infection. What microorganism living in the intestine is unlikely to be the causative agent of the illness?
+ Bifidobacteria.
– Bacteroides.
– Enterococci.
– Escherichia.
– Proteus.
21. The feces of the patient with acute intestinal disease were sent for bacteriological study. The material was seeded on the nutrient medium and on the second day the answer from the laboratory said –”no pathogenic strains of intestinal bacterium are observed”. The study of what properties of the bacterial culture made it possible to get such a result?
+Antigenic.
– Tinctorial.
– Morphological.
– Sugarlytical.
– Proteolytical.
22. To prevent dysbacteriosis remedy containing bifidobacteria is used. What group of preventive medication does it refer to?
+ Eubiotics.
– Vaccines.
– Serum.
– Immunoglobulins.
– Chemical drugs.
23. What is the argument to prove that young children are not susceptible to develop dysenterial escherichiosis but are infected by serotypes of enteropathogenic E. coli?
+ The presence of IgG.
– The presence of IgM.
– The presence of serum IgA.
– The presence of IgE.
– Immunological tolerance.
24. A 6-month-old child was hospitalized with signs of acute intestinal infection. The feces were seeded on Endo agar for bacteriological diagnostics. The typical growth of the agent on the nutrient medium showed the initial result – the causative agent was Escherichia coli. Give the characteristic cultural properties of the agent on Endo agar.
+ Red colonies with metallic sheen.
– Large mucous colonies.
– Small colourless colonies.
– Pink colonies with white rim.
– ”Swarming” type of growth on agar.
25. Bacteriological study of the urine revealed E. coli, the number of which counted 106 /ml. What is it evident of?
+ Ascending infection of the urinary apparatus (pyelonephritis).
– Glomerulonephritis with autoimmune component.
– Infection of the urine by urethra microphlora.
– Infection of the urine by air microphlora.
– Septicemia followed by the discharge of the agent with urea.
26. A child was hospitalized complaining of general malaise, diarrhea with bleeding, back ache in the renal area. The body temperature is normal. The coproscopy didn’t reveal any leucocytes. What microorganism is likely to cause the disease?
+ Enterohemorrhagic E. coli.
– Enteropathogenic E. coli.
– Enterotoxigenic E. coli.
– Enteroinvasive E. coli.
– Enteroaggregative E. coli.
27. Pure culture of E. coli was isolated from feces of the patient. Which from the listed below is not typical for this very type? Colon bacillus doesn’t refer to:
+ Toxic at lysogenia.
– Normal colon microphlora of large intestine.
– Causative agent of pyogenic inflammatory processes.
– Causative agent of cholera-like diseases.
– Active component of eubiotics.
28. A patient underwent the course of antibiotic therapy because of the acute attack of chronic pneumonia, diarrhea, intestinal disturbances, meteorism. Bacteriologic study didn’t reveal E. coli, but the decrease of the number of lacto- and bifidobacteria. What remedy should be administered to the patient?
+ Eubiotics and vitamins.
– Antibiotics and eubiotics.
– Sulfonamides and eubiotics.
– Antibiotics and vitamins.
– Sulfonamides and vitamins.
29. An isolated strain of colon bacillus appeared to be able to synthesize bactericins. What is this capability due to?
+ Plasmids.
– Mutations.
– Reparations.
– Dissociation.
– Bacteriophage.
Causative agents of Shigellosis
30. Shigella sonnei was isolated from feces of a patient. What additional investigation should be done for the determination of the infection source?
– Study sensitivity to antibiotics.
– To make the precipitation test.
– To make the complement fixation test.
+ Phage typing of the isolated pure culture.
– To make the neutralization test.
31. Shigellosis agent was isolated from a child infected with acute intestinal infection. What morphological properties is this agent characterised by?
– Gram-positive mobile bacillus.
– Capsule on the nutritious medium.
– Spore in the environment.
– Gram-positive bacilli arranged in chain.