The specific CNS complication of Chickenpox is
cerebellitis
meningitis serosa
polyradiculoneuritis - Guillain-Barre
Treatment of cerebral oedema includes
Diuretics – spironolactone
Diuretics – mannitol, furanthril
Non-steroidal anti-inflammatory drugs
Common presentations of AIDS are
prolong morning low grade fever, weight loss, diarrhea
hyperpyrexia with profuse sweating, dehydration with metabolic changes
bulimia, hyperactivity, psychomotor agitation
Which meningitis is characterized by the following CSF findings – lymphocytic pleocytosis, normal or slightly elevated protein and normal glucose level?
Viral
Purulent
Tuberculous
The rash in Scarlet fever is
maculo-papules, vesicular, different stages at the same time
vesicular rash, which most commonly affects a thoracic dermatome
pustular, at the same stage of development, deep-seated, firm, round, well-circumscribed
Typical for Diptheria are
dense, dirty gray, hard deposits on the tonsils
whitish deposits on the tonsils and buccal mucosa, easily removable
the disease is widespread in Bulgaria
The most common clinical manifestation of Salmonellosis is
sepsis
cholecystitis
gastroenteritis
Which is the antibiotic of choice of for Mediterranean spotted fever
Gentamycin
Doxycycline
Ceftriaxone
Poliomyelitis is characterised by
flaccid asymmetric, proximal paralysis
flaccid symmetric, proximal paralysis
full recovery of the affected limb
Typical for clinical presentation of Cholera is
rigor and high fever
‘rice water’ stools
persistent vomiting, severe stomach pain
The agent of which disease has teratogenic effect?
Rubella
Scarlet fever
Measles
The main factor for chronicity in HBV infection is
age
innate immunity
gender
The diarrheal syndrome in shigellosis is characterised with
large amount of watery stools + abdominal pain
sparse, bloody mucoid stools + tenesmi
voluminous liquid, ” rice water” type stools
Hepatitis with the most severe course with possibility of acute liver failure is
acute hepatitis C
acute hepatitis B+ hepatitis D
viral hepatitis E
viral hepatitis A
Which infection is vaccine preventable
Salmonella
Hypopotassemia may be suspected in a patient with
enhanced motility and spastic colon
intestinal paresis and bloated abdomen
generalized seizures
Empirical therapy for bacterial meningitis includes
3rd generation Cephalosporins + Vancomycin
Penicillin + Metronidazole
3rd generation Cephalosporins + Clindamycin
Measles rash appears
24 h after onset of the disease
the disease begins with it
on 3-5-the day of disease onset
The stools in cholera resemble
rice water
sputum with mucus, blood and pus
raspberry jelly
The most common causative agents of purulent meningitis are
S.pneumoniae, N. meningitidis, H. influenzae
S.pneumoniae, Staph.aureus, Myc. tuberculosis
N meningitidis, L. monocytogenes, St. epidermidis
The rash of Chicken pox is
Who is NOT at risk for severe Chickenpox
persons with cellular immunodeficiency
pregnant
children aged 2-6
The earliest laboratory test for confirmation of acute hepatitis C is
Anti-HCV by ELISA
HCV RNA by PCR
HCV Ag by ELISA
Pregnant in the 1st trimester has discrete macular rash and negative serological test (ELISA) for Rubella. What is the next step?
Therapeutic abortion
Ribavirin therapy
Repeating the test after 3 weeks
Shigellosis is likely to present with seizures in
elderly people
children under the age of 3 years
such onset is unlikely
Which test is best to confirm EBV as causative agent of infectious mononucleosis
detection of heterophile antibodies
detection of specific antibodies to EBV
detection of nucleic acid of EBV in the blood
Raspberry tongue is typical for
Chickenpox
The most common neoplasm in HIV infection is
Kaposki‘s sarcoma
Pulmonary carcinoma
Melanoma
The aminotransferases (ALT and AST) in acute viral hepatitis are
Normal
100 E/L
> 1000 E/l
Etiological treatment of choice in cholera is
penicillin
cephalosporin 4-th generation
tetracycline
Antibiotic of choice for the treatment of Scarlet fever is
penicillin / beta-lactam
gentamicin
Meningeal irritation includes
nuchal rigidity, hyperesthesia
diminished tendon reflexes
altered mental status
Route of transmission in Lyme disease is
via tick bite
via drinking unpasteurized milk
via mosquito bites
The most common causative agent of pneumonia in AIDS patients is
Mycoplasma pneumoniae
Pneumocystis jiroveci (carinii)
Hantavirus
Typical clinical manifestation of tetanus is
confusion
periodic muscle rigidity
permanent muscle rigidity and periodic seizures
Antibiotic of choice for treatment of Erythema migrans is
Cefrtiaxone
Gentamycine
Measles rash
appears after 24 h after the disease onset
the disease starts with it
appears on 3-5th day of disease onset
At risk of acute viral hepatitis C are
intravenous drug abusers
newborns in poor sanitary conditions
travellers to tropical countries
The rash of meningococcemia is
hemorrhagic necrotic, localized predominantly on the lower limbs and buttocks
vesicular, diffuse
vesicular, highly pruritic
Initial treatment of infectious diarrhea includes
rehydration
antibiotic
correction of ↓K
On suspicion of acute viral hepatitis the minimum laboratory TESTS are
alkaline phosphate, gamma glutamyl transferase
urine (bile pigments), serum (ALT and AST, bilirubin)
complete blood count, electrolytes, acid-base metabolism
The evolution of Chickenpox rash is
macula – papule - vesicle - crust
macula- papule - brown pigmentation
petechiae- ecchymosis- suffusion
The mainstay of diphtheria treatment is
antibiotics
antitoxin serum
corticosteroids
Which infection is vaccine-preventable
Lyme borreliosis
Koplik spots are pathognomonic sign for
Jaundice as a clinical manifestation of acute viral hepatitis C is seen
in a few patients
in the majority of patients
in about half of the cases
Laboratory minimum for suspected viral hepatitis is
CBC, electrolytes, acid-base balance
abdominal ultrasound
Meningeal irritation, prolonged clouding consciousness and focal neurological findings are common in
meningoencephalitis
encephalitis
meningitis
The incubation period in Shigellosis is
2 weeks
1-7 days
4-6 hours
What type of toxin is released by Salmonella bacteria on cell lysis
endotoxin
neurotoxin
enterotoxin
Which of the following agents causes hemolytic-uremic syndrome
enterohemorrhagic E.coli
enteroinvasive E.coli
pathogenic E.coli
Which of the following statements regarding enteroviruses as causative agents of aseptic meningitis are NOT TRUE?
Enteroviruses account for up to 80% of cases of viral meningitis.in children
the clinical presentation in children is milder than in adults
lymphocytes are predominant in the first 24 hours, later neutrophils prevail
Which type of immunity is impaired in HIV infection?
humoral
cell mediated
innate
Viral hepatitis A is transmitted via
fecal-oral mechanism
parenteral mechanism
sexual mechanism
The most common causative agent of of Infectious mononucleosis is
Epstein-Barr virus
Cytomegalovirus
HIV
The main route of transmission of hepatitis C virus is
fecal-oral
intravenous usage
sexual
The rash in Scarlet fever is ???
maculo-papules, vesicular, fast evolution of stages
The mental status in tetanus is
blurred
alert
hallucinations are typical
Typical Measles rash is
maculo-papular rash appearing on the first day of the disease
maculo-papular rash, confluent, appears on the 4-5 the day
discrete maculo-papular rash fades after 3 days
Which type of meningitis is characterized by the following CSF findings – lymphocytic pleocytosis, elevated protein and decreased glucose level
viral
purulent
tuberculous
Which of the following conditions are NOT AIDS-defining illness?
Herpes zoster
Kaposki’s sarcoma
Esophageal candidiasis
Cholera initially presents with
chills and high fever
diarrhea ” rice water” type
intractable vomiting
Which of the following microorganisms is associated with diarrhoea after antibiotic therapy or severe operations
Cl. difficile
E.coli
Diarrheal syndrome in shigellosis is characterised by
A pregnant woman in first trimester had contact with a sick child, suspected to have rubella. How could you manage her
to clarify if the child has Rubella
to recommend abortion on medical grounds
to determine her immunity by serology
The most common presentation of Lyme borreliosis is
erythema migrans
arthritis
neuritis
The most common initial complaints in acute viral hepatitis are
fatigue, anorexia, nausea, loss of appetite
severe abdominal pain radiating to the shoulders and vomiting
fever and diarrhoea
First choice antibiotic for treatment of pertussis is
ceftriaxone
macrolides
amikacin
Empirical treatment on suspicion of bacterial meningitis includes
Thick pseudomembrans, spreading across the pharyngeal mucosa and bleeding while dislodging, are characteristic for
mononucleosis
diphtheria
strepto pharyngitis
Pustula maligna is typical for
Anthrax
Mediterranean spotted fever
Tularemia
Anthrax infection results from
exposure to cattle and goats
tick bite
mosquito bite
Acute hepatitis C becomes chronic in
30-80%
< 2%
>90%
The stages in the course of HIV/AIDS infection are
early HIV infection, latency period, AIDS
catarrhal period , rash period , convalescent period
initial intoxication period, period of generalized lymphnodulomegaly, period of hepatosplenomegaly
Serological markers of acute viral hepatitis B are
HBsAg (+) and anti HBc IgM (+)
HBsAg (+) and anti HBc total (+)
anti HBsAg (+) and anti HAV IgM (+)
Arthralgia in acute viral hepatitis presents with
joint pain without swelling and redness
swelling, redness and forced position
swelling without pain and redness
Tache noire (black spot) at the site of the tick bite represents
painless ulcer covered with black (necrotic) crust
painless oval or round pink or red skin plaque> 5 cm
painful hot red plaque with raised edges
Which of the following findings IS NOT characteristic of infant meningitis?
bulging fontanelle, Lessage sign
distended abdomen
crie encephalique
The screening test for HIV infection is
anti HIV (ELISA)
viral RNA (PCR)
anti HIV (immunoblot)
The rash in Mediterranean spotted fever is
maculopapular
vesicular
erythematous
Which diseases in not vaccine preventable
Poliomyelitis
The most common electrolyte abnormalities in patients with diarrhea are
hyponatremia and hypokaliemia
hypercalcemia and hyperkaliemia
hypernatriemia and hyperchloremia
Acyclovir is recommended to which of following cases
Chicken pox - mandatory
Chicken pox in immunocompromised patients
Kaposi sarcoma
Which of the following statements regarding leptospirosis IS NOT true”
Leptospirosis is a biphasic illness with multiorgan involvement
Gentamycin is the antibiotic of choice
Infection is acquired during walking or bathing in rivers
At risk for development of Herpes Zoster are
adolescents (aged 11-19 years)
patients with HIV infection
newborns
Characteristic clinical manifestation of enteroviral infections is
Herpagina
Gingivostomatitis
Exudative pharyngitis
small maculopapules predominantly in the axilar and inguinal regions
pustular, at the same stage of development, deep-seated, firm, round, well-circumscribe
Inflammatory diarrhea is commonly caused by
Shigella sp., Campylobacter jejuni, Cl. difficile
Viruses, enterotoxigenic E. coli
S. aureus, B. cereus, most Salmonella sp.
When is ART warranted
For all HIV positive regardless of CD4 count
CD4<200 cells/µL
CD4< 350 cells/µL
In the case of infectious mononucleosis-like symptoms, it is important to consider
primary HIV infection
neoplasms
syphilis