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CHILDHOOD INFECTION



1. An autopsy of 3-year-old child revealed hyperemic, turbid arachnoids, which had a form of yellowish-greenish ‘cap’. At microscopic investigation a characteristic findings of arachnoids thickening, hyperemia, purulent with fibrin exudate infiltration was present. What is the most likely diagnosis?

A. *Meningococcal infection

B. Tuberculosis

C. Anthrax

D. Ifluenza

E. Measles

2. A child presented with catarrhal conjunctivitis, pharyngitis, a laryngotracheobronchitis. A gross investigation of the oral cavity revealed white spot on the buccal mucosa opposite the first molar. In addition, a blotchy and papular rash appeared on the patient’s face, trunk and extremities later. What is the most likely diagnosis?

A. * Measles

B. Scarlet fever

C. Meningococcal infection

D. Epidemic typhus

E. Influenza

3. A 4-year-old child presented to the hospital with a fever and a sore throat. An oral cavity examination revealed an edema of a soft palate and grey membranes on tonsils. These membranes left a raw hemorrhagic surface when forcibly removed. What the most likely diagnosis is among listed below?

A. *Diphtheria fauces

B. Simonovsky-Vensans’ angina

C. Lacunar angina

D. Infectious mononucleosis

E. Necrotic angina

4. An autopsy of 11-year-old child revealed plural hemorrhages, mainly in skin of breeches and lower extremities, serous and mucosas, and also in a brain. Gross investigation determined a focal necrosis and massive hemorrhages in adrenals, a necrotic nephrosis in kidneys, a purulent arthritis, an iridocyclitis and vasculitis. Choose the correct diagnosis.

A. *Meningococcemia

B. Epidemic typhus

C. Periarteritis nodosa

D. Systemic lupus erythematosus

E. Radiation syndrome

5. A 7-year-old child presented with raised body temperature up to 38,5о, rhinitis, conjunctivitis, and cough. A physical investigation revealed blotchy and papular skin rash and whitish bran-like rashes in a buccal mucosa. On the fourth day appeared a dyspnea and wet pulmonary rhonchuses. Soon, difficulty of breath resulted in patient death from asphyxia. What is the most likely diagnosis?

A. *Measles

B. Meningococcemia

C. Influenza

D. The pulmonary form of a mucoviscidosis

E. Pneumonia

6. A 7-year-old boy presented to the hospital with an acute catarrh in pharynx and tonsils which had extended on a mouth mucosa, tongue and fauces. A tongue was fiery red (crimson red) with prominent papillae (‘raspberry’ or ‘strawberry’ tongue). A gross investigation of tonsils showed superficial necroses. A casting-off necrotic tissue resulted in ulcers formation. Cervical lymphatic nodules were enlarged. A punctuate erythematous rash was determined over the trunk, arms and legs. Face was also involved but a small area about the mouth remained unaffected to produce circumoral pallor. What is the most likely diagnosis?

A. *Scarlet fever

B. Diphtheria

C. Angina

D. Measles

E. Meningococcal nasopharyngitis

7. An autopsy of 4-year-old child revealed hyperemic, yellowish-greenish arachnoids, infiltrated by purulent and fibrinous exudate resembled a ‘cap’. What is the most likely diagnosis?

A. *Meningococcal meningitis

B. Tubercular meningitis

C. Influenzal meningitis

D. Anthrax meningitis

E. Epidemic typhus meningitis

8. An autopsy of a child revealed a necrotic tonsillitis, neck phlegmon, purulent otitis and purulent meningitis. These alterations are the most typical for:

A. * Septic scarlet fever

B. Meningococcal infection

C. Toxic scarlet fever

D. Fauces diphtherias

E. Otogenic sepsis

9. A child presented with acute a catarrhal nasopharyngitis. In 2 days he died. An autopsy revealed arachnoids were markedly hyperemic, edematous, infiltrated with turbid, thick, yellowish-greenish liquid. A brain was swelled, cerebellum tonsils were enlarged in volume, and sulcus of the cerebrum impaction was well defined. The described changes are the most typical for:

A. * Meningococcal infection

B. Influenza

C. Whooping cough

D. Diphtheria

E. Measles

10. A 5-year-old child presented with raised body temperature, punctulated rash, and conjunctivitis. He died of the superimposed pneumonia. A histological research of lungs revealed endo - mezo - panbronchitis and giant-cell pneumonia. For what disease the presented changes are characteristic?

A. *Measles

B. Scarlet fever

C. Croupous pneumonia

D. Diphtheria

E. Smallpox

11. A 43-year-old male, with a history of kidney transplantation, followed by immunosuppressive therapy, died of intoxication. A histological investigation of his lungs, kidneys and pancreas revealed strikingly enlarged (giant) cells with basophilic cytoplasm and large nucleus. The violet intranuclear inclusions surround by a small clear halo, reminded an eye of an owl. What is the most likely diagnosis?

A. *Cytomegaly

B. Tuberculosis

C. Syphilis

D. Lepra

E. Plague

13. 11-year-old child presented with a body temperature up to 40°С, an acute headache, vomiting, anxiety and a fever. In four days appeared a hemorrhagic skin rash, an oliguria and adrenal insufficiency, resulted in patient’s death. A bacteriological study of smear preparation from a pharynx revealed a meningococcus. What form of disease is found out?

A. Meningococcemia

B. Meningococcal meningitis

C. Meningocephalitis

D. Meningococcal nasopharyngitis

E.

12. A young 19-year-old man, with an acute onset of disease, died of an infectious-toxic shock. An autopsy revealed the enlarged tonsils, covered with grey-white membranes, which extended on the palatine arch. In addition, an edema of the neck soft tissues determined. Histological investigation showed the necrosis of an epithelium of tonsils and the palatine arch. Tissues underneath were infiltrated by a fibrinous exudate, which formed massive stratifications on a surface. What is the most likely diagnosis?

A. *Diphtheria

B. Scarlet fever

C. Adenoviral infection

D. Infectious mononucleosis

E. Staphylococcal infection

14. An oral cavity examination of a 4-year-old child, revealed a hyperemia of the fauces and tonsils mucus membranes. Gross investigation showed enlarged tonsils, covered by dense, whitish-yellowish membranes. They left a raw surface, with deep defect, when forcibly removed. Soft tissues of a neck were edematous, regional lymph nodes were enlarged and painful. What the most likely diagnosis is among listed below?

A. *Diphtheria

B. Scarlet fever

C. Measles

D. Parotitis

E. Adenoviral infection

15. An autopsy of 2-year-old child revealed hemorrhagic enanthesis (skin rash), mild hyperemia and edema of nasopharynx mucous, fine hemorrhages in mucosas and internal organs, severe dystrophy in a liver and myocardium, an acute necrotic nephrosis, massive hemorrhages in adrenals. What disease is the most likely to present such symptoms?

A. *Meningococcal infection

B. Scarlet fever

C. Diphtheria

D. Measles

E. Epidemic typhus

16. A child presented to a hospital with an acute fever, sore throat and swelling of submaxillary (submandibular) lymph nodes. A gross investigation of fauces revealed the edematous and slightly hyperemic mucous membrane, enlarged tonsils, covered by the grayish-whitish membranes. They left a raw surface, when forcibly removed. What is the most likely diagnosis?

A. * Diphtheria

B. Catarrhal angina

C. Scarlet fever

D. Meningococcal infection

E. Measles

17. A 7-year-old girl developed an acute disease. She presented to the hospital with a sore throat, and a fever, accompanied with a widespread rash. A physical examination revealed severe hyperemia of a pharynx, a ‘raspberry’ tongue, and enlarged bright red tonsils with some grayish and yellowish dim areas. These zones also extended on peritonsillar tissues. Submandibular lymph nodes were enlarged. For what disease the given changes are characteristic?

A. *Scarlet fever

B. Measles

C. Fauces diphtheria

D. Larynx diphtheria

E. Meningococcal nasopharyngitis

18. A 9-year-old child developed a sharp pain at swallowing and a neck edema. His body temperature had risen to 390С. A motley-red, punctulated , widespread rash appeared. A physical examination revealed severe hyperemia of a pharynx (‘fiery pharynx’) and a ‘raspberry’ tongue. The enlarged bright red tonsils presented with some grayish necrotic zones. What is the most likely diagnosis?

A. * Scarlet fever

B. Meningococcal nasopharyngitis

C. Diphtheria

D. Influenza

E. Measles

19. A 6-year-old boy developed pain at swallowing and raised body temperature. On a second day of the disease, a physical investigation revealed the appearance of the fine, densely set, widespread skin rash with a small unaffected circumoral area. An oral cavity examination showed the bright reddening of a pharynx, enlarged tonsils and raspberry-red tongue. What is the most likely diagnose?

A. *Scarlet fever.

B. Adenoviral infection.

C. Fauces diphtheria.

D. Measles.

E. Streptococcal angina.

20. An 8-year-old child presented with raised body temperature up to 39о C, rhinitis, conjunctivitis, and cough. A physical investigation revealed blotchy skin rash and whitish rashes on a buccal mucosa. Suddenly appeared pant resulted in asphyxia, followed by patient death. What is the most likely diagnosis?

A. *Measles

B. Scarlet fever

C. Diphtheria

D. Meningococcal nasopharyngitis

E. Influenza

21. A 3-year-old girl presented with a sharp pain at the swallowing, a marked neck edema, and the body temperature raised to 40° С. A gross investigation of tonsils revealed the grayish-yellowish membranes, which left a raw surface with bleeding ulceration, when forcibly removed. What is the most likely diagnosis?

A. *Diphtheria

B. Scarlet fever

C. Measles

D. Meningococcal nasopharyngitis

E. Influenza

22. A child died of a spontaneous pheumothorax. A post-mortem revealed a collapse and interstitial emphysema of the right lung, focal atelectases of lungs, a punctual hemorrhage in a brain and a conjunctiva of eyes. What is the most likely diagnosis?

A.* Whooping cough

B. Bronchopneumonia

C. Measles

D. Diphtheria of respiratory tracts

E. Scarlet fever

23. A child presented to the clinic with paralysis of a phrenic nerve and dysphagia, resulted in his death soon. An autopsy revealed ulcers of tonsils with a cuticularization, a hemorrhage in adrenals, and flaccidity of a myocardium. Specify disease for which the described changes and complications are characteristic.

A.* Diphtheria

B. Scarlet fever

C. Agranulocytosis

D. Measles

E. Poliomyelitis

24. A child complains of the general weakness, a pharyngalgia at swallowing and nausea. Objectively, a bright reddening revealed in fauces; tonsils were enlarged. Later, the fine, densely located maculae, size about papaverous grain, appeared on a neck, in the top of a back and a breast. Microscopical investigation showed in a mucosa and tonsils tissue an acute plethora and grayish, dim areas of necroses. On the periphery of the necrotic zones, within the edema and fibrinous inflammation areas, the chains of streptococcuses were defined. What is the most likely diagnosis?

A. * Scarlet fever

B. Diphtheria

C. Measles

D. Influenza

E. Meningococcal nasopharyngitis

25. A 7-year-old child presented to the hospital with a punctuated bright-pink rash on hyperemic skin of a forehead, a neck, in the bottom of abdomen and popliteal fossa. A nasolabial triangle remained pale. Physical investigation of a stomato-pharynx revealed circumscribed bright red hyperemia of mucosa, ‘raspberry’ tongue. His tonsils were friable and edematous; lacunas filled with pus. Lymph nodes of a neck were enlarged, dense and painful. What is the most likely diagnosis?

A. *Scarlet fever

B. Rubella

C. Whooping cough

D. Diphtheria

E. Infectious mononucleosis

26. A child with a history of an acute catarrh of the upper respiratory tract, conjunctivas and blotchy, papular skin rash, died of pulmonary insufficiency. A histological investigation revealed an interstitial pneumonia with focal serous macrophageal inflammation and set of giant cells within alveoli walls. What is the most likely diagnosis?

A. *Measles

B. Influenza

C. Parainfluenza

D. Adenoviral infection

E. Cytomegaly

27. A 4-year-old child died of respiratory insufficiency as a result of a respiratory musculation paralysis. Histological investigation revealed a hyperemia of the thoracal part of a spinal cord, the unclear pattern of the grey substance, punctual hemorrhages and fine sinking down sites of an encephalomalacia. In addition, there was an inflammation with a neuroglia proliferation around and by the necrotic neurons. What is the most likely diagnosis?

A. *Poliomyelitis

B. Meningococcal infection

C. Cytomegaly

D. Toxoplasmosis

E. Adenoviral infection

 







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