Pathogens of bacterial respiratory infections microbiology. Causative agents of bacterial respiratory infections: diphtheria, whooping cough. What not to do if you suspect an infection
Pathogentuberculosis
The causative agents of tuberculosis are mycobacteria (Mycobacterium tuberculosis, Mucobacteriuin bovis) - Gr+ thin curved rods without spores, capsules and flagella; due to the characteristics of the chemical composition (increased lipid content), the tuberculosis bacillus is stained as spores (according to Ziehl-Neelsen, it is stained burgundy , background - blue). The pathogen does not grow on simple media; it is grown, for example, on an egg medium with starch, glycerin and malachite greens to suppress the growth of accompanying microflora (Levenshtein-Jensen medium).
Two types of mycobacteria are pathogenic for humans:
M. tuberculosis are thin, slightly curved rods that grow better on media containing glycerol; Guinea pigs are more sensitive to them; source of infection- Human, infection- by airborne droplets or airborne dust; pulmonary tuberculosis develops more often;
M-bovis - thick short sticks; rabbits are more sensitive to them; source of infection- farm animals; infection- more often through the alimentary (food) route; tuberculosis of the mesenteric lymph nodes is observed.
The virulence of mycobacteria is associated with endotoxin and cord factor (cell wall glycolipids); allergenic properties are associated with cellular proteins. The incubation period ranges from several weeks to several years.
Disease occurs in various forms and can be generalized with damage to the organs of the genitourinary system, bones, meninges, eyes, and skin. Features of immunity in tuberculosis:
marked natural predisposition b people to tuberculosis, determined by genotype;
immunity non-sterile(to superinfection) - while there are tuberculosis bacilli in the body, newly entering mycobacterium tuberculosis is inactivated (die or encapsulated);
antibodies do not play a protective role, and their high titer only indicates the severity of the process (protection is mainly due to immune T-lymphocytes);
immunity is accompanied by development allergies;
Nonsterile immunity after the body is freed from the pathogen becomes sterile.
Microbiological diagnostics carried out by microscopy of stained smears from the material, by the microbiological method, by infection with material from a sick guinea pig (biological method); Allergy diagnostics are also carried out (Mantoux test with tuberculin).
Specific treatment: in accordance with the sensitivity of the isolated strain is prescribed antibiotics(streptomycin, kanamycin, rifampicin, etc.), drugsPACK(para-aminosalicylic acid), GINK preparations(isonicotinic acid hydrazides - ftivazide, etc.)
Specific prevention: at 5-7 days of age it is administered intradermally live vaccine BJ (BCG - attenuated strain of M. bovis, obtained by Calmette and Guerin); revaccination is carried out for persons under 30 years of age with a negative Mantoux test. This test is done
annually by intradermal injection tuberculin(specific extractable protein allergen of Mycobacterium tuberculosis). In adults, the Mantoux test is usually positive; in the absence of clinical manifestations, this indicates that the body is infected with tuberculosis bacilli and, therefore, the presence of immunity to tuberculosis. In children, the test is either negative or positive with a swelling diameter at the injection site of 5-10 mm (vaccine allergy). If the diameter is more than 10 mm or the intensity of the reaction increases by 6 mm or more over the course of a year, the child needs additional examination to exclude or confirm tuberculosis.
Pathogendiphtheria
Corynebacterium diphtheriae - Gr+ thin, slightly curved rods, located at an angle to each other in preparations. There are no spores or capsules (they form a microcapsule in the body), they are immobile. In the thickenings at the ends of the sticks there are grains of volutin, which are identified using special staining methods. They do not grow on simple media; they are grown on coagulated horse serum, blood tellurite and other media. Diphtheria is most often caused by C. diphtheriae biovar gravis, less often by other biovars (mitis or intennedius). Biovars are distinguished by cultural and biochemical properties. As part of the normal microflora of the human body, there are non-pathogenic corynebacteria (false diphtheria bacilli, diphtheroids), which are distinguished by morphological and physiological characteristics.
Diphtheria bacilli are relatively stable in the external environment; can be stored on toys for up to 2 months; they are stored for a long time in diphtheritic films. Sensitive to drying, heating, sunlight and conventional disinfectants. Based on their ability to produce exotoxin, diphtheria bacilli are divided into toxigenic and nontoxigenic. Non-toxigenic ones can acquire the ability to produce exotoxin under the influence of a moderate bacteriophage that carries toxigenic genes (tox genes). The C.diphtheriac exotoxin has general And local action. Locally, it causes necrosis (death) of tissues and increased vascular permeability: a dense gray film is formed, “fused” to the underlying tissues. In addition, the exotoxin is absorbed into the blood and circulating in the body, affecting its tissues, especially the myocardium, adrenal glands, and nervous system (general effect).
Source of infection- a sick person or microbial carrier.
Infection More often it occurs by airborne droplets, less often by household contact (through toys, dishes) or alimentary route.
Disease characterized by severe intoxication and local symptoms. There are diphtheria of the pharynx, nose, larynx, and wounds. eyes, other locations. Immunity is mainly antitoxic and unstable.
diphtheria and diphtheria microbial carriage is carried out by examining material from the source of inflammation (microscopy of stained smears, isolation of a pure culture with identification and mandatory determination of its toxicity).
Specific treatment. At the first suspicion of diphtheria, an antitoxic antidiphtheria drug is administered. whey(heterologous). For antimicrobial therapy, antibiotics are prescribed; They are also used for the sanitation of microbial carriers.
Specific prevention held diphtheria toxoid(from the 1st year of life). It is part of the associated DPT vaccines. ADS (the drug ADS-M with a reduced dose of antigen is administered to weakened individuals and children with allergic status).
Pathogenwhooping cough
Whooping cough is caused by Bordetella pertussis - Gr is a polymorphic rod without spores and flagella. Forms a capsule in the body. Does not grow on simple media; it is grown on a potato-glycerin medium with blood, on casein-charcoal agar. It forms small, smooth, shiny (like droplets of mercury) colonies, which are studied with side lighting (they cast a cone-shaped beam of light onto the medium). Biochemically inactive. Identification is carried out based on a complex of morpho-physiological characteristics and antigenic structure. The causative agent of whooping cough has endotoxin and produces substances such as exotoxins. Unstable in the external environment. Sensitive to heat, sunlight, and common disinfectants.
Source of infection- a microbe carrier or a sick person who is contagious in the last days of the incubation and catarrhal periods of the infection. Infection- by airborne droplets. Children get sick more often. Disease is accompanied by allergization and occurs in several periods: 1) catarrhal(characterized by symptoms of acute respiratory infections); 2) spasmodic(convulsive), when Bordetella toxins irritate the endings of the vagus nerve and a focus of excitation is created in the brain: attacks of indomitable coughing are noted, which often ends in vomiting; 3) period recovery. Immunity is cellular and humoral, persistent.
Microbiological diagnostics in the early period of the disease it is carried out by isolating a pure culture of B. pertussis from sputum, in a later period - by serodiagnosis in the RSC, etc.).
Specific treatment: antibiotics, human immunoglobulin.
Specific prevention: killed vaccine (part of the DTP vaccine).
Pathogenmeningococcalinfections
Meningococci, or Neisseria meningitidis (Neisseria meningitidis) - Gr-cocci that look like coffee beans and are located in pairs with concavities towards each other. There are no spores or flagella; form a capsule in the body. They do not grow on simple media; They are grown on serum media, where they form medium-sized, round, transparent colonies. Biochemically inactive. They have a complex antigenic structure. Meningococci serogroup A usually cause epidemic outbreaks and the most severe diseases. The pathogen is very sensitive to cooling and dies quickly at room temperature; therefore, the material being tested (cerebrospinal fluid, swabs from the back of the throat, blood) is sent to the laboratory warm, for example, after covering it with heating pads. Disinfectants are destroyed instantly.
Pathogenicity factors meningococci - fimbriae(ensure adhesion of the microbe to the epithelium of the nasopharynx), capsule(invasive and antiphagocytic properties), enzymes hyaluronidase and neuraminidase (distribution in tissues). Bacteremia that occurs during infection is accompanied by the breakdown of microbial cells and the release endotoxin, large amounts of which can cause endotoxic shock(with damage to blood vessels, coagulation of blood in them and the development of acidosis).
Source of infection:- a bacteria carrier or a sick person. Infection- by airborne droplets (in close contact). The incubation period is 5-7 days. The following types are distinguished: rms meningococcal infection: epidemic cerebrospinal meningitis(inflammation of the soft meninges), epidemic nasopharyngitis(proceeds like an acute respiratory infection), meningococcal sepsis (meningococemia). Generalization of infection occurs, as a rule, in persons with immunodeficiency. Allergic reactions are involved in the pathogenesis of severe forms of infection. Immunity is persistent, type-specific, cellular and humoral; recurrent illnesses are possible.
Microbiological diagnosis is carried out using the microbiological method; in case of meningitis, microscopy of stained preparations from cerebrospinal fluid sediment is also carried out.
Specific treatment: antibiotics (in large doses); human immunoglobulin.
Specific prevention: chemical vaccine(from polysaccharide antigens of the causative agent of meningococcal infection A and C)
CAUSES OF INTESTINAL BACTERIAL INFECTIONS
ADD THE PHRASE
1. The causative agent of cholera belongs to the species V. cholerae
2. Cholera is caused by Vibrio cholerae serogroups O1 And O139
3. The causative agent of intestinal yersiniosis belongs to the species Y. enterocolitica
4. Salmonella classification according to Kaufman-White is carried out according to antigenic structure.
5. The causative agent of typhoid fever – S.typhy
6. Material for bacteriological examination of a patient with typhoid fever at 1 week of illness - blood
7. Materials for bacteriological research for shigellosis are: excrement (feces).
8. S.flexneri is a pathogen shigellosis
9. The main pathogenicity factor of S.dysenteriae 1 is Shiga toxin
10. To identify the source of infection in typhoid fever, determine serovar S.Typhi.
11. Diarrheagenic Escherichia is differentiated from opportunistic Escherichia by antigenic structure.
12. The causative agent of pseudotuberculosis – Y. pseudotuberculosis
13. Taxonomic position of the causative agent of typhoid fever:
1. Genus Salmonella
2. Family Vibrionaceae
3. Family Enterobacteriaceae
4. Genus Vibrio
14. Taxonomic position of causative agents of colienteritis:
1. Genus Escherichia
2. Family Vibrionaceae
3. Family Enterobacteriaceae
4. Genus Shigella
15. Taxonomic position of the causative agent of intestinal yersiniosis:
1. Genus Escherichia
2. Family Vibrionaceae
3. Family Enterobacteriaceae
4. Genus Yersinia
16. Properties of bacteria of the Enterobacteriaceae family:
1. Gram-negative rods
2. Do not form a dispute
3. Facultative anaerobes
4. Have volutin grains
17. Properties of bacteria of the Enterobacteriaceae family:
1. Need alkaline nutrient media
2. Gram-negative rods
3. Form spores
4. Ferment glucose
18. Culture media used to isolate enterobacteria from patient material:
1. Alkaline agar
2. Kligler's medium
3. Peptone water
4. Lactose-containing differential diagnostic media
19. Properties of bacteria of the genus Salmonella:
1. Produce H2S
2. Lactose negative
3. Mobile
4. Gram positive
20. Methods for microbiological diagnosis of typhoid fever:
1. Bacterioscopic
2. Bacteriological
3. Biological
4. Serological
21. Material for bacteriological research in the 1st week of typhoid fever:
2. Feces
3. Serum
4. Blood
22. Methods for microbiological diagnosis of typhoid fever in the 3rd week of the disease:
1. Bacterioscopic
2. Bacteriological
3. Biological
4. Serological
23. Nutrient media for isolating and identifying blood cultures of the pathogen in typhoid fever:
1. Bile broth
2. Kligler
3. Alkaline peptone water
4. Levina
24. The serological method for diagnosing typhoid fever allows:
1. Assess the dynamics of the disease
2. Detect bacterial carriage
3. Carry out retrospective diagnostics
4. Serotype the pathogen
25. For the serological method of diagnosing typhoid fever, the following reactions are used:
1. RPGA
2. ELISA
4. RA on glass
26. Diagnostic preparations for identifying salmonella:
1. Polyvalent Salmonella Serum
2. Monoreceptor adsorbed O-serum
3. Monoreceptor adsorbed H-serum
4. Salmonella Vi-diagnosticum
27. Diagnostic drugs used in the serological method for diagnosing typhoid fever:
1. Erythrocyte O-diagnosticum
2. Adsorbed O9 monoreceptor serum
3. Erythrocyte H-diagnosticum
4. Adsorbed monoreceptor HD serum
28. Drugs for specific prevention of typhoid fever:
1. Chemical vaccine
2. Inactivated corpuscular vaccine
3. Bacteriophage
4. Anatoxin
29. The development of diarrhea syndrome with salmonellosis is the result of:
1. Actions of enterotoxin
2. Reproduction of Salmonella in epithelial cells of the surface epithelium
3. Activation of the arachidonic acid cascade by endotoxin
4. Actions of Shiga-like toxin
30. Culture media for isolation and identification of Salmonella:
1. Bismuth sulfite agar
2. Levina
3. Kligler
4. Bile broth
31. The importance of E. coli for the macroorganism:
1. Antagonist of pathogenic putrefactive microflora
2. Breaks down fiber
3. May cause inflammation in the bladder and gallbladder
4. May cause sepsis
32. Properties of bacteria of the genus Escherichia:
1. Gram-positive
2. Lactose positive
3. Ferment glucose
4. Do not produce H2S
33. Diarrheagenic Escherichia coli:
1. Produce enterotoxins
2. Lactose positive
3. Have pathogenicity plasmids
4.Have endotoxin
34. Diarrheagenic Escherichia coli:
1. Produce enterotoxins
2. Normally found in the intestines
3. Have pathogenicity plasmids
4. Cause colienteritis
35. Diarrheagenic and opportunistic Escherichia coli differ in:
1. Tinctorial properties
2. Ability to utilize lactose
3. Morphological properties
4. Antigenic structure
37. Diarrheagenic and opportunistic Escherichia coli differ in:
1. Ability to produce enterotoxins
2. Ability to utilize glucose
3. Presence of endotoxin
4. Antigenic structure
38. Diarrheagenic E. coli differ in:
1. Presence of virulence plasmids
2. Pathogenicity factors
3. Antigenic structure
4. H2S products
39. Culture media for isolation and identification of the causative agent of colienteritis:
1. Endo
2. Kligler
3. Gissa
4. Bile broth
40. Properties of bacteria of the genus Shigella:
1. They form spores
2. Lactose negative
3. Have H-antigen
4.Do not produce H2S
41. Properties of bacteria of the genus Shigella:
1.Lactose negative
2.Moveable
3. Ferment glucose
4. Oxidase negative
42. Pathogenicity factors of Shigella:
1. Invasive outer membrane proteins (rpa)
2. Endotoxin
3. Shiga-like toxin
4. Cholerogen
43. Material for bacteriological research for shigellosis:
2. Blood serum
4. Excreta
44. Material for bacteriological research in cholera:
2. Vomit
4. Feces
45. Culture media for isolation and identification of the causative agent of shigellosis:
1. Ploskireva
2. Kligler
3. Endo
4. Alkaline peptone water
46. Causative agent of intestinal yersiniosis:
1. Produces enterotoxin
2. Has psychrophilicity
3. Characterized by incomplete phagocytosis
4. Produces a neurotoxin
47. The causative agent of intestinal yersiniosis:
1. Produces enterotoxin
2. Has psychrophilicity
3. Gram-negative rod
4. Produces spores
48. Conditions for cultivating the causative agent of intestinal yersiniosis:
1. Alkaline nutrient media
2. Strictly anaerobic conditions
3. Incubation time 6 hours
4. Temperature 20-25° C
49. Methods for microbiological diagnosis of intestinal yersiniosis:
1. Bacteriological
2. Bacterioscopic
3. Serological
4. Biological
50. Pathogens of cholera:
1. May belong to serogroup O1
2. May also belong to serogroup O139
3. Produce enterotoxin
4. Psychrophiles
51. Pathogens of cholera:
1. Gram-negative rods
2. Have a capsule
3. Mobile
4. Form spores
52. Pathogenicity factors of cholera pathogens:
1. Invasive outer membrane proteins
2. Enterotoxin
3. Shiga Toxin
4. Neuraminidase
53. Vibrio cholerae biovars cholerae and eltor are distinguished by:
1. Agglutination with O1 serum
2. Sensitivity to polymyxin
3. Agglutinations with Inaba serum
4. Sensitivity to specific bacteriophages
54. Vibrio cholerae serovars O1:
1. Ogawa
2. Inaba
3. Gikoshima
4. Choleresuis
55. Methods for microbiological diagnosis of cholera:
1. Bacteriological
2. Serological (determination of antibodies to pathogen antigens)
3. Bacterioscopic
4. Allergic
56. Nutrient media for isolating cholera pathogens from the test material:
1. Alkaline peptone water
2. Kligler medium
3. Alkaline agar
4. Bile broth
57. Nutrient media for the accumulation of cholera pathogens:
2. Kligler
3. Bile broth
4. Alkaline peptone water
58. Typhoid fever B
59. Shigellosis D
60. Cholera A
61. Intestinal yersiniosis B
B. Y. enterocolitica
62. Cholera G
63. Shigellosis D
64. Salmonellosis B
65. Intestinal escherichiosis A
B. S Enteritidis
66. Cholera B
67. Paratyphoid A D
68. Intestinal escherichiosis G
69. Shigellosis A
A. S. dysenteriae
B. S. Typhimurium
D.S.Paratyphi A
70. Salmonellosis B
71. Intestinal yersiniosis B
72. Typhoid fever A
73. Shigellosis G
B. S. Enteritidis
B. Y. enterocolitica
74. Intestinal escherichiosis G
75. Intestinal yersiniosis D
76. Typhoid B
77. Cholera A
B. S. Choleraesuis
D. Y.enterocolitica
78. Agglutinated by polyvalent Escherichiosis OK serum (antibodies to O111, O157)
79. Cause purulent-inflammatory diseases of various localizations A
80. Produce enterotoxins B
81. Possess psychrophilicity G
A. Opportunistic Escherichia coli
B. Diarrheagenic Escherichia coli
G. Neither one nor the other
82. The main route of transmission is contact and household B
83. The main route of transmission is water.
84. Produces Shiga-like toxin A
85. Produces Shiga toxin B
B. S. dysenteriae
G. Neither one nor the other
86. Mannitol A is broken down
87. Most often transmitted by water A
88. Most often transmitted through household contact B
89. Reproduces in the lymphoid tissue of the intestine D
B. S. dysenteriae
G. Neither one nor the other
90. The main route of transmission is water B
91. The main route of transmission is nutritional A
92. Produces Shiga-like toxin B
93. Does not break down mannitol G
G. Neither one nor the other
94. Belongs to serogroup O1 A
95. Resistant to polymyxin B
96. Sensitive to bacteriophage C A
97. Produces enterotoxin B
A. Biovar cholerae
B. Biovar eltor
G. Neither one nor the other
98. Attachment and damage to the apical part of the villi of the small intestinal epithelium B
99. Invasion and intracellular reproduction in the epithelium of the colon D
100. Attachment and colonization of the surface of the epithelium of the small intestine A
101. Transcytosis of the epithelium of the small intestine with reproduction in the regional lymphoid tissue of the intestine B
102. Invasion and intracellular reproduction in the epithelium of the colon A
103. Attachment and colonization of the surface of the epithelium of the small intestine B
A. Shigella
B. Salmonella
B. Vibrio cholerae
104. Transcytosis of the epithelium of the small intestine D
105. Invasion and reproduction in the epithelium of the colon B
106. Attachment and colonization of the surface of the epithelium of the small intestine A
V. Shigella
G. Yersinia
107. Attachment and colonization of the surface of the epithelium of the small intestine B
108. Invasion and reproduction in the epithelium of the colon A
109. Transcytosis of the epithelium of the small intestine with reproduction in regional lymphoid tissue B
A. Shigella
B. Vibrio cholerae
B. Salmonella
110. Attachment and colonization of the surface epithelium of the small intestine B
111. Invasion and intracellular reproduction in the epithelium of the colon D
112. Epithelial transcytosis with cytotoxic effect A
A. Yersinia
B. Vibrio cholerae
B. Salmonella
G. Shigella
Under numbers 100-104, indicate the correct sequence of actions for the bacteriological method of diagnosing typhoid fever:
A. Reseeding on Endo, Levina 2 media
B. Phage typing 5
B. Reseeding of lactose-negative colonies on Kligler medium 3
D. Identification of the isolated culture 4
D. Inoculation of the test material in bile broth 1
Under numbers 105-109, indicate the correct sequence of actions for bacteriological examination for colienteritis:
A. Subculture of agglutinating colonies on Kligler medium 3
B. Inoculation of the test material on Endo 1 medium
B. Identification of the isolated culture 4
D. Study of lactose-positive colonies with polyvalent OK serum in PA on glass 2
E. Determination of the sensitivity of an isolated pure culture to antibiotics 5
Under numbers 110-114, indicate the correct sequence of actions for the microbiological diagnosis of shigellosis:
A. Identification of isolated pure culture 4
B. Subculture of lactose-negative colonies on Kligler medium 2
B. Reseeding of material on Levin and Ploskirev media and others 1
D. Determination of sensitivity to antibiotics 3
E. Epidemiological labeling of pure culture 5
Under numbers 115-119, indicate the correct sequence of actions for the bacteriological diagnosis of intestinal yersiniosis:
A. Selection of lactose-negative colonies and subculture of them on MPA. 3
B. Inoculation of the test material in phosphate buffer or enrichment medium 1
B. Identification of pure culture to species by biochemical activity 4
D. Cold enrichment (t 4C) with periodic seeding on Endo 2 medium
D. Intraspecific identification 5
Under numbers 120-124, indicate the correct sequence of actions for the bacteriological diagnosis of cholera:
A. Determination of sensitivity to antibiotics 4
B. Setting up an agglutination reaction with sera O1 and O139, transferring to slant agar 3
B. Inoculation of the test material in alkaline peptone water 1
D. Transfer from alkaline peptone water to alkaline agar 2
D. Identification of isolated pure culture 5
138. Salmonella is isolated by plating vomit and feces on bismuth sulfite agar because
Salmonella produces H2S. +++
139. The causative agent of typhoid fever is isolated from feces in the 1st week of the disease, because
The causative agent of typhoid fever infects the epithelium of the colon
intestines.- - -
140. The serological research method makes it possible to identify carriers of the causative agent of typhoid fever, because
· serological research method allows you to detect Vi-antibodies.+++
141. Adsorbed Salmonella monoreceptor O9 serum is used to treat typhoid fever because
·adsorbed Salmonella monoreceptor O9 serum allows you to differentiate Salmonella within the genus into serovars. - + -
142. To isolate the causative agent of colienteritis, feces are sown on Endo medium, because
· causative agents of colienteritis - diarrheagenic Escherichia coli - lactose negative.+ - -
143. Infants are more susceptible to intestinal escherichiosis because
·in infants the normal microflora of the body has not been formed and the production of their own antibodies is imperfect.+++
144. Colienteritis is diagnosed by serological method, because
colienteritis is caused by diarrheagenic Escherichia with a specific antigenic structure.+++
145. S.dysenteriae serovar 1 is the most virulent pathogen of shigellosis because
·S.dysenteriae serovar 1 is transmitted through household contact.++ -
146. S.dysenteriae is the most virulent pathogen of shigellosis because
·S.dysenteriae does not utilize mannitol.++ -
147. S. sonnei is the least virulent pathogen of shigellosis because
·S.sonnei does not cause bacteremia.++ -
148. To diagnose shigellosis, it is necessary to isolate a blood culture of the pathogen, because
Shigellosis is accompanied by the development of bacteremia. - - -
149. The causative agent of intestinal yersiniosis causes the development of mesenteric lymphadenitis and allergization of the body, because
The causative agent of intestinal yersiniosis is psychrophil. + - -
150. Vibrio cholerae biovars cholerae and eltor are differentiated from each other by serotyping with Ogawa and Inaba sera, because
Vibrio cholerae biovars cholerae and eltor belong to serogroup O1.-+-
151. The causative agent of cholera causes dehydration of the body because
The arachidonic acid cascade is activated by the causative agent of cholera during its reproduction in the subepithelial space.+++
152. Cholera is caused by V.cholerae serogroups O1 and O139 because
biovars of cholera vibrio cholerae and eltor belong to different
serogroups.+ - -
153. Probiotics are used in the treatment of intestinal infections because
Antibiotic therapy for intestinal bacterial infections leads to the development of dysbiosis.+++
CAUSES OF RESPIRATORY BACTERIAL INFECTIONS
ADD THE PHRASE
1. Drug for the Mantoux reaction - tuberculin
2. Main biovars of C. diphtheriae: gravis And mitis
3. Planned specific prevention of diphtheria is carried out with diphtheria toxoid
4. The causative agent of diphtheria - C. diphtheriae
5. Drug for planned specific prevention of tuberculosis: BCG
6. The causative agent of whooping cough – B. pertussis
7. In the treatment of toxic forms of diphtheria, in addition to antibiotics, they must use anti-diphtheria serum
8. Mantoux test performed for diagnosis tuberculosis, defines fourth type of hypersensitivity.
9. Bordet-Gengou medium is used to isolate the pathogen whooping cough
10. To create artificial active immunity against diphtheria, drugs containing diphtheria toxoid
11. For planned specific prevention of whooping cough, the vaccine is used - DTP
12. Micropreparations for bacterioscopic examination of tuberculosis are stained using the Ziehl-Neelsen
13. Causative agent of leprosy – M. leprae
CHOOSE ONE OR MORE CORRECT ANSWERS
14. The causative agent of diphtheria:
1. Gram-positive rod
2. Polymorphic
3. Movable
4. Has volutin grains
15. Morphological structures of the causative agent of diphtheria:
2. Fimbriae
3. Flagella
4. Volutin grains
16. Characteristic arrangement of diphtheria bacilli in pure culture:
1. In bunches
2. In the form of chains
3. In the form of a “picket fence”
4. At an angle to each other
17. Basic differential biochemical properties of the causative agent of diphtheria:
1. Does not break down urea
2. Breaks down lactose
3. Breaks down cysteine
4. Breaks down sucrose
18. Biovar gravis differs from biovar mitis in the following properties:
1. Morphological
2.Cultural
3. Antigenic
4. Biochemical
19. C.diphtheriae is distinguished from opportunistic corynebacteria by its properties:
1. Morphological
2.Cultural
3.Biochemical
4.Toxigenic
20.. C.diphtheriae is distinguished from opportunistic corynebacteria by:
1. Polymorphism
2. The presence of bipolar volutin grains
3. Arrangement of cells in the form of V, X
4. Biochemical properties
21. The significance of opportunistic corynebacteria:
1. They can cause osteomyelitis
2. Overdiagnosis of diphtheria may be associated with them
3. They Can Cause Meningitis
4. They can cause diphtheria (if the tox gene is present)
22. Nutrient media for cultivating the causative agent of diphtheria:
2. Blood tellurite agar
3. Yolk salt agar
4. Curdled whey
23. Factors of pathogenicity of diphtheria bacillus:
1. Exotoxin
2. Cord factor
3. Adhesins
4. Neuraminidase
24. The main pathogenicity factor of C.diphtheriae:
1. Cord factor
2. Endotoxin
3.Exotoxin
4. Neuraminidase
25. Diphtheria toxin has a pathological effect on:
1. Heart muscle
2. Kidneys
3. Adrenal glands
4. Nervous ganglia
26. Mechanism of action of diphtheria exotoxin:
1. Impaired respiration of body cells
2. Inactivation of transferase II enzyme
3. Impaired transmission of impulses through neuromuscular synapses
4. Suppression of protein synthesis in the cells of the macroorganism
27. Localization of genes regulating the synthesis of diphtheria exotoxin:
1. In the bacterial chromosome
2. In a plasmid
3. Associated with transposons
4. In prophage
28. Entrance gate for the causative agent of diphtheria:
1. Mucosa of the upper respiratory tract
2. Genitals
3. Eyes ears
4. Wound surface
29. Sources of infection for diphtheria:
1. Sick people
2. Pets
3. Bacteria carriers
30. Routes of transmission of diphtheria:
1. Airborne
2. Contact
3. Nutritional
4. Transmissible
31. Immunity for diphtheria:
1. Antibacterial
2. Antitoxic
3. Non-sterile
4. Humoral
32. Methods for microbiological diagnosis of diphtheria:
1. Microscopic
2. Biological
3. Bacteriological
4. Allergic
33. Material for microbiological examination for suspected diphtheria:
1. Mucus from throat
2. Throat film
3. Mucus from the nose
34. Serological reactions to determine antitoxic immunity in diphtheria:
3. Agglutination reaction
4. RNGA
35. Drugs for planned specific prevention of diphtheria:
1. Tetraanatoxin
2. ADS
3. Antitoxic anti-diphtheria serum
36. Planned specific prevention of diphtheria is postponed until the child is 3-4 months old due to:
1. Receipt of secretory Ig A with mother’s milk
2. Lack of formed normal microflora
3. Production of high titers of own antibodies
4. The presence of Ig G received from the mother through the placenta
37. Drugs for specific emergency prevention of diphtheria:
1. DTP
2. Killed vaccine
3. Bacteriophage
4. Anatoxin
38. The phenomenon due to which diphtheria toxoid is effective for emergency prevention of diphtheria:
3. Immunological tolerance
4. Immunological memory
39. Pathogens of tuberculosis:
1. M. tuberculosis
2. M. africanum
3. M.bovis
40. Pathogens of mycobacteriosis:
1. M.avium
1. M. tuberculosis
4. M.leprae
42. Diseases caused by mycobacteria:
1. Actinomycosis
2. Tuberculosis
3. Deep mycoses
4. Leprosy
43. Morphological transformations of tuberculosis pathogens, contributing to the chronicization of the inflammatory process, the persistence of the microbe, and the diversity of the clinical picture of the disease:
1. Non-acid-fast forms
2. L-shape
3. Filterable forms
4. Bacillary forms
44. The main sources of tuberculosis:
1. Patients with open form of tuberculosis
2. Patients with closed form of tuberculosis
3. Sick farm animals with destructive processes
4. Guinea pigs
45. Basic methods of microbiological diagnosis of tuberculosis:
1. Microscopic
2. Bacteriological
3. Allergic
4. PCR
46. Material for research in pulmonary forms of tuberculosis:
1.Sputum
2. Pleural fluid
3. Bronchial lavage water
4. Ascitic fluid
47. Microscopic examination methods for tuberculosis allow:
1. Detect acid-fast bacteria
2. Identify microbes to species
3. Tentatively suggest a diagnosis
4. Determine the type of microbe
48. Method of accelerated bacteriological diagnosis of tuberculosis:
1. Homogenization
2. Microcultivation
3. Precipitation
4. Price method
49. Methods of “enrichment” of the test material for microscopic diagnosis of tuberculosis:
1. Homogenization and sedimentation
2. Price method
3. Flotation method
50. Laboratory animals used in the microbiological diagnosis of tuberculosis:
1. White mice
2. Rabbits
4. Guinea pigs
51. The Mantoux test allows:
1. Identify infected people
2. Assess the strength of anti-tuberculosis immunity
3. Select persons for revaccination
4. Detect class M immunoglobulins
52. Mantoux reaction:
1. Belongs to type IV according to Jell and Coombs
2. Belongs to type III according to Jell and Coombs
3. Indicates that a person is infected
4. Reliably indicates the presence of the disease
53. Drugs for specific prevention of tuberculosis:
2. BCG-M
4. BCG
54. Vaccine for specific prevention of tuberculosis:
2. Live
3. Anatoxin
55. Epidemiological features of leprosy:
1. Source - sick person
2. Contact transmission path
3. Airborne transmission
4. Source - rodents
56. Biological models for cultivating the causative agent of leprosy:
1. Guinea pigs
2. Rabbits
3. Golden hamsters
4. Armadillos
57. Characteristic location of the causative agent of leprosy in the affected tissues:
1. In intercellular spaces
2. Intracellular
3. In the form of long chains
4. Forms clusters of cells in the form of balls
58. You can distinguish the causative agent of tuberculosis from the causative agent of leprosy during microbiological diagnostics by:
1. Acid resistance
2. Growth on artificial nutrient media
3. PCR results
4. Bioassay results
59. Antigen for staging the Mitsuda reaction:
1. Autoclaved suspension of the causative agent of leprosy, obtained by homogenizing the contents of leprosy
2. Lepromin-A
3. Integral lepromin
4. Dry purified tuberculin
60. To prevent leprosy, use:
1. Dry purified tuberculin
2. Integral lepromin
4. BCG
61. Properties of the causative agent of whooping cough:
1. Gram-negative rod
2. Forms exotoxin
3. Biochemically inactive
4. Produces spores
62. Properties of the causative agent of whooping cough:
1. Demanding on nutrient media
2. Biochemically inactive
3. Highly sensitive to environmental factors
4. Grows on simple media
63. Nutrient media for cultivating the causative agent of whooping cough:
2. Casein charcoal agar
3. Clauberg environment
4. Bordet-Gengou environment
64. Pathogenicity factors of the causative agent of whooping cough:
1. Filamentous hemagglutinin
2. Pertussis toxin
3. Extracellular adenylate cyclase
4. Endotoxin
65. Methods for microbiological diagnosis of whooping cough:
1. Bacterioscopic
2. Bacteriological
3. Allergic
4. Serological
66. Legionellosis causative agent:
1. L.pneumophila
67. Properties of Legionella:
1. They form spores
2. Free-living bacteria
3. Have endotoxin
4. Gram-negative rods
68. Main forms of legionellosis:
1. Philadelphia fever
2. Fort Bragg Fever
3.Pontiac fever
4. Legionnaires' disease
69. Material for microbiological diagnosis of legionellosis:
1. Pleural fluid
2. Sputum
3. Pieces of lungs
4. Blood serum
70. Serological tests for the diagnosis of legionellosis:
1. Hemagglutination reaction
2. REEF
3. Precipitation reaction
4. ELISA
71. Methods for microbiological diagnosis of legionellosis:
1. PCR
2. Serological
3. Allergic
4. Bacteriological
MAKE LOGICAL PAIRS: QUESTION-ANSWER
72. Biovar gravis B
73. Biovar mitis B
A. Forms large, smooth, red colonies
B. Forms small black colonies
B. Forms large, rough, gray colonies
74. Breaks down urea B
75. Does not have cystinase B
76. Does not have urease A
77. Produces cystinase A
A. The causative agent of diphtheria
B. Opportunistic corynebacteria
G. Neither one nor the other
79. Produce urease G
A. Toxigenic strains of diphtheria bacillus
B. Non-toxigenic strains of diphtheria bacillus
G. Neither one nor the other
80. The pathogen is released into the environment B
81. Can be detected during an allergological study D
82. Can be detected during bacteriological examination B
83. Can be a source of infection for diphtheria B
A. Patients with diphtheria
B. Bacterial carriers of the causative agent of diphtheria
G. Neither one nor the other
Describe the course of bacteriological examination for diphtheria
A. Subculture of suspicious colonies with coagulated serum 2
B. Inoculation of the test material on Clauberg medium 1
B. Identification of isolated pure culture 3
87. M. leprae A
88. M.kansassii B
89. M.africanum B
B. Mycobacteriosis
B. Tuberculosis
91. M.lergae A
93. M. tuberculosis G
A. Located intracellularly, forming clusters in the form of balls
B. Gram-negative cocci
B. Long thin sticks
G. Short thick sticks
94. B.pertussis B
95. L.pneumophila G
96. B.parapertussis A
A. Parawhooping cough
B. Whooping cough
V. Paratyphoid
G. Legionellosis
98. M.leprae B
99. M.kansassi G
100. M. tuberculosis A
A. Guinea pigs
B. Rabbits
B. Nine-banded armadillos
D. Rapid growth on nutrient media
ESTABLISH IF STATEMENT I IS TRUE, IF STATEMENT II IS TRUE AND IS THERE A CONNECTION BETWEEN THEM?
101. Myocarditis is often a complication of diphtheria, because
Diphtheria exotoxin disrupts protein synthesis in myocardial cells. +++
102. C.pseudodiphtheriticum causes diphtheria because
The pseudodiphtheria bacillus lives in the pharynx. - + -
103. For specific emergency prevention of diphtheria, diphtheria toxoid can be used because
·people vaccinated against diphtheria have an immunological memory.+++
104. Anti-diphtheria serum is administered according to Bezredka, because
After administration of anti-diphtheria serum, serum sickness may develop. +++
105. M. tuberculosis causes tuberculosis only in humans because
·M. tuberculosis is not capable of infecting laboratory and farm animals. + - -
106. The main route of transmission of M.bovis is nutritional, because
·M.bovis is more often transmitted from sick animals through milk.+++
107. The most reliable method of microbiological diagnosis of tuberculosis is microscopic, because
· tuberculosis pathogens grow slowly on nutrient media. - + -
108. The microscopic method for diagnosing tuberculosis is indicative because
The microscopic method for diagnosing tuberculosis does not allow determining the type of pathogen.+++
109. The detection of tuberculosis pathogens in pathological material reliably indicates the activity of the infectious process, because
· detection of antibodies in blood serum allows only indirect assessment of the nature of tuberculosis activity. ++ -
110. The microscopic method is a mandatory method for diagnosing tuberculosis because
· Ziehl-Neelsen staining allows one to distinguish acid-fast pathogens of tuberculosis from opportunistic mycobacteria. - - -
111. When diagnosing mycobacteriosis, pathogens are identified to species and sensitivity to antibiotics is determined, because
· opportunistic mycobacteria are similar in some biological properties to tuberculosis pathogens, but are resistant to anti-tuberculosis drugs. ++ -
112. Pasteurization of milk is aimed at preventing tuberculosis because
· tuberculosis pathogens are transmitted through milk and dairy products. -+-
113. Bacteriological research is important in differentiating the pathogens of tuberculosis and leprosy, because
The causative agent of leprosy does not grow on artificial nutrient media.+++
114. The tuberculoid form of leprosy is a prognostically favorable form because
The Mitsuda reaction for tuberculoid leprosy is negative. + - -
115. The causative agent of whooping cough and other representatives of this genus differ in biochemical properties because
· the causative agent of whooping cough has pronounced saccharolytic and proteolytic activity. + - -
116. Filamentous hemagglutinin is one of the main pathogenicity factors of the causative agent of whooping cough, because
· thanks to hemagglutinin, B. pertussis adheres to the epithelium of the respiratory tract.+++
117. Pertussis endotoxin is the main pathogenicity factor of the causative agent of whooping cough, because
·thanks to pertussis endotoxin, the pathogen attaches to the epithelium of the respiratory tract.+ - -
118. Extracellular adenylate cyclase is one of the main pathogenicity factors of the pertussis pathogen, because
B. pertussis adenylate cyclase suppresses the phagocytic activity of macrophages.+++
119. Whooping cough has a long course because
·in the patient’s body, the virulence of the whooping cough pathogen increases.+++
120. The pathogenesis of whooping cough includes adhesion of the pathogen to the surface epithelium of the trachea, bronchi and the action of toxic substances, because
· in the patient’s body, the microbe can move from phase I (virulent) to phase IV (non-virulent). + - -
121. Blue-green algae are important in the spread of Legionella because
mucous secretions of algae retain the pathogen in aerosols and provide a high infectious dose.+++
122. In the spread of the causative agent of legionellosis, the leading role belongs to the water factor, because
· Legionella's natural habitat is warm water bodies, where they are in symbiotic association with blue-green algae and amoebae.+++
123. To diagnose legionellosis, a bacterioscopic method for examining sputum and blood is used, because
Legionella are not cultivated on nutrient media. - - -
124. Legionellosis is classified as a sapronotic infection because
Legionellosis is easily transmitted from person to person. - - -
125. When diagnosing legionellosis, the microscopic method is not used because
· sputum and pleural fluid contain few microbes ++ -
126. Tuberculin is used to treat tuberculosis because
· tuberculin is an anti-tuberculosis chemotherapeutic
65 A 20-year-old young man was injected with toxoid for prophylactic purposes. Which of the following diseases was vaccinated against?
A.* Diphtheria
B. Tuberculosis
C. Scarlet fever
D. Meningitis
E. Whooping cough
167 A 6-year-old child, who was suspected of having an active tuberculosis process, underwent the diagnostic Mantoux test. What immunobiological preparation was used in this case?
A.* Tuberculin.
B. BCG vaccine.
C. DTP vaccine.
D. Tularin.
E. ADS vaccine.
364 When examining a child with suspected diphtheria, bacteria with bipolar, intensely colored inclusions were identified in a throat smear. Which of the recalculated dyeing methods were used?
A. Leffler.
B. Grama.
C. Ziehl-Neelsen.
D. Burri-Ginsa.
E. Ozheshki.
367 The maternity hospital plans to vaccinate children against tuberculosis. Which of the listed medications do you need to have for this?
A. BCG vaccine.
B. DTP vaccine.
C. Tuberculin.
D. ADS vaccine.
E. STI vaccine.
368 Microscopy of smears stained with methylene blue revealed rods with club-shaped thickenings at the ends, similar to C. Diphteria. Which of the following coloring methods should be additionally applied to clarify the assumption?
A. Neisser.
B. Kozlovsky.
C. Ziehl-Neelsen.
D. Zdrodovsky.
E. Ozheshko.
415 While examining the child, the dentist discovered plaque on the tonsils and suspected an atypical form of diphtheria. A smear was prepared, cultured on nutrient media, and the toxicity of the isolated pure culture was determined. What reaction was used to determine the toxigenicity of the isolated strain of diphtheria bacillus?
A.*Precipitation reaction in gel
B. Agglutination reaction on glass
C.
D. Hemolysis reaction
E. Ring precipitation reaction
531 The sputum of a patient with tuberculosis is sent to the bacteriological laboratory. For bacterioscopic examination of preparations - smears and detection of tuberculosis bacillus, you need to use one of the indicated staining methods:
A.*Tsilya - Nielsen
B. Burri - Ginsa
C. Zdrodovsky
D. Gramma
E. Romanovsky
627 A preparation for microscopy was prepared from the urine sediment of a patient with suspected pochard tuberculosis. What staining method is used to identify the pathogen?
A.* According to Ziehl-Neelsen
B. According to Burri
C. By Gram
D. According to Leffler
E. According to Ozheshko
780 When staining bacterial preparations prepared from sputum using the Ziehl-Neelsen method, the presence of bright red rods was revealed, which were placed one at a time or in groups and were not sensitive to the action of acids. On nutrient media, the first signs of growth appear on days 10-15. What are these microorganisms?
A.*Micobacterium tuberculosis
B. Versinia pseudotuberculosis
C. Histoplasma dubrosii
D. Klebsiella rhinoscleromanis
E. Coxiella burnettii
826 Antitoxic serums are used for the prevention and treatment of:
A.*Diphtheria.
B. Whooping cough.
C. Dysentery.
D. Gonorrhea.
E. Tuberculosis.
852 A child was admitted to the hospital with a diagnosis of diphtheria. What specific therapy drugs will you use?
A.*Antidiphtheria antitoxic serum, antibiotics
B. Diphtheria toxoid, antibiotics
C. Vaccine "Codivac", sulfonamides
D. Diphtheria vaccines: DTP, ADS, AD
E. Diphtheria bacteriophage
867 No mycobacteria were found in a smear prepared from the sputum of a tuberculosis patient. Is it possible to increase the probability of bacterioscopic detection of a pathogen in sputum? If yes, then by what methods?
A.* Methods of enrichment of the studied material (centrifugation by flotation)
B. Biological method
C. Inoculation of material into enrichment media
D. By enzyme immunoassay method
E. By serological methods
969 Mycobacteria were not detected in sputum smears of a patient with pulmonary tuberculosis. What method can be used to increase the likelihood of detecting mycobacteria in pathological material?
A.* Homogenization and flotation
B. Price and Shkolnikova
C. Dark-field microscopy
D. Microscopy of Ziehl-Neelsen stained specimens
E. Microscopy of native micropreparations
1109 A child with diphtheria, 10 days after the administration of antitoxic anti-diphtheria serum, developed skin rashes that were accompanied by severe itching, body temperature increased to 38C, and joint pain appeared. What reason do you suppose for these presented?
A. Serum sickness
B. Anaphylactic reaction
C. Atopy
D. Delayed hypersensitivity
E. Contact allergy
1110 If tuberculosis was suspected, a Mantoux test was performed on a sick child. After 24 hours, swelling, hyperemia and pain appeared at the site of allergen injection. What are the main components that determine this body reaction?
A. Mononuclear cells, T-lymphocytes and lymphokines
B. Granulocytes, T-lymphocytes and Ig G.
C. Plasma cells, T lymphocytes and lymphokines
D. B lymphocytes, Ig M
E. Macrophages, B lymphocytes and monocytes
1157 The laboratory received sputum from a patient with tuberculosis. Which staining method should be used to identify tuberculosis pathogens?
A.*Ziehl-Neelsen
B. Grama-Sineva
C. Giemse-Romanovsky
D. Burri-Ginsa
E. Neissera
1167 When examining the patient, the otolaryngologist noticed hyperemia and significant swelling of the tonsils with a gray coating on them. Plaque microscopy revealed gr+ rods located at an angle to each other. What disease should you think about?
A.*Diphtheria
B. Angina
C. Scarlet fever
D. Meningonasopharyngitis
E. Parotitis
1171 A patient was brought to the clinic in serious general condition, with high fever and difficulty breathing. Bacterioscopic examination of material from the throat and respiratory tract made it possible to preliminarily diagnose diphtheria croup. What painting method was used?
A.*Neissera
B. Ziehl-Neelsen
C. Guinsa-Burri
D. Peshkova
E. Ozheshki
1225 In connection with the case of diphtheria, it became necessary to carry out preventive vaccinations in the student group. Which drug should be used to create artificial active immunity?
A.*Diphtheria toxoid
B. Antidiphtheria serum
C. Specific immunoglobulin
D. DPT vaccine
E. Killed bacteria vaccine
1256 In a closed group, it became necessary to check the state of immunity against diphtheria in order to justify the need for vaccination. What research should be conducted for this purpose?
A.*Set antitoxin titer in RNGA
B. Check team members for diphtheria bacillus carriage
C. Determine the level of antibodies against diphtheria bacillus
D. Check medical documentation regarding vaccination
E. Check the state of immunity regarding diphtheria bacillus
1319 A smear of material taken from a patient with suspected diphtheria revealed yellow rods with blue grains at the ends. What coloring method was used in this case?
A.* Neissera
B. Leffler
C. Ziehl-Nielsen
D. Kozlovsky
E. Romanovsky
1336 When examining the patient's sputum using the Price method, red rod-shaped bacteria were found in the smears, forming convoluted cords. What substance causes these bacteria to stick together and grow in the form of ropes?
A.*Cord factor
B. Altuberculin
C. Phthionic acid (phosphatide)
D. Tuberculostearic acid
1351 From a sick child with suspected diphtheria, discharge from the affected mucous membrane of the pharynx was taken for examination. A smear is prepared and painted. Microscopy revealed yellow rods with dark blue thickenings at the ends. What structural element of a microbial cell is determined in the identified microorganisms?
A.*Volutin grains
B. Plasmids
C. Capsule
D. Controversy
E. Flagella
1355 During a medical examination of 1st grade students, a Mantoux test was performed. Of the 35 students, 15 had a negative Mantoux test. What should be done for children with a negative Mantoux test?
A.*Administer BCG vaccine
B. Administer antitoxic serum
C. Administer rabies vaccine
D. Try again
E. Examine blood serum
2216 A patient with tuberculosis with a history of open pulmonary form of the disease underwent microscopic examination of sputum to identify the pathogen. What painting method is advisable to use for this?
A.*Ziehl-Neelsen method
B. Gram method
C. Burri-Gins method
D. Romanovsky-Giemsa method
E. Neisser method
2221 There are cases of sore throat among boarding school children. Microscopy of smears from the tonsils, stained using the Neisser method, revealed thin yellow rods with dark brown grains at the ends, which were arranged in the shape of the Roman numeral five. What infection can be suspected in this case?
A.*Diphtheria
B. Infectious mononucleosis
C. Listeriosis
D. Tonsillitis
E. Scarlet fever
2340 Microscopic examination of a biopsy sample from the affected area of the oral mucosa revealed rods located in the form of clusters that resemble a pack of cigars. According to Ziehl-Neelsen, they are colored red. What type of pathogen is likely detected in the biopsy specimen?
A.* M. leprae
B. M. tuberculosis
C. A. bovis
D. A. israilii
E. M. avium
2524
A.* BCG vaccine.
B. STI vaccine.
C. EV vaccine.
D. DTP vaccine.
E. Tuberculin.
2797 In the laboratory, microscopy of Ziehl-Neelsen stained sputum smears from a patient with chronic pulmonary disease revealed red rods. What property of the tuberculosis bacillus was revealed in this case?
A.*Acid resistance
B. Alkali resistance
C. Alcohol resistance
D. Capsule formation
E. Sporulation
2798 When registering a child for school to decide on the need for revaccination, a Mantoux test was performed, which turned out to be negative. What does this test result indicate?
A.*About the absence of cellular immunity to tuberculosis
B. On the presence of cellular immunity to tuberculosis
C. About the absence of antibodies to tuberculosis bacteria
D. About the absence of antitoxic immunity to tuberculosis
E. About the presence of antibodies to tuberculosis bacteria
2819 To determine the toxigenicity of diphtheria bacilli, a strip of filter paper soaked with antitoxic diphtheria serum was placed on a solid nutrient medium, and next to it the studied microbial culture and a known toxigenic strain were inoculated in the form of plaques. If the studied microbial culture produces an exotoxin, then the following are formed:
A.*Precipitation lines
B. Hemolysis zones
C. Areas of diffuse opacification
D. Zones of lecithinase activity
E. Precipitation ring
2821 To determine the level of anti-diphtheria immunity in the child, it was decided to perform a passive hemagglutination test. How should erythrocytes be sensitized in order to solve the problem?
A.*Diphtheria toxoid
B. Diphtheria antitoxin
C. Antigens of diphtheria bacillus
D. Antidiphtheria serum
E. Hemolytic serum
2837 When studying sputum taken from a patient with suspected tuberculosis, a preparation was prepared and stained according to Ziehl-Neelsen. What is the microscopic picture when confirming the suspected diagnosis?
A.*Small red bacteria
B. Microorganisms with a ruby red nucleus and blue cytoplasm
C. Red ovoid bacteria bipolar stained
D. Rod-shaped microbes in the form of chains, purple
E. Red coccoid microorganisms
2884 A 7-year-old girl was admitted to the infectious diseases clinic with a high fever, complaints of a sore throat, and general weakness. The doctor suspected diphtheria and ordered to take material from the throat and isolate a pure culture of the pathogen. Select which of the following is decisive for confirming the diagnosis of diphtheria after isolating a pure culture of the pathogen?
A.*Toxigenicity test
B. Identification of volutin grains in the pathogen
C. Cystinase test
D. Hemolytic ability of the pathogen
E. Phagolysability
3017 In the children's department of the infectious diseases clinic, the boy was diagnosed with diphtheria. What drug should be administered to the patient first?
A. Antidiphtheria antitoxic serum.
B. Diphtheria toxoid.
C. DPT.
D. ADS.
E. TABte.
3018 A smear from plaque on the tonsils of a patient with suspected diphtheria revealed blue rods with thickenings at the poles. What method of coloring the smears was used?
A. Leffler.
B. Burri.
C. Ginsa.
D. Grama.
E. Neisser.
3019 The maternity hospital immunized infants against tuberculosis. Which of the listed vaccines was used?
A.*BCG.
B. ADS.
C. DPT.
3020 In the first grade, a medical examination of students was carried out in order to select children for revaccination against tuberculosis. Which of the following samples was used?
A.*Mantoux test.
B. Chic sample.
C. Skin test with tularin
D. Burnet's test.
E. Test with anthraxin
3021 Vaccination against whooping cough is planned in the kindergarten. Which of the following drugs should be used for this purpose?
A.*DTP vaccine.
B. BCG vaccine.
C. Type-specific serum.
D. Normal gamma globulin.
E. ADS toxoid.
3252 In the maternity hospital, the newborn should be vaccinated against tuberculosis. What drug should be used for this?
A.* BCG vaccine.
B. STI vaccine.
C. EV vaccine.
D. DTP vaccine.
E. Tuberculin.
3538 The doctor, examining the child, discovered a gray-yellow film on the tonsils that was difficult to separate from the tissues. Considering the patient’s complaints of pain when swallowing, the elevated temperature was made with a preliminary diagnosis of “diphtheria?” " By what method can a suspected diagnosis be reliably confirmed or rejected?
A.* Bacteriological
B. Serological
C. Biological
D. Allergological
E. Microscopic
4008 A 10-year-old child was given a Mantoux test (with tuberculin). After 48 hours, a papule measuring up to 8 mm in diameter appeared at the site of tuberculin injection. What type of hypersensitivity reaction developed after tuberculin administration?
A.* Type IV hypersensitivity reaction.
B. Arthus phenomenon type reaction.
C. Serum sickness type reaction.
D. Atopic reaction.
E. Type II hypersensitivity reaction.
Pathogeny anaerobes and spirochetes
92 A patient injured in a car accident with a fracture of the lower jaw was provided with emergency care and antitetanus serum was administered, but after 2 months the patient was taken to the infectious diseases department with symptoms of “late” tetanus. How should tetanus prophylaxis be carried out correctly to avoid these complications?
A.*Carry out active-passive prophylaxis of tetanus
B. Administer a large dose of antitoxic serum
C. Administer antitetanus human gammaglobulin
D. Get a blood transfusion
E. Carry out autohemotherapy
532 A bacteriological laboratory examined home-made dried fish, which caused severe food poisoning. Microscopy of a culture isolated on Kitt-Tarozzi medium revealed microorganisms similar to a tennis racket. What diagnosis will the doctor make?
A.*Botulism
B. Salmonellosis
C. Cholera
D. Dysentery
E. Typhoid fever
579 After eating canned meat, patient N. developed double vision, severe headache, difficulty swallowing, difficulty breathing, and muscle weakness. A diagnosis of botulism was made. What pathogenicity factor is associated with the clinical manifestations of this disease?
A.*Exotoxin.
B. Hemolysin.
C. Endotoxin.
D. Plasmocoagulase.
E. Fibrinolysin.
611 The laboratory conducted research on the diagnosis of tetanus. What method of sterilization should be used to destroy the excreted tetanus culture?
A.*Autoclavable
B. Boiling
C. Tyndalization
D. Dry heat
E. Pasteurization
694 In a patient who was injured in a car accident, the doctor suspected the possible development of an anaerobic wound infection. Which drug is most appropriate for specific treatment even before a laboratory diagnosis is established?
A.* Polyvalent specific serum
B. Anatoxin
C. Type-specific immune serum
D. Native plasma
E. Placental gamma globulin
743 A patient was admitted to the infectious diseases clinic with a diagnosis of “epidemic relapsing fever?” “What material taken from the patient should be examined first?
A.*Blood
B. I'm pissing
C. Liquor
D. Feces
E. Nasopharyngeal wash
782 When examining a patient hospitalized on the 5th day of illness with lesions of the spleen, muscle pain, chills, and nosebleeds. During laboratory diagnostics, a bacteriologist performed dark-field microscopy of a drop of the patient’s blood. Name the causative agents of the disease.
A.*Leptospira interrogans
B. Borrelia dutlonii
C. Calymmatobacterium granulomatis
D. Bartonella bacilloformis
E. Rickettsia mooseri
837 A patient who had syphilis was found to have a hard chancre on his genitals. What form of infection can we talk about in this patient?
A.*Primary infection
B. Secondary infection
C. Mixed infection
D. Relapse
E. Superinfection
865 A patient with gas gangrene of the leg was admitted to the surgical department. The etiology is not established. What is the specific treatment for this patient?
A.*Introduce a polyvalent antitoxic anti-gangrenous
B. Perform surgical treatment of the wound
C. Prescribe high doses of sulfa drugs
D. Get vaccinated
E. Prescribe high doses of antibiotics
911 For the serological diagnosis of syphilis in the Waserman reaction, a laboratory doctor prepared the following reagents: cardiolipin antigen, alcoholic extract of lipoids from bovine heart muscle with cholesterol, antigen from treponemes destroyed by ultrasound, hemolytic system, saline solution, test serum. What other component is needed to stage the reaction?
A.* Complement
B. Live Treponemas
C. Sheep red blood cells
D. Diagnostic precipitating serum
E. Antiglobulin serum
1153 During a microscopic examination of a blood microscope stained according to Romanovsky-Giemsa, the doctor identified a microorganism in the form of thin blue-violet threads with several large curls from 10 to 30 microns in length or more. What infectious disease is this microscopic picture typical for?
A.*Relapsing typhus
B. Syphilis
C. Leptospirosis
D. Trypanosomiasis
E. Leishmaniasis
1154 In a microslide made from punctate of a regional lymph node of a patient, stained according to Romanovsky-Giemsa, the doctor identified thin microorganisms with 12-14 uniform curls with sharp ends, 10-13 microns long, pale pink in color. What infectious disease causative agent can be discussed in this case?
A.*Syphilis
B. Trypanosomiasis
C. Leptospirosis
D. Relapsing fever
E. Leishmaniasis
1168 Patient N. was admitted to the hospital with complaints of vomiting, dizziness, double vision, and difficulty swallowing. The doctor suspected botulism. What diagnostic methods are appropriate to use to confirm the diagnosis?
A.*Biological sample, bacteriological
B. Allergy test, serological
C. Bacteriological, mycological
D. Protozoological, microscopic
2190 When examining the patient, the dentist revealed tension in the masticatory muscles and limited mouth opening. What infectious disease are these symptoms characteristic of?
A.* Tetanus
B. Flu
C. Diphtheria
D. Leptospirosis
E. Cholera
2507 When examining a patient with necrotic phlegmon of the maxillofacial area, the doctor suspected gas gangrene. Microscopy of purulent discharge from the wound revealed gram-positive rod-shaped microorganisms. What nutrient medium should be used to isolate a pure culture of the pathogen?
A.* Kitta-Tarozzi environment.
B. Endo environment.
C. Levin's Wednesday.
D. Meat peptone agar.
E. Milk-salt agar.
2543 A patient with an open fracture of the lower jaw was admitted to the Department of Dental Surgery. Which drug should be used for active immunization against tetanus?
A.*Tetanus toxoid
B. Tetanus immunoglobulin
C. Antitetanus serum
D. Pertussis-diphtheria-tetanus vaccine
E. Gamma globulin from the blood of donors immunized against tetanus
2820 Relapsing fever caused by B. caucasica occurs only in certain areas where there is a tick vector of the genus Alectorobius. What can you call such an infection?
A.*Endemic
B. Exotic
C. Sporadic
D. Pandemic
E. Epidemic
2874 The patient with syphilis underwent a course of antibiotic therapy and was completely cured. After some time, he was again infected with Treponema pallidum. This form of infection can be attributed to:
A.*Reinfections
B. Relapse
C. Secondary infection
D. Superinfections
E. Complication
2938 The Waserman reaction in a 30-year-old patient is sharply positive (++++). What infectious disease is the Waserman reaction used to diagnose?
A.*Syphilis
B. Brucellosis
C. Tuberculosis
D. Polio
E. Flu
3238 When examining a patient with necrotic phlegmon of the maxillofacial area, the doctor suspected gas gangrene. Microscopy of purulent discharge from the wound revealed gram-positive rod-shaped microorganisms. What nutrient medium should be used to isolate a pure culture of the pathogen?
A.* Kitta-Tarozzi environment.
B. Endo environment.
C. Levin's Wednesday.
D. Meat peptone agar.
E. Milk-salt agar.
3480 In a patient with an ulcer located on the oral mucosa, Romanovsky-Giemsa staining revealed thin, spiral-shaped, pale pink microorganisms with 12-14 curls and pointed ends. What pathogen has these symptoms?
A.* The causative agent of syphilis
B. The causative agent of leptospirosis
C. The causative agent of relapsing fever
D. The causative agent of campylobacteriosis
E. The causative agent of fusobacteriosis
3495 On the oral mucosa of a 20-year-old woman, a dentist noticed a round ulcer with a dense bottom and smooth edges, which resembles a chancre. What diagnostic method should be used at this stage of the disease to confirm its etiology?
A.* Bacterioscopic
B. Bacteriological
C. Biological
D. Serological
E. Allergic
3660 From a patient with a preliminary diagnosis of syphilis, a laboratory technician took blood serum to establish an immune reaction, which is based on identifying antibodies that stop the movement of treponemes and lead to their death. What reaction was used for diagnosis?
A.* Immobilization reaction
B. Complement fixation reaction
C. Agglutination reaction
D. Precipitation reaction
E. Neutralization reaction
3674 The patient was taken to the hospital with a preliminary diagnosis of botulism. What serological reaction should be used to detect botulinum toxin in the test material?
A.* Neutralization reaction
B. Agglutination reaction
C. Complement fixation reaction
D. Precipitation reaction
E. Immunofluorescence reaction
3745
A.*Kitt-Tarozzi
B. Leffler
C. Lowenstein-Jensen
D. Endo
E. Ploskireva
3745 7 days after plastic surgery performed by a dentist, the patient developed tetanus. It was suspected that the cause was suture material contaminated with the causative agent of tetanus, which was delivered to the bacteriological laboratory. What nutrient medium should be used for the initial sowing of material?
A.*Kitt-Tarozzi
B. Leffler
C. Lowenstein-Jensen
D. Endo
E. Ploskireva
3778 In the bacteriological laboratory, canned meat is tested for botulinum toxin content. To do this, an experimental group of mice was injected with an extract from the test material and antitoxic anti-botulinum serum of types A, B, E; The control group of mice was injected with the extract without botulinum serum. What serological reaction was used?
A.*Neutralization
B. Precipitation
C. Complement fixation
D. Opsono-phagocytic
E. Double immune diffusion
3974 In the endemic zone of leptospirosis, the population suffers from this dangerous infection. Which source of infection poses the greatest danger?
A.* Rodents.
B. Dairy products.
C. Cattle.
D. Meat products.
E. Ticks.
3975 A veterinarian was admitted to the infectious diseases hospital with suspected brucellosis. What serological test can confirm the diagnosis?
A.*Wright agglutination reaction
B. Widal agglutination reactions
C. Ascoli precipitation reactions
D. Weigl agglutination reactions
E. Wasserman complement fixation reactions
ADD THE PHRASE
1. The drug for the Mantoux reaction is ______.
2. The main biovars of C. diphtheriae: ________ and ________.
3. Planned specific prevention of diphtheria is carried out with diphtheria ______.
4. The causative agent of diphtheria is _________ ___________
5. Drug for planned specific prevention of tuberculosis: _____________.
6. The causative agent of whooping cough is ______ __________.
7. In the treatment of toxic forms of diphtheria, in addition to antibiotics, _________ ________ must be used.
8. The Mantoux test, performed for the diagnosis of ________, determines the ____ type of hypersensitivity.
9. Bordet-Gengou medium is used to isolate the pathogen __________.
10. To create artificial active immunity against diphtheria, drugs containing __________ __________ are used.
11. For routine specific prevention of whooping cough, the vaccine used is _________.
12. Micropreparations for bacterioscopic examination of tuberculosis are stained using the _______ method.
13. The causative agent of leprosy is _____________.
CHOOSE ONE OR MORE CORRECT ANSWERS
14. The causative agent of diphtheria:
1. Gram-positive rod
2. Polymorphic
3. Movable
4. Contains volutin grains
15. Morphological structures of the causative agent of diphtheria:
2. Fimbriae
3. Flagella
4. Volutin grains
16. Characteristic arrangement of diphtheria bacilli in pure culture:
1. In bunches
2. In the form of chains
3. In the form of a “picket fence”
4. At an angle to each other
17. Basic differential biochemical properties of the causative agent of diphtheria:
1. Does not break down urea
2. Breaks down lactose
3. Breaks down cysteine
4. Breaks down sucrose
18. Biovar gravis differs from biovar mitis in the following properties:
1. Morphological
2. Cultural
3. Antigenic
4. Biochemical
19. C.diphtheriae is distinguished from opportunistic corynebacteria by its properties:
1. Morphological
2. Cultural
3. Biochemical
4. Toxigenic
20.. C.diphtheriae is distinguished from opportunistic corynebacteria by:
1. Polymorphism
2. The presence of bipolar volutin grains
3. Arrangement of cells in the form of V, X
4. Biochemical properties
21. The significance of opportunistic corynebacteria:
1. They can cause osteomyelitis
2. Overdiagnosis of diphtheria may be associated with them
3. They Can Cause Meningitis
4. They can cause diphtheria (if the tox gene is present)
22. Nutrient media for cultivating the causative agent of diphtheria:
2. Blood tellurite agar
3. Yolk salt agar
4. Curdled whey
23. Factors of pathogenicity of diphtheria bacillus:
1. Exotoxin
2. Cord factor
3. Adhesins
4. Neuraminidase
24. The main pathogenicity factor of C.diphtheriae:
1. Cord factor
2. Endotoxin
3. Exotoxin
4. Neuraminidase
25. Diphtheria toxin has a pathological effect on:
1. Heart muscle
3. Adrenal glands
4. Nerve ganglia
26. Mechanism of action of diphtheria exotoxin:
1. Impaired respiration of body cells
2. Inactivation of transferase II enzyme
3. Impaired transmission of impulses through neuromuscular synapses
4. Suppression of protein synthesis in the cells of the macroorganism
27. Localization of genes regulating the synthesis of diphtheria exotoxin:
1. In the bacterial chromosome
2. In a plasmid
3. Associated with transposons
4. In prophage
28. Entrance gate for the causative agent of diphtheria:
1. Mucosa of the upper respiratory tract
2. Genitals
3. Eyes, ears
4. Wound surface
29. Sources of infection for diphtheria:
1. Sick people
2. Pets
3. Bacteria carriers
30. Routes of transmission of diphtheria:
1. Airborne
2. Contact
3. Nutritional
4. Transmission
31. Immunity for diphtheria:
1. Antibacterial
2. Antitoxic
3. Non-sterile
4. Humoral
32. Methods for microbiological diagnosis of diphtheria:
1. Microscopic
2. Biological
3. Bacteriological
4. Allergic
33. Material for microbiological examination for suspected diphtheria:
1. Mucus from the throat
2. Film from the throat
3. Nasal mucus
34. Serological reactions to determine antitoxic immunity in diphtheria:
3. Agglutination reaction
35. Drugs for planned specific prevention of diphtheria:
1. Tetraanatoxin
3. Antitoxic anti-diphtheria serum
36. Planned specific prevention of diphtheria is postponed until the child is 3-4 months old due to:
1. Receipt of secretory Ig A with mother’s milk
2. Lack of formed normal microflora
3. Production of high titers of own antibodies
4. The presence of Ig G received from the mother through the placenta
37. Drugs for specific emergency prevention of diphtheria:
2. Killed vaccine
3. Bacteriophage
4. Anatoxin
38. The phenomenon due to which diphtheria toxoid is effective for emergency prevention of diphtheria:
3. Immunological tolerance
4. Immunological memory
39. Pathogens of tuberculosis:
1. M. tuberculosis
40. Pathogens of mycobacteriosis:
1. M. tuberculosis
42. Diseases caused by mycobacteria:
1. Actinomycosis
2. Tuberculosis
3. Deep mycoses
43. Morphological transformations of tuberculosis pathogens, contributing to the chronicization of the inflammatory process, the persistence of the microbe, and the diversity of the clinical picture of the disease:
1. Non-acid-resistant forms
3. Filterable forms
4. Bacillary forms
44. The main sources of tuberculosis:
1. Patients with open form of tuberculosis
2. Patients with closed form of tuberculosis
3. Sick farm animals with destructive processes
4. Guinea pigs
45. Basic methods of microbiological diagnosis of tuberculosis:
1. Microscopic
2. Bacteriological
3. Allergic
46. Material for research in pulmonary forms of tuberculosis:
1. Sputum
2. Pleural fluid
3. Bronchial lavage water
4. Ascitic fluid
47. Microscopic examination methods for tuberculosis allow:
1. Detect acid-fast bacteria
2. Identify microbes to species
3. Roughly suggest a diagnosis
4. Determine the type of microbe
48. Method of accelerated bacteriological diagnosis of tuberculosis:
1. Homogenization
2. Microcultivation
3. Precipitation
4. Price method
49. Methods of “enrichment” of the test material for microscopic diagnosis of tuberculosis:
1. Homogenization and sedimentation
2. Price method
3. Flotation method
50. Laboratory animals used in the microbiological diagnosis of tuberculosis:
1. White mice
2. Rabbits
4. Guinea pigs
51. The Mantoux test allows:
1. Identify those infected
2. Assess the strength of anti-tuberculosis immunity
3. Select persons for revaccination
4. Detect class M immunoglobulins
52. Mantoux reaction:
1. Belongs to type IV according to Jell and Coombs
2. Belongs to type III according to Jell and Coombs
3. Indicates that a person is infected
4. Reliably indicates the presence of the disease
53. Drugs for specific prevention of tuberculosis:
54. Vaccine for specific prevention of tuberculosis:
3. Anatoxin
55. Epidemiological features of leprosy:
1. The source is a sick person
2. Contact transmission path
3. Airborne transmission
4. Source - rodents
56. Biological models for cultivating the causative agent of leprosy:
1. Guinea pigs
2. Rabbits
3. Golden hamsters
4. Armadillos
57. Characteristic location of the causative agent of leprosy in the affected tissues:
1. In intercellular spaces
2. Intracellular
3. In the form of long chains
4. Forms clusters of cells in the form of balls
58. You can distinguish the causative agent of tuberculosis from the causative agent of leprosy during microbiological diagnostics by:
1. Acid resistance
2. Growth on artificial nutrient media
3. PCR results
4. Bioassay results
59. Antigen for staging the Mitsuda reaction:
1. Autoclaved suspension of the causative agent of leprosy, obtained by homogenizing the contents of leprosy
2. Lepromin-A
3. Integral lepromin
4. Dry purified tuberculin
60. To prevent leprosy, use:
1. Dry purified tuberculin
2. Integral lepromin
61. Properties of the causative agent of whooping cough:
1. Gram-negative rod
2. Forms exotoxin
3. Biochemically inactive
4. Produces spores
62. Properties of the causative agent of whooping cough:
1. Demanding on nutrient media
2. Biochemically little active
3. Highly sensitive to environmental factors
4. Grows on simple media
63. Nutrient media for cultivating the causative agent of whooping cough:
2. Casein charcoal agar
3. Clauberg environment
4. Bordet-Gengou medium
64. Pathogenicity factors of the causative agent of whooping cough:
1. Filamentous hemagglutinin
2. Pertussis toxin
3. Extracellular adenylate cyclase
4. Endotoxin
65. Methods for microbiological diagnosis of whooping cough:
1. Bacterioscopic
2. Bacteriological
3. Allergic
4. Serological
66. Legionellosis causative agent:
1. L. pneumophila
67. Properties of Legionella:
1. They form spores
2. Free-living bacteria
3. Have endotoxin
4. Gram-negative rods
68. Main forms of legionellosis:
1. Philadelphia fever
2. Fort Bragg Fever
3. Pontiac Fever
4. Legionnaires' disease
69. Material for microbiological diagnosis of legionellosis:
1. Pleural fluid
2. Phlegm
3. Pieces of lungs
4. Blood serum
70. Serological tests for the diagnosis of legionellosis:
1. Hemagglutination reaction
3. Precipitation reaction
71. Methods for microbiological diagnosis of legionellosis:
2. Serological
3. Allergic
4. Bacteriological
MAKE LOGICAL PAIRS: QUESTION-ANSWER
72. Biovar gravis
73. Biovar mitis
A. Forms large, smooth, red colonies
B. Forms small black colonies
B. Forms large, rough, gray colonies
74. Breaks down urea
75. Does not have cystinase
76. Does not have urease
77. Produces cystinase
A. The causative agent of diphtheria
B. Opportunistic corynebacteria
G. Neither one nor the other
79. Produce urease
A. Toxigenic strains of diphtheria bacillus
B. Non-toxigenic strains of diphtheria bacillus
G. Neither one nor the other
80. Release the pathogen into the environment
81. Can be detected during an allergy test
82. Can be detected by bacteriological examination
83. Can be a source of infection for diphtheria
A. Patients with diphtheria
B. Bacterial carriers of the causative agent of diphtheria
G. Neither one nor the other
Describe the course of bacteriological examination for diphtheria
A. Subculture of suspicious colonies with coagulated serum
B. Inoculation of the test material on Clauberg’s medium
B. Identification of the isolated pure culture
B. Mycobacteriosis
B. Tuberculosis
91. M.1ergae
93. M. tuberculosis
A. Located intracellularly, forming clusters in the form of balls
B. Gram-negative cocci
B. Long thin sticks
G. Short thick sticks
95. L.pneumophila
96. B.parapertussis
A. Parawhooping cough
B. Whooping cough
V. Paratyphoid
G. Legionellosis
100. M. tuberculosis
A. Guinea pigs
B. Rabbits
B. Nine-banded armadillos
D. Rapid growth on nutrient media
ESTABLISH IF STATEMENT I IS TRUE, IF STATEMENT II IS TRUE AND IS THERE A CONNECTION BETWEEN THEM?
101. Myocarditis is often a complication of diphtheria, because
Diphtheria exotoxin disrupts protein synthesis in myocardial cells.
102. C.pseudodiphtheriticum causes diphtheria because
The pseudodiphtheria bacillus lives in the pharynx.
103. For specific emergency prevention of diphtheria, diphtheria toxoid can be used because
· People vaccinated against diphtheria have an immunological memory.
104. Anti-diphtheria serum is administered according to Bezredka, because
After administration of anti-diphtheria serum, serum sickness may develop.
105. M. tuberculosis causes tuberculosis only in humans because
·M. tuberculosis is not capable of infecting laboratory and farm animals.
106. The main route of transmission of M.bovis is nutritional, because
·M.bovis from sick animals is more often transmitted through milk.
107. The most reliable method of microbiological diagnosis of tuberculosis is microscopic, because
· tuberculosis pathogens grow slowly on nutrient media.
108. The microscopic method for diagnosing tuberculosis is indicative because
The microscopic method for diagnosing tuberculosis does not allow determining the type of pathogen.
109. The detection of tuberculosis pathogens in pathological material reliably indicates the activity of the infectious process, because
· detection of antibodies in blood serum allows only indirect assessment of the nature of tuberculosis activity.
110. The microscopic method is a mandatory method for diagnosing tuberculosis because
· Ziehl-Neelsen staining allows one to distinguish acid-fast pathogens of tuberculosis from opportunistic mycobacteria.
111. When diagnosing mycobacteriosis, pathogens are identified to species and sensitivity to antibiotics is determined, because
· opportunistic mycobacteria are similar in some biological properties to tuberculosis pathogens, but are resistant to anti-tuberculosis drugs.
112. Pasteurization of milk is aimed at preventing tuberculosis because
· tuberculosis pathogens are transmitted through milk and dairy products.
113. Bacteriological research is important in differentiating the pathogens of tuberculosis and leprosy, because
The causative agent of leprosy does not grow on artificial nutrient media.
114. The tuberculoid form of leprosy is a prognostically favorable form because
The Mitsuda reaction for tuberculoid leprosy is negative.
115. The causative agent of whooping cough and other representatives of this genus differ in biochemical properties because
· the causative agent of whooping cough has pronounced saccharolytic and proteolytic activity.
116. Filamentous hemagglutinin is one of the main pathogenicity factors of the causative agent of whooping cough, because
· thanks to hemagglutinin, adhesion of B. pertussis to the epithelium of the respiratory tract occurs.
117. Pertussis endotoxin is the main pathogenicity factor of the causative agent of whooping cough, because
Thanks to pertussis endotoxin, the pathogen attaches to the epithelium of the respiratory tract.
118. Extracellular adenylate cyclase is one of the main pathogenicity factors of the pertussis pathogen, because
· B. pertussis adenylate cyclase suppresses the phagocytic activity of macrophages.
119. Whooping cough has a long course because
· in the patient’s body the virulence of the whooping cough pathogen increases.
120. The pathogenesis of whooping cough includes adhesion of the pathogen to the surface epithelium of the trachea, bronchi and the action of toxic substances, because
· in the patient’s body, the microbe can move from phase I (virulent) to phase IV (non-virulent).
121. Blue-green algae are important in the spread of Legionella because
· mucous secretions of algae retain the pathogen in aerosols and provide a high infectious dose.
122. In the spread of the causative agent of legionellosis, the leading role belongs to the water factor, because
Legionella's natural habitat is warm water bodies, where they are in symbiotic association with blue-green algae and amoebae.
123. To diagnose legionellosis, a bacterioscopic method for examining sputum and blood is used, because
Legionella is not cultivated on nutrient media.
124. Legionellosis is classified as a sapronotic infection because
Legionellosis is easily transmitted from person to person.
125. When diagnosing legionellosis, the microscopic method is not used because
· sputum and pleural fluid contain few microbes
126. Tuberculin is used to treat tuberculosis because
· Tuberculin is an anti-tuberculosis chemotherapy drug.
The causative agents of airborne infections listed in Table. 14.1, belong to different families, genera and species, which differ significantly from each other in morphology, cultural and biochemical properties, and antigenic structure. Respiratory infections of various etiologies are clinically diagnosed as acute respiratory infections (ARI) or pneumonia. Their pathogens can only be identified using micro-
| Microorganisms Disease (or syndrome) Haemophilus influenzae (-) A Pneumonia, bronchitis Klebsiella pneumoniae (-) A subspecies pneumoniae Pneumonia subspecies ozaenae Ozena (fetid runny nose) subspecies rhinoscleromatis Rhinoscleroma Escherichia coli (-) A Pneumonia (aspiration) Enterobacter spp. (-) And the same Proteus spp. (-) A » » Providentia spp. (-) A » » Serratia spp. (-) A » » Legionella pneumophila (-)A Legionellosis Moraxella catarrhalis (~)A Bronchopneumonia Mycoplasma pneumoniae A Pneumonia Streptococcus pneumoniae (+)A Same Staphylococcus aureus (+)A » » Streptococcus pyogenes (+)A » » Bacteroides spp . (-)An Pneumonia, lung abscess Peptococcus spp. (+)An The same Prevotella spp. (-)An » » Veillonella spp. (-) AN Pneumonia, sinusitis, otitis media chlamydophila psittaci ornithosis (pneumonia) Chlamydophila pneumoniae pneumonia COXIELLA Burnetii q-dummy (pneumonia) Bordetella pertussis (--) A) A) A) A) IS (-) a paracosclay Corynebacterium diphtheriae (+) a diphtheria neisseria meningitidis ( -)A Meningococcal infection Family Mycobacteriacea (k/u)A M. tuberculosis complex (MTS): Pulmonary tuberculosis M. tuberculosis M.bovis M.africanum M.avium complex (MAC): Mycobacteriosis (predominantly M.avium pulmonary infection ) M. intracellulare Mycobacterium kansasii Mycobacterioses |
| Microorganisms Disease (or syndrome) Mycobacterium chelonae Mycobacteriosis Mycobacterium ulcerans Mycobacterium leprae Leprosy Actinomyces israelii (+)An Actinomycosis (lungs) Actinomyces bovis Actinomyces naeslundii (viscosus) Nocardia asteroides (+)A Nocardiosis (lungs) |
Modern express methods are gaining great importance in the diagnosis of bacterial pneumonia: immunochemical and molecular biological, which make it possible to make a preliminary diagnosis within 1 day from the onset of the disease. The leading diagnostic method is bacteriological, which allows identifying the pathogen and determining individual sensitivity to antibiotics. Since most bacteria that cause pneumonia are opportunistic, present in the normal microflora of the upper respiratory tract, a quantitative study is required. In the diagnosis of atypical pneumonia, rapid methods play a leading role. Detection of an increase in the titer of antibodies to the pathogen (using the method of paired sera) is used for the purpose of retrospective diagnosis.
a Program
Biological properties of pathogens of pneumonia and acute respiratory infections, their pathogenicity, ecology, characteristics of infection and epidemiology of the diseases caused.
Microbiological diagnostics.
a Demonstration
Smears from pathological material and pure cultures of Streptococcus pneumoniae and Klebsiella pneumoniae.
Colonies of S. pneumoniae on blood agar and K. pneumoniae on nutrient agar.
RSC with antigens Coxiella burnetii, Chlamydophila psittaci and Mycoplasma pneumoniae.
Diagnostic, preventive and therapeutic drugs.
Assignment for students
Microscope stained smears from the material being examined. Draw a conclusion and outline a plan for further research.
Make a conclusion about a possible causative agent of a respiratory infection based on data from bacterioscopic and bacteriological studies obtained from the laboratory (students receive completed forms with the results of the relevant tests).
Serodiagnosis of atypical pneumonia. Note the results of serological reactions (agglutination, RSC) with antigens C.bumetii, C.psittaci, M.pnewnoniae and L. pneumophila.
4. Give a brief description of diagnostic, preventive and therapeutic drugs.
a Methodical instructions
Microbiological diagnosis of infections caused by Streptococcus pneumoniae
MATERIAL FOR STUDY: sputum, aspirate from the trachea and bronchi, bronchial lavage water, exudate from the pleural cavity, blood, cerebrospinal fluid in meningitis, discharge from the pharynx and nose in acute respiratory infections.
DIAGNOSTIC METHODS:
Bacterioscopic examination. Smears for primary bacterioscopy are prepared from pathological material, with the exception of blood, and stained using the Gram method. The presence of gram-positive diplococci in them, somewhat elongated, lancet-shaped (0.5-1.25 µm), surrounded by a capsule (Fig. 14.1.1; inset), allows for a preliminary diagnosis.
Bacteriological research. The material is inoculated on blood agar and/or sugar broth with the addition of blood serum. After incubation at 37 °C, after 24 hours, small, tender colonies are formed on the agar, surrounded by a small greenish zone of hemolysis. Smears are made from the colonies to study morphology and tinctorial properties, and then subcultured onto a slant of blood agar or whey broth to isolate a pure culture.
To differentiate S.pnewnoniae from S.pyogenes, the sensitivity of the isolated culture to bile and optochin and inulin fermentation are tested.
Serotyping is carried out in an agglutination reaction with type-specific sera (out of more than 80 known variants, 23 main serovars play a leading role in human pathology). An express method for serotyping S.pneumoniae is the Neufeld reaction, which is based on the phenomenon of swelling of the streptococcal capsule in the presence of type-specific serum.
Bioassay. To isolate a pure culture of S.pneumoniae, in some cases the material is injected intraperitoneally into white mice, which are highly sensitive to this microorganism. A culture of streptococcus is isolated from the blood and organs of a dead or slaughtered animal, and bacterioscopy of fingerprint smears made from its organs is also carried out. Currently, the method is practically not used.
Express diagnostic methods: immunochemical, biochemical and molecular biological studies. Immune chemical research. To detect the specific antigen of S.pneumoniae in the cerebrospinal fluid of patients with meningitis, indirect latex agglutination reactions, RIGA, etc. are used.
Microbiological diagnosis of respiratory infections caused by Klebsietta pneumoniae
MATERIAL FOR STUDY: sputum, bronchial lavage water, exudate from the pleural cavity, blood, cerebrospinal fluid in meningitis, discharge from the pharynx and nose in acute respiratory infections; mucus and scrapings from the nose with scleroma.
DIAGNOSTIC METHODS:
Bacterioscopic examination. Smears for primary bacterioscopy are prepared from pathological material and stained using the Gram and Burri-Hins method. The presence of gram-negative capsular bacteria in smears (see Fig. 2.2.5) allows us to make a preliminary conclusion. In the case of scleroma, histological examination of granulomatous tissue taken from the nose reveals peculiar Mikulicz giant cells containing Klebsiella.
Bacteriological research. The material is inoculated on Petri dishes with nutrient agar containing penicillin to suppress the growth of accompanying microflora, or on differential diagnostic media with lactose and bromothymol blue. On nutrient agar, Klebsiella forms shiny, convex mucous colonies. On differential bromothymol medium, colonies of K. pneumoniae subspecies rhinoscleromatis and K. pneumoniae subspecies ozaenae, which do not break down lactose, are colored in the color of the medium (blue), and on bromocresol medium - violet. Lactose-positive K.pneumoniae subspecies pneumoniae produces yellow colonies. On the 2nd day, smears are made from suspicious colonies, stained using the Gram, Burri-Gins method and subcultured onto slants of agar or Ressel's medium (see topic 13.1) to obtain a pure culture. On the 3rd day, growth on agar and Ressel's medium is taken into account. Lactose-negative bacteria stain only the medium column red, while Lactose-positive bacteria color the entire medium and often rupture the medium as a result of gas formation during glucose fermentation. Identification of the isolated culture is carried out by the presence of a capsule, lack of motility and other characteristics. To determine the serovar of the isolated culture, an agglutination or immunofluorescence reaction is performed with type-specific anticapsular sera.
Express diagnostic methods: biochemical and molecular biological studies. The test material obtained from the source of infection is used to detect pathogen DNA using GTCR. If the corresponding molecules are detected, a preliminary diagnosis can be made.
Serodiagnosis. Conducted with the sera of sick people in the RSC or RIGA for the purpose of retrospective diagnosis.
Quantitative microbiological study for pneumonia and acute respiratory infections
Assessing the results of microbiological studies in inflammatory diseases of the respiratory system, when a variety of opportunistic microorganisms are inoculated, presents certain difficulties, since many of these bacteria are part of the normal microflora of the upper respiratory tract. Therefore, quantitative microbiological accounting is used as an additional method. The test material (sputum) is pre-homogenized in a jar with glass beads, in a mortar with quartz sand, or using a magnetic stirrer. Tenfold dilutions of the material are prepared from 10" 1 to 10~ 7 and 0.1 ml of the corresponding dilution is inoculated on nutrient media, the composition of which depends on the expected groups of microorganisms (blood agar, LSA, Endo medium, Sabouraud medium, etc.). After incubation in the thermostat, the number of grown colonies is counted, microorganisms are identified and the results obtained are evaluated.
In inflammatory diseases of the respiratory system, the quantitative content of opportunistic microorganisms in 1 ml of sputum or bronchial lavage water increases. Quantitative indicators that are not typical for the body of healthy people have diagnostic value and indicate the etiological role of microorganisms: S.pneumoniae, H.influenzae - 10^, Staphylococcus spp. - 10 5, Enterobacter - 10 4, Candida spp. - 10 3 or more colony-forming units (CFU) per 1 ml. In cases of dominance of individual species in microbial associations, especially with repeated studies, as well as in the presence of epidemiological data, these diagnostic criteria can be reduced by one order of magnitude. The combination of qualitative and quantitative microbiological research allows obtaining reliable results.
mussels, bioassays are also used (infection of guinea pigs and mice, respectively).
Express diagnostic methods: immunochemical, biochemical and molecular biological studies. Immunochemical studies. Antigens of pathogens can be detected in material from a patient using serological reactions (RSC, etc.).
Biochemical and molecular biological research. The test material obtained from the source of infection is used to detect pathogen DNA using PCR. If the corresponding molecules are detected, a preliminary diagnosis can be made.
Serodiagnosis of atypical pneumonia. One of the leading methods for diagnosing atypical pneumonia is serodiagnosis. The paired serum method is used.
Serodiagnosis of Ku-rickettsiosis. Starting from the 8th day of illness, to detect specific antibodies, an agglutination test or RSK test is performed with standard diagnostic tests from C.bumetii. The antibody titer in RSC reaches 1:80-1:160 at 5-6 weeks of illness. The reaction is considered positive when the antibody titer increases by at least 2 times (Table 14.1.1). For serodiagnosis, RIGA, indirect IF method, ELISA, RIA are also used. The most informative for early diagnosis is the detection of class M antibodies in the 1st week of illness.
Table 14.1.1. Results of RSC with three diagnostic tests
| Diagnosticum | Serum dilution | |||||
| 1:10 | 1:20 | 1:40 | 1:80 | 1:160 | 1:320 | 1:640 |
Coxsiella burnetii
Chlamydophila pneumonia - - - - - - -
Mycoplasma pneumonia +++ +++ +++ +++ +++ + -
Serodiagnosis of pneumonia caused by Chlamydophila spp. For
To confirm the diagnosis of pneumonia caused by C.psittaci - psittacosis (ornithosis), RSC is made with a standard psittacosis diagnosticum and patient sera taken the first time on the 7th day of the disease, and the second time at the end of the 3rd week. If there is no increase in antibody titer, the reaction is repeated 4 weeks after the onset of the disease. An increase in antibody titer of at least 2 times has diagnostic significance (see Table 14.1.1). For the early diagnosis of pneumonia caused by C.pneumoniae, the indirect IF method is used, which makes it possible to detect class M antibodies, which is especially important for the timely diagnosis of the disease in newborns.
Serodiagnosis of pneumonia caused by M. pneumoniae. Antibodies in the sera of patients are detected in the RSC with a standard mycoplasma diagnosticum or in the RIGA, which uses sheep erythrocytes with mycoplasma antigen adsorbed on them. An increase in antibody titer by 4 times or more in paired blood sera taken from the patient on the 7-8th day and at the end of the 2nd week of illness is of diagnostic significance. A high titer of antibodies detected in these reactions in a single study is not evidence of the disease, since a positive reaction often occurs after the disease has been transmitted, even in the form of an asymptomatic infection. Complement-fixing antibodies persist after the disease for about 1.5 years, and antibodies detected in RIGA are somewhat longer. In laboratory conditions, RSC is often diagnosed simultaneously with rickettsial, ornithosis and mycoplasma diagnosticums according to the following scheme (see Table 14.1.1).
Skin allergy test. To diagnose ornithosis, a skin allergy test with the allergen C.psittaci is performed.
Microbiological diagnosis of legionellosis
Laboratory diagnosis of legionellosis is carried out in cases of severe pneumonia of unknown etiology.
MATERIAL FOR STUDY: sputum, bronchial lavage water.
DIAGNOSTIC METHODS:
Bacteriological diagnostics. To isolate the pathogen, selective nutrient media of complex composition are used, containing yeast extract and other growth factors, as well as various antibiotics to suppress the growth of accompanying microflora. Legionella is a slow-growing microorganism. Microcolonies, visible under a microscope, appear on the 2nd day of growth, macroscopic ones - after 3-5 days. The colonies have a regular round shape, smooth edges, a shiny surface and small sizes (2-4 mm). Young colonies have a characteristic pink or blue-green rim and opalescent center. Identification of the isolated pure culture is carried out according to morphology, tinctorial, cultural and biochemical characteristics to the genus. For species identification, direct IF methods are used, as well as biochemical and molecular biological studies: gas-liquid chromatography, restriction analysis, and DNA probes.
Express diagnostic methods: immunochemical, biochemical and molecular biological studies. Immunochemical studies.
F Material from the lesion is examined by the direct IF method, which makes it possible to identify pathogen antigens.
4 Detection of soluble Legionella antigens. Antigens of the pathogen can be present not only in material from the source of infection, but also in blood and urine and are detected using sensitive serological reactions (ELISA, RIA).
Biochemical and molecular biological research. The test material obtained from the source of infection is used to detect pathogen DNA using PCR. If the corresponding molecules are detected, a preliminary diagnosis can be made.
Serodiagnosis. To determine antibodies, the method of indirect IF with antigen from Legionella is used. An antibody titer of 1:32 or more and its increase by 4 times or more in the dynamics of the disease have diagnostic significance. Other serological tests (ELISA, RIGA, microagglutination and
Diagnostic, preventive and therapeutic drugs
Diagnostic sera for antipneumococcal type-specific types I, II and III. Used for typing (establishing serovar) of streptococcus pneumoniae.
Polyvalent polysaccharide pneumococcal vaccine.
Includes capsular polysaccharide antigens of the 23 most common S. pneumonia serovars.
Klebsiella diagnosticums for RSK and RIGA.
Polyvalent polysaccharide Klebsiella vaccine. Includes capsular polysaccharide antigens of the 24 most common serovars of K.pneumonia subspecies pneumonia.
Rickettsial dry soluble antigen C. burnetii for RSK and RIGA. It has higher activity than rickettsial diagnostics^.
Psittacosis diagnosis! for RSK.
Mycoplasma diagnosticum for RSK and RIGA.
Dry live vaccine M-44. Dried suspension of a vaccine strain of C. burnetii grown in a chicken embryo. Used to prevent Q fever.
Antibiotics: p-lactams, macrolides, aminoglycosides, tetracyclines, sulfonamides, quinolones, etc.
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