Sepsis is a severe generalized human disease, in which microorganism

Introduction

Evaluation of practical as well as theoretical skills of medical students during the course of practical training at the medical institute is a demanding peculairity of the future professional career. It is closely associated with the obligation to gain a great volume of theoretical knowledge at the level of judgement establishing the basis for the development of practical skills in future. Consequently, Ministry of Public Health of Ukraine had to provide compulsory evaluation test into the system of higher education called "Step 1. General Medical Training".

Scientific researches testify that testing aimed to evaluate students’ skills can be considered as a method of estimation which answers the basic methodical criteria of quality and provides objectivity of the training process. At the same time testing is a method of interpreting processes of academic studying. This problem is of great importance as estimation of the students’ knowledge according to the "credit-module-rating" system should be standardized and unified enough.

Independent evaluation of the quality of medical training in fundamental biomedical sciences is provided by Testing Center of Мinistry of Public Health of Ukraine with the licensed test "Step 1. General Medical Training". A course of Medical Microbiology, Immunology and Virology is one of the fundamental subjects. Control of results of training strengthens inner motivation of teachers of each fundamental discipline to qualified teaching, gives an opportunity to reveal weak places in the process of students’ training, and to realize what subjects need improvement.

The manual includes tests in Microbiology ("Special Bacteriology" unit), obtained from a database of the Center of testing of the professional experts’ competence at the Ministry of Public Health of Ukraine for higher educational institutions of ІІІ - ІV levels of accreditation and tests from the books published recently.

The tests are grouped according to the basic units of Special Microbiology: Gram-positive cocci (staphylococci, streptococci), Gram-negative cocci (neisseria), causative agents of intestinal bacterial infections, bacteria of genus Clostridium, Corynebacterium spp., pathogenic mycobacteria, causative agents of extremely dangerous infections (plague, tularemia, brucellosis, anthrax), pathogenic spirochetes, infections caused by bacteria of genus Rickettsia and Coxiella, chlamidia, mycoplasmas, sanitary bacteriological investigation of certain objects microflora, causative agents of nosocomial infections and human mycosis.

Each thematical block of situational tasks opens with the drawings demonstrating microbiological particularities of the corresponding group of infections. It gives the student possibility to realize the essence of certain situational tasks better.

Each test contains only one correct or best answer which is to be chosen by the student. Every student can estimate the results of the test matching them with the answers given at the beginning of each paragraph.

The tests collected in the manual will enable the student to prepare well and pass the licensed exam "Step 1. General Medical Training", since the book of tests contains a definite number of tests suggested for students in the previous years. Moreover, these tests will be of use for students in selfchecking in practical classes, thematic submodule and Module ІІ "Special Bacteriology".

Nowadays it is possible to ascertain that passing the licensed exam "Step 1. General Medical Training" gives a powerful motivation to studying the discipline "Microbiology, Virology and Immunology".

Gram-positive Cocci: Staphylococci [1]

1. On examination the patient, a physician noted a suppuration of a deep wound. In a micropreparation of the pus, bacteriologist isolated staphylococci and clostridia. What remedy will be administered to the patient to prevent the spread of infection?

A. Donor γ (gamma) - globulin.

B. Staphylococcal toxoid.

C. Tetanus toxoid.

D. Sextatoxoid.

E. Staphylococcal bacteriophage.

2. A physician diagnosed sepsis due to clinical signs of suppurated open fracture of a hip. What research technique will bacteriologist apply to confirm the diagnosis?

A. Isolation of pure culture in the blood.

B. Isolation of pure culture in the wound.

C. Identification of antibodies to staphylococcal toxin.

D. Microscopy of blood smears.

E. Study of the patient’s immune system.

3.What remedy is expected to be prescribed to a pregnant woman for specific prophylaxis of postnatal staphylococcal infection?

A. Staphylococcal toxoid.

B. Inactivated staphylococcal vaccine.

C. Attenuated (live) staphylococcal vaccine.

D. Staphylococcal bacteriophage.

E. Ampicillin.

4. An old man had been attacked by influenza but did not visit a doctor. Serological research confirmed the diagnosis of influenza. The patient recovered but some days later he was admitted to hospital with fever and productive cough with purulent sputum. X-ray examination revealed numerous abscesses in the lungs of the patient. Sputum was identified for coagulase-positive bacteria with enzyme DNA activity. What microorganism was revealed by bacteriologist?

A. Staphylococcus aureus.

B. Streptococcus pyogenes.

C. Clostridium perfringens.

D. Clostridium septicum.

E. Staphylococcus intermedius.

5. A 20-year-old patient developed a suppurated post operational wound after purulent appendectomy. Bacterioscopy of pus swab obtained from the wound revealed a considerable number of leukocytes and Gram-positive bacteria. What microorganism appeared to be the cause of suppuration of the postoperative wound?

A. Staphylococcus.

B. Tetracoccus.

C. Streptococcus.

D. Gonococcus.

E. Meningococcus.

6. A 15-year-old female patient visited a dermatologist complaining of frequent furunculosis. Within several months on her face and neck there had been formed 1-2 furuncles; they disclosed, healed and then new furuncles appeared. The patient underwent a course of vitamin and antibiotic therapy, applied local treatment, was administered a course of special diet (without carbohydrates) but therapy appeared to be ineffective. What microorganism is the causative agent of furunculosis?

A. Staphylococcus.

B. Enterococcus.

C. Fungi of genus Candida.

D. Escherichia coli.

E. Streptococcus.

7. To prevent frequent respiratory infections patients are often administered ‘Ribomunil’ inhalations. The remedy contains antigens of widespread causative agents of bacterial respiratory infections: golden staphylococcus, pneumococcus, Klebsiella pneumoniae, Haemophilus influenzae. What is the mechanism of its therapeutic effect?

A. Synthesis of specific secretory IgA is induced.

B. Synthesis of specific seral IgA is induced.

C. Formation of specific cytotoxic T-lymphocytes is induced.

D. Synthesis of specific IgG is induced.

E. Synthesis of specific IgM is induced.

8. A child is admitted to hospital with the diagnosis " staphylococcal sepsis ". What nutrient medium will be used to isolate a causative agent in the blood?

A. Meat peptone agar (MPA).

B. MPA with bile.

C. Sugar peptone broth.

D. Buczyna’s medium.

E. Yolk-salt agar.

9. A female patient visited a doctor complaining of frequent formation of furuncles on the face, neck and shoulders. Bacterioscopy of pus swab from a furuncle revealed microorganisms of round shape arranged in grape clusters. What bacterium was revealed by bacteriologist?

A. Diplococcus.

B. Staphylococcus.

C. Micrococcus.

D. Streptococcus.

E. Tetracoccus.

10. Immune therapy of staphylococcal diseases includes drugs, except:

A. Antistaphylococcal plasma.

B. Antistaphylococcal horse serum.

C. Antistaphylococcal immunoglobulin.

D. Staphylococcal γ (gamma) - globulin.

E. Staphylococcal toxoid.

11. A 55-year-old patient suspected of sepsis is hospitalized to the surgical clinic. What material from the patient is it necessary to investigate, and in what bacteriological medium should the material grow?

A. Blood; in sugar broth.

B. Cerebrospinal fluid; on serum agar.

C. Urine; in meat peptone broth.

D. Pus; on yolk salt agar.

E. Punctate of lymph node; on cysteine agar.

12. Administration of antibiotic therapy for a septic patient has been discussed by specialists. What particularity of the causative agent should be taken into consideration before obtaining the results of the patient’s sensitivity to antibiotics?

A. Capability toformcapsule.

В. Gram staining results.

C. Acid-fast properties of bacterium.

D. Presence of aggressive factors.

E. Formation ofspore.

13. Examining the medical staff of the surgical unit, bacteriologist isolated Gram-positive cocci from the nasopharynx of the operational sister. In a preparation microorganisms were arranged in grape clusters, on yolk salt agar they produced colonies of S-shape with turbidity, in anaerobic conditions they fermented mannitol with acid formation. What test will confirm that it is Staphylococcus aureus?

A. Plasma coagulase test.

B. Catalase test.

C. Urease test.

D. Testing penicillinase.

E. Testing fibrinolysin.

14. A patient with an open fracture of a thigh is admitted to a casualty department. On examination, the doctor revealed wound suppuration. Bacteriological research of pus identified microbic association of staphylococcus and Escherichia coli. What is the type of infection?

A. Mixed infection.

B. Secondary infection.

C. Primary infection.

D. Endogenous infection.

E. Superinfection.

Sepsis is a severe generalized human disease, in which microorganism

A. is within the gallbladder.

B. is identified in the lymph.

C. is transported in the blood.

D. multiplies in the blood.

E. is within the feces.

Дата добавления: 2015-10-30