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1. Your patient is a child who has no detectable T and B cells. This immunodeficiency is most probably the result of a defect in:
A. the bursal equivalent
B. T cell-B cell interaction
C. stem cells originating in the bone marrow
D. phagocytosis
E. *stem cells originating in the bone marrow
2. If we don’t detect in child T and B cells, this immunodeficiency is most probably the result of a defect in:
A. the thymus
B. T cell-B cell interaction
C. phagocytosis
D. the bursal equivalent
E. *stem cells originating in the bone marrow
3. If an individual was genetically unable to make J chains, which immunoglobulin(s) would be affected?
A. IgG
B. IgM
C. IgA
D. IgG and IgM
E. *IgM and IgA
4. When a substance is added to a solid medium which inhibits the growth of unwanted bacteria but permits the growth of wanted bacteria, this is such medium:
A. basal media.
B. enrichment medium.
C. enriched medium.
D. differential medium.
E. *selective medium.
5. When a substance is added to a liquid medium which inhibits the growth of unwanted bacteria and favours the growth of wanted bacteria, it is known as:
A. selective medium.
B. enriched medium.
C. differential medium.
D. basal media.
E. *enrichment medium.
6. Choose among listed the period of microbial growth curve when microorganisms are growing and dividing at the maximal rate:
A. lag phase.
B. stationary phase.
C. decline phase.
D. maximum phase
E. *log phase.
7. If a person were rushed to the hospital in anaphylactic shock from a bee sting, which antibodies would be found in the highest amount?
A. IgD
B. IgG
C. IgA
D. IgM
E. *IgE
8. If you are of a particular blood type, that means that you have no antibodies against the antigens present on your blood cells. What kind of antibodies are you missing?
A. IgG
B. IgE
C. IgD
D. IgA
E. *IgM
9. In systemic lupus erythematosus (SLE), autoantibodies are primarily made against which of the following?
A. neurons
B. RNA
C. blood cells
D. dermis
E. *DNA
10. Cell-associated differentiation antigens (CDs) are functional cell surface proteins or receptors that can be measured in situ.
A. In normal individuals the concentration of these molecules in serum is always low.
B. Thousands of CDs have been characterized.
C. All of the above are true.
D. None of the above are true.
E. *Detecting these soluble molecules may help in the management of disease.
11. Desensitization to an allergen involves injection of the allergen beneath the skin to induce production of which of the following immunoglobulins?
A. IgA
B. IgD
C. IgE
D. IgM
E. *IgG
12. Monochromatic (one color) light is sometimes used to increase the resolution of light microscopes. Light of which color below would give you the best resolution?
A. Red
B. Orange
C. Green
D. Yellow
E. *Blue
13. The process by which bacteriophage P1 packages random phage-genome-sized pieces into phage heads and thereby allows transfer of pieces of the bacterial chromosomal DNA between bacteria is called:
A. Nongeneral transposition
B. Specialized transduction
C. High-frequency recombination
D. Reverse conjugation
E. *Generalized transduction
14. The portion of the lipopolysaccharide molecule that varies the most among different bacteria and thus exhibits antigenic differences is the:
A. Lipid A.
B. Core polysaccharide.
C. Dipicolinic acid.
D. Exotoxin component.
E. *Side polysaccharide chain.
15. The steps leading to the synthesis of peptidoglycan occur in the cytoplasm, on the cytoplasmic membrane, and extracellularly. Which antibiotic inhibits peptidoglycan biosynthesis?
A. Cycloserine
B. Rifampin
C. Bacitracin
D. Streptomycin
E. *Penicillin
16. Amino acids are found in the protein, peptidoglycan,and capsule of bacteria. Which of the following amino acids is found only in peptidoglycan?
A. L-Lysine
B. D-Glutamate
C. L-Alanine
D. None of the above
E. *Diaminopimelic acid
17. The ability to use compounds and ions other than oxygen as terminal oxidants in respiration is a widespread microbial trait.This capacity is called:
A. Photosynthesis
B. Fermentation
C. Substrate phosphorylation
D. Nitrogen fixation
E. *Anaerobic respiration
18. Material from a patient with suspicion on shigellosis (dysentery) was inoculated on the Ploskirev’s medium. What color do colonies of lactose-negative Shigella have?
A. dark blue
B. green
C. red with metallic hue
D. brown
E. *colorless
19. A child stung by a bee experiences respiratory distress within minutes and lapses into unconsciousness. This reaction is probably mediated by
A. IgG.antibody
B. sensitized T cell
C. complement
D. IgM antibody
E. *IgE antibody
20. After inoculation of Escherichia coli on Ploskirev’s medium the growth of bacteria is inhibited. What chemical does predetermine this phenomenon?
A. oxalic acid
B. sodium sulphite
C. *brilliant green
D. Bismuth salts
E. fuchsin
F.
21. Material from a patient with suspicion on an intestinal infection was inoculated on the Ploskirev’s medium. What color do colonies of Escherichia coli have?
A. dark blue
B. colorless
C. *rose
D. brown
E. green
22. Material from a patient with suspicion on colienteritis was inoculated on Endo’s medium. What color do colonies of Escherichia coli have?
A. blue
B. colorless
C. *red with metallic hue
D. brown
E. green
23. What color does acquire the semi-solid Giss’s media with the indicators water blue and rosolic acid there is sugar utilization?
A. red
B. green
C. *dark blue
D. brown
E. a color does not change
24. After inoculation of the patient’s faces on Endo’s medium there were grown to types of colonies: one – red with metallic hue, other - colorless. To what group of nutrient media does Endo’s medium belong to?
A. *Differential diagnostic
B. Elective
C. Enriching media
D. Universal
E. Selective
25. Energy which is generated by a cell exists in the form of electrochemical transmembrane gradient of hydrogen ions -?µН+ or in ATP molecules. What is the mechanism of transformation of one type of energy into another?
A. electronic ATF-synthesizing complex
B. *proton ATF-synthesizing complex
C. molecular ATF-synthesizing complex
D. all answers are correct
E. all answers are wrong
26. For checking the quality of filters in an experiment a fluid containing test-microbe was filtered. Later a filter was laid on the surface of nutrient medium and put into the incubator. How much time is it necessary to hold it on medium to give a final answer about its quality?
A. 1 day at an optimum temperature
B. optimum temperature, 2 days
C. optimum temperature, 3 days
D. optimum temperature, 4 days
E. *at an optimum temperature, 5 day
27. It is necessary to study ability of microbes to utilize glucose, saccharose, lactose, production of hydrogen sulphide and utilization of urea. What nutrient media will you recommend?
A. Ru’s medium
B. Leffler’s medium
C. Endo’s medium
D. Ploskirev’s medium
E. *Olkenitsky’s medium
28. Laboratory diagnosis of tetanus was made in the laboratory. What method of sterilization is it necessary to use for killing the selected cultures?
A. *Autoclaving
B. Boiling
C. Tindalizatio
D. In the heat oven
E. Pasteurization
29. Material from a patient with suspicion on typhoid fever was inoculated on Endo’s medium. What color do colony of lactosonegative Salmonella typhi have?
A. dark blue
B. *colorless
C. red with metallic hue
D. brown
E. green
30. Material from a patient with suspicion on dysentery was inoculated on Endo’s medium. What color do colony of lactosonegative Shigella have?
A. dark blue
B. green
C. red with metallic hue
D. brown
E. *colorless
31. On the Endo’s medium colonies Escherichia and Salmonella were isolated. According to what signs is it possible to make differentiation between them?
A. sizes
B. character of the edges
C. character of surfaces
D. consistency
E. *color
32. Salmonella typhi, which utilizes glucose to acid was inoculated in Ressel’s medium. What changes will be observed in nutrient medium, which verify utilization of glucose?
A. *Changes of the color from a pinky to dark blue in the column of agar
B. Changes of the color from a pinky to dark blue of the slant surface of agar
C. Changes of the color from a pinky to red of the slant surface of agar
D. Changes of the color from a pinky to dark blue in the column of agar and slant part of agar
E. Changes of the color from a pinky to red in the column of agar
33. Some microorganisms lost their capacity for a synthesis of some necessary growth factors, therefore they do not can grow on minimum nutrient media. They are called:
A. *auxotrophs
B. paratrophs
C. prototrophs
D. myxotrophs
E. oligotrophs
34. The wild bacteria are able to synthesize all necessary for them substances from a limited number of organic compounds, for example, from glucose and ammonium salts. They are called:
A. auxotrophs
B. paratrophs
C. *prototrophs
D. myxotrophs
E. oligotrophs
35. What indicator may be added into nutrient medium for cultivation of anaerobes, which can testify expedience of its use for inoculation of tested material?
A. Fuchsine
B. Brilliant green
C. Methylene green
D. *Methylene blue
E. Fenolrot
36. In a pharmacy it is necessary to sterilize the small bottles with physiological sodium chloride solution for injection. What method is it necessary to apply for their sterilization?
A. *in an autoclave, 2 atmospheres
B. in an autoclave by fluid steam
C. in a heat oven
D. by X-ray
E. by ultraviolet light
37. Because of ill-timed treatment of pulpitis lower jaw osteomyelitis has developed in patient. What examination is it necessary to carry out for identification of causative agents and to choose effective preparation for treatment?
A. Complex serological examination
B. To examine the presence of proper antibodies
C. Microscopic examination of the pus
D. To examine bacterial antigens
E. *To isolate bacterial pure culture and examine its susceptibility to antibiotics
38. Escherichia coli was inoculated in Ressel’s medium. What changes will be observed in nutrient medium, which verify utilization of glucose and lactose?
A. Changes of the color from a pinky to dark blue in the column of agar
B. Changes of the color from pinky to dark blue of the slant surface of agar
C. Changes of the color from a pinky to red of the slant surface of agar
D. *Changes of the color from a pinky to dark blue in the column of agar and slant surface of agar
E. Changes of the color from a pinky to red of the column of agar
39. For examination of lipolytic properties of microbes lipids and lipid-like substances – tweens – are supplemented into the medium. According to what signs is it possible to check the lipolytic activity of bacteria?
A. The colonies of bacteria lose their typical form
B. *Bacteria form iridescent halos round the colonies
C. The colonies of bacterium are painted in the color of indicator
D. The colonies of bacteria become semilucent
E. If microbes lipolytic properties they do not grow on an medium
40. In a bacteriological laboratory it is necessary to nutrient media, which contain matters, changing at a temperature higher then 100 °С (urea, carbohydrates, proteins). What method of sterilization can you offer?
A. *by live steam
B. autoclave, pressed steam
C. boiling
D. tindalization
E. pasteurization
41. In a hospital chief of department decided to check the quality of instruments sterilization in an autoclave by biological method. What bacteria can be used for this test?
A. Pathogenic
B. Capsule-forming
C. Acid fast
D. *Spore-forming
E. Thermophilic
42. In a laboratory for acceleration of sterilization of media with sugar by live steam this procedure was made in one day: in the morning, in the day-time and in the evening for 30 min. How it was necessary to sterilize these media correctly?
A. To sterilize 1 hour
B. To sterilize 15 minutes
C. To sterilize 45 minutes
D. *To sterilize three times with 24 hour interval
E. To sterilize twice for a days
43. In MPB it is necessary to check the peptolytic properties of bacteria. How is it possible to prove, if microbes produces the hydrogen sulphide?
A. to insert the indicator paper, saturated with the lead acetate; the hydrogen sulphide is changed its color, it becomes red
B. to insert the indicator paper, saturated with the lead acetate; the hydrogen sulphide is changed its color, it becomes dark blue
C. *to insert the indicator paper, saturated with a lead acetate; the hydrogen sulphide is changed its color, it becomes black
D. the color of medium becomes greyish
E. to insert the indicator paper, saturated with an oxalic acid; the hydrogen sulphide is changed by its color, it becomes black
44. In MPB it is necessary to verify the peptolytic properties of bacteria. What signs will show the positive results – indole production?
A. to insert the indicator, saturated with a litmus; an indole is changed its color, it becomes red
B. to insert the indicator paper, saturated with an oxalic acid; an indole is changed its color, it becomes dark blue
C. to insert the indicator paper, saturated with a litmus; a indole is changed its color, it becomes dark blue
D. the color of medium becomes rose
E. *to insert the indicator paper, saturated with an oxalic acid; a indole is changed by its color, it becomes rose
45. What changes will be observed in a Olkenitsky’s medium, if Escherichia coli will confirm utilization of glucose and lactose?
A. The changes of the color from a pinky to yellow in the column of agar
B. The changes of the color from a pinky to yellow of slant surface of agar
C. The changes of the color from a pinky to red of slant surface of agar
D. *The changes of the color from a pinky to yellow of the column of agar and slant surface of agar
E. The changes of the color from a pinky to red of the column of agar
46. In Olkenitsky’s medium Escherichia coli was inoculated. What changes will be observed in a medium, which will confirm utilization of glucose and lactose?
A. The changes of the color from a pinky to yellow in the column of agar
B. The changes of the color from a pinky to yellow of slant surface of agar
C. The changes of the color from a pinky to red of slant surface of agar
D. *The changes of the color from a pinky to yellow of the column of agar and slant surface of agar
E. The changes of the color from a pinky to red of the column of agar
47. It is necessary to check the quality of sterilization by compressed steam at 121 °С. What chemical indicator of sterilization effectiveness may be used?
A. benzonaphtolum
B. antipyrine
C. sulphur
D. *benzoic acid
E. urea
48. It is necessary to check the quality of sterilization by compressed steam at 110 °С sterilization. What chemical indicator of sterilization quality can be utilized?
A. *benzonaphtolum
B. antipyrine
C. sulphur
D. benzoic acid
E. urea
49. It is necessary to check the quality of sterilization by compressed steam at 115 °С. What chemical indicator of sterilization quality can be utilized?
A. benzonaphtolum
B. *antipyrine
C. sulphur
D. benzoic acid
E. urea
50. It is necessary to check the quality of sterilization by compressed steam at 132 °С. What chemical indicator of sterilization quality can be utilized?
A. benzonaphtolum
B. antipyrine
C. sulphur
D. benzoic acid
E. *urea
51. It is necessary to make biochemical identification and examine saccharolytic properties of bacteria. What media could you offer?
A. Veynberg’s medium
B. Zeisscler’s medium
C. *Giss’ media
D. Kitt-Tarozzi’s medium
E. Milk
52. The pure culture of microorganisms grows and develops at presence of oxygen in an atmosphere (no less what 20 % oxygen). What group of microorganisms according to their respiration does this culture belong to?
A. *Obligate aerobes
B. Obligate anaerobes
C. Facultative anaerobes
D. Microaerophilic bacteria
E. Capneic bacteria
53. What chemicals can you offer for separation of staphylococci and bacilli from other microbes according to biological principle?
A. magnesium sulfate
B. aluminium nitrate
C. ascetic lead
D. oxalic acid
E. *7,5-10 % sodium chloride
54. What is it necessary to take into consideration during collection of tested material for isolation of anaerobic causative agents?
A. Warning neutralizing effect of antibodies
B. *Warning toxic effect of oxygen
C. Warning influence of disinfectants
D. Warning changes of tinctorial properties
E. Warning changes of serologic properties
55. What substance must be added into nutrient medium for examination of bacterial proteolytic properties?
A. Agar-agar
B. *Gelatin
C. Agarose
D. All answers are correct
E. All answers are wrong
56. After filtration of 2 l water onto filter grew 4 grey and 6 red colonies of bacteria. What are coli-titre and coli-index of such water. Choose the correct answer:
A. 50 and 20
B. 125 and 8
C. 250 and 4
D. *330 and 3
E. 500 and 2
57. Research of drinking-water quality is conducted in a bacteriological laboratory. The general microbal number appeared near to 100. What microorganisms were taken into account here?
A. Enteropatogenic bacteria and viruses.
B. Colibacilli.
C. Pathogenic for people and animals bacteria.
D. Nonpathogenic microorganisms.
E. *All of bacteria which grew onto medium
58. The air condition of in an operating-room before an operation is examinate by sedimentation method. 5 rounded colonies with the hemolytic zone round them were visible. What medium is used?
A. *Blood MPA
B. MPA
C. Endo
D. YSA
E. Levin’s
59. A examination of air bacterial contamination includes an account the total number microorganisms in a certain amount and qualitative composition of microflora. What microorganisms are sanitary -indicated for indoor air?
A. *Staphylococcus aureus
B. Escherichia coli
C. Bacillus subtilis
D. Yeast fungi
E. mold fungi
60. According to the requirements of Pharmacopoeia and WHO a number of bacteria and fungi allowed in various non-sterile dosage. How many saprophytic bacteria and fungi in 1 g (ml) of oral drugare safety guarantee?
A. *1000 bacteria and100 mold fungi
B. 500 bacteria and 50 mold fungi
C. 250 bacteria and 25 mold fungi
D. 500 and 200 bacteria, mold fungi
E. 1500 bacteria and 150 mold fungi
61. Bacteriological control of non-sterile drugs involves the possible presence of a small number of groups of microorganisms. What of following microbes is possible presence in non-sterile drugs?
A. *sarcina
B. E.coli
C. Ps. aeruginosa
D. Staphylococcus aureus
E. hemolytic streptococcus
62. Doctor prescribes the patient drug to prevent intestinal disbacteriosis when receiving antibiotic therapy. What drugs is used to save normal microflora?
A. Sulphanilamides
B. *Eubiotics
C. Interferon
D. Antifungal
E. Nitrophuranes.
63. During bacteriological examination of the air condition in a chemist's appartment where manufactured injection forms of drugs, five small rounded colonies with hemolysis zone around them were detected by sedimentation method. What is medium use for?
63.
A. *blood agar.
B. Endo’s medium
C. MPA.
D. yolk -salt agar.
E. Levin’s medium.
64. During the bacteriological control of air in chemist shop were isolated B. cereus, M. luteus, yeast, hemolytic streptococci. Which of these microbes are sanitary indicated microorganisms?
A. *hemolytic streptococci
B. B. cereus
C. M. luteus
D. yeast
E. all of them
65. During the bacteriological examination for check of bacterial carier amoung pharmacy workers bacteria of the genus Staphylococcus were isolated from nasopharynx. What morphological characteristic of this microbes?
A. *grape like cluster
B. cells arranged in chain
C. cells arranged singles
D. location of cell pairs
E. group of four
66. For air sampling in a pharmacy, a bacteriologist used Krotov’s apparatus. What of the following methods is used for investigation of the air?
A. *aspiration
B. membrane filters
C. Termoprecipitation
D. Sedimentation
E. vacuum
67. For microbacteriological control of herbal raw materials was ranked at various differential-diagnostic media. What are the microorganisms that cause plant diseases can not be defined in such research?
A. *Viruses
B. Bacteria
C. Mycoplasma
D. Fungi
E. actinomycetes
68. In the chemist shop the presence of pathogenic microorganisms in the air may be provided by the presence of sanitary-indicative bacteria. Choose among the listed bacteria, which are indicate direct epidemiological danger:
A. *hemolytic streptococci
B. Sarcina
C. Moulds
D. yeasts
E. micrococcus
69. Laboratory staff conducted compliance sanitary and epidemic profile in the pharmacy, particularly in its aseptic room. They have studied the air. What air microorganisms are sanitary -indicative in the pharmacy?
A. *Staphylococcus aureus and hemolytic streptococcus
B. Staphylococcus aureus and Staphylococcus epidermal
C. Staphylococcus aureus and Staphylococcus saprofitnyy
D. epidermal hemolytic streptococcus and staphylococcus
E. Saprofitnyy hemolytic streptococcus and staphylococcus
70. Medicines which contain protein were ssterilized during a week at temperature 55?C a hour every day. What is method of sterilizaation used?
A. *Tindalization.
B. Boiling
C. Pasterization
D. by flame.
E. fluid steam.
71. On the plantation of medicinal plants a disease spread in which one the leaves are formed yellow spots and areas of necrosis. Juice of diseased plants retains infectivity during passage through a bacterial filter, but it plated on nutrient media the growth agent is not found. Which group of pathogenic microorganisms most likely belongs strain of the disease?
A. *Viruses
B. Fungi
C. Actinomycetes
D. Bacteria
E. Mycoplasma
72. Phytopathogenic bacteria cause diseases of plants, leading to deterioration of medical plants. Name the main location in the environment phytopathogenic microbes?
A. *Soil
B. Water
C. air
D. Animals
E. Insects
73. Plant material should be examined for the presence yeast. What meduim should be used for cultivation of these microorganisms, but inhibit growth of concomitant microflora?
A. *Saburo agar
B. Endo agar
C. meat pepton agar
D. Milk-salt agar
E. blood agar
74. Preliminary disinfection of air and working equipment surfaces was did in aseptic box befor making drugs which are used for internal administration. What is the preferable method of sterilization use?
A. *UV sterilization
B. fluid steam
C. sterilization by radiation
D. boiling
E. by formalin
75. Preparation of many drugs requires strict aseptic conditions. One of the sources of drugs contamination by microorganisms of laboratory glasswar. Which method of sterilization is the best one?
A. *dry heat
B. through flame
C. boiling
D. Tyndalizatsiya
E. pasteurization
76. Pure culture of gram-negative bacteria was obtained from drug by bacteriological examination. What medium is used to examine the biochemical properties of bacteria by their enzymatic activity?
A. *differential diagnostic
B. elective
C. meat-peptone agar
D. meat pepton broth
E. semi solid agar
77. Quality of medicines includes some indicators. One of them is bacteriological purity. Which of following drugs which contain more saprophytic bacteria compared to other forms of?
A. *extract
B. Aerosols
C. suppository
D. Eye drops
E. solutions for injection
78. Results of microbacteriological examinations of black mint leaves extract is bad according to the requirements of Pharmacopoeia because pathogenic microflora identified. Indicate this pathogenic microflora:
A. *Ps.aeruginosa
B. yeast
C. epidermal staphylococcus
D. mold fungi
E. micrococcus
79. Solutions made in the pharmacy inoculated on medium to detect of microbial contamination. On Endo medium red colonies with metallic blisten grew. What it can be microbes?
A. *Escherihia
B. Shigella
C. Staphylococcus
D. streptococci
E. Salmonella
80. Tablet medication after bacteriological examination was found unsuitable for use, although its overall microbial contamination does not exceed the norm. Detecting of what microorganisms in the sample allowed to make such a conclusion?
A. *Enterobacteriaceae
B. mold
C. Actinomycetes
D. micrococcus
E. Sarcina
81. The child is six months doctor has ordered drug for oral administration. What is the maximum number of bacteria and fungi is acceptable 1g of the drug according the requirements of WHO and the Pharmacopoeya?
A. *Not more than 50 total bacteria and fungi
B. is not more than 500 bacteria and fungi summarily
C. Not more than 1000 bacteria and fungi total
D. Not more than 1000 bacteria and 100 fungi
E. Not more than 500 bacteria and fungi
82. The medicinal plants have uncharacteristic for it proliferation: lateral shoots (witches broom), the cessation of fruiting and number of other signs of infection. What a group of phytopathogenic microbe can cause such changes?
A. *mycoplasma
B. fungi
C. actinomycetes
D. viruses
E. viroids
83. The medicinal product for intenal using contains more than 1 billion living microbial cells in 1 ml. Nevertheless, the drug was found suitable for use. Which group of drugs its true for?
A. *eubiotics
B. antibiotics
C. vitamins
D. sulfonamide
E. immunoglobulin
84. The pharmaceutical company received raw plants for the manufacture of medications. What microbacteriological tests should be used for the quality of this raw material?
A. *The total number of microorganisms in 1 g of raw
B. Coli -titre
C. Coli -index
D. antibacterial activity
E. Pyrogenecity
85. The pharmacy prescription ear drops prepared. What is the maximum number microbial cells is allowed in 1 ml of drops in accordance with WHO and Pharmacopoeya?
A. *No more than 100
B. 50 or
C. Not more than 1000
D. Less than 500
E. Not more than 150
86. The phytopathogenic microorganisms was selected from medicinal plants, forming colonies as "fried eggs" on a nutrient medium. What are microbes?
A. *Mycoplasma
B. yeast
C. Actinomycetes
D. Nokardia
E. Pseudomonas
87. To treat eczema, a doctor ordered the patient the drug, which should be used transdermally. What is the maximum amount of microbial acceptable 1y this means, in accordance with the requirements of WHO and the Pharmacopoeya?
A. *100 bacteria and fungi summarily
B. 100 bacteria and 50 fungi
C. 1000 bacteria and fungi
D. 100 bacteria and 100 fungi
E. 500 bacteria and fungi
88. A previously healthy 8-year old presents with a large boil (carbuncle) at the back of his neck. Gram stain from incision and drainage reveals sheets of polymorphonuclear leukocytes and gram-positive cocci in clusters. Pending susceptibility testing in the laboratory, which of the following would be the most appropriate antimicrobial therapy?
A. *Oxacillin
B. Penicillin G
C. Tetracycline
D. Gentamicin
E. Aztreonam
89. Chemical modification of benzylpenicillin (penicillin G) has resulted in several beneficial changes in the clinical use of this drug. Which one of the following is NOT one of those beneficial changes?
A. Lowered frequency of anaphylaxis
B. Increased activity against gram-negative rods
C. *Increased resistance to stomach acid
D. Reduced cleavage by penicillinase
E. No correct answer
90. Corynebacteria diphtheria strain without a tox-gene was cultivated into the media with temperate phage. After several passages toxigenic strain of C.diphtheria was isolated. It arose due to following type of recombination (choose from the list one correct answer):
A. *Transduction
B. Conjugation
C. DNA transformation
D. Transposition
E. No correct answer
91. During an outbreak of gastrointestinal disease caused by an Escherichia coli strain sensitive to ampicillin, tetracycline, and chloramphenicol, a stool sample from one patient yields E. coli with the same serotype resistant to the three antibiotics. This phenomenon is the most closely associated with the next process:
A. Transduction
B. *Conjugation
C. DNA transformation
D. Transposition
E. No correct answer
92. Some bacterial enzymes belong to invasion factors and play important role in the pathogen spreading from the portal of entry. Choose from the list culture media for detection bacterial hemolysins:
A. MPB
B. MPA
C. *Blood agar
D. Salt yolk agar
E. No correct answer
93. Each of the following statements concerning the variable regions of heavy chains and the variable regions of light chains in a given antibody molecule is correct EXCEPT:
A. *They have the same amino acid sequence
B. They define the specificity for antigen
C. They are encoded on different chromosomes
D. They contain the hypervariable regions
E. They bind with epitop
94. Which one of the immunoglobulins BEST fits the following description: It is found in plasma as a dimer with a J chain. As it passes through mucosal cells, it acquires a secretory piece that protects it from degradation by proteases.
A. IgM
B. IgG
C. *IgA
D. IgD
E. IgE
95. Your patient became ill 10 days ago with a viral disease. Laboratory examination reveals that the patient's antibodies against this virus have a high ratio of IgM to IgG. What is your conclusion?
A. *It is unlikely that the patient has encountered this organism previously
B. The patient is predisposed to IgE-mediated hypersensitivity reactions
C. The patient has encountered this organism previosly
D. It is likely that the patient has an autoimmune disease
E. The patient has chronic viral disease
96. A latex-agglutination test is one of variants of indirect agglutination which is widely used for the diagnostics of bacterial meningitis of different etiology, hepatitis, etc. What can it find out by this test?
A. antibodies in the blood serum, urine
B. autoantibodies in serum
C. *bacterial, viral antigens in a serum, urine, CSF.
D. incomplete antibodies in serum
E. incomplete antibodies on red blood cells
97. Salmonella typhi murium was isolated from the patient with acute gastroenteritis. What serologic reaction was used for identify an antigen structure of this bacteria?
A. *Agglutination test
B. Complement fixation test
C. Neutralization test
D. Precipitation test
E. Opsonization test
98. A 2-year-old child suffers of recurrent staphylococcal infections arrives at the emergency department at the local hospital. His neutrophils show normal chemotaxis, degranulation, and phagocytosis. However, intracellular killing of staphylococci by the neutrophils is severely impaired. Myeloperoxidase activity of his neutrophils is normal. The child has no history of streptococcal infection. Which of the following is the most likely disease affecting this patient?
A. rheumatoid arthritis
B. Graves disease
C. *chronic granulomatous disease
D. severe combined immunodeficiency disease (SCID)
E. systemic lupus erythematosus (SLE)
99. A 20-year-old girl suddenly experiences severe dyspnea after the consumption of fish at a local restaurant. Upon arrival at the local emergency room she is found to be severely hypotensive and in respiratory distress.Urticarial wheals are also noted all over her body. As the resident physician you quickly realize this to be a hypersensitivity reaction.Physical examination reveals severe laryngeal edema resulting in a marked hoarseness when the 20-year-old girl attempts to speak. Also,her lips and tongue show significant swelling.Which of the following chemicals most likely caused this edematous swelling?
A. corticosteroids
B. cromolyn sodium
C. epinephrine
D. *histamine
E. 5-lipoxygenase
100. A 25-year-old female presents to her doctor’s office with a rash over the malar eminences of her face, sparing the nasolabial folds; a skin rash due to exposure to sunlight; and painless nasopharyngeal ulcers. Suspecting an autoimmune disorder, her physician obtains an anti-nuclear antibody test of her blood and finds high titers of anti-ouble-stranded DNA anti-bodies. Which one of the following diseases is most likely responsible for this immunological reaction?
A. Goodpasture syndrome
B. multiple sclerosis
C. myasthenia gravis
D. rheumatoid arthritis
E. *systemic lupus erythematosus
101. A 27-year-old man was treated with penicillin for gonorrhea. Thirty-five days later he was reinfected with the same germ, and his physician administered an intramuscular dose of penicillin. Two minutes following the injection of penicillin, the patient experienced hypoten-sion and shock and became unconscious. This reaction was most likely mediated by which of the following?
A. activation of the alternate complement pathway
B. activation of the classical complement
C. IgD
D. *IgE
E. IgG
102. A 3-year-old child arrives at the hospital in severe respiratory distress. Periorbital edema is also noted. Blood analysis reveals decreased levels of C4 and decreased levels of C1 inhibitor. This complement deficiency is likely to lead to which of the following conditions?
A. *angioedema
B. an increased susceptibility to pyogenic infections
C. bacteremia
D. decreased production of anaphylatoxins
E. enhancement of antibody production
103. A 3-year-old child with a history of recurrent staphylococcal infections arrives at the emergency department at the local hospital. His neutrophils show normal chemotaxis, degranulation, and phagocytosis. However, intracellular killing of staphylococci by the neutrophils is severely impaired. Myeloperoxidase activity of his neutrophils is normal. The child has no history of streptococcal infection. Which of the following is the most likely disease affecting this patient?
A. *chronic granulomatous disease
B. Graves disease
C. rheumatoid arthritis
D. severe combined immunodeficiency disease (SCID)
E. systemic lupus erythematosus (SLE)
104. A 34-year-old female patient is sneezing and has a runny nose and watery eyes every summer. Her physician is convinced that the patient is suffering from an allergy and performs some skin tests. The results of these test sare shown below: Allergen used Response to allergen for testing(wheal diameter in mm) cat dander 1, house dust 4, Kentucky blue grass13, pollen7, fungal spores 6, solvent-only control 5. Which of the following test allergens is most likely to be inducing the patient’s symptoms?
A. cat dander
B. house dust
C. *Kentucky blue grass
D. mold
E. pollen
105. A 35-year-old male with end-stage renal disease must undergo a kidney transplant. Which of the following is true of immunologic suppression for transplantation?
A. *It can occur by antilymphocyte globulin.
B. It cannot be achieved by cyclosporine administration.
C. It cannot occur by lymphoid irradiation.
D. It is facilitated by gamma interferon administration.
E. It is not likely to respond to steroid administration.
106. A 35-year-old woman suffers of severe muscular weakness. Antibodies against acetylcholine neural receptors were measured in a woman and are thought to be involved in the pathogenesis of which of the following
A. acute idiopathic polyneuritis
B. Guillain-Barr syndrome
C. *myasthenia gravis
D. multiple sclerosis
E. postpericardiotomy syndrome
107. A 45-year-old male was admited to hospital with a rash over the malar eminences of his face, sparing the nasolabial folds; a skin rash due to exposure to sunlight; and painless nasopharyngeal ulcers. Suspecting an autoimmune disorder, his physician obtains an anti-nuclear antibody test of his blood and finds high titers of anti-ouble-stranded DNA anti-bodies. Which one of the following diseases is most likely responsible for this immunological reaction?
A. *systemic lupus erythematosus
B. multiple sclerosis
C. myasthenia gravis
D. rheumatoid arthritis
E. Goodpasture syndrome
108. A 5-month-old baby presents to the local community clinic with noted oral candidiasis, chronic diarrhea, extensive diaper rash, and an overall failure to thrive. Previously this infant has been seen for multiple severe, recurrent infections from viruses, fungi, bacteria, and protozoa. Chest x-ray reveals an absent thymic shadow. Which of the following immunodeficiencies best explains this baby’s recurrent infections?
A. Bruton agammaglobulinemia
B. deficiencies in the C5–C8 components of complement
C. deficiency in neutrophil NADPH oxidase
D. DiGeorge syndrome
E. *severe combined immunodeficiency(SCID)
109. A 6-month-old girl has severe combined immunodeficiency(SCID). Which of the following can most likely restore the immunological competency of this 6-month-old girl?
A. administration of purine nucleosidephosphorylase
B. B-cell supplementation
C. T-cell treatment
D. injection of adenosine deaminase
E. *compatible bone marrow transplantation
110. A 7-month-old boy suffers of candidiasis, chronic diarrhea, extensive diaper rash, and an overall failure to thrive. Previously this infant has been seen for multiple severe, recurrent infections from viruses, fungi, bacteria, and protozoa. Chest x-ray reveals an absent thymic shadow. Which of the following immunodeficiencies best explains this baby’s recurrent infections?
A. Bruton agammaglobulinemia
B. deficiencies in the C5–C8 components of complement
C. *severe combined immunodeficiency(SCID)
D. DiGeorge syndrome
E. deficiency in neutrophil NADPH oxidase
111. A child disturbs a wasp nest, is stung repeatedly, and goes into shock within minutes, manifesting respiratory failure and vascular collapse. This is MOST likely to be due to
A. *systemic anaphylaxis
B. serum sickness
C. an Arthus reaction
D. cytotoxic hypersensitivity
E. endotoxic shock
112. A girl has a genetic defect and cannot produce the J chain which is important in the strucure of some immunoglobulin molecules.Which of the following will most likely be observed in this individual?
A. *a decrease in serum IgM
B. a decrease in mature T lymphocytes
C. a decrease in mature B cells
D. an increase in IgA in the intestine
E. an increase in serum IgM
113. A high school student while on a field trip encounters poison ivy and develops a severe contact dermatitis, which is classified as type IV hypersensitivity. Contact dermatitis is differentiated from type III hypersensitivity by which of the following facts?
A. It is associated with cell bound antigens of human erythrocytes.
B. It is associated with cytotoxic reactions.
C. It is encountered in atopic individuals.
D. It is mediated by antigen-antibody complexes.
E. *It is mediated by cellular immunity.
114. A little boy presents to the local community clinic with noted oral candidiasis, chronic diarrhea, extensive diaper rash, and an overall failure to thrive. Previous diagnosis is severe combined immunodeficiency(SCID). Which of the following can most likely restore the immunological competency of this 5-month-old baby?
A. administration of purine nucleosidephosphorylase
B. B-cell supplementation
C. *compatible bone marrow transplantation
D. injection of adenosine deaminase
E. T-cell treatment
115. A patient is hospitalized with a tentative diagnosis "Hepatitis B". Serologic test is used for the diagnostics. It is based on co-operating of antigen with an antibody, chemically related to peroxydase. What name does this test have?
A. *ELISA
B. RIA
C. Immunofluorescence test
D. CFT
E. Immobilization test
116. A patient skin-tested with purified protein derivative (PPD) to determine previous exposure to Mycobacterium tuberculosis develops induration at the skin test site 48 hours later. Histologically, the reaction site would MOST probably show
A. Eosinophils
B. Neutrophils
C. *Helper T cells and macrophages
D. B cells
E. NK cells
117. A patient with rheumatic fever develops a sore throat from which.beta-hemolytic streptococci are. cultured. The patient is started on treatment wilh penicillin, and the sore throat resolves within several days. However, 7 days after initiation of penicillin therapy the patient develops a fever of 103 F, a generalized rash, and proteinuria. This MOST probably resulted from
A. recurrence of the rheumatic fever
B. a different infectious disease
C. an IgE response to penicillin
D. *an IgG-M response to penicillin
E. a delay hypersensitivity reaction to penicillin
118. A rock singer is hospitalized with a tentative diagnosis "AIDS". Serologic test is used for the diagnostics. It is based on co-operating of antigen with an antibody, chemically related to peroxydase. What name does this test have?
A. *ELISA
B. RIA
C. Immunofluorescence test
D. CFT
E. Immobilization test
119.?A student has a genetic defect and cannot produce the J chain which is important in the strucure of some immunoglobulin molecules.Which of the following will most likely be observed in this individual?
A. a decrease in mature B cells
B. a decrease in mature T lymphocytes
C. *a decrease in serum IgM
D. an increase in IgA in the intestine
E. an increase in serum IgM and decrease in IgE
120. A women with rheumatic heart disease has tonsillitis. From the sputum beta-hemolytic streptococci are obtained. The patient is treatment with penicillin, and the tonsillitis resolves within several days. However, 8 days after initiation of penicillin therapy the patient develops a fever of 39°C, a generalized rash, and proteinuria. This most probably resulted from
A. recurrence of the rheumatic fever
B. a different infectious disease
C. an IgE response to penicillin
D. *an IgG-M response to penicillin
E. a delay hypersensitivity reaction to penicillin
121. A young girl was treated with penicillin for gonorrhea. Twenty-two days later she was reinfected with the same germ, and his physician administered an intramuscular dose of penicillin. Two minutes following the injection of penicillin, the patient experienced hypotension and shock and became unconscious. This reaction was most likely mediated by which of the following?
A. activation of the alternate complement pathway
B. activation of the classical complement
C. IgD
D. IgG
E. *IgE
122. A young housworker suffers of systemic lupus erythematosus. Administration of which one of the following substances is likely to be most beneficial to this patient?
A. gamma interferon
B. interleukin-1
C. plasmapheresis
D. *prednisone
E. tumor necrosis factor (TNF)
123. A young infant suffers of recurrent pyogenic infections. Low low levels of all immunoglobulins (IgG, IgA, IgM, IgD, IgE) are found in young infant. He has which of the following diseases?
A. Myasthenia gravis
B. Goodpasture syndrome
C. Graves disease
D. *Bruton disease
E. Addison disease
124.?According an anamesis of this disease patient has been very susceptible to opportunistic bacterial and fungal infections. This disease is due to a defect in the intracellular microbicidal activity of neutrophils as a result of a lack of NADPH oxidase activity (or similar enzymes). What immunodeficiency disease does patient have?
A. Chronic Granulomatosis Disease (CGD)
B. Hereditary Angloedema
C. Ataxia-Telangiectasia
D. Agammaglobulinemia
E. HIV-infection
125. Acording to a complement fixation test for serologic diagnosis, the reactants should be added in what sequence? (Ag = antigen; Ab = antibody; C = complement; EA = antibody-coated indicator erylhrocytes.)
A. Ag + EA + C/wait/ + patient's serum
B. C + patient's serum + EA/wait/+ Ag
C. Ag + patient's serum + EA/wait/+ C
D. patient's serum + EA +C/wait
E. *Ag + patient's serum + C/wait/+ EA
126. An 8-month old boy presents to the emergency room in respiratory distress from a recurrent upper respiratory tract bacterial infection. Labsreveal low levels of IgA, IgD, IgE, IgG, and IgM. Suspecting an immune deficiency disorder, genetic testing reveals a defect in a tyrosinekinase gene. Which of the following would be seen in patients with this immune deficiency disorder?
A. particular susceptibility to viral and fungal infections
B. profound deficiencies of cell-mediated immunity
C. depletion of lymphocytes in the paracortical areas of lymph nodes
D. normal numbers of B lymphocytes
E. *very low quantities of immunoglobulinin their serum
127. Causative agent of the acute gastroenteritis was isolated from the patient’s organism. It is necessary to identify him after the detection of an antigen structure. What serologic reaction can be used for this purpose?
A. *Agglutination test
B. Complement fixation test
C. Neutralization test
D. Precipitation test
E. Opsonization test
128. Child, 7 mounth old, has bleeding and eczema. Recurrent pyogenic infections occur frequency. What immunodeficiency does child have?
A. *Wiskott-Aldrich Syndrome
B. Chronic Granulomatosis Disease (CGD)
C. Hereditary Angloedema
D. Ataxia-Telangiectasia
E. Agammaglobulinemia
129.?Following the consumption of fish at a local restaurant, a 17-year-old girl suddenly experiences severe dyspnea. Upon arrival at the local emergency room she is found to be severely hypotensive and in respiratory distress.Urticarial wheals are also noted all over her body. As the resident physician you quickly realize this to be a hypersensitivity reaction.To which of the following immunoglobulins does the allergen bind rapidly during the activation stage of mast cells?
A. IgA
B. IgD
C. *IgE
D. IgG
E. IgM
130. Hemolytic disease of the newborn caused by Rh blood group incompatibility requires maternal antibody to enter the fetal bloodstream. Therefore, the mediator of this disease is
A. IgE antibody
B. *IgG antibody
C. IgM antibody
D. IgA antibody
E. IgD antibody
131. In antibodies which occure in the organism under such diseases as brucellesis, autoimmune diseases, etc. one of the active centres is blocked. An idirect Coombs test is used for their detection. Specify that can be defined by this reaction.
A. incomplete antibodies on the red blood cells
B. deficient antigens on the red blood cells
C. *incomplete antibodies in the blood serum
D. incomplete antibodies on the platelets
E. haptens on the red blood cells
132. One of the active centres of antibodies which present in the organism under such diseases as brucellesis, autoimmune diseases, etc. is blocked. An idirect Coombs test is used for their detection. Specify that can be defined by this reaction.
A. incomplete antibodies on the red blood cells
B. deficient antigens on the red blood cells
C. *incomplete antibodies in the blood serum
D. incomplete antibodies on the platelets
E. haptens on the red blood cells
133. One of variants of indirect agglutination is a latex-agglutination test. This test is widely used for the diagnostics of bacterial meningitis of different etiology, hepatitis, etc. What can it find out by this test?
A. antibodies in the blood serum, urine
B. autoantibodies in serum
C. *bacterial, viral antigens in a serum, urine, CSF.
D. incomplete antibodies in serum
E. incomplete antibodies on red blood cells
134. Penicillin is a hapten in both humans and mice. To explore the hapten-carrier relationship, a mouse was injected with penicillin covalently bound to bovine serum albumin and, at the same time, with egg albumin to which no penicillin was bound. 0f the following, which one will induce a secondary response to penicillin when injected into the mouse 1 month later?
A. Penicillin
B. cephalosporins
C. Penicillin bound to egg albumin
D. Egg albumin
E. *bovine serum albumin
135. The home worker is hospitalized with a tentative diagnosis "Hepatitis B". Serologic test is used for the diagnostics. It is based on co-operating of antigen with an antibody, chemically related to peroxydase. What name does this test have?
A. *ELISA
B. RIA
C. Immunofluorescence test
D. CFT
E. Immobilization test
136. The person’s clothes with brown spots defined tham as blood is delivered to the forensic medical examination laboratory. An expert defined them as tracks of blood. What test does need to should be used to confirm this blood belonging to human?
A. Complement fixation test
B. *Ring precipitation test
C. Flocullation test
D. ELISA
E. Agglutination test
137. The woman’s shoe with red spots defined tham as blood is delivered to the forensic medical examination laboratory. An expert defined them as tracks of blood. What test does need to should be used to confirm this blood belonging to human?
A. Complement fixation test
B. *Ring precipitation test
C. Flocullation test
D. ELISA
E. Agglutination test
138. This electrophoretic pattern of serum proteins was likely to be obtained from a 6-month-old infant suffering from recurrent pyogenic infections. Very low levels of all immunoglobulins are found in young infant. He has which of the following diseases?
A. Addison disease
B. *Bruton disease
C. Graves disease
D. Goodpasture syndrome
E. Myasthenia gravis
139. A patient suspected on anthrax is admitted to hospital. For express diagnostics the direct immunofluorescense method was utillized. What ingredient is used for these diagnostics?
A. Toxoid
B. Immune antibacterial serum
C. Immune antitoxic serum
D. *Specific fluorescent serum
E. Protective antigen
140. Two cases of anthrax took place in New village. The patients were admitted to hospital. For express diagnostics the direct immunofluorescense method was utillized. What ingredient is used for these diagnostics?
A. Toxoid
B. Immune antibacterial serum
C. Immune antitoxic serum
D. *Specific fluorescent serum
E. Protective antigen
141. While on a wilderness vacation, a banker develops extensive skin lesions noted for their varying degrees of erythema, edema, and vesiculations. His physician tells him that these lesions are due to delayed type hypersensitivity. If this is actually the case, which of the following statements is accurate?
A. *Delayed-type hypersensitivity can be transferred passively to volunteers by sensitized lymphocytes.
B. Delayed-type hypersensitivity is suppressed by antihistaminic drugs.
C. This allergy does not cause tissue damage.
D. This allergy is due to IgE absorbed on mast cells.
E. This type of allergy usually occurs after inhalation of grass pollens.
142. You have a patient who makes autoantibodies against his own red blood cells, leading to hemolysis. Which one of the following mechanisms is MOST likely to explain the hemolysis?
A. Performs from cytotoxic T cells lyse the red cells
B. Neutrophils release proteases that lyse the red cells
C. lnterieukin-2 binds to its receptor on the red cells, which results in lysis of the red cells
D. *Complement is activated, and membrane attack complexes lyse the red cells
E. Autoantibodies direct lyse the red cells
143. Young girl is hospitalized with a tentative diagnosis "Hepatitis B". Serologic test is used for the diagnostics. It is based on co-operating of antigen with an antibody, chemically related to peroxydase. What name does this test have?
A. *ELISA
B. RIA
C. Immunofluorescence test
D. CFT
E. Immobilization test
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