Krok 1 – 2013 Base(Microbiology)

Quite often the cause of secondary immunodeficiency is an infection involvement, when the causative agents propagate directly in the cells of immune system and destroy it. The following diseases are characterized by:

It is planned to use the territory of an old cattle burial ground (which is not used for more than 50 years) for building houses. But ground analysis revealed presence of the pathogen of the very dangerous illness. Which of the indicated microorgonisms is likely to remain in the ground for such a long time?

From the nasopharynx of a 5-year-old child it was excreted amicroorganism which is identical to Corynebacterium diphtheriae dose according to morphological and biochemical signs.Microorganism does not produce exotoxin. As a result of what process can this microorganism become toxigenic?

While studying a microslide obtained from the punctuate of a regional lymph node and stained by Romanovsky-Giemsa method a physician revealed some light-pink thin microorganisms with 12-14 regular spiral coils and pointed ends, up to 10-13 micrometer long. This might be the causative agent of the following disease:

Sanitary bacteriological research on water by the membrane filter method revealed two red colonies on a membrane filter (Endo agar) through which 500 ml of analyzed water were passed. Calculate the coli index and coli titer of the analyzed water:

While examining a patient an otolaryngologist noticed hyperaemia and significantly edematous tonsils with a grayish film upon them. Microscopical examination of this film revealed some gram-positive bacilli placed at an angle with each other. What disease might be suspected?

Patient with vomiting, dizziness, sensation of dubble vision, difficult swallowing was admitted to the hospital. Doctor suspects botulism. What diagnostic methods should be used for diagnosis approving?

A man who was bitten by the unknown dog applied to the surgeon. Wide ragged woundes were localised on the face. What curative-prophylactic aid should be given to prevent rabies?

In a patient with clinical signs of immunodeficiency the number and functional activity of T and B lymphocytes are not changed. Defect with dysfunction of antigen-presentation to the immunocompetent cells was found during investigation on the molecule level. Defect of what cells is the most probable?

A patient with complaints of 3-day-long fever, general weakness, loss of appetite came to visit the infectionist. The doctor suspected enteric fever. Which method of laboratory diagnosis is the best to confirm the diagnosis?

A consumptive patient has an open pulmonary form of disease. Choose what sputum staining should be selected for finding out the tubercle (Kochs) bacillus?

During surgical operation a blood transfusion was made. The blood must be checked to find antigens of some disease. What disease is expected to be found?

A 42-year-old man who has been injured in a car accident is brought into the emergency room. His blood alcohol level on admission is 250 mg/dL. Hospital records show a prior hospitalization for alcohol related seizures. His wife confirms that he has been drinking heavily for 3 weeks. What treatment should be provided to the patient if he goes into withdrawal?

A patient who came to the doctor because of his infertility was administered to make tests for toxoplasmosis and chronic gonorrhoea. Which reaction should be performed to reveal latent toxoplasmosis and chronic gonorrhoea of the patient?

On bacteriological study of rinsing water of the patient with food poisoning, the pure bacterial culture was inoculated with the following properties: gram-negative motile bacillus in the Endo environment grows like achromic colony. Representative of what genus has caused the illness?

The person was selling “homemade pork” sausages on the market. State sanitary inspector suspected falcification of the sausages.With help of what serological immune reaction can food substance be identified?

While registering the child to the school Mantus test was made to define whether revaccination was needed test result is negative. What does this result of the test mean?

The donor who didn’t donate the blood for a long time was investigated with IFA method. Anti-HBs antibodies were revealed. What does positive result of IFA in this case mean?

Bacteriological examination of purulent discharges from the urethra revealed gram-negative bacteria looking like coffee beans. They were localized in the leukocytes and could decompose glucose and maltose to acid. These are the causative agents of the following disease:

Scraps of the mycelium of a fungus, spores, air bubbles and fat drops were discovered on microscopy of the patients hair excluded from the infected areas. For what fungus disease is this microscopic picture characteristic?

In order to speed up healing of a wound of oral mucosa a patient was prescribed a drug that is a thermostable protein occuring in tears, saliva, mothers milk as well as in a new-laid hens egg. It is known that this protein is a factor of natural resistance of an organism. What is it called?

Study of bacteriological sputum specimens stained by the Ziel-Neelsen method revealed some bright-red acid-resistant bacilli that were found in groups or singularly. When they were inoculated onto the nutrient media, the signs of their growth show up on the 10-15 day. These bacteria relate to the following family:

A man was admitted to the hospital on the 5th day of disease that manifested itself by jaundice, muscle aching, chill, nose bleedings. In course of laboratory diagnostics a bacteriologist performed dark-field microscopy of the patients blood drop. Name a causative agent of this disease:

Gramnegative bin-shaped diplococcus inside and outside of leucocytes were detected on bacteriological examination of the purulent exudates from the cervix of the uterus. Name the causative agent of purulent inflammation of the cervix of the uterus

Patient with diarrhoea was admitted to the infection unit. Gramnegative curved rod-like bacteria were founded on bacterioscopic examination of faecal masses. What is the most likely disease in this patient?

In a 2-year-old child with catarrhal presentations and skin rash a pediatrician suspected scarlet fever. The child was given intracutaneously a small dose of serum antibody to the streptococcal erythrogenic toxin; on the site of injection the rash disappeared. What do the reaction results mean?

From the defecation of a 6-year-old ill child, who has artificial feeding, the intestinal bacillus with antigen structure 0-111 is excreted. What is the diagnosis?

For serological diagnostics of the whooping cough it was made large-scale reaction with parapertussis and pertussis diagnosticums. At the bottom of the test-tubes with diagnosticum of Bordetella parapertussis grain-like sediment formed. What antibodies have this reaction revealed?

A man died from an acute infectious disease accompanied by fever, jaundice, haemorrhagic rash on the skin and mucous membranes as well as by acute renal insufficiency. Histological examination of renal tissue (stained by Romanovsky-Giemsa method) revealed some convoluted bacteria looking like C und S letters. What bacteria were revealed?

A 16 y.o. boy from a countryside entered an educational establishment. Scheduled Manteux test revealed that the boy had negative reaction. What are the most reasonable actions in this case?

Examination of a patient with pustular skin lesions allowed to isolate a causative agent that forms in the blood agar roundish yellow middle-sized colonies surrounded by haemolysis zone. Smears from the colonies contain irregular-shaped clusters of gram-positive cocci. The culture is oxidase- and catalase-positive, ferments mannitol and synthesizes plasmocoagulase. What causative agent was isolated?

Microscopic examination of a Gram-stained scrape from patients tongue revealed oval, round, elongated chains of dark-violet gemmating cells. What disease can be caused by this causative agent?

From pharynx of a child with suspected diphtheria a pure culture of microorganisms was isolated. Their morphological, tinctorial, cultural and biochemical properties appeared to be typical for diphtheria causative agents. What study should be conducted in order to draw a conclusion that this is a pathogenic diphtheria bacillus?

Examination of a child revealed some whitish spots looking like coagulated milk on the mucous membrane of his cheeks and tongue. Analysis of smears revealed gram-positive oval yeast-like cells. What causative agents are they?

A duodenal content smear of a patient with indigestion contains protosoa 10-18 mm large. They have piriform bodies, 4 pairs of filaments, two symmetrically located nuclei in the broadened part of body. What kind of the lowest organisms is it?

Blood of a patient with presumable sepsis was inoculated into sugar broth. There appeared bottom sediment. Repeated inoculation into blood agar caused growth of small transparent round colonies surrounded by hemolysis zone. Examination of a smear from the sediment revealed gram-positive cocci in form of long chains. What microorganisms are present in blood of this patient?

Bacterioscopy of nasopharyngeal mucus taken from a 2.5 year old child with nasopharyngitis revealed gram-positive diplococci looking like coffee grains. What organs of the child are most likely to be affected if these microorganisms penetrate the blood?

Analysis of sputum taken from a patient with suspected pneumonia revealed rather elongated gram-positive diplococci with somewhat pointed opposite ends. What microorganisms were revealed in the sputum?

Serological diagnostics of infectious diseases is based upon specific interaction with antigenes. Specify the serological reaction that underlies adhesion of microorganisms when they are affected by specific antibodies in presence of an electrolyte:

The immunoblot detected gp120 protein in the blood serum. This protein is typical for the following disease:

HIV has gp41 and gp120 on its surface interacts with target cells of an organism. Which of the following human lymphocyte antigens is gp120 complementary bound with?

On bacteriological examination of the defecation of a 4-months-old baby with the symptoms of acute bowel infection there were revealed red colonies spread in the large quantity in the Endo environment. What microorganism can it be?

The contents of vesicles that appeared on the mucous membrane of a patient with variola was sent to a virological laboratory. Which of the listed changes were revealed during the smear microscopy?

Bacteriological examination of a patient with food poisoning required inoculation of a pure culture of bacteria with the following properties: gram-negative movable bacillus that grows in the Endos medium in form of colourless colonies. A representative of which species caused this disease?

Examination of a young man in the AIDS centre produced a positive result of immune-enzyme assay with HIV antigens. Patient didn’t complain on state of his health. What can the positive result of immune-enzyme assay be evidence of?

Microscopy of stained (Ziehl-Neelsen staining) smears taken from the sputum of a patient with chronic pulmonary disease revealed red bacilli. What property of tuberculous bacillus was shown up?

Reaction of passive hemagglutination conducted with erythrocytic typhoid Vi-diagnosticum helped to reveal some antibodies in the dilution of the patients serum at a ratio of 1:80 that exceeds the diagnostic titer. Such result witnesses of:

In order to determine toxigenicity of diphtheria bacilli a strip of filter paper impregnated with antitoxic diphtherial serum was put on the dense nutrient medium. There were also inoculated a studied microbal culture and a strain that is known to be toxigenic. If the microbal culture under examination produces exotoxin, it will result in formation of:

A 50-year-old patient with typhoid fever was treated with Levomycetin, the next day his condition became worse, temperature rised to 39.6°С. What caused worthening?

A patient underwent esophagogastroduodenoscopy. Analysis of the biopsy material enabled doctors to diagnose him with helicobacteriosis. What property of the bacteria found in this patient had to be obligatory taken into account during their cultivation?

In order to estimate toxigenity of diphtheria agents obtained from patients the cultures were inoculated on Petri dish with nutrient agar on either side of a filter paper strip that was put into the centre and moistened with antidiphtheric antitoxic serum. After incubation of inoculations in agar the strip-like areas of medium turbidity were found between separate cultures and the strip of filter paper. What immunological reaction was conducted?

A patient with clinical signs of encephalitis was delivered to the infectious diseases hospital. Anamnesis registers a tick bite. Hemagglutination-inhibition reaction helped to reveal antibodies to the causative agent of tick-borne encephalitis in the dilution 1:20 which is not diagnostic. What actions should the doctor take after he had got such result?

The first grade pupils were examined in order to sort out children for tuberculosis revaccination. What test was applied for this purpose?

Clinical diagnosis of a female patient was gonorrhoea. What examination method can be applied for confirmation of this diagnosis?

A patient suffering from periodical attacks caused by inhalation of different flavoring substances was diagnosed with atopic bronchial asthma. IgE level was increased. This is typical for the following type of reactions:

Bacteriological laboratory examines canned meat whether it contains botulinum toxin. For this purpose an extract of test specimen and antitoxic antibotulinic serum of A, B, E types were introducted to a group of mice under examination; a control group of mice got the extract without antibotulinic serum. What serological reaction was applied?

For the purpose of retrtospective diagnostics of recent bacterial dysentery it was decided to perform serological examination of blood serum in order to determine antibody titer towards Shiga bacilli. What of the following reactions should be applied?

During the repeated Widals agglutination test it was noticed that the ratio of antibody titers and O-antigens S.typhi in the patients serum had increased from 1:100 to 1:400. How would you interpret these results?

A patient recovered from Sonne dysentery and was once more infected with the same causative agent. What is such infection form called?

A 10-year-old child had the mantoux tuberculin test administered. 48 hours later a papule up to 8 mm in diameter appeared on the site of the injection. What type of hypersensitivity reaction developed after the tuberculin injection?

A patient with clinical presentations of immunodeficiency went through immunological examinations. They revealed significant loss of cells that form rosettes with erythrocytes of a ram. What conclusion can be made according to the analysis data?

As a result of durative antibiotic therapy a 37-year old patient developed intestinal dysbacteriosis. What type of drugs should be used in order to normalize intestinal microflora?

Among junior children of an orphanage an outbreak of intestinal infection with signs of colienteritis was registered. In order to identify isolated causative agent it is necessary to:

Urine examination of a patient with acute cystitis revealed leukocytes and a lot of gram-negative bacilli. Inoculation resulted in growth of colonies of mucous nature that formed green soluble pigment. What microorganism is the most probable cause of the disease?

A laboratory received a material from a patients wound. Ppreliminary diagnosis is gaseous gangrene. What microbiological method should be applied to determine species of causative agent?

A virological laboratory obtained pathological material (mucous discharges from nasal meatuses) taken from a patient with provisional diagnosis “influenza”. What quick test will allow to reveal specific viral antigen in the material under examination?

In the surgical department of a hospital there was an outbreak of hospital infection that showed itself in often postoperative wound abscesses. Bacteriological examination of pus revealed aurococcus. What examination shall be conducted to find out the source of this causative agent among the department personnel?

A 7 year old child often suffers from streprococcic angina. Doctor suspected development of rheumatism and administered serological examination. The provisional diagnosis will be most probably confirmed by presence of antibodies to the following streptococcic antigen:

A culture of monkey cells (Vero) and a group of mouse sucklings were infected with an inoculum taken from a child with provisional diagnosis “enterovirus infection”. There was no cytopathic effect on the cell culture but mouse sucklings died. What enteric viruses might have caused disease of this child?

A patient has been suffering from elevated temperature and attacks of typical cough for 10 days. Doctor administered inoculation of mucus from the patients nasopharynx on the agar. What microorganism is presumed?

A patient of surgical department complains about pain in the small of her back and in the lower part of her belly; painful and frequent urination. Bacteriological examination of urine revealed gram-negative oxidase-positive rod-like bacteria forming greenish mucoid colonies with specific smell. What causative agent can it be?

There was a record of some anthrax cases among animals in a countryside. The spread of disease can be prevented by means of immunization. What kind of vaccine should be used?

A female patient underwent liver transplantation. 1.5 month after it her condition became worse because of reaction of transplant rejection. What factor of immune system plays the leading part in this reaction?

Microscopical examination of a microbal culture revealed fusiform spore-forming microorganisms that get violet-blue Grams stain. What microorganisms were revealed?

A specimen stained by Ozheshko method contains rod-like microorganisms stained blue with round terminal components stained red. What are these components called?

During the regular sanitary-epidemiological inspection of a pharmacy, the bacteriological analysis of air was performed. The air was found to have bacilli, yeast fungi, hemolytic streptococci, micrococci. Which of the detected microorganisms indicate the direct epidemic danger?

A bacteriological laboratory received sputum sample of a patient suffering from tuberculosis. Bacterioscopic examination of smears and detection of tuberculosis bacillus can be realized by one of enrichment methods that involves processing of sputum only with solution of caustic soda. What is this method called?

A pregnant woman was registered in an antenatal clinic and underwent complex examination for a number of infections. Blood serum contained IgM to the rubella virus. What is this result indicative of?

A 65-year-old man has purulent abscess on his neck. Analyses revealed a culture of gram-positive cocci with plasmocoagulase activity. This culture relates most likely to:

Material taken from a patient with provisional diagnosis “influenza” was referred to a laboratory. For virological examination the hemadsorption reaction was applied. This reaction can be applied for detection of the following viruses:

Vomiting material of a patient suspected of having cholera was delivered to the bacteriological laboratory. The material was used for preparing a “hanging drop” specimen. What type of microscopy will be applied for identification of the causative agent by its mobility?

Inoculum from pharynx of a patient ill with angina was inoculated into blood-tellurite agar. It resulted in growth of grey, radially striated (in form of rosettes) colonies 4-5 mm in diameter. Gram-positive bacilli with clublike thickenings on their ends placed in form of spread wide apart fingers are visible by microscope. What microorganisms are there?

During examination of a patient a dentist revealed a lot of “white spots” – zones of enamel demineralization. What microorganisms take part in the development of this process?

Planned mass vaccination of all newborn 5-7 day old children against tuberulosis plays an important role in tuberculosis prevention. In this case the following vaccine is applied:

A 4-year-old child presents with general weakness, sore throat and deglutitive problem. After his examination a doctor suspected diphtheria and sent the material to the bacteriological laboratory. In order to determine the diphtheria causative agent the material should be inoculated into the following differential diagnostic medium: