In What Term from the Beginning of Illness Does the Typical Rentgenological Picture Of

Phthisiology

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In what term from the beginning of illness does the typical rentgenological| picture of miliary tuberculosis appear ?
On the first days
* On 7th days
Through 3-4 weeks
Through 2-3 months
Through 5-6 months.
What kind of rentgenological| picture is most typical for miliary tuberculosis?
Flakes of snow".
Snow-storm".
Bat’s wings|
Weeping willow".
* Looks like millet dissemination
By what method does selection of bacteriae| usually appear at miliary tuberculosis?
Bakterioskopy.
Bakterioskopy after the using method of flotation.
Bacteriological.
Biological.
* Usually doesn’t appear by any method.
конецформыначалоформыWhat sputum in patients with miliary tuberculosis?
Mucous.
Mucous and purulent.
Purulent.
Mucous| with bloodstreaks.
* Sputum is absent.
How does usually miliary tuberculosis finish without treatment?
Spontaneous curing.
* By death in 4-5 weeks.
By death in 5-7 months.
Passing to infiltration tuberculosis.
Passing to chronic tuberculosis.
What character usually has temperature reaction for a patient on miliary tuberculosis?
Subfebrility| during the first 3-5 days of illness.
Protracted inconstant subfebrility|.
Fever during the first 3-5 days of illness.
* The Wrong fever
Normal temperature.
What is the most characteristic investigation, if miliary tuberculosis does not end with death of patient?
* Convalescence with development of diffuse pneumofibrosis.
Convalescence with forming the hearths of Gon.
Passing into subsharp disseminated tuberculosis.
Passing into fibrous-cavernous tuberculosis.
Development the cirrhosis of lungs.
What complication is not typical |for miliary tuberculosis?
* Sharp insufficiency of kidney.
Cerebral comma.
Sharp hepatic insufficiency.
Amyloidosis.
Endotoxicosis.
What is correct continuation of suggestion? Miliary tuberculosis....
Is the most frequent form of tuberculosis.
Takes the second place (after the infiltration tuberculosis) in the structure of morbidity on secondary tuberculosis.
* Nowadays meets rarely.
Takes the second place (after the tuberculosis of intrathoracic nodes) in the structure of morbidity on primary tuberculosis.
Nowadays meets in casuistic cases.
What thesis is faithful?
* Miliary tuberculosis is one of the most unfavourable| form of tuberculosis.
Miliary tuberculosis is a favourable form of tuberculosis.
Miliary tuberculosis is a torpid| form of tuberculosis.
Miliary tuberculosis is a subclinical form of tuberculosis.
Miliary tuberculosis is a | form of tuberculosis without symptome.
What thesis is faithful?
Miliary tuberculosis is a local form of tuberculosis.
* Miliary tuberculosis is a general |form of tuberculosis.
Miliary tuberculosis is characterized by migrant defeats of different organs.
Only the lungs are struck at miliary tuberculosis .
The defeat takes place in 1-2 parenchymal |organs at miliary tuberculosis.
What is the method of provocation of wheezes for patients with tuberculosis?
deep breathing
breathing through the mouth.
* deep inhalation after the easy coughing.
breathing through the nose.
quiet breathing
Patient of 35 at a reception to tuberculosis dispensary complains about a weakness, promoted sweating, cough with sputum of mucus character. Roentgenological: in S1,2 of left lung darkening of weak intensity with unclear contours was found. What kind of research should be done to confirm diagnosis tuberculosis?
General blood test.
Biochemical blood test.
* Sputum’s test on MBT.
Immunological research of blood.
Sputum’s test on the second flora.
Patient of 43 undergo a coursus-cav of anmycobacterial medication treatment concerning FDT (12.12.1998) of left lung’s upper part (fibrocavernous, phase of infiltration and dissemination), Destr-+ Mbt+ M+ K+ resist 0, ISTO, Cat4 Cog4(2004).What research above all should be done to a patient to set an optimum combination of chemo medication?
Determine a type of MBT.
Determine presence of the second flora.
* Determine sensitiveness of MBT to antimycobacterial medication.
To define massiveness of bacterioexcretion
To define virulence of MBT.
Indicate the incorrect formulation of clinical diagnosis of lung tuberculosis
FDTB (16.06.2003) of the lungs upper sections (disseminated), Destr +, (infiltration ), MBT +M+C+, Resist -, Hist 0, Cat1 Coh2(2003).
CTB (12.01.2000) the upper section of the right lung (fibrous-cavernous), Destr +, (infiltration), MBT +M-C+ Resist I (S, H) Hist0. Lung haemoptysis. RI II, Cat 4 Coh1(2000).
FDTB (20.03.2001) of the lower part of the right lung (tuberculoma), Destr +, MBT- M-C-, Hist 0, Cat1 Coh1(2001).
* FDTB (20.09.2003), (nidus tuberculosis), (infiltration), MBT-M-C-, Hist 0, Cat3 Coh3(2003).
RTB (20.06.2003) of the upper part of the right lung (infiltrative), Destr -, MBT- M-C-, Hist 0, Cat2 Coh2(2003).
How is tuberculous etiology of pleurisy confirmed?
By the presence of tuberculous changes in lungs or other organs.
Finding of MBT| in a pleural exudate or in sputum|.
Mantouex test reaction is positive or recent tuberculin intensifier|.
Puncture biopsy of pleura.
* All indicated are correct.
What is the mechanism of development of pleural inflammation by MBT| ?
Sputogenic.
Only lymphogenic|.
* Lympho-hematogenic.
Bronchogenic|.
Only hematogenic |.
What is the reason of appearance of exsudate in a pleural cavity at different clinical forms of tuberculosis?
The anatomic and functional connection between the sheets of pleura, lymphatic nodes and lymphatic system of lungs.
The inflammation of pleura that caused by MBT|, that penetrate into pleura by lymphogenic way from the hearths or infiltrations| in lungs.
Pleura hypersensibilization by MBT decay products |.
The inflammation of pleura that caused by MBT|, that penetrate into pleura because of bacteriemia||.
* All indicated assertions are faithful.
At what type of exsudate is a small amount of free liquid in a pleural cavity , an exsudate is organized quickly|?
Purulent.
Serous.
* Fibrinous and serous-fibrinous
Haemorrhagic and serous-haemorrhagic.
Serous-purulent|.
What of tubercular pleurisy is the most widespread ?
* Exudative (serous or serous-haemorrhagic liquid).
Armourclad.
Chillous.
Haemorrhagic.
Purulent.
What is the character of exsudate at the tuberculous empyema ?
Serous-fibrinous| and fibrinous |.
Haemorrhagic
* Serous-purulent| and purulent.
Serous-haemorrhagic.
Chillous.
For what disease or state transudate into pleural cavity is not typical |?
Myxedema|.
* Cirrhosis of liver.
Tuberculosis.
Stagnant cardiac insufficiency.
Nefrotic syndrome.
What composition of pleural liquid is typical for an exsudate?
All indicated is an exsudate.
* Relative density - 1025, protein content- 45 g/l, protein (in effusion/ in the serum of blood)-0,8, activity of LDG| -2,1 mmol/(l/hour), content of cells -2,1?109/l.
Relative density - 1010, protein content - 20 g/l, protein (in effusion/ in the serum of blood)-0,2, activity of LDG| - 1,1 mmol/(l/hour), content of cells- 0,8?109/l.
Relative density - 1005, protein content- 15 g/l, protein (in effusion/ in the serum of blood)-0,3, activity of LDG| -0,9 mmol/(l/hour), content of cells -0,5?109/l.
Relative density - 1000, protein content- 10 g/l, protein (in effusion/ in the serum of blood)-0,4, activity of LDG| -1,3 mmol/(l/hour), content of cells -0,6?109/l.
What method of research is decisive in diagnostics of pleurisy of any etiology?
* Pleural puncture
Roentgenologic examination|.
Ultrasound examination.
Clinic and information of physical| methods.
Tuberculin tests.
Complication of what form of tuberculosis can be an allergic pleurisy?
Lung infiltrative tuberculosis|.
Nidus lung tuberculosis.
Subacute disseminated lung tuberculosis|.
Lung tuberculoma.
* Tuberculosis of intrathoracic |lymphatic nodes.
What method help to find MBT in pleural liquid at an allergic tubercular pleurisy||?
* It is impossible to find .
By an ordinary bacterioscopy|.
By flotation method.
By cultural method.
By luminescent microscopy.
Complication of what form of tuberculosis can be development of perifocal pleurisy?
Fibrous-cavernous lung tuberculosis.
Lung infiltrative tuberculosis|.
Subacute disseminated lung tuberculosis|.
Chronic disseminated lung tuberculosis|.
E. * All noted forms.
What measures are the most important in treatment at the purulent (exudative) tuberculous pleurisy?
To increase the amount of antimycobacterial drugs.
* Repeated aspirations of exsudate with creation of negative pressure in a pleural cavity.
Setting of corticosteroids|.
Desintoxication| therapy.
All marked.
What complications can accompany a tuberculous empyema?.
Broncho-pleural fistula||.
Toracic fistula|.
Amyloidosis of internal organs.
Pneumopleurisy|.
* All marked.
What is the exsudate at tuberculous pleurisy?
* Mainly lymphocytic
Mainly neutrophilic.
Chillous.
Monocytic|.
Macrophagic.
What tuberculin and at dose is used at mass tuberculinization?
100 % Koch alt tuberculin
* PPD-L in standard dilution in 2TU dose
PPD-L in standard dilution in 5TU dose
PPD-L in standard dilution in 10TU dose
25 % dilution of purified dry tuberculin
The sensitivity of organism to tuberculin may be intensified with:
Senile age
Lymphogranulomatosis
Lymphosarcoma
Treatment with immunodepressants
* Bronchial asthma
Koch’s testing is used for:
Prophylaxis of tuberculosis
Early tuberculosis revealing
Determination of infection index of population with tuberculosis
* Differential diagnostics of infectious and postvaccinal allergy
Revealing the persons with the increased risk of tuberculosis illness
A 2-years old child reaction to Mantoux test with 2 TU – 7 mm infiltration, at the age of 4 – 3 mm. Postvaccinal seam of 4 mm. Define the character of tuberculin reaction.
Infectious allergy
A “range” of tuberculin testing
The child is ill with tuberculosis
* Postvaccinal allergy
Doubtful Mantoux reaction
From what age and in what terms is mass tuberculinization performed:
* From 12-months age, annually
At 7 and 14 years of age only
From 12-months age, once in 2-3 years
From 7 up to 14 years annually
From 7 and each 5 years up to 30-years old age
What is the “range” of tuberculin reactions?
Transition of negative reaction to tuberculin to a positive one after BCG vaccination
Transition of negative reaction to tuberculin to a positive one after BCG revaccination
* Sensitivity change to tuberculin due to the primary infection with tuberculosis mycobacteria
Appearance of hyperergy reaction to tuberculin in patients infected with tuberculosis
Negative reaction to tuberculin in seriously ill tuberculosis patients
What is the aim of mass tuberculinization:
For prophylaxis of MBT infection
For prophylaxis of tuberculosis illness
* For early tuberculosis revealing among children
For early tuberculosis revealing among adults
For revealing the persons with the increased risk of tuberculosis illness
A 6 years old boy K., had a “range” of tuberculin reaction. What examinations should be done?
* General clinical examination, inspection roentgenogram of the thoracic cage organs, general blood and urine test
Koch’s testing, general blood and urine test
Fluorography, general blood and urine test
Tomography, smear examination from pharynx for MBT
Fibrobronchoscopy, examination of contents from bronchi for MBT
While carrying out the differential diagnostics between infectious postvaccinal reactions on the tuberculin is not taken into account:
The contact with the tuberculosis patients
The intensiveness of the reaction on the Mantoux test of previous years
A presence of postvaccinal scar
The time of the carrying out of the vaccibation BCG
* The poisoning by the carbon oxide some yars ago
If there is the positive reaction on the tuberculin with 2 TU on the skin of antebrachium there can be visible:
* Infiltrate by the size of 5 –16 mm
Infiltrate with a vesicle in the centre
Hyperemia more than 5 mm
Infiltrate by the size more than 16 mm
Infiltrate by the size of 2-4 mm
Which one from the mentioned diseases can decrease the sensibility of an organism to tuberculin?
Cataral otitis
Allergic rhinitis
Bronchial asthma
Hypertonic disease
* Measles
Primary forms of tuberculosis comprise:
Nidus
Disseminated
* Tuberculosis intoxication
Caseous pneumonia
Infiltrative
Specific complications comprise:
Haemophthisis
Chronic lung heart
Lung atelectasis
* Larynx tuberculosis
Amyloidosis disease
The characteristic phase of tuberculous process progression is:
Suction
Condensation
* Sowing
Scarring
Calcination
Formulating the clinical diagnosis of lung tuberculosis, first of all should be defined:
The process phase
The clinical form
Bacterial secretion
Localisation process
* Type of tuberculuos process
Single nidal shades of small intensity with vague contours were revealed on the apex of both lungs of a 19-years old woman patient during the prophylactic fluorographyc examination. What is the clinical form of tuberculosis?
Infiltrative
Lung tuberculoma
* Nidus
Caseous pneumonia
Disseminated
A 25-year-old patient fell ill acutely. Complaints for headache, dry cough, dyspnea, temperature rise up to 39,0? C. Objectively: general condition is grave, lips cyanosis, rales are not heard. Blood analysis: leuk. – 12x109/l, ESR – 16 mm/hour. Plain roengenogram: the whole length of both lungs is full with multiple, small focal shadows of low intensity. Mantoux test – 5mm infiltrate. What clinical form of lungs tuberculosis does this patient have?
Nidus
Infiltrative
Disseminated
* Miliary tuberculosis
Caseous pneumonia
Patient N., 26. Roentgenologic examination showed multiple focal shadows in upper and medial lungs segments of low and medium intensity. Sputum contains MBT. Blood analysis: ESR – 38 mm/hour. What diagnosis is the most probable one?
Infiltrative lung tuberculosis
Nidus lung tuberculosis
* Disseminated lung tuberculosis
Caseous pneumonia
Lung fibrous-cavernous tuberculosis
To the primary forms of tuberculosis belong:
Disseminated
Nidus
Infiltrative
Tuberculoma
* Tuberculosis of intrathoracic lymphatic nodes
The most informative method of roentgenologic examination at the diagnostics of a small form of tuberculosis of intrathoracic lymphatic nodes:
A. A target roentgenogram
B. A fluorogram
* C. A tomogram on the level of trachea bifurcation
D Observation roentgenogram of the thoracic cage
E Bronchogram
The patient of 52 years old, during 9 months was treated because of the infiltrative tuberculosis of the upper part of the right lung, decay phase, MBT (+). At X-ray examination: the upper part of the right lung became smaller in volume, under the clavicle there’s a decay cavity 3 cm in diameter, the trachea is moved to the right, MBT (-). Define the form of tuberculosis.
Cyrrhotic
Caseuos pneumonia
* Fibrous-cavernous
Infiltrative
Nidus
What is meant by the diagnosis “tuberculous intoxication in children”?
An intoxication syndrome at a small form of tuberculosis of intrathoracic lymphatic nodes.
* A symptom complex of functional and objective signs of intoxication as a result of primary infestation with tuberculosis mycobacteria with unestablished localization.
An intoxication syndrome at a primary tuberculous complex.
An intoxication syndrome at a primary tuberculous complex of ileocecal section of intestine.
Subfebrile body temperature, perspiration appeared, cough, voice hoarseness.
Paraspecific manifestations of primary tuberculosis:
* Micropolyadenitis, nodual erythema, phlyctenuar keratoconjunctivitis
Tuberculosis of skin and tonsils
Amiloidosis of internal organs, pleural empyema
Tuberculosis pleurisy and pericarditis
Tuberculous peritonitis and tuberculosis of intestine
What is the primary tuberculosis?
First diagnosed tuberculosis
Tuberculosis that develops in firstly infected persons.
Tuberculosis what has developed after the primary tuberculous complex.
Tuberculosis revealed during the prophylactic examination.
* Tuberculosis caused by mycobacteria of beef type.
Phtisiologist tactics to a 7-year-old child with a diagnosis of tuberculous intoxication.
To observe in a tuberculous dispensary for 2 years.
To undergo treatment with 3 antimycobacterial preparations within 4-6 months assuming the follow of sanatoric-hygiene regime.
To improve the health in a recreation camp.
* To observe in a children’s out-patient department up to the age of 14.
To make chemioprophylaxis with isoniazide within 3 months.
The most common complication for the primary tuberculous complex.
Chronic lung tuberculosis
Lung haemophtisis
Spontaneous pneumothorax
* Pleurisy
Amiloidosis of intestinal organs
To detect the “small” form of tuberculous bronchoadenitis, it’s necessary to perform:
Inspection roentgenography
Target roentgenography
Fibrobronchoscopy
* Tomography on bifurcation trachea
USE
The most frequent segmental localization of the primary lung affect:
I, II, III, IV segments
I, II, IV, VII segments
I, II, IV, VI segments
* II, III, VIII, IX segments
I, II, VI, VII segments
Patients with firstly diagnosed tuberculosis of lungs may receive sick leaves with the term up to:
1 month
4 months
6 months
* 10 months
14 months
Particularly risk for the human comes from ill with tuberculosis:
* Cows
Horses
Hens
Goats
Dogs
What is BCG and BCG-M vaccine?
Killed mycobacteria culture
Mycobacteria vital activity products
* Mycobacteria live weakened culture
Compound of purified tuberculin and killed mycobacteria
Insufficient by purified dry tuberculin
What is the value of BCG vaccine?
Tuberculosis lighter course
Prevents infestation
Guarantee from an illness
* Less chance of catching tuberculosis
Prevents tuberculosis relapse
In what time after BCG-vaccination does the immunity develop?
In 6-8 days
* In 6-8 weeks
In 6-8 months
In 9-12 months
In 5-7 years
In what cases is revaccination with BCG vaccine done?
To infestated persons
* To noninfected persons
To contractual persons with doubtful reaction on Mantoux test with 2 TU
To tuberculosis patients
To persons who had previously been ill with tuberculosis
The terms of BCG revaccination performance in Ukraine.
On 3-5th day after birth
On 3-5th week after birth
At 3, 5 years of age
* At 7,14 years of age
At 17, 30 years of age
A healthy child was born weighing 3200 g. On what day after the birth is the BCG vaccination done?
1-2
* 2-5
7-11
13-15
25-30
Vaccination and revaccination with BCG vaccine is done:
Cutaneously
* Intracutaneously
Subcutaneously
Intramuscularly
Perorally
What does a 5 mm seam formed in 4 months after BCG vaccination testify?
To high reaction of vaccine
To complication - keloid seam
To violation of vaccine injection techniques
To the lack of antituberculous immunity
* To the presence of postvaccinal immunity
What antimycobacterial preparation is prevalently used to make the chemoprophylaxis?
Streptomycinum
Rifampicinum
Pyrazinamidum
* Isoniazidum
Ethambutolum
The chemoprophylaxis is performed during:
3 days
3 weeks
* 6 months
1 months
9 months
After realized BCG vaccine inoculation some not used vaccine remained. What is to be done with it?
* In 2-3 hours after dilution the not used vaccine has to be destroyed by boiling
In 24 hours the not used vaccine has to be destroyed
To preserve 2-3 days. Then to destroy
To preserve during one week in a refrigerator
To preserve during one year in a refrigerator
Principal method of revealing tuberculosis among children.
Bacterioscopy of sputum
Fluorography
* Tuberculinodiagnostics (Mantoux test with 2 TU)
Bronhoscopy
Tomography on bifurcation level
What organs are more frequent struck at miliary tuberculosis?
* Lungs.
B. Kidneys.
Brain-tunics.
Overhead respiratory tracts.
Lymphatic nodes.
What kind are the hearths at miliary tuberculosis?
* They are small, exsudative, without a tendency to confluence and disintegration.
They are large exsudative with a tendency to confluence and disintegration.
They are small, productive, compact and calcinated.
They are polymorphic.
They are large calcinates |.
What form have cavities of disintegration at miliary tuberculosis?
Bilateral symmetric thin-walled cavities.
Bilateral asymmetric thick-walled cavities.
One-sided plural cavities of different form.
One thick-walled cavity and plural thin-walled "daughters's" cavities .
* There aren’t cavities
What result of Mantoux text is typical for clinical picture of miliary tuberculosis?
* Negative
Doubtful
Positive
Giperergichniy
Results are different
What reason for evolving of cavernous pulmonary tuberculosis?
Resistance to antimicrobial medication.
Not timely process definition.
Medical mistakes.
Injurious clinical course.
* Any with above possible to be a reason for evolution of cavernous pulmonary tuberculosis.
What is the main characteristic of fibrous cavernous pulmonary tuberculosis?
Disposition to forming acinar, acinar-nodes and lobular centers.
Disposition for creation infiltrations and caverns.
* Old fibrous cavity and fibrosis in abutting pulmonary tissue.
Polychemoresistance.
Periodical or permanent bacterioexcretion.
What is clinic category for fibrous cavernous pulmonary tuberculosis patient with long term?
* Fourth.
First.
Second.
Third.
Fifth
What are typical complications for fibrous-cavernous pulmonary tuberculosis?
Tuberculosis bronchus.
Bronchogenic dissemination.
Tuberculosis larynx.
Tuberculosis colitis.
* All with above.
What need take into account for prescription of medicine for fibrous-cavernous pulmonary tuberculosis patient?
Symptoms of intoxication.
Attendant pathology.
* Sensitivity to anti-tuberculosis medications.
Bronchial-lung syndrome.
Quantity and size of caverns.
What clinical course is typical for fibrous-cavernous pulmonary tuberculosis?
* Wavy, with remission and exacerbation.
Acute, progressive.
Near acute.
Without symptoms or with few symptoms.
Quick feedback.
What clinical presentation is typical for fibrous-cavernous pulmonary tuberculosis?
No complaints or cough with minor spew.