Bank of Krok testing to module N1

A Of primary infection
B Of a chronic process
C The woman is healthy
D Of exacerbation of a chronic disease
E Of recurring infection with rubella virus
*For prevention of infectious diseases immunization of population is made, and it accompanies with immunity formation. Cooperation of which immune competent cells is it necessary for effective formation of primary humoral immune response?

1. 
   Macrophages, T-cells, B-cells
   
2. 
   T-cells, plasma cells, B-cells
   
3. 
   Macrophages, plasma cells
   
4. 
   Mast and plasma cells
   
5. 
   B-cells and T-cells
   

*For prevention of infectious diseases immunization of population is made, and it accompanies with immunity formation. Cooperation of which immune competent cells is it necessary for effective formation of primary cellular immune response?

1. 
   Macrophages and T-cells
   
2. 
   T-cells and plasma cells
   
3. 
   Macrophages and plasma cells
   
4. 
   Mast and plasma cells
   
5. 
   B-cells and T-cells
   

* Which type of interleukin is secreted by macrophages after phagocytosis for triggering of immune response to bacterial antigen?

1. 
   IL-1
   
2. 
   IL-2
   
3. 
   IL-3
   
4. 
   IL-5
   
5. 
   IL-6
   

46. After penetration into an organism bacteria are ingested by macrophages. What is the function of macrophages in immunocompetent cells cooperation at the first stage of immune response?

A. Activation of NK-cells.
B. T-killers activation.
C. Processing and presentation of antigen to T-helpers.
D. Antibodies production.
E. Processing and presentation of antigen to T-killers.
*Immunogram of HIV patient has been made, and abnormality of T-helper and T-supressor ratio has been revealed. Which major surface molecules CD (cluster differentiation ) do T-helpers have?

1. 
   CD2, CD3, CD4
   
2. 
   CD2, CD3, CD8
   
3. 
   CD19, CD21, CD22
   
4. 
   CD23, CD24, CD37
   
5. 
   CD16, CD56
   

Immunopathology and immunodeficiency

*01*,*02,*06* Donor skin has been transplanted to a patient with extensive burn. In 4-5 days the skin transplant adapted, but it became swollen and changed color on the eighth day. Ten days later it started to reject. Which cells take part in this process?

A. T-lymphocytes.
B. Erythrocytes.
C. Basophiles.
D. Eosinophils.
E. B-lymphocytes.

*00* Patient after transplantation of kidney graft has rejection. Which major effector cells take part in this immunological reaction?

1. 
   *Cytotoxic T-cells
   
2. 
   B-cells
   
3. 
   Plasma cells
   
4. 
   Suppressor T -cells
   
5. 
   Helper T-cells
   

*After 1.5 months of liver transplantation the patient state was getting worse due to onset of graft rejection. Which factor of immune system acts the predominant part in this reaction?

1. 
   T-killers
   
2. 
   Interleukin-I
   
3. 
   Natural killers
   
4. 
   B-cells
   
5. 
   T-helpers
   

*The boy, 11 years old, has ekzematous rash onto the trunk and legs. History revealed otitis, pneumonia, furunculosis. Laboratory assay shows thrombocytopenia, low activity of T-helpers and T-suppressors, decreasing of IgM level at normal data for Iga and IgG. Which type of immunodeficiency is at this case?

1. 
   Wiskott-Aldrich syndrome
   
2. 
   Louis-Barr syndrome
   
3. 
   DeGeorgy syndrome
   
4. 
   Chediak-Higashi syndrome
   
5. 
   Swiss syndrome
   

The child, 2 years old, suffering from severe form of chicken pox, has face defects, mongoloid slant. History revealed spasms, oral cavity mycosis . There is lymphocytopenia at normal level of B-cells and immunoglobulins into the blood assay. Which immunodeficiency syndrome does child have?

1. 
   DiGeorgy syndrome
   
2. 
   Wiskott-Aldrich syndrome
   
3. 
   Louis-Barr syndrome
   
4. 
   Kleinefelter’s syndrome
   
5. 
   Shereshevsky- Turner’s syndrome
   

*07* 64. B-12 Immunological tests of a patient with clinical symptoms of immunodeficiency have been carried out. Significant decrease of cells, forming rosettes with sheep erythrocytes, has been revealed. What conclusion should be made on the basis of analysis data?

1. 
   Decrease of complement system level.
   
2. 
   Decrease of B-cells level.
   
3. 
   Decrease of natural killers (NK-cells) level.
   
4. 
   Decrease of T-cells level.
   
5. 
   Decrease of thrombocytes (platelets) quantity
   

*03* 41. B-12 A patient with clinical symptoms of immunodeficiency with invariable quantity and functional activity of T-and B-cells is found to have a molecular level defect. This defect is accompanied by the disorder of antigen-presenting function of immunocompetent cells. Name these cells.

1. 
   NK-cells.
   
2. 
   T- and B-lymphocytes.
   
3. 
   Macrophages and monocytes.
   
4. 
   Fibroblasts, T- and B-lymphocytes.
   
5. 
   B-lymphocytes.
   

*05* A patient with clinical symptoms of primary immunodeficiency is found to have a defect of antigen-presenting function of immunocompetent cells. The structure defect of what cells is possible?

1. 
   NK-cells
   
2. 
   В- cells
   
3. 
   Т- cells
   
4. 
   Plasma cells
   
5. 
   *Macrophages, monocytes
   

42. Acquired defect of immune system of a patient is diagnosed - a disorder of complement system activation by the classical pathway against the background of the sufficient content of system components. Defect of antibody production is suspected. Decrease in number of what antibodies can be expected first of all?

A. IgM, IgA.
B.IgA, IgG.
C.IgD, IgG.
D.IgE, IgG.
E. IgM, IgG.

53. A 37-year-old woman periodically had infectious diseases of bacterial genesis during a year. Their clinical course was extremely prolonged, remissions were short-term. Hypogamma­ globulinemia was revealed by examination. The functional defect of what cells might be the direct cause of the disease?

A. Neutrophiles.
B. Eosinophils.
C. B-cells.
D. Macrophages.
E. Basophiles.

*Young woman with blood group A had suffered in road accident , and she was transfused with donor blood of group B by mistake. Posttransfusion reaction set up, leading mechanism of which is immunopathological reaction. Which type does it belong to?

1. 
   Cytotoxic
   
2. 
   Anaphylaxis
   
3. 
   Immune complex
   
4. 
   Cellular
   
5. 
   Stimulating
   

51. A 54-year-old woman referred to a doctor with complaints of hen's eggs intolerance, which appeared recently. Antihistamines prescribed by the doctor slightly improved the status of the patient. What antibodies could provide the development of this reaction?

1. 
   IgA.
   
2. 
   IgE.
   
3. 
   IgD
   
4. 
   IgG.
   
5. 
   IgM.
   

For detection of sensitivity to antibiotic patient is injected with 0.2 ml of penicillin solution intracutaneously. After 10 min hyperemia and edema appear in the site of injection. Which type according Cumbs-Jelly’s classification has this reaction belong to?

1. 
   Anaphylaxis (phenomenon Auveri)
   
2. 
   Cytotoxic
   
3. 
   Delayed type of hypersensitivity
   
4. 
   Reaction is like Artus phenomenon
   
5. 
   Tuberculin type reaction
   

At flat repair woman suddenly has had bout of breathless with sensation of lack of air, difficulties with breathing out, dry cough and anxiety. Bronchial asthma has been diagnosed. Which allergy mediator causes such effects?

1. 
   Histamine
   
2. 
   Serotonin
   
3. 
   Prostaglandin E
   
4. 
   Interleukin I
   
5. 
   Interleukin 6
   

*The woman, 40 years old, visited doctor with complains onto itching, reddening, burning sensation of the checks. Vanishing crème had been used 1 hour ago. Which type of allergy reaction of I group due to Combs and Jelly does patient have?

1. 
   Quincke’s edema
   
2. 
   Bronchial asthma
   
3. 
   Anaphylactic shock
   
4. 
   Urticaria
   
5. 
   Pollen allergy
   

The worker of factory with 20 years record of work has had contact dermatitis of hands. Which type of immunological disorder does such illness belong to?

1. 
   Delayed type of allergy
   
2. 
   Primary immunodeficiency
   
3. 
   Immediate type of allergy
   
4. 
   B-cell immunodeficiency
   
5. 
   T-cell immunodeficiency
   

*01* After some minutes of injection made for patient with tetanus breathless and frequent pulse appeared, blood pressure decreased. Which drug was the most probable reason of complication?

1. 
   Sulfonamide
   
2. 
   Donor gamma-globulin
   
3. 
   Anatoxin (Toxoid)
   
4. 
   Antibiotic
   
5. 
   *Antitoxic serum
   

*04*,*06* After 8 days of antitetanus serum injection patient with contaminated wound of the foot has fever (38 С), joint pain, rash and itching. Blood assay demonstrated leucopenia and thrombocytopenia. Which type of allergy reaction arises in this case?

1. 
   Delayed type of hypersensitivity
   
2. 
   Cytotoxic
   
3. 
   Anaphylaxis
   
4. 
   *Immune complex
   
5. 
   Stimulating
   

*07* The patient, female, 27 years old, had taken eyes drops, including penicillin. After some minutes she had itching and burning of body, edema of lips and eyelids, whistle cough; blood pressure started to decrease. Which kind of Ig takes part in such allergic reaction?

1. 
   IgG and IgD
   
2. 
   IgA and IgM
   
3. 
   *IgE and IgG
   
4. 
   IgM and IgG
   
5. 
   IgM and IgD
   

*Woman had being suffered from pollen allergy for 25 years. The treatment had been made with desensitization method (periodic injection with small doses of allergens) and allowed to heal. What type of mechanism for inhibition of allergy was the most probable?

1. 
   Accumulation of T-suppressors and IgG
   
2. 
   Basophiles inactivation
   
3. 
   Blockage of cellular histamine and heparin receptors
   
4. 
   Formation of immune complex
   
5. 
   Decreasing of complement concentration into serum
   

Vaccines
34. Numerous vaccine preparations have been used to induce human active immunity. Which preparation is presented by live attenuated bacteria?

1. 
   APDT (DPT) vaccine.
   
2. 
   BCG vaccine.
   
3. 
   Salk's vaccine.
   
4. 
   TABTe vaccine.
   
5. 
   Hepatitis B vaccine.
   

*The process of killed vaccine creation consists from several steps. The choice of vaccine strain has crucial significance at this event . Choose the most important criterion for sampling:

1. 
   To take strains with maximal virulence
   
2. 
   To use bacteria with prominent biochemical activity
   
3. 
   To select the strains with low pathogenecity
   
4. 
   To use strains with low antigenecity and immunogenecity
   
5. 
   To take resistant strains to antibiotics
   

*During outbreak of diphtheria DT vaccine was used for adult immunization. Which type of immunity is created by this preparation?

1. 
   Natural
   
2. 
   Antitoxic
   
3. 
   Cellular
   
4. 
   Passive
   
5. 
   Post infectious
   

In region , where epicenter of rabies among wild animals has been registered, the bitten with wild dog man visited policlinics. For rabies prevention he was injected with antirabies vaccine. Which type of vaccine does this medicine belong to?

1. 
   Attenuated
   
2. 
   Inactivated
   
3. 
   Molecular
   
4. 
   Anatoxin (toxoid)
   
5. 
   Synthetic
   

*Schedule vaccination against measles has been made in child community. Which method can be used to check efficacy of immunization?

1. 
   Virological
   
2. 
   Allergic test (allergic probe)
   
3. 
   Immunological
   
4. 
   Biological
   
5. 
   Viroscopic (microscopy)
   

It is necessary to provide vaccines for schedule immunization into kindergarten. Which property should vaccine have?

1. 
   Immunogenecity, areactivity
   
2. 
   Immunogenecity, areactivity, avirulence
   
3. 
   Avirulence, easy technology of production
   
4. 
   Areactivity, easy usage
   
5. 
   Immunogenecity
   

Bacterial preparation institute creates vaccines for schedule immunization. What is the name of vaccine composed from microbial cells and toxoid of another causative agent?

1. 
   Chemical
   
2. 
   Gene engineered
   
3. 
   Associated
   
4. 
   Autovaccine
   
5. 
   Combined
   

*05* Immunization against whooping cough is planned in kindergarten. Which medicine should be used for this purpose?

1. 
   Type specific serum
   
2. 
   BCG vaccine
   
3. 
   Normal gamma-globulin
   
4. 
   DTT
   
5. 
   *DPT vaccine (ADPT)
   

Immune sera

14. When using treatment antitoxic serums a patient is always given precisely defined doses. In what units is the activity of antitoxic antidiphtheric serum measured?

A. International.
B. Flocculation.
C. Antigenic.
D. Agglutination.
E. Neutralization.
*The sole medicine, that allow to treat successfully such toxic infection as diphtheria, tetanus, and botulism, is antitoxic sera (antitoxins). Choose the way which is used to obtain such sera:

1. 
   Hyper immunization of horses with medicine obtained from toxin
   
2. 
   Enzymatic dialysis (Diaferm)
   
3. 
   Immunization of horses with toxigenic bacteria
   
4. 
   Hyper immunization of rabbits with corresponding toxins with following purification
   
5. 
   Usage of recombinant techniques
   

* In traumatologic department patient is made primary surgery of wound and the next drug is given for passive immunity creation:

1. 
   Vaccines
   
2. 
   Immune sera
   
3. 
   Toxoids
   
4. 
   Antibiotics
   
5. 
   Vitamins
   

*2013* a child cut his leg with a piece of glass while playing and was brought to the clinic for the injection of tetanus antitoxin. In order to prevent the development of anaphylactic shock the serum was administered by Bezredka’s method. What mechanism underlies this method for desentization of the body?

1. 
   Binding of IgE fixed to the mast cell
   
2. 
   Stimulation of the synthesis of antigen-specific IgG
   
3. 
   Blocking the mediator synthesis in the mast cell
   
4. 
   Stimulation of the immune tolerance to the antigen
   
5. 
   Binding of IgE receptors to the mast cell
   

Serological reactions (tests)

5. A patient referred to a doctor on the second week of illness, which resembled of typhoid-paratyphoid disease by clinicoepidemiologic findings. The doctor decided to confirm the diagnosis by detecting specific antibodies. What preparation should be used for this purpose?

1. 
   Adsorbed monoreceptor serums.
   
2. 
   Diagnostic serums.
   
3. 
   Labeled serums.
   
4. 
   Monoclonal antibodies.
   
5. 
   Diagnosticums.
   

47.b-12 Serologic diagnostics of infectious diseases is based on specific antigen-antibody interaction. Name the serological reaction, which consists in microorganisms clumping under the influence of specific antibodies in the presence of electrolyte.

1. 
   Hemadsorption.
   
2. 
   Precipitation.
   
3. 
   Complement fixation test.
   
4. 
   Agglutination.
   
5. 
   Neutralization.
   

*Pure culture isolated from the blood at suspicious enteric fever is investigated in bacteriological laboratory. Which serological test should be made to study its antigenic structure?

1. 
   Precipitation
   
2. 
   Agglutination
   
3. 
   CFT
   
4. 
   ELISA (IFA)
   
5. 
   Flocculation
   

*For serodiagnostics of enteric fever test is made by next way: diagnosticums of three types are added to different dilution of patient serum. Test result is registered by deposit appearance, consisting from clumped bacteria. Which mechanism of interaction between antigen and antibody takes place at this test?

1. 
   Agglutination
   
2. 
   Precipitation
   
3. 
   Lysis
   
4. 
   Bacteriolysis
   
5. 
   Hemolysis
   

*At negative result of bacteriological method patient diagnosis is made with serology. Thereafter clumping of bacteria under the influence of antibody is named:

1. 
   Complement fixation test
   
2. 
   Precipitation
   
3. 
   Agglutination
   
4. 
   Lysis
   
5. 
   Immobilization
   

48. Serologic diagnostics of infectious diseases is based on specific antigen-antibody interaction. Name the serological reaction, during which highly refined antigens are adsorbed on erythrocytes.

1. 
   Neutralization.
   
2. 
   Precipitation.
   
3. 
   Complement fixation test.
   
4. 
   Hemadsorption.
   
5. 
   Indirect hemagglutination.
   

67. Effective diagnostics of enteric bacteria carrying is based on detecting antibodies to certain bacteria antigens during indirect hemagglutination test. Name the standard preparation which should be used.

A. Sheep erythrocytes and hemolytic serum.
B. Antibodies against immunoglobulins of basic classes.
C. Monoclonal antibodies.
D. Monoreceptor diagnostic serum.
E. Erythrocytic diagnosticum (erythrocyte adsorbed by bacteria antigens).

49. Serologic diagnostics of infectious diseases is based on specific antigen-antibody interaction. How is the antigen sedimentation from solution reaction under the influence of immune serum in the presence of electrolyte called?

1. 
   Neutralization.
   
2. 
   Agglutination.
   
3. 
   Complement fixation.
   
4. 
   Hemadsorption.
   
5. 
   Precipitation.
   

54. Bloodstains are revealed on the clothes of a person accused of a murder. What test can prove that the blood is human?

1. 
   Neutralization.
   
2. 
   Immunofluorescence test.
   
3. 
   Complement fixation test.
   
4. 
   Agglutination.
   
5. 
   Precipitation.
   

b-12 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?