test_base_imunology_eng

Bank of tests from “Clinical Immunology and Allergology” (5-th course)

to preparation for module

The patient, 52 years old, complains of pain in the joints, muscles, weakness in muscles, sore throat during eating. Fell sick about a year ago. Treating with nonsteroidal anti-inflammatory drugs gave no effect, the patient's condition gradually deteriorated. On examination: the independent movements of the trunk and limbs hampered, there is dark erythema in paraorbital area and on sternum. Palpation of skeletal muscle is painful. Left heart border extended to the left for 2 cm, cardiac sounds are weakened, systolic sound over the apex. What is the main pathogenetic mechanism of this disease?

A. Synthesis of myosin-specific antibodies. B. Synthesis of antimicrosomal antibodies. C. Antibodies response to the RNA. D. Antibodies response to native DNA. E. The formation of antinuclear antibodies.

The patient, 42 years old, has ulcerative colitis, acute form, the heavy course, total intestinal lesions, the activity of the third degree, toxic dilatation of large intestine. What should be assigned in the case of a significant increasing of gamma globulins?

A. Glucocorticoids. B. B vitamins C. Anabolic hormones. D. Nonsteroidal anti-inflammatory agents. E. Cytostatics.

Girl, 10 years old, is sick about 6 months. When noted signs of arthritis of the right knee for first time, after 1.5 months the same changes appeared in ankle joints, a few days ago right radial-carpal joint became involved in the process. Periodically has the subfebrile condition. In the blood: ESR - 25 mm/h, the reaction Vaalera Rose - 1:32. Diagnosis of rheumatoid arthritis established. What drugs from listed below are the most suitable for treatment?

A. Methotrexate. B. Voltaren. C. Kryzanol. D. Delahil. E. Prednisolone.

The patient, 42 years old, 1.5 months after treatment (ampicillin and sulfonamides) had general weakness, joint pain, temperature increased to 38⁰C. The examination revealed enlarged lymph nodes, liver, spleen, papular rash with lihanification of the skin. In the blood: mild anemia, leukopenia, ESR - 40 mm/hour. Specify the most important method of examination in differential diagnosis of drug allergy, affecting the many organs from the systemic lupus erythematosus.

A. Clinical analysis of blood. B. Rheumatic tests of blood. C. Titer of Vaalera Rose reaction. D. Determination of LE-cells in the blood. E. Determination of antibodies to native DNA.

Female, 40 years old hospitalized with complaints of attacks of breathlessness, cough with sputum. Sick for 4 years. First attack of breathlessness appeared while staying in the village. Further attacks bothered during the cleaning up the house. After 3 days of treatment in the hospital situation has improved considerably. What are the most probable etiological factor?

1. Pollen of plants.

2. Infectious.

3. Chemicals.

4. Household allergens.

5. Psychogenic.

The patient, 25 years in July appealed with complaints about the labored wheezing, coughing, seizures of sneezing , watery eyes. These manifestations notes annually in the same period during 2 years. Objectively: sclera hyperemia, vesicular breathing with extended exhalation, scattered dry, whistling wheezing. What research is inappropriate at this stage of allergo-diagnostic?

1. Spirometry.

2. Bronchoscopy.

3. Cutaneous allergo-tests.

4. Roentgenography of the lungs.

5. Determination of the level of serum IgE.

The patient, 35 years old, complaining on severe bouts of breathlessness, runny nose with considerable watery discharge, sneezing, itching, rash on exposed areas of the body, swelling of the face. Symptoms arise during the finding in rural areas, especially near the stables and seats of cattle. what is the most probable allergen that causing pathological manifestations?

1. Epidermal.

2. Microbial.

3. Pollen of plants.

4. Fungal.

5. House dust.

The patient, 20 years old, complains of bouts of breathlessness at night, cough with phlegm of mucous character that stands out is difficult. His condition was grave. Distant dry rales. Respiration rate - 30/ min, pulse - 110/ min. Blood pressure - 160/90 mmHg. Thorax is emphysematous . Auscultated on the background of prolonged expiratory dry scattered wheezing. In the pathogenesis of this condition in the patient leading role belongs to:

1. Decrease in activity of cholinergic receptors.

2. Inflammation of the bronchi, caused by IgE.

3. Increase of the level of T-regulatory-suppressor lymphocytes.

4. Decrease of synthesis of prostaglandins.

5. Decrease of histamine synthesis.

In women, 42 years old, who suffers from chronic sinuitis, has evolved an acute form of arthritis. Physician appointed acetylsalicylic acid. In anamnesis: predisposition to allergic reactions were not. Suddenly, after taking the drug in the patient has evolved bronchospasm. The most probable pathogenetic mechanism of bronchoconstriction is:

1. Adrenergic imbalance.

2. Infectious-dependent.

3. Primary-altered reactivity of the bronchi.

4. Atopic.

5. Cholinergic imbalance.

Which antihistamines belong to the first generation?

1. Fenkarol.

2. Loratadine.

3. Cetirizine.

4. Desloratadine.

5. Fexofenadine.

Disadvantages of the first generation antihistamines:

А. The ability to penetrate through hematoencephalic barrier.

В. Sedative effect.

С. Reduce the ability to learn.

D. All the listed above.

E. None of the above.

Indications for the appointment of antihistamines:

A. Pollinosis.

В. Perennial allergic rhinitis.

С. Hives.

D. Atopic dermatitis.

Е. All the listed above.

To topical of antihistamines are included:

1. Acrivastine.

2. Hydrocortisone.

3. Fenistil.

4. Suprastin.

5. Allergodil.

What drugs are not included in the standards of treatment of seasonal allergic rhinitis of easy flow?

А. Systemic antihistamines.

В. Medications of Sodium cromoglycate.

С. Topical glucocorticosteroids.

D. Topical antihistamines.

Е. All the listed above.

Patient K., 22 years old, entered to the hospital with complaints of bouts of breathlessness to 3-4 times a day, cough with thick transparent of phlegm, shortness of breath. On examination: cyanosis of the lips, thorax barrel shaped, swollen neck veins, tachycardia (110 per minute). Cardiac sounds are weakened. Percussion: on the lungs are box sound. Breathing weakened, Breathing out extended. From both sides mass of dried whistling wheezing. What diagnosis was possible?

1. Cardiac asthma.

2. Spontaneous pneumothorax.

3. Chronic nonobstructive bronchitis.

4. Hysterical asthma.

5. Bronchial Asthma.

The cause of asthmatic status is:

1. Contact with allergen.

2. Exacerbation of chronic or development of acute infectional process.

3. Cancellation glucocorticosteroids in hormone dependent patient.

4. Overdose of sympathomimetics.

5. All the listed above.

The patient, 32 years old, during the month worried cough, fever up to 38.00 C. In the anamnesis - ascariasis. On Roentgenogram revealed a separate homogeneous infiltrate without clear contours. In blood: eosinophils to 55%. What is the most likely diagnosis?

1. Pulmonary Tuberculosis.

2. Eosinophilic infiltrate (Leffler syndrome).

3. Chronic bronchitis, exacerbation.

4. Lobular pneumonia.

5. Lung tumor.

The patient, 52 years old, notes the cough with release of mucous phlegm in the autumn-winter period within 5 years. When X-ray examination of chest pathology were found. Among the etiological factors of this disease first place by the importance lead away:

1. Inhalation of tobacco smoke.

2. Viral infection.

3. Bacterial infection.

4. Volatile pollutants of industrial character.

5. Congenital deficiency of α1-antitrypsin.

When urgent therapy of asthmatic status the drugs of first choice is:

1. H₂-histamine-blockers.

2. Vasoactive products.

3. Glucocorticosteroids.

4. Heart glycosides.

5. Sympathomimetics.

Female, 23 years old, who suffer from bronchial asthma, attacks which eliminated with β-adrenomimetics, suddenly felt shortness of breath, body temperature increased to 39C, cough with viscous dark sputum. Objectively: dry rales, at the top of the right lung - small-vesicles moist rales. Which of the following research will help establish the final diagnosis?

1. Clinical analysis of blood.

2. Analysis of sputum.

3. Disquisition of function of external breathing.

4. Radiography of the chest.

5. Peakflowmetry.

Female, 23 years old, complaining of acute pain in the left half of the chest, shortness of breath, which increases with any movement. Suffering from asthma, above mentioned complaint arose during an attack of breathlessness, which was accompanied by prolonged cough. On examination a moderate cyanosis of the face, left half of the chest lags behind in the act of breathing. Percussion: left tympanitis, weakened breathing. Respiration rate - 26/ minute. Cardiac sounds are weakened. Heart rate - 96/ min. What survey is the most appropriate?

А. Ultrasonography.

В. Computer tomography of the lungs.

С. Electrocardiography.

D. Peakflowmetry.

E. Spirography.

The patient, 34 years old, from childhood notes shortness of breath, the intensity of which increases; joined dry cough. In the father and aunt also marked dyspnea, cough. Not smoking. Objectively: breathing "noisy" 28/ min. Thorax emphysematous, boxes percussion sound. Breathing and cardiac sounds weakened. Radiography: increased transparency of the lung fields, aperture located low. In development of disease plays a leading role:

A. Deficiency of α1-antitrypsin.

В. Bronchopulmonary system infection.

С. Occupational harmfulness.

D. Cardiogenic pneumopathy.

Е. Smoking.

The prevalence of allergic rhinitis in developed countries:

1. Less than 10%.

2. More than 10%.

3. 10-20 %.

4. 20-25 %.

5. 25-30 %.

The main system, that reacts, at anaphylactic shock:

А. Respiratory system.

В. Cardiovascular system.

С. Digestive System.

D. Urogenital system.

Е. Nervous System.

Antigen is a substance that has the following properties:

A. Foreignness. B. Antigenicity. C. Iimmunogenicity. D. Specificity. E. All of the listed above.

Antibodies are produced by:

A. T-helper cells. B. B-cells. C. Epithelial cells. D. Plasmatic cells. E. Cells of spleen.

What classes of immunoglobulins have the opportunity to fix a complement? A. IgD. B. IgG. C. IgA. D. IgE. E. All have it.

The main immunoglobulins in secretions of the respiratory tract in a healthy person are: A. IgM. B. IgG. C. IgA. D. IgE. E. IgD.

Clinical manifestations of common variable immunodeficiency are: A. Jaundice. B. Constipation. C. Abdominal syndrome. D. Purulent sinusitis. E. Attack of breathlessness.

The presence of allergic laryngeal edema may be indicated by: A. Wheezy vote. B. "Barking" cough. C. Stridor breathing. D. Expiratory wheeze. E. All of the listed above.

What urgent measures are justified by allergic swelling of the larynx? A. Intravenous corticosteroids injection. B. Parenteral carrying of adrenaline. C. Parenteral carrying of furasemid. D. All listed above. E. None of the listed above.

Reliable methods of in vivo and in vitro diagnosis of drug allergy: A. Sublingual test. B. Skin Application test. C. Lysis of lymphocytes. D. All listed above. E. None of the listed above.

The immunomodulators with bacterial origin are: A. Immunofan. B. Lisobakt. C. Halavit. D. IRS-19. E. Polioksydoniy.

The immunoglobulin medicines for parenteral use are: A. Pentaglobin. B. Oktagam. C. Bioven-mono. D. All listed above. E. None of the listed above.

Macrophages were found, surrounded by foreign erythrocytes, at smear microscopy of the exudate, obtained from rats with aseptic peritonitis, with the addition in exudate of bird erythrocytes. What stage of phagocytosis was described?

A. Approximation. B. Sticking. C. Immersion. D. Intracellular digestion. E. Incomplete phagocytosis.

Young man 20 years old injured right testicle. What is the danger for the left (healthy) testicle at 2-3 weeks after the injury?

A. The development of infectious process. B. The development of atrophy. C. The development of hypertrophy. D. Uncovering of the antigen and development of damage by antibodies. E. It does not threaten by anything.

Synthesis of “acute phase” proteins begins in the body at inflammatory processes. What substances are stimulants of their synthesis?

A. Interleukin-1. B. Immunoglobulins. C. Interferons. D. Biogenic amines. E. Angiotensin.

The patient D., 32 years old, has festering wound in the lower third of the forearm. A smear of pus from wound was made for patient. Which cells are mainly found in the smear colored by Romanovsky-Himza?

A. Erythrocytes.

B. Eosinophils.

C. Lymphocytes.

D. Neutrophils.

E. Basophils.

The woman has cervical erosion, which is a precancerous pathology. What protective mechanism may prevent tumor development?

A. Increased activity of lysosomal enzymes. B. High immunological tolerance. C. Increasing of natural killer (NK-cells). D. Simplification of the antigenic structure of tissues. E. Low immunological tolerance.

Thymus gland has been removed from newborn rats in the experiment. It caused a disease characterized by a sharp decreasing of lymphocyte level in blood, the development of infections, splenomegaly, stopping of growth and lethal outcome. What dysfunction of the immune system is this?

A. Lack of T-lymphocytes. B. Lack of B-lymphocytes. C. Overactivity of T-lymphocytes. D. Overactivity of B lymphocytes. E. Combined defect of T-and B-lymphocytes.

Body temperature, the content of antibodies and white blood cells increased while modeling an inflammation of the lower extremity in the animal. What substance caused the development of these general reactions in inflammation?

A. Somatomedin. B. Glucocorticoids. C. Mineralocorticoids. D. Biogenic amines. E. Interleukin.

The woman, 23 years old, hospitalised with diagnosis "pneumonia." She got ill acutely 2 days ago. She got fever to 39°C, fatigue, dry cough. Which of these inflammatory mediators has the properties of endogenous pyrogen?

A. Histamine. B. Serotonin. C. Bradykinin. D. Interleukin-1. E. Thromboxane A2.

How many clinical stages of AIDS do you know?: A. 3. B. 5. C. 4. D. 2. E. 6.

What external receptors should have cells to get HIV-infection: A. CD -6. B. CD 12. C. CD -4. D. CD-10. E. CD 8.

Treatment of AIDS includes: A. Nucleoside reverse transcriptase inhibitors. B. Protease inhibitors. C. Non-nucleoside reverse transcriptase inhibitors. D. Everything listed above. E. None of listed above.

Immune status of the girl, 16 years old, who is inpatient treatment becouse of a protracted pneumonia, was studied. Immunogram: IgA - 0,9 g / l, IgG - 4,5 g / l, IgM - 0,3 g / L. Common variable immunodeficiency was diagnosed (primary). The most useful in the treatment of is assignment of:

A. Bioven-mono. B. Levamisole. C. Cycloferon. D. Timalin. E. Molgramostim.

Reduction of CD4 + lymphocytes in the blood to 300 cells in 1 ml registered in the patient with HIV infection. In the therapy should be assigned:

A. Acyclovir. B. Lamivudine. C. Hancyklovir. D. Glucocorticoids. E. Interferons.

The patient N., 23 years old, hospitalized from diphtheria epidemic hearth, with pain in the throat. On examination of throat: tonsils with membraneous whitish stratifications, that were hard to take off with trowel, the surface beneath them was bleeding. What therapy is a primary?

A. Appointment of non-steroidal anti-inflammatory drugs. B. The introduction of antibiotics. C. Introduction of antidiphtherial serum. D. Appointment of immunomodulators. E. Infusional detoxification therapy.

Four pupils from 9th grade of secondary school fell ill with viral hepatitis A (HAV), the last one was hospitalized 2 days ago. There were 25 pupils in the class, aged 14-15 years, which placed under medical observation, carried out disinfection measures. Which of these next steps are most appropriate for students who are not sick of HAV?

A. Immediately conduct the active immunization with recombinant vaccine "HAVRIX". B. Immediately start the course of immunomodulators. C. Immediately enter alpha-interferon. D. Immediately enter antyHAV donor immunoglobulin. E. Do not enter anything.

Patient M., 42 years old, complained of general weakness, sweating, irritability, decrease in working capacity, recurrent bacterial infections. Over the past 3 years she suffered from otitis, sinusitis, double pneumonia, acute respiratory infections repeatedly. Studing immunological parameters revealed decreasing of IgA, phagocytic activity of neutrophils and macrophages. Which of the drugs are recommended for the patient to stimulate antimicrobial immunity?

A. Cyclophosphamide. B. Prednisolone. C. Dekaris. D. Dexamethasone. E. Rybomunil.

The patient, 42 years old, came to the clinic complaining of pain in the right submaxillary area, fever up to 37,5 ° C. Palpated lymph node - up to 2 cm, elastic, painful on palpation. Other groups of lymph nodes were not enlarged. Make a preliminary diagnosis and assign treatment.

A. Lymphogranulomatosis, chemotherapy. B. Non-Hodgkin's lymphoma, chemotherapy. C. Infectious mononucleosis, antiviral therapy. D. Reactive lymphadenitis, antibiotics. E. Cytomegalovirus infection, antiviral therapy.

To the infectious department entered patient M., 58 years old complaining of pain in the left half of the chest, fever. On examination: body temperature 37,5 ° C, over the course of XI-XII intercostal spaces on hyperemial-swollen background grouped small blisters filled with clear content. What drug is optional for treating of this patient?

A. Suprastin. B. Laferon. C. Prednisolone. D. Biseptol. E. Cefazolin.

The patient is operated becouse of phlegmonous cholecystitis. He complaints of pain in right hypochondrium, fever to 38 ° C, a common weakness. Objective: general condition is heavy. Skin is pale, subicterouse. Peripheral lymph nodes were not enlarged. In the lungs - vesicular breathing, respiration rate - 23/min. Heart - tones are rhythmical, sonorous. heart rate-85/min. Abdomen - a bit tight in the right hypochondrium during palpation. Liver +2 cm. Symptom of Pasternatskiy is weak positive on both sides. Set the diagnosis and assign treatment.

A. The syndrome of systemic inflammatory immune response. Antibiotic therapy. B. After-operational abscess. Antibiotic therapy, the introduction of immunoglobulins intravenously, detoxification therapy. C. Multiple organ failure. Conducting of dialysis. D. Acute liver failure. Detoxification therapy. E. Syndrome of a systemic inflammatory immune response. the introduction of immunoglobulins intravenously, detoxification therapy.

The main for prevention of influenza are: A. Always wash your hands. B. Drink decoction of herbs. C. Heat insulation of the room. D. Prophylactic taking of Remantadin. E. Rinsing of mouth.

Patient A., 47 years old, becouse of ARVI took aspirin and Biseptolum (2 tablets of both). 4 hours later the condition suddenly deteriorated: increased fever, occured sore throat, general weakness, and in 8 hours increased neck and axillar lymph nodes, sclera became icterouse, the skin of the trunk and extremities covered with papular-macular rash, further jaundice and angina developed with necrosis and ulcers on the mucous membrane of the mouth. What preliminary diagnosis is most likely?

A. Sepsis. B. Acute myeloblast leukemia. C. Autoimmune hepatitis. D. Viral hepatitis A. E. Immune (hapten) agranulocytosis.

Patient M., 48 years old, on the 20th day after kidney transplantation complains about back pain, oliguria, subfebrile and general weakness. Found increasing concentrations of creatinine and urea, as well as increasing the IRI (immune regulatory index) by the T-helper cells. What should you assign to a patient?

A. Reducing the dose of immunosupressors. B. A diet with depleted salt content and proteins. C. Enterosorbents. D. Vitamins C and E. E. Increasing the dose of immunosupressors.

Patient M., 54 years old, more than 20 years was suffering from osteomyelitis of the femur. Last month swelling of the lower extremities appeared and gradually increased. In urine proteinuria - 6.6 g / l, in blood dysproteinemia in the form of hypoalbuminemia, increased α2-and γ-globulin, ESR (erythrocyte sedimentation rate) - 50 mm / hour. What is the probable diagnosis?

A. Acute glomerulonephritis. B. Myeloma. C. Secondary amyloidosis of the kidneys. D. Cardiovascular failure. E. Systemic lupus erythematosus.

The patient got radiation exposure. Complains about general weakness, frequent nasal bleeding, bruises on the body, palpitations, wheeze. Often suffer from respiratory diseases. In the blood: red blood cells - 1.2 *10¹² / l, hemoglobin - 54 g / l, white blood cells - 1.7 *10⁹ / l, eosinophils - 0%, banded neutrophils - 0%, segmented neutrophils - 62%, lymphocytes - 32%, monocytes - 6%, ESR - 52 mm / h, platelets - 30 *10⁹ / liter. The most appropriate treatment in this case:

A. Transfusion of packed red blood cells. B. Transfusion of platelet mass. C. Transfusion of whole blood. D. Bone marrow transplantation. E. Antilymphocytic immunoglobulin.

Is it necessary a compatibility of donor and recipient by ABO system for kidney transplantation?

A. Groups of blood of donor and recipient do not identify at kidney transplantation. B. Possible O (I) group for all recipients. C. Possible AB (IV) group for all recipients. D. Not necessarily. E. Required.

20-year-old girl suffers from intestinal polyposis. She had frequent fungal and viral diseases in anamnesis. What link of immune system is most likely affected in this case?

A. Phagocytes. B. B-lymphocytes. C. Natural killers. D. Complement. E. T-lymphocytes.

What change in blood test most likely indicates the presence of inflammation in the body?

A. The increased number of reticulocytes.

B. The increased number of neutrophilic leukocytes.

C. The increased number of platelets.

D. The increased number of basophilic leukocytes.

E. The decreased number of monocytes.

Child 3 days, has malformations, perinatal encephalopathy, a syndrome of respiratory disorders. Born from the first pregnancy, which ran against the backdrop of repeated Acute Respiratory Viral Infection(ARVI), mostly in the first semester. Given the above, had been put previous diagnosis of intrauterine infection. Which survey will allow confirm this diagnosis?

2. Determination the level of total IgG.

3. Determination antibodies IgG to HSV type I and II.

4. Determination antibodies IgG to CMV.

5. Determination the level of total IgM.

6. Determination antibodies IgG to EBV.

During the medical examination of 19 old worker was discovered generalized swollen lymph nodes with primary lesion the posterior neck, elbow and axilla. On the skin of ulnar bends - multiple traces of injections. use drug denies, traces of injections explains the treatment of influenza. In the blood: er. - 3.2 * 1012 g / l, Hb - 100 g / l, leukocytes - 3.1 * 109 / l, moderate lymphopenia. What kind of research should be done first?

1. Sternal puncture.

2. Immunological research.

3. Enzyme-linked immunosorbent assay (ELISA) for HIV.

4. Roentgenography of the lungs.

5. Lymph node biopsy.

The patient, 18 years; after prolonged insolation were fixed erythema face , ulceration of oral cavity, not-erosive arthritis of small joints of the hands, fever, resistant to treatment with antibiotics and anti-inflammatory drugs, tachycardia; electrocardiographically - diffuse changes in the myocardium. Which laboratory parameters is pathognomonic for this disease?

1. Antibodies to native DNA in high titer.

2. Leukocytosis with a leftward shift.

3. Leukocytosis with a shift to the right.

4. Lymphocytosis.

5. Positive HBs-Ag in blood.

In the baby with the sluggish progress of pneumonia for two months was found the hypoplasia of retrosternal gland. What will be change in the immune response?

1. Decrease the humoral and normal cellular immunity.

2. Decrease of cellular immunity.

3. Normal cellular response.

4. Decrease of cellular and humoral immunity.

5. Increase of cellular and humoral immunity.

The patient N., 38 years old, diagnosed with thymoma - a tumor of the thymus. The disease accompanied by hypogammaglobulinemia (decreased levels of IgG, IgM, IgA), lymphopenia with characteristic functional defect of lymphocytes. How does exactly?

1. Killer activity.

2. High suppressor activity.

3. Helper activity.

4. By changing of humoral immunity.

5. Change NK-cells.

After use of analgin, in the patient appeared hives, increased body temperature, in the blood - leukopenia. What type of hypersensitivity has evolved in the patient?

1. IgE-mediated and cytotoxic.

2. Immunocomplex.

3. Immediate.

4. Delayed.

5. Cytotoxic.

The patient after walks outside the city complaining of a sudden runny nose, itching in nose, sneezing, dark circles under the eyes. What are the antibodies react in this type of reaction?

A. Ig E, Ig M.

В. Ig M, Ig G₄.

С. Ig E, Ig A.

D. Ig A, Ig M.

Е. Ig E, Ig G₄.

Girl, 6 years old, suffers from atopic bronchial asthma. Her grandpa has asthma also. Patient was made an immunological examination, indicators of certain classes of immunoglobulins were pathological. Raising of which class Ig in atopic form of asthma will be pathognomonic?

A. Ig A.

В. Ig M.

С. Ig E.

D. Ig D.

Е. Ig G.

Child 3 years old was diagnosed with atopic dermatitis. For the first time manifestation appeared at 6 months in the form of erythematous-squamous rash after eating citrus fruits. Now with the words of mother in baby has food allergy "to all". Laboratory tests that will be used for diagnostic necessarily must include:

1. Determination of HLA phenotype of the child.

2. Determination of total and specific Ig E.

3. Determining the level of interleukins -1 and -6.

4. Determining the level of T-and B-lymphocytes.

5. Determining the level of Ig M and Ig G.

In the patient on the lip of the vesicle appeared, surrounded by hyperemia. The doctor was suspected herpes. What research is the best to conduct, to quickly confirm the diagnosis?

1. Microscopy of blood serum.

2. Immunofluorescent blood test.

3. Isolation of virus from vesicles in cultures of tissue.

4. Microscopy of content of vesicles.

5. Immunofluorescent research of content vesicles.

In the boy, 5 years old, recurrent furunculosis, in the mother and grandmother - periodontitis, brother was operated after appendicitis phlegmonous. Which are the most likely violation of immunity in a child?

1. Of phagocytosis.

2. Of humoral link.

3. Of cellular link.

4. Selective deficiency IgA.

5. Deficiency of complement system.

Patient 18 years old, arrived with complaints of headache, weakness, fever, sore throat. OBJECTIVELY: enlarged lymph nodes of all groups, 1-3 cm in diameter, elastic, little painful, not soldered together. Hepatosplenomegaly. In the blood - leukocytosis, atypical mononuclear cells - 15%. Probable diagnosis?

1. Angina.

2. Diphtheria.

3. Infectious mononucleosis .

4. Acute lympholeukemia.

5. Chronic myeloleukemia.

Thirty Years old patient for 2-years suffering from diffuse toxic goiter. Traditional conservative therapy does not gave the effect. Which breach there is in a patient?

1. Increase of immunoglobulins A.

2. Increase of immunoglobulins M.

3. Increase of immunoglobulins D.

4. Increase of immunoglobulins E.

5. Increase of immunoglobulins G.

The patient, 20 years old, complains of a small general weakness, fever to 37.5 C during the last 6 days, mucous nasal discharge, feeling of "sand" in the eyes. Objectively: hyperemia of the fauces, tonsillar hypertrophy, increased posterior-cervical, submandibular lymph nodes, swelling and injection of vessels conjunctiva. Previous diagnosis: Pharyngo-conjunctival Fever. Informative methods of diagnosis with this disease are:

1. Skin allergic test.

2. Blood culture.

3. Bacteriological method.

4. Immunofluorescence reaction.

5. The reaction of agglutination and lysis.

Patient R., 22 years old, turned to the hospital on the second day of illness with complaints of high fever, headache in the forehead area, pain during movements of the eyeballs, pain in muscles and joints. Objectively: T-39, 0 ° C. Hyperemia of the face, injection of scleras. The mucous membrane of the soft palate, posterior wall of pharynx is hyperemic with dot hemorrhages, follicles are hypertrophied . What changes in hemogram typical for this disease?

1. Leukocytosis.

2. Neutrocytosis.

3. Leukopenia.

4. Accelerated ESR (erythrocyte sedimentation rate).

5. Lymphocytosis.

The patient, 23 years, entered the department with the diagnosis: ulcerative-necrotic angina. From the side of internal organs pathology were detected. Before the admission independently was taken streptocide of 1.0 g 4 times a day. In the blood: Leukocytes - 2.2 g / l, basophils-0%, eosinophils-1%, band neutrophils-0%,segmented neutrophils-10%, lymphocytes-77%, monocytes-12%, ESR - 40 mm / hour. Probable diagnosis?

1. Acute leukemia.

2. Immuno-allergic agranulocytosis.

3. Sepsis.

4. Iso-immune neutropenia.

5. Immuno-allergic granulocytosis.

A patient with morning stiffness, pain in metacarpal-phalangeal and proximal interphalangeal joints. Available symmetrical lesions of joints and rheumatoid nodules. In the blood - normochromic anemia, leukocytosis, accelerated erythrocyte sedimentation rate, reaction Vaaler-Rose 1:120 (normal 1:32). What phenotype of T lymphocytes interacts with synovial cells at this disease?

А. CD3.

В. CD2.

С. CD25.

D. CD1.

Е. CD4.

The patient, 49 years spent alotransplantation of kidney. Index of histocompatibility 75%. After a kidney transplant patient was appointed immunosuppressive therapy. On the 16th day after surgery the abscess was opened with a greenish exudation and suddenly there were signs of acute renal failure. In immunogram: significant decrease in the number of CD4-cells at an increase in the number of CD8-and CD19-lymphocytes, IRI (immune regulation index)-0.8. What threatens the patient?

A. Infectious complications.

В. Acute crisis of rejection.

С. Over-acute crisis of rejection.

D. Drug glomerulonephritis.

Е. Chronic crises of rejection.

The patient, 19 years old, acutely fell ill - increased body temperature to 39.0 ° C, appeared weakness, nausea. Vomiting and abdominal pain was not. The temperature is kept at high numbers for 2 days, then decreased to normal. On the sixth day of illness the urine darkened , on fifth noticed Icterus scleral. By this time the patient feel better, vanished nausea, weakness. Objectively: moderate icterus of skin and scleras, no rash. Pulse - 66 beats / min, blood pressure - 110/70 mm Hg. The abdomen is soft, painless in all sections, liver at 2.5 cm stands from under the costal arch, spleen is palpable. What is the cause of fever in pre-icteric period of this disease?

1. Toxemia.

2. Virusemia.

3. Cholecystitis.

4. Bacteremia.

5. Erythrocyte hemolysis.

In women, age 20, for 8 years in August-September arises rhinitis, conjunctivitis, and last year joined the attacks of breathlessness or cough with difficulty breathing. At skin testing was revealed hypersensitivity to the ragweed pollen. Which Interleukin is crucial in the synthesis of antibodies, causing disease?

А. IL 6.

В. IL 1.

С. IL 2.

D. IL 3.

Е. IL 4.

To immunodeficiency with B-cell deficiency is belongs:

1. Wiskott-Aldrich Syndrome.

2. Chronic granulomatosis.

3. Bruton's disease.

4. Di-George Syndrome.

5. Nezelof's syndrome.

Among the primary immunodeficiencies the most common is next:

1. Agammaglobulinemia.

2. Hyper IgM syndrome.

3. Insufficient of complement.

4. Insufficient of secretory IgA.

5. Syndrome of "naked" lymphocytes.

Deficiency of which cells is Bruton's disease:

1. Macrophages.

2. Neutrophils.

3. B-cells.

4. T-cells.

5. Natural killers.

With which impaired in the system of protection is associated the chronic granulomatosis?

1. Insufficient complement system.

2. Violation functions neutrophils.

3. Violation functions macrophages.

4. Violation of B-cells.

5. Violation of T-cells.

Clinical manifestations of common variable immunodeficiency isn't the following:

1. Icterus.

2. Herpetic damage.

3. Diarrhea.

4. Purulent sinusitis.

5. Chronic purulent bronchitis.

Boy, 10 years old, entered the hospital with pneumonia, purulent otitis, arthritis right the knee joint. From anamnesis - ill from early childhood to one year endured twice pneumonia, frequent diarrhea, in 3 years was diagnosed bronchiectasis, purulent bronchitis, in 5 years - sinusitis, in 7 - bilateral purulent otitis. At research of the immune status were found: decrease of level IgG, absent IgA, saved the level of IgM, immunoregulatory index 0.6, moderate leukocytosis, medium severity anemia, accelerated ESR, phagocytosis is not impaired, reduced levels of blood gammaglobuline. About that it comes the diagnosis? Tactics of conducting the patient?

1. Secondary induced immunodeficiency, infectious syndrome, subacute course, humoral-cellular, medium severity, sub-compensated, immune deficiency II-III. Treatment in Pulmonological department with the introduction of immunoglobulins, plasma, correction of cell violations under the supervision immunologist.

2. Primary immunodeficiencies: common variable immunodeficiency, sub-compensated, immune deficiency II-III. Treatment in immunological department with the introduction of immunoglobulins, plasma, correction of cell disorders . Prolonged immunorehabilitation and replacement therapy. Dispensary observation and treatment in immunologist for life.

3. Secondary induced immunodeficiency, infectious, autoimmune syndrome, subacute course, humoral-cellular, medium severity, sub-compensated, immune deficiency II.

Girl, 14 years. Since childhood, frequent respiratory viral infection, diarrhea, asthma. General blood test unchanged, decreased levels of IgG, IgM, absent IgA, decreased amount of B cells, T-cell immunity and phagocytosis without violations. Your diagnosis? Further tactics?

А. Primary immunodeficiency, violation of humoral immunity. Treatment and clinical examination in immunologist.

В. Secondary induced (viral), immunodeficiency, infectious and allergic syndrome. Treatment in the Allergologist.

С. Bronchial asthma, chronic pancreatitis. Treatment in doctor of general practice with a review of the gastroenterologist, Allergologist. Appointment of Echinacea.

To deficiency system of phagocytes is not belong :

A. Deficiency of the expression of adhesion molecules.

В. Chronic granulomatosis.

С. Job's syndrome.

D. Chediak-Higashi Syndrome.

Е. Louis-Bar syndrome.

At the heart of Di-George syndrome is:

1. Deficiency of humoral link of immunity.

2. T-cell defect.

3. Combined of T-and B-immunodeficiency.

4. Deficiency of complement system.

5. Deficiency of the system of phagocytosis.

Development of innate angioneurotic edema caused by inhibitor deficiency:

А. С3.

В. С5.

С. С8.

D. С6.

Е. С1.

Immune changes at AIDS resemble the following congenital immunodeficiencies: A. Common variable immunodeficiency. B. Severe combined immunodeficiency. C. Bruton disease. D. B-cell failure. E. Lack of phagocytosis.

Epstein-Bar virus mainly affects: A. Macrophages. B. Leukocytes. C. B-lymphocytes. D. T-lymphocytes. E. T-helpers I type.

AIDS affects mainly: A. Macrophages. B. Leukocytes. C. B-lymphocytes. D. Cytotoxic T-lymphocytes. E. T-helpers.

The causes of secondary immunodeficiencies are, except: A. Diabetes. B. Burn disease. C. Rheumatoid arthritis. D. Hypertension. E. Frequent psychological and emotional overload.

At secondary immunodeficiency on the basis of diabetes occurs: A. Allergy syndrome. B. Imunoproliferative syndrome. C. Autoimmune syndrome. D. Infection syndrome. E. Syndrome of "naked" lymphocytes.

In what case in the surgical department patients need help of immunologist? A. Planned surgery - cholecystectomy in patients with bronchial asthma. B. Septic state peritonitis after stab wounds. C. Rheumatoid arthritis with visceritis, perforative steroid ulcer of duodenal bulb. D. No need in any case. E. Necessary in all three cases.

Female, 35 years old, is being treated in the therapeutic department with diagnosis "pneumonia". Three courses of antibiotic therapy brought no result. Fever, systemic lymphadenopathy, splenomegaly, infiltration of lung tissue, leukocytosis, weight loss are still keeping . Over the last two years, frequent viral infections, genital candidiasis, two months ago - pyelonephritis. Your preliminary diagnosis? Further tactics?

A. HIV infection. Appropriate additional examination, review by infectiologist. B. Hemoblastosis. Sternal puncture, review by hematologist, to inform relatives. C. Tuberculosis. Additional examination in the diagnostic department Phtisiatric and Pulmonologic Center. D. Sarcoidosis. Additional examination in Pulmonological department. E. Out-hospital pneumonia, a protracted course, induced secondary immunodeficiency, infectious and imunoproliferatyvnyy syndrome. Transfer to imuno-therapeutic department.

Cyclosporine inhibits the graft rejection by:

A. Blocking production of IL-2 by T-helper cells. B. Inhibition of macrophage activity. C. Complement-dependant cytolytic action on T lymphocytes of the recipient. D. Block graft antigens. E. Blocking receptors of antigenpresenting cells.

A child with blood group 0 (I) Rh (+) born from mother whose blood group 0 (I) Rh (-). What must be entered to mother to prevent Rh disease in the future?

A. Glucocorticosteroids. B. Anti-Rh antibodies. C. Membranstabilizing drugs. D. Replaceable blood transfusion. E. Cytostatics.

There was a jaundice in newborn at the age of one day. Total bilirubin of blood serum is 144 micromol/l, indirect bilirubin - 130 micromol /liter. Cumb's test is positive. A child was borne from the first pregnancy. The mother has blood group - 0 (I) Rh (-). What is the most likely cause of jaundice?

A. Physiological jaundice. B. Rhesus incompatibility. C. AV0-incompatibility. D. Atresia of bile-excreting tracts. E. Fetal hepatitis.

A newborn with hemolytic disease has blood group 0 (I) Rh (+), his mother has A (II) Rh (-). What groupe of blood is necessary to transfuse at the operation of replacement blood transfusion?

A. O (I) Rh (-). B. A (II) Rh (+). C. A (II) Rh (-). D. B (III) Rh (-). E. O (I) Rh (+).

The main factor of natural tolerance of female body to spermatozoa and blastocysts are:

A. High levels of estrogen. B. Increased T-helper cells. C. The absence of molecules in gamete HLA. D. Reduced activity of phagocytosis. E. Synthesis of anti-HLA antibodies by mother against father's haplotype.

The child was born healthy, weighing 3500 g, length 51 cm, estimation for the Aphar - 8 points. It was the first pregnancy for this woman, childbirth in time. Mother - 0 (I) Rh (-), father - A (II) Rh (+), child - 0 (I) Rh (+). What complications may occur?

A. Anti-Rh-immunoglobulins in a child. B. Anti-Rh-immunoglobulins in the mother. C. The conflict by AB0 system between mother and child. D. Antisperm immune conflict. E. No complications.

CA-125 is a tumor marker, specific for: A. Pancreatic cancer. B. Breast cancer. C. Ovarian сancer. D. Lung cancer. E. Rectal cancer.

The patient, 60 years old, complains of loss of appetite, heaviness in epigastrium, nausea, general weakness. He is sick for 2 months. Peripheral lymph nodes are not enlarged. Tongue dry and coated with white flew. The abdominal wall is resistant, painful in epigastrium. The reaction is positive for hidden blood in stool. Your diagnosis?

A. Chronic gastritis. B. Peptic ulcer. C. Chronic cholecystitis. D. Stomach cancer. E. Bowel cancer.

Detection of malignant cells in regional lymph nodes indicates: A. Activation of cellular immune response. B. Hyperreactivity of the body. C. Lack of immune response. D. Adequate immune response. E. The probability of metastasis.

Investigation of of tumor-specific antigens enables: A. To set change of antigenic structures of the tumor. B. To exclude the diagnosis of oncopathology. C. To evaluate the activity of the immune response. D. To identify violations of specific immune response. E. To identify recurrent or metastasis of tumor.

Female, 37 years old, complains of pain in the knee, carpal-radial, small joints of hands, morning stiffness in joints up to 2 hours, increased fatigue. Fell sick 3 years ago. On examination: swelling, defiguration, tenderness at palpation and movements in the listed joints. On radiograph of hands: epiphyseal osteoporosis, narrowing of the articular gap, single attritions. What mechanism of development of disease is the leading?

A. Influence of bacterial agent. B. Genetically-determined autoimmune processes. C. Decreasing the amount of cartilage proteoglycans. D. Contact with HLA B27 antigen. E. The deposition of urate microcrystals.

The patient, 26 years old, complaining of wheeze at physical exercises, dry cough, a pain in small joints of hands and feet, fever to 38^оС, weight loss, hair loss, a red rash on the face. Objective: condition of the patient heavy, hyperemia of face, nose, changing of shape of the proximal interphalangeal joints. Arterial pressure is 100/70 mmHg. Pulse is 100 per minute, rhythmic. Borders of the heart displaced to the left, cardiac sounds are weakened, systolic sound at the apex. At X-ray examination of thorax revealed interlobular pleural thickening, increased left ventricle. Analysis of blood: erythrocytes – 2,6*10¹²/l, Hb – 96 g/l, leukocytes – 3,3*10⁹/l, ESR - 68 mm/hour. Analysis of urine: protein - 1,65 g/l, erythrocytes - 8-10 in sight, hyaline cylinders - 4-5 in sight . About what disease you can think in this case?