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Infantile hospital received a child with a temperature of 39 ° C and severe symptoms of general intoxication (weakness, adynamia, headache, chills). In the throat there is diffuse hyperemia and edema, the surface of the tonsils is covered with a thick coating of dirty-gray color. Heart sounds are deaf, tachycardia. All cervical lymph nodes are enlarged. A preliminary diagnosis of diphtheria was made. To confirm the clinical diagnosis, a microscopy of the test material (mucus from throat, nasopharynx, Gram stain, Neisser and Leffler) was performed. A crop was also produced on the folded Klauberg serum to obtain a pure culture. Microscopy gave a negative result. What conclusions can be drawn from this? On the folded serum, small colonies with compacting in the center grew. On the environment of Klauberg, grayish-black colors with radial striation formed. Then, the pellet was transferred to a folded serum to isolate the pure culture.
What should be done, what is the final answer? What biological properties of C. diphtheriae distinguish it from corynebacteria similar to it? What is your treatment strategy based on a diagnosis based on laboratory tests? How is diphtheria preventive?
The child has 4 years old, runny nose, malaise, low-grade fever, dry cough. Sick for about 10 days. In the last 2 days there were sharp bouts of spasmodic cough. A preliminary diagnosis was established: whooping cough.
The method of "cough plate" is sowing on blood potato-glycerin agar containing penicillin. After 3 days at a temperature of 37 ° C, very fine shiny gray colonies appeared on the surface of the medium, like the droplets of mercury, convex and moist, with a small hemolysis zone. Microscopically, smear from these colonies revealed ovoid Gram-negative rods. Colony material gave a positive agglutination reaction with pertussis serum. Is this enough to give a definitive answer? What other Tests are needed to identify the selected culture? In what cases are serodiagnostics used? Name the drugs for specific prevention and treatment of whooping cough.
1. Before the re-vaccination of BCG (revaccination) in school, all children underwent a Mantoux intradermal test. One of the children had a strongly positive Mantoux reaction. Should he be revaccinated.
2. Patient N. addressed the clinic, 40 years old, with complaints of weakness, shortness of breath, coughing with phlegm, sweating, fever up to 37.5-38.5 ° C. He is sick for about three months. Two months ago he returned from prison. Objectively: reduced nutrition, acrocyanosis, tachycardia. In the upper parts of the right lung, wet rales are heard. On the fluorogram in the upper lobe of the right lung, the foci of darkening. Preliminary diagnosis: "Right-sided pulmonary tuberculosis of the lung". The patient was referred to the TB dispensary. When microscopic smears from the sputum of the patient, stained by Tsilyu-Nielsen acid-resistant rods are not found. What does it say? In smears prepared using the flotation method and stained by Tsiol-Nielsen, thin, slightly curved red sticks are found, located in groups, in some sticks, dark grains are visible. What conclusion can be drawn? How to increase the diagnostic value of the bacterioscopic method?
3. The patient was subjected to a skin-allergic test with tuberculin. After 48 hours at the injection site appeared hyperemia with a diameter of 5 cm, a papule with a diameter of 12 mm, lymphangitis. How to evaluate the results of a sample of tuberculin? Sputum culture on Levenstein-Jensen medium after 20 days of incubation at 37 ° C increased R-form, wrinkled grayish colonies. In smears from these colonies, red sticks were found. The isolated culture did not grow on MPA and on egg medium at 22 ° C, did not form a pigment, had catalase, urease and nitrate reductase activity. Are these tests sufficient to identify the pathogen? What types of mycobacteria should be differentiated? What other signs need to be investigated additionally, how to identify them? How to make an accelerated diagnosis of tuberculosis? Name the drugs for specific prevention and treatment.
Tests:
1. A substance added to the growth inhibitory media of other bacterial species when the diphtheria pathogen is cultivated
A) Sodium Chloride
B) potassium tellurite
C) penicillin
D) brilliant green
E) Sodium sulfate
2. The main factor pathogenicity pertussis pertussis
A) thermolabile exotoxin
B) Capsule
C) hyaluronidase
D) lecithinase
E) plasmocoagulase
3. The DTP vaccine is used for prevention
A) diphtheria
B) measles
C) tularemia
D) dysentery
E) typhus
4. To detect toxigenicity of diphtheria bacteria, the following methods are used, except
A) biological tests
B) infection of chick embryos
C) infection of cell cultures
D) Immunoblotting
E) DNA probe method
5. A sample that is placed to determine cystinase in the corynebacterium of diphtheria
A) Dick
B) Shika
C) Sachs
D) Pisa
E) Birne
6. Growth of pertussis causative agent in liquid medium
A) diffuse cloudiness with a dense sediment
B) thin film
C) opacity of the medium
D) flocculent sediment
E) slight opalescence of the medium
7. The Pisa test for diphtheria is set to determine
A) urease
B) B-Lactomases
C) cystinase
D) urea
E) lecithinase
8. Biotypes of diphtheria bacillus
A) intermedius
B) bovis
C) canis
D) ovis
E) suis
9. Gram-positive curved sticks causing antitoxic, persistent post-infectional immunity, are pathogens
A) mycoplasmosis
B) scarlet fever
C) pertussis
D) tuberculosis
E) diphtheria
10. Infectious disease, characterized by bouts of spasmodic cough, observed mainly in preschool children
A) mycoplasmosis
B) diphtheria
C) scarlet fever
D) tuberculosis
E) whooping cough
11. Disease caused by pyogenic cocci synthesizing erythrogenin, determined by Dick's test
A) whooping cough
B) diphtheria
C) scarlet fever
D) tuberculosis
E) actinomycosis
11. A sample that determines the ability of the culture to synthesize nicotinic acid
A) Burne test
B) Mitsuda test
C) Mantoux test
D) Connaught test
E) Shik's test
12. The property of the causative agent of tuberculosis
A) Gram negative
B) is motionless
C) forms a capsule
D) forms spores
E) anaerobic
13. The main factor of pathogenicity of the causative agent of tuberculosis
A) Fithioic acid
B) tuberculin
C) toxic glycolipid
D) mycolic acid
E) tuberculostearic acid
14. Method of staining of a tubercle bacillus
A) Romanowski-Giemsa
B) Neisser
C) Tsilya-Nielsen
D) Burri-Hinsa
E) Zdrodowski
15. Property of the causative agent of leprosy
A) Gram negative
B) there is no dispute
C) is mobile
D) forms a capsule
E) grows on simple nutrient media
16. Disease in which the Mitsuda reaction is carried out
A) whooping cough
B) diphtheria
C) tuberculosis
D) scarlet fever
E) leprosy
17. The cultures of microorganisms in which the granular forms occur, the fly's grains, are pathogens
A) diphtheria
B) pneumonia
C) pertussis
D) scarlet fever
E) tuberculosis
18. Gram-positive long sticks, slightly curved giving a positive niacin test, are pathogens
A) tuberculosis
B) pneumonia
C) pertussis
D) diphtheria
E) scarlet fever
19. Disease, in which an accelerated method of detection of microorganisms in crops is used according to the Price method
A) scarlet fever
B) tuberculosis
C) diphtheria
D) actinomycosis
E) whooping cough
20. A disease in which drugs are used to treat: pyrazinamide, ethambutol, isoniazid, streptomycin, rifampicin, and others.
A) pneumonia
B) scarlet fever
C) diphtheria
D) tuberculosis
E) Whooping cough
Lesson№7
1. Topic: Diseases transmitted sexually. MDD diseases transmitted sexually (syphilis, gonorrhea, urogenital chlamydia).
Self-study on the following topics: "Mushroom systematics, cultural and morphological properties. Pathogens fungi and role in human pathology. Pathogenic protozoa: classification. Role in human pathology »
2. Aim: Master the metabolic syndrome of sexually transmitted diseases (syphilis, gonorrhea, urogenital chlamydia) and biological properties and mycosis of the protozoal infection.
.3. Objectives: To teach methods of laboratory diagnosis of sexually transmitted diseases (syphilis, gonorrhea, urogenital chlamydia).
4. Main questions of the topic:
1. Biological features of spirochetes.
2. Morphology and cultural properties of the causative agent of syphilis.
3. Biochemical properties, antigenic structure, resistance and epidemiology of the causative agent of syphilis.
4. Pathogenesis, clinic and immunity in syphilis.
5. Microbiological diagnosis of syphilis.
6. Treatment and prevention of syphilis.
7. Morphological and cultural signs of gonococci.
8. Biochemical properties and antigenic structure of gonococci.
9. Resistance and epidemiology of gonococci.
10. Pathogenicity factors, pathogenesis, clinic and postinfectious immunity of gonorrhea.
11. Laboratory diagnosis of gonorrhea.
12. Specific prophylaxis and treatment of gonorrhea and blenorrhea of newborns.
13. Features and MDD, treatment and prevention of urogenital chlamydia.
14. Systematics of protozoa.
15. Dysenteric amoeba.
16. Lamblias.
17. Trichomonads.
18. Leishmania.
19. Trypanosomes.
20. Plasmodium malaria.
21. Toxoplasma.
22. Balantidia.
23. Systematics of fungi.
24. Morphological features of fungi.
25. Physiological and biochemical properties of fungi.
26. Cultural properties of fungi.
27. Stability of fungi to environmental factors.
28. Mycosis subdivision for lesion localization.
29. Pathogenesis of mycoses.
30. Laboratory diagnosis of mycoses.
31. Diagnostic, preventive and curative drugs used in mycosis.
5. Methods of learning and teaching: Presentation of Tests, solution of situational tasks, mute maps
6. Literature:
1. Galaktionov V.T. Immunology. - M. - Ed. "RIC MDK". - 2000. -487
2. Vorobiev A.A. "Microbiology, Immunology" Moscow: MIA, 2002
3. Medical microbiology, virology and immunology. Ed. Vorobyeva A.A. - Moscow: MIA, 2008. - 690 p.
4. Medical microbiology, virology, immunology. Ed. Borisova LB ..- M .: MIA, 2006.-734 p.
5. A.A. Shortanbaev, S.V. Kozhanova "General Immunology", Almaty, 2009
6. R.M. Khaitov "Immunology", Moscow, 2009
7. A. Karaulov "Clinical Immunology and Allergology", Moscow, 2002
Additional:
1. D. Mail, J. Brostoff, D.B. Roit "Immunology", Moscow, 2007
2. N.V. Medunitsyn "Vaccinology", Moscow, 2004
3. D.H. Playfler "Visual Immunology", 2008
4. E. Chepel "Fundamentals of Clinical Immunology", 2008
5. R.M. Khaitov "Clinical Allergology", Moscow, 2002
6. G.B. Fedoseev "Allergology", St. Petersburg, 2001
7. Gordan Ada, Alistair Ramsay "Vaccines, vaccination and immune response", Moscow, 2002
8. S.A. Ketlinsky, A.S. Simbirtsev "Cytokines", St. Petersburg, 2008
9. K.A. Lebedev, I.D. Ponyakina "Immune Deficiency", Moscow, 2003
10. A.A. Totolyan, I.S. Freidlin "Cells of the immune system" I-II, SPb, 2000
11. G.T. Kaliakbarova "Cytokines", Almaty, 2004
12. G.T. Balpanova "Fundamentals of Transplantation Immunity. System HLA », Almaty, 2003
13. B.B. Bizhigitova "The role of the complement system and antigen-presenting cells in the immune response", Almaty, 2006
14. S.G. Mukhambetova, A.S. Karakushikova, Kozhanova SV, Sadvakasova GS "Assessment of the immune status of a person in a clinic", Almaty, 2005
Дата: 2018-12-21, просмотров: 222.