MCQ day 2.  Secondary immunodeficiencies. Dental aspects of diseases of the immune system.
Minimum number of correct answers 6/10
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The patient, 42 years old, with the background of a long-growing headache, had convulsions, loss of consciousness. On examination: level of consciousness - stupor, right-sided hemiparesis, positive Babinsky symptom on both sides, meningeal symptoms are negative. Blood ELISA for HIV antibodies - positive. Level CD4 + 4% - 21 cells / ml. On an MRI of the brain - in the occipital region two ring-shaped lesions that accumulate contrast. What is the probable diagnosis? *
1 point
Name, group, subgroup
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Indicate the side effects of inhaled corticosteroids: *
1 point
A 40-year-old injecting drug user complained of prolonged fever, night sweats, a sharp decrease in body weight, pain in muscles, throat, joints, and recurrent diarrhea. Objectively: generalized lymphadenopathy. What disease should be suspected? *
1 point
The patient was diagnosed with herpes zoster. The patient has suffered from diabetes since childhood, his father and grandfather - from bronchial asthma. A few days ago, he suffered food poisoning. For 7 days, he took analgin for a headache. During the examination of the patient, an increase in the level of antibodies against HIV was found. Which of the factors has the greatest pathogenetic significance? *
1 point
The patient has a diffuse toxic goiter. Receives Mercazolil in a dose of 50 mg per day. After 3 weeks from the beginning of the treatment, the body temperature rose to 38.1oC, a sore throat, and painful mouth ulcers appeared. General blood analysis: er. - 3.1x1012/l; Nv - 94 g/l; CP – 1.0; leyk 1.0x109/l; ESR – 28 mm/h. What is the most likely reason for the deterioration of the patient's condition? *
1 point
The driver is 40 years old and has been sick for two months: general weakness, sweating, weight loss of 12 kg, frequent long-term diarrhea and recurrent respiratory infections. Objectively: generalized lymphadenopathy, oral candidiasis; in feces - impurities of mucus and blood. A decrease in the number of T-helpers was detected, T4/T8 is less than 0.5. What is the most likely diagnosis? *
1 point
A 30-year-old patient, after working for a living, turned to a dermatologist with complaints of a rash all over the skin. Over the past 3 months, he has noticed a sharp weight loss, general weakness, constant low-grade fever. For which disease is it advisable to examine the patient? *
1 point
A 21-year-old patient without a permanent place of residence complains of decreased bowel movements for 2 months, weight loss of 13 kg, weakness, constant low-grade fever, recurrent herpes. Herpetic rashes on the lips, generalized lymphadenopathy, enlargement of the liver up to 2 cm. In the blood: erythrocytes - 4.4 • 1012/l, Hb - 115 mg/l, erythrocyte sedimentation rate - 15 mm/h, leukocytes - 10.0 • 109 /l, e.- 2%, p.- 6%, s.- 61%, l.-17%, m.- 3%. Atypical mononuclear cells - 6%. What is the most likely diagnosis? *
1 point
During the medical examination of a 19-year-old worker, a generalized increase in lymph nodes with a predominant lesion of the posterior cervical, axillary and elbow nodes was revealed. There are multiple traces of injections on the skin of the elbows. He denies taking drugs, explains the traces of injections as treatment for the flu. In the blood: er - 3.2x10 12 g/l, hemoglobin - 100 g/l, leukocytes - 3.1x10 9/l, moderate lymphopenia. What research should be done first? *
1 point
A 35-year-old patient complains of an increase in body temperature to 37.3°C, a feeling of lack of air, and weakness over the past 2 weeks. Objectively: a state of moderate severity, consciousness is preserved. Peripheral cyanosis. Moderate shortness of breath, 84% saturation. In the lungs, weakened breathing on both sides. An X-ray of the lungs shows signs of interstitial pneumonia. An HIV antibody test is positive. In the past, she was injecting drugs user. What is the most probable diagnosis? *
1 point
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