MINISTRY OF HEALTH OFTHE REPUBLIC OF UZBEKISTAN
CENTER OF DEVELOPMENT OF MEDICAL EDUCATION
TASHKENT MEDICAL ACADEMY
Department of infectious and pediatric infectious diseases
Subject: Infectious diseases
THEME: Whooping cough. Tetanus. Infectious mononucleosis.
Educational-methodical guideline for teachers and students of Treatment Faculty
TASHKENT
MINISTRY OF HEALTH OFTHE REPUBLIC OF UZBEKISTAN
CENTER OF DEVELOPMENT OF MEDICAL EDUCATION
TASHKENT MEDICAL ACADEMY
"A F F I R M E D"
Pro-rector of educational work
Professor Teshaev O.R.
__________________________
«____»____________2012
Department of infectious and pediatric infectious diseases
Subject: Infectious diseases
THEME: Whooping cough. Tetanus. Infectious mononucleosis.
Educational-methodical guideline for teachers and students of Treatment Faculty
"A F F I R M E D"
at a DNC meeting of Therapeutic Faculty
Protocol № ___from_________2012
Chairman of DNC, Professor
Karimov M.Sh.___________
TASHKENT
THEME: Whooping cough. Tetanus. Infectious mononucleosis.
1. Place of the lessons, equipping
- The auditorium;
- The emergency room;
- Diagnostic department;
- The laboratory.
- TCO: Case patients with whooping cough, tetanus, and infectious mononucleosis; slide
projector; TV-video, teaching, supervising the program, methods of work scenarios in small
groups, case studies.
2. The duration of the study subjects
Number of hours - 4
3. The purpose of subject
- Develop the ability to diagnose whooping cough, tetanus, and infectious mononucleosis in
children and adults;
- To familiarize students with the basic clinical and laboratory examinations;
- To define a rational therapeutic tactics;
- Preventive measures in the outbreak;
- Provide students with the etiology, epidemiology, pathogenesis, main clinical symptoms of
tetanus;
Objectives
The student should know:
- Statement of the clinical diagnosis of whooping cough, tetanus, infectious mononucleosis;
- Therapeutic tactics in whooping cough, tetanus, infectious mononucleosis;
- Prevention of pertussis, tetanus, infectious mononucleosis.
The student should be able to:
- To collect patient complaints;
- To collect epidemiologic anamnesis;
- Examine the patient for organs and systems;
- To make a differential diagnosis of the nature of cough;
- Make a differential diagnosis lymphoadenopatia and changes in the throat;
- Supporting distinguish the symptoms of clinical history and to form a presumptive diagnosis;
- Plan the laboratory examination;
- To determine the therapeutic tactics;
- Carry out anti-epidemic measures in the outbreak.
As a result of training the student should learn practical skills:
- To take blood for serology;
- Take material from the throat for bacteriological examination by cough plates;
- The introduction of tetanus toxoid serum.
4. Motivation
Distribution of deleted and atypical forms of pertussis especially in adults, the high
susceptibility of individuals, independent of age, severity and high mortality in young children
requires knowledge of physicians supporting GP clinical and laboratory symptoms of the
infection.
5. Inter-subject and intero-subject communication
Teaching this topic is based on the knowledge bases of students of biochemistry
metabolism, microbiology, immunology, pathological anatomy, pathological physiology,
physiology and histology of the upper respiratory tract infections. The findings of the studies of
knowledge will be used during the passage of medicine, surgery, obstetrics, gynecology,
hematology and other clinical disciplines.
6. The content of training
6.1. The theoretical part
Whooping cough is a disease that causes very severe coughing that may last for months.
You can cough so hard that you hurt a rib.
Whooping cough is also called pertussis.
Whooping cough is contagious. This means it spreads easily from one person to another.
You can prevent whooping cough by getting shots, called vaccines, that protect you from the
disease.
Whooping cough can lead to other problems, such as pneumonia. These problems can be
very serious in adults ages 60 and older and in young children, especially babies who are born
early or have not had shots to prevent whooping cough. With good care, most people recover
from whooping cough with no problems.
Anyone can get whooping cough. Before the vaccine was available, whooping cough was
most common in infants and young children. Because most infants now get the vaccine, people
ages 11 and older are now more likely to get it.
Epidemiology. The source of infection is a sick man. Infectious period from day 1 to 4 to
6 weeks. Contagion is particularly high at the beginning of spasmodic period. Asymptomatic
forms of the epidemiology of significant values have not. The mechanism of transmission of
airborne infection. The index of contagiousness 0.7 - 0.75. Sick person at any age: of all the
diseases of children under 1 year - 10%, from 1 to 5 years - 80-85%, from 6 to 10 years - 1013%. Seasonal spring and summer.
Pathogenesis of Academic Musabaeva IK:
Phase I - introduction of the pathogen to adapt it to the respiratory tract.
Phase II - the formation of stagnant home in the CNS.
Phase III - secondary changes in the organs and systems.
Phase IV - the formation of immunity and the elimination of the infectious process.
Classification of AD Shvalko:
I. Typical forms: a) easy and b) medium heavy, and c) severe.
II. Atypical forms: a) the worn out, and b) subclinical c) Pertussis in infants.
III. Pertussis in vaccinated.
Clinic. There are four periods of the disease: the incubation (8.5 times the duration of 2-3
or 14 days); catarrhal period (1.5-2 weeks) period of spasmodic cough (3-4 weeks)
convalescence (2-4 weeks).
Symptoms of an initial period of catarrhal diseases: the beginning of a gradual and
imperceptible, there is a slight cough and runny nose sometimes, the body temperature is normal
or 37-37,5 º C, leukocytosis without a small change in the formula, erythrocyte sedimentation
rate is normal, in the light scattered dry rales.
Symptoms of the disease in the period of spasmodic cough: irritability, anxiety, cough becomes
persistent, criminal, composed of a series of strong aftershocks short cough, cough after a bout of
shock pause and then a deep breath whistling (reprise), after an attack of a transparent, viscous
sputum in older children AURA .
Kind of a child during cough: the face puffy, red, sometimes cyanotic, the veins of head
and neck were swollen, the eyes of plaque in blood, wide open, the eyes stand out from the nasal
mucus sometimes with blood, the child is excited, looking for support, holding on to something,
spasms of facial muscles, involuntary urination, defecation.
Kind of a child is in a period of spasmodic cough: the face puffy, cyanotic, swollen
eyelids, the sclera hemorrhage after an attack of spasmodic cough complete exhaustion.
Respiratory symptoms of 98.5%: the scattering of dry rales auscultated, then wet, X-ray pulmonary emphysema, detected in 80% of cases and the "basal triangle" Gethe, asphyxia.
Symptoms of cardiovascular system: increased heart rate, increased blood pressure venous,
hemorrhagic syndrome (9-20% of cases), expanding the boundaries of the right of the stomach.
Symptoms of central nervous system: there are the late catarrhal period, lethargy, irritability,
mild agitation, sleep disturbance, increased tendon reflexes, intermittent paresis of cranial nerves
and limbs.
Changes of peripheral blood: the catarrhal period: a slight leukocytosis without changes,
a normal erythrocyte sedimentation rate, in a period of spasmodic cough: leukocytosis,
hyperleukocytosis (70-90%), marked lymphocytosis, ESR is normal.
Clinico-pathogenetic parallels in whooping cough. The mechanism of formation of the clinical
symptoms.
Causes whooping cough
Whooping cough is caused by bacteria that infect the top of the throat (pharynx) where it
meets the nasal passages. The bacteria bother the throat, which causes coughing.
Whooping cough spreads easily from person to person. When someone with the disease
coughs, sneezes, or laughs, tiny drops of fluid holding the bacteria are put into the air. The
bacteria can infect others when they breathe in the drops or get them on their hands and touch
their mouths or noses. After the bacteria infect someone, symptoms appear about 7 to 14 days
later.
Sign and symptoms
Adults usually have milder symptoms than children. How bad your symptoms are also
depends on whether you had the vaccine and how long ago it was.
Symptoms of whooping cough usually last 6 to 10 weeks, but they may last longer. In
young children, three stages can occur. Older children and adults don't always have the same
stages.
In stage 1, symptoms are like those of a cold:
You sneeze and have a runny nose, a mild cough, watery eyes, and sometimes a mild fever. The
symptoms last from several days to 2 weeks. This is when you are most likely to spread the
disease.
In stage 2, the cold symptoms get better, but the cough gets worse.
The cough goes from a mild, dry, hacking cough to a severe cough that you can't control. You
may cough so long and hard that you can't breathe. When you can take a breath of air, it may
make a whooping noise. After a coughing fit, you may vomit and feel very tired. Between
coughing fits, you feel normal. Symptoms are most severe in this stage. They usually last 2 to 4
weeks or longer.
In stage 3, you get better and grow stronger. The cough may get louder.
Coughing fits may happen off and on for weeks. Coughing fits may flare up if you get a cold or
have a similar illness. This stage may last longer if you have never had the vaccine.
Diagnosis
Clinic epidemiologic. Bacteriologic culture. And also we can use method of cloth’s plates.
Serological methods.
Treatment. Bed rest is not necessary. Etiotropic. Pathogenetic. Desensitizing. Enhancing
the immune (defense) reactions.
The treatment protocol is carried out in all patients, regardless of the form and severity of
clinical manifestations and complications. Hospitalization to be young children, as well as all
patients with severe pertussis in the presence of complications. Patients with mild without
complications are treated at home.
Diagnosis. The diagnosis of pertussis is established on the basis of clinical and epidemiological
data. In establishing the diagnosis of pertussis should be guided by the following criteria:
In the prodromal period of suspicion for pertussis should arise in the case of persistent,
slowly progressive cough in the absence of intoxication, fever, acute catarrhal symptoms of the
respiratory tract.
Diagnosis in the spasmodic stage, based on the presence of a typical patient with the
characteristic spasmodic cough reprises, stringy expectoration of viscous sputum, often - in the
late attack of vomiting, puffiness face, bridle sores on the tongue.
Of great importance is a succession of periods of illness - catarrhal, spasmodic,
permission.
Laboratory examination:
Complete blood count: leukocytosis, lymphocytosis with normal ESR.
Bacteriological method: the material is mucus from the upper respiratory tract, coughing
deposited on the back of the throat. The method of cough plates.
Serological Diagnosis - HAI, PA
Immuno-sorbent assay
Basic therapy.
In the treatment of patients with pertussis is very important and well-organized mode of
care. Throughout the disease the patient shows a fresh, cool air, which has a calming effect on
the CNS.
Necessary to exclude external stimuli that cause coughing. The patients showed a
complete fortified food.
Pathogenetic and symptomatic treatment:
Oxygen - the fight against hypoxia and hypoxemia - oxygen tent, stay in the fresh air, artificial
respiration.
Anti-spasm - aminophylline, ephedrine, no-spa.
To improve the bronchial conductivity (aminophylline), aerosol therapy - inhalation.
Antitussives.
Antipsychotic agents: chlorpromazine, propazin.
Antihistamines: Diphenhydramine, Promethazine, suprastin.
Corticosteroids: prednisone, hydrocortisone.
Antibiotics - early in the disease in the catarrhal period and in the early days of spasmodic cough
(erythromycin, ampicillin, chloramphenicol). Course of treatment: 7-10 days. In the spasmodic
period of antibiotics are not effective.
Monitoring and control
Monitoring the effectiveness of treatment is the dynamics of the disappearance of clinical
symptoms and laboratory results. Patients with pertussis must be derived from the collective
period of 25-30 days from the date of the disease. Children under 7 years were in contact with
patients with pertussis and vaccinated established quarantine for 14 days from the date of last
contact with the patient. If the patient is treated with pertussis at home, children under 7 years
were with him in contact, without a history of whooping cough are subject to dissociation of 25
days from the onset of cough of the sick child. Children older than 7 years old and an adult can
not be divisive, but should be under medical control within 25 days of onset of cough in sick.
Prevention. In the fight against pertussis is crucial routine immunizations. Especial
conducted a comprehensive drug prevention DPT vaccine to all children from 2 months of age,
three times a month to 4 months to 0.5 ml. revaccination is carried out in 16 months - 0.5 ml.
immunizations for children older than 3 years old are not carried out. Pertussis monovalent
applied at a dose of 0.1 ml under the skin of children previously immunized against diphtheria
and tetanus. Children under the age of 1 year without a history, not grafted at the contact is
recommended to introduce a dose of immune globulin in 6.0 ml of 3.0 ml every other day.
Isolation of patients 25-30 days. Hospitalization may be needed. A survey of contact.
USED IN THIS LESSON, NEW EDUCATIONAL TECHNOLOGY, "THREE-STEP
INTERVIEW," "INTERACTIVE TEACHING METHODS."
USING "THREE-STEP INTERVIEW»
In each group (3 person) are distributed as a "doctor", "sick", "expert". "Patients' reported
anonymous diagnosis. Each group conducts counseling for 10-15 minutes. "Expert" assesses and
records of the doctor in 3 sections:
1. What has been done correctly?
2. What is wrong?
3. How should they do?
Each group demonstrates a consultation with an expert commentary, which are valued by
all participants in learning.
Following the comments of the expert discussions held throughout the group, led by the
teacher. Evaluation is carried out within a maximum one-day ball THEN.
Options for abstracts:
1. Pertussis: an acute infectious disease characterized by cycles and during bouts of
whooping cough. Refers to the air - drop anthroponoses.
2. The main manifestation of the disease: the disease appears gradually with catarrh of the
upper respiratory tract without the expressed intoxication. The increase in spasmodic cough until
you cough with shortness of breath, which shows on the involvement of the CNS.
3. Source of infection: a sick man.
4. Transmission of the disease: the way airborne contamination (direct or continuous
communication).
5. Duration of infectious period of the disease: from the early days of catarrhal period to 28-30
days of illness.
6. Entrance gates in whooping cough: a mucous membrane of the upper respiratory tract.
7. Immunity: Stalwart - life.
8. Exposure to toxic substance on mucous membranes: effects of toxic substances and intense
irritation of the mucous membrane of the respiratory tract.
9. The toxic action of endotoxin on the nervous system: a generalized vascular spasm, spasm of
the bronchial tubes, the glottis, twitching, excitation of the nerve centers (respiratory,
vasomotor).
10. The formation of stable focus of excitation in the CNS (with the signs of the dominant
Ukhtomsky), a disorder of blood circulation in the lungs, impaired pulmonary ventilation, the
violation of the permeability of capillary walls, reduction of nonspecific resistance.
11. Catarrhal symptoms of the period: a mild fever, dry cough, gradually increasing by the end of
this period - Bole or less prolonged bouts of coughing.
12. The course of spasmodic periods: the attacks of spasmodic cough that occur suddenly or after
the aura as a series of aftershocks cough, following one another without a break, reprises
(whistling sound with breathing), cough with viscous sputum clear at the end of the attack and
possible vomiting.
13. Objective data during the attack: facial flushing, swelling of the neck veins, his eyes
bloodshot, watery eyes, protruding tongue, sore on the bridle of language, low-grade fever,
pulmonary emphysema, bronchitis. Pulse speeded up, the A / D increased, bleeding on the skin
and mucous membranes.
14. Peculiarities of atypical forms of pertussis: no symptoms of intoxication, t-normal, spastic
cough symptoms do not happen, cough, mild, lasts for 4-6 weeks. Must take into account the
epidemiological history and conducts laboratory tests.
15. The course of pertussis in vaccinated: pertussis in vaccinated rarely expressed. Often occurs
in the form of abortive or asymptomatic form, complications are rare.
16. The course of the children of the first months of life: whooping cough in children of the first
months of life runs hard. In these children, and the incubation period is short catarrhal. Can the
development of intoxication, the general cyanosis, loss of consciousness, twitching of facial
muscles, sometimes clonic-tonic seizures, characterized by early development of pneumonia.
17. The main methods of laboratory diagnosis of whooping cough: a specific method of
diagnosis is bacteriological, serological test, allergy test, the method of "cough plates."
18. Complications of pertussis: young children (emphysema, atelectasis, pneumonia).
19. Basic principles of treatment of pertussis: etiotropic treatment: antibiotics (ampicillin,
erythromycin, tetracycline); pathogenetic therapy: pertussis immune globulin) for severe or
complications - corticosteroids.
20. Prevention of whooping cough: Vaccination with DTP vaccine, starting with 2 - 3 months of
age with an interval of 30-45 multiple days. Revaccination after 1-1,5-2 years.
USING "INTERACTIVE TEACHING METHODS"
CHOOSING A THEME:
A) the pathogenesis of cough in whooping cough
B) The period of whooping cough, spasmodic
Students are divided into two groups, each sub-group discusses the answer to the question
and writes on a sheet of paper.
The expected answer to the question:
A) the introduction of agent: the agent of pertussis enters the upper respiratory tract, in
the cells of columnar epithelium proliferates and spreads on small bronchioles and alveoli. The
originator selects a toxin that affects the mucous membrane of the respiratory tract, causing
coughing as a result of prolonged irritation of the mucous membranes of nerve receptors of the
respiratory tract. Cough assumes the character of spasmodic cough. As a result of a continuous
flow of pulses due to the prolonged stimulation of the receptor apparatus of the respiratory tract
is formed persistent excitation center in the medulla oblongata - Ukhtomsky center.
B) The period of Spasmodic pertussis. Spasmodic cough cough series of tremors on the
exhale coming one after the other, for there is a breath cough shock arising from spastic
narrowing of the glottis whistling sound (reprise).
Aura-precursors phenomenon. Paroxysms - the number of reprises cough during the day
40-50 times or more.
Puffy face, swollen eyelids, bleeding on the skin and conjunctiva, sore on the bridle of
the language. Vomiting after coughing, discharge of viscous mucus. VHS: tachycardia, increased
blood pressure. The skin is pale, cyanotic during an attack. In the light shade of a box of
percussion sound, dry rales over the lungs, the symptoms of emphysema.
Talk to answer the question for 10-15 minutes.
Representatives of the sub-options are read out.
There is a discussion of possible answers to this question.
If the parties find it difficult to discuss a complete answer, the teacher asks leading
questions, give additional time for reflection, and then tells them.
At the end of the discussion the teacher counts the number of correct answers in each
subgroup, gives an estimate of each student to discuss the answer to this question.
6.2. The analytical part of
Case studies:
Task number one. Patient D., aged 6, fell ill gradually, when there was a dry cough and
mild fever. In the following days, coughing persistently held, differed obsession, gradually grew.
Over 2 weeks cough became paroxysmal character to wear, and sometimes ended with vomiting,
nosebleeds often appeared.
On admission the temperature of 36,6 º C. At the time of inspection there is a fit of
coughing lasting up to 2-3 minutes. There have been bleeding in the sclera. The attack ended
with vomiting, nasal bleeding. There is puffiness person through coughing easy cyanosis of the
lips.
№
1.
2.
3.
1. What kind of disease you can think of?
2. What are the symptoms may help clarify the diagnosis?
3. With the help of laboratory data which can confirm the diagnosis?
answer
About whooping cough.
The diagnosis of pertussis can be established on the basis of disease recurrence (previous
catarrhal conditions), the nature of paroxysmal cough, accompanied by cyanosis of lips,
bleeding in the sclera and ending with vomiting, nasal bleeding.
Diagnosis can be confirmed by changes in the haemogram: leukocytosis with absolute
lymphocytosis, abjection, serological studies.
Task number 2. Nagy, R., 1.9 months., Was in the somatic compartment on bilateral
pneumonia.
Ill gradually, in the early days was observed dry, compulsive coughing. The temperature
was subfebrile. In hospital acquired paroxysmal cough character, marked reprise. The child's
condition remained satisfactory. On examination, marked puffiness face, edema of the eyelids.
Coughing accompanied by redness of the face, lacrimation, and ended with the release of viscous
mucus.
1. What kind of illness you need to think?
2. What should I do with the sick?
3. What control measures should be carried out on the hearth?
№ answer
1. You can think of whooping cough.
2. Patient transferred to the Department of pertussis.
3. Children under 7 years old without a history of whooping cough and were in contact with
the patient, expose disunity within 14 days from the date of last contact with the patient.
Task number 3. The patient Yu, 24 years old, enrolled in an 8-day illness. Concerned
about a fever, headache, sore throat when swallowing, fever up to 37,8 º C. On examination,
moderate condition, injected sclera, puffy face, flushing of the pharynx, the tonsils are enlarged,
with purulent follicles, increased lymph nodes on the neck and shoulders, liver and spleen. In
the blood, leukocytosis, lymphocytosis.
1. Write a reasonable preliminary diagnosis.
2. The etiology and pathogenesis of fever.
3. Types of temperature curves.
№ Answer
1. Infectious mononucleosis, as noted a gradual onset, chills, fever, injected sclera, face
puffiness, redness throat, the presence of purulent follicles in the pharynx, the increase in
zadnesheynyh lymph nodes, liver, spleen, leukocytosis and monocytosis.
2. Infectious and noninfectious. In the mechanism of fever leading role belongs to
pyrogenic substances, which are divided into two groups: exogenous and endogenous. In
infectious diseases febrile reaction starts and is supported by the interaction of bacterial
and endogenous pyrogens.
3. Types of fever: a constant, laxative, intermittent, debilitating, atypical.
Task number 4. In the hospital admitted patient A., 18. The disease started acutely with
pain in the throat and neck muscles, fever up to 38 º C, the patient noticed a swelling in the neck,
seen on day 7 of the disease state of moderate severity, the temperature remains high, the sclera
injected in the throat congestion, greatly enlarged tonsils - they loose, with purulent overlay in
the gaps. Increased by all the groups of lymph nodes, liver and spleen. Blood tests: MDL. 17000, lymph. - 73%, Mon. - 13% of lymphocytes are cells with large pale cytoplasm.
1. Place a diagnosis.
№
1.
2.
2. What treatment is necessary to appoint?
answer
Infectious mononucleosis.
Antibiotics, corticosteroids, multivitamins, calcium, ascorbic acid.
Task number 5. B. The patient, a driver for a week outpatients treated at the follicular
tonsillitis. Fever 38-39 º C, the daily chilling, fatigue, headache, malaise.
1. If in this case to assume infectious mononucleosis:
A) What are the data of objective inspection will be revealed?
B) The nature of the peripheral blood (changes in the quantitative and qualitative
composition of white blood cells) in this disease.
№ answer
1. A) hyperemia of the throat, enlargement of the tonsils, tonsillitis, an increase in all groups
of lymph nodes, enlarged liver and spleen;
Task number 6. Patient R., aged 20, was delivered to the infectious disease clinic with a
diagnosis of "infectious hepatitis" sick 7 days. The disease started acutely with chills, fever up to
38,5 º C and headache. On the 7th day notice sclera jaundice, has been hospitalized. On
examination, moderate condition, the temperature of 38,8 º C, hyperemic pharynx, the tonsils are
enlarged, there is no air raids. On the skin of the trunk, armpits elements petechial rash. Mucous
ikterichnost throat, skin with a slight tinge subikterichnym. Palpable enlarged liver and spleen.
Peripheral lymph nodes were enlarged. No meningeal symptoms. The heart and lungs were
normal. The doctor receptionist did not agree with Allative diagnosis.
1. What kind of illness should think about? What are the causes of diagnostic errors
Allative diagnosis?
2. What research should I do? What are the results of laboratory tests confirm the
diagnosis?
№ answer
1. In this case we can think of infectious mononucleosis. The causes of diagnostic error was
in underestimating the lack predzheltushnogo period of high temperatures in the icteric
period, hemorrhagic rash, enlarged lymph nodes, changes in the pharynx.
2. Necessary to make the morphological and serological examination of blood. Diagnosis
will confirm the following findings: leukocytosis, lymphocytosis, the presence of
limfomononuklearov, a positive reaction, Paul Bunnelya 1:64 or higher; gemolizinovy
test (+ + + +).
6.3. The practical part
Sampling of material for bacteriological examination in whooping cough by the
"cough plates."
Purpose: Select pertussis culture to confirm the diagnosis and choice of treatment.
Indications: Long-term coughing patients.
Equipment needed: Petri dishes with the medium (casein-charcoal agar or Bordet-Zhang
Wednesday), forms, directions, sterile gloves, mask, sterile spatula.
Running steps (steps):
№ Measure
has
not Fully
complied
implemented
(0 point)
correctly
(10 points)
1. The physician must be in the mask. Wear sterile gloves
0
10
2. The patient sit on a chair
0
10
3. Ask the patient to open his mouth and stick out tongue
0
10
4.
5.
Take a sterile spatula in his right hand
Under the control eyes to have a spatula in a patient's
mouth
6. Irritating to the movements of the back of the throat to
cause the cough reflex
7. Open a petri dish with the environment and bring it to the
patient at a distance of 5-8 cm in front of your mouth when
you cough
8. The patient makes a shock 6.5 cough, resulting in mucus
when you cough which separates and settles on the
environment
9. Close the Petri dish
10. Indicate the patient's data on the form, direction, and send
a preliminary diagnosis of bacteriological laboratory
Total
0
10
0
10
0
10
0
10
0
0
10
10
0
0
10
100
7. Test questions
1. Determination of pertussis, tetanus, infectious mononucleosis.
2. The etiology of whooping cough, tetanus, infectious mononucleosis.
3. The epidemiology of pertussis, tetanus, infectious mononucleosis.
4. The pathogenesis of whooping cough, tetanus, infectious mononucleosis.
5. The clinical picture of whooping cough, tetanus, infectious mononucleosis.
6. Complications of whooping cough, tetanus, infectious mononucleosis.
7. Laboratory diagnosis of whooping cough, tetanus, infectious mononucleosis.
8. Differential diagnosis of whooping cough, tetanus, infectious mononucleosis.
9. Outcomes and complications of pertussis, tetanus, infectious mononucleosis.
10. Treatment of whooping cough, tetanus, infectious mononucleosis.
11. Prevention of pertussis, tetanus, infectious mononucleosis.
12. What skills are used in whooping cough?
8. The recommended literature
1. Majidov V.M. Infectional diseases. Т., 1992.
2. Maxmudov O.S. Children inflectional diseases, Т., 1995.
3. Uchaykin V.R. Manual by children inflectional diseases, М.,2005.
4. Shuvalova E.P. Infectional diseases, М.,1999.
5. Musabaev I.K. «the Management on intestinal infections», Т, 1999.
7. Pokrovsk Century И, Pak Of this year, etc. «Infectious diseases and epidemiology». - М,
2003
8. Jushchuk N.D., Vengerov J.J. «Lectures on infectious diseases». - М, 1999.
9. Uchajkin V. F «the Management on infectious diseases at children», - М, 1998.
10. Internet resources (www <http://www.medlinks.ru/> medlinks
<http://www.medlinks.ru/><http://www.medlinks.ru/>ru <http://www.medlinks.ru/>,
www.cdc.gov <http://www.cdc.gov/>).