infektsionniy (yakuniy attestattsiya javoblar)

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infektsionniy bilet №1 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya tsitomegalovirusnoy infektsii. bilet №2 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya kori. bilet №3 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya brutseleza. bilet №4 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya covid-19. bilet №5 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya roji. bilet №6 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya epidemicheskogo sipnogo tifa. bilet №7 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya lyamblioza. bilet №8 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya sibirskoy yazvi. bilet №9 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya malyarii. bilet №10 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya bryushnogo tifa. bilet №11 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya xoleri. bilet №12 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya enterobioza. bilet №13 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya salmonellyoza. bilet №14 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya virusnix gepatitov. bilet №15 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya skarlatini. bilet №16 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya …

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pnom lechenii tsmvi preparati s uspexom ispolzuemie pri drugix gerpesvirusnix boleznyax (atsiklovir, valatsiklovir, ribavirin, preparati interferonovogo ryada i immunomodulyatori) okazalis neeffektivni. dokazannoy effektivnostyu pri manifestnoy tsmvi obladayut protivovirusnie preparati: gantsiklovir (tsimeven*), valgantsiklovir (valtsit*), foskarnet natriya (foskavir*) i tsidofovir*. lechenie gantsiklovirom (tsimeven*) provoditsya putem ejednevnix vnutrivennix infuziy v doze 5 mg/kg massi tela v techenie 1 chasa, cherez kajdie 12 chasov (10 mg/kg/sut) v techenie 2–6 ned v zavisimosti ot klinicheskoy formi zabolevaniya. valgantsiklovir (valtsit*) primenyaetsya peroralno (odna tabletka valtsita* soderjit 450 mg valgantsiklovira) dlya lecheniya tsmv–retinita. kriteriyami effektivnosti terapii slujat normalizatsiya sostoyaniya patsienta, ischeznovenie dnk tsmv iz krovi. bolnim vich–infektsiey, proshedshim kurs lecheniya manifestnoy tsmvi, dlya profilaktiki retsidiva naznachaetsya podderjivayushaya terapiya valgantsiklovirom (valtsit*) ili gantsiklovirom (tsimeven*). u beremennix pri diagnostike ostroy tsmvi ili aktivnoy tsmvi vsledstvie reinfektsii ili reaktivatsii virusa preparatom vibora yavlyaetsya neotsitotekt* — antitsitomegalovirusniy immunoglobulin cheloveka dlya vnutrivennogo vvedeniya. preparat naznachayut beremennim dlya profilaktiki antenatalnogo i intranatalnogo zarajeniya …

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sitsya k paramiksovirusam (semeystvo paramyxoviride, rod morbilli virus). k rodu korevix virusov otnosyatsya takje virusi podostrogo skleroziruyushego panentsefalita, chumi sobak i chumi rogatogo skota. razmeri ego 120–250 nm. obolochka virusa kori sostoit iz belkovoy membrani i lipidov v narujnix glikoproteidnix vistupax. virus gemoliziruet i agglyutiniruet eritrotsiti obezyan i patogenen dlya nix; kultiviruetsya na kletkax koji cheloveka i obezyan. epidemiologiya. kor — tipichnoe antroponoznoe zabolevanie. bolnoy chelovek videlyaet v okrujayushuyu sredu virus kori s poslednix dvux dney inkubatsionnogo perioda do 4–go dnya visipaniya. peredacha infektsii proisxodit vozdushno–kapelnim putem. ne bolevshie koryu i neprivitie ostayutsya vospriimchivimi k kori v techenie vsey jizni i mogut zabolet eyu v lyubom vozraste. patogenez. vnedrenie i reproduktsiya virusa proisxodit v kletkax mertsatelnogo epiteliya i v alveolotsitax. eshe v inkubatsionnom periode nastupaet virusemiya, prodoljayushayasya do 3 – 4 - go dnya visipaniy na koje i prekrashayushayasya s poyavleniem virus – neytralizuyushix antitel. porajaetsya limfoidnaya sistema i krovenosnie …

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ryu redki. kor privodit k sostoyaniyu anergii, v svyazi s chem obostryayutsya xronicheskie i b (tuberkulez i dr.) i ischezayut vnutrikojnie reaktsii na vvedenie diagnosticheskix allergenov. immunodepressiya prodoljaetsya neskolko mesyatsev. posle epidemicheskix vspishek kori smertnost detey ot drugix zabolevaniy vozrastaet v 10 raz. anergiya okazivaet vliyanie na klinicheskie proyavleniya kori, osobenno v sluchayax sochetannogo techeniya kori i vich–infektsii. klinika. inkubatsionniy period 9 – 11 dney. u lits, poluchavshix s profilakticheskoy tselyu immunoglobulin, inkubatsiya mojet udlinyatsya do 15–28 dney. nachalniy (prodromalniy) period xarakterizuetsya simptomami intoksikatsii i povisheniem temperaturi tela do 38–39°s; poyavlyayutsya grubiy (layushiy) kashel, giperemiya kon'yunktiv, svetoboyazn, oxriplost. na slizistoy obolochke myagkogo i tverdogo nyoba, chashe shechnoy poverxnosti, naprotiv malix korennix zubov, poyavlyaetsya patognomonichniy dlya kori simptom — pyatna belskogo–filatova–koplika. eto melkie belesovatie, slegka vozvishayushiesya pyatnishki, okrujennie krasnovatoy kaymoy, ne snimayushiesya shpatelem. po vneshnemu vidu oni napominayut mannuyu krupu ili otrubi. s poyavleniem sipi na koje oni ischezayut. cherez 3–4 …

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, obrazuyutsya pigmentnie pyatna, pozdnee shelushashiesya; shelushenie — melkoe otrubevidnoe. v eto vremya tipichen vid bolnogo koryu: litso odutlovatoe, glaza krasnie, gnoyashiesya, veki utolsheni, nos i verxnyaya guba otechnie; obilnoe videlenie iz nosa. slizistie obolochki polosti rta i rotoglotki giperemirovani. perifericheskie limfaticheskie uzli uvelicheni, slegka chuvstvitelni pri palpatsii. nad legkimi vislushivayutsya rasseyannie suxie xripi, edinichnie vlajnie. poyavlyaetsya odishka, uvelichivayushayasya pri razvitii pnevmonii; gluxost tonov serdtsa, taxikardiya, inogda aritmii, gipotoniya. u nekotorix bolnix otmechayutsya boli v jivote, jidkiy stul, svyazannie s aktivatsiey i prisoedineniem drugix vozbuditeley (kampilobakter, rotavirusi, lyamblii i dr.). krayne tyajelo protekaet gemorragicheskaya forma kori. naprotiv. u lits, poluchavshix gamma–globulin, razvivayutsya mitigirovannie formi kori, protekayushie legko, s inkubatsionnim periodom do 3 nedel i pri otsutstvii pyaten belskogo–filatova–koplika. samim chastim oslojneniem kori yavlyayutsya pnevmonii, v rannie sroki virusno–bakterialnie, a v bolee pozdnie — preimushestvenno bakterialnie. kor mojet oslojnyatsya keratitom (inogda vedushim k slepote), entsefalitom, meningitom, otitom, piodermiey, enterokolitom. u lits …

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infektsionniy bilet №1 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya tsitomegalovirusnoy infektsii. bilet №2 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya kori. bilet №3 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya brutseleza. bilet №4 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya covid-19. bilet №5 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya roji. bilet №6 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya epidemicheskogo sipnogo tifa. bilet №7 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya lyamblioza. bilet №8 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya sibirskoy yazvi. bilet №9 oporno-diagnosticheskie priznaki i primernaya sxema lecheniya malyarii. bilet №10 opo...

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