This document contains a test for students studying infectious diseases. It includes multiple choice questions covering topics like disease transmission routes, clinical manifestations, diagnostic tests, and treatments. The questions are presented in two sections - the first section contains individual questions and the second contains case studies to analyze.

1. 1
Test of Lemology
《传染病学》2017 级留学生试卷 （试卷类别：A 卷, 60 分钟)
（校历 2021－2022 学年第 2 学期）
Student ID number_________ Chinese Name_________ Score__________
Ⅰ. Multiple choices（2 points/each, 100 points）
Direction: There is ONLY ONE correct answer, please mark the corresponding letter on answer
sheet.
Section A (1-24, 2 points/each)
1. Which of the following is the manifestation during the process of infection?
A. Latent infection
B. Covert infection
C. Overt infection
D. Carrier
E. The above all
2. The following items are basic characteristic of communicable disease, but EXCEPT：
A. Pathogen
B. Communicability
C. Post infection immunity
D. Infected toxic symptom
E. Epidemiologic feature
3. Which of the following is to determine the quarantine period of communicable disease ?
A. Isolation period
B. Communicable period
C. Longest incubation period
D. Shortest incubation period
E. Mean incubation period
4.The sequence one after another of rash emerging in these exanthematous infectious disease is:
A. scarlet fever, varicella, measles, typhus, typoid fever
B. varicella, scarlet fever, measles, typhus, typoid fever
C. smallpox, scarlet fever, measles, typhus, typoid fever
D. scarlet fever, varicella, measles, typhus, typoid fever
E. varicella, scarlet fever, measles, typoid fever, typhus
5.Which of the following has the least value for the diagnosis of acute liver failure?
A. ALT>500U/L
B. Deep jaundice
C. The liver shrink rapidly
D. Hepatic encephalopathy
E. Prothrombin activity (PTA)<40%
6. The main route of transmission of HDV should be excluded:
A. Shared needles

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B. Unprotected sexual contact
C. From infected mother to the newborns at the time of birth
D. Fecal-oral route
E. Recipients of previously untested blood products
7. Which of the following serological markers of HBV has protective effect?
A. HBsAg
B. Anti-HBe
C. HBeAg
D. Anti-HBs
E. Anti-HBc
8. The main signs of chronic viral hepatitis should exclude:
A. Spider angioma
B. Gynecomastia
C. Rash
D. Liver palms
E. Hepatic face
9. Leukocytosis can be seen in the following diseases, but EXCEPT:
A. Japanese encephalitis
B. Typhoid fever
C. Rabies
D. Infectious mononucleosis
E. Meningococcal meningitis
10. Which of the following is the first choice drug for treatment of Typhoid fever ?
A. Ampicillin
B. Ofloxacin
C. Penicillin
D. Chloromycetin
E. SMZco
11. The transmission route of Epidemic cerebrospinal meningitis is:
A. Sexual contract
B. Indirect communication
C. Respiratory tract is transmitted directly from the air by droplets
D. Digestive tract
E. Fecal-oral route
12. Which of the following is wrong about Epidemic cerebrospinal meningitis?
A. Pathogen was Gram negative
B. Invades from nasopharynx
C. Purulent meningitis
D. Skin ecchymosis is primarily caused by shock or DIC
E. Most of the meningococcal infected patients are asymptomatic
13. A 47-year-old woman with known HIV/AIDS(CD4+ lymphocyte 106
/µL and viral load
35,000/mL) presents with painful growths on the side of her tongue (many white striped damage).
Which diagnosis is considered most possible?
A. Aphthous ulcers

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B. Herpes stomatitis
C. Hairy leukoplakia
D. Mycobacteria Avium infection
E. Oral Kaposi’s sarcoma
14. Which of the following is the clinical feature of AIDS ?
A. No lymphadenopathy
B. A variety of neoplasm and opportunity infections
C. Constipation is common
D. Increase of body weight
E. No fever
15. Risk factors of Rabies include , but EXCEPT:
A. The location of bite
B. The severity of the bite
C. Age of victims
D. The treatment of wound
E. Vaccination and immunity
16. The most important points of clinical differentiation between Encephalitis B and
Meningococcal meningitis are:
A. Occurrence and degree of disturbance of consciousness
B. Petechial and ecchymosis of skin
C. Severity of convulsion
D. Abnormal physiological reflex and pathological refle
E. Age of victims
17. Which of the following is main causes of death of Japanese encephalitis ?
A. Hypothermic coma
B. Hypoxia
C. Hyponatremia encephalopathy
D. Central respiratory failure
E. Peripheral respiratory failure
18. The feature of Cholera is :
A. Blood-mucous stool, dehydration
B. Prominent changes in small intestine
C. Pathological changes caused by enterotoxin
D. O 139 strain may be the pathogen of the seven pandemics
E. Totally recovery during the convalescence
19.Which of the following is not proper in management of Hemorrhagic fever with renal
syndrome when hyperkalemia occurs?
A. Insulin and dextrose solutions
B. Whole blood transfusion
C.10% calcium gluconate
D. Hemodialysis
E. 5% sodium bicarbonate
20. The most cardinal reason of bleeding in febrile period of Hemorrhagic fever with renal
syndrome is:

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A. DIC
B. Heparin-like substance increasing
C. Coagulation factor decreasing
D. Thrombocytopenia and vascular injury
E. Azotemia
21. To Rabies, the most correct treatment measures for category Ⅲ exposure are :
A. Debridement + rabies passive immunization + vaccination
B. Injection of large dose of gamma globulin + antiviral drugs
C. Debridement + antibiotics
D. Injection of rabies virus immune serum + antiviral drugs
E. Debridement + injection of rabies virus immune serum
22. The main pathological change of Rabies is:
A. Cerebral pachymeningitis
B. Acute diffuse pachymeningitis
C. Leptomeningitis
D. Acute and diffuse cerebrospinal meningitis
E. Acute local parenchymatitis
23. Which of the following is to cause Malaria relapse ?
A. Gametocyte
B. Tachysporozoite
C. Bradysporozoite
D. Merozoite
E. Trophozoites
24. Which of the following is the main transmission route of Shigellosis?
A. Sexual contract
B. Fecal-oral route
C. Blood product transmission
D. From mother to child
E. Contaminated surgical instruments
Section B (25-50, 2 points/ each)
Case1: Within a two-day period, a pediatrician in a rural community sees sixteen children between
the ages of 2 and 6 with gastroenteritis. The illness began with a fever and abdominal pain. The
diarrhea was initially watery, but in some patients, subsequently became mucoid and bloody.
Three days before the onset of illness, all of the children had attended a picnic at a city park. Stool
cultures performed on these children show a non-motile gram-negative rod that does not ferment
Iactose.
25.Which of the following organisms is the most likely cause of the illnesses?
A. Campylobacter jejuni
B. Enterohemorrhagic E.coli
C. Salmonella enteritidis
D.Vibrio cholerae
E. Shigella flexneri
26.The diagnosis may be :
A. Bacillary dysentery

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B. Poisoning of food
C. Cholera
D. Acute gastroenteritis
E. Other disease
Case 2: A 4-year-old child with high fever, coma, convulsion for 2 days. Physical examination: T
41℃, P140 / min, Bp12.5/8kpa, R 40 / min, shallow and irregular, sobbing respiration, pupil 4mm
right, 2mm left, unresponsive superficial reflex, neck resistance, Kerning’s sign (+), Brudzinski’s
sign (+). Peripheral blood test: WBC 15×
109
/L, N 0.85, L 0.15; Cerebrospinal fluid examination
after dehydration: clear, WBC 150×
106
/L, polynuclear 70%, mononuclear 30%, Glu 4.8 mmol/L,
Chloride 130 mmol/L, Protein 0.6 g / L.
27.The most likely diagnosis is:
A. Leptospirosis (meningoencephalitis type)
B. Epidemic cerebrospinal meningitis
C. Epidemic encephalitis B
D. Cerebral malaria
E. Toxic bacillary dysentery
28. In order to confirm diagnosis, which of the following test is the first choice?
A. PCR RNA
B. Test blood specific IgM
C. Blood routine test
D. Culture of blood
E. Culture of urine
Case 3: A 45-year-old woman complains of yellow skin and dark urine. On physical examination,
the woman is noted to have an enlarged liver with an irregular edge on palpation. Serum serology
studies demonstrate the following: IgG anti-HAV: (+)；IgM anti-HAV: (-)；IgM HBcAb: (-)；IgG
HBcAb:(+), HBsAg: (+), HBeAg: (+); Anti-HCV: (-).
29. Which of the following diagnosis is considered most possible?
A. Chronic hepatitis C
B. Hepatitis A
C. Hemorrhagic fever with renal syndrome
D. Chronic hepatitis B
E. Acute hepatitis B + hepatitis A
30. In order to confirm diagnosis, which of the following test is the first choice?
A. HCV RNA
B. Blood routine
C. Culture of urine
D. Culture of blood
E. HBV DNA
Case4: An male patient, 40 years old, farmer was admitted for fever, headache for 7 days and
oliguria for 2 days. Physical examination: T 38.5℃, P 120 times/min, Bp 75/60 mmHg, R 22
times /min. Physical examination: drunken face , chemosis and petechia in chest and back skin.
Heart and lung were normal. Abdominal tenderness (+). Blood routine examination: WBC
15×
109
/L, N 80%, L20%, PLT 20×
109
. Urine routine test : Urine protein (+++), RBC 3-5/HP.
31. Which of the following diagnosis is considered most possible?

6. 6
A. Typhoid fever
B. Hemorrhagic fever with renal syndrome
C. Typhus
D. Acute glomerulonephritis
E. Leptospirosis
32. In order to confirm diagnosis, which of the following test is the first choice ?
A. Blood routine test
B. Smear of blood
C. Test blood specific IgM
D. Culture of blood
E. Culture of urine
33.Which of the following is the main source of infection for the disease?
A. Pig
B. Apodemus agrarius
C. Acute patients and carries
D. Dog
E. Chronic carriers
Case 5: A male, 25 years old, farmer, hospitalized on 10 August due to fever for 12 days. Low
fever 12 days ago , 37º
C , medication for cold, unrelieved, the daily temperature increasing up
more than 39º
C, with chills, significant loss of appetite, watery diarrhea. Admission examination:
T 39.8º
C , P 80 times / min. Indifferent, lack of facial expression. No abnormal findings in heart
and lung. Abdominal fullness, liver palpable 2cm below ribs, soft, palpable tenderness, palpable
spleen 1cm below rib, right lower abdominal tenderness. Blood routine test: WBC 3.0 ×109
/ L;
Liver function: ALT 90 IU / L; Anti-HBs(+); IgG anti-HAV: (+). Widal test: “O” 1:160, “H”
1:320.
34. Which of the following diagnosis is considered most possible?
A. Acute hepatitis A (icteric type) and HBsAg chronic carrier
B. Acute hepatitis A and acute hepatitis B
C. Acute hepatitis A (icteric type)
D. Typhoid fever
E. Acute hepatitis A and chronic persistent hepatitis B
35. In order to confirm diagnosis, which of the following test is the first choice ?
A. HBV DNA
B. Stool routine
C. Smear of stool
D. Culture of blood
E. Culture of stool
36. The main route of transmission of this disease included:
A. Unprotected sexual contact
B. From infected mother to the newborns at the time of birth
C. Fecal-oral route
D. Shared needles
E. Recipients of previously untested blood products

7. 7
Case 6: Patient, male, 42y, fever, discomfortable, fatigue, mental depression for 2 days. Physical
examination: T 39.5º
C, BP 70/40 mmHg, P 112/min, R 30/min. scattered ecchymosis, different
sizes of rashes of whole body, meningeal irritation sign is negative. Blood-routine test: WBC
15.2×
109
/L, N 0.92, L 0.80. This patient lived in epidemic area of Cerebrospinal meningitis.
37. Which of the following diagnosis is considered most possible?
A. Leptospirosis (meningoencephalitis type)
B. Epidemic encephalitis B
C. Epidemic cerebrospinal meningitis
D. Cerebral malaria
E. Toxic bacillary dysentery
38.What stage should the patient's course of disease belong to:
A. Incubation period
B. sepsis stage
C. Upper Respiratory stage
D. Meningitis stage
E. Convalescence stage
39. To confirm diagnosis, what further investigation is not included ?
A. Lumbar punture
B. Gram stain for the CSF or purpuric rash
C. Culture for blood or CSF
D. Limulus test
E. Head MRI
Case 7: A female, 22 years old, in sub-Saharan Africa, was hospitalized because violent diarrhea
and profuse vomiting, no fever, no abdominal pain, the diarrhea is more than 20 times with a large
amount of watery stool. He often drank well water. Stool routine test: WBC 1-3/HP, RBC 0-1/HP.
The stool is colorless and has flecks of mucus in it.
40.Which of the following diagnosis is considered most possible?
A. Bacillary dysentery
B. Poisoning of food
C. Cholera
D. Acute gastroenteritis
E. Other disease
41. In order to confirm diagnosis, which of the following test is the first choice?
A. Blood routine
B. Stool routine
C. Smear of stool
D. Culture of stool
E. Culture of blood
42. What is the most appropriate treatments for this condition?
A. Injection of cirofloxacin
B. Injection of humorous
C. Injection of 5:4:1 solution
D. Injection of blood product
E. Injection of dopamine

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Case 8: A 39-year-old HIV-positive man is brought into the emergency room after experiencing a
seizure witnessed by several friends. The observers relate that the patient suddenly lost
consciousness and experienced both leg and arm jerking. The man's tongue has been severely
bitten, and loss of bowel and bladder function is evident upon admission. On physical examination,
the patient is lethargic, unable to answer simple questions, and has an obvious left-sided
hemiparesis. An MRI of the head shows multiple ring-enhancing lesions.
43.Infection with which of the following agents is most likely responsible for this presentation?
A. Cryptococcus neoformans
B. Toxoplasma gondii
C. Mycobacteria tuberculosis
D. JC virus
E. Herpes simplex
44. Which of the following test should you order for the patient?
A. CD4+
lymphocyte count
B. Detection of anti-HIV
C. Lung MRI
D. Culture of blood
E. The above all
Case 9: A patient who travels internationally with his family, had intermittent fever for 20 days,
feeling tired , diarrhea, anemia and parasitic protozoa were found in blood thick smear.
45.The chief vector of this disease may be:
A. Culex fasciatus
B. Anopheles
C. Aedes aegypti
D. Biting midge
E. Dog
46. In order to make diagnosis, what is the first choice of the test?
A. PCR
B. Detection of antigen
C. Blood routine test
D. Blood culture test
E. Thin smear of blood
47.What is the most appropriate treatment for this condition?
A. Chloroquine+Pyrimethamine
B. Quinine+ Primaquine
C. Chloroquine+Primaquine
D. Parenteral artesunate
E. Quinine+ Pyrimethamine
Case 10: A 48-year-old man is sent to emergency department because of coma. His wife tells that
he has the history of chronic hepatitis B. On physical examination, the man is noted to have deep
jaundice and spider angiomata. Liver function : AST 800 U/L, ALT 1700 U/L, TBil 245umol/L.
48. Which diagnosis is considered most possible?
A. Cerebral hemorrhage
B. Liver failure

9. 9
C. Cerebral embolism
D. Myocardial infarction
E. Hypoglycemic coma
49. Which of the following is most important for evaluating the severity of the disease?
A. HBV DNA
B. ALT
C. Blood routine
D. Prothrombin activity(PTA)
E. HBsAg
50. Which of the following treatment is not recommended for this patient?
A. Blood precautions
B. Enough nutrition
C. Interferon for antiviral therapy
D. Hepato-protective agents
E. Enough rest