Infectious diseases that use the digestive tract as the portal of invasion are typhoid fever (right D); meningococcal meningitis (wrong A) is mainly spread directly from the respiratory tract through droplets through coughing and sneezing; Japanese encephalitis (wrong B) is mainly It is transmitted through mosquito bites; hepatitis C virus (C error) is transmitted through blood transfusion and blood products, injections, acupuncture, organ transplantation, bone marrow transplantation, hemodialysis, and sexually; hookworm (E error) is mainly transmitted through the skin.

Typhoid bacilli do not produce exotoxins, but the endotoxins (A pair) released by lysis of the bacteria play an important role in the pathogenesis.

Mainly endotoxin: typhoid fever, dysentery, meningococcal meningitis Exotoxins: Cholera Typhoid, cholera, and dysentery are spread through the fecal-oral (digestive tract) Respiratory spread of meningococcal meningitis

, the bacterium also has a polysaccharide virulence antigen (Vi antigen), and the Vi antigen is weak in antigenicity (C right). When typhoid bacilli are cleared from the human body, the Vi antibodies also disappear (D wrong).

)&"Salmonella typhi group D

Only Gram-positive bacteria will have spores, but not all Gram-positive bacteria will have spores. A negative Gram stain means there are no spores

No spores, no capsule, but flagella!

Chloramphenicol-resistant typhoid strains (E error) have been discovered in the 1950s; some typhoid strains are multidrug-resistant.

) & "Carriers or patients are the only source of infection for typhoid fever

). There are three types of carriers: 1. Those who are carriers during the incubation period have excreted the bacteria in their feces during the incubation period (pair B), 2. Temporary carriers shed bacteria during the recovery period but stop after 3 months. 3. Chronic carriers shed bacteria for more than 3 months during the recovery period (C is wrong, which is the correct answer to this question). Because Salmonella typhi grows better in bile-containing media than in ordinary media, Therefore, a small number of patients with biliary system diseases such as cholelithiasis or chronic cholecystitis can excrete bacteria for life (pair D). Typical typhoid fever patients shed the largest amount of bacteria during the 2nd to 4th week of the illness (E pair).

). The transmission route of typhus is human-lice-human, rat-flea-human (E is wrong).

, the clinical features are persistent fever, apathetic expression, relatively slow pulse, roseola, hepatosplenomegaly, and leukopenia.

, the main pathological feature of typhoid fever is the proliferative reaction of the systemic mononuclear-macrophage system (pair B); The basic lesion of typhus is small vessel vasculitis (A is wrong), The distinguishing point from typhoid fever is that the former does not have signs of relatively slow pulse and may have systemic hemorrhagic rash; Pallor and edema of the small intestinal mucosa (C error) are pathological characteristics of cholera. The difference from typhoid fever is that the former has an acute onset, severe diarrhea, often accompanied by vomiting, and severe dehydration symptoms; The main lesions of AIDS are in immune organs such as lymph nodes and thymus (False D). The difference from typhoid fever is that the former does not have signs of hepatosplenomegaly; The intestinal mucosa of acute bacillary dysentery shows diffuse fibrin exudative inflammation (E error). The difference between acute bacillary dysentery and typhoid fever is that the former has an acute onset, obvious abdominal pain and diarrhea, which may be accompanied by tenesmus, and a shorter natural course.

Epidemic hemorrhagic fever, hantavirus, ribavirin Japanese encephalitis, Japanese encephalitis virus, symptomatic Leptospirosis, Leptospira (pomonatran), Penicillin Typhoid fever, Salmonella typhi, quinolones Bacillary dysentery, Shigella, quinolones Cholera, Vibrio cholerae, symptomatic Meningococcus, meningococci, penicillin Malaria, malaria, chloroquine, primaquine, pyrimethamine Schistosomiasis japonicum, schistosomiasis, praziquantel

. Because quinolones can cause fetal malformations and bone development disorders in children, third-generation cephalosporins are often the first choice for pregnant women in children, but not for adult men.

Hemorrhagic rash (P11), also known as petechiae, is more common in infectious diseases such as hemorrhagic fever with renal syndrome, dengue fever, and epidemic cerebrospinal meningitis. Typhoid fever (A is wrong, is the correct answer to this question) Roseola is mostly a congestive rash that can fade away under pressure, typhus (B pair), epidemic cerebrospinal meningitis (C pair), measles (D pair), septicemia (E Yes) and several other later stages are hemorrhagic rashes that do not fade.

Single for 38 years, single-core 3% to 8% Middle-aged without a wife, 50% to 70% neutrophils Death from gonorrhea, lymphocytes 20% to 40% The event is strange, 0 to 1% of basophils Miscalculation, eosinophils 0.5% to 5%

The clinical manifestations of typhoid fever are divided into initial stage, extreme stage, remission stage and recovery stage. Characteristic clinical manifestations of typhoid fever appear in the extreme stage (B pair): persistent fever, symptoms of nervous system poisoning, relatively slow pulse, roseola, digestive system symptoms, and hepatosplenomegaly; In the early stage (A is wrong), the earliest symptom is fever; Typhoid fever does not have a high fever period (C wrong); During the remission period (D error), the body temperature gradually drops, and neurological and digestive system symptoms are relieved. However, because the pathological changes in the small intestine are still in the ulcer stage, complications such as intestinal bleeding and intestinal perforation may also occur. ; Recovery period (E error): body temperature normalizes, neurological and digestive system symptoms disappear, liver and spleen return to normal

5-40U/L

Ecchymoses are hemorrhagic, meningococcal meningitis

In the extreme stage of typhoid fever, small bleeding spots may appear on the skin instead of ecchymosis (D is wrong, which is the correct answer to this question).

Intestinal bleeding and perforation are prone to occur during the remission period of typhoid fever

Strengthening nutrition (wrong A), increasing activity (wrong B), continuing to use sufficient antibiotics (wrong D), and getting enough sleep (wrong E) are general supportive treatments and do not require special attention.

During the remission period (D error), the body temperature gradually drops, and neurological and digestive system symptoms are relieved. However, because the pathological changes in the small intestine are still in the ulcer stage, complications such as intestinal bleeding and intestinal perforation may also occur.

, the main pathological feature of typhoid fever is the proliferative reaction of the systemic mononuclear-macrophage system (

The culture of Salmonella typhi is the "gold standard" for the diagnosis of typhoid fever. The preferred tests are blood culture (B right) and bone marrow culture (E wrong) for those who have been treated with antibacterial drugs, especially those with negative blood culture. It can also be understood that in the early stage, blood culture is the main method, and in the later stage, bone marrow culture can be considered, which will help to increase the positive rate ratio. Urine culture (False A) and stool culture (False D) can be used as auxiliary diagnosis.

Typhoid: Rekindle: Rekindle from the ashes Relapse: from scratch to something

The bleeding and perforation type should refer to the Xiaoyao type, but there is no such name. The Xiaoyao type means that the symptoms are not obvious and the perforation is discovered only after the perforation.

light violence and leisure

The culture of Salmonella typhi is the "gold standard" for the diagnosis of typhoid fever. The preferred tests are blood culture (B right) and bone marrow culture (E wrong) for those who have been treated with antibacterial drugs, especially those with negative blood culture.

Typical typhoid fever patients shed the largest amount of bacteria during the 2nd to 4th week of the illness (E pair).

Typhoid fever test, 12 blood, 34 stool, 45 fat

Intestinal bleeding is the most common and intestinal perforation is the most serious The number of bleeding layers is small and easy to occur Perforated in many layers, serious

Typhoid fever test, 12 blood, 34 stool, 45 fat

12 blood 23Complications 34 poop 45 fat 24 row bacteria are highly contagious

), the perforation site mostly occurs in the terminal ileum, and is more common in adults than in children (

). Perforation can occur within a few days after the pathogen is treated and the patient's condition improves significantly, but not within a few days when the condition worsens (

If you ask when it usually occurs, it is 2-3w because the virus is most toxic at this time. But it is also likely to happen during the remission period, when the body temperature drops, but the intestines are still relatively weak, and perforation occurs after eating something hard.

Vi antibodies persist and have certain significance in the investigation of chronic carriers H antibody alone is not significant if elevated O antibodies can only be judged as Salmonella infection, which is of little significance in the investigation of chronic carriers.

Are o-antibodies and h-antibodies used for diagnosis

If vi can diagnose, why did Feida check for OH?

, H antibody titer exceeds the normal value, and O antibody titer is normal, which may be due to vaccination with typhoid fever vaccine or recall reaction of vaccination (BC error); The O antibody titer exceeds the normal value, and the H antibody titer is normal. It may be early stage of typhoid fever or other salmonella infections (AD error);

Average height: very likely typhoid fever Neither is high: it is very unlikely to be typhoid fever Ho: Vaccine or recall reaction Oh: early typhoid or other salmonella

Blood culture and bone marrow culture diagnosis, hypertrophy aid

Neostigmine Pharmacology Anticholinesterase

Quinolones (Pair A) are the first choice for the treatment of multidrug-resistant typhoid pathogens. Chloramphenicol (D error), cephalosporins (C error), amoxicillin (E error) and trimethoprim-sulfamethoxazole (B error) are only used for the treatment of sensitive strains.

A "Easy to win, not easy to die"

Symptoms of systemic poisoning of typhoid fever are severe, with lingering fever and mild gastrointestinal symptoms, but intestinal perforation and intestinal bleeding are prone to occur, and the recurrence rate is low. Paratyphoid A and B have mild systemic poisoning symptoms, common flaccid fever, and severe gastrointestinal symptoms, but are less prone to intestinal perforation and intestinal bleeding, and have a higher recurrence rate.

To expand, so Proteus food poisoning can cause allergic reactions such as facial flushing, headaches and urticaria.

Escherichia coli type O157-acute hemorrhagic colitis Shigella - bacillary dysentery Salmonella enterica serovar Typhi - Typhoid fever. Enterovirus 70-acute hemorrhagic conjunctivitis Rotavirus Group A - Rotavirus diarrhea in infants and young children

Diarrhea caused by bacillary dysentery is invasive diarrhea (pair A). Diarrhea caused by cholera is secretory diarrhea (False B). The characteristic lesions of intestinal amoeba are jam-like stools

, for severe infectious diseases that require compulsory management, such as plague and cholera, they are required to be reported through the infectious disease epidemic monitoring information system within 2 hours of discovery. Now there is a new regulation of 2 hours for Category A and 24 hours for Category B and C. 2h reporting: cholera, plague, pulmonary anthrax, SARS, new coronavirus pneumonia

Now there is a new regulation of 2 hours for Category A and 24 hours for Category B and C. Information is now developed, regardless of urban or rural areas! This kind of question can be deleted!

O1: Classical type and Elto type Non-O1, non-agglutinating Vibrio Atypical O1 (not pathogenic)

Because Salmonella typhi grows better in bile-containing media than in ordinary media, Therefore, a small number of patients with biliary system diseases such as cholelithiasis or chronic cholecystitis can excrete bacteria for life (pair D).

The most suitable medium for the growth of Vibrio cholerae is alkaline peptone water (

Vibrio cholerae is Gram-negative (wrong A), has a flagellum at the end, and is extremely active (right B).

) & "Water sources and food contaminated by Vibrio cholerae (pair B) can cause cholera outbreaks."

Because cholera causes dehydration due to diarrhea and vomiting, less bile is concentrated and excreted, and then the stool loses color.

Rice swill means lack of bile

The cholera fox bacterium does not enter the blood Blood culture is meaningless

Serum agglutination test (B pair) is used to detect anti-agglutination antibodies in antibacterial antibodies. It usually appears on the 5th day of illness and is helpful for diagnosis. However, it is not suitable for rapid diagnosis of patients with this problem and is mainly used for epidemiology. Retrospective diagnosis and diagnosis of suspicious patients with negative stool cultures. defecate

Leptospirosis is gastrocnemius tenderness

Cholera is gastrocnemius spasm

non-invasive enteritis

Diarrhea caused by bacillary dysentery is invasive diarrhea (pair A). Diarrhea caused by cholera is secretory diarrhea (False B)

Cholera: The stool changes from muddy or watery with fecal matter and mucus, to watery stool like rice swill or watery stool after washing meat. Bacillary dysentery: pus, blood and mucus

No tenesmus or fishy smell

Bacillary dysentery with tenesmus

Vibrio cholerae can move, shuttle-like movement

Mainly affects the small intestine

: Painless severe diarrhea (A

, hypokalemia can cause hypotonia, loss of tendon reflexes, tympanic bowel, and even arrhythmia.

) & "Due to vomiting and diarrhea, a large amount of sodium salt (B pair) is lost, and low sodium can cause spasm of the gastrocnemius and rectus abdominis muscles.

(I came back after taking the infectious disease exam...) After thinking about it, is it possible that low sodium causes cell edema, relatively high potassium outside the cells, and the absolute value of high potassium resting potential decreases, increasing the excitability of smooth muscle cells? I don’t know if it’s right or not

Typhoid fever, right lower quadrant pain and diarrhea Cholera rectus abdominis spasm Bacillary dysentery, left lower quadrant pain and diarrhea

Cholera parasitizes in the human small intestine, and the optimal growth temperature must be the human core temperature

Diarrhea less than 10 times, normal blood pressure, mild condition Moderate cholera has diarrhea 10 to 20 times and blood pressure is 70-90 mmHg. Severe cholera diarrhea more than 20 times, blood pressure <70mmHg No diarrhea and blood pressure <70mmHg is dry cholera No diarrhea, normal blood pressure, considered a carrier or normal person

Four absences: no fever, no tenesmus, no abdominal pain, and no fecal odor.

During the recovery period, toxins may enter the blood and cause fever.

Bile is typhoid

First choice: fecal smear motility test Confirmed: Vibrio cholerae, stool culture

The main causes of death from cholera are circulatory failure and renal failure

. Pay attention to potassium supplementation in urine (

Adjuvant treatment: antibacterial, quinolone-floxacin

The purpose of antibacterial treatment (Pair A) is to shorten the course of the disease, reduce the frequency of diarrhea and quickly eliminate pathogenic bacteria in the feces

, respectively within 24 hours for light, medium and heavy rehydration patients. 3000～4000, 4000～8000, 8000～12000mL (

b is not distributed, water is popular, food is distributed

Mild: Mild poisoning symptoms throughout the body Ordinary type: thick mucus and blood in the stool, tenesmus, severe fever Heavy: Shock Poisoning type: coma, neurological symptoms

Macrophages (phagocytic cells) in stool: bacillary dysentery

Infectious disease book 184: Stool routine, if there are macrophages, it is helpful for diagnosis.

Atypical loose stools Typical bloody and purulent stool Toxic type circulatory or respiratory failure

Quinolones are the first choice for the original treatment of bacillary dysentery, but these drugs are contraindicated under the age of 18 because they affect cartilage development, so the second-line drug recommended by WHO - ceftriaxone

Visible mottling on the skin (a sign of septic shock),

Our country is a developing country, and it is the The developed countries belong to the Song Dynasty, because we were developed countries during the Song Dynasty

Cholera dehydration shock Hemorrhagic fever with renal syndrome and plasma loss shock Bacillary dysentery infection toxic shock

The feces of Crohn's disease (8th edition of Internal Medicine P391) (False D) are mostly mushy, generally without pus, blood and mucus.

I remember our infectious disease teacher said about a case where a doctor’s child loved to come to the hospital to play. One morning, I came with a fever. After playing for only two hours, the child gave up. He fell to the ground and convulsed. After the convulsions, his condition became worse. Many teachers were invited to come for consultation, and they considered purulent meningitis, tuberculous meningitis, etc. Finally, one teacher said that the central nervous system showed signs of fever only two or three hours later. The disease progressed so quickly, and dysentery should be considered. In the end, he was treated as dysentery, and the diagnosis was correct.

Toxic bacillary dysentery—stool culture

Typhoid ileum, cholera small intestine

Typhoid fever, right lower quadrant pain and diarrhea Cholera rectus abdominis spasm Bacillary dysentery, left lower quadrant pain and diarrhea

The typical pathological process of acute bacillary dysentery is initial acute catarrhal inflammation, followed by characteristic pseudomembranous inflammation and ulceration, and finally healing. The basic pathological change of the intestinal mucosa is diffuse fibrin exudative inflammation."

Toxic bacillary dysentery is more common in children aged 2 to 7 years old, and occasionally occurs in adults.

Bacillary dysentery: mucus, pus and bloody stools Cholera: Rice-like watery stools Amoebic dysentery: jam-like stool Bacterial food poisoning: watery stool, fishy smell

There are four types of acute dysentery: Ordinary type (typical), mucus, pus and bloody stool Mild (atypical), with mucus but no pus and blood Heavy, frail elderly Toxic bacillary dysentery, healthy children aged 2-7 years old Chronic, more than two months

The main pathological feature of typhoid fever is the proliferative reaction of the systemic mononuclear-macrophage system (B

Includes cephalosporins (cephalosporins) (

People are just here to fix you, no matter whether you are perfect or not

Even if the mucosal structure is intact, the disease will occur! So it doesn't affect

Let me tell you, toxic bacillary dysentery is divided into shock type and cerebral type. Shock type septic shock does not have meningeal irritation, only cerebral type does.

Poisoning type Shock type (peripheral circulatory failure) Cerebral type (respiratory failure) Mixed type (the above two types)

The clinical symptoms are mainly severe toxemia, shock (low blood pressure) and/or toxic encephalopathy, while local intestinal symptoms are mild or absent (abdominal pain, mild tenesmus or none)

Cerebral type: convulsions, coma, central respiratory failure Shock type: circulatory failure Cerebral type is more severe and the mortality rate is high

Shock type→expansion anti-shock Cerebral type → diuresis and lowering intracranial pressure

Bacillary dysentery: left lower abdominal pain, tenesmus, mucus, pus and bloody stools, and a large number of white blood cells in the stool. Amoebic dysentery: right lower abdominal pain, no tenesmus, jam-like stool, and a small amount of white blood cells in the stool.

), colonic amebic trophozoites were found (possibly combined with amebic infection),

This reminds me that Salmonella typhi causes bacteremia, and blood culture is included in the diagnosis.

Bacillary dysentery and cholera do not enter the blood and are confirmed by stool examination

) & "Sequelae are mainly neurological sequelae (right A), which can produce symptoms such as deafness (right B), aphasia (right C), and limb paralysis (right D is true and E is wrong, which is the correct answer to this question)."

Low urine means toxic shock

Toxic dysentery is divided into shock type and cerebral type

The common type (typical) (A wrong) has an acute onset, with chills and fever, and the body temperature can reach above 39°C, accompanied by headache, fatigue, loss of appetite, abdominal pain, diarrhea, and often watery stools first." (P184) & "Shock type (B error) (peripheral circulatory failure type): relatively common, with septic shock as the main manifestation. Symptoms include pale complexion, cold limbs, mottling on the skin, cyanosis, accelerated heart rate, and thin pulse The speed cannot even be touched, and the blood pressure gradually drops." (

Acute within 2 weeks, chronic over 2 months.

Some carriers are asymptomatic and it is impossible to control the source of infection

[Prevention] Take comprehensive preventive measures focusing on cutting off the transmission route (C pair)

Neisseria meningitidis (also known as meningococci) belongs to the genus Neisseria. Gram stain is negative (C is right). This bacterium is resistant to dryness, damp heat (D is wrong, the correct answer to this question), cold, sunlight, ultraviolet rays and general Disinfectants are all extremely sensitive and can easily autolyze in vitro (pair B) and cause death. The endotoxin (A pair) released by bacteria is an important factor in the pathogenesis of this disease and is sensitive to general antibiotics (E pair).

The specific antigen of Neisseria meningitidis is not mainly located on the cell membrane (False B). There have been many national pandemics in our country, and the prevalent strains are mainly group A (D is wrong).

Capsular polysaccharide antigen

D Salmonella - typhoid fever B. flexneri - bacillary dysentery A——Meningococcal disease

Japanese encephalitis: It is more common in children under 10 years old, especially in those between 2 and 6 years old. Meningococcal meningitis: It is more common in children under 5 years old, especially between 6 months and 2 years old.

Meningitis and Japanese encephalitis are both common in latent infections, but meningitis is mainly transmitted through the respiratory tract, so carriers spread it more, while Japanese encephalitis is transmitted through mosquitoes.

The first choice for meningococcal meningococcal disease is omeline, which requires a large dose to create a meningeal barrier.

Typhoid fever, Salmonella typhi, quinolones Bacillary dysentery, Shigella, quinolones Cholera, Vibrio cholerae, symptomatic Meningococcus, meningococci, penicillin

Meningococci are extremely sensitive to dryness, heat and humidity, cold, sunlight, ultraviolet rays and general disinfectants, and can easily autolyze and die outside the body (B is wrong, which is the correct answer to this question). Among the common bacterial groups of meningococci, group C is the most pathogenic, group B is the second most pathogenic, and group A is the weakest (pair A). Chocolate blood agar plates (pair C) are generally used to culture meningococci. The resistance to sulfa drugs is severe in groups C and B, and the resistance base of group A is also increasing (pair E).

The causative agent of meningococcal meningococcal meningitis is Neisseria meningitidis, a gram-negative diplococcus (pair B). Additional common test points: The causative agents of typhoid, cholera, and plague are Gram-negative bacteria; The causative agent of tetanus is a Gram-positive bacillus.

70%-90% (E is wrong, the correct answer to this question) of meningococcal patients have petechiae on the skin and mucous membranes all over the body (right B), which appear bright red at first, rapidly increase and expand, and are common on the limbs, soft palate, conjunctiva, buttocks, etc. parts, In severe cases, the hemorrhagic rash (Pair A) can expand rapidly, with purple-black necrosis or blister in the center (Pair C). Patients may develop cold sores during the recovery period

The main lesion in the sepsis stage is vascular endothelial damage In the meningitis stage, the lesions are mainly the leptomeninges and arachnoids The main lesion in fulminant type is the brain parenchyma

The main lesions in the meningitis stage are in the leptomeninges and arachnoid mater, manifesting as vascular congestion and hemorrhage, inflammation and edema.

During the period of meningococcal septicemia, vascular endothelial damage, inflammation of the blood vessel wall, necrosis and thrombosis will occur (False A), focal bleeding in the skin and mucous membranes, and widespread bleeding in the lungs, heart, gastrointestinal tract, and adrenal cortex (False B) ). During the meningococcal outbreak, the lesions are mainly brain tissue, with obvious congestion and edema, increased intracranial pressure, and can form cerebral herniation (C error). In the meningitis stage, the main lesions are the leptomeninges and arachnoid mater (D is wrong, so E is the correct answer to this question).

I actually thought Schwarzman and Asics were the same thing.

). Endotoxins cause a systemic Schwarzman reaction (C is wrong, the correct answer to this question), activate complement, significantly increase serum inflammatory mediators, and produce circulatory disorders and shock (D

Arthur's reaction is an experimental localized allergic reaction. It refers to the occurrence of severe inflammatory reactions such as edema, hemorrhage and necrosis at the injection site after multiple injections during the vaccination process, which is a type III hypersensitivity reaction.

Schwartzman reaction: This is a nonspecific cellular immune response. Discovered by Schwarzman in 1928. He injected rabbits with Gram-negative vaccines intradermally. After 24 hours, intravenously inject the same or heterogeneous vaccine into the same animal. A few hours later, redness, swelling, ulcers and other inflammatory reactions will appear at the original intradermal vaccine injection site.

Japanese encephalitis: initial stage, extreme stage, recovery stage, sequelae stage Meningococcal meningitis: prodromal stage, sepsis stage, meningitis stage, recovery stage Renal syndrome hemorrhagic fever: fever phase, shock phase, oliguria phase, polyuria phase, recovery phase

Meningoencephalitis and Japanese encephalitis have no febrile phase, and hemorrhagic fever with renal syndrome has no prodromal phase.

Meningococcal meningitis is a purulent inflammation (mainly exudation of large amounts of neutrophils) Japanese encephalitis is a degenerative inflammation (mainly degeneration and necrosis)

Japanese encephalitis: initial stage, extreme stage, recovery stage, sequelae stage Meningococcal meningitis: prodromal stage, sepsis stage, meningitis stage, recovery stage Renal syndrome hemorrhagic fever: fever phase, shock phase, oliguria phase, polyuria phase, recovery phase

Meningoencephalitis and Japanese encephalitis have no febrile phase, and hemorrhagic fever with renal syndrome has no prodromal phase.

Cholera bacilli have no capsule and are mainly caused by enterotoxins, followed by exotoxins.

Neisseria meningitidis causes disease mostly by releasing endotoxin

Not comatose, so it’s not a meningoencephalitis outbreak.

In the explosive type, it becomes serious within 24 hours. This has been two days.

No symptoms of consciousness disorder or shock, normal type

Conjunctival hyperemia is seen in hemorrhagic fever with renal syndrome

Hemorrhagic fever with renal syndrome: conjunctival edema and congestion

Why can’t we use hypertonic sodium salts for dehydration?

It’s useless even if it’s injected in. The osmotic pressure of crystalloids inside and outside the blood vessels is about the same.

Elevated white blood cells and neutrophils, cerebrospinal fluid like rice soup

Meningococcal meningitis is divided into: mild type, common type, fulminant type, and chronic type. Japanese encephalitis is divided into: light, common, heavy, and fulminant.

), the fulminant type is divided into shock type, meningoencephalitis type and mixed type (B

Complications: Organ parts vary widely across servers The sequelae are still located in the same location, centered on the cerebrospinal membrane.

P209 Hydrocephalus and subdural effusion are sequelae

Complications are all inflammation, and sequelae are other symptoms.

Neutrophils are multinucleated cells

, the number of cells in cerebrospinal fluid is more than 1000×10⁶/L, mainly multinucleated cells.

In patients with fulminant meningococcal meningitis, if the ecchymoses expand rapidly and merge into sheets, DIC should be highly suspected, and heparin anticoagulant therapy should be applied as soon as possible.

Now for group A and C meningococcal polysaccharide vaccine

) & "Genital warts are one of the most common STDs worldwide and are caused by the human papillomavirus." (

p221Twenty to forty p223 Original words "The mortality rate of hospital-acquired sepsis and fungal sepsis is 40% to 80%." There is still a difference in the sense of courtyard

Gram-positive bacterial sepsis, represented by Staphylococcus aureus sepsis, mainly manifests as chills (pair C), high fever (residual fever or flaccid fever) (pair A), rash (pair D), and metastatic abscess (pair B) etc. Coma and septic shock are less common (E is wrong, the correct answer to this question).

Warm shock-gram yang-three high Cold shock-Gram negative-three lows

Almost all bacilli are G-: such as Proteus, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa, but there are three exceptions: anthrax, diphtheria, and tetanus are G- Almost all cocci are G: such as Staphylococcus aureus and Streptococcus, but meningococci and gonorrhea are G-

) & "(2) Acute gonorrhea in women: 60% of women infected with gonorrhea have no symptoms or mild symptoms, and it mostly occurs in the cervix and urethra.

The most common STD in my country is gonorrhea, and the most common in developed countries is chlamydia.

Alternating constipation and diarrhea = intestinal tuberculosis + rectal cancer

Controlling the source of infection is fundamental

When the pathogenic bacteria are unknown, broad-spectrum antibiotics that can cover common pathogenic bacteria should be used, with ampicillin being the first choice.

The identification of diarrhea should be based on the frequency of diarrhea, Dehydration identification is the peripheral circulation state. I've done similar questions.

History of extensive antibiotic use for Staphylococcus aureus and fungi

Childhood sweetheart, death is imminent

Penicillin, syphilis, gonorrhea

It definitely can’t be cholera. I haven’t eaten out. It’s not poisoning or tenesmus. It’s just ordinary diarrhea. It’s enteritis.

Bacillary dysentery is mucus, pus and bloody stool, not watery. This brain

) & "Carriers or patients are the only source of infection for typhoid fever (pair A). Carriers have the following situations: ① carriers during the incubation period, that is, typhoid patients have excreted bacteria from their feces during the incubation period (pair B); ② temporary carriers , that is, those who still shed bacteria during the recovery period but stop within 3 months (D pair); ③ chronic carriers, that is, those who shed bacteria for more than 3 months during the recovery period (E pair)... Typical typhoid fever patients shed bacteria within 2-4 weeks of the disease The amount of bacteria is the largest, with billions of bacteria per gram of feces, and it is highly contagious (pair C)."

Typhoid fever rash manifests as roseola, and about half of the patients will develop small light red maculopapular rashes, called roseola, within 7-14 days of the disease (A pair). Diameter 2-4mm (Pair B), fades when pressed, mostly less than 10, mainly distributed on the chest, abdomen (Pair D), shoulders and back, rare on the limbs, usually fades and disappears within 2-4 days (Pair E) , can appear in batches (pair C). Sometimes it can become a small bleeding point that does not fade under pressure.

light violence and leisure

Clinical manifestations: typical other types Other types include mild, fulminant, protracted, and casual

The clinical manifestations of typhoid fever are divided into initial stage, extreme stage, remission stage and recovery stage.

Vibrio cholerae group O1 is the main pathogenic bacteria of cholera and can be divided into classical biotype (D error) (CVC) and Elto biotype (E error) (EVC). According to three different zero antigen serotypes, it can be divided into: ① Ogawa type (A pair), ② Inaba type (B pair) (prototype), ③ Hikoshima type (C pair) (intermediate type).

Acute pulmonary edema cannot replenish blood volume, and vasoactive drugs are not needed in shock.

The antibacterial drugs used to treat Vibrio cholerae serotype O139 are (AE wrong): ciprofloxacin (B pair), norfloxacin, doxycycline (C pair), compound sulfamethoxazole tablets (SMZco) (D right).

Toxic dysentery is mainly characterized by severe toxemia symptoms, and local intestinal symptoms are very mild or absent. The symptoms of toxemia are mainly endotoxins entering the blood, and the cerebrospinal fluid may not change significantly. My personal understanding, please correct me if there are any mistakes.

First, sepsis. This type of sepsis is mostly caused by Shigella flexneri, a species of Shigella. It is characterized by persistent high fever, abdominal pain, diarrhea, nausea, and vomiting. The stool is mucus-watery or mucus-purulent and bloody, and may be accompanied by disturbance of consciousness. , rash, etc. Severe patients may develop sepsis, septic shock, renal failure, and even death of the child. Second, hemolytic uremic syndrome. It is mostly caused by Shigella dysenteriae and manifests as hemolytic anemia, disseminated intravascular coagulation (DIC), and some cases are accompanied by renal failure. Third, arthritis. This complication is less common and usually occurs in the acute or recovery phase of bacillary dysentery. It manifests as exudative arthritis of large joints and local swelling and pain. The effect of hormone therapy on this disease is obvious. Fourth, Reiter syndrome. This complication has a triad of symptoms, manifesting as arthritis, urethritis and conjunctivitis, and may ultimately leave sequelae such as deafness, aphasia, and limb paralysis.

Because most latent infections and purulent meningitis are overt infections, D is wrong. (Are word games fun? Question maker

Mild cases are more common in the late stages of meningococcal epidemics (pair E). The lesions are mild and the clinical manifestations include low-grade fever, mild headache (wrong C) and sore throat and other upper respiratory tract symptoms (pair A). A few bleeding spots can be seen (pair B). Most of the cerebrospinal fluid has no obvious changes (False D). Culture of skin bleeding points and throat swabs may show the growth of Neisseria meningitidis.

Neisseria meningitidis (N. meningitidis) is referred to as meningococci (

(Gram-negative bacteria, Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Neisseria meningitidis, Pseudomonas aeruginosa)