Hygiene of Children and Teenagers

40) Subject and tasks of hygiene of children and teenagers. Laws of growth and development of children. Schemes of age periodization. Problems of acceleration.

41) Physical development of children and teenagers as a criterion of individual health and health of children's contingent as a whole. Methods of research of physical development.

42) Methods of estimation of physical development of children and teenagers. Methods of estimation of harmonicity of physical development.

43) Hygienic requirements to location, layout of site and building of children's preschool institutions. Functional zones of site. A principle of group isolation.

44) Hygienic requirements to a group section in children's preschool institutions. Standards of layout, microclimate, illumination in a game room.

45) Hygienic requirements to toys in children's preschool institutions.

46) Principles of hardening and physical training of children. The control of adequacy of physical load. The basic reasons, manifestations and prevention of hypodynamia and hyperkinesias.

47) Hygienic requirements to a daily regimen of preschool age children and pupils. Ways of adaptation to training at school. Requirements to school time-table.

48) Medical-professional consultation at school, its tasks and organization at school and polyclinic. Health groups of children and basic groups of occupations.

49) Hygienic requirements to location of schools and school site. Zones of site. Characteristics of school construction systems. Layout of school building.

50) Hygienic requirements to layout, microclimate, illumination of classrooms and studies at school. Advantages and disadvantages of study system of education.

51) Hygienic requirements to school furniture, basic parameters and norms. Methods of selection and marking of school furniture, requirement to placement of desks in classrooms.

52) Features of nutrition hygiene of children and teenagers. The reasons of difference from nutrition of adult people.

 

Hygiene of Hot Climate

53) Types of climate in hot countries and its influence on person. Features of tropical climate. Features of desert climate.

54) Influence of climate of hot countries on organism thermoregulation (on processes of heat production).

55) Influence of climate of hot countries on organism thermoregulation (on processes of heat emission).

56) Acclimatization of organism to conditions of hot climate. Prevention of adverse manifestations of acclimatization to conditions of hot climate.

57) Types of disturbances of organism thermoregulation in conditions of hot climate, their reasons and pathogenesis.

58) Influence of hot climate on water metabolism. Drinking illness, symptoms, prevention. Dehydration of organism in conditions of hot climate, its reasons and prevention.

59) Alimentary diseases in conditions of hot climate (kvashiorcor, spru), their reasons, symptoms and prevention.

60) Food poisonings of a microbe etiology in hot climate. Influence of hot climate on occurrence of food poisonings of a microbe etiology. Prevention.

61) Food poisonings of non-microbe etiology, characteristic of conditions of hot climate (heliotropic toxicosis, aflotoxicosis).

62) Hygiene of work in conditions of hot climate. Influence of hot climate on occurrence of occupational poisonings and their prevention.

63) Methods of improvement of microclimatic factors in manufacture under conditions of hot climate and control of their efficiency.

64) Epidemic significance of water in conditions of hot climate, signs of water epidemics.

65) Control of epidemic safety of water in conditions of hot climate.

66) Hygienic requirements to inhabited premises in conditions of hot climate.

 

An Example of  Test

1. A patient with a body overweight visited the doctor. The patient's diet contained a lot of bread products, cream products, pork, cheese, cottage cheese, carrot, cabbage, fruit. The endocrine disorders in the patient are absent. Give recommendations as to correction of his diet.

А. To restrict protein products (cheese, cottage cheese) in the diet

*В. To restrict carbohydrates and fat products (bread, cream, pork)

С. To restrict the use of vegetables

D. To restrict the use of fruit

Е. To include macaroni products in a ration

2. In a 55-year-old patient the expressed atherosclerosis is revealed. From his words, he prefers fatty and sweet food: fatty meat, sugar, candies. What is the role of meal in this disease?

А. Etiological

*В. A risk factor

С. Pathogenesis

D. Factor of transmission

Е. Secondary

3. A patient came to the doctor with complaints of stomatorrhagia, nasal bleedings, swelling of lower extremities. Objectively: the reduced resistance of capillaries, hypochromic anemia in the blood. The diet of this patient includes bread, meat canned food, concentrates from various cereals. What are your recommendations on prophylaxis of similar diseases?

*А. Satisfaction of physiological requirements in vitamin C

В. Inclusion of products, rich in vitamin В1 in a diet

С. Enrichment of ration with vitamin РР

D. Usage of fish fat

Е. UV irradiation

4. The patient complains of increased fatigability and worsening of vision. On examination the signs of vitamin insufficiency are detected: adipose seborrhea near nostrils, in nasolabial folds, in the area of forehead and ears; anguiitis and pericorneal dilation of vessels. These manifestations are most probably associated with

А. polyhypovitaminosis.

В. В6–hypovitaminosis.

С. РР–hypovitaminosis.

D. В1–hypovitaminosis.

*Е. В2-hypovitaminosis.

5. A 25-year-old suckling woman’s diet contains 1,000 mg of calcium, 1,300 mg of phosphorus and 20 mg of iron lactate per day. How should the content of mineral substances in her diet be modified?

*А. To increase the content of phosphorus

B. To reduce the content of calcium

С. To increase the content of calcium       

D. To decrease the content of phosphorus

Е. To increase the content of iron lactate

6. A high level of cardiovascular pathology is registered in children and women of fertile age in the region during many years. There are the following clinical signs: asthenovegetative syndrome, extrasystole, disorder of atrioventricular conductivity, diffuse-sclerotic, metabolic disorders and hypertrophy of myocardium, increasing activity of blood glutationperoxidase and gastric acidity. What microelement deficiency in foodstuff caused this disease?

*А. Selenium

В. Manganese

С. Copper

D. Zinc

Е. Cobalt

7. A 35-year-old patient has acute hepatitis in the phase of recovery with disorder of hepatic function and bile ducts without accompanying diseases of stomach and intestine. To normalize the functions of the liver and bile ducts, cholesterol and fat metabolism the diet should be enriched with

А. protein.

B. extractives.

C. fat.

*D. lipotropic substances.

Е. carbohydrates.

8. An 8-month child has mental and physical developmental retardation. What amino acid is necessary to eliminate from the child’s diet?

А. Tyrosine

B. Leucine

C. Tryptophan

*D. Phenylalanine

Е. Histidine

9. A 32-year-old woman with the complaints of menstrual cycle disorders, frequent diarrhea, edema around the eyes visited the doctor. OD: pale skin, hypochromic anemia, reticulocytosis. The woman said that she followed the vegetarian diet. These clinical manifestations are associated with deficiency of

*A. copper.

B. iron.

C. manganese.

D. magnesium.

E. iodine.

10. A daily ration of a 29-year-old doctor-surgeon contains 90 g of proteins (including 39 g of animal origin), 101 g of fats, 412 g of carbohydrates. The daily caloricity is 3,000 kcаl. Give recommendation as for modifying the diet?

*A. To increase the content of animal proteins

B. To increase a calory content of the ration

C. To increase the content of carbohydrates

D. To increase the content of proteins

E. To decrease the content of fats

11. In autumn 20 schoolchildren of a village school were poisoned with food. The poisoning was characterized by subfebrile temperature, nausea, vomiting, colic pains (spasms) in the abdomen. These manifestations occurred in 1-3 hours after breakfast (pancakes with sour cream). The cause of the disease became home-made sour cream bought at a rural inhabitant. What microorganism could have become the reason of the disease?

*А. Staphylococcus

В. Streptococcus

С. Bacterium of a Proteus type

D. Pathogenic strains of E. Coli

Е. Cl. perfringens

12. On investigation of alimentary poisoning the diagnosis of poisoning with amanita palloides (toadstools) was established. What toxicant contained in mushroom could have become the reason of poisoning?

А. Gelvelic acid

*В. Amanitotoxin

С. Girometrin

D. Solanine

Е. Fasin

13. Among the pupils of a boarding-school the case of common alimentary poisoning was detected. According to epidemiological anamnesis, the reason was the use of cakes with cream. These cakes were stored at the nutrition unit with the disturbed temperature regimen. Which of the enumerated methods is the most effective in prophylaxis of staphylococcal toxicosis?

А. Elimination of staphylococcal carrier among the workers of the nutrition unit

В. Elimination of staphylococcal carrier among animals

*С. Prevention of staphylococcal reproduction in foodstuffs and production of toxin

D. Exclusion of foodstuff contamination by staphylococci

Е. Following the methods of thermal processing of foods

14. The onset of disease in the kindergarten was sudden, 2-3 hours after the consumption of curds, not subjected to heat processing. All had abundant multiple vomiting, abdominal pain, liquid stool, paleness of skin, some of them had a slight fever (up to 37˚C). The clinical manifestations were controlled within a day. What is the most probable diagnosis?

А. Poisoning with salts of heavy metals

В. Bacterial toxicosis

С. Acute intestinal infection

D. Mycotoxicosis

*Е. Alimentary toxinfection

Municipal Hygiene

1. The research of water taken from the mine well is carried out. The following is found out: transparence–18 cm, color–15°, smell –3 points, hardness–12 mg/equivalent, oxidability – 4 mg/l, the content of nitrogen – 0.2 mg/l, nitrogen oxide – 0.05 mg/l, sodium chloride – 80 mg/l, coli titer – 80, coli index – 12. Give hygienic estimate of drinking water quality.

A. Water does not meet hygienic requirements

B. Water meets hygienic requirements

C. Water does not meet hygienic requirements, it needs purification

*D. Water does not meet hygienic requirements, it needs disinfection

E. Water does not meet hygienic requirements, it needs deactivation

2. Before removing sewage of infectious hospital into a city sewer net, it is cleaned and disinfected on local construction including a lattice, airtank, sand collector, contact tank, dehelmintizator. Which of the following is used for biological purification of sewage?

A. Dehelmintizator

B. S and collector

C. Contact tank

D. Lattice

*E. Airtank

3. In the inhabitants of settlement A., situated in 3 climatic zones, there is a mass affection of teeth with fluorosis. At what concentration of F-ion in drinking water can fluorosis occur?

*B. 1.5

С. 1.0

D. 0.3

E. 0.1

4. Diseases of children with methemoglobinemia are registered in the baby's house. On examination it has been revealed that those children’s alimentary admixtures are diluted with drinking water. Identify chemical substance which excess in drinking water can cause this disease?

A. Chloride

B. Sulfate

*C. Nitrate

D. Lead

E. Mercury

5. On hygienic estimation of conditions of garbage dump in a reservoir of 1st category of water use it has been determined that conditions of dump do not correspond to hygienic requirements for biological consumption of oxygen (BCO). What standard of BCO of reservoir water quality was used in that case?

*A. No more than 3 mg of О2/dm3

B. No more than 2 mg of О2/dm3

C. No more than 4 mg of О2/dm3

D. No more than 5 mg of О2/dm3

E. No more than 6 mg of О2/dm3

6. The typhoid epidemic of water origin is registered in settlement NN. Which of the following is not characteristic of the given epidemic?

A. An epidemic tail (loop)

B. A sharp rise of disease curve

*C. A three-phase character of disease curve

D. A falling level of disease after liquidation of waterpipe failure

E. The contingent of fallen ill population lives in one microdistrict

7. A man, aged 28, a citizen of Kiev, has the diagnosis of "chronic gastritis with reduced secretory and acidogenetic function of the stomach with frequent aggravations, the phase of remission”. He receives the necessary therapy at aggravations, follows a diet. Suggest the most expedient gastroenterological sanatorium with mineral waters.

A. Sanatorium in Mirgorod

*B. Sanatorium in Essentuky

C. Sanatorium in Druskeeninkai (Baltic)

D. Sanatorium in Staraya Russa

E. All above mentioned

8. On laboratory analysis of potable water from an artesian borehole it is established that the transparency makes up 50 cm; chromaticity –200; turbidity–0.5 mg/l; smell and smack–1 point; general water hardness–12.5 mg/l; fluorine–1.5 mg/l; oxidability–0.7 mg/l; coli titer –500 mg/l; coli index –2; microbic number–10. Which method of purification is necessary for improvement of potable water quality?

A. Disinfection

B. Deodorization

C. Defluorization

*D. Softening

E. Purification

9. The settlement receives potable water from an artesian borehole. The water has passed a full work cycle of water preparation. Results of potable water analysis are: transparency – 30 cm, chromaticity – 20, smell – 1 point, dry residue – 1,000 mg/dm3, dry residue – 5.5 mg/dm3, nitrates – 20 mg/dm3, fluorine – 4.0 mg/dm3, coli titer – 300 ml, microbic number – 100. Identify the disease which incidence will be influenced by the use of this water?

A. Urolithic illness

*B. Fluorosis

C. Chronic gastritis

D. Water-nitrogen mеthemoglobinemia

E. Iron-deficiency anemia

10. The investigation of potable water quality in city A. is carried out. It has been determined that organoleptic parameters are lower than properties of water, hardness does not exceed the norm, and nitrates and coli titer are higher than the norms specified in State Standard "Drinking Water". What can the use of this water cause?

A. Urolithiasis

B. Infectious disease of intestinal group

C. Cholelithiasis

*D. Меthemoglobinemia       

E. It is unpleasant to drink

11. In a hospital ward sized 5 х 3.5 m2 there are two windows. The aeration of the ward is carried out by repeated opening of window leaves within a day. The estimation of carbon dioxide content is carried out by the passing of air through Petry's absorber with an alkaline solution. Identify the allowable content of carbon dioxide in the ward air (in %).

A. 0.04

*B. 0.1

C. 0.01

D. 0.15

E. 0.20

12. At estimation of effect of atmospheric air quality on health of population a degree of danger of atmospheric air impurity is taken into account. At what degree of atmospheric air pollution is it possible to expect the increase of incidence of specific and nonspecific deseases, acute poisoning, death rate?

A. Slightly dangerous

B. Moderately dangerous

C. Dangerous

*D. Very dangerous

E. Rather dangerous

13. For disinfection of air in operating room a source of ultraviolet radiation is planned to be used. To establish the necessary regimen of irradiation, 5 regimens have been tested. The estimation of efficiency of air disinfection has been carried out with the help of Krotov's device. The efficiency of sanitation (in %) has been designed. Identify the optimal dose.

A. 55 %

B. 85 %

C. 75 %

D. 65 %

*E. 95 %

14. At laboratory research of air in settlement M. it has been found out that concentration of some chemical substances exceeds the maximum permissible concentration by 5 times. What changes are expected in a health state of population?

A. Changes of some functional parameters

B. Specific and nonspecific mobidity

*C. Expressed physiological disturbances

D. Acute poisonings

E. Lethal poisonings

15. At laboratory research of the air environment quality of a ward it has been established in summer that bacterial contamination makes up 4 cells/m3, hemolytic streptococcus – 25 colonies per 1 m3, content of carbon dioxide – 0.1 %. Estimate the degree of air clearness.

A. Very clear

B. Clear

C. Polluted

*D. Satisfactorily clear

E. Very polluted

16. Patient with thyrotoxicosis is in a 2-bed hospital ward of therapeutic department. The area of the ward is 18 m2, its height – 3 m, ventilation rate – 2.5/h. Air temperature is 20˚С, relative humidity – 45%, air movement speed – 0.3 m/sec, light coefficient – 1/5, noise level – 30 dB. Make hygienic assessment of the conditions.

*A. discomfortable microclimate

B. non-effective ventilation

C. poor lighting

D. a high level of noise

E. all conditions are comfortable

17. By order of the doctor the nurse has taken measurements necessary for estimation of microclimatic conditions of the ward of therapeutic department. The results of measurements are the following: the average temperature of air makes up 20°С, air movement speed – 0.02 m/sec, relative humidity of air – 58 %. Make hygienic assessment of the ward microclimate.

A. Discomfortable microclimate of a heating type

B. Discomfortable microclimate of a cooling type

*C. Microclimate is comfortable

D. Microclimate is discomfortable due to increased humidity of air

E. Microclimate is discomfortable due to increased air movement

18. In the departments of infectious hospital the instrumental control over the general work of ventilation system and keeping the optimal parameters of microclimate is planned. The following devices are prepared for this purpose: Krotov's device, anemometer, thermograph, catathermometer, Assman's aspirational psychrometer. Which of the listed devices are intended for measuring air movement speed in hospital premises?

A. Assman's aspirational psychrometer

B. Anemometer

*C. Catathermometer

D. Krotov's device

E. Thermograph

19. The doctor-cardiologist in Chernigov has received the urgent report of weather forecast: "Due to chromospheric flash on the Sun a great magnetic storm is expected". Give recommendation as for changes in treatment of patients with chronic ischemic heart disease in the hospital.

A. To continue the treatment administered before

B. To administer hypotensive preparations

C. To administer bed regimen

*D. To strengthen spasmolytic and anticoagulant therapy

E. To cancel serious medical-diagnostic procedures administered the day before

20. In a classroom sized 6 х 10 m2 six light points are fixed, equipped with filament lamps having capacity 150 W each. The illumination intensity on workplaces ranges within the limits of 70 – 80 lux. Make the hygienic estimate of artificial illumination in the classroom.

A. Artificial illumination of the classroom is uniform and sufficient: illumination intensity on workplaces is low.

B. Artificial illumination of the classroom is uniform: illumination intensity on workplaces is low.

C. Artificial illumination of the classroom is non-uniform, but sufficient: illumination intensity on workplaces is sufficient.

D. Artificial illumination of the classroom is uniform and sufficient: illumination intensity on workplaces is sufficient.

*E. Artificial illumination of the classroom is non-uniform and insufficient: illumination intensity on workplaces is low.

Hygiene of Work

1. In a thermal shop of a machine-building factory the excess of obvious heat makes up 81 kkal/m3 per year. The air temperature changes from 25°C up to 30° C (normal–18–20° C), heat emission — up to 1800 kkal/m2 a year, relative humidity –40–60 % (normal –40–60 %), speed of air movement–0.5–0.7 m/sec (normal–0.2 m/sec). Which of the above factors can cause an eye disease such as cataract?

А. Speed of air movement

В. Convection warmth

С. Air temperature

D. Relative humidity of air

*Е. Heat emission

2. An electric welder of a mechanical workshop performs operations on welding and kerf of metal accompanied by intensive UV-radiation on a welding post supplied with effective mechanical cooling. What occupational disease is most probable to develop in him?

*А. E lectrophthalmia

B. A dust disease

C. Chronic overheating

D. A vegetovascular dystonia

Е. Thermal shock

3. On a workplace of a worker the power of electrical and magnetic fields form electromagnetic field, created by high-frequency generator located at a distance of 3 m from the workplace. What zone of exposure is the workplace located in?

*A. Induction

B. Undulatory

C. Interference

D. Alienation

E. Reverberation

4. Student B. and student M. of the medical faculty were given the task to make a hygienic estimation of noise at a plant shop, namely: to research a noise level /for student B./ and its effect on organism /for student M/. What instrument should student М. use to make the research?

*A. A udiometer

B. Actinometer

C. Radiometer

D. Noise-vibration-meter

E. Noise spectrum analyzer

5. A constant noise from the external sources penetrates into the hospital wards and doctors' consulting rooms in the daytime. Identify the permissible level of noise in the daytime for the hospital wards.

*A. 35 dB

B. 45 dB

C. 85 dB

D. 60 dB

E. 75 dB

6. In a tool shop the currents of high frequency are used. The working conditions are characterized by exceeding the limited noise levels, EMF, content of dust (iron, molybdenum, silicon dioxide), eyestrain. On examination of a worker neurasthenia, disorders of endocrine regulation are diagnosed. The etiological factor is:

*A. EMF

B. Noise

C. Iron dust

D. Molybdenum dust

E. Silicon dioxide

7. In a mechanical shop a turner at a lathe is exposed to a high level of noise. In 6–8 years of work by speciality the decrease of hearing can develop in him. Identify the most significant preventive measures.

*A. Measures of technological character

B. Layout measures

C. Measures of technical character

D. Measures of individual protection

E. Measures of medical prophylaxis

8. The drivers of heavy haulers are subjected to effect of low-frequency transport vibration. In 5–8 years of work by speciality such illnesses can occur in them as radiculitis and ishialgia, dysfunction of a vestibular analyzer, and early fatigue. Identify the most significant preventive measures.

*A. the decrease of vibration intensity of the source (at the expense of design improvement)

B. means of external protection from vibration

C. decrease of working hours

D. a rational regimen of work and rest

E. elimination of immediate contact with vibrant equipment

9. On receiving an appointment of announcer in the regional broadcasting company citizen Н. was directed to medical-prophylactic establishment to undergo the initial medical examination. The medical brigade should include the following doctors-specialists:

*A. Therapeutist, neuropathologist

B. Therapeutist, otolaryngologist

C. Therapeutist, ophthalmologist, neuropathologist

D. Therapeutist, otolaryngologist, ophthalmologist

E. Therapeutist, urologist, neuropathologist

10. On initial medical examination of a person, who arrived to work with the source of noise and vibration, otosclerosis with unfavorable prognosis was detected. The working conditions are connected with effect of numerous harmful production factors of a physical nature. Contraindication to work by the given speciality is

A. local industrial vibration.

B. ultrasound.

*C. industrial noise.

D. infrasound.

E. electromagnetic fields.

11. In a city some unfavorable factors simultaneously act: atmospheric contamination, noise, electromagnetic radiation and some others. The effect of these harmful factors is characterized as

A. complex.

*B. associated.

C. combined.

D. mixed.

E. additive.

 

Radiation Hygiene

1. After an accident on atomic power station people take iodine drugs. What is the purpose of this measure?

А. To maintain regular processes

В. To strengthen a bactericidal action of tissues

*С. To prevent hypoplasia of the thyroid gland

D. To increase the resistance of organism

Е. To strengthen a protective effect

2. At the enterprise demanding a particular observance of measures of ecological safety, there was a serious accident accompanied with ignition, explosion, considerable contamination of the environment with products dangerous to life. In casualties the following signs were observed: excitement, headache, instability of vegetative functions, erythropenia, leukopenia, thrombocytopenia, decrease of cytophagous activity and formation of antibodies, bleeding, vomiting, diarrhea, inflammation of the tongue and gums, necrotic angina, pneumonia and other disturbances. What is the main etiological factor of the described syndrome?

А. Damage caused by blast wave

В. Damage caused by high temperature

С. Toxic and chemical substances in the air and nutrition

D. Mental stress

* Е. Radiation damage

3. Mr. S, 45 years old, living on radioactively-contaminated territory, addressed the doctor after the advice to use vegetables removing radionuclides from organism. Give recommendations as for chemical composition of vegetables and their content in a diet.

А. Sweet pepper

*В. Carrots

C. Potatoes

D. Tomatoes

Е. Watermelon

4. The gamma-radiography with the help of a cobalt defectoscope is used for a qualitative control of details. Identify the type and danger of the used source for workers.

A. Open

B. Non-radioactive

С. Alpha radiation

D. Dangerous at internal exposure

*Е. Closed, causing the external exposure

5. In the radiological department for intracavitary therapy the gamma-ray irradiation device "Agat" is used with the source of cobalt isotope, which is in a steel ampoule. Which of the following ways of staff protection from effect of ionizing radiation should be used primarily in view of type of source?

*А. Screening of the source and workplace

В. Capsulation of installation

С. Layout measures (zones of location)

D. Equipment of departmentwith effective ventilation

Е. Use of means of individual protection and cleansing staff

6. Specify a maximum permissible dose  per year for a category A (person, permanently or temporarily working with immediate sources of ionizing radiation) according to norms of radiation safety (NRS–97).

*А. 2 rem/year

B. 4 rem/year

С. 0.2 rem/year

D. 1 rem/year

Е. 0.5 rem/year

7. Citizen A. (aged 28 years, body height–175 cm, body mass –74 kg), working at the establishment with radiation, received 2 maximum permissible doses of radiation during a local radiation accident. He was referred to a medical commission to solve the problem on possibility of further work with industrial sources of ionizing radiation. On medical examination citizen A. did not have any complaints concerning his health. The experts, who carried out the examination, considered him to be practically healthy. Evaluate the possibility of further work of citizen A. with sources of ionizing radiation.

*А. The exposure is admitted without any limitations

В. The exposure is admitted conditionally with limitation of a dose

С. The exposure is admitted conditionally with limitation of time

D. The exposure is admitted conditionally with limitation of work with open sources

Е. The exposure is admitted only to closed sources

8. Farmer А. addressed the radiological department with the request to make the analysis of potatoes as for the content of radionuclides and to draw the hygienic conclusion on possible use of complete product. The results of the analysis showed that the content of radioactive substance cesium–137 in the potatoes were equal to 40 Bq /kg, and strontium–90 – 8 Bq/kg. Identify the most probable variant of the conclusion.

А. The potatoes can be used only as forage to cattle

*В. The potatoes can be used without limitations

С. The potatoes can be utilized for production of ethanol

D. The potatoes can be utilized for production of amylum

Е. The potatoes can be utilized for production of chips