1 із 200
Step 2 - Medicine 2008
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2 із 200
A woman complains of having slight dark bloody discharges and mild pains in the lower part of abdomen for several days. Last menses were 7 weeks ago. The pregnancy test is positive. Bimanual investigation: the body of the uterus indicates for about 5-6 weeks of pregnancy, it is soft, painless. In the left appendage there is a retort-like formation, 7x5 cm large, mobile, painless. What examination is necessary for detection of fetus localization?
Ultrasound
Hromohydrotubation
Hysteroscopy
Colposcopy
Cystoscopy
3 із 200
A pregnant woman in her 40th week of pregnancy undergoes obstetric examination: the cervix of uterus is undeveloped. The oxytocin test is negative. Examination at 32 weeks revealed: AP 140/90 mm Hg, proteinuria 1 g/l, peripheral edemata. Reflexes are normal. Choose the most correct tactics:
Labour stimulation after preparation
Caesarian section immediately
Absolute bed rest for 1 month
Complex therapy of gestosis for 7 days
Complex therapy of gestosis for 2 days
4 із 200
A 26 year old woman had the second labour within the last 2 years with oxytocin application. The child’s weight is 4080 gr. After the placent birth there were massive bleeding, signs of hemorrhagic shock. Despite the introduction of contractive agents, good contraction of the uterus and absence of any cervical and vaginal disorders, the bleeding proceeds. Choose the most probable cause of bleeding:
Atony of the uterus
Hypotonia of the uterus
Injury of cervix of the uterus
Hysterorrhexis
Delay of the part of placenta
5 із 200
On the first day after labour a woman had the rise of temperature up to 39°C. Rupture of fetal membranes took place 36 hours before labour. Examination of the bacterial flora of cervix of the uterus revealed hemocatheretic streptococcus of A group. The uterus body is soft, tender. Discharges are bloody, with admixtures of pus. Specify the most probable postnatal complication:
Metroendometritis
Infective contamination of the urinary system
Thrombophlebitis of veins of the pelvis
Infectious hematoma
Apostasis of sutures after the episi-otomy
6 із 200
A woman of a high-risk group (chronic pyelonephritis in anamnesis) had vaginal delivery. The day after labour she complained of fever and loin pains, frequent urodynia. Specify the most probable complication:
Infectious contamination of the urinary system
Apostasis of sutures after episiotomy
Thrombophlebitis of veins of the pelvis
Endometritis
Infectious hematoma
7 із 200
A woman in her 39th week of pregnancy, the second labour, has regular birth activity. Uterine contractions take place every 3 minutes. What criteria describe the beginning of the II labor stage the most precisely?
Cervical dilatation by no less than 4 cm
Rupture of fetal bladder
Cervical smoothing over 90%
Presenting part is in the lower region of small pelvis
Duration of uterine contractions over 30 seconds
8 із 200
A 24 years old primipara was hospitalised with complaints about discharge of the amniotic waters. The uterus is tonic on palpation. The position of the fetus is longitudinal, it is pressed with the head to pelvic outlet. Palpitation of the fetus is rhythmical, 140 bpm, auscultated on the left below the navel. Internal examination: cervix of the uterus is 2,5 cm long, dense, the external os is closed, light amniotic waters out of it. Point a correct component of the diagnosis:
Antenatal discharge of the amniotic waters
Early discharge of the amniotic waters
The end of the 1st stage of labour
Pathological preterm labour
The beginning of the 1st stage of labour
9 із 200
A 29 year old patient underwent surgical treatment because of the benign serous epithelial tumour of an ovary. The postoperative period has elapsed without complications. What is it necessary to prescribe for the rehabilitational period:
Hormonotherapy and proteolytic enzymes
Antibacterial therapy and adaptogens
Lasertherapy and enzymotherapy
Magnitotherapy and vitamin therapy
The patient does not require further care
10 із 200
A patient was delivered to a surgical department after a road accident with a closed trauma of chest and right-sided rib fracture. The patient was diagnosed with right-sided pneumothorax, it is indicated to perform drainage of pleural cavity. Pleural puncture should be made in:
In the 2nd intercostal space along the middle clavicular line
In the 7th intercostal space along the scapular line
In the 6th intercostal space along the posterior axillary line
In the point of the greatest dullness on percussion
In the projection of pleural sinus
11 із 200
A primagravida with pregnancy of 3738 weeks complains of headache, nausea, pain in epigastrium. Objective: the skin is acyanotic. Face is hydropic, there is short fibrillar twitching of blepharons, muscles of the face and the inferior extremities. The look is fixed. AP- 200/110 mm Hg; sphygmus of 92 bpm, intense. Respiration rate is 32/min. Heart activity is rhythmical. Appreciable edemata of the inferior extremities are present. Urine is cloudy. What medication should be administered?
Droperidolum of 0,25% - 2,0 ml
Hexenalum of 1% - 2,0 ml
Dibazolum of 1% - 6,0 ml
Pentaminum of 5% - 4,0 ml
Papaverine hydrochloride of 2% - 4,0 ml
12 із 200
A 40 year old woman has changes of mammary gland. What are the most often symtomps that precede the malignizati-on?
Skin induration with inverted nipple
Bloody discharges from the nipple
Painful movable induration
Pure discharges from the nipple
Painless movable induration
13 із 200
A patient who takes diuretics has developed arrhythmia as a result of cardiac glycoside overdose. What is the treatment tactics in this case?
Increased potassium concentration in blood
Reduced magnesium concentration in blood
Increased calcium concentration in blood
-
Increased sodium consentration in blood
14 із 200
An onset of severe preeclampsia at 16 weeks gestation might be caused by:
Hydatidiform mole
Maternal renal disease
Anencephaly
Interventricular defect of the fetus
Twin gestation
15 із 200
A 9 year old girl with a history of intermittent wheezing for several years is brought to the pediatrician. The child has been taking no medications for some time. Physical examination reveals agitation and perioral cyanosis. Intercostal and suprasternal retractions are present. The breath sounds are quiet, and wheezing is audible bilaterally. The child is admitted to the hospital. Appropriate interventions might include all of the following EXCEPT:
Prescribe nebulized cromolyn sodium
Administer supplemental oxygen
Prescribe intravenous corticosteroids
Prescribe nebulized metaproterenol
Prescribe intravenous aminophylline
16 із 200
Routine examination of an otherwise healthy child with a history of bronchial asthma reveals AP of 140/90 mm Hg. The most likely cause of the hypertension is:
Renal disease
Chronic lung disease
Theophylline toxicity
Coarctation of the aorta
Obesity
17 із 200
The average body lenth of newborn boys is 50,9 cm at a sigma 1,66; and average mass - 3432 at a sigma 5,00. What criterion is necessary to compare degree of variability of these signs?
Coefficient of variation
Amplitude
Sigma
Limit
Coefficient of association
18 із 200
What method is applied to establish rate of correlation between age of men and their mortality due to myocardial infarction?
Method of grade correlation (Spirman)
Correlation ratio
The quadrate method (Pirson)
The Indirect method (Student)
Method of graduated correlation (Armler)
19 із 200
Adenosine triphosphate may be expected to convert which of the following arrhythmias to sinus rhythm?
Paroxysmal supraventricular tachycardia
Ventricular fibrillation
Paroxysmal ventricular tachycardia
Atrial fibrillation
Atrial flutter
20 із 200
A 48 year old man complains of fati-que and shortness of breath. His Ht is 32%, and Hb - 103 g/l. Peripheral blood smear reveals macrocytosis. Serum vitamin Bi2 level is 90 pg/ml (normal is 170 to 940); serum folate level is 6 ng/ml (normal is 2 to 14). Possible causes to consider include all of the following EXCEPT:
Colonic diverticulitis
Fish tapeworm infection
Regional enteritis
Vegetarianism
Pancreatitis
21 із 200
A 56 year old man complains of fatigue, dyspnea on exertion and palpitations. He has had a murmur since chi- ldhood. Examination reveals a lift at the left sternal border, split Si, and fixed splitting of S2. There is a grade 3/6 midsystolic pulmonic murmur and a 1/6 middiastolic tricuspid murmur at the lower left sternal border. Chest x-ray shows right ventricular enlargement and prominent pulmonary arteries. ECG demonstrates atrial fibrillation with a right bundle branch block. The most likely diagnosis is:
Arterial septal defect
Coarctation of the aorta
Tetralogy of Fallot
Ventricular septal defect
Patent ductus arteriosus
22 із 200
Generalized low voltage on an ECG (QRS deflection < 5 mm in limb leads and <10 mm in precordial leads) may be a marker for all of the following disorders EXCEPT:
Hyperthyroidism
Coronary artery disease
Pericardial effusion
Cardiac transplant rejection
Amyloidosis
23 із 200
Five days after a total hip replacement a 72 year old woman becomes acutely short of breath, diaphoretic and hypotensive. Both lung fields are clear to auscultation and percussion, but examination of the neck reveals mild jugular venous distension with prominent A waves. Heart sounds are normal. ECG shows sinus tachycardia with a new right bundle branch block and minor nonspecific ST — T wave changes. The most likely diagnosis is:
Pulmonary thromboembolism
Aspiration
Aortic dissection
Pericarditis
Acute myocardial infarction
24 із 200
A child is 6 years old. Within one year of observation he had URI that lasted 8 days. Physical state is satisfactory. Specify hi health group:
I
III (c)
III (a)
III (b)
II
25 із 200
Which of the following IS NOT TYPICAL for Addison’s disease?
High serum Na+
Elevated BUN
Dilute urine
Elevated hematocrit
High serum K+
26 із 200
A 38 year old man, previously in good health, suddenly develops severe abdominal pain radiating from the left loin to groin and accompanied by nausea, perspiration and the need for frequent urination. He is restless, tossing in bed but has no abnormal findings. The most likely diagnosis is:
Leftsided renal colic
Sigmoid diverticulitis
Herpes zoster
Torsion of the left testicle
Retroperitoneal haemorrhage
27 із 200
A 40 year old woman has a selfdetected hard breast mass. The procedure of choice for confirming the diagnosis is:
Excision biopsy
Ultrasonography
Aspiration biopsy with cytology
Thermography
Mammography
28 із 200
A 38 year old man was admitted to a hospital from his working place on July 19 because of hip fracture. He was invalid till November 19. Requires prolongation of treatment. Who decides on the issue of further temporary invalidity?
Specialized (traumatologic) MSEC
DCC
Interregional general MSEC
Regional MSEC
The head physician of a polyclinic
29 із 200
During investigation for chronic, severe, epigastric pain, a 40 year old alcoholic man is found to have multiple areas of narrowing alternating with dilatation ('chain of lakes'appearance) of the main pancreatic duct. The operation of choice is:
Lateral pancreaticojejunostomy
Sphincterotomy
Distal pancreaticojejunostomy
Total pancreatectomy
Distal pancreatectomy
30 із 200
The treatment of choice for duodenal obstruction caused by secondary duodenal hematoma that developed a few days after blunt abdominal injury is:
Nasogastric decompression and parenteral alimentation
Immediate exploration
Duodenojejunostomy
Retrocolic gastrojejunostomy
Tube duodenostomy
31 із 200
A 25 year old man has a sudden onset of chest pain on the right and dyspnea. His trachea is deviated to the left. All of the following would be anticipated EXCEPT:
Pleural friction rub on the left
Absence of rhonchi
Distant breath sounds on the right
Hyperresonance over the right chest
Absence of rales
32 із 200
A 5 tons milk batch was sampled. The lab analysis revealed: fat content 2%, specific density -1,04 g/cm3, acidity - 210T, reductase probe - weak-positive. What way is the product to be used in?
Sell but inform customers about milk quality
Sell without limitations
Do the product away
Technical utilization
Discard for animal feeding
33 із 200
What guarantees against the preconceived attitude to the physician in cases of professional law violations do you know?
Sanction of public prosecutor, inquiry by preliminary investigator of prosecutor’s office, committee of experts
Conduct forensic medical examination by district forensic medicine expert
Conduct an inquiry by preliminary investigator of police department
Utilisation copy of medical documents
Draw up a statement about forensic medical examination
34 із 200
If a child has adherent fingers on his right hand, then what will be your diagnosis?
Syndactyly
Ectromelia
Macrodactyly
Polydactyly
Ectrodactyly
35 із 200
A 16 year old patient with complaints of frequent pain in the abdomen was diagnosed with melanoma, examination revealed also pigmentation of the mucosa and skin, polyp in the stomach and large intestine. It is know that the patient’s mother has an analogous pigmentation and has been often treated for anemia. What disease is suspected?
Peytz-Egers’s polyposis
Hirschprung’s disease
Chron’s disease
Adolescent polyposis
Tuberculosis of the intestine
36 із 200
A 41 year old patient was admitted to the intensive care unit with haemorrhagic shock due to gastric bleeding. He has a history of hepatitis B during the last 5 years. The source of bleeding are esophageal veins. What is the most effective method for control of the bleeding?
Introduction of obturator nasogastric tube
Intravenous administration of pituitrin
Administration of plasma
Operation
Hemostatic therapy
37 із 200
It is suspected that a 34 year old patient has an abscess of Douglas pouches. What diagnostic method is to be chosen?
Digital examination of rectum
R-scopy of abdominal cavity
Rectoromanoscopy
Percussion and auscultation of stomach
Laparoscopy
38 із 200
A 52 year old man has recurrent transient ischemic attacks. Auscultation of the carotid arteries detected murmur. What diagnostic method is to be applied in the first place?
Ultrasound dopplerography
Electroencephalography
CT of the brain
Cerebral angiography
MRI of the brain
39 із 200
A 34 year old woman in the 10th week of gestation (the second pregnancy) consulted a doctor of antenatal clinic in order to be registered there. In the previous pregnancy hydramnion was observed, the child’s birth weight was 4086 g. What examination method should be applied in the first place?
The test for tolerance to glucose
Determination of the contents of fetoproteinum
A cardiophonography of fetus
US of fetus
Bacteriological examination of discharges from vagina
40 із 200
A patient with acute purulent otitis media complicated by mastoiditis was admitted to a hospital. Roentgenogram of mastoid processes showed the shadiowi-ng of the cellular system on the lesion, absence of bone septa was present. What are the necessary therapeutic +actions at the second stage of mastoiditis?
Mastoidotomy
Cateterization of the Eustachian tube
Tympanoplasty
Radical operation on the middle ear
Paracentesis of the drum
41 із 200
A 22 year old patient was admitted to trauma center with complaints of pain in the left ankle joint that was getting worse during moving and weight bearing. On the clinical examination it was found that the patient had the closed fracture of medial malleolus without displacement. In which position should the foot be fixed in plaster cast?
In position of dorsal flexion of foot
In position of supination
In position of pronation
In position of planter flexion of foot
At right angle with varus positioning of the foot
42 із 200
A patient with acute respiratory viral infection (3rd day of disease) complains of pain in lumbar region, nausea, dysuria, oliguria. Urinalysis - hematuria (100-200 RBC in eyeshot spot), specific gravity -1002. The blood creatinin level is 0,18 mi-llimole/l, potassium level - 6,4 millimole/l. Make the diagnosis:
Acute interstitial nephritis
Acute renal colic
Acute renal failure
Acute cystitis
Acute glomerylonephritis
43 із 200
A 3 month old infant suffering from acute segmental pneumonia has dyspnea (respiration rate - 80 per minute), paradoxical breathing, tachycardia, total cyanosis. Respiration / pulse ratio is 1:2 . The heart dullness under normal size. Such signs characterise :
Respiratory failure of III degree
Respiratory failure of II degree
Congenital heart malformation
Respiratory failure of I degree
Myocarditis
44 із 200
A 3 year old child has been suffering from fever, cough, coryza, conjunctivitis for 4 days. He has been taking sulfadimethoxine. Today it has fever up to 39oC and maculopapular rash on its face. Except of rash the child’s skin has no changes. What is your diagnosis?
Measles
Rubella
Scarlet fever
Pseudotuberculosis
Allergic rash
45 із 200
A 2 year old girl has been ill for 3 days. Today she has low grade fever, severe catarrhal presentations, slight maculopapular rash on her buttocks and enlarged occipital lymph nodes. What is your diagnosis?
Rubella
Adenoviral infection
Measles
Scarlet fever
Pseudotuberculosis
46 із 200
A 3 year old boy fell ill abruptly: fever up to 39oC, weakness, vomi-tng. Haemorrhagic rash of various size appeared on his lower limbs in 5 hours. Meningococcemia with infective - toxic shock of the 1 degree was diagnosed. What medications should be administered?
Chloramphenicol succinate and prednisone
Chloramphenicol succinate and interferon
Penicillin and prednisone
Ampicillin and immunoglobulin
Penicillin and immunoglobulin
47 із 200
A 7 year old girl has mild form of varicella. Headache, weakness, vertigo, tremor of her limbs, ataxia, then mental confusion appeared on the 5th day of illness. Meningeal signs are negative. Cerebrospinal fluid examination is normal. How can you explain these signs?
Encephalitis
Meningitis
Meningoencephalitis
Neurotoxic syndrome
Myelitis
48 із 200
A 14 year old patient complains of chest pain, temperature up to 38,5oC, breathlessness. He had acute tonsillitis 2 weeks ago. He is in grave condition. The skin is pale. Heart borders are dilated, heart sounds are quiet. Above total heart area you can hear pericardium friction sound. Electrocardiogram: the descent of QRS voltage, the inversion T. The liver is enlarged by 3 cm. ESR - 4 mm/h, ASL - 0 - 1260, C-reactive protein +++. Your diagnosis:
Rheumatic pancarditis
Rheumatic myocarditis
Rheumatic endocarditis
Rheumatic pericarditis
Septic endocarditis
49 із 200
A woman born a child. It was her fith pregnancy but the first delivery. Mother’s blood group is A(II)Rh-, newborn’s -A(II)Rh+. The level of indirect bilirubin in umbilical blood was 58 micromole/l, hemoglobin -140 g/l, RBC- 3,8 • 1012/l. In 2 hours the level of indirect bilirubin turned 82 micromole/l. The hemolytic disease of newborn (icteric-anemic type, Rhincompatibility) was diagnosed. Choose the therapeutic tactics:
Replacement blood transfusion (conservative therapy)
Symptomatic therapy
Blood transfusion (conservative therapy)
Conservative therapy
Antibiotics
50 із 200
A mother consulted a pediatrician about her son. Her son was born with body mass of 3 kg and length of 48 cm. He’s 1 year old now. What is the required normal mass?
10,5 kg
11,0 kg
12,0 kg
15,0 kg
9,0 kg
51 із 200
A 2 month old healthy infant with good appetite is given artificial feeding since he turned 1 month old. When is it recommended to start the corrective feeding (fruit juice)?
4,0 months
1,5 months
2,0 months
1,0 months
3,0 months
52 із 200
A nine year old child is at a hospital with acute glomerulonephritis. Clinical and laboratory examinations show acute condition. What nutrients must not be limited during the acute period of glomerulonephritis?
Carbohydrates
Liquid
Fats
Proteins
Salt
53 із 200
Examination of a 3-month-old child revealed scrotum growth on the right. This formation has elastic consistency, its size decreases during sleep and increases when the child is crying. What examination will be helpful for making a correct diagnosis?
Palpation of the thickened cord crossing the pubical tubercule (sign of the silk glove)
Palpation of the external inguinal ring
Diaphanoscopy
Examination of the formation in Trendelenburg’s position
Puncture of the scrotum
54 із 200
A rounded well-defined shadow was found in the costo-vertebral angle on the chest roentgenogram of an otherwise healthy 9 year old girl. Make a preliminary diagnosis:
Ganglioneuroma
Sarcoma of the vertebra
Sympatoblastoma
Sympatogonioma
Ganglioneuroblastoma
55 із 200
A 52 year old patient with history of functional Class II angina complains of having intense and prolonged retrosternal pains, decreased exercise tolerance for 5 days. Angina is less responsive to nitroglycerine. What is the most probable diagnosis?
IHD. Unstable angina
Myocardial dystrophy
Cardialgia due to spine problem
IHD. Functional Class II angina
Myocarditis
56 із 200
A 52 year old patient has hypervolaemic type of essential hypertension. Which of the following medications is to be prescribed either as monotherapy or in complex with other antihypertensive drugs?
Hypothiazid
Dibazol
Nifedipin
Clonidine
Kapoten
57 із 200
A 62 year old patient complains of rest dyspnea, heart pains. 3 years ago he had myocardial infarction. Physical examination: orthopnea, acrocyanosis, swollen cervical veins. Ps - 92, total heart enlargement, the liver is enlarged by 7 cm, shin edema. What is the stage of chronic heart failure (CHF)?
CHF- 2 B
CHF- 2 A
CHF- 0
CHF- 1
CHF- 3
58 із 200
A patient, aged 49, complains of fever of 37,5oC, heart pain, dyspnea. Si is clapping; S2 is accentuated in the aortic area; opening snap, presystolic murmur can be auscultated. What is the most efficient examination for valvular disorder assessment?
Echocardiography+Doppler-Echocardiography
Ballistocardiogram
Chest X-ray
ECG
Phonocardiography
59 із 200
A patient with nosocomial pneumonia presents signs of collapse. Which of the following pneumonia complications is most likely to be accompanied by collapse?
Septic shock
Bronchial obstruction
Toxic hepatitis
Emphysema
Exudative pleuritis
60 із 200
A patient, aged 48, complains of heaviness in the right hypochondrium, itching of the skin. Repeatedly he had been treated in infectious diseases hospital because of icterus and itch. Objectively: meteorism, ascitis, dilation of abdominal wall veins, protruding navel, spleen enlargement. Diagnosis is:
Liver cirrhosis
Cancer of the liver
Cancer of the head of pancreas
Viral hepatitis B
Gallstones
61 із 200
A 27 year old man complains of pains in epigastrium which are relieved by food intake. EGDFS shows antral erosive gastritis, biopsy of antral mucous presents Helicobacter Pylori. Diagnosis is:
Gastritis of type B
Gastritis of type A
Reflux-gastritis
Menetrier’s gastritis
Rigid antral gastritis
62 із 200
A 62 year old patient suffers from DM-2. Diabetes is being compensated by diet and Maninilum. The patient has to undergo an operation on inguinal hernia. What tactics of hypoglycemic therapy should be chosen?
Prescribe fast-acting insulin
Give Glurenorm instead of Maninilum
Prescribe guanyl guanidines
Prescribe long-acting insulin
Continue with the current therapy
63 із 200
Prophylactic photoroentgenography examination of a 25 year old man revealed focal shadowings of small and medium intensity with irregular contours in the 1st and 2nd segments of the right lung. Which clinical form can be suspected?
Focal
Tuberculoma
Miliary
Fibro-cavernous
Disseminated
64 із 200
A triad of symptoms ('stearing spot', 'terminal film', 'blood dew') has been revealed on examination of a patient. What disease should you think about?
Psoriasis
Ritter’s disease
Lichen ruber planus
Vasculitis
Seborrhea
65 із 200
A female 28 years old patient became depressed, her mood is melancholic; this state is accompanied by hypobulia, hypokinesia, slow speed of thinking. Her attitude towards her past, present and future is pessimistic. The pathogenetic mechanism of this state is supposed to involve dysfunction in the:
Hypothalamus
Corpus callosum
Hippocampus
Pituitary
Frontal lobes
66 із 200
The observed patient’s movements are retarded, she answers no questions. Sometimes she spontaneously stays in strange postures. It is possible to set her body and limbs into different positions artificially. If the psychiatrist lifts her arm or leg, so that she remains standing on the other leg, the patient can stay in such a position for quite a long time. Name the probable disorder:
Catatonic stupor, schizophrenia
Depressive stupor, bipolar disorder
Psychogenic stupor, stress disorder
Apathetic stupor, schizophrenia
Dissociative stupor, dissociative psychosis
67 із 200
A 50 year old patient has been admitted to the clinics with atrophic gastritis. Blood count: erythrocytes -3,8 • 1012/l, Hb - 68 g/l, c.i. - 1, macroanisocytosis, poikilocytosis. There is megaloblastic type of haemopoesis. A number of leukocytes, reticulocytes and thrombocytes is lreduced. Which pathology is suspected?
B12-deficiency anemia
Post-hemorrhagic anemia
Hemolytic anemia
Irondeficiency anemia
Thalassaemia
68 із 200
A 28 year old patient was admitted to the clinic with complaints of the temperature rise up to 39,0oC, headache, weakness, constipation on the 9th day of the disease. On examination : single roseolas on the skin of the abdomen are present. The pulse rate is 78 bpm. The liver is enlarged by 2 cm. What is the most probable diagnosis?
Typhoid fever
Leptospirosis
Malaria
Sepsis
Brucellosis
69 із 200
A patient has been in a hospital. The beginning of the disease was gradual: nausea, vomiting, dark urine, acholic stools, yellowness of the skin and scleras. The liver is protruded by 3 cm. Jaundice progressed on the 14th day of the disease. The liver diminished in size. What complication of viral hepatitis caused deterioration of the patient’s condition?
Hepatic encephlopathy
Cholangitis
Meningitis
Infectious-toxic shock
Relapse of viral hepatitis
70 із 200
An 18 year old patient was admitted to a hospital with complaints of headache, weakness, high temperature, sore throat. Objectively: enlargement of all groups of lymph nodes was revealed. The liver is enlarged by 3 cm, spleen - by 1 cm. In blood: leukocytosis, atypical lymphocytes 15 %. What is the most probable diagnosis?
Infectious mononucleosis
Adenoviral infection
Acute lymphoid leukosis
Diphtheria
Angina
71 із 200
A 75 year old man who has been suffering from diabetes for the last six months was found to be jaundiced. He was asymptomatic except for weight loss at the rate of 10 pounds in 6 months. Physical examination revealed a hard, globular, right upper quadrant mass that moves during respiration. A CT scan shows enlargement of the head of the pancreas, with no filling defects in the liver. The most likely diagnosis is:
Carcinoma of the head of the pancreas
Infectious hepatitis
Haemolytic jaundice
Metastatic disease of liver
Malignant biliary stricture
72 із 200
A 33 year old male patient was brought to Emergency Department with the signs of cardiovascular collapse: BP - 60/30 mm Hg, Ps - 140 bpm, the skin is pale and moist, diuresis 20 ml/h, Hb - 80 g/l, red blood cell count - 2,5 • 1012/l. The reduction of blood volume averages:
30-40%
20-25 %
10-15 %
25-30 %
15-20 %
73 із 200
A 19 year old girl was admitted to emergency department: unconsciousness, cyanosis, myotic pupils are present, superficial breathing is 12/min. BP is 90/60 mm Hg, Ps- 78/min. Choose the action necessary in this clinical situation:
Controlled respiration
Oxygen inhalation
Cordiamine injection
Gastric lavage
Caffeine injection
74 із 200
A pregnant woman may be diagnosed with hepatitis if it is confirmed by the presence of elevated:
SGOT (ALT)
WBCs
Alkaline phosphatase
Sedimentation rates
BUN
75 із 200
An endometrial adenocarcinoma that has extended to the uterine serosa would be classified as stage:
IIIA
IVAB
IIA
IC
IIB
76 із 200
A 56 year old woman has an acute onset of fever up to 39°C with chills, cough, and pain on respiration in the right side of her chest. On physical examination: HR - 90/min, BP- 95/60 mm Hg, RR-26/min. There is dullness over the right lung on percussion. On X-ray: infiltrate in the right middle lobe of the lung. What is the diagnosis?
Community-acquired lobar pneumonia of moderate severity
Acute lung abscess
Nosocomial lobar pneumonia
Acute pleuritis
Community-acquired bronchopneumonia
77 із 200
A 26 year old man was admitted to the hospital because of stabbing back pain on inspiration and dyspnea. Examination results: BT of 37°C, Ps of 24/min, HR of 92/min, vesicular breath sounds. There is a dry, grating, low-pitched sound heard on both expiration and inspiration in the left inferior lateral part of the chest. What is the most likely diagnosis?
Acute fibrinous pleuritis
Pneumothorax
Pneumonia
Acute bronchitis
Myocarditis
78 із 200
A 34 year old woman fell ill 3 months ago after cold exposure. She complained of pain in her hand and knee joints, morning stiffness and fever up to 38oC. Interphalangeal, metacarpophalangeal and knee joints are swollen, hot, with reduced ranges of motions; ESR of 45 mm/h, CRP (+++), Vaaler-Rouse test of 1:128. What group of medicines would you recommend the patient?
Nonsteroidal anti-inflammatory drugs
Fluorchinolones
Tetracyclines
Cephalosporines
Sulfonamides
79 із 200
A 50 year old woman complained of attacks of right subcostal pain after fatty meal she has been suffering from for a year. Last week the attacks repeated every day and became more painful. What diagnostic study would you recommend?
Ultrasound examination of the gallbladder
Liver function tests
Ultrasound study of the pancreas
X-ray examination of the gastrointestinal tract
Blood cell count
80 із 200
A 25 year old woman complained of edema on her face and legs, rise of blood pressure up to 160/100 mm Hg and weakness. She fell ill 3 weeks after recovering from angina. Urinalysis data: protein of 0,5 g/l, erythrocytes of 17-20/field, leukocytes of 2-3/field, erythrocyte casts. What treatment should be initiated after specifying the diagnosis?
Penicillin OS
Heparin
Ceftriaxone
Dipyridamole
Ciprofloxacine
81 із 200
A fitter of a metallurgic factory with occupational exposure to high concentrations of mercury fumes for 16 years presents instability of pulse and blood pressure, general hyperhydrosis, asymmetric innervations of facial muscles and tongue, positive subcortical reflexes, hand tremor on physical examination. A dentist revealed paradontosis and chronic stomatitis. What is the most probable diagnosis?
Chronic mercury intoxication
Parkinson syndrome
Neuroinfection
Acute mercury intoxication
Mercury encephalopathy
82 із 200
A 6 week old child is admitted because of tachypnea. Birth had been uneventful, although conjunctivitis developed on the third day of life and lasted for about 2 weeks. Physical examination reveals tachypnea, bilateral inspiratory crackles and single expiratory wheezing. Bilateral pneumonia is evident on chest X-ray. The child is afebrile and has no history of fever. White blood cell count is 15 • 109/l, with 28% of eosinophils. The most likely cause of this child’s symptoms is:
Clamydia trachomanis
Varicella
Pneumocystis carinii
Visceral larva migrans
Mycoplasma pneumoniae
83 із 200
A 42 year old woman complains of dyspnea, edema of the legs and tachycardia during minor physical exertion. Heart borders are displaced to the left and S1 is accentuated, there is diastolic murmur on apex. The liver is enlarged by 5 cm. What is the cause of heart failure?
Mitral stenosis
Mitral regurgitation
Tricuspid regurgitation
Aortic stenosis
Tricuspid stenosis
84 із 200
A 60 year old man complains of fever, significant weight loss, bone and joint pain, bleeding gums. Examination revealed paleness, lymphadenopathy, hepato- and splenomegaly. CBC: WBC - 270 • 109/l with 13% lymphocytes, 1% monocytes, 21% basophiles, 29% neutrophils, 9 % blasts, 12% promyelocytes, 12% myelocytes, 2% metamyelocytes, 1% eosinophils. ESR -22 mm/h. Name the drug for treatment:
Myelosan
Vinblastine
Cytosar
Blood transfusion
Prednisolone
85 із 200
A 54 year old woman complains of increasing fatigue and easy bruising of 3 weeks’ duration. Physical findings included pale, scattered ecchymoses and petechiae and mild hepatosplenomegaly. Blood count: RBC- 2,5 • 1012//; Hb - 73 g/l; Ht - 20%; PLT- 23 • 109//; and WBC-162 • 109// with 82% blasts, that contained Auric rods; peroxidase stain was positive. What is the most probable diagnosis?
Acute leukemia
Thrombocytopenia
Hemolytic anemia
Chronic leukemia
Megaloblastic anemia
86 із 200
The highest risk of congenital anomalies probably occurs when human embryos or fetuses are exposed to ionizing radiation. At what stage of gestational period does it occur?
18-45 days after conception
The third trimester
90-120 days after conception
The first 7 days
10-14 days after conception
87 із 200
A 28 year old woman was admitted to the emergency room with a slightly reddened, painful 'knot'8 cm above the medial malleolus. Examination in the standing position demonstrates a distended vein above and below the mass. There are no other abnormalities on physical examination. The most likely diagnosis is:
Superficial venous thrombosis
Cellulitis
Early deep vein thrombosis
Subcutaneous hematoma
Insect bite
88 із 200
A 25 year old patient complains of pain in the I finger on his right hand. On examination: the finger is homogeneously hydropic, in bent position. On attempt to unbend the finger the pain is getting worse. Acute pain appears during the probe in ligament projection. What decease is the most likely?
Thecal whitlow (ligament panaritium)
Bone panaritium
Articular (joint) panaritium
Subcutaneous panaritium
Paronychia
89 із 200
A 30 year old man complains of acute pain in his right ear, hearing loss, high temperature for three days. Objectively: right ear whispering language - 0,5 mm, external ear is intact, otoscopically - eardrum protrusion, hyperemia and swelling, loss of landmarks. What disease is it?
Acute purulent otitis media
Chronic purulent otitis media
Eustachian tube disfunction
Chronic secretory otitis media
Acute mastoiditis
90 із 200
Among the following causes of acute renal failure, the one that would be classified as 'postrenal'is:
Calculi
Cardiac failure
Rhabdomyolysis
Acute glomerulonephritis
Septicemia
91 із 200
A patient complains about strong dyspnea that is getting worse during physical activity. Presentations appeared suddenly 2 hours ago at work: acute chest pain on the left, cough. The pain was abating, but dyspnea, dizziness, pallor, cold sweat and cyanosis were progressing. Vesicular respiration is absent, X-ray picture shows a shadow on the left. What pathology might be suspected?
Spontaneous left-sided pneumothorax
Pulmonary infarction
Pulmonary abscess
Left-sided pneumonia
Pleuritis
92 із 200
During an operation for presumed appendicitis the appendix was found to be normal; however, the terminal ileum is evidently thickened and feels rubbery, its serosa is covered with grayishwhite exudate, and several loops of apparently normal small intestine are adherent to it. The most likely diagnosis is:
Crohn’s disease of the terminal ileum
Acute ileitis
Perforated Meckel’s diverticulum
Ileocecal tuberculosis
Ulcerative colitis
93 із 200
A 50 year old woman with a 2-year history of mild, diffuse, tender thyroid enlargement complains of 10 pound weight gain and fatigue. What is the most probable diagnosis?
Hashimoto’s thyroiditis
Riedel’s thyroiditis
Subacute thyroiditis
Papillary thyroid carcinoma
Suppurative thyroiditis
94 із 200
A severely traumatized patient who has been receiving prolonged parenteral alimentation develops diarrhea, mental depression, alopecia and perioral and periorbital dermatitis. Administration of which of the following trace elements is most likely to reverse these complications?
Zinc
Selenium
Silicon
Copper
Iodine
95 із 200
A patient has got pain in the axillary area, rise of temperature developed 10 hours ago. On examination: shaky gait is evident, the tongue is coated with white deposit. The pulse is frequent. The painful lymphatic nodes are revealed in the axillary area. The skin over the lymph nodes is erythematous and glistering. What is the most probable diagnosis?
Bubonic plague
Lymphogranulomatosis
Tularemia
Anthrax
Acute purulent lymphadenitis
96 із 200
A 56 year old patient has worked at the aluminium plant over 20 years. Within 3 last years he has been experiencing loosening of teeth, bone and joint pains, piercing pains in heart region, vomiting. The provisional diagnosis is:
Fluorine intoxication
Lead intoxication
Manganese intoxication
Mercury intoxication
Phosphorus intoxication
97 із 200
An excited patient constantly tries to look into the next room because he is sure of his friends’ presence. He claims to hear his friends and other people talking although no-one is there. He tries to persuade his doctor that people in the next room are disputing about 'his punishment', repeats aloud phrases he has allegedly heard from the next room. What state is it?
Acute hallucinosis
Delusion
Verbal illusions
Confabulations
Obsessional ideas
98 із 200
Survey radiograph of chest of a 62 year old smoker who often suffers from 'pneumonias'showed a triangle shadow in the right lung, its vertex is pointing towards the lung root. It also showed devi- ation of heart and mediastinum shadows towards the lesion. What is the most probable diagnosis?
Cenral cancer of lung
Lung cyst
Lung abscess
Atelectasis
Peripheral cancer of lung
99 із 200
A 68 year old patient has been suffering from chronic pancreatitis for 35 years. During the last 5 years he has been observing abatement of pain syndrome, abdominal swelling, frequent defecations up to 3-4 times a day (feces are greyish, glossy, with admixtures of undigested food), progressing weight loss. Change of symptom set is caused by joining of:
Irritable bowels syndrome
Exocrine pancreatic insufficiency
Syndrome of lactase deficiency
Endocrine pancreatic insufficiency
Chronic enterocolitis
100 із 200
A 60 year old patient has been suffering from arterial hypertension for 15 years. After recurrent stroke she started complaining about amotivati-onal bad mood, problems with attention concentration; she forgets to close the entrance door, cannot recall events of the last day. Computer tomography shows areas of postinfarction changes in the cortical postfrontal regions. What is the most probable diagnosis?
Vascular dementia
Dissociative amnesia
Pick’s disease
Huntington’s chorea
Alzheimer’s disease
101 із 200
A 40 year old patient complains of yellowish discharges from the vagina. Bimanual examination revealed no pathological changes. The smear contains Trichomonas vaginalis and blended flora. Colposcopy revealed two hazy fields on the frontal labium, with a negative Iodine test. Your tactics:
Treatment of specific colpitis and subsequent biopsy
Cervix ectomy
Cryolysis of cervix of the uterus
Diathermocoagulation of the cervix of the uterus
Specific treatment of Trichomonas colpitis
102 із 200
A patient complained about problems with pain and tactile sensitivity, pain in the nail bones at the end of the working day. He works at a plant with mechanical devices. What pathology can be suspected?
Vibration disease
Noise disease
Overwork symptoms
Hypovitaminosis of B1
Caisson disease
103 із 200
A 25 year old patient complains about weakness, dizziness, appearance of haemorrhagic skin rash. She has been suffering from this for a month. Blood count: erythrocytes: 1,0 • 1012/l, Hb- 37 g/l, colour index - 0,9, leukocytes - 1,2 • 109/l, thrombocytes - 42 • 109/l. What diagnostic method will be the most effective?
Sternal puncture
Liver biopsy
Abdominal ultrasound
Spleen biopsy
Coagulogram
104 із 200
A 28 year old woman had the second labour and born a girl with manifestations of anemia and progressing jaundice. The child’s weight was 3 400 g, the length was 52 cm. The woman’s blood group is B (III) Rh-, the father’s blood group is A (III) Rh+, the child’s blood group is B ( III) Rh+. What is the cause of anemia?
Rhesus incompatibility
Antigen A incompatibility
Antigen AB incompatibility
Antigen B incompatibility
Intrauterine infection
105 із 200
A 25 year old patient was admitted on the 1st day of the disease with complaints of double vision in the eyes, heavy breathing. The day before the patient ate home-made mushrooms. On objective examination: paleness, mydriatic pupils, difficult diglutition, bradycardia, constipation. What is the diagnosis?
Botulism
Salmonellosis, gastrointestinal form
Leptospirosis
Yersiniosis
Lambliasis
106 із 200
Maximum permissible concentration of carbon dioxide in the air is considered to be a sanitary index of air purity in a classroom. What concentration of carbon dioxide in the air is accepted as maximum permissible?
0,1%
0,15%
0,2%
0,05%
0,3%
107 із 200
Study of actual diet of an adult revealed the following: proteins make up 16% of energy value of daily ration, fats - 25%, carbohydrates - 59%. Evaluate compliance of protein, fat and carbohydrate share in the energy value of daily ration with the recommended shares of these nutrients?
Carbohydrate share is insufficient, there is excess of proteins
Carbohydrate share is insufficicent
Carbohydrate share is excessive
Nutrient content complies with the recommended shares of energy value
Fat share is insufficient
108 із 200
A healthy 75 year old woman who leads a moderately active way of life went through a preventive examination that revealed serum concentration of common cholesterol at the rate of 5,1 millimol/l and HDL (high-density lipoproteins) cholesterol at the rate of 70 mg/dl. ECG reveals no pathology. What dietary recommendation is the most adequate?
Any dietary changes are necessary
Decrease of saturated fats consumption
Decrease of carbohydrates consumption
Decrease of cholesterol consumption
Increase of cellulose consumption
109 із 200
Periodical survey of a worker of a chemicals plant revealed a malignant neoplasm on the urinary bladder. This occupational disease was the most probably caused by contact with the following industrial poison:
Benzidine
Vinyl chloride
Nickel carbonyl
Arsenic
Asbestos
110 із 200
A 52 year old patient was admitted to a hospital because of high hemorrhagic diathesis of mucous membranes, massive skin haemorrhages in form of ecchymoses and spots, nasal and stomachal haemorrhages. After clinical examinations her illness was diagnosed
Generation of antithrombocytic antibodies
Deficit of the VIII factor of blood coagulation
Iron deficit in blood serum, bone marrow and depot
Inherited insufficiency of plasm factors of blood coagulation
Disturbed hemostasis
111 із 200
A child with tetralogy of Fallot is most likely to exhibit:
Increased pressure in the right ventricle
Normal pressure gradient across the pulmonary valve
Increased pulmonary blood flow
Normal oxygen tension (PaO2) in the left ventricle
Increased pulse pressure
112 із 200
In treatment and prevention establishments, regardless of their organisational and proprietary form, the rights of patients should be observed. Which of these rights is the most significant?
The right to the protection of the patient’s interests
The right to the free choice
The right to be heard
The right to the information
The right to the protection from incompetence
113 із 200
A military unit stopped for 3-day’s rest in an inhabited locality after a long march. The sanitary-epidemiological reconnaissance found several water sources. It is necessary to choose the source complying with the hygienic standards for drinking water in the field conditions:
Artesian well water
Rain water
Spring water
Melt snow water
River water
114 із 200
A man in grave condition was delivered to the admission ward of a hospital on the 2nd day of illness. Examination revealed body temperature of 36,1oC, sharpened features of face, dry skin that makes a fold, aphonia, convulsive twitching of some muscle groups. Acrocyanosis is present. Heart sounds are muffled, Ps is 102 bpm, AP is 50/20 mm Hg. Abdomen is soft, drawn-in, painless. Anuria is presnt. Stool is liquid in form of rice water. What is the most probable diagnosis?
Cholera
Salmonellosis
Acute dysentery
Intestinal amebiasis
Escherichiosis
115 із 200
At year-end hospital administration has obtained the following data: annual number of treated patients and average annual number of beds used for patients’ treatment. What index of hospital work can be calculated on the base of this data?
Bed turnover
Average duration of patients’ presence in the hospital
Average annual bed occupancy
Bed resources of the hospital
Average bed idle time
116 із 200
A 3 year old child with weight deficiency suffers from permanent moist cough. In history there are some pneumonias with obstruction. On examination: distended chest, dullness on percussion over the lower parts of lungs. On auscultation: a great number of different rales. Level of sweat chloride is 80 millimol/l. What is the most probable diagnosis?
Mucoviscidosis (cystic fibrosis)
Pulmonary hypoplasia
Bronchial asthma
Bronchiectasis
Recurrent bronchitis
117 із 200
A 14 year old girl complains of profuse bloody discharges from genital tracts during 10 days after suppresion of menses for 1,5 month. Similiar bleedings recur since 12 years on the background of disordered menstrual cycle. On rectal examination: no pathology of the internal genitalia. In blood: Hb - 70 g/l, RBC-2, 3 • 1012/l, Ht - 20. What is the most probable diagnosis?
Juvenile bleeding, posthemorrhagic anemia
Werlholf’s disease
Incomplete spontaneous abortion
Polycyst ovarian syndrome
Hormonoproductive ovary tumor
118 із 200
A 43 year old patient had cholecystectomy 6 years ago because of chronic calculous cholecystitis. Lately he has been suffering from pain in the right subcostal area and recurrent jaundice. Jaundice hasn’t gone for the last 2 weeks. Stenosing papillitis 0,5 cm long has been revealed. What is the best way of treatment?
To perform endocsopic papillosphincterotomy
To treat conservatively: antibiotics, spasmolytics, antiinflammatory drugs
To perform choledochoduodenostomy
To perform external choledoch drainage
To perform transduodenal papillosphincterotomy
119 із 200
A full-term infant is 3 days old. On the different parts of skin there are erythemas, erosive spots, cracks, areas of epidermis peeling. The infant has scalded skin syndrome. Nikolsky’s symptom is positive. General condition of the infant is grave. Anxiety, hyperesthesia, febrile temperature are evident. What is the most probable diagnosis?
Exfoliative dermatitis
Impetigo neonatorum
Finger’s pseudofurunculosis
Phlegmon of newborn
Mycotic erythema
120 із 200
An outpatient hospital made record of 11600 diseases within one year. Among them influenza and ARD make up 5800, circulatory system diseases - 3480, digestion diseases - 1300, other diseases - 1020. What relative index can be calculated according this data?
Extensive
Correlation
Intensive
Visualization
-
121 із 200
A 35 year old woman consulted a doctor about affection of arm skin and lower third of forearm in form of a large edema, hyperemia, vesiculation and maceration. The disease developed after using a laundry detergent 'Lotos'. The patient has been using it for a month. She hasn’t suffered from dermatological diseases before. What is the most probable diagnosis?
Allergic dermatitis
Dermatitis simplex
Toxicoallergic dermatitis
Localized neurodermatitis
Microbial eczema
122 із 200
A 32 year old patient complains about heartburn and dull pain in the epigastrium that appear 2-3 hours after meal. Exacerbations happen in spring and in autumn. The patient has food intolerance of eggs and fish. Objectively: stomach palpation reveals painfulness in the gastroduodenal area. Electrophasoduodenoscopy revealed a 5 mm ulcer on the anterior wall of duodenum. Urease test is positive. What is the most probable leading mechanism of disease development?
Chelicobacterial infection
Reduced prostaglandin synthesis
Autoantibody production
Dietary allergy
Disorder of gastric motor activity
123 із 200
A 48 year old woman complains about weakness, weight loss, appetite loss, headache. The patient had acute glomerulonephritis when she was young. She has been suffering from arterial hypertension since she was 25. She didn’t undergo systematic treatment, consulted a doctor rarely. Examination revealed signs of chronic renal insufficiency of the I stage ( creatinine - 0,43 millimole/l). What dietary recommendations are the most reasonable?
Restriction of protein consumption
Diet with high content of 'alkaline' dishes
Restriction of carbohydrate consumption
Consumption of higher amounts of liquid
Restriction of fat consumption
124 із 200
A 50 year old woman complains about dull cardiac pain, asphyxia, body temperature rise up to 38 oC. She had influenza a week ago. Objectively: Ps -100 bpm, dropped-beat pulse during inspiration. AP - 100/70 mm Hg, heart sounds are muffled. ECG: reduced voltage, ST segment is above the isoline in all leads. X-ray picture shows extensively enlarged cardiac silhouette. Palmus is of small amplitude. What is the most probable diagnosis?
Exudative pericarditis
Myocarditis
Myocardium infarction
Stenocardia
Dilatation cardiomyopathy
125 із 200
Examination of a 4 month old child revealed some lemon-yellow squamae with fatty crusts on the scalp. What is the most probable diagnosis?
Gneiss
Strophulus
Pseudofurunculosis
Milk crust
Infantile eczema
126 із 200
A 39 year old patient complained about morning headache, appetite loss, nausea, morning vomiting, periodic nasal haemorrhages. The patient had acute glomerulonephritis at the age of 15 . Examination revealed rise of arterial pressure up to 220/130 mm Hg, skin haemorrhages on his arms and legs, pallor of skin and mucous membranes. What chemestry test has the greatest diagnostic importance in this case?
Blood creatinine
Uric acid
Blood bilirubin
Blood sodium
Fibrinogen
127 із 200
A 14 year old child suffers from vegetovascular dystonia of pubertal period. He has got sympathoadrenal atack. What medicine should be used for attack reduction?
Obsidan
Aminophylline
No-shpa
Corglicone
Amysyl
128 із 200
A 23 year old man complains about face edemata, headache, dizziness, reduced urination, change of urine colour (dark-red). These presentations appeared after pharyngitis. Objectively: face edemata, pale skin, temperature -37,4oC; heart rate - 86/min, AP - 170/110 mm Hg. Heart sounds are muffled, the II sound is accentuated above aorta. What etiological factor is probable in this case?
(3-hemolytic streptococcus
Alpha-hemolytic streptococcus
Staphylococcus aureus
Pyogenic streptococcus
Saprophytic staphylococcus
129 із 200
A 12 year old girl complains about abrupt weakness, nausea, dizziness, vision impairment. The day before she ate home-made stockfish, beef. Examination revealed skin pallor, a scratch on the left knee, dryness of mucous membranes of oral pharynx, bilateral ptosis, mydriatic pupils. The girl is unable to read a simple text (mist over the eyes). What therapy
Parenteral introduction of polyvalent antibotulinic serum
Gastric lavage
Parenteral introduction of antitetanus serum
Parenteral disintoxication
Parenteral introduction of antibiotics
130 із 200
A 19 year old patient was admitted to a hospital with acute destructive appendicitis. He suffers from hemophilia of B type. What antihemophilic medications should be included in pre- and postoperative treatment plan?
Fresh frozen plasma
Fresh frozen blood
Cryoprecipitate
Native plasma
Dried plasma
131 із 200
An 18 year old woman consulted a gynecologist about the pain in the lower part of abdomen, fever up to 37,5oC, considerable mucopurulent discharges from the genital tracts, painful urination. Vaginal and speculum examination results: the urethra is infiltrated, cervix of the uterus is hyperemic, erosive. The uterus is painful, ovaries are painful, thickened; fornixes are free. Bacterioscopy test revealed diplococcus. What diagnosis is the most probable?
Recent acute ascending gonorrhea
Trichomoniasis
Candydomycosis
Chronic gonorrhea
Chlamydiosis
132 із 200
A 26 year old woman who delivered a child 7 months ago has been suffering from nausea, morning vomiting, sleepiness for the last 2 weeks. She suckles the child, menstruation is absent. She hasn’t applied any contraceptives. What method should be applied in order to specify her diagnosis?
Ultrasonic examination
Speculum examination
Bimanual vaginal examination
Roentgenography of small pelvis organs
Palpation of mammary glands and pressing-out of colostrum
133 із 200
A 2 month old full-term child was born with weight 3500 g and was on the mixed feeding. Current weight is 4900 g. Evaluate the current weight of the child:
Corresponding to the age
Paratrophy of the I grade
Hypotrophy of the II grade
Hypotrophy of the I grade
150 g less than necessary
134 із 200
A woman consulted a doctor on the 14th day after labour about sudden pain, hyperemy and induration of the left mammary gland, body temperature rise up to 39oC, headache, indisposition. Objectively: fissure of nipple, enlargement of the left mammary gland, pain on palpation. What pathology would you think about in this case?
Lactational mastitis
Phlegmon of mammary gland
Breast cancer
Lacteal cyst with suppuration
Fibrous adenoma of the left mammary gland
135 із 200
A 32 year old patient complai- ns about pain in small joints of her hands, paresthesia at the tips of fingers, weakness, difficult diglutition. She has been suffering from this for 13 years. Objectively: face amimia, shortening of nail bones, skin indurations in the area of shoulder girdle are present. Roentgenological examination of lungs revealed basal pneumosclerosis. Fibrogastroscopy revealed esophagus constriction in its cardial part. Blood count: leukocytes 9,8 • 109/l, ESR - 22 mm/h, y-globulin - 22%. What is the most probable diagnosis?
Systemic scleroderma
Myxedema
Systemic lupus erythematosus
Rheumatoid arthritis
Dermatomyositis
136 із 200
A 30 year old woman ill with influenza felt palpitation and dull cardiac pain during moderate physical exercise. Objectively: Ps - 96 bpm, AP - 100/60 mm Hg. The first sound is quiet above the apex, soft systolic murmur is present. What complication is indicated by these clinical presentations?
Acute viral myocarditis
Acute allergic infectious myocarditis
Idiopathic myocarditis
Myocardiopathy
Neurocirculatory dystonia
137 із 200
A 5 month old boy was born prematurely, he didn’t suffer from any disease at the infant age and later on. Examination at an outpatient’s hospital revealed paleness of skin, sleepiness. Blood count: Hb - 95 g/l, erythrocytes - 3,5 • 1012/l, reticulocytes - 9%o, colour index - 0,7, osmotic stability of erythrocytes - 0,44-0,33%, serum iron - 4,9 micromole/l. What is the most probable cause of anemia?
Iron deficit
Hemogenesis immaturity
Erythrocyte hemolysis
Infectious process
B12 deficit
138 із 200
A 13 year old girl consulted the school doctor on account of moderate bloody discharge from the genital tracts, which appeared 2 days ago. Secondary sexual characters are developed. What is the most probable cause of bloody discharge?
Menarche
Werlhof’s disease
Juvenile hemorrhage
Endometrium cancer
Haemophilia
139 із 200
An 8 year old girl complains about joint pain, temperature rise up to 38oC, dyspnea. Objectively: the left cardiac border is deviated by 2,5 cm to the left, tachycardia, systolic murmur on the apex and in the V point are present. Blood count: leukocytes - 20,0 • 109/l, ESR - 18 mm/h. What sign gives the most substantial proof for rheumatism diagnosis?
Carditis
Fever
Accelerated ESR
Leukocytosis
Arthralgia
140 із 200
During inspection of sanitary conditions of studying at a technical university it was necessary to evaluate the visual regimen of students, who study from 9 a.m to 3 p.m. What index of natural light will be the most informative?
Natural light coefficient
Depth of study room
Light coefficient
Presence of mixed (superolateral) light
Time of the room insolation
141 із 200
A 70 year old man is suffering from coronary heart disease. His mood is evidently depressed, anxious. As a result of continious sleeplessness he has got fears, suicidal thoughts. He would sit for a long time in the same pose, answer after a pause, in a low, monotonous voice. His face has a look of suffering, pain, fear. What is the main psychopathologic syndrome?
Depressive syndrome
Asthenic syndrome
Obsessive syndrome
Phobic syndrome
Paranoid syndrome
142 із 200
A 37 year old farmer complains about general weakness, spastic pain in the lower parts of his abdomen, mainly in the left iliac area, frequent defecations up to 18 times a day, feces contain admixtures of mucus and blood. The illness began abruptly 3 days ago with chill, fever, headache. General condition is moderately severe, body temperature is 37,8oC. Sigmoid colon is spasmed and painful. What is the most probable diagnosis?
Dysentery
Amebiasis
Nonspecific ulcerative colitis
Salmonellosis
Yersiniosis
143 із 200
A 3 year old child fell acutely ill, body temperature rose up to 39,5oC, the child became inert, there appeared recurrent vomiting, headache. Examination revealed positive meningeal symptoms, after this lumbal puncture was performed. Spinal fluid is turbid, runs out under pressure, protein concentration is 1,8 g/l; Pandy reaction is +++, sugar concentration is 2,2 millimole/l, chloride concentration - 123 millimole/l, cytosis is 2, 35 • 109 (80% of neutrophils, 20 % of lymphocytes). What is the most probable diagnosis?
Purulent meningitis
Brain tumour
Serous tuberculous meningitis
Serous viral meningitis
Subarachnoid haemorrhage
144 із 200
A 39 year old patient suffering from hypertension felt suddenly intense headache in the region of occiput; there appeared recurrent vomiting. These presentations has been lasting for 5 hours. Objectively: Ps - 88 bpm, AP - 205/100 mm Hg, painfulness of occipital points, rigidity of occipital muscles are present. Kernig’s symptom is bilaterally positive. Subarachnoid haemorrhage is also suspected. What diagnostic method will be of the greatest importance for confirmation of provisional diagnosis?
Lumbar puncture
Computer tomography
EEG
Ultrasonic dopplerography
Examination of eye fundus
145 із 200
A 10 year old girl complains about abdominal pain that is arising and getting worse after eating rough or spicy food. She complains also about sour eructation, heartburn, frequent constipations, headache, irritability. She has been suffering from this for 12 months. Objectively: the girl’s diet is adequate. Tongue is moist with white deposit at the root. Abdomen is soft, painful in its epigastric part. What study method will help to make a diagnosis?
Esophagogastroduodenoscopy
Biochemical blood analysis
Fractional examination of gastric juice
Contrast roentgenoscopy
Intragastral pH-metry
146 із 200
A 35 year old patient who suffers from chronic glomerulonephritis and has been hemodialysisdependent for the last three years developed intermissions of heart activity, hypotension, progressing weakness, dyspnea. ECG showed bradycardia, atrioventricular block type I, high pointed waves T. The day before the flagrant violation of diet took place. What is the most probable cause of these changes?
Hyperkaliemia
Hypernatriemia
Hyperhydratation
Hypocalciemia
Hypokaliemia
147 із 200
A 34 year old coal miner who has been in service for 10 years was discharged from an occupational disease clinic after examination and treatment. He was diagnosed with the I stage of anthracosilicosis, peribronchitis, 0 stage of respiratory failure. What expert decision should be taken about his working capacity?
He should be referred to the local medical expert comission for determination of his disability group for the period of re-training
He should be referred to the local medical expert comission for determination of percentage of working capacity loss
He should be given medical certificate for the further out-patient treatment
He can continue working as coal miner provided that sanitary and hygienic conditions are observed
He should stay on the sick-list to consolidate treatment results
148 із 200
A 52 year old woman complains about face distortion. It appeared 2 days ago after supercooling. Objectively: body temperature is 38, 2oC. Face asymmetry is present. Frontal folds are flattened. Left eye is wider than right one and doesn’t close. Left nasolabial fold is flattened, mouth corner is lowered. Examination revealed no other pathology. Blood count: leukocytes - 10 • 109/l, ESR - 20 mm/h. What is the most probable diagnosis?
Facial neuritis
Trigeminus neuralgia
Hemicrania (migraine)
Brain tumour
Ischemic stroke
149 із 200
A patient complained about general weakness, fever, painful rash on his trunk skin . He has been suffering from this for 3 days. Objectively: lateral surface of trunk on the left is hyperemic and edematic, there are some groups of vesicles with serous and haemorrhagic contents. What is the most probable diagnosis?
Herpes zoster
Herpetiform Duhring’s dermatosis
Contact allergic dermatitis
Microbial eczema
Contact dermatitis simplex
150 із 200
Internal obstetric examination of a parturient woman revealed that the sacrum hollow was totally occupied with fetus head, ischiadic spines couldn’t be detected. Sagittal suture is in the straight diameter, occipital fontanel is directed towards symphysis. In what plane of small pelvis is the presenting part of the fetus?
Plane of pelvic outlet
Wide pelvic plane
Plane of pelvic inlet
Over the pelvic inlet
Narrow pelvic plane
151 із 200
A 24 year old patient complains about general weakness, dizziness, body temperature rise up to 37,5oC, sore throat, neck edema, enlargement of submaxillary lymph nodes. Objectively: mucous membrane of oropharynx is edematic and cyanotic, tonsils are enlarged and covered with films that spread beyond the tonsils and cannot be easily removed. What is the leading mechanism of this illness’ development?
Action of bacterial exotoxin
Action of bacterial endotoxin
Allergic
Accumulation of suboxidated products
Bacteriemia
152 із 200
A 38 year old man complains about mild pain and muscle weakness of shoulder and pelvic girdles and back that has been progressing for the last 3 weeks. He has also significant problems with getting up, going up and down the stairs and shaving. It is suspected that the patient is suffering from dermatomyosi-tis. Blood count: Hb - 114 g/l, leukocytes - 10,8 • 109/l, eosin - 9%, ESR - 22 mm/h, C-reactive protein (++). Change of the following laboratory factor will be of the greatest diagnostic importance:
Creatine phosphokinase
y-globulins
Sialic acids
Antibodies to the native DNA
Ceruloplasmin
153 із 200
A 9 year old boy has been suffering from diabetes mellitus for a year. He gets insulin injections ( humulin R, NPH), the dose makes up 0,4 units per 1 kg of body weight a day. Insulin is untroduced subcutaneously (into the shoulder) by means of a syringe. What measures should be taken in order to prevent lipodystrophy?
To change point of introduction
To administer antioxidants
To apply periodically other types of insulin
To reduce insulin dose
To limit fats in the boy’s diet
154 із 200
A 25 year old pediatrician fell ill a week ago: body temperature rose up to 37,6oC, there appeared a slight swelling on his neck. His illness was diagnosed as ARD, cervical lymphadenitis. Treatment course included erythromycin, hot compress on the neck. In course of treatment body tempearture rose up to 39oC, there appeared headache, repeated vomiting, meningeal syndrome. What studies are necessary for the final diagnosis?
Cerebrospinal puncture
Sputum test for secondary flora
Complete blood count
Puncture of cervical lymph node
Roentgenological examination of lungs
155 із 200
A 41 year old woman has suffered from nonspecific ulcerative colitis for 5 years. On rectoromanoscopy: evident inflammatory process of lower intestinal parts, pseudopolyposive changes of mucous membrane. In blood: WBC- 9,8 • 109/l, RBC- 3,0 • 1012/l, ESR - 52 mm/hour. What medication provides pathogenetic treatment of this patient?
Sulfosalasine
Vikasolum
Linex
Kreon
Motilium
156 із 200
A 49 year old female patient was admitted to a hospital with acute attacks of headache accompanied by pulsation in temples, AP rose up to 280/140 mm Hg. Pheochromocytoma is suspected. What mechanism of hypertensive atack does this patient have?
Increase of catecholamine concentration
Increase of thyroxine secretion
Increase of plasma renin activity
Increase of aldosterone level in blood
Increase of vasopressin secretion
157 із 200
A child was born with body weight 3250 g and body length 52 cm. At the age of 1,5 month the actual weight is sufficient (4350 g), psychophysical development corresponds with the age. The child is breast-fed, occasionally there are regurgitations. What is the cause of regurgitations?
Aerophagia
Esophageal atresia
Pylorospasm
Pylorostenosis
Acute gastroenteritis
158 із 200
Three weeks after acute angina the patient is still weak, inert, subfebrile, his retromaxillary lymph nodes are enlarged. Tonsils are flabby, stick together with arches, there are purulent plugs in lacunae. What is the most probable diagnosis?
Chronic tonsillitis
Paratonsillitis
Chronic pharyngitis
Acute lacunar tonsillitis
Tonsillar tumour
159 із 200
A 43 year old patient had rightsided deep vein thrombosis of iliofemoral segment 3 years ago. Now he is suffering from the sense of heaviness, edema of the lower right extremity. Objectively: moderate edema of shin, brown induration of skin in the lower third of shin, varix dilatation of superficial shin veins are present. What is the most probable diagnosis?
Postthrombophlebitic syndrome, varicose form
Parkes-Weber syndrome
Acute thrombophlebitis of superficial veins
Lymphedema of lower right extremity
Acute thrombosis of right veins
160 із 200
A 23 year old patient fell ill 3 weeks ago when she noticed a very painful induration in her axillary crease. 4-5 days later it burst and discharged a lot of pus. After that some new infiltrations appeared around the affected area. The patient has never suffered from skin diseases before. What is the most probable diagnosis?
Hydradenitis
Streptococcal impetigo
Mycosis
Furuncle
Herpes zoster
161 із 200
A child is 1 day old. During delivery there had been problems with extraction of shoulders. Body weight is 4300,0. Right arm hangs down along the body, hand is pronated, movement in the arm is absent. 'Scarf'symptom is positive. What is the most probable diagnosis?
Total right-sided obstetric paralysis
Proximal right-sided obstetric paralysis
Hemiparesis
Tetraparesis
Distal right-sided obstetric paralysis
162 із 200
An outbreak of food poisoning was recorded in an urban settlement. The illness was diagnosed as botulism on the grounds of clinical presentations. What foodstuffs should be chosen for analysis in the first place in order to confirm the diagnosis?
Tinned food
Pasteurized milk
Cabbage
Potatoes
Boiled meat
163 із 200
A 42 year old metalworker has been working at the turning machine for production of heavy large-size parts for 5 years. His work requires using of hand and pedal levers that involves considerable physical force. What means for osteoarthrosis prevention should be recommended?
To limit physical work
To administer protein-and-carbohydrate diet
To improve health at the Black sea coast
To go in for weightlifting
To administer protein-and-vitamin diet
164 із 200
A 30 year old patient undergoes treatment because of Werlhof’s disease. Objectively: the patient is pale, there are petechial haemorrhages on the extension surfaces of forearms. Ps is 92 bpm, AP is 100/60 mm Hg. The lower edge of spleen is at a level with umbilicus. Blood count: erythrocytes: 2,8 • 1012/l, Hb - 90 g/l, Ht -0,38, thrombocytes - 30 • 109/l. The patient is being prepared for splenectomy. What transfusion medium should be chosen in the first place for the preoperational preparation?
Thrombocytic mass
Native erythrocytic mass
Erythrocytic suspension
Stored blood
Washed erythrocytes
165 із 200
A 19 year old boy was admitted to a hospital with closed abdominal trauma. In course of operation multiple ruptures of spleen and small intestine were revealed. AP is falling rapidly, it is necessary to perform hemotransfusion. Who can specify the patient’s blood group and rhesus compatibility?
A doctor of any speciality
A surgeon
A laboratory physician
An anaesthesilogist
A traumatologist
166 із 200
Clinical and statistical study was devoted to the effect of a new pharmacological medication upon the patients with coronary heart disease. What parametric criterion (coefficient) can be used for estimation of results validity?
Student’s coefficient (t)
Sign criterion
Wilcoxon’s t-criterion
Kolmogorov-Smirnov’s criterion
Conformity coefficient
167 із 200
It is planned to make complete isolation boxes in the infectious department in order to prevent nosocomial airborne infections. The boxes consist of a tambour, a ward and a lock chamber. What structure should be also included in a complete isolation box?
Bathroom unit
Patient’s examination room
Doctor’s consulting room
Manipulation room
Nursing room
168 із 200
A 30 year old man complains of intense pain, reddening of skin, edema in the ankle-joint area, fever up to 39oC. There was an acute onset of the illness. In the past there were similar attacks lasting 5-6 days without residual changes in the joint. The skin over the joint is hyperemic and ill-defined, without infiltrative bank on the periphery. What is the most likely diagnosis?
Gout
Rheumatoid arthritis
Infectious arthritis
Osteoarthritis
Erysipelatous inflammation
169 із 200
Preventive examination of a 55 year old patient revealed diabetes mellitus. The patient hasn’t received treatment for it. Objectively: height is 170 cm, weight is 106 kg, skin humidity is normal. Ps is 76 bpm, rhythmic, left border of relative heart dullness is deviated by 1 cm to the left from the middle clavicular line, heart sounds are quiet, AP is 140/80 mm Hg. Glycemia on an empty stomach is 6,9 millimole/l. Glucose rate in the daily urine is 0,5%, diuresis makes up 2,5 l. What treatment tactics should be chosen?
To administer dietotherapy
To administer repaglinide
To administer metformin
To administer insulin
To administer glibenclamid
170 із 200
The results of 5 year monitoring allowed to estimate the level of environmental influence upon health indices of popultaion. What statistic method should be chosen?
Calculation of correlation coefficient
Calculation of coefficient of difference validity
Calculation of conformity coefficient
Calculation of dynamic indices
Calculation of regression coefficient
171 із 200
In order to improve organism tolerance of boarding-school pupils a doctor developed a program. The program is based upon the following principles: graduality, consistency, individuality, coomplexity. What of the main principles of organism tempering wasn’t taken into account?
Systematicness
Autodefense increase
Increase of resistance
Increase of influence force
Increase of influence intensity
172 із 200
A patient complains about pyrosis and permanent pain behind his breastbone. When he bends forward after eating there appears regurgitation. Roentgenological examination revealed extrasaccular cardiofunctional hernia of esophageal opening of diaphragm. Esophagoscopy revealed signs of reflux-esophagitis. What is the necessary tretment tactics?
Operation in a surgical department
Conservative treatment in the therapeutic hospital
Conservative treatment in an outpatients’ clinic
Treatment at a health resort
Conservative treatment in a surgical department
173 із 200
15 minutes after the second vaccination with diphteria and tetanus toxoids and pertussis vaccine a 4 month old boy manifested symptoms of Quincke’s edema. What medication should be applied for emergency aid?
Prednisolone
Furosemide
Adrenalin
Heparin
Seduxen
174 із 200
During examination a patient is unconscious, his skin is dry and hot, face hyperemia is present. The patient has Kussmaul’s respiration, there is also smell of acetone in the air. Symptoms of peritoneum irritation are positive. Blood sugar is at the rate of 33 millimole/l. What emergency actions should be taken?
Intravenous infusion of short-acting insulin
Intravenous infusion of neohaemodesum along with glutamic acid
Introduction of long-acting insulin
Intravenous infusion of glucose along with insulin
Intravenous infusion of sodium chloride saline
175 із 200
In order to study impact of microclimate upon the human organism it is necessary to make systematic observation of air temperature over 3 days. Choose a device that will allow to make the most precise temperature records:
Thermograph
Alcohol thermometer
Assmann psychrometer
August’s psychrometer
Mercury thermometer
176 із 200
A 3 month old child has occiput alopecia, anxious sleep, excessive sweating. What disease might be suspected?
Rachitis
Chondrodystrophy
Phosphate diabetes
Anemia
Spasmophilia
177 із 200
After delivery and revision of placenta there was found the defect of placental lobule. General condition of woman is normal, uterus is firm, there is moderate bloody discharge. Speculum inspection of birth canal shows absence of lacerations and raptures. What action is nesessary?
Manual exploration of the uterine cavity
Introduction of uterine contracting agents
Urine drainage, cold on the lower abdomen
Introduction of hemostatic medications
External massage of uterus
178 із 200
A 7 year old boy has periods of loss of attention that last 10-15 seconds and occur several times a day. During these periods he stands still in one position, doesn’t answer the questions or react when he is called by his name. Neurological examination revealed no changes. What diagnostic method should be applied to specify his diagnosis?
Electroencephalography
Examination of evoked potentials
Computer tomogram
Skull roentgenogram
Echoencephalography
179 із 200
A 52 year old patient complains about pain in the right part of her chest, dyspnea, cough with a lot of foul-smelling albuminoid sputum in form of 'meat slops'. Objectively: the patient’s condition is grave, cyanosis is present, breathing rate is 31/min, percussion sound above the right lung is shortened, auscultation revealed different rales. What is the most probable diagnosis?
Lung gangrene
Chronic pneumonia
Pleura empyema
Multiple bronchiectasis
Lung abscess
180 із 200
A 15 year old patient suffers from headache, nasal haemorrhages, sense of lower extremity coldness. Objectively: muscles of shoulder girdle are developed, lower extremities are hypotrophied. Pulsation on the pedal and femoral arteries is sharply dampened. AP is 150/90 mm Hg, 90/60 on the legs. Systolic murmur can be auscultated above carotid arteries. What is the most probable diagnosis?
Aorta coarctation
Coarctation of pulmonary artery
Aortal insufficiency
Aorta aneurism
Aortal stenosis
181 із 200
A patient with frostbite of both feet was delivered to the admission ward. What actions should be taken?
To apply a bandage, to introduce vasodilating medications
To administer cardiac medications
To put feet into hot water
To rub feet with snow
To apply an alcohol compress
182 із 200
A patient has a stab wound on his right foot. On the fourth day after injury the patient’s body temperature rose up to 38oC, inguinal lymph nodes became enlarged and painful, skin over them reddened. What complication might be suspected?
Lymphadenitis
Erysipelas
Tetanus
Phlegmon
Lymphangitis
183 із 200
A 52 year old patient complains about headache, weakness of his upper left extremity. Neurological symptoms become more intense during physical stress of the left extremity. Pulsation on the arteries of the left extremity is sharply dampened but it remains unchanged on the carotid arteries. What is the most probable diagnosis?
Occlusion of the left subclavicular artery, steal syndrome
Thoracal outlet syndrome
Raynaud’s syndrome
Occlusion of brachiocephalic trunk
Takayasu’s disease
184 із 200
A 57 year old patient abruptly lost the sight of one eye. Examination revealed that his sight made up 0,02 excentri-cally, eye fundus has haemorrhages of different forms and sizes ( 'squashed tomato'symptom). Disc of optic nerve is hyperemic. In anamnesis general vascular pathology is recorded. Direct-acting anticoagulants were administered. What is the most probable diagnosis?
Thrombosis of central vein of retina
Diabetic retinopathy
Hypertensive angiopathy
Hypertensive angioneuropathy
Embolism of central artery of retina
185 із 200
A 28 year old patient complained about prolongation of intermenstrual periods up to 2 months, hirsutism. Gynaecological examination revealed that the ovaries were enlarged, painless, compact, uterus had no peculari-ties. Pelvic ultrasound revealed that the ovaries were 4-5 cm in diameter and had multiple enlarged follicles on periphery. Roentgenography of skull base showed that sellar region was dilated. What is the most probable diagnosis?
Stein-Leventhal syndrome
Morgagni-Stewart syndrome
Premenstrual syndrome
Algodismenorrhea
Sheehan’s syndrome
186 із 200
A woman consulted a therapeutist about fatigability, significant weight loss, weakness, loss of appetite. She has been having amenorrhea for 8 months. A year ago she born a full-term child. Haemorrhage during labour made up 2 l. She got blood and blood substitute transfusions. What is the most probable diagnosis?
Sheehan’s syndrome
Homological blood syndrome
Vegetovascular dystonia
Shereshevsky-Turner’s syndrome
Stein-Leventhal syndrome
187 із 200
A 68 year old patient complains about acute pain in his right foot, toe edema and darkening of skin of the IV toe. He has been suffering from diabetes melli-tus for 15 years, doesn’t receive regular treatment. What complication of diabetes mellitus is it?
Gangrene of the IV toe on the right foot
Panaritium
Erysipelas
Haematoma
Fracture of the IV toe on the right foot
188 із 200
Preventive examination of an 11 year old boy helped to determine his habitus type. It was established that the child’s shoulders were deviated and brought forward, with forward flexion of head, the thorax was flattened, abdomen was convex. The child’s backbone had signs of deepened cervical and lumbar curvatures. What habitus is it?
Kyphosis
Corrected
Round-shouldered
Normal
Lordosis
189 із 200
During hygienic examination of a hospital it was established that the area for each bed in a double ward was: in the infectious department for children - 7 m2, in the infectious department for adults -8 m2, in the burns department - 9 m2, in the radiological department -10 m2, in the critical care department - 13 m2. In which wards the area for each bed doesn’t correspond with hygienic requirements?
In burns wards
In infectious wards for adults
In infectious wards for children
In critical care wards
In radiological wards
190 із 200
A 2 year old child has been ill with acute respiratory viral infection of upper thrice a year - in February, in April and in December. How should these occurences be recorded?
It is necessary to fill in 3 statistic talons signed (+)
It is necessary to fill in 3 statistic talons signed (-)
It is necessary to fill in 1 statistic talon signed (+)
It is necessary to fill in 1 statistic talon signed (+) and 2 statistic talons signed (-)
It is necessary to fill in 1 statistic talon signed (-)
191 із 200
Researchers studied disease incidence of influenza and acute respiratory viral infection within the last 5 years. What kind of graphic presentation should be used for the best visualization of this data?
Linear diagram
Pie diagram
Histogram
Bar diagram
Radial diagram
192 із 200
A 55 year old patient felt suddenly sick in a hospital corridor, he was immediately examined by a doctor. Examination revealed that the patient’s skin was pale, autonomous respiration was absent, pulse on carotid arteries couldn’t be felt, pupils were mydriatic. What action should be taken at the beginning of cardiac resuscitation?
Precordial thump
Defibrillation
Restoration of airway patency
Mouth-to-mouth ventilation
Closed-chest cardiac massage
193 із 200
A 24 year old patient complained about putting on weight, limosis. Objectively: the patient’s constitution is of hypersthenic type, body weight index is 33,2 kg/m2, waist circumference is 100 cm. Correlation of waist circumference to the thigh circumference is 0,95. What is the most probable diagnosis?
Alimentary constitutional obesity of the I stage, abdominal type
Alimentary constitutional obesity of the II stage, abdominal type
Alimentary constitutional obesity of the III stage, gynoid type
Hypothalamic Itsenko-Cushing obesity of the II stage, gynoid type
Hypothalamic Itsenko-Cushing obesity of the I stage, abdominal type
194 із 200
A parturient woman is 27 year old, it was her second labour, delivery was at term, normal course. On the 3rd day of postpartum period body temperature is 36,8oC, Ps - 72/min, AP 120/80 mm Hg. Mammary glands are moderately swollen, nipples are clean. Abdomen is soft and painless. Fundus of uterus is 3 fingers below the umbilicus. Lochia are bloody, moderate. What is the most probable diagnosis?
Physiological course of postpartum period
Postpartum metroendometritis
Subinvolution of uterus
Lactostasis
Remnants of placental tissue after labour
195 із 200
Esophagus wall of a 72 year old patient with severe concomitant pathology was injured during urgent fi-broesophagogastroscopy. This resulted in progressing of acute respiratory failure and collapse of the left lung. What aid should be rendered?
Drainage of pleural cavity by Bullaux method, mediastinum drainage, antibacterial therapy
Left-sided thoracotomy, closure of esophagus wound
Left-sided thoracotomy, closure of esophagus and mediastinum wound
Buelau’s drainage of pleural cavity, antibacterial therapy
Endoscopic closure of esophagus wound, drainage
196 із 200
A 46 year old woman who has been suffering from hypertension for 5 years was diagnosed with hypertensive crisis. She complains about palpitation, sense of head pulsation; heart rate is 100/min, AP is 190/100 mm Hg (haemodynamics is of hyperkinetic type). What medication should be the medication of choice?
3-adrenoceptor blocker
Diuretic
Dihydropyridine calcium antagonist
^-adrenoceptor blocker
Adenosine pyrophosphate inhibitor
197 із 200
A 30 year old patient complains about inability to become pregnant over 3 years of married life. The patient is of supernutrition type, she has hair along the median abdominal line, on the internal thigh surface and in the peripapillary area. Menses started at the age of 16, they are infrequent and non-profuse. US revealed that the uterus was of normal size, ovaries were 4 x5x5 cm large and had a lot of cystic inclusions. What is the most probable diagnosis?
Polycystic ovaries
Ovarian cystoma
Bilateral ovarian tumours
Chronic oophoritis
Menstrual irregularity
198 із 200
A 4 month old child was admitted to a surgical department 8 hours after the first attack of anxiety. The attacks happen every 10 minutes and last for 23 minutes, there was also one-time vomiting. Objectively: the child’s condition is grave. Abdomen is soft, palpation reveals a tumour-like formation in the right iliac area. After rectal examination the doctor’s finger was stained with blood. What is the most probable diagnosis?
Ileocecal invagination
Gastrointestinal haemorrhage
Helminthic invasion
Pylorostenosis
Wilm’s tumour
199 із 200
During preventive examination a 16 year old patient presented no problems. Objectively: the patient has signs of malnutrition, he is asthenic, AP is 110/70 mm Hg, Ps is 80 bpm, cardiac border is normal, auscultation above the cardiac apex reveals three sounds, cardiac murmur is absent. ECG shows no pathological changes, phonocardiogram shows that the third sound comes 0,15 s after the second one above the apex. How are these changes called?
III physiological sound
IV physiological sound
Protodiastolic gallop rhythm
Atrial gallop rhythm
Fout-ta-ta-rou (reduplication of the 2nd sound)
200 із 200
A 52 year old patient with disseminated vertebral osteochondrosis lifted a significant load that resulted in lumbar pain and pain along the sciatic nerve. Objectively: positive Lasegue’s sign on the left, reduced Achilles reflex. What drug would be the most effective from the pathogenetic point of view?
Diclofenac
Analgin
Aspirin
Novocaine
Spasmalgon