Krok2 - Medicine - 2009

Krok 2 Medicine 2009 1
1. A woman complains of having slight A. Infectious contamination of the urinary

dark bloody discharges and mild pains in system
the lower part of abdomen for several B. Thrombophlebitis of veins of the pelvis
days. Last menses were 7 weeks ago. C. Infectious hematoma
The pregnancy test is positive. Bimanual D. Endometritis
investigation: the body of the uterus indi- E. Apostasis of sutures after episiotomy
cates for about 5-6 weeks of pregnancy,
it is soft, painless. In the left appendage 5. In the woman of 24 years about earli-
there is a retort-like formation, 7х5 cm er normal menstrual function, cycles
large, mobile, painless. What examination became irregular, according to tests of
is necessary for detection of fetus locali- function diagnostics - anovulatory. The
zation? contents of prolactin in blood is boosted.
Choose the most suitable investigation:
A. Ultrasound
B. Hysteroscopy A. Computer tomography of the head
C. Hromohydrotubation B. Determination of the level of
D. Colposcopy gonadotropins
E. Cystoscopy C. USI of organs of small pelvis
D. Progesterone assay
2. A pregnant woman in her 40th E. Determination of the contents of
week of pregnancy undergoes obstetric testosteron-depotum in blood serum
examination: the cervix of uterus is
undeveloped. The oxytocin test is negati- 6. A patient was delivered to a surgical
ve. Examination at 32 weeks revealed: department after a road accident with a
AP 140/90 mm Hg, proteinuria 1 g/l, peri- closed trauma of chest and right-sided
pheral edemata. Reflexes are normal. rib fracture. The patient was diagnosed
Choose the most correct tactics: with right-sided pneumothorax, it is indi-
cated to perform drainage of pleural cavi-
A. Labour stimulation after preparation ty. Pleural puncture should be made in:
B. Absolute bed rest for 1 month
C. Complex therapy of gestosis for 2 days A. In the 2nd intercostal space along the
D. Caesarian section immediately middle clavicular line
E. Complex therapy of gestosis for 7 days B. In the 6th intercostal space along the
posterior axillary line
3. A 26 year old woman had the second C. In the 7th intercostal space along the
labour within the last 2 years with scapular line
oxytocin application. The child’s weight is D. In the projection of pleural sinus
4080 g. After the placent birth there were E. In the point of the greatest dullness on
massive bleeding, signs of hemorrhagic percussion
shock. Despite the injection of contracti-
ve agents, good contraction of the uterus 7. A patient who takes diuretics has
and absence of any cervical and vaginal developed arrhythmia as a result of
disorders, the bleeding proceeds. Choose cardiac glycoside overdose. What is the
the most probable cause of bleeding: treatment tactics in this case?
A. Atony of the uterus A. Increased potassium concentration in

B. Injury of cervix of the uterus blood
C. Hysterorrhexis B. Increased sodium consentration in
D. Delay of the part of placenta blood
E. Hypotonia of the uterus C. Reduced magnesium concentration in
blood
4. A woman of a high-risk group (chronic D. Increased calcium concentration in
pyelonephritis in anamnesis) had vagi- blood
nal delivery. The day after labour she E. -
complained of fever and loin pains,
frequent urodynia. Specify the most 8. A 20 year old patient was delivered to
probable complication: the hospital in summer from the street wi-
th haemorrage from the brachial artery.
First medical aid involved aplication of
a tourniquet for provisional arrest of
bleeding. What is the maximal exposure
of the tourniquet?
A. 120 minutes A. Leftsided renal colic

B. 15 minutes B. Herpes zoster
C. 30 minutes C. Sigmoid diverticulitis
D. 60 minutes D. Torsion of the left testicle
E. 180 minutes E. Retroperitoneal haemorrhage
9. The average body lenth of newborn 13. A 40 year old woman has a self-
boys is 50,9 cm at a sigma 1,66; and detected hard breast mass. The procedure
average mass - 3432 at a sigma 5,00. What of choice for confirming the diagnosis is:
criterion is necessary in order to compare
degree of variability of these signs? A. Excision biopsy
B. Mammography
A. Coefficient of variation C. Thermography
B. Sigma D. Ultrasonography
C. Limit E. Aspiration biopsy with cytology
D. Amplitude
E. Coefficient of association 14. What is the maximum durati-
on of medical certificate in case of
10. Indicate the registration medical tuberculosis?
document for the patient, who 21.02. was
addressed to the doctor with diagnosis A. 2 months
ARVD for the first time in this year: B. Week
C. 2 weeks
A. The statistical coupon is to be filled in D. Month
and it is necessary to deliver on a sign (+) E. 10 months
B. The statistical coupon for registration
of final diagnosis is not necessary 15. The student has the following devices:
C. The statistical coupon is to be filled in, Geiger counter, Ebert counter, Krotov’s
but a sign (+) is not necessary to be put in apparatus, Mischuk device, Ebert device.
D. It is necessary to fill in the emergency What device can he use to assess air germ
notice on a case of a contagion pollution?
E. The necessary registration form is not A. Krotov’s apparatus
indicated B. Ebert’s counter
11. Five days after a total hip joi- C. Geiger’s counter
nt replacement a 72 year old woman D. Mischuk’s device
becomes acutely short of breath, di- E. Ebert’s device
aphoretic and hypotensive. Both lung 16. Student В. lives in the canalized
fields are clear to auscultation and house in the flat with complete set of
percussion, but examination of the neck
sanitary equipment (WC, bath, shower,
reveals mild jugular venous distension wi-
th prominent A waves. Heart sounds are local water heater). How much water
normal. ECG shows sinus tachycardia wi- consumption has he got?
th a new right bundle branch block and A. 160-200 l
minor nonspecific ST − T wave changes. B. 10-15 l
The most likely diagnosis is: C. 50-100 l
A. Pulmonary thromboembolism D. 300-400 l
B. Acute myocardial infarction E. 500 l
C. Aortic dissection 17. What guarantees against the
D. Pericarditis preconceived attitude to the physician in
E. Aspiration cases of professional law violations do
12. A 38 year old man, previously in you know?
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:
A. Sanction of public prosecutor, inquiry is transparent, other parts of eyeball

by preliminary investigator of prosecutor’s have no changes. Visus 0,9. Right eye
office, committee of experts is healthy, Visus 1,0. What additional
B. Draw up a statement about forensic method would you choose first of all?
medical examination
C. Conduct an inquiry by preliminary A. Staining test with 1% fluorescein
investigator of police department B. X-ray examination of orbit
D. Utilisation copy of medical documents C. Tonometria
E. Conduct forensic medical examination D. Gonioscopia
by district forensic medicine expert E. Cornea sensation-test
18. A 63 year old patient was diagnosed 23. A patient with acute purulent otitis
with purulent mediastinitis. What of the media complicated by mastoiditis was
below listed diseases are NOT the cause admitted to a hospital. Roentgenogram
of purulent mediastinitis? of mastoid processes showed the shadi-
owing of the cellular system on the lesion,
A. Cervical lymphadenitis absence of bone septa was present. What
B. Deep neck phlegmon are the necessary therapeutic actions at
C. Perforation of the cervical part of the the second stage of mastoiditis?
oesophagus
D. Perforation of the thoracic part of the A. Mastoidotomy
oesophagus B. Paracentesis of the drum
E. Iatrogenic injury of the trachea C. Radical operation on the middle ear
D. Tympanoplasty
19. A 36 year old patient was diagnosed E. Cateterization of the Eustachian tube
with right-sided pneumothorax. What
method of treatment is indicated to the 24. The most available and informative
patient? diagnostic method for closed trauma of
the urinary bladder is:
A. Surgical treatment: drainage of the
pleural cavity A. Retrograde cystography
B. Antiinflammation therapy B. Pelvic arteriography
C. Symptomatic therapy C. Cystography
D. Pleural puncture D. Sonography of the urinary bladder
E. Thoracotomy E. Palpation and percussion of abdomen
20. It is suspected that a 34 year old pati- 25. Female 45 year old patient was admi-
ent has an abscess of Douglas pouches. tted to the traumatological ward with the
What diagnostic method is to be chosen? closed fracture of the medial malleolus
with its displacement up to 3 mm. The
A. Digital examination of rectum foot is to be fixed with a plaster cast in
B. Rectoromanoscopy the following position:
C. Laparoscopy
D. Percussion and auscultation of stomach A. At right angle with varus positioning
E. R-scopy of abdominal cavity of the foot
B. In position of planter flexion of foot
21. A patient has restrained umbilateral C. In position of pronation
hernia complicated by phlegmon hernia, D. In position of supination
it is necessary to take following actions: E. In position of dorsal flexion of foot
A. Herniotomy by Mayo-Sapezhko 26. A 3 month old infant suffering from
B. Herniotomy by Mayo acute segmental pneumonia has dyspnea
C. Herniotomy by Sapezhko (respiration rate - 80 per minute),
D. Herniotomy by Lekser paradoxical breathing, tachycardia, total
E. Herniotomy by Grenov cyanosis. Respiration and pulse - ratio is
1:2. The heart dullness under normal size.
22. A 10 year old boy complains Such signs characterise:
about pain in his left eye and strong
photophobia after he had injured his
left eye with a pencil at school. Left
eye examination: blepharospasm, cili-
ary and conjunctival congestion, cornea
A. Respiratory failure of III degree

B. Respiratory failure of I degree A. Replacement blood transfusion
C. Respiratory failure of II degree (conservative therapy)
D. Myocarditis B. Conservative therapy
E. Congenital heart malformation C. Blood transfusion (conservative
therapy)
27. A 3 year old child has been sufferi- D. Symptomatic therapy
ng from fever, cough, coryza, conjuncti- E. Antibiotics
vitis for 4 days. He has been taking
sulfadimethoxine. Today it has fever up 31. Infant is 6,5 months now and is given
to 39o C and maculopapular rash on its natural feeding since birth. Body mass
face. Except of rash the child’s skin has was 3,5 kg, with length 52 cm at birth.
no changes. What is your diagnosis? How many times per day the supplement
(up feeding) should be given?
A. Measles
B. Allergic rash A. 2
C. Rubella B. 3
D. Scarlet fever C. 1
E. Pseudotuberculosis D. 0
E. 4
28. A 2 year old girl has been ill for
3 days. Today she has low grade fever, 32. A 12 year old child has the ulcer di-
severe catarrhal presentations, slight sease of stomach. What is the etiology of
maculopapular rash on her buttocks and this disease?
enlarged occipital lymph nodes. What is
your diagnosis? A. Intestinal bacillus
B. Helicobacter pylory
A. Rubella C. Salmonella
B. Scarlet fever D. Lambliosis
C. Measles E. Influenza
D. Adenoviral infection
E. Pseudotuberculosis 33. A nine year old child is at a hospi-
tal with acute glomerulonephritis. Cli-
29. A 3 year old boy fell ill abruptly: nical and laboratory examinations show
fever up to 39o C , weakness, vomi- acute condition. What nutrients must not
tng. Haemorrhagic rash of various si- be limited during the acute period of
ze appeared on his lower limbs within glomerulonephritis?
5 hours. Meningococcemia with infecti-
ve - toxic shock of the 1 degree was di- A. Carbohydrates
agnosed. What medications should be B. Salt
administered? C. Liquid
D. Proteins
A. Chloramphenicol succinate and predni- E. Fats
sone
B. Penicillin and prednisone 34. Examination of a 3-month-old chi-
C. Penicillin and immunoglobulin ld revealed scrotum growth on the right.
D. Chloramphenicol succinate and This formation has elastic consistency, its
interferon size decreases during sleep and increases
E. Ampicillin and immunoglobulin when the child is crying. What examinati-
on will be helpful for making a correct
30. A woman delivered a child. It was diagnosis?
her fifth pregnancy but the first deli-
very. Mother’s blood group is A(II)Rh− , A. Palpation of the thickened cord crossi-
newborn’s - A(II)Rh+ . The level of indi- ng the pubical tubercule (sign of the silk
rect bilirubin in umbilical blood was 58 glove)
micromole/l, haemoglobin - 140 g/l, RBC- B. Diaphanoscоpy
3, 8 · 1012 /l. In 2 hours the level of indi- C. Palpation of the external inguinal ring
rect bilirubin turned 82 micromole/l. The D. Punction of the scrotum
hemolytic disease of newborn (icteric- E. Examination of the formation in
anemic type, Rh-incompatibility) was di- Trendelenburg’s position
agnosed. Choose the therapeutic tactics:
35. A 52 year old patient with history
of functional Class II angina complai- A. Focal

ns of having intense and prolonged B. Disseminated
retrosternal pains, decreased exercise C. Miliary
tolerance for 5 days. Angina is less D. Fibro-cavernous
responsive to nitroglycerine. What is the E. Tuberculoma
most probable diagnosis?
40. A woman 26 years old has abused
A. IHD. Unstable angina alcohol for 7 years. She has psychologi-
B. Cardialgia due to spine problem cal dependence on alcohol, but no wi-
C. IHD. Functional Class II angina thdrawal syndrome. Drinks almost every
D. Myocarditis day approximately 50-100 g of wine. She
E. Myocardial dystrophy is in her 4-th week of pregnancy. Primary
prevention of fetal alcohol syndrome
36. A 52 year old patient has requires:
hypervolaemic type of essential
hypertension. Which of the following A. Treatment of alcoholism and full absti-
medications is to be prescribed either as nance from alcohol during all the period
monotherapy or in complex with other of pregnancy
antihypertensive drugs? B. Medical abortion
C. Decrease of alcohol use
A. Hypothiazid D. Participation in the A-ANON group
B. Dibazol E. Gyneacological observation
C. Clonidine
D. Kapoten 41. The observed patient’s movements
E. Nifedipin are retarded, she answers no questions.
Sometimes she spontaneously stiffens in
37. A 62 year old patient complains of strange postures. It is possible to set her
rest dyspnea, heart pains. 3 years ago body and limbs into different positions
he had myocardial infarction. Physical artificially. If the psychiatrist lifts her arm
examination: orthopnea, acrocyanosis, or leg, so that she remains standing on
swollen cervical veins. Ps - 92, total heart the other leg, the patient can stay in such
enlargement, the liver is enlarged by 7 a position for quite a long time. Name the
cm, shin edema. What is the stage of probable disorder:
chronic heart failure (CHF)?
A. Catatonic stupor, schizophrenia
A. CHF- 2 B B. Depressive stupor, bipolar disorder
B. CHF- 1 C. Apathetic stupor, schizophrenia
C. CHF- 2 А D. Psychogenic stupor, stress disorder
D. CHF- 0 E. Dissociative stupor, dissociative
E. CHF- 3 psychosis
38. A 27 year old man complains of pai- 42. The man, aged 42, applied to the
ns in epigastrium which are relieved by therapeutist with complaints of pricking
food intake. EGDFS shows antral erosive pains in scapulas area, dyspnea on physi-
gastritis, biopsy of antral mucous presents cal exertion, cough with discharge of
Hеlicobacter Pylori. Diagnosis is: small amount of sputum. During 10 years
he works in coal mining. On percussion-
A. Gastritis of type B box-note sound in the lower parts, on
B. Gastritis of type A auscultation- a harsh breathing. There
C. Reflux-gastritis were no changes in the heart. Possible
D. Menetrier’s gastritis diagnosis?
E. Rigid antral gastritis
A. Silicosis
39. Prophylactic photoroentgenography B. Tuberculosis of lungs
examination of a 25 year old man C. Silicatosis
revealed focal shadowings of small and D. Bronchiectatic disease
medium intensity with irregular contours E. Chronic bronchitis
in the 1st and 2nd segments of the ri-
ght lung. Which clinical form can be 43. A man, aged 37, working on the
suspected? collective farm on sowing, was admitted
to the infectious hospital with the clini-
cal symptoms: miosis, labored breathing,
sweating.What kind of poisoning is it and weakness, high temperature, sore throat.

what is the first aid? Objectively: enlargement of all groups of
lymph nodes was revealed. The liver is
A. Poisoning by POC. Treatment: atropine enlarged by 3 cm, spleen - by 1 cm. In
B. Poisoning by lead. Treatment: tetacine blood: leukocytosis, atypical lymphocytes
Calcii - 15%. What is the most probable di-
C. Poisoning by the methylic alcohol. agnosis?
Treatment: ethylic alcohol
D. Poisoning by vapours of mercury. A. Infectious mononucleosis
Treatment: unithiol B. Acute lymphoid leukosis
E. - C. Diphtheria
D. Angina
44. The 25 year old patient was admi- E. Adenoviral infection
tted on the 1st day of the disease wi-
th complaints of double vision in the 48. A 4 year old girl was playing with
eyes, difficult respiration. The day before her toys and suddenly she got an attack
the patient ate home-made mushrooms. of cough, dyspnea. Objectively: respirati-
On objective examination: paleness, wi- on rate - 45/min, heart rate - 130/min.
dened pupils, disorder of swallowing, Percussion revealed dullness of percutory
bradycardia, constipation are marked. sound on the right in the lower parts.
What is the diagnosis? Auscultation revealed diminished breath
sounds with bronchial resonance on the
A. Botulism right. X-ray pictue showed shadowing of
B. Yersiniosis the lower part of lungs on the right. Blood
C. Leptospirosis analysis revealed no signs of inflammati-
D. Salmonellosis, gastrointestinal form on. The child was diagnosed with foreign
E. Lambliasis body in the right bronchus. What compli-
cation caused such clinical presentations?
45. A 28 year old patient was admi-
tted to the clinic with complaints of the A. Atelectasis
temperature rise up to 39, 0oC , headache, B. Emphysema
weakness, constipation on the 9th day C. Pneumothorax
of the disease. On examination: single D. Bronchitis
roseolas on the skin of the abdomen are E. Pneumonia
present. The pulse rate is 78 bpm. The li-
ver is enlarged by 2 cm. What is the most 49. A 75 year old man who has been
probable diagnosis? suffering from diabetes for the last six
months was found to be jaundiced. He
A. Typhoid fever was asymptomatic except for weight loss
B. Leptospirosis at the rate of 10 pounds in 6 months.
C. Brucellosis Physical examination revealed a hard,
D. Sepsis globular, right upper quadrant mass that
E. Malaria moves during respiration. A CT scan
shows enlargement of the head of the
46. A patient has been in a hospital. The pancreas, with no filling defects in the
beginning of the disease was gradual: liver. The most likely diagnosis is:
nausea, vomiting, dark urine, аcholic
stools, yellowness of the skin and scleras. A. Carcinoma of the head of the pancreas
The liver is protruded by 3 cm. Jaundi- B. Infectious hepatitis
ce progressed on the 14th day of the di- C. Haemolytic jaundice
sease. The liver diminished in size. What D. Malignant biliary stricture
complication of viral hepatitis caused E. Metastatic disease of liver
deterioration of the patient’s condition?
50. A 60 year old man with unstable angi-
A. Hepatic encephlopathy na pectoris fails to respond to heparin,
B. Meningitis nitroglycerin, beta adrenegic blockers
C. Relapse of viral hepatitis and calcium channel antagonist. The best
D. Cholangitis management includes:
E. Infectious-toxic shock
47. An 18 year old patient was admitted to
a hospital with complaints of headache,
A. Coronary artery bypass grafting murmur on apex. The liver is enlarged by

B. Intravenous streptokinase 5 cm. What is the cause of heart failure?
C. Excercise testing
D. Oral aspirin A. Mitral stenosis
E. Antihypertensive therapy B. Mitral regurgitation
C. Tricuspid stenosis
51. A 22 year old woman complained D. Tricuspid regurgitation
of right subcostal aching pain, nausea, E. Aortic stenosis
and decreased appetite. She fell ill
2 months after appendectomy when 55. A 32 year old welder complains of
jaundice appeared. She was treated in weakness and fever. His illness started as
an infectious hospital. 1 year later above tonsillitis a month before. On exam, BT
mentioned symptoms developed. On of 38, 9o C , RR of 24/min, HR of 100/min,
exam: the subicteric sclerae, enlarged fi- BP of 100/70 mm Hg, hemorrhages
rm liver. Your preliminary diagnosis: on the legs, enlargement of the lymph
nodes. CBC shows Hb of 70 g/l, RBC of
A. Chronic viral hepatitis 2, 2 · 1012 /l, WBC of 3, 0 · 109/l with 32% of
B. Calculous cholecystitis blasts, 1% of eosinophiles, 3% of bands,
C. Gilbert’s disease 36% of segments, 20% of lymphocytes,
D. Acute viral hepatitis and 8% of monocytes, ESR of 47 mm/h.
E. Chronic cholangitis What is the cause of anemia?
52. A 25 year old woman complained A. Acute leukemia
of edema on her face and legs, rise B. Chronic lympholeukemia
of blood pressure up to 160/100 mm C. Aplastic anema
Hg and weakness. She fell ill 3 weeks D. Vitamin B12 deficiency anemia
after recovering from angina. Urinalysis E. Chronic hemolytic anemia
data: protein of 0,5 g/l, erythrocytes
of 17-20/field, leukocytes of 2-3/field, 56. A male patient, 60 years old, tobacco
erythrocyte casts. What treatment should smoker for 30 years, alcoholic, has
be initiated after specifying the di- dysphagia and weight loss since 4 months.
agnosis? Suggested diagnosis?
A. Penicillin OS A. Cancer of the esophagus
B. Heparin B. Esophageal achalasia
C. Ceftriaxone C. Hanter’s disease
D. Dipyridamole D. Esophagitis
E. Ciprofloxacine E. Esophageal diverticulum
53. A fitter of a metallurgic factory 57. Which of the following symptoms
with occupational exposure to high would occur only if a total-body acute
concentrations of mercury fumes for 16 radiation exposure exceeded 5.000 rad
years presents instability of pulse and (50 Gy)
blood pressure, general hyperhydrosis,
asymmetric innervations of facial muscles A. Hallucinations and impairment of
and tongue, positive subcortical reflexes, vision
hand tremor on physical examination. A B. Nausea and vomiting
dentist revealed paradontosis and chronic C. Diarrhea
stomatitis. What is the most probable di- D. Bleeding gums
agnosis? E. Epilation (hair loss)
A. Chronic mercury intoxication 58. In the 43rd week of gestation a
B. Neuroinfection long, thin infant was delivered. He is
C. Parkinson syndrome apneic, limp, pale, and covered with "pea
D. Acute mercury intoxication soup"amniotic fluid. The first step in the
E. Mercury encephalopathy resuscitation of this infant at delivery
should be:
54. A 42 year old woman complai-
ns of dyspnea, edema of the legs and
tachycardia during minor physical exerti-
on. Heart borders are displaced to the left
and S1 is accentuated, there is diastolic
A. Suction of the trachea under direct abating, but dyspnea, dizziness, pallor,
vision cold sweat and cyanosis were progressi-
B. Artificial ventilation with bag and mask ng. Vesicular respiration is absent, X-ray
C. Artificial ventilation with endotracheal picture shows a shadow on the left. What
tube pathology might be suspected?
D. Administration of 100% oxygen by
mask A. Spontaneous left-sided pneumothorax
E. Catheterization of the umbilical vein B. Pulmonary infarction
C. Pleuritis
59. 25 children at the age of 2-3 years D. Left-sided pneumonia
who don’t attend any child welfare insti- E. Pulmonary abscess
tutions should be observed by a district
pediatrician within the current year. How 63. Which of the methods of examination
many initial visits of this group of chi- is the most informative in the diagnostics
ldren should be planned? of a tube infertility?
A. 50 A. Laparoscopy with chromosalpi-
B. 20 ngoscopy
C. 40 B. Pertubation
D. 100 C. Hysterosalpingography
E. 200 D. Transvaginal echography
E. Bicontrast pelviography
60. A 25 year old patient complai-
ns of pain in the I finger on his ri- 64. A 38 year old man worked at roofi-
ght hand. On examination: the finger is ng and drain pipes production for 15
homogeneously hydropic, in bent positi- years. He seeks medical help for expi-
on. On attempt to unbend the finger the ratory breathlessness on exertion, and
pain is getting worse. Acute pain appears dry cough. On exam, wheezes above
during the probe in ligament projection. both lungs, grayish warts on fingers are
What decease is the most likely? seen. Factory physician has diagnosed
asbestosis. What method is the most
A. Thecal whitlow (ligament panaritium) important for this diagnosis?
B. Subcutaneous panaritium
C. Articular (joint) panaritium A. Chest X-ray
D. Bone panaritium B. Bronchoscopy
E. Paronychia C. Blood gas analysis
D. Spirography
61. A 26 year old manual worker E. Electrocardiography
complained of 3 weeks history of
fevers and fatigue, weight loss with 65. A patient has got pain in the axillary
no other symptoms. Physical findings: area, rise of temperature developed 10
Temperature 37, 6oC , Ps- 88 bpm, blood hours ago. On examination: shaky gait is
pressure 115/70 mm Hg, superficial lymph evident, the tongue is coated with white
nodes (occipital, submental, cervical, axi- deposit. The pulse is frequent. The pai-
llary) are enlarged, neither tender nor nful lymphatic nodes are revealed in the
painful. Rubella-like rash on the trunk axillary area. The skin over the lymph
and extremities. Herpes simplex lesi- nodes is erythematous and glistering.
ons on the lips. Candidosis of oral cavi- What is the most probable diagnosis?
ty. What infectious disease would you A. Bubonic plague
suspect? B. Acute purulent lymphadenitis
A. HIV infection C. Lymphogranulomatosis
B. Influenza D. Anthrax
C. Rubella E. Tularemia
D. Infectious mononucleosis 66. Examination of a 9 month old girl
E. Tuberculosis revealed skin pallor, cyanosis during exci-
62. A patient complains about strong tement. Percussion revealed transverse
dyspnea that is getting worse during dilatation of cardiac borders. Auscultati-
physical activity. Presentations appeared on revealed continuous systolic murmur
suddenly 2 hours ago at work: acute chest on the left from the breastbone in the
pain on the left, cough. The pain was 3-4 intercostal space. This murmur is
conducted above the whole cardiac regi- should be applied for the diagnosis confi-
on to the back. What congenital cardiac rmation?
pathology can be suspected?
A. Echocardiography
A. Defect of interventricular septum B. Roentgenography of chest
B. Defect of interatrial septum C. Phonocardiography
C. Coarctation of aorta D. ECG
D. Fallot’s tetrad E. Veloergometry
E. Pulmonary artery stenosis
71. A 28 year old parturient complai-
67. A 32 year old patient complains about ns about headache, vision impairment,
cardiac irregularities, dizziness, dyspnea psychic inhibition. Objectively: AP-
at physical stress. He has never suffered 200/110 mm Hg, evident edemata of
from this before. Objectively: Ps- 74 bpm, legs and anterior abdominal wall. Fetus
rhythmic. AP- 130/80 mm Hg. Auscultati- head is in the area of small pelvis. Fetal
on revealed systolic murmur above aorta, heartbeats is clear, rhythmic, 190/min.
the first heart sound was normal. ECG Internal investigation revealed complete
showed hypertrophy of the left ventri- cervical dilatation, fetus head was in the
cle, signs of repolarization disturbance area of small pelvis. What tactics of labor
in the I , V5 and V6 leads. Echocardiogram management should be chosen?
revealed that interventricular septum was
2 cm. What is the most probable di- A. Forceps operation
agnosis? B. Cesarean
C. Embryotomy
A. Hypertrophic cardiomyopathy D. Conservative labor management with
B. Aortic stenosis episiotomy
C. Essential hypertension E. Stimulation of labor activity
D. Myocardium infarction
E. Coarctation of aorta 72. A patient complained about problems
with pain and tactile sensitivity, pain
68. An 8 year old boy suffering from in the nail bones at the end of the
haemophilia was undergoing transfusion working day. He works at a plant with
of packed red cells. Suddenly he got pain mechanical devices. What pathology can
behind the breastbone and in the lumbar be suspected?
area, dyspnea, cold sweat. Objectively:
pale skin, heart rate - 100/min, AP- 60/40 A. Vibration disease
Hg; oliguria, brown urine. For treatment B. Caisson disease
of this complication the following drug C. Noise disease
should be administered: D. Overwork symptoms
E. Hypovitaminosis of B1
A. Prednisolone
B. Lasix 73. A 25 year old patient complains about
C. Adrenaline weakness, dizziness, haemorrhagic skin
D. Aminophylline rash. She has been suffering from this
E. Analgine for a month. Blood count: erythrocytes:
1, 0 · 1012 /l, Hb- 37 g/l, colour index - 0,9,
69. A maternity hospital registered 616 li- leukocytes - 1, 2 · 109 /l, thrombocytes -
ve births, 1 stillbirth, 1 death on the 5th 42 · 109 /l. What diagnostic method will be
day of life over a 1 year period. What the most effective?
index allows the most precise estimation
of this situation? A. Sternal puncture
B. Spleen biopsy
A. Perinatal mortality C. Liver biopsy
B. Crude mortality rate D. Coagulogram
C. Natality E. Abdominal ultrasound
D. Neonatal mortality
E. Natural increase 74. A 68 year old female patient complai-
ns about temperature rise up to 38, 3oC ,
70. After objective clinical examination a haematuria. ESR- 55 mm/h. Antibacteri-
12 year old child was diagnosed with mi- al therapy turned out to be ineffective.
tral valve prolapse. What complementary What diagnosis might be suspected?
instrumental method of examination
78. A healthy 75 year old woman who

A. Renal cancer leads a moderately active way of life
B. Polycystic renal disease went through a preventive examinati-
C. Renal amyloidosis on that revealed serum concentration
D. Urolithiasis of common cholesterol at the rate of
E. Chronic glomerulonephritis 5,1 millimole/l and HDL (high-density
75. A 48 year old female patient complai- lipoproteins) cholesterol at the rate of
ns about contact haemorrhage. Speculum 70 mg/dl. ECG reveals no pathology.
What dietary recommendation is the
examination revealed hypertrophy of most adequate?
uterus cervix. It resembles of cauliflower,
it is dense and can be easily injured. Bi- A. Any dietary changes are necessary
manual examination revealed that forni- B. Decrease of cholesterol consumption
ces were shortened, uterine body was C. Decrease of saturated fats consumption
nonmobile. What is the most probable D. Decrease of carbohydrates consumpti-
diagnosis? on
A. Cervical carcinoma E. Increase of cellulose consumption
B. Metrofibroma 79. A parturient complains about pain in
C. Endometriosis the mammary gland. Palpation revealed
D. Cervical pregnancy a 3х4 cm large infiltration, soft in the
E. Cervical papillomatosis centre. Body temperature is 38, 5oC .
76. A 34 year old female patient has What is the most probable diagnosis?
been suffering from anxious depressi- A. Acute purulent mastitis
on accompanied by panic attacks for B. Pneumonia
2 years. She has been a patient of a C. Pleuritis
psychotherapist. Treatment resulted in D. Retention of milk
incomplete remission. The patient had E. Birth trauma
to break off psychotherapy because of
moving to a new place of residence. Soon 80. A 52 year old patient was admi-
after this her condition grew significantly tted to a hospital because of hi-
worse, she was almost permanently anxi- gh hemorrhagic diathesis of mucous
ous, panic attacks turned up 5-6 times a membranes, massive skin haemorrhages
day and were accompanied by palpitati- in form of ecchymoses and spots, nasal
on, dyspnea, cold sweat, thanatophobia. and stomachal haemorrhages. After cli-
What drug group is the most appropriate nical examinations her illness was di-
for medicamental therapy? agnosed as thrombocytopenic purpura.
What is the most probable cause of this
A. Antidepressants disease?
B. Sedative neuroleptics
C. Antipsychotic neuroleptics A. Generation of antithrombocytic anti-
D. Lithium drugs bodies
E. Cardiotonics, respiratory analeptics B. Disturbed hemostasis
C. Deficit of the VIII factor of blood
77. 1,5 hour after start of gullet bougi- coagulation
enage a 48 year old patient suffering from D. Inherited insufficiency of plasm factors
corrosive stricture felt acute abdominal of blood coagulation
pain. Previously he had been sufferi- E. Iron deficit in blood serum, bone
ng from duodenal ulcer. Examination marrow and depot
revealed that abdomen was very tense
and painful; Ps- 110 bpm, painful si- 81. A 37 year old patient applied
alophagia, skin pallor. What is the most to a local therapeutist. As a result
probable diagnosis? of exacerbation of chronic obstructi-
ve bronchitis the patient had been
A. Perforation of abdominal part of temporarily disabled for 117 days within 1
esophagus year. What tactics will be legally correct?
B. Acute myocardium infarction
C. Strangulation of diaphragmal hernia
D. Perforation of duodenal ulcer
E. Thrombosis of mesenteric vessels
A. The patient should be referred to the

medicosocial expertise A. Tuberculous
B. The therapeutist should extend a B. Cancerous
medical certificate C. Staphylococcal
C. The patient should be referred to D. Viral
the medical consultation comission for E. Autoimmune
extension of medical certificate
D. The therapeutist should issue a new 85. At year-end hospital administration
medical certificate has obtained the following data: annual
E. The patient shoul be referred to the number of treated patients and average
sanatorium-and-spa treatment annual number of beds used for patients’
treatment. What index of hospital work
82. A 54 year old male patient complai- can be calculated on the base of this data?
ns about permanent dull pain in the
mesogastral region, weight loss, dark A. Bed turnover
blood admixtures in the feces, constipati- B. Bed resources of the hospital
ons. He put off 10 kg within a year. In C. Average annual bed occupancy
blood: erythrocytes: 3, 5·1012 /l, Hb- 87 g/l, D. Average duration of patients’ presence
in the hospital
leukocytes - 12, 6 · 109 /l, stab neutrophil E. Average bed idle time
shift, ESR- 43 mm/h. What is the most
probable diagnosis? 86. A female patient has been suffering
from pain in the right subcostal area, bi-
A. Cancer of transverse colon tter taste in the mouth, periodical bile
B. Gastric ulcer vomiting for a month. The patient put off
C. Chronic colitis 12 kg. Body temperature in the evening
D. Chronic pancreatitis is 37, 6oC . Sonography revealed that bi-
E. Stomach cancer le bladder was 5,5х2,7 cm large, its wall -
83. A 10 month old boy has been ill for 0,4 cm, choledochus - 0,8 cm in diameter.
5 days after consumption of unboiled Anterior liver segment contains a roundi-
milk. Body temperature is 38 − 39o C , sh hypoechoic formation up to 5 cm in
there is vomiting, liquid stool. The chi- diameter and another two up to 1,5 cm
ld is pale and inert. His tongue is covered each, walls of these formations are up to
with white deposition. Heart sounds are 0,3 cm thick. What is the most probable
muffled. Abdomen is swollen, there is diagnosis?
borborygmus in the region of ubbilicus, A. Alveolar echinococcus of liver
liver is enlarged by 3 cm. Stool is liquid, B. Liver cancer
dark-green, with admixtures of mucus, 5 C. Liver abscess
times a day. What is the most probable D. Cystous liver cancer
diagnosis? E. Paravesical liver abscesses
A. Salmonellosis 87. A 3 year old child with weight defi-
B. Staphylococcal enteric infection ciency suffers from permanent moi-
C. Escherichiosis st cough. In history there are some
D. Acute shigellosis pneumonias with obstruction. On exami-
E. Rotaviral infection nation: distended chest, dullness on
84. Examination of a 22 year old man percussion over the lower parts of lungs.
suffering from polyarthralgia and hi- On auscultation: a great number of di-
gh fever revealed right-sided exudati- fferent rales. Level of sweat chloride is
ve pleuritis. X-ray picture showed a 80 millimol/l. What is the most probable
homogenous shadow below the IV rib on diagnosis?
the right. In the II segment there were A. Mucoviscidosis (cystic fibrosis)
single dense focal shadows. Mantoux B. Bronchial asthma
test with 2 TU resulted in formation C. Recurrent bronchitis
of a papula 16 mm large. Pleural liquid D. Bronchiectasis
has increased protein concentration, Ri- E. Pulmonary hypoplasia
valta’s reaction is positive, there was
also increased number of leukocytes with 88. A 14 year old girl complains of
prevailing lymphocytes. What is the most profuse bloody discharges from genital
probable etiology of pleuritis? tracts during 10 days after suppresion of
menses for 1,5 month. Similiar bleedings The first heart sound is weakened on
recur since 12 years on the background the apex, auscultation revealed systolic
of disordered menstrual cycle. On rectal souffle. What is the most probable aeti-
examination: no pathology of the internal ological factor that caused this pathologi-
genitalia. In blood: Нb - 70 g/l, RBC- cal process?
2, 3 · 1012 /l, Ht - 20. What is the most
probable diagnosis? A. β -haemolytic streptococcus
B. Staphylococcus
A. Juvenile bleeding, posthemorrhagic C. Pneumococcus
anemia D. Virus
B. Werlholf’s disease E. Fungi
C. Polycyst ovarian syndrome
D. Hormonoproductive ovary tumor 92. A 50 year old locksmith was di-
E. Incomplete spontaneous abortion agnosed with typhoid fever. The pati-
ent lives in a separate apartment with all
89. A 46 year old patient is to be prepared facilities. Apart of him there are also 2
to the operation on account of stomach adults in his family. What actions should
cancer. Preoperative preparation involves be taken about persons communicating
infusion therapy. It was injected up to 3 l with the patient?
of solutions into his right lunar vein. On
the next day he got tensive pain in the A. Bacteriological study
region of his right shoulder. Examinati- B. Antibiotic prophylaxis
on of interior brachial surface revealed C. Isolation
an oblong area of hyperemia, skin edema D. Dispensary observation
and painful cord. What complication is it? E. Vaccination
A. Acute thrombophlebitis 93. A 39 year old patient complained

B. Vein puncture and edema of about morning headache, appetite loss,
paravenous cellular tissue nausea, morning vomiting, periodic nasal
C. Necrosis of paravenous cellular tissue haemorrhages. The patient had acute
D. Acute lymphangitis glomerulonephritis at the age of 15.
E. Phlegmon of paravenous cellular tissue Examination revealed rise of arterial
pressure up to 220/130 mm Hg, skin
90. A 58 year old female patient complai- haemorrhages on his arms and legs,
ns about periodical headache, dizziness pallor of skin and mucous membranes.
and ear noise. She has been sufferi- What biochemical index has the greatest
ng from diabetes mellitus for 15 years. diagnostic importance in this case?
Objectively: heart sounds are rhythmic,
heart rate is 76/min, there is diastolic A. Blood creatinine
shock above aorta, AP is 180/110 mm B. Blood bilirubin
Hg. In urine: OD- 1,014. Daily loss of C. Blood sodium
protein with urine is 1,5 g. What drug D. Uric acid
should be chosen for treatment of arteri- E. Fibrinogen
al hypertension? 94. A 43 year old patient was admitted
A. Ihibitor of angiotensin converting to the infectious diseases hospital wi-
enzyme th high body temperature and intense
B. β -blocker headache. The iIlness has lasted for 2
C. Calcium channel antagonist days. Examination revealed a carbuncle
D. Thiazide diuretic on his forearm. The area around it was
E. α-blocker apparently edematic and slightly painful.
Regional lymphadenitis and hepatoli-
91. A 25 year old patient had pharyngi- enal syndrome were also present. It is
tis 2 weeks ago. Now he complains known from the anamnesis that the pati-
about body temperature rise up to 38o C , ent works at a cattle-breeding farm. What
general weakness, dyspnea during walki- disease should be suspected in the first
ng, swelling and shifting pain in the arti- place?
culations. Objectively: cyanosis of lips,
rhythmic pulse of poor volume - 100 bpm.
Left cardiac border deviates outwards
from the mediaclavicular line by 1 cm.
A. Anthrax haemorrhagic elements have necrosis in

B. Erysipelas the centre. What is the most probable di-
C. Erysipeloid sease?
D. Skin cancer
E. Eczema A. Meningococcemia
B. Rubella
95. Study of morbidity with temporary di- C. Influenza
sability among workers of a machine bui- D. Haemorrhagic vasculitis
lding plant revealed that average durati- E. Scarlet fever
on of a case was 20 days. What diseases
influenced upon the index value? 99. A 13 year old girl was admitted to
the cardiological department because of
A. Chronic pain in the muscles and joints. Exami-
B. Acute nation of her face revealed an edematic
C. Subacute erythema in form of butterfly in the regi-
D. Preexisting diseases on of nose bridge and cheeks. What is the
E. Hard to determine most probable diagnosis?
96. A 14 year old child suffers from A. Systemic lupus erythematosus
vegetovascular dystonia of pubertal peri- B. Rheumatism
od. He has got sympathoadrenal atack. C. Dermatomyositis
What medicine should be used for attack D. Rheumatoid arthritis
reduction? E. Periarteritis nodosa
A. Obsidan 100. A 15 year old girl suddenly got
B. No-shpa arthralgia, headache, nausea, vomiting;
C. Amysyl pain and muscle tension in the lumbar
D. Aminophylline area; body temperature rose up to 38 −
E. Corglicone 39o C . Pasternatsky’s symptom was disti-
nctly positive on the right. In the uri-
97. A 52 year old male patient complai- ne: bacteriuria, pyuria. What is the most
ns about attacks of asphyxia, pain in his probable diagnosis?
left side during respiration. These mani-
festations turned up all of a sudden. It A. Acute pyelonephritis
is known from his anamnesis that he B. Renal colic
had been treated for thrombophlebitis C. Acute glomerulonephritis
of the right leg for the last month. In D. Pararenal abscess
the admission ward the patient suddenly E. Cystitis
lost consciousness, there was a sudden
attack of asphyxia and pain in his left 101. A 19 year old patient was admi-
side. Objectively: heart rate - 102/min, tted to a hospital with acute destructive
respiratory rate - 28/min, AP- 90/70 appendicitis. He suffers from hemophilia
mm Hg. Auscultation revealed diastolic of B type. What antihemophilic medicati-
shock above the pulmonary artery, gallop ons should be included in pre- and post-
rhythm, small bubbling rales above the operative treatment plan?
lungs under the scapula on the right,
pleural friction rub. What examination A. Fresh frozen plasma
method will be the most informative for B. Cryoprecipitate
a diagnosis? C. Fresh frozen blood
D. Native plasma
A. Angiography of pulmonary vessels E. Dried plasma
B. Echocardioscopy
C. Study of external respiration function 102. A 59 year old female patient applied
D. ECG to a maternity welfare clinic and complai-
E. Coagulogram ned about bloody discharges from the
genital tracts. Postmenopause is 12
98. A 4 month old child fell seriously ill: years. Vaginal examination revealed that
body temperature rose up to 38, 5o C , the external genital organs had signs of age
child became inert and had a single vomi- involution, uterus cervix was not erosi-
ting. 10 hours later there appeared rash ve, small amount of bloody discharges
over the buttocks and lower limbs in form came from the cervical canal. Uterus was
of petechiae, spots and papules. Some of normal size, uterine appendages were
unpalpable. Fornices were deep and pai- enlargement of the left mammary gland,
nless. What method should be applied for pain on palpation. What pathology would
the diagnosis specification? you think about in this case?
A. Separated diagnosic curretage A. Lactational mastitis
B. Laparoscopy B. Lacteal cyst with suppuration
C. Puncture of abdominal cavity through C. Fibrous adenoma of the left mammary
posterior vaginal fornix gland
D. Extensive colposcopy D. Breast cancer
E. Culdoscopy E. Phlegmon of mammary gland
103. A 26 year old woman who delivered 107. A 32 year old patient suffering
a child 7 months ago has been suffering from chronic viral hepatitis complains
from nausea, morning vomiting, sleepi- about dull pain in the right subcostal
ness for the last 2 weeks. She suckles the area, nausea, dry mouth. Objecti-
child, menstruation is absent. She hasn’t vely: liver dimensions are 13-21-11
applied any contraceptives. What method cm (according to Kurlov), spleen is
should be applied in order to specify her by 2 cm enlarged, aspartate ami-
diagnosis? notransferase is 3,2 micromole/l·h, alani-
ne aminotransferase - 4,8 millimole/l·h.
A. Ultrasonic examination Serological study revealed HBeAg , high
B. Roentgenography of small pelvis concentration of DNA HBV . What drug
organs should be chosen for treatment of this
C. Palpation of mammary glands and patient?
pressing-out of colostrum
D. Bimanual vaginal examination A. α-interferon
E. Speculum examination B. Acyclovir
C. Remantadinum
104. A boy is 1 year old. Previously he D. Arabinoside monophosphate
had purulent otitis. After that he started E. Essentiale-forte
complaining about pain in the upper thi-
rd of his left thigh, body temperature 108. A 5 month old boy was born
rose up to 39o C . Objectively: the thigh is prematurely, he didn’t suffer from any
swollen in its upper third, inguinal fold is disease at the infant age and later on.
smoothed. Extremity is in half-bent posi- Examination at an outpatient’s hospi-
tion. Active and passive movements are tal revealed paleness of skin, sleepiness.
impossible because of acute pain. What is Blood count: Hb - 95 g/l, erythrocytes
the most probable diagnosis? - 3, 5 · 1012 /l, reticulocytes - 90 /00 ,
colour index - 0,7, osmotic stability of
A. Acute haematogenic osteomyelitis erythrocytes - 0,44-0,33%, serum iron
B. Acute coxitis - 4,9 micromole/l. What is the most
C. Intermuscular phlegmon probable cause of anemia?
D. Osteosarcoma
E. Brodie’s abscess A. Iron deficit
B. Hemogenesis immaturity
105. A 2 month old full-term child was C. Infectious process
born with weight 3500 g and was on the D. Erythrocyte hemolysis
mixed feeding. Current weight is 4900 g. E. B12 deficit
Evaluate the current weight of the child:
109. A 45 year old woman complains
A. Corresponding to the age about unbearable pain attacks in the left
B. 150 g less than necessary part of face lasting 1-2 minutes. Such
C. Hypotrophy of the I grade attacks are provoked by mastication.
D. Hypotrophy of the II grade These symptoms appeared 2 months ago
E. Paratrophy of the I grade after exposure to cold. Objectively:the
106. A woman consulted a doctor on pain is localized in the ending points of
the 14th day after labour about sudden trigeminus on the left. A touch near nose
pain, hyperemy and induration of the wing provokes another pain attack and
left mammary gland, body temperature tonic spasm of face muscles. What is the
rise up to 39o C , headache, indisposi- most probable diagnosis?
tion. Objectively: fissure of nipple,
A. Neuralgia of trigeminus intense headache in the region of occi-

B. Neuralgia of glossopharyngeal nerve put; there appeared recurrent vomiting.
C. Arthritis of mandibular joint These presentations has been lasting for
D. Facial migraine 5 hours. Objectively: Ps - 88 bpm, AP -
E. Maxillary sinusitis 205/100 mm Hg, painfulness of occipital
points, rigidity of occipital muscles are
110. A 38 year old man was delivered present. Kernig’s symptom is bilaterally
to the hospital in unconscious state. The positive. Subarachnoid haemorrhage is
symptoms of illness turned up a day also suspected. What diagnostic method
before: headache, nausea, vomiting, to - will be of the greatest importance for
38, 5o C , dizziness, delusion. For the last confirmation of provisional diagnosis?
4 days he had been complaining of pain
and hearing loss in the left ear. Objecti- A. Lumbar puncture
vely: sopor, rigidity of occipital muscles, B. Examination of eye fundus
bilateral Kernig’s symptom, general C. Ultrasonic dopplerography
hyperesthesia, purulent discharges from D. EEG
the left ear. What is the most probable E. Computer tomography
diagnosis?
114. Immediately after delivery a woman
A. Secondary purulent meningitis had haemorrhage, blood loss exceeded
B. Primary purulent meningitis postpartum haemorrhage rate and was
C. Tuberculous meningitis progressing. There were no symptoms of
D. Subarachnoidal haemorrhage placenta detachment. What tactics should
E. Parenchymatous subarachnoidal be chosen?
haemorrhage
A. Manual removal of placenta and
111. A 70 year old man is suffering from afterbirth
coronary heart disease. His mood is evi- B. Uterus tamponade
dently depressed, anxious. As a result C. Instrumental revision of uterine cavity
of continious sleeplessness he has got walls
fears, suicidal thoughts. He would sit for D. Removal of afterbirth by Crede’s
a long time in the same pose, answer method
after a pause, in a low, monotonous voi- E. Intravenous injection of
ce. His face has a look of suffering, pain, methylergometrine with glucose
fear. What is the main psychopathologic
syndrome? 115. A 33 year old patient was delivered
to the infectious diseases department on
A. Depressive syndrome the 7-th day of disease. He complained
B. Paranoid syndrome about great weakness, high temperature,
C. Asthenic syndrome pain in the lumbar area and leg muscles,
D. Phobic syndrome icteritiousness, dark colour of urine,
E. Obsessive syndrome headache. The acute disease started with
chill, body temperature rise up to 40o C ,
112. A 23 year old female patient headache, pain in the lumbar area and
complains about periodical chill and sural muscles. Icterus turned up on the
body temperature rise up to 40o C , sense 4th day, nasal and scleral haemorrhages
of heat taking turns with profuse sweati- came on the 5th day. Fever has lasted for
ng. The patient has had already 3 attacks 6 days. Diuresis - 200 ml. What is the most
that came once in two days and lasted 12 probable diagnosis?
hours. She has lived in Africa for the last
2 months. Liver and spleen are enlarged. A. Leptospirosis
In blood: erythrocytes - 2, 5 · 1012 /l. What B. Typhoid fever
is the most probable diagnosis? C. Virus A hepatitis
D. Sepsis
A. Malaria E. Yersiniosis
B. Spotted fever
C. Sepsis 116. A 72 year old male patient complai-
D. Haemolytic anaemia ns about itch in his left shin, especially
E. Leptospirosis around a trophic ulcer. Skin is reddened
and edematic, there are some oozing lesi-
113. A 39 year old patient sufferi- ons, single yellowish crusts. The focus of
ng from hypertension suddenly gotb affection is well-defined. What is the most
probable diagnosis? ld revealed diffuse thyroid enlargement

of the II degree. Heart auscultation
A. Microbial eczema revealed dullness of heart sounds, heart
B. Allergic dermatitis rate was 64/min. The child has frequent
C. Seborrheic eczema constipations, anemia. Concentration of
D. Cutaneous tuberculosis thyreoglobulin antibodies is increased.
E. Streptococcal impetigo What disease might have caused such
symptoms?
117. A 29 year old female patient
complains about periodical right-sided A. Autoimmune thyroiditis
headache that is usually provoked by B. Diffuse toxic goiter
strong smells or excitement. The patient’s C. Thyroid carcinoma
mother suffers from the same disease. D. Thyroid hyperplasia
Objectively: examination of internal E. Endemic goiter
organs revealed no pathology. During the
attack there are general hyperesthesia 121. A 13 year old patient is suffering
and nausea, at the end of the attack from an acute disease with the followi-
polyuria is observed. Palpation of the ng symptoms: thirst, polyuria, weakness.
right temporal artery during the attack Objectively: his general condition is sati-
revealed tension and painfulness of the sfactory, there is no smell of acetone.
artery. Complete blood count and urine Glucose concentration in blood on an
analysis reveale dno pecularities. What is empty stomach is 32 micromole/l, in urine
the most probable diagnosis? - 6%, acetone +. What treatment should
be administered?
A. Migraine
B. Neuritis of the facial nerve A. Short-acting insulin
C. Neuralgia of trigeminus B. Long-acting insulin
D. Meniere’s syndrome C. Biguanides
E. Epilepsy D. Sulfonylurea
E. Diet
118. A 52 year old woman complains
about face distortion. It turned up 2 days 122. Surgical department admitted a 37
ago after supercooling. Objectively: body year old patient with a big crushed wound
temperature is 38, 2oC . Face asymmetry is of his left thigh 4 hours after he got
present. Frontal folds are flattened. Left this trauma. What is the main provisi-
eye is wider than right one and doesn’t on for successful prevention of gaseous
close. Left nasolabial fold is flattened, gangrene?
mouth corner is lowered. Examinati-
on revealed no other pathology. Blood A. Removal of necrotic tissues and timely
count: leukocytes - 10 · 109 /l, ESR - 20 surgical processing of the wound
mm/h. What is the most probable di- B. Injection of specific serum 3 000 U
agnosis? C. Injection of specific serum 30 000 U
D. Infiltration of soft tissues around the
A. Facial neuritis wound with antibiotic solution
B. Trigeminus neuralgia E. Wound lavage with 6% solution of
C. Hemicrania (migraine) hydrogen peroxide
D. Ischemic stroke
E. Brain tumour 123. A 40 year old patient was bitten by a
stray dog for about an hour ago. The bite
119. A 10 year old boy suffers from can be seen on the patient’s left shin in
chronic viral hepatitis type B with maxi- form of a wound 4х2х0,5 cm large. What
mal activity. What laboratory test can kind of aid would be recommended in
give the most precise characteristic of this case?
cytolysis degree?
A. Wound lavage with soapsuds, retension
A. Transaminase test sutures
B. Weltman’s coagulation test B. Aseptic bandage
C. Takata-Ara test C. Salve bandage
D. Prothrombin test D. Blind suture
E. Test for whole protein E. Retension sutures
120. Examination of a 12 year old chi- 124. A patient has got acute macrofocal
myocardial infarction complicated by A. Sulfosalasine

cardiogenic shock. The latter is progresi- B. Motilium
ng under conditions of weak general C. Vikasolum
peripheric resistance and lowered cardi- D. Linex
ac output. What antihypotensive drug E. Kreon
should be injected to the patient in the
first place? 128. A 38 year old female patient
complains about body stiffness in
A. Dopamine the morning, especially in the arti-
B. Noradrenaline culations of her upper and lower li-
C. Adrenaline mbs, that disappears 30-60 minutes
D. Mesatonum later after active movements. She has
E. Prednisolone also arthritis of metacarpophalangeal
and proximal phalangeal articulations,
125. A patient applied to the subfebrile temperature. ESR- 45 mm/h.
traumatology cenre and complained Roentgenography revealed osteoporosis
about a trauma of the lower third of the and erosion of articular surface of small
volar forearm surface caused by cut on hand and foot articulations. What is the
a piece of galss. Objectively: flexion of most probable diagnosis?
the IV and V fingers is impaired, sensi-
tivity of the interior dorsal and palmar A. Rheumatoid arthritis
surface of hand as well as of the IV finger B. Psoriatic arthropathy
is reduced. What nerve is damaged? C. Osteoarthrosis deformans
D. Systemic lupus erythematosus
A. Ulnar E. Reactive polyarthritis
B. Radial
C. Median 129. A child was born with body wei-
D. Musculoskeletal ght 3250 g and body length 52 cm. At
E. Axillary the age of 1,5 month the actual wei-
ght is sufficient (4350 g), psychophysical
126. It was noticed that a 7 year old pupil development corresponds with the age.
had been innattentive several times duri- The child is breast-fed, occasionally there
ng the lessons. The teacher also noticed are regurgitations. What is the cause of
that the child had been smacking his lips regurgitations?
and had vacant look. There were no falls
and convulsions. During such short peri- A. Aerophagia
ods of absence the child didn’t react to B. Pylorostenosis
calling his name. His mother notic such C. Pylorospasm
phenomena before but didn’t pay much D. Acute gastroenteritis
attention to them thinking that the child E. Esophageal atresia
was deep in thought. What type of epi-
leptic attack (according to the standard 130. Three weeks after acute angina
classification) is it? the patient is still weak, inert, subfebri-
le, his retromaxillary lymph nodes are
A. Absentia enlarged. Tonsils are flabby, stick together
B. Generalized tonoclonic epilepsy with arches, there are purulent plugs in
C. Simple partial epilepsy lacunae. What is the most probable di-
D. Complex partial epilepsy agnosis?
E. Jacksonian partial epilepsy
A. Chronic tonsillitis
127. A 41 year old woman has suffered B. Chronic pharyngitis
from nonspecific ulcerative colitis for C. Acute lacunar tonsillitis
5 years. On rectoromanoscopy: evident D. Paratonsillitis
inflammatory process of lower intesti- E. Tonsillar tumour
nal parts, pseudopolyposive changes of
mucous membrane. In blood: WBC- 131. A 23 year old patient fell ill 3 weeks
9, 8 · 109 /l, RBC- 3, 0 · 1012 /l, ESR - ago when she noticed a very painful
52 mm/hour. What medication provides induration in her axillary crease. 4-5 days
pathogenetic treatment of this patient? 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 di-
seases before. What is the most probable A. Nascent submucous fibromatous node
diagnosis? B. Abortion in progress
C. Cervical carcinoma
A. Hydradenitis D. Cervical myoma
B. Furuncle E. Algodismenorrhea
C. Mycosis
D. Herpes zoster 135. A child is 1 day old. During delivery
E. Streptococcal impetigo there had been problems with extracti-
on of shoulders. Body weight is 4300,0.
132. A 28 year old woman has bursti- Right arm hangs down along the body,
ng pain in the lower abdomen during hand is pronated, movement in the arm is
menstruation; chocolate-like discharges absent. "Scarf"symptom is positive. What
from vagina. It is known from the is the most probable diagnosis?
anamnesis that the patient suffers from
chronic adnexitis. Bimanual examinati- A. Total right-sided obstetric paralysis
on revealed a tumour-like formation of B. Proximal right-sided obstetric paralysis
heterogenous consistency 7х7 cm large C. Distal right-sided obstetric paralysis
to the left from the uterus. The formati- D. Hemiparesis
on is restrictedly movable, painful when E. Tetraparesis
moved. What is the most probable di-
agnosis? 136. A 42 year old man applied to a
hospital 10 minutes after he got stung
A. Endometrioid cyst of the left ovary by a bee and complained about face
B. Follicular cyst of the left ovary edema and difficult respiration. Objecti-
C. Fibromatous node vely: Ps- 98 bpm, AP- 130/80 mm Hg.
D. Exacerbation of chronic adnexitis A doctor on duty injected him 1 ml of
E. Tumour of sigmoid colon 1% dimedrol solution intramuscularly
and recommended to apply to his local
133. As a result of prophylactic medical therapeutist on the next day. What tacti-
examination a 35 year old woman was di- cs of treatment should be chosen for this
agnosed with alimentary and constituti- patient?
ve obesity of the III degree. It is known
from her anamnesis that the patient A. Intravenous introduction of predni-
doesn’t observe rules of rational nutri- solone and hospitalization
tion: she often overeats, the last food B. Intravenous introduction of calcium
intake is usually 10-15 minutes before chloride
going to bed, prefers fattening and ri- C. The patient needs no further medical
ch in carbohydrates food. What is the aid
main alimentary risk factor of obesity D. Hospitalization for observation
development? E. Intravenous introduction of calcium
chloride and hospitalization
A. Energetic unprofitableness of nutrition
B. Excess of carbohydrates 137. A 44 year old man has been worki-
C. Excess of fats ng in coke industry for 16 years. Dust
D. Lack of cellulose concentration at his workplace is 5-10
E. Violation of dietary pattern times more than maximum permissi-
ble concentration. Roentgenography of
134. A 40 year old female patient has lungs revealed changes that are typical
been observing excessive menstruati- for pneumoconiosis. What is the most
on accompanied by spasmodic pain probable type of pneumoconiosis in this
in the lower abdomen for a year. Bi- case?
manual examination performed during
menstruation revealed a dense formati- A. Anthracosis
on up to 5 cm in diameter in the cervi- B. Anthracosilicosis
cal canal. Uterus is enlarged up to 5-6 C. Silicatosis
weeks of pregnancy, movable, painful, of D. Asbestosis
normal consistency. Appendages are not E. Siderosis
palpable. Bloody discharges are profuse.
What is the most probable diagnosis? 138. Study of morbidity rate in a city
N revealed that population of different
administrative districts differed in age
structure. What statistic method allows
to eliminate influence of this factor upon the most probable diagnosis?

morbidity indices?
A. Poisoning with carbon monooxide
A. Standardization B. Poisoning with hydrocyanic acid
B. Wilcoxon’s t-criterion C. Poisoning with anilin colouring agents
C. Correlative regressive analysis D. Poisoning with methane
D. Analysis of dynamic series E. Poisoning with benzine
E. Calculation of average values
143. The amount of ultraviolet radiati-
139. An outbreak of food poisoning was on dose was measured in minutes. What
recorded in an urban settlement. The device was applied for measurement of
illness was diagnosed as botulism on the the biodose?
grounds of clinical presentations. What
foodstuffs should be chosen for analysis A. Gorbachev’s biodosimeter
in the first place in order to confirm the B. UV-meter
diagnosis? C. Actinometer
D. Radiometer
A. Tinned food E. Catathermometer
B. Potatoes
C. Pasteurized milk 144. A 63 year old patient complai-
D. Boiled meat ned about pain in the lumbar area. He
E. Cabbage underwent a course of physiological
treatment on account of radiculitis but
140. A 72 year old female patient has this led to no improvement of his conditi-
been treated for urolithiasis in the on. R-graphy of spinal column and pelvic
urological department. After atropine bones revealed osteoporosis and serious
injection she got acute pain in her left eye bone defects. Blood analysis revealed
and abrupt vision impairment. Objecti- moderate normochromic anaemia, uri-
vely: visual acuity of the left eye is 0,01, ne analysis revealed proteinuria. Whole
the eye is dense but painful on palpati- blood protein made up 10,7 g/l. What di-
on, cornea is opaque, there is cyanotic sease should be suspected?
induration of eyeball vessels. What is the
most probable diagnosis? A. Myelomatosis
B. Urolithiasis
A. Acute attack of primary glaucoma of C. Acute radiculitis
the left eye D. Metastases in bones
B. Acute iridocyclitis of the left eye E. Systemic osteoporosis
C. Secondary glaucoma of the left eye
D. Acute keratitis of the left eye 145. A sergeant was injured by a shell
E. Degeneration of the left eye cornea splinter in the left subcostal area. He
was bandaged with a first-aid pack on
141. Administration of a plant producing a battlefield. The patient was delivered
red lead paint intends to form a group of to the regiment medical aid station. He
medical specialists for periodical medi- complains about dizziness, weakness, thi-
cal examinations. What specialist must rst, abdominal pain. General condition is
be obligatory included into this group? grave, the patient is pale. Ps is 120 bpm.
Abdomen is soft, painful on palpation.
A. Neuropathologist The bandage is well fixed but a little bit
B. Gynaecologist soaked with blood. The patient should be
C. Psychiatrist evacuated to the medical battalion with
D. Dermatologist the following transport and in the followi-
E. Otolaryngologyst ng turn:
142. A 42 year old man works in a A. With medical vehicle in the first turn
boiler room. He complains about gi- B. With a passing car in the first turn
rdle headache and recurring vomiting. C. With medical vehicle in the second turn
There was also short-term consciousness D. With a passing car in the second turn
loss. Objectively: increase of tendon E. With a passing car in the third turn
reflexes, spontaneous myofibrillations.
AP is 150/80 mm Hg, Ps- 104 bpm. Vi- 146. On the 5th day after labor body
sible mucous membranes and cutaneous temperature of a parturient suddenly
surfaces have crimson colouring. What is rose up to 38, 7oC . She complains about
weakness, headache, abdominal pain, A. Noncarrying of pregnancy

irritability. Objectively: AP- 120/70 mm B. Intestinal obstruction
Hg, Ps- 92 bpm, to - 38, 7oC . Bimanual C. Fetus hypotrophy
examination revealed that the uterus was D. Premature placenta detachment
enlarged up to 12 weeks of pregnancy, E. Late gestosis
it was dense, slightly painful on palpati-
on. Cervical canal lets in 2 transverse fi- 150. It is planned to make complete
ngers, discharges are moderate, turbid, isolation boxes in the infectious
with foul smell. In blood: skeocytosis, department in order to prevent
lymphopenia, ESR- 30 mm/h. What is the nosocomial airborne infections. The
most probable diagnosis? boxes consist of a tambour, a ward and
a lock chamber. What structure should be
A. Endometritis also included in a complete isolation box?
B. Parametritis
C. Pelviperitonitis A. Bathroom unit
D. Metrophlebitis B. Manipulation room
E. Lochiometra C. Doctor’s consulting room
D. Patient’s examination room
147. A 19 year old boy was admitted E. Nursing room
to a hospital with closed abdominal
trauma. In course of operation multi- 151. A 3 year old boy has petechi-
ple ruptures of spleen and small intesti- al eruption. Examination revealed no
ne were revealed. AP is falling rapidly, other pathological changes. Thrombocyte
it is necessary to perform hemotransfusi- number is 20 · 109 g/l; haemoglobin and
on. Who can specify the patient’s blood leukocyte concentration is normal. What
group and rhesus compatibility? is the most probable diagnosis?
A. A doctor of any speciality A. Immune thrombocytopenic purpura
B. A laboratory physician B. Schonlein-Henoch disease
C. A surgeon C. Disseminated intravascular
D. A traumatologist coagulopathy
E. An anaesthesilogist D. Acute lymphoblastic leukemia
E. Systemic lupus erythematosus
148. A 36 year old man was delivered
to the surgical department an hour after 152. Indices that characterize populati-
a road accident. His condition is getti- on health include demographic indices.
ng worse: respiratory insufficiency is What environment is used for calculation
progressing, there are cardiac abnormali- of these indices?
ties. Clinical and roentgenological
investigations revealed mediastinal di- A. Population number
splacement. What process has caused this B. Employment number
complication? C. Number of hospitalized people
D. Number of patients
A. Valvular pneumothorax E. Number of population being liable to
B. Open pneumothorax preventive examination
C. Closed pneumothorax
D. Subcutaneous emphysema 153. An infant is full-term. Delivery was
E. Mediastinitis pathological, with breech presentation.
Examination of the infant revealed li-
149. An 18 year old primigravi- mited abduction of the right leg to 50o ,
da in her 27-28 week of pregnancy positive "clicking"symptom on the right,
underwent an operation on account of asymmetric inguinal folds. What is the
acute phlegmonous appendicitis. In the most probable diagnosis?
postoperative period it is necessary to
take measures for prevention of the A. Inborn dislocation of the right hip
following pegnancy complication: B. Inborn dislocation of both hips
C. Varus deformity of both femoral necks
D. Fracture of both femoral necks
E. Right hip dysplasia
154. A 30 year old man complains of
intense pain, reddening of skin, edema
in the ankle-joint area, fever up to 39o C . A. Injection of narcotic analgetics and

There was an acute onset of the illness. In powdered blood substitutes
the past there were similar attacks lasting B. Primary surgical pocessing
5-6 days without residual changes in the C. Administration of detoxicating blood
joint. The skin over the joint is hyperemic substitutes
and ill-defined, without infiltrative bank D. Necrotomy of burn surface,
on the periphery. What is the most likely haemotransfusion
diagnosis? E. Antibacterial and detoxicating therapy
A. Gout 158. A 54 year old female patient was
B. Infectious arthritis admitted to the hospital with evident
C. Rheumatoid arthritis acrocyanosis, swollen cervical veins,
D. Erysipelatous inflammation enlarged liver, ascites. Cardiac borders
E. Osteoarthritis are dilated. Heart sounds cannot be
auscultated, apical beat is undetectable.
155. The results of 5 year monitoring AP is 100/50 mm Hg. X-ray picture of
allowed to estimate the level of envi- chest shows enlarged heart shadow in
ronmental influence upon health indi- form of a trapezium. What pathology mi-
ces of popultaion. What statistic method ght have caused these symptoms?
should be chosen?
A. Cardiac tamponade
A. Calculation of correlation coefficient B. Exudative pleuritis
B. Calculation of conformity coefficient C. Complex heart defect
C. Calculation of coefficient of difference D. Acute cardiac insufficiency
validity E. Hiatal hernia
D. Calculation of regression coefficient
E. Calculation of dynamic indices 159. 15 minutes after the second vacci-
nation with diphteria and tetanus toxoi-
156. A 37 year old miner has lifted si- ds and pertussis vaccine a 4 month old
gnificant loads and afterwards felt pain boy manifested symptoms of Quincke’s
in the lumbar area irradiating to his edema. What medication should be appli-
left leg. He walks slowly and carefully. ed for emergency aid?
Lumbar lordosis is flattened. There is
also left-sided scoliosis and tension of A. Prednisolone
paravertebral muscles. Neri’s and Dejeri- B. Heparin
ne’s symptoms are positive, there is C. Adrenalin
Lasegue’s sign on the left from the angle D. Furosemide
of 350. What method will help to specify E. Seduxen
the diagnosis?
A. CT of lumbosacral part of vertebral underwent an operation on account of
column diffuse toxic goiter of the III-IV degree
B. Lumbal puncture 12 years ago. Now she has recurrence of
C. Renal sonography thyrotoxicosis. The patient was offered
D. Descending myelography operative intervention, but it is necessary
E. Electromyography first to localize the functioning gland ti-
ssue. What method should be applied for
157. A 47 year old male patient got a this purpose?
flame burn of trunk and upper extremiti-
es and was delivered to the hospital. The A. Gland scanning
patient is in grave condition, confused B. USI
mental state, with fever. AP- 80/50 mm C. Puncture aspiration biopsy
Hg, Ps- 118 bpm. It was locally stated that D. Roentgenography of neck
the patient got III B degree burns with E. Roentgenography of esophagus
total area of 20%. What medical actions
should be taken? 161. Examination of a 26 year old female
patient revealed a node in the right lobe
of thyroid gland. The node appeared
no earlier than 3 months ago. The pati-
ent associates this node with stress. She
doesn’t complain either about pain or
enlargement of the node. Ultrasonic
scanning revealed a 2x2,5 cm large node A. Delirious

in the inferior part of the right lobe of B. Oneiric
thyroid gland. What treatment should be C. Amentive
administered? D. Twilight state
E. Asthenic confusion
A. Surgical intervention
B. Conservative therapy 165. On the third day of life an infant’s
C. Dynamic observation skin got icteric colouring. The child was
D. No need for treatment born with body weight of 3,200 kg,
E. - body length of 52 cm. The child is acti-
ve. There is puerile respiration above
162. During examination a patient is the lungs. Respiratory rate is 36/min,
unconscious, his skin is dry and hot, heart sounds are rhythmic, heart rate is
face hyperemia is present. The patient 130/min. Abdomen is soft, liver comes
has Kussmaul’s respiration, there is also out from the edge of costal arch by 2 cm,
smell of acetone in the air. Symptoms of spleen is not palpable. Feces are in form
peritoneum irritation are positive. Blood of meconium. What is the most probable
sugar is at the rate of 33 millimole/l. What diagnosis?
emergency actions should be taken?
A. Physiologic jaundice
A. Intravenous infusion of short-acting B. Hemolytic disease of newborn
insulin C. Neonatal sepsis
B. Intravenous infusion of glucose along D. Minkowsky-Shauffard disease
with insulin E. Biliary tracts atresia
C. Introduction of long-acting insulin
D. Intravenous infusion of 166. A pediatrician talked to a mother of
neohaemodesum along with glutamic a 7 month old breast-fed boy and found
acid out that the child was fed 7 times a day.
E. Intravenous infusion of sodium chlori- How many times should the child of such
de saline age be fed?
163. A patient complains about evaginati- A. 5 times
ons in the region of anus that appear duri- B. 3 times
ng defecation and need to be replaced. C. 4 times
Examination with anoscope revealed 1x1 D. 6 times
cm large evaginations of mucosa above E. 7 times
the pectineal line. What is the most
probable diagnosis? 167. In order to study impact of microcli-
mate upon the human organism it is
A. Internal hemorrhoids necessary to make systematic observati-
B. Acute paraproctitis on of air temperature over 3 days. Choose
C. External hemorrhoids a device that will allow to make the most
D. Anal fissure precise temperature records:
E. -
A. Thermograph
164. A 34 year old patient was delivered B. Alcohol thermometer
to the hospital because of follicular tonsi- C. Mercury thermometer
llitis charactirized by high temperature. D. August’s psychrometer
The patient has been abusing alcohol E. Assmann psychrometer
for 12 years. In the evening on the day
of hospitalization he became anxious, 168. A prematurely born girl is now
couldn’t stay in bed, left his ward several 8 months old. She has dyspnea,
times and applied to the staff on duty tachycardia, hepatosplenomegaly, physi-
with different complaints. He reported cal developmental lag, limb cyanosis.
about seeing alot of spiders and flies in There is also parasternal cardiac hump,
his ward as well as abou hearing threats auscultation revealed systolodiastolic
from the corridor. He was exasperated by murmur in the II intercostal space on
the fact that other patients didn’t hear the left. AP is 90/0 mm Hg. What disease
them. He lost also spatial orientation. should be suspected?
What psychopathological syndrome is it?
A. Patent ductus arteriosus is the most probable diagnosis?

B. Coarctation of aorta
C. Stenosis of aortal valve A. Sheehan’s syndrome
D. Stenosis of pulmonary artery B. Stein-Leventhal syndrome
E. Nonclosure of interventricular septum C. Shereshevsky-Turner’s syndrome
D. Homological blood syndrome
169. A 72 year old patient complains E. Vegetovascular dystonia
about pain and bleeding during defecati-
on. Digital rectal investigation revealed 173. A 35 year old female patient sufferi-
a tumour of anal canal. After verificati- ng from cholelithiasis has broken her di-
on of the diagnosis the patient was diet, and this caused an acute pain attack
agnosed with squamous cell carcinoma. in the right subcostal are. The pain eased
The secondary (metastatic) tumour will off on the third day, but the patient got
be most probably found in: progressing jaundice. What non-invasive
diagnostic method should be applied?
A. Lungs
B. Liver A. Endoscopic retrograde cholangi-
C. Pelvic bones opancreatography
D. Mediastinum B. Infusive cholecystocholangiography
E. Brain C. Test for bilirubin
D. Duodenal probing
170. A 52 year old patient complains E. Survey radiography of abdominal
about headache, weakness of his upper organs
left extremity. Neurological symptoms
become more intense during physical 174. A 68 year old patient complains
stress of the left extremity. Pulsation on about acute pain in his right foot, toe
the arteries of the left extremity is sharply edema and darkening of skin of the IV
dampened but it remains unchanged on toe. He has been suffering from diabetes
the carotid arteries. What is the most mellitus for 15 years, doesn’t receive
probable diagnosis? regular treatment. What complication of
diabetes mellitus is it?
A. Occlusion of the left subclavicular
artery, steal syndrome A. Gangrene of the IV toe on the right
B. Thoracal outlet syndrome foot
C. Raynaud’s syndrome B. Panaritium
D. Takayasu’s disease C. Haematoma
E. Occlusion of brachiocephalic trunk D. Erysipelas
E. Fracture of the IV toe on the right foot
171. A 25 year old woman applied to a
maternity welfare clinic and complained 175. A plot of land with total area of 2,0
about being unable to conceive within 3 hectare was intended for building of a
years of regular sexual life. Examinati- hospital. The maximal capacity of the
on revealed weight gain, male pattern of hospital will be:
hair distribution on the pubis, excessi-
ve pilosis of thighs. Ovaries were dense A. 100 beds
and enlarged, basal temperature was B. 200 beds
monophase. What is the most probable C. 400 beds
diagnosis? D. 800 beds
E. Over 1000 beds
A. Sclerocystosis of ovaries
B. Tubo-ovaritis 176. A 26 year old woman complai-
C. Adrenogenital syndrome ns about edemata, swelling and pai-
D. Premenstrual syndrome nfulness of mammary glands, headache,
E. Gonadal dysgenesis tearfulness, irritability. These signs turn
up 5 days before menstruation and di-
172. A woman consulted a therapeutist sappear after its start. What clinical
about fatigability, significant weight loss, syndrome is it?
weakness, loss of appetite. She has had
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
A. Premenstrual syndrome A. Muscle biopsy

B. Postcastration syndrome B. ECG
C. Adrenogenital syndrome C. Echocardiogram
D. Climacteric syndrome D. Electromyography
E. Stein-Leventhal syndrome E. Determination of cortisol concentrati-
on in blood and urine
177. A 27 year old patient suffers from
haemophilia. He was admitted to the 180. A 33 year old patient has acute blood
hospital with melena and skin pallor. loss (erythrocytes - 2, 2·1012/l, Hb- 55 g/l),
Objectively: Ps- 110 bpm, AP- 100/60 mm blood group is A(II)Rh+ . Accidentally
Hg. In blood: Hb- 80 g/l, erythrocytes - the patient got transfusion of donor
2, 8 · 1012 /l. What medication should be packed red blood cells of AB(IV )Rh+
administered in the first place? group. An hour later the patient became
anxious, got abdominal and lumbar pain.
A. Cryoprecipitate Ps- 134 bpm, AP- 100/65 mm Hg, body
B. Stored blood temperature - 38, 6o C . After catheteri-
C. Packed red blood cells zation of urinary bladder 12 ml/h of
D. Dicinone dark-brown urine were obtained. What
E. Epsilon-aminocapronic acid complication is it?
178. A 38 year old patient complains A. Acute renal insufficiency
about inertness, subfebrile temperature, B. Cardial shock
enlargement of lymph nodes, nasal C. Allergic reaction to the donor red
haemorrhages, bone pain. Objecti- blood cells
vely: the patient’s skin and mucous D. Citrate intoxication
membranes are pale, palpation revealed E. Toxic infectious shock
enlarged painless lymph nodes;
sternalgia; liver was enlarged by 2 cm, 181. A parturient woman is 27 year old,
spleen - by 5 cm, painless. In blood: it was her second labour, delivery was
erythrocytes - 2, 7 · 1012 /l, Hb- 84 g/l, at term, normal course. On the 3rd day
leukocytes - 58 · 109 /l, eosinophils - of postpartum period body temperature
1%, stab neutrophils - 2%, segmented is 36, 8oC , Ps - 72/min, AP - 120/80 mm
neutrophils - 12%, lymphocytes - 83%, Hg. Mammary glands are moderately
lymphoblasts - 2%, smudge cells; ESR- swollen, nipples are clean. Abdomen is
57 mm/h. What is the most probable di- soft and painless. Fundus of uterus is
agnosis? 3 fingers below the umbilicus. Lochia
are bloody, moderate. What is the most
A. Chronic lymphatic leukemia probable diagnosis?
B. Chronic myeloleukemia
C. Acute lymphatic leukemia A. Physiological course of postpartum
D. Acute myeloleukemia period
E. Lymphogranulomatosis B. Subinvolution of uterus
C. Postpartum metroendometritis
179. A 36 year old female patient D. Remnants of placental tissue after
complains about general weakness, labour
edemata of her face and hands, rapid E. Lactostasis
fatigability during walking, difficult di-
glutition, cardiac irregularities. These 182. A patient suffering from
symptoms turned up 11 days after holi- gastroesophageal reflux has taken from
day at the seaside. Objectively: face time to time a certain drug that "reduces
erythema, edema of shin muscles. Heart acidity"for 5 years. This drug was
sounds are muffled, AP is 100/70 mm recommended by a pharmaceutist. The
Hg. In blood: ASAT activity is 0,95 following side effects are observed:
millimole/h·l, ALAT - 1,3 micromole/h·l, osteoporosis, muscle weakness, indi-
aldolase - 9,2 IU/l, creatine phosphoki- sposition. What drug has such following
nase - 2,5 micromole Р/g·l. What method effects?
of study would be the most specific?
A. Aluminium-bearing antacid got married a month ago. Objectively:

B. Inhibitor of proton pump general state is satisfactory. Lung exami-
C. 2 -blocker nation revealed vesicular respiration.
D. Metoclopramide Heart sounds are rhythmic, heart rate is
E. Gastrozepin 78/min, AP- 128/68 mm Hg. Abdomen is
soft, painful in the suprapubic area. Uri-
183. A 34 year old patient complai- ne contains 12-18 erythrocytes and 12-15
ns of profuse sweating at night, skin bacteria within eyeshot. What is the most
itching, weight loss (9 kg within the probable diagnosis?
last 3 months). Examination revealed
malnutrition, skin pallor. Palpation of A. Infection of inferior urinary tracts -
neck and inguinal areas revealed dense cystitis
elastic lymph nodes for about 1 cm in di- B. Urolithiasis
ameter, nonmobile, non-adhering to skin. C. Infection of superior urinary tracts -
What is the most probable diagnosis? pyelonephritis
D. Gonorrhoea
A. Lymphogranulomatosis E. Primary syphilis
B. Chronic lymphadenitis
C. Lymphosarcoma 187. Examination of placenta revealed
D. Burkitt’s lymphoma a defect. An obstetrician performed
E. Cancer metastases manual investigation of uterine cavi-
ty, uterine massage. Prophylaxis of
184. A department chief of an in-patient endometritis in the postpartum period
hospital is going to examine resident should involve following actions:
doctors as to observation of medical-
technological standards of patient servi- A. Antibacterial therapy
ce. What documentation should be B. Instrumental revision of uterine cavity
checked for this purpose? C. Haemostatic therapy
D. Contracting agents
A. Health cards of in-patients E. Intrauterine instillation of dioxine
B. Statistic cards of discharged patients
C. Treatment sheets 188. A 9 year old boy had acute respi-
D. Registry of operative interventions ratory viral infection. After it there
E. Annual report of a patient care insti- appeared polydipsia, polyuria, weakness,
tution nausea. Examination revealed the
following symptoms: mental confusion,
185. A woman is 34 years old, it is her dry skin, soft eyeballs, Kussmaul’s respi-
tenth labor at full term. It is known ration, acetone smell from the mouth,
from the anamnesis that the labor started muffled heart sounds, soft and painless
11 hours ago, labor was active, painful abdomen. Blood sugar was 19 millimole/l.
contractions started after discharge of What acute condition is it?
waters and became continuous. Suddenly
the parturient got knife-like pain in A. Ketoacidotic coma
the lower abdomen and labor activity B. Hyperosmolar coma
stopped. Examination revealed positive C. Cerebral coma
symptoms of peritoneum irritation, ill- D. Hepatic coma
defined uterus outlines. Fetus was easi- E. Acute renal insufficiency
ly palpable, movable. Fetal heartbeats
wasn’t auscultable. What is the most 189. A patient consulted a venereologi-
probable diagnosis? st about painful urination, reddening of
the external opening of urethra, profuse
A. Rupture of uterus purulent discharges from the urethra. He
B. Uterine inertia considers himself to be ill for 3 days. He
C. Discoordinated labor activity also associates the disease with a casual
D. Risk of uterus rupture sexual contact that took place for about a
E. II labor period week ago. If provisional diagnosis "acute
gonorrheal urethritis"will be confirmed,
186. A 22 year old female patient then bacteriological study of urethral di-
complains about frequent and painful uri- scharges will reveal:
nation, urge to urinate at night, enuresis,
pain in the suprapubic and lumbar area.
Her urine often has beer colouring. She
A. Gram-negative diplococci ting. Objectively: the child’s condition is

B. Gram-positive diplococci grave. Abdomen is soft, palpation reveals
C. Spirochaete a tumour-like formation in the right ili-
D. Proteus vulgaris ac area. After rectal examination the
E. Mycoplasma doctor’s finger was stained with blood.
What is the most probable diagnosis?
190. A 30 year old patient complai-
ns about inability to become pregnant A. Ileocecal invagination
over 3 years of married life. The pati- B. Gastrointestinal haemorrhage
ent is of supernutrition type, she has hair C. Wilm’s tumour
along the median abdominal line, on the D. Helminthic invasion
internal thigh surface and in the peripapi- E. Pylorostenosis
llary area. Menses started at the age of 16,
they are infrequent and non-profuse. US 194. Estimation of physical development
revealed that the uterus was of normal of a child involved dynamometry and
size, ovaries were 4х5х5 cm large and had estimation of body weight and length,
a lot of cystic inclusions. What is the most annual gain in body length, chest ci-
probable diagnosis? rcumference, number of permanent
teeth, secondary sexual characters, lung
A. Polycystic ovaries vital capacity. Which of the mentioned
B. Ovarian cystoma indices relates to the physiometric ones?
C. Chronic oophoritis
D. Menstrual irregularity A. Lung vital capacity, dynamometry
E. Bilateral ovarian tumours B. Body length and weight, chest ci-
rcumference
191. On the second day after preventi- C. Secondary sexual characters
ve vaccination a 2 year old boy got D. Number of permanent teeth
abdominal pain without clear localizati- E. Annual gain in body length
on, body temperature rose up to 38o C .
On the third day the child got red papular 195. During preventive examination a 16
haemorrhagic eruption on the extensor year old patient presented no problems.
surfaces of limbs and around the joints. Objectively: the patient has signs of
Knee joints were edematic and slightly malnutrition, he is asthenic, AP is 110/70
painful. Examination of other organs mm Hg, Ps is 80 bpm, cardiac border
and systems revealed no pathological is normal, auscultation above the cardi-
changes. What is the most probable di- ac apex reveals three sounds, cardi-
agnosis? ac murmur is absent. ECG shows no
pathological changes, phonocardiogram
A. Haemorrhagic vesiculitis shows that the third sound comes 0,15
B. Thrombocytopenic purpura s after the second one above the apex.
C. Meningococcemia How are these changes called?
D. Urticaria
E. DIC syndrome A. III physiological sound
B. Fout-ta-ta-rou (reduplication of the
192. On the 6th day of life a child got 2nd sound)
multiple vesicles filled with seropurulent C. Protodiastolic gallop rhythm
fluid in the region of occiput, neck and D. Atrial gallop rhythm
buttocks. General condition of the chi- E. IV physiological sound
ld is normal. What disease should be
suspected? 196. Estimation of community health
level involved analysis of a report on
A. Vesiculopustulosis diseases registered among the populati-
B. Impetigo neonatorum on of district under charge (reporting
C. Miliaria form 12). What index is calculated on the
D. Impetigo grounds of this report?
E. Epidermolysis bullosa
193. 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 2-3
minutes, there was also one-time vomi-
A. Common sickness rate A. Cortisol

B. Index of pathological affection B. Corticotropin (ACTH)
C. Index of morbidity with temporary C. Adrenaline
disability D. Noradrenaline
D. Index of hospitalized morbidity E. Adrostendion
E. Index of basic non-epidemic morbidity
197. A 37 year old male patient was complains about edemata of face and
admitted to the resuscitation department legs, pain in the lumbar area that is getti-
because of attacks of tonoclonic spasms ng worse at moving; great weakness,
repeating every half an hour. Between sometimes nasal haemorrhages, rise of
the attacks the patient remains unconsci- body temperature up to 38, 4o C . Objecti-
ous. AP is 120/90 mm Hg, Ps- 100 bpm. vely: painfulness of vertebral column
A day before the patient was at weddi- and ribs on palpation. Laboratorial study
ng and consumed alcohol. 5 years ago he revealed daily proteinuria of 4,2 g, ESR-
had a closed craniocerebral trauma and 52 mm/h. What changes of laboratory
brain contusion that later caused single indices are to be expected?
convulsive attacks accompanied by loss
of consciousness, but the patient didn’t A. Whole protein of blood serum - 101 g/l
undergo antiepileptic treatment. What B. Leukocytes - 15,3 g/l
drug should be injected for emergency C. Haemoglobin - 165 g/l
aid? D. Albumins - 65%
E. γ -globulins - 14%
A. Diazepam
B. Magnesium sulfate 200. A female patient consulted a doctor
C. Sodium oxybutyrate about gain in weight, chill, edemata,
D. Aminazine dry skin, sleepiness, problems with
E. Sodium thiopental concentration. Objectively: the patient’s
height is 165 cm, weight is 90 kg, gynoid
198. A 43 year old female patient was body proportions, to - 35, 8oC , ESR-
delivered to the hospital in grave condi- 58/min, AP- 105/60 mm Hg. Heart sounds
tion. She suffers from Addison’s di- are weakened, bradycardia is present.
sease. The patient had been regularly Other internal organs have no changes.
taking prednisolone but a week before Thyroid gland is not palpable. Mammary
she stopped taking this drug. Objecti- glands ooze milk droplets. Hormonal
vely: sopor, skin and visible mucous study revealed rise of TSH and prolactin
membranes are pigmented, skin and concentration, reduction of T4 . What
muscle turgor is lowered. Heart sounds factor caused obesity?
are muffled, rapid. AP- 60/40 mm Hg,
heart rate - 96/min. In blood: Na- A. Primary hypothyroidism
120 millimole/l, K- 5,8 micromole/l. B. Secondary hypothyroidism
Development of this complication is pri- C. Prolactinoma
marily caused by the deficit of the followi- D. Hypopituitarism
ng hormone: E. Adiposogenital dystrophy

Krok2 - Medicine - 2009

Uploaded by

Copyright:

Available Formats

Krok2 - Medicine - 2009

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Krok2 - Medicine - 2009

Uploaded by

Copyright:

Available Formats

Krok 2 Medicine 2009 1

1. A woman complains of having slight A. Infectious contamination of the urinary

A. Atony of the uterus A. Increased potassium concentration in

A. 120 minutes A. Leftsided renal colic

A. Sanction of public prosecutor, inquiry is transparent, other parts of eyeball

A. Respiratory failure of III degree

of functional Class II angina complai- A. Focal

sweating.What kind of poisoning is it and weakness, high temperature, sore throat.

A. Coronary artery bypass grafting murmur on apex. The liver is enlarged by

78. A healthy 75 year old woman who

A. The patient should be referred to the

A. Acute thrombophlebitis 93. A 39 year old patient complained

A. Anthrax haemorrhagic elements have necrosis in

A. Neuralgia of trigeminus intense headache in the region of occi-

probable diagnosis? ld revealed diffuse thyroid enlargement

myocardial infarction complicated by A. Sulfosalasine

to eliminate influence of this factor upon the most probable diagnosis?

weakness, headache, abdominal pain, A. Noncarrying of pregnancy

in the ankle-joint area, fever up to 39o C . A. Injection of narcotic analgetics and

scanning revealed a 2x2,5 cm large node A. Delirious

A. Patent ductus arteriosus is the most probable diagnosis?

A. Premenstrual syndrome A. Muscle biopsy

A. Aluminium-bearing antacid got married a month ago. Objectively:

A. Gram-negative diplococci ting. Objectively: the child’s condition is

A. Common sickness rate A. Cortisol

You might also like