Крок 2 Загальна лікарська підготовка

Медичний профіль – Терапія

ItemText Правильна DistrB DistrC DistrD DistrE
відповідь -
Classical X-ray image of intestinal obstrustion is: DistrA
*Gas and horizontal Filling defect High positioned Reactive pleuritis Pneumatosis
levels diaphragm

A 15-year-old girl was examined with a history of * Chest x-ray Liver or bone marrow Tuberculin skin testing Sputum smear and Bronchoscopy
gradual onset of fever, malaise, loss of weight. biopsy culture of
There was nothing typical about the kind of fever, M.tuberculosis
which has been present for more than 7-10 days
and changed quickly. Physical examination was
unremarkable. What is the single most important
examination for excluding miliary tuberculosis?

A 58-year-old man complained of severe *Morphine, Theophylline, Albuterol, atropine, Strophanthine, Cordiamine,
inspiratory dyspnea and expectoration of frothy furosemide, prednisolon papaverine potassium chloride, isoproterenol
and blood-tinged sputum. He had been suffering nitroprusside sodium plathyphylline
from essential hypertension and ischemic heart
disease. On exam, acrocyanosis, “bubbling”
breathing, PR of 30/min, BP of 230/130 mm Hg,
bilateral wet rales. Choose medicines for treatment.
An attack of severe substernal pain developed in a *Cardiogenic shock Acute left-sided heart Acute right-sided heart Radicular syndrome Acute vascular
patient at night. On exam: confusion, pallor of the failure failure insufficiency
skin, acrocyanosis, cold sweating, BP of 80/50 mm
Hg, PR of 120/min, irregular and weak pulse.
Note, what condition are these features typical for?

A 61-year-old man complained of sneezing and *Unstable angina Angina pectoris of a Myocarditis Radiculitis Stable angina pectoris
substernal pain on exertion. The prior 2 weeks such pectoris new onset of III functional class
pain had appeared at rest, with increased
frequency, and failed to respond to 1 tabl of
nitroglycerin. What is the most likely diagnosis?

A patient with ischemic heart disease and chronic *Multiple microreentry Enhanced automatic Disturbances of Sick sinus syndrome. Accelerated diastolic
heart failure develops sudden loss of in the ventricles. activity of the neurohumoral depolarization, a
consciousness; on exam, cyanosis, the widened ventricles. regulatory systems. disturbance in
pupils, peripheral pulse and blood pressure are not electrolyte balance.
defined. On ECG: ventricular complexes are
absent; instead of them there are waves of different
shape and amplitude with irregular rhythm. What
is the mechanism of this rhythm disturbance
development?
A 41-year-old woman complains of weakness, *Production of Production of antibodies Production of Production of Production of
fatigue, fever up to 38°C, rash on the face skin, antibodies to double- to myocytes. antibodies to antibodies to myosin. antimitochondrial
pain in the wrists and the elbows. On physical stranded DNA. endothelial cells. antibodies.
exam, erythematous rash on the cheeks with
“butterfly” appearance, the wrists and elbow joints
are involved symmetrically, swollen, tender on
motions, friction rub over the lungs, the heart
sounds are weak, regular, HR of 88/ minute, BP of
160/95 mm Hg. CBC shows anemia, leucopenia,
A man with liver cirrhosis complained of nasal *Decreased liver As a consequence of Thrombocytopenia. As a result of portal K and C
bleedings, right subcostal pain, weakness, nausea. production of DIC. hypertension. hypovitaminosis.
On physical examination: jaundice, hemorrhagic procoagulants.
rash, enlarged liver span (of 14 cm), liver edge
irregular. What is the cause of hemorrhagic
syndrome in this patient?

A 56-year-old woman has an acute onset of fever *Community-acquired Community-acquired Acute pleurisy. Acute lung abscess. Hospital-acquired lobar
up to 39°C with chills, cough, and pain on lobar pneumonia with bronchopneumonia. pneumonia.
respiration in the right side of the chest. On moderate severity.
physical examination: HR of 90/minute, BP of
95/60 mm Hg, PR of 26 per minute. There is
dullness over the right lung. On X-ray: infiltrate in
the right middle lobe of the lung. What is the
diagnosis?
A 36-year-old woman during 6 years has had *Inhaled IV theophylline and Specific Dexamethasone and Ephedrine P.O. and
bronchial asthma. She is sick all the year. She is beclomethason 100 clarithromycin P.O. desensitization with theophylline P.O. inhaled isoproterenol
working in the premises where walls are covered mcg t.i.d. after dust mites and feathers during an attack.
by mould. She has allergy to aspirin, analgin, and previous inhalation of allergens.
acetaminophen. Now she has four asthma attacks fenoterol.
per day, especially at night. Nasal breathing is
disturbing too. There is wheezing on expiration
over the lungs. Skin tests with feathers, dust mites,
and wood dustswoman
A 44-year-old (maplecomplained
and alder-tree) are positive.
of weakness, *Hodgkin’s disease. Tuberculosis. Sarkoidosis. Tumor metastases. Chronic myelocytic
subfebrile fever, and pallor of the skin. Physical leukemia.
examination revealed the enlarged lymph nodes in
the right supraclavicular area. On X-ray film, there
was enlargement of bronchopulmonary and
paratracheal lymph nodes. The liver was enlarged,
with increased firmness. What is the diagnosis?
A 40-year-old man complained of headache in *Chronic Essential arterial Chronic Polycystic disease of Cushing’s disease.
occipital area. On physical examination, the skin glomerulonephritis. hypertension. pyelonephritis. the kidneys.
was pale; there was face and hand edema, blood
pressure of 170/130 mm Hg. On EchoCG, there
was concentric hypertrophy of the left ventricle.
Ultrasound examination of the kidneys revealed
thinned cortical layer. Urinalysis showed
proteinuria of 3.5 g/day. What is the diagnosis?
A 29-year-old woman is critically ill. The illness *Acute pyelonephritis Exacerbation pf chronic Acute Acute cystitis Nephrolithiasis
was manifested by high fever, chills, sweating, pyelonephritis glomerulonephritis
aching pain in lumbar area, a discomfort in
urination, and frequent voiding. Pasternatsky’s sigh
is positive in both sides. On lab exam, WBC of
20.000/mcL; on urinalysis protein of 0.6g/L,
leukocyturia, bacteriuria. Your preliminary
diagnosis.
A 26-year-old man was admitted to the hospital *Acute fibrinous Myocarditis Pneumonia Acute bronchitis Pneumothorax
complaining of stabbing back pain on inspiration pleuritis
and dyspnea. On exam, BT of 37°C, PR of 24/min,
HR of 92/min, vesicular breath sounds. There is a
dry, grating, low-pitched sound heard in both
expiration and inspiration in the left lower lateral
part of the chest. What is the most likely
diagnosis?
A 58 year-old man complained of pain and *Increased biosynthesis Immune response to Hyperproduction of Decreased amount of Production of
swelling of the left foot small joints. The skin over of uric acid streptococcal infection autoantibodies to chondroitin sulfate antibodies to native
these joints was purple, BT was 38°C. For the last collagen DNA
6 years he has had a few episodes of such arthritis
with duration of each one up to 7 – 10 days. He
also suffered from chronic tonsillitis. On exam,
there were abnormal features in the left
metatarsophalangeal joints. What is the
pathogenetic mechanism of this disease
A 31-year-old man with past history of rheumatic *Infective endocarditis Rheumatic aortic valve Typhoid fever Acute viral hepatitis Acute nephritis
fever was severely ill and complained of fever up disease
to 38 – 39°C, abdominal pain, dyspnea, palpitation;
he felt ill 6 days prior. On exam, the left heart
border was shifted to the left, heart sounds were
faint, there were systolic and dyastolic murmurs at
the aortic area, BP of 160/30 mm Hg, positive
Rumpel-Leede sign, enlargement of the liver and
the
A 14spleen, diarrhea,
year old patient.and
Hedark urea. What
complains is the
of chest pain, *Rheumatic pancarditis Rheumatic pericarditis Rheumatic Rheumatic endocarditis Septic endocarditis
temperature 38,5, breathlessness. He had acute myocarditis
tonsillitis2 weeks ago. He is in a bad state. The
skin is pale. Heart borders are widened, the tones
are weakened. Above all heart area you can hear
pericardium friction sound. Electrocardiogramm:
the descent of voltage QRS, the inversion T. The
liver is 3 sm enlarged. ESR – 4mm/h, ASL – 0 –
1260, C-reaction protein
A 52-year-old patient +++. Your
with diagnosis:
previously * IHD. Unstable angina Cardialgia due to spine IHD. Functional Myocarditis Myocardial dystrophy
functional Class П angina complains of 5 problem Class П angina.
days of intensified and prolonged
retrosternal pains, decreased exercise
tolerance. Angina is less responsive to
Nitroglycerinum. Which of the following
diagnosis is most likely?

An ECG of postinfartional [a year ago] patient * Septal and anterior Anterolateral Anterior Inferior Postrolateral
shows pathological QS waves in leads VI-V3, I,
aVL. Determine the location of old myocardial
infarction.
A 52-year-old patient has hypervolaemic type of * Hypothiazid Dibazol Clophelin Kapoten Nifedipin
essential hypertension. Which of the following is
necessary to prescribe either as monotherapy, or in
a complex with other antihypertensive remedies?

A 62-year-old patient complains of rest dyspnea, * CHF-2 B CHF- 1 CHF- 2 А CHF-0 CHF-3
heart pains. 3 years ago he had myocardial
infarction. Physical examination: orthopnea,
acrocyanosis, swollen cervical veins. Pulse – 92,
total heart enlargement, the liver is enlarged by 7
cm, shin edema. What is the stage of chronic heart
failure [CHF]?

A patient, aged 49, complains of fever of 37,5 * Phonocardiography Ballistocardiogram Chest x-ray ECG
0С, heart pain, dyspnea. S1 is clapping; Echocardiography+Do
S2 is accentuated in the aortic area; ppler-
opening snap, presystolic murmur are Echocardiography
auscultated. What is the most useful
investigation for valvular disorder
assessment?

Physical examination of a person with chronic * All of them Low diaphragm Hyperresonant Hyperinflated lungs Expansion of
bronchitis reveals expansion of intercostal spaces, percussion note intercostal spaces
hyperresonant percussion note, decreased
whispered voice sounds. Chest x-ray shows
hyperinflated lungs, low and flattened diaphragm.
Which of the signs is helpful in diagnosing lung
emphysema?
A patient with nosocomial pneumonia presents * Septic shock Exudative pleuritis Bronchial obstruction Toxic hepatitis Emphysema
signs of collapse. Which of the following
pneumonia complications is most likely to be
accompanied with collapse?

A 45-year-old man for 1 month has complained of *Cancer of the Gallbladder stones Chronic pancreatitis Chronic cholangitis Chronic hepatitis
epigastric and right subcostal aching pain, pruritus, pancreas head
indigestion, dark color of the urine and acholic
stool, fever, and significant weight loss. On exam:
jaundice, presence of Curvuasier’s sign. US scan
did not reveal stones in the gallbladder and
choledochus. What is the most likely diagnosis?

A 34-year-old woman fell ill 3 months ago after *Nonsteroidal anti- Cephalosporines Tetracyclines Sulfonamides Fluorchinolones
cold exposure. She complained of pain in the hand inflammatory drugs
and knee joints, morning stiffness, and fever up to
38°C. Interphalangeal, metacarpophalangeal and
knee joints are swollen, hot, with decreased ranges
of motions; ESR of 45 mm/hr, CRP (+++), Vaaler-
Rouse test of 1:128. What group of medicines
would you recommend to the patient?
A 47-year-old obese man complained of periodic *Gout arthritis Reiter’s disease Rheumatoid arthritis Rheumatic arthritis Osteoarthritis
attacks of acute arthritis in the 1st left
tarsophalangeal joint. Lab exam revealed increased
serum level of uric acid. What is the diagnosis?
A 22-year-old woman complained of right *Chronic viral hepatitis Calculous cholecystitis Gilbert’s disease Acute viral hepatitis Chronic cholangitis
subcostal aching pain, nausea, and decreased
appetite. She fell ill 2 months after appendectomy
when jaundice appeared. She was treated in an
infectious hospital. 1 year later above mentioned
symptoms developed. On exam: the subicteric
sclerae, enlarged firm liver. Your preliminary
diagnosis
A 50 -year-old woman for 1 year complained of *Ultrasound Liver function tests X-ray examination of Ultrasound study of the Blood cell count
attacks of right subcostal pain after fatty meal. Last examination of the the gastrointestinal pancreas
week the attacks have repeated every day and gallbladder tract
become more painful. What diagnostic study
would you recommend?

A 27 -year-old man complained of aching *Chronic type A Chronic type B gastritis Peptic ulcer of the Chronic type C gastritis Menetrier’s disease
epigastric pain just after meal, heartburn, and gastritis stomach
nausea. Stomach endoscopy revealed a large
amount of mucus, hyperemia and edema of
mucous membrane in gastric fundus with areas of
atrophy. Establish the diagnosis.

A 25 -year-old woman complained of edema on *Penicillin OS Heparin Ceftriaxone Dipyridamole Ciprofloxacine

the face and legs, elevation in blood pressure up to
160/100 mm Hg, and weakness. She fell ill 3
weeks after sore throat. On urinalysis, protein of
0.5 g/L, erythrocytes of 17 – 20/field, leukocytes of
2 – 3/field, erythrocyte casts. What treatment
should be initiated after establishing of the exact
diagnosis?
A 25-year-old woman complained of fatigue, hair * Ferrous sulfate orally Iron dextrin injections Vitamin B12 Blood transfusion Packed RBCs
loss, and brittle nails. On exam, pallor of skin, PR intramuscularly transfusion
of 94/min, BP of 110/70 mm Hg. On blood cell
count, Hb of 90 g/L, RBC 3.5·1012/L, color index
of 0.7, ESR of 20 mm/h. Serum iron level was 8.7
mcmol/L. what treatment would you initiate?

A 38-year-old man worked at roofing and drain *Chest X-ray Bronchoscopy Blood gas analysis Spirography Electrocardiography
piper production for 15 years. He seeks medical
help for expiratory breathlessness on exertion, and
dry cough. On exam, wheezes above both lungs,
grayish warts on fingers are seen. Factory
physician has diagnosed asbestosis. What method
is the most important for this diagnosis?

The patient has worked 13 years as a bulldozer *Vibration disease Raynaud’s disease Syringomyelia Atherosclerosis Periarteritis nodosa
driver. He complains of dizziness, headache, finger obliterans
dumbness and pain at night. On exam, tactile
sensivity of peripheral type disturbes him, ankle
muscles are painful, and pulsation on a. dorsalis
pedis is weak. What is the most probable
diagnosis?

A worker of chemistry factory had occupational *Chronic lead Chronic lead Porphyria Hereditary hemolytic Lead carrier
exposure to lead for 20 years. Total blood count: intoxication, II stage intoxication, I stage anemia
RBC of 3.5•1012/L, Hb of 100 g/L, reticulocytes
of 3.3\%, granulated erythrocytes of 40 on 50
fields of view; lead blood concentration of 0.042
mg\%, porphyrinurea of 0.32 mg/L. What is the
probable diagnosis?
A fitter of metallurgic factory with occupation *Chronic mercury Neuroinfection. Parkinson syndrome. Acute mercury Mercury
exposure to high concentrations of mercury fumes intoxication. intoxication. encephalopathy.
during 16 years presents instability of pulse and
blood pressure, general hyperhydrosis, asymmetric
innervations of facial muscles and tongue, positive
subcortical reflexes, hand tremor on physical
examination. Dentist consultation revealed
paradontosis, and chronic stomatitis. What is the
most probable coal
A 45-year-old diagnosis?
miner complains of cough with *Anthracosis, nodular, Silicosis, nodular, Siderosis, interstitial, Bissinosis, interstitial, Asbestosis, interstitial,
black sputum, breathlessness on exertion, which slowly progressing slowly progressing slowly progressing slowly progressing slowly progressing
occurred 4 years before. On physical examination, form, first stage. form, first stage. form, first stage. form, first stage. form, first stage.
wheezes above both lungs, heart sounds are
without changes, heart rate of 72 beats per minute.
Chest radiography shows multiple, small irregular
opacifications throughout both lungs. What is the
most probable diagnosis?
A 40-year-old woman who has worked in weaving *Noise-induced Hypertension. Atopic bronchial Asteno-vegetative Encephalopathy.
branch for 10 years complains of frequent disease. asthma. syndrome.
headache, sleeplessness, irritability, fatigue,
tiredness. Physical examination revealed instability
of blood pressure, internal organs are without
changes. What is the most probable diagnosis?

A worker of a printing house complains of *Plumbism, severe Mercurialism, severe Aluminium Asbestosis, severe form Cyanides poisoning,
abdominal pain, constipation during last 5 days. He form form intoxication, severe severe form
presents a liliac line at the gingival-tooth border, form
tachycardia of 100/min, BP of 160/90 mm Hg,
painful abdomen on palpation. Aminolevulinic
acid in plasma is elevated. CBC shows signs of
normocytic and normochromic anemia. What is the
preliminary diagnosis?
A 45-year-old driver was admitted to the hospital *Acute myocardial Stable angina Pulmonary embolism Acute myocarditis Acute left ventricular
with 5 hour substernal pain. Nitroglycerin is not infarction failure
effective. He is pale, heart sounds are regular but
weak. HR 96 per minute, BP of 100/60 mm Hg.
What is the most probable diagnosis?

A 38 -year-old woman is seriously ill. She *Bronchial asthma, Chronic obstructive Atopic bronchial Bronchiectasis, Ischemic heart disease,
complains of frequent paroxysms of expiratory status asthmaticus bronchitis asthma, respiratory respiratory failure of the pulmonary edema
dyspnea. The last paroxysm lasted over 12 hours failure of the III II - III degree
and failed to respond to theophylline. The skin is degree
palish gray, moist, RR of 26/min. On auscultation,
breath sounds are absent over some areas. Your
preliminary diagnosis

A 46- year-old patient has ischemic heart disease, *Nitroglycerin Platelet inhibiting Spasmolitics (No-spa) Digitalis IV Sedative agents
angina on exertion, II functional class. What is the sublingually agents (aspirin) IV (Seduxenum) orally
drug of choice in treatment of acute attack?

A 19-year-old girl admitted to the hospital *Beta-hemolytic Viral-bacterial Autoimmune disorder. Staphylococci. Ricchetsia.
complained of pain in the knee and fever of streptococci. association.
38.6°C. She is ill for 2 weeks after acute tonsillitis.
On exam, hyperemia and swelling of both knees,
BT of 37.4°C, HR of 94/min, BP of 120/80 mm
Hg, and heart border is displaced to the left; S1 is
weak, systolic murmur is present. Total blood
count shows the following: Hb – 120 g/L, WBC –
9.8•109/L, ESR of 30 mm/L. ECG findings: the
A 42-year-old woman complains of dyspnea, *Mitral stenosis Mitral regurgitation Tricuspid stenosis Tricuspid regurgitation Aortic stenosis
edema of the legs, and tachycardia during small
physical exertion. Heart borders are displaced to
the left and S1 is accentuated, there is
protodiastolic murmur on xiphoid process. The
liver is enlarged by 5 cm. What is the cause of
heart failure?

A 33-year-old man with a history of rheumatic *Infectious Rheumatic fever Acute hepatitis Acute nephritis Aortic regurgitation
fever complains of fever up to 38 - 39°, abdominal endocarditis
pain, dyspnea, tachycardia. Heart borders are
displaced to the left by 2 cm, systolic and diastolic
murmurs above aorta, BP of 160/30 mm Hg.
Petechial rash occurs after measurement of blood
pressure. Liver is enlarged by 3 cm, spleen is
palpable. Urine is brown-yellow. What is the most
probable diagnosis?
A 60-year-old man complains of fever, significant *Myelosan Prednisolone Cytosar Vinblastine Blood transfusion
weight loss, bone and joint pain, and bleeding
gums. On exam, paleness, lymphadenopathy,
hepato- and splenomegaly. CBC: WBC –
270•109/L with 13\% lymphocytes, 1\%
monocytes, 21\% basophiles, 29\% neutrophils,
9\% blasts, 12\% promyelocytes, 12\% myelocytes,
2\% metamyelocytes, 1\% eosinophils. ESR – 22
mm/h. Name the
A 54-year-old drug for
woman treatment.
complains of increasing *Acute leukemia Chronic leukemia Thrombocytopenia Hemolytic anemia Megaloblastic anemia
fatigue and easy bruising of 3 weeks’ duration.
Physical findings included pale, scattered
ecchymoses and petechiae and mild
hepatosplenomegaly. CBC: RBC – 2.550.000/mcL;
Hb – 73 g/L; HCT 20\%; PLT – 23.000/mcL; and
WBC – 162.000/mcL with 82\% blasts, that
contained Auric rods; peroxidase stain was
positive; What is the most probable diagnosis?
A 60-year-old woman has increased BP up to *Essential Essential hypertension, Symptomatic Cardiomyopathy Ischemic heart disease
210/110 mm Hg during last 7 years. On exam, hypertension, 2nd stage 1st stage hypertension
heart apex is displaced to the left. There are signs
of left ventricular hypertrophy on ECG. What is
the most probable diagnosis?

A 39 -year-old woman complained of squeezed *Revealing of Detection of Gastrin level in blood Examination of stomach Examination of
epigastric pain 1 hour after meal and heartburn. Helicobacter infection autoantibodies in the secretion stomach motor
She had been ill for 2 years. On palpation, there in gastric mucosa serum function
was moderate tenderness in pyloroduodenal area.
Antral gastritis was revealed on gastroscopy. What
study can establish genesis of the disease?

A 20- year-old patient with a history of preceding *Acute Acute pyelonephritis Rheumatic fever Essential hypertension Bacterial endocarditis
streptococcal infection complains of malaise, glomerulonephritis
headache, anorexia, subfebrile fever. On exam,
mild generalized edema, BP of 150/90 mm Hg, HR
of 100/min, RR of 20/min, the urinalysis showed
increased protein, red cell casts and hyaline casts.
What is your diagnosis?

A 32 -year-old welder complains of weakness and *Acute leukemia Chronic Aplastic anema Vitamin B12 deficiency Chronic hemolytic
fever. His illness started as tonsillitis a month lympholeukemia anemia anemia
before. On exam, BT of 38.9°C, RR of 24/min, HR
of 100/min, BP of 100/70 mm Hg, hemorrhages on
the legs, enlargement of the lymph nodes. CBC
shows Hb of 70 g/L, RBC of 2.2·1012/L, WBC of
3.0·109/L with 32\% of blasts, 1\% of eosinophiles,
3\% of bands, 36\% of segments, 20\% of
lymphocytes, and 8\% of monocytes, ESR of 47
A 30- year-old patient complains of breathlessness, *Dilated Infectious endocarditis Acute myocarditis Rheumatic fever, mitral Acute pericarditis
pain in the right rib arc place, dry cough and the cardiomyopathy stenosis
leg edema. He is ill for 2 months. He was treated
for rheumatic fever without effect. On exam,
cyanosis, edema of the legs, BT of 36.6°C, RR of
28/min, HR of 90/min, BP of 110/80 mm Hg,
crackles above low parts of both lungs, heart
borders are displaced to the left and to the right,
weak sounds,
The risk systolic
of cancer murmur
being above
the result the apex.
of radiation * All of the below The high incidence of The low risk of cancer The long interval None of the above
doses of 100 Gray or less to the whole body is mentioned cancer of the general from small doses between radiation and mentioned
difficult to estimate reliably. The reasons for this population clinical presentation of
uncertainty are : cancer.

For which of the following diagnostic * None of the below Chest radiography Barium enema study IVP Abdominal CT
examinations performed with modern techniques mentioned
on an unknown pregnant patient should therapeutic
abortion be considered the result of putative risk
from radiation?

The highest risk of congenital anomalies probably *18-45 days after The first 7 days 10-14 days after 90-120 days after The third trimester
occurs when human embryos or fetuses are conception conception conception
exposed to ionizing radiation. During which part of
gestational period does it occur?
A 38-year-old patient has been treated in a * Cephalosporins Penicillin Erythromycin Tetracycline Streptomycin
hospital. A fever of 39 C, chest pain which is of the Ш
worsened by breathing, cough, brownish sputum generation
appeared on the 7th day of the treatment. Chest x
ray shows left lower lobe infiltrate. Which of the
following is the treatment of choice for this
patient?

A patient, aged 48, complains of heaviness in the * Liver cirrhosis Cancer of the liver Cancer of the head of Gallstones Viral hepatitis B
right hypochondrium, itching of the skin. pancreas
Repeatedly he had been treated in infectious
diseases hospital due to icterus and itch.
Objectively: meteorism, ascitis, dilation of
abdominal wall veins, protruded navel, spleen
enlargement. Diagnosis is:

A 27-year-old man complains of pains in * Gastritis of type B Gastritis of A type Reflux - gastritis Menetrier's gastritis Rigid antral gastritis
epigastrium which are relieved by food intake.
EGDFS shows antral erosive gastritis, biopsy of
antral mucous presents Hеlicobacter Pylori.
Diagnosis is:

A man, aged 25, presents with facial edema, * Acute Acute pyelonephritis Cancer of the kidney Urolithiasis Chronic
moderate back pains, body temperature of 37,5 С, glomerulonephritis glomerulonephritis
BP 180/100 mmHg, hematuria [ up to
100 in v/f], proteinuria [2,0 g/L], hyaline
casts - 10 in v/f., specific gravity -1020.
The onset of the disease is probably
connected with acute tonsillitis 2 weeks
ago. The most likely diagnosis is:
A patient had stomach resection a year ago. He * Iron-deficiency B12-deficiency anemia Сhronic Aplastic anemia Chronic lymphoid
complains of general weakness, giddiness. Blood anemia myeloleukosis leukosis
count: Er 2,6 g/L, Hb 80 g/L, C.ind 0.7, L – 3.7
g/L, reticulocytes 1\%, segm 56\%, lymp 34\%,
mon. 6\%, ESR 17 mm/hour. Erythrocytes are
hypochromic; there are anisocytosis & poikilo-
cytosis. Fe of serum 5 mkmol/L. Diagnosis is:

A patient of 62 years with DM-2. * Prescribe the drugs of Give Glurenorm in To continue with the Prescribe the drugs of Prescribe guanyl
Diabetes is being compensated by diet an insulin of short place of Maninilum. current therapy insulin of long activity guanidines
and Maninilum. Pаtient has to undergo activity
an operation for inguinal hernia. What
should be tactics of hypoglycemic
therapy?

A 33-year-old lady has been suffering from DM * DM 1st type, severe DM 2nd type, severe DM 1st type, severe DM 2nd type, moderate DM 1st type, severe
for 5 years. The last 3 years she has taken more form, decompensation, form, decompensation form, form, Zabrodi form, decompensation,
than 100 units of insulin per day. Body weight has insulin resistant subcompensation, phenomenon allergic response on
increased up to 10 kg. Fasting blood glucose is 13 Somoji phenomenon insulin
mmol /L, glucoseuria - 3\%. Generalized
microangiopathy. By increasing the dose of insulin
the parameters of glycemia do not change. The
diagnosis is:
A patient of 32 complains of severe weakness, * Diffuse toxic goiter Diffuse euthyroid goiter Chronic autoimmune Chronic fibrous Toxiferous adenoma of
tremor of extremities. Objective examination: body of the 3rd degree, of the 3rd degree. thyroiditis, thyroiditis the thyroid gland
weight loss, wet & warm skin. The thyroid gland is thyrotoxicosis of the hypertrophic type
enlarged up to the 3rd degree, painless, elastic. average degree
Pulse: 108. BP- 160\55 mmHg. Everything else is
normal. The diagnosis is:
In the development of the inflammation processes * Phospholipase A2 Arachidonic acid Lipoxygenasе Cyclooxygenase – 1 Cyclooxygenase – 2
glucocorticoids reduce the level of a certain most
important active enzyme. It results also in the
reducing of the synthesis of prostaglandins and
leukotrienes which has a key-role in the
development of the inflammation processes. Give
the exact term of this enzyme.

А patient is suffering of a chronic heart * Indomethacin Digoxin Furosemide Panangin Riboxinum

insufficiency [degree II; phase A]. The
patient has been given a proper
therapeutic treatment along with
furosemide. Later the patient developed
a lumbosacral nerve root syndrom. To reduce
the acute pains the doctor prescribed a certain
agents, which lowered the effect of furosemide.
Give
Whichtheofname of this medicine.
the following is used for tuberculin PPD-L standard ATK tuberculin PPD-L diluted in 5 Dry pure tuberculin Tuberculin in the form
diagnosis in the masses dilution of 2 TU in TU in 0,1 ml of ungutum
0,1 ml

Vaccination of BCG should be conducted on: 5 days 3 months 10 days 12 months 5 years
In a male aged 25 focal shadowings of small and Focal Disseminated Miliary Fibro-cavernous Tuberculoma
medium intensity with unequal contours in the 1st
and 2nd segments of the right lung were revealed
during prophylactic photoroentgenography
investigation. Which clinical form can be
suspected in this patient?

A woman 26 years old has abused alcohol for 7 * Treatment of Medical abortion Decrease of alcohol Participation in the A- Gyneacological
years. She has psychological dependence on alcoholism and full use ANON group observation
alcohol, but no withdrawal syndrome. Drinks abstinance from
almost every day approximately 50 – 100 gr. of alcohol during all the
wine. Is at her 4-th week of pregnancy. Primary period of pregnancy
prevention of fetal alcohol syndrome requires:

Interpret GTT. Glycemia: I trial – 5,3 mMol/l, II *Normal Impairment of Diabetes mellitus Necessary to repeat test Necessary to order
trial – 8,2 mMol/l, III trial – 4,8 mMol/l carbohydrate tolerance additional laboratory
tests.

What points, concerning myxedema coma are * Hypothermia is Feeling warm may Cause is – increased Hyperfunction of Thyroid cancer
correct ? common provoke myxedema sensitivity to T 3 and adrenal glands
coma T4 receptors.
Developing of gigantism is conditioned by: *Overwhelming Overwhelming secretion Overwhelming Overwhelming Inborn sensitivity lack
secretion of GH in of GH in old age secretion of GH in secretion of in tissues to GH
adolescence adults somatostatin in
adolescence

Choose factors, which can cause Addison’s disease *Tuberculosis Tumor acting on adrenal Autoimmune Diabetes Mellitus Brain tumor
hormone destruction of thyroid
gland

To remove onset of tetany you will order *Calcium chloride Benzylpenicillin Prednisolone Potassium citrate Magnesium sulphate

Macroangiopathy, as a symptom of diabetes *Brain Lung Kidneys Retina Intestine

mellitus, most often destroy vessels of:
The treatment of Grave’s disease usually include *Antagonists of thyroid Antidepressants Narcotic analgesics Diuretics Sulfonylureas
hormones

Choose the correct initial interaction of a photon * Interaction of the Production of an Dissipation of the Chemical changes in None of the above
with an atom in a biological system leading to cell photon with a energetic changed energy of the electron the ionizing / excited mentioned
damage subatomic particle. For particle usually a photo along its path by molecules.
x-ray imaging radiation or recoil electron. ionization and
this will be an electron. excitation.

Which of the following statements concerning * They are sensitive to They are very resistant They are sensitive to They are sensitive to Cells that survive can't
undifferentiated cells in tissues is correct? radiation but easily to radiation radiation and most are radiation and difficult to go on to form a tumor
replaced when killed killed by doses in the replace if killed.
diagnostic range

Which of the following symptoms would occur * Hallucinations and Nausea and Vomiting Diarrhea Bleeding Gums Epilation (hair loss)
only if a total-body acute radiation exposure impairment of vision
exceeded 5.000 rad (50 Gy)
A total body dose of 200 rad will cause the * 180 Days 30 days 60 days 120 days 240 days
hematopoietic syndrome. The time for maximum
hematological recovery will be :

Patient N., 27 years old was hospitalized to the * Supportive treatment Long-term Psychiatric Participation in a self- Psychoanalytic
psychiatric hospital for the 4-th time during 2 with neuroleptics of hospitalization observation help group treatment
years. Heard voices commenting on his actions, prolonged action
had delusions of persecution [was sure that the
Mafia wanted to kill him]. After a course of
treatment with neuroleptics was discharged from
hospital with the diagnosis of schizophrenia, state
of remission. The secondary prevention of the
relapses ofmale,
Patient K, schizophrenia requires:
19 years old, has suffered * All the above Supervision of a social Physical work under Supervision of relations None of the above
moderate mental retardation since childhood. Is mentioned worker supervision [ if any] mentioned
illiterate, can take care of himself, do simple
household work and other kinds of easy work
under supervision. His rehabilitation [tertiary
prevention] requires:

Patient F., male, 16 years old was behind other * Chromosome Gene abnormality Maternal alcohol Pathological delivery Infection in mother
children in development since early childhood and abnormality abuse during during pregnancy
still has moderate mental retardation. He is short, pregnancy
has dismorphic body, his face is round, flattened,
his eyes are narrow and slanted, and there are
epicantial folds in the corners of his eyes. There is
only one transversal flexor line on his palms.
What is the probable etiology of this state?
Patient A., male, 27 years old came to consult a * Severe stress Adjustment disorder Environmental factors Patient’s personality Endogenic factors
psychiatrist with the following complaints: after a features
bad car accident, the victim of which he was and in
which his wife was killed, he suffered depression,
anxiety, flash-backs of the event, sleep disorders
and nightmares about the accident. He also had
emotional numbness and fatigue. The cause of the
disorder was:
A female patient 28 years old, became depressed, * Hypothalamus Frontal lobes Pituitary Hippocampus Corpus callosum
her mood is melancholic; this state is associated
with hypobulia, hypokinesia, slow speed of
thinking. Her attitude towards her past present and
future is pessimistic. The pathogenetic mechanism
of this state is supposed to involve dysfunction in
the:

A patient, while making repairs at home, suddenly * Petit mal, epilepsy Grand mal, epilepsy Jacksonian fit, Disphoria, epilepsy Twilight state, epilepsy
stood quite still with the painting brush in his hand. epilepsy
This state lasted for a few seconds. After that the
patent was rather confused, for some moments he
couldn’t understand what was happening. He
totally forgot the state he was in and the events
around him, occurring while he was in that state.
Name the disorder:
The observed patient’s movements are retarded, * Catatonic stupor, Depressive stupor, Apathetic stupor, Psychogenic stupor, Dissociative stupor,
she answers no questions. Sometimes she shizophrenia bipolar disorder shizophrenia stress disorder dissociative psychosis
spontaneously stays in strange postures. It is
possible to set [form] her body and limbs into
different positions artificially. If the psychiatrist
lifts her arm or leg, so that she remains standing on
the other leg, the patient can stay in such a position
for quite a long time. Name the probable disorder:
Patient T., female, 35 years old, suffers from * All the above Individual approach Gradual beginning Continuous long-term None of the above
epileptic fits since she was 15 years old. She has mentioned treatment mentioned
seizures during which she loses consciousness,
falls down and has tonic and clonic convulsions.
The fits occur once a week. What are the main
principles of treetment in epilepsy?

What auscultative data are watched in * The clinical picture Bronchial breathing. Amphoric breathing. Dry whistling rales. Moist fine bubbling
bronchoectatic disease? depends on full or rales [non-
empty bronchiectasia consonating].
and on caliber of
bronchus.

What from enumerated syndromes is main in acute * Syndrome of muco- Syndrome of bronchial Syndrome of Syndrome of pulmonary Syndrome of
diffuse bronchitis ? ciliary insufficiency. obstruction. respiratory tissues insufficiency. pulmonary tissues
insufficiency. augmented aerisation.

The primary bronchopneumonia more often arises * Complication of Complication of Complication of Complication of infarct Complication of
as … acute bronchitis. pneumorrhagia. stagnation of blood in of the lungs. pneumoconiosis.
the lungs.
What auscultative data of the lungs does in lobar * Bronchial breathing. Crepitation. Moist consonating Moist non-consonating Increased vesicular
pneumonia exist at stage of hepatization ? rales. rales. breathing.

What is the basic of crepitation ? * The separation of Existence of Existence of a cavern Stenosis of a clear space Friction of the
alveoli during bronchiectasis filled by containing liquid and of bronchus. inflamed pleural layers
inspiration on walls of pus. air. during respiration.
which the fibrin has
put.

Sputum “full mouth” [is more often in morning * Bronchoectatic Pulmonary tuberculosis. Focal pneumonia. Acute bronchitis. Empyema of pleura.
time] is characteristic for: disease.

What is auscultated in syndrome of infiltration of * Pathological Intensified vesicular Decreased vesicular Harsh. Amphoric breathing.
pulmonary tissue ? bronchial breathing. breathing. breathing, dry rales.
When can pulmonary bleeding arise ? * Bronchoectatic Diffuse catarrhal Bronchiolitis. Lobar pneumonia in a Bronchopneumonia.
disease. bronchitis. stage of red
hepatization.

What auscultative phenomenon arises at beginning * Harsh. Moist fine bubbling Crepitation. Moist medium bubbling Vesiculo-bronchial
of acute bronchitis ? rales. rales. breathing.

Symptoms of the effected pallidar system do not *Hemibalism Plastic hypertension Bradikinesia Hipomimia Micrografy
include?

What of the mentioned symptoms isn't *Disturbance of Hypotension Hyporeflexia Hypotrophy Torpid distal paralysis
characteristic of poliomyelitis? sensitiveness
Name the symptom of stretching of the ishiatic *Lasseg's Lessage's Brudzinsky's Kernig's Vasserman's
nerve?

Name the nuclei of the cranial nerves which are *Oculomotor Accessory Glossopharyngeal Vagus Hypoglossal
affected Weber's alternating syndrome?

Neuralgia of the trigeminal nerve is characterized *Transient pain on the Permanent pain in the Loss of sensitivity on Trophical disturbances Positives effect from
by? face and trigger areas area of innervation the face of cornea and loss of sponging by 5\%
corneal reflex solution of cocaine on
the posterior surface of
the mucosa of the
middle turbinate bone

Central paresis of the mimic muscles is * Affection of mimic Affection of masticatory Prolapse of papillary Trophic disorders Affection of mimic
characterized by: muscles of the lower group of muscles reflex muscles of half of the
half of the face? face
The patient H., aged 36,works as a nightman * An acute Chronic arsenious An acute poisoning by Carbone bisulfide Leaden intoxication
during 12 years.He applied with complaints of the intoxication intoxication from OPS intoxication
headache, loss of appetite, syncopal conditions, pesticides
metallic taste in the mouth, sometimes
stomachache, dispeptical frustration, diarrhea and
constipation. Objective: fragility of nails,
hyperkeratosis of palms. Diagnosis?

A diagnosis of chronic arsenious intoxication was * Haemolytic anemia Aplastic anemia Iron deficiency anemia Hyper sideric anemia Normochromic anemia
defined in a patient Y., a nightman. What form of
anemia is characteristic in this disease?

The man, aged 42, applied to the therapeutist with * Silicosis Tuberculosis of lungs Silicatosis Bronchiectatic disease Chronic bronchitis
complaints of pricking pains in scapulas area,
dyspnea on physical exertion, cough with
discharge of small amount of sputum. During 10
years he works in coal mining. On percussion-box-
note sound in the lower parts, on auscultation- a
harsh breathing. There were no changes in the
heart. Possible diagnosis?
A sick man M., aged 52, a street cleaner. He was ill * Alkaline inhalations Broncholitics Oil inhalations Sulfonilamides Antibiotics
with pneumoconiosis during 2 years. It’s nessesary
to recommened for the treatment of this disease:
The woman, aged 42, works at the factory on the *Unithiol Pentoxil Magnesium sulphate Sodium hydrate of Seduxen
fabrication of mercury thermometers, complains carbon
of the headache, swoons, reduction of memory,
small and frequent flutter of fingers of drawn
hands, the eyelids and the tongue, bleeding gums,
gingivitis. What preparation is it nessesary to use
for the elimination of mercury from the organism ?

A man,aged 37,working on the collective farm on *Poisoning by POC. Poisoning by lead. Poisoning by the Poisoning by vapours of Seduxen
sowing,was admitted to the infectious hospital with Treatment: atropine Treatment: tetacine methylic alcohol. mercury.
the clinical symptoms: miosis,labored Calcii Treatment: ethylic Treatment:unithiol
breathing,sweating.What kind of poisoning is it alcohol
and what is the first aid?

A woman of 36 years is on the 12-th week of the *Monitory of the Interruption of the Immune globulin Cyclovin administration Interferon
first pregnancy. We know from the history that she specific Ig G Ig M with pregnancy injection administration
was treated for infertility. She was in the guests the ELISA
and contacted with child who developed rubella in
2 days after meeting. Woman doesn’t know if she
has ever been infected with rubella. What is the
adequate tactics?

Patient L., 50-year old, has been admitted to the *B-12-deficiency Irondeficiency anemia Hemolytic anemia Post-hemoragic anemia Thalassaemia
clinics with atrophic gastritis. In the blood test: anemia
erythrocytes 3.8 T/L, Hb 68 g/l, c.i. 1,
macroanisocytosis, poikilocytosis. There is a
megaloblastic type of haemopoesis. A number of
leukocytes, reticulocytes and thrombocytes is
lowed. Which pathology is suspected?i
A 32-year old woman developed the Laiel’s *Steroid Non-specific immune Specific immune Interferons Non-steroid
syndrome after taking the biceptol. What immunodepressants modulators modulators immunedepressants
immunotrope remedies are indicated in this
situation?

The disease began acutely. The frequent watery *Cholera Toxic food-borne Salmonellosis Dysentery Typhoid fever
stool developed 6 hours ago. The body’s infection
temperature is normal. Then the vomiting was
joined. On examination: his voice is hoarse, eyes
are deeply sunken in the orbits. The pulse is
frequent. Blood pressure is low. There is no urine.
What is the preliminary diagnosis?

The patient 25-years-old was admitted on the 1st *Botulism Yersiniosis Leptospirosis Salmonellosis, Lambliasis
day of the disease with complaints of double vision gastrointestinal form
in the eyes, difficult respiration. The day before the
patient ate home-made mushrooms. On objective
examination: paleness, widened pupils, disorder of
swallowing, bradycardia, constipation are marked.
What is the diagnosis?

The patient Н., of 28 years old, was *Typhoid fever. Leptospirosis. Brucellosis. Sepsis. Malaria.
admitted to the clinic with complaints of
the temperature increase up to 39,0(С,
headache, weakness, constipation on
the 9th day of the disease. On
examination: single roseolas are on skin
of the abdomen. The pulse rate is 78 per
minute. The liver is enlarged by 2 cm. What is the
probable diagnosis?
The patient was admitted to the hospital on the 7th *Leptospirosis Yersiniosis Salmonellosis Brucellosis Trichinellosis
day of the disease with complaints of high
temperature, headache, pain in the muscles,
especially in calf muscles. The dermal integuments
and scleras are icteric. There is hemorrhagic rash
on the skin. Urine is bloody. The patient went
fishing two weeks ago. What is the diagnosis?

The patient has been in the hospital. The *Hepatic Meningitis Relapse of viral Cholangitis Infectious-toxic shock
beginning of the disease was gradual: encephlopathy hepatitis
nausea, vomiting, dark urine, аcholic
stools, yellowness of the skin and
scleras. The liver is protruded by 3 cm.
Jaundice was intensified on the 14th day
of the disease. The liver diminished in sizes.
Due to what complication of viral hepatitis, has
the
Thepatient’s condition worsened?
patient, 18-years-old was admitted to the *Infectious Acute lymphoid Diphtheria. Angina. Adenoviral infection.
hospital with complaints of headache, weakness, mononucleosis. leukosis.
high temperature, pain in the throat. Objectively:
enlargement of all groups of lymphatic nodules
was revealed. The liver is enlarged by 3 cm, spleen
- by 1 cm. In the blood - leukocytosis, atypical
lymphocytes - 15\%. What is the probable
diagnosis?
The patient 28-years-old was hospitalized with *Epidemic typhus Measles Alcohol delirium Leptospirosis Typhoid fever
preliminary diagnosis "influenza". Roseolous-
petechial rash appeared on the 5th days
of disease on the trunk. The
temperature is 41(С. Hyperemia of the
face, reddening of scleras, tremor of the
tongue, tachycardia, splenomegaly are
marked. What is the most probable
diagnosis ?
The patient, 43-years-old was admitted to the *Anthrax Carcinoma of skin Erysipelas Erysipeloid Eczema
hospital with complaints of high temperature of
the body and severe headache. On examination:
carbuncle is revealed on the forearm. There are
intense edema around it, insignificant pain,
regional lymphadenitis. The patient is a worker of
cattle-ranch. What disease is it necessary to think
about first ?
In the patient of 21 years old the disease *Meningococcal Meningococcal Secondary purulent Serous meningitis. Infectious
began with increase of temperature to infection: purulent infection: serous meningitis. mononucleosis.
39,0(С, headache, chill, repeated meningitis. meningitis
vomiting. Rigidity of occipital muscles is
determined. The analysis of liquor:
cytosis - 1237 in 1ml, of them: 84 \% of
neutrophils, 16 \% of lymphocytes. On
bacterioscopy gram-negative cocci, are found in
liquor. Whatofisself
The theory theregulation
most probable disease?
of epidemiological * Localization of the Geno- and phenotypic Mutability of the The phase The regulation role of
process by V.D. Belyakov includes all mentioned parasite in the host heterogeneity of the biological properties selfreorganisation of the social and natural
bellow except organism and the ways populations of a parasite of the parasite and the parasite populations and conditions in the phase
of discharging of the and host host populations a host reorganization of the
parasite into the epidemiological
environment process

The diagnosis of the AIDS epidemic initially was * The epidemiological The bacteriological The virological The viroscopic method The serological method
made in the USA by means of method method method
The contagious hypothesis by D. Frocastro and D. * The alive germs, The environmental The miasma of The pathological Invasion of the body
Samoylovich being considered as a causative agent which are transmitted factors cosmotelluric origin discharges of an by the evil spirits
of infectious diseases from one person to organism
another

A 70yr. Old alcoholic male with poor dental *Amoxycillin Vancomycin Tetracycline Co-trimoxazole Imipenem
hygiene is to have his remaining teeth extracted for
subsequent dentures.He has mitral valve
stenosis with mild cardiac insuffiency
and is being treated with
сaptopril,digoxin and furosemide.The
dentist decides that his medical history
warrants prophylactic antibiotic therapy
prior
A 20 yrtoold
the procedure
woman and
with a 3-4 prescribes:
month history of *Ulcerative colitis Gastroenteritis Carcinoid syndrome Zollinger-Ellison Granulomatous colitis
bloody diarrhoea; stool examination negative for syndrome
ova and parasites;stool cultures negative for
clostridium,campylobacter and yersinia;normal
small bowel series;oedema,hyperemia and
ulceration of the rectum and sigmoid colon seen on
sigmoidoscopic examination.Select the most likely
Diagnosis:
A patient treated for springtime allergies with *Erythromycin Ampicillin Cefactor Doxycycline Co-trimoxazole
terefenadine develops an upper respiratory tract
problem.He receives an antibiotic and develops a
cardiac arrhythmia.What was the likely antibiotic?
A 75yr. Old man who had developed diabetes *Carcinoma of the Infectious hepatitis Haemolytic jaundice Malignant biliary Metastatic disease of
within the last six months was found to be head of the pancreas stricture liver
jaundiced.He was asymptomatic except for weight
loss of 10 pounds in 6 months.On physical
examination he is found to have a nontender,
globular, right upper quadrant mass that moves
with respiration. A CT scan shows enlargement of
the head of the pancreas,with no filling defects in
the liver.Old
A 16yr. Most likelypresents
female diagnosis:
with abdominal pain *Henoch Schonlein Haemolytic uraemic Thrombotic Heavy metal poisoning Sub acute bacterial
and purpuric spots on the skin. Laboratory purpura syndrome thrombocytopenic endocarditis
investigations reveals a normal platelet count,with purpura
haematuria and proteinuria.The most likely
diagnosis:

A 60yr. Old asthmatic man comes for a check up *Doxazosin Labetalol Phetolamine Propranolol Isoproterenol
and complains that he is having some difficulty in
“starting to urinate”. Physical examination
indicates that the man has blood pressure of
160/100mmHg, and a slight enlarged prostate.
Which of the following medications would be
useful in treating both of these conditions:

A 36yr. Old alcoholic patient has cirrhosis and *Zinc Copper Selenium Chromium Manganese
pancreatic insufficiency due to recurrent
pancreatitis. He complaints of nightblindness,
decreased ability to taste food, and dry skin with
hyperpigmentation. These complaints suggest
deficiency of:
A 47 year old man presents to his physician with *Chronic Pancreatitis Tuberculosis Cirrhosis with Hepatitis Alcoholic liver disease
progressive abdominal swelling.On examination he hepatocellular with cirrhosis
is found to have ascites and a tender,enlarged carcinoma
liver.If the patient describes a chronic course
associated with wasting and low grade fever,the
diffrential diagnosis should include everything
EXCEPT:

A 60yr. Old man with unstable angina pectoris *Coronary artery Intravenous strptokinase Excercise testing Oral aspirin Antihypertensive
fails to respond to heparin, nitroglycerin, beta bypass grafting therapy
adrenegic blockers and calcium channel antagonist.
The best management includes:

A 42yr. Old patient suffering from alcoholism has *Insufficient protien Bleeding esophageal Excessive diuretic Non compliance with Spontaneous bacterial
advanced liver disease with ascites. He is ingestion therapy lactulose therapy peritonitis
hospitalised for agitation and bizarre behaviour.
Examination reveals asterixes on the hands, ankle
clonus, and spider angiomas on the face and
chest.Blood ammonia level is twice its
baseline.Precipitating factors to look for include all
of the following EXCEPT:
A 45yr. Old man is admitted with his 3rd episode *Supression of A fasting gastrin level Post operative notes Liver metastasis on CT A history of diarrhoea
of upper gastrointestinal haemorrhage. He had 2 hypergastrinaemia by of 450pg/ml. detailling ulcers in the scan
prior ulcer operation. Zollinger-Ellison syndrome secretin given IV duodenum and
is suspected. All the following would support your jejunum
suspicions EXCEPT:
A 60yr. Old woman, mother of 6 children, *Choledocholithiasis Benign biliary stricture Malibnant biliary Carcinoma of the head Choledochal cyst
developed sudden onset of upper abdominal pain stricture of the pancreas
radiating to the back, associated with nausea,
vomitting, fever and chills. Subsequently, she
noticed yellow discoloration of her sclera and skin.
On physical examination the patient was found to
be febrile with temp.of 38.9C, along with right
upper quadrant tenderness.Most likely Diagnosis:
A 30yr. Old man presents with a history of *Bronchoectasis Chronic bronchitis Disseminated Pulmonary neoplasm Chronic obstructive
recurrent pneumonias and a chronic cough pulmonary emphysema
production of foul smelling, pirulentsputum, tuberculosis
ocassionally glood tinged,which is worse in the
morning and on lying down.on physical
examination, the patient appears chronically ill
with clubbing of fingers, wet inspiratory reils at the
base of lungs posteriorly. Most likely diagnosis:
The 30-years old patient with the complications on * In the second In a first In a fourth In a third In a fifth
a headache in a nucha ,poor dream with
nightmares has addressed to policlinic. A BP was
150/95 Hg.An item. A boundary arterial
hypertension was diagnosed. In what dispensary
group he mast be addresseed for supervision on an
arterial hypertension?

3.In the young patient at the reference to policlinic * Twice. Once. 3 times. 4 times. 5 times.
there was diagnosed the 1 stage of hypertension.
How many times during the year it is necessary to
examine him?
11 Patient K.,52 years old, has sustained an acute * 1.07.2001. 1.03.2001. 1.04.2001. 1.05.2001. 1.06.2001.
myocardial infarction 2.01.2001. State of health is
satisfactory.After what time according to the
instruction he can be send on sanatorium treatment
to specialized sanatorium?

16 The family doctor diagnosed in a patient an *The urgent To inject intravenously The urgent A day time hospital. A hospital at home.
acute bleeding of an intestine. What is professional hospitalisation in the aminocapronic acid. hospitalization in
tactics of the doctor in this situation? sergical departmewnt. therapeutic
department.

In the structure of death rate in Ukraine the major *Diseases of Oncological disease. Disease of digesstive Disease of respiratory Disease of urinary and
place is taken by the diseases of? cirkulatory sistem. sysstem. system. endocrine systems.

68 The doctor of the city cardiological center *200/110-240/120 140/90-160/100 90/60-120/80 160/90-180/90 180/110-90/60
solves the problem of the patient after the
discharge from a hospital to the balneal department
of sanatorium:who cannot be routed?
Woman age 40,ill on rheumatic disease with *Mitral Conduction of current Assiging of Assiging of venous
composite mitral disease with prevalence of the comissurotomia. bicilino-prophilaxis. anticoagulants. vasodilatators .
stenosis of left venous foramen.Complainse on the
palpitation,fatigability progressing dyspnea,attacks
of a dyspnea and hemoptysis.Now she can not
execute even the mild activities.What tactics is the
most expedient?

The man,42 years old, has died in a road accident *25-30\%. 6-9\%. 10-14\%. 15-20\%. 35-50\%.
after the hemorrhage on the place ,due to acute
hemorrhagic anemia. What minimum percent of all
volume of blood could result in death at acute
hemorrhage?

In the woman of 42 years ,who suffers from * Euphylinum Izardin. Corazolum. Morphinum Strophanthin
bronchial asthma ,the acute attack of a bronchial hydrochloride.. hydrochloride .
asthma has developed. What medication from
listed below is contraindicated at granting the first
aid to this woman?

Patient K., laboratory-assistant-radiograph; the * Chronic radiation Chronic radiation Acute radiation Acute radiation sickness Acute radiation
amount of Gamma-radiation per day is 0,65 R. disease of the second disease of the third sickness of moderate of light degree sickness of severe
Two years later with 60 Co while examining degree of severity degree of severity. degree degree
irritability, head aches, poor appetite have
developed. Blood count is normal. While
examining 6 years later after cessation of any
contact with ionizing radiation she complained of
severe head - aches, dizziness, cardiac pains,
undue fatigability, weakness; instability of
In checking the results of patient?s spinal tap, the *Meningococcal Meningism Cerebral trauma Viral meningitis Tuberculous meningitis
CSF glucose level of 1,65 mmol/l with apparently meningitis
cloudy CSF, is typical of:

A 26-year-old manual worker complained of 3 *HIV infection Influenza Rubella Infectious Tuberculosis
weeks history of fevers and fatigue, weight loss mononucleosis
with no other symptoms. Physical findings:
Temperature 37,6?C, pulse 88 b/pm, blood
pressure 115/70 mmHg, superficial lymph nodes
(occipital, submental,cervical, axillary) are
enlarged, not tender or painful. Rubella-like rash
on the trunk and extremities. Herpes simplex
lesions
Each ofonthethe lips. Candidosis
following of concerning
statements oral cavity. What *The initial lesion in Inhalation anthrax Cutaneous anthrax, The drug of choice in The preferred
features of anthrax is correct EXCEPT cutaneous anthrax results from the alveolar untreated, results in cutaneous anthrax is serodiagnostic test for
consists of the black deposition of airborne death in 10\% to 20\% penicillin. anthrax is ELISA
eschar, surrounding particles contaminated of cases
erythema and painful with spores of B.
pitting edema anthracis.

A 27-year old patient with malaria caused by P. *Chloroquine resistant Glucose-6-phosphate Late recognition of Inappropriate route of Hypersensitivity of the
falciparum was treated with Chloroquine (600 mg strain of P. falciparum dehydrogenase infection due to P. administration patient to Chloroquine
base followed by 300 mg base in 6 hours, then 300 deficiency in patient falciparum
mg base a day for 2 days) without clinical and
parasitologic responses to treatment. What is the
most likely reason for the failure to respond to
therapy?
Ten hours before initial observation patient C. had *Intravenous Antibiotic therapy Cardiac glycosides Disintoxicational Antibotulistic serum
frequent feces and vomiting. Fecal and vomiting rehydration therapy injection
masses became like rice-water. Nausea and
abdominal pain weren’t observed. Hiccup and
convulsions of lower limbs, temperature 35.4(C,
hoarse voice, greyish wry face, acrocianosis were
usually observed. Breathing 40/min, thread – like
pulse 120/min, blood-pressure 40/0mm/Hg,
abdomen is drawn.
A sick person M. is What treating
staying in the measures should
hospital with the *Intestinal Thrombophlebitis Meningitis Nephroso-nephritis Hepatite
diagnosis of abdominal typhus. During the 3d haemorrhage
week from the beginning of the disease the patient
stopped keeping diet and confinement to bed. As a
result the body temperature and rapid pulse
decreased and melena appeared. What kind of
complications should we think first of?

A nurse of the kindergarten was taken to the *Salmonelosis Dysentery Cholera Food toxic infection Enterovirus infection
hospital with complaints of accute pain in
parumbilical part, convulsions of lower limbs,
multiple bile vomiting, frequent watery foul faces
of green colour in huge amounts. At the same time
all the staff in the childrengarden got ill. Two days
ago everybody of them ate cottage cheese with
sour cream. General condition of patients is of
average severity.
A 25-year-old manTemperature 38.2
was admitted degrees
with of C.of * Isoniazid +
2 months Streptomycin + Isoniazid + ethambutol Kanamycin + P-aminosalicylic acid +
cough and fever. A chest x-ray showed extensive rifampicin + isoniazid ethambutol + streptomycin
left upper lobe disease with a 2 cm cavity. All pyrazinamide pyrazinamide
three points were strongly positive on direct smear
and grew M. Tuberculosis, fully sensitive to all
first-line drugs. Patient must be treated with:
A 5-year-old boy was progressively getting more * Hilar or paratracheal Atelectasis with Cavity formation Miliary tuberculosis Hematogenous
unwell than during the previous 2 months. A chest lymph node obstructive pneumonia dissemination leading
x-ray had shown right middle lobe collapse. A enlargement to extrapulmonary
tuberculin skin test had been strongly positive. tuberculosis
What is the most characteristic finding in primary
tuberculosis?

A 50-year-old man was examined in the clinic with * Optic neuritis Eighth cranial nerve Hepatic enzyme Peripheral neuropathy Mental symptoms
persistant cavitation and sputum. He was treated damage elevation
with rifampicin, isoniazid, ethambuthol. The most
common toxic effect of ethambutol is:

To reduce the number of adult infection cases in * Give good treatment BCG vaccination Tuberculin skin testing Health education Chest x-ray screening
the population it is much more important to: to all sputum positive campaigns on
patients tuberculosis

The father had been admitted to hospital with * Isoniazid Rifampicin Streptomycin Ethionamide Cycloserine
pulmonary tuberculosis. He had infected his son,
aged 3 years. If tuberculin skin testing was
positive, with no evidence of illness, the child
should have been given chemoprophylaxis with:
Under what circumstances can preventive therapy * High risk close People with chest x-ray Low-income groups People who inject illicit People with symptoms
be given to people who have a negative tuberculin contacts (young findings with poor access to drugs of pulmonary disease
test reaction? children, HIV-infected health care
persons)