c





 
   

1.patient 30 years to increased body temperature 38,5 oC, there was pain in small joints, and
swelling and erythema face. In the blood: er . - 2.6 * 1012 / l; Hb -98 g / l, Lake . - 2 * 109 / l, ESR-58
mm / hour. In Urine: protein - 3,1 g / l, er .- 10-15 in p / s. On any illness you can think in this case?
A. Systemic scleroderma
B. Acute glomerulonephritis
C. Sepsis
D. Nodular periarteriyit
E. Systemic lupus vivchak

2.In full-term infants have: CHDR -26/hv. And HR-90/hv., Blue skin, muscle tone low, the suction
catheter from the nose and mouth of mucus and amniotic fluid baby responds grimace. Reflexes
reduced. Auscultatory: The lungs weaken ed vesicular breathing. Heart tones sounding. After 5
minutes - breathing rhythmically, 38/hv.And HR -120/hv. What is the most likely diagnosis?
A. Asphyxia
B. Syndrome of respiratory disorders
C. Bronchopulmonary dysplasia
D. Congenital pneumonia
E. Birth injury

3 .Sergeant wounded projectile fragments in the left subcostal area. On the battlefield, in order of
mutual aid, it was imposed bandage individual package. Delivered to the WFP. Complains of
dizziness, weakness, thirst, abdominal pain. The general condition of hard, pale, Ps -
120/hv.Abdomen soft, painful during palpation. Dressing well is fixed, but a bit saturated with blood.
What type of transport and in which all you need to evacuate the victim OmedB?
A. Sanitation trucks to turn 1 -shu
B. Passing vehicles in the 3 -rd place
C. Passing vehicles in the 2 nd place
D. Sanitation trucks in the 2 nd place
E. Passing vehicles in an all -shu

4. patients 30 years turned to the doctor complaining of lack of menstruation for 2 years after birth,
hair loss, loss of body weight. Birth complicated by bleeding at the uterine hypotonia. OBJECTIVE:
ill asthenic, hypoplastic external genitalia, the body of the uterus small size, gentle. Add the uterus
is determined. What is the most likely diagnosis?
A. Galactorrhea-amenorrhea syndrome
B. Ovarian amenorrhea
C. Ovarian Syndrome
D. Shereshevsky-Turner Syndrome
E. Shihan Syndrome

5 .In women 38 years after we hypothermia were muscle pain, fever up to $ 39 ^ oC $, headache,
dysuria, positive symptom Pasternatskoho. In urine: leukocyteuria, bacteriuria. In the blood:
hemoglobin decrease to 103 g / l, leukocytosis with left shift, acceleration of ESR to 32 mm / hour.
Blood urea - 6.0 mmol / liter. What is the most likely diagnosis?
A. Tuberculosis of kidneys
B. Chronic lung disease
C. Acute pyelonephritis
D. Acute glomerulonephritis
E. Acute cystitis
 6 .TO travmpunktu addressed trauma patients volyarnoyi glass surface of distal forearm.
OBJECTIVE: bending violation IV and V fingers, reduced sensiti vity of the inner surface of the back
and palm of hand and finger IV. What nerve is injured?
A. Muscle-bone
B. Median
C. Ray
D. Cubital
E. Axillary

7. When a review of placental defects. A manual examination of uterine cavity, uterine massage
fist. How to prevent endometritis in the postpartum period?
A. Intrauterine instillation dioxidin
B. Instrumental revision of uterine cavity
C. Means of reducing
D. Hemostatic therapy
E. Antibacterial therapy

8 .A pregnant 30 years at 32 weeks of pregnancy prenatal addressed complaints to the

appearance of vaginal secretions sanguinolent bright color. With suspected placenta previa taken
her to hospital. In conditions appropriate to conduct internal investigations for the diagnosis?
A. In the hospital admission department
B. In the operating of its readiness for operation
C.In prenatal Review
D.In the delivery room in compliance with all rules of asepsis
E. Do not hold because the risk of profuse bleeding

9. When examining a patient for 46 years the diagnosis: left breast cancer T2N2M0, cl. gr. II -A.
What is the treatment of this patient's plan?
A. Only chemotherapy
B. Operation + radiotherapy
C. Radiotherapy alone
D. Radiotherapy + surgery + chemotherap y
E. Only surgery

10. patients 16 years Davydova JV Operated 12 years ago with diffuse toxic goiter at the III -IV
degree. At this time there was a relapse in patients with thyrotoxicosis. Patients offered surgery,
but before that we should find out whe re the functioning tissue cancer. What kind of research
method to use?
A. Puncture aspiration biopsy cancer
B. Fluoroexamesophagus
C. Fluoroexam neck
D. Scanning cancer
E. Ultrasound Cancer

11.In patient 28 -years the uterine cavity curettage because of incomplete abortion. Bloodloss 900
ml. Launched transfusion. After the introduction of 60 ml erytromasy appeared pain in the lumbar
area, fever, resulting in transfusion stopped. After 20 minutes condition has deteriorated:
adynamia, sharp pale skin, a crocyanosis, profuse perspiration, prolonged fever, to -38,5oC, Ps-
110/hv., SC, 70/40 mmHg What is the most likely diagnosis?
A. Septic shock
B. Anaphylactic shock
C. ICE syndrome
D. Hemorrhagic shock
E. Hemotransfuziynyy shock

12.In patient 2 days ago is a sharp pain in the left half of the chest, weakness, fever and
headache. OBJECTIVE: 4 -5 mizhreber'yi left on the background of multiple erythematous grouped
blisters filled with clear content, 2 -4 mm in size. For a disease characterized by the abov e
symptoms?
A. Herpes zoster
B. Herpes simplex
C. HerpetyformnyydermatosisDuhring
D. Pemphigus
E. Streptococcal impetigo

13. In patients with acute myocardial infarction complicated by krupnovohnyschevyy cardiogenic

shock. The latter occurs at a low total peripheral resistance and reduced cardiac output. What
antyhipotenzyvnyy drug should enter the patient first?
A. Adrenalin
B. Noradrenaline
C. Prednisolone
D. Mezaton
E. Dopamine

14.In patients 30 years of sudden syncope, tonic -clonic seizures, AT-150/100 mmHg, heart rate -
100/hv. Before the attack felt dizzy, feelings of unreality reality, unexplained feelings of fear of
attack by the court does not remember. What is the most likely diagnosis?
A. Transient ischemic attack
B. Epilepsy
C. Vestibular swoon
D. Hyperventilation ischemic attack
E. Syndrome Morhanyi -Adams-Stokes

15. of 350 steel plant workers who were subject to preventive inspection this year, to territorial
polyclinic by 325 peop le. As a result - one employee suspended from work, 15 have been further
improvement in the sanatoria, 10 provided diets. What is the factor that characterizes the work of
prevention clinics, should be used in this case?
A. The share of persons who have i mproved their health in preventive
B. Densities of individuals suspended from work
C. Completeness of coverage of periodical medical examinations
D. The frequency of diseases during the review
E. The share of persons having diets

16. staff laborator ies manufacturing instrumentation (pressure gauges, thermometers, etc.)
complain of a metallic taste in the mouth, stomatitis, dyspeptic phenomena, sleep disorders, fragile
walking, a sharp decline in cardiac performance. Which substance caused the poisoni ng of these
manifestations?
A. Lead
B. Tetraethyl lead
C. Toluene
D. Manganese
E. Mercury
 17 .patients for 46 years, which is preparing for surgery on gastric cancer, conducted preoperative
infusion therapy. In the vein of the right elbow put to 3, 0 l solutions. On the next day he felt a
drawing pain in the right shoulder. In review: the inner surface of the shoulder observed
longitudinal stripe flushing, swelling of skin, painful cord. What complications developed in a
patient?
A. Acute limfanhoyi t
B. Phlegmonparavenoznoyifiber
C. Venepuncture and tissue swelling paravenoznoyi
D. Acute thrombophlebitis
E. Paravenoznoyifiber necrosis

18. To the admissions department of the hospital received a patient with hoarse breathing (more
difficulty breathing), cyanosis of skin, tachycardia and hypertension. In history - asthma.Hour as did
inhalation of salbutamol and forgot to remove the cap, which aspiruvav during deep inhalation.
What doctor?
A. Make inhalation s 2 adrenomimetykiv
B. Immediately execute konikotomiyu
C. Call the anesthesiologist and wait for its appearance
D. Run acceptance Heymliha
E. Enter subcutaneous dexamethasone

19. Female 41-year over 8 years suffering from chronic cholecystitis.Worryingly almost constant
monotonous aching or feeling of heaviness in the right hypochondrium, bitter morning mouth,
constipation. During palpation of the abdomen is marked tenderness at the point a small projection
of the gall bladder. Volume bladder bile after lunch decreased by only 15% (according to
ultrasound). Appointments are most appropriate medicines?
A. Holekinetyky
B. Miotropnispasmolytics
C. Holeretyky
D. Nonnarcotic analgesics
E. Peripheral M-holinolityky

20 .patients 36 years ago while hospitalized for surgical de partment after an accident. Condition
progressively worse: increasing respiratory failure, marked cardiac activity. Based on clinical and
radiological data revealed displacement of the mediastinum. What process caused this
complication?
A. Valvular pneumo thorax
B. Closed pneumothorax
C. Mediastynit
D. Subcutaneous emphysema
E. Open pneumothorax

21. A young man of 16 years admitted to hospital complaining of nekupovanu bleeding from the
nose and unbearable pain in the right elbow. OBJECTIVE: damaged j oints increased in size,
defihurovanyy, hyperemia of the skin above it. There are other signs of arthropathy of the joints.
Ps-90/hv. In the blood: er . - 3.9 * 1012 / l, Nb -130 g / l, 1.0 -MP, Lake .- 5.6 * 109 / l, tr . - 220 * 109 /
l, ESR-6 mm / hour. Time blood coagulation by Lee -White: The Beginning - 24 minutes, the end -
27 minutes 10 seconds. Which drug is most effective in treating this patient?
A. Aminokapronovaya acid
B. Vikasol
C. Erytromasa
D. Calcium chloride
E. Kriopretsipitat

22 .patient 46 years of disability leaflet issued on 10 days over the exacerbation of chronic
cholecystitis. The general condition of the patient improved, but clinical manifestations of the
disease still in place. Who is eligible to continue medical certificate?
A. Surgeon
B. Family Doctor
C. LKK
D. Deputy chief medical examination on labor
E. Deputy chief physician of clinical work

23. patients 50 years during the year complained of attacks of pain in right hypochondrium, which
arise mainly after consuming fat ty foods. Last week attacks recur every day, become more painful.
At 3-day hospital stay appeared zhovtyanychnist sclera and skin, emptying znebarvylysya, urine
has become dark. In the blood: neutrophilicleukocytosis - 13,1 * 109 / l, ESR -28 mm / hour. Wha t is
the most likely diagnosis?
A. Chronic calculouscholecystitis
B. Chronic pancreatitis, recurrent form
C. Chronic cholangitis in the acute stage
D. Hypertensive gallbladder dyskinesia
E. Fatty liver

24 .to the admissions department of a hospital patient delivered 40 minutes after a minor injury
complaining of pain in the thoracic spine. In history: pulmonary tuberculosis. At radiography:
suspected compression fracture VIII and IX thoracic vertebrae. What is the pathological process in
the spine may contribute to pathological fracture of vertebral bodies?
A. Syphilis
B. Traumatic fracture
C. Metastasis of malignant tumor
D. Osteomyelitis
E. Trachelokyphosis

25 .workers that is under dispensary observation over the ulcer, addressed this year wi th an
aggravation of the disease in February, May and September. How to statistically register the case?
A. Three stattalony the request, with every sign ( -)
B. One of stattalon sign ( -) in the first visit this year
C. Three stamps ambulatory code 2
D. One stattalon in the first treatment with the sign (+) and two stattalony with the sign ( -)
E. One coupon ambulatory code 2 and two stamps with the code 3

26 .In women 38 years old in the blood: Nb -84 g / l, er .- 3,5 * 1012 / L, MP -0.72, Lake .- 4.1109 / l
Retyk .- 2%, ESR - 26 mm / hour. Blood iron - 9,0mmol / liter. It was intended treatment. At the 6 -
day treatment investigated peripheral blood. What are the changes in rates will most likely confirm
the adequacy of the therapy?
A. Increase the color index
B. Increasing the number of reticulocytes
C. Normalization of erythrocytes
D. Normalization of hemoglobin level
E. Slow clotting of red blood cells

27. In patients 65 years, has long suffered from deep vein thrombophlebitis of lower extremit ies
were suddenly short of breath, coughing up phlegm and impurities separation of blood, chest pain
with irradiation to the right side. Ps -100/hv, SC, 90/50 mm Hg, CHP -300 mm vod.st. What
complication has arisen in the patient?
A. Acute pneumonia
B. Acute cardiovascular insufficiency
C. Pulmonary embolism
D. Myocardial infarction
E. Acute pericarditis

28 .patients 35 years first came to the psychiatric hospital. The diagnosis: schizophrenia, paranoid
form. What treatment should apply?
A. Vitamin therapy
B. Physiotherapy
C. Neuroleptic therapy
D. Psychotherapy
E. Reflexology

29. Surgeon examined patients 42 years. Diagnosis: boil the right forearm, purulent -necrotic
stage. An autopsy boils. Bandage which must be put in the preparation phase of hydration?
A. Chloramines
B. Vishnevsky Ointment
C. Ihtiolova ointment
D. Hypertonic solution
E. Dimexid

30. boys, 8 years. The state of physical development of age -appropriate. From the birth of the
heart auscultated noise. OBJECTIVE: skin and visible mucous normal color. AT -100/70 mmHg
Auscultated over the pulmonary artery systolic -diastolic noise and focus the second tone. ECG -
features left-heart overload. When roentgenoscopy marked increase of pulmonary picture eclipse
of the heart normal form. What is the most likely diagnosis?
A. Pulmonary artery stenosis
B. Interatrial defect partitions
C. Open ductusarteriosus
D. Koarktatsiya aorta
E. TetradaFallo

31 .patients 30 years suffering from infertility for 10 years, expresses complaints of heavy, long
menstrual periods, accompanied pereymopodibnym pain. When bimanualnomu study: enlarged
uterus with 8 weeks of pregnancy, applications are not determined. When sensing uterine cavity is
defined by its deformation. What is the most likely diagnosis?
A. Submukozna uterine fibroids
B. Metrorahiya
C. Utero pregnancy
D. Chronic endometritis
E. Algomenorrhea

32.In children 3 months with signs of rickets occur Hvosteka symptoms, Trusso, Maslova. Twenty -
four hours so parents watched attack cyanosis, wall -eye, child breathed, covered with sticky sweat.
After one minute it's a great breath, and then normalized sta te. What is the basis of the above
symptoms?
A. Reducing blood phosphorus
B. Metabolic acidosis
C. Reduction of blood calcium
D. Increased blood calcium
E. Increasing the level of blood phosphorus

33 .primigravides 18 years at 27 -28 weeks of pregna ncy had surgery for acute appendicitis
abscess. Prevention of complications should be done in the postoperative period?
A. Miscarriage
B. Late gestosis
C. Abruptio placenta
D. Intussusception
E. Fetal malnutrition

34. patients 68 years we asked the doctor complaining of the presence of tumor in the left breast.
OBJECTIVE: upper inner quadrant of left breast there is an establishment with a diameter up to 2,5
cm, dense, hilly, painless at palpation. Regional lymph nodes are not enlarged. What is the l ikely
diagnosis?
A. Mastopatia
B. Cyst
C. Fibroadenoma
D. Lipoma
E. Cancer

35 .In a worker 44 years, working more than 16 years for coke dust concentration in the workplace
exceeds MCL in 5-10 times. When X -ray revealed lung changes characteristic of pneumoconiosis.
What type of pneumoconiosis is most likely in this case?
A. Asbestosis
B. Siderosis
C. Antrakosylikoz
D. Anthracosis
E. Sylikatoz

36 .Female 34 years complains of weakness, weight loss of 12 kg for six months, sweating,
palpitations, irritability. OBJECTIVE: thyroid gland III degree, elastic, on a background of diffuse
increase in the right lobe junction. Limfatychni cervical nodes were not enlarged. What is the most
reasonable treatment tactics?
A. Immediate surgery
B. Immediate telehamaterapiya
C. Operation after antithyroid therapy
D. Appointment of radioactive io dine
E. Conservative Antithyroid therapy

37. Female 62 years after lifting heavy felt a sharp pain in the lumbar area, buttocks, right thigh
zadnobokoviy surface, the outer surface of the right leg and the back surface of the foot.
OBJECTIVE: anterior tibial muscle weakness, long extensor of the thumb, short extensor fingers of
the right foot. Reduced Achilles reflex on the right.Positive symptom Lasegue. What is the most
informative method of investigation to clarify the diagnosis dyskohennoyi L5 root compression?
A. Angiography
B. Magnetic resonance scanning
C. Spine Radiography
D. Electromyography
E. Lyumbalna puncture
 38. patients 20 years on the tenth day after discharge from the maternity department approached
with complaints of fever to 39 oC, pain in the right breast. OBJECTIVE: mammary gland increased
in the upper outer quadrant area marked hyperemia, ibid palpated seal with vague contours,
laktostaz, no fluctuations. Lymph nodes in right armpit enlarged, painful. What is the most likely
diagnosis?
A. Tumor
B. Wildfire
C. Abscess
D. Lactational mastitis
E. Dermatitis

39. The vague dark December days in the area of the power station is working on solid fuel, the
number of diseases and respiratory symptoms of intoxication. There were deaths among older
people. Which factor is most likely triggered toxic effects?
A. Reduced Temperature
B. Calm
C. Suspended Solids
D. Temperature gradient
E. High humidity

40 .men 35 years worked in 1913 bulldozer. Complains of dizziness, headache at the end of the
working day, numbing fingers and pain in the leg muscles at night. When examining the breach of
pain and tactile sensitivity for the peripheral type, painful calf muscle. Ripple and on. dorsalispedis
saved. What is the disease most likel y?
A. Obliterating atherosclerosis
B. Raynaud's Disease
C. Vibration disease
D. Vegetative polyneuritis
E. Syrinhomiyeliya

41 .In a boy 2 years on the second day after prophylactic vaccination appeared to rise in
temperature to 38oC and abdominal pain without specific localization. On Day 3 of a child have a
red-haemorrhagic papular rash on the extremities rozhynalnyh surfaces and around the joints. It is
noted swelling and minor pain of the knee. From other organs and systems - without pathological
changes. What is the most likely diagnosis?
A. ICE syndrome
B. Hemorrhagicvasculitis
C. Urticaria
D. Thrombocytopenic purpura
E. Meninhokoktsemiya

42. men 32 years last year worried about pain in the buttocks and hip joints, pain and stiffness
with movement in the lumbar spine. ESR -56 mm / hour. X -ray revealed signs of duplex
sakroileyitu. The patient is a carrier of antigen NLA V27. What is the most likely diagnosis?
A. Spondylosis
B. Reiter's disease
C. Rheumatoid arthritis
D. Ankylosing spondylitis
E. Hip

43. in patients 56 years, scientist, there is a squeezing chest pain several times a day when
walking at a distance of 10 0-150 meters, up to 10 minutes. Pain is eliminated nitroglycerin.
OBJECTIVE: high food outside of the heart are normal, rhythmic tones, Ps -78/hv., AT-130/80
mmHg ECG: low amplitude T wave in V4 -5. On any illness you can think of?
A. Stable angina FC II
B. Stable angina FC III
C. Stable angina IV FC
D. Unstable angina
E. Stable angina I FC

44.During the forensic post -mortem examination revealed the newborn: weight 3500 g, body
length 50 cm, umbilical smooth, wet, shiny, with no signs of drying. Swimm ing lung samples
positive. What are the results of swimming tests in this case?
A. A child born alive
B. The child was stillborn
C. Hyaline membrane disease
D. Secondary atelectasis
E. Primary atelectasis

45.Girl was born with the assessment by Apga r score at 1 and 5 minutes of 7 -8 points. During
childbirth observed short -term difficulty in deriving the shoulder girdle. After the birth of a child
experiencing dysfunction of the proximal right position and forced to handle. Brachium rotated
inward, straighten the elbow, forearm pronation was observed, wrist bent in a "hand puppets".
What is the diagnosis in this child?
A. Intracranial hemorrhage
B. Injury to soft tissues of the right handle
C. Myelitis right knob
D. Injury to the thoracic spine
E. Duchenne-Erb paresis

46. patients 36 years complained of rashes on the skin, which appeared a week ago and not
subjective concerns. OBJECTIVE: skin palm and soles - lentykulyarni multiple disseminated
papules that do not rise above the skin, stagnant re d-covered cluster of horn flakes during
palpation dense. What preliminary diagnosis?
A. Palmar-pidoshvovyy psoriasis
B. Omozolilosti hands and soles
C. Rubrofitiya hands and soles
D. Multiple warts
E. Secondary Syphilis

47. patients with 28 -years, three days after casual sex delivered to the gynecological department.
Disturbing the lower abdomen and pain during urination, significant purulent vaginal discharge,
fever up to 37,8oC. The diagnosis: acute adnexitis duplex. Furth er examination found: 4 purity
vaginal contents, leucocytes cover the whole field of view, diplococci bacteria are located intra -and
extracellular matrix. What is the etiology of acute adnexitis in sick?
A. Chlamydial
B. Gonorrheal
C. Staphylococcal
D. Circle-cocci: bacillar
E. Trichomonas

48 .Female 53 years complained of pain and disruption in the heart. Ill since childhood, her father
suffered from heart arrhythmia. OBJECTIVE: heavy state, Ps -220/hv., SC, 80/60 mmHg ECG: HR -
215/hv., Enlargement and distortion of QRS complex with the presence of
atrioventriculardissociation; prong P - positive. Further, heart rate decreased to 45/hv., A full
separation of wave and complex P QRST. Which of the most effective in treating the sick?
A. Cardiac glycosides
B. Implantation of artificial pacemaker
C. Calcium antagonists
D. Holinolityky
E. s -blocker

Child hospitalized in 1949 with fire changes in skin folds. During examination of child restless, the
skin is dry, with individual elements and papular areas lihenifikatsiyi with fuzzy edges. Rash on the
skin accompanied by strong itching. Improving child is celebrated in the summer months,
worsening - in the winter. A child of 2 months on the artificial rearing, postponed exudative
diathesis. My grandmother o n maternal side is suffering from bronchial asthma. What is the most
likely diagnosis?
A. Seborrhoic eczema
B. Atopic dermatitis
C. Hives
D. Strofulyus
E. Contact Dermatitis

50 patients 40 years was operated on phlegmon lumbar area. He again sharply increased body
temperature to 38oC, appeared intoxication, the number of leukocytes in the blood. In the wound
that almost was purified from necrotic tissue and granulation filled and there are hnylisni selection,
granulation became pale. What complicatio n has arisen in this patient?
A. Hnylisnaphlegmon
B. Beshyhove inflammation
C. Allergic reaction
D. Erizipeloyid
E. Sepsis

51 patients 32 years of complaints addressed to the fluctuations in the heart, dizziness, shortness
of breath during exercise. By this time, not sick. OBJECTIVE: Ps -74/hv., Rhythmic. AT-130/80
mmHg At auscultation: the first tone sonority normal, systolic murmur over the aorta. ECG: left
ventricular hypertrophy, signs of repolarization in I, V5, V6 assignments. Echocardiography:
interventricular membrane 2 cm What is the most likely diagnosis?
A. Koarktatsiya aorta
B. Hypertension
C. Aortic stenosis mouth
D. Hypertrophic cardiomyopathy
E. Myocardial infarction

52 The patient, 44 years after ezofahoskopiyi and biopsy the nex t day appeared emphysema both
supraclavicular areas, pain during swallowing and chest, cyanosis. The temperature of 39oC. In
the blood: Lake . - 16 * 109 / l, differential count shift left. In X -ray eclipse is determined by a limited
posterior mediastinum a t the level of tracheal bifurcation. Diagnosed: rupture of esophagus. What
kind of tactics to choose the most appropriate treatment?
A. Operational: mediastinaldrainage, overlay hastrostomy
B. Observation
C. Conservative treatment of bacterial
D. Operational: Overlay hastrostomy
E. Radical surgical wound with stitches esophagus
 53 girls 10 years admitted to hospital with manifestations of carditis . In history: Two weeks ago
there was an aggravation of chronic tonsillitis. What is the most probable causative factor in this
case?
A. Klebsiella
B. Streptococcus
C. Proteus
D. Staphylococcus
E. Pneumococcus

54 In chronic smoker 52 years while lif ting a bag of potato suddenly appeared strong stabbing
pain in the left half of the chest, coughing, shortness of breath is strong, tachycardia, decreased
blood pressure. ECG: signs of right heart overload. On the roentgenogram of thorax absent
pulmonary picture in the left half of the thorax, mediastinum shifted to the right authorities. The
state meet this clinical picture?
A. Acute pneumonia nearside
B. Exudative pleuritis
C. Acute myocardial infarction
D. Pulmonary embolism
E. Spontaneous pneumothor ax

1.5 years in 1955 child acutely ill: fever to 39oC, vomiting appeared to 5 times. Investigation of the
nervous system showed positive symptoms Kerniha, Brudzynskoho. The above symptoms are
related to:
A. Syndrome dyskoordynatsiyi
B. Entsefalichnoho syndrome
C. No evidence of infectious toxicosis
D. Meningeal signs
E. Syndrome movement disorders

56 patients 43 years complained of skin rash right foot, pain, weakness, raising the temperature to
38oC. Acutely ill. OBJECTIVE: the skin of his right f oot in the area of foot swelling, sharply edged
bright red spot, hot to the touch, irregular contour in the form of tongues of flame. In the cell is
isolated bubbles. What preliminary diagnosis?
A. Hemorrhagicvasculitis
B. Toksykodermiya
C. Microbial eczema
D. Contact Dermatitis
E. Wildfire

57 The teenager 15 years in the military during examination revealed systolic murmur interval at
the top of the heart, focus on the second tone of pulmonary embolism, tachycardia. Which of
additional diagnostic t esting is most informative for diagnosis?
A. Echocardiography
B. Radiography
C. Electrocardiography
D. Fonokardiohrafiya
E. Reography

58 patients 22 years old office worker.Works all day in air -. In the summer of acutely ill: fever,
shortness of breath, dry cough, pleural pain, myalgia, arthralgia. OBJECTIVE: The Case of moist
rales, pleural friction noise. Radiological continued infiltration remains lower lobe. In the blood:
Lake .- 11 * 109 / l, Mr - 6%
C. - 70%, lymph .- 8%, ESR-42 mm / hour. What is the causative factor in pneumonia?
A. Streptococcus
B. Pneumococcus
C. Staphylococcus
D. Legionella
E. Mycoplasma

In 1959 the maternity hospital in the child at 3 -day life appeared haemorrhagic rash, vomiting with
blood, excrement black. The ex amination revealed anemia, blood clotting time prolongation,
hipoprotrombinemiyu, normal platelet count. What is the optimal therapeutic tactics?
A. Vitamin K
B. Epsilon-aminokapronovaya acid
C. Etamzylat sodium
D. Calcium gluconate
E. Fibrinogen

60 patients 47 years we got the flames burn the upper limbs and trunk. During hospitalization
status is difficult, marred consciousness, fever, AT -80/50 mm Hg, Ps-118/hv. Local ascertained III
B degree of care is 20%. What therapeutic steps should be taken?
A. Assign detoxification blood substitutes
B. Enter narcotic analgesics and blood substitutes antishock
C. Antibacterial therapy and disintoxication
D. Conduct primary surgical treatment of burn wounds
E. Nekrotomiya burn surface, transfusion

61 Patient 68 years we complained to the rise in temperature 38,3oC, hematuria. SHOE -55 mm /
hour. Antibacterial therapy is not effective. Which may suggest the diagnosis?
A. Renal amyloidosis
B. Chronic lung disease
C. Chronic glomerulonephritis
D. Multicystic kidney
E. Kidney Cancer

62 In patients 18 years after 2 weeks of ARI were pain and swelling in ankle joints and diffuse
abdominal pain that increases after eating, periodic liquid hemorrhagicdiarrhea, hemorrhagic -
papular rash on the lower extrem ities. In the blood: er . - 3.0 * 1012 / l, Hb -95 g / l, ESR-40 mm / h,
platelets are normal. What is the most likely diagnosis?
A. Hemorrhagicvasculitis
B. Disease Verlhofa
C. Infective endocarditis
D. Systemic lupus vivchak
E. Rheumatoid arthritis

63 men 35 years got sick the first time. Complained of intense back pain that irradiyuye to the
inguinal area, external genitals, thigh, pochaschene urination, chills, nausea, vomiting.
OBJECTIVE: positive symptom Pasternatskoho. In urine: red cells and whit e blood cells cover the
entire field of view, high protein content. What is the most likely pathology caused this clinical
picture?
A. Myocardial kidney
B. Osteochondrosis, acute radicular syndrome
C. Gallstone disease, biliary colic
D. Chronic lung di sease, renal colic
E. Intussusception

64 Patients 60 years complained of breathlessness, palpitations, rapid fatigue. Over 8 years

suffering from hypertension. Objective: Left heart border shifted by 2 cm left from
serednoklyuchychnoyi lines, rhythmic heart beat, weakened and over grafting - accent II tone. AT -
170/100 mmHg Liver 2 cm pastoznist shins. ECG: heart axis deviation to the left, left ventricular
hypertrophy. EF-63%. Which option of heart failure observed in this case?
A. Systolic
B. Mixed
C. Indefinite
D. Norm
E. Diastolic

65 In patients 56 years with diffuse toxic goiter observed atrial fibrillation with PE -110/hv, arterial
hypertension. AT-165/90 mmHg What next mercazolil treatment should be recommended in this
case?
A. Radioiodine
B. Korynfar
C. Anaprylin
D. Novokayinamid
E. Verapamil

66 patients 44 years called complaining of difficulty in urination, feeling of incomplete emptying of

the bladder. During sonographic study of the bladder in front of the urethra is defined oval
hyperechoic formation of continuous edge size 2x3 cm, which moved during the study. What
conclusion can you do?
A. Calculus
B. Primary tumor of the ureter
C. Malignant tumor of urinary bladder
D. Bladder polyp
E. Adenoma of prostate

67 ambulance brou ght in unconscious patient, picked up on the streets in winter. OBJECTIVE:
pale, shallow breathing, bradycardia with heart rate -54/hv, to-35,0oC. AT-100/60 mmHg During
palpation of the abdomen and chest and peritoneal signs there. The smell of alcohol from the
mouth. What is the most likely diagnosis?
A. Clinical death
B. Acute cardiovascular insufficiency
C. -
D. Frostbitten trunk, limbs
E. Total cooling

68 in the mental status of patients 32 years of steady decline pathological mood. OBJECTIVE:
contact, briefly, but basically answers the question. Language production is very concise, in slow
motion. Movement bound and retarded. Expresses the idea of self-accusation and self -
abasement.Preparations of the group first shown to the patient?
A. Sedative
B. Antipsychotics
C. Antidepressant
D. Hippotyky
E. Normotymiky
 69 male 59 years complained of pain in the heart, cough, fever up to 38oC. Suffered a my ocardial
infarction 3 weeks ago. OBJECTIVE: Ps -86/hv, rhythmic, AO-110/70 mmHg Auscultatory:
pericardial friction noise, moist rales in the scapula. Radiological pathology there. In the blood:
Lake .- 10 * 109 / l, ESR-35 mm / hour. ECG - no speakers. Appointment of a pharmacological
drug groups would be most justified?
A. Direct anticoagulants
B. Fibrynolityky
C. Antibiotics
D. Nitrates and nitrites
E. Glucocorticoids

70 55 years with gastric cancer, was operated on 1.5 years ago, held chemotherapy. During 4
months of notes difficulty in the right hypochondrium, nausea, bitter taste in the mouth, vomiting,
sometimes with admixture of bile subfibrylitet evening.When ultrasound revealed multiple
volumetric formation in the liver. Gall bladder and pancr eas did not change. Previous diagnosis:
metastatic liver damage. Definition of a substance radioimmunoassay can confirm this diagnosis?
A. Insulin
B. Gastrin
C. Prolactin
D. CA-19-9
E. s 2 microglobulin

71 Pregnant 32 years complains of episodes of syncope, spontaneous fainting, fast disappearing

when changing body position. Fainting may be accompanied by bradycardia, which quickly passes.
In the rest of the pregnancy proceeds without complications. Name the most possible cause of this
condition:
A. Vegeto-vascular dystonia with cardiac type
B. Reducing the pressure in the veins of lower extremities
C. Compression of the inferior vena cava pregnant uterus
D. Increased pressure in the veins of upper extremities
E. Psycho-somatic violation

72 According to laboratory soil sanitary conditions in hospitals, in terms of sanitary numbers

malozabrudnenyy soil, with captions Escherichia coli - contaminated by captions anaerobes (Cl.
perfringens) - malozabrudnenyy. It shows:
A. Insufficient intensity of humification processes in soil
B. Permanent arrivals protein organic pollutants
C. Insufficient insulation and aeration of the soil
D. Receipt of fresh faecal contamination
E. The old fecal contamination

73 patients 37 years old taken to the office in unconscious. Got a closed abdominal trauma in the
area.Suspected intraperitoneal bleeding, damage to internal organs.Coming urgent surgical
intervention. The doctor determined using standard serum blood group and got the following result:
0 (I) - no agglutination, A (II) - no agglutination, B (III) - no agglutination. What is blood in the
victim?
A. B (III)
B. 0 (I)
C. -
D. A (II)
E. AB (IV)
 74 patients with post -traumatic acute pain after administration of morphine was considerably
easier. Which of the above mechanisms of action provided the antishock effect of morphine in this
patient?
A. Excitation of benzodiazepine receptors
B. Stimulation of opioid receptors
C. Inhibition of dopaminergic mediation
D. Boost GABA ergic reactions
E. Blockade of central holinoretseptoriv

Among 75 patients of general medical practice in recent years is the steady increase in the
number of elderly and senile age. What type of disease prevalence to wait in the structure of
morbidity of the population served?
A. Acute pathology
B. Chronic pathology
C. Infectious diseases
D. Production pathology
E. Neepidemichna pathology

76 Female 27 years expresses complaints monthly with occasional delays up to 2 -3 months,

significant weight gain, hirsutism. Married 5 years, no pregnancies.During the study of vaginal
uterus slightly smaller than normal, with both sides determined dense, mobile ovaries to 4 -5 cm in
diameter. What kind of pathology can be dealt with in this case?
A. Hipomenstrualnyy syndrome
B. Chronic salpingitis duplex
C. Tuberculosis of uterus
D. Two-sided ovarian cyst
E. Ovarian Syndrome sklerokistoznyh

77 Child 5 months, born full -term, but in the early days of symptoms of hemolytic disease of
newborns. In the maternity hospital has n ot received any vaccinations. Which vaccine should
immunize it first?
A. ADT
B. BCG
C. ADT-M
D. Koreva
E. AKDP

78 child 3 years old came to the office complaining of osalhiyi, raising the temperature to 39oC.
OBJECTIVE: state of the child hard, can not stand because osalhiy expressed intoxication, lymph
nodes up to 1,5 cm to 3 cm liver and spleen 2 cm protruding from under the edge of costal arch. In
the blood: er . - 3.0 * 1012 / l, Hb -87 g / L, MP-0.87, thrombus .- 190 * 109 / l, Lake . - 3.2 * 109 / l, e.
- 1% , § - 1%, c .- 0, l .- 87% of the city - 2%, ESR-36 mm / hour. What research should be done to
determine the diagnosis?
A. Ultrasound
B. Lymph node biopsy
C. Puncture of lymph node
D. Sternalna puncture
E. Computed Tomography

79 Patient 54 years admitted to hospital to hospital with severe acrocyanosis, nabuhlymy cervical
veins, enlarged liver, ascites. Borders of the heart expanded. Heart tones not vysluhovuyutsya,
apical impulse is not defined. AT -100/50 mmHg On the radiograph of the c hest revealed enlarged
heart shadow in a trapezoid. What can explain the pathological conditions mentioned symptoms in
sick?
A. Acute heart failure
B. Hiatal hernia
C. Exudative pleuritis
D. Cardiac tamponade
E. Combined heart disease

80 Female 60 years old hospitalized with acute transmural infarction. Hour that the patient's
condition became worse: there was shortness of breath, which is growing, dry cough. CHDR
30/hv-and HR-130/hv., SC, 90/60 mmHg Heart beat is weak, the emphasis on the second tone of
pulmonary arteries. In the lower right and left lung wet serednopuhyrchasti wheezing. Temperature
- 36,4oC. Which drug should apply in the first place?
A. Heparin
B. Digoxin
C. Dopamine
D. Promedol
E. Eufilin

81 remontuvav car driver in a closed garage, then called complaining of headache, dizziness,
nausea, muscle weakness, drowsiness. OBJECTIVE: rapid pulse, respiration, agitation,
hypertension, persecution complex. What is the most likely diagnosis?
A. Hypertensive crisis
B. Intoxication etylovanym gasoline
C. Posttraumatic encephalopathy
D. Astheno-vegetative syndrome
E. Carbon monoxide intoxication

82 to the surgical department after 4 hours after injury victim received 37 years with a crushed left
hip wound. What is the main condition for successful prevention of gas gangrene in the victim?
A. Introduction of specific serum OD 3000
B. Removing non-viable tissue and timely debridement
C. Infiltration of soft tissue around the wound antibiotic solution
D. Introduction of specific serum 30 000 OD
E. Flushing the wound solution of hydrogen peroxide 6%

83 girl 11 years acutely ill: there were plo t lumbar pain, nausea, vomiting, frequent urination,
temperature 39oC. OBJECTIVE: abdomen soft, painful during palpation in the lumbar area. In
urinalysis significant leukocyteuria, bacteriuria.With urine vysiyana Escherichia coli. What is the
most likely diagnosis?
A. Acute Vulvovaginitis
B. Acute pyelonephritis
C. Chronic glomerulonephritis
D. Acute appendicitis
E. Acute glomerulonephritis

84 practitioner assigned to analyze the health of the adult population in the service station. What
groups of indicators it will be involved in this analysis?
A. Morbidity, mortality, physical development
B. Fertility, morbidity, disability
C. Morbidity, disability, death
D. Demographic, morbidity, physical development
E. Demographic, morbidity, disability

85 travmpunktu turned farmer who during work in the field of injured right foot. When he was
cultivating, can not remember the army did not serve. When ohlyadi right stupni found
contaminated wound length of 5 -6 cm nerivnym edges. What further management DOCTOR?
A. Assign antibiotic
B. Enter tetanus toxoid
C. Only debridement
D. Enter protypravtsevu serum
E. Enter tetanus toxoid and serum protypravtsevu

86 patients 20 years, delivered in the summer from the street bleeding from a brachial artery,
while providing first aid to stop bleeding temporary binder was imposed. Specify the maximum
exposure tow:
A. 180 minutes
B. 30 minutes
C. 15 minutes
D. 120 minutes
E. 60 minutes

87 patients 24 years of "injecting" drug addict, within 4 months of suf fering from infective
endocarditis, is in inpatient treatment for the cardiology department. The patient was conducted
three times with different antibiotic schemes. The patient complained of fever up to 37,5oC,
showing signs of left ventricular failure. W hen clinical examination revealed aortic valve
insufficiency III level. What is most expedient treatment tactics?
A. Treatment of nonsteroidalantiinflammatory drugs
B. Replacement of antibiotic
C. Introduction to the treatment scheme of probiotics
D. Treatment with immunomodulators
E. Surgical treatment (aortic valve prosthesis)

88 Female 19 years complained of stomach ache and joints, all require new injections of
painkillers and sleeping pills medication. The examination revealed no pathology of gy necological
and urological fields. OBJECTIVE: superficial veins of the extremities along the traces of old
punctures, whose origin is not explained. Tendon reflexes of upper and lower limbs are the same
lively. Photoreactions weak pupils. Tongue furred gra y bloom. In conversation - affective
unbalanced. Celebrated diarrhea without pathological inclusions. What further management of the
patient?
A. Medications that require patient
B. Additional surgical consultation
C. Consultation by infectious disease
D. Assign antibiotic
E. Consultation narcologist

89 In patients 45 years of age suffering from urolithiasis, renal colic attack originated. What is the
mechanism of attack?
A. Violation of the outflow of urine from the kidney
B. Renal artery spasm
C. Creases ureter
D. Damage to the renal glomerular
E. Increasing the relative density of urine
 90 The diagnosis of "typhoid fever" was set man age 50 years, working mechanic and lives in an
isolated apartment with all amenities. In addition to his fa mily two adults. What measures are
conducted on persons who had communicated with patients?
A. Bacteriological study
B. Vaccination
C. Antibiotic
D. Dispensary supervision
E. Isolation

91 Three days ago the boy from under the nail plate is removed foreign body. After 2 days is a
sharp throbbing pain at the end of nail phalanx, especially when pressed, hyperemia nail shaft,
body temperature rose to 37,5 oC, changed the color of nail plate. What is the most likely
diagnosis?
A. Abscess
B. Wildfire
C. Pidnihtovyy felon
D. Erizipeloyid
E. Paronychia

92 A child of 6 -day life in the area back of the head, neck and buttocks were blisters filled with
serous-purulent content that densely cover the skin. The general condition of the child is not
disturbed. On any illness should think about?
A. Impetigo
B. Neonatal pemphigus
C. Bullous epidermoliz
D. Pitnytsya
E. Vezykulopustuloz

93 Patient 40 years suffering from rheumatism. Complains of severe pain in his left eye, especially
at night, blurred visi on, photophobia, lacrimation. Diseases with anything not connect.
OBJECTIVE: perykornealna weak injection, zhladzhenistraduzhky relief, change its color. What is
the most likely diagnosis?
A. Keratitis
B. Acute attack of glaucoma
C. Irydotsyklit
D. Choroiditis
E. Iryt

94 Patient 43 years old hospitalized in serious condition. Was suffering from Addison's disease.
Always took prednisolone. Throughout the week, stopped receiving. OBJECTIVE: soporoznyy
condition, skin and visible mucous pigmentation, turg or of skin and muscle decreased. Muffled
heart tones, pochascheni, AO -60/40 mmHg, HR-96/hv. In the blood: Na -120 mmol / l, K-5,8mmol /
liter. Hormone deficiency plays a role in the development of this complication?
A. Kortykotropin (ACTH)
B. Androstendion
C. Adrenalin
D. Cortisol
E. Noradrenaline

95 The girls are 14 years old about a year ago were irritability and tearfulness. Then determined
diffusely enlarged thyroid gland is the second degree. The state was regarded as signs of puberty,
treatment was conducted. Irritability gradually changed complete apathy. Soon there were
puffiness face pastoznist soft tissues, bradycardia, constipation. Knap pale skin, she became waxy
hue. The gland became more dense. What disease should we assume?
A. Toxic goiter
B. Thyroid cancer
C. Adolescent youth bazofilizm
D. Subacute thyroiditis
E. Autoimmune thyroiditis

96 people 26 years complained of stabbing pain when breathing, coughing, shortness of breath.
Objective: to-37,3oC, CHDR-19/hv. And HR = Ps - 92/hv.; AT-120/80 mmHg Vesicular breath. Left
in thorax nyzhnolateralnyh departments in the phase of inhalation and exhalation auscultated noise
that increases when you phonendoscope and stored after coughing. ECG - unsuspicious. What is
the most likely diagnosi s?
A. Spontaneous pneumothorax
B. Acute pleurisy
C. Intercostal neuralgia
D. Dry pericarditis
E. Subcutaneous emphysema

97 soldier 27 years received by WFP in 1,5 hours after being shot in the stomach fragment
bombs. OBJECTIVE: condition serious, pale, Ps-132/hv., SC, 80/60 mmHg In the subcostal area
imposed band of IPP, which is impregnated with blood. Abdomen tight.Perkutornoho: stupidity is
defined in places hood that moves when changing body position. Defined symptoms of irritation of
the peritoneum. In which section should be helped by WFP?
A. In evacuation
B. Through self -help
C.In prison
D. In receiving and sorting tent
E. In the dressing

98 patients 65 years complained of pain in the lumbar spine, moderate dysuria. Ill about six
months.Prostate volume - 45 cm3 (hipoehohenni units available in both lobes, invasion
capsules).Prostate-specific antigen - 60 ng / ml.According to the biopsy of the prostate -
adenocarcinoma. Which of the following additional methods of analysis will set the stage tumor in
this patient?
A. Excretory urography
B. Skennuvannya bones
C. Radiography of the lumbar spine
D. Computed tomography of the pelvis
E. Radiography of the chest

99 and 21 days after onset of rash vezykuloznoho of varicella in a child 7 years appeared ataxia,
nystagmus, intentional tremor, muscle hypotonia. In the low lymphocytic pleotsytoz liquor, slightly
increased the protein level. What complication has developed in this child?
A. Acute neuritis
B. Pneumonitis
C. Postherpetychna neuralgia
D. Encephalitis
E. Purulent meningitis

100 Patient 32 years turned to the doctor complaining of lack of pregnancy within 4 years. 5 years
ago the first pregnancy ended in abortion artificially. According to the study of vaginal ultrasound
examination and the diagnosis: endometrioid cyst right ovary. What is the optimal method of
treatment?
A. Anti-inflammatory therapy
B. Conservative therapy of estrogen -gestagen preparations
C. Spa treatment
D. Operative laparoscopy
E. Hormonal therapy of male sex hormones

101 In examining the incidence in N was found that the population of different districts differ in
their age structure. Which statistical methods will eliminate the influence of this factor for
morbidity?
A. Calculation of averages
B. Standardization
C. The analysis of time series
D. Correlation and regressive analysis
E. T-criterion Vilkoksona

102 patients 52 years, secretary -typist, work experience 30 years.Complains of cramps in the right
hand during the work and the impossib ility of printing and writing. Load brush - up to 80% of the
time. Ill for 2 years. OBJECTIVE: right hand tense muscles increased, while trying to write having
seizures. When examining the pathological manifestations of the CNS were found. What is the
most likely diagnosis?
A. Paretychna form koordynatornoho neurosis
B. Chronic manganese intoxication
C. Neuralgic form of neurosis koordynatornoho
D. Hysterical neurosis
E. Tic form of neurosis koordynatornoho

103 Child, 4 years, 5 of his illness. Compla ints of cough, skin rashes, to -38,2oC, facial puffiness,
photophobia, conjunctivitis. OBJECTIVE: the face, neck, upper half of the thorax bright
maculopapular, sometimes confluent rash. Ziv congested. On the nose - seropurulent selection. In
the lungs - dry rales. What is the most likely diagnosis?
A. Enterovirus exanthema
B. Measles
C. Rubella
D. Scarlet fever
E. Adenovirus infection

104 Patient 34 years approached with complaints of general fatigue, swelling of the face and
hands, tiredness when walking, difficulty in swallowing, fluctuations in heart. These symptoms
appeared after 11 days of rest at sea. OBJECTIVE: erythema face, swelling of the leg muscles.
Muffled heart tones, AO -100/70 mmHg In the blood: increased AST, 0.95 mmol / h * l, ALT -1.3
mmol / h * l aldolazy - 9,2mmol / h * l, creatine serum - 2,5 mg P / h * l. What method is the most
specific test?
A. Electromyography
B. ECG
C. Echo-CG
D. Muscle Biopsy
E. Determination of cortisol in the blood and urine

105 patients 67 years complained of swelling of the face and legs, back pain, exacerbated during
movements, sharp weakness, sometimes - nasal bleeding, fever up to 38,4 oC. OBJECTIVE:
tenderness on palpation of the spine and ribs. In laboratory studies: p roteinuria - 4,2 g / day,
SHOE-52 mm / hour. What changes of laboratory parameters most anticipated?
A. Albumin - 65%
B. Leucocytes - 15,3 * 109 / l
C. Total serum protein - 101 g / l
D. Hemoglobin - 165 g / l
E. ×IgG - 14%

49 106 patient years of clinical supervision is about uterine fibroids. Last year uterine tumor
increased to 20 weeks of pregnancy. What is the rational method of treatment?
A. Hormonal treatment
B. Operative treatment
C. Further observations
D. Embolization of uterine arteri es
E. Inhibition of prostaglandins

107 in the maternity hospital were born alive in year 616 children, 1 child was stillborn, 1 child died
on the 5 th day of life. With a parameter you can most accurately assess this situation?
A. Birth rate
B. Total mortality
C. Perinatal mortality
D. Infant mortality
E. Natural increase

108 primigravides 20 weeks in the term complained of pain in the bottom of the stomach,
mazhuchi bleeding from genital tract. High tone in the uterus, the movements of the fetu s feels.
When bimanualnomu study: enlarged uterus under the pregnancy, the cervix is reduced to 0.5 cm,
external eye open at 2 cm Highlight spotting, mazhuchi. What is the most likely diagnosis?
A. Missed abortion
B. Abortion, which began
C. Abortion in progress
D. Threatened miscarriage
E. Incomplete abortion

109 woman in labor 25 years, second day postpartum period. Childbirth first, urgent, passed
without complications. What should be the nature lohiy?
A. Mucous
B. The blood
C. Serous
D. Purulent
E. The blood-serous

110 patients 49 years operated on thyroid cancer. In conducting the audit of the tumor and rapid
diagnosis is set: the extent of the process - T3Na M0, morphologically - papillary carcinoma form.
What should be the volume of radical surgery?
A. Resection of the infected part of the isthmus
B. Tyreoydektomy
C. Subtotal resection of cancer
D. Resection of the infected part
E. Tumorenucleation

111 girl 22 years for 2 days complained of rashes in the area of the face with itching. Diseases
linked with the use of cosmetic cream. OBJECTIVE: pronounced reddening and swelling of the
skin in the area of the cheeks, chin, forehead, the presence of small papules -vezykuloznoyi rash.
What is the most likely diagnosis?
A. Eczema
B. Wildfire
C. Allergic dermatitis
D. Neurodermatitis
E. Simple dermatitis

112 Women 49 years complained of headache, hot flushes heat "to the head, neck, increased
sweating, palpitations, high blood pressure to 170/100 mmHg, irritability, insomnia, t earfulness,
weakening of memory, liquid scanty menstruation, weight gain 5 kg over the past six months. What
is the most likely diagnosis?
A. Menopause
B. Vasoneurosis
C. Premenstrual syndrome
D. Hypertension
E. Postcastration syndrome

113 Girl 8 years admitted to hospital for cardiological department. OBJECTIVE: skin lesions
observed on the surfaces of joints rozhynalnymy with atrophic scars, depigmentation, symmetrical
lesions of skeletal muscles (weakness, pain, swelling, hypotrophy). For which di seases are most
prominent these changes?
A. Systemic scleroderma
B. Reiter's disease
C. Pseudotrichiniasis
D. Systemic lupus vivchak
E. Nodular periarteriyit

114 patients 40 years for heavy menstruation, the notes that accompanied pereymopodibnym pain
lower abdomen. When bimanualnomu study during menstruation: the cervical canal formation is
determined to 5 cm diameter, thick consistency. Uterus enlarged to 5 -6 weeks of pregnancy,
normal consistency, movable, painful. Appendages are not detected. Selec t spotting, abundant.
What is the diagnosis can be assumed?
A. Abortion in progress
B. Cervical cancer
C. Algomenorrhea
D. Submukoznyyfibromatous node that is born
E. Cervical myoma

115 Patients 46 years old participated in the accident at nuclear po wer plants. It is currently in
inpatient treatment. Diagnosis: progressive autonomic failure. To which group effects of ionizing
radiation include this disease?
A. Somato-stochastic
B. Heterosis
C. Hormezys
D. Genetic
E. Somatic

116 Patients 58 years complains of feeling numb, sharp zblidnennya II -IV fingers, feeling of
tightness in the muscles, fluctuations in heart. Also found poliartralhiya, manifestations of
dysphagia, constipation. Face the patient "maskopodibne, dense brush swelling. Increased h eart
size, lung vysluhovuyutsya dry rales. In the Blood: ESR -20 mm / h, total protein - 85 g / l, ×-
globulins - 25%. What is the most likely diagnosis in this case?
A. Rheumatoid arthritis
B. Raynaud's Disease
C. Pseudotrichiniasis
D. Systemic scleroderma
E. Systemic lupus vivchak

117 After the conversation with his mother somymisyachnoho boy who is on breastfeeding,
pediatrician found that children fed 7 times a day. How many feedings established for a child this
age?
A. 7 times
B. 3 times
C. 6 times
D. 4 times
E. 5 times

118 held for a long time to study the trends in changes of the general mortality rate of different
population groups residing in different administrative areas. Which statistical methods can be used
for this purpose?
A. Evaluation of reliability indices difference
B. The analysis of time series
C. Analysis of levels of relative values
D. Correlation and regressive analysis
E. Analysis of standardized indicators

119 lead train 39 years hospitalized in 4 -day illness with complaints of headache, weakness,
dizziness, sweating, insomnia, fever. OBJECTIVE: face congested, swollen, conjunctivitis. In the
transitional fold test conjunctivitis - sporadic petechiae. The skin of trunk, chest, abdomen,
extremities, profuse rozeoloznopetehialna rash.Tachycardia. AT -100/60 mmHg Underlined tongue
tremor. Palpating liver, spleen. Draining delayed. What is the most likely diagnosis?
A. Leptospirosis
B. Flu
C. Typhoid
D. Meninhokoktsemiya
E. Typhus

120 patients 19 years ago day injured as a result of falling from a height of 1.5 meters - rode on a
wooden beam. Sechovyvedennya sharply difficulty, makrohematuriya, uretrorahiya.The perineum
and scrotum - hematoma. During uretrohrafiyi found leaking contrast material in the depar tment of
membranous urethra. What should be the treatment tactics?
A. Implementation of primary urethral seam
B. Cold to the perineum, Hemostatic therapy
C. Bouginage urethra
D. Catheterization of the bladder to the urinary tract
E. Operation epitsystostomiya

In 121 patients 26 years, with left -handed nyzhnochastkovoyu pneumonia during cough is a sharp
pain in the left chest. OBJECTIVE: diffuse cyanosis, enlargement of the left half of the chest.
Perkutornoho - high tympanit.Auscultatory - absence of respiratory sounds over the left half of the
chest.The offset to the right edge of the heart serednoklyuchychnoyi line. Which test is most
informative?
A. Bronhohrafiya
B. Spirography
C. Radiography
D. Bronchoscopy
E. Pnevmotahometriya

122 adult die t contains in terms of mehakaloriyu (1000 kcal = 4184 kJ) - 30 g protein, 37 g fat, 137
g carbohydrates, 15 mg vitamin C, 0,6 mg thiamine (vitamin B1). Balanced diet not the contents:
A. Thiamine
B. Protein
C. Vitamin C
D. Fat
E. Carbohydrates

123 patients preparing for surgery on varical lower extremities. When you review the soles peeling
mukopodibne found along the skin folds. All nails feet grayish -yellow, thickened and partially
destroyed. What kind of skin disease should think in this case?
A. Microbial eczema
B. Rubromikoz
C. Bran eruption
D. Microsporia
E. Candidiasis

124 boy 9 years with 3 years of age suffering from bronchiectasis. Aggravation arise frequently, 3 -
4 times a year. After conservative therapy - brief periods of remission. Disease progresses, the
child is behind in physical development. Skin pale, acrocyanosis, deformed nails as a "watch
skelets. According bronhohrafiyimishkopodibni revealed bronchiectasis of the lower part of right
lung. What should be further therapeutic tactics?
A. Spa treatment
B. Physiotheraty
C. Operative treatment
D. Hardening of the child
E. Continue to conservative therapy

125 girl 10 years turned to the doctor complaining of thirst, frequent urination, weight loss.
Considers himself sick about a month. OBJECTIVE: pathology of internal organs were found. What
medical examinations should be held in the first place?
A. Urinalysis for acetone
B. Hlyukozurichnyy profile
C. Urine analysis for sugar, daily diuresis
D. Blood sugar fasting
E. Tolerance test glucose

When examining the 126 women 25 years who applied to the antenatal clinics at the lack of
pregnancy within 3 years of regular sex life, found: increased body weight, height pubescence on
the male type, increased ovolosinnya thi ghs, dense ovaries, enlarged, basal temperature
monofazna. What is the most likely diagnosis?
A. Inflammation of the uterus applications
B. Sklerokistoz ovarian
C. Adrenohenitalnyy syndrome
D. Dysgenesis of gonads
E. Premenstrual syndrome

127 bacterial research premises in winter by Krotov apparatus showed that the total number of
microorganisms in 1 m3 of air is 7200. What is the allowable number of microorganisms
characterizes air quality as "clean"?
A. To 7500
B. 5500
C. To 4500
D. To 3500
E. 2500

128 Institute of Occupational Diseases Clinic set worker who works at the concentration plant,
occupational disease - chronic dust bronchitis. Case investigation conducted by commission
composed of representatives of: businesses, health of, terri torial SES, department of social
insurance, trade union organization. The representative of the institution which should lead the
commission in accordance with the current "Regulations on the investigation ..."?
A. Unionized
B. Health of the
C. Territorial SES
D. Enterprises
E. Social Insurance Fund

129 Assessing the health of secondary school graduates, the physician has established one of the
students in tonsil hypertrophy of the third degree, chronic rhinitis and dystonia. Features body
reduced. For health reasons this student belongs to:
A. Group IV
B. V group
C. Group II
D. Group III
E. I group

130 patients with gastroesophageal reflux disease over 5 years time, the recommendation of the
pharmacist takes the drug, "which reduces the acid ity. Having the following side effects:
osteoporosis, muscle weakness, malaise. Which drug has the side effect?
A. Proton pump inhibitor
B. H2-blocker
C. Metoclopramide
D. Alyuminiyvmischuyuchyy antacids
E. Hastrotsepin

131 At the 4 th day after tak ing in perforatyvnoyi gastric ulcer in a patient who suffers from
emphysema, spontaneous pneumothorax developed. The most favorable place for drainage of
pleural cavity for eliminating pneumothorax are:
A. Second mizhreber'yaserednoklyuchychniy on line
B. Seventh mizhreber'ya on the front lines aksylyarniy
C. Eighth mizhreber'yaaksylyarniy back on line
D. Fifth mizhreber'yaserednoklyuchychniy on line
E. Sixth mizhreber'ya the front axillary line

In 132 women 67 years of suffering with hypertension, a t night suddenly appeared headache,
shortness of breath, which quickly turned into asthma. OBJECTIVE: pale forehead sweat, AO -
210/140 mmHg, heart rate -120/hv. Over isolated lungs dry rales in the lower divisions - moist rales.
Impasto legs. What first aid is most expedient in this case?
A. Digoxin and nitroglycerin in / in
B. Nitroglycerine and furosemide / v
C. Enalapril and furosemide / v
D. Nitroglycerin in / in and inside kapoten
E. Labetalol and furosemide / v

133 patients 58 years complained of periodic headaches, dizziness and tinnitus. Over 15 years
suffering from diabetes. OBJECTIVE: rhythmic heart beat, heart rate -76/hv., II focus on the tone of
the aorta, the AT -180/110 mmHg In urine: relative density - 1.014. The daily loss of protein in urine
to 1.5 g drug of choice for treatment of hypertension in this patient is:
A. Calcium channel antagonist
B.  -blocker
C. s -blocker
D. ACE inhibitor
E. Thiazide diuretics

134 patients 26 years complained of a sharp muscle weakness, dizziness, diffuse abdominal pain,
nausea and vomiting, which does not improve the patient's condition. The disease gradually began
6 months ago. Amplified general weakness, darkened skin. The state has deteriorated since the
ARD, have abdominal pain and frequent vomiting. OBJECTIVE: dry skin, diffusely pigmented.
Heart tones sharply weakened, HR -60/hv., AT-80/40 mmHg Abdomen somewhat painful in the
epigastric area. In the blood: Lake . - 8.1 * 109 / l, glucose - 3.0 mmol / liter. What is the most likely
diagnosis?
A. Acute pancreatitis
B. Infectious and toxic shock
C. Chronic adrenal insufficiency. Addisonichnyy management
D. Acute food poisoning
E. Acute cholecystitis

135 Male 52 years over 18 years suffering from diabetes. A y ear ago, moved tsystit. Takes maninil
0,005 - 3 times a day. OBJECTIVE: Height - 176 cm, weight - 82 kg. Fluctuations hlikemiyi fasting -
10,3-12,4 mmol / liter. Detected proteyinuriya - 0.033 grams per liter. To prevent the progression of
diabetic nefropa tiyi most appropriate:
A. Increase dose maninilu
B. Assign antibacterial therapy
C. Reduce daily food kalorazh
D. Replace maninil on insulin
E. Add insulin therapy

136 patients 58 years complained of shortness of passage of solid food in the esophagu s,
coughing while eating. Considers himself sick over four months. OBJECTIVE: supraclavicular
areas in one dense lymph nodes up to 0,7 cm in diameter. What is the most likely diagnosis in this
case?
A. Mediastinaltumor
B. Esophagitis
C. Esophageal Cancer
D. Lymphogranulomatosis
E. Tracheitis

In 137 men for 45 years, the last two weeks there was increased activity, a multilingual, euphoric,
had fallen, said that could "save humanity", is able to solve the problem of cancer and AIDS has
handed out money to strangers. What is the most likely diagnosis?
A. Panic disorder
B. Katatonichne excitation
C. Manic attack
D. Azhytovana depression
E. Shyzoafektyvnyy disorder

138 patients complained of severe sore throat Push more thing, the impossibility of s wallowing
even liquids. Ill 5 days. OBJECTIVE: hard state, to -38,9oC, speech difficulties, voice clenched, his
mouth barely open. Inframaxillary lymph nodes painful matter, increased. What is the most likely
diagnosis?
A. Angina Symanovskoho Vincent
B. Pharynx tumor
C. Paratonzylyarnyy abscess
D. Quinsy
E. Diphtheria

In 139 patients 25 years of autumn is a pain in the epigastrium, resulting from 1,5 -2 hours after
meals and at night. Complains of heartburn, constipation. The pain is worse when you receive a
sharp, salty and sour food, decreases - after using baking soda and hot -water bottle. Sick during
the year. OBJECTIVE: language is not imposed, humid. On palpation the abdomen - pain in the
right epigastrium, in the sa me area - resistance of the abdominal muscles. What is the disease
most likely?
A. Chronic pancreatitis
B. Ulcer of duodenum 12
C. Gastric ulcer
D. Diaphragmatic hernia
E. Chronic cholecystitis

140 Total Area Chamber of Medicine Department is 28 m2. In what the maximum number of beds
designed this house?
A. 3
B. 5
C. 1
D. 2
E. 4

Apprentice 141 5 th class asked about widespread skin rash, accompanied by strong itching,
especially at night. OBJECTIVE: interdigital folds in the area of both hands, flexural surface of the
radiocarpal joints, the skin on the abdomen and buttocks and inner thighs revealed small red
papules that tend to pair location. In the center of individual papules seen mihurtsi or serous -
hemorrhagic crust. Multiple ekskoriats iyi are noted. What is the most likely diagnosis?
A. Scabies
B. Toksykodermiya
C. Eczema
D. Smooth skin mycosis
E. Dermatitis

142 A worker who is on medical check -up on ulcer duodenum 12, the company reduced permit
allocated for spa treatment for 24 days. Duration of basic annual leave an employee is 24 calendar
days to travel to the resort and back to spend 4 days. What is the order processing of temporary
disability in this case?
A. A leaflet issued LKK disability at 28 days
B. Physician in charge sheet issued disability in 4 days
C. A leaflet issued LKK disability in 4 days
D. Physician issues a certificate and "sanatorium card" for 28 days
E. In LKK a reference of 4 days

143 hospital received pershonarodzhuyucha complaining of irregular, p ainful contractions that

continue 36 hours. Tired, not sleeping the night. OBJECTIVE: Longitudinal fetal position, the main
presentation. Fetal heart clear, rhythmic - 145/hv. Vaginal investigation: cervix up to 3 cm thick, is
backwards, external eye closed. Mucus. What is the most likely diagnosis?
A. Abnormal preliminary period
B. The primary weakness of delivery
C. Physiological preliminary period
D. Dystotsiya cervical
E. Recycled weakness of delivery

144 girls in the 9 months of clinical examin ation appear: pale skin, of cyanosis during anxiety.
Perkutornoho: expanding the boundaries of the heart in the transverse direction. Auscultatory: left
of sternum in 3-4 mizhreber'yi long systolic murmur auscultated, conducted over the entire area of
the heart and back. What kind of birth defect heart be suspected in a child?
A. Intraventricular septum defect
B. Interatrial defect partitions
C. Koarktatsiya aorta
D. Pulmonary artery stenosis
E. TetradaFallo

145 to Psychiatry addressed patient comp laining of painful urination, redness of the external
urethral opening, copious purulent discharge from the urethra. Considers himself sick for 3 days.
Diseases linked to casual sexual intercourse, about a week ago. If the preliminary diagnosis of
acute gonorrheal urethritis is confirmed, then the bacterioscopic study in secretions from the
urethra are found:
A. Proteus vulgar
B. Spirochaete
C. Diplococci Gram
D. Mycoplasma
E. Gram-negative diplococci

146 patients 29 years 3 days ago came the pulsatin g nature of pain in the rectal area, fever,
general weakness. OBJECTIVE: local pain in the anal area at 6 o'clock. When finger Rectal painful
infiltration that reaches Comb line. What is the most likely diagnosis?
A. Acute paraproctitis
B. Acute prostatitis
C. Rectal tumor
D. Acute anal fissures
E. Acute hemorrhoid

147 in women 42 years over the past 10 years, menstruation leaked by type and progressive
hyperpolymenorrhoeaalgomenorrhea. Gynecological research: neck unmodified, moderate
allocation, "chocolate" color, slightly enlarged uterus, painful, applications not palpating, vaults
deep anesthesia. What is the most likely diagnosis?
A. Endometriosis of uterus
B. Subserous uterine fibroids
C. Endomiometrit
D. Endometriosis appendages
E. Uterine cancer

148 Development of chronic venous insufficiency of lower limbs depends on the functional state of
so-called "pump m'yazovovenoznoyi. Relative to the group of muscles used this term?
A. Tibia
B. Hips
C. Foot
D. Gluteal area
E. Abdominal wall

149 Women 26 years complained of bleeding from genital tract during the last 14 days, lower
abdomen pain, general fatigue, weakness, weight loss, fever, chest pain, shortness of breath. 5
weeks ago underwent surgery artificial termination of pregnancy in term of 6 -7 weeks.
OBJECTIVE: pale, lifeless. When bimanualnomu study: uterus enlarged to 8 -9 weeks of
pregnancy. In the blood: Hb -72 g / dL. Investigation of urine hCG dramatically positive. What is the
most likely diagnosis?
A. Perforation of the uterus
B. Metroendometryt
C. Uterine fibroids
D. Hysterocarcinoma
E. Chorionepithelioma

150 patients 72 years complained of itchy skin left leg, especially around venous ulcers where the
skin became red and swollen, the available places moknuttya, single yellow kirochky. The limits of
localization crisp. What is the most likely diagnosis?
A. Seborrhoic eczema
B. Lupus
C. Allergic dermatitis
D. Microbial eczema
E. Streptodermiya

In 151 patients 47 yea rs old with decompensated pyloric stenosis of stomach ulcer genesis is
convulsive syndrome. Name the most likely pathogenetic basis of this syndrome:
A. Cachexia
B. Iron deficiency anemia
C. Ahlorhidriya
D. Hypovolemia
E. Hipohloremiya

152 child 9 year s for 4 years treated on chronic glomerulonephritis. Under out -patient records.
What is necessary to test for the study of glomerular filtration?
A. Daily proteinuria
B. Endogenous creatinine clearance
C. Urinalysis
D. Test Zymnytskoho
E. The level of residual nitrogen and urea in the blood

Among the 153 employees in the current school year is never sick - 10%, once - 30%, two times -
15%, four times ill - 5%, other - 5 or more times. What part of the employees will be assigned to the
first group and health?
A. 22%
B. 60%
C. 10%
D. 55%
E. 40%

154 Patient 47 years old complain of cough with purulent sputum separation, pain in the lower half
of the left chest, periodic fever. Ill about 10 years. OBJECTIVE: distal phalanx in the form of drum
sticks. What will be the most informative test for diagnosis?
A. Bacteriological study of specimens
B. Bronhohrafiya
C. Bronchoscopy
D. Plain film pulmonary
E. Puncture of the pleural cavity

155 Patients 30 years turned to a family physician 2 months after surgery on an open fracture of
the humerus. OBJECTIVE: the patient's condition is satisfactory in the area are operating wound
fistula with a slight purulent discharge, redness, fluctuations. On radiograph - destruction of bone
sequestration. What complications arose in patients in the postope rative period?
A. Hematogenous osteomyelitis
B. Suppurating wounds
C. Lihaturna fistula
D. Posttraumatic osteomyelitis
E. Posttraumatic phlegmon

156 to the department with suspected meningitis delivered patient, geologist working in Southeast
Asia. The disease began very badly, has developed rapidly and was accompanied by
hyperthermia, headache, vomiting. OBJECTIVE: right in the inguinal area revealed increased to
3h5 cm, very painful, with blurred contours, tambourine. The skin over it purple, shini ng. Meningeal
signs are negative. What is the most likely diagnosis?
A. Plague
B. Anthrax
C. Tularaemia
D. Acute leukemia
E. Benign limforetykuloz (felinoz)

157 have complained of breathlessness and coughing in a child 2 years. In the neonatal perio d in
the girl's rough systolic murmur. OBJECTIVE: pale skin, shifts the boundaries of the heart in the
left side and up, rough systolic -diastolic noise in the second mizhreber'yi the left, which is held to
the apex of the heart, the neck vessels, aorta, mi zhlopatkovyy space, increased tone in pulmonary
II artery. Above the lungs breathing hard, moist ralescalibers. Liver 3 cm What preliminary
diagnosis?
A. Interatrial defect partitions
B. Open ductusarteriosus
C. Pulmonary artery stenosis
D. Bilateral bronchopneumonia
E. Pulmonary hypertension

In 158 patients with risk factors of inadequate nutrition, steatorrhea, 4 hours after eating there is
abdominal pain, especially above the navel and to the left. Diarrhea may change locks to 3 -5 days.
Palpatory: moderate pain in holedohopankreatychniy zone. The level of amylase in the blood did
not increase. X-ray revealed kaltsynaty that are located above the navel. What is the most likely
diagnosis?
A. Chronic pancreatitis
B. Syndrome Tsolinher -Alison
C. Chronic gastro
D. Ulcer 12-duodenum
E. Chronic calculouscholecystitis

159 patients 24 years turned to the doctor complaining of increasing submandibular lymph nodes.
OBJECTIVE: Increased submandibular, axillary and inguinal lymph nodes. On the radiograph of
the chest - enlarged lymph nodes of mediastinum. In the blood: er . - 3.4 * 1012 / l, Hb -100 g / l,
CP-0.88, tr .- 190 * 109 / l, Lake . - 7.5 * 109 / l, e. - 8%, Mr - 2%, c .- 67% lymph .- 23%, ESR-22
mm / hour. What research is indicated to verify the c auses lymphadenopathy?
A. Sternalnapuncture
B. Mediastinal tomography
C. An ultrasound of the abdomen
D. Needle biopsy of lymph nodes
E. Open biopsy of lymph nodes

160 in women 46 years a day after the beginning of flu intensified headache, dizziness appeared,
nausea. OBJECTIVE: preserved consciousness, psychomotor agitation, general hypersensitivity,
mild meningeal syndrome, nystagmus. Tendon reflexes on the right above, reduced muscle
strength in the right limbs, right Babinskoho pathological reflex. Liquor: a transparent, pressure 220
mm vod.st., moderate lymphocytoses - 46.3 * 106 / L, mostly lymphocytes. Which diagnoses are
most likely?
A. Bacterial meningoence phalitis
B. Subarachnoid hemorrhage
C. Parenchymatous-subarachnoid hemorrhage
D. Influenzalmeningoencephalitis
E. Ischemic stroke

161 Boy 3 years discharged from cardiology department, where he was due to frequent attacks of
breathlessness, due tsianoty chnymytetradyFallo. Which drug is most appropriate to use to prevent
further attacks?
A. Relanium
B. Kurantil
C. Kordaron
D. Digoxin
E. Obzidan

162 10 months in hospital in serious condition with expiratory shortness of breath and dry cough.
Sick week - was cold, the temperature 38oC. OBJECTIVE: The lungs perkutornohotympanit,
auscultatory - Whistlers many dry and moist rales unit on both sides. What is the most likely
diagnosis?
A. Bronchial asthma
B. Pertussis
C. Pneumonia
D. Acute bronchitis
E. Acute obstructive

In 163 camps for children brought canned. At external examination marked cans - banks with
deep dents, when you vhynayutsya inside and did not immediately return to its original position, no
rust, banks greased technical fat. Identify bombazh:
A. Biological
B. Physical
C. Chemical
D. Physicochemical
E. Mixed

164 children 7 months. Birth weight - 3450 grams located on breastfeeding. Pidhodovuvannya
introduced on time. Determine the daily needs of the child in the squirrel:
A. 3.5 g / kg
B. 2,0 g / kg
C. 3,0 g / kg
D. 4.0 g / kg
E. 2,5 g / kg

165 patients 55 years old smoker complained of cough, sputum selection (sometimes with streaks
of blood), shortness of breath during physical exertion. OBJECTIVE: lag in breathing righ t half of
the chest, supraclavicular fossa is involved. Breathing it weakened, liquid, dry rales. X -ray - lower
pnevmatyzatsiyi upper portion, seal associated with the root of the lungs. To verify the diagnosis in
the first place to carry out:
A. One-time detection of mycobacteria
B. Computed tomography
C. Presumptive treatment of tuberculosis
D. Transthoracic biopsy
E. Lung scanning with radioisotopes

166 A child of 2 years appear often prolonged respiratory infections and

malabsorptionpankreatohen na form. It was suspected cystic fibrosis. What research is necessary
to to confirm the diagnosis?
A. Karyotyping
B. Immunogram
C. Bronchoscopy
D. The content of chlorides in sweat fluid
E. Radiograph of the chest

167 on Day 4 after experimental cold patients hospitalized with complaints of cough with the
allocation unit spitting mucosal specimens. On Day 2 once vydilylos about 250 ml of purulent
sputum streaked with blood. OBJECTIVE: moderate condition. CHDR -28-30/hv., Ps-96/hv, AO-
110/70 mmHg Breath of the left lung vesicular above right - weakened, moist rales over the lower
calibers and share amforychne breathing at an angle blades. What is the most likely diagnosis?
A. Acute focal pneumonia
B. Piopnevmotoraks
C. Empyema
D. Acute lung abscess
E. Exudative pleuritis

168 Female 30 years old, long suffering from chronic pyelonephritis, complains of significant
weakness, drowsiness, decreased diuresis and 100 ml / day. AT -200/120 mmHg In the blood:
creatinine - 0.62 mg / l, hipoproteyinemiya, albumins - 32 g / L, potassium - 6.8 mmol / l
hipohromnaanemia, increased ESR. What is a priority in treating a patient?
A. Blood transfusion
B. Hemodialysis
C. Antibacterial therapy
D. Hemosorbtion
E. Enterosorption

Farbuvalnyka automobile 169 in the diagnosis of acute poisoning by benzene amidospolukamy

medium severity. After patient treatment takes place significant improvement status. What the
experts should take a decision in this case?
A. Dispatched to MSEK for a disability group in connection with occupational diseases
B. To publish a newsletter for outpatient treatment of disability
C. Dispatched to MSEK to determine percent loss of professional capacity
D. It may continue, subject to sanitary standards
E. Return "profbyuleten for outpatient treatment

170 a woman in 24 years, the 5 thday after birth suddenly increased body temperature. Complains
of weakness, headache, pain below the stomach, irritability. OBJECTIVE: AT -120/70 mm Hg, Ps-
92/hv., To-38,7oC.Bimanualno: uterus enlarged to 12 weeks of pregnancy, dense, slightly painful
on palpation, cervical canal passes two cross your fingers, the allocation of moderate, cloudy, with
an unpleasant smell. In the blood: leukocytosis with left shift, lymphopenia, S HOE-30 mm / hour.
What is the most likely diagnosis?
A. Endometritis
B. Metroflebit
C. Parametritis
D. Lohiometra
E. Pelvioperytonit

171 women in 28 years when we arrive to the hospital complaining of headache, visual
disturbances, retardation. OBJECTIV E: AT-200/110 mmHg, pronounced swelling of legs, anterior
abdominal wall. Fetal heart clear, rhythmic - 190/hv. At home study: cervical opening full, head
fetus in pelvic cavity. What further management childbirth?
A. Blending Operation obstetrical forcep s
B. Plodoruynivna operation
C. Cesarean section
D. Stimulation of labor activity
E. Conservative of the delivery of epiziotomiyeyu

172 newborn head has dolihotsefalichnu form elongated front to back. During the tour heads to
the back of the determin ed ancestral tumor, located in the middle between large and small
Fontanels. At a presentation held fetal head labor?
A. Rear view of occipital presentation
B. Front view of occipital presentation
C. Front-parietal presentation
D. Frontal presentation
E. Face presentation

173 Child 10 months. Complaints to -39,6oC, liquid excrement. On Day 5: to -38,7oC, limp, pale.
Tongue moist, overlaid with a white bloom.Muffled heart tones. Moderately swollen belly, navel
urchannya in the field, pieces of thin and thick intestines are sensitive during palpation. Emptying
of liquid, 8 times, dark green, smelly, with an admixture of mucus. What preliminary diagnosis?
A. Salmonellosis
B. Dysentery
C. Yersiniosis
D. Rotavirus infection
E. Esherihioz
 174 patients with peptic ulcer disease 12 duodenum called complaining of weakness, shortness of
breath with very little physical exercise, the desire to eat chalk. OBJECTIVE: pale, trophic skin
changes. In the blood: Hb -90 g / l, er .- 3.6 * 1012 / l, CP -0.75, Retyk .- 2%, iron blood - 5,6 mmol /
liter. What complications developed in a patient?
A. Hemolyticanemia
B. B12-anemia foliyevodefitsytna
C. Aplastic anemia
D. Iron deficiency anemia
E. Erythraemia

175 ill 28-year ambulance rushed to the admissions department in the unconscious with
generalized epileptic seizures, repeated in 15 -20 minutes. When transporting a patient twice
introduced, sybazon, magnesia, but the level of consciousness has not recove red. Which
department should provide emergency care?
A. Surgical
B. Reanimation
C. Therapeutic
D. Psychiatric
E. Neurologic

176 For the assessment of health status derived and analyzed a report on the disease, registered
in the public service area (FA 12). What is the rate calculated on the basis of this report?
A. Value of pathological lesions
B. Score hospitalized morbidity
C. General incidence rate
D. Incidence rate for temporary disability
E. Neepidemichnoyi incidence rate of primary

In 177 patients 33 years of acute hemorrhage (er. - 2,2 * 1012 / l, Hb -55 g / l), blood group A (II)
Rh +. He mistakenly held transfusion donor erytromasy AB (IV) Rh +. An hour later there were
anxiety, backache, stomach. Ps -134/hv., AT-100/65 mmHg, body temp erature - 38,6oC.When
bladder catheterization received 12 ml / h urine dark brown. What complication has arisen in the
patient?
A. Acute renal failure
B. Infectious and toxic shock
C. Allergic reaction to donor erytromasu
D. Cardiac shock
E. Citrated intoxication

178 head office wants to hospital expertise of doctors, medical residents and technological
standards of patient care. What he should check the documentation for this purpose?
A. Medical hospital record
B. Maps medical appointments
C. Statistical maps of patients who dropped out of hospital
D. Annual report of health care setting
E. Journal of surgical interventions

179 votes 52 years complaining of attacks of breathlessness, pain in the right botsi during
respiration. Zahvoriv sudden ly. Since history is well known that the last month he likuvavsya about
tromboflebitukintsivky right bottom. In the admission department suddenly lost consciousness, a
choking pain in i botsi. OBJECTIVE: HR -102/hv., CHDR-28/hv., SC, 90/70 mmHg Auscultatory :
focus on tone II pulmonary arteries, gallop over the lungs on the right side under scapula
dribnopuhyrtsevi wheezing, pleural friction noise. What are the most informatyvnym investigation to
establish the diagnosis?
A. ECG
B. Anhiohrafiya pulmonary ves sels
C. Koagulogramma
D. Study of external respiratory function
E. Ehokardioskopiya

180 patients during the month concerned in the right hypochondrium pain, bitterness in mouth,
weakness, weight 12 kg, periodic vomiting with an admixture of bile. Body temperature in the
evening 37,6oC. At sonography: gall bladder 5.5 x2, 7 cm, 0.4 cm wall it, common bile duct - 0,8
cm in diameter. In front of an existing segment of the liver round hipoehohenne formation to 5 cm
in diameter, close to two more similar - by 1.5 cm wall structures to 0,3 cm thick. What is the most
likely diagnosis?
A. Key words: echinococcal liver alveolar
B. Liver cancer
C. Liver abscess
D. Cystic liver cancer
E. Paravezikalni liver abscesses

181 The patient is active, lively, bustl ing. Countering the test.Chatty fast, loud, spontaneous
expression, inconsistent. Identify psychopathologic condition:
A. Katatonichne excitation
B. Psychomotor agitation
C. Behavioral Disorders
D. Paranoid syndrome
E. Delirium

182 patients 38 years old complains of weakness, subfebrylitet, swollen lymph nodes, nasal
bleeding, bone pain. OBJECTIVE: pale skin and mucous membranes, palpating enlarged painless
lymph nodes, sternalhiya, 2 cm liver, spleen 5 cm painless. In the blood : er .- 2.7 * 1012 / l, Hb -84
g / l, Lake .- 58 * 109 / l, e. - 1%, Mrs. - 2%, with 12% .-, limfots. - 83% limfobl .- 2%, cell-
HumprehtaBotkin, ESR-57 mm / hour. What is the most likely diagnosis?
A. Lymphogranulomatosis
B. CML
C. Chronic lymphocytic leukemia
D. Acute miyeloleykoz
E. Acute lymphocytic leukemia

183 to which the blood cells of human immunodeficiency virus has the largest tropnist?
A. T-suppressor
B. Platelets
C. T-killer cells
D. Erythrocytes
E. T-helpers

184 patients 19 years com plained of rashes on the skin, which appeared 2 days ago after the use
of smoked fish. Rash fades in 4 -6 hours, but then appears again. Accompanied by itching.
OBJECTIVE: on the trunk and upper limbs available, numerous blisters the size of peas to beans,
the color pink. What is the most likely diagnosis?
A. Allergic dermatitis
B. Angioneuroticedema
C. Prurigo
D. Acute urticaria
E. Toksykodermiya

185 Female 32's turned to the doctor with complaints of skin lesions trunk, face and limbs after
oral administration biseptolu. Diagnosed drug toksykodermiyi. What treatments are most effective
for patients?
A. Extracorporeal therapy
B. Disintoxication therapy
C. Antihistamine therapy
D. Anti-inflammatory therapy
E. Immunotherapy

186 Men 34 years deliver ed to the neurological department complaining of intense headache,
double vision when looking straight, intolerance of light and noise. Acutely ill, the attack occurred
while lifting heavy weights. OBJECTIVE: stunning, moderate divergent strabismus, diplop ia.
Symptoms Kerniha on both sides.Paresises no.Sanguinolent liquor. Which drug should be first?
A. Aspirin
B. Heparin
C. Epsilon-aminokapronovaya acid
D. Glutamic acid
E. Niacin

187 Patient 25 years express complaints to the slaughter and pain dur ing urination, purulent
discharge from the urethra, which appeared 2 days ago. OBJECTIVE: sponges urethra swollen,
congested, with copious purulent urethral discharge. Previous diagnosis: acute gonorrheal
urethritis fresh. What additional data will help cl arify the clinical examinations diagnosed?
A. Detection kokovyh cells during microscopy selections
B. Microscopy of urethral discharge
C. Detection of yeast cells during microscopy selections
D. Serological testing of blood
E. Total blood

188 Patient 35 years complained of pain and morning stiffness of joints palms of her hands and
temporomandibular joints are longer than 30 minutes. Ill for 2 years. OBJECTIVE: swelling of the
proximal interphalangeal joints of hands and limited movement in them. Wh at research to conduct?
A. The reaction of Baal -Rose
B. Radiography palms of her hands
C. Immunogram
D. Total blood
E. Proteinohrama

189 sick that lasted eats refined foods, complains of headache, fatigue, depression, insomnia,
irritability. OBJECTIV E: muscular asthenia, pain and cramps in the shin muscles in the course
comes on the heel, then on the outer edge of the foot. In the cardiovascular system - tachycardia,
hypoxia, dystrophic changes of the heart muscle. Are noted violations of the alimenta ry canal.
What is the diagnosis can be installed?
A. Hypovitaminosis B15
B. Hypovitaminosis B6
C. Hypovitaminosis B12
D. Hypovitaminosis B2
E. Hypovitaminosis B1

190 young man 20 years turned to the hospital complaining of pain that occurs in the lower third of
the femur during loading and at rest. Injury denies. OBJECTIVE: normal skin color, pastoznist and
pain during deep palpation, reduction of motion in the kn ee joint. On radiograph distal femur - the
zone of destruction and spicule. In the blood: immature cells form, signs of inflammation are
absent. What is the most likely diagnosis?
A. Osteogenic sarcoma
B. Multiple myeloma
C. Hiperparatyreoyidna dystroph y
D. Chronic osteomyelitis
E. Marble bone disease

In the 191 workers who work in the paint shops of textile factories, studied the link between work
experience and content of the blood eosinophils. With a rate most appropriate to analyze these
data?
A. Standardized Score
B. Criterion Student
C. The correlation coefficient
D. The criterion of adequacy
E. Index Marks

192 The patient was 27 years, a history in which bronchial asthma, bee stung. There were feeling
the pressure in the chest, lack of air, difficulty exhaling, feeling the heat in the upper half of body,
dizziness, expressed itching, seizures. OBJECTIVE: noisy breathing, wheezing, SC, 90/60 mm Hg,
Ps-110/hv. Auscultatory: cardiac rhythmic tones, loose and over the lungs - breathing hard, dry
whistling wheezing. Which group of drugs should take priority?
A. Methylxanthine
B. Cardiac glycosides
C. Glucocorticoids
D. Anticonvulsant
E. Analgesics

For 193 clinically healthy baby 5 months, which is on breastfeeding, you must first be
pidhodovuvannya. What food is most appropriate to recommend in this case?
A. 5% Semolina porridge
B. Vegetable purees
C. Friction apple
D. Cookies
E. Yachnyeva porridge

194 In 1-month-old boy with symptoms of agitation and head circumference is 37 cm, size 2x2 cm
large Fontanels zryhuye baby after feeding small portions of milk; emptying normal in composition
and volume. Tonus are ok. What is the most likely diagnosis?
A. Pilorospazm
B. Meningitis
C. Pilorostenoz
D. Kraniostenoz
E. Microcephaly

195 The boy 8 years after 2 weeks after experimental angina were swelling of the face, lower
extremities. OBJECTIVE: serious condition, SC -120/80 mmHg Urine brown. Oliguria. In urine:
relative density - 1.015, protein - 1,2 g / l, erythrocytes - alkiline, covering the entire field of view,
granular cylinders - 1-2 in the u / s, salt - urate (large quantity). What is the most likely diagnosis?
A. Acute glomerulonephritis with isolated urinary syndrome
B. Acute glomerulonephritis with nephrotic syndrome
C. Acute glomerulonephritis with nephrotic syndrome, hematuria and hypertension
D. Nyrkovokam'yana disease
E. Acute glomerulonephritis with nephritic syndrome

196 Women 42 years complained of bruising on his legs and prolonged menstruation, general
weakness, the noise in the head. OBJECTIVE: A large number hemorahiy spotted on the legs and
torso. Tachypnea, tachycardia, systolic murmur at all points. AT -75/50 mmHg In the blood: er . - 1.9
* 1012 / l, Nb-60 g / l, 0.9-MP, Lake .- 6.5 * 109 / l, tr . - 20 * 109 / l, ESR-12 mm / hour. Duration of
bleeding at Duque - 12 minutes. In the bone marrow - a large number of young immature forms
mehakarioblastiv no signs vidshnuruvannya platelets. What is the most likely diagnosis?
A. This thrombocytopenic purpura
B. Hemophilia B
C. Hemophilia A
D. Acute leukemiamehakarioblastnyy
E. Disease Villebranta

197 38 years old during the fall from a height of two meters bumped his head against a metal
object, briefly lost consciousness. Complains of headache, nausea, dizziness, a selection of light
drops from the right nasal fluid move. OBJECTIVE: symptom of "glasses" retrograde amnesia.
Focal neurological symptoms absent. What is the most probable cause nasal likvoreyi?
A. Inflammation of the nasal mucosa
B. Bruising of the brain
C. Liquor hypertension
D. Base of skull fracture
E. Violation of liquor outflow

198 Patients 47 years old complains of fever, general weakness, diffuse dull abdominal pain that
increases bowel movements before and after it subsided. Draining to 10 times a day containing
blood.Ill for 2 months. OBJECTIVE: pale skin is dry. Palpation of the colon is grievous. Cecum
palpated as tyazhu. What is the most informative test for diagnosis?
A. Survey X-ray examination of the abdomen
B. Sigmoidoscopy
C. Colonoscopy
D. Iryhoskopiya
E. Fibrohastroskopiya

199 Male 43 years old, who has contact with etylovanym gasoline, came to the clinic complaining
of general weakness, dizziness, memory impairment, drowsiness during the day and insomnia at
night, the feeling of "Hair" in the mouth, kolkovyy pain in right hypochondrium . What is the most
likely diagnosis?
A. Alcoholic delirium
B. Chronic manganese intoxication
C. Chronic lead intoxication
D. Chronic mercury intoxication
E. Chronic intoxication o f tetraethyl

200 in women 30 years that was sick, flu, found an empty stomach hlikemiya - 11,3 mmol / l
hlyukozuriya - 25 grams per liter. Height 168 cm, weight 67 kg. What is the most informative study
to clarify the diagnosis?
A. Daily fluctuations of glycemia
B. Glucose Tolerance Test
C. Glycemia hour after eating
D. Daily fluctuations glycosuria
E. Fasting insulinemia