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-1, -2, -3 -

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

A 15-year-old girl was examined with a history of * Chest x-ray gradual onset of fever, malaise, loss of weight. There was nothing typical about the kind of fever, 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, inspiratory dyspnea and expectoration of frothy furosemide, and blood-tinged sputum. He had been suffering nitroprusside sodium 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.

Liver or bone marrow biopsy

Tuberculin skin testing Sputum smear and culture of M.tuberculosis

Bronchoscopy

Theophylline, prednisolon

Albuterol, atropine, papaverine

Strophanthine, potassium chloride, plathyphylline

Cordiamine, isoproterenol

An attack of severe substernal pain developed in a *Cardiogenic shock patient at night. On exam: confusion, pallor of the 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 substernal pain on exertion. The prior 2 weeks such pectoris pain had appeared at rest, with increased frequency, and failed to respond to 1 tabl of nitroglycerin. What is the most likely diagnosis?

Acute left-sided heart failure

Acute right-sided heart Radicular syndrome failure

Acute vascular insufficiency

Angina pectoris of a new onset

Myocarditis

Radiculitis

Stable angina pectoris of III functional class

A patient with ischemic heart disease and chronic *Multiple microreentry Enhanced automatic heart failure develops sudden loss of in the ventricles. activity of the consciousness; on exam, cyanosis, the widened ventricles. pupils, peripheral pulse and blood pressure are not 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 fatigue, fever up to 38C, rash on the face skin, antibodies to doublepain in the wrists and the elbows. On physical stranded DNA. 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, lymphopenia; on urinalysis: proteinuria, leukocyturia, casts. What is the main mechanism of disease development?

Disturbances of neurohumoral regulatory systems.

Sick sinus syndrome.

Accelerated diastolic depolarization, a disturbance in electrolyte balance.

Production of antibodies Production of to myocytes. antibodies to endothelial cells.

Production of antibodies to myosin.

Production of antimitochondrial antibodies.

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A man with liver cirrhosis complained of nasal bleedings, right subcostal pain, weakness, nausea. On physical examination: jaundice, hemorrhagic rash, enlarged liver span (of 14 cm), liver edge irregular. What is the cause of hemorrhagic syndrome in this patient? *Decreased liver production of procoagulants.

-1, -2, -3 - As a consequence of DIC. Thrombocytopenia. As a result of portal hypertension. K and C hypovitaminosis.

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A 56-year-old woman has an acute onset of fever *Community-acquired Community-acquired up to 39C with chills, cough, and pain on lobar pneumonia with bronchopneumonia. 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 bronchial asthma. She is sick all the year. She is working in the premises where walls are covered by mould. She has allergy to aspirin, analgin, and acetaminophen. Now she has four asthma attacks 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 dusts (maple and alder-tree) are positive. Order treatment according to the type of asthma and severity of its course *Inhaled beclomethason 100 mcg t.i.d. after previous inhalation of fenoterol. IV theophylline and clarithromycin P.O.

Acute pleurisy.

Acute lung abscess.

Hospital-acquired lobar pneumonia.

Specific Dexamethasone and desensitization with theophylline P.O. dust mites and feathers allergens.

Ephedrine P.O. and inhaled isoproterenol during an attack.

A 44-year-old woman complained of weakness, *Hodgkins disease. subfebrile fever, and pallor of the skin. Physical 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?

Tuberculosis.

Sarkoidosis.

Tumor metastases.

Chronic myelocytic leukemia.

A 40-year-old man complained of headache in occipital area. On physical examination, the skin 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?

*Chronic glomerulonephritis.

Essential arterial hypertension.

Chronic pyelonephritis.

Polycystic disease of the kidneys.

Cushings disease.

A 29-year-old woman is critically ill. The illness *Acute pyelonephritis was manifested by high fever, chills, sweating, aching pain in lumbar area, a discomfort in urination, and frequent voiding. Pasternatskys 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 complaining of stabbing back pain on inspiration pleuritis and dyspnea. On exam, BT of 37C, 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?

Exacerbation pf chronic Acute pyelonephritis glomerulonephritis

Acute cystitis

Nephrolithiasis

Myocarditis

Pneumonia

Acute bronchitis

Pneumothorax

A 58 year-old man complained of pain and *Increased biosynthesis Immune response to swelling of the left foot small joints. The skin over of uric acid streptococcal infection these joints was purple, BT was 38C. For the last 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 development?

Hyperproduction of autoantibodies to collagen

Decreased amount of chondroitin sulfate

Production of antibodies to native DNA

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-1, -2, -3 - A 31-year-old man with past history of rheumatic *Infective endocarditis Rheumatic aortic valve fever was severely ill and complained of fever up disease to 38 39C, 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 spleen, diarrhea, and dark urea. What is the most likely diagnosis? A 14 year old patient. He complains of chest pain, *Rheumatic pancarditis Rheumatic pericarditis temperature 38,5, breathlessness. He had acute 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 +++. Your diagnosis: A 52-year-old patient with previously functional * IHD. Unstable angina Cardialgia due to spine Class angina complains of 5 days of intensified problem 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 shows pathological QS waves in leads VI-V3, I, aVL. Determine the location of old myocardial infarction. * Septal and anterior Anterolateral Typhoid fever Acute viral hepatitis Acute nephritis

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Rheumatic myocarditis

Rheumatic endocarditis Septic endocarditis

IHD. Functional Class Myocarditis angina.

Myocardial dystrophy

Anterior

Inferior

Postrolateral

A 52-year-old patient has hypervolaemic type of * Hypothiazid essential hypertension. Which of the following is necessary to prescribe either as monotherapy, or in a complex with other antihypertensive remedies?

Dibazol

Clophelin

Kapoten

Nifedipin

A 62-year-old patient complains of rest dyspnea, * CHF-2 B 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 0, heart pain, dyspnea. S1 is clapping; S2 is accentuated in the aortic area; opening snap, presystolic murmur are auscultated. What is the most useful investigation for valvular disorder assessment?

CHF- 1

CHF- 2

CHF-0

CHF-3

* Phonocardiography Echocardiography+Do pplerEchocardiography

Ballistocardiogram

Chest x-ray

ECG

Physical examination of a person with chronic * All of them bronchitis reveals expansion of 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?

Low diaphragm

Hyperresonant percussion note

Hyperinflated lungs

Expansion of intercostal spaces

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A patient with nosocomial pneumonia presents signs of collapse. Which of the following pneumonia complications is most likely to be accompanied with collapse? * Septic shock

-1, -2, -3 - Exudative pleuritis Bronchial obstruction Toxic hepatitis Emphysema

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A 45-year-old man for 1 month has complained of *Cancer of the 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 Curvuasiers 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 anticold exposure. She complained of pain in the hand inflammatory drugs and knee joints, morning stiffness, and fever up to 38C. Interphalangeal, metacarpophalangeal and knee joints are swollen, hot, with decreased ranges of motions; ESR of 45 mm/hr, CRP (+++), VaalerRouse 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 attacks of acute arthritis in the 1st left tarsophalangeal joint. Lab exam revealed increased serum level of uric acid. What is the diagnosis?

Gallbladder stones

Chronic pancreatitis

Chronic cholangitis

Chronic hepatitis

Cephalosporines

Tetracyclines

Sulfonamides

Fluorchinolones

Reiters disease

Rheumatoid arthritis

Rheumatic arthritis

Osteoarthritis

A 22-year-old woman complained of right 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

*Chronic viral hepatitis Calculous cholecystitis

Gilberts disease

Acute viral hepatitis

Chronic cholangitis

A 50 -year-old woman for 1 year complained of *Ultrasound attacks of right subcostal pain after fatty meal. Last examination of the week the attacks have repeated every day and gallbladder become more painful. What diagnostic study would you recommend?

Liver function tests

X-ray examination of the gastrointestinal tract

Ultrasound study of the Blood cell count pancreas

A 27 -year-old man complained of aching epigastric pain just after meal, heartburn, and 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.

*Chronic type A gastritis

Chronic type B gastritis Peptic ulcer of the stomach

Chronic type C gastritis Menetriers disease

A 25 -year-old woman complained of edema on *Penicillin OS 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?

Heparin

Ceftriaxone

Dipyridamole

Ciprofloxacine

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-1, -2, -3 - A 25-year-old woman complained of fatigue, hair * Ferrous sulfate orally Iron dextrin injections loss, and brittle nails. On exam, pallor of skin, PR of 94/min, BP of 110/70 mm Hg. On blood cell count, Hb of 90 g/L, RBC 3.51012/L, color index of 0.7, ESR of 20 mm/h. Serum iron level was 8.7 mcmol/L. what treatment would you initiate? Vitamin B12 intramuscularly Blood transfusion Packed RBCs transfusion

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A 38-year-old man worked at roofing and drain *Chest X-ray 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 fo r this diagnosis? The patient has worked 13 years as a bulldozer *Vibration disease driver. He complains of dizziness, headache, finger 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 exposure to lead for 20 years. Total blood count: RBC of 3.51012/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? *Chronic lead intoxication, II stage

Bronchoscopy

Blood gas analysis

Spirography

Electrocardiography

Raynauds disease

Syringomyelia

Atherosclerosis obliterans

Periarteritis nodosa

Chronic lead intoxication, I stage

Porphyria

Hereditary hemolytic anemia

Lead carrier

A fitter of metallurgic factory with occupation *Chronic mercury exposure to high concentrations of mercury fumes intoxication. 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 diagnosis?

Neuroinfection.

Parkinson syndrome.

Acute mercury intoxication.

Mercury encephalopathy.

A 45-year-old coal miner complains of cough with *Anthracosis, nodular, Silicosis, nodular, black sputum, breathlessness on exertion, which slowly progressing slowly progressing occurred 4 years before. On physical examination, 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 branch for 10 years complains of frequent 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 abdominal pain, constipation during last 5 days. He presents a liliac line at the gingival-tooth border, 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? *Noise-induced disease. Hypertension.

Siderosis, interstitial, slowly progressing form, first stage.

Bissinosis, interstitial, slowly progressing form, first stage.

Asbestosis, interstitial, slowly progressing form, first stage.

Atopic bronchial asthma.

Asteno-vegetative syndrome.

Encephalopathy.

*Plumbism, severe form

Mercurialism, severe form

Aluminium intoxication, severe form

Asbestosis, severe form Cyanides poisoning, severe form

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A 45-year-old driver was admitted to the hospital with 5 hour substernal pain. Nitroglycerin is not 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? *Acute myocardial infarction

-1, -2, -3 - Stable angina Pulmonary embolism Acute myocarditis Acute left ventricular failure

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A 38 -year-old woman is seriously ill. She *Bronchial asthma, complains of frequent paroxysms of expiratory status asthmaticus dyspnea. The last paroxysm lasted over 12 hours and failed to respond to theophylline. The skin is 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 angina on exertion, II functional class. What is the sublingually drug of choice in treatment of acute attack? A 19-year-old girl admitted to the hospital *Beta-hemolytic complained of pain in the knee and fever of streptococci. 38.6C. She is ill for 2 weeks after acute tonsillitis. On exam, hyperemia and swelling of both knees, BT of 37.4C, 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 9.8109/L, ESR of 30 mm/L. ECG findings: the rhythm is regular, PQ = 0.24 sec. What is a causative agent of the disease?

Chronic obstructive bronchitis

Atopic bronchial asthma, respiratory failure of the III degree

Bronchiectasis, Ischemic heart disease, respiratory failure of the pulmonary edema II - III degree

Platelet inhibiting agents (aspirin)

Spasmolitics (No-spa) Digitalis IV IV

Sedative agents (Seduxenum) orally

Viral-bacterial association.

Autoimmune disorder. Staphylococci.

Ricchetsia.

A 42-year-old woman complains of dyspnea, 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?

*Mitral stenosis

Mitral regurgitation

Tricuspid stenosis

Tricuspid regurgitation Aortic stenosis

A 33-year-old man with a history of rheumatic *Infectious 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 weight loss, bone and joint pain, and bleeding gums. On exam, paleness, lymphadenopathy, hepato- and splenomegaly. CBC: WBC 270109/L with 13\% lymphocytes, 1\% monocytes, 21\% basophiles, 29\% neutrophils, 9\% blasts, 12\% promyelocytes, 12\% myelocytes, 2\% metamyelocytes, 1\% eosinophils. ESR 22 mm/h. Name the drug for treatment. A 54-year-old woman complains of increasing *Acute leukemia 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?

Rheumatic fever

Acute hepatitis

Acute nephritis

Aortic regurgitation

Prednisolone

Cytosar

Vinblastine

Blood transfusion

Chronic leukemia

Thrombocytopenia

Hemolytic anemia

Megaloblastic anemia

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A 60-year-old woman has increased BP up to 210/110 mm Hg during last 7 years. On exam, heart apex is displaced to the left. There are signs of left ventricular hypertrophy on ECG. What is the most probable diagnosis?

-1, -2, -3 - *Essential Essential hypertension, hypertension, 2nd stage 1st stage Symptomatic hypertension Cardiomyopathy Ischemic heart disease

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A 39 -year-old woman complained of squeezed *Revealing of epigastric pain 1 hour after meal and heartburn. Helicobacter infection She had been ill for 2 years. On palpation, there in gastric mucosa 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 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 fever. His illness started as tonsillitis a month before. On exam, BT of 38.9C, 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 2.21012/L, WBC of 3.0109/L with 32\% of blasts, 1\% of eosinophiles, 3\% of bands, 36\% of segments, 20\% of lymphocytes, and 8\% of monocytes, ESR of 47 mm/h. What is the cause of anemia?

Detection of autoantibodies in the serum

Gastrin level in blood

Examination of stomach Examination of secretion stomach motor function

Acute pyelonephritis

Rheumatic fever

Essential hypertension

Bacterial endocarditis

Chronic lympholeukemia

Aplastic anema

Vitamin B12 deficiency Chronic hemolytic anemia anemia

A 30- year-old patient complains of breathlessness, *Dilated pain in the right rib arc place, dry cough and the cardiomyopathy 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 36.6C, 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, systolic murmur above the apex. What is the preliminary diagnosis? The risk of cancer being the result of radiation doses of 100 Gray or less to the whole body is difficult to estimate reliably. The reasons for this uncertainty are : * All of the below mentioned

Infectious endocarditis

Acute myocarditis

Rheumatic fever, mitral Acute pericarditis stenosis

The high incidence of cancer of the general population

The low risk of cancer The long interval from small doses between radiation and clinical presentation of cancer. Barium enema study IVP

None of the above mentioned

For which of the following diagnostic * None of the below examinations performed with modern techniques mentioned on an unknown pregnant patient should therapeutic abortion be considered the result of putative risk from radiation?

Chest radiography

Abdominal CT

The highest risk of congenital anomalies probably *18-45 days after occurs when human embryos or fetuses are conception exposed to ionizing radiation. During which part of gestational period does it occur?

The first 7 days

10-14 days after conception

90-120 days after conception

The third trimester

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A 38-year-old patient has been treated in a hospital. A fever of 39 C, chest pain which is worsened by breathing, cough, brownish sputum 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 right hypochondrium, itching of the skin. 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 epigastrium which are relieved by food intake. EGDFS shows antral erosive gastritis, biopsy of antral mucous presents Hlicobacter Pylori. Diagnosis is: * Cephalosporins of the generation

-1, -2, -3 - Penicillin Erythromycin Tetracycline Streptomycin

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* Liver cirrhosis

Cancer of the liver

Cancer of the head of pancreas

Gallstones

Viral hepatitis B

* Gastritis of type B

Gastritis of A type

Reflux - gastritis

Menetrier's gastritis

Rigid antral gastritis

A man, aged 25, presents with facial edema, moderate back pains, body temperature of 37,5 , 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:

* Acute glomerulonephritis

Acute pyelonephritis

Cancer of the kidney

Urolithiasis

Chronic glomerulonephritis

A patient had stomach resection a year ago. He complains of general weakness, giddiness. Blood 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 & poikilocytosis. Fe of serum 5 mkmol/L. Diagnosis is: A patient of 62 years with DM-2. Diabetes is being compensated by diet and Maninilum. Ptient has to undergo an operation for inguinal hernia. What should be tactics of hypoglycemic therapy?

* Iron-deficiency anemia

B12-deficiency anemia hronic myeloleukosis

Aplastic anemia

Chronic lymphoid leukosis

* Prescribe the drugs of Give Glurenorm in an insulin of short place of Maninilum. activity

To continue with the current therapy

Prescribe the drugs of insulin of long activity

Prescribe guanyl guanidines

A 33-year-old lady has been suffering from DM * DM 1st type, severe DM 2nd type, severe for 5 years. The last 3 years she has taken more form, decompensation, form, decompensation than 100 units of insulin per day. Body weight has insulin resistant increased up to 10 kg. Fasting blood glucose is 13 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, tremor of extremities. Objective examination: body weight loss, wet & warm skin. The thyroid gland is enlarged up to the 3rd degree, painless, elastic. Pulse: 108. BP- 160\55 mmHg. Everything else is normal. The diagnosis is: * Diffuse toxic goiter of the 3rd degree, thyrotoxicosis of the average degree

DM 1st type, severe form, subcompensation, Somoji phenomenon

DM 2nd type, moderate DM 1st type, severe form, Zabrodi form, decompensation, phenomenon allergic response on insulin

Diffuse euthyroid goiter Chronic autoimmune of the 3rd degree. thyroiditis, hypertrophic type

Chronic fibrous thyroiditis

Toxiferous adenoma of the thyroid gland

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In the development of the inflammation processes 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. * Phospholipase A2

-1, -2, -3 - Arachidonic acid Lipoxygenas Cyclooxygenase 1 Cyclooxygenase 2

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patient is suffering of a chronic heart * Indomethacin 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 the name of this medicine. Which of the following is used for tuberculin diagnosis in the masses PPD-L standard dilution of 2 TU in 0,1 ml

Digoxin

Furosemide

Panangin

Riboxinum

ATK tuberculin

PPD-L diluted in 5 TU in 0,1 ml

Dry pure tuberculin

Tuberculin in the form of ungutum

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 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?

Focal

Disseminated

Miliary

Fibro-cavernous

Tuberculoma

A woman 26 years old has abused alcohol for 7 years. She has psychological dependence on alcohol, but no withdrawal syndrome. Drinks almost every day approximately 50 100 gr. of wine. Is at her 4-th week of pregnancy. Primary prevention of fetal alcohol syndrome requires:

* Treatment of alcoholism and full abstinance from alcohol during all the period of pregnancy

Medical abortion

Decrease of alcohol use

Participation in the AANON group

Gyneacological observation

Interpret GTT. Glycemia: I trial 5,3 mMol/l, II trial 8,2 mMol/l, III trial 4,8 mMol/l

*Normal

Impairment of carbohydrate tolerance

Diabetes mellitus

Necessary to repeat test Necessary to order additional laboratory tests.

What points, concerning myxedema coma are correct ?

* Hypothermia is common

Feeling warm may provoke myxedema coma

Cause is increased sensitivity to T 3 and T4 receptors.

Hyperfunction of adrenal glands

Thyroid cancer

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Developing of gigantism is conditioned by: *Overwhelming secretion of GH in adolescence

-1, -2, -3 - Overwhelming secretion Overwhelming of GH in old age secretion of GH in adults Overwhelming secretion of somatostatin in adolescence Inborn sensitivity lack in tissues to GH

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Choose factors, which can cause Addisons disease *Tuberculosis

Tumor acting on adrenal Autoimmune hormone destruction of thyroid gland

Diabetes Mellitus

Brain tumor

To remove onset of tetany you will order

*Calcium chloride

Benzylpenicillin

Prednisolone

Potassium citrate

Magnesium sulphate

Macroangiopathy, as a symptom of diabetes mellitus, most often destroy vessels of:

*Brain

Lung

Kidneys

Retina

Intestine

The treatment of Graves disease usually include

*Antagonists of thyroid Antidepressants hormones

Narcotic analgesics

Diuretics

Sulfonylureas

Choose the correct initial interaction of a photon * Interaction of the with an atom in a biological system leading to cell photon with a damage subatomic particle. For x-ray imaging radiation this will be an electron.

Production of an energetic changed particle usually a photo or recoil electron.

Dissipation of the Chemical changes in energy of the electron the ionizing / excited along its path by molecules. ionization and excitation.

None of the above mentioned

Which of the following statements concerning undifferentiated cells in tissues is correct?

* They are sensitive to They are very resistant radiation but easily to radiation replaced when killed

They are sensitive to They are sensitive to Cells that survive can't radiation and most are radiation and difficult to go on to form a tumor killed by doses in the replace if killed. diagnostic range

Which of the following symptoms would occur only if a total-body acute radiation exposure exceeded 5.000 rad (50 Gy)

* Hallucinations and impairment of vision

Nausea and Vomiting

Diarrhea

Bleeding Gums

Epilation (hair loss)

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A total body dose of 200 rad will cause the hematopoietic syndrome. The time for maximum hematological recovery will be : * 180 Days 30 days

-1, -2, -3 - 60 days 120 days 240 days

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Patient N., 27 years old was hospitalized to the psychiatric hospital for the 4-th time during 2 years. Heard voices commenting on his actions, 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 of schizophrenia requires: Patient K, male, 19 years old, has suffered moderate mental retardation since childhood. Is illiterate, can take care of himself, do simple household work and other kinds of easy work under supervision. His rehabilitation [tertiary prevention] requires:

* Supportive treatment Long-term with neuroleptics of hospitalization prolonged action

Psychiatric observation

Participation in a selfhelp group

Psychoanalytic treatment

* All the above mentioned

Supervision of a social worker

Physical work under supervision

Supervision of relations None of the above [ if any] mentioned

Patient F., male, 16 years old was behind other * Chromosome children in development since early childhood and abnormality still has moderate mental retardation. He is short, 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?

Gene abnormality

Maternal alcohol abuse during pregnancy

Pathological delivery

Infection in mother during pregnancy

Patient A., male, 27 years old came to consult a * Severe stress psychiatrist with the following complaints: after a 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 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 stood quite still with the painting brush in his hand. This state lasted for a few seconds. After that the patent was rather confused, for some moments he couldnt 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 patients movements are retarded, * Catatonic stupor, she answers no questions. Sometimes she shizophrenia 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:

Adjustment disorder

Environmental factors Patients personality features

Endogenic factors

Frontal lobes

Pituitary

Hippocampus

Corpus callosum

Grand mal, epilepsy

Jacksonian fit, epilepsy

Disphoria, epilepsy

Twilight state, epilepsy

Depressive stupor, bipolar disorder

Apathetic stupor, shizophrenia

Psychogenic stupor, stress disorder

Dissociative stupor, dissociative psychosis

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Patient T., female, 35 years old, suffers from epileptic fits since she was 15 years old. She has 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? * All the above mentioned

-1, -2, -3 - Individual approach Gradual beginning Continuous long-term treatment None of the above mentioned

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What auscultative data are watched in bronchoectatic disease?

* The clinical picture depends on full or empty bronchiectasia and on caliber of bronchus.

Bronchial breathing.

Amphoric breathing.

Dry whistling rales.

Moist fine bubbling rales [nonconsonating].

What from enumerated syndromes is main in acute * Syndrome of mucodiffuse bronchitis ? ciliary insufficiency.

Syndrome of bronchial obstruction.

Syndrome of respiratory insufficiency.

Syndrome of pulmonary Syndrome of tissues insufficiency. pulmonary tissues augmented aerisation.

The primary bronchopneumonia more often arises * Complication of as acute bronchitis.

Complication of pneumorrhagia.

Complication of Complication of infarct Complication of stagnation of blood in of the lungs. pneumoconiosis. the lungs.

What auscultative data of the lungs does in lobar pneumonia exist at stage of hepatization ?

* Bronchial breathing. Crepitation.

Moist consonating rales.

Moist non-consonating Increased vesicular rales. breathing.

What is the basic of crepitation ?

* The separation of Existence of Existence of a cavern alveoli during bronchiectasis filled by containing liquid and inspiration on walls of pus. air. which the fibrin has put.

Stenosis of a clear space Friction of the of bronchus. inflamed pleural layers during respiration.

Sputum full mouth [is more often in morning time] is characteristic for:

* Bronchoectatic disease.

Pulmonary tuberculosis. Focal pneumonia.

Acute bronchitis.

Empyema of pleura.

What is auscultated in syndrome of infiltration of pulmonary tissue ?

* Pathological bronchial breathing.

Intensified vesicular breathing.

Decreased vesicular breathing, dry rales.

Harsh.

Amphoric breathing.

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When can pulmonary bleeding arise ? * Bronchoectatic disease.

-1, -2, -3 - Diffuse catarrhal bronchitis. Bronchiolitis. Lobar pneumonia in a stage of red hepatization. Bronchopneumonia.

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What auscultative phenomenon arises at beginning * Harsh. of acute bronchitis ?

Moist fine bubbling rales.

Crepitation.

Moist medium bubbling Vesiculo-bronchial rales. breathing.

Symptoms of the effected pallidar system do not include?

*Hemibalism

Plastic hypertension

Bradikinesia

Hipomimia

Micrografy

What of the mentioned symptoms isn't characteristic of poliomyelitis?

*Disturbance of sensitiveness

Hypotension

Hyporeflexia

Hypotrophy

Torpid distal paralysis

Name the symptom of stretching of the ishiatic nerve?

*Lasseg's

Lessage's

Brudzinsky's

Kernig's

Vasserman's

Name the nuclei of the cranial nerves which are affected Weber's alternating syndrome?

*Oculomotor

Accessory

Glossopharyngeal

Vagus

Hypoglossal

Neuralgia of the trigeminal nerve is characterized by?

*Transient pain on the Permanent pain in the face and trigger areas area of innervation

Loss of sensitivity on the face

Trophical disturbances of cornea and loss of corneal reflex

Positives effect from sponging by 5\% solution of cocaine on the posterior surface of the mucosa of the middle turbinate bone Affection of mimic muscles of half of the face

Central paresis of the mimic muscles is characterized by:

* Affection of mimic muscles of the lower half of the face?

Affection of masticatory Prolapse of papillary group of muscles reflex

Trophic disorders

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The patient H., aged 36,works as a nightman * An acute during 12 years.He applied with complaints of the intoxication headache, loss of appetite, syncopal conditions, 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 defined in a patient Y., a nightman. What form of anemia is characteristic in this disease? * Haemolytic anemia

-1, -2, -3 - Chronic arsenious intoxication from pesticides An acute poisoning by Carbone bisulfide OPS intoxication Leaden intoxication

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Aplastic anemia

Iron deficiency anemia Hyper sideric anemia

Normochromic anemia

The man, aged 42, applied to the therapeutist with * Silicosis 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-boxnote sound in the lower parts, on auscultation- a harsh breathing. There were no changes in the heart. Possible diagnosis?

Tuberculosis of lungs

Silicatosis

Bronchiectatic disease

Chronic bronchitis

A sick man M., aged 52, a street cleaner. He was ill * Alkaline inhalations Broncholitics with pneumoconiosis during 2 years. Its nessesary to recommened for the treatment of this disease:

Oil inhalations

Sulfonilamides

Antibiotics

The woman, aged 42, works at the factory on the *Unithiol fabrication of mercury thermometers, complains 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. sowing,was admitted to the infectious hospital with Treatment: atropine the clinical symptoms: miosis,labored breathing,sweating.What kind of poisoning is it and what is the first aid?

Pentoxil

Magnesium sulphate

Sodium hydrate of carbon

Seduxen

Poisoning by lead. Treatment: tetacine Calcii

Poisoning by the methylic alcohol. Treatment: ethylic alcohol

Poisoning by vapours of Seduxen mercury. Treatment:unithiol

A woman of 36 years is on the 12-th week of the *Monitory of the Interruption of the first pregnancy. We know from the history that she specific Ig G Ig M with pregnancy was treated for infertility. She was in the guests the ELISA and contacted with child who developed rubella in 2 days after meeting. Woman doesnt know if she has ever been infected with rubella. What is the adequate tactics? Patient L., 50-year old, has been admitted to the clinics with atrophic gastritis. In the blood test: 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 *B-12-deficiency anemia Irondeficiency anemia

Immune globulin injection

Cyclovin administration Interferon administration

Hemolytic anemia

Post-hemoragic anemia Thalassaemia

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A 32-year old woman developed the Laiels syndrome after taking the biceptol. What immunotrope remedies are indicated in this situation? *Steroid immunodepressants

-1, -2, -3 - Non-specific immune modulators Specific immune modulators Interferons Non-steroid immunedepressants

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The disease began acutely. The frequent watery *Cholera stool developed 6 hours ago. The bodys 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 day of the disease with complaints of double vision 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 ., of 28 years old, was *Typhoid fever. admitted to the clinic with complaints of the temperature increase up to 39,0(, 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?

Toxic food-borne infection

Salmonellosis

Dysentery

Typhoid fever

Yersiniosis

Leptospirosis

Salmonellosis, gastrointestinal form

Lambliasis

Leptospirosis.

Brucellosis.

Sepsis.

Malaria.

The patient was admitted to the hospital on the 7th *Leptospirosis 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 encephlopathy beginning of the disease was gradual: nausea, vomiting, dark urine, cholic 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 patients condition worsened? The patient, 18-years-old was admitted to the *Infectious hospital with complaints of headache, weakness, mononucleosis. 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 *Epidemic typhus hospitalized with preliminary diagnosis "influenza". Roseolous-petechial rash appeared on the 5th days of disease on the trunk. The temperature is 41(. Hyperemia of the face, reddening of scleras, tremor of the tongue, tachycardia, splenomegaly are marked. What is the most probable diagnosis ?

Yersiniosis

Salmonellosis

Brucellosis

Trichinellosis

Meningitis

Relapse of viral hepatitis

Cholangitis

Infectious-toxic shock

Acute lymphoid leukosis.

Diphtheria.

Angina.

Adenoviral infection.

Measles

Alcohol delirium

Leptospirosis

Typhoid fever

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The patient, 43-years-old was admitted to the 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 ? *Anthrax

-1, -2, -3 - Carcinoma of skin Erysipelas Erysipeloid Eczema

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In the patient of 21 years old the disease *Meningococcal infection: purulent began with increase of temperature to meningitis. 39,0(, headache, chill, repeated 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. What is the most probable disease? The theory of self regulation of epidemiological process by V.D. Belyakov includes all mentioned bellow except * Localization of the parasite in the host organism and the ways of discharging of the parasite into the environment

Meningococcal infection: serous meningitis

Secondary purulent meningitis.

Serous meningitis.

Infectious mononucleosis.

Geno- and phenotypic heterogeneity of the populations of a parasite and host

Mutability of the biological properties of the parasite and the host populations

The phase The regulation role of selfreorganisation of the social and natural parasite populations and conditions in the phase a host reorganization of the epidemiological process The viroscopic method The serological method

The diagnosis of the AIDS epidemic initially was made in the USA by means of

* The epidemiological The bacteriological method method

The virological method

The contagious hypothesis by D. Frocastro and D. * The alive germs, Samoylovich being considered as a causative agent which are transmitted of infectious diseases from one person to another

The environmental factors

The miasma of cosmotelluric origin

The pathological discharges of an organism

Invasion of the body by the evil spirits

A 70yr. Old alcoholic male with poor *Amoxycillin dental 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 aptopril,digoxin and furosemide.The dentist decides that his medical history warrants prophylactic antibiotic therapy prior to the procedure and prescribes:of A 20 yr old woman with a 3-4 month history *Ulcerative colitis bloody diarrhoea; stool examination negative for 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 terefenadine develops an upper respiratory tract problem.He receives an antibiotic and develops a cardiac arrhythmia.What was the likely antibiotic?

Vancomycin

Tetracycline

Co-trimoxazole

Imipenem

Gastroenteritis

Carcinoid syndrome

Zollinger-Ellison syndrome

Granulomatous colitis

Ampicillin

Cefactor

Doxycycline

Co-trimoxazole

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A 75yr. Old man who had developed diabetes *Carcinoma of the within the last six months was found to be head of the pancreas 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. Most likely diagnosis: A 16yr. Old female presents with abdominal pain *Henoch Schonlein and purpuric spots on the skin. Laboratory purpura investigations reveals a normal platelet count,with haematuria and proteinuria.The most likely diagnosis:

-1, -2, -3 - Infectious hepatitis Haemolytic jaundice Malignant biliary stricture Metastatic disease of liver

KrokTest.org.ua-----

Haemolytic uraemic syndrome

Thrombotic thrombocytopenic purpura

Heavy metal poisoning Sub acute bacterial endocarditis

A 60yr. Old asthmatic man comes for a check up 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 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:

*Doxazosin

Labetalol

Phetolamine

Propranolol

Isoproterenol

*Zinc

Copper

Selenium

Chromium

Manganese

A 47 year old man presents to his physician with *Chronic Pancreatitis progressive abdominal swelling.On examination he is found to have ascites and a tender,enlarged 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 fails to respond to heparin, nitroglycerin, beta bypass grafting adrenegic blockers and calcium channel antagonist. The best management includes:

Tuberculosis

Cirrhosis with hepatocellular carcinoma

Hepatitis

Alcoholic liver disease with cirrhosis

Intravenous strptokinase Excercise testing

Oral aspirin

Antihypertensive therapy

A 42yr. Old patient suffering from alcoholism has *Insufficient protien advanced liver disease with ascites. He is ingestion 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 of upper gastrointestinal haemorrhage. He had 2 hypergastrinaemia by prior ulcer operation. Zollinger-Ellison syndrome secretin given IV is suspected. All the following would support your suspicions EXCEPT:

Bleeding esophageal

Excessive diuretic therapy

Non compliance with lactulose therapy

Spontaneous bacterial peritonitis

A fasting gastrin level of 450pg/ml.

Post operative notes Liver metastasis on CT A history of diarrhoea detailling ulcers in the scan duodenum and jejunum

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A 60yr. Old woman, mother of 6 children, *Choledocholithiasis developed sudden onset of upper abdominal pain 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 recurrent pneumonias and a chronic cough production of foul smelling, pirulentsputum, 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 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. there was diagnosed the 1 stage of hypertension. How many times during the year it is necessary to examine him?

-1, -2, -3 - Benign biliary stricture Malibnant biliary stricture Carcinoma of the head of the pancreas Choledochal cyst

KrokTest.org.ua-----

Chronic bronchitis

Disseminated pulmonary tuberculosis

Pulmonary neoplasm

Chronic obstructive emphysema

In a first

In a fourth

In a third

In a fifth

Once.

3 times.

4 times.

5 times.

11 Patient K.,52 years old, has sustained an acute * 1.07.2001. 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?

1.03.2001.

1.04.2001.

1.05.2001.

1.06.2001.

16 The family doctor diagnosed in a patient an *The urgent acute bleeding of an intestine. What is professional hospitalisation in tactics of the doctor in this situation? sergical departmewnt.

To inject intravenously The urgent the aminocapronic acid. hospitalization in therapeutic department.

A day time hospital.

A hospital at home.

In the structure of death rate in Ukraine the major place is taken by the diseases of?

*Diseases of cirkulatory sistem.

Oncological disease.

Disease of digesstive sysstem.

Disease of respiratory system.

Disease of urinary and endocrine systems.

68 The doctor of the city cardiological center *200/110-240/120 solves the problem of the patient after the discharge from a hospital to the balneal department of sanatorium:who cannot be routed?

140/90-160/100

90/60-120/80

160/90-180/90

180/110-90/60

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Woman age 40,ill on rheumatic disease with *Mitral composite mitral disease with prevalence of the comissurotomia. 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\%. 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?

-1, -2, -3 - Conduction of current bicilino-prophilaxis. Assiging of anticoagulants. Assiging of venous vasodilatators .

KrokTest.org.ua-----

6-9\%.

10-14\%.

15-20\%.

35-50\%.

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

Izardin.

Corazolum.

Morphinum hydrochloride..

Strophanthin hydrochloride .

Patient K., laboratory-assistant-radiograph; the amount of Gamma-radiation per day is 0,65 R. Two years later with 60 Co while examining 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

* Chronic radiation disease of the second degree of severity

Chronic radiation disease of the third degree of severity.

Acute radiation sickness of moderate degree

Acute radiation sickness Acute radiation of light degree sickness of severe degree

In checking the results of patient?s spinal tap, the CSF glucose level of 1,65 mmol/l with apparently cloudy CSF, is typical of:

*Meningococcal meningitis

Meningism

Cerebral trauma

Viral meningitis

Tuberculous meningitis

A 26-year-old manual worker complained of 3 *HIV infection weeks history of fevers and fatigue, weight loss 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 on the lips. Candidosis of concerning What *The initial lesion in Each of the following statements oral cavity. features of anthrax is correct EXCEPT cutaneous anthrax consists of the black eschar, surrounding erythema and painful pitting edema

Influenza

Rubella

Infectious mononucleosis

Tuberculosis

Inhalation anthrax results from the alveolar deposition of airborne particles contaminated with spores of B. anthracis.

Cutaneous anthrax, The drug of choice in untreated, results in cutaneous anthrax is death in 10\% to 20\% penicillin. of cases

The preferred serodiagnostic test for anthrax is ELISA

A 27-year old patient with malaria caused by P. *Chloroquine resistant Glucose-6-phosphate falciparum was treated with Chloroquine (600 mg strain of P. falciparum dehydrogenase base followed by 300 mg base in 6 hours, then 300 deficiency in patient 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?

Late recognition of infection due to P. falciparum

Inappropriate route of administration

Hypersensitivity of the patient to Chloroquine

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Ten hours before initial observation patient C. had *Intravenous frequent feces and vomiting. Fecal and vomiting rehydration masses became like rice-water. Nausea and abdominal pain werent 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. What treating measureswith the *Intestinal A sick person M. is staying in the hospital should 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 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. Temperature 38.2 degrees of C. * Isoniazid + A 25-year-old man was admitted with 2 months of cough and fever. A chest x-ray showed extensive rifampicin + left upper lobe disease with a 2 cm cavity. All 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:

-1, -2, -3 - Antibiotic therapy Cardiac glycosides Disintoxicational therapy Antibotulistic serum injection

KrokTest.org.ua-----

Thrombophlebitis

Meningitis

Nephroso-nephritis

Hepatite

Dysentery

Cholera

Food toxic infection

Enterovirus infection

Streptomycin + isoniazid

Isoniazid + ethambutol Kanamycin + ethambutol + pyrazinamide

P-aminosalicylic acid + streptomycin

A 5-year-old boy was progressively getting more * Hilar or paratracheal Atelectasis with unwell than during the previous 2 months. A chest lymph node obstructive pneumonia x-ray had shown right middle lobe collapse. A enlargement tuberculin skin test had been strongly positive. What is the most characteristic finding in primary tuberculosis?

Cavity formation

Miliary tuberculosis

Hematogenous dissemination leading to extrapulmonary tuberculosis

A 50-year-old man was examined in the clinic with * Optic neuritis persistant cavitation and sputum. He was treated with rifampicin, isoniazid, ethambuthol. The most common toxic effect of ethambutol is:

Eighth cranial nerve damage

Hepatic enzyme elevation

Peripheral neuropathy

Mental symptoms

To reduce the number of adult infection cases in the population it is much more important to:

* Give good treatment BCG vaccination to all sputum positive patients

Tuberculin skin testing Health education campaigns on tuberculosis

Chest x-ray screening

The father had been admitted to hospital with 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:

* Isoniazid

Rifampicin

Streptomycin

Ethionamide

Cycloserine

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-1, -2, -3 - Under what circumstances can preventive therapy * High risk close People with chest x-ray Low-income groups be given to people who have a negative tuberculin contacts (young findings with poor access to test reaction? children, HIV-infected health care persons) People who inject illicit People with symptoms drugs of pulmonary disease

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