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Examination bank of test tasks Krok 2 General medical preparation




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Examination bank of test tasks

Krok 2 General medical preparation

Therapeutic type. 1.7. Radiation medicine.

2002-2006

16367 the Clinical blood test: red corpuscles - 2,3*1012/l, haemoglobin - 80 g/l, coloured index - 0,9, Thrombocytes - 30*109/l, Leucocytes -0,8x109/l. A count is impossible due to low elements level, single cells which limfocity and monocity are. What period of ARS do these indexes testify to?

A. *Final stage of period of clinical manifestation

B. Latent period of severe ARS.

C. Period of primary general reaction after the high dose of irradiation

D. Recovery period

E. Moderate chronic radiation sickness

17418 Patient 45 years complains about paroxismal cough, tickling feeling in the throat. It was in the area of contamination after a failure on Chernobl NPP during 10 days. Rhinoscopy: signs of considerable irritation of nasopharingeal mucous. What radioactive nuclide can irritate of mucous membrane?

A. Radio-active iodine

B. Radio-active caesium

C. Radio-active strontium

D. Radio-active plutonium

E. Radio-active cobalt

17621 A worker was exposed to the general irradiation during a hour in a dose about 8 Gr. Which Is the preliminary diagnosis?

A. Acute radiation sickness, marrow form, severe degree

B. Acute radiation sickness, toxic form

C. Acute radiation sickness, cerebral form

D. Acute radiation sickness, intestinal form.

E. Acute radiation sickness, marrow form, easy degree

18932 Serviceman 30 years was irradiated at one-time in a dose 15 Gr. Complaints appeared about squeezing headache, fervescence to 380C, nausea, two-time vomiting. What form of acute radiation sickness will develop at this man?

A. *Intestinal

B. Marrow

C. Toxic

D. Cerebral

E. -

19044 Patient was irradiated with general gamma-radiation. On 14 day it is marked in peripheral blood: WBC 3,0 x109/l, RBC 3,4x1012/l and BP 80x109 /l. What is cause of these changes?

A. *Depression of haemopoiesis

B. Reducing terms of hematocytes life

C. Hypersplenism

D. Increase of differentiation terms of cells

E. Hemophilia

19409 Patient Yu, liquidator of failure ChernoblNPP, there is suspicion in the presence of pulmonary pathology. What method of inspection is optimal for this patient?

A. *X-ray

B. Fluorography

C. Roentgenoscopy

D. CT

E. MRI

19956 Patient 40 years old was admitted to a hospital after a general external irradiation in a dose of 36 cGy. Patient was inspected during 8 days. According to clinical, laboratory and instrumental data the patient’s condition in a norm. Can you expect the development of acute radiation defeat in the future?

A. *No.

B. Yes, during the first month.

C. Yes, during two months.

D. Yes, during 6 months.

E. Yes, during 1 year.

19957 Patient T. 33 years, speciality – roentgen laboratory assistant, complains of nasal and gingival bleeding, general weakness, periodic nausea and vomiting, which related to the ingestion of spice food, epigastric pain. These complaints arose up about 3 weeks ago. Objective inspection - a stomach is sensible at a palpation in an area of epigastrium. A tongue is covered with white incrustation. Other changes it is not discovered. In a blood test: RBC - 3.1*1012/l, Hb - 99 g/l, color index 0.95, WBC - 4,0*109/l, AP 150/90 mm Me. What radiation defeat can be suspected from resulted data?

A. *Chronic radiation sickness, 1-st stage

B. Acute radiation sickness, 1 stage

C. Agranulocytosis

D. Intestinal form of acute radiation sickness.

E. Radial gastroenteritis.

20230 Man 35 years, participant of liquidation of failure on NPP, consulted a doctor in 1 hour after a failure with complaints about permanent headache, dizziness, general weakness, frequent vomiting. Objective status: skin and visible mucous membranes are low-grade hyperemic, body temperature is 38,70C. Datum of individual dosimeter is 5 Gy. What diagnoses is most credible?

A. *Acute radiation sickness of severe degree

B. Acute radiation sickness of terminal degree

C. Acute radiation sickness of moderate degree

D. Acute radiation sickness of mild degree

E. Acute radial reaction

20343 Man, 38 years old, works in an area of action of ionizing radiation. Have no any complaints. Blood test: RBC 4,5*1012/L, Hb -80 g/l, WBC 2,8*109/L, BP 30*109/L. Is it possible to admit this patient to work with the sources of ionizing radiations?

A. *Contraindicated the work with radionuclides and other sources of ionizing radiations.

B. Admitted to work with radionuclides.

C. Can work only with the radionuclides of low activity.

D. Admitted to work after the extended medical inspection.

E. Admitted to work with radionuclides with limitation of burn-time.

20344 Patient 40 years consulted a doctor with complaints on tickling feeling in the throat, paroxysmal cough, general weakness, rapid fatigability at the physical activity. Worked as the liquidator of Chernobyl NPP accident on 14 calendar days. What radionuclide did this clinical symptoms lead to?

A. *Radioactive iodine.

B. Radio-active plutonium.

C. Radio-active caesium.

D. Radio-active tritium.

E. Radio-active cobalt.

20345 Patient 30 years after an irradiation in a dose 1,2 Gy, nausea occurred in 3 hours, there was the single vomiting. Complaints about rapid fatigability at the physical activity, distraction, palpitation, general weakness. What is preliminary diagnosis?

A. *Acute radiation sickness from the external irradiation, mild degree.

B. Acute radiation sickness, moderate degree.

C. Radiation sickness from the incorporated radio nuclides.

D. Chronic radiation sickness, mold degree.

E. Chronic radiation sickness, moderate degree

20346 Doctor-radiologist, professional standing 10 years, consulted by dermatologist with complaints about tingle and itch of palmar skin, lost of fingertips’ sensitivity. All of these complaints considerably diminish in the period of vacation. Objectively: a skin is dry, peels, low-elastic, the picture of skin is smoothed out. What is the most reliable diagnosis?

A. *Radial dermatitis.

B. Allergodermia.

C. System scleriasis.

D. Stand dermatitis.

E. Toksikoalergichniy dermatitis.

20445 Worker of NPP is 36 years was admitted in 1 hour after a radiation accident with complaints about the multiple vomiting, considerable weakness, dizziness, chill. At examination: skin’s hyperemia, injection of sklera and mucous membranes, temperature - 38,30C, HR - 120/min., AP 90/60 mm Me. Blood test: WBC - 9,5*109/l. according to preliminary data of dosimetry the dose of irradiation is 8 Gy. What is the most credible diagnosis?

A. * ARS marrow form, terminal degree.

B. ARS marrow form.

C. ARS intestinal form.

D. ARS toxemic form.

E. ARS cerebral form.

20448 Child 7 years was evacuated from territory on 2 days which was muddy with radionuclides as a result of NPP accident. What critical organ will get a maximal dose of irradiation?

A. * Thyroid.

B. Marrow.

C. Gonads.

D. Liver.

E. Kidneys.

20770 What individual dosimeters will be used by the rescue group for control of exposure dose of gamma-radiation during the work on polluted territory with radionuclidess?

A. *DCS-50 A

B. DS-70 MP

C. MDCR

D. DS-5B

E. DS-64

20772 What device will be used by the radiation rescue group for measuring of radioactive contamination level on polluted territory after NPP accident?

A. *DS-5B

^ B. MPKHR.

C. VPKHR.

D. DP-24.

E. IDES-1.

21095 The persons (40 years old, electrician) moved from radioactive polluted territory (area of the absolute obligatory settling out) to Kiev. In consideration of unfavorable factors of production environment do the recommendations for job placement.

A. *Factory on making of radio components

B. Factory of chemical fibre

C. Bituminous concrete factory

D. Chemical pharmaceutical factory

E. Factory of leatherettes and film materials

21179 The functional disorder of liver and gall-bladder was occurred at liquidator of ChNPP accident in a year after the working in area of high radiation contamination. What method of research is most rational in this case ?

A. *US

B. Roentgenoscopy of stomach

C. Cholecystography

D. CT

E. MRI

22550 *Man 28 years, an operator of power supply system during a NPP accident was on the workplace. As a result of steam-and-air explosion approximately 30 kg of radio-active iodine-31 were thrown out in an atmosphere. Which radioprotector is the most effective in this case?

A. *Iodine potassium

B. Cystaminum

C. Valine

D. Leucinum

E. Tiomochevina

22828 NPP worker 36 years old in 1 hour after a radiation accident was admitted with complaints about the multiple vomiting, considerable weakness, dizziness, chill. At examination: dermahemia, injection of skler and mucous membranes, body temperature - 38,30C, HR - 120/min., AP 90/60 mm Me. In a blood test: WBC - 9,5x109/l. The preliminary data of dosimetry - 8 Gy. What is most credible diagnosis?

A. * ARS marrow form, severe degree.

B. ARS marrow form, moderate degree

C. ARS intestinal form.

D. ARS toxemic form.

E. ARS cerebral form.

22829 the Duty NPP operator 35 years after a radiation accident was hospitalized with complaints about vomiting which arose up in 1,5 hour after an irradiation, weakness, moderate headache, dizziness. At examination: insignificant dermahemia, body temperature - 37,40C, HR - 92/min., AP 110/60 mm Me. Individual dosimetr indication is 2,4 Gy. What is most credible diagnosis?

A. * ARS: marrow form of moderate degree

B. ARS: marrow form of mild degree

C. ARS: marrow form of severe degree

D. ARS: marrow form of terminal degree

E. ARS: intestinal form

22830 NPP Employee was single-time irradiated in a dose 3 Gy as a result of radiation accident. In 20 minutes was hospitalized with suspicion on ARS without clinical symptoms. How many time after exposure is it possible to expect the origin of vomiting at this patient?

A. * in 1 - 2 hours.

B. in 5 - 30 minutes.

C. in 30 - 60 minutes.

D. in 2 - 3 hours.

E. Vomiting will not arise up quite.

22831 Patient of 42 years was hospitalized with the diagnosis of ARS: marrow form, severe degree. In what term after an irradiation is it necessary to expect the appearance of agranulocytosis at this patient?

A. *from 8 to 20 days.

B. from 3 to 5 days.

C. from 6 to 8 days.

D. from 20 to 28 days.

E. from 28 to 33 days.

22832 Child 7 years was evacuated in 2 days from territory which was polluted by radionuclides as a result of NPP accident. What organ will get the maximal dose of irradiation?

A. Thyroid.

B. Marrow.

C. Gonades.

D. Liver.

E. Kidneys.

22992 At patient that was irradiated in a dose 3 Gy of general gamma-irradiation. The diminishing in peripheral blood of uniform elements was detected in 2 weeks after exposure. What is the cause of blood elements diminishing?

A. *Depression of haemopoiesis

B. Reducing terms of hematocytes life

C. Growing up of cellular elements death in peripheral blood.

D. The increase the maturation terms of cellular elements.

E. The delay of form elements in a marrow.


The patient B 47 years old, liquidator of ChNPP accident consequences. Diagnosis: acute radiation sickness, severe degree (1986), period of remote consequences, equivalent dose 420 cSv . The complaints about weight in area of right subcostal area, periodical nausea which increases after violation of diet were disturbed during the last 1,5 years. During the last 3 months nose-bleeds take a place on a background of high blood pressure, which last to 30-40 minutes. Also marks the protracted bleeding after the intramuscular injections and traumas (cuts, other). Objective evidence: ordinary color of skin, sclera is subicteric. US: found the moderate increasing of liver; sizes of spleen are a top limit of norm. Blood test: plate celll - 174x109/l, general albumen 57 g/l, AST - 56 mmol/l, ALT - 68 mmol/l, general bilirubin 34, 5 mmol/l, direct bilirubin - 7,8 mmol/l. Duration of bleeding time byr Dyuke is 13 minutes, protrombin index - 63%, recalcification plasma time - 140“, Fibrinogenum B - absents. What addition is needed to the diagnosis?

Incoagulability of the second origin

Trombocitopatiya.

DIC syndrome, phase of incoagulability.

Second hemorragic syndrome.

Symptomatic trombocitopeniya.

Patient 59 years old liquidator of NPP accident consequences in 1986, equivalent dose of irradiation of 21,5 cSv. Complains of the periodic bleeding from a rectum during the last 4 years, dryness of skin, a psilosis, fragility of nails, desires are raw dough, groats. Objectively: skin covers - ochre, visible mucous membranes are pale. The sizes of liver and spleen are not megascopic. Blood test – RBC - 4,1x1012/l, Hb - 74 g/l, WBC -5,6x109/l, BP – 178x109/l, eos -2, stab neutr-3, segm. -65, lymph -28, mon - 2, ESR - 5 mm/hour. Level of serum iron - 5,9 mmol/l. Rectoscopy: discovered 2 haemorrhoids knot by sizes 2 and 3 cm. What is the most credible diagnosis?

Posthemorrhagic anaemia.

Anaemia as a result of thrombocytopenia.

Symptomatic anaemia.

Hypochromic anaemia.

Normochromic anaemia.

Patient, 73 years old liquidator of NPP accident consequences in 1986, equivalent dose of irradiation 18,5 cSv. During the last six months the patient marks growing of general weakness, shortnesses of breath, hyperhidrosis (mainly at night), loss the body mass on 14 kg, worsenings of appetite. Blood test: RBC- 3,2x1012 /l, Hb - 58 g/l, WBC -11,2x109/l, BP – 64x109/l, stab neutr-1, segm -12, lymph-87, ESR - 22 mm/hour. Due to an anaemic syndrome the transfusion of one-group concentrated red cells was performed in a volume 320,0 ml. In 20 minutes after transfusion patient began to complain of feeling retrosternal pressure, pains in overhead third of stomach and lumbal area, dyspnoea. Objective evidence: the excited, shortness of breath, body temperature - 38,70C, wet skin. AP 140/90 mm Me, HR – 92/min. Tones of heart soundings, rhythmic, Patient condition improved after intravenous stream injection of Dexamethazonum (16 mg), Dimedrolum 1% - 1,0 ml, anaciny 50% - 4,0 ml and paracetamol 500 mg, the temperature of body had gone down to 37,40C, a fever and shortness of breath disappeared, moderate pains are saved in lumbal area, general weakness. Urine test in 1 hour - bilious pigments ++. What is the most probable diagnosis?

Posttransfusion reaction.

Symptomatic globulinemic reaction.

Second toxemia

Anaphylactic reaction.

Hemotransfusion syndrome.


A patient was exposed to the radiation irradiation as a result of failure on AES. Complains about a general weakness, frequent nose-bleeds, formation of bruises, shortness of breath. It is often ill respirator diseases. In blood: Hb-56 of g/l, E-1,1kh1012/l, T-30kh109/l, L-1,5kh109/l, e-0%, p-0%, s-30%, l-64%, m-6%, SOE-58ìì/÷àñ. What treatment most expediently in this case?

Transfusion of mass of red corpuscles

Etamsylatum

Antibiotics

Whole blood transfusion

Transfusion of trombokoncentratu

416

What method of dosimetria ionizing a radiation does allow more precisely to define eaten up a dose at postradavshego?

*Citogeneticheskiy.

Photographic.

Stintillation.

Colorimetery.

Chemical.

417

After a failure on Chernobyl'skoy AES the grown man inhabitants of sufferings districts with the purpose of prophylaxis of finding of radio-active iodine-131 in a thyroid accepted iodine potassium in a dose:

*0,25

0,04

0,125

0,4

0,5

418

At the working 4th block of CHAES in 3 hours a general weakness, nausea and single vomiting, appeared after a failure. Rapid fatigueability was after days marked at the physical loading, decline of capacity for the concentration of attention. you will define the degree of weight of acute radiation sickness.

*Easy.

Middle.

Heavy.

As heavy as lead.

Fatal outcome.

419

In postradavshego, that got a dose general gamut-irradiation in 3 Gr diminishing in peripheral blood of its uniform elements is marked in 2 weeks. What it vizvano?

*Oppressing of cellular krovetvoreniya.

By reduction of terms of life of formennikh elements of peripheral blood.

By growth of death of cellular elements of peripheral blood.

By the increase of terms of ripening of cellular elements.

By the delay of formennikh elements in marrow.

420

The limit of dose of irradiation makes for a population (mSv/year):

*1,0

0,5

1,5

2,0

2,5

677

Postradavshiy, 42 years, was exposed to influence of ionizing radiation. There is a general weakness, nausea and frequent vomiting. Sclerotica of giperemirovany. It is not exposed in the internalss of pathological changes. In a blood test on 2 days after an irradiation: E-4,3*1012, Nv-135 of g/l, c.p.-0,8, tr.-200*109, L-20,1*109 e-3%, p-6%, s-80%, l-3%, m-8%, retikulocitov -7%, SOE-24 mm/hour. Hemodiastase - 200 mg/ml/chas. What criterion is given by possibility to suspect a radiation defeat in this patient?

* Hypolymphemia

Frequent vomiting

Clasmocytoma

Leykocitoz

Indexes of hemodiastase

678

Because of external gamma-oblucheniya of all of organism (the eaten up a dose 3,5 Gr) acute radiation sickness developed for postradavshego. What tactic of conduct of this patient at the end of latent period?

* Biseptolum-480

Transfuziya of leykocitarnoy mass

Transfuziya of trombocitarnoy mass

Antivomitive facilities

Transplantation of marrow


Patient of T., 39 years, participant of liquidation of consequences of failure on CHAES in 1988, equivalent dose of irradiation of 13 szv. During the last two years marks propensity to the frequent cold diseases - 5-6 times per a year, by the increase of neck and subinguinal lymphatic knots. At an objective inspection: skin covers and visible mucous membranes of ordinary color, teperatura bodies within the limits of norm, megascopic peripheral lymphatic knots pal'piruyutsya (neck - to 0,6 - 0,8 see, arm-pits - to 0,4-1,0 see, inguinal - to 0,2-0,3 see). In the cavities of mouth - moderate increase of amygdales. The lower edge of liver pal'piruetsya on 2 see below than contour of right podreber'ya, spleen - not pal'piruetsya. In a peripheral blood test - eritrocity- 4,3 Kh10 12 /l, NV-124 of g/l, leucocytes -6,4 kh 109 /l, thrombocytes - 228,0 kh 109 /l, e-1, p-4, s-47, lf-46, mcode - 2, SOE - 5 mm/year. At an inspection in the presence of antibodies to to toksoplazm a result is negative, at sowing of whey of blood it is not discovered growth of microbal flora.

Limfoadenopatiya.

Absolute lymphocytosis.

Limfadenit.

Relative lymphocytosis.

Infectious mononukleoz.

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