Krok Medicine-2010 icon

Krok Medicine-2010

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Krok 2. Medicine-2010

1 A heat station working on solid fuel is located in a residential district. On cloudy foggy days in december there was an increase in diseases with upper airway affection and signs of general intoxication. There were also mortal cases among the elderly peopl E. What is the most likely factor that provoked toxic effect?

A. High air humidity

B. Low air temperature C. Temperature gradient D. Calm

E. Suspended materials

2 Over a current year among workers of an institution 10% haven't been ill a single time, 30% have been ill once, 15% - twice, 5% - 4 times, the rest - 5 and more times. What is the percentage of workers relating to the I health group?

A. 10% B. 60% C. 40% D. 55% E. 22%

3 A 25-year-old woman came to a maternity welfare clinic and complained about being unable to conceive within 3 years of regular sexual lif E. Examination revealed weight gain, male pattern of hair distribution on the pubis, excessive pilosis of thighs. Ovaries were dense and enlarged, basal temperature was monophas E. What is the most likely diagnosis?

^ A. Sclerocystosis of ovaries

B. Gonadal dysgenesis

C. Adrenogenital syndrome D. Premenstrual syndrome E. Tubo-ovaritis

4 A patient was delivered to the admission ward 40 minutes after a minor trauma with complaints of pain in the thoracic spin E. He has a history of pulmonary tuberculosis. Roentgenography results: suspected compression fracture of the VIII and IX thoracic vertebra E. What pathological process in spine might have stimulated pathological fracture of vertebral bodies?

^ A. Syphilis

B. Osteomyelitis

C. Malignant tumour metastasis

D. Tuberculous spondylitis

E. Traumatic fracture

5 2 days ago a patient presented with acute pain in the left half of chest, gneral weakness, fever and headach E. Objectively: between the 4 and 5 rib on the left the skin is erythematous, there are multiple groups of vesicles 2-4 mm in diameter filled with transparent liqui D. What diease are these symptoms typical for?

^ A. Herpes zoster

B. Herpetiform Duhring's dermatosis

C. Herpes simplex

D. Streptococcal impetigo

E. Pemphigus

6 350 workers of a mettalurgical plant had to undergo a yearly preventive examination. A territorial polyclinic carried out preventive examination of 325 workers. As a result of it, 1 worker was recognized as temporarily disabled, 15 workers underwent further rehabilitation at an after-work sanatorium, 10 workers were provided with diet meal. What index characterizing the preventive work of the polyclinic should be applied in this case?

^ A. Percentage of people who were provided with diet meal

B. Frequency of case detection during examinations

C. Coverage of preventive medical examinations

D. Percentage of temporarily disabled people

E. Percentage of people who underwent rehabilitation at an after-work sanatorium

7 A 3-year-old male patient consulted a family doctor 2 months after he had been operated for an open fracture of brachial bon E. Objectively: the patient's condition is satisfactory, in the region of the operative wound there is a fistula with some purulent discharge, redness, fluctuation. X-ray picture shows brachial bone destruction with sequestr A. What complication arose in the postoperative period?

^ A. Posttraumatic osteomyelitis

B. Posttraumatic phlegmon

C. Suture sinus

D. Hematogenic osteomyelitis

E. Wound abscess

8 A patient suffering from gastroesophageal reflux has taken from time to time a certain drug that "reduces acidity" over 5 years. This drug was recommended by a pharmaceutist. The following side effects are observed: osteoporosis, muscle asthenia, indisposition. What drug has such following effects?

^ A. Gastrozepin

B. Inhibitor of proton pump

C. H2-blocker

D. Aluminium-bearing antacid

E. Metoclopramide

9 A children's health camp received a party of tinned foo D. External examination of the tins revealed that they had deep dents; formed a concavity when pressed and didn't immediately return to the initial state; rust was absent; the tins were greased with inedible fat. Specify the bloat type:

A. Physical B. Biological C. Chemical

D. Physicochemical

E. Combined

10 A 52-year-old patient works as a secretary and has 30 year record of servic E. She complains of spasms in her right hand during working and inability to type and writ E. Up to 80% of her work involves hand loa D. The patient has been presenting with these symptoms for 2 years. Objectively: the right hand is tense, there is an increase in muscle

tone, attempts to write cause spasms. Examination revealed no pathological changes of

CNS. What is the most likely diagnosis? ^ A. Spastic form of coordination neurosis B. Paretic form of coordination neurosis C. Hysteric neurosis

D. Chronic manganese intoxication

E. Neuralgic form of coordination neurosis

11 1 day ago a 19-year old male patient got a trauma after a fall from 1,5 m height when he "bestrode" a wooden beam. Urination is extremely difficult, there is macrohematuria, urethrorrhagi A. There is a hematoma in the perineum and on the scrotum. Urethrography revealed flowing of contrast medium into the membranous part of urethr A. What is the treatment tactics of choice?

^ A. Cold to the perineum, hemostatic therapy

B. Primary suturing of urethra

C. Urethra bougienage

D. Epicystostomy

E. Urine bladder catheterization for urine diversion

12 A 60-year-old female patient was admitted to a hospital for acute transmural infarction. An hour ago the patient's contition got wors E. She developed progressing dyspnea, dry cough. Respiratory rate - 30/min, heart rate - 130/min, AP- 90/60 mm Hg. Heart sounds are muffled, diastolic shock on the pulmonary artery. There are medium moist rales in the lower parts of lungs on the right and on the left. Body temperature -

36,4oC. What drug should be given in the first place?

^ A. Aminophylline

B. Heparin

C. Dopamine D. Promedol E. Digoxin

13 A 16-year-old boy was admitted to the hospital for the reason of intractable nasal haemorrhage and intolerable pain in the right cubital articulation. Objectively: the affected articulation is enlarged and exhibits defiguration and skin hyperaemi A. There are manifestations of arthropathy in the other articulations. Ps- 90 bpm; colour index -

1,0, WBC - 5,6*109/l, thrombocytes- 220*109/l, ESR - 6 mm/h. Lee-White coagulation time: start - 24', finish - 27'10''. What drug will be the most effective for this patient treatment?

^ A. Vicasol

B. Erythromass

C. Calcium chloride

D. Cryoprecipitate

E. Aminocapronic acid

14 On the next day after being taken by influenza a 46-year-old woman presented with intensified headache, dizziness, nause A. Objectively: the patient is conscious, psychomotor excitement is present; there is general hyperesthesia, moderate meningeal syndrome, nystagmus. Tendon teflexes are higher on the right, right extremities display muscle weakness, right-sided pathological Babinski's sign is present. Liquor is transparent, pressure is 220 mm of water column; cytosis is 46/3 with prevailing lymphocytes. What is the most likely diagnosis?

^ A. Subarachnoidal haemorrhage

B. Ischemic stroke

C. Bacterial meningoencephalitis

D. Parenchymatous subarachnoidal haemorrhage

E. Influenzal meningoencephalitis

15 A 28-year-old parturient complains about headache, vision impairment, psychic inhibition. Objectively: AP- 200/110 mm Hg, evident edemata of legs and anterior abdominal wall. Fetus head is in the area of small pelvis. Fetal heartbeats is clear, rhythmic, 190/min. Internal examination revealed complete cervical dilatation, fetus head was in the area of small pelvis. What tactics of labor management should be chosen?

^ A. Cesarean

B. Conservative labor management with episiotomy

C. Stimulation of labor activity

D. Embryotomy

E. Forceps operation

16 A 40-year-old patient underwent an operation for a lumbar phlegmon. Body temparature rose again up to 38oC, he got intoxication symptoms, there was an increase of leukocyte number in bloo D. The wound that was nearly free from necrotic tissues and full of granulations started to discharge pus, the granulations turned pal E. What complication dveloped in this patient?

^ A. Erysipeloid

B. Allergic reaction

C. Erysipelas

D. Putrid phlegmon

E. Sepsis

17 A 3-year-old child has been admitted to a hospital because of ostealgia and body temperature rise up to 39oC. Objectively: the patient is in grave condition, unable to stand for ostealgia, there is apparent intoxication, lymph nodesare enlarged up to 1,5 cm. Liver can be palpated 3 cm below the costal margin, spleen - 2 cm below the costal margin. In blood: RBCs - 3,0*1012/l, Hb- 87 g/l, colour index - 0,9, thrombocytes –

190*109/l, WBCs - 3,2*109/l, eosinophils - 1, stab neutrophils - 1, segmented neutrophils - 0, lymphocytes - 87, monocytes - 2, ESR - 36 mm/h. What examination should be conducted in order to specify the diagnosis?

^ A. Ultrasound

B. Computer tomography

C. Sternal puncture

D. Lymph node biopsy

E. Lymph node puncture

18 On the 5th day after labor body temperature of a 24-year-old parturient suddenly rose up to 38,7oC. She complains about weakness, headache, abdominal pain, irritability. Objectively: AP- 120/70 mm Hg, Ps- 92 bpm, to- 38,7oC. Bimanual examination revealed that the uterus was enlarged up to 12 weeks of pregnancy, it was dense, slightly painful on palpation. Cervical canal lets in 2 transverse fingers, discharges are moderate, turbid, with foul smell. In blood: skeocytosis, lymphopenia, ESR - 30 mm/h. What is the most likely diagnosis?

^ A. Metrophlebitis

B. Lochiometra

C. Endometritis

D. Pelviperitonitis

E. Parametritis

19 A 40-year-old patient complains of colic pains in the lower abdomen and profuse bloody discharges from the genital tracts. Over the last 2 years she has been having menses for 15-16 days, profuse, with clots, painful. In anamnesis there are 2 medical abortions. On bimanual investigation: in the canal of the uterine cervix some fibromatous nodes are palpable, they are 3 cm in diameter, on the thin crus. Discharges are bloody, moderat E. Choose the correct treatment tactics:

^ A. Hormonal hemostasis

B. Supravaginal ablation of the uterus without appendages

C. Hysterectomy without appendages D. Operation: untwisting of the nodes E. Step-by-step vitamin therapy

20 A 30-year-old woman with a long history of chronic pyelonephritis complains about considerable weakness, sleepiness, decrease in diuresis down to 100 ml per day. AP-

200/120 mm Hg. In blood: creatinine - 0,62 millimole/l, hypoproteinemia, albumines -

32 g/l, potassium - 6,8 millimole/l, hypochromic anemia, increased ESR. What is the first step in the patient treatment tactics?

A. Haemodialysis B. Enterosorption C. Haemosorption

D. Antibacterial therapy

E. Blood transfusion

21 Statistic of patients of common medical practice displays constant increase in elderly and old people number. What kind of pathology is expected to prevail in the morbidity structure of population in question?

^ A. Non-epidemic pathology B. Occupational pathology C. Infectious pathology

D. Acute pathology

E. Chronic pathology

22 A 9-year-old boy has been suffering from bronchoectasis since he was 3. Exacerbations occur quite often, 3-4 times a year. Conservative therapy results in short periods of remission. The disease is progressing, the child has physical retardation. The child's skin is pale, acrocyanotic, he has "watch glass" nail deformation. Bronchography revealed saccular bronchiectases of the lower lobe of his right lung. What is the further treatment tactics?

^ A. Further conservative therapy

B. Surgical treatment

C. Physiotherapeutic treatment

D. Tempering of the child's organism

E. Sanatorium-and-spa treatment

23 A 32-year-old patient consulted a doctor about being inable to get pregnant for 5-6 years. 5 ago the primipregnancy ended in artificial abortion. After the vaginal examination and USI the patient was diagnosed with endometrioid cyst of the right ovary. What is the optimal treatment method?

^ A. Sanatorium-and-spa treatment

B. Conservative therapy with estrogen-gestagenic drugs

C. Anti-inflammatory therapy

D. Surgical laparoscopy

E. Hormonal therapy with androgenic hormones

24 A 47-year-old patient complains about cough with purulent sputum, pain in the lower part of the left chest, periodical body temperature ris E. She has been suffering from these presentations for about 10 years. Objectively: "drumstick" distal phalanges. What examination would be the most informative for making a diagnosis?

^ A. Bronchoscopy

B. Survey radiograph of lungs

C. Pleural puncture

D. Bacteriological analysis of sputum

E. Bronchography

25 An emergency team has delivered to a hospital an unconscious patient found lying in the street in winter. Objectively: the patient is pale, with superficial respiration; bradycardia with heartrate 54/min, to- 35,0oC. AP- 100/60 mm Hg. Palpation of chest

and abdomen revealed no peritoneal symptoms. There is a smell of alcohol from the patient's mouth. What is the most likely diagnosis?

A. -

B. Acute cardiovascular insufficiency

^ C. Hypothermia

D. Apparent death

E. Frostbite of trunk and extremities

26 A 28-year-old patient was delivered to the admission ward in the unconscious state with generalized epileptic attacks taking place every 15-20 minutes. During transportation the patient was given two injections of diazepam, magnesia sulphate, but they failed to bring the patient to consciousness. What department should render emergency aid?

^ A. Neurological department B. Therapeutic department C. Psychiatric department

D. Resuscitation department

E. Surgcal department

27 A baby was born at 36 weeks of gestation. Delivery was normal, by natural way. The baby has a large cephalohematom A. The results of blood count are: Hb- 120g/l, Er- 3,5*1012/l, total serum bilirubin - 123 mmol/l, direct bilirubin - 11 mmol/l, indirect -

112 mmol/l. What are causes of hyperbilirubinemia in this case?

^ A. Disturbance of the conjugative function of liver

B. Bile condensing

C. Mechanical obstruction of the bile outflow

D. Intravascular hemolysis

E. Erythrocyte hemolysis

28 A 36-year-old alcoholic patient has cirrhosis and pancreatic insufficiency due to recurrent pancreatitis. He complains of night blindness, decreased ability to taste food, and dry skin with hyperpigmentation. These complaints suggest deficiency of:

^ A. Zinc

B. Copper

C. Chromium D. Manganese E. Selenium

29 On the second day after preventive vaccination a 2-year-old boy presented with abdominal pain without clear localization, body temperature rose up to 38oC. On the third day the child got red papular haemorrhagic eruption on the extensor surfaces of limbs and around the joints. Knee joints were edematic and slightly painful. Examination of other organs and systems revealed no pathological changes. What is the most likely diagnosis?

^ A. Meningococcemia

B. Thrombocytopenic purpura

C. Urticaria

D. Haemorrhagic vasculitis

E. DIC syndrome

30 A 49-year-old patient undergoes regular medical check-up for uterine fibromyom A. Within the last year the uterus has enlarged up to 20 weeks of gestation. What is the rational way of treatment?

^ A. Hormonal therapy

B. Embolization of uterine arteries

C. Treatment with prostaglandin inhibitors

D. Surgical treatment

E. Further surveillance

31 A worker who undergoes regular medical check-up for duodenal ulcer received a subsidized 24-day sanatorium voucher from his plant. The term of annual leave of a worker is 24 calender days, it will take 4 days more to get to the sanatorium and back hom E. What is the procedure of obtaining a 4-day sick-leave?

^ A. Medical Expert Commission issues a 28-day sick list

B. The doctor in charge issues a health certificate and sanatorium patient's file for 28 days

C. The doctor in charge issues a 4-day sick list

D. Medical Expert Commission issues a 4-day health certificate

^ E. Medical Expert Commission issues a 4-day sick list

32 Surgical department admitted a 37-year-old patient with a big crushed wound of his left thigh 4 hours after he got this traum A. What is the main provision for successful prevention of gaseous gangrene?

^ A. Injection of specific serum 30 000 U

B. Infiltration of soft tissues around the wound with antibiotic solution

C. Removal of necrotic tissues and timely surgical processing of the wound

D. Injection of specific serum 3 000 U

^ E. Wound lavage with 6% solution of hydrogen peroxide

33 A 60-year-old patient complains about asphyxia, palpitation, rapid fatiguability. He has 8 year history of essential hypertension. Objectively: the left cardiac border is 2 cm deviated to the left from the medioclavicular line, heart sounds are rhythmic and weak; there is diastolic shock above aort A. AP- 170/100 mm Hg. Liver - +2 cm; shin pastosity is present. ECG shows deviation of cardiac axis to the left, left ventricle hypertrophy. Ejection fraction - 63%. What type of cardiac insufficiency is observed?

A. It's a norm B. Unspecified C. Systolic

D. Combined

E. Diastolic

34 A 65-year-old patient complains about pain in the lumbar spine, moderate disuri A. He has been suffering from these presentations for about half a year. Prostate volume is

45 cm3 (there are hypoechogenic nodes in both lobes, capsule invasion). Prostate- specific antigen is 60 ng/l. Prostate biopsy revealed an adenocarcinom A. Which of the supplemental examination methods will allow to determine the stage of neoplastic process in this patient?

^ A. Roentgenography of chest

B. Excretory urography

C. Computer tomography of pelvis

D. Roentgenography of lumbar spine

E. Bone scintigraphy

35 A 47-year-old obese man complained of periodic attacks of acute arthritis in the st left tarsophalangeal joint. Lab exam revealed increased serum rate of uric aci D. What is the diagnosis?

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Krok Medicine-2010 iconKrok 1 Medicine 2004
В2 is administered. The synthesis disorder of which enzymes does this medicine cause in microorganisms?
Krok Medicine-2010 iconKrok 1 Medicine 2004
В2 is administered. The synthesis disorder of which enzymes does this medicine cause in microorganisms?
Krok Medicine-2010 iconKrok 1 Medicine 2004
В2 is administered. The synthesis disorder of which enzymes does this medicine cause in microorganisms?
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