Krok Medicine-2011 icon

Krok Medicine-2011

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Krok 2. Medicine-2011

1 A children's health camp received a party of tinned food. External examination of the tins revealed that they had deep dents, could be easily concaved when pressed and wouldn't immediately return to the initial state; rust was absent; the tins were greased with inedible fat. Specify the bloat type:

A. Physical

B. Physicochemical

C. Combined

D. Biological

E. Chemical

2 During a surgery on a 30-year-old patient a dark ileo-ileal conglomerate was discovered, the intussusceptum intestine was considered to be unviable. The intussuscipiens intestine was dilated to 7-8 cm, swollen, full of intestinal contents and gases. What pathology led to the surgery?

A. Strangulation obstruction

B. Obturation obstruction

C. Paralytic obstruction

D. Spastic obstruction

E. Invagination (combined) obstruction

3 A primigravida is 22 years ol d. She has Rh(-), her husband has Rh(+). Antibodies to Rh weren't found at 32 weeks of pregnancy. Redetermination of antibodies to Rh didn't reveal them at 35 weeks of pregnancy as well. How often should the antibodies be determined hereafter?

A. Montly

B. Once in three weeks

C. Once in two weeks

D. There is no need in further checks

E. Once a week

4 A 7-year-old boy has been managed for a month. Immediately after hospitalization there were apparent edemata, proteinuria - 7,1 g/l, daily urine protein - 4,2 g. Biochemical blood test shows persistent hypoproteinemia (43,2 g/l), hypercholesterolemia (9,2 millimole/l). The patient is most likely have the following type of glomerulonephritis:

A. Hematuric

B. Nephritic

C. Nephrotic

D. Combined

E. Isolated urinary

5 On the 2nd day after a surgery for toxic mixed goiter IV a 35-year-old patient complains of heart pain. ECG shows prolonged QT intervals. Chvostek's and Trousseau symptoms cannot be clearly defined. The patient is provisionally diagnosed with latent tetany. What study will allow to confirm the diagnosis?

^ A. Determination of thyroid hormones

B. Determination of sodium

C. Determination of thyrotropic hormone

D. Determination of potassim

E. Determination of blood calcium and phosphor

6 In autumn a 25-year-old patient developed stomach ache arising 1,5-2 hours after having meals and at night. He complains of pyrosis and constipation. The pain is getting worse after consuming spicy, salty and sour food, it can be relieved by means of soda and hot-water bag. The patient has been suffering from this disease for a year. Objectively: furred moist tongue. Abdomen palpation reveals epigastrial pain on the right, resistance of abdominal muscles in the same region. What is the most likely diagnosis?

A. Duodenal ulcer

B. Diaphragmatic hernia

C. Stomach ulcer

D. Chronic cholecystitis

E. Chronic pancreatitis

7 A 42-year-old female patient suffers from micronodular cryptogenic cirrhosis. Over the last week her condition has deteriorated: there appeared convulsions, mental confusion, increased jaundice. What study may explain such aggravation?

^ A. Determination of cholesterol ethers

B. Determination of serum ammonia

C. Determination of alkaline phosphatase rate

D. Determination of ALAT and ASAT

E. Determination of alpha-phetoprotein rate

8 A parturient woman is 23 years old. Vaginal obstetric examination reveals full cervical dilatation. There is no fetal bladder. Fetal head is in the plane of pelvic outlet. Sagittal suture is in mesatipellic pelvis, anterior fontanel is closer to pubes. The fetal head diameter in such presentation will be:

^ A. Suboccipito-bregmaticus

B. Suboccipitio-frontalis

C. Biparietal

D. Fronto-occipitalis recta

E. Mento-occipitalis

9 A 49-year-old patient complains of dyspnea, cough. There are no sputum discharges. He has repeatedly used salbutamol and intal but with no effect. Objectively: he is only able to sit while leaning on the table. Cyanosis of face, acrocyanosis are present. Breathing is shallow, laboured, in some parts it cannot be auscultated; there are diffuse rales, expiration is significantly prolonged. Heart sounds are muffled, tachycardia is present. Ps - 112/min., AP - 110/70 mm Hg. Liver is located near the costal arch. There are no peripheral edemat a. What is your provisional diagnosis?

^ A. Status asthmaticus

B. Cardiac asthma

C. Chronic obstructive bronchitis

D. Bronchiale asthma, moderate gravity

E. Foreign object aspiration

10 A patient who had eaten mushrooms in the morning was delivered to the infectious diseases hospital at night. The disease development was rapi d. The patient presented with stomach pain, frequent diarrhea, intractable vomiting, burning thirst, headache and dizziness. He died on the third day. What mushrooms are most likely to have caused mycetismus?

A. Russules

B. Morels

C. Deadly amanita

D. Fly agarics

E. Sulfur-tufts

11 The institutions which take part in carrying out medical examinations can be prevention and treatment facilities, medical board of Ministry of Defense, medical board of Ministry of Home Affairs, medico-social expert commissions, forensic medical boards etc. What institutions are responsible for temporary disability examination?

^ A. Medical boards of Ministry of Defense

B. Prevention and treatment facilities

C. Medical boards of Ministry of Home Affairs

D. Medico-social expert commissions

E. Sanitary-and-prophylactic institutions

12 A 26-year-old patient with left lower lobe pneumonia experiences an acute chest pain on the left during coughing. Objectively: diffuse cyanosis, widening of the left half of chest. Percussion reveals high tympanitis. Auscultation reveals no respiratory murmurs above the left half of chest. There is a deviation of the right cardiac border towards the midclavicular lin e. What examination will be the most informative?

A. X-Ray

B. Spirography

C. Bronchography

D. Pneumotachometry

E. Bronchoscopy

13 A 54-year-old female patient consulted a gynaecologist about bloody discharges from the vagina for 1 month. Last menstruation was 5 years ago. Gynaecological examination revealed no pathological changes. What is the tactics of choice?

A. Cytosmear

B. Colposcopy

C. Symptomatic therapy

D. Diagnostic fractional curettage of uterine cavity


14 A child was born at a gestational age of 34 weeks in grave condition. The leading symptoms were respiratory distress symptoms, namely sonorous and prolonged expiration, involving additional muscles into respiratory process. The Silverman score at birth was 0 points, in 3 hours it was 3 points with clinical findings. Which diagnostic study will allow to diagnose the form of pneumopathy?

A. Immunoassay

B. Proteinogram

C. X-ray of chest

D. Determination of blood gas composition

E. Clinical blood test

15 It is required to analyze the level of daylight illumination in a ward of therapeutics unit. What device should be applied to estimate the level of daylight illumination?

A. Anemometer

B. Illuminometer

C. Actinometer

D. Psychrometer

E. Katathermometer

16 A 38-year-old male patient has been taking alcohol for 3 years. 3 days after a regular drinking period he felt anxiety and fear. It appeared to him that he was surrounded by spiders and worms, pursued by some "condemnatory voices". His behaviour became aggressiv e. The patient demonstrated correct self-awareness but impairment of temporal and spatial orientation. What is the most likely diagnosis?

^ A. Delirium alcoholicum

B. Pathologic intoxication

C. Alcoholic encephalopathy

D. Alcoholic hallucinosis

E. Alcoholic paranoia

17 A pregnant woman was delivered to the gynecological unit with complaints of pain in the lower abdomen and insignificant bloody discharges from the genital tracts for 3 hours. Last menstruation was 3 months ago. Vaginal examination showed that body of womb was in the 10th week of gestation, a fingertip could be inserted into the external orifice of uterus, bloody discharges were insignificant. USI showed small vesicles in the uterine cavity. What is the most likely diagnosis?

^ A. Threat of spontaneous abortion

B. Grape mole

C. Abortion in progress

D. Incipient abortion

E. Incomplete abortion

18 A 58-year-old patient complains about sensation of numbness, sudden paleness of II-IV fingers, muscle rigidness, intermittent pulse. The patient presents also with polyarthralgia, dysphagia, constipations. The patient's face is masklike, solid edema of hands is present. The heart is enlarged; auscultation revealed dry rales in lungs. In blood: ESR - 20 mm/h, crude protein - 85/l, -globulines - 25%. What is the most likely diagnosis?

^ A. Systemic lupus erythematosus

B. Dermatomyositis

C. Raynaud's disease

D. Systemic scleroderma

E. Rheumatoid arthritis

19 A 40-year-old patient, the forester, complains of severe headache, body temperature rise up to 39,5oC, trembling limbs. From the patient's history we know that he had seriously cut his hand during the dissection of a killed fox. Objectively: depressed mood. The patient asks not to turn on the light or open the door. Any noise causes apparent motor excitation. When he saw a carafe of water, he developed convulsive throat spasms. What tactics should an emergency doctor choose?

^ A. Deliver the patient to the infectious disease hospital

B. Deliver the patient to the neurological department

C. Let him stay at home and consult a psychiatrist

D. Deliver the patient to the psychiatric hospital

^ E. Deliver the patient to the resuscitation department

20 While asessing the health status of graduates of a secondary school, the doctor found one of them to have grade 3 tonsillar hypertrophy, chronic rhinitis and vegetative-vascular dystonia. The organism functionality is reduced. This student belongs to the following health group:


B. V

C. I



21 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. Hormonal therapy with androgenic hormones

B. Anti-inflammatory therapy

C. Conservative therapy with estrogen-gestagenic drugs

D. Sanatorium-and-spa treatment

E. Surgical laparoscopy

22 A patient is being prepared for the operation on account of varix dilatation of lower extremities veins. Examination of the patient's soles revealed flour-like desquamation along the skin folds. All the toenails are greyish-yellow, thickened and partially decayed. What dermatosis should be suspected?

A. Microsporia

B. Candidosis

C. Pityriasis versicolor

D. Microbial eczema

E. Rubromycosis

23 A 3-year-old child has been taken to a pediatrician. He has no recent history of any diseases. Objective examination revealed no pathology of the internal organs. The child needs the routine immunization against the following disease:

^ A. Type B hepatitis

B. Measles, rubella, parotitis

C. Diphtheria and tetanus

D. Poliomyelitis

E. Pertussis

24 While staying in a stuffy room a 19-year-old emotionally labile girl developed severe weakness, dizziness, blackout, nausea and loss of consciousness without convulsions. Objectively: the patient is unconscious, the skin is pale, extremities are col d. AP - 90/60 mm Hg, Ps- 96/min, deficient, breathing is shallow. Pupillary and tendon reflexes are present. There are no pathological signs. What is the most likely diagnosis?

A. Syncope

B. Epileptic attack

C. Transient ischemic attack

D. Hysterical neurosis

E. Vegetovascular paroxysm

25 A factory worker has ARD complicated by acute bronchitis. He receives treatment in the outpatient setting. The attending doctor has issued him a medical certificate for 5 days and then extended its duration by 5 more days. Patient can't get down to work because of his health status. Who should extend the duration of medical certificate for this patient?

^ A. Deputy medical superintendent in charge of temporary disability examination

B. Medical advisory commission

C. Medical superintendent

D. A department chief

E. Deputy medical superintendent in charge of medical treatment

26 Head circumference of a 1-month-old boy with signs of excitement is 37 cm, prefontanel is 2x2 cm large. After feeding the child regurgitates small portions of milk; stool is normal in respect of its volume and composition. Muscle tonus is within norm. What is the most likely diagnosis?

A. Meningitis

B. Pylorospasm

C. Pylorostenosis

D. Craniostenosis

E. Microcephaly

27 A 32-year-old male patient has been suffering from pain in the sacrum and coxofemoral joints, painfulness and stiffness in the lumbar spine for a year. ESR - 56 mm/h. Roentgenography revealed symptoms of bilateral sacroileitis. The patient is the carrier of HLA B27 antigen. What is the most likely diagnosis?

^ A. Ankylosing spondylitis

B. Rheumatoid arthritis

C. Reiter's disease

D. Coxarthrosis

E. Spondylosis

28 A 14-year-old girl has been presenting with irritability and tearfulness for about a year. A year ago she was also found to have diffuse enlargement of the thyroid gland (II grade). This condition was regarded as a pubertal manifestation, the girl didn't undergo any treatment. The girl's irritability gradually gave place to a complete apathy. The girl got puffy face, soft tissues pastosity, bradycardia, constipations. Skin pallor and gland density progressed, the skin became of a waxen hue. What disease may be suspected?

^ A. Autoimmune thyroiditis

B. Thyroid carcinoma

C. Subacute thyroiditis

D. Diffuse toxic goiter

E. Juvenile basophilism

29 A 38-year-old patient complains of inertness, subfebrile temperature, enlargement of lymph nodes, nasal haemorrhages, bone pain. Objectively: the patient's skin and mucous membranes are pale, palpation revealed enlarged painless lymph nodes; sternalgia; liver was enlarged by 2 cm, spleen - by 5 cm, painless. In blood: erythrocytes - 2,7*1012/l, Hb- 84 g/l, leukocytes – 58*109/l, eosinophils - 1%, stab neutrophils - 2%, segmented neutrophils - 12%, lymphocytes - 83%, lymphoblasts - 2%, smudge cells; ESR- 57 mm/h. What is the most likely diagnosis?

^ A. Lymphogranulomatosis

B. Chronic myeloleukemia

C. Acute myeloleukemia

D. Acute lymphatic leukemia

E. Chronic lymphatic leukemia

30 On the 5th day after a surgery for colon injury a patient complains of bursting pain in the postoperative wound, weakness, drowsiness, headache, fever up to 40oC. Objectively: the skin around the wound is swollen, there is gas crepitation. The wound discharges are scarce foul-smelling, of dark-gray colorl. What is the most likely diagnosis?

^ A. Postoperative wound infection

B. Abscess

C. Anaerobic clostridial wound infection

D. Erysipelas

E. Phlegmon

31 A patient is 50 years old, works as a builder with 20 years of service recor d. He was admitted to the hospital for chest pain, dry cough, minor dyspnea. Objectively: sallow skin, acrocyanosis, asbestos warts on the hands. In lungs - rough respiration, diffuse dry rales. The x-ray picture shows intensification of pulmonary pattern, signs of pulmonary emphysema. What is the most likely diagnosis?

A. Lung cancer

B. Chronic obstructive bronchitis

C. Tuberculosis

D. Asbestosis

E. Pneumonia

32 A 68-year-old patient consulted a doctor about a tumour in her left breast. Objectively: in the upper internal quadrant of the left breast there is a neoplasm up to 2,5 cm in diameter, dense, uneven, painless on palpation. Regional lymph nodes are not enlarged. What is the most likely diagnosis?

A. Cyst

B. Mastopathy

C. Lipoma

D. Fibroadenoma

E. Cancer

33 A 50-year-old male suburbanite underwent treatment in rural outpatient clinic for pneumonia. The treatment didn't have effect and the disease got complicated by exudative pleuritis. What prevention and treatment facility should the patient be referred to for further aid?

^ A. Phthisio-pulmonological dispensary

B. Tuberculosis dispensary

C. Central district hospital

D. Municipal hospital

E. Regional hospital

34 A woman consulted a doctor on the 14th day after labour about sudden pain, hyperemy and induration of the left mammary gland, body temperature rise up to 39oC, headache, indisposition. Objectively: fissure of nipple, enlargement of the left mammary gland, pain on palpation. What pathology would you think about in this case?

^ A. Lactational mastitis

B. Fibrous adenoma of the left mammary gland

C. Phlegmon of mammary gland

D. Lacteal cyst with suppuration

E. Breast cancer

35 A 45-year-old man has been exhibiting high activity for the last 2 weeks, he is talkative, euphoric, has little sleep, claims being able "to save the humanity and solve the problem of cancer and AIDS", gives money to starangers. What is the most likely diagnosis?

^ A. Agitated depression

B. Schizo-affective disorder

C. Panic disorder

D. Catatonic excitation

E. Maniacal onset

36 A 43-year-old female patient complains of unstable defecation with frequent constipations, abdominal swelling, headache, sleep disturbance. Body weight is unchanged. What disease are these clinical presentations typical for?

^ A. Chronic pancreatitis

B. Chronic atrophic gastritis

C. Colorectal cancer

D. Irritable colon syndrome

E. Chronic enteritis

37 An 8-year-old boy suffering from haemophilia was undergoing transfusion of packed red cells. Suddenly he felt pain behind the breastbone and in the lumbar area, dyspnea, cold sweat. Objectively: pale skin, heart rate - 100/min, AP - 60/40 mm Hg; oliguria, brown urine. For the treatment of this complication the following drug should be administered:

A. Aminophylline

B. Analgine

C. Prednisolone

D. Lasix

E. Adrenaline

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Krok Medicine-2011 iconKrok Medicine-2011

Krok Medicine-2011 iconKrok 1 Medicine 2004
В2 is administered. The synthesis disorder of which enzymes does this medicine cause in microorganisms?
Krok Medicine-2011 iconKrok 1 Medicine 2004
В2 is administered. The synthesis disorder of which enzymes does this medicine cause in microorganisms?
Krok Medicine-2011 iconKrok 1 Medicine 2004
В2 is administered. The synthesis disorder of which enzymes does this medicine cause in microorganisms?
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