Profile1 Therapy

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DistrB DistrC DistrD DistrE

Classical X-ray image of intestinal obstrustion is: *Gas and horizontal

levels

Filling defect High positioned

diaphragm

Reactive pleuritis Pneumatosis

A 15-year-old girl was examined with a history of

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 wasunremarkable. What is the single most important

examination for excluding miliary tuberculosis?

* Chest x-ray Liver or bone marrow

biopsy

Tuberculin skin testing Sputum smear and

culture of

M.tuberculosis

Bronchoscopy

A 58-year-old man complained of severeinspiratory dyspnea and expectoration of frothy

and blood-tinged sputum. He had been suffering

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.

*Morphine,furosemide,

nitroprusside sodium

Theophylline, prednisolon

Albuterol, atropine, papaverine

Strophanthine, potassium chloride,

plathyphylline

Cordiamine,

isoproterenol

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An attack of severe substernal pain developed in a

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?

*Cardiogenic shock Acute left-sided heart

failure

Acute right-sided heart

failure

Radicular syndrome Acute vascular

insufficiency

A 61-year-old man complained of sneezing and

substernal pain on exertion. The prior 2 weeks such

pain had appeared at rest, with increased

frequency, and failed to respond to 1 tabl of nitroglycerin. What is the most likely diagnosis?

*Unstable angina

pectoris

Angina pectoris of a

new onset

Myocarditis Radiculitis Stable angina pectoris

of III functional class

A patient with ischemic heart disease and chronic

heart failure develops sudden loss of

consciousness; on exam, cyanosis, the widened

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. Whatis the mechanism of this rhythm disturbancedevelopment?

*Multiple microreentry

in the ventricles.

Enhanced automatic

activity of the

ventricles.

Disturbances of

neurohumoral

regulatory systems.

Sick sinus syndrome. Accelerated diastolic

depolarization, a

disturbance in

electrolyte balance.

A 41-year-old woman complains of weakness,

fatigue, fever up to 38°C, rash on the face skin,

pain in the wrists and the elbows. On physical

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?

*Production of

antibodies to double-

stranded DNA.

Production of antibodies

to myocytes.

Production of

antibodies to

endothelial cells.

Production of

antibodies to myosin.

Production of

antimitochondrial

antibodies.




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 hemorrhagicsyndrome in this patient?

*Decreased liver

production of

procoagulants.

As a consequence of

DIC.

Thrombocytopenia. As a result of portal

hypertension.

K and C

hypovitaminosis.

A 56-year-old woman has an acute onset of fever up to 39°C with chills, cough, and pain on

respiration in the right side of the chest. On

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 thediagnosis?

*Community-acquiredlobar pneumonia with

moderate severity.

Community-acquired bronchopneumonia.

Acute pleurisy. Acute lung abscess. Hospital-acquired lobar

pneumonia.

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.

Specific

desensitization with

dust mites and feathersallergens.

Dexamethasone and

theophylline P.O.

Ephedrine P.O. and

inhaled isoproterenol

during an attack.

A 44-year-old woman complained of weakness,

subfebrile fever, and pallor of the skin. Physical

examination revealed the enlarged lymph nodes inthe 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?

*Hodgkin’s disease. 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.

Cushing’s disease.

A 29-year-old woman is critically ill. The illnesswas manifested by high fever, chills, sweating,

aching pain in lumbar area, a discomfort in

urination, and frequent voiding. Pasternatsky’s sigh

is positive in both sides. On lab exam, WBC of

20.000/mcL; on urinalysis protein of 0.6g/L,

leukocyturia, bacteriuria. Your preliminarydiagnosis.

*Acute pyelonephritis Exacerbation pf chronic pyelonephritis

Acuteglomerulonephritis

Acute cystitis Nephrolithiasis

A 26-year-old man was admitted to the hospital

complaining of stabbing back pain on inspiration

and dyspnea. On exam, BT of 37°C, 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?

*Acute fibrinous

pleuritis

Myocarditis Pneumonia Acute bronchitis Pneumothorax

A 58 year-old man complained of pain and

swelling of the left foot small joints. The skin over

these joints was purple, BT was 38°C. 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 leftmetatarsophalangeal joints. What is the

pathogenetic mechanism of this disease

*Increased biosynthesis

of uric acid

Immune response to

streptococcal infection

Hyperproduction of

autoantibodies to

collagen

Decreased amount of

chondroitin sulfate

Production of

antibodies to native

DNA




A 31-year-old man with past history of rheumatic

fever was severely ill and complained of fever up

to 38 – 39°C, abdominal pain, dyspnea, palpitation;

he felt ill 6 days prior. On exam, the left heart

border was shifted to the left, heart sounds werefaint, 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?

*Infective endocarditis Rheumatic aortic valve

disease

Typhoid fever Acute viral hepatitis Acute nephritis

A 14 year old patient. He complains of chest pain,

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 tonesare 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:

*Rheumatic pancarditis Rheumatic pericarditis Rheumatic

myocarditis

Rheumatic endocarditis Septic endocarditis

A 52-year-old patient with previously functional

Class П angina complains of 5 days of intensified

and prolonged retrosternal pains, decreased

exercise tolerance. Angina is less responsive to

Nitroglycerinum. Which of the following diagnosis

is most likely?

* IHD. Unstable angina Cardialgia due to spine

problem

IHD. Functional Class

П angina.

Myocarditis Myocardial dystrophy

An ECG of postinfartional [a year ago] patient

shows pathological QS waves in leads VI-V3, I,

aVL. Determine the location of old myocardialinfarction.

* Septal and anterior Anterolateral Anterior Inferior Postrolateral





A 52-year-old patient has hypervolaemic type of

essential hypertension. Which of the following is

necessary to prescribe either as monotherapy, or in

a complex with other antihypertensive remedies?

* Hypothiazid Dibazol Clophelin Kapoten Nifedipin

A 62-year-old patient complains of rest dyspnea,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]?

* CHF-2 B CHF- 1 CHF- 2 А CHF-0 CHF-3

A patient, aged 49, complains of fever of 37,5 0С, heart pain, dyspnea. S1 isclapping; S2 is accentuated in the aortic

area; opening snap, presystolic murmur are

auscultated. What is the most useful investigation

for valvular disorder assessment?

*

Echocardiography+Do

ppler-Echocardiography

Phonocardiography Ballistocardiogram Chest x-ray ECG

Physical examination of a person with chronic

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 lungemphysema?

* All of them Low diaphragm Hyperresonant

percussion note

Hyperinflated lungs Expansion of

intercostal spaces




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 Exudative pleuritis Bronchial obstruction Toxic hepatitis Emphysema

A 45-year-old man for 1 month has complained of epigastric and right subcostal aching pain, pruritus,

indigestion, dark color of the urine and acholic

stool, fever, and significant weight loss. On exam:

jaundice, presence of Curvuasier’s sign. US scan

did not reveal stones in the gallbladder and

choledochus. What is the most likely diagnosis?

*Cancer of the pancreas head

Gallbladder stones Chronic pancreatitis Chronic cholangitis Chronic hepatitis

A 34-year-old woman fell ill 3 months ago after

cold exposure. She complained of pain in the hand

and knee joints, morning stiffness, and fever up to38°C. Interphalangeal, metacarpophalangeal and

knee joints are swollen, hot, with decreased ranges

of motions; ESR of 45 mm/hr, CRP (+++), Vaaler-

Rouse test of 1:128. What group of medicines

would you recommend to the patient?

*Nonsteroidal anti-

inflammatory drugs

Cephalosporines Tetracyclines Sulfonamides Fluorchinolones

A 47-year-old obese man complained of periodic

attacks of acute arthritis in the 1st left

tarsophalangeal joint. Lab exam revealed increased

serum level of uric acid. What is the diagnosis?

*Gout arthritis Reiter’s 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 mentionedsymptoms developed. On exam: the subicteric

sclerae, enlarged firm liver. Your preliminary

diagnosis

*Chronic viral hepatitis Calculous cholecystitis Gilbert’s disease Acute viral hepatitis Chronic cholangitis

A 50 -year-old woman for 1 year complained of attacks of right subcostal pain after fatty meal. Last

week the attacks have repeated every day and

become more painful. What diagnostic study

would you recommend?

*Ultrasoundexamination of the

gallbladder

Liver function tests X-ray examination of the gastrointestinal

tract

Ultrasound study of the pancreas

Blood cell count

A 27 -year-old man complained of aching

epigastric pain just after meal, heartburn, and

nausea. Stomach endoscopy revealed a largeamount 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 Menetrier’s disease

A 25 -year-old woman complained of edema on

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 treatmentshould be initiated after establishing of the exactdiagnosis?

*Penicillin OS Heparin Ceftriaxone Dipyridamole Ciprofloxacine




A 25-year-old woman complained of fatigue, hair

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 3.5·1012/L, color index

of 0.7, ESR of 20 mm/h. Serum iron level was 8.7mcmol/L. what treatment would you initiate?

* Ferrous sulfate orally Iron dextrin injections Vitamin B12

intramuscularly

Blood transfusion Packed RBCs

transfusion

A 38-year-old man worked at roofing and drain 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?

*Chest X-ray Bronchoscopy Blood gas analysis Spirography Electrocardiography

The patient has worked 13 years as a bulldozer

driver. He complains of dizziness, headache, finger

dumbness and pain at night. On exam, tactilesensivity of peripheral type disturbes him, ankle

muscles are painful, and pulsation on a. dorsalis

pedis is weak. What is the most probable

diagnosis?

*Vibration disease Raynaud’s disease Syringomyelia Atherosclerosis

obliterans

Periarteritis nodosa

A worker of chemistry factory had occupational

exposure to lead for 20 years. Total blood count:

RBC of 3.5•1012/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

Chronic lead

intoxication, I stage

Porphyria Hereditary hemolytic

anemia

Lead carrier





A fitter of metallurgic factory with occupation

exposure to high concentrations of mercury fumes

during 16 years presents instability of pulse and

blood pressure, general hyperhydrosis, asymmetric

innervations of facial muscles and tongue, positivesubcortical reflexes, hand tremor on physical

examination. Dentist consultation revealed

paradontosis, and chronic stomatitis. What is the

most probable diagnosis?

*Chronic mercury

intoxication.

Neuroinfection. Parkinson syndrome. Acute mercury

intoxication.

Mercury

encephalopathy.

A 45-year-old coal miner complains of cough with

black sputum, breathlessness on exertion, which

occurred 4 years before. On physical examination,

wheezes above both lungs, heart sounds arewithout changes, heart rate of 72 beats per minute.

Chest radiography shows multiple, small irregular

opacifications throughout both lungs. What is the

most probable diagnosis?

*Anthracosis, nodular,

slowly progressing

form, first stage.

Silicosis, nodular,

slowly progressing

form, first stage.

Siderosis, interstitial,

slowly progressing

form, first stage.

Bissinosis, interstitial,

slowly progressing

form, first stage.

Asbestosis, interstitial,

slowly progressing

form, first stage.

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?

*Noise-induced

disease.

Hypertension. Atopic bronchial

asthma.

Asteno-vegetative

syndrome.

Encephalopathy.

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?

*Plumbism, severeform

Mercurialism, severeform

Aluminiumintoxication, severe

form

Asbestosis, severe form Cyanides poisoning,

severe form




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

Stable angina Pulmonary embolism Acute myocarditis Acute left ventricular

failure

A 38 -year-old woman is seriously ill. Shecomplains of frequent paroxysms of expiratory

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

*Bronchial asthma,status asthmaticus

Chronic obstructive bronchitis

Atopic bronchialasthma, respiratory

failure of the III

degree

Bronchiectasis,respiratory failure of the

II - III degree

Ischemic heart disease,

pulmonary edema

A 46- year-old patient has ischemic heart disease,

angina on exertion, II functional class. What is thedrug of choice in treatment of acute attack?

*Nitroglycerin

sublingually

Platelet inhibiting

agents (aspirin)

Spasmolitics (No-spa)

IV

Digitalis IV Sedative agents

(Seduxenum) orally

A 19-year-old girl admitted to the hospital

complained of pain in the knee and fever of 38.6°C. She is ill for 2 weeks after acute tonsillitis.

On exam, hyperemia and swelling of both knees,

BT of 37.4°C, 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 –

9.8•109/L, ESR of 30 mm/L. ECG findings: therhythm is regular, PQ = 0.24 sec. What is acausative agent of the disease?

*Beta-hemolytic

streptococci.

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. Theliver 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

fever complains of fever up to 38 - 39°, abdominal

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?

*Infectious

endocarditis

Rheumatic fever Acute hepatitis Acute nephritis Aortic regurgitation

A 60-year-old man complains of fever, significant

weight loss, bone and joint pain, and bleeding

gums. On exam, paleness, lymphadenopathy,

hepato- and splenomegaly. CBC: WBC – 270•109/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.

*Myelosan Prednisolone Cytosar Vinblastine Blood transfusion

A 54-year-old woman complains of increasing

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; andWBC – 162.000/mcL with 82\% blasts, that

contained Auric rods; peroxidase stain was

positive; What is the most probable diagnosis?

*Acute leukemia Chronic leukemia Thrombocytopenia Hemolytic anemia Megaloblastic anemia




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?

*Essential

hypertension, 2nd stage

Essential hypertension,

1st stage

Symptomatic

hypertension

Cardiomyopathy Ischemic heart disease

A 39 -year-old woman complained of squeezed

epigastric pain 1 hour after meal and heartburn.

She had been ill for 2 years. On palpation, there

was moderate tenderness in pyloroduodenal area.

Antral gastritis was revealed on gastroscopy. What

study can establish genesis of the disease?

*Revealing of

Helicobacter infection

in gastric mucosa

Detection of

autoantibodies in the

serum

Gastrin level in blood Examination of stomach

secretion

Examination of

stomach motor

function

A 20- year-old patient with a history of preceding

streptococcal infection complains of malaise,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?

*Acute

glomerulonephritis

Acute pyelonephritis Rheumatic fever Essential hypertension Bacterial endocarditis

A 32 -year-old welder complains of weakness and

fever. His illness started as tonsillitis a month before. On exam, BT of 38.9°C, 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 2.2·1012/L, WBC of

3.0·109/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?

*Acute leukemia Chronic

lympholeukemia

Aplastic anema Vitamin B12 deficiency

anemia

Chronic hemolytic

anemia





A 30- year-old patient complains of breathlessness,

pain in the right rib arc place, dry cough and the

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 36.6°C, 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?

*Dilated

cardiomyopathy

Infectious endocarditis Acute myocarditis Rheumatic fever, mitral

stenosis

Acute pericarditis

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

The high incidence of

cancer of the general

population

The low risk of cancer

from small doses

The long interval

between radiation and

clinical presentation of

cancer.

None of the above

mentioned

For which of the following diagnostic

examinations performed with modern techniqueson an unknown pregnant patient should therapeutic

abortion be considered the result of putative risk from radiation?

* None of the below

mentioned

Chest radiography Barium enema study IVP Abdominal CT

The highest risk of congenital anomalies probably

occurs when human embryos or fetuses are

exposed to ionizing radiation. During which part of

gestational period does it occur?

*18-45 days after

conception

The first 7 days 10-14 days after

conception

90-120 days after

conception

The third trimester




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?

* Cephalosporinsof the Шgeneration

Penicillin Erythromycin Tetracycline Streptomycin

A patient, aged 48, complains of heaviness in theright 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:

* Liver cirrhosis Cancer of the liver Cancer of the head of pancreas

Gallstones Viral hepatitis B

A 27-year-old man complains of pains in

epigastrium which are relieved by foodintake. EGDFS shows antral erosivegastritis, biopsy of antral mucouspresents Hеlicobacter Pylori. Diagnosisis:

* Gastritis of type B Gastritis of A type Reflux - gastritis Menetrier's gastritis Rigid antral gastritis

A man, aged 25, presents with facialedema, moderate back pains, bodytemperature of 37,5 С, BP 180/100mmHg, hematuria [ up to 100 in v/f],proteinuria [2,0 g/L], hyaline casts - 10

in v/f., specific gravity -1020. The onsetof the disease is probably connected with

acute tonsillitis 2 weeks ago. The most likely

* 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 & poikilo-cytosis. Fe of serum 5 mkmol/L. Diagnosis is:

* Iron-deficiency

anemia

B12-deficiency anemia Сhronicmyeloleukosis

Aplastic anemia Chronic lymphoid

leukosis

A patient of 62 years with DM-2.Diabetes is being compensated by dietand Maninilum. Pаtient has to undergoan operation for inguinal hernia. Whatshould be tactics of hypoglycemictherapy?

* Prescribe the drugs of an insulin of short

activity

Give Glurenorm in place of Maninilum.

To continue with thecurrent therapy

Prescribe the drugs of insulin of long activity

Prescribe guanyl

guanidines

A 33-year-old lady has been suffering from DM

for 5 years. The last 3 years she has taken morethan 100 units of insulin per day. Body weight hasincreased 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:

* DM 1st type, severe

form, decompensation,insulin resistant

DM 2nd type, severe

form, decompensation

DM 1st type, severe

form,subcompensation,Somoji phenomenon

DM 2nd type, moderate

form, Zabrodi phenomenon

DM 1st type, severe

form, decompensation,

allergic response on

insulin

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

Diffuse euthyroid goiter

of the 3rd degree.

Chronic autoimmune

thyroiditis,

hypertrophic type

Chronic fibrous

thyroiditis

Toxiferous adenoma of

the thyroid gland




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. Givethe exact term of this enzyme.

* Phospholipase A2 Arachidonic acid Lipoxygenasе Cyclooxygenase – 1 Cyclooxygenase – 2

А patient is suffering of a chronic heart

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.

* Indomethacin Digoxin Furosemide Panangin Riboxinum

Which of the following is used for tuberculin

diagnosis in the masses

PPD-L standard

dilution of 2 TU in0,1 ml

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 7years. 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 alcoholuse

Participation in the A-ANON 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




Developing of gigantism is conditioned by: *Overwhelming

secretion of GH in

adolescence

Overwhelming secretion

of GH in old age

Overwhelming

secretion of GH in

adults

Overwhelming

secretion of

somatostatin in

adolescence

Inborn sensitivity lack

in tissues to GH

Choose factors, which can cause Addison’s disease *Tuberculosis Tumor acting on adrenalhormone

Autoimmunedestruction 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 Grave’s disease usually include *Antagonists of thyroid

hormones

Antidepressants Narcotic analgesics Diuretics Sulfonylureas

Choose the correct initial interaction of a photonwith an atom in a biological system leading to cell

damage

* Interaction of the photon with a

subatomic particle. For

x-ray imaging radiation

this will be an electron.

Production of anenergetic changed

particle usually a photo

or recoil electron.

Dissipation of theenergy of the electron

along its path by

ionization and

excitation.

Chemical changes inthe ionizing / excited

molecules.

None of the above

mentioned

Which of the following statements concerning

undifferentiated cells in tissues is correct?

* They are sensitive to

radiation but easilyreplaced when killed

They are very resistant

to radiation

They are sensitive to

radiation and most arekilled by doses in thediagnostic range

They are sensitive to

radiation and difficult toreplace if killed.

Cells that survive can't

go on to form a tumor

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)




A total body dose of 200 rad will cause the

hematopoietic syndrome. The time for maximum

hematological recovery will be :

* 180 Days 30 days 60 days 120 days 240 days

Patient N., 27 years old was hospitalized to the

psychiatric hospital for the 4-th time during 2years. 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 therelapses of schizophrenia requires:

* Supportive treatment

with neuroleptics of prolonged action

Long-term

hospitalization

Psychiatric

observation

Participation in a self-

help group

Psychoanalytic

treatment

Patient K, male, 19 years old, has suffered

moderate mental retardation since childhood. Is

illiterate, can take care of himself, do simplehousehold work and other kinds of easy work

under supervision. His rehabilitation [tertiary

prevention] requires:

* All the above

mentioned

Supervision of a social

worker

Physical work under

supervision

Supervision of relations

[ if any]

None of the above

mentioned

Patient F., male, 16 years old was behind other

children in development since early childhood andstill 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?

* Chromosome

abnormality

Gene abnormality Maternal alcohol

abuse during pregnancy

Pathological delivery Infection in mother

during pregnancy





Patient A., male, 27 years old came to consult a

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 hademotional numbness and fatigue. The cause of the

disorder was:

* Severe stress Adjustment disorder Environmental factors Patient’s personality

features

Endogenic factors

A female patient 28 years old, became depressed,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:

* Hypothalamus Frontal lobes Pituitary Hippocampus Corpus callosum

A patient, while making repairs at home, suddenly

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

couldn’t 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:

* Petit mal, epilepsy Grand mal, epilepsy Jacksonian fit,

epilepsy

Disphoria, epilepsy Twilight state, epilepsy

The observed patient’s movements are retarded,

she answers no questions. Sometimes she

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 onthe other leg, the patient can stay in such a positionfor quite a long time. Name the probable disorder:

* Catatonic stupor,

shizophrenia

Depressive stupor,

bipolar disorder

Apathetic stupor,

shizophrenia

Psychogenic stupor,

stress disorder

Dissociative stupor,

dissociative psychosis




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

Individual approach Gradual beginning Continuous long-term

treatment

None of the above

mentioned

What auscultative data are watched in bronchoectatic disease?

* The clinical picturedepends on full or

empty bronchiectasia

and on caliber of

bronchus.

Bronchial breathing. Amphoric breathing. Dry whistling rales. Moist fine bubbling

rales [non-

consonating].

What from enumerated syndromes is main in acute

diffuse bronchitis ?

* Syndrome of muco-

ciliary insufficiency.

Syndrome of bronchial

obstruction.

Syndrome of

respiratoryinsufficiency.

Syndrome of pulmonary

tissues insufficiency.

Syndrome of

pulmonary tissues

augmented aerisation.

The primary bronchopneumonia more often arises

as …

* Complication of

acute bronchitis.

Complication of

pneumorrhagia.

Complication of

stagnation of blood in

the lungs.

Complication of infarct

of the lungs.

Complication of

pneumoconiosis.





What auscultative data of the lungs does in lobar

pneumonia exist at stage of hepatization ?

* Bronchial breathing. Crepitation. Moist consonating

rales.

Moist non-consonating

rales.

Increased vesicular

breathing.

What is the basic of crepitation ? * The separation of alveoli during

inspiration on walls of

which the fibrin has

put.

Existence of bronchiectasis filled by

pus.

Existence of a caverncontaining liquid and

air.

Stenosis of a clear spaceof bronchus.

Friction of the

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.




When can pulmonary bleeding arise ? * Bronchoectatic

disease.

Diffuse catarrhal

bronchitis.

Bronchiolitis. Lobar pneumonia in a

stage of red

hepatization.

Bronchopneumonia.

What auscultative phenomenon arises at beginningof acute bronchitis ?

* Harsh. Moist fine bubblingrales.

Crepitation. Moist medium bubblingrales.

Vesiculo-bronchial

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 areaffected Weber's alternating syndrome?

*Oculomotor Accessory Glossopharyngeal Vagus Hypoglossal

Neuralgia of the trigeminal nerve is characterized

by?

*Transient pain on the

face and trigger areas

Permanent pain in the

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

Central paresis of the mimic muscles is

characterized by:

* Affection of mimic

muscles of the lower

half of the face?

Affection of masticatory

group of muscles

Prolapse of papillary

reflex

Trophic disorders Affection of mimic

muscles of half of the

face




The patient H., aged 36,works as a nightman

during 12 years.He applied with complaints of the

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?

* An acute

intoxication

Chronic arsenious

intoxication from

pesticides

An acute poisoning by

OPS

Carbone bisulfide

intoxication

Leaden intoxication

A diagnosis of chronic arsenious intoxication wasdefined in a patient Y., a nightman. What form of

anemia is characteristic in this disease?

* Haemolytic anemia Aplastic anemia Iron deficiency anemia Hyper sideric anemia Normochromic anemia

The man, aged 42, applied to the therapeutist with

complaints of pricking pains in scapulas area,dyspnea on physical exertion, cough withdischarge of small amount of sputum. During 10

years he works in coal mining. On percussion-box-

note sound in the lower parts, on auscultation- a

harsh breathing. There were no changes in the

heart. Possible diagnosis?

* Silicosis Tuberculosis of lungs Silicatosis Bronchiectatic disease Chronic bronchitis

A sick man M., aged 52, a street cleaner. He was ill

with pneumoconiosis during 2 years. It’s nessesary

to recommened for the treatment of this disease:

* Alkaline inhalations Broncholitics Oil inhalations Sulfonilamides Antibiotics





The woman, aged 42, works at the factory on the

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 usefor the elimination of mercury from the organism ?

*Unithiol Pentoxil Magnesium sulphate Sodium hydrate of

carbon

Seduxen

A man,aged 37,working on the collective farm onsowing,was admitted to the infectious hospital with

the clinical symptoms: miosis,labored

breathing,sweating.What kind of poisoning is it

and what is the first aid?

*Poisoning by POC.Treatment: atropine

Poisoning by lead.Treatment: tetacine

Calcii

Poisoning by themethylic alcohol.

Treatment: ethylic

alcohol

Poisoning by vapours of mercury.

Treatment:unithiol

Seduxen

A woman of 36 years is on the 12-th week of the

first pregnancy. We know from the history that shewas treated for infertility. She was in the guestsand contacted with child who developed rubella in

2 days after meeting. Woman doesn’t know if she

has ever been infected with rubella. What is the

adequate tactics?

*Monitory of the

specific Ig G Ig M withthe ELISA

Interruption of the

pregnancy

Immune globulin

injection

Cyclovin administration Interferon

administration

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 islowed. Which pathology is suspected?i

*B-12-deficiency

anemia

Irondeficiency anemia Hemolytic anemia Post-hemoragic anemia Thalassaemia




A 32-year old woman developed the Laiel’s

syndrome after taking the biceptol. What

immunotrope remedies are indicated in this

situation?

*Steroid

immunodepressants

Non-specific immune

modulators

Specific immune

modulators

Interferons Non-steroid

immunedepressants

The disease began acutely. The frequent waterystool developed 6 hours ago. The body’s

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?

*Cholera Toxic food-borneinfection

Salmonellosis Dysentery Typhoid fever

The patient 25-years-old was admitted on the 1st

day of the disease with complaints of double visionin 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?

*Botulism Yersiniosis Leptospirosis Salmonellosis,

gastrointestinal form

Lambliasis

The patient Н., of 28 years old, wasadmitted to the clinic with complaints of the temperature increase up to 39,0(С,headache, weakness, constipation onthe 9th day of the disease. On

examination: single roseolas are on skinof the abdomen. The pulse rate is 78 per minute. The liver is enlarged by 2 cm. What is

*Typhoid fever. Leptospirosis. Brucellosis. Sepsis. Malaria.





The patient was admitted to the hospital on the 7th

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 wentfishing two weeks ago. What is the diagnosis?

*Leptospirosis Yersiniosis Salmonellosis Brucellosis Trichinellosis

The patient has been in the hospital. Thebeginning of the disease was gradual:nausea, vomiting, dark urine, аcholic

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 insizes. Due to what complication of viral hepatitis,

has the patient’s condition worsened?

*Hepaticencephlopathy

Meningitis Relapse of viralhepatitis

Cholangitis Infectious-toxic shock

The patient, 18-years-old was admitted to the

hospital with complaints of headache, weakness,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?

*Infectious

mononucleosis.

Acute lymphoid

leukosis.

Diphtheria. Angina. Adenoviral infection.

The patient 28-years-old washospitalized with preliminary diagnosis"influenza". Roseolous-petechial rashappeared on the 5th days of disease onthe trunk. The temperature is 41(С.

Hyperemia of the face, reddening of scleras,tremor of the tongue, tachycardia, splenomegaly

are marked. What is the most probable diagnosis ?

*Epidemic typhus Measles Alcohol delirium Leptospirosis Typhoid fever




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 Carcinoma of skin Erysipelas Erysipeloid Eczema

In the patient of 21 years old the diseasebegan with increase of temperature to39,0(С, 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?

*Meningococcalinfection: purulent

meningitis.

Meningococcalinfection: serous

meningitis

Secondary purulentmeningitis.

Serous meningitis. Infectious

mononucleosis.

The theory of self regulation of epidemiological

process by V.D. Belyakov includes all mentioned bellow except

* Localization of the

parasite in the hostorganism and the waysof discharging of the

parasite into the

environment

Geno- and phenotypic

heterogeneity of the populations of a parasiteand host

Mutability of the

biological propertiesof the parasite and thehost populations

The phase

selfreorganisation of the parasite populations anda host

The regulation role of

social and naturalconditions in the phase

reorganization of the

epidemiological

process

The diagnosis of the AIDS epidemic initially was

made in the USA by means of

* The epidemiological

method

The bacteriological

method

The virological

method

The viroscopic method The serological method





The contagious hypothesis by D. Frocastro and D.

Samoylovich being considered as a causative agent

of infectious diseases

* The alive germs,

which are transmitted

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 poordental hygiene is to have his remainingteeth extracted for subsequentdentures.He has mitral valve stenosiswith mild cardiac insuffiency and isbeing treated with сaptopril,digoxin andfurosemide.The dentist decides that his

medical history warrants prophylactic antibiotic

*Amoxycillin Vancomycin Tetracycline Co-trimoxazole Imipenem

A 20 yr old woman with a 3-4 month history of

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:

*Ulcerative colitis Gastroenteritis Carcinoid syndrome Zollinger-Ellison

syndrome

Granulomatous colitis

A patient treated for springtime allergies with

terefenadine develops an upper respiratory tract

problem.He receives an antibiotic and develops a

cardiac arrhythmia.What was the likely antibiotic?

*Erythromycin Ampicillin Cefactor Doxycycline Co-trimoxazole




A 75yr. Old man who had developed diabetes

within the last six months was found to be

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 moveswith respiration. A CT scan shows enlargement of

the head of the pancreas,with no filling defects in

the liver. Most likely diagnosis:

*Carcinoma of the

head of the pancreas

Infectious hepatitis Haemolytic jaundice Malignant biliary

stricture

Metastatic disease of

liver

A 16yr. Old female presents with abdominal pain

and purpuric spots on the skin. Laboratoryinvestigations reveals a normal platelet count,with

haematuria and proteinuria.The most likely

diagnosis:

*Henoch Schonlein

purpura

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 beuseful in treating both of these conditions:

*Doxazosin Labetalol Phetolamine Propranolol Isoproterenol

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 suggestdeficiency of:

*Zinc Copper Selenium Chromium Manganese





A 47 year old man presents to his physician with

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 everythingEXCEPT:

*Chronic Pancreatitis Tuberculosis Cirrhosis with

hepatocellular

carcinoma

Hepatitis Alcoholic liver disease

with cirrhosis

A 60yr. Old man with unstable angina pectorisfails to respond to heparin, nitroglycerin, beta

adrenegic blockers and calcium channel antagonist.

The best management includes:

*Coronary artery bypass grafting

Intravenous strptokinase Excercise testing Oral aspirin Antihypertensive

therapy

A 42yr. Old patient suffering from alcoholism has

advanced liver disease with ascites. He ishospitalised 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:

*Insufficient protien

ingestion

Bleeding esophageal Excessive diuretic

therapy

Non compliance with

lactulose therapy

Spontaneous bacterial

peritonitis

A 45yr. Old man is admitted with his 3rd episode

of upper gastrointestinal haemorrhage. He had 2

prior ulcer operation. Zollinger-Ellison syndrome

is suspected. All the following would support your

suspicions EXCEPT:

*Supression of

hypergastrinaemia by

secretin given IV

A fasting gastrin level

of 450pg/ml.

Post operative notes

detailling ulcers in the

duodenum and

jejunum

Liver metastasis on CT

scan

A history of diarrhoea




A 60yr. Old woman, mother of 6 children,

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:

*Choledocholithiasis Benign biliary stricture Malibnant biliary

stricture

Carcinoma of the head

of the pancreas

Choledochal cyst

A 30yr. Old man presents with a history of 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:

*Bronchoectasis Chronic bronchitis Disseminated pulmonary

tuberculosis

Pulmonary neoplasm Chronic obstructive

emphysema

The 30-years old patient with the complications on

a headache in a nucha ,poor dream withnightmares has addressed to policlinic. A BP was150/95 Hg.An item. A boundary arterial

hypertension was diagnosed. In what dispensary

group he mast be addresseed for supervision on an

arterial hypertension?

* In the second In a first In a fourth In a third In a fifth

3.In the young patient at the reference to policlinic

there was diagnosed the 1 stage of hypertension.

How many times during the year it is necessary to

examine him?

* Twice. Once. 3 times. 4 times. 5 times.





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

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?

* 1.07.2001. 1.03.2001. 1.04.2001. 1.05.2001. 1.06.2001.

16 The family doctor diagnosed in a patient anacute bleeding of an intestine. What is professional

tactics of the doctor in this situation?

*The urgenthospitalisation in

sergical departmewnt.

To inject intravenouslythe aminocapronic acid.

The urgenthospitalization 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

solves the problem of the patient after the

discharge from a hospital to the balneal department

of sanatorium:who cannot be routed?

*200/110-240/120 140/90-160/100 90/60-120/80 160/90-180/90 180/110-90/60




Woman age 40,ill on rheumatic disease with

composite mitral disease with prevalence of the

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 themost expedient?

*Mitral

comissurotomia.

Conduction of current

bicilino-prophilaxis.

Assiging of

anticoagulants.

Assiging of venous

vasodilatators .

The man,42 years old, has died in a road accidentafter 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?

*25-30\%. 6-9\%. 10-14\%. 15-20\%. 35-50\%.

In the woman of 42 years ,who suffers from

bronchial asthma ,the acute attack of a bronchialasthma has developed. What medication fromlisted below is contraindicated at granting the first

aid to this woman?

* Euphylinum 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,

* 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

of light degree

Acute radiation

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 3weeks 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 rashon the trunk and extremities. Herpes simplex

*HIV infection Influenza Rubella Infectiousmononucleosis

Tuberculosis

Each of the following statements concerning

features of anthrax is correct EXCEPT

*The initial lesion in

cutaneous anthraxconsists of the black eschar, surrounding

erythema and painful

pitting edema

Inhalation anthrax

results from the alveolar deposition of airborne particles contaminated

with spores of B.

anthracis.

Cutaneous anthrax,

untreated, results indeath in 10\% to 20\%of cases

The drug of choice in

cutaneous anthrax is penicillin.

The preferred

serodiagnostic test for anthrax is ELISA

A 27-year old patient with malaria caused by P.

falciparum was treated with Chloroquine (600 mg

base followed by 300 mg base in 6 hours, then 300

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?

*Chloroquine resistant

strain of P. falciparum

Glucose-6-phosphate

dehydrogenase

deficiency in patient

Late recognition of

infection due to P.

falciparum

Inappropriate route of

administration

Hypersensitivity of the

patient to Chloroquine




Ten hours before initial observation patient C. had

frequent feces and vomiting. Fecal and vomiting

masses became like rice-water. Nausea and

abdominal pain weren’t observed. Hiccup and

convulsions of lower limbs, temperature 35.4(C,

hoarse voice, greyish wry face, acrocianosis wereusually observed. Breathing 40/min, thread – like

pulse 120/min, blood-pressure 40/0mm/Hg,

*Intravenous

rehydration

Antibiotic therapy Cardiac glycosides Disintoxicational

therapy

Antibotulistic serum

injection

A sick person M. is staying in the hospital with thediagnosis of abdominal typhus. During the 3d

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?

*Intestinalhaemorrhage

Thrombophlebitis Meningitis Nephroso-nephritis Hepatite

A nurse of the kindergarten was taken to the

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

*Salmonelosis Dysentery Cholera Food toxic infection Enterovirus infection

A 25-year-old man was admitted with 2 months of

cough and fever. A chest x-ray showed extensive

left upper lobe disease with a 2 cm cavity. All

three points were strongly positive on direct smear

and grew M. Tuberculosis, fully sensitive to all

first-line drugs. Patient must be treated with:

* Isoniazid +

rifampicin +

pyrazinamide

Streptomycin +

isoniazid

Isoniazid + ethambutol Kanamycin +

ethambutol +

pyrazinamide

P-aminosalicylic acid +

streptomycin





A 5-year-old boy was progressively getting more

unwell than during the previous 2 months. A chest

x-ray had shown right middle lobe collapse. A

tuberculin skin test had been strongly positive.

What is the most characteristic finding in primary

tuberculosis?

* Hilar or paratracheal

lymph node

enlargement

Atelectasis with

obstructive pneumonia

Cavity formation Miliary tuberculosis Hematogenous

dissemination leading

to extrapulmonary

tuberculosis

A 50-year-old man was examined in the clinic with persistant cavitation and sputum. He was treated

with rifampicin, isoniazid, ethambuthol. The most

common toxic effect of ethambutol is:

* Optic neuritis Eighth cranial nervedamage

Hepatic enzymeelevation

Peripheral neuropathy Mental symptoms

To reduce the number of adult infection cases in

the population it is much more important to:

* Give good treatment

to all sputum positive patients

BCG vaccination Tuberculin skin testing Health education

campaigns ontuberculosis

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




Under what circumstances can preventive therapy

be given to people who have a negative tuberculin

test reaction?

* High risk close

contacts (young

children, HIV-infected

persons)

People with chest x-ray

findings

Low-income groups

with poor access to

health care

People who inject illicit

drugs

People with symptoms

of pulmonary disease



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