(A) LleHmp mecmyBaHHa (pu Anaretal export Vers Sample test questions Krok 2 MedicineKrok 2 Medicine 1 1. Disease onset was acute. A child developed general weakness, pain. in the joints, and fever, Later these signs became accompanied by itching skin 1 manifested as erythematous” spots mm in size. The rash gradually turned hemorrhagic. Large:joints-are=painful and swollen: painyattacks periodically occur in the paraumbilicalvarea; there are signs of intestinal hemorrhage. What is the most likely diagnosis? A. Hemorrhagic vasculitis (Henoch-Schonlein purpura) B. Scarlet fever C. Hemorrhagic meningoencephalitis D, Streptococcal impetigo E. Rheumatism 2. After eating-shrimps; a 25-year-old man suddenly developedskin itching, some areas of his skin-beeame-hyperemic or erupted into vesicles. Make the diagnosis: A. Acute urticaria.» f bud af B. Hemorthagie vasculitis (Henoch-Schonlein purpura) C. Urticaria pigmentosa D. Psoriasis E. Scabies 3. A district doctor has diagnosed one of his patients with dysentery, What accounting document reflects this type of morbidity’? A, Urgent report B. Statistical report C. Report on a major non-epidemic dise: D, Certificate of temporary disability E. Control card of a patient registered for regular check-ups 4, A 39-year-old man, a hawlereattendant, suddenly developed’ weakness, loss 0} appetite, nonlocalized colicky abdominal ins, and nausea. Objectively, his skin gray; there is a pink: ripe on his gums; the abdomen is soft and_ sharply painful. Blood test detected erythrocytes with basophilic stippling and anemia. The patient has a history of peptic ulcer disease of the stomach, Constipations occur each lays, What is the most likely provisional e A, Saturnism (lead poisosning) 7 B. Acute appendicitis Perforation of gastric uleer D. Acute cholecystitis E. Chronic alcoholism 5. A S8-yearold man complains of weakness and tumor-like formations that appeared on the anterior surface of his neck and in the inguinal region. Palpation detects mobile cervical and inguinal lymph nodes up to 2 em in diameter. The liver protrudes by 2.cm from the edge of the costal margin, the lower splenic pole is at the umbilical level, In blood: erythrocytes - 3.5 + 10R/L, Hb- 88 g/L, leukocytes = 86 + 10°/L, band neutrophils - 1% segmented neutrophils - 10%, lymphocytes, ~ 85%, eosinophils - 2%, basophils - 0%, monocytes - 2%, erythrocyte sedimentation rate - 15 mm/hout, Gumprecht=shadows, What is the most likely diagnosis? A. Chronic lymphocytic leukemia B. Lymphocytic leukemoid reaction . Acute leukemia D. Chronic myeloid leukemia E. Lymphogranulomatosis 6. Employees work in_ conditions of high dust concentration, Certain chemical licon_ dioxide content) and physical properties of dustaerosols contribute io the development of occupational dust-induced diseases. What is the main physical property of dust aerosols? A. Dispersion B. Magnetization . Electric charge D, Solubility E. Tonization 7 A 20-year-old patient complains of a severe headache, double=visio weakness, fever, irritability. Objectively body=temperature is:38:1°C, the patient is reluctant to contact, sensitive to stimuli There are «ptosis ‘of the left eyelid, exotropia;anisocoria S>D, and pronounced: meningeal syndrome. On lumbar puncture the cerebrospinal fluid flowed out under a pressure of 300 mm Hg, the fluid is clear, ‘tly opalescent. 24 hours later there APRA ATOM film. Protein = 1.4 gil lymphocytes ~ 600 per mm’, gluc mmol/L. What is the provisiot gnosis? A. Tuberculous meningitis B. Meningococcal meningitis C. Lymphocytic (Armstrong's) meningitis D. Syphilitic meningitis E. Mumps meningitis, 8. A 52-year-old woman has been suffering for 2 years from dull, occasionally exacerbating pain_in_her_tight_subcostal area, occurring AST Sating MgICTaT foods Tonstipations, and flatulence. Objectively she is obese, her body temperature is 36.9°C; there is a coating on the root of her tongue; the abdomen is moderately distended and painfulsin=theareaof gallbladder=projection. What examinationKrok 2 Medicine would be the most helpful forediagnosis- making? ‘A. Ultrasound B. Duodenal probe C Cholecystography D. Duodenoscopy E. Liver scanning 9. A 3-month-old child with signs of rickets presents with positive Chvostek, Trousseal ind Maslov stuns. On fay ago the parents wil -yanotic attack in their child - the child broke into a cold sweat, the eyes bulged, and respiratory arrest occurred. One minute later the child drew in a loud breath and the child’s condition normalized again. What is the cause of the described. signs of the disease? A. Decrease of blood calcium levels B. Increase of blood calcium levels C. Decrease of blood phosphorus levels D. Increase of blood phosphorus levels E. Metabolic acidosis, 10. A man works in casting of nonferrous: metals» and alloys for 12 years. In the of working area there was registered high content of heavy metals, carbon monoxide, and nitrogen. During’ periodic health examination the patient presents with asthenovegetative sy abdominal pains, con hepatic aed. In urine: aminolevulinie-acid and coproporphyrin-are detected. In blood: reticulocytosis, low hemoglobin level, Sucl intoxication is caused by: A. Lead and lead salts B. Tin. € Carbon monoxide ; D. Nitric oxide=> mpthanaglobia E. Zine 11. A 48-year-old woman complains of disturber Henstrual cycle: her-periods last for 7-9 days and are excessively profuse throughout the last half-year, She notes irritability, and headaches. Her skin. is of normal color, Blood pressure - 150/90 mm Hg, pulse - 90/min., rhythmic. The abdomen is soft and painless. Bimanual examination shows no uterine enlargement, the appendag The vagitar Tornices are Tree likely diagnosis ‘A. Climacteric syndrome yas menapauiel B, Premenstrual syndrome €. Adrenogenital syndrome D. Stein-Leventhal syndrome (polycystic ovary syndrome) E, Uterine myoma 12. A 23-year-old woman came to the gynecological clinic. She complains of pain, itching, and-burningein-her-vulva, general weakness, indisposition, elevated body temperature up to 372°C. and headache, O} examing multiple Vesicles uy in diameter will ea against the background of hyperemia and mucosal edema, Make the provisional diagnosis ‘A. Genital herpes infection B. Primary syphilis C: Papillomavirus infection D, Vulvar cancer E, Cytomegalovirus infection 13. A woman with the pregnaney:termof8 weeks-complains of levatet Temperature up to 376°C, skin rash that can be characterized "as macular exanthema, enlargement of posterior cervical and occipital lymph nodes, small amount of bloody discharge from’ the genital tracts. She was examined by the infectious diseases specialist and diagnosed with rubella, What tactics should the obstetrician-gynecologist choose? A. Abortion B. Prescription of antibacterial therapy C. Prescription of antiviral therapy D. Treatment of incipient abortion E, Prescription of hemostatic therapy 14, The S+year-old child has been ill for 2 weeks eueloped first a During n wore then followed by reprises. cervical veins bulge. The cough attacl siduce vomiting X ray shows intensific bronchial pattern. Blood test: leukocytes - 16 - 10°/L , lymphocytes - 72%, erythrocyte sedimentation rate - 4 mm/hour. What is the most likely diagnosis? A, Pertussis B. Obstructive bronchitis C Pneumonia D. Adenovirus infection E, Foreign body 15. On laboratory investigation of a pork sample there is 1'dead trichinella-detected iment cen in 24 sections. A. Handed over for technical disposal B. Allowed for sale with no restrictions C. Processed and sold through public catering network D. Processed for boiled sausage production E. Frozen until the temperature of -10°C is reached in the deep layers, with subsequent exposure to cold for 15 d:Krok 2 Medicine 3 16. A 48-year-old woman was delivered into the surgical unit with wounds in her thigh. On examination the wound surface has a. dinty-gray--coating--withsunpleasant sweet,smell. The wound content resembles TUTEpheny jelly. Skin tissues around the wound are. glossy and turgid. Palpation Teveals moderate ereptation in-tfSTRSiee— What bacteris the most TECly To COS such inflammation? A. Anaerobic clostridial B. Anaerobic non-clostridial C Streptococci . Staphylococci E. Blue pus bacillus 17, A 25-year-old woman was brought into the gynecological department with profuse bloody discharge from her genital tracts. She is 12 we gnant, the pregnancy is planne she was experiencing_pa her lower abc en that eventually ‘ted resembling cramps, re developed bleeding. Her skin is pale, pulse - 88/min., blood pressure - 100/60 mm ‘body temperature - 36,8°C. Vaginal examination: the uterus size corresponds to Il weeks of gestation, the=cervical canal allows inserting 1 finger and contains fragments of the fertilized ovum, the discharge: is: bloody-and-profuse. What is the most likely diagnosis? A. 12-week pregnancy, spontaneous abortion in progres B. 12-week pregnancy, threatened spontaneous abortion . Disturbed menstrual cycle, hyperpolymenorrhea D, Disturbed menstrual cycle, amenorrhea E. Full-term pregnancy, term labor 18, A 38-year-old patient has been delivered by an ambulance to a surgical department with complaints of general weakness, indisposition, black, On examination the patient “Ws pale, there are dotted ‘extremities. 7 is ‘are Dlack feces on the glove. Blood test Hb-T08 g/L. ghromboeytopenia. Anamne: Sates that sinilarcondition wis observed T r ago. Make the diagnosis: ‘4. Thrombocytopenic purpura _ B. Hemophilia c€ & : C. Uleerative bieeding 5 v9 Ho v7 D. Rectal tumor E. Nonspecific ulcerative colitis 2p? ssuder 19, A 20-year-old woman, gravida 2, para 1 has been in slaborefor’ 4=hours, Her condition is satisfactory. Moderately painful contractions-occur-every-3-minutes and last Tosmo- Trunk. for 35-40 seconds. The waters have not burst yet. The fetus is in longitudinal position. Fetal heartbeats are 136/min., clear and rhytmic. Major segment-of the-fetal head is engaged to the epelvie~inlet. Vaginal examination shows smooth eervix of 6 em, t, sagitfal suture 1s mn the left oblique diameter, occipital fontanel is on the right near the symphysis pubis What stage of the labor is it? A. Active phase of the fi labor B, Latent phase of the fi labor C. The second stage of normal labor D, Precursors of childbirth E. Preliminary stage 20, A I2-yearold girl after-a=case~of respiratory infection developed dyspnea at rest, paleness of skin, Heartrateis 110/min., BP=is-90/55-mm Hg. Heartesounds are t stage of normal 1 stage of normal aiuiiled. Borders of relative heart qummesss— right - the parasternal line, upper - the III rib, left - 1,0 em outwards from the midclavicular line. Make the provisional diagnosis: A. Infectious myocarditis B. Functional cardiopathy C Somatoform autonomic dysfunction D. Hypertrophic cardiomyopathy E, Exudative pericarditis, 21, A 72-year-old man with pneumonia, complains of marked dyspnea, chest pain, Severe _coughmnt—cspeciortion —t 395-40°C, no urination for the last 24 ‘TOUTS, Objectively the patient is conscious. Respiratory raté is 36/min, Percussion sound is dull over the right lower pulmonary lobe; on auscultation there is bronchial respiration and numerous moist_cracl Blood pressure Hy, Heart Tae min, Heart sounds saulec Shech, “There is tachycardia. What tactics should the family doctor choose for the management of this patient? A. Hospitalization into the intensive care unit B, Outpatient treatment C. Treatment in the day patient facility D. Hospitalization into. the pulmonology unit E. Hospitalization into the neurology unit 22. 3. hours “aftersastrauma, a young an developed «bradycardia of 46/min., anisocoria_D>S, ‘hemi-hyperreflexia_S>D, cpemihypesthesia “STS and convulsive disorder, The character of this cess needs to be clarified. What method of examinationwill be the most accurate forKrok 2 Medicine 4 this purpose? A. Head CT B. Skull X-ray C. Electroencephalography D. Echoencephalography E. Lumbar puncture 23, 2 hours after eating unknown mushrooms, a 28-year-old man Sensed a of his ability to focus. This condition was hon followed by a state of agitation and imression, On examiantion he is disoriented and his speech is illegible, 4 hours later he developed fetor_hepaticus and lost his consciousnéss. What syndrome can be observed in this patient? A. Acute hepatic failure B. Hepatolienal syndrome Portal hypertension D. Cholestatic syndrome E. Cytolytic syndrome 24, During regular medical examination lyceum student presents with ilitis that manifests as_epithel ation in the area of lip seal. The e bright-red, with single vertical bs. These Tiinical signs are most likely caused by sufficient content of the following in the lips cracks covered with brown-red di A. Riboflavin B, Ascorbic acid C. Retinol D. Thiamine E, Caleiferol 25, During regular examination of a (2 year-old:boy, he presents with enlarged left kidney, painless on palpation. Theeright kidney =was~undetectable “on-~palpation. Exoretory urogi s contrast on the tight. Cytoscopy detected hemiatrophy of the urinary bladder trigone, the right ureteral orifice is not detected. What pathology is it? ‘A. Agenesis of the right kidney B. Dystopia of the right kidney C. Hypoplasia of the right kidney D. Agenesis of the right ureter E, Ectopic right ureteral orifice 26, A 13-year-old girl for a month has been complaining of fatigability, dull pain-in-her right-subeostal-area, abdominal distension, and constipations. Abdominal palpation reveals positive Kehr, Murphy, and Ortner signs, while Desjardins and Mayo-Robson points are painless. Total bilirubin is 14.7 memol/L, predominantly indirect, ALT- 30 U/L, AST- 40 U/L, amylase - 6.3 mmol/L. A. Hypokinetic biliary dyskinesia B. Hyperkinetic biliary dyskinesia : Chronic pancreatitis D. Acute pancreatitis E. Chronic hepatitis 27. A surgery unit received a person with an incised stab wound on the upper third of the right thigh. Examination detects an incised stab wound 3.0x0).5x2.0 cm in size on the inner surface of the upper third of the right thigh. Bright-red Iblood-flows from deep within thé wound in a pulsing stream, Characterize this type of bleeding: A. Arterial B. Venous CC. Parenchimatous D. Capillary , intoxication symptoms appeared, regional lymph nodes enlarged. Complete blood count: anemia, ~ Ieukocytos neutrocytosis, raised ESR. What diagnosis will you make? A. Pscudofurunculosis B. Pemphigus C. Vesiculopustulosis D, Scalp phlegmon 29, A 25-year-old man was hospitalized with complaints of pain in his lower abdomen and right lumbar area that appeared one hour ago. The patient’s general state is moderately severe, Body temperature - 38.2°C, heart rate - 102/imin, The tongue is dry. The abdomen is painful on deep palpation in the right iliac area and-in-the Petit triangle. Aure-Rozanov and Gabay signs=are~ positive: Make the provisional diagnosis: A. Acute appendicitis B. Right-sided renal colic . Cecal tumor D. Intestinal obstruction E. Acute cholecystitis 30, A 32-year-old woman complains of general “weakness, low-grade fever persisting for 4 months, lumbar pain, and dysuria, Anamnesis includes frequent acute respiratory diseases, overexposure to cold, low-calorie diet, _a_case— of “pulmonary tuberculosis“ in childhood. Clinical urine elKrok 2 Medicine 5 analysis; pH- 4.8, leukoeyturiay hematuria Complete blood count: leukocytosis, lymphocytosis, raised ESR. Urography Concludes: dilatation-of-renal® pelvis and calyceal. system of both kidneys, foci of calcification™-in--the==projection of =right Kidney parenchyma What is the most likely diagnos A. Nephrotuberculosis, B. Right renal cyst C Right renal carcinoma D, Acute glomerulonephriti E. Chronic pyelonephritis 31. A full-term newborn (born with the body weight of 3900 g ‘at gestational age of 39 weeks) on the first day of his life developed respiratory disturbances: dyspnea, arrhythmic respiration, cyanosis attacks. On examination there is side of the chest laps bel ane breathing, On auscultation the respiration EeWeakened’ in the lungs--on- the lett. Neurologist diagnosed the patient withrleft- sided Erb-Duch« sx Complete blood count shows no changes, What is the most likely diagnosis? A. Left-sided diaphragm paresis B. Congenital pneumonia C. Left-sided pneumothorax D. Respiratory distress syndrome E, Transient tachypnea of the newborn 32. A Bive: ild has been brought to a hospital with complaints of pain in the leas fever, and loss of appetite. jectively: gic rash, painless, dense elastic, not matted tovether Banss— joints and abdome The liver ‘and spleenare enlarged. Hlemogram: Hb- 88 gL. color index - 1.3, platelets - 80 - 10°/L, leukocytes - 25.8 + 10%L, lymphoblasts - 970%." ESR- 52. mm/hour. Make the provisional diagnosis: A. Acute leukemia B. Thrombocytopenie purpura C Acute rheumatic fever D, Infectious mononucleosis E. Hemorrhagic vasculitis (Henoch-Schonlein purpura) 33. A 22-year-old postparturieni informs of fever up to 39°C for the last 3 days and pain in her right mammary gland The rightmammars-sland-isenlaned hot Palpation reveals there a dense infiltration SxS.cm.with a fluctuation in its comer What A. Postpartum period, day 12. Right-sided —infltyntive-puudent mastitis ‘ostpartum period, day 12 serous mastitis C. Postpartum period, day 12 gangrenous mastitis D. Postpartum period, day 12 phlegmonous mastitis Postpartum period, day 12. Right-sided Right-sided Right-sided old woman came ‘Anamnesis states i pregnancies, Bimanual examination: the uterus and uterine appendages are without changes. During diagnostic curetiageof the A. Endometrial carcinoma B. Adenomyosis CC. Subserous uterine myoma D, Cervical carcinoma Ovarian carcinoma 35. A patient has gradually lost his consciousness. The skin is pale and dry. There is smell of ammonia from the mouth. is are deep and noisy. Heart sounds are muffled, pericardialfriction-rub is present, Blood pressure is 180/130 mm Hg, Blood test: Hb- 80 g/L, leukocytes - 12- 10%/L, blood glucose - 6.4 mmol/L, urea - 50 mmoV/L, creatinine - 1200 memol/L, blood osmolarity - 350 mOsmol/kg 1,0. No urinary excretion. Make the diagnosis: A. Uremic coma te renal failure D. Acute disturbance of cerebral circulation E. Hyperosmolar coma 36. During winter epidemics of influenza caused predominantly by virus ‘alifornia/04/2009 (HIN1), on the 2nd day after the disease onset a 30-year-old hospitalized man presented with high fever, dry cough, myalgia, headache, and general weakness, What should be prescribed as an ctiotropictreatmentin this case? A, Neuraminidase inhibitors (oseltamivir) B. Antibiotics C Immunoglobulin D. Interferon inducers E. Acyclovir 3% A 30-year-old woman made an appointment with the family doctor for scheduled vaccination _of her 2-year-oldKrok 2 Medicine 6 child. What type of healthcare provides such medical services? A. Primary healthcare D. Tertiary healtheare E. Palliative 4K An 18-year-old patient_always obeys others and adapts his needs fo the demands of the people on whom he depends. He excessively defers to their wishes and makes them responsible for his wellbeing, cannot defend his interests and needs support from other people. Such psychic profile has been formed in the childhood, remains unchanged, and hinders adaptation, What psyehic disorder is observed in this patient? A. Dependent personality disorder B. Anxiety (avoidant) personality disorder C. Anankastic personality disorder D. Markedly accentuated personality E, Psychopathy-like state 39. A.45-year-old man with thrombophlebitis, ofsthe sudder after xe nes Sea pain-in his thorax on the right, dyspnea, and hemoptysis. Objectively his’ condition is severe; he presents with acrocyanosis, shortening of pulmonary-percussion sound on the right, and weakened respiration, Respiration is 30/min., blood pressure is 110/80 mm Hg. ECG shows sinus tachycardia, his heart rate is 120/min., the elecitical axis of the heart deviates to the right, S)-Qyr;. What is the most likely diagnosis? A. Pulmonary embolism B. Community-acquired right-sided pheumonia C. Cancer of the right lung D. Right-sided exudative pleurisy E. Spontaneous pneumothorax 40, An 18-year-old patient complains of skin rash, The patient has been suffering from this condition for 5 years. The first instance of this disease occurred after a car accident. Objectively: the patient presents tha Ere "thimble”sign (small pits on the nails), aap What is the most likely SS A. Psoriasis B. Panaritium C. Onychomycosis D. Lupus erythematosus E, Rheumatism 41, A woman complains of frequent watery stool (up to 9-10 times per day) with mucus and.blood-admixtures, dull pain in_ the hypogastrium, weight loss of 4 kg within the last year Objectively: malnutrition, dry skin, low turgor, aphihous stomatitis. The abdomen is soft, the sigmoid:colon is spastic and painful on palpation. Occult blood test is positive. Fibrocolonoscopy: edema, hyperemia, mucosal granulation, pseudopolyps, smail ulcers with irregular Garee Hate the diagnosis A. Nonspecific ulcerative colitis Bloody dante B. Chronic enterocolitis C. Colon cancer D. Irritable bowel syndrome E. Crohn's disease, (regional enteritis) yuokery, dante Bint Teun) 42. A 48. r-old woman has een hospitalized’ due to development of tachysystolie atrial fibrillation. She has lost Si ob body w RTE ‘2-months, On pele ne uu orb od ee j thyroid gland, What pathology resulted Th The development of this condition? A. Toxic nodular goiter B. Aterosclerotic cardiosclerosis C. Chronic thyroiditis D. Nontoxic nodular goiter E. Autoimmune thyroiditis 43. After a long drive with the window open a man developed a faciabasymmetry? jm. he-cannoteclosehisoright-eye, his right nasolabial fold is smoothed oui, movements of expression are absent on the right, there is a disturbance of taste sensation in the tongue on the right. No other neurological abnormalities were detected. What disease can be provisionally diagnosed in this case? A. Neuropathy of the facial nerve B, Neuropathy of the trigeminal nerve ney, C: Trigeminal ganglionitis D. Neuropathy of the oculomotor nerve E, Ischemic stroke 44, On ultrasound of the thyroid gland, a 47-year-old woman presents with hypoechoic node 1.6 cm in diameter with blurred margins and intranodular hypervascularization, The doctor suspects il carcinom ‘Witat metho SHOUTT Method Should be TTT ve A. Fine-needle aspiration biopsy B. Thyroid scintigraphy C. Case monitoring D. Determine TSH level in the blood E. Positron emission tomography (PET) 45. A 19-year-old young man complains of cough with expectoration of purulent sputum in amount of 100 mL perKrok 2 Medicine 7 day, hemoptysis, dyspnea, increased body temperature up to 378°C. general weakness, weight loss. “The _ patient's condition lasts for 4 years, Exacerbations occur 2-3 times a year: The patient presents with malnutrition, pale skin, cyanosis of the lips, drumstick (clubbed) agers. Tympanic percussion sound in the lungs, weakened respiration, and various numerous moist crackles in’ the lower pulmonary segments on the left can be observed in this patient. In blood: erythrocytes - 3.2-10'/L, leukocytes, - 84+ 10"/L, ESR- 56 mm/hour, On X- ray: lung fields are emphysematous, the left pulmonary root is deformed and dilated. What is the most likely diagnosis? A. Multiple bronchiectasis of the left lung, B. Chronic left-sided pneumonia C. Chronic abscess of the left lung D. Left-sided pulmonary cystic dysplasia E. Suppuration of the cyst in the left lung 46. A 56-year-old woman was diagnosed with stage 2 hypertension of the 2nd degree. She belongs to the group of moderate tisk nd has bronchial asthma, What group of drugs. is ICATED to this patient? A. f-blockers B. Angiotensin-converting enzyme inhibitors C. Diureties D. Calcium antagonists E, Imidazoline receptor antagonists, 2A 40-year-old vietim of a traffic accident ined the following injuries: closed diaphyseal femur fracture, brain concussion, multiple rib fractures. hemopneumothorax, degloving.-shin.injuries, What injuries require the most urgentattention? A. Multiple rib fractures, hemopneumothorax B. Closed diaphyseal femur fracture C. Brain concussion D, Degloving shin injuries E. All injuries are equivalent 48. A 28-year-old man, a’teacher, after an emotional stress developed ppaimfulomascle spasms in his right hand that occur during writingynow he has to hold the pen between the second and third fingers. He has no problems with=typing-or writing on the blackboard; no other motor disturbances or neurological pathologies are detected. What is the most likely diagnosis? A. Writer’s cramp B. Cortical agraphia Parkinsonism D. Neuropathy of the right ulnar nerve E. Neuropathy of the right radial nerve 49, A 45-year-old man underwent a cardiac surgery One week ago. His general state has been deteriorating since then: dyspnea at rest, retrosternal pain that irradiates to the neck, marked weakness. Objectively his body temperature is heetic. His cardiac borders are expanded, apical beat is weakened. Auscultg et b What is the most likely diagnosis? A. Acute pericarditis B. Acute cardiac aneurysm . Myocardial infarction D. Acute myogenic dilatation of the heart E. Pulmonary embolism 50. A 73-year-old woman came to the family physician for one of her regular follow-up examinations. Three-months ago she was found_to_hay. fabetes mellitus. je was Keeping to her die RETEISE plan and taking phylopreparations. On examination her fasting glucose was within the range of 78-8.6 mmol/L, HbA lc - 79%. Height - 164 cm, weight --83-ke What blood»glucose-controlling-medicine should she be prescribed first in the course of her pharmacological therapy? A. Metformin B. Glibenclamide C.Glimepiride D, Gliclazide E. Insulin 51. A 27-year-old man complains of pain in his leg joints, purulentdischarge from the eyeseand painful burning tions GUurIMg —inmation. The disease onset was acute. He has a history of influenza, The patient smokes and drinks alcohol in excess. In his line of work he is often away on business trips» What is the most likely etiological factor of this disease? A. Chlamydia B. Adenovirus Streptococci D. Staphylococci E. Candida 82°A child was born at 40=weeks~of gestation with the weight of 370g. The child's Apear score is 7/9. The baby was put to breast immediately after birth and Suekled actively: On the 3rd day of life the child's weight decreased to 3600-8, What transitory-condition. is observed in. this child?Krok 2 Medicine 8 A. Physiological weight loss B. Transient dysbiosis . Physiological jaundice D. Toxic erythema E. Uric acid infarction 53. A 26-year-old man complains of chills, rhinitis, dry cough, and fever up to 38°C. Examination shows him to be in a moderately severe condition; there are small pale pink nouemergingrspots-onthe ~alpation reveals enlarged=oceipitaland» auls-bmphoses No information about jon history could be obtained. What, is the likely etiology of this disease? A. Rubella virus B. Epstein-Barr virus C. Streptococcus D. Mumps virus, E. Meningococcus $4, A 19-year-old young man was diving and hit his head on'the bottom of the pool He complains of pain in the neck, his head 1. During examination his head is bowed forward and to the right and the patient supports it with his hands. Palpation detects tense neck “muscles and protruding spinous process ofethe=1V~cervieal-vertebra=(C4). When pressure is applied to this process and to the head (axial load), the pain intensifies. Make the provisional diagnosis: A. Uncomplicated cervical fracture B. Cervical contusion Complicated cervical fracture oH! 1D. Neck muscle injury 5 E, Spinal root injury eta 58, A 75-year-old man in a severe condition suffers from dyspnea at rest, marked and arrhythmia, Abdominal | further on systolic- murmur detected Palpation reveals a volumetric formation in the mesogastrium. Blood pressure is mm Hg, There js There is no-pulsation over tie Lemoual-aiesses—Oliguria is detected. nich diagnosis is the correct one? A. Dissecting aortic aneurysm B. Pancreatic cyst C. Acute pericarditis D. Cardiosclerotic aneurysm E. Acute cardiac aneurysm 56. The body of a citizen was found at the place of his dwelling. On his face, neck, and wounds, varying from 2x3 eeu to 4x5 cm in size. The skin and underlying tissues are absent in the wounds, The margins of the wounds are uneven, with major and:minor scalloping along. the edges and no signs of at is the initiating mecha of these wounds? A. Animal bite wounds B. Pellet gunshot wound C. Local effect of cold D. Blast injury E, Multiple stab and incised wounds 5% A pregnant woman at 34 weeks of gestation underwent which revealed a reverse= diastolic component. Objectively, the height of the uterus is 27 em above the pubic bone, the head of the fetus is mobile and located above the entrance to the lesser pelvis, Fetal heartbeat is 136/min, Vaginal examination shows that the uterine coris is closed, its length js 3. om. What tactics should the obstetrician choose’? ‘A. Urgent cesarean section B. Repeated dopplerometry next day G. Fetal biophysical profile D, Ultrasound photometry of the fetus E. Labor induction with oxytocin 58, A 26-year-old woman was hospitalized into the gynecological department with complaints of body temperature up to 38.2°C, fever, general weakness, and dirty- ted blood discharge from her genital tracis. She is hemodynamically stable. Two=days U gnaney, Ultrasound detects th i hat are the tactic the patient management in this case? of A. Revision of the uterine cavity with vacuum aspirator, Antibiotic therapy B. Laparotomy. Supravaginal uterine amputation, Abdominal drainage C. Pipelle biopsy D. Uterine cavity treatment with antibiotic solutions E. Laparotomy. Extirpation of the uterus and tubes. Abdominal drainage 59. During a regular examination, an &- year-old itl with type T diabetes mellitus with a "The swelling is 3 cm dense, painless on palpation, ‘The skin over this formation has normal color and temperature. Localization ofthe i iT the most Ti ort presentation?Krok 2 Medicine 9 A. Development of hypertrophic lipodystrophy B. Development of atrophic lipodystrophy C. Formation of a post-injection abscess D. Formation of a post-injection infiltration E, Allergic response 60. A pregnant woman at 32. weeks of gestation with the risk-ofpreterm: I labor undergoes a treatment to prevent So ‘What as she prescribe A. Dexamethasone B. Gynipral (hexoprenaline) C. Progesterone D. Oxytocin E. Misoprostol 61, A family doctor performed an external obsterical examination. of a pregnant woman and determined that her -uterine» fundus is located at the level of the navel. What is the most likely term of pregnancy in this woman? A. 24 weeks B. 8 weeks C. 16 weeks: 1D. 32 weeks E. 40 weeks, 62. Examination detected vesicles with 4th day of life. The patient’s condition is satisfactory, the child is active, all newborn reflexes can be fully induced, the umbilical cord is at the stagé of mummification, the umbilical area is without any peculiarities What disease can be suspected? A. Vesiculopustulosis B. Neonatal pemphigus C: Miliaria D. Phlegmon E, Epidermolysis bullosa 63. On the abortion the woman was hospitalized into the gynecological department in a severe condition with { intoxicati abdominal pain, and purulent discharge from the vagina. Objectively, the patient's condition is severe, her body temperature is 38.8°C’, pulse is 100/min., blood pressure is 110/70 mm Hg, the uterus is soft, the uterine fundus is located at the level of the navel, there arc_positive signs of_peritongal ‘irritation, What is the most likely diagnosis? A. Pelviperitonitis B. Acute metroendometritis C. Uterine perforation D, Acute suppurative salpingo-oophoritis E. Ectopic pregnaney 64. A 10-year-old boy came to the polyclinie with complaints of stuffy=nose. It is known that these signs occur in the child eriodicalh He as a i The Objectively, the boy’s face is pale and slightly swollen, Respirations are 22/min Auscultation detects vesicular respiration over the lungs, Rhinoscopy shows swollen and pale nasal mucosa, What disease can be suspected? A. Allergic rhinitis B. Recurrent respiratory disease C. Acute rhiniti D, Acute maxillary sinusitis, E. Acute adenoidit 65. A Tyear-old boy after_a fall from_a height, presents with Tapid and shallow ‘Preathing and cyanotic face. "The tight half-of his-thoraxis distended and takes no part in the respiration, Percussion detects tympanitis in the affected aca, while auscultation=detects no~ breathing there. What pathology is the most likely cause of this clinical presentation? What instrumental examination would be the most informative in this case? A. Right-sided tension pneumothorax. Chest Xray B. Mediastinitis, Survey X-ray of the chest G. Tension cyst of the right lung. ‘Tracheobronchoscopy D, Airway foreign body: Diagnostic- therapeutic bronchoscopy E. Right-sided hemothorax. Survey X-ray of the chest, 66. A 9-year-old boy fell off a tree and hit the back of his head, A brief loss of consciousness was observed. The child’s condition is satisfactory, he has a headache and vertigo, Skull_X-ray_ scan What treatment tactics is indicated for this patient? A. Surgical intervention B. Anii-inflammatory therapy CC. Hemostatic therapy D. Lumbar puncture fo relieve the pressure E. Complex conservative treatment 67, A 57-year-old man, arminer, complains of a pain in his chest, dyspnea on physicalKrok 2 Medicine 10 exertion, excessive sweating, constant subfebrile tempeature, and cough that produces blood-streaked sputum. He. has been smoking for approximately 40 ears (2 packs a day) and frequently has pneumonias” Survey chest X-ray shows a triangular shadow in the middle lobe of the right-lung One of the apices of the shadow points to the lung root, Cardiac and the affected area. Make the provisional ‘diagnos A. Cancer of the right lung B. Pheumoconiosis Right-sided pleuropneumonia D. Tuberculosis of the right lung E. Chronic bronchiti 68. A 45-year-old man came to the hematologist with complaints of general weakness, elevated body temperature, excessive sweating, enlarged cervical lymph nodes. Objectively. his body temperature is 325°C. the skin is pale and dry, the posterior cervieal lymph nodes are dense and clastic, up to 2 cm in diameter, mobile. There are no peculiarities in the patient’s heart and lungs. Hepatosplenomegaly was detected, What ~Sxamination is necessary to determine the oat Ppraneas! A. Computed tomography B. Abdominal X-ray C. Ultrasound of the cervical lymph nodes. D. Complete blood count E. Bone scintigraphy 69. A 54-year-old woman complains of a fogged. vision..in-her=tight-eye= rainbow circles in her vision, headache, and nausea Within the last month she twice experienced a similar condition, but back then all the signs eventually disappeared and her sight was restored, Currently, all the signs have bed persisting for over 2 days. Objectively, the patient has eyelid edema, congestive injection of the eyeball, coreal=opacity, shallow anterior chamber of the eye, and dilated pupil that is unresponsive to the light, Herintraocularpressureis48:mm Hg, Make the diagnosis: ‘A. Glaucoma B. Keratitis C. Iridocyclitis D. Iritis E. Cyclitis 70. A newborn has a round red:formation in the suprapubic region. Examination shows that urine is being discharged in pulses from the:two-orifiges: located in the lower part of this formation, Name this developmental anomaly; A. Bladder exstroph B. Vesico-umbilical fistula C. Bladder diverticulum D. Urachal eyst E. Bladder agenesis 71. A 20-year-old woman complains of headaches. vertigo. tearfulness, vomiting, pain in the area of the heart, and tachycardia, ‘The signs-appear 6-7 days diagnosis: A. Premenstrual syndrome B. Algomenorrhea C. Metabolic craniopathy D. Diencephalic syndrome E. Stein-Leventhal syndrome 72. After semolina. was introduced into the diet, old child for 2 months has been presenting with loss of appetite, irritability, loss of body mass, and loss of previously learned skills. The feces are copious and foul-smelling, The skin is pale and dry, the hair is brittle. The abdomen is distended, while the limbs are thin, Stool test shows high levels of fatty acids. What is the most likely diagnosis? A. Coliac disease B. Mucoviscidosis C. Lactase deficiency D. Functional diarrhea E. Irritable bowel syndrome 73. On the Stheday-alter=giving=birth a postparturient’ woman complains of a pain in her ‘left=-mammary~gland. and body temperature up to” 381°C. Examination shows that her mammary d is enlarged and painful on palpation, the nipple is edematous and has fissures, pmnLoLihe gland is yperemic, Name the measures that would have prevented the development of this complication in the patient: A, Feeding on demand, expression of breast milk, prevention of nipple fissures B, Feeding on schedule C. Constant expression of breast milk D. Feeding no longer that 10 minutes through an overlay E, Stop breastieedi 74, A.2.5-year-old child is ill for the second day, The onset of the disease was associated with the temperature up to 378°C. a single bout o 2 iar io 5 times During the second i vomiting occurred twice, body temperature is 38.0°C’, the child has low appetite, watery diarrhea continues. The treatment of the 2 when fissures appearyo Krok 2 Medicine u child should start with the following: A. Prescribe oral rehydration B. Prescribe nifuroxazide C. Prescribe ceftriaxone D. Preserbe polymyxin lo E, Prescribe loperamide 75. A 12-year-old gitl has been suflering op from h Lately her periods of excitation have been intermittent with depression, she does Objectively, her condition is severe, the girl is sluggish, gives one-word- responses, tremor insher-extremities, her skin is icteric, with single hemorrhagic rashes. Name the likely complication of her disease: ‘A. Hepatic encephalopath: Bekidhey failure C. Bipolar affective disorder D. Sepsis E, Reye syndrome A 19-yearold girl complains of 2 Thoderate itching and hair loss on her head, Objectively, on the skin of her occipital region there is a single round erythematous focus 3 em in diameter with cléar margins. Asbestos-like scales can be observed on the surface of the lesion. The hairin-the focus of the lesion is broken off at the length of 6-8:mm What is the most likely diagnosis? A. Microsporia B. Thichophytosis . Psoriasis D.Seborrhea E. Scabies 77, A 43-year-old man complains offacial edema, dyspnea, and difficult-swallowing that appeared 3 hours alterhe-wasstunoy _uingeetObjectively. the skin of is eyelids ie eks, and lips is acutely hyperemic and edematous, What medieines should he be prescribed for A. Glucocortivosteroids B. Antihistamines C. Muscle relaxants D. Nonsteroidal anti-inflammatory drugs E. Diuretics 78. A 68-year-old woman with congestive> heart-failure and left ventricular ejection fraction of <40% receives the followin pharmacotherapy scheme: ramipril, torasemide, bisoprolol, clopidogrel, and During one’ of her regular ‘examinations, frequent polymorphic were “detected in the patient, What medicine should be removed from her therapy scheme? A. Digoxin B. Torasemide C. Ramipril D. Clopidogrel E. Bisoprolol 79. A 23-year-old woman with diabetes-mellitus during the 2nd week of community-acquired pneumonia developed nausea and vomiting, In the evening she has lost her consciousness and was hospitalized. Objectively, the patient’s skin is pale and dry. Her respiration is loud, the tongue is dry, with brown deposit, Her heart rate is 129/min., blood pressure is 85/50 mm Hy. Palpation of the patient's abdomen provokes no response. The liver is +3 cm, blood 26 mmoll/L, Make the provisional A. Ketoacidotic coma B. Hepatic coma C. Lactacidemic coma D. Hyperosmolar coma E. Infectious toxic shock rl complains of a-pain it and cody to 39°C: 2 weeks ago she s. Objectively, her joints are swollen, sharply painful, and their mobility is reduced, On the skin of her trunk and limbs there are barely visible circle-shaped-pale-pink-spots, Heart rate is 95/min., blood pressure is 90/60 mm Hg, heart sounds are weakened, there is a solt systolic noise over the apex. Make the provisional diagnosis: A. Acute rheumatic fever B. Reactive arthritis C Rheumatoid arthritis, D. Erythema nodosum E. Systemic scleroderma 81. A 45-year-old man has been suffering from apkoiosinassnandyliiiniiiedSayeans For the last 3 years he has been noticing facial swelling and edemas of the limbs, Objectively, he assumes a “beggar’s” position, X-ray shows "bamboo spine” Changes. in the thorace—and-- RTD segments. Heart ultrasound shows aortic regurgitation. Complete blood count: Hb- 106 g/L; leukocytes - 8.9 - 10°/L; ESR- 40 mm/hour, Daily proteinuria 9.6 g r 34 hours, Blood creatinine ~ 230 memolL, What is the cause of kidney failure in this, case?Krok 2 Medicine 2 A. Renal amyloidosis B. Medicine side effects C. Pyclonephritis D. Concomitant heart disease E. Urolithiasis 82. A 2-yearold man headache, general weakness, and dace edema, that appears in the morning. 18 days earlier he _had_a_case_of tonsillitis. ‘Objectively, his skin is pale, there are edema under his eyes, Heart rate is 60/min., blood pressure is 185/100 mm Hg. The sign of costovertebral angle tenderness (punch sign in the lumbar region) is negative, Urinalys color of * protein - 4.5 g/L, altered nee 40-45 in the vision field, in the vision field, 24- hour diuresis is 400 mL, What is the most likely diagnosis? suffers from A. Acute glomerulonephritis B. Acute pyelonephritis C. Systemic lupus erythematosus D. Urolithiasis E, Renal amyloidosis 83. A 45-year-old woman undergoes an inpatient treatment. She complains of up to 390°C, pain inher right lumbar area, turbid urine with blood, CT scan shows «area Tow density within the parenchyma, no difference between the cortical and medullary layers, and i i What is oan A. Pyelonephritis B. Glomerdlonepbsitis C. Renal carcinoma D. Renal abscess E. Paranephritis 84. A__ patient was referred for a psychiatrist is 45 years old. He a consultation with due to complaints of abdominal pain and discomfort that occur in emotionally — straining situations, Objectively, no-changes of the were detected, The complaints emerged over=10=years~ago poisoning, The patient has who were has beep epeatcdly Visitin roenterologists, ‘unable to nays Significant changes in the patient, The prescribed therapy was ineffective. What is the likely conclusion? A, Somatoform autonomic dysfunction B. Functional dyspepsia C. Chronic alcoholism D, Organic brain disorder E. No disorders Es 30-year-old woman complains of 7 . predominantly in the evening and-at night. The condition lasts for 2 weeks already. On the skin of the interdigital folds, ‘eeaiaiameieiomeiianitiyilail and thighs there are numerous fine papular and papulovesicular rashes located in pairs, ‘There is no rash on the face and neck, Similar rash is observed in the husband of the patient. What is the most likely diagnosis? A. Scabies B. Neurodermatitis C. Eczema D. Herpes E. Epidermophytosis G@. What should be prescribed as secondary ‘A. Oral anticoagulants, B. f/-blockers C. Aspirin or clopidogrel D. Calcium antagonists E. Nootropies 87 After the pregnant woman's waters broke, it was noted that they are Upon birth, the , remains inert, “tre—sknr 1S cyanrone and coyered:in-meconiumy heart rate is 98/min, What resuscitation=-measures» should be taken after the baby is born? A, Direct laryngoscopy, intubation, sanation of the trachea B, Sanation of the upper respiratory tracts with a rubber balloon G. Tactile stimulation of the newborn D. Give adrenaline intravenously E. Artificial pulmonary ventilation with a mask and Ambu bag 88. A 16-year-old boy developed dizziness. His heart rate is 35/min., blood pressure is 85/45 mm Hg. Heart borders are not enlarged, Heart’ sounds are loud and clear. different rhytim of atria and ventricles is accompanied by varying location of P wave in relation to QRST complex. This presentation is the most characteristic of the following disease: A. Complete atrioventricular block (III degree) B. Atrioventricular block (II degree) C. Atrioventricular dissociation D. Extrasystole us bradycardiaKrok 2 Medicine 2B 93. A 65-year-old man underwent a left hemicoleciomy due to a malignant tumor in the descending colon, On-the-4th-day after 89. A 35-year-old woman complains of a ‘pain-in-her.right-axillary. region. She has arma been suffering from this condition for a week. Her body temperature is 38’C. In the | right axillary region there are 2 formations, nthe Homans ign i postive on 5 oy 2-cm=inesize each, The skin over ihe the left. What postoperative tonplication *py7puap formations is dark reson thin, Palpation developed in this patient? vu te miagh) fistula pcnins What is the most likely A. Acute postoperative thrombosis of the & diagno: deep veins inthe left shin mets * cute postoperative thrombosis of the” A. Hydradenitis » abscess puttuls in B. Carbuncle (comp Great, grit 9 » gin) C. Furuncle Awvat glands D. Folliculitis 90. A 58-year-old woman has _ E. Lymphadenitis ‘Te MN Torin, She prepares for ciolecaesiame ObjsinoR: He ROBT hy. her hergl is T6t cm. weight is 90 kg, heart rate is 72imin., blood pressure is 130/80 mm Hyg. Her abdomen is soft, painful in the right subcostal region, The liver is not enlarged. Fasting glucose - 6,2 mmol/L. Glycated hemoglobin=6.5%. What further tactics of sugar-lowering therapy should be chosen in this case" A. Prescription of a short-acting insulin B. Prescription of an insulin mixture €: Prescription of a long-acting insulin D. Continue the present scheme of therapy E, Prescription of glurenorm (gliquidone) 91, A 56-year-old woman has been working asia disis She complains of general weakness, nausea, bitter taste ier_mouth, heavy sensation—™m—Ter in FEAT sMeostal area, and rapid fatigability jeclively, her body temperature is 371°C, the sclerae are icteric. and the liver is fotal bilirubin is 40 memol/L. enlarged. ‘Ty What is the likely diagnosis? ‘A. Occupational toxic hepatitis B. Chronic cholecystitis, C. Acute cholecystitis D. Biliary dyskinesi E. Chronic pancreatitis 92, During examination of a patient, the doctor detected in him disorders of the eyes (hemeralopia, Bitot’s spots), skin and skin appendages, mucosa, and gastrointestinal tract. He ‘was provisionally diagnosed wit What causes the development of this pathology? A. Zine deficieney B. Vanadium deficiency . Iron deficiency D. Manganese deficiency E. Copper deficiency popliteal artery on the left $s C Acute distirbance of the cerebral blood low D. Acute postoperative lymphangitis of the left shin E, Postoperative allergic reaction 94, Alter "1 ya 2 year-old ch . stridorous respirations, urges to vomit, and cyanosis against the background of relative somatic health, What should the doctor suspect first when examining this child? A. Foreign body aspiration B. Acute laryngotracheitis CG. Pertussis D. Pneumonia E, Acute obstructive bronchitis, 98. What_modern=organzational™method i ie Seitiements with, Gmely access 10 quality medical aid and such medical services as consulting, diagnostics, and treatment, especially in the situations when time and distance are crucial? A. Telemedicine B. Mobile communication C Field medical teams D. Air medical services E. Ambulance services 96. 40% of the workers, who polish the ° : ry nt, are diagnosed with ulnar neuritis, 21% - with vegetative polyneuritis, and “12% - with yegetomyofascitis of ‘the upper limbs. ‘These pathologies are associated with the following harmful factor: A. Vibration B. Microclimate Dust D. Noise E, Electromagnetic field A 45 -year-old woman complains of Bests body weight throughout the last year. Examination-=revealed.-moon re face syndrome, brittle hair. hirsutism, stretchy “marksonethe-abdomen, andKok 2 Medicine 4 disproportionally"thin' limbs. The patient's height is 162 em, her body weight is 94 kg, her body mass index is kg/m?, What type of obesity is it? A. Dysplastic B. Android © Gynoid D. Alimentary E. Cerebral constitutive 98. A 4S- year old man with a history of attack of palpi bs a e sensations of lack of air, fear and vertigo, food pressure is °G during the attack shows extey S. complex (0.13 seconds) with heart rate of Siymin. discordant: shit of ST_scament and Te waves=dissociation..0f-atrial..and Yentricularthythm. What disturbance of cardiac rhythm is it? du 40 R87 abronmautun A, Paroxysmal Veniricular oe ‘ardia B. Paroxysmal supraventricular tachycardia C Ventricular fibrillation D. Atrial fibrillation E. Frequent ventricular extrasystoles 99. A 45-year-old woman was hospitalized with complaints of periodical severe headaches against the background of elevated blood pressure up to. 180/90 mm Hg, muscle weakness, and frequent urination (at night as well). Her anamnesis, states that despite combining various antihypertensive drugs and adjusting. their dosage her arterial hypertension cannot be corrected with drugs. The patient's blood serum potassium levels are 20-aumalil, blood “serum Sodium levels are 1a. mmol/L. Ultrasound imaging detects three- dimensional formations approximately 10 em in diameter in the both adrenal glands, Selective endovascular blood sampling from the suprarenal veins was performed, which revealed significant increase-of-cortisoland aldosterone levels:Make the diagnosis: , A. Aldosteromaey Corns B. Androsteroma C. Pheochromocytoma D. Cushing's disease E. Cushing's syndrome 100. An 8:day-old-boy'was delivered to the hospital on the second day after the onset of the disease. His parents complain of his, fussiness, regurgitation, body temperature up to 385°C, red_skin with infiltration in the lumbar area, His medical history has no peculiarities. The child is in the severe condition, inert, pale, suckles poorly. In the lumbar area, on the sacrum and buttocks there is a tense infiltration with hyperemic and cyanotic areas and with a soft spot 8x7 em in its-center, The stool is 10 times in 24 hours, with green and mucoi os What is the most Tikely diagnosis? A. Phlegmon of the newborn B. Adiponecrosis C: Erysipelas D. Heman, E. Congenital soft-tissue tumor 101. A. 55-year-old woman complains of thyroid=gland=enlargement that can be observed throughouth the last 2 years and a discomfort during swallowing, Objectively, she has signs of hypothyroidism. The thyroid gland on palpation is dense, non- fused with the surrounding’ tissues and g. The regional lymph ‘um there A, Hashimoto's thyroiditis B. Thyroid cancer C Acute thyroiditis, D. ndemic goiter Midline cervical cyst 102, A patient. was brought into. the pulmonology department with complaints of inspiratory dyspnea and dry cough at the highest point of inhalation, On examination the following is observed: pale Skin, cyanotic lips. “Hippnctatic ingess™, Ausculiation detects Velero-type crackles (like opening a Velero fastener). X shows a “groundoglassopacity” pattern. Whos heme ee ly diagnosis? A. Idiopathic pulmonary fibrosis B. Exogenous allergic alveolitis, CC: Pulmonary histiocytosis X D, Hand-Schuller-Christian disease E. Idiopathic pulmonary hemosiderosis we 35-year-old woman had acute onset e disease that started with fever up to 39.0°C’ and cough. 3 days later her dyspnea at rest increased up to 35/min Downward from her right shoulder-blade percussion detects a dull sound, No fremitus, respiratory sounds cannot be auscultated, What is the treatment tactics? A. Pleural tap B. Antibiotic therapy C. Artificial lung ventilation D, Oxygen therapy Physiotherapy 104, Children from a certain township present withsbrittlesteeth, malocclusion, dental enamel erosions, and dental Pigmentation that looks like yellow-brownKok 2 Medicine 15 spots, What is the likely cause of this presentation? A. High levels of fluorine in water B. Low levels of fluorine in water C. High levels of sulfates in water D. Low levels of sulfates in water E. High levels of nitrates 10, A 48-year-old man came to a doctor with complaints of vomiting that. brings no relief and a burning pain in his left subcostal region that irradiates to the lett signs are, icytosis Tncreased ESR. In the urine: elevated diastase levels. Make the diagnosi ‘A. Chronic pancreatitis in the exacerbation st B. Chronic gastritis in the exacerbation stage C. Renal colic D. Gastric ulcer perforation E. Chronic cholecystitis in the exacerbation stage 106. A multigravida, labor I, 36-37 weeks of gestation, has gone into. labor, Her waters broke 8 hours ago, the labor activity continues for the last 4 hours, it is regular, with contractions that las -conds and occur every 3-4 minutes. The child is in the cephalic presentation, with the head pressed to the entrance into the lesser pelvis. The parturient woman complains of a sudden sharp abdominal pain. Her pulse is 100/min., blood pressure is 110/70 - 100/70 mm Hy, The uterus is tense and does not relax between the contractions, Fetal heartbeat is mufiled - 100/min. Theamniotic fluid is blood-coloy fat is the most likely dia nosis? A. Premature detachment of the normally positioned placenta B. Uterine rupture C. Rupture of the umbilical vessels D. Partial placenta previa E. Cervical rupture 107%, A. 65-year-old man with anteriorsmyocardial~infaretion devel ATsphiyxra attack, EXMMMTATION Wetecta d ‘cyanosis. In the lungs there are numerous heterogeneous wet crackles. Heart rate is 100/min. Blood~pressure is 120/100 mm Hg, What- complication occurred in this patient? acute ‘A. Pulmonary edema B. Cardiogenic shock CC Pulmonary embolism D. Ventricular septal rupture E. Hypertensive crisis 108. A woman came to the gynecologist to plan her pregnancy. She was advised to increase her intake of the products rich instiglic-acid particularly soy beans, bread made of coarsely ground flour, fruits, leaf green vegetables, Such changes in her dict will work toward the prevention of: A. Non-closure of the neural tube in the fetus B. Rickets C.Non-closure of the fontanel D. Iron-deficiency anemia in the pregnant woman E. Polyhydramnios A patient Dyearsago had a Q-wave myocardial-infarction of the posterior wall the left ventricle. For the last: 2eweeks he has been suffering from-daily attacks of atrial fibrillation and brag FERRO EPICS accompanied Dy-Douts_of vertigo. Wiha tactics is the most advisable in this case? A. Pacemaker implantation B. Prescription of procainamide C. Prescription of digoxin D. Prescription of amiodarone E. Prescription of bisoprolol A woman complains of a severe pain in her throat on the left, difficult swallowing and mouth opening, elevated body temperature, and general malaise. The onset of the disease was 4-days-ago after rene-oL tonsils Eemnaton ctects SMmus of the masticatory muscles, the left tonsil is displaced toward the midline, the anterior palatal arch is-infiltrated-and protruding, The regional-lymph=nodes on the right are enlarged~and painful on palpation. Make the diagnosis: A. Peritonsillar abscess B. Lacunar tonsillitis . Tonsillar tumor D. Acute pharyngitis, E. Infectious mononucleosis Gh A S-year-old child had acute onset the disease that manifested in body D °C’, marked chills, weakness sinerin kin pallor, and headache. 8=hours-later=a-shemorrhagic bale ‘eloped on the skin of the buitocks ‘and-Tegs, The child is sluggish, the body temperature has dropped, blood pressure is 80/40 mm Hg, respirations are 28-30/mii diuresis.is decreased. Make the provisional diagnosis: