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Krok 2 Medicine exam Ukrainian (Fully translated To English)

14 / MAY / 2024

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1. The six-year-old girl has: physical retardation, attacks of fainting, shortness of breath, pale
skin, widening of the boundaries of the heart and systolic trembling in 11 intercostals, accent I
tone over the pulmonary artery and systolic-diastolic noise in the intersonal region. During the
radiography of the OGC, the following was revealed:

Increased pulmonary pattern, cardiome-gallium due to the left parts of the heart, protrusion of
the pulmonary artery arch. What is the most likely diagnosis?

А. Open oval window

V. Open arterial duct

С. Terada Fallo

D. Pulmonary artery opening stenosis

E. Transposition of main vessels

2. Several chemicals enter the human body from the atmospheric air.

What is the type of combined action in which the cumulative effect exceeds the sum of the
sfects of each individual substance included in the combination, in the case of its isolated
action on the organism?

А. Combined action

V. Complex action

С. Isolated action

D. Antagonism

E. Potentiation

① 3. A ten-month-old child has acrocyanosis, mucous membrane cyanosis, tachycardia and

shortness of breath. It is known from the history that the child with his parents lives in a
settlement with a decentralized water supply. Exceeding the concentration of which compound
in drinking water is most likely to cause-

Is the disease in the child?

А. Myshyak

V. Lead

С. Nitrates
D. Aluminum

E. Cobalt

4. A 64-year-old patient fell on his left side.

Objectively observes the shortening.

Left limb, external thigh rotation, symptom of the sticky heel. During palpation and tapping on
the village. Which feels pain in the hip joint. What is the most likely diagnosis?

А. Hip fracture

V. Fracture of a large verglug

Yes. Hip dislocation

F. Fracture of the upper third of the femur

E. Hip joint bruise

5. What is a reliable laboratory pok-

The severity of acute venous thrombosis?

А. Increased fibrin level

V. Increased blood clotting time

С. Reduced fibrinogen level

D) Increased O-dimer level

E. Reduced prothrombin index

6. A 29-year-old patient complains of irritability, relaxation, headache,

Chukarta yunana bam in pita me serra.

Zm. These complaints occur 6 days before menstruation and disappear on the eve or in the
first two days. During the bimanual study, the uterus and appendages were found unchanged.
What is the most likely diagnosis?

А. Genital endometriosis

E. Neurosis

7. A patient aged 28 complains of pain in the lower abdomen on the right, delayed
menstruation for 10 days. The vaginal examination revealed: the cervix is cyanotic, the body of
the uterus is softened, slightly enlarged in size. In the projection of right applications, there is a
painful tumor-like formation up to 4 cm in diameter. On the left, the applications are not
palpable. The discharge is dark-hemorrhagic, sco-days. According to the results of the blood
test, it is observed: hCG is positive. What is the most likely diagnosis?
А. Left ovary cyst

Acute appendicitis

Right-sided tubal pregnancy

D. Leiomyoma of the uterus

E. Apoplexy of the right ovary

8. The patient complains of sharp paroxysmal pain in the left lumbar region, nausea, periodic
vomiting, red urine and frequent urination. From the history, it is known that she got sick
acutely a few hours ago, after a trip in the car. Taking a bath somewhat reduced the pain, but in
a few hours it increased dramatically again. Objectively observed: sharp pain during palpation
in the area of the left kidney, a positive symptom of Pasternatsky on the left. What is the most
likely diagnosis?

А. Urolithiasis, left-lateral renal colic

V. Polycystic kidney, exacerbation of chronic shelonephritis

С. Acute pyelonephritis, kidney abscess

D. Addison's disease, crises

E. Ureterocele, hydroureteronephrosis

9. A 48-year-old patient was hospitalized with inadequate behavior. It is known from the history
that she constantly used painkillers due to migraine and back pain. Objectively observed:
yellowness of the sclera, sensitivity in Right upper quadrant of the abdomen and asterixis.
According to the results of the blood test

BHSBICHO: AJIT - 649 O/t, sararsan Gi

Ruby - 95.8 μmol/l, MNV - 6.8. What is the most likely diagnosis?

Acute liver failure

V. Acute cerebral circulation disorder

С. Intoxication with anticonvulsants

D. Acute adrenal insufficiency

E. Acute renal failure

10. The patient aged 26 years complains of cramping abdominal pain, diarrhea with 1
significant amount of 1 blood mucus, an increase in body temperature to 38°C, objectively
observed: pale skin and mucous membranes, asthenic structure of the body. During palpation,
pain was detected during the course of the colon. During colonofibroscopy, the walls of the
rectum and sigmoid intestine were swollen, erosions, small ulcers, in the lumen of mucus with
blood. What is the most likely diagnosis?
А. Dysentery

V. Crohn's disease

С. Nonspecific ulcerative colitis

D. Colon cancer

E. Chronic enteritis

11. The patient had massive bleeding after the birth of twins through the natural birth canal.
Objectively observed: children's place and birth canal goals. The floor of the uterus above the
navel, the uterus during palpation is soft, does not respond to the introduction of uterotonics.

What is the most likely cause of bleeding?

А. Cervical damage

V. Hypotension of the uterus

C Atony of the uterus

D. Uterine rupture

V. Placental lobe delay

12. A 40-year-old patient with disseminated pulmonary tuberculosis suddenly had severe pain
in the right half of the chest and increased shortness of breath. Objectively observed: the skin
is pale, heart rate - 120/min. Auscultatively heard: the right of breathing is sharply donkeyed,
the left is hard. What is the most likely diagnosis?

А. Pulmonary embolism

V. Pneumonia

С. Spontaneous pneumothorax

D. Pleurisy

E. Myocardial infarction

13. A 20-year-old patient was hospitalized with complaints of irregular cramps and bleeding
from the genital tract. It is known from the history that the gestational age is 39 weeks. During
an external obstetric study, the manifestation-

Len: position of the fetus is longitudinal, head-

Not presentation. Uterine hypertension is determined. According to the results of an internal

obstetric study, the following were found: 1 cm long cervix, cervical

Ka-

Nal open by 2 cm. The head will be presented

Fetus, pressed to the entrance to the small pelvis.

The discharge is bloody, with convolutions. Fetal heartbeat is arrhythmic, 80-100/min. What
complication did the patient have?

А. Premature placental detachment

V. Cervical rupture

С. Uterine rupture

D. Full presentation of the placenta

E. Regional presentation of the placenta

14. A 55-year-old patient complains of headache, dizziness, itching of the skin and bleeding
from the gums. Objectively observed; skin with a red-cyanotic tint, silenomegaly. According to
the results of a general blood test, you Revealed: erythrocytes - 7.5 • 1012/l, hemo-
Globin - 206 g/l, KP - 0.95, leukocytes - 10, 3 • 10%/l, ESR - 2 mm/h. What is the most likely
diagnosis?

А. Eritrea

V. Lymphogranulomatosis

С. Misloma disease

D. Chronic myeloid leukemia

E. Acute myeloid leukemia

15. A 28-year-old patient was hospitalized with complaints of sharp pain in the lower abdomen,
short-term loss of consciousness at home. It is known from the history that the last
menstruation was 12 days ago. During the vaginal examination, the uterus was found: the
uterus of the common form, non-pain, the applications on the left are slightly enlarged and
painful during palpation.

The rear arch is hanging, tense and cut

KO 60104e. Sixnk HakiMoBipHinห" _tiarno3?

А. Twist the legs of the cyst

V. Apoplexy of the right ovary

С. Piosalpinx on the right

D. Exacerbation of chronic adnexitis

E. Ectopic pregnancy
16. A 35-year-old man with epilepsy developed a major convulsive attack lasting 4 minutes. 10
minutes after the attack, consciousness did not recover, repeated tonic-clonic seizures
occurred.

What medication should be used in this situation?

А. Haloperidol

V. Carbamazepine

С. Amitriptyline

V. Valproic acid

E) Diazepam

17. A 45-year-old patient referred to a doctor with complaints of fever to 39.5°C, fever, perineal
pain, calls to urinate, absence of se-These last 8 hours. Objectively observes-

Th: a painful anato- is floating over the womb

Mic formation, the upper edge of which reaches

Navel.

During a rectal examination, the prostate gland is bleached,

MINO KOMCHCTCHI piKo Gonicha mit tac

Palpation. What is the most likely diagnosis?

1. Prostate cancer

V. Toastria prostatitis

С. Prostate hyperplasia

D. Acute paraproctitis

E. Acute urethritis

18. A 30-year-old patient complains about the absence of menstruation during the year. It is
known from the history that massive postpartum bleeding occurred during childbirth.
Objectively observed: secondary genitals are developed correctly, hairing according to the
female type. During a bima-nual study, the uterus and

Appendages without features. Which is possible

The cause of amenorrhea?

А. Pituitary necrosis

V. Necrosis of the adrenal cortex

С. Thyroid disorders

D. Ovarian insufficiency

E. Hypothalamic insufficiency

19. Among all registered diseases of the population served by the city's polyclinic, patients
with diabetes

Are 21%. What statistical point-of-disape is given?

А. Seed

V. Extensive

С. Correlations

D. Intense

E. Ratio

20. A 25-year-old patient was hospitalized in a serious condition with symptoms of intoxication,
abdominal pain and purulent discharge from the neave. From the history it is known that 3 days

That's why an artificial abortion was done. About actively

Observed: severe condition, temperature-

P1070 M pr: 9 ly tac uartal Te

But: the uterus is soft, its bottom is at the level of the navel, the symptoms of peritoneum
irritation are positive.

What is the most likely diagnosis?

А. Acute metroendometritis

V. Acute purulent salpingoophoritis

С. Perforation of the uterus

D. Pelvioperitonite

E. Ectopic pregnancy

21. The patient complains of severe sore throat on the left, difficulty swallowing and opening
her mouth, fever, general malaise. With a history of vi-domo, which has an acute farin-git for 4
days. Objectively observed: trism of chewing muscles, left amygdala

Pushed to the middle line, the front palatine bracket is infiltrated and protrusions.
Regional lymph nodes on the left are enlarged and painful during palpation. What is the most
likely diagnosis?

А. Diphtheria

V. Scarlet fever

С. Infectious mononucleosis

D Paratonsylar abscess

E. Tonsil tumor

22. A 38-year-old natient has a paroxysmal increase in blood pressure to 235/120 mm Hg.
During an attack, a natite complains of nausea, bleating, tachycardia, slutty, death, headache,
shortness of breath, tremor of the hands and skin. Attacks start suddenly and last 20-40
minutes. In the blood during the attack there is: leukocytosis with sozinophilia, blood glucose -
6.3 mmol/l. The attack ends with polyuria, after which the patient notes drowsiness, redness of
the skin, general weakness and fracture persist for a long time. What is the most likely li-

А. Diabetes

V. Graves' disease

С. Itenko-Cushing's disease

D. Theochromocytoma

E. Primary hyperaldosteronism

23. A 53-year-old patient complains of pain in the small joints of both hands, a feeling of
morning stiffness while walking and movements. Objectively observed:

Interphalangeal joints are deformed, the muscles of the hands are atrophied. According to the
results of the blood test, hemoglobin - 90

G/l, leukocytes - 9.0 • 10%/l, ESR - 38

Mm/h, LE cells. During X-ray examination of the hands, epiphyseal osteoporosis, marginal
erosion and narrowing of the joint slit are observed. What is the most likely diagnosis?

А. Ankylosing spondyloarthritis

V. Gout

С. Systemic erythematous lupus

D. Systemic scleroderma

E Rheumatoid arthritis

24. A 32-year-old patient complains of weight loss, lack of menstruation and a decrease in hair
in the external genital organs. From the history it is known: it links complaints to childbirth that
occurred 2 years ago and Were accompanied by significant bleeding.
According to the results of a blood test, the level of gonadotronic, thyroid-stimulating and
adrenocorticotropic hormones was reduced by 50% from normal. During the vaginal
examination, pathology was not revealed. What is the most likely diagnosis?
А. Itenko-Cushing's disease

B, Shihan Syndrome

С. Itenko-Cushing Syndrome

D. Stein-Levental syndrome

E. Testicular feminization syndrome

25. A seven-year-old child has subfebrile body temperature, vesicle-bladddom on the skin of
the face, trunk and limbs with the transformation of the rash into the crust

Chki. On the 6th day of the disease appeared:

Repeated vomiting, nystagmis, shaky gait, chanted speech and instability in the Rom-berg
pose. What is the most likely diagnosis?

А. Enterovirus infection complicated by meningIt

V. Meningococcal infection

С. Rubella complicated by an encephalic reaction

D. Chickenpox, complicated by meningoence-phalitis

E. Influenza, severe form, neurotoxicosis

26. Patient age

32 years complains

For increased body temperature to 40°C, chills, cough with sputum, hemorrhage and chest
pain during breathing, myalgia, diarrhea. It is known from the history that he works in an air
conditioning service firm. A few days ago, his colleague went to the hospital with the same
complaints.

During the radiography of the OGK, the following were found: vo-o-orne infiltrative shadows of
various shapes and densities in both lungs. Which causative agent most likely caused the
disease?

А. Mycoplasma

V. Legionella s. Staphylococcus

D. Klebsiela

E. Pneumococcus

27. A 60-year-old patient complains of minor bleeding from the genital tract that appeared after
4 years of menopause. During the bimanual study, the following were found: the cervix of a
cylindrical shape, the entire epithelium. The uterus in the anteflexio, slightly enlarged in size,
movable. The applications of the uterus do not finger, the discharge is hemorrhagic. During the
diagnostic vyscrea-

Bath of the uterus was obtained by the brain

Similar scraping. What is the most likely di-

Agnosis?

А. Dysfunctional uterine bleeding

V. Climacteric bleeding

С. Leiomyoma of the uterus

D. Uterine body cancer

E. Adenomyosis of the uterus

28. A patient aged 64 complains of weakness and sweating that increased over 3 months. It is
known from the history that he often suffers from colds.

Objectively observed: palpable

Mnixi Ta maxoBi indarnuni Bystu posmipom

029424

To hazelnuts, soft consistency, not soldered with surrounding tissues, painless. Liver +2 cm.
According to the results of the blood test, red blood cells - 4, 1 • 1012/l, hemoglobin - 123 g/l,
KP - 0.9, leukocytes - 41 • 10% l, eosinophils - 1%, rod-nuclear - 2%, segment nuclei.

No

- 21%, lymphocytes - 74%, monocytes

- 2%, ESR - 40 mm/h, platelets -

220- 10%/l, Botkin-Gumprecht shadows. What is the most likely diagnosis?

А. Chronic lymphocytic leukemia

V. Lymphosarcoma

С. Lymphogranulomatosis

D. Infectious mononucleosis

E. Chronic myeloid leukemia

29. A 29-year-old patient complains of a culsing field in the rectum area, fever in the rear, and
general weakness. Objectively observed: local pain in the anal area. During the finger
examination of the rectum, a painful infil-trate was revealed, reaching the comb lin. What is the
most likely diagnosis?

А. Acute hemorrhoids

V. Acute paraproctitis

С. Acute anal fissure

D. Acute prostatitis

E. Tumor of the rectum

30. In a 30-year-old patient with diabetes during a fluorographic examination

Ves were discovered

A few focal those-

In the first segment of the left lung of low intensity. The man's well-being is satisfactory

The Mantoux test with 2 TO is 21 mm in diameter. What is the most likely diagnosis?

А. Disseminated tuberculosis

V. Bronchial asthma

С. Metastatic lung cancer

D. Focal tuberculosis

E. Pneumonia

31. A 45-year-old patient complains of abdominal pain and discomfort that occurs in stressful
situations. Objectively observed: no pathological changes in the gastrointestinal tract were
detected. It is known from the history that complaints arose more than 10 years ago against
the background of severe alcohol poisoning. The patient repeatedly contacted
gastroenterologists who did not find any essential changes, the prescribed treatment was
ineffective. What is the most likely diagnosis?

. Oneroid

V. Somatoform disorder

С. Organic brain damage

D. Functional dyspepsia

E. Chronic alcoholism

32. Two-year-old child hospitalized with mother's complaints of promotion

Body temperature up to 38.8°C and barking cough that occurred during sleep. Objectively
observed: the child is restless, pale, instructive shortness of breath. Duscultatively, a weakened
fever is heard, BH —
46/min, heart rate - 120/kw, AT

- 80/40 mm Hg.

What is the most likely diathnosis?

А. Foreign body of the lower respiratory tract

V. Acute bronchitis

С. Acute stenosing laryngotracheitis

1. Bronchial asthma attack

E. Angioedema of Quincke

33. A patient aged 14 complains of frequent, painful urination, an increase in body temperature
to subfebrile numbers, irritability, sleep disorders and enuresis. It is known from the history: the
disease is associated with hypothermia. Objectively observed: Pasternatsky's symptom is
negative. According to the results of urine analysis, it was found: leukocyturia, bacteriuria.
What kind of nai-

MotipHiman parko3?

А. Neurogenic bladder weakness

V. Urethritis

С. Cystitis

V. Pyelonephritis

E. Tubulointerstitial nephritis

34. A 70-year-old patient complains of acute chest pain and shortness of breath. It is known
from the history that a day ago pro-opero-

In connection with atherosclerotic gan-

Green foot. Objectively observed:

The skin is cold, wet, cyanosis of the upper half of the chest and neck of the type of "Stokes",
tachycardia, a drop in blood pressure. What is the most likely dia-

Gnosis?

А. Bronchial asthma attack

V. Acute cerebral circulation disorder

С. Aortic aneurysm stratifying

R. Myocardial infarction
E. Pulmonary embolism

35. A 40-year-old patient complains of sharp pain in the shoulder joint. It is known from the
history that 2 hours ago I fell on the hand. Objectively observed: the right arm is withdrawn and
bent in the elbow joint.

There is a depression in the area of the del-like muscle. The head of the humerus is determined
under the beak-shaped growth of the shoulder blade. Active movements are impossible,

Passive movements are elastic. What is the most likely diagnosis?

А. Shoulder dislocation

V. Surgical fracture of the shoulder neck

BONES

С. Fracture of the head of the humerus

D. Fracture of the large humerus

E. Fracture of the collarbone

36. A 55-year-old patient complains of propos, peeling and pigmentation of open areas of the
gil (neck, arms and feet), irritability. It is known from the history that one of the main products in
her diet is corn, other vegetables and legumes a woman rarely eats, meat and fish eats ns
What is the most likely diagnosis in a patient?

А. Psoriasis
Pellagia
V. Skorbut

С. Swift's Dermatitis

1. Berry-bury

CE Ilevarpa

37. A young man of 16 years old had a memorization. Objectively observed: heart rate

- 35/min, AT - 85/45 mm Hg. The boundaries of the heart are not widened. Auscultatively
heard: heart tones are sonorous and pure. For the result-

TATAM# EKT BHSBICHO: 3yori P He mo8 wbani

With ORS complexes, dissociation and different rhythm of atria and ventricles are
accompanied by a different arrangement of the tooth

P regarding the QRST complex. What is the most likely diagnosis?

. Extrasystole
B,

Atrioventricular blockade of III degree

С. Atrial fibrillation

•. Sinus oradycardia

E. Atrioventricular blockade |1 degree

38. A patient of 25 years of age has multiple hyperpigmented spots on his back against the
background of tanned skin, during scratching of which seeding-coc-like exfoliation is
observed. The balzer test is positive. What is the most likely diagnosis?

А. Pink Pityriase

V. Vitiligo

С. Scleroderma

D. Multicolored lichen

V. Seborrheinia dermatitis

39. A tooth extraction is planned for a 23-year-old patient. It is known from the history that
from childhood he suffers from hemophilia A. Vve-

What medical product for the purpose of

Is hemostasis ensured necessary before and after surgery?

А. Etamzilate

V. Fresh frozen plasma

(C) Cryoprecipitate

D. Ascorbic acid

E. Aminocaproic acid

40. An eight-year-old child complains On

Weakness, headache, oznoa and increase in body temperature to 39°C. It is objectively
posterned: pronounced catarrhal phenomena of the pharynx, film conjunctivitis and moderate
hepatolienal syndrome. Which HakiMonipaitni Jiarno3?
А. Adenovirus infection

V. Rhinovirus infection

С. Parainfluenza

D. Flu
E. Respiratory-syncytial infection

41. An eighteen-month-old child had baldness of the back of his head, restless sleep and
increased sweating. What is the most likely diagnosis?

Rachit

V. Chondrodystrophy

С. Phosphate-diabetes

D. Spasmophilia

E. Anemia

42. The patient has encephalopathy, polyneuropathy, porphyrin metabolism disorders. The
general blood test observes: basophilic granularity of erythrocytes. The function of the kidneys
and liver is broken. What metal poisoning caused such clinical symptoms?

А. Cadmium

V. Silver

С. Lead

D. Manganese

E. Mercury

43. A patient aged 50 years for a month and a half has a stable increase in jaundice, anemia
with periodic podiomas of body temperature. Md during pal-patsi was found: a solden and
painless gallbladder. What is the most likely dia-

Gnosis?

А. Gallbladder cancer

V. Echinococcosis of the liver

С. Cholelstone disease

D. Pancreatic head cancer

E. Primary sclerosive cholangitis

44. A 58-year-old patient complains of general weakness, rapid fatigue, sleep disturbance and
weight gain.

Objectively observed: excess body weight, tendon reflexes are reduced,

Pulse - 38/min, blood pressure - 100/60 mm Hg, BH -

14/min. It is known from the history that a year ago she underwent subtotal resection of the
thyroid gland. What is the most likely diagnosis?
А. Diabetes

V. Thyroid cancer

С. Hypoparathyroidism

D. Hypothyroidism

E. Graves' disease

45. A 30-year-old patient complains about

Expressed

Headache of high inten-

Grayness. The pain arose against the background of psycho-emotional stress. During a
neurological examination, the following is observed: obsidity of the muscles, anisocoria. There
is no reaction of the dilated pupil to light. What is the most likely di-

Arhos?

А. Trigeminal nerve neuralgia

V. Epilepsy

С. Subarachnoid hemorrhage

D. Myelit

E. Encephalitis

46. A 15-year-old patient complains of headache, weakness, fever and sore throat. Objectively
observed: moderate hyperemia of the mucous membrane of the pharynx, enlarged tonsils and
all groups of lymph nodes, 1-3 cm in diameter, dense, elastic, slightly painful and not soldered
together. Hepatosplenomegaly. According to the results of a blood test, leicocytosis,
lymphomonocytosis, virocytes - 15% were revealed. What is the most likely diagnosis?

А. Scarlet fever

V. Adenovirus infection

С. Diphtheria

D. Acute lymphoblastic leukemia

E. Infectious mononucleosis

47. The eight-day child was hospitalized with parents' complaints of anxiety, regurgitation,
fever to 38.5°C, redness and skin infiltration in the lumbar region. Anamnesis without special-

Vosti.
Objectively observed: the condition is severe, the child is flabby, pale and sucks badly. In the
lumbar region, sacrum and buttocks, a tight infiltrate with areas of gy-peremia and cyanization
was found, in the center there is a softening of 8x7 cm. Chair up to 10 times a day with
admixtures of greens and mucus.

What is the most likely diagnosis?

А. Hemangioma

V. Adiponecrosis

С. Beshiha

D. Congenital soft tissue tumor

E. Phlegmon of newborns

48. A 35-year-old patient complains of weakness, itching, fever to 37.5°C, pain in the left and
right subchondrium, enlarged lymph nodes. According to the results of the general blood test,
neutrophilic leukocytosis, lymphocytopenia, anemia, enlarged SHOV are observed.

During a lymph node biopsy, it was detected: polymorph cell granulomas and cli-

Berezovsky-Sternberg. Which on-

Is the diagnosis more likely?

А. Acute leukemia

V. Chronic myeloid leukemia

С. Lymphogranulomatosis

D. Myeloma disease

E. Chronic lymphocytic leukemia

49. A full-term newborn girl on the 4th day of life had a petechial rash on the skin of the trunk
and face, hematuria, Ground. The general condition is not disturbed. 3
History is known that pregnancy and childbirth in
Mothers ran without complications. According to the results of a blood test, prolonged
prothrombin time and time of partial activation of thromboplastin, decreased activity of PI, VII,
IX, X blood clotting factors. What is the most likely diagnosis?

А. Hypoplastic anemia

V. Hemolytic disease of newborns

С. Hemorrhagic disease of newborns

D. Hemophilia A

E. ICE syndrome
50. A patient aged 18 complains of weakness, dizziness, decreased appetite and menorrhagia.
It is objectively observed: on the skin of the upper limbs of petechia of different colors.
According to the results of the blood test, hemoglobin - 105 g/l, era-

Trocytes - 3.2 • 1012/l, KP - 0.95, trom-

Bocytes — 20 • 10% l. Blood fusion time for

Lee-White

— 5 minutes, duration of bleeding per

Dux — 14 minutes. What is the most likely dia-

Gnosis?

А. Hemophilia

V. Hemorrhagic diathesis

С. Markiafavi-Mikeli disease

D. Iron deficiency anemia

E. Idiopathic thrombocytopenic purpura

51. A 42-year-old patient has a lung disease. From the history, it is known that it works in an
enterprise in the air of the working area of which the concentration of silicon dioxide exceeds
the MPC three times. What occupational disease is most likely to have occurred in the pack-

Ent?

А. Ciderosis

V. Antracose

С. Silicone

D. Silicatosis

E. Aluminosis

52. A six-year-old child complains of fever, headache and pain when swallowing. Objectively
observed:

Bright red

Crane in sik nao-peremon and rivkri,

More abundant on the lateral surface of the trunk and in natural folds, differentiated hyperemia
of the oropharyngeal mucosa, purulent plaque on the tonsils. Which is the most likely

Diagnosis?
А. Infectious mononucleosis

V. Scarlet fever

С. Rubella

D. Kip

E. Diphtheria

53. A 23-year-old pregnant woman stays in the maternity ward for 6 hours with regular labor
activity, weight gain - 17 kg, estimated fetal weight 4300 200 grams, pelvic size

27-30 cm. Interruct every 2-3 minutes by

45-50 seconds during the last hour.

Complains about the pain of the last intermites, Vasten's symptom is positive. During the
vaginal examination, the following was discovered: the cervix is smoothed, opening 10 cm,
edges

Necks with swelling. Fetal positions

Longitudinal, occipital preposition, and position, front view, fetal head above the entrance to
the small pelvis, discharge from the seam mucosal. What is the most likely diagnosis?

L. Physiological course of the second period of childbirth

V. Threat of uterine rupture

С. Clinically narrow pelvis

D. Premature placental detachment

E. Discoordination of maternity activities

54. A 25-year-old patient complains of lower abdominal pain and minor spotting bleeding from
the genital tract for 3 hours. It is known from the history that the last menstruation was 2
months ago. During the vaginal examination, it was found: the body of the uterus is enlarged to
10 weeks of pregnancy, the outer eye passes the tip of the finger, the discharge is hemorrhagic
minor. According to the results of ultrasound, it is observed: the uterine cavity is expanded -
the picture of "snow in1-chry". What is the most likely diagnosis?

А. Ovarian apoplexy

V. Bubble skid

С. Threat of spontaneous miscarriage

D. Miscarriage on the move

E. Endometriosis
55. A 24-year-old patient complains of lower abdominal pain, minor purulent discharge from
the genital tract, fever to 38°C. It is known from the history that the last menstruation ended 2
days ago, urgent. Sex life from the age of 19.

Objectively observed: AT - 110/70 mm Hg. Pulse - 92/min. The abdomen is soft, painful in the
lower parts. Urination is painless. During the bimanual study, the uterus of the usual simers was
discovered, mobile, painless. The appendages on both sides are enlarged, painful during
palpation.

The discharge is purulous, insignificant. What is the most likely diagnosis?

А. Tubovarial tumors

V. Gonorrheal urethritis

С. Acute salpingo-ophoritis

1. Acute appendicitis

E. Acute metroendometritis

56. A 25-year-old patient complains of infertility, delayed menstruation and a small number of
them. Objectively observed:

Height — 165 cm, body weight — 80 kg, hair growth on the face, hips is noted. According to
the results of a bimanual study on both sides, increased dense consistency of the ovary with
dimensions of 5x5 cm was revealed. The same data is confirmed during ultrasound. Yaki

HakiMoBipHininn piarnos?
А. Premenstrual syndrome

V. Androblastoma of the ovaries

С. Adrenogenital syndrome

D. Chronic bilateral adnexitis

E. Polycystic ovary syndrome

57. A 35-year-old patient had an attack during which palpitations, chills and fear of death
appeared. Objectively observed:

Pale skin and increased blood pressure. The attack ended with the release of a large amount of
urine.

What pathological condition did the patient have?

А. Collapse

V. Epileptic seizure

С. Thyrotoxic crisis

D. Hyperglycemic coma
E. Sympatho-adrenal crisis

3b. A 39-year-old man has been hospitalized

On the 4th day of illness with complaints about the head-

Pain, weakness, dizziness, sweating, insomnia and fever. Objectively observed: the face is
hyperemic, swollen, conjunct-vit. On the transitional fold of the conjunctiva are single petechia.
On the skin of the trunk, chest, abdomen, limbs there is an abundant roseol-petechial rash.
Tachycar-action. AT - 100/60 mm Hg. There is a tremor of the tongue. The liver and spleen are
palpated. What is the most likely diagnosis?

А. Flu Fiphus
V. Meningococcemia

• Peptostrosis
Epidemic
D. Typhoid fever

E. Typhoid fever

59. A 60-year-old patient complains of frequent, painful urination,

110-

The effusion of blood impurities with convolutions at the end of urination. What research
method should be assigned to establish di-

Agnosis?

А. Examination cystoscopy

V. Urethra smear

С. Kidney ultrasound

D. Survey urography

E. Computed tomography of kidneys

60. A 39-year-old patient has been ill for 15 years. During the examination, she says that her
brain has long been taken over by "criminal physicists" who test various types of psychotropic
weapons on it. Feels affected by laser rays, constantly hears messages that are transmitted

1st directly into the brain. Emotionally mono-ton, periodically makes some records that does
not show to anyone. Consciousness is clear, formal intellectual-mnestic times-

Shen was not found. Which

The most likely

Diagnosis?
А. Chronic delusional disorder

13. Reactive paranoid

C, Maranoid schizophrenia

D. Schizo-affective psychosis

E. Involutionary paranoid

61. A 32-year-old man, after a 3 km race, at an air temperature of 28°C and sunny weather,
suddenly complained of dirring, headache, general weakness, palpitations, heartbeats and a
feeling of trembling on his body, fainting. From the history of history, it is known that he has
diabetes and epilepsy, takes insulin, the last time he ate about an hour ago. Objectively
observed: skin pale, cold, sticky sweat, blood pressure

- 100/70 mm Hg, heart rate - 94/min, tone

Muscles are elevated, clonic seizures. What is the most likely diagnosis?

А. Heat stroke

V. Epileptic seizure

С. Hypoglycemic coma

F. Sunstroke

E. Collapse

62. A 34-year-old patient complains of weakness, an increase in blood pressure to 170/95 mm

Hg, the appearance of swelling on the feet and lower legs, lower back pain. From the history of
history, it is known that he often has ARVI, tonsillitis. According to the results of a general urine
analysis, the following were revealed:

Volume weight — 1,022, leukocytes — 6-8 in p/z.

Erythrocytes — 9-10 in p/z. Daily excretion of protein with urine — 5.8 g/l. In the urine analysis
according to Nechiporenko, it is observed: leukocytes-

You - 2, 1 - 10¾, red blood cells - 1, 1 • 10%/l,

Cylinders — 1 - 10% l hyaline. Hypercholester-nemia and hypoproteinemia were found in a

biochemical blood test. What kidney damage syndrome is observed in this patient?

А. Nephrotic

V. Urinary

С. Nephrotic

D. Acute renal failure

E. Chronic kidney failure

63. A 36-year-old patient complains

For attacks of shortness of breath with mostly difficult- By exhalation, which occur up to 2-3
times a day and are removed by inhalations of 32-adrenomimetics. It is known from the history
that he has been ill for 10 years. Objectively observed: the chest is dilated, a boxed percussion
tone is above the lungs, a hard one is heard during auscultation
Breathing with extended exhalation. For the result-There are many eosinophils, Sharko-Leiden
crystals and Kurshma-na spirals have been found in a laboratory study of sputum. What is the
most likely diagnosis?
А. Bronchial asthma

V. Heart asthma

С. Tuberculosis

D. Spontaneous pneumothorax

E. Chronic obstructive bronchitis

64. After psychosmocial stress, the patient felt a sharp weakness, headache, dizziness and
trembling of the limbs.

Objectively observed: facial skin hyperemia, body temperature - 36.4°C, BH

- 22/min, heart rate - 98/min, AT - 185/100 mm Hg:

Art. During auscultation, heart tones are rhythmic and muted, with an accent of 2 tones over
the aorta. What is the most likely di-

Agnosis?

А. Sympathoadrenal crisis

V. Myocardial infarction

С. Thyrotoxic crisis

D. Acute cerebral circulation disorder

E. Hypertensive crisis

65. A 22-year-old pregnant woman is hospitalized in a serious condition. Over the past three
days, swelling, headache, nausea, one-time vomiting have appeared. Objectively observed:
obsciousness is overshadowed, blood pressure - 160/130 mm Hg, small fibrillary twitching of
facial muscles, difficulty nasal breathing. During trans-

Porting began twitching top-

Their limbs, the woman's body stretched, the spine bent, the jaws tightly clenched, breathing
stopped. After that, clonic seizures appeared, expressed cyanosis. Then the cramps stopped,
a deep one appeared
Noisy breath, tna appeared on the lips, for-

Styed with blood. What is the most likely di-

Agnosis?

А. Eclampsia

V. Chorea

С. Epilepsy

O. Hypertensive crisis

E. Dabetic coma

66. A 60-year-old patient turned to a doctor with complaints of general fatigue, palpitations,
shortness of breath and weight loss.

It is known from the history that he has been drinking alcohol for 5 years. Objectively observed:
muscle tissue atrophy, lower leg muscle pain during palpation, moderate

Dyzhna pain goma sikka heard in

Is it a diagnosis?

А. Pelagra

V. Berry-bury

С. Rachit R : bo
1. Hemeralopia

E. Skorbut

67. A 36-year-old patient complains of joint and muscle pain, loss of appetite, constipation,
rapid fatigue and subfebril body temperature. Objectively revealed: dysphagia, symmetrical
arthritis and thickening of the skin on the hands and feet, atrophy and small ulcers on the
bundles of the fingers, Raynaud's syndrome, telangiectasia. What is the most likely diagnosis?

А. Raynaud's disease

V. Systemic scleroderma

С. Systemic erythematous lupus

D. Rheumatoid arthritis

E. Dermatomyositis

68. The city's water supply is provided by drinking water from underground artesian sources,
which is characterized by high quality and cleanliness. Which of the following treatment
methods is provided for by sanitary requirements for water obtained from underground
interlayer pressure sources?

А. Coagulation

V. Filtering

С. Disinfection

Đ. Defroling

E. Defluorization

69. A patient aged 64 with a diagnosis of coronary heart disease, diffuse cardio-osclerosis,
constant form of atrial fibrillation, heart failure of III functional class, is on outpatient treatment.
Pharmacoterania consists of amiodarone twice a day, torasemide every other day,
trimetazidine twice a day.

Family doctor for the prevention of thrombo-

Education recommended taking warfa-

Rhine (3 mg per day). What indicator measurement in order to control the effectiveness and
safety of anticoagulant therapy is necessary in this case?

А. Number of platelets

V. Blood clotting time according to Lee-White

С. Erythrocyte sedimentation rates

. International Normalized Re-

Shenya

E. Fibrinogen level

70. A patient aged 19 complains of shortness of breath, rhinitis and eyelid swelling. It is known
from the history that the symptoms appeared on the 7th day after the start of treatment of
inneumonia, has polynosis. Objectively observed: redness and swelling of the eyelids, swelling
of the soft palate, tongue and palatine tonsils. Auscultatively in the lungs is heard: single small-
hurtz wet wheezing. What is the most likely diagnosis?

А. Swelling of Quincke

V. Multiform exudative erythema

whiritis
С. Allergic conjunctivitis &

hangin
. Aggration of polynosis M-

E. Bronchial asthma
71. A 30-year-old patient complains of a violation of pain and tactile sensitivity-Waxes, pain in
the end phalanges of the fingers that occurs after work. It is known from the history that the
company works with mechanical devices. What is the most likely diagnosis?

А. Noise disease

V. Raynaud's syndrome

С. Quezon's disease

V. Hypovitaminosis of vitamin B, E. Vibration disease

72. During the examination of the child on the 4th day of life, serous-purulent contents
appeared in the neck, back of the head and buttocks.

Objectively observed: the state of satisfaction-

Ny, the child is active, the reflexes of the newborn

Jens are caused in full, the umbilical cord is at the mummification stage, the cup area without
features. What is the most likely diagnosis?

А. Phlegmon

V. Bubbles of newborns

С. Bullous epidermolysis

D. Vesiculopustulosis

E. Sweating

73. A 45-year-old patient has en-cephalopathy, pneumoconiosis,

Extra-

Copper deficiency with primary leg injuries — "cock walk". It is known from the history that he
works as a welder.

What is the most likely diagnosis?

А. Selenium poisoning

V. Manganese poisoning

С. Ciderosis

D. Antracose

E. Lead poisoning

74. A four-month-old child fell ill with a go-stro. Objectively observed: elevated body
temperature to 38.5°C, one-time vomiting, flabbyness. 10 hours later, there was a rash on the
buttocks and lower limbs in the form of petechia, spots and papules.
Some hemorrhagic elements with necrosis in the center. What disease is most likely

Did the child have it?

А. Meningococcemia

V. Scarlet fever

С. Rubella

D. Hemorrhagic vasculitis

E. Flu

75. A patient aged 52 years older than two years has rashes on the hair of the chin and lips.
Self-treatment with lily tincture and anti-inflammatory ointments gave a temporary effect.
Objectively observed: in the area of the hair part of the chin and lips - inflammatory foci with
clear boundaries. Against the background of hy-transformed and infiltrated skin - ostiofoliculitis
and folliculitis, yellow crusts are grouped. The body temperature does not rise. What is the
most likely diagnosis?

10

А. Atonic dermatitis

V. Vulgar sycosis

С. Vulgar acne

D. Face eczema

E. Parasitic sycosis

76. A ten-year-old girl complains of pain in the epigastric fat on an empty stomach, often at
night, the pain eases after eating, and the child is also concerned about heartburn and
headache. It is known from the history that it is sick for about 2 weeks. Objectively observed:
severe pain during palpation in the piloroduodenal area. Positive-

A quick ursase test for Helicobacter

Pylori. What is the most likely diagnosis?

А. Gastric ulcer

V. Acute gastritis

С. Acute pancreatitis

D. Functional dyspepsia

E. Twelfal ulcer

INTESTINES
77. A 65-year-old patient turned to the doctor with complaints of weakness in the left ends,
which arose in the morning and gradually increased throughout the day. Objectively observed:
gum consciousness, blood pressure - 190/100 mm Hg, heart rate - 80/min, pulse rhythmic,
systolic noise on the neck in the projection of bifurcation of the right common common carotid
artery. During the study of neurological status, it was determined: smoothing of the nasolabial
fold of the left, deviation of the tongue to the left, decreased muscle strength in the left limbs to
3 points, tendon reflexes S > D, positive symptom

Babinsky on the left, left-sided hemigipesthesia.

What is the most likely diagnosis?

А. Brain infarction

V. Progressive vascular leukoencephalopia-

С. Subarachnoid hemorrhage

R. Multiple sclerosis

E. Acute hypertensive encephalopathy

78. A 14-year-old patient complains of a dry cough, residue. It is known from the history that he
has been sick for one year. Shortness of breath attacks are short-term, 1-2 times a month.

Objectively observed: pale skin, cyanosis of the nasolabial triangle, respiratory type shortness
of breath, BH - 48/min. Above the lungs is a percussive sound with a box shade. Auscultatively
over the lungs is heard: breathing is weakened, dry wheezing on both sides. The volume of
forced exhalation is 80% of the proper. What drug should be prescribed to the patient?

А. Euphilin

V. Prednisolone

С. Salbutamol

D. Indomethacin

E. Suprastin

79. A patient aged 34 years after a rapid change in body position from horizontal to vertical
sharply pale and fell. Objectively observed: the skin is moist, the limbs are cold, the pupils are
dilated, the pulse is accelerated and filamentous, blood pressure is 50/25 mm Hg. What
pathological condition did the patient develop?

А. Morganyi-Adams-Stokes Syndrome

V. Hyperglycemic coma

С. Collapse

D. Anaphylactic shock
E. Ventricular fibrillation

80. A 36-year-old patient complains of headache, swelling in the lower extremities, general
weakness and rapid fatigue

It is known from the history that he had ARVI 14 days ago. Objectively observed: skin and
visible mucous membranes are pale pink, swelling on the lower extremities, blood pressure -

150/100 mm Hg, Pasternatsky's symptom

Weakly positive on both sides. According to the results of a general urine analysis, the
following were revealed:

Proteinuria — 2.7 g/l and erythrocyturia -

15-20 in sight. What is the most likely dia-

Gnosis?

А. Acute pyelonephritis

V. Tuberculosis of the kidneys

С. Urothiasis

0. Amylodosis of the kidneys

E. Acute glomerulonephritis

81. The patient complains about frequent, abundant, without pathological impurities, frothy
emoliation, cramping pain in the circumumbical region, rumbling in the abdomen, fever. From
the history of history, it is known about the use of duck eggs in the hey. Which pathogen is
more likely

Caused the disease?

A. Salmonella typhi

B. Salmonella enteritidis

C. Shigella sonnei

D. Escherichia coli

E. V. cholerue

82. A 55-year-old patient complains of sharp pain in the right subcondrium and spigastria,
which radiates under the right shoulder blade, nausea and multiple vomiting. From the history,
it is known that he has been sick for several years, the pain was previously removed by
drotaverine. It is objectively observed: overweight of the body, insignificant icteric sclerosis,
body temperature of 38°C, the abdomen is moderately swollen, painful and tense in the right
subchondrium and epigastric. A positive symptom of Ortne-ra, Frenick us-symptom on the
right. As a result of a blood test, leicocytosis, accelerated SHOV was detected. What is the
most likely diagnosis?

11

А. Chronic cholangitis

V. Chronic cholecystitis

С. Hypotonic gallbladder dyskinesia

D. Gallbladder cancer

E.) Cholelstone disease

83. The patient complains of itching in the area of the hands, ginota and genitals

Opra-

Niv, which intensifies in the evening and at night. It is known from the history that it is sick for 2
months.

Objectively revealed: in the area of hands, abdomen and genital organs is observed

Papular-vesiculous rash, which is

Tassed in pairs, as well as excoriations and single papules. Pathology of internal organs has
not been detected. What is the most likely diagnosis?

А. Neurodermit

V. Eczema

С. Scabies

D. Psoriasis

E. Toxidermia

84. A woman aged 27 years, pregnancy I, childbirth I, is hospitalized to the maternity ward. It is
known from the history: primary infertility for three years. Objectively observed: crums occur
every 4-5 minutes, for 20-25 seconds, duration

— 9 hours, 2.5 hours ago, the fertile water went away. Fetal heart rate - 136/min. The head with
a small segment is located in the plane

Entrance to the small pelvis. The cervix smoothes

On, opening — 4 cm. The fruit bubble is absent. What complication occurred during childbirth?

А. Discoordinated maternity activities

V. Primary weakness of labor activity

С. Secondary weakness of labor activity

D. Pathological preliminary period

E. Normal labor activity

85. A 58-year-old patient complains of dizziness and squaliness, lost 14 kg for 2 months. The
history is noted: tuberculosis has been transferred. Objectively observed: increased skin
pigmentation, body weight deficit - 10 kg, blood pressure - 90/55: As a result of maol on blood
lysis

Mmol/l, C1- — 116 mmol/l, [NSO3] - 27

MEKB/L, TTOK032 — 2,9 MMOJS/I. Slkkห Haหi-

A more language diagnosis?

А. Goodnascher syndrome

V. Chronic kidney failure

С. Tumor secreting ACTH D, adrenal insufficiency

E. Renal vein thrombosis

86. Patient aged 15 Pain, in washing the iliac action ski I will take m on Body, bowel
movements up to 6 times a day with impurities of mucus and blood. It is known from the
history that he is sick for about a year. During fibrocolonoscopy, the mucous membrane was
detected.
The colon of the large intestine is segmentally gi-smothered, bumpy in the type of "pavers",
single deep aphthous ulcers, significant thickening of the wall at the affected areas. What is the
most likely diagnosis?

A. Xporivan onTepoxo

V. Crohn's disease

C. Xporiyanisupaskonn kom

D. Colon cancer

E. Chronic non-ulcer colitis

87. The military had a state during the battle

Immobilization, mutism, verbal con-

Tact 13 is impossible by him, for tactile

Contact, the affect of fear increases. Objectively observed: on the face the expression of fear,
does not move, the look is fixed at one point, does not answer the question. Which

HaMiMoRipHitแห$ jtiarno3?
А. Somatized disorder

V. Acute reactive stupor

С. Iochondric disorder

D. Post-traumatic stress disorder

E. Depressive disorder

88. A 75-year-old patient complains of resting shortness of breath, severe weakness and
arrhythmia. Objectively observed: severe condition, abdominal aortic pulsation, diastolic noise.
During palpation, volumetric formation in the mesogastric and lack of pulsation on the femoral
arteries was detected. AT - 70/40 mm Hg, oli-guria. What is the most likely diagnosis?

А. Cardiosclerotic aneurysm of the heart

diasting
V. Aortic aneurysm stratifying

С. Pancreatic cyst
Abdominan
a
D. Acute pericarditis

E. Acute heart aneurysm

89. A 20-year-old patient complains of diarrhea without abdominal pain that started a day ago.
From the history of history, it is known that the disease began with diarrhea up to 20 times a
day, then vomiting, weakness and thirst joined. Objectively observed:

Body temperature - 36°C, blood pressure - 70/50 mm Hg, pulse is weak - 130/min, tachypnea,
dry mouth, the skin is pale with a cyanotic shade, turgor is lowered, facial features are pointed,
the voice is hoarse, cramps of the calf muscles. What is the most likely diagnosis?

А. Salmonellosis

V. Eterichiosis

С. Amebias

D.-
Shytelosis

E. Cholera

90. A 52-year-old patient complains of cough with a significant amount of mucous-purulent

sputum, shortness of breath during exercise, an increase in body temperature to 37.8°C, and
general weakness. It is known from the history that it has been sick for several years, the
deterioration of the condition occurred 5 days ago. It is objectively observed: fingers in the
form of "drum sticks", nails in the form of "clock glass".

During chest percussion, a shortened one was found in the lower right

Pulmonary sound. Ausculgatively listening-

Medium-bully wet wheezing is numing.

According to the results of a bronchographic study, multiple cylindrical bronchial extensions

are observed in the lower lobe of the right lung. What is the most likely diagnosis?

А. Right-sided lower lateral pneumonia

V. Abscess of the lower house of the right lung

С. Bronchiectatic disease in the stage of

Strena

D. Chronic bronchitis in the acute stage

E. Pulmonary tuberculosis

91. The patient has damage to the eyes (hemeralopia, Bito syndrome), skin and its
appendages, mucous membranes and digestive tract, sleep disorders. What trace element
deficiency is found in the papient?

А. Vanadium

V. Midi

С. Zinc

D. Manganese

E. Selena

92. At the regional multiple sclerosis research center, scientists compare the effectiveness of
new and standard treatments for secondary progressive multiple sclerosis. 114 patients took
part in the study. They were divided into experimental and control

Groups using a computer sp-

Sku random numbers. At the beginning of the study, there were no substantial differences in
the initial characteristics of the compared groups.

What kind of research was used?

А. Meta-analysis

V. Randomized controlled trial-

Dzhen

С. Case-control study

D. Blind research

E. Description of the series of cases

93. A 20-year-old patient complains of swelling on the legs and face, an increase in blood
pressure to 170/105 mm Hg. from a history, it is known that 2 years ago he had acute
glomerulone-frit. According to the results of urine analysis, it was revealed: proteinuria — 5.5 g.
What pathogenetic therapy should be prescribed?

А. Diuretic

V. NSAIDs

С. Cytostatics

D. Antibiotics

E. ACC inhibitors

94. A one-year-old girl from the first month of life has a constant cough, sputum separates
hard. There is a lag in physical development.

Objectively observed: cyanosis of the nose

Labial triangle. According to the results of ana-

Blood lysis was found: neutrophilic leukocytosis, serum electrolytes (Na - 130 mmol/l, SI - 88
mmol/l). Electrolytes of sweat (SI — 80 mmol/l). What is the most likely diagnosis?

1. Cartagener's syndrome

I'm an idiopathic fibrosing alveolitis

С. Acute obstructive bronchitis

D. Bronchiolitis

E. Cystic fibrosis

95. A four-year-old child was hospitalized with

Complaints about a hoarse voice, rough barking-

Whose cough and difficulty breathing. Objectively observed: the child's condition is severe, the
child is restless, pale, the temperature is ti-

La - 37.1°C, BH - 30/min, breathing is noisy,

Heard at a distance, with the participation of auxiliary mu-sculature, inspiratory shortness of

breath. Which of the viruses most likely caused the development of such a condition?

А. Cytomegalovirus

V. Flu

С. Epstein-Barr
D. Parainfluenza

E. Rhinovirus

96. A 65-year-old patient with acute anterior myocardial infarction had

Attack

Shortness of breath. During the examination, diffuse cyanosis is observed. Auscultatively, a

large number of wet different-caliber wheezing is heard in the lungs. Heart rate - 100/min.

AT - 120/100 mm Hg. What a complication

Developed into a patient?

А. Rupture of the interventricular membrane

V. Pulmonary edema

С. TELA

D. Hypertensive crisis

E. Cardiogenic shock

97. A 36-year-old patient turned to a doctor complaining of burning chest pain, which usually
occurs 1-1.5 hours after eating and increases in a horizontal position. During EGDS, two focal
lesions of the lower third of the esophageal mucosa up to 5 mm in size, located within the
same fold, were found. What doctor's tactic will be most espediable?

А. Appointment of non-narcotic analges-

KiD

V. Appointment of proton pom- inhibitors

С. Stationary surveillance

D. Surgical treatment

E. Appointment of clarithromycin

98. A woman aged 36 has after physical

Go load there was shortness of breath, ka-

Shel with pink sputum secretion.

It is known from the history that he has rheumatism and mitral heart disease. Auscultatively
heard over the heart and lower lungs small and middle vesillary wet wheezing. What is the
leading mechanism of deterioration?

А. Decreased lymphatic outflow

V. Increased erythrocyte aggregation and

Hydrostatic blood pressure shydification

1. Decreased oncotic blood pressure

E. Increase in oncotic blood pressure

99. A twelve-year-old boy complains of pain in the hip joint radiating to the knee. Parents have
noticed a loss of appetite in the child, weight loss, general malaise and evening subfsbriltet
over the past two months. Objectively observed:

Moderate atrophy of the limb muscles, restriction of withdrawals and rotational movements in
the hip joint, a positive symptom of Ole-xandrov. According to the results of the blood test,
increased ESR, lymphocytosis and moderate anemia were revealed. During radiography, it is
observed: in the head and neck of the femur there are foci of osteoporosis with fuzzy contours,
the gap of the hip joint is narrowed. What is the most likely diagnosis?

А. Hematogenic osteomyelitis

V. Hip dysplasia

С. Hip tuberculosis

D. Metastases of a malignant tumor

Ki Osteochondropathy of the femoral head

100. A 28-year-old patient complains of pain in the left lower limb for 6 months, intermittent
lameness after 50-100 m, recurrent night pain. During the examination, the limb is olid, cold.
There is no arterial pulsation on the lower leg. What is the most likely diagnosis?

А. Embolism of the femoral artery

V. Obliterating atherosclerosis

С. Raynaud's syndrome

V. Takayasu's disease

E. Obliterating endarteritis

101. The patient complains of a painful headache in the chin, general ailment, and headache.
Objectively observed: in the area of the chin acutely inflamed dense knot of the cone-shaped
Forms. The skin above him is tense, she is. Inside the node there is an ulcer with upright edges
and a necrotic rod of dirty green color. The enlarged lymph nodes on the right are enlarged and
painful.

What is the most likely diagnosis?

А. Boil

V. Tertiary syphilis
С. Tuberculosis

D. Carbuncle

E. Deep Trichophytosis

102. In a premaured boy who naro-

Look from 11 pregnancies, 18 hours after birth appeared icteric colored skin and sclera. Mom
has blood type O (1),

Rh factor is negative, the child has a group

Blood O (!), Rh factor positive. Total serum bilirubin - 220

MKMOT5/7. Slxห$ หลหMoBipriห& riarso3?

A.

Atresia of the biliary tract

V. Hemophilia A

С. Hemolytic disease of the newborn

D. Minkowski-Schoffar's anemia

E. Hemorrhagic disease of the newborn

103. The patient aged 16 years complains of pain in large joints, swelling and redness of the
left knee joint, an increase in body temperature to 37.9°C.

It is known from the history that complaints appeared 5 days ago after acute pharyngitis. What
is the most likely diagnosis?

А. Gout

V. Reactive arthritis

С. Deforming arthrosis

D. Rheumatic arthritis

E. Rheumatoid arthritis

104. A patient aged 25 years has ulcerative-necrotic changes in the oral cavity, diffuse bleeding
of the gums, petechia and ecchymosis on the skin. According to the results of a blood test, red
blood cells were revealed

— 2.2 • 10 2/l, hemoglobin - 70 g/l, KP -

0.9, platelets - 30 - 10%/l, leukocytes -

10 - 10%/l, blasts — 36%, sticks

— 4%, segmented neutrophils — 22 0, lymphocytes — 30%, monocytes — 8%, ESR

— 34 mm/h. What is the most likely diagnosis?

А. Acute tonsillitis

V. Acute lymphadenitis

С. Lymphoma

D. Chronic leukemia

E. Acute leukemia

105. A 40-year-old patient complains of general weakness, a feeling of stiffness in the joints of
the hand mainly in the morning for up to 1 hour. During the examination of the hands, slight
swelling and hyperemia in the area of the metacarpal-phalangeal joints of the 2nd and 3rd
fingers were found, there was pain in case of lateral compression of the hands. According to
the results of the analysis, a high titer of antinuclear antibodies, an-tichil to cyclic citruline
vimen-tin was not detected, a positive reaction Va-

Serman, uric acid - 350 μmol/l.

Am I the most likely diagnosis?

А. Systemic erythematous lupus

V. Systemic scleroderma

С. Osteoarthritis of the joints of the hands

D. Rheumatoid arthritis

E. Gout

106. In the second grade of the general secondary education institution, a microclee
assessment was carried out.

Mat for optimization purposes. The following values of microclimate indicators are obtained:

Air temperature — 20°C, radiation temperature — 19°C, air speed — 0.2 m/s, relative humidity
— 58%. Give a hygienic assessment of the microclimate in the classroom.

1. The microclimate is uncomfortable with high radiation temperature

V. The microclimate is uncomfortable, cool-

Type of val

С. The microclimate is comfortable

D. The microclimate is uncomfortable, overheating-

YUCHY

E. The microclimate is uncomfortable with low humidity

107. A 26-year-old patient complains of discomfort, sharp pain in the lower third of the labia
majora on the left.

It is known from the history that she got sick acutely 2 days ago, after menstruation.
Objectively observed: body temperature 37.9°C.

During the examination of the left labia, it was detected: formation, up to 4 cm in diameter with
a hyperemated surface, sharply painful when touched, with symptoms

Touch, with a dreamdian of fluctuation. Which

А. Bartholin gland cyst

V. Labia hypertrophy

С. Vulva cancer

D. Acute bartholinitis

E. Vulva fibroid

108. A 40-year-old female patient complains of weakness and rapid fatigue. It is known from
the anamnesis that the complaints appeared during the year, about a month ago, heaviness in
the left hypochondrium and sweating joined, the body temperature rose to 37.5°C, she started
losing weight. Objectively

observed: condition of medium severity, pale skin with petechial rash. The lymph nodes are not
enlarged, the lungs and heart are unremarkable. Hepato-splenomegaly, dense and moderately
painful spleen. According to the results of a blood test
globin 110 g/l, CP - 3.0 1012/l, hemo- 50.109/l, basophils - 3%, eosinophils - 1.1, leukocytes -
6%, myelocytes - 10%, rods -19%, cerMerToRtepHi - 17%, nimdonerm

- 22%, platelets

- 105 - 10°/l, blastti

Cells

- 23%, SEAM

- 32 mm/h. Which

The most likely diagnosis?

А. Lymphogranulomatosis

V. Erythroleukemia

С. Chronic myeloid leukemia

1. Acute lymphoblastic leukemia

V. Chronic monocytic leukemia

109. The effect of which of the following is

Factors can be the reason for the occurrence of professional cata-

Cancer?

А. Infrared radiation

V. Convection heat

С. Dust in the air of the working area

D. Noise and vibration

E. Toxic substances in the air of the working area

110. A premature newborn has 32

Weeks of gestation in an hour after birth, respiratory disorders appeared, estimated on the
Dows scale - 6 points. Auscultatively, weakened breathing and scattered creeping wheezing
are heard above the lungs. BH - 66/min.

During radiography of the chest organs, a decrease in the transparency of pulmonary tissue
due to a diffuse mesh-grained pattern was revealed. What is the most likely diagnosis?

А. Respiratory distress syndrome Novona-

Born

V. Edema-hemorrhagic syndrome

С. Congenital pneumonia

D. Diaphragm keel

E. Trachso-esophal fing

111. The microclimate of the production room is characterized by the following indicators:

Average air temperature - + 28°C, radiation temperature - +29°C, relative humidity

— 60%, speed of movement

Air — 3.0 m/s. Specify the main heat transfer route for such microclimatic

Conditions.

А. Radiation
V. Evaporation

С. Convection

D. Conduction

E. Radiation and convection

112. A 23-year-old patient complains of significant purulent discharge from the genital tract
with an unpleasant odor, heartburn, itching in the areas of the external genital organs for 3
days. It is known from the history that these sim-shtoms appeared after unprotected sexual
intercourse. During the vaginal examination, the vaginal mucosa was hypereminated, the
discharge was significant, yellow-green, and foamy. What is the most likely diagnosis?

А. Candidiasis colpitis

V. Trichomonad colnitis

С. Bacterial vaginosis

D) Chlamydia

E. Mycoplasmosis

113. A patient aged 25 years after giving birth increased precariousness during gait and
weakness in the legs. From the history, it is known that he has been sick for 6 years, notes the
deterioration of the condition every year in the fall. Objectively observed: the woman is
euphoric, reduced criticality to her condition, horizontal nystagmus, high tendon reflexes,
clonus of the feet, pathological foot reflexes, abdominal reflexes are absent,

aTa-

Xia during the Romberg test, intential tremor and miss during coordination tests. Temporal
paleness of the discs of the optic nerves was found on the eye bottom. What is the most likely
diagnosis?

А. Multiple sclerosis

V. Segren's syndrome

С. Myasthenia gravis

D. Amyotrophic lateral sclerosis

E. Acute multiple encephalomyelitis

114. During the forensic examination of the body of a 59-year-old man, which

Mayor suddenly at home without any signs on-

Strong death, revealed:

Pink
Skin and mucous membrane color, genus-

Ka blood of bright red color, pov-

Nokrivya

TA

Bright red colored-

Internal organs.

According to the results

Forensic toxicity analysis in the blood is observed ethyl alcohol in concentrations — 1.44°/o
and carboxyhemoglobin - 55%. Poisoning with what compound caused the death of a man?

А. Alcohol

V. Anilin

С. Potassium cyanide

D. Arsenic

V. Carbon monoxide

115. A patient aged 18 suddenly had severe headache, vomiting, fever up to 39°C. Objectively
observed: position in bed with head thrown back and legs brought to the stomach. General
hyperesthesia. Positive symptoms of Brudzinsky and Kerni-ha. There is no focal neurological
symitomatics. According to the results of the cerebrospinal analysis, neutrophilic pleocytosis
was revealed. Which

HakiMoBipuitnn piaro3?

A/ Meningitis

V. Encephalitis

С. Subarachnoid hemorrhage

D. Subdural hematoma

E. Abeces of the brain

116. A 62-year-old patient complains of an increase in body temperature to 38.7°C, General

weakness, nausea, vomiting and pain in the lumbar cell on the right. From the history of history,
it is known that the patient has type 2 diabetes, chronic pancreatitis,

Housing and communal services. Objectively observed: hyperemic skin, blood pressure -
150/90 mm Hg, heart rate
— 92/min, body temperature 38.7°C, free and vesicular breathing, the stomach is soft and
painless. Pasternatsky's symptom is positive on the right. According to the results of a blood
test, hemoglobin - 120 g/l, era-

Trocytes - 3.8 - 1012, leukocytes - 12 - 10° platelets - 220 - 109

. What is the most likely-

Is it a diagnosis?

А. Gastroenteritis

V. Housing and communal services. Attack of bile colic

С. Acute pyelonephritis

D. Tocrpri nankpeaTหา

E. Typhoid fever

117. A 14-year-old woman complains of abundant bleeding from the genital tract that lasts for
9 days after the delay of menstruation for 2 months. From the history it is known: menarche
from the age of 13, menstruation 3-4 days after 28 days, moderate, painless.

He doesn't live a sex life. During the recto-abdominal examination, pathology was not revealed.
According to the results of a blood test, hemoglobin is observed — 95 g/l. What is the most
likely diagnosis?

А. Hormone-producing ovarian tumor

V. Cervical cancer

С. Abnormal uterine bleeding

D. Leukoplakia of the cervix

E. Cervical polyp

118. In a patient aged 67 years, according to the results of a blood test, an increased level of
the PSA tumor marker was found. Which oncopatology is most likely to develop in the patient?

А. Prostate cancer

V. Stomach cancer

С. Kidney cancer

D. Lung cancer

E. Rectal cancer

119. A 40-year-old patient complains of menstrual irregularities, heavy menstruation over the
past year. From the history it is known: 1 birth, 2 artificial abortions. Objectively observed: the
general condition is satisfactory. During the vaginal examination, the external genitals were
developed correctly. The cervix is cylindrical, macroscopically unchanged.

The body of the uterus is enlarged to 9-10 weeks of pregnancy, dense, with a bumpy surface,
mobile, painless. Appendages on both sides without features. Discharges are mucous,
moderate. What is the most likely diagnosis?

А. Leiomyoma of the uterus

V. Internal endometriosis

С. Uterine pregnancy

D. Uterine body cancer

E. Acute endometritis

120. A patient with a dislocation of the shoulder complains of a feeling of numbness in the
fingers of the hand. Objectively observed: limited active withdrawal of the first finger. Which
nerve is damaged in the patient?

L. Shoulder

V. Middle

С. Ray

D. Elbow

E. Skin

121. A patient with hypertension had complaints: headache, frostbose, tinnitus, altered speech,
which became illecrible. Objectively observed: horizontal nystagmus when looking to the sides,
nasolabial asymmetry

Folds. After 3 hours, the symptoms are re-

Was gressing. What is the most likely diagnosis?

А. Cardioembolic ischemic stroke

V. Subarachnoid hemorrhage

С. Transient ischemic attack

D. Lacunar ischemic stroke

E. Atherothrombotic ischemic stroke

122. A 55-year-old patient went to a doctor complaining of thyroid enlargement and discomfort
during swallowing. It is known from the history that these complaints have been of concern for
the past two years.
Objectively observed: signs of hypo-thyroidism, palpatory thyroid gland is dense, not soldered
with surrounding tissues and mobile during swallowing. Regional lymph nodes are not
enlarged. According to the results of a blood test, antitithyroid-day antibodies were detected.
What is the most likely diagnosis?

А. Endemic eiter

V. Thyroid cancer

С. Acute thyroiditis

D. Middle cyst of the neck

E. Autoimmune thyroiditis (Gashimoto)

123. A 35-year-old patient went to a doctor complaining about the presence of a neoplasm on
the skin of the left lower leg. During the examination, it was discovered that dark purple
exophytic is observed in the middle third of the left lower leg

Neoplasms

Wrong

Forms 1x1.5 cm with ulceration and uneven color. What is the most likely diagnosis?

А. Skin melanoma

V. Hemangioma

С. Trophic ulcer

D. Varicose disease

E. Skin fibroma

124. A 50-year-old patient was hospitalized on the 9th day after the onset of the disease with
complaints of fever to 38.5°C, weakness, pain in the right shoulder blade during breathing and
dry cough. Objectively observes-

Th: BH - 28/min, pulse - 100/min, signs

Intoxications. In the area of the right scapula, blunting of percutor sound, bronchial breathing,
single dri-bnomigurtseve and crepitating wheezing are heard. Three days later, there was a
cough attack with discharge

200 ml of purulent sputum, after which

The background temperature has dropped. For the result-

There is an X-ray examination of the OGK, at the level of the angle of the scapula, against the
background of infiltration of the lung — rounded enlightenment with a horizontal level. What is
the most likely diagnosis?

А. Limited empyema pleural poro-

ZHINY

V. Lung cyst

С. Acute lung abscess

D. Tuberculoma

E. Lung cancer with decay

125. A 23-year-old girl became a conflict at work for no obvious reason, believed that she was
underestimated by management, and was able to hold the position of deputy director because
she speaks four languages, is very attractive and can improve the company's contacts. Ex-
travagantly dressed, flirted with a col-gama, sang loudly in the office. He has an education of a
computer operator, does not speak foreign languages. What is the most likely diagnosis?

А. Mental retardation of a mild degree

V. Depressive disorder

С. Schizophrenia

D. Manic episode

E. Epilepsy

126. A patient aged 58 years has during

Multiple spots appeared in front of the right eye for 2-3 hours. During the examination, it is
observed: visual acuity is 0.02 eccentric, the pupil of the right eye is moderately expanded,
direct reaction to light is lowered. According to the results of ophthalmoscopy, it was revealed:
on the eyebally, multiple hemorrhages of various sizes and shapes (symptom of "crushed
tomato"), the optic nerve disc is swollen, hyperemic. The history of the presence of
hypertension of the second degree is known from the history. What is the most likely
diagnosis?

А. Hypertensive angioneuropathy

V. Hypertensive angionatia

6, retinal pentral artery embolism

1. Central retinal vein thrombosis

E. Diabetic retinopathy

127. A patient aged 62 years has developed a pronounced

Muscle weakness in the muscles of the shoulder and pelvic girdle, back. Objectively observed:
erythema around the eyes in the form of glasses, coarsening, peeling and cracks on the
fingertips and the palm surface of the hands. What is the most likely diagnosis?

А. Dermatomyositis
V. Acute rheumatic fever

С. Systemic scleroderma

D. Rheumatoid arthritis

E. Systemic erythematous lupus

128. A 40-year-old patient complains of a periodic cough with a small amount of sputum and
slight shortness of breath during physical activity.

It is known from the history that he smokes 13 18 years more than a pack of cigarettes per day
4D

— 20/min. Auscultatively in the lungs

Hides hard vesicular breathing, extended exhalation, a large number of dry scattered wheezing.
According to the results of the X-ray examination of the OGK revealed:

Lung pattern incision. Which on-

Is the diagnosis more likely?

А. Pneumonia

V. Bronchial asthma

С. Chronic obstructive bronchitis

D. Pulmonary tuberculosis

E. Lung cancer

129. A 28-year-old patient complains of headache, tinnitus, periodic dizziness and shortness of
breath, nasal bloods, leg fatigue after minimal stress. During the measurement of blood
pressure, systolic upper body hypertension, hypotension in the lower part were found. There is
a decrease in the temperature of the lower extremities. Vascular noise is heard during
auscultation on the back. What is the most likely diagnosis?

А. Arterial hypertension

V. Acute cerebral circulation disorder

С. Aortic coarctation

D. Infectious myocarditis

E. Heart failure

130. A 38-year-old patient complains of weakness, an increase in body temperature to 38.5°C,

cough with scanty sputum, difficulty breathing. She got sick after hypothermia 2 days ago.
During X-ray examination, local darkening in the lower lobe of the right lung is observed.
According to the results of a general blood test, leukocytes - 14 - 10 /l,
ESR - 44 mm/h, CRP - 140 mg/l. Which on-

More likely diagnosis?

А. Tuberculosis

V. Bronchial asthma

C,Pleurisy

D. Pneumonia

E. Acute bronchitis

131. The patient complains of pain in the area of the body temperature up to 38°C. Objectively
revealed: swelling and hyperemia of the nail phalanta, which is most pronounced in the area of
the nail roller. Percussive sharp pain of the nail phalanx. There is a detachment of the whist
plate due to the accumulation of pus under it. What is the most likely diagnosis?(131. The
patient complains of pain in the area

PI of the right finger, raising the body temperature to 38°C. Objectively detected: swelling and
hyperemia of the nail phalanx, which is most pronounced in the area of the nail roller.
Percussive sharp pain of the nail phalanx. There is a detachment of the nest plate due to the
accumulation of pus under it. What is the most likely diagnosis?)

А. Paronychia

V. Subungular panaritium

С. Bryzypeloid

0. The subcutaneous panarytium

V. Circumsticum panarity

132. Villagers use water from a mine well located on the outskirts. The well has an old wooden
fastening, a lid, and there is no common bucket. During laboratory analysis of water from this
well, an increased content of thermo-stable E. coli was found. What does this indicate?

А. Fecal pollution

V. Organic pollution

Of animal origin

С. Ingress of contaminated waters

D. Virus pollution

E. Organic pollution

133. An eight-year-old girl with di-zembryogenesis stigmas is examined by a doctor.

Objectively observed: the pulse on the right brachial artery is satisfactory, on the left reduced
content. AT on the right hand - 110/60 mm Hg, on the left - 100/60 mm Hg. Ausculatively,
systolic expulsion noise of 3-4 degrees in the II intercostal interval and to the right of the chest
is heard. Noise is made on the neck and on the left edge of the chest-

Not up. According to the results of the ECG,

But: left ventricular hypertrophy. What a flaw

Did the child's hearts be found?

А. Open arterial duct

V. Aortic coarctation

С. Interventricular septum defect

D. Aortic stenosis

E. Fallo's notebook

134. A 40-year-old patient went to the doctor with complaints of a feeling of heaviness and
bursting in the epigastric region after eating, vomiting 1 time in 2-3 days with food residues
consumed the day before, weight loss - about 10 kg in the last 2 months. It is known from the
history that the patient is sick

For gastric ulcer for 5

Years. What complication of peptic ulcer disease did the patient have?

L. Diaphragmatic hernia

V. Penetration

С. Stepose of the stomach goalkeeper

D. Perforation

E. Duodenogastric reflux

135. A three-month-old child has low-productive cough, nasolabial cyanosis, pronounced

respiratory shortness of breath, and 80/min, in a three-month-old child against the background
of subfebrile body temperature and rhinitis. Per-

Corner over the lungs found a box-

Sound. A large number of small-bubble wet wheezing is heard on both sides. What is the most
likely diagnosis?

А. Acute obstructive bronchitis

V. Aspiration of a foreign body

С. Bilateral pneumonia
D. Acute bronchitis

E. Acute bronchiolitis

136. A 33-year-old patient was hospitalized on the 7th day of the disease with complaints of
severe weakness, high body temperature, pain in the muscles of the legs and lower back,
jaundice, dark color of urine and headache. It is known from the history that he became acutely
ill with chills, an increase in body temperature to 40°C, headache, pain in the li-

Muscle and lower back. On the 4th day of the disease, jaundice appeared, on the 5th -
nosebleeds and hemorrhage in the sclera. Triva-

Fever leaf - 6 days. Diuresis — 200 ml.

What is the most likely diagnosis?

А. Viral hepatitis A

V. Leptoshrosis

С. Iersiniosis

D. Typhoid fever

E. Sepsis

137. A patient aged 20 years complains of pain in the breast area and an increase in body
temperature to 39°C. It is known from the history that 8 days passed after the birth. Objectively
observed: the mammary glands are swollen, the left is much more, hot to the touch, the skin is
hyperemic. What is the most likely diagnosis?

А. Mastopathy

V. Breast tumor

С. Lactation mastitis

D. Breast cyst

E. Mastodynia

138. A 48-year-old patient complains of recurrent intense epigastric pain with irradiation to the
lower back, nausea after any food, frequent liquid bowel movements. It is known from the
history that she lost 12 kg within 2 months. Objectively observed: body weight deficiency, soft
stomach, pain at the Desjardins point. The liver comes out from under the edge of the costal
arch by 1.0 cm, painless.

Emptying - 3-4 times a day, from home

Neutral fat cags. During the analysis of gastric juice, free salt

Acid

— 30 Od. O-amylase of urine - 16 Od.

What is the most likely diagnosis?

А. Cholera

V. Chronic cholecystitis

С. Tepatite V

. Chronic automunous gastritis

E. Chronic pancreatitis

139. After extracting minerals and quickly lifting to the surface from a depth of 80 m, workers
have: joint and muscle pain, paresis of the lower extremities, cramps. What pathological
condition did employees have?

А. Thromboembolism of the vessels of the lower extremities

V. Horn disease

С. Noise disease

D. Caisson disease

E. High-altitude disease

140. A patient aged 29 in the evening suddenly developed aching pain of a permanent nature
in the epigastric region. For two

Hours there was nausea, it was a one-time

Ostinoza mi.

Vomiting. By morning, the pain became cutting and moved to the right iliac area. Objectively
observed: body temperature

37.6°C, heart rate — 90/min. During palpation, pain and tension of the muscles of the anterior
abdominal wall in the right iliac region, a positive symptom of Voskresensky was revealed.
What is the most likely diagnosis?

4. Acute appendicitis

V. Perforative stomach ulcer with gastritis pits

D. Acute pancreatitis

E. Acute intestinal obstruction

141. The five-year-old child became acutely ill, there is an increase in saw temperature to 39.2
C, a single peeling, complaints of cramping in the abdomen, te-nesms, frequent bowel
movements (low-calorie, with a lot of mucus, impurities of pus and blood veins). During the
examination, it was revealed: a compacted sigmoid intestine, painful during palpation. What is
the most likely diagnosis?
А. Rotavirus infection

V. Shigelosis

С. Salmonellosis

D. Acute appendition

E. Cholera

142. The six-year-old boy complains of an unproductive cough and remote wheezing on
exhalation over the past 2 weeks, without fever or catarrhal phenomena. It is known from the
history that the above complaints appeared in the evening, after a visit to the dentist and
extraction of the ba. Allergological history and heredity are not burdened. According to the
results of a general blood test, no pathological changes were found. What is the most likely
diagnosis?

L. Bronchial asthma

V. Obstructive bronchitis

С. Foreign body in the respiratory tract

D. Pneumonia

B. ARVI

143. A 45-year-old patient went to a doctor with complaints of shortness of breath, an increase
in body temperature to 38.1°C, pain behind the chest, which increases when the head tilts
back. It is known from the history: 5 days ago he was treated by a maxillofacial surgeon in
connection with phlegmon of the oral cavity. The patient was disclosed and

Draining phlegmon, as well as appoint-

For conservative therapy. After treatment, the condition of the nation was still progressively
worsening. According to the results of radiography of the chest organs, it was revealed:
expanding the shadow of the mediastinum and reducing the transparency of its departments.
What is the most likely diagnosis?

А. Exudative pericarditis

V. Pharyngeal abscess

С. Purulent thyroiditis

D. Infectious endocarditis

E. Acute purulent mediastinitis

144. A 62-year-old patient complains of weakness, fatigue, and paresthesia in the ends. It is
known from the history that a stomach resection was performed 3 years ago due to peptic
ulcer disease. Objectively observed: the tongue of crimson color, "grinded", shakyness in the
Romberg position. According to the results of the blood test, red blood cells - 2.5 - 1012/l,
hemoglobin - 96 g/l, KP - 1.3, macrocytosis. What is the most likely diagnosis?
А. Hemolytic anemia

V. In 12-deficiency anemia

С. Iron deficiency anemia

D. Brain tumor

E. Metastases of stomach cancer in the liver

145. A 75-year-old patient complains of frequent urination (4-5 times per night), thinning of the
urine stream. During the pal-pator examination of the prostate was revealed: the prostate is
enlarged - 4hb cm, tight-slastic consistency, with clear contour-

Frames, smooth. Results of uroflouro-

Meters — 42 ml/s. During ultrasound, an additional formation with clear contours is observed
in the bladder lumen. Residual urine — 100 ml. What is the most likely cia-Gnosis?
А. Benign prostate hyperplasia

V. Bladder cancer

С. Chronic prostatitis

D. Prostate sclerosis

E. Prostate cancer

146. In a patient aged 28 years per day after thyroidectomy due to Grave's disease

Sa there were cramps of the hands, feet, face

And pain in the heart area. There are positive symptoms of Khvostek and Trusso.

According to the results of the ECG, the following were revealed:

Interval O-T. What complication did the patient have?

А. Hypoparathyroidism

V. Thyrotoxic crisis

С. Hyperparathyroidism

D. Paresis of the laryngeal nerves

E. Thyrotoxic myocardiodystrophy

147. A 42-year-old patient complains of thirst (drinks 8-10 liters of water per day), poly-uria,
headache and general weakness.

It is known from the history that he suffered a traumatic brain injury. During the examination,
the pathology of internal organs was not revealed.
According to the results of the blood test

Discovered-

No: glucose - 4.5 mmol/l. Na+ - 159

Mmol/l, osmolarity of blood plasma - 305 mosmol/l. The general analysis of urine observes:
specific gravity — 1.001-1.004, white-lock, leukocytes 2-3 in the field of view. What is the most
likely diagnosis?

А. Diabetes

V. Acute glomerulonephritis

С. Theochromocytoma

D. Primary hyperaldosteronism

E. Diabetes mellitus

148. A 46-year-old patient went to the doctor with complaints of a rash on the hands

Hands that appeared a week ago and supro-

Is watered by severe itching. It is known from the history that the patient has bronchial asthma
and has a seasonal allergy. During the physical examination, the skin of the hands was
discovered: the skin of the hands is dry, on the back side of both hands there are multiple
erythematous papules and vesicles with serous content. areas of lichsnification and excoria.
What is the most likely diagnosis?

А. Eczema

V. Scabies

С. Psoriasis

D. Seborrheic dermatitis

E. Contact dermatitis

149. A 52-year-old patient was questioned with complaints of sharp weakness, dizziness, loss
of consciousness, weight loss, lack of appetite, nausea and vomiting, sharp pain in the
epigastric region, diarrhea and increased skin pigmentation. AT - 90/60 mm Hg. What is the
most likely diagnosis?

А. Scleroderma

V. Addison crisis

С. Acute gastroenteritis

D. Meningoencephalitis
E. Pelagra

150. A one-year-old child has a decrease in appetite, irritability, weight loss and acquired skills.
It is known from the history that the deterioration of the condition occurred after the
introduction of semolina porridge into the diet.

Objectively revealed: bowel movements are abundant and stinky, skin is olid and dry, hair is
brittle. The abdomen is enlarged in size, the limbs are thin. According to the results of the
coprogram, an increased content of fatty acids was found.

What is the most likely diagnosis?

А. Celiac disease

V. Lactase deficiency

С. Functional diarrhea

D. Irritable bowel syndrome

V. Cystic fibrosis