Started on Wednesday, 15 January 2025, 10:04 AM

State Finished
Completed on Wednesday, 15 January 2025, 10:49 AM
Time taken 45 mins 1 sec
Marks 74.00/100.00
Grade 37.00 out of 50.00 (74%)

Question 1

Incorrect

Mark 0.00 out of 1.00

What wall of the inguinal canal is damaged in case of indirect inguinal hernia?

a. Superior

b. Posterior-inferior
c. Anterior

d. Posterior 
e. Inferior

Question 2

Correct

Mark 1.00 out of 1.00

A 47 year-old man with gastric cancer, complicated by profuse hemorrhage was successfully treated by surgical intervention. After the
operation the native blood plasma transfusion was performed. Whereupon developed: acrocyanosis, hypersalivation, hyperpnoea, BP 80/40
mm Hg, 120 pulses/min. The initial drug therapy had to begin with injection of

a. Prednisolon
b. Epinephrine 

c. Diphenylhidramin
d. Dopamine

e. Aminophilline
Question 3

Incorrect

Mark 0.00 out of 1.00

Which of the following is the most appropriate in the initial management of a patient with confirmed esophageal corrosive injury

a. Esophagectomy with gastrostomy, cervical esophagostomy, and delayed reconstruction 

b. Esophagectomy with immediate reconstruction
 c. Parenteral hyperalimentation and prohibition of oral intake for 2 to 3 weeks

d. Prompt institution of serial esophageal dilatation

e. Steroids for 3 weeks

Question 4

Correct

Mark 1.00 out of 1.00

A woman 70 years old had had a planned laparoscopic cholecystectomy done according biliary calculi. Six months later the patient again has
attacks of severe pains in the right hypochondrium accompanied by jaundice and dark urine and stool discoloration. The total serum bilirubin
is increased up to 60 mcmol/l, direct 40 mcmol/l. What disease does the patient have

a. Residual choledocholithiasis 
b. Papillostenosis

c. Tumour of the large duodenal papilla

d. Choledochus stricture

e. Tumour of the pancreas head

Question 5

Incorrect

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A patient, male, 50 years old, has a black flat mole on the skin of the leg for 10 years. Since 4 months the shapes of the mole become
irregular. What diagnostic methods should be used

a. Smear for microscopic examination 

b. Thermography
c. Excision biopsy

d. Fine needle biopsy

e. Incision biopsy

Question 6

Correct

Mark 1.00 out of 1.00

What is the most common histological type of malignant tumors of the prostate

a. Seminoma

b. Squamous cell carcinoma

c. Rhabdomyosarcoma

d. Transitional cell carcinoma

e. Adenocarcinoma 
Question 7

Correct

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Patient К, 65 years old, inpatient of surgical department of hospital after hernioplasty on the 6 day suddenly lost consciousness; there was
cyanosis of the upper part of a thorax and the face and dyspnea. What is the diagnosis

a. Hypoglycemic Coma

b. Heart attack of a myocardium

c. Hyperglycemic Coma

d. Perforation of stomach Ulcer

e. Pulmonary artery thromboembolism 

Question 8

Incorrect

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Female-patient K, of 45 years old, was admitted to the traumatological ward with the closed fracture of the medial malleolus with its
displacement up to 3 mm. In which position the foot has to be fixed with a plaster cast

a. In position of planter flexion of foot

b. In position of pronation 

c. In position of dorsal flexion of foot

d. At right angle with varus positioning of the foot

e. In position of supination

Question 9

Correct

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A 22 years old woman was admitted to the reception department. She complains of severe cramping lower abdomen pain occurred
unexpectedly, general weakness, sleeplessness, appetite loss and fever up to 39,90 C. At first the pain was appeared in point between
umbilical region and epigastrium and then it was localized in the in the right iliac region. The patient recall the last menses 8 weeks ago. On
clinical examination the abdomen is soft, painful in the right iliac. The Schyotkin - Blumberg's symptom is slightly positive, Michelson's
symptom is clear positive. On
bimanual gynecological examination the soft uterus is enlarged according pregnancy onset. Near the uterus there is a soft swelling identified
as a separated ovary. In CBC the WBCs (leucocytes) are 15x109 /l. There is high ESR up to 65 mm/h. What is the most probable cause
provoked above written condition

a. Acute salpingoophoritis

b. Acute appendicitis and ectopic pregnancy 

c. Tubo-ovarian abscess

d. Pyosalpinx
e. Acute appendicitis
Question 10

Correct

Mark 1.00 out of 1.00

Contraindications for operation in acute pancreatitis are

a. Peritonitis
b. Hemodynamic unstability and pancreatogenic shock 

c. Erosive bleeding

d. Purulent and septic complications

e. Functional insufficiency of the parenchymatous organs

Question 11

Incorrect

Mark 0.00 out of 1.00

What develops in cases with decompensated pyloric stenosis

a. Renal insufficiency 
b. Intoxication

c. sotonic dehydration

d. Hypotonic dehydration
e. Hypertonic dehydration

Question 12

Correct

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The diagnosis – melanoma was made to a 16 year old patient after examination with complaints of frequent pain in the abdomen,
pigmentation of the mucosa and skin, polyp in the stomach and large intestine was found. It is know that the mother of the patient analogous
pigmentation and was treated often for anemia What disease is suspected

a. Adolescent polyposis
b. Peytz – Egers’s polyposis 

c. Tuberculosis of the intestine

d. Hirschprung’s disease

e. Chron’s disease
Question 13

Not answered

Marked out of 1.00

A 19-year-old girl was admitted to Emergency Department: unconsciousness state, cyanosis, myotic pupil, shallow breathing – 12/min. BP
90/60 mm Hg, 78 pulses/min. Choose the action corresponding to this clinical situation

a. Controlled respiration

b. Gastric lavage
c. Oxygen inhalation

d. Cordiamine injection

e. Caffeine injection

Question 14

Correct

Mark 1.00 out of 1.00

The patient with an acute middle purulent otitis complicated by mastoiditis has been admitted to hospital. On roentgenogram of mastoid
processes the shading of the cellular system on the lesion, absence of bone septs have been marked. What are medical actions in the second
stage of mastoiditis

a. Paracentesis of the drum

b. Tympanoplasty
c. Radical operation on the middle ear

d. Mastoidotomy 
e. Cateterization of the Eustachian tube

Question 15

Correct

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Woman age 40,ill on rheumatic disease with composite mitral disease with prevalence of the stenosis of left venous foramen. Complains on
the palpitation, fatigability progressing dyspnea, attacks of a dyspnea and hemoptysis. Now she can not execute even the mild activities.
What tactics is the most expedient

a. Conduction of current bicilino-prophilaxis

b. Assigning of anticoagulants

c. Assigning of venous vasodilatators

d. Mitral comissurotomia 
Question 16

Correct

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Patient K., 37 years old complains of pain in the right arm, which increases during motion, increase body temperature up to 39° C. In the right
cubital fossa there is a place of injection, hyperemia and thickening along the vein. Your diagnosis

a. Phlebitis 

b. Abscess
c. Erizipeloid

d. Phlegmon

e. Inflammation of lymph

Question 17

Correct

Mark 1.00 out of 1.00

What is the treatment choice for 60-year old male with renal cell carcinoma T2N0M0 and normal contrlateral kidney

a. Resection of the kidney

b. Radiation therapy
c. Nephroureterectomy

d. Radical nephrectomy 

e. Simple nephrectomy

Question 18

Correct

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Patient 48 years old, chief complain of dysphasia for solid and liquid food, nausea,
and fatigue. In radiographic examination of esophagus- stricture of lower third esophagus and dilatation of upper third esophagus. Diagnosis-
Cardiospasm III stage. What is the volume of necessary treatment needed

a. Vandal's Operation [Plastic surgery of lower third esophagus]

b. Conservative treatment: Cerucal, Rantac, No-spa, Intravenous infusion

c. Lewis Operation -Transhiatal resection of esophagus with gastroplasty

d. Esophagectomy Abdomino-cervical Method

e. Heller's Operation 
Question 19

Correct

Mark 1.00 out of 1.00

Which of the following are absolute indications for common bile duct exploration without preliminary cholangiography

a. Multiple small stones in the gallbladder

b. Bilirubinate stones in the gallbladder

c. Toxic cholangitis 

d. Pancreatitis
e. Dilated common bile duct

Question 20

Correct

Mark 1.00 out of 1.00

A man, 52-year-old have recurrent transient ischemic attacks. Auscultation of the carotid arteries detected murmur. What diagnostic method
is necessary to apply the first

a. Cerebral angiography

b. MRI of the brain

c. Ultrasound Doppler 

d. Electroencephalography

e. CT of the brain

Question 21

Correct

Mark 1.00 out of 1.00

The method of treating the unresectable stenotic cancer of the pyloric area of the stomach is

a. Phytotherapy

b. Chemotherapy
c. Phytotherapy + chemotherapy

d. Sidetracking anastomoses 

e. Radiotherapy
Question 22

Correct

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A 75yr. old man who had developed diabetes within the last six months was found to be jaundiced. He was asymptomatic except for weight
loss of 10 pounds in 6 months. On physical examination he is found to have a nontender, globular, right upper quadrant mass that moves with
respiration. A CT scan shows enlargement of the head of the pancreas, with no filling defects in the liver. Most likely diagnosis

a. Metastatic disease of liver

b. Haemolytic jaundice

c. Infectious hepatitis
d. Carcinoma of the head of the pancreas 

e. Malignant biliary stricture

Question 23

Correct

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Patient В, 64 years, complains of difficulty in swallowing solid food, vomiting, weakness, loss of weight. In esophagodudenoscopy on a
posterior-lateral wall, sub mucous layer tumour with the precise contours, easily movable is determined. The diagnosis: Benign tumour of
lower third esophagus. Your tactics

a. Endoscopic removal of a tumour 

b. Heller's Operation
c. Operation Vandal's -lastic of the Lower third of esophagus

d. Lewis's operation - Transhiatal resection of esophagus

e. Esophagectomy

Question 24

Correct

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Patient К. 19 years old admitted with the diagnosis “Chest Wall Trauma (Thoracic Trauma)” with Complain of difficulty in expiration and
inspiration. On examination patient is pale. Blood Pressure 90/50 mm.Hg. On auscultation: Silent on left side (no breathe Sound). On chest X-
ray:- Shift of mediastinal organs to right, atelectasis of left lung, your diagnosis

a. Left sided Tension Pneumothorax 

b. Cardiac Injury
c. Hemothorax

d. Injuries of a chest wall

e. Fracture of Ribs
Question 25

Correct

Mark 1.00 out of 1.00

A 47 year old man presents to his physician with progressive abdominal swelling. On examination he is found to have ascites and a tender,
enlarged liver. If the patient describes a chronic course associated with wasting and low grade fever, the differential diagnosis should include
everything EXCEPT

a. Chronic Pancreatitis 
b. Tuberculosis

c. Cirrhosis with hepatocellular carcinoma

d. Alcoholic liver disease with cirrhosis

e. Hepatitis

Question 26

Correct

Mark 1.00 out of 1.00

A patient 40 year old is diagnosed: 1. Medular thyroid gland cancer. 2. Feochromatcitoma. What operation should be made at first

a. Krail’s operation
b. Operation on thyroid gland

c. Vanach’s operation
d. Subtotal resection of thyroid gland and fascicular resection of lymphatic nodes

e. Operation concerning feochromatcitoma 

Question 27

Correct

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A 30 yr. old man presents with a history of recurrent pneumonias and a chronic cough production of foul smelling, purulent sputum,
occasionally good tinged, which is worse in the morning and on lying down on physical examination, the patient appears chronically ill with
clubbing of fingers, wet inspiratory rails at the base of lungs posteriorly. Most likely diagnosis

a. Chronic bronchitis

b. Pulmonary neoplasm

c. Chronic obstructive emphysema

d. Bronchiectasia 

e. Disseminated pulmonary tuberculosis

Question 28

Correct

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A 62 years old woman complains of severe constant pain in the right hypochondrium, jaundice, discoloration of stool and dark urine, mild
fever up to 37,5оС. Above mentioned complaints were appeared after an attack of severe abdomen pain connected with fatty food intake. On
clinical examination the abdomen is soft. A painful enlarged gall bladder is palpated. The Orthner, Kerr's symptoms are positive. What is the
probable diagnosis

a. Liver cancer
b. Infectious hepatitis

c. Liver abscess

d. Acute cholecystitis, choledochus calculi and obstructive jaundice 

e. Liver cirrhosis

Question 29

Correct

Mark 1.00 out of 1.00

What kind of injures is often happened while carthquakes

a. Abdominal traumas

b. Fracture of lower extremities

c. Cranio-facial trauma

d. Crash syndrome 
e. Fracture of upper extremities

Question 30

Correct

Mark 1.00 out of 1.00

Following bilateral femoral embolectomy, a patient with atrial fibrillation becomes oliguric and passes red-colored urine. All the following
measures may be appropriate in this patient’s management EXCEPT

a. Administration of sodium bicarbonate

b. Administration of mannitol

c. Cessation of heparin 
d. Determination of serum potassium

e. Aggressive hydration
Question 31

Correct

Mark 1.00 out of 1.00

The method of treatment of the stenotic cancer of the rectum with local spread is

a. Chemotherapy
b. Hormonal therapy

c. Phytotherapy

d. Phytotherapy + chemotherapy
e. Colostomy 

Question 32

Correct

Mark 1.00 out of 1.00

The first treatment of rupture of varicose vein at the ankle should be

a. rest in prone position of patient

b. direct pressure and elevation 

c. application of tourniquet distally

d. application of tourniquet proximally

Question 33

Incorrect

Mark 0.00 out of 1.00

The patient with aquired heart failure has diastolic pressure 0 mm Hg. What heart failure does the patient have

a. Aortal insufficiency 

b. Mitral insufficiency
c. Mitral stenosis 

d. Aortal stenosis

e. Rheumatism
Question 34

Correct

Mark 1.00 out of 1.00

A patient with a history of coronary artery disease and atrial fibrillation develops sudden pain and weakness of the left leg. Examination
reveals a cool, pale extremity with absent pulses below the groin and normal contrlateral leg. The most likely diagnosis is

a. Cerebrovascular accident

b. Acute thrombophlebitis
c. Arterial thrombosis

d. Arterial embolism 

e. Dissecting aortic aneurysm

Question 35

Not answered

Marked out of 1.00

Patient 19 years old, Presented to Emergency department in critical condition after Trauma of Chest with chief complain of Left sided chest
pain, Dyspnea, Fatigue, left sided massive subcutaneous emphysema of chest wall. On chest X-ray Atelectasis of left lung, Shift of mediastinal
organs to left. Cardiac cavity not enlarged. Your Diagnosis

a. Detachment of Left main bronchus

b. Left sided total Hemothorax

c. Left sided post-traumatic pleuritis

d. Fracture of left Ribs, left sided Pneumo-hemothorax

e. Left sided Post-traumatic pneumothorax

Question 36

Correct

Mark 1.00 out of 1.00

A 35 year old woman was admitted to thoracic surgery department with elevation of body temperature up to 40 *C, onset of pain with deep
breath in the side, cough with big quantity of purulent sputum and blood with bad smell. What disease causes these symptoms

a. Actinomycosis of lungs

b. Bronchiectatic disease

c. Tuberculosis of lungs
d. Complication of liver echinococcosis

e. Abscess of the lungs 

Question 37

Correct

Mark 1.00 out of 1.00

Which of the following best summarizes indications for operation on an abdominal aortic aneurysm

a. Only ruptured aneurysm

b. Only symptomatic aneurysm greater than 5 cm in diameter

c. Only symptomatic aneurysm

d. Any aneurysm greater than 5 cm in diameter 

e. Any abdominal aortic aneurysm

Question 38

Not answered

Marked out of 1.00

A growth of the right side of the scrotum was found at the examination of a 3-month-old child. This formation has elastic consistency, its size
decreases in sleep and increases when the child is crying. What investigation will be helpful for make a correct diagnosis

a. Palpation of the thickened cord, crossing the pubical tubercle - sign of the silk glove

b. Puncture of the scrotum

c. Diaphanoscоpy

d. Examination of the formation in Trendelenburg’s position

e. Palpation of the external inguinal ring

Question 39

Correct

Mark 1.00 out of 1.00

The majority of arterial emboli originate from which one of the following sites

a. Left ventricle

b. Abdominal aorta
c. Left atrium 

d. Thoracic aorta

e. Cardiac valves
Question 40

Correct

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A 20 yr old woman with a 3-4 month history of bloody diarrhea; stool examination negative for ova and parasites; stool cultures negative for
clostridium, campylobacter and Yesinia; normal small bowel series; edema, hyperemia and ulceration of the rectum and sigmoid colon seen
on sigmoidoscopic examination. Select the most likely Diagnosis

a. Zollinger-Ellison syndrome
b. Gastroenteritis

c. Carcinoid syndrome
d. Ulcerative colitis 

e. Granulomatous colitis

Question 41

Correct

Mark 1.00 out of 1.00

A woman, 35 years old, admitted to reanimation department in asthmatic state. What is most trustworthy criterion of breath effectively

a. Respiratory volume
b. Minute respiratory volume

c. РаСО2 and РаО2 

d. espiratory volume

e. Determination of “dead” space

Question 42

Correct

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A 50-year-old woman presents with a 2-year history of mild, diffuse, tender thyroid enlargement with a 10-pound weight gain and fatigue. Of
the following which is the most likely diagnosis

a. Suppurative thyroiditis

b. Hashimoto’s thyroiditis 
c. Subacute thyroiditis

d. Papillary thyroid carcinoma

e. Riedel’s thyroiditis
Question 43

Correct

Mark 1.00 out of 1.00

A 70 years old woman had had a planned laparoscopic cholecystectomy done according biliary calculi. Six months later the patient again has
attacks of severe pains in the right hypochondrium accompanied by jaundice and dark urine and stool discoloration. The total serum bilirubin
is increased up to 60 mcmol/l, direct 40 mcmol/l. What disease does the patient have

a. Stricture
b. Tumour of the pancreas head

c. Papillostenosis
d. Esidual choledocholithiasis 

e. Tumour of the large duodenal papilla

Question 44

Correct

Mark 1.00 out of 1.00

A 44 years old patient, presented with dizziness, an episode of decreased brain blood circulation, complains of a pain over the umbilicus after
meal ,sometimes very sharp, is accompanied by vomiting, a episode of diarrhea. History of Blood in stool sometimes. Cardiac activity
arrhythmic, extra systole. Moderate tenderness around umbilicus. What is the most probable diagnosis

a. Acute intestinal ischemia

b. Chronic cholecystitis
c. Crohn's Diseases

d. Non- specific ulcerative colitis 

e. Duodenal Ulcer with penetration

Question 45

Correct

Mark 1.00 out of 1.00

~A 24-year-old law student is brought into the emergency room complaining of severe abdominal pain of 6-8 hours duration. He had been to a
party the night before. The pain is in the epigastrium radiating to the back and is associated with nausea. The patient vomited twice prior to
coming to the emergency room. Clinical examination reveals an anxious, acutely ill youth with a regular pulse rate of 100/min, blood pressure
og 100/68 mm Hg, and a temperature of 38,1 C. The most likely diagnosis is

a. Mesenteric adenitis

b. Acute cholecystitis

c. Acute diverticulitis
d. Acute appendicitis

e. Acute pancreatitis 
Question 46

Not answered

Marked out of 1.00

Patient M., 37 years old. He came to the clinic wounded after an hour. On the abdominal skin there is pain around umbilicus due to prick and
cut wound of about 0,5 x 1 cm with slight bleeding. What help would you provide to the patient

a. Aseptic bandage

b. Drainage of the wound with rubber strip

c. Survey the wound with canal probe

d. Suture the wound

e. Laparotomy, survey organs of abdominal cavity. Primary surgical processing of the wound

Question 47

Correct

Mark 1.00 out of 1.00

The diagnosis of Right sided pnuemothorax is made to a 36 year old patient. What method of treatment is indicated to the patient

a. Pleural puncture

b. Surgical treatment: Drainage of the pleural cavity 

c. Antiinflammation therapy

d. Thoracotomy

e. Symptomatic therapy

Question 48

Correct

Mark 1.00 out of 1.00

A patient 67 years old Hyperstenic features, suffering from varicose veins of both legs since 18 years. During last 2 years three times had
thrombophlebitis of superficial veins of the right leg. 4 months back on the lower third of right leg trophic ulcer developed. What method of
investigation is informative for specification of the diagnosis of the patient

a. Phlebography

b. Ultrasonic duplex scanning 

c. Functional tests to determine the condition of Valve

d. Dopplerography of deep veins

e. Isotope Phlebography
Question 49

Correct

Mark 1.00 out of 1.00

Purulent mediastinitis is diagnosed on a 63 year old patient. What of the below listed diseases are not the cause of purulent mediastinitis

a. Iatrogenic injury of the trachea

b. Deep neck phlegmon

c. Perforation of the thoracic the esophagus

d. Cervical lymphadenitis 
e. Perforation of the cervical part of the esophagus

Question 50

Correct

Mark 1.00 out of 1.00

Triangle of Callot is orientation for exposure of

a. Common hepatic duct

b. Cystic duct

c. Common bill duct

d. Hepatic artery
e. Cystic artery 

Question 51

Correct

Mark 1.00 out of 1.00

What is the most frequent cause of acute urinary retention in men over 60 years old

a. Urethral stricture
b. Urethral stones

c. Urinary bladder cancer

d. Prostate cancer
e. Benign prostatic hyperplasia 
Question 52

Correct

Mark 1.00 out of 1.00

A 73 years old patient hospitalized with the diagnosis of “Tumour of Abdominal Cavity”. On examination: On the right side of the abdomen a
mass of 10х15 cm size is palpated. Patient is suffering of ischemic heart diseases, Hypertension ІІ-ІІІ stages. It is suspected an aneurysm of
an abdominal aorta. For the verification of the diagnosis it is necessary to execute

a. Irrigoscopy
b. Laparocenthesys

c. Aortoarteriography 
d. X-ray of Abdomen

e. Diagnostic puncture

Question 53

Correct

Mark 1.00 out of 1.00

A 42yr. old patient suffering from alcoholism has advanced liver disease with ascites. He is hospitalized for agitation and bizarre behavior.
Examination reveals apteryxes on the hands, ankle clonus, and spider angiomas on the face and chest. Blood ammonia level is twice its
baseline. Precipitating factors to look for include all of the following EXCEPT

a. Bleeding esophageal

b. Spontaneous bacterial peritonitis

c. Non compliance with lactulose therapy

d. Excessive diuretic therapy

e. Insufficient protein ingestion 

Question 54

Correct

Mark 1.00 out of 1.00

Patient K., 34 years old. A dog bit him 3 hours before. In the left arm there is wound by the tooth of dog`s bite without bleeding . What surgical
help would you provide to such a patient

a. Wash wound with detergent water and apply anti-septic. 

b. Complete suture of the wound

c. Aseptic bandage
d. Incomplete suture of the wound

e. Cream bandage
Question 55

Correct

Mark 1.00 out of 1.00

Patient K. 35 years old, after abortion developed deep veins thrombosis of leg and on the 3-day cough and a retrosternal pain developed with
hemoptysis. Which investigation is necessary at first to make the correct diagnosis

a. Auscultation of Lungs

b. Palpation of stomach
c. Ultrasonography of Abdomen

d. Electrocardiogram, Chest X-Ray 

e. Phlebography, Dopplerography

Question 56

Not answered

Marked out of 1.00

A 45 yr. old man is admitted with his 3rd episode of upper gastrointestinal haemorrhage. He had 2 prior ulcer operation. Zollinger-Ellison
syndrome is suspected. All the following would support your suspicions EXCEPT

a. Post operative notes detailling ulcers in the duodenum and jejunum

b. Liver metastasis on CT scan

c. Suppression of hypergastrinaemia by secretin given IV

d. A history of diarrhea

e. A fasting gastrin level of 450pg/ml

Question 57

Correct

Mark 1.00 out of 1.00

What kind of injures is often happened while explosions at mines

a. Fractures
b. Poisoned of CO 

c. Cranio-facial trauma
d. Crash – syndrome

e. Burns
Question 58

Correct

Mark 1.00 out of 1.00

Which one of these antibacterial drugs shows an ototoxic action

a. Cefalexine
b. Amoxycilline

c. Ciprofloxacine

d. Оfloxacine
e. Gentamicine 

Question 59

Correct

Mark 1.00 out of 1.00

A patient 40 year old is diagnosed: 1. Medular thyroid gland cancer. 2. Feochromatcitoma. What operation should be made at first

a. Operation concerning feochromatcitoma 

b. Subtotal resection of thyroid gland and fascicular resection of lymphatic nodes

c. Vanach’s operation

d. Operation on thyroid gland

e. Krail’s operation

Question 60

Correct

Mark 1.00 out of 1.00

A 36 years old patient presented with complains of dyspnea, dizziness. History of Thoracic trauma 2 days back. On examination decrease
movement of the left side of the chest wall. On chest X-ray – Collapse of the 1/3 of left lung. Fracture of left 4-6 ribs. What are the possible
complication patients has developed

a. Empyema of pleura
b. Pleuritis

c. Pneumothorax 
d. Posttraumatic Hemothorax

e. Posttraumatic pneumonia
Question 61

Incorrect

Mark 0.00 out of 1.00

A 48 years old patient, suffering from posttrombotic syndrome of the left leg since 2 years. On examination: Dilated superficial veins of left leg
and thigh, and pubic region, a significant swelling of the left leg. Light physical exertion aggravates pain. What kind of treatment should be
recommended to patient

a. Phlebo-sclero-obliteration
b. Reconstructive operation on deep veins of the left thigh

c. Compression treatment
d. Conservative therapy 

e. Phlebectomy

Question 62

Incorrect

Mark 0.00 out of 1.00

A 50-year-old male patient was brought to Emergency Department with diffuse abdominal pain and signs of cardiovascular collapse. Upon
arrival he had BP 95/60 mm Hg, 120 pulses/min, diuresis 20 ml/h, HgB 100 g/l, red blood cells count 2.1·1012/l. The patient needs infusion of

a. Crystalloid and 5\% dextrose

b. 5% dextrose and red blood cells

c. Crystalloid and red blood cells

d. Crystalloid and colloid

e. 5% dextrose and colloid 

Question 63

Incorrect

Mark 0.00 out of 1.00

A 58 years old woman with overweight right before has had an attack of right hypochondrium pain and jaundice with dark urine and stool
discoloration appeared. On clinical examination the abdomen is distended and painful on palpation in the right hypochondrium, The mild liver
enlargement there is. In blood the total bilirubin is 90 mkmol/l, direct (conjugated) 60 mkmol/l. What investigation is the most informative to
clarify the diagnosis

a. Intracutaneous intrahepatic cholegraphy 

b. Infusional cholegraphy
c. Ultra sound investigation of the hepatopancreatobiliary zone

d. Retrograde cholangiopancreatography
e. Intravenous cholegraphy
Question 64

Correct

Mark 1.00 out of 1.00

A 60 yr. old man with unstable angina pectoris fails to respond to heparin, nitroglycerin, beta adrenegic blockers and calcium channel
antagonist. The best management includes

a. Coronary artery bypass grafting 

b. Intravenous streptokinase
c. Oral aspirin

d. Antihypertensive therapy

e. Exercise testing

Question 65

Correct

Mark 1.00 out of 1.00

A 28-year-old woman comes to the Emergency Room with a slightly reddened, painful “knot”, 8 cm above the medial malleolus. Examination in
the standing position demonstrates a distended vein above and below the mass. There are no other abnormalities on physical examination.
The most likely diagnosis is

a. Superficial venous thrombosis 

b. Early deep vein thrombosis

c. Insect bite

d. Cellulitis
e. Subcutaneous hematoma

Question 66

Not answered

Marked out of 1.00

On dispensary supervision at therapist are the patients with diabetes mellitus, hypertonic disease, obesity. The cancer with what localizations
in this group is necessary to expect with a high degree of risk

a. Gulet

b. Liver

c. Uterus body
d. External sexual organs

e. Uterus neck
Question 67

Correct

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In patients who have sustained blunt trauma to the chest, which of the following would most likely be the cause of acute cardiopulmonary
collapse

A 50-year-old man comes to the emergency room with a history of vomiting of 3 days’ duration. His past history reveals that for approximately
20 years, he has been getting epigastric pain, lasting for 2 to 3 weeks, during early spring and autumn. He remembers getting relief from pain
by taking milk and antacids. Physical examination showed a fullness in the epigastric area with visible peristalsis, absence of tenderness, and
normal active bowel sounds. The most likely diagnosis is
{=Gastric outlet obstruction
~Small bowel obstruction
~Volvulus of the colon
~Incarcerated umbilical hernia
~Cholecystitis}

a. Rib fractures
b. Pulmonary contusion

c. Acute adult respiratory distress syndrome

d. Pneumothorax 
e. Hemothorax

Question 68

Correct

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The patient K. is 23 years old. He has wounded left arm due to the gunfire. The bones of the arm are undamaged. What appropriate surgical
help must be provided to such a patient

a. Primary surgical Processing with a flowing suction 

b. Aseptic dressing of the wound

c. Suture wound and dry it

d. Suture wound

e. Dry wound with towel gauzes

Question 69

Correct

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A patient 25 years old presented to emergency department after 40 minutes of stab injury of chest in a projection of heart in a critical
condition. Confused, cold sweating, Blood Pressure 60/20 mm.Hg, Pulse on peripheral arteries was absent. What is the most probable
diagnosis

a. Injury of intercostals vessels

b. Cardiac Injury 

c. Lung Injury
d. Pneumohemothorax

e. Bleeding from soft tissues of chest wall

Question 70

Correct

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Which of the listed below operation are not done in cases of perforated duodenal ulcers

a. Vagotomy + Pyloroantrumectomy
b. Vagotomy + resection of the ulcer

c. Gastrostomy 
d. Suturing of the ulcer

e. Resection of 2/3 - 3/4 of the stomach

Question 71

Correct

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Increasing of central venous pressure is marked on the base of decreasing arterial pressure during the dynamic investigation of it at victim
with plural combined injuries. What is this combination evidence of

a. Blood deposition in venous channel

b. Addition of cardiac insufficiency 

c. Growth of bleeding speed

d. Hypervolemia
e. Shunting
Question 72

Correct

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Which of the following is the most common clinical manifestation of an abdominal aortic aneurysm

a. Acute rupture
b. Peripheral embolization

c. Most are asymptomatic 

d. Back pain
e. Chronic peripheral ischemia

Question 73

Correct

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A patient 40 year old presented to Emergency department with the cut injury on the right side of the chest wall. Profuse bleeding from the
wound but the patient is in conscious, B.P - 120/60 mm.Hg, pulse 100 beats per minute. Which one from below listed methods allows to
define character of wound with the greatest accuracy

a. Ultrasound of thoracic Cavity

b. CT scan

c. Primary surgical cleaning and exploration of Wound 

d. Chest X-ray

e. Bronchoscopy

Question 74

Incorrect

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To the doctor 28 years old a woman has addressed with the complaints to increase of the size of pigment nevus which was available from
birth, get wetting, itch. What method of research should not be applied to diagnostics in this case

a. Glass-print

b. Incision biopsy
c. Radioisotope diagnostics

d. Yaks’s reaction 
e. Thermography
Question 75

Correct

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What from the listed operations in treatment of ulcer of stomach and duodenum is carried out only under emergency indications

a. Selective proximal vagotomy

b. Resection of stomach by Bilroth II

c. Truncal vagotomy with pyloroplastic

d. Resection of stomach by Bilroth I

e. Sewing up perforated ulcer 

Question 76

Correct

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The method of treating a small cell of anaplastic lung cancer T2NxM1, with bone methastases is

a. Chemotherapy 
b. Lobectomy

c. Pneumonectomy

d. Immunotherapy
e. Radiotherapy

Question 77

Correct

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A 53 years old patient, complains of a heartburn, regurgitation of air, vomiting. In

esophagodudenoscopy: Marked prolapse of squamous mucous of stomach into the esophagus. In radiogram marked protrusion of 1/3
stomach into the posterior mediastinum. Provisional Diagnosis A sliding hiatal hernia, ІІІ degree. What is the tactics of treatment

a. Plastic of a diaphragm according to Belsey 

b. Vandal's operation

c. Heller's Operation
d. Esophagectomy, Abdomino-cervical Method

e. Lewis's operation
Question 78

Incorrect

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At the patient of 34 years of age you suspect an abscess of Douglas spaces. What method of research is preferable to diagnostics

a. Digital research of rectum

b. Laparoscopy

c. R-scopy of abdominal cavity

d. Percussion and auscultation of a stomach 

e. Rectoromanoscopy

Question 79

Correct

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A patient 32 years old presented in a hospital in a critical condition with chief complain of acute retrosternal chest pain with radiation to back.
On examination:- skin and mucous are pale, t-38,8 С. Marked subcutaneous emphysema of soft tissues of a neck, одутловатость face. On
the eve ate fish. On Chest X-ray expansion of mediastinum is revealed. What is the most probable diagnosis

a. Pneumothorax
b. Mediastinitis 

c. Heart attack
d. Abscess of lung

e. Pneumonia

Question 80

Incorrect

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A nonalcoholic 45-year-old woman presents with an asymptomatic, septated 10-cm cystic mass in the body of the pancreas. She should be
advised that

a. Drainage by Roux-en-Y jejunostomy is indicated

b. Total pancreatectomy is the preferred surgical management

c. It is cancerous and she will likely die from it in 12 months 

d. The lesion is probably benign and requires observation only

e. Complete excision of the lesion is indicated
Question 81

Correct

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A patient 52 years old admitted in vascular department of the hospital with sever edema and pain of holding apart character in the right leg
and thigh, aggravated by passive movements. On examination: On the right leg sever edema starting from the foot till inguinal ligaments are
observed cyanotic skin. What is the most probable diagnosis

a. Phlegmon of the right Leg

b. Acute iliofemoral vein thrombosis 

c. Erysipelas of the right leg

d. Lymphostatsis

e. Acute thrombophlebitis of superficial veins

Question 82

Correct

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A 60 years old woman has been ill with chronic calculous cholecystitis for 10 years. During the treatment in sanatorium the patient had had a
hepatic colic with jaundice. Ultra sound investigation revealed a lot of calculi sized 5-6 mm in the gallbladder. Choledochus is widened to 15
mm and contains concrements up to 6 mm in diameter in the distal part. What method of treatment is the most adequate and current

a. Cholecystectomy, choledocholithotomy, external choledochus drainage according to Kerr

b. Endoscopic papillosphincterotomy, laparoscopic cholecystectomy 

c. Cholecystectomy, transduodenal papillosphincterotomy

d. Cholecystectomy, choledochojejunostomy

e. Cholecystectomy, choledochoduodenostomy

Question 83

Correct

Mark 1.00 out of 1.00

Classical X-ray image of intestinal obstruction is

a. High positioned diaphragm

b. Pneumatosis

c. Gas and horizontal levels 

d. Filling defect

e. Reactive pleuritis
Question 84

Incorrect

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What is normal daily diuresis in adult

a. 500-1000 ml
b. 2500-3000 ml 

c. 200-500 ml

d. 1500-2000 ml
e. 2000-2500 ml

Question 85

Correct

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A 45 years old man presented with chief complains of rise in temperature up to 38c, pain and swelling in lumbar region and painful mass 5х6
sm. in size, crimson color of skin over the mass, in the center purulent - necrotic fistulas which is secreting pus. What is the most probable
diagnosis

a. Erysipelas inflammation
b. Carbuncle of lumbar region 

c. Renal Colic
d. Abscess of lumbar region

e. Para nephritis

Question 86

Correct

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The patient K. 42 years old, presented with the diagnosis of “Acute iliofemoral vein thrombosis(1 rst. Day), Pulmonary artery
thromboembolism” and admitted in vascular department of the Hospital. What is your tactics

a. Thrombolytic therapy plus implantation of Cava filter 

b. Surgical treatment
c. Bronchoscopy

d. Elastic Bandage of legs

e. Introduction of low-molecular wt. Heparin
Question 87

Correct

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The male patient, 60-year-old, tobacco smoker for 30 years, alcoholic, has dysphagia and weight loss since 4 months. Suggested diagnoses

a. Esophageal achalasia
b. Esophageal diverticulum

c. Esophagitis

d. Cancer of the esophagus 

e. Hanter`s disease

Question 88

Correct

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A 45-year-old male patient was admitted to the intensive care unit because of myocardial infarction. An hour later the ventricular facilitation
occurred. What from following should be administered

a. Adrenalin injection

b. External chest compression

c. Cardiac pacing

d. Lidocaine injection

e. Defibrillation 

Question 89

Correct

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In order to differentiate diagnosis of anuria and ishuria you should accomplish:

a. None of the above

b. Analysis of urine
c. Excretory urography

d. Analysis of the blood

e. Catheterization of the urinary bladder 

Question 90

Not answered

Marked out of 1.00

A pregnant woman with 24 weeks gestation term has felt a cramping pain in low abdomen. Nausea and vomiting are absent. She looks for a
medical aid in the gynecologic out-patient office. On clinical examination the abdomen is soft and tender on the right. The Schyotkin -
Blumberg, Rovzing, Koap's symptoms are slightly positive and Brendo, Michelson's signs are strongly positive. What is the most adequate
tactics of the doctor in the situation

a. To send the patient to the in-patient department at once to solve the problem of urgent surgical operation
b. Urgent interruption of pregnancy

c. To observe the patient for the next 24 hours at home to clarify the condition

d. Medication therapy
e. Emergent diagnostic abdominal cavity puncture through the posterior vaginal fornix in this female dispensary office

Question 91

Incorrect

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What treatment is shown for the patient of 63 years of age with an attack of bilious colic, caused by gall-bladder stone

a. Conservative treatment

b. Emergency operation 
c. Urgent operation after cupping an attack

d. Antienzyme therapy
e. Laparoscopic cholecystotomy

Question 92

Correct

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A patient 35 years old complains of a difficult swallowing, pain behind the breastbone. He can eat only liquid food. While swallowing
sometimes he has attacks of cough and dyspnea. Above mentioned complaints is progressing. It is known that the patient has had a
chemical burn of esophagus one month ago. What complication does the patient have

a. Cardia Achalasia
b. Corrosive Esophagitis and stricture 

c. Cardia insufficiency
d. Esophageal diverticulum

e. Esophagitis
Question 93

Not answered

Marked out of 1.00

A 41 year old patient was admitted to the intensive care unit with hemorrhagic shock due to gastric bleeding. He has a history of hepatitis B
during the last 5 years. The source of bleeding are esophageal veins. What is the most effective method for control of the bleeding

a. Haemostatic therapy

b. Introduction of obturator nasogastric tube.

c. Administration of plasma

d. Operation

e. Intravenous administration of pituitrin

Question 94

Incorrect

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A young man, 15 years old, has the ulcer disease of stomach. What is the etiology of this disease

a. Lambliosis 

b. Intestinal bacillus
c. Salmonella

d. Helicobacter pylory

e. Influenza

Question 95

Correct

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A man 42 years old with long history of disease complains of a frequent heartburns, moderate pain in epigastrium and behind breastbone
propagated in the back in point between shoulder blades. Pain appears with meals or just after meals and can be provoked by physical
exertion. Also he has had a relapsed bronchopneumonia earlier and events of melena. The CBC reveals anemia. On X-Ray film there is a
bubble of gas in the posterior mediastinum. ECG documents an arrhythmia. What is your diagnosis

a. Mediastinitis

b. Ischemic heart disease Gastric ulcer

c. Hiatus hernia of esophagus 

d. Chronic pancreatitis
Question 96

Incorrect

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With the restrained umbilateral hernia which has become complicated by phlegmon of hernia sac, it is necessary to make for patient

a. Herniotomy by Lekser 
b. Herniotomy by Sapegko

c. Herniotomy by Meio-Sapegko

d. Herniotomy by Grenov
e. Herniotomy by Meio

Question 97

Incorrect

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A 45 years old woman was operated because of biliary calculi and obstructive jaundice. A two months later after operation there is continuing
bile discharge up to 500,0-600,0 ml per day through the Kerr`s external choledochus drainage. On fistulography using the drainage in the distal
part of the choledochus “a forgotten stount” up to 8 mm in diameter was identified. The choledochus is dilated up to 16 mm. The most correct
surgeon treatment in this case is

a. Choledocholithotomy and drainage of the choledochus

b. Endoscopic papillosphincterotomy and removing a concrement from choledochus

c. Choledocholithotomy with close seam on choledochus

d. Choledocholithotomy choledochojejunostomy 
e. Choledocholethotomy choledochoduodenostomy

Question 98

Correct

Mark 1.00 out of 1.00

Classical X-ray image of intestinal obstruction is

a. High positioned diaphragm

b. Pneumatosis
c. Reactive pleuritis

d. Filling defect
e. Gas and horizontal levels 
Question 99

Correct

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Patient А., 44 Years old, presented to Emergency Department after 3 hours of trauma with chief complain of Right sided Chest pain, Dyspnea,
Fatigue, Dizziness. Cyanosis. Unstable Hemodynamic. On Chest X-ray-Fracture of Right four Posterior-Lateral ribs, Collapse of right lung 2\3
Volume. What is the possible diagnosis.

a. Right-sided Hemothorax
b. Hematoma Mediastinum

c. Right sided post-traumatic exudative pleuritis

d. Detachment of Main Bronchus

e. Right sided Post-traumatic Pneumothorax 

Question 100

Not answered

Marked out of 1.00

During an operation for presumed appendicitis, the appendix is found to be normal; however, the terminal ileum is markedly thickened and
feels rubbery to firm, its serosa is covered with a gray-white exudate, and several loops of apparently normal small intestine are adherent to it.
The most likely diagnosis is

a. Perforated Meckel’s diverticulum

b. Acute ileitis
c. Ileocecal tuberculosis

d. Crohn’s disease of the terminal ileum

e. Ulcerative colitis