Minisry of Health of Ukraine
Zaporizhzhya State Medical University
Chair of Internal Diseases-1
Collection of initial and current control tests
for 4th course students of medical and pediatric faculties
content modules: gastroenterology,
endocrinology, pulmonology, hematology,
physiotherapy
(english version)
Zaporizhzhya – 2016
Recensent: Head of Internal Disease Propedeutics with Care Chair of ZSMU, professor
Syvolap V.V.
Approved: by Central Metodic Council of ZSMU.
Protocol № 1 of 29.09.2016 y.
Autors: assistant Solovyuk A.O., MD, PhD. assistant Zemlyanoy Ja.V.., MD, PhD
Tests for assessment of current knowledge level were included in collection and
appropriate programm of Internal Diseases (gastroenterology, endocrinology, pulmonology, hematology, physiotherapy ).
The aim of this material is approvement of studying teoretical knowledge by 4th
course students in accordance with Internal Diseases programm in VII-VIII semestres.
Instruction: every question has a seweral alternative answers. Please choose only
one answer.
 Zaporizhzhya State Medical University
 Production of ZSMU
2
Сontent
Collection of initial control tests
4
Gastroenterology
4
Endocrinology
14
Pulmonology
20
Hematology
28
Checking of true answers
34
Collection of current control tests
37
Endocrinology
37
Pulmonology
63
Gastroenterology
82
Hematology
107
Physiotherapy
123
Checking of true answers
131
3
Collection of initial control tests
Gastroenterology
1. Patient of 54 y.o. complains about permanent
for meat food appeared. In blood: Hb-92g/l.
dull pain in mesogastrium, weight loss (10kg
Concrements have dark brown color. What
during last year), addition of dark blood in ex-
most probable complication developed at the
crements, constipations. Blood count: RBC –
patient?
12
9
3,5х10 /l Hb-87 g/l, WBC-12,6х10 /l, left
A. Perforation
shift, ESR-43 mm/hr. What is a provisional di-
B. Pyloric stenosis
agnosis?
C. Bleeding
A. Chronic pancreatitis
D. Penetration
B. Transversal colon cancer
E. Malignancy
C. Peptic ulcer
D. Chronic colitis
4. Man of 26 y.o. complains about a
E. Cancer of stomach
paroxysmal abdominal pain, a diarrhea with
addition of mucus and blood. He is ill for 3
2. The patient of 52 y.o, complains about
years, lost weight about 14kg. Objectively: HR
delicacy last half a year, fast fatigability, meat
– 96/min., BP -110/70 mm hg., temperature-
food dislike, weight loss. Objectively: pale
37,60C. Abdomen is soft, there is morbidity in
skin, in left subclavial area the lymphatic nodus
palpation along of colon, especially at the left.
is palpated. There is resistance of an abdominal
Irrigoscopy – a large intestine is narrowed,
wall in epigastrium. In blood – anemia, in
haustration is absent, contours are uneven,
gastric contents - lactic acid. This clinical
indistinct. What diagnosis is most probable?
picture is most characteristic:
A. Nonspecific ulcerative colitis*
A. Lymphogranulomatosis
B. Intestine tuberculosis
B. B 12 -deficiency anemia
C. Amebic dysentery
C. Iron deficiency anemia
D. Crohn's disease
D. Chronic atrophic gastritis
E. Irritable colon syndrome
E. Cancer of stomach *
5. Chronic autoimmune gastritis with secretory
3. Patient S., 55 y.o., is ill with a peptic ulcer of
insufficiency was found in patient of 60 y.o. af-
stomach for 10 years. For the last 6 months he
ter examination. What medicine is most indi-
lost weight by 15kg. He noted that pain in
cated to this patient?
epigastric
A. Almagel
area
became
permanent
from
periodic, delicacy amplified, anorexia, dislike
B. De-nol
4
C. Ranitidine
B. Esophageal tumor
D. Gastric juice
C. C. Hysteria
E. Venter
D. Sklerodermia
E. Esophageal strikture
6. Men of 40 y.o, is ill with autoimmune
hepatitis. In blood: albumin/globulin ratio –
9. Patient complains about progressive dyspha-
0,8, total bilirubin – 42 umol/l, transaminases:
gia with malnutrition last two months. Difficul-
ALAT-2,3
ASAT-1,8
ty in a swallowing only of firm food was oc-
mmol/(l*hr). What from listed is the most
cured at first, and later liquid nutrition also.
effective in treatment?
What the most reliable pathology is present at
A. Antibacterial medicines
the patient?
B. Glucocorticoids, cytostatics
A. Sideropenic dysphagia
C. Hepatoprotektors
B. Sclerodermia
D. Antiviral medicines
C. Esophageal cancer
E. Haemosorption, vitamines
D. Benign tumor of a mediastinum
mmol/(l*hr),
E.
Esophageal diverticulum
7. The leading syndromes are the dysphagia
and malnutrition at the patient. What methods
10. Vomiting by leftovers with an unpleasant
of laboratory and instrumental examinations is
smell, periodically swallowing violation, a sali-
the most informative for diagnostics?
vation, an weight loss is observed at the patient.
A. Blood count
He is ill for several years, recently he has be-
B. Laryngoscopy
gun to notice tumour-like formation on neck.
C. Biochemical blood test
what pathology of a esophageus it is the most
D. Contrast X-ray examination of esophagus
reliable to think of ?
E. Alpha-fetoprotein level assessment
A. Upper part gullet diverticulum
B. Bifurcation diverticulum
8. Progressive dysphagia led to malnutrition
C. Gullet cancer
last year in patient of 50 y.o. Body weight defi-
D. Benign tumor of a gullet
cit more 25kg. In anamnesis subtotal resection
E. Mediastinitis
of stomach was performed 20 years ago. X-ray
of esophagus: without abnormalities exept for
11. Sharp pains behind a breast bone, nausea, a
dilay of barium on level of piriform formations
dyspnea developed at patient N., during an
on aperture of esophagus. What pathology may
endoscopy. Endoscopic research was stopped.
be occur first of all?
What examination needs to be conducted?
A. ECG
A. Sideropenic dysphagia
B. Computer tomography
5
C. Contrast X-ray examination of esophagus
found on ECG. What esophageal pathology it is
D. Fluorography of thorax organs
necessary to think first of all of?
E. Repeated endoscopy after anesthesia
A. Diverticulum of middle third of esophagus
B. Benign tumor of esophagus
12. The expressed heartburn, pain when pass-
C. Diverticulum of the upper third of esopha-
ing food in the lower department of a breast,
gus
frequently at the level of a xiphoidal shoot, es-
D. Esophagus cancer
pecially after acceptance of sour and salty food
E. Esophagitis
the long time is observed at the patient T. In
objective examination abnormalities from in-
15. Defect of filling with accurate equal con-
ternals are not revealed. What examinations
tours is detected in X-ray examination in the
should be conducted to the patient?
lower third of a gullet of patient N. of 19 y.o.
A. Contrast X-ray analysis of a gullet
The dysphagia disturbs for 1 year, the general
B. Analysis of gastric content
condition is broken a little. Of what pathology
C. Digestive tract roentgenoscopy in a Trende-
it is necessary to think first of all?
lenburg position
A. Gullet varicosity
D. Endoscopy
B. Gullet cancer
E. All listed
C. Benign tumor
D. Hernia of diafragmal part of a gullet
E. Mediastinal disease
13. The peptic ulcer of a gullet has been diagnosed in patient S. of 41 y.o. What treatment it
is necessary to administrated?
16. Patient G., complains of dull pain that initi-
A. Antacides
ated by meals, localized in an epigastrium,
B. Conservative
without accurate irradiation. Heartburn, acidic
C. The choice of treatment will depend on a
belch disturb the patient periodically. In anam-
condition of gastric secretion
nesis - similar complaints appeared 6 years ago.
D. Surgical
Proceeding from the anamnesis what the most
E. The choice of treatment will depend on re-
probable diagnosis is?
sults of a biopsy
A. Chronic pancreatitis
B. Peptic ulcer
14. Paroxysmal pains behind a breast bone oc-
C. Chronic cholecystitis
cured at the patient more often at home in the
D. Chronic gastritis
afternoon or in the evening, more often after
E. Chronic cholangitis
meals or in left-side position. The patient was
17. Complaints to pain in epigastrium after sour
eobserved by the physitian, changes weren't
food without accurate dependence on time of
6
her reception are present at patient of 18 y.o.
months ago. What medicines have to be includ-
She is ill 10 years. Objectively: furred tongue
ed in treatment of this patient?
and extended pain in epigastrium. What of the
A. M-cholinolitics
listed groups of medicines should be included
B. Protone pomp blockers
in treatment scheme of the patient?
C. Metronidazole
A. M-cholinolitics
D. Amoxicyllin
B. Beta - blockers
E. All specified
C. Iron medicines
D. M-cholinomimetics
21. Chronic gastritis with survived secretory
E. Calcium channel blockers
and acid-forming function in remission has
been diagnosed in patient N. What types of
18. Duodenogastral reflux and hypertrophy of
sanatorium are indicated for this patient and
folds of pyloroantral department are found in
when?
the patient in X-ray examination. In the analy-
A. Morshin in a cold season
sis of gastric content – free hydrochloric acid is
B. Khmelnik in summer
absent in all portions. What drugs shall be in-
C. Zakarpatya group of resorts in summer
cluded in treatment of the patient?
D. Zakarpatiia group of resorts at all seasons
A. Gastric juice as replacement therapy
E. Southern shore of the Crimea in summer
B. Prokinetics
C. M-cholinolitics
22. Factors of protection of gastric and duode-
D. Antacides
nal mucous:
E. All listed
A. Protective mucous barrier; active regeneration of mucous; adequate blood supply; antroduodenal acid brake
19. Menetrier's disease was diagnosed in pa-
B. Protective mucous barrier; adequate motoric
tient. What indications to surgical treatment?
A. Signs of malignisation
and evaquatory function; active regenera-
B. Frequent relapses
tion of mucous; an-troduodenal acid brake
C. Adequate blood supply; motoric and evaqua-
C. Exocerbation phase
D. Inefficacy of treatment
tory function; antroduodenal acid brake; ac-
E. Appearance of erosions
tive regeneration of mucous.
D. Active regeneration of mucous; adequate
20. The patient K., 17y.o., was hospitalized to
blood supply, antroduodenal acid brake;
gastroenterology department with diagnosis:
hypoproduction of HCl and pepsin.
chronic antral gastritis with increased secretory
E. Protective mucous barrier, hypoproduction
and acid-forming function, exocerbation phase.
of HCl and pepsin, active regeneration mu-
The analysis of gastric contents is carried out 2
cous, adequate blood supply.
7
23. Giant ulcers such which have in the diame-
26. High possibility of ulcer in duodenum is
ter:
observed at next values of the maximum
A. More than 10 mm
histamine test:
B. More than 20 mm
A. Basal acidity > 12-14 mecv/hr; maximal
acidity > 45-50 mecv/hr
C. More than 30 mm
B. Basal acidity > 12-14 mecv/hr; maximal
D. More than 40 mm
acidity > 40-45 mecv/hr
E. More than 50 mm
C. Basal acidity > 14-16 mecv/hr; maximal
acidity > 45-50 mecv/hr
24. What are the M-cholinolitics:
D. Basal acidity > 14-16 mecv/hr; maximal
A. Atropine, metacil, chlorosil, cimetidin
acidity > 40-45 mecv/hr
B. Metacyne, atropine, gasrocepine, pro-bantin
E. Basal acidity > 7-12 mecv/hr; maximal
C. Atropine, platiphylline, nisatidine, metacyne
acidity > 35-40 mecv/hr
D. Platiphylline, atropine, ranitidine, chlorodil
E. Platiphylline, atropine, metacyl,
27. What drugs are indicated in case of
gastrocepine
piloroduodenal location of ulcer:
25. The increased acid-forming function of a
A. Oxyferriscorbone, H 2 -histamine receptor
stomach is found in the patient with peptic
blockers,de-nol, antacides
ulcer in maximal pentagastrine test. What
B. H 2 -histamine receptor blockers,
indicators indicate the specified secretion?
gasrocepine, antacides
A. Volume of juice (ml) 220; total acidity
C. Oxyferriscorbone, H 2 -histamine receptor
(titr.un.) 130; free HCl (titr.un.) 120; HCl
blockers, antacides
debit-time (mecv/hr) 80
D. Gastrocepine, biogastron, oxyferriscorbone
B. Volume of juice (ml) 60; total acidity
E. Reparants, H 2 -histamine receptor blockers,
(titr.un.) 90; free HCl (titr.un.) 90; HCl
antacides
debit-time (mecv/hr) 50
C. Volume of juice (ml) 220; total acidity
(titr.un.) 100; free HCl (titr.un.) 100; HCl
28. Reddening, increased vulnerability, staxis
debit-time (mecv/hr) 80
of a mucosa of all small intestine and colon
D. Volume of juice (ml) 180; total acidity
with existence of fibrous coat it is revealed at
(titr.un.) 100; free HCl (titr.un.) 90; HCl
patient S. with complaints about diarrhea and
debit-time (mecv/hr) 50
blood
E. Volume of juice (ml) 240; total acidity
in
feces
after
colonoscopy.
The
inflammation of colon mucosa with existence
(titr.un.) 100; free HCl (titr.un.) 90; HCl
of abscesses of crypts is revealed by histology
debit-time (mecv/hr) 50
8
examination of bioptat. What most reliable
year.
Repeatedly
she
was
examined
in
disease at the patient?
infectious diseases hospital where diagnoses of
A. Ischemic colitis
acute infectious diseases were excluded. By
B. Crohn’s disease
physical examination: the patient of down-
C. Ulcerous colitis*
nutrition, skin is dry, decreased elastance.
D. Infectious colitis
Tongue is bright red, abdomen is soft, a
E. Haemorrhoids
palpation of a sigmoid intestine sharply morbid.
The liver is enlarged on 3 cm from under edge
29. The lesion of mucous in the form of "cob-
of a costal arch, dense. Pulse 86, rhythmic, soft.
blestone pavement" with sites of intact mucosa
BP 100/60 mm hg.
after colonoscopy is revealed at the patient K.,
weakened. BR 20/min. In excrements are
who complains about periodically abdominal
insignificant quantity of liquid contents with
pain last 5 years. What is the most reliable dis-
addition of blood. What most possible disease
ease at the patient?
at the patient?
A. Ulcerous colitis
A. Helminthic invasion
B. Crohn's disease
B. Crohn's disease
C. Infectious colitis
C. Diverticular disease
D. Ischemic colitis
D. Chronic enteritis
E. Diverticular diseas
E. Nonspecific ulcerous colitis, severe form
30. Alterations of skin (Erythema nodozum),
32. Patient S., 29 y.o., complains about ab-
tumescence of joints, inflammation of eyes,
dominal pain, 5-6 defecation acts daily with
perianal lesion and pain in palpation of colon
addition of mucus and blood, weight loss, gen-
are observed in patient V. What is the most re-
eral weakness, working capacity loss. He is ill
liable disease at the patient?
4 years, periodically 1-2 times yearly he has
A. Uveitis
exacerbations after diet inaccuracys and strong
B. Polyarthritis
emotions. After treatment these changes were
C. Reuters' syndrome
disappeared. Koprogramm data: a feces have
D. Ulcerous colitis
porridge-like consistence, reaction alkaline,
E. Osteoarthritis
without impurity of mucus and blood. Micros-
Cardiac tones
are
copy muscular fibers and undigested fat,
31. Patient G., 41 y.o., complains about liquid
starched grains, iodofil flora, appreciable quan-
excrements (till 10-12 times daily) with
tity of leucocytes, erythrocytes, intestinal epi-
addition of mucus and blood, diffuse pain in
thelial cells are found. The analyses of a feces
lower parts of abdomen, weight loss on 4 kg for
on dysenteric and typhus-paratyphus flora are
the last year. The patient considers itself ill last
9
negative. What the most reliable disease at the
was performed half year ago. Objectively: pa-
patient?
tient of the down-nutritinal, skin is pale, BP
A. Chronic enteritis
150/90 mm hg, pulse 80 per min, soft, satisfac-
B. Krohn’s disease
tory filling. A stomach in palpation is soft,
C. Chronic pancreatitis, exacerbation
painless. The liver isn't enlarged. Lungs, heart
D. Nonspecific ulcerous colitis, recurrent
are normal. What is the most reliable disease at
course
the patient?
E. Intolerance to carbohydrates
A. Peptic ulcer, inactive phase, condition after
a subtotal gastrectomy by Billroth-ІІ, a
dumping syndrome
33. Patient S., 25 y.o., complains about periodically dull pain in the right ileal site, unstable
B. Intolerance to carbohydrates
liquid stool, a frequent meteorism, low grade
C. Chronic coloenteritis, exacerbation phase
fever, general weakness, periodically arthralgi-
D. Toxic dilatation of a large intestine
as. He is ill about 2 years. In the anamnesis –
E. Alimentary toxinfection
appendectomy. Objectively: there is moderate
abdominal swelling, in the right ileal area tu-
35. Patient K., 48y.o., complains of weakness
morous formation was detected, that in projec-
which appears in 15 min. after meal, especially
tion of terminal part of ileum. At fibrokolon-
after intake of milk, palpitation, sweating, nau-
oskopy - thickenings of cords of mucosa and
sea, tummy rumbling. In anamnesis - surgical
spicular evaginations of ileocecal part are de-
treatment of peptic ulcer 2 years ago. X-ray ex-
tected, on a relief of a mucosa contrast maculae
amination - acceleration of evacuation of bari-
of hyperemia are defined, ileocecal transition is
um suspension and its fast passage to small in-
contracted. What most reliable disease at the
testine. What is the most reliable disease at the
patient?
patient?
A. Crohn's disease, chronic course
A. Hypoglycemic syndrome
B. Chronic coloenteritis
B. Exacerbation of chronic pancreatitis
C. Nonspecific ulcerous colitis
C. Afferent loop syndrome
D. Intestine tuberculosis
D. Dumping syndrome
E. Intestine tumor
E. Peptic ulcer of anastomosis
34. Patient S., 47 y.o., complains of weakness,
36. Surgical treatment was carried out to the
giddiness, palpitation, headache, sweating, cold
patient S. with peptic ulcer. He complains of
fit, weight loss. In anamnesis: last 20 years
strong feeling of hunger which is followed by
chronic atrophic gastritis, ulcerous disease with
pain in epigastric area, a body tremor, feeling
location of ulcer in cardial part of stomach be-
of fever and palpitation, giddiness, sometimes
cause of it subtotal gastrectomy by Billroth-ІІ
with a loss of consciousness that often appears
10
after a break in nutrition or intensive physical
39. The patient of 36 y.o. complains of persis-
activity. What complication should be suspect-
tent diarrhea, pain in left ileal area during a
ed at the patient?
defecation, presence of fresh blood in a feces,
A. Dumping syndrome
fever. Objectively: skin is dry, pale, maceration
B. Peptic ulcer of an anastomosis
of corners of mouth, morbidity in left meso-
C. Hypoglycemic syndrome
and hypogastrium were found. Specify the pro-
D. Diabetes mellitus
visional diagnosis
E. Afferent loop syndrome
A. Chronic colitis
B. Crohn’s disease
37. The patient K., 65y.o., complains of general
C. Ulcerous colitis
weakness, appetite loss, constipations. Objec-
D. Whipple's disease
tively: BP 100/50 mm hg, pulse 100 per min.
E. Colon tumor
Skin is pale, in palpation of descending part of
colon formation with sizes 40 x 20 mm is de-
40. Syndrome of portal hypertensia includes:
tected. Hb 72g/l, ESR 52 mm/hr. In feses: posi-
A. Jaundice, ascites, hepatomegaly, splenomegaly
tive reaction on hidden blood. What method of
diagnostics is the most informative for verifica-
B. Ascites, dilatation of abdominal wall, gullet
tion of the final diagnosis?
C. Jaundice, dilatation of abdominal wall, gullet
A. Rectoromanoscopy
B. Ultrasound examination
D. Ascites, dilatation of abdominal wall
C. Irrigoskopy
E. Dilatation of anterior abdominal wall, gullet,
anorectal region, splenomegaly
D. Colonoscopy with target biopsy
E. Coprogramm
41. Intensity of hepatocellular insufficiency is
38. Patient complains of diarrhea 6-8 times a
estimated by following indicators:
day with addition of undigested fragments of
A. Jaundice, ascites, fibrinogen, level of total
protein
food. Objectively: morbidity in paraumbilical
B. Jaundice, ascites, encephalopathy, level of
region. Specify organ which is the most authen-
serum globulins, fibrinogen
tically damaged:
C. Ascites, level of bile acids, level of total pro-
A. Small intestine
tein, fibrinogen
B. Stomach
D. Jaundice, ascites, encephalopathy, level of
C. Pancreas
serum albumine, prothrombin
D. Colon
E. Level of serum globulins and albumine, asci-
E. Duodenum
tes, jaundice, prothrombin
11
tion of ammonia in intestine, drugs with pro-
42. Clinical signs of cholestatic syndrome in-
tection of neurotransmitter ballance
clude:
B. Elimination of provocative factor, reduction
A. Skin itch, icterus, malabsorbtion of fats or
of production and absorption of ammonia in
liposoluble vitamins
intestine, antibiotics
B. Skin itch, icterus, maldigestion
C. Skin itch, icterus, hepatomegaly
C. Elimination of provocative factor, reduction
D. Skin itch, icterus, splenomegaly
of production and absorption of ammonia in
E. Skin itch, icterus, anemia
intestine, drugs with protection of neurotransmitter ballance
D. Elimination of provocative factor, anticon-
43. Specify symptoms of hepatic encephalopa-
vulsants, drugs with protection of neuro-
thy:
transmitter ballance
A. Hepatic smell, loss of consciousness, icterus
E. Elimination of provocative factor, reduction
B. Hepatic smell, disorders of consciousness,
of production and absorption of ammonia in
motional disorders
intestine
C. Motional disorders, disturbances of mentality, disorders of consciousness
D. Icterus, hepatic smell, motional disorders
46. Conservative treatment of ascites at cirrho-
E. Motional disorders, disturbance of mentality,
sis includes:
A. Limitation of use of sodium, loop diuretics,
icterus
bed rest
B. Spironolacton, loop diuretics, limitation of
44. Specify medicines which are used for
sodium use, high-protein food
treatment of skin itch in patients with chronic
C. Aldosterone antagonists, bed rest, high-
diseases of liver:
protein food
A. Holestiramin, essentsiale, phenobarbital
D. Limitation of sodium use, spironolacton,
B. Rifampicin, phenobarbital, ursodeoxycholic
bed rest
acid
E. Limitation of sodium use, high-protein food,
C. Holestiramin, allochol, phenobarbital
bed rest
D. Holestiramin, phenobarbital, ursodeoxycholic acid
47. The leading groups of drugs in treatment of
E. Holestiramin, prednisolonum, essentsiale
chronic active hepatitis are:
A. Cyclosporine A, glucocorticosteroids
45. Treatment of hepatic encephalopathy in-
B. Imunodepresants, hepatoprotectors
cludes:
C. Imunodepresants, cyclosporine A
A. Disintoxication, elimination of provocative
D. Hepatoprotectors, glucocorticosteroids
factor, reduction of production and absorp-
E. Glucocorticosteroids, immunodepressants
12
A. Maldigestion syndrome
48. Patient G., 44 y.o., complains of sharp gen-
B. Syndrome of incretory insufficiency of pan-
eral weakness, heaviness in right hypochondri-
creas
um, weight loss, permanent nausea, gingival
C. Dispepsia syndrome
hemorrhage, drowsiness. In anamnesis alcohol
D. Syndrome of excretory insufficiency of pan-
abuse. Objectively: the skin is dry, sclera and
creas
skin are icteric, there are "vascular asterisks"
E. Dysbacteriosis
on face of skin and shoulder girdle . Abdomen
is soft, painless in palpation, liver +6cm, edge
50. Patient of 42y.o. complains of pain in left
is round, painful. Lien +2cm. What is the most
hypochondrium with irradiation to back, intol-
reliable disease at the patient?
erance of milk products, meteorism, presence
A. "Congestive liver"
of undigested products in feces. Objectively:
B. Chronic active hepatitis of alcoholic genesis
pulse 100 per min., rhythmical. Positive
C. Budd–Chiari syndrome
Georgiyevsky-Mussi,
D. Leukosis
toms. What method is the most informative for
E. Alcoholic cirrhosis
verification of the diagnosis?
Mayo-Robson
symp-
A. Gregersen's reaction
49. The patient K., complains of intolerance of
B. Survey X-ray of abdominal cavity
many products, especially milk, crude fruit and
C. Cholecystography
vegetables, hot spices, cold and hot food, mete-
D. Analysis of a feces on dysbacteriosis
orism and massive depletions with creato-, ami-
E. US, coprogramm, definition of enzymes in
lo- and steatorrhea. What is the most probable
duodenal contents
syndrome at the patient?
13
Endocrinology
1. Adenohypophysis doesn’t produce such
B.
АCTH
hormones:
C.
Prolactin
А.
Hydrocortisone
D.
Prednisolonum
B.
Corticotropin
E.
Epinephrine
C.
Growth hormone
D.
Prolactin
6. Hormone of an adrenal medulla is:
E.
Follicle-stimulating hormone
А.
Phenylalanine
B.
Hydrocortisone
2. Insulin is produced by such cells of Langer-
C.
Epinephrine
hans' islets:
D.
Aldosteronum
А.
α cells
E.
Glucagon
B.
β cells
C.
δ cells
7. A place of epinephrine synthesis is:
D.
γ cells
А.
Sympathetic paraganglia
E.
τ cells
B.
Diencephalon
C.
Adrenal medulla
3. Hormones which are produced by Langer-
D.
Follicles of ovaries
hans' islets:
E.
Leidig's cells
А.
Prolactin
B.
Luteinizing hormone
8. Basic mechanism of endocrine diseases.
C.
Epinephrine
А.
Pathology of cardiovascular system
D.
Glucagon
B.
Violation of biosynthesis and secretion
E.
Antidiuretic hormone
of hormones
C.
Cachexia
4. Adrenal medulla consist from:
D.
Physical and mental overloads
А.
Basophilic cells
E.
Infectious processes
B.
Eosinophilic cells
C.
Polychromatic cells
9. Physiologic regulator of synthesis and secre-
D.
Chromaffin cells
tion of insulin is such factor:
E.
Acidophilic cells
А.
Concentration of glucose blood level
B.
Concentration of serum catecholamines
5. Hormone of a cortical layer of adrenal glands
C.
Concentration of blood proteins
is:
D.
Concentration of blood triglycerides
А.
Aldosteronum
14
E.
Concentration
of
nonesterificational
14. To "ketone bodies" belong:
А.
Acetoacetic acid
B.
Lactat
10. Biological effect of glucagon?
C.
Coenzyme-A
А.
It promotes synthesis of proteins
D.
Chylomicron
B.
It promotes lipogenesis
E.
Acetoacetyl-coenzyme-A
C.
It has hyperglycemical effect
D.
It promotes catabolism of proteins
15. To endocrine system belong:
E.
It rises level of blood aminoacids
А.
Excreting enzymes
B.
Excreting in internal environment of
fatty acids
11. How the epinephrine raise of blood glucose
organism high-activity substance
level?
C.
Having excretory ducts
А.
It promotes glycogenesis
D.
Excreting proteases
B.
It promotes glyconeogenesis
E.
Excreting diastases
C.
It invokes glycogenolysis
D.
It enhances synthesis of glucose from
16. To adenohypophysis refer:
pyruvate and lactic acids
А.
Anterior lobe of hypophysis
E.
B.
Middle lobe of hypophysis
C.
Anterior and medium lobes of hypoph-
It enhances adsorption of glucose in
bowels
ysis
12. To mineralocorticoids such hormones of
D.
Posterior lobe of hypophysis
adrenal glands belong:
E.
Waterincanoid lobe of hypophysis
А.
Cortisol
B.
Dehydrocorticosterone
17. Hormones of adrenal cortical shell are such,
C.
Aldosterone
except for:
D.
Testosterone
А.
Epinephrine
E.
Epinephrine
B.
Testosterone
C.
Cortisol
13. Mineralocorticoids influence an metabo-
D.
Aldosterone
lism:
E.
Desoxycorticosterone
А.
Carbohydrates
B.
Mineral salts
18. Concentration of serum glucose of healthy
C.
Fats
man is in limits:
D.
Proteins
А.
1-2 mmol/l
E.
Nucleic acids
B.
3,5-5,5 mmol/l
C.
8-10 mmol/l
15
D.
12-20 mmol/l
23.
Specify
E.
More than 25 mmol/l
cholesterol
hormones
–
derivatives
of
A. Aldosterone
19. Insulin controls metabolism in such organs
B. Thyroxine
and tissues, except for:
C. Prolactinum
А.
Muscles
D. Vazopressin
B.
Futty tissue
E. True all
C.
Liver
D.
Nervous tissue
24. Specify hormones – derivatives of aminoac-
E.
Myocardium
ids:
A. Insulin
20. Weight loss it is typical of endocrine dis-
B. Cortisol
eases, except for:
C. Aldosterone
А.
Diabetes type 1
D. Progesterone
B.
Toxic goiter
E. True all
C.
Pheochromocytoma
D.
Hypothalamic syndrome of puberty
25. Specify a substratum for progesterone syn-
E.
Hypopituitarism
thesis:
A. C-peptide
21. The Cushing's syndrome shows a sympto-
B. Dofamine
matology, except for:
C. Serotonin
А.
Dysplastic obesity
D. Cholesterol
B.
Atrophic strias
E. Lutropin
C.
Hyperglycemia
D.
Osteoporosis
26. What investigational methods of hormonal
E.
Hypotonia
background research are used for assessment of
endocrine system function:
22. Daily need for iodine for a thyroid hor-
A. Detection of hormones and their metabolites
mones biosynthesis is:
level in daily urine
А.
1-2 g
B. Detection of hormones fasting blood level
B.
14-17 mg
C. Tests with suppression of function of gland
C.
100-150 µg
D. Tests with stimulation of function of gland
D.
98-104 ng
E. All listed
E.
123-228 µmol
16
27. What instrumental method of examination
31. What hormones regulate synthesis and se-
is applied for research of hypothalamo-pituitary
cretion level of TSH
system
A. Corticotropin
A. Echoencephalography
B. Triiodinethyronine
B. Electroencephalography
C. Tireotropin-releasing-hormone
C. CT of a brain
D. Truly B and C
D. Rheoencephalography
E. True all
E. Skanning of a brain with radioactive iso32. Specify time of the maximum secretion of
topes
GH in normal condition?
28. What hormones are secreted in hypothala-
A. In the morning when awakening
mus?
B. During the first hours after sleeping
A. Oxytocin
C. For days GH level in norm remains invaria-
B. Liberins
ble
C. Statins
D. After the main meals
D. True all
E. In the first half a day
E. True B and C
33. FSG function 29. What part of hypophysis has a neural
A. Stimulation of formation of sperm
origin:
B. Stimulation of ovarian follicle
A. Hypophysis fully
C. Stimulation of estrogens synthesis
B. Anterior lobe of a hypophysis
D. All listed
C. Intermediate lobe of a hypophysis
E. True B and C
D. Posterior lobe of a hypophysis
E. Hypophysis develops from Ratke's pocket
34. Function of a lutropin
fully
A. Stimulation of endometrial desquamation
B. Stimulation of ovulation and progesterone
30. What bone structure surrounds a hypophy-
synthesis
sis?
C. Stimulation of testosterone synthesis in men
A. Superior part of ethmoidal bone
D. True all
B. Turkish saddle
E. True B and C *
C. Fossa pterigo-palatina
D. Sfenoidal synus
35. What visual violation can testify indirectly
E. Anterior nasal sinus
about space-occupying lesion in the field of the
Turkish saddle
A. Bitemporal hemianopsia
17
B. Daltonism
40. Where prolactinum is produced?
C. Miopia
A. Back lobe of a hypophysis
D. Hypermetropia
B. Intermediate part of hypophysis
E. All is true
C. Anterior part of a hypophysis
D. Hypothalamic nuclei
E. Ovarian follicles
36. Where are synthesized oxytocin and vasopressin?
A. True B and C
41. What hormone of a hypophysis stimulates
B. Supraoptic nuclei of hypothalamus
growth processes
C. Paraventrikular nuclei of hypothalamus
A. Somatotropin
D. Back lobe of a hypophysis
B. TSH
E. True all
C. Somatostatine
D. Thyroxin
E. ACTH
37. What changes in urine are typical for deficit
of vasopressin?
A. Leykocituria
42. Where the growth hormone is produced?
B. Hyperstenuria
A. Ovarian follicles
C. Hypoisostenuria
B. Intermediate lobe of anterior part of hy-
D. Erythrocituria
pophysis
E. Proteinuria
C. Posterior part of hypophysis
D. Hypothalamic nuclei
E. Anterior part of hypophysis
38. What hormone of a hypophysis stimulates
lactation processes
A. Estradiol
43. Call a functional unit of a thyroid gland
B. Prolactinum
A. Lobe
C. FSH
B. Thyrocite
D. ACTH
C. Follicle
E. Progesterone
D. Langergans' island
E. Ashkenazi's cell
39. By chemical structure prolactin is
A. Steroid
44. What hormone is produced by C-cells of a
B. Simple protein
thyroid gland?
C. Derivative of aminoacids
A. TSH
D. Derivative of fatty acids
B. Thyroxin
E. Biogene monoamine
C. Triiodtironin
D. Calcitonin
18
E. C-cells are hormonal no inactive
E. Interstitial tissue of adrenal glands
45. What clinical signs are typical for a hypo-
48. What factors have impact on plasma aldos-
thyroidism?
terone?
A. True B and C
A. True B and C
B. Drowsiness, locks, weight gain
B. Serum potassium
C. Bradycardia, decrease of pulse arterial pres-
C. Activity of renin-angiotensin-aldosterone
sure
system
D. The body temperature increase, the in-
D. Level of blood cortisol
creased perspiration
E. True all
E. True all
49. What hormones regulate level of blood cal46. What hormones are produced in cortical
cium?
layer of adrenal glands?
A. Aldosteron
A. Catecholamines
B. Parathormone
B. Glucocorticoids
C. Calcitonin
C. Androgens
D. True B and C
D. True B and C
E. True all
E. True all
50. Call an endogenous stimulator of synthesis
47. In what structure of adrenal glands cate-
and secretion of a parathormone?
cholamines are produced?
A. Calcium (concentration decrease)
A. Glomerular zone of adrenal cortex
B. Phosphorus (concentration decrease)
B. Chromaffinic tissue of adrenal medulla
C. Potassium (concentration increase)
C. Zone fasciculata of adrenal cortex
D. Aldosteron (concentration increase)
D. Reticular zone of adrenal cortex
E. Vitamin D (concentration decrease)
19
Pulmonology
1. The most typical complaint of patients with
C. Sarcoidosis of intrathoracic lymphatic nodes
bronchial asthmais:
D. Postpneumonia pneumosclerosis
A. Сough with selection large quanti-
E. Postpleurisy pleuro-diafragmal comissura
ty of sputum
B. Hacking unproductive cough
5. Patient D., 24y.o., with bronchial asthma last
C. Expiratory dyspnea
6 years. Asthmatic attacks occur yearly in au-
D. Periodic asthmatic fits
gust-september to 3-4 times. At this time he in-
E. Inspiratory dyspnea
takes β 2 -agonists, inhalation corticosteroides,
sometimes system corticosteroides. Specify de-
2. The fullest auscultative picture in exocerba-
gree of asthma?
tion of bronchial asthma is:
A. І degree (intermittent)
A. Hard vesicular breathing and buzzing dry
B. ІІ degree (persistent, mild)
rales
C. ІІІ degree (persistent, moderate)
B. Hard vesicular breathing with expiratory
D. ІV degree (persistent, severe)
dyspnea
E. V degree (persistent, severe, hormonal-
C. Hard vesicular breathing with expiratory
dependent)
dyspnea and dry sibilant rales
D. Muffled breathing and sibilant rales
6. Patient D., 24 y.o., is ill with bronchial
E. Bronchial breathing and moist rales
asthma of 6 years. Attacks of a dyspnea appear
to 3-4 times per day, 1 time early in the
3. Leading risk factors of bronchial asthma are:
morning.
Patient
intakes
β2-agonists
A. Family anamnesis of bronchial asthma
(salbutamolum till 6-10 doses daily), inhalation
B. Contact with pets, mold or yeast fungi and
corticosteroids (beclomethasone 1000ug a day),
other allergens
systemic corticosteroids (dexamethazonum 8
C. Treated bronchites, pneumonias without ef-
mg a day). What is degree of asthma?
fect
A. І degree (intermittent)
D. Long-term work in dirtyness
B. ІІ degree (persistent, mild)
E. All listed
C. ІІІ degree (persistent, moderate)
D. ІV degree (persistent, severe)
4. What disease that was diagnosted 10 year
E. V degree (persistent, severe, hormonal-
ago, leads to more significant progressive
dependent)
dyspnea after moderate physical activity
A. COPD
7. The patient complains of periodic cough,
B. Bronchial asthma
occasionally with excretion of same of gray20
yellow sputum, a dyspnea when walking, low
possible to estimate existence and expression of
grade fever, weakness. He is ill 5 years.
patency of airways disorders?
Smoker. In percussion over lungs clear
A. Bronchoscopy
pulmonary sound, in auskultation – hard
B. Roentgenoscopy
breathing with scattered dry rales. Choose the
C. Peakflowmetry
most probable diagnosis.
D. Spirometry
A. Pneumonia
E. Computer tomography
B. COPD, lung failure 1
С. Chronic nonobstructive bronchitis
11.
D. Bronchoectatic disease
immunostimulators, antibiotics were prescribed
E. COPD, lung failure II
to the patient with the diagnosis of chronic
Expectoration
medicines,
obstructive bronchitis. What needs to be added
8. The patient complains of dry cough,
for increasing of efficacy of treatment?
weakness, dyspnea when walking. He is ill for
A. ACE inhibitors
15 years. He was periodically treated as in- and
B. β–adrenoblockers
out-patient. He smokes for 20 years. In
C. Diuretics
percussion above lungs there is thympanitis, in
D. Inhibitors of cough reflex
auskultation - dispersed dry rales. Choose the
E. Simpatomimetics
most probable diagnosis.
A. Emphysema, lung failure II
12. The patient is ill with chronic bronchitis
B. Chronic nonobstructive bronchitis
since the childhood. Cough disturbs last 5 years
C. COPD, lung failure I
permanently. In exacerbation a sputum is
D. COPD, lung failure II
purulent to 300 ml a day, it is frequent with
E. COPD, lung failure III
addition of blood. Obectively – fingers in the
form of "drumstick". There is dullness on
9. Index Tiffno has made 85% at the patient.
percussion in inferiolateral parts of thorax,
What it testifies to?
where it is auscultated fine and medium moist
A. Norma
rales were defined. Specify the preliminary
B. Violation of bronchial passability
diagnosis?
C. Decrease of vital capacity of lungs
A. Chronic obstructive bronchitis
D. Decrease of reserve volume of lungs of
B. Bronchoectatic disease
expiration
C. Diffuse pneumosclerosis
E. Decrease of reserve volume of inspiration
D. Chronic abscess of lungs
E. Emphysema of lungs
10. Сhronic obstructive bronchitis was suspected at the patient. By means of what method it is
21
13.
The
patient,
drifter,
complains
of
insufficiency 2A. Treatment: aminoglycosides,
periodically dry cough, remote rales in
expectorants, adrenomimetics, diuretics. What
respiration, increasing of body temperature to
it is possible to add treatment for imrovement
37,5br, weakness, rest dyspnea which amplifies
of efficacy?
when walking. He is ill for 10 years. Labial
A. Immunodepresants
cyanosis, acrocianosis. Percussion data: above
B. ACE inhibitors
lungs - box sound, in auscultation – diffuse dry
C. β – adrenoblockers
rales in hard breathing. Right shift of cardiac
D. Inhibitors of cough reflex
borders on 1.5cm from right edge of sternum,
E. Pro-kinetics
upper – the III intercostal space, left shift on 1
cm from the left medioclavicular line. Cardiac
16. Attacks of asthma are noted at the patient
activity is rhythmical. Accent of the II tone on
last 13 years. He periodically uses inhalations
pulmonary artery. The liver +2 cm. Pastosity of
with salbutamol and beclometazon in dose 500
legs. FEV 1 – 38%. Choose the most probable
ug a day with a positive effect. For the last year
diagnosis.
he began to note constant dyspnea after
A. COPD, lung failure II
physical activity and walking. In auscultation
B. COPD, lung failure III
of lungs breathing is vesicular, diminished
C. COPD, lung failure, III. Chronic pulmonary
breath sounds. In percussion of border of lungs
heart, CI 2
are lowered. FEV1 <60%, are noted decrease
D. Emphysema of lungs, lung failure II
of in vital capacity of lungs and increase of
E. Emphysema of lungs, lung failure II.
residual volume of lungs. Of what complication
Chronic pulmonary heart, CI 1
of the main disease it is possible to think at this
patient?
14. The exacerbation of chronic obstructive
A. Pheumothorax
bronchitis was detected at the patient. What
B. Emphysema of lungs
group of drugs shouldn't be prescribed to the
C. Pulmonary heart
patient?
D. Asthmatic status
A. Expectorants
E. All listed incorrectly
B. Broncholitics
C. Antibiotics
17. The dyspnea at pneumonia can be caused:
D. Blockers of cough relex
A. Big area of lesion of pulmonary tissue
E. Mucolitics
B. Intoxication syndrome
C. Lesion of pleural leaves
15. The patient has a diagnosis: exacerbation of
D. Widespread edema of bronchial tree mucous
chronic obstructive bronchitis, emphysema,
and hypersecretion of mucus
respiration failure III, chronic pulmonary heart,
E. All listed
22
22. The reason of cough with blood spitting
18. What of the following changes of respira-
which is followed by a dyspnea, can be:
tion at auscultation of lungs is most characteris-
A. Lobal pneumonia
tic for focal pneumonia?
B. Left ventricular failure
A. Rigid vesicular respiration
C. Pulmonary thromboembolism
B. Weakened vesicular respiration
D. All above-listed
C. Bronchial respiration
E. Nothing above-listed
D. Amforic respiration
E. Hard vesicular respiration with the extended
23. Signs of severity of nonhospital pneumonia
expiration
is:
A. Cyanosis, disturbance of consciousness,
19. If in case of pneumonia pathological
dyspnea (BR<30 per min.)
process is localized in a parenchyma of lungs,
B.
then:
Tachycardia,
arterial
hypotension
(BP>90/60 mm hg)
A. Сough will be dry, periodic
C. Leukocytosis or leukopenia
B. Сough will be moist, periodic
D. Radiological symptoms of bilateral or mul-
C. Сough will be absent
tilobal unilateral pneumonia
D. Сough can accelerated in horizontal position
E. All listed
E. Сough will be with addition of blood
24. If the infiltration was detected in 72 hours
20. Cough can occur in case of:
after hospitalization of the patient by X-ray,
A. Irritation of receptors of a pleura
this pneumonia is called:
B. Irritation of receptors of airways
A. Nonhospital
C. Irritation of n.vagus owing to a tumor of a
B. Nosocomial (hospital)
mediastinum, aorta aneurism
C. Congestive
D. All above-listed
D. Nothing of above-listed
E. Nothing above-listed
E. All above-stated
21. The pleural exudate can be caused:
25. The most widespread causative agent of not
A. Pneumonia
hospital pneumonia is:
B. Congestive heart failure
A. S.pneumoniae
C. Specific lesion of lungs
B. H.influenzae
D. Pleural mesothelioma
C. M. pneumoniae
E. All above-listed
D. M. catarrhalis
E. C. Pneumoniae.
23
26. What of the next definitions of pneumonia
C.
> 1005
is correct:
D.
< 1005
A. Pneumonia – an acute infectious disease of a
bacterial etiology when moist rales, a crepita-
30. Main clinical signs of pleurisy:
tion are defined in auskultation
A. Thorax pain, dyspnea, productive cough
B. Pneumonia – an inflammatory disease of
B. Thorax pain, asthmatic attacks, productive
respiratory parts of lungs of any etiology which
cough
is confirmed by X-ray
C. Thorax pain, dyspnea, unproductive cough
C. Pneumonia – an acute infectious disease,
D. Thorax pain, unproductive cough, intoxica-
mainly bacterial etiology which is characterized
tion
by a focal lesion of respiratory departments of
lungs and existence of an intraalveolar exuda-
31. Patognomonic for exudative pleurisy is:
tion
A. Amforic breathing
D. All above-listed
B. Clear pulmonary sound
E. Nothing above-listed
C. Massive dullness at percussion
D. A sound of the burst pot
E. Crepitation
27. Accumulation of pathological liquid in a
pleural cavity at inflammatory processes is
called:
32. The pleuritis which developed after resolve
A. Exudate
of pneumonia is called:
B. Transsudate
A. Parapneumonic
C. Both answers are false
B. Metapneumonic
D. Both answers are true
C. Nosocomial
D. Posttraumatic
E. Bronchopulmonary
28. Rivalt's test is based on appearance of turbidity at addition of a drop of exudate in solution of:
33. Triangular space on a healthy side near a
A. Sulfuric acid
backbone with the dulled sound:
B. Linolenic acid
A. Raukfus-Grocco's triangle
C. Acetic acid
B. Damuazo's triangle
D. Hydrochloric acid
C. Garland's triangle
E. Nitric acid
D. Scoda's triangle
29. Relative density of exudates:
34. The minimum quantity of liquid which can
A.
> 1015
be defined by a X-ray examination:
B.
< 1015
A. 500 ml
24
B. 200 ml
A. Esherihia coli
C. 100 ml
B. B. fragilis
D. 300 ml
C. P. aeruginosa
D. S. аureus
35. Threat of pleural empyema formation in patients with parapneumonic pleurisy exists in
40. Objective data when forming abscess with-
case of glucose level:
out communication with a bronchial tube:
A. < 2,22 mmol/l
A. Small place of the shortened percutory
sound and muffled vesicular breathing
B. < 3,33 mmol/l
C. > 2,22 mmol/l
B. Amforic breathing
D. > 1,22 mmol/l
C. Small place of percutory sound and bronchial breathing
D. Small place of the accelerate percutory
36. The main objective of treatment of patients
sound and the weakened vesicular breathing
with pleural exudation:
A. Evacuation of pleural contents
B. Antibacterial therapy
41. What complications of abscess?
C. Therapy of the main disease
A. Pleural empyema, pyopneumothorax, pul-
D. Desintoxication therapy
monary bleeding, sepsis
B. Pulmonary bleeding, dyspnea attacks, lung
37. What processes treat to acute purulent dis-
atelectasis, sepsis
eases of lungs with destruction of pulmonary
C. Pleural empyema, lung cancer, chronic pul-
tissue:
monary heart
A. Abscess
D. Pleura empyema, hydrothorax, metastasis,
B. Gangrene
sepsis
C. Abscessed pneumonia
42. Chronic abscess is a condition with empti-
D. All answers are true
ness in pulmonary tissue remains more, than:
38. Abscess of lungs by etiology can be:
A. 3 months
A. Purulent or putrefactive
B. 2 months
B. Acute or chronic
C. 1 month
C. Single or multiple
D. 6 months
D. Bronchopulmonary, post-traumatic, lym43. Signs of parapneumonic process in exami-
phogenic or hematogenic-embolic
nation of pleural liquid:
39. In etiology of abscess of lungs the
A. Presence of atypical cells
following microorganism doesn't matter:
B. Negative test of Rivalt
25
C. Quantity of leukocytes less than 10000 in 1
of chest. Breathing is vesicular. X-ray shows
mm3
darkening and sharp decrease in size of the
D. Quantity of leukocytes 10000 and more in 1
lower lobe distinctly visible on the X-ray image
mm3
as a streak 2-3 cm wide situated at the angle
from lung root to the frontal costodiaphragmat-
44. Among radial methods of diagnostics by
ic recess. The most likely diagnosis is:
the most sensitive for identification of empye-
A. Middle lobe syndrome
ma is:
B. Bronchiectasis
A. Ultrasonography
C. Pneumonia
B. X-ray
D. Peripheral lung cancer
C. Computer tomography
E. Interlobular pleurisy
D. Radionuclear scanning
48. A 26-year-old male patient complains of
45. Choice antibiotics at an empyema:
piercing pain during breathing, cough, dyspnea.
A. Cephalosporins of ІІІ generation in combi-
Objectively: to- 37,3oC, respiration rate is
nation with anti-staphylococc β-laktam
19/min, heart rate is 92/min; BP is 120/80 mm
penicillins
Hg. Vesicular respiration is observed. In the inferolateral parts of chest auscultation in both
B. Macrolids in combination with antistaphylococc β-laktam penicillins
inspiration and expiration phase revealed noise
C. Respiratory ftorchinolones
that was getting stronger at phonendoscope
D. Nitrofurans
pressing and could be still heard after cough.
ECG showed no pathological changes. What is
46. The deep lesion of the bronchopulmonary
the most likely diagnosis?
device with formation of irreversible local ex-
A. Pericarditis sicca
pansion of the infected bronchi is called:
B. Intercostal neuralgia
A. Bronchoectatic disease
C. Subcutaneous emphysema
B. Gangrene
D. Spontaneous pneumothorax
C. The abscessed pneumonia
E. Acute pleuritis
D. Chronic obstructive disease of lungs
49. A 52-year-old patient complains of pain in
47. A 29-year-old patient works as a motor me-
the right part of her chest, dyspnea, cough with
chanic. Anamnesis shows frequent exposure to
a lot of albuminoid sputum emitting foul smell
cold, exacerbation of chronic bronchitis attend-
of "meat slops". Objectively: the patient’s con-
ed by cough with relativly small amount of
dition is grave, cyanosis is observed, breathing
mucopurulent sputum, subfebrility, sometimes
rate is 31/min, percussion sound above the right
joined by hemoptysis and pain in the right side
lung is shortened, auscultation revealed various
26
moist rales (crackles). What is the most proba-
of conjunctivas and pharynx is hyperemic.
ble diagnosis?
Heart rate is 120/min, breathing rate is 38/min.
A. Lung abscess
In the lower lung segments shortening of per-
B. Lung gangrene
cussion sound and moist rales (crackles) can be
C. Pleura empyema
detected. What additional investigation should
D. Multiple bronchiectasis
be performed first of all to specify the diagno-
E. Chronic pneumonia
sis?
A. Heart US
50. A 40-year-old patient suffers from influen-
B. ECG
za. On the 5th day of illness there are pain be-
C. Lung X-ray
hind sternum, cough with sputum, inertness.
D. Mantoux test
Temperature is 39, 5oC. Face is pale. Mucosa
E. Spirography
27
Hematology
1. At anemia surely decreases:
A. Dyspnea
A. Quantity of erythrocytes and hemoglobin
B. Stomatitis
B. Quantity of erythrocytes and color index
C. Koilonychosis
C. Level of a hemoglobin and color index
D. Transversal banding of nails
E. Hair fragility
2. The varnished tongue is typical for:
A. Iron deficiency anemia
7. What quantity of erythrocytes is the lower
B. B 12 , folic-deficit anemia
border of norm in men?
C. Werlhof's disease
A. 4,5*1012/l
D. Hemophilia
B. 4,0*1012/l
E. Thrombocytopenia
C. 3,5*1012/l
D. 3,0*1012/l
3. The main differentiate-diagnostic sign for the
diagnosis of iron deficiency anemia is:
8. The daily need in iron makes:
A. Age of the patient
A. 1-3 mg
B. Severity of anemia
B. 10-30 mg
C. Color index
C. 100-300 mg
D. Content of iron in serum
D. 1000-3000 mg
4. What anemia occurs most often in pregnant
9. In case of B 12 vitamin entering lack from the
women:
outside the clinic of B 12 -deficit anemia will be
A. Hemolitic
developed through:
B. Hypoplastic
A. 2-3 weeks
C. Posthemorrhagic
B. 3-4 months
D. Folic deficit
C. 10-12 months
E. Iron deficit
D. 3-5 years
5. What color index is typical for normo-
10. B 12 -deficit anemia can be followed by eve-
chromic anemia?
rything called below, except for:
A. 0,75-1,0
A. Nephropathy
B. 0,85-1,05
B. Funicular myelosis
C. 1,0-1,3
C. Jaundice
D. Enlargement of a liver and lien
6. Doesn't treat to sideropenic syndrome:
28
11. Jolie's bodies and Kebo's rings are:
16. Distribution of leukemias on acute and
A. The remains of the destroyed leucocytes
chronic are based upon:
B. Globin particles of a hemoglobin
A. Rate of disease progress
C. The remains of nuclei of erythrocytes
B. Acuteness onset disease
D. Products of degranulation of basophiles
C. Maturity degree of leukemic cells
D. Quantity of leukemic cells
12. For what disease is typical burning sensation of tongue in patient:
17. What factors promote development of leu-
A. Addison-Birmer's anemia
kemias?
B. Chronic iron deficiency anemia
A. Viral
C. Acute posthemorrhagic anemia
B. Chemical
D. Chronic mieloleukemia
C. Heriditary
E. Thrombocytopenias
D. Radial
E. All mentioned
13. Call the complaints of the patient that are
typical for iron deficiency anemia
18. The Philadelphian chromosome, as a rule,
A. Taste change
meets at:
B. Emergence of morbid cracks in mouth cor-
A. Acute mieloleukemia
ners
B. Chronic mieloleukemia
C. Weight loss
C. Chronic limpholeukemia
D. Feeling of " creeping sensation"
D. Myeloma disease
E. Fragility of nails, concavity
19. The basophilic and eosinophilic association
14. Megalocytes appear in:
meets at:
A. Chronic iron deficiency anemia
A. Acute mieloleukemia
B. Acute posthemorrhagic anemia
B. Chronic mieloleukemia
C. B 12 -deficit anemia
C. Chronic limpholeukemia
D. Hemolitic anemia
D. Can meet at any of these diseases
15. Kebo's rings and Jolie's bodies appear in:
20. Erythrocyte sedimentation rate in patients
A. Chronic iron deficiency anemia
with a leukemia:
B. Acute posthemorrhagic anemia
A. Sharply enlarged
C. B 12 -deficit anemia
B. Slowed down;
D. Hemolitic anemia
C. Moderately enlarged
D. Not changed
E. Normal
29
21. What bones are punctated for receiving of
26. The aim of induction of remission is:
marrow:
A. Deduction of quantity of leucocytes at opti-
A. Frontal
mum level
B. Tibial
B. Achievement of fast decrease of a leukemic
C. IV thoracal vertebra
pool
D. Breast bone
C. Decrease of clinical implications of disease
E. Ribs
27. Prognosis in case of acute leukemia
22. Botkin-Humprecht's shadows are:
A. Always unfavorable prognosis
A. Remains of neutrophils nucleus
B. Always favorable prognosis
B. Remains of lymphocytes nucleus
C. It depends on morphological substrate of
C. Young lymphocytes
tumor
D. Remains of erythrocytes cover
D. It depends on age of the patient
23. The leukemic lapse in blood count is typical
28. What syndrome isn't typical for leukemias?
for:
A. Anemic
A. Lymphogranulomatosis
B. Ulcerative and necrotic
B. Chronic myeloleukemia
C. Polineuropatic
C. Chronic lympholeukemia
D. Hepatolienal
D. Acute leukemia
29. What rib lien length percussionly is deter-
E. Thrombocytopenias
mined by?
24. Sign of acute leukemia
A. IX
A. Leukocytosis
B. XI
B. Increasing of ESR
C. XII
C. Existence of blast cells
D. X
D. Depression of hemoglobin level
30. What abdominal organ is often enlarged in
E. leukopenia.
case of hemopoetic system diseases:
25. The most often cause of death in patients
A. Pancreas
with chronic lympholeukemia is:
B. Stomach
A. Accessions of anemia
C. Lien
B. Lien infarct
D. Kidneys
C. Trombotic complications
D. Accession of secondary infections
30
D. B 12 -deficit anemia
31. Non-Hodjkin lymphoma is a malignant disease of a blood which develops from:
A. Cells of a myeloid row
36. What is the typical laboratory symptom of
B. Cells of a lymphoid row
an idiopathic thrombocytopenic purpura?
C. Cells of a erythroid row
A. Elongation of a blood clotting time by Lee-
D. Cells of a megakariocyte row
White
B. Depression of a prothrombin index
32. The diagnosis of a Hodjkin’s lymphoma
C. Bleeding duration augmentation by Duke
can be established on the basis:
D. Depression of blood fibrinogen level
A. Analysis of complaints of the patient (fever,
E. Elongation of a blood clotting time on
lymphadenitis, weight loss, etc.)
Burker
B. A punction biopsy of the enlarged lymphatic
node
37. Thrombocytopenia in patients with idio-
C. Blood count and urinalysis
pathic thrombocytopenic purpura arises owing
D. Histological research of remote node and
to (in most cases):
obligatory identification of "diagnostic" cells
A. Disturbances of megacaryocytes prolifera-
(Berezovsky-Sternberg’s)
tion
B. Disturbance of peeling of platelets from
33. Tumor substrate in a multiple myeloma:
megacaryocytes
A. Plasmatic cells
C. Disturbance of exit of platelets from marrow
B. B-lymphocytes
D. Autoimmune aggression concerning plate-
C. T-lymphocytes.
lets
D. Myelocytes.
E. Deficiencies and as a result of fast destruction of platelets
34. Main methods of treatment of a multiple
myeloma:
38. A thrombocytopenia is typical for:
A. Antibacterial therapy
A. Werlhof's disease
B. Transfusion of blood components
B. Schonlein-Henoch's disease
C. Hemodialysis
C. Hemophilias
D. Cytostatic therapy (chemotherapy)
D. Trombocytopaties
E. Hemophilias and Schonlein-Henoch's dis-
35. The renal failure is the most frequent com-
ease
plication of:
A. Multiple myeloma
39. Hemophylia B is caused by deficit of a fac-
B. Hodjkin's lymphoma
tor:
S. Non-hodjkin’s malignant lymphoma
A. III
31
B. VII
C. VIII
44. At hemophilia:
D. IX
A. The enlarged bleeding time by Duke
E. XI
B. The retraction of a bloody clot is slowed
down
40. A hemarthroses are typical for:
C. The extended blood clotting time
A. Idiopathic thrombocytopenic purpura
D. Positive result of Konchalovsky-Rumpel-
B. Hemophilias
Leede’s test
C. Hemorrhagic vasculitis
E. The reduced quantity of platelets in a blood
D. Trombocytopathy
E. Randu-Osler's disease
45. For Idiopathic thrombocytopenic purpura is
typical positive test:
41. Late (in several hours) bleedings in case of
A. Quick-Pittel’s
damage of small vessels are typical for:
B. Konchalovsky-Rumpel-Leede’s
A. Idiopathic thrombocytopenic purpura
C. Adis-Kakovsky’s
B. Hemophilias
D. Thorn’s
C. Hemorrhagic vasculitis
E. Prevel’s
D. Trombocytopathy
46. Hemophilia A is caused by deficiency of
E. Randu-Osler's disease
factor:
42. "A leopard skin" is typical for:
A. III
A. Hemophilias
B. VII
B. Hemorrhagic vasculitis
C. VIII
C. Werlhof's disease
D. IX
D. Iron deficiency anemia
E. XI
E. B 12 - deficiency anemia
47. The onset of disease in the form of bleed43. An optimum agent from the point of view
ings on the first years of life is typical for:
of efficiency and safety is:
A. Idiopathic thrombocytopenic purpura
A. Cryoprecipitat
B. Hemophilia
B. Concentrate of the VIII factor
C. Hemorrhagic vasculitis
C. Anti-hemophilic plasma
D. B 12 -deficiency anemia
D. A direct hemotransfusion from the donor to
E. Chronic myeloleukemia
the patient
E. A direct hemotransfusion from mother to the
48. The blood clotting time by Lee-White
patient
makes:
32
A. 1-3 min
D. Hemorrhagic vasculitis
B. 3-5 min
E. Randu-Osler's disease
C. 5-10 min
D. 10-15 min
50. The blood clotting time is extended at:
E. Till 20 min
A. Thrombocytopenic purpura
B. Hemophilias
49. Bleedings at first dentition are typical for:
C. Hemorrhagic vasculitis
A. Idiopathic thrombocytopenic purpura
D. Trombocytopaties
B. Trombocytopaty
E. All hemorrhagic diathesis
C. Hemophilia
33
Checking of true answers
Gastroenterology
No. of question
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Answer
B
E
C
A
D
B
D
A
C
A
C
E
E
A
C
D
A
D
A
E
D
A
C
B
A
No. of question
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Answer
E
B
C
B
D
E
C
A
A
D
C
D
A
C
E
D
A
C
D
C
B
E
B
D
E
Endocrinology
No. of question
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Answer
A
B
D
D
A
C
C
B
A
C
C
C
B
A
B
C
A
B
D
D
No. of question
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
34
Answer
E
C
D
D
B
D
B
D
B
A
A
C
B
B
C
A
E
C
D
A
21
22
23
24
25
E
C
A
A
D
46
47
48
49
50
D
B
A
D
A
Pulmonology
No. of question
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Answer
D
C
E
A
D
D
B
C
A
C
E
B
C
D
B
B
E
C
E
D
E
D
D
B
A
No. of question
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Answer
C
A
C
A
C
C
B
A
B
B
A
D
B
B
A
A
B
D
C
A
A
D
E
B
C
Hematology
No. of question
1
2
3
4
5
6
7
8
9
10
11
12
Answer
A
B
A
D
B
A
B
B
B
A
C
A
No. of question
26
27
28
29
30
31
32
33
34
35
36
37
35
Answer
B
C
C
D
C
B
D
A
D
A
C
D
13
14
15
16
17
18
19
20
21
22
23
24
25
E
C
C
C
E
B
B
A
D
B
D
C
D
38
39
40
41
42
43
44
45
46
47
48
49
50
A
D
B
A
C
A
C
B
C
B
B
C
B
36
Collection of current control tests
Endocrinology
1. Adenohypophysis produces these hormones,
E. Adrenaline.
except for:
6. Hormone of the adrenal medulla is:
A. Cortisol.
A. Phenylalanine.
B. ACTH.
B. Cortisol.
C. STH.
C. Adrenaline.
D. Prolactin.
D. Aldosterone.
E. FSH.
E. Glucagon.
2. Insulin is produced by such cells of islets of
7. The place which synthesis of adrenaline:
Langerhans:
A. Sympathetic chromaffin body.
A. α-cells.
B. Diencephalon.
B. β-cells.
C. Adrenal medulla.
C. δ-cells.
D. Ovarian follicles.
D. γ-cells.
E. Leydig cells.
E. τ-cells.
8. What is a "permissive" effects of hormones?
3. Which hormones are produced by the islets
A. Dishormonal shifts.
of Langerhans:
B. Activation of peripheral glands, released the
A. Prolactin.
hormone.
B. lutropin.
C. Provide some hormones to optimal condi-
C. Adrenaline.
tions for the action.
D. Glucagon.
D. Neutralization of the action of the another
E. Vazopresin.
hormone.
4. Adrenal medulla consists of:
E. Blockade of hormone reception.
A Basophil cells.
9. The main mechanism of endocrine diseases.
B. Eosinophilic cells.
A. Pathology of the cardiovascular system.
C. Polychrome cells.
B. Violation of the biosynthesis and secretion
D. Chromaffin cells.
of hormones.
E. Acidophilic cells.
C. Cachexia.
5. Hormone of the adrenal cortex is:
D. Physical and mental overload.
A. Aldosterone.
E. Infectious processes.
B. ACTH.
10. Whach factor is a physiological regulator of
C. Prolactin.
the synthesis and secretion of insulin:
D. Prednisolone.
A. The concentration of blood glucose.
37
B. The concentration of circulating catechola-
B. Lactate.
mines.
C. Coenzyme-A.
C. The concentration of blood proteins.
D. Chylomicron.
D. The concentration of triglycerides.
E. Acetoacetyl coenzyme A.
E. The concentration of non-esterified fatty ac-
16. Endocrine system consist of glands, which:
ids.
A. Secrets enzymes.
11. What is the biological effect of glucagon?
B. Secrets in the internal environment highly
A. It promotes the synthesis of proteins.
active substances.
B. Promotes lipogenesis.
C. Having ducts.
C. Hyperglycemic effect.
D. Secrets protease.
D. Promotes protein catabolism.
E. Secrets s amylase.
E. Improves blood amino acids.
17. Adenohypophysis includes:
12. How adrenaline improves blood sugar lev-
A. Anterior pituitary.
els?
B. Central pituitary.
A. Promotes glycogenesis.
C. The front and middle lobe of the pituitary.
B. Promotes gluconeogenesis.
D. Posterior lobe of the pituitary.
C. Causes glycogenolysis.
E. Leykopituitary gland.
D. Increases the synthesis of glucose from py-
18. Adrenal cortex hormones are those, except:
ruvic and lactic acids.
A. Adrenaline.
E. Increases glucose absorption in the digestive
B. Testosterone.
tract.
C. Cortisol.
13. Mineralocorticoid adrenal hormones is:
D. Aldosterone.
A. Cortisol.
E. Androstenedione.
B. Dehydrocorticosterone.
19. The glucose concentration in the blood
C. Aldosterone.
plasma of a healthy human is in the range:
D. Testosterone.
A. 1-2 mmol/l.
E. Adrenalin.
B. 3,5-5,5 mmol/l.
14. Mineralocorticoid hormones affect metabo-
C. 8-10 mmol/l.
lism:
D. 12-20 mmol/l.
A. Carbohydrates.
E. More than 25 mmol/l.
B. Fats.
20. Insulin is involved in glucose transport in
C. Mineral salts.
these organs and tissues, except:
D. Protein.
A. Muscle.
E. Nucleic Acids.
B. Fatty tissue.
15. "Ketone bodies" are:
C. Liver.
A. Acetoacetate.
D. Nervous.
38
E. Cardiomyocytes.
B. Normalisation of insulin receptors interac-
21. What ions played the most important role
tion.
in biosynthesis of insulin:
C. Reduction of gluconeogenesis.
A. Calcium.
D. Increasing of glucagon secretion.
B. Zinc.
E. Potentiating effect on the action of insulin.
C. Potassium.
26. The patient has ketoacidosis. Which meth-
D. Magnesium.
od of insulinotherapy is the most rational?
E. Sodium.
A. Injection of short-acting insulin 4-5 times a
22. What is the main intermediate marker,
day.
which display pancreatic insulin function in pa-
B. Injection of long-acting insulin 1 time per
tients who receives the insulin?
day in the morning.
A. Preproinsulin.
C. Injection of intermediate-acting insulin in
B. C-peptide.
the morning and evening.
C. Proinsulin.
D. Combining long-acting insulin with 2-3 in-
D. Insulin-like growth factor-1.
jections of short-acting insulin.
E. Glucagon.
E. Injection of intermediate-acting insulin in
23. Which of the following investigations is
the morning and evening with short-acting in-
most effective in assessing the compensation of
sulin.
diabetes mellitus?
27. Which of the following complications of
A. Fasting blood glucose level.
biguanides treatment is the most dangerous?
B. Glucose level throughout the day.
A. Dyspepsia.
C. Indicators glycosuria during the day.
B. Allergy.
D. Indicator glycated hemoglobin.
C. Ketoacidosis.
E. Ketonuria level.
D. B12 and folic acid deficiency anemia.
24. Which of the following methods is required
E. Lactic acidosis.
in the treatment of all clinical forms of diabetes
28. Which of the following methods for calcu-
mellitus?
lating daily dose of insulin is used in newly di-
A. Diet therapy.
agnosed insulin-dependent diabetes without ke-
B. Herbal drugs.
toacidosis?
C. Physiotherapy.
A. 0,5 units per 1 kg normal body weight per
D. Hypoglycemic oral drugs.
day.
E. Insulin.
B. 0,7-0,8 units per 1 kgnormal body weight
25. All these mechanisms are characterized by
per day.
a hypoglycemic effect of sulfonylurea deriva-
C. 40 units.
tives, except:
D. 1 unitper 1 kg normal body weight per day.
A. Betacytotropic action.
39
E. 0,9 units per 1 kg normal body weight per
D. Needed for insulin therapy.
day.
E. Vascular complications at the time of onset
29. Which of the following methods is neces-
of the disease.
sary for treatment of hypoglycemic coma?
34. Diabetes mellitus type 2 is not character-
A. The intravenous drip of 10% glucose.
ized by:
B. The intravenous bolus of 40% glucose.
A. The beginning of the disease in old age.
C. The intravenous drip of 40% glucose.
B. Slow onset.
D. The intravenous drip of 5% glucose.
C. Overweight.
E. The intravenous drip of 40% glucose with 6-
D. Stable flow.
8 units of insulin.
E. Tendency to ketoacidosis.
30. For diabetic autonomic neuropathy is not
35. To evaluate of glucose tolerance test:
typical:
Fasting – 7,0 mmol/l; after 1 hour – 13,2 mmol
A. Postural hypotension.
/l; after 2 hours – 11,4 mmol/l.
B. Impotence.
A. Normal test.
C. Urinary retention.
B. Explicit diabetes mellitus.
D. Gastroparesis.
C. It should be retested.
E. Skin hyperpigmentation.
D. Impaired glucose tolerance.
31. Diabetic ketoacidosis is characterized by
E. It is necessary to carry out glucose-
such symptoms, except:
prednisolone test.
A. Reduction of glucose utilization by tissues.
36. What methods can be used to evaluate the
B. Increase of protein catabolism.
compensation of diabetes mellitus in an outpa-
C. Reduction of lipolysis.
tient setting?
D. Increase of diuresis.
A. Determination of the glycemic profile.
E. Increase of plasma osmolality.
B. Determination of glycated hemoglobin.
32. Which drugs can be applied to patients with
C. Determination of fasting glucose.
diabetes without metabolic complications?
D. Test of tolerance to carbohydrates.
A. Beta-blockers.
E. Determination of lipoproteins in the blood.
B. Alpha-adrenoceptor agonists.
37. Stages of diabetic angiopathy of lower ex-
C. Glucocorticoids.
tremities, except:
D. Acetylsalicylic acid.
A. Preclinical (metabolic).
E. Thiazides.
B. Functional.
33. Diabetes mellitus type 1 is not character-
C. Organic.
ized by:
D. Necrotizing.
A. The beginning of the disease at a young age.
E. Terminal.
B. Acute onset.
38. Stage of diabetic retinopathy, except:
C. Weight loss.
A. Non-proliferative retinopathy.
40
B. Preproliferative retinopathy.
acute myocardial infarction, heart failure 1
C. Proliferative retinopathy.
stage.
D. Ulceroglandular proliferative retinopathy.
E. Diabetes mellitus type 1, moderate severity,
39. What signs are not characteristic of diabetic
compensation stage during surgery - cholecys-
angiopathy of lower extremities:
tectomy.
A. Pain, coldness, paresthesia in the legs.
42. In which of the following сonditions in dia-
B. Violation of the trophism, atrophy of the leg
betic patients are not contraindicated sulfonylu-
muscles and feet.
reas drugs?
C. Reduction or absence of pulsation in the ar-
A. Сytopenia.
teries of the foot.
B. Acute hepatitis.
D. Changes in microcirculation according
C. Extraction of the tooth.
capillaroscopy.
D. Lactation and pregnancy.
E. No changes on teplovizogramme.
E. Severe exacerbation of chronic infection.
40. In which conditions in patients with diabe-
43. Complications of insulin therapy may in-
tes mellitus insulin therapy is not recommend-
clude:
ed?
A. Leukopenia, thrombocytopenia.
A. Diabetes mellitus type 1, the middle severity
B. Hypertension.
in decompensation stage. Diabetic ketoacidosis.
C. Constipation.
B. Diabetes mellitus type 1, the middle severity
D. Fatty liver.
in compensation stage. Pregnancy.
E. Lipodystrophy.
C. Newly diagnosed diabetes. Obesity III stage.
44. Which of the symptoms of diabetes mellitus
D. Diseases of the blood.
are not a direct contraindication for pregnancy?
E. Diabetes mellitus type 2. Acute myocardial
A. Proliferative angioretinopathy.
infarction.
B. Labile insulin resistance and diabetes.
41. In which of the following сonditions in dia-
C. Progressive nephropathy.
betic patients are recommended sulfonylureas
D. Diabetes severe form, compensation stage.
drugs?
E. Diabetes in husband of patient.
A. Diabetes mellitus type 1, compensation
45. In which clinical forms of diabetes mellitus
stage. Diabetic nefropathy, nephrotic stage.
is recommended spa treatment:
B. Diabetes mellitus, mild severity, compensa-
A. Diabetes mellitus without complications,
tion stage.
mild form, compensation stage.
C. Diabetes mellitus type 2, moderate severity.
B. Diabetes mellitus, severe decompensated.
Nonproliferative angioretinopathy.
Diabetic retinal angiopathy.
D. Diabetes mellitus type 2, moderate severity,
C. Labile course of diabetes mellitus.
compensation stage. Coronary artery disease,
D. Diabetes mellitus with diabetic neuropathy
with severe pain.
41
E. Diabetes mellitus, proliferative diabetic reti-
high hyperglycemia, acute dehydration, hyper-
nopathy.
chloremia, hypernatriemia. Ketonemia and ace-
46. Which of these professions are not contra-
tonuria are absent. Correct diagnosis:
indicated for patients with diabetes mellitus of
A. Hyperlactacydemic coma.
moderate and severe forms?
B. Acute renal failure.
A. Pilot, driver.
C. Hyperketonemic diabetic coma.
B. Work related to night shifts, trips.
D. Chronic renal failure.
C. High-altitude work.
E. Hyperosmolar coma.
D. Machinist.
51. Man 26 years old, complains of thirst, in-
E. Teacher at the school.
creased urination, general weakness, decrease
47. Which of these mechanisms do not partici-
body weight. Objectively: dry skin, red cheeks,
pate in the pathogenesis of diabetic ketoacido-
vesicular breathing. Tongue dry. Without
siscoma?
symptoms of peritoneal irritation. What re-
A. Activationcontrinsulin hormons.
search is the most informative for diagnosis?
B. Gluconeogenesis.
A. Analysis of blood glucose.
C. Glycogenolysis.
B. General blood analysis.
D. Hyperosmolarity.
C. General urine analysis.
E. Limiting the glucose supply to the brain
D. Analysis of urine on Zimnitskiy.
cells.
E. Blood liver function tests.
48. Which of the following symptoms are not
52. At a man 25 years old, who suffer from di-
typical for hyperosmolar coma?
abetes mellitus for 8 years, had developed a
A. Surface, accelerated breathing.
coma. Objectively: skin is dry, reduced turgor,
B. Local neurological symptoms.
Kussmaul breathing, blood pressure - 105/60
C. Ketoacidosis.
mm Hg, pulse - 116 for a min., the acetone
D. High hyperglycemia.
odor in the air. What kind of coma can be sus-
E. Dehydration.
pected?
49. Which of the following symptoms are not
A. Hypoglycemic coma.
typical for hypoglycemia?
B. Hyperosmolar coma.
A. Cramps.
C. Lactic acid coma.
B. Increased reflexes.
D. Ketoacydotic coma.
C. Diplopia.
E. Brain coma.
D. Hunger.
53. The patient was 46 years old, who suffer
E. All of the above.
from diabetic mellitus for 9 years, receives in-
50. Patient 63 years old, suffering from diabe-
sulin Humodar B - 26 units in the morning and
tes mellitus type 2. Against the background of
18 units in the evening. Complains of weak-
acute cerebral circulatory disorders developed
ness, headache, sweating at night. Objectively:
42
Pulse 72 for a min, blood pressure - 125/70 mm
mm Hg. The skin is dry, turgor reduced. Breath
Hg. Liver + 4cm. Blood glucose: 8.00 - 14
deep, noisy, rare. Acetone smell in the air. Liv-
mmol/l; 12.00 - 9 mmol/l; 17.00 - 11 mmol/l;
er 5 cm. Glycemia - 32 mg/dL, blood pH - 6.9.
2.00 - 3.8 mmol/l. What caused of these com-
What solution would recommended to the nor-
plains&
malization of metabolic processes?
A. Low insulin dose in the morning.
A. 0,9% sodium chloride solution.
B. Low insulin dose in the evening.
B. 5% glucose solution.
C. Hepatosis.
C. 4,2% sodium hydrogen carbonate solution.
D. Climacteric Syndrome.
D. 1% potassium chloride solution.
E. High insulin dose in the evening.
E. Reopoliglyukin.
54. The patient 27 years old, who suffer from
57. A man 20 years, suffers from diabetes
diabetic mellitus type 1 with satisfactorily
mellitus for two years. Objectively: dry tongue.
compensated, complains of frequent hypogly-
Diabetic blush. Liver 4 sm. Fasting glucose –
cemia, nausea, bowel disorders, skin hyper-
12,3 mmol/l, glucosuria - 25 g/l. Elevated lev-
pigmentation, blood pressure decreased to
els of plasma triglycerides. For the prevention
80/50 mm Hg., Hb -105 g/l. What is the cause
of diabetes complications recommended:
of low blood pressure?
A. Assign aldosoreductase inhibitors.
A. Diabetic enteropathy.
B. Assign angioprotective means.
B. Diabetic gastropathy.
C. Assign vitamins A, E, C.
C. Chronic adrenal insufficiency.
D. Achieving stable normoglycemia.
D. Overdose antidiabetic drugs.
E. Assign lipid-lowering therapy.
E. The development of diabetes insipidus.
58. Why in hyperosmolar coma there is no
55. The patient is 19 years old. Acutely
signs of ketoacidosis?
ill.Thirst, polyuria, weakness, weight loss of 4
A. Retained residual insulin secretion, which
kg for 2 weeks. Objectively: general condition
inhibits lipolysis.
is satisfactory, there is no smell of acetone.
B. Increased activity contrinsulin hormones.
Glucose levels: fasting blood - 32 mmol/l, in
C. Increased levels of glucose neutralized li-
urine - 6% acetone (+). Your tactics?
polysis.
A. Diet therapy.
D. Reducing blood volume blocks lipolysis.
B. Appointment of antidiabetic herbs.
E. Prevails lipogenesis.
C. Appointment of biguanides.
59. Eighteen-year woman suffer from diabetes
D. Appointment of sulfonylureas.
mellitus for 5 years. She gets 36 units of insulin
E. Appointment of insulin.
per day. During pneumonia condition had de-
56. At man 28 years on the backdrop of bron-
veloped thirst, abdominal pain, nausea, vomit-
chopneumonia had developed a coma. Objec-
ing, drowsiness. The patient refused to eat in
tively: HR - 122/min. Blood pressure - 80/45
the evening and did not receive the next even43
ing dose of insulin. In the morning she lost
Weight lost for 5 kg. Fasting glucose - 12
consciousness. Objectively: the unconscious,
mg/dl. What hypoglycemic therapy is most
the skin is dry, turgor reduced. Tongue dry,
recommended?
noisy breathing and deep, smell of acetone
A. Sulfonylurea drugs of II generation.
breath. The body temperature – 36,6 0C, pulse -
B. Insulin.
100/min, blood pressure - 90/50 mm Hg. In
C. Sulfonylurea drugs of III generation.
urine positive reaction to acetone. Blood glu-
D. Biguanides (metformin).
cose - 33 mg/dL. What is the preliminary diag-
E. Sulfonylurea drugs of I generation.
nosis?
62. Patient 64 years old, who suffers from dia-
A. Lactic acid coma.
betes mellitus type 2, had ill hepatitis A. Dur-
B. Hyperosmolar coma.
ing the last 2 years has received glibenclamide
C. Ketoacydotic coma.
15 mg per day. Fasting glucose is 13,6 mmol/l.
D. Hepatic coma.
Determine the tactics subsequent treatment:
E. Brain coma.
A. Assign sulfonylurea drugs of III generation.
60. The patient was hospitalized in the depart-
B. Assign biguanides in addition.
ment unconscious. Suffers from diabetes melli-
C. Increase the dose of glibenclamide to 20 mg
tus for 5 years.He got the long-acting insulin
per day.
for a dose of 24 units in the morning and 18
D. Assign acarbose in addition.
units in the evening. Suddenly he lost con-
E. Assign insulin,
sciousness. The skin is moist, increased muscle
63. Patient K., 25 years old, suffers from diabe-
tone. Tonus eyeballs is normal. Ps - 96 / min,
tes mellitus type 1. While climbing the stairs he
blood pressure - 120/80 mm Hg. Rhythmic
had collapsed. Objectively: consciousness is
breathing. Tongue is moist. Meningeal symp-
absent. The skin is moist, increased muscle
toms are absent. What treatment is recom-
tone. Tonus eyeballs is normal. Pulse - 80/min,
mended in this situation?
rhythmic. Blood pressure -110 / 70 mm Hg.
A. Injection of short-acting insulin intravenous-
Meningeal symptoms are absent. Your diagno-
ly.
sis is:
B. Injection of 40% glucose solution intrave-
A. Hyperosmolar coma.
nously.
B. Hypoglycemic coma.
C. Injection of 4% sodium hydrogencarbonate
C. Ketoacydotic coma.
solution intravenously.
D. Lactic acid coma.
D. Injection of hydrocortisone intravenously.
E. Hepatic coma.
E. Injection of adrenaline subcutaneously.
64. Patient K., suffers from diabetes mellitus
61. Patient B., 46 years old, height 170 cm,
for 28 years. Over the last year, the insulin dose
weight 93 kg. Over 2 months he was on diet
decreased by 14 units. In the analysis of urine:
therapy with restriction of energy intake.
44
protein – 1,7 g/l, sugar – 0,8%, many erythro-
C. Clinical symptoms of diabetes mellitus and
cytes, cylinders. These symptoms are signs of:
increasing the level of fasting blood glucose
A. Insulin resistance.
higher than 5,5mmol/l, but not more than
B. Diabetic nephropathy.
6,1mmol/l.
C. Decompensation of diabetes.
68. Oral glucose - tolerance test results, which
D. Pyelonephritis
indicated of impaired glucose tolerance:
E. Syndrome of chronic insulin overdose.
A. Fasting blood glucose is higher than
65. All of the following mechanisms character-
5,5mmol/l and over 2 hours after exercise is
ize insulin resistance, expect for:
less than 7,8 mmol/l.
A. Reduced amount of insulin receptors in
B. Fasting blood glucose is less than 6,1mmol/l
muscle tissue.
and over 2 hours after exercise is less than 11,1
B. Neutralizing antibody to insulin.
mmol/l.
C. Violations of hormone-receptor interactions.
C. Fasting blood glucose is less than 6,1mmol/l
D. Formation of autoantibodies to the insular
and over 2 hours after exercise is higher than
apparatus of the pancreas.
7,8mmol/l but less than 11,1 mmol/l.
E. Severe parenchymal liver disease.
69. Hyperinsulinemia is typical for:
66. Diabetes mellitus diagnosis is confirmed
A. Chronic pancreatitis.
by:
B. Cushing syndrome.
A. Level of fasting plasma glucose higher then
C. Hyperaldosteronism
5,5mmol/l.
D. Hemochromatosis.
B. Level capillary fasting blood glucose higher
E. Gestational diabetes mellitus.
then 11,1mmol/l.
70. Pathological conditions that develop on the
C. Level of fasting plasma glucose higher then
background of hyperglycemia:
7,8mmol/l.
A. Osmotic dieresis.
D. Level of capillary fasting blood glucose
B. Glycosuria.
higher then 6,1mmol/l.
C. Water and electrolyte loss.
67. The glucose - tolerance test is carried out in
D. Weight loss
the absence of:
E. All answers right.
A. Clinical symptoms of diabetes mellitus and
71. Reactive (functional) hypoglycemia is typi-
increasing the level of fasting blood glucose
cal for:
higher than 6,1mmol/l.
A. Increasing vagal tone.
B. Clinical symptoms of diabetes mellitus and
B. Gastric ulcer.
increasing the level of fasting blood glucose
C. Precursor stage of diabetes mellitus type 2.
higher than 5,5 mmol/l, but not more than
D. Kidney diseases.
6,7mmol/l.
72. The clinical manifestations of insulin resistance syndrome include:
45
A. Arterial hypertension.
77. Woman, 38 years old, was admitted to hos-
B. Abdominal obesity.
pital in the condition of stupor. Fasting glyce-
C. Dyslipidemia.
mia - 2,2mmol/l, insulin – 85 MED/ml (normal
D. Diabetes mellitus type 2 or impaired glucose
less than 22), C-peptide - 5,2 ng/ml (normal
tolerance.
0,5-2,0), proinsulin - 0,6 ng/ml (normal less
E. All of the above.
than 0,02). Hypoglycemia can be caused by:
73. Typical symptoms of visceral neuropathy
A. Metformin drugs.
are:
B. Taking insulin.
A. Orthostatic hypotension.
C. Insulinoma.
B. Atony of bladder.
D. Taking acarbose.
C. Impotence.
78. Which animal insulins are similar in amino
D. Diarrhea.
acid composition to human insulin?
E. All answers right.
A. Dog insulin.
74. Determine the stage of diabetic retinopathy
B. Bovine insulin.
which is characterized by the presence of exu-
C. Pigs insulin.
dates and hemorrhages, vascular fibrosis near
79. The main source of glucose during pro-
or at the optic nerve, the capillary loops in the
longed starvation:
macular site:
A. Glycogen in the liver.
A. Nonproliferative angioretinopathy.
B. Glyceryl released from triglyceride.
B. Preproliferative angioretinopathy.
C. Lactate from skeletal muscle.
C. Proliferative angioretinopathy.
D. Synthesis of glucose from amino acids in the
75. For diabetic peripheral neuropathy is typi-
liver.
cal:
E. Synthesis of glucose from free fatty acid in
A. Pain in the symmetric parts of the limbs.
the liver.
B. Paresthesia.
80. Woman, 40 years old, complains of tachy-
C. Anesthesia for "sock" type.
cardia, anxiety, tremors. The symptoms in-
D. Violation of perspiration.
creased over the last few months, they disap-
E. All of the above.
pear or decrease after a meal. Objectively: obe-
76. The cause for the absence of ketoacidosis at
sity and hypertension (blood pressure - 170/100
hyperosmolar coma:
mm Hg.). The only physical finding was a sin-
A. Presence of residual insulin secretion.
gle hemorrhage in both eyes and the absence of
B. The absence of a significant increase of con-
Achilles tendon reflexes. During the oral glu-
trainsular hormones.
cose tolerance test were symptoms of hypogly-
C. Increased insulin sensitivity.
cemia, confirmed by laboratory tests. The cause
D. Gluconeogenesis blockade.
of these symptoms is:
A. Reactive hypoglycemia.
46
B. Thyrotoxicosis.
B. The presence of antibodies to the islet of
C. Diabetes mellitus.
pancreatic tissue.
D. Insulinoma.
C. Reducing the number of insulin receptors.
E. Pheochromocytoma.
D. Increased insulin resistance.
81. At what disease is the most reduction the
E. Increased plasma osmolality.
number of receptors for insulin?
86.
A. Diabetes mellitus type 2.
istic of diabetic nephropathy?
B. Diabetes mellitus type 1.
A. Selective albuminuria.
C. Insulinoma
B. Orthostatic proteinuria.
D. Obesity
C. Transient hypertension.
E. In hypothyroidism.
D. Reduced glomerular filtration rate.
82. In the pathogenesis of type 1 diabetes the
E. Increased blood creatinine level.
most important:
87.
Which of the early symptoms character-
The most characteristic feature for dia-
A. The genetic defect of antiviral immunity.
betic ketoacydotic coma is:
B. The genetic defect of T-lymphocytes.
A. Hypothermia.
C. Contrinsular hormones
B. Dehydration.
D. The primary destructive process of the pan-
C. Hypotensionю
creas
D. The presence of the smell of acetone in
E. Insulin resistance.
breath.
83.
E. Dry skin
Which hormones inhibits the secretion
of insulin most of all?
88.
A. Adrenaline.
betic lactic acid coma is:
B. Somatostatin.
A. Kussmaul Breathing.
C. Glucagon.
B. Nausea, vomiting.
D. Norepinephrine.
C. Increase lactate levels in blood.
E. Prolactin.
D. Symptoms of dehydration.
84.
E. All of the above.
Which of the tissue is the most insulin-
The most characteristic feature for dia-
dependent?
89.
A. Muscle.
tachycardia in patients with diabetes mellitus
B. Nervous.
type 1 are:
C. Adipose.
A. Combination of diabetes with thyrotoxico-
D. Bone.
sis.
E. Lymphoid.
B. Diabetic cardiomyopathy.
85.
C. Coronary heart disease.
The most characteristic feature of diabe-
The most probable cause of persistent
tes mellitus type 1 is:
D. Autonomous cardiac neuropathy.
A. The association with HLA-antigens.
E. Hypokalemia.
47
E. Hydronephrosis.
94.
90.
the diet of patients with diabetes mellitus con-
The most characteristic defeat of organs
Products that contain cellular tissue in
of vision in patients with diabetes mellitus are:
tributes to:
A. Violation of accommodation.
A. Reduction of hyperglycemia.
B. Diabetic retinopathy.
B. Reduction of hyperlipidemia.
C. Cataracts.
C. Reduction of glucose absorption in the intes-
D. Myopia.
tine.
E. Conjunctivitis.
D. Increasing the synthesis of vitamins B.
91.
E. All of the above.
What is the main mechanism of hypo-
glycemic action of the biguanide?
95.
A. Improving the utilization of glucose by pe-
ing?
ripheral tissues.
A. Protafan.
B. Increased secretion of insulin from the beta
B. Actrapid.
cells.
C. Lantus.
C. Reduction of liver insulinase activity.
D. Levemir.
D. Reduction of glucose absorption in the intes-
E. Humodar B.
tine.
96.
E. Inhibition of gluconeogenesis and gly-
ration of action?
cogenolysis.
A. Actrapid.
92.
B. Farmasulin H.
The main indication for the treatment of
Which of following insulins is short act-
Which of the insulins has a middle du-
sulfonylureas drugs:
C. NovoRapid.
A. Diabetes mellitus type 2 in adults.
D. Epaydra.
B. Juvenile diabetes.
E. Protafan.
C. Labile course of diabetes mellitus.
97.
D. Diabetes mellitus type 2 in pregnancy.
most prolonged duration of action?
E. Diabetes mellitus type 2 in obese patients.
A. Actrapid.
93.
What treatment is most recommended
B. Protafan.
for patients with diabetes mellitus in pregnan-
C. Epaydra.
cy?
D. Humodar B.
A. Short-acting Insulin.
E. Lantus
B. Biguanides.
98.
C. Sulfonylureas drugs.
are:
D. Long-acting insulin.
A. Overeating.
E. Long-acting insulin in combination with
B. Stressful situations.
short-acting insulin.
C. Atherosclerosis.
48
Which of the following insulins has the
Risk factors of diabetes mellitus type 2
D. The presence of diabetes mellitus type 2 in
A. Estrogens.
relatives.
B. Progesterone.
E. Al answers are true.
C. Bromocriptine (parlodel).
99.
D. Infusion of somatostatin.
What is the main effect of insulin on the
protein metabolism?
E. L-DOPA.
A. Anabolic.
104. Weight loss is characteristic of endocrine
B. Catabolic
diseases, except:
C . It stops the breakdown of proteins.
A. Diabetes mellitus type 1.
D. No effect on protein metabolism.
B. Toxic goiter.
E. A and C are true.
C. Phaeochromocytomas.
100.
D. Hypothalamic syndrome of puberty.
Insulin is recommended for patients
with diabetes mellitus and:
E. Hypopituitarism.
A. Coronary artery disease.
105. Cushing's syndrome is manifested by such
B. Ketoacidosis.
symptoms, except:
C. Diabetic enteropathy.
A. Dysplastic obesity.
D. Diabetic hepatopathy.
B. Atrophic stretch marks.
E. Arterial hypertension.
C. Hyperglycemia.
101. All of the following features characterize
D. Osteoporosis.
congenital hypothyroidism, except:
E. Arterial hypotension.
A. Delay of sexual development.
106. The daily need of iodine for thyroid hor-
B. Delay of growth.
mone biosynthesis is:
C. Backlog of bone age of the passport.
A. 1-2 g
D. Backlog of the mental development.
B. 14-17 mg.
E. Signs of defeat of the hypothalamic-pituitary
C. 100-150 mcg.
system.
D. 98-104 ng.
102. All of these activities are recommended
E. 123-228 mmol.
for the treatment of hypothyroid coma, except:
107. To induce the sexual development of boys
A. Injection of thyroid hormone.
used:
B. Admission of glucocorticoids.
A. Methyltestosterone.
C. Treatment of hypoventilation.
B. Progesterone.
D. Rehydration.
C. Andriol.
E. Treatment of opportunistic infections and
D. Сhorionic gonadotropin.
other diseases, which led to the development of
E. Kortinef.
coma.
108. Patient K, 52 years old, complains of
103. The most recommended treatment of ac-
weight gain, weakness, constipation, memory
romegaly:
impairment. These symptoms slowly evolved
49
over the last 1.5 years. Objectively: dry skin, a
B. Adisson crisis.
mild tumor of the face and extremities, pulse -
C. Hypoglycemic coma.
66/min, blood pressure -110/70 mm Hg., the
D. Hypothyroid coma.
thyroid gland is not palpable. In the blood were
E. Lactic acid coma.
indicated antibodies to thyroglobulin (+) and
111. The patient was 47 years old, last 4 years,
the microsomal antigen (+++); the level of thy-
complains of weakness in the limbs, pain in the
roid-stimulating hormone – 15,2 mIU/l. Ultra-
calf muscles and the back. On the X-Ray of the
sound of thyroid gland: reduced size, inhomo-
bones were found osteoporosis, cysts, patholog-
geneous structure. Diagnosis:
ical fractures. The calcium level in the blood is
A. Diffuse nontoxic goiter.
increased. Your diagnosis?
B. Autoimmune thyroiditis, euthyroidism.
A. Stein-Leventhal syndrome.
C. Endemic goiter.
B. Primary hyperparathyroidism.
D. Subacute thyroiditis.
C. Osteoblastoma.
E. Autoimmune thyroiditis, hypothyroidism.
D. Hypoparathyroidism.
109. A woman 25 years old at the time of med-
E. Cushing's disease.
ical examination found enlargement of the thy-
112. Woman 36 years with primary hypothy-
roid gland. He resides in endemic region. The
roidism receives L-thyroxine in daily dosage 50
internal organs are normal. The thyroid gland is
mg. What investigation is the most recom-
diffusely increased to II stage, elastic, smooth.
mended to assess the effectiveness of the dose?
The level of thyroid hormones in the normal
A. Determination of thyroxine level.
range. Ultrasound: thyroid gland is large, in-
B. Determination of triiodothyronine level.
creased echogenicity is not altered. Diagnosis:
C. Determination of thyrotropin level.
A. Diffuse nontoxic goiter euthyroid II stage.
D. Determination of thyroglobulin level.
B. Autoimmune thyroiditis, euthyroidism.
E. Determination of cholesterol.
C. Diffuse endemic goiter euthyroid II stage.
113. Woman 32 years old, complains of thirst,
D. Nodular goiter.
frequent urination up to 6 liters per day, which
E. Chronic thyroiditis.
intensified after the stress. Urine specific gravi-
110. An elderly woman was hospitalized with
ty - 1001-1004; acidic reaction.Your diagnosis?
serious condition. Objective: blood pressure -
A. Trauma of skull.
90/60 mm Hg, pulse - 56/min. Body tempera-
B. Psycho-emotional overload.
ture - 35,8 C. The skin is pale, cold, very dry.
C. Chronic pyelonephritis.
Hair sparse, thin, areas of alopecia. Stomach
D. Chronic glomerulonephritis.
peristalsis does not listen. Swelling in the legs
E. Primary hyperaldosteronism.
and around the eyes. Glycemia – 3,2 mmol/l.
114. Man 48 years old, miner, complains of the
What is the pathology in the patient?
increasing headache, changes in appearance. In
A. Hypercalcium crisis.
history - chronic tonsillitis. Abuse alcohol, to50
bacco. Objective: height - 178 cm, weight - 92
tively: height 165 sm, weight 54 kg, pulse -
kg. Increased eyebrows, nose, ears, tongue.
56/min, blood pressure -90/50 mm Hg. The
Prognathism. Enlarged hands and feet. The skin
skin is pale, dry. Fasting glucose – 3,3 mmol/l.
is thickened, greasy. The liver +2 cm. Conges-
The development of which complications is
tion of the optic nerve nipple in the eye fundus.
most probably?
Fasting glucose – 7,2 mmol / l. What is the
A. Primary adrenal insufficiency.
most possible cause of this condition?
B. Pituitary insufficiency.
A. Brain Tumor.
C. Primary hypogonadism.
B. Chronic infection.
D. Hypothalamic syndrome.
C. Alcohol abuse.
E. Pituitary adenoma.
D. Working conditions.
118. Boy 10 years old, was hospitalized with
E. Chronic overeating.
complains of polydipsia, polyuria - up to 9 li-
115. A woman 52 years old after strumectomy
ters per day, weakness, poor appetite. The first
appeared
constricting
symptoms appeared after 2 weeks after suffer-
chest, paresthesia in the face, extremities. The
ing flu. Fasting glucose level – 4,2 mmol/l.
appearance of the symptom is most probably?
What additional investigation recommended to
A. Shtelvaga.
the clinical diagnosis?
B. Babinski.
A. General analysis of blood.
C. Chvostek.
B. General analysis of urine.
D. Moebius.
C. Analysis of urine for acetone.
E. Graefe.
D. Analysis of urine by Nechiporenko.
116. Woman 46 years old after subtotal resec-
E. Analysis of urine by Zimnitsky.
tion of the thyroid gland appeared paresthesia
119. The woman 14 years old during the last
in the area of the face, extremities, difficulty
year weight loss (7 kg). She complains of head-
breathing, chest pain, periodic leg cramps. HR -
aches, general weakness. Objectively: the ac-
89 / min. Blood pressure - 150/100 mm Hg.
cumulation of fat is more pronounced on the
What medications is most recommended in
neck, chest, abdomen. On the side surfaces of
acute period?
the abdominal were tretching band. Mammary
A. Nitrate
glands are underdeveloped, absent menstrua-
B. Neuroleptics.
tion, body hair of male type. Blood pressure -
C. Tranquilizers.
160/100 mm Hg., HR - 92/min. On skull X-
D. Calcium.
Ray indicated osteoporosis, enlarged pituitary
E. Beta-blockers.
sella. Clinical diagnosis?
117. Woman 32 years old, complains of weak-
A. Primary hypoparathyroidism.
ness, apathy, chilliness, amenorrhea, which
B. Cushing syndrome.
have evolved after the severe childbirth. Objec-
C. Puberty dispituitarism.
inspiratory dyspnea,
51
D. Cushing disease.
B. Monitoring after 6 months.
E. Stein Leventhal syndrome.
C. Appointment Merkazolil and control after 3
120. Woman 48 years old complains of irrita-
months.
tion, sweating, tremor, weight loss, progressive
D. Subtotal resection of the thyroid gland.
weakness, sleep disturbance. Sick for about a
E. Receiving of thyroid hormones and control
year. Objectively: skin is moist, warm, thyroid
after 3 months.
gland diffusely enlarged up to the second de-
123. Patient K., 37 years old, complains of
gree, elastic consistency. Patient has symptoms
thirst, polyuria (up to 10 liters per day), weak-
Kocher, Graefe, Shtelvaga. Pulse - 118/min,
ness. The disease is caused by craniocerebral
Blood pressure - 150/60 mm Hg. Clinical di-
trauma. Common blood test - no change;
agnosis:
Common urine test: specific weight – 1001,
A. Chronic autoimmune thyroiditis.
protein – no, sugar - no. Clinical diagnosis?
B. Diffuse goiter II st., Thyrotoxicosis.
A. Chronic glomerulonephritis.
C. Diffuse goiter II st., Euthyroidism.
B. Acute renal failure, polyuria stage.
D. Diffuse goiter II st., Dystonia.
C. Diabetes mellitus.
E. Diffuse goiter II st., Menopausal syndrome.
D. Primary hyperaldosteronism.
121. The patient 36 years old, ills over 1-1,5
E. Diabetes insipidus
years. He complains for weakness, poor appe-
124. Woman 52 years old, complains of weak-
tite, nausea. Weight loss at 10 kg for 1 year.
ness, memory loss, increased weight, constipa-
Skin and nipples are hyperpigmented. Pulse -
tion. Sick about 3 years. Objective: height - 164
60 / min, blood pressure - 80/50 mm Hg. High
cm, weight - 87 kg, the skin is dry, dense, cold,
levels of adrenocorticotropic hormone in plas-
fat distribution is normal. Pulse - 60 / min,
ma. Your preliminary diagnosis?
heart sounds are muffled, blood pressure -
A. Chronic adrenal insufficiency.
145/85 mm Hg., Body temperature - 35,8 C.
B. Diabetes mellitus.
What is the most probable cause of increased
C. Hypopituitarism.
weight?
D. Chronic gastritis.
A. Cushing's disease.
E. Chronichepatitis.
B. Hypothalamic syndrome.
122. Woman 32 years old, the thyroid gland is
C. Climacteric syndrome.
diffusely enlarged II stage, clinical signs of hy-
D. Hypothyroidism.
perthyroidism are absent. Ultrasound: the thy-
E. Hypoestrogenemy.
roid gland is inhomogeneous, in both particles
125. Patient S., 38 years old, complains of
are visualized hypoechogenic structures in size
headache, thirst, increased blood pressure and
from 1x1 to 4x4 mm; lymph nodes were not en-
weight (46 kg over 3 years). The disease is as-
larged. What medical tactic is recommended?
sociated with the flu. Height - 176 cm, weight -
A. Total thyroidectomy.
143 kg. Division of adipose tissue: primarily on
52
the torso, thighs, abdomen, multiple striae with
128. The etiological factors of hyperprolac-
cherry color. Blood pressure - 180/100 mm Hg.
tinemia:
Your preliminary diagnosis?
A. The physiological stimulation of the pitui-
A. Alimentary-constitutional obesity Article
tary gland in the background hyperestro-
III.
genemia.
B. Hypothyroidism.
B. Diabetes mellitus.
C. Hypothalamic syndrome, neuroendocrine
C. Diffuse toxic goiter.
form.
D. Receiving of acetylsalicylic acid.
D. Cerebral obesity III degree.
E. All of the above.
E. Pituitary Cushing.
129. The etiological factors of hyperprolac-
126. Patient G., 37 years old, with asymmetric
tinemia:
enlargement of the thyroid gland II stage, gland
A. Diabetes mellitus.
is painful on palpation. Body temperature – 38
B. Receiving of metoclopramide.
C. A week ago suffered from tonsillitis. The
C. Diffuse toxic goiter.
general analysis of blood - accelerated ESR.
D. Angina.
Preliminary diagnosis:
E. All of the above.
A. Fibrous thyroiditis.
130 The etiological factors of
B. Graves' disease.
tinemia:
C. Toxic thyroid adenoma.
A. Insufficiency of the adrenal cortex
D. Autoimmune thyroiditis.
B. Microadenoma pituitary secreting prolactin.
E. Subacute thyroiditis.
C. Primary hypothyroidism.
127. Patient P., 32 years old, complains of con-
D. Receiving of antidepressants.
stant irritability, tachycardia, pain in the eyes,
E. All of the following.
tearing, weight loss at 10 kg about 4 months.
131. Clinical manifestations of hyperprolac-
Objectively: skin is warm, moist, easy exoph-
tinemia:
thalmos, positive symptoms of Graefe, Kocher,
A. Amenorrhea.
Mobius. The thyroid gland is diffusely en-
B. Algomenorrhea.
larged, unpainful. Pulse - 108/min, blood pres-
C. Hypermenorrhoea.
sure - 140/66 mm Hg. Mild tremor of the fin-
D. Endocrine ophthalmopathy.
gers.Your diagnosis?
E. Prognathism.
A. Acute thyroiditis.
132. Clinical manifestations of hyperprolac-
B. Nodular toxic goiter.
tinemia:
C. Diffuse toxic goiter.
A. Galactorrhea.
D. Neurasthenia.
B. Amenorrhea.
E. Subacute thyroiditis.
C. Headache uncertain localization.
D. Bitemporal hemianopsia.
53
hyperprolac-
E. All of the above.
C. Menerin.
133. The concentration of prolactin in the blood
D. Adiuretin.
of women in physiological conditions (absence
E. Glyukofazh.
of pregnancy and lactation):
138. Negative effects of the use of cabergoline:
A. Less than 20 ng/ml.
A. Arterial hypotension.
B. Less than 200 ng/ml.
B. Hirsutism.
C. 10-15 mg/ml.
C. Amenorrhea.
D. 8-10 mkE/ml.
D. Hypertension.
E. 50 ng/ml.
E. Atrial Fibrillation.
134. What additional investigation is needed to
139. What are the etiological factors for acro-
verify the diagnosis of hyperprolactinemia?
megaly:
A. Investigationof heart rate variability
A. Ectopic secretion of somatoliberin.
B. Electroencephalography.
B. Pituitary tumor.
C. Rheoencephalography.
C. Ectopic secretion of growth hormone.
D. Computer tomography of the brain (Turkish
D. MEN-1 syndrome.
saddle)
E. All of the above.
E. All of the above.
140. Clinical manifestations of acromegaly:
135. What drugs are used for the functional
A. Tachycardia, polyuria, «acantosis nigri-
(stimulus) tests for the diagnosis of hyperpro-
cans».
lactinemia:
B. Hyperthyroidism, hyperuricemia, diarrhea.
A. Bromkreptin.
C. Melasma, metabolic syndrome, amenorrhea.
B. Aspirin.
D. Coarsening of facial features, diastema,
C. Omeprazole.
prognathism, hyperprolactinemia.
D. L-thyroxine.
E. Polyphagia, pterygoid neck wrinkle, hair
E. Metoclopramide.
loss.
136. What drugs are used for medical treatment
141. Which skin defeats are typical for acro-
of hyperprolactinemia:
megaly?
A. L-thyroxine.
A. Myxedema.
B. Bromkreptin.
B. Impetigo.
C. Glimepiride.
C. Seborrhea.
D. Metformin.
D. Lipoid necrobiosis.
E. Androkur.
E. Hyperkeratosis.
137. What drugs are used for medical treatment
142. Which bone defeats are typical for acro-
of nhyperprolactinemia:
megaly?
A. Cabergoline.
A. Osteoporosis.
B. Diane-35.
B. Front hyperostosis.
54
C. Osteomalacia.
E. All of the above.
D. Pathologic fractures.
147. Clinical manifestations of hypoparathy-
E. Joint of Charcot.
roidism:
143. Which defeats of the cardiovascular sys-
A. Correct B and E.
tem are typical for acromegaly?
B. Spasmodic contraction of different muscle
A. Left ventricular hypertrophy.
groups.
B. Atrial fibrillation.
C. All are correct.
C. Myocardial infarction.
D. Hyperglycemia.
D. Atrio-ventricular block.
E. Defects of tooth enamel.
E. Myocarditis.
148. Which symptom reveals the hidden forms
144. The main methods for treatment of acro-
of tetany?
megaly:
A. Kernig.
A. Medical (dopamine receptor agonist thera-
B. Chvostek.
py).
C. Delrimplya.
B. Surgery (prostatectomy).
D. Graefe.
C. Medical (Therapy with somatostatin ana-
E. Kukoverova-Sirotinina.
logues).
149. What electrolyte disorders are typical for
D. Ray (gamma-therapy and proton therapy).
hypoparathyroidism?
E. All of the above.
A. Hypercalcemia, hyperphosphatemia.
145. What are the objective signs of acromeg-
B. Hypercalcemia, hypophosphatemia.
aly?
C. Hypocalcemia, hypophosphatemia.
A. The presence of pituitary adenoma, hy-
D. Hypocalcemia, hyperphosphatemia.
perprolactinemia, enlarged hands and feet.
E. Hypercalcemia, Hypocalciuria.
B. Daytime sleepiness, weight gain.
150. What are the principles of treatment of
C. Headache, sweating, tachicardia and short-
hypoparathyroidism?
ness of breath.
A. Limitation of phosphorus-containing prod-
D. Violations of the menstrual cycle, weakness,
ucts.
reduced disability.
B. Diet rich in calcium salts.
E. All of the above.
C. Drugs with vitamin D.
146. Which of brain structure compresses by
D. Calcium drugs.
primarily
E. All of the above.
somatotropinoma
at
extrasella
growth?
151. What radiological signs are typical for hy-
A. The brain stem.
poparathyroidism?
B. Cerebellum.
A. Osteoporosis of the sella turcica.
C. The optic chiasm.
B. Increased bone density and calcification of
D. Сortices of parietal lobes.
the basal ganglia of the brain.
55
C. Increase airiness of the sphenoidal sinus.
E. All are true.
D. Reducing the lumen and osteoporosis of
155. What disorders of the endocrine system
large joints.
are typical for autoimmune polyglandular syn-
E. Pathological vertebral fractures.
drome type 2?
152. Pseudohypoparathyreosis is:
A. Adrenal insufficiency.
A. The disease, which is characterized by bone
B. Diabetes mellitus type 1.
resorption amid increased production of para-
C. Autoimmune thyroiditis.
thyroid hormone.
D. True B and C.
B. The disease, which is characterized by re-
E. All are true.
sistance to parathyroid hormone, hypocalcemia,
156. The treatment of autoimmune polyglandu-
dysplasia.
lar syndrome:
C. The disease, which is characterized by de-
A. Hormone replacement therapy of impaired
creased function of the parathyroid glands in
functions.
the background of diffuse toxic goiter or nodu-
B. Removal of the affected organs.
lar goiter.
C. Dynamic observation, palliative care.
D. The disease, which is characterized by de-
D. Radiation therapy to area of the sella turcica.
creased production of parathyroid hormone on
E. All are true.
the background of exogenous calcium deficien-
157. What disease is characterized by a combi-
cy.
nation of insulinoma, prolactinoma and hy-
E. The disease, which is characterized by the
perparathyroidism?
production of antibodies against parathyroid
A. Syndrome MEN-2B (Gorlin syndrome).
tissue.
B. Syndrome MEN-2A (Syndrome Sipple).
153. Which changes the blood level of alkaline
C. Syndrome MEN-1 (Werner syndrome).
phosphatase is typical for hypoparathyroidism?
D. Autoimmune polyglandular syndrome type
A. Value is in the normal range
1.
B. Increases.
E. Autoimmune polyglandular syndrome type
C. Decreases.
2.
D. Significantly increased.
158. What disease is characterized by a combi-
E. Significantly reduced.
nation of medullary thyroid cancer, pheochro-
154. What disorders of the endocrine system
mocytoma, hyperparathyroidism and mucosal
are typical for autoimmune polyglandular syn-
neuromas?
drome type 1?
A. Syndrome MEN-2 B (Gorlin syndrome).
A. Hyperprolactinaemia.
B. Syndrome MEN-2A (Syndrome Sipple).
B. Hypoparathyroidism.
C. Syndrome MEN-1 (Werner syndrome).
C. Adrenal insufficiency.
D. Autoimmune polyglandular syndrome type
D. True B and C.
1.
56
E. Autoimmune polyglandular syndrome type
162. Woman 39 years old, complains of head-
2.
ache, weakness, and paresthesias in extremities,
159. What disease is characterized by a combi-
polyuria. Objective: heart tones are muffled,
nation of medullary thyroid cancer, pheochro-
heart rate - 94 / min, blood pressure - 190/105
mocytoma and hyperparathyroidism?
mm Hg. Blood Glucose – 5,5 mmol/l,plasma
A. Syndrome MEN-2B (Gorlin syndrome).
sodium - 148 mmol/l, potassium plasma – 2,7
B. Syndrome MEN-2A (Syndrome Sipple).
mmol/l. Urine: specific weight - 1012, protein
C. Syndrome MEN-1 (Werner syndrome).
0,1 g/l, the reaction is alkaline, l - 3-4, er - 2-3
D. Autoimmune polyglandular syndrome type
p/h. Clinical diagnosis:
1.
A. Arterial hypertension.
E. Autoimmune polyglandular syndrome type
B. Amyloidosis.
2.
C. Diabetes insipidus.
160. The sign, which occurs only in pheochro-
D. Chronic glomerulonephritis.
mocytoma, and differs it from other forms of
E. Primary hyperaldosteronism.
hypertension:
163. What caused the skin hyperpigmentation
A. Impaired glucose tolerance.
in Addison's disease?
B. Weight loss.
A. Hypersecretion of ACTH.
C. Frequent headache.
B. Hypersecretion of melanotropin.
D. Orthostatic hypotension.
C. Violation of chromogenic liver function.
E. Tachycardia and perspiration.
164. What caused the presence of vitiligo on
161. Woman 14 years old during the last year
the background of the skin hyperpigmentation
weight gain by 7 kg. She had frequent head-
in Addison's disease?
aches, general weakness. Objectively: the ac-
A. Impaired liver function.
cumulation of fat is more pronounced on the
B. Autoimmune process.
neck, chest, abdomen. On the side surfaces of
C. Violations of the skin trophism.
the abdominal stretching band. Mammary
165. In which cases hypertension may occur in
glands are underdeveloped, absent menstrua-
Addison's disease?
tion, there is body hair of male type. Blood
A. Kidney disease.
pressure - 160/100 mm Hg., HR -92 / min. On
B. The history of hypertension.
skull radiographs were osteoporosis, enlarged
C. Overdose of glucocorticoids.
sella turcica. Clinical diagnosis?
D. Overdose mineralocorticoid.
A. The primary hypoparathyroidism.
E. All are true.
B. Cushing syndrome.
166. What are the features of manifestation of
C. Puberty dispituitarism.
secondary adrenal insufficiency?
D. Pituitary Cushing.
A. Absence of hyperpigmentation.
E. Stein Leventhal Syndrome.
57
B. No violation of mineralocorticoid adrenal
172. Which electrolytes are stimulators of al-
function.
dosterone secretion?
C. Signs of insufficiency of secretion of other
A. Sodium.
tropic hormones.
B. Potassium.
D. All are right.
C. Calcium.
167. Status of calcium metabolism in Addison's
D. Phosphorus.
disease is characterized by:
173. Which factors are involved in the regula-
A. Hypercalcemia.
tion of aldosterone secretion?
B. Hypercalciuria
A. Changes in the circulating of blood volume.
C. Hypocalcemia.
B. Osmotic blood pressure.
D. Normocalcaemia.
C. Oncotic blood pressure.
E. A and B are true.
D. All of the above.
168. Who does more often suffer from extra-
174. What level of renin is typical for second-
adrenal pheochromocytoma localization?
ary hyperaldosteronism?
A. Adult.
A. High.
B. Elderly people.
B. Low.
C. Children.
C. Unchanged.
169. What hormones are produced bypheo-
175. Which test is conducted for the differential
chromocytoma?
diagnosis of primary and secondary hy-
A. Adrenalin at adrenal localization.
pogonadism?
B. Norepinephrine at extraadrenal localization.
A. Small dexamethasone test.
C. Cortisol at adrenal localization.
B. Big dexamethasone test.
D. A and C are true.
C. Test with corticotrophin.
E. A and B are true.
D. Test with thyrotropin.
170. Changes in the blood, which are typical
E. Test with Chorionic gonadotropin.
during the crisis of pheochromocytoma:
176. What is necessary to differentiate diabetes
A. Leukocytosis.
insipidus?
B. Eosinophilia.
A. Diabetes mellitus.
C. Lymphocytosis.
B. Psychogenic dyspepsia.
D. All are true.
C. Hyperparathyroidism.
171. Which condition is characterized by "un-
D. Chronic glomerulonephritis.
controlled hemodynamic" in pheochromocyto-
E. All of the above.
ma?
177. What tests are used to diagnose diabetes
A. Persistent preserving critical hypertension.
insipidus?
B. High and low blood pressure.
A. With starvation.
C. The development of acute heart failure.
B. With fluid restriction.
58
C. With the introduction of sodium chloride.
B. Radiation thyroiditis.
D. With the introduction of diuretics.
C. Subacute thyroiditis.
E. With tolbutamide.
D. Syphilitic thyroiditis.
178. What underlies of Parhona syndrome?
E. All are true.
A. Overproduction vasopressin.
183. Which endocrine diseases that manifest
B. Absence of vasopressin.
obesity?
C. Excess of tropic pituitary hormones.
A. Cushing's disease.
D. Absence of tropic pituitary hormones.
B. Addison's disease.
E. Hyperproduction of mineralocorticoid.
S. Hyperparathyroidism.
179. Climacteric syndrome can occur in wom-
D. Diffuse toxic goiter.
en:
E. Diabetes mellitus 1 type.
A. In the normal menstrual cycle.
184. The patient, 14 years old, complains of
B. In violation of the menstrual cycle.
growth retardation and sexual development.
C. With the onset of menopause.
Born in a timely manner normal pregnancy
D. In the postmenopausal period.
with a body weight of 3,5 kg, a length of 50
E. All of the above.
sm. The growth has always lagged behind the
180. What hormonal disorders are associated
same age. Objectively: growth 132 sm, weight
"flushes" in menopause syndrome?
36 kg. The chest is broad, the mamma glandu-
A. Increase the secretion of growth hormone.
las are not developed. The neck is short, with
B. Increase the secretion of luteinizing hor-
alar folds, low growth of hair on the neck. Ex-
mone.
ternal genitalia are developed on the female
C. Increase the secretion of thyroid-stimulating
type on the age of 4-6 years. Preliminary diag-
hormone.
nosis:
D. Increase the secretion of corticotrophin.
A. Congenital adrenal hyperplasia.
E. All of the above.
B. Syndrome Stein-Levenetalya.
181. What are the best time of operative treat-
S. Turner Syndrome.
ment of diffuse toxic goiter in the presence of
D. Syndrome incomplete masculinization.
severe damage of liver and heart?
E. Testicular feminization syndrome.
A. Upon reaching of euthyroid state.
185. What karyotype is typical for the testicular
B. After month of the payment of thyrotoxico-
feminization syndrome?
sis.
A 46XX.
C. After 2-3 months of the payment of thyro-
B. 46XY.
toxicosis.
S. 47XXX.
182. What inflammatory diseases are accompa-
D. 47XXY.
nied by clinic of hyperthyroidism?
E. 47XYY.
A. Fibrous thyroiditis.
186. The hormone of adipose tissue is:
59
A. Glucagon.
E. Female pseudohermaphroditism.
B. Thyroxine.
191. Patient M, 30 years old, complains of
S. Dehydroepiandrosterone.
headaches, blurred vision, coarsening of facial
D. Cortisol.
features, increase in the size of the hands and
E. Leptin.
feet, amenorrhea. Sick about 2 years. The pre-
187. What indicator is typical for diabetes in-
liminary diagnosis?
sipidus?
A. Hypothalamic syndrome.
A. Hypophosphatemia.
B. Cushing's Disease.
B. Hypercalcemia.
S. Acromegaly.
C. Hypokalemia.
D. Sheehan's syndrome.
D. Low relative density of urine.
E. Pachydermoperiostosis.
E. Hyponatremia.
192. Patient S., 30 years old, complains of obe-
188. Determine the pathological condition
sity, which is developed gradually, increased
caused by deficiency of growth hormone:
appetite, thirst, polyuria, almost constant
A. Delay of physical development.
drowsiness, amenorrhea. Often there is an in-
B. Excitability.
crease in body temperature up to 38-39 C with
C. Insomnia.
chills,
D. Hyperglycemia.
blood pressure. Which segment of the nervous
E. Acceleration of mental processes.
system is damaged?
189. Determine the degree of obesity in a pa-
A. The hypothalamus.
tient with a body mass index 33 kg/m2?
B. The cerebral cortex.
A. Normal body weight.
C. The thalamus.
B. Overweight.
D. Elongated brain.
C. I degree.
E. Cerebellum.
D. II degree
93. The patient complains of thirst, polyuria.
E. III degree.
Condition of the patient connects with cranio-
190. University student complains of absence
cerebral trauma. Urine specific gravity 1002.
of breasts and menstruation. Height 172 cm,
Clinical diagnosis?
eunuchoid proportions of the body, according
A. Neurogenic polydipsia.
to the pelvic ultrasound ovaries are absent,
B. Diabetes mellitus.
there is only the uterus. The preliminary diag-
C. Chronic glomerulonephritis.
nosis?
D. Diabetes insipidus.
A. Turner Syndrome.
E. Enuresis.
B. Dyskinesia gonads syndrome.
194. Woman 34 years old have seen obesity,
C. Absolut gonadal agenesis,
mainly on the shoulders, torso, purplish cyanot-
D. Testicular feminization syndrome.
60
perspiration,
tachycardia,
increased
ic skin stretch marks on the chest and abdomen.
years. Body weight - 90 kg, height 160 cm, the
Clinical diagnosis?
figure is correct. Adipose tissue distribution is
A. Hypothyroid obesity.
normal. On the thighs, abdomen and the breasts
B. Cushing's Disease.
- pink thin striae. Blood pressure - 145/90 mm
C. Gipoovarialne obesity.
Hg. Your preliminary diagnosis?
D. Alimentary obesity.
A. Vegetative-vascular dystonia.
E. Pubertal obesity.
B. Alimentary and constitutive obesity.
195. In endocrinology department examined
C. Puberty and youth dispituitarism.
the woman 42 years old with an acute increase
D. Cushing's Disease.
(in the past 6 months to 20 kg) of body weight,
E. Cushing's Syndrome.
menstrual disorders, headache. The symptoms
198. The patient was 37 years old, went to the
appeared after a viral infection. Ambulatory
doctor on the overweight for the purpose of
were defined the levels of TTH, T3, T4, adrenal
weight loss. Objective: height 160 cm, weight
hormones, made an electrocardiogram. No sig-
125 kg. Normal distribution of adipose tissue.
nificant abnormalities were recorded. Which
What method of treatment would be most ap-
examination is necessary to determine the
propriate?
cause of the increased weight of the body?
A. Drug therapy.
A. Ultrasound of adrenal gland.
B. Diet.
B. Chest X-ray.
C. Diet and exercise.
C. X-ray of the skull.
D. Surgical correction of weight.
D. Determine the creatinine levels in the blood.
E. Psychotherapeutic correction of eating.
E. Determine the potassium level in blood so-
199. Patient C. 28 years complained of insuffi-
dium.
ciency of sexual development, reduction of po-
196. Patient K., 43 years old, complains of a
tency, sterility. Objective: eunuchoid body pro-
moderate weight gain, shortness of breath on
portions, height 185 cm, weight 75 kg, gyne-
exertion. Body weight - 124 kg, height - 176
comastia. External genitalia are formed correct-
cm. Adipose tissue distribution is normal. Clin-
ly, the sizes correspond to age. Testicles are re-
ical diagnosis?
duced in size, are sealed. The sex chromatin is
A. Alimentary obesity.
32%. Karyotype 47XXY/46XY. Your prelimi-
B. Hypothalamic Obesity.
nary diagnosis?
C. Disgonadic obesity.
A. Absolutly gonadal dysgenesis.
D. Cushing disease.
B. Klinefelter syndrome.
E. Adipozo-genital dystrophy.
C. Turner Syndrome.
197. Patient 15 years old, complains of excess
D. The primary hypogonadism.
weight, headaches, irritability, rapid fatigue. A
E. Mayer-Rokitansky-Kyustnera syndrome.
significant increasing the body weight from 14
61
200. According to the chemical structure of the
D. Thyroid hormones.
steroid hormones:
E. Hormones of the adrenal medulla.
A. Pituitary hormones.
B. Hormones of adrenal cortex.
C. Parathyroid hormone.
62
Pulmonology
1. Which immunological mechanisms are the
D. Treatment of acute bronchitis.
IgE-mediated type?
E. Treatment of pneumonia.
A. Immediate type allergic reactions.
6. Systemic corticosteroids are used for:
B. Delayed-type allergic reaction.
A. Treatment of intermittent stages of bronchial
C. Non-specific stimulation of mast cells.
astma.
D. Immune complex mechanism.
B. Prevention of attacks of breathlessness.
E. B and D are true.
C. Treatment of asthma attacks 1 stage of se-
2. In the infiltration of bronchial walls in asth-
verity.
ma is dominated?
D. Treatment of COPD1 stage of severity.
A. Alveolar macrophages.
E. Treatment of asthma IV stageseverity.
B. Lymphocytes.
7. Pollen asthma is characterized by:
C. Eosinophils.
A. Exacerbation in the winter season.
D. Plasma cells.
B. All year round persistence of the process.
E. B-lymphocytes.
C. Aggravation in time of cleaning apartments.
3. The cause of respiratory failure in asthma is
D. Worsening at spring and summer.
all of the above, except:
E. Worsening on the background of the contact
A. Bronchospasm.
with pets.
B. Intensified ventilation.
8. Diseases with hereditary predisposition are
C. Hypersecretion.
all listed, except:
D. Edema of the mucous membrane of the
A. Diabetes mellitus type II.
bronchial tree.
B. Emphysema.
E. Cells infiltration of the bronchial mucosa
C. Asthma.
walls, especially eosinophils.
D. Cystic fibrosis
4. Indications for inhalation of the Intalum:
E. Chronic bronchitis.
A. Treatment of status asthmaticus.
9. Bronchial obstruction is detected by:
B. Treatment of acute attack of asthma.
A. Spirography, peak flow.
C. Prevention of asthma attack.
B. Bronchoscopy.
D. Treatment of acute infections of the upper
C. Study of blood gases.
respiratory tract.
D. Plethysmography.
E. Treatment of pneumonia.
E. Radiography.
5. Short-acting ß2-adrenoceptor agonists are
10. The simplest device to determine the bron-
used for:
chial obstruction is:
A. Relief of acute attacks of breathlessness.
A. Spirograph.
B. Long-term prevention of asthma attacks
B. Peak Flow Meter.
C. Treatment of status asthmaticus.
C. Plethysmograph.
63
D. Bronchoscope.
D. Intra-arterial.
E. Pulse Oximeter.
E. Intramuscular.
11. Which method should be used to diagnose
15. At inhaled the bronchospasmolytic agents,
the bronchoconstriction by a spirography and
spray inhaler should be located:
peak flow?
A. Directly from the open mouth of the patient.
A. Exercise stress.
B. At a distance of 3-4 cm from the patient's
B. Inhalation of ß2-agonists.
mouth.
C. Inhalation of oxygen.
C. At a distance of 10-12 cm from the patient's
D. Inhalation of glucocorticosteroids.
mouth.
E. Inhalation of ß-blocker.
D. At a distance of 5-7 cm from the patient's
12. The reversibility of airflow obstruction con-
mouth.
firmed by:
E. At a distance of 4-6 cm from the patient's
A. The results of spirographic investigation us-
mouth.
ing ß2-agonists.
16. At the time of spraying bronchospasmolytic
B. Increasing the vital capacity for spirogram.
agents of spray inhaler patient should:
C. B and E are true.
A. Make a sharp intake of breath.
D. The results of tests with dosed physical ex-
B. Make slow breaths (no more than 0,5 liter
ercises.
per second).
E. Results of the tests with inhalation of oxy-
C. Hold the breath.
gen.
D. Make a sharp exhalation.
13. Reversible airflow obstruction components
E. Make a slowly intake of breath (no more
include all of these, except:
than 0,5 liter per second).
A. Bronchospasm.
17. After inhalation of bronchospasmolytic
B. Inflammatory edema of bronchial mucosa.
agents of spray inhaler patient should:
C. Dysfunction of the mucociliary apparatus of
A. Exhale sharply.
the bronchi.
B. Exhale slowly.
D. Stenosis, obliteration and expiratory col-
C. Hold your breath for 10 seconds
lapse of the bronchi.
D. Inhale sharply.
E. Cells infiltration of the mucosa bronchus
E. Inhale slowly.
wall, especially eosinophils.
18. Group of short-acting ß2-agonists broncho-
14. The most convenient methods to injection
dilators includes:
bronchospasmolytic agents in outpatient setting
A. Theophylline.
is:
B. Berotek.
A. Intravenous.
C. Ortsiprenalin sulfate (alupent, astmopent).
B. Oral.
D. Salbutamol (Albuterol, Ventolin).
C. Inhalation.
E. Kromogligat Na (Intal).
64
19. Among holinolitics most effective and safe
25. Mediator, playing a leading role in the de-
is:
velopment of early bronchospastic reactions in
A. Atropine.
patients with immune genesis bronchial asthma
B. Ipratropium bromide (Atrovent).
is:
C. Aprofen.
A. Histamine.
D. Metacin.
B. Slow reacting substance of anaphylaxis.
E. Propantheline bromide.
C. Prostaglandins, thromboxane.
20. Group of purine derivatives (methylxan-
D. Platelet aggregation factor.
thines) prolonged bronchodilators includes:
E. Eosinophilic chemotactic factor.
A. Theophylline.
26. The main drugs used in asthma are all
B. Teofedrin.
listed, except:
C. Teopek, teodur, retafil, durofillin.
A. ß2-agonists.
D. Eufillin.
B. Methylxanthines.
E. Teoverin.
C. Mucolytics.
21. Of these allergens cause of atopic asthma
D. Inhaled glucocorticoids.
are all, except:
E. Membrane stabilizing drugs.
A. House dust.
27. Salbutamol (Ventolin) dilates the bronchi
B. Spores of fungi.
by:
C. Waste products of bacteria in the air.
A. Blocking the bronchial tree ß-receptors.
D. Pet allergens.
B. Selective excitation of ß2-adrenergic recep-
E. Helminths.
tors of the bronchi.
22. Bronchial obstruction in asthma is caused
C. Effect on the smooth muscles of the bronchi.
by those mechanisms, except:
D. Reduction of vagal tone.
A. Bronchospasm.
E. Blocking the production of histamine.
B. Inflammatory edema of bronchial mucosa.
28. What are the characteristics of breathless-
C. Closure of the bronchi by viscous secret.
ness during an attack of bronchial asthma?
D. Mucus hypersecretion.
A. Inspiratory bradipnoe.
E. Destruction of the alveoli.
B. Biot breathing.
23. The main target cell, which plays a leading
C. Orthopnea.
role in the development of immediate hyper-
D. Cheyne-Stokes breathing.
sensitivity in asthma is:
E. Polypnoe.
A. Macrophage.
29. Man 55 years old, suffers from COPD for
B. Lymphocyte.
many years. Complains from breathlessness at
C. Neutrophils.
rest, cyanosis, enlarged liver, edema in the legs.
D. Mast cell.
What changes in the ECG appear at this stage
E. Erythrocyte.
of COPD?
65
A. Two-humped P.
C. Eosinophils.
B. High R wave in V5,6 leads.
D. Bodies of Creole/clusters of bronchial epi-
C. High P in II, III, aVF leads.
thelial cells.
D. Biphasic P.
E. Monocytes.
E. Left ventricular hypertrophy.
40. Specify complications that do not occur at
31. Changes of which indicators of spirogram
systemic steroid therapy in patients with bron-
are typical for bronchial obstruction?
chial asthma:
A. Vital capacity.
A. Obesity.
B. Residual volume of the lungs.
B. Osteoporosis.
C. Forced vital capacity.
C. Hypotension.
D. Minute volume of breath.
D. Hyperglycemia.
E. Minute ventilation.
E. Gastropathy.
37. Step severity of asthma is determined by all
41. Voiced rales are typical for:
of criteria, except for:
A. Emphysema.
A. Number of daytime symptoms per day,
B. Lung abscess.
week and the severity of violations of physical
C. Pneumonia.
activity.
D. Asthma.
B. Number of nocturnal symptoms perweek
E. Congestiveheartfailure.
and the severity of sleep disorders.
42. What percussion sound is typical for com-
C. Values of peak expiratory flow and its per-
munity-acquired pneumonia in the heat of dis-
centage with proper or best value.
ease?
D. Daily fluctuations of peak expiratory flow.
A. Blunt tympanitis.
E. Daily dosage of corticosteroid
B. Boxed sound.
38. The attack of bronchial asthma is character-
C. Tympanitis.
ized by the following symptoms, except for:
D. Blunt.
A. Inspiratory dyspnea.
E. Metal sound.
B. Expiratory dyspnea.
43. The weakening of the voice jitter is typical
C. Treble wheezing.
for:
D. Dry wheezing on exhalation.
A. Bronchiectasis.
E. Hard breathing with prolonged exhalation.
B. Exudative pleuritis.
39. Indicate which of the elements of sputum
C. Lung abscess in cavity step.
taken from the patient after the asthma attack,
D. Focal pneumonia.
not a sign of allergic process in the bronchial
E. Lobar pneumonia.
tree:
44. Respiratory volume is:
A. Kurshman spirals.
A. The maximum volume of air inhaled after
B. Charcot-Leyden crystals.
the normal inspiratory.
66
B. The maximum volume of air exhaled after
48. Cephalosporin group includes all of these,
the normal expiration.
except:
C. The volume of inhaled or exhaled air.
A. Rifampicin.
D. The volume of air, remaining in the lungs
B. Cephaloridin.
after maximum exhalation.
C. Cephalothin sodium salt.
E. The volume of air in the chest after maximal
D. Kefzol.
inhalation.
E. Cephalexin.
45. Reserve inspired tidal volume is:
49. Tetracycline group includes all of these, ex-
A. The maximum volume of air inhaled after
cept:
the normal inspiratory.
A. Morfocycline.
B. The maximum volume of air exhaled after
B. Metacycline.
the normal expiration.
C. Doxycycline
C. The volume of inhaled or exhaled air.
D. Tarivid.
D. The volume of air, remaining in the lungs
E. Vibramicin.
after maximum exhalation.
50. Aminoglycosides group includes all of the-
E. The volume of air in the chest after maximal
se, except:
inhalation.
A. Monomycin.
46. The vital capacity is:
B. Sizomycin sulfate.
A. The maximum volume of air vented during
C. Gentamycin
1 min.
D. Ristomycin sulfate.
B. The amount of air remaining in the lungs af-
E. Tobramycin.
ter the normal expiration.
51. Diseases with hereditary predisposition are
C. The maximum volume of air exhaled from
all listed, except:
the lungs after maximum inhalation.
A. Diabetes mellitus type II.
D. The maximum volume of air that can be in-
B. Emphysema.
haled after the normal expiration.
C. Bronchial asthma.
E. The volume of air in the chest after maximal
D. Cystic fibrosis.
inhalation.
E. Chronic bronchitis.
47. Penicillin group includes all of these, ex-
52. For pneumonia, complicating of chronic
cept:
bronchitis is typical:
A. Doxycycline.
A. Occurrence after the exacerbation of bron-
B. Carbenicillin disodium salt.
chitis.
C. Sodium salt of dicloxacillin.
B. Frequent absence of a local physical symp-
D. Oxacillin sodium salt.
toms.
E. Ampicillin.
C. Defeated several segments in the depths of
the lung.
67
D. Tendency to a prolonged duration and recur-
57. The diagnosis of pneumonia in the presence of
rence.
clinical signs of the disease may be established if
E. All of the above.
all these changes were found on chest X-ray, ex-
53. Pneumonia is:
cept:
A. Inflammation in the lung.
A. Enriched lung pattern.
B. Infectious inflammation of the lung.
B. Focal shadows.
C. Infectious inflammation of the lung with dif-
C. Dark areas, occupying part of the segment of
ferent etiology and pathogenesis.
lung.
D. Infectious inflammation of the small bronchi
D. Dark areas, occupyin gall of the segment of
and interstitial lung with different etiology and
lung.
pathogenesis.
E. Dark areas, occupyin gall of the lobe of lung.
E. Infectious inflammation of the lung with dif-
58. The most often causative agent of community-
ferent structures and defeated of respiratory de-
acquired pneumonia is:
partment.
A. Streptococcus pneumoniae
54. At pneumonia defeated all listed, except:
B. Streptococcus.
A. Large bronchi.
C. Staphylococcus aureus.
B. Trachea.
D. E. Coli.
C. Alveoli.
E. Klebsiella.
D. Interstitial lung.
59. The causative agents of hospital (nosocomial)
E. Middle bronchi.
pneumonia are all of the microorganisms, except:
55. Auscultation of the lungs in patients with
A. Pneumococcus.
pneumonia can be identified listed, except:
B. Staphylococcus aureus.
A. Weakened breathing in the absence of
C. Klebsiella.
breath wheezes.
D. Chlamydia.
B. Dry wheezes.
E. Enterobacteria.
C. Finely moist wheezes.
60. The most common cause of hospital (noso-
D. Сrepiting wheezes.
comial) pneumonia in elderly patients is:
E. Amforic breathing.
A. Streptococcus pneumonia.
56. Pneumonia Diagnosis is based on the fol-
B. Mycoplasma.
lowing investigations, except:
C. Klebsiella.
A. Clinical symptoms of the disease.
D. Proteus.
B. Data of physical examination.
E. Chlamydia.
C. Results of X-ray study.
61. In persons, suffering from chronic alcoholism,
D. Indicators of blood laboratory tests.
increased frequency of pneumonia caused by:
E. Ultrasonic lung study.
A. Pneumococcus.
B. Sreptococcus.
68
C. E. coli.
D. Alcoholism.
D. Klebsiella.
E. All of the above.
E. Staphylococcus.
66. In pneumonia used drugs all listed treatment,
62. The most common cause of pneumonia in pa-
except:
tients with acquired immunodeficiency syndrome
A. Etiotropic treatment.
is:
B. Expectorants drugs.
A. Streptococcus pneumonia.
C. Bronchospasmolytic treatment.
B. Klebsiella.
D. Immunomodulating drugs.
C. Pneumocystis.
E. Narcotic drugs.
D. Mycoplasma.
67. If you select an antibiotic treatment of
E. E. Coli.
pneumonia, you must take into account:
63. Pneumonia flow is determined all, except:
A. Duration of the disease.
A. Causative agent of pneumonia.
B. Nature of the pathogen causing pneumonia.
B. Time the beginning of the etiotropic treatment.
C. Comorbidity diseases.
C. Status of the bronchi.
D. Individual tolerability to antibacterial drugs.
D. Presence or absence the diseases, reduced the
E. Patient’s age.
reactivity of the organism:
68. Whatcombination of antibiotic therapy is
E. Patient's gender.
the most rational in patients with pneumonia:
64. Pneumonia is considered to be prolonged if:
A. Penicillin and sulfonamides.
A. Signs of disease persist after 4 weeks after the
B. Penicillins and tetracyclines.
beginning.
C. Penicillins and aminoglycosides.
B. Disease continues for more than 4 weeks, but
D. Sulfonamides and tetracycline.
the cure ends with adequate therapy.
E. Sulfonamides and aminoglycosides.
C. In spite of the treatment, changing lung pattern
69. The indications for combination antibiotic
on the radiograph arepreserved for more than 4
treatment for pneumonia are:
weeks after the removal of the clinical symptoms
A. Severity of the pneumonia in the absence of
of the disease.
information about the nature of the infectious
D. Signs of disease persist after 2 weeks after
agent.
thebeginning.
B. Mixed nature of the infection.
E. Disease continues for more than 6 weeks, but
C. Need to enhance the antibacterial effect.
the cure ends with adequate therapy.
D. Absence of data about the nature of the in-
65. Transition of acute pneumonia in a prolonged
fectious agent whith indirect indication of the
due to the following factors:
possible participation of Gram-negative bacte-
A. Elderly patient.
ria.
B. Prior pathological processes in the bronchi.
E. All of the above.
C. Hypofunction of the adrenal cortex.
69
70. In patients with allergic reactions to penicillin
D. Infusion of heparin.
should be given:
E. Plasmapheresis.
A. Ampicillin.
75. If you suspect a pneumonia caused by
B. Cefazolin.
Klebsiella, all of these drugs can be used, ex-
C. Gentamicin.
cept:
D. Amoxicillin.
A. Penicillin 1st generation.
E. Ceftriaxone.
B. Cephalosporins 3rd generation.
71. If you suspect a pneumococcal pneumonia,
C. Penicillins 5th generation.
should be used:
D. Aminoglycosides.
A. Oletetrin.
E. Fluoroquinolones.
B. Streptomycin.
76. Antibiotic treatment of acute pneumonia
C. Penicillins.
should be discontinued:
D. Erythromycin.
A. 1 week after the beginning of treatment.
E. Chloramphenicol.
B. 2 days after normalization of body tempera-
72. If you suspect a mycoplasma pneumonia,
ture.
should be used:
C. After disappearance of pulmonary rales.
A. Penicillins.
D. After the elimination of clinical and radio-
B. Erythromycin.
graphic signs of disease.
C. Chloramphenicol.
E. 7 - 10 days after the beginningof treatment.
D. Streptomycin.
77. In protracted and recurrent course of pneu-
E. Ceporin.
monia at men older than 40 years doctor must
73. Staphylococcal pneumonia often develop
be think about:
on the background of:
A. Pulmonary embolism.
A. Flu.
B. Pulmonary tuberculosis.
B. Diabetes mellitus.
C. Lung cancer.
C. Elderly age.
D. Bronchiectasis.
D. Chronic bronchitis.
E. Pleuritis.
E. Patients in hospitals (nosocomial infection).
78. In the treatment of pneumonia in pregnant
74. Pathogenetic therapy in patients with bilat-
woman can not be used:
eral staphylococcal pneumonia includes all of
A. Penicillin.
the above, except:
B. Tetracycline.
A. Transfusion of fresh frozen plasma.
C. Ampicillin.
B. Parenteral injection of glucocorticoids.
D. Cephaloridine.
E. Ceftriaxone.
C. Intravenous injections of immunoglobu-
79. Acute lung abscess is differented from
lindrugs.
pneumonia with abscess formation by:
70
A. More severe clinical course.
E. Pleural friction.
B. Quantity and nature of sputum.
83. For nonhospital pneumonia is typical:
C. Typical staged of the disease and the preva-
A. Dullness, weakened breathing and bron-
lence in the formation of abscess in the lung
hofoniya, mediastinal shift to the opposite side.
necrobiotic
B. The same, but the shift toward blunting.
reactions over the inflammatory.
C. Blunting of tympanic sound, amforic breath-
D. X-ray picture.
ing, large bubbling rales.
E. Physical data.
D. Dullness, bronchial breathing, reinforced
80. Patient 64 suffers from COPD for a long
bronhofoniya.
time wits yearly exacerbations. The last 4
E. Inspiratory dyspnea, lung volume reduction,
months increased cough, chest pain, shortness
crepitus.
of breath. On the left of the middle of the blade
84. For what pathological process is typical dry
is determined a dullness. Breathing in this area
rales over the entire surface of the lungs?
is not carried out. Radiologically determined
A. Increasing light airiness
mediastinal displacement to the left. Probable
B. Presence of fluid in the lung cavity.
Diagnosis:
C. Violation of bronchial patency.
A. Obstructive atelectasis of the lower lobe.
D. Compaction lung tissue
B. Confluent pneumonia.
E. the presence of the cavity in the lung tissue
C. Lobar pneumonia.
85. What sign indicates of exudative pleurisy in
D. Massive schwarts.
difference to the nonhospital lobar pneumonia?
E. Pleuraleffusion.
A. Percussion dullness in the affected area
81. Specify the main (permanent) diagnostic
B. Bronchial breathing.
feature of acute pneumonia:
C. Bronhofoniya breathing in the defeated area.
A. Dullness
D. Crepitus.
B. Bronchial breathing at the site of blunting.
E. The lag of the chest when breathing
C. Fever.
86. COPD is characterized by all indications,
D. Small bubbling rales.
except:
E. Weakening of breath.
A. Boxed percussion sound.
82. For pneumonia in difference from conges-
B. Elongation of breath.
tive heart failure typical following features, ex-
C. Dry rales on exhalation.
cept:
D. Bronchial breathing.
A. Unvoiced rales in the lower-posterior de-
E. Expiratory dyspnea.
partments of the lung.
87. Which pneumonia less oftencomplicated by
B. Resonant rales.
abscess formation?
C. Pain in time of breathing.
A. Staphylococcal.
D. Focal shadows.
B. Streptococcal.
71
C. Aspiration.
E. On inhalation and first two-thirds of exhala-
D. Viral.
tion.
E. Pneumococcal.
93. Amforic breathing occurs at:
88. At what causative agent of acute pneumo-
A. Focal pneumonia.
nia is most common lung destruction?
B. Bronchitis.
A. Streptococcus pneumonia.
C. Bronchial asthma.
B. Streptococcus.
D. Lung abscess.
C. Staphylococcus aureus.
E. Emphysema.
D. Legionella.
94. Putrid, fetid smell of sputum occurs at:
E. Virus.
A. Chronic bronchitis.
89. In lobar pneumonia may be all the compli-
B. Lung cancer.
cations, except:
C. Lung abscess.
A. Pulmonary fibrosis.
D. Lobar pneumonia.
B. Exudative pleuritis.
E. Bronchial asthma.
C. Pulmonary hemorrhage.
95. Elastic fibers are found in the sputum at:
D. Abscess formation.
A. Chronic bronchitis.
E. Restrictive respiratory failure.
B. Lobar pneumonia.
90. Choose one of the signsthat distinguish vi-
C. Bronchial asthma.
ral from bacterial pneumonia:
D. Pulmonary emphysema.
A. Infiltrative changes on chest radiography.
E. Lung cancer in stage of decomposition.
B. Leukocytosis with a left shift.
96. The most informative method to detection
C. Just noticeable physical changes.
of bronchiectasis is:
D. Pulse corresponds to the temperature.
A. X-ray.
E. Cough with purulent sputum.
B. Tomography.
91. Breathing at emphysema is:
C. Bronchography.
A. Vesicular.
D. Angiography.
B. Weakened vesicular.
97. Bronchoscopy is recommended at:
C. Increased vesicular.
A. Atelectasis of lobar or lung segment.
D. Bronchial.
B. Acute lobar or segmental pneumonia.
E. Saccadic.
C. Exudative pleuritis.
92. Bronchial breathing auscultated :
D. Bronchial asthma.
A. On inspiration.
E. Pulmonary heart.
B. On exhalation.
98. Pulmonary heart may occurs in:
C. On inspiration and one-third exhalation.
A. Arterial hypertension.
D. Throughout the entire of inspiration and ex-
B. Hyperthyroidism.
halation.
C. Myocarditis.
72
D. COPD.
103. Chronic bronchitis, flowing with the pro-
E. All of the above.
gressive deterioration of bronchial obstruction,
99. Expectorants drugs can induce all of the
regardless of the mechanism of its violations
above, except:
named:
A. Enhance the secretion of bronchial glands.
A. Simple bronchitis.
B. Thinning of sputum.
B. Purulent bronchitis.
C. Enhance motor function of bronchi.
C. COPD.
D. Deepening the breath.
D. Bronchitis emphysematous.
E. Rapid breathing.
E. Mixed bronchitis.
100. The main cause of acute bronchitis is:
104. Chronic bronchitis, flowing with periodic
A. Inhalation of gases and aerosols, which irri-
exacerbations, but without progressive of bron-
tants the mucous membrane of bronchi.
chial obstruction, named:
B. Hypothermia.
A. Simple bronchitis.
C. Viral and bacterial infections.
B. Purulent bronchitis.
D. Smoking.
C. Obstructive bronchitis.
E. Inhalation of pollen.
D. Bronchitis emphysematous.
101. At young people (30-35 years) the most
E. Mixed bronchitis.
common cause of COPD is:
105. Chronic bronchitis, flowing with second-
A. Reinfection of viral and bacterial.
ary infection, the abundance of different-sized
B. Impact of industrial gases and aerosols,
rales and sputum production with a large num-
smoking.
ber of neutrophils named:
C. Cosmetic agents.
A. Simple bronchitis.
D. Congenital functional failure of the mucocil-
B. Purulent bronchitis.
iary apparatus of bronchi.
C. Obstructive bronchitis.
E. Violation of vascular tone.
D. Bronchitis emphysematous.
102. In people over the age of 30-35 years, in-
E. Mixedbronchitis.
cluding the elderly, the most common cause of
106. The main symptom of chronic bronchitis
COPD is:
with a primary defeating of the mucous membrane of the large bronchi is:
A. Reinfection of viral and bacterial.
A. Intense dry cough.
B. Impact of industrial gases and aerosols,
B. Cough with sputum.
smoking.
C. Breathlessness.
C. Concomitant diseases of the cardiovascular
D. Attacks of breathlessness.
system.
E. Cough without sputum.
D. Congenital functional failure of the mucociliary apparatus of bronchi.
E. Cosmetic agents.
73
107. The main symptom of chronic bronchitis
8. Normal content of peripheral blood RBCs
with a primary defeating of the mucous mem-
and hemoglobin.
brane of the small bronchi is:
A. Correct 1, 3, 5, 7.
A. Intense dry cough.
B. Correct 1, 4, 5, 7.
B. Cough with sputum.
C. Correct 2, 3, 6, 8.
C. Breathlessness.
D. Correct 2, 3, 5, 7.
D. Attacks of breathlessness.
E. Correct 1, 3, 6, 7.
E. Cough without sputum.
110. Dry cough in chronic bronchitis is caused
108. At obstructive bronchitis bronchospasm
by:
mechanism is determined by all of the above,
A. Inflammation of the mucous membrane of
except:
the large bronchi.
A. Reducing the activity of the sympathetic
B. Inflammation of the mucous membrane of
nervous system mediators
the small bronchi.
B. Prevalence of the activity of the parasympa-
C. Increased sensitivity of the reflex zones of
thetic nervous system mediators.
the mucous membrane of the large bronchi.
C. Inflammatory edema of bronchial mucosa.
D. Hypertrophy of the bronchial mucosa.
D. Increased sensitivity of the reflex zones of
E. Bronchial mucosa atrophy and detection
the mucous membrane of the large bronchi.
nerve endings in it.
E. Enlargement and deformation of bronchi.
111. Cough in chronic bronchitis indicates a
109. For patients with chronic bronchitis with a
violation of mucociliary transport, depending
primary defeating of the small bronchi are typi-
of the following factors:
cal the following features of appearance, physi-
A. Quantity and functional activity of ciliated
cal and hematologic signs:
epithelium of bronchial mucosa cells.
1. Hypersthenic physique with muscular, barrel
B. Quantitative and qualitative characteristics
chest, the pink color of the skin.
of the secretions of the mucous glands of the
2. Asthenic constitution, cyanosis of the mu-
bronchi.
cous membranes, weight loss.
C. Function of lung surfactant system.
3. Boxed shade percussion sound of light, low
D. All of the above
standing of diaphragma.
E. Right A and B.
4. Boxed pulmonary percussion sound.
112. Bronchial obstruction is detected by:
5. Reduced air and an abundance of different
A. Spirography, pneumotachography.
types of dry rales in lungs.
B. Bronchoscopy.
6. Weakening of breath and absence of rales in
C. Investigation of blood gases.
the lungs.
D. Plethysmography.
7. Polycythemia, increased hemoglobin.
E. Radiography.
74
113. The simplest device to determine airflow
C. Inhalation with oxygen.
obstruction is:
D. With Inhaled glucocorticosteroids.
A. Spirograph.
E. Inhalation of ß-blocker.
B. Peak flow meter.
116. Mucolytics, that destroyed the peptide
C. Plethysmograph.
bonds of proteins bronchial mucus, include:
D. Bronchoscope.
A. Trypsin, himopsin.
E. Pulse Oximeter.
B. Bacterial enzymes.
114. For patients with chronic bronchitis with a
C. Derivatives of thiols – acetylcysteine.
primary defeating of the largebronchi are typi-
D. Pulmonary surfactant system stimulants
cal the following features of appearance, physi-
(bromhexine, ambroxol)
cal and hematologic signs:
E. Correct A and B.
1. Hypersthenic physique with muscular, barrel
117. Reversible airflow obstruction compo-
chest, the pink color of the skin.
nents include all of these, except:
2. Asthenic constitution, cyanosis of the mu-
A. Bronchospasm.
cous membranes, weight loss.
B. Inflammatory edema of bronchial mucosa.
3. Boxed shade percussion sound of light, low
C. Dysfunction of mucociliary apparatus of the
standing of diaphragma.
bronchi.
4. Boxed pulmonary percussion sound.
D. Stenosis and obliteration of the lumen of the
5. Reduced air and an abundance of different
bronchi and them expiratory collapse.
types of dry rales in lungs.
E. Infiltration of the mucosa of bronchus walls,
6. Weakening of breath and absence of rales in
especially eosinophils.
the lungs.
118. The degree of airway obstruction corre-
7. Polycythemia, increased hemoglobin.
lates with:
8. Normal content of peripheral blood RBCs
A. The intensity of cough and quantity of spu-
and hemoglobin
tum.
A. Correct 1, 3, 5, 7.
B. The intensity of breath sounds over the lungs
B. Correct 1, 4, 5, 7.
and rales.
C. Correct 2, 3, 6, 8.
C. The data of spirography.
D. Correct 2, 3, 5, 7.
D. Correct B and C.
E. Correct 1, 4, 6, 7.
E. All of the above.
115. What test must be used to diagnose bron-
119. For obstructive chronic bronchitis in the
choconstriction by spirography and pneumo-
clinical picture are typical such signs:
tachography:
A. Bronchospasm.
A. Exercise stress.
B. Inflammation of the bronchial mucous
B. Inhalation of ß2-agonists and anticholinergic
membrane
agents.
transport.
75
and
impaired
of
mucociliary
C. Infection.
C. Bronchopneumonia.
D. Bronchial dyskinesia and expiratory col-
D. Respiratory failure and chronic pulmonary
lapse of small bronchi wall.
heart.
E. All the above.
E. Spontaneous pneumothorax.
120. In chronic bronchitis with mainly defeat-
124. For hypertension in the pulmonary circula-
ing of small bronchi occurrence of respiratory
tion in chronic bronchitis causes all of the
failure due with:
above, except:
A. Bronchospasm.
A. Spasm of small blood vessels of the pulmo-
B. Inflammation of the bronchial mucosa and
nary circulation due to parenchymal lung venti-
impaired of mucociliary transport.
lation violation.
C. Obliteration of the lumen of small bronchi
B. Obliteration of small vessels of the pulmo-
and clapping valve syndrome.
nary circulation due to the development of
D. Correct A and C.
pulmonary fibrosis.
E. All of the above.
C. Obliteration and collapse vessels of the pul-
121. For purulent bronchitis is typical such
monary circulation at emphysema and lung bul-
clinical symptoms:
lae formation.
A. Bronchospasm
D. Increased flexibility of the walls of the large
B. Inflammation of the bronchial mucosa and
vessels of the pulmonary circulation.
impaired mucociliary transport.
E. Extrathoracic deposit of blood, due to in-
C. Infection.
creased intrathoracic pressure and bronchial
D. All of the above.
obstruction.
E. Correct B and C.
125. Patients with chronic bronchitis most of-
122. Complications of chronic bronchitis are all
ten die from:
listed, except:
A. Pneumonia and pulmonary suppuration.
A. Dilatation and deformation of the bronchi-
B. Pneumonia and pulmonary-cardiac insuffi-
oles and small bronchi.
ciency.
B. Focal and diffuse pneumothorax.
C. Cardiopulmonary failure and pulmonary
C. Bullous emphysema.
hemorrhage.
D. Obliteration of small vessels of the pulmo-
D. Diastolic heart failure.
nary circulation and hypertrophy of the wall of
E. Pulmonary hemorrhage and pulmonary sup-
the right ventricle of the heart.
puration.
E. Lobal and segmental lung cirrhosis.
126. The most common infectious agents that
123. Complications of chronic bronchitis are all
cause exacerbation of chronic bronchitis, are:
listed, except:
A. Streptococcus pneumonia.
A. Hemoptysis.
B. Haemophilus influenza.
B. Pulmonary hemorrhage.
C. Staphylococcus and Streptococcus.
76
D. Association of staphylococcus and anaero-
E. All of the above.
bic asporogenous microorganisms.
130. For pneumonia, complicating the course
E. Correct A and B.
of chronic bronchitis, is typical:
127. The indications for antibiotic therapy in
A. The emergence after the exacerbation of
chronic bronchitis are:
bronchitis.
A. Exacerbation of the disease, accompanied
B. The frequent absence of a local physical
by the appearance of rales in the lungs.
symptoms.
B. Exacerbation of the disease, accompanied by
C. Defeated several segments in the depths of
strengthening of cough and increasing the
the lung.
auantity of sputum.
D. Tendency to a prolonged duration and recur-
C. Exacerbation of the disease, accompanied by
rence.
a strong cough and symptoms of bron-
E. All of the above.
chospasm.
131. In chronic obstructive bronchitis treatment
D. Exacerbation of the disease, accompanied
of the patient should be carried out:
by signs of infection.
A. Continuously.
E. All of the above.
B. In the period of acute illness.
128. Clinical signs of infectious complications
C. In the period of acute disease and a prophy-
of chronic bronchitis are all of the above, ex-
lactic course in spring and autumn.
cept:
D. In the period of remission.
A. Intoxication.
E. With the appearance of complications.
B. Nausea, vomiting.
132. In the selection of oral bronchospasmolyt-
C. Physical and radiological pneumonia symp-
ic drugs for patients with chronic obstructive
toms.
bronchitis FEV1 determined before obtain and:
D. Increased cough, increased sputum.
A. After 1 hour.
E. Appearance of bronchospasm.
B. After 5 min.
129. In appointing the patients with chronic
C. After 15 min.
bronchitis antibacterial agents, the choice of
D. After 30 min.
dose and method of injection should take into
E. After 3 hours.
account:
133. In the selection of inhalation bron-
A. The nature of the microflora of the tracheo-
chospasmolytics for patients with chronic ob-
bronchial secretions.
structive bronchitis FEV1 determined before
B. The sensitivity of microorganisms to chemo-
obtain and:
therapeutic drugs.
A. After 1 hour.
C. The concentration of the drug, that be estab-
B. After 5 min.
lished in the bronchial mucus.
C. After 15 min.
D. Patient’s tolerance to the drug to.
D. After 30 min.
77
E. After 3 hours.
C. Displacement of mediastinal organs to the
134. The weakening of the voice is typical for:
opposite side of defeated lung.
A. Bronchiectasis.
D. Weakening or absence of voice jitter over an
B. Exudative pleuritis.
area of pleural effusion.
C. Lung abscess in step of cavity.
E. All of the above.
D. Focal pneumonia.
139. Chest movement is symmetrical, box
E. Lobar pneumonia.
sound on percussion, weakened vesicular
135. Dry pleurisy accompanied by all symp-
breathing with prolonged exhalation, liver dull-
toms, except:
ness is shifted down. Your diagnosis:
A. Chest pain.
A. Hydrothorax.
B. Dry cough.
B. Pleural effusion.
C. Sweating.
C. Chronic obstructive pulmonary disease, em-
D. Subfebrile.
physema.
E. Acrocyanosis.
D. Focal pneumonia
136.The most effective method of detecting
E. Lobular pneumonia.
small amounts of fluid in the pleural cavity is:
140. In patient 55 years old was found backlog
A. X-ray (in the normal position - ortho posi-
of the right side of the chest at breathing, blunt-
tion).
ing below the third rib and weakened breathing
B. X-ray.
there. X-ray - displacement of the heart to the
C. Computer tomography.
left. Diagnosis:
D. Lateroskopiya (X-ray in lateroposition)
A. Pleural effusion.
E. Magnetic resonance tomography.
B. Lobar pneumonia.
137. Pleural exudate is determined by percus-
C. Emphysema.
sion when its volume not less than:
D. Pulmonary fibrosis.
A. 50 ml.
E. Pneumothorax.
B. 100 ml.
141. At the patient: chest form is normal, there
C. 200 ml.
is no displacement of the mediastinum, dull
D. 500 ml.
sound on percussion, voiced voiced bubbling
E. 1000 ml.
rales and distinct crepitus. Your diagnosis:
138. The main features of exudative pleuritis
A. Lobar pneumonia.
are:
B. Emphysema.
A. Dullness of percussion sound in the area of
C. Pneumothorax.
localization of pleural effusion.
D. Bronchiectasis.
B. Weakening of respiratory sounds at auscul-
E. Lung fibrosis.
tation of the lungs in the area of dullness.
142. The patient 15 years complains of cough
with 200 ml muco-purulent sputum with a
78
smell, coughing up blood, fever up to 38,2 °C,
D. Contains a high number of eosinophils.
shortness of breath. Cough often noted in
E. «Glassy».
childhood. During the last 5 years - annual ex-
147. The most informative method of detection
acerbation. Diagnosis:
of bronchiectasis is:
A. Bronchiectasis.
A. X-ray.
B. Pleural effusion.
B. Computed tomography.
C. Chronic lung abscess.
C. Bronchography.
D. Chronic bronchitis.
D. Angiography.
E. Polycystic of lung.
E. Magnetic resonance tomography.
143. Voiced bubbling rales are typical for:
148. Bronchoscopy should be carried out in:
A. Emphysema.
A. Atelectasis of lobe and segment of lung.
B. Lung abscess.
B. Acute lobar, segmental pneumonia.
C. Pneumonia.
C. Exudative pleuritis.
D. Bronchial asthma.
D. Acute lung abscess.
E. Congestion of blood in the pulmonary circu-
E. Correct A and D.
lation
149. Infectious agents that cause acute abscess
144. Amforic breathing is typical for:
and gangrene of the lung, penetrate to the lung
A. Focal pneumonia.
tissue mainly:
B. Bronchitis.
A. Through bronchi.
C. Bronchial asthma.
B. Through lymphatic vessels.
D. Lung abscess.
C. Through blood vessels.
E. Emphysema.
D. At the lung injury.
145. The weakening of the voice jitter is typical
E. All of the above.
for:
150. Diagnosis of acute lung abscess based on
A. Bronchiectasis.
the:
B. Exudative pleuritis.
A. Clinical signs (cough with allocation of a
C. Lung abscess in step of cavity.
large number of purulent sputum and others).
D. Focal pneumonia.
B. Results of laboratory examination of sputum
E. Lobar pneumonia.
(sputum with abundant pyogenic microflorA..
146. At the lung abscess sputum:
C. Clinical and radiological signs.
A. Has a thick consistency due to the presence
D. Results of instrumental studies (pneumota-
of pus.
chometry).
B. Has a viscous consistency due to the pres-
E. Results of angiography.
ence of mucus.
151. Clinical and X-ray examination can diag-
C. Has a liquid consistency due to the presence
nose acute lung abscess:
of blood plasma.
79
A. Since the start of lung inflammation and in-
C. Predominance of necrotic inflammatory
fection process.
changes in the lungs.
B. Since the formation of an abscess in the
D. Associated complications - hemoptysis and
lung.
pulmonary hemorrhage, acute pneumoempye-
C. After a penetration lung abscess to the bron-
ma, heart failure.
chial tree.
E. Absence of clinical and radiographic signs
D. All of the above.
of restriction inflammatory and necrotic pro-
E. Any one of the above cases.
cess in the lungs.
152. In a study of patients with acute lung ab-
156. Occurrence gangrene of lung mainly due
scess carried all of the above, except:
to:
A. General clinical research methods.
A. The impact of infectious factor-association
B. Bacteriological examination of sputum,
of pyogenic microflora and anaerobic asporog-
pulmonary abscess contents.
enous.
C. Bronchoscopy.
B. Local conditions for growing infection
D. Computer tomography.
agents.
E. Bronchography.
C. General factors, reducing organism re-
153. For violation of bronchial drainage in
sistance to infection.
acute lung abscess is typical:
D. Combination of all the above factors.
A. An Increase the abscess cavity.
E. Correct A and B.
B. Pulmonary atelectasis.
157. Complications of bronchiectasis can be all
C. The liquid level in the abscess cavity.
of these, except:
D. All of the above.
A. Cardiopulmonary diseases.
E. Correct A and C.
B. Hemoptysis and pulmonary hemorrhage.
154. Treatment of the patient with acute lung
C. Amyloidosis of internal organs.
abscess should be performed in:
D. Metastatic abscess and sepsis.
A. Outpatient setting.
E. Atherosclerosis of vessels of the pulmonary
B. Hospital therapeutic department.
circulation.
C. Hospital pulmonology department.
158. Decisive significance for the diagnosis of
D. Department of Thoracic Surgery.
bronchiectasis has:
E. Intensive care department.
A. Clinical and X-ray method.
155. Gangrene of the lung distinguishes from
B. Bronchoscopy.
acute abscess all of the above, except:
C. Bronchography.
A. Disease pathogens.
D. Pneumotachometry.
B. More severe course of the disease with pro-
E. Computer tomography.
gression of purulent necrotic process in the
159. Patients with bronchiectasis, usually fol-
lungs.
lowing these complains:
80
A. Fever, chest pain.
C. Hemoptysis, pulmonary hemorrhage.
B. Cough with sputum, more often in the morn-
D. Breathlessness.
ing.
E. All of the above.
81
Gastroenterology
1. Patient 54 years old, complains of a constant
4.A man 26 years old, complains of paroxysmal
dull pain in mesogastric area, weight loss, dark
abdominal pain, diarrhea with mucus and
blood in the stool, constipation. Throughout the
blood. Sick for 3 years, weight lost 14 kg. Ob-
year weight loss of up to 10 kg.In the blood: Er
jective: Pulse - 96/min, Blood pressure -110 /
- 3,5х1012/l; Hb - 87 g/l; L-12,6 х 109/l, SEC -
70 mm Hg., temperature -37,6 C. The abdomen
43 mm/hour. Diagnosis?
was soft, painful on palpation along the colon,
A. Cancer of transverse colon.
especially in the left. Irrigoscopy - colon nar-
B. Gastric ulcer.
rowed, haustrum absent, contours rough, fuzzy.
C. Chronic colitis.
Diagnosis?
D. Chronic pancreatitis.
A. Ulcer colitis.
E. Gastric Cancer.
B. Tuberculosis of intestines.
2. A patient of 52 years old, complains of a
C. Amoebic dysentery.
weakness, weight loss, aversion to meat eating.
D. Crohn's Disease.
Objectively: pale, in the area of the left subcla-
E. Irritable bowel syndrome.
vian palpable lymph node. In the analysis of
5.In The patient 60 years old, on the investiga-
blood – anemia. In gastric content – lactic acid.
tion was found a chronic autoimmune gastritis
Presented the clinical picture is most common
with secretory deficiency. What is the most
for:
recommended for this patient?
A. Gastric Cancer.
A. Gastric juice.
B. B12-deficiency anemia
B. De-nol.
C. Iron deficiency anemia.
C. Ranitidine.
D. Chronic atrophic gastritis.
D. Almagell.
E. Hodgkin's disease.
E. Venter.
3. Patient S., 55 years old, suffers from gastric
6. Man 40 years old, suffering from autoim-
ulcer for 10 years. Over the past 6 months
mune hepatitis. In the blood: total bilirubin - 42
weight lost for a 15 kg, epigastric pain from pe-
mmol/l, ALT – 2,3 mmol/l/h, AST – 1,8
riodic became to constant, appeared anorexia,
mmol/l/h. Which is the most effective treat-
aversion to meat eating. In the blood: Hb-92
ment?
g/l. Feces are dark brown. What is the compli-
A. Glucocorticoids, cytostatics.
cation of ulcer in this patient?
B. Antibacterial agents.
A. Bleeding.
C. Hepatoprotectors.
B. Pyloric stenosis.
D. Antiviral drugs.
C. Perforation.
E. Hemosorption, vitamins.
D. Penetration.
7. Patient complains dysphagia and malnutri-
E. Malignization.
tion. What method of laboratory and instrumen82
tal investigations is the most informative for the
neck. What disease of the esophagus is the
diagnosis?
most probably?
A. Contrast radiography of the esophagus.
A. Upper esophageal diverticulum.
B. Laryngoscopy.
B. Bifurcation of diverticulum.
C. Biochemical analysis of blood.
C. Cancer of the esophagus.
D. General blood test.
D. Benign esophageal tumors.
E. Determination of alpha – fetoprotein.
E. Mediastinitis.
8. Patient 50 years old, complains of dysphagia
11. In the patient N., during endoscopy ap-
over the year, which has steadily progressed
peared chest pain, nausea, shortness of breath.
and weight lost more than 25 kg. 20 years ago
Endoscopy had to stop. What examinations
patient incurs a subtotal gastrectomy. On theX-
should be carried out?
Ray esophagus study barium delayed near the
A. Contrast radiography and rentgenoscopy of
pear formations at the entrance to the esopha-
esophagus.
gus. What disease should be considered in the
B. Computer tomography.
first time?
C. ECG examination.
A. Sideropenic dysphagia.
D. Chest Fluorography.
B. Esophageal tumor.
E. Repeat endoscopy after anesthesia.
C. Hysteria.
12. Patient K., complains of heartburn, pain
D. Scleroderma.
during the passage of food in the lower part of
E. Stricture of esophagus.
the sternum, especially after receiving acidic
9. Patient complains of progressive dysphagia
and salty foods. On the objective examination
for two months with severe malnutrition. First
were found no changes of the internal organs.
there were difficulties to swallow solid food
What examinations should be carried out?
only, and later to swallow a liquid food too. Di-
A. Contrast radiography of the esophagus.
agnosis?
B. Analysis of gastric contents.
A. Cancer of the esophagus.
C. Radioscopy of gastrointestinal tract into the
B. Scleroderma.
Trendelenburg position.
C. Sideropenic dysphagia.
D. Endoscopy.
D. Tumor of the mediastinum
E. All of the above.
E. Esophageal diverticulum.
13. At the patient S., 41 years old were found
10.Patient complains of regurgitation remains
the peptic ulcer of the esophagus. What treat-
of food with an unpleasant odor, periodically
ment should be appointed?
violation of swallowing, drooling, weight lost.
A. The choice of treatment will depend on the
Sick for several years. Last time patient began
results of a biopsy.
to notice the tumor formation in the area of the
B. Conservative therapy.
83
C. The choice of treatment will depend on the
E. Chronic cholangitis.
condition of gastric secretion.
17. The patient 18 years old complains of epi-
D. Surgical treatment.
gastric pain after taking acidic food. Sick about
E. Conservative antacid treatment.
10 years. Objective: Tongue is coated of
14. Patient сomplains of paroxysmal pain be-
plaque, diffuse epigastric pain. Which of the
hind the breastbone, usually in the afternoon or
following groups of drugs should be included
in the evening, after a meal. Any changes de-
to the treatment of patient?
tected on the ECG. Preliminary diagnosis?
A. M-anticholinergics.
A. Diverticulum in the middle third of the
B. Beta – blockers.
esophagus.
C. Iron drugs.
B. Benign esophageal tumor.
D. M-cholinomimetics.
C. Diverticulum in the upper third of the
E. Blockers of proton pump.
esophagus.
18. In the patient on X-Ray were detected duo-
D. Cancer of the esophagus.
denal reflux and hypertrophy the folds of pylo-
E. Esophagitis.
ric department. In the analysis of stomach con-
15. In the patient N., 19 years old., on the X-ray
tents - free hydrochloric acid is absent in all
detected defect with clear smooth contours in
portions. Which drugs should be included in
the lower third of the esophagus. He complains
the treatment of the patient?
of dysphagia over 1 year. Preliminary diagno-
A. Antacids.
sis?
B. Drugs, that regulate gastric motility.
A. Benign tumor.
C. M – anticholinergics.
B. Cancer of the esophagus.
D. All of the above.
C. Varicose veins of the esophagus.
E. Gastricjuice.
D. Diaphragmatic hernia of the esophagus.
19. At a patient was diagnosed Menetries dis-
E. Mediastinal disease.
ease. What are the indications for surgical
16. Patient G., complains of blunt pain, that
treatment?
arise immediately after a meal and located in
A. Signs of malignancy.
the epigastric area. Periodical, the patient suf-
B. Frequent recurrences.
fers from heartburn, acid regurgitation. From
C. Acute phase.
anamnesis it is known that such complaints
D. Noeffectedtreatment.
were 6 years ago. What is the most probable
E. Appearance of erosions.
diagnosis?
20. To the gastroenterological department en-
A. Chronic gastritis.
tered patient K., 17, with diagnosis of chronic
B. Peptic ulcer.
antral gastritis with increased secretion and ac-
C. Chronic cholecystitis.
id-forming function, exacerbation phase. Anal-
D. Chronic pancreatitis.
ysis of gastric contents held two months ago.
84
What drugs should be included to the treatment
E. Protective mucosal barrier, hypoproduction
of this patient?
of HCl and pepsin, the active regeneration of
A. All of the following.
the mucous membrane, adequate blood supply.
B. Proton pump blockers.
23. Giant ulcers are those, that have a diameter
C. Metronidazol.
of:
D. Amoxicillin.
A. More than 30 mm;
E. M-anticholinergics.
B. More than 20 mm;
21. At a patient N. was chronic gastritis with
C. More than 10 mm;
preserved acid-secretory function in remission
D. More than 40 mm;
stage. What sanatorium is recommended for
E. More than 50 mm.
this patient and when?
24. M-anticholinergics include:
A. Zakarpatsky group of resorts, at any time of
A. Atropine, metacyl, chlorosis, cimetidine;
the year.
B. Metacin, atropine, gatrotsepin, pro-buntin;
B. Khmelnik in the summer time.
C. Atropine, platifelin, nizatidine, metacin;
C. Zakarpatsky group of resorts in the summer
D. Platifilin, atropine, ranitidine, hlorodil;
time.
E. Platifilin, atropine, metacyl, gastrocepin.
D. Morshyn in the cold season.
25. In patients with peptic ulcer at maximum
E. Southern coast of Crimea in the summer.
pentagastrin test revealed increased acid-
22. Protect factors of the gastric mucosa in-
forming function of the stomach. What indica-
clude:
tors indicate of this type of secretion?
A. The protective mucosal barrier, active re-
A. Juice volume (ml) 220; total acidity (titr.ed.)
generation of the mucous membrane, adequate
130; Free HCL (titr.ed.) 120; debit-time HCL
blood supply, antroduodenalnye acidic brake.
(mekv. / hour) 50.
B. The protective mucosal barrier, adequate
B. Juice volume (ml) 60; total acidity (titr.ed.)
motor-evacuation function, active regeneration
90; Free HCL (titr.ed.) 90; debit-time HCL
of the mucous membrane, antroduodenalny
(mekv. / hour) 50.
acidic brake.
C. Juice volume (ml) 220; total acidity (titr.ed.)
C. An adequate blood supply, adequate motoric
100; Free HCL (titr.ed.) 100; debit-time HCL
evacuation function, antroduodenalny acidic
(mekv. / hour) 80.
brake, active regeneration of the mucous mem-
D. Juice volume (ml) 180; total acidity (titr.ed.)
brane.
100; Free HCL (titr.ed.) 90; debit-time HCL
D. Active regeneration of the mucous mem-
(mekv. / hour) 50.
brane, adequate blood supply, antroduodenalny
E. Juice volume (ml) 240; total acidity (titr.ed.)
acid brake; hypoproduction of HCl and pepsin.
100; Free HCL (titr.ed.) 90; debit-time HCL
(mekv. / hour) 50.
85
26. The high frequency of the ulcers in the du-
29. Patient K, who for 5 years complains of in-
odenum observed of the following indicators of
termittent pain in the abdomen, on the colonos-
maximal histamine test:
copy detected defeatedmucosa as a "bridge"
A. Basal acidity>7-12 mekv / hour; the maxi-
with areas of healthy segments. What is the
mum acidity of> 35-40 mekv / hour.
most probable disease in a patient?
B. Basal acidity> 12-14 mekv / hour; the max-
A. Crohn's Disease.
imum acidity of> 40-45 mekv / hour.
B. Ulcerative colitis.
C. The basal acidity> 14-16 mekv / hour; the
C. Infectious colitis.
maximum acidity of> 45-50 mekv / hour.
D. Ischemic colitis.
D. The basal acidity> 14-16 mekv / hour; the
E. Diverticular disease.
maximum acidity of> 40-45 mekv / hour.
30. At the patient B., on examining observed
E. Basal acidity> 12-14 mekv / hour; the max-
changes on the skin (Erythema), swelling of the
imum acidity of> 45-50 mekv / hour.
joints, inflammation of the eyes, perianal dam-
27. What indicates at pyloric and duodenal ul-
age and pain on palpation of the colon. What is
cer?
the most probable disease in a patient?
A. H2 histamine receptor blockers, gas-
A. Ulcerative colitis.
trotsepin, antacid.
B. Polyarthritis.
B. H2 histamine receptor blockers, de-nol, ant-
C. Reiter's Syndrome.
acid.
D. Uveitis.
C. H2 histamine receptor blockers, antacid.
E. DOA.
D. Gastrotsepin, biogastron.
31. Woman G., 41, complains about the pres-
E. Reparants, H2 histamine receptor blockers,
ence of liquid feces (10-12 times a day) with
antacid.
mucus and blood, pain in the lower of abdo-
28. The patient with complaints of diarrhea and
men, weight loss of 4 kg for the last year. Suf-
blood in the stool. Colonoscopy revealed red-
fers from these complaints about a year. Diag-
ness, increased vulnerability, mucosal bleeding
nosis of acute infectious diseases were exclud-
throughout the colon and rectum to the pres-
ed. Objectively: the skin is dry, reduced elastic-
ence of fibrous layers. The histological study of
ity. Tongue is bright red, abdomen is soft, pal-
biopsies - inflammation of the colon mucosa
pation of the sigmoid colon is acutely painful.
with the presence of crypt abscesses. What is
Pulse 86 for 1 min., rhythmic. BP 100/60
the most probable disease in a patient?
mmHg In the feces were few amount of the liq-
A. Ulcerative colitis.
uid contents from the blood. What is the most
B. Crohn's Disease.
probable disease in patients?
C. Ischemic colitis.
A. Ulcerative colitis, a severe form.
D. Infectious colitis.
B. Crohn's Disease.
E. Hemorrhoids.
C. Diverticular disease.
86
D. Chronic enteritis.
C. Ulcerative Colitis.
E. Worm infestation.
D. Tuberculosis of intestines.
32. Patient S., 29, complaints of pain in the
E. Intestinal tumor.
stomach, diarrheaof 5-6 times a day with mu-
34. Patient S., 47 years, complains of weak-
cus and blood, emaciation, general weakness,
ness, dizziness, tachycardia, headache, sweat-
loss of working capacity. Sick for 4 years, peri-
ing, feeling hot, fever, weight loss. Over 20
odically 1-2 p. annual exacerbations. After
years suffers from chronic atrophic gastritis,
treatment, these changes disappear. On copro-
peptic ulcer with localization of ulcers in the
gram: pasty consistency of feces, alkaline reac-
gastric cardia. Therefore incurs subtotal gas-
tion, without mucus and blood. On microscopy
trectomy Billroth-II six months ago. Objective-
revealed muscle undigested fibers, starch
ly: skin pale, blood pressure 150/90 mm Hg,
grains, iodophilic flora, a large number of leu-
pulse 80 beats per minute, soft, satisfactory fill-
kocytes, erythrocytes, cells of the intestinal epi-
ing. Abdominal palpation is soft, not painful.
thelium. Fecal flora is negative for dysentery.
The liver is not large. Lungs, heart are normal.
What is the most probable disease in a patient?
What is the most probable disease in a patient?
A. Ulcerative colitis, relapsing course.
A. Stomach ulcer, inactive phase, the state after
B. Crohn's Disease.
subtotal gastrectomy Billroth-II, dumping syn-
C. Chronic pancreatitis, exacerbation.
drome.
D. Chronic enteritis.
B. Carbohydrate intolerance.
E. Carbohydrate untolerance.
C. Chronic enterocolitis, acute phase.
33. Patient S., 25 years old, complains of peri-
D. Toxic dilation of the colon.
odic dull pain in the right iliac area, intermittent
E. Food poisoning.
diarrhea, frequent bloating, low-grade fever,
35. Patient K., 48, 2 years ago was operated on
general weakness, intermittent pain in the
the gastric ulcer, complains of weakness, which
joints. Sick about 2 years.In anamnesis - ap-
occurs after 15 minutes after eating, tachycar-
pendectomy surgery. Objectively: abdomen is
dia, sweating, nausea, rumbling in the abdo-
moderately deflated, in the right iliac area is de-
men. On X-ray examination revealed accelera-
termined by tumor formation. On fibrocolonos-
tion of evacuation barium suspension and its
copy – thickening of folds of mucous mem-
rapid passage through the small intestine. What
brane and spinous protrusions of ileocecal de-
is the most probable disease in a patient?
partment, on the relief of the mucous mem-
A. Dumping syndrome.
brane are determined contrasting patches of
B. Exacerbation of chronic pancreatitis.
hyperemia, ileocecal junction narrowed. What
C. Afferent loop syndrome.
is the most probable disease in a patient?
D. Hypoglycemic syndrome.
A. Crohn's disease, a chronic course.
E. Peptic ulcer of anastomosis.
B. Chronic enterocolitis.
87
36. Patient S., was operated for peptic ulcer
D. Colon.
disease, complains of a strong sense of hunger,
E. Duodenum.
which is accompanied by pain in the epigastric
39. Patient 36, years old, complains of persis-
region, body tremors, hot flashes and palpita-
tent diarrhea, pain in the left iliac region during
tions, dizziness, sometimes with loss of con-
defecation, presence of fresh blood in the feces,
sciousness, which often occurs after a break in
fever. Objective: skin is dry, pallor and macer-
power or high physical exertion. What compli-
ation of the corners of the mouth, pain in the
cation should be suspected in a patient?
left meso and hypogastric regions. Choose pre-
A. Hypoglycemic syndrome.
liminary diagnosis:
B. Peptic ulcer of anastomosis.
A. Ulcerative colitis.
C. Dumping syndrome.
B. Crohn's Disease.
D. Diabetes mellitus.
C. Chronic colitis.
E. Afferent loop syndrome.
D. Whipple's Disease.
37. Patient K., 65 years old, complains of gen-
E. Colon tumor.
eral weakness, loss of appetite and constipa-
40. The syndrome of portal hypertension in-
tion. Objective: blood pressure 100/50 mm Hg,
cludes:
pulse 100 per minute. The skin is pale, on the
A. Varicose veins of the anterior abdominal
palpation of descending part of the colon is
wall, esophagus, anorectal region, splenomeg-
formation measuring 40 x 20 mm. HB- 72 g/l,
aly.
SEC-52 mm/hour. In feces: positive reaction
B. Ascites, varicose veins of the esophagus,
for occult blood. Which method of diagnosis is
abdominal wall.
the most informative for the verification of the
C. Jaundice, varicose veins of the esophagus,
final diagnosis?
abdominal wall.
A. Colonoscopy with biopsy.
D. Ascites, varicose veins of the abdominal
B. Ultrasonography.
wall, esophagus.
C. Irrigoscopy.
E. Jaundice, ascites, hepatomegaly, splenomeg-
D. Sigmoidoscopy.
aly.
E. Koprograma.
41. The degree of hepatocellular insufficiency
38. The patient complains of diarrhea 6-8 times
assessed on the following parameters:
a day with undigested food fragments. On ex-
A. Jaundice, ascites, encephalopathy, the level
amination revealed the pain in the umbilical re-
of serum albumin, prothrombin.
gion. Choose the organ, that authentically just
B. Jaundice, ascites, encephalopathy, the level
defeated:
of serum globulins, fibrinogen.
A. Small intestine.
C. Ascites, the level of bile acids, the level of
B. Stomach.
total protein, fibrinogen.
C. Pancreas.
88
D. Jaundice, ascites, fibrinogen, total level of
A. Elimination of provoking factors, reducing
protein.
the ammonia production and absorption in the
E. The level of serum globulins and albumin,
intestine, used drugs that improve neurotrans-
ascites, jaundice, prothrombin.
mitter balance.
42. Clinical signs of cholestasis syndrome in-
B. Elimination of provoking factors, reducing
clude:
the ammonia production and absorption in the
A. Skin itching, jaundice, malabsorption of fats
intestine, antibiotics.
and fat-soluble vitamins.
C. Detoxification activities, reducing the am-
B. Skin itching, jaundice, maldigestiya.
monia production and absorption in the intes-
C. Skin itching, jaundice, hepatomegaly.
tine, used drugs that improve neurotransmitter
D. Itching, jaundice, splenomegaly.
balance.
E. Skin itching, jaundice, anemia.
D. Elimination of provoking factors, anticon-
43. Choose symptoms of hepatic encephalopa-
vulsants appointment, used drugs that improve
thy:
neurotransmitter balance.
A. Movement disorders, mental disorders, dis-
E. Elimination of provoking factors, reducing
orders of consciousness.
the ammonia production and absorption in the
B. Hepatic smell, consciousness disorder,
intestine, used the diuretic.
movement disorders.
46. Treatment of ascites in liver cirrhosis in-
C. Hepatic smell, loss of consciousness, jaun-
cludes:
dice.
A. Spironolactone + loop diuretics, sodium re-
D. Jaundice, hepatic smell, movement disor-
striction of the use of high-protein diet.
ders.
B. Limit sodium intake, loop diuretics, bed rest
E. Movement disorders, mental disorders,
C. Aldosterone antagonist, bed rest, high-
jaundice.
protein diet.
44. Choose drugs that are used for the treatment
D. Limit sodium intake, spironolactone, bed
itching of skin in patients with chronic liver
rest.
disease:
E. Limit sodium intake, high-protein diet, bed
A. Cholestyramine, phenobarbital, ursodeoxy-
rest.
cholic acid.
47. The most effective groups of drugs in the
B. Rifampicin, phenobarbital, deoxycholic ac-
treatment of chronic active hepatitis are:
id.
A. Corticosteroids, immunosuppressants.
C. Cholestyramine, alohol, phenobarbital.
B. Immunosuppressants, hepatoprotectors.
D. Holestiramin, essentiale, phenobarbital.
C. Immunosuppressants, cyclosporin A.
E. Holestiramin, prednisolone, essential.
D. Hepatoprotectors, glucocorticosteroids.
45. The treatment of hepatic encephalopathy
E. Cyclosporine A, glucocorticosteroids.
includes:
89
48. Patient G., 44 years old, complains of a
50. Patient K., 22 years old, complains of pain
sharp general weakness, feeling of heaviness in
in the right upper quadrant, nausea, decreased
the right upper quadrant, weight lost, constant
appetite. In history - appendectomy 3 years
nausea, bleeding of gums, drowsiness. From
ago. Jaundice appeared after 2 months after
history we know, that patient abuses alcohol.
surgery. After 1 year was appeared pain in the
Objectively: dry skin, icteric sclera and skin, on
right upper quadrant, enlarged dense liver, liver
the skin of the face and shoulder girdle are
function tests are negative. What disease is the
"spider veins". The abdomen is deflated, soft,
most probable in the patient?
no tenderness, liver enlarged for 6 cm, painful.
A. Chronic persistent hepatitis.
Spleen enlarged for 2 cm. What is the most
B. Gallstone disease.
probable disease in a patient?
C. Chronic cholecystitis.
A. Chronic active hepatitis of alcoholic origin.
D. Liver cirrhosis.
B. The "Congestive liver".
E. Liver cancer.
C. Budd-Chiari syndrome.
51. Patient S., 44 years old, complains of peri-
D. Leukemia.
odic paroxysmal pain in the right upper quad-
E. Alcoholic cirrhosis.
rant, which occurs after physical exercises and
49. Patient B., 36 years old, complains of jaun-
errors in diet, nausea, bitter taste in mouth, ten-
dice, itching, nausea, pain and feeling of heavi-
dency to constipation. In the history is jaundice.
ness in the right upper quadrant, increased body
On examination: tongue coated with white
temperature, bleeding of gums. He was treated
bloom. On palpation the liver is not enlarged,
on an outpatient basis over cholecystitis. The
pain in point Kera, positive Ortner symptom.
skin and the sclera is icteric, eyelids xan-
During duodenal sensing the second portion
thelasma. The abdomen was soft, painful on
(B) is absent. On the cholecystography
palpation in the right upper quadrant and point
gallbladder is not contrasts. What is the prelim-
Kera. Liver enlarged from 4 cm, painful edge,
inary diagnosis of the patient?
smooth, spleen is not enlarged. On the duode-
A. Chronic calculous cholecystitis.
nal sounding were found elements of inflam-
B. Sclerosing cholangitis.
mation in the portion B and C. In the biochemi-
C. Head of pancreas cancer.
cal analysis of blood – hyperbilirubinemia and
D. Sphincter of Oddi cancer.
in the urine - bile pigments. What disease is the
E. Duodenitis.
most probable in the patient?
52. Patient P., 54 years old, complains of a con-
A. Chronic cholestatic hepatitis.
stant dull pain in the right upper quadrant and
B. Chronic cholecystitis.
epigastric, nausea, low-grade fever, general
C. Liver cirrhosis.
weakness. 10 years ago she suffered from a vi-
D. Liver Cancer.
ral hepatitis. On examination, the abdomen en-
E. Hemolytic anemia.
alarged due to ascites, painful on palpation in
90
the right upper quadrant. The liver enlarged at 6
109/l, ESR-54 mm / hour. Your preliminary di-
cm from under the costal arch, rounded, painful
agnosis:
and thick edge. The spleen is palpated of 4 cm
A. Metastatic liver cancer.
below the edge of the left costal arch. Your pre-
B. Chronic persistent hepatitis.
liminary diagnosis:
C. Liver cirrhosis.
A. Liver cirrhosis.
D. Hypochromic anemia.
B. Chronic cholecystitis, exacerbation.
E. Ehinocock liver.
C. Chronic persistent hepatitis.
55. Patient K., 46 years old, complains of pain
D. Liver cancer.
in the right upper quadrant, which is enhanced
E. Cancer head of pancreas.
after eating greasy fried food, bitter taste in the
53. Patient N., 52 years old, complains of par-
mouth. Frequent bouts of pain over the last
oxysmal abdominal pain, mostly in the right
years. After one of the attacks appeared the fe-
upper quadrant, which is radiating to the right
ver, jaundice and discolored of feces. In re-
shoulder, nausea, bitter taste in the mouth after
viewing severe jaundice, especially on the scle-
oily and spicy food. Sick over 7 years. Objec-
ra. Frenikus phenomenon is positive. Painful-
tively: the sclera is icteric. In the right upper
ness in the point of Musso. The abdomen is not
quadrant, especially clearly in the position of
swollen, not painful, except the right hypo-
the patient on the left side, was palpable painful
chondrium. The liver was not palpable due to
gall bladder. On the duodenal sounding bile
the muscular protection. In the urine reaction of
portion B is not obtained. On the cholecys-
the bile pigments is strongly positive. Total bil-
tography
irubin in blood – 142 umol/l, direct bilirubin –
gallbladder is not contrasts. Your
preliminary diagnosis:
110 umol/l, indirect bilirubin – 32 mmol/l.
A. Gallstone disease.
Transaminases: ASAT 0,46 mmol /l, ALAT 0,6
B. Gallbladder hydrops.
mmol /l. What is the probable disease in pa-
C. Chronic noncalculous cholecystitis.
tient?
D. Sclerosing cholangitis.
A. Chronic calculous cholecystitis in acute
E. Sphincter of Oddi cancer.
jaundice.
54. Patient A., 62 years old, complains of in-
B. Acute cholecystitis.
creasing weakness, absence of appetite and
C. Acute pancreatitis.
pain in the right upper quadrant and epigastric
D. Chronic hepatitis.
pain, weight loss, itchy skin. In reviewing: ic-
E. Sclerosing cholangitis.
teric skin with an earthy shade, dry with
56. Patient B., 49 years old, complains that
scratching. On palpation liver has rocky density
bloody vomiting, heaviness in the left upper
with protruding from under the edge of the cos-
quadrant, anorexia and weakness. Prior abused
tal arch for 7 cm. Blood test: HB- 90 g/l, L - 6 x
alcohol. He considers himself a patient about
40 years old when first appeared jaundice. For
91
10 years, he was treated in the infectious ward,
vomiting, without bettering. Acutely ill. In his-
and then in the therapeutic. In reviewing: skin
tory - chronic cholecystitis, tried outpatient
and visible mucous membranes yellow, "spider
treatment, six months ago suffered from acute
veins" above the collarbone. Subcutaneous fat
pancreatitis. In reviewing: 37,4 C fever, jaun-
and muscle system is developed enough (height
dice of the sclera, tongue dry. The abdomen is
167 cm, weight 54 kg). Systolic murmur over
deflated, palpation symptoms of peritoneal irri-
all points. Abdomen enlarged in size, "Head of
tation are absent, colon segments unpainful,
Medusa", bulging belly button. Determined as-
pain in Chauffard area, positive Ortner symp-
cites. Liver sharp, not painful, + 2 cm. The
tom, the liver is enlarged, the edge is thickened,
spleen is significantly enlarged, not painful.
pain in point Kera, Courvoisier symptom is
Blood test: HB - 84 g/l, leukocytes - 3 x 109,
negative. Your preliminary diagnosis:
9
platelets - 90 x 10 /l. What is a probable dis-
A. Chronic pancreatitis in acute phase, painful
ease in a patient?
form.
A. Portal cirrhosis.
B. Chronic calculous cholecystitis, acute phase.
B. Chronic hepatitis.
C. Cancer of the pancreas head.
C. Liver cancer.
D. Sclerosing cholangitis.
D. Budd-Chiari syndrome.
E. Chronic gastritis, acute phase.
E. Chronic lymphocytic leukemia.
59. Patient T., 29 years old, complains of pain
57. Patient K., 24 years old, complains of an
in the abdomen, which appeared sharp and
enlarged abdomen. In the history of abdominal
weakness. Throughout the night the pain was
trauma 2 years ago. After 8 months appeared
localized in the epigastrium at the xiphoid pro-
ascites. Treated diuretic, there was no effect. In
cess, extended to the left upper quadrant and
reviewing the stomach greatly enlarged pro-
the lower back. In the morning there was a re-
truding navel, percussion free fluid, liver + 3
peated vomiting with bile, which does not bring
cm, not painful. Blood test: erythrocytes – 4.8 x
relief, diarrhea. In reviewing: pale skin, pulse
1012/l, Hb – 140 g/l, leukocytes – 6,8 x 109/l,
110 in 1 minute, rhythmic, soft, BP 85/40
ERS – 10 mm/hour. What is a probable disease
mmHg. Sharply expressed epigastric pain, es-
in a patient?
pecially on the left. Painfulness in the Mayo-
A. Budd-Chiari syndrome.
Robson point. The temperature - 38,5 C. Blood
B. Tumor of the liver
test: leukocytes – 10,2 x 109/l, erythrocytes - 7
C. Cirrhosis of the liver.
x 1012/l, stab shift to the left, ERS - 36 mm /
D. Tuberculosis peritonitis.
year.
E. Chronic lymphocytic leukemia.
A. Acute pancreatitis.
58. Patient P., 51 year, complains of pain in the
B. Chronic pancreatitis, acute phase.
area of the right hypochondrium, which radi-
C. Chronic cholecystitis, acute phase.
ates to the left hypochondrium section, nausea,
D. Cancer the head of pancreas.
92
E. Sclerosing cholangitis.
A. The syndrome of exocrine pancreatic insuf-
60. Patient S., 50 years old, complains of mod-
ficiency.
erate pain in the upper abdomen more pro-
B. The syndrome of endocrine pancreatic insuf-
nounced in the left hypochondrium, worse after
ficiency.
a meal. Suffers from diarrhea. On the X-ray
C. Dyspeptic syndrome.
study of the abdomen are multiple calcinates at
D. Maldigestion syndrome.
the pancreas area.
E. Dysbacteriosis.
A. Chronic calcific pancreatitis with severe ex-
63. The patient in 42, complains of pain in the
ocrine pancreatic insufficiency.
area of the left hypochondrium, which radiates
B. Chronic calculous cholecystitis, acute phase.
to the back, poor tolerance of milk products,
C. Cancer the head of pancreas.
flatulence, the presence of undigested food in
D. Chronic enterocolitis, acute phase.
the feces. Objectively: Pulse 100 in a minute,
E. Pancreatic cysts.
rhythmic. Positive symptom of Musso-
61. Patient K., 56 years old, complains of loss
Georgievskiy, Mayo-Robson. Which method is
of appetite, intolerance to milk products, fatty
the most informative for the verification of the
foods, and sometimes nausea, frequent bloat-
diagnosis?
ing. There is a diarrhea, the remnants of undi-
A. Ultrasound, coprogram, enzymes in duode-
gested food in the feces. In reviewing: multiple
nal contents.
telangiectasias marked by the type of "blood
B. Radiography of the abdominal organs.
dew". Ultrasound detected signs of liver steato-
C. Cholecystography.
sis, diffuse sclerotic changes in the pancreas,
D. Analysis of fecal for dysbacteriosis.
concrements in both kidneys. In a laboratory
E. Gregersen reaction.
study were found steatorrhea, kreatoreya, am-
64. X-ray examination of the digestive tract
ylase activity in urine by Wohlgemuth - 4 OD.
within 12 hours after taking barium suspension
A. Chronic sclerosing pancreatitis.
evaluates all of the above, except:
B. Chronic calculous cholecystitis, acute phase.
A. Condition of the colon.
C. Chronic enterocolitis, acute phase.
B. Condition of the ileocecal region.
D. Cyst of pancreas.
C. Duration of the passage of barium suspen-
E. Chronic hepatitis.
sion through the digestive tract.
62. Patient K., complains about the intolerance
D. Condition of the duodenum.
of many products, especially milk, raw fruits
E. Condition of the rectum.
and vegetables, hot spices, hot and cold food,
65. On the X-ray of the stomach was detected a
such symptoms as flatulence and massive
niche on the small curvature of the stomach up
evacuation with kreato-, amyloid- and steator-
to 1 cm in diameter, surrounded the infiltrating
rhea. What is the most probable syndrome in a
was a symmetrical oval with elastic walls. For
patient?
93
what disease these changes are the most typi-
69. The most important etiological factor of
cal?
peptic ulcer disease of duodenum is:
A. Ulcer in uncomplicated peptic ulcer.
A. Helicobacter Pilory.
B. Penetrating ulcer.
B. Smoking.
C. Malignancy ulcer.
C. Eating disorders.
D. Infiltrative-ulcerous cancer.
D. Emotional stress.
E. Erosive gastritis.
E. Alcohol.
66. On the X-ray of the stomach were detected
70. The most important local mechanisms for
a sandwich niche, serving for a stomach con-
gastric ulcerogenesis is:
tour, scar deformity of the stomach and in-
A. Motor-evacuation disorders.
flammation transformation of the mucous
B. Acid-peptic factor.
membrane. For what disease these changes are
C. Condition of the protective mucosal barrier.
the most typical?
D. Back diffusion of hydrogen ions.
A. Acute stomach ulcer.
E. The balance of acid-peptic factor and condi-
B. Penetrating ulcer.
tion of protective mucosal barrier.
C. Malignancy of gastric ulcer.
71. The pathogenetic factors of peptic ulcer of
D. Infiltrative-ulcerous cancer.
duodenum are all listed, expect:
E. Perforated ulcer.
A. Acid-peptic factor.
67. On the X-ray of the stomach was detected a
B. Accelerated evacuation.
flat niche in the gastric antrum, 2,5 cm in diam-
C. "Acidic" stasis in the duodenum.
eter, with irregular form and large aperistaltic
D. Smoking.
area around. For what disease these changes are
E. Increased mucoproteid secretion.
the most typical?
72. Helicobacter pylori infection promotes the
A. Uncomplicated ulcer of gastric antrum.
development of pathological conditions, ex-
B. Penetrating ulcer.
cept:
C. Malignancy ulcer.
A. Pyloroantral ulcers of the stomach.
D. Perforated ulcer.
B. Ulcers of the duodenal bulb.
E. Erosive cancer in the early stages.
C. Ulcers of the stomach cardia.
68. Hereditary predisposition is most common
D. Postbulbar ulcers.
for the following gastroenterological diseases:
E. Chronically antral gastritis.
A. Peptic ulcer disease of duodenum.
73. The mechanism of pain in peptic ulcer of
B. Calculous cholecystitis.
the duodenum due to all factors, except:
C. Pancreatitis.
A. Acid-peptic factor.
D. Biliary dyskinesia.
B. Spasm of pyloroduodenalzone.
E. Chronic atrophic gastritis.
C. Increasing the pressure in the stomach and
duodenum.
94
D. Perivisceritis.
B. Exacerbation of peptic ulcer disease.
E. Violation of the IgA production.
C. Ulcers malignancy.
74. For peptic ulcer of duodenal are typical all
D. Ulcer penetration.
listed, except:
E. Ulcer perforation.
A. "Hungry" pain in the epigastric region.
78. The production of hydrochloric acid are re-
B. Night pain.
duced by all drugs, expect:
C. Pain within 1,5 - 2 hours after meal.
A. Ranitidine.
D. Pain within 15 to 20 minutes after meal.
B. Gastrotsepin.
E. Heartburn.
C. De nol.
75. For postbulbar ulcer is typical all listed, ex-
D. Omeprazole.
pect:
E. Creon.
A. Pain within 3-4 hours after meal.
79. Aluminum gel therapy often causes:
B. Pain with radiating to the left and/or right
A. Hypercalcemia.
hypochondrium.
B. Hypocalcaemia.
C."Throbbing" pain.
C. Hyperphosphatemia.
D. Bleeding.
D. Hypophosphatemia.
E. Pain within 15-20 minutes after meal.
E. Hypermagniemia.
76. The patient, long suffering from peptic ul-
80. From anti-ulcer agents for the treatment of
cer with localization in the stomach, com-
pyloroduodenal ulcers the most effective is:
plainsof weakness, nausea, loss of appetite,
A. Gastrocepin.
constant epigastric pain, weight loss. What
B. Ranitidine.
complication of peptic ulcer disease is ap-
C. Omeprazole.
peared?
D. Dalargin.
A. Stenosis of the output of the stomach.
E. Atropine.
B. Ulcers malignancy.
81. Cytoprotective effect against the gastric and
C. Ulcer penetration.
duodenal mucosa has:
D. Bleeding.
A. De-nol.
E. Ulcerperforation.
B. Sucralfate.
77. The patient, long suffering from peptic ul-
C. Atropine.
cer with localization in the bulb of duodenum,
D. Vitamins.
recently changed the clinical picture: there is
E. De-nol and sucralfate.
heaviness after eating, nausea, profuse vomit-
82. Gastric ulcer on the background of a four-
ing of food, foul breath, weight loss. What
week treatment were not cicatrized, saved the
complication of peptic ulcer disease is ap-
pain in the epigastric, decreased appetite,
peared?
weight loss. Further tactics of the patient in-
A. Organic stenosis of pyloroduodenal zone.
cludes:
95
A. Continuation of previous treatment.
C. Constant dull pain, not associated with food
B. Entering correction to the treatment.
intake.
C. Endoscopy with biopsy and histological ex-
D. Epigastric pain occurring on an empty stom-
amination.
ach and 2-3 hours after a meal.
D. Surgical treatment.
E. Pain in 30 minutes after a meal.
E. Ultrasound examination of the gastrointesti-
87. Which signs are not typical for acute peptic
nal tract.
ulcer disease of duodenum?
83. Symptomatic gastroduodenal ulcers are all
A. Pain on an empty stomach.
listed, expect:
B. Pain in 30 minutes after a meal.
A. Stressful.
C. Pain in 1,5-2 hours after a meal.
B. Endocrine.
D. Pain on the right of epigastric.
C. Postbulbar.
E. Heartburn, acid regurgitation.
D. Ulcers in pathological conditions of other
88. Drug ranitidine is:
internal organs.
A. H2-blocker.
E. Medication ulcers.
B. Total anticholinergic.
84. Medication ulcers are caused by the follow-
C. Topical anticholinergic.
ing medicines, expect:
D. Antacid.
A. Corticosteroid.
E. Miotonik.
B. Pancreatin.
89. To pick up the characteristic for amagel:
C. Indomethacin.
A. H2-blocker.
D. Reserpine.
B. Total anticholinergic.
E. Aspirin.
C. Topical anticholinergic.
85. Peptic ulcer usually occurs at the age of:
D. Antacid.
A. 10-20 years old.
E. Miotonik.
B. 20-30 years old.
90. In a patient with long-term course of gastric
C. 10 years old.
ulcer appeared almost constant pain radiating to
D. After 40 years old.
the back. What complication can be assumed?
E. 30-40 years old.
A. Pyloric stenosis.
86. What nature of the pain is associated with
B. Penetration.
duodenal peptic ulcer disease?
C. Malignancy.
A. Dull, pressing pain of the epigastric, worse
D. Perforation.
after a meal.
E. Dumping syndrome.
B. Colicy aching pain in the right hypochondri-
91. At what disease acid-secretory function of
um radiating to the right shoulder, worse after
the stomach is decreased?
taking fat.
A. Chronic antrum gastritis.
B. Chronic atrophic gastritis.
96
C. Chronic hypertrophic gastritis.
D. Secretin.
D. Zollinger-Ellison syndrome.
E. Intrinsicfactor.
E. All of these forms.
97. Which of the following symptoms can con-
92. Which method is the most reliable to ex-
firm the penetration of peptic ulcer?
clude malignancy of gastric ulcers?
A. The appearance of the night pain.
A. X-ray.
B. Decrease effectiveness of antacids.
B. Endoscopic.
C. The appearance of back pain.
C. Analysis of feces for occult blood.
D. Increased pain and changes in the character-
D. Analysis of gastric juice by histamine.
istic rhythm of pain.
E. Endoscopy with biopsy.
E. Melena.
93. Patient, suffering from gastric ulcer, in the
98. Gastrin is secreted by:
period of the next exacerbation complains of
A. Antrum.
burping by "rotten egg", vomiting of food, eat-
B. Fundic of stomach.
en food the day before. What complication oc-
C. Duodenalmucosa.
curred in a patient?
D. Brunnerovglands.
A. Penetration.
E. Pancreas.
B. Perforation.
99. The acidity of the gastric juice does not re-
C. Bleeding.
duce by:
D. Pyloric stenosis.
A. Somatostatin.
E. Malignancy.
B. Secretin.
94. Kreatoreya is most typical for:
C. Glucagon.
A. Functional dyspepsia.
D. Insulin.
B. Putrid dyspepsia.
E. All are wrong.
C. Exocrine insufficiency of the pancreas.
100. There are following types of gastric secre-
D. Superficial gastritis.
tion, except:
E. Peptic ulcer.
A. Excitable.
95. Gastric mucosa parietal cells secrete:
B. Asthenic.
A. Hydrochloric acid.
C. Continuous.
B. Lactic acid.
D. Brake.
C. Biermerin.
E. Inert.
D. Castel factor.
101. General principles of treatment of func-
E. Hydrochloric acid and Castel factor.
tional disorders of the stomach include:
96. Additional gastric mucosa cells secrete:
A. Split meal.
A. Mucin.
B. Psychotherapy.
B. Bicarbonates.
C. Physiotherapy.
C. Gastrin.
D. Reflexology.
97
E. All of the above.
106. Upon detection of Helicobacter pylori in
102. The main diagnostic method, that allows
chronic gastritis are recommended all listed,
to verify the diagnosis of chronic gastritis is:
expect:
A. Analysis of gastric juice.
A. De-nol.
B. Gastric radioscopy.
B. Metronidazole.
C. Duodenal probing.
C. Ampicillin.
D. Morphological investigation of the gastric
D. Pancreatin.
mucosa.
E. Omeprazole.
E. Ultrasonography.
107. Physical therapy in the treatment of gastri-
103. What is the nature of the pain associated
tis indicates for:
with peptic ulcer of duodenum?
A. Rigidity antral gastritis.
A. Dull, pressing pain in the epigastric, worsen-
B. Polyposis gastritis.
ingafter a meal.
C. Hemorrhagic gastritis.
B. Colicy aching pain in the right hypochondri-
D. Erosive gastritis.
um radiating to the right shoulder while taking
E. Atrophic gastritis.
fat.
108.
C. Constant dull pain, not associated with food
drugs include:
intake.
A. Constipation.
D. Epigastric pain occurring on an empty stom-
B. Slowing of gastric emptying.
ach and 2-3 hours after a meal.
C. Hypokinetic dyskinesia of the gallbladder.
E. Pain in 30 minutes after a meal.
D. Atropin resistens hyperchlorhydria.
104.
E. All of the above.
Drug treatment of chronic atrophic gas-
Contraindications
to
anticholinergics
tritis includes all listed, except:
109. Effective drugs with enzyme action are:
A. Knitting and enveloping drugs.
A. All of the above.
B. Methyluracilum.
B. Pancreatin.
C. Antibiotics.
C. Mezimforte.
D. Replacement therapy.
D. Festal.
E. Reparants.
E. Panzinorm.
105.To improve the trophic processes in chron-
110. The most informative method for identify-
ic atrophic gastritis recommended:
ing the tumor processes in the pancreas is:
A. Methyluracilum.
A. X-ray examination of the stomach and intes-
B. Solkoseril.
tines with barium suspension.
C. Sea buckthorn oil.
B. CT scan.
D. Tranquilizers.
C. Intravenous cholegraphy.
E. Vitamins group B.
D. Retrograde cholangiopancreatography.
E. Relaxation duodenography.
98
111. α-amylase secreted by:
D. Increased activity of aminotransferases.
A. Parotid salivary gland.
E. Hepatomegaly.
B. Pancreas.
117. The most informative method for diagno-
C. Intestines.
sis the pathology of the pancreas is:
D. Parotid salivary glands and the pancreas
A. X-ray.
E. Everything is wrong.
B. CT scan.
112.
α -amylase catalyses hydrolysis of:
C. Ultrasound.
A. Starch.
D. Celiac trunk angiography.
B. Glucose.
E. Portal vein angiography.
C. Disaccharides.
118. What is the most actively stimulates the
D. Fiber.
secretion of pancreatic juice?
E. All the above.
A. Somatostatin.
113.Trypsin activity increased in serum at:
B. Gastrin.
A. Acute pancreatitis.
C. Secretin.
B. Exacerbation of chronic pancreatitis.
D. Cholecystokinin.
C. Peptic ulcer disease.
E. Everything is wrong.
D. Peritonitis.
119. The forms of chronic pancreatitis include:
E. Acute pancreatitis or exacerbation of chronic
A. Calcifying.
pancreatitis.
B. Obstructive.
114. Kreatoreya observed in:
C. Cysts, pseudocysts.
A. Ahilia.
D. Fibro-sclerotic.
B. Putrid dyspepsia.
E. All of the above.
C. Exocrine insufficiency of pancreas.
120. For patients with chronic pancreatitis with
D. All is correct.
a latency course indicates:
E. Everything is wrong.
A. Common complete diet.
115. Steatorrhea with a neutral fat is typical for:
B. Diet with a predominance of fat.
A. Jaundice.
C. Diet with a predominance of carbohydrates.
B. Parenchymal jaundice.
D. Moderate carbohydrate-protein diet.
C. Chronic pancreatitis.
E. A diet with a high content of iron.
D. All is correct.
121.
E. Everything is wrong.
remission phase recommended:
116. The typical clinical sign of chronic pan-
A. Corticosteroids.
creatitis is:
B. Contrycal (trasilol).
A. The development of diabetes mellitus.
C. Enzyme drugs.
B. Reduction of exocrine function.
D. None of these drugs.
C. Jaundice.
E. All of these drugs.
99
To treat the chronic pancreatitis in a
122.
significant weight loss. The liver and spleen are
In acute pancreatitis and chronic pain
syndrome complex therapy includes:
not enlarged. Normal temperature. Hemoglobin
A. Baralgin.
- 96 g/l, leukocytes – 9,5 * 109/l, erythrocyte
B. Contrycal (trasilol) or Gordoks.
sedimentation rate - 60 mm/hour, general bili-
C. Liquid antacids.
rubin – 34,2 mmol/l (direct – 5,2). The activity
D. Blockers of histamine H2-receptor.
of amylase of blood and urine, blood sugar lev-
E. All of the above.
els are in the normal range. What diagnostic
123.In the acute phase of chronic pancreatitis
method should be used to set the correct diag-
with the syndrome of "evasion enzymes" drug
nosis:
therapy includes:
A. Duodenal sounding.
A. M-anticholinergics Gastrocepin.
B. Ultrasonography.
B. Enzyme drugs.
C. X-ray examination.
C. Antifermental drug Trasylol or Contrikal.
D. Cholecystography.
D. Almagel in large dosage.
E. Ultrasound and X-ray examination.
E. Gastrocepin.
127. The patient was 65 years old, suffers from
124. Effective drugs with enzyme action do not
a chronic persistent pancreatitis. Over the last
include:
6-8 months has changed the nature of pain,
A. Holenzim.
worsened appetite, vomiting, periodically ap-
B. Pancreatin.
peared jaundice, discolored feces, general
C. Mezim forte.
weakness. In a hospital were icteric of the skin,
D. Festal.
paleness of the visible mucous membranes,
E. Panzinorm.
significant weight loss. The liver and spleen are
125.Chronic recurrent pancreatitis occurs more
not enlarged. Normal temperature. Hemoglobin
often in:
- 96 g/l, leukocytes – 9,5 * 109/l, erythrocyte
A. Peptic ulcer disease.
sedimentation rate - 60 mm/hour, general bili-
B. Cholelithiasis.
rubin – 34,2 mmol/l (direct – 5,2). The activity
C. Syndrome after resection of stomach.
of amylase of blood and urine, blood sugar lev-
D. Chronic colitis.
els are in the normal range. What diagnosis can
E. Giardiasis.
be suspected first of all:
126.The patient was 65 years old, suffers from
A. Pancreas cancer.
a chronic persistent pancreatitis. Over the last
B. Cancer of the major duodenal papilla (Vater
6-8 months has changed the nature of pain,
papilla).
worsened appetite, vomiting, periodically ap-
С. Pseudotumor form of chronic pancreatitis.
peared jaundice, discolored feces, general
D. Correct: cancer and pseudotumor form of
weakness. In a hospital were icteric of the skin,
chronic pancreatitis.
paleness of the visible mucous membranes,
100
E. Correct: pancreatic cancer and cancer of the
131. Intravenous cholecystography is an in-
major duodenal papilla (Vater papilla).
formative method for diagnosis:
128. The patient was 65 years old, suffers from
A. Dilatation of common bile duct.
a chronic persistent pancreatitis. Over the last
B. Chronic calculous cholecystitis.
6-8 months has changed the nature of pain,
C. Chronic active hepatitis.
worsened appetite, vomiting, periodically ap-
D. Dilatation of the common bile duct and
peared jaundice, discolored feces, general
chronic calculous cholecystitis.
weakness. In a hospital were icteric of the skin,
E. All of the above.
paleness of the visible mucous membranes,
132.
significant weight loss. The liver and spleen are
include are all of these, except:
not enlarged. Normal temperature. Hemoglobin
A. Deholin.
9
Drugs, increasing the secretion of bile
- 96 g/l, leukocytes – 9,5 * 10 /l, erythrocyte
B. Allohol.
sedimentation rate - 60 mm/hour, general bili-
C. Xylitol.
rubin – 34,2 mmol/l (direct – 5,2). The activity
D. Holenzim.
of amylase of blood and urine, blood sugar lev-
E. Hologon.
els are in the normal range. The diagnosis will
133. Urobilinogen produced in the:
be allow by the:
A. Intestine.
A. All of the above.
B. Kidney.
B. Ultrasonography.
C. Liver.
C. Gastroduodenoscopy with biopsy.
D. All is correct.
D. X-ray examination of the stomach and duo-
E. Everything is wrong.
denum.
134. Conjugated bilirubin produced in liver
E. Analysis of anamnestic data.
cells by the enzyme:
129. Combination of urobilinogenuria with bili-
A. Glukuroniltransferase.
rubinuria is typical for:
B. Leucine aminopeptidase.
A. Obstructive jaundice.
C. Acid phosphatase.
B. Hemolytic jaundice.
D. Nucleotidase.
C. Hepatic jaundice.
E. All of the above is wrong.
D. Congestive kidney.
135. Increasing the blood levels of unconjugat-
E. Renal infarction.
ed bilirubin is due to all of these metabolic ab-
130. Pronounced bilirubinuria is typical for:
normalities, except:
A. Obstructive jaundice.
A. Increasing of bilirubin.
B. Hemolytic jaundice.
B. Reducing the capture of bilirubin by the liv-
C. Nephrolithiasis.
er.
D. Congestive kidney.
C. Glukuroniltransferase deficiency in hepato-
E. Chronic nephritis.
cytes.
101
D. Liver disorders of excretion of bilirubin.
C. Initial part of the colon.
E. Increasing of erythrocyte hemolysis.
D. All of these departments.
136.Increasing the serum alanine transaminase
E. Jejunum and initial part of the colon.
activity can be caused by all of the above con-
141. For hepatic cytolytic syndrome is typical
ditions, except:
all of these biochemical changes, except:
A. Hepatocyte necrosis any aetiology.
A. Increasing the activity of alanine ami-
B. Kidney disease.
notransferase.
C. Skeletal muscle injury.
B. Increasing the activity of aspartate ami-
D. Myocardial infarction.
notransferase.
E. Hemolysis.
C. Increasing the activity of aldolase.
137. In the diagnosis of cholestatic syndrome
D. Increasing the level of serum iron.
are important all of these indicators, except:
E. Reduction of all parameters.
A. Increasingthe activity of alkaline phospha-
142. In cholestatic syndrome urobilinogen in
tase blood.
urine:
B. Increasing the level of conjugated bilirubin.
A. Increases.
C. Increasing the level of cholesterol.
B. Decreases.
D. Increasing the activity of γ-glutamyl.
C. Disappears.
E. Increase the level of indirect bilirubin.
D. Not changes.
138. Alanine transaminase activity in blood is
E. Decreases or disappears.
increased by all of these diseases, except:
143. Most early and sensitive indicator of hepat-
A. Chronic active hepatitis.
ic cytolytic syndrome is:
B. Active liver cirrhosis.
A. Increased activity of alanine aminotransfer-
C. Myocardial infarction.
ase.
D. Fatty hepatosis.
B. Aldolase increased activity.
E. Chronic cholestatic hepatitis.
C. Increased activity of aspartate aminotrans-
139.Increasing the concentration of lipids in the
ferase.
blood is observed in all of these diseases, ex-
D. Hypoalbuminemia.
cept:
E. Increased the level of serum iron.
A. Diabetes mellitus.
144. Intrahepatic cholestasis is characterized by
B. Hyperthyroidism.
all of these indicators, except:
C. Biliary cirrhosis.
A. Increasing unconjugated bilirubin in serum .
D. Cholestatic hepatitis.
B. Bilirubinuria.
E. Alcoholism.
C. Increasing the activity of the alkaline phos-
140.Bile reabsorption is in:
phatase in blood.
A. Duodenum.
D. Hypercholesterolemia.
B. Jejunum.
E. Appearance of bile acids in the urine.
102
145. The appearance of bilirubin in the urine
150.
indicates of:
characterized by an increasing in blood:
A. Parenchymal jaundice.
A. γ-globulins.
B. Obstructive jaundice.
B. Cholesterol.
C. Hemolytic jaundice.
C. Alkaline phosphatase.
D. Parenchymal and obstructive jaundice.
D. Bilirubin.
E. All of the above.
E. Albumin.
146.
151.
The deсreasing of stercobilin in the fe-
Mesenchymal inflammatory syndrome
For hemolytic jaundice is not typical:
ces observed in:
A. Increasing unconjugated bilirubin in blood.
A. Parenchymal jaundice.
A. Normal activity of serum alkaline phospha-
B. Obstructive jaundice.
tase.
C. Hemolytic anemia.
B. Normal activity of serum transaminases and
D. Parenchymal and obstructive jaundice.
γ-glutamyl.
E. Everything is wrong.
C. Bilirubinuria.
147.
D. Reticulocytosis.
In the etiology of chronic hepatitis the
most important are:
152.
A. Infectious agents.
A. Reticulocytosis.
B. Toxic factors (including alcoholism).
B. Increasing of unconjugated bilirubin.
C. Toxic allergic factors.
C. Splenomegaly.
D. Circulatory failure.
D. Bone marrow hyperplasia.
E. All of the above.
E. All of the above.
148.
153. High levels of transaminases in the serum
The main forms of chronic hepatitis B
In hemolytic jaundice occurs:
are all listed, except:
indicates for:
A. Chronic persistent hepatitis.
A. Micronodular cirrhosis.
B. Chronic active hepatitis.
B. Cholestasis.
C. Chronic lobular hepatitis.
C. Viral hepatitis.
D. Interstitial hepatitis.
D. Primary biliary cirrhosis.
E. Chronic autoimmune hepatitis.
E. Aminazine jaundice.
149.
154.
The clinical manifestations of biliary
The subjective symptom of chronic per-
syndrome of chronic liver disease are all listed,
sistent hepatitis is:
except:
A. Asthenia.
A. Jaundice.
B. Constipation.
B. Skin itch.
C. Hemorrhage.
C. Xanthelasma.
D. Fever.
D. Enlarged liver with a bumpy surface.
E. Diarrhea.
E. High level of serum alkaline phosphatase.
103
155.
C. Increasing the production of hepatic lymph.
Transition chronic active hepatitis B to
cirrhosis is characterized by:
D. Increasing the activity of the renin-
A. Esophageal varices.
aldosterone system and the production of vaso-
B. Splenomegaly.
pressin.
C. Jaundice.
E. Inflammation of the peritoneum.
D. Hypoalbuminemia.
159. For ascites are typical all the following
E. Esophageal varices and splenomegaly.
symptoms, except:
156.
A. Veins of the esophagus.
Viral hepatitis has such symptoms:
A. Jaundice, itching, xanthoma, hepatospleno-
B. Reduction of the daily urine output.
megaly, high activity of alkaline phosphatase
C. «Head of Medusa".
and cholesterol.
D. Enlarged abdomen.
B. Jaundice, anorexia, nausea, mild enlarged
E. Arterial hypertension.
liver, high activity of transaminases and normal
160. The cause of obstructive jaundice is:
activity of alkaline phosphatase.
A. Choledocholithiasis.
C. Jaundice, hepatosplenomegaly, moderate in-
B. Stricture of Vaterpapilla.
creasing of transaminase activity, hyper-γ-
C. Cancer the head of pancreas.
globulinemiya, a positive reaction of antibodies
D. None of the above.
to smooth muscle.
E. All of the above.
D. Jaundice, fever, hepatomegaly, kidney fail-
161. Сytolysis syndrome, that develops in viral
ure, coma, changes in EEG activity and a mod-
hepatitis and other acute liver damage, is char-
erate increasing of transaminases.
acterized by:
E. Jaundice (not always), the pain in the right
A. Increased activity of AST, ALT, LDH.
upper quadrant of the abdomen, the abdomen is
B.
soft, leukocytosis.
glyutamattranspeptidazy,
157.
lipoproteins, hypercholesterolemia, hyperbili-
To treatment the patient with liver cir-
Increased
alkaline
phosphatase,
g-
increased
b-
rhosis and insufficient effect of furosemide
rubinemia.
should be added:
C. Reduction of cholinesterase, prothrombin,
A. Hypotiazid.
total protein, especially albumin, cholesterol,
B. Uregit.
hyperbilirubinemia.
C. Diakarb.
D. Increased level of g-globulin, changes in the
D. Veroshpiron.
protein-sediment samples, increased levels of
E. Triamterene.
immunoglobulins.
158.
E. Increased alkaline phosphatase, decreased
The development of ascites in liver cir-
rhosis is independent from:
cholinesterase, increased g-globulin, hyperbili-
A. Portal hypertension.
rubinemia.
B. Hypoalbuminemia.
104
162.Rational measures of the treatment of asci-
C. Aminotransferase levels.
tes in liver cirrhosis are:
D. Alkaline phosphatase.
A. Diet with limited sodium chloride to 5 g.
E. Level of acid phosphatase.
B. Restriction daily liquid consumption to 1 li-
167.
ter, if the sodium concentration in serum is
gallbladder and biliary tract includes:
more than 130 mmol/l.
A. Hypokinetic form.
C. Increasing the daily diuresis.
B. Hyperkinetic form.
D. Use from 100 to 400 mg of veroshpiron dai-
C. Mixed form.
ly.
D. A and B are correct.
E. All of the above.
E. None of the above.
163. Hepatomegaly, splenomegaly and melena
168. Hyperkinetic form of gallbladder dyskine-
are typical for:
sia is characterized by:
A. Bleeding from duodenal ulcer.
A. Colicky or cramping pain.
B. Bleeding from veins of the esophagus in liv-
B. Pain, appeared at 1-2 hours after a meal,
er cirrhosis.
usually radiate to the right shoulder blade, col-
C. Mesenteric artery thrombosis.
lar bone, lower back and the epigastric region.
D. Ulcerative colitis.
C. Contraction of the gallbladder and its rapid
E. Bleeding from stomach ulcer.
emptying identified by X-ray examination.
164. At what disease increased the level of di-
D. A and B are correct.
rect and indirect bilirubin?
E. Nothing of the above.
A. Hemolytic anemia.
169. In the treatment of hypokinetic dyskinesia
B. Gilbert's syndrome.
of the gallbladder used:
C. Choledocholithiasis.
A. Holekinetiks.
D. Active hepatitis.
B. Spasmolytics.
E. Pancreas tumor.
C. Surgical treatment.
165.The gallbladder is shrinking under the in-
D. Antacids.
fluence of:
E. Enzymes.
A. Gastrin.
170. Hypokinetic form of dyskinesia of the
B. Pancreatic juice.
gallbladder is characterized by:
C. Cholecystokinin.
A. Aching pains in the right upper quadrant.
D. Secretin.
B. Elongation, extension, delayed emptying on
E. All of the above factors.
the X-ray.
166. Increasing of what indicators evidenced
C. Frequent combination with duodenal ulcer
about the intrahepatic cholestasis:
and gastroduodenitis.
A. Bromsulfalein sample.
D. A and Bare correct.
B. Level of g-globulins.
E. All is correct.
105
Classification of dyskinesia of the
171.The diagnosis of gallbladder dyskinesia is
D. A and B are correct.
based on:
E. All of the above.
A. Clinical data.
B. Results of five-phase duodenal sounding.
C. X-ray data.
106
Hematology
1. What indicators confirm the diagnosis of B-
5. Which of these diseases is characterized by
12 deficiency anemia?
the following haematological parameters: ane-
A. In the anamnesis - surgery on the intestines.
mia, leukopenia, the increased number of plas-
B. Frequent acute respiratory viral infections.
ma cells in the bone marrow (over 15%)?
C. Intestinal dysbiosis.
A. Acute leukemia.
D. Macrocytosis blood erythrocytes.
B. Chronic myelogenous leukemia.
E. Increase the number of reticulocytes blood.
C. Multiple myeloma.
2. Which of the following diseases is character-
D. Chronic lymphocytic leukemia.
ized by hyperthrombocytosis?
E. Lymphogranulomatozis.
A. Iron deficiency anemia.
6. What disorders are typical for hemorrhagic
B. Agranulocytosis
vasculitis?
C. Chronic hepatitis.
A. The presence of hematoma.
D. Idiopathic myelofibrosis
B. Extravasates.
E. Chronic gastritis.
C. Increased level of circulating complexes.
3. Which of the following indicators of periph-
D. Hypercoagulable phenomen.
eral blood are most typical for clinical picture
E. Violations of the kallikrein - kinin system.
of multiple myeloma?
7. Which of the following diseases due to a
A. Anemia, moderate leukopenia, ESR in-
high content of plasma cells in the bone mar-
creased sharply.
row?
B. Anemia, thrombocytopenia, hyperleukocy-
A. Chronic myelogenous leukemia.
tosis, increased ESR.
B. Erythremia.
C. Normal number of red blood cells, platelets,
C. Multiple myeloma.
neutrophilic leukocytosis, elevated ESR.
D. Chronic hepatitis.
D. Anemia, thrombocytopenia, severe leukope-
E. Acute leukemia.
nia, moderately elevated ESR.
8. Chronic hemorrhagic anemia is:
E. Erythrocytosis, thrombocytosis, leukocyto-
A. Regenerator, hyperchromic, with erythro-
sis, reduced ESR.
blastic type of hematopoiesis.
4. For which of the following diseases is typical
B. Hyperregenerator, hypochromic, with eryth-
pancytosis in the peripheral blood?
roblastic type of hematopoiesis.
A. Lymphogranulomatosis.
C. Hyperregenerator, hyperchromic, with eryth-
B. Chronic lymphocytic leukemia.
roblastic type of hematopoiesis.
C. Erythremia.
D. Hyperregenerator, hypochromic, with mega-
D. Acute leukemia.
loblastic type of hematopoiesis.
E. Multiple myeloma.
E. Hyperregenerator, hyperchromic, with
megaloblastic type of hematopoiesis.
107
9. What violations do not occur in hemophilia
C. Low levels of erythropoietin.
A?
D. Hyperthrombocytosis.
A. Hemarthrosis.
E. Bleeding.
B. Bleeding.
14. For what disease is typical eosinophilic-
C. Extravasates.
basophilic association?
D. Violation of blood clotting.
A. Lymphogranulomatosis.
E. Extension of recalcification time.
B. Acute myeloid leukemia
10. Which of the following drugs is not indicat-
C. Chronic myeloid leukemia.
ed for treatment of patients with aplastic ane-
D. Chronic lymphocytic leukemia.
mia?
E. Henoch - Schönlein.
A. Glucocorticoids.
15. Patient S., 68 years old, hospitalized for se-
B. Androgens.
vere anemia. On examination: atrophy of the
C. Antibiotics.
tongue papillae surface, icteric sclera, symmet-
D. Iron drugs.
ric paresthesia, gait disturbance, atrophic gastri-
E. Vitamins.
tis with achlorhydria, splenomegaly and mac-
11. What kind of diseases characterized by
rocytosis. This is typical for what disease?
thrombocytopenia in the peripheral blood and
A. Hemolytic anemia.
increased level of megakaryocytes in the bone
B. Iron-deficiency anemia.
marrow punctate?
C. B - 12 deficiency anemia.
A. Aplastic anemia.
D. Folic - deficiency anemia.
B. Acute leukemia.
E. Thalassemia.
C. Chronic lymphocytic leukemia.
16. Patient S., 68 years old, hospitalized for se-
D. Idiopathic thrombocytopenic purpura.
vere anemia. On examination: atrophy of the
E. Chronic hepatitis.
tongue papillae surface, icteric sclera, symmet-
12. Which of the following symptoms is not
ric paresthesia, gait disturbance, atrophic gastri-
typical for patients with deficiency of vitamin
tis with achlorhydria, splenomegaly and mac-
B - 12?
rocytosis. Which drug you must use for treat-
A. Numbness in the extremities.
ment of this patient?
B. Violation of deep sensitivity.
A. Iron drugs.
C. Positive symptom of Romberg.
B. B - 12.
D. Hypokinesia and muscle stiffness.
C. Prednisolone.
E. Spastic paraparesis.
D. Anabolic steroids.
13.Which of the following laboratory parame-
E. Red blood cell transfusions.
ters is most typical for hemolytic anemia?
17. Patient S., 68 years old, hospitalized for se-
A. Elevated serum transferrin.
vere anemia. On examination: atrophy of the
B. Reticulocytosis.
tongue papillae surface, yellowness sclera,
108
symmetric
paresthesia,
gait
A. Splenomegaly.
disturbance,
atrophic gastritis with achlorhydria, spleno-
B. Lymphadenopathy.
megaly and macrocytosis. How to verify the
C. Leukopenia.
diagnosis?
D. High reticulocytosis.
A. Sternal puncture.
E. Hyperthrombocytosis.
B. Abdominal ultrasound.
22. Of which of the following conditions is ob-
C. Consultation of a neurologist.
served pancytopenia?
D. Determination of iron serum.
A. Iron deficiency anemia.
E. Puncture of the spleen.
B. Idiopathic thrombocytopenic purpura.
18. What elements of white blood cells belong
C. Aplastic anemia.
to agranulocytes?
D. Hemophilia A.
A. Stab neutrophils.
E. Agranulocytosis.
B. Eosinophils.
23.What anemia is characterized by hyper-
C. Monocytes.
chromia, macrocytosis, decreased recovery
D. Basophils.
form on the period of exacerbation?
E. Segmented neutrophils.
A. B-12 deficiencyanemia.
19. Patient K., 18 years old, complains of se-
B. Acute hemorrhagicanemia.
vere bleeding after tooth extraction. Patient suf-
C. Hemolyticanemia.
fers from hemophilia A.. Which drug is most
D. Irondeficiencyanemia.
effective in the treatment of such bleeding?
E. Aplastic anemia.
A. Ascorutin.
24. Which of the following diseases are often
B. Aminocaproic acid.
accompanied by severe thrombocytopenia with
C. Calcium chloride
signs of hemorrhagic diathesis?
D. Vikasol.
A. Acute leukemia.
E. Cryoprecipitate.
B. Chronic myelogenous leukemia.
20. In Patient K., who taking Mercazolilum for
C. Erythremia.
a long time about hyperthyroidism, suspected
D. Lymphogranulocytosis.
agranulocytosis. What changes can be expected
E. Agranulocytosis.
in leukoformule?
25. Which of the conditions is accompanied by
A. Leukocytosis with lymphocytosis.
thrombocytosis?
B. Leukocytosis with neutrophilia.
A. Idiopathic thrombocytopenic purpura.
C. Leukocytosis with lymphopenia.
B. Acute leukemia.
D. Leukopenia with neutrophilia.
C. Hypersplenism.
E. Leukopenia with neutropenia.
D. Status after splenectomy.
21. Which of the following symptoms will be
E. B - 12 deficiency anemia.
observed in patients with aplastic anemia:
109
26. What changes are not typical for folic acid
C. Lymphadenopathy.
deficiency anemia?
D. Erythrocytosis.
A. Long-feeding milk goat.
E. Myelocytes, metamyelocytes in the periph-
B. Reduction of blood hemoglobin level.
eral blood.
C. Reduction of the number of red blood cells.
31. Patient Z., 23 years old, with acute myeloid
D. Forms and dimensions of erythrocytes.
leukemia appeared hemorrhagic syndrome in
E. Hypersegmentation of neutrophil nuclei.
the form of massive subcutaneous hemorrhage,
27. Which of the following figures contradict
epistaxis. In the analysis of a blood: severe
the diagnosis of megaloblastic anemia?
anemia, blasts 30%, thrombocytopenia - 10 *
A. Macrocytosis.
109/l. What urgent treatment of this patient?
B. Gunter glossitis.
A. Continuation of chemotherapy.
C. Ictericof sclera.
B. Red blood cell transfusions.
D. Microcytosis.
C. Platelet transfusion.
E. Hypersegmentation of neutrophil nuclei.
D. Iron drugs
28. Which of the following signs is the most
E. Vikasol.
valid in the diagnosis of chronic myelogenous
32. Which diagnostic criteria is not typical for
leukemia?
acute lymphoblastic leukemia?
A. Leukocytosis.
A. Immunological markers of leukemic cells.
B. Anemia.
B. Hepatosplenomegaly.
C. Leukemoid shift of leukogram.
C. Leukocytosis.
D. The presence of the Philadelphia chromo-
D. Anemia.
some.
E. Thrombocytosis.
E. Splenomegaly.
33. Which of the following laboratory changes
29. Which of the following conditions is most
is typical for iron deficiency anemia?
typical for chronic lymphocytic leukemia in the
A. Hyperthrombocytosis.
early stages of the disease?
B. Sideropenia.
A. Anemia.
C. Macrocytosis.
B. Lymphadenopathy.
D. Monocytosis.
C. Enlarged liver.
E. Hyperglycemia.
D. Splenomegaly.
34. What violations are not typical for aplastic
E. Thrombocytopenia.
anemia?
30. Which of the following conditions can be
A. Reduction of the number of red blood cells
observed in patients with chronic lymphocytic
and the level of hemoglobin.
leukemia?
B. Thrombocytopenia.
A. Hyperthrombocytosis.
C. Increasing the number of white blood cells.
B. Elevated levels of vitamin B - 12 in serum.
D. Ulcer - necrotic processes.
110
E. Increasing the number of erythro -, leuco -,
E. Multiple myeloma.
tromboantitel.
39. According to the formula of blood: E
35. Which of these diseases must be first dif-
1,3x1012/l; Hb 58 g/l; Col. Index 1,3; megalo-
ferentiated with multiple myeloma?
blasts 2x100,leukocytes 2.8 109/l, erythrocyte
A. Osteochondrosis.
sedimentation rate 30 mm/h, anisocytosis, poi-
B. Osteomyelitis.
kilocytosis, macrocytosis, decide what addi-
C. Rheumatism.
tional investigation is needed to confirm the
D. Aplastic anemia.
presumptive diagnosis.
E. Chronic hepatitis.
A. Sternal puncture.
36.What criteria is necessary for a diagnosic
B. Ultrasound of the liver and spleen.
lymphogranulomatosis?
C. X-ray light.
A. Enlarged lymph nodes.
D. Analysis of the vitamin B -12 in the blood
B. Violation of immunity.
serum.
C. Hemorrhagic syndrome.
E. Analysis of the iron content in the blood se-
D. The presence in the lymph node cells Bere-
rum.
zovsky - Sternberg.
40. Patient G., 57 years old, complains of epi-
E. Enlarged liver and spleen.
gastric pain after eating, diarrhea, fever 37,5 C,
37. According to the formula of blood: E
numbness and tingling in the limbs, general
1,3x1012/l; Hb 58 g/l; Col. Index 1,3; megalo-
weakness. After 4 years after gastric resection
blasts 2x100,leukocytes 2.8 109/l, erythrocyte
due to peptic ulcer disease were abdominal
sedimentation rate 30 mm/h, anisocytosis, poi-
pain, diarrhea, anemia in 4 years. Objectively:
kilocytosis, macrocytosis, set the diagnosis:
icteric pale skin. Tachycardia, a soft systolic
A. Iron deficiency anemia.
murmur fifth point. The liver is enlarged by 3
B. B – 12 deficitis anemia.
cm, 2 cm spleen. An. Blood: E-2,3x1012/l, Hb -
C. Aplastic anemia.
80 g/l, L – 2,3x109/l, the formula is not
D. Acute leukemia.
changed, the ESR - 45 mm/hour. Macrocytosis.
E. Agranulocytosis.
What is the presumptive diagnosis?
38. According to the formula of blood: E
12
A. Iron deficiency anemia.
9
3,5x10 /l, Hb 110 g/l, leukocytes 2,3x10 /l,
B. Gastric Cancer.
promyelocytes 2%, myelocytes 22%, metamye-
C. B - 12 deficiency anemia.
locytes 20,5%, erythrocyte sedimentation rate
D. Congenital hemolytic anemia.
20 mm / h, set the diagnosis.
E. Folic - deficiency anemia.
A. Acute leukemia.
41. Patient G., 57 years old, complains of epi-
B. Chronic lymphocytic leukemia.
gastric pain after eating, diarrhea, fever 37,5 C,
C. Chronic myelogenous leukemia.
numbness and tingling in the limbs, general
D. Erythremia.
weakness. After 4 years after gastric resection
111
due to peptic ulcer disease were abdominal
painless lymph nodes of 4-5 cm, in the right
pain, diarrhea, anemia in 4 years. Objectively:
supraclavicular region, periodic increases in
icteric pale skin. Tachycardia, a soft systolic
body temperature to 39 C, itching and pain in
murmur fifth point. The liver is enlarged by 3
the bones of the pelvis and chest. Blood test:
cm, 2 cm spleen. An. Blood: E-2,3x1012/l, Hb -
Hb 95 g/l, L – 12x109/l, e -10%, ESR – 35mm /
80 g/l, L – 2,3x109/l, the formula is not
hour. On the chest radiography enlarged medi-
changed, the ESR - 45 mm/hour. Macrocytosis.
astinal lymph nodes. Your tactics?
What investigation is needed to confirm the di-
A. Lymph node biopsy.
agnosis?
B. Monitoring.
A. Ultrasound of the liver and spleen.
C. Antibiotic.
B. Sternal puncture.
D. Physiotherapy.
C. EGD.
E. Surgery - cervical lymphadenectomy
D. Investigation of bilirubin.
45. Woman, 26 years old, complains of the ap-
E. X-ray examination of the stomach.
pearance of dense, not soldered to the skin
42. Which of these features is not typical for
glands of 2-4 cm in diameter in the neck on the
congenital hemolytic anemia?
left and the right supraclavicular region, in-
A. Anomalies of the skull.
creased body temperature to 39 C, itching, pro-
B. Beginning in childhood.
fuse night sweats, weight loss of 10 kg. He suf-
C. Reduction of the osmotic resistance of leu-
fers in the last month. In the study of material
kocytes.
lymph node biopsy revealed cells Berezovsky -
D. Positive Coombs reaction.
Sternberg. Your diagnosis?
E. Enlargement of the spleen.
A. Lymphogranulomatosis.
43. Patient 18 years old, suffers from hemophil-
B. Tuberculosis of lymph nodes.
ia A. After the trauma appeared hemarthrosis of
C. Chronic leukemia.
the knee and elbow joints. He was taken to the
D. Cancer metastases in neck and supraclavicu-
hematology department of the regional hospi-
lar lymph nodes.
tal. Bleeding time by Duke – 4 min, the clotting
E. Lymphosarcoma.
time by Lee White - 16min. What drug in most
46. Patient 32 years old, complains of general
recommended in this situation?
weakness, sweating, itching, fever, appearance
A. Injection of recombinant factor VIII.
of dense formations on the left of the neck.
B. Fresh frozen plasma.
Lymph nodes are dense, painless, not soldered
C. Cryoprecipitate.
to the skin and each other. The liver and spleen
D. Platelets.
are not enlarged in size. Blood analysis: er.
E. Platelet Concentrate.
3,3x1012/l, Hb 90 g/l, L– 14,5x109/l. Erythro-
44. Man, 24 years old, complains of a con-
cyte sedimentation rate of 55 mm/hour. Plate-
glomerate of dense, not soldered to the skin
lets 360x109/l. Your preliminary diagnosis?
112
A. Lymphogranulomatoz.
D. Lymphoma.
B. Tuberculosis of lymph nodes.
E. Cancer metastasis of cervical lymph nodes.
C. Lymphoma.
49. Basic principles of treatment of iron defi-
D. Chronic leukemia.
ciency anemia is:
E. Cancer metastases in neck and supraclavicu-
A. Transfusion of whole blood.
lar lymph nodes.
B. Long and carefully injection of intravenous
47. Patient, 29 years old, complains for throat
iron preparations.
of swallowing, fever up to 39 °C., and head-
C. Elimination the causes of iron deficiency.
aches. Tongue dry, on the mucous membrane
D. Appointment of oral iron drugs for the long
of the gums, soft and hard palate, tonsils are
term.
multiple ulcers, covered with dirty-gray patina.
E. Elimination of the causes of iron deficiency
Pulse 110 min. Blood pressure 110/60 mm Hg.
and appointment of oral iron drugs for the long
Blood tests: Er. 3,2x1012/l, Hb 100 g/l, L –
term.
80,0x109/l, blast cells 75%. ESR 65 mm/hr.
50. The cause of iron deficiency anemia in
Platelets 42x109/l. What investigation is needed
men can be all of the above, except:
to confirm the diagnosis?
A. Blood loss from the gastrointestinal tract on
A. Sternal puncture.
the background of duodenum ulcer.
B. Microreaction for syphilis.
B. Irritable bowel syndrome.
C. Blood on sterility
C. Hemorrhoids.
D. Smear of throaton the diphtheria.
D. Gastrectomy.
E. Smear on AK and BK.
E. Esophageal varices in cirrhosis.
48. Patient A., 48 years old, complaints of the
51. The cause of iron deficiency anemia in
enlarged of the cervical lymph nodes, tempera-
women can be all of the above, except:
ture 37,6, which beginning 3 months ago. Ob-
A. Severe and prolonged menstrual blood loss.
jectively: the right and left side of the neck pal-
B. Duodenal ulcer.
pable painless, moving the lymph nodes 2x2
C. Hemorrhoids.
cm. The skin over the lymph nodes are not
D. Tumors of the gastrointestinal tract.
changed, the pulse 72 beats/min, rhythmic. The
E. Chronic biliary dependent pancreatitis.
liver and spleen are not enlarged. Blood test:
52. Specify the clinical manifestations of the
Er. 2,2x1012/l, Hb 72 g/l, platelets 100 x 109/l,
sideropenic syndrome:
L 80x109/l, lymphocytes 90%, erythrocyte sed-
A. Angular stomatitis.
imentation rate 10 mm/h. What is the prelimi-
B. Perversion of taste and smell.
nary diagnosis?
C. Glossitis.
A. Chronic lymphocytic leukemia.
D. All of the above.
B. Lymphogranulomatosis.
E. None of the above.
C. Tuberculosis of lymph nodes.
113
53. The patient, 19 years old, complains of
A. Enlarged spleen.
weakness. Gynecological history: menstruation
B. Reducing the number of platelets in periph-
from 12 years, abundant, for 5-6 days. The skin
eral blood.
is pale. In the blood: Hb - 85 g/l, Er. – 3,8 mil-
C. Reducing the number of granulocytes in pe-
lion, Color index - 0.67, serum iron - 4 mmol/l,
ripheral blood.
Leuk. - 6 thousands, the formula without fea-
D. Reducing the number of platelets, erythro-
tures. What preparation is most recommended?
cytes and granulocytes in peripheral blood.
A. Red blood cell.
E. Splenomegaly, reduction the number of
B. Vitamin B12.
granulocytes in peripheral blood.
C. Ferropleks.
58. Which factor is necessary for absorption of
D. Pyridoxine.
vitamin B12?
E. Ferrum.
A. Hydrochloric acid.
54. A woman, 42 years old, with fibroid uterus
B. Gastrin.
and menorrhagia found anemia: Hb - 80 g/l,
C. Gastromukoprotein.
and hypochromia microcytosis erythrocytes.
D. Pepsin.
Your diagnosis?
E. Folic Acid.
A. B12-deficiency anemia.
59. What sign is not typical for the diagnosis of
B. Sickle cell anemia.
iron deficiency anemia?
C. Aplastic anemia.
A. Color index 0,7.
D. Hereditary spherocytosis.
B. Hypochromia of erythrocytes.
E. Iron deficiency anemia.
C. Microcytosis.
55. Which of the following laboratory parame-
D. Aniso-poikilocytosis.
E. Hypersegmentation of neutrophil nuclei.
ters is most typical for hemolytic anemia?
A. Elevated serum transferrin.
60. Iron deficiency anemia is characterized by:
B. Reticulocytosis.
A. Hypochromia, microcytosis, sideroblasts in
C. Low levels of erythropoietin.
the sternal punctate.
D. Hyperthrombocytosis.
B. Hypochromia, microcytosis, red blood cells
E. Bleeding.
in a form of target.
56. What are the elements of white blood cells
C. Hypochromia, microcytosis, increased se-
do not belong to granulocytes?
rum iron binding capacity.
A. Stab neutrophils.
D. Hypochromia, microcytosis, decreased se-
B. Eosinophils.
rum iron binding capacity.
C. Monocytes.
E. Hypochromia, microcytosis, desferalov posi-
D. Basophils.
tive test.
E. Segment neutrophils.
61. Iron drugs include:
57. Hypersplenism is:
A. Contrycal.
114
B. Phytin.
C. Oral iron for the long term.
C. Globiron.
D. Intramuscular iron preparations.
D. Fezam.
E. Appointment of a diet rich of iron.
E. Glicised.
66. Iron drugs include:
62. For pregnant women with chronic iron de-
A. Tardiferon.
ficiency anemia recommended:
B. Terafleks.
A. Ingest iron drugs to the childbirth and the
C. Ranferon.
entire period of nursing mothers.
D. Feniluks
B. Include in a diet salmon, pomegranates and
E. Fenoten.
carrots.
67. Among the methods for detecting blood
C. Transfuse packed red blood cells before
loss from the gastrointestinal tract the most in-
birth.
formative is:
D. 10 intravenous injections of Ferrum Lek.
A. Gregersen test.
E. None of the above.
B. Weber test.
63. The basic amount of iron in the human
C. Determination of blood loss using radioac-
body is absorbed in:
tive chromium.
A. The rectum.
D. Determination of iron levels in the feces.
B. The downstream section of the colon.
E. Coprogram.
C. The duodenum and jejunum.
68. The most common cause of iron deficiency
D. Ileum.
anemia in men is:
E. All are correct.
A. Blood loss from the gastrointestinal tract.
64. For the treatment of iron deficiency should
B. Glomus kidney tumor.
be appointed:
C. Alcoholic hepatitis.
A. Iron preparations intravenously in combina-
D. Hematuric form of glomerulonephritis.
tion with the meat diet.
E. Chronic gastritis.
B. Iron preparations intravenously in combina-
69. The cause of iron deficiency anemia in
tion with B vitamins intramuscularly.
women can be all of the above, except:
C. Regular transfusion of packed red blood
A. Heavy and prolonged menstrual blood loss.
cells in combination with a diet rich of fruits.
B. Rendu – Osler disease.
D. Oral iron for the long term.
C. Hemorrhoids.
E. None of the above.
D. Tumors of the gastrointestinal tract.
65. Basic principles of treatment of iron defi-
E. Chronic gastritis.
ciency anemia include:
71. During the day, the iron can be absorbed no
A. Transfusion of whole blood.
more than:
B. Carefully injection of intravenous iron prep-
A. 0.5-1.0 mg
arations for the long term.
B. 1.5-2.5 mg
115
C. 4.0-4.5 mg
of the chest revealed the shadow of the medias-
D. 10.0-12.0 mg
tinum dilatation and presence of polycyclic
E. 15 mg.
contours. What disease is most probable?
72. The cause of post-hemorrhagic anemia as-
A. Lymphogranulomatosis.
sociated with blood loss from the gastrointesti-
B. Dermoid cyst.
nal tract, diagnosed by:
C. The tumor of the thymus.
A. X-ray of the gastrointestinal tract.
D. Tuberculosis.
B. Gastrointestinal ultrasound.
E. Non-Hodgkin'slymphoma.
C. Abdominal palpation.
77.
D. Endoscopic examination of the gastrointes-
toms of stage 2 chronic lymphocytic leukemia:
tinal tract.
A. Adenopathy.
E. Sigmoidoscopy.
B. Hemorrhagic syndrome.
73. Iron is best absorbed in the form of:
C. Hemolytic crises.
A. Ferritin A.
D. Hepato splenomegaly.
B. Hemosiderin.
E. All of the above.
C. Heme.
78.
D. Free trivalent iron
the peripheral blood at the beginning of the ad-
E. Free bivalent iron.
vanced stage of chronic myeloid leukemia?
74. For iron deficiency anemia is typical:
A. Anemia.
A. Nausea, vomiting.
B. Lymphocytosis.
B. Ulcerations in the tonque.
C. Reticulocytosis.
C. Facials welling.
D. Leukocytosis with a shift of granulocytes.
D. Dysgeusia.
E. Thrombocytopenia.
E. Paresthesia in extremities.
79. The patient revealed enlarged soft-elastic
75. The patient is at the dispensary with a diag-
lymph nodes in the neck and armpit 6-7 cm, the
nosis of Haemophilia A, severe stage. Received
liver protruded from the costal arch to 5 cm, the
hospital with hemarthrosis right knee joint.
spleen - 8 cm, sensitive to palpation. Excessive
What type of treatment should be applied?
sweating, weakness, weight loss. Sick for 3
A. Cryoprecipitate at a dose of 20 U/kg.
months. General analysis of blood: Hb - 112
B. Blood transfusion.
g/l, CI -0,9, L-120,0 * 109/l, platelets, 220,0 *
C. Chemotherapy.
109/l, ESR - 20 mm/h, n-1% C-8%, M-2%,
D. Antibiotic therapy.
lymphocytes-89%, a lot of Botkin cells. What
E. Hormone therapy.
is preliminary diagnosis?
76.
A. Chronic lymphocytic leukemia.
Patient 19 years old, admitted to hospital
Specify the most typical clinical symp-
Specify the most characteristic changes in
with complaints of weakness, fever, dyspnea
B. Acute lymphocytic leukemia
and cough, weight loss. At X-ray examination
C. Acute myeloid leukemia.
116
D. Lymphosarcoma.
C. Anemia.
E. Mononucleosis.
D. Thrombocytopenia.
80.
E. Blastemia.
One of the clinical manifestations of the
tumor intoxication syndrome in acute leukemia
85. What changes of peripheral blood are typ-
is:
ical for chronic lymphocytic leukemia?
A. Enlarged liver.
A. Leukopenia.
B. Fever.
B. Eosinophilia.
C. Itching of the skin.
C. Hypolymphemia.
D. Angiostaxis.
D. Leukocytosis, absolute lymphocytosis.
E. Adenopathy.
E. All are wrong.
81. What content of the blast cells in the bone
86. Specify the main method of treatment for
marrow punctate is valid during the period of
acute leukemia:
clinical remission?
A. Chemotherapy.
A. 4%.
B. Antibiotics.
B. 5%.
C. Glucocorticoid therapy.
C. 8%.
D. Blood transfusion.
D. 10%.
E. Leukopheresis.
E. 15%.
87. Specify the most frequent clinical symp-
82. What examination is needed to confirm the
tom of chronic myeloid leukemia:
diagnosis of neuroleukemia?
A. Fever.
A. Sternal puncture.
B. Angiostaxis.
B. Trepanobiopsy.
C. Adenopathy.
C. Liquortest.
D. Enlarged liver.
D. CT scan.
E. Enlarged spleen.
E. Bloodtest.
88. When does most often occur absolute hy-
83. What variant of acute leukemia is most
perleukocytosis with lymphocytosis?
common in adults?
A. Acute leukemia.
A. Lymphoblastic.
B. Chronic lymphocytic leukemia.
B. Myelogenous.
C. Tuberculosis
C. Monoblastny.
D. Whooping cough.
D. Undifferentiated.
E. Agranulocytosis.
E. Promyelocytic.
89.
84. What laboratory sign is typical for acute
weakness, fever, jaundice. Objectively t =
leukemia?
38,50C, blood pressure - 100/60 mm Hg, heart
A. Leukopenia.
rate - 102/min. Skin pale and jaundiced. Ab-
B. Leukocytosis.
domen soft, painless. The liver enlarged at 2
117
Patient B., 24 years old, complains of
cm, spleen enlarged at 1 cm. In the blood: Er -
93.
Patient D., 24 years, complaints of dry
2,8x1012/l, Hb - 92 g/l, Reticulocytes - 26%.
cough at the night, expressed sweating, itching
The preliminary diagnosis?
of the skin, weight loss about 10 kg. Objective-
A. Hemolytic anemia.
ly: pale skin, percussion sound is significantly
B. Acute hemorrhagic anemia.
shortened in the intercapular area, vesicular
C. Acute hepatitis.
breathing in the lungs. Chest X-Ray: polycyclic
D. B-12 deficiencyanemia.
enlarged the mediastinal lymph nodes. Reac-
E. Aplastic anemia.
tion Mantoux is negative. What is the prelimi-
90. In which of these anemia occurs micro-
nary diagnosis?
spherocytosis?
A. Lymphogranulomatosis.
A. Fanconi's.
B. Sarcoidosis.
B. Marchiafawa Michele.
C. Tubadenit.
C. Addison-Birmera.
D. Central lung cancer
D. Chauffard-Minkowski.
E. Atopic dermatitis
E. Puli disease.
94. The patient, 25 years old, complains of
91. Which anemia is characterized by an in-
swollen lymph nodes in the neck, itching,
creased content of reticulocytes in the peripher-
sweating, increased temperature to 39 C. Ob-
al blood?
jective: cyanosis, neck edema, liver and spleen
A. Iron deficiency.
were not enlarged, lymph nodes have diameter
B. Megaloblastic.
of 1,5 - 2 cm, soldered to surrounding tissues.
C. Hypoplastic.
On the puncture of lymph node - Sternberg Be-
D. Hemolytic.
rezovsky cells. What is the preliminary diagno-
E. Metaplastic.
sis?
92. The patient, 66 years old, complains of a
A. Megakaryoblastoma
violation of swallowing at eating, pain in the
B. Lymphogranulomatosis.
right shoulder joint, edema of the face. Objec-
C. Infectious mononucleosis.
tively: cyanosis of the face and neck, paresthe-
D. Lymphosarcoma.
sia, violations of the right hand sensitivity, en-
E. Metastases to the lymph nodes.
larged regional lymph nodes. What is the most
95. The patient is 27 years old, fells ill acutely.
informative diagnostic method needed to use?
The body temperature is 39,5 C, trembling, ex-
A. Chest X-Ray.
cessive sweating. Enlarged lymph node. After 2
B. Lymph node biopsy.
weeks of treatment with antibiotics the body
C. Bronchoscopy.
temperature is maintained, increased sweating.
D. Mantoux test.
Blood tests: Er.3,0x1012/l, Hb- 90g/l, L-
E. Ultrasonography of the abdomen.
13x109/l, ESR-58mm. What additional tests is
needed to use?
118
A. Biopsy of the cervical lymph node.
98. Patient A., 20 years old, complains of peri-
B. General urine analysis.
odic appearance of jaundice, weakness, heavi-
C. Biochemical examination of blood.
ness in the left upper quadrant. Objectively: not
D. X-ray of the chest cavity
enlarged lymph nodes, liver near the edge of
E. Consultation of Lor doctor.
the costal arch, the spleen + 3 cm below the
96. Patient K., 20 years old, was taken to hos-
costal
pital with bleeding from incised wounds, suf-
2,7x1012/l, Hb 84 g/l, CI -0.96, reticulocytes
fers for 4 hours. Objectively: pale skin, a band-
18%, erythrokaryocytes, microspherocytes. In-
age on his left foot soaked with blood. The
direct bilirubin - 32 mmol/l, in the urine - he-
right knee is deformed, limited in movement.
mosiderin, iron content in blood serum - 23.5
Native brother of the patient suffering from
mmol/l. Your diagnosis?
hemophilia A. Hb - 42 g/l, the bleeding time by
A. Minkowski - Chauffard anemia.
Duke - 6 minutes, coagulation Lee-White time
B. Autoimmune hemolytic anemia.
- 20 min. The blood does not clot. Your first
C. Sideroahrestical anemia.
support?
D. Anemotrophy.
A. Intravenous bolus of cryoprecipitate.
E. B 12, folic deficiency anemia.
B. Intramuscular injection of cryoprecipitate.
99. The patient, 58 years old, was treated for a
C. Intravenous drip of cryoprecipitate
long time with vinca drugs. He complains of
D.
Intravenous
injection
of
epsilon-
arch.
General
blood
analysis:
Er
weakness, shortness of breath, frequent nose
aminocapronic acid.
bleeds. Objectiely: Ps - 100 in 1 min, systolic
E. Platelet transfusion.
sound over the top, the liver and spleen are not
97.
enlarged.
Patient S., 23 years old, complaints of
General
blood
analysis:
Er.
-
12
bleeding from the nose, gums, hemorrhagic
2,2x10 /l, Hb -70 g/l, CI - 0.87, reticulocytes -
manifestations in the skin, which appeared one
0%, leuk.–2,4x109/l. tromb. – 80x109/l. ERS -7
month ago. Objectively: skin petechial rash,
mm/hr. Serum iron – 17,3 mmol/l. Your diag-
positive tweak sample, changes of the internal
nosis?
organs are not revealed. Blood tests: Hb - 105
A. Aplastic anemia.
g/l, leukocytes – 5,4x109/l, platelets – 11x109/l,
B. B12, folic deficiency anemia.
leykoformula without abnormalities, bleeding
C. Autoimmune hemolytic anemia.
time 23 min. What pathology of hemostasis is
D. Sideroahrestical anemia.
here?
E. Iron-deficiency anemia.
A. Idiopathic thrombocytopenic purpura.
100. Patient, 42 years old, complains of gen-
B. Vilebrandt disease.
eral weakness, shortness of breath, dizziness.
C. Thrombocytopathy.
Throughout the year appeared graying hair,
D. Coagulopathy.
nails began to exfoliate, the taste has changed.
E. DIC syndrom, phase III.
About 5 years she is on dispensary observation
119
at the gynecologist about uterine fibroids.
B. Desferal application.
Blood tests: Er. – 3,0x1012/l, Hb - 86 g/l, CI–
C. Blood transfusion.
0,8, Retik. - 7%, thrombocytes– 160x109/l,
D. Using of iron drugs.
Leuk. – 5,0x109/l, anisotropy, microcytosis,
E. Using of prednisolone.
ESR - 10 mm/h. About what form of anemia
103. The patient, 50 years old, complains of
you should be thinking?
general weakness, dizziness, heaviness in the
A. Iron deficiency.
upper abdomen, paresthesia of the fingertips of
B. Hypoplastic.
the upper and lower extremities. Objecively: ic-
C. B12 (folic), deficiency.
teric skin, tongue with crimson-colored, hepa-
D. Autoimmune hemolytic anemia.
tomegaly. In the blood: HB - 90 g/l, er -
E. Chauffard-Minkowski.
2,3x1012/l, retic. – 0,2%,CI 1,2, macrocytosis;
101.
Jolly bodies, Kebot rings. What method of
At 68-year-old patient, suffering from
coronary artery disease, appearance more fre-
treatment would be most recommended?
quent bouts of chest pain, increased needed of
A. Cyanocobalamin.
nitroglycerine, shortness of breath. ECG with-
B. Tardiferon.
out speakers. The blood test: Er. – 2,4x1012/l,
C. Globiron.
Hb - 70 g/l, CI – 1,2, leuk. – 3,8x109/l, throm-
D. Ferrum-Lek.
9
bocytes – 130x10 /l, ESR - 26 mm/h. From
E. Ferropleks.
bone marrow examination patient refuses.
104. After receiving dopegit appeared jaundice
What treatment is most recommended in this
skin and mucous membranes, enlarged spleen.
situation?
General blood analysis: Er.-2,3x1012/L, Hb - 72
A. Vitamin B12 intramusculary.
g/l, CI 0,84, Le – 15x109/l, reticulocytes 26 ‰.
B. Iron therapy drugs.
Indirect bilirubin in serum is 37 mmol/l. In
C. Increasing the daily dose of nitroglycerine.
urine and faeces increased level of stercobilin.
D. Transfusion of red blood cells.
What blood tests will help to verify the diagno-
E. Parenteral injection of iron preparations.
sis?
102. The patient, 50 years old, complains of
A. Osmotic resistance of erythrocytes.
general weakness, dizziness, heaviness in the
B. Blood level of B12.
upper abdomen, paresthesia of the fingertips of
C. Serum iron.
the upper and lower extremities. Objecively: ic-
D. Coagulogram.
teric skin, tongue with crimson-colored, hepa-
E. Proteinograma.
tomegaly. In the blood: HB - 90 g/l, er -
105. In the anamnesis of the patient: chronic
2,3x1012/l, retic. – 0,2%,CI 1,2, macrocytosis;
renal failure, recently treated about iron defi-
Jolly bodies, Kebot rings. What method of
ciency anemia. The general analysis of blood:
treatment would be most recommended?
Er. 2,0x1012/l, Hb 55 g/l, CI 0,72. The patient is
A. Using of vitamin B12.
assigned a transfusion of fresh frozen blood.
120
How many tests of individual compatibility you
C. Cyanocobalamin.
need to do?
D. Bloodtransfusion.
A. Three.
E. Polyvitamins.
B. One.
108. Patient 28 years old, in the past noted the
C. Two.
weakness and periodic occurrence of mild
D. Four.
jaundice of the skin. After severe hypothermia
E. Five.
arose fever, muscles pain and pain in the upper
106. The patient was 27 years old, complains of
abdomen. After a day apearenced moderate
dizziness, muscle weakness, nausea, loss of ap-
jaundice, dark urine and feces. Moderate en-
petite, dry skin, brittle nails and hair. Sick for
larged liver and spleen, jaundice of the skin and
about six months (after giving birth). Objec-
mucous membranes. Blood tests: hemoglobin -
tively: skin and mucous membrane are pale. PS
80 g/l, erythrocytes 2,8x1012/l, the color index
= 80 min., rhythmic. Cardiac systolic murmur
is 0,8, platelets 230x109/l, leukocytes 9,5x109/l
at the apex of the heart. Abdomen soft, painless
(Formula unchangeD.. ESR - 20 m/h, bilirubin
on palpation. Further examination: Hb 80 g/l;
– 77,0 mmol/l, direct – 8,6 mmol/l. What dis-
Er. 2,6x1012/l, CI 0,8. Anisocytosis, poikilocy-
ease is most probable?
tosis, reticulocytes - 1%. The content of iron in
A. Hemolytic anemia.
the blood – 6,8 mmol/l. What treatment is most
B. Exacerbation of chronic cholecystitis.
recommended?
C. Acute infectious diseases.
A. Oral iron supplements.
D. Iron-deficiency anemia.
B. Transfusion of fresh blood.
E. Chronic hepatitis.
C. Transfusion of red blood cells.
109. The patient 20 years old, last 2 months
D. Parenteral injections of iron preparations.
suffers from increasing weakness, bleeding
E. Parenteral injections of B vitamins.
(hemorrhage skin, nasal bleeding), low-grade
107.
40-year-old woman, who suffers from
fever. The lymph nodes, liver and spleen are
menorrhagia, complains of flicker "flies" be-
not enlarged. Blood tests: hemoglobin - 50 g/l,
fore the eyes, dizziness, dry skin, hair loss.
erythrocytes 1,5x1012/l, CI 1,0, leu. 1,8x109/l,
Paleness of the skin and mucus membranes. Ps-
thromb. 30x109/l, ESR - 60 mm/h. What is a
100 min. rhythmic, 2nd tone at the top is rein-
presumptive diagnosis:
forced, systolic murmurover all points of the
A. Iron-deficiency anemia.
heart. Hb 90 g/l, Er. 3,3x1012/l, CI-0,7, Leuk.
B. Acute leukemia.
3,1x109/l, hypochromia, erythrocytes anisocy-
C. Aplastic anemia.
tosis, microcytosis, serum iron, 7,2 mol / l.
D. Hemolytic anemia.
What is the prevention of the disease?
E. B12-deficiency anemia.
A. Iron preparations per os.
110. Woman 35 years old, complains of gen-
B. Suffice diet.
eral weakness, irritability, dry skin, brittle nails,
121
hair loss. Objectively: skin is pale, PS-96 per
sedimentation rate is 26 mm/h. Gastric Ph-
minute, blood pressure 100/60 mm Hg. In the
metry indicates achilia. Fibrogastroscopy -
blood: HB- 70g/l; er-3.4; CI – 0,7; leukocytes –
atrophic gastritis, gastric polyp. Specify a pre-
4,7x109/l; ESR-15 mm/hr; Serum iron, 7,3
liminary diagnosis:
mmol/l; total protein 70 g/L. The deficit of the
A. Chronic intoxication of benzene.
which factor leds to the emergence of the dis-
B. Gastrogenic iron deficiency anemia
ease?
C. Hypoplastic anemia.
A. Serum iron.
D. Hemolyticanemia.
B. Folic acid.
E. B12-deficiency anemia.
C. Cyanocobalamin.
112. Patient 32 years old, the pilot, hospital-
D. Blood proteins.
ized on the 10th day of illness. Severe condi-
E. Osmotic resistance of erythrocytes.
tion. The body temperature - 39,7 C, inhibited,
111. The patient 42 years old complains of
responds poorly to questions. Suffers from
general weakness, nausea, loss of appetite, ten-
headache, nausea. Meningeal signs are absent.
dency to diarrhea, paresthesia in the legs. 12
Moderately icteric skin. Pulse - 120 r/min, the
years worked as a teacher, the last 2 years –in
liver and spleen are moderately enlarged, thick
the chemistry laboratory, where there is contact
consistency. In the blood: HB - 75 g/l, er –
with gasoline, benzene, acetone. Skin and visi-
2,2x1012/l, CI – 0,8, leuk.11,2x109/l, erythro-
ble mucous membrane pale. Pulse 82 beats per
cyte sedimentation rate - 39 mm/h. What type
min., BP140/80 mm Hg. Tones of heart are
of anemia occurs:
rhythmic. Vesicular breathing. The edge of the
A. Hemorrhagic anemia.
liver protrudes from under the costal arch to 3
B. Hereditary hemolytic anemia, due to chang-
cm, not painful. In the neurological status: ten-
es in the activity of enzymes.
don reflexes are uniformly increased, hypoes-
C. Folic acid deficiency anemia.
thesia on the "golf" type. Blood test: Hb-110
D. Hemolytic anemia caused by hemolysis of
g/l, Er 2,8x1012/l, L-4,6x109/l, megaloblasts -
erythrocytes.
2%, megakaryocytes - 4%, macro anisotropy
E. Aplastic anemia.
and poikilocytosis, Tr -156x109/l, erythrocyte
122
Physiotherapy
1. What type of electric current used in galva-
E. Hyperemia.
nization and electrophoresis:
6. Contraindication for galvanization and elec-
A. Polusinosoidal.
trophoresis is:
B. High voltage current.
A. Arterial hypertension I and II st.
C. DC.
B. Asthma.
D. Pulsed current.
C. Chronic gastritis.
E. Modulated sinusoidal pulse.
D. Peptic ulcer disease.
2. What is the maximum current density used in
E. Eczema.
the local galvanization and electrophoresis in
7. What pulses are used in the method of elec-
adults:
trosleep?
A. 1 A/cm2;
A. Sine waves.
B. 20-30 mA/cm2;
B. Exponential.
C. 5-10 mA/cm2;
C. Rectangular.
D. 1-4 mA/cm2;
D. Triangular.
E. 0,1 mA/cm2;
E. Half-sine waves.
3. The concentration of ions, which leads to in-
8. What does not belong to the basic mecha-
creasing excitability of nerve receptors:
nisms of electrosleep action?
A. Sodium and potassium ions;
A. Direct effect on the central nervous system.
B. Calcium and magnesium ions;
B. Reflex action.
C. Chlorine ions and iron.
C. Desensitizing effect.
D. Phosphorus ions
D. Humoral action;
E. Zinc ions, iodine.
E. Braking.
4. The concentration of ions, which leads to re-
9. What phases are distinguish in the mecha-
ducing excitability of nerve receptors:
nism of therapeutic electrosleep action?
A. Sodium and potassium ions;
A. Braking phase.
B. Calcium and magnesium ions;
B. Excitation phase.
C. Chlorine ions and iron.
C. Release phase.
D. Phosphorus ions
D. Deceleration and release phases;
E. Zinc ions, iodine.
E. Indifferent phase.
5. During the galvanization and electrophoresis
10. Diadynamic therapy does not have the fol-
may be following complications:
lowing effects:
A. Thermal burns.
A. Motor;
B. Chemical burns.
B. Ganglioblocker.
C. Loss of sensation.
C. Hypnotic.
D. Blanching.
D. Analgesic.
123
E. Antispasmodic.
16. The greatest amount of heat at inducto-
11. Which type of frequency of sinusoidal cur-
thermy generated in:
rent used in the amplipulse therapy?
A. Skin.
A. Low frequency.
B. Adipose tissue.
B. High frequency.
C. Connective tissue.
C. Ultra high frequency.
D. Blood and lymph.
D. Ultra high frequency.
E. Bone.
E. Extremely high frequency.
17. Inductothermy is not indicated for:
12. What frequency of sinusoidal current used
A. Acute pneumonia with abscess formation;
used in amplipulse therapy?
B. Chronic bronchitis.
A. 100 Hz.
C. Bronhial asthma.
B. 500 Hz.
D. Peptic ulcer disease.
C. 1000 Hz.
E. Degenerative diseases of the joints.
D. 5000 Hz.
18. UHF therapy has such dosages:
E. 10000 Hz.
A. Athermic.
13. In what diseases amplipulse is contraindi-
B. Oligotermic.
cated?
C. Thermal.
A. Bronchial asthma.
D. Hyperthermic.
B. Radiculitis.
E. Right A, B, C.
C. Chronic gastritis.
19. Franklinization is a method of influence:
D. Peptic ulcer, complicated of bleeding.
A. Constant high voltage electric field.
E. Rheumatoid arthritis;
B. Alternating current;
14. Which methods of high frequency electro-
C. Constant magnetic field;
therapy have irritant effect?
D. Electromagnetic field.
A. Inductothermy.
E. Alternating magnetic field.
B. Ultra high frequency therapy.
20. During the general franklinization patient
C. Darsonvalization.
feels:
D. Super high frequency therapy.
A. Skin tingling.
E. Extra high frequency therapy.
B. Freshness, "whiff" of wind.
15. What effects are the basis of the action of
C. Itchy skin.
high-frequency electrotherapy?
D. Hot flashes.
A. Thermal.
E. Vibration.
B. Oscillator.
21. In the method of EHF - therapy used:
C. Heat and oscillator;
A. Electric field.
D. Sedative.
B. Electromagnetic radiation with decimeter
E. Spastic.
range.
124
C. Electromagnetic radiation with centimeter
C. 0.1 - 0.4 W/cm2.
range.
D. 0,6 - 0,8 W/cm2.
D. Electromagnetic radiation with millimeter
E. 1 - 2 W/cm2.
range.
27. Ultrasound is contraindicated in:
E. High-frequency current.
A. Peptic ulcer.
22. Which method of EHF - therapy is applied:
B. Intervertebral osteochondrosis with radicular
A. Intravenous EHF – therapy.
syndrome.
B. Intraorganic EHF – therapy.
C. Bronchial asthma.
C. Percutaneous EHF – therapy.
D. Diseases of supporting - motor apparatus.
D. Transorganic EHF – therapy.
E. Thrombophlebitis.
E. Intra EHF – therapy.
28. Which method can not injection drugs into
23. What disease is a contraindication for the
the body&
EHF – therapy?
A. Darsonvalization.
A. Alcoholism.
B. Galvanizing.
B. Drug abuse.
C. Ultrasound.
C. Bronchial asthma.
D. Electrophoresis.
D. Myocardial infarction.
E. Phonophoresis.
E. Diabetic angiopathy.
29. Infrared rays have the following effects:
24. What mechanism does not apply to the ul-
A. Сhemical.
trasound action?
B. Biological.
A. Mechanical.
C. Heat.
B. Heat
D. Radiation.
C. Physical – chemical.
E. Mechanical.
D. Antiallergic.
30. Erythema under infrared irradiation occurs
E. All of the above.
through:
25. The highest absorption of ultrasound expo-
A. Few minutes.
sure is in:
B. 20-30 minutes.
A. Muscle tissue.
C. 2-3 hours.
B. Blood.
D. After 3 hours.
C. Bone and nervous tissues.
E. On the 2nd day.
D. Skin.
31. How deep penetrate visible rays into the
E. Parenchymal organs.
skin?
26. What is the intensity of the ultrasound is
A. 5-10 cm.
used in the treatment of diseases of the joints:
B. 3-5 cm.
A. 0.01 - 0.05 W/cm2.
C. 1-3 cm.
B. 0.05 - 0.1 W/cm2.
D. 1 cm..
125
E. 1 mm.
A. Bactericidal.
32. What color is absent in the visible light
B. Anti-inflammatory.
spectrum:
C. Immunoactivity.
A. Blue;
D. Hemostatic.
B. Pink.
E. Antirahitic.
C. Red.
38. What is the temperature of the water is
D. Orange.
called the indifferent?
E. Yellow.
A. Below 20.
33. What color inhibits the neuro - psychic ac-
B. 20-33.
tivity of patient?
C. 34-36.
A. Red.
D. 37-38.
B. Orange.
E. above 39.
C. Yellow.
39. The greatest intensity of exposure is in the
D. Blue.
shower:
E. Green.
A. Charcot.
34. What action have the medium-wave of UV?
B. Circular.
A. Bactericidal.
C. Needle.
B. Producing vitamins.
D. Scotland.
C. Eritema.
E. Fan.
D. Bronchodilator.
40. For nitrogen bath typical are the following
E. Calorific.
steps:
35. At what depth penetrate ultraviolet rays into
A. Tonic.
the tissues?
B. Anti-inflammatory.
A. 1 mm.
C. Desensitizing.
B. 3-5 mm.
D. Analgesic, sedative, desensitizing.
C. 5-10 mm.
E. Analgesic.
D. 1-2 cm.
41. In functional disorders of the nervous sys-
E. 2 cm.
tem are assigned:
36. What action have the short-waves of UV?
A. Hydrogen sulfide baths.
A. Eritema.
B. Bubble baths.
B. Producing vitamins.
C. Radon baths.
C. Bactericidal.
D. Turpentine baths.
D. Heat.
E. Chloride baths.
E. Stimulating.
42. What baths have the greatest impact on the
37. What action does not have the total UV ex-
endocrine system?
posure?
A. Radon.
126
B. Nitrogen.
E. Thermal and Mechanical.
C. Carbon dioxide.
49. In which diseases is indicated sulfide wa-
D. Oxygen.
ters treatment?
E. Pearl.
A. Pulmonary tuberculosis.
43. What baths can be assigned to 3 months af-
B. Liver disease.
ter myocardial infarction?
C. Chronic bronchitis.
A. Conifers.
D. Diseases of the joints.
B. Oxygen.
E. Kidney disease.
C. Pearl.
50. When mineral water are taken at high acid-
D. Carbon dioxide.
ity:
E. All baths are contraindicated.
A. 20 minutes before meals.
44. What step factor of mud on the body does
B. 1,5 hours before meal.
not belong to the primary:
C. During the meal.
A. Thermal.
D. After 15 minutes after meal.
B. Psihitropny.
E. After breakfast 2 hours after meal.
C. Mechanical.
51. At what disease is not indicated sanatorium
D. Chemical.
- spa treatment?
E. Biological.
A. Hypertension.
46. At what disease is contraindicated mud
B. Peptic ulcer.
therapy?
C. Deforming osteoarthritis.
A. Parameter.
D. Alcoholism.
B. Ovarian cyst.
E. Chronic cholecystitis.
C. Gout;
52. At what disease is indicated sanatorium -
D. Peptic ulcer.
spa treatment:
E. Reiter's syndrome.
A. Drug addiction.
47. Ozocerite treatment can be given in:
B. Chronic leukemia.
A. Chronic enterocolitis.
C. Cachexia.
B. Thyrotoxicosis.
D. Schizophrenia.
C. Amyloidosis.
E. Bronchial asthma.
D. Glomerulonephritis.
53. In arterial hypertension stage 1 for the seda-
E. Angina.
tion action used:
48. Major factors in the action of wax are:
A. Amplipulse.
A. Heat.
B. Carbonic acid bath.
B. Chemical.
C. Iodine-bromine bath.
C. Mechanical.
D. Magnetotherapy.
D. Mechanical and chemical.
E. Diadynamic.
127
54. In arterial hypertension stage 2 for the vas-
B. Darsonvalization.
odilatory effect used:
C. Electrosleep.
A. Amplipulse.
D. Circular shower.
B. Contrast baths.
E. Flucktuorization.
C. Magnesium electrophoresis.
60. In chronic cholecystitis without appoints:
D. UV.
A. UHF-therapy
E. Ultrasound therapy.
B. Magnesium electrophoresis.
55. In hypotension appoints:
C. Circular shower
A. Inductothermy.
D. Mud.
B. Ultrasound therapy.
E. Franklinization.
C. Carbonic acid bath.
61. In chronic colitis and intestinal dyskinesia
D. Sulfide baths.
with prevalence spasms appoints:
E. Microwave therapy.
A. Sharko shower.
56. In rheumatoid arthritis in inactive phase can
B. Carbonic acid bath.
be applied:
C. Electrophoresis papaverine.
A. UV.
D. Calcium Electrophoresis.
B. Amplipulse.
E. Circular shower.
C. Mud.
62. In chronic colitis and intestinal dyskinesia
D. Aeroionization.
with prevalence atonia appoints:
E. Sulfide baths.
A. Diadynamic.
57. In acute pneumonia on 3-5 days of illness
B. Electrophoresis atropine.
can be assigned:
C. Microwave therapy.
A. Inductothermy.
D. UHF-therapy.
B. UHF-therapy.
E. Flucktuorization.
C. Franklinization.
63. In chronic glomerulonephritis with hyper-
D. Radon baths.
tensive syndrome (blood pressure 165/105
E. Diadynamic therapy.
mmHg) appoints:
58. In chronic bronchitis in remission appoints:
A. Inductothermy.
A. Sulfide baths.
B. Sulfide baths.
B. Inductothermy.
C. Darsonvalization.
C. UV
D. Franklinization.
D. Circular shower.
E. Pine bath.
E. Electrosleep.
64. In myocardial infarction without Q physio-
59. In uncomplicated peptic ulcer in acute peri-
therapy appointed:
od appoints:
A. On the 1st day.
A. UV.
B. On the 5th day.
128
C. On the 10th day.
A. Sulfide baths.
D. On the 15th day.
B. Underwater shower massage.
E. On the 20th day.
C. Calcium electrophoresis.
65. Sedation effect has all of the above, ex-
D. UHF-therapy.
cept:
E. EHF-therapy.
A. Iodine-bromine baths.
70. In bronchial asthma (infectious-allergic
B. Diadynamic therapy.
form) with moderate course in the remission
C. Bromine electrophoresis on a collar zone.
stage appoints:
D. Radon baths.
A. Sulfide baths.
E. Coniferous baths.
B. Amplipulse.
66. In purulent inflammation is contraindicat-
C. Ultrasound therapy.
ed:
D. Circular shower.
A. UHF-therapy.
E. Carbonic baths.
B. Microwave therapy.
71. In chronic gastritis with increased secretion
C. UV.
appoints:
D. Inductothermy.
A. Darsonvalization.
E. Electrophoresis with dimedrol.
B. UV.
67. In rheumatic heart disease in the inactive
C. Flucktuorization.
phase can be applied:
D. Ultrasonic therapy.
A. Oxygen baths.
E. Electrophoresis with metacin.
B. Circular shower.
72. Therapeutic physical exercises is indicate
C. Calcium electrophoresis.
in:
D. UHF-therapy.
A.
E. Darsonvalization.
bleeding.
68. In acute traheobronhitis (on day 3) desig-
B. Duodenal ulcer 2 months after the bleeding.
nates:
C. Myocardial infarction with Q after 3 weeks
A. Sulfide baths.
from the onset of the disease.
B. Ultrasonic therapy.
D. Acute lobar pneumonia in 7 days from the
C. UV.
onset of the disease.
D. Circular shower.
E. For all listed.
E. Electrosleep.
69. In bronchial asthma with mild course in the
remission stage appoints:
129
Duodenal ulcer after 2 weeks after the
No. of question
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Answer
А
В
D
D
A
C
C
C
B
А
С
С
С
С
А
В
С
А
В
D
B
B
D
A
D
Checking of true answers
Endocrinology
No. of question
Answer
26
A
27
E
28
A
29
B
30
E
31
C
32
D
33
E
34
E
35
B
36
B
37
E
38
D
39
E
40
C
41
С
42
C
43
E
44
E
45
А
46
Е
47
Е
48
С
49
Е
50
Е
No. of question
51.
52.
53.
54.
55.
56.
57.
58.
59.
60
61
62
63
64
65
66
67
68
69
70
71
Answer
А
D
Е
С
Е
С
D
A
B
B
D
E
В
В
Е
D
C
B
E
Е
С
No. of question
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
130
Answer
A
C
C
A
D
A
D
B
A
B
A
D
C
D
B
A
A
E
E
B
E
72
73
74
75
E
E
B
E
97
98
99
100
E
E
A
B
No. of question
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
Answer
E
D
C
D
E
C
D
E
C
D
B
C
A
A
C
D
B
E
D
B
A
B
E
D
E
No. of question
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
Answer
E
C
A
B
E
A
E
A
D
E
B
A
A
E
D
C
B
A
E
A
C
A
B
D
E
No. of question
151
152
153
154
155
156
157
158
159
160
161
162
163
Answer
B
B
A
D
E
A
C
A
B
E
D
E
А
No. of question
176
177
178
179
180
181
182
183
184
185
186
187
188
Answer
Е
В
А
Е
В
А
С
А
С
В
Е
D
А
131
164
165
166
167
168
169
170
171.
172
173
174
175
В
Е
D
Е
С
Е
D
В
В
А
А
Е
No. of question
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Answer
A
C
B
C
A
E
D
E
A
B
B
C
D
C
A
B
C
B
B
C
E
E
D
A
C
No. of question
51
52
53
54
55
56
57
58
Answer
E
E
E
B
E
E
A
A
189
190
191
192
193
194
195
196
197
198
199
200
С
С
С
А
D
В
С
А
С
D
В
В
Pulmonology
No. of question
Answer
B
26
C
27
C
28
C
29
E
30
A
31
E
32
C
33
B
34
E
35
D
36
C
37
B
38
D
39
B
40
C
41
D
42
B
43
C
44
A
45
C
46
A
47
A
48
D
49
D
50
No. of question
76
77
78
79
80
81
82
83
132
Answer
B
C
B
C
E
D
A
D
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
A
C
D
C
E
B
E
E
B
C
E
C
C
B
E
B
A
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
C
C
D
D
C
E
C
B
D
D
C
E
C
A
D
E
C
No. of question
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
Answer
B
B
C
A
B
B
C
E
C
C
D
A
В
А
B
E
D
D
B
D
E
E
B
D
B
No. of question
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
Answer
E
D
B
E
E
A
A
C
B
E
D
C
E
C
A
A
A
C
D
B
A
C
E
A
C
No. of question
151
152
153
154
155
Answer
C
E
E
D
A
No. of question
156
157
158
159
Answer
D
E
C
E
133
Gastroenterology
No. of question
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Answer
E
A
E
A
A
A
A
B
A
C
A
E
A
E
D
B
E
A
A
B
A
A
A
E
A
No. of question
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Answer
C
C
A
B
A
A
A
A
A
A
C
A
A
A
A
A
A
A
A
A
A
D
E
A
A
No. of question
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
Answer
A
A
A
C
A
A
A
B
A
A
A
A
A
E
A
D
C
A
A
E
E
No. of question
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
Answer
B
A
E
C
C
E
C
C
B
E
D
B
A
D
B
B
E
D
C
E
B
134
72
73
74
75
C
E
D
E
97
98
99
100
D
A
B
C
No. of question
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
Answer
E
D
D
C
A
D
E
E
A
B
D
E
E
D
C
B
B
C
E
D
C
E
C
A
B
No. of question
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
Answer
B
A
A
C
A
D
A
A
A
D
B
E
D
B
D
D
E
A
A
D
D
A
E
D
A
No. of question
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
Answer
C
E
C
A
E
B
D
A
E
E
A
E
B
D
C
D
D
D
No. of question
Answer
135
169
170
171
A
D
E
Hematology
No. of question
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Answer
D
D
A
C
C
A
C
B
C
B
D
С
B
B
C
B
A
C
E
D
C
C
A
A
D
No. of question
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Answer
A
D
D
B
C
B
E
B
C
B
D
B
C
D
C
B
C
C
A
A
A
A
B
D
B
No. of question
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
Answer
E
D
C
E
B
C
D
E
E
C
C
A
C
D
C
B
A
A
No. of question
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
Answer
A
E
D
A
B
B
C
B
E
D
A
E
B
A
D
D
B
A
136
69
70
71
72
73
74
75
A
D
B
D
E
D
A
94
95
96
97
98
99
100
B
A
A
A
A
A
A
No. of question
101
102
103
104
105
106
107
108
109
110
111
112
Answer
A
E
A
A
A
A
A
A
A
C
A
E
No. of question
Answer
Physiotherapy
No. of question
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Answer
С
C
A
B
B
E
C
C
D
C
A
D
D
C
C
D
A
E
A
B
D
C
D
D
C
No. of question
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
137
Answer
D
E
A
C
A
D
B
D
B
A
C
D
C
D
D
B
A
E
B
C
B
A
E
D
B
No. of question
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
Answer
D
E
C
C
C
A
B
B
C
B
C
A
A
A
D
B
C
B
B
D
E
E
No. of question
138
Answer