Назва наукового напрямку (модуля):
Семестр: 6
1.General surgery. Situftional tasks.
Опис:
3с. med
1.
A.
B.
C. *
D.
E.
2.
A.
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D.
E.
3.
A.
B.
C.
D. *
E.
4.
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B. *
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5.
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6.
Перелік питань:
The patient K., 63, diagnosed clinically and endoscopically gastric cancer. On the
left supraclavicular region was palpable lymph node measuring 3 x 3 cm, limited
in mobility. Indicate the most likely character pathology lymph node.
Trivial supraclavicular lymphadenitis.
Virchow metastases.
Virchow regional metastases.
Distant metastasis Krukenberg.
Krukenberg regional metastases.
At patient N., 42, when examining the right breast revealed a painful infiltration
in the upper quadrant of the breast. Tone at percussion is decreased. Positive
symptom of "lemon peel". What pathology is diagnosed at the patient. What
should
do for theUltrasound
ultimate diagnosis?
Fibrous you
mastopathy.
of the breast.
fibrocystic mastopathy. Mammography.
Breast cancer, biopsy.
Mastitis, the stage of infiltration, biopsy.
Suppurative mastitis, biopsy.
Patient A., age 45, operated on for papillary carcinoma of thyroid gland. After the
operation has received two courses of radioiodine therapy. The control scans
using radioactive iodine in 5 years - uptake were found. To which clinical cancer
group should the patient be included.
II
II A.
IV
III
I B.
The patient operated on for cancer of the stomach. Intraoperative tumor antrum
with endophyte growth, which led to a breach of the entrance to pyloroduodenal
channel. In the right and left parts, liver metastatic nodes were found in
diameter from 1 to 3 cm patient imposed gastroenteroanastomoses for Petersen.
Which clinical group with cancer should the patient be included. Which
III clinical group radical
IV clinical group palliative
III clinical group radical
III clinical group palliative
II clinical group symptomatic
Patient N., 50, operate for cancer of the breast. The surgeon had a radical
mastectomy. Before sewing the wounds, on the entire wound surface for 1
minute put the gauze soaked with 96% ethanol solution. What do you call this
method of cancer surgery.
Asepsis.
ablation
Antiblastic.
Zonation
Chemotherapy
7. At patients with acute intestinal obstruction diagnosed intraoperatively with
cancer of hepatic flexure colon with invasion into the inferior vena cava and the
duodenum. What operation is indicated in this case.
A.
B.
C. *
D.
E.
7.
A.
B.
C.
D. *
E.
8.
A.
B.
C. *
D.
E.
9.
A.
B.
C. *
D.
E.
10.
A.
B.
C. *
D.
E.
11.
A. *
B.
C.
D.
E.
Palliative, gemikolonektomiyA.
Radical, gemikolonektomiyA.
Palliative, enterotransverzoanastomoz.
Palliative, tsenostomiyA.
Diagnostic, laparotomy.
The patient S., 36 years clinically, radiologically and cytologically diagnosed with
Ewing's sarcoma. Which way of metastasis is most typical for this type of
tumors.
Contact.
osteogenic.
lymphogenous.
Hematogenous
perineuralis.
Patient K., 60, operable by the acute obstructive intestinal obstruction.
Intraoperative tumor sigmoid colon. Weighing the presence of obstruction of the
surgeon made a resection of the sigmoid colon with the tumor, the distal part of
which sewed up tight, and the proximal brought onto the anterior abdominal wall
in the form of a finite colostomy. What operation did the surgeon perform?
coercion.
palliativE.
radically.
Combination
symptomatic
The patient clinically, endoscopic and sonographic diagnosis of cancer of the
stomach. The tumor with exophyte growth on the back of the body of the
stomach, 3 cm in diameters metastases in the regional lymphatic nodes and
distant metastases were found. Which clinical group with cancer should include
Ithe
A. patient.
II.
II A
III.
IV.
The patient with the needle biopsy of breast cancer. Clinically, the tumor in
upper lateral side 1,5 cm x 2 regional lymph nodes were not enlarged. When Xray,sonography examination and CT of distant metastases were found. Describe
this N1,
clinical
T1,
M1. situation using the TNM system.
T1, Nh, Mx.
T1, No., M 1.
T2, N1, M1.
T2, No., Mo.
The patient with the needle biopsy of the breast cancer. Clinically, the tumor in
upper -lateral quadrant, size 1.5 x 2 cm thick palpable mobile lymph nodes in
axillary area, distant metastases were found. Describe this clinical situation
using
the
TNM system.
T2,
N1,
Mo.
T1, N2, Mx.
T2, No., M 1.
T3, N1, M1.
T2, N3, M o.
12.
The patient after clinical, radiological and CT examination revealed lung cancer.
According to the international classification of tumors assessed as T1, N1, M1. At
what stage would you assign a carcinoma.
A.
B.
C.
D.
E. *
13.
II
II A
III
III A
IV
The patient discovered cancer diagnosis shield-like cancer. During
thyroidectomy. In auditing the cellular spaces found lonely enlarged lymph
nodes. What is important in evaluating lymph nodes for metastases.
Consistency.
Colors.
Express biopsy
Palpation.
The use of special dyes.
The patient with the needle biopsy revealed breast cancer. Clinically, the tumor 6
cm in diameter, thick, skin over the tumor in the form of lemon rind. Nipple
retracted. Aksilyarnie lymph nodes were large, welded, limited mobility. CT
revealed destruction and lumbar vertebra. Describe this clinical situation the
system
TNM.
T3,
N2, M1.
T4, N3, M1.
T4, N3, M o.
T3, N3, Mo.
T4, N3, M1.
In patient H, 64 years, resulting in a compressive survey establishes the
presence of tumor of the rectum. For the survey results oncoproctology identified
tumor as T1, No., Mo. Which clinical group would you assign such a patient.
II B
III.
II A
II.
III.
In a patient with X-ray revealed right lower leg locus of destruction in
metadiafeze of the tibia bone size 3 x 2,5 cm. Around discovered pockets - signs
of osteosclerosis. Which method should I choose for the final verification of the
diagnosis. tomography
computer
computer tomography with contrast enhancement.
Osteopunctiones foci of hystologycal and microbiological examination.
MRT
Skun bone with radioactive gold.
The patient with gastroduodenoscopy found the body of stomach ulcer in
diameter, 3.5 cm biopsy from the bottom and edges of the ulcer. Histological
examination established the presence of highly differentiated adenocarcinoma.
What
is the most probable path of metastasis in this case.
Hematogenous
Implantationes.
Low differentiation adenocarcinoma not metastases.
A.
B.
C. *
D.
E.
14.
A. *
B.
C.
D.
E.
15.
A.
B.
C. *
D.
E.
16.
A.
B.
C. *
D.
E.
17.
A.
B.
C.
D. *
E.
18.
lymphogenous
Contact.
Oncological patient operated on for cancer of the caecum. Operation - rightsided gemikolonektomy. Postoperatively, the patient was appointed
chemotherapy. What do you call this method of treating cancer patients.
A.
B.
C. *
D.
E.
19.
Specific
Radical.
Complex.
CompoundeD.
Radical.
Patient N., 30 years old, was operated on for cancer of thyroid gland. Before the
operation, performed puncture biopsy of the tumor - the result is papillary
carcinoma. Operation - thyroidectomy. In the final histological examination
confirmed the diagnosis of papillary carcinoma. Where else in need of treatment
a patient.
Chemotherapy.
radiotherapy.
Therapy with radioactive iodine.
Hormone replacement therapy by glucocorticoids.
Immunomodelling therapy.
An emergency Doctor examines a woman at home. Complaints of unbearable
pain in the left wreaths, forearms and shoulders. Pain accompanied by numbness
of fingers brush dysfunction. By palpation brush cold to the touch. In anamnesis
in patients with acute strokes three years ago. Your diagnosis. What additional
information
continuing
Paralysis
leftshould
upper obtain
extremity,
review review?
neurologist.
Miyelomna disease, X-ray bone forearm.
brachial artery embolism, by palpation definition ripple on the shoulder, elbow
and
radiation arteries.
brachio-scamulares
periartritis determine the amount of passive and active
movements.
pathologic fracture of the left shoulder, shoulder radiography.
In patient K., 63 years, clinical and sonographic set the right brachial artery
embolism (12 hours of onset). A history of three years ago, myocardial infarction,
atrial fibrillation. The most likely source of embolus. Treatment?
Mozart lower limb, thrombolytic therapy.
Left ventricle, surgical treatment.
The right ventricle, surgical treatment.
Pulmonary trunk, surgical treatment.
Left ventricle, thrombolytic treatment.
Patient N., 62 years, has a history of myocardial infarction, atrial fibrillation.
Climbed out of bed in the morning and felt a sudden sharp pain in the left foot
and skin. When you review in 8 hours of onset: pallor of skin lividity spots
(marble color), skin cold feet and shins. Pain and impaired tactile sensitivity. Your
diagnosis.
Thethrombosis,
most informative
non-invasive diagnostic method to confirm it.
Acute
venous
flebografya.
Of acute arterial embolism, lower extremity vascular ultrasound.
Acute arterial embolism, aortoarteriografya.
Acute Syndrome radicularys, radiography of the spine.
Acute ileofemoralis thrombosis, ultrasound venous trunks.
A.
B.
C. *
D.
E.
20.
A.
B.
C. *
D.
E.
21.
A.
B. *
C.
D.
E.
22.
A.
B. *
C.
D.
E.
23.
A.
B.
C.
D. *
E.
24.
A.
B.
C. *
D.
E.
25.
A.
B.
C.
D.
E. *
26.
A.
B.
C.
D. *
E.
27.
A. *
B.
C.
D.
E.
28.
A.
B.
C.
In the patient "like a bolt from the blue" appeared unbearable pain in the area of
the left foot and lower third of shin. Patient 60, a history of myocardial infarction,
left ventricular aneurysm. Clinical atrial fibrillation, foot and lower third of shin is
pale, cold to the touch. Your diagnosis. What additional information should obtain
continuing
review?
popliteal
artery
thrombosis, ECG data.
Acute thrombosis ileofemeralnyy given flebohrafiyi.
Radykulyarnyy syndrome, data on neurological status.
Popliteal artery embolism, data Paltseva study lower extremity arterial trunks.
obliterating trombanhit given sonography.
In 1962 the patient complained of pain, sleep and cold sensation in feet and shin
areas. After 200 meters through the intense pain in calf muscles, patient should
stop and rest to continue working. Pulse on both femoral arteries are not
defined. Yourendarteritis,
diagnosis. What's
this syndrome?
obliterating
alternating
lameness.
Lerisha syndrome, alternating lameness.
Panchenko syndrome, hypoxic lameness.
Moschowitz syndrome, hypoxic lameness.
Burger's disease, alternating lameness.
The patient complains of pain, feelings of sleep and stop cold areas. Limp
through alternating every 200 meters. Pulse on the femoral arteries is not
defined. Decreased
libido. Your diagnose.
Panchenko
syndrome.
Moschowitz syndrome.
Ratner syndrome.
Burger's disease.
Lerisha syndrome.
In a survey in 1970 revealed the patient obliterating the right lower extremity
atherosclerosis, KHAN IV century., Gangrene right foot. What is the main criterion
in the differential diagnosis of dry and wet gangrene.
The level of atherosclerotic occlusion.
V. Data vascular ultrasound.
S. The level no ripple.
Demarcation line.
The expression of alternating lameness.
In the patient suddenly 6 hours ago appeared an acute unbearable pain in the
area of right foot and shin. The patient is 60 years old. A history of myocardial
infarction, left ventricular aneurysm. Clinical atrial fibrillation, the right foot and
leg is like pale marble shade, cold to the touch. Pulse on the right femoral artery
is determined in the left femoral artery satisfactory performance. Your diagnosis.
Right femoral artery embolism, ultrasound, surgical treatment.
Thrombosis of the right femoral artery thermometry, surgical treatment.
Pravobichnyy Lerisha syndrome, arteriohrafiya, surgical treatment.
Obliterating aortoarteriyit, aortoanhiohrafiya, thrombolytic therapy.
right femoral artery embolism, ultrasound, thrombolytic therapy.
In 1970 the patient obliterating atherosclerosis of both lower limbs. CHAI right
lower extremity II art., The right fourth century. Wet gangrene right foot. What is
crucial
to choose the level of amputation?
Borderline.
Age of the patient.
Prevalence of necrosis.
D. *
E.
29.
A.
B.
C. *
D.
E.
30.
A.
B.
C. *
D.
E.
31.
A.
B.
C. *
D.
E.
32.
A.
B.
C. *
D.
E.
33.
A. *
B.
C.
D.
E.
34.
A. *
B.
C.
The level of atherosclerotic occlusion according to ultrasound.
The level of lack of pulsation vessels.
In 1946 patients diagnosed with acute right femoral artery embolism. Urgent
Agenda patient operated on. Operation embolectomy performed with Fogarty
catheter. What embolectomy was done?
instrumental.
indirect.
Direct.
Surgical.
Reconstructive.
In patient K., 1956, on the basis of clinical, sonographic and angiographic
examinations, the presence of duplex Lerisha syndrome. Collateral circulation in
the state subcompensated. No concurrent disease. What is the treatment most
appropriate?
Physiotherapeutic
of action of lumbar sympathectomic trunk.
Conservative treatment of disagregant"s and thrombolytic therapy.
Aortofemoralis bifurcation synthetic bypass prosthesis.
Anticoagulant and thrombolytic therapy.
intravenous drug prostaglandin E (alprostan, vazoprostan).
In patient S., 59 years, coronary heart disease, angina pectoris. When
aortocoronarography found one local stenotic narrowing of coronary arteries.
Which type of treatment should be given preference in this case?
Koronarolityky and anticoagulants.
Aortokoronarne bypass.
stenting space narrowing.
Endovascular laser destruction of places of occlusion.
Intimtrombektomiya space occlusion.
Patient K., suffers from varicose disease of the right lower extremity for over 10
years. Two days ago in the area appeared varical acute thrombophlebitis. The
surgeon noted in reviewing the availability of acute ascending thrombophlebitis
hip and thigh with the spread to the upper third of thigh . How dangerous this
disease.
Development
ileofemoralnoho thrombosis.
Thrombosis of cerebral vessels.
pulmonary artery thrombosis.
Renal artery thrombosis.
myocardial infarction.
Patient K., suffers from varicose disease of the right lower extremity over 10
years. Varicosity in a pool of large saphenous veins. Three days ago there was
thrombophlebitis. The surgeon noted in reviewing acute ascending
thrombophlebitis
ofinsuperficial
veins of the upper third of thigh. Medical
Surgical
treatment
urgent procedure.
Thrombolysis, planned surgical treatment.
anticoagulant and thrombolytic therapy.
Bed rest, tire Bellera, anticoagulants.
bed rest, thrombolytic, anticoagulant.
In patient N., 54 years old after foot injury (fell on the foot plate) developed dry
necrosis of fingers I-IV. Ripple of arteries of lower limbs preserved. Surgical
tactics.
necrectomy
after formation of a clear demarcation line
Transmetatarsal amputation.
necrectomy departing 5 cm above the demarcation.
D.
E.
35.
A.
B.
C.
D.
E. *
36.
A.
B.
C. *
D.
E.
37.
A.
B.
C.
D. *
E.
38.
A. *
B.
C.
D.
E.
39.
A.
B. *
C.
D.
E.
40.
A.
Angioprotective replacement therapy and anticoagulants.
Chemical and biological evolutionary necrectomy.
In patient K., 1940, varicose veins in the region of large saphenous vein of the
third degree. NEC - III. Trophic ulcers on the medial surface of the lower third of
shin. On ultrasound expressed valve insufficiency perforating veins. What is a
cardinal in
treatment
trophic
ulcers
this casE.
Cleaning
ofthe
necrotic
tissueoffrom
ulcers
andinautodermoplasty.
Of compressive therapy using thin gelatin UNA bandage.
Infection control, cleaning sores, autodermoplasty defect closure.
Compressive therapy, ulcer treatment, autodermoplasty
Surgical treatment of varicose diseasE.
In patient K., 72 years-old, peptic ulcer disease left lower extremity third degree.
Extensive trophic ulcer in the area of localization Kokketa veins. A history of
myocardial infarction. Heart Failure II B. Optimal method of treatment of trophic
ulcers.
Conservative
treatment of locally mazevi bandages.
Treatment of compression bandage, followed by UNA autodermoplasty.
Purification of necrotic ulcer tissue defect closure ksenoskin.
Surgical treatment of peptic ulcer with subsequent autodermoplasty ulcer.
sclerotherapy varykouse veins autodermoplastic of ulcer.
In patient K., 65 years, there was a sudden intense pain in the area of the left
foot and shin. A history of myocardial infarction. Clinical and ultrasound in the
presence of femoral artery embolism. Tactics of treatment.
Therapy anticoagulants.
Thrombolysis
lumbar sympatectomy
Surgical treatment
Thrombolysis and rheological agents.
Patient S., 1965. Complains of intense pain in gastrocnemius, which occurs every
three - five meter walk. The pain causes the patient to stop and rest. As the
name of this symptom for which disease it is typical.
alternating lameness, Lerisha syndromE.
Coronary lameness, obliterating endarteritis.
atherosclerotic limp, Burger's diseasE.
Alternating lameness, femoral artery embolism.
alternating lameness, femoral artery thrombosis.
When you review the patient K., 1953, the surgeon noted the presence of two
trophic ulcer size 2 and 3 x 1.5 x 1.5 cm in medial surface area of the right shin.
Skin ulcers around changed. For such a disease characterized by localization of
ulcers.
Posttromboflebityc
syndrome, phase of recanalisationes.
Of varicose disease, vein valve insufficiency Kokket.
Posttromboflebityc syndrome, vein valve insufficiency Bohid.
Obliterating endarteritis, Phase trophic changes.
Obliterating arteriosclerosis
Patient N., 1920, diving from the pier, head banged to the floor, injured cervical
spine. In tetraplegia patient, pelvic organs dysfunction. Two and a half days of
bed regime. When you review in the area of sacrum and coccyx hyperemia,
swelling of skin, size 12 x 10 cm, necrosis in the center area of 5 x 4 cm your
diagnosis.
Postinjectiones
abscess.
B.
C. *
D.
E.
41.
A.
B. *
C.
D.
E.
42.
A. *
B.
C.
D.
E.
43.
A.
B.
C.
D. *
E.
44.
A. *
B.
C.
D.
E.
45.
A.
B.
C.
D. *
E.
46.
A.
Burn II - III degree
bedsores.
Erysipelas.
Allergic dermatitis.
Patient N., 40 years, operated on a closed fracture of the middle third of right
thigh. Operation - open reposition fragments, intramedullary metaloosteosyntez.
For 7 days after the operation suddenly, without apparent reason there was a
sharp swelling of the foot, shin and thigh. Ending two times greater in volume
compared with
Body temperature 38,6 ?. Your diagnosis.
Erysipelas
righthealthy.
lower extremity.
Acute thrombosis ileofemoral.
Posttromboflebitalnyy syndromE.
Acute thrombophlebitis of superficial veins.
hematoma in the area of surgical intervention.
The patient, 70 years old, inoperable tumor on head of pancreas, obstructive
jaundice performed the operation - holetsystoenterostomiyu. What's this
operation,
type of fistulas?
Palliative, artificial
fistula, inner biliodyhestyvnA.
Root, artificial fistula, inner biliobiliarnA.
Palliative S., acquired fistula, external, billiari.
Symptomatic fistula artificial, external, billiari.
Root, artificial fistula, external, billiari.
In patient S., 1950, against a background of varicose veins disclosure surface
developed acute thrombophlebitis. Concurrent disease in a patient there. Third
day of onset. What are the main indications to surgical treatment of this
category
ofage
patients.
The
young
of the patient.
The appearance of necrotic changes.
Secondary limfanhoit and lymphadenitis.
Acute ascending thrombophlebitis.
Acute nyshidnyy thrombophlebitis.
For a patient on the dorsum of II finger of the left brush after implementation of
agricultural works abscesses appeared with the presence of festering bar in a
center. Around edema, hyperemia, loss of finger functions. Your diagnosis.
Subcutaneous panaricium.
Intraskin panaricium.
Furuncle.
Erysipelas.
Bone panaricium.
For a patient K., after a microtrauma an abscess appeared in the area of the left
brush nail phalanx palm surface of II finger. At the examination a bubble is
determined in a diameter 1,5 sm and pus inside. Motions in a finger are
practically
unreserved.
method
of anaesthetizing.
Hypodermic
panaricium,Diagnosis,
operation,tactic,
explorer
anesthesia.
Hypodermic panaricium, operation, anesthesia.
Panaricium «for as a cuff-link», operation, anesthesia.
An indermic panaricium, dissection of necrotic epidermis, anesthesia is not
needed.
Bull fibroma of erysipelas, conservative treatment.
For a patient the hypodermic panaricium of nail phalanx of II finger of the left
brush is clinically diagnosed. In anamnesis two sleepless nights. Medical tactic,
method
of anaesthetizing?
Conservative
therapy for 2-3 days, at unsuccessfulness operation under
anesthesia.
B.
C.
D. *
E.
47.
A.
B.
C.
D. *
E.
48.
A.
B. *
C.
D.
E.
49.
A.
B. *
C.
D.
E.
50.
A.
B.
C.
D. *
E.
51.
A.
B.
C. *
D.
E.
Surgical treatment, opening of abscess, anesthesia.
Surgical treatment, opening, local anesthesia.
Surgical treatment, opening of abscess, explorer anesthesia.
Regional novocaine blockade with antibiotics, at unsuccessfulness there is an
operation, local anesthesia.
A patient has acute ligaments panaricium of I finger of the left brush becomes
complicated festering tendovaginitis with development of «V» - like phlegmon.
Specify the most credible way of metastasis of festering-septic process.
At tendon vaginas of II-IV of fingers.
In the area of tenor and hypotenor.
In the area of deep palm fat space.
In Pirogov-Paron’s space.
At hypothenar and forearm.
Patient D., 30 years old, appealed for a medical help with complaints about a
myalgia in the area of III finger of the left brush. A surgeon diagnosed a
ligament panaricium, conducted an operation. What is necessary in subsequent
treatment
Daily
bandages.
Immobilization.
Vitamin-therapy.
Early restoration therapy.
Local cryotherapy.
For a patient hypodermic panaricium I finger of right brush. It is ill 4 days, last
night sleepless. All finger hurts, however most in the area of nail phalanx. What
method is most informative for determination of localization of hearth and place
of access to the abscess?
X-Ray.
«Palpation» by a probe.
Thermometry.
Ultrasound investigation.
Computer tomography.
Patient A. during the cooking of meat got the microtrauma of II finger of right
brush. In two days in the area of finger formed hyperemia on a background
which cyanotic spots, acute pain. At a review a finger is incrassate, acutely
sickly, the function
of finger is loss. Your diagnosis.
Hypodermic
panaricium.
Ligaments panaricium.
Phlegmon of finger.
Erysipelas.
Acute tendovaginitis.
For a patient ligament panaricium of III finger of right brush. A patient is
prepared to operative treatment. Due to what the panaricium certainly as
separate festering-septic pathology and that decides in the lead through of
surgical treatment.
Character
of virtual complications.
Severity of clinical motion.
Topography-anatomical features of fingers and brush structure.
To the high risk of brush function loss.
Possibility of pathological process distribution on a brush and forearm.
52.
A.
B. *
C.
D.
E.
53.
A.
B.
C.
D. *
E.
54.
A. *
B.
C.
D.
E.
55.
A.
B.
C.
D. *
E.
56.
A.
B.
C.
D. *
E.
57.
A.
B.
C.
A patient has bone panaricium of nail phalanx of II finger of the left brush. Pain
syndrome is expressed, three sleepless nights, in eve of hospitalization, t° 38,60, in a blood test is leukocytosis. Specify the optimum method of
anaesthetizing.
Local
anesthesia.
Anesthesia by Oberst-Lukashewich.
Local anesthesia by O.V.Vishnevsky.
Intravenous narcosis.
Perydural anesthesia.
A patient with a commissural phlegmon had an acute edema and hyperemia of
dorsum of the left brush. A patient is operated, pain diminished, the temperature
of body had been normalized. What most reliable reason of this edema, surgical
tactic.
Duration
of festering process through the commissural openings, surgical
treatment. of commissural phlegmon and phlegmon of opisthenar, surgical
Combination
treatment.
Combination of commissural phlegmon and erysipelas, conservative therapy.
Edema reactive, conservative therapy.
Inadequate opening of abscess, repeated surgical treatment.
After pregnancy of 25 years old women a surgeon diagnosed acute lactational
mastitis. Temperature of body 39°C. On ultrasound investigation in retromammar
space liquid education in a diameter 6,8 see. Diagnosis, tactic, access.
Retromammar mastitis, surgical treatment, access by Bardengoer.
Intramammar mastitis, surgical treatment, access by Angerer.
Retromammar mastitis, punction of liquid, antibacterial therapy.
Retromammar cyst, punction, cytological examination.
Panmastitis, surgical treatment, access by Rayer.
After pregnancy after a duty massage and straining of right mammary gland
concerning lactostasis, a temperature rise to 390C. In to lower-external square of
gland dense, acutely sickly, infiltrate is palpated in the size of 8x6 sm. The
symptom of fluctuation is positive. Information of ultrasound investigation not
convincing. That it follows to execute with the purpose of subsequent
Mammography.
CT of mammary gland.
Determinations of the microorganism from a nipple.
Diagnostic punction.
A control cut of infiltrate by Angerer.
At patient S. after pregnancy, 25 years old, acute festering lactational
retromamary mastitis is diagnosed. Conducted operation, opening of mastitis
under a local anesthesia by the Angerer’s incision. Comment on a situation.
Anesthesia and access is adequate.
Anesthesia is adequate, access is done wrong.
Method to the choice at the venerable are a intravenous narcosis, access is
adequate.
The anesthesia and access is chosen wrong.
The patient it is possible to threat by a punction method with using of antibiotics.
At patient A. after pregnancy, 20 years old, it is diagnosed acute festering
intramammary lactational mastitis. Opening of mastitis is conducted by Angerer
with the areola area passing. What can in future become complicated motion
postoperational
period?
Decreasing of nipple
sensitiveness.
Formation of colloid scar.
Cosmetic defect.
D. *
E.
58.
A.
B. *
C.
D.
E.
59.
A. *
B.
C.
D.
E.
60.
A.
B.
C.
D.
E. *
61.
A.
B.
C.
D. *
E.
62.
A.
B.
C.
D. *
E.
Milk fistula.
Lactostasis.
For patient K. 21 year old, after pregnancy, acute festering lactational mastitis is
diagnosed. Under a intravenous narcosis the conducted access by Angerer.
Infiltrate is dissected overhead-external square of mummary gland. The
presence of abscesses plenty is thus set in a diameter from 0,5 to 1 sm. What
spread on all area
of infiltrate?
Your diagnosis.
of in
operations?
Apostematouse
«multifocal»
mastitis,
delete ofVolume
infiltrate
volume of sectoral
resection.
Phlegmonouse mastitis, opening and draining of abscess.
Gangrenouse mastitis, opening and draining of abscess.
Serous-infiltrative mastitis, antibacterial therapy.
Aktinomikosis of mummary gland, conservative specific therapy.
At patient D. after pregnancy, 28 years old, it is diagnosed acute lactational
gangrenous panmastitis. Sepsis, septic shock. What volume of operation is
indicated
in thisintratracheal
case, anesthetic
providing.
Mammectomy,
anesthesia.
Opening of abscess by four accesses by Angerer, intravenous narcosis.
Opening of abscess by Bardengoer wide access with imposition of contraperture,
intravenous of
narcosis.
Amputation
mammary gland, retromammar anaesthesia.
Mammectomy, intravenous narcosis.
At a patient, 46 years old, without apparent cause in the area of right mammary
gland, formed hyperemia, edema. At palpation a sickly, not mobile infiltrate is
determined in a upper lateral square. A megascopic, moderato sickly, lymphatic
knot is palpated in an axillar area. Conservative therapy (antibiotics, antiinflammatory
drugs)
uneffective.
Reliable
diagnosis. Tactic.
Serous
mastitis,
continue
conservative
therapy.
Serous infiltrative mastitis, continue massive antibacterial therapy.
Acute festering mastitis, access by Angerer, drainage.
Infiltrative mastitis, carving of infiltrate in volume of sectoral resection with next
histological
Mastitis-like research.
cancer of mammary gland. For verification of diagnosis - punction
biopsy,
cytology.
Patient K., 30 years old, appealed for a medical help with complaints about pain
in the area of III finger of the left brush. At a review on the dorsum of basic
phalanx inflammatory infiltrate with three necrotizing bars in a center. Diagnosis.
Subcutaneous panaricium.
Ligament panaricium.
Abscess of finger.
Carbuncle of finger.
Furuncle of finger.
Sick N., 35 years old, operated 17 days ago back concerning acute lactational
phlegmonous mastitis. The state of patient is heavy. Wounds with the signs of
inflammation, selection are active, festerings with the admixtures of milk.
Straining of mammary glands is painfully. An increase of temperature is to 38°C.
That it isthe
needed
to execute
for rapidtherapy.
convalescence of patient.
Change
program
of antibacterial
Made the repeated debriding of festerings hearths.
Prescribe the imunomodulate therapy.
To stop a lactation.
To put right the wash-draining system.
63.
A.
B.
C.
D. *
E.
64.
A.
B.
C. *
D.
E.
65.
A.
B.
C.
D. *
E.
66.
A.
B. *
C.
D.
E.
67.
A.
B.
C.
D. *
E.
Patient K., 40 years old, entered to surgical department with complaints about a
pulsating pain in the nail phalanx of II finger of right brush. At a review the
accumulation of pus is marked under the epidermis as a bubble. A bubble is
exposed, selected near 1 ml. leave to rot, an epidermis is carved. At the review
of wound surface in a center a white dot is determined by a size in the head of
Epidermic panaricium, antibacterial therapy.
Subcutaneous panaricium, surgical treatment.
Bone panaricium, revision of fistula.
Panaricium as a «cuff-link», surgical treatment.
Ligament panaricium, surgical treatment.
Patient A., 30 years old, operated concerning of the ligament panaricium of the V
finger of right brush. On five day after an operation did the state of patient
become worse, temperature of body 390C. Excretions festering from a wound. In
lower third of forearm edema, hyperemia, acute pain. Positive symptom of
fluctuation.
What complication
arose
up for a patient? Tactic?
Acute
lymphangoitis,
conservative
therapy.
Erysipelas of forearm, conservative therapy.
Phlegmon of Pirogov-Paron space, surgical treatment.
«V» (ve) similar phlegmon, surgical treatment.
Acute tendovaginitis of forearm, conservative treatment.
Patient M., 58 years old, entered to surgical department in 12 days from the
beginning of disease, engaged in self-treatment. Disturbs pain in the area of II
finger of the left brush. According to a patient after the breach of pus the state
became better. The nail phalanx of mace – like incrassate, cyanosis of skin. On a
side fistula is determined with festerings excretions. Your diagnosis? What it is
Ligament panaricium, determination of the microorganism from a wound.
Subcutaneous panaricium, fluctuation.
Pandactilitis, ultrasound investigation of finger.
Bone panaricium, X-Ray of finger.
Hematogene osteomielitis, fistula form, X-Ray of finger.
Patient M., 22 years old, complaints about pulsating pain in the area of brush.
Objective: acute edema, hyperemia of brush rear. The symptom of fluctuation is
doubtful. Near basis of III finger in place of callosity moderate hyperemia, acute
pain in palpation.
Temperature of body 390 C. Diagnosis?
Phlegmon
of opisthenar.
Commissural phlegmon of brush.
Erysipelas.
A Pirogov’s space phlegmon.
«V» (ve) similar phlegmon of brush.
Patient M., 26 years old, complaints about exhausting pulsating pain more in a
right brush. From anamnesis – operated 7 days ago concerning to the ligament
panaricium of I finger. Excretions from a wound festerings in great numbers. For
the last days the state became worse. Temperature of body is 39° C, there was
an edema, pain, phlegmon
bend contracture,
Subaponeurotic
of brush.in the area of the V finger. Your diagnosis?
Phlegmon of tenor and hypotenor.
Commissural phlegmon of brush.
«V» (ve) similar phlegmon of brush.
Phlegmon of Pirogova-Paron space.
68.
A.
B.
C. *
D.
E.
69.
A.
B.
C. *
D.
E.
70.
A.
B.
C.
D. *
E.
71.
A.
B. *
C.
D.
E.
72.
A.
B.
C. *
D.
E.
73.
For a patient K., 42, subcutaneous panaricium of I finger of right brush. He is ill
for 4 days, in anamnesis there is sleepless night. A surgeon in the conditions of
festering operating-room after treatment of the operating field executed explorer
anaesthesia by Oberst - Lukashevich. Defined the place of cut. What is necessary
to do
for an
a high-quality
To
enter
antibiotic. opening of panaricium?
Explored anaesthesia complement by N < A.
Stop of blood flow through finger by imposition of plait.
To enter antihistaminic preparations.
To complement explorer anaesthesia a phlebonarcosis.
In 5 days after the operation of appendectomy concerning by acute
phlegmonous appendicitis appeared for a patient pain, slight swelling, turning
red in the area of postoperational wound. Palpation - infiltrate is determined with
fluctuation in a center. Temperature of body of 38° C. Define character of
complication?
Suppuration
of postoperational wound.
Infiltrate of postoperational scar.
Abscess of postoperational scar.
Infiltrate of postoperational wound.
Foreign body of postoperational wound.
Women appealed to the surgeon of polyclinic department with complaints about
pain in the area of nail phalanx of II finger of right brush. During work pricked a
finger by a long needle, night did not sleep of pain. At a review on palm's surface
of nail phalanx the expressed tension and painful of soft tissues, hyperemia and
hyperthermia. In the area of puncture of removing layer by layer of epidermis
Subcutaneous panaricium.
Intraskin panaricium.
Phlegmon of II finger of right brush.
Subcutaneous panaricium as a «cuff-link».
Bone panaricium.
After clipping of sheep skin, the man becomes the complaints about a general
weakness, presence of infiltrate in an inguinal area with an ulcer. Bottom of ulcer
is black. At a review round an ulcer shallow blisters with serosal content. What
disease does
speech go
about?
Carbuncle
of inguinal
area.
Siberian ulcer.
Syphilitic ulcer.
Trophic ulcer.
Cancer of skins with an ulcer.
For a patient B., 65 years old, chronic osteomielitis of right shin. It is ill 15 years.
Two-three times on a year there is intensifying of disease, fistula is opened with
festering content and bone sequesters. What complication from the side of
internal pyelonephritis.
organs can arise up for this patient?
Chronic
Ulcerative disease of stomach.
Amiloidosis of kidneys.
Hepatitis C.
Hospital pneumonia.
To the surgeon of the polyclinic a man appealed of 40 years old with complaints
in the presence of sickly compression in the area of overhead lip with a festering
bar in a center, head pain, fervescence, to 39°. Edema from an overhead lip
spreads on a person and right eye. Your diagnosis? Tactic of doctor of polyclinic?
A.
B. *
C.
D.
E.
74.
A.
B.
C.
D. *
E.
75.
A.
B.
C. *
D.
E.
76.
A.
B.
C.
D. *
E.
77.
A. *
B.
C.
D.
E.
78.
A.
B.
C.
Carbuncle of overhead lip, surgical treatment.
Furuncle of nosolabial triangle, exigent hospitalization in a surgical clinic.
Furuncle of overhead lip, opening of furuncle.
Thrombosis of cavern sine, conservative treatment.
Furuncle of overhead lip, sepsis, antibiotic-therapy.
Patient S., 20 years old, soldier of urgent service. After an appeal and heavy
physical loadings, feel pain and edema in lower third of right shin. Temperature
of body 37,40C. On a X-Ray the limited necrosis of spongy part of tubular bone.
Edges
of focusofare
levels,
clear. Your
diagnosis. Surgical tactic.
Osteomielitis
Ol'e,
conservative
treatment.
Osteomielitis Garre, antibacterial therapy.
Antibiotic osteomielitis of Popkirov, surgical treatment.
Abscess Brody, trepanation of bone, curetasis of focus.
Abscess Brody, antibacterial therapy, immobilization of leg
A women., 52 years old, chronic osteomielitis of right shin is diagnosed. A year
ago an operation is intramedular osteosinthesis of splinter fracture of middle
third of shin. At a examination –a shin is enlarge in volume, in the middle third is
edema, hyperemia, in a center - fistula with festerings excretions and
hypergranullation tissue. What is important in diagnostics and subsequent
Bacteriologic examination, antibacterial therapy.
X-Ray of thighs, sanation of fistula motion.
Fistulography, surgical treatment with the evacuation of metallic bar.
Computer tomography, antibacterial therapy.
Computer tomography, evacuation of fistula.
For a patient B., 65 years old, chronic osteomielitis. Duration of disease is 9
years. After protracted remission 1 – 2 times there is sharpening on a year,
fistula is opened with festering excretions with an inflammatory local reaction
and general displays of purulent-septic process. What more credible than all
supports
chronic motion of resistance
disease in of
this
case?
Value
of immunobiological
organism.
Changes of microflora character.
Frostbitten and repeated traumas.
Presence of bone sequesters.
Chronic inflammation of soft tissues in the place of defeat.
Patient A., is ill for more than 10 years, done 8 operations of sequester-ectomy.
At a review in the area of right shin the pulled in scars, wrong form with fistula,
in the center of one of them. Excretions from fistula are moderate. In the area of
fistula surplus excrescence of granulation tissue as a cauliflower. Most credible
diagnosis.
Subsequentmalignisation
diagnostics. of fistula, excision biopsy.
Chronic
osteomielitis,
Chronic osteomielitis, fistulography.
Chronic osteomielitis, fistula form, fistulography.
Primary chronic osteomielitis of Garre, fistula form, malignisation of fistula,
biopsy. early osteomielit of Ol'e, malignisation of fistula, cytology of application
Primary
stroke.
At
patient N., 30 years old, diagnosed pandactilitis of the left brush first finger. At
a review - except for changes an edema, hyperemia, is marked in the area of
finger, pain in the area of the tuberculum of the first finger. What complication
arose up for a patient, method of anesthetizing in the case of surgical operation?
Phlegmon of tenar, explorer anaesthesia.
Absces in the area of tenar, local anaesthesia
Phlegmon of tenar, anaesthesia by Usol'ceva.
D. *
E.
79.
A.
B.
C.
D.
E. *
80.
A.
B.
C.
D. *
E.
81.
A.
B.
C.
D. *
E.
82.
A.
B.
C. *
D.
E.
83.
A.
B. *
C.
D.
E.
Phlegmon of tenar, intravenous narcosis.
Abscess in the area of tenar, anaesthesia by Braunom-Usol'ceva.
Sick M., 49 years, operated 6 months ago concerning the opened fracture of
right thigh. Operation – metaloosteosinthesis. During postoperative period a
wound become purulent and in later transformed in fistula. On a X-Ray an
osteoporosis is marked in the area of fracture, ends of bone with the phenomena
of destruction and presence of small sequester. The thickness of metallic bar
Chronic post-traumatic osteomielitis, sequester-ectomy, replacement of metallic
bar.
Chronic
post-traumatic osteomielitis, replacement of intramedular
osteosynthesis
on extramedullar.
Acute
post-traumatic
osteomielitis, opening of abscess, sequester-ectomy.
Acute post-traumatic osteomielitis, sequester-ectomy, antibacterial therapy.
Chronic post-traumatic osteomielitis, evacuetion of metaloconstruction,
sequester-ectomy, imposition of Ilizarov's apparatus.
At sick K., 25 years old, diagnosed the hypodermic panaricium of nail phalanx of
II finger of the left brush. Surgeon through lateral access exposed an abscess,
washing cavity by solution of antiseptic and put drainage. What rule of Yu.
Dzhanelidze
was
ignored
by a surgeon?
It
is necessary
before
an operation
to conduct an antibiotic prophylaxis.
Surgeon chosen access wrong.
Operation needs to be executed after previous imposition of plait on a finger.
A surgeon chose the inadequate method of anesthetizing.
Surgeon chosen solution of small concentration.
At patient D., 36 years old, in the area of palm's surface of nail phalanx of I
finger of the left brush insignificantly sickly bubble by the size - 1,5 x 2 sm.
Around of the bubble of narrow line of hyperemia. Through the thin wall of
bubble examines can see pus. The function of finger is insignificantly broken.
Became ill after
a microtrauma. Your diagnosis.
Hypodermic
panaricium.
Erysipelas.
Mallow, bull form.
Skin panaricium.
Allergic dermatitis, bull form.
Patient K., 28 years old, got the microtrauma of brush on a production. On the
third day for a patient is diagnosed a skin form of the panaricium of II finger of
right brush. In anamnesis one sleepless night is because of pain syndrome. With
what is needed
to differentiate a skin form of panaricium?
Mallow,
bull form.
Erysipelas.
Panaricium as a «cuff-link».
Hypodermic panaricium.
Allergic dermatitis, bull form.
Patient P., 29 years old, grumbles about a pulsating pain which increases at
lowering of hand. Objective: edema and hyperemia of periungual roller. Under a
nail plate the accumulation of rather yellow liquid is translucent. At pressure in
the
area of nail phalanx acute pain. Your diagnosis?
Paronikhium.
Subnail panaricium.
Hypodermic panaricium.
Panaricium as a «cuff-link».
Bone panaricium.
84.
A.
B. *
C.
D.
E.
85.
A.
B. *
C.
D.
E.
86.
A.
B.
C.
D.
E. *
87.
A.
B.
C.
D.
E. *
88.
A.
B.
C.
D.
E. *
89.
A.
B. *
At patient K., 26 years old, pain in the area of middle and basic phalanx of III
finger of the left brush. The finger is insignificantly enlarged in volume.
Hyperemia is not. The finger is in half-bent position, there is unbearable pain at
the attempt
of him to
unbend.
Your diagnosis? Surgical tactic?
Arthral
panaricium,
surgical
treatment.
Ligament panaricium, surgical treatment.
Pandactilitis, surgical treatment.
Acute tendovaginitis, immobilization.
Bone panaricium, surgical treatment.
Patient M., 30 years old, operated concerning hypodermic panaricium seven
days ago. The wound does not heal over, transformed in fistula with the
presence of hypergranullation. Excretions festerings. The nail phalanx of mace –
like staggered
Your diagnosis.
Foreing
body isincrassate.
in a wound.
Bone panaricium.
Mallignisation of tissues in the area of wound.
Paralysis of regeneration.
Ligament panaricium with sequestration.
Patient X., 40 years old, got the microtrauma of right brush 4 days ago. At a
review the state of patient is heavy. Temperature of body of 38,6° C. In middle
part of palm slight swelling, acute painful. An edema and hyperemia of
opisthenar is expressed, pain on a dorsum is absent by palpation. III-IV fingers
are in the forced
half-bent position; their unbending is caused by unbearable
Comissural
phlegmon.
Ligament panaricium.
Phlegmon of hypothenar.
V-similar phlegmon of brush.
phlegmon of middle palm's space.
For patient Yu., 30 years old, the phlegmon of tenar is diagnosed. Surgical
treatment is rotined. What is urgently important during the leadthrough of
operation
in this
case?
Wide
opening
of abscess.
Adequate draining.
Adequate anaesthetizing.
Draining of blood of operation place.
Damage of motive branches of middle nerve.
Patient S., 30 years old, during two weeks ambulatory treated as outpatient
concerning a hypodermic panaricium of I finger of the left brush. At a review the
finger of sharply incrassate, deformed. A skin is tense, cyanochroic. In the area
of finger two fistulas is with festerings excretions, round fistula there is necrosis
of tissues. Phenomenon of lymphangoitis, lymphaedenitis. On an X-Ray Erysipelas.
Bone panaricium.
Ligament panaricium.
Arthral panaricium.
Pandactilitis.
Patient N., 50 years old, working on the small holding injured a foot. For medical
help did not apply. In 7 days round a wound there were cramps which spread on
the skeletal musculature of extremity and trunk. Formed disorders of breathing.
Natively
under
scab.
Yourstupor.
diagnosis.
Quick
as wound
lightning
formaof
wound
Wound ascending stupor.
C.
D.
E.
90.
A. *
B.
C.
D.
E.
91.
A.
B.
C.
D.
E. *
92.
A.
B.
C.
D. *
E.
93.
A.
B.
C. *
D.
E.
94.
A.
B.
C.
D.
E. *
Wound descending stupor.
Generalize quick as lightning stupor.
Wound general stupor, chronic form.
Patient L., 65 years old, does grumble about a megalgia in the area of
gastrocnemius muscles what force him to be stopped through each 500 meters
of step. Objectively: both feet pale, cold by touch, without a hair cover. Your
previous diagnosis?
Necessary
element ofof
clinical
inspection
patient.
Obliterate
atherosclerosis.
Determination
pulsation
on the of
arteries
of
extremity.
Obliterate endarteriitis, determination of pulsation on the arteries of extremities.
Obliterate endarteriitis, ultrasound investigation of vessels.
Thrombosis of arteries of lower extremities, palpation of main arteries of lower
extremities.
Obliterate atherosclerosis, angiography of lower extremities.
Patient N., 64 years old, operated six months ago concerning the adenoma of
prostate. A postoperative period became complicated by an acute ileofemoral
thrombosis which was transformed in a postthrombophlebitic syndrom E. What
method of deep veins communicating estimation is most simple and informing?
Leadthrough of functional tests (March test).
Descending phlebography.
Thermometry.
Ascending phlebography.
Ultrasound investigation of venous barrels.
For patient N., 36 years old, the furuncle of overhead lip is diagnosed.
Temperature of body 390C, the edema of right half of person is acutely
expressed in the projection of branches of front facial vein. Specify on the
possible
way .ofV.distribution
of pylephlebitis.
V.
anguliaris,
facialis, sinus
cavernosus.
V. ophtalmica, V. facialis, sinus cavernosus.
V. ophtalmica, sinus cavernosus.V. anguliaris.
V. anguliaris, V. ophtalmica, sinus cavernosus.
V. anguliaris, . V. facialis, sinus cavernosus.
Patient K., 40 years old, is ill varicose illness of both lower extremities 8 years.
Complaints about pain, turning red, edema in an area varicose - veins disease
which appeared 4 days ago. Engaged in self-treatment. At a review varicoseveins are the extended knots dense, sickly, tissues are infiltrated round them. A
process
spreads from
a shin to overhead third of thigh. Your diagnosis?
Acute
ascending
phlebothrombosis.
Acute descending thrombophlebitis.
Acute ascending thrombophlebitis
Acute thrombophlebitis, lymphangoitis.
Acute ileofemoral thrombosis.
94. Patient of S., 56 years old, a year ago operated concerning opened fracture
of right thigh. A postoperative period became complicated by an acute
ileofemoral thrombosis. At a review edema right shin, polychromia and
induration of skin. In the lower third on a medial surface trophic ulcer by the size
of 5 x 4 sm. In the area
of shin and
thigh varicose
veins.
Your diagnosis?
Postthrombophlebitic
syndrome,
a varicose
is primary.
Varicose disease, indurative-ulcerative form, a varicose is primary.
Varicose illness, a varicose is second.
Postthrombophlebitic syndrome, stage of recanalization, a varicose is primary.
Postthrombophlebitic syndrome, indurative-ulcerative form, a varicose is second.
95.
A.
B. *
C.
D.
E.
96.
A.
B.
C.
D. *
E.
97.
A.
B. *
C.
D.
E.
98.
A.
B.
C.
D. *
E.
99.
A. *
B.
C.
D.
E.
Patient M., 32 years old, grumbles about pain, presence of hearth of
inflammation in the area of right forearm. Temperatures of body are to 38,6°C.
Objectively: in middle third of the left forearm infiltrate by the size of 3 x 3 cm.,
what knobs above the surface of skin as a pyramid. Skin is hyperemic, in a
center through
refined skin looked grey - green education (bar). Your
Furuncle,
stage the
of infiltration.
Furuncle, stage of abscessing and tearing away, festering-necrotizing bar.
Furuncle, stage of scarring.
Carbuncle, stage of forming of purulent - hearth.
Carbuncle, stage of abscessing and tearing away, festering-necrotizing bar.
96. Patient K., 46 years old. Complaint about pain, presence of infiltrate in a
back area, fever increased to 39° C, general weakness. Objective: in a back area
inflammatory infiltrate by the size of 10 x 8 sm., a skin above him is bloodshot
with a cyanosis. In the center of infiltrate necrosis of skin, acute pain in the
palpation. At palpation through openings festerings masses are selected in the
Inflammatory infiltrate.
Actinomikosis.
Seborea.
Carbuncle.
Phlegmon.
97. Patient N., 56 years old, grumbles about pain in the area of right buttock,
fervescence, to 38,6°C. Treated oneself in neurological permanent
establishment, got nonsteroid anti-inflammatory preparations. Objectively: in the
area of right buttock edema, hyperemia. Infiltrate by the size of 10 x 8 sm by
palpation, acutely sickly. The symptom of fluctuation is doubtful. Your diagnosis.
Post-injection infiltrate, diagnostic punction
Post-injection abscess, diagnostic punction.
Post-injection abscess, X-Ray.
Post-injection haematoma, tomography.
Post-injection abscess, thermography.
Patient K., 36 years old, after an attempt to stamp a festering bar, the pouredout edema appeared from a furuncle, hyperemia in the area of the left forearm,
which grow quickly. At a review in the area of forearm vast infiltrate without clear
contours, there is fluctuation in a center. Temperatures of body are to 40°C. Your
diagnosis. furuncle.
Abscessing
Carbuncle.
Abscessing furuncle, lymphangoitis.
Phlegmon of forearm.
Abscess forearm.
99. At patient B., 70 years old, suddenly the temperature of body rose to 39° C
with a chill. Complaints of nausea, head pain, general weakness, pain and
turning in the area of shin red. It is ill two days. Objectively: in the area of front
surface of shin edema and hyperemia as languages of flame with clear contours.
Your
diagnosis?
Mallow,
eritematouse form.
Phlegmon of shins.
Phlegmon of shins, lymphangoitis.
Mallow, bull form.
Mallow, phlegmonous form.
100.
A.
B.
C.
D. *
E.
101.
A.
B.
C. *
D.
E.
102.
A.
B.
C. *
D.
E.
103.
A.
B.
C. *
D.
E.
104.
A.
B. *
C.
D.
E.
105.
A. *
100. At patient K., 64, complaints about a fervescence to 38,6° C, general
weakness, head pain, nausea, pain, in the area of the left shin. It is ill 7 days.
Objectively: a shin is enlarged in a volume due to an edema, skin of hyperemic,
covered bubbles from 2 to 5 cm in a diameter which are filled a hemorrhagic
exudate.eritematouse
Round bubbles
and under bubbles skin cyanoti
C. Your diagnosis?
Mallow,
form.
Phlegmon shins.
Mallow, eritematouse-bull form.
Mallow, bull-necrotizing form.
Wet gangrene of shin.
At patient V., 43 years old, varicose veins disease of vena safhaena is diagnosed
in the system of vena saphena magna. The sick inspects with the purpose of
subsequent surgical treatment. With the help of what functional test it is
possible to estimate the state of ostial valve?
Prett.
Del'be - Pertes.
Troyanov - Trendelenburg.
Shaynis.
Gakkenbrukh-Sikar.
Patient N., 35, operated for acute gangrenous appendicitis. The fourth day after
surgery. Body temperature 38 0 C, White blood cell - 15,6 • 10 9 per litter.
Tachycardia - 100 beats per minute. Hyperventilation - 25 respiratory
movements per minute.
Purulent-resorbtive
fever.Your diagnosis.
Intoksication syndrome.
sepsis.
Endotoxicosis.
system inflammatory response syndrome.
103. In patient K., 49 years old, diagnosed with acute suppurative thyroiditis
complicated by a phlegmon of the neck and sepsis. What is crucial in treatment
of this patient.
Correction
of metabolic disorders.
Elimination of foci of infection.
antibacterial therapy.
Antitoxic therapy.
Correction of hemodynamic disorders.
104. At patient S., 10 years old, suddenly without apparent cause the
temperature of body rose to 40° with a strong chill. General state heavy, general
weakness, tachycardia. On the second day a, holding apart megalgia in the area
of lower third of the left thigh and bend contracture appeared in knee and to
genicular joints. In 7 days at palpation and percussion it is discovered local pain
Abscess of Ford.
Acute hematogenne osteomielitis.
Acute hematogenne periostitis.
Phlegmon of the left thigh.
Acute festering arthritis.
105. To the patient with varicose disease of right lower extremity in the pool of
vena saphena magna upended at maximally gap-filling superficial veins on
overhead third of thigh imposed a rubber plait. Suggested to take place a patient
5 minutes, the complete emptying of veins came whereupon.
As such test is
named,
what
it
testifies
to?
Del'be - Pertes, complete communicating of deep veins and full value of valvular
vehicle of deep and perforant veins.
B.
C.
D.
E.
106.
A.
B.
C.
D. *
E.
107.
A.
B.
C. *
D.
E.
108.
A.
B.
C. *
D.
E.
109.
A.
B.
C. *
D.
E.
110.
A.
B.
C. *
D.
E.
Troyanov Trendelenburg, insolvency of ostial valve and valvular perforant veins.
Shaynis, insolvency of valvular vehicle of superficial veins, good communicating
of
deep veins.
Meyo-Prett,
about the satisfactory function of the deep venous system.
Schwarz, insufficiency of valves of basic barrel of large saphena, good
communicating
of deep
veins.
106. 2. In patients
39 years
of clinical and ultrasound diagnosis given
appendicular abscess. The patient operated under intravenous anesthesia. The
operation - opening access for gathering and gynecology. Appointed antibacterial
therapy - after which patients suddenly emerged: general weakness, tachycardia
to 130 beats per
minute,
70/60 mm.hg.C.,
cold sweat. What complications
anaphylactic
shock
at theAP
introduction
of antibiotics.
Of septic shock resulting from underlying disease.
Heavy SIRS syndrome.
Endotoksycal shock as a result of endotoxin release from bacteria under the
action of as
antibiotics.
collapse
a result of underlying disease and Anaesthesia.
107. In patients with acute destructive pancreatonecrosis infected. When
ultrasonography revealed the presence of free fluid in the bag packings, in the
left pleural cavity. Body temperature 39 °C. What should be particularly taken
into account
at the start of antibacterial therapy in this patient.
Hardness
of SIRS.
Severity of underlying disease.
Yarysha-Heksheymera syndrome (massive disintegration of the bacteria release
a large amount of endotoxin).
Severity of SIRS.
severity of POI syndrome.
108. 5. In patients of 28 years, diagnosed with acute destructive
pancreonecrosis infected. Clinical and laboratory found in patients with acute
respiratory dystressyndrom, acute hepatic and renal failure. Assess the patient's
condition.
In
patients with pancreatic sepsis.
In patients with severe SIRS.
The patient POI syndrome.
In hvorohyi severe SARS.
In patients with severe sepsis.
109. 6. Patients N., 30 years, during ambulatory anesthesia lidocaine uncovered
subcutaneous felon second toe of his right wrist. The next day the patient's
condition is extremely serious. Hospitalized in emergency surgical clinic.
Consciousness marred. Body temperature 39,5 °, tachycardia, systolic
auscultatory rude
noise. In X-ray signs of pneumonia lungs. Meninhialni positive
Endotoksycal
shock.
Of septicemia, a form of lightning.
sepsis, POI syndrome.
Heavy SIRS.
anaphylactic shock.
110. Patient K., 39 years, operated on uncomplicated superficial varicose veins
of the lower extremity. At 5 days after the operation, wound in the shin area
marked flushing, swelling, pain. When the audit probe wounds seen the
emergence of purulent exudate. What infection developed in the patient.
quotidian.
Specific.
Nosocomial .
Surgery.
postoperative.
111.
A.
B.
C. *
D.
E.
112.
A.
B.
C.
D.
E. *
113.
A.
B. *
C.
D.
E.
114.
A.
B.
C. *
D.
E.
115.
A. *
B.
C.
D.
E.
116.
In patient N., diagnosed with acute suppurative lactational mastitis. An
ultrasound detected in the area of the square verhnozovnishnoho right breast
center with irregular rarefaction. Under the control of sonography conducted
puncture-fire returned 35 ml. Manure. Abscess cavity is drained through PVC
pipe cut-puncture. The next day the patient pohirshav. Body temperature to 39
reduced or distorted imunoreaktyvity patient.
Absens ofdetoxication therapy.
inadequate volume of surgical intervention.
High virulence of microorganisms.
wrong choice of antybakteryal therapy.
Patient V., 56 years, operated on chronic calculous cholecystitis. Operation
performed under intravenous anesthesia with artificial ventilation, passed
without complications. At 6 postoperative day, the patient was diagnosed
pneumonia. How
to mean this complication.
non-hospital
pneumonia.
hypostatic pneumonia
aspiration pneumonia.
Viral pneumonia.
nosocomial pneumonia.
113. 14. The patient operated on appendicular abscess who willfully broke into
the abdominal cavity. The state of the patient difficult. Body temperature 39 °,
tachycardia, Hyperventilation, stable arterial hypotension (BP 80/50 mmHg)
despitesepsis.
adequate correction of hypovolemia. What the patient.
Heavy
septic shock.
multiple organ dysfunction syndrome.
Heavy SIRS.
sepsis syndrome.
114. In patients with hematogenous osteomyelitis acute - hyperthermia,
tachycardia, Hyperventilation, leykocytosis(L-25 • 10%). Fifth day after
osteoperforation purulent drainage and fires in the area methadiafisial right
tibia. Your diagnosis.
Criptogenic
sepsis.
Primary sepsis.
Secondary sepsis.
Subacute sepsis.
fulminant sepsis.
115. In patient N., 36 years old, operated in emergency procedure for acute
intestinal obstruction. For 7 days after surgery increased body temperature to 39
°, which was accompanied by chills, painful emergence of infiltration in the area
of the square verhnozovnishnoho right buttock. The other day while inspecting
the surgeon found the center fluctuation infiltration. The nature of infection,
nosocomial, afterinjection abscess, surgical treatment.
Hospital, afterinjection infiltrate, conservative therapy.
quotidian, with posttravmatyc hematoma cryptopyic, surgical treatment.
Quotidian, metastatic abscess, surgical treatment.
staphylococcal, right buttock abscess, surgical treatment.
116. 13. Patients with polytrauma, traumatic shock made the right subclavian
vein catheterization for Seldinherom. After 14 days appeared edema and
hyperemia of the skin around the catheter. Palpatorno pain and appearance of
purulent discharge. In the patient body temperature 38,6 ?; leykotsytosys (L-20,
6 • 109), tachycardia. A purulent-septic foci were not found. The nature of
A.
B. *
C.
D.
E.
117.
A.
B.
C. *
D.
quotidian, fester place catheterization.
nosocomial, katheterysational anhiohenic sepsis.
idiopathic, anhiohenic sepsis.
Staphylococcal, septic-resorbtive fever .
Specific, katheterysational anhiohenic sepsis.
117. 16. Patient V., 39 years, operated on extensive phlegmon left shoulder.
After surgery, a difficult situation. Complaints of pain in the right lumbar area,
body temperature is 39 °. When ultrasound examination revealed purulent
paranefral
fire in the
area fromby
thesepticemia.
right. Your diagnosis.
Rightside abscess
complicated
Septicopiemia with secondary metastatic hearth.
Rightside abscess.
Urologic sepsis, acute purulent abscess.
Secondary sepsis, hiperefichna form.
118. Patient A., 42 years old, operated for acute gangrenous perforative
appendicitis-perforatyvnoho. Patient's condition is difficult, due to abdominal
sepsis severity. Bakanalisis found hramnegative pathogenic microflora. What is
leading in the
pathogenesis
of sepsis in patients.
endotoxin
hramnegative
flora.
Proteolysis in violation of general enzymatic hemostasis.
exotoxins microbial origin.
Increased blood lactate content.
Depression of the phagocytic and bactericidal activity of granulocytes.
119. In patient M., 36, diagnosed with extensive left retroperitoneal phlegmon.
Body temperature 38,6 °C. Pulse - 120 beats per 1 minute, leykotcytosis (21 •
109 1L, saturation of arterial blood - 86, bilirubin 84 mmol / l, aminotransferases
activity two times higher than normal. Sick retarded. Your diagnosis. What is the
main treatment
in this treatment.
patient.
Heavy
sepsis, surgical
septic shock, antishock therapy.
STRS syndrome, intensive care in DAIT.
Heavy sepsis, antibacterial therapy.
Heavy sepsis, and compensation functions of the system and immune correction.
120. In patients with acute purulent lactic panmastytis diagnosed sepsis,
septycopiemia, rightside abscessed pneumonia. In patients with body
temperature 39 °, tachycardia. What in this case is the leading component of
treatment.
medicine.
antitoxic therapy.
infusion-transfusion therapy.
Surgical treatment of primary fire and secondary fire rehabilitation.
bacterial therapy, immunotherapy, and detoxification.
121. Surgeon operates on patient phlegmon left hip. It noted extensive damage
subcutaneous tissue, muscle and fascias. Muscles are weak, no roof, as "filthy
rags". In many intervals betweenfascial liquid manure, with smell. Your
diagnosis.
grampositive
phlegmon.
Anaerobic gas phlegmon.
nonclostrydial anaerobic phlegmon.
Streptococcal phlegmon.
E.
staphylococcal phlegmon.
A.
B. *
C.
D.
E.
118.
A. *
B.
C.
D.
E.
119.
A. *
B.
C.
D.
E.
120.
A.
B.
C.
D. *
E.
121.
122.
A.
B.
C. *
D.
E.
123.
A.
B.
C.
D. *
E.
124.
A.
B.
C. *
D.
E.
125.
A.
B.
C. *
D.
E.
126.
A.
B.
C. *
D.
E.
127.
A. *
B.
C.
D.
122. Patient N., 42 years old, hospitalized in the reanimation department of
state heavy with polytrauma. On 6 day been in the department with a
permanent catheter in the bladder in a patient examed acute cystitis, rightside
pyelonephritis. What's this infection?
ascending.
Urologic
Nosocomial .
catheterogenic.
reanimation.
In obstetric hospital, five women appeared with acute purulent neonatal lactic
mastytis. At babies diagnosed signs of staphylococcus infection. During
bacteriological study found staphylococcus.. What's mean this phenomen.
staphylococcal infection.
obstetrical infection.
Gynaecologic infection.
Nozocomialis infection.
Gram-positive infection.
5. In patient G., 36 years old, diagnosed subaponevrotic phlegmon middle palm
space left. Expressed intoxication, body temperature of 39 °, leykocytosis, off set
formula right. The surgeon diagnosed sepsis. What is a leading component in the
treatment
of the patient.
antitoxic therapy.
antiseptic therapy.
Surgical treatment.
antibacterial.
immunomodulatory therapy.
At the patient N., 36 years old, diagnosed pandaktylit left thumb and wrist.
Patients treated in the clinic about panaricium 12 days. Concomitant pathology
in patients found. A blood sugar level as normal. What is the most likely cause of
pandaktylitis.
The
high virulence of microorganisms.
Immunosuppression of patients.
Failed of ambulance treatment of patient.
Topographoanatomic texture features of finger.
Lack of antibacterial therapy.
Patient K., 36, was injured at work. OBJECTIVE: As part of the right forearm sliver
size 10 x 3 x 2 cm, contaminated land, with moderate bleeding. Since the injury
took 3 hours. What is the nonspecific prophylaxis of tetanus in this case.
Introduction antitetanouse serum.
Introduction antitetanouse immunoglobulin.
the initial debridement.
Introduction antitetanouse anatoxin.
Introduction antitetanouse serum and anatoxin by Bezredko.
127. Obstetrician gynecologist complaining of pain and presence of ulcers in the
area of a finger nail phalanx II left wrist. In aksilyar region palpated increased
lymph node. From anamnesis know that 5 years ago the doctor spent surgery
and needle pierced finger. In patients positive reaction Vasermana. Your
diagnosis?.
chancre
panaricium.
subcutaneous panaricium
Erizypeloid.
Anthrax.
E.
128.
A.
B.
C.
D. *
E.
129.
A.
B.
C.
D. *
E.
130.
A.
B.
C.
D. *
E.
131.
A.
B.
C.
D.
E. *
132.
A.
B.
C.
D. *
E.
Granulation wound of thumb.
128. The patient, 30 years old, received a gunshot wound. When you review the
hole diameter to 1 cm, the source 10 cm in diameter, wound edges are uneven,
ragged, with the phenomena of necrosis. With intensive venous bleeding
wounds. In place of wounds pathological mobility and crepitation. What is a
cardinal inimmobilization.
the prevention of anaerobic infections in the present case.
Transport
Therapeutic immobilization.
antibiotic.
Primary debridement.
Fitting the primary sutures.
129. 11. At the patient K., 40 years after disclosure of subcutaneous panaricium
third toe of his right wrist fever till 38 °. Appeared in the area of pain forearm
and shoulder. When you review on the front surface of the forearm and shoulder
as hyperemia by palpation pain and compression. What complications arose in
the patient.
Mug.
erysipeloid.
Acute ascending thrombophlebitis.
Limfanhoitis.
phlegmon forearm and shoulder.
130. At the patient N., 56 years, complaints of general weakness, pain in the
area of the right shin, fever do38, 6 °. Seven days ago shovel wounded leg.
OBJECTIVE: tibia swollen, thickened, skin tight, positive symptom "razor blades",
Melnikov’s expressed
Your diagnosis.
erysipelas,
necrotizingendotoxicosis.
form.
staphylococcal phlegmon.
abscess, sepsis.
Anaerobic phlegmon.
tetanus, a form of lightning.
131. At the a patient with a gunshot wound right thigh, complicated fracture,
with a massive fragmentation and rupture of femoral neurovascular bundle,
developed anaerobic gas infection. Your tactics.
incisions in the thigh area, outfired metaloosteosyntez.
Disclosure of purulent foci, vascular suture, Ilizarov apparat use.
incisions, ligation of main vessels, skeletal correction.
Debridement, ligation of vessels, window formed immobilization bandage.
limb amputation guillotine means without stitching stump.
132. Patient N., 62 years old, while working under fell on his hand stretched.
When you review diagnosed open fracture of both bones of the right forearm.
Wound contaminated land. Surgeon clinic put on a wound stitches, held
overnight reposition fragments and put plaster bandage. The third patient's
condition bed. Body temperature 39 0C, intensive pain in the hand. Dressing is
removed. In the area of wound edema, hyperemia, which apply to all forearm.
suppurating wounds, phlegmon forearm.
Extensive hematoma of the forearm.
displacement of bone fragments, hematoma.
Anaerobic gas infection.
tetanus, a form of lightning.
133.
A. *
B.
C.
D.
E.
134.
133. 14. At the patients diagnosed with anaerobic gas gangrene of foot with
the transition to shin. The state of the patient difficult. Symptom "ligatures" –
Melnikov’s is positive at the middle third of skin. It is necessary for vital
indications amputate
limbs.
Features
andmiddle
level of
amputation.
Amputation
by guillotine
method
at the
third,
no stitching stump.
Amputation of the lower third by Kalender.
way of guillotine amputation at the middle third of the thigh wound fluid
stitching
seams.
Amputation
at the middle third of thigh by Pirogov with liquid stitches on a
wound.
amputation
at the upper third of the shin with the laying of mines stump.
At the patients diagnosed with extensive anaerobic gas phlegmon right forearm
and shoulder, with the transition to the chest. A surgical intervention - abscess
revealed wide sections of dissected subfascial and cellular spaces. What method
of treatment, in combination with surgery is most effective in this case.
A.
medicine.
B.
antygangrenouse serum.
C.
antitoxic therapy.
D. * Hyperbaric oxygenation.
E.
Ultraviolet irradiation of autoblood and hemosorbtion.
135. 135. Urgent surgeon examines the patient with Ragged wound of right thigh. As
for the wounds treated for 5 days on sick patient. When the review is striking: a
dry wound, without decay, with a small amount of an unpleasant odor. The skin
around the wound with bronze colour and bluish spots. Muscles in the wound
look like "boiled meat", swelling. The skin visible traces of "close" bandages. The
X-ray visible seams between individual muscles and muscle bundles, positive
A.
Mug, purulent necrotic form.
B.
Mug, phlegmonouse form.
C.
Purulent phlegmon.
D. * Anaerobic phlegmon gas.
E.
Diphtheria of wound