Назва наукового напрямку (модуля):
Семестр: 6
Internal Medicine Propaedeutics (indepedent work)
Опис:
3 course, medical
Перелік питань:
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? When you obtain patient’s heredity you should ask him all aspects except of:
Present health state of patient’s parents or cases of their death
Present health state of patient’s wife (husband)
Present health state of patient’s uncles (aunts)
Present health state of patient’s cousins, nephewes;
Present health state of patient’s sisters and brothers
What is typical for “leprosy face” (“lion face”)?
Face is distorted with tubercular and nodal sickness of skin
Deep eyes, pointed face pattern
Enlarged eyebrows
Thin face with pointed nasolabial folds
Protruded cheek-bones, nose, lips are stretched, mouth angles are lowered, wrinkles around the
mouth
In which case may we revealed O-shaped shins?
In cardiovascular pathology
In syphilis
In the case if the patient had rachitis in childchood
In respiratory pathology
In pathology of digestive system
Erythematous plaques which cover patient’s nose and cheeks in the form of butterfly are typical for:
Lupus erythematodus
Rheumatic fever
Nettle rash
Chronic hepatitis
Chronic pancreatitis
For the face of a patient with parkinsonism it is typical the following sign:
Face is distorted with tubercular and nodal sickness of skin
Amimic face
Rare blinking of eyelids
Patient’s head is declined forward
Slipped skin and excess salivation
Delirium develops in:
Hypertension
Alcohol excess
Chronic hepatitis
Nettle rash
Thyrotoxicosis
Hirsutism is the sign of:
Rheumatic heart disease
Ovarial tumour
Nephritis
Hypertension
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Hepatitis
Cyanosis is typical for:
Fever
Respiratory failure
Hepatitis
Nephritis
Bacterial endocarditis
What is it possible to reveal during inspection of a neck?
Pulsations of carotic arteries
Edema
Deformation
No any changes
Hyperemia
What is it possible to reveal during inspection of a neck?
Pulsations of jugular veins
Edema
Deformations
No any changes
Hyperemia
Which component of ECG reflects excitation of atriums?
T wave
P wave
QRS complex
PQ interval
ST interval
Which component of ECG reflects total excitation of ventricles?
T wave
P wave
QRS complex
PQ interval
ST interval
II heart sound on Phonocardiogram begins in:
0,03 sec before Т wave beginning;
0,02 sec before Т wave ending;
May appear in the same time with the beginning of Т wave;
May appear in the same time with the ending of Т wave
0,02 sec after its beginning
Causes of sinoatrial block:
Disturbance of impulse production by sinus node,
Disturbance of impulse conduction from sinus node to atriums;
Disturbance of impulse conduction through AV node;
Disturbance of impulse conduction through the right Hiss budle branch;
Disturbance of impulse conduction through the left Hiss budle branch.
Clinical manifestation of pulmonary artery thromboembolism:
A.
Sudden “discoordinated palpitation”, feeling of dull kicks in heart region, dyspnea, fear and
irritation
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C.
Sudden strong palpitation, anginous pain, dizziness, faint, tick-tack heart rhythm (embriocardia)
Faint, absence of pulse and blood pressure as well as heart sounds, pupillas become dilated,
uncontrolled urination and defecation
Sudden dizziness and convulsions
Intensive pressing chest pain, intensive feeling of air hunger and hemopthysis
Cardioversion: this is …
Treatment with electrical impulses with sufficient energy
Treatment with influence on myocardium of electrical current of sufficient potential and frequency
Recording of the movements of heart apex during contractions
Intracardial administration of medicines
Administration of roentgencontrast into large vessels
Cardiac electrostimulation: this is…
Treatment with electrical impulses with sufficient energy
Treatment with influence on myocardium with electrical current of sufficient potential and
frequency
Recording of the movements of heart apex during contractions
Intracardial administration of medicines
Administration of roentgencontrast in large vessels
Select the life-threatening arrhythmia:
sinual tachicardia;
ventricular flutter;
sinual arrhythmia;
atrial flutter;
paroxismal tachycardia
ECG signs of sinus non-respiratory arrhythmia?
R-R intervals periodically are shorter but sometimes they become longer. All components of ECG
are not changed. Change of RR interval duration don’t depend on respiratory phases
R-R intervals periodically are shorter but sometimes they become longer. All components of ECG
are not changed. Change of RR interval duration depends on respiratory phases;
R-R intervals periodically are shorter but sometimes they become longer. QRS complex is
disfigured, P wave is absent.
R-R intervals are shorter than normal, heart rate 106 per min
R-R intervals are longer than normal, heart rate 56 per min
Clinical manifestation of sinus respiratory arrhythmia:
Feeling of escape of heart beats
Palpitation
Dizziness, faints
Morgagni-Adams-Stock’s syndrome
No symptoms
Clinical manifestation of marked tachycardia:
feeling of escape of heart beats
palpitation
dizziness, faints
morgagni-Adams-Stock’s syndrome
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no symptoms
Clinical manifestation of attack of extrasystoly:
Sudden “discoordinated palpitation”, feeling of dull kicks in heart region, dyspnea, fear and
irritation
Sudden strong palpitation, anginous pain, dizziness, faint, tick-tack heart rhythm (embriocardia)
Faint, absence of pulse and blood pressure as well as heart sounds, pupillas become dilated, a patient
develops convulsions, uncontrolled urination and defecation
Sudden dizziness and convulsions
Intensive pressing chest pain, intensive feeling of air hunger and sudden death
Clinical manifestation of Morgagni-Adams-Stocks syndrome:
Sudden “discoordinated palpitation”, feeling of dull kicks in heart region, dyspnea, fear and
irritation
Sudden strong palpitation, anginous pain, dizziness, faint, tick-tack heart rhythm (embriocardia)
Faint, absence of pulse and blood pressure as well as heart sounds, pupillas become dilated,
uncontrolled urination and defecation
Sudden dizziness and convulsions
Intensive pressing chest pain, intensive feeling of air hunger and sudden death
Clinical manifestation of paroxysmal tachycardia:
Sudden “discoordinated palpitation”, feeling of dull kicks in heart region, dyspnea, fear and
irritation
Sudden strong palpitation, anginous pain, dizziness, faint, tick-tack heart rhythm (embriocardia)
Faint, absence of pulse and blood pressure as well as heart sounds, pupillas become dilated, a patient
develops convulsions, uncontrolled urination and defecation
Sudden dizziness and convulsions
Intensive pressing chest pain, intensive feeling of air hunger and sudden death
Clinical manifestation of ventricular fibrillation:
Sudden “discoordinated palpitation”, feeling of dull kicks in heart region, dyspnea, fear and
irritation
Sudden strong palpitation, anginous pain, dizziness, faint, tick-tack heart rhythm (embriocardia)
Faint, absence of pulse and blood pressure as well as heart sounds, pupills become dilated
Sudden dizziness and convulsions
Intensive pressing chest pain, intensive feeling of air hunger and sudden death
Which drug belongs to cholekinetics?
allohol
epsom salt (MgSO4)
cholosas
cholagon
galstena
Which drugs are used in cholelithiasis?
choleretics and cholekinetics
cholestatics
cholelitics, cholemimetics
cholesympatolytics
nitrates
Laboratory examination of feces for scant (hidden) blood may be positive:
In intake of meet during meals
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In chronic pancreatitis
In chronic gastritis
In intake of too much plant fibers
In intake of fatty food
А typical sign of stomach cancer is the folloving:
Loss of appetite (disgust for meat)
Body weight gain
Pain in right or left hypochondrium
Periodical constipation
Heartburn
Select the most appropriate factors contributing to the development of gallstone disease:
Genetic predisposition and operations on bile ducts
Metabolic changes and obesity
Bile ducts dysfunction
Insolation
Genetic predisposition, metabolic changes, bile ducts dysfunction
Select the most appropriate factors contributing to the development of gallstone disease:
Operations on bile ducts
Metabolic changes and obesity
Bile ducts dysfunction
Insolation
Prolonged hypothermia
Gallstones are divided on:
Pigment and cholesterol
Bilirubin and phosphorous
Calcium and cholesterol
Pigment and magnesium
Calcium and uric acid-containing
Select antihistamine agent among presented below that might be prescribed in acute bronchitis:
Ambroxol
Codein
Augmentin
Aloe extract
Claritin
What preparation should a doctor prescribe for a patient with bronchial obstruction?
Corticosteroids
Antibiotics
Mucolytics
Enzymes
Bronchodilators
Acute bronchitis of moderate severity is observed in 26 y.o. patient. Which antibiotic should be
prescribed in 1ts line of treatment?
Cephalosporin antibiotics
Sulfonamides
Aminoglycosides
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Riphampycin
Amoxicillin or macrolid
Select the drug for correction of dry intensive cough cough for a patient with acute bronchitis:
Ambroxol
Augmentin
Claritin
Aloe extract
Codein
Lobar pneumonia was diagnosed in the patient. What is the mechanism of pain?
Affection of lung parenchima,
Affection of intercostal nerves,
Irritation of bronchial mucosa,
Affection of a heart.
Affection of pleura,
Which findings will be in spyrogram of a patient with bronchial obstruction?
Decreased vital lungs capacity, Tiffneu’s index and FEV1 are not changed;
Vital lungs capacity is not changed,
Decreased vital lungs capacity, Tiffneu’s index and VFE1, inspiratory reserve volume,
Decreased total lungs capacity.
Decreased vital lungs capacity, Tiffney’s index and FEV1, expiratory reserve volume;
Patient Т, 62 years old, develops bronchial asthma attacks everyday, but they are not prolonged.
There are episodes of nictural dyspnea about 1 for a month. Which course of the disease does the the
patient have?
Intermittent,
Moderate persistent,
Severe persistent,
Mild intermittent.
Mild persistent,
What is severith of bronchial asthma when attacks occure everyday, they are prolonged and released
by corticosteroids, the patient has dyspnea between attacks, there are episodes of nictural dyspnea
every night?
Intermittent,
Mild persistent,
Moderate persistent,
Mild intermittent.
Severe persistent,
By percussion above the lungs bandbox sound is revealed, enlargement of Krenig’s
area,displacement downward of the lower lungs borders. What the revealed signs testify about?
Consolidation of pulmonary tissue;
Air accumulation in pleural cavity;
Cavity in the lungs;
Fluid in the pleural cavity.
Air hyperinflation of the lungs;
Select data of percussion during the attack of bronchial asthma:
Thympanic sound over the lungs, displacement of lower lung borders downwards, restriction of their
mobility, rising of lungs apexes;
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Dull sound over the lower lungs lobes, displacement of lower lung borders upwards, restriction of
their mobility, decreased dimensions of lungs apexes;
Bandbox sound over the lungs, displacement of lower lung borders upwards, , restriction of their
mobility, decreased dimensions of lungs apexes;
There are no chances.
Bandbox sound over the lungs, displacement of lower lung borders downwards, restriction of their
mobility, rising of lungs apexes;
Select data of auscultation during the attack of asthma:
Harsh respiration, diffuse dry whistling rales;
Harsh respiration, moist fine rales;
Weakened vesicular breathing, crepitation over the lower lungs borders;
Respiration is absent over the left lower lung lobe.
Weakened vesicular breathing, diffuse dry whistling rales;
What medical preparation is it necessary to prescribe to the patient to improve expectoration of
sputum in chronic bronchitis?
Diuretics;
Antitussive agents;
Broncholitics;
Beta-blockers.
Expectorants;
Patient P, 54 years old, suffers from bronchial asthma for 10 years. Data of inspection of his chest:
its anterior-posterior diameter is enlarged, the chest is of barrel shape. What type of the chest is
present in this patient?
Paralitic;
Rachitic;
Lordosis;
Normal.
Emphysematous ;
Patient К. 28 y.o., complains of expiratory dyspnea, general weakness. Data of percussion: above the
lungs bandbox sound is heard, enlargement of the Krenig’s area, bilateral displacement of the lower
lungs borders downward. What the revealed signs typical for?
Bronchial obstruction,
Consolidation of pulmonary tissue,
Norm,
Right-sided hydrothorax.
Pulmonary emphysema,
All of the following may cause elevation of serum troponin EXCEPT:
Congestive heart failure
Myocarditis
Myocardial infarction
Pneumonia
Pulmonary embolism
In which disease we expect to see vegetations by ultrasound examination of a heart?
Infective endocarditis
Viral myocarditis
Acute pericarditis
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Rheumatic heart disease
Hypertrophied cardiomyopathy
Etiology of rheumatic fever is:
Beta-hemolytic streptococci.
Alfa-hemolytic streptococci
The HACEK group
H. influenza
Staphylococcus aureus
Which of the following is characteristic of rheumatoid arthritis
asymmetric oligoarticular arthritis
symmetric polyarthritis of hand joints
arthritis of distal interphalangeal joints
severe destructive polyarthritis (arthritis mutilans)
sacroiliitis with or without peripheral arthritis
Wenckebach phenomenon is defined as...
Progressive shortening of PR interval till a beat is dropped
Progressive lengthening of PR interval till a beat is dropped
Irregular heart rate and PVC’s
Shortened QT intervals
Slurred QRS complex
Which of these statements is true regarding renin-angiotensin system-blocking agents?
Less effective when combined with a diuretic than when used alone
More effective in patients of African descent than in white patients
Preserve kidney function in addition to lowering blood pressure
Are the first-line antihypertensive medications in pregnancy
Affect kidnet function
Renin-dependent hypertension includes:
Primary hyperaldosteronism
Essential hypertension
Pheochromocytoma
Cushing syndrome
Renovascular hypertension
The proportion of essential (primary) hypertension among all hypertension causes is as high as
25-30%
40-45%
60-65%
70-75%
90-95%
All of the following are risk factors for hypertension, EXCEPT
Increased body weight
Family history of hypertension
Excessive intake of sodium
Regular use of one glass of wine per day
Cigarette smoking
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Which BP profile below identifies the patient with the highest risk for development of cardiovascular
complications?
160/90 mmHg
160/65 mmHg
140/100 mmHg
130/90 mmHg
120/70 mmHg
Target organs in hypertension include all of the following EXCEPT
Brain and eyes
Heart
Kidneys
Peripheral arteries
Liver
Each of the following statements regarding hypertension is true EXCEPT:
Pure "white coat hypertension is found in 20 to 30% of patients
When measuring BP, an inappropriately small cuff size results in a spuriously low systolic
measurement
Pseudohypertension may occur in patients with sclerotic brachial arteries
Chronic renal disease is the second most common cause of hypertension after essential hypertension
Coarctation of the aorta, Cushing disease, primary aldosteronism account for approximately 1% of
all hypertensive patients
Optimal blood pressure (BP) is defined as a BP level of
<120/80 mmHg
<130/80 mmHg
<140/90 mmHg
<160/100 mmHg
<125/80 mmHg
Specify the most typical triad of symptoms in acute pyelonephritis:
Thirst, anorexia, nausea
Vomiting, diarrhoea, abdominal pain
Chills, lumbar pain, dysuria
Pain in bones, joints and muscles
Nausea, vomiting, fever
Specify the obvious condition for development of pyelonephritis:
Arterial hypertension
Heart failure
Disordered urine outflow
Increased body weight
Renal failure
The plain X-ray of kidney allows to define:
condition of the pyelocaliceal system;
position of ureters;
sizes of kidneys;
condition of glomerular apparatus of kidneys;
presence of a tumor.
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The plain X-ray of kidneys allows to define:
state of the pyelocaliceal system;
placing of ureters;
kidney stones;
state of glomerular aparatus of kidneys;
presence of tumor.
What can NOT be the reason of edema in kidney diseases?
Increased hydrostatic pressure in lower limbs
Increase of permeability of capillary wall
Diminishing of oncotic pressure of blood plasma
Accumulation of sodium ions in blood and tissues
Acute delay of selection of urine by kidneys
What pain pattern is typical for nephrocolic?
Dull, aching pain in lumbar region
Intensive permanent pain in lumbar region
Intensive sharp attack-like pain in lumbar region from one side irradiating downward to the internal
surface of the shin and perineum.
Intensive sharp attack-like pain in lumbar region from the right side irradiating upward to the right
shoulder and scapula.
Pain at the bottom of a stomach
What results of Zimnitsky’s test do testify about violation of concentration function of kidneys?
Prevalence of night diuresis above daily one
Increased relative gravity of urine in separate portions.
Presence of at least one portion of urine with relative gravity is below 1010
Monotonous high relative gravity of urine in all of portions.
High albumen concentration in urine.
How many stages of goiter do you know according to WHO classification?
5
4
3
2
1
What is term which describes increased amount of urine?
Pollakiuria
Nicturia
Polyuria
Oliguria
Anuria
Insulin secretion is primarily regulated by:
Physical activity
Blood glucose levels
Level of zinc in the blood
Stressors
Diet
All of following are oral hypoglycemic agents EXCEPT:
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Sulfonilureas
Biguanides
Thiazolidinediones
Phluoroquinolones
Glinides
Which test can you recommend as the most indicative of average recent blood glucose levels:
Fasting serum glucose level
Random serum glucose level
Oral glucose tolerance test
Serum level of hemoglobin A1C
Urine glucose concentration
Skin fold measurements are used to estimate which of the following?
Percentage of body fat
Degree of obesity
Body mass index
Degree of malnutrition
Type of fat distribution
What body mass index (BMI) should older adults have?
Less than 21
Between 20 and 24
Between 24 and 27
Greater than 30
Between 27 and 30
? In which disease a patient first expectorates fresh blood in sputum, and then in several days– dark
one?
Acute catarrhal bronchitis
Bronchial asthma attack
Pulmonary artery thrombembolism
Chronic bronchitis
Pneumonia
How will patient’s body temperature change after rupture of lung abscess into a bronchus?
Will be increase
Will be decreased
Will be hectic
Will be remitting
Will be subnormal
What disease can you suspect in a patient if he periodically diacharges large anount of sputum in one
certain position of his body?
Croupous pneumonia
Diffuse bronchitis
Bronchiectatic disease
Lung cancer
Bronchial asthma
Name factors which provoke lung cancer:
Chronic bronchitis, smoking, irradiation
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Bacterial infection
Moistness of air
Bronchial obstruction
Allergy
By inspection of a chest during attacks of bronchial asthma we can find:
Affected part of the chest is decreased
Paralytic chest
Elevattion of supraclavicualr regions
Retardation of affected part of the chest in breathing
Participation of adventitious muscles in respiration
Select the spyrograsphy index which is assential in determination of bronchial obstruction degree?
Respiratory lung volume
Inspiratory reserve volume
FEV1
Vital lung capacity
Peak velocity
Назва наукового напрямку (модуля):
Семестр: 6
Internal Medicine Propaedeutics (text-test)
Опис:
3 course, medical
Перелік питань:
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? What should be paid attention to during inspection of a neck?
Pulsations of carotic arteries, stretching of sternocleidomastoid muscles
Pulsations of jugular veins
Swelling of carotic arteries
Thyroid gland enlargement
Cricoid cartilage position
Which of enumerated conditions is pale skin color typical for?
Anaemia
Fever
Respiratory failure
Hypertonic crisis
Hyperrtermia
Which of enumerated conditions is red skin color typical for?
Anaemia
Renal failure
Heart failure
Hyperthermia
Respiratory failure
Which part of inquiry does allegrological anamnesis belong to?
Patient’s complaints
History of main disease
Anamnesis vitae
Review of systems
Passport data
Which position is typical for the patient in coma:
Active
Passive
Forced
Orthopnoe
Supine
Which quality of pain may be expressed in the terms "crumping, dull boring, burning, pierching"?
Character
Intensity
Location
Irradiation
Conduction
Which information should a doctor obtain from a patient to reveal AIDS risk factors?
Does the patient suffer of hyprtension
Did he has frequent respiratory infections?
Did he has hemotransfusions in the past?
Does he suffers of diabetes mellitus?
Did he suffer of hepatitis A?
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Which information belongs to “anamnesis vitae”?
Professions in the past
The cause of the disease
Character of disease onset
How long does the disease last
Patient’s complains
Which of enumerated conditions is cyanosis typical for?
Anaemia
Renal failure
Heart failure
Hypertermia
Hypertension
What diseases should you obviously ask about when you obtain patient’s past medical history?
Flu
Chicken pox
Tuberculosis
Pneumonia
Chronic colitis
What is typical for face of feverish patient?
Face is distorted with tubercular and nodal sickness of skin
Deep eyes, pointed face pattern
Enlarged eyebrows
Shining eyes, pale cheeks with flash on them, cyanosis of a nose, lips, ears
Protruded cheek-bones, nose, lips are stretched, mouth angles are lowered, wrinkles around mouth
“Spider angiomata” are the sign of inflammatory process in:
Kidney
Brain
Heart
Liver
Intesatine
Interrupted (scanding) speech of a patient is typical for:
Chronic bronchitis
Neurological disorder
Rheumatic fever
Chronic cholecystitis
Chronic hepatitis
Mark AIDS-risk factors:
Pregnancy
Operations, hemotransfusions
Upper airways infection
Talking with HIV-infected person
Alcohol abuse
How is the symptom called when a patent has focal depigmentation of skin of different sizes?
Vitiligo
Albinismus
C.
D.
E.
16.
A.
B. *
C.
D.
E.
17.
A.
B. *
C.
D.
E.
18.
A. *
B.
C.
D.
E.
19.
A.
B.
C.
D.
E. *
20.
A.
B.
C.
D. *
E.
21.
A. *
B.
C.
D.
E.
22.
A.
B.
C. *
D.
E.
Hypertrichosis
Achromia
Hyperchromia
Edema on face may be in:
Diseases of a heart
Kidney diseases
Pneumonia
Bronchitis
Hepatitis
Enlarged skull is observed in:
Microcefalia
Hydrocefalia
Rheumatic heart disease
Hepatitis
Nephritis
Small skull is typical for:
Microcephalia
Hydrocephalia
Rheumatic heart disease
Hepatitis
Nephritis
Excess skin dryness may be the sign of:
Hypertension
Thyrotoxicosis
Hypoglycaemia
Peptic ulcer
Dehydratation due to diarrhoea
Excess sweating may develop in:
Chronic recidive pancreatitis
Chronic bronchitis
Peptic ulcer
Thyrotoxicosis
Hypothyreosis
Hallucinations develop in:
Chronic alcoholism
Hypertension
Hypothyreosis
Thyrotoxicosis
Rheumatic fever
“Hippocrate’s face” appears in:
Presence of air in stomach
Presence of fluid in stomach
Peritonitis
Ascites
Ventroptosis
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.
D.
E.
29.
A.
B. *
C.
D.
E.
30.
A.
Hirsutism may be the sign of:
Rheumatic fever
Cushing’s disease
Nephritis
Hypertension
Nettle rash
Hoarse voice is observed in:
Aortic aneurism
Hypertension
Rheumatic heart disease
Nephritis
Hepatitis
Dark-brown color of skin including skin folds is typical for:
Peptic ulcer
Adrenal glands insufficiency
Chronic hepatitis
Chronic cholecystitis
Renal failure
Delirium develops in:
Hypertension
Infectious diseases due to intoxication
Chronic hepatitis
Nettle rash
Thyrotoxicosis
A posture of “suppliant” is typical for:
Rheumatic disease
Bechterev’s disease
Chronic hepatitis
Peptic ulcer
Chronic nephritis
Edematous legs are typical for:
Heart disease
Rachitis
Respiratory pathology
Syphilis
Brucellosis
Absolute absence of skin pigment is called:
Vitiligo
Albinismus
Hyperthrichosis
Achromia
Hyperchromia
Asymmetric movements of facial muscles as well as uneven depth of nasolabial folds may be the
sign of:
Hypertension
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.
D.
E.
35.
A. *
B.
C.
D.
E.
36.
A. *
B.
C.
D.
E.
37.
A.
B.
C.
Brain stroke
Rheumatic heart disease
Hepatitis
Nephritis
Blue skin color is typical for:
Peptic ulcer
Respiratory insufficiency
Hepatitis
Nephritis
Nettle rash
Light-brown color of skin (like coffee with milk) is typical for:
Diabetes mellitus
Rheumatic fever
Septic endocarditis
Bronchitis
Peptic ulcer
Which of enumerated conditions is cyanosis typical for?
Anaemia
Renal failure
Respiratory failure
Hypertermia
Arterial hypertension
What should be paid attention to during inspection of a neck?
Pulsations of carotic arteries
Width of the neck
Swelling of carotic arteries
Thymus
Direction of sternocleidomastoid mucscles
What should be paid attention to during inspection of a neck?
Thyroid gland enlargement
Width of the neck
Swelling of carotic arteries
Thymus
Direction of sternocleidomastoid mucscles
What should be paid attention to during inspection of a neck?
Swelling and pulsations of jugular veins
Width of the neck
Swelling of carotic arteries
Thymus
Direction of sternocleidomastoid mucscles
Asthenic type of constitution is characterized by:
Epigastric angle is more than 90 degrees
Transversal body dymensions prevail in comparation with normosthenics (patient’s parts of body
are broad and short)
Cholesterol concentration is increased in blood
D.
E. *
38.
A. *
B.
C.
D.
E.
39.
A.
B.
C. *
D.
E.
40.
A.
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.
Blood pressure is increased
Hypofunction of adrenal glands
Asthenic type of constitution is characterized by:
Epigastric angle is less than 90 degrees
Transversal body dymensions prevail in comparation with normosthenics (patient’s parts of body
are broad and short)
Cholesterol concentration is increased in blood
Blood pressure is increased
Hyperfunction of adrenal glands
Asthenic type of constitution is characterized by:
Epigastric angle is more than 90 degrees
Transversal body dymensions prevail in comparation with normosthenics (patient’s parts of body
are broad and short)
Low cholesterol concentration in blood
Blood pressure is increased
Hyperfunction of adrenal glands
Asthenic type of constitution is characterized by:
Epigastric angle is more than 90 degrees
Transversal body dymensions prevail in comparation with normosthenics (patient’s parts of body
are broad and short)
Cholesterol concentration is increased in blood
Blood pressure is decreased
Hyperfunction of adrenal glands
Hypersthenic type of constitution is characterized by:
Logitudinal body dimensions prevail in comparation with normosthenics (patients are slim and tall)
Transversal body dimensions prevail in comparation with normosthenics (patient’s parts of body are
broad and short)
Slightly decreased blood pressure
Epigastric angle is 90 degrees
Hypofunction of adrenal and sex glands
Asthenic type of constitution is characterized by:
Logitudinal body dymensions prevail in comparation with normosthenics (patients are slim and tall)
Transversal body dymensions prevail in comparation with normosthenics (patient’s parts of body
are broad and short)
Bilirubin concentration is increased in blood
Blood pressure is increased
Hyperfunction of adrenal glands
Hypersthenic type of constitution is characterized by:
Logitudinal body dymensions prevail in comparation with normosthenics (patients are slim and tall)
Epigastric angle is more than 90 degrees
Slightly decreased blood pressure
Epigastric angle is 90 degrees
Hypofunction of adrenal and sex glands
What from the following is typical for paroxysmal tachycardia?
Premature appearance of cardiac complex on ECG
Complete compensatory pause
C. *
D.
E.
45.
A.
B.
C. *
D.
E.
46.
A. *
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.
Abrupt beginning and finish
Prolongation of PQ interval
Displacement of ST segment fron isoelectric line
ECG signs of ventricular extrasystole:
Р wave is present, ventricular complex is not changed;
Unbroadened Р wave, altered ventricular complex;
Missed Р wave and broadened disfigured ventricular complex;
Р wave present and ventricular complex is missed;
Presence of negative Р wave before altered QRS.
ECG-sign of atrial fibrillation?
different duration of RR intervals
heart rhythm is always accelerated
P wave appears after QRS
QRS complex is disfigured
P wave is absent, large waves F are recorded instead of P
ECG-sign of atrial flutter?
Different duration of RR intervals
Heart rate is less than 40 per min
P wave appears after QRS
QRS complex is disfigured
P wave is absent, large waves F are recorded instead of P
ECG-signs of ventricular fibrillation?
Different duration of RR intervals
Zero line with oscillations, waves and complexes on ECG is not possible to recognize
P wave appears after QRS
Sinusoid line, waves and complexes on ECG is not able to recognize
P wave is absent, large waves F are recorded instead of P
ECG-signs of ventricular flutter?
Different duration of RR intervals
Heart rhythm is always accelerated
P wave appears after QRS
Sinusoid line, waves and complexes on ECG is not able to recognize
P wave is absent, large waves F are recorded instead of P
Normal value of electric axis of the heart (angle ?) is equal to:
-30° to -60°;
0° to -30°;
0° to +30°;
+30° to +69°;
+70° to +90°.
Wave P represents potentials of:
Sino-atrial node;
Atriums
Left ventricle;
Right ventricle;
Atrioventricular node.
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.
D.
E.
58.
A. *
B.
C.
D.
E.
59.
A.
B.
What ECG-signs of left atrial hyperthrophy do you know?
Rising of amplitude of wave P.
Rising of amplitude of wave R.
Decreasing of amplitude of wave R.
Duration of wave P is not changed.
Appearance of byphasic P wave.
Which component of ECG reflects cardiac electrical diastole?
T wave
QRS complex
P-T interval
T-P interval
P-Q interval
Which component of ECG reflects cardiac electrical systole?
T wave
P wave
QRS complex
PT complex
ST interval
Which component of ECG reflects conduction of impulse through AV node?
T wave
P wave
QRS complex
PQ interval
ST interval
Which component of ECG reflects excitation of ventricles?
T wave
P wave
QRS complex
PQ interval
ST interval
Which component of ECG reflects repolarization of ventricles?
T wave
P wave
QRS complex
PQ interval
ST interval
Clinical manifestation of extrasystole:
Feeling of escape of heart beats
Palpitation
Dizziness, faints
Morgagni-Adams-Stock’s syndrome
No symptoms
Clinical manifestation of marked bradycardia:
feeling of escape of heart beats
palpitation
C. *
D.
E.
60.
A.
B.
C.
D. *
E.
61.
A.
B.
C.
D.
E. *
62.
A.
B.
C.
D. *
E.
63.
A.
B.
C.
D.
E. *
64.
A.
B.
C. *
D.
E.
65.
A.
B.
C.
D. *
E.
66.
Dizziness, faints
Morgagni-Adams-Stock’s syndrome
No symptoms
Clinical manifestation of transition of incomplete AV block to complete one:
feeling of escape of heart beats
palpitation
Dizziness, faints
Morgagni-Adams-Stock’s syndrome
No symptoms
ECG signs of sinus bradicardia:
R-R intervals periodically are shorter but sometimes they become longer. All components of ECG
are not changed. Change of RR interval duration don’t depend on respiratory phases
R-R intervals periodically are shorter but sometimes they become longer. All components of ECG
are not changed. Change of RR interval duration depends on respiratory phases;
R-R intervals periodically are shorter but sometimes they become longer. QRS complex is
disfigured, P wave is absent.
R-R intervals are shorter than normal, heart rate is morge than 90 per min
R-R intervals are longer than normal, heart rate is 40-60 per min
ECG signs of sinus tachicardia?
R-R intervals periodically are shorter but sometimes they become longer. All components of ECG
are not changed. Change of RR interval duration don’t depend on respiratory phases
R-R intervals periodically are shorter but sometimes they become longer. All components of ECG
are not changed. Change of RR interval duration depends on respiratory phases;
R-R intervals periodically are shorter but sometimes they become longer. QRS complex is
disfigured, P wave is absent.
R-R intervals are shorter than normal, heart rate is 90-150 per min
R-R intervals are longer than normal, heart rate is 40-60 per min
What among the following is typical for complete AV block?
Heart rate 60-90 per min
Heart rate 90-160 per min
Heart rate more than 160 per min
Heart rate 40-60 per min
Heart rate less than 40 per min
What among the following is typical for paroxismal tachycardia?
Heart rate 60-90 per min
Heart rate 90-160 per min
Heart rate more than 160 per min
Heart rate 40-60 per min
Heart less than 40 per min
What among the following is typical for sinus bradycardia?
Heart rate 60-90 per min
Heart rate 90-160 per min
Heart rate more than 160 per min
Heart rate 40-60 per min
Heart less than 40 per min
What among the following is typical for sinus tachycardia?
A.
B. *
C.
D.
E.
67.
A. *
B.
C.
D.
E.
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.
A.
B. *
C.
Heart rate 60-90 per min
Heart rate 90-160 per min
Heart rate more than 160 per min
Heart rate 40-60 per min
Heart less than 40 per min
What among the following is typical normocardia?
Heart rate 60-90 per min
Heart rate 90-160 per min
Heart rate more than 160 per min
Heart rate 40-60 per min
Heart less than 40 per min
Which extrasystole is followed with complete compensatory pause?
atrioventricular;
atrial;
Sinoatrial
ventricular;
Atrioventricular.
Which extrasystole is manifested with negative P wave before QRS complex?
Atrioventricular;
Atrial;
Sinus
From left ventricle;
From right ventricle.
Which extrasystole is manifested with negative P wave recorded after QRS complex?
Atrioventricular;
Atrial;
Sinus
From left ventricle;
From right ventricle.
Which extrasystole is not followed with compensatory pause?
Atrioventricular;
From left ventricle
Sinoatrial
Atrial
From right ventricle.
Asystoly may develop as the result of:
Atrial fibrillation
Ventricular fibrillation
Atrial flutter
Ventricular flutter
Atrioventricular block
Asystoly may develop as the result of:
Intraventricular block of the right Hiss bundlebranch
Ventricular fibrillation
Intraatrial block
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.
D.
E.
79.
A.
B.
C.
D.
E. *
80.
A.
B.
C.
D.
E. *
81.
Ventricular flutter
Intraventricular block of the left Hiss bundlebranch
Asystoly of ventricles leads to:
Cessation of blood circulation and clinical death
Cardiogenic shock
Thrombogenesis and embolism
Hypotension
Myocardial infarction
Asystoly: this is…
Absence of P wave in ECG, shaotic waves f, intervals R-R are different
Absence of any waves on ECG
QRS complexes are absent, ECG shows shaotic waves with different shape and amplitude
Frequent regular waves similar in shape and amplitude
Periodical missing of complete cardiac cycle
Select the normal duration of QRS complex:
0,1 sec
0,12 sec
0,14 sec
0,16 sec
0,18 sec
Normal position of ST segment on ECG curve?
On izoelectrical line
May deviate from izoelectrical line not more than on 1 mm
May deviate from izoelectrical line not more than on 2 mm
May deviate from izoelectrical line not more than on 3 mm
May deviate from izoelectrical line not more than on 4 mm
? Vital lung capacity – this is a summation of…
Respiratory and residual volumes of lungs
Respiratory volume, reserve inspiratory and expiratory volumes
Respiratory volume, reserve expiratory and minute volumes
Respiratory volume, reserve expiratory volume
Residual volume, reserve inspiratory and expiratory volumes
In which respiratory phases are rales heard?
During inspiration and first 1/3 of expiration
In 1st phase of inspiration
In 1st phase of expiration
During inspiration and the last 1/3 of expiration
During inspiration and expiration
Pleural friction is heard…
During inspiration and first 1/3 of expiration
In 1st phase of inspiration
In 1st phase of expiration
During inspiration and the last 1/3 of expiration
During inspiration and expiration
Crepitation is heard…
A.
B. *
C.
D.
E.
82.
A. *
B.
C.
D.
E.
83.
A.
B.
C.
D. *
E.
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.
During inspiration and expiration
In 1st phase of inspiration
In 1st phase of expiration
In last phase of inspiration
In last phase of expiration
Rivolt’s test is used for…
Differentiation of exssudate and transsudate
Determination of allergic sensitivity
Determination of sputum viscosity
Assessment of immune resistance
Assessment of blood coagulation
What percussion sound occurs during percussion above Traube’s space?
dull
dull-to-resonance;
resonance
thympanic
dull-to-thympanic.
What pulmonary sound can occur in percussion above the Traube’s space in left-sided hydrothorax?
Dull
Dull-to-resonance
Resonance
Tympanic
Dull-to-thympany
The lower border of the left lung at the parasternal line is located at:
IV rib
V rib
VI rib
VII rib
It is not determined
The lower border of the right lung at the scapula line is located at:
VI rib
VII rib
VIII rib
ІХ rib
Х rib
The height of lungs apexes above clavicles in a healthy person takes approximately:
lungs apexes don’t go upwards from the the level of clavicle
Rise up to 1 cm
1-2 cm
3-4 cm
4-6 cm
Tiffneu index -this is ratio of:
Volumes of forced inspiration to expiration
Volumes of forced inspiration to vital lung capacity
Volumes of forced inspiration to reserve inspiratory volume
D.
E.
89.
A.
B.
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.
95.
A.
B. *
C.
D.
E.
96.
Volumes of forced expiration to vital lung capacity
Volumes of forced expiration and inspiration vital lung capacity
Pneumotachymetry is the method for determination of
Arterial blood gases
Respiratory volumes
Velocity of air streams
Location of pathological process in the lungs
Ethiology of disease of respiratory system
In physiological conditions crepitation is heard in the following case…
Heavy physical activity
Intake of large volume of liquid
Overheating
Long-term bed mode in old patients
In low temperature of environment
A patient is lying on the affected side of the chest to diminish caugh in the case of :
Bronchial asthma
Chronic bronchitis
Cavity in the lungs on the affected side
Myocardial infarction
Pneumonia
Which shape of a chest is typical for terminal stage of tuberculosis?
Foveated
Truncated
Pigeon
Barrel-shaped
Paralytic
The cause of displacement of the lower lung border upwards is:
Hepatomegaly
Acute bronchitis
Basal pneumosclerosis
Dry pleurisy
Bronchial asthma
The cause of displacement of the lower lung border downwards is:
Bronchial asthma
Hepatomegaly
Pneumothorax
Basal pneumosclerosis
Dry pleurisy
Which adventitious examination is it necessary to execute for diagnostics of bronchial asthma?
Complete blood count
Pneumotachymetry
Plan chest X-ray
Contrast chest X-ray
Computer tomography
Which changes may be revealed on X-ray in pneumonia?
A. *
B.
C.
D.
E.
97.
A.
B. *
C.
D.
E.
98.
A.
B.
C.
D. *
E.
99.
A. *
B.
C.
D.
E.
100.
A. *
B.
C.
D.
E.
101.
A.
B. *
C.
D.
E.
102.
A.
B. *
C.
D.
E.
103.
A. *
B.
Pulmonary tissue infiltration
Lung emphysema
Multiple small focci in the lungs
Cavity in the lung
Norm
Which changes of main respiratory sounds combined usually with diffuse dry rales ?
Amphoric breathing
Harsh breathing
Pueril respiration
Interrupted breathing
Intensified vesicular breathing
Which changes will be on X-ray in pleurisy with effusion?
Pulmonary tissue infiltration
Increased transparency of the lungs, depressed diaphragm
Pointed lung pattern
Intensive homogenous darkening with oblique upper edge
Diffuse small focci in lower parts of the lungs, enlarged paratracheal lymph nodes.
Which character of pain will be in pleurisy with effusion?
Pressing
Pierching
Stubbing
No pain
Cutting
Which data of auscultation will be above affected part of the lung in II stage of lobar pneumonia
(corresponds to pulmonary tissue consolidation)?
Bronchial breathing
Amphoric breathing at the affected side
Vesicular breathing
Bronchovesicular breathing
Weakened vesicular breathing
Which pathological conditions are dry rales typical for?
Pneumonia, especially lobar one
Bronchitis
Dry pleurisy
Lung emphysema
Atelectasis
Which pathological conditions are dry low-pitched rales typical for?
Pneumonia
Chronic bronchitis
Dry pleurisy
Pulmonary emphysema
Pleurisy with effusion
Which reasons for pulmonary tissue consolidation do you know?
Accumulation of liquid in alveoli
Accumulation of air in alveoli
C.
D.
E.
104.
A. *
B.
C.
D.
E.
105.
A.
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. *
Accumulation of air in pleural cavity
Atelectasis, I stage
Pneumonia, I stage
Which reasons for pulmonary tissue consolidation do you know?
Replacement of pulmonary tissue to connective one
Accumulation of air in alveoli
Accumulation of air in pleural cavity
Atelectasis, I stage
Pneumonia, I stage
Which reasons for pulmonary tissue consolidation do you know?
Accumulation of air in alveoli
Tumour in the lungs
Accumulation of air in pleural cavity
Atelectasis, I stage
Pneumonia, I stage
Which reasons for pulmonary tissue consolidation do you know?
Atelectasis, I stage
Accumulation of air in alveoli
Accumulation of air in pleural cavity
Complete atelectasis
Pneumonia, I stage
Accentuation of II heart sound above pulmonary artery occurs in:
Aortal stenosis;
Bronchial asthma attack
Syphilitic mesaortitis;
Atherosclerosis of aorta;
Acute catarrhal bronchitis
Weakened vesicular breathing with prolonged expiration are the signs of the following syndrome…
Consolidation of pulmonary tissue
Air accumulation on pleural cavity
Fluid accumulation in pleural cavity
Accumulation of air and fluid in pleural cavity
Bronchial obstruction
What is typical for croupous pneumonia on spirogram?
Decreased vital lung capacity
Increased vital lung capacity
Increased residual volume
Increased minute lung ventilation
Respiratory acidosis
The cause of restrictive type of respiratory failure may be all presented below except of:
Bronchial tumour which closes completely its lumen
Pneumofibrosis
Pneumonia
Pneumothorax
Bronchial obstruction
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.
A.
B.
C. *
D.
E.
117.
A.
B.
C.
D.
E.
118.
A. *
The following auscultative criterion is typical for the syndrome of pulmonary emphysema…
Bronchial breathing
Vesicular breathing
Crepitation
Weakened vesicular breathing and prolonged expiration
Weakened vesicular breathing and prolonged inspiration
The most informative method for diagnostics of pleurisy with effusion is…
Roentgenography
Fluorography
Ultrasound examination of pleural cavity
Bronchoscopy
Bronchography
Respiratory insufficiency of obstructive type develops due to:
Appearance of air in the pleural cavity
Limitation of the chest wall movements
Obstruction of bronchial lumen
Diminishing of lungs' reespiratory surface
Diminishing of lungs parenchyma elasticity
Poor bronchopulmonary pattern on X-ray film is typical for…
Focal pneumonia
Lobar pneumonia
Chronic bronchitis
Bronchial asthma
Pleurisy with effusion
In patient’s sputum there were found solis spiral-shaped transparent elements with shiny central part.
What is this?
Cholesterol crystals
Hematoidin crystals
Charcot-Leyden’s crystals
Curshman’s spirals
Ditrich’s plaques
Intensification of bronchopulmonary pattern on X-ray film is typical for…
Focal pneumonia
Lobar pneumonia
Chronic bronchitis
Bronchial asthma
Pleurisy with effusion
ANSWER: B
Differentiation of exssudate and transsudate
Determination of allergic sensitivity
Determination of sputum viscosity
Assessment of immune resistance
Assessment of blood coagulation
Moist coarse consonant rales may be heard above…
Lung abscess filled with pus and air and connected with a bronchus
B.
C.
D.
E.
119.
A.
B.
C.
D.
E. *
120.
A.
B.
C.
D. *
E.
121.
A.
B. *
C.
D.
E.
122.
A.
B.
C.
D.
E. *
123.
A.
B.
C.
D.
E. *
124.
A.
B.
C.
D. *
E.
125.
A.
B.
C.
Narrowed bronchi
Cavern not connected with a bronchus (isolated)
Pleural liquid
Empty bronchiectasia
Neutrophil leycocytosis and shift to the left, toxic granulosity of neutrophils, increased ESR – these
signs are typical for …
Bronchial asthma
Acute bronchitis
Chronic bronchitis
Pulmonary emphysema
Croupous pneumonia
Curshman’s spirals are observed in sputum of patients with…
Acute bronchitis
Bronchopneumonia
Croupous pneumonia
Bronchial asthma
Lung cancer
Decreased Tiffneu index indicates on…
Presence of cavity in the lungs
Obstructive disorders of lung ventilation
Restrictive disorders of lung ventilation
Compensatory erythraemia
Spontaneous pneumothorax
Crimson gelly-like consistence of sputum is the symptom of:
croupous pneumonia,
bronchiectatic disease,
lung tuberculosis,
lung abscess,
lung cancer.
Discharge of a large volume of sputum in special position of the patient testify about:
Croupous pneumonia
Diffuse bronchitis
Lung tuberculosis
COPD
Bronchiectatic disease
During percussion above a cavern it is possible to obtain the following sound…
Bandbox
Dull
Dull-to-thympany
Tympanic
Resonant
By inspection of a chest during attacks of bronchial asthma we can find:
Affected part of the chest is decreased
Paralytic chest
Elevattion of supraclavicualr regions
D.
E. *
126.
A. *
B.
C.
D.
E.
127.
A.
B.
C.
D.
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.
Retardation of affected part of the chest in breathing
Participation of adventitious muscles in respiration
Hemorrhagic exssudate is typical for…
Lung cancer
Pneumonia
Bronchitis
Pneumoconniosis and tuberculosis
Ascaridosis and mucoviscidosis
If the patient with pneumonia develops crepitation over the lower lobe of the right lung, which main
respiratory sound should be expected to hear with auscultation at affected area?
Bronchial breathing
Amphoric breathing
Vesicular breathing
Pueril breathing
Weakened vesicular breathing
In which disease will vocal fremitus be absent on the side of affection?
Croupous pneumonia
Tumour of the large bronchus with uncompleteobturation of the bronchus
Tumour of the large bronchus with complete obturation of the bronchus
Pneumosclerosis
Bronchial asthma
In which disease will vocal fremitus be intensified on the side of affection?
Pleurisy with effusion
Croupous pneumonia
Bronchial asthma
Pulmonary emphysema
Pneumothorax
Which data will be in percussion of a patient’s chest in croupous pneumonia, consolidation stage?
Dull sound
Bandbox sound
Tympanic sound
Clear pulmonary (resonant) one
Dull-to-thympany sound
Crepitation is the symptom of
Croupous pneumonia
Acute bronchitis
Dry pleurisy
Chronic bronchitis
Pulmonary emphysema
Which peculiarities of pulmonary cyanosis do you know?
Diffuse, warm, located at a tongue and oral mucosa
Diffuse, it is cold
It is located on small area of a body, it is cold
Located in one limb
There is no elevation on pressure
133.
A.
B.
C.
D.
E. *
134.
A. *
B.
C.
D.
E.
135.
A. *
B.
C.
D.
E.
136.
A. *
B.
C.
D.
E.
137.
A.
B. *
C.
D.
E.
138.
A.
B. *
C.
D.
E.
139.
A. *
B.
C.
D.
E.
140.
A.
A patient developed pleurisy with effusion. Which changes of bronchophony will be?
Intensification on affected side
Weakening on affected side
Symmetrical intensification
Symmetrical symmetrical
Absent on affected side
A patient developed pneumonia. Which changes of bronchophony will be?
Intensification on affected side
Symmetrical on affected side
Symmetrical intensification
Symmetrical weakening
Absent on affected side
Which temperature curve is typical for cropous pneumonia (if the patient doesn’t receive specific
treatment)?
Stable febril fever
Litic decrease of temperature
Critical drop of temperature
Periodical high elevation of temperature
Prolonged subfebril
«Rusty» sputum may be in patients with…
Mitral valvular stenosis complicated with heart failure
Bronchopneumonia
Pleurisy with effusion
Dry pleurisy
Bronchiectatic disease
Which kind of sound will be obtained above the zone of dry costal pleurisy?
Dull sound
Resonant sound
Bandbox sound
Tympanic sound
Complete dullness (flat sound)
Which elements in sputum are typical for bronchial asthma?
Fridlender’s bacilli
Charcot-Leyden’s crystals
Mycobacteria
Pneumococci
Erythrocytes
What percussion sound occurs in the II stage of athelectasis (complete collapse of lung lobe)?
Dull sound
Dull-to-resonance sound
Dull-to-thympanic sound
Resonant sound
Thympanic sound
In which cases among the following vocal fremitus become intensified?
Pulmonary emphysema
B.
C.
D. *
E.
141.
A.
B. *
C.
D.
E.
142.
A. *
B.
C.
D.
E.
143.
A.
B. *
C.
D.
E.
144.
A.
B. *
C.
D.
E.
145.
A. *
B.
C.
D.
E.
146.
A.
B. *
C.
D.
E.
147.
A.
B. *
C.
D.
The I stage of lobar pneumonia
Bronchiectatic disease
The II stage of lobar pneumonia
Above the cavern, filled with liquid
Which adventitious examination is it necessary to execute for diagnostics of bronchial asthma?
Complete blood count
Pneumotachymetry
Plan chest X-ray
Contrast chest X-ray
Computer tomography
Which changes may be revealed on X-ray in pneumonia?
Pulmonary tissue infiltration
Lung emphysema
Multiple small focci in the lungs
Cavity in the lung
Norm
Which disease is sputum with sharp unpleasant smell typical for?
Bronchial asthma
Lung gangroene
Acute bronchitis
Lung infarction
Pneumonia
Which elements in sputum are typical for croupous pneumonia?
Fridlender’s bacilli
Cocci, macrophages
Mycobacteria
Pneumococci
Erythrocytes
Which pathological conditions is crepitation typical for?
Pneumonia
Bronchitis
Dry pleurisy
Lung emphysema
Pleurisy with effusion
Accentuation of II heart sound above pulmonary artery occurs in:
Aortal stenosis;
Bronchial asthma attack
Syphilitic mesaortitis;
Atherosclerosis of aorta;
Acute catarrhal bronchitis
Decreased Tiffneu index indicates on…
Presence of cavity in the lungs
Obstructive disorders of lung ventilation
Restrictive disorders of lung ventilation
Compensatory erythraemia
E.
148.
A.
B.
C.
D. *
E.
149.
A.
B.
C. *
D.
E.
150.
A.
B.
C.
D.
E. *
151.
A. *
B.
C.
D.
E.
152.
A.
B.
C. *
D.
E.
153.
A.
B.
C. *
D.
E.
154.
A.
B. *
C.
D.
E.
155.
A. *
Spontaneous pneumothorax
Diffuse dry whistling high pitched rales are heard in…
Bronchiectatic disease
Croupous pneumonia
Bronchopneumonia
Bronchial asthma attack
Cardiac asthma attack
Ditrich’s plaques are present in sputum in…
Acute broncitis
Chronic bronchitis
Bronchiectasia
Exudative pleurisy
Dry pleurisy
For diagnostics of central lung cancer optimal is…
Chest roentgenoscopy
Chest roentgenography
Fluorography
Computer tomography
Bronchoscopy
Harsh breathing indicates on…
Bronchitis
Dry pleurisy
Pleurisy with effusion
Pulmonary emphysema
Pneumonia
Respiratory insufficiency of obstructive type develops due to:
Appearance of air in the pleural cavity
Limitation of the chest wall movements
Obstruction of bronchial lumen
Diminishing of lungs' reespiratory surface
Diminishing of lungs parenchyma elasticity
? Which sound is heard above the abdomen during its percussion?
Bundbox
Dull sound
Thympanic sound
Dull-to-thympany sound
Resonant
What is normal location of liver lower border on anterior median line revealed by percussion?
At costal arch
Between the upper and medial thirds of the distance between the navel and xyphois process
Between the lower and medial thirds of the distance between the navel and xyphois process
At the navel
At xyphois process
What is normal location of liver lower border on midclavicular line revealed by percussion?
At costal arch
B.
C.
D.
E.
156.
A.
B.
C. *
D.
E.
157.
A.
B.
C.
D. *
E.
158.
A.
B.
C.
D.
E. *
159.
A.
B.
C.
D. *
E.
160.
A.
B. *
C.
D.
E.
161.
A. *
B.
C.
D.
E.
162.
A.
B. *
C.
1 сm upper from the costal arch
2 сm upper from the costal arch
2 сm lower from the costal arch
1 сm lower from the costal arch
What is normal location of liver upper border on midclavicular line revealed by percussion?
at 4 rib
at 5 rib
at 6 rib
at 7 rib
at 8 rib
What is the length of the 3rd (oblique) size of a liver?
10± 1 сm
9± 1 сm
8± 1 сm
7±1 сm
6±1 сm
What is the sequence of palpation of intestine?
Sigmoid, caecum, terminal part of ileum, transverse colon, ascending colon, descending colon
Terminal part of ileum, sigmoid, ascending colon, transverse colon, descending colon, caecum
Sigmoid, caecum, terminal part of ileum, ascending colon, transverse colon, descending colon
Terminal part of ileum, ascending colon, descending colon, sigmoid, caecum, transverse colon
Sigmoid, caecum, terminal part of ileum, ascending colon, descending colon, transverse colon
Superficial palpation of an abdomen (when a patient does not complain of any pain) should be started
from:
Epigastrium
Left hypochondrial region
Right hypochondrium
Left iliac region
Suprapubical region
The lover edge of normal liver is palpated at:
Parasternal line
Midclavicular line
Anterior axillary line
Mid axillary line
Midline
Normal sizes of a liver by Kurlov’s method are:
9 ±1 сm, 8±1 сm, 7±1 сm
12±1 сm, 11±1 сm, 10±1 сm
10±1 сm, 8±1 сm, 6±1 сm
8±1 сm, 7±1 сm, 6±1 сm
11±1 сm, 10±1 сm, 8±1 сm
How is the method of inspection of large colon mucosa is named?
Gastroduodenoscopy
Colonoscopy
Rectoromanoscopy
D.
E.
163.
A.
B.
C. *
D.
E.
164.
A.
B.
C. *
D.
E.
165.
A.
B.
C.
D.
E. *
166.
A.
B. *
C.
D.
E.
167.
A.
B. *
C.
D.
E.
168.
A.
B.
C. *
D.
E.
169.
A.
B.
C. *
D.
E.
Cystoscopy
Laparoscopy
How many centimeters is liver size on the midline (obtained by percussion by Kurlov’s method)?
10±1 сm
9±1 сm
8± 1 сm
7±1 сm
6± 1 сm
How many centimeters is liver size on the right midclavicular line (obtained by percussion by
Kurlov’s method)?
11±1 сm
10± 1 сm
9± 1 сm
8± 1 сm
7± 1 сm
Skin itching in jaundice is caused by:
Increased concentration of hemoglobin
Increased concentration of bilirubin
Increased concentration of cholesterol
Increased concentration of creatinine
Increased concentration of bile acids
In first stage of chronic hepatitis:
fibrosis is absent
poorly expressed periportal fibrosis
moderate fibrosis with porto-portal septa
expressed fibrosis with porto-central septa
liver cirrhosis
In the second stage of chronic hepatitis fibrosis is:
expressed
moderate
poorly expressed
absent
liver cirrhosis develops
In the fourth stage of chronic hepatitis the following process develops:
moderate fibrosis poorly expressed fibrosis
expressed fibrosis
liver cirrhosis
hepatonecrosis
poorly expressed fibrosis
Select the ultrasound data of hepatitis:
deformation of bile ducts;
thickness of bile ducts walls
diffuse thickness of the liver;
single large centuriated inclusion;
deformation of a liver
170.
E.
Select data of hypersplenism:
anemia, thrombocytopenia;
leukocytosis, anemia;
leukocytosis, hyperbilirubinemia, thrombocytopenia;
leukocytosis, anemia, thrombocytopenia;
leukopenia, anemia, thrombocytopenia
In treatment of biliary colic, it is necessary to prescribe:
sedatives
spasmolytic and analgesics
antibiotics
hepatoprotectors
vitamins
Leading symptoms in case of chronic cholecystitis are:
Pain, dysuria
Pain, dyspepsia
Hepatic failure
Dyspepsia, dysuria
Pain, intoxication
The main ethiologic factor of chronic cholecystitis is:
Character of nutrition
Anomaly of the liver development
Genetic predisposition
Bile ducts dyskinesia
Virus
174.
A.
B.
C. *
D.
E.
175.
A.
B. *
C.
D.
E.
176.
A. *
B.
C.
D.
E.
177.
A.
B.
What symptom appears simultaneously with the pain in biliary colic?
hemorrhagic
splenomegaly
nausea, vomiting
belching, bloating, constipation
diarrhea, flatulence
Itching of the skin in liver diseases indicates on:
Presence of duodenogastric reflux
Increased content of bile acids due to cholestasis
Affected proteins production by a liver
Deranged process of bilirubin conjugation
Increase of detoxication function of a liver
Name basic clinical signs of cholestasis syndrome:
Jaundice, skin itching
Jaundice, hepatosplenomegaly
Pallor, jaundice, hepatosplenomegaly
Stomach-aches, jaundice
Pallor, skin itching
Name character of pain in perforation of stomach ulcer:
Boring
Burning
A.
B.
C.
D.
E. *
171.
A.
B. *
C.
D.
E.
172.
A.
B. *
C.
D.
E.
173.
A.
B.
C.
D. *
C.
B.
C.
Pressing
“Knife-like”
Belting
What pain pattern is typical for biliary colic?
Discomfort in right subcostal area
Epigastric pain on hunger or at night
Intensive, paroxysmal pain in right subcostal area
Distension pain in the mesogastrium
Discomfort in left subcostal area
What pain pattern is typical for chronic hepatitis?
Dull-boring or mild pressing pain in right subcostal area
Epigastric pain on hunger or at night
Intensive, paroxysmal pain in right subcostal area
Distension pain in the mesogastrium
Discomfort in left subcostal area
Select the proper appearance of xanthomas:
They look like angiomas elevated above the skin
They look like yellow plaques
They look like excoriations
They look like hemorrhagic rash
They look like nettle rash
Accumulation of liquid in abdominal cavity is called:
Ascites
Hydrothorax
Pneumothorax
D.
E.
182.
A. *
B.
C.
D.
E.
183.
A.
B. *
C.
D.
E.
184.
A. *
B.
C.
D.
E.
Hydropericardium
Exudate
Which data among the follofing indicate on decreased synthetic function of a liver?
Hypoalbuminemia, decreased levels of fibrinogenum and prothrombin
Hyperbilirubinemia, decreased levels of fibrinogenum and prothrombin
Hypoalbuminemia, hypercholesterolemia, hyperazotemia
Hyperbilirubinemia, hypercholesterolemia, hyperazotemia
Hyperalbuminemia, decreased levels of fibrinogenum and prothrombin
Dilatation of anterior abdominal wall veins are typical for:
Bile ducts dyskinesia
Portal hypertension
Gastritis
Duodenitis
Colitis
The next symptoms are typical for chronic cholecystitis:
Pain in the right hypochondrium after intake of fatty or fried food
Pain in a stomach after the physical loading
Pain in the right hypochondrium after sleep
Pain in the right hypochondrium during urination
Pain in the right hypochondrium before sleep
D. *
E.
178.
A.
B.
C. *
D.
E.
179.
A. *
B.
C.
D.
E.
180.
A.
B. *
C.
D.
E.
181.
A. *
185.
A. *
B.
C.
D.
E.
186.
A.
B.
C. *
D.
E.
187.
A.
B.
C. *
D.
E.
188.
A.
B.
C. *
D.
E.
189.
A.
B. *
C.
D.
E.
190.
A. *
B.
C.
D.
E.
191.
A.
B. *
C.
D.
E.
192.
A.
The next symptoms are typical for chronic autoimmune hepatitis:
Pain in the right hypochondrium, hepatosplenomegaly
Pain in the left hypochondrium
Diarrhea, intoxication
Splenomegaly, jaundice
Pain in the stomach
Pain in the inguinal area relates to:
Presence of gastritis
Presence of duodenitis
Presence of spastic colitis
Presence of pancreatitis
Normal finding
Positive Ortner’s sign is characteristic for:
Gastritis
Pancreatitis
Cholecystocholangitis, hepatitis
Duodenitis
Colitis
The main ethiologic factor of chronic hepatitis is:
Bacteria
Parasites
Virus
Fungi
Bile
The syndrome of "cholestasis" includes the increased levels of:
АsАТ, АlАТ, total bilirubin
Cholesterol, direct bilirubin, alkaline phosphatase
Cholesterol, indirect bilirubin, alkaline phosphatase
General bilirubin, remaining nitrogen
General bilirubin, АsАТ, АlАТ
The syndrome of "cytolysis" includes:
Increase of the АsАТ level, АlАТ, LDG
Increase level of cholesterol, iron, LDG
Decrease level of proteins, cholesterol, bilirubin, СRP
Decrease level of СRP, remaining nitrogen, АsАТ, АlАТ
Decrease of the АsАТ level, АlАТ, LDG, bilirubin
To the obvious biochemical researches for patients with the diseases of hepatobiliary system belong
the following:
General albumen, CRP, seromucoid, bilirubin
General protein and fractions, transaminases, bilirubin, cholesterol
General protein and fractions, urea, creatinin, cholesterol
General protein and fractions, CRP, seromucoid, urea
General protein and fractions, CRP, cholesterol
How is jaundice with occlusion of the common bile duct called?
Physiological
B.
A. *
B.
C.
D.
Hemolytic
Mechanical
Parenchymatous
Combined
Where pain in the attack of biliary colic is conducted?
To the left shoulder, small finger, left part of a neck
To spinal cord
To the left sternoclavicular joint
To the right shoulder, right part of a neck, right scapula
To the epigastrium
Which changes in coprogram are typical for chronic pancreatitis?
Semiliquid feces with unpleasant smell, steatorrhea, creatorrhea, amylorrhea
Hard feces
Hidden blood ion feces
Helmints ova in feces
Fresh scarles blood streaks on the surface of feces
Which laboratory test is informative in diagnostics of chronic pancreatitis exacerbation?
Complete blood count
Investigation of amylase, lipase, trypsin levels and their inhibitors
Investigation of serum proteins
Coprogram
Amylase in urine
Which method is the most informative in differentiation of peptic ulcer and stomach cancer?
Esophagogastroduodenoscopy with biopsy
Roentgenoscopy of the stomach
Roentgenography of the stomach
Examination of feces for scant blood
E.
197.
A.
B.
C. *
D.
E.
198.
A.
B. *
C.
D.
E.
199.
A.
B.
C.
D.
Investigation of stomach secretion
Which pain is typical for chronic enteritis?
Diffuse pain in all abdominal region
In the left iliac region
In paraumbilical region
In epigastrium
In lower parts of abdomen
Which radiopaque preparation is necessary for X-ray examination of stomach and intestine?
Cholevid
Barium sulphate
Bilignost
Iopagnost
Urotrast
Which pathology belching with smell like rotten eggs is typical for?
Stomach ulcer,
Pancreatitis,
Liver cirrhosis,
Euteritis.
C. *
D.
E.
193.
A.
B.
C.
D. *
E.
194.
A. *
B.
C.
D.
E.
195.
A.
B. *
C.
D.
E.
196.
E. *
200.
A.
B.
C.
D.
E. *
201.
A.
B.
C.
D.
E. *
202.
A.
B.
C.
D.
E. *
203.
A.
B.
C.
D.
E. *
204.
A.
B.
C. *
D.
E.
205.
A.
B.
C.
D.
E. *
206.
A.
B.
C.
D.
E. *
Stomach cancer,
Which symptoms are typical for duodenal ulcer?
Pain in the right hypochondrium after meals, nausea and vomiting, discolored feces;
Pain in the left hypochondrium, meteorism;
Pain in epigastrium after meals, nausea and vomiting, constipation;
Pain in epigastrium, diarrhea, dark stool.
Pain in duodenal region on fasten stomach, nausea and vomiting, constipation;
Which disease diarrhea after milk intake is typical for?
Stomach ulcer,
Stomach cancer,
Liver cirrhosis,
Colitis.
Pancreatitis,
Which symptoms are typical for stomach ulcer?
Pain in the right hypochondrium after meals, nausea and vomiting, discolored feces;
Pain in the left hypochondrium, meteorism;
Pain in duodenal region on fasten stomach, nausea and vomiting, constipation;
Pain in epigastrium, diarrhea, dark stool.
Pain in epigastrium after meals, nausea and vomiting, constipation;
Which pathology heartburn is typical for?
Stomach cancer,
Pancreatitis,
Liver cirrhosis,
Colitis.
Stomach ulcer,
Which method is useful in recognition of Helikobakter pilori infection?
Intragastral рН–metry
Complete blood count
С-respiration test
Determination of uropepsinogen
Stomach probing
A doctor has performed deep sliding palpation of patient’s intestine. Which part of the intestine is it
necessary to examine in first order?
Caecum
Transverse colon
Ascending colon
Descending colon
Sigmoid colon
A doctor has performed deep sliding palpation of patient’s stomach. In the norm stomach lower
border is situated:
2-3 сm below the navel
At the level of the navel
At xyphoid process
1-2 сm below the navel
2-3 сm above the navel
207.
A.
B.
C.
D.
E. *
208.
A.
B.
C.
D.
E. *
209.
A.
B.
C.
D.
E. *
210.
A.
B.
C.
D.
E. *
211.
A.
B.
C.
D.
E. *
212.
A.
B.
C.
D.
E. *
213.
A.
B.
A doctor has performed deep sliding palpation of patient’s intestine. What is normal diameter of
caecum?
1-2 сm
2-3 сm
5-6 сm
6-7 сm
3-4 сm
A doctor has performed deep sliding palpation of patient’s intestine. Which part of the intestine is
necessary to examine after sigmoid intestine?
Appendix
Terminal part of ileum
Ascending colon
Transverse colon
Caecum
A doctor has performed deep sliding palpation of patient’s intestine. Which part of the intestine is
necessary to examine after caecum?
Sigmoid intestine
Descending part of colon
Transverse part of colon
Appendix
Terminal part of ileum
A doctor performs deep sliding palpation of patient’s intestine. Which part of the intestine is
examined in the last order?
Caecum
Descending colon
Appendix
Terminal part of ileum
Transverse colon
A patient has peptic ulcer and pylorostenosis. Which character of vomiting masses will be in this
case?
vomit with admixtions of bile
vomit with admixtions of blood
mucus and pus in vomiting masses
undigested food in vomiting masses
vomiting with food used a day before
During inspection of a patient with liver disease “spider angiomata” were revealed. What type of rash
is this?
plaques
excoriations
hemorrhagic rash
allergic rash.
angiomas
Patient complains of nausea, vomiting, eructation and heartburn. Which syndrome these complaints
are typical for?
asthenic syndrome
dumping-syndrome
C.
D.
E. *
214.
A.
B.
C.
D.
E. *
215.
A.
B.
C.
D.
E. *
216.
A.
B.
C.
D.
E. *
217.
A.
B.
C.
D.
E. *
218.
A.
B.
C.
D.
E. *
219.
A.
B.
C.
D.
E. *
220.
syndrome of cholestasis
syndrome of malabsorption
dyspeptic syndrome
In a patient a smooth dense painless formation was found by palpation in the left hypochondrium.
What may it be?
Caecum,
Sigmoid colon,
Appendix,
Liver.
Spleen or the left kidney,
Patient is troubled with periodical pain in epigastrium, which appears 25-30 min after meals. This
pain is called:
late
pain on hunger
night pain
seasonal pain
early
Patient complains of impossibility to swallow, unpleasant sensations behind the sternum during
meals. This symptom is named:
dyspepsia
dystonia
anorexia
bulimia
dysphagia
In a patient splashing sound was revealed by percussion palpation of the abdomen in 8 hours after the
last meal. What this sign indicates on?
Decreased stomach secretion
Achilia
Intensified motor and evacuatoty function of the stomach
Norm
Pylorostenrsis
What taste in the mouth is typical for exacerbation of chronic cholecystitis?
Metalic taste,
Taste of rotten eggs,
Acid taste,
No any taste.
Bitter taste,
A patient complains of periodic spastic pain in paraumbilical region. Affection of which part of
intestine such a localization of pain is typical for?
Stomach,
Esophagus,
Gallbladder,
Pancreas,
Small intestine.
Patient complains of eructation with the smell of “rotten eggs” and on diarrhea. Such complaints are
typical for:
A.
A.
B. *
increased acidity of stomach juice
stomach bleeding
normal acidity of stomach juice
intestinal bleeding
decreased acidity of stomach juice
In a patient with stomach cancer achylia was revealed. What character of belch is typical for the
pathology?
Belch with mealic taste,
Belch with air,
Sour belch,
Belch with bitter taste.
Belch with smell of rotten eggs,
The most mobile part of large bowel is:
Caecum
Transverse colon
Ascending colon
Descending colon
Sigmoid
Causes of Liver Cirrhosis are all of the following except:
Viral hepatitis B,
Primary biliary cirrhosis,
Viral hepatitis C,
Non-alcoholic steatohepatitis
Alcoholic liver disease
? What process is controlled by parathyroid glands?
Protein metabolism
Lipid metabolism
Phosphoric-calcium metabolism
Vitamin metabolism
Carbohydrates metabolism
Graefe’s symptom is characteristic for:
Diabetes mellitus
Hyperthyroidism
C.
D.
E.
226.
A. *
B.
C.
D.
E.
227.
A.
B.
Myxedema
Acromegaly
Addison's disease
Select specific feature of the skin in patients with hyperthyroidism?
It is smooth, warm and humid
Dry and cold
Swollen
With pustular rash
Vascular pattern (marble) and tensile bars
The treatment of Grave’s disease usually include:
Sulfonylureas
Diuretics
B.
C.
D.
E. *
221.
A.
B.
C.
D.
E. *
222.
A.
B.
C.
D.
E. *
223.
A.
B.
C.
D. *
E.
224.
A.
B.
C. *
D.
E.
225.
C.
D.
E. *
228.
A.
B. *
C.
D.
E.
229.
A.
B.
C.
D.
E. *
230.
A.
B. *
C.
D.
E.
231.
A.
B. *
C.
D.
E.
232.
A. *
B.
C.
D.
E.
233.
A.
B.
C. *
D.
E.
234.
A.
B.
C. *
D.
Narcotic analgesics
Antidepressants
Thyrostatics
Which of the following is the most active form of thyroid hormone:
Thyroxine (T4)
Triiodothyronine (T3)
Thyrotropin
Thyroglobulin
Thyroid peroxidase
Which of the following may be helpful in diagnostics of subclinical hypothyroidism?
Low thyroid hormone levels but no symptoms
Classic symptoms of hypothyroidism but normal thyroid function test results
Low free T4 levels but normal serum thyroid-stimulating hormone (TSH) level
Low serum TSH but normal free T4 levels
Increased serum TSH but normal free T4 levels
The main cause of secondary hypothyroidism is:
Inflammation of the thyroid gland
Hypopituitarism
Thyrostatic therapy
Iodine deficiency status
Disorders of cells sensitivity to thyroid hormones
As a rule endemic goiter is presented by:
Acute thyroiditis
Diffuse goiter
Hyperthyroid
Solitary nodule
Subacute thyroiditis
Which menstrual disorder is typical for hypothyroidism?
Menorrhagia
Oligomenorrhoea
Amenorrhea
Painful menstruations
Menstruations are normal
Which type of thyroiditis is the most common?
Reidel's Thyroiditis
Subacute lymphocytic thyroiditis
Hashimoto's thyroiditis
De Quervain's thyroiditis
Acute thyroiditis
In collaboration with the dietician, what dietary modification should the physician suggest for the
patient with hyperthyroidism?
Decrease calories and proteins and increase carbohydrates.
Eliminate carbohydrates and increase proteins and fats.
Increase calories, proteins, and carbohydrates.
No dietary modification is needed.
E.
D.
E.
239.
A. *
B.
C.
D.
E.
240.
A. *
B.
C.
Decrease calories, proteins, and carbohydrates
Hormone that acts directly on the thyroid gland is:
TSH
TRH
FSH
Thyroxine
Triiodothyronine
Endemic goiter is characterized by:
Investigations invariably show some degree of hypothyroidism
There is a clear evidence of an increased incidence of carcinoma of the thyroid
Administration of thyroxine will often cause the goitre to shrink
Administration of iodine occasionally precipitates hyperthyroidism
The incidence after puberty is much higher in females
Specfy what is typical for hypothyroidism:
Menorrhagia or oligomenorrhoea
Oversweating
Tremor
Exophthalmos
Fever
Which product is not synthesized in thyroid gland:
Thyroxine (T4)
Triiodothyronine (T3)
Thyrotropin
Thyroglobulin
Thyroid peroxidase
In hypothyroidism, patients can present with:
Puffiness of feet
Heat intolerance
Exophthalmos
Diarrhea.
Fever
In hyperthyroidism could be revealed:
Tachycardia
Constipation
Depression
D.
E.
241.
A. *
B.
C.
D.
E.
242.
A. *
Weight gain.
Hypotermia
The treatment of Grave’s disease usually includes the following:
Antagonists of thyroid hormones
Antidepressants
Narcotic analgesics
Diuretics
Sulfonylureas
Select clinical criteria of hyperglycaemic coma:
Signs of general dehydratation, fruit smell from the mouth;
235.
A. *
B.
C.
D.
E.
236.
A.
B.
C. *
D.
E.
237.
A. *
B.
C.
D.
E.
238.
A.
B.
C. *
B.
A.
B.
C. *
D.
E.
247.
A.
B.
C.
D. *
E.
248.
A.
Rapid development of coma;
Skin pallor, oversweating;
Excitation, sudden hunger, tremor;
Normal tonus of eyeballs
Select laboratory criteria of hyperglycaemic coma:
Glucose level more than 20 mmol/L;
Blood рН more than 7,3, hypernatremia;
Decreased blood hematocrit;
Hypoglicemia;
Hyperlactacidemia
Select laboratory criteria of hyperglycaemic coma:
Acetonuria, glucosuria;
Blood рН more than 7,3, hypernatremia;
Decreased blood hematocrit;
Hypoglicemia;
Hyperlactacidemia
Precursors of diabetic coma are:
Face pallor with mild flash on the cheeks, cyanosis is absent;
Shallow respiration audible on the distance;
Pointed face features;
Dry skin, atonic muscles;
Loss of appetite, nausea, vomiting, pain in the stomach;
The cause of sudden vision loss in patient with diabetic retinopathy can be due to:
Cataract
Glaucoma
Vitreous haemorrhage
Papilloedema
Iritis
How many % of beta-cells should be destroyed in pancreas to cause hyperglycemia:
40 %
60 %
80 %
90 %
100 %
Which statement is true about HbA1C:
Absent in normal people
B.
C.
D.
E. *
249.
A.
B. *
C.
D.
A mutant of haemoglobin
Is a result of enzymatic degradation of glucose
Diagnostic criteria of diabetes
Indicates average levels of glucose in blood
The main cause of hyperosmolar coma is:
Insulin deficiency
Dehydration
Extreme activity
Hypoxia
C.
D.
E.
243.
A. *
B.
C.
D.
E.
244.
A. *
B.
C.
D.
E.
245.
A.
B.
C.
D.
E. *
246.
E.
D.
E.
254.
A.
B.
C.
D. *
E.
255.
A.
B.
C. *
D.
E.
Intercurrent infection
Minimum amount of carbohydrate required to prevent ketonuria in a case of diabetes is about:
10 gm/daily
25 gm/daily
100 gm/daily
150 gm/daily
200 gm/daily
Commonest cause of lactic acidosis during treatment of diabetes is:
Diuretics
Insulin treatment
Sulfonylurea preparations
Biguanides
Nonsulfonylurea insulin stimulators
What symptom is not typical for diabetes mellitus type 1?
Polyuria
Hirsutism
Polydipsia
Dry skin
Loss of weight
What is not possible to reveal during examination of a patient with hyperthyroidism?
Excitation of a patient, excess movements, fast speech
Dry cold skin
Ocular symptoms (Graefe’s, Mobius’s, Shtelvag’s, Kocher’s, Delrimpl’s signs)
Thinning of subcutaneous fat
Stretchet and dry skin of forehead, deep eyes
Which of the following is not true about Type 1 DM?
May be linked to autoimmunity
Onset usually prior to age 20
Beta islet cells destroyed
Does not require insulin injections
Onset usually after age 20
Which of the following is not true about Type 2 DM?
Considered adult onset diabetes
Cause unknown may be due to genetics
Require insulin 80% of cases
May take a drug that sensitize cells or increase insulin release
Onset usually prior to age 20
256.
A. *
B.
C.
D.
E.
257.
A.
Which organ is the place of insulin primary action?
Muscle
Brain
Kidney
Adrenals
Bones
? What is a term, which describes the increased amount of urine?
Pollakiuria
250.
A.
B.
C. *
D.
E.
251.
A.
B.
C.
D. *
E.
252.
A.
B. *
C.
D.
E.
253.
A.
B. *
C.
B.
A.
B. *
C.
D.
E.
262.
A.
B.
C.
D.
E. *
263.
A.
B.
C.
Nоcturia
Polyuria
Oliguria
Anuria
Specify the name for attack of pain caused by kidney block with a stone:
Nephrocolick
Biliary colic
Intestinal colic
Spasmodic pain
Dull boring pain
Specify the degree of albumin secretion with urine, which refers to microalbuminuria:
30-300 mg/24 hours
400-600 mg/24 hours
700-900 mg/24 hours
>100 mg/24 hours
>1000 mg/24 hours
A hypertonic type of chronic glomerulonephritis is manifested with:
Normal blood pressure (BP) and uric syndrome
High BP
Edema and uric syndrome
High BP and edema
Total edema
Progression of chronic glomerulonephritis is usually caused by:
Infection
Hemodynamic changes in glomeruli
Immune disorders
Disorders of urine outflow
Hyperurikemia
The main difference between primary and secondary chronic pyelonephritis is the following:
diabetes mellitus
tonsillitis, caries
chronic prostatitis
decreased immune reactivity
disorders of urine outflow
The most often complication of acute pyelonephritis is:
Hypotension
Hypertension
Acute renal failure
D. *
E.
264.
A.
B.
C. *
D.
Paranephritis
Cardiopulmonary insufficiency
Specify the most typical provoking factor of primary pyelonephritis:
Violation of a diet
Disorders in urine outflow
Decreased immune defense
Hemodynamic disorders in kidney
C. *
D.
E.
258.
A. *
B.
C.
D.
E.
259.
A. *
B.
C.
D.
E.
260.
A.
B.
C.
D. *
E.
261.
E.
D.
E.
269.
A.
B.
C. *
D.
E.
270.
A.
B.
C. *
D.
E.
271.
A.
Diabetes mellitus
Typical signs of renal edema:
Appear in the evening
First appear on legs
First appear on arms
Appearance on face in the morning
Early appearance of anasarca
What is ishuria?
absence of urination because of affection of kidney excretory function
absence of urination because of impossibility to discharge urine from the bladder
increase of amount of urine more than 2 liters per day
decrease of amount of urine less than 1 liter per day
amount of urine excreted per day is 0-30 ml because of affection of kidney excretory function
What is anuria?
absence of urination because of affection of kidney excretory function
absence of urination because of impossibility to discharge urine from the bladder
increase of amount of urine more than 2 liters per day
decrease of amount of urine less than 1 liter per day
amount of urine excreted per day is 0-30 ml because of affection of kidney excretory function
What is location of edema in initial stages of kidney affection?
Below eyes
On lower limbs
On upper limbs
In lumbar region
In abdominal cavity
What is oliguria?
frequent urination
increase of amount of urine more than 2 liters per day
decrease of amount of urine less than 1 liter per day
increase of specific gravity of urine
lowering of specific gravity of urine
What is pollakiuria:
urination 3-4 times per day
urination 4-7 times per day.
urination 8-11 times per day
absence of urination
urination 1-2 times per day.
What is polyuria?
frequent urination
B. *
C.
D.
E.
272.
A.
increase of amount of urine more than 2 liters per day
decrease of amount of urine less than 1 liter per day
increase of specific gravity of urine
lowering of specific gravity of urine.
What is stranguria?
urination 3-4 times per day
265.
A.
B.
C.
D. *
E.
266.
A.
B. *
C.
D.
E.
267.
A.
B.
C.
D.
E. *
268.
A. *
B.
C.
B. *
A.
B.
C.
D. *
E.
277.
A. *
B.
C.
D.
E.
278.
A.
B.
C.
D. *
E.
painful urination
urination 8-11 times per day
absence of urination
urination 1-2 times per day.
What is the probable origin of destroyed erythrocites appearance in common urine analyses?
Acute glomerulonephritis
Urolithiasis
Paranephritis
Acute cystitis
Pyelonephritis
What pathology of the kidney is cramping pain typical for?
Attack of nephrocolic
Kidney eclampsia
Tuberculosis of kidneys
Tumor of kidneys
Glomerulonephritis
When does the enlargement of one kidney appear on plane X-ray?
In diffuse nephritis
In the case of polycystosis
In chronic renal failure, II stage
In uncomplicated urolithiasis
In hydronephrosis.
When does the increase of shade of both kidneys appear at plain X-ray?
In chronic pyelonephrituis
In the case of hypertrophy
In the case of diabetic nephropathy
In the case of polycystic degeneration
In chronic kidney insufficiency
Antibiotics of which group are used for treatment of glomerulonephritis are nephrotoxic?
Hentamycin
Penicillin
Fluorochynolones
Macrolides
Cephalosporines
Which clinical sign is not typical for the beginning of pyelonephritis?
Febril fever
Lumbar pain
Dysuria
Arterial hypertension
Chills
279.
A.
B.
C.
D. *
Which laboratory test is useful for assessment kidney filtration function?
Complete blood count;
Nechyporenko’s test;
Canalicular reabsorption
Clearance by endogenous creatinine
C.
D.
E.
273.
A. *
B.
C.
D.
E.
274.
A. *
B.
C.
D.
E.
275.
A.
B.
C.
D.
E. *
276.
E.
A.
B.
Determination of daily proteinuria.
Which level of protein in urine is typical for acute glomerulonephritis?
0,03 g/l
0,03-1 g/l
1-2 g/l
2-3 g/l
More than 3 g/l
Which level of protein in urine is typical for acute pyelonephritis?
No protein in urine
0,03-1 g/l
1-2 g/l
2-3 g/l
More than 3 g/l
Which main sign of chronic renal failure is the main criterion of its severity?
Hypertension
Serum creatinine
Degree of anemia
Proteinuria
Heart failure
Which syndrome is not typical for pyelonephritis?
Uric syndrome
Nephrotic syndrome
Pain
Intoxication syndrome
Dysuric syndrome
Which laboratory test is useful in diagnostics of pyelonephritis?
Biochemical blood study;
ECG;
Nechyporenko’s test;
Zimnicki’s test
Determination of daily proteinuria.
Which way of infection contamination is typical for primary pyelonephritis?
Through the ureter (in bladder-ureter reflux)
Along the ureter walls
Hematogenic
Lymphogenic
Contact
For which period of time is it necessary to prescribe bed mode for a patient with acute
glomerulonephritis?
Till disappearance of uric syndrome
On 1-3 days
C. *
D.
E.
287.
Till disappearance of edema and normalization of blood pressure
On 3-5 days
On 10-14 days
? What is normal value of ejection fraction?
280.
A.
B.
C.
D.
E. *
281.
A.
B. *
C.
D.
E.
282.
A.
B. *
C.
D.
E.
283.
A.
B. *
C.
D.
E.
284.
A.
B.
C. *
D.
E.
285.
A.
B.
C. *
D.
E.
286.
A. *
B.
C.
D.
E.
288.
A. *
B.
C.
D.
E.
289.
A. *
B.
C.
D.
E.
290.
A.
B.
C. *
D.
E.
291.
A.
B. *
C.
D.
E.
292.
A. *
B.
C.
D.
E.
293.
A.
B.
C.
D. *
E.
294.
A.
B.
C. *
more than 55 %
more than 34 %;
more than 45%
more than 62%
more than 80%
Echocardiography: this is …
The method of imaging of a heart and large vessels with usage of ultrasound
Administration of roentgen-contrast agent into the right of left coronary artery with special catheters
Recording of the movements of heart apex during contractions
Investigation of heart contours pulsation with usage of special photoelectric cell
Registration of sounds which occur in a heart during its contraction
Which valve is listened at Botkin-Erb’s point?
Aortal valve
Pulmonary trunk valve
Mitral valve
Tricuspid valve
Mitral valve and Tricuspid valve
Which valve is listened at heart apex?
Aortal valve
Pulmonary trunk valve
Mitral valve
Tricuspid valve
Aortal valve and Mitral heart valve
Which valve is listened at II interspace leftward of the sternum?
Aortal valve
Pulmonary trunk valve
Mitral valve
Tricuspid valve
Aortal valve and Mitral heart valve
Which valve is listened at II interspace rightward of the sternum?
Aortal valve
Pulmonary trunk valve
Mitral valve
Tricuspid valve
Aortal valve and Mitral heart valve
Which valve is listened at xyphoid process?
Aortal valve
Plmonary trunk valve
Mitral valve
Tricuspid valve
Tricuspid valve and Mitral valve heart valve
Where is Botkin-Erb’s point located?
V interspace 1-1,5 cm medially from the left midclavicular line
II interspace leftward of the sternum
III-IV interspaces leftward of the sternum
D.
E.
295.
A.
B.
C.
D. *
E.
296.
A.
B. *
C.
D.
E.
297.
A.
B.
C. *
D.
E.
298.
A. *
B.
C.
D.
E.
299.
A.
B.
C.
D. *
E.
300.
A.
B.
C. *
D.
E.
301.
A. *
B.
At the xyphoid process
II interspace rightward of the sternum
Relative systolic murmur differs from organic one in such a way:
It doesn’t depend on respiratory phases;
It is hough, loud and long;
It doesn’t change in physical load
Is not transmitted (“dies at the place of occurence”);
It is heard in all points of auscultation.
Projection of aortal valve on the chest wall is the following:
II intercostal space leftward of the sternum
At the midpoint of the line connecting II costal cartilages of left and right ribs
Leftward of the sternum at the point of junction of the Ш rib with the sternum
At the midpoint of the line connecting junction of the Ш left rib and junction of V left rib to the
sternum
At the level of 3rd ribs at the midpoint of the sternum
Projection of mitral valve on the chest wall is the following:
II intercostal space leftward of the sternum
At the midpoint of the line connecting II costal cartilages of left and right ribs
Leftward of the sternum at the point of junction of the Ш rib with the sternum
At the midpoint of the line connecting junction of the Ш left rib and junction of V left rib to the
sternum
At the level of 3rd ribs
Projection of pulmonary trunk valve to the chest wall is the following:
II intercostal space leftward of the sternum
At the midpoint of the line connecting II costal cartilages of left and right ribs
Leftward of the sternum at the point of junction of the Ш rib with the sternum
At the midpoint of the line connecting junction of the Ш left rib and junction of V left rib to the
sternum
At the level of 3rd ribs
Projection of tricuspid valve on the chest wall
II intercostal space leftward of the sternum
At the midpoint of the line connecting II costal cartilages of left and right ribs
Leftward of the sternum at the point of junction of the Ш rib to the sternum
At the midpoint of the line connecting junction of the III left rib to the sternum and junction of V
right rib to the sternum
At the level of 3rd ribs
In the V interspace 1-1,5 cm medially from the left midclavicular line it is possible to listen to:
Aortal valve
Pulmonary trunk valve
Mitral valve
Tricuspid valve
No any heart valve
Which auscultation data is it possible to found in norm?
III sound
IV sound,
C.
D.
E.
302.
A.
B.
C.
D. *
E.
303.
A.
B. *
C.
D.
E.
304.
A.
B.
C. *
D.
E.
305.
A. *
B.
C.
D.
E.
306.
A.
B.
C. *
D.
E.
307.
A.
B. *
C.
D.
E.
308.
A. *
B.
C.
D.
E.
Extra-pericardial sound
Gallop rhythm,
Opening snup
Functional systolic murmur differs from organic one because it:
Does not depend on a phase of respiration
Is rasping, sonorous, long
Does not vary at exertion;
Is not conducted
Is heard at all points of auscultation.
Which method is better for percussion of a heart?
Immediate percussion
Mediate percussion finger by finger
Mediate percussion through clothes
Mediate percussion with iron pleximeter
Combined percussion
Which disease is Musse’s sign typical for?
Hypertension
Ischemic heart disease
Aortal valve incompetence
Rheumatic heart disease
Chronic pyelonephritis
Displacement of borders of relative heart dullness leftwards is typical for:
Left ventricular failure
Splanchnoptosis
Left sided hydrothorax
Left atrial dilatation
Pulmonary emphysema
What is necessary to find out before determination of the right border of relative cardiac dullness?
Blood pressure and pulse of a patient
Degree of severity of the disease
The heght of the diaphragm on the right side
Resiliance of the chest
The square and location of cardiac beat
What is normal location of the left border of relative cardiac dullness?
0,5 сm outside from the right sternal border
1-1,5 сm medially from the left midclavicular line
At the left sternal border
At medial line
1-1,5 см medially from medial line
What is normal location of the right border of relative cardiac dullness?
1-1,5 сm laterally from the right sternal border
1-1,5 сm inside from the left midclavicular line
At the left sternal border
At medial line
1-1,5 см medially from midline
309.
A.
B.
C. *
D.
E.
310.
A. *
B.
C.
D.
E.
311.
A.
B.
C. *
D.
E.
312.
A. *
B.
C.
D.
E.
313.
A.
B. *
C.
D.
E.
314.
A.
B.
C. *
D.
E.
315.
A.
B. *
C.
D.
E.
316.
A.
B. *
C.
What is normal location of the upper border of relative cardiac dullness?
The upper edge of 4th rib
The upper edge of 3rd rib
The lower edge of 3rd rib
In 3rd interspace
The upper edge of 2nd rib
The square of normal apex beat is equal to
1-2 cm square
3-4 cm square
5-6 cm square
0,2-0,5 cm square
0,5 -1 cm square
Pulse filling characterises the following:
Level of maximal arterial blood pressure
Cardiac output
Amplitude of dilatation of arteries in systole
Speed of myocardial contractions
Width of vascular bundle
Pulse tension characterises the following:
Level of maximal arterial blood pressure
Volume of circulating blood
Cardiac output
Speed of myocardial contractions
Degree of dilatation of arteries
In which case displacement of the right border of relative cardiac dullness is possible?
In dilatation of vascular bundle
In dilatation of the right atrium and right ventricle
In dilatation of left atrium
In dilatation of the left ventricle
In hypertrophy of the left ventricle
Limits for diastolic blood pressure are:
50-80 mm of Hg
50-90 mm of Hg
60-90 mm of Hg
60-95 mm of Hg
70-95 mm of Hg
Limits for normal systolic blood pressure are:
90-120 mm of Hg
100-140 mm of Hg
100-160 mm of Hg
105-160 mm of Hg
110-160 mm of Hg
Function of arterioli are as follows:
Change with metabolites between blood and tissues
Maintainance of proper pressure in arterial bed
Act as a shunts
D.
E.
317.
A.
B.
C. *
D.
E.
318.
A.
B. *
C.
D.
E.
319.
A.
B. *
C.
D.
E.
320.
A. *
B.
C.
D.
E.
321.
A.
B.
C.
D.
E. *
322.
A.
B.
C.
D.
E. *
323.
A.
B. *
Accumulate blood in heart failure
Gas exchange between blood and alveolar air
How apex beat will be changed in pericardial adhesions?
Absent
High
Negative
Diffuse
Resistant
If the upper border of relative cardiac dullness is located at the ІІ interspace on the left parasternal
line – it may be due to:
Atelectasis of the right lung
Hyperthrophy of the left atrium
Dilatation of the left ventricle
Dilatation of aorta
Narrow pulmonary artery
If apex beat is determined in V intercostal space on 1,5сm medially from the left midclavicular line,
it is necessary to suspect…
Left ventricular hyperthrophy
Normal location of apex beat
Right-side pneumothorax
Pleurisy with effusion on the right side
Pulmonary emphysema
If the left border of relative cardiac dullness is located in the VІ interspace on the left midclavicular
line – it may be due to:
Left ventricular dilatation
Left side pneumothorax
Low position of diaphragm
Normal position of the border
Sclerosis of the right lung
If the right border of relative cardiac dullness is located at the right sternal border – it means …
compensatory emphysema of the right lung
hyperthrophy of the right ventricle
right ventricular dilatation
left atrial dilatation
normal location of the border
If the upper border of relative cardiac dullness is located at the ІIІ interspace on the left parasternal
line – it may be due to:
Atelectasis of the right lung
Hyperthrophyt of the left atrium
Dilatation of the left ventricle
Dilatation of aorta
Normal position
If the upper border of relative cardiac dullness is located at the ІІ interspace on the left parasternal
line – it may be due to:
Atelectasis of the right lung
Hyperthrophy of the left atrium
C.
D.
E.
324.
A.
B.
C. *
D.
E.
325.
A. *
B.
C.
D.
E.
326.
A.
B.
C.
D.
E. *
327.
A.
B.
C.
D. *
E.
328.
A. *
B.
C.
D.
E.
329.
A. *
B.
C.
D.
E.
330.
A.
B.
C.
D. *
Dilatation of the left ventricle
Dilatation of aorta
Narrow pulmonary artery
Place of auscultation of murmur in aortic stenosis:
Heart apex;
Botkin-Erb’s point;
Second intercostal space righwards from the sternum
Second intercostal space leftwards from the sternum;
Fifth intercostal space righwards from the sternum.
During examination of patient S. aortal stenosis was revealed. Which murmur may be heard by
auscultation?
Systolic at aortal valve
Diastolic at Botkin-Erb’s point,
Systolic at heart apex
Diastolic at aortal valve
Diastolic at heart apex.
Accentuation of П heart sound above the aorta is observed in:
Mitral incompetence;
Mitral stenosis;
Aortal stenosis
Hypertension in lesser circulation;
Arterial hypertension.
Conduction of murmur in aortic valvular defects:
Left axillary region
Botkin-Erb’s point;
Right axillary region
Interscapular space
Epigastyrium
Conduction of murmur in mitral valvular defects:
Left axillary region
Botkin-Erb’s point;
Right axillary region
Interscapular space
Epigastyrium
Which auscultative fenomenon is observed above femoral artery in aortal incompetence?
Durosier’s murmur
Opening snup sound
Pendulum rhythm
Gallop rhythm
Pericardial click
Slupping І sound at heart apex is typical for:
Mitral incompetence;
Aortal stenosis;
Aortal incompetence;
Mitral stenosis;
E.
331.
A.
B.
C.
D. *
E.
332.
A.
B. *
C.
D.
E.
333.
A.
B. *
C.
D.
E.
334.
A.
B. *
C.
D.
E.
335.
A.
B.
C. *
D.
E.
336.
A.
B.
C.
D. *
E.
337.
A.
B. *
C.
D.
E.
338.
A. *
Pneumosclerosis
Splitting of ІІ heart sound at pulmonary artery is observed in
Aortal incompetence
Aortal stenosis
Acute bronchitis
Mitral stenosis
Rheumatic myocarditis
Which heart defect the organic systolic murmur is typial for?
Stenosis of mitral orifice
Stenosis of aortic orifice
Aortic incompetence
Anaemia;
Prolapse of mitral valve.
Which organic murmur at heart apex resembles sensation of a cat’s purr?
Systolic murmur of the mitral valve inompetence
Diastolic murmur of mitral stenosis
Systolic murmur of aortic stenosis
Diastolic murmur of aortic incompetence
Systolic murmur of stenosis of pulmonary artery
Place of auscultation of murmur in aortic incompetence:
Heart apex;
2nd intercostal space righwards from the sternum
3rd intercostal space righwards from the sternum
2nd intercostal space leftwards from the sternum
Fifth intercostal space righwards from the sternum
Which organic murmur gives the filling of “cat’s purr” at basis of the heart?
Systolic murmur in mitral incompetence
Diastolic murmur in mitral stenosis;
Systolic murmur in aortal stenosis;
Diastolic murmur in aortal incompetence;
Systolic murmur in in anemia
In which arrhythmia pulse is irregular in the form of periodical early appearance of pulse wave?
Sinus tachicardia;
Sinus bradicardia;
Sinus arrhythmia;
Extrasystolic arrhythmia;
Atrial flutter.
Intensification of 1 heart sound at heart apex is typical for:
Mitral incompetence
Mitral stenosis
Hypertension
Myocardial infarction
Myocarditis
Weakening of the first heart sound is observed in:
Mirtal incompletence
B.
C.
D.
E.
339.
A.
B.
C.
D. *
E.
340.
A. *
B.
C.
D.
E.
341.
A. *
B.
C.
D.
E.
342.
A.
B. *
C.
D.
E.
343.
A.
B.
C.
D.
E. *
344.
A. *
B.
C.
D.
E.
345.
A.
B. *
C.
D.
Mitral stenosis
Aortal valve calcification;
Pulmonary hypertension
Arterial hypertension
Which auscultative fenomenon (cardiac melody) includes opening snup sound?
Presystolic gallop rhythm
Pendulum rhythm
Protodiastolic gallop rhythm
Tripple rhythm
Artificial cardiac valve melody
Which auscultative fenomenon is observed above femoral artery in aortal incompetence?
Durosier’s murmur
Opening snup sound
Pendulum rhythm
Gallop rhythm
Pericardial click
Which auscultative fenomenon is observed above femoral artery in aortal incompetence?
Double Traube’s sound
Opening snup sound
Pendulum rhythm
Gallop rhythm
Pericardial click
Which auscultative fenomenon is observed in mitral stenosis?
Durosier’s murmur
Opening snup sound
Pendulum rhythm
Gallop rhythm
Pericardial click
Which auscultative fenomenon is observed in pericardial adhesions?
Durosier’s murmur
Opening snup sound
Pendulum rhythm
Gallop rhythm
Pericardial click
Which heart defect is the organic systolic murmur on the apex typical for?
Mitral incompetence
Aortal incompetence
Mitral stenosis
Stenosis of pulmonary artery;
Tricuspid valve stenosis.
Which ishaemic heart defect is the organic ejection systolic murmur typical for?
Stenosis of mitral orifice
Stenosis of aortic orifice
Aortic incompetence
Pulmonary artery valvular stenosis;
E.
346.
A.
B.
C.
D. *
E.
347.
A. *
B.
C.
D.
E.
348.
A.
B. *
C.
D.
E.
349.
A.
B. *
C.
D.
E.
350.
A.
B. *
C.
D.
E.
351.
A.
B.
C. *
D.
E.
352.
A.
B.
C.
D. *
E.
353.
A.
Tricuspid valve incompetence.
Which rheumatic heart defect is the organic systolic murmur on II intercostal space typical for?
Stenosis of mitral orifice
Mitral incompetence
Aortic incompetence
Stenosis aortal valve;
Tricuspid valve incompetence.
Which heart defect is the organic regurgitation diastolic murmur typical for?
Aortal incompetence
Mitral incompetence
Aortic stenosis
Stenosis of pulmonary artery;
Tricuspid valve stenosis.
Which heart defect is the organic regurgitation systolic murmur typical for?
Aortal incompetence
Mitral incompetence
Mitral stenosis
Stenosis of pulmonary artery;
Tricuspid valve stenosis.
Accentuation of II heart sound above pulmonary artery occurs in:
Hypertension in larger circulation
Hypertension in lesser circulation
In systemic arterial hypertension
In myocardial infarction
In emotional stress
Accentuation of II heart sound above pulmonary artery occurs in:
Aortal stenosis;
Mitral stenosis
Syphilitic mesaortitis;
Atherosclerosis of aorta;
Acute catarrhal bronchitis.
In which pathology we can find Corvisar’s face?
Kidney diseases
Infections
Heart failure
Anaemia
Severe disease of abdominal cavity organs
What colour do marked cardiac edema have?
Red
Green
White
Dark-blue
Yellow
What hemodynamic parameter is pulse filling equval to?
Minute volume of blood
B.
C.
D. *
E.
354.
A.
B. *
C.
D.
E.
355.
A.
B.
C. *
D.
E.
356.
A.
B. *
C.
D.
E.
357.
A.
B.
C.
D. *
E.
358.
A.
B.
C.
D.
E. *
359.
A.
B.
C.
D. *
E.
360.
A.
The common resistance of periferic vessels
Combination of minute blood volume and common resistance of periferic vessels
Cardiac output
Viscosity of blood
What hemodynamic parameter pulse tension is equal to?
Minute volume of blood
The common resistance of perypheric vessels
Combination of minute blood volume and common resistance of periferic vessels
Viscosity of blood
Cardiac output
What is the cause of aortal heart configuration?
Dilatation of the right ventricle
Dilatation of the right atrium
Dilatation of the left ventricle
Dilatation of the left atrium
Sickness of intraventricular septum
What is duration of pain in the case of attack of angina pectoris?
For 1-2 minutes
For 5-10 minutes
For 40-60 minutes
From several seconds till 20-60 minutes
For hours, days
What characteristics of pain in the case of the attack of angina pectoris do you know?
Burning, lasts by hours, days
Dull, diffuse ache, irradiates to the left hand
Pressing, burning, irradiates to the left hand, does not disappears after taking of validol or
nitroglycerin
Retrosternal, burning paine, irradiates to the left hand, disappears after taking of validol or
nitroglycerin
Aching pain in one point of precordium, does not irradiate
Select a proper patient’s behaivior during attack of angina pectoris:
The patient is “restless”
The patient is restless, with locomotory and speech excitation
The patient is sitting upright (orthopnea)
The patient is staying upright
The patient is “stiffing in one position” – staying in the same position from the beginning of the
attack till its finish
What is the cause of mitral heart configuration?
Dilatation of the right ventricle
Dilatation of the right atrium
Dilatation of the left ventricle
Dilatation of the left atrium
Sickness of intraventricular septum
True liver pulsation is the sign of:
Congestion in the larger circulation
B.
C.
D.
E. *
361.
A.
B.
C.
D. *
E.
362.
A.
B.
C. *
D.
E.
363.
A.
B. *
C.
D.
E.
364.
A.
B.
C.
D. *
E.
365.
A.
B.
C.
D. *
E.
366.
A.
B.
C. *
D.
E.
367.
A.
B. *
C.
D.
Cardial liver cirrhosis
Pulmonary hypertension
Aortal valve incompetence
Tricuspid valve incompetence
Systolic blood pressure level depends on:
Blood viscosity
General perypheric resistance of vessels
Volume of circulating blood
Cardiac output
Heart rate
Pulse deficiency is typical for:
incompetence of aortal valve
Stenosis of aortal valve
Atrial fibrillation (electrical disfunction of atriums)
Sharp decreasing of vascular tonus
Severe myocardial lesion
By inspection of a patient with heavy cardiac insufficiency it is possible to discover:
Pale and puffy face
Cachexy or anasarca
Edema on the legs without elevation of skin under the pressure
Fingers as “drumsticks”
Jaundice
By palpation patient’s pulse is dull. In what disease is dull pulse observed?
Myocarditis
Pericarditis
Mitral defects
Hypotension
Heart insufficiency
By palpation patient’s pulse is low and slow. “Pulsus parvus and tardus” is observed in:
Mirtal incompetence
Mitral stenosis
Aortal incompetence
Stenosis of ostium of aorta
Hypertension
By palpation patient’s pulse is quick and high. “Pulsus celler et altus” is observed in:
mirtal incompetence
mitral stenosis
aortal incompetence
stenosis of aortal valve
hypertension
ANSWER: A
Heart apex;
Basis of xyphoid process;
Second intercostal space righwards from the sternum
Second intercostal space leftwards from the sternum;
E.
368.
A. *
B.
C.
D.
E.
369.
A.
B.
C.
D. *
E.
370.
A.
B.
C. *
D.
E.
371.
A.
B.
C. *
D.
E.
372.
A. *
B.
C.
D.
E.
373.
A. *
B.
C.
D.
E.
374.
A.
B.
C. *
D.
E.
375.
A. *
Fifth intercostal space righwards from the sternum.
? Functional murmurs in anemia are often:
Systolic
Diastolic
Protodiastolic
Presystolic
Systolodiastolic
Most sensitive and specific test for diagnosis of iron deficiency is:
Serum iron level
Serum ferritin level
Serum transferrin receptor population
Transferrin saturation
Hb level
All are true for sickle cell anemia, except of:
Pulmonary hypertension
“Fish vertebra”
Leukopenia
Enlargement of a heart
Patient may require frequent blood transfusions
Which is not seen in a chronic case of Sickle cell anemia :
Pulmonary hypertension
Cardiomegaly
Hepatomegaly
Splenomegaly
Structural orthopedic abnormalities
What possible changes in the bone marrow in aplastic anemia?
Replacement of marrow elements with adipose tissue
Replacement of marrow elements with fibrous tissue
Prevalence of megaloblasts
Presence of blast cells
Absolute lymphocytosis
What is anisocytosis:
erythrocytes of different size
appearance of red corpuscles of different form
appearance of leucocytes of different form
appearance of leucocytes of different size
appearance of thrombocytes of different size
Which patient is most at risk for hematologic problems?
48-year-old man who had myocardial infarction 5 years ago
62-year-old woman with diabetes mellitus on insulin therapy
55-year-old man with chronic alcoholism
27-year-old woman taking oral contraceptives
18-year-old girl with rheumatic fever
What is the cause of geographic tongue in pernicious anemia?
Papillar athrophy
B.
C.
D.
E.
376.
A.
B. *
C.
D.
E.
377.
A.
B. *
C.
D.
E.
378.
A.
B.
C.
D. *
E.
379.
A.
B.
C.
D. *
E.
380.
A.
B. *
C.
D.
E.
381.
A.
B.
C.
D.
E. *
382.
A.
B.
C. *
D.
Fungal infection
Bacterial infection
Edema of the tongue
Papillar hyperhrophy
Select the appropriate treatment for patients with vitamin B12-deficiency anemia:
Iron preparations
Cyancobalamin
Hemotransfusions
Splenectomy
Glucocorticoids
The patient’s face with Adison-Birmer anemia is:
Pale, diffusely edematic;
«Waxen doll»;
Cyanotic, edematic;
Pale, exhausted;
Moonlike.
The 37-year-old male patient has hemoglobin level 22.1 g/dL. What is the doctor’s best action?
Document the report as the only action.
Institute infection precautions.
Institute bleeding precautions.
Prescribe transfusion of compatible blood
Prescribe transfusion of blood plasma
Select typical signs of syderopoenic syndrome:
Skin pallor, dyspnoe
Skin redness, paresthesia in limbs
Necrotic pharyngitis
Skin dryness, fragidity of nails
Gigantic liver and spleen, jaundice
In which disease you can find angular stomatitis in the patient?
Chronic lympholeukosis
Iron-deficiency anemia
Folic acid deficiency anemia
Hemolytic anemia
Lymphogranulomatosis
In which parts of digestive system the main part of iron is absorbed?
In a stomach
In a duodenum and initial part of thin colon
In a sigmoid colon
In a caecum
Along the whole length of digestive tract
Which disease is charaxterized by Color Index more than 1,05?
Iron-deficiency anaemia
Posthemarrhagic anaemia
В12 (folic acid)- deficiency anaemia
Hemolytic anaemia
E.
383.
A.
B. *
C.
D.
E.
384.
A.
B.
C. *
D.
E.
385.
A. *
B.
C.
D.
E.
386.
A. *
B.
C.
D.
E.
387.
A.
B. *
C.
D.
E.
388.
A.
B.
C. *
D.
E.
389.
A.
B.
C.
D.
E. *
390.
A.
Acute leukaemia
In patients with leukemia leukocyte count is:
decreased;
increased;
not changed;
increased rate of segmented neutrophils.
decreased rate of segmented neutrophils.
Sternalgia and ostealgia are typical for:
Hodgkin's disease;
Hemophilia;
acute leukemia;
iron deficiency anemia;
thrombocytopenia
How many classes of haemopoetic cells there are?
6
4
7
5
3
Choose the correct statement concerning idiopathic thrombocytopenic purpura in children:
Often follows a viral infection
Typically has a chronic course, with relapses following each remission
Is characteristically associated with splenomegaly
Is associated with reduction of megacaryocytes on bone marrow examination
Requires splenectomy in more than 20 % cases
What is the synonym of idiopathic thrombocytopenic purpura?
Von Willebrand's disease
Werlhof’s disease
Schonlein-Henoch purpura
Bernard-Soulier syndrome
Graves' disease
Cause of idiopathic thrombocytopenic purpura is:
Vasculitis
Antibodies to vascular epithelium
Antibodies to platelets
Antibodies to clotting factors
Antibodies to vascular wall
Select typical signs of chronic lympholeycosis:
Skin redness, paresthesia in limbs
Necrotic pharyngitis
Skin dryness, fragidity of nails
Gigantic liver and spleen, jaundice
Enlarged and solid lymph nodes of all groups
Select typical signs of chronic myeloleycosis:
Skin pallor, dyspnoe
B.
C.
D.
E. *
391.
A. *
B.
C.
D.
E.
392.
A. *
B.
C.
D.
E.
393.
A.
B.
C.
D.
E. *
394.
A.
B.
C. *
D.
E.
395.
A.
B. *
C.
D.
E.
396.
A.
B. *
C.
D.
E.
397.
A.
B.
Skin redness, paresthesia in limbs
Necrotic pharyngitis
Skin dryness, fragidity of nails
Gigantic liver and spleen, jaundice
What is coagulation time by Ly-White?
5-10 min
3-5 min
6-12 min
1-3 min
12-13 min
Where do lymphocytes develop?
In lymphatic nodes and in all lymphoid organs.
In red bone marrow
In a thymus
In a spleen
In kidneys
What is shift on the right in leucocyte formula?
Appearance of increased amount of lymphocytes in perypheral blood
Appearance of increased amount of leucocytes perypheral blood
Appearance of increased amount of monocytes perypheral blood
Appearance of increased amount of erythrocytes perypheral blood
Appearance of decreased amount of stab neutrophil and juvenile neutrophilsperypheral blood
What is normal spleen longitudinal diameter assessed by percussion?
4-6 сm
2-4 сm
6-8 сm
8-10 сm
10-12 сm
Give a description of articular syndrome in rheumatic fever:
Deformation of the joints is expected
Flying character of pathological changes
Sustained pain syndrome
Formation of ankyloses
Morning stiffness in joints
Patient S. experienced tonsillitis with the following pain in knee joints (occurring in 3 weeks after
tonsillitis). What disease is it typical for?
Gout
Rheumatic feer
Myocarditis
Rheumatoid arthritis
Angina pectoris
Patient R. suddenly, developed redness and swelling in the toe of his left foot. There was no trauma
in his medical history. Which test of the following will be helpful to verify diagnosis?
Complete blood count.
Laboratory indexes of activity of inflammation.
C.
D.
E. *
398.
A.
B.
C.
D.
E. *
399.
A. *
B.
C.
D.
E.
400.
A.
B.
C.
D.
E. *
401.
A.
B.
C.
D. *
E.
402.
A. *
B.
C.
D.
E.
403.
A.
B.
C. *
D.
E.
404.
A.
B. *
Electrophoresis of proteins.
Fibrinogen lever in the serum
Concentration of uric acid in blood serum.
Data of inspection and observation of a patient: separate joints become reddish-cyanotic, in the area
of the elbow joints there are whitish nodular formations, containing thick viscous fluid of
gray-whitish color. Biochemical blood serum test shows high uric acid level. Select the name of
nodes:
Rheumatoid nodes
Rheumatic nodes
Bushar’s nodes
Geberden’s nodes
Tophuses
Which of the following is most clearly indicative of the inflammatory nature of articular pain?
Swelling and local temperature rise.
Crepitation.
Deformation of the joint.
Instability of the joint.
Pain in motions.
Joint deformation is associated with ...
Changes in bone tissue
Fibrous layers formation
Edema of the periarticular tissues
Development of flexural and extension contracture and ankylosis
Proliferative process in the joint
The technique of physical examination of joints does not include
Patient interview
Percussion
Palpation
Auscultation
Inspection
Muscular atrophy is observed at:
Rheumatoid arthritis
Gout
Osteoarthritis
Rheumatic fever
Osteochondrosis
Heberden’s nodes and Buschar’s nodes located in eth area of interphalangeal joints of hands are
characteristic of:
Rheumatoid arthritis;
Rheumatic arthritis;
Osteoarthritis;
Dermatomyositis;
Systemic lupus erythematosus.
Joint defiguration - this is:
Smoothing of joint contours, disappearance of bone protuberances
Smoothing of joint contours with enlargement of the joint sizes
C.
D.
Uneven enlargement of the joint, rough persistent changes in it
Smoothing of joint contours with limitation of active bending movements
Smoothing of joint contours with limitation of active and passive movements in the joint
Joint deformity is associated with .the following:
Changes in bone tissue
Exudation process in the joint
Edema of the periarticular tissue in the joint
Intraarticular effusion
Consolidation of periarticular tissue
The main etiological factors of osteoarthritis are the following, with the exception of:
Joint injury
Carbohydrate metabolism disorder
Functional overload of the joint
Violation of statics
E.
407.
A.
B.
C.
D.
E. *
Dysplasia
What joints are more often impressed with osteoarthritis?
Intervertebral joints
Proximal interphalangeal joints
Hip joints
Shoulder joints
Knee joints
D.
E.
405.
A. *
B.
C.
D.
E.
406.
A.
B. *
C.
Назва наукового напрямку (модуля):
Семестр: 6
Internal Medicine Propaedeutics (situational tests)
Опис:
3 course, medical
Перелік питань:
1.
A.
B.
C.
D.
E. *
2.
A.
B.
C.
D.
E. *
3.
A.
B.
C.
D.
E. *
4.
A.
B.
C.
D.
E. *
5.
A.
B.
C.
D.
E. *
6.
A.
B.
C.
D.
E. *
?Patient D., aged 21, was hospitalized in the infectious department of the hospital with fever and
thore throat. What should you ask him when you are obtaining inforlation about AIDS-risk factors?
Eating of spoiled food;
Chemotherapy;
Contact with a person having acute pharyngitis;
Handshake of a person ill with AIDS.
Surgical operations in past medical history
Students during practrical class work upon the technique of clinical examination of a patient. It is
necessary to collect patient’s anamnesis. Specify the option which is the component of life history:
Main complaints;
Secondary complaints;
Passport data;
Present illness.
Allergic reactions in the past
Students during practrical class work upon the technique of clinical examination of a patient. It is
necessary to collect patient’s anamnesis. Specify the option which is the component of life history:
Main complaints;
Secondary complaints;
Passport data;
Present illness.
Previous diseases, traumas and operations
You have to collect patient’s anamnesis. What should you ask a patient about while you are obtaining
history of his present illness?
Patient’s heredity
Patient’s harmful habits;
Allergic reactions in the past;
Nutrition
Onset of the disease;
You have to collect patient’s anamnesis. What should you ask a patient about while you are obtaining
history of his present illness?
Patient’s heredity
Patient’s harmful habits;
Allergic reactions in the past;
Nutrition
Change of symptoms of main disease in the dynamics;
You have to collect patient’s anamnesis. What should you ask a patient about while you are obtaining
history of his present illness?
Patient’s heredity
Patient’s harmful habits;
Allergic reactions in the past;
Nutrition
Results of laboratory examinations done in the past;
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. *
12.
A.
B. *
C.
D.
E.
You have to collect patient’s anamnesis. What should you ask a patient about while you are obtaining
history of his present illness?
Patient’s heredity
Patient’s harmful habits;
Allergic reactions in the past;
Nutrition
Frequency, severity and duration of exacerbtions
Patient R., aged 47, has been troubled with severe dyspnea, cough, sweating, weakness for about
recent 5 years. The patient in his professional activity deals with building industry for many years
and often he works on the open. What factor in patient’s history indicate on industrial hazard as a
possible cause of this patological condition?
Noise;
High ambient temperature;
Low ambient temperature;
Contact with infections.
Coal dust in the air;
Students during practrical class work upon the technique of clinical examination of a patient. A
student is assessing patient’s body built. Which of the following signs are typical for hypersthenic
type of constitution?
Sternum is protruded forward
Low blood preasure
Dereased blood cholesterol level
Hypofunction of adrenal and sex glands
Sub- and supraclavicular fossae are flat
Students during practrical class work upon the technique of clinical examination of a patient. A
student is assessing patient’s body built. Which of the following signs are typical for asthenic type of
constitution?
Sternum is protruded forward
Anterioposterior diameter of the chest is larger than the normal one
High blood pressure
Hyperfunction of adrenal and sex glands.
Low blood pressure
Students during practrical class work upon the technique of clinical examination of a patient. A
student is assessing patient’s body built. Which disease is “pigeon chest” typical for?
Pulmonary emphysema;
Tuberculosis;
Scoliosis;
Syringomyelia.
Rickets;
Students during practrical class work upon the technique of clinical examination of a patient. A
student is assessing patient’s body built. Which disease is paralythic chest typical for?
Pulmonary emphysema;
Tuberculosis;
Scoliosis;
Syringomyelia.
Rickets;
13.
Students during practrical class work upon the technique of clinical examination of a patient. A
student is assessing patient’s body built. Which disease is funnel chest typical for?
A.
B.
Pulmonary emphysema;
Tuberculosis;
Scoliosis;
Syringomyelia.
Rickets;
Patient’s S. body temperature is 40 0C. The patient moves in his bed from one side to another,
speaks to somebody who is absent in the room, doesn’t answer for the questions of medical stuff.
How is this disorder of consciousness called?
Coma;
Stupor;
Sopor;
Clear conscioussness
Delirium;
Patient’s S. body temperature is 39 °C. The patient answers for questions with delay, simply,
sometimes with minimal jesticulation only, looks to be inhibited. How is this disorder of
consciousness called?
Delirium;
Coma;
Sopor;
Hallucinations.
Stupor;
Patient S. was admitted to a hospital with meningitis. At the moment of examination he looks as
being sleeping. He does not answer for questions, just opens eyes on loud sounds, on pinching with
neurological needle he avoids the irritation with all the trunk. How is this disorder of consciousness
called?
Delirium;
Coma;
Stupor;
Hallucinations.
Sopor;
Patient M. was admitted to a hospital with poisoning. The patient is unconscious. How the
complete unconscious condition is called?
Delirium;
Stupor;
Sopor;
Hallucinations.
Coma;
Patient M. was admitted to a hospital with poisoning. The patient does not react on doctor’s
questions and on pinching with neurological needle. Pupil and corneal reflexes are negative. Pulse is
of 82 bpm, blood pressure – 110/60 mm of Hg, respiratory rate – 20 per min. Select the appropriate
option that best fits to this status?
Shock
Stupor;
Sopor;
Collapse.
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.
A.
B.
C.
D.
E. *
19.
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.
Coma;
Patient M. was admitted to a hospital with poisoning. The patient does not react on doctor’s
questions and on pinching with neurological needle. Pulse is of 82 bpm, blood pressure – 110/60 mm
of Hg, respiratory rate – 20 per min. What is it necessary to check in the patient to asses
consciousness?
Blood pressure on the legs
Pulse on carotide eateries;
Pupil and corneal reflexes;
Kitaev’s reflex.
Coher’s reflex;
Patient B. is seeking for medical advice because of body temperature rise up to 39 °C, pain in the left
part of the chest. The disease has begun sharply after overcooling. The data of inspection: skin
hyperemia, eyes are shining, flash on the cheeks. What facial expression is present in this case?
Corvisar’s face;
Facies febrilis;
Facies Basedovica;
Myxedematous face.
Hippocrate’s face;
Students during practrical class work upon the technique of clinical examination of a patient. A
student have to collect anamnesis of a patient. What from the following subsections belong to life
history?
Anamnesis of present illness;
Cause of illness on patient’s opinion;
Development of the illness;
Complaints.
Physical and mental development in the childhood;
Students during practrical class work upon the technique of clinical examination of a patient. A
student have to collect anamnesis of a patient. Into what section is allergic anamnesis included?
Complaints of a patient;
History of present disease;
Review of systems;
Passport information.
Life history;
A patient was undergone several propcedures of blood transfusion. What disease may develop as a
complication of blood transfusion?
Pneumonia;
Cirrhosis of liver;
Hypertension;
Rheumatism.
Viral hepatitis;
Students during practical class work upon the technique of clinical examination of a patient. Taking
patient’s life history a student established that the patient was undergone several propcedures of
blood transfusion. Blood transfusion is a risk-factor of such disease as:
Cirrhosis of liver;
Hypertension;
Rheumatism.
D. *
E.
25.
A.
B.
C.
D. *
E.
26.
A.
B.
C.
D.
E. *
27.
A.
B.
C.
D.
E. *
28.
A.
B.
C.
D.
E. *
29.
A.
B.
C.
D.
E. *
30.
A.
B.
AIDS;
Hemorrhage
Students during practical class work upon the technique of clinical examination of a patient. A
student have to collect anamnesis of a patient with bronchial asthma. What question must be put if
to ask about history of present illness?
Presence of palpitation, heart intermissions;
Patient’s name and surname;
Presence of pain in the stomach;
The onset of the disease and development of symptoms in dynamics.
Character, duration, conduction (irradiation) of pain;
Students during practrical class work upon the technique of clinical examination of a patient. A
student should assess patient’s facial expression. Which pathological condition is “Korvizar’s face”
typical for?
Kidney pathology;
Infectious diseases;
Anaemia;
Peritonitis.
Cardiac failure;
Students during practrical class work upon the technique of clinical examination of a patient. A
student should assess patient’s facial expression. Which pathological condition is “Hyppocrite’s
face” typical for?
Kidney diseases;
Infectious diseases;
Cardiac insufficiency;
Anaemia;
Peritonitis.
Students during practrical class work upon the technique of clinical examination of a patient. A
student should assess patient’s facial expression. Which pathological condition “Facies Basedovica”
is typical fo?
Kidney diseases;
Infectious diseases;
Cardiac insufficiency;
Anaemia;
Toxic goitre.
Patient E. suffers from heart failure. He is on the bed mode. Which part of patient’s body is it
necessary to check for cardiac edema if the patient is on the bed mode?
feet;
under the eyes;
hands;
it is useless because there are no edema
the lumbar region;
Patient E. suffers from renal failure. By physical examination it was revealed that all patient’s body
is equally swollen: edema are present on patient’s face, arms, legs, anterior abdominal wall. Such a
generalized accumulation of liquid in subcutaneous tissue of whole the body is called:
Ascites
Hydtothorax
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.
D.
E. *
35.
A.
B.
C.
D.
E. *
36.
A.
B. *
C.
D.
Obesity
Edema
Anasarca
Patient T., 61 years old, now is on in-patient treatment in a therapeutic department of a hospital. He
can independently sit in a bed, change his position, wash his face. How to characterize patient’s
position?
Passive;
Forced;
Orthopnea;
Horizontal.
Active;
Patient S., 70 years old, was admitted to intensive care unit of a hospital. The patient is unconscious.
What position in a bed can he assume?
Active;
Forced;
Orthopnea;
Upright.
Passive;
Patient A., 70 years old, was admitted to the therapeutic department of a hospital because of
ischemic heart disease. He can sit with the lowered legs but cannot lie down due to dyspnea. How to
characterize patient’s position?
Passive;
Active;
Forced passive;
Horizontal,
Orthopnea;
Patient I., 23 years old, is tall, his face is narrow, the neck is thin and long, the chest is narrow and
flat. Epigastric angle is near 80 degrees. Specify patient’s constitution type:
Normosthenic;
Hypersthenic;
Mixed;
No corect answer
Asthenic;
Patient К., 37 years old, assumes forced posture. He is sitting, and bending forward and pressing
arms to his abdomen. Which pathological condition is this posture typical for?
Heart failure
Pneumonia
Fever
Hypertonic crisis
Peptic ulcer
Patient C., 47 years old, complains of pain in the chest. He assumes forced posture. He prefers to lie
in ha bed on one side of his trunk. Which disease is this posture typical for?
Angina pectoris, myocardial infarction
Pneumonia, pleurisy
Fever, chills
Hypertonic crisis
E.
37.
A.
B.
C.
D.
E. *
38.
A.
B.
C.
D.
E. *
39.
A.
B.
C.
D.
E. *
40.
A.
B. *
C.
D.
E.
41.
A.
B.
C.
D.
E. *
42.
A.
B.
C.
D.
Peptic ulcer, gastritis
A doctor is assessing patient’s chest characteristics. Which of the following signs are typical for
kyphoscoliosis?
Sternum is protruded forward;
Epigastric angle is more than 90degrees;
Deviation of spinal cord laterally;
Deviation of spinal cord backwards;
Deviation of spinal cord backwards and laterally;
On the electrocardiogram intervals Р-Р are equal to 0,9 seconds, R-R=1,5 seconds. P waves and QRS
complexes are recorded independently each of other. What pathology should you think about?
Sinoatrial block,
Atrial block,
Non-complete AV block,
Hiss bundlebranch block.
Complete AV block,
In all the leads of electrocardiogram after Р waves (they are normal) there are widened (0,12
second) and deformed complexes QRS. What disorder of heart rrythm is present in this case?
Sinoatrial block,
Atrial block,
Incomplete AV block,
Complete AV block,
Hiss bundlebranch block.
In patient Н., 37 years old, which suffers from rheumatic heart disease within the recent 10 years,
electrocardiogram was recorded. On the ECG - PQ interval is equal to 0,24 seconds in all leads.
What disorder of heart rrythm is present in this case?
Sinoatrial block,
Intraatrial block,
Complete AV block,
Hiss bundlebranch block.
Incomplete AV block,
Patient М., 55 years old, periodically feels attacks of angina pectoralis within the recent year.
Recently he developed pronounced bradycardia. Pulse rate is 36 per min. Frequent attacks of
dizzinesses and faints are present for the last 2 month. Doctors tell about the necessity of artificial
pacemaker implantation as only way to improve patient’s condition. Which heart rhythm is such
grave bradycardia typical for?
Norm
Intraatrial block,
Non-complete AV block,
Hiss bundlebranch block.
Complete AV block,
Data of ECG in a boy 18 years old: on inspiration R-R intervals are shorter, than on expiration.
What these data testify about?
Sinus bradycardia,
Sinus tachycardia,
Ectopic arrhythmia,
Sinus non-respiratory arrhythmia.
E. *
43.
A.
B.
C.
D.
E. *
44.
A.
B.
C.
D.
E. *
45.
A.
B.
C.
D.
E. *
46.
A.
B.
C.
D.
E. *
47.
A.
B.
C.
D.
E. *
48.
A.
B.
C.
D.
Sinus respiratory arrhythmia,
A man 58 years old suffers from periodic pains of squeezing character behind the sternum, which
appear after physical and emotional tension and pass after 5-7 min of rest. What changes on
electrocardiogram is it possible to expect during pains in the heart area?
Disappearance of cardiac complexes,
Deep and wide Q wave,
Increased voltage of wave R,
Broadewning of QRS complex.
Appearance of high acute T wave,
Patient A., 54 years old, suffers from rheumatic attacks within recent 25 years. Displacement of his
heart dullness borders upwards and rightwards was revealed by percussion becouse of hyperthrophy
of the left atrium and right ventricle. What ECG-signs of left atrial hyperthrophy do you know?
Increased amplitude of P wave,
Increased amplitude of R wave,
Decreased amplitude of R wave,
Duration of wave P is not changed,
Appearance of byphasic P wave.
Patient B. 60 years old, complains of dispnoe, palpitation, oedema of feet. During the last 10 years he
sufferes from stenocardia, hypertension. On ECG: there is no P wave before ventricular complex,
zero line is wave-shaped, ventricular complexes are registrated in equal time intervals. Which heart
rhythm disorder is present in the patient?
sinual tachicardia;
ventricular fibrillation;
sinual arrhythmia;
paroxismal tachycardia
atrial flutter
Patient A., 28 years old, has aortic incompetence. Electrocardiographic examination was prescribed
for her. What are ECG-signs of this heart defect?
Hyperthrophy of the right ventricle.
Hyperthrophy of the right atrium.
Hyperthrophy of the left atrium.
Normogram.
Hypertrophy of the left ventricle.
Patient A., 38 years old, has mitral incompetence. Electrocardiographic examination was prescribed
for her. What are ECG-signs of this heart defect?
Hyperthrophy of the right ventricle.
Hyperthrophy of the right atrium.
Hypertrophy of the left ventricle.
Normogram.
Hyperthrophy of the left atrium and ventricle.
Patient A., 28 years old, has mitral stenosis. Electrocardiographic examination was prescribed for
her. What are ECG-signs of this heart defect?
atrioventricular block;
hypertrophy of the right atrium
ventricular flutter and fibrillation;
ventricular extrasystole
E. *
49.
A.
B.
C.
D.
E. *
50.
A. *
B.
C.
D.
E.
51.
A.
B.
C.
D.
E. *
52.
A.
B.
C.
D.
E. *
53.
A.
B.
C.
D.
E. *
54.
A.
B.
C.
hypertrophy of the left atrium
The patient with diagnosis “Arterial hypertension, II degree” is 64 years old. His ECG data are the
following: increased wave R in leads V5-6 and deep wave S v1v2, segment ST is displaced
downward in left leads. What that ECG changes indicate on?
Hyperthrophy of the right ventricle,
Hyperthrophy of the left atrium,
Hyperthrophy of the left atrium,
Hyperthrophy of the right ventricle and atrium.
Hyperthrophy of the left ventricle,
Data of ECG in a boy 18 years old: waves and complexes on ECG are not changed, R-R intervals are
longer than 0.9 sec, heart rhythm is regular, heart rate is 56 per min. What these data testify about?
Sinus bradycardia,
Sinus arrhythmia,
Ectopic arrhythmia,
AV block.
Sinus tachycardia,
Data of ECG in a boy 18 years old during period of respiratory viral infection with body temperature
enlargement: waves and complexes on ECG are not changed, R-R intervals are shorter than normal,
heart rhythm is regular, heart rate is 106 per min. What these data testify about?
Sinus bradycardia,
Sinus arrhythmia,
Ectopic arrhythmia,
Complete AV block.
Sinus tachycardia,
Which heart rhythm disorder is present in a patient if on his ECG premature cardiac complexes are
periodically is recorded; in these complexes Р wave is absent, QRS is disfigured and broad, there
are displacement of ST from isoelectrical line and complete compensatory pause?
atrial extrasystole;
atrioventricular extrasystole;
atrial fibrillation;
ventricular fibrillation
ventricular extrasystole.
Patient S. suffers from rheumatic heart disease for about 15 years. Atrioventricula block, I degree
was diagnosed. Which are singns of І degree AV block?
Heart rate more than 160 per min
Heart rate more than 90 per min
Premature appearance of cardiac complex on ECG
heart rate less than 40 per min
PQ interval is prolonged in all leads, no missing of QRS, normal heart rate
In patient S., which suffers from rheumatic heart disease and mitral stenosis, atrioventricular block
was revealed. What are signs of AV block II degree, Mobitz I?
PQ interval is prolonged in all leads, peridically QRS omplex is missed
Prolongation of PQ interval in all leads with frequent QRS omplex missing (more P than QRS), P is
fixed to QRS
PQ interval is prolonged in all leads, no missing of QRS
D.
E. *
55.
A. *
B.
C.
D.
E.
56.
A.
B.
C.
D.
E. *
57.
A.
B.
C.
D.
E. *
58.
A.
B.
C.
D.
E. *
59.
A.
B.
C.
D.
E. *
60.
A.
B.
Frequent QRS omplex missing more P than QRS), P appears independently of QRS, heart rate less
than 40 per min
Gradual prolongation of PQ interval with periodical QRS complex missing
In patient S., who suffers from from rheumatic heart disease, atrioventricular block was revealed.
What are signs of AV block II degree, Mobitz II?
PQ interval is prolonged in all leads, peridically QRS omplex is missed
gradual prolongation of PQ interval with peridical QRS omplex missing
PQ interval is prolonged in all leads, no missing of QRS
frequent QRS omplex missing more (P than QRS), P appears independently of QRS, heart rate less
than 40 per min
prolongation of PQ interval in all leads with frequent QRS complex missing (more P than QRS), P
is fixed to QRS
In patient Н., 37 years old, who suffers from rheumatic heart disease within the recent 10 years,
electrocardiogram was recorded. On the ECG - periodical appearance of premature cardic complex.
What disorder of heart rhythm is present in this case?
Intraatrial block,
Non-complete AV block, I degree
Complete AV block,
Non-complete AV block, II degree.
Extrsystoly
In the II standard lead cardiac complex PQRST appeared more early than normal, wave P in this
complex is negative and registered after QRS. Which heart rhythm disorder is present in this case?
sinus extrasystole
atrial extrasystole
left ventricular extrasystole;
right ventricular extrasystole;
atrioventricular extrasystole
On the basis of ECG data a patient was put diagnosis “atrial extrasystolic arrhythmia”. ECG signs of
atrial extrasystole are the following:
Abcence of Р wave and change of ventricular complex;
Р wave form is changed (biphase), it is present before QRS complex, QRS complex is changed;
Р wave presence and periodical missing of ventricular complex;
Р wave is recorded after ventricular complex.
Р wave form is changed (biphase with positive and negative parts), it is present before QRS
complex, QRS complex is not changed;
In a patient pulse is of different filling and tension, its deficiency is 15 per minute, pauses between
pulse waves are different. Which heart rhythm disorder is present in this case?
Sinus arrhythmia;
Ventricular fibrillation;
AV block;
Normal findings.
Atrial fibrillation;
Students during practical classes evaluate ECG’s.ECG of a patient with arterial hypertension shows
the following correlations: RI>RII>RIII;
Rv6>Rv5>Rv4, prolongation of QRS. Which
pathological condition is it typical for?
Hyperthrophy of the right ventricle,
Hyperthrophy of the left atrium,
C.
D.
E. *
61.
A.
B.
C.
D.
E. *
62.
A. *
B.
C.
D.
E.
63.
A.
B. *
C.
D.
E.
64.
A.
B.
C. *
D.
E.
65.
A.
B.
C.
D.
E. *
Hyperthrophy of the left atrium,
Norm.
Hyperthrophy of the left ventricle,
Students during practical classes evaluate ECG’s.ECG of a patient with COPD shows the following
correlations: RIII > RII > RI; Rv1v2> Rv4> Rv5,v6. Evaluate such correlation of the waves on
ECG.
Hyperthrophy of the left ventricle,
Hyperthrophy of the left atrium,
Hyperthrophy of the eight atrium,
Norm.
Hyperthrophy of the right ventricle,
? Patient B. is seeking for medical advice because of body temperature rise up to 39 °C, pain in the
left part of the chest at deep breathing and coughing. Pleuropneumonia was diagnosed during
examination of the patient. Which forced position may patient assume in this case?
Lying on the affected side;
Lying on non-affected side;
Sitting with legs dependent;
Sitting and learning on the window-steel.
Patientis restless;
Patient B. is seeking for medical advice because of body temperature rise up to 39 °C, dry cough,
pain in the left part of the chest in deep breathing and coughing,oversweating. The disease has begun
sharply after overcooling. The data of inspection: skin hyperemia, eyes are shining, flash on the
cheeks (facies febrilis). Patient’s skin is moist and hot. Specify, which sign indicates on intoxication
syndrome?
Pain in the chest;
Facies febrilis
Dry cough;
Skin hyperemia;
Acute beginning of the disease
Patient B. is seeking for medical advice because of body temperature rise up to 39 °C, dry cough,
pain in the left part of the chest in deep breathing and coughing,oversweating. The disease has begun
sharply after overcooling. The data of inspection: skin hyperemia, eyes are shining, flash on the
cheeks. Patient’s skin is moist and hot. Specify, which sign indicates on mucociliary infufficiensy
syndrome?
Pain in the chest;
Fever;
Dry cough;
Acute onset of the disease.
Skin hyperemia;
Patient R. can’t sleep at night because of severe dyspnea, which make him to sit in a bed. Data of
inspection: patient is sitting in a bed, exaggerate skin cyanosis is present, as well as edema on the
legs. How does such position of the patient in a bed is called?
Dyspnoe;
Tachypnoe;
Eupnoe;
Bradypnoe.
Ortopnoe;
66.
A.
B.
C.
D.
E. *
67.
A.
B.
C.
D.
E. *
68.
A.
B.
C.
D.
E. *
69.
A.
B.
C.
D.
E. *
70.
A.
B.
C.
D.
E. *
71.
A.
B.
C.
D.
E. *
Patient А. complaints of cоugh with attacks of dyspnea. By palpation weakened vocal fremitus was
revealed while bandbox sound was heard during percussion. What these signs indicate on?
Consolidation of pulmonary tissue,
Cavity in the lungs,
Liquid in the pleural cavity,
Air in the pleural cavity.
Pulmonary emphysema,
During inspection of the patient’s chest decreasing of its anterio-posterior and lateral diameters are
revealed, the chest is narrow and flat. What is the type of the chest?
Normosthenic,
Hypersthenic,
Emphysematous,
Paralitic.
Asthenic,
Patient H. suffers from pneumonia. He complains of acute pain in the right part of the chest, which
intensity becomes more severe at cough, deep breathing. What is the mechanism of development of
pain of such pattern?
Distension of pleura;
Irritation of bronchial mucosa;
Irritation of lung parenchyma;
Pressing of the heart.
Irritation of pleura because of its ruffness;
Patient T. complains of sharp pain in the right part of his chest at deep breathing and cough. This type
of pain is typical for:
Bronchiolitis,
Bronchiectatic disease,
Diffuse bronchitis,
Exudative pleurisy.
Dry pleurisy,
Patient K. was admitted to a hospital with pneumonia. He complains of fever and pain in the left part
of the chest during cough and deep breathing. What is the reason for pain in the chest?
Affection of bronchi,
Affection of trachea,
Affection of respiratory muscles,
Affection of lung parenchyma,
Affection of pleura.
Patient R. complains of feeling of air hunger. Data of inspection: patient is staying and leaning
against a window-still. Respiratory rate is 28 per min, wheezes are heard on the distance. What
revealed signs testify about?
Inflammation of pulmonary tissue;
Air in the thoracic cavity;
Hydrothorax;
Asphyxia.
Bronchial obstruction;
72.
A.
B.
C.
D.
E. *
73.
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.
Patient A. complains of dyspnea. Vocal fremitus is absent on the left side. By percussion there is the
area of dullness on the left scapular line from the level of 6 th rib downwards. Attending doctor
carried out the pleural puncture to the patient and obtained transparent light-yellow liquid of low
specific gravity. Which pathological condition is present in the patient?
Bronchiectatic disease,
Emphysema of the lungs,
Acute bronchitis,
Pneumonia of the low part of the right lung,
Hydrothorax.
Patient A. was admitted to the hospital with pneumonia. He complains of dyspnea. Vocal fremitus is
absent on the left side. By percussion there is the area of dullness on the left scapular line from the
level of 6 th rib downwards. Pleural effusion was found on patient’s X-ray. Which procedure is it
necessary to carry out?
Prescribe antibiotics,
This condition does not requires any interventions,
Pleural puncture,
Surgical operation,
Prescribe diuretics.
During examination of adolescent person a family doctor revealed that the lungs apexes rise above
the clavicles up on 3 cm. Evaluate obtained data:
Pulmonary emphysema,
Bronchial obstruction,
Consolidation of pulmonary tissue,
Right-sided hydrothorax,
Norm,
Patient J. 48 y.o., complains of dyspnea, cough, night sweating. The height of the right lung apex is 1
cm, the width of the Krenig’s area is reduced on this side. What the revealed signs indicate on?
Pulmonary emphysema,
Pneumothorax,
Norm,
Right-sided hydrothorax.
Consolidation or sclerosis of the apex,
Patient G. complains of expiratory dyspnea and dry cough. During percussion bandbox sound is
heard. Lung lower border is bilaterally displaced downward. The mobility of the lower lungs border
is limited. What the revealed signs testify about?
Pneumofibrosis of the apex (may be due to tuberculosis),
Pneumothorax,
Norm
Right-sided hydrothorax.
Pulmonary emphysema,
During auscultation of patient P., 60 years old, who suffers from bronchial asthma, dry high-pitched
whistling rales (weezes) as well as weakened vesicular breathing were heard above all parts of the
lungs. What is the mechanism of such auscultatory phenomena origin?
Induration of pulmonary tissue(pneumonia),
Lung emphysema,
Accumulation of liquid in the pleural cavity,
Accumulation ofviscous mucus in the bronchial tree.
E. *
78.
A.
B.
C.
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.
Obstruction of fine bronchi,
During auscultation of patient P., 60 years old, who suffers from bronchial asthma, dry high-pitched
whistling rales (weezes) as well as weakened vesicular breathing were heard above all parts of the
lungs. What is the mechanism of bronchial obstruction in this disease?
Spasm of smooth muscles of fine bronchi,
Accumulation of viscous mucus in bronchi and spasm of smooth muscles
Accumulation of liquid in the pleural cavity
Swelling of mucous membrane and accumulation of viscous mucus in fine bronchi
Spasm of smooth muscles, accumulation of viscous mucus and swelling of mucosa in fine bronchi
Patient N. is suffrering from cough, fever, dyspnea. Retardation of the left half of the chest during
breathing was revealed as well as dull percussion sound and bronchial breathing at the zone placed
downward from the VІ intercostal space. Which pathological condition these do signs testify about?
Lung emphysema,
Thin chest wall,
Physical loading,
Norm.
Consolidationof pulmonary tissue,
During inquiry of patient X. the following findings were obtained as: complaints on fever, cough,
night sweating; at objective examination: asthenic chest; vocal fremitus is not changed, thympanic
percussion sound is heard at the right subscapular region, while by auscultation amphoric breathing is
heard in the same region. Which pathological condition these signs indicate on?
Appearence of consolidation focus in pulmonary tissue,
Lung emphysema,
Thin chest wall,
Norm.
Cavity in the lung,
During examination of patient С., 62 years old, considerable decrease offorced expiration volume
(FEV1)was revealed by spirometry. What is probably cause of this finding?
Bronchodilatation,
Affection of lung parenchyma,
Meteorism,
Accumulation of fluid in pleural cavity.
Bronchial obstruction,
Patient A., 70 years old, complains of dyspnea at physical exertion, fever and cough with
expectoration of mucopurulent sputum. 5 days before the patient was diagnosed pneumonia. What
additional method of diagnostics is necessary?
Bronchigraphy;
Bronchoscopy;
CT scan;
Lung biopsy.
Chest X-ray
Patient Т, 62 years old, suffers from bronchial asthma for 15 years. Attacks of expiratory dyspnea
occur everyday, the attacks are released by beta-agonists. There are episodes of nictural dyspnea
about 1 for a weak. Which course of the disease does the patient have?
Intermittent,
Mild persistent,
Severe persistent,
D.
E. *
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.
No any one
Moderate persistent,
Patient S. suffers from chronic bronchitis. During spirographic examination index FEV1 (forced
inspiration volume) is 47% of vital lung capacity. Define, please, the type of respiratory
insufficiency.
Restruclive,
Mixed,
Residualve,
No any respiratory insufficiency.
Obstructive,
Patient А. suffers from chronic obstructive bronchitis for recent 20 years. Now he complains of
dyspea, cough with expectoration of mucopurulent sputum mostly in the morning, feeling of
heaviness in the right hypoсhondrium, edema on the legs. Data of examination: the patient is in
position of orthopnea, swelling of neck veins and diffuse cyanosis are detectible. What complication
of chronic bronchitis developed in the patient?
Pleurisy;
Lung cancer;
Exacerbation of the disease;
Total heart failure.
Chronic right-ventricular failure;
Patient R. presents at the moment complaints on dyspnea, cough with expectoration of
mucopurument sputum, fever. Data of inspection: respiratory rate is 28 per min, diffuse cyanosis is
present s well as participation of additional muscles in respiration. Which syndrome is present in this
case?
Consolidation of pulmonary tissue;
Accumulation of fluid in pleural cavity;
Cavity in the lungs;
Accumulation of air in pleural cavity.
Respiratory insufficiency;
During auscultation of patient P., 60 years old, with exacerbation of chronic non-obstructive
bronchitis, crepitation is heard below the left scapula as well as weakened vesicular breathing in this
zone. What is your diagnosis?
Bronchial asthma;
Acute bronchitis;
Chronic bronchitis, phase of exacerbation;
Bronchiectatic disease.
Pneumonia;
A patient complains of cough, fever, dyspnea, pierching pain in the lover part of the right lung during
cough and deep breathing. Lobar pneumonia was diagnosed in the patient. What is the cause of pain?
Affection of lung parenchima,
Affection of intercostal nerves,
Irritation of bronchial mucosa,
Affection of a heart.
Affection of pleura,
During inspection a patient is sitting in orthopnoe position, patient’s skin is cyanotic, the chest is of
barrel-like shape; data of auscultation: weakened vesicular breathing, dry high-pitched rales are heard
over entire chest. What pathological process is possible in the patient?
A.
B.
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.
Accumulation of viscous mucus in bronchi;
Accumulation of liquid in pleural cavity;
Pulmonary emphysema;
Accumulation of liquid sputum in bronchi.
Bronchial obstruction;
A patient, 25 years old, is fallen ill for the last ten days. After viral infection with catarrh he
developed fever, last 2 days - cough with expectoration of yellow viscous sputum, sweating.
Bronchitis is diagnosed by a doctor during examination. Select correct antibiotic to start treatment:
Cephalosporin antibiotic
Sulfonamides
Aminoglycosides
Ofloxacin
Augmentin or azitromycin
A patient of 18 years old is suffering from acute respiratory viral infection during 6 days. The
productive cough has increased, the temperature has raised to 37,5-37,6 oC. During auscultation
breathing is harsh with scattered small-and medium bubbling rales, percussion shows bandbox sound.
What determines the worsening of the disease?
Pneumonia
Relapse of the ARVI
Bronchoectatic desease
Croup syndrome
Bronchitis
A 38 -year-old woman is seriously ill. She complains of frequent paroxysms of expiratory dyspnea.
The last paroxysm lasted over 12 hours and failed to respond to theophylline. The skin is palish gray,
moist, RR of 36/min in rest. On auscultation, breath sounds are absent over some areas. Which
degree of respiratory failure is present in the patient?
I
II
IV
V
III
A 38-year-old man worked at building business for 15 years. All this time he had contact (inhalation)
with dust. He seeks medical help for expiratory breathlessness on exertion and dry cough. On exam,
wheezes above both lungs. Factory physician has diagnosed COPD. What method is necessary to
prescribe for determination of severity of the disease?
Chest X-ray
Bronchoscopy
Blood gas analysis
Electrocardiography
Spirography
A 38-year-old man worked at building business for 15 years. All this time he had contact (inhalation)
with dust. He seeks medical help for permanent expiratory breathlessness which intensifies at on
exertion and dry cough. On exam, wheezes above both lungs. Which disease may be suspected?
Bronchial asthma
Chronic non-obstructive bronchitis
Pneumonia
Allergy
E. *
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. *
100.
A.
COPD
For the patient of 52 years old heavy attack of expiration shortness of breath, is followed by a heavy
dry cough heard from distance, wheezes, palpitation. What preparation more expedient in all to enter
at the first aid?
Strophanthin
Lazolvan
Atrovent
Prednizolon
Salbutamol
In a male aged 45 y.o. on X-ray film lung pattern is pointed, hiluses are enlarged. The patient
smockes for 20 years, 20 cigarettes per day. Now he complains of moist morning cough with
expectoration of mucopurulent sputum, inspiratory dyspnoe in pysical load. Each year he has
exacerbations. Spyrogram is normal. Which disease is possible in this case?
Bronchial asthma
COPD
Pneumonia
Allergy
Chronic non-obstructive bronchitis
In a male aged 45 yers aold on X-ray film lung pattern is poor, diaphragm is horizontal and displaced
downward, ribs are horizontal. The patient plays saxofon for 20 years, smocks. Now he complains of
dizziness, permanent expiratory dyspnoe which intesifies in pysical load. Which disease is possible in
this case?
Bronchial asthma
Chronic non-obstructive bronchitis
Pneumonia
Allergy
COPD, pulmonary emphysema
A 26-year-old man was admitted to the hospital complaining of stabbing back pain on inspiration and
dyspnea. On exam, BT of 37°C, PR of 24/min, HR of 92/min, vesicular breath sounds. There is a dry,
grating, low-pitched sound heard in both expiration and inspiration in the left lower lateral part of the
chest. What is the most likely diagnosis?
Pneumonia
Acute bronchitis
Myocarditis
Pneumothorax
Acute fibrinous pleuritis
The patient complains of expiratory dyspnea, cough with difficult expectoration of viscous mucous
sputum. He assumes forced position. Which position is typical for the disease?
Tachipnoe
Bradipnoe
Eupnoe
Polypnoe
Orthopnoe
During auscultation of patient P., 60 years old, with exacerbation of chronic non-obstructive
bronchitis, crepitation is heard below the left scapula as well as weakened vesicular breathing in this
zone. What is your diagnosis?
Bronchial asthma;
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.
B.
C.
D.
E. *
106.
A.
B.
Acute bronchitis;
Chronic bronchitis, phase of exacerbation;
Bronchiectatic disease.
Pneumonia;
During inspection a patient is sitting in orthopnoe position, patient’s skin is cyanotic, the chest is of
barrel-like shape; data of auscultation: weakened vesicular breathing, dry high-pitched rales are heard
over entire chest. What pathological process is possible in the patient?
Accumulation ofviscous mucus in bronchi;
Accumulation of liquid in pleural cavity;
Pulmonary emphysema;
Accumulation of liquid sputum in bronchi.
Bronchial obstruction;
In the patient pleurisy with effusion on the right side was defined. How the lower lung border will be
changed?
Shifted downward from both sides,
Shifted upward from both sides,
Shifted downward from the left side,
Will be not changed.
Shifted upward from the right side,
In the patient pleurisy with effusion on the right side was defined. What method of examination may
be helpful in diagnostics?
Microscopy of sputum,
Bacteriological examination of sputum,
Bronchigraphy,
Tomography.
Ultrasound examination of pleural cavity,
In the patient pleurisy with effusion on the right side was defined. What method of examination is of
first importancein diagnostics?
Microscopy of sputum,
Bacteriological examination of sputum,
Bronchigraphy,
Tomography.
Chest X-ray,
During inspection a patient is sitting in the posture orthopnoe, patient’s skin is cyanotic, the chest is
of barrel-like shape; data of auscultation: weakened vesicular breathing, dry high-pitched rales are
heard over entire chest. Describe, please, characteristics of percutory soung that might be obtained in
the patient?
Dull,
Dull-to-thympany,
Thympanic,
Resonant.
Bundbox,
In a patient dry pleurisy from the right side was defined. What will be data of auscultationof the
chest?
Dry high-pitched rales,
Dry low-pitched rales,
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.
111.
A.
B.
C.
D.
E. *
112.
Moistrales,
Crepitation,
Pleural friction.
In a patient pleuropneumonia of the right lower lobe of the lung was defined. When crepitation will
be heard over the affected zone?
I stage,
II stage,
III stage,
In I and II stages,
In I and III stages.
Patient Т, 62 years old, suffers from bronchial asthma for 20 years. Atacks of expiratory dyspnea
occure everyday, they are prolonged and released by corticosteroids, the patient has dyspnea between
attacks, his activity is decreased, night sleep is deranged because of attacks. There are episodes of
nictural dyspnea every night. Which course of the disease does the the patient have?
Intermittent,
Mild persistent,
Moderate persistent,
No any one.
Severe persistent,
The patient L, 60 years old, sufers from bronchial asthma for 10 years. Data of examination: dyspnea
in rest, barrel-like chest, bundbox sound is heard by percussion. By auscultation weakened
respiration with dry diffuse rales are obtained. Which findings will be in patient’s sputum?
Tread offibrin, leucocites, macrophages;
Grain of haematoidine;
Elastic fibers;
Crystals of cholesterol, eosinophils.
Crystals of cholesterol, Cursmann spirals, Charcot-Leyden’s cristals, eosinophils;
At inspection of a patient it was revealed the following: enlargement of the right half of the chest,
intensified vocal fremitus in this part of the chest as well as thympanic percutory sound, bronchial
breathing, moist coarse rales. X-rays show ring shadow in the right lung. Which syndrome these
sings are typical for?
Compression of pulmonary tissue,
Hydrothorax,
Presence of cavity in the lungs,
Dry pleurisy,
Pulmonary hyperinflation.
Patient R. can’t sleep at night because of severe dyspnea, which make him to sit in a bed. Data of
inspection: patient is sitting in a bad, exaggerate skin cyanosis is present as well as edema on the
legs. What do revealed data testify about?
Pleurisy,
Lung abscess,
Exacerbation of chronic cholecystitis,
Renal colick.
Respiratory insufficiency,
Patiant К., 72 years old, developed periodical hemopthysis.He suffers from permanent chest pain
which gradually rises withinr the last year. The patient noticed loosing of body weight on 8 kg within
the last several month. What is the cause of hemopthysis on your opinion?
A. *
B.
C.
D.
E.
113.
A.
B.
C.
D. *
E.
114.
A.
B.
C.
D.
E. *
115.
A.
B.
C.
D.
E. *
116.
A.
B.
C.
D.
E. *
117.
A.
B.
C.
D.
E. *
118.
A.
Lung cancer,
Ishemic heart disease,
Rupture of vessels,
Chronic bronchitis,
Because of caugh.
In patient К, 64 years old, lung cancer was revealed by computer tomography of the chest. Which
typical for lung cancer elements may be revealed in patient’s sputum?
Curchmann’s spirals,
Charcot-Leyden crystals,
Eosynophils,
Atypical cells,
Koch’s bacilli.
Patient К., 64 years old, suffers from lung cancer. For the last month he developed dyspnoe at
minimal physical loading. On the chest X-ray there are signs of atelectasis. Which type of dyspnoe
will be in this case?
Еxpiratory,
Absent,
Mixed,
Subjective.
Inspiratory,
Patient М., 58 years old, developed dyspnoe and caugh. The patient suffers from chronic obstructive
bronchitis for recent 10 years. Spyrographic examination was prescrobed for the patient. What is the
most informative index of this test concerning diagnostics of bronchial obstruction?
Maximal lung ventilation · respiratory volume,
Maximal lung ventilation · respiratory rate,
Respiratory rate · respiratory volume,
Volume of forced expiration for the 1rst second/vital lung capacity.
Volume of forced expiration for the 1rst second, %,
In patient С., 59 years old, stubbing pain developed in the right part of the chest. On the X-ray film
pulmonary infiltration of the right lung is revealed which is connected with lung hilus. Which
character of pain is typical for lung cancer?
Burning,
Constricting,
Colicky-like,
Stubbing.
Permanent,
Pleurocentesis was prescribed for patient О., 76 years old, which suffers from pleurisy whith
effusion. Which elements do you expect toreveal in pleural content if the patient has lung cancer?
Leucocites,
Basophils,
Neutrophils,
Eosynophils.
Аtypical cells,
Dry pleurisy was revealed in patient С. 30 years old, on the right side of the chest. Which data of
auscultation are typical for this disease?
Intensified vesicular breathing on the right side, diffuse dry rales,
B.
C.
D. *
E.
119.
A.
B.
C.
D.
E. *
120.
A. *
B.
C.
D.
E.
121.
A.
B.
C.
D.
E. *
122.
A.
B.
C.
D.
E. *
123.
A.
B.
C.
D.
E. *
124.
Weakened vesicular breathing, pleural friction sound on the right side,
Intensified vesicular breathing on the right side, crepitation,
Normal vesicular breathing, pleural friction sound on the right side,
Crepitation on the right side.
Pleurisy with effusion was revealed in patientН., 48 years old, on the right side of the chest. Over the
zone of effusion it is triangle determined where percutorial sound is dull-to-thympany. How is this
triangle called?
Damuazo’s triangle,
Rauhfuse triangle,
Sokolov’s one,
Botkin’s triangle,
Garland’s one,
In patient L., 48 years old, which is now on a long-standing treatment in a hospital because of
exacerbation of bronchitis, cough becomes more intensive, the patient started to expectorate e lot of
purulent sputum (200-300 mlper day), body temperature became38,50С. The sputum is better to
expectorate if the patients lies on the left side. What can you suspect in the patient?
Bronchiectatic disease,
Recidive of pleurisy with effusion,
Pneumonia,
Empyema of pleura,
Dry pleurisy,
Dry pleurisy was revealed in patient М., 45 years old. What is the most typical symptom for this
disease?
Dyspnoe,
Moist cough,
Increased body temperature,
Expectoration of sputum,
Pain in one part of the chest at the top of inspiration,
Patient D., 50 years old, is under observation of district doctor for 15 years because of disease of
respiratory system. At present time the patient has developed transitory respiratory failure of
obstructive type. Which disease this type of respiratory failure is typical for?
Community-acquired pneumonia,
Chronic non-obstructive bronchitis,
Pleurisy with effusion,
Bronchiectatic disease.
Bronchial asthma,
Patient P. was admitted to a hospital with right-sided pleurisy with effusion. Respiratory rate at
admission is 25 per min, vital lung capacity was decreased to 50 %. How to evaluate patient’s
functional condition?
Respiratory failure (RF) is absent,
Respiratory failure of I degree,
Respiratory failure of II degree,
Hypoxaemic coma.
Respiratory failure of III degree,
Patient Х. suffers from bronchial asthma for the recent 8 years. Which indexes should you determine
for verification of the form of respiratory failure?
A.
B.
C.
D.
E. *
125.
A.
B.
C.
D.
E. *
126.
A.
B.
C. *
D.
E.
127.
A.
B.
C.
D.
E. *
128.
A.
B.
C.
D.
E. *
129.
A.
B.
C.
D.
E. *
Respiratory volume and vital lung capacity,
Reserve expiratory volume and minute respiratory volume,
Total lung capacity,
Reserve inspiratory volume and residual volume.
Peak velocity of expiration and volume of forced expiration for the first second,
In patient D., was admitted to pulmonological department with signs of pleurofibrosis caused by past
right-sided purulent pleurisy (empyema pleure). Which type of respiratory failure is present in the
patient?
Alveolar-respiratory,
Оbstructive,
Оbstructive and alveolar-respiratory,
Global.
Restrictive,
Patient A., 70 years old, complains of dyspnea at physical exertion, fever and cough with
expectoration of mucopurulent sputum. 5 days before the patient was diagnosed pneumonia. What
additionalmethod of diagnostics is necessary?
Bronchigraphy;
Bronchoscopy;
Plane X-ray of the chest;
CT scan;
Lung biopsy.
In patient K., 50 years old, atopic bronchial asthma is diagnosed. Describe, please, data of
auscultation during the attack of asthma:
Harsh respiration, diffuse dry whistling rales;
Harsh respiration, moist fine rales;
Weakened vesicular breathing, crepitation over the lower lungs borders;
Respiration is absent over the left lower lung lobe.
Weakened vesicular breathing, diffuse dry whistling rales;
While observing the patient M. with chronic lung disease, the doctor found diffuse cyanosis,
accessory muscles participation in respiration. Respiratory rateis about 32-34 per min. What degree
of respiratory insufficiency does occur in this patient?
I degree,
II degree,
IV degree,
V degree.
III degree,
The patient (50 years old) complains of dyspnea during moderate physical load. The patient is
diagnosed pneumoconiosis. In the past he worked in the mine. What type of respiratory insufficiency
takes place in this patient?
Obstructive,
Mixed,
Residual,
No any respiratory insufficiency.
Restruclive,
130.
A.
B.
C.
D.
E. *
131.
A.
B. *
C.
D.
E.
132.
A.
B.
C.
D.
E. *
133.
A.
B.
C.
D.
E. *
134.
A.
B.
C.
D.
E. *
135.
A.
B.
C.
Patient А. suffers from chronic obstructive bronchitis for recent 20 years. Now he complains of
dyspea, cough with expectoration of mucopurulent sputum mostly in the morning, feeling of
heaviness in the right hypohondrium, edema on the legs. Data of examination: the patient is in
position of orthopnea, swelling of neck veins and diffuse cyanosis are detectible. What complication
of chronic bronchitis developed in the patient?
Pleurisy;
Lung cancer;
Exacerbation of the disease;
Total heart failure.
Chronic right-ventricular failure;
Patient S. suffers from chronic bronchitis. During spirographic examination index FEV1 (forced
inspiration volume) is 47% of vital lung capacity. Define, please, the type of respiratory
insufficiency.
Restructive,
Obstructive,
Mixed,
Residual,
No any respiratory insufficiency.
Patient C., 60 years old, complains of cough with expectoration of viscous purulent sputum in the
morning, general weakness, ferver (38°C). He suffers from chronic bronchitis during 15 years. Data
of objective examination: “Hippocrat’s fingers ": harsh breathing is heard above the lungs, fine moist
rales are heard in intrascapular region. Bronchiectatic disease is suspected in the patient. Which
methods of examination are necessary fordiagnosis?
Urianalysis, X-ray, total blood count;
Total blood count, analysis of sputum;
Plane X-ray, analysis of sputum, lung biopsy;
Biochemicalblood analysis, ultrasonic examination of the chest.
Total blood count, X-ray, spyrography, analysis of sputum, brouchography;
In a patient pleuropneumonia of the right lower lobe of the lung was defined. When crepitation will
be heard over the affected zone?
I stage,
II stage,
III stage,
In I and II stages,
In I and III stages.
In a patient dry pleurisy from the right side was defined. Which changeswill be observed on
spyrogram?
No changes,
Obstructive type of respiratory insufficiency,
Mixed type of respiratory insufficiency,
Asphixia.
Restrictive type of respiratory insufficiency,
In a patient large cavern of the right lung was revealsed on X-ray film with diameter 7 cm. The
cavern is filled with liquid on one half. Which rales do you expect to reveal by auscultation?
Dry high-pitched rales,
Dry low-pitched rales,
Moist finerales,
D.
E. *
136.
A.
B. *
C.
D.
E.
137.
A.
B. *
C.
D.
E.
138.
A.
B.
C.
D.
E. *
139.
A.
B. *
C.
D.
E.
140.
A. *
B.
C.
D.
E.
141.
A. *
Moist medialrales,
Moist coarserales.
Patient Т, 62 years old, suffers from bronchial asthma for 5 years. Atacks of expiratory dyspnea
occure everyday, but attacks are not prolonged. There are episodes of nictural dyspnea about 1 for a
month. Which course of the disease does the the patient have?
Intermittent,
Mild persistent,
Moderate persistent,
Severe persistent,
Status asthmaticus.
? In patient R. biochemical blood study was performed. Serum unconjugated bilirubin and urine
urobilinogen concentration were revealed to be elevated. Select pathological condition appropriate
for these changes:
anemia of chronic disease
Extravascular hemolytic anemia
anemia of acute hemorrhage
aplastic anemia
iron deficiency anemia
A 45-years-old woman with long-standing rheumatoid arthritis was diagnosed with "anemia of
chronic disease ". The predominant mechanism causing this type of anemia is as follows:
defective porphyrin synthesis
impaired incorporation of iron into porphyrin
intravascular hemolysis
depressed erythroid maturation due to decreased erythropoietin production
impaired transfer of iron stored in reticuloendothelial tissue to marrow erythroid precursors
A patient complains of gingival bleedings, increased body temperature till 38`C,marked general
weakness.He feels himself sick for the recent 2weeks.Data of objective examination: petechnia on the
skin,by palpation enlarged submandibular, axillary and femoral lymph nodes.Data of CBC:
thrombocytes-120000/l, Le-18,6 .10`9/l, blast cels-80%, ESR-36 mm/hr. Acute leukaemia is
diagnosed. Which symptom indicate on intoxication syndrome?
petechnia, gingival bleeding, low account of thrombocytes
general weakness, fever
enlarged lymph nodes,decreased amount of RBC, thrombocytes,blast cells in CBC
all findings
no any finding
A 42-years-old patient complains of back pain, dark urine, general weakness, dizziness occurred after
treating a flu with aspirin and ampicillin. CBC: RBCs - 2,6 x 1012/l, Hb - 60 g/l, CI - 0,9, ESR - 38
mm/hour, reticulocytes - 24%. Total bilirubin - 38 mmol/l. What complication occurred in the
patient?
Acquired hemolytic anemia
Toxic hepatitis
Cholelithiasis
Agranulocytosis
Paroxysmal nocturnal hemoglobinuria
35 y.o. woman is suspected of aplastic anemia. The bone marrow punction has been administered
with the diagnostic purpose. What possible changes in the bone marrow?
Replacement of marrow elements with adipose tissue
B.
C.
D.
E.
142.
A.
B. *
C.
D.
E.
143.
A.
B.
C.
D.
E. *
144.
A.
B.
C. *
D.
E.
145.
A.
B. *
C.
D.
E.
146.
A.
B. *
C.
D.
E.
147.
A.
B. *
C.
Replacement of marrow elements with fibrous tissue
Prevalence of megaloblasts
Presence of blast cells
Absolute lymphocytosis
The patient has anemia and all the following clinical manifestations. Which manifestation indicates
to the doctor that the anemia is a long-standing problem?
Headache
Clubbed fingers
Circumoral pallor
Orthostatic hypotension
Tachicardia
Patient I., 40 years old, has developed severe uterine bleeding. The examination has revealed signs of
hypochromic anemia. What research is specific for the diagnosis?
ESR
Blood proteins
Reticulocites level
Shape of erythrocites
Serum iron
In patient D.,30 years old, iron deficiency anemia is diagnosed. Indicate the most common complaint
for iron deficiency.
The loss of tactile sensitivity
graying hair
Increased fragility of nails
Fissuras of lips
Anosmia
Data of CBC: erythrocites.1,0х1012/L; Hb 30 g/L; Color Index 0,90, leukocites 1,2х109/L;
thrombocites – 42х109/L. What method of research will be most appropriate for diagnosis?
Computer tomography
Sternal puncture
Biopsy of the spleen
Biopsy of the liver
Blood coagulation assessment
The patient A, 38 years old, complains of weakness, dizziness, shortness of breath, heartburn
sensations in the tongue. In examination the signs of folc-deficiency anemia were revealed. Describe
the appearance of this tongue, please?
Geographic
Shiny and smooth
Tongue is covered with gray coating;
Clear
Edematous
In carrying out routine inspection of a teenager blood it was held CBC which revealed leukocytes:
stub neutrophils - 3%, swgmented - 10%. Which cells of granulocytic series are normally in the
bloodstream?
Juvenile
Stub neutrophils
Myelocites
D.
E.
148.
A.
B.
C. *
D.
E.
149.
A. *
B.
C.
D.
E.
150.
A.
B.
C. *
D.
E.
151.
A. *
B.
C.
D.
E.
152.
A.
B. *
C.
D.
E.
153.
A. *
B.
C.
Promyelocites
Metamyelocites
Patient T. has developed severe gastrointestinal bleeding and needs blood transfusion. A doctor on
duty is observing about side reactions of the procedure. In blood transfusion, all may be seen except:
Tetany
Thrombocytopenia
Hypokalemia
Haemosiderosis
Dizziness
CBC: Нb- 123 g/L, WBC - 5,6 x 109/L, Pl – 354 x 109/L, PT - 12 seconds (normally 10-15 seconds),
aPTT - 72 seconds (normally 35-45 seconds). Bleeding time is normal, Factor VIII is 4% of norm.
What is the most probable diagnosis?
Hemophilia A
Hemophilia B
Schoenlein-Henoch disease
Vitamin K deficiency
Thrombocytopenia
Patient A. with generalized lymphadenopathy was diagnosed with chronic lymphatic leukemia. What
are the main laboratory findings in patient with chronic lymphatic leukemia?
Elevated ESR
Thrombocytosis and lymphocytosis
Lymphocytosis and anemia
Eosinophilia
Philadelphia chromosome in abnormal cells
Patient S. with chronic atrophic gastritis is undergone physical examination. A doctor suspect
pernitious anaemia as a result of the main disease. Specify the appropriate statement for vitamin B12
deficiency anemia:
Hyper-segmented neutrophils
Microcytosis preceeds hypochromia
MCHC<50%
Vitamin B12 deficiency is the commonest cause of anemia
Low level of serum ferritin
Patient A. with peptic ulcer complains of periodical discharge of dark colored feces. Erythrocites and
hemoglobin content in CBC are normal. Most sensitive and specific test for diagnosis of iron
deficiency is:
Serum iron levels
Serum ferritin levels
Serum transferrin receptor population
Transferrin saturation
MCHC<50%
Patient 45 years old, сomplaints of weakness, dizziness, dyspnea, pearching sensations in his tongue
at inspection signs of vitamin B12 deficiency anaemia are reveale Which changes of a tongue are
typical for this disorder?
Brilliant and smooth
Geographical
Coated
D.
E.
154.
A. *
B.
C.
D.
E.
155.
A.
B.
C.
D. *
E.
156.
A.
B.
C.
D. *
E.
157.
A. *
B.
C.
D.
E.
158.
A.
B.
C. *
D.
E.
Clean
Swollen
Peripheral blood smear: RBC 4.00 х 1012/L, Hb 120 g/L, Ht 37 %, MCV 89 fl, Reticulocyte Count
1.0 %, Pl 210 х 109/L, WBC 12.8 х 109/L, Segmented Neutrophils 54 %, Band Neutrophils 15 %,
Metamyelocytes 3 %, Myelocytes 5 %, Monocytes 3 %, Eosinophils 0 %, Basophils 0 %,
Lymphocytes 20 %, ESR 32 mm/h. What is the most likely diagnosis?
Leukemoid reaction
Chronic lymphocytic leukemia III st
Chronic myeloid leukemia, accelerated phase
Chronic myeloid leukemia, chronic phase
Chronic lymphocytic leukemia IV st
CBC reveals: RBC 4.3 х 1012/L, Hb 141 g/L, Ht 41 %, MCV 78 fl, Reticulocyte Count 1.0 %, Pl 545
х 109/l, WBC 55,4 х 109/L, Segmented Neutrophils 52 %, Band Neutrophils 15 %, Metamyelocytes
8 %, Myelocytes 5 %, Monocytes 4 %, Eosinophils 8 %, Basophils 6 %, Lymphocytes 2 %, ESR 32
mm/h. What is the most likely diagnosis?
Chronic myeloid leukemia, blast crises
Chronic myeloid leukemia, accelerated phase
Chronic lymphocytic leukemia
Chronic myeloid leukemia, chronic phase
Multiple myeloma
CBC reveals: RBC 3.9х 1012/L, Hb 128g/L, Ht 41%, MCV 78fl, Reticulocyte Count 1.0 %, Pl 945 х
109/L, WBC 125,4х 109/L, Segmented Neutrophils 62%, Band Neutrophils 10%, Metamyelocytes
3%, Myelocytes 5%, Monocytes 4%, Eosinophils 8%, Basophils 6%, Lymphocytes 2%, ESR
27mm/h. What is the most likely diagnosis?
Acute leukemia
Chronic lymphocytic leukemia III st
Chronic lymphocytic leukemia I st
Chronic myeloid leukemia
Chronic lymphocytic leukemia IV st
CBC: RBCs - 3,6 x 1012/l, Hb- 87 g/l, Pl – 45 x 109/l, WBCs – 13 x 109/l, blasts - 87%, band
neutrophils - 1%, segmented neutrophils - 7%, lymphocytes - 5%, ESR - 55 mm/h. What is the most
likely diagnosis?
Acute leukemia
Erythremia
Chronic lymphocytic leukemia
Chronic myeloid leukemia
Multiple myeloma
CBC reveals: RBC 2.34 х 1012/L, Hemoglobin 78 g/L, Hematocrit 40 %, MCV 90 fl, Reticulocyte
Count 1.0 %, Pl 245 х 109/L, WBC 71.9 х 109/L, Segmented Neutrophils 2 %, Band Neutrophils 0
%, Monocytes -0% Eosinophils -0 %, Basophils -0%, Lymphocytes 98%, ESR 24mm/h. What is the
most likely diagnosis?
Acute leukemia
Erythremia
Chronic lymphocytic leukemia
Chronic myeloid leukemia
Multiple myeloma
159.
A. *
Diagnosis of idiopathic thrombocytopenic purpura was put to patient D. Which of the following
statements regarding patients with idiopathic thrombocytopenic purpura (ITP) is true?
Bone marrow megakaryocytes are generally decreased
Platelet-associated immunoglobulin G (IgG) is diagnostic
Splenomegaly and other cytopenias are usually present
The platelet life span is prolonged
Splenectomy can be effective therapy
Patient R, was hospitalized due to thrombosis of lower limbs veins. All of the following conditions
predispose to thrombosis except:
Paroxysmal nocturnal hemoglobinuria
Horhocystinurea
Hypomagnesemia
Behcets syndrome
Atrial fibrillation
In patient B. during cytological examination of bone marrow smear there were revealed smudged
cells. Smudged cells are seen in peripheral blood smear in
Chronic lymphoid leukaemia
Chronic myeloid leukaemia
Acute lymphoid leukaemia
Acute myeloid leukaemia
Idiopathic thrombocytopoenic purpura
In patient C. during physical examination a doctor has palpated enlarged spleen which lower edge is
shifted down toward the left cubital region. Splenomegaly is the most common physical finding in
patients with
Chronic lymphoid leukaemia
Chronic myeloid leukaemia
Acute lymphoid leukaemia
Acute myeloid leukaemia
Idiopathic thrombocytopoenic purpura
Lymph node biopsy shows "owl-eyed" appearance of abundant lymphocytes. What is the name of the
finding the pathologist is describing?
Reed-Sternberg cells.
Auer cells.
Smudge cells.
Lymphocytic clue cells.
Jon-Fredrickson phenomenon.
In patient T. chronic myelogenous leukemia was diagnosed. What genetic change is characteristic of
chronic myelogenous leukemia?
Philadelphia chromosome in abnormal cells
B.
C.
D.
E.
165.
A.
B.
No sings
3 chromosomes in the 21-st pare
Lack of chromosome 13 pare
Translocations of bcl-2 from chromosome 8 to chromosome 14
What is the initial therapy that is most appropriate for 23-years-old man with severe aplastic anemia?
Aggressive, marrow ablative chemotherapy
Interferon (IFN)
A.
B.
C.
D.
E. *
160.
A.
B.
C. *
D.
E.
161.
A. *
B.
C.
D.
E.
162.
A.
B. *
C.
D.
E.
163.
A. *
B.
C.
D.
E.
164.
C. *
D.
E.
166.
A.
B.
C.
D.
E. *
167.
A.
B.
C.
D.
E. *
168.
A.
B.
C.
D.
E. *
169.
A.
B.
C.
D.
E. *
170.
A.
B.
C.
D. *
E.
Bone marrow transplantation (BMT)
Supportive therapy such as transfusions о cellular components and erythropoietin
Antibiotics
A 24 year old female fell ill 3 months ago after cold exposure. She complained of pain in her hand
and knee joints, morning stiffness and fever up to 38oC. Interphalangeal, metacarpophalangeal and
knee joints are swollen, hot, with reduced ranges of motions; ESR of 45 mm/h, CRP (+++),
Vaaler-Rouse test of 1:128. What group of medicines would you recommend the patient?
Sulfonamides
Tetracyclines
Fluorchinolones
Cephalosporines
Nonsteroidal anti-inflammatory drugs
A 20-year-old patient complains of joint pain and impossibility of movement in left knee and right
elbow. 2 weeks ago he had tonsillitis. Physical examination data: t - 38,5°C and ankle dysfunction,
enlargement of cardiac dullness on 2 cm, tachycardia, weakness of I heart sound, gallop rhythm,
weak systolic murmur near apex. Which diagnosis corresponds to such symptoms?
Reactive arthritis
Juvenile rheumatoid arthritis
Reiter's disease
Systemic lupus erythematosus
Acute rheumatic fever
A17 y.o. patient complains of acute pain in the knee joint and t°- 38°C. He was ill with streptococcal
tonsillitis 3 weeks ago. Objectively: deformation and swelling of the knee joints with skin hyperemia.
Small movement causes an acute pain in the joints. Which diagnose is the most correct?
Reactive polyarthritis
Systemic lupus eritematodes
Rheumarthritis
Infectious-allergic polyarthritis
Rheumatic heart disease, polyarthritis
A 16 y.o. male patient complains of pain in knee and ankle joints, temperature elevation to 39, 5°C.
He had a respiratory disease 1,5 week ago. On examination: temperature — 38,5°C, swollen knee
and ankle joints, pulse — 106 bpm, rhythmic, AP — 90/60 mm Hg, heart borders without changes,
sounds are weakened, soft systolic apical murmur. What indicator is connected with possible etiology
of the process?
Seromucoid
Creatinkinase
Alfa1-antitrypsine
Rheumatic factor
Antistreptolysine-0
The patient complains of high body temperature, pain in knee joints, morning stiffness in them. From
what system should you start questioning review of systems?
Respiratory system
Digestive system
Cardiovascular system
Musculoskeletal system
Non-affected system
171.
A.
B.
C. *
D.
E.
172.
A.
B.
C. *
D.
E.
173.
A. *
B.
C.
D.
E.
174.
A. *
B.
C.
D.
E.
175.
A.
B. *
C.
D.
E.
A patient was delivered to admissious department of a hospital by ambulance. The patient complains
of pain in the right knee joint, the inability of active movements because of pain. In anamnesis – the
patient was injured 3 days before (joint commotion). Objective: the patient is lying on the side, the
right knee joint is enlarged, hyperemic, the limb is half-bent. How to classify patient’s position?
Active
Passive
Forced
Orthopnea
Posture of a suppliant
A patient was delivered to admission department of a hospital by ambulance. The patient complains
of pain in the right knee joint, the inability of active movements because of pain. In anamnesis – the
patient was injured 3 days before (joint commotion). Objective: the patient is lying on the side, the
right knee joint is enlarged, hyperemic, the limb is half-bent. How to classify patient’s position? Why
does the patient have such a forced situation in this pathology?
Due to the stiffness of the hip muscles
Reduces blood flow to the joint
Decreases intra-articular pressure which reduces joint pain
Decreases pressure on the shin
Releases pressure from the left limb
The patient complains of severe pain in the muscles of shins at walking, which disappear in rest and
during walking occur again after some time. Because of this, the patient is forced to stop and rest
periodically. What is the name of such a violation of the walking?
intermittent lameness
puppet walking
duck walking
atactic walking
hemiplegic walking
104 The patient applied to the doctor with complaints on severe pain in the small joints of the wrists,
feet, elbow and knee joints, stiffness in the morning which lasts up to 30 minutes. During inspection,
the doctor noted presence of nodules in the area of the final interphalangeal joints. What are the
names of these nodes?
Geberden’s nodes
Bushar's nodes
Fibromatous nodes
Rheumatic nodes
Fibrous nodules
A woman 32 years old complains of morning stiffness, pain in carporadial and-interphalangeal joints,
pain in the left half of the chest, especially at height of breath, shortness of breath, temperature rise
up to 39 ° C. She is ill for the last 2 months, when swelling of the joints is observed. On
auscultation of the chest pleural friction is heard. Data of CBC: L - 9.2x109 / l, ESR -58 mm / h.,
Valler-Rose reaction - 1: 256. Data of chest X-ray: intensification of pulmonary pattern. Which
of the following diagnoses is most likely?
Bronchitis
Rheumatoid arthritis
Pneumonia
Rheumatism
Gout
176.
A.
B.
C.
D.
E. *
177.
A.
B.
C. *
D.
E.
178.
A.
B. *
C.
D.
E.
179.
A.
B. *
C.
D.
E.
180.
A. *
B.
A woman 34 years old, was fallen ill acutely 3 months ago, when after acute respiratory infection
pain in the interphalangeal joinsts occur, in 2 weeks it arose in knee joints/ Pain was followed with
morning stiffness, increased body temperature up to 38 ° C. Objective: interphalangeal,
interphalangeal, knee joint are swollen,hot on touch, with limited movements in them. What
mechanism of the disease is it possible to think about?
Dystrophic pathological process
Allergic process
Metabolic disorder
Degenerative pathological process
Autoimmune pathological process
A patient, 16 years old, complains of dull boring pain heart region. This symptom disturbs the
patient for the last 2 weeks after he was experienced sore throat. The pain is not irradiating, followed
by shortness of breath, palpitation during physical activity. Objective: body temperature - 37.8 ° C,
heart rate - 96 / min, on heart apex heart sound are weakened, and systolic murmur are heard. Data of
ECG: interval PQ = 0.24 sec. Data CBC: - ESR - 28 mm / hr. What research is leading in
determining the etiological factor of the disease?
Complete blood count
Blood sterility
Titration of streptococcal antibodies
Level of C-reactive protein
Level of fibrinogen
In the patient K., 37 years old, suddenly at night after the birthday celebration, severe pain occur in
the Ist phalangeal joint of the toe. The joint is enlarged, skin over it is bluish-purple. Body
temperature - 38,8 ° С. Data of CBC: leukocytes - 9,6 x 10 9 g / liter, neutrophils - 74%, ESR - 30
mm / hr. Uric acid serumconcentration -0.60 mmol / liter. What kind of preliminary diagnosis can be
put in this case?
Reactive arthritis
Gouty arthritis
Rheumatoid arthritis
Deforming arthrosis
Rheumatic arthritis
Patient of 50 years old, complaints of pain, swelling, stiffness of the joints of the hands, feet and knee
joints. Data of physical examination - ulnar deviation of the wrists, swelling of interphalangeal joints.
data of X-ray: pronounced osteoporosis of the bones, isolated usurae, narrowing of the inter-articular
slits. Diagnosis established is “Rheumatoid arthritis”. What laboratory parameters are most
characteristic for this disease?
Increased levels of uric acid in blood and urine
Positive rheumatoid factor
High ESR
Increased level of myoglobin
Neutrophil leukocytosis
The patient, 38 years old, complains of morning stiffness in whole the body, especially in the joints
of the upper and lower extremities/ The stiffness disappears after active movements in 60 minutes.
Attending doctor has foundarthritis of interphalangeal joints, especially proximal, low-grade fever,
ESR - 45 mm / hr. data of X-ray:, osteoporosis and urazation of the articular surface of small joints of
the hands and feet. What is the most likely diagnosis?
Rheumatoid arthritis
Rheumatic fever
C.
D.
E.
181.
A.
B.
C. *
D.
E.
182.
A.
B. *
C.
D.
E.
183.
A. *
B.
C.
D.
E.
184.
A.
B.
C.
D. *
E.
185.
A. *
Deforming osteoarthritis
Gout
Reactive polyarthritis
A man 49 years old, complaints of sharp pain in the Ist phalangeal joint of the toe. On examination,
edema is visible, as well as skin hyperemia, temperature of the body - 37,8 ° С. On the X-ray "stamped" defects of epiphyses with sclerotic fringe, large (5-7 mm in diameter). The patient was
diagnosed gouty arthritis. What laboratory changes are most common in this disease?
Rheumatoid factor
Eosinophilia
Hyperuricemia
Antinuclear antibodies
Bacteremia
The patient is 55 years old. When looking at patient’s ears, the solid formations are visible that
protrude above the skin surface, with a diameter for about 2 mm. In past medical history - acute
pains in the I phalangeal joint of the left foot, accompanied by hyperemia of the skin above it.
Objective: body temperature is normal, heart rate - 80 / min, blood pressure - 150/90 mm Hg. Data of
biochemical blood serum test: uric acid - 0,500 mmol / l. What disease is characterized by detected
changes?
Rheumatic fever
Gout
Rheumatoid arthritis
Felthy's syndrome
Sjogren syndrome
Patient P., 34 years old, was fallen ill 3 months ago after acute respiratory infection. There was pain
in the interphalangeal joints, in 2 weeks pain spreded on knee joints, morning stiffness occur, body
temperature increased up to 38.0 ° C. Movements in interphalangeal, knee loints are limited, they
areswollen. Heart sounds are loud, no murmurs. Which disease is it typical for?
Rheumatoid arthritis
Rheumatic polyarthritis
Gouty arthropathy
Osteoarthritis
Reactive polyarthritis
Patient L., 23 years old, complained about swelling and pain in knee joints. He was fallen ill 2 weeks
ago, when the temperature increased up to 38 ° C after overcooling. Fever lasted for the first 2 days
of the disease. The borders of relative cardiac dullness are normal. Heart sounds are weakened,
systolic murmur is heard on heart apex. Heart rate - 100 / min., blood pressure -120/70 mm Hg. Mark
the most likely diagnosis:
Infectious-allergic myocarditis
Bacterial endocarditis
Viral myocarditis
Acute rheumatic fever
Gout
Patient C, 24 years old, complains of persistent pain in the small joints of the fingers and toes, in the
elbow and knee joints for 4 last months. He was treated by family doctor with insignificant clinical
effect. Data of current examination: the contours of the joints are smoothed, the temperature of the
skin above them on touch is increased. Rheumatoid arthritis is suspected. What X-ray examination of
joints should be prescribed to a patient?
X-ray of wrists and feet.
B.
C.
D.
E.
186.
A. *
B.
C.
D.
E.
187.
A.
B.
C.
D.
E. *
188.
A.
B.
C.
D.
E. *
189.
A.
B.
C.
D.
E. *
190.
A.
B.
C.
D.
E. *
191.
A.
B.
Knee joints
Elbow joints
Skull X-ray.
Cervical part of a spine
Patient C, 48, complains of pain in small joints of wrists, especially intensive in the second part of
the night and in the morning, also he suffers from morning stiffness in joints for 4 hours.
Objective: affection of interphalangeal proximal joints, their deformation, subluxations, atrophy of
interjsseal muscles. He is ill for 5 years. What kind of preliminary diagnosis can be put?
Rheumatoid arthritis
Rheumatic arthritis
Gouty arthritis
Deforming arthrosis
Reactive arthritis
? Patient S., 30 years old, has applied for medical care because of periodic nausea and vomiting,
heatburn, constipation, pain in epigastric region after meals. Gastritis was diagnosed by a doctor.
What additional method of examination is the most informative in diagnostics?
General blood test;
Coprogram;
Stomach X-rays;
Examination of stomach contents.
Esophagogastroduodenoscopy;
Liver dimensions of 47-year patient according to Kurlov are 15, 13, 11 cm. Liver edge is slightly
rounded with smooth surface, painful at palpation. Which disease is this typical for?
Cholecystitis;
Chronic pancreatitis;
Mechanical jaundice;
Liver cirrhosis;
Hepatitis.
Patient M., 36 years old, has applied for medical care because of headache, heaviness in the right
hypochondrium, decreased body weight. Data of inspection: the skin is yellow, with cyanotic tint,
gynecomastia and spider angiomata are present. These signs are typical for:
Pancreatitis,
Adrenal insyfficiency,
Vasculitis,
Cholecystitic.
Liver cirrhosis,
Patient P., 44 years old was hospitalized because of stomach ulcer complicated by bleeding. Which
signs are typical for this type of bleeding?
Vomiting with scarlet blood mixed with air;
Discolorated feces;
Increased arterial pressure;
Bradicardia.
Tarry stools (melena);
Patient K., 18 years old, suffers from pain in epigastric region after meals, nausea, vomiting. After
vomiting nausea decreases. The same symptoms were observed twice a year: in spring and autumn.
Which disease is it typical for?
Stomach cancer;
Pancreatitis;
C.
D.
E. *
192.
A.
B.
C.
D.
E. *
193.
A.
B.
C.
D.
E. *
194.
A.
B.
C.
D.
E. *
195.
A.
B.
C.
D.
E. *
196.
A.
B.
C.
D.
E. *
197.
A.
Liver cirrhosis;
Colitis.
Stomach ulcer;
Patient Т., 36 years old, complaints of heaviness in epigastric region, periodical vomiting, general
weakness, loosing of body weight on 20 kg. The patient suffers from stomach ulcer for years and has
exacerbations every year. Presented before clinical symptoms have appeared 1 year before. How will
the patient describe vomiting if he has pylorostenosis?
Vomiting on fasten stomach with previous nausea;
Vomiting on fasten stomach without previous nausea;
Vomiting on declining forward without previous nausea;
Vomiting 30 min after meals with previous nausea;
Vomiting several hours after meals with undigested food.
In patient P., 44 years old, who was hospitalized due to stomach ulcer intestinal bleeding developed.
Which signs are useful to reveal this type of bleeding?
Vomiting with scarlet blood mixed with air;
Discolorated feces;
Hypertension;
Bradicardia.
Vomiting with “coffee ground”;
Patient M., 36 years old, has applied for medical care because of headache, heaviness in the right
hypochondrium, decreased body weight. Data of inspection: the skin is yellow; gynecomastia, spider
angiomata are present. Liver by palpation is dull, tuberous and painless, its edge is acute. What
disease is it possible to suppose?
Pancreatitis
Cholecystitis
Hepatitis
Enterocolitis
Liver cirrhosis
Patient A. was urgently admitted to a clinic with complaints on sharp constant abdominal pain. The
abdomen is of the board-like form. At superficial palpation strain of abdominal wall muscles is
revealed. What this sign is typical for?
Pain,
Meteorism,
Ascites,
Umbilical hernia.
Peritoneal irritation,
By inspection of a patient the following was revealed: the abdomen is enlarged in lateral and inferior
parts, the navel is protruded. Percutory sound is dull in lateral and inferior parts of the abdomen, the
zone of dullness shifts according to patient’s position. Which pathology these data are typical for?
Peritoneal irritation,
Pylorostenosis,
Meteorism,
Peptic ulcer of a duodenum.
Ascites,
At research in a patient the enlarged abdomen was revealed with venous vessels on the frontal
abdominal wall. Which pathology this sign is typical for?
Peritoneal inflammation,
B.
C.
D.
E. *
198.
A.
B.
C.
D.
E. *
199.
A.
B.
C.
D.
E. *
200.
A.
B.
C.
D.
E. *
201.
A.
B.
C.
D.
E. *
202.
A.
B.
C.
D.
E. *
203.
Meteorism,
Ascites,
Cholecystitis
Portal hypertension;
Liver dimensions of 47-year patient according to Kurlov are 15, 13, 11 cm. Liver is solid, its edge is
sharp with tuberous surface, painless at palpation. Which disease is this typical for?
Cholecystitis;
Chronic pancreatitis;
Mechanical jaundice;
Hepatitis.
Liver cirrhosis;
Patient A. complains of jaundice and skin itching. By palpation it was revealed smooth pear-shaped
painless formation of mild consistency in the right hypochondrium just below liver lower border.
What pathological condition is present?
Kidney enlargement;
Tumor of transverse colon;
Enlargement of pancreas;
Tumor of the liver.
Gallbladder block due to stone or a tumor;
In patient B. which suffers from jaundice, bed appetite, periodical nausea and vomiting, liver is of
hard consistence at palpation, its surface is tuberous, the edge is sharp. Which disease is it typical
for?
Chronic hepatitis;
Multiple cancer metastases in the liver,
Amiloidosis;
Liver echinococcosis.
Liver cirrhosis;
In patient S. is suffering from pain in the left hypochondrium, bed appetite, periodical nausea and
vomiting, diarrhea. Hard formation with diameter 4-5 cm was found in him by palpation along the
line 3 cm upper from the navel which propagates to the left hypochondrium. The patient develops
exacerbation after eating fatty food. From anamnesis it is known that drinking milk causes meteorism
and diarrhea. Pathology of what organ is this typical for?
Spleen;
Transverse colon,
Left kidney;
Stomach;
Pancreas
Patient X. complains of heartburn, nausea and pain in epigastric region after meals. During X-ray
examination of a stomach the “niche symptom” was revealed. Which disease is it typical for?
stomach cancer
chronic gastritis
pylorostenosis
penetration of an ulcer
peptic ulcer
During deep sliding palpation of parts of intestine, a doctor revealed sigmoid colon with decreased
diameter, with solid consistence and painful. What these data indicate on?
A.
B.
C.
D.
E. *
204.
A.
B.
C.
D.
E. *
205.
A.
B.
C.
D.
E. *
206.
A.
B.
C. *
D.
E.
207.
A.
B.
C.
D.
E. *
208.
A.
B.
C.
D.
E. *
209.
A.
Intestinal atonia
Adhesions between intestine and posterior abdominal wall
Ascess accumulation of gas in the intestine
Coprostasis
Spasm of smooth muscles of the intestine because of its inflammation
During palpation of a liver a doctor revealed it in the right hypochondrium. Liver lover border is at
midclavicular line, its edge is acute, mild-elastic, painless. It is typical for:
hepatitis
cirrhosis
congestion in the liver
fat hepatosis
norm
A student determined position of stomach lower border by percussion palpation. With the usage of
deep sliding palpation, he revealed elastic cylinder of 2 cm length in 3 cm below stomach lower
border. The palpated formation is slightly movable and painless without rumbling sounds. What the
organ is this?
Pylorus
Duodenum
Pancreas
Small stomach curve
Transverse colon
In patient H. who suffers from peptic ulcer during palpation of abdominal wall it was revealed
muscular defence. Abdominal wall is dull, the patient can not relax muscles by voluntary effort, liver
dullness is absent. Which possible complication is present in the patient?
Peryvisceritis
Bleeding
Perforation
Malignization
Penetration.
Patient F. which often uses alcohol, suffers from viral hepatitis for the recent 5 years. During
inspection "caput medusae" was revealed. Which pathological condition is this sign typical for?
Peptic ulcer
Intestinal obstruction
Chronic colitis
Pancreatitis
Liver cirrhosis
In a patient splashing sound was revealed by percussion palpation of the abdomen in 8 hours after the
last meal. What this sign indicate on?
Norm
Achilia
Decreased stomach secretion
Intensified motor and evacuatoty function of the stomach
Weakened motor and evacuatory function of the stomach or hypersecretion
During examination of a patient with chronic cholecystitis exacerbation it was revealed pain in
tapping with the rib of the palm on the right patient’s hypochondrium. This symptom is called:
Boas’ sign
B.
C.
D. *
E.
210.
A. *
B.
C.
D.
E.
211.
A.
B.
C.
D.
E. *
212.
A.
B.
C.
D.
E. *
213.
A.
B.
C.
D.
E. *
214.
A. *
B.
C.
D.
E.
215.
Mendel’s sign
Ker’s sign
Ortner’s sign
Vasylenko’s sign
Data of examination of a patient: sclera a slightly yellow, "spider angiomata" on the skin, palmary
erythema, falling off hairs, dilatation of veins of abdominal wall. Affection of which organ can you
suspect?
Liver
Gallbladder
Intestine
Pancreas
Spleen
Patient L. complains of pain in epigastrium which occurs mostly at night and disappears after meals.
This problem arises in autumn and spring. Which disease this pain pattern is typical for?
esophagitis
stomach cancer
enteritis
stenosis of esophagus
duodenal ulcer
Patient G. is seeking for medical advice because of periodical crumping pain in the lower parts of
abdominal region, pain does not depend on food intake and it arises before defecation. Affection of
which part of digestive tract should you suspect?
stomach
small intestine
spleen
pancreas
large intestine
A patient complaint of pain in epigastrium which intensifies after intake of spicy food. Sometimes he
develops vomiting with previous nausea. Affection of which part of digestive tract should you
suspect?
esophagus
gallbladder
large intestine
liver
stomach
Patient R. complains of increased frequency of defecation till 4-5 times a day within the last week.
Volume of stool and amount of liquid in it are also increased. Which possible cause of this condition
do you know?
Intestinal infection
Disfunction of a gallbladder
Stomach hyperacidity
Stomatitis
Hemorrhoids
Patient applies for medical advice because of pain in paraumbilical region which appears mostly in
the morning. Pain is crumping and is followed with intestinal inflation. Affection of which part of
digestive tract should you suspect?
A.
B.
C.
D.
E. *
216.
A.
B.
C.
D.
E. *
217.
A.
B.
C.
D.
E. *
218.
A.
B.
C.
D.
E. *
219.
A.
B.
C.
D.
E. *
220.
A.
B.
C.
D.
E. *
221.
stomach
esophagus
gallbladder
pancreas
intestine
Patient applies for medical advice with complaints on pain in the left hypochondrium which
propagates toward spinal cord. Pain occurs after fatty food intake and decreases after usage of
enzymes. Affection of which part of digestive tract can you suspect?
stomach
intestine
gallbladder
liver
pancreas
When the patient with jaundice and cholelithiasis was examined, enlarged gallbladder was found in
him. What is the probably reason of this enlargement?
Pancreatitis;
Non-calculous cholecystitis;
Cirrhosis
Hepatitis.
Mechanical jaundice;
Liver sizes of 50-year patient according to percussion by Kurlov’s method are 13, 11, 9 cm. Liver
edge is slightly rounded with smooth surface, painful at palpation. In what pathological conditions
such signs can be observed?
Peptic urcer;
Pancreatitis;
Cholecystitis;
Duodenitis;
Hepatitis.
In patient N., 58 years old, painless elastic cylinder with diameter 4-5 cm is palpated in the upper
abdominal area 2 cm lower from stomach grater curvature. Which part of intestine is this?
Small intestine,
Sigmoid colon,
Caecum,
Ascending colon,
Transverse colon.
Data of inspection of a patient: sclera are yellow, spider angiomata are present on the skin, palmary
erythema, loss of hair, ascites, dilatation of superficial veins on anterior abdominal wall. Which
organ is affected?
Gallbladder,
Intestine,
Pancreas,
Spleen.
Liver,
During inspection of abdominal wall in vertical position of a patient the spherical-shaped protrusion
was found in umbilical region. Its diameter is 5 cm. It becomes more visible when the patient inflates
the abdomen. In recumbent position the found formation considerably decreases. What it that?
A.
B.
C.
D.
E. *
222.
A.
B.
C.
D.
E. *
223.
A.
B.
C.
D.
E. *
224.
A.
B.
C.
D.
E. *
225.
A.
B.
C.
D.
E. *
226.
A.
B.
C.
D.
E. *
Tumor,
Lipoma,
Rectus ,abdominis muscles,
Normal finding.
Hernia,
Patient R. asks medical advice because of periodical sharp spastic pain in abdominal region which
arise independently of food intake. Pain occurs before defecation and disappears after it. Which part
of digestive system is affected?
Small intestine,
Gallbladder,
Stomach,
Liver,
Colon,
During inquiry of a patient it was established that he has general weakness, dizziness and tarry stools
(feces are equally mixed with blood). Vomiting and nausea are absent. Which pathology should
doctor suspect in the patient?
Bleeding from the lower parts of the colon,
Fissure of the rectum,
Hemorrhoids,
Dysentery.
Вleeding from the upper parts of the colon or small intestine,
In patient I., who is on in-patient treatment in therapeutic department of a hospital because of
stomach ulcer, suddenly general weakness has developed as well as dizziness, nausea, vomiting.
Vomit masses look like „coffee-grounds”. What condition are such symptoms characteristic for?
Intestinal bleeding,
Malignization of the ulcer,
Intestinal obstruction,
Pylorospasm.
Gastric bleeding,
A patient complains of pain in epigastrium which arises mainly at night and diminishes after meals.
Such problem usually presents in spring and autumn. What disease such complaints are most
characteristic for?
Esophagitis,
Colitis,
Enteritis,
Narrowing of esophagus,
Peptic ulcer,
A patient complains of pain in epigastrium which intensifies after spicy meals, heartburn. Such
problem usually presents in spring and autumn. What disease such complaints are most characteristic
for?
Hepatitis,
Colitis,
Enteritis,
Cholecystitis,
Gastritis type B,
227.
A.
B.
C.
D.
E. *
228.
A.
B.
C.
D.
E. *
229.
A.
B.
C.
D.
E. *
230.
A.
B.
C.
D. *
E.
231.
A.
B.
C.
D.
E. *
232.
A.
B.
C.
D.
E. *
A patient is disturbed with periodical spastic pain in abdominal region. The patient complains of
constipation, the feces are fragmented and hard (as a «sheep dung»). What disease this stool is typical
for?
Chronic enteritis,
Non-specific ulcerous colitis,
Chronic pancreatitis,
Gаstric ulcer,
Chronic spastic colitis,
Patient S, 25 years old, suffers of gastritis for about 5 years. According to data of laboratory
examination the patient has high acidity of stomach juice. What will be appearance of patient’s
tongue?
«Lacquered» (papillary atrophy),
Moist, pink and clean,
Dry, as a brush,
Smooth, of raspberry color.
Papillary hypertrophy,
In patient B. atrophic gastritis was diagnosed with the considerable decrease of secretory function of
the stomach. What will be appearance of patient’s tongue?
Hyperplasy of papillae,
Moist, pink and clean,
Dry, as a brush,
Smooth, of raspberry color.
«Lacquered» (papillary atrophy),
Patient D. complains of frequent stools (up to 4-5 times a day), the volume and water content of each
stool are increased. Which possible cause of this condition may be?
Pylorostenosis
Cholecystitis
Colitis
Enteritis
Peptic ulcer
A patient is disturbed because of decreased appetite, unpleasant taste in the mouth, belch with air and
smell like rotten eggs. What disease is such character of belch characteristic for?
Chronic gastritis of type B,
Duodenal ulcer,
Stomach ulcer,
Chronic pancreatitis.
Chronic gastritis of type A,
Patient A., 60 years old, complains of poor appetite, unpleasant taste in the mouth, belch with air and
smell like rotten eggs, diarrhea. What disease are these signs characteristic for?
Chronic gastritis with stomach juice hyperacidity,
Duodenal ulcer,
Colitis,
Cholecystitis,
Chronic gastritis with stomach juice hypoacidity,
233.
A.
B.
C.
D.
E. *
234.
A.
B.
C.
D.
E. *
235.
A.
B.
C.
D.
E. *
236.
A.
B.
C.
D.
E. *
237.
A.
B.
C.
D.
E. *
238.
A.
B.
C.
D.
A patient complains of periodic pain and heaviness in epigastric region, especially after spicy and
sour food as well as on the fasten stomach and during night sleep. The pain diminishes after drinking
milk and has seasonal character. What disease such pain pattern is characteristic for?
Enteritis,
Cholangitis,
Pancreatitis,
Stomach ulcer.
Duodenal ulcer,
A patient with peptic ulcer of the stomach notices that within the recent weak pain in the stomach
became less intensive, but general weakness and vomit like “coffee-grounds” periodically appeared.
What pathology such vomiting is characteristic for?
Drinking coffee,
Penetration,
Pylorostenosis,
Intestinal obstruction.
Gastric bleeding,
A patient with peptic ulcer of the stomach notices that within the recent 6 months pain in the stomach
became permanent, the patient developed anorexia, disgust for meat and general weakness. What
pathology such symptoms are characteristic for?
Gastritis,
Peptic ulcer in exacerbation phase,
Pylorostenosis,
Intestinal obstruction.
Malignization of ulcer,
A patient complains of intensive pain in the right hypochondrium with conduction to the right
shoulder and below the right scapula. The pain appears suddenly, lasts for some seconds and
disappears. What organ is affected?
Stomach,
Esophagus,
Pancreas,
Small intestine.
Gallbladder,
A patient complains of semibelting pain (propagating through the left hypochondrium toward the left
lumbar region till paravertebral line). Pain appears after intake of fatty, spicy of acid food. What
organ is affected?
Stomach,
Esophagus,
Gallbladder,
Small intestine.
Pancreas,
A patient complains of vomits with undigested food immediately after meals, without preceding
nausea, vomiting easily develop if the patient declines forward. Which part of digestive tract is
affected on your opinion?
Stomach,
Duodenum,
Small intestine,
Colon.
E. *
239.
A.
B.
C.
D.
E. *
240.
A.
B.
C.
D.
E. *
241.
A.
B.
C.
D.
E. *
242.
A.
B. *
C.
D.
E.
243.
A.
B.
C.
D.
E. *
244.
A.
B.
C.
Esophagus,
A 27-year-old man complains of pains in epigastrium which are relieved by food intake.
Esophagogastroduodenoscopy shows antral erosive gastritis, biopsy of antral mucous presents
Hеlicobacter Pylori. Diagnosis is:
Reflux-gastritis
Menetrier's gastritis
Rigid antral gastritis
Gastritis of A type
Gastritis of type B
A 39 -year-old woman complained of squeezed epigastric pain 1 hour after meal and heartburn. She
had been ill for 2 years. On palpation, there was moderate tenderness in pyloroduodenal area. Antral
gastritis was revealed on gastroscopy. What study can establish genesis of the disease?
Detection of autoantibodies in the serum
Gastrin level in blood
Examination of stomach secretion
Examination of stomach motor function
Revealing of Helicobacter infection in gastric mucosa
A 27 -year-old man complained of aching epigastric pain just after meal, heartburn, and nausea.
Stomach endoscopy revealed a large amount of mucus, hyperemia and edema of mucous membrane
in gastric fundus with areas of atrophy. Establish the diagnosis.
Chronic type B gastritis
Peptic ulcer of the stomach
Chronic type C gastritis
Menetrier’s disease
Chronic type A gastritis
A patient suffers of pain in the right hypochondrium which appeared suddenly after intake of fried
food and irradiated to the right shoulder. Which organ is affected?
intestine
gallbladder
pancreas
esophagus
stomach
A patient is under dispensary observation because of calculous cholecystitis. He developed itching
and jaundice. Itching is more often observed in:
parenchymatous jaundice
hemolytic jaundice
in false jaundice
in all types of jaundice
mechanic jaundice
A patient complains of pain in the right hypochondrium. The upper border of liver dullness is not
changed. By palpation the location of liver lower border on midclavicular line is 5 сm lower of the
costal arch. The edge is hard, round, painful, its surface is smooth. Which reasons of these findings
may be?
Echinococcus.
Tumor of the liver.
Liver cirrhosis.
D.
E. *
245.
A.
B.
C.
D.
E. *
246.
A.
B.
C.
D.
E. *
247.
A.
B.
C.
D.
E. *
248.
A.
B.
C.
D.
E. *
249.
A.
B.
C.
D.
E. *
250.
Abscess of the liver
Hepatitis.
A patient grumbles about intensive pain in the upper part of stomach with irradiation in the back,
itching of skin. At objective inspection there were revealed yellow colouring of skin and visible
mucose, excoriations on the trunk. General bilirubin – 80,5 mkmoll/l, direct one – 70,5 mkmoll/l,
Van den Berg reaction is accelerated. Bilirubin is present in urine, urobilin is absent, the reaction of
excrement on sterkobilin is negative. About what disease is it possible to think?
Chronic hepatitis.
Liver cirrhosis.
Acute enteritis
Acute pancreatitis.
Cholelithiasis
Patient K., 35 y.o., grumbles about periodic aching pain in right hypochondrium, which arises up
after the use of spicy and fat food, on fever up to 37,3 degree. S. He considered to be ill for 4 years.
At deep palpation of his liver pain vas revealed in the projection of the gallbladder. A liver is not
enlarged. About what disease it is possible to think?
Chronic pancreatitis, phase of exacerbation
Acute cholecystitis
Chronic persisting hepatitis.
Liver cirrhosis.
Chronic cholecystitis, phase of exacerbation
In admissions department a patient was admitted with complaints about sharp pain in right
hypochondrium, vomiting. Pain arose up after the use of the fatty, spicy fried food. At palpation of
the abdomen tenderness was revealed in right hypochondrium. Positive Ortner’s symptom and
frenicus-symptom. About what pathology is it possible to think?
Peptic ulcer.
Acute pancreatitis.
Acute gastritis.
Acute appendicitis.
Biliary colick.
Analyzing the result of total blood count in a patient which is on treatment concerning the cirrhosis of
liver, a doctor found out thrombocytopenia in combination with anemia and leukopenia. Such
changes are the sign of:
jaundice
syndrome of hepatic insufficiency
portal hypertension
cholestasis
hypersplenism
For patient N., 48 years old, which is abused with alcohol, it is discovered: increase of the abdomen
due to ascites, expansion of subcutaneous weans on a stomach. There signs are typical for:
cholestasis
hypersplenism
splenomegaly
hepatocellular insufficiency
portal hypertension
During investigation of sizes of patient’s liver by Kurlov’s method they were equal to 12 cm, 10 cm
and 9 cm. The increase of liver is accompanying all states, except for:
A.
B.
C.
D.
E. *
251.
A.
B.
C.
D.
E. *
252.
A.
B.
C.
D.
E. *
253.
A.
B.
C.
D.
E. *
254.
A.
B.
C.
D.
E. *
255.
A. *
B.
C.
D.
E.
Chronic hepatitis
Liver cirrhosis
Cancer of a liver
Heart failure
Cholecystitis
During examination of a patient it was revealed increase of an abdomen, “caput medusae”, varicose
veins of esophagus. Portal hypertension syndrome was established. What disease is this syndrome
typical for?
pancreatitis
in cholelithiasis
in acute cholecystitis
in cholangitis
liver cirrhosis
A patient with liver cirrhosis appealed to the doctor concerning appearance of vascular pattern on the
skin of abdominal wall (spider angiomata) and mammary glands enlargement. What is the cause of
these changes in liver cirrhosis?
Allergic reaction
Portal hypertension
Thrombocytopenia
Hypercoagulation
Hyperestrogenaemia
During inspection of a patient the enlarged abdomen was revealed with dilated venous vessels on the
frontal abdominal wall. What disease is it typical for?
Cholecestitis,
Cushing's disease,
Pancreatitis,
Diabetes mellitus,
Liver cirrhosis,
Patient A. visited a doctor because of complaints on belching with the smell of «rotten eggs»,
periodical diarrhea. These complaints may be in:
Gastritis with increased acidity of stomach juice,
Gastric bleeding,
Esophagitis,
Intestinal bleeding,
Gastritis with decreased acidity of stomach juice,
Patient C. complains of increased frequency of defecation till 4-5 times a day within the last week.
Volume of stool and amount of liquid in it are also increased. Data anamnesis: the patient was
undergone gamma-therapy because of malignant tumor. Which possible cause of this condition do
you know?
Radiation colitis
Disfunction of a gallbladder
Stomach hyperacidity
Esophagitis
Hemorrhoids
256.
A.
B.
C.
D.
E. *
257.
A.
B.
C. *
D.
E.
258.
A.
B.
C. *
D.
E.
259.
A.
B. *
C.
D.
E.
260.
A.
B. *
C.
D.
E.
261.
A.
B.
C. *
D.
During palpation of person of asthenic constitution in vertical position a doctor revealed by palpation
the lower pole of the right kidney. Kidney surface is smooth, painless and solid. The left kidney was
nor felt by palpation. What these data testify about?
chronic pyelonephritis;
cancer of the right kidney;
atrophy of the left kidney;
chronic glomerulonephritis.
variant of norm;
? Patient A. who suffers from diabetes mellitus has developed acute pyelonephritis. Which statement
made by the diabetic patient who has a urinary tract infection indicates correct understanding
regarding antibiotic therapy?
“If my temperature is normal for 3 days in a row, the infection is gone and I can stop taking my
medicine.”
“If my temperature goes above 100° F (37.8° C) for 2 days, I should take twice as much medicine.”
“Even if I feel completely well, I should take the medication until it is gone.”
“When my urine no longer burns, I will no longer need to take the antibiotics.”
“Antibiotics are harmful so I'll neve use them.”
In patient A. who suffers from diabetes mellitus ketone bodies were found in urine. Why is ketosis
rare in patients with type 2 diabetes, even when blood glucose levels are very high (higher than 900
mg/dL)?
Ketosis is less prevalent among obese adults.
People with type 2 diabetes have normal lipid metabolism.
There is enough insulin produced by type 2 diabetes to prevent fat catabolism but not enough to
prevent hyperglycemia.
Oral antidiabetic agents do not promote the breakdown of fat for fuel (lipolysis), and exogenous
insulin spares carbohydrates at the expense of fats.
Because treatment is more effective
Patient A. who suffers from diabetes mellitus presents symptoms of polyneuropathy. The most
typical symptom of diabetic distal polyneuropathy of legs are:
leg pain when walking
cramps in the calf muscles, leg pain at night
dry gangrene of the toes
chilly feet
symptom of "amputation" toes in these thermography
Patient A. 68 years old suffers from diabetes mellitus type 2. Lactic acidosis was found by laboratory
tests. Lactic acidosis in patients with diabetes may be caused by:
glibenclamide
metformin
chlorpropamide
glimepiride
insulin
Diabetic ketoacidotic coma has developed in patient. Which insulin should be given preference?
long-acting
intermediate acting insulin
short-acting
rapid onset-fast acting insulin
E.
262.
A. *
B.
C.
D.
E.
263.
A.
B.
C.
D. *
E.
264.
A.
B.
C.
D. *
E.
265.
A.
B.
C.
D. *
E.
266.
A. *
B.
C.
D.
E.
267.
A.
B.
C.
D.
E. *
268.
A. *
combined insulin
Patient A. 68 years old with diabetes mellitus after long period of diarrhoea has developed coma.
What is the most important principle in the treatment of hyperosmolar coma?
Correction of dehydration
Correction of hyperglycemia
Correction of electrolyte disorders
Prevention of vascular collapse
Correction of hypercoagulation
Which of the following best describes the mechanism of action of pioglitazone and rosiglitazone in
treating diabetes mellitus?
Decreased production of glucose by the liver
Increased absorption of glucose by the intestine
Increased secretion of insulin by the pancreas
Increased sensitivity of peripheral tissues to insulin
Increased production of glucose by the liver
Diagnosis of diabetes mellitus was put for patient A., 66 years old. Which of the following not a
cardinal sign of diabetes mellitus?
polyuria
polydipsia
polyphagia
Hyperglycaemia.
Acetonuria
Plasma glucose level greater than 140 mg/dL, but less than 200 mg/dL, 2 hours after an oral load of
75 g of glucose is most closely associated with
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Impaired fasting glucose
Impaired glucose tolerance
Diabetic ketoacidosis
In the blood of patient D. who suffers from diabetes mellitus it was found very high serum level of
anti-islet cell antibodies. It is most closely associated with:
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Impaired fasting glucose
Impaired glucose tolerance
Diabetic ketoacidosis
In the blood of patient D. who suffers from diabetes mellitus it was found very high serum level of
acetoacetate. It is most closely associated with:
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Impaired fasting glucose
Impaired glucose tolerance
Diabetic ketoacidosis
Patient A. who suffers from diabetes mellitus and uses insulin has developed insulin resistance. The
main role in the pathogenesis of insulin resistance belongs to :
antibodies to insulin
B.
C.
D.
E.
269.
A. *
B.
C.
D.
E.
270.
A.
B.
C.
D. *
E.
271.
A. *
B.
C.
D.
E.
272.
A.
B. *
C.
D.
E.
273.
A.
B.
C.
D. *
E.
274.
A.
B.
C.
body weight loss
sclerosis of pancreas
renal failure
high blood pressure
Patient A. who suffers from diabetes mellitus and uses insulin has developed insulin resistance. The
main role in the pathogenesis of insulin resistance belongs to :
autoantibodies to insulin receptors
body weight loss
sclerosis of pancreas
renal failure
high blood pressure
Patient A. who suffers from diabetes mellitus for 15 years and uses insulin has lost vision. The most
likely cause of blindness in the patient, which has diabetes for so long time is:
glaucoma
cataract
Optic atrophy
Proliferative retinopathy
autonomic neuropathy
A 35-years-old man was operated on peptic ulcer of the stomach. Body mass deficit of the body is 10
kg. The level of fasting plasma glucose after operation 6,7 mmol. During repeated examination - 11,1
mmol (after meal), level of HbA1c - 10%. Could you please make an interpretation of the given data?
Diabetes mellitus
Impared glucose tolerance
Diabetes mellitus risk group
Normal
Postoperative hyperinsulinemia
Diagnosis of diabetes mellitus was put for patient A, 26 years old. The patient develops comatous
states very often. Which of the following is not an indicator of a hypoglycemic condition?
Fatigue
Poor appetite
Tachycardia
Confusion
Not correction
Patient A. who has not prewious history of diabetes mellitus has developed hypoglicaemia. Which of
the following diseases is characterized by hypoglycemia?
Cushing's syndrome
Acromegaly
Hypothyroidism
Hypopitutarism
Pheochromocytoma
A 42-years-old diabetic actor is started on Propanolol for stage fright. He collapses after a day
shooting. He has not changed his insulin regime. What treatment can you recommend?
Insulin sliding scale, Heparin, 0.9% saline
Insulin sliding scale, Heparin and 0.45% saline
Insulin sliding scale, 0.9% Na and potassium replacement
D.
E. *
275.
A.
B. *
C.
D.
E.
276.
A. *
B.
C.
D.
E.
277.
A. *
B.
C.
D.
E.
278.
A. *
B.
C.
D.
E.
279.
A.
B.
C.
D.
E. *
280.
A.
B.
C.
D.
E. *
281.
A. *
B.
Insulin sliding scale, 0.45% Na and potassium replacement
50 ml of 50% dextrose IV
Patient A. suffers from diabetes mellitus type 1. What is the most likely cause of persistent
tachycardia in patients with type 1 diabetes?
hypokalemia
cardiac autonomic neuropathy
combination of diabetes with thyrotoxicosis
diabetic cardiomyopathy
coronary heart disease
A patient with BMI 34 serum glucose 26 mmol/l, urinary ketones 4+ requires:
Insulin
Glibenclamide
Metformin
Glimepiride
Acarbose
A patient with BMI > 30 (kg/m2), serum glucose 24 mmol/L, urinary ketones ++++, he requires:
Insulin
Glibenclamide
Metformin
Phenformin
Oral bicarbonate
Patient A. who suffers from diabetes mellitus has developed coma. Hyperosmolar hyperglycemic
non-ketonic coma is characterized by such level of glycemia:
55 mmol/1
20 mmol/1
30 mmol/1
5 mmol/1
25 mmol/1
Which of the following complications of diabetes related to microangiopathy?
Myocarditis
Myocardial infarction
Stroke
Polyneuropathy
Nephropathy
Diabetes mellitus may cause various complications. Which of the following complication of diabetes
is NOT a microangiopathy?
Nephropathy
Retinopathy
Microangiopathy of upper extremities
Microangiopathy of lower extremities
Coronary artery disease
Diagnosis of diabetes mellitus was put for patient A, 26 years old. The recommended screening test
for diabetes mellitus is the following:
Fasting serum glucose level
Random serum glucose level
C.
D.
E.
282.
A.
B.
C.
D. *
E.
283.
A. *
B.
C.
D.
E.
284.
A.
B.
C. *
D.
E.
285.
A.
B.
C.
D. *
E.
286.
A.
B.
C.
D.
E. *
287.
A.
B.
C. *
D.
E.
Serum glucose level 2 hours after a 75-g oral glucose load (oral glucose tolerance test)
Serum level of hemoglobin A1c
Urine glucose concentration
Diagnosis of diabetes mellitus was put for patient A, 26 years old. Select the test that is most
indicative of average recent blood glucose levels:
Fasting serum glucose level
Random serum glucose level
Serum glucose level 2 hours after a 75-g oral glucose load (oral glucose tolerance test)
Serum level of hemoglobin A1c
Urine glucose concentration
Patient A. who suffers from diabetes mellitus has developed acute appendicitis. What is the most
appropriate management of diabetic patient during the surgery?
To administer short insulin
To continue taking glibenclamide
To administer long-acting insuline TD
To administer glurenorm
To administer metformin
Patient A. who suffers from diabetes mellitus was prescribed test for blood glucose control. What
maximal after food glycemia in diabetic patient is appropriate for the optimal glycemic control?
3,6 – 6,1 mmol/L
4,4 – 7,0 mmol/L
5,0 - 11,0 mmol/L
11,0 – 14,0 mmol/L
More than 14,0 mmol/L
Patient A. who suffers from diabetes mellitus was prescribed test for blood glucose control. What
maximal after food glycemia in diabetic patient is appropriate for the suboptimal glycemic control?
3,6 – 6,1 mmol/L
4,4 – 7,0 mmol/L
5,0 - 11,0 mmol/L
11,0 – 14,0 mmol/L
More than 14,0 mmol/L
Patient A. who suffers from diabetes mellitus was prescribed test for blood glucose control. What
after food glycemia in diabetic patient is appropriate for the high risk for the life glycemic control?
3,6 – 6,1 mmol/L
4,4 – 7,0 mmol/L
5,0 - 11,0 mmol/L
11,0 – 14,0 mmol/L
More than 14,0 mmol/L
Patient A. who suffers from diabetes mellitus was prescribed test for blood glucose control. What
maximal glycated hemoglobin (Hb Alc) level is appropriate for the ideal glycemic control in diabetic
patient?
Less then 4, 0 %
Less than 5,0 %
Less than 6,0 %
Less than 7,6 %
Less than 9,0 %
288.
A.
B.
C.
D. *
E.
289.
A.
B.
C.
D.
E. *
290.
A.
B. *
C.
D.
E.
291.
A.
B.
C.
D. *
E.
292.
A.
B.
C.
D.
E. *
293.
A.
B.
C.
D.
E. *
294.
Patient A. who suffers from diabetes mellitus was prescribed test for blood glucose control. What
maximal glycated hemoglobin (Hb Alc) level is appropriate for the optimal glycemic control in
diabetic patient?
Less then 4, 0 %
Less than 5,0 %
Less than 6,0 %
Less than 7,6 %
Less than 9,0 %
Patient A. who suffers from diabetes mellitus was prescribed test for blood glucose control. What
maximal glycated hemoglobin (Hb Alc) level is appropriate for the suboptimal glycemic control in
diabetic patient?
Less then 4, 0 %
Less than 5,0 %
Less than 6,0 %
Less than 7,6 %
Less than 9,0 %
Patient A. who suffers from diabetes mellitus was prescribed test for blood glucose control. What
maximal fasting glycemia in diabetic patient is appropriate for the ideal glycemic control?
2,2 – 5,5 mmol/L
3,6 – 6,1 mmol/L
4,0 - 7,0 mmol/L
8,0 – 9,0 mmol/L
More than 9,0 mmol/L
Patient A. who suffers from diabetes mellitus was prescribed test for blood glucose control. What
maximal fasting glycemia in diabetic patient is appropriate for the suboptimal glycemic control?
2,2 – 5,5 mmol/L
3,6 – 6,1 mmol/L
4,0 - 7,0 mmol/L
8,0 – 9,0 mmol/L
More than 9,0 mmol/L
Patient A. who suffers from diabetes mellitus was prescribed test for blood glucose control. What
fasting glycemia in diabetic patient is appropriate for the high risk for the life glycemic control?
2,2 – 5,5 mmol/L
3,6 – 6,1 mmol/L
4,0 - 7,0 mmol/L
8,0 – 9,0 mmol/L
More than 9,0 mmol/L
Patient A. who suffers from diabetes mellitus was prescribed test for blood glucose control. What is
screening laboratory method of diabetes mellitus diagnostic?
Estimation of insulin level in plasma
Estimation of glucose level in urine
Insulin tolerance test
Glucose tolerance test (GTT)
Estimation of glucose level in blood
Patient A. who suffers from diabetes mellitus was prescribed laboratory tests. What are the laboratory
signs of diabetic ketoacidosis?
A.
B.
C. *
D.
E.
295.
A.
B.
C. *
D.
E.
296.
A.
B. *
C.
D.
E.
297.
A.
B. *
C.
D.
E.
298.
A.
B.
C.
D.
E. *
299.
A.
B.
C. *
D.
E.
300.
A.
B.
C.
Hyperglycaemia, glucosuria, hyperbilirubinemia
Hyperglycaemia, glucosuria, proteinuria
Hypoglycaemia, glucosuria, ketonuria
Acidosis, normoglycaemia, ketonuria
Hyperglycaemia, glucosuria, ketonuria
What minimal 2-hours glucose level in blood indicates diabetes mellitus according glucose tolerance
test (GTT)?
More than 8,5 mmol/L
More than 9,0 mmol/L
More than 11,1 mmol/L
More than 14,0 mmol/L
More than 16,1 mmol/L
What minimal fasting plasma glucose level in blood indicates diabetes mellitus according glucose
tolerance test (GTT)?
More than 5,5 mmol/L
More than 7,0 mmol/L
More than 7,7 mmol/L
More than 8,0 mmol/L
More than 11,0 mmol/L
Diabetic patient is on long-standing treatment in a hospital. At the moment he has deep sighing
respiration. The main cause of Kussmaul breathing is:
Hyperglycemia
Metabolic acidosis
Dehydration
Hypokalemia
Ketonemia
Patient L., 49 years old, height 163 cm, weight 76 kg, level of fast (on an empty stomach) glucose is
6,3-7,2-8,7 mmol/l. What is the possible diagnosis?
Normal.
Impaired glucose tolerance.
Diabetes mellitus type 1
Impaired fasting glycemia.
Diabetes mellitus type 2
Diabetic K., 31 y-r-old, is pregnant. What laboratory data we have to control in pregnant diabetes,
EXCEPT fast glycemia?
The level of postprandial glycemia.
The level of glucosurea.
The level of glycated Hb
The level of the insulin in the blood.
The level of cholesterol.
A 47 year-old obese female complains of thirst. The results of the glucose tolerance test: a fasting
serum glucose is 5,7 mmol/l, 2-hour postprandial serum glucose is 7,4 mmol/l. Make the diagnosis,
please?
Normal.
Impaired glucose tolerance.
Diabetes mellitus.
D. *
E.
301.
A. *
B.
C.
D.
E.
302.
A.
B.
C. *
D.
E.
303.
A. *
B.
C.
D.
E.
304.
A. *
B.
C.
D.
E.
305.
A. *
B.
C.
D.
E.
306.
A.
B.
C. *
D.
E.
Impaired fast glucose tolerance.
These results are not correct and cannot be taken into account
? In patient A., who sufers from chronic glomerulonephritis, kidneys concentration function is
diagnosed to be low. This means that the patient has developed renal failure. Which pathological
changes in kidneys from listed below can be the cause of renal failure and their poor concentration
function in chronic glomerulonephritis?
glomerular sclerosis
edema of kidney parenchyma
canalicular sclerosis
obstruction of canaliculi with destroyed erythrocytes
collaps of tubular apparatus.
Patient E., 52 years old, who suffers from chronic pyelonephritis for 12 years, has developed renal
failure. Which changes in the results of biochemical blood test may be found in renal failure?
increased blood serum glucose level
increased bilirubin concentration
increased creatinine concentration
increased amylaze concentration
increased alkaline phosphatase level in blood serum
patient I., 54 years old, was diagnosed with paranephritis. What position of a patient is typical for
pranephritis?
Patient is lying on affected side with legs bended in hip and knee joints and pressed to the stomach
Orthopnea position
Patient is lying on the affected side
Knee-elbow position
Patient is sitting and bending forward.
Patient I., 54 years old, was diagnosed with paranephritis. What kind of disease is paranephritis?
Inflammation of tissues surrounding the kidney
Inflammation of a bladder
Inflammation of kidney calicies
Inflammation of kidney parenchyma
Inflammation of peritoneum surrounding the kidney
Changed red blood cells are found in common urine analysis of patient S., 43 years old. Which
pathological condition are typical for?
acute nephritis;
urolithiasis;
acute cystitis;
kidney amyloidosis;
cancer of urinary bladder.
Casts, leucocytes, bacteria and protein were found in patient’s urine during its laboratory
investigation. Which disease are these findings typical for?
Paranephritis
Acute glomerulonephritis
pyelonephritis
Amyloidosis
Kidney cancer
307.
A.
B. *
C.
D.
E.
308.
A.
B.
C.
D. *
E.
309.
A.
B. *
C.
D.
E.
310.
A.
B.
C.
D. *
E.
311.
A.
B.
C.
D. *
E.
312.
A.
B.
C. *
D.
E.
313.
A. *
B.
C.
Patient P., 43 years old, complains of burning sensations in urethra during urination. Crystals of solts
were revealed in his urine. What do these findings indicate on?
acute nephritis;
urolithiasis;
acute cystitis;
kidney amyloidosis;
cancer of urinary bladder.
Patient A., 35 years old, is instructed to collect urine for Zimnitsly’s test. Which substance in urine
does determine specific gravity of urine?
uric acid salts;
oxalates;
bilious pigments;
glucose;
uric acid.
Patient E., 38 years old, complains of attack-like pains in lumbar area, which irradiate downward.
What does can this symptom testify about?
acute glomerulonephritis;
urolithiasis;
hypernephroma;
chronic glomerulonephritis;
heart attack.
Patient F., 38 years old , developed acute pyelonephritis. What appearance of urine is typical for the
disease?
red;
color of «meat wastes»;
color of beer;
cloudy, with white sediment
straw-yellow.
Patient E., 48 years old, is ill with chronic pyelonephritis for 10 years. What changes in biochemical
blood test do indicate on kidney insufficiency?
albuminemia;
beta-lipoproteinemia;
hyperbilirubinemia;
creatiniemia
dysproteinemia.
Patient O., 39 years old, complains of nicturia. What pathology is this symptom typical for?
acute nephritis;
diabetes mellitus;
chronic kidney insufficiency;
chronic cardiac insufficiency;
diencephalic syndrome.
A 21-year-female patient was diagnosed with urinary syndrome during routine laboratory
examinations. What amount of albumin in urine is it typical for urinary syndrome?
less than 3,5 g/day;
to 4,5 g/day;
to 5,5 g/day;
D.
E.
314.
A. *
B.
C.
D.
E.
315.
A.
B.
C.
D.
E. *
316.
A.
B.
C. *
D.
E.
317.
A.
B.
C.
D. *
E.
318.
A.
B.
C.
D.
E. *
319.
A. *
B.
C.
D.
E.
320.
A.
B.
to 6,5 g/day;
to 9,5 g/day.
What may be revealed in common urine analysis of patient with acute pyelonephritis within first 48
hours of the disease?
Bacteriuria, proteinuria
Pyuria
Pyuria, erythrocyturia
Casts
Hematuria, proteinuria
What pathology of urinary system is manifested with attack-like crumping pain in lumbar region
from one side?
Paranephritis
Nephroptosis
Acute pyelonephritis
Acute glomerulonephritis
Renal colic.
What syndrome the following signs: edema, high proteinuria, hypoproteinemia, dysproteinemia,
hypercholesterolemia - are typical for?
Uric syndrome
Nephritic one
Nephrotic syndrome
Hypertensive syndrome
Renal eclampsia.
Which changes in biochemical blood study are possible if the patient suffers from chronic
pyelonephritis for 10 years?
Hypoproteinemia
Hyperpliporoteinemia
Hyperbilirubinemia
hypercreatininemia
Dysproteinemia
Which changes in complete blood count are the most often presented in acute pyelonephritis?
Increased ESR
Leucocytosis
Decreased hemoglobin content
Thrombocytopenia
Shift to the left
Which changes of kidney concentration function are typical for chronic pyelonephritis?
hypoisosthenuria
isosthenuria
hypersthenuria
hyposthenuria
oliguria
Which degree of nephroptosis is present if it is possible to palpate all the kidney in iliac region, it is
easily displaceable and is able to move to the opposite side of the body?
I
II
C. *
D.
E.
321.
A. *
B.
C.
D.
E.
322.
A.
B.
C. *
D.
E.
323.
A.
B.
C.
D. *
E.
324.
A.
B.
C. *
D.
E.
325.
A. *
B.
C.
D.
E.
326.
A. *
B.
C.
D.
E.
III
IV;
total nephroptosis.
Which degree of nephroptosis is present if it is possible to palpate all the kidney, it is easly
displaceble, but is not able to move to the opposite side of the body?
I
II
III
IV;
total nephroptosis.
Which examination should you prescribe for a patient if there are erythrocytes, protein and casts in
his urine?
Renography
Chest X-ray
Ultrasound examination of kidneys
Renal scintigraphy
Duodenal probing
A patient suffers from urinary tract infection. Which of the following beverages should be the patient
recommended to drink?
Carbonated beverages
Citrus juices
Milk
Tomato juice
Coca-Cola
Laboratory examination list of patient R., who suffers with chronic pyelonephritis, includes
Nechyporenko’s test. What is the purpose of Nechyporenko’s test execution?
to reveal which part of urinary system is the source of hematuria or leukocyturia,
estimation of kidney concentration function
for calculation of formed elements (red cells, leukocytes, casts) in urine with the method of
Kakovsky-Addis
for determination of diuresis
for determination of the amount of albumen in urine.
Patient K was hospitalized with acute pyelonephritis. Treatment was prescribed. Which is main drug
for treatment of acute pyelonephritis?
Antibiotics
Glucocortecoids
Immunodepressants
Diuretics
Calcium channel antagonists
Patient R. suffers from chronic pyelonephritis for many years. According to location of pathological
process chronic pyelonephritis may be:
Unilateral, bilateral, pyelonephritis of a single kidney
Bilateral, unilateral,
Pyelonephritis of a single kidney
Unilateral, bilateral, combined
Unilateral, bilateral, pyelonephritis of a renal segment
327.
A.
B.
C.
D. *
E.
328.
A. *
B.
C.
D.
E.
329.
A. *
B.
C.
D.
E.
330.
A.
B.
C. *
D.
E.
331.
A. *
B.
C.
D.
E.
332.
A. *
B.
C.
D.
E.
Patient K was hospitalized with acute glomerulonephritis. Heparin was included to treatment of the
patient. Anticoagulants are prescribed in the following course of glomerulonephritis:
With uric syndrome
With uric syndrome and hematuria
In resistant hypertension
With nephrotic syndrome
With acute nephritic syndrome
Patient N. was hospitalized with sharp pain in lumbar region and fever. Acute primary pyelonephritis
was verified. For treatment of primary acute pyelonephritis the following drugs are used as:
Antibiotics, sulfa drugs, uroseptics, phitodiuretics
Sulfa drugs, spasmolytics
Antibiotics, uroseptics, hemostatics
Antibiotics, spasmolytics, phitodiuretics
Sulfa drugs, spasmolytics, vitamina
Laboratory examination list of patient R who presents leucocyturia includes Tompson’s test. For
what purpose Tompson’s test is performed (tree-glass test)?
for the exposure of department of the urinary system, which is the source of hematuria or
leukocyturia,
estimation of kidney concentration function
for calculation of formed elements (red cells, leukocytes, casts) in urine with the method of
Kakovsky-Addis
for determination of diuresis
for determination of the amount of albumen in urine.
Patient N was hospitalized with fever and hematuria. Acute glomerulonephritis was verified. For
which period of time is it necessary to prescribe a bed mode for a patient with acute
glomerulonephritis?
Till disappearance of uric syndrome
On 1-3 days
Till disappearance of edema and normalization of blood pressure
On 3-5 days
On 10-14 days
Patient R. suffers from acute pyelonephritis. What may be found in urine sediments in acute
pyelonephritis?
Protein and erythrocytes
Protein and uric acid salts crystals
Leucocytes
Leucocytes and hyaline casts
Erythrocytes and calcium oxalatis crystals
Patient R. suffers from chronic pyelonephritis. In pathogenesis of chronic glomerulonephritis the
most important role belongs to:
Inflammation
Authoimmune process
Immune disorders
Disorders of hemostasis
Liver disease
333.
A.
B.
C. *
D.
E.
334.
A. *
B.
C.
D.
E.
335.
A. *
B.
C.
D.
E.
336.
A. *
B.
C.
D.
E.
337.
A.
B.
C.
D. *
E.
338.
A. *
B.
C.
D.
E.
339.
A.
Patient R. was hostitalized because of acute pyelonephritis. A doctor prescribed laboratory tests for
him. Which laboratory sign will testify about pyelonephritis?
Large amount of casts in urine
Lipiduria
Prevalence of leucocyturia against of erythrocyturia in urine
Prevalence of erythrocyturia against of leucocyturia in urine
Proteinuria more than 2 g per day
Patient R. is on in-hostital treatment because of acute glomerulonephritis. Most often the causative
agent of acute glomerulonephritis is:
Hemolythic streptococcus group A
Viruses
Staphylococci and pneumococci
E.Coli
Fungi
Patient R. is on in-hostital treatment because of acute pyelonephritis. Most often the causative agent
of acute pyelonephritis is:
Coli
Proteus
Streptococcus
Viruses
Chlamidia
Patient N. was hospitalized with sharp pain in lumbar region and fever. Chronic pyelonephritis
exacerbation was verified. Which provoking factor is the most appropriate for pyelonephritis?
Overcooling
Focuses of infection in the organism
Immune deficiency state
Acute cystitis
Delivery in females
Laboratory examination list of patient R who suffers from chronic pyelonephritis, includes Reberg’s
test. Reberg’s test is performed with the purpose:
to reveal which part of urinary system is the source of hematuria or leukocyturia,
assessment of kidney concentration function
for calculation of formed elements (red cells, leukocytes, casts) in urine with the method of
Kakovsky-Addis
for assessment of glomerular filtration and canalicular reabsorption
for determination of the amount of albumen in urine.
Patient K, has developed acute glomerulonephritis. Which complication of acute glomerulonephritis
may develop in this disease:
Acute renal failure
Chronic renal failure
Toxic shock
Bleeding
Ishuria
Patient K. has developed acute glomerulonephritis. Which complication of acute glomerulonephritis
may develop in this disease:
Acute renal failure
B.
C.
D.
E. *
340.
A.
B.
C.
D. *
E.
341.
A. *
B.
C.
D.
E.
342.
A.
B.
C.
D.
E. *
343.
A. *
B.
C.
D.
E.
344.
A.
B.
C. *
D.
E.
345.
A.
B.
C. *
D.
Chronic renal failure
Toxic shock
Bleeding
Hypertonic crisis
A pregnant women has developed acute pyelonephritis. Select the method of assessment of urine
outflow disorders in pyelonephritis of a pregnant women:
Excretory urography
Chromocystoscopy
Ultrasound
Ultrasound, chromocystoscopy
Radioisotopic renography
Patient R was hospitalized with acute secondary pyelonephritis. Select the most informative method
of diagnostics of acute secondary pyelonephritis:
X- ray and ultrasound
Laboratory tests
Ultrasound
Chromocystoscopy
Radioisotopic renography
Patient R was hospitalized with acute secondary pyelonephritis. The most typical symptoms of acute
pyelonephritis:
Bacteriuria
Chills and hectic fever
Leucocyturia, pain
Hematuria and leucocyturia
Lumbar pain, chills and hectic fever
Patient R was hospitalized with acute glomerulonephritis with nephrotic syndrome. The what least of
albumen in urine is characteristic for a nephrotic syndrome?
3,5 g per day
4,1 g per day
5,0 g per day
2,0 g per day
0,33 g per day
Patient T, was hospitalized with acute glomerulonephritis. The patient presents such signs as edema,
high proteinuria, hypoproteinemia, dysproteinemia, hypercholesterolemia What syndrome do they
belong to?
Uric syndrome
Nephritic syndrome
Nephrotic syndrome
Renal hypertension
Renal hypotension
During examination of patient T, who suffers with chronic pyelonephritis granulous casts were
revealed in his urine. What are casts?
Mucus, which changed its consistency in acid urine
Protein molds from renal canaliculi
Accumulation of bacteria
Thrombocytes pressed together
E.
346.
A. *
B.
C.
D.
E.
347.
A.
B.
C.
D.
E. *
348.
A.
B.
C.
D.
E. *
349.
A.
B.
C.
D.
E. *
350.
A.
B.
C.
D.
E. *
351.
A.
B.
Salt corks
Results of laboratory examination of patient R. show appearance of destroyed erythrocites in urine.
What is the origin of destroyed erythrocites in urianalyses?
Acute glomerulonephritis
Urolithiasis
Paranephritis
Acute cystitis
Pyelonephritis
? A patient, 26 years old, complains of neck thickness, elevation of blood pressure, irritability,
insomnia. Thyroid gland is enlarged, homogenous. Eyes are protruded. Tremor of fingers is
detectible. Blood pressure is 180/90 mm Hg. What type of hypertension does the patient have?
Renal,
Hemodynamic,
Cerebral.
Essential,
Endocrine,
A patient, 33 years old, complains of elevation of blood pressure, irritability, insomnia, periodical
headache. All the symptoms had developed after brain commotion 2 years before. Blood pressure is
180/90 mm Hg. What type of hypertension does the patient have?
Essential,
Endocrine
Renal,
Hemodynamic,
Cerebral.
A patient, 35 years old, complains of elevation of blood pressure, pain in lumbar region, discharge of
urine like meat wastes, fever. All the symptoms developed 3 weaks after streptococcal tonsillitis.
Blood pressure is 220/110 mm Hg. What type of hypertension does the patient have?
Essential,
Endocrine,
Hemodynamic,
Cerebral,
Renal.
In patient B., 48 years old, attacks of retrosternal pain have become more intensive, pain may occur
suddenly at rest. Nitroglycerin is effective in releasing of pain. ECG recorded at the top of attack
reflects transient elevation of ST segment in chest leads. There are no changes in the biochemical
analysis of blood serum (troponins, myoglobin). What diagnosis is the most probable in this case?
Stable angina pectoris,
Primary angina pectoris at exertion,
Acute anterior myocardial infarction,
Acute posterior myocardial infarction.
Progressing angina pectoris at exertion,
In patient D., 46 years old, retrosternal pain has occur first time in his life. Pain developed after
physical exertion and it is localised behind the lower third of the sternum. Data of ECG: depression
of ST segment more than on 2 mm in ІІ, ІІІ, аVF. There are no changes in the biochemical analysis
of blood serum (troponins, myoglobin). What diagnosis is the most probable in this case?
Spontaneous angina pectoris,
Progressing angina pectoris at exertion,
C.
D.
E. *
352.
A.
B.
C.
D.
E. *
353.
A.
B.
C.
D.
E. *
354.
A.
B.
C.
D.
E. *
355.
A.
B.
C.
D.
E. *
356.
A.
B.
C.
D.
E. *
357.
Acute anterior myocardial infarction,
Acute posterior myocardial infarction.
Primary angina pectoris at exertion,
Patient N., 49 years old, was admitted to cardiologic departament with complaints of retrosternal pain
which has occur at first about 1 hour ago after physical exertion. Pain irradiared to the left scapula,
left half of the neck and left arm. Usage of nitroglycerin doesn’t decrease intensity of pain.
ECG-findings: depression of ST segment and inversion of T wave in V3-V5. Troponins T and G
level in the blood, activity of creatininphosphokynase MB-fraction is above the norm. What can you
syspect in the patient?
Exertional angina pectoris,
Hypertonic crisis,
Non-exertional angina pectoris,
Variant angina pectoris.
Myocardial infarction,
A patient, 63 years old, had elevated blood pressure aout 170/90 mm Hg during the last 3 years .
Diagnosis is: hypertension, II stage. Which disorder is typical for this stage?
Renal failure,
Retinal hemorrhage,
Brain stroke,
Myocardial infarction.
Hyperthrophy of the left ventricle,
A 17-year-old male complains of shortness of breath, swelling on shins, irregular heart beats, and
pain in the left part of the chest with irradiation to the left scapula. Treatment is ineffective. On
physical exam: heart's sounds are diminished, soft systolic murmur on the apex. Electrocardiogram
(ECG): left ventricular extrasystoly, decreased voltage. What method of investigation is necessary to
do to determine the diagnosis?
Coronarography
X-ray kymography
Veloergometria
ECG in the dynamics
Echocardiography
Patient S. suffers from ischemic heart disease. Data of inspection: pulse is 90 per min, arrhythmic (4
extrasystoles per min), blood pressure is 140/90 mm Hg, a gallop rhythm is heard on the apex of the
heart, systolic murmur in ІІ interspace near the edge of breastbone. Which among the presented
symptoms is the most serious sign of severe myocardial lesion?
Weakening of heart sounds,
Systolic murmur,
Tachycardia,
Extrasystoly.
Gallop rhythm,
In a patient with attack of retrosternal pain which lasts for 35 min a doctor suspects myocardial
infarction. Results of what blood test does the doctor need for verification of the diagnosis?
Alaninaminotransferase,
Bilirubin,
Alkaline phosphatase,
Cholesterol.
Creatininphosphokinase,
For what clinical situation the most characteristic are appearance of the raging breathing, audible in
the distance, expectoration of foamy rose sputum and the masses of moist rales above all the chest:
A.
B.
C.
D.
E. *
358.
A.
B.
C.
D.
E. *
359.
A.
B.
C.
D.
E. *
360.
A.
B.
C.
D.
E. *
361.
A.
B.
C.
D.
E. *
362.
A.
B.
Chronic right ventricular insufficiency,
Chronic bronchitis,
Acute right ventricular insufficiency,
Pulmonary artery thromboembolism.
Acute left ventricular insufficiency: lung edema,
Patient A., 50 years old, hospitalized with complaints on pain in the area of heart and shortness of
breath, which arose up suddenly after a considerable physical overload 30 min before. On ECG it is
fixed elevation of ST segment in I, aVL, V5-V6 leads. An increase of KFK- MV twice is recorded.
What diagnosis is the most reliable?
Acute posterior myocardial infarction,
Exertional angina pectoris,
Primary angina pectoris,
Progressive angina pectoris,
Acute anterior and lateral myocardial infarction .
In a patient 56 years old, during the physical loading intensive pain appeared behind the sternum and
is accompanied by shortness of breath. The pills of nitroglycerine did not help. Objectively: the
condition is severe, acrocianosis. Pulse is 100 per min, BP 160/100 mm Hg. Heart sounds are
weakened. On ECG - rhythm is fast, in V1-V4 is the deep Q wave. What happened with the patient?
Unstable angina pectoris,
Acute myocardial infarction of anterior heart wall,
Acute myocardial infarction of the left ventricle,
Hypertonic crisis.
Acute myocardial infarction of anterior-septal-apical area,
A man 60 years old suffers from daily pains in epigastric area by duration 30-40 minutes. A disease
has begun 2 weeks ago with sharp pain in a stomach and loss of consciousness. Data of inspection:
heart rate 100 per min, heart sounds are weakened, 5-6 extrasystoles per 1 minute. Organs of
abdominal region are without pathological changes. On ECG there are elevation of ST segment in II,
ІІІ, aVF. Which clinical form of myocardial infarction takes place?
Arrhythmical,
Asthmatic,
Cerebral,
Painless,
Gastralgic.
A patient 68 years old was admitted to cardiological department of a hospital with pain in the left part
of the chest. Data of ECG: rhythm is a sinus, heart rate 102 per min, pathological deep Q wave in I,
aVL, V1-V3and rising of ST segment with negative T in the same leads. What is localization of
myocardial infarction?
Posterior wall of the left ventricle ,
Lateral wall of the left ventricle,
The right ventricle,
Upper parts of the heart.
Anterior wall of the left ventricle,
Patient S., 48 years old, suffers from pain behind the sternum, which appears at rapid walking on the
distance 500-600 m and at going upstairs on 2 floors and more. What from the following tests is
necessary to do for the patient in first time for verification of the diagnosis?
Test with hyperventilation,
Spyrography,
C.
D.
E. *
363.
A.
B.
C.
D.
E. *
364.
A.
B.
C.
D.
E. *
365.
A.
B.
C.
D.
E. *
366.
A.
B.
C.
D.
E. *
367.
A.
B.
C.
D.
E. *
368.
A.
B.
C.
Ergometric test,
Pneumotachymetry,
Veloergometry.
In which cardiac rhythm disorder waves and complexes on ECG is not possible to recognize,
sinusoid (wave)-shaped line is registered?
Norm
Atrial fibrillation
Extrasystole
Paroxysmal tachycardia
Ventricular flutter
Which cardiac rhythm disorder starts abruptly and abruptly may disappear, on the ECG cardiac
complexes are not deformed, equal, P wave is registered close to QRS complex, heart rate is more
than 180 per min?
Ventricular extrasystoles
Atrial fibrillation
Ventricular paroxysmal tachycardia
Norm
Atrial paroxysmal tachycardia
Which cardiac rhythm disorder starts abruptly and abruptly may disappear, on the ECG cardiac
complexes are deformed, equal, p wave is absent in them, heart rate is more than 180 per min?
Ventricular extrasystoles
Atrial fibrillation
Atrial paroxysmal tachycardia
Norm
Ventricular paroxysmal tachycardia
Data of an echocardiogram: considerable enlagrement of sizes of aorta, abnormal systolic movements
of its walls, decreased diameter of aortic orifice at the moment of separation of cusps. What disease is
possible in the patient?
Mitrall incompetence,
Aneurism
Myocardial infarction
Angina pectoris
Aortal stenosis,
Data of an echocardiogram: hypertrophy of the left atrium, deformation and adhesion of mitral valve
cusps, unidireted movement of cusps in separation phase. What disease is possible in the patient?
Mitral incompetence,
Aortal stenosis,
Prolapse of the mitral valve,
Tricuspidal stenosis.
Mitral stenosis,
Patient B., 56 years old, complains of retrosternal pain at fast walk on the distance 1000 m and when
he is going upstears on 4 floors an more. . What from following additional methods of examinations
should be performed at first?
Test with hyperventilation,
Test with cold,
Test with ergotamin,
D.
E. *
369.
A.
B.
C.
D.
E. *
370.
A.
B.
C.
D.
E. *
371.
A.
B.
C.
D.
E. *
372.
A.
B.
C.
D.
E. *
373.
A.
B.
C.
D.
E. *
374.
A.
B.
C.
Test with chlorethil,
Veloergometry.
In patient E, 30 years old, mitral valve incompetence was found after examination. What pulse is
typical for this heart defect?
Dull,
Mild,
Equal,
Different on both arms.
Not changed,
Patient C, 30 years old, suffers from dizziness, weakness, patient's skin is cianotic. In the data of his
anamnesis there is information about rheumatic attack and following development of aortic stenosis.
What pulse is typical for this heart defect?
Not changed,
Quick and high,
Equal,
Different on both arms.
Small and slow,
In the patient S., 23 years old, pulse rate is about 100 per min. Pulse is high and quick. Blood
pressure is 160/30 mm Hg. What heart defect should y ou expect in this case?
Stenosis of the aortic rout,
Stenosis of the mitral valve,
Trycuspid valve incompetence,
Mitral valve incompetence.
Aortic valve incompetence,
A student established that a patient's pulse is 4 beats per min rare than the heart rate, the pulse is
irregular and of different feeling and tension. The patient has signs of mitral heart defect. What heart
rhythm disorder can the student suspect in the patient?
Extrasystoly,
Atrioventricular block,
Paroxysmal tachycardia,
Bradicardia.
Atrial fibrillation,
At examination of a 30-aged man the following signs are revealed: capillary pulse and, Musse's sign
are positive, apex beat is diffuse and displaced. What heart defect these signs are typical for?
Stenosis of the aortic rout,
Stenosis of the mitral valve,
Tricuspid valve incompetence,
Mitral valve incompetence.
Aortic valve incompetence,
Patient P., 28 years old, complains of periodical pressing pain in the heart region and loosing of
consciousness. Data of examination: skin is pale, apex beat is displaced leftward diffuse and resistant.
Weakened I sound at the heart apex and the II sound at the aorta as well as rough systolic murmur at
the aorta are heard by auscultation. What heart defect these signs are typical for?
Stenosis of the mitral valve,
Tricuspid valve incompetence,
Aortic valve incompetence,
D.
E. *
375.
A.
B.
C.
D.
E. *
376.
A.
B.
C.
D.
E. *
377.
A.
B.
C.
D.
E. *
378.
A.
B.
C.
D.
E. *
379.
A.
B.
C.
D.
E. *
Mitral valve incompetence.
Stenosis of the aortic rout,
Patient A, 19 years old, suffers from periodical dyspnea, palpitation at physical loading. 3 month ago
the patient had pharingitis, with following edema and acute pain in joints. Data of present inspectioncyanosis of the lips, apex beat is displaced leftwards and downwards. The I heart sound is weakened
at heart apex, systolic murmur is registered by auscultation, which concide to the II sound- as well as
accentuation of the II sound at pulmonary trunk. What heart defect these signs are typical for?
Stenosis of the aortic rout,
Stenosis of the mitral valve,
Tricuspid valve incompetence,
Aortic valve incompetence,
Mitral valve incompetence.
Patient M., 40 years old, suffers from cough with periodical hemopthysis and palpitation. At
inspection specific redness and cyanosis of the face were revealed. Apex beat is reduced, diastolic
thrill is detectible over the heart region. Data of auscultation: loud I sound, additional sound and
diastolic murmur. What heart defect these signs are typical for?
Stenosis of the aortic rout,
Tricuspid valve incompetence,
Aortic valve incompetence,
Mitral valve incompetence.
Stenosis of the mitral valve,
Patient M., 50 years old, suffers from cough with periodical hemopthysis and palpitation. At
inspection specific redness and cyanosis of the face were revealed. Apex beat is reduced, diastolic
thrill is detectible over the heart region. Data of auscultation: loud I sound, additional sound and
diastolic murmur. What kind of sound should you expect in this case?
Pleuropericardial friction murmur.
III heart sound,
IV heart sound,
Pericardial click.
Mitral click,
At inspection of the patient R. 29 years old, paleness of the skin and capillary "carotid shudder" were
revealed. Data of auscultation: the I sound at the apex and 2 sound at the aorta are weakened. Soft
blowing protodiastolic murmur is heard. What phenomena may be revealed at patient's femoral
artery?
Systolic murmur,
Intermittent pulse,
Paradoxic pulse,
Absence of sounds.
Douruasie murmur and Doble Traube's sound,
Patient P., 20 years old, is suffering from septic endocarditis. Sharp weakening of the II sound at the
aorta and diastolic murmur are heard by auscultation of the patient. What heart defect is probably
present in this case?
Stenosis ot the mitral valve,
Mitral valve incompetence,
Defect of intreventricular septum,
Stenosis of the aortic rout.
Aortic valve incompetence,
380.
A.
B.
C.
D.
E. *
381.
A.
B.
C.
D.
E. *
382.
A.
B.
C.
D.
E. *
383.
A.
B.
C.
D.
E. *
384.
A.
B.
C.
D.
E. *
385.
A.
B.
C.
D.
E. *
At auscultation of a patient, which is suffering from rheumatic heart diseases within the recent 30
years, the following data were obtained: loud 1 heart sound, opening snap. What actualtv heart detect
is present in the patient?
Mitral valve incompetence,
Aortic valve incompetence,
Stenosis of the aortic rout,
Trycuspid valve incompetence.
Mitral valve stenosis,
In a patient, 23 years old, tachycardia was found about 100 per min, the pulse is high and quick.
Blood pressure is 160/50 mm Hg. Data of auscultation: weakening of the I heart sound at heart apex,
diastolic murmur at the aorta and Botkin’s point. What heart defect are these signs characteristic for?
Aortic stenosis,
Mitral stenosis,
Tricuspid incompetence,
Mitral incompetence.
Aortic insufficiency,
In a man, 28 years old, during examination it was found rising of blood pressure, that corresponds to
the mild one. What is the level of this type of hypertension?
130-139/85-89,
160-179/100-109,
180-190/100-109,
more than 199/115.
140-159/90-99,
Examination revealed the ІІ stage of hypertension. Disorders of what organs are typical for this
stage?
Renal failure,
Apoplexy,
Retinal hemorrhage,
Absent.
Proteinuria,
Prednisolonum 3 times a day permanently. She notices rising of blood pressure. How would you
characterize this hypertension?
Essential hypertension,
Renal one,
Transitory hypertension,
Neurogenic one.
Drug-induced one,
Patient D., 38 years old, suffers from hypertension for 6 years. BP violates within the limits of
160/100 – 180/110 mm of Hg. What kind of arterial hypertension according to BP level takes place
in this case?
Soft AH,
Bordeline AH,
Isolated systolic AH,.
Severe AH.
Moderate AH.
386.
A.
B.
C.
D.
E. *
387.
A.
B.
C.
D.
E. *
388.
A.
B.
C.
D.
E. *
389.
A.
B.
C.
D.
E. *
390.
A.
B.
C.
D.
E. *
391.
A.
B.
C.
D.
E. *
A student 20 years old, marks the increase of AT during 5-6 years within the range of blood pressure
normal pressure. Select the answer which correspond to this type of violation of BP.
140-159/90-99 mm Hg ,
160-179/100-109 mm Hg,
180-190/ > 110 mm Hg ,
more than 199/115 mm Hg.
130-139/85-89 mm Hg,
A man 58 years old suffers from periodic pain of squeezing character behind a breastbone, which
appear after physical and emotional tension and passes after 5-7 min of rest. Which syndrome is it
typical for?
Left-ventricular insufficiency,
Myocarditis,
Right-ventricular insufficiency,
Endocarditis.
Coronary insufficiency,
A patient, 43 years old, complains of weight gain. Blood pressure is elevated, mummary glands are
enlarged. Data of examination: round face with purpur flush on the cheeks, obesity of the upper part
of the body, gynecomastia. Blood pressure is 210/130 mm Hg. What is the type of hypertension?
Essential hypertension,
Drug-induced one,
Hypertonic crisis,
Stable hypertension.
Symptomatic one,
A 46- year-old patient has ischemic heart disease, angina on exertion, II functional class. What is the
drug of choice in treatment of acute attack?
Platelet inhibiting agents (aspirin)
Spasmolitics (No-spa) IV
Digitalis IV
Sedative agents (Seduxenum) orally
Nitroglycerin sublingually
A 60-year-old woman has increased BP up to 210/110 mm Hg during last 7 years. On exam, heart
apex is displaced to the left. There are signs of left ventricular hypertrophy on ECG. What is the most
probable diagnosis?
Essential hypertension, 1st stage
Symptomatic hypertension
Cardiomyopathy
Ischemic heart disease
Essential hypertension, 2nd stage
Patient M., 72 years old, suffers from ischemic heart disease. On inspection it was revealed
movements of a head in anterioposterior direction synchronous with cardiac beats, the skin is pallid.
Pulsation of carotic arteries is present on the neck. How is the last phenomenon called?
Norm;
Kurvuazie’s sign;
Koher’s sign;
Carotic pulsation.
”Carotic shudder”;
392.
A.
B.
C.
D.
E. *
393.
A.
B.
C.
D.
E. *
394.
A.
B.
C.
D.
E. *
395.
A.
B.
C.
D.
E. *
396.
A.
B.
C.
D.
E. *
397.
A.
B.
C.
Patient S., 69 y.o., is on in-patient treatment in cardiological department of a hospital because of
advanced cardiac failure. What is possible to reveal during inspection of a patient with advanced
cardiac failure?
Pale and puffy face;
Oversweating
Edema on the legs without elevation of skin under the pressure;
Brittle nales
Cyanosis, edema, orthopnoe
During auscultation of patient’s heart the changable murmur is heard in the third - fourth intercostal
spaces between medioclavicular and anterior axillary lines, it is heard very close to the ear of the
examiner. The murmur intensifies at deep inspiration, corresponds to respiration and heart rate. What
is this murmur?
Systolic murmur,
Diastolic murmur,
Pericardial friction murmur,
Functional intracardiac murmur,
Pleuropericardial friction murmur,
During examination of a patient’s heart the following data of auscultation were revealed: the heart
sounds are weakened, tachycardia, tripple rhythm is heard at the apex which is better auscultated
when the patient is lying on the left side. Which pathological condition are these data typical for?
Stenosis of aortic orifice;
Aortic incompetence;
Stenosis of pulmonary artery;
Tricuspid valve incompetence.
Stenosis of mitral orifice;
During examination of a patient with mitral stenosis the following data of auscultion were revealed:
the heart sounds are weakened, tachycardia, specific rhythm is heard at the apex which is better
auscultated when the patient is lying on the left side. How such a rhythm is called?
Presystolic gallop rhythm,
Protodiastolic gallop rhythm,
Mezodiastolic gallop rhythm,
Pendulum rhythm,
Tripple rhythm.
During examination of a patient with mitral stenosis the following data of auscultion were revealed:
the heart sounds are weakened, tachycardia, specific rhythm is heard at the apex which is better
auscultated when the patient is lying on the left side. How such a rhythm is called?
Presystolic gallop rhythm,
Protodiastolic gallop rhythm,
Mezodiastolic gallop rhythm,
Pendulum rhythm,
Tripple rhythm.
During examination of a patient with mitral stenosis the following data of auscultion were revealed:
the heart sounds are weakened, tachycardia, specific rhythm is heard at the apex which is better
auscultated when the patient is lying on the left side. How such a rhythm is called?
Presystolic gallop rhythm,
Protodiastolic gallop rhythm,
Mezodiastolic gallop rhythm,
D.
E. *
398.
A.
B.
C.
D.
E. *
399.
A.
B.
C.
D.
E. *
400.
A.
B.
C.
D.
E. *
401.
A.
B.
C.
D.
E. *
402.
A.
B.
C.
D.
E. *
403.
A.
B.
C.
D.
E. *
404.
A.
B.
Pendulum rhythm,
Tripple rhythm.
The patient L., 75 years old, suffers from atherosclerosis. The aortic valve incompletence was
diagnosed. What change of pulse filling is typical for this pathology?
Decreased,
Different,
Not changed,
All mentilned above.
Increased,
The patient L., 75 years old, suffers from atherosclerosis. The aortic valve stenosis was diagnosed.
What change of pulse filling is typical for this pathology?
Increased,
Different,
Not changed,
All mentilned above.
Small and slow
The patient L., 75 years old, is suffering from atherosclerosis. Atrial fibrillation was diagnosed. What
change of pulse filling is typical for this pathology?
Increased,
Decreased,
Not changed,
All mentilned above.
Different,
The patient’s pulse is high and quick, the ІІ heart sound above aorta is sharply weakened. On the
X-ray the heart has aortic configuration What changes of blood pressure should you expect in this
case?
Low systolic and diastolic,
High systolic and diastolic,
Low systolic and high diastolic,
No changes.
High systolic and low diastolic,
By palpation patient’s pulse is dull. In what disease dull pulse is observed?
Myocarditis;
Pericarditis;
Mitral defects;
Heart insufficiency.
Arterial hypotension;
By palpation patient’s pulse is dull. In what disease dull pulse is observed?
Myocarditis;
Pericarditis;
Mitral defects;
Heart insufficiency.
Advanced atherosclerosis in elderly;
During examination of patient’s pulse a student revealed bradycardia. Rare pulse is observed in the
case of:
Increased body temperature;
Heart insufficiency;
C.
D.
E. *
405.
A.
B.
C.
D.
E. *
406.
A.
B.
C.
D.
E. *
Myocarditis;
Thyrotoxicosis.
Complete atrioventricular block;
A 22 year old patient with rheumatic fever complains of rest dyspnea, heart pains. 3 years ago he had
myocardial infarction. Physical examination: orthopnea, acrocyanosis, swollen cervical veins. Ps –
112 bpm, total heart enlargement, the liver is enlarged by 7 cm, shin edema. What is the stage of
chronic heart failure (CHF)?
Chronic heart failure, 3 stage
Chronic heart failure, 2 А stage
Chronic heart failure, 0 stage
Chronic heart failure, 1 stage
Chronic heart failure, 2 B stage
A patient 65 years old had myocardial infarction in the past. Now he complains of shortness of breath
in rest. Data of objective inspection: cyanosis, moist fine bubbling rales in the lungs. What
mechanism of development of the indicated symptoms?
Congestion of blood is in the large circle of circulation,
Chronic respiratory insufficiency,
Decreased level of haemoglobin of blood,
Narrowing of the left atrioventricular aperture.
Congestion of blood in the small circle of circulation,
Назва наукового напрямку (модуля):
Пропедевтика внутрішньої медицини. Тести прості
Опис:
3 курс 5 семестр
Перелік питань:
1.
A. *
B.
C.
D.
E.
2.
A.
B.
C.
D. *
E.
3.
A.
B.
C.
D.
E. *
4.
A. *
B.
C.
D.
E.
5.
A. *
B.
C.
D.
E.
6.
A.
B.
C.
D.
E. *
7.
A. *
B.
C.
D.
E.
?1. Which respiratory sounds are the main:
Harsh respiration
Dry rales
Crepitation
Moist rales
Pleural friction sound
2. Indicate the site of vesicular breathing origination:
Main bronchus
Vocal slit
Bronchioles
Alveoli
Pleural cavity
3. Harsh respiration is heard in:
Dry pleurisy
Pulmonary tuberculosis
Lung tumor
Acute pneumonia
Bronchial asthma
4. Indicate the site of dry rales origination:
Bronchus
Vocal slit
Cavity in the lung
Alveoli
Pleural cavity
5. Moist rales (crackles) are heard in patients with:
Acute lobar pneumonia (initial stage)
Acute lobar pneumonia (consolidation stage)
Bronchial asthma
Pulmonary edema
Effusive pleurisy
6. Crepitation is heard in the patients with:
Bronchial asthma
Acute bronchitis
Chronic bronchitis
Acute lobar pneumonia (consolidation stage)
Acute lobar pneumonia (initial stage)
7. Pleural friction sound is heard in patients with:
Dry pleurisy
Acute bronchitis
Acute lobar pneumonia (initial stage)
Bronchial asthma
Pulmonary emphysema
Семестр: 5
8.
A.
B.
C.
D. *
E.
9.
A. *
B.
C.
D.
E.
10.
A.
B. *
C.
D.
E.
11.
A. *
B.
C.
D.
E.
12.
A.
B.
C.
D. *
E.
13.
A. *
B.
C.
D.
E.
14.
A.
B. *
C.
D.
E.
15.
A. *
B.
8. Paralitic chest shape is observed in:
Acute bronchitis
Pneumonia
Bronchopneumonia
Lungs tumor
Exudation pleurisy
9. A Boat-shaped chest is observed in:
rachitis
scoliosis
syringomyelia
tuberculosis
bronchitis
10. Barrel-shaped chest is typical for:
pulmonary tuberculosis
emphysema of the lungs
exudation pleurisy
pneumothorax
acute bronchitis
11. Enlargement of one part of the chest is observed in:
hydrothorax
pneumosclerosis
obstructive atelectasis of the lung
bronchopneumonia
bronchitis
12. Diminished one part of the chest is observed in:
Exudation pleurisy
pneumothorax
bronchopneumonia
pneumosclerosis
pulmonary emphysema
13. Kussmaul respiration is observed in:
diabetic coma
stroke
heart failure
lung failure
pulmonary tuberculosis
14. Lateral curvature of the spine is observed in:
lordosis
scoliosis
kyphosis
rachitis
kyphoscoliosis
15. Cheyne-Stocks respiration is typical for:
acute insufficiency of the brain circulation
pulmonary emphysema
C.
D.
E.
16.
A.
B. *
C.
D.
E.
17.
A. *
B.
C.
D.
E.
18.
A.
B.
C. *
D.
E.
19.
A.
B.
C. *
D.
E.
20.
A.
B.
C.
D. *
E.
21.
A.
B. *
C.
D.
E.
22.
A.
B. *
C.
pneumothorax
bronchial asthma
hydrothorax
16. Increased voice resonance is observed in:
hydrothorax
compression atelectasis
pulmonary emphysema
pneumothorax
pneumothorax
17. Which color of the skin is typical in the patients with aortic regurgitation?
Pale
Peripheral cyanosis
Jaundice
Diffuse cyanosis
Purple
18. Edema of the feet, more pronounced in the evening, acrocyanosis, cold skin over edema are
typical in:
Pericarditis
Glomerulonephritis
Heart failure
Liver cirrhosis
Thyrotoxicosis
19. Cardiac hump is observed in:
Mitral heart valvular disease that arises in 30 years old patient
Aortic aneurism
Congenital heart disease
Pericarditis with effusion
Hydrothorax
20. Which heart chamber takes part in the cardiac beat formation?
Left ventricle
Right ventricle
Left atrium
Right atrium
Left atrium and left ventricle
21. Which color of the skin is typical in the patients with mitral stenosis?
Pale
Peripheral cyanosis
Jaundice
Diffuse cyanosis
Purple
22. In which pathology protrusion of the heart region, leveling of the intercostals spaces are observed
in inspection?
Mitral stenosis
Pericarditis with effusion
Aortic aneurism
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.
D.
E.
29.
A.
B.
C.
D.
E. *
Pulmonary artery stenosis
Tricuspid regurgitation
23. In which pathology apex beat is impalpable?
Right-sided pleurisy with effusion
Right-sided lobar pneumonia
Left-sided lobar pneumonia
Left-sided pleurisy with effusion
Right-sided spontaneous pneumothrorax
24. Which color of the skin is typical in the patients with aortic stenosis?
Pale
Peripheral cyanosis
Jaundice
Diffuse cyanosis
Purple
25. Edema of the lower limbs, more pronounced in the evening is typical in:
Pericarditis
Glomerulonephritis
Heart failure
Liver cirrhosis
Thyrotoxicosis
26. In which pathology pulsation in the jugular fossae is observed?
Mitral regurgitation
Mitral stenosis
Pericarditis with effusion
Myocarditis
Aortic arch aneurism
27. In which pathology apex beat is displaced to the left?
Aortic stenosis
Tricuspid regurgitation
Mitral stenosis
Dry pericarditis
Left-sided pleurisy with effusion
28. Which color of the skin is typical to the patients with cardiogenic shock?
Pale
Peripheral cyanosis
Jaundice
Diffuse cyanosis
Purple
29. Which color of the skin is typical in the patients with infectious endocarditis?
Pale with yellowish tint
Peripheral cyanosis
Jaundice
Diffuse cyanosis
Coffee with milk
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. *
D.
E.
35.
A.
B.
C.
D. *
E.
36.
A.
B. *
C.
D.
30. In which pathology pulsation and protrusion in the second intercostals space to the left of the
sternum can observed?
Aortic stenosis
Combined aortic defect
Tricuspid regurgitation
Aortic regurgitation
Pulmonary hypertension in mitral valve defects
31. In which pathology carotid arteries pulsation is observed?
Mitral stenosis
Aortic stenosis
Tricuspid regurgitation
Aortic regurgitation
Mitral regurgitation
32. In which cardiac disease diffuse cyanosis can be observed?
Essential hypertension
Aortic stenosis
Congenital heart diseases
Mitral regurgitation
Mitral stenosis
33. In which acute condition forced sitting posture, dyspnoea, diffuse cyanosis, hemoptysis are
typical?
Loss of consciousness
Pulmonary artery thromboemolism
Pericarditis with effusion
Cardigenic shock
Edema of the lungs
34. In which pathology protrusion and pulsation in the second intercostals space to the right of the
sternum is observed?
Aortic stenosis
Mitral stenosis
Aortic aneurism
Pericarditis with effusion
Myocarditis
35. In which pathology apex beat is displaced to the left and downward?
Aortic stenosis
Tricuspid regurgitation
Mitral stenosis
Aortic regurgitation
Myocarditis
36. In which pathology protrusion and pulsation in the third-fourth intercostals spaces to the right of
the sternum can be observed?
Mitral regurgitation
Aneurism of the anterior wall of the left ventricle
Mitral stenosis
Aortic stenosis
E.
37.
A. *
B.
C.
D.
E.
38.
A. *
B.
C.
D.
E.
39.
A.
B. *
C.
D.
40.
A.
B.
C.
D. *
E.
41.
A.
B.
C. *
D.
E.
42.
A.
B. *
C.
D.
E.
43.
A.
B. *
C.
D.
E.
44.
A.
Essential hypertension
37. Right border of the relative cardiac dullness is formed by:
Right atrium
Left atrium
Right ventricle
Left ventricle
Aorta
38. Right contour of the heart and vessels is formed by:
Vena cava superior and right atrium
Right ventricle and aorta
Left ventricle and aorta
Left ventricle and pulmonary artery
Right atrium and pulmonary artery
39. Left contour of the heart and vessels is formed by:
Vena cava superior, right atrium, right ventricle
Aortic arch, pulmonary trunk, left ventricle, left atrium C. Pulmonary trunk, left ventricle, left
atrium
Left ventricle, left atrium
Vena cava superior, left atrium, left ventricle
40. Upper border of the relative cardiac dullness is formed by:
Right ventricle
Pulmonary artery
Vena cava
Left atrium
Right atrium
41. Left border of the relative cardiac dullness is formed by:
Left atrium
Right atrium
Left ventricle
Pulmonary artery
Aorta
42. What is the cause of outward displacement of the right border of the relative cardiac dullness?
Coronary heart disease
Mitral stenosis
Aortic stenosis
Aortic regurgitation
Essential hypertension
43. In mitral stenosis, outward displacement of … is observed:
Upper border of the relative cardiac dullness
Upper and right borders of the relative cardiac dullness
Left and right borders of the relative cardiac dullness
Upper, Left and right borders of the relative cardiac dullness
Right border of the relative cardiac dullness
44. In mitral regurgitation, outward displacement of … is observed:
Upper border of the relative cardiac dullness
B.
C.
D. *
E.
45.
A. *
B.
C.
D.
E.
46.
A.
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.
Upper and right borders of the relative cardiac dullness
Left and right borders of the relative cardiac dullness
Upper and left borders of the relative cardiac dullness
Right border of the relative cardiac dullness
45. In aortic stenosis, outward displacement of … is observed:
Left border of the relative cardiac dullness
Upper and right borders of the relative cardiac dullness
Left and right borders of the relative cardiac dullness
Upper, Left, and right borders of the relative cardiac dullness
Right border of the relative cardiac dullness
46. Absolute cardiac dullness is formed by:
Left atrium
Right atrium
Left ventricle
Right ventricle
Aorta
47. Which forced posture of the patient is typical in peritonitis:
Lying with the face up
Lying with the face down
Sitting posture
Knee-elbow posture
On one side
48. Which forced posture of the patient is typical in dry pleurisy:
On healthy side
On affected side
Lying with the face up
Lying with the face down
Sitting posture
49. Forced posture of the patient on affected side is typical in:
Bronchial asthma
Peritonitis
Ribs fracture
Pulmonary abscess
Liver cirrhosis
50. Which face is observed in the patients with heart failure:
Facies Hippocratica
Facies Corvisart’s
Facies leontina
Facies mitrale
Facies basedovica
51. Which face is observed in the patients with thyrotoxicosis:
Facies Hippocratica
Facies Corvisart’s
Facies leontina
Facies mitrale
E. *
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.
D.
E.
58.
A.
B.
C. *
D.
E.
59.
A.
Facies basedovica
52. Which face is observed in the patients with peritonitis:
Facies Hippocratica
Facies Corvisar’s
Facies leontina
Facies mitrale
Facies basedovica
53. What is it pulsus differens:
Difference between pulse rate and heart rate
Different pulse on both radial arteries
Escape of the separate pulse waves
Different volume of the pulse waves
Alternation of large and small pulse waves
54. A normal resting pulse rate in adult is:
60-70 beats per minute
60-80 beats per minute
50-80 beats per minute
65-85 beats per minute
55-85 beats per minute
55. What is it tachycardia:
Large volume pulse
Heart rate more than 80 beats per minute
The full pulse – p. plenus
Heart rate less than 60 beats per minute
Heart rate more than 90 beats per minute
56. What is it bradycardia:
Heart rate more than 80 beats per minute
The full pulse – p. plenus
Large volume pulse
Heart rate less than 60 beats per minute
Heart rate more than 90 beats per minute
57. What is it pulse deficit:
Different pulse on both radial arteries
Difference between pulse rate and heart rate
Escape of the separate pulse waves
Different volume of the pulse waves
Alternation of large and small pulse waves
58. The pulse is firm (p. durus) in:
Hypotension
Aortic stenosis
Hypertension
Bleeding
Collapse
59. A large volume pulse is found in:
Aortic regurgitation
B.
C. *
D.
E.
60.
A. *
B.
C.
D.
E.
61.
A.
B.
C.
D. *
E.
62.
A.
B.
C.
D. *
E.
63.
A. *
B.
C.
D.
E.
64.
A.
B.
C.
D. *
E.
65.
A. *
B.
C.
D.
E.
66.
A.
B.
C. *
D.
Collapse
Profuse vomiting
Profuse diarrhea
Aortic stenosis
60. Decreased volume pulse (p. vacuus) is found in:
Reduced stroke volume due to heart failure
Fever
Anemia
Thyrotoxicosis
Aortic regurgitation
61. Thready pulse (p. filiformis) is found in:
Anemia
Fever
Pregnancy
Shock
Aortic regurgitation
62. What is the name of device for blood pressure measurement:
Pneumotachometer
Oscillometer
Phlebomanometer
Sphygmomanometer
Phonocardiograph
63. To which section of the case history is the complaint of dyspnea entered:
Present complaints
Details of the complaints
Questioning about the organs and systems
Anamnesis morbi
Anamnesis vitae
64. Inheritance linked to the gender is characteristic:
Ulcer disease
Hypertension disease
Diabetes mellitus
Hemophilia
Bronchial asthma
65. Previous diseases are described in the following section:
Anamnesis vitae
Passport part
Questioning about organs and the systems
Present complaints
Anamnesis morbi
66. Which section of the case history is called medical biography:
Present complaints
Passport part
Anamnesis vitae
Anamnesis morbi
E.
67.
A.
B.
C.
D.
E. *
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.
A. *
B.
C.
D.
E.
74.
Asking about the organs and systems
67. A 28-year-old patient complains of a pronounced productive cough, weakness, perspiration,
fatigue, loss of appetite. His main complaint is:
Weakness
Fatigue
Loss of appetite
Perspiration
Productive cough
68. To which section is the complaint of weight loss entered?
Asking about general condition
Present complaints
Anamnesis vitae
Anamnesis morbi
Asking about organs and systems
69. A detailed description of the complaints is entered to the following section:
Asking about organs and systems
Present complaints
Anamnesis _morbi
Anamnesis vitae
Passport part
70. Asking about the systems is started from:
The system the patient complains on
Nervous system
Cardiovascular system
Genitourinary system
Respiratory system
71. In which section of the case history are unhealthy habits described?
Present complaints
Anamnesis morbi
Anamnesis vitae
Asking about organs and systems
Asking about general condition
72. History taking is:
Subjective method
Objective method
Additional method
Laboratory method
Instrumental method
73. « noise of splash » at healthy personse is determine:
Just after food
In 1-3 hours after food
In 3-5 hours after food
In 5-7 hours after food
In 7-10 hoursafterfood
74. Pulse pressure is defined as:
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.
D.
E. *
79.
A.
B.
C.
D.
E. *
80.
A. *
B.
C.
D.
E.
81.
A.
B.
C.
Maximum blood pressure level
Minimum blood pressure level
Difference between SBP and DBP levels
Venous pressure
Average SBP levels
75. What conductivity complex QRS reflects?
Atrioventricular;
Intraatrial;
Intraventricular;
The conductivity of the left Hiss bundle branch;
Conductivity on the right Hiss bundle branch.
76. Which is normal duration of P wave:
0.02-0.03 sec
0.03-0.04 sec;
0.04-0.06 sec;
0.06-0.10 sec;
0.12-0.18 sec.
77. What is the speed of the impulse transmission through AV node?
0.02-0.05 mm / sec;
0.08-0.10 mm / sec;
0.30-0.80 mm / sec;
1.0-2.0 mm / sec;
3.0-4.0 mm / sec.
78. What ECG element reflects impulse pathway in atria?
P-Q segment;
P-Q interval;
P wave;
T wave;
QRS complex
79. What is the speed of the pulse conduction in Hiss bundle branch block?
0.02-0.05 mm / sec;
0.08-0.10 mm / sec;
0.30-0.80 mm / sec;
1.0-2.0 mm / sec;
3.0-4.0 mm/ sec.
80. What ECG element reflects impulse conduction through AV node?
P-Q segment;
P-Q interval;
P wave;
T wave;
QRS complex
81. What ECG element reflects impulse conduction through Hiss bundle branch?
P-Q segment;
P-Q interval;
P wave;
D.
E. *
82.
A.
B. *
C.
D.
E.
83.
A. *
B.
C.
D.
E.
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.
T wave;
QRS complex
82. Which QRS complex duration is normal?
0.02-0.05 sec;
0.06-0.10 sec;
0.16-0.20 sec;
0.21-0.30 sec;
0.30-0.40 sec.
83. Electrical axis of the heart deviation to the left ECG signs:
The highest R wave in lead I, the deepest S wave in lead III;
The highest R wave in lead III, the deepest S wave in lead I;
The deepest S wave in aVR lead;
The highest R wave in lead I;
The highest R wave in lead III.
84. What is normal P-Q interval duration?
0.08-0.10 sec;
0.03-0.04 sec;
0.04-0.08 sec;
0.06-0.10 sec;
0.12-0.18 sec.
85. Electric axis of the heart normal position ECG signs:
The highest R wave in lead I, the deepest S wave in lead III;
The highest R wave in lead III, the deepest S wave in lead I;
The highest R wave in lead I;
The highest R wave in lead II;
The highest R wave in lead III.
86. What is the value of the alpha angle in right axis deviation ECG characteristic?
0 - 30
30 - 70
70 - 90
90 - (+ 180)
0 - (- 180)
87. What is the value of the alpha angle in left axis deviation ECG characteristic?
0 - 30
30 - 70
70 - 90
90 - (+ 180)
0 - (- 180)
88. Right axis of the heart deviation is observed in:
Sinoatrial block;
Intra-atrial block;
Atrioventricular block;
Intraventricular block;
Left posterior His bundle branch block;
89. Left axis of the heart deviation to left to the left rejected when:
A.
B.
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.
Sinoatrial block;
Intra-atrial block;
Atrioventricular block;
Left anterior His bundle branch block;
Left posterior His bundle branch block;
90. Which heart block is characterized by elongation of P-Q interval duration?
Intra-atrial block;
Sinoatrial block;
Incomplete AV block;
Left bundle branch block;
Right bundle branch block.
91. The main sign of His bundle branch block?
Elongation of P-Q interval;
The increase in the QRS complex with deformation;\
The increase in the QRS complex without deformation;
Reducing of the P-Q segment duration;
S-T segment displacement.
92. Primary ECG sign of 1 degree AV block?
The constant increase in the duration of the P-Q interval;
Periodic increase in the duration of the P-Q interval;
Periodic loss of complex QRS;
Periodic loss of complex PQRST;
Permanent increase in QRS duration.
93. Which heart block is characterized by P wave elongation?
Intra-atrial block;
Sinoatrial block;
Incomplete AV block;
Left bundle branch block
Right bundle branch block
94. The main ECG sign of intraventricular block:
Extending the P-Q interval;
The increase in the QRS complex with deformation
The increase in the QRS complex without deformation
Reducing the length of the P-Q segment
S-T segment displacement
Назва наукового напрямку (модуля):
Пропедевтика внутрішньої медицини. Ситуаційні задачі
Опис:
3 курс 5 семестр
Семестр: 5
Перелік питань:
1.
A. *
B.
C.
D.
E.
2.
A.
B. *
C.
D.
E.
3.
A.
B.
C. *
D.
E.
4.
A.
B. *
C.
D.
E.
5.
A.
B.
C.
D. *
E.
6.
A.
B.
C.
D. *
E.
7.
?1. The patient is sitting in bed with his hand supporting the edge of the bed, the legs are lowered
down. This is typical for:
Attack of bronchial asthma
Heart failure
Gastric ulcer
Cholecystitis
Appendicitis
2. The patient is sitting in bed thrown back with his legs lowered down. This is typical for:
Attack of bronchial asthma
Heart failure
Angina attack
Appendicitis
Cholecystitis
3. The patient is in bed with his head thrown back and the legs pressed against the abdomen. This is
the sign of:
Cranial injury
Appendicitis
Meningitis
Cholecystitis
Ulcer disease
4. The patient’s position is forced, he is in knee-elbow position. This is the sign of:
Bronchial asthma attack
Gastric ulcer
Attack of renal colic
Attack of cardiac asthma
Cholecystitis
5. Voice resonance is weak over the lungs, band box sound in percussion, decreased vesicular
respiration. What diagnosis can be suggested?
Exudation pleurisy
Bronchitis
Pneumonia
Pulmonary emphysema
Lung cancer
6. The patient’s position is forced, he is sitting resting his hands against the edge of the chair. There
are numerous whistling rales against vesiculotympanic resonance and weak vesicular respiration all
over the lungs. What diagnosis can be supposed?
Lung cancer
Bronchitis
Pulmonary emphysema
Bronchial asthma
Lung abscess
7. In the right subscapular area from the 7th to the 10th ribs there is dull percussion sound, bronchial
respiration. What diagnosis can be supposed?
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.
12.
A.
B.
C. *
D.
E.
Height of lobar pneumonia
Lung cancer
Lung abscess
Pneumosclerosis
Exudation pleurisy
8. Solitary coarse moist rales are heard over the left apex of the lung against a background of
tympanic sound and amphoric respiration. What diagnosis can be supposed?
Bronchial asthma
Lung cancer
Pneumonia
Bronchitis
Cavity in the lung
9. The patient complains of pain in the left hemithorax, which becomes worse on breathing in. Lung
sound is heard on percussion of the chest. Auscultation demonstrates weak vesicular respiration,
pleura friction rub in the left axiliary area. What diagnosis can be supposed?
Pneumothorax
Exudation pleurisy
Pleuropneumonia
Dry pleurisy
Lung emphysema
10. Dull tympanic sound, weak vesicular respiration and crepitation are heard over the left
hemithorax at the level of 4th-10th interspace. What diagnosis can be supposed?
Lung abscess
Focal pneumonia
Initial stage of lobar pneumonia
Lung edema
Pneumothorax
11. The patient complains of dyspnea on moderate exercise. Acrocyanosis. The ratio of
anteroposterior to transverse size of the chest is 0.92; the voice resonance is weak; the chest is rigid.
The resonance is vesiculotympanic, the respiration is weak vesicular. ERF investigation demonstrates
a “shark’s tooth” curve and abrupt reduction of the ERF parameters What diagnosis can be supposed?
Emphysema
Chronic obstructive lung disease.
Bronchial asthma
Lung cancer
Pneumonia
12. The patient complaints of attacks of difficult breathing especially on breathing out, morning
cough with some mucous sputum. Microscopy of the sputum demonstrates bronchial epithelium,
eosinophils, and Charcot-Leiden crystals. What diagnosis can be supposed?
Emphysema
Chronic obstructive lung disease.
Bronchial asthma
Lung cancer
Pneumonia
13.
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.
A.
B.
13. A smoker complains of cough with moderate sputum discharge. The sound over the lungs is
clear, rigid, vesicular. The rales are disseminated buzzing. Investigation of the sputum demonstrates
bronchial epithelium separately and in aggregates, leukocytes in moderate amounts, Churchman’s
spirals. X-ray demonstrates increased lung picture. Fibrobronchoscopy shows hyperemia and edema
of the bronchial mucosa. ERF has not reveal any ventilation abnormality. What diagnosis can be
supposed?
Emphysema
Chronic obstructive lung disease.
Bronchial asthma
Lung cancer
Pneumonia
14. The patient has tympanic sound on the left of the 2nd and 3rd interspace. X-ray demonstrate a
cavity with horizontal fluid level. Laboratory study demonstrates elastic fibers in the sputum. What
diagnosis can be suggested?
Lung cancer
Bronchial asthma
Pneumonia
Chronic bronchitis
Lung abscess
15. The patient with chronic obstructive lung disease has dyspnea at rest, acrocyanosis. RR at rest is
28/min. Computer spirography demonstrates considerably pronounced disorders of a mixed type
(vital lung capacity 55%, forced expiration volume1 50%, Tiffno’s index 60%). What diagnosis can
be supposed?
Stage 1 respiratory failure.
Stage 2 respiratory failure.
Stage 3 respiratory failure.
Pulmonary emphysema
Pneumosclerosis
16. The patient has a constant fever. On the left side along all lines from the 4th interspace downward
all lines there is intermediate percussion sound, decreased vesicular respiration. What diagnosis can
be suggested?
Initial stage of lobar pneumonia
Exudation pleurisy
Lung cancer
Bronchitis
Pulmonary emphysema
17. On the right over the lungs there is weak voice resonance, tympanic percussion sound, the
respiration is not heard. What diagnosis can be suggested?
Pulmonary emphysema
Pneumothorax
Bronchial asthma
Obstructive bronchitis
Exudation pleurisy
18. There is clear percussion sound and harsh respiration over the lungs is heard. What diagnosis can
be suggested?
Bronchial asthma
Pulmonary emphysema
C. *
D.
E.
19.
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. *
Bronchitis
Pneumonia
Lung cancer
19. The patient’s chest is barrel-shaped, band-box percussion sound and decreased vesicular
respiration is heard. What diagnosis can be suggested?
Acute lobar pneumonia (initial stage)
Acute lobar pneumonia (resolution stage)
Bronchitis
Pulmonary emphysema
Obstructive bronchitis
20. On the left over the chest there is dull percussion sound along the midaxillary line from the 4th
interspace, along the scapular line from the 6th interspace along the vertebral line from the 7th
interspace downwards. It transforms to dulness, over the area of dullness the respiration is not heard.
What diagnosis can be suggested?
Lung carnification
Pneumonia
Lung abscess
Lung cancer
Exudation pleurisy
21. The patient complains of absence of appetite, loss of weight. The body temperature is subfebrile.
In the right subclavicular area there is tympanic sound and amphoric respiration. What diagnosis can
be suggested?
Pneumonia
Cavity
Bronchial asthma
Lung cancer
Exudation pleurisy
22. The right hemithorax delays in respiration: on breathing in the right subclavicular area there is
tympanic sound and amphoric respiration. What diagnosis can be suggested?
Bronchitis
Exudation pleurisy
Pneumothorax
Pulmonary emphysema
Cavity in the lung
23. The patient’s chest is normosthenic. The respiratory motions are symmetrical. The voice
resonance is unchanged. The percussion sound is respiratory. The respiration is rough. What
diagnosis can be suggested?
Bronchitis
Bronchial asthma
Pneumonia
Lung cancer
Lung abscess
24. The patient has an attack of dyspnea. His position is forced; he is sitting resting his hands on the
edge of the bed. The voice resonance over the lungs is weak. What diagnosis can be supposed?
Pulmonary emphysema
Bronchial asthma
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.
D.
E.
29.
A. *
B.
C.
D.
E.
30.
A. *
B.
C.
D.
E.
Kussmaul respiration
atelectasis
Cheyne-Stokes respiration
25. The examination has revealed delay in the act of respiration of the right part of the thorax. What
diagnosis can be supposed?
pneumothorax
hydrothorax
pulmonary emphysema
obturation atelectasis
pneumonia
26. The right part of the thorax is protruding, delays in the act of respiration, the voice resonance is
not observed. The respiration is superficial. The respiratory rate is 32 per min. What diagnosis can be
supposed?
Pneumonia
Hydrothorax, pneumothorax
Pulmonary emphysema
atelectasis
bronchial asthma
27. The chest is asymmetrical, its right half protrudes. The voice resonance downward the middle of
the scapula is weak. What diagnosis can be supposed?
Hydrothorax, pneumothorax
Pulmonary emphysema
atelectasis
pneumonia
cavity in the lung
28. The chest is ball-shaped. The ratio of anterior-posterior size to transverse size is 8.0. The area of
the costal cartilages is thickened. What diagnosis can be supposed?
Asthenic chest
Rachitic chest
Hypersthenic chest
Emphysema chest
Paralytic chest
29. The right part of the thorax protrudes, delays in the act of respiration, the voice resonance is not
heard. The respiration is superficial, 32 per min. What diagnosis can be supposed?
Hydrothorax, pneumothorax
Pulmonary emphysema
Pneumonia
Atelectasis
Cavity in the lung
30. Respiratory movements are interrupted with pauses lasting up to 30 seconds. What diagnosis can
be supposed?
Biots respiration
Cheyne-Stocks respiration
Bronchial asthma
pneumothorax
Kussmaul respiration
31.
A.
B. *
C.
D.
E.
32.
A. *
B.
C.
D.
E.
33.
A.
B.
C.
D. *
E.
34.
A.
B.
C. *
D.
E.
35.
A.
B.
C. *
D.
E.
36.
A.
B.
C. *
D.
E.
37.
31. The left part of the thorax delays in the act of respiration, the voice resonance is increased along
the paravertebral, scapular, posterior-, mid-, and anterior axillary lines downwards the fifth
interspace. What diagnosis can be supposed?
atelectasis
hydrothorax
pneumothorax
Cavity in the lung
Bronchial asthma
32. The patient has dyspnea and cyanosis. The right half of the chest protrudes, delays in the act of
respiration. The voice resonance is decreased downward the middle of the scapula. What diagnosis
can be supposed?
Hydrothorax,
pneumothorax
Cavity in the lung
Pulmonary emphysema
Atelectasis
33. There is dullness over the chest beginning from the 5th rib along the posterior axillary line, from
the 8th rib along the paravertebral line, from the 7th rib along midaxillary line to the lower border of
the lungs. What diagnosis can be supposed?
Pneumonia
Lung infarction
Lung cornification
Exudation pleurisy
Congestion in the lungs
34. There is bandbox sound along the anterior surface of the chest. What diagnosis can be supposed?
Cavity in the lungs
Pneumothorax
Lung emphysema
Incomplete obstructive atelectasis of the lungs
Exudation pleurisy
35. There is tympanic sound from the 2nd rib to the lower border of the lungs on the right side of the
chest. What diagnosis can be supposed?
Pulmonary emphysema
Cavity in the lungs
Pneumothorax
Incomplete obstructive atelectasis
Exudation pleurisy
36. There is tympanic sound from the 7th to the 9th interspace in the left axillary area, the sound is
dull under this area. What diagnosis can be supposed?
Pneumonia
Pulmonary emphysema
Pyopneumothorax
Pneumothorax
Exudation pleurisy
37. There is tympanic sound on the right along the parasternal and midaxillary areas from the 2nd to
the 4th ribs. What diagnosis can be supposed?
A.
B. *
C.
D.
E.
38.
A. *
B.
C.
D.
E.
39.
A.
B.
C.
D.
E. *
40.
A.
B. *
C.
D.
E.
41.
A.
B.
C.
D. *
E.
42.
A. *
B.
C.
D.
E.
43.
A.
Pneumothorax
Cavity in the lungs
Pulmonary emphysema
Pneumonia
Exudation pleurisy
38. The patient aged 41 have suddenly fallen ill after cold. He complains of cough with sputum
discharge, pain in the chest, weakness, and elevated body temperature (390С), loss of appetite.
Fatigue, perspiration. Right-sided pleuropneumonia was diagnosed. What are his main complaints:
Cough with sputum discharge, pain in the chest
weakness
perspiration
perspiration
loss of appetite
39. A patient aged 50 has 8-year history of bronchial asthma. He was admitted with complains on
attacks of shortness of breath with expiratory dyspnea twice a day, perspiration, pain in the chest,
perspiration, fatigue. Which complaints are secondary?
Shortness of breath
Expiratory dyspnea
Headache
Pain in the chest
Fatigue
40. When investigating secondary complains of a 39-year old patient the physician revealed
complaints of insomnia, decreased memory, headache. Which system is involved?
Respiratory
Nervous
Cardiovascular
Digestive
Urinary
41. A 20-year old patient developed edema of the face, pain in the lumbar area 3 days after tonsillitis.
Changes in the urine were revealed. Which system can be involved?
Nervous
Respiratory
Cardiovascular
Genitourinary
Digestive
42. A 53-year-old patient with a 10-year history of hypertension complaints on headache, pain in the
heart. His father and grandfather on the father’s side also have hypertension disease. Which section
of the case history are the type of inheritance and pedigree entered to?
Anamnesis vitae
Present complaints
Asking about organs and systems
Anamnesis vitae
Passport part
43. 73-year-old patient with a 10-year history of coronary artery disease complains of pain in the
precordial area, dyspnea. Which type of dyspnea is typical for heart diseases?
Expiratory
B.
C. *
D.
E.
44.
A.
B.
C.
D. *
E.
45.
A. *
B.
C.
D.
E.
46.
A. *
B.
C.
D.
E.
47.
A. *
B.
C.
D.
E.
48.
A.
B.
C. *
D.
E.
49.
A.
Inspiratory
Mixed
Dyspnea of effort
Fit-like dyspnea
44. A 48-year-old patient with diabetes mellitus complains of itching, dryness in the mouth, increased
appetite, polyuria, weakness. Which is a secondary complaint?
Itching
Dryness in the mouth
Increased appetite
Weakness
Polyuria
45. The father of the 48-year-old patient with hemophilia is also ill with hemophilia. What is the type
of inheritance?
Inheritance linked to the sex chromosome
Autosomal-recessive
Autosomal dominant
Genetic mutations
Polygenic type
46. Which method aid in specifying the role of inheritance in forming the pathology when
questioning the patient with an inherited disease?
Genealogical
Subjective
Objective
Subjective and objective
Specific methods are absent
47. A 64-year-old patient developed a severe retrosternal pain, weakness, nausea, dyspnea, anxiety
after an emotional stress. A diagnosis of acute myocardial infarction was made. What is the main
complaint of the patient?
Retrosternal pain
Nausea
Dyspnea
Weakness
Anxiety
48. The patient, 38 years has arrived with complaints to difficulty of swallowing of firm food,
vomiting, decrease in body weight. In the anamnesis - a poisoning with a alkali. Inspection: pallor
skin, an exhaustion. At superficial palpation the abdomen is soft and painless. What organ defeat it is
possible to think of?
Stomach
Pancreas
Oesophagus
Intestines
Liver
49. The patient, 33 years complaints to a heartburn, a pain in epigastrium that arises right after food,
tarry [currant jelly] stool during 2 days, fainting fit, weakness. In the anamnesis - a stomach ulcer.
Inspection - pallor skin. What complication is it possible to think of?
Perforation
B.
C.
D. *
E.
50.
A.
B.
C. *
D.
E.
51.
A.
B.
C.
D. *
E.
52.
A.
B.
C.
D. *
E.
53.
A.
B. *
C.
D.
E.
54.
A.
Penetration
Malignization
A bleeding
Pilorostenosis
50. Patient Р. 60 years is disturbed heavy sense epigastral site, with disgust for meat food, vomiting
by the food eaten on the eve, decrease in body weight. In the anamnesis - a stomach. Inspection: pallor skin, the expressed growing thin, above left clavicle a dense lymph nod is palpate. Detonation
of abdomen wall in epigastral site is determined. At palpation in epigastral site it is more than
stomach to the left of a median line, palpable formation in the size 3x4 cm. Your previous diagnosis?
Pilorostenosis
Bleeding.
Stomach cancer
Atrophic gastritis
Ulcer
51. The patient, 42 years, complains of dyspnea, increase of abdomen. In the anamnesis - abusing
alcohol. Abdomen inspection – is increased, umbilicus is protruding by formation of a hernia, behind the umbilicus « the head of a jellyfish ». Your diagnostic assumptions?
Flatting
Obesity
Tumor
Ascitis
Cyst
52. The patient, 48 years, complains of weight in right hypochondrium, increase abdomen. During 10
years suffers on chronic persistent hepatitis. At abdomen inspection in vertical position -is
loose-hanging, umbilicus is protruding a little. In horizontal position detonation of lateral
departments abdomen is marked. Your diagnostic assumptions?
Flatting
Obesity
Tumor
Ascitis
Cyst
53. The patient, 70 years has arrived in clinic with complaints on sharp knife-like pain in the top of
the abdomen that has appear after rise heavy. In the anamnesis - a stomach ulcer during 4 years.
Inspection. Position of the patient is forced - lays with the pressed to a breast legs, features are
aggravated, pale skin, covered sticky then. Superficial palpation: the poured pressur of abdomen wall
muscles, sharp painess in epigastral part is marked. What pathology is it possible to think of?
Stomach ulcer exacerbation
Ulcer perforation
Acute cholecystitis
Peritonitis
Bleeding
54. The patient, 35 years complains of a pain in epigastrium, that appears in 30 minutes after food, a
heartburn, decrease of appetite, tarry [currant jelly] stool. The anamnesis. 4 year of stomach ulcer.
The beginning of disease connects with stress, an aggravation during the autumn-spring period.
Inspection tongue is covered by white patch near root. Superficial palpation: moderate plainness in
epigastral part. Your diagnostic assumptions?
Ulcer penetration
B.
C.
D.
E. *
55.
A.
B.
C. *
D.
E.
56.
A.
B.
C.
D. *
E.
57.
A.
B.
C.
D.
E. *
58.
A.
B. *
C.
D.
E.
59.
Ulcer perforation
Ulcer malignization
Peritonitis
Bleeding
55. The patient, 70 years, has arrived in clinic with complaints to a constant pain and sensation of
spreading in paraumbilical site that amplify after reception even a small amount of food. The
simplification comes after vomiting. In the anamnesis - stomach ulcer. Last aggravation about three
months ago. Inspection – skin is dry, the patient of lowered feed, visible peristaltics of stomach in the
form of deep waves which go from left hypochondrium to right is determined. Your diagnosis?
Flatting
Perforation
Pilirostenosis
Ascitis
Tumor of stomach
56. The patient, 19 years, complains on colicky [cramping] pain that arises after fat food and attend
by heartburn, an eructation sour. Objectively: tongue is densely imposed white patch. At palpation –
moderate painness in epigastrium. Your diagnosis?
Atrophy gastritis
Stomach ulcer
Calculous cholecystitis
Chronic gastritis
Pilorostenosis
57. Patient, 35 years, complains of a pain in epigastrium that arises shortly after food, faintness. An
eructation, stool instability. Diseases developed gradually, first attributes has been appears about
three years ago. Inspection: patient is satisfactory fatness, tongue is imposed white patch, crude with
reflections teeth on edges. Moderate palpatory tenderness is defined at epigastric region. Your
previous diagnosis?
Acute gastritis
Chronic cholecystitis
Stomach ulcer
Chronic pancreatitis
Chronic gastritis
58. The patient, 39 years, complains of frequent liquid excrements (till 10-12 time on times) with an
impurity of slime and blood, decrease in body weight of 4 kg for last year. Marks itself ill about one
year. Repeatedly inspected in the infectious hospital where diagnoses of sharp infectious diseases
have been removed. At inspection: patient is sharply lowered fatness, skin is flabby, dry. The
abdomen is soft, palpation in left iliac region is sharply painful. In excrements insignificant amount
of rare contents with an impurity of blood. What organ defeat is it possible to think of ?
Stomach
Sigmoid colon
Liver
Transversus colon
Cecum
59. Patient Р. 66 years Disturbs the heavy feeling in the epigastral region, disgust for meat food,
decrease in body weight. In the anamnesis atrophyc gastritis. Inspection: pallor skin, expressed
weight loss, the dense lymph node is palpable above left clavicular. Detonation of a abdomen wall in
epigastral region. Blunt painess is define in epigastral region during palpation. Percussion - big
curvature of the stomach is below the umbilicus about 2 sm. Your previous diagnosis?
A.
B.
C. *
D.
E.
60.
A.
B. *
C.
D.
E.
61.
A. *
B.
C.
D.
E.
62.
A.
B.
C.
D. *
E.
63.
A.
B.
C. *
D.
Pilorostenosis
Bleeding
Cancer of the stomach
Atrophic gastritis
Ulcer of the stomach
60. Patient D. 50 years has arrived with complaints on heavy and sensation of completeness in
epigastral region that amplify after food, an eructation rotten, and also the food eaten on the eve. The
simplification comes after vomiting. In the anamnesis - a stomach duodenal ulcer during 10 years.For
last month has weight loss about 3 kg.Inspection. The lowered feed}, dry skin, cheilitis, tongue is
covered by white patch. Superficial palpation of the abdomen: the abdomen is a little swell, painful in
epigastral region is determine. Percussion of the abdomen: «splashing» noise above epigastral region,
the lower border of the stomach is on 2-3 sm below umbilicus. What complication of a stomach ulcer
has arisen in the patient?
Penetration
Pilorostenosis
Perforation
Bleeding
Malignization
61. The patient, 45 yeasr has in anamnesis the stomach ulcer, has suddenly felt „knife-like» pain in
epigastral region that irradiates to wright scapula, and then extended in the right half of the abdomen.
The pain has accompanied by reusable vomiting. Inspection: position of the patient - laying with
knees led to the trunk, breath is superficial, features are aggravated. Palpation of the abdomen plank-buttress.Percussion of the lateral region - dullness.Shchetkin-Blumberg symptom is positive.
Your diagnosis?
Perforatsion
Penetration
Malignization
Bleeding
Pylorostenosis
62. The patient, 30 years delivered to the admition dep. with complaints of the general weakness,
fainting, palpitation. The anamnesis. The heartburn during one year that arises just after the meal,
especially sour or sharp, that accompanies by epigastral pain. Becomes ill sharply when suddenly has
quickly lost consciousness (works on construction). Inspection.Pale skin, АP-80/50 Hg, pulse - 120
per minute, weak filling and a pressure. Tones of the heart are weakened, rhythmic, systolic noise on
the top. Palpation of the abdomen – moderate painess in the epigastrium Abdomen is soft, symptoms
of peritoneum irritation are absent. Your previous diagnosis?
Perforatsion
Penetration
Malignization
Bleeding
Pylorostenosis
63. The patient, 33 years, has arrived in surgical branch with complaints of the pain in right side of
the abdomen. Hurt occurrence he connects with the use of sharp and rough food. Pain in the right
iliac region has been revealed during palpation and percussion. Your previous diagnosis?
Acutecholecystitis
Acute gastritis
Acute appendicites
Stomach ulcer
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. *
68.
A.
B.
C.
D.
E. *
69.
Enterocolitis
64. The patient, 22 years, has arrived in surgical branch with complaints of intensive pain in right
side. Painful palpation of the abdomen in right iliac region, painful palpation of Mac-Burneus
point.Your previous diagnosis?
Acute cholecystitis
Acute gastritis
Acute appendicitis
Stomach ulcer
Enterocolitis
65. The patient, 76 years, complains of constants constipation, a swelling of the abdomen, a periodic
pain in the left side. At the palpation - sigmoid colon is dense, painful, its surface unequal, hilly.
Your previous diagnosis?
Sigmoiditis
Colitis
Dysentery
A malignant new growth
Plenty gases accumulation
66. The patient, 78 years, complains of a pain in the left side. In the anamnesis - constopation during
many years. Last defecation was 1 week ago. At palpation the blind gut is considerably increased at
the rate, dense, painful, does not hum, with a corpulent surface. Your previous diagnosis?
Appenditsitis
Plenty cal mass accumulation
Tuberkulesis
A malignant new growth
Plenty gases accumulation
67. In patient K., 50 years old, bronchial asthma is diagnosed. Describe, please, data of percussion
during the attack of bronchial asthma:
Thympanic sound over the lungs, displacement of lower lung borders downwards, restriction of their
mobility, rising of lungs apexes;
Dull sound over the lower lungs lobes, displacement of lower lung borders upwards, , restriction of
their mobility, decreased dimensions of lungs apexes;
Hyperresonant (bandbox) sound over the lungs, displacement of lower lung borders upwards, ,
restriction of their mobility, decreased dimensions of lungs apexes;
There are no chances.
Hyperresonant sound over the lungs, displacement of lower lung borders downwards, restriction of
their mobility, rising of lungs apexes;
68. In patient K., 50 years old, bronchial asthma is diagnosed. Describe, please, data of auscultation
during the attack of asthma:
Harsh respiration, diffuse dry whistling rales;
Harsh respiration, moist fine rales;
Weakened vesicular breathing, crepitation over the lower lungs borders;
Respiration is absent over the left lower lung lobe.
Weakened vesicular breathing, diffuse dry whistling rales;
69. Patient L, 60 years old, suffers from bronchial asthma for 10 years. Data of examination: dyspnea
in rest, barrel-like chest, hyperresonant sound is heard by percussion over the lungs. By auscultation
weakened respiration with dry diffuse reales are obtained. Which findings should be expected to find
on patient’s spyrogram?
A.
B.
C.
D.
E. *
70.
A.
B.
C.
D.
E. *
71.
A.
B.
C.
D.
E. *
72.
A.
B.
C.
D.
E. *
73.
A.
B.
C.
D.
E. *
74.
Decreased vital lungs capacity, Tiffneu’s index and FEV1 are not changed;
Vital lungs capacity is not changed,
Decreased vital lungs capacity, Tiffneu’s index and VFE1, inspiratory reserve volume,
Decreased total lungs capacity.
Decreased vital lungs capacity, Tiffneu’s index and FEV1, expiratory reserve volume;
70. Patient Т, 62 years old, suffers from bronchial asthma for 5 years. Attacks of expiratory dyspnea
occur everyday, but attacks are not prolonged. There are episodes of noctural dyspnea about 1 for a
month. Which course of the disease does the the patient have?
Intermittent,
Moderate persistant,
Severe persistant,
No any one.
Mild persistant,
71. Patient Т, 62 years old, suffers from bronchial asthma for 15 years. Attacks of expiratory dyspnea
occur everyday, the attacks are released by beta-agonists. There are episodes of noctural dyspnea
about 1 for a week. Which course of the disease does the the patient have?
Intermittent,
Mild persistent,
Severe persistent,
No any one
Moderate persistent,
72. A patient complains of severe expiratory dyspnea, paroxysmal dry cough, general asthenia. This
condition lasts for 28 hours. Within this period the patient used Salbutamol (6-8 inhalations
everyday) with no effect. Data of examination: the patient is staying and leaning against
window-still, diffuse cyanosis and swelling of neck veins are observed, distant weezes are heard, by
percussion hyperresonant sound is heard, by auscultation – weakened vesicular breathing, prolonged
expiration, difuse dry wistling rales. What condition has developed in the patient?
Attack of bronchial asthma;
Exacerbation of chronic bronchitis;
Attack of cardiac asthma,
Right-ventricular acute heart failure.
Severe exacerbation of bronchial asthma (status asthmaticus)
73. Patient A., 38 years, complains of cough with expectoration of smal amount of liquid white
sputum. The cough is observed for the recent 5 days. The patient never develop the same symptoms
before. Data of inspection: body temperature is 37,4°C, respiratory rate is 18 per minute. Vocal
fremitus and percutory sound are not changed. At auscultation harsh breathing and dry rales are
heard. What disease should you suspect in the patient?
Bronchial asthma;
Chronic bronchitis, phase of exacerbation;
Pneumonia;
Bronchiectatic disease.
Acute bronchitis;
74. Patient C., 60 years old, complains of cough with expectoration of viscous purulent sputum in the
morning, general weakness, ferver (38-39° C). The sputum is better discharged when the patient is
lying on the right side. He suffers from chronic bronchitis during 15 years, within the last years he
started to expectorate larger amount of permanently green sputum. Data of objective examination:
“Hippocrat’s (clubbing) fingers "; harsh vesicular breathing is heard above the lungs, fine moist rales
are heard in intrascapular region. What is your diagnosis?
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.
D.
E. *
79.
Bronchial asthma;
Acute bronchitis;
Chronic bronchitis, phase of exacerbation;
Pneumonia;
Bronchiectatic disease.
75. Patient S. suffers from chronic bronchitis. During spirographic examination index FEV1 (forced
inspiration volume) is 47% of vital lung capacity. Define, please, the type of respiratory
insufficiency.
Restruclive,
Mixed,
Residualve,
No any respiratory insufficiency.
Obstructive,
76. Patient Т. suffers from pulmonary disease for the recent 2 years. Data of anamnesis: 2 years ago
the patient developed pneumonia, after antibioticotherapy he periodically noticed rising of body
temperature and expectoration of mucopurulent sputum. Now the patient complains of permanent
fever (it lasts for 1 month), cough with periodical expectoration of large amount (0,5-1 liter) of
purulent sputum. What diagnosis is possible in the patient?
Lung cancer;
Pneumonia;
Sepsis;
Acure lung abscess.
Chronic lung abscess;
77. Patient Т. suffers from pulmonary disease for the recent 2 years. Data of anamnesis: 2 years ago
the patient developed pneumonia, after antibioticotherapy he periodically noticed rising of body
temperature and expectoration of mucopurulent sputum. Now the patient complains of permanent
fever (it lasts for 1 month), cough with periodical expectoration of large amount (0,5-1 liter) of
purulent sputum. What method of examination is the most informative in diagnostics of the disease?
Blood count;
Analysis of sputum;
Plain X-ray examination;
ECG.
Computer tomography;
78. Patient А. suffers from chronic obstructive bronchitis for recent 20 years. Now he complains of
dyspea, cough with expectoration of mucopurulent sputum mostly in the morning, feeling of
heaviness in the right hypohondrium, edema on the legs. Data of examination: the patient is in
position of orthopnea, swelling of neck veins and diffuse cyanosis are detectible. What complication
of chronic bronchitis developed in the patient?
Pleurisy;
Lung cancer;
Bronchial obstruction;
Acute left-ventricular heart failure.
Chronic right-ventricular failure;
79. Patient A., 38 years old, complains of cough with expectoration of little quantity of liquid
sputum. The cough is observed for the recent 5 days. Data of inspection: body temperature is 37,4°C,
respiratory rate is 18 per minute. Vocal fremitus and percutory sound are not changed. At
auscultation harsh breathing is heard. What disease should you suspect in the patient?
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. *
84.
A.
B.
C.
Acute purulent bronchitis;
Acute hemorrahgic bronchitis;
Acute necrotic bronchitis;
Chronic bronchitis in exacerbation phase.
Acute catarrhal bronchitis;
80. Patient C., 60 years old, complains of cough with expectoration of viscous purulent sputum in the
morning, general weakness, ferver (38°C). He suffers from chronic bronchitis during 15 years. Data
of objective examination: “Hippocrat’s (clubbing) fingers ", harsh breaming is heard above the lungs,
fine moist rales are heard in intrascapular region. Bronchiectatic disease is suspected in the patient.
Which methods of examination are necessary for diagnosis?
Urianalysis, X-ray, total blood count;
Total blood count, , analysis of sputum;
Plane X-ray, analysis of sputum, lung biopsy;
Biochemical blood analysis, ultrasonic examination of the chest.
Total blood count, X-ray, spyrography, analysis of sputum;
81. Patient R. presents at the moment complaints on dyspnea, cough with expectoration of
mucopurument sputum, fever. Data of inspection: respiratory rate is 28 per min, diffuse cyanosis is
present as well as participarion of additional muscles in respiration. Which syndrome is present in
this case?
Consolidation of pulmonary tissue;
Accumulation of fluid in pleural cavity;
Cavity in the lungs;
Accumulation of air in pleural cavity.
Respiratory insufficiency;
82. During inspection a patient is sitting in orthopnoe position, patient’s skin is cyanotic, the chest is
of barrel-like shape; data of auscultation: weakened vesicular breathing, dry high-pitched rales are
heard over the entire chest. What pathological process is possible in the patient?
Accumulation of viscous mucus in bronchi;
Accumulation of liquid in pleural cavity;
Pulmonary emphysema;
Accumulation of liquid sputum in bronchi.
Bronchial obstruction;
83. A patient complains of cough, fever, dyspnea, pierching pain in the lover part of the right lung
during cough and deep breathing. Lagging of one half of the chest is observed during respiration
while dull percutory sound is obtained by percussion of the chest. Lobar pneumonia was diagnosed in
the patient. Select, please, data of palpation that might be present in this case.
Intensifiesd vocal fremitus on both sides of the chest,
Weakened vocal fremitus on both sides of the chest,
Weakened vocal fremitus on the affected side,
Absent vocal fremitus on the affected side.
Intensified vocal fremitus on the affected side,
84. Patient S., 30 years old, has applied for medical care because of periodic nausea and vomiting,
heatburn, constipation, pain in epigastric region after meals. Gastritis was diagnosed by a doctor.
What additional method of examination is the most informative in diagnostics?
General blood test;
Coprogram;
Stomach X-rays;
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.
C.
D.
E. *
90.
Examination of stomach contents.
Esophagogastroduodenoscopy;
85. Patient S., 30 years old, has applied for medical care because of periodic nausea and vomiting,
heatburn, constipation, pain in epigastric region after meals. Erosive gastritis was diagnosed during
endoscopic examination. Data of CBC: hypochromic anemia? Whike objectively there are no signs
of gastrointestinal bleeding. What additional method of examination is the most informative in
diagnostics of blood loss?
Complete blood count;
Coprogram;
Stomach X-rays;
Examination of stomach contents.
Gregersen’s test;
86. A patient, 45 years old, was delivered by an ambulance to the admitting office with complaints of
general weakness, dizziness, noize in the ears. Blood pressure usualy is about 140-150/80 vv Hg/
Blood pressure at the moment of examination is 190/120 mm Hg. Woman suffers from hypertonic
disease for the last 2 years. What diagnosis is possible in this case?
Coma,
Collapse,
Sopor,
Myocardial infarction.
Hypertonic crisis,
87. A patient, 63 years old, had elevated blood pressure aout 170/90 mm Hg during the last 3 years.
Diagnosis is: hypertension, II stage. Which disorder is typical for this stage?
Renal failure,
Retinal hemorrhage,
Brain stroke,
Myocardial infarction.
Hyperthrophy of the left ventricle,
88. A patient, 26 years old, complains of neck thickness, elevation of blood pressure, irritability,
insomnia. Thyroid gland is enlarged, homogenous. Eyes are protruded. Tremor of fingers is
detectible. Blood pressure is 180/90 mm Hg. What type of hypertension does the patient have?
Renal,
Hemodynamic,
Cerebral.
Essential,
Endocrine,
89. A patient, 26 years old, complains of elevation of blood pressure, irritability, insomnia, periodical
headache. All the symptoms had developed after brain commotion 2 years before. Blood pressure is
180/90 mm Hg. What type of hypertension does the patient have?
Essential,
Endocrine
Renal,
Hemodynamic,
Cerebral.
90. A patient, 26 years old, complains of elevation of blood pressure, pain in lumbar region,
discharge of urine like meat wastes, fever. All the symproms developed 3 weaks after streptococcal
tonsillitis. Blood pressure is 220/110 mm Hg. What type of hypertension does the patient have?
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. *
Essential,
Endocrine,
Hemodynamic,
Cerebral.
Renal,
91. A patient, 26 years old, complains of elevation of blood pressure, pain in lumbar region,
discharge of urine like meat wastes (cola-coloured) and fever. All the symproms developed 3 weaks
after streptococcal tonsillitis. Blood pressure is 220/110 mm Hg. In life history there were no any
eisodes of renal impairment. Which disease is likely present in the patient?
Essential hypertension,
Acute pyelonephritis.,
Chronic pyelonephritis,
Acute glomerulonephritis.
Chronic glomerulonephritis,
92. In patient B., 48 years old, attacks of retrosternal pain become more intensive, pain occurred
periodically even in rest. Nitroglycerin was effective in releasing of pain. ECG recorded at the top of
attack reflected transient ST segment elevation in chest leads. There were no changes in the
biochemical analysis of blood serum (troponins, myoglobin). Which at diagnosis among presented
below is the most likely present for the patient?
Spontaneous angina pectoris,
Primary angina pectoris at exertion,
Acute anterior myocardial infarction,
Acute posterior myocardial infarction.
Progressing angina pectoris at exertion,
93. In patient D., 46 years old, retrosternal pain occured first time in his life. Pain developed after
physical exertion and was localised behind the lower third of the sternum. Data of ECG: depression
of ST segment more than on 2 mm in ІІ, ІІІ, аVF. There are no changes in the biochemical blood
serum tests (troponins, myoglobin). Which at diagnosis among presented below is the most likely
present for the patient?
Spontaneous angina pectoris,
Progressing angina pectoris at exertion,
Acute anterior myocardial infarction,
Acute posterior myocardial infarction.
Primary angina pectoris at exertion,
94. In patient L., 44 years old, severe attack-like pain developed 1,5 weeks ago. Pain was localized in
the low jow, its duration was about 5-20 min. Later attacks become more frequent, to 10 times a day.
Usage of analgethics and spasmolithics was not effective, but patient’s condition benefitds after
intake of 3 tables of nitroglycerin. Which at diagnosis among presented below is the most likely
present for the patient?
Spontaneous angina pectoris,
Progressing angina pectoris at exertion,
Acute anterior myocardial infarction,
Acute posterior myocardial infarction.
Primary angina pectoris at exertion,
95.
A.
B.
C.
D.
E. *
96.
A.
B.
C.
D.
E. *
95. Patient N., 49 years old, was admitted to cardiologic departament with complaints of retrosternal
pain which has occur at first about 1 hour ago after physical exertion. Pain irradiared to the left
scapula, left half of the neck and left arm. Usage of nitroglycerin didn’t decrease intensity of pain.
ECG-findings: depression of ST segment and inversion of T wave in V3-V5. Troponins T and G
level in the blood, activity of creatininphosphokynase MB-fraction is above the norm. What can you
syspect in the patient?
Exertional angina pectoris,
Hypertonic crisis,
Non-exertional angina pectoris,
Variant angina pectoris.
Myocardial infarction,
96. Patient B., 63 years old, complains of retrosternal pain at fast walk on the distance 500-600 m and
when he is going upstears on 2 floors an more. . What functional class of angina pectoris does the
patient have?
II,
III,
IV,
No any one.
I,