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11
General questions in surgery (situational task) 6 course
Опис:
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Перелік питань:
Complaints of cough with purulent sputum, increased body temperature to 39°C, pain in the left
half of the chest. Has been ill for 2 weeks, the onset is caused by undercooling. The lag of the left
half of the chest during breathing, lung sounds by percussion, by auscultation crackling rales over
the lower lobe of the left lung. On X-ray of the chest expressed infiltration of lung tissue with areas
of enlightenment in the center. What is the primary diagnosis?
Abscessing pneumonia.
Pleural empyema.
Acute lung abscess.
Pyopneumothorax.
Bronchiectatic disease.
Complaints of cough with purulent sputum, increased body temperature to 39°C, pain in the left
half of the chest. Has been ill for 2 weeks, the onset is caused by undercooling. The lag of the left
half of the chest during breathing, the shortening of percussion sound over the lower lobe, by
auscultation weakened breathing with amphoric sound, crackling rales. On X-ray of the chest
expressed infiltration of lung tissue with enlightenment in the center with fluid level. What is the
primary diagnosis?
Acute lung abscess.
Pleural empyema.
Abscessing pneumonia.
Pyopneumothorax.
Bronchiectatic disease.
Complaints of cough with purulent sputum, increased body temperature to 39°C, pain in the left
half of the chest. Has been ill for 2 months, the onset is caused by undercooling. The lag of the left
half of the chest during breathing, the shortening of percussion sound over the lower lobe, by
auscultation weakened breathing with amphoric sound. On X-ray of the chest the destruction cavity
with the fibrous capsule in the projection of lower lobe of the left lung, infiltration of lung tissue is
not determined. What is the primary diagnosis?
Chronic lung abscess.
Pleural empyema.
Acute lung abscess
Abscessing pneumonia.
Pyopneumothorax.
Complaints of cough with purulent sputum, increased body temperature to 39°C, pain in the left
half of the chest. Has been ill for 2 weeks, the onset is caused by undercooling. The lag of the left
half of the chest during breathing, the shortening of percussion sound over the lower lobe, by
auscultation weakened breathing with amphoric sound. On the X-ray of chest the destruction cavity
with the fluid level, with a clear thin-walled capsule in the projection of the lower lobe of the left
lung. Infiltration of lung tissue is not determined. What is the primary diagnosis?
Suppurative cyst of the lung.
Pleural empyema.
Acute lung abscess
Abscessing pneumonia.
Pyopneumothorax.
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Complaints of cough with purulent sputum, increased body temperature to 39°C, pain in the left
half of the chest. Has been ill for 2 weeks, the onset is caused by undercooling. The lag of the left
half of the chest during breathing, over the left lobe a dull percussion sound, by auscultation the
breathing is absent. On X-ray of the chest the shadow in the basal parts of the left lung with an
oblique upper level along Damuazo's line. What is the primary diagnosis?
Pleural empyema.
Acute lung abscess
Chronic lung abscess.
Suppurative cyst of the lung.
Pyopneumothorax.
Complaints of cough with purulent sputum, increased body temperature to 39°C, pain in the left
half of the chest, dyspnea. Has been ill for 2 weeks, the onset is caused by undercooling. The lag of
the left half of the chest during breathing, the shortening of percussion sound over the lower lobe,
by auscultation the breathing is absent. On X-ray of the chest the shadow in the basal parts of the
left lung with a horizontal fluid level and enlightenment over it. Is visible the edge of collapsed
lung. What is the primary diagnosis?
Limited pyopneumothorax.
Acute lung abscess
Chronic lung abscess.
Pleural empyema.
Total pyopneumothorax.
Complaints of cough with foul-smelling purulent sputum with streaks of blood, increased body
temperature to 40°C, pain in the left half of the chest, dyspnea at rest. Has been ill for 2 weeks, the
onset is caused by undercooling. The lag of the left half of the chest during breathing, with a
shortening of the pulmonary percussion sound, by auscultation moist rales over the left lung. On
X-ray of the chest expressed infiltration of the left lung with multiple sites of destruction. What is
the primary diagnosis?
Gangrene of the lung.
Pleural empyema.
Acute lung abscess
Abscessing pneumonia.
Pyopneumothorax.
Complaints of cough with foul-smelling purulent sputum with streaks of blood, increased body
temperature to 40°C, pain in the left half of the chest, dyspnea at rest. Has been ill for 2 weeks, the
onset is caused by undercooling. The lag of the left half of the chest during breathing, with a
shortening of the pulmonary percussion sound, by auscultation moist rales over the lower lobe of
the left lung. On X-ray of the chest expressed infiltration of left lung tissue with a giant cavity in
the lower lobe with the level of the fluid. What is the primary diagnosis?
Gangrenous abscess of lung.
Pleural empyema.
Acute lung abscess
Abscessing pneumonia.
Gangrene of the lung.
Complaints of cough with purulent sputum, increased body temperature to 39°C, pain in the left
half of the chest. Has been ill for 2 weeks, the onset is caused by undercooling. The lag of the left
half of the chest during breathing, the shortening of percussion sound over the lower lobe, by
auscultation weakened breathing. On X-ray of the chest paracostal fusiform shadow in the
projection of the left lower lobe of the lung. What is the primary diagnosis?
Limited empyema.
Wide-spread pleural empyema.
C.
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Acute lung abscess
Chronic lung abscess.
Pyopneumothorax.
In the patient on the fourth day after the chest trauma on X-ray - heterogeneous shadow in the
lower lobe. By puncture received a small amount of light yellow fluid with blood clots. What
treatment are the best for the patient?
Drainage of the pleural cavity
Operational - lung decortication
Daily puncture
Resorbed therapy
Antibacterial therapy
In the patient, 48 years old, on the seventh day after the onset of a moderate pain in the chest,
severe cough, fever to 39°C appeared the bad-smell sputum. The patient's condition remains grave,
with expectoration more than 600 ml of gray-green sputum, and hectic fever. On X-ray – on the
background of the heterogeneous shadow of the lower lobe of right lung revealed a cavity with a
horizontal level of fluid. What is the primary diagnosis?
Abscess of the right lung
Gangrene of the right lung
Acute abscess of the right lung
Suppuration cyst of the right lung
Suppuration tuberculous cavern
In the patient, 35 years old, during the physical exertion appeared severe pain in the left half of the
chest. Objectively: the patient is covered with cold sweat, dyspnea, pain during inspiration. By
auscultation: vesicular breathing on the right side, on the left - is absent. Tachycardia, pulse 100
beats/min. What is the primary diagnosis?
Spontaneous pneumothorax
Angina pectoris
Acute myocardial infarction
Left-sided pleurisy
Pneumonia
The patient A., age 37, entered with complaints of cough with purulent sputum to 150 ml per day,
pain in the right half of the chest, fever to 38°C. Has been ill for two weeks. The day before the
entrance to the clinic during cough attack expectorated to 300 ml of purulent bad-smell sputum. On
examination: a shortening of the pulmonary percussion sound under the right scapula, and the
weakening of vesicular breathing. What is the primary diagnosis?
Acute lung abscess
Acute bronchitis
Exacerbation of chronic abscess
Exacerbation of bronchoectatic disease
Pleural empyema
Patient A., aged 42, had been treated for two months for an acute abscess of the upper lobe of right
lung without improvement. The treatment: intramuscular injection of antibiotics, sulfanilamidns
drugs. Remains the cough with purulent sputum to 80-100 ml per day, fever (37,6°C). What is the
primary diagnosis?
Chronic lung abscess
Acute abscess of the right lung
Tuberculous cavern
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Peripheral lung cancer
Suppurative cyst of lung
The patient, 78 years old, entered with complaints of pain in the left half of the chest, coughing,
with daily 80 ml of mucopurulent sputum, fever to 37,2°C. The X-rays of the lower lobe of right
lung revealed a cavity with irregular internal border and outside spicules with minor infiltration
around. What is the primary diagnosis?
Hollow form of lung cancer
Chronic lung abscess
Suppuration cyst of lung
Fibro-cavernous tuberculosis
Limited empyema
The patient has a pyogenic lung abscess, which was complicated by repeated bleeding., The patient
is undergoing the operative treatment. What antibiotics are the most suitable for preoperative
prophylaxis?
Cephalosporins.
Penicillin.
Macrolides.
Aminoglycosides.
Fluorohinolones.
The patient with bilateral hydrothorax has undergone the repeat pleural puncture of both sides.
After the last puncture felt the deterioration, fever, pain in the chest. Therapeutist on the next day
during pleural puncture on the right obtained the pus. What is the mechanism of acute right-side
empyema?
Contact-aspirating.
Lymphogenous.
Hematogenous.
Implantation.
Airborne.
The patient has the pyogenic lung abscess, which was complicated by bleeding. What medicines
are the most suitable to stop the bleeding?
Vitamin K.
Anticoagulants.
Antibiotics.
Antiaggregants.
Prostaglandins.
The patient has the lung abscess, which was complicated by bleeding. What medicines are the most
suitable to stop the bleeding?
Dicynon.
Heparin.
Penicillin.
Courantil.
Alprostan.
The patient has the lung abscess, which was complicated by bleeding to 200 ml. How this bleeding
is classified?
I degree
0 degree
II degree
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III degree
IV degree
The patient received chest trauma 2 hours ago. Complains of the severe pain in the right half of
the chest, dyspnea at rest. On examination: the lag of the right half of the chest during breathing,
crepitation along the V-VI ribs on the right side, by percussion - tympanic sound, by auscultation breathing is absent. What is the primary diagnosis?
Closed chest trauma. Fractures of V-VI ribs on the right side. Posttraumatic pneumothorax.
Closed chest trauma. Fractures of V-VI ribs on the right side.
Closed chest trauma. Fractures of V-VI ribs on the right side. Posttraumatic hemothorax.
Closed chest trauma. Fractures of V-VI ribs on the right side. Posttraumatic subcutaneous
emphysema.
Closed chest trauma. Fractures of V-VI ribs on the right side. Posttraumatic complicated
hemothorax.
The patient received chest trauma 2 hours ago. Complains of the severe pain in the right half of
the chest, dyspnea at rest. On examination: the lag of the right half of the chest during breathing,
crepitation along the V-VI ribs on the right side, by percussion - tympanic sound, by auscultation breathing is absent. The primary diagnosis: Closed chest trauma. Fractures of V-VI ribs on the right
side. Posttraumatic pneumothorax. What is the typical treatment of rib fracture?
Novocaine block
External fixation of ribs
Intrmedullary costal osteosynthesis;
Mechanical ventilation with positive end-expiratory pressure
Thoracotomy
The patient received chest trauma 2 hours ago. Complains of the severe pain in the right half of
the chest, dyspnea at rest. On examination: the lag of the right half of the chest during breathing,
crepitation along the V-VI ribs on the right side, by percussion - tympanic sound, by auscultation breathing is absent. The primary diagnosis: Closed chest trauma. Fractures of V-VI ribs on the right
side. Posttraumatic pneumothorax. What is the treatment of pneumothorax?
Pleural drainage
Pleural puncture
Thoracotomy
Pneumonectomy, bilobectomy, lobectomy
Conservative treatment
The patient received chest trauma 2 hours ago. Complains of the severe pain in the right half of
the chest, dyspnea at rest. On examination: the lag of the right half of the chest during breathing,
crepitation along the V-VI ribs on the right side, by percussion - tympanic sound, by auscultation breathing is absent. The primary diagnosis: Closed chest trauma. Fractures of V-VI ribs on the right
side. Posttraumatic pneumothorax. Where the drainage of pleural space in pneumothorax is
performed?
II intercostal space, midclavicular line
II intercostal space, scapular line
IV intercostal space, anterior axillary line
VII intercostal space, midclavicular line
VII intercostal space, scapular line
The patient received chest trauma 14 days ago. Complains of a moderate pain in the right half of
the chest, dyspnea, fever up to 38,5°C. Lag of the right half of the chest during breathing, narrowing
of the intercostal spaces. By percussion - a shortening of the percussion sound over the right lung,
by auscultation - weakening of breathing. What is the primary diagnosis?
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Right-side suppurative hemothorax.
Right-side posttraumatic pneumonia.
Right-side hemothorax.
Right-side pyopneumothorax.
Consolidated rib fractures.
Was pressed by the truck to the wall. Complains of the expressed dyspnea, difficult breathing, chest
pain. On examination the expressed cyanosis. The frequency of respiratory movements - 26-28 per
1 min. Unstable hemodynamics. The chest is deformed, abnormal mobility of the front wall. The
swelling of soft tissues of the neck with crepitation. What is the primary diagnosis?
Mediastinal emphysema.
Posttraumatic pneumothorax.
Posttraumatic hemothorax.
Posttraumatic pneumonia
Subcutaneous emphysema.
Was pressed by the truck to the wall. Complains of the expressed dyspnea, difficult breathing, chest
pain. On examination the expressed cyanosis. The frequency of respiratory movements - 26-28 per
1 min. Unstable hemodynamics. The chest is deformed, abnormal mobility of the front wall. The
swelling of soft tissues of the neck with crepitation. The primary diagnosis: Mediastinal
emphysema. What is the treatment of mediastinal emphysema?
Drainage of anterior mediastinum
Conservative treatment
Drainage of pleural cavity
Novocaine block
Pericardial puncture
Was pressed by the truck to the wall. Complains of the expressed dyspnea, difficult breathing, chest
pain. On examination the expressed cyanosis. The frequency of respiratory movements - 26-28 per
1 min. Unstable hemodynamics. The chest is deformed, abnormal mobility of the front wall. The
swelling of soft tissues of the neck with crepitation. The primary diagnosis: Mediastinal
emphysema. What is the main cause of mediastinal emphysema?
Disruptions of trachea, bronchi
Rib fracture
Pneumothorax
Hemothorax
Mediastinal tumours
Was pressed by the truck to the wall. Complains of the expressed dyspnea, difficult breathing, chest
pain. On examination the expressed cyanosis. The frequency of respiratory movements - 26-28 per
1 min. Unstable hemodynamics. The chest is deformed, abnormal mobility of the front wall. The
swelling of soft tissues of the neck with crepitation. The primary diagnosis: Mediastinal
emphysema. What does the mediastinal emphysema result in?
Cardiac tamponade
Hemoptysis
Pleural empyema
Pneumothorax
Lung atelectasis
Female patient, 62 years old, was got in accident. On examination was detected the region of the
right half of the chest, which disengages during inspiration. What are the most appropriate
therapeutic measures?
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External fixation of a floating area
Introduction of narcotic analgetics
Vagosympathetic block by Vishnevsky
Tight chest bandage
Paravertebral blockade
In the patient after the accident with multiple rib fracture during the puncture of pleural cavity
received the gastric content. What additional examination is the most suitable?
Chest X-ray with contrast of the stomach
Plain X-ray of abdominal cavity
Esophagogastroscopy
Computer tomography
Tomography of the chest
In the patient on the fourth day after the chest trauma on X-ray - heterogeneous shadow in the
lower lobe. By puncture received a small amount of light yellow fluid with blood clots. What
treatment are the best for the patient?
Drainage of the pleural cavity
Operational - lung decortication
Daily puncture
Resorbed therapy
Antibacterial therapy
In the patient after blunt chest trauma with a sternum fracture appeared the weakness, hypotension,
cyanosis of the upper half of the body, distension of the neck veins. By pleural puncture the content
is absent. Pulse 120 beats.per min, rhythmic, weakened. What is the primary diagnosis?
Cardiac tamponade
Pulmonary embolism
Contusion of the heart
Acute myocardial infarction
Coagulated hemopericardium
The patient entered in 3 hours after the injury with expressed subcutaneous emphysema of the
upper half of the body, dyspnea, tachycardia, pulse - 120 beats/min. On X-ray the pneumothorax
was found out with significantly enlargement of the mediastinum in both sides. What is the first
aid?
Drainage of the anterior mediastinum
Puncture of the pleural cavity
Drainage of the pleural cavity
Thoracoscopy
Thoracotomy
The patient entered in 3 hours after the injury with expressed subcutaneous emphysema of the
upper half of the body, dyspnea, tachycardia, pulse - 120 beats/min. On X-ray the pneumothorax
was found out with significantly enlargement of the mediastinum in both sides. What is the primary
diagnosis?
Mediastinal emphysema.
Posttraumatic pneumothorax.
Posttraumatic hemothorax.
Posttraumatic pneumonia
Subcutaneous emphysema.
Patient S., 25 years old, entered the hospital after the chest trauma. During clinical and X-ray
examination was diagnosed the left-side tension pneumothorax. What is the first aid?
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38.
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41.
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Drainage of the pleural cavity
Intravenous infusion
Oxygenotherapy
Intubation
Analgesics
Patient S., 25 years old, entered the hospital after the chest trauma. During clinical and X-ray
examination was diagnosed the left-side tension pneumothorax. Where the drainage of pleural
space in pneumothorax is performed?
II intercostal space, midclavicular line
II intercostal space, scapular line
IV intercostal space, anterior axillary line
VII intercostal space, midclavicular line
VII intercostal space, scapular line
Patient S., 35 years old, entered the hospital after the chest trauma. During clinical and X-ray
examination was diagnosed the left-side hemothorax. Where the drainage of pleural space in
hemothorax is performed?
VII intercostal space, scapular line
II intercostal space, midclavicular line
II intercostal space, scapular line
IV intercostal space, anterior axillary line
VII intercostal space, midclavicular line
Patient S., 35 years old, entered the hospital after the chest trauma. During clinical and X-ray
examination was diagnosed the left-side hemothorax. What method is the most informative in the
diagnostic of hemothorax?
Pleural puncture
General blood analysis
Sputum analysis
Auscultation
X-ray examination
Patient S., 35 years old, entered the hospital after the chest trauma. During clinical and X-ray
examination was diagnosed the left-side hemothorax. What test is used to determine the
continuity of pleural bleeding?
Revilour-Greguar's test
Troyanov-Trendelenburg's test
Talman's test
Mayo-Pratt's test
Delbe-Pertess test (marching test)
In the patient, 35 years old, during the physical exertion appeared severe pain in the left half of the
chest. Objectively: the patient is covered with cold sweat, dyspnea, pain during inspiration. By
auscultation: vesicular breathing on the right side, on the left - is absent. Tachycardia, pulse 100
beats/min. What is the primary diagnosis?
Spontaneous pneumothorax
Angina pectoris
Acute myocardial infarction
Left-sided pleurisy
Pneumonia
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E.
54 years old patient complains of dysphagia. Two years ago noticed on the left side of neck the
appearance of protrusion after eating, vomiting by food, night cough. Began to lose his weight. On
X-ray of esophagus with barium at the level of the clavicle was revealed the depot of barium like
chicken egg by the size and shape. What is the most probable diagnosis?
Diverticulum of the esophagus
Esophagotraheal fistula
Esophageal cancer
Stenosis of the esophagus
Esophageal achalasia
54 years old patient complains of dysphagia. Two years ago noticed on the left side of neck the
appearance of protrusion after eating, vomiting by food, night cough. Began to lose his weight. On
X-ray of esophagus with barium at the level of the clavicle was revealed the depot of barium like
chicken egg by the size and shape. What complication is probable for this disease?
Diverticulitis
Obstructive jaundice
Intestinal obstruction
Myocardial infarction
Lung atelectasis
54 years old patient complains of dysphagia. Two years ago noticed on the left side of neck the
appearance of protrusion after eating, vomiting by food, night cough. Began to lose his weight. On
X-ray of esophagus with barium at the level of the clavicle was revealed the depot of barium like
chicken egg by the size and shape. What is the typical treatment of this disease?
Surgical treatment
Spasmolytics
Analgetics
Nonsteroid antiinflammatory drugs
Antibiotics
54 years old patient complains of dysphagia. Two years ago noticed on the left side of neck the
appearance of protrusion after eating, vomiting by food, night cough. Began to lose his weight. On
X-ray of esophagus with barium at the level of the clavicle was revealed the depot of barium like
chicken egg by the size and shape. What operation is performed in this disease?
Resection of diverticulum
Esophagomyotomy
Esophagogastric anastomosis
Extirpation of esophagus
Esophageal plastics by intestine
To the hospital entered a man in the critical condition: acrocyanosis, dyspnea, subcutaneous
emphysema on the neck and upper part of body. Complains of severe pain behind the breastbone
and epigastrium. The body temperature of 38,9°C, pulse 130 beats/min, blood pressure 80/50 mm
Hg. From anamnesis 6 years ago after drinking appeared the vomit, which resulted in the signatic.
What is the primary diagnosis?
Spontaneous rupture of esophagus
Incarceration of paraesophageal hernia
Spontaneous pneumothorax
Pulmonary embolism
Perforated ulcer
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50.
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51.
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E.
52.
38-year-old woman complains of difficulty passing of food through esophagus, periodic vomiting.
Has been ill for 1,5 years. Last 6 months notes appearance of food on the pillow during sleep. Lost
15 kg of body weight. There were constipations, stool once in 3-4 days. On plain X-ray film the
absence of the gas bubble of the stomach. What stage of dysphagia relates to such manifestations?
II
I
III
IV
V
38-year-old woman complains of difficulty passing of food through esophagus, periodic vomiting.
Has been ill for 1,5 years. Last 6 months notes appearance of food on the pillow during sleep. Lost
15 kg of body weight. There were constipations, stool once in 3-4 days. On plain X-ray film the
absence of the gas bubble of the stomach. What is the roentgenological sign of this disease in
contrast X-ray with barium?
"Rat tail" sign
Filling defects
"Niche" sign
"Bell" sign
Blunt His angle
38-year-old woman complains of difficulty passing of food through esophagus, periodic vomiting.
Has been ill for 1,5 years. Last 6 months notes appearance of food on the pillow during sleep. Lost
15 kg of body weight. There were constipations, stool once in 3-4 days. On plain X-ray film the
absence of the gas bubble of the stomach. What is the main method of diagnostic of this disease?
X-ray examination with barium swallow
Pleural punctere
Ultrasound examination
Plain X-ray examination of the chest
Irrigoscopy
On X-ray of the esophagus in the right lateral projection in the middle third on the front wall was
found out the additional shadow, of round shape with smooth contours to 2 cm in diameter. What is
the most probable diagnosis?
Diverticulum of the esophagus
Achalasia of the esophagus
Esophageal cancer
Chemical burn of the esophagus
Diaphragmatic hernia
The tool dilation of burn and peptic stricture of the esophagus has a risk of perforation with the
development of purulent mediastinitis and pleural empyema. What is the least dangerous method
for perforation should be applied in the first attempt of dilation of the stricture?
Dilatation of the stricture by balloon dilatator with a stable diameter of the cylinder.
Bouginage under the control of esophagoscope.
Bouginage along the metal conductor.
The blind bouginage under local anesthesia.
Bouginage under the control of X-ray
Female complains of difficult passing of food through esophagus, vomiting by unchanged food,
regurgitation in night and weight loss. Anamnesis about 10 years. On X-ray study revealed
achalasia of esophagus of the IV stage with S-shaped deformation. What is the optimal treatment?
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B.
C.
D.
E.
53.
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B.
C.
D.
E.
54.
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B.
C.
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E.
55.
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C.
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E.
56.
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B.
C.
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E.
57.
A. *
B.
C.
D.
Operation esophagocardiomyotomy with plastic by the stomach fundus.
Cardiodilatation by hard probe.
Cardiodilatation balloon probe.
Operation esophago-fundoanastomosis by Heyrovsky.
Resection of the cardia with esophageal anastomosis.
Female complains of difficult passing of food through esophagus, vomiting by unchanged food,
regurgitation in night and weight loss. Anamnesis about 10 years. On X-ray study revealed
achalasia of esophagus of the IV stage. What is the characteristic feature of the IV stage of this
disease?
Considerable esophageal dilation with S-shaped elongation.
Cicatrical changes with expressed esophageal dilation, the peristalsis is absent
Asymptomatic
Functional spasm without esophageal dilation
Constant spasm with a moderate esophageal dilation and maintained peristalsis
Patient 52 entered the clinic with complaints of complete obstruction of the esophagus, salivation,
weakness, t-38,7°C. Dysphagia has been for 8 days, after the swallowing of piece of the meat with
bone. On X-ray the barium delays at the middle third of the esophagus. On fibroesophagoscopy
was found a wedged bone with hyperemia and edema of the mucous membrane, covered by fibrin.
What is the optimal treatment strategy in this case?
Surgical treatment: thoracotomy, esophagotomy, removal of foreign body (bone), suturing of the
esophagus + gastrostomy.
Endoscopic removal of foreign body by rigid esophagoscope
Pushing of foreign body in the stomach by bougie.
Removal of foreign body by the Fogarty's probe
Removal of foreign body by fiberoptic endoscope.
Among the methods of esophageal plastic the most physiologic and safe modern method is:
Isoperistaltic plastic by tube of the greater curvature of the stomach after the extirpation of the
esophagus through a cervical-laparotomy access.
Large intestine plastic in antiperistaltic position of the transplant.
Large intestine plastic in isoperistaltic position of the transplant.
Large intestine plastic with a skin flap.
Large intestine plastic by ileocecal segment.
The patient has the postburn stenosis of the esophagus. After the next bouginage felt the fever,
tachycardia, pain behind the breastbone. On X-ray: the horizontal level of fluid in the posterior
mediastinum. What is the most probable diagnosis?
Acute posterior mediastinitis.
Acute anterior mediastinitis.
Diverticulum of the esophagus.
Acute pleural empyema.
Paraesophageal hernia.
Complaints of burning, pain behind the breastbone, loss of weight. Has been ill for 7 months. Last 2
weeks noticed difficult passing of solid food. On contrasting X-ray was diagnosed: filling defect of
lower thoracic part of the esophagus, a "niche" sign of the lesser curvature of stomach. What is the
most probable diagnosis?
Gastric ulcer
Paraesophageal hernia
Decompensated pyloric stenosis
Sliding esophageal hernia
E.
58.
A. *
B.
C.
D.
E.
59.
A. *
B.
C.
D.
E.
60.
A. *
B.
C.
D.
E.
61.
A. *
B.
C.
D.
E.
62.
A. *
B.
C.
D.
E.
Peptic duodenal ulcer
Complaints of the pain behind the breastbone, difficult passage of solid food, weight loss,
dizziness. Has been ill for 3 months. Last 2 days disturbs the vomiting after fluid food, the
stagnation of fluid food. On EGDS severe narrowing of the esophagus, rigidity of the walls,
hyperemic mucosa without folds. What is the most probable diagnosis?
Esophageal cancer
Sliding esophageal hernia
Paraesophageal hernia
Reflux esophagitis
Varicose veins of the esophagus
In the patient six months ago appeared the complaints of pain behind the sternum and a strong
burning sensation in the esophagus. Sometimes observed dysphagia. On X-ray examination found
the presence of diverticulum of the left wall of esophagus at the level of tracheal bifurcation 3?4
cm, just below the aortic arch. The patient was not treated. What tactics of treatment should be
choused?
Right-side thoracotomy, diverticulectomy.
Left-side thoracotomy, diverticulectomy.
Right-side thoracotomy, resection of the esophagus.
Large intestine plastic of esophagus
Large intestine plastic of esophagus
The woman aged 52 complains of pain behind the breastbone, difficult passing of solid food
through esophagus, increased salivation. The doctor advised 0,1 % solution of atropine before
eating. After 3 days on X-rays no pathology was revealed. The doctor should do for this patient:
Send to fibroesophagoscopy
Allow the job
Control visit after 2 months
Treatment by spasmolytics
Send to ECG
The woman, 38 years old, complains of difficulty passage of solid meal on esophagus, vomiting by
undigested food, night regurgitation (sign of ,,wet pillow"), loss of weight. Has been ill for 10
years. On X-ray examination with barium the sign of "rat tail", dilation of the esophagus to 6 cm
with maintained peristalsis. What stage of achalasia is there in this patient?
II
I
0
III
IV
53 year old man complains of recurrent pain behind the breastbone, heartburn, especially in the
horizontal position. Sometimes the burning pain behind the sternum occurs after hot or spicy food.
Two weeks ago was vomiting by blood and lost of consciousness. Has entered the hospital after
repeated gastric bleeding. What is the most probable diagnosis?
Sliding esophageal hernia, reflux esophagitis
Diverticulum of the esophagus
Varicose veins of the esophagus
Mallory-Weiss syndrome
Crohn's disease.
63.
A. *
B.
C.
D.
E.
64.
A. *
B.
C.
D.
E.
65.
A. *
B.
C.
D.
E.
66.
A. *
B.
C.
D.
E.
67.
A. *
B.
C.
D.
E.
53 year old man complains of recurrent pain behind the breastbone, heartburn, especially in the
horizontal position. Sometimes the burning pain behind the sternum occurs after hot or spicy food.
Two weeks ago was vomiting by blood and lost of consciousness. Has entered the hospital after
repeated gastric bleeding. What roentgenological sign confirms the pathology?
"Bell" sign
"Rat tail" sign
Filling defects
"Bird-beak" sign
Esophageal dilatation
53 year old man complains of recurrent pain behind the breastbone, heartburn, especially in the
horizontal position. Sometimes the burning pain behind the sternum occurs after hot or spicy food.
Two weeks ago was vomiting by blood and lost of consciousness. Has entered the hospital after
repeated gastric bleeding. What drugs are used for the treatment of this pathology?
Blockers of proton pomp
Spasmolytics
Adrenoblockers
Blockers of calcium channel
Anticoagulants
53 year old man complains of recurrent pain behind the breastbone, heartburn, especially in the
horizontal position. Sometimes the burning pain behind the sternum occurs after hot or spicy food.
Two weeks ago was vomiting by blood and lost of consciousness. Has entered the hospital after
repeated gastric bleeding. What disease should be this pathology differentiated from?
Peptic ulcer
Pancreatitis
Intestinal obstruction
Cholecystitis
Bronchial asthma
53 year old man complains of recurrent pain behind the breastbone, heartburn, especially in the
horizontal position. Sometimes the burning pain behind the sternum occurs after hot or spicy food.
Two weeks ago was vomiting by blood and lost of consciousness. Has entered the hospital after
repeated gastric bleeding. What is the main treatment of this pathology?
Conservative treatment
Esophagostomy
Esophageal plastic
Resection of the esophagus
Resection of the stomach
53 year old man complains of recurrent pain behind the breastbone, heartburn, especially in the
horizontal position. Sometimes the burning pain behind the sternum occurs after hot or spicy food.
Two weeks ago was vomiting by blood and lost of consciousness. Has entered the hospital after
repeated gastric bleeding. What type of operation is used for treatment of this pathology?
Cruroplasty with Nissen's fundoplication
Esophagostomy
Cruroplasty
Resection of the esophagus
Resection of the stomach
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.
After the birth of the child appeared the signs of respiratory failure. By auscultation on the left side
the breathing is absent. On X-ray expressed mediastinal shift to the right, the presence of protrusion
on the left side. What is the most probable diagnosis?
Left-sided diaphragmatic hernia
Hypoplasia of right lung
Polycistosis of the left lung
Relaxation of the diaphragm
Esophageal stricture
The patient, 45 years old, complains of retrosternal pain, which increase at night, heartburn,
belching. Has been ill for 4 months. What research is the most appropriate?
X-ray contrast study in Trendelenburg's position.
Plain chest X-ray
Fibroesophagogastroduodenoscopy
Plain X-ray of the abdominal cavity.
Computer tomography
The patient, 45 years old, complains of retrosternal pain, which increase at night, heartburn,
belching. Has been ill for 4 months. What is the most probable diagnosis?
Sliding esophageal hernia, reflux esophagitis
Diverticulum of the esophagus
Varicose veins of the esophagus
Mallory-Weiss syndrome
Crohn's disease.
What is the most wide-spread cause of the peptic stricture of esophagus associated with
reflux-esophagitis?
Sliding esophageal hernia.
Prolonged nasogastric intubation in the esophagus.
Short stay nasogastric intubation.
Frequent vomiting of pregnancy.
Achalasia of the esophagus
X-ray signs: the "bell" sign, blunt Hiss angle, absence of gas bubble of the stomach are
characteristic for:
Sliding esophageal hernia.
Paraesophageal hernia.
Relaxation of the diaphragm.
Malignant tumor of the esophagus.
Achalasia of the esophagus
The patient has the pain behind the breastbone, heartburn, which increases after the meal. Has been
ill for 6 months. For 5 days has a black chair. On X-ray examination revealed the "bell" sign, blunt
Hiss angle, absence of gas bubble of the stomach. What is the most probable diagnosis?
Sliding esophageal hernia.
Paraezofagalnaya esophageal hernia.
Relaxation of the diaphragm.
Malignant tumor of the esophagus.
Achalasia of the esophagus
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. *
Complaints of heaviness in the epigastric region, nagging pain after eating. When EGDS pathology
identified. On X-ray examination pronounced gas bubble of the stomach is is visible the to the level
III intercostal space on the left. What is the most probable diagnosis?
Relaxation of the diaphragm.
Paraezofagalnaya esophageal hernia.
Sliding esophageal hernia.
Malignant tumor of the esophagus.
Achalasia of the esophagus.
The patients with sliding esophageal hernia mostly complain of:
Heartburn, pain behind the breastbone.
Difficult passage of food, loss of weight.
The pain behind the breastbone, difficulty in food passage.
Pain in the epigastric region with irradiation into the right hypochondrium.
Pain in the epigastric region with irradiation into the back.
Complications paraesophageal hernias of esophagus:
Incarceration
Malignancy.
Esophageal stricture.
Dysphagia.
Reflux esophagitis.
In the patient at night appeared a severe pain in the epigastric region, nausea, vomiting. 6 months
ago was diagnosed paraesophageal hernia. What complication arose?
Incarceration
Malignancy.
Esophageal stricture.
Dysphagia.
Reflex esophagitis.
In the patient at night appeared a severe pain in the epigastric region, nausea, vomiting. 6 months
ago was diagnosed paraesophageal hernia. What type of operation is is indicated for this patient?
Cruroplasty
Esophagostomy
Resection of the esophagus
Resection of the stomach
Cruroplasty with Nissen's fundoplication
Complaints of heartburn, pain behind the breastbone, outpour of food. Has been ill for 2 months.
On X-ray examination revealed the "bell" sign, blunt Hiss angle, absence of gas bubble of the
stomach. Your tactics?
Conservative therapy.
Bouginage of esophagus.
Surgical intervention.
Large-intestinal plastic of esophageal cardia.
Small-intestinal plastic of esophageal cardia.
The patient has the postburn stenosis of the esophagus. After the next bouginage felt the fever,
tachycardia, pain behind the breastbone. On X-ray: the horizontal level of fluid in the posterior
mediastinum. What is the most probable diagnosis?
Acute posterior mediastinitis.
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.
D.
E.
85.
A.
B. *
C.
D.
E.
86.
A.
Acute anterior mediastinitis.
Diverticulum of the esophagus.
Acute pleural empyema.
Paraesophageal hernia.
Complaints of burning, pain behind the breastbone. Has been ill for 4 months. On contrasting X-ray
was diagnosed: the "bell" sign, the absence of gas bubble of the stomach, blunt Hiss angle. What is
the most probable diagnosis?
Sliding esophageal hernia
Paraesophageal hernia
Gastric ulcer
Peptic duodenal ulcer
Decompensated pyloric stenosis
5 hours ago, after the bouginage of esophageal cicatricle stricture appeared the pain behind the
breastbone, a feeling of compression, subcutaneous crepitation on the neck, fever to 38,5°C. On
examination the weakening of the heart tones by auscultation. On plain X-ray of chest –
mediastinal emphysema, mediastinal extension of the shadows. What is the most probable
diagnosis?
Acute mediastinitis
Reflux esophagitis
Sliding esophageal hernia
Paraesophageal hernia
Achalasia of the esophagus
A 34-year-old female with hypertension is considering to become a pregnant. Which of the
following medications would be absolutely contraindicated to control her BP during pregnancy?
Methyldopa
Metoprolol
Labetalol
Captopril
Nifedipine
A 34-year-old male with isolated essential hypertension came to clinic and it was found high BP
of 180/100 mm Hg after failure of behavioral modifications. What is the most appropriate next step?
Start hydrochlorothiazide
Start hydrochlorothiazide and lisinopril
Repeat BP in 4 weeks
Start amlodipine
Start doxazozin
A 34-year-old male with isolated essential hypertension came to clinic and it was found high BP
of 180/100 mm Hg item after failure of behavioral modifications. What is the most appropriate next
step?
Start hydrochlorothiazide
Start hydrochlorothiazide and lisinopril
Repeat BP in 4 weeks
Start amlodipine
Start doxazozin
A 40-year-old diabetic patient with a blood pressure (BP) of 145/90 mm Hg item and proteinuria.
Which BP profile represents the best therapeutic goal for this patient?
160/90
B.
C.
D. *
E.
87.
A.
B.
C. *
D.
E.
88.
A.
B.
C.
D. *
E.
89.
A. *
B.
C.
D.
E.
90.
A. *
B.
C.
D.
E.
91.
A. *
B.
C.
D.
E.
92.
A.
140/90
130/85
125/75
140/85
A 40-year-old diabetic patient presents with a blood pressure (BP) of 145/90 mm Hg item and
proteinuria. What is the best medication for the initial management of this patient’s hypertension?
Calcium channel blockers
Beta blockers
ACE-inhibitors / angiotensin receptor blockers
Alpha blockers
Diuretics
A 42-year-old female with chronic obsctructive pulmonary disease is found on multiple office visits
to have elevated BP measurements. Which of the following medications is contraindicated?
Hydrochlorothiazide
Metoprolol
Lisinopril
None of above
All of the above
A 42-year-old male comes in for a routine physical examination. He is noted to have impaired
glucose methabolism, and a BP of 135/85 mmHg. What is the best treatment plan for this
individual?
Aggressive lifestyle modification
Institute thiazide diuretic regimen
No treatment at this time
Initiate an ACE-inhibitor
Initiate a beta-blocker
A 45-year-old male comes in for a routine physical examination. He is noted to have impaired
glucose methabolism, and a BP of 140/85 mmHg. What is the best treatment plan for this
individual? lifestyle modification
Aggressive
Institute thiazide diuretic regimen
No treatment at this time
Initiate an ACE-inhibitor
Initiate a beta-blocker
A 48-year-old male with diabetes mellitus, hypertension, and hyperlipidemia has a hypertensive
emergency. His arterial pressure is 150/100 mmHg item. Which medications would be most
appropriate therapy for this patient?
Nitroprusside
Enteral metoprolol
Fenoldopam
Intravenous nitroglycerine
Any of the above
?A 48-year-old obese male with hypertension, dyslipidemia, and diabetes mellitus presents to the
outpatient clinic for his yearly physical. He has refused medications in the past, but now is willing
to consider treatment. His BP is 145/95 mmHg with a HR of 80 bpm. His laboratory data are
significant for the presence of microalbuminuria. Which of the following medications would be the
most appropriate?
Carvedilol
B.
C. *
D.
E.
93.
A.
B.
C. *
D.
E.
94.
A.
B.
C. *
D.
E.
95.
A.
B.
C. *
D.
E.
96.
A.
B. *
C.
D.
E.
97.
A.
B.
C. *
D.
Methyldopa
Lisinopril
Chlorthalidone
Terazozin
A 48-year-old obese male with hypertension, dyslipidemia, and diabetes mellitus presents to the
outpatient clinic for his yearly physical. He has refused medications in the past, but now is willing
to consider treatment. His BP is 145/95 mmHg with a HR of 80 bpm. His laboratory data are
significant for the presence of microalbuminuria. Which of the following medications would be the
most appropriate?
Carvedilol
Methyldopa
Lisinopril
Chlorthalidone
Terazozin
A 56-year-old male on hydralazine, hydrochlorothiazide, lisinopril, and metoprolol begins to
develop a malar rash and arthralgias. Which of the above antihypertensive agents is known to cause
drug-induced lupus?
Hydrochlorothiazide
Lisinopril
Hydralazine
Metoprolol
None of the above
A 53-year-old male on hydralazine, hydrochlorothiazide, lisinopril, and metoprolol begins to
develop a malar rash and arthralgias. Which of the above antihypertensive agents is known to cause
drug-induced lupus?
Hydrochlorothiazide
Lisinopril
Hydralazine
Metoprolol
None of the above
A 60-year old white man consults you with a headache. Examination data are unremarkable, except
that the blood pressure is raised and subsequent measurements confirm readings of 170/106 mmHg.
He is obese, smokes 15 cigarettes per day and drinks 2 pints of beer per day. His investigations
reveal a cholesterol of 6 mmol/l with a normal blood sugar and electrolyte profile and normal renal
function. There is no evidence of target organ damage.
This man needs immediate treatment with antihypertensive drugs, aspirin and a statin
Initiate antihypertensive therapy with two-drug combination
At this age it is far more important to control the hyperlipidaemia than the BP
This man’s blood pressure could be wholly ascribed to his alcohol intake
This patient can be observed and counseled on maintaining a reasonable BMI
A 62-year-old man with isolated essential hypertension, currently taking hydrochlorothiazide 25 mg
PO daily, comes to you for his first clinic visit. He notes that his BP at home is always less than
140/80 mmHg, but in clinic it is always at least 155/95 mmHg. What is the next step?
Increase dose of thiazide
Addition of second antihypertensive medication
Do nothing as he has white coat hypertension
Evaluate for secondary causes of hypertension
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.
C.
D.
Start metoprolol
A 62-year-old man with isolated essential hypertension, currently taking hydrochlorothiazide 25 mg
PO daily, comes to you for his first clinic visit. He notes that his BP at home is always less than
140/80 mmHg item, but in clinic it is always at least 155/95 mmHg. What is the next step?
Increase dose of thiazide
Addition of second antihypertensive medication
Do nothing as he has white coat hypertension
Evaluate for secondary causes of hypertension
Start metoprolol
At a routine examination, an asymptomatic 46-year-old man is found to have a BP of 150/110
mmHg item, but no other abnormalities are present. What do you do next?
Reassure the patient and repeat the physical examination in 12 months
Initiate antihypertensive therapy
Obtain repeated BP recordings in your office and/or the patient’s home or work site
Hospitalize patient for renal arteriography
Order a 24-h ambulatory BP monitoring
For the case below, select the most significant adverse effect of the antihypertensive and/or cardiac
agent in question: a 45-year old female has been on diuretic, but BP remains elevated at 145/95,
leading to the proposed addition of lisinopril. Which key potential adverse effect should be
discussed?
Increased triglyceride levels
Peripheral edema
Lupus-like syndrome
Cough
Gynecomastia
For the case below, select the most significant adverse effect of the antihypertensive and/or cardiac
agent in question: a 58-year old male truck driver has significant hypertension, still not controlled
on a diuretic plus calcium channel blocker. Clonidine is being considered as the next medication,
but in this patients is concerned by sedation, sexual dysfunction.
Increased triglyceride levels
Cough
Gynecomastia
Rebound hypertension
Urinary retention
In patients with a history of stroke or TIA the preferred drug combination is:
ACE-inhibitor and diuretic
Calcium-channel blocker and beta-blocker
Beta-blocker and diuretic
Angiotensin receptor blocker and beta blocker
Beta- and alpha blocker
The initial antihypertensive medication recommended for patients who have no compelling
indications or contraindications is
ACE-inhibitor
Calcium-channel blocker
Diuretics
Beta blocker
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.
Any of the above
To reduce the patient’s cardiovascular morbidity and mortality, which therapy would you prescribe?
Hydralazine
Atenolol
Losartan
Doxazosin
Clonidine
What is the appropriate course of action regarding the patient’s antihypertensive therapy?
Advise a low-sodium diet
Finish doxazosin therapy and consider an alternative agent
Advise high dietary intake of calcium and potassium
Increase the doxazosin to 4 mg a day
Advise magnesium supplements
You see a diabetic patient presents with BP readings that are 155/95 or higher. All of the following
statements about the treatment of this patient's hypertension are correct EXCEPT:
Pharmacologic blocade of the renin-angiotensin system reduces the risk of both microvascular and
macrovascular events
Aggressive BP control reduces cardiovascular events more in diabetics than in nondiabetics
Calcium channel blockers show no benefit in reducing cardiovascular events
The goal BP for this patient is <130/80 mmHg
All the above statements are correct
During the operation concerning strangular impassability of bowels, which conducted under
general anaesthesia of i/v with ALV, at a patient the stop of cardiac diyal-nosti happened 50 years in
the moment of mesenretium streching by the surgeon. What would prevent the stop of heart in this
case?
i/v injection atropin
i/v injection of cardiac glycozidis
Deepening of general anaesthesi
Additional injection of relaxants
Additional injection droperidol
Patient 30 years after a road-transport failure complaints of the acute tahypno Ob-ly: a skin is
pale, cyanosi Hypodermic emphysema in the region of thorax, stomach, right side of the neck.
Auscultative: breathing on the right side is not conducted; pulse – 130/min., AP – 80/60
mm.mercury., CVP – 140 mm wt., FB – 30 /min., Ht – 0,27, Hb – 90 g/l. Subsequent therapy must
include above all things:
punction of pleura cavity.
Urgent ALV
Massive infusion therapy of the crystalloid solutions
Infusion of dofamin, 2-5 mcg/cg/min
100% oxygen
Patient has BP - 80/40 mm mercury, pulse - 120 per min, shock index for him:
120/80=1,5
80+40)120=1
80/120=0,67
120/40=3
Not determined, as blood loss is unknown
110.
A. *
B.
C.
D.
E.
111.
A. *
B.
C.
D.
E.
112.
A.
B.
C. *
D.
E.
113.
A. *
B.
C.
D.
E.
114.
A. *
B.
C.
D.
E.
Patient N., 47 years, treated in the hospital with the diagnosis: carbuncle of right kidney. Suddenly
general condition deteriorated, body temperature 39.50 C, skin cold, humid, consciousness kept,
expressed choking. Breath deep, noisy, 26/min. Pulse - 110/min., SC - 90/60 mm.mercury., oliguri
Which complications we can think about?
Infectious-toxic shock
Vascular dystonia
Epilepsy
Anaphylactic shock
Orthostatic collapse
Patient, 40 years, with the trauma of both thighs is delivered from the scene of accident by a
“passing transport”. Objectively: cyanosys, rubor of the lower half of the neck, tahypnoe, AP 60/40
mm mer st., HBA=120 /min, in lungs moist wheezes, diuresis – 20 ml/h., Nb 100 g/l. Which from
the offered diagnoses most reliable?
Fatty embolism
Traumatic shock
Hemorhagic shock
Pain shock
Tromboembolism
The patient 60 years is delivered in the department of intensive therapy with a diagnosis: bite of
bee, anafilactic shock.. Which medicine will be primary and most effective?
Adrenalin
Calcium the chloride
Prednizolon
Dimedrol
Suprastin
The patient 25 years is hospitalized in the surgical department with a diagnosis: penetrable wound
of abdominal region. Objectively: it is excited, skin covers and visible mucous shells are pale;
peripheral pulse of the weak filling, frequent, AP – 110/60 mm mercury Positive symptom
of ”desolation” of peripheral hypodermic vein Diuresis is lowere How to characterize this state?
The compensated shock
Preagonia
Circulating shock
Agony
Irreversible shock
The patient 36 years with ulcerous of gaster in anamnesis is hospitalized in the surgical department
with complaints on vomiting by "coffee-grounds", diarhea, moderately expressed thirst.
Objectively: a skin is pale, covered by a death-damp, a tongue is dry, AP – 80/60 mm rt.st., HBA –
120/min., BF – 28/min., diuresis – 25 ml/h. Blood test: Era - 2,8 1012/l, Hb – 98 g/l. What will be
most expedient in medical treatment:
solutions with colloid
5% solution of glucose
Whole blood
Red corpuscles mass
Colloid solutions with red corpuscles mass
115.
A. *
B.
C.
D.
E.
116.
A. *
B.
C.
D.
E.
117.
A. *
B.
C.
D.
E.
118.
A. *
B.
C.
D.
E.
119.
A. *
B.
C.
D.
E.
118. Patient 48 years the second day in dpartment of intensive therapy concerning the acute
front-partition heart attack of myocardium. During a review “wheezing” suddenly, non-permanent
tonic constricting of muscles is marked, pupils are extended, pulse on carotis not palpitat What
doctor have to do in the first place?
Triple Safar method
Record of ECG
Cardial hit in the area of heart
Artificial respiration by the method of Silvester
Intracardial injection of adrenalin with an atropine
The patient entered the department with a diagnosis: acute intestinal impassability. Complaints:
insignificant thirst, dizziness at an attempt to get up from a be At a review: patient apathetical,
turgor is lowered, eyeballs are soft, tongue is dry with crack Pulse – 110 min., AP – 80 /60 mm of
mer item, diuresis – 25 ml /h. Electrolyte composition: Na+ - 142 mmol/l, C+ - 4 mmol/l,
glucose – 6 mmol/l, urea – 7 mmol/l. What variant of infusion is most expedient during operation?
Transfusion of crystalloid
Transfusion of solution of glucos
Transfusion of albumen.
Transfusion of native plasm
Transfusion of poliglucin.
The patient, 28 years, 2 hours ago fell down from the ground floor of hous Sopor, pale, there are
the plural scratches of face, the lacerated hemorhagic wounds on the left forearm. The closed break
of the left shoulder and thigh. Pulse –110, Lc-10T/l, Hb – 100, AP – 90/40 mm of rt. item In the
blood test: red corpuscles – 3,5 g/l. What infouziyniy serednic does not need to be used for medical
treatment of shock?
5% solution of glucose
Solution of crystalloids
Solutions gelatin
Solutions of calcium
Solution of albumen
Anafilactic shock appeared at a patient. The state heavy and progressively gets wors HBA – 110
in a 1 minute, AP – 60/30 mm mercury. Prescribe medicine for the rescue of life of patient above all
things?
Adrenalin.
Chloride of calcium.
Prednizolon.
Dofamin.
Suprastin.
At a patient 20 years on a background the injection of vitamin B1 suddenly there was excitation,
fear of death, falling of AP to 50 mm rt.st., hard breathing. Which of medicine it is necessary to
inject firstly?
Adrenalin
Prednizolon
Calcium
Dimedrol
Eufilin
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.
At a patient 60 years with the third day after an exterpation uterus acute insufficiency of breathing
developed suddenly, a skin became at first cyanotic, and then ash-colored color. Tachypnoe, cough
with bloody sputum, retrosternal pain. BP – 100/70 mm. mercury, HR – 120, BR – 32 in 1 min.,
CVP – 300 mm wt.col. What most reliable reason of worsening of the state of patient ?
Tromboembolism of pulmonary artery
Bleeding
Pain shock
Hypostatic pneumonia
Heart attack of myocardium
At a patient in the ward of intensive therapy you marked appearance on the monitor of fibrillation
of ventricule Your first actions?
To conduct defibrillation three times
To inject adrenalin
To inject a chloride
To begin the closed massage of heart
To inject lidocain
At a patient with the acute heart attack of myocardium best of all to warn relapsing fibrillation of
ventricles with :
cordaronum
lidocainum
ornidinum
electrocardiostimulation
there is no right answer
At a patient with the acute heart attack of myocardium in the region of partition on a 5th day after
the brief episode of loss of consciousness there is reduction of frequency of pulse to 32 in a
minut BP - 80/40 mm Consciousness at the level of sopor. He immediately needs :
to put right a craniotserebral hypothermia, to enter lasics, prednisoloni, tserebrolizin
to enter an atropine, eoufilin, to begin infouziyo of aloupenta
to conduct urgent cardiostimoulation
all answers are faithful
there is no right answer
At a patient, carried to a 2 year ago the heart attack of myocardium, the acute decline of
cholecystyties planned cholecystectomy, signs of electric instability of myocardium . Actions of
anaesthesiologist must include:
injection of prednisoloni, lidocaini, hyperventilation, take the ECG
injection of dopamini, after stabilisation of BP - nitroglycerine + infusion therapy under the control
CVP, conducting of neurovegetative defence, take the ECG
injection of streptodecasol, stream infusion of reopoliglyocinum, injection of lidocainum, increase
of dose of analgetics
correctly A) and C)
all answers are faithful
At a patient, that is found on medical treatment in the therapeutic department, the sudden stopping
of circulation of blood happene Medical personnel begun the reanimation measure Define the
most rational way of injection of adrenalin for renewal of heart abbreviations in default of vein
access:
To
enter to a 3 ml solution of adrenalin in a trachea
To enter to a 1 ml solution of adrenalin in muscle
To enter adrenalin in muscle, multiplying a dose in 3 time
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.
The intracardial injection.
Adrenalin can be not enterea
At a patient, that is found under the permanent electrocardioscopic supervision, microwave
fibrillation of myocardium and diagnosed clinical death develope It is necessary to do:
to inject the solution of calcium in cor
to conduct high-voltage electric defibrillation
to inject solution of atropine in cor
to inject solution of adrenalin in cor
All answers are wrong
At the patient operated concerning the festering peritonitis coused by perforation of gastric ulcer, in
a postoperation period appeared: high temperature, frequency of breathing 35/min., AP – 70/40 mm
of mer item, diuresis -20 ml/h temperature of body to 39 , leucocitosi Transfusion during 12
hours 1,8 of a 0,9% solution of chlorous sodium and 0,8 of solution of reopoliglucin did not
improve general condition. Central vein pressure – 130 mm wt.st. For stabilization of
hemodinamics will be optimum infusion:
Dopamin
Mezaton
Adrenalin
Noradrenalin
Ephedrine
At the ventilated patient with the edema of lungs at low pressure and septic shock intravenous
infusion 7,5 mcg/kg/min dopamini will increase
RaO2, saturation of oxygen of the mixed vein blood, consumption of oxygen
diuresis
cardiac systolic volume
right A) and B)
faithful all answers
In 2 hours after renewal of cardial activity at a patient, that carried the sudden stop of heart on a
background hemorhagic shock (blood lost near 2,5 l) and is found on ALV, unstable hemorhagia
(AP – 80/40 – 90/60 mm of mer item, tahycardia)is marked, central vein pressure – 5 mm wt.st. It
is related to:
By Hypovolume syndrome
By cardia insufficiency
By the inadequate interchange of gases
Vasoplegia
By the inadequate anaesthetizing
In a clinic a patient with the traumatic tearing of both lower extremities off at the level of
knee-joints is delivere A patient is extremly inert, languid, pale, pulse 140 bmin, threadlike, AP
500. On both lower extremities there are the imposed plait Bleeding at the receipt is not present.
From the words of doctor of first-aid, lost about 3 litres of blood in place of event. What principal
reason of heavy of the state of Patient?
acute hemorrhag
Pain shock.
Ishemia of extremities as a result of application of tourniquet
Fatty embolism
acute kidney insufficiency
131.
A.
B. *
C.
D.
On a 4 day after incompatible (on a group) blood transfusion at a patient acutely reduced diouresis,
anuria developed, the common state became worse acutely, arterial pressure ros At laboratory
research: creatinin plasma – 680 mlmol/l, urea of plasma - 24 mmol/l. What illness and what stage
of illness it follows to think about in the first place?
Acute kidney insufficiency, anuria
Anaphylactic shock, acute kidney insufficiency, anuria
Hemotransfusion shock, postrenal acute kidney insufficiency, anuria
Posthemoragic acute kidney insufficiency, anuria
acute interstitsial nephritis, postrenal anuria
Patient 20 years for verification of the functional state of kidneys the X- ray examination with v/v
injection of cardiotrast is conducte At the end of injection the state of patient acutely became
worse, the shortness of breath, hyperemia of skin, itch appeare AP – 60/20 mm of mer item,
HBA – 132/min. A similar research was conducted 3 months ago, such effects were not observe
What most reliable diagnosis?
Medicinal anafilactic shock
Acute kidney insufficiency
Tromboembolism of pulmonary artery
Stress on the conducted manipulation
Heart attack miocardium
Patient 38 years, native plasma was poure At the end of infusion the state became worse: Patient
confused, excited, cyanosys, hypersalivation. Breathing frequency 36 on 1 min., AP – 70/40 mm of
mer item, whistling dry wheeze Which from the following mediceni must be injected firstly?
Adrenalin.
Eufilin.
Suprastin.
Noradrenalin.
Prednizolon.
Patient 40 years with the acute gastro - intestinal bleeding a canned blood was poured in a volume
400 ml after conducting of all tests on compatibility. After hemotransfusion the state of patient
became worse, appeared head pains and pains in muscles athe temperature of body rose to 38,8
What can explaine the state of patient?
Pyroxene reaction of middle heavy
By development of hemotransfusion shock
Allergic reaction
By development of bacterial-toxic shock
By air embolism
Patient 40 years with the acute gastro - intestinal bleeding a canned blood was poured in a volume
400 ml after conducting of all tests on compatibility. After hemotransfusion the state of patient
became worse, appeared head pains and pains in muscles athe temperature of body rose to 38,8
What can explaine the state of patient?
Pirogenic reaction of middle heavy
By development of hemotransfusion shock
Alergic reaction
By development of bacterial-toxic shock
E.
By air embolism
A. *
B.
C.
D.
E.
132.
A. *
B.
C.
D.
E.
133.
A. *
B.
C.
D.
E.
134.
A.
B.
C. *
D.
E.
135.
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.
Patient 62 years the third day of presense in department of intensive therapy concerning the acute
transmural heart attack of myocardium of front-partition localization. At night woked up from a
suffocating cough, feeling of fear and troubl At a review: cyanosys, FB – 30 after 1 min., HBA –
132/ min., a rhythm is correct, tones of heart are deaf, accent ІІ tone above a pulmonary artery,
AP – 180/110 mm mercury. There is the loosened breathing above lungs with the far of
moist wheezes in lower fate What probably became the reason of worsening of the state?
Edema of lungs
Embolism of pulmonary artery
The repeated heart attack miocardium
Hypertensive crisis
Attack of bronchial asthma
Patient L is hospitalized in gynecological department with the temperature of 39 degrees C, with
complaints of pain in the bottom of stomach, vomit, diarrhea . Criminal abortion have been done 4
days befor AP 80/60, breathing is difficult, psychosomatic excitation. Symptom of
Schotkin-blumberg is positiv Uterus is enlarged as on 9 weeks of pregnancy, limitedly mobile,
painles Pus with blood appeare Your Diagnosis?
septic shock
Perforation of uterus
Pelvic peritonitis
Acute appendicitis
Acute adnexia inflammation
Patient N., 28 years ol 6 day after the complicated birth The clinical hematological signs of
subacute disseminate intravascular coagulation syndrome developed after skin hemorrhage and
uterine bleeding. The state of patient is very ba blood: Er-2,7 of T/l, Hb-78 of gm/l, CI - 0,93,
L-4,7 of Gm/l, thrombocytes-88 of gm/l, time of blood cloating - 16 min, prothrombin time - 25 sec,
ethanol test +, fibrinogen-1,4 gramme/l, What preparations should be prescribed ?
freezed plasma
Heparinum
Reopoliglycin
Cryoprecipitate
U-aminokapric acid
Patient N., 40 years, groom. In anamnesis there is an allergy to nonsteriidal antiinflammatory. After
injection of antitetanus on a method Besredco concerning the hammered wound of right shin,
through 20 mines, there was a acute weakness, labouring breath, through 10 mines, loss of
consciousnes What mechanism of development of anafilactic form of illness?
Sensitization to the albumen of horse whey
Low quality of horse whey
Breach of the technique of PPS injection
Presence in anamnesis of medical allergy
Infection of whey
Patient N., 40 years, groom. In anamnesis there is an allergy to nonsteroidal antyinflammatory.
After injection of antytetanus on a method Besredco concerning the hammered wound of right shin,
through 20 mines, there was a acute weakness, labouring breath, through 10 mines, loss of
consciousnes What mechanism of development of anafilactic form of illness?
Sensitization to the albumen of horse whey
Low quality of horse whey
Breach of the technique of PPS injection
Presence in anamnesis of medical allergy
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.
Infection of whey
Persons 48 years, patient by the heart attack of miocardium, suddenly lost consciousness, breathing
and palpitation. On ECG of highwave fibrilation of ventricule Conducted defibrilation. Did not
pick up normal cardial activity. What medicine needs to be entered for the rise of sensuality to
defibrillation?
Amiodaron
Propranolon
Lidocain
Strofantin
Atropini sulfati
Pharmacological medicine, that diminish the (afterload) left ventricle at a patient with the acute
heart attack of myocardium, are not included
nitroglycerine
strophantine
nitroproussid sodium
esmolol (brevibloc)
nifedipinum
Sick 46 years treated oneself in a therapeutic department with pneumonia of lower dole of right
lung. Planned antibacterial therapy - amoxiklav. After 40 min after intramuscular injection of duty
dose, the patients feeled dizziness, pain behind a breastbon AT 60/40 mm mer , pulse, - 120 a min.,
rhythmical. During examination of lungs: wheezes under both lung Temperature is 38,5 What
is worsening of the condition related to?
Anaphylactic shock
Infectious toxic shock
Collapse
Tromboembolia of pulmonary artery
Infectious shock
The patient 20 years old, delivered to ambulance department on the 2nd day of illness in a grave
condition: temperature of body 39°c, symptoms of intoxication are expresse On extremities,
trunk, buttocks, present hemorrhagic rash as eczema with necrosis in the center. One day before cut
his leg. Now has the wound in that plac In 2 hours the decline of AP is registered from 100/70 to
60/30 mm of Hg, diffused cyanosi Application of prednisolon of 120 mg and reopolyglucin did not
give any effect. What complication does it follow to think about?
acute sub renal failure
Septic shock
hypovolemic shock
Hemorragic shock
Respirator distress syndrom of adults
The patient 32 years have infusion of native plasm At the end of infusion the state became worse:
disorientation, cyanosys, excitation, appeared hypersalivation, tahypnoe, AP =70/40 mm mer st., in
lungs – the dissipated dry wheeze What medicine must be injected firstly?
Adrenalin.
Suprastin.
Gidrocortizon.
Dopamin.
Eufilin.
146.
A. *
B.
C.
D.
E.
147.
A. *
B.
C.
D.
E.
To patient P., 50 years, with an unspecific ulcerous colitis with the purpose of correction of anaemia
transfusion of selfgroup blood 500 ml A(ІІ) the Rh(-) was conducte A doctor went out from
a chamber after conducting of necessary tests before hemotransfusion. In 20 minutes he
was quickly asked to the patient. Patient without consciousnes The cyanosys of upper
body part. Irregular breathing with the selection of a plenty of foamy, with the admixtures of
blood, phlegm. Pulse on peripheries and arterial pressure are not determine Tones of
heart are deaf, unrhythmical. An ampoule and transfusion system is empty. What
complication arose up as a result of hemotransfusion?
Air embolism of pulmonary artery
Tromboembolism of pulmonary artery
Edema of lungs
Heart attack of myocardium
Syndrome of massive hemotransfusion
To the patient 45 years with suspicion on holecystitis the rentgencontrast i/v is quickly injecte
Tahycardiya, arterial hypotension, cyanosys, shortness of breath appeared, acute swelling of veins
of neck, extension of liver, CVT to 200 mm wt.st. acute insufficiency of what part of the
cardial-vascular system is observed at a patient?
Right ventricle of heart
The left ventricle of heart
Both ventricles of heart
Vessels
Uneffective heart
Назва наукового напрямку (модуля):
Семестр:
General questions in surgery 6 course
Опис:
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.
Перелік питань:
In preparations for parenteral nutrition include:
plasma; Mr. casein hydrolysates;
albumin;
Mr. casein hydrolysates
protein;
polivinilpirrolidon
In preparations for parenteral nutrition do not include:
dextran
protein hydrolysates;
10% glucose;
20% glucose;
lipomays
In preparations for parenteral nutrition do not include:
salt
hidrolizyn;
casein hydrolysates;
10% glucose;
lipofundin
Frequently the cause of early complications after surgery using ditylinu:
laryngism;
inhibition of the respiratory center;
collapse;
zapadinnya root of the tongue
Arrhythmia
Frequently the cause of early complications after surgery using Arduan:
zapadinnya root of the tongue
inhibition of the respiratory center;
dehydration;
laryngism;
bronhiolospazm
Frequently the cause of early complications after surgery using mononarkozu ketaminom:
laryngism;
violations heart rate;
collapse;
halyutsynoz, inadequate behavior
breathing "anarchy"
Frequently the cause of early complications after surgery using the central analgesia:
depressed respiration
bronhiolospazm;
hypotension;
cardiac arrest;
acute liver failure
11
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.
Immediately after the operation under anesthesia prozeryn vykorystovuyut to:
restore tone respiratory center;
removing the residual after applying kuraryzatsiyi depolyaryzuyuchyh muscle relaxants;
removing the residual after applying kuraryzatsiyi antydepolyaryzuyuchyh muscle relaxants
stimulation of intestinal peristalsis;
Prevention bronhiolospazmu
Please list the required corrective surgery therapy
narcotic analgesics, antibiotics, cardiovascular drugs, electrolytes, vitamins;
correction of hemostasis, anesthesia, parenteral nutrition, exercise;
Correction pain, external respiration, volume hidremiyi, stimulation of peristalsis;
anesthesia, the use of central respiratory stimulants, antibiotics, drugs for parenteral breathing;
correction of homeostasis, pain, antibacterial therapy, exercise therapy
Peritonitis is divided into:
reactive, toxic, terminal
compensated, subkompensovanyy, terminal;
stage (I; II; III);
upper and lower half of the abdomen;
Early and late
In a nakrkozu in patients with peritonitis significantly increases the risk of such complications:
respiratory depression due to pulmonary edema;
bronhiolospazmu;
acute heart failure due to mediastinal shift raised diaphragm;
regurgitation and aspiration
hiperkaliyemichnoyi cardiac arrest
The most frequent disorders of homeostasis in peritonitis are:
metabolic acidosis
respiratory acidosis;
deep vein thrombosis of lower extremities, thromboembolism
respiratory alkalosis;
metabolic alkalosis
When jet peritonitis hemodynamics often seen:
collapse;
hipodynamichnym regime;
hiperdynamichnym regime
hypovolemic shock;
depends on initial blood pressure
When toxic peritonitis Cardiac Output:
depends on the value of blood pressure;
increases;
does not change significantly;
reduced
depends on the total peripheral vascular resistance
The optimal anesthetic during the operation y of patients with peritonitis are:
with intravenous mioplehiyeyu and ventilation
Maskovyy inhalant;
C.
epidural anesthesia;
D.
E.
16.
A.
B.
C. *
D.
E.
17.
A.
B.
C.
D. *
E.
spinal anesthesia;
conductor and infiltrative anesthesia
Acute intestinal obstruction causes are primarily disorders of homeostasis:
intoksykatsiynyy syndrome;
respiratory violations;
hipohidratatsiya, dyzelektrolitemiya
acute hepatic, kidney failure;
septic state due to the phenomenon of translocation
Decompensated pilorostenoz especially dangerous:
intoksykatsiynym syndrome;
hiponatriyemiyeyu and hipohidratatsiyeyu;
Respiratory alkalosis and metabolic acidosis;
Hypokalemia, hipohloremiyeyu, metabolic alkalosis
acute adrenal insufficiency
Intestinal obstruction significantly increased risk:
regurgitation and aspiration
septic state;
multiple organ failure;
liver failure;
painful shock
What is characterized by acute destructive pancreatitis?
drop intoksykatsiynoho cardiac output due to myocardial lesions;
metabolic and respiratory acidosis;
hipohidratatsiyeyu, hypotension
compensatory hipertenziynym syndrome;
Injuring hepatocytes
The most desirable preparation for infusion therapy of pancreatitis are:
reosorbilakt;
polihlyukin;
starch derivatives;
izotonichnymy Mr. sodium chloride;
glucose solution
The most frequent complication of pancreatic necrosis are:
pankreatohennyy shock
acute heart failure;
sepsis;
acute liver failure;
pulmonary edema
What is under ICE - Syndrome?
primary, consumption coagulopathy, anemia;
hypercoagulation, consumption coagulopathy, abnormal fibrinolysis, resolution;
hypercoagulation, hipokoahulyatsiyi;
hypercoagulation, consumption coagulopathy, abnormal fibrinolysis, pixels
offset, subkompensated, decompensated
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.
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.
The most reasonable treatment for drug-ICE syndrome are:
Kriopretsipitat;
erytrotsytna weight;
whole blood;
Refortan;
quick-frozen plasma
When expressed anemia caused by acute massive hemorrhage in obstetric practice, primarily to:
eliminate hypovolemia
pour erytrotsytnu mass;
enter hemostatyky;
Kriopretsipitat apply;
ensure the infusion of fibrinogen
To be carried out by blood tests?
now the whole blood transfusion is therefore not necessary to conduct tests;
determining blood type, biological samples;
to save time and Rh blood group-membership can be estimated by documented data (in passport),
to conduct a biological sample;
blood group O (I) Rh (-) is universal for transfusions for any recipient;
blood grouping, Rh accessories, group and individual compatibility of biological samples
Which of the following belong to the mullion components of blood?
antystafilokokova plasma antyhemofilna plasma erytrotsytna mass, fibrinogen, Kriopretsipitat;
native plasma mass erytrotsytna, washed erythrocytes, Kriopretsipitat, polibiolin;
All types of plasma fibrinogen, washed erythrocytes, leykotsytna weight, albumin;
native plasma mass erytrotsytna, washed red cells, platelet mass
native plasma mass erytrotsytna, washed erythrocytes, aminokrovin, polibiolin, thrombus and
leykomasa
Which of the symptoms characteristic for diagnosis hemotransfuziynoho complications due to
incompatible system AB (0) during anesthesia?
znobinnya patient;
sudden pulmonary edema;
expressed hyperthermia;
acute anuria;
motiveless sudden hypotension
What happens in the bloodstream of the patient with an incompatible blood transfusion him?
thrombus;
hemolysis
arteriospazm acute;
hypertension due hiperkateholaminemiyi;
Go beyond the liquid part of blood vessel wall
Severe anemia occurs when a massive loss of blood volume:
30% of bcc;
40% of the bcc
50% of bcc;
60% of bcc;
70% of the bcc
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.
E.
37.
A. *
B.
Bcc in adults is:
1 / 10 of body weight;
5-6% of body weight;
5000 ml;
7% of body weight
1 / 20 on body weight
The reason for ICE - Syndrome can be:
incompatible blood transfusion;
massive hemorrhage;
septic state;
amniotic fluid embolism;
All listed conditions
Laboratory features of 1-under ICE - syndrome are:
decrease in fibrinogen;
reduce the clotting time by Lee-White;
reduction of bleeding by Dyuk'om;
reduction in prothrombin time;
all listed features
How is the diagnosis of the general peritonitis set to the operation?
roentgenologic
anamnestetic
by laboratory determination the signs of inflammatory reaction
on clinical signs
on the level secretion the gastric juice
For the late stage of peritonitis all is characteristic, except for:
swelling of stomach
hypovolemia
disappearance of intestinal noises
hypoproteinemia
increased peristalsis
Diffusive festering peritonitis can be investigation of all transferred diseases, except for:
perforations Meckel's diverticulum
destructive appendicitis
stenosis of large duodenal nipple
Richter strangulation of hernia
acute intestinal impassability
Fibrinogenous impositions on a peritoneum are not at peritonitis:
fibrinogenous
festering
putrid
excrement
serosal
The exsudate painted blood in an abdominal region is observed always, except for:
tubercular peritonitis
violations of extra-uterine pregnancy
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. *
B.
C.
D.
E.
44.
A. *
B.
C.
D.
mesenteric ischemia
acute pancreatitis
twisted oothecoma
Middle laparotomy must be conducted at:
diffusive peritonitis
local unlimited peritonitis
abscess of Duglas space
periappendiceal infiltration
acute appendicitis
. The best method of treatment the subhepatic abscess is:
thoracolaparotomy
lumbotomy
double-stage transpleural approach
laparotomy by Fedorov
extrapleural extra-peritoneal method
Inexpressive leucocytosis in acute appendicitis is characteristic for:
elderly patients
females
children
pregnant
males
For the acute appendicitis, complicated by appendicular infiltrate, in contrast to the tumour of
caecum, is characteristic:
Tendency to diminishing of the tumour in the process of supervision
Long-term anamnesis
Excretion of blood from rectum
Curvuasier's sign
Frequent partial intestinal obstruction in anamnesis
The conditions, which contribute to the formation of appendicular infiltrate include:
Phlegmonous changes of appendix
Chronic appendicitis
Meckel's diverticulum
Pylephlebitis
Perforation of appendix
Only during the operation is possible the differential diagnostics of acute appendicitis with:
terminal ileitis
renal colic
acute pyelonephritis
acute paraproctitis
acute pancreatitis
After appendectomy for pregnant is recommended
Application of abortion prophylaxis.
More frequent use of peritoneal dialysis
Active postoperative period
More rare use of peritoneal dialysis
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.
More prolonged draining of the abdominal cavity
The distinctive peculiarities of acute appendicitis in the second half of pregnancy are:
Weak express of pain syndrome, similar to the ligamentary tension of uterus
Absence of Volkovcha-Kocher's sign
Expressed signs of peritoneal irritation
The express local muscular tension in a right iliac area
Expressed of Obraztsov's sign
For the differential diagnostics of acute appendicitis with the urology diseases is not used
Irrigoscopy
Urography
Cystochromoscopy
X-ray of kidneys
Urine analysis
In the diagnostics of pelvic appendicitis the most valuable is:
rectal and vaginal examination
laboratory analyses
laparocentesis
laparoscopy
colonoscopy
For the retrocaecal appendicitis is not typical:
Volkovcha-Kocher's sign
delayed diagnostics
late entrance of patients in the hospital
frequent development of destructive forms
weak expressed signs of peritoneal irritation
For the perforation of appendix is not characteristic:
Decrease of body temperature
Acute pain in a right iliac area, especially expressed after false improvement
Tension of the abdominal wall at first in a right iliac area, and then spreading on other departments
Increasing swelling of abdomen
Leucocytosis
Initially-gangrenous appendicitis differs from inflammatory-gangrenous form mostly developing in
persons:
of elderly age
children of early age
pregnant in the first half of pregnancy
pregnant in the second half of pregnancy
with concomitant diseases
What does the Bartomier-Mikhelson's sign mean?
The increase of pain intensity during the palpation of right iliac area when the patient lies on the
left side.
Increased pain with coughing
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Migration of pain to the right iliac area from epigastric
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. *
What does the Blumberg's sign mean?
The sharp increase of pain quick taking off the hand during palpation of anterior abdominal wall.
Increased pain with coughing
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Migration of pain to the right iliac area from epigastric
What does the Voskresenky’s sign mean?
The increase of pain during quick sliding movements by the tips of fingers from epigastric to right
iliac area.
Increased pain with coughing
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Migration of pain to the right iliac area from epigastric
What does the Rozdolsky’s sign mean?
Painfulness in a right iliac area during percussion.
Increased pain with coughing
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Migration of pain to the right iliac area from epigastric
What does the Yaure-Rozanov sign mean?
Painfulness during palpation of Petit triangle
Increased pain with coughing
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Migration of pain to the right iliac area from epigastric
What does the Gabay’s sign mean?
Blumberg’s sign in Petit triangle
Increased pain with coughing
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Migration of pain to the right iliac area from epigastric
What does the psoas sign mean?
Pain on extension of right thigh
Increased pain with coughing
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Migration of pain to the right iliac area from epigastric
The sign of gas migration is called:
Rovsing's sign
Kocher’s sign
Sitkovsky’s sign
Bartomier’s sign
Dunphy's sign
The Rovsing's sign is typical for:
Simple appendicitis
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.
Retrocecal appendicitis
Retroperitoneal appendicitis
Pelvic appendicitis
Left-side appendicitis
The Sitkovsky’s sign is typical for:
Simple appendicitis
Retrocecal appendicitis
Retroperitoneal appendicitis
Pelvic appendicitis
Left-side appendicitis
The Bartomier’s sign is typical for:
Simple appendicitis
Retrocecal appendicitis
Retroperitoneal appendicitis
Pelvic appendicitis
Left-side appendicitis
The Dunphy's sign is typical for:
Simple appendicitis
Retrocecal appendicitis
Retroperitoneal appendicitis
Pelvic appendicitis
Left-side appendicitis
The Blumberg’s sign is typical for:
Phlegmonous appendicitis
Simple appendicitis
Retrocecal appendicitis
Retroperitoneal appendicitis
Pelvic appendicitis
The Voskresenky’s sign is typical for:
Phlegmonous appendicitis
Simple appendicitis
Retrocecal appendicitis
Retroperitoneal appendicitis
Pelvic appendicitis
The Rozdolsky’s sign is typical for:
Phlegmonous appendicitis
Simple appendicitis
Retrocecal appendicitis
Retroperitoneal appendicitis
Pelvic appendicitis
The Yaure-Rozanov sign is typical for:
Retrocecal appendicitis
Phlegmonous appendicitis
Simple appendicitis
Left-side appendicitis appendicitis
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.
A. *
Pelvic appendicitis
The Gabay’s sign is typical for:
Retrocecal appendicitis
Phlegmonous appendicitis
Simple appendicitis
Left-side appendicitis appendicitis
Pelvic appendicitis
The Pasternatsky’s sign is typical for:
Retrocecal appendicitis
Phlegmonous appendicitis
Simple appendicitis
Left-side appendicitis appendicitis
Pelvic appendicitis
The psoas sign is typical for:
Retrocecal appendicitis
Phlegmonous appendicitis
Simple appendicitis
Left-side appendicitis appendicitis
Pelvic appendicitis
The expressed pain in a right lumbar area is typical for:
Retrocecal appendicitis
Phlegmonous appendicitis
Simple appendicitis
Left-side appendicitis appendicitis
Pelvic appendicitis
The dysuria is typical for:
Pelvic appendicitis
Retrocecal appendicitis
Phlegmonous appendicitis
Simple appendicitis
Left-side appendicitis appendicitis
The pulling rectal pain is typical for:
Pelvic appendicitis
Retrocecal appendicitis
Phlegmonous appendicitis
Simple appendicitis
Left-side appendicitis appendicitis
The tenesmi are typical for:
Left-side appendicitis appendicitis
Pelvic appendicitis
Retrocecal appendicitis
Phlegmonous appendicitis
Simple appendicitis
The absence of muscular tenderness is typical for:
Pelvic appendicitis
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.
D.
Retrocecal appendicitis
Phlegmonous appendicitis
Simple appendicitis
Left-side appendicitis appendicitis
The painfulness of anterior rectal wall is typical for:
Pelvic appendicitis
Retrocecal appendicitis
Phlegmonous appendicitis
Simple appendicitis
Left-side appendicitis appendicitis
Painfulness of posterior vaginal vault is typical for:
Pelvic appendicitis
Retrocecal appendicitis
Phlegmonous appendicitis
Simple appendicitis
Left-side appendicitis appendicitis
The painfulness of the left iliac region is typical for:
Left-side appendicitis appendicitis
Pelvic appendicitis
Retrocecal appendicitis
Phlegmonous appendicitis
Simple appendicitis
For the simple appendicitis is typical:
Rovsing's sign
Blumberg's sign
Yaure-Rozanov sign
Voskresensky's sign
Kulenkampf's sign
For the simple appendicitis is typical:
Sitkovsky’s sign
Blumberg's sign
Yaure-Rozanov sign
Voskresensky's sign
Kulenkampf's sign
For the simple appendicitis is typical:
Bartomier’s sign
Blumberg's sign
Yaure-Rozanov sign
Voskresensky's sign
Kulenkampf's sign
For the simple appendicitis is typical:
Dunphy's sign
Blumberg's sign
Yaure-Rozanov sign
Voskresensky's sign
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.
A. *
Kulenkampf's sign
For the retrocecal appendicitis is typical:
Yaure-Rozanov sign
Rovsing's sign
Blumberg's sign
Voskresensky's sign
Kulenkampf's sign
For the retrocecal appendicitis is typical:
Gabay’s sign
Rovsing's sign
Blumberg's sign
Voskresensky's sign
Kulenkampf's sign
For the retrocecal appendicitis is typical:
Pasternatsky’s sign
Rovsing's sign
Blumberg's sign
Voskresensky's sign
Kulenkampf's sign
For the retrocecal appendicitis is typical:
Psoas sign
Rovsing's sign
Blumberg's sign
Voskresensky's sign
Kulenkampf's sign
For the retrocecal appendicitis is typical:
Expressed pain in a right lumbar area
Flank tenderness in right lower quadrant
The painfulness of the left iliac region
Clinic of irritation of pelvic organs
Painfulness of anterior rectal wall and posterior vaginal vault
For the retroperitoneal appendicitis is typical:
Flank tenderness in right lower quadrant
Peritoneal signs
The painfulness of the left iliac region
Clinic of irritation of pelvic organs
Painfulness of anterior rectal wall and posterior vaginal vault
For the left-side appendicitis is typical:
The painfulness of the left iliac region
Expressed pain in a right lumbar area
Flank tenderness in right lower quadrant
Clinic of irritation of pelvic organs
Painfulness of anterior rectal wall and posterior vaginal vault
For the pelvic appendicitis is typical:
Clinic of irritation of pelvic organs
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.
A. *
B.
C.
D.
The painfulness of the left iliac region
Expressed pain in a right lumbar area
Flank tenderness in right lower quadrant
Peritoneal signs
For the pelvic appendicitis is typical:
Painfulness of anterior rectal wall
The painfulness of the left iliac region
Expressed pain in a right lumbar area
Flank tenderness in right lower quadrant
Peritoneal signs
For the pelvic appendicitis is typical:
Painfulness of posterior vaginal vault
The painfulness of the left iliac region
Expressed pain in a right lumbar area
Flank tenderness in right lower quadrant
Peritoneal signs
Characteristic changes in the general blood analysis in appendicitis:
neutrophil leucocytosis with deviation of the differential count to the left
neutrophil lymphocytosis with deviation of the differential count to the left
neutrophil eosonophilia with deviation of the differential count to the left
neutrophil leucocytosis with deviation of the differential count to the right
white cells neutrophilia with deviation of the differential count to the right
The most informing method of instrumental diagnostics of acute appendicitis is:
tomography
esophagogastroscopy
colonoscopy
gastroscopy
contrasting roentgenoscopy
The most informing method of instrumental diagnostics of acute appendicitis is:
ultrasound examination
contrasting roentgenoscopy
gastroscopy
esophagogastroscopy
colonoscopy
Acute appendicitis in the 1st phase is necessary to differentiate from:
gastric ulcer
pancreatitis
cholecystitis
intestinal obstruction
strangulated hernia
Appendicular infiltrate is treated:
conservative therapy, then surgery
only conservative therapy
puncture
drainage
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.
C.
D.
E.
104.
A. *
only surgical treatment
Appendicular infiltrate is treated:
antibiotics, paranephral blockade, detoxication therapy
antiseptics, analgesia, antibiotics, anti-inflammatory therapy
antibiotics, diuretics, antispasmodic, anti-inflammatory therapy
analgesia, antibiotics, diuretics, anti-inflammatory therapy
anti-inflammatory drugs, paranephral blockade, detoxication therapy
Appendicular infiltrate appears after:
3-5 days
1-2 days
5-6 days
7-8 days
8-10 days
Conservative treatment of appendicular infiltrate is going on:
1-2 weeks
1 week
3-4 weeks
1-2 months
2-4 months
Appendectomy after the treatment of appendicular infiltrate performed after:
2-4 months
1-2 weeks
3-4 weeks
1-2 months
3-5 days
For appendectomy the most suitable surgical access is:
Volkovich-Dyakonov
McBurney
Lenander
Sprengel
Kocher
The removal of appendix from apex - is :
antegrade appendectomy
retrograde appendectomy
retrocecal appendectomy
antececal appendectomy
laparoscopic appendectomy
The removal of appendix from the base is:
Retrograde appendectomy
antegrade appendectomy
retrocecal appendectomy
antececal appendectomy
laparoscopic appendectomy
On the line between the anterior-superior process of the iliac bone and umbilicus located the point:
McBurney's
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.
111.
A. *
B.
C.
Kalk's
Kehr's
Lenander's
Volkovich-Dyakonov
The point through which the Volkovich-Dyakonov access is performed located on the line between
anterior-superior process of the iliac bone and umbilicus:
between external and middle third
between external and internal third
in the internal third
in the middle
in external third
Which method of appendectomy is used in children before age 3?
ligation
amputation
retrograde
antegrade
laparoscopic
Modern method of appendectomy is:
laparoscopic
microlaparotomy
laparocentesis
laparotomy
ligation
After appendectomy the patient stands out of bed on:
first day
second day
third day
fourth day
fifth day
During appendectomy the most frequent complication is:
bleeding
infiltrate
leak of the sutures
infecting
peritonitis
After appendectomy to early postoperative complications belongs:
peritonitis
intestinal fistula
ventral hernia
ligature fistula
colitis
Appendectomy, as a rule, is performed under such anaesthesia:
intravenous anaesthesia
local anaesthesia
ether anaesthesia
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. *
B.
C.
D.
E.
119.
conducting anaesthesia
endotracheal anaesthesia
Pain during palpation in a lumbar region - is the sign:
Yaure-Rozanov sign
Sitkovsky's sign
Obrastsow's sign
Voskresensky's sign
Kulenkampf's sign
Pain during palpation in the Petit triangle - is the sign:
Yaure-Rozanov sign
Sitkovsky's sign
Obrastsow's sign
Voskresensky's sign
Kulenkampf's sign
Pain during palpation in a lumbar region after taking away of the hand is the sign:
Gabay's sign
Sitkovsky's sign
Obrastsow's sign
Voskresensky's sign
Kulenkampf's sign
For retrocecal appendicitis is characteristic the sign:
Yaure-Rozanov sign
Sitkovsky's sign
Obrastsow's sign
Voskresensky's sign
Kulenkampf's sign
For retrocecal appendicitis is characteristic the sign:
Gabay's sign
Sitkovsky's sign
Obrastsow's sign
Voskresensky's sign
Kulenkampf's sign
For retroperitoneal appendicitis is characteristic the sign:
Pasternatsky's
Sitkovsky's
Yaure-Rozanov
Rovzing's
Koer's
Microhematuria is typical for such kind of appendicitis:
retroperitoneal
retrocecal
pelvic
subhepatic
left-side
The pelvic appendicitis manifests by:
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.
D.
E.
126.
A. *
B.
C.
dysurination
dyspepsia
hyperthermia
hematuria
dystrophy
The pelvic appendicitis manifests by:
tenesmi
spasms
myalgia
paresis
enuresis
For pelvic appendicitis is characteristic the sign:
Kulenkampf's sign
Yaure-Rozanov sign
Sitkovsky's sign
Obrastsow's sign
Voskresensky's sign
The pelvic appendicitis manifests by:
diarrhea
vomiting
constipation
nausea
colicks
The undiagnosed destructive appendicitis complicated by:
infiltrate
fistula
adhesions
bleeding
colic
Causes of the appendicular infiltrate development:
late hospitalisation, misdiagnosed appendicitis
aggressive infection, impaired immunity
adhesions, increased immunity
peritonitis, abscessing
surgical trauma, infection
The clinical manifestation of appendicular infiltrate is:
swelling
the signs of peritoneal irritation
muscular tension
high temperature
leucocytosis
Tumour with fluctuation are the main clinical manifestation of:
appendicular abscess
appendicular peritonitis
appendicular infiltrate
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.
133.
A. *
B.
C.
D.
E.
appendicular mesadenitis
appendicular typhlitis
The most frequent complications of appendicitis are:
infiltrate, abscess, pilephlebitis, peritonitis
infiltrate, abscess, thrombophlebitis, hepatitis
conglomerate, adhesions, cystitis, peritonitis
infiltrate, conglomerate, hepatitis
abscess, peritonitis, adhesions, phlebitis
The peculiarities of the clinical course of appendicitis in children are caused:
by the bailer form of appendix
by the tubular form of appendix
by hypertrophy of appendix
by atrophy of appendix
by the spherical form of appendix
Lymphoid hypoplasia determines the peculiarities of the clinical course of appendicitis in:
children
elderly patients
pregnant
males
females
The pain all over the whole abdomen in acute appendicitis is characteristic for:
children
females
pregnant
males
elderly patients
The omental hypoplasia influences on the peculiarities of the course of acute appendicitis in:
children
females
males
pregnant
elderly patients
Dyspeptic syndrome is characteristic for acute appendicitis in:
children
females
males
pregnant
elderly patients
The rapid spread of inflammatory process in acute appendicitis is characteristic for:
children
females
males
pregnant
elderly patients
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.
B. *
C.
D.
E.
Reduced reactivity of the organism influences on the peculiarities of the course of acute
appendicitis in:
elderly patients
females
males
pregnant
children
Rapid destruction of the appendix in the course of acute appendicitis is characteristic for:
elderly patients
children
pregnant
males
females
Inexpressive abdominal pain in acute appendicitis is characteristic for:
Children
elderly patients
females
males
pregnant
Inexpressive muscular tension of anterior abdominal wall in acute appendicitis is characteristic for:
elderly patients
females
children
pregnant
males
Inexpressive leucocytosis in acute appendicitis is characteristic for:
elderly patients
females
children
pregnant
males
The expressed deviation of the differential leukocyte count to the left in acute appendicitis is
characteristic for persons :
females
elderly patients
males
pregnant
children
The clinical manifestation of acute appendicitis does not relate to destructive changes in the
appendix in:
children
elderly patients
females
males
pregnant
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.
E.
148.
A. *
The destructive changes in the appendix don't relate to the clinical manifestation of acute
appendicitis in:
children
females
males
elderly patients
pregnant
The clinical manifestation of acute appendicitis in pregnancy depends on:
the term of pregnancy
degree of inflammatory changes
the relation of appendix to peritoneum
the duration of appendicitis
the form of appendicitis
The clinical manifestations of acute appendicitis in the first trimester of the pregnancy are:
typical
atypical
expressed
unexpressed
absent
The clinical manifestations of acute appendicitis in the second trimester of the pregnancy are:
typical
atypical
expressed
unexpressed
absent
The clinical manifestations of acute appendicitis in the third trimester of the pregnancy are:
atypical
typical
expressed
unexpressed
absent
The clinical manifestations of acute appendicitis in pregnancy are characterised by the changes of:
localization of pain
severity of pain
irradiation of pain
duration of pain
character of pain
The changes of clinical manifestations of acute appendicitis in pregnancy are caused by:
distension of anterior abdominal wall by uterus
inflammation of uterus
irritation of anterior abdominal wall by uterus
compression of appendix by uterus
inflammation of the right ovarium
The changes of clinical manifestations of acute appendicitis in pregnancy are caused by:
absence of muscular tension of anterior abdominal wall
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. *
B.
C.
absence of tension of the uterus
presence of tension of the uterus
expressed muscular tension of anterior abdominal wall
presence of tension of peritoneum of anterior abdominal wall
The changes in clinical manifestation of acute appendicitis in pregnancy is characterized :
by the absence of signs of peritoneal irritation
by the presence of signs of peritoneal irritation
by the presence of expressed signs of peritoneal irritation
by displacement of the signs of peritoneal irritation
by the change of the character of signs of peritoneal irritation
What is the medical tactic of the acute appendicitis in pregnant:
to operate
to prescribe antibiotics
to prescribe conservative therapy
to observe
to interrupt pregnancy
The changes of clinical manifestations of acute appendicitis in pregnancy are caused by the
displacement of appendix in relation to cecum:
upword
lateral
downword
medial
retroperitoneal
What is the lethality in acute appendicitis caused by?
late hospitalization
tactical errors
concomitant diseases
technical errors during an operation
severity of disease
The bailer form of appendix is characteristic for:
new-born
males
females
pregnant
elderly patients
The appendix ends its formation at the age of:
7 years
6 months
1 year
3 years
3 months
The purulent inflammation of portal vein as the complication of acute appendicitis - is:
pilephlebitis
mesadenitis
tiphlitis
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.
D.
E.
thrombophlebitis
adnexitis
The most informative for differentiation of appendicitis with a basal pleurisy is:
X-ray film
percussion
tomography
auscultation
bronchoscopy
The most informative for differentiation of appendicitis with an epigastric form of myocardial
infarction are the changes in:
ECG
hemodynamic disturbances
expressed shortness of breath
auscultation
tachycardia
The most informative for differentiation of appendicitis with intercostal neuralgia is:
paravertebral blockade
laparoscopy
microlaparotomy
laparocentesis
peridural blockades
The most informative for differentiation of appendicitis with food poisoning is:
frequent vomit
single vomit
nausea
increased peristalsis
slow peristalsis
The most informative for differentiation of appendicitis with gastric phlegmon is:
esophagogastroscopy
roentgenoscopy
palpation
laparocentesis
ultrasound examination
The most informative for differentiation of appendicitis with perforative ulcer of duodenum is:
absence of hepatic dullness
presence of hepatic dullness by percussion
absence of the splenic dullness
presence of a high tympanic sound by percussion
absence of the gastric dullness
The most informative for the differentiation of appendicitis with cholecystitis is:
ultrasound examination
X-ray film
anamnesis
laparocentesis
laparoscopy
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.
170.
A. *
B.
The most informative for the differentiation of appendicitis with pancreatitis is:
ultrasound examination
blockades
laparostomy
laparoscopy
X-ray film
The most informative for the differentiation of appendicitis with intestinal obstruction is:
X-ray film
ultrasound examination
blockade
laparotomy
laparoscopy
What form of the appendicitis results in the developing of fibrosis of the appendix?
chronic
phlegmonous
catarrhal
gangrenous
perforative
What form of the appendicitis results in the obliteration of the appendix??
chronic
phlegmonous
catarrhal
gangrenous
perforative
Chronic primary appendicitis - is the development of pathological changes in appendix after:
without the signs of acute appendicitis in anamnesis
acute appendicitis
appendicular infiltrate
appendicular abscess
pilephlebitis
To the chronic secondary appendicitis belongs:
residual
catarrhal
empyema
phlegmonous
gangrenous
Chronic residual appendicitis arises up after:
acute appendicitis
chronic appendicitis
colicks
recurrent appendicitis
primary chronic appendicitis
Chronic residual appendicitis arises up after:
appendicular infiltrate
chronic appendicitis
C.
D.
E.
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.
176.
A. *
B.
C.
D.
E.
177.
A. *
B.
C.
D.
E.
recurrent appendicitis
colicks
primary chronic appendicitis
Chronic residual appendicitis arises up after:
appendicular abscess
colicks
chronic appendicitis
recurrent appendicitis
primary chronic appendicitis
The most prominent clinical sign of chronic appendicitis is:
pain by deep palpation
pain by percussion
pain by superficial palpation
skin hyperesthesia
pain by bimanual palpation
What form of appendicitis the signs of peritoneal irritation are absent in?
chronic
calculous
perforative
appendicular infiltrate
appendicular abscess
Hyperaemia, thickening, oedema of appendix are the signs of:
catarrhal appendicitis
phlegmonous appendicitis
gangrenous appendicitis
gangreno-perforating appendicitis
dystrophic appendicitis
Hyperemia, fibrino-purulent fur, pus the lumen are the signs of:
phlegmonous appendicitis
catarrhal appendicitis
gangrenous appendicitis
gangreno-perforative appendicitis
dystrophic appendicitis
Black colour, fibrino-purulent fur, perforation are the signs of:
gangreno-perforative appendicitis
phlegmonous appendicitis
gangrenous appendicitis
catarrhal appendicitis
dystrophic appendicitis
The peculiarities of the clinical course of appendicitis in children are caused:
by the bailer form of appendix
by the tubular form of appendix
by hypertrophy of appendix
by atrophy of appendix
by the spherical form of appendix
178.
A. *
B.
C.
D.
E.
179.
A. *
B.
C.
D.
E.
180.
A. *
B.
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. *
Lymphoid hypoplasia determines the peculiarities of the clinical course of appendicitis in:
children
elderly patients
pregnant
males
females
The pain all over the whole abdomen in acute appendicitis is characteristic for:
children
females
pregnant
males
elderly patients
The omental hypoplasia influences on the peculiarities of the course of acute appendicitis in:
children
females
males
pregnant
elderly patients
Dyspeptic syndrome is characteristic for acute appendicitis in:
children
females
males
pregnant
elderly patients
For acute appendicitis typical t° is:
38° С
37° С
subfebrile
37-39° С
38-40° С
The rapid spread of inflammatory process in acute appendicitis is characteristic for:
children
females
males
pregnant
elderly patients
Reduced reactivity of the organism influences on the peculiarities of the course of acute
appendicitis in:
elderly patients
females
males
pregnant
children
Rapid destruction of the appendix in the course of acute appendicitis is characteristic for:
elderly patients
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. *
B.
C.
D.
children
pregnant
males
females
Inexpressive abdominal pain in acute appendicitis is characteristic for:
children
females
males
pregnant
elderly patients
Inexpressive muscular tension of anterior abdominal wall in acute appendicitis is characteristic for:
females
children
pregnant
males
elderly patients
What kind of acute intestinal obstruction the invagination belongs to?
Mixed
Paralytic
Volvulus
Strangulation
Dynamic
Invagination much more frequent in:
Children
Pregnant
Elderly people
Teenagers
Does not depend on age
What is the most frequent localization of invagination:
The region of cecum
Splenic angle
Hepatic angle
Rectosygmoid angle
Patients with the Led's syndrome
The most frequent cause of the large intestinal obstruction is:
Tumours
Invagination
Volvulus
Hemorrhoids of IV degree
Errors in the diet
The first phase of the clinical course of acute intestinal obstruction lasts:
To 12 hours
To 2 hours
To 1 days
More than 1 day
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. *
B.
C.
D.
E.
198.
A. *
B.
C.
D.
E.
199.
A. *
B.
C.
D.
E.
200.
A. *
To 1 hour
The leading signs in acute intestinal obstruction are:
Wave-like pain, vomiting, delay of gases and stool
„Knife-like” pain, wooden abdomen, proper anamnesis
„Knife-like” pain, wooden abdomen, vomiting
Wave-like pain, anaemia
Nausea, loss of appetite, metallic taste in the mouth
Name the character of peristalsis in the onset of the acute intestinal obstruction:
Hyperperistalsis
Normal peristalsis
Absent
Variable
Heard only in regions upper the obstruction
The Sklyarov's sign in acute intestinal obstruction is:
Noise of splash
Good heard cardiac tones during auscultation of the abdomen
Dullness in the lower regions
Sound of falling drop
Gaping of anus
The Grekov's sign in acute intestinal obstruction is:
Gaping of anus
Good heard cardiac tones during auscultation of the abdomen
Dullness in the lower regions
Sound of falling drop
Noise of splash
In acute intestinal obstruction the basic X-ray sign is:
Air-fluid levels, Kloiber's cups
Expressed limitation of mobility of the right dome of diaphragm
Diffusely dilated loops of bowels
Free gas in the abdomen
Sklyarov's sign
The Spasokukotsky's sign in acute intestinal obstruction is:
Sound of falling drop
Good heard cardiac tones during auscultation of the abdomen
Dullness in the lower regions
Noise of splash
Gaping of anus
What are the Kloiber's cups?
Horizontal air-fluid levels
Gas bubble of the stomach
Folds of intestine
Gas sickles under the domes of diaphragm
None of mentioned
Name the method of examination which is not obligatory in acute intestinal obstruction:
All are obligatory
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.
207.
A. *
B.
C.
D.
General blood analysis
General urine analysis
Coagulogramm
Electrolytes
Is obligatory the X-ray examination at suspicion on acute intestinal obstruction?
Yes
No, if you know that acute intestinal obstruction is of obturative origin
Yes, if you know that acute intestinal obstruction is of obturative origin
No
Yes, except for children and pregnant
Is obligatory the digital examination of rectum at suspicion on acute intestinal obstruction?
Yes
No, if you know that acute intestinal obstruction is of obturative origin
Yes, if you know that acute intestinal obstruction is of obturative origin
No
Yes, except for children, pregnant
The purpose of conservative therapy in compensated acute intestinal obstruction:
All mentioned
Preoperative preparation
Treating
Detoxication
Diagnostic
The purpose of conservative therapy in decompensated acute intestinal obstruction:
Preoperative preparation
Treating
Detoxication
All mentioned
None of mentioned
What does not belong to conservative therapy of acute intestinal obstruction?
Liquidation of hypervolemia
Decompression of gastrointestinal tract
The struggle against abdominal-pain shock
Detoxication
Correction of microcirculation
What does not belong to the fight against abdominal-pain shock?
Performing of siphon enema
Paranephral novocaine blockade
Neuroleptanalgesia
Peridural anaesthesia
Spasmolytic therapy
The decompression of gastrointestinal tract includess everything, except:
Lavage of abdominal cavity
Endoscopic intubation
Enterotomy with aspiration
Washing of the stomach
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.
C.
D.
E.
214.
A. *
B.
C.
Performing of siphon enema
Name duration of conservative treatment of acute intestinal obstruction in the stage of
compensation?
5-7 days
1-2 days
12-24 hours
To 12 hours
Not less than 2 weeks
Treatment of patients with acute intestinal obstruction in the stage of decompensation must be:
2-4 hours of conservative, then operative
To 24 hours of conservative, then operative
Immediately operative
During the first days conservative treatment with the gradual increase of volume of infusion
Conservative in ambulatory conditions
The treatment of patients with strangulation acute intestinal obstruction which accompanied by the
manifestations of peritonitis must include:
2 hours of conservative treatment, then operative
To 12 hours conservative treatment, then operative
Immediately operative without conservative
Conservative in ambulatory conditions
During the first days conservative with the gradual increase of volume infusion
The criteria of the efficiency of gastrointestinal tract passage renewal during conservative therapy
of acute intestinal obstruction is:
Pulling of gases and stool
Normalization of rectal temperature
Absence of Shchotkin-Blumberg's sign
Feeling of heartburn
None of mentioned
To the criteria of permanent renewal of the gastrointestinal tract passage as efficiency of
conservative treatment belongs:
Absence of stagnant content in the stomach
Absence of Shchotkin-Blumberg's sign
Normalization of rectal temperature
Feeling of heartburn
None of mentioned
The absolute indication for operative treatment of acute intestinal obstructionє:
III phase of the course of acute intestinal obstruction
II phase of the course of acute intestinal obstruction
I phase of the course of acute intestinal obstruction
The prolonged anamnesis of acute intestinal obstruction
Dynamic acute intestinal obstruction
The indication for operative treatment of acute intestinal obstruction is:
Mechanical acute intestinal obstruction in inefficient conservative treatment
I phase of the course of acute intestinal obstruction
II phase of the course of acute intestinal obstruction
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.
A. *
B.
C.
The prolonged anamnesis of acute intestinal obstruction
Mechanical acute intestinal obstruction
In what case the drainage of the abdominal cavity is inadvisable in operative treatment of acute
intestinal obstruction?
None of mentioned cases
In formation of anastomosis
In formation of haematoma
In formation of stoma
In all these cases
When is the operative intervention for acute intestinal obstruction accompanied by the drainage of
abdominal cavity?
In all mentioned cases
In formation of stoma
In increased bleeding during dissecting of adhesions
In formation of anastomosis
None of mentioned cases
Is the programmable laparostomy suitable in the treatment of І-ІІ stage of acute intestinal
obstruction?
No
Yes
Only in the case of formation of anastomosis
Only in strangulation acute intestinal obstruction
Only in obturation acute intestinal obstruction
Optimal access in the operative treatment of acute intestinal obstruction is:
Middle laparotomy
Phanenstil's
Vinkelman's
Fedorov's
Right pararectal
Choose the correct algorithm of the operative intervation for the II stage of acute intestinal
obstruction :
Laparotomy, liquidation of obstruction, intestinal intubation, sanation of abdominal cavity, suturing
of the abdomen
Laparotomy, liquidation of the source of peritonitis, sanation of abdominal cavity, suturing of the
abdomen
Laparotomy, liquidation of obstruction, sanation of abdominal cavity, suturing of the abdomen
Laparotomy, liquidation of obstruction, intestinal intubation, sanation of abdominal cavity,
laparostomy
Laparotomy, liquidation of obstruction, liquidation of the source of peritonitis, intestinal intubation,
sanation of abdominal cavity, suturing of the abdomen
Choose the correct algorithm of operative intervation for the III stage of acute intestinal
obstruction:
Laparotomy, liquidation of the source of peritonitis, intestinal intubation, sanation of abdominal
cavity, suturing of the abdomen or laparostomy
Laparotomy, liquidation of obstruction, intestinal intubation, sanation of abdominal cavity, suturing
of the abdomen
Laparotomy, liquidation of obstruction, intestinal intubation, sanation of abdominal cavity,
laparostomy
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.
A. *
B.
C.
D.
E.
226.
A. *
B.
C.
D.
E.
227.
A. *
B.
C.
D.
Laparotomy, liquidation of obstruction, intestinal intubation, sanation of abdominal cavity, suturing
of the abdomen
Laparotomy, liquidation of obstruction, liquidation of peritonitis, sanation of abdominal cavity,
suturing of the abdomen
Arterial mesenteric acute intestinal obstruction belongs to:
Obturation
Strangulation
Paralytic
Spastic
Mixed
What is the essence of arterial mesenteric intestinal obstruction?
Superior mesenteric artery compresses the duodenum
Duodenum compresses the superior mesenteric artery
Acute intestinal obstruction on the background of mesenteric thrombosis
Mesenteric thrombosis caused by obstruction
Duodenum compresses inferior mesenteric artery
What treatment is indicated in gall-stones intestinal obturation?
Only operative
Only conservative
Operative in the case of the development of peritonitis
Treatment is not required
Tactic depends on the size of stone
The tumour obturation of cecum requires:
Right-side hemicolectomy
Resection of cecum
Cecostomy
Only ileostomy
Only intubation of small intestine
What treatment tactic of acute intestinal obstruction, caused by a tumour obturation is required?
Operative intervation
Liquidation of tumour by a chemotherapy
Liquidations of tumour by radiotherapy
Operative intervation only after chemotherapy
Only symptomatic treatment
What is the volvulus?
Torsion of the bowel with its mesentery along longitudinal axis
Torsion of the bowel with the mesentery of another loop
Invagination of one part of the bowel in another
Obturation of the bowel lumen
Torsion of the bowel with its mesentery along transverse axis
The most frequently the sygmoid volvulus arises in:
Elderly patients with frequent constipations
Females with menstrual arrest
Children
Elderly patients people with permanent diarrhea
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.
E.
235.
A. *
New-borns
What is the aim of the operative treatment of volvulus if the bowel „alive”?
Detorsion, decompression, fixing to the abdominal wall
Detorsion, resection, fixing to the abdominal wall
Detorsion, dilation, decompression, fixing to the abdominal wall
Detorsion, dilation, decompression
Decompression, fixing to the abdominal wall
The nodulus requires:
Untie the knot, if impossible – resection of the bowel
Resection of the bowel
Untie the knot
To perform the stoma. The second stage the resection of the bowel
None of mentioned
A typical sign for invagination in irrigoscopy is:
„Cockades”
„Candles”
„Rat tail”
Spizharny's sign
Bartomier-Mikhelson's sign
The indication for cecopexia in the operative treatment of invagination is:
For the prophylaxis of relapses
For self desinvagination
For better desinvagination
Is not indicated
Not performed
The peritonitis, caused by perforation of gastric ulcer is characterised by such type of obstruction:
Paralytic
Spastic
Strangulation
There is no characteristic type
The obstruction can not develop in this case
The peritonitis, caused by perforation of duodenal ulcer is characterised by such type of
obstruction:
Paralytic
Spastic
Strangulation
There is no characteristic type
The obstruction can not develop in this case
Describe the Kloiber's cups in small intestinal obstruction:
Wide, not high, maltiple
Not wide, high, single
Not characteristic
Wide, not high, with folds
Of different size, localization
Describe the Kloiber's cups in large intestinal obstruction:
Not wide, high, single
B.
C.
D.
E.
236.
A. *
B.
C.
D.
E.
237.
A. *
B.
C.
D.
E.
238.
A. *
B.
C.
D.
E.
239.
A. *
B.
C.
D.
E.
240.
A. *
B.
C.
D.
E.
241.
A. *
B.
C.
D.
E.
242.
A. *
B.
C.
Wide, not high, maltiple
Not characteristic
Wide, not high, with folds
Of different size, localization
The air-fluid levels (Kloiber's cups) are not characteristic for such type of acute intestinal
obstruction, as:
Spastic
Paralytic
Obturation
Invagination
All kinds
The "trident", "crescent" signs are characteristic for such type of acute intestinal obstruction, as:
Invagination
Spastic
Obturation
Strangulation
All kinds
Which type of acute intestinal obstruction is connected with previous operations:
Strangulation
Spastic
Obturation
Invagination
All kinds
For strangulation is not typical:
Normal body temperature
Tension of abdominal wall
Leucocytosis
Frequent vomit
Wahl's symptom
For strangulation is not typical:
Leucopenia
Tension of abdominal wall
Frequent vomit
Body temperature 37,5°C and higher
Wahl's symptom
The contributory factor of the development of strangulation is:
Long intestinal mesentery
Stool stones
Gall-stones
Tumour
None of mentioned
The contributory factor of the development of obturation is:
Stool stones
Long intestinal mesentery
Adhesions in abdominal cavity
D.
E.
243.
A. *
B.
C.
D.
E.
244.
A. *
B.
C.
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.
All of mentioned
None of mentioned
Where is the pain localized in acute appendicitis?
Right iliac region
Epigastric region
Left iliac region
Left subcostal region
Right lumbar region
Where does the pain arise in the onset of acute appendicitis?
Epigastric region
Left iliac region
Right iliac region
Left subcostal region
Right lumbar region
Where does the pain irradiate in acute appendicitis?
Not irradiate
Lumbar region
Left iliac region
Right scapular
Perineum
What dyspeptic manifestations are typical for acute appendicitis?
Single nausea and vomiting
Constant vomiting and nausea without any relief
Vomiting by bile without any relief
Absence of peristalsis
Constant diarrhea
What objective manifestations are typical for acute appendicitis?
Muscular tension in a right iliac area
Abdominal distension
Absence of hepatic dullness
Absence of peristalsis
Rigidity of anterior abdominal wall
What signs are typical for phlegmonous appendicitis in contrast to simple appendicitis?
Peritoneal signs
Signs of gas migration
Signs of pain migration
Muscular tension in a right iliac area
Nausea and vomiting
What sign is typical for phlegmonous appendicitis in contrast to simple appendicitis?
Blumberg's sign
Kocher’s sign
Bartomier’s sign
Sitkovsky’s sign
Dunphy's sign
What sign is typical for phlegmonous appendicitis in contrast to simple appendicitis?
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.
256.
A. *
B.
C.
D.
E.
257.
A. *
B.
Voskresenky's sign
Sitkovsky’s sign
Bartomier’s sign
Kocher’s sign
Dunphy's sign
What does the Voskresenky's sign mean?
Increase of pain during quick sliding movements by the tips of fingers from epigastric to right iliac
area
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Increased pain with coughing
Migration of pain to the right iliac area from epigastric
What does the Rozdolsky’s sign mean?
Painfulness in a right iliac area during percussion
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Increased pain with coughing
Migration of pain to the right iliac area from epigastric
What signs are typical for gangrenous appendicitis in contrast to simple appendicitis?
Signs of intoxication
Signs of gas migration
Retention of stool or single diarrhea
Muscular tension in a right iliac area
Single nausea and vomiting
Who usually suffer from gangrenous appendicitis?
People of old age
Newborns
Children
Pregnant women
Young men
Where is the pain localized in retrocaecal appendicitis?
Right lumbar region
Right iliac region
Epigastric region
Left iliac region
Left subcostal region
What objective manifestations are typical for retrocaecal appendicitis?
Pain and muscular rigidity in a right iliac area during palpation
Abdominal distension
Absence of hepatic dullness
Clinic of retroperitoneal phlegmon
Rigidity of anterior abdominal wall
What sign is typical for retrocaecal appendicitis in contrast to simple appendicitis?
Pasternatsky’s sign
Kocher’s sign
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.
E.
262.
A. *
B.
C.
D.
E.
263.
A. *
B.
C.
D.
E.
264.
A. *
B.
C.
D.
E.
Bartomier’s sign
Sitkovsky’s sign
Dunphy's sign
What sign is typical for retrocaecal appendicitis in contrast to simple appendicitis?
Psoas sign
Sitkovsky’s sign
Bartomier’s sign
Kocher’s sign
Dunphy's sign
What does the Pasternatsky’s sign mean?
Tapping of lumbar region cause the pain
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Increased pain with coughing
Migration of pain to the right iliac area from epigastric
What does the Yaure-Rozanov sign mean?
Painfulness during palpation of Petit triangle
Pain in right lower quadrant during palpation of left lower quadrant
Migration of pain to the right iliac area from epigastric
Tapping of lumbar region cause the pain
Increase of pain in a right iliac area when the patient lies on the left side
What does the Gabay’s sign mean?
Blumberg’s sign in Petit triangle
Pain in right lower quadrant during palpation of left lower quadrant
Migration of pain to the right iliac area from epigastric
Tapping of lumbar region cause the pain
Increase of pain in a right iliac area when the patient lies on the left side
What does the psoas-sign mean?
Pain on extension of right thigh
Painfulness during palpation of Petit triangle
Migration of pain to the right iliac area from epigastric
Tapping of lumbar region cause the pain
Increase of pain in a right iliac area when the patient lies on the left side
What manifestation is predominant for retroperitoneal appendicitis?
Clinic of retroperitoneal phlegmon
Clinic of acute abdomen
Dyspeptic syndrome
Clinic of acute intestinal obstruction
Clinic of acute pancreatitis
What manifestation is predominant for pelvic appendicitis?
Clinic of irritation of pelvic organs (dysuria, pulling rectal pain, tenesmi)
Clinic of acute abdomen
Clinic of retroperitoneal phlegmon
Clinic of acute intestinal obstruction
Clinic of acute pancreatitis
265.
A. *
B.
C.
D.
E.
266.
A. *
B.
C.
D.
E.
267.
A. *
B.
C.
D.
E.
268.
A. *
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.
What manifestation is typical for pelvic appendicitis?
Absence of muscular tenderness
Clinic of retroperitoneal phlegmon
Clinic of acute intestinal obstruction
Clinic of acute abdomen
Clinic of acute pancreatitis
What objective manifestations are typical for retrocaecal appendicitis?
Painfulness of anterior rectal wall and posterior vaginal vault
Abdominal distension
Absence of hepatic dullness
Clinic of retroperitoneal phlegmon
Rigidity of anterior abdominal wall
Where is the pain localized in left-side appendicitis?
Left iliac region
Epigastric region
Right iliac region
Left subcostal region
Right lumbar region
What clinical picture is typical for appendicitis in children?
Clinic of destructive forms of appendicitis and intoxication
Abdominal distension
Absence of dyspeptic manifestation
Absence of muscular tenderness
Clinic of acute intestinal obstruction
What does the examination of infant children in acute appendicitis require to use?
Chloralhydrate enema
Contrast enema
Siphon enema
Cleaning enema
X-ray with barium swallow
What complication is typical for acute appendicitis?
Appendicular infiltrate
Appendicular bleeding
Acute intestinal obstruction
Appendicular-intestinal fistula
Malignization
What complication is typical for acute appendicitis?
Appendicular abscess
Appendicular bleeding
Acute intestinal obstruction
Appendicular-intestinal fistula
Malignization
What is the treatment of appendicular infiltrate?
Conservative treatment
Draining operation
C.
D.
E.
273.
A. *
B.
C.
D.
E.
274.
A. *
B.
C.
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.
Appendectomy
Hemicolectomy
Caecostomy
Typical complications of the appendicitis are:
infiltrate, abscess, peritonitis, pilephlebitis
abscess, phlegmon, paraproctitis, pilephlebitis
infiltrate, gangrene, paraproctitis, pilephlebitis
abscess, phlegmon, peritonitis, pilephlebitis
infiltrate, abscess, osteomyelitis, pilephlebitis
For acute appendicitis is typical:
Kocher-Volkovitch's sign
Ortner's sign
Homans sign
Sklyarov's sign
Meyo-Robson sign
For acute appendicitis is typical:
Rovsing's sign
Ortner's sign
Homans sign
Sklyarov's sign
Meyo-Robson sign
For acute appendicitis is typical:
Sitkovsky’s sign
Ortner's sign
Homans sign
Sklyarov's sign
Meyo-Robson sign
For acute appendicitis is typical:
Bartomier’s sign
Ortner's sign
Homans sign
Sklyarov's sign
Meyo-Robson sign
For acute appendicitis is typical:
Dunphy's sign
Ortner's sign
Homans sign
Sklyarov's sign
Meyo-Robson sign
For acute appendicitis is typical:
Blumberg’s sign
Ortner's sign
Homans sign
Sklyarov's sign
Meyo-Robson sign
280.
283.
A. *
B.
C.
D.
E.
284.
A. *
B.
C.
D.
E.
285.
A. *
B.
C.
D.
E.
286.
A. *
B.
C.
D.
E.
For acute appendicitis is typical:
Voskresenky’s sign
Ortner's sign
Homans sign
Sklyarov's sign
Meyo-Robson sign
For acute appendicitis is typical:
Rozdolsky’s sign
Ortner's sign
Homans sign
Sklyarov's sign
Meyo-Robson sign
For acute appendicitis is typical:
Yaure-Rozanov's sign
Ortner's sign
Homans sign
Sklyarov's sign
Meyo-Robson sign
For acute appendicitis is typical:
Gabay’s sign
Ortner's sign
Homans sign
Sklyarov's sign
Meyo-Robson sign
For acute appendicitis is typical:
Psoas sign
Ortner's sign
Homans sign
Sklyarov's sign
Meyo-Robson sign
For acute appendicitis is typical:
Obrastsow's sign
Ortner's sign
Homans sign
Sklyarov's sign
Meyo-Robson sign
Kocher-Volkovitch's sign is typical for:
acute appendicitis
acute cholecystitis
acute intestinal obstruction
food poisoning
acute pancreatitis
287.
A. *
B.
Rovsing's sign is typical for:
acute appendicitis
acute cholecystitis
A. *
B.
C.
D.
E.
281.
A. *
B.
C.
D.
E.
282.
A. *
B.
C.
D.
E.
C.
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.
acute intestinal obstruction
food poisoning
acute pancreatitis
Sitkovsky’s sign is typical for:
acute appendicitis
acute cholecystitis
acute intestinal obstruction
food poisoning
acute pancreatitis
Bartomier’s sign is typical for:
acute appendicitis
acute cholecystitis
acute intestinal obstruction
food poisoning
acute pancreatitis
Dunphy's sign is typical for:
acute appendicitis
acute cholecystitis
acute intestinal obstruction
food poisoning
acute pancreatitis
Blumberg’s sign is typical for:
acute appendicitis
acute thrombophlebitis
pneumothorax
food poisoning
bleeding ulcer
Rozdolsky’s sign is typical for:
acute appendicitis
acute thrombophlebitis
pneumothorax
food poisoning
bleeding ulcer
Voskresenky’s sign is typical for:
acute appendicitis
acute thrombophlebitis
pneumothorax
food poisoning
bleeding ulcer
Yaure-Rozanov's sign is typical for:
acute appendicitis
acute thrombophlebitis
pneumothorax
D.
E.
food poisoning
bleeding ulcer
D.
E.
288.
A. *
B.
C.
D.
E.
289.
A. *
B.
C.
D.
E.
290.
A. *
B.
295.
298.
A. *
B.
C.
D.
E.
299.
A. *
B.
C.
D.
E.
300.
A. *
B.
C.
D.
E.
301.
A. *
B.
C.
D.
E.
302.
A. *
Gabay’s sign is typical for:
acute appendicitis
acute thrombophlebitis
pneumothorax
food poisoning
bleeding ulcer
Psoas sign is typical for:
acute appendicitis
acute thrombophlebitis
pneumothorax
food poisoning
bleeding ulcer
Obrastsow's sign is typical for:
acute appendicitis
acute thrombophlebitis
pneumothorax
food poisoning
bleeding ulcer
Pain in the iliac region during elevation of the leg - is:
Obrastsow's sign
Sitkovsky's sign
Kocher-Volkovitch's sign
Bartomier-Mikhelson's sign
Voskresensky's sign
Pain during sliding of hand on abdominal wall - is:
Voskresensky's sign
Sitkovsky's sign
Obrastsow's sign
Kocher-Volkovitch's sign
Bartomier-Mikhelson's sign
Strengthening of pain in right iliac region on the left side - is:
Sitkovsky's sign
Obrastsow's sign
Voskresensky's sign
Kocher-Volkovitch's sign
Bartomier-Mikhelson's sign
Pain in the right iliac region during palpation of the iliac region on the left side - is:
Bartomier-Mikhelson's sign
Sitkovsky's sign
Obrastsow's sign
Voskresensky's sign
Kocher-Volkovitch's sign
Pain during digital examination of rectum - is:
Kulenkampf's sign
B.
Obrastsow's sign
A. *
B.
C.
D.
E.
296.
A. *
B.
C.
D.
E.
297.
A. *
B.
C.
D.
E.
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.
309.
A. *
B.
C.
D.
E.
Voskresensky's sign
Kocher-Volkovitch's sign
Sitkovsky's sign
Pain during percussion by fingers of anterior abdominal wall - is:
Rozdolsky's sign
Obrastsow's sign
Sitkovsky's sign
Voskresensky's sign
Kulenkampf's sign
Pain in the right iliac region by pushing of the left - is:
Rovsing's sign
Sitkovsky's sign
Obrastsow's sign
Voskresensky's sign
Kulenkampf's sign
Pain during removing of the hand from abdominal wall after its pressing - is:
Shchotkin-Blumberg's sign
Rovsing's sign
Sitkovsky's sign
Obrastsow's sign
Kulenkampf's sign
Migration of pain to the right iliac area from epigastric is:
Kocher-Volkovitch's sign
Rovsing's sign
Sitkovsky's sign
Obrastsow's sign
Kulenkampf's sign
Increased pain with coughing is:
Dunphy's sign
Rovsing's sign
Sitkovsky's sign
Obrastsow's sign
Kulenkampf's sign
Painfulness during palpation of Petit triangle is:
Yaure-Rozanov's sign
Rovsing's sign
Sitkovsky's sign
Obrastsow's sign
Kulenkampf's sign
Blumberg’s sign in Petit triangle is:
Gabay’s sign
Rovsing's sign
Sitkovsky's sign
Obrastsow's sign
Kulenkampf's sign
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.
D.
E. *
317.
A. *
Pain on extension of right thigh is:
Psoas sign
Rovsing's sign
Sitkovsky's sign
Obrastsow's sign
Kulenkampf's sign
What does the Kocher’s sign mean?
Migration of pain to the right iliac area from epigastric
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
The increase of pain intensity during the palpation of right iliac area when the patient lies on the
left side.
Increased pain with coughing
What does the Rovsing's sign mean?
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
The increase of pain intensity during the palpation of right iliac area when the patient lies on the
left side.
Increased pain with coughing
Migration of pain to the right iliac area from epigastric
What does the Dunphy's sign mean?
Increased pain with coughing
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
The increase of pain intensity during the palpation of right iliac area when the patient lies on the
left side.
Migration of pain to the right iliac area from epigastric
In what vein is a venous outflow carried out in from a stomach?
V. Portae;
V. odd;
V. pair;
V. overhead hollow;
V. lower hollow;
What time urgent operations are executed at acute bleeding
6 – 12 hours;
6 – 10 hours;
6 – 8 hours
6 – 14 hours;
6 – 20 hours
Esophagogastroduodenoscopy can find out next changes in a stomach, except for
tumours
ulcers
bleeding polypuses
erosions
changes of evacuation function
Hemobilia is
all answers are correct;
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.
C.
D.
E.
324.
A.
B. *
C.
D.
bleeding the bilious ways and liver;
bleeding the general bilious channel;
bloody clot in the big duodenal papilla;
all answers are not correct.
Giant ulcer is an ulcer measuring
over 4,5 cm
over 3 cm
over 4 cm
over 5 cm
over 3,5 cm
Duration the period of primary shock at a perforeted ulcer
3-6 hours
6-12 hours
1-3 hours
12-24 hours
24-36 hours
For bleeding ulcer characteristically
melena
tension the muscles of front abdominal wall
Spazarskiy’s sing
sickliness the back vault of vagina
irradiation pain in a shoulder or shoulder-blade
For bleeding ulcer characteristic sign is
pain in an epigastrium;
knife-like pain;
signs irritation of peritoneum;
presence fresh blood in incandescence
melena;
For perforeted ulcer characteristically
tension the muscles of front abdominal wall
melena
vomiting by coffee-grounds
high intestinal impassability
vomiting stagnant gastric maintenance
For pneumoperitoneum is characteristic symptom
Zhober’s;
Khelatid’s;
Podlag’s;
Vigats’s;
Udin’s.
For the heavy flow of ulcerous illness characteristically
2 and anymore relapses on a year
3 and anymore relapses on a year
4 and anymore relapses on a year
5 and more relapses are on a year
E.
6 and more relapses are on a year
325.
A. *
B.
C.
D.
E.
326.
A.
B. *
C.
D.
E.
327.
A. *
For the heavy flow of ulcerous illness characteristically
development of complications
seasonal exacerbation more not frequent 1-2 times per a year
1-2 relapse on a year
liquid, but protracted exacerbation
exacerbation duration more than 10 days
For motion of disease ulcerous illness of middle weight characteristically
development of complications
relapses 1-2 times per a year
4 and anymore relapses on a year
5 and more relapses are on a year
3 and anymore relapses on a year
To absolute indication to operative interference at ulcerous illness does not belong
scarry-ulcerous stenosis
perforation of ulcer
profuse bleeding
diameter ulcer a more than 3 cm
bleeding what does not stopped with conservative
Diet at bleeding gastric and duodenum ulcers
Meulengracht's
№ 1 by Pevznerom
№ 5 by Pevznerom
№ 15 by Pevznerom
№ 7 by Pevznerom
From what department degestyive tract developmentp more frequent than all the bleeding at the
Mallory-Weiss syndrome
gastric fundus
cardial pert;
pyloric department;
from duodenal;
from a thick intestine
At ulcerous illness can a bleeding source be
artery;
veins;
shallow vessels and ulcers;
all answers are not correct.
all answers are correct
Disappearance or diminishing the pain with beginning of bleeding from an ulcer is
Bergman’s sing
Spazarskiy’s sing
Mendel’s suing
De Keven’s sing
Eleker’s sing
To the gastric – intestinal bleeding of unulcerous etiology belong
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.
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.
Mallory-Weiss syndrome;
hemorragic erosive gastritis;
diseases by Randyu – Oslera – Vebera;
Menetrie's sing;
all answers are correct.
What from the transferred operations on the stomach organ protective is
selective proximal vagotomy
resection by Bilrot I
resection by Bilrot II
gastrectomy
all are transferred
What from the transferred operations does not belong to organ protective
trunk vagotomy
resection by Bilrot II
selective vagotomy
selective proximal vagotomy
the all transferred does not belong
What localization of ulcer is most characteristic for the patients of elderly and senile age
cardial department of stomach
overhead third of gullet
lower third of gullet
bulb of duodewnum
small curvature
What colouring of chair is most characteristic for bleeding from the ulcer of stomach and
duodwnum?
Tarry excrement
Presence on the formed excrement of strokes of red blood
Littlechanged blood in an excrement
Excrement of the raspberry colouring with the admixtures of mucus
Acholic excrement
What external signs are characteristic for the profuse bleeding from a gastric ulcer?
Vomiting by the littlechanged blood, excrement of the raspberry colouring
Vomiting by the littlechanged blood, tarry darkly-cherry chair
Vomiting by a complete mouth by dark blood with clots, black formed excrement
Vomiting on the type of "coffee-grounds", presence on the formed incandescence of strokes of red
blood
Tarry darkly-cherry chair
What preparations, except for other properties, own yet and a bacteriostatic effect on Hеlісоbасtеr
руlоrіs
all are transferred preparations
Almagel
Vinylin
De-nol
Claritromycin
What products are recommended in the diet of № 1?
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.
E.
346.
A. *
hen in a steam kind
pancakes
raw egg-white
bread rye fresh
acute cheeses
What violation of mineral exchange is characteristic for patients with ulcerous illness of stomach
and intestine
hypocalcemia
hypokaliemia
Hyponatremia
Hypercalcinemia
hyperkaliemia
What complication the ulcerous illness of stomach is most characteristically for the patients of
elderly and senile age
perforation
perforation bleeding
pylorus stenosis
malignization penetration
bleeding
What from preparations has the expressed bacteriostatic action on Hеlісоbасtеr руlоrіs
trichopol
Licviroton
oxiferiskorbon
atropine
pirinzsipin
What method diagnostics hte ulcerous illness most informing
esophagogastroduodenoscopy
analysis of excrement on the hidden blood
X-rye
global analysis of blood
research of gastric secretion
What preparation does behave to blocker H2-retseptors?
tavegil
obzidan
hystdol
cerucal
oraza
What syndrome is characteristic for hemorragic erosive gastritis?
ulcerous
hemorragic;
pain;
all answers are correct;
all answers are not correct.
When apply Teylor’s method at ulcerous illness
at conservative treatment perforeted ulcers
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.
B.
C. *
D.
at conservative treatment sanguifluous ulcers
at conservative treatment penetration ulcers
at conservative treatment malignization ulcers
at conservative treatment of cicatrical pyloristenosis
Blood loos I stage characterized such indexes
Ht 48-44, Hb 120
Ht 23 and below, Hb 50 and below
Ht 31-23, Hb 80
Ht 38-32, Hb 100
Ht 44-40, Hb 110 /e
Blood loos II stage characterized
Ht 23 and below,
Hb 50 and below
Ht 31-23, Hb 80
Ht 44-40, Hb 110
Ht 48-44, Hb 120
Blood loos III stage characterized a degree such indexes
Ht 23 and below, Hb 50 and below
Ht 31-23, Hb 80
Ht 38-32, Hb 100
Ht 44-40, Hb 110
Ht 48-44, Hb 120
At perforated ulcer the pulled wooden belly is determined in the stage of peritonitis
terminal
toxic
reactive
terminal-toxic
there is not a right answer
At percusion in the first clock after perforation the ulcer more possibly
expansion of percusion border of liver
dulling in the gently sloping places of stomach
tympanitis in left subcosctal area
expansion of percusion border the spleen
there is not a right answer
For differentiation of acute appendicitis with the covered perforete ulcer useful:
gastroduodenoscopy, X-rye of abdominal region, USD of abdominal region
survey X-rye of abdominal region, USD of abdominal region, irrigoscopy
gastroduodenoscopy, X-rye of abdominal region, laparoscopy
X-rye of abdominal region, irrigoscopy
X-rye of abdominal region, laparoscopy
Ulcerous diaeases behaves to the diseases
because of alcoholism
because of the broken circulation of blood
hronic recurrent
innate
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.
B.
C.
D. *
traumatic
Hepatic dullness is not determined at
perforations of gastric ulcer
break of bud
break of spleen
volvulus of stomach
mesenterial ishemia
Penetration of gastric content in an abdominal region possibly at
stenosis
penetration
bleeding
malignixation
perforations
Hectic fever is possible at
bleeding from an ulcer
perforations of ulcer in the first clock
penetration
the uncomplicated ulcer
cicatricle-ulcerous stenosis
For clarification diagnosis of perforete ulcer used
X-rye of abdominal region
X-rye of abdominal region, after gastroscopy, then X-rye of abdominal region
Gastroscopy
CT
There is not a right answer
At operations on a stomach sometimes by mistake bandage an additional hepatic artery, that, in
same queue, can result to necrosis the segment, sectors or even stakes of liver. An additional
hepatic artery more frequent walks away from an artery
splenic
general hepatic
overhead mesenteric
all answers are faithful
left stomach
Most guarantee against the recedive of ulcer during an operation concerning ulcerous diseases of
duodenum gives
trunks vagotomy with a pyloroplasty
resection no less than a 2/3 stomach
selective-proximal vagotomy
antrumectomy with selective vagotomy
veritable antrumectomy
Direct sign of ulcer at x-ray research
violation of evacuation from a stomach
change of tone of stomach
form the stomach as "sand-glasses"
symptom of "niche"
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.
E.
defect of filling
Hectic fever is possible at
to the uncomplicated ulcer
cicatrical-ulcerous stenosis
penetration
perforations of ulcer in the first clock
bleeding from an ulcer
Tactic of family doctor during the covered perforation of ulcer
urgent hospitalization in surgical permanent establishment
planned hospitalization in surgical permanent establishment
supervision on to the house
hospitalization in therapeutic permanent establishment
there is not a right answer
Change in the analysis of blood at a perforete ulcer
leucopenia
anaemia
eosinophilia
leucocytosis with a neutrophilic change
there is not a right answer
In treatment of ulcerous illness the stomach and duodenum executed only on urgent indications
stomach resection by Bilrot-II
sewing up of the perforete opening
selective-proximal vagotomy
trunk vagotomy with a pyloroplasty
stomach resection by Bilrot-I
At the perforete ulcer of duodenum used more frequent
sewing up gastroenteroanastomosis
resection of stomach
sewing up of the perforate opening
resection of stomach for a shutdown
different types of vagotomy in combination with the economy resection of stomach and other
draining operations
The ways distribution of gastroenteric content during the perforation of ulcer depend on
anatomic structure of the lateral ductings
locations of stomach
localizations of the perforate opening
only transferred
forms and locations of transversal rim bowel
Sudden and painful pain with localization in the middle departments of stomach with an irradiation
in the back more characteristic for
heart attack the myocardium
break aneurysm the aorta
bilious colic
perforate ulcers
nephrocolic
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.
In the moment of perforation the gastric or duodenum ulcer meets most often
suddenly arising up megalgia
cramp-like pain
noncommunicative, moderate pain
liquid chair
tachycardia
Numbers of complications the ulcerous illness
5
4
1
3
2
A stomach-ache develops suddenly at (complication of ulcerous illness)
bleeding
malignization
stenosis
penetration
perforations
For a perforete gastric ulcer in the first six clock typical
great sudden pains in a stomach, frequent vomiting, swelling of stomach, disappearance the
hepatic dullness, "sickle" under the right dome of diaphragm
frequent vomiting, swelling of stomach, disappearance the hepatic dullness, "sickle" under the right
dome of diaphragm
great sudden pains in a stomach, wooden belly, swelling of stomach
great sudden pains in a stomach, wooden belly, disappearance the hepatic dullness, "sickle" under
the right dome of diaphragm
combinations of signs are equivalent
Most informing method diagnostics the perforate ulcers
X-rye examination
USD
EGDS
laparoscopy
laparocentezis
Tension the muscles of stomach in an initial period of perforation ulcer
absents
visible
sickliness under the left shoulder-blade
appears at palpation
there is not a right answer
Rational operation at the subcompensated ulcerous stenosis of pylorus
antrumectomy
resection 2/3 stomach
front gastroenteroanastomosis
gastrectomy
selective proximal vagotomy
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.
380.
A. *
B.
C.
D.
E.
381.
A.
B. *
C.
D.
E.
382.
A. *
B.
At suspicion on a duodenal ulcer conduct above all things
research of gastric secretion
EGDS
X-rye examination organs of abdominal region
determination the level of gastrin the whey blood
cholecystography
At a perforation gastric ulcer, vomiting blood is
often
very often
it is never
rarely
there is not a right answer
What basic method the treatment of acute pancreatitis is:
Surgical
Conservative
Homoeopathic
Physical therapy
A right answer is not present
Acute pancreatitis with a heavy flow treat in terms:
Ambulatory
Permanent establishment
Department of intensive therapy
All answers are faithful
A faithful answer is not present
Conservative treatment the acute pancreatitis includes:
Hunger
Povzner’s diet №5
Povzner’s diet №15
Moderation in a meal
Morning gymnastics
Early complications the acute pancreatitis is not:
Fistula of pancreas
Pancreatic shock
Collapse
Ferment peritonitis
Pancreatic delirious syndrome
Name principal reason the acute pancreatitis:
Trauma the pancreas
Bile-stone diseases
Alimentary factor
Chronic alcoholic pancreatitis
Cardiospasm
What operation on a pancreas is indicated at the oedematous form the acute pancreatitis:
Interference on a pancreas is not needed
Pancreatectomy
C.
D.
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.
Omentopankreatopeksy
Abdominisation pancreas
Marsupialization
At a frequent „fat” chair with disseminations of undigested meat and permanent thirst, it is
foremost necessary to think about:
Chronic pancreatitis
Chronic duodenitis
Chronic hepatocholecystitis
Ulcerous diseases of duodenum
Hepatocirrhosis
Name most frequent complication after ERDPH:
Pancreatitis
Cholangitis
Pancreatic sepsis
Reactive cholecystitis
Obstructing papillitis
How often does the pancreatitis department the general bilious channel pass through the head of
pancreas?:
80-90 %
90-100 %
75-85 %
50-60 %
40-50 %
What primary purpose treatment the patients with the heavy form of hemorragic pancreatonecrosis
to the operation is:
Liquidations the pain
Disintoxication the organism
Liquidations crampy the big duodenal papilla
Declines secretory activity the pancreas
Improvements microcirculation
What primary purpose treatment the patient with fatty pancreatonecrosisto the operation is:
Liquidations the pain
Disintoxication the organism
Liquidations crampy the big duodenal papilla
Declines secretory activity the pancreas
Improvements microcirculation
What most optimum resort is which used for pathology the pancreas:
Pyatigorsk
Morshin
Kuyal'nik
Truskavets
Nemirov
Name the optimum volume of operation at acute biliary pancreatitis:
Deleting exsudate from an abdominal region
Decapsulation pancreas
C.
D. *
E.
390.
A.
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.
Pancreatectomy
Sanitization and draining the bilious ways
Draining the chanel of pancreas
Name the optimum lines the operative interference concerning a acute pancreatitis after the
beginning of disease:
7-8 days
1-3 days
1-5 days
3-5 days
Surgical treatment is not indicate
Among acute surgical diseases acute pancreatitis occupies:
First place
Third place
Fifth place
Second - third place
Most widespread
What is condition hematomesis at acute pancreatitis:
Presence concomitant gastric ulcer
Presence concomitant gastritis
Formation erosions in a stomach
Violation of microcirculation
Enzymes in blood
ERCP apply at:
Postcholecystectomy syndrome
Stenosing papillitis
Stenosis the supraduodenal department of choledoch
Stricture the terminal department of choledoch
Mechanical icterus
What preparation is attributed to the proteases inhibitors:
Garamycin
Gaviskon
Gordox
Halidor
Gramicidin
What preparation is attributed to the proteases inhibitors:
Tocopherol
Triampur
Tagamet
Trasylol
Trypsin
What preparation is not attributed to the inhibitors proteases:
Pantripin
Kontrikal
Gordox
Trasylol
E. *
397.
A.
B.
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.
Trypsin
What preparation is applied at violation the extrasecretory function of pancreas at a chronic
pancreatitis:
Pyracetam
Papaverin
Pantocrin
Panzinorm
Panthenol
What operation is used for suppuration the pseudocysts of pancreas:
Cystojejunostomy on the eliminated loop
External draining the cyst
Cystogastrostomy
Cystoduodenostomy
Cystoenteroanastomosis
What operation is used for the pseudocyst of pancreas in the 3th stage of its forming:
Cystojejunostomy on the eliminated loop
External draining the cyst
Cystogastrostomy
Cystoduodenostomy
Cystoenteroanastomosis
What operation is most often used for localization the formed pseudocyst in the area of tail the
pancreas:
Cystojejunostomy on the eliminated loop
External draining the cyst
Cystogastrostomy
Cystoduodenostomy
Cystoenteroanastomosis
What preparations from the cytostatic group use for intensifying the chronic pancreatitis:
Cyanocobalamin
Methyluracil
5-fluorouracil
Furadolizon
Mezimforte
What most effective blocker secretion of pancreas at acute pancreatitis:
Cyanocobalamin
Ubretid
Arginine
Sandostatin
Benzogeksoniy
Indication to early operative interference at acute pancreatitis is:
Acute oedematous pancreatitis
Acute pancreatolysis
Acute biliary pancreatitis
Acute fatty pancreatitis
Forming of pseudocyst
404.
A.
B.
C. *
D.
E.
405.
A.
B.
C.
D.
E. *
406.
A.
B.
C.
D.
E. *
407.
A. *
B.
C.
D.
E.
408.
A.
B. *
C.
D.
E.
409.
A.
B.
C.
D. *
E.
410.
A.
B.
C. *
D.
E.
411.
A. *
B.
Indication to early operative interference at acute pancreatitis is:
Acute pancreatolysis
Acute oedematous pancreatitis
Progressive multiple organ failure what not added conservative therapy during 48-72 hours
Acute fatty pancreatitis
Forming of pseudocyst
What from operations does not execute at surgical treatment complicated acute pancreatitis:
Through draining the stuffing-box bag
Abdominisation the pancreas
Omentopankreatopeksiy
Left-side resection of gland
Pancreatojejunostomy
At pancreatitis abscesses and infected necrosises execute such operations, except for:
Opening of abscess with draining
Pancreaticnecrsekvestrektomy
Pancreaticsekvestrektomy
Pancreaticsekvestrektomy with laparostomy
Total pancreatotomy
What most effective treatment the unformed uncomplicated cyst is:
Conservative treatment
External draining cyst
Resection cyst within the limits of the unchanged gland
Cysticenterostomy
Cystogastrostomy
What most effective treatment the unformed complicated cyst is:
Conservative treatment
External draining cyst
Resection cyst within the limits of the unchanged gland
Cysticenterostomy
Cystogastrostomy
What most effective treatment the formed uncomplicated cyst is:
External draining the cyst
Marsupialization
Resection the cyst within the limits of the unchanged gland
Cysticenterostomy
Cystogastrostomy
What nosotropic conditionality Voscresencky’s sing at acute pancreatitis:
Reflex paresis of colon
Thrombosis of abdominal aorta
Inflammatory edema of pancreas
Embolism of abdominal aorta
Development of peritonitis
All surgical interferences at the destructive forms of acute pancreatitis divide on:
Early, late, deferred operations
Primary, second, repeated operations
C.
D.
E.
412.
A. *
B.
C.
D.
E.
413.
A.
B. *
C.
D.
E.
414.
A.
B.
C. *
D.
E.
415.
A.
B.
C.
D. *
E.
416.
A. *
B.
C.
D.
E.
417.
A. *
B.
C.
D.
E.
418.
A. *
B.
C.
D.
E.
Invasion, not invasion operations
Complicated, operations are not complicated
Not divided
What is sequestrotomy:
Delete the necrotic area within the limits of nonviable fabrics
Delete the necrotic area within the limits of healthy fabrics
Delete part of organ with his transversal cutting within the limits of the changed fabrics
Total delete of organ
There is not a faithful answer
What is necrectomy:
Delete the necrotic area within the limits of nonviable fabrics
Delete the necrotic area within the limits of healthy fabrics
Delete part of organ with his transversal cutting within the limits of the changed fabrics
Total delete of organ
There is not a faithful answer
What is resection the pancreas:
Delete the necrotic area within the limits of nonviable fabrics
Delete the necrotic area within the limits of healthy fabrics
Delete part of organ with his transversal cutting within the limits of the changed fabrics
Total delete of organ
There is not a faithful answer
What is pancreatectomy:
Delete the necrotic area within the limits of nonviable fabrics
Delete the necrotic area within the limits of healthy fabrics
Delete part of organ with his transversal cutting within the limits of the changed fabrics
Total delete of organ
There is not a faithful answer
What is pancreas located in relation to a peritoneum:
Retroperitoneal
Mesoperitoneal
Intraperitoneal
All answers are incorrect
Variously
What is blood supply the body and tail pancreas:
Splenic artery
A.gastroduodenalis
A.gastrica sinistra
A.cystica
Variously
Mondor’s sing at acute pancreatitis:
Violet spots on face and trunk
Cyanosis sides of stomach and trunk
Cyanosis skin of stomach
Icteritiousness round a belly-button
Cyanosys of hands
419.
A. *
B.
C.
D.
E.
420.
A.
B.
C. *
D.
E.
421.
A.
B.
C.
D. *
E.
422.
A. *
B.
C.
D.
E.
423.
A.
B.
C. *
D.
E.
424.
A.
B. *
C.
D.
E.
425.
A. *
B.
C.
D.
E.
426.
A.
B. *
Turner’s sing at acute pancreatitis:
Violet spots on face and trunk
Cyanosis sides of stomach and trunk
Cyanosis skin of stomach
Icteritiousness round a belly-button
Cyanosys of hands
Holsted’s sing at acute pancreatitis:
Violet spots on face and trunk
Cyanosis sides of stomach and trunk
Cyanosis skin of stomach
Icteritiousness round a belly-button
Cyanosys of hands
Kulen’s sing at acute pancreatitis:
Violet spots on face and trunk
Cyanosis sides of stomach and trunk
Cyanosis skin of stomach
Icteritiousness round a belly-button
Cyanosys of hands
Voskresenskiy’s sing at acute pancreatitis:
Absence pulsation the abdominal aorta
Sickliness in left costal-vertebral coal
Sickliness and proof tension the muscles in an epigastrium with passing to left subcostal area
Icteritiousness round a belly-button
Skin hyperesthesia in projection the gland
Kerte’s sing at acute pancreatitis:
Absence pulsation the abdominal aorta
Sickliness in left costal-vertebral coal
Sickliness and proof tension the muscles in an epigastrium with passing to left subcostal area
Icteritiousness round a belly-button
Skin hyperesthesia in projection the gland
Meyo-Robson’s sing at acute pancreatitis:
Absence pulsation the abdominal aorta
Sickliness in left costal-vertebral coal
Sickliness and proof tension the muscles in an epigastrium with passing to left subcostal area
Icteritiousness round a belly-button
Skin hyperesthesia in projection the gland
How many is the period of haemodynamic violations and pancreatic shock lasts:
1-3 days
3-7 days
More 7 days
2 weeks
2 hour
How many is the period of functional insufficiency of parenchymatous organs lasts:
1-3 days
3-7 days
C.
D.
E.
427.
A.
B.
C. *
D.
E.
428.
A. *
B.
C.
D.
E.
429.
A.
B. *
C.
D.
E.
430.
A.
B.
C. *
D.
E.
431.
A.
B.
C.
D. *
E.
432.
A. *
B.
C.
D.
E.
433.
A.
B. *
C.
D.
E.
More 7 days
2 weeks
2 hour
How many is the period of degenerative and festerings complications lasts:
1-3 days
3-7 days
More 7 days
2 weeks
2 hour
What hormone of pancreas has influences on metabolism glucose:
Insulin
Vasopressin
Adrenalin
Somatotropin
Tiroksin
What cages of pancreas are make insulin:
? клетки
? клетки
? -клетки
None of cages
D-клетки
What hormone of pancreas has influences on the exchange of fats:
Insulin
Glyukagon
Lipocainu
Adrenalin
Somatotropin
At what disease pain of girdle character is characteristic:
Gastric ulcers
Acute cholecystitis
Intestinal impassability
Acute pancreatitis
Acute cystitis
The leading clinical symptoms the acute pancreatitis is:
Stomach-ache
Vomiting by „coffee-grounds”
Disuria
Febrile temperature of body
Lock
pathognomonic symptom at acute pancreatitis is:
Pasternatskiy’s sing
Kulen’s sing
Ker’s sing
Lenander’s sing
Rovsing’s sing
434.
A.
B.
C.
D. *
E.
435.
A.
B.
C. *
D.
E.
436.
A. *
B.
C.
D.
E.
437.
A. *
B.
C.
D.
E.
438.
A. *
B.
C.
D.
E.
439.
A.
B.
C. *
D.
E.
440.
A.
B.
C.
D. *
E.
441.
A.
B.
Characteristic complication the acute pancreatitis is:
Paranephritis
Duglas’s abscess
Pylephlebitis
Pancreonecrosis
Cyst of pancreas
The laboratory signs of total pancreonecrosis is:
Growth glucose concentration
Diminishing maintenance fibrinogenum
Growth activity diastase
Diminishing activity diastase
Growth index AST
For diagnostics of acute pancreatitis most informing is:
USD
CT
Cholangiography
Esophagogastroduodenoscopy
Colonoscopy
What norm diastase is:
To 160
To 50
To 200
To 300
To 1200
What level diastase answers a chronic pancreatitis:
200-500
100-160
600-1000
1000-1500
10-20
What level diastase answers a acute pancreatitis:
100-160
200-500
600-1000
1000-1500
10-20
What level diastase answers pancreonecrosis:
600-1000
200-500
100-160
1000-1500
10-20
For what pathology appearance of violet spots on the skin of person and trunk is characteristic:
Perforated ulcer
Acute cholecystitis
C. *
D.
E.
442.
A. *
B.
C.
D.
E.
443.
A. *
B.
C.
D.
E.
444.
A. *
B.
C.
D.
E.
445.
A. *
B.
C.
D.
E.
446.
A. *
B.
C.
D.
E.
447.
A.
B. *
C.
D.
E.
448.
A. *
B.
C.
D.
E.
Acute pancreatitis
Intestinal obstruction
Acute appendicitis
At what pathology is absence pulsation of abdominal aorta
Acute cholecystitis
Acute pancreatitis
Perforated ulcer
Intestinal obstruction
Acute appendicitis
At what pathology is appearance cyanosys the sides of stomach:
Acute pancreatitis
Perforated ulcer
Acute cholecystitis
Intestinal obstruction
Acute appendicitis
At what pathology is appearance of sickliness in left costal-vertebral coal:
Acute pancreatitis
Acute cholecystitis
Perforated ulcer
Intestinal obstruction
A right answer is not present
As the first period flowing of acute pancreatitis is named:
Haemodynamic violations and pancretic shock
To functional insufficiency of parenchymatous organs
Degenerative and festerings complications
All answers are faithful
A right answer is not present
As the second period flowing of acute pancreatitis is named:
Haemodynamic violations and pancretic shock
To functional insufficiency of parenchymatous organs
Degenerative and festerings complications
All answers are faithful
A right answer is not present
As the third period flowing of acute pancreatitis is named:
Haemodynamic violations and pancretic shock
To functional insufficiency of parenchymatous organs
Degenerative and festerings complications
All answers are faithful
A right answer is not present
What complications at a acute pancreatitis is behave to early:
Peritonitis
Phlegmon retroperitoneum space
Formation of pseudocysts
Development of saccharine diabetes
Intestinal impassability
449.
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450.
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451.
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452.
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453.
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454.
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455.
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456.
What complications at a acute pancreatitis is behave to late:
Peritonitis
Phlegmon retroperitoneum space
Formation of pseudocysts
Development of saccharine diabetes
Intestinal impassability
What a clinical flow can be at acute pancreatitis:
Easy, middle, heavy
Acute, chronic
Abortive, making progress
Edema, necrosis
Any variant
For the abortive flowing characteristically:
A process limited to the acute edema with convalescence in 7-8 days
A process limited to tearing away of the pathologically changed gland
A process limited to tearing away of the pathologically unchanged gland
A disease completed so not attaining clinical displays
Changes from the side of organ are not present
Specify the optimum volume operation at acute biliar pancreatitis:
Deleting exsudate from abdominal region
Decapsulation pancreas
Pancreatectomy
Sanitization and draining bilious ways
Draining pancreas channel
What preparation is applied at violation the extrasecretory function pancreas at a chronic
pancreatitis:
Pyracetam
Papaverin
Pantocrin
Mezim-forte
Panthenol
In obedience to classification complications of acute pancreatitis, after etiology and pathogeny,
distinguish such complications, except for:
Infectiously inflammatory
Enzymic
Allergic
Mixed
Trombogemoragic
Characteristic complication acute pancreatitis is:
Pancreonecrosis
Pylephlebitis
Hepatocirrhosis
Veritable pancreas cyst
Hepatitis
After time of origin complications acute pancreatitis select:
A.
B.
C.
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E.
457.
A.
B.
C.
D.
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458.
A.
B.
C.
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E.
459.
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460.
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461.
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462.
A.
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C.
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463.
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C.
Premature and remote
Urgent and deferred
Primary and second
Early and late
Any of variants faithful
To early complications acute pancreatitis attribute:
Shock
Acute hepatic-kidney insufficiency
Poured out peritonitis
Icterus
All answers are faithful
In the postoperative period the patient must be treated with volume infusion likely for:
50 ml / kg;
10 ml / kg;
20 ml / kg;
40 ml / kg
30 ml / kg
Vital body functions:
hemodynamic state of consciousness;
respiration, activity of kidney, liver, gastrointestinal tract;
hemodynamics, somatic and autonomic nervous system;
breathing, heart activity, liver;
respiratory, hemodynamic, central nervous system activity
Please provide optimal kalorazh during postoperative parenteral nutrition patients:
40 kcal / kg
10 kcal / kg;
20 kcal / kg;
30 kcal / kg;
50 kcal / kg
Parenteral nutrition patients displayed:
if you can not enteral
All patients who are treated in VAITi;
all terminally ill;
with disorders of vital functions;
in the postoperative period
In preparations for parenteral nutrition include:
polihlyukin;
albumin;
plasma;
starch derivatives;
lipofundin
In preparations for parenteral nutrition include:
10% glucose solution
albumin;
plasma;
D.
E.
starch derivatives;
karbikarb
Назва наукового напрямку (модуля):
Семестр:
12
KROK 2 SURGERY 6 year
Опис:
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Перелік питань:
?During medical examination a cadet in the naval college was detected to have a painless dense
ulcer 1.5x0.5 in size in his perianal area at the 2 o’clock position. The ulcer ?oor resembles ”old
fat”. What is the provisional diagnosis?
Hard syphilitic chancre of the rectum
Rectal ?ssure
Rectal ?stula
Anal cancer
Anal crypt suppuration
A 10-year-old boy, who was outdoors in windy and cold weather, developed moderate pain and
tingling in his ?ngers and toes. When he had returned home, his parents noticed that the tips of
his ?ngers and toes were white and their sensitivity was lost. The affected areas are warming up,
the ?ngers are tingling and in pain. Skin pallor changed into redness, tingling stopped, slight itching
and swelling of the ?ngers appeared. Determine the frostbite degree in this child:
Frostbite of the I degree
Perniosis
Frostbite of the II degree
Frostbite of the III degree
Frostbite of the IV degree
4 days after a patient received a gunshot wound to the soft tissues of middle third of the thigh, his
condition suddenly began deteriorating. There are complaints of bursting pain in the wound; pain
has been increasing during the last 12 hours. Oedema of skin and hypodermic tissue quickly grows.
Body temperature is 38,2oC, heart rate is 102/min. The wound edges gape, are dull in colour; the
muscles, viable as of day before, now protrude into the wound, look boiled, are dull in colour, have
dirty-grey coating, and fall apart when held with forceps. What infection has developed in the
wound?
Anaerobic
Aerobic gram-negative
Putrid
Aerobic gram-positive
Diphtheria of the wound
A patient received ?ame burns of both hands. On the dorsal and palmar surface of the hands there
are blisters ?lled with serous ?uid. The wrist joint region is hyperaemic. The forearms were not
injured. What is the provisional diagnosis?
II degree ?ame burn of the hands, 4% of body surface area
II degree ?ame burn of the hands, 2% of body surface area
IIIa degree ?ame burn of the hands, 4% of body surface area
III degree ?ame burn of the hands, 4% of body surface area
IIb degree ?ame burn of the hands, 2% of body surface area
On the 4th day after recovery from a cold a patient was hospitalized with complaints of solitary
spittings of mucoid sputum. On the 2nd day there was a single discharge of about 250 ml of
purulent blood-streaked sputum. Objectively: the patient’s condition is moderately severe.
Respiratory rate - 2830/min., Ps- 96/min., BP- 110/70 mm Hg. Respiration over the left lung is
vesicular, over the right lung - weakened. There are various moist crackles over the lower lobe and
amphoric breath sounds near the angle of scapula. What is the most likely diagnosis?
Acute pulmonary abscess
Exudative pleuritis
C.
D.
E.
6.
A. *
B.
C.
D.
E.
7.
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B.
C.
D.
E.
8.
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B.
C.
D.
E.
9.
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B.
C.
D.
E.
10.
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B.
C.
D.
Acute focal pneumonia
Pleuralempyema
Pyopneumothorax
A 65-year-old woman on abdominal palpation presents with a tumour in the umbilical region and
above it; the tumour is 13x8 cm in size, moderately painful, nonmobile, pulsing. On auscultation
systolic murmur can be observed. What is the most likely diagnosis?
Abdominal aneurysm
Gastric tumour
Arteriovenous aneurysm
Tricuspid insuf?ciency
Bicuspid insuf?ciency
After a case of purulent otitis a 1-year-old boy has developed pain in the upper third of the left
thigh, body temperature up to 39oC. Objectively: swelling of the thigh in its upper third and
smoothed-out inguinal fold. The limb is in semi-?exed position. Active and passive movements are
impossible due to severe pain. What diagnosis is the most likely?
Acute haematogenous osteomyelitis
Acute coxitis
Intermuscular phlegmon
Osteosarcoma
Brodie’s abscess
A 74-year-old patient was delivered into admission room with clinical presentations of acute deep
vein thrombosis of the shin. What symptom is the most typical of this pathology?
Homans’ sign
Rovsing’s sign
Courvoisier’s sign
Mayo-Robson’s sign
Grey Turner’s sign
A 50-year-old patient was delivered to a hospital with complaints of blood traces in urine. Urination
is painless and undisturbed. Macrohematuria had been observed for 3 days. Objectively: kidneys
cannot be palpated, suprapubic area is without alterations, external genitalia are non-pathologic. On
rectal investigation: prostate is not enlarged, painless, has normal structure. Cystoscopy revealed no
alterations. What is the most likely diagnosis?
Renal carcinoma
Bladder tuberculosis
Varicocele
Dystopic kidney
Necrotic papillitis
A man complains of constant dull pain in the perineum and suprapubic area, weak ?ow of urine,
frequent dif?cult painful urination, nocturia. The patient has been suffering from this condition for
several months, during which urination was becoming increasingly dif?cult, and pain in the
perineum has developed. On rectal examination: the prostate is enlarged (mainly its right lobe),
dense, asymmetrical, central ?ssure is smoothed out, the right lobe is of stony density, painless,
tuberous. What disease is it?
Prostate cancer
Prostate sclerosis
Urolithiasis, prostatolith of the right lobe
Prostate tuberculosis
E.
11.
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B.
C.
D.
E.
12.
A. *
B.
C.
D.
E.
13.
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B.
C.
D.
E.
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C.
D.
E.
15.
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E.
Chronic congestion prostatitis
A 17-year-old young man complains of general weakness, trismus, twitching of the muscles in his
left shin. 7 days ago he pierced his foot with a nail. Objectively: at the sole of the foot there is a
wound, 0,3х0,2 mm in size, with small amount of serous-purulent discharge, the skin around
the wound is hyperaemic. What is the most likely diagnosis?
Tetanus
Phlegmon
Osteomyelitis
Infected wound
Erysipelas
A patient with trauma of the lower third of the forearm volar surface caused by a glass shard came
to a ?rst-aid centre. Objectively: ?exion of the IV and V ?ngers is impaired, sensitivity of the inner
dorsal and palmar surfaces of the hand and IV ?nger is decreased. What nerve is damaged?
Ulnar
Radial
Median
Musculocutaneous
Axillary
A man diagnosed with closed-angle glaucoma, grade IIa, of the right eye is registered for regular
medical check-ups. In the evening an acute glaucoma attack occurred in his right eye; an
ambulance was called. What emergency aid would be optimal in this case?
Pilocarpine, Diacarb (Acetazolamide), lytic mixture
Atropine eye drops
Antibiotic eye drops, broad-spectrum
Sulfacetamide sodium eye drops
Dexamethasone eye drops
A 58-year-old patient complains of pain in the lower left extremity, which aggravates during
walking, and sensation of cold and numbness in the both feet. The patient has been suffering from
this condition for 6 years. Objectively: the skin is pale and dry, with hyperkeratosis. On the left shin
hair is scarce. Pulse cannot be detected over the pedal and popliteal arteries and is weakened over
the femoral artery. On the right limb pulsation of the popliteal artery is retained. What is the most
likely diagnosis?
Atherosclerosis obliterans of the lower extremities
Obliterating endarteritis
Femoral artery thrombosis
Raynaud’s disease
Buerger’s disease (thromboangiitis obliterans)
A 47-year-old woman came to the admission room with complaints of general weakness, dizziness,
vomiting with blood clots. Condition onset was 3 hours ago. The patient has no preceding illnesses.
Blood pressure is 90/60 mm Hg, pulse is 106/min., of poor volume. The abdomen is soft, with mild
tenderness in the epigastrium. Blood test: erythrocytes - 2.1 • 1012/L, Нb- 70 g/L, hematocrit 28%. What tactics should the doctor on duty choose?
Consult the surgeon
Refer the patient to the family doctor
Give spasmolytics
Perform gastric lavage
Make an appointment for colonoscopy
16.
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D.
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17.
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D.
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18.
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B.
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20.
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C.
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E.
A 52-year-old patient complains of pain in the right part of her chest, dyspnoea, cough with large
amounts of foamy sputum emitting foul smell and resembling ”meat slops”. Objectively: the
patient’s condition is grave, cyanosis is observed, breathing rate is 31/min., percussion sound above
the right lung is shortened, auscultation revealed various moist rales (crackles). What is the most
likely diagnosis?
Lung gangrene
Lung abscess
Empyema of pleura
Multiple bronchiectasis
Chronic pneumonia
A man complains of sore throat on the left, pain in his left ear, to up to 39oC, and nasal sound of his
voice. Disease onset was 5 days ago. Marked trismus and increased salivation are observed. The
head tilts to the left shoulder. Left side of the soft palate presents with swelling, hyperaemia, and
in?ltration. Retromandibular lymph nodes on the left are acutely painful on palpation. Otoscopy
results are normal. Make the diagnosis:
Left-sided peritonsillar abscess
Retropharyngeal abscess
Parapharyngeal phlegmon
Peritonsillitis on the left
Cervical phlegmon on the left
A patient has the second and third degree burns of the 15% of the body surface. On the 20th day
after the trauma the patient presents with sharp increase of body temperature, general weakness,
rapid vesicular respiration; facial features are sharpened, BP is 90/50 mm Hg, heart rate is 112/min.
What complication is it?
Sepsis
Pneumonia
Acute intoxication
Purulent bronchitis
Anaerobic infection
A patient in the state of clinical death is being resuscitated through mouth-to-mouth arti?cial
pulmonary ventilation and external cardiac massage. A doctor noticed that air does not ?ow into the
patient’s airways and his head and torso are positioned at the same level. Why is arti?cial
respiration ineffective in the given case?
Tongue retraction
Low breathing volume
External cardiac massage
Probe is absent from the stomach
The patient’s mouth is too small
A patient complains of suppuration from the ear and impaired hearing of the left ear, which have
been observed for the past 6 years. The patient had periodical headaches, general indisposition,
fever. Objectively: otoscopy of the external auditory meatus revealed mucopurulent odorless
substance. The eardrum is of normal colour, with central perforation. What is the most likely
diagnosis?
Chronic mesotympanitis
Otosclerosis
Acute otitis media
Chronic epitympanitis
Chronic sensorineural hearing loss
21.
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C.
D.
E.
22.
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B.
C.
D.
E.
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B.
C.
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24.
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C.
D.
E.
25.
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C.
D.
E.
In 2 hours after a traf?c accident a 28-yearold man in grave condition was delivered to a hospital.
The patient complains of abdominal pain. He received a blow to the abdomen with the steering
wheel. Objective examination revealed the following: the abdomen does not participate in
respiration, is tense and acutely painful on palpation; abdominal guarding is present, peritoneal
irritation signs are positive, hepatic dullness is absent. BP is 90/60 mm Hg, heart rate is 120/min.
What further treatment tactics should be chosen?
Laparotomy
Laparoscopy
Cold to the abdomen
Abdominal X-ray
Laparocentesis
A 48-year-old woman was arrived to the surgical unit with wounds in her thigh. On examination the
wound surface has dirty-grey coating with unpleasant sweet smell. Wound content resembles
raspberry jelly. Skin tissues around the wound are glossy and turgid. Palpation reveals moderate
crepitation in the tissues. What micro?ora is the most likely to cause such in?ammation?
Anaerobic clostridial
Anaerobic non-clostridial
Streptococci
Staphylococci
Blue pus bacillus
A 30-year-old patient was hospitalized in an intensive care unit with a diagnosis of multiple bee
stings. Skin is pale and covered with cold sweat. Pulse can be palpated only at the carotid arteries
and is 110/min.; breathing rate is 24/min., rhythmical, weakened. What drug must be administered
immediately?
Epinephrine hydrochloride
Prednisolone
Norepinephrine hydrochloride
Dopamine
Tavegyl (Clemastine)
A 46-year-old woman has been hospitalized with open fracture of the left thigh in its middle third.
She underwent the surgery-?xation with extraosseous osteosynthesis plates. On the 4th day after the
surgery she developed pain in the wound, body temperature rose over 39oC. What measures should
be taken in this case?
Undo the sutures, drain the wound, and prescribe antibiotics
Prescribe broad spectrum antibiotics and hormonal agents
Administer antibiotics intraosseously and hypothermia locally
Inject antibiotics into the area surrounding the wound, prescribe spasmolytics and analgesics
Remove the ?xation, prescribe sulfanilamides
A 42-year-old man was delivered to a surgical in-patient department with complaints of icteric skin,
pain in the right subcostal area. Biochemical blood analysis: total bilirubin 140 mcmol/l, direct
bilirubin - 112 mcmol/l. On US: choledoch duct - 1,4 cm, a concrement is detected in the distal area.
Gallbladder is 40 cm, no concrements. What treatment tactics should be chosen?
Endoscopic papillo sphincterotomy
Laparoscopic cholecystectomy
Laparotomy with choledoch duct drain
Laparotomy with cholecystectomy
Treatment in an infectious diseases hospital
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30.
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E.
4 weeks after myocardial infarction a 56year-old patient developed acute heart pain, marked
dyspnoea. Objectively: the patient’s condition is extremely grave, there is marked cyanosis of face,
swelling and throbbing of neck veins, peripheral pulse is absent, the
carotidarterypulseisrhythmic,130/min., BPis 60/20mmHg.Auscultationoftheheartreveals extremely
muf?ed sounds, percussion reveals heart border extension in both directions. What is the optimal
treatment tactics for this patient?
Pericardiocentesis and immediate thoracotomy
Oxygen inhalation
Puncture of the pleural cavity on the left
Conservative treatment, infusion of adrenomimetics
Pleural cavity drainage
A 43-year-old woman complains of persistent stomach ache with recurrent pain attacks, nausea,
repeated vomiting with stagnant bowel content, abdominal distension, and ?atulence. She has been
presenting with these signs for 7 hours. Pulse is 116/min. The tongue is dry and brown. The
abdomen is symmetrically distended, soft, painful. Percussion reveals tympanitis. On auscultation
there are bowel sounds with metallic overtone, splashing, and dripping. Make the diagnosis:
Acute intestinal obstruction
Acute necrotizing pancreatitis
Acute destructive cholecystitis
Acute erosive gastritis
Acute nonspeci?c colitis
An infant cries during urination, the foreskin swells and urine is excreted in drops. What approach
to treatment should be chosen?
Create an opening into the foreskin cavity
Prescription of ?-adrenergic blocking agents
Prescription of antispasmodic agents
Urinary bladder catheterization
Epicystostomy
A 20-year-old patient complains of pain in the left lumbar region, arterial pressure rises up to
160/110 mm Hg. US revealed that the structure and size of the right kidney were within age norms,
there were signs of the 3rd degree hydronephrotic transformation of the left kidney. Doppler
examination revealed an additional artery running to the lower pole of the kidney. Excretory
urogram shows a narrowing in the region of ureteropelvic junction. Specify the treatment tactics:
Surgical intervention
Administration of spasmolytics
Administration of ACE inhibitors
Kidney catheterization
Administration of ?-blockers
A 49-year-old patient consulted a doctor about dif?cult swallowing, voice hoarseness, weight loss.
These symptoms have been gradually progressing for the last 3 months. Objectively: the patient is
exhausted, there are enlarged supraclavicular lymph nodes. Oesophagoscopy revealed no
oesophageal pathology. Which of the following investigations is the most appropriate in this case?
Computed tomography of chest and mediastinum
X-ray of lungs
Multiplanar imaging of oesophagus
Radioisotope investigation of chest
Ultrasound investigation of mediastinum
31.
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34.
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35.
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C.
D.
E.
A 38-year-old patient has been delivered by an ambulance to a surgical department with complaints
of general weakness, indisposition, black stool. On examination the patient is pale, there are dotted
haemorrhages on the skin of his torso and extremities. On digital investigation there are black
faeces on the glove. Blood test: Hb- 108 g/L, thrombocytopenia. Anamnesis states that similar
condition was observed 1 year ago. Make the diagnosis:
Thrombocytopenic purpura
Haemophilia
Bleeding from an ulcer
Rectal tumour
Nonspeci?c ulcerative colitis
A 3-year-old child presents with sharp deterioration of his general condition. He has a history of
purulent otitis. His temperature is now 38.5oC. The left leg is pressed to the torso, active
movements are absent, the lower third of the thigh and knee joint are thickened, hyperaemic, with
localized fever. Axial load leads to acute discomfort of the patient. What is the most likely
diagnosis?
Epiphyseal osteomyelitis on the left
Left hip fracture
Rheumatoid arthritis
Osteogenic sarcoma
Hygroma of the knee
A patient after a blow to the head developed general symptoms of cerebral disturbance, nausea,
vomiting, focal signs hemi-hyperre?exia S>D, hemihyperesthesia on the left, marked meningeal
syndrome. Neither cranial X-ray nor computer tomography revealed any pathologies. What
examination method would allow making and clari?cation of the diagnosis?
Lumbar puncture
Echoencephalography
Electroencephalography
Angiography
Pneumoencephalography
A burn victim with ?ame burns of the IIIA-B and IV degrees on his face, neck, and anterior surface
of the thorax was brought into the admission room. The hairs in his nostrils are burnt, his labial and
glossal mucosa are gray-white. The voice is hoarse; respirations are frequent and shallow; the
patient has trumpet-like cough that produces soot-streaked sputum. The signs of respiratory failure
were progressing, while the patient was being transported into the intensive care unit. What
emergency care must be provided to this patient?
Intubation of the trachea and mechanical ventilation
Tracheostomy
Administration of bronchial spasmolytics
Administration of respiratory analeptics
Inhalation of moisturized oxygen
The body of a 24-year-old woman with probable signs of poisoning has been found on the street.
Forensic medical examination was requested by an investigator during examination of the site and
the body. According to the Criminal Procedure Code currently in force in Ukraine, forensic medical
examination is required when it is necessary to determine the:
Cause of death
Manner of death
Time of death
Mode of death
Mechanism of death
36.
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40.
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D.
A 27-year-old man was hospitalized in severe condition 50 minutes after receiving a penetrating
wound to the left side of the chest. Objectively the patient is in a stupor, his skin is pale and
acrocyanotic. Pulse is 120/min., of poor volume, weak. Blood pressure is 80/40 mm Hg. Heart
sounds are muf?ed, cardiac borders are markedly expanded. In the III intercostal area along the
parasternal line on the left there is a stab-incised wound. Plain chest X-ray shows enlarged heart
shadow with smoothed out waist of the heart, there is haemothorax on the left to the 5th rib. What
contributes the most to the severity of the patient’s condition?
Cardiac tamponade
Acute heart failure
Cardiac rhythm disturbance
Blood loss
Haemothorax and acute respiratory failure
During regular examination of a 2-yearold boy, he presents with enlarged left kidney, painless on
palpation. The right kidney was undetectable on palpation. Excretory urography shows no contrast
on the right. Cytoscopy detected hemiatrophy of the urinary bladder trigone, the right ureteral
ori?ce is not detected. What pathology is it?
Agenesis of the right kidney
Dystopia of the right kidney
Hypoplasia of the right kidney
Agenesis of the right ureter
Ectopic right ureteral ori?ce
A 64-year-oldpatienthasbeenhospitalized with complaints of progressive jaundice that developed
over 3 weeks without pain syndrome and is accompanied by general weakness and loss of appetite.
Objectively: temperature is 36,8oC, heart rate is 78/min, abdomen is soft and painless, peritoneum
irritation symptoms are not detected, palpation reveals sharply enlarged tense gallbladder. What
disease can be characterised by these symptoms?
Cancer of pancreas head
Duodenal ulcer
Acute cholecystitis
Chronic cholecystitis
Cholecystitis caused by lambliasis
A 37-year-old patient complains of pain in the spinal column, reduced mobility. The condition
persists for 7 years. ”Sway back” is observed, there is no movement in all spinal regions. On
X-ray: ”bamboo spine” is detected. What is the most likely diagnosis?
Ankylosing spondylitis
Osteochondrosis
Spondylitis deformans
Tuberculous spondylitis
Spondylolisthesis
A 54-year-old patient complains of weakness, jaundice, itching skin. Disease onset was1.5 months
ago: fever up to 39oC appeared at ?rst, with progressive jaundice developed 2 weeks later. On
hospitalisation jaundice was severely progressed. Liver cannot be palpated. Gallbladder is enlarged
and painless. Blood bilirubin is 190 mcmol/L (accounting mainly for direct bilirubin). Stool is
acholic. What is the most likely reason for jaundice in this patient?
Mechanicaljaundice
Hepatocellularjaundice
Hemolyticjaundice
Caroli syndrome
E.
41.
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45.
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D.
Gilbert’s syndrome
A 23-year-old man came to the surgeon with complaints of pain, redness of the skin, and swelling
in the area of his proximal interphalangeal joint of the III ?nger on the right hand. Six days ago he
pricked his ?nger with a wire. Objectively the III ?nger on the right hand is swollen, hyperaemic,
prominent in the projection of interphalangeal joint, sharply painful on touch and during
movements. Finger mobility is reduced. Fluctuation sign is present. What diagnosis corresponds to
the given clinical presentation?
Articular panaritium
Bone panaritium
Subcutaneous panaritium
Pandactylitis
Finger furuncle
A 30-year-oldpatient was in a car accident. He is unconscious, pale, has thready pulse. In the middle
third of the right thigh there is an extensive laceration with ongoing profuse external arterial
bleeding. What urgent actions must be taken to save the life of the patient?
Tourniquet above the wound of the right thigh
Tourniquet below the wound of the right thigh
Arti?cial lung ventilation
Precordial thump
Application of plaster bar
A 25-year-old patient has been admitted to the hospital with the following problems: weakness,
sweating, itching, weight loss, enlarged submandibular, cervical, axillary, inguinal lymph nodes.
Objectively: hepatomegaly. Lymph node biopsy revealed giant Berezovsky-Reed-Sternberg cells,
polymorphocellular granuloma composed of lymphocytes, reticular cells, neutrophils,
eosinophils, ?brous tissue, and plasma cells. What is the most likely diagnosis?
Lymphogranulomatosis (Hodgkin’s lymphoma)
Lymph node tuberculosis
Lymphoreticulosarcoma
Cancer metastases to the lymph nodes
Macofollicularreticulosis
A 68-year-old man complains of inability to urinate for a day. On attempt of urinary bladder
catheterization there was detected a rough stricture in the membranous portion of the urethra.
What ?rst aid tactics should be applied in this case?
Troacarcystostomy
Adenomectomy
Optical internal urethrotomy
?-adrenoblockers
Urinary bladder catheterization
Heart X-ray of a 31-year-old man has revealed the following: with tightly ?lled opaci?ed
oesophagus there is a marginal ?lling defect in its middle third on the posterior wall; the defect is
1,8x1,3 cm in size with clear oval border. Mucosal folds are retained and envelop the defect; wall
peristalsis and elasticity are not affected. There are no complaints regarding the condition of the
patient’s alimentary canal. Make the provisional diagnosis:
Oesophageal tumour
Achalasia cardiae
Oesophageal burns
Diverticulum
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.
Barrett oesophagus
A 45-year-old woman underwent one year ago mastectomy followed by chemo- and radiation
therapy. She now complains of dyspnoea at rest and temperature up to 37.2oC. Her general
condition is severe, acrocyanosis is observed. The right side of her chest practically does not
participate in respiration. Percussion reveals a dull sound below the 3rd rib; auscultation detects
acute weakening of the respiratory sounds. Pleural puncture on the right has yielded a large amount
of haemorrhagic exudate. What complication has developed in the patient?
Carcinomatous pleuritis
Acute pleural empyema
Acute right-sided pleuropneumonia
Right lung abscess
Pulmonary embolism
A patient with signs of general overexposure to cold presenting with local frostbites of ?ngers has
been delivered into an admission room. Objectively: conscious, inert, speech is slow, the skin of the
face is cold, body temperature is 34oC, heart rate is 68/min. What would be the actions of a doctor
on call?
Hospitalize the patient to the surgical department
Hospitalize the patient to the therapeutics department
Hospitalize the patient to the traumatology department
Let the patient go home
Refer to a family doctor on the next day
A 24-year-old patient had been delivered to a thoracic department with a chest injury, fracture of the
IV, V, VI ribs on the right. Plan radiography showed the ?uid level in the pleural cavity to be
reaching the III rib on the right. Puncture contained blood clots. What is the optimal treatment
tactics?
Emergency thoracotomy
Pleural puncture
Thoracentesis and thoracostomy
Haemostatic therapy
Medical thoracoscopy
A 74-year-old patient visited a urologist with complaints of pain above the pubis and inability to
urinate for 8 hours. At home he had taken antispasmodics and had a warm bath but no improvement
occurred. Objectively: abdomen is soft and painful above the pubis; dullness of percussion sound is
observed above the pubis. Murphy’s (Pasternatski’s) punch sign is negative on the both sides. What
condition does the patient have?
Acute urinary retention
Paradoxalischuria
Chronic urinary retention
Anuria
Oliguria
During preventive examination a 58-yearold man on chest X-ray presents with multiple globular
pale shadows 3 cm in diameter within parenchyma of the both lungs. Examination in the oncologic
hospital: the primary focus is not found; transbronchial biopsy with cytologic investigation detected
cells of glandular neoplasm. What tactics should the physician choose?
Polychemotherapy courses
Exploratory laparotomy
Exploratory thoracotomy
Laparoscopy
E.
51.
A. *
B.
C.
D.
E.
52.
A. *
B.
C.
D.
E.
53.
A. *
B.
C.
D.
E.
54.
A. *
B.
C.
D.
E.
55.
A. *
B.
C.
D.
Symptomatic treatment at home
A 35-year-old man complains of persisting enlargement of his peripheral lymph nodes that cause
him no discomfort. The case history states that the ?rst lymph nodes to enlarge were cervical,
supraclavicular, and axillary; new groups of lymph nodes emerged. Objectively the lymph nodes
are soft and elastic on palpation, enlarged, painless, not ?xed to the surrounding tissue. What
examination method would be the most informative for early diagnostics of this disease?
Needle biopsy
Magnetic resonance tomography
Radioisotope scanning of the skeleton
Ultrasound
X-ray
A woman in her early- to mid-thirties has lost her consciousness 3-5 minutes ago. On examination:
the skin is pale, no pulse over the carotid arteries, no spontaneous respiration, pupils are dilated; the
patient is nonresponsive, presents with atony. The patient’s condition can be determined as:
Apparent death
Natural death
Syncope
Brain death
Coma
A 38-year-old man underwent surgical treatment of a wound with a suppuration focus. On the 8th
day after the procedure the wound cleared of purulo-necrotic discharge and granulations appeared.
However, against the background of antibacterial therapy, the patient’s body temperature persists as
high as 38.5-39.5oC; chills, excessive sweating, and euphoria are observed in the patient; heart rate
is 120/min. What complication of the local suppurative in?ammatory process can be suspected?
Sepsis
Purulent-resorptive fever
Trombophlebitis
Meningitis
Pneumonia
A 28-year-old woman complains of girdle pain in her epigastric and left subcostal areas with
irradiation to the back, nausea, and vomiting without relief. On examination a surgeon observes
stomach distension and meteorism. There are positive Mondor’s, Mayo-Robson’s, and Cullen’s
symptoms. What is the most likely diagnosis?
Acute pancreatitis
Acute cholecystitis
Acute intestinal obstruction
Aortic dissecting aneurysm
Splenic infarction
A man complains of high fever, pain in the area of his right mastoid bone, and purulent discharge
from the right ear. One week ago he had a case of URTI. Objectively the right auricle protrudes, the
skin behind the ear is hyperaemic and pastose; on palpation of the mastoid bone the pain intensi?es;
the auditory meatus is ?lled with thick pus, posterosuperior meatal wall sags; the tympanic
membrane is red and perforated. Make the diagnosis:
Acute mastoiditis
Furuncle of the external auditory meatus
Acute otitis media
Acute otitis externa diffusa
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. *
Exacerbation of chronic mesotympanitis
A 28-year-old man after car accident received a wound to the right side of his chest in?icted by a
sharp metal object. A foamy liquid ?ows out from the wound, there are tympanitis and acutely
weakened respirations in the right. Blood pressure is 70/30 mm Hg, pulse is 120/min., Hb is 28 g/L.
X-ray shows collapsed right lung, horizontal ?uid level is at the 3rd rib. What treatment tactics
should be chosen?
Urgent thoracotomy
Delayed thoracotomy
Drain the right pleural cavity
Apply occlusive dressing to the wound
Conservative therapy
When her car collided with a tree, a 37year-old woman felt sharp pain in her left hip joint. She was
unable to get out of the car. Her position is forced, the hip is pressed to the abdomen, ?xed, and
rotated inwards; the limb is ?exed in the knee, any attempt to change the position results in sharp
pain. Make the diagnosis:
Closed dislocation of the left hip
Contusion of the left hip joint
Hemarthrosis of the left hip joint
Arthritis of the left hip joint
Closed cervical fracture of the left hip
A 22-year-old man at 18:00 developed persisting dull pain in the epigastrium. Three hours later
nausea appeared, he vomited once. By the morning the pain shifted to the right iliac area. Body
temperature rose to 38.6oC, developed tachycardia of 110/min. On examination there are muscle
rigidity and Bloomberg’s sign (rebound tenderness) in the right iliac area of the anterior abdominal
wall. Plain x-ray of the abdomen shows no ?uid levels, free air under the diaphragm on the right.
Make the diagnosis:
Perforation of a gastric ulcer
Renal colic
Acute appendicitis
Acute pancreatitis
Acute cholecystitis
On ultrasound of the thyroid gland, a 47year-old woman presents with a hypoechoic node 1.6 cm in
diameter with blurred margins and intranodular hypervascularization. The doctor suspects thyroid
carcinoma. What method should be used to verify the diagnosis?
Fine-needle aspiration biopsy
Thyroid scintigraphy
Case monitoring
Determine TSH level in the blood
Positron emission tomography(PET)
A 19-year-old young man complains of cough with expectoration of purulent sputum in amount of
100 ml per day, haemoptysis, dyspnoea, increased body temperature up to 37.8oC, general
weakness, weight loss. The patient’s condition has been persisting for 4 years. Exacerbations occur
2-3 times per year. The patient presents with malnutrition, pale skin, cyanosis of the lips, drumstick
(clubbed) ?ngers. Tympanic percussion sound in the lungs, weakened respiration, various numerous
moist crackles in the lower pulmonary segments on the left can be observed. In blood: erythrocytes
- 3.2 • 1012/L, leukocytes -8.4•109/L, ESR-56 mm/hour. On X-ray: lung ?elds are emphysematous,
the left pulmonary root is deformed and dilated. What is the most likely diagnosis?
Multiple bronchiectasis of the left lung
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.
Chronic left-sided pneumonia
Chronic abscess of the left lung
Left-sided pulmonary cystic dysplasia
Suppuration of the cyst in the left lung
An 8-year-old child presents with blood pressure up to 180/100 mm Hg in the upper limbs
accompanied by headaches, tinnitus, occasional nosebleeds, and high fatigability. On examination
there is no pulse over the leg arteries. ECG shows left ventricular hypertrophy. MRI-scan shows
aortic narrowing to 5 mm in the typical place. Coarctation of aorta is diagnosed. What kind of
treatment should be prescribed in this case?
Surgical
Conservative
Physical therapy
Case monitoring
Abstain from surgery in favour of complex conservative therapy
A 6-year-old girl arrived to the in-patient unit with complaints of enlargement of the lower third of
her right thigh. According to the case history, she has been stepping carefully on her right leg and
limping for 6 months. Blood test detected anaemia. X-ray of the right thigh shows a round bone
defect with clear margins resembling melting sugar in the distal metaphysis. What provisional
diagnosis can be made in this case?
Osteogenic sarcoma of the right femur
Rheumatoid arthritis of the right knee joint
Acute haematogenous osteomyelitis of the distal femoral metaphysis on the right
Tuberculous osteitis of the distal femoral metaphysis on the right
Giant cell tumour of the right femur
A 46-year-old man came to the surgeon’s of?ce. He complains of twitching sensation in the wound
on his left foot, insomnia, and anxiety. According to the patient, he received this wound 5 days ago,
when he accidentally stepped on a glass shard, while on the beach. He requested no medical
assistance. Objectively the patient’s general condition is satisfactory, pulse is 75/min., blood
pressure is 130/80 mm Hg, temperature is 36.9oC. On the plantar surface of his foot there is a
wound 1.5 cm long and up to 3 cm deep. The wound edges are moderately hyperaemic, no
discharge from the wound is observed. What disease can be suspected in this patient?
Tetanus
Diphtheria
Anthrax
Fasciitis
Phlegmon
A 20-year-old student was brought to the ?rst-aid centre. He has a closed fracture of the left forearm
and a contused lacerated wound on his left shin. After the patient received initial wound
management, he presented the documents con?rming that he has received all the necessary
preventive vaccination as scheduled. What should the doctor do to prevent tetanus in this patient?
Dynamic case monitoring
Administration of tetanus immunoglobulin
Administration of anti-tetanus serum
Antibiotic therapy
Administration of tetanus toxoid
?During medical examination a cadet in the naval college was detected to have a painless dense
ulcer 1.5x0.5 in size in his perianal area at the 2 o’clock position. The ulcer ?oor resembles ”old
fat”. What is the provisional diagnosis?
A. *
B.
C.
D.
E.
66.
A. *
B.
C.
D.
E.
67.
A. *
B.
C.
D.
E.
68.
A. *
B.
C.
D.
E.
69.
A. *
B.
C.
D.
E.
Hard syphilitic chancre of the rectum
Rectal ?ssure
Rectal ?stula
Anal cancer
Anal crypt suppuration
A 32-year-old woman complains of tumourlike formation on the anterior surface of her neck that
appeared 2 years ago. Within the last 3 months the tumour has been rapidly growing. It hinders
swallowing and impairs speech; the tumour causes a sensation of pressure. Objectively the skin
moisture is normal, pulse is 80/min., rhythmic, blood pressureis130/80mmHg.Intherightlobeof the
thyroid gland there is a dense lumpy node 3.0x3.5 cm that moves during swallowing. Scanning
image shows a ”cold nodule” in the thyroid gland. Make the provisional diagnosis:
Thyroid cancer
Thyroid adenoma
Thyroid cyst
Nodular goitre
Autoimmune thyroiditis
After a surgery for a left thigh phlegmon the disease progression was complicated by sepsis. On the
7th day after the surgery there are marked signs of a generalized in?ammatory reaction, in blood
there are signs of toxic anaemia and progressing hypoproteinemia, bilirubin levels are 40 mcmol/L,
AST and ALT exceed the norm by 2.5 times. Oliguria persists (700 mL of urine per day). Name the
phase of sepsis progression:
Catabolic phase
Stress phase
Anabolic phase
Recovery phase
Mixed phase
A 10-year-old boy, who was outdoors in windy and cold weather, developed moderate pain and
tingling in his ?ngers and toes. When he returned home, his parents noticed that the tips of
his ?ngers and toes were white and their sensitivity was lost. As the affected areas were warming
up, the ?ngers and toes developed tingling and painful sensations. Skin pallor changed into redness,
tingling stopped, mild itching and swelling of the ?ngers appeared. Determine the frostbite degree
in this child:
Frostbite of the I degree
Perniosis
Frostbite of the II degree
Frostbite of the III degree
Frostbite of the IV degree
A 16-year-old patient has made an appointment with an otolaryngologist. He complains of elevated
body temperature and sore throat. Disease onset was 2 days ago, after the patient ate two portions
of ice-cream. Pharyngoscopy shows hyperaemic mucosa of the palatine tonsils, with purulent
exudate in the lacunae. Make the provisional diagnosis:
Lacunar tonsillitis
Follicular tonsillitis
Diphtheria
Acute pharyngitis
Pseudomembranous (Vincent’s) tonsillitis
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.
A. *
B.
A 35-year-old woman complains of high body temperature and pain in the upper outer quadrant of
her right buttock, which developed after an injection. She has been presenting with this condition
for 3 days. At the site of injection, the skin is hyperaemic; there is a painful in?ltrate with an area of
softening in its centre. The woman is diagnosed with a postinjection abscess of the right buttock.
What tactics should the surgeon choose in this case?
Abscess incision, sanation and drainage of the cavity
Hospitalization, prescription of antibiotics, UHF
Abscess puncture, pus removal followed by application of antiseptics
10-15 minutes of low-intensity laser radiation directed at the right buttock
Antipyretic agents, massage, and application of dry heat to the right buttock
A 65-year-old woman on abdominal palpation presents with a tumour in the umbilical region and
above it; the tumour is 13x8 cm in size, moderately painful, nonmobile, pulsing. On auscultation
systolic murmur can be observed. What is the most likely diagnosis?
Abdominal aortic aneurysm
Gastric tumour
Arteriovenous aneurysm
Tricuspid insuf?ciency
Bicuspid insuf?ciency
A 32-year-old man complains of pain in his legs that intensi?es during walking, intermittent
claudication, numbness of his toes, extremity coldness, and inability to walk more than 100 meters.
When he sleeps, his leg usually hangs down. The patient has been smoking since he was 16. He
drinks alcohol in excess. The left leg is colder than the right one; the skin of the extremities is dry.
No pulse can be detected on the pedal arteries, while pulsation of the femoral arteries is retained.
What is the most likely diagnosis?
Obliterating endarteritis
Diabetic angiopathy
Leriche syndrome (aortoiliac occlusive disease)
Raynaud disease
Deep thrombophlebitis
A 50-year-old patient was brought to a hospital with complaints of blood in urine. Urination is
painless and undisturbed. Macrohematuria had been observed for 3 days. Objectively: kidneys
cannot be palpated, suprapubic area is without alterations, external genitalia are nonpathologic. On
rectal investigation: prostate is not enlarged, painless, has normal structure. Cystoscopy revealed no
changes. What is the most likely diagnosis?
Renal carcinoma
Bladder tuberculosis
Varicocele
Dystopic kidney
Necrotic papillitis
A 59-year-old man complains of pain in his left eye and left side of his head, signi?cant vision
impairment of the left eye, nausea, and vomiting. Visual acuity of the right eye is 1.0. Visual acuity
of the left eye is 0.03, attempts at correction bring no improvement. Right eye intraocular pressure 21 mm Hg, left eye intraocular pressure 65 mm Hg. Congestive injection is observed on the sclera
of the left eye. The cornea is thick and swollen. The anterior chamber is shallow, moist, and clear.
The pupil is dilated and unresponsive to the light, the fundus of the eye is not visible. What is the
most likely diagnosis?
Acute attack of glaucoma of the left eye
Acute iridocyclitis of the left eye
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.
Stage II intraocular tumour of the left eye
Endophthalmitis of the left eye
Panophthalmitis of the left eye
On the 15th day after a small trauma of the right foot, the patient developed indisposition,
fatigability, irritability, headache, elevated body temperature, and sensation of constriction, tension,
and twitching in the muscles of the right shin. What disease can be suspected?
Tetanus
Anaerobic gas gangrene
Erysipelas
Acute thrombophlebitis
Thrombophlebitis of the popliteal artery
A patient has the second and third degree burns of the15% of the body surface. On the 20th day
after the trauma the patient presents with sharp increase of body temperature, general weakness,
rapid vesicular respiration; facial features are sharpened, BP is 90/50mm Hg, heart rate is 112/min.
What complication is it?
Sepsis
Pneumonia
Acute intoxication
Purulent bronchitis
Anaerobic infection
2 hours after a traf?c accident a 28-yearold man in a grave condition was brought to a hospital. The
patient complains of abdominal pain. He received a blow to the abdomen with the steering wheel.
Objective examination revealed the following: the abdomen does not participate in respiration, is
tense and acutely painful on palpation; the abdominal muscles are defensively tense, peritoneal
irritation signs are positive, hepatic dullness is absent. BP is 90/60 mm Hg, heart rate is 120/min.
What further treatment tactics should be chosen?
Laparotomy
Laparoscopy
Cold to the abdomen
Ultrasound investigation
Laparocentesis
A 48-year-old woman has arrived to the surgical unit with wounds in her thigh. On examination the
wound surface has dirty-grey coating with unpleasant sweet smell. Wound content resembles
raspberry jelly. Skin tissues around the wound are glossy and turgid. Palpation reveals moderate
crepitation in the tissues. What micro?ora is the most likely to cause such in?ammation?
Anaerobic clostridial
Anaerobic non-clostridial
Streptococci
Staphylococci
Blue pus bacillus
After a pain attack in the right subcostal area, a 58-year-oldwomanwithovernutrition developed
icteric skin and sclera, light-coloured faeces, and dark urine. Her abdomen is distended and painful
on palpation in the right subcostal area. Palpation detects liver enlargement by 2-3 cm. Blood test:
total bilirubin - 90 mcmol/L, conjugated bilirubin - 60 mcmol/L. What method of examination will
be the most informative for diagnosis clari?cation?
Retrograde cholangiopancreatography
Intravenous cholegraphy
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.
Infusion cholegraphy
Percutaneous transhepatic cholegraphy
US of the hepatopancreatobiliary zone
An 11-year-old boy for a month has been presenting with increasing pain in the right femur. In the
painful area there is a nonmobile painful tumour with unclear margins. The child complains of
general indisposition, weakness, increased body temperature up to 39oC.X-ray shows widened
medullary cavity, small foci of cancellous bone destruction, and onion-like lamellar exfoliation of
the cortical layer. What is the most likely pathology resulting in such clinical presentation?
Ewing sarcoma
Osteogenic sarcoma
Fibrosarcoma
Chondrosarcoma
Juxtacortical sarcoma
A 43-year-old man complains of a protrusion in the right inguinal region, that enlarges due to strain.
He has been presenting with this condition for 6 months. Within this period the protrusion has
grown. Objectively in the right inguinal region an elastic protrusion 8x5 cm is visible. On palpation
it disappears, leaving an empty space 4x4 cm between the pedicles of the Poupart ligament. ”Cough
push” sign is positive over this opening. Make the diagnosis:
Right-sided reducible inguinal hernia
Right-sided reducible femoral hernia
Cyst of the right spermatic cord
Right-sided inguinal lymphadenitis
Right-sided reducible arcuate line hernia
A 78-year-old man with a prostate adenoma underwent a herniotomy for a direct inguinal hernia.
After the surgery he presents with absent urination. Enlarged urinary bladder is detectable above
the patient’s pubis. What measures should be taken in this case?
Bladder catheterization
Apply cold to the urinary bladder area
Prescribe processing of the postoperative wound with UHF ?eld
Prescribe proserin (neostigmine) intramuscularly
Prescribe antispasmodics subcutaneously
A 38-year-old patient has been brought by an ambulance to the surgical department with complaints
of general weakness, indisposition, black stool. On examination the patient is pale, there are dotted
haemorrhages on the skin of his torso and extremities. On digital investigation there are black
faeces on the glove. Blood test: Hb- 108
Thrombocytopenic purpura
Haemophilia
Ulcerative bleeding
Rectal tumour
Nonspeci?c ulcerative colitis
A 30-year-old man came to the family physician. 2 months ago he underwent a surgery for open
fracture of the humerus. On examination the patient’s condition is satisfactory; in the area of the
postoperative wound there is a ?stula that discharges a small amount of pus; the area itself is
red; ?uctuation is detected. X-ray shows destruction of the humerus with sequestra. What
complication did the patient develop during the postoperative period?
Posttraumatic osteomyelitis
Haematogenous osteomyelitis
C.
D.
E.
85.
A. *
B.
C.
D.
E.
86.
A. *
B.
C.
D.
E.
87.
A. *
B.
C.
D.
E.
88.
A. *
B.
C.
D.
E.
89.
A. *
B.
C.
D.
E.
Wound suppuration
Posttraumatic phlegmon
Suture sinus
3 hours after a trauma, a young man developed bradycardia of 46/min., anisocoria D>S,
hemi-hyperre?exia S>D, hemihypesthesia on the left, and a convulsive disorder. The character of
this process needs to be clari?ed. What method of examination will be the most accurate for this
purpose?
Brain CT
Skull X-ray
Electroencephalography
Echoencephalography
Lumbar puncture
The body of a 24-year-old woman with suspected poisoning has been found on the street. Forensic
medical examination was requested by an investigator during examination of the site and the body.
According to the Criminal Procedure Code currently in force in Ukraine, forensic medical
examination is required when it is necessary to determine the:
Cause of death
Manner of death
Time of death
Mode of death
Mechanism of death
A 37-year-old patient complains of pain in the spinal column, reduced mobility. The condition
persists for 7 years. ”Sway back” is observed, there is no movement in all spinal regions. X-ray
shows ”bamboo spine” vertebral column. What is the most likely diagnosis?
Ankylosing spondyloarthritis
Osteochondrosis
Spondylitisdeformans
Tuberculous spondylitis
Spondylolisthesis
A surgery unit received a person with an incised stab wound on the upper third of the right thigh.
Examination detects an incised stab wound 3.0x0.5x2.0 cm in size on the inner surface of the upper
third of the right thigh. Bright-red blood ?ows from deep within the wound in a pulsing stream.
Characterize this type of bleeding:
Arterial
Venous
Parenchimatous
Capillary
Mixed
A 47-year-old man developed the signs of decompensated laryngeal stenosis against the background
of acute phlegmonous laryngitis. He presents with inspiratory dyspnea at rest, forced position,
cyanotic skin covered in cold sweat, tachycardia, de?cient pulse, and low blood pressure. What
urgent treatment tactics should be chosen?
Tracheostomy
Oral administration of hyposensitization substances and broncholytics
Intravenous administration of dehydrating agents
Administration of glucocorticoid hormones
Oxygen therapy
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.
Heart X-ray of a 31-year-old man has revealed the following: with tightly ?lled opaci?ed
oesophagus there is a marginal ?lling defect in its middle third on the posterior wall; the defect is
1.8x1.3 cm in size with clear oval border. Mucosal folds are retained and envelop the defect; wall
peristalsis and elasticity are not affected. There are no complaints regarding the condition of the
patient’s alimentary canal. Make the provisional diagnosis:
Oesophageal tumour
Achalasia cardiae
Oesophageal burns
Diverticulum
Barrett oesophagus
A 25-year-old man was hospitalized with complaints of pain in his lower abdomen and right lumbar
area that appeared one hour ago. Patient’s general state is moderately severe. Body temperature –
38.2oC, heartrate – 102/min. The tongue is dry. The abdomen is painful on deep palpation in the
right iliac area and in the Petit triangle. Aure-Rozanov and Gabay signs are positive. Make the
provisional diagnosis:
Acute appendicitis
Right-sided renal colic
Cecal tumour
Intestinal obstruction
Acute cholecystitis
A 45-year-old man diagnosed with acute pulmonary abscess suddenly developed sharp pain in his
chest on the right and dyspnoea up to 30/min. Examination detects facial cyanosis and shallow
rapid respirations. Auscultation reveals acutely weakened respiration throughout the whole right
lung; percussion reveals a vesiculotympanitic (bandbox) resonance at the lung apex and dullness in
the lower lobe. What complication developed in this patient?
Pyopneumothorax
Pleuropneumonia
Pneumothorax
Acute mediastinitis
Oesophageal perforation
A 5-year-old child was brought to the ENT department by an ambulance. The child presents with
cough and dif?cult respiration. From the patient’s history it is known that the child was playing
with a toy construction set, when suddenly started coughing and developed laboured breathing.
Examination detects periodical cough, laboured expiration, and respiratory lag in the left side of the
child’s thorax. Auscultation: diminished respiration on the left. Percussion: tympanitis. X-ray
shows a displacement of the mediastinal organs to the right. Make the diagnosis:
A foreign body in the left bronchus, valvular bronchostenosis
A foreign body in the right bronchus, valvular bronchostenosis
A foreign body in the trachea
A foreign body in the left bronchus, complete bronchostenosis
A foreign body in the right bronchus, partial bronchostenosis
A 30-year-old man was brought to the neurosurgical department with complaints of constant
headaches, nausea, vomiting, fever, and weakness of the right-side limbs. Anamnesis states that one
month ago the patient had a surgery for left-sided suppurative otitis and mastoiditis. He has been
undergoing treatment in an ENT department. Approximately 2 weeks ago the temperature
increased, and the patient developed headaches. Objectively: heart rate - 98/min., BP- 140/90 mm
Hg, temperature 38.3oC. Neurologically manifested stiff neck: bilateral Kernig’s symptom,
unsteadiness during the Romberg’s maneuver. Computer tomography of the brain revealed a three
dimensional growth with a capsule in the left hemisphere. Make the diagnosis:
A. *
B.
C.
D.
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.
Cerebral abscess
Echinococcus
Haemorrhage
Hydrocephalus
Arnold-Chiari malformation
The burns unit received a patient, who 6 hours ago during a ?re received ?ame burns. On the
patient’s body there is graybrown area of necrosis that covers 3/4 of the body perimeter.
Occasionally there are small blisters with haemorrhagic contents and patches of shredded
epidermis. What local therapy is necessary in this case?
Decompression necrectomy
Chemical necrolysis
Blister puncture
Necrectomy with xenotransplantation
Necrectomy with dermal autograft
A woman in her early- to mid-thirties has lost her consciousness 3-5 minutes ago. On examination:
the skin is pale, no pulse over the carotid arteries, no spontaneous respiration, pupils are dilated; the
patient is nonresponsive, presents with atony. The patient’s condition can be determined as:
Clinical death
Natural death
Syncope
Brain death
Comatose state
A boy had a foreign body removed from under his nail plate. 3 days later he developed a sharp
throbbing pain at the end of his distal phalanx, which intensi?es when the phalanx is pressed,
hyperaemia of the nail fold, elevated body temperature up to 38.5oC, and nail plate discoloration.
Make the diagnosis:
Subungual panaritium
Erysipelas
Paronychia
Erysipeloid
Abscess
A 32-year-old woman complains of body weight loss despite her increased appetite, nervousness,
and tremor of the extremities. Objectively: the skin is moist; the thyroid gland is diffusely enlarged,
painless, soft, and mobile. Blood test: increased level of T3, T4, and thyroid-stimulating hormone
(THS). What is the most likely diagnosis?
Diffuse toxic goitre
Thyroid carcinoma
Autoimmune (Hashimoto’s) thyroiditis
Thyroid adenoma
Diffuse nontoxic goitre
A 19-year-old young man complains of cough with expectoration of purulent sputum in the amount
of 100 mL per day, haemoptysis, dyspnoea, increased body temperature up to 37.8oC, general
weakness, weight loss. The patient’s condition lasts for 4 years. Exacerbations occur 2-3 times a
year. The patient presents with malnutrition, pale skin, cyanosis of the lips, drumstick
(clubbed) ?ngers. Tympanic percussion sound in the lungs, weakened respiration, numerous various
moist crackles in the lower pulmonary segments on the left can be observed. In blood: erythrocytes
-3.2•1012/L, leukocytes-8.4•109/L,ESR-56mm/hour. On X-ray: lung ?elds are emphysematous, the
left pulmonary root is deformed and dilated. What is the most likely diagnosis?
A. *
B.
C.
D.
E.
100.
A. *
B.
C.
D.
E.
101.
A. *
B.
C.
D.
E.
102.
A. *
B.
C.
D.
103.
A. *
B.
C.
D.
E.
104.
A. *
B.
C.
D.
E.
Multiple bronchiectasis of the left lung
Chronic left-sided pneumonia
Chronic abscess of the left lung
Left-sided pulmonary cystic dysplasia
Suppuration of the cyst in the left lung
A 57-year-old woman during a regular ultrasound examination presented with a space-occupying
heterogeneous lesion in the right kidney. What is the most informative method of renal tumour
diagnostics?
Spiral computed tomography
Excretory urography
Retrograde pyelography
Radioisotope renography
Three glass urine test
A 40-year-old victim of a traf?c accident sustained the following injuries: closed diaphyseal femur
fracture, brain concussion, multiple rib fractures, hemopneumothorax, degloving shin injuries.
What injuries require the most urgent attention?
Multiple rib fractures, hemopneumothorax
Closed diaphyseal femur fracture
Brain concussion
Degloving shin injuries
All injuries are equivalent
At the railroad crossing a passenger train collided with a bus. In this collision 26 bus passengers
died, another 18 passengers received mechanical injuries of varying severity. Where will be
professional medical aid provided for the victims of this accident? Who will provide this aid?
In medico-prophylactic institutions; general physicians and surgeons
At the site of the accident; ?rst-response emergency teams
At the site of the accident; specialized second-response emergency teams
In medico-prophylactic institutions; specialized second-response emergency teams E. In
medical institutions; all listed types of healthcare workers
A 45-year-old man underwent a cardiac surgery one week ago. His general state has been
deteriorating since then: dyspnoea at rest, retrosternal pain that irradiates to the neck, marked
weakness. Objectively his body temperature is hectic. His cardiac borders are expanded; apical beat
is weakened. Auscultation detects pericardial friction rub. What is the most likely diagnosis?
Acute pericarditis
Acute cardiac aneurysm
Myocardial infarction
Acute myogenic dilatation of the heart
Pulmonary embolism
A 45-year-old man was brought by an ambulance into the emergency hospital. He complains of
sudden pain in the lumbar area, frequent painful urination, and vomiting. Examination detects pain
in the lumbar area, costovertebral angle tenderness, pain on palpation of kidneys and along the
ureter on the right. Urine test: proteins, fresh erythrocytes, leukocytes. Make the provisional
diagnosis:
Urolithiasis, renal colic
Acute pyelonephritis
Acute glomerulonephritis
Acute renal failure
Polycystic kidney disease
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.
?A 40-year-old man was brought into a hospital wiyh a closed chest trauma. Examination shows
that the right side of his chest lags behind during breathing. Palpation detects a sharp pain in the
projection of ribs V, VI, and VII on the anterior axillary line and subcutaneous emphysema on the
right side of the torso. Percussion reveals tympanitis over the right-sided segments of the chest.
Auscultation detects no breathing on the right and vesicular breathing on the left. What surgical
procedure is necessary for this patient ?
Immediate thoracotomy
Tight bandaging of the chest
Drainage of subcutaneous emphysema
Splint stabilization of the rib facture
Drainage of the right pleural cavity
Two weeks after an antibacterial therapy for a febrile illness, a 25-year-old woman developed
severe watery diarrhea, colicky abdominal pain, and elevated body temperature. Proctosigmoscopy
detects focal mucosal lesions with a pale yellow coating. What is the most likely diagnosis in this
case?
Gastroenteritis
Crohn’s disease
Ulcerative colitis
Pseudomembranous colitis
Ischemic colitis
A 75-year-old man in severe condition suffers from dyspnea at rest, marked weakness, and
arrhythmia. Abdominal aortic pulsation is observed, further on there is a systolic murmur
detected. Palpation reveals a volumetric formation in the mesogastrium. Blood pressure is 70/40
mm Hg. There is no pulsation over the femoral arteries. Oliguria is detected. Which diagnosis is the
correct one ?
Dissecting aortic aneurysm
Pancreatic cyst
Cardiosclerotic aneurysm
Acute pericarditis
Acute cardial aneurysm
A man complains of a heaviness behind his sternum, periodical sensation of food retention, and
dysphagia. Durig X-ray the barium contrast reveals a single pouch-like protrusion in the right
anterior wall of the esophagus. The protrusion has clear margins and a clearly defined neck. What is
most likely diagnosis in this case?
Hiatal hernia
Varicose veins of the esophagus
Esophageal carcinoma
Esophageal polyp
Esophageal diverticulum
A 48-year-old woman has arrived to the surgical unit with wounds in her thigh. On examination the
wound surface has dirty-gray coating with unpleasant sweet smell. Wound content resembles
raspberry jelly. Skin tissues around the wound are glossy and turgid. Palpation reveals moderate
crepitation in the tissues. What microflora is the most likely to cause such inflammation?
Anaerobic clostridial
Anaerobic non-clostridial
Streptococci
Staphylococci
Blue pus bacillus
110.
A. *
B.
C.
D.
E.
111.
A. *
B.
C.
D.
E.
112.
A. *
B.
C.
D.
E.
113.
A. *
B.
C.
D.
E.
114.
A. *
B.
C.
D.
A man suddenly developed a sharp pain in the right side of his chest. Dyspnea has rapidly
progressed. Objectively, the patient has marked acrocyanosis and is in a severe condition.
Subcutaneous emphysema is observed in the area of the patient’s neck and upper chest. Over the
right lung a bandbox resonance can be heard, respiration is absent there. The heart borders are
displaced to the left. The patient’s heart rate is 110/min., blood pressure - 110/60 mm Hg. What is
the most likely disease in this case?
Spontaneous pneumothorax
Exudative pleurisy
Myocardial infarction
Community-acquired pneumonia
Lung infarction
A 17-year-old girl complains of a pain and swelling of her second finger on the right hand. Three
days ago she made a manicure. The pain developed on the second day after that. Objectively, her
nail fold is swolen, hyperemic, overhangs the nail plate, and is painful on palpation. What is most
likely diagnosis in this case?
Paronychia
Subcutaneous panaritium
Erysipeloid
Subungual panaritium
Cutaneous panaritium
A 47-year-old man has been ill for 3 days already. Palpation detects a painful inflamed infiltration
in his right subcostal region. His body temperature is 38,9oC. Sonography allowed diagnosing him
with calculous destructive cholecystitis. Clinical and laboratory data are not indicative of chole
docholithiasis. What tractics should be chosen for the treatment of this man?
Surgical treatment - cholecystectomy
Choleretics, hepatoprotectors, corticosteroids
Complex anti-inflammatory therapy
Laparocentesis, abdominal drainage
Monitoring, cholecystectomy if peritonitis starts developing
A 36-year-old woman complains of nausea, belching, liquid stool, and a pain in the epigastrium
after meals. For the last 2 years the disease has been slowly progressing. Objectively, her skin is
pale and dry, her tongue is coated, moist, and has imprints of the teeth on its edges. Abdominal
palpation detects a diffuse pain in the epigastrium. What test will be the most informative in this
case and should be conducted next?
Fibrogastroscopy with biopsy of the gastric mucosa
Gastrointestinal X-ray
Comprehensive complete blood count
Abdominal CT scan
Fractional analysis of gastric secretion
For the last 2 years, a 32-yesr-old woman has been observing periodical pain attacks in her right
subcostal area that could be removed with no-spa (drotaverine). The pain is not always associated
with meals, sometimes it's caused by anxiety and accompanied by cardiac pain and palpitations.
Objectively, the woman is emotionally labile. Abdominal palpation detects a slight pain in the area
of the gallbladder. What pathology is the most likely to cause such clinical presentation?
Chronic cholecystitis
Duodenitis
Chronic cholangitis
Chronic pancreatitis
E.
115.
A. *
B.
C.
D.
E.
116.
A. *
B.
C.
D.
E.
117.
A. *
B.
C.
D.
E.
118.
A. *
B.
C.
D.
E.
119.
A. *
B.
C.
D.
Biliary dyskinesia
A 47-year-old man has received a polytrauma in a car accident: closed displaced fractures on his
right humerus and the bones of his left forearm and a closed blunt abdominal trauma. He was
brought into the admmision room 30 minutes after the trauma. His skin is pale. His blood pressure
is 90/20 mm Hq, the fracture sites are deformed and painful. The abdomen is rigid and its palpation
causes sharp pain. The Bloomberg's sign is positive. What medical procedures must be performed
first in this case?
Urgent laparotomy
Additional examination to determine the exact diagnosis
Fracture blockade with a topical anesthetic
Infusion therapy to stabilize the blood pressure
Immobilization of the fractures, pain relief
A 65-year-old man complains of cough attacts that ocuur when he eats liquid foods. Three months
ago he was diagnosed with a carcinoma in the upper third of the esophagus. He underwent radiation
therapy. What complication developed in this man?
Tracheoesophageal fistula
Tracheal stenosis
Lung abscess rupture into the pleural cavity
Spontaneous pneumothorax
Perforation of a gastric cardia ulcer
A 74-yesr-old woman came to a doctor complaining of a pain in her right inguinal region. The signs
appeared suddenly, approximately 2 hours ago. The woman notes that she already had these sins 3
weeks ago, but back then they disappeared on their own after she lay down. Objectively, palpation
detects below the Poupart's ligament a sharply painful, dense, and tense formation 3.5 cm in
diameter. The Dejerine sign (aggravation on coughing) is negative. What is the most likely
diagnosis in this case?
Acquired incarcerated inguinal hernia
Acquired incarcerated femoral hernia
Acquired strangulated inguinal hernia
Acquired strangulated femoral hernia
Inguinal lymphadenitis
A 39-yesr-old man came to a doctor complaining of a pain in his left leg. The disease onset was 2
days ago. Objectively, his body temperature is 37.8C and he has subcutaneus varicose veins on the
inner surface of his left thigh and shin. The skin over the varicose veins is hot and red. The Moses
and Homans signs are negative. What is the most likely diagnosis in this case?
Acute ascending thrombophlebitis of the saphenous veins in the left leg
Varicose saphenous veins in the left leg
Thrombosis of the tibial arteries on the leg
Postthrombotic syndrome of the left leg
Acute deep vein thrombosis in the left leg
A 74-yesr-old man has been brought into a vascular surgery department with complaints of pain and
chills in his leg. Ultrasound of his leg arteries dhows atherosclerotic method is necessary t
odetermine the localization and the extent of the pathologic process in this case?
Angiography
Chest X-ray
X-ray of the extremities
Thermometry
E.
120.
A. *
B.
C.
D.
E.
121.
A. *
B.
C.
D.
E.
122.
A. *
B.
C.
D.
E.
ECG
A 72-yesr-old man on the 7th day after a surgical reposition of an intertrochanteric hip fracture has
suddenly developed dyspnea and an intense pain in the left side of his chest. Examination reveals
distended cervical veins and cyanosis. His respiration rate is 26/min. Auscultation detects weakened
breathing over the left lung. Heart rate - 98/min. Blood preasure - 120/70 mm Hq. CT scan shows
significant disappearance of the lung pattern on the left. Echocardiography shows no signs of right
ventricle overload. What next step will be the most advisable in this case?
Surgical embolectomy
Installing a vena cava filter
Prescribing aspirin (acetylsalicylic acid)
Trombolytic injection into the left pulmonary artery
Prescribing low molecular weight heparin
A 43-yesr-old woman complains of persistent stomachache with reccurent pain attacks, nausea?
repeated vomiting with sragnant bowel content, abdominal distension, and flatulence. She has been
presenting wit these signs for 7 hours. Pulse is 116/min. The tongue is dry and brown. The abdomen
is symmetrically distended, soft, painful. Percussion reveals tympanitis. On auscultation there ere
bowel sounds with metallic overtone, splashing, and dripping. make the diagnosis:
Acute intestinal obstruction
Acute destructive cholecystitis
Acute nonspecific colitis
Acute necrotizing pancreatitis
Acute erosive gastritis
A 35-yesr-old man complains of rapidly incresing fatigue, palpitations, "visual snow", dizziness. he
has a history of peptic ulcer of the stomach. Objectively the skin is pale. Vesicular respiration is
observed in the lungs. Systolic murmur is detected over the cardiac apex, heart rate is 100/min,
blood preasure is 100/70 mm Hq. The epigastrium is slightly tender on palpation. Blood test:
erythrocytes - 3.2 * 10 12/L, color index- 0.95. What type of anemia is the most likely present in this
case?
Posthemorrhagic anemia
Hemolytic anemia
Chronic iron-deficiency anemia
Syderoblastic anemia
Hypoplastic anemia
Назва наукового напрямку (модуля):
Семестр:
SRS
Опис:
6 course
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.
Перелік питань:
The site of crossing with left bronchus is:
The second anatomical narrowing of esophagus
The first anatomical narrowing of esophagus
The third anatomical narrowing of esophagus
The first physiological narrowing of esophagus
The second physiological narrowing of esophagus
What is the main objective manifestation of Zenker's diverticula?
Compressible mass on the left side of the neck
Signs of achalasia
Cyanosis of the upper part of body
Esophago-bronchial fistula with aspiration pneumonia
Lung atelectasis
For the clinical manifestation of esophageal diverticulum is typical:
The sign "of a wet pillow"
Dyspnea
Cyanosis of the upper part of body
Retention of stool and gases
Vomiting by "coffee masses"
What is the main method of diagnostic of esophageal diverticula?
X-ray examination with barium swallow
Pleural punctere
Ultrasound examination
Plain X-ray examination of the chest
Irrigoscopy
The failure of the lower esophageal sphincter to relax is called:
Achalasia
Chalasia
Esophageal diverticulum
Pilorostenosis
Intestinal obstruction
What is the cause of achalasia?
Disturbance of innervation of esophagus
Ischemia of esophagus
Tumour growth of esophagus
Diverticula of esophagus
Cicatrical changes after the burn of esophagus
What is the cause of achalasia?
Psycho-emotional trauma
Ischemia of esophagus
Tumour growth of esophagus
Diverticula of esophagus
Cicatrical changes after the burn of esophagus
11
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.
What is the cause of achalasia?
Influence of vegetotrophic substances on muscular fibers
Ischemia of esophagus
Tumour growth of esophagus
Diverticula of esophagus
Cicatrical changes after the burn of esophagus
What is the main treatment of the II stage of achalasia?
Cardiodilatation
Diet, conservative treatment
Esophagomyotomy (Heller's operation)
Esophagogastroanastomosis (Helerovsky's operation)
Esophageal plastics by intestine
What is the main treatment of the III stage of achalasia?
Esophagomyotomy (Heller's operation)
Diet, conservative treatment
Cardiodilatation
Esophagogastroanastomosis (Helerovsky's operation)
Esophageal plastics by intestine
What is the main treatment of the IV stage of achalasia?
Esophagogastroanastomosis (Helerovsky's operation)
Diet, conservative treatment
Cardiodilatation
Esophagomyotomy (Heller's operation)
Esophageal plastics by intestine
Helerovsky's operation is used for the treatment of:
Esophageal achalasia
Esophageal ulcer
Esophageal diverticulum
Pilorostenosis
Intestinal obstruction
What is the main prophylaxis of esophageal stricture after the chemical burn?
Esophageal bougienage
Spasmolytics
Parenteral feeding
Pneumocompression
Gastrostomy
What complication is typical for esophageal burn?
Disturbances of epiglottic valve
Esophageal diverticulum
Obstructive jaundice
Intestinal obstruction
Lerishe's syndrome
What is the chief clinical manifestations of reflux-esophagitis?
Heartburn
Achalasia
C.
Dysphagia
D.
E.
16.
A. *
B.
C.
D.
E.
17.
A. *
B.
C.
D.
E.
Vomiting
Coughing
For the clinical manifestation of sliding diaphragmatic hernia is typical:
Pain behind breastbone
Dyspnea
Cyanosis of the upper part of body
Retention of stool and gases
Vomiting by "coffee masses"
What is the X-ray sign of diaphragmatic relaxation?
Inflection of abdominal part of esophagus
Filling defect
"Rat tail" sign
Sign of "nishe"
Pneumoperitoneum
What disease should be the diaphragmatic relaxation differentiated from?
Diaphragmatic elevation
Pancreatitis
Intestinal obstruction
Cholecystitis
Bronchial asthma
Treatment of patients with acute intestinal obstruction in the stage of decompensation must be:
2-4 hours of conservative, then operative
To 24 hours of conservative, then operative
Immediately operative
During the first days conservative treatment with the gradual increase of volume of infusion
Conservative in ambulatory conditions
The treatment of patients with strangulation acute intestinal obstruction which accompanied by the
manifestations of peritonitis must include:
2 hours of conservative treatment, then operative
To 12 hours conservative treatment, then operative
Immediately operative without conservative
Conservative in ambulatory conditions
During the first days conservative with the gradual increase of volume infusion
Arterial mesenteric acute intestinal obstruction belongs to:
Obturation
Strangulation
Paralytic
Spastic
Mixed
What is the essence of arterial mesenteric intestinal obstruction?
Superior mesenteric artery compresses the duodenum
Duodenum compresses the superior mesenteric artery
Acute intestinal obstruction on the background of mesenteric thrombosis
Mesenteric thrombosis caused by obstruction
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.
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.
Duodenum compresses inferior mesenteric artery
What sign is typical for phlegmonous appendicitis in contrast to simple appendicitis?
Voskresenky's sign
Sitkovsky’s sign
Bartomier’s sign
Kocher’s sign
Dunphy's sign
What does the Voskresenky's sign mean?
Increase of pain during quick sliding movements by the tips of fingers from epigastric to right iliac
area
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Increased pain with coughing
Migration of pain to the right iliac area from epigastric
What does the Pasternatsky’s sign mean?
Tapping of lumbar region cause the pain
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Increased pain with coughing
Migration of pain to the right iliac area from epigastric
What does the Yaure-Rozanov sign mean?
Painfulness during palpation of Petit triangle
Pain in right lower quadrant during palpation of left lower quadrant
Migration of pain to the right iliac area from epigastric
Tapping of lumbar region cause the pain
Increase of pain in a right iliac area when the patient lies on the left side
What does the Bartomier-Mikhelson's sign mean?
The increase of pain intensity during the palpation of right iliac area when the patient lies on the
left side.
Increased pain with coughing
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Migration of pain to the right iliac area from epigastric
What does the Blumberg's sign mean?
The sharp increase of pain quick taking off the hand during palpation of anterior abdominal wall.
Increased pain with coughing
Pain in right lower quadrant during palpation of left lower quadrant
Increase of pain in a right iliac area when the patient lies on the left side
Migration of pain to the right iliac area from epigastric
The most informing method of instrumental diagnostics of acute appendicitis is:
ultrasound examination
contrasting roentgenoscopy
gastroscopy
esophagogastroscopy
colonoscopy
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.
E.
37.
A. *
Acute appendicitis in the 1st phase is necessary to differentiate from:
gastric ulcer
pancreatitis
cholecystitis
intestinal obstruction
strangulated hernia
For retrocecal appendicitis is characteristic the sign:
Gabay's sign
Sitkovsky's sign
Obrastsow's sign
Voskresensky's sign
Kulenkampf's sign
For retroperitoneal appendicitis is characteristic the sign:
Pasternatsky's
Sitkovsky's
Yaure-Rozanov
Rovzing's
Koer's
Causes of the appendicular infiltrate development:
late hospitalisation, misdiagnosed appendicitis
aggressive infection, impaired immunity
adhesions, increased immunity
peritonitis, abscessing
surgical trauma, infection
The clinical manifestation of appendicular infiltrate is:
swelling
the signs of peritoneal irritation
muscular tension
high temperature
leucocytosis
The most informative for differentiation of appendicitis with an epigastric form of myocardial
infarction are the changes in:
ECG
hemodynamic disturbances
expressed shortness of breath
auscultation
tachycardia
The most informative for differentiation of appendicitis with intercostal neuralgia is:
paravertebral blockade
laparoscopy
microlaparotomy
laparocentesis
peridural blockades
Chronic residual appendicitis arises up after:
acute appendicitis
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. *
B.
C.
D.
E.
44.
A. *
B.
C.
chronic appendicitis
colicks
recurrent appendicitis
primary chronic appendicitis
Chronic residual appendicitis arises up after:
appendicular infiltrate
chronic appendicitis
recurrent appendicitis
colicks
primary chronic appendicitis
Hyperaemia, thickening, oedema of appendix are the signs of:
catarrhal appendicitis
phlegmonous appendicitis
gangrenous appendicitis
gangreno-perforating appendicitis
dystrophic appendicitis
Hyperemia, fibrino-purulent fur, pus the lumen are the signs of:
phlegmonous appendicitis
catarrhal appendicitis
gangrenous appendicitis
gangreno-perforative appendicitis
dystrophic appendicitis
The peculiarities of the clinical course of appendicitis in children are caused:
by the bailer form of appendix
by the tubular form of appendix
by hypertrophy of appendix
by atrophy of appendix
by the spherical form of appendix
For the acute appendicitis, complicated by appendicular infiltrate, in contrast to the tumour of
caecum, is characteristic:
Tendency to diminishing of the tumour in the process of supervision
Long-term anamnesis
Excretion of blood from rectum
Curvuasier's sign
Frequent partial intestinal obstruction in anamnesis
In preparations for parenteral nutrition do not include:
salt
hidrolizyn;
casein hydrolysates;
10% glucose;
lipofundin
Frequently the cause of early complications after surgery using the central analgesia:
depressed respiration
bronhiolospazm;
hypotension;
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.
cardiac arrest;
acute liver failure
What is the lung abscess characterized by?
Purulent destruction of pulmonary tissue within 1 segment with formation of cavity, filled by pus
Multiple destructive foci 0,3-0,5 cm in size within 1-2 segments of lungs
Purulent, necrosis of a pulmonary tissue within 2-3 segments, detached from adjacent pulmonary
parenchyma
Diffuse purulent, ichorous necrosis more than lobe without the tendency to defined demarcation
Accumulation of pus in a pleural cavity
What is the lung gangrenous abscess characterized by?
Purulent, necrosis of a pulmonary tissue within 2-3 segments, detached from adjacent pulmonary
parenchyma
Multiple destructive foci 0,3-0,5 cm in size within 1-2 segments of lungs
Purulent destruction of pulmonary tissue within 1 segment with formation of cavity, filled by pus
Diffuse purulent, ichorous necrosis more than lobe without the tendency to defined demarcation
Accumulation of pus in a pleural cavity
Homogeneous spherical shadow with regular edge on the background of intact pulmonary tissue on
X-ray is typical for:
Lung cyst
Tuberculoma
Peripheral lung cancer
Tubercular cavern
Lung emphysema
Heterogeneous shadow with calcifications and regular edge on X-ray is typical for:
Tuberculoma
Lung cyst
Peripheral lung cancer
Tubercular cavern
Lung emphysema
What is the typical method of treatment of pyopneumothorax?
Drainage of pleural space
Pleural puncture
Thoracotomy
Pneumonectomy, bilobectomy, lobectomy
Conservative treatment
Where is performed the drainage of pleural space in pyopneumothorax?
II intercostal space, midclavicular line and VII intercostal space, scapular line simultaneously
II intercostal space, midclavicular line
II intercostal space, scapular line
VII intercostal space, midclavicular line
VII intercostal space, scapular line
What is the typical treatment of noncomplicated rib fracture?
Novocaine block
External fixation of ribs
Intrmedullary costal osteosynthesis;
D.
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.
Mechanical ventilation with positive end-expiratory pressure
Thoracotomy
What is the first aid of floating rib fracture?
Fixation of floating segment
Analgesics
Spasmolytics
Hemostatic drugs
Antibiotics
What type of Novocaine block is used for the treatment of floating rib fracture?
Paravertebral block
Paranephral block
Spinal block
Epidural anesthesia
Lung root dlock
Partial pneumothorax means:
Collapse of lung to 1/3 of its volume
No collapse of lung
Collapse of lung to 2/3 of its volume
Collapse of lung more than 2/3 of its volume
Total collapse of lung
What is revealed in pneumothorax by auscultation?
The breathing isn't auscultated
Vesicular breathing
Amphoric breathing with moist rales
Bronchial breathing with moist rales
Harsh breathing with dry rales
The absence of breathing sound by auscultation is typical for:
Pneumothorax
Chronic bronchitis
Pneumonia
Lung emphyzema
Lung abscess
What is the first aid in closed pneumothorax?
It doesn't require first aid measures
Pleural drainage
Compression bandage with closure of the wound
Artificial respiration
Intubation
What is revealed in hemothorax by auscultation?
The breathing isn't auscultated
Vesicular breathing
Amphoric breathing with moist rales
Bronchial breathing with moist rales
Harsh breathing with dry rales
What method is the most informative in differential diagnostic of hemothorax with pleurisy?
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. *
E.
64.
A. *
B.
C.
D.
E.
65.
A. *
B.
C.
D.
E.
66.
A. *
B.
C.
Pleural puncture
Clinical manifestation
Sputum analysis
Auscultation
X-ray examination
What method is the most informative in the diagnostic of hemothorax?
Pleural puncture
General blood analysis
Sputum analysis
Auscultation
X-ray examination
Indication to early operative interference at acute pancreatitis is:
Acute oedematous pancreatitis
Acute pancreatolysis
Acute traumatic pancreatitis at the „fresh” break the gland
Acute fatty pancreatitis
A faithful answer is not present
Indication to early operative interference at acute pancreatitis is:
Acute pancreatolysis
Acute oedematous pancreatitis
Progressive multiple organ failure what not added conservative therapy during 48-72 hours
Acute fatty pancreatitis
Forming of pseudocyst
What is pancreatectomy:
Delete the necrotic area within the limits of nonviable fabrics
Delete the necrotic area within the limits of healthy fabrics
Delete part of organ with his transversal cutting within the limits of the changed fabrics
Total delete of organ
There is not a faithful answer
What is pancreas located in relation to a peritoneum:
Retroperitoneal
Mesoperitoneal
Intraperitoneal
All answers are incorrect
Variously
What is blood supply the body and tail pancreas:
Splenic artery
A.gastroduodenalis
A.gastrica sinistra
A.cystica
Variously
Mondor’s sing at acute pancreatitis:
Violet spots on face and trunk
Cyanosis sides of stomach and trunk
Cyanosis skin of stomach
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.
D.
Icteritiousness round a belly-button
Cyanosys of hands
Holsted’s sing at acute pancreatitis:
Violet spots on face and trunk
Cyanosis sides of stomach and trunk
Cyanosis skin of stomach
Icteritiousness round a belly-button
Cyanosys of hands
Pulsating tumor-like formation with a reddish tinge of the skin over his right or left from the front
of the sternum is characteristic:
Aneurism
Aneurysms of the descending aorta
Abdominal aortic aneurysms
Embolism of aorta
Thrombosis of the aorta
Pulsating tumor-like formation with a reddish tinge of the skin over his right or left from the front
of the sternum is characteristic:
No right answer
Aneurysms of the descending aorta
Aneurysms of the abdominal aorta
Embolism of aorta
Thrombosis of the aorta
For coarctation of the aorta is characterized
Well muscled shoulder girdle
Poor development of the musculature of the shoulder girdle
Well muscled legs
Good development of the pelvic belt
All answers are correct
For coarctation of the aorta is characterized
Poor development of the pelvic girdle muscles
Poor development of the musculature of the shoulder girdle
Well muscled legs
Good development of the pelvic belt
All answers are correct
For diagnostic coarctation of the aorta used:
Contrast aortography
Pulse Oximetry
Radiography limbs
Radiography abdominal
All answers are correct
For diagnostic coarctation of the aorta used:
No right answer
Pulse Oximetry
Radiography limbs
Radiography abdominal
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.
A. *
All answers are correct
Reducing pulsations on the left radial artery characteristic for:
Lesion of the left subclavian artery
Lesions of the aortic arch
Occlusion of the brachial artery
Lesions of the abdominal aorta
Lesions of the superior vena cava
In the diagnosis pathology of the subclavian artery leading place is:
No right answer
Thermometry
Radiography of the neck
Radiography of the chest cavity
Ultrasonography of the abdomen
In the diagnosis of atherosclerotic lesions an important role plays:
Nuclear Magnetic Resonance
Thermometry
Rheovasography
Radiological examination of the neck
Ultrasonography of the abdomen
Indications for carotid endarterctomy based on
Degree of stenosis of internal carotid artery
Limitation of atherosclerosis
Prescription treatment of atherosclerosis
Patient's wishes
Want doctor
Carotid endarterctomy contraindicated
At liver failure
4-5 months. myocardial infarction
Up to 10 weeks after stroke
Contraindications No
All true
For aneurysms the thoracic aorta is characterized
No right answer
Reduced breast pressure
Pressure changes do not
All answers are correct
The lower abdominal pressure
For the initial part of the aortic arch aneurysm is characterized by
No right answer
The decrease and ¬ pazdyvanie pulse on the carotid artery on the left
The increase in size and acceleration of the pulse at the radial artery on the right
The increase in size and acceleration of the pulse at the radial artery on the left
All answers are correct
For diagnosis of aneurysms of the thoracic aorta is used:
No right answer
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.
D.
Pulse oximetry
Peripheral vascular ultrasound
Ultrasonography of the abdomen
Thermometry
For coarctation of the aorta is characterized
Well muscled shoulder girdle
Poor development of the musculature of the shoulder girdle
Well muscled legs
Good development of the pelvic belt
All answers are correct
For coarctation of the aorta is characterized
No right answer
Pulse on the femoral artery is absent
Pulse on the femoral artery is defined clearly
Pulse on the femoral artery satisfactory
All answers are correct
For diagnostic coarctation of the aorta used:
ECG
Pulse Oximetry
Radiography limbs
Radiography abdominal
All answers are correct
Syndrome of vertebrobasilar insufficiency characteristic:
Lesions of vertebral arteries
Lesions of the internal carotid arteries
Lost external carotid arteries
Lesions of brachial artery
Lesions of the aortic arch
For lesions the subclavian artery is characterized by:
Weak hands
Dermahemia hands
Increased filling of subcutaneous veins of the upper extremities
The pulsation of the arteries of the upper extremities is not broken
All true
For atherosclerotic carotid arteries is characterized by:
The pulsation of the carotid arteries is not determined
Dermahemia neck
Increased filling saphenous veins neck
The pulsation of the carotid artery is not broken
All true
Indications for carotid endarterctomy based on
Structural characteristics of atherosclerotic plaque
Limitation of atherosclerosis
Prescription treatment of atherosclerosis
Patient's wishes
E.
89.
A. *
B.
C.
D.
E.
90.
A. *
B.
C.
D.
E.
No right answer
Localization relapsing great saphenous vein are
2-3 cm below the inguinal ligament
In the upper third of the lower extremity
In the popliteal fossa
In the lower third of the thigh
In the lumbar region
Transient edema of lower limbs is characteristic for:
Varicose
Atherosclerotic lesions
Obliterative endarteritis
Leriche
Femoral artery embolism
Назва наукового напрямку (модуля):
Семестр:
12
SRS2018
Опис:
MIX
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.
Перелік питань:
?A patient with uterine fibromyoma sized up to 8-9 weeks of pregnancy consulted a gynaecologist
about acute pain in the lower abdomen. Examination revealed pronounced positive symptoms of
peritoneal irritation, high leukocytosis. Vaginal examination revealed that the uterus was enlarged
up to 9 weeks of pregnancy due to the fibromatous nodes, one of which was mobile and extremely
painful. Appendages were not palpable. Discharges were mucous, coming in moderate amounts.
What is the treatment tactics?
Urgent surgery (laparotomy)
Surveillance and spasmolytic therapy
Fractional diagnostic curettage of the uterine cavity
Surgical laparoscopy
Surveillance and antibacterial therapy
To perform a diagnostic laparoscopy on suspicion of cyst of the right lobe of the liver, staging port
for laparoscope is typically placed
In the periumbilical area
On the midline of the abdomen in the epigastrium
On the midline of the abdomen in hypogastrium
At McBurney point
At Volkovych-Kocher point
The maximum flow rate of gas through the needle of Veresh?
1 L / min
5 L / min
7 L/ min
3 L / min
9 L / min
The parts of tools for connecting tissues are
Handless and inserts without cremaliers
Cremaliers without handles, inserts and tube
With handles and inserts with cremaliers
Tools are solid
Cremalier handles, inserts and tube
To perform a diagnostic laparoscopy on suspicion of cyst of the right lobe of the liver, staging
second port typically is placed
On the midline of the abdomen in the epigastrium
In the periumbilical area
On the midline of the abdomen in hypogastrium
At McBurney point
At Volkovych-Kocher point
The reason why surgeons use fiber optic cable is
To transfer the "cold" light
For gas supply
For the signal from the camera
To apply liquid
For coagulation
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. *
13.
A.
B.
C.
D. *
E.
14.
The solution used in the suction-irrigator is
Glucose
Furacillinum
Physiological
Solution with antibiotic
Chlorhexidine
The three main groups of instruments for laparoscopy are
For access, basic and supportable
For access, general and special purpose
General, special, utility
For separation of tissues, specific, for connection of tissues
Tools for laparoscopy are not divided into groups
The three main indicators of apparatus for insufflation important for the surgeon during surgery are
The pressure in the abdomen, gas temperature and carbon dioxide level in the tank
Pressure in the abdomen, the rate of gas supply and gas temperature
The pressure in the abdominal cavity, the gas flow rate and the level of carbon dioxide in the tank
The pressure in the abdominal cavity, the gas flow rate and the amount of gas spent
The rate of gas supply, the amount of spent gas and gas temperature
The three main types of laparoscopes by angle?
0 °, 15 °, 45 °
0 °, 45 °, 60 °
10 °, 25 °, 50 °
0 °, 30 °, 45 °
0 °, 5 °, 10 °
The tools that are used in preparing and applying pneumoperitoneum include all of these except:
Janet Syringe
Scalpel
Puncture needle
Clamp
Needle clamp
The tools that are used when preparing and applying the pneumoperitoneum include all of these,
except:
Janet Syringe
Scalpel
Puncture needle
Clamp
Dressing
The tools used in the performance of laparoscopic cholecystocholangiography include all of these
except:
"Record"Syringe
Iversen - Roholm Needle
Scalpel
Soft clip
Metal palpator
Thoracoscopy - is:
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. *
Overview of the abdominal cavity using a special endoscope
Overview of the chest cavity using a special endoscope
Review of the mediastinum using a special endoscope
Review the joint cavity using a special endoscope
Pelvic exam using a special endoscope
To dissect cancer node surgeon should use this tool:
monopolar electrode
surgical "crocodile" clamp
anatomical clip
bipolar forceps
"universal" clamp
To isolate gallbladder surgeon can use this tool:
monopolar "scoop" electrode
surgical clamp
anatomical clip
bipolar forceps
monopolar electrode
To isolate the cystic artery surgeon should use this tool:
dissector
surgical clamp
anatomical clip
bipolar forceps
"universal" clamp
To isolate the cystic duct surgeon should use this tool:
dissector
surgical clamp
anatomical clip
bipolar forceps
"universal" clamp
When carrying out a diagnostic laparoscopy on suspicion of liver echinococcosis, optical port input
is typically carried out
In the periumbilical area
On the midline of the abdomen in the epigastrium
On the midline of the abdomen in hypogastrium
At McBurney point
At Volkovych-Kocher point
To perform arthroscopy there is necessity of:
Introduction of air into the abdominal cavity
Intubation of main bronchi
The introduction of air into the chest cavity
The introduction of air into the joint cavity
The introduction of fluid into the joint cavity
When carrying out a diagnostic laparoscopy on suspicion of acute pancreatitis, port for laparoscope
typically is placed
In the periumbilical area
B.
C.
D.
E.
22.
A. *
B.
C.
D.
E.
23.
A. *
B.
C.
D.
E.
24.
A.
B. *
C.
D.
E.
25.
A. *
B.
C.
D.
E.
26.
A. *
B.
C.
D.
E.
27.
A.
B.
C. *
D.
E.
28.
A. *
B.
C.
On the midline of the abdomen in the epigastrium
On the midline of the abdomen in hypogastrium
At McBurney point
At Volkovych-Kocher point
To perform laparoscopy surgeon needs:
Introduction of air into the abdominal cavity
Introduction of fluid in the abdominal cavity
Introduction of air into the chest cavity
Introduction of fluid in the chest cavity
The introduction of fluid into the joint cavity
To perform laparoscopy there is necessity of:
Introduction of air into the abdominal cavity
Introduction of fluid in the abdominal cavity
The introduction of air into the chest cavity
Introduction of fluid in the chest cavity
The introduction of fluid into the joint cavity
To perform thoracoscopy there is necessity of:
Introduction of air into the abdominal cavity
Intubation of main bronchi
The introduction of air into the chest cavity
Introduction of fluid in the chest cavity
The introduction of fluid into the joint cavity
When carrying out a diagnostic laparoscopy on suspicion of abscess of Douglas space, the first port
is typically placed
In the periumbilical area
On the midline of the abdomen in the epigastrium
On the midline of the abdomen in hypogastrium
At McBurney point
At Volkovych-Kocher point
To stop the bleeding from the liver surgeon can use this tool:
monopolar electrode "scoop"
surgical clamp
anatomical clip
bipolar forceps
"universal" clamp
Trocar used in laparoscopy differs from the classic by:
No valve
Always disposable
The presence of a special valve
Has a length of 10 cm
Similar to other trocars
Trocar used in performance of laparoscopic thoracoscopy is special because of the next reason:
No valve
Always disposable
The presence of a special valve
D.
E.
29.
A.
B.
C.
D.
E. *
30.
A.
B. *
C.
D.
E.
31.
A. *
B.
C.
D.
E.
32.
A.
B.
C.
D.
E. *
33.
A.
B.
C.
D.
E. *
34.
A. *
B.
C.
D.
E.
35.
A.
B.
C.
D. *
Has a length of 10 cm
Similar to other trocars
Videocomplex for laparoscopy has the following components:
The monitor
Camcorder
Light
Laparoscope
All answers are correct
VideoRS is:
Apparatus for coagulation
Apparatus for recording video
Tools for fixation of the abdominal cavity
Apparatus for recording image
The device for the aspiration of fluid from the abdominal cavity
Visual laparoscopy was first applied by:
Kelling in 1901
Ott in 1901
Caroli in 1909
Bergman in 1926
Rumann in 1932
What are the parts of tools for connecting tissues?
Handless and inserts without cremaliers
Cremaliers without handles, inserts and tube
With handles and inserts with cremaliers
Tools are solid
Cremalier handles, inserts and tube
What are the parts of tools for tissue separation?
Handles and inserts without cremaliers
cremaliers without handles, inserts and tube
with handles and inserts with cremaliers
tools for dissection are solid
Handles with cremaliers, inserts and tube
When carrying out a diagnostic laparoscopy on suspicion of cyst of the left lobe of the liver,
entering the first port is typically carried out
In the periumbilical area
On the midline of the abdomen in the epigastrium
On the midline of the abdomen in hypogastrium
At McBurney point
At Volkovych-Kocher point
What are the three main indicators of apparatus for insufflation important for the surgeon during
surgery?
The pressure in the abdomen, gas temperature and carbon dioxide level in the tank
Pressure in the abdomen, the rate of gas supply and gas temperature
The pressure in the abdominal cavity, the gas flow rate and the level of carbon dioxide in the tank
The pressure in the abdominal cavity, the gas flow rate and the amount of gas spent
E.
36.
A.
B.
C.
D. *
E.
The rate of gas supply, the amount of spent gas and gas temperature
What are the three main types of laparoscopes in the classification of angle?
0 °, 15 °, 45 °
0 °, 45 °, 60 °
10 °, 25 °, 50 °
0 °, 30 °, 45 °
0 °, 5 °, 10 °
Назва наукового напрямку (модуля):
Семестр:
12
KROK2018
Опис:
MIX
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.
Перелік питань:
?"Blind" trocar is:
first (optical) Trocar
Surgical Trocar
Assistant Trocar
Trocar type «Visiport»
all answers are correct
"Minimally invasive surgery" means:
perform operations at minimum access
perform the operation as quickly as possible
perform operations using laser
executing operation in only one anatomic site
perform operations after prior chemotherapy
Arthroscopy is:
Overview of the abdominal cavity using a special endoscope
Overview of the chest cavity using a special endoscope
Review of the mediastinum using a special endoscope
Review the joint cavity using a special endoscope
Pelvic exam using a special endoscope
Aspirator-irrigator is:
The device that provides a supply of fluid into the abdominal cavity
The device that ensures removal of fluid from the abdominal cavity
The device that maintains pressure in the abdomen
There is no right answer
Answers A, B are right
At laparoscopy one can figure out all of the listed except:
Color of tumor
The morphological structure of the tumor
The presence of metastases
The consistency of the tumor
The mobility of tumor
At what temperature presterilization of laparoscopic instruments is performed?
50 ° C
20 ° C
30 ° C.
90 ° C
120 ° C
At what temperature sterilization of laparoscopic instruments in dry-air camera is performed?
100-120 ° C
140-160 ° C
170-180 ° C
190-200 ° C
80-90 ° C
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.
Before the needle of Veresh puncture one must:
Fix the abdominal wall
Press the epigastrium
Press the left and right sides
Add the liquid into the urinary catheter
Ask permission from the anesthesiologist
For of laparoscopy on perforated ulcer, a second port input is carried out
In mesogastrium 1 cm above or below the navel on the median line
On the midline of the abdomen in the epigastrium 10 cm above the navel
At Volkovych-Kocher point
At McBurney point
At Kerr point
Benefits of operations performed by laparoscopic method over traditional:
More quick
More effective
Short postoperative period
Cosmetic effect
Answers C and D are correct
Culdoscopy is:
Overview of the abdominal cavity using a special endoscope
Overview of the chest cavity using a special endoscope
Review of the mediastinum using a special endoscope
Review the joint cavity using a special endoscope
Pelvic exam using a special endoscope
In the implementation of laparoscopy for suspected salpingal disorder, optical port input is done
In mesogastrium 1 cm above or below the navel the median line
On the midline of the abdomen in the epigastrium 10 cm above the navel
On the midline of the abdomen in hypogastrium 10 cm below the navel
At McBurney point
At Kerr point
Diagnostic laparoscopy is informative at:
Vesico-ureteric reflux
Acute appendicitis
Adrenal tumor
Hemophilia
Femoral hernia
Diagnostic laparoscopy is performed for:
Confirmation of the diagnosis
Removal of the gallbladder
Removal of fluid at ascites
Appendectomy
There is no right answer
Directly into the abdominal cavity carbon dioxide is supplied through:
Laparoscope
Insuflator
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.
Coagulator
Trocar
Light
In the implementation of laparoscopy on suspicion of pelvic tumor, staging port for laparoscope is
put
In mesogastrium 1 cm above or below the navel the median line
On the midline of the abdomen in the epigastrium 10 cm above the navel
On the midline of the abdomen in hypogastrium 10 cm below the navel
At Volkovych-Kocher point
At Kerr point
During laparoscopy abdominal pressure is maintained within:
20 mm Hg.
5 mm Hg.
12 mm Hg.
25 mm Hg.
8 mm Hg.
During laparoscopy abdominal pressure supports device called:
Duomat
Infusion pump
Insuflator
Aspirator
Respirator
Endosurgical complex consists of:
Videocomplex
Systems of aspiration and irrigation
Systems of insufflation
Coagulation Systems
All answers are correct
Endovideosurgery complex consists of:
Videocomplex
Systems of aspiration and irrigation
Systems of insufflation
Coagulation system
All answers are correct
For aspiration biopsy instruments are sterilized by:
boiling
autoclaving
dry high temperature camera
In formaline camera
In the antiseptic solution
For imposing pneumoperitoneum by needle of Veresh into the abdominal cavity one must not enter:
Above the pubis of the white line of the abdomen
In the right iliac region
In the left iliac region
Below the navel on the white line of the abdomen
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. *
30.
Above the navel on the white line of the abdomen
For imposing pneumoperitoneum needle puncture into the abdominal cavity can be made through:
above the pubis in linea alba
In the right iliac region
In the left iliac region
below the navel on linea alba
above the navel on linea alba
For the creation of pneumoperitoneum in modern laparoscopy mostly is used:
Air
Nitrous Oxide
Carbon dioxide
Oxygen
Saline
For traction of gallbladder surgeon should use this tool:
dissector
surgical clamp
anatomical clip
bipolar forceps
monopolar electrode
Furrier needle is used to:
continuous suture of the intestine
knot suture of the intestine
for the closure of parenchymal organs
for stitching wounds
for suturing the stomach wall
Hasson Trocar is used for:
open method of setting the optical trocar
after a needle of Veresh for carboxyperitoneum
as a surgical port for working tools
as an additional assistant trocar
in all these cases
In the implementation of laparoscopy on suspicion of pelvic tumor, setting the working port is
carried out
On the midline of the abdomen in hypogastrium 10 cm below the navel
In mesogastrium 1 cm above or below the navel the median line
On the midline of the abdomen in the epigastrium 10 cm above the navel
At Volkovych-Kocher point
At Kerr point
How much time is spent for sterilization of laparoscopic instruments in dry-air closet?
30 minutes
2 hours
2 h 30 min
3 hours
1 hour
How much time is spent on presterilization processing of laparoscopic instruments?
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.
E.
10 minutes
20 minutes
30 minutes
15 minutes
1 hour
In some of these cases using monopolar coagulation is prohibited?
At the presence titanium plates
At the presence of adrenal lesions
At the presence of pacemaker
At the presence of echinococcal liver disease
At the presence of bladder damage
In the medial fold there is:
Hepatic artery
portal vein
choledochus
Inferior vena cava
Obliterated umbilical artery
To perform a diagnostic laparoscopy on intra-tumor staging, the second port typically is placed
Depending on the tumor site
On the midline of the abdomen in the epigastrium
At Kerr point
At McBurney point
At Volkovych-Kocher point
In the round ligament of liver there is:
Hepatic artery
portal vein
choledochus
Inferior vena cava
Obliterated hepatic vein
Insuflator is:
The device that provides air flow in the abdominal cavity
The device, which provides creating space in the abdominal cavity
The device that maintains pressure in the abdomen
There is no right answer
Listed answers are right
Into clinical practice laparoscopic method of examination was introduced by:
Kelling in 1901
Yakobeus in 1910
Schmidt in 1927.
Tracking in 1929
Raddok in 1929