Крок 2 (2014) иммунология и аллергология.
1/16
A child 10 years old was diagnosed with lacunar tonsillitis, cervical lymphadenitis. On the
5th day of illness, the child has revealed an increase in liver size up to 2 cm and spleen on
sm In the General analysis of blood identified: the lake . - 15,6 * 109 / l , F - 3% , P - 4% ,
15 % , L - 45 % , M - 10 % , veracity - 23%. What disease can be suspected ?
A * Infectious mononucleosis
B Adenovirus infection
C Strep infection
D Diphtheria oropharynx
E Angina Simanovsky - Vincent
2/ 26
The boy 6 years was introduced donor immunoglobulin in connection with a contact on
viral hepatitis in the family. According to the schedule of vaccination at this time was
planned revaccination against measles. The child examined by a district pediatrician and
declared healthy . For some reason, the doctor - immunologist did not grant permission to
vaccination :
A * inefficiency of vaccination against the background entered immunoglobulin.
B a Possible anaphylactic reaction to the vaccine.
With a High probability of measles vaccination.
D Possible development of viral hepatitis due to measles vaccination.
3/ 41
The child of 8 years recovering from a sore throat appeared on the skin of the legs and
belly petajalampi pink color and temperature rose to 38 0C . The number of platelets in the
blood 90,0 g / l , bleeding time of 15 minutes. What kind of disease you can think of ?
A * Idiopathic thrombocytopenic purpura
B Deficiency anemia
C Hemorrhagic vasculitis
D Acute lymphoblastic leukemia
E Hemophilia
4/49
The child is 8 years of age diagnosed with mumps ". His brother , 4 years of mumps was
sick and not vaccinated. Applying what measures can prevent disease mumps this child?
A * Gammaglobulinemia
B Antibiotikoterapiei
C Chemoprophylaxis
D Vaccination
E pageprofile
5/ 67
Child was born from HIV - infected mothers . The General condition satisfactory. On Apgar
scale - 8 points . Weight 3200, length - 50 see Prenatal , birth and postpartum prophylaxis
of AIDS was conducted . How soon can be defined by ELISA HIV infection?
A * 18 months
B 6 months
C in 3 months
D in 1 month
E In the first days after birth
6/ 68
The 5 - year-old child with a serious form of varicella with abundant polymorphic
vesiculate - papular and hemorrhagic rash . The temperature within the 39 - 40 0C.
Which of antiviral drugs should be administered in this case ?
A * Acyclovir
B Lamivudine
C Reaferon
D Arbidol
E Rimantadine
7/83
The child of 20 - days-old was admitted to hospital on 3-rd day of the disease in heavy
condition.Observed febrile fever , profuse polymorphic (spots, papules , vesicles )rash on
the entire body , mucous membranes , almost all vesicles have hemorrhagic content . With
application of which drug should begin therapy ?
A * Acyclovir
B prednisolone
C anti-herpes vaccine
D amantadine
E interferon
8/94
When transfusions in 8 year old boy with hemophilia A ,suddenly have pain in the chest
and lower back , shortness of breath , cold sweat. objectively :the skin is pale curves 100/min . , AD - 60/40 mm Hg Oliguria , urine brown. The attraction of this complication
primary purpose is :
A * prednisolone
B lasix
C Adrenaline
D Eufillina
E dipyrone
9/99
The child receiving inpatient treatment for Hodgkin's disease
(Hodgkin's disease ) , increased body temperature up to 38,2 OS , appeared rich
polymorphic rash (spots , papules , vesicles ) on the whole body. additionally, using any
medicines is the most reasonable in this case?
A * Acyclovir
B prednisolone
C ribavirin
D Ceftriaxone
E vancomycin
10/103
The girl complaints papular rash on the face , chest , abdomen . Itchy rash, disappearclicking. " Geographic tongue" . Temperature is normal.
On the eve ate drink " Fanta " , chocolate sweets , fish products. Vnutrennyuyu pathology
was not found . Eosinophilia . What is the diagnosis?
A * Acute urticaria
B Atopic dermatitis
C Systemic lupus erythematosus
D Thrombocytopenic purpura
E Measles
11/109
Child 6 years, complains of headache , fatigue , weakness , decreased appetite, increased
body temperature to 37.4-37,80 With , pain in the joints of his left hand , more at night
,gemorragii . Complaints appeared 1 month ago. In the General analysis of blood
:erythrocytes-,9 g / l hemoglobin - 45 g / l , color indicator -0,77 ; ESR 70 mm / h; platelets
60 g / l, leucocytes-8,0 G / l ; myeloblaste -35 % ; promyelocyte necrophilia - 0,5 % ; stab
neutrophils - 2% ; segmented of-21.5 % ; eosinophils - 6 % ; lymphocytes -32 % ;
monocytes -3 %. What the diagnosis should be put .
A * Acute leukemia
B chronic leukemia
C Rheumatoid arthritis
D Thrombocytopenic purpura
E deficiency anemia
12/10
The 25 - year-old woman half a year ago, I had an abortion. complaining about the
disappearance of appetite, weakness , arthralgia , two weeks appeared dark urine , and
jaundice , against which the General condition continues to deteriorate . Suspected viral
hepatitis Some of Ismankulov viral hepatitis is likely to be positive, the patient?
A * Anti - HBc IgM .
B Anti - HEV IgM .
C Anti - CMV IgM .
D Anti - HBs
E Anti - HAV IgM
13/20
The patient is 50 years complains of severe weakness , dizziness , skin spots. month
ago had quinsy , was treated with antibiotics. Objective: total
the condition is severe , the skin and the mucous membrane pale. On the face and trunk
spots of different size , blue and brown. Palpation of the abdomen painless ,the liver +1.5
cm stands out from the edge of the right costal arch. General analysis of blood: EP -1,2
x1012 / l , NV - 50 g / l , color indicator 0,70 , platelets - 2x109 / l , unsophistication . ESR 55mm / hour. What is the diagnosis?
A * Thrombocytopenic purpura
B Hemorrhagic vasculitis , abdominal form
C posthemorrhagic anemia
D Myeloma
E Hemophilia
14/27
The patient 24 years during the last two months is observed a growing headache , General
weakness , dizziness , bleeding ( epistaxis , hemorrhage on kojei mucous membranes) .
Lymph nodes , liver and spleen are not Tbilisians blood :Hb -50 g / l , R - 1,6 x1012 / l , p 1 , 0 , lake -2 , 0x109 / l , p - 1% , C -35 % , e -1 % , b - 1% , l -10% ,m 4% , trom 30x109/laki likely diagnosis ?
A * Aplastic anemia
B Acute leukemia
C Deficiency anemia
D-12 - deficiency anemia
E Hemolytic anemia
15/39
Sick 62 years gospitalizirovn complaining increase cervical, supraclavicular, and axillary
lymph nodes, weakness , increased sweating , low-grade fever within the last 3 months. In
the analysis of blood - leikozita - h / l , in the formula - lymphocytes 72%. Research
method is useful for further diagnosis ?
A * Kilogramme
B Lymphography
C Lymphoscintigraphy
D x-Ray examination
E Thermography
16/43
The guy 15 years suffers from childhood atopic dermatitis allergic to shellfish meat. The
last 3 months after purchase of aquarium fish , appeared rhinitis ,conjunctivitis , itch in the
nose. The level of some immunological parameters determine the patient?
A * IgE
B IgJ
C IgM
D IgA
E Circulating immune complexes
17/48
The patient is 19 years old, suffers from systemic lupus red , acute with kidney , heart ,
pleura , joints , it is planned to assign pathogenetic treatment. In the analysis of blood
erythrocytes - 3,8 g / l , NV -120 g / l , laki. -2 , h / l ,thrombi . - 150 x 109 / l , urea to 6.9
mmol / L. Select the right treatment option .
A * Prednisolone 60 mg / day .
B Cyclophosphamide 200 mg in / in a day
C Timolin 10 mg / m daily .
D Laferon 5 million unit / m 2 times a week .
E Levamisole 150 mg / day in the scheme .
18/50
In a patient with chronic lymphocytic leukemia has increased weakness , appeared
jaundice. In an . blood : er - 2,1 g / l of HB - 55 g / l ; C.P. - 1,1; Reticuli . 51 per thousand.
The bilirubin the General . - 80,3 mmol / l , on " govani - 65,3 mmol / l In urine increased
level of urobilin Pryamoi test Kumbsa positive. What leading pathogenetic factors resulted
in lower hemoglobin ?
A * Autoimmune hemolysis
B aplasia of hematopoiesis
C Develop myelofibrosis
D Deficiency folic acid
E B12 Deficiency
19/51
Patient 53 years appealed to the neurologist with complaints of pain in the lower back On
the x-ray of the spine and pelvis identified osteoporosis and large bone defects . In blood
reasonable normohromnaja anemia , in the urine - proteinuria to 2.0 g / l . Total protein
blood 107 g / lcuqae study should be undertaken to establish a definitive diagnosis?
A * sternal puncture
B Extended an . the blood.
C ultrasound examination of abdominal cavity organs
D cytochemical study
E Radioisotope renografii
20/60
The patient K. 4 days ago got a rash on the skin, accompanied by itching . Bother
bloating , dull pain in the right hypochondrium , constipation. The day before ate
kopcheniya. Earlier similar reaction came after drinking excessive amounts of tomatoes ,
strawberries ,chocolate. Objective : on the skin of face , trunk , limbs urticarnae skin
rashes . the total IgE level in a normal. What is the most likely diagnosis ?
A * Pseudoallergy .
B Idiosyncrasy .
C Food Allergy.
D Atopic dermatitis .
E Chronic krapiwnice .
21/61
Patient 37 years , sold , complain of itchy skin of the hands , face and neck , which
appears in contact with cold water , and in winter - at the exit to the street. An objective
examination in open areas of skin melkorublenoy rash ,excoriation . Specify the diagnosis?
A * Cold urticaria .
B Scabies .
C Atopic dermatitis .
D pigment urticaria .
E Contact dermatitis .
22/62
Woman, 40 years hospitalized with complaints of attacks of breathlessness , cough. Hurts
4 years. For the first time, choking, appeared at the patient stays in the village .
subsequently the asthma disturbed during the cleaning. After 3 days of stay in hospital her
state improved significantly. What are the most likely causative factor ?
A * Household allergens.
B Pollen.
C Infectious .
D Chemicals.
E Psychogenic .
23/ 63
Patient K. had complained of wheezing shortness of breath , choking the appearance of
asthma attacks at night 3-4 times a month, and day 2-3 times a week Objective : vesicular
breath with a longer expiration , scattered dry , whistling grippe survey : FEV1 60 % of
normal , daily fluctuations PSV 28%.to assign for short-attack at this stage of asthma?
A * Salbutamol .
B Flixotide .
C Theopack .
D Serevent .
E tavegil .
24/ 82
In the rheumatology Department has been sick for 20 years with symptoms of arthritis. On
agelica - redness in the form of butterflies . In the analysis of urine - protein 4.8 g / l .
Fractionary presence at the patient of systemic lupus erythematosus . Additional
mediclean is the most informative method for diagnosis verification?
A * a blood test for antinuclear antibodies
B General blood analysis
C Immunological blood examination
D a blood test for Le cells
E a blood test for rheumatoid factor
25/ 83
The patient is 25 years , in connection with the transferred angina was appointed bicillin - 5
, which she did not. In 2 weeks after suffering a sore throat swelling of the face,decreased
amount of urine , raised blood pressure. Creatinine of the blood - 340 umol / l , urea - 42
mmol / l What is the most likely diagnosis ?
A *Acute glomerulonephritis . Acute renal failure
B Acute glomerulonephritis , nephrotic syndrome
C Acute glomerulonephritis , urinary syndrome
D Acute glomerulonephritis , hypertension .
E Chronic glomerulonephritis , chronic renal insufficiency
26/85
The patient 36, complaining of severe pain in the chest. Objectively: a serious condition.
Intoxication syndrome -38 - 40C . Ps -88 bpm . Increased submandibular lymph nodes ,
sore . Respiration is weakened vesicular , in the projection of the lower lobe heard crepitus
and mixed gripper : er - 3,0 x1012/L, Hb 100 g/L , Tr - 180x109 / l , Lc12x109/L / blasts 2% , promyelocyte -3 %, myelocyte -5%, metamyelocyte - 10 %, band cell- 15 %, segs -65
%. ESR -35 mm / hour. Toxic granularity of neutrophils and degenerative changes in them.
What is the nature of the changes in the peripheral blood ?
A *Leukemoid reaction myeloid type
B Myeloproliferative process
C Hyperleukocytosis
D Bicytopenia
E Blast transformation
27/ 106
Patient P. , 20, went to the doctor with complaints : fever , pain in the heart ,expressed
General weakness , fatigue , joint pain , rashes on the skin , pain and a sense of gravity in
the right hypochondrium. The complaint came after returning from a holiday. Objective :
skin slightly yellowish , hemorrhagic rash , "butterfly" on the face Immunologicheskie blood
analysis : reducing the number of T - suppressors , lupus cells , high titers of antinuclear
antibodies , antibodies to smooth muscle . Put the diagnosis .
A *Autoimmune hepatitis , type 1
B Systemic lupus erythematosus
C Rheumatism
D Autoimmune hepatitis , type 2
E Rheumatoid arthritis
28/111
Sick 22, after 5 weeks after hypothermia concerned about the fever ,weakness , muscle
pain , inability to move independently . Objective: pain ,tightness of the muscles of the
shoulders , legs ; active movement minimum, chest erythema; periorbital edema with
heliotropic erythema, positive Gottron symptom. What research should be carried out for
verification of diagnosis?
A *Muscle biopsy
B Transaminases
C Joint x-ray
D Titer ASLO
E Rheumatoid factor
29/116
Patient 35 years, complains of reduced efficiency , long febrility , rash , pain in the small
joints of hands. Objective: on the cheeks - erythematous "butterfly" , joints symmetrically
swollen , in lungs - noise pleural friction. Conclusion: anemia , leukopenia ,lymphopenia .
Urine - proteinuria , cylinderuria. Your diagnosis ?
A *Systemic lupus erythematosus
B Dermatomyositis
C Reactive arthritis
D Rheumatic fever
E Rheumatoid arthritis
30/117
Patient 27 years, with bronchial asthma , was bitten by a bee . There was a feeling of
pressure in the chest , shortness of breath , shortness of breath, a sense of heat in the
upper half of the body , dizziness , expressed itching , seizures. Objectively: the noisy
breathing, wheezing , AP - 90 /60 mm Hg , Ps - 110 bpm., heart - rhythmic tones, in lungs
- hard breathing , dry wheezing. What group of drugs should be used in the first place?
A *Glucocorticoids
B Methylxanthines
C Cardiac glycosides
D Anticonvulsant
E Analgesics
31/120
The woman of 42 years , suffering from chronic sinusitis, developed acute form of arthritis.
The doctor prescribed treatment with acetylsalicylic acid. History of the propensity to
allergic reactions, the patient was not. Suddenly after the injection, the patient developed
bronchospasm. The most likely pathogenetic mechanism of bronchospasm are:
A *Primary changed reactivity bronchi
B Adrenergic imbalance
C Infection-dependent
D Atopic
E Immunopathological
32/131
Patient 28 years complains of pain , swelling interphalangeal joints and left knee joint ,
morning stiffness . Objectively: the interphalangeal joints, metacarpophalangeal stiff ,
swollen , movement in them painful, not in full , minor atrophy intercostals muscles of the
hand. An . blood : L - 9,6 h / l, ESR - 48 mm / hour. ; CRP + + + , Waaler-Rose Test 1:128 Diagnosis :
A *Rheumatoid arthritis
B Rheumatis arthritis
C Deforming osteoarthrosis
D Gouty arthritis
E Reactive arthritis
33/145
Patient 19 years complained of shortness of breath during physical activity , increased
body temperature to 37,5 oC , weakness. Suffering from chronic tonsillitis , a week ago
there was a sharp aggravation . Objective: mild cyanosis, Ps -110 bpm. Weakened first
tone, systolic murmur over the top. Blood test: Lc 8,9 h/L, ESR -27 mm/hour. ECG: sinus
rhythm, R - 0,08 s, PQ - 0.25 s, QRS - 0,09 s. Your diagnosis:
A * infectious - allergic myocarditis
B Tonsillitis carditis
C Constrictive pericarditis
D Vegetative - vascular dystonia in cardiac type
E Dilatation cardiomyopathy
34/165
The patient after receiving biseptol appeared oliguria, jaundice with a strong paleness of
skin and mucous membranes , increased spleen. Blood test: er. - 2,2 G/L , Hb-60 g/L,
Color index - 0,62 , Le - 14x109/l , reticulocytes 24 ‰. Indirect bilirubin in blood serum is
35 mmol/l. Urine and stool is dark color , the increased level stercobilin . What is the most
likely diagnosis in this patient?
A *Hemolytic anemia
B Toxic hepatitis
C Acute leukemia
D Aplastic anemia
E Obstructive jaundice
35/168
Patient M , 22 years old with suspected systemic lupus erythematosus complains of
"flying" pain in the joints of the hands and feet , the temperature increase up to 38.5-39 oC
for 3 weeks ,shortness of breath , palpitations , weakness. Objective: erythema on the
cheeks and nose. In blood : Hb 90 g/L, platelets - 135x109, ESR - 43 mm / hour. Urine :
protein - 2,66 g / l , red blood cells is 8-10. Which antibodies in blood test of patient is most
significant for diagnosis?
A *To the native DNA.
B To the platelets.
C To phospholipids.
D Rheumatoid factor.
E Crioglobuline .
36/170
Patient R. , 59 years old , was admitted in the rheumatology department on suspicion of
scleroderma in a very serious condition. Objective: underweight, "a mask-like" face,
osteolysis of ungual phalanges. In the blood - er. - 2,2 x1012/L, ESR - 40 mm / hour. Urine
- raising the level of free hydroxyproline . One of the most probable stages of pathogenesis
are:
A *Appearance of antibodies to collagen .
B Antibodies to native DNA.
C Antibodies to uniform elements of blood.
D Antibodies to striated muscles .
E Antibodies to the vessel wall.
37/182
Patient, 24 years old , went to a doctor when found increased submandibular lymph
nodes. Upon further examination by a doctor detected increased under-axillary and
inguinal lymph nodes. On the x-ray of the chest - enlarged lymph nodes in the
mediastinum. In blood test: er. 3,4x1012 /L , hemoglobin 100 g / l; a color parameter - 0,88
,platelets - 190x109/L, leucocytes - 7,5 g / l , eosinophils - 8 % , stab - 2% ,segmented - 67
% , lymphocytes - 23% , ESR - 22 mm / hour. What the study shows for the verification of
the cause of lymphadenopathy ?
A* An Open biopsy of the lymph nodes.
B Ultrasound examination of abdominal cavity organs
C Tomography mediastinum.
D Needle biopsy of the lymph nodes.
E Sternal puncture .
38/192
In the trauma center hospital turned Builder 38 years immediately after the foot injury by
hobnail. When inspecting the condition is satisfactory , on the sole of the right foot found
wound . It is established that in the last three years three times conducted prevention of
tetanus . What prevention is feasible at the present time?
A * In / m to enter 0.5 ml . tetanus toxoid .
B In / m enter 3000 IU of tetanus toxoid.
C In / m to type 1 ml . tetanus toxoid , 3000 IU of tetanus toxoid.
D Assign course of antibiotic therapy.
E to Treat the wound with soap and water.
39/201
The child 2 years began to complain of a rash on the mucosa after a long
antibiotic therapy about pneumonia. Objective : on the mucous membrane
the mouth cavity , the tongue , the corners of the mouth is red spots covered by the crust ,
easy to remove shpatelem. Put the diagnosis .
A * Candidiasis mucous membranes.
B Pemphigus vulgaris
C Multiforme exudative erythema.
D Leukoplakia .
E Streptococcal angular cheilitis.
40/202
A pregnant woman of 25 years with aggravated allergological history (Allergic rhinitis) in
pregnancy 28 weeks after the stressful situation suddenly appeared loud wheezing ,
shortness of breath ,cyanosis face . On auscultation: breathing weakened, many dry
wheezing with percussion - tympanic sound. After the attack in women was allocated a
small amount of viscous sputum . What is the most likely diagnosis ?
A * an Attack of bronchial asthma.
B pulmonary Edema.
C obstructive bronchitis.
D pulmonary Embolism.
E a Threat of miscarriage.
41/234
The patient 40 years , a homosexual , had complained of prolonged fever , night sweats ,
sudden weight loss , muscle pain , sore throat , joint pain , recurrent diarrhea. Then the
examination detected generalized lymphadenopathy . What disease should be suspected
?
A * AIDS
B Limfogranulematose
C Sepsis
D Tuberculosis
E Lymphocytic leukemia
42/238
Sick of 20 years. After a wasp sting developed angioedema , on the body rash in
the form of blisters , papules . Emergency care should begin with :
A *Prednisolone , antihistamines
B Rheopolyglucin , gemodez
C Norepinephrine , mezaton
D Fresh frozen plasma , E - aminocaproic acid
E Gipotiazid , furosemide
43/239
The patient aged 32 , pharmacist , worked with benzocaine . 5 days later on the hands
appeared induration, skin and erythematous . Select the diagnosis .
A *Contact dermatitis is an allergic
B Atopic dermatitis
C Psoriasis
D Hemorrhagic vasculitis
E Pigment urticaria
44/ 240
Patient N. , 25 years. Suddenly after taking shrimp developed itching in some areas of the
body appeared blisters , redness . Put the diagnosis .
A *Acute urticaria
B Hemorrhagic vasculitis
C Pigment urticaria
D Psoriasis
E Itching
45/ 241
The patient A. 22 years. Complaints of itching of the skin on the neck , ears. Sick since
childhood. Father suffers from allergic rhinitis. When viewed erythema and lichenification
on ears, neck, popliteal pits . The most likely diagnosis is :
A *Atopic dermatitis
B Seborrheic eczema
C Psoriasis
D Contact dermatitis
E Itching
46/255
The patient is 25 years complains of weakness, dizziness, a hemorrhagic rash. Ill about
month. In blood : er . - 1,0 x1012 / l , Hb - 37 g / l , color index - 0,9 , Le. - 1,2 x109 / l ,
platelets - 42x109 / L. the Method of the study will be most appropriate for the diagnosis?
A *Sternal puncture
B Biopsy spleen
C Liver Biopsy
D Coagulogram
E Abdomen sonography
47/260
Patient 55 years complains of pain in the sternum and lumbar spine, ribs.
In anamnesis - pathological fracture of the right Shin. In blood
protein - 110g / l , positive M-gradient. Urine - Bence Jones protein. Your diagnosis ?
A *Myeloma
B Osteochondrosis
C Angina FC
D Glomerulonephritis
E Neuralgia
48/263
Patient 20 years complaining on increase of body temperature to 38oC , shortness of
breath , rapid heartbeat , swelling in the legs , pain in the joints. On the cheeks - erythema
. Tachycardia , systolic noise at the top , a modest increase sizes of liver , spleen. In the
analysis of blood : anemia , leukopenia , ESR 52mm / hour. In the analysis of urine:
proteinuria - 5.6 g / l , red blood cells 20 - 30 , cylinders hyaline to 10 . Which method is
necessary for diagnosis?
A *Detection of antibodies to DNA
B Ultrasound of the kidneys
C Blood for About antistreptolysin
D ECHO - KG
E Renal Biopsy
49/280
Child 4 days. He was transferred from the maternity hospital with the symptoms of
infectious toxicosis. During the inspection revealed: difficulty breathing through the nose ,
virginiamoreno - hemorrhagic discharge from the nose. Suspected early congenital syphilis
. Which of the surveys will allow to confirm the suspicion ?
A * the detection of specific antibodies in the blood.
B Common blood test.
C retinoscopy.
D cerebrospinal fluid Examination.
E Radiography tubular bones.
50/ 281
A pregnant woman in the second trimester diagnosed with primary syphilis , about which
received adequate antibiotic treatment . Pregnancy informed . the neonatal period was
uneventful , but a newborn baby found a high titer protivodiareynah antibodies. The child
should be fed :
A * Maternal breast milk.
B donor breast milk.
C Adapted mixture.
D Adapted a mixture of soy .
E Simple formula.
51/289
In a patient with extensive QS - myocardial infarction in the acute period of the disease
observed the reduction of blood pressure to 80/ 60 mm Hg , mercatello fibrillation and
blockade right bundle branch . On the 10th day of the disease detected the presence of
ECG complexes QS-elevation of ST segment . In this case, the patient showed signs of
pericarditis , fever and pleurisy. What complications of myocardial infarction said in this
case ?
A * Syndrome Dresler
B left ventricular Aneurysm
C cardiogenny shock
D Electromechanical dissociation
E pulmonary embolism
52/292
Patient S. 36 years , the pain of rheumatoid arthritis for 8 years. Two months ago
appeared swelling of the left knee , resistant to treatment. objectively :
synovitis of the left knee . The puncture of the joint and received 50 ml
exudation. Which cells will be revealed in the study of articular punctate ?
A * Rugocytes
B LE cells
C Cells Berezovsky
D Erythrocytes
E Eosinophils
53/320
Long distance driver 40 years , is ill for two months : General weakness , sweating , weight
12 kg , frequent prolonged diarrhea and recurrent respiratory infections. Objective :
generalized lymphadenopathy , phenomena candidiasis of the oral cavity , in the faeces admixture of mucus and blood. We found a decrease in the number of T - helper cells ,
T4/T8 less than 0.5 . What is the most likely diagnosis ?
A * AIDS
B Shigellosis
C Amoebiasis
D Tuberculosis
E Sepsis
54/339
The patient has a diagnosis of herpes zoster . The patient suffers from childhood diabetes
, father and grandfather - bronchial asthma. A few days ago, I had food poisoning. Within 7
days took analgin about headache . when examining a patient found increased levels of
antibodies against HIV. What factors has more pathogenic significance ?
A * HIV - related immunodeficiency
B Allergiesrelatives
C Food poisoning
D diabetes
E analgesics
E analgesics
55/353
Sick 30 years after their stay at work appealed to the dermatologist with complaints rashes
all over the body . For the last 3 months notes the dramatic weight loss ,weakness ,
persistent fever . On the subject of any disease it is advisable to examine the patient ?
A * AIDS
B syphilis
C Tuberculosis
D cytomegalovirus infection
E malignant skin neoplasms
56/363
Woman 36 years, suffering from hay fever for 7 years. Last 2 years in August - September
( during flowering ambrosia ) the patient complaints 2-3 asthma that are fixed 1 dose of
salbutamol . Objectively : the temperature is 36,5oC , NPV - 18 min . , Pulse - 78 u . / Min .
, BP-115/ 70 mm Hg Above the lungs - vesicular breath . The cardiac sounds sonorous ,
regular rhythm . The use of any drug will most effectively to prevent asthma attacks in
critical patient season?
A * Inhalation Intal
B Inhalation Berotec .
C atrovent Inhalation .
D Reception suprastin .
E Reception theopack .
57/370
Woman 63 years complained of General weakness , feeling of heaviness , pressure ,
fullness in epigastria , nausea , belching after meal . Sick about 15 years. Objectively: the
temperature - 36,4 OS , NPV - 20/min , pulse-88/XB , BP - 115/MT . Skin and mucous
pale. In blood : red cells is 2,0 g / l , NV - 100 g / l . Antibodies were detected
obkladochnykh cells of the stomach. What is the most likely cause of anemia in this patient
?
A * the Production of antibodies to the internal factor
B a violation of the synthesis of hemoglobin
C a violation of the synthesis of erythropoietin
D malabsorption of iron
E Increased consumption of iron
58
A child of 12 years during preventive examination detected diffuse enlargement of the
thyroid gland of the II degree. Auscultation of the heart revealed muting heart sounds, HR 64/min Has a tendency to constipation. Found anemia. Increased levels of antibodies to
thyroglobulin. What is the presumable reason specified symptoms?
A. Endemic goiter.
B. thyroid Cancer.
C. Diffuse toxic goiter.
D. Hyperplasia of the thyroid gland.
E.* Autoimmune thyroiditis.
59.
The patient 32 years with chronic viral hepatitis a dull, aching pain in the right
hypochondrium, nausea, dry. The size of the liver by Kurlov - 13-12-11 cm, spleen +2 .
AST - 3.2 mmol/GHL, Alt - a 4.8 mmol/GHL. Serological study revealed HBeAg, high
concentration of DNA NV. Which of the following remedies is the drug of choice in the
treatment of this patient ?
A.*alpha interferon
B. Arabinoside monophosphate
C. Acyclovir
D. Essentiale-Forte
E. Rimantadine
60.
A male 37 years when conducting pielografii using urografia arose itchy skin, swelling of
the face, dizziness, fear of death. HELL 70/40 mm RT century, PS -130 beats in minutes
noisy Breathing, wheezing heard in the distance, auscultation of breath weakened, single
dry rales. What preparation you must enter the patient in the first place?
A.*Adrenaline.
B. Prednisolone.
C. Lasix
D. Suprastin.
E. Aminophylline.
61.
25. Woman, 34 years old pain in acute 3 months ago, after acute respiratory infections
hurt interphalangeal joint, and then after 2 weeks in the knee joints, morning stiffness,
increased body temperature to 38os. Interphalangeal joints, metacarpophalangeal joint,
knee swollen, stiff, swollen, hot to the touch. In the blood tests: ESR-45 mm/h, SLO +++,
the reaction of Valer-Rose 1:128. What is the mechanism of the disease you can think of?
A. *Autoimmune.
B. Allergic.
C. Exchange.
D. Degenerative
E. Dystrophic.
62.
Woman, 35 years due to pneumonia was appointed ampicilin. In 20 minutes after
intravenous injection of the drug the patient felt a sudden weakness, itching of the face,
hands, nausea, cough, shortness of breath, pain in the chest. About-but: cyanosis,
swelling of eyelids, face, with red rash. The pulse was 120 per minute, BP - 70/20 mm Hg
heart sounds deaf, frequent breathing, surface, with different-sized moist rales. Varicose
veins on the right leg. What is the most likely cause of sudden deterioration of the patient?
A.*Anaphylactic shock
B. Angioedema
C. Urticaria
D. Asthma attack
E. Tromboembolia branches pulmonary artery
63.
30. The patient is 18 years of age suffering from seasonal bronchial asthma, atopic form,
is in remission. Skin tests to house dust allergen 006 - +; 008 - +; the rye pollen - ++;
wheat - +++. If the patient needs in specific giposencibilization if Yes, then what allergen?
A. Yes, to the antigen wheat
B. Yes, to the antigen rye
C. Yes, to house dust 006, 008
D. * Yes, to the antigen of rye and wheat
E. No
65.
Man 18 years in connection with a headache took aspirin. 20 minutes later developed
swelling of the eyelids, lips, appeared difficulty breathing, urticarnae elements on the skin.
The father periodically noted swollen cheeks, lips after the extraction of teeth. Response
inhibition of migration of leukocytes with aspirin negative. Immunoglobulin E - 115 ng/ml
what is the most likely diagnosis.
A.*Hereditary angioedema
B. Angioedema
C. the Attack of bronchial asthma
D. Allergic dermatitis
E. Pigment urticaria
66.
40. Patient 23 years taken to the emergency room with contaminated knife cut wound of
the right foot. Initial debridement, entered tetanus serum. Some time later, the patient's
condition worsened dramatically: there was a sudden weakness, dizziness, frequent
heartbeat. On-but: there paleness of skin, cold sweat, rapid pulse weak filling up to 100
beats/min, HELL 90/40 mm RT. Art. and therefore there was a sharp deterioration of the
patient?
A.* anaphylactic shock
B. hemorrhagic shock
C. pain shock
D. toxic shock
E. drug ( serum ) disease.
67.
42. The clinic received the patient is 18 years with complaints expressed shortness of
breath, skin itch. Acutely ill, about an hour later, after taking ampicillin. In childhood urticaria, food polyallele. About-but: periorbital edema, redness and swelling of the face.
The breath wheezing. PS 96 1 minutes, HELL 80/50 mm RT. senior Drug emergency?
A.*Hydrocortisone
B. Aminophylline
C. Diphenhydramine
D. Dopamine
E. Mezaton
68.
47. In women 35 years of age 30 minutes after intramuscular injection ampicilina there are
sharp weakness, itching of the face and hands, nausea, cough, shortness of breath, pain
in the chest. About-but: cyanosis, swelling of eyelids, face, neck, skin wet with red rash.
Pulse - 120/min ,AD - 70/20 mm Hg, heart sounds deaf, frequent breathing, surface with a
large number of heterogeneous moist rales. With the introduction of a drug, you should
immediately begin therapy?
A.* Adrenaline
B. Prednisolone
C. Astmopent
D. Eufillin
E. Dopamine
69.
50. The man who had 2 days ago sexual contact, as it turned out later, with an HIVinfected partner, has addressed with the request to eliminate the possibility of infection.
When it is necessary to carry out the first study of antibodies to HIV?
A.*a month after sex
B. on the day of treatment
C. in 3 months
D. in 6 months
E. in 1.5 years .
70.
The 12-year-old girl after drinking two aspirin for 4-5 hours the body temperature rose to
39-40 degrees. Complains of the total nedomoganie, dizziness, unexpected appearance of
red spots on skin blistering or peeling of the skin with eroded surface. Lesions on the skin
was like a second-degree burn. Symptom Nikolsky - positive. What is the most likely
diagnosis?
A. * Acute epidermal necrolysis syndrome Layla.
B. Bladderwort vulgar.
C. Polymorphic exudative erythema.
D. Bolotny dermatitis.
E. dermatitis Herpetiformis of during.
71.
A woman 20 years 8 years in August-September occurs rhinitis, conjunctivitis, and last
year joined asthma or cough with difficult breathing. When conducting skin tests revealed
hypersensitivity to ragweed pollen. What interleukin is critical synthesis of antibodies,
obuslavlivayuschih disease?
A..* IL 4.
B. IL 1.
C. IL 2.
D. IL 3.
E. IL 6. .
72.
The girl of 18 years after extraction of the tooth appeared solid sickly pale facial swelling,
abdominal pain without clear localization, nausea. Similar symptoms occurred several
times previously, after stress or before menstruation. And passed without treatment within
3-4 days. Specify the cause of the above-mentioned condition of the patient.
A. Cholinergic imbalance.
B. Giperergicakie reaction I type.
C. Giperergicakie reaction III type.
D.*Shortfall of C1 inhibitor of complement.
E. Pseudo allergic reaction.