1
Woman of 60-th years, about 15-th years suffers by arterial hypertention After the repeated
stroke grumbles about the amotivational decline of mood, weight of concentration of attention,
forgets to close entrance doors, does not remember the event of past day. On CT - areas of
poststrokes changes are in crust postfrontal areas. What diagnosis is most reliable at patient?
A *Cererbrovascular dementia
B Illness of Al'cgeymer’s
C Illness of Gentington’s
D Peak illness
E Dissociativ amnesia
2
Patient of 68-th years, office worker. There are about two years disorders of memory had began :
patient is helpless in work and way of life, did not get along at official duties. Gradually began
to forget the names of relatives, names of objects, became helpless, speech was violated. Lost
skills of letter, reading, care of itself. At CT research: atrophy of cortex of large hemispheres of
brain. What diagnosis is most reliable ?
A *Illness Al'cgeymer’s
B Peak illness
C Atherosclerotic dementia
D Senil'naya dementia
E Progressive paralysis
3
Patient of 31 years, economist, from youth age suffers epilepsy with large convulsive attacks,
constantly accepted anticonvulsive treatment. Entered in hospital with the considerable
becoming more frequent of attacks. In a separation there are serial attacks between which a
patient does not come in consciousness. What measures is it most expedient to use?
A *Inta venois infusion of cybazon’s.
B Parenteral'noe introduction of aminazin.
C To increase doses of medicine usually used by patients.
D Introduction of camphorae.
E Elektro - shocking therapy.
4
A woman of 56 years on a background a climax have attacks which are characterized great head
pain, by the increase of arterial pressure to 180/ 100 мм of Hg, tachycardia, the shortness of
breath, general shaking. Duration of attack 30-40 min. An attack ends with urination. What type
of crysis is it more possible?
A * Simpato-adrenalin’s crysis
B Vago-insulin’s crysis
C Low blood pressure crysis
D Hypertensive crysis
E Epileptic attack
5
A girl of 18 years got illnes sharply: there is a cold, cough, stomach-aches, temperature of 38,5С.
To the third day the catarrhal phenomena diminished, temperature of 36,6С. On a fourth day of
illnesses are a weakness in a right foot. Objectively: active motions absent in a leg, passive –
sickly. The muscles of thigh are languid, sickliness on motion nervous barrels. Knee and axilles
reflex on a right foot not caused, the symptom of “triangle” is positive. In blood leuc. - 4,2*109.,
SFE – 6 mm/min. Credible diagnosis?
A *Poliomyelitis, spinal form
B Poliomyelitis, pontine form
C Sausage-poisoning
D Encephalomielit
E Tick encephalitis
6
The attacks of twitches of right foot, which spread on all of leg and lasted during a few minutes,
appeared for a patient. Not lost consciousness. At examination: paresis of right foot after an
attack, deep reflexes on a right foot are promoted, symptom of Babinskogo on the right. Specify
the type of attack:
A *Jeckson’s epilepsy
B Kozhevnikovskiy epilepsy
C Miokloniya
D Genaral tonico-clonic attack
E Absans
7
A man of 35 years worked 13 years a bulldozerman. Grumbles about dizziness, head pain at the
end of working day, numbness of fingers and pain in the muscles of feet at night.
At
an
inspection violations of pain and tactil sensitiveness are exposed on a peripheral type, sickliness
of sural muscles, pulsation on and dorsalis pedis is stored. What disease most probably?
A *Vibration illness
B Illness of Reyno
C Siringomieliya
D Vegetative (ANS) polyneuripathy
E Obliterating atherosclerosis
8
The patient of 22 years grumbles about sudden palenaess of finger-tips, developing at cooling.
At warming fingers acquire at first cyanosis, and then purple colouring. Preparation of choice for
treatment of this syndrome is:
A *Nifedipin
B Dipiridamol
C No-shpa
D Aspirin
E Nitrates
9
A man is neat in the street in the unconscious state and delivered in hospital. With small intervals
he have the repeated attacks of tonic and clonic cramps of hands and feet. Consciousness is lost,
pupils are wide, irresponsive on light. In language are biting tracks. There was involuntary
urination. Signs of hearth defeat of cerebrum it is not exposed. AP - 140/ 90 мм Hg. The head of
patient can be freely resulted to the breast. you will define the most credible pathology.
A Epilepsy, epileptic status
B Brain hemorrhage
C Ishemic stroke
D Stupor
E Sharp meningoencephalitis
10
7- years schoolboy during lessons to on once or twice became inattentive, began to smack lips.
During short "absence" he did not respond to the name. Falling and cramps at this time were not
observed. A mother noticed such phenomena and before, but did not attach a significance them,
considering that a child was thoughtful. What most reliable diagnosis ?
A Absans
B Generalized myoclonick attack
C Adversive attack
D Complex partial attack
E Dzhekson’s partial attack
11
At a 25-years-old woman the attack of the following character developed on a background the
signs of vegetative dystonia: pains appeared in area of heart, feeling of difficulty in breathing,
nausea, dizziness, redness of person, the loss of consciousness, lasting about minute, came after.
ABP is 80/60 мм of Hg. Frequency of pulse - 56 /min. Vagoinsulyar crysis is diagnosed,
syncopes. What Is basic direction of therapy?
A Simpatomimetic preparations
B Simpatolytic preparations
C Kholinomimetic preparations
D Vasjactive
E Degidrative
12
In patient of 17 years a disease arose up very sharply and developed stormily: chill, increase of
temperature to 40,0 With, intensive poured out head pain, vomiting, the loss of consciousness
came afterwards . Objectively: menigeal signs. SCF (liquor) turbid. Cells - 4600 /mm3., an
albumin is 1680 mgs/l, sugar - 2,5 mml/l, chlorides -100 mml/l, neutrophils - 98 %, lymfocytes 2 %. What Is the most credible diagnosis?
A Meningococcal meningitis
B Tubercular meningitis
C Limphocyte choriomeningitis
D Enterovirus meningitis
E Parotitis meningitis
13
A girl of 17 years got electro-trauma. After conducting of reanimation there was hospitalized.
Which from the followings complications, dangerous for life, possible through a few clock or
days after it:
A Fibrillation of ventricles
B Stop of breathing
C pulmonary edema
D Comatose state
E Violation of neuro-muscular conductivity
14
The woman of 45-th years complains on sudden unbearable pain in the left half of face by
duration 1-2 minutes. Attacks are provoked mastication. Start of illness two months back after
supercooling. Objectively: pain in points the output of trigeminal nerve on the left. A touch near
the wing of nose on the left causes a next attack with the tonic cramp of muscles of face. What
from this diagnoses is most reliable?
A Tic douloureux
B Neuralgia of n.glosssofarineus
C Arthritis of low jaw joint
D Facial migraine
E Antritis
15
The man of 38-th years entered hospital in the unconscious state. Start of problem was yesterday:
head pain, nausea, vomiting, appeared T 38,5 C, there was disorientation, delirium, . During the
last 4 days grumbled about pain and decline of ear on a left ear. Objectively: state of sopor,
rigidity of cervical muscles, symptom of Kernig’s on either side, general hyperaesthesia,
suppuration from a left ear. What is from this diagnoses most reliable?
A Second festering meningitis
B Primary festering meningitis
C Tubercular meningitis
D Subarachnoidite hemorrhage
E Brain hemorrhage
16
At a woman 46 years old through one day after the beginning of flu head pain increased,
appeared disorientation, nausea. Objectively: consciousness is stored, psychomotorical
excitation; general hyperaesthesia, midle meningale syndrome. Nistagm. Tendon reflexes on the
right is higher, force of muscles is reduced in right extremities, on the right side is pathological
reflexes of Babinskiy. CCF: transparent, pressure 220 мм. item, cytosis - 46,3, mainly
lymphocytis. What from diagnoses is most reliable ?
A Influenzal meningoencephalitis
B Bacterial meningoencephalitis
C Subarachnoidal hemorrhage
D Brain hemorrhage
E Ischemic stroke
17
Girl of 15-th years during a day once or twice suddenly hardens on 5-15 sec, erecting a look
upwards, irresponsive on an address to it. After an attack does not realize that happened with it.
For the last year for a girl memory was worsened, success went down at school. On EEG
convulsive activity is registered by frequency of 3/sec. What diagnosis is most reliable?
A Absanse
B Adversive attacks
C Sinkope
D Neuroticlike state
E Transitory ischemic attack
18
The man of 74 years complains of periodic disorientation, violation of speech, loss of memory
on current events, slow gait. It is ill about 5 years. Objectively: speech with dysarthria, mimic is
poore, hunched carriage. Tendon reflexes is S>D, symptom Babinskogo from 2th sides,
symptoms of oral automatism, muscular tone is promoted on a plastic type. In a pose Romberg’s
is unsteady, nistagm is horizontal. What diagnosis is most reliable ?
A Dyscirculatory encephalophaty
B Illness of Parkinson’s
C Meningoencephalitis
D Encephalomielitis
E -19
A man is 57 years old delivered in a neurological department with complaints on the weakness
of left arm, feet, head pain, prolapsus of right age, doubling. Problem start gradually during some
the times after nervous overloads. Objectively: stunning, speech is stored, going away cross-eye
of left eye, ptosis of right eyelid, diplopia. Force of muscles in left extremities is reduced.
Tendon reflexes on the left higher. What from the transferred diagnoses is most reliable ?
A Ischemic stroke
B Brain hemorrhage
C Meningoencephalitis
D Miasteniya
E Sausage-poisoning
20
Male 34 years was delivered to the neurological department with complaints of severe headache,
double vision when looking straight, intolerance of light, noise. Fell ill with acute attack
developed in weightlifting. OBJECTIVE: stunning, mild exotropia (divergent strabismus),
double vision. Kernig's symptom on both sides. No paresis. Liquor bloody. Which drug should
appoint the first place?
A Epsilon-aminocaproic acid
B Acetyl-salicylic acid
C Heparin
D nicotinic acid
E glutamic acid
21
Male 25 years old, who is sick for 4 years with multiple sclerosis, complaining about increased
unsteadiness, weakness of lower extremities, urine retention. OBJECTIVE: Central
tetraparesis. Cerebellar ataxia, dysfunction of pelvic organs. What is the most useful therapy in
this case?
A Glucocorticoid
B Antibiotics
C Nootropics
D desensitization
E Vitamins
22
In 70-year-old man during moderate headache for two days appeared and intensified speech
disturbances, weakness in the right extremities. In the history of: myocardial infarction,
arrhythmia suffers. In the neurological status: elements of motor aphasia, central paresis of the
VII and XII of pairs of cranial nerves on the right, on the same side of hemiparesis on the central
type and gemigiperesteziya. What is the most likely diagnosis?
A Ischemic stroke
B Hemorrhagic stroke
C transient ischemic attack
D Epidural hematoma
E brain tumor
23
The patient aged 39, suffering from hypertension suddenly developed severe headache in the
neck, nausea, repeated vomiting. Condition lasts five hours. OBJECTIVE: Ps-88/min., AD205/100 mmHg, occipital pain points, stiff neck. Symptom Kernig positive on both sides. There
is a suspicion of subarachnoid hemorrhage. Which of the following methods of examination is
crucial to confirm the preliminary diagnosis?
A lumbar puncture
B Examination of fundus
C Ultrasonic Doppler
D EEG
E CT
24
Polisher Combine Works 50 years turned to the shop physicians with complaints of general
weakness, numbness phalanges and severe pain in them. OBJECTIVE: pale skin fingers. In the
study of pain, tactile, and temperature sensitivity revealed minor violations. From other organs
and systems are no deviations. What disease is most likely?
A Vibration disease
B polyneuritis
C Raynaud's disease
D Syringomyelia
E Deforming arthrosis
25
The patient D., 48 years on the second day after surgery for perforated ulcers night developed
right-sided central hemiparesis, gemigipesteziya and speech disorders.What paraclinical methods
of examination can verify the diagnosis?
A CT
B Contrast angiography
C Ultrasonic Doppler
D Survey of coagulating properties of blood
E Ehoentsefaloskopiya
26
Patient S., aged 25, fell ill with acute: in the morning appeared, severe headache, vomiting,
reusable, body temperature rose to 39.9 C. Took fever, but condition worsened. Evening and lost
consciousness. OBJECTIVE: pronounced muscular rigidity neck, Kernig sign. Leukocytosis
blood -18,0 X10 * 9 / liter. What is the most likely diagnosis in the patient?
A Bacterial meningitis
B Typhus, typhoid mill
C Viral meningoencephalitis
D sepsis, an infectious-toxic shock
E Influenza, gipertoksicheskaya form
27
After lifting the weight 38 year old Steve suddenly felt an unbearable headache, tinnitus, he
began to vomit. There was a convulsive fit with involuntary urination. OBJECTIVE: the patient
disoriented, complained of pain in the neck, back, photophobia. Total hyperesthesia,
psychomotor agitation. Paresis of course not. Muscular rigidity neck.Ptosis and divergent
strabismus, anisocoria. Pulse - 52/min. AD-180/110 mmHg At the fundus of the eye: dilated
veins, tortuous, optic disk was edematous. Liquor on day 5 of illness: xanthosis, cells 372 / 3,
protein - 4,2%. What is the most likely diagnosis?
A Subarachnoid hemorrhage
B Acute meningitis
C Acute meningoencephalitis
D Intracerebral Hemorrhage
E Subdural hematoma
28
Female 52 years complains of bias to the right person. Pain in 2 days ago after hypothermia. The
temperature rose to 38.2 C. OBJECTIVE: marked facial asymmetry.Left frontal folds
smoothed. The left palpebral fissure wider than the right and not closed.Flattened left nasolabial
fold. Omitted corner of his mouth. Another pathology was not detected. In the blood: Leuk .10,0 x10 * 9 / L, ESR - 20 mm / hour. What is the most likely diagnosis?
A * Neuritis of the facial nerve
B prosoponeuralgia
C Gemikraniya (migraine)
D Ischemic stroke
E brain tumor
29
The patient was 43 years complains of recurrent bouts of pain in the right half of the face. During
the attack marked spasm of mimic muscles of the right half face, the skin on that side of his face
redden. Analysis of blood without pathology. Was diagnosed with trigeminal neuralgia on the
right. Which drug is most expedient to appoint?
A * Finlepsin
B Prednisolone
C Actovegin
D Analgin
E Indomethacin
30
Woman 62 years after the lifting felt a sharp pain in the lumbar region, buttocks, posterior-lateral
surface of the right thigh, the outer surface of the right lower leg and dorsum of the
foot. Objective: weak tibialis anterior muscle, long extensor muscle of thumb, short extensor
muscle of fingers of the right foot. Reduced ankle reflex on the right. Positive symptom
Lassega. What is the most informative research methods for the diagnosis of discogenic
compression of L5 root?:
A * Magnetic Resonance Imaging
B X-ray of the spine
C Electromyography
D Angiography
E Lumbar puncture
31
Asked the man to the hospital with complaints that after lifting heavy weight felt a sharp
pain. From anamnesis it was reported that more than 10 years the patient suffers from chronic
sciatica. What additional LIMITED survey method must be kidding?
A CT scan of the lumbar spine
B X-ray of the pelvic bones
C Lumbar puncture
D Elektromiografiya
E Ultrasound kidney
32
Patient 25 years old, who is being treated in hospita,lsuddenly developed an attack, which was
accompanied by impaired consciousness, spasms of limbs, biting tongue, foam from his
mouth. Diazepam was introduced intravenously, but the attack does not cropped. After 15
minutes of the re-introduction of the drug also proved to be ineffective. What is the state of
emergency has developed in a patient?
A status epilepticus
B epileptic seizure
C epileptic reaction
D vegetative crises
E syncopal attack
33
Patient 28 years transported to the hospital in an unconscious state, with repeated 15-20 min
generalized seizures. During transport the patient was administered twice sibazon, sulphate of
magnesia, but the level of consciousness is not restored. Which department should provide
emergency care?
A Intensive care unit
B Neurology department
C Surgery department
D Therapeutic department
E Psychiatric Unit
34
Man 45 years old, longshoreman, complains of back pain and right leg. These symptoms persist
2 months and after a course of conservative therapy has not diminished. OBJECTIVE: motion in
the lumbar spine is limited, symptom Lasegue positive right. Knee-jerk D = S, alive. Achilles:
S> D, right sharply reduced. What a survey should be executed for the patient the diagnosis?
A * Magnetic Resonance Imaging
B X-ray of the spine
C Electromyography feet
D Reovasography feet
E-
35
Patient 37 years old hospitalized in the intensive care unit due to the repeated every half hour
tonic-clonic seizures. Patient between seizures in mind did not come. BP- 120/90 mm. Hg, PS100/min.Yesterday evening he was at a wedding, drinking alcohol. 5 years ago suffered a closed
head injury, brain contusion, and then appeared single seizures with loss of consciousness, but
the patient did not take anti-epileptic medication. Which drug should first be introduced for first
aid?
A * Diazepam
B Magnesium sulfate
C Oxybutyrate sodium
D Aminazin
E Thiopental sodium
36
In patient S., aged 35, during an ultrasound examination of carotid and vertebral arteries arose
dizziness, weakness, nausea, difficulty breathing and lost consciousness for 20
seconds. OBJECTIVE: skin is pale, BP - 90/60 mm Hg, HR - 96 beats / min. Reduced reaction
to light. Focal neurological symptoms are observed. EEG and echoencephalogram pathological
changes were observed. Your preliminary diagnosis?
A * syncope
B epileptic seizure
C Minor ischemic stroke
D Transient ischemic attack
E Vagoinsulyarny crisis
37
Patient D., aged 23, at the doctor suddenly stopped and froze for several seconds, eyes glazed,
simultaneously raising both hands, sobbing, muscles of the body is tensed, then relaxed for 3
min. And then, after incontinent he fell asleep for 20 minutes.Patient developed amnesia on this
attack. What is needed to conduct a survey after the attack?
A Electroencephalography
B Rheoencephalography
C MRI
D X-ray of the skull bones
E Axial CT
38
The patient was 52-years, the secretary-typist, worked for 30 years. Complains of cramps in the
right hand at work, the impossibility of printing and writing. The load on the hand - up to 80% of
the working time.The patient is sick for 2 years. Objective data: the right hand tight, muscle tone
is increased, while trying to write there are seizures. In a study of pathological manifestations of
the CNS was not found. Your preliminary diagnosis.
A * convulsive form of coordination neurosis
B neuralgic form of coordination neurosis
C paretic form of coordination neurosis
D hysterical neurosis
E chronic manganese intoxication
39
The patient 52 years with common spinal osteochondrosis, after heavy lifting, there was
backache, and pain along the left sciatic nerve. Objective: to the left positive symptom Lassega
and reduced ankle reflex. Which drug belongs to the pathogenetic therapy?
A Diclofenac
B Aspirin
C Analgin
D Novocaine
E Spazmalgon
40
A woman 35 years there was an attack, during which appeared heartbeat, chills, fear of
death. Revealed pale skin, increased blood pressure. Attack ended with the release of large
amounts of urine. What kind of character attack should be considered?
A * sympathoadrenal crisis (panic attacks)
B vago insular crisis
C hypotonic crisis
D hyperglycemic coma
E epileptic seizure
41
Patient had resection of the stomach. During the operation, the left upper extremity patient was
assigned and fixed to the operating table for anesthetic management.Postoperatively, the patient
developed a dysfunction of the upper extremity in the form of "hanging" brush. Violation of any
anatomical structure led to the emergence of this symptom?
A radial nerve
B axillary nerve
C ulnar nerve
D median nerve
E Muscle-cutaneous nerve
42
In travpunkt asked the patient to the trauma glass bottom third of the forearm. OBJECTIVE:
broken flexion IV and V fingers, reduced sensitivity of the inner surface of the back and palm of
the hand and finger IV. What nerve is injured?
A * ulnar
B radial
C Median
D Muscle-cutaneous
E axillary
43
The patient 38 years after the lifting came a pain in the lumbar spine with radiation to the back of
his left leg. The pain increases when the position of the body and in an upright position. The
examination revealed the positive symptoms of tension. What preliminary diagnosis can be made
to the patient?
A * Pathology of the intervertebral discs
B Spinal cord tumor
C arahnomielit
D polyneuritis
E myelopathy
44
On the second day after birth (large fetus), the doctor noted that the
infant does not produce active abduction, rotation and flexion of the shoulder joint.Range of
motion in the elbow is limited, and in the radiocarpal joint and joints of fingers
saved. Diagnosis?
A * Upper brachial plexus palsy.
B Lower brachial plexus palsy.
C fracture of the clavicle.
D fracture of the humerus.
E Congenital contracture of the shoulder joint.
45
To the hospital a patient appealed with complaints about violation pain and haptic
to the sensitiveness, pain in the eventual phalanxes of fingers, that arises up after work. On an
enterprise he works with mechanical devices. What pathology is necessary to be suspected?
A * Oscillation illness
B Decompression sickness
C Murmur illness
D Signs of overstrain
E Hypovitaminosis of vitamin of B_1
46
Analysing the results of periodic physical examination workers-polish of artistic glass was
educed, that at 40% workers with the protracted experience in age 30-45 years neuritis of ulnar
is set nerve, at 21% is vegetative-sensible полиневрит, at 12% - Vegetomiofascitis overhead
extremities. Workers polish wares by means of revolved abrasive disk. To the action of what
unfavorable factor data are related pathologies?
A Vibration
B the Unfavorable microclimate
C Dust
D Murmur
E Electromagnetic leakage field
47
A driver repaired a machine in the closed garage, whereupon appealed with
by complaints about a headache, dizziness, nausea, muscular weakness,
somnolence., at examination, making more frequent of pulse, breathings, excitation is marked,
hypertension, craze of pursuit. Most credible diagnosis
A *Intoxication by the oxide of carbon
B Intoxication by the ethylated petrol
C Posttraumatic encephalopathy
D the Hypertension stroke
E Astheeia-vegetative syndrome
48
At the machine-building plant, stripping of founding is conducted with a help
fitting machines which are the source of local vibration. What most effective prophylactic
measures for warning of her harmful influence on the organism of working?
A *the use of gloves which extinguish a vibration
B of realization of previous and periodic physical examinations
C massage of racemes of hands
D acceptance of warm baths for hands
E realization of sanitary-educational work among workers
49
On physical examination the machinist of port faucet produced complaints on
dizziness, nausea, feeling of pressure on ear-drums, chills tremor, motion in area of bowels,
difficulty in breathing, cough. Works executed on height of, related to nervously-emotional
tension. On workers operate vibration: general and local, murmur, infra-sound, steamdisengaging in summer cooling the winter microclimate. With the action of what factor you do
you link the complaints of worker?
A *Vibration
B Murmur
C Infra-sound
D Tension of labour
E of Work on height of
50
Workers of laboratory on making of measuring devices (manometers,
thermometers and others like that) grumble about metallic taste in to the mouth, stomatitis,
dyspepsia phenomena, parahypnosis, shaky gait, fall-off of cardiac activity. Specify reason of
origin of this poisoning.
A * Mercury.
B Lead.
C Manganese.
D Toluene.
E Tetraethyllead.
51
A 52 y.o. man has recurrent transient ischemic attacks. Auscultation of the carotid arteries
detects murmur. What diagnostic method is necessary to apply first?
A. Ultrasound dopplerography
B. Cerebral angiography
C. MRI of the brain
D. Electroencephalography
E. CT of the brain
52
A patient, aged 16, complains of headache, mainly in the frontal and temporal areas,
superciliary arch, appearing of vomiting at the peak of headache, pain during the eyeballs
movement, joint's pain. On examination: excited, t0- 390С, Ps- 110/min. Tonic and clonus
cramps. Uncertain meningeal signs. What is the most likely diagnosis?
A. Influenza with cerebral edema manifestations
B. Adenovirus infection
C. Respiratory syncytial virus
D. Influenza, typical disease duration
E. Parainfluenza
53.
A full-term new-born suffered ante- and intranatal hypoxia, was born in asphyxia (Apgar score
2-5 points). After birth baby's excitation is progressing, occurs vomiting, nystagmus, spasms,
squint, spontaneous Babinski and Moro's reflexes. What is the most probable location of the
intracranial haemorrhage in this case?
A. Subarachnoid hemorrhages
B. Haemorrhages in ventricles of brain
C. Subdural hemorrhages
D. Small hemorrhages in brain tissue
E. Periventricular hemorrhages
54.
Male 30 y.o., noted growing fingers and facial scull, changed face. Complains of poor
eyesight, weakness, skin darkening, loss of body weight. X-ray shows broadening of sella
turcica, thinning of tuberculin sphenoidale, signs of increased intracranial pressure. What
diagnosis can you make?
A. Adenoma of hypophysis
B. Tumor of pondo-cerebellar corner
C. Adrenal gland tumor
D. Encephalitis of truncus
E. Optico - hiasmatic arachnoiditis
55.
A newborn aged 3 days with hyperbilirubinemia (428 mkmol/L) developed following disorders.
From beginning there were severe jaundice with poor suckling, hypotomia and hypodynamia.
Little bit later periodical excitation, neonatal convulsions and neonatal primitive reflexes loss
are noted. Now physical examination reveals convergent squint, rotatory nystagmus and setting
sun eye sign. How to explain this condition?
A. Encephalopathy due to hyperbilirubinemia
B. Spastic cerebral palsy
C. Hydrocephalus
D. Skull injury
E. Brain tumour
56.
During intramuscular DTP vaccination in clinic, a 3 m.o. child developed signs of
laryngospasm, paleness of skin, cyanosis of lips, "cock cry", stop of respiration, tension of the
whole body with overturned backward head. Allergological history of the child is not
complicated. What is the most probable diagnosis?
A. Spasmophilia, tonic spasms
B. Meningoencephalitic reaction, clonic and tonic spasms
C. Meningism, clonic and tonic spasms
D. Cerebral haemorrhage, tonic spasms
E. Anaphylactic shock, clonic spasms
57.
A 65 y.o. woman complains of complicated mouth opening following foot trauma 10 days ago.
Next day she ate with difficulties, there were muscles tension of back, the back of the head and
abdomen. On the third day there was tension of all muscle groups, generalized convulsions
every 10-15 min. What is the most probable diagnosis?
A. Tetanus
B. Tetania
C. Meningoencephalitis
D. Hemorrhagic stroke
E. Epilepsy
58.
Ambulance was called to a 48 y.o. man. From the words of relatives he has had three episodes
of lost consciousness and attacks during the day. On examination: the following fit is observed:
patient is unconscious, fell on the floor, tonic and then clonic convuesions of trunk and
extremities happened. The attack lasted for 4 minute, ended by involuntary urination. What type
of attack was observed?
A. Major epileptic seizure
B. Fainting
C. Absence
D. Vegetatic crisis
E. Episode of hysteria
59
On the 5-th day of the respiratory disease a 24 y.o. man has developed progressive headaches
systemic dizziness, feeling of seeing double, paresis of mimic muscles on the right, choking
while swallowing. Acute viral encephalitis has been diagnosed. What is the main direction of
urgent therapy?
A. Zovirax
B. Glucocorticoids
C. Hemodesis
D. Lasix
E. Ceftriaxon
60
A 14 y.o. child suffers from of vegetovascular dystonia of pubertal period. He has developed
sympathoadrenal crisis. What medicine should be used for crisis reduction?
A. Obsidan
B. Euphyline
C. Corglicone
D. Amisyl
E. No-shpa
61
A 70 y.o. male patient with mild headaches complains of speech disorder, weakness in right
limbs. There was a history of miocardial infarction and arrhythmia. On nu eroligical
examination there are elements of motor aphasia, central paresis of VII and XII cranial nerves
pairs on the right side, cental type of hemiparesis and hemihyperesthisia on the same side. What
is the most probable diagnosis?
A. Ischemic stroke
B. Hemorrhagic stroke
C. Cerebral tumor
D. Epidural hematoma
E. Transitory ischemic attack
62
A 60 y.o. patient complains of having passing reduction of strength in his left extremities for a
month. Some time later he has got persistent weakness of extremities in the mornings.
Objectively: AP- 140/90 mm Hg, conscious, central paresis of the VII and XII pair of left-side
cranial nerves, central hemiparesis and hemihyperesthesia also on the left side. What medicines
should be chosen for the differentiated treatment of the patient?
A. Anticoagulants
B. Diuretics
C. Hypotensive
D. Corticosteroids
E. Hemostatics
63
The disease of a 21 y.o. patient began with raise of temperature up to 39,00С, headache, chill,
repeated vomiting. Rigidity of occipital muscles is determined. The analysis of liquor revealed:
cytosis - 1237 in 1 ml, including: 84% of neutrophils, 16% of lymphocytes. On bacterioscopy:
gram-negative cocci are found in liquor. What is the most probable disease?
A. Meningococcal infection: purulent meningitis
B. Meningococcal infection: serous meningitis
C. Serous meningitis
D. Secondary purulent meningitis
E. Infectious mononucleosis
64
A 54 y.o. man was admitted to the hospital with complaints of sudden intense headache in
occipital region and vomiting. In the medical hystory: moderate arterial hypertension, the patient
was taking hydrochlorothiazide. Three days ago he consulted a therapeutist about intense
headache that was suppressed by an analgetic. Objectively: consciousness is confused, left pupil
is mydriatic. Evident photophobia and tension of neck muscles. Left-side hemiparesis with
increased muscle tonus and reflexes. Body temperature is low, rash is absent. AP- 230/130 mm
Hg, Ps- 50 bpm, BR- 12/min. What is your preliminary diagnosis?
A. Acute subdural hematoma
B. Migraine
C. Acute bacterial meningitis
D. Myasthenia
E. Disseminated sclerosis
65
A 47 y.o. woman complains of having paroxysmal headaches for the last 5 years. The pain is
one-sided, intense, localised in frontal region of head, accompanied by nausea and stomach
discomfort, begins one of a sudden. Onset is usually preceded by vision reduction. Anamnesis
gives evidence of periodical AP rise, but at the moment the woman doesn't take any medicines.
Inbetween the onsets of headache her state is satisfactory. Objectively: high-calorie diet (body
weight index - 29), AP- 170/95 mm Hg. Neurologic state has no pecularities. What is the most
probable diagnosis?
A. Migraine
B. Hypertensive encephalopathy
C. Epilepsy
D. Chronic subdural hematoma
E. Benign intracranial hypertension
66
A 38 y.o. patient lifted a heavy object that resulted in pain in the lumbar part of spine irradiating
to the posterior surface of his left leg. The pain increases during changing body position and also
in the upright position. Examination revealed positive symptoms of tension. What is the
preliminary diagnosis?
A. Pathology of intercostals disks
B. Polyneuritis
C. Myelopathy
D. Spinal cord tumor
E. Arachnomyelitis
67
A 75 y.o. woman with coronary heart disease constantly takes warfarin. She was taken to the
acute care department with complaints of sudden sensation of weakness in the left half of her
body and eyeball deviation to the left. What examination of the patient will be a primary task?
A. Computer tomography of brain
B. Ultrasonic examination of carotid arteries
C. Magnetic resonance tomography of brain
D. Electroencephalogram
E. Spinal punction
68
A 43 y.o. patient complains of periodical pain attacks in the right half of her face. The attack is
characterized by spasm of mimetic muscles of the right face's half, reddening of skin on this side.
Blood has no pathologies. She was diagnosed with right-sided trifacial neuralgia. What
medication should be prescribed?
A. Finlepsin
B. Actovegine
C. Indometacin
D. Prednisolone
E. Analgine
69
A 7 y.o. girl has mild form of varicella. Headache, weakness, vertigo, tremor of her limbs,
ataxia, then mental confusion appeared on the 5th day of illness. Meningeal signs are negative.
Cerebrospinal fluid examination is normal. How can you explain these signs?
A. Encephalitis
B. Meningoencephalitis
C. Myelitis
D. Meningitis
E. Neurotoxic syndrome
70
Male 25 years old, who is sick for 4 years with multiple sclerosis, complaining about increased
unsteadiness, weakness of lower extremities, urine retention. OBJECTIVE: Central
tetraparesis. Cerebellar ataxia, dysfunction of pelvic organs. What is the most useful therapy in
this case?
A.Glucocorticoid
B.Antibiotics
C.Nootropics
D.desensitization
E.Vitamins
1
Woman of 60-th years, about 15-th years suffers by arterial hypertention After the repeated
stroke grumbles about the amotivational decline of mood, weight of concentration of attention,
forgets to close entrance doors, does not remember the event of past day. On CT - areas of
poststrokes changes are in crust postfrontal areas. What diagnosis is most reliable at patient?
A *Cererbrovascular dementia
B Illness of Al'cgeymer’s
C Illness of Gentington’s
D Peak illness
E Dissociativ amnesia
2
Patient of 68-th years, office worker. There are about two years disorders of memory had began :
patient is helpless in work and way of life, did not get along at official duties. Gradually began
to forget the names of relatives, names of objects, became helpless, speech was violated. Lost
skills of letter, reading, care of itself. At CT research: atrophy of cortex of large hemispheres of
brain. What diagnosis is most reliable ?
A *Illness Al'cgeymer’s
B Peak illness
C Atherosclerotic dementia
D Senil'naya dementia
E Progressive paralysis
3
Patient of 31 years, economist, from youth age suffers epilepsy with large convulsive attacks,
constantly accepted anticonvulsive treatment. Entered in hospital with the considerable
becoming more frequent of attacks. In a separation there are serial attacks between which a
patient does not come in consciousness. What measures is it most expedient to use?
A *Inta venois infusion of cybazon’s.
B Parenteral'noe introduction of aminazin.
C To increase doses of medicine usually used by patients.
D Introduction of camphorae.
E Elektro - shocking therapy.
4
A woman of 56 years on a background a climax have attacks which are characterized great head
pain, by the increase of arterial pressure to 180/ 100 мм of Hg, tachycardia, the shortness of
breath, general shaking. Duration of attack 30-40 min. An attack ends with urination. What type
of crysis is it more possible?
A * Simpato-adrenalin’s crysis
B Vago-insulin’s crysis
C Low blood pressure crysis
D Hypertensive crysis
E Epileptic attack
5
A girl of 18 years got illnes sharply: there is a cold, cough, stomach-aches, temperature of 38,5С.
To the third day the catarrhal phenomena diminished, temperature of 36,6С. On a fourth day of
illnesses are a weakness in a right foot. Objectively: active motions absent in a leg, passive –
sickly. The muscles of thigh are languid, sickliness on motion nervous barrels. Knee and axilles
reflex on a right foot not caused, the symptom of “triangle” is positive. In blood leuc. - 4,2*109.,
SFE – 6 mm/min. Credible diagnosis?
A *Poliomyelitis, spinal form
B Poliomyelitis, pontine form
C Sausage-poisoning
D Encephalomielit
E Tick encephalitis
6
The attacks of twitches of right foot, which spread on all of leg and lasted during a few minutes,
appeared for a patient. Not lost consciousness. At examination: paresis of right foot after an
attack, deep reflexes on a right foot are promoted, symptom of Babinskogo on the right. Specify
the type of attack:
A *Jeckson’s epilepsy
B Kozhevnikovskiy epilepsy
C Miokloniya
D Genaral tonico-clonic attack
E Absans
7
A man of 35 years worked 13 years a bulldozerman. Grumbles about dizziness, head pain at the
end of working day, numbness of fingers and pain in the muscles of feet at night.
At
an
inspection violations of pain and tactil sensitiveness are exposed on a peripheral type, sickliness
of sural muscles, pulsation on and dorsalis pedis is stored. What disease most probably?
A *Vibration illness
B Illness of Reyno
C Siringomieliya
D Vegetative (ANS) polyneuripathy
E Obliterating atherosclerosis
8
The patient of 22 years grumbles about sudden palenaess of finger-tips, developing at cooling.
At warming fingers acquire at first cyanosis, and then purple colouring. Preparation of choice for
treatment of this syndrome is:
A *Nifedipin
B Dipiridamol
C No-shpa
D Aspirin
E Nitrates
9
A man is neat in the street in the unconscious state and delivered in hospital. With small intervals
he have the repeated attacks of tonic and clonic cramps of hands and feet. Consciousness is lost,
pupils are wide, irresponsive on light. In language are biting tracks. There was involuntary
urination. Signs of hearth defeat of cerebrum it is not exposed. AP - 140/ 90 мм Hg. The head of
patient can be freely resulted to the breast. you will define the most credible pathology.
A Epilepsy, epileptic status
B Brain hemorrhage
C Ishemic stroke
D Stupor
E Sharp meningoencephalitis
10
7- years schoolboy during lessons to on once or twice became inattentive, began to smack lips.
During short "absence" he did not respond to the name. Falling and cramps at this time were not
observed. A mother noticed such phenomena and before, but did not attach a significance them,
considering that a child was thoughtful. What most reliable diagnosis ?
A Absans
B Generalized myoclonick attack
C Adversive attack
D Complex partial attack
E Dzhekson’s partial attack
11
At a 25-years-old woman the attack of the following character developed on a background the
signs of vegetative dystonia: pains appeared in area of heart, feeling of difficulty in breathing,
nausea, dizziness, redness of person, the loss of consciousness, lasting about minute, came after.
ABP is 80/60 мм of Hg. Frequency of pulse - 56 /min. Vagoinsulyar crysis is diagnosed,
syncopes. What Is basic direction of therapy?
A Simpatomimetic preparations
B Simpatolytic preparations
C Kholinomimetic preparations
D Vasjactive
E Degidrative
12
In patient of 17 years a disease arose up very sharply and developed stormily: chill, increase of
temperature to 40,0 With, intensive poured out head pain, vomiting, the loss of consciousness
came afterwards . Objectively: menigeal signs. SCF (liquor) turbid. Cells - 4600 /mm3., an
albumin is 1680 mgs/l, sugar - 2,5 mml/l, chlorides -100 mml/l, neutrophils - 98 %, lymfocytes 2 %. What Is the most credible diagnosis?
A Meningococcal meningitis
B Tubercular meningitis
C Limphocyte choriomeningitis
D Enterovirus meningitis
E Parotitis meningitis
13
A girl of 17 years got electro-trauma. After conducting of reanimation there was hospitalized.
Which from the followings complications, dangerous for life, possible through a few clock or
days after it:
A Fibrillation of ventricles
B Stop of breathing
C pulmonary edema
D Comatose state
E Violation of neuro-muscular conductivity
14
The woman of 45-th years complains on sudden unbearable pain in the left half of face by
duration 1-2 minutes. Attacks are provoked mastication. Start of illness two months back after
supercooling. Objectively: pain in points the output of trigeminal nerve on the left. A touch near
the wing of nose on the left causes a next attack with the tonic cramp of muscles of face. What
from this diagnoses is most reliable?
A Tic douloureux
B Neuralgia of n.glosssofarineus
C Arthritis of low jaw joint
D Facial migraine
E Antritis
15
The man of 38-th years entered hospital in the unconscious state. Start of problem was yesterday:
head pain, nausea, vomiting, appeared T 38,5 C, there was disorientation, delirium, . During the
last 4 days grumbled about pain and decline of ear on a left ear. Objectively: state of sopor,
rigidity of cervical muscles, symptom of Kernig’s on either side, general hyperaesthesia,
suppuration from a left ear. What is from this diagnoses most reliable?
A Second festering meningitis
B Primary festering meningitis
C Tubercular meningitis
D Subarachnoidite hemorrhage
E Brain hemorrhage
16
At a woman 46 years old through one day after the beginning of flu head pain increased,
appeared disorientation, nausea. Objectively: consciousness is stored, psychomotorical
excitation; general hyperaesthesia, midle meningale syndrome. Nistagm. Tendon reflexes on the
right is higher, force of muscles is reduced in right extremities, on the right side is pathological
reflexes of Babinskiy. CCF: transparent, pressure 220 мм. item, cytosis - 46,3, mainly
lymphocytis. What from diagnoses is most reliable ?
A Influenzal meningoencephalitis
B Bacterial meningoencephalitis
C Subarachnoidal hemorrhage
D Brain hemorrhage
E Ischemic stroke
17
Girl of 15-th years during a day once or twice suddenly hardens on 5-15 sec, erecting a look
upwards, irresponsive on an address to it. After an attack does not realize that happened with it.
For the last year for a girl memory was worsened, success went down at school. On EEG
convulsive activity is registered by frequency of 3/sec. What diagnosis is most reliable?
A Absanse
B Adversive attacks
C Sinkope
D Neuroticlike state
E Transitory ischemic attack
18
The man of 74 years complains of periodic disorientation, violation of speech, loss of memory
on current events, slow gait. It is ill about 5 years. Objectively: speech with dysarthria, mimic is
poore, hunched carriage. Tendon reflexes is S>D, symptom Babinskogo from 2th sides,
symptoms of oral automatism, muscular tone is promoted on a plastic type. In a pose Romberg’s
is unsteady, nistagm is horizontal. What diagnosis is most reliable ?
A Dyscirculatory encephalophaty
B Illness of Parkinson’s
C Meningoencephalitis
D Encephalomielitis
E -19
A man is 57 years old delivered in a neurological department with complaints on the weakness
of left arm, feet, head pain, prolapsus of right age, doubling. Problem start gradually during some
the times after nervous overloads. Objectively: stunning, speech is stored, going away cross-eye
of left eye, ptosis of right eyelid, diplopia. Force of muscles in left extremities is reduced.
Tendon reflexes on the left higher. What from the transferred diagnoses is most reliable ?
A Ischemic stroke
B Brain hemorrhage
C Meningoencephalitis
D Miasteniya
E Sausage-poisoning
20
Male 34 years was delivered to the neurological department with complaints of severe headache,
double vision when looking straight, intolerance of light, noise. Fell ill with acute attack
developed in weightlifting. OBJECTIVE: stunning, mild exotropia (divergent strabismus),
double vision. Kernig's symptom on both sides. No paresis. Liquor bloody. Which drug should
appoint the first place?
A Epsilon-aminocaproic acid
B Acetyl-salicylic acid
C Heparin
D nicotinic acid
E glutamic acid
21
Male 25 years old, who is sick for 4 years with multiple sclerosis, complaining about increased
unsteadiness, weakness of lower extremities, urine retention. OBJECTIVE: Central
tetraparesis. Cerebellar ataxia, dysfunction of pelvic organs. What is the most useful therapy in
this case?
A Glucocorticoid
B Antibiotics
C Nootropics
D desensitization
E Vitamins
22
In 70-year-old man during moderate headache for two days appeared and intensified speech
disturbances, weakness in the right extremities. In the history of: myocardial infarction,
arrhythmia suffers. In the neurological status: elements of motor aphasia, central paresis of the
VII and XII of pairs of cranial nerves on the right, on the same side of hemiparesis on the central
type and gemigiperesteziya. What is the most likely diagnosis?
A Ischemic stroke
B Hemorrhagic stroke
C transient ischemic attack
D Epidural hematoma
E brain tumor
23
The patient aged 39, suffering from hypertension suddenly developed severe headache in the
neck, nausea, repeated vomiting. Condition lasts five hours. OBJECTIVE: Ps-88/min., AD205/100 mmHg, occipital pain points, stiff neck. Symptom Kernig positive on both sides. There
is a suspicion of subarachnoid hemorrhage. Which of the following methods of examination is
crucial to confirm the preliminary diagnosis?
A lumbar puncture
B Examination of fundus
C Ultrasonic Doppler
D EEG
E CT
24
Polisher Combine Works 50 years turned to the shop physicians with complaints of general
weakness, numbness phalanges and severe pain in them. OBJECTIVE: pale skin fingers. In the
study of pain, tactile, and temperature sensitivity revealed minor violations. From other organs
and systems are no deviations. What disease is most likely?
A Vibration disease
B polyneuritis
C Raynaud's disease
D Syringomyelia
E Deforming arthrosis
25
The patient D., 48 years on the second day after surgery for perforated ulcers night developed
right-sided central hemiparesis, gemigipesteziya and speech disorders.What paraclinical methods
of examination can verify the diagnosis?
A CT
B Contrast angiography
C Ultrasonic Doppler
D Survey of coagulating properties of blood
E Ehoentsefaloskopiya
26
Patient S., aged 25, fell ill with acute: in the morning appeared, severe headache, vomiting,
reusable, body temperature rose to 39.9 C. Took fever, but condition worsened. Evening and lost
consciousness. OBJECTIVE: pronounced muscular rigidity neck, Kernig sign. Leukocytosis
blood -18,0 X10 * 9 / liter. What is the most likely diagnosis in the patient?
A Bacterial meningitis
B Typhus, typhoid mill
C Viral meningoencephalitis
D sepsis, an infectious-toxic shock
E Influenza, gipertoksicheskaya form
27
After lifting the weight 38 year old Steve suddenly felt an unbearable headache, tinnitus, he
began to vomit. There was a convulsive fit with involuntary urination. OBJECTIVE: the patient
disoriented, complained of pain in the neck, back, photophobia. Total hyperesthesia,
psychomotor agitation. Paresis of course not. Muscular rigidity neck.Ptosis and divergent
strabismus, anisocoria. Pulse - 52/min. AD-180/110 mmHg At the fundus of the eye: dilated
veins, tortuous, optic disk was edematous. Liquor on day 5 of illness: xanthosis, cells 372 / 3,
protein - 4,2%. What is the most likely diagnosis?
A Subarachnoid hemorrhage
B Acute meningitis
C Acute meningoencephalitis
D Intracerebral Hemorrhage
E Subdural hematoma
28
Female 52 years complains of bias to the right person. Pain in 2 days ago after hypothermia. The
temperature rose to 38.2 C. OBJECTIVE: marked facial asymmetry.Left frontal folds
smoothed. The left palpebral fissure wider than the right and not closed.Flattened left nasolabial
fold. Omitted corner of his mouth. Another pathology was not detected. In the blood: Leuk .10,0 x10 * 9 / L, ESR - 20 mm / hour. What is the most likely diagnosis?
A * Neuritis of the facial nerve
B prosoponeuralgia
C Gemikraniya (migraine)
D Ischemic stroke
E brain tumor
29
The patient was 43 years complains of recurrent bouts of pain in the right half of the face. During
the attack marked spasm of mimic muscles of the right half face, the skin on that side of his face
redden. Analysis of blood without pathology. Was diagnosed with trigeminal neuralgia on the
right. Which drug is most expedient to appoint?
A * Finlepsin
B Prednisolone
C Actovegin
D Analgin
E Indomethacin
30
Woman 62 years after the lifting felt a sharp pain in the lumbar region, buttocks, posterior-lateral
surface of the right thigh, the outer surface of the right lower leg and dorsum of the
foot. Objective: weak tibialis anterior muscle, long extensor muscle of thumb, short extensor
muscle of fingers of the right foot. Reduced ankle reflex on the right. Positive symptom
Lassega. What is the most informative research methods for the diagnosis of discogenic
compression of L5 root?:
A * Magnetic Resonance Imaging
B X-ray of the spine
C Electromyography
D Angiography
E Lumbar puncture
31
Asked the man to the hospital with complaints that after lifting heavy weight felt a sharp
pain. From anamnesis it was reported that more than 10 years the patient suffers from chronic
sciatica. What additional LIMITED survey method must be kidding?
A CT scan of the lumbar spine
B X-ray of the pelvic bones
C Lumbar puncture
D Elektromiografiya
E Ultrasound kidney
32
Patient 25 years old, who is being treated in hospita,lsuddenly developed an attack, which was
accompanied by impaired consciousness, spasms of limbs, biting tongue, foam from his
mouth. Diazepam was introduced intravenously, but the attack does not cropped. After 15
minutes of the re-introduction of the drug also proved to be ineffective. What is the state of
emergency has developed in a patient?
A status epilepticus
B epileptic seizure
C epileptic reaction
D vegetative crises
E syncopal attack
33
Patient 28 years transported to the hospital in an unconscious state, with repeated 15-20 min
generalized seizures. During transport the patient was administered twice sibazon, sulphate of
magnesia, but the level of consciousness is not restored. Which department should provide
emergency care?
A Intensive care unit
B Neurology department
C Surgery department
D Therapeutic department
E Psychiatric Unit
34
Man 45 years old, longshoreman, complains of back pain and right leg. These symptoms persist
2 months and after a course of conservative therapy has not diminished. OBJECTIVE: motion in
the lumbar spine is limited, symptom Lasegue positive right. Knee-jerk D = S, alive. Achilles:
S> D, right sharply reduced. What a survey should be executed for the patient the diagnosis?
A * Magnetic Resonance Imaging
B X-ray of the spine
C Electromyography feet
D Reovasography feet
E-
35
Patient 37 years old hospitalized in the intensive care unit due to the repeated every half hour
tonic-clonic seizures. Patient between seizures in mind did not come. BP- 120/90 mm. Hg, PS100/min.Yesterday evening he was at a wedding, drinking alcohol. 5 years ago suffered a closed
head injury, brain contusion, and then appeared single seizures with loss of consciousness, but
the patient did not take anti-epileptic medication. Which drug should first be introduced for first
aid?
A * Diazepam
B Magnesium sulfate
C Oxybutyrate sodium
D Aminazin
E Thiopental sodium
36
In patient S., aged 35, during an ultrasound examination of carotid and vertebral arteries arose
dizziness, weakness, nausea, difficulty breathing and lost consciousness for 20
seconds. OBJECTIVE: skin is pale, BP - 90/60 mm Hg, HR - 96 beats / min. Reduced reaction
to light. Focal neurological symptoms are observed. EEG and echoencephalogram pathological
changes were observed. Your preliminary diagnosis?
A * syncope
B epileptic seizure
C Minor ischemic stroke
D Transient ischemic attack
E Vagoinsulyarny crisis
37
Patient D., aged 23, at the doctor suddenly stopped and froze for several seconds, eyes glazed,
simultaneously raising both hands, sobbing, muscles of the body is tensed, then relaxed for 3
min. And then, after incontinent he fell asleep for 20 minutes.Patient developed amnesia on this
attack. What is needed to conduct a survey after the attack?
A Electroencephalography
B Rheoencephalography
C MRI
D X-ray of the skull bones
E Axial CT
38
The patient was 52-years, the secretary-typist, worked for 30 years. Complains of cramps in the
right hand at work, the impossibility of printing and writing. The load on the hand - up to 80% of
the working time.The patient is sick for 2 years. Objective data: the right hand tight, muscle tone
is increased, while trying to write there are seizures. In a study of pathological manifestations of
the CNS was not found. Your preliminary diagnosis.
A * convulsive form of coordination neurosis
B neuralgic form of coordination neurosis
C paretic form of coordination neurosis
D hysterical neurosis
E chronic manganese intoxication
39
The patient 52 years with common spinal osteochondrosis, after heavy lifting, there was
backache, and pain along the left sciatic nerve. Objective: to the left positive symptom Lassega
and reduced ankle reflex. Which drug belongs to the pathogenetic therapy?
A Diclofenac
B Aspirin
C Analgin
D Novocaine
E Spazmalgon
40
A woman 35 years there was an attack, during which appeared heartbeat, chills, fear of
death. Revealed pale skin, increased blood pressure. Attack ended with the release of large
amounts of urine. What kind of character attack should be considered?
A * sympathoadrenal crisis (panic attacks)
B vago insular crisis
C hypotonic crisis
D hyperglycemic coma
E epileptic seizure
41
Patient had resection of the stomach. During the operation, the left upper extremity patient was
assigned and fixed to the operating table for anesthetic management.Postoperatively, the patient
developed a dysfunction of the upper extremity in the form of "hanging" brush. Violation of any
anatomical structure led to the emergence of this symptom?
A radial nerve
B axillary nerve
C ulnar nerve
D median nerve
E Muscle-cutaneous nerve
42
In travpunkt asked the patient to the trauma glass bottom third of the forearm. OBJECTIVE:
broken flexion IV and V fingers, reduced sensitivity of the inner surface of the back and palm of
the hand and finger IV. What nerve is injured?
A * ulnar
B radial
C Median
D Muscle-cutaneous
E axillary
43
The patient 38 years after the lifting came a pain in the lumbar spine with radiation to the back of
his left leg. The pain increases when the position of the body and in an upright position. The
examination revealed the positive symptoms of tension. What preliminary diagnosis can be made
to the patient?
A * Pathology of the intervertebral discs
B Spinal cord tumor
C arahnomielit
D polyneuritis
E myelopathy
44
On the second day after birth (large fetus), the doctor noted that the
infant does not produce active abduction, rotation and flexion of the shoulder joint.Range of
motion in the elbow is limited, and in the radiocarpal joint and joints of fingers
saved. Diagnosis?
A * Upper brachial plexus palsy.
B Lower brachial plexus palsy.
C fracture of the clavicle.
D fracture of the humerus.
E Congenital contracture of the shoulder joint.
45
To the hospital a patient appealed with complaints about violation pain and haptic
to the sensitiveness, pain in the eventual phalanxes of fingers, that arises up after work. On an
enterprise he works with mechanical devices. What pathology is necessary to be suspected?
A * Oscillation illness
B Decompression sickness
C Murmur illness
D Signs of overstrain
E Hypovitaminosis of vitamin of B_1
46
Analysing the results of periodic physical examination workers-polish of artistic glass was
educed, that at 40% workers with the protracted experience in age 30-45 years neuritis of ulnar
is set nerve, at 21% is vegetative-sensible полиневрит, at 12% - Vegetomiofascitis overhead
extremities. Workers polish wares by means of revolved abrasive disk. To the action of what
unfavorable factor data are related pathologies?
A Vibration
B the Unfavorable microclimate
C Dust
D Murmur
E Electromagnetic leakage field
47
A driver repaired a machine in the closed garage, whereupon appealed with
by complaints about a headache, dizziness, nausea, muscular weakness,
somnolence., at examination, making more frequent of pulse, breathings, excitation is marked,
hypertension, craze of pursuit. Most credible diagnosis
A *Intoxication by the oxide of carbon
B Intoxication by the ethylated petrol
C Posttraumatic encephalopathy
D the Hypertension stroke
E Astheeia-vegetative syndrome
48
At the machine-building plant, stripping of founding is conducted with a help
fitting machines which are the source of local vibration. What most effective prophylactic
measures for warning of her harmful influence on the organism of working?
A *the use of gloves which extinguish a vibration
B of realization of previous and periodic physical examinations
C massage of racemes of hands
D acceptance of warm baths for hands
E realization of sanitary-educational work among workers
49
On physical examination the machinist of port faucet produced complaints on
dizziness, nausea, feeling of pressure on ear-drums, chills tremor, motion in area of bowels,
difficulty in breathing, cough. Works executed on height of, related to nervously-emotional
tension. On workers operate vibration: general and local, murmur, infra-sound, steamdisengaging in summer cooling the winter microclimate. With the action of what factor you do
you link the complaints of worker?
A *Vibration
B Murmur
C Infra-sound
D Tension of labour
E of Work on height of
50
Workers of laboratory on making of measuring devices (manometers,
thermometers and others like that) grumble about metallic taste in to the mouth, stomatitis,
dyspepsia phenomena, parahypnosis, shaky gait, fall-off of cardiac activity. Specify reason of
origin of this poisoning.
A * Mercury.
B Lead.
C Manganese.
D Toluene.
E Tetraethyllead.
51
A 52 y.o. man has recurrent transient ischemic attacks. Auscultation of the carotid arteries
detects murmur. What diagnostic method is necessary to apply first?
A. Ultrasound dopplerography
B. Cerebral angiography
C. MRI of the brain
D. Electroencephalography
E. CT of the brain
52
A patient, aged 16, complains of headache, mainly in the frontal and temporal areas,
superciliary arch, appearing of vomiting at the peak of headache, pain during the eyeballs
movement, joint's pain. On examination: excited, t0- 390С, Ps- 110/min. Tonic and clonus
cramps. Uncertain meningeal signs. What is the most likely diagnosis?
A. Influenza with cerebral edema manifestations
B. Adenovirus infection
C. Respiratory syncytial virus
D. Influenza, typical disease duration
E. Parainfluenza
53.
A full-term new-born suffered ante- and intranatal hypoxia, was born in asphyxia (Apgar score
2-5 points). After birth baby's excitation is progressing, occurs vomiting, nystagmus, spasms,
squint, spontaneous Babinski and Moro's reflexes. What is the most probable location of the
intracranial haemorrhage in this case?
A. Subarachnoid hemorrhages
B. Haemorrhages in ventricles of brain
C. Subdural hemorrhages
D. Small hemorrhages in brain tissue
E. Periventricular hemorrhages
54.
Male 30 y.o., noted growing fingers and facial scull, changed face. Complains of poor
eyesight, weakness, skin darkening, loss of body weight. X-ray shows broadening of sella
turcica, thinning of tuberculin sphenoidale, signs of increased intracranial pressure. What
diagnosis can you make?
A. Adenoma of hypophysis
B. Tumor of pondo-cerebellar corner
C. Adrenal gland tumor
D. Encephalitis of truncus
E. Optico - hiasmatic arachnoiditis
55.
A newborn aged 3 days with hyperbilirubinemia (428 mkmol/L) developed following disorders.
From beginning there were severe jaundice with poor suckling, hypotomia and hypodynamia.
Little bit later periodical excitation, neonatal convulsions and neonatal primitive reflexes loss
are noted. Now physical examination reveals convergent squint, rotatory nystagmus and setting
sun eye sign. How to explain this condition?
A. Encephalopathy due to hyperbilirubinemia
B. Spastic cerebral palsy
C. Hydrocephalus
D. Skull injury
E. Brain tumour
56.
During intramuscular DTP vaccination in clinic, a 3 m.o. child developed signs of
laryngospasm, paleness of skin, cyanosis of lips, "cock cry", stop of respiration, tension of the
whole body with overturned backward head. Allergological history of the child is not
complicated. What is the most probable diagnosis?
A. Spasmophilia, tonic spasms
B. Meningoencephalitic reaction, clonic and tonic spasms
C. Meningism, clonic and tonic spasms
D. Cerebral haemorrhage, tonic spasms
E. Anaphylactic shock, clonic spasms
57.
A 65 y.o. woman complains of complicated mouth opening following foot trauma 10 days ago.
Next day she ate with difficulties, there were muscles tension of back, the back of the head and
abdomen. On the third day there was tension of all muscle groups, generalized convulsions
every 10-15 min. What is the most probable diagnosis?
A. Tetanus
B. Tetania
C. Meningoencephalitis
D. Hemorrhagic stroke
E. Epilepsy
58.
Ambulance was called to a 48 y.o. man. From the words of relatives he has had three episodes
of lost consciousness and attacks during the day. On examination: the following fit is observed:
patient is unconscious, fell on the floor, tonic and then clonic convuesions of trunk and
extremities happened. The attack lasted for 4 minute, ended by involuntary urination. What type
of attack was observed?
A. Major epileptic seizure
B. Fainting
C. Absence
D. Vegetatic crisis
E. Episode of hysteria
59
On the 5-th day of the respiratory disease a 24 y.o. man has developed progressive headaches
systemic dizziness, feeling of seeing double, paresis of mimic muscles on the right, choking
while swallowing. Acute viral encephalitis has been diagnosed. What is the main direction of
urgent therapy?
A. Zovirax
B. Glucocorticoids
C. Hemodesis
D. Lasix
E. Ceftriaxon
60
A 14 y.o. child suffers from of vegetovascular dystonia of pubertal period. He has developed
sympathoadrenal crisis. What medicine should be used for crisis reduction?
A. Obsidan
B. Euphyline
C. Corglicone
D. Amisyl
E. No-shpa
61
A 70 y.o. male patient with mild headaches complains of speech disorder, weakness in right
limbs. There was a history of miocardial infarction and arrhythmia. On nu eroligical
examination there are elements of motor aphasia, central paresis of VII and XII cranial nerves
pairs on the right side, cental type of hemiparesis and hemihyperesthisia on the same side. What
is the most probable diagnosis?
A. Ischemic stroke
B. Hemorrhagic stroke
C. Cerebral tumor
D. Epidural hematoma
E. Transitory ischemic attack
62
A 60 y.o. patient complains of having passing reduction of strength in his left extremities for a
month. Some time later he has got persistent weakness of extremities in the mornings.
Objectively: AP- 140/90 mm Hg, conscious, central paresis of the VII and XII pair of left-side
cranial nerves, central hemiparesis and hemihyperesthesia also on the left side. What medicines
should be chosen for the differentiated treatment of the patient?
A. Anticoagulants
B. Diuretics
C. Hypotensive
D. Corticosteroids
E. Hemostatics
63
The disease of a 21 y.o. patient began with raise of temperature up to 39,00С, headache, chill,
repeated vomiting. Rigidity of occipital muscles is determined. The analysis of liquor revealed:
cytosis - 1237 in 1 ml, including: 84% of neutrophils, 16% of lymphocytes. On bacterioscopy:
gram-negative cocci are found in liquor. What is the most probable disease?
A. Meningococcal infection: purulent meningitis
B. Meningococcal infection: serous meningitis
C. Serous meningitis
D. Secondary purulent meningitis
E. Infectious mononucleosis
64
A 54 y.o. man was admitted to the hospital with complaints of sudden intense headache in
occipital region and vomiting. In the medical hystory: moderate arterial hypertension, the patient
was taking hydrochlorothiazide. Three days ago he consulted a therapeutist about intense
headache that was suppressed by an analgetic. Objectively: consciousness is confused, left pupil
is mydriatic. Evident photophobia and tension of neck muscles. Left-side hemiparesis with
increased muscle tonus and reflexes. Body temperature is low, rash is absent. AP- 230/130 mm
Hg, Ps- 50 bpm, BR- 12/min. What is your preliminary diagnosis?
A. Acute subdural hematoma
B. Migraine
C. Acute bacterial meningitis
D. Myasthenia
E. Disseminated sclerosis
65
A 47 y.o. woman complains of having paroxysmal headaches for the last 5 years. The pain is
one-sided, intense, localised in frontal region of head, accompanied by nausea and stomach
discomfort, begins one of a sudden. Onset is usually preceded by vision reduction. Anamnesis
gives evidence of periodical AP rise, but at the moment the woman doesn't take any medicines.
Inbetween the onsets of headache her state is satisfactory. Objectively: high-calorie diet (body
weight index - 29), AP- 170/95 mm Hg. Neurologic state has no pecularities. What is the most
probable diagnosis?
A. Migraine
B. Hypertensive encephalopathy
C. Epilepsy
D. Chronic subdural hematoma
E. Benign intracranial hypertension
66
A 38 y.o. patient lifted a heavy object that resulted in pain in the lumbar part of spine irradiating
to the posterior surface of his left leg. The pain increases during changing body position and also
in the upright position. Examination revealed positive symptoms of tension. What is the
preliminary diagnosis?
A. Pathology of intercostals disks
B. Polyneuritis
C. Myelopathy
D. Spinal cord tumor
E. Arachnomyelitis
67
A 75 y.o. woman with coronary heart disease constantly takes warfarin. She was taken to the
acute care department with complaints of sudden sensation of weakness in the left half of her
body and eyeball deviation to the left. What examination of the patient will be a primary task?
A. Computer tomography of brain
B. Ultrasonic examination of carotid arteries
C. Magnetic resonance tomography of brain
D. Electroencephalogram
E. Spinal punction
68
A 43 y.o. patient complains of periodical pain attacks in the right half of her face. The attack is
characterized by spasm of mimetic muscles of the right face's half, reddening of skin on this side.
Blood has no pathologies. She was diagnosed with right-sided trifacial neuralgia. What
medication should be prescribed?
A. Finlepsin
B. Actovegine
C. Indometacin
D. Prednisolone
E. Analgine
69
A 7 y.o. girl has mild form of varicella. Headache, weakness, vertigo, tremor of her limbs,
ataxia, then mental confusion appeared on the 5th day of illness. Meningeal signs are negative.
Cerebrospinal fluid examination is normal. How can you explain these signs?
A. Encephalitis
B. Meningoencephalitis
C. Myelitis
D. Meningitis
E. Neurotoxic syndrome
70
Male 25 years old, who is sick for 4 years with multiple sclerosis, complaining about increased
unsteadiness, weakness of lower extremities, urine retention. OBJECTIVE: Central
tetraparesis. Cerebellar ataxia, dysfunction of pelvic organs. What is the most useful therapy in
this case?
A.Glucocorticoid
B.Antibiotics
C.Nootropics
D.desensitization
E.Vitamins