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Pediatrics
Tests (текстові тестові завдання)
Name the main way of the infection entering at pneumonia:
A.
*bronchogenic
B.
hematogenic
C.
lymphogenic
D.
mixed
E.
urogenic
In pneumonia etiology prevails:
A.
candida
B.
klebsiella
C.
*pneumococci
D.
staphylococci
E.
streptococci
At the early childhood an acute pneumonia most often is:
A.
interstitial
B.
croupous (lobar)
C.
*microfocal
D.
segmental
E.
polysegmental
Typical physical data at pneumonia are:
A.
diffuse dry wheezes
B.
local small moist wheezes
C.
diffuse small moist wheezes
D.
*diminished breath sounds
E.
local dry wheezes
The chest X-ray sign typical for acute pneumonia is:
A.
strengthening of pulmonary picture (lung pattern)
B.
*infiltrative shadows
C.
emphysema
D.
dilation of lungs' roots
E.
pneumosclerosis
What medicine is not used for improvement of the rheologic blood properties and
microcirculation during treatment of acute pneumonia?
A.
rheopoliglucin
B.
heparin
C.
trental
D.
*droperidol
E.
curantil
Duration of an acute pneumonia is:
A.
up to 4 weeks
B.
*up to 8 weeks
C.
up to 10 weeks
D.
up to 2 weeks
E.
up to 6 weeks
In most cases an acute pneumonia at children of the early age develops as a result of:
A.
overheat
B.
super cooling
C.
violation of the regime
D.
*upper respiratory tract viral infection
E.
upper respiratory tract microbial infection
To the pathogenetic links of an acute pneumonia does not belong:
A.
hypoxemia
B.
C.
D.
E.
10.
11.
12.
13.
14.
15.
16.
17.
*alcalosis
acidosis
hypoxia
bacteriemia
To bronchopneumonia are not typical such laboratory changes:
A.
*reticulocitosis
B.
leucocytosis
C.
neutrophylosis
D.
elevated ESR
E.
anemia
The clinical features of an acute pneumonia at children of the early age do not depend on the
following:
A.
age
B.
sex
C.
premorbid state
D.
*nationality
E.
weight
To the criteria of an acute pneumonia diagnosis do not belong:
A.
intoxication
B.
*epidemiological history
C.
local physical changes
D.
respiratory acidosis
E.
percussion changes
Correlation of pulse and breathing 2 - 1,5 : 1 is typical for:
A.
Respiratory ins. 0 st.
B.
Respiratory ins. I st.
C.
Respiratory ins. II st.
D.
*Respiratory ins. III st.
E.
Respiratory ins. IVst.
Oxygen saturation of the blood 90 % is typical for:
A.
Respiratory ins. 0 st.
B.
*Respiratory ins. I st.
C.
Respiratory ins. II st.
D.
Respiratory ins. III st.
E.
Respiratory ins. IVst.
Inconstant perioral cyanosis is typical for:
A.
Respiratory ins. 0 st.
B.
*Respiratory ins. I st.
C.
Respiratory ins. II st.
D.
Respiratory ins. III st.
E.
Respiratory ins. IVst.
Level РСО2 40 mm Hg. is typical for:
A.
Respiratory ins. 0 st.
B.
Respiratory ins. I st.
C.
Respiratory ins. II st.
D.
*Respiratory ins. III st.
E.
Respiratory ins. IVst.
Mostly destructive pneumonia is caused by:
A.
pneumococci
B.
*staphylococci
C.
proteus
D.
klebsiella
E.
streptococci
18.
19.
20.
21.
22.
23.
24.
25.
26.
What type of oxygen therapy is the best for a child with the Respiratory ins. III st.?
A.
serve of oxygen through an oxygen pillow
B.
serve of oxygen in an oxygen tent
C.
serve of oxygen through a nasal catheter
D.
*serve of oxygen through an intubation tube
E.
serve of humidified oxygen through a mask
What type of oxygen therapy is the best for a child with the Respiratory ins. II st.?
A.
serve of oxygen through an oxygen pillow
B.
serve of oxygen in an oxygen tent
C.
serve of oxygen through a nasal catheter
D.
serve of oxygen through an intubation tube
E.
*serve of oxygen through a mask
What group of antibiotics is not used for pneumonia treatment at children of the early age?
A.
penicyllines
B.
*tetracyclin
C.
aminoglicosydes
D.
cefalosporines
E.
macrolides
At mild pneumonia antibacterial therapy lasts:
A.
5 - 7 days
B.
3 - 5 days
C.
*7 - 10 days
D.
10 - 14 days
E.
15 - 18 days
At moderate pneumonia antibacterial therapy lasts:
A.
5 - 7 days
B.
7 - 10 days
C.
*10 - 14 day
D.
14 - 20 days
E.
15 - 18 days
At severe pneumonia antibacterial therapy lasts:
A.
7 - 10 days
B.
10 - 14 days
C.
*14 - 21 day
D.
21 - 24 days
E.
24 - 28 days
For treatment of mild pneumonia semisynthetic penicillin’s are used in a dose:
A.
30 - 50 mg/kg/daily
B.
*50 - 80 mg/kg/daily
C.
80 - 100 mg/kg/daily
D.
100 - 150 mg/kg/daily
E.
150 - 200 mg/kg/daily
For treatment of moderate pneumonia semisynthetic penicillin’s are used in a dose:
A.
30 - 50 mg/kg/daily
B.
50 - 80 mg/kg/daily
C.
*80 - 100 mg/kg/daily
D.
100 - 150 mg/kg/daily
E.
150 - 200 mg/kg/daily
For treatment of severe pneumonia semisynthetic penicillin’s are used in a dose:
A.
30 - 50 mg/kg/daily
B.
50 - 80 mg/kg/daily
C.
80 - 100 mg/kg/daily
D.
100 - 150 mg/kg/daily
E.
27.
28.
29.
30.
31.
32.
33.
34.
35.
*150 - 200 mg/kg/daily
In definition of pneumonia is absent the following position:
A.
*it is an noninfectious disease of pulmonary parenchyma
B.
pneumonia is diagnosed at presence of respiratory disorders
C.
pneumonia is diagnosed at presence of tachypnea
D.
pneumonia is diagnosed at presence of infiltrative changes on x-ray
E.
pneumonia is diagnosed at presence of respiratory insufficiency
Among the forms of pneumonia is absent:
A.
community acquired
B.
hospital
C.
*teenagers' pneumonia
D.
ventilator associated
E.
bronchopneumonia
In classification of pneumonia forms is absent:
A.
pneumonia in children who have an immune deficit
B.
ventilator associated
C.
congenital pneumonia
D.
*extraschool
E.
hospital
Hospital pneumonia is one that developed:
A.
during 6 hours being in the hospital
B.
during 12 hours being in the hospital
C.
during a 24 hours being in the hospital
D.
*during 48 hours being in the hospital
E.
during 56 hours being in the hospital
Hospital pneumonia is one that developed:
A.
during 6 hours after discharge from the hospital
B.
during 12 hours after discharge from the hospital
C.
during a 24 hours after discharge from the hospital
D.
*during 48 hours after discharge from the hospital
E.
during 56 hours after discharge from the hospital
Pulmonary complications of pneumonia don’t belong to:
A.
pleurisy
B.
pneumothorax
C.
pyopneumothorax
D.
*DIC syndrome
E.
abscess
More often the etiology of community acquired pneumonia in children from 6 months to 6 years
is:
A.
chlamydia
B.
mycoplasm
C.
*pneumococcus
D.
staphylococcus
E.
E. coli
More often the etiology of community acquired pneumonia in children from 7 to 15 years is:
A.
streptococcus
B.
Listeria monocytogenes
C.
*pneumococcus
D.
hemophilus influenza
E.
E. coli
What is the definition of tachypnea in children 2-12 mo:
A.
*>50 breaths/min
B.
>80
>60
>40
>35
What is the definition of tachypnea in children 1-5 ya:
A.
>50 breaths/min
B.
>80
C.
>60
D.
*>40
E.
>35
To the most frequent etiological agents of hospital pneumonia does not belong:
A.
E. coli
B.
*pneumococcus
C.
proteus
D.
enterobacter
E.
virus
Ventilator associated pneumonias (with less than four days of artificial ventilation), usually, are
conditioned by:
A.
pneumococcus
B.
B. cereus
C.
*klebsiella
D.
enterobacter
E.
virus
Pneumococci are absolutely non-sensitive to:
A.
penicillines
B.
*aminoglicozides
C.
macrolydes
D.
cephalosporin’s
E.
tetracycline’s
Medicine of choice to treat typical community acquired pneumonias is:
A.
*aminopenicillins
B.
carbapenems
C.
fluorquinolones
D.
antibiotics of other groups
E.
tetracycline’s
To the antibiotics of the first choice to treat typical community acquired pneumonias do not
belong:
A.
amoxycillin
B.
macrolides
C.
*fluorquinolones
D.
inhibitor-protected penicillins
E.
carbapenems
Positive effect of pneumonia treatment by antibiotic is all, except
A.
improvement of the general condition
B.
decrease of temperature below 38°C in 24 - 48 hours from the beginning of treatment
C.
*increase of dyspnea
D.
roentgenologic changes do not increase or even decrease
E.
decrease of dyspnea
An absent effect of pneumonia treatment by antibiotic is all, except:
A.
fever remains
B.
*improvement of the general condition
C.
increase of pathological changes in the lungs
D.
increase of dyspnea and hypoxemia
E.
decrease of dyspnea and hypoxemia
C.
D.
E.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
For the beginning of lobar pneumonia is not typical:
A.
headache
B.
normal or subfebrile temperature
C.
*poor consciousness
D.
cough with «ferruginous» sputum
E.
febrile temperature
What symptom of pneumonia is typical only for one month old children?
A.
Cough
B.
Foamy excretions from a nose and mouth
C.
Dulling of percussion sound
D.
*Nod motions by a head
E.
Dissipated moist wheezes
At what respiratory insufficiency stage is observed inconstant perioral cyanosis ?
A.
*At the firs
B.
At the second
C.
At the third
D.
At all stages
E.
Does not have the diagnostic value
Beginning of lobar pneumonia reminds sometimes:
A.
attack of bronchial asthma
B.
rheumatism
C.
*acute appendicitis
D.
pyelonephritis
E.
gastritis
?More often the reason of obstructive bronchitis is:
A.
*Viral – bacterial flora
B.
Parasites
C.
Fungi’s
D.
Bacterial - fungi’s flora
E.
Viral – fungi’s flora
The beginning of obstructive bronchitis is:
A.
*Catarrhal syndrome
B.
Allergic reactions
C.
Inspiration dyspnea
D.
Expiration dyspnea
E.
Tonsillitis
At the acute phase of obstructive bronchitis is prevailing:
A.
Intoxication
B.
*Cough
C.
Dyspnea
D.
Wheezing
E.
Tonsillitis
Percussion during the acute phase of obstructive bronchitis is:
A.
Clear lung sound
B.
*Box sound
C.
Dullness of lung sound
D.
Dullness of lung sound in lower parts
E.
Dullness of lung sound in upper parts
Auscultation during the acute phase of obstructive bronchitis is:
A.
Prolonged inspiration
B.
Decrease of breathing
C.
*Dry rales and moist diffuse rales
D.
Crepitation
Local moist rales
During the acute period of obstructive bronchitis on X-ray is present:
A.
*Perivascular and peribronhial infiltration, increasing of lung pattern and enlarged roots of
lungs
B.
Particularly clear lung field
C.
Hyperinflation
D.
Occasional scattered areas of consolidation
E.
Local infiltration of lung tissue
The main treatment of obstructive bronchitis is:
A.
Liquidation of viruses
B.
Desintoxication therapy
C.
* Normalization of drainage function of bronchus
D.
Rehydratation therapy
E.
Antibiotics
The chest falls on inspiration and rises on expiration. What type of respiration is it?
A.
Kussmaul’s respiration
B.
*Paradoxical respiration
C.
Normal respiration
D.
Biot’s respiration
E.
Cheyne-Stokes respiration
What type of respiratory movements is in children after 7 years?
A.
*Thoracic
B.
Abdominal
C.
Costal
D.
Sternly
E.
Diaphragmatic
What is tachypnea?
A.
*The increase of the respiratory rate
B.
The distress during breathing
C.
The decrease of the respiratory rate
D.
The cessation of breathing
E.
The increase of the respiratory depth
What is an average respiratory rate in 1-year old child?
A.
20
B.
*30
C.
18
D.
50
E.
60
What is apnea?
A.
The increase of the respiratory rate
B.
The distress during breathing
C.
The decrease of the respiratory rate
D.
*The cessation of breathing
E.
The increase of the respiratory depth
What is bradypnea?
A.
The increase of the respiratory rate
B.
The distress during breathing
C.
*The decrease of the respiratory rate
D.
The cessation of breathing
E.
The decrease of the respiratory depth
What is an average respiratory rate in children after 12 years?
A.
22
B.
32
E.
53.
54.
55.
56.
57.
58.
59.
60.
61.
C.
D.
E.
62.
63.
64.
65.
66.
67.
68.
*18
25
45
What is usual ratio of breaths to heartbeats?
A.
1:1
B.
1:2
C.
1:3
D.
*1:4
E.
1:5
What is an average respiratory rate in newborn?
A.
22
B.
30
C.
18
D.
*45
E.
64
What main clinical features are useful in the diagnosis of bronchiolitis
A.
Paroxysmal cough
B.
*Wheezing
C.
Tachypnea
D.
Dyspnea
E.
Tension and flaring of the nostris
What main X-ray features are useful in the diagnosis of acute bronchitis?
A.
*Perivascular and peribronhial infiltration
B.
Particularly clear lung field
C.
Hyperinflation
D.
Occasional scattered areas of consolidation
E.
Local infiltration of lung tissue
What examination is most important in the case of bronchitis?
A.
Complete blood count
B.
Culture of sputum
C.
Culture of alveolar fluid
D.
Biochemical examination of the blood
E.
*Chest X-ray
Bronchitis is caused most often by:
A.
Fungi
B.
*Viruses
C.
Bacteria
D.
Parasites
E.
Mixed flora
All factors can lead to bronchitis, except:
A.
Cooling
B.
*Poor feeding
C.
Allergies
D.
Genetically predilection
E.
Bad ecology
69.
What sound is typical for obstructive bronchitis?
A.
*Clear pulmonary sound
B.
Box sound
C.
Local shortness of pulmonary sound
D.
Total shortness of pulmonary sound
E.
Mosaic sound
70.
Such auscultation picture may be determined at obstructive bronchitis, except:
A.
*Local decrease of vesicular breathing
Increase vesicular breathing
Rough breathing
Puerile breathing
Bronchus breathing
What is the main feature of bronchiolitis?
A.
Puerile breathing
B.
Dry wrestling rales
C.
Course bubbling rales in lower parts of lungs
D.
*Diffuse fine rales
E.
Decreased vesicular breathing
The criteria of acute obstructive bronchitis are all, except:
A.
*Severe intoxication
B.
The great quantity of dry rales
C.
Nonproductive cough
D.
Box sound during percussion
E.
Perivascular infiltration of lung tissue
The X-ray criteria of acute bronchitis is all, except:
A.
*Atelectasis
B.
Increase of lung pattern
C.
Perivascular infiltration
D.
Peribronchial infiltration
E.
Infiltration of roots
According classification bronchitis cannot be:
A.
Acute
B.
*Latent
C.
Relapse
D.
Chronic
E.
Bronchiolitis
The main symptom of acute bronchitis is:
A.
Wheezing
B.
Pain in throat
C.
*Cough
D.
Dyspnea
E.
Hyperthermia
The first sign of acute bronchitis is everything, except:
A.
Hyperthermia
B.
Wheezing
C.
*Vomiting
D.
Pharyngitis
E.
Cough
There is not typical such type of rales during bronchitis:
A.
Diffuse
B.
Symmetrical
C.
*Local
D.
Decreasing or disappearing of rales after coug
E.
Dry rales
There is not typical such auscultation dates during bronchitis:
A.
Rough breathing
B.
*Decrease breathing
C.
Dry rales
D.
Moist diffuse rales
E.
Decreasing or disappearing of rales after cough
The auscultation date during bronchitis is:
B.
C.
D.
E.
71.
72.
73.
74.
75.
76.
77.
78.
79.
Puerile breathing
Decrease breathing
*Rough breathing
Moist local rales
Crepitus rales
During acute bronchitis respiratory insufficiency is most often of:
A.
*0 stage
B.
1 stage
C.
2 stage
D.
3 stage
E.
2-3 stage
X-ray criterion of acute bronchitis is
A.
*Symmetrical increasing of lung pattern
B.
Symmetrical decreasing of lung pattern
C.
Infiltration of lung tissue
D.
Infiltration of lung tissue near roots
E.
Symmetrical decreasing of lung pattern and infiltration of lung tissue
Complex of treatment of acute bronchitis does not include:
A.
Mucolitics
B.
Physiotherapy
C.
*Antacids drugs
D.
Antipiretics drugs
E.
Antibiotics
Bronchoobstructive syndrome is characterized by:
A.
*Noisy breathing
B.
Paroxysmal breathing
C.
Stridor breathing
D.
Silent breathing
E.
Diminished breathing
What main clinical features are useful in the diagnosis of bronchial asthma?
A.
Chest pain
B.
*Dispnoe
C.
Tahycardia
D.
Vomiting
E.
Wet cough
What examination is the most important at bronchial asthma?
A.
Stools examination
B.
Culture of sputum
C.
*Immunoglobulin E
D.
Biochemical examination of the blood
E.
Chest X-ray
What special substances may be found in sputum in case of bronchial asthma?
A.
*Eosinophyls
B.
Erythrocytes
C.
Neuthrophyls
D.
Leucocytes
E.
Monocytes
What will be the therapeutic management of acute attacks of asthma?
A.
*Bronchodilators
B.
Anti-inflammatory agents
C.
Commonly sodium
D.
Inhalation of corticosteroids
E.
Prednizolon orally
A.
B.
C.
D.
E.
80.
81.
82.
83.
84.
85.
86.
87.
88.
89.
92.
93.
94.
95.
96.
97.
98.
There is necessary to use for control the effect of treatment of bronchial asthma:
A.
Spirography
B.
ECG
C.
Allergic tests
D.
*Peak Flow Meter
E.
X-ray
More often the reason of bronchial asthma is the
A.
*Dust
B.
Drugs
C.
Food
D.
Bacteria
E.
Viruses
What symptom is not specific for atrial septal defect?
A.
Difficulty breathing (dyspnea)
B.
*Cyanosis
C.
Frequent respiratory infections in children
D.
Sensation of feeling the heart beat (palpitations)
E.
Shortness of breath with activity
Children with such pathology have a high risk of the congenital heart disease, except for:
A.
Down syndrome
B.
Genetic disorders (chromosomal abnormalities)
C.
Premature babies
D.
Children with multiple extracardiac (other than the heart defect) malformations
E.
*Newborns with chronic intrauterine hypoxia
The most common symptoms of patent ductus arteriosus are:
A.
Tachycardia or other arrhythmia
B.
Shortness of breath and other respiratory problems
C.
*Continuous machine-like murmur
D.
Enlarged heart
E.
All mentioned above
What heart murmur is characteristic for patent ductus arteriosus?
A.
Systolic
B.
Diastolic
C.
Systolic and diastolic
D.
*Continuous machine-like murmur
E.
May be variants
What symptom is not typical for hypoplastic left heart?
A.
cyanosis
B.
cold extremities
C.
*hepatosplenomegaly
D.
Lethargy
E.
Poor pulse
What symptoms are typical for aortic coarctation (aortarctia)?
A.
Dizziness or fainting
B.
Shortness of breath
C.
headache
D.
Chest pain
E.
*all that is mentioned
Attack of rheumatic fever is more frequent after the:
A.
flu
B.
sinusitis
C.
*scarlet fever
D.
measles
rhinitis
Etiology of rheumatic fever is:
A.
*streptococcus
B.
pneumococcus
C.
the virus of influenza
D.
fungi
E.
staphylococcus
What does confirm streptococcal etiology of rheumatic fever?
A.
previous measles
B.
*previous acute tonsillitis
C.
previous influenza
D.
previous sepsis
E.
previous pneumonia
What heart defect is most often formed on a background of rheumatic fever?
A.
*mitral valve insufficiency
B.
stenosis of aorta valves
C.
insufficiency of aortic valves
D.
tricuspid valve insufficiency
E.
stenosis of mitral valve
What is the main criterion of rheumatic fever?
A.
*carditis
B.
hepatitis
C.
nephritis
D.
pneumonia
E.
gastritis
What is the main criterion of rheumatic fever?
A.
nephritis
B.
hepatitis
C.
*carditis
D.
pneumonia
E.
gastritis
What is the main criterion of rheumatic fever?
A.
*polyarthritis
B.
hepatitis
C.
dermatitis
D.
pneumonia
E.
gastritis
What is the main criterion of rheumatic fever?
A.
*rheumatic nodules
B.
dermatitis
C.
nephritis
D.
pneumonia
E.
gastritis
What is the criterion of carditis?
A.
*damage of myocardium and endocardium
B.
cardialgias
C.
damage of epicardium
D.
only pericarditis
E.
hypothermia
What is typical for myocarditis?
A.
heart borders narrowed
B.
strengthening of the heart tones
C.
syndrome WPW
E.
99.
100.
101.
102.
103.
104.
105.
106.
107.
СLС syndrome
*heart borders dilatation
What is typical for myocarditis?
A.
*decrease of arterial pressure
B.
increase of arterial pressure
C.
normal arterial pressure
D.
high pulse pressure
E.
СLС syndrome
For rheumatic polyartritis is typical:
A.
morning stiffness
B.
constant deformations of the joints
C.
*inconstant damage of joints
D.
damage of spine
E.
damage of neck
Small chorea is characterized for..
A.
violation of consciousness
B.
central paralyses
C.
damage of the cranial-cerebral nerves
D.
*muscular hypotonia
E.
muscular hypertonia
Rheumatic endocarditis is characterized by:
A.
*rough systolic murmur on the apex
B.
accent of 2 tone above the aorta
C.
soft systolic murmur on the apex
D.
systolic murmur above the pulmonary artery
E.
soft systolic murmur on the aorta
ECG in case of rheumatism characteristically is characterized by:
A.
lengthening of the QT interval
B.
*lengthening of the PQ interval
C.
deformation of the QRS complex
D.
increase of voltage
E.
decrease of voltage
In the case of the rheumatism's acute duration is better to use:
A.
plaquenil
B.
delagyl
C.
ibuprophen
D.
*aspirin
E.
analgin
In the case of the rheumatism's prolonged duration is better to use:
A.
voltaren
B.
*plaquenil
C.
ibuprophen
D.
aspirin
E.
analgin
What is prescribed in case of penicillin allergy for rheumatism etiological treatment?
A.
gentamycin
B.
claforan
C.
chloramphenicol
D.
kanamycin
E.
*erythromycin
What is the dose of prednisolone in case of severe rheumatic carditis?
A.
1 mg/kg;
B.
*2 mg/kg;
D.
E.
108.
109.
110.
111.
112.
113.
114.
115.
116.
3 mg/kg;
4 mg/kg;
5 mg/kg
What is the complication of rheumatic fever?
A.
*mitral valve insufficiency
B.
tricuspid valve insufficiency
C.
stenosis pulmonary artery
D.
pulmonary artery valves insufficiency
E.
pulmonary artery valves stenosis
What is typical for myocardiosclerosis?
A.
*arrhythmia
B.
low blood pressure
C.
high blood pressure
D.
bradypnea
E.
tachypnea
What is typical for rheumatic arthritis?
A.
Morning stiffness
B.
Permanent course
C.
*Symptoms subside within 2 week
D.
Pale skin over joints
E.
All transffered
Arthralgia associated with rheumatic fever differs from arthralgia associated with rheumatoid
arthritis by:
A.
Permanent course
B.
*Absence of tenderness during passive movement of the affected joint
C.
More expressed in the morning
D.
More expressed in the evening
E.
Increases day by day
Sydenham’s chorea is characterized by involuntary movements, specially:
A.
On the legs
B.
On the hands
C.
On the face
D.
*On the face and limbs
E.
All over the body
Clinic of Sydenham’s chorea includes:
A.
Concomitant psychological dysfunction
B.
Increased emotional labiality
C.
Hyperactivity
D.
Age-regressed behaviour
E.
*All transferred
Name wrong assertion about annular erythema at rheumatic fever
A.
Pale pink rash in the form of a thin ring-shaped rim
B.
Does not rise above the skin surface
C.
Disappears when pressing
D.
*Appears in 30-40% of children with rheumatism
E.
Appears mostly at an altitude of disease and usually is fragile
Choose WRONG assertion about diagnostic of rheumatic fever
A.
No exact diagnostic test has been developed to test for its presence
B.
*Only blood tests to check for the presence of a strep infection are helpful
C.
A careful exam by a qualified medical practitioner is necessary
D.
Just as there is no particular laboratory test to diagnose Rheumatic fever
E.
Throat swab for culture, Antistreptolysin O titre (ASOT) and blood for acute phase
reactants must be done
C.
D.
E.
117.
118.
119.
120.
121.
122.
123.
124.
125.
126.
127.
128.
129.
130.
131.
132.
133.
The duration of salicylates treatment at rheumatic fever is:
A.
1 week
B.
2 weeks
C.
*3-4 weeks
D.
6 weeks
E.
2 months
Name the main treatment of rheumatic carditis
A.
Cortiscoteroids
B.
Salicylates
C.
Vasodilators
D.
Digoxin
E.
*All that is mentioned
Name the main treatment of Sydenham’s chorea.
A.
Corticosteroids
B.
Salicylates
C.
Vasodilators
D.
*Haloperidol
E.
Diuretics
The acute phase of rheumatic fever lasts in 75% of cases:
A.
2 weeks
B.
4 weeks
C.
*6 weeks
D.
2 months
E.
3 months
What is primary prevention of rheumatic fever?
A.
Periodic examination of people who have a family history of Rheumatic fever
B.
Good nutrition
C.
Obligatory antibiotic therapy after dental operations
D.
*Treatment of the streptococcal upper respiratory infection with antibiotics
E.
All that is mentioned
Patients without rheumatic carditis need a secondary prophylaxis:
A.
2 yrs
B.
3 yrs
C.
*5 yrs
D.
10 yrs
E.
Whole life
What is not acquired heart diseases in children?
A.
Mitral insufficiency
B.
*Coarctation of aorta
C.
Tricuspid insufficiency
D.
Mitral stenosis
E.
Aortic stenosis
Pathogenesis of mitral insufficiency includes:
A.
Constant retrograde flow of blood in the left atrium during systole of the lef ventricle
B.
Expansion and hypertrophy of the left ventricle
C.
Stagnation in the pulmonary veins
D.
Decompositions of right ventricular stagnation
E.
*All that is mentioned
Clinic of mitral insufficiency includes:
A.
Weakness
B.
Poor appetite
C.
Pale skin
D.
*Shortness of breath
Nothing that is mentioned
Clinic of mitral insufficiency includes:
A.
Weakness
B.
Palpitations
C.
Pasty legs and feet
D.
*All that is mentioned
E.
Nothing that is mentioned
Name the most common rheumatic heart disease
A.
Mitral insufficiency
B.
Coarctation of aorta
C.
Tricuspid insufficiency
D.
*Mitral stenosis
E.
Aortic stenosis
Name auscultation data at mitral stenosis
A.
*The first heart sound is unusually loud
B.
The second heart sound is unusually loud
C.
The first heart sound is unusually dull
D.
The second heart sound is unusually dull
E.
Heart sounds are normal
Name auscultation data at mitral stenosis.
A.
Mid-diastolic rumbling murmur
B.
*Mid-systolic rumbling murmur
C.
Mid-systolodiastolic rumbling murmur
D.
Blowing systolic murmur
E.
Blowing diastolic murmur
Clinic at mitral stenosis includes:
A.
Butterfly rash
B.
Arthralgia
C.
*Ankle/sacral edema
D.
Ascites
E.
All transferred
Name changes of arterial pressure at aortic insufficiency
A.
The maximum arterial pressure is dramatically reduced with high minimum
B.
*The minimum arterial pressure is dramatically reduced with high maximum
C.
High arterial pressure on hands and low on legs
D.
Arterial hypertension
E.
May be different variants
The most characteristic feature in tricuspid insufficiency is:
A.
Systolic murmur
B.
Diastolic murmur
C.
Loud heart tones
D.
*Pulsation of the neck veins and the liver
E.
Peripheral oedema
Cardiac catheterization provides in tricuspid insufficiency an opportunity to identify:
A.
Size of defect
B.
Diagnose
C.
Presence of hypertrophy
D.
*High pressure in the right atrium and the portal veins
E.
All that is mentioned
On the first place as ethiologic factor at nonrheumatic carditises are:
A.
Bacteria
B.
*Viruses
C.
Viruses + bacteria
E.
134.
135.
136.
137.
138.
139.
140.
141.
142.
Fungi
Alergic reactions
What is the main clinical feature of early congenital carditis?
A.
*Progressive left-heart cardiac insufficiency, refraction to the therapy
B.
Physical and psychomotor retardation
C.
Tachycardia
D.
Occurs under influence of harmful factors
E.
ECG: high R
Fibroelastosis is a result of:
A.
Viral carditis
B.
Bacterial carditis
C.
Fungi carditis
D.
*Early congenital carditis
E.
Late congenital carditis
What is used for treatment of acute nonrheumatic carditis?
A.
*Glucocorticoids+ nonsteroid anti-inflammatory drugs
B.
Chinoline derivatives+ nonsteroid anti-inflammatory drugs
C.
Antibiotics
D.
Vitamins
E.
All transferred
What dose of Heparin is used at treatment of nonrheumatic carditis?
A.
50 U/kg
B.
*100 U/kg
C.
150 U/kg
D.
200 U/kg
E.
250 U/kg
Name the wrong assertion about cardiomyopathy.
A.
Cardiomyopathy is a chronic and progressive disease in which the heart muscle
B.
*abnormally enlarged, thickened and stiffened
C.
Cardiomyopathy affects only children at any stage of their life
D.
It is not gender, geographic, race or age specific
E.
It is a rare disease when diagnosed in infants and young children
F.
Cardiomyopathy continues to be the leading reason for heart transplants in
G.
ldren
What type of cardiomyopathy does not exist?
A.
Restrictive cardiomyopathy
B.
Dilated
C.
Hypertrophic
D.
*Hypotrophic
E.
Ischemic cardiomyopathy
What is the main symptom of cardiomyopathy?
A.
*Arrhythmia
B.
Fatigue
C.
Difficulty breathing
D.
Poor appetite
E.
All transferred
What investigation can differentiate between hypertrophic, restrictive or dilated cardiomyopathy
in most cases?
A.
24-hour Holter monitor
B.
ECG
C.
*EchoCG
D.
X-ray of chest
E.
All that is mentioned
D.
E.
143.
144.
145.
146.
147.
148.
149.
150.
151.
152.
153.
154.
155.
156.
157.
158.
A.
B.
C.
What is the most common form of cardiomyopathy?
A.
*Dilated
B.
Restrictive
C.
Hypertrophic
D.
Infiltrative
E.
Ischemic
Basis of therapy of hypertrophic cardiomyopathy is:
A.
Calcium antagonists of Verapamilum group
B.
Metoprolol succinate
C.
Propranolol
D.
Atenolol
E.
*All that is mentioned
Basis of therapy of hypertrophic cardiomyopathy is:
A.
*Calcium antagonists of Verapamilum group
B.
Antiunrhythmical preparations
C.
inhibitors of ACE (angiotensin converting enzyme)
D.
Cardiac glycozides
E.
All that is mentioned
Surgical treatment of hypertrophic cardiomyopathy is indicated at:
A.
Immediately after diagnose
B.
In early age
C.
*Absence of clinical effect from active medicinal therapy
D.
Appearance of heart failure
E.
All that is mentioned
Specify one of symptoms of acute left heart insufficiency.
A.
Swelling of neck veins
B.
Skin cyanosis
C.
*Foamy excretions from mouth
D.
Hepatomegalia
E.
Edema on extremities
Specify one of symptoms of acute left heart insufficiency.
A.
Olyguria
B.
Expansion of right border of heart
C.
Decline of arterial pressure
D.
*Forced sitting position of body
E.
Edema on extremities
At what degree of cardiac insufficiency does ascites appear?
A.
IA
B.
IB
C.
II A
D.
II B
E.
*III
Specify indications for prescription of cardiac glycosides.
A.
*Cardiac insufficiency
B.
Atrioventricular blockade
C.
Expressed bradycardia
D.
Group extrasystoles
E.
Expressed hypokaliemia
F.
159.
At what type of collapse is necessary to include mezatoni and adrenalini in
urgent therapy?
Toxic
Sympathotonic
*Paralytic
D.
E.
159.
160.
161.
162.
163.
164.
165.
166.
167.
Ortostatic
Hypoxic
At what type of collapse is necessarily to include aminasini in urgent therapy?
A.
Toxic
B.
Paralytic
C.
Hypoxic
D.
*Sympathotonic
E.
Ortostatic
Ratio of indirect heart massage and artificial respiration for children of all age groups is:
A.
2:1
B.
3:1
C.
*4:1
D.
5:1
E.
6:1
Name one of symptoms of acute left heart insufficiency.
A.
Edema of extremities
B.
Accent of 2nd tone on a pulmonary artery
C.
Swelling of neck veins
D.
Hepatomegaly
E.
*Weak pulse or undetermined
Position of patient at syncope must be:
A.
Horizontal with the low position of feet
B.
*Horizontal with high position of feet
C.
Half sitting with the inclined head to the right
D.
Half sitting with the inclined head to the left
E.
Raised with the low position of feet
The best medicines at symphatotic collapse are:
A.
Cordiamini, caffeini
B.
Eyphyllini, salbutamoli
C.
*Droperidoli,aminasini
D.
Adrenalini, mezatoni
E.
Reopolyglucini, polyglucini
The best medicines at vagotonic collapse are:
A.
*Adrenalini, mezatoni
B.
Droperidoli,aminasini
C.
Eyphyllini, salbutamoli
D.
Cordiamini, caffeine
E.
Reopolyglucini, polyglucini
Paroxismal tachycardia is the attack of sudden tachycardia:
A.
More than 90-100 per minute
B.
More than 110-130 per minute
C.
More than 130-140 per minute
D.
*More than 150-180 per minute
E.
More than 200 per minute
The general electrocardiography criteria of paroxysmal tachycardia are:
A.
Presence 3 and anymore groups of extrasystoles
B.
Absence of compensating pause
C.
C. Cardiac frequency more than 150 per 1 minute
D.
*Outbreak and sudden end
E.
All that is mentioned
The first medicine at treatment of ventricular paroxysmal tachycardia is:
A.
Cordaroni
B.
Novocainomidi
Corgluconi
*Lidocaini
Seduxeni
Symptomatic hypertension in children is conditioned:
A.
By illnesses of kidneys
B.
By the anomalies of vessels
C.
By illnesses of adrenal glands
D.
By nothing of these
E.
*By all of these
Basic in determination of clinical death is:
A.
Absence of the independent breathing
B.
Absence of photoreaction of pupils on light
C.
*Permanent expansion of pupils
D.
Absence of pulse on carotid and femoral arteries
E.
All of these
What drug is possible to enter only intracardiac?
A.
Lidocaini
B.
Atropini
C.
*Adrenalini
D.
All that is mentioned
E.
sodium hydrocarbonatum
What is the best method for diagnostic of arrhythmias?
A.
ECG
B.
*Holter-monitoring
C.
EchoCG
D.
Heart catheterization
E.
All transferred
Chronic cardio-vascular insufficiency (heart failure) is classified as:
A.
Left heart, right heart, arythmogenes, total
B.
Systolic, diastolic, mixed
C.
*On stages: I-A, I-B, II-A, II-B,III
D.
Left heart, right heart, systolic, diastolic
E.
All of these
Ventricular tachycardia is indeed the most dangerous of the cardiac arrhythmias with a real risk
of:
A.
Infarction
B.
*Sudden cardiac death
C.
Myocardiosclerosis
D.
Heart failure
E.
All transferred
C.
D.
E.
168.
169.
170.
171.
172.
173.
174.
175.
What type of tachycardia does not exit?
A.
Supraventricular tachycardia
B.
Ectopic atrial tachycardia
C.
*Restrictive tachycardia
D.
Ventricular tachycardia
E.
All exit
?What systemic connective tissue disease is on the first place of prevalence in children?
A.
Systemic lupus erythematosus
B.
*Rheumatoid arthritis
C.
Dermatomyositis
D.
Periarteritis nodosa
E.
Scleroderma
176.
177.
178.
179.
180.
181.
182.
183.
184.
How many criteria out of ten (according criteria) are enough to put the diagnosis of SLE?
A.
3
B.
*4
C.
5
D.
6
E.
7
Affection of the eyes is specific for:
A.
Infectious arthritis
B.
Acute rheumatic lever
C.
systemic lupus erythematosus
D.
*Juvenile rheumathoid arthritis
E.
Osteomyelitis
The dose of aspirin for the treatment of juvenile rheumatoid arthritis is:
A.
10-20 mg/kg/day
B.
25-50 mg/kg/day
C.
*50-120 mg/kg/day
D.
100-120 mg/kg/day
E.
150-200 mg/kg/day
The dose of ibuprofen for the treatment of juvenile rheumatoid arthritis is:
A.
*10-30 mg/kg/day
B.
30-50 mg/kg/day
C.
50-120 mg/kg/day
D.
100-120 mg/kg/day
E.
150-200 mg/kg/day
The “gold standard” of JRA treatment considered to be:
A.
Aspirin
B.
Cyclophosphamide
C.
Azathioprine
D.
*Methotrexate
E.
Hydroxychloroquine
How long should be present arthritis in patient to diagnose JRA (according WHO criteria)?
A.
More than 1 month
B.
More than 2 months
C.
*More than 3 months
D.
More than 6 months
E.
More than 1 year
The main clinical criterion of juvenile rheumatoid arthritis is:
A.
*Arthritis more than 3 months
B.
Morning stiffness of joints
C.
Symmetrical affection of small joints
D.
Effusion in joint cavity (under the capsule)
E.
Joint contracture.
Among clinical criteria of juvenile rheumatoid arthritis is NOT present:
A.
Arthritis more than 3 months
B.
Morning stiffness of joints
C.
Symmetrical affection of small joints
D.
Effusion in joint cavity (under the capsule)
E.
*Subfebrile temperature
What joints are the most frequently damaged in JRA?
A.
*Knee
B.
Ankles
C.
Wrists
D.
Elbow
Hip
Choose the most typical sign of rheumatoid arthritis in children in difference from adults:
A.
Symmetrical involvement of small joints
B.
Rheumatoid nodules
C.
*Damage of neck and mandible joints
D.
Resistance to the treatment
E.
Rare mono- or pauciarticular types development
What is NOT characteristic for the damage of mandible joint at JRA?
A.
Limited possibility to open the mouse
B.
Further lower jaw dysplasia
C.
Pain during opening the mouse
D.
Crepitating at palpation
E.
*Edema of parotid area
What form is absent in the JRA classification?
A.
Systemic
B.
Pauciarticular
C.
Still’s syndrome
D.
Polyarticular
E.
*Waterhouse-Friderichsen syndrome
What is Still's syndrome?
A.
*Systemic form JRA
B.
Pauciarticular form JRA
C.
Subclinical form JRA
D.
Damage of spine in JRA
E.
Damage of eyes in JRA
Choose the most typical sign of Still's syndrome?
A.
Muscular atrophy
B.
*Salmon pink rush on the body
C.
Symmetrical involvement of small joints
D.
Eyes involvement
E.
Presence of rheumatoid nodules
Choose the most typical sign of Still's syndrome?
A.
Muscular atrophy
B.
Iritis, uveitis
C.
Symmetrical involvement of small joints
D.
*Fever
E.
Presence of rheumatoid nodules
For polyarticilar form of JRA typical is damage of more than:
A.
1 joint
B.
3 joints
C.
*5 joints
D.
10 joints
E.
4 joints
What factors contribute to the immune system disturbances observed in lupus?
A.
Genetic predisposition
B.
Hormonal imbalance
C.
Allergens (eggs, drugs)
D.
Sunlight exposure
E.
*All mentioned above
What is the daily dose of prednisolone (mg) for pulse-therapy?
A.
50
B.
100
C.
250
E.
185.
186.
187.
188.
189.
190.
191.
192.
193.
500
*1000
What daily dose of prednisolone (mg/kg) should be given for treatment of polyarteritis nodosa
with abdominal syndrome?
A.
0,5 - 0,75
B.
1-2
C.
2,5 - 5
D.
*5 - 7
E.
10
What average daily dose of prednizolne (mg/kg) shoild be given for polyarteritis nodosa
treatment?
A.
0,5 - 0,75
B.
*1 - 2
C.
2,5 - 3
D.
5-7
E.
10
What is the most frequent cardio-vascular system involvement symptom at polyarteritis nodosa?
A.
*Ischemia of myocardium
B.
Fibroelastosis
C.
Myocarditis
D.
Myocardiosclerosis
E.
Pancarditis
The characteristic skin changes at polyarteritis nodosa are named
A.
*Livedo reticularis
B.
Nodular erythema
C.
Annular erythema
D.
«Butterfly»-rash
E.
Heliotrope erythema
What is NOT the diagnostic criterion of polyarteritis nodosa?
A.
*Annular (ring-form) erythema
B.
Loss more than 4 kg of body weight during the month
C.
Diffuse myalgia
D.
Polyneuropathy
E.
Increased level of urea in the blood
What from enumerated is NOT typical for dermatomyositis?
A.
Leucocytosis
B.
Creatininuria
C.
Increased activity ALT, АSТ
D.
Presence of MSA
E.
*Lymphocytosis
What is NOT included in Peter’s and Bohan’s criteria of juvenile dermatomiositis?
A.
Symmetrical proximal muscle weakness
B.
Elevated serum enzymes (CK,CPK, LDH, and/or aldolase)
C.
Abnormal EMG (abnormal activity and muscle movements)
D.
Inflammation or necrosis on muscle biopsy
E.
*Hypertermia and intoxication syndrome
What is NOT included in Peter’s and Bohan’s criteria of juvenile dermatomiositis?
A.
Symmetrical proximal muscle weakness
B.
Characteristic skin eruption
C.
Abnormal EMG (abnormal activity and muscle movements)
D.
Inflammation or necrosis on muscle biopsy
E.
*All signs mentioned above are among criteria
Heart pain at dermatomyositis is more frequent caused by all enumerated, EXEPT:
D.
E.
194.
195.
196.
197.
198.
199.
200.
201.
202.
Intercostal myositis
*Stenocardia
Coronaritis
Necrosis of myofibrils
Pericarditis
Limitation of motions at patients with dermatomyositis is due to:
A.
Flexors hypertonia
B.
Atrophy of muscles
C.
*Pain in muscles
D.
Pain in joints
E.
Damage of innervation
The characteristic skin changes at dermatomyositis are named:
A.
Livedo reticularis
B.
Nodular erythema
C.
Annular erythema
D.
«Butterfly»-rash
E.
*Heliotrope erythema
Calcinosis at dermatomyositis can develop mainly in:
A.
Kidneys
B.
Cardiac muscl
C.
Lung
D.
*Perypheral muscle
E.
Joints
A.
B.
C.
D.
E.
203.
204.
205.
206.
Dermatomyositis is more frequently seen in:
A.
*Girls
B.
Boys
C.
Newborns
D.
Preschoolers
E.
Teenagers
207.
What of the following is NOT the systemic scleroderma symptom?
A.
Raynaud's phenomenon
B.
*Weakness of the proximal muscles
C.
Thickening, hardening, and discoloration of the skin
D.
Ulcers in the oral cavity
E.
Swelling of the fingers, hands, forearms
What of the following is the systemic scleroderma symptom?
A.
Symmetrical proximal muscle weakness
B.
*Thickening, hardening, and discoloration of the skin
C.
Abnormal EMG (abnormal activity and muscle movements)
D.
Inflammation or necrosis on muscle biopsy
E.
Leukocytosis and eosynophilia in peripheral blood
What medicine is used for the basic therapy of systemic scleroderma?
A.
Delagyl
B.
*Penicillamine
C.
Methotrexate
D.
Ibuprofen
E.
Prednisolone
?Etiology of chronic gastroduodenitis is:
A.
Streptococcus
B.
Staphylococcus
C.
*Helicobacter pylori
D.
E. coli
E.
Candida
208.
209.
210.
211.
212.
213.
214.
215.
216.
217.
218.
219.
Name aggressive factor of the stomach mucus membrane damage:
A.
*HCl
B.
Mucus production
C.
Prostaglandin Е2
D.
Bicarbonates
E.
NaCl
Name aggressive factor of the stomach mucus membrane damage:
A.
*Pepsin
B.
Mucus production
C.
Prostaglandin Е2
D.
Bicarbonates
E.
KCl
The regulator of the hydrochloric acid secretion is:
A.
Somastatin
B.
Glucagon
C.
*Gastrin
D.
Insulin
E.
Bicarbonates
Name the factor of the stomach mucus membrane protection:
A.
Pepsin
B.
HCl
C.
*Mucus production
D.
Gastrin
E.
NaCl
Pathogenesis of the gastritis development is:
A.
Increase of mucus production
B.
*Increase of the salt acid secretion
C.
Increase of bicarbonates secretion
D.
Physiological blood stream in a mucus membrane
E.
Decrease of the salt acid secretion
The secret of cells of the stomach mucus membrane consists of:
A.
* HCl
B.
Bicarbonates
C.
Mucus
D.
Endorphins
E.
Blood
Helicobacter pylori is the cause of:
A.
Esophagitis
B.
*Gastritis
C.
Colitis
D.
Hepatitis
E.
Uretritis
Helicobacter pylori is colonized at the:
A.
Cardial part of the stomach
B.
Fundal part of the stomach
C.
Pyloric part of the stomach
D.
*Antral part of the stomach
E.
Esophagus
What enzyme is produced by Helicobacter pylori?
A.
Lactase
B.
*Urease
C.
Peptidase
D.
Lipase
E.
Amylase
220.
221.
222.
223.
224.
225.
226.
227.
228.
Product of urea hydrolyses in the gastric juice is:
A.
Oxygen
B.
*Ammonium
C.
Nitrogen
D.
Chlorine
E.
HCl
What neutralizes the ammonia in the stomach juice?
A.
Pepsin
B.
*HCl
C.
Bicarbonates
D.
Mucus
E.
Ammonium
Name main syndromes of chronic gastritis:
A.
Pain, dyspepsic, hemorrhagic
B.
*Pain, dyspepsic, intoxication
C.
Disuric, dyspepsic, intoxication
D.
Pain, hemorrhagic, dysuric
E.
Pain, dyspepsic, dysuric
At patients with hyperacidic gastritis pain arises up through:
A.
* 15-30 min. after a meal
B.
30-45 min. after a meal
C.
45-60 min. after a meal
D.
1-1.5 hours after a meal
E.
2-2.5 hours after a meal
In the case of increased secretion in patients with gastritis more prominent is:
A.
*Pain
B.
Dyspepsia
C.
Intoxication
D.
Dysuria
E.
Hemorrhagic syndrome
In case of increased secretion in patients with gastritis pain is:
A.
Mild
B.
Dull
C.
Moderate
D.
*Intensive
E.
No intensive
In case of decreased secretion in patients with gastritis pain is:
A.
intensive
B.
*mild
C.
acute
D.
absent
E.
moderate
At patients with duodenitis pain arises up more frequent through:
A.
15-30 min. after a meal
B.
30-45 min. after a meal
C.
45-60 min. after a meal
D.
*1-1.5 hours. after a meal
E.
2-2.5 hours. after a meal
Most frequent localization of pain at gastritis is:
A.
In mesogastrium
B.
Right hypochondria
C.
Left hypochondria
D.
*Epigastria
Hypogastria
Most frequent localization of pain at duodenitis is:
A.
In mesogastrium
B.
Right hypohondrium
C.
*Pyloroduodenal area
D.
Left hypochondria
E.
Hypogastria
Pain on empty stomach is characteristic for patients with:
A.
*Increased acid production
B.
Normal acid production
C.
Decreased acid production
D.
Achlorhydria
E.
Hypochlorhydria
Nightly pains are characteristic for patients with:
A.
*Increased acid production
B.
Normal acid production
C.
Decreased acid production
D.
Achlorhydria
E.
Hypochlorhydria
Predominance of pain above a dyspepsia syndrome is characteristic for gastroduodenitis with:
A.
*Increased acid production
B.
Normal acid production
C.
Decreased acid production
D.
Achlorhydria
E.
Hypochlorhydria
Predominance of dyspepsia above a pain syndrome is characteristic for gastroduodenitis with:
A.
Increased acid production
B.
Normal acid productio
C.
*Decreased acid production
D.
Achlorchydria
E.
Hypochlorhydria
Feeling of overweight in epigastria is characteristic for patients with:
A.
Increased acid production
B.
Normal acid production
C.
*Decreased acid production
D.
Achlorhydria
E.
Hypochlorhydria
Meteorism is characteristic for gastritis with:
A.
Increased acid production
B.
Normal acid production
C.
*Decreased acid production
D.
Achlorhydria
E.
Hypochlorhydria
Constipation is characteristic for gastritis with:
A.
*Increased acid production
B.
Normal acid production
C.
Decreased acid production
D.
Achlorhydria
E.
Hypochlorhydria
Secondary gastroduodenitis develops more frequently on the background of:
A.
Food poisoning
B.
Helicobacter pylori persistency
C.
Parasites invasion
E.
229.
230.
231.
232.
233.
234.
235.
236.
237.
D.
E.
238.
239.
240.
241.
242.
243.
244.
245.
246.
*Other chronic diseases of digestive organs
Gastroenteral enzymopathy
Chronic gastroduodenitis more frequently begins at children in:
A.
The first month of life
B.
The first year of life
C.
*Preschool age
D.
First three years of life
E.
School age
Chronic gastroduodenitis more frequently combines with diseases of:
A.
CNS
B.
*Hepatobiliary system
C.
Respiratory system
D.
Heart and vessels
E.
Urinary system
What syndrome is the most constant in case of chronic gastroduodenitis at children?
A.
*Pain
B.
Dyspepsic
C.
Intoxication
D.
Epithelial
E.
Hemrrhagic
The intensity of dyspepsia at chronic gastroduodenitis in children depends on:
A.
*Secretory function
B.
Age of child
C.
Peculiarities of feeding
D.
Intervals between the receptions of meal
E.
Balanced food ingredients
In case of the decreased stomach juice acidity more frequently is observed:
A.
Constipation
B.
*Diarrhea
C.
Intensive pain
D.
“Hungry” pain
E.
Vomiting
In case of the decreased stomach juice acidity is not characteristic:
A.
Constipation
B.
*Diarrhea
C.
Pain in epigastrium
D.
Belch (regurgitation
E.
Nausea
Classification of the chronic gastroduodenitis by the etiology is:
A.
*Primary and secondary
B.
Inborn and acquired
C.
Postinfectious and alimentary
D.
Widespread and limited
E.
Allergic and toxic
What secretory function in gastritis is the most characteristic for children?
A.
Decreased
B.
Decreased or normal
C.
*Increased or normal
D.
Decreased
E.
Served
What from the instrumental methods is most informative for the diagnostics of chronic
gastroduodenitis
A.
*Esophagogastroduodenoscopy
рН-metry
Breath test
Colonoscop
X-ray of abdomen
In children most rare chronic gastroduodenitis according the endoscopic description is:
A.
Superficial
B.
Hemorrhagic
C.
*Atrophic
D.
Mixed
E.
Erosive
What from the helicobacteriosis diagnostics methods belongs to invasive?
A.
*Biopsy of the stomach mucus membraine with its bacteriological investigation
B.
PCR of feces and saliva
C.
Respiratory tests
D.
Determination of specific immunoglobulines
E.
"Aerotest"
Treatment of children with chronic gastroduodenitis must be (choose the most perfect answer):
A.
Prolonged and intensive
B.
Permanent
C.
*Complex and phased
D.
Stationary
E.
Ambulatory
What does determine duration of the bed regime in case of chronic gastroduodenitis in children?
A.
Severity of dyspepsia
B.
Type of secretion
C.
*Severity of pain syndrome
D.
Age of child
E.
Endoscopic changes
What diet is appointed at the exacerbation of chronic gastroduodenitis?
A.
№1
B.
№5
C.
№ 10
D.
№9
E.
*№ 1A, 1B
What from antacids is the most reasonable to appoint to the children?
A.
Sodium hydrocarbonate
B.
*Aluminium hydrate + Magnesium hydrochloride
C.
Calcium carbonate
D.
Magnesium hydrochloride + Carbonic acid
E.
Carbonic acid
What from the medicine belongs to Н2 histamine-blockers?
A.
*Cimetidin
B.
Maalox
C.
Vicalin
D.
Methacin
E.
Gastropharm
What from medicine belongs to procinetics?
A.
*Domperidon
B.
Panzynorm
C.
Renegast
D.
Bellaspon
E.
Ranitidin
What physical therapy procedure is reasonable to apply to the children with chronic
B.
C.
D.
E.
247.
248.
249.
250.
251.
252.
253.
254.
255.
256.
257.
258.
259.
260.
261.
262.
263.
gastroduodenitis with the expressed pain syndrome?
A.
Ozocerite appliques
B.
Probbing with xylitol
C.
*Electrophoresis with novocaine
D.
Diathermy
E.
Balneotherapy
What from the named medicine is used for Helicobacter pylori eradication?
A.
*De-nol
B.
Maalox
C.
Motilium
D.
Cimetidin
E.
Benzylpenicilliun
The leading symptom of the 1st stage of peptic ulcer disease is:
A.
*Pain
B.
Vomiting
C.
Belch (regurgitation)
D.
Heartburn
E.
Local tension of muscles
The sequence of symptoms at the Moinighan rhythm is the following:
A.
The intake of meal - pain - hunger - relief
B.
*Hunger - pain - the intake of meal - relief
C.
Pain - hunger - the intake of meal - relief
D.
Hunger - relief - the intake of meal - pain
E.
The intake of meal - relief - pain - hunger
?Name the forms of chronic hepatitis at children:
A.
Persistent, active, autoimmune
B.
*Viral, autoimmune, medicinal-induced, toxic
C.
Medicinal, autoimmune, alcoholic
D.
Cryptogenic, viral, toxic
E.
Cryptogenic, autoimmune, toxic, alcoholic
Phases of chronic hepatitis activity are:
A.
Active (minimum, moderate, expressed)
B.
Active (mild, moderate, severe) and nonactiv
C.
*Active (minimum, moderate, expressed) and nonactiv
D.
Active, incomplete clinic-laboratory remission, complete clinic-laboratory remission
E.
Incomplete clinic-laboratory remission, complete clinic-laboratory remission
Amylase level of blood is:
A.
10-15 g/hour/l
B.
*16-32 g/hour/l
C.
33-45 g/hour/l
D.
46-60 g/hour/l
E.
60-90 g/hour/l
To the necessary biochemical researches for patients with the diseases of hepatobiliary system
belong:
A.
General albumen, CRP, seromucoid, bilirubin
B.
*General protein and fractions, transaminases, bilirubin, cholesterol
C.
General protein and fractions, urea, creatinin, cholesterol
D.
General protein and fractions, CRP, seromucoid, urea
E.
General protein and fractions, CRP, cholesterol
The syndrome of "cytolysis" includes:
A.
*Increase of the АsАТ level, АlАТ, LDG, iron, bilirubin
B.
Increase level of cholesterol, iron, LDG
C.
Decrease level of proteins, cholesterol, bilirubin, СRP
Decrease level of iron, СRP, remaining nitrogen, АsАТ, АlАТ
Decrease of the АsАТ level, АlАТ, LDG, iron, bilirubin
Name basic clinical signs of cholestasis syndrome:
A.
*Jaundice, skin itching
B.
Jaundice, hepatosplenomegaly
C.
Pallor, jaundice, hepatosplenomegaly
D.
Stomach-aches, jaundice
E.
Pallor, skin itching
Markers of the chronic hepatitis С are:
A.
HBe Ag, HBs Ag, HBV-DNA, anti-HBe Ig G, anti-HBs Ig G
B.
HAV-RNA, anti-HAV Ig M, anti-HAV Ig G
C.
*HСV-RNA, anti-HСV Ig M
D.
HBs Ag, HDV-RNA, anti-HDV Ig M, anti-HBe Ig M
E.
HGV-RNA, anti-E2 HGV
Markers of the chronic hepatitis D are:
A.
HBe Ag, HBs Ag, HBV-DNA, anti-HBe Ig G, anti-HBs Ig G
B.
HAV-RNA, anti-HAV Ig M, anti-HAV Ig G
C.
HСV-RNA, anti-HСV Ig M
D.
*HBs Ag, HDV-RNA, anti-HDV Ig M, anti-HBe Ig M
E.
HGV-RNA, anti-E2 HGV
Markers of the chronic hepatitis G are:
A.
HBe Ag, HBs Ag, HBV-DNA, anti-HBe Ig G, anti-HBs Ig G
B.
HAV-RNA, anti-HAV Ig M, anti-HAV Ig G
C.
HСV-RNA, anti-HСV Ig M
D.
HBs Ag, HDV-RNA, anti-HDV Ig M, anti-HBe Ig M
E.
*HGV-RNA, anti-E2 HGV
What color of feces is in case of viral hepatitis?
A.
Bright-yellow
B.
Dark-brown
C.
*Clays color
D.
Mud-color
E.
Black
What medicine does belong to interferons?
A.
Essentiale
B.
Cholenzym
C.
*Intron A
D.
Carsyl
E.
Prednisolon
Viferon is the medicine of group:
A.
Glucocorticoids
B.
Antibiotics
C.
Antihystamine
D.
*Interferon
E.
Vitamins
Main treatment of autoimmune hepatitis is:
A.
Antiviral therapy
B.
*Immunesuppressive therapy
C.
Antibiotic therapy
D.
Immunomodulators
E.
Antihystamines
What medicine with immune suppressive effect will you use for treatment of chronic hepatitis?
A.
*Prednisolon
B.
Voltaren
D.
E.
264.
265.
266.
267.
268.
269.
270.
271.
272.
Cycloferon
Essential
Vitamins
What medicine does belong to immune suppressive therapy of chronic hepatitis?
A.
Indomethacin
B.
*Azatioprin
C.
Penicillin
D.
Cholenzym
E.
Vitamins
Primary dyskinesia of bile ducts is connected with:
A.
Pathology of stomach
B.
Pathology of duodenum
C.
Pathology of large intestine
D.
*Neurohumoral regulation dysfunction
E.
Pathology of esophagus
Secondary dyskinesia of bile ducts is connected with:
A.
Neurohumoral regulation dysfunction
B.
Disorder of the vegetative nervous system
C.
*Pathology of stomach and duodenum
D.
Pathology of hypophysis
E.
Pathology of esophagus
At the decreased synthetic function of liver is observed:
A.
*Hypoalbuminemia, decreased levels of fibrinogen and protrombin
B.
Hyperbilirubinemia, decreased levels of fibrinogen and protrombin
C.
Hypoalbuminemia, hypercholesterolemia, hyperazotemia
D.
Hyperbilirubinemia, hypercholesterolemia, hyperazotemia
E.
Hyperalbuminemia, decreased levels of fibrinogen and protrombin
About the decreased detoxication function of liver testifies:
A.
Hyperbilirubinemia, hypoproteinemia, hypoazotemia
B.
Hyperbilirubinemia, hypoproteinemia, hypophenolemia
C.
*Hyperazotemia, hyperphenolemia, hyperamiakemia
D.
Hypoazotemia, hyperphenolemia, hypoamiakemia
E.
Hypoazotemia, hypophenolemia, hyperamiakemia
Ultrasonography signs of hypotonic form of bile ducts dyskinesia are:
A.
Increase of liver
B.
*Enlarged goal bladder
C.
Goal bladder is diminished in sizes
D.
Diminishment of liver
E.
Decrease of liver
Ultrasonography signs of hypertonic form of bile ducts dyskinesia are:
A.
Increase of liver
B.
Diminishment of liver
C.
*Goal bladder is diminished in sizes
D.
Enlarged goal bladder
E.
Decrease of liver
In treatment of hypotonic form of bile ducts dyskinesias apply:
A.
Analgetics
B.
Spasmolitics
C.
*Choleretics and cholekinetics
D.
Hepatoprotectors
E.
Vitamins
In treatment of hypertonic form of bile ducts dyskinesias apply:
A.
Analgetics
C.
D.
E.
273.
274.
275.
276.
277.
278.
279.
280.
281.
B.
C.
D.
E.
282.
283.
284.
285.
286.
287.
288.
289.
290.
*Spasmolitics and sedatives
Antibiotics
Hepatoprotectors
Vitamins
Etiology of chronic cholecystocholangitis is:
A.
Streptococcus
B.
Viruses
C.
*E. coli
D.
Micopolasms
E.
Staphylococcus
Chronic cholecystocholangitis is the chronic inflammation of:
A.
Stomach and duodenu
B.
Stomach and goal bladder
C.
*Goal bladder and bile ducts
D.
Goal bladder and pancreas
E.
Stomach and bile ducts
Leading syndromes in case of chronic cholecystocholangitis are:
A.
Pain, dysuria
B.
*Pain, dyspepsia
C.
Toxic, hemorrhagic
D.
Dyspepsia, dysuria
E.
Pain, toxic
Presence of vascular asterisks is characteristic for:
A.
Gastritis
B.
Duodenitis
C.
*Cholecystocholangitis
D.
Bile ducts dyskinesia
E.
Colitis
Toxic syndrome is more characteristic for:
A.
Bile ducts dyskinesia
B.
*Cholecystocholangitis
C.
Gastritis
D.
Duodenitis
E.
Colitis
Enlargement of liver is typical for:
A.
Bile ducts dyskinesia
B.
*Cholecystocholangitis
C.
Gastritis
D.
Pancreatitis
E.
Colitis
Medicine of choice at the cytolitic syndrome is:
A.
*Essentiale
B.
Cholenzym
C.
Interferon
D.
No-spa
E.
Papaverin
Medicine of choice at cholestasis is:
A.
Essentiale
B.
Carsil
C.
No-spa
D.
*Cholenzym
E.
Papaverin
Medicine of choice at the low synthetic function of liver is:
Essentiale
*Carsyl
Cholenzym
Interferon
Papaverin
Distension of the skin capillaries on the back is characteristic for:
A.
Bile ducts dyskinesia
B.
*Cholecystocholangitis
C.
Gastritis
D.
Duodenitis
E.
Colitis
Medicine of choice in case of lambliosis (giardiasis) is:
A.
Gentamycin
B.
Penicillin
C.
Aspirin
D.
*Furasolidon
E.
Papaverin
Causes of secondary chronic pancreatitis are:
A.
Viral-bacterial infections
B.
*Liver pathology
C.
Allergic factors
D.
Medicinal damages
E.
Traumas of stomach
Localization of pain at chronic pancreatitis:
A.
In the right subcostal area
B.
In the left subcostal area
C.
*In epigastrium
D.
In the left inguinal area
E.
In the right inguinal area
Typical point tenderness at chronic pancreatitis is:
A.
Mendehl
B.
*Mayo-Robson
C.
Kehr
D.
Orthner
E.
Maslov
What symptom is a positive at chronic pancreatitis?
A.
*Shoffar
B.
Mendehl
C.
Orthner
D.
Musse-Georgievsky
E.
Kehr
Feces at chronic pancreatitis are:
A.
Solid
B.
Thick
C.
*Porridge-like or liquid
D.
Putty-like
E.
Normal
Chronic pancreatitis is characterized by:
A.
Hyperbilirubinemia
B.
*Hyperamylasemia
C.
Hypoamylasemia
D.
Hypercholesterolemia
E.
Hypobilirubinemia
A.
B.
C.
D.
E.
291.
292.
293.
294.
295.
296.
297.
298.
299.
300.
301.
302.
303.
304.
305.
306.
307.
Steatorrhea is characteristic for:
A.
Gastritis
B.
Hepatitis
C.
Colitis
D.
*Pancreatitis
E.
Esophagatis
Kreatorrhea is characteristic for:
A.
Gastritis
B.
Hepatitis
C.
Colitis
D.
*Pancreatitis
E.
Esophagatis
Diastasuria is characteristic for:
A.
Hepatitis
B.
Cholecystitis
C.
*Pancreatitis
D.
Colitis
E.
Esophagatis
For correction of endotoxic shock in the patients with pancreatitis is used:
A.
Albumen
B.
*Rheopoliglucin
C.
Crioprecipitate
D.
Haemodes
E.
Heparin
What parasites may not be present in bile?
A.
Giardia
B.
Opistarchosis
C.
Stroingyloides
D.
*Ascaridosis
E.
All may be present
?All of the following conditions are cause of glomemlonephritis, except:
A.
*Allergies
B.
Bacterial infection
C.
Viral
D.
Fungal
E.
Vaccination
Which symptom is the criterion of nephritic variant of acute glomerulonephritis?
A.
*А. Hematuria
B.
В. Leucocyturia
C.
С. Bacteruria
D.
Anasarca
E.
Proteinuria more than 3g per day
What investigation must be performed to confirm the kidneys dysfunction during chronic
glomerulonephritis?
A.
General analysis of urine
B.
*Endogenous creatinin clearance
C.
Nechiporenko test
D.
Estimation of daily proteinuria
E.
Estimation of cholesterol
What dose of heparin is necessary to prescribe for treatment of acute glomerulonephritis?
A.
50-100 IU/kg
B.
*100-300 IU/kg
C.
10-20 IU/kg
500-600 IU/kg
250-500 IU/kg
Which syndrome is contraindication for prescribing of heparin?
A.
Nephrotic syndrome of acute glomerulonephritis
B.
Mixed form of chronic glomerulonephritis
C.
Sub acute malignant glomerulonephritis
D.
*Aplastic anemia
E.
Nephrotic syndrome of chronic glomerulonephritis
Which position is incorrect in relation to treatment of nephrotic syndrome:
A.
Corticosteroid therapy is appointed
B.
The dose of diuretics is depending from an effect
C.
*To all patients with nephrotic syndrome it is necessary to prescribe cytostatics
D.
During the expressed edema and hyper coagulation it is necessary to prescribe heparin
E.
It is necessary to prescribe cytostatics according the needing
During the hormone depending nephrotic form of chronic glomerulonephritis it is necessary to
prescribe with the prednisolone:
A.
Non-steroid antiinflamation drugs
B.
Preparates of aminohinoline group
C.
*Cytostatics
D.
Heparin
E.
Curantil
Which method of research is most informing at the syndrome of malignant hypertension?
A.
X-ray of kidneys
B.
Excretory X- ray of kidneys
C.
*Angiography
D.
Ultrasound investigation of kidneys
E.
Biochemical analysis of blood
Which position is incorrect relatively to nephritic variant of edema syndrome?
A.
Edema syndrome more frequent is moderately expressed
B.
In. the basic of mechanism of such edema is violation of the vascular penetrating
C.
*In the basic of mechanism of such edema is hypoproteinemia
D.
In the basic of mechanism of such edema hypoproteinemia is not important
E.
In. the basic of mechanism of such edema is increase of pressure
Excretory urography allows estimate:
A.
Anatomical state of urinary tract and urodinamics
B.
State of nephrons
C.
Functional state of urinary tract
D.
State of urinary bladder
E.
Functional state of urodinamics
Which variant of therapy is most expedient during the mixed form of chronic glomerulonephritis?
A.
Monotherapy of prednizolone
B.
*Prednisolone and cytostatics
C.
Prednisolone and heparin
D.
Prednisolone and heparin with curantil
E.
Prednisolone and heparin with curantil and cytostatics
Which position is incorrect in relation to treatment of nephrotic syndrome?
A.
Corticosteroid therapy is appointed
B.
The dose of diuretics depends of effect
C.
*Cytostatics are prescribing to all patients
D.
During edema syndrome and hypercoagulation it is necessary to prescribe heparin
E.
Cytostatics are prescribing only according indications
Violation of desintoxication function of kidneys in the beginning of glomerulonephritis is
characteristic for:
D.
E.
308.
309.
310.
311.
312.
313.
314.
315.
316.
Isolated urinary syndrome
*Nephritic syndrome
Nephrotic syndrome
Mixed form
Nephrotic syndrome with arterial hypertension
Which biochemical test can’t demonstrate activity of inflammatory process of
glomerulonephritis?
A.
Protein and its fractions
B.
C – reactive protein
C.
Seromucoid
D.
ESR
E.
*Ca and P of blood
The children of school age have normal content of urea in the blood:
A.
21,44-32,76 mmol/l
B.
3,33-8,32 mmol/l
C.
15,66-17,45 mmol/l
D.
1,76-2,87 mmol/l
E.
2,43-3,76mmol/l
The children of school age have normal content of creatinine in the blood:
A.
*Up to 0,1 mmol/l
B.
2,1-3,2 mmol/l
C.
4,3-7,3 mmol/l
D.
15,0-17,3 mmol/l
E.
4,2- 1,1 mmol/l
Which formula is necessary for the calculation of day's amount of urine for children?
A.
*600+100(n-1), where n-amount of years
B.
500х(n+5), where n-amount of years
C.
mass +10
D.
600х(n+5), where n-amount of years
E.
600х(n+10), where n-amount of years
Excretory urography does not allow discover:
A.
Position, sizes, form of kidneys
B.
State of nephrons
C.
Functional state of urinary tract
D.
Anomaly of kidney vessels
E.
State of urinary bladder
What is the main feature of kidney edema?
A.
Appears at morning, warm, pale
B.
Appears in the second half of day, cold, cyanotic
C.
Dense
D.
Disposed mainly on trunk
E.
Disposed mainly on place or sex organs
Kidney angiography is the main investigation for:
A.
Suspicion on the defects of development or disease of vessels
B.
Arterial hypertension
C.
Nephroptosis
D.
Nephritis
E.
Glomerulonephritis
What is the normal correlation between daily and nightly dieresis?
A.
1:1
B.
2:1
C.
3:1
D.
4:1
A.
B.
C.
D.
E.
317.
318.
319.
320.
321.
322.
323.
324.
1:2
Which drug do we use for pathogenetical treatment of nephrotic syndrome?
A.
*Prednisolone
B.
Penicillin
C.
Curantil
D.
Suprastin
E.
Ascorutin
Which diet is necessary prescribes during acute glomerulonephritis?
A.
1
B.
2
C.
3
D.
*7
E.
5
What reason of glomerulonephritis is the more often?
A.
*Streptococcus
B.
Staphylococcus
C.
E.Соlі
D.
Virus of hepatitis A
E.
Virus of flu
What is the main pathogenetical mechanism of development of glomerulonephritis?
A.
Bacterial inflammation
B.
Allergy reaction
C.
*Immunocomplex damaging
D.
Violation of passage of urine
E.
Reflux
Which symptom is not characteristic for glomerulonephritis?
A.
Pain in back
B.
*Pain during the act of urination
C.
Hypertension
D.
Edema
E.
Oliguria
For nephrotic variant of acute glomerulonephritis is characteristic:
A.
Hypoglycemia
B.
Hyperbilirubinemia
C.
*Hyperlipidemia
D.
Azotemia
E.
Hypocalcaemia
Which level of proteinuria is the criterion of nephrotic variant of acute glomerulonephritis?
A.
*3 g/l and more
B.
2-3 g/l
C.
1-3 g/l
D.
Up to 1 g/l
E.
0,5-2 g/l
Which symptom isn’t characteristic for isolated urine syndrome during acute glomerulonephritis:
A.
Proteinuria
B.
Erythrocyturia
C.
Cylindruria
D.
Absence of extra renal signs
E.
*Leucocyturia
Which investigation is demonstrates the concentration function of kidneys?
A.
General analysis of urine
B.
Analysis of urine by Nechiporenko
C.
*Analysis of urine by Zimnitskiy
E.
325.
326.
327.
328.
329.
330.
331.
332.
333.
Ultrasound investigation of kidneys
Biochemical analysis of blood
Which sign does give information about the damaging of function of kidneys?
A.
Hypoproteinemia
B.
Proteinuria
C.
*Asotemia
D.
Hyperlipidemia
E.
Hyperglycemia
Recovering after acute glomerulonephritis is the period of clinical and laboratory remission
during:
A.
1 year
B.
*3 years
C.
5 years
D.
2 years
E.
6 months
The main criterion of hematuric form of chronic glomerulonephritis is:
A.
Arterial hypertension
B.
Proteinuria
C.
*Hematuria
D.
Cylindruria
E.
Leucocyturia
Severe edema syndrome is most characteristic for:
A.
*Nephrotic syndrome
B.
Nephritic syndrome
C.
Mixed form of chronic glomerulonephritis
D.
Hematuric form
E.
Isolated urinary syndrome
What is the reason of pain during glomerulonephritis:
A.
Inflammation syndrome
B.
Stagnation of urine
C.
*Enlargement of capsules of kidneys
D.
Physical exertion
E.
Hematuria
Which medicine do we use during pathogenetical treatment of nephritic variant of
glomerulonephritis?
A.
Reserpin
B.
Lasix
C.
Tavegil
D.
Delagil
E.
*Prednisolone
Which dose of indometacin is use for treatment of nephritic variant of glomerulonephritis?
A.
*2-3 mg/kg/day
B.
1-2 mg/kg/day
C.
3 – 5 mg/kg/day
D.
0,5 – 1 mg/kg/day
E.
0,8 – 1 mg/kg/day
It is nessesary to prescribe imunosupressors during acute glomerulonephritis in the case of:
A.
Suddenly beginning of disease
B.
Severe proteinuria
C.
*The absence of effect from the treatment of prednisolone during 3-4 weeks in the case of
nephrotic variant
D.
The absence of effect from the treatment of prednisolone during 3-4 weeks in the case of
nephritic variant
D.
E.
334.
335.
336.
337.
338.
339.
340.
341.
The damaging of functions of kidneys at the beginning of disease
Severe edema syndrome is more characteristic for:
A.
Myocarditis
B.
*Glomerulonephritis
C.
Pyelonephritis
D.
Kidney stones disease
E.
Cystitis
The Zimnitski test of urine gives information about:
A.
*Concentration function
B.
Bacteruria
C.
Leucocyturia
D.
Erithrocyturia
E.
Glucosuria
Which from these products are eliminated in a diet 7?
A.
Rice
B.
Porridge
C.
Vegetable puree
D.
Egg
E.
*Meat
What from diseases more frequent can result in development of chronic kidney insufficiency?
A.
Kidney stones disease
B.
Metabolic nephropathies
C.
Reflux
D.
*Glomerulonephritis chronic
E.
Oxalaturia
The middle age dose of lasix is:
A.
*1-2 mg/kg/day
B.
4-5 mg/kg/day
C.
10 mg/kg/day
D.
0,5-1 mg/kg/day
E.
0,5mg/kg/day
What test is used to confirm filtration function of kidneys?
A.
Urinanalysis
B.
Nechiporenco
C.
Zimnitski test
D.
*Creatinine clerance test
E.
Rebergs test
The most frequent complication of hereditary nephropathy is:
A.
ARF
B.
Pyelonephrosis
C.
*CRF
D.
Nephrolithiasis
E.
Amiloidosis of kidneys
The development of hereditary nephropathy is often associated with:
A.
Sex chromosome abnormality
B.
*Gene mutations
C.
Chronic inflammatory diseases of the mother
D.
Measles of pregnant women
E.
Change of the number of chromosomes
What is Alport syndrome?
A.
Cystic kidneys
B.
*Hereditary nephritis with deafness
C.
Hereditary nephritis without deafness
E.
342.
343.
344.
345.
346.
347.
348.
349.
350.
Renal diabetes
Embryonic kidney tumor
What kidney disease is disease with chromosomal aberrations?
A.
Hereditary nephritis
B.
Primary tubulopathy
C.
Secondary tutulopathy
D.
Renal amyloidosis
E.
*Cystic kidneys
Disease caused by gene mutations is:
A.
*Hereditary nephritis
B.
Primary tubulopathy
C.
Secondary tubulopathy
D.
Renal amyloidosis
E.
Cystic kidneys
Secondary tubulopathy is observed at:
A.
Phosphate-diabetes
B.
Tubulyar renal acidosis
C.
Disease de Toni-Debrae-Fanconi
D.
Hereditary nephritis
E.
*Galaktozemia
Hereditary nephritis is inherited by:
A.
*Dominant type, connected with the X chromosome
B.
Recessive type, connected with the X chromosome
C.
Dominant type, connected with Y chromosome
D.
Recessive type, connected with Y chromosome
E.
Autosomal recessive type
The basis of the pathogenesis of hereditary nephritis is:
A.
Inflammatory process in glomerulars
B.
*Dysembriogenesis of connective tissue
C.
Violation of intravascular coagulation in glomerular capillaries
D.
Failure of proximal tubules in reabsorbtion of bicarbonates
E.
Violation of the process in tubular transport
Most distinctive feature of the initial period of hereditary nephritis is:
A.
Leukocyturia
B.
Bacteriuria
C.
*Microhematuria
D.
Oxaluria
E.
Uraturia
What symptom is observed at initial period of hereditary nephritis?
A.
*Vascular hypotension
B.
Hypertension
C.
Polyuria
D.
Oliguria
E.
Edema
Hereditary nephritis with deafness is called:
A.
Disease-de Toni- Debrae- Fanconi
B.
Berger's disease
C.
*Alport syndrome
D.
Harnupa disease
E.
Leu syndrome
Which extrarenal signs do point the possibility of hereditary nephritis at presence of urinary
syndrome?
A.
*Stigmes of dyzembriogenesis
D.
E.
351.
352.
353.
354.
355.
356.
357.
358.
359.
Edema of legs
Skin edema
Increased AP
Haemorrhagic rash
The diagnostic criterion of hereditary nephritis does not include:
A.
Urinary Syndrome
B.
Deafness
C.
Dysmorphies
D.
*Prior tonsillaties
E.
Similar illness in family
For urinary syndrome at hereditary nephritis is not typical:
A.
*Bacteriuria
B.
Microhematuria
C.
Poteinuria
D.
Macrohematuria
E.
Cylindruria
Hereditary nephritis typically ends with:
A.
Recovering
B.
Formation of pyelonephrosis
C.
*CRF
D.
Development of urolithiasis
E.
Acute renal failure
Rickets like changes among hereditary nephropathy are often found at:
A.
Cystic kidneys
B.
*Phosphate-diabetes
C.
Renal without hereditary deafness
D.
Renal with hereditary deafness
E.
Renal amyloidosis
What is not characteristic for hereditary nephritis?
A.
*Edema
B.
Arterial hypotension
C.
Hematuria
D.
Proteinuria
E.
Dyzmorphies
The main criterion of differential diagnose of hereditary nephritis is:
A.
*Genetic anamnesis
B.
Hematuria
C.
Proteinuria
D.
Previous renal colic attacks
E.
Hypertension
At hereditary nephritis connection of bacterial infection in children leads to:
A.
Azotemia
B.
Cylindruria
C.
*Piuria
D.
Hypoproteinemia
E.
Crystaluria
The main role in etiology of pielonephritis plays:
A.
*Bacteria
B.
Viruses
C.
Micoplasma
D.
Parasites
E.
Fungi
What from such drugs is not used at treatment of acute pyelonephritis?
B.
C.
D.
E.
360.
361.
362.
363.
364.
365.
366.
367.
368.
Antibiotics
Uroseptics
*Hormones
Antiinflamation drugs
Diet
What from such drugs is ineffective at treatment of pyelonephritis?
A.
Ampicillin
B.
Amicin
C.
Cefatoxin
D.
*Levomicetin
E.
Loracin
What from these signs do not present at pyelonephritis?
A.
Leucocytosis
B.
Leucocyturia
C.
Little proteinuria
D.
*Hematuria
E.
Bacteriuria
What sign gives information about the damaging of kidneys function?
A.
Hypoproteinemia
B.
Proteinuria
C.
*Azotemia
D.
Hyperlipidemia
E.
Hyperglycemia
In oxalaturia it is necessary to eliminate from ration:
A.
Potatoes
B.
*Sorrel
C.
Cabbage
D.
Pea
E.
Mushrooms
What diet it is necessary prescribe during acute pyelonephritis?
A.
1
B.
2
C.
3
D.
7
E.
*5
The main sign of pielonephritis is:
A.
Leukocyturia
B.
Hematuria
C.
Erythrocyturia
D.
Proteinuria
E.
Cylindruria
Excretory urographia allows to estimate:
A.
*Anatomical state of urinary tract and urodinamics
B.
State of nephrons
C.
Functional state of urinary tract
D.
State of urinary bladder
E.
Functional state of urodinamics
At what pathology ultrasound research is most informing?
A.
*Kidney tumor
B.
Hydronephrotic transformation
C.
Glomerulonephritis
D.
Pielonephritis
E.
Cystitis
A.
B.
C.
D.
E.
369.
370.
371.
372.
373.
374.
375.
376.
377.
378.
379.
380.
381.
382.
383.
384.
385.
What is predispositive factor of the development bladder-urether-pelvis reflux in children?
A.
*Anatomic immaturity of urether orifice
B.
Intravesicular obstruction
C.
Neurogenic dysfunction of urine bladder
D.
Recanalization in violation of urethers in embriogenesis
E.
All transferred
What is the etiologic factor of primary tubulopathy?
A.
Microbs
B.
*Violation of membrane substances inrenal tubules
C.
Reflux
D.
Anatomic anomaly of kidney
E.
Insufficiency of podotcytes
Which of the following pathogenic mechanisms occur at chronic obstructive pyelonephritis in
children?
A.
Immune damage of the glomerular capillaries of the kidneys
B.
*Malformations of the urinary system, impeding outflow of urine
C.
Fatty degeneration of the epithelium of tubules
D.
Reflux
E.
All transferred
Which of the following symptoms are typical for acute pyelonephritis in children?
A.
Proteinuria more than 3g / day
B.
Macrohematuria and bacteriuria
C.
Microhematuria and bacteriuria
D.
Microhematuria and proteinuria
E.
*Pyuria and bacteriuria
What system of organism is damaged first of all at renal failure?
A.
Cardiovascular
B.
CNS
C.
Digestive
D.
Respiratory
E.
*All equally
What symptom is uncommon at cystitis in children?
A.
*Blood in urine
B.
Fever
C.
Vomiting or diarrhea
D.
Crying, going off feeds and generally unwell
E.
Appear to be in pain
What is the main feature of urine infection in children?
A.
Leucocyturia
B.
*Bacteriuria
C.
Erythrocyturia
D.
Cylindruria
E.
All transferred
The main task of therapy of acute cystitis in children should be directed to:
A.
The elimination of pain
B.
Normalization of urination disorders
C.
Elimination of microbial-inflammatory process in the bladder
D.
Liquidation of spasms
E.
*All transferred
Urethritis almost always occurs in children:
A.
First year old
B.
Preschoolers
C.
*Before puberty
14-17 years old
Of all age groups
What is not characteristic for urethritis in children?
A.
Discomfort, stinging, or burning when urinating
B.
Feeling an urgent and frequent need to urinate
C.
*Fever
D.
Itching in the genital area
E.
Pain in the genital area
What are the main causes of urethritis in children?
A.
Irritation by chemicals in bubble bath
B.
Shampoo left on the genital area
C.
Soap left on the genital area
D.
Urinary tract infections
E.
*All transferred
Pyelonephritis is distinguishing from low urinary infection by:
A.
Fever more than 38,5°С
B.
Leukocytosis and increasing of ESR
C.
Increasing of concentration function of kidneys
D.
Proteinuria and aminoaciduria
E.
*All transferred
?The main symptom of chronic bronchitis is:
A.
Hyperthermia
B.
Wheezing
C.
*Prolonged cough
D.
Dyspnea
E.
Intoxication
What is the most important reason of all organs and systems dysfunction in chronic lung disease
in children?
A.
Surfactant deficiency
B.
*Hypoxia
C.
Intoxication
D.
Hemodynamic disorders
E.
Immunity impairment
What symptom is the sign of the continuous hypoxemia?
A.
Cyanosis of nasolabial triangle
B.
Acrocyanosis
C.
Wet cough in the morning
D.
Total cyanosis
E.
*Deformation of the terminal phalanges as "drumsticks" and "watch glasses"
What are the auscultation signs of chronic lung disease in children?
A.
A variety of wheezes
B.
A variety of dry and moist rales
C.
*Permanent local fine rales
D.
Amphoric breathing
E.
Crepitation
What X-ray changes are characteristic for chronic lung disease in children?
A.
Infiltration of lung tissue in basal areas
B.
Lung tissue infiltration on the tops of the lungs
C.
Availability of cavities
D.
*Increased and deformation of the lung pattern
E.
Scanty lung pattern
What is the leading component of complex treatment of chronic lung disease in children?
A.
Antibacterial therapy
D.
E.
386.
387.
388.
389.
390.
391.
392.
393.
394.
B.
C.
D.
E.
395.
396.
397.
398.
399.
400.
401.
402.
403.
*Restoration of bronchial drainage function
General stimulation therapy
Therapeutic feeding
Immune therapy
Final diagnose of pulmonary hypoplasia is based on:
A.
*Bronchography
B.
Bronchoscopy
C.
X-ray examination
D.
US observation of lungs
E.
CT-scan
What is NOT typical for lung agenesia?
A.
Cyanosis
B.
The heart is shifted towards the lesion
C.
On the lesion side thorax is flattened, and the healthy half is convex
D.
*On the lesion side thorax is convex, and the healthy half is flattened
E.
Nail "drumsticks" on phalanges
The incidence of lung hypoplasia is higher in:
A.
Big birth weight infants
B.
Low birth weight infants
C.
Newborns after pathological pregnancy
D.
Newborns after pathological delivery
E.
*Preterm infants
Pulmonary hypoplasia occurs as a result of:
A.
Oligohydramnios
B.
Potter’s syndrome
C.
Abnormalities of the thoracic cage
D.
Diaphragmatic hernia
E.
*All mentioned above
What does predominate in the clinical presentation of cystic adenomatous malformation?
A.
Hypoxia
B.
Respiratory acidosis
C.
*Disturbance of the bronchial drainage function
D.
Arrhythmic respiration
E.
Respiratory failure
What examinations are the most important in cystic adenomatous malformation
A.
Chest X-ray and CT-scan
B.
Bronchoscopy and chest X-ray
C.
Chest X-ray and bronchography
D.
*CT-scan and bronchography
E.
Bronchoscopy and bronchography
What complication may occur at cystic adenomatous malformation?
A.
Infection
B.
Hemorrhage
C.
Acute respiratory failure
D.
Neoplastic transformation
E.
*All mentioned above
Choose the wrong statement about cystic adenomatous malformation?
A.
Cysts may be filled with air or fluid
B.
*Cysts can not be asymptomatic
C.
Cysts arise from an abnormal budding of the ventral foregut
D.
Such complications as infection, hemorrhage, and malignancy can occur
E.
Dysphagia and epigastric discomfort can occur
What is not characteristic for cystic adenomatous malformation?
Dullness of percussion sounds
Respiratory failure
Auscultation with the weakening of breath
Wheezing of various sizes
*Dry rales
What is pulmonary sequestration?
A.
Increasing of the number of lobes
B.
Increasing of the mass of lobes
C.
Histological changes of lung tissue
D.
*Benign mass of non-functioning lung tissue
E.
Intralobar malformation
What is the predominant localization of pulmonary sequestration?
A.
*Left lower lobe
B.
Left upper lobe
C.
Right lower lobe
D.
Right upper lobe
E.
Right middle lobe
What is NOT typical for pulmonary sequestration?
A.
Chronic cough
B.
Recurrent pneumonias
C.
Poor exercise resistance
D.
*Pain in the chest
E.
Congestive cardiac failure
What is the reason of chronic cough in children with pulmonary sequestration?
A.
Compression of the lung tissue
B.
Decreased mucociliary clearan
C.
*Recurrent respiratory tract infections
D.
Disturbance of the drainage function
E.
All mentioned above
Choose the gastrointestinal sign of pulmonary sequestration?
A.
Vomiting
B.
Failure to thrive
C.
Abdominal pain
D.
Poor appetite
E.
*All mentioned above
What is the main distinguishing feature of sequestration of the lung?
A.
Progressive respiratory failure
B.
Chronic cough
C.
Recurrent respiratory tract infections
D.
*Additional large vessel
E.
Small bubbling (moist) rales
The main diagnostic value at sequestration of the lung has:
A.
*Angiography
B.
Bronchoscopy
C.
X-ray
D.
Bronchography
E.
CT
Choose the wrong statement about surgical treatment at sequestration of the lung:
A.
Can be recommended for asymptomatic patients
B.
Is obligatory after diagnostics
C.
Is recommended in compression of normal lung mass
D.
It is preventive measure
E.
*Should be performed only in patients with recurrent infections
A.
B.
C.
D.
E.
404.
405.
406.
407.
408.
409.
410.
411.
412.
413.
414.
415.
416.
417.
418.
419.
420.
What is the main distinguishing clinical feature of Mounier-Kuhn syndrome
(tracheobronchomegaly)?
A.
Attacks of spasmodic cough
B.
Dry unproductive cough
C.
Wet unproductive cough
D.
*Brassy paroxismal cough
E.
Dry cough
What is the main distinguishing clinical feature of tracheobronchomegaly?
A.
Spasmodic cough
B.
Dry unproductive cough
C.
Wet unproductive cough
D.
*Brassy paroxismal cough
E.
Dry productive cough
What auscultation data are characteristic for tracheobronchomegaly?
A.
Fine moist rales
B.
Crepitation
C.
Dry rales
D.
*Variety of wheezing
E.
All mentioned above
Choose the best method of tracheobronchomegaly diagnostics?
A.
Chest x-ray
B.
*Bronchoscopy
C.
Chest ultrasound
D.
Chest CT-scan
E.
Angiography
Choose the synonym of the Williams– Campbell syndrome:
A.
Tracheobronchomegaly
B.
Sclerotic changes in the peribronchial tissues
C.
Deformation of trachea and bronchi
D.
Expansion of the lumen of the trachea and main bronchi
E.
*Congenital generalized bronchiectasis
What is the reason of Williams– Campbell syndrome?
A.
*Bronchial cartilage defect
B.
Bronchial muscular defect
C.
Mucociliary clearance insufficiency
D.
Atrophy of the longitudinal elastic fibres
E.
Disturbance of the bronchial drainage function
What is the typical localization of pathological process at Williams– Campbell syndrome?
A.
Upper lobes of lungs
B.
*Low lobes of lungs
C.
Middle lobe of right lung
D.
Mediastinum
E.
Trachea
Choose RIGHT statement about Williams– Campbell syndrome.
A.
The clinical signs are typical for bronchial obstruction
B.
Bronchopulmonary infection is frequent symptom
C.
The pathological process becomes chronic always
D.
Is typical chest deformation
E.
*All is correct
Choose WRONG statement about Williams– Campbell syndrome.
A.
The clinical signs are typical for bronchial obstruction
B.
Bronchopulmonary infection is frequent symptom
C.
The pathological process becomes chronic always
Is typical chest deformation
*All is correct
Choose the best method of Williams– Campbell syndrome diagnostics?
A.
Chest x-ray
B.
Chest ultrasound
C.
*Bronchography
D.
CT-scan
E.
Angiography
Choose the WRONG statement about congenital lobar emphysema:
A.
*There is abundant anomaly
B.
Respiratory insufficiency can develop immediately after birth
C.
Surgical treatment is necessary
D.
Can be diagnosed with the help of chest x-ray
E.
Is typical absence or hypoplasia of bronchi cartilages at the part of lung
What percussion data are characteristic for congenital lobar emphysema?
A.
Local dullness
B.
Tympanic sound
C.
Diffuse dullness
D.
*Bandbox sound
E.
Tympanic sound
Cyanosis, shortness of breath, coughing, choking during breastfeeding is the most typical for:
A.
*Tracheoesophageal and bronchoesophageal fistulas
B.
Atresia of the esophagus
C.
Tracheobronchomegalia
D.
Atonia of esophagus
E.
Cogenital achalasia of esophagus
What type of inheritance is characteristic for Kartagener syndrome?
A.
Autosomal dominant
B.
*Autosomal recessive
C.
X-linked dominant
D.
X-linked recessive
E.
Y-linked
Hamman-Rich syndrome is characterized by:
A.
*Rapidly progressive diffuse pulmonary fibrosis
B.
Bronchial agenesia
C.
Tracheobronchomegalia
D.
Bronchial aplasia
E.
All is correct
What main treatment is used at Hamman-Rich syndrome?
A.
*Corticosteroids
B.
Antibiotics
C.
Bronchodilatators
D.
Expectorants
E.
Surgical
What changes in biochemical blood analysis are typical for the idiopathic pulmonary
hemosiderosis:
A.
Hypoproteinemia and hypobilirubinemia
B.
Increased level of direct bilirubin and transaminases
C.
Decreased level of serum iron and hypoproteinemia
D.
Increased level of serum iron and hypobilirubinemia
E.
*Decreased level of serum iron and increased level of indirect bilirubin
Treatment of idiopathic pulmonary hemosiderosis includes:
A.
Oxygen therapy
D.
E.
421.
422.
423.
424.
425.
426.
427.
428.
429.
Glucocorticoids
Cytostatics
Deferoxamine
*All mentioned above
What type of inheritance is characteristic for primary pulmonary hypertension?
A.
*Autosomal dominant
B.
Autosomal recessive
C.
Y-linked
D.
X-linked recessive
E.
X-linked dominant
What type of inheritance is characteristic for cystic fibrosis?
A.
Autosomal dominant
B.
*Autosomal recessive
C.
Y-linked
D.
X-linked recessive
E.
X-linked dominant
What form of cystic fibrosis is typical only for newborns?
A.
Pulmonary
B.
Enteric
C.
Mixed
D.
*Meconium ileus
E.
Edematous-anemic
What medicines are the basic in the cystic fibrosis treatment?
A.
Antibiotics
B.
Mycolitics
C.
*Enzymes
D.
Cytostatics
E.
Glucocorticoids
A typical percussion sign of acute bronchitis is:
A.
shortening of pulmonary sound in the upper parts of the lungs
B.
shortening of pulmonary sound in the lower parts of the lungs
C.
shortening of the lung sound all over the lungs
D.
local tympanic sound
E.
* clear lung sound
?Weight deficit 10 - 20% is typical for:
A.
2nd degree malnutrition
B.
3rd degree of malnutrition
C.
eutrophia
D.
everything is wrong
E.
* 1st degree malnutrition
Weight deficit 21 - 30% is typical for:
A.
1st degree malnutrition
B.
3rd degree of malnutrition
C.
eutrophia
D.
everything is wrong
E.
* 2nd degree malnutrition
Weight deficiency more than 30% is typical for:
A.
1st degree malnutrition
B.
2nd degree malnutrition
C.
eutrophia
D.
everything is wrong
E.
* 3rd degree of malnutrition
Paratrofia is manifested by:
B.
C.
D.
E.
430.
431.
432.
433.
434.
435.
436.
437.
438.
decreased body weight proportionally to the length
increased body weight in stunted growth
decreased body weight with an accelerated growth
everything is correct
* increased body weight proportionally to the length
Paratrofia is manifested by:
A.
reduction of subcutaneous fat
B.
reduced skin elasticity
C.
increased soft tissues turgor
D.
everything is correct
E.
* increased subcutaneous fat
In the biochemical analysis of blood ща сhild with malnutrition will be:
A.
hyperglycemia
B.
hypercalcemia
C.
hyperalbuminemia
D.
everything is correct
E.
* hypoproteinemia
In coprogram of child with malnutrition will be detected signs of:
A.
hyperenzymopathy
B.
inflammation
C.
worms invasion
D.
erythrocytes
E.
* hypoenzymopathy
The main cause of malnutrition
A.
enzymopathy
B.
pneumonia
C.
rickets
D.
dysbacteriosis
E.
* inadequate dietary intake
Common form of malnutrition is:
A.
spasmophylia
B.
thrombocytopenia
C.
hypoplastic anemia
D.
everything is correct
E.
* iron deficiency
Body temperature in children with severe malnutrition is:
A.
increased
B.
normal
C.
subfebrile
D.
hectic
E.
* decreased
For severe malnutrition is typical:
A.
weight-length coefficient is 60
B.
trophy index is 0
C.
irritability of the child
D.
weight loss is 10-20%
E.
* "Old man" face
Therapeutic feeding for children with malnutrition:
A.
diet according to the age
B.
diet, taking into account the concomitant disease
C.
diet with adapted formulas
D.
diet with maladapted formulas
E.
* rejuvenation food
A.
B.
C.
D.
E.
439.
440.
441.
442.
443.
444.
445.
446.
447.
448.
449.
450.
451.
452.
453.
454.
455.
How many days does the period of tolerance to food last in mild malnutrition?
A.
1 - 5 days
B.
7 days
C.
10 days
D.
everything is correct
E.
* 1 - 3 days
Why is not good to give full food volume for the child with malnutrition?
A.
Because of hyperenzymopathy
B.
Because of dyspancreatysm
C.
Because of poor appetite
D.
everything is wrong
E.
* Because of hypoenzymopathy
Name principles of nutrition in malnutrition:
A.
diet, taking into account the concomitant disease and cause of malnutrition
B.
diet, taking into account children's age and cause of malnutrition
C.
diet using adopted formulas and age of the child
D.
maximum feeding
E.
* tolerance to food establishment and food rejuvenation
What does the principle of two-phase feeding mean?
A.
establishment of tolerance to food and the maximum feeding
B.
establishment of tolerance to food and minimum feeding
C.
establishment of tolerance to food and breastfeeding
D.
maximum feeding
E.
* establishment of tolerance to food and optimal feeding
Using of pancreatic enzymes is appropriate:
A.
1 hour before the meal
B.
after the meal
C.
1 hour after the meal
D.
before eating
E.
* during the meal
Choose the Drug for replacement therapy in case of malnutrition:
A.
pentoxyl
B.
apylac
C.
thiotriazoline
D.
glucose
E.
* pancreatin
Name peculiarities of the diet in paratrophia:
A.
protein restriction
B.
restriction of vitamins
C.
increase in fat
D.
everything is wrong
E.
* reduce of carbohydrate
The aim of probiotics therapy:
A.
for correcting the oral cavity microflora
B.
for correcting the bronchial microflora
C.
to fight infection
D.
everything is correct
E.
* for correcting the intestinal microflora
Choose bacterial drugs (probiotics):
A.
pancreatin
B.
clarithromycin
C.
penthoxyl
D.
everything is correct
E.
456.
457.
458.
459.
460.
461.
462.
463.
464.
* linex
The main clinical syndromes of diarrhea are:
A.
dyspepsia, dehydration, bleeding
B.
dyspepsia, endotoxemia, portal hypertension
C.
constipation, endotoxemia, dehydration
D.
everything is correct
E.
* dyspepsia, dehydration, endotoxemia
Dyspeptic syndrome includes:
A.
constipation, flatulence, fatigue
B.
fever, vomiting, jaundice
C.
vomiting, constipation, jaundice
D.
diarrhea, fever, jaundice
E.
* diarrhea, flatulence, vomiting
Which symptoms belongs to the clinical syndromes of enzymopathy?
A.
hepatosplenomegaly
B.
swelling of the brain
C.
renal failure
D.
everything is correct
E.
* dehydration
Choose drug, which is used for rehydration:
A.
lypofundin
B.
jelatynol
C.
alvezin
D.
rheopolyglucine
E.
* 5% glucose solution
Choose drug, which is used for detoxification
A.
alvezin
B.
acesol
C.
lypofundin
D.
potassium chloride
E.
* rheosorbilact
It is advisable to give When diarrhea :
A.
glucocorticoids
B.
membrane stabilization medicine
C.
vitamins
D.
antibiotics
E.
* enterosorbents
Ciprofloxacin belongs to:
A.
macrolides
B.
cephalosporins
C.
aminoglycosides
D.
penicillins
E.
* fluoroquinolones
The daily dose of ciprofloxacin to the child is:
A.
5 - 10 mg / kg
B.
15 - 20 mg / kg
C.
20 - 25 mg / kg
D.
30 - 40 mg / kg
E.
* 10 - 15 mg / kg
The daily dose of cephalosporin to the child is:
A.
100 - 150 mg / kg
B.
150 - 200 mg / kg
C.
200 - 250 mg / kg
10 - 30 mg / kg
* 50 - 100 mg / kg
Dehydration syndrome includes:
A.
polyuria
B.
edema
C.
bulging large fontanel
D.
everything is correct
E.
* loss of body weight
Hypertonic dehydration is characterized by:
A.
normal body temperature
B.
hypothermia
C.
sleepiness
D.
everything is correct
E.
* hyperthermia
Hypertonic dehydration is characterized by:
A.
sodium levels are normal
B.
chloropenia
C.
reduced hematocrit
D.
decreased urine density
E.
* increased urine density
Choose indications for the antibiotic therapy in case of diarrhea:
A.
dyspnea
B.
convulsions
C.
hyperthermia
D.
vomiting
E.
* pathological admixtures in feces
How many fluid does healthy infant need per day?
A.
60 - 100 ml/kg
B.
110 - 120 ml/kg
C.
100 - 110 ml/kg
D.
120-130 ml/kg
E.
* 130 - 150 ml/kg
How many fluid does infant with severe dehydration need per day?
A.
150 - 160 ml
B.
170 - 180 ml
C.
100 - 120 ml
D.
50 - 100 ml
E.
* 200 - 220 ml
What ratio of salt and water solutions for infant with hypotonic dehydration should be?
A.
2: 1
B.
3: 1
C.
4: 1
D.
1: 2
E.
* 1: 1
Name the most common cause of bronchitis
A.
fungi
B.
bacteria
C.
helminth
D.
enzymopathy
E.
* viruses
RS-infection often causes bronchiolitis in:
A.
preschoolers
B.
toddlers
D.
E.
465.
466.
467.
468.
469.
470.
471.
472.
473.
school age children
teens
* infants
Helminth infection is often the cause of bronchitis in:
A.
infants
B.
toddlers
C.
adolescents
D.
school age children
E.
* preschoolers
The main symptoms of acute bronchitis is:
A.
sore throat
B.
running nose
C.
dyspnea
D.
fever
E.
* cough
The typical auscultatory sing of acute bronchitis is:
A.
weakened vesicular breathing
B.
puerile breathing
C.
local whezing
D.
local rales
E.
* harsh breathing
In what age group of children bronchitis is more often?
A.
infants
B.
newborns
C.
toddlers
D.
teens
E.
* preschoolers
What degree of respiratory failure severity is the most often in acute bronchitis?
A.
1st degree
B.
2nd degree
C.
3rd degree
D.
everything is correct
E.
* 0 degree
Radiological signs of acute bronchitis are:
A.
symmetrical attenuation of lung pattern
B.
symmetrical amplification pattern of lung with small focal hilar infiltration
C.
symmetrical amplification pattern of lung in hilar and lowermedial zones
D.
symmetrical attenuation of bases of lungs
E.
* symmetrical amplification of lung pattern
Typical changes in Common blood test of patients with acute bronchitis:
A.
significant leucopenia
B.
moderate leucocytosis
C.
significant leucocytosis, accelerated erythrocyte sedimentation rate
D.
anemia
E.
* leucopenia, lymphocytosis
Etiotropic therapy of viral infection in the acute bronchitis is more effective when it was given:
A.
no effective
B.
for 5-7 days
C.
throughout the disease
D.
after 7th day of disease
E.
* in the first 2 days of illness
The effectiveness of expectorants in acute bronchitis depends on:
A.
appointment of antiviral drugs
C.
D.
E.
474.
475.
476.
477.
478.
479.
480.
481.
482.
appointment of antihistamines
appointment of vitamins
everything is correct
* sufficient drinking
Typically, recurrent bronchitis exacerbation is absent in:
A.
spring
B.
winter
C.
autumn
D.
everything is correct
E.
* summer
What is a dominating symptom In clinical exacerbation of recurrent bronchitis?
A.
intoxication
B.
dyspnea
C.
running nose
D.
everything is correct
E.
* cough
Cough with recurrent bronchitis exacerbation is more severe:
A.
at night
B.
by the day
C.
in the evening
D.
everything is correct
E.
* in the morning
Percussion in patients with recurrent bronchitis exacerbation reveals:
A.
clear lung sound
B.
shortening of sound in the lower parts
C.
clear sound with a short bandbox between the scapulas
D.
everything is correct
E.
* bandbox sound
In acute obstructive bronchitis, auscultation reveals:
A.
weakened breathing
B.
only prolonged expiration
C.
small bubbling rales diffusely
D.
small bubbling rales locally
E.
* dry rales, medium bubbling rales on inspiration, prolonged expiration
Bronchoscopy in recurrent bronchitis exacerbation reveals:
A.
diffuse changes in the form of mucosal atrophy
B.
diffuse changes in the form of mucosal hyperemia
C.
local changes of bronchial mucosa
D.
everything is correct
E.
* diffuse changes in the form of mucosal hyperemia, thickening of the bronchial walls and
mucous secretion
Bronchoscopy in remission of recurrent bronchitis reveals:
A.
hyperemia of the bronchial mucosa
B.
atrophy of the bronchial mucosa
C.
normal bronchial mucosa
D.
everything is correct
E.
* granulation on bronchial mucosa
The main treatment of recurrent bronchitis is:
A.
toxicosis liquidation
B.
antiviral treatment
C.
dehydration liquidation
D.
everything is correct
E.
* decrease of bronchial obstruction
B.
C.
D.
E.
483.
484.
485.
486.
487.
488.
489.
490.
491.
492.
493.
494.
495.
496.
497.
498.
499.
In the treatment of acute recurrent bronchitis postural drainage is better to use:
A.
after breakfast
B.
in the afternoon
C.
at bedtime
D.
everything is wrong
E.
* after awakening
Duration of antibiotic therapy in patients with recurrent bronchitis exacerbation is:
A.
14 days
B.
21 days
C.
28 days
D.
everything is correct
E.
* 7 days
Recurrent bronchitis, which lasts more than 5 years, is a harbinger of:
A.
asthma
B.
scoliosis
C.
polyhypovitaminosis
D.
everything is wrong
E.
* chronic bronchitis
The main symptom of chronic bronchitis is:
A.
running nose
B.
fever
C.
dyspnea
D.
everything is correct
E.
* persistent cough
Name the criteria for chronic bronchitis:
A.
stable localized wheezing in the lungs
B.
wet cough
C.
recurrent exacerbations
D.
everything is correct
E.
* diffuse non-permanent rales in the lungs
The most typical symptom of bronchiectasis is:
A.
inspiratory dyspnea
B.
expiratory dyspnea
C.
dry cough nadsadisty
D.
everything is correct
E.
* cough
The final diagnosis of bronchiectasis needs:
A.
spirography
B.
bronchoscopy
C.
X-ray of the chest
D.
everything is wrong
E.
* bronchography
In chronic bronchitis are affected:
A.
bronchi
B.
lung parenchyma
C.
alveoli
D.
everything is wrong
E.
* all the structures of the bronchopulmonary system
The thorax in children with chronic bronchitis is:
A.
cylinder
B.
conical
C.
unmodified
D.
everything is correct
E.
500.
501.
502.
503.
504.
505.
506.
507.
508.
* asymmetric
Which of the symptoms indicate prolonged hypoxemia?
A.
productive cough, more in the morning
B.
hyperhidrosis
C.
perynasal cyanosis
D.
everything is wrong
E.
* clubbing fingers
Which of the auscultatory signs indicate chronic respiratory pathology?
A.
variety of wheezing and moist rales
B.
local small bubbling rales
C.
"amphora" breath
D.
everything is correct
E.
* constant variety of rales
Secondary chronic pneumonia develops:
A.
in the presence of bronchial "foreign body"
B.
1 month after acute pneumonia
C.
on the basis of reduced immunity
D.
everything is correct
E.
* on the background of systemic and inherited pulmonary diseases
What is the lead point for the integrated treatment of chronic bronchopulmonary pathology in
children?
A.
antibacterial therapy
B.
general-stimulation therapy
C.
nutritional care
D.
everything is correct
E.
* renewal of the bronchial drainage
What is the dose of penicillins to children with chronic bronchopulmonary pathology?
A.
50 - 100 thousand IU / kg / day
B.
100 - 200 thousand IU / kg / day
C.
300 - 500 thousand IU / kg / day
D.
10 - 25 thousand IU / kg / day
E.
* 100 - 150 thousand IU / kg / day
What is the most effective route of antibacterial drugs administration in patients with chronic
respiratory pathology?
A.
intravenous
B.
endobronchial
C.
intramuscular
D.
everything is wrong
E.
* intraorganic electrophoresis
What is the duration of antibiotic therapy to children with chronic bronchopulmonary pathology?
A.
2 months
B.
7 - 14 days
C.
1 month
D.
everything is correct
E.
* 14 - 21 days
What dose of aminophylline (euphylline) is used for intraorganic electrophoresis?
A.
5 - 7 mg / kg
B.
2 - 3 mg / kg
C.
9 - 11 mg / kg
D.
15 - 20 mg / kg
E.
* 3 - 5 mg / kg
What is the requirement to inhalatory antibiotics, which are used for children with chronic
bronchopulmonary pathology?
minimal sensitization of children
wide range of activity
selective effect on Gram-positive flora
everything is wrong
* good solution in water
When (after exacerbation of chronic broncho-pulmonary pathology) children may be sent to the
resort treatment?
A.
In 1 month
B.
Directly into the second stage
C.
In 6 months
D.
In 3 weeks
E.
* In 3 months
Which investigation is mandatory in patients with chronic respiratory pathology?
A.
X-ray of the chest
B.
spirometry
C.
fluorography
D.
everything is wrong
E.
* bronchography
What radiological changes are characteristic for chronic bronchopulmonary pathology in
children?
A.
infiltration of lung tissue in the basal zones
B.
infiltration of lung tissue on the tips of the lungs
C.
presence of "bullas"
D.
everything is correct
E.
* amplification and distortion of lung pattern
The main cause of croup is:
A.
bacterial infections
B.
fungal infections
C.
parasitic lesions
D.
everything is correct
E.
* viral infections
Among the viruses that cause croup, the first place has:
A.
Adenovirus
B.
Influenza virus
C.
RS- virus
D.
Everything is wrong
E.
* Parainfluenza virus
Most major croup is developed:
A.
in the afternoon
B.
in the evening
C.
in the morning
D.
everything is correct
E.
* at night
Acute stenotic laryngotracheobronchitis of the 1st degree - is:
A.
subcompensated croup
B.
de compensated croup
C.
asphyxia
D.
everything is correct
E.
* compensated croup
Name the main route of infection penetration in pneumonia:
A.
hematogenous
B.
lymphogenous
C.
mixed
A.
B.
C.
D.
E.
509.
510.
511.
512.
513.
514.
515.
516.
everything is correct
* bronchiogenic
The etiology of pneumonia is dominated by:
A.
klebsiella
B.
pathogenic fungi
C.
staphylococci
D.
viruses
E.
* pneumococci
What type of pneumonia in infants develops more often?
A.
croupous
B.
interstitial
C.
segmentary
D.
lobar
E.
* focal
Typical physical data for pneumonia are:
A.
weakened breathing
B.
diffuse small moist rales
C.
diffuse dry wheezing
D.
everything is correct
E.
* local small moist rales
Typical radiological sign for pneumonia is:
A.
increased lung pattern
B.
emphysematous lung distension
C.
expansion of the roots of the lungs
D.
everything is correct
E.
* the presence of infiltrative shadows
Duration of acute pneumonia is:
A.
to 6 - weeks
B.
to 10 - weeks
C.
to 12 - weeks
D.
up to 3 months
E.
* to 8 - weeks
Value of pulse and respiration 2 - 15: 1 is characteristic to:
A.
Respiratory insufficiency 1 degree
B.
Respiratory insufficiency 2 degree
C.
Respiratory insufficiency 0 degree
D.
everything is wrong
E.
* Respiratory insufficiency 3 degree
Blood oxygen saturation by 90% is typical for:
A.
Respiratory insufficiency 0 degree
B.
Respiratory insufficiency 2 degree
C.
Respiratory insufficiency 3 degree
D.
everything is wrong
E.
* Respiratory insufficiency 1 degree
Not stable perioral cyanosis is characteristic for:
A.
Respiratory insufficiency 0 degree
B.
Respiratory insufficiency 2 degree
C.
Respiratory insufficiency 3 degree
D.
everything is wrong
E.
* Respiratory insufficiency 1 degree
What is the most common cause of necrotizing (destructive) pneumonia:
A.
pneumococcus
B.
klebsiella
D.
E.
517.
518.
519.
520.
521.
522.
523.
524.
525.
proteus
everything is correct
* staphylococcus
What type of oxygen therapy is the best for the child with Respiratory insufficiency 3 degree?
A.
the flow of oxygen in an oxygen tent
B.
flow of oxygen through the intranasal catheter
C.
the flow of oxygen through the oxygen bag
D.
everything is wrong
E.
* the flow of oxygen through the endotracheal tube
What type of oxygen therapy is the best for the child with Respiratory insufficiency 2 degree?
A.
the flow of oxygen through the oxygen bag
B.
flow of oxygen through the intranasal catheter
C.
the flow of oxygen through the endotracheal tube
D.
everything is wrong
E.
* the flow of oxygen in an oxygen tent
What is the typical X-ray sign in the necrotizing (destructive) pneumonia when abscess
formation?
A.
the appearance of a round air formations on the base of the lung infiltration
B.
parietal and sinuses infiltration near the pulmonary infiltration
C.
homogeneous total infiltration
D.
displacement of the mediastinal organs to the opposite
E.
* the appearance of a round high degree infiltration with the level of liquid on the base of
the lung infiltration
What is the duration of antibacterial therapy in children with mild pneumonia?
A.
3 - 5 days
B.
5 - 7 days
C.
10 - 14 days
D.
1 - 3 days
E.
* 7 - 10 days
What is the duration of antibacterial therapy in children with moderate pneumonia?
A.
7 - 10 days
B.
5 - 7 days
C.
14 - 20 days
D.
20 - 25 days
E.
* 10 - 14 days
What is the duration of antibacterial therapy in children with severe pneumonia?
A.
10 - 14 days
B.
7 - 10 days
C.
21 - 28 days
D.
everything is correct
E.
* 14 - 21 days
What is the dose of semisynthetic penicillins in children with mild pneumonia?
A.
30 - 50 mg / kg / day
B.
80 - 100 mg / kg per day
C.
100 - 150 mg / kg / day
D.
150 - 200 mg / kg / day
E.
* 50 - 80 mg / kg / day
What is the dose of semisynthetic penicillins in children with moderate pneumonia?
A.
50 - 80 mg / kg / day
B.
30 - 50 mg / kg / day
C.
100 - 150 mg / kg / day
D.
150 - 200 mg / kg / day
E.
* 80 - 100 mg / kg / day
C.
D.
E.
526.
527.
528.
529.
530.
531.
532.
533.
534.
535.
536.
537.
538.
539.
540.
541.
542.
What is the dose of semisynthetic penicillins in children with severe pneumonia?
A.
50 - 80 mg / kg / day
B.
80 - 100 mg / kg / day
C.
30 - 50 mg / kg / day
D.
150 - 200 mg / kg / day
E.
* 100 - 150 mg / kg / day
The hospital pneumonia is that pneumonia which developed:
A.
within 12 hours of hospitalization
B.
within 24 hours of hospitalization
C.
within 6 hours of hospitalization
D.
everything is correct
E.
* within 48 hours of hospitalization
Most community-acquired pneumonia in children from 6 months to 6 years is caused by:
A.
Mycoplasma
B.
Chlamydia
C.
Staphylococcus
D.
E. coli
E.
* Pneumococcus
Ventilator - associated pneumonia up to four days stay on the ventilator, usually is caused by:
A.
Enterobacteria
B.
Streptococci
C.
Klebsiella
D.
everything is wrong
E.
* Pneumococci
Pneumococcal bacteria is completely resistant to:
A.
penicillins
B.
macrolides
C.
cephalosporins
D.
fluoroquinolones
E.
* aminoglycosides
The drug of choice for treatment of typical community-acquired pneumonia is:
A.
carbapenems
B.
fluoroquinolones
C.
aminoglycosides
D.
preparations of other groups
E.
* amino penicillins
What percussion data are characteristic for the focal pneumonia?
A.
bandbox sound over the entire surface of the lungs
B.
shortening of the percussion sounds at an angle of scapula
C.
shortening percussion sound in axillar region
D.
everything is correct
E.
* clear lung sounds over the entire surface of the lungs
Shortening of the percussion sounds in infants with focal pneumonia occurs:
A.
in 3 - 5 days of illness
B.
in the first day of illness
C.
in 10 - 15 days of illness
D.
in 2 - 3 day of illness
E.
* in 5 - 10 days of illness
At times, the beginning of lobar pneumonia, is misdiagnosed with:
A.
rheumatism
B.
bronchial asthma
C.
pyelonephritis
D.
sepsis
E.
543.
544.
545.
546.
547.
548.
549.
550.
551.
* appendicitis
A typical inspection sign in a patient with lobar pneumonia is:
A.
jaundiced skin
B.
butterfly rash
C.
gray color
D.
everything is correct
E.
* color, usually on the side of lesion
What the inspection reveals in patient with lobar pneumonia:
A.
synchronous movement of both chest parts
B.
"healthy" part of the chest lag in the breathing
C.
spasmodic twitching of hands and feet
D.
everything is wrong
E.
* "sick" part of the chest lag in the breathing
Staphylococcal pneumonia develops mainly in:
A.
adolescents
B.
preschoolers
C.
infants
D.
everything is correct
E.
* schoolchildren
Obstructive respiratory failure is caused by:
A.
alveolar lesion
B.
violation of the breathing neuromuscular control
C.
capillary pulmonary circulation lesion
D.
everything is correct
E.
* development of the respiratory tract mucous edema
Parenchymatous respiratory failure is caused by:
A.
changes in respiratory muscle
B.
compression of the airway from the outside
C.
impairment of the respiratory center
D.
everything is correct
E.
* lesion of the alveoli and capillary pulmonary circulation
Ventilating respiratory failure is caused by:
A.
the presence of bronchospasm
B.
aspirated foreign body
C.
inflammatory lung diseases
D.
everything is correct
E.
* violation of the breathing neuromuscular control
Treatment of respiratory failure provides oxygen, the oxygen concentration must not exceed:
A.
80%
B.
70%
C.
90%
D.
everything is correct
E.
* 60%
The absence of respiratory sounds during inspiration is characteristic for:
A.
Respiratory insufficiency 1 degree
B.
Respiratory insufficiency 2 degree
C.
Respiratory insufficiency 0 degree
D.
everything is correct
E.
* Respiratory insufficiency 3 degree
Bradipnoe is characteristic for:
A.
Respiratory insufficiency 1 degree
B.
Respiratory insufficiency 2 degree
C.
Respiratory insufficiency 0 degree
everything is correct
* Respiratory insufficiency 3 degree
Value of pulse to the breathing 3,5 - 2,5: 1 is characteristic for:
A.
Respiratory insufficiency 1 degree
B.
Respiratory insufficiency 0 degree
C.
Respiratory insufficiency 3 degree
D.
everything is correct
E.
* Respiratory insufficiency 2 degree
Value of pulse to the breathing 2,5 - 2: 1 is typical for:
A.
Respiratory insufficiency 1 degree
B.
Respiratory insufficiency 2 degree
C.
Respiratory insufficiency 0 degree
D.
everything is correct
E.
* Respiratory insufficiency 3 degree
The most common cause of asthma is:
A.
medications
B.
foodstuffs
C.
bacterial allergy
D.
chemicals
E.
* house dust
The main source of antigens in house dust is:
A.
dry food for aquarium fish
B.
wool and scurf of animal
C.
hair and scurf of people
D.
everything is wrong
E.
* house dust mites
Mostly house dust mites are found in:
A.
soft toys
B.
upholstery
C.
bed linen
D.
pillows
E.
* carpets
The cardinal symptom of asthma is:
A.
itchy nose
B.
constant sneezing
C.
dry compulsive cough
D.
running nose
E.
* dyspnea
Mostly dyspnea in asthma patient occurs:
A.
at dawn
B.
in the morning
C.
by the day
D.
during meal
E.
* at night
What is the base anti-inflammatory therapy in mild bronchial asthma?
A.
oral corticosteroids
B.
intravenous corticosteroids
C.
nonsteroidal anti-inflammatory drugs
D.
methylxanthines
E.
* cromoglycate sodium
What inflammation of the mucous membrane is typical for bronchial asthma?
A.
infectious
B.
infectious - allergic
D.
E.
552.
553.
554.
555.
556.
557.
558.
559.
560.
mixed
everything is wrong
* allergic
What type of dyspnea is typical for bronchial asthma?
A.
inspiratory
B.
mixed
C.
Schick
D.
Kussmaul
E.
* expiratory
What peripheral blood changes are typical for bronchial asthma?
A.
anemia
B.
leukocytosis
C.
lymphocytosis
D.
monocytosis
E.
* eosynophylia
What is reveal in percussion during bronchial asthma attack?
A.
expansion of the heart borders
B.
clear lung sound
C.
local shortening of lung sound
D.
mosaic changes
E.
* bandbox sound over the lungs
An asthmatic status means asthma attack duration:
A.
for 24 hours
B.
more than 2 hours
C.
more than 5 hours
D.
more than 10 hours
E.
* more than 6 hours
What is the aminophylline (euphyllin) dose in the mild attack of bronchial asthma?
A.
1 - 2 mg / kg
B.
10 - 12 mg / kg
C.
24 mg / kg
D.
0,5 - 1 mg / kg
E.
* 4 mg / kg
What antihystamines are used in bronchial asthma?
A.
diphenhydramine
B.
klaritin
C.
allergodyl
D.
everything is correct
E.
* calcium gluconate
What is the aminophylline (euphylline) dose in asthmatic status?
A.
15 - 16 mg / kg / day
B.
40 mg / kg / day
C.
10 mg / kg / day
D.
5 - 7 mg / kg / day
E.
* 24 mg / kg / day
Name the form of bronchial asthma according to the classification
A.
allergic
B.
nonatopic
C.
infectious
D.
recurrent
E.
* persistent
What prevails in infants in asthma attack?
A.
bronchospasm
C.
D.
E.
561.
562.
563.
564.
565.
566.
567.
568.
569.
engorgement of the lungs
emphysema
pneumorrhagia
* edema of the respiratory tract mucosa
What prevails in schoolchildren in asthma attack?
A.
edema of the respiratory tract mucosa
B.
respiratory violation
C.
allergic inflammation
D.
engorgement of the lungs
E.
* bronchospasm
What is the aminophylline (euphylline) dose in the moderate attack of bronchial asthma?
A.
10 mg / kg
B.
15 mg / kg
C.
3 mg / kg
D.
1 - 2 mg / kg
E.
* 5 - 7 mg / kg
What is the prednisolon dose in asthmatic status?
A.
2 - 3 mg / kg / day
B.
6 - 8 mg / kg / day
C.
3 - 5 mg / kg / day
D.
0,5 - 1 mg / kg / day
E.
* 1 - 2 mg / kg / day
What is recommended for children in the period of asthma remission?
A.
antihystamines
B.
antibacterial therapy
C.
bronchodilator therapy
D.
nothing
E.
* anti-inflammatory therapy
Severe asthma requires the appointment of:
A.
aminophylline (euphylline)
B.
intal
C.
adrenaline
D.
ephedrine
E.
* glucocorticoids
What is the way of specific asthma allegro diagnostic?
A.
inhalation tests
B.
determining the percentage of eosinophils in the blood
C.
allergenic anamnesis
D.
Mantoux test
E.
* skin allergic tests
What is the atopy marker in children?
A.
elevated levels of immunoglobulin A
B.
eosinophilia
C.
leukopenia
D.
monocytosis
E.
* elevated levels of immunoglobulin E
Anti-inflammatory therapy of bronchial asthma is continued for:
A.
6 months
B.
2 weeks
C.
1 year
D.
all the life
E.
* not less than two months
Which inhalers are used in the treatment of bronchial asthma?
B.
C.
D.
E.
570.
571.
572.
573.
574.
575.
576.
577.
578.
aminophylline
ingalipt
amerton
instaryl
* salbuthamol
Children with asthma are at the dispensary supervision by:
A.
pediatrician
B.
immunologist
C.
pulmonologist
D.
everything is wrong
E.
* allergist
One of the criteria for asthmatic status is:
A.
attack more than 10 hours
B.
acute adrenal insufficiency
C.
heart failure
D.
chronic pulmonary heart
E.
* violation of bronchial drainge function
What mainly leads to disruption of all organs and systems in asthma children?
A.
surfactant deficiency
B.
hemodynamics violation
C.
low immunity
D.
anemia
E.
* hypoxia
First place among the allergens that cause hives, take:
A.
Pollen
B.
Epidermal allergens
C.
Medicines
D.
Physical factors
E.
* Foodstuffs
When urticaria next changes are developed:
A.
The lesion of the subcutaneous layer of the dermis
B.
The lesion of the submucosal layer of the dermis
C.
The lesion of the subcutaneous tissue
D.
Lesion in the connective tissue of the internal organs
E.
* Increased microvascular permeability
Quincke’s edema affected deeper layers of skin in the following places, except:
A.
Face
B.
Head
C.
Neck
D.
Genitalia
E.
* The lateral surface of the body
In acute allergic urticaria rash occurs after contact with an allergen through:
A.
Few seconds
B.
Few minutes
C.
Few days
D.
Few weeks
E.
* Few hours
Elements of urticaria often are coloured as:
A.
Cyanotic
B.
Icteric
C.
Scarlet
D.
Umber
E.
* As skin
A.
B.
C.
D.
E.
579.
580.
581.
582.
583.
584.
585.
586.
587.
588.
589.
590.
591.
592.
593.
594.
595.
Elements of urticaria preserved for:
A.
20-30 seconds
B.
5-6 minutes
C.
2-3 days
D.
1-2 weeks
E.
* 1-6 hours
Quincke's edema can preserved for:
A.
Up to 10-20 seconds
B.
30-40 minutes
C.
1-2 hours
D.
1-2 weeks
E.
* 2-3 days
The primary element of the rash of acute hives are:
A.
Papule
B.
Pustule
C.
Spot
D.
Crust
E.
* Urtica
Base symptomatic treatment of urticaria consists in the application of:
A.
Antibacterial drugs
B.
Anti-inflammatory drugs
C.
Sedatives
D.
Desintoxication drugs
E.
* Antihystamines
Which system pathology is often in children with chronic urticaria?
A.
Cardiovascular
B.
Respiratory system
C.
Nervous system
D.
Locomotor
E.
* Digestive
What color is Quincke’s edema?
A.
Pale
B.
Cyanotic
C.
Gray
D.
Icteric
E.
* The same as skin
What is the main localization of children's eczema?
A.
Feet
B.
Elbows
C.
Abdomen
D.
Knees
E.
* Cheeks
When skin process mostly disappears in children’s eczema?
A.
Up to 1 year
B.
Up to 2 years
C.
Up to 3 years
D.
Up to 4 years
E.
* Up to 5 years
In atopic dermatitis exudative skin lesions are typical to the next age group:
A.
2-4 years
B.
4-6 years
C.
6-8 years
D.
8-15
E.
596.
597.
598.
599.
600.
601.
602.
603.
604.
* Before 2 years
In atopic dermatitis erythematous-squamous skin lesions aretypical to the next age group:
A.
0-3 months
B.
3-9 months
C.
9-18 months
D.
12-24 months
E.
* 2-15 years
First place among the concomitant disease in atopic dermatitis belongs to the diseases of:
A.
Nervous system
B.
Respiratory system
C.
Endocrine system
D.
Urinary System
E.
* Digestive system
In the patient with atopic dermatitis is increased:
A.
Ig A
B.
Ig G
C.
Ig M
D.
T cells
E.
* Ig E
What is the evidence of the rheumatic fever streptococcal etiology?
A.
increased seromucoid
B.
increased sialic acids
C.
increased LDH
D.
positive formol test
E.
* increased antihyaluronidase
In rheumatism pathogenesis the leading role belongs to:
A.
bacterial infection
B.
aseptic inflammation
C.
allergic reactions
D.
everything is correct
E.
* immune reactions
What is pathogenetic link of rheumatism?
A.
intracellular sensitization
B.
constant persistence of streptococci in the blood
C.
persistence of streptococci in the connective tissue
D.
everything is wrong
E.
* primary streptococcal sensitization
Which heart lining are often affected with rheumatic disease in children?
A.
endocardium
B.
myocardium
C.
all
D.
everything is wrong
E.
* endomyocardium
What heart disease most often is formed on the background of rheumatic fever?
A.
stenosis of the aorticvalve
B.
aortic valve insufficiency
C.
tricuspid valve insufficiency
D.
pulmonary valve insufficiency
E.
* mitral insufficiency
What are peculiarities of rheumatism in children?
A.
only polyarthritis
B.
prolonged duration
C.
latent course
subacute course
* formation of the heart defects
What are peculiarities of rheumatism in children?
A.
only polyarthritis
B.
only nodules
C.
latent course
D.
arthralgia
E.
* chorea
The main criteria of rheumatic fever are:
A.
hepatitis
B.
nephritis
C.
pneumonia
D.
meningitis
E.
* carditis
The main criteria of rheumatic fever are:
A.
meningitis
B.
hepatitis
C.
dermatitis
D.
pneumonia
E.
* polyarthritis
The main criteria of rheumatic fever are:
A.
urticaria
B.
hemorrhages
C.
pneumonia
D.
bleeding
E.
* erythema marginatum
Additional criteria of rheumatism are:
A.
hematoma
B.
bleeding into the joints
C.
petechia
D.
chorea
E.
* nosebleeds
Additional criteria of rheumatism are:
A.
arthritis
B.
muscle pain
C.
backache
D.
headaches
E.
* arthralgia
Criteria for rheumatic carditis are:
A.
only myocarditis
B.
cardialgia
C.
epicardium lesion
D.
only pericarditis
E.
* lesion of the myocardium and endocardium
What is typical for myocarditis?
A.
decreased heart size
B.
increased heart tones
C.
WPW syndrome
D.
CLC syndrome
E.
* expansion of the heart borders
Which joints are often affected with rheumatism?
A.
interphalangeal
B.
mandibular
D.
E.
605.
606.
607.
608.
609.
610.
611.
612.
613.
cervical spine
lumbar spine
* knee
Rheumatic arthritis is characterized by:
A.
morning stiffness
B.
resistant strain of joints
C.
spine lesion
D.
contractures
E.
* volatility of joint damage
Chorea is characterized by:
A.
violation of consciousness
B.
central paralysis
C.
lesion of cranial nerves
D.
decrease of tendon reflexes
E.
* muscular hypotonia
Chorea is characterized by:
A.
impaired consciousness
B.
central paralysis
C.
lesion of cranial nerves
D.
decrease of tendon reflexes
E.
* poor coordination
Rheumatic endocarditis is characterized by:
A.
accent II tone of the aorta
B.
soft systolic murmur at apex
C.
systolic murmur over the pulmonary artery
D.
diastolic murmur on the apex
E.
* rough systolic murmur at apex
Rheumatic pancarditis is characterized by:
A.
increased heart sounds
B.
increased BP
C.
decrease in heart size
D.
accent II tone of the aorta
E.
* significant cardiomegaly
The ECG for rheumatism is characterized by:
A.
lengthening the QT interval
B.
deformation of the QRS complex
C.
increasing of the voltage
D.
syndrome CLC
E.
* lengthening of the PQ interval
What is an antibiotic of choice in rheumatism?
A.
ampicillin
B.
gentamicin
C.
kefzol
D.
ceftriaxone
E.
* penicillin
What is the dose of penicillin for rheumatism per kg?
A.
200-250 thousand units
B.
100-150 thousand units
C.
10-20 thousand units
D.
250 - 350 thousand units
E.
* 30-50 thousand units
What is advisable to appoint in acute rheumatic fever?
A.
plaquenil
C.
D.
E.
614.
615.
616.
617.
618.
619.
620.
621.
622.
delagil
paracetamol
sigan
* ibuprofen
What is advisable to appoint in protracted rheumatic fever?
A.
aspirin
B.
voltaren
C.
ibuprofen
D.
paracetamol
E.
* plaquenil
What is advisable to appoint for treatment of rheumatism if you are allergic to penicillin?
A.
gentamicin
B.
klaforan
C.
chloramphenicol
D.
ceftriaxone
E.
* azithromycin
The dose of prednisolone in severe rheumatic carditis is:
A.
1 mg / kg
B.
3 mg / kg
C.
4 mg / kg
D.
5 mg / kg
E.
* 2 mg / kg
The duration of outpatient (dispensary) treatment of rheumatic fever depends on:
A.
process activity
B.
duration of attack
C.
child’s age
D.
everything is wrong
E.
* development of complications
What is used for year-round prevention of rheumatism?
A.
penicillin
B.
aspirin
C.
delagyl
D.
ampicillin
E.
* bicillin
What is bicillin-1 dose for schoolchildren?
A.
600 thousand units 2 times a month
B.
600 thousand IU 1 time per month
C.
1200 thousand units 2 times a month
D.
everything is correct
E.
* 1200 thousand units 1 time per month
What is bicillin-1 dose for preschoolers?
A.
600 thousand IU 1 time per month
B.
1200 thousand units 2 times a month
C.
1200 thousand units 1 time per month
D.
everything is correct
E.
* 600 thousand units 2 times a month
The duration of outpatient (dispensary) treatment of complicated rheumatic fever is:
A.
2 years
B.
3 years
C.
4 years
D.
1 year
E.
* 5 years
The duration of outpatient (dispensary) treatment of uncomplicated rheumatic fever is:
B.
C.
D.
E.
623.
624.
625.
626.
627.
628.
629.
630.
631.
2 years
4 years
5 years
1 year
* 3 years
Name the complication of rheumatic disease
A.
myocardial infarction
B.
hypertonic disease
C.
myocardial distrophy
D.
everything is correct
E.
* myocardiosclerosis
Plaquenil dose per kg of body weight is:
A.
3mg
B.
5mg
C.
10mg
D.
1 mg
E.
* 8mg
What is the pathogenesis of rheumatoid arthritis?
A.
Bone osteomalacia
B.
Metabolic abnormalities in the bones
C.
Acute infectious inflammation of the joints
D.
Systemic connective tissue dysplasia
E.
* Autoimmune processes in the connective tissue
Rheumatoid arthritis is characterized by:
A.
No changes in the bones and joint surfaces
B.
Hemarthrosis availability
C.
The absence of effusion in the joint cavity
D.
Expansion of joint space
E.
* Narrowing of joint space
What means “pannus" in rheumatoid arthritis?
A.
Edema and hyperemia around the affected joint
B.
The form of joint deformation
C.
Effusion in the joint cavity
D.
The form of rheumatoid spine lesions
E.
* Microvilli proliferation of the synovial membrane
Heart damage in rheumatoid arthritis is most often seen as:
A.
Left ventricular hypertrophy
B.
Formation of mitral stenosis
C.
Infringement of the coronary circulation
D.
Development of acute cardiac insufficiency
E.
* The development of myocarditis
Which of the joints are most often affected in patients with rheumatoid arthritis?
A.
Ankles
B.
Sternocostal
C.
Shoulders
D.
Hips
E.
* Knees
Which of the following is typical rheumatoid arthritis clinic in children (unlike adults)?
A.
Frequent lesion of small hand joints
B.
Deformation of joints
C.
The symmetry of joint damage
D.
Less developed of mono- and pauciarticular form
E.
* Frequent injury of the cervical spine
A.
B.
C.
D.
E.
632.
633.
634.
635.
636.
637.
638.
639.
640.
641.
642.
643.
644.
645.
646.
647.
648.
Which of the joints in JRA is deformed in globular?
A.
Elbow
B.
Radial-carpal
C.
Shoulder
D.
Hip
E.
* Knee
Which of the joints in JRA is deformed in a spindly?
A.
Knee
B.
Radial-carpal
C.
Shoulder
D.
Hip
E.
* Elbow
The lesion of the cervical spine in JRA usually occurs at the level of:
A.
1st vertebrae
B.
2-3 vertebrae
C.
4th vertebrae
D.
7th vertebrae
E.
* 5-6 vertebrae
Violation of the bones growth in JRA occurs:
A.
Throughout the skeleton
B.
In the lower extremities
C.
Mainly in the flat bones
D.
In areas remote from the lesion
E.
* In areas that border to the affected joints
The leading symptoms of Still's syndrome are:
A.
Eye
B.
Nephritic syndrome
C.
Carditis and vasculitis
D.
The lesion of the spine
E.
* Fever and rash
Seropositive form of JRA is defined by:
A.
Leukocytosis in the blood
B.
A positive CRP
C.
Increased levels seromucoid
D.
By increasing the ESR
E.
* A positive rheumatoid factor
Systemic forms of JRA usually are characterized by:
A.
Meningitis
B.
Nephritic syndrome
C.
Abdominal syndrome
D.
Pneumonia
E.
* Polyserositis
What JRA eye damage is mainly manifested?
A.
conjunctivitis
B.
Retinopathy
C.
Retinal degeneration
D.
Cataracts
E.
* Iridocyclitis
What clinical triad often accompanies systemic form of JRA?
A.
Arthralgia, chorea, morning stiffness
B.
Arthritis, eye disease, carditis
C.
Rash in the area of the affected joint, fever, heart damage
D.
Resistant articular syndrome, carditis, fever
E.
649.
650.
651.
652.
653.
654.
655.
656.
657.
* Intermittent fever, rash at the height of fever, arthralgia
What from ennumerated is a clinical diagnostic criterion of JRA?
A.
Carditis
B.
Chorea
C.
Rheumatic nodules
D.
Erythema marginatum
E.
* Muscle atrophy
Which of the following drugs is a part of the JRA basic treatment?
A.
Hydrocortisone
B.
Ketotifen
C.
Diclofenac
D.
Indomethacin
E.
* Methotrexate
Non-rheumatic carditis in children most often affects:
A.
all of the heart lining
B.
endocardium
C.
pericardium
D.
endo-and pericardium
E.
* myocardium
Early congenital carditis is formed in gestational age of:
A.
1 - 3 months
B.
7 - 9 months
C.
At birth
D.
10 - 12 months
E.
* 4 - 6 months
Congenital heart defects are formed in gestational age of:
A.
4 - 6 months
B.
7 - 9 months
C.
At birth
D.
10 - 12 months
E.
* 1 - 3 months
Late congenital carditis is formed in gestational age of:
A.
1 - 3 months
B.
4 - 6 months
C.
At birth
D.
10 - 12 months
E.
* 7 - 9 months
Fibroelastosis in a child may be suspected when there is:
A.
rough systolic murmur in the 5-th point
B.
stable bradyarrhythmia
C.
frequent extrasystoles
D.
rough systolic murmur at the apex of the heart
E.
* resistant, refractory to therapy, tachycardia
Fibroelastosis may be suspected in achild when there is:
A.
kyphoscoliosis
B.
pectus excavatum
C.
sinistral lordosis
D.
pigeon chest
E.
* “Heart hump”
What is the main complication of fibroelastosis?
A.
pulmonary insufficiency
B.
cardiosclerosis
C.
ventricular extrasystoles
arterial hypertension
* heart failure
What is the prognosis of fibroelastosis?
A.
recovery
B.
death in the early school age
C.
death at a young age
D.
everything is correct
E.
* death up to 2 years
What is the drug of choice for fibroelastosis?
A.
aspirin
B.
prednisolone
C.
delagyl
D.
penicillin
E.
* digoxin
Symptomatic therapy of fibroelastosis requires the appointment of:
A.
hypotensive
B.
enzymes
C.
antiarrhythmic medicine
D.
antibiotics
E.
* cardiac glycosides
Symptomatic therapy of fibroelastosis requires the appointment of:
A.
hypotensive
B.
vitamins
C.
antiarrhythmic medicine
D.
antibiotics
E.
* diuretics
By what is characterized the clinic of the late congenital carditis?
A.
significant cardiomegaly
B.
progressive tachycardia
C.
persistent bradycardia
D.
everything is wrong
E.
* multiple arrhythmias
Acute non-rheumatic carditis in young children mainly is caused by:
A.
bacteria
B.
toxins
C.
allergic conditions
D.
fungi
E.
* viruses
Acute non-rheumatic carditis is characterized by:
A.
decreased heart borders
B.
elevated blood pressure
C.
increased heart sounds
D.
everything is correct
E.
* cardiac rhythm impairment
Acute non-rheumatic carditis is characterized by:
A.
organic systolic murmur
B.
elevated blood pressure
C.
increased heart sounds
D.
rough systolic murmur on the apex
E.
* functional systolic murmur
The ECG in acute carditis shows:
A.
lengthening PQ
B.
shortening PQ
D.
E.
658.
659.
660.
661.
662.
663.
664.
665.
666.
increased voltage
everything is wrong
* decreased voltage
The ECG in acute carditis shows:
A.
lengthening PQ
B.
shortening PQ
C.
increased voltage
D.
everything is correct
E.
* ventricular extrasystols
The left ventricular heart failure is characterized by:
A.
hepatomegaly
B.
swelling of the neck veins
C.
swelling of the hands veins
D.
edema on feet
E.
* moist rales in the lungs
The right ventricular heart failure is characterized by:
A.
wet cough
B.
moist rales in the lungs
C.
accented 2nd tone of the LA
D.
hemoptysis
E.
* swelling of the neck veins
The left ventricular heart failure is characterized by:
A.
hepatomegaly
B.
swelling of the neck veins
C.
swelling of the hands veins
D.
accented 2nd tone of the aortha
E.
* accented 2nd tone of the LA
The 2nd -B st of the heart failure in non-rheumatic carditis is characterized by:
A.
dyspnea on physical load
B.
anasarca
C.
dry cough
D.
everything is wrong
E.
* moist rales in the lungs
The 3rd stage of the heart failure in non-rheumatic carditis is characterized by
A.
pneumonia
B.
meningitis
C.
hepatitis
D.
splenomegaly
E.
* pulmonary edema
The 2nd -A st of the heart failure in non-rheumatic carditis is characterized by:
A.
swellings on the legs
B.
anasarca
C.
dry cough
D.
hepatomegaly
E.
* dyspnea at rest
The 1 st of the heart failure in non-rheumatic carditis is characterized by:
A.
swellings on the legs
B.
anasarca
C.
dry cough
D.
cardiac asthma
E.
* dyspnea on physical load
What is echocardioscopic sign in fibroelastosis?
A.
hyperkinetic myocardial areas
C.
D.
E.
667.
668.
669.
670.
671.
672.
673.
674.
675.
hypertrophy of the left ventricle
the presence of fluid in the pericardium
anatomical defects of the heart
* increased diastolic volume of the left ventricle
What is echocardioscopic sign in acute carditis?
A.
hyperkinetic myocardial areas
B.
hypertrophy of the left ventricle
C.
dilatation of the left ventricle
D.
everything is wrong
E.
* decreased ejection fraction
What is echocardioscopic sign in chronic carditis?
A.
akinetic myocardial areas
B.
hyperkinetic myocardial areas
C.
the presence of fluid in the pericardium
D.
anatomical defects of the heart
E.
* hypertrophy of the left ventricle
What is the drug of choice for severe acute carditis?
A.
digoxin
B.
delagyl
C.
indomethacin
D.
penicillin
E.
* prednisolone
What is the dose of prednisolone in acute myocarditis?
A.
1,5 - 2,5 mg / kg
B.
2,5 - 3,5 mg / kg
C.
3,5 - 4,5 mg / kg
D.
everything is correct
E.
* 0,5 - 1,5 mg / kg
What is the dose of delagyl at carditis?
A.
1 - 2 mg / kg
B.
3 - 4 mg / kg
C.
7 - 8 mg / kg
D.
everything is wrong
E.
* 5 - 6 mg / kg
What is the maintenance dose of digoxin from the dose-saturation:
A.
1/2 - 1/3
B.
1/3 - 1/4
C.
1/5 - 1/6
D.
1/7 - 1/8
E.
* 1/4 - 1/5
Which drugs improve myocardial function?
A.
prednisolone
B.
corglycon
C.
methyluracil
D.
digoxin
E.
* mildronate
Ventricular septal defect is characterized by:
A.
weakened 2nd tone of the pulmonary arthery
B.
accented 2nd tone of the aorta
C.
weakened 2nd tone of the aorta
D.
everything is wrong
E.
* accented 2nd tone of the pulmonary arthery
Ventricular septal defect is characterized by:
B.
C.
D.
E.
676.
677.
678.
679.
680.
681.
682.
683.
684.
accented 2nd tone of the aorta
weakened 2nd tone of the aorta
soft systolic murmur over the apex
rough systolic murmur over the pulmonary arthery
* rough systolic murmur over the apex
Atrial septal defect is characterized by:
A.
weakened 2nd tone of the pulmonary arthery
B.
accented 2nd tone of the aorta
C.
weakened 2nd tone of the aorta
D.
everything is wrong
E.
* accented 2nd tone of the pulmonary arthery
Atrial septal defect is characterized by:
A.
rough systolic murmur over the apex
B.
accented 2nd tone of the aorta
C.
weakened 2nd tone of the aorta
D.
rough systolic murmur over the pulmonary arthery
E.
* soft systolic murmur over the apex
Patent ductus arteriosus is characterized by:
A.
rough systolic murmur over the apex
B.
weakened 2nd tone of the aorta
C.
soft systolic murmur over the apex
D.
rough systolic murmur over the pulmonary arthery
E.
* systolic-diastolic murmur of the pulmonary arthery
Ventricular septal defect belongs to the group of the congenital heart disease with:
A.
a shunt to the left
B.
an obstacle to blood flow
C.
mixing of blood in the atria
D.
mixing of blood in the aorta
E.
* a shunt to the right
The disease of Fallot belongs to the group of the congenital heart disease with:
A.
a shunt to the right
B.
an obstacle to blood flow
C.
mixing of blood in the atria
D.
mixing of blood in the pulmonary arthery
E.
* a shunt to the left
The disease of Fallot is characterized by:
A.
pale skin
B.
acrocyanosis
C.
paratrophia
D.
anemia
E.
* dyspneic-hypercyanotic attacks
The disease of Fallot is characterized by:
A.
pale skin
B.
acrocyanosis
C.
thrombocytopenia
D.
anemia
E.
* polycythemia
What is x-ray finding in the Fallot disease?
A.
increased lung pattern
B.
ribs "rosary"
C.
reducing the size of the heart
D.
"uzures" on the ribs
E.
* weakening of the lung pattern
A.
B.
C.
D.
E.
685.
686.
687.
688.
689.
690.
691.
692.
693.
694.
695.
696.
697.
698.
699.
700.
701.
What is x-ray finding in coarctation of the aorta?
A.
weakening of the lung pattern
B.
increased lung pattern
C.
ribs "rosary"
D.
reducing the size of the heart
E.
* "uzures" on the ribs
What is x-ray finding in ventricular septal defect?
A.
weakening of the lung pattern
B.
ribs "rosary"
C.
reducing the size of the heart
D.
"uzures" on the ribs
E.
* increased lung pattern
Coarctation of the aorta is characterized by:
A.
arterial hypotension
B.
paresthesia in the fingers
C.
muscular hypotonia of the upper extremities
D.
everything is wrong
E.
* arterial hypertension
Coarctation of the aorta is characterized by:
A.
arterial hypotension
B.
paresthesia in the fingers
C.
muscular hypotonia of the upper extremities
D.
everything is wrong
E.
* paresthesia in the lower extremities
What belongs tothe functional gastric disorders?
A.
Chronic esophagitis
B.
Chronic gastritis
C.
Stomach ulcer
D.
Chronic duodenitis
E.
* Duodenogastric reflux
Gastroesophageal reflux belongs to:
A.
Functional disorders of the stomach by the secretory type
B.
Chronic gastritis
C.
Biliary dyskinesia
D.
Chronic duodenitis
E.
* Functional disorders of the stomach by the motor type
What is the main pathology in gastroesophageal reflux disease?
A.
The pain behind the sternum
B.
Nausea
C.
Vomiting
D.
Flatulence
E.
* Heartburn
What is the main method for diagnosis of gastroesophageal reflux disease?
A.
EGDS
B.
Ultrasound
C.
X-ray of the esophagus
D.
Duodenal probing
E.
* PH-metry of the esophagus
Prescribe prpeparat to a patient with gastroesophageal reflux to improve motility of the stomach:
A.
Almagel
B.
Gastronorm
C.
Quamatel
D.
No-spa
E.
702.
703.
704.
705.
706.
707.
708.
709.
710.
* Motilium
Prescribe prpeparat tocorrect secretory disorders in reflux esophagitis:
A.
Motilium
B.
No-spa
C.
Gastropharm
D.
Smectic
E.
* Quamatel
Etiology of chronic gastroduodenitis
A.
streptococcus
B.
staphylococcus
C.
E. coli
D.
Candida
E.
* Helicobacter pylori
Name agression factors of gastric mucosa:
A.
mucous discharge
B.
prostaglandin E2
C.
bicarbonate
D.
everything is wrong
E.
* hydrochloric acid
What is the regulator of hydrochloric acid secrection?
A.
somastatin
B.
glucagon
C.
insulin
D.
trypsin
E.
* gastrin
Name protectors of gastric mucosa:
A.
pepsin
B.
hydrochloric acid
C.
gastrin
D.
trypsin
E.
* mucous discharge
Name protectors of gastric mucosa:
A.
hydrochloric acid
B.
pepsin
C.
gastrin
D.
everything is correct
E.
* secretory Іg A
What belongs to the pathogenesis of gastritis?
A.
increased mucus formation
B.
increased secretion of bicarbonate
C.
physiological blood flow in the mucous
D.
decreased secretion of hydrochloric acid
E.
* increased secretion of hydrochloric acid
Helicobacter pylori colonizes:
A.
stomach cardia
B.
fundus of the stomach
C.
pylorus
D.
everything is correct
E.
* antrum
Helicobacter pylori produces an enzyme:
A.
lactase
B.
peptidase
C.
lipase
amylase
* urease
The enzyme urease hydrolyzed in the gastric content:
A.
pepsin
B.
HCl
C.
mucus
D.
bile
E.
* urea
Three leading syndromes of chronic gastritis are:
A.
pain, dyspeptic, hemorrhagic
B.
dysuria, dyspeptic, toxic
C.
pain, bleeding, dysuria
D.
everything is correct
E.
* pain, dyspeptic, toxic
Which syndrome is more pronounced in patients with gastritis that has increased secretion?
A.
dyspepsia
B.
toxic
C.
disuric
D.
haemorrhagic
E.
* pain
In patients with increased secretion in gastritis pain is:
A.
mild
B.
dull
C.
moderate
D.
absent
E.
* intensive
In patients with reduced secretion in gastritis pain is:
A.
intensive
B.
acute
C.
absent
D.
everything is wrong
E.
* mild
In patients with gastritis pain occurs through:
A.
30-45 min after meals
B.
45-60 min after meals
C.
1-1,5 hours after meals
D.
everything is wrong
E.
* 15-30 min after meals
In patients with duodenitis pain occurs more frequently through:
A.
15-30 min after meals
B.
30-45 min after meals
C.
45-60 min after meals
D.
everything is correct
E.
* 1-1,5 hours after meals
Night pain is typical for patients with:
A.
normal acid-function
B.
reduced acid-function
C.
achlorhydria
D.
everything is correct
E.
* high acid-function
The prevalence of pain over the dyspeptic syndrome is characteristic gastroduodenitis with:
A.
normal acid-function
B.
reduced acid-function
D.
E.
711.
712.
713.
714.
715.
716.
717.
718.
719.
achlorhydria
everything is correct
* high acid-function
The prevalence of dyspeptic over the pain syndrome is characteristic for gastroduodenitis with:
A.
high acid-function
B.
normal acid-function
C.
saved acid-function
D.
everything is wrong
E.
* reduced acid-function
Which of the syndromes is the most constant in chronic gastroduodenitis in children?
A.
dyspeptic
B.
intoxication
C.
epithelial
D.
syderopenic
E.
* pain
Severity of dyspeptic manifestations in chronic gastroduodenitis in children depends on:
A.
age of the child
B.
dietary peculiarities
C.
intervals between meals
D.
balance of food ingredients
E.
* secretory function
What is most often observed in the reduced acidity of gastric juice?
A.
tendency to constipation
B.
"sour" burping
C.
"Hunger pains"
D.
vomiting
E.
* unstable stols
What secretory function is the most characteristic in childhood gastritis?
A.
Reduced
B.
reduced and normal
C.
increased
D.
conservation
E.
* increased and normal
Which of the methods is the most important for the diagnosis of chronic gastroduodenitis?
A.
pH meters
B.
fractional test of gastric contents
C.
atsidotest
D.
X-ray
E.
* EGDS
Which of the methods of Helicobacter pylori infection diagnostic belong to invasive?
A.
feces and saliva study by polymerase chain reaction
B.
breath tests
C.
immunoglobulins establishment
D.
“Aerotest”
E.
* Bacteriological study of gastric mucosa biopsy
Which of the methods of Helicobacter pylori infection diagnostic belong to non-invasive?
A.
urease test
B.
De-nol-test
C.
study of nucleic acids
D.
biopsy of the gastric or duodenum mucosa
E.
* "Aerotest"
What determines the duration of bed rest in the treatment of chronic gastroduodenitis children?
A.
severity of dyspeptic manifestations
C.
D.
E.
720.
721.
722.
723.
724.
725.
726.
727.
728.
quantity of secretion
age of the child
endoscopic changes
* the severity of pain
Which antacid drugs is the most appropriate to be used in children?
A.
sodium bicarbonate
B.
calcium carbonate
C.
magnesium sulfate
D.
carbon dioxide
E.
* maalox
What almagel A dose is prescribed for children under 10 years?
A.
? tablespoon 3 times a day
B.
? teaspoon 4 times a day
C.
1 tablespoon 3 times a day
D.
1 dessert spoon 3 times a day
E.
* 1 teaspoon 4 times a day
Which of the products belongs to the blockers of histamine H2-receptor?
A.
maalox
B.
vikalin
C.
methacine
D.
gastropharm
E.
* cimetidine
What is the daily dose of cimetidine used in the treatment of chronic gastroduodenitis children?
A.
1 mg / kg
B.
3 mg / kg
C.
5 mg / kg
D.
20 mg / kg
E.
* 10 mg / kg
What kind of drugs refers to reparants?
A.
panzynorm
B.
renegast
C.
bellaspon
D.
ranitidine
E.
* gastropharm
What physiotherapy procedure can be applied to children with chronic gastroduodenitis with the
expressed pain syndrome?
A.
ozokerite applications
B.
xylitol probing
C.
diathermy
D.
mud
E.
* electrophoresis of novocaine
Which of the following drugs are attributed to Hpylori?
A.
maalox
B.
gastropharm
C.
cimetidine
D.
penicillin
E.
* amoxacilline
What is the leading symptom in the 1st stage ulcer?
A.
vomiting
B.
belching
C.
heartburn
D.
local muscle tension
E.
* pain
B.
C.
D.
E.
729.
730.
731.
732.
733.
734.
735.
736.
737.
738.
739.
740.
741.
742.
743.
744.
745.
What characteristic of dyspeptic manifestations at the healing stage of ulcer?
A.
expressed
B.
nausea
C.
acid regurgitation
D.
heartburn
E.
* absent
What feature of the ulcer disease course is typical for children?
A.
mild
B.
latent course
C.
sluggish course
D.
chronic course
E.
* as a rule severe
What are peculiarities of the peptic ulcer, mild course?
A.
term healing of ulcers up to 2 weeks, with remission up to 6 months
B.
term healing of ulcers up to 2 months with remission less than 1 year
C.
term healing of ulcers 1 month, relapse up to 2 times a year
D.
term healing of ulcers up to 2 months, relapse once a year
E.
* term healing of ulcers up to 1 month with remission for over a year
What are peculiarities of the peptic ulcer, moderate course?
A.
term healing of ulcers up to 1 month with remission for over a year
B.
term healing of ulcers up to 2 weeks, with remission up to 6 months
C.
term healing of ulcers 1 month, relapse up to 2 times a year
D.
term healing of ulcers up to 2 months, relapse once a year
E.
* term healing of ulcers up to 2 months with remission less than 1 year
What are peculiarities of the peptic ulcer, severe course?
A.
term healing of ulcers up to 1 month with remission for over a year
B.
term healing of ulcers up to 2 weeks, with remission up to 6 months
C.
term healing of ulcers up to 2 months with remission less than 1 year
D.
term healing of ulcers up to 2 months, relapse once a year
E.
* term healing of ulcers 1 month, relapse up to 2 times a year
What is the drug of choice in Helisobaster pylori invasion?
A.
penicillin
B.
gentamicin
C.
cefazolin
D.
erythromycin
E.
* metronidazole
What is the most frequent complication of peptic ulcer in children?
A.
stenosis of pylorus
B.
penetration
C.
perforation
D.
peryvistseritis
E.
* bleeding
Name radiological signs of gastric ulcers:
A.
radial convergence of the of the stomach walls
B.
thickening of the walls
C.
thickening of the mucosal folds
D.
smoothed mucous folds
E.
* "niche" with inflammatory shaft
What is the duration of peptic ulcer triple or quadro therapy in children?
A.
5 - 7 days
B.
10 - 14 days
C.
14 - 21 days
D.
21 - 30 days
E.
746.
747.
748.
749.
750.
751.
752.
753.
754.
* 7 - 10 days
Which drug is a reparant of gastric mucosa in duodenal ulcer?
A.
cimetidine
B.
renegast
C.
smectic
D.
motilium
E.
* spirulina
What is advisable to appoint in gastrointestinal dysmotility?
A.
no-spa
B.
smectic
C.
gastropharm
D.
almagel
E.
* motilium
When the cytoprotectors are given to children with peptic ulcer?
A.
from the beginning of treatment
B.
in case of hyperacidity
C.
in the process of ulcers healing
D.
in remission
E.
* after antihelicobacter therapy
Name forms of chronic hepatitis in children
A.
persistent, active, autoimmune
B.
medical, autoimmune, alcoholic
C.
cryptogenic, viral, toxic
D.
cryptogenic, autoimmune, toxic, alcoholic
E.
* viral, autoimmune, drug-induced, toxic
Name phases of chronic hepatitis activity
A.
active (minimal, moderate, severe)
B.
active (mild, moderate, severe), inactive
C.
active, incomplete clinical and laboratory remission, complete clinical and laboratory
remission
D.
incomplete clinical and laboratory remission, complete clinical and laboratory remission
E.
* active (minimal, moderate, severe), inactive
What tells us about the minimal activity of chronic hepatitis?
A.
normal ALT
B.
ALT 5 times higher than normal
C.
ALT 5-10 times higher than normal
D.
ALT levels above the norm more than 10 times
E.
* ALT 3 times higher than normal
Pain in chronic hepatitis is manifested as:
A.
epigastric fasting pain
B.
nocturnal epigastric pain
C.
belting pain 1-2 hours after meal
D.
pain in the left hypochondrium during physical activity
E.
* pain in the right hypochondrium during physical activity
What are the main clinical manifestations of cholestasis syndrome?
A.
jaundice, hepatosplenomegaly
B.
pallor, jaundice, hepatosplenomegaly
C.
abdominal pain, jaundice
D.
pallor, skin itching
E.
* jaundice, skin itching
Mesenchymal-inflammatory syndrome is characterized by:
A.
increased AST, ALT
B.
prothrombin reduction
increased alkaline phosphatase
raised indirect bilirubin
* dysproteinemia
Viferon belongs to:
A.
Glucocorticoids
B.
Antibiotics
C.
Antihystamines
D.
Antiinflammatory
E.
* Interferon
What is the main direction of autoimmune hepatitis treatment?
A.
antiviral therapy
B.
antibacterial therapy
C.
immunostimulatory therapy
D.
antiinflammatory therapy
E.
* immunosuppressive therapy
Name the immunosuppressive therapy of chronic hepatitis B.
A.
Indomethacin
B.
Penicillin
C.
Cholenzym
D.
Essenciale
E.
* Azathioprine
What are the signs of hypotonic biliary dyskinesia in duodenal probing?
A.
Increased portion A
B.
Increased portion C
C.
Decreased portion B
D.
Decreased portion C
E.
* Increased portion B
What are the signs of hypertonic biliary dyskinesia in duodenal probing?
A.
Increased portion A
B.
Increased portion B
C.
Increased portion C
D.
Decreased portion C
E.
* Decreased portion B
What are the signs of hypotonic biliary dyskinesia in sonogram (USE)?
A.
Increased liver
B.
Contracted gallbladder
C.
Reduced liver
D.
Normal gallbladder
E.
* Dilated gallbladder
What are the signs of hypertonic biliary dyskinesia in sonogram (USE)?
A.
Increased liver
B.
Reduced liver
C.
Dilated gallbladder
D.
Normal gallbladder
E.
* Contracted gallbladder
What is the treatment of hypotonic biliary dyskinesia?
A.
Analgesics
B.
Antispasmodic
C.
Hepatoprotectors
D.
Sedative
E.
* Choleretics and cholekinetics
What is the physiotherapy of hypotonic forms of biliary dyskinesia?
A.
СаСІ2 electrophoresis
C.
D.
E.
755.
756.
757.
758.
759.
760.
761.
762.
763.
Inductothermy
Ozokerite applications
Microwaves therapy
* MgSO4 electrophoresis
What is used in the treatment of hypertonic biliary dyskinesia?
A.
Analgesics
B.
Antibiotics
C.
Hepatoprotectors
D.
Cholekynetics
E.
* Antispasmodic and sedatives
What is the physiotherapy of hypertonic forms of biliary dyskinesia?
A.
MgSO4 electrophoresis
B.
proserin electrophoresis
C.
Electrical stimulation of the phrenic nerve
D.
Microwaves therapy
E.
* Inductothermy
What are the leading clinical syndromes in chronic cholecystocholangitis?
A.
Pain, dysuria
B.
Toxic, hemorrhagic
C.
Dyspeptic, dysuria
D.
Dyspeptic, hemorrhagic
E.
* Pain, dyspeptic
The presence of vascular asterisks is characteristic for:
A.
Gastritis
B.
Duodenitis
C.
Gastroenterocolitis
D.
Pancreatitis
E.
* Biliary dyskinesia
What determines the pain character in cholecystocholangitis?
A.
age of the patient
B.
sex of the patient
C.
the state of the nervous system
D.
the duration of the disease
E.
* type of dyskinesia
Dilated intradermal capillaries on the back is characteristic for:
A.
Biliary dyskinesia
B.
Gastritis
C.
Duodenitis
D.
Pancreatitis
E.
* Cholecystocholangitis
What are the causes of primary chronic pancreatitis?
A.
Pathology of the stomach
B.
Pathology of duodenal ulcer
C.
Pathology of the liver
D.
Pathology of intestinal
E.
* Viral-bacterial infection
What are the causes of secondary chronic pancreatitis?
A.
Viral-bacterial infection
B.
Allergic factors
C.
Drug therapy induced lesion
D.
Abdominal trauma
E.
* Pathology of the liver
Feces in chronic pancreatitis are:
B.
C.
D.
E.
764.
765.
766.
767.
768.
769.
770.
771.
772.
Solid
Thick
Putty-like
Mixed with blood
* Pasty or liquid
What is the normal level of blood serum amylase in children?
A.
10-15 g / hour liter
B.
16-32 g / hour liter
C.
33-45 g / hour liter
D.
46-60 g / hour liter
E.
* 5 - 10 g / hour liter
Diastasuria is typical for:
A.
Hepatitis
B.
Cholecystitis
C.
Colitis
D.
Duodenitis
E.
* Pancreatitis
What is the diet in the early days of pancreatitis?
A.
Diet № 1
B.
Diet № 5
C.
Diet № 7
D.
Diet № 9
E.
* Hunger
What medicine is used to decrease the pain in pancreatitis?
A.
Aspirin
B.
Indomethacin
C.
Caffeine
D.
No-spa
E.
* Baralgin
What medicine is used to treat an acute attack of pancreatitis?
A.
Penicillin
B.
Heparin
C.
Vicasol
D.
Voltaren
E.
* Contrical
What medicine is used for pharmacological suppression of pancreatic function?
A.
Ranitidine
B.
Almagel
C.
Linex
D.
Quamatel
E.
* Creon
What is the physiotherapy during exacerbation of chronic pancreatitis?
A.
Ozokerite applications
B.
Inductothermy
C.
UHF (ultra high frequency)
D.
microwaves
E.
* Gordox electrophoresis
What is the leading etiologic factor of chronic hepatitis?
A.
bacteria
B.
parasites
C.
fungi
D.
prions
E.
* viruses
A.
B.
C.
D.
E.
773.
774.
775.
776.
777.
778.
779.
780.
781.
782.
783.
784.
785.
786.
787.
788.
789.
What is the leading etiological factor of chronic cholecystocholangitis?
A.
feeding character
B.
anomaly of the liver
C.
genetic susceptibility
D.
congenital malformations
E.
* biliary dyskinesia
What complex of symptoms is characteristic for chronic hepatitis?
A.
abdominal pain, bleeding, arthritis
B.
abdominal pain, diarrhea, intoxication
C.
abdominal pain, splenomegaly, jaundice
D.
everything is correct
E.
* abdominal pain, hepatosplenomegaly, bleeding
The pathology of biliary tract is characterized by:
A.
abdominal pain immediately after taking food
B.
abdominal pain after sleeping
C.
abdominal pain during urination
D.
everything is correct
E.
* abdominal pain after physical exertion
The dyspeptic syndrome in the pathology of biliary tract is characterized by:
A.
diarrhea after drinking milk
B.
frequent profuse diarrhea
C.
persistent constipation since birth
D.
everything is correct
E.
* recurrent constipation
Hypotonic biliary dyskinesia is characterized by:
A.
hungry, nocturnal pain in the abdomen
B.
intense, cramping pain in right hypochondrium
C.
arching pain in umbilical area
D.
intense night pain
E.
* heaviness, discomfort in the right hypochondrium
Hypertonic biliary dyskinesia is characterized by:
A.
heaviness, discomfort in the right hypochondrium
B.
hungry, nocturnal pain in the abdomen
C.
arching pain in umbilical area
D.
intense night pain
E.
* intense, cramping pain in right hypochondrium
Chronic pancreatitis is characterized by:
A.
hepatomegaly, jaundice, recurrent constipation
B.
splenomegaly, jaundice, diarrhea
C.
local pain pyloroduodenal zone, anemia, constipation
D.
intense night pain
E.
* "girdle" abdominal pain, anemia, and diarrhea
What is characteristic for the liver cirrhosis?
A.
splenomegaly, anemia, hemorrhage
B.
splenomegaly, anemia, jaundice
C.
hepatosplenomegaly, anemia, hemorrhage
D.
hyposplenism
E.
* hepatosplenomegaly, anemia, jaundice,
What is characteristic for the gallstone disease?
A.
arching, constant pain in the abdomen
B.
dull, aching pain in right hypochondrium
C.
hungry pain in right hypochondrium
D.
intense night pain
E.
790.
791.
792.
793.
794.
795.
796.
797.
798.
* intense, cramping pain in the right hypochondrium
Which investigations are necessary for patients with hepatobilliary system diseases?
A.
PH-meters, ultrasound, duodenal probing
B.
PH-metry, EGDS, ultrasound
C.
EGDS, ultrasound, laparoscopy
D.
PH-metry, EGDS, duodenal probing, ultrasound
E.
* Ultrasound, laparoscopy, duodenal probing
Which biochemical tests are necessary for patients with hepatobilliary system diseases?
A.
total protein, CRP, seromucoid, bilirubin
B.
total protein and fractions, urea, creatinine, cholesterol
C.
total protein and fractions, CRP, seromucoid, urea
D.
total protein and fractions, seromucoid, bilirubin
E.
* total protein and fractions, transaminases, bilirubin, cholesterol
What "cytolysis" syndrome includes?
A.
increasing levels of cholesterol, direct bilirubin, iron, LDH
B.
reduction of albumin, cholesterol, bilirubin, CRP
C.
reduction of iron, CRP, residual nitrogen, AST, ALT
D.
reduction of iron, CRP, increased AST, ALT
E.
* increasing AST, ALT, LDH, iron, bilirubin
What is observed in reduced synthetic liver function?
A.
luminemia, hypercholesterolemia, hyperasotemia
B.
hyperbillirubinemia, hypercholesterolemia, hyperasotemia
C.
reduction of iron, CRP, increased AST, ALT
D.
reduction of iron, CRP, residual nitrogen, AST, ALT
E.
* hypoalbuminemia, reduced levels of fibrinogen and prothrombin
What is observed in reduced detoxication liver function?
A.
hyperbillirubinemia, hypoproteinemia, hypoasotemia
B.
hyperbillirubinemia, hypoproteinemia, hypophenolemia
C.
hyperasotemia, hypophenolemia, hyperammoniemia
D.
hypobillirubinemia, hypoproteinemia, hypophenolemia
E.
* hyperasotemia, hyperfenolemia, hyperammoniemia
Polyclonal hammapathia syndrome is characterized by:
A.
hyperproteinemia, hypoimmunoglobulinemia, positive sediment samples
B.
hypoproteinemia, hypoimmunoglobulinemia, hyperbillirubinemia
C.
hypoproteinemia, hyperimmunoglobulinemia, hyperbillirubinemia
D.
hypobillirubinemia, hypoproteinemia, hypophenolemia
E.
* hyperproteinemia, hyperimmunoglobulinemia, positive sediment samples
What ultrasound symptom is typical for cholecystocholangitis?
A.
enlarged liver
B.
gallbladder deformation
C.
sediment in the gallbladder
D.
gallbladder hypotonia
E.
* thickening of the gallbladder walls
What ultrasound symptom is typical for hepatitis?
A.
deformation of the bile ducts
B.
thick walls of the bile ducts
C.
multiple concrements
D.
liver size reduction
E.
* diffuse thick structure of the liver
On what day of the duodenogastric reflux treatment cholekinetics are prescribed?
A.
20 th
B.
14 th
C.
10 th
2nd
* 7 th
What should be used for electrophoresis in duodenogastric reflux?
A.
procaine
B.
magnesium sulfate
C.
papaverine
D.
no-spa
E.
* neostigmine
What should be appointed for hypertonic biliary dyskinesia?
A.
holenzim
B.
carsil
C.
convoflavin
D.
motillium
E.
* no-spa
What should be appointed for hypotonic biliary dyskinesia?
A.
no-spa
B.
carsil
C.
essenciale
D.
motilium
E.
* holenzim
What is the drug of choice for intestine giardiasis?
A.
gentamicin
B.
penicillin
C.
aspirin
D.
pyrantel
E.
* furazolidone
Violation of nitrogen excretion renal function in the onset of glomerulonephritis is typical for:
A.
isolated urinary syndrome
B.
nephrotic syndrome
C.
mixed syndrome
D.
everything is correct
E.
* nephritic syndrome
Excretory urography give us possibility to evaluate (give the most complete answer):
A.
anatomical status of urinary tract and urodynamic
B.
calyx-pelvic system state
C.
functional ability of urinary tract
D.
size of the kidneys
E.
* everything is correct
What time after exacerbation of chronic glomerulonephritis resort treatment is possible?
A.
3 months
B.
12 months
C.
It is not performed
D.
5 years
E.
* 6 months
Which drug is used for basic therapy of acute glomerulonephritis with nephrotic syndrome?
A.
Curantyl
B.
Penicillin
C.
Suprastin
D.
Ascorutin
E.
* Prednisolone
Which factor is most weighty in the etiology of glomerulonephritis?
A.
S aureus
B.
E. cоlі
D.
E.
799.
800.
801.
802.
803.
804.
805.
806.
807.
Influenza virus
hepatitis A
* Streptococci
Which of the pathogenic mechanisms of damage is characteristic for glomerulonephritis?
A.
bacterial inflammation of the kidney bowls
B.
immediate type allergic reaction
C.
violation of the urine passage
D.
vesicoureteral reflux
E.
* immune complex glomerular damage
The nephritic variant of acute glomerulonephritis is characterized by:
A.
high proteinuria
B.
hyperphosphaturia
C.
pyuria
D.
bacteriuria
E.
* hematuria
What level of proteinuria is a criterion for nephrotic variant of acute glomerulonephritis?
A.
more than 1 g / day
B.
less than 1 g /day
C.
more than 3 g / l
D.
up to 1 g / l
E.
* more than 3 g / day
What is characteristic for the isolated urinary syndrome?
A.
proteinuria up to 2 g/l
B.
expressed leukocyturia
C.
expressed edema
D.
arterial hypertension
E.
* proteinuria up to 1 g/l
By which investigation is it possible to evaluate the state of renal concentration function?
A.
analysis of urine
B.
Nechiporenko urine analysis
C.
ultrasonic investigation
D.
excretory urography
E.
* Zimnitsky test
The criterion of acute glomerulonephritis transition in a chronic form is saving of clinicallaboratory signs longer than:
A.
6 months
B.
3 months
C.
6 weeks
D.
9 months
E.
* 1 year
The expressed edema syndrome is most characteristic for:
A.
isolated urinary syndrome
B.
nephritic variant of acute glomerulonephritis
C.
mixed form of chronic glomerulonephrita
D.
gematuricheskoy forms of chronic glomerulonephritis
E.
* nephrotic form of chronic glomerulonephritis
What from this belong to pathogenetic therapy of chronic glomerulonephritis hematuric form?
A.
leukeran
B.
prednisolon
C.
chlorbutin
D.
imuran
E.
* delagyl
What is the evidence to give immune suppressors at acute glomerulonephritis?
C.
D.
E.
808.
809.
810.
811.
812.
813.
814.
815.
816.
sudden, acute disease beginning
presence of expressed proteinuria
absence of NSAIDs treatment effect for 3-4 weeks in children with the nephrotic variant
of the acute glomerulonephritis
D.
violation of renal function at the disease beginning
E.
* absence of glucocorticoids treatment effect for 3-4 weeks in children with the nephritic
variant of the acute glomerulonephritis
At the nephrotic form of acute glomerulonephritis prednizolon is appointed in a maximal
therapeutic dose not less than:
A.
3-4 weeks
B.
6-8 weeks
C.
2-3 days
D.
5-10 days
E.
* 2-3 weeks
Ultrasonic investigation of which kidney pathology is the most informing?
A.
hydronefrotic kidney
B.
glomerulonephritis, pyelonephritis
C.
renal pelvic distopia
D.
everything is uncorrect
E.
* tumour, renal stones
What from this is one of absolute indications to chronic gemodyalisis at chronic kidney
insufficiency?
A.
blood billirubin 150 mmol/l;
B.
cholesterol more than 10 mmol/l;
C.
urea 12-15 mmol/l;
D.
increased potassium to 4 mmol/l
E.
* blood creatinyne 0,7-0,9 mmol/l;
Which casts form from the protein in acid urine pH?
A.
Erythrocyte
B.
Leucocyte
C.
Grainy
D.
Epithelial
E.
* Hyalin
Leucocyturia in acute glomerulonephritis lasts for:
A.
1-2 hours
B.
1-2 days
C.
10-20 days
D.
1-2 months
E.
* 1-2 weeks
Which casts are typical for glomerulonephritis?
A.
Leucocyte
B.
Hyalin
C.
Grainy
D.
Epithelial
E.
* Erythrocyte
What dose of heparin is used in the treatment of glomerulonephritis in children?
A.
50-100 IU / kg / day
B.
150-200 IU / kg / day
C.
100-300 IU / kg / day
D.
50-500 IU / kg / day
E.
* 100-150 IU / kg / day
What dose of indomethacin is prescribed to children with nephritic variant of acute
glomerulonephritis?
A.
B.
C.
817.
818.
819.
820.
821.
822.
823.
824.
1-2 mg / kg / day
3-5 mg / kg / day
0,5-1 mg / kg / day
0,8-1 mg / kg / day
* 2,5-3 mg / kg / day
Which of these products are excluded from the diet 7?
A.
rice or buckwheat porridge with jam and sugar
B.
vegetable purees, vegetable soup, egg
C.
vegetable oil and butter
D.
fruit
E.
* meat, fish
Pain in the lower abdomen (suprapubic) radiating to the perineum, increasing pain at the end of
the urination or after it, are typical for:
A.
glomerulonephritis
B.
pyelonephritis
C.
renal amyloidosis
D.
urolithiasis
E.
* cystitis
Which of the symptoms are characteristic for pyelonephritis?
A.
intoxication
B.
abdominal pain, lumbar
C.
pyuria
D.
pathological bacteriuria
E.
* everything is correct
How long is anibacterial therapy after the normalization of urine analysis in primary
pyelonephritis?
A.
1,5-3 months
B.
3-6 months
C.
1 year
D.
6 months
E.
* 14 days-1 month
What tactics of the physician in leukocyturia identifying in girls:
A.
appointment of antibacterial therapy
B.
appointment of uroseptics
C.
cystoscopy
D.
descending urography
E.
* screened for helminths, with the exception of vulvovaginitis
Which antibacterial therapy should be preferable in treatment of active phase of pyelonephritis:
A.
monotherapy by antibiotic
B.
monotherapy by uroseptic
C.
phytotherapy
D.
physiotherapy
E.
* combined (antibiotic and uroseptic)
The secondary pyelonephritis in children most often occurs on the background:
A.
glomerulonephritis
B.
acute viral respiratory infection
C.
systemic lupus erythemathosus
D.
tonsillitis
E.
* anomalies of the urinary tract
Most of pyelonephritis are caused by:
A.
klebsiella
B.
staphylococcus
C.
streptococcus
A.
B.
C.
D.
E.
825.
826.
827.
828.
829.
830.
831.
832.
Proteus
* E. coli
Which feature of back pain in pyelonephritis?
A.
diffuse
B.
bilateral
C.
irradiate in the sacral region
D.
in the form of attacks
E.
* unilateral
Which syndrome is crucial for the diagnosis of pyelonephritis
A.
toxic
B.
pain
C.
dysuria
D.
astheno-vegetative
E.
* uric
What level of proteinuria is typical for pyelonephritis?
A.
up to 0,5 g / l
B.
up to 2 g / l
C.
up to 3 g / day
D.
up to 1 g / day
E.
* up to 1 g / l
Diagnostic criteria for pyelonephritis in the general analysis of urine is:
A.
crystaluria
B.
hematuria
C.
cylindruria
D.
glycosuria
E.
* piuria
What is the value of microbial numbers (number of bacteria in 1 ml of urine) is a criterion for
pyelonephritis?
A.
5,000,000 or more
B.
10,000 or more
C.
50,000 or more
D.
1000 and more
E.
* 1,000,000 or more
What ultrasound of the kidneys in children with primary pyelonephritis is typical?
A.
reduced size of kidneys
B.
presence of salt crystals
C.
thick structure of the kidneys
D.
thinning of the parenchyma
E.
* pyeloectasia
What investigation is the most informative for urinary tract abnormalities diagnosis?
A.
ultrasound
B.
cystoscopy
C.
cystography
D.
thermography
E.
* excretory urography
What diet is appropriate at pyelonephritis?
A.
№1
B.
№2
C.
№7
D.
№9
E.
*№5
Which factor most of all may be a cause of hematuria in secondary pyelonephritis?
A.
increased permeability of the glomerular capillaries
D.
E.
833.
834.
835.
836.
837.
838.
839.
840.
841.
hemorrhage in the glomeruli
ruptures of the glomerular capillaries
renal intravascular coagulation
* urinary tract mucosa damage by stones
Antibacterial therapy of pyelonephritis is given for:
A.
7-14 days
B.
14-21 days
C.
for 6 months
D.
to partial clinical and laboratory remission
E.
* to full clinical and laboratory remission
Which of the following antibiotics is appropriate to a child in the debut of pyelonephritis?
A.
kefzol
B.
palin
C.
benzylpenicillin
D.
erythromycin
E.
* augmentin
What is the duration of outpatient treatment (dispensarization) for children after acute
pyelonephritis?
A.
1 year
B.
2 years
C.
4 years
D.
5 years
E.
* 3 years
What time after the onset of clinical and laboratory remission children with pyelonephritis can be
sent to the resort?
A.
6-9 months
B.
9-12 months
C.
1-3 months
D.
1-2 years
E.
* 3-6 months
Which of physiotherapeutic methods is indicated for the pyelonephritis treatment?
A.
ozokerite applications on the right hypochondrium
B.
ozokerite applications on the suprapubic area
C.
electrophoresis with calcium chloride and vitamin C at the lumbar area
D.
novocaine electrophoresis at the lumbar area
E.
* furadonine electrophoresis at the lumbar area
The clinic of acute pyelonephritis in infants is dominated by:
A.
Dysuric disorders
B.
Pain syndrome
C.
Dysuria and pain syndrome
D.
Enuresis manifestation
E.
* Intoxication syndrome
What reserve antibiotic is used in the treatment of pyelonephritis?
A.
Ampicillin
B.
Ampiox
C.
Cephalosporins of 2nd generation
D.
Cephalosporins of third generation
E.
* Aminoglycosides
Secondary pyelonephritis develops on the background of:
A.
Organic hemodynamic changes
B.
Functional hemodynamic changes
C.
Organic urodynamic changes
D.
Functional changes urodynamic
B.
C.
D.
E.
842.
843.
844.
845.
846.
847.
848.
849.
E.
850.
851.
852.
853.
854.
855.
856.
857.
858.
* Everything is correct
What is “zigzag” diet in children who have an acute pyelonephritis?
A.
The alternation of salt-free and sugar-free days
B.
The alternation of KCl and protein products
C.
Rotation Diet № 5 and Diet № 15
D.
The alternation of fasting and nutrition
E.
* Alternation products that are acidified or make alkaline urine
Latent course of chronic pyelonephritis is characterized by:
A.
The presence of only intoxication syndrome
B.
The presence of only pain
C.
The presence of pain and intoxication syndromes
D.
The presence of pain and urinary syndromes
E.
* The presence of only urine syndrome
In infants, patients with pyelonephritis, symptoms of intoxication are combined with dysfunction
of:
A.
Respiratory system
B.
Cardiovascular system
C.
Endocrine system
D.
Nervous system
E.
* Digestive system
Chronic pyelonephritis is diagnosed when symptoms of pyelonephritis occur in a child longer
than:
A.
3 months
B.
6 months
C.
9 months
D.
18 months
E.
* 12 months
What dose of aminoglycosides (gentamicin) is used for pyelonephritis treatment in children?
A.
10-20 mg / kg / day
B.
20-50 mg / kg / day
C.
5-10 mg / kg / day
D.
50-100 mg / kg / day
E.
* 4-6 mg / kg / day
What dose of amoxicillin is used for pyelonephritis treatment in children?
A.
20-50 mg / kg / day
B.
50-100 mg / kg / day
C.
100-200 mg / Kg / day
D.
150-250 mg / kg / day
E.
* 50-80 mg / kg / day
What dose of nitrofurans is used for pyelonephritis treatment in children?
A.
50-100 mg / kg / day
B.
1-2 mg / kg / day
C.
15-20 mg / kg / day
D.
20-50 mg / kg / day
E.
* 5-10 mg / kg / day
Which of the following preventive measures is the most effective when hypovitaminosis D?
A.
Storage of food at low temperatures
B.
The use of refined carbohydrates
C.
Use fresh vegetables and fruits
D.
Prevent the formation of smog
E.
* Sunbathing
In which period of rickets Spasmophylia is usually developde?
A.
height
initial
residual
anyone
* convalescence
Rapid intravenous injection of calcium preparations may cause:
A.
bradycardia
B.
apnea
C.
tachycardia
D.
arrhythmia
E.
* bronchospasm
The immediate cause of spasmophylia is:
A.
hypoglycemia
B.
hypophosphatemia
C.
hypoproteinemia
D.
hypolipidemia
E.
* hypocalcemia
Vitamin D in case of spasmophylia is appointed after seizures through:
A.
1 - 2 days
B.
3 - 4 weeks
C.
3 - 4 months
D.
everything is wrong
E.
* 3 - 4 days
What product must be limited to children with spasmophylia?
A.
breast milk
B.
vegetable puree
C.
cereal porridges
D.
eggs
E.
* cow’s milk
Doses of vitamin D in the treatment of rickets depends on:
A.
child’s weight
B.
body surface
C.
age child
D.
everything is correct
E.
* severity of illness
What is the duration of rickets treatment?
A.
15 - 30 days
B.
10 - 15 days
C.
45 - 60 days
D.
5 - 7 days
E.
* 30 - 45 days
What is the duration of the rickets initial period?
A.
1 - 4 days
B.
1 - 4 months
C.
1 - 4 years
D.
1 - 4 hou
E.
* 1 - 4 wks
What concentration of calcium gluconate is used for spasmophylia treatment ?
A.
1 - 2% solution
B.
0,1 - 0,2% solution
C.
10 - 20% solution
D.
3 - 5% solution
E.
* 5% - 10% solution
In order to eliminate alkalosis children with spasmophylia receive:
B.
C.
D.
E.
859.
860.
861.
862.
863.
864.
865.
866.
867.
Calcium chloride
Sodium chloride
Potassium chloride
Physiologic saline
* Ammonium chloride
Daily dose of vitamin D for term infants (the method of "small doses") is:
A.
100 IU
B.
1,000 IU
C.
2,000 IU
D.
5,000 IU
E.
* 500 IU
The daily dose of vitamin D3 is:
A.
1,000 – 2,000 IU
B.
500 – 1,000 IU
C.
5,000 – 10,000 IU
D.
500 – 1,000 I
E.
* 2,000 – 5,000 IU
Carpopedal spasm - is:
A.
hands and feet muscles clonic contractions
B.
tonic contractions of facial muscles
C.
tonic contractions of glottis
D.
convulsions
E.
* hands and feet muscles tonic contractions
Acid - base balance in rickets is:
A.
shifted toward alkalosis
B.
not changed
C.
everything is wrong
D.
everything is corre
E.
* shifted toward acidosis
What is the criterion for vitamin D course completion in rickets treatment?
A.
increased muscle tone
B.
normalization of sleep
C.
closure of a large fontanel
D.
everything is correct
E.
* normalization of biochemical changes
Laboratory changes in the peak of rickets include:
A.
hypercalcemia
B.
hyperphosphatemia
C.
alkalosis
D.
reduction of alkaline phosphatase
E.
* increase alkaline phosphatase
What are laboratory criteria of spasmophylia?
A.
hyponatremia
B.
kaliopenia
C.
hypophosphataemia
D.
hypernatremia
E.
* hypocalcemia
What is the most dangerous manifestation of carpopedal spasm?
A.
spasm of the hands muscles
B.
spasm of the smooth muscles
C.
spasm of masticatory muscles
D.
spasm of respiratory muscles
E.
* spasm of the heart muscle
A.
B.
C.
D.
E.
868.
869.
870.
871.
872.
873.
874.
875.
876.
877.
878.
879.
880.
881.
882.
883.
884.
The highest level of phosphorus in the blood occurs in patients with rickets:
A.
during the height period
B.
in the initial period
C.
in the residual period
D.
constantly
E.
* during convalescence
The initial period of rickets is mostly diagnosed to the child of:
A.
2-3 months old
B.
3-5 months old
C.
5-7 months old
D.
After 1 year
E.
* 1 month
The normal level of phosphorus in the blood is observed in:
A.
height period of rickets
B.
convalescence period of rickets
C.
initial period of rickets
D.
constantly
E.
* residual period of rickets
Rickets provoking factor is feeding with overload of:
A.
fat
B.
protein
C.
vitamins
D.
minerals
E.
* carbohydrates
In the initial period of rickets study of the nervous system detect:
A.
muscular hypertension
B.
muscle atrophy
C.
decreasing muscular strength
D.
muscle pain
E.
* muscular hypotension
What is the activity of alkaline phosphatase in the initial stage of rickets?
A.
normal
B.
reduced
C.
invariable
D.
everything is wrong
E.
* increased
In rickets the deformation of the chest appears in:
A.
1 -3 months
B.
6 - 9 months
C.
9 - 12 months
D.
0 - 1 month
E.
* 3 - 6 months
In rickets the deformation of the lower extremities occurs in:
A.
3 - 6 months
B.
6 - 9 months
C.
1 - 3 months
D.
0 - 1 month
E.
* 9 - 12 month
In rickets the bones of the skull are affected in:
A.
3 - 6 months
B.
6 - 9 months
C.
9 - 12 month
D.
0 - 1 month
E.
885.
886.
887.
888.
889.
890.
891.
892.
893.
* 1 -3 month
What is one of the hypocalcemia mechanisms in spasmophylia?
A.
hyperparathyroidism
B.
hyperthyroidism
C.
hypotyroidism
D.
hypogonadism
E.
* hypoparatyroidism
Anticonvulsant therapy is prescribed in spasmophylia simultaneously with:
A.
Vitamin D
B.
detoxication therapy
C.
rehydration therapy
D.
antipyretics
E.
* calcium supplementation
What is Maslov sign in spasmophylia?
A.
rapid feet abduction when tapped below the fibular
B.
contraction of the facial muscles when tapped in the facial nerve area
C.
fingers convulsions when shoulder compression
D.
everything is wrong
E.
* stop of breathing at a light skin pricks
What is Chvostek sign in spasmophylia?
A.
stop of breathing at a light skin pricks
B.
rapid feet abduction when tapped below the fibular
C.
fingers convulsions when shoulder compression
D.
everything is wrong
E.
* contraction of the facial muscles when tapped in the facial nerve area
When is done specific antenatal prevention of rickets for healthy pregnant women?
A.
In 24 - 28 weeks of gestation
B.
It is not needed
C.
throughout the pregnancy
D.
before delivery
E.
* In 28 - 32 weeks of gestation
Specific prevention of rickets for full-term children begins:
A.
from their birth
B.
on the sixth month of life
C.
on the tenth month of life
D.
on the third month of life
E.
* on the second month of life
What is the daily dose of vitamin D3 for the antenatal prevention of rickets in healthy pregnant
women
A.
200 IU
B.
500 IU C. 100 IU
C.
2000
D.
* 100IU
Scific prevention of rickets to preterm children begins:
A.
rom their birth
B.
on the sixth month of life
C.
on the tenth month of life
D.
on the second month of life
E.
* in two weeks of life
What peculiarity can be cause of conjunctivitis in case of upper respiratory tract infection in early
age children more ofte
A.
crease of local immune response
B.
*Nasolacrimal duct is short
Contagion is high
Rubbing ey
Wrong bwing nos
When sinuses evelopment in children will finish?
A.
Before birth
B.
to 1 year
C.
to 3 years
D.
to 5 years
E.
*to 12 years
What medical term is synonym for “laryngitis”?
A.
*Croup
B.
Epiglottitis
C.
Vocalitis
D.
Tonsillitis
E.
Chondritis
What organs are connected by Eustachian tube?
A.
*the middle ear & the throat
B.
the middle ear & larynx
C.
the inner ear & the throat
D.
the inner ear & the middle ear
E.
the outer ear & the middle ear
What is feature of the right primary bronchus?
A.
*Is like a direct extension of the trachea
B.
Look like is separated from the trachea.
C.
Has specific structure
D.
Is longer than left one
E.
Is thinner than left one
What is feature of the left primary bronchus?
A.
Is like a direct extension of the trachea
B.
*Look like is separated from the trachea.
C.
Has specific structure
D.
Is shorter than right one
E.
Is wider than right one
What is typical orientation of the ribs in the infant?
A.
A. *
Horizontal
B.
Downward
C.
Upward
D.
Without typical orientation
E.
Puerile
What is typical orientation of the ribs in 10 years old children?
A.
Horizontal
B.
*Downward
C.
Upward
D.
Without typical orientation
E.
Puerile
Breathing: pulse ratio from birth till 1 month of life:
A.
*1:3
B.
1:4
C.
1:5
D.
1:2
E.
1:6
Breathing: pulse ratio from 8 till 14 years of life:
A.
1:3
C.
D.
E.
894.
895.
896.
897.
898.
899.
900.
901.
902.
B.
C.
D.
E.
903.
904.
905.
906.
907.
908.
909.
910.
911.
*1:4
1:5
1:2
1:6
What is average respiratory rate at rest of newborn?
A.
25 per minute
B.
*40-60 per minute
C.
16-20 per minute
D.
More then 60 per minute
E.
Less then 25 per minute
What is average respiratory rate at rest of 5-year-old child?
A.
*25 per minute
B.
40-60 per minute
C.
16-20 per minute
D.
More then 60 per minute
E.
Less then 25 per minute
Choose description of «Hyperpnea»:
A.
*Increase of the respiratory depth
B.
Increase of respiratory rate and dept
C.
Increase of the respiratory rate
D.
Distress during breathing
E.
Cessation of breathing
Kussmaul respiration is characterized by:
A.
*Slow deep breathing, hyperventilation, gasping and labored respiration
B.
Totally irregular breathing with no pattern
C.
Cyclical increase and decrease in depth of respiration
D.
The chest falls on inspiration and rises on expiration
E.
Decrease depth and irregular rhythm of respiration
What sounds you can determine over solid areas during percussion of the lung?
A.
Resonant
B.
Hyper-resonance
C.
Tympanic
D.
*Flat
E.
Cracked-pot sound
Choose description of Seesaw (paradoxic) respirations:
A.
cyclical increase and decrease in depth of respiration
B.
slow deep breathing, hyperventilation, gasping and labored respiration
C.
*the chest falls on inspiration and rises on expiration.
D.
totally irregular respirations with no pattern
E.
an increasing of rate and depth of respiration
When does a hyper resonant (ban-box) sound may be determined during percussion of the lung?
A.
*Asthma
B.
Pneumonia
C.
Pleural effusions
D.
Haemothorax
E.
Hydrothorax
What sounds are soft, blowing, lower pitched during auscultation of the lung?
A.
*Vesicular
B.
Bronchial
C.
Tracheal
D.
Puerile
E.
Wheezes
What sounds are loud and high in pitch with a short pause between inspiration and expiration
912.
913.
914.
915.
916.
917.
918.
919.
during auscultation of the lun
A.
Vesicar
B.
*Brchial
C.
Tracheal
D.
Puerile
E.
Wheezes
During auscultation of the lung louder shot inspiration and a hollow expiratory phase, blowing
character is typical fo
A.
Vesilar breath
B.
Bronchial breath
C.
Tracheal breath
D.
*Puerile breath
E.
Wheezes
Choose group of sounds, which can be determined over the normal lung tissue:
A.
*Tracheal, bronchial, broncho-vesicular and vesicular sounds
B.
Wheeze, bronchial, broncho-vesicular and vesicular sounds
C.
Tracheal, bronchial, broncho-vesicular sounds, rhonchi
D.
Tracheal, bronchial, broncho-vesicular sounds, crackles
E.
Tracheal, bronchial, rales, vesicular sounds
Puerile breath during auscultation of the lung is typical for:
A.
Pneumonia
B.
Atelectasis
C.
*Healthy children till three years old
D.
Healthy children after age 3 years
E.
Asthma
Bronchial breath sound is abnormal in such places during auscultation of the lung:
A.
Over the large airways
B.
Over the manubrium of the sternum
C.
*Peripheral areas of the lung
D.
In the anterior chest wall
E.
In the posterior right interscapular space
What types of breath sounds are «adventitious» breath sounds?
A.
*Rales, wheezes, pleural friction rubs, stridor
B.
Rales, wheezes, puerile sounds, stridor
C.
Rales, ban-box, pleural friction rubs, stridor
D.
Crackles, wheezes, pleural friction rubs, vesicular sounds
E.
Crackles, wheezes, pleural friction rubs, tracheal sounds
Stridor can be indicative of:
A.
Pneumonia
B.
*Serious airway obstruction
C.
Bronchial asthma
D.
Purulent bronchitis
E.
Satisfactory condition
Crackles are often associated with inflammation or infection of the
A.
*Small bronchi, bronchioles and alveoli
B.
Large bronchi
C.
Pleural surfaces
D.
Trachea
E.
Larynx
What is definition of Wheeze?
A.
Discontinuous, nonmusical, brief sounds heard more commonly on inspiration
B.
Low-pitched, grating, or creaking sounds
C.
High-pitched harsh sound heard during inspiration
D.
E.
920.
921.
922.
923.
924.
925.
926.
927.
928.
*Continuous, high pitched, hissing, whistling or sibilant sounds
Soft, blowing, lower pitched and softer than bronchial breathing
Crackles are often associated with:
A.
*Pneumonia
B.
Bronchitis
C.
Tracheitis
D.
Laryngitis
E.
Pleurisy
Wheezes are often associated with:
A.
Pneumonia
B.
*Bronchitis
C.
Tracheitis
D.
Laryngitis
E.
Pleurisy
Dyspnea with long wheezing expiration, skin pallor with cyanotic shade, strain of neck muscles
are typical fo
A.
Convulsive
B.
*Asthmatic
C.
Laryngospasm
D.
Hyperthermic
E.
Comatose
Which information is most important in rheumatic fever?
A.
A fever that started 3 days ago
B.
Lack of interest in food
C.
*A recent episode of pharyngitis
D.
Vomiting for 2 days
E.
Artralgia 1 month ago
Urinalysis includes following information EXEPT:
A.
Colour of urine
B.
Specific gravity
C.
Level of protein, glucose
D.
Quantity of WBC and RBC
E.
*Daily urine volume
How to collect urine for urinalysis:
A.
Collect the morning middle portion of urine, after careful washing
B.
Collect all urine during night
C.
Collect urine during 24 hours (8 portions)
D.
Collect the middle portion of urine in any time of the day, after careful washing
E.
*Collect all morning urine after careful washing
How to collect urine for Zimnitsky’s test?
A.
Collect the morning urine, middle portion, after careful washing
B.
Collect all urine during night
C.
*Collect urine during 24 hours (8 portions)
D.
Collect the middle portion of urine in any time of the day, after careful washing
E.
Collect all morning urine after careful washing
Mild proteinuria is typical for all diseases, except:
A.
Cystitis
B.
Urethritis
C.
Vulvovaginitis
D.
*Glomerulonephritis with nephrotic syndrome
E.
Pyelopephritis
Nechyporenko urine test is used for evaluation of the cells in:
A.
0.1 ml of urine
B.
C.
D.
E.
929.
930.
931.
932.
933.
934.
935.
936.
*1 ml of urine
5 ml of urine
10 ml of urine
1 L of urine
Nephrotic syndrome is characterized by (choose the most correct statement)\:{
A.
Heavy proteinuria, hematuria, hypoproteinemia
B.
*Hypertension, hematur
C.
Hypoalbuminemia, pteinuria, edema
D.
Pain in lumbar regn, intoxication
E.
Isolated hematuri or pyuria, proteinuria
What laboratory sign is the most typical for pyelonephritis?
A.
* active leucocytes in urine;
B.
considerable proteinuria;
C.
uraturia;
D.
oxalaturia;
E.
glucosuria.
Significant proteinuria is the most typical for:
A.
Cystitis
B.
Uretritis
C.
Vulvovaginitis
D.
* Glomerulonephritis
E.
Pyelopephritis
Renal function can be indicated by all tests, EXCEPT:
A.
Glomerular filtration rate
B.
Plasma Creatinine level
C.
Plasma Urea level
D.
Zimnitsky’s test
E.
* Nechyporenko test
The most common bacteria in acute bacterial pyelonephritis is:
A.
Klebsiella
B.
Chlamydia
C.
* E. Coli
D.
Pseudomonas
E.
Candida
The most diagnostic value of excretory urography is in case of:
A.
Glomerulonephritis
B.
Amiloidosis
C.
* Pyelonephritis
D.
Nephrotic syndrome
E.
Renal tumour
What day / night diuresis ratio is normal?
A.
1\:1
B.
* 2\:1
C.
1\:2
D.
4\:5
E.
6\:1
Urinary syndrome indicates maohematuriya, protein 1.6 g / liter. Which the disease is
characterized by such changes
A.
*Glomerulonephritis
B.
isolated urinary syndrome
C.
pyelonephritis
D.
cystitis
E.
urolithiasis
955.
956.
957.
958.
959.
960.
961.
962.
963.
Positive Erb, Trousseau, Maslov symptoms are typical for
A.
Renal eclampsia
B.
Hyperthermia
C.
Epilepsy
D.
Meningoencephalitis
E.
* Spasmophylia
After the emergency treatment of the child with spasmophylia further therapeutic tactics is:
A.
Assign vitamin D in doses of 2000 IU a week supplementation with calcium.
B.
Assign vitamin D in doses of 4000 IU once.
C.
Do not assign vitamin D
D.
Assign vitamin D in doses of 500 IU immediately
E.
* Assign vitamin D in doss of 500 IU a week supplementation with calcium.
Soft edge of a large fontanel, softening of the occipital bone in baby with rickets are typical for
such course of the disease:
A.
Subacute
B.
Recurrent
C.
Latent
D.
Limp
E.
* Acute
Increase the frontal and parietal tuber, thickened edges of large fontanel, ribs "rosary" are typical
for such course of the rickets:
A.
Acute
B.
Recurrent
C.
Latent
D.
Limp
E.
* Subacute
Increase of frontal and parietal tubers, ribs "rosary", "bracelets", "string of pearls", thickening of
the large fontanelle edges, increased liver, Harrison's groove. What course of rickets in this child?
A.
Acute
B.
Recurrent
C.
Latent
D.
Limp
E.
* Subacute
Which clinical symptoms indicate the moderate severity of rickets?
A.
Harrison’s groove
B.
The predominance of osteoid hyperplasia
C.
The predominance of osteomalacia
D.
The age of 7 months
E.
* The presence of bone changes simultaneously on the head and trunk.
How it is possible to confirm the diagnosis of a spasmophilia?
A.
To do Sulkovitch’s test
B.
To determine a level of potassium in a blood
C.
To determine a level of magnesium in a blood
D.
To click the radical of tongue
E.
* To test Hvostek, Lust signs
What changes of muscular system will be present in initial stage of a rickets?
A.
Hypertonia of muscles
B.
Muscle atrophy
C.
Decrease of muscles forces
D.
Increase of muscles forces
E.
* Hypotonia of muscles
What medicine must be prescribed for child with gastroenteral enzymopathy?
A.
Antibacterial therapy
Immunostimulators
Sorbents
Multivitamins
* Enzymes and bacterial drugs
What from this is better to prescribe the child to correct dysbacteriosis?
A.
Festal
B.
Apilac
C.
Ampicillin
D.
Nistatin
E.
* Bifidumbacterin
Water deficiency dehydration is characterized by such dates of laboratory examinations:
A.
Decrease of hematocrit
B.
Decrease of K, Na, Cl level in the blood, considerable increase of hematocrit
C.
Decrease of K, Na, Cl level in the blood
D.
Detection of a bacterial infection
E.
* Increase of potassium level
What investigation will confirm the Salmonellosis?
A.
General blood test.
B.
Bacteriological examination of cerebrospinal fluid.
C.
Bacteriological investigation of nasal swab.
D.
Bacteriological investigation of pharyngeal swab.
E.
* Bacteriological examination of the feces on dysentery, typhoid, paratyphoid fever.
What duration of the food tolerance determination period in Malnutrition 1st degree?
A.
1-2 weeks
B.
2-3 weeks
C.
7-14 days
D.
3-4 weeks
E.
* 1-3 days
How to correct the deficit of the protein?
A.
By the Porridge
B.
By the Vegetable puree
C.
By the Yoghurt
D.
By the Fruit juice
E.
* By the pot cheese
Choose a physiometric method of investigation from the below given:
A.
Determination of thorax form
B.
Determination of vertebra form
C.
Determination of body weight
D.
Measurement of growth
E.
* Determination of vital capacity of lungs
What diagnostic method can determine pneumopathy's type in the child?
A.
Immunologic investigation
B.
Blood gases
C.
Proteinogram
D.
Blood test
E.
* Chest X-ray
What drugs will be used as a base therapy for child with obstructive bronchitis?
A.
Antibiotics
B.
Antiallergic medicine
C.
Mucolytics
D.
Hormons
E.
* Broncholytics
Rough barking cough, hoarseness of the voice, expressed inspiratory dyspnea, involvement of the
B.
C.
D.
E.
964.
965.
966.
967.
968.
969.
970.
971.
972.
973.
974.
975.
976.
977.
978.
979.
980.
auxiliary musculature in breathing, skin pallor, tachycardia describe:
A.
Pneumonia
B.
Bronchiolitis
C.
Obstructive bronchitis
D.
Pharyngitis
E.
* Croup syndrome
What is single dose of panadol?
A.
0.05 g/kg
B.
0.1 g/kg
C.
0.2 g/kg
D.
0.3 g/kg
E.
* 0.01 g/kg
On X-ray: lungs’ roots are broad, infiltrated, and in both sides are little shadows. What form of an
acute pneumonia corresponds with this X-ray?
A.
Interstitial
B.
Monosegmental
C.
Polysegmental
D.
Crupose
E.
* Bronchopneumonia
What bacteria cause the interstitial pneumonia more often?
A.
Staphylococcus
B.
Streptococcus
C.
Pneumocysta
D.
Pneumococcus
E.
* Klebsiella
What auscultation picture is typical for focal bronchopneumonia in child?
A.
Diffuse dry rales
B.
Rough breathing
C.
Diffuse wet rales
D.
Decrease breathing
E.
* Local wet rales
What medication should be applied for emergency aid in case of Quincke's edema?
A.
Adrenalin
B.
Furosemide
C.
Heparin
D.
Seduxen
E.
* Prednisolone
What changes in the blood analysis give us the possibility to prove allergic etiology of disorders?
A.
Anemia
B.
Lymphocytosis
C.
Neutrophylosis
D.
Erythremia
E.
* Eosynophylia
What from parameter will help to confirm the rheumatoid arthritis most faithfully?
A.
Hyperazotemia
B.
Presence of LE-cells in blood
C.
Hypergammaglobulinemia
D.
Thrombocytopenia
E.
* C-reactive protein
What indicator is connected with possible etiology of the rheumatic process?
A.
Seromucoid
B.
Creatinkinase
C.
1-antitrypsine
Rheumatic factor
* Antistreptolysine-0
What medication is the most expedient for secondary prevention of rheumatic fever?
A.
Erythromycin
B.
Bicillin-1
C.
Ampicillin
D.
Oxacillin
E.
* Bicillin-5
What complication is the most possible to reveal in rheumatoid arthritis, monoarticular form?
A.
Stomatitis
B.
Pulmonitis
C.
Nephritis
D.
Carditis
E.
* Uveitis
What etiologic factor caused rheumatic arthritis?
A.
Virus
B.
Staphylococcus
C.
Pneumococcus
D.
Fungus
E.
* Beta hemolytic streptococcus
What is most reasonable to prescribe for long-term therapy of child with rheumatoid arthritis,
polyarticular form ?
A.
Aspirin
B.
Azulfadine
C.
Delagyl
D.
Prednisolon pulse-therapy
E.
* Methothrexat
What dose of prednisolone must be used at the beginning of treatment of child with acute
norheumatic carditis?
A.
2 mg\kg\day
B.
3 mg\kg\day
C.
1 mg\kg\day
D.
5 mg\kg\day
E.
* 0,5 mg\kg\day
What method of examination is the most informative in case of dilated heart boarders to the left
side, aortic systolic murmur?
A.
Sphygmography
B.
Phonocardiography
C.
X-ray
D.
Coronarography
E.
* Echocardiography
What is the most efficient examination for valvular disorder assessment?
A.
Ballistocardiogram
B.
Chest X-ray
C.
Phonocardiography
D.
ECG
E.
* Echocardiography + Doppler-Echocardiography
Cardiomegaly, steadfast tachyarrythmia, stagnant rales in both lungs, dyspnea, increased liver to 3
cm were revealed in child with early congenital carditis. What stage of the cardiac insufficiency
has this child?
A.
I stage
B.
II A
C.
III
D.
E.
981.
982.
983.
984.
985.
986.
987.
988.
D.
E.
989.
990.
991.
992.
993.
994.
995.
996.
IV
E. *
II B
Irregularity of development of the upper and lower parts of body, hypotonia of muscles of the
feet, an absent pulsation on the femoral arteries, systolic murmur in intrascapular region were
revealed. What pathology may be suspected in the patient?
A.
Kawasaki disease
B.
Takajasu disease
C.
Aneurysm of aorta
D.
Nothing of these
E.
* Coartation of the aorta
The patient with aquired heart failure has diastolic pressure 0 mm Hg. What heart failure does the
child have?
A.
Rheumatic carditis
B.
Aortic stenosis
C.
Mitral insufficiency
D.
Mitral stenosis
E.
* Aortic insufficiency
What is the most probable leading mechanism of ulcer disease development?
A.
Dietary allergy
B.
Reduced prostaglandin synthesis
C.
Disorder of gastric motor activity
D.
Autoantibody production
E.
* Helicobacterial infection
What is the most effective medication to treat ulcer defect of the mucous membrane of the
duodenum in child?
A.
Almagel
B.
Papaverin
C.
No-spa
D.
Atropin
E.
* De-nol
What method of investigation will be the most useful for proof of ulcer disease?
A.
Ultrasound examination of abdomen
B.
pH-metry
C.
Ureatic test
D.
Stomach X-ray
E.
* Esophagogastroduodenoscopy with biopsy
What is the etiology of chronic antral gastritis?
A.
St. Aureus
B.
beta-hemolytic streptococcus of group A
C.
Candida
D.
Enterovirus
E.
* Неlicobacter pylori
What is the main diagnostic sign of functional disturbance of the stomach?
A.
Abdominal pain
B.
Regurgitation by air
C.
Signs of chronic intoxication
D.
Decrease of the appetite
E.
* Absence of the organic changes during esophagogastroduodenoscopy
Choose a drug for correction of the motility in case of duodenogastral reflux ІІ degree.
A.
Imodium
B.
Gastrocepin
C.
Halidor
D.
Dicitel
E.
997.
998.
999.
1000.
1001.
1002.
1003.
1004.
* Motilium
What drugs should be assigned for treatment of hypertonic biliary dyskinesia first of all?
A.
Sedative and cholikinetics
B.
Choleretics and cholikinetics
C.
Antioxidants
D.
Antibiotics
E.
* Spasmolitics and choleretics
What drugs should be assigned for treatment of hypotonic biliary dyskinesia?
A.
Analgetics
B.
Choleretics
C.
Cholekinetics
D.
Spasmolitics
E.
* Choleretics and cholikinetics
Periodic short-lived cutting pain in the right subcostal area, which occurs after the greasy food, is
typical for what type of biliary dyskinesia?
A.
Hypotonic
B.
Dystonic
C.
Hepatalgic
D.
Asthenic
E.
* Hypertonic
Edema, arterial hypertension, hematuria, proteinuria (1,8 g/per day), granular and erythrocital
casts are typical for:
A.
Pyelonephritis
B.
Cystitis
C.
Intestinal nephritis
D.
Renal amyloidosis
E.
* Glomerulonephritis
Fever, frequent painful urination, changes in urinalysis (proteinuria [0,066 g/L], leukocytouria
[entirely within eyeshot]),acteriuria [105 colony forming units/mL] are typical for:
A.
Acute glomerulonephritis
B.
Acute cystitis
C.
Dysmetabolic nephropathy
D.
Urolithiasis
E.
* Acute pyelonephritis
Which of the following is the most appropriate test for prescribing of etiotropic treatment of client
with pielonephritis?
A.
Nechiporenko test
B.
Zimnitsky tes
C.
Cystography
D.
Intravenous urography
E.
* Urine culture
What biochemical index is of the greatest diagnostic importance in case of acute
glomerulonephritis?
A.
Uric acid
B.
Fibrinogen
C.
Blood sodium
D.
Blood bilirubin
E.
* Blood creatinine
Mild generalized edema, increased blood pressure, and the urinalysis showed increased protein,
red cell casts and hyaline casts are typical for:
A.
Acute pyelonephritis
B.
Rheumatic fever
C.
Essential hypertension
Bacterial endocarditis
* Acute glomerulonephritis
What nutrition recommendations are the most suitable for the patient with chronic renal failure
first degree?
A.
Ingestion with the increased content of the "alkaline"
B.
Fluid amount increase
C.
Adipose control
D.
Carbohydrate control
E.
* Protein control
Decrease of urine volume (200 mL per day), peripheral and cavity edema were revealed.
Urinanalysis: protein 3,6 g/L. What is the most likely diagnosis?
A.
Interstitial nephritis
B.
Infection of urinary tract
C.
Chronic glomerulonephritis
D.
Acute glomerulonephritis with nephritic syndrome
E.
* Acute glomerulonephritis with nephrotic syndrome
Proteinuria - 7.1 g/L, protein in daily urine - 4.2 g. Blood biochemical profile: stable
hypoproteinaemia (43.2 g/L), hypercholesterinaemia (9.2 mmol/L). Which variant of
glomerulonephritis is the most probable in this case?
A.
Isolated urinary
B.
Hematuric
C.
Mixed
D.
Nephritic
E.
* Nephrotic
What is the urine color of the patient with acute poststreptococcal glomerulonephritis?
A.
dark brown urine
B.
bright red
C.
dark violet
D.
pink
E.
* smokey brown urine
What specific changes in the blood will be present in patients with chronic glomerulonephritis?
A.
increases bilirubin
B.
decline of ESR
C.
increases cholesterol
D.
increases transaminases
E.
* increases kreatinin
In the complete analysis of urine: dark color of urine, protein is 0,98 g/l, leucocytes 3-2 in a
visual, erythrocytes – 1/3 of visual field, hyaline casts 1-2 in a visual field are observed. What
variant of acute glomerulonephritis is more reliable in this child?
A.
Nephrotic
B.
Nephritic
C.
Nephrotic syndrome, hematuria and arterial hypertension
D.
Sub acute malignant glomerulonephritis
E.
* Isolated urine syndrome
Appearance of a lot of changed red blood cells in the urine (1/2 of visual field) can be caused of:
A.
Uncomplicated urolithiasis
B.
acute cystitis
C.
paranephritis
D.
cancer of urinary bladder
E.
* acute glomerulonephritis
What etiological factor is cause of rheumatic carditis?
A.
Staphylococcus
B.
Pneumococcus
D.
E.
1005.
1006.
1007.
1008.
1009.
1010.
1011.
1012.
Virus
Fungus
* Beta-hemolytic streptococcus
Results of urinalysis: urine is brown, specific gravity -1025, protein - 1,2 g/l, erythrocytes cover
all visual field, casts 1-2 in a visual field. Protein in day's urine - 0,78 gr. Such lab changes are
typical for:
A.
Acute glomerulonephritis with nephrotic syndrome
B.
Urolythiasis
C.
Acute glomerulonephritis with nephrotic syndrome, hematuria and arterial hypertension
D.
Acute glomerulonephritis with isolated urine syndrome
E.
* Acute glomerulonephritis with nephritic syndrome
In the patient’s urine sediment 5-6 leucocytes and single fresh erythrocytes in a vision field were
found. What investigation must be appointed to a patient for clarification of diagnosis?
A.
total blood count
B.
ECG
C.
Zimnitsky test
D.
determination of daily proteinuria
E.
* Nechyporenko test
Appearance of what substance in urine can be cause of cloudy urine which doesn’t disappear in
an hour?
A.
salts
B.
bilious pigments
C.
glucose
D.
urinary acid
E.
* protei
Appearance of what substance in urine can be cause of cloudy urine which disappears in an hour?
A.
protein
B.
bilious pigments
C.
glucose
D.
urinary acid
E.
* salts
Appearance of what substance in urine makes its gravity increased?
A.
salts
B.
protein
C.
bilious pigments
D.
urinary acid
E.
* glucose
What is the peculiarity of edema in patient with acute glomerulonephritis?
A.
appears in the evening
B.
first appears on lower extremities
C.
first appears on overhead extremities
D.
Early development of anasarca.
E.
* appears on face in the morning
Complains of edema in the morning which is located mainly on her face (eyeleads) can be present
in case of:
A.
cardiovascular disorder
B.
Neurological pathology
C.
Respiratory system pathology
D.
Digestive diseases
E.
* Urinary system pathology
What urine color is typical for glomerulonephritis?
A.
red
B.
color of beer
C.
D.
E.
1013.
1014.
1015.
1016.
1017.
1020.
1021.
1022.
sulphur
straw-yellow.
* color of «meat wastes»
What investigation must be done if patient complains of edema below the eyes in the morning?
A.
ECG
B.
Ultrasound of a heart
C.
determination of cholesterol in blood
D.
Chest X-ray.
E.
* general analysis of urine
What pathology is characterized by nocturia?
A.
acute nephritis
B.
diabetes mellitus
C.
chronic cardiac insufficiency
D.
diencephalic syndrome.
E.
* chronic kidney insufficiency
Complains on pain in suprapubic area, frequent painful urination by small portions, subfebril
temperature, negative Pasternatsky symptom are typical for:
A.
Dysmetabolic nephropathy
B.
Acute pyelonephritis
C.
Urolithiasis
D.
Acute glomerulonephritis
E.
* Acute cystitis
What changes in biochemical blood test can be present in patient with renal failure?
A.
increase of glucose level in blood
B.
increase of bilirubin
C.
increase of amylaze
D.
increase of alkaline phosphatase.
E.
* increase of creatinine
What changes in biochemical blood test will prove kidney insufficiency?
A.
albuminemia
B.
beta-lipoproteinaemia
C.
hyperbilirubinemia
D.
dysproteinemia.
E.
* creatininemia
What investigation is it necessary to do to know the level of urinary system damaging?
A.
To take urine by catheter
B.
Bacteriological test of urine
C.
Ultrasound investigation
D.
Zimnitsky test
E.
* Urographia
What investigation is it necessary to do before etiotropic treatment?
A.
Cystographia
B.
Urogrphia
C.
Zimnitsky test
D.
Nechiporenko test
E.
* Bacteriological test of urine
What dates are typical to diagnose urinary tract infection?
A.
Proteinuria
B.
Leucocyturia
C.
Erytrocyturia
D.
Hypostenuria
E.
* Bacteruria 105 and more
What investigation will prove the genesis of leucocyturia?
C.
D.
E.
1023.
1024.
1025.
1026.
1027.
1028.
1029.
1030.
1031.
Urography
Nechiporenko test
Endogenous creatynine clearance
Zimnitsky test
* 3 glasses test
A pain syndrome at ulcer of duodenum is not characterized by:
A.
"hungry" pain;
B.
nightly pain;
C.
late pain;
D.
*pain immediately after meal;
E.
pain after the physical loading.
Antibacterial therapy for peptic ulcer disease requires the use of:
A.
Analgesics
B.
Antipyretics
C.
*Probiotics
D.
Hormones
E.
Cytostatics
In case of gastritis abdominal pain is increased:
A.
* 15-30 min. after a meal
B.
30-45 min. after a meal
C.
45-60 min. after a meal
D.
1-1,5 hours. after a meal
E.
2-2,5 hours. after a meal
Constipation is characteristic for gastritis in patients with:
A.
* increased acid production
B.
normal acid production
C.
decreased acid production
D.
achlorhydria
E.
hypohlorhydria
Dyspeptic syndrome includes next symptoms:
A.
increased levels of total and conjugated bilirubin and cholesterol;
B.
increased levels of ASAT, ALAT, LDG;
C.
increased levels of amylase, tripsin, lipase;
D.
* vomiting, nausea, heartburn feeling, decrease of appetite;
E.
weakness, lucidity, bad sleep, headaches, irritability, tearfulness, increased disposition to
perspiration, blue shadows under the eye
Famotidin belongs to a group of
A.
antacids
B.
* histamine H2-blockers
C.
proton pump blockers,
D.
reparants
E.
cytoprotectors
Functional gastric disorders include:
A.
Chronic esophagitis.
B.
Chronic gastritis.
C.
* Duodenogastric reflux.
D.
Stomach ulcer.
E.
Chronic duodenitis.
Gastroesophageal reflux belongs to:
A.
Secretory type functional disorders of the stomach.
B.
* Motor type functional disorders of the stomach.
C.
Chronic gastritis.
D.
Biliary dyskinesia.
A.
B.
C.
D.
E.
1032.
1033.
1034.
1035.
1036.
1037.
1038.
1039.
Chronic duodenitis.
Helicobacter pylori produces an enzyme:
A.
lactase
B.
* urease
C.
peptidase
D.
lipase
E.
amylase
Untreated Helicobacter pylori can lead to:
A.
esophagitis
B.
* gastritis
C.
colitis
D.
hepatitis
E.
uretritis
In case of disease associated with increased gastric acid secretion more prominent is:
A.
* pain,
B.
dyspepsia,
C.
intoxication
D.
disuria
E.
hemorrhagic syndrome
What medication is used for treatment of gastric ulcer?
A.
Analgene
B.
* De-nol
C.
Essentiale
D.
Prednisolone
E.
Aspirin
Intoxication syndrome includes next symptoms:
A.
increased levels of total and conjugated bilirubin and cholesterol;
B.
increased levels of ASAT, ALAT, LDG;
C.
increased levels of amylase, tripsin, lipase;
D.
vomiting, nausea, heartburn feeling, decrease of appetite;
E.
* weakness, lucidity, bad sleep, headaches, irritability, tearfulness, increased disposition
to perspiration, blue shadows under the eyes, functional heart murmu
Belching disorders includes:
A.
*Aerophagia
B.
Functional vomiting
C.
Irritable Bowel Syndrome
D.
Functional Bloating
E.
Functional Constipation
Functional Bowel Disorders includes:
A.
Aerophagia
B.
Functional vomiting
C.
*Functional Bloating
D.
Functional dyspepsia
E.
Functional Constipation
Meteorism is characteristic sign for gastritis with:
A.
increased gastric acid secretion
B.
normal gastric acid secretio
C.
* decreased gastric acid secretion
D.
achlorhydria
E.
hypohlorhydria
What are aggressive factors of the gastric mucosa
A.
* HCl
B.
mucus production
E.
1040.
1041.
1042.
1043.
1044.
1045.
1046.
1047.
1048.
prostaglandin -Х2
bicarbonates
Na Cl
What are gastric mucosal defensive factors?
A.
pepsin
B.
HCl
C.
* bicarbonates
D.
gastrin
E.
Na C
Empty stomach pain is typical for patients with:
A.
* increased gastric acid secretion
B.
normal gastric acid secretion
C.
decreased gastric acid secretion
D.
achlorhydria
E.
hypohlorhydria
Ranitidine is used to treat conditions related to the stomach:
A.
normoacidity
B.
* hyperacidity
C.
hypoacidity
D.
concomitant duodeno-gastric reflux
E.
achalasia of the esophagus
Vomiting bile is usually a sign of disorder of:
A.
esophagus
B.
stomach
C.
* duodenum
D.
colon
E.
small intestinum
How many components are included into Eradication Treatment of H. pylori-associated
gastroduodenal disease in children?
A.
one component;
B.
two components;
C.
* three components;
D.
five components;
E.
a lot of components.
The X-ray sign of gastric ulcer is:
A.
radial convergence of stomach walls;
B.
bulge of walls;
C.
bulge of mucus membraine folds;
D.
* presence of "Ulcer crater";
E.
decrease of mucus membraine folds.
What medication does belong to histamine H2-blockers?
A.
smecta
B.
almagel
C.
acidophilus
D.
* famotidine
E.
motilium
What medication does belong to Proton pump inhibitors (PPIs)?
A.
smecta
B.
almagel
C.
ranitidine
D.
* omeprazole
E.
motilium
What medication does belong to probiotics?
C.
D.
E.
1049.
1050.
1051.
1052.
1053.
1054.
1055.
1056.
1057.
Aevit
Smecta
*Acidophilus
Procainamide
Saline
What medication does belong to cytoprotectors?
A.
de-nol
B.
omeprazole
C.
* sukralfat
D.
famotidine
E.
maalox
What medication does belong to reparants?
A.
* gastrofarm;
B.
panzynorm;
C.
renegast
D.
bellaspon;
E.
ranitidin.
What is invasive method of helicobacteriosis diagnostics?
A.
* biopsy of the stomach mucosa with its bacteriological investigation;
B.
PCR of feces and saliva;
C.
Breath Test
D.
determination of specific immuneglobulines
E.
"aerotest".
What instrumental methods is most considerable for the diagnostics of chronic gastroduodenitis?
A.
* endoscopy;
B.
aerometry;
C.
fractional research of the gastric content;
D.
acid-test;
E.
X-ray.
What clinico-pharmacological group includes De-nol?
A.
*antiulcer drug ;
B.
reparants;
C.
probiotics;
D.
proton pump inhibitors;
E.
histamine H2-blockers.
What is gastroesophageal reflux?
A.
This is involuntary leakage of intestinal contents into the stomach
B.
* This is involuntary leakage of gastric contents into the esophagus
C.
This is involuntary leakage of gastric contents into the oral cavity
D.
This is pylorus insufficienc
E.
This is stomach fundus insufficiency
Epigastric pain is typical for:
A.
*gastritis
B.
cholangitis
C.
cholecystitis
D.
biliary dyskinesi
E.
colitis
Causes of right upper quadrant pain include:
A.
pyelonephritis
B.
paraesophageal hiatal hernia
C.
gastritis
D.
*cholecystitis
E.
appendicitis
A.
B.
C.
D.
E.
1058.
1059.
1060.
1061.
1062.
1063.
1064.
1065.
1066. Bifidobacteria in the child body contribute to:
A.
Stabilization and normalization of intestinal mikrobiocinose
B.
Improve processes of absorption and hydrolysis of fat
C.
Improve processes of absorption and hydrolysis of carbohydrates
D.
Normalization of protein and mineral metabolism
E.
* The maintenance of nonspecific resistance
1067. Celiac disease is associated with:
A.
Infection enterocolitis
B.
Dysbiosis
C.
Family predisposition
D.
* Malabsorbtion
E.
Functional constipation
1068. Crohn's disease is:
A.
Infection disease
B.
Congenital disease
C.
Hereditary disease
D.
* Autoimmune disese
E.
Metabolic disease
1069. Ulcer disease can be suspected by:
A.
Periodic attacks of pain in the epigastria
B.
Long persistent dyspeptic disorders
C.
The high acid-forming function of the stomach
D.
* Fecal occult blood test
E.
Vomiting
1070. Signs of dyspepsia syndrome are:
A.
Stomach pain
B.
Headache
C.
General weakness
D.
* Nausea
E.
Abdomen pain
1071. What symptom is not typical for irritable bowel syndrome?
A.
Abdominal pain or discomfort
B.
Intestinal bloating
C.
Irregular bowel habits, including diarrhea, constipation, or both
D.
* Blood in the stool
E.
Mucus in the stool
1072. The diagnostic of functional abdominal pain is based on:
A.
Stool test
B.
Blood test
C.
* Symptoms and physical examination
D.
Endoscopy
E.
Bacteriological examination of feces
1073. The diagnostic of irritable bowel syndrome is based on:
A.
* Clinical symptoms
B.
Colonoscopy
C.
Duodenoscopy
D.
Rectoroscopy
E.
Bacteriological examination of feces
1074. What diet is recommended for children with functional constipation?
A.
* High in protein and fiber
B.
High in carbohydrates and fiber
C.
High in protein and carbohydrates
D.
High in carbohydrates and fat
High in protein and fat
What is typical for functional abdominal pain?
A.
* absence of influence on the child’s physical and psychological development
B.
The reason is abnormality of intestine
C.
The reason is abnormality of bowels
D.
Is due to mechanical disturbances
E.
Is due to dysbiosis
What disorder can be cause of constipation in babies?
A.
Breast feeding
B.
* Rickets
C.
Big amount of juice
D.
Vegetables in diet
E.
Lactose intolerance
What is the main treatment of celiac disease?
A.
Enzymes
B.
Vitamins
C.
Lactobacteria
D.
Bifidobacteri
E.
* Gluten free diet
What can be used for treatment of irritable bowel syndrome with constipation?
A.
Psychotherapy
B.
* A diet with dietary fibers
C.
Coordinax
D.
Duphalac (lactulose
E.
No-spani
What medication is used for treatment of irritable bowel syndrome with diarrhea?
A.
* Imodium
B.
Smecta
C.
Maalox
D.
Duphalac (lactulose)
E.
Psychotherapy
What products is gluten free?
A.
Malted milk
B.
Barley, oats, rye
C.
Creamed vegetables
D.
* Fruits
E.
Sauces
What serologic markers are used for celiac disease screening?
A.
* Serum Ig A
B.
Serum Ig G
C.
Serum Ig E
D.
Serum Ig M
E.
Testing for gliadin antibodies
Diagnostic test for detection of localization of upper gastrointestinal bleeding
A.
*Endoscopy
B.
Upper GI series
C.
Hemoglobin (Hb) levels and hematocrit (HCT)
D.
Arteriography
E.
Ultrasound
Primary diagnostic indicator for pancreatitis:
A.
Elevated blood urea nitrogen (BUN)
B.
*Elevated serum lipas
C.
Elevated aspartate aminotransferase (AST)
E.
1075.
1076.
1077.
1078.
1079.
1080.
1081.
1082.
1083.
Increased lactate dehydrogenase (LD)
Elevated bilirubin
Feature of functional abdomen pain:
A.
*Normal exam and no significant weight loss
B.
Stool occult blood positive
C.
Abnormal laboratory screen
D.
Stressors doesn’t exacerbate pain
E.
Significant weight loss
Common cause of gastric ulceration:
A.
Cryptosporidium
B.
*Helicobacter pylori
C.
Cytomegalovirus
D.
Treponema pallidum
E.
Herpes simplex virus-type
What is the most effective means in treatment of autoimmune hepatitis?
A.
*Glucocorticoids, cytostatics
B.
Hepatoprotectors
C.
Antibacterial medication
D.
Hemosorbtion, vitamin therapy
E.
Antiviral medications
Patient with skin itching, jaundice, discomfort in the right subcostal area. In blood: alkaline
phosphatase — 2,0 mmol/hour/L, general bilirubin — 60 mkmol/L, cholesterol — 8,0 mmol/L.
What is the leading syndrome in this patient?
A.
Cytolyt
B.
Asthec
C.
Mesenchymal inflammatory
D.
Liver-cells insufficiency
E.
*Cholestatic
What method of investigation is to be used on the first stage of examining the patient with sudden
acute pain in the right epigastric area after having fatty food?
A.
*Ultrasonic
B.
Radionuclide
C.
Magnetic-resonance
D.
Roentgenological
E.
Thermographic
Which laboratory tests accurately characterizes the degree of cytolysis in a patient?
A.
Prothrombin
B.
Veltman’s test
C.
Takata-Ara’s test
D.
*Transaminases
E.
Total protein
Which laboratory tests should be carried out to confirm the diagnosis “pancreatitis”?
A.
Serum Transaminases
B.
*Serum Amylase
C.
Beta-lipoproteins
D.
Blood glucose
E.
The level of total bilirubin
What coprologic syndrome is characteristic for pancreatitis?
A.
Little amount of mushy stool; creatorea, mucus, leukocytes
B.
*Many oily stool with putrid smell; creatorea, stearrhea, amilorea
C.
Stool with mucus, pus, blood, leukocytes, erythrocytes, cylindrical epithelium
D.
Foam feces with sour smell, amilorea, many acidophilic flora
E.
Big amount of liquid stool without pathological inclusions
D.
E.
1084.
1085.
1086.
1087.
1088.
1089.
1090.
1091.
1092. Resonant percussion sound is characteristic for:
A.
*Healthy children
B.
Newborns
C.
6 month children.
D.
5 years children.
E.
Only adults.
1093. Puerile respiration is auscultated in children in the age:
A.
Only before 6 months old
B.
Only before one year old
C.
*From 1 months till 5 years old
D.
Before 3 years old
E.
After 5 years old
1094. At what age respiratory movements are diaphragmatic?
A.
Under 15 years
B.
At 1-2 year
C.
*Under 6-7 years
D.
Under 12-13 years
E.
Under 1st months
1095. Right lung is divided into:
A.
Upper and lower (superior and inferior)
B.
Front and back (anterior and posterior)
C.
*Upper, middle and lower (superior, middle and inferior)
D.
Upper (superior) and middle
E.
Front, middle and back (anterior, middle and posterior)
1096. What is dyspnea?
A.
The increase of the respiratory rate
B.
*The distress during breathing
C.
The decrease of the respiratory rate
D.
The cessation of breathing
E.
The increase of the respiratory depth
1097. What is hyperpnea?
A.
The increase of the respiratory rate
B.
The distress during breathing
C.
The decrease of the respiratory rate
D.
The cessation of breathing
E.
*The increase of the respiratory depth
1098. What type of respiratory movements is in elder 7 years-old girl?
A.
*Thoracic
B.
Abdominal
C.
Costal
D.
Sternly
E.
Diaphragmatic
1099. Left lung is divided into:
A.
Front and back (anterior and posterior)
B.
Upper, middle and lower (superior, middle and inferior)
C.
*Upper and lower (superior and inferior)
D.
Upper (superior) and middle
E.
Front, middle and back (anterior, middle and posterior)
1100. What is tachypnea?
A.
*The increase of the respiratory rate
B.
The distress during breathing
C.
The decrease of the respiratory rate
D.
The cessation of breathing
The increase of the respiratory depth
Average respiratory rate for 12 years old children:
A.
20 per minute
B.
30 per minute
C.
*16-20 per minute
D.
35-40 per minute
E.
30-35 per minute
What is bradypnea?
A.
The increase of the respiratory rate
B.
The distress during breathing
C.
*The decrease of the respiratory rate
D.
The cessation of breathing
E.
The decrease of the respiratory depth
What is usual ratio of breaths to heartbeats?
A.
1:1
B.
1:2
C.
1:3
D.
*1:4
E.
1:
What is hypoventilation
A.
The decrease of the respiratory rate and irregular rhythm
B.
The distress during breathing
C.
The increase of the respiratory depth and irregular rhythm
D.
The cessation of breathing
E.
*The decrease of the respiratory depth and irregular rhythm
Average respiratory rate for newborn:
A.
20 per minute
B.
30 per minute
C.
16-20 per minute
D.
*35-40 per minute
E.
30-35 per minute
What is hyperventilation?
A.
The increase of the respiratory rate and irregular rhythm
B.
The distress during breathing
C.
*The increase of the respiratory rate and depth
D.
The cessation of breathing
E.
The decrease of the respiratory depth and irregular rhythm
The tympanic resonance is determined over the lungs in case of:
A.
Pulmonary edema
B.
Tumors
C.
Bifurcation lymphadenitis
D.
*Obstruction of a major bronchu
E.
Adiposity
The pathological dullness during lung percussion is heard in case of:
A.
Asthmatic bronchitis
B.
Abscess of lung
C.
*Large infiltration at pneumonia
D.
Pneumothora
E.
Emphysema of lung
Average respiratory rate for 5 years old children:
A.
20 per minute
B.
30 per minute
C.
16-20 per minute
E.
1101.
1102.
1103.
1104.
1105.
1106.
1107.
1108.
1109.
35-40 per minute
*25 per minute
What is respiratory rhythm in newborns?
A.
*Arrhythmic breathing
B.
The distress during breathing
C.
The reduction of the BR by 10% and more
D.
The cessation of breathing
E.
The decrease of the respiratory depth
Expiratory dyspnoea develops in case of:
A.
Respiratory failure of the third degree
B.
Diabetic coma
C.
Viral croup syndrome
D.
Foreign body aspiration
E.
*Bronchial asthma
Barking cough is typical for…
A.
Dry pleurisy
B.
Pleurisy with effusion
C.
*Laryngitis
D.
Pneumothorax
E.
Tuberculosis
Character of cough is can’t be:
A.
Dry
B.
Wet
C.
*Pituitary
D.
Bitonal
E.
Spastic
Crepitation is characterized by:
A.
Appears when you press chest by phonendoscope
B.
Is determined by percussion
C.
*Does not change when bending the body
D.
Is determined by palpation
E.
Depends on the density of attachment to the chest wall by phonendoscope
Crepitation is heard…
A.
During inspiration and expiration
B.
*In 1st phase of inspiration
C.
In 1st phase of expiration
D.
In last phase of inspiration
E.
In last phase of expiration
Crepitation is the symptom of
A.
*Croupous pneumonia
B.
Acute bronchitis
C.
Dry pleurisy
D.
Chronic bronchitis
E.
Pulmonary emphysema
During inspection of a patient with severe respiratory failure you may observe the following skin
color
A.
Pale skin
B.
Hyperemia
C.
*Diffuse cyanosis
D.
Yellow color
E.
Spider angiomata
Typical changes of skin in patient with respiratory failure:
A.
Pink skin
D.
E.
1110.
1111.
1112.
1113.
1114.
1115.
1116.
1117.
1118.
Hyperemia
*Cyanosis
Icterus
Grey color
Harsh breathing indicates on…
A.
*Bronchitis
B.
Dry pleurisy
C.
Pleurisy with effusion
D.
Pulmonary emphysema
E.
Pneumonia
Pulmonary root not included
A.
Large bronchi
B.
Receptacles
C.
Trachea-bronchial lymph nodes
D.
Broncho-pulmonary lymph nodes
E.
*Thymus gland
In what disease crepitation are diffuse in nature?
A.
*Acute bronchiolitis
B.
Pneumonia
C.
Bronhoektatychna disease
D.
Local pulmonary fibrosis tissue
E.
Chronic bronchiolitis with obliteration
In what disease crepitation are local in nature?
A.
*pneumonia
B.
Bronchitis
C.
Bronchial asthma
D.
Alveolitis
E.
Acute bronchiolitis
Leading role in the diagnosis of respiratory tract foreign body is
A.
*Endoscopy airways
B.
Overview
C.
Percussion and auscultation
D.
Radiography of the chest
E.
Stripped tomography
First aid during nose bleeding:
A.
To ask a child to blow his nose;
B.
*To put a tampon with 3% Hydrogen peroxide into the nose and ice on the bridge of the
nose;
C.
Oxygen therapy;
D.
To bring into the nose a tampon with Calcium chloride;
E.
Non of above
What examinations do we use in the case of bronchitis?
A.
Complete blood count
B.
Culture of sputum,
C.
Culture of alveolar fluid,
D.
Biochemical examination of the blood (hyponatremia, hypokalemia)
E.
*Chest X-ray.
What child infectious disease is characterized by attacks of spasmodic cough accompanied
reprises?
A.
*Pertussis
B.
Measles
C.
Diphtheria
D.
Scarlatina
B.
C.
D.
E.
1119.
1120.
1121.
1122.
1123.
1124.
1125.
1126.
Red rash
The most informative method for diagnose pneumonia is:
A.
* Radiography
B.
Tomography
C.
Bronchography
D.
Bronchoscopy
E.
Fluorography
The clinical manifestations of acute stenotic laryngitis include:
A.
* Crass "barking" cough
B.
Dullness of percussion sound
C.
Have difficulties exhaling
D.
Moist rales in the lungs
E.
Emphysema
Dry barking cough is characteristic for:
A.
*Laryngitis.
B.
Bronchitis.
C.
Flu.
D.
Pneumonia.
E.
Bronchiectasic pneumosderosis.
Clear percussion sound is characteristic for:
A.
*Healthy children.
B.
Newborns.
C.
6 month children.
D.
5 years children.
E.
Adults.
How many stages of respiratory stenosis are?
A.
1
B.
2
C.
*4
D.
3
E.
5
What main clinical features are useful in the diagnosis of bronchial asthma?
A.
Chest pain
B.
*Dispnae
C.
Tahycardia
D.
Vomiting
E.
Dry cough
What conclusion after auscultation of the lungs will be in case of bronchial asthma?
A.
*Both types of rales
B.
Fine budding rales
C.
Sebelent dry rales
D.
Coarse bubling rales
E.
Crepitation rales
What food is not limited during the acute period of glomerulonephritis?
A.
*Carbohydrates
B.
Salt
C.
Liquid
D.
Proteins
E.
Fats
Which of the following laboratory findings is unusual in patients with simple (nutritional) rickets?
A.
*Hypercalciuria
B.
Hyperphosphaturia
C.
Elevated levels of serum alkaline phosphatase
E.
1127.
1128.
1129.
1130.
1131.
1132.
1133.
1134.
1135.
Aminoaciduria
Hypophosphatemia
What should a daily doze of ergocalciferol be for prophylaxis of rickets for full-term breast-fed
child?
A.
*400-500 IU
B.
200-300 IU
C.
300-400 IU
D.
500-600 IU
E.
100-200 IU
What should a daily doze of ergocalciferol be for prophylaxis of rickets for premature infant?
A.
*1000-1200 IU
B.
800-1000 IU
C.
1200-1500 IU
D.
400-500 IU
E.
1300-1500 IU
To what age should prophylaxis of rickets carry out for full-term breast-fed child?
A.
*1,5 years
B.
2 years
C.
2,5 years
D.
1 year
E.
6 months
Determine a remedy for primary prophylaxis of spasmophilia for breast-fed child.
A.
*Ergocalciferol
B.
Calcium gluconate
C.
Calcium chloride
D.
Natrium chloride
E.
Calcium pantothenate
What solution is necessary to prescribe for rehydratation?
A.
*Rehydron
B.
5 \% glucose solution
C.
Boiled water
D.
Tea
E.
Broth of a camomile (medical)
The child regurgitates after feeding by small portions of milk (changed and unchanged); stool is
normal. Muscle tonus is normal. What is the most probable diagnosis?
A.
*Pylorospasmus
B.
Meningitis
C.
Pylorostenosis
D.
Microcephaly
E.
Craniostenosis
Pollen of grasses causes:
A.
*Respiratory allergies
B.
Food allergies
C.
Contact allergies
D.
Medical allergies
E.
Croup syndrome
Curvature of the spine in a child with rickets is due to:
A.
*Muscular hypotonia
B.
Muscle hypertonus
C.
Bone deformities
D.
Perverted osteogenesis
E.
Respiratory diseases
“Drumsticks” symptom is characteristic for:
D.
E.
1136.
1137.
1138.
1139.
1140.
1141.
1142.
1143.
1144.
congenital heart disease
acute heart failure
*chronic diseases of the heart and lungs
polyarticular form of juvenile rheumatoid arthritis
systemic form of juvenile rheumatoid arthritis
Choice of antibacteryal preparations for treatment of pyelonephritis is determined:
A.
By age of the child
B.
By the cost of preparation
C.
* By the sensitiveness of bacteria cultured from urine
D.
By a country-produc
E.
By duration of the disease
Intravenous urography does not allow to discover:
A.
Position, sizes, shape of kidneys
B.
Functional state of nephrons
C.
Functional state of urinary tract
D.
* Anomaly of kidney vessels
E.
Condition of urinary bladder
For pyelonephritis typical is:
A.
Hematuri
B.
Proteinuria
C.
Leukocyturia and hematuria
D.
* Leukocyturia and bacteriuria
E.
Proteinuria and casts
Investigation of sediment in 1 ml of urine is known as :
A.
* Nechyporenko test
B.
Amburzhe tes
C.
Reberg tes
D.
Kakovsky-Addys test
E.
Pasternatsky test
The child has signs of intoxication, in a general analysis of urine significant pyuria, in daily urine
- oxalic acid - 870 mmol / day (dysmetabolic nephropathy). Your diagnosis?
A.
* Secondary acute pyelonephritis
B.
Primary acute pyelonephritis
C.
Acute glomerulonephritis
D.
Interstitial nephritis
E.
Hereditary nephritis
Main features of kidney’s edema are :
A.
* Appear in the morning, warm, pal
B.
Appear in the second part of the day, cold, cyanotic
C.
Dense
D.
Disposed mainly on trunk
E.
Disposed mainly on sex organs
Intoxication syndrome contains next symptoms :
A.
increased levels of total and conjugated bilirubin and cholesterol;
B.
increased levels of ASAT, ALAT, LDG;
C.
increased levels of amylase, tripsin, lipase;
D.
vomiting, nausea, heartburn feeling, decrease of appetite;
E.
* weakness, lucidity, bad sleep, headaches, irritability, tearfulness, increased disposition
to perspiration, blue shadows under the eyes, functional heart murmur.
The child has cloudy urine. What additional investigation will help to establish the diagnosis?
A.
Zimnitsky test
B.
Complete blood test
C.
* General urinalysis
A.
B.
C.
D.
E.
1145.
1146.
1147.
1148.
1149.
1150.
1151.
1152.
Analysis of urine for sugar from the urine daily amount
Koprocytogram
What is Pasternatsky’s symptom?
A.
Pain in palpation of lumbar region in the area of projection of kidneys
B.
Appearance of pain in lumbar region during trunk rotation
C.
* Appearance of pain at tapping lumbar region in the area of kidneys
D.
Appearance of pain in the lumbar area at coughing
E.
Appearance of pain in the projection of ureter at passing of stone from a kidney
What changes in the urinary sediment are characteristic for pyelonephritis?
A.
Microhematuria, hyaline cylinders
B.
* Pyuria, bacteriuria.
C.
Hematuria, proteinuria.
D.
Proteinuria, granular cylinders, renal epithelium.
E.
Fresh red blood cells, oksalaturiya.
Normally, in a general analysis of urine rate of red blood cells is:
A.
* should not be
B.
up to 1-2 in the field of view
C.
up to 5 in the field of view
D.
up to 15 in the field of view
E.
up to 10 in the field of view
When does the displacement of one kidney appear on plane X-ray?
A.
In diffuse nephritis
B.
In the case of polycystosis
C.
In chronic kidney insufficiency of the II stage.
D.
* In nephroptosis
E.
In hydronephrosis.
Dyspeptic syndrome contains next symptoms:
A.
increased levels of total and conjugated bilirubin and cholesterol;
B.
increased levels of ASAT, ALAT, LDG;
C.
increased levels of amylase, tripsin, lipase;
D.
* vomiting, nausea, heartburn feeling, decrease of appetite;
E.
weakness, lucidity, bad sleep, headaches, irritability, tearfulness, increased disposition to
perspiration, blue shadows under the eyes.
Chronic gastroduodenitis more frequent combines with diseases of:
A.
CNS;
B.
* hepatobiliary system;
C.
respiratory system;
D.
heart and vessels;
E.
urinary system.
Functional gastric disorders include:
A.
Chronic esophagitis.
B.
Chronic gastritis.
C.
* Duodenogastric reflux.
D.
Stomach ulcer.
E.
Chronic duodenitis.
Pain in the epigastric area characterised:
A.
* gastritis
B.
cholangitis
C.
cholecystitis
D.
biliary dyskinesia
E.
colitis
D.
E.
1153.
1154.
1155.
1156.
1157.
1158.
1159.
1160.
Pediatrics.
Tasks (ситуаційні задачі)
1.
2.
3.
4.
5.
6.
7.
12 years old female put is on a dispensary observation by gastroenterologist because of duodenal
ulcer, biliary dyskinesia. How often antirelapse courses should be given?
A.
Every 2 months
B.
*Twice a year
C.
Every 3 months
D.
Once a year
E.
Three times a year
1.5 years’ old child is ill for 1 week. Objectively: body temperature is 38.5? C, often moist cough,
dyspnea in the rest. On X-ray: lungs’ roots are broad, infiltrated, and in both sides are little
shadows. What form of an acute pneumonia is according to X-ray?
A.
Interstitial
B.
*Bronchopneumonia
C.
Monosegmental
D.
Polysegmental
E.
Crupous
10-years’ old boy is ill for 4 days. He complaints on subfebrile temperature, dry cough.
Objectively: pallor of the skin, red cheeks, greater on right side. Percussion: on right side dull
sound in lowest part, and in axillar region. Auscultation: on right sight lower than angle of the
scapula decrease of breathing, crepitating. What form of an acute pneumonia is possible in this
case?
A.
Bronchopneumonia
B.
Monosegmental
C.
Polysegmental
D.
*Crupous
E.
Interstitial
5-years' old child was hospitalized because of destructive pneumonia. The bacteriological
investigation from pleural cavity has found staphylococci. What antibacterial medicine is better to
prescribe?
A.
Penicillin
B.
Ampicillin
C.
Vankomycin
D.
Erythromycin
E.
Gentamycin
A previously healthy 13-year –old boy develops a mild pneumonia characterised by a
nonproductive cough. The therapy is:
A.
*Mucalthin
B.
Ventolin
C.
Euphullin
D.
Prednisolon
E.
Salbutamol
The 5-month's child with an acute pneumonia was hospitalized. The clinical blood analysis is:
erythrocytes 2.86 х 10??/l, Нb - 86 g/l, CI – 0.8, leucocytes 11,2 х 109/l, eosynophyles - 3 %,
neutrophyles: band forms - 2 %, segments - 30 %, lymphocytes - 58 %, monocytes - 7 %, ESR - 8
mm/hour. Name the pathological changes.
A.
Lymphopenia, anemia
B.
*Leucocytosis, anemia
C.
Leucopenia, increase of ESR
D.
Shift of the formula to the left
E.
Lymphocytosis, monocytosis
The 7-months' old child has body temperature 38.3° C, cyanosis of perinasal triangle, breathing
rate is 54 per minute. During percussion: dullness of the sound paravertebrally. During
auscultation: big amount of small moist riles all over the lungs, diminished breathing and crackles
8.
9.
10.
11.
12.
13.
on the right. The most possible diagnosis is:
A.
Upper respiratory tract viral infection
B.
Acute bronchitis
C.
Acute bronchioliti
D.
*Acute bronchopneumonia
E.
Acute interstitial pneumonia
The 7-years’ old child was hospitalized with complaints of high body temperature 38.5?C, often
moist cough, dyspnea at rest. What investigation will resolve the diagnosis?
A.
Clinical analysis of a blood
B.
Bacteriological investigation of sputum
C.
X-ray of chest
D.
Spirography
E.
Bronchoscopy
The 9 months' old child who disturbs cough, dyspnea, subfebrile body temperature was examined
by district pediatrician. Focal bronchopneumonia was suspected. What auscultation picture is
typical for this case?
A.
Diffuse dry rales
B.
Rough breathing
C.
Diffuse wet rales
D.
Decrease breathing
E.
*Local crackles
The child is 7 years old. He has influenza for 5 days. The condition of the child sharply worsened.
Once again has increased the body temperature, has appeared: moist cough with separation of
mucous-purulent phlegm, dyspnea. Breathing - 30 per 1 min., cyanosis of perioral triangle, in
lower parts of the lungs, more in the right, dullness of the lung sound, moist small rales. Pulse 120 per 1 min., heart tones are weakened. What complication of influenza is possible?
A.
Croup syndrome
B.
*Pneumonia
C.
Meningitis
D.
Myocarditis
E.
Obstructive bronchitis
The child, 7 years old, has measles for 10 days. He complains of increasing of the body
temperature to 39 ?С, general weakness, and periodic humid cough with mucous phlegm.
Objectively: the general condition is moderate, skin is pale with pigmented rashes. On
auscultation – dull sound, small rales in lower parts of lungs. What complication of the measles
has appeared in child?
A.
Tracheobronchitis
B.
Bronchitis
C.
Bronchiolitis
D.
*Pneumonia
E.
Pharyngitis
An 18-month-old child is taken to hospital on the 4-th day of the disease. The disease began
acutely with temperature 39°C, weakness, cough, restlessness. He is pale, has cyanosis, febrile
temperature for more than 3 days. There are crackles and small bubbling rales at the auscultation
on the right. Percussion sound is shortened in right under scapula area. X-ray picture:
unhomogenous segmental infiltration 8-10 at the right, the increase of vascular picture,
unstructural roots. What is the most likely diagnosis?
A.
Bronchitis
B.
Bronchiolitis
C.
Interstitial pneumonia
D.
Influenza
E.
*Segmental pneumonia
15 yr old female was admitted to thoracic surgery department with fever up to 40°C, onset of pain
14.
15.
16.
17.
18.
19.
in the side caused by deep breathing, cough with considerable quantity of purulent sputum and
blood with bad smell. What is the most likely diagnosis?
A.
Complication of liver echinococcosis
B.
Pulmonary tuberculosis
C.
*Abscess of the lung
D.
Actinomycosis of lungs
E.
Bronchiectatic disease
A 10-year-old boy complains of a headache, weakness, fever (temperature - 40° C), vomiting. On
physical examination: there is an expressed dyspnea, pale skin with a flush on a right cheek, right
hemithorax respiratory movement delays, dullness on percussion of the lower lobe of the right
lung, weakness of vesicular respiration in this region. The abdomen is painless and soft by
palpation. What disease causes these symptoms and signs?
A.
*Pneumonia crupous
B.
Intestinal infection
C.
Acute appendicitis
D.
Acute cholecystitis
E.
Influenza
A 14-year-old patient has been treated in a hospital. A fever of 39°C, chest pain which is
worsened by breathing, cough, brownish sputum appeared on the 7th day of the treatment. Chest
X-ray shows left lower lobe infiltrate. Which of the following is the treatment of choice for this
patient?
A.
*Cephalosporines of the III generation
B.
Erythromycin
C.
Streptomycin
D.
Penicillin
E.
Tetracycline
A 16-year-old male was admitted to the hospital complaining of stabbing back pain on inspiration
and dyspnea. On exam, t - 37°C, Ps 92/min, BR of 24/min, vesicular breath sounds. There is a
dry, grating, low-pitched sound heard in both expiration and inspiration in the left lower lateral
part of the chest. What is the most likely diagnosis?
A.
*Acute fibrinous pleuritis
B.
Acute bronchitis
C.
Pneumonia
D.
Pneumothorax
E.
Myocarditis
A 3 month old infant suffering from acute segmental pneumonia has dyspnea (respiratory rate 80 per minute), paradoxical breathing, tachycardia, total cyanosis. Respiration/pulse ratio is 1:2.
The relative heart dullness borders are normal. Such signs are characteristic for:
A.
Congenital heart defect
B.
Respiratory failure of 0 degree
C.
Respiratory failure of I degree
D.
Respiratory failure of II degree
E.
*Respiratory failure of III degree
A 6 year old girl has an acute onset of fever up to 39oC with chills, cough, and pain on respiration
in the right side of her chest. On physical examination: HR - 120/min, BP- 85/45 mm Hg, RR36/min. There is dullness over the right lung on percussion. On X-ray: infiltrate in the right
middle lobe of the lung. What is the diagnosis?
A.
Interstitial pneumonia
B.
Acute pleuritis
C.
Community-acquired lobar pneumonia
D.
Acute lung abscess
E.
Nosocomial lobar pneumonia
8-month-old child was entered to the hospital. After bacteriological observation it is diagnosed
20.
21.
22.
23.
24.
atypical community-acquired Chlamidia trachomatis pneumonia. Select the best antibiotic.
A.
*Macrolides
B.
Carbopenem
C.
Aminopenicilline
D.
Cephalosporin
E.
Aminoglycosides
A boy, 8 years old, has addressed to pediatrician with complains of increasing of the body
temperature to 37.5 ?С, sore throat, cough, serous discharge from nose, lacrimation. During
examination mild hyperemia and edema of the tonsils and back pharyngeal wall, conjunctives
were revealed. The physician suspects adenoviral infection. Which method of express-diagnostics
is better to use for acknowledgement of the diagnosis?
A.
The selection of the virus on tissue culture
B.
*Immunofluorescent method
C.
Serological investigation
D.
bacteriological investigation
E.
Bacteriosсopy investigation of pharyngeal swab
A patient with nosocomial pneumonia presents signs of collapse. Which of the following
pneumonia complications is most likely to be accompanied by collapse?
A.
Exudative pleuritis
B.
Bronchial obstruction
C.
Toxic hepatitis
D.
*Septic shock
E.
Emphysema
An 18-month-old child is taken to hospital on the 4-th day of the disease. The disease began
acutely with temperature 39°C, weakness, cough, restlessness. He is pale, has cyanosis, febrile
temperature for more than 3 days. There are crackles, fine bubbling rales at the auscultation.
Percussion sound is shortened in right under scapula area. X-ray picture: unhomogenous
segmental infiltration 8-10 in the right, the increase of vascular picture, unstructural roots. What is
the most likely diagnosis?
A.
Bronchitis
B.
Bronchiolitis
C.
Interstitial pneumonia
D.
Influenza
E.
*Segmental pneumonia
A 7-year-old boy has body temperature 39.4°C, productive cough and intoxication. During the
examination: a voice fremitus is stronger, short percussion sound, depressed breathing and
bronhophonia over the right lung. The X-ray: a homogeneous infiltration of the right lung lower
lobe. What is the diagnosis?
A.
*Acute right-sided lobar pneumonia
B.
Acute right-sided segmental pneumonia
C.
Acute right-sided pleuritis
D.
Acute right-sided pneumothorax
E.
Acute right-sided intersticial pneumonia
A 9 month-old baby has fever, cough, dyspnea. She is sick for 5 days after contact with ARVI
patient. Condition of the child is severe. Temperature 38°C, nasolabial triangle is cyanotic. RR 54
per 1 min, nostrils flaring during breathing. Percussion: a shortening of the sound below the right
scapula angle, over the other sites - tympanic sound. On auscultation - small bubbling moist rales
on both sides, more on the right side. What is the most likely diagnosis?
A.
Acute bronchiolitis
B.
ARVI
C.
Acute laryngotracheitis
D.
Acute bronchitis
E.
*Acute pneumonia
25.
26.
27.
28.
29.
30.
A child of 10 months has acute bronchopneumonia with destruction of the left lung. Which agent
is most likely caused this disease?
A.
Pneumococcus (S. pneumoniae)
B.
*St. aureus
C.
Colibacillus (E. Coli)
D.
Pseudomonas aeruginosa
E.
Proteus vulgaris
Patient 14yrs during the week noted the deterioration of general condition, sub-febrile
temperature. Then suddenly developed fever to 38°C, there was pain in the right half of the chest,
a dry cough. On the right of the 3 ribs downwards shortening of percussion sounds is determined.
Above the shortening of the sound breathing is not listened. The blood leukocytes 10.5x109, ESR
- 32mm/h. X-ray on the right intense homogenous darkening of 3 ribs down. The heart is shifted
to the left. What disease should be suspected in a patient?
A.
*Pleural effusion
B.
Pneumonia
C.
Spontaneous pneumothorax
D.
Cancer of the lung
E.
Acute lung abscess
Child 2.5 years is acutely ill. Body temperature is raised to 38° C and appeared with abdominal
pain, vomiting once. Condition of the child is severe. Skin is pale. Breathing rate is 80 per minute.
There is cyanosis of naso-labial triangle. Dullness of percussion sound is in the right lower part of
chest, there is diminished breathing, crackles is absent. Abdomen is moderately swollen, painful
to palpation in the right upper ribs region. At chest X-ray- right side is infiltrated in 7-10
segments. What is the most likely diagnosis?
A.
Membranous pneumonia
B.
Acute appendicitis
C.
Right side pericardial pleurisy
D.
Acute obstructive bronchitis
E.
*Acute right side polysegmental pneumonia
Child in 12y.o. diagnosed pneumonia, which is caused by Mycoplasma pneumoniae. What
treatment should be chosen?
A.
Adrenalin
B.
Cephalosporines
C.
Aminopenicillin
D.
*Macrolide
E.
Antifungal drugs
Child is two years old. The mother appealed to the district pediatricians with complaints of child
cough, runny nose, fever up to 38.5°C, weakness and decrease in appetite. Objectively: condition
of the child is moderately severe, skin is pale, RR 40 per 1 min., Auscultation: lung breathing is
hard, there is crackles on the lower right side. What is the diagnosis?
A.
Acute bronchiolitis
B.
*Pneumonia
C.
Obstructive bronchitis
D.
Acute bronchitis
E.
Bronchial asthma
A 2 years old child has dry cough, dyspnea, body temperature is 37.5°C. Percussion: clear
pulmonary sound without dullness. Auscultation: dry whistling and different moist rales. In the
peripheral blood: leukocytosis, eosynophylia, increased ESR. What disease is possible?
A.
Acute simple bronchitis
B.
*Obstructive bronchitis
C.
Whooping cough
D.
Acute pneumonia
E.
Bronchial asthma
31.
32.
33.
34.
35.
36.
Pediatrician was called to the 2-years old child who’s mother complaints of a subfebrile
temperature, rhinitis and dry cough. He is ill for 3 days. During percussion: a clear pulmonary
sound without dullness. During auscultation: puerile breathing. Laboratory findings: leucopenia,
lymphocytosis, increased ESR. What disease is possible first of all?
A.
Acute obstructive bronchitis
B.
*Acute tracheitis
C.
Acute bronchopneumonia
D.
Recurrent bronchitis
E.
Acute bronchitis
The 5-months' old child has subfibrile temperature, paroxysmal cough and dyspnea. He is
hospitalized. 3 days ago he was in a contact with sister ill on acute upper respiratory tract viral
infection. Objectively: the condition is severe, skin is cyanotic, considerable expiration dyspnea,
oral crepitation. Percussion: tympanic sound. Auscultation: a scattered, wet rales in both sides,
respiratory rate is 80 per 1 minute. What disease is possible?
A.
Bronchial asthma
B.
Aspiration of a foreign body
C.
Acute bronchitis
D.
*Bronchiolitis
E.
Acute pneumonia
The 4 year child with frequent respiratory tract, which are observed from the 1st year of life, is
examined in the hospital. The most typical clinical manifestations of lung malformation are the
following symptoms, except:
A.
Recurrent bronchitis or pneumonia
B.
Shortness of breath during physical exercises
C.
Deformation of the chest
D.
*Attacks of dyspnea at night
E.
Fingers clubbing and “drum sticks”
A district pediatrician examined the 5-year-old child, whom disturbed wet cough. During this
year, same problems developed for the third time. After clinical examination a doctor thought
about chronic disease of lungs. What auscultation signs are characteristic for this disease?
A.
Dry diffuse rales
B.
Weakened breathing
C.
Moist rales
D.
*Persistent local moist rales
E.
Hard breathing
A patient with stomach bleeding was hospitalized. Endoscopic examination revealed an acute
gastric ulcer. In the history: rheumatoid arthritis, pharmacotherapy. Name the drug that caused the
development of acute gastric ulcer and bleeding.
A.
Delagyl
B.
*Sodium diclofenac
C.
Klaritin
D.
Dekaris (levamisole)
E.
Plazmol
The 7-years’ old child was hospitalized with complaints on wet cough. His condition has
worsened 10 days ago. He is ill during last 4 years: viral infections 3-4 times per year are
accompanied by bronchitis. Objectively: cough with sputum. Percussion: a clear pulmonary
sound. Auscultation: rough breathing, nonconstant single diffuse wet rales. X-ray: lung pattern is
increased, roots are nonstructural. What disease is possible in this case?
A.
Viral infection
B.
Acute bronchitis
C.
*Relapsed bronchitis
D.
Acute pneumonia
E.
Chronic disease of lungs
37.
38.
39.
40.
41.
42.
43.
The child is 7 years old. He has influenza for 5 days. The condition of the child sharply worsened.
Once again has increased the body temperature, has appeared: moist cough with sputum, dyspnea.
RR - 30 per min., cyanosis of perioral triangle, in lower parts of the lungs is dullness of the lung
sound, moist small rales. Pulse - 120 in 1 min., heart tones are weak. What complication of
influenza is possible?
A.
Croup syndrome
B.
*Pneumonia
C.
Meningitis
D.
Myocarditis
E.
Obstructive bronchitis
The child, 2 years old, is treated from influenza. His condition suddenly became worse: the body
temperature has increased to 39.8 ?С, has appeared rough barking cough, hoarseness of the voice,
expressed inspiratory dyspnea. Objectively: involvement of the auxiliary muscles in breathing,
skin pallor, tachycardia. What complication of influenza has developed?
A.
Pneumonia
B.
Bronchiolitis
C.
Croup syndrome
D.
Obstructive bronchitis
E.
Pharyngitis
A 2 years old child has dry cough, dyspnea, body temperature is 37.5°C. Percussion: tympanic
sounds. Auscultation: breath sounds are coarse, dry whistling and different moist rales. In the
peripheral blood: leucocytosis, eosynophylia, increased ESR. What disease is possible?
A.
Acute simple bronchitis
B.
*Obstructive bronchitis
C.
Whooping cough
D.
Acute pneumonia
E.
Bronchial asthma
Pediatrist was called to the 2-years child in connection with subfibrile fever, rhinitis and dry
cough. Child is sick 3-d day. Percussion: a clear pulmonary sounds. Auscultation: breath sounds
are coarse. By results of examinations: a leucopenia, lymphocytosis, accelerated ESR. What
disease is possible first of all?
A.
Acute obstructive bronchitis
B.
Acute tracheitis
C.
Acute bronchopneumonia
D.
Relapse bronchitis
E.
*Acute bronchitis
The 9-month's child in a severe condition is hospitalized. Diagnose is bronchiolitis. What is the
reason of the severe condition of the child?
A.
Neurotoxicosis
B.
Heart failur
C.
*Respiratory failure
D.
Epinephral failure
E.
Exicosis
The 5-years child has obstructive bronchitis. There is non-productive cough and dyspnea. What
drugs will be as a base of therapy?
A.
Antibiotics
B.
Hyposensibilization
C.
*Broncholitics
D.
Mucolitics
E.
Hormones
The 5-month's child with the complaints of subfibrile fever, inefficient tussis, dyspnea is
hospitalized. He was ill 3 days ago after a contact with ill on virus sister. Objectively: the
condition is very severe, skin is cyanotic, considerable expiration dyspnea, oral crepitation.
44.
A.
B.
C.
D.
E.
45.
46.
47.
48.
Percussion: sound boxes. Auscultation: prolonged expiratory, scattered whistling sounds, RR 80
per 1 minute. What disease is possible?
A.
Bronchial asthma
B.
Aspiration of a foreign body
C.
Acute bronchitis
D.
*Bronchioliti
E.
Acute pneumonia
12-month old child after contact with cat has a frequent paroxysmal, irritative, nonproductive
cough. The child has short breathing, he tries to breathe more deeply and the expiratory phase
becomes prolonged and is accompanied by an audible wheezing. His lips are cyanotic, cyanosis
observed in the nail beds and skin, especially around the mouth. The child is restless and anxious.
Sweating is prominent as the attack progresses. In history: allergy on food products. Put your
diagnosis.
A.
Acute pneumonia
B.
Respiratory virus infection
C.
*Bronchial asthma
D.
Obstructive bronchitis
E.
Bronhiolitis
F.
45. The child of 6 years – diagnose asthma bronchial the first time. After liquidation of
attack period it was decided to prescribe antiinflamation therapy. It is necessary to give:
Aspirin
Diclofenac
Prednizolon
*Nedocromil
Іndometacini
The child of 10 years – diagnose bronchial asthma during 5 yrs. Attack periods appear in summer
during flowering. In period between attacks the child needs such treatment:
A.
Antiinflamation
B.
Antibacterial
C.
Broncholitical
D.
Mucolitical
E.
*Inhaled corticosteroids
The child of 10 years – diagnose bronchial asthma during 5 years. Duration of an attack period is
more than 6 hours. It is necessary to prescribe:
A.
*Prednizolon
B.
Adrenalin
C.
Іntal
D.
Suprastin
E.
Еfedrin
1.5 years old child is sick the second day. Body temperature is 37.8°C, restless, barking cough,
hoarse voice, noisy breathing, stridor, pallor of skin, retraction at rest. Put diagnosis.
A.
Pneumonia
B.
*Laryngitis
C.
Bronchiolitis
D.
Foreign body aspiration
E.
Bronchial asthma
A child 10 months was entered to the hospital in severe condition with expiratory shortness of
breath, dry cough, the temperature 38°C. At percussion over lungs there is tympanic sound.
Auscultation reveals prolonged expiration, many dry wheezing and occasional wet rales on both
sides. What is your diagnosis?
A.
Bronchial asthma
B.
Pneumonia
C.
*Acute obstructive bronchitis
Pertussis
Acute bronchitis
A child is 11 months. He is ill ARI. On the second day it was marked the emergence of a barking
cough, hoarse voice, strdor, breath difficulties, shortness of breath, cyanosis. In what department
is hospitalized child?
A.
Pulmonary
B.
Infectious
C.
Junior childhood
D.
Otolaryngology
E.
*Intensive care unit
A child 5 years is ill. Premorbid anamnesis is good. There is a mild indisposition, increasing t° to
37.3°C, decreased appetite, frequent coughing, significant nasal drainage. Objectively: RR-25 per
1 min., percussion lung sound, auscultation reveals different bubble rales, after the cough
character of rales changes. It was diagnosed ARI, acute bronchitis. What kind of treatment is most
faithful?
A.
Aminoglycosides
B.
Cephalosporines
C.
Sulphamids
D.
*Mucolytics and vitamins
E.
Antihistamines
A child 7 years is ill. There is a slight indisposition, increasing t° to 37.3°C, decrease of appetite,
frequent coughing, significant nasal drainage. ARI is diagnosed, acute bronchitis. What kind of
treatment is most faithful?
A.
Antibiotics
B.
Vitamins
C.
*Mucolytics
D.
Physiotherapy
E.
Antihistamine
A child of 9 months is acutely ill: increased body temperature to 38,8°C, cough, runny nose. On
3d day of illness, at night, the condition became worse: the child became restless, barking cough,
stridor and hoarse voice appeared, inspiratory shortness of breath. It was diagnosed croup. Which
of the pathogens most likely is the reason of croup in children?
A.
Adenovirus
B.
Influenza
C.
*Virus parainfluenza
D.
Rynovirus
E.
Enteroviruse
Children under eight months came to hospital complaining of non-productive, intense cough for 2
days, wheezing breath, increased body t° to 37.8°C. Objectively: perioral cyanosis; barrel thorax;
auscultation: different wet rales. It was diagnosed obstructive bronchitis. What is the basic
therapy?
A.
*Broncholytics
B.
Corticosteroids
C.
Antibiotics
D.
Mukolytics
E.
Enzymes
Child is 2 years. He is Ill at the first time. Sick 2 days: t° - 37.4°C, dry cough, RR 60 per min,
expiratory dyspnea. There is box sound over lungs. Auscultation reveals hard breathing,
crepitation and dry whistling. What is the diagnosis?
A.
Bronchiolitis
B.
Congenital stridor
C.
Acute bronchitis
D.
Pneumonia
D.
E.
49.
50.
51.
52.
53.
54.
E.
55.
56.
57.
58.
59.
60.
61.
*Acute obstructive bronchitis
8 year old child complains of coughing with purulent sputum, especially in the morning. He is ill
5 years after foreign body aspiration episode. After that he had pneumonia two times. What
disease is the most probable?
A.
*Chronic disease of lungs
B.
Recurrent pneumonia
C.
Recurrent bronchitis
D.
Pulmonary tuberculosis
E.
Bronchial asthma
Child is 2 years. He is Ill at the first time. Sick 2 days: t° - 37.4°C, dry cough, RR 30 per min.
There is clear lung sound. Auscultation reveals hard breathing, crepitation and dry rales. The Xray shows increasing of pulmonary pattern. What is the most likely diagnosis?
A.
*Acute (simple) bronchitis
B.
Obstructive bronchitis
C.
Congenital strydor
D.
Pneumonia
E.
Bronchiolitis
Child is four months old. He is acutely ill with fever to 37.8°C, coughing. On 3d day cough
increased, shortness of breath appeared, percussion tympanic sound over lungs, auscultation:
prolonged expiration, a large number of fine wet and wheezing rales on exhalation on both sides.
What is your preliminary diagnosis?
A.
ARI, pneumonia
B.
*ARI, acute bronchiolitis
C.
ARI, acute bronchitis
D.
ARI, obstructive bronchitis
E.
ARI, focal pneumonia
Child is 6 months. He is acutely ill with fever to 37.8°C, coughing. On 3d day cough increased,
shortness of breath appeared, percussion tympanic sound over lungs, auscultation: on both sides a
large number of fine wet and wheezing rales on exhalation. Acute bronchiolitis was diagnosed.
What is the reason of such disease?
A.
Rinovirus
B.
Flu
C.
Adenovirus
D.
Virus parainfluenza
E.
*Respiratory syncytial virus
The girl 10 months was entered to the hospital the next day of illness with complaints of increase
body temperature to 39°C, dry, barking cough. After clinical examination the diagnosis of acute
laryngitis was established. What breathing disorder is characteristic for this situation?
A.
Mixed breathlessness
B.
Expiratory dyspnea
C.
Hoarse breath
D.
*Inspiratory dyspnea
E.
Stridor breath
Three-year-old boy was delivered to the hospital at night by ambulance. He is ill 2 days. On
background of ARVI loud inspiratory dyspnea occurred with retraction of intercostal spaces,
blowing nostrils and barking cough. The most probable diagnose is:
A.
Epiglottitis
B.
Bronchial asthma
C.
*Viral false croup
D.
Real (diphtheric) croup
E.
Foreign body of air ways
5-year-old child is hospitalized with complaints of wet cough. He is ill for 3 years, he had left side
low lobe pneumonia three times before. During examination: skin is pale, perioral and periorbital
62.
63.
64.
65.
66.
67.
cyanosis. During percussion: local dullness below the lower corner of the left scapulae. During
auscultation: many fine moist rales under the left scapulae. X-ray of chest: deformation of
bronchial pattern on the left side. Which of the following will prove diagnosis?
A.
Biplane (two-dimensional) chest x-ray
B.
Chest ultrasound
C.
CT of chest
D.
*Bronchoscopy or bronchography
E.
Spirography
6-year-old child is hospitalized with constant complaints of cough with purulent sputum. He is ill
during 3 years, exacerbations periods develop 3-4 times per year. After the clinical and
instrumental examinations was diagnosed chronic disease of lungs. What is the basic complex
treatment of this disease?
A.
*Restoration of drainage function of bronchi
B.
Antibacterial therapy
C.
Physiotherapy
D.
Desensitization therapy
E.
Physiotherapy
The child 5 years was admitted to the hospital with rapid breathing disorders. Skin is pale,
acrocyanosis, stenotic breathing, breathing with participation of auxiliary muscles, retractions at
rest, hoarse voice. He has contact with ill ARI person. Your diagnosis is:
A.
*Laryngotracheitis
B.
Laryngeal papillomatosis
C.
Bronchitis
D.
Foreign body of larynx
E.
Foreign body of trachea
A 2 year boy is admitted to the hospital with complaints of persistent cough, periodic diarrhea and
malnutrition. He had bronchitis 4 times before and pneumonia 2 times before. Also was
diagnosed sinusitis. What is the most likely preliminary diagnosis?
A.
Chronic pneumonia
B.
Tracheobronchomegaly
C.
*Cystic fibrosis
D.
Intestinal infection
E.
?-1-antitripsin deficiency
A 2 months boy is admitted to the hospital with complaints of persistent cough, dyspnea,
cyanosis, prolonged jaundice, hepatomegaly. During lungs percussion there is bandbox sound.
What is the most likely preliminary diagnosis?
A.
Chronic pneumonia
B.
Tracheobronchomegaly
C.
Cystic fibrosis
D.
Intestinal infection
E.
*?-1-antitripsin deficiency
A 5 year girl is suffering from bronchitis frequently. The physical development is delayed. There
is persistent cough with mucous-purulent sputum. The doctor suspected chronic disease of lungs.
What symptoms will allow to the physician to make such conclusion?
A.
Delay in physical development
B.
Cough with mucous-purulent sputum
C.
Relapsing course of disease
D.
Persistent local changes in lung
E.
*All mentioned above
A 5 year child is suffering from bronchitis frequently. The physical development is delayed.
There is persistent cough with mucous-purulent sputum. The doctor suspected chronic disease of
lungs. Which method is the most informative to confirm this diagnosis?
A.
*Bronchography
Spirography
Echocardiography
X-ray of the chest
Sputum analyses
A 5 year old boy was hospitalized with a preliminary diagnosis of chronic disease of lungs. He is
ill during 4 years. There is a constant wet cough, persistent moist rales in the lower lobe of the
right lung. Which of the following will prove diagnosis?
A.
Biplane (two-dimensional) chest x-ray
B.
Chest ultrasound
C.
Bronchoscopy
D.
*Bronchography
E.
Spirography
In 5 year child who has frequent maxillary sinusitis and respiratory diseases was suspected
Kartagener syndrome. All symptoms are typical for this disease EXEPT:
A.
Situs inversus
B.
Chronic bronchitis with bronchiectasis
C.
Ethmoidoantritis
D.
*Nephritis
E.
Endocrine glands hypofunction
5-year-old child is hospitalized with complaints of wet cough, shortness of breath during exercise.
Condition worsened 10 days ago after contact with patients with acute respiratory infection. From
anamnesis it is known that a child is suffering from pneumonia 2-3 times per year. There was a
suspicion of chronic disease of lungs. What research will be definitive in establishing of the final
diagnosis?
A.
Arteriography
B.
X-ray of the chest
C.
Spirography
D.
Bronchoscopy
E.
*Bronchography
8-year-old child is treated in a hospital from chronic disease of lungs. Sputum was taken for
bacteriological study from the bronchi during medical and diagnostic bronchoscopy.
Pneumococci were revealed, sensitive to cephalosporines. Which way is the best for introduction
of antibiotics?
A.
Oral
B.
Intravenous
C.
*Endobronchial
D.
Intramuscular
E.
Electrophoresis
In 3 year child was revealed situs inversus, chronic recurrent bronchitis, frontal sinuses
hypoplasia, congenital heart defect. The most probable diagnosis is:
A.
Mounier-Kuhn syndrome
B.
Williams-Campbell syndrome
C.
?-1-antitripsin deficiency
D.
*Kartagener syndrome
E.
Cystic fibrosis
A district pediatrician examined the 9-year-old child, whom disturbed wet cough and shortness of
breath during physical exercises. Child is sick during 6 years: frequent respiratory diseases, 1-2
times per year - pneumonia. After analysis of anamnesis and clinical examination chronic disease
of lungs was diagnosed. What is the most typical symptom of this disease?
A.
Dyspnea
B.
Perioral cyanosis
C.
Pale skin
D.
*Persistent cough
B.
C.
D.
E.
68.
69.
70.
71.
72.
73.
Subfebrile temperature
The 7 year boy is suffering from persistent wet cough. There was a suspicion of chronic disease
of lungs. What chest X-ray changes are the most typical for the chronic disease of lungs?
A.
Local infiltration of lung tissue
B.
Presence of the round shape shadow
C.
*Intensification and deformation of the lungs pattern
D.
Lungs extension and hyperaeration
E.
Heart extension
A 5 year boy is suffering from bronchitis and pneumonia often. At bronchologic examination
bronchiectasis were revealed. In addition, the child suffers from chronic sinusitis, there is
dextracardia. The most likely diagnosis is:
A.
Mounier-Kuhn syndrome
B.
*Kartagener syndrome
C.
Williams-Campbell syndrome
D.
Hammen-Rich syndrome
E.
Cystic fibrosis
In 1 year child was revealed chronic recurrent bronchitis and tracheobronchomegaly,
ethmoidoantritis. The most probable diagnosis is:
A.
*Mounier-Kuhn syndrome
B.
Williams-Kempbell syndrome
C.
Alfa-1-antitripsin deficiency
D.
Kartagener syndrome
E.
Cystic fibrosis
In 5 year child was revealed dyspnea during physical exercises, heart pain, collapse attacks,
cyanosis, 2 tone accent above the pulmonary artery, systolic murmur above the pulmonary artery.
Chest x-ray revealed deceased intensity of the lungs pattern, enlarged heart. The most probable
diagnosis is:
A.
Mounier-Kuhn syndrome
B.
Williams-Campbell syndrome
C.
?-1-antitripsin deficiency
D.
*Primary pulmonary hypertension
E.
Idiopathic pulmonary hemosiderosis
In 5 year child was revealed dyspnea during physical exercises, heart pain, collapse attacks,
cyanosis, 2 tone accent above the pulmonary artery, systolic murmur above the pulmonary artery.
Chest x-ray revealed deceased intensity of the lungs pattern, enlarged heart. The most probable
diagnosis is:
A.
Mounier-Kuhn syndrome
B.
Williams-Kampbell syndrome
C.
alfa-1-antitripsin deficiency
D.
*Primary pulmonary hypertension
E.
Idiopathic pulmonary hemosiderosis
In 8 month child there is high possibility of cystic fibrosis according the clinical and anamnestic
criteria. What examination will prove the diagnosis?
A.
Level of lipids in blood
B.
*Level of chlorides in the sweat
C.
Koprogram
D.
Chest x-ray
E.
Level of ?-1-antitripsin in blod
The 6 year boy was hospitalized with the complaints of shortness of breath, frequent cough, loss
of weight. He is ill during 4 years since the idiopathic fibrosing alveolitis was diagnosed. What is
pathogenic treatment:
A.
Antibiotics
B.
*Corticosteroids
E.
74.
75.
76.
77.
78.
79.
80.
NSAID’s
Broncholytics
Immune modulators
A 7-year-old child was hospitalized with exacerbation of chronic disease of lungs. A child was
born from premature pregnancy. He suffered from rickets and anemia during the first year of life,
in 1,5 yr - acute pneumonia, in two years a foreign body aspiration (button). He has acute
respiratory tract infections 3-4 times per year. What probably caused the development of chronic
disease of lungs?
A.
Prematurity
B.
Rickets
C.
Anemia
D.
*Foreign body aspiration
E.
Frequent acute respiratory tract infections
A 10 year child is suffering from bronchitis frequently. The physical development is delayed.
There is persistent cough with mucous-purulent sputum. The doctor suspected bronchiectasis.
Select the primary method for diagnosis of bronchiectasis:
A.
*Bronchography
B.
Bronchoscopy
C.
CT of the chest
D.
Chest x-ray
E.
Scintigraphy
Patient is 5 years old. He has chronic cough, recurrent pneumonias and poor physical exercises
resistance. Auscultation reveals a murmur and congestive cardiac failure.
A.
iogram reveals signs of lungs tissue consolidation. Vomiting, failure to thrive and
abdominal pain periodically occur. Very often there are cough, fever, shortness of breath
and small bubbling moist rales. What diagnosis is suspected?
B.
*Cystic adenomatous malformation
C.
Sequestration of the lung
D.
Aplasia of lung
E.
Lung atelectasis
F.
Idiopathic fibroalveolitis
Child is 6 years old. He has frequent respiratory diseases. There is a poor tolerance to physical
activity, development of shortness of breath, sometimes accompanied by attacks of
breathlessness. Syncope often appears at an exercise, heart failure signs are present. Put the most
probable diagnosis.
A.
*Idiopathic pulmonary hypertension
B.
Idiopathic hemosiderosis
C.
Idiopathic fibroalveolitis
D.
Congenital carditis
E.
Cardiomyopathy
At 3 months child three times bronchoobstructive syndrome occurred without previous catarrhal
phenomena. The cough is unproductive. Stool has unpleasant smell from the first days of life.
Diagnosis of cystic fibrosis, mixed form was suggested. What research can confirm the diagnosis?
A.
Radiography of the chest
B.
X-ray of lungs
C.
Coprogram
D.
*Determination of sweat chlorides
E.
Determination of blood lipids
The child is 4 years old. During the first year of life an acute pneumonia occured, and then a
chronic bronchopulmonary process was formed eventually. Objectively chest is looking like
hump.The cough is resistant with shortness of breath. At percussion of the lungs there is bandbox
sound, at auscultation– dry and moist rales of various sizes. Phalanges and nails become
"drumsticks", "hour-glass", a violation of external respiration is present. Radiological findings in
C.
D.
E.
81.
82.
83.
84.
85.
86.
87.
88.
89.
90.
91.
92.
the lungs: increased pulmonary pattern, the phenomenon of emphysema. At bronchography there
are determined generalize bronchiectasis with balloon expansion during inspiration and collapse.
Put diagnosis.
A.
*Williams– Campbell syndrome
B.
Kartagener syndrome
C.
Idiopathic fibroalveolitis
D.
Mounier -Kuhn syndrome
E.
Cystic fibrosis
A patient with nosocomial pneumonia has signs of collapse. Which of the following pneumonia
complication is the most likely to be accompanied with collapse?
A.
*Septic shock
B.
Toxic hepatitis
C.
Bronchial obstruction
D.
Emphysema
E.
Exudative pleurisy
A 1-year-old child with fibroelastosis fell ill with acute respiratory viral infection. Suddenly he
develops anxiety, acrocyanosis, Ps- 132 per min, BR - 50/min, small bubbling rales in lower
lungs, pO2 60 mmHg, pCO2 55mm Hg. On X-ray: cardiomegaly, amplification of lung pattern,
radix pulmonis resembles butterfly wings. What is the most likely reason of child condition
worsening?
A.
Pulmonary abscess
B.
Angioneurotic (Quincke's) edema
C.
Bronchiolitis
D.
Double-sided pneumonia
E.
*Pulmonary edema
A 6-year-old boy has suffered from tonsillitis. In 2 weeks he started complaining of migratory
joint pain, edema of joints, restriction of movements, fever. On examination: an acute rheumatic
heart disease, activity of the III-rd degree, primary rheumocarditis, polyarthritis; acute course of
disease, cardiovascular failure II A. What medication should be prescribed?
A.
Delagil
B.
*Prednisone
C.
Diprazinum
D.
Erythromycin
E.
Cefazolin
The boy of 3 months has poor increase in mass at satisfactory appetite, periodic cyanosis of the
child during feeding, the changes on the part of heart are auscultated from birth, deficit of weight
15 %, paleness and xeroderma; rough systolic murmur in all points, is maximum in ІІІ left
intercostal area. What diagnosis is possible to suspect?
A.
Atrial septal defect
B.
*Fallout illness
C.
Ventricular septal defect
D.
Stenosis of pulmonary artery
E.
Coarctation of aorta
The neonatal boy was born with weight 3,100 from І normal pregnancy, which one past with
toxicosis during the first trimester, has cried at once; rough systolic murmur in ІІ intercostal to the
left of a breast bone, skin pink, clean. What diagnosis is possible to suspect?
A.
Patent ductus arterioses
B.
Ventricular septum defect
C.
*Atrial septal defect
D.
Coarctation of aorta
E.
Stenosis of pulmonary artery
Child 2 month was born premature. Clinically: mild cardiomegaly, proof arrhythmias from birth,
which are interrupted by medicines. EchoCG: moderate dilatation of the left ventricle,
93.
94.
95.
96.
97.
98.
hypokinesia of its walls, without the morphological changes. Late congenital carditis was
diagnosed. What can be the reason of late congenital carditis?
A.
Hereditary predilection
B.
Anemia of pregnant women
C.
*Acute respiratory infection in the last trimester of pregnancy
D.
Prenatal malnutrition
E.
Birth trauma
A 1.5 years girl with problematic obstetrics anamnesis, decrease of physical development,
deficiency of mass 24%. During objective examination: paleness of skin and mucus, quantity of
breathing-52 per minute with participation of additional muscles, expressed cardiomegalia, liver
+4sm, and quantity of heart beating-145, edema. What disease can be in this case?
A.
Rheumatic myocarditis
B.
Acute no rheumatic carditis
C.
Exudative perycarditis
D.
Hereditary nonrheumatic carditis
E.
*Fibroelastosis
The 10-year-old girl marks a frequent headache, dizziness, noise in ears; such complaints are
present during 6 months, with the tendency to increase; physical development normal, a
hypersthenic constitution; cardiomegalia, systolic murmur on apex and between scapulae, a
tachycardia; arterial pressure on hands-180/100. What diagnosis the most probable in this case?
A.
Essentsial hypertension
B.
Renal hypertension
C.
Stenosis of aorta
D.
*Coartation of aorta
E.
Pheochromocytoma
Parents of the 7-year-old boy come to the neurologist with complaints of decrease in his
movement activity, disturbance of walking. These complaints developed gradually, without any
reason. At examination: irregularity of development of the upper and lower parts of body, a
hypotonia of muscles of the feet, an absent pulsation on the femoral arteries, systolic murmur in
intrascapular region. What pathology can be suspected at the patient?
A.
*Coartation of aorta
B.
Kawasaki illness
C.
Takajasu Illness
D.
Aneurysm of aorta
E.
Endartereitis of femoral arteries
The girl of 6 months is ill during 10 days. The disease began acutely with high temperature and
catarrhal syndrome. During objective examination: paleness of skin and mucus, dyspnea,
acrocyanosis, cardiomegalia. During nonrheumatic carditis is surprised more often:
A.
All covers of heart
B.
*Myocardium
C.
Endocardium
D.
Pericardium
E.
Myocardium and pericardium
Child is 2 month old. Clinically: cardiomegaly at birth, its rapid progress, formation of cardiac
hump, progressive left-heart cardiac insufficiency, refraction to the therapy. Early hereditary
carditis belongs to:
A.
Acute myocarditis
B.
Chronic myocarditis
C.
*Fibroelastosis
D.
Cardiac sclerosis
E.
Myocardiodistrophy
Child 2 month was born premature. Clinically: mild cardiomegaly, proof arrhythmias from birth,
which are interrupted by medicines. EchoCG: moderate dilatation of the left ventricle,
99.
100.
101.
102.
103.
104.
hypokinesia of its walls, without the morphological changes. Late congenital carditis was
diagnosed. Late hereditary carditis is formed in terms of gestation:
A.
1 – 3 months
B.
4 – 6 months
C.
*7 – 9 months
D.
During a birth
E.
1-6 months
Child is 2 month old. Clinically: cardiomegaly at birth, its rapid progress, formation of cardiac
hump, progressive left-heart cardiac insufficiency, refraction to the therapy. Fibroelastosis was
diagnosed. It is possible to suspect fibroelastosis when:
A.
*The refraction to therapy tachycardia
B.
Rough systolic murmur on apex
C.
Bradiarythmia
D.
Diastolic murmur on apex
E.
Diastolic murmur on aorta
Child is 2 month old. Clinically: cardiomegaly at birth, its rapid progress, formation of cardiac
hump, progressive left-heart cardiac insufficiency, refraction to the therapy. Fibroelastosis was
diagnosed. For changes during fibroelastos it is not characteristic:
A.
Cardiac hump
B.
Decrease of physical development
C.
Hepatomegalia
D.
*Leucocytosi
E.
Cardiac noise
Child 5 yrs old was entered to the hospital with complaints of weakness, decline of appetite,
shortness of breath. Clinically it was revealed cardiomegaly, weakness of heart tones,
arrhythmias, soft systolic murmur on the apex. Acute nonrheumatic carditis was diagnosed. It is
caused by:
A.
Viruses
B.
Bacteria
C.
Toxins
D.
Allergic conditions
E.
*All transferred
Child 5 yrs old was entered to the hospital with complaints of weakness, decline of appetite,
shortness of breath. Clinically it was revealed cardiomegaly, weakness of heart tones,
arrhythmias, soft systolic murmur on the apex. Acute nonrheumatic carditis was diagnosed. For
acute nonrheumatic carditis is not characteristic:
A.
Tachycardia
B.
Cardiomegalia
C.
Dullness of heart tones
D.
*Pain in joints
E.
Bradycardia
Child 8 yrs old was entered to the hospital with complaints of weakness, decline of appetite,
shortness of breath. Clinically it was revealed cardiomegaly, weakness of heart tones,
arrhythmias, soft systolic murmur on the apex. Acute nonrheumatic carditis was diagnosed. The
forecast during acute nonrheumatic carditis
A.
*Recovering
B.
Death till 6 years
C.
Death till 3 years
D.
Death till 1 year
E.
The illness during all life
Child 7 yrs old had acute nonrheumatic carditis 2 year ago. 1 year ago it was relapse of carditis.
Mother interrupted therapy after 1 month of treatment. Clinically it is revealed physical
retardation, cardiac hump and signs of cardiac failure.
Chronic nonrheumatic carditis is diagnosed. The forecast is:
*Recovering
Cardiac insufficiency
Death till 3 years
Death till 1 year
Child is 3 month old. Clinically: cardiomegaly at birth, its rapid progress, formation of cardiac
hump, progressive left-heart cardiac insufficiency, refraction to the therapy. Fibroelastosis was
diagnosed. Cardinal in treatment of fibroelastosis is:
A.
*Heart transplantation
B.
Surgical correction of infringements of hemodynamics
C.
Catheterisation of heart cavities
D.
Antibiotic therapy
E.
Hormones therapy
Child 7 yrs old was entered to the hospital with complaints of weakness, decline of appetite,
shortness of breath. Clinically it was revealed cardiomegaly, weakness of heart tones,
arrhythmias, soft systolic murmur on the apex. Acute nonrheumatic carditis was diagnosed.
Preparation of choise during acute nonrheumatic carditis is:
A.
*Aspirin
B.
Planquenil
C.
Digoxin
D.
Delagil
E.
Lasix
Child 7 yrs old had acute nonrheumatic carditis 1 year ago. Mother interrupted therapy after 1
month of treatmen Clinically it is observed periodic cardialgias, weak heart tones,
tachyarrhythmia, functional systolic murmur. Subacute nonrheumatic carditis is diagnosed.
Preparation of choise is:
A.
Aspirin
B.
Prednisolone
C.
Digoxin
D.
*Delagil
E.
Indometacin
Child 9 yrs old was entered to the hospital with complaints of weakness, decline of appetite,
shortness of breath. Clinically it was revealed cardiomegaly, weakness of heart tones,
arrhythmias, soft systolic murmur on the apex. Acute nonrheumatic carditis was diagnosed. The
daily dose of prednisolon during acute nonrheumatic carditis is:
A.
*0,5 – 1,5 mg/kg
B.
1,5 – 2,5 mg/kg
C.
2,5 – 3,5 mg/kg
D.
3,5 – 4,5 mg/kg
E.
5 mg/kg
Child 10 yrs old had acute nonrheumatic carditis 2 year ago. 1 year ago it was relapse of carditis.
Mother interrupted therapy after 1 month of treatment. Clinically it is revealed physical
retardation, cardiac hump and signs of cardiac failure. Chronic nonrheumatic carditis is
diagnosed. Drug which does not improve function of myocardium is:
A.
Riboxin
B.
Mildrona
C.
Fosphaden
D.
Cardonat
E.
*Metiluracil
Child was born in term. From 2 weeks sudden episodes of bluish skin from crying or feeding was
observed. Clinical examination permits to suspect congenital heart disease. What are the blood
compensatory mechanisms in cyanotic defects?
A.
*Polycythemia, hyperhemoglobinemia, high blood viscosity
A.
B.
C.
D.
E.
105.
106.
107.
108.
109.
110.
Leucocytosis with left shift, elevation of ESR
Hypohemoglobinemia, low blood viscosity, erythrocytopenia
Thrombocytosis, high blood viscosity
Leucocytopenia, Hypohemoglobinemia
Clinical examination of child has revealed tachycardia, cardiomegaly, dyspnea at physical
activity. Instrumental observations were prescribed. What heart defect is characterized by round,
apple-shaped heart during X-ray examination?
A.
Fallout tetralogy
B.
Pulmonary stenosis
C.
Atrial septal defect
D.
Aortic stenosis
E.
*Tricuspid atresia
Child 1 month was born in term. Clinically it is observed tachycardia, arrhythmia, respiratory
problems, shortness of breath, continuous machine-like murmur. Patent ductus arteriosus is
diagnosed clinically. How can you characterize the patent ductus arteriosus?
A.
Cyanotic heart defect with right-to-left shunt
B.
Acquired heart disease
C.
*Acyanotic heart defect with left-to-right shunt
D.
Complication of the congenital heart disease
E.
Acyanotic heart defect without shunt
A patient, 14 yrs old, suffering from heart failure, undergoes inpatient treatment. On ECG:
changes in the form of a trough-shaped displacement of ST segment below isoline and frequent
ventricular extrasystoles. What is the most probable cause of these changes?
A.
Carditis
B.
Potassium overdose
C.
Myocardiodystrophy
D.
*Cardiac glycosides overdose
E.
Myocardiosclerosis
A 5-year-old child had an attack of palpitation with nausea, dizziness, generalized fatigue. On
ECG: tachycardia with heartbeat rate of 220/min, ventricle complexes are deformed and widened,
P wave is absent. What medication is to be prescribed to provide first aid?
A.
Seduxen
B.
Isoptin
C.
*Lidocain
D.
Novocainamides
E.
Strophantin
During examination of the 4 months old boy were revealed: cardiomegaly, steadfast
tachyarrythmia, stagnant wheezes in lungs, dyspnea, increasing liver to 3cm. Early inborn carditis
was diagnosed. What degree of the cardiac insufficiency has this child?
A.
1st
B.
2A
C.
*2-B
D.
3rd
E.
4th
During examination of 1 year child next findings were observed: mild peryoral cyanosis,
respiratory rate is 47 per min., pulse rate is 144 beats/min., auscultation: normal lung sound,
diminished heart sounds and rough systolic murmur on the apex and Erb’s point; hepatomegaly
+2 cm, moderate edema on legs. Such clinical findings are character to:
A.
The I degree of heart failure
B.
*The II A degree of heart failure
C.
The II B degree of heart failure
D.
The III degree of heart failure
E.
The 0 degree of heart failure
B.
C.
D.
E.
111.
112.
113.
114.
115.
116.
117.
118.
119.
120.
121.
122.
Girl 7 years in the hospital with congestive heart failure is receiving digoxin. On the fifth day of
treatment there were vomiting, nausea, anorexia, headache, disturbance of color vision, liquid
emptying. What is the most likely cause of this complication?
A.
Acute renal failure
B.
Exacerbation of underlying disease
C.
*Dygitalis intoxication
D.
Acute meningoencephalitis
E.
Botulism
A 16-year old girl with mitral stenosis after exercise there was a mixed attack of breathlessness,
cough with frothy sputum release. AP is 140/95mm Hg. What did cause the deterioration of the
patient?
A.
Left auricular acute failure
B.
Bronchoobstructive syndrom
C.
Acute right ventricular failure
D.
Increase in total peripheral resistance
E.
*Acute left ventricular failure
In children 1 year with fibroelastosis on the background of ARI suddenly appeared anxious,
acrocyanosis, pulse 132 per minute, BR 50 per min, fine moist rales in the lower areas of lungs,
pO2 60mm Hg, pCO2 55mm Hg. On X-ray: - cardiomegaly, increased pulmonary pattern, roots
are as butterfly wings. Exacerbation is the result of:
A.
Bronchiolitis
B.
Angioneurotic edem
C.
Lung abscess
D.
Both sides pneumonia
E.
*Pulmonary edema
A child 12 years old suffers from rheumatic mitral heart defect. After exercise there was shortness
of breath, paroxysmal cough, unproductive cough, bubbling breath. On auscultation on the
background of hard breathing there are different-sized moist rales. HR - 120 per 1 minute, AP 110/60mm Hg. What emergency state has developed in a child?
A.
Acute heart failure is a total type
B.
Acute heart failure, right ventricular type
C.
*Acute heart failure, left ventricular type
D.
Acute vascular insufficiency
E.
Acute respiratory failure
A child is 13 years old. He has combined rheumatic mitral valve defects with predominance of
failure. On the background of acute respiratory viral infections increased shortness of breath,
general weakness, there was a feeling of tightness in the chest, a dry cough. The position is semisitting. There are air of long suffering on his face and cyanosis of the lips. Pulse on peripheral
vascular is weak filling. Heart rate is 150 per 1 min. In the lungs on the background of hard
breathing in low back areas variegated moist rales are listened. Liver is on the costal arch. What
emergency state has developed in a child?
A.
*Acute left ventricular heart failure
B.
Acute right ventricular heart failure
C.
Total acute heart failur
D.
Chronic left ventricular failure
E.
Acute vascular insufficiency
The boy 12 years, suffering from mitral stenosis, after playing basketball has increasing
breathing, feels a lack of air, attack and dyspnea, bubbling secreations on the lips. In the lungs
(back basal areas) there are fine moist rales. The most likely cause of worsening of the child
condition is associated with:
A.
Acute vascular insufficiency
B.
Cardiac total insufficiency
C.
*Cardiac left-type insufficiency
Acute respiratory failure
Acute heart right-type insufficiency
Patient 15 years with mitral heart defect is treated by digoxin (0.00025g twice daily) and
furosemid (0,04g twice a week). At 10 day of treatment appeared acute heartbeat, frequent
ventricular extrasystoles, nausea, vomiting. Your tactics is:
A.
*Cancel digoxin, prescribe potassium preparations, unitiol i/m
B.
Add to digoxin indomethacin
C.
Reduce digoxin dose in 2 times
D.
Cancel digoxin, prescribe atropine subcutaneously
E.
Replace digoxin on strophantin i/v
Child 4yrs old complains of unpleasant feeling in heart, pain in abdomen. The boy in the
maternity hospital was diagnosed congenital heart defects (ventricular septum defect. Suddenly
quickening of the heartbeat at rest to 150-200 beats per minute was observed. What must parents
do?
A.
Call ambulance cardiologic help
B.
Give Phenobarbital
C.
Put child in a horizontal position
D.
*Put child in a horizontal position and call ambulance cardiologic help
E.
Press on carotid sinus
Child 10yrs old with acute carditis complains of discomfort in the heart, constricting pain in the
chest, pain in the epigastric region, dizziness, vomiting. Child feels fear. Skin is pale, there are
acrocyanosis, swelling of neck veins. Pulse is weak, heart rate can not be counting. On ECG
pulse is 260 per 1 minute. What complication did occur?
A.
Acute left heart failure with sinus tachycardia
B.
Acute right heart failure with sinus tachycardia
C.
Total heart failure with sinus tachycardia
D.
Ventricular paroxysmal tachycardia
E.
*Supraventricular paroxysmal tachycardia
Child 10yrs old with acute carditis complains of discomfort in the heart, constricting pain in the
chest, pain in the epigastric region, dizziness, vomiting. ECG pulse is 240 per 1 minute,
complexes QRS are not changed, wave P merges with T. Put the diagnosis.
A.
Acute left heart failure with sinus tachycardia
B.
Acute right heart failure with sinus tachycardia
C.
Total heart failure with sinus tachycardia
D.
Ventricular paroxysmal tachycardia
E.
*Supraventricular paroxysmal tachycardia
Child 10yrs old with acute carditis complains of discomfort in the heart, constricting pain in the
chest, pain in the epigastric region, dizziness, vmiting. ECG pulse is 180 per 1 minute, complexes
QRS are changed (ventricular extrasystoles), wave P is absent. Put the diagnosis.
A.
Acute left heart failure with sinus tachycardia
B.
Acute right heart failure with sinus tachycardia
C.
Total heart failure with sinus tachycardia
D.
*Ventricular paroxysmal tachycardia
E.
Supraventricular paroxysmal tachycardia
The 12-year-old boy had a first episode of syncope in 10 years. He was treated for "family
convulsant syndrome". He has a history of ventricular tachycardia and ventricular fibrillation
from 4 days of age. On ECG all T-wave are abnormal; T wave in V-4 lead is particularly
changed, the final part of the T wave in V-4 lead is greater in amplitude than the initial part. Put
the diagnosis.
A.
*Congenital elongation of QT interval
B.
Ventricular paroxysmal tachycardia
C.
Supraventricular paroxysmal tachycardia
D.
Congenital sinus tachycardia
D.
E.
123.
127.
128.
129.
130.
131.
Congenital carditis
Child 10yrs old with acute carditis complains of discomfort in the heart, constricting pain in the
chest, pain in the epigastric region, dizziness, vomiting. ECG pulse is 180 per 1 minute,
complexes QRS are changed (ventricular extrasystoles), wave P is absent. What medicines must
be introduced intravenously first of all?
A.
Novocainamid
B.
Isoptin
C.
Corglucon
D.
*Lidocain
E.
Potassium orotatis
Child 10yrs old with acute carditis complains of discomfort in the heart, constricting pain in the
chest, pain in the epigastric region, dizziness, vomiting. ECG pulse is 240 per 1 minute,
complexes QRS are not changed, wave P merges with T. Syndrome of premature ventricular
excitation was diagnosed. What medicines must be introduced intravenously first of all
A.
Novocainamid
B.
Isoptin
C.
Corglucon
D.
Lidocain
E.
*Cordaron
Child 10 yrs old with acute carditis complains of heart beating, constricting pain in the chest, fear,
lack of air. ECG: early ventricular extrasystoles, superimposed on T waves preceding cardiac
cycle, frequent isolated ectopic extrasystoles (more than 5 per min), and group polytopic
extrasystoles. What treatment must be prescribed?
A.
*Amiodaron
B.
Isoptin
C.
Lidocain
D.
Phenobarbital
E.
Electric defibrillation
Child is 1yr old. Mother complaints of marked anxiety, refusal to eat, pale skin, tachypnea,
excessive sweating, cyanosis of nasolabial triangle and vomiting. n the ECG there is the
replacement of normal P wave rapid oscillations, tachycardia 160 per min. Put diagnose.
A.
*Atrial fibrillation
B.
Ventricular fibrillations
C.
Ventricular paroxysmal tachycardia
D.
Supraventricular paroxysmal tachycardia
E.
Sinus tachycardia
Child 10 yrs old with acute carditis complains of discomfort in the heart, constricting pain in the
chest, pain in the epigastric region, dizziness, vomiting. ECG pulse is 240 per 1 minute,
complexes QRS are not changed, wave P merges with T. Put the diagnosis. Suddenly loss of
consciousness, pallor cyanosis, tonic seizures occur, stop respiratory rhythm, blood pressure is not
determined. What complication did occur?
A.
Atrial fibrillations
B.
*Morgagni-Adams-Stokes syndrome
C.
Left heart failure
D.
Right heart failur
E.
Total heart failure
During procedure of taking blood in boy for general blood analysis weakness, dizziness, nausea,
vomiting appear. This is accompanied by a darkening of the eyes, tinnitus with the following brief
loss of consciousness. The patient falls to the floor. Skin is pale, his pupils are dilated, react to
light. Extremities are cold. Breathing is shallow, bradypnea, bradycardia, weak pulse. Heart
sounds are muffled. Blood pressure is lowered. Put the diagnosis.
A.
*Syncope
B.
Paralytic collapse
E.
132.
133.
134.
135.
136.
137.
Vagotonic collapse
Sympatotonic collapse
Post hemorrhagic collapse
Child is 6yrs old. On background of severe pneumonia there is marked pallor, cool extremities,
rising of systolic blood pressure. Heart sounds are loud, tense, urine output is decreased. Patient is
exiting, reflexes are increased, convulsions. Put the diagnosis.
A.
Acute renal failure
B.
Acute heart failure
C.
Vagotonic collapse
D.
*Sympatotonic collapse
E.
Neurotoxicosis
Child is 6 yrs old. On background of severe pneumonia child became adinamic, consciousness is
darkened, facial features are sharp. Marbling of the skin, cold, clammy sweat, the empty veins are
observed . The first heart tone is flapping, pulse is thready, blood pressure is decreased, urine
output is significantly reduced. To restore vascular tone it is necessary to enter:
A.
Prednisolon
B.
*Mezaton or adrenalin
C.
Reopolyglucin
D.
Sodium ascorbinati
E.
All that is mentioned
Child 11 yrs old was entered to the hospital with abdominal trauma. Doctor notes in patient
hiccups, vomiting, persistent red dermographism, salivation, bradycardia, increased the difference
between maximum and minimum blood pressure. What complication of trauma does occur?
A.
Paralytic collapse
B.
Sympatotonic collapse
C.
*Vagotonic collapse
D.
Post hemorrhagic collapse
E.
Toxic collaps
A 5-year-old patient complains of bloating and rumbling in the abdomen, increased outgoing of
gases foamy liquid stool of acid odor. Symptoms appear after eating of milk products. What is the
name of such symptom complex?
A.
*Acid dyspepsia syndrome
B.
Adipose dyspepsia syndrome
C.
Dyskinesia syndrome
D.
Decaying dyspepsia syndrome
E.
Malabsorbtion syndrome
A 10 year old girl complains about abdominal pain that is arising and getting worse after eating
rough or spicy food. She complains also about sour eructation, heartburn, frequent constipations,
headache, irritability. She has been suffering from this for 12 months. Objectively: the girl's diet
is adequate. Tongue is moist with white deposit at the root. Abdomen is soft, painful in its
epigastric part. What study method will help to make a diagnosis?
A.
Fractional examination of gastric juice
B.
*Esophagogastroduodenoscopy
C.
Intragastral pH-metry
D.
Biochemical blood analysis
E.
Contrast roentgenoscopy
A 12 year old patient complains about heartburn and dull pain in the epigastrium that appear 2-3
hours after meal. Exacerbations happen in spring and in autumn. The patient has food intolerance
of eggs and fish. Objectively: stomach palpation reveals painfulness in the gastroduodenal area.
Esophagogastroduodenoscopy revealed a 5 mm ulcer on the anterior wall of duodenum. Urease
test is positive. What is the most probable leading mechanism of disease development?
A.
Dietary allergy
B.
Reduced prostaglandin synthesis
C.
D.
E.
138.
139.
140.
141.
142.
143.
Disorder of gastric motor activity
Autoantibody production
*Chelicobacterial infection
A 15-year-old patient with “fast food” abnormal diet complains of pain in epigastrium that occurs
in 1-1,5 hours after having meal. Fibrogastroduodenoscopy: marked hyperemia, small defects,
and easy appearance of sores on the mucous membrane in the antral section of the stomach. What
is the most probable reason for this pathology
A.
*Helicobacter pylori infection
B.
Presence of antibodies to parietal cells
C.
Nervous overstrain
D.
Alimentary factor
E.
Toxic action of alcohol
A 14-year-old boy periodically complains of pain in the epigastrium on an empty stomach, nausea
and heartburn during 3 years. Gastroduodenoscopy: signs of gastroduodenitis and ulcer defect of
the mucous membrane of the duodenum. What is the most effective medication to treat this child?
A.
*De-nol
B.
Almagel
C.
Papaveri
D.
No-spa
E.
Atropin
A 16-year-old female complains of heartburn and squeezing epigastric pain 1 hour after meal. She
has been ill for 2 years. On palpation, there is moderate tenderness in pyloroduodenal area.
Gastroscopy: antral gastritis. What study can prove the etiology of the disease?
A.
Detection of autoantibodies in the serum
B.
Gastrin level in blood
C.
Examination of stomach motor function
D.
Examination of stomach secretion
E.
*Revealing of Helicobacter infection in gastric mucosa
A 1-year-old child suffers of attack-like cough. The child presents with the history of dyspepsia
since birth. On physical examination there are signs of delay in physical development, bronchial
obstruction, respiratory insufficiency, 1 grade. Blood count: signs of inflammatory process. Sweat
chlorides 120 mEq/L. What is the most likely diagnosis?
A.
*Cystic fibrosis
B.
Bronchopulmonary dysplasia
C.
Kartagener's syndrome
D.
Acute respiratory infection, bronchitis
E.
Severe bronchial asthma
A 4-year-old child attends the kindergarten. Complaints of the bad appetite, fatigue. Objective
examination: skin and mucous membrane are pale, child is asthenic. In the hemogram:
hypochromic anemia 1st, eosinofilia. What is the most likely diagnosis?
A.
*Worm invasion
B.
Lymphoprolipherative process
C.
Duodenal ulcer
D.
Hypoplastic anemia
E.
Atrophic gastritis
A patient, aged 15, complains of frequent heart-burns, air and acid eructation, burning,
constringent pains behind the breast-bone, along esophagus, that appear after meals, during
forward inclination of body. The patient was not examined, takes Almagel by self-medication,
after the intake of which feels better. What is the most probable diagnosis?
A.
Cardiospasm
B.
Duodenal ulcer
C.
Functional dyspepsia
D.
Stomach ulcer
C.
D.
E.
144.
145.
146.
147.
148.
149.
E.
150.
151.
152.
153.
154.
155.
* Gastroesophageal reflux
A male patient complains of heartburn wich gets stronger while bending the body, substernal pain
during swallowing. There is a hiatus hernia on X-ray. What disoder should be expected at
gastroscopy?
A.
Chronic gastritis
B.
Gastric peptic ulcer
C.
*Gastroesophageal reflux
D.
Acute erosive gastritis
E.
Duodenal peptic ulcer
A 17 years female complains of dull pain in the right subcostal area and epigastric area, nausea,
appetite decline during 6 months. There is a history of gastric peptic ulcer. On examination:
weight loss, pulse is 70 per min, AP is 120/70 mm Hg. Diffuse tenderness and resistance of
muscles on palpation. There is a hard lymphatic node l x l cm in size over the left clavicle. What
method of investigation will be the most useful?
A.
*Esophagogastroduodenoscopy with biopsy
B.
Ultrasound examination of abdomen
C.
pH-metry
D.
Ureatic test
E.
Stomach X-ray
4-year-old child attends kindergarten. Complaints about poor appetite, fatigue. Results: skin and
mucous membranes are pale, child is malnoirished. In hemogram: hypochromic anemia 1st
degree, eosinophilia. What pathology should be excluded in the first place?
A.
Lymphoproliferative process
B.
Duodenal ulcer
C.
Hypoplastic anemia
D.
Atrophic gastritis
E.
*Parasitic invasion
The patient of 15 years complains of frequent heartburn, air and sour burping, burning,
constricting pain behind the sternum along the esophagus that occur after eating, while tilting the
body forward. The patient was not examined, takes almagel and then feels better. What is the
most likely diagnosis?
A.
*Gastroesophageal reflux disease
B.
Kardiospazm
C.
Duodenal Ulcer
D.
Functional dyspepsia
E.
Gastric ulcer
17 year old girl complains of dull pain in right hypochondrium and epigastrium region, nausea,
loss of appetite for 6 months. She has the history of stomach ulcer. In inspection: weight loss,
heart rate 70 beats / min, BP 120/70 mm Hg. Diffuse pain and resistance of abdominal muscles
during palpation. Compacted lymph nodes are palpated 1 x 1cm above the left clavicle. Which
research method would be most helpful?
A.
*EGDS with biopsy
B.
Ultrasound
C.
pH-metry
D.
Urease test
E.
Radiograph of the stomach
12-year-old boy for 2 years complains of abdominal pain, which occur at any time of the day,
often at night, sometimes is accompanied by vomiting. Occult blood test is positive. The father of
a boy also has frequent abdominal pain. What is the probable diagnosis?
A.
*Peptic ulcer disease
B.
Meckel diverticulum
C.
Ileus
D.
Parasitic infestation
Appendicitis
13-year-old boy during a month is complaining of pain in the upper abdomen. They appears at
any time of the day: morning on an empty stomach, at night, after 1-1.5 hours after eating.
Gregersen test is positive. He is emotionally labile. Temperature is normal. There is a tendency to
constipation. The father of a boy also has frequent abdominal pain. What is the probable
diagnosis?
A.
Meckel diverticulum
B.
Biliary dyskinesia
C.
*Peptic ulcer
D.
Ulcerative colitis
E.
Appendicitis
16-year-old boy is suffering from duodenal ulcer with increased secretion: free HCl in the fasting
gastric juice is 28 title units, the basal production is 44 units, stimulate submaximal production is
68 title units. Choose the best option of treatment tactics in this case.
A.
*H2-histamine blockers + De-nol + solcoseril
B.
H2-histamine blockers + clarythromycin
C.
H2-histamine blockers + antispasmodic + antacid
D.
H2-histamine blockers + metronidazole
E.
H2-histamine blockers + antacid
17 years old patient turned to a local doctor complaining heaviness in the epigastric area
immediately after a meal, regurgitation, a tendency to diarrhea. She is sick for 3 years.
Preliminary diagnosis: chronic atrophic gastritis with secretory insufficiency. What the X-ray data
confirm the diagnosis of chronic atrophic gastritis in this patient?
A.
*The presence of gross rigid folds
B.
The presence of filling defect
C.
The presence of pyloric stenosis
D.
The local absence of contractility
E.
Rapid evacuation of barium
Patient A. 14 yrs old is sick for about 2 years. Concerned about hunger pains in pyloroduodenal
area, heartburn, sour belching. EGDS found a defect in the duodenal front wall 0.5 x0.5 cm,
covered with fibrin. Antibodies to Helicobacter pylori in the blood are found. Which drug for Hp
eradication should be used?
A.
Gastrocepin
B.
Famotidin
C.
Ranitidine
D.
*Amoxicillin
E.
Almagel
Female 12 years old within two years has chronic gastritis. Last 6 months pain in the abdomen at
night appears. What is useful to examine the patient?
A.
Occult blood fecal test
B.
*EGDS
C.
Gastric juice pH-metry
D.
Ultrasonography of the abdomen
E.
Fractional study of gastric juice
A child of 10 years old complains of appetite loss, heartburn, pain around the navel, which is dull
and occurs more often within 2-3 hours after meal in the morning - on an empty stomach. The
pain decreases after meal. She is sick for three years. OBJECTIVE: Skin is pale. Abdomen is soft,
painful during deep palpation in the epigastric and pyloroduodenal area. Mendel’s symptom is
positive. What is the most likely diagnosis?
A.
Chronic cholecystitis
B.
Crohn's disease
C.
*Chronic gastroduodenitis
D.
Peptic ulcer of the stomach
E.
156.
157.
158.
159.
160.
161.
Mesadenitis
A child of 11 years is hospitalized for exacerbation of chronic gastroduodenitis. EGDS diagnosed
duodenogastric reflux 2nd degree. Assign a treatment for motility correction.
A.
*Motilium
B.
Imodium
C.
Gastrocepin
D.
Almagel
E.
De-nol
Female 10 years old has admitted to the hospital with complaints of aching night pain in the
epigastrium. Palpation of the abdomen reveals pain in the epigastric and pyloroduodenal zone.
What examination should be held first of all?
A.
Ultrasound of the abdominal cavity
B.
Biochemical blood test: bilirubin, cholesterol, ALT, AST, amylase
C.
*Esophagogastroduodenoscopy
D.
Duodenal intubation
E.
Complete blood test
10 years old boy has admitted to the clinic with duodenal ulcer relapse, associated with
helicobacter pylori. Which drug is included into H. pylori eradication scheme?
A.
Ranitidine
B.
Maalox
C.
*Amoxicillin
D.
Famotidin
E.
Gastrocepin
A boy of 14 was delivered to the clinic with complaints of weakness, dizziness, nausea, "coffee
grounds" vomiting. What is the most reasonable examination?
A.
Abdominal X-ray
B.
Sigmoidoscopy
C.
*Esophagogastroduodenoscopy
D.
Colonoscop
E.
Ultrasonography of the abdomen
A 17 years old patient suffers from duodenal ulcer for three years. In the first day of the
exacerbation period intragastric pH-metry was done before treatment. Choose the most probable
results.
A.
*pH in the stomach body -1.5, pH in the antrum -1.5
B.
pH of the stomach body -2.5, pH in the antrum -5.0
C.
pH of the stomach body -7.5, pH in the antrum -7.5
D.
pH of the stomach body -5.0, pH in the antrum -2.5
E.
pH in the stomach body -5.5, pH in the antrum -7.5
17 year old patient complains of intensive skin itching, jaundice, bone pain. The skin is
hyperpigmentated. There are multiple xanthelasma palpebrae. The liver is +6 cm enlarged with
acute edge. The blood analysis revealed total bilirubin 160 mkmol/L, direct — 110 mkmol/L,
AST (asparate aminotransferase) — 2,1 mmol/L per hour, ALT-1,8 mmol/L, alkaline phosphotase
— 4,6 mmol/L per hour, cholesterol- 9,2 mmol/L, antimitochondrial antibodies M2 in a high titer.
What is the probable diagnosis?
A.
*Primary biliary liver cirrhosis
B.
Primary liver cancer
C.
Acute viral hepatitis В
D.
Chronic viral hepatitis В
E.
Alcoholic liver cirrhosis
A 10 year old girl complained of attacks of right subcostal pain after fatty meal she has been
suffering from for a year. Last week the attacks repeated every day and became more painful.
What diagnostic study would you recommend?
A.
X-ray examination of the gastrointestinal tract
E.
162.
163.
164.
165.
166.
167.
168.
Ultrasound study of the pancreas
*Ultrasound examination of the gallbladder
Liver function tests
Blood cell coun
A 10-year-old boy is ill with autoimmune hepatitis. Blood test: A/G ratio 0,8, bilirubin — 42
mkmol/L, transaminase: ALT — 2,3 mmol/L, AST — 1,8 mmol/L. What is the most effective
means in treatment?
A.
*Glucocorticoids, cytostatics
B.
Hepatoprotectors
C.
Antibacterial medication
D.
Hemosorbtion, vitamin therapy
E.
Antiviral medications
A 12-year-old girl complains of dull right subcostal pain, nausea, decreased appetite. History:
disease started with jaundice in 2 months after appendectomy. She was treated in an infectious
hospital. 1 year later present complaints have developed. Physical examination: subicteric sclerae,
enlarged firm liver. What is your preliminary diagnosis?
A.
*Chronic viral hepatitis
B.
Chronic cholangitis
C.
Acute viral hepatiti
D.
Calculous cholecystitis
E.
Gilbert's disease
A 14 year-old patient was admitted to the gasteroenterology with skin itching, jaundice,
discomfort in the right subcostal area, generalized weakness. On examination: skin is jaundice,
traces of scratches, liver is +5 cm, splin is 6x8cm. In blood: alkaline phosphatase — 2,0
mmol/hour/L, general bilirubin — 60 mkmol/L, cholesterol — 8,0 mmol/L. What is the leading
syndrome in the patient?
A.
Cytolytic
B.
Asthenic
C.
Mesenchymal inflammatory
D.
Liver-cells insufficiency
E.
*Cholestatic
A 15 year old patient has been suffering from chronic pancreatitis for 5 years. During the last 5
years he has been observing abatement of pain syndrome, abdominal swelling, frequent
defecations up to 3-4 times a day (feces are grey, glossy, with admixtures of undigested food),
progressing weight loss. Change of symptom set is caused by joining of:
A.
Syndrome of lactase deficiency
B.
Exocrine pancreatic insufficiency
C.
Chronic enterocolitis
D.
Endocrine pancreatic insufficiency
E.
*Irritable bowels syndrome
A 17-years old patient has sudden acute pain in the right epigastric area after having fatty food.
What method of investigation is to be used on the first stage of examining the patient?
A.
*Ultrasonic
B.
Radionuclide
C.
Magnetic-resonance
D.
Roentgenological
E.
Thermographic
7 years old child complains of an acute abdominal pain, which arises after mental loading, use of
cold drinks, ice-cream. The diagnosis: Dyskinesia of gallbladder, hypertonic type. What drugs
should be assigned first of all for treatment?
A.
Sedative and cholikinetics
B.
Choleretics and cholikinetics
C.
*Spasmolitics and choleretics
B.
C.
D.
E.
169.
170.
171.
172.
173.
174.
Antioxidants
Antibiotics
The boy of 12 years complains of a periodic short-lived cutting pain in the right subcostal area,
which occurs after the greasy food. For what type of dyskinesia these complaints are typical?
A.
*Hypertonic
B.
Hypotonic
C.
Dystonic
D.
Hepatalgic
E.
Asthenic
The child 12 years old complaints of the skin and mucous membranes jaundice, clay-colored
feces and dark color of the urine, weakness. He is ill for 2 weeks. Jaundice has appeared on the
10th day of the disease. Three months ago had hemotransfusion because of bleeding. The liver is
+3 cm, spleen +1cm. Hepatitis В is suspected. What examination will realistically confirm the
diagnosis?
A.
The biochemical blood test
B.
The urinalysis on bile pigments
C.
*Polymerase Chain Reaction
D.
Investigation of Anti-HAV Ig M
E.
Investigation of Anti-HAV Ig G
The child, 12 years old, was treated because of the chronic hepatitis. He discharges from the
hospital on the 24th day in satisfactory condition. What is the duration of dispensary observation?
A.
6 months
B.
9 months
C.
1 year
D.
3 years
E.
*5 years
To the child of 5 years, who has chronic cholecystocholangitis the biochemical blood analysis is
performed. Syndrome of cholestasis is detected. What parameters will be increased?
A.
Transaminase
B.
*Alkaline phosphatase
C.
Diastase
D.
Thrombinogen
E.
Thymol test
14-year-old patient has admitted to the intensive care unit with hemorrhagic shock due to gastric
bleeding. He has been ill hepatitis B for the last 5 years. The source of bleeding - veins of the
esophagus. What is the most effective method to control bleeding?
A.
*Introduction of the obturator through the nasogastric tube
B.
Intravenous pituitrin
C.
Fresh frozen plasma I/V
D.
Operation
E.
Hemostatic therapy
Patient complains of pain in the epigastric region, in the right hypochondrium radiating to the
right scapula. It was vomiting ithout relief. The body temperature is 37.6°C. The abdomen is
moderately distended, tense and painful in the epigastrium and right hypochondrium. A mild
muscle strain of the abdominal wall in the right hypochondrium is palpated. Ortner’s symptom is
positive. Put a preliminary diagnosis.
A.
Acute appendicitis
B.
Acute pancreatitis
C.
Stomach ulcer penetration
D.
*Acute cholecystitis
E.
Acute intestinal obstruction
7 years old girl is ill during 3 years. Hypotonic type of gallbladder dyskinesia was diagnosed.
Which of the following is inappropriate in the complex therapy?
D.
E.
175.
176.
177.
178.
179.
180.
181.
A.
B.
C.
D.
E.
182.
183.
184.
185.
186.
*Antispasmodic drugs
Physiotherapy of tonic type
Cholekinetics
Duodenal intubation
Mineral water of high salinity
A 15 years old girl has gallstone disease. She has chills, increase body temperature up to 38° C,
jaundice during three days. Symptoms of peritonitis are negative, the pain is not increased. Blood
bilirubin is 45 mmol / l, leucocytes -18 x 10 9/L. What kind of complications should be
considered?
A.
Perforation of the gallbladder
B.
*Choledocholithiasis
C.
Subhepatic abscess
D.
Acute cholangitis
E.
Hemolytic jaundice
Patient 14yrs old complained of recurrent pain in the right hypochondrium, which irradiates to the
right shoulder, periodic jaundice with fever, metallic taste in the mouth. These complaints appear
after overeating. OBJECTIVE: a patient is being overweight, sclera are yellowish, local
tenderness in the right hypochondrium, Ortner’s, Kera’s symptoms are positive. In the blood there
is the high level of direct bilirubin. What kind of diseases you can think about?
A.
Chronic pancreatitis
B.
Urolithiasis
C.
Gastric ulcer
D.
*Cholelithiasis
E.
Hemolytic jaundice
Patient 16yrs old is suffering from chronic calculous cholecystitis with periodic exacerbations, as
a short-term biliary colic. After colic sclera and palate icteric, darkening of urine color was
observed. After the next exacerbation and examination in the hospital a surgical method of
treatment was recommended. What of the following methods will be the most reliable way to
exclude choledocholithiasis in this case?
A.
Fibrogastroduodenoscopy
B.
Laparoscopy
C.
Ultrasound of the liver and biliary tract
D.
Duodenal intubation
E.
*Cholecystocholangiography
Patient 12yrs old is feeling heaviness in the right hypochondrium and sometimes nausea or
bitterness in his mouth, a tendency to constipation. An objective examination revealed no
abnormalities. At ultrasound: the liver and the pancreas are not changed; gall bladder is enlarged,
hypotonic, with parietal cholestasis. At duodenal intubation: fraction B - 90 ml, the time of its
excretion - 50 minutes with no changes in the bile microscopy. Which disease is possible?
A.
Chronic pancreatitis
B.
Giardiasis
C.
Chronic cholecystitis
D.
*Biliary dyskinesia
E.
Chronic hepatitis
Patient 17yrs old was hospitalized to the surgical department with complaints of nausea,
vomiting, pain in the right hypochondrium. She has been ill for the last 3 days, when there were
the same complaints. Prior to this, she ate greasy and fried dishes. Objectively: the patient's state
is moderate. Abdomen is soft at palpation, tender in the right hypochondrium. Grekov-Ortner’s,
Kera’s signs are positive. In the blood analysis: leukocytosis 14 x 109/l, with a shift to the left.
Put the correct diagnosis.
A.
Acute appendicitis
B.
Acute pancreatitis
C.
Duodenal ulcer
D.
E.
187.
188.
189.
190.
191.
192.
*Acute cholecystitis
Stomach ulcer
The patient 10 years old suddenly fell ill about 12 hours ago. There was a pain in the epigastric
region, nausea, single vomiting. A few hours later the pain was localized in the right iliac region,
where now the positive symptoms of peritoneum irritation are determined. In the blood analysis:
leukocytosis 12.2 x 109/l, with a shift to the left. What is the most likely diagnosis?
A.
Acute pancreatitis
B.
Acute cholecystitis
C.
Perforated ulcer
D.
Right-sided renal colic
E.
*Acute appendicitis
Patient 15 years old was brought by an ambulance to the pediatric department with acute pain in
the right hypochondrium and vomiting. The doctor on duty has diagnosed acute calculous
cholecystitis. Which of the invasive methods of radiology screening of the patient should do?
A.
Computed tomography
B.
Radionuclide diagnosis
C.
Thermography
D.
Magnetic resonance imaging
E.
*Ultrasound
The 10 years old boy has chronic viral hepatitis B with maximum activity. Which laboratory tests
accurately characterizes the degree of cytolysis in a patient?
A.
Prothrombin
B.
Veltman’s test
C.
Takata-Ara’s test
D.
*Transaminases
E.
Total protein
In patient 11yrsold, that for a long time has been suffering from the liver cirrhosis, has recently
appeared complaints of moderate pain in the epigastric region, constant flatulence, which
intensifies after meals. OBJECTIVE: Symptoms of free fluid in the abdomen, enlarged liver and
spleen. At ultrasonography: extended portal vein, enlarged liver and spleen. What kind of
cirrhosis complications has this patient?
A.
Bleeding from esophageal varices
B.
Intestinal dysbacteriosis
C.
Peritonitis
D.
Hepatocellular failure
E.
*Portal hypertension
In a patient with chronic hepatitis B jaundice was growing, increased weakness and fatigue, he
became drowsy during the day. The liver is uniformly decreased. Diuresis is normal. Name the
further tactics of the patient’s treatment.
A.
Appointment of choleretic and nonsteroidal anti-inflammatory drug
B.
Appointment of trental and heparin
C.
Laferon appointment
D.
*Appointment of prednisolone and increased detoxification
E.
Appointment of legalon and essentiale
Patient 17yrs old, student, came to the clinic of the University. The last 4 days has being
complained of general weakness, fatigue and impaired appetite. Skin and sclera are yellowish,
brick-colored urine. In the blood analysis: hyperbilirubinemia (35 mcmol/L) with the
predominance of direct bilirubin; ALT – 2.1; AST – 1.9. What is the reason of jaundice?
A.
Malaria, hemolytic anemia
B.
Cholelithiasis, obstructive jaundice
C.
Macronodular cirrhosis
D.
*Viral hepatitis
E.
Hemolytic anemia
193.
194.
195.
196.
197.
198.
A 8 years old boy was ill with hepatitis B a year ago. In the past two months, he is complaining
about fatigue, sleep disturbance, appetite loss, nausea, especially in the morning. Skin is without
jaundice, liver and spleen were palpable 1cm below the costal edge, not painful. ALT is 2,2
mmol/L. This situation can be regarded as:
A.
*Development of chronic hepatitis B
B.
Recurrence of hepatitis B
C.
Dyskinesia of bile ducts
D.
Residual phenomena of acute hepatitis
E.
The development of cirrhosis
Boy 12 years old was entered to the intensive care unit in extreme severe condition. At the
inspection: absent conscious, skin and sclera are yellow. Liver is enlarged, splenomegaly and
ascites. There are respiratory arrythmia, tachycardia, pulse 120 per min, AP 90/40 mm Hg,
hemorrhagic syndrome, erythema of palms. Laboratory results: metabolic acidosis, pH 4.2, AST
1.8 mmol/L, ALT 2.1 mmol/L, bilirubin 334.2 mcmol/L, blood serum sodium 90 mmol/L,
potassium blood serum 5.9 mmol/L. The worsening of condition is due to?
A.
CVF III st
B.
Violation of cerebral circulation
C.
Thyreotoxic crisis
D.
*Hepatic coma
E.
Acute renal failure
The child 7 months has unmotivated vomiting and fever, physical development retardation, severe
progressive rickets chans in the bones. The mother considers that the child is sick from the first
months of life. The examination revealed
A.
ercalciuria and hypokaliemia. What is the most likely diagnosis?
B.
Phosphate diabetes
C.
Disease de Toni-Debre-Fanconi
D.
*Renal tubular acidosis type
E.
Renal tubular acidosis type II
F.
Vitamin D-resistant rickets
In children 1.5 years there were found O-distortion legs, muscular hypotonia. There is physical
and mental retardation. Blood: hypophosphatemia, increasing the level of alkaline phosphatase. In
urine: hyperphosphaturia. What is the most probable disease?
A.
*Phosphate-diabetes
B.
Disease de Toni-Debre-Fanconi
C.
Hereditary nephritis
D.
Renal tubular acidosis type I
E.
Renal tubular acidosis type II
Child 1yr old has unmotivated fever, frequent vomiting, physical development retardation, rickets
changes of bones. In laboratory studies: alkaline reaction of urine, lack of alkalis in the blood.
What disease is most likely a child?
A.
Renal tubular acidosis I type
B.
*Renal tubular acidosis II type
C.
The hereditary nephritis
D.
Phosphate-diabetes
E.
Disease de Toni-Debre-Fanconi
15 years old patient was hospitalized with straining pain in the left hypochondrium, which
irradiates to the back. He notes nausea, decreased appetite, weight loss, vomiting without relief,
diarrhea. He has been ill for over 5 years. Exacerbation has developed because of errors in the
diet. OBJECTIVE: t ° = 37,0°C, pulse rate 94 per minute, BP 125/75 mm Hg. Skin is pale, pain in
the epigastrium, right and left hypochondrium. In the blood: leuk. 10.4 x 109/l, ESR 22 mm/hour.
The worsening of what disease is the most likely in this case?
A.
Stomach ulcer
B.
Chronic gastritis
C.
D.
E.
199.
200.
201.
202.
203.
204.
*Chronic pancreatitis
Chronic cholecystitis
Chronic enterocolitis
In the boy 6 years old microhematuria was accidentally revealed. Objectively: stigmas
dyzembriogenesis (hypertelorism, epicant, abnormal ear auricles, gothic palate). According
resulys of audiogram there is detectable hearing loss. In the analysis of urine: protein 0.099g/L, 43 leukocytes in vision field, alkiline erythrocytes 20-22 in vision field. What disease can be
suspected?
A.
Chronic glomerulonephritis
B.
*Hereditary nephritis
C.
Dysmetabolitic nephropathy
D.
Chronic pyelonephritis
E.
Renal tubular acidosis
In the girl 2 years there is severe distortion of the feet, which appeared in 1yr old. During
examination: height 70cm, weight 12kg, strong body structure, O-foot deformity. On the
radiograph of bones of lower extremities: diaphysis with extensive thickening of cortical layer.
Phosphate- diabetes was diagnosed. What laboratory changes will help to confirm the diagnosis?
A.
*Hypophosphatemia, hyperphosphaturia, increased alkaline phosphatase
B.
Hyperphosphatemia, hypoproteinemia, hyperoxaluria
C.
Hypoproteinemia, hematuria, significance proteinuria
D.
Cylindruria, hyperphosphaturia, leukocyturia
E.
Hypocalcemia, significance proteinuria and reduced alkaline phosphatase
Patient is 3 years old. Incidentally during prophylaxis observation changes in urine were found:
protein - 0,75g/l, leucocytes - 4-6 in vision field, erythrocytes - 10-12 in vision field. A child was
born from full-term pregnancy (the previous two ended in miscarriage). In the hospital the
diagnosis of hereditary nephritis was put. What drugs should be prescribed?
A.
Vitamin D
B.
Prednisolone
C.
Heparin
D.
*Activators metabolism (vitamins, cocarboxilazae, ATP)
E.
Cytostatics
Patient is 1.5yrs old. Mother complains of the presence of a child's fever, frequent urination and
thirst. Objectively: malnutrition, pale skin and mucous membranes, bone deformations. A child
does not walk and has mental retardation. Abdomen is soft, the liver is at 3cm lower the costal
arch. Blood glucose is 5.4 mmol/L, blood in urine is 1.5%. What disease is the most probable in
the child?
A.
*Disease de Toni-Debre-Fanconi
B.
Phosphate-diabetes
C.
Diabetes mellitus
D.
Renal tubular acidosis type I
E.
Renal tubular acidosis type II
In child 4 years old, who is being treated at orthopedic department with the expressed O-strain
feet, phosphate- diabetes is diagnosed. High doses of vitamin D were appointed. Which test is
necessary to control the adequacy of therapy?
A.
Zymnitski test
B.
*Sulkovich test
C.
Urinalysis
D.
Determination of urea and creatinine in blood
E.
Clearance of endogenous creatinine
A child with disease de Toni-Debre-Fanconi has marked bone deformations, periodic pyrexia,
polyuria, polydipsia, physical and mental retardation. What kind of diet should be recommended?
A.
*Potato - Cabbage
B.
Restricted protein and salt
Fruit - sugar
Milk and vegetable
Hypoallergic
Mother of the child 3 years old comes to the doctor. She complains of child deafness. It is known
that in the family was a case of deafness in the boy, who died at age 13yrs old from kidney
disease. Objectively congenital dyzmorphias were revealed. What observation is necessary to
conduct to confirm Alport syndrome?
A.
*General analysis of urine
B.
Excretory urography
C.
Urinalysis by Zymnitski
D.
Determination of blood levels of phosphorus and calcium
E.
Sulkovich test
A child 5 years old has growth retardation, rickets changes in bones, intermittent polyuria and
dehydration. Ultrasound examination revealed the presence of calculus in the kidneys. In
urinalysis: urine alkaline, protein - 0.033g/L, leucocytes - 15-17 in vision field, calcium oxalate in
large quantities. What is the disease most likely in a child?
A.
Phosphate-diabetes
B.
The hereditary nephritis
C.
*Renal tubular acidosis type I
D.
Renal tubular acidosis type II
E.
Disease de Toni-Debre-Fanconi
A child 5 years old with renal tubular acidosis type I has growth retardation, rickets changes in
bones, intermittent polyuria and dehydration. Ultrasound examination revealed the presence of
calculus in the kidneys. The first goal of therapy is to:
A.
Normalise calcium level in blood
B.
Normalise potassium level in blood
C.
Normalise endocrine balance
D.
*Neutralize acid in the blood
E.
All transferred
C.
D.
E.
205.
206.
207.
F.
A.
B.
C.
D.
E.
F.
208.
209.
208.
a child 4 yrs old with periodic acute pain in back and abdomen, attacks of pyelonephritis despite
of proper treatment, enuresis megaureter is suspected. Examination reveals hematuria and
urolithiasis. What examination is needed to confirm the diagnosis?
*USD
Voiding cystouretrogram
Three glass test
Cystoscopy
All transferred
A child 5 years old was hospitalized for surgical treatment of glaucoma. Objectively: thickness of
nail plates, hypoplas of the proximal radial head, iliac bone with patologic of their projections ,
deformity of the foot (" horse toes"), flexion contracture of the joints (especially elbows).
Laboratory: no changes in blood, proteinuria, microhematuria. Put the diagnosis:
A.
Hereditary nephritis
B.
Congenital tubulopathy
C.
Edward syndrome
D.
Patau syndrome
E.
*Syndrome nail-patella
A child 4 yrs old has complains of periodic acute pain in back and abdomen. During 1 year he had
3 attack of pyelonephritis despite of proper treatment, enuresis. Objectively on the left side of
abdomen there is palpable abdominal tumor formation. Examination reveals hematuria and
urolithiasis. What diagnosis is suspected?
A.
Tubulopathy
B.
C.
D.
E.
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*Megaureter
Cystoureter reflux
Hereditary nephritis
Polycystic kidney
A 9-year-old girl is seriously ill. The illness was manifested by high fever, chills, sweating,
aching pain in lumbar area, a discomfort in urination and frequent urination. Pasternatsky’s sigh is
positive in both sides. On laboratory examination, WBC is 20.000/mcL; on urinalysis protein is
0.6g/L, leukocyturia, bacteriuria. Your preliminary diagnosis is:
A.
*Acute pyelonephritis
B.
Exacerbation of chronic pyelonephritis
C.
Acute glomerulonephritis
D.
Acute cystitis
E.
Nephrolithiasis
A 9-year-old girl is seriously ill. The illness was manifested by high fever, chills, sweating,
aching pain in lumbar area, a discomfort in urination and frequent urination. Pasternatsky’s sigh is
positive in both sides. A pain syndrome at pyelonephritis is characterized by the following, exept:
A.
Sense of tension in lower back
B.
*Acute paroxysmal pain in lower back
C.
Pain increases when position is changed
D.
Pain diminishes at warming of lower back
E.
Pain presents at pattering of lower back
A 12-year-old girl is seriously ill. The illness was manifested by high fever, chills, sweating,
aching pain in lumbar area, a discomfort in urination and frequent urination. Pasternatsky’s sigh is
positive in both sides. She has chronic pyelonephritis. Biochemical blood test was done. What
changes can be in it?
A.
Increase of glucose level
B.
Increase of bilirubin
C.
*Increase of kreatinine
D.
Decrease of alfa-amylase
E.
Increase of alkaline phosphatase
At sick boy 10 years old urine was taken for analysis. Hyaline casts were found in urine. What are
hyaline casts?
A.
Acide, that had changed the consistency in sour urine
B.
*Albuminous molds of kidney tubuli
C.
Accumulation of bacteria
D.
Pressed thrombocytes
E.
Salt corks
A 14-year-old girl is seriously ill. She has acute pyelonephritis. Doctor recommends a zigzag diet.
What does this diet mean?
A.
Alternation of salt free and sugar free days
B.
Alternation of protein free and fat free products
C.
Alternation of diet № 5 and diet № 15
D.
*Alternation of acid and alcaline products
E.
Alternation of starvation and valuable feed
At sick girl 7 years old impairment of urine filtration was found. The illness was manifested by
high fever, sweating, aching pain in lumbar area, a discomfort in urination and frequent urination.
What department of nephrone filtration of urine is performed in?
A.
Proximal ductule
B.
Interstitium of kidney
C.
Glomerulus
D.
*Henle loop
E.
Distal ductule
Sick girl 7 years old has pyelonephritis. The illness is manifested by high fever, sweating, aching
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pain in lumbar area, a discomfort in urination and frequent urination. What laboratory sign is most
characteristic for this pathology?
A.
*Active leucocytes in urine
B.
Casturia
C.
Considerable proteinuria
D.
Uraturia
E.
Oxalaturia
Sick girl 7 years old has pyelonephritis. The illness is manifested by high fever, sweating, aching
pain in lumbar area, a discomfort in urination and frequent urination. Doctor prescribed antibiotic.
Choice of antibacterial preparations for pyelonephritis treatment is determined by:
A.
Age of the child
B.
Severity of illness
C.
Duration of the disease
D.
*Sensitiveness of bacteria cultured from urine
E.
All transferred
During palpation of kidneys the following was revealed: it is possible to palpate the kidney, it is
easly displaceble, but does not move to the opposite side of the body. Which degree of
nephroptosis is present
A.
I
B.
*II
C.
III
D.
IV
E.
Total nephroptosis
A 14-year-old girl is seriously ill. She has chronic pyelonephritis. Excretory urography is
prescribed. This investigation does not allow discover:
A.
Position, sizes, form of kidneys
B.
Functional state of nephrons
C.
Functional state of urinary tract
D.
*Anomaly of kidney vessels
E.
State of urinary bladder
During investigation of patient’s urine the following findings were revealed: 5-6 leucocytes are
found in 1 visual field, single fresh rd corpuscles in 1 visual field. What investigation must be
appointed to this patient for diagnosis clarification?
A.
Complete blood count
B.
ECG
C.
*Nechiporenko’s test
D.
Zimnitskiy’s test
E.
Determination of daily proteinuria
A 14-year-old girl is seriously ill. She has chronic pyelonephritis with frequent exacerbations.
Excretory urography is prescribed to estimate:
A.
Anatomic state of urinary ways and urine dynamics
B.
State of the kidney’s pelvis system
C.
Functional ability of urinary ways
D.
Sizes of kidneys
E.
*Everything is correct
A patient 8 years old had attack-like pains in lumbar area, which irradiate downward. Pain
syndrome was severe with dysuric sis. What disease is the most probable?
A.
Acute glomerulonephritis
B.
*Urolithiasis
C.
Hypernephroma
D.
Chronic glomerulonephritis
E.
Dysmetabolic nephropathy
Sick girl 7 years old has pyelonephritis. The illness is manifested by sweating, aching pain in
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lumbar area, a discomfort in urination and frequent urination. What is not typical for acute
pyelonephritis?
A.
Beginning of illness on a background of an acute bacterial infection
B.
Dysuria
C.
Pain in the lower back
D.
*Normal body temperature
E.
Nausea, vomiting
Sick girl 12 years old has chronic pyelonephritis for 6 yrs. During exacerbation biochemical blood
test is conducted. What change will confirm the renal failure first of all?
A.
Increase of glucose in blood
B.
Increase of bilirubin
C.
Increase of creatinine
D.
*Increase of nitrogen
E.
Increase of alkaline phosphatase
Patient 15 years old is troubled with appearance of sediment in his urine which makes the urine
cloudy but disappear in an hour. Appearance of what substance in urine can you suspect?
A.
*Salts
B.
Protein
C.
Bilious pigments
D.
Glucose
E.
Urinary acid
Patient 15 years old is troubled with appearance of sediment in his urine which makes the urine
cloudy and don’t disappear in an hour. Appearance of what substance in urine can you suspect?
A.
Salts
B.
*Protein
C.
Bilious pigments
D.
Glucose
E.
Urinary acid
Patient A., 15 years old, is troubled with increased amount of urine excreted per day. During
examination it was revealed that urine specific gravity is increased. Appearance of what substance
in urine makes its gravity increased?
A.
Salts
B.
Protein
C.
Bilious pigments
D.
*Glucose
E.
Urinary acid
Patient 8 years old is ill with chronic pyelonephritis for 5 years. During exacerbation biochemical
blood test is conducted. What changes in biochemical blood test will prove kidney insufficiency?
A.
Albuminemia
B.
Dysproteinemia
C.
?-lipoproteinaemia
D.
*Creatininemia
E.
Hyperbillirubinemia
Patient has renal failure. By physical examination it was revealed swelling of subcutaneous tissue
of the whole body. Accumulation of liquid in subcutaneous fat tissue on the whole body is called:
A.
Ascites
B.
*Anasarca
C.
Hives
D.
Edema
E.
Renal failure
Patient 8 years old complains of attack-like pains in lumbar area, which irradiate downwards.
What does can this symptom testify about?
A.
Acute glomerulonephritis
B.
C.
D.
E.
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*Urolithiasis
Hypernephroma
Urethritis
Cystitis
Patient 7 years old entered clinic with complaints of edema under eyes, increase of body
temperature up to 37.8°С, discoloration of urination. 2 weeks ago he had tonsillitis. What test
must be done first of all?
A.
Estimation of ASL-O
B.
*General analysis of urine
C.
Ultrasound of abdomen
D.
Bacteriologic study of pharynx smash
E.
All transferred
At sick boy 10 years old with pyelonephritis urine was taken for analysis. The analysis of urine in
this case is not characterized by:
A.
*Proteinuria more than 1 g/l
B.
Neutrophils leukocyturia
C.
Plenty of cellular epithelium
D.
Sometimes plenty of salts
E.
The specific gravity of urine is normal
The child of 10 years is ill during one week. The disease appears after cooling. Her disease
symptoms are: pain in abdomen, back, body temperature 38°С. In urine analysis: leucocytes – 2530 in the visual field, protein – 0.33 g/l. Diagnose is acute pyelonephritis. What investigation is it
necessary to do before prescribing the etiotropic treatment?
A.
Cystographya
B.
Urogrphya
C.
Zimnitskiy test
D.
Nechiporenko test
E.
*Bacteriological test of urine
The child of 10 years complains of high temperature, pain in abdomen, and pain during urination.
In urinalysis: protein – 0.33 g/l, leucocytes – in all visual field, erythrocytes 5-10 in visual field.
What investigation is it necessary to do to know the level of urinary system damaging?
A.
*Urographya
B.
To take urine by catheter
C.
Bacteriological test of urine
D.
Ultrasound investigation
E.
Zimnitskiy test
The child of 5 years is ill for 2 days. He complains of: often pain during urination, urine
incontinence. Temperature is normal, abdomen is painful in hypogastrium. What dates are typical
to diagnose urinary tract infectio
A.
Proteinuria
B.
Leucocyturia
C.
Erythrocyturia
D.
*Bacteriuria 105 and more
E.
Hypostenuria
The child of 9 years become ill acutely: temperature is 39oС, pain in lower back, and pain during
urination. Pasternatskiy symptom is positive bylaterally, more in the left. What disease has this
child?
A.
*Acute pyelonephritis
B.
Acute viral infection
C.
Acute cystitis
D.
Acute glomerulonephritis
E.
Kidney colic
The girl of 3 years has high temperature, pain in abdomen the third time during last year. In
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urinalysis: leucocytes – 70-80 in visual field, erythrocytes 1-2 in visual field. What investigation
will prove the genesis of leucocyturia?
A.
Urography
B.
*3 glasses test
C.
Nechiporenko test
D.
Endogenous creatynine clearance
E.
Zimnitskiy test
The girl of 6 years complains of temperature 39°С, vomiting, pain in abdomen, disuria. In
urinalysis: protein – 0.58 g/l, leucocytes – in all visual field, erythrocytes 4-5 in visual field.
Blood test: ESR – 30 mm/hour. Diagnose is acute pyelonephritis. What investigation will prove
the diagnosis?
A.
*Bacteriological test of urine
B.
Zimnitskiy test
C.
Nechiporenko test
D.
Blood urea
E.
Endogenous creatynine clearance
The girl of 10 years complains of the pain in lower back during 4 days. She has also the increased
temperature, decrease of appetite, and the pain during urination. One week ago was ill (acute viral
infection). What investigation is it necessary to make first of all?
A.
*General analysis of urine
B.
General analysis of blood
C.
Urogrphy
D.
Ultrasound investigation
E.
Zimnitski test
Mother of a girl 7 years old complained of recurrent abdominal pain and skin rash, increased
sweating, decrease in urine output and concentrated character. Nocturia is noted. AP is 90/60mm
Hg. General urine analysis: the relative gravity of urine - 1028, protein - 0,04g/l, Leuc. - 9-10 in
v/f, Eryth. – changed 6-8 in v/f, casts - not detected, salts - oxalates large number. Set a
preliminary diagnosis.
A.
*Dysmetabolic nephropathy
B.
Acute glomerulonephritis with nephritic syndrome
C.
Urinary infection
D.
Tubulopathy
E.
Acute renal failure
Patient 14yrs old complained of intense pain in the right lumbar region, chills, accompanied by
fever up to 39°C. The abdomen is soft, painful in the right area. Palpation of right kidney is
painful. In the blood: leukocytes 30.0 x109/L, ESR - 50 mm/hour. In urine an.: acid reaction,
leukocytes in the entire field of vision. According to the US - the left kidney is normal, the
contours of the right kidney are increased. What disease is the most probable in this case?
A.
Right paranephritis
B.
*Acute right-sided pyelonephritis
C.
Tuberculosis of the right kidney
D.
Swelling of the right kidney
E.
Polycystic kidney degeneration
A child 13 years old complains of pain in the suprapubic region, frequent urination in small
quantities of urine. Fever is 37.7°C. In the analysis of urine: proteinuria 0.03g/L, fresh
erythrocytesin all vision field, salt-oxalate in small amount. What is the most likely diagnosis?
A.
Dysmetabolic nephropathy
B.
*Acute cystitis
C.
Acute glomerulonephritis
D.
Acute pyelonephritis
E.
Urolithiasis
Boy aged 1 month was hospitalized. Prenatally left-sided pyeloectasis was diagnosed. Intravenous
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urography, cystography and ultrasound revealed hydronephrosis in child an early stage. Data
about secondary pyelonephritis are absent. What tactics is appropriate in this patient?
A.
Observation for 6 months
B.
Observation during the year
C.
Antibacterial therapy
D.
*Surgery
E.
No need for supervision and treatment
In child 3 years with periodic abdominal pain and pyuria ultrasound revealed an enlarged kidney
and rounded shape of the cavities, which are connected with an pelvis. Right kidney is not altered.
What diagnosis is correc
A.
Multicystosis
B.
Hydronephrosis
C.
Echinococcusis
D.
Kidney stone
E.
*Polycystic kidney
The girl 4 years old is suffering from atopic dermatitis, occasionally abdominal pain disturbed.
Palpation: abdomen is soft and painless. Liver is 2 cm below the costal arch. Stools and urine are
normal. Urinalysis - muddy, urine pH 7.0, protein 0.05g/L, red blood cells modified and
unmodified - 30-40 in v/f, white blood cells - 6-8 in v/f, salts - oxalates increased amount. Daily
proteinuria is 0,03g. Put preliminary diagnosis.
A.
Allergic nephropathy
B.
Pyelonephritis
C.
*Dysmetabolic nephropathy
D.
Glomerulonephritis
E.
Hemorrhagic cystitis
In the patient 13 years old with normal body mass on clinical examination of the urine calcium
salts of phosphoric acid were revealed. His diet consists of rye and wheat bread, pasta, butter,
boiled meat, fried fish, mashed potatoes, milk, cheese, coffee, tea, broth rose, currant jelly.
Energy in diet corresponds to power consumption. What is necessary to eliminate from the diet?
A.
Milk and cheese
B.
*Coffee and Te
C.
Pasta and bread
D.
Broth hips and jelly
E.
Meat and fish
For a boy 7 years in 2 weeks after the carried tonsillitis edema appeared on face, lower
extremities. The state is heavy, predefined by intoxication syndrome. Blood pressure - 140/80.
Urine has brown color. General analysis of urine: specific gravity -1015, protein – 1,2 g/l, red
corpuscles cover all field of view, cylinders 1 – 2 in field of view. Protein in day's urine – 0,78 gr.
What most reliable diagnosis?
A.
Acute glomerulonephritis with nefrotic syndrome
B.
Nephrolithiasis
C.
Acute glomerulonephritis with nefrotic syndrome, hematuria and arterial hypertension
D.
*Acute glomerulonephritis with nephritic syndrome
E.
Acute glomerulonephritis with isolated urine syndrome
The boy of 3 has an edema syndrome like as anasarca. Blood pressure - 95/60. In the general
analysis of urine: protein – 6,3 g\l, leucocytes 2-3 in field of view, red corpuscles 1-2 in field of
view, cylinders - 2-3 in field of view. General protein of blood – 44,2 g\l, albumen – 38,1%,
cholesterol of blood – 8,6 mmol\l. What clinical variant of acute glomerulonephritis does take
place probably?
A.
Acute glomerulonephritis with nephritic syndrome
B.
*Acute glomerulonephritis with nefrotic syndrome
C.
Acute glomerulonephritis with isolated urine syndrome
D.
Acute glomerulonephritis with nefrotic syndrome, hematuria and arterial hypertension
Acute glomerulonephritis with hematuria
The girl of 8 years has complaints to pain in back during 4 days. She has also the increase
temperature, decrease of appetite, and the pain during urination. One week ago was acute viral
infection. What investigation it is necessary to make first of all?
A.
*General analysis of urine
B.
General analysis of blood
C.
Urogrphia
D.
Ultrasound investigatio
E.
Zimnitskiy test
The child of 10 years is ill during one week. The disease appears after cooling. The symptoms:
pain in abdomen, back, temperature 38оС. In analysis of urine: leucocytes – 25-30 in field of
view, protein – 0,33 g/l. Diagnose – acute pielonephritis. What investigation it is necessary to
prescribe for making of etiotropic treatment
A.
Cistographia
B.
Urogrphia
C.
Zimnitskiy test
D.
Nechiporenko test
E.
*Bacteriological test of urine
The child of 8 years ill acute: temperature 39С, pain in back, and the pain during urination,
symptom of Pasternatskiy positive from both sides, more in left. What disease is present?
A.
*Acute pielonephritis
B.
Acute viral infection.
C.
Acute cystitis
D.
Acute glomerulonephritis
E.
Kidney colic
Acute glomerulonephritis is diagnosed. What from the resulted investigations is informing for
kidneys function estimation?
A.
General analysis of urine
B.
Protein estimation in day’s urine
C.
Nechiporenko test
D.
*Zimnitskiy test
E.
Estimation of daily diuresis
The child of 10 years. The complaints increase of temperature, pain in abdomen, and pain during
urination. In analysis of urine: protein – 0,33 g/l, leucocytes – in all field of view, erythrocytes 510 in field of view. What investigation it is necessary to prescribe to know the level of damaging
of urinary system?
A.
*Urographia
B.
To take urine by catheter
C.
Bacteriological test of urine
D.
Ultrasound investigation
E.
Zimnitskiy test
The child of 5 years. The 2-day of disease. The complaints: often pain during urination,
incontinence. Temperature normal, pain in abdomen in lower part. What dates is typical to
diagnose: infection of urinary ways?
A.
Proteinuria
B.
Leucocyturi
C.
Erytrocyturia
D.
*Bacteruria 10^5 or more
E.
Hypostenuria
The girl of 6 years has temperature 39оС, vomiting, pain in abdomen, troubled urine. In analysis
of urine: protein – 0,58 g/l, leucocytes – in all field of view, erythrocytes 4-5 in field of view.
Analysis of: ESR – 30 mm/hour. Diagnose – acute pielonephritis. What investigation it is
necessary to make to prove the diagnose.
E.
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A.
B.
C.
D.
E.
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*Bacteriological test of urine
Zimnitskiy tes
Nechiporenko test
Urine of blood
Endogenic creatinin clirens
The girl 3 years the third time during the last year has the complaints to the high temperature, pain
in abdomen. In analysis of urine: leucocytes – 70-80 in field of view, erythrocytes 1-2 in field of
view. What investigation it is necessary to make to know the genesis of leucocyturia?
A.
Urogrphia
B.
*Cistographi
C.
Nechiporenko test
D.
Uria of blood and creatinin
E.
Zimnitskiy test
What from the resulted symptoms is the criterion of acute glomerulonephritis, nephritic variant?
A.
*Hematuria
B.
Leucocyturia
C.
Bacteruria
D.
Anasca
E.
Proteinuria more than 3 gr per day
A 10 years old boy has acute glomerulonephritis during a mouth. He has edema. In urine: protein
– 2,5 g/l, in the biochemical blood test: total protein – 48 g/l, cholesterol- 9,8 mmol|l. What from
this medicine must be appointed to the child in the complex of pathogenetical therapy?
A.
Delagyl
B.
Plaquenyl
C.
*Prednisolon
D.
Heparin
E.
Curantil
Dark color of urine is observed at a 9 years boy, that 3 weeks ago had an tonsillitis, arterial blood
presser 100|50, in the complete analysis of urine: protein is 0,98 g|l, leucocytes 3-2 in field of
view, erythrocytes on 1/3 in field of view, hyaline casts 1-2 in field of view. What variant of acute
glomerulonephitis is more reliable in the child?
A.
Nefrotic
B.
Nephritic
C.
*Isolated urine syndrome
D.
Nefrotic syndrome, hematuria and arterial hypertension
E.
Subacute malignant glomerulonephritis
The 7 years boy with edema, headache, red urine, blood pressure 130/90. The 10 day before were
pain in throat, hypothermia. In general analysis of urine: protein-2,5 g/l, leuc. – 2-3, erythr. On all
field of view, casts gialine 2-3. What can lead to such changes?
A.
*Streptococci
B.
Enteroviruses
C.
Respiratory viruses
D.
Staphylococci
E.
Coli
The girl of 10 years. One month before was tonsillitis. Last 2 weeks is observed general malaise,
painless of skin; urine specific gravity – 1018, protein 0.91 g/l, leukocytes in urine –2-3, erythr. 1/2 of field of view. Blood pressure – 140/90. What drug is necessary to give:
A.
*Indometacin
B.
Prednisolone
C.
Chlorbutin
D.
Plaquenil
E.
Methothrexate
A 7 yrs old child had elevation of temperature t° to 40°C in anamnesis. For the last 3 months he
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presents fusiform swelling of fingers, ankle joints and knee joints, pain in the upper part of the
sternum and cervical part of the spinal column. What is the most probable diagnosis?
A.
Septic arthritis
B.
*Juvenile rheumatoid arthritis
C.
Toxic synovitis
D.
Rheumatism
E.
Osteoarthritis
A 14 year old female fell ill 3 months ago after cold exposure. She complained of pain in her
hand and knee joints, morning stiffness and fever up to 38oC. Interphalangeal,
metacarpophalangeal and knee joints are swollen, hot, with reduced ranges of motions; ESR of 45
mm/h, CRP (+++), RF (+). What group of medicines would you recommend to the patient?
A.
Sulfonamides
B.
Tetracyclines
C.
Fluorchinolones
D.
Cephalosporines
E.
*Nonsteroid anti-inflammatory drugs
A 4 years old girl was hospitalized with complaints of pain and swelling in the right knee and an
ankle joints, morning stiffness, rapid fatigue, subfebrile temperature. She is ill for 4 months.
Beginning of illness she connects with ARI. The disease began with a knee violation. She
received aspirin, but the effect was absent. After 3 months the process has spread to the
radiocarpal joint. Put a preliminary diagnosis.
A.
Rheumatic fever
B.
Infectious-allergic arthritis
C.
Systemic lupus erythematosis
D.
*Rheumatoid arthritis
E.
Systemic scleroderma
A 6 years old girl with eye problems was consulted by ophthalmologist. Diagnosis of uveitis was
established. There are complaints of pain and swelling in the right knee and a ankle joints, rapid
fatigue, subfebrile temperature. She is ill for 4 months. Affection of the eyes is special for:
A.
Infectious arthritis
B.
Acute rheumatic lever
C.
*Juvenile rheumathoid arthritis
D.
Overuse syndrome
E.
Osteomyelitis
3 yrs old girl has fever, rash, arthritis and signs of inflammation of internal organs. Systemic form
of the juvenile rheumatoid arthritis was suspected. It is characterized with:
A.
*Evanescent salmon-pink macular rash
B.
Chronic pain and swelling of many joints in a symmetric fashion
C.
Chronic asymmetric arthritis of large joints
D.
Purpuric skin rash
E.
Hemarthrosis
Girl is 8 years old. Complaints: the general malaise, periodic arthralgia, tingling sensation in
fingers, spotty rash on her face. She is ill during the year. Beginning of illness mother connects
with the rest in the summer in the south. Objectively: integuments and visible mucous membranes
are pale, on the face, neck, palms there is expressed capillaritis, weakness of muscles. Joints are
not changed. Cardiac tones are rhythmic, weakened, delicate dyastolic murmur on the apex, HR is
100 per min.
A.
r previous diagnosis is:
B.
*Raynaud's Syndrome
C.
Systemic lupus erythematosis
D.
Nodular peryartheriitis
E.
Atopic dermatitis
F.
Rheumatic fever
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A 8 years old girl was hospitalized with complaints of pain and swelling in the left knee and left
ankle joints, morning stiffness, rapid fatigue, subfebrile temperature. She is ill for 4 months.
Beginning of illness she connects with ARI. Pauciarticular form of the juvenile rheumatoid
arthritis is characterized by:
A.
*Chronic asymmetric arthritis of large joints
B.
Hepatosplenomegaly
C.
Salmon-pink macular rashes
D.
Purpuric skin rashes
E.
Hemarthrosis
The 14-years old girl has the complaints of presence of white colour patches on the wrists, legs
and face. These patches are cold, firm, thick and dry. The movements of wrists joints are not
limited. From the anamnesis is known that she had signs of Raynaud's syndrome the year before
and there is decreased sensitivity of hands and feet now. No changes in the inner organs were
founded. What observation is the most helpful to confirm the diagnosis?
A.
ANA test
B.
*Skin biopsy
C.
MRI
D.
Angiography
E.
General blood analysis
The 14-years old girl has the complaints of presence of white colour patches on the wrists, legs
and face. These patches are cold, firm, thick and dry. The movements of wrists joints are not
limited. From the anamnesis is known that she had signs of Raynaud's syndrome the year before
and there is decreased sensitivity of hands and feet now. No changes in the inner organs were
founded. Localized scleroderma was diagnosed. What treatment would be prescribed?
A.
Penicillamine
B.
Pentoxifylline
C.
Cyclophosphamid
D.
Physiotherapy
E.
*All mentioned above
The 8 years old boy complaints of body temperature 37.4 – 37.8?C, muscle weakness, pain in
knees and legs. These symptoms appeared 8 days ago. During examination was noticed violetcolored rash on eyelids and around the nails, periorbital edema. Palpation of the shin muscles is
painful, movements of legs are limited. There is hyperemia of the oral cavity, multiple ulcers on
the gingiva. No changes in the inner organs were found. What observation is the most helpful to
confirm the diagnosis?
A.
*Skin and muscle biopsy
B.
ANA test
C.
MRI
D.
Serum muscle enzymes (CK,CPK, LDH, and/or aldolase)
E.
General blood analysis
A boy 10 years old has complaints of significant fatigue, fever, dysphagia, hardness in flexion of
wrist fingers. He is ill during months; his mom thinks that his disease is provoked with
overcooling. During examination: the weight of patient is less than normal, there are firm small
tubercles under the skin and in the muscles. The movements in hand joints are painless and
decreased. The oral cavity mucosa is dry with hemorrhages. Three months ago in this boy was
diagnosed stomach ulcer. Put the most probable diagnosis.
A.
Atopic gingivatis
B.
Systemic vasculitis
C.
Myastenia gravis
D.
Polyneuropathy
E.
*Juvenile dermatomyositis
The 16-years old boy has the complaints of skin discoloration on the face and feeling of “hard
skin” around the mouth. Also there is swelling of wrists joints and limited but painless
274.
275.
276.
277.
movements in these joints. During examination there were registered dull heart sounds,
tachycardia, decreased sensitivity in the hands and feet. In ultrasound examination was diagnosed
heart fibrosis. Put the diagnosis.
A.
*Scleroderma systemica
B.
JRA
C.
JDM
D.
Polyarteritis nodosa
E.
Restrictic cardiomyopathy
The 16-years old boy has the complaints of skin discoloration on the face and feeling of “hard
skin” around the mouth. Also there is swelling of wrists joints and limited but painless
movements in these joints. During examination there were registered dull heart sounds,
tachycardia, decreased sensitivity in the hands and feet. In ultrasound examination was diagnosed
heart fibrosis. What observation is the most helpful to confirm the diagnosis?
A.
General blood analysis, ANA test
B.
MRI, CT
C.
*Skin biopsy
D.
EchoCG
E.
ECG
Patient 10 years old admitted to the hospital with intermittent high fever, allergic rash, pain and
swelling in the knee and ankle joints, increase of peripheral lymph nodes, liver and spleen. In
general blood analysis - leukocytes 27x109/l, ESR - 65mm/hour, increased immunoglobulin "M"
and "G". Which of the following diagnoses is most probable?
A.
Sepsis
B.
*Systemic juvenile rheumatoid arthriti
C.
Systemic lupus erythematosus
D.
Rheumatc fever
E.
Leukemia
The 17-years old girl came to hospital because of dysphagia symptoms. According anamnesis
data was revealed abnormal sensitivity to cold in the hands and feet. During examination were
found: painful calcium deposits under the skin, pallor and cyanosis of hands and feet, tightening
of the skin on the fingers or toes and presence of dilated capillaries on the hands and face. Put the
diagnosis.
A.
Systemic vasculitis
B.
Polyarteritis nodosa
C.
Localized scleroderma
D.
*Progressive Systemic Sclerosis
E.
Raynaud's syndrome
The 13 years old girl complaints of body temperature 37.8 – 38.2?C, muscle weakness, pain in
knees and legs. These symptoms appeared 4 days ago. During examination was noticed violetcolored rash on eyelids and around the nails, periorbital edema. Palpation of the shin muscles is
painful, movements of legs are limited. There is hyperemia of the oral cavity, multiple ulcers on
the gingiva. No changes in the inner organs were found. Put the diagnosis.
A.
Atopic gingivatis
B.
Systemic vasculitis
Myastenia gravis
*Juvenile dermatomyositis
Polyneuropathy
The 12-years old girl has the complaints of presence of white colour bands on the arms and legs.
These bands are firm, thick and dry. The girl describes the feelings at the areas of lesions presence
like “tightening” or “compression”. From the anamnesis is known that she had signs of Raynaud's
syndrome the year before and there is decreased sensitivity of hands and feet now. No changes in
the inner organs were founded. Put the diagnosis.
C.
D.
E.
278.
Atopic dermatitis
Systemic vasculitis
Polyneuropathy
Obliterised endarteriitis
*Localized scleroderma
A boy 5 years old was hospitalized because of pain in the neck, knees and decrease of movements
in these joints especially in the morning. Two weeks ago was ARI with tonsillitis. The disease
have acute onset: hyperthermia, hard movements of the head, pain and edema of joints. After antiinflammatory drugs the pain became less intensive, but decreasing of active movements still
remained. During examination: skin pallor, deformation of knee joints with decrease movements
in them and neck. What examination will help to put early diagnosis of JRA?
A.
Coombs test
B.
ESR, CRP
C.
Pheumatoid factor
D.
*Biopsy of synovial membrane
E.
US of joints
During investigation of patient’s urine the folowing findings were revealed: 5-6 leucocytes are
found in 1 visual field, single fresh red corpuscles in 1 visual field. What investigation must be
appointed to this patient for diagnosis clarification?
A.
Complete blood count
B.
ECG
C.
Zimnitsky’s test
D.
determination of daily proteinuria.
E.
* Nechiporenko’s test
During palpation of kidneys the following was revealed: it is possible to palpate all the kidney, it
is easly displaceble, but does not move to the opposite side of the body. Which degree of
nephroptosis is present?
A.
1st
B.
3rd
C.
4th
D.
total nephroptosis.
E.
* 2nd
For patient E., 12 years old, ill with chronic pyelonephritis for 6 yers, biochemical blood test is
conducted. What changes can be when the patient has renal failure?
A.
increase of glucose level in blood
B.
increase of bilirubin
C.
increase of amylaze
D.
increase of alkaline phosphatase.
E.
* increase of creatinine
For patient I., 14 years old, paranephritis is diagnosed. What position is typical for this case?
A.
B.
C.
D.
E.
279.
280.
281.
282.
283.
Semirecumbent position with lowered legs (orthopnoe)
Lying on a sick side
Knee-elbow position
Sitting, bending forward.
* On affected side with legs bended hip and knee joints and by the leg pressed to the
stomach from the side of affection
In patient A., violation of kidneys concentration function was found. What part of nephrone
concentrates the urine?
A.
glomerulus
B.
Henle’s loop
C.
proximal tubule
D.
convoluted tubes.
A.
B.
C.
D.
E.
284.
E.
285.
286.
287.
288.
289.
290.
291.
* distal tubule
Patient E. 8 years old., is ill with chronic pyelonephritis for 5 years. What changes in biochemical
blood test will prove kidney insufficiency?
A.
albuminemia
B.
beta-lipoproteinaemia
C.
hyperbilirubinemia
D.
dysproteinemia.
E.
* creatininemia
Patient E., 8 years old, complains of attack-like pains in lumbar area, which irradiate downwards.
What does can this symptom testify about?
A.
acute glomerulonephritis
B.
hypernephroma
C.
chronic glomerulonephritis
D.
heart attack.
E.
* urolithiasis
The child of 10 years complains of high temperature, pain in abdomen, and pain during urination.
In urinalysis: protein – 0,33 g/l, leucocytes – in all visual field, erythrocytes 5-10 in visual field.
What investigation is it necessary to do to know the level of urinary system damaging?
A.
To take urine by catheter
B.
Bacteriological test of urine
C.
Ultrasound investigation
D.
Zimnitsky test
E.
* Urographia
The child of 10 years is ill during one week. The disease appears after cooling. Her disease
symptoms are: pain in abdomen, back, temperature 38оС. In analysis of theurine: leucocytes –
25-30 in the visual field, protein – 0,33 g/l. Diagnose is – acute pyelonephritis. What investigation
is it necessary to do before etiotropic treatment?
A.
Cystographia
B.
Urogrphia
C.
Zimnitsky test
D.
Nechiporenko test
E.
* Bacteriological test of urine
The child of 5 years is ill for 2 days. He complains of: often pain during urination, urine
incontinence. Temperature is normal, abdomen is painful in hypogastrium. What dates are typical
to diagnose urinary tract infection?
A.
Proteinuria
B.
Leucocyturia
C.
Erytrocyturia
D.
Hypostenuria
E.
* Bacteruria 105 and more
The child of 9 years become ill acutely: temperature is 39oС, pain in lower back, and pain during
urination, Pasternatskiy symptom is positive bylaterally, more in the left. What disease has this
child?
A.
Acute viral infection.
B.
Acute cystitis
C.
Acute glomerulonephritis
D.
Kidney colic
E.
* Acute pyelonephritis
The girl of 10 years complains of the pain in lower back during 4 days. She has also the increased
temperature, decrease of appetite, and the pain during urination. One week ago was ill (acute viral
infection). What investigation it is necessary to make first of all?
A.
General analysis of blood
B.
Urogrphia
Ultrasound investigation
Zimnitsky test
* General analysis of urine
The girl of 3 years has high temperature, pain in abdomen the third time during last year. In
urinalysis: leucocytes – 70-80 in visual field, erythrocytes 1-2 in visual field. What investigation
will prove the genesis of leucocyturia?
A.
Urography
B.
Nechiporenko test
C.
Endogenous creatynine clearance
D.
Zimnitsky test
E.
* 3 glasses test
The girl of 6 years complains of temperature 39о С, vomiting, pain in abdomen, disuria. In
urinalysis: protein – 0,58 g/l, leucocytes – in all visual field, erythrocytes 4-5 in visual field.
Blood test: ESR – 30 mm/hour. Diagnose is acute pyelonephritis. What investigation will prove
the diagnose?
A.
Zimnitsky test
B.
Nechiporenko test
C.
Blood urea
D.
Endogenous creatynine clearance
E.
* Bacteriological test of urine
A 14-year-old boy has rheumatism. Over the last 2 years he has had 3 rheumatic attacks. What
course of rheumatism does the patient have?
A.
Persistent-reccurent
B.
Subacute
C.
Acute
D.
Latent
E.
*Prolonged
After supercooling a 15-year-old girl developed muscle pain, body temperature rise up to 39oC,
headache, dysuria, positive Pasternatsky's symptome. In the urine: leukocyturia, bacteriuria. In
blood: decrease in Hb rate down to 103 g/l, left shift leukocytosis, ESR acceleration up to 32
mm/h. Blood urea - 6,0 millimole/l. What is the most likely diagnosis?
A.
Acute cystitis
B.
Acute glomerulonephritis
C.
Urolithiasis
D.
*Acute pyelonephritis
E.
Renal tuberclosis
An 18-month-old child was taken to a hospital on the 4-th day of the disease. The disease began
acutely with temperature 39, weakness, cough, breathlessness. He is pale, cyanotic, has had
febrile temperature for over 3 days. There are crepitative fine bubbling rales on auscultation.
Percussion sound is shortened in the right infrascapular region. X-ray picture shows nonhomogeneous segment infiltration 8-10 mm on the right, the intensification of lung pattern. Your
diagnosis:
A.
Grippe
B.
Interstitial pneumonia
C.
*Segmentary pneumonia
D.
Bronchitis
E.
Bronchiolitis
A 27-year-old patient with a history of bronchial asthma was stung by a bee. He had a sensation
of chest compression, breath shortage, difficult expiration, sense of heat in the upper half of body,
dizziness, apparent itch, convulsions. Objectively: noisy wheezing breath, AP - 90/60 mm
Hg, Ps- 110 bpm. Auscultation revealed weak rhythmic heart sounds, rough respiration above
lungs, sibilant rales. What drug group should be administered in the first place?
A.
Anticonvulsive
C.
D.
E.
292.
293.
294.
295.
296.
297.
Analgetics
*Glucocorticoids
Cardiac glycosides
Methylxanthines
A pediatrician had a conversation with a mother of a 7-month-old breast-fed boy and found out
that the child was fed 7 times a day. How many times should the child of such age be fed?
A.
7 times
B.
3 times
C.
6 times
D.
*5 times
E.
4 times
2 weeks after recovering from angina an 8-year-old boy developed edemata of face and lower
limbs. Objectively: the patient is in grave condition, AP- 120/80 mm Hg. Urine is of dark brown
colour. Oliguria is present. On urine analysis: relative density -1,015, protein - 1,2 g/l, RBCs are
leached and cover the whole vision field, granular casts - 1-2 in the vision field, salts are
represented by urates (big number). What is the most likely diagnosis?
A.
*Acute glomerulonephritis with nephritic syndrome
B.
Nephrolithiasis
C.
Acute glomerulonephritis with nephrotic syndrome
D.
Acute glomerulonephritis with nephrotic syndrome, hematuria and hypertension
E.
Acute glomerulonephritis with isolated urinary syndrome
79 A 16-year-old girl complains of nasal blockage, sneezing, watery nasal discharges. The
body temperature is normal. Objectively - edema of nasal mucous membrane on both sides,
especially of the lower turbinate (with cyanosis). Blood test data - mild leukocytosis and
eosinophilia. What is the diagnosis?
A.
*Allergic rhinitis
B.
Acute sinusitis
C.
Infective rhinitis
D.
Foreign body in the nose
E.
Atrophic rhinitis
In autumn a 15-year-old patient developed stomach ache that arose 1,5-2 hours after having meals
and at night. He complains about pyrosis and constipation. The pain is getting worse after
consuming spicy, salty and sour food, it can be relieved by means of soda and hot-water bag. The
patient has been suffering from this disease for a year. Objectively: furred moist tongue.
Abdomen palpation reveals epigastrial pain on the right, resistance of abdominal muscles in the
same region. What is the most likely diagnosis?
A.
Stomach ulcer
B.
Chronic pancreatitis
C.
Diaphragmatic hernia
D.
Chronic cholecystitis
E.
*Duodenal ulcer
A boy, aged 14, presents with facial edema, moderate back pains, body temperature of 37,5oC,
BP- 150/100 mm Hg, hematuria (up to 100 in v/f), proteinuria (2,0 g/l), hyaline casts - 10 in v/f,
specific gravity - 1020. The onset of the disease is probably connected with acute tonsillitis 2
weeks ago. The most likely diagnosis is:
A.
Urolithiasis
B.
Chronic glomerulonephritis
C.
*Acute glomerulonephritis
D.
Cancer of the kidney
E.
Acute pyelonephritis
A 16-year-old boy with a history of rheumatic fever complains of fever up to 38-39oC, abdominal
pain, dyspnea, tachycardia. Heart borders are displaced to the left by 2 cm, systolic and diastolic
murmurs above aorta, BP of 140/30 mm Hg. Petechial rash occurs after measurement of blood
B.
C.
D.
E.
298.
299.
300.
301.
302.
303.
304.
305.
306.
307.
308.
309.
pressure. Liver is enlarged by 3 cm, spleen is palpable. Urine is brown-yellow. What is the most
likely diagnosis?
A.
Rheumatic fever
B.
* Infectious endocarditis
C.
Acute nephritis
D.
Acute hepatitis
E.
Aortic regurgitation
A boy is 8 year old. His physical development is compliant with his age. The child has had
cardiac murmur since birth. Objectively: skin and visible mucous membranes are of normal
colour. AP- 100/70 mm Hg. Auscultation revealed systolo- diastolic murmur and diastolic shock
above the pulmonary artery. ECG shows overload of the left heart. Roentgenoscopy shows
coarsening of the lung pattern, heart shadow of normal form. What is the most likely diagnosis?
A.
Fallot's tetrad
B.
Pulmonary artery stenosis
C.
* Atrio-septal defect
D.
Aorta coarctation
E.
Patent ductus arteriosus
The patient with quired heart failure has diastolic pressure of 0 mm Hg. What heart failure does
the child have
A.
Mitral stenosis
B.
Mitral insufficiency
C.
Aortal stenosis
D.
* Aortal insufficiency
E.
Rheumatism
?The child is 7 months, he has artificial feeding (cow's milk, cream of wheat). He entered the
hospital with fever up to 37,8 ? C, brief bouts of tonic-clonic seizures, signs of rickets 2 degree.
Positive Erb, Trousseau, Maslov symptoms. What is the preliminary diagnosis?
A.
Renal eclampsia
B.
Hyperthermia
C.
Epilepsy
D.
Meningoencephalitis
E.
* Spasmophylia
The child is 1,5 months. He was born premature with a weight of 2000. During pregnancy the
mother suffered from preeclampsia 1st and 2nd half of pregnancy. 2 weeks to the increased
sweating, excitability. Which pathological condition is the most likely in this child?
A.
The consequences of perinatal lesions of the nervous system
B.
Functional disorders of the gastro-intestinal system
C.
Spasmophylia
D.
The initial manifestation of ARVI
E.
* Rickets
The child is 11 months. He is hospitalized because of spasmophylia as evidenced tetany. After the
emergency treatment of the child health has improved, convulsions ceased. Determine further
therapeutic tactics
A.
Assign vitamin D in doses of 2000 IU a week supplementation with calcium.
B.
Assign vitamin D in doses of 4000 IU once.
C.
Do not assign vitamin D
D.
Assign vitamin D in doses of 500 IU immediately
E.
* Assign vitamin D in doses of 500 IU a week supplementation with calcium.
The child is 3 months. An objective examination of observed pallor of the skin, excessive
sweating, anxiety, palpation - soft edge of a large fontanel, softening of the occipital bone. What
is the course of the disease?
A.
Subacute
B.
Recurrent
Latent
Limp
* Acute
The child is 3 months. An objective examination has observed pallor of the skin, excessive
sweating, anxiety, palpation - soft edges of a large fontanel, softening of the occipital bone. What
are your recommendations.
A.
nalidixic acid and calcium glycerophosphate
B.
videin-3 in 3 days
C.
ultraviolet irradiation 20 sessions
D.
vitamin D 400 IU per day.
E.
* videin-3 and calcium glycerophosphate
The child is 6 months. Located on breastfeeding, prevention of rickets was made. Fruit and
vegetable products, fruit juice does not get. His mother said that child has anxiety, increased
sweating. An objective examination: severe frontal and parietal tubers, large fontanel has the size
3x4 cm, and its edges are thickened. At the ribs "rosary" are palpated. Severe muscular hypotonia:
"frog belly", the child badly stands with support on his feet. Determine the course of the disease.
A.
Acute
B.
Recurrent
C.
Latent
D.
Limp
E.
* Subacute
The little girl was 7 months. The mother complained of seizures, jittery child, cyanosis, crying.
The attack lasts from 30 seconds to 1 minute. Childbirth is not complicated. Located on the
inadequate artificial feeding. Vegetables, fruits, juices did not receive. An objective examination:
pale, overly well-fed, head of the square shape, ribs "rosary", is not sitting, on the legs is not
supported. Your preliminary diagnosis?
A.
Rickets, severe, acute course, period of the outbreak
B.
Rickets, the moderate severity, residual period
C.
Rickets, acute course, period of convalescence, spasmophylia, eclampsia
D.
De Toni Debre-Fanconi Disease.
E.
* Rickets, severe, subacute course, the crisis period, spasmophylia, laryngospasm
The little girl was 7 months. The mother complained of seizures, jittery child, cyanosis, crying.
The attack lasts from 30 seconds to 1 minute. Childbirth is not complicated. Located on the
misallocation of artificial feeding. Vegetables, fruits, juices did not receive. An objective
examination: pale, overly well-fed, head of the square shape, ribs "rosary", is not sitting, on the
legs is not supported. What laboratory tests are needed for staging the final diagnosis?
A.
Determining the level of phosphorus in the blood.
B.
Complete blood analysis.
C.
Determination of sweat chloride.
D.
Determining the level of vitamin D in the blood.
E.
* Determining the level of calcium in the blood.
Child is 7 months. Observed pallor of the skin, frontal and parietal tubers, ribs "rosary",
"bracelets", "string of pearls", thickening of the large fontanelle edges, increased liver, Harrison's
groove. What course of rickets in this child
A.
Acute
B.
Recurrent
C.
Latent
D.
Limp
E.
* Subacute
The child is 7 months. Observed pallor of the skin, frontal and parietal tuber, rib "rosary",
"bracelets", "string of pearls", thickening of the edges of the large fontanelle, increased liver,
Harrison's groove. The diagnosis: Rickets, moderate severity. Which clinical symptoms indicate
the severity of rickets?
C.
D.
E.
310.
311.
312.
313.
314.
315.
Harrison’s groove
The predominance of osteoid hyperplasia
The predominance of osteomalacia
The age of 7 months
* The presence of osteoid hyperplasia signs simultaneously on the head, hands and trunk.
The child of 8 months is fed exclusively with cow's milk. Locomotor activity is low. He is not
sitting, standing with support. Has Olympic forehead, the ribs “rosary”, “bracelets”, the lower
limbs with O-shaped deformation. Heart tones are deaf. Liver and spleen are increased. Clinical
manifestations correspond to:
A.
Rickets severe, acute course
B.
secondary Rickets, severe, acute course
C.
secondary Rickets, severe, subacute course
D.
Rickets mild, subacute course
E.
* Rickets severe, subacute course
Female 7 month was fed artificially, physical development is satisfactory. During the prolonged
crying suddenly she was covered with sticky sweat, breath has stopped, cyanosis of the face has
developed. After a few seconds - loud inbreath ("cock"-sound), after which the child become
normal. Seen a girl, doctor found signs of rickets. To diagnose disease the most informative
studies are:
A.
Electroencephalogram
B.
Sulkovitch’s test
C.
Blood sugar investigation
D.
Investigation of aminoaciduria
E.
* Investigation of blood calcium
The district pediatrician is examining the healthy full-term baby of 1 month old, who is breastfed.
The prevention of which disease will be recommended first of all?
A.
Paratrofiya
B.
Anemia
C.
Hypotrophy
D.
Spasmophylia
E.
* Rickets
The district pediatrician is examining the child of two months. Mother complaints of periodic
anxiety, increased sweating in the child. Occiput is flattened, bald. The edges of the great
fontanelle are pliable. What is the disease?
A.
Vitamin D-resistant rickets
B.
Phosphate-diabetes
C.
Syndrome De Toni-Debre-Fanconi
D.
Spasmophylia
E.
* Rickets
The district pediatrician is examining the child of two months. Mother complaints of periodic
anxiety, increased sweating in the child. Occiput is flattened, bald. The edges of the great
fontanelle are pliable. What dose of vitamin D3 should be appointed to the child?
A.
5-10 thousand IU / day
B.
20-25 thousand IU / day
C.
10 - 15 thousand IU / day
D.
15-20 thousand IU / day
E.
* 2 - 5 thousand IU / day
Monthly child became restless, with increased sweating of the head. From the history of life: was
born in September. Is fed with cow's milk. Visible craniotabes is seen. Doctor has ordered the
course of UV irradiation. Does the child need ergocalciferol?
A.
No need
B.
In combination with UV-irradiation
C.
Immediately after completion of the course UFO
A.
B.
C.
D.
E.
316.
317.
318.
319.
320.
321.
1 month after completion of the course UFO
* A 2-2,5 months after the end of the course UFO
During the intramuscular injection of DTP vaccine in the clinic for the child at the age of 3
months suddenly had appeared phenomena of laryngism, pale skin, cyanosis of the lips, "cock”
crowing, stop of breathing, tension the entire body with his head thrown back. Allergic child's
history is not complicated. Before inoculation some abnormalities were noted by pediatrician.
What is the most likely diagnosis?
A.
Meningism, clonic-tonic convulsions
B.
Anaphylactic shock, clonic convulsions
C.
Meningoenciphalitic reaction, clonic-tonic convulsions
D.
Bleeding into the brain, tonic convulsions
E.
* Spasmophylia, tonic convulsions
After preventive examination of the child of 1 month, born in September, in gestation age of 38
weeks, and now is breastfed, the doctor has advised to the mother to start vitamin D 500 IU per
day. Would you agree with this recommendation? If not, why not?
A.
No. We have to start the prevention of rickets in 2 months.
B.
No. Prophylactic dose of vitamin D for this child should be 1000 IU, because he was born
premature.
C.
No. When breastfeeding should stop, than further appoint vitamin D, it needs overlap with
mother's milk.
D.
No. Vitamin D is not necessary to appoint, as a child has no signs of rickets.
E.
* Yes. Prophylactic dose of vitamin D doctor has named correctly.
After preventive examination of the child of 1 month, born in September, in gestation age of 35
weeks, and now is breastfed, the doctor has advised to the mother to start vitamin D 500 IU per
day. Would you agree with this recommendation? If not, why not?
A.
Yes. Prophylactic dose of vitamin D doctor has named correctly.
B.
No. We have to start the prevention of rickets in 2 months.
C.
No. When breastfeeding should stop, than further appoint vitamin D, it needs overlap with
mother's milk
D.
No. Vitamin D is not necessary to appoint, as a child has no signs of rickets.
E.
* No. Prophylactic dose of vitamin D for this child should be 1000 IU, because he was
born premature.
A 2,5-month-old child presents with muscle hypotonia, sweating, alopecia of the back of the
head. The child is prescribed massage, curative gymnastics and vitamin D. What is the dosage
and frequency of vitamin D administration?
A.
1000 IU every two days
B.
500 IU daily
C.
500 IU every two days
D.
1000 IU daily
E.
* 3000 IU daily
Child is 7 months. The mum has addressed with the complaints on periodic twitching of a chin,
which strengthens during disturbing, jerk of separate groups of muscles, shudder in dream. How it
is possible to confirm the diagnosis of a spasmophilia for this child?
A.
To do Sulkovitch’s test
B.
To determine a level of potassium in a blood
C.
To determine a level of magnesium in a blood
D.
To click the radical of tongue
E.
* To test Hvostek, Lust signs
Child is 8 months old. His mother says that during dressing the child began to cry, noisy breathing
has appeared, the child become blue, and covered by cold sweet, then was a short-time apnea.
Mother washed his face by cold water, and the boy has noisy inhaled, in some minutes became in
norm, began to play. Deliver the previous diagnosis.
A.
Latent Spasmophylia
D.
E.
322.
323.
324.
325.
326.
327.
Manifestive Spasmophylia, eclampsia
Manifestive Spasmophylia, carpopedal spastic stricture
Ricket
* Manifestive Spasmophylia, laryngospasm
Child is 8 months old. His mother says that during dressing the child began to cry, noisy breathing
has appeared, the child become blue, and covered by cold sweet, then was a short-time apnea.
Mother washed his face by cold water, and the boy has noisy inhaled, in some minutes became in
norm, began to play. What laboratory investigations will confirm the diagnosis of Spasmophylia?
A.
investigation of sodium and potassium in a blood
B.
investigation of magnesium in a blood
C.
Sulkovitch test
D.
glucose tolerant test
E.
* investigation of Ca and Р in a blood
Child of 9 months old has viral infection, cramps, general cyanosis, and loss of consciousness.
Objectively – clonic and tonic convulsions, skin cyanosis, foam on the lips, signs of a Rickets.
Changes in lungs are not detected, as meningeal signs too. What is the first aid?
A.
Vitamin D
B.
Peroral calcium, anticramps drugs
C.
anticramps drugs
D.
Spasmolytics intravenously
E.
* Introducing intravenously calcium and anticramps drugs
District pediatrician examines a healthy carried 1-month-old child. The child is breast-fed.
Prophylaxes of what disease will the doctor recommend to do first of all?
A.
Spasmophylia
B.
Malnutrition
C.
Parathropy
D.
Anemia
E.
* Rickets
During intramuscular DTP vaccination in clinic, a 3-month-old child developed signs of
laryngospasm, paleness of skin, cyanosis of lips, "cock cry", stop of respiration, and tension of the
whole body with overturned backward head. Allergological history of the child is not
complicated. What is the most probable diagnosis?
A.
Cerebral haemorrhage, tonic spasms
B.
Meningoencephalitic reaction, clonic and tonic spasms
C.
Anaphylactic shock, clonic spasms
D.
Meningism, clonic and tonic spasms
E.
* Spasmophilia, tonic spasms
In a medical procedures’ room during injection the 9 months’ old child has screamed, in the shorttime has arisen apnea and skin cyanosis, then pallor, the child was very flabby. Life history: the
child is from І normal pregnancy, artificial feeding by formula from two weeks till 2 months, then
by cow’s milk, porridges from 6 months. He did not receive juices, fruits and vegetables.
Objectively: body temperature is normal, skin is pale, perioral cyanosis, frontal bossing, large
fontanelle is 1х1.5 cm, with infiltrated dense margins, rachitic rosary were found. The child sits
with support, does not stay independently, and has not teeth. What is the diagnosis?
A.
Manifestive form of Spasmophylia.
B.
Hypervitaminosis D.
C.
Latent form of Spasmophylia.
D.
Eclampsia.
E.
* The Rickets ІІ stage, subacute course, the period of progression. The manifistive form of
Spasmophylia.
In the 10 months’ old child on the background of viral infection have appeared repeated cramps.
Objectively - signs of Rickets, 2 stage are present. A level of the blood calcium is 1.6 mmol/l,
interval QT on ECG – 0.33 sec. The child has artificial feeding, without vegetable foods. What
B.
C.
D.
E.
328.
329.
330.
331.
332.
333.
334.
335.
336.
337.
338.
339.
disease has manifested on the phone of viral infection?
A.
Encephalitis
B.
Meningitis
C.
Encephalitic reaction
D.
Neurotoxicosis
E.
* Spasmophylia
In the 11 months’ old child, who has viral infection, have appeared cramps, general cyanosis, loss
of consciousness. (In an anamnesis he received treatment by Videin-3). Objectively – clonic and
tonic convulsions, skin cyanosis, foam on the lips, signs of Rickets. Changes in lungs are not
detected, as meningeal signs too. What is the previous diagnosis?
A.
Spasmophylia, laryngospasm
B.
Neurotoxicosis
C.
Hypervitaminosis D
D.
Meningitis
E.
* Spasmophylia. Eclampsia.
Mother with an infant visited the pediatrician. Her baby was born with body mass of 3,2 kg and
50 cm length. He is 1 year old now. How many teeth the baby should have?
A.
10
B.
20
C.
6
D.
12
E.
*8
Pediatrician has examined 6-month's old child\: the skin is pale, muscular tonus is reduced, frontal
bossing is present, sizes of large fontanelle is 1х1 cm, its’ margins are dense, “rachitic rosary”
were found. The diagnosis is rickets. What course of the disease is possible in this child?
A.
Acute
B.
Chronic
C.
Persistent
D.
Relapsed
E.
* Subacute
The 10 months old child has frontal bossing, “rachitic rosary", “bow legs”, sizes of large
fontanelle is 1.5х2 cm. The vitamin D3 was included in a treatment. What is its’ daily dose?
A.
100-500 IU
B.
1000-2000 IU
C.
5000-10000 IU
D.
10000-20000 IU
E.
* 2000-5000 IU
The 5-months' old girl has general cramps, loss of consciousness. It is known, that last three
weeks the child had receive vitamin D3 in a dose 3000 IU and general ultra violet insolation every
day to treat Rickets. Day before she had a short-time apnea. Objectively - body temperature is
normal signs of the Rickets are present. What can provoke this complication?
A.
Rickets
B.
Hypervitaminosis D
C.
Error in a feed
D.
Polyhypovitaminosis
E.
* Spasmophylia
The child of 10 months on the phone of virus infection has appeared repeated cramps. At the view
- the signs of a rickets of 2 stage. A level of calcium of a blood - 1,6 mmol/l, interval QT on ECG
- 0,33 sec. Artificial feeding, without vegetable foods. What disease was exhibited on the phone
of virus infection?
A.
Encephalitis
B.
Meningitis
C.
Encephalitical reacting
Neurotoxicosis
* Spasmophilia
The doctor has examined the 3-month's child and suspected an initial stage of a rickets. What
changes of muscular system will be present in him?
A.
Hypertonia of muscles
B.
Muscle atrophy
C.
Decrease of muscles forces
D.
Increase of muscles forces
E.
* Hypotonia of muscles
The mother of the 4-month's child has addressed to the doctor with complaints on a decrease of
appetite, regurgitation, subferile temperature in her child. It is known, that from the 2nd month of
life the child receives vitamin D3 in preventive dose /500 IU each day/, from the 3-rd month of
life because of irritability and sweating was prescribed general ultra-violet insolation.
Objectively: large fontanelle is closed, skin with perioral cyanosis. Laboratory investigations:
Sulcovich test is positive (++), serum calcium – 3.5 mmol/l. Name the most probable diagnosis:
A.
Rickets
B.
Spasmophylia
C.
Personal intolerance of vitamin D
D.
Hypovitaminosis D
E.
* Hypervitaminosis D
The pediatrician has examined 1-month's old child, which was born from the І physiological
pregnancy. In 3 weeks of life because of mother’s hypohalactia he start to receive bottle feeding
by cow’s milk in 2:1 dilution. He does not receive the fresh air. What disease should be prevented
first of all?
A.
Anemia
B.
Malnutrition
C.
Spasmophylia
D.
Diarrhea
E.
* Rickets
To the doctor has addressed the mother of the 4-month's child with the complaints to a decrease of
appetite, regurgitation, fervescence subfibrile. It is known, that since 2 month of life the child
with the preventive purpose receives vitamin Д3 /500 IU each day /, since 3-rd month of life in
connection with appearance of disturbing and sweating was intended general ultra-violet. At the
view: large crown closed, skin acyanotic, periorale cyanosis. By results of examination: assay
Sulcovich ++, serumal calcium - 3,5 mmol/l. To call the most probable diagnosis:
A.
Rickets
B.
Spasmophilia
C.
Personal intoleranse of vitamin D
D.
Hypovitaminosis D
E.
* Hypervitaminosis D
10 months’ old girl was treated from otitis, received Penicillin injections. In 4 days diarrhea has
developed. What corrections in treatment are necessary?
A.
stop Penicillin injections.
B.
add bacterial drugs.
C.
stop Penicillin injections, add bacterial drugs.
D.
stop Penicillin injections, to change it for gentamicine, add bacterial drugs.
E.
* stop Penicillin injections, change it for ampicilline, add bacterial drugs.
2-months’ old child with body weight 4,300 was hospitalized to the clinic because of
gastroenteral enzymopathy, isotonic dehydration. What medicine, except rehydration therapy
must be prescribed to this child?
A.
Antibacterial therapy
B.
Immunostimulator
C.
Sorbents
D.
E.
340.
341.
342.
343.
344.
345.
Multivitamins
* Enzymes and bacterial drugs
3.5 months’ old child has lost more than 10% of the body weight. Dehydration features are
following: shock - falling blood pressure with tachycardia, coma, anuria. What type of
dehydration does this child have?
A.
Water deficiency
B.
Mixed
C.
Isotonic.
D.
Data of laboratory examinations are necessary for definition of the dehydration type
E.
* Salt deficiency
3.5 months’ old child is treated from acute bilateral bronchopneumonia complicated by secondary
gastroenteral enzymopathy. What main principles of treatment?
A.
Antibacterial, immunostimulation therapy
B.
Oral rehydration and antibacterial therapy
C.
Massive bacterial therapy
D.
Enzymes without an antibiotic
E.
* Antibacterial, rehydration, bacterial therapy
6-weeks’ old child has a frequent stool, vomits, and draws his legs up to the abdomen. The
biochemical examination of the blood shows hyponatremia, hypokalemia, hypoalbuminemia
mother notes that symptoms have develop after using new food (egg). Put your diagnosis.
A.
pyloric stenosis
B.
peptic ulcer
C.
infectious diarrhea.
D.
Pylorospasm
E.
* functional diarrhea
A 1-year-old child suffers of attack-like cough. The child presents with the history of dyspepsia
since birth. On physical examination there are signs of delay in physical development, bronchial
obstruction, respiratory insufficiency, 1 grade. Blood count: signs of inflammatory process. Sweat
chlorides 120 mEq/L. What is the most likely diagnosis?
A.
Bronchopulmonary dysplasia
B.
Kartagener's syndrome
C.
Acute respiratory infection, bronchitis
D.
Severe bronchial asthma
E.
* Cystic fibrosis
A 1-year-old infant is admitted for failure to thrive. During the neonatal period he had an
exploratory laparotomy for intestinal obstruction. At 3,8 and 11 month of age, he had respiratory
infections diagnosed as bronchitis. Physical examination: weight of 6,8 kg, thin extremities with
very little subcutaneous tissue, and a protuberant abdomen. The essentials diagnostic study in this
child is:
A.
Skin test for milk allergy
B.
Bronchoscopy
C.
Serum immunoglobulin level
D.
Tuberculin skin test
E.
* Sweat electrolytes
A 2 month old full-term child was born with weight 3500 g and was on the mixed feeding.
Current weight is 4900 g. Evaluate the current weight of the child:
A.
Hypotrophy of the II grade
B.
150 g less than necessary
C.
Hypotrophy of the I grade
D.
Paratrophy of the I grade
E.
* Corresponding to the age
A 2 y.o. boy was admitted to the hospital with weight loss, unstable discharges, anorexia,
following the semoli¬na's introduction (since 5 months). The child is adymanic, flabby, pale dry
D.
E.
346.
347.
348.
349.
350.
351.
352.
353.
354.
355.
356.
357.
358.
skin, subcutaneous layer is emaciated. Distended and tensed abdomen, tympanitis on percussion
of the upper part of the abdomen, splashing sounds, feces are foamy, of light color, foul. On
coprocytogram\: a lot of neutral fat. What is the cause of the disease?
A.
Intestinal dysbacteriosis
B.
Mucoviscidosis (cystic fibrosis)
C.
Disaccharidase insufficiency
D.
Chronic enteritis
E.
* Celiakia (celiac disease)
A 6-month-old infant was born with body mass of 3 kg and 50 cm length. He is breast-fed. How
many times per day should the infant is fed?
A.
8
B.
4
C.
6
D.
7
E.
*5
A child was born with body weight 3250 g and body length 52 cm. At the age of 1,5 month the
actual weight is sufficient (4350 g), psychophysical development corresponds with the age. The
child is breast-fed, occasionally there are regurgitations. What is the cause of regurgitations?
A.
Esophageal atresia
B.
Acute gastroenteritis
C.
Pylorospasm
D.
Pylorostenosis
E.
* Aerophagia
A child, 4 years old, has Entheropathogenic Escherichiosis, moderate degree. Prescribe the
pathogenetical treatment.
A.
Pancreatin
B.
Nifuroxasid
C.
Enterol
D.
Sorbit
E.
* Oralit
A child, 5 years old, has dyspeptic syndrome, moderate intoxication syndrome, and abdominal
pain. Salmonellosis was diagnosed. What changes in the general blood test are typical to this
disease?
A.
Leucopenia, aneosinophylia, lymphocytosis.
B.
Leucocytosis, lymphocytosis.
C.
Leucopenia, neutrophyllosis, ESR decreasing.
D.
Leucocytosis, lymphomonocytosis, atypical mononuclear cells.
E.
* Leucocytosis, neuthrophyllosis, ESR increasing.
A mother consulted a pediatrician about her son. Her son was born with body mass of 3 kg and
length of 48 cm. He's 1 year old now. What is the required normal mass?
A.
9,0 kg
B.
15,0 kg
C.
11,0 kg
D.
12,0 kg
E.
* 10,5 kg
A neonate from gestation with severe gestosis of the second half was born on the 41st week with
2400 g birth weight and 50cm long. On physical examination: skin is flaccid, subcutaneous fatty
cellular tissue is thin, muscle hypotonia, new-born period reflexes are decreased. Internal organs
are without pathological changes. How would you estimate this child?
A.
Term infant with normal body weight
B.
Premature infant
C.
Postmature infant
D.
Immature infant
E.
359.
360.
361.
362.
363.
364.
365.
* Term infant with pre-natal growth retardation
In a child, 4 months old, suddenly has increased the temperature to 38.5 ?С. Later has appeared
frequent defecation near 15 times per day. Excrements are yellow-green, liquid consistency, with
mucus. During examination: skin is pale, lips are bright, dry. The child has thirst. Big fontanel is
1.5х1.5 cm, sunken. Breathing is puerile, 42 per 1 minute. Heart tones are loud, rhythmic, 148 per
1 minute. The abdomen is mildly distended, painful. Salmonellas are found in excrements.
Biochemical blood analyses: Nа - 163 mmol/l, K - 5.7 mmol/l. What type of dehydration is
possible?
A.
Isotonic.
B.
Hypotonic.
C.
Salt deficient.
D.
Dehydration is absent.
E.
* Hypertonic.
In a child, 7 years old, dysentery reveals itself by often defecation to 20-25 times per day, skin is
pale, dry, elasticity is reduced, the body temperature is 38.9 ?С, repeated vomiting, colicky pain
are present. What is the severity of the disease in this case
A.
Mild
B.
Moderate
C.
severe
D.
severe degree with prevalence of toxicosis.
E.
* severe degree with prevalence of the local manifestations.
In the 3 months' old child, who is on the breast feeding was diagnosed Malnutrition 2nd degree.
What from this is better to prescribe the child to correct dysbacteriosis?
A.
Festal
B.
Apilac
C.
Ampicillin
D.
Nistatin
E.
* Bifidumbacterin
In the 5 months’ old child signs of water deficiency dehydration were found. What probable dates
of laboratory examinations?
A.
Decrease of hematocrit
B.
Decrease of K, Na, Cl level in the blood, considerable increase of hematocri
C.
Decrease of K, Na, Cl level in the blood
D.
Detection of a bacterial infection
E.
* Increase of potassium level
The 4 months' old child is treated in the hospital because of Malnutrition 3rd degree. What
duration of the parentheral feeding is optimal for this child?
A.
1-2 days
B.
10 days
C.
On whole period of treatment
D.
2-3 weeks.
E.
* 7-14 days
The 7-months' child is treated from alimentary Malnutrition 2nd degree. The weight deficit is
25%. What accompanying disease most often could be present in this child?
A.
Salmonellosis
B.
Sepsis
C.
Spasmophylia
D.
Exudative-catarrhal diathesis
E.
* Rickets
The boy, 3 months old, is treated in infectious department because of Salmonellosis, moderate
degree, caused by Salmonellae typhimurium. Which etiological treatment is reasonable to use?
A.
Benzylpenicillin.
B.
Erythromycin.
Cefazolin.
Oxacillin.
* Cefotaxim.
The boy, 4 years old, complains of abdominal pain, repeated vomiting, increased frequency of
defecation, fluid feces, high body temperature – 38 ?С. He is ill for 4 days. Parents did not
address to physician before. The patient received Ampicillin in tablets. Because of poor condition
(the appearing of blood in feces) he entered to infectious department. The skin is pale tongue is
covered by white stratification. The abdomen is distended, mildly painful. The feces are greengray, with mucus, blood. Salmonellosis is suspected. What investigation will confirm the
diagnosis?
A.
General blood test.
B.
Bacteriological examination of cerebrospinal fluid.
C.
Fat drop.
D.
Bacteriological investigation of pharyngeal swab.
E.
* Bacteriological examination of the feces on dysentery, typhoid, paratyphoid fever.
The child 4 months old has expressed thinning of the subcutaneous cellulose. The thickness of the
pleat near the umbilicus is 0.4 cm. The child is flaccid, hypodynamic, shouted weakly, the body
temperature is reduced, his face is wrinkled. Malnutrition 3rd degree was diagnosed. What weight
deficit is typical for this degree of malnutrition
A.
21-30%
B.
10-20%
C.
10-30%
D.
5-25%.
E.
* 40-50%
The child 5 months' old, has entered to the clinic with Malnutrition 1st degree. The diet was
prescribed to him. What duration of the food tolerance determination period in this case?
A.
1-2 weeks
B.
2-3 weeks
C.
7-14 days
D.
3-4 weeks
E.
* 1-3 days
The child 6 months' old suffers from alimentary Malnutrition 2nd degree, period of recovery. He
is on the step of optimum feeding. At calculation of the feeding has appeared the deficit of the
protein part of ration. How to correct the protein deficit?
A.
By the Porridge
B.
By the Vegetable puree
C.
By the Yoghurt
D.
By the Fruit juice
E.
* By the pot cheese
The Child has entered to clinic with complaints on anxiety, increased appetite, metheorism. Under
objective examination thinning of the subcutaneous tissue on the abdomen and trunk was
revealed. The weight deficit is 22%. Malnutrition 2nd degree was diagnosed. What part from
necessary volume of the food is necessary to give the child during the first week?
A.
Full volume of the food
B.
3/4 of the necessary volume
C.
1/3 of the necessary volume
D.
2/3 of the necessary volume
E.
* Half of the necessary volume
The child is 6 months. His birth weight is 3 kg, now his weight is 6.800 kg (weight deficit *
13%) This corresponds:
A.
The variant of the rate
B.
Malnutrition 2nd degree
C.
Malnutrition 3rd degree
C.
D.
E.
366.
367.
368.
369.
370.
371.
Paratrophia, 1st degree
* Malnutrition 1st degree
The child was born prematurely, with body weight 2.200 kg (in 33-34 weeks of gestation). The
trophyc index (TI) is 0. Such value of TI is typical for:
A.
Prenatal Malnutrition 1st degree
B.
Prenatal Malnutrition 2nd degree
C.
Prenatal Malnutrition 3rd degree
D.
Paratrophya
E.
* Normotrophya
The Child, 2 years old, is treated because of Entheroinvasive Escherichiosis. Prescribe the
ethiothrope treatment.
A.
Nifuroxasid
B.
Pancreatin
C.
Enterol
D.
Enterodes
E.
* Ampicillin
The child, 3 years old, is treated in infectious department because of acute Shigellosis. During
objective examination: the body temperature is 39.9 ?С, skin is pale, dry, periodic tonic twitches
of the muscles, limbs are cool, abdomen is sealled, sensitive in left inguinal region, anus is open.
Name the diagnose.
A.
Shigellosis typical form, moderate degree.
B.
Shigellosis, atypical form.
C.
Shigellosis typical form, severe degree.
D.
Shigellosis typical form, severe degree with prevalence of the local manifestations.
E.
* Shigellosis typical form, severe degree with prevalence of toxicosis.
The child, 7 months old, is treated in infectious department because of Salmonellosis,
gastrointestinal form, moderate gravity, toxicosis with exicosis II degree, caused Salmonellae
enteritidis. What percent of weight loss is probable in this case?
A.
1-3 %.
B.
3-6 %.
C.
Less than 5 %.
D.
10-15 %.
E.
* 5-10 %.
The mother of 3-months' old girl has addressed to district pediatrician with complaints on anxiety
of the child, small interval between feedings less than 3.5-hours. Objectively\: thinning of the
subcutaneous fat on the abdomen and trunk. The malnutrition 2nd degree was diagnosed. What
weight deficit is characterized for this degree of malnutrition?
A.
10-20%
B.
30-40%
C.
40 % and more
D.
5-10%
E.
* 20-30%
To study physical development of children and adolescents, anthropometric investigations are
widely used. Choose a physiometric method of investigation from the below given.
A.
Determination of thorax form
B.
Determination of vertebra form
C.
Determination of body weight
D.
Measurement of growth
E.
* Determination of vital capacity of lungs
15 y.o. female was admitted to thoracic surgery department with fever up to 40°C, onset of pain
in the side caused by deep breathing, cough with considerable quantity of purulent sputum and
blood with bad smell. What is the most likely diagnosis?
A.
Complication of liver echinococcosis
D.
E.
372.
373.
374.
375.
376.
377.
378.
Pulmonary tuberculosis
Actinomycosis of lungs
Bronchiectatic disease
* Abscess of the lung
2 years old child has dry cough, dyspnea, body temperature is 37.5 °C. Percussion: clear
pulmonary sound without dullness. Auscultation: dry whistling and different moist rales. In the
peripheral blood: leukocytosis, eosynophylia, increased ESR. What disease is possible?
A.
Acute simple bronchitis
B.
Whooping cough
C.
Acute pneumonia
D.
Bronchial asthma
E.
* Obstructive bronchitis
A 1-year-old child suffers of attack-like cough. The child presents with the history of dyspepsia
since birth. On physical examination there are signs of delay in physical development, bronchial
obstruction, respiratory insufficiency, 1 grade. Blood count\: signs of inflammatory process.
Sweat chlorides 120 mEq/L. What is the most likely diagnosis?
A.
Bronchopulmonary dysplasia
B.
Kartagener's syndrome
C.
Acute respiratory infection, bronchitis
D.
Severe bronchial asthma
E.
* Cystic fibrosis
A 1-year-old infant is admitted for failure to thrive. During the neonatal period he had an
exploratory laparotomy for intestinal obstruction. At 3,8 and 11 month of age, he had respiratory
infections diagnosed as bronchitis. Physical examination: weight of 6,8 kg, thin extremities with
very little subcutaneous tissue, and a protuberant abdomen. The essentials diagnostic study in this
child is:
A.
Skin test for milk allergy
B.
Bronchoscopy
C.
Serum immunoglobulin level
D.
Tuberculin skin test
E.
* Sweat electrolytes
A 1,5-year-old child has following symptoms: chronic cough with purulent sputum discharge.
Dyspnea, physical retardation, large amount of stool. Sweat chloride isl50 mEq/L. The child has
been ill since 2 month age. Diagnosis: cystic fibrosis. What is the most suitable therapy?
A.
Vitamins + mucolytics
B.
H2-blockers + hepatoprotectors
C.
Cholepoietic+adaptogenetic medicines
D.
Vitamins+antibiotics
E.
* Enzymes + antibiotics
A 10-year-old boy complains of a headache, weakness, fever [temperature — 40° C], vomiting.
On physical examination: there is an expressed dyspnea, pale skin with a flush on a right cheek,
right hemithorax respiratory movement delays, dullness on percussion of the lower lobe of the
right lung, weakness of vesicular respiration in this region. The abdomen is painless and soft by
palpation. What disease causes these symptoms and signs?
A.
Intestinal infection
B.
Acute appendicitis
C.
Acute cholecystitis
D.
Influenza
E.
* Pneumonia croupousa
A 10-year-old boy has a history of recurrent pneumonias and chronic cough production of foul
smell, purulent sputum, ocassionally gloom tinged, which becomes worse in the morning and in
reclining position. On physical examination, it is a chronic patient with clubbing of fingers, wet
inspiratory tract at the root of lungs from behind. What is the most probable diagnosis?
B.
C.
D.
E.
379.
380.
381.
382.
383.
384.
Disseminated pulmonary tuberculosis
Pulmonary neoplasm
Chronic bronchitis
Chronic obstructive emphysema
* Bronchoectasis
A 14-year-old patient has been treated in a hospital. A fever of 39°C, chest pain which is
worsened by breathing, cough, brownish sputum appeared on the 7th day of the treatment. Chest
X-ray shows left lower lobe infiltrate. Which of the following is the treatment of choice for this
patient?
A.
Erythromycin
B.
Streptomycin
C.
Penicillin
D.
Tetracycline
E.
* Cephalosporins of the III generation
A 16-year-old male was admitted to the hospital complaining of stabbing back pain on inspiration
and dyspnea. On exam, t - 37°C, Ps 92/min, RR of 24/min, vesicular breath sounds. There is a
dry, grating, low-pitched sound heard in both expiration and inspiration in the left lower lateral
part of the chest. What is the most likely diagnosis?
A.
Acute bronchitis
B.
Pneumonia
C.
Pneumothorax
D.
Myocarditis
E.
* Acute fibrinous pleuritis
A 16-year-old male was discharged from the hospital after having an out-of-hospital pneumonia.
He has no complaints. On physical xam: his temperature is — 36,6°C, RR-18/min, Ps — 78 bpm,
BP — 120/80 mm Hg. During ausculation there is harsh respiration to the right of the lower part
of the lung. Roentgenologically: infiltrative changes are absent, intensification of the pulmonary
picture to the right in the lower lobe. How long should the doctor keep the patient under
observation?
A.
1 month
B.
3 months
C.
Permanently
D.
6 months
E.
* 12 months
A 3 month old infant suffering from acute segmental pneumonia has dyspnea (respiration rate - 80
per minute), paradoxical breathing, tachycardia, total cyanosis. Respiration / pulse ratio is 1:2.
The heart dullness under normal size. Such signs characterise:
A.
Congenital heart malformation
B.
Myocarditis
C.
Respiratory failure of II degree
D.
Respiratory failure of I degree
E.
* Respiratory failure of III degree
?A 3 year old child with weight defficiency suffers from permanent moist cough. In history there
are some pneumonias with obstruction. On examination: distended chest, dullness on percussion
over the lower parts of lungs. On auscultation: a great number of different rales. Level of sweat
chloride is 80 millimol/l. What is the most probable diagnosis?
A.
Pulmonary hypoplasia
B.
Recurrent bronchitis
C.
Bronchial asthma
D.
Bronchiectasis
E.
* Mucoviscidosis (cystic fibrosis)
A 3-month-old infant who is suffering from acute segmental pneumonia reveals dyspnea,
respiration rate is 80 per minute, paradoxical breathing, tachicardia, total cyanosis. RespirationA.
B.
C.
D.
E.
385.
386.
387.
388.
389.
390.
391.
392.
393.
394.
395.
396.
pulse ratio is 1:2. The heart size is normal. What are these signs indicative for?
A.
Congenital heart disease
B.
Respiratory failure of I degree
C.
Respiratory failure of II degree
D.
Myocarditis
E.
* Respiratory failure of III degree
A 5-year-old girl with the transitory immunodeficiency according to T-system has a clinical
picture of a right-sided pneumonia during 2 months. How pneumonia progress can be described?
A.
Acute
B.
Reactivating
C.
Chronic
D.
Wavelike
E.
* Delaying
A 6 year old girl has an acute onset of fever up to 39oC with chills, cough, and pain on respiration
in the right side of her chest. On physical examination: HR - 120/min, BP- 85/45 mm Hg, RR36/min. There is dullness over the right lung on percussion. On X-ray: infiltrate in the right
middle lobe of the lung. What is the diagnosis?
A.
Community-acquired lobar pneumonia of moderate severity
B.
Acute pleuritis
C.
Acute lung abscess
D.
Nosocomial lobar pneumonia
E.
* Community-acquired bronchopneumonia
A boy, 8 years old, has addressed to pediatrician with complains of increasing of the body
temperature to 37.5 ?С, sore throat, cough, serous discharge from nose, tearing. During
examination mild hyperemia and edema of the tonsils and back pharyngeal wall, conjunctives,
narrowing of ocular slots were revealed. The physician suspects adenoviral infection. Which
method of express-diagnostics is better to use for acknowledgement of the diagnosis?
A.
The separation of the virus on tissue culture
B.
Serological investigation
C.
bacteriological investigation
D.
Bacteriosсopy investigation of pharyngeal swab
E.
* Immunofluorescent method
A child was born at 34 weeks of gestation in bad condition. The cardinal symptoms show
respiratoty disorders: sound prolonged expiration, additional muscles taking part in breathing,
crepitation rales on the background of the rough breath sounds. Assesment according to
Silverman's scale was 0, in 3 hours- 6 with presence of clinical data. What diagnostic method can
determine pneumopathy's type in the child?
A.
Immunologic investigation
B.
Blood gases
C.
Proteinogram
D.
Blood test
E.
* Chest X-ray
A patient with nosocomial pneumonia presents signs of collapse. Which of the following
pneumonia complications is most likely to be accompanied by collapse?
A.
Exudative pleuritis
B.
Bronchial obstruction
C.
Toxic hepatitis
D.
Emphysema
E.
* Septic shock
An 18-month-old child is taken to hospital on the 4-th day of the disease. The disease began
acutely with temperature 39 °C, weakness, cough, reastlessness. He is pale has cyanosis, febrile
temperature for more than 3 days. There are crepitative fine bubbling rales at the auscultation.
Percussion sound is shortened in right under scapula area. X-ray picture: unhomogenous
397.
398.
399.
400.
401.
segmental infiltration 8-10 in the right, the increase of vascular picture, unstructural rools. What is
the most likely diagnosis?
A.
Bronchitis
B.
Bronchiolitis
C.
Interstitial pneumonia
D.
Influenza
E.
* Segmental pneumonia
In the anamnesis of a 2-year-old girl there are recurrent pneumonias with signs of obstruction.
There are heterogeneous moist and dry rales, respiration is weakened. Dense, viscous secretion is
difficult to hawk. There are "drumsticks", physical retardation. What is the most probable
diagnosis?
A.
Pulmonary tuberculosis
B.
Bronchial asthma
C.
Recidivating bronchitis
D.
Congenital pulmonary polycystosi
E.
* Cystic fibrosis, pulmonary form
In the child, 7 years old, disease has acute beginning, with increasing of the body temperature to
39 ?С. Objectively: hyperemia of the face, injection of sclera vessels, moderate cyanosis of the
lips. During examination of the oral cavity exists maculous exanthema on soft palate, groiness of
the back pharyngeal wall. The skin is clean, pale tachycardia is present. What disease is most
probable in this case?
A.
Measles.
B.
Typhoid fever.
C.
Hemorrhagic fever.
D.
Parainfluenza.
E.
* Influenza.
In the infectious hospital has admitted 5 years old girl with pharyngoconjunctivitis phenomena.
The physician has suspect adenoviral infection. What method from express-diagnostics is
reasonable to use to prove this diagnosis?
A.
Binding complement reaction
B.
Indirect hemaglutination reaction
C.
neutralization reaction
D.
Direct hemaglutination reaction
E.
* The fluorescence antibody method
Pediatrician was called to the 2-years old child who’s mother complaints of a subfebrile
temperature, rhinitis, dry cough. He is ill for 3 days. During percussion: a clear pulmonary sound
without dullness. During auscultation\: puerile breathing. Laboratory findings: leukopenia,
lymphocytosis, increased ESR. What disease is possible first of all?
A.
Acute obstructive bronchitis
B.
Acute bronchopneumonia
C.
Resedive bronchitis
D.
Acute bronchitis
E.
* Acute tracheitis
The 5-months' old child has subfibrile temperature, paroxysmal cough, and dyspnea. He is
hospitalized. 3 days ago he was in a contact with sister ill on acute upper respiratory tract viral
infection. Objectively: the condition is severe skin is cyanotic, considerable expiration dyspnea,
oral crepitation. Percussion: dull sound. Auscultation\: a plenty of wet rales in both sides,
respiratory rate is 80 per 1 minute. What disease is possible?
A.
Bronchial asthma
B.
Aspiration of a foreign body
C.
Acute bronchitis
D.
Acute pneumonia
E.
* Bronchiolitis
402.
403.
404.
405.
406.
407.
408.
The 5-years old child has obstructive bronchitis. What drugs will be used as a base therapy?
A.
Antibiotics
B.
Antiallergic medicine
C.
Mucolytics
D.
Hormons
E.
* Broncholytics
The 7-years’ old child was hospitalized with complaints on wet cough. His condition has
worsened 10 days ago. He is ill during last 4 years: viral infections 3-4 times per year are
accompanied by bronchitis. Objectively: cough with slimy sputum. Percussion: a clear pulmonary
sound. Auscultation: rough breathing, nonconstant single diffuse wet rales. X-ray: lung figure is
increased, roots are nonstructural. What disease is possible in this case?
A.
Viral infection
B.
Acute bronchitis
C.
Acute pneumonia
D.
Chronic pneumonia
E.
* Relapsed bronchitis.
The 9-month's ols child was hospitalized because of severe condition. Diagnose - bronchiolitis.
What from this tells us about the severity?
A.
Neurotoxicosis
B.
Heart failure
C.
Suprarenal failure
D.
Exicosis
E.
* Respiratory failure
The boy is 8 years old. He complains of headache, increasing of the body temperature to 39 ?С,
and general weakness. The diagnosis is: influenza, typical form, hard degree. How long bed
regimen must be prescribed?
A.
3 days
B.
5 days
C.
14 days
D.
18 days
E.
* 7 days
Head circumference of a 1-month-old boy with signs of excitement is 37 cm, prefontanel is 2x2
cm large. After feeding the child regurgitates small portions of milk; stool is normal in its volume
and composition. Muscle tone is within norm. What is the most likely diagnosis?
A.
Meningitis
B.
Pylorostenosis
C.
*Pylorospasm
D.
Microcephaly
E.
Craniostenosis
A 16-year-old patient complains about skin rash that appeared 2 days ago after eating smoked
fish. The rash disappears after 4-6 hours but then turns up again. It is accompanied by itch.
Objectively: trunk and upper limbs are covered with multiple pink blisters as big as a pea or a
bean. What is the most likely diagnosis?
A.
Allergic dermatitis
B.
Toxicodermia
C.
*Acute urticaria
D.
Quincke's edema
E.
Purigo
Examination of a 9-month-old girl revealed skin pallor, cyanosis during excitement.
Percussion revealed transverse dilatation of cardiac borders. Auscultation revealed continuous
systolic murmur on the left from the breastbone in the 3-4 intercostal space. This murmur is
conducted above the whole cardiac region to the back. What congenital cardiac pathology can be
suspected?
Coarctation of aorta
Pulmonary artery stenosis
*Defect of interventricular septum
Fallot's tetrad
Defect of interatrial septum
130 A child was taken to a hospital with focal changes in the skin folds. The child was anxious
during examination, examination revealed dry skin with solitary papulous elements and illdefined lichenification zones. Skin eruption was accompanied by strong itch. The child
usually feels better in summer, his condition is getting worse in winter. The child has been
artificially fed since he was 2 months old. He has a history of exudative diathesis. Grandmother
by his mother's side has bronchial asthma. What is the most likely diagnosis?
A.
Urticaria
B.
Contact dermatitis
C.
*Atopic dermatitis
D.
Seborrheal eczema
E.
Strophulus
A 6-year-old boy was brought to the emergency room with a 3-hour history of fever up to 39,5oC
and sore throat. The child looks alert, anxious and has a mild inspiratory stridor. You should
immediately:
A.
* Prepare to establish an airway
B.
Obtain an arterial blood gas and start an IV line
C.
Order a chest x-ray and lateral view of the neck
D.
Admit the child and place him in a mist tent
E.
Examine the throat and obtain a culture
A 10-year-old girl was admitted to a hospital with carditis presentations. It is known from the
anamnesis that two weeks ago she had exacerbation of chronic tonsillitis. What is the most
likely etiological factor in this case?
A.
Staphylococcus
B.
Proteus
C.
Klebsiella
D.
Pneumococcus
E.
*Streptococcus
An 11-year old girl was taken by an acute disease: she got pain in the lumbar region, nausea,
vomiting, frequent urination, body temperature 39oC. Objectively: the abdomen is soft, painful on
palpation in the lumbar region. Common urine analysis revealed considerable leukocyturia,
bacteriuria. The urine contained colibacilli. What is the most likely diagnosis?
A.
Acute vulvovaginitis
B.
Acute appendicitis
C.
Acute glomerulonephritis
D.
Chronic glomerulonephritis
E.
*Acute pyelonephritis
An infant was born with body mass 3 kg and body length 50 cm. Now he is 3 years old. His
brother is 7 years old, suffers from rheumatic fever. Mother asked the doctor for a cardiac check
up of the 3-year-old son. Where is the left relative heart border located?
A.
1 cm left from he left parasternal line
B.
1 cm right from the left medioclavicular line
C.
*1 cm left from the left medioclavicular line
D.
Along the left medioclavicular line
E.
1 cm right from the left parasternal line
During examination at a military commissariat a 15-year-old teenager was found to have interval
systolic murmur on the cardiac apex, diastolic shock above the pulmonary artery, tachycardia.
Which of the supplemental examination methods will be the most informative for the diagnosis
specification?
A.
B.
C.
D.
E.
409.
410.
411.
412.
413.
414.
Roengenography
Phonocardiography
Electrocardigraphy
Rheography
*Echocardiography
A 10-year-old girl consulted a doctor about thirst, frequent urination, weight loss. She has been
observing these symptoms for about a month. Objectively: no pathology of internal organs was
revealed. What laboratory analysis should be carried out in the first place?
A.
Glucose tolerance test
B.
Glucosuric profile
C.
Glucose in urine test on the base of daily diuresis
D.
*Blood glucose analysis on an empty stomach
E.
Acetone in urine test
On the third day of disease a 10 years old child with acute respiratory infection developed
productive cough. The percussion is without pathologic features. The auscultation reveals
bilateral rales over the lung surface. What diagnosis should be made?
A.
*acute bronchitis
B.
relapsing bronchitis
C.
obstructive bronchitis
D.
Asthma
E.
Pneumonia
An infant aged 1 year on the third day of common cold at night developed inspiratory stridor,
hoarse voice and barking cough. Physical examination revealed suprasternal and intercostal
chest retractions. There is a bluish skin discoloration moistly seen over the upper lip. The
respiratory rate is 52 per min and pulse rate 122 per min. The body temperature is 37,50C. What
disease does the infant have?
A.
*Acute infectious croup due to viral laryngotracheitis grade II of airway obstruction,
incomplete compensation state
B.
Acute laryngitis
C.
Bronchopneumonia without complications
D.
Acute bronchiolitis with respiratory distress
E.
Acute epiglottitis
One week old male infant had one episode of vomiting yesterday and 2 episodes of spitting up
with poor feeding today. There is no history of fever, diarrhea or coughing. His urine output is
decreased. He was born at term weight 3.2 kg. Weight now is 3.0 kg. Laboratory data: Na 128
mmol/l, K 6.9mmol/l. What is the most probable diagnosis?
A.
*Salt wasting form of adrenal insufficiency
B.
Gastroenterocolitis
C.
Birth trauma of central nervous system
D.
Pylorospasm
E.
Pylorostenosis
The boy is 10 years old. Two weeks ago he suffered from acute tonsillitis. Now he complains on
common weakness, oedema of eyelids, ankle joints, headache, nausea. Skin is pale, appetite is
reduced, daily diuresis is 600 ml. In urinalysis: protein – 0,066 g/l, WBC – 4-6, RBC – 40-45.
The most probable diagnosis is?
A.
*Glomerulonephritis with nephritic syndrome
B.
Interstitial nephritis
C.
Pyelonephritis
D.
Glomerulonephritis with nephrotic syndrome
E.
Polycystic kidney disease
4300-g infant was born at term gestation to a poorly controlled insulin-dependent diabetic mother.
Initially, the infant did well, but at 2 hours of age he was noted to be lethargic and than develop
tonic-clonic seizures. Blood glucose is 1.6 mmol/l. What is the most likely reason of seizures?
A.
B.
C.
D.
E.
415.
416.
417.
418.
419.
420.
A.
B.
C.
D.
E.
421.
422.
423.
424.
425.
426.
*hypoglycemia
hypocalcemia
hypomagnesemia
hyponatremia
pyridoxine deficiency
Boy is 2 months old. He was born in September. Не is on breast feeding. What should a daily
doze of ergocalciferol be for prophylaxis of rickets?
A.
*400-500 IU
B.
200-300 IU
C.
300-400 IU
D.
500-600 IU
E.
100-200 IU
A 7 year old male presents to physician with the chief complaint of dark "cola colored" urine,
facial puffiness and abdominal pain for the past 2 days. 14 days ago he had a sore throat and
fever. He has had abdominal pain. His urine is dark. Urine analysis shows an increased specific
gravity, RBCs are too numerous to count. What is the most probable diagnosis?
A.
*Glomerulonephritis. Nephritic Syndrome
B.
Glomerulonephritis. Nephrotic Syndrome
C.
Acute heart failure
D.
Acute infection of urinary tract
E.
Hemolytic uremic syndrome
A 4 year old female has been limping with swelling of her right knee for several months. Physical
examination demonstrates swelling of her right knee, flexion contracture of 10 degrees and
flexion to 120 degrees. Lab. data: WBC 8 g/l, with 45\% neutr., 47 lymphs\%, 8\% mon. Hgb 120
g/l. ESR 20mm/h. Rheum. factor neg., ANA 1:640 speckled. What is the most probable
diagnosis?
A.
*Juvenile Rheumatoid Arthritis
B.
Rheumatism
C.
Lupus
D.
Osteomyelitis
E.
Infection Arthritis
Mother of a previously healthy 4 year old male complains of cough and wheeze. Boy had playing
with a small toy. During examination the right side of a chest show hyperresonance, diminished
vocal resonance and poor air entry. What is the most probable diagnosis?
A.
*Foreign body aspiration
B.
Asthma
C.
Pneumonia
D.
Bronchitis
E.
Bronchiolitis
1 month old female presents to the intensive care unit with severe cyanosis, congestive heart
failure, normal first sound, single second sound and an insignificant one to two ejection systolic
murmur. The electrocardiogram shows right axis deviation and right ventricular hyperthrophy.
The thoracic roentgenogram shows cardiomegaly with narrow base and plethoric lung fields.
What is the most probable diagnosis?
A.
*Congenital heart disease, right to left shunt
B.
Congenital heart disease, left to right shunt
C.
Pneumonia
D.
Congenital lung malformation
E.
Bronchiolitis
16 month old female presents with an acute onset of her hands and feet "drawing up. Both her
hands are flexed at the wrists with hyperextended fingers at the proximal and distal
interphalangeal joints and flexion at the metacarpophalangeal joints. Neurologic exam reveals
symmetric hyperreflexia, decreased muscle strength and tone. Lab.data: Ca 0,9 mmol/l, P 0.4
427.
428.
429.
430.
431.
432.
433.
mmol/l. What is the most probable diagnosis?
A.
*Vitamin D deficiency, spasmophylia
B.
Epilepsy
C.
Acute infection of central nervous system
D.
DiGeorge syndrome
E.
Glycogenosis
Child is 2 months old. He is premature infant. What should a daily doze of ergocalciferol be for
prophylaxis of rickets?
A.
*1000-1200 IU
B.
800-1000 IU
C.
1200-1500 IU
D.
400-500 IU
E.
1300-1500 IU
Girl is 4 months old. She was born in October. She is on breast feeding. To what age should
prophylaxis of rickets carry out?
A.
*1,5 years
B.
2 years
C.
2,5 years
D.
1 year
E.
6 months
Boy is 4 months old. Не is on breast feeding. Determine a remedy for primary prophylaxis of
spasmophilia.
A.
*Ergocalciferol
B.
Calcium gluconate
C.
Calcium chloride
D.
Natrium chloride
E.
Calcium pantothenate
Child is 3 months old. At investigation in a polyclinic rickets was diagnosed. The basic process
characteristic for rickets is infringement of a metabolism.
A.
*Calcium and phosphorus
B.
Calcium and potassium
C.
Calcium and magnesium
D.
Calcium and sodium
E.
Calcium and zinc A
The child is 7 months old. He suffers from spasmophilia. What infringement of a kind of an
exchange is a pathogenic part at spasmophilia?
A.
*Phosphoric-calcic
B.
Phosphoric-potassic
C.
Phosphoric-sodium
D.
Phosphoric-magnesion
E.
Phosphoric-zinc
A 6-year-old boy with asthma has had mild wheezing only four times since you began treating
him 3 months ago with Cromolyn inhalation twice each day. For the past 2 days, he has again had
mild coughing and wheezing. What should you recommend to treat acute attack of asthma?
A.
*inhalation Salbutamol
B.
inhalation corticosteroids
C.
Loratadine
D.
Aspirin
E.
Theophylline
Full term newborn has developed jaundice at 10 hours of age. Hemolytic disease of newborn due
to Rh-incompatibility was diagnosed. 2 hours later the infant has indirect serum bilirubin level
increasing 14 mmol/L. What is most appropriate for treatment hyperbilirubinemia in this infant?
A.
*exchange blood transfusion
phototherapy
phenobarbital
intestinal sorbents
infusion therapy
7 -year-old boy with chronic cinusitis and reccurent pulmonary infections has chest a x-ray
demonstrating a right-sided cardiac silhouette. What is the most likely diagnosis?
A.
*Kartagener syndrome
B.
cystic fibrosis
C.
bronhiolitis obliterans
D.
laryngotracheomalacia
E.
antitrypsin deficiency
Parents of 3-year-old girl complain of rectal prolapse and failure to gain weight in spite of a good
appetite. Patient has a history of recurrent prolonged respiratory infections and frequent, bulky,
greasy stools. Sweet chloride is 126 mmol/l. What is the diagnosis?
A.
*cystic fibrosis
B.
antitrypsin deficiency
C.
Kartagener syndrome
D.
celiac disease
E.
Hirschprung’s disease
2-year-old previously healthy boy had eaten peanuts and suddenly presents with an acute onset of
cough, choking, and respiratory distress. Physical examination reveals a RR of 45 and wheezing,
body temperature is normal. There is no history of asthma or allergic reactions, and no one at
home is ill. What is the most likely diagnosis?
A.
*foreign body aspiration
B.
acute bronchiolitis
C.
attack of asthma
D.
acute laryngitis
E.
angioedema
A 6-year-old girl has had a dry cough without sputum for 2 months. The cough is getting worse
after exercises and at night. Family history revealed that the parents have eczema. On physical
examination, you hear a wheeze in both lung fields. She has none of the signs of chronic lung
disease. What is the most likely diagnosis?
A.
*bronchial asthma
B.
pertussis
C.
foreign body aspiration
D.
bronchiectasis
E.
interstitial pneumonia
A 3 month child has vomiting, poor feeding, fever up to 38°C for the 2 days. His stool is
frequent, with slime. Infant has lost 250 g of weight. He is pale, mucous are dry, fontanel is
“fallen”, turgor is reduced, the abdomen is moderately inflated. The diagnosis of enterocolitis was
made, dehydratation of 2nd degree. What solution is necessary to prescribe for rehydratation?
A.
*Rehydron
B.
5 % glucose solution
C.
Boiled water
D.
Tea
E.
Broth of a camomile (medical)
The girl is 3 years old. She has admitted to hospital with the parents’ complaint on poorly
walking. The excessive development of shoulder muscles is noticed, the lower extremities are
poor developed, muscle hypotonia. The borders of relative heart dullness are extended to the left
on 2 cm. There is systolic murmur in 2nd intercostal interspace on the right side of the sternum.
Blood pressure on arms – 100/70, on legs – 40/20. Which diagnosis could be suspected?
A.
*Coarctation of aorta
B.
Ventricle septal defect
B.
C.
D.
E.
434.
435.
436.
437.
438.
439.
Atrium septal defect
Tetralogy of Fallot
myocarditis
A mother consults her 3 years old daughter by pediatrician. The child complains of hoarse voice,
barking cough, laboured breathing with difficult inspiration. The infectious croup due to acute
laryngitis is diagnosed. What anatomical feature predisposes a child to laryngeal stridor?
A.
*Narrow vocal slit
B.
Wide laryngeal lumen
C.
Watering-pot form of the larynx
D.
Poor vascularization of the mucous membrane
E.
Diaphragmatic type of respiration
The child is 3 months old. He has admitted to hospital to diagnose the reason for cardiac murmur.
Complaints of parents: low weight gain, attacks of dyspnoea and cyanosis which amplify at a
physical load. Systolic murmur in 3rd intercostal interspace on the left side, systolic murmur
under 2nd intercostals interspace on the right side of the sternum, hypertrophia of right ventricle.
What diagnosis should be suspected?
A.
*Tetralogy of Fallot
B.
infectious endocarditis
C.
ventricular septal defect
D.
hypertrophyc cardiomyopathy
E.
atrial septal defect
The child aged 12 yr complains of slight fever up to 38.00C, knee joints pain, a day before ankle
pain, tenderness in active and passive movements, common weakness and cardiac pain. It is
known he was ill with acute tonsillitis two weeks ago. Physical examination reveals left heart
border external shift, non frequent cardiac premature bites. What disease should be suspected?
A.
*Rheumatic fever
B.
Now-rheumatic carditis
C.
Rheumatoid arthritis.
D.
Systemic lupus erythematosus
E.
Reactive arthritis
8 years old girl had had a rheumatic fever manifested with chorea and carditis 6 months ago.
She was treated in-patient department within 1,5 months. Now she is under long term observation
by the rheumocardiologist in children out-patient department. The prevention therapy of
rheumatic fever relapse foresees:
A.
*The administration of bicillin-5 every month during 5 years
B.
The administration of bicillin-5 every month during a year
C.
The administration of bicillin-5 every month during 3 years
D.
The administration of bicillin-3 every month during a year
E.
The administration of bicillin-3 every month during 3 years
2 years old child has simple dyspepsia with nausea and vomiting. There are not signs of
dehydration. he prevention of pathological fluid losses consists in the following administration:
A.
*Oral rehydration solution (ORS)
B.
Intravenous infusion 5\% glucose in water solution
C.
Starvation during 12 hours
D.
Antibacterial therapy
E.
Gastric lavage
The child aged 12 yr complains of cramping pain in the right hypochondrium which is easily
controlled with antyspasmotic preparations. During attacks nausea and less often vomiting
occur. Palpation of the abdomen reveals tenderness in the gallbladder projection point. The liver
is not enlarged. What additional method of clinical investigation is the most informative in this
case?
A.
*Ultrasound examination
B.
Esophagogastroduedenoendoscopy
C.
D.
E.
440.
441.
442.
443.
444.
445.
CBC (complete blood count)
X-Ray upper Gastrointestinal (GI) series
Coprologic examination
A 11 month female has poor appetite, stool with plenty of faeces, periodically vomiting after
introduction of solid food during last months. Temperature is normal. Bodyweight is 7 kg. On
physical exam there are pale, oedema on legs, enlargement of abdomen. Coprogram shows a lot
of greasy acids. The diagnosis of celiac disease was made, the aglutenic diet was prescribed.
What is necessary to exclude from child diet?
A.
*Cereals
B.
Milk products
C.
Meat
D.
Egg
E.
Easy absorbed carbohydrates
A 2 year boy has subfebrile temperature, dry, persistent, prolonged, attacked cough, frequent
breathing with hindered exhalation. The breathing under auscultation is harsh, there are diffuse
dry sibilant rales. X-ray lung examination shows increased transparency. There is leukopenia in
blood. What diagnosis is the most probable?
A.
*Obstructive bronchitis
B.
Pertussis
C.
Pneumonia
D.
Rhinitis
E.
Bronchiolitis
A 1,5 year old boy has non-productive cough with purulent sputum, dyspnea, retardation in
physical development, polyfecalia, increasing of sweat chloride up to 150 mEq/l. The cystic
fibrosis was diagnosed. What treatment will you prescribe?
A.
*Enzymes + antibiotics
B.
Choleretics + adaptogens
C.
Н2-histaminic blockaders + hepatoprotectors
D.
Vitamins + antibiotics
E.
Vitamins + mucolytics
Boy is 3 years old. Complaints: dyspnoe, fast tiredness, frequent episodes of respiratory diseases
in history. Borders of relative heart dullness are extended to the left, strengthening of the 2nd
heart sound in the 2nd intercostal interspace on the left side, hard systolo-dyastolic murmur in the
second intercostal interspace on the left side and above the clavicle (“machine noise”), which is
conducted on interscapular interspace. What is the most probable diagnosis?
A.
*patent arterial duct
B.
aortal stenosis
C.
atrial septal defect
D.
ventricle septal defect
E.
Isolated stenosis of arteria pulmonalis
The infant aged 2 months complaints of restlessness, subcutaneous fat wasting and underweight.
The deficiency calculated from the ratio between the actual and average expected weight for his
age is 14\%. The constipation and little amount of stools with undigested bits are noted. The child
is in the breast feeding. The total day breast milk volume is not known. There is not evidence of
infection in this case. What is the most probable diagnosis:
A.
*Hyponutrition in development
B.
Mucoviscidosis, intestinal form
C.
Acute gastroenteritis
D.
Chronic gastroduodenitis
E.
Dehydration
What kind of breathing can be heard above the lungs in healthy children aged 7 years?
A.
*Vesicular
B.
Puerile
C.
D.
E.
446.
447.
448.
449.
450.
451.
Weakened vesicular
Coarse
Grunting
The girl is 5 years old. She has been hospitalised with the complaints on generalized oedema
(face, abdomen, lower extremities), reduce of daily urine volume up to 300 ml, loss of appetite. In
urinalysis – protein – 3 g/l, RBC – 1-2, WBC – 6-7, specific gravity – 1027. CBC – Hb – 110 g/l,
WBC – 10 G/l. What diagnosis is most probable?
A.
*Glomerulonephritis with nephrotic syndrome
B.
Interstitial nephritis
C.
Pyelonephritis
D.
Polycystic kidney disease
E.
Glomerulonephritis with nephritic syndrome
The girl is 11 years old. She complains on pain in abdomen and lumbar region, headache, increase
of temperature up to 39 C, vomiting, reduce of appetite. Skin is pale, hot, respiration is normal,
heart rate – 100 per minute, positive Pasternatsky symptom. CBC: RBC – 3,9 T/l, WBC - 18 G/l,
ESR-34 mm/hour. Urinalysis - protein 0,066 g/l, WBC – 30-40, RBC – 1-2, bacteria - a lot of.
Most probable diagnosis is?
A.
*Acute pyelonephritis
B.
Acute glomerulonephritis
C.
Cystitis
D.
paranephritis
E.
Polycystic kidneys disease
The girl of 12 years old is suffering from acute glomerulonephritis. Daily diuresis is 700 ml, heart
rate – 100 per minute, blood pressure – 130/95, temperature – 37,3 C. In urinalysis – RBC – 3040, WBC – 5-6, protein – 0,099 g/l. Which medicines should be prescribed in this case?
A.
*Antibiotic, hypotensive, diuretic, vitamin C
B.
Antibiotics + prednisone
C.
Antihistaminic + vitamins
D.
Antiaggregants + diuretics
E.
Sulfanilamids + cytostatics
The girl is 12 years old. Yesterday she was overcooled. Now she complains on pain in suprapubic
area, frequent painful urination by small portions, temperature is 37,8 C. Pasternatsky symptom is
negative. Urinalysis – protein - 0,033 g/l, WBC – 20-25, RBC – 1-2. What diagnosis is most
probable?
A.
*Acute cystitis
B.
Dysmetabolic nephropathy
C.
Acute glomerulonephritis
D.
Acute pyelonephritis
E.
Urolithiasis
The polycystic kidney disease was diagnosed at the boy of 3 years old. Mother complaints that the
boy has growth retardation, poor appetite, vomiting. Skin is pale, turgor of soft tissues is reduced,
heart rate - 120 per minute, harsh breathing at auscultation, abdomen is enlarged, soft.
Biochemical tests – urea – 14 mmol/l, creatinine – 0,130 mmol/l, protein – 58 g/l. Which
condition has been developed?
A.
*Chronic renal failure
B.
Acute renal failure
C.
Encephalopathy
D.
Interstitial nephritis
E.
Pyelonephritis
The boy of 9 years old. He is ill for 3 days. He has complaints on pain and restriction of
movements in right knee and left elbow joints, dyspnoea. He was suffered from acute tonsillitis 2
weeks ago. There are fever (38,5 C), oedema of joints, extension of the borders of cordial dullness
on 2 cm left, HR - 110 per 1 min, weakness of 1st sound, "soft" systolic murmur on an apex.
C.
D.
E.
452.
453.
454.
455.
456.
457.
458.
What diagnosis should be suspected?
A.
*Acute rheumatic fever
B.
systemic lupus erythematodes
C.
juvenile rheumatoid arthritis
D.
Reiter’s disease
E.
reactive arthritis
The 7 years old boy developed an asphyxic attack, expiratory wheezing and cough. In past
history the child has had relapsing rhinitis and red eyes syndrome. His sister suffers with atopic
dermatitis. The correct diagnosis is:
A.
*bronchial asthma;
B.
acute bronchitis;
C.
viral croup;
D.
acute obstructive bronchitis;
E.
pneumonia.
Tests for pictures (тести до малюнків)
1.
2.
3.
4.
5.
6.
All of the following conditions are cause of glomerulonephritis (Fig. 89), except:
A.
*Allergies
B.
Bacterial infection
C.
Viral
D.
Fungal infection
E.
Vaccination
Excretory urography (Fig. 87) allows evaluating:
A.
*Anatomical state of urinary tract and urodinamics
B.
State of nephrons
C.
Functional state of urinary tract
D.
State of urinary bladder
E.
Functional state of urodinamics
Excretory urography (Fig. 87) DOES NOT allow evaluating:
A.
Position, sizes, form of kidneys
B.
State of nephrons
C.
Functional state of urinary tract
D.
*Anomaly of kidney vessels
E.
State of urinary bladder
What etiology of glomerulonephritis (Fig. 89) is the most often seen?
A.
*Streptococcus
B.
Staphylococcus
C.
E. cоlі
D.
Virus of hepatitis A
E.
Virus of flu
What is the main pathogenetical mechanism of development of glomerulonephritis (Fig. 89)?
A.
Bacterial inflammation
B.
Allergy reaction
C.
*Immunocomplex damaging
D.
Violation of passage of urine
E.
Reflux
Which sign does give information about the damaging of function of kidneys (Fig. 89)?
A.
Hypoproteinemia
B.
Proteinuria
C.
*Asotemia
D.
Hyperlipidemia
E.
Hyperglycemia
7.
8.
9.
10.
11.
12.
13.
14.
Secondary tubulopathy is observed at (Fig. 89):
A.
Phosphate-diabetes
B.
Tubulyar renal acidosis
C.
Disease de Toni-Debrae-Fanconi
D.
Hereditary nephritis
E.
*Galaktozemia
Hereditary nephritis (Fig. 89) is inherited by:
A.
*Dominant type, connected with the X chromosome
B.
Recessive type, connected with the X chromosome
C.
Dominant type, connected with Y chromosome
D.
Recessive type, connected with Y chromosome
E.
Autosomal recessive type
Hereditary nephritis (Fig. 89) with deafness is called:
A.
Disease-de Toni- Debrae- Fanconi
B.
Berger's disease
C.
*Alport syndrome
D.
Harnupa disease
E.
Leu syndrome
What is the etiologic factor of primary tubulopathy (Fig. 89)?
A.
Microbs
B.
*Violation of membrane substances inrenal tubules
C.
Reflux
D.
Anatomic anomaly of kidney
E.
Insufficiency of podotcytes
At sick girl 7 years old impairment of urine filtration was found. The illness was manifested by
high ever, sweating, aching pain in lumbar area, a discomfort in urination and frequent urination.
What epartment of nephrone (Fig. 89) filtration of urine is performed in?
A.
Proximal ductule
B.
Interstitium of kiney
C.
Glomerulus
D.
*Henle loop
E.
Distal ductule
A 14-year-old girl is seriously ill. She has chronic pyelonephritis with frequent exacerbations.
xcretory urography (Fig. 87) should be prescribed to evaluate:
A.
Anatomic state of urinary ways and urine dynamics
B.
State of the kidney’s pelvis system
C.
Functional ability of urinary ways
D.
Sizes of kidneys
E.
*All is correct
The child of 8 years ill acute: temperature 39.5 C, pain in back, and the pain during urination,
ymptom of Pasternatskiy positive from both sides, more in left. (Fig. 88). What disease is
present?
A.
* Acute pielonephritis
B.
Acute viral infection.
C.
Acute cystitis
D.
Acute glomerulonephritis
E.
Kidney colic
?When does opened ductus arteriosus will diagnose as congenital heart disease fig.40?
A.
If it not closed after 1 weak of life of the newborn
B.
If it not closed after 2weak of life of the newborn
C.
If it not closed after 3weak of life of the newborn
D.
If it not closed after 4 weak of life of the newborn
E.
*If it not closed after 2 month of life of the newborn
15.
16.
17.
18.
19.
20.
21.
22.
23.
What clinical symptom is the most typical to the patent ductus arteriosus fig 40?
A.
Systolic murmur
B.
Diastolic murmur
C.
*Systolic-diastolic murmur
D.
Presystolic murmur
E.
Prediastolic murmur
What pathological sine does appear from the beginning of patent ductus arteriosus fig 40?
A.
Hypertrophy of left ventricle
B.
Hypertrophy of right ventricle
C.
Hypertrophy of ventricles
D.
*Lung’s hypertension
E.
right ventricle failure
What kind of therapy of patent ductus arteriosus is the most effective fig 40?
A.
cardiac glycosides
B.
Hypotensive medicines
C.
prostaglandins
D.
lock of b-receptors
E.
*surgeon correction
What does appear due to decomposition of patent ductus arteriosus fig 40?
A.
left ventricle failure
B.
edema of lung
C.
cardiac asthma
D.
*all that is mentioned
E.
nothing that is mentioned
Hypertrophy of what ventricle does appear from the beginning of ventricle septal defect fig. 41?
A.
Right ventricle
B.
*Left ventricle
C.
Right atrium
D.
Left atrium
E.
Aorta
Hypertrophy of what heart cavity does appear from the beginning of atrial septal defect fig. 41?
A.
Right ventricle
B.
Left ventricle
C.
*Right atrium
D.
Left atrium
E.
Aorta
Hypertrophy of what ventricle does appear due to patent ductus arteriosus fig. 41?
A.
*Right ventricle
B.
Left ventricle
C.
Right atrium
D.
Left atrium
E.
Aorta
Hypertrophy of what heart cavity does appear due to tetralogy of Fallot fig. 41?
A.
*Right ventricle
B.
Left ventricle
C.
Right atrium
D.
Left atrium
E.
Aorta
Hypertrophy of what heart cavity does appear from the beginning of transposition of grate vessels
fig. 5?
A.
*Right ventricle
B.
Left ventricle
C.
Right atrium
Left atrium
Aorta
Hypertrophy of what heart cavity does appear from the beginning of pulmonary arteria stenosis
fig. 5?
A.
*Right ventricle
B.
Left ventricle
C.
Right atrium
D.
Left atrium
E.
Aorta
Hypertrophy of what heart cavity does appear from the beginning of aortal stenosis fig. 45?
A.
Right ventricle
B.
*Left ventricle
C.
Right atrium
D.
Left atrium
E.
Aorta
This pathology (Fig. 85) refers to:
A.
kidney multicystosis
B.
horseshoe kidney
C.
anomalies of kidney location and form
D.
additional kidney
E.
*aplasia, renal dysplasia
Hypertrophy of what heart cavity does appear from the beginning of coartation of aorta fig. 45?
A.
Right ventricle
B.
*Left ventricle
C.
Right atrium
D.
Left atrium
E.
Aorta
In what point of auscultation does systolic murmur due to coarctation of aorta have maximum
sound ig. 7?
A.
Second intercostals space on a right side from sternum
B.
Second intercostals space on a left side from sternum
C.
Heart apex
D.
*Intrascapular space
E.
On a sternum
Due to what caned of congenital heart disease appear hypertrophy of left ventricle most quickly
fig. 3?
A.
pulmonary arteria stenosis
B.
*aortal stenosis
C.
Тransposition of grate vessels
D.
coarctation of aorta
E.
ventricle septal defect
Name the most typical clinical symptom of tetralogy of Fallot fig. 45?
A.
Cyanosis of skin and mucosal membrane
B.
tachycardia
C.
Dispneae
D.
*Fit of cyanosis and dispneae
E.
edema
Leg in physical development of the child is most typical to…fig. 7
A.
ventricle septal defect
B.
tetralogy of Fallot
C.
aortal stenosis
D.
*all that is mentioned
E.
nothing that is mentioned
D.
E.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
In case of pulmonary stenosis we can see most probable… fig. 43
A.
Left ventricle hypertrophy
B.
Isolated right atrium hypertrophy
C.
Both left and right ventricles hypertrophy
D.
*Right ventricle hypertrophy
E.
Isolated left atrium hypertrophy
What are the blood compensatory mechanisms in cyanotic defects fig. 58?
A.
*Polycythemia, hyperhemoglobinemia, high blood viscosity
B.
Leucocytosis with left shift, elevation of ESR
C.
Hypohemoglobinemia, low blood viscosity, erythrocytopenia
D.
Thrombocytosis, high blood viscosity
E.
Leucocytopenia, Hypohemoglobinemia
What changes of EKG shows to us absolute necessity of surgery operation in aortic stenosis fig.
60?
A.
High R wave in V1, V2
B.
*Depression of S-T segment in V5, V6
C.
High R wave in V5, V6
D.
Depression of S-T segment in V1, V2
E.
High P wave in V1, V2
What examination is the most important for the patients with masked aortic stenosis fig 60?
A.
X-ray examination
B.
Electrocardiography
C.
Echocardioscopy
D.
Phonocardiography
E.
*Cardiac catheterization
In the case of aortic stenosis we can see most probably … fig. 42?
A.
Both left and right ventricles hypertrophy
B.
Isolated right atrium hypertrophy
C.
*Left ventricle hypertrophy
D.
Right ventricle hypertrophy
E.
Isolated left atrium hypertrophy
How can you characterize the patent ductus arteriosus fig. 58?
A.
*Cyanotic heart defect with right-to-left shunt
B.
Acquired heart disease
C.
Acyanotic heart defect with left-to-right shunt
D.
Complication of the congenital heart disease
E.
Acyanotic heart defect without shunt
At what congenital defect can we see round, apple-shaped heart during X-ray examination fig.43?
A.
tetralogy of Fallot
B.
Pulmonary stenosis
C.
Atrial septal defect
D.
Aortic stenosis
E.
*Tricuspid atresia
Choose the most right assertion fig. 63:
A.
During indirect heart massage the frequency of sternum compression is 40-60 times per 1
minute, fter 1 inspiration we make 4 compressions
B.
During indirect heart massage te frequency of sternum compression is 60-100 times per 1
minute, after 1 inspiration we make 2 compresions
C.
*During indirect heart massage the frequency of sternum compression is 60-100 times per
1 minute, fter 1 inspiration we make 4 compressions
D.
During indirect heart massage the frequency of sternum compression is 60-100 times per 1
minute, fter 1 inspiration we make 1 compressions
E.
During indirect heart massage the frequency of sternum compression is 40-60 times per 1
40.
41.
42.
43.
44.
45.
46.
47.
48.
minute, fter 1 inspiration we make 2 compressions
Give a conclusion about the reslts of ECG fig. 46.
A.
*Ventricle tachycardia
B.
Weakness of ventricle with disorded retractive ability
C.
Complete AV blockade
D.
Ventricular extrasystole
E.
Supraventricular tachycardia
Give a conclusion about the results of ECG fig. 47.
A.
Widespread QRS tachycardia
B.
Weakness of ventricle with disordered retractive ability
C.
*Complete AV blockade
D.
Ventricle tachycardia
E.
Supraventricular tachycardia
Give a conclusion about the results of ECG fig. 48.
A.
Disordered atrio-ventricular conduction 2:1
B.
Disordered atrio-ventricular conduction 3:1
C.
*Disordered atrio-ventricular conduction 4:1
D.
Cardiac flutter
E.
Sinus tachycardia
Give a conclusion about the results of ECG fig. 49
A.
Disordered atrio-ventricular conduction 2:1
B.
Disordered atrio-ventricular conduction 3:1
C.
Disordered atrio-ventricular conduction 4:1
D.
*Disordered atrio-ventricular conduction 1:1
E.
Cardiac fibrillation
Give a conclusion about the results of ECG fig. 50
A.
Disordered atrio-ventricular conduction 3:1
B.
Disordered atrio-ventricular conduction 4:1
C.
Sinus tachycardia
D.
Cardiac fibrillation
E.
*Wolff- Parkinson-White-syndrome
Give a conclusion about the results of ECG fig. 51
A.
Disordered atrio-ventricular conduction 4:1
B.
*Supraventricular tachycardia
C.
Ventricle tachycardia
D.
Sinus tachycardia
E.
Cardiac fibrillation
What indicate medicine of the first chose for treatment of this pathology fig. 51
A.
Lidocainum
B.
Novokainomid
C.
Ajmaline
D.
Kordaron
E.
*Isoptinum
Give a conclusion about the results of ECG fig. 52.
A.
Disordered atrio-ventricular conduction 4:1
B.
Supraventricular tachycardia
C.
Ventricle tachycardia
D.
*Sinus tachycardia
E.
Cardiac fibrillation
Give a conclusion about the results of ECG fig. 53
A.
Disordered atrio-ventricular conduction 4:1
B.
Supraventricular tachycardia
C.
Ventricle tachycardia
D.
E.
49.
50.
51.
52.
53.
54.
55.
56.
*Sinus tachycardia
Cardiac fibrillation
What medical manipulations will be adequate in this case fig. 53?
A.
*Removal (sublation) of the reason
B.
Sedatives
C.
Antiarrhythmical medicines
D.
Cardiac glycosides
E.
potassium contained medicines
Give a conclusion about the results of ECG fig. 54
A.
Disordered atrio-ventricular conduction 4:1
B.
Supraventricular tachycardia
C.
*Ventricle tachycardia
D.
Sinus tachycardia
E.
Cardiac fibrillation
WhatIndicate medicine of the first chose for treatment of this pathology fig. 54
A.
*Lidocainum
B.
Novokainomid
C.
Ajmaline
D.
Kordaron
E.
Isoptinum
Give a conclusion about the results of ECG fig. 55.
A.
*Cardiac fibrillation
B.
Supraventricular tachycardia
C.
Ventricle tachycardia
D.
Sinus tachycardia
E.
Supraventricular tachycardia
What congenital heart defect is following with frequent infections of lower respiratory tract fig.
62?
A.
Coarctation of the aorta
B.
*Patent ductus arteriosus
C.
Tetralogy of Fallot
D.
Pulmonary valve stenosis
E.
Persistent truncus arteriosus
Which disorder is characterized by systolic ejection murmur in the pulmonic area and middiastolic urmur in the lower right sternal area fig. 7?
A.
Ventrical septal defect
B.
Patent ductus arteriosus
C.
Tetralogy of Fallot
D.
Atrial septal defect
E.
*Pulmonary valve stenosis
What symptom is occurred in children with tetralogy of Fallot fig. 7?
A.
The murmur is harsh and is best heard at the midsternal or lower left sternal boder.
B.
A systolic and diastolic ejection murmur is heard in the pulmonic area.
C.
*A systolic ejection murmur is in the pulmonic area
D.
A harsh systolic ejection murmur is heard along the sternal boder
E.
A diastolic ejection murmur is in the pulmonic area
What features is occurred on the chest x-ray in children with patent ductus arteriosus fig. 62?
A.
The heart and main pulmonary artery segment are enlarged
B.
The chest radiograph may be normal
C.
*Cardiomegaly, increased pulmonary vascularity and enlargement of the left atrium and
left ventricle re seen
D.
The heart size is normal. The apex is uptilted, and a concavity is noted in the pulmonary
segment, hich gives the heart the appearance of a boot
Notching of the fourth through eighth ribs
What congenital heart defect is following with frequent infections of lower respiratory tract fig.
62?
A.
Persistent truncus arteriosus
B.
Tetralogy of Fallot
C.
*Atrial septal defect
D.
Aortic valve and discrete subaortic stenosis
E.
Coarctation of the aorta
What symptom is occurred in children with atrial septal defect fig. 7?
A.
The murmur is harsh and is best heard at the midsternal or lower left sternal boder
B.
*A systolic and diastolic ejection murmur is heard in the pulmonic area
C.
A harsh systolic ejection murmur is heard along the sternal boder
D.
A systolic ejection murmur is in the pulmonic area
E.
A diastolic ejection murmur is in the pulmonic area
What feature is occurred on the chest x-ray in children with tetralogy of Fallot fig. 9?
A.
the heart and main pulmonary artery segment are enlarged
B.
the chest radiograph may be normal
C.
cardiomegaly, increased pulmonary vascularity and enlargement of the left atrium and left
ventricle re seen.
D.
*the heart size is normal; the apex is uptilted, and a concavity is noted in the pulmonary
segment, hich gives the heart appearance of the boot
E.
Notching of the fourth throug eighth ribs
Which of the lesion are characterized of tetralogy of Fallot fig. 84?
A.
*pulmonary atresia with ventricular septal defect
B.
left ventricular hypertrophy
C.
coarctation of the aorta
D.
ventricular septal defect
E.
atrial septal defect
What congenital heart defect is following with frequent infections of lower respiratory tract fig.
62?
A.
Tetralogy of Fallot
B.
Pulmonary valves stenosis
C.
Coarctation of the aorta
D.
*Ventricular septal defect
E.
Transposition of the great arteries
What symptom is occurred in children with patent ductus arteriosus fig.7?
A.
A systolic and diastolic ejection murmur is heard in the pulmonic area
B.
*The murmur is harsh and is best heard at the midsternal or lower left sternal border
C.
A systolic ejection murmur is in the pulmonic area
D.
A harsh systolic ejection murmur is heard along the sternal border
E.
A diastolic ejection murmur along the sternal border
What feature is occurred on the chest X-ray in children with atrial septal defect fig. 9?
A.
*cardiomegaly, increased pulmonary blood flow and enlargement of the left atrium and
left ventricle re seen
B.
the heart and main pulmonary artery segment are enlarged
C.
the chest radiograph may be normal
D.
the heart size is normal; the apex is uptilted, and a concavity is noted in the pulmonary
segment, hich gives the heart appearance of the boot.
E.
notching of the fourth througheighth ribs
What lesion of tetralogy of Fallot is physiologically important fig. 84?
A.
* variable right ventricular outflow tract obstruction
B.
dextraposition of the aorta
C.
ventricular septal defect
E.
57.
58.
59.
60.
61.
62.
63.
64.
right ventricular hypertrophy
Mixed blood flow throw aorta
During which congenital structural disorders does pulmonary blood flow increased fig. 84?
A.
Coarctation of the aorta
B.
patent ductus arteriosus
C.
Tetralogy of Fallot
D.
Pulmonary valves stenosis
E.
*Persistent truncus arteriosus
What congenital heart defect is following with systolic ejection murmur in pulmonary area fig. 7?
A.
Ventricular septal defect
B.
*patent ductus arteriosus
C.
Coartation of the aorta
D.
Tetralogy of Fallot
E.
Pulmonary valves stenosis
What symptom is occurred in children with ventricular septal defect fig. 7?
A.
*The murmur is harsh and is best heard at the midsternal or lower left sternal border
B.
A systolic ejection murmur is in the pulmonary area
C.
A systolic and diastolic ejection murmur is heard in the pulmonary area
D.
A harsh systolic ejection murmur is heard along the sternal border
E.
A systolic ejection murmur is in the aortal area
What feature is occurred on the chest X-ray in children with coarctation of the aorta fig. 9?
A.
the heart and main pulmonary artery segment are enlarged
B.
the chest radiograph may be normal
C.
cardiomegaly, increased pulmonary blood flow and enlargement of the left atrium and left
ventricle re seen
D.
the heart size is normal; the apex is up tilted, and a concavity is noted in the pulmonary
segment, hich gives the heart appearance of the boot.
E.
* notching of the fourth througheighth ribs
During which congenital structural disorders is pulmonary blood flow increased fig.84?
A.
Tetralogy of Fallot
B.
Coarctation of the aorta
C.
*Ventricular septal defect
D.
Pulmonary valves stenosis
E.
Transposition of the great arteries
?Which of the following assertion is wrong (fig. 80)?
A.
The most intense pancreas is increasing in the first 3 years
B.
Glandular apparatus of the pancreas is not enough differentiated after birth
C.
The development the liver parenchyma ends to 8 years
D.
*Endocrine function of the pancreas is less developed, than exocrine
E.
Children under 1 year of the high content of taurocholic bile acid
What infectious disease does most frequently cause inflammatory changes in the tissue of the
ancreas (fig. 80)?
A.
*Mmps
B.
Chickenpox
C.
Viral hepatitis
D.
Streptococcal infection
E.
Measles
Signs of hypotonic form of bile ducts dyskinesia at the duodenal probing are (fig. 80):
A.
Increase of portion A volume
B.
*Increase of portion B volume
C.
Increase of portion С volume
D.
Decrease of portion B volume
E.
Decrease of portion A volume
D.
E.
65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.
80.
81.
Signs of hypertonic form of bile ducts dyskinesia at the duodenal probing are (fig. 80):
A.
Increase of portion A volume
B.
Increase of portion B volume
C.
Increase of portion С volume
D.
*Decrease of portion B volume
E.
Decrease of portion A volume
Up to what age in healthy children in the supine position the lower edge of the liver can be
palpated fig.82)?
A.
Up to 3 years
B.
Up to 5 years
C.
*Up to 7 years
D.
Up to 10 years
E.
Up to 12 years
In children of the first three years lower edge of liver (on a mid clavicle line) (fig. 82):
A.
Does not extends from the rib arch
B.
Extends from the rib arch up to 0,5-1 cm
C.
Extends from the rib arch up to 1-2 сm
D.
*Extends from the rib arch up to 2-3 сm
E.
Extends from the rib arch up to 3-5 сm
At the healthy children of what age does not palpated lower edge of liver (on a mid clavicle line)
(fig. 2)?
A.
From 1 year
B.
From 3 years
C.
From 5 years
D.
*From 7th years
E.
From 10 years
In neonates the liver has the following features (fig.82):
A.
*Weight is 4-6% of body weight
B.
Parenchyma is little differentiated
C.
Sanguineous
D.
A distinct lobed structure
E.
All transferred
For dyspepsia syndrome in case of bile ducts pathology is typically (fig.83):
A.
Diarrhea after the use of milk
B.
Diarrhea is frequent, profuse
C.
Stabile constipation from the birth
D.
*Periodical constipation
E.
Diarrhea before the use of milk
In case of hypotonic biliary dyskinesia is typically (fig.83):
A.
*Discomfort in right subcostal area
B.
Hungry, nightly stomach-ache
C.
Intensive, paroxysmal pain in right subcostal area
D.
Distension pain in the mesogastrium
E.
Discomfort in left subcostal area
In case of hypertonic biliary dyskinesia is typically (fig.83):
A.
Discomfort in right subcostal area
B.
Hungry, nightly stomach-ache
C.
*Intensive, paroxysmal pain in right subcostal area
D.
Distension pain in the mesogastrium
E.
Discomfort in left subcostal area
For chronic pancreatitis are typical (fig. 79):
A.
Hepatomegaly, jaundice, periodic constipation
B.
Splenomegaly, jaundice, diarrhea
Local pain in a pylorodyodenal area, anemia, constipation
*Girdling abdominal pain, anemia, diarrhea
Discomfort in left subcostal area
What complex of investigations is needed for patients with the diseases of hepatobiliary system
(fig. 0)?
A.
РH-metry, ultrasonography, duodenal probing
B.
РH-metry, EFGDS, ultrasonography
C.
EFGDS, ultrasonography, laparoscopy
D.
*Laparoscopy, ultrasonography, duodenal probing
E.
EFGDS, laparoscopy
For the depression of the external secretion function of the pancreas is better to give (fig.79):
A.
Tramadol
B.
Tavegil
C.
*Atropine
D.
No-spa
E.
Heparin
For liquidation of pain in the patient with pancreatitis is prescribed (fig. 79)::
A.
*Baralgin
B.
Aspirin
C.
Indomethacin
D.
Caffeine
E.
Papaverin
For treatment of the acute pancreatitis attack is prescribed (fig. 79):
A.
Penicillin
B.
Heparin
C.
*Contrical
D.
Vicasol
E.
Voltaren
For medicinal suppression of the pancreas is used (fig. 79):
A.
*Ranitidin
B.
Almagel
C.
Creon
D.
Linex
E.
Vicasol
F.
t in the first days in case of the pancreatitis attack is (fig. 79):
G.
Hunger
H.
Diet № 1
I.
Diet № 5
J.
Diet № 7
K.
Diet № 8
Which of the following assertion is wrong (fig. 79)?
A.
The most intense pancreas is increasing in the first 3 years
B.
Glandular apparatus of the pancreas is not enough differentiated after birth
C.
The development the liver parenchyma ends to 8 years
D.
*Endocrine function of the pancreas is less developed, than exocrine
E.
Children under 1 year of the high content of taurocholic bile acid
The pancreas of the newborn has the following features (fig. 79):
A.
Enough differentiated parenchyma
B.
Much vascularized
C.
Has a poor connective tissue
D.
*The head of pancreas is most developed
E.
Detoxification organ
In neonates the liver has the following features (fig. 82):
C.
D.
E.
82.
83.
84.
85.
86.
87.
88.
89.
A.
B.
C.
D.
E.
90.
91.
92.
93.
94.
95.
96.
97.
*Weight is 4-6% of body weight
Parenchyma is little differentiated
Sanguineous
A distinct lobed structure
All transferred
What type of biliary dyskinesia does occur with the predominance of sympatic tone of the
nervous ystem of patients (fig. 83)?
A.
Hypertonic
B.
Normotonic
C.
*Hypotonic
D.
Primary
E.
Secondary
Pain syndrome, dyspeptic syndrome, hepatomegaly, positive gallbladder symptoms are
characterized or (fig. 83):
A.
Hypertonic
B.
Normotonic
C.
*Hypotonic
D.
Primary
E.
Secondary
The first phase of fractional duodenal intubation is (fig. 80):
A.
The selection of hepatic bile
B.
A time of closed sphincter of Oddi
C.
*Choledochic
D.
A time of the opening of the sphincter of Oddi
E.
A period of emptying of the gall bladder
The second phase of fractional duodenal intubation is (fig. 80):
A.
The selection of hepatic bile
B.
*A time of closed sphincter of Oddi
C.
Choledochic
D.
A time of the opening of the sphincter of Oddi
E.
A period of emptying of the gall bladder
The third phase of fractional duodenal intubation is (fig. 80):
A.
The selection of hepatic bile
B.
A time of closed sphincter of Oddi
C.
Choledochic
D.
*A time of the opening of the sphincter of Oddi
E.
A period of emptying of the gall bladder
The fourth phase of fractional duodenal intubation is (fig. 80):
A.
*A period of emptying of the gall bladder
B.
The selection of hepatic bile
C.
A time of closed sphincter of Oddi
D.
Choledochic
E.
A time of the opening of the sphincter of Oddi
The fifth phase of fractional duodenal intubation is (fig. 80):
A.
A period of emptying of the gall bladder
B.
*The selection of hepatic bile
C.
A time of closed sphincter of Oddi
D.
Choledochic
E.
A time of the opening of the sphincter of Oddi
Cholangiography is used for diagnose of (fig. 83):
A.
Parenchimatous jaundice
B.
Hemolytic jaundice
C.
*Obstructive jaundice
Conjugation jaundice
All types of jaundice
What type of cholangiography is absent (fig. 83)?
A.
Percutaneous transhepatic cholangiography
B.
Intraoperative cholangiography
C.
Endoscopic retrograde cholangiopancreatography
D.
Magnetic resonance cholangiopancreatography
E.
*Contrast cholangiography
What is not used for diagnostic of cholecystitis (fig. 83)?
A.
Ultrasound
B.
Cholescintigraphy
C.
CT Scan
D.
Cholangiography
E.
*All are used
?Which pathology is depicted on the Fig. 85?
A.
*Left kidney aplasia
B.
Left kidney hypoplasia
C.
Doubling right kidney
D.
Left kidney dystopia
E.
Right kidney dystopia
Which the main complication of this pathology (Fig. 86) do you know?
A.
polycystic kidney
B.
glomerulonephritis
C.
primary pyelonephritis
D.
*hydronephrosis
E.
phosphate diabetes
Which pathology is represented on the Fig. 86?
A.
Left kidney aplasia
B.
Left kidney hypoplasia
C.
Doubling right kidney
D.
Left kidney dystopia
E.
*Horseshoe kidney
Which investigation is the most effectiveness for diagnostic this pathology (Fig. 86)?
A.
Ultrasound examination
B.
*Excretory urography
C.
Cystoscopy
D.
Cystografia
E.
Thermography
For diagnostic of this pathology (Fig. 85) you can use all methods, except
A.
Excretory urography
B.
Ultrasound examination
C.
Computer tomography
D.
*Cystoscopy
E.
MR tomography
This examination (Fig. 87) gives information about
A.
anatomical status of urinary tract and urodynamic
B.
state of pelvis of the kidney
C.
functional ability of urinary tract
D.
kidney’s size
E.
*all right
What is the name of this examination (Fig. 87)?
A.
*Excretory urography
B.
Ultrasound examination
D.
E.
98.
99.
100.
101.
102.
103.
104.
105.
106.
Computer tomography
Cystoscopy
MR tomography
What is the main contraindication for this examination (Fig. 87)?
A.
Pyelonephritis
B.
Persistent isolated urinary syndrome
C.
Hypertension
D.
*Terminal chronic renal failure
E.
Tumor in the abdominal cavity or retroperitoneal space
What is the name of this symptom (Fig. 88)?
A.
Blyooberh
B.
Voskresensky
C.
Babinski
D.
Ortner
E.
*Pasternatsky.
For which disease is positive this symptom (Fig. 88)?
A.
Kidney aplasia
B.
*Pyelonephritis
C.
Cystitis
D.
Kidney dystopia
E.
Enuresis
The structure of this organ (Fig. 89) you can define using
A.
Cystography
B.
Cystoscopy
C.
Nechiporenko’s test
D.
Endogenous creatinine clearance
E.
*Ultrasound examination
Which structures of this organ (Fig. 89) are damaged by pyelonephritis?
A.
glomerulus
B.
*channels of kidney
C.
mucous membrane of the ureter
D.
kidney capsule
E.
glomerular capillaries.
How long is continues antibacterial therapy of inflammation process of this organ (Fig. 89)?
A.
7-14 days
B.
14-21 days
C.
*before the complete clinical and laboratory remission
D.
within 6 months
E.
before the partial clinical-laboratorial remission
Put diagnosis in patient according to chest X-ray on fig. 1:
A.
*Destructive pneumonia
B.
Bronchopneumonia
C.
Interstitial pneumonia
D.
Lobar pneumonia
E.
Segmental pneumonia
Choose the most possible etiological agent of pneumonia on fig. 1:
A.
Esherichia coli
B.
*St. aureus
C.
Klebsiella pneumoniae
D.
Strep. Pneumoniae
E.
Hemophylus influenzae
Choose dosage of Penicillin group antibiotic for treatment of pneumonia on fig. 1.
A.
80-100 000 IU/kg/ day
C.
D.
E.
107.
108.
109.
110.
111.
112.
113.
114.
115.
100-120 000 IU/kg/ day
120-150 000 IU/kg/ day
150-200 000 IU/kg/ day
*200-300 000 IU/kg/ day
Put diagnosis in patient according to chest X-ray on fig.2:
A.
Destructive pneumonia
B.
Bronchopneumonia
C.
Pneumothorax
D.
*Pleuritis
E.
Abscess
What complication of pneumonia is shown on fig. 2:
A.
Pneumothorax
B.
Abscess
C.
*Pleuritis
D.
Infective endocarditis
E.
Infectious-toxic shock
Put diagnosis in patient according to chest X-ray on fig. 3:
A.
Destructive pneumonia
B.
*Lower lobar pneumonia
C.
Interstitial pneumonia
D.
Pneumothorax
E.
Pleuritis
Put diagnosis in patient according to chest X-ray on fig. 3:
A.
Pleuritis
B.
Empyema
C.
*Lower lobar pneumonia
D.
Parapneumonic effusions
E.
Pneumothorax
Choose dosage of Penicillin group antibiotic for treatment of pneumonia on fig.3:
A.
80-100 000 IU/kg/ day
B.
50-90 000 IU/kg/ day
C.
*120-150 000 IU/kg/ day
D.
500-1000 IU/kg/ day
E.
250-300 000 IU/kg/ day
What clinical signs are typical for pneumonia on fig.3:
A.
Scattered coarse rales
B.
Scattered high-pitched wheezing
C.
Barking cough
D.
*Tachypnea
E.
Hoarse voice
Put diagnosis in patient according to chest X-ray on fig. 4:
A.
*Empyema
B.
Destructive pneumonia
C.
Lower lobar pneumonia
D.
Interstitial pneumonia
E.
Pneumothorax
What complication of pneumonia is shown on fig. 4:
A.
Abscess
B.
*Pleuritis
C.
Infective endocarditis
D.
Infectious-toxic shock
E.
Pneumothorax
Choose the most possible etiological agent of complicated pneumonia in children on fig. 4.
B.
C.
D.
E.
116.
117.
118.
119.
120.
121.
122.
123.
124.
A.
B.
C.
D.
E.
125.
126.
127.
128.
129.
130.
131.
132.
*Strep. Pneumoniae
St. aureus
Esherichia coli
Klebsiella pneumoniae
Hemophylus influenzae
What clinical signs are typical for pathological condition on fig. 4:
A.
Scattered coarse rales
B.
Scattered high-pitched wheezing
C.
Inspiratory and expiratory wheezing
D.
Tympanic on percussion
E.
*Dullness on percussion
Put diagnosis in patient according to chest X-ray on fig.5:
A.
Destructive pneumonia
B.
Empyema
C.
Polysegmental pneumonia
D.
Interstitial pneumonia
E.
Pneumothorax
Choose the most possible etiological agent of pneumonia in preschool children on fig.5.
A.
*Strep. Pneumoniae
B.
St. aureus
C.
Esherichia coli
D.
Klebsiella pneumoniae
E.
St. epidermitis
Choose the most possible etiological agent of pneumonia in children 1-6 months on fig.5:
A.
Strep. Pneumoniae
B.
*St. aureus
C.
Esherichia coli
D.
Klebsiella pneumoniae
E.
Mycoplasma pneumoniae
Choose the most possible etiological agent of nosocomial pneumonia in children on fig.5:
A.
*Ps. aeruginosa
B.
Strep. Pneumoniae
C.
St. aureus
D.
Esherichia coli
E.
Mycoplasma pneumoniae
What pathology is revealed on chest X-ray on fig. 6:
A.
Right lobar pneumonia
B.
Left side pyothorax
C.
Right side pneumothorax
D.
Left hemorrhagic pleuritis
E.
Right side abscess
What complication of pneumonia is shown on fig. 6:
A.
Abscess
B.
*Pneumothorax
C.
Infective endocarditis
D.
Pleuritis
E.
Empyema
Put diagnosis in patient according to chest X-ray on fig.6:
A.
Right side pleuritis
B.
Lower lobar pneumonia on the left side
C.
Parapneumonic effusions on the left side
D.
*Pneumothorax on the right side
E.
Abscess on the left side
133.
134.
135.
136.
137.
138.
139.
140.
141.
What clinical signs are typical for pneumonia on fig. 7
A.
Inspiratory and expiratory wheezing
B.
Scattered high-pitched wheezing
C.
Diminished breath sound
D.
Scattered dry rales
E.
Tympanic on percussion
What clinical signs are typical for acute bronchitis on fig. 7
A.
Fever
B.
Tachypnea
C.
Backy cough
D.
*Coarse breath sound
E.
Prolongation of the expiratory of breathing
What clinical signs are typical for acute bronchiolitis on fig. 7
A.
Runny nose
B.
Stridor
C.
Backy cough
D.
Drooling
E.
*Prolonged expiratory
What clinical signs are typical for bronchial asthma on fig.7
A.
Stridor
B.
Hoarseness
C.
Inspiratory and expiratory wheezing
D.
Diminished breath sound
E.
Barky cough
Put diagnosis in patient according to chest X-ray on fig. 8:
A.
Aspiration pneumonia
B.
*Lobar pneumonia
C.
Bronchopneumonia
D.
Interstitial pneumonia
E.
Segmental pneumonia
What is the possible etiological agent of lobar pneumonia on fig. 8:
A.
Ps. aeruginosa
B.
Strep. Pneumoniae
C.
Mycoplasma pneumoniae
D.
Esherichia coli
E.
*St. aureus
What are clinical signs of pathology on fig 8:
A.
Expiratory whistling sound, wheezing
B.
Stridor, barky cough
C.
Runny nose, drooling
D.
Muffled voice, sore throat
E.
*Diminished breath, tachypnea
Choose the most possible diagnosis on fig.8:
A.
Abscess
B.
Interstitial pneumonia
C.
Pneumothorax
D.
*Lobar pneumonia
E.
Pleuritis
What examination is shown on fig.9?
A.
Chest X-ray
B.
MRI examination
C.
Ultrasound examination of lungs
D.
CT of lungs
E.
142.
143.
144.
145.
146.
147.
148.
149.
150.
*UVB-therapy
What is the purpose of such method on fig.9?
A.
To diagnose pneumonia
B.
To diagnose pneumonia complications
C.
To treat pneumonia in flare-up period
D.
*To treat pneumonia in recovery period
E.
To treat complications of pneumonia
Choose the right diagnosis on fig.10:
A.
*Right side emphysema
B.
Right lobar pneumonia
C.
Right side pneumothorax
D.
Left side pleuritis
E.
Left lobar pneumonia
What objective changes can be revealed on pathology on fig 10?
A.
*Tympanic sound on the right side on percution
B.
Dullness on the right side on percution
C.
Ban-box sound on left side on percution
D.
Clear lung sound on the left side on auscultation
E.
Scattered high-pitched wheezing on auscultation
What objective changes can be revealed on pathology on fig. 10?
A.
Ban-box sound on the right side on percution
B.
Diminished breath sound on the right side
C.
Decreased relative dullness of heart
D.
Low diaphragm disposition
E.
*Everything correct
What measures such tool on fig. 11?
A.
*Speed and volume of breath out
B.
Concentration of О2 during breathing
C.
Concentration of СО2 during expiration
D.
Supplement with oxygen
E.
All correct
What is shown on fig.11?
A.
Inhalation therapy
B.
*Spirometry
C.
Оxygen-therapy
D.
UVB-therapy
E.
Pulse oximetry
At what age can be performed such examination on fig.11?
A.
First month
B.
First year
C.
*after 5 years
D.
after 4 years
E.
after fourteen years
Choose typical sign of pneumonia in newborn on fig.12:
A.
Rhythm breathing disorder
B.
Decreased activity
C.
Tachypnea
D.
Nostril flaring
E.
*All correct
Choose the most common sign of congenital pneumonia on fig.12:
A.
Tachypnea
B.
Cyanosis
C.
Retraction
Grunting
*All correct
Choose the most possible etiological agent of congenital pneumonia on fig. 12:
A.
Chlamydia pneumonia
B.
St. aureus
C.
Group B Streptococci
D.
Strep. Pneumoniae
E.
Hemophylus influenzae
Put the diagnosis according the chest X-ray (Fig. 27):
A.
Bronchoectasis
B.
*Left lung hypoplasia
C.
Polycystic lung disease
D.
Chronic lung disease
E.
Lung tumor
Put the diagnosis according the tomogram (Fig. 28):
A.
Lung abscess
B.
Lung tumor
C.
Lung hypoplasia
D.
*Bronchogenic cyst
E.
Lung sequestration
Put the diagnosis according the chest X-ray (Fig. 29):
A.
Lung abscess
B.
Lung tumor
C.
Lung hypoplasia
D.
Lung sequestration
E.
*Congenital cyst
Name is the method of examination (Fig. 30):
A.
Bronchography
B.
*Aortography
C.
Angiography
D.
Contrast tomography
E.
Cystocholangiography
This method is used for the diagnostics of (Fig. 30):
A.
*Lung sequestration
B.
Bronchoectasis
C.
Liver diseases
D.
Pneumonia
E.
Chronic lungs diseases
What disease is schematically pictured in the Fig. 31?
A.
Hamman-Rich syndrome
B.
Williams-Campbell syndrome
C.
*Mounier-Kuhn syndrome
D.
Kartagener syndrome
E.
Cystic fibrosis
What is the main method of the treatment of disease which is pictured in Fig. 31?
A.
Surgical resection
B.
Bronchus drainage
C.
Physiotherapy
D.
*Complex conservative treatment
E.
There is no treatment
Bronchoscopy and bronchography (Fig. 32) isn’t allow to diagnose:
A.
Tracheo-esophageal fistula
B.
Williams-Campbell syndrome
D.
E.
151.
152.
153.
154.
155.
156.
157.
158.
159.
Mounier-Kuhn syndrome
Kartagener syndrome
*Hamman-Rich syndrome
Bronchoscopy (Fig. 32) is used in children:
A.
After 1 month of life only
B.
After 1 year of life only
C.
After 5 years of life only
D.
After 10 years of life only
E.
*In any age
What disease is schematically pictured in the Fig. 33?
A.
Hamman-Rich syndrome
B.
*Williams-Campbell syndrome
C.
Mounier-Kuhn syndrome
D.
Kartagener syndrome
E.
Cystic fibrosis
What examination is the most useful for the diagnosis of this disease (Fig. 33)?
A.
*Bronchography
B.
Bronchoscopy
C.
Chest X-ray
D.
Spirography
E.
CT-scan
The localization of the bronchoectasises in the lower parts of lungs (Fig. 34) is typical for:
A.
Hamman-Rich syndrome
B.
*Williams-Campbell syndrome
C.
Mounier-Kuhn syndrome
D.
Kartagener syndrome
E.
Cystic fibrosis
Put the diagnosis according the chest X-ray (Fig. 35):
A.
Hamman-Rich syndrome
B.
Williams-Campbell syndrome
C.
Mounier-Kuhn syndrome
D.
*Kartagener syndrome
E.
Cystic fibrosis
What congenital chronic lung disease is pictured in the Fig. 35?
A.
Hamman-Rich syndrome
B.
Williams-Campbell syndrome
C.
Mounier-Kuhn syndrome
D.
*Kartagener syndrome
E.
Cystic fibrosis
The diffuse lungs tissue abnormalities presented in the Fig. 36 are typical for:
A.
*Hamman-Rich syndrome
B.
Williams-Campbell syndrome
C.
Mounier-Kuhn syndrome
D.
Kartagener syndrome
E.
Cystic fibrosis
The diffuse pathological changes in the bronchial glands presented in the Fig. 37 are typical for:
A.
Hamman-Rich syndrome
B.
Williams-Campbell syndrome
C.
Mounier-Kuhn syndrome
D.
Kartagener syndrome
E.
*Cystic fibrosis
In the treatment of cystic fibrosis (Fig. 37) the most important is:
A.
Antibiotics
C.
D.
E.
160.
161.
162.
163.
164.
165.
166.
167.
168.
Mucolytics
*Enzymes
Massage
Immunomodulators
The pathological changes of the hands presented in the Fig. 38 are typical for:
A.
Rheumatoid artritis
B.
Rheumatic fever
C.
*Chronic hypoxia
D.
Dermatomyositis
E.
Nephrotic syndrome
What diseases can cause the pathological changes of the hands presented in the Fig. 38?
A.
*Chronic lungs diseases
B.
Systemic connective tissue diseases
C.
Kidneys diseases
D.
Chromosomal diseases
E.
All mentioned above
The chest deformation presented in the Fig. 39 is typical for:
A.
Chronic bronchitis
B.
Congenital lungs disease
C.
Cystic fibrosis
D.
Chronic acquired lungs disease
E.
*All mentioned above
The chest deformation presented in the Fig. 39 is NOT typical for:
A.
Chronic bronchitis
B.
Congenital lungs disease
C.
Cystic fibrosis
D.
*Rickets
E.
Chronic acquired lungs disease
In the Fig. 64 are presented skin changes on the face which are typical for the:
A.
Systemic scleroderma
B.
Dermatomyositis
C.
*Systemic lupus erhythematosus
D.
Rheumatoid artritis
E.
Systemic vasculitis
Besides of typical skin changes on the face (Fig. 64) for the systemic lupus erhythematosus is
haracteristic:
A.
*Polyserositis and nephritis
B.
Artritis with joints destruction
C.
Myositis and nephritis
D.
Myositis and artritis
E.
Hepato- and splenomegaly and intoxication
Such appearance of the patient (Fig. 65) the most probably is the result of:
A.
Heredity
B.
Chromosomal disease
C.
Obesity
D.
*Prolonged glucocorticoids intake
E.
Nephrotic syndrome
What syndrome is presented in the Fig. 65?
A.
Nephrotic
B.
Obesity
C.
Prader – Willey syndrome
D.
Hypothalamic syndrome
E.
*Cushing syndrome
B.
C.
D.
E.
169.
170.
171.
172.
173.
174.
175.
176.
177.
178.
179.
180.
181.
182.
183.
184.
185.
What is reason of the appearance of the patient in the Fig. 65?
A.
Overeating
B.
Constitutional peculiarities
C.
*Hyperadrenocorticism
D.
Congenital metabolic disease
E.
Lack of physical activity
In the Fig. 66 are presented face changes (periorbital edema and heliotrope rush) which are
typical or:
A.
Systemic scleroderma
B.
*Dermatomyositis
C.
Systemic lupus erhythematosus
D.
Rheumatoid artritis
E.
Systemic vasculitis
What is the name of symptom presented in the Fig. 66?
A.
Gottron patches
B.
“Butterfly” symptom
C.
Annular erythema
D.
*Heliotropic rash
E.
Livedo reticularis
The subcutaneous nodulas presented on the Fig. 67 are typical for the:
A.
Systemic scleroderma
B.
Dermatomyositis
C.
Systemic lupus erhythematosus
D.
*Rheumatoid artritis
E.
Systemic vasculitis
In the rheumatoid nodules (Fig. 67) besides of RF can be founded:
A.
Lymphocytes accumulation
B.
Collagen
C.
*Immune complexes
D.
Calcificates
E.
All mentioned above
The symmetrical proximal muscles weakness which is indicated in the Fig. 69 is typical for:
A.
Systemic scleroderma
B.
*Dermatomyositis
C.
Systemic lupus erhythematosus
D.
Rheumatoid artritis
E.
Systemic vasculitis
Patient with the symmetrical proximal muscles weakness in dermatomyositis (Fig. 69) should be
ndergone a:
A.
Magnetic resonance imaging (MRI)
B.
Biochemical blood test
C.
EMG
D.
Muscle biopsy
E.
*All mentioned above
Deformations of the wrist joints are the most typical for (Fig. 70):
A.
Systemic scleroderma
B.
Dermatomyositis
C.
Systemic lupus erhythematosus
D.
*Rheumatoid artritis
E.
Systemic vasculitis
Uveitis and iritis (Fig. 70) is the typical for:
A.
Systemic scleroderma
B.
Dermatomyositis
Systemic lupus erhythematosus
*Rheumatoid artritis
Systemic vasculitis
Ophtalmologist consultation for this patient (Fig. 70) is obligatory in:
A.
Systemic scleroderma
B.
Dermatomyositis
C.
Systemic lupus erhythematosus
D.
*Rheumatoid artritis
E.
Systemic vasculitis
Gottron’s patches on the skin (Fig. 72) are typical for the
A.
Systemic scleroderma
B.
*Dermatomyositis
C.
Systemic lupus erhythematosus
D.
Rheumatoid artritis
E.
Systemic vasculitis
The prolonged glucocorticoids intake can cause (Fig. 65):
A.
Adrenogenital syndrome
B.
Waterhouse-Friderichsen syndrome
C.
Prader – Willey syndrome
D.
Hypothalamic syndrome
E.
*Cushing syndrome
Swelling of the fingers, hands with thickening, hardening, and discoloration of the skin
(“nonliving, rtificial” skin) (Fig. 68) is typical for the:
A.
*Systemic scleroderma
B.
Dermatomyositis
C.
Systemic lupus erhythematosus
D.
Rheumatoid artritis
E.
Systemic vasculitis
What ayes complications are typical for the JRA (fig. 71):
A.
Conjunctivitis
B.
Blepharitis
C.
*Uveitis
D.
Glaucoma
E.
All mentioned above
The presence of ayes complications in JRA (Fig. 71) is indication for the beginning of the therapy
ith:
A.
Methothrexate
B.
Penicillamin
C.
NSARD’s
D.
*Glucocorticoids
E.
Gold compounds
Enter the basic mechanism of bronchial obstruction in newborn infants fig.13:
A.
Foreign body in bronchus
B.
*Mucus inside the bronchus
C.
Reduction of bronchial muscle
D.
Swelling of the bronchial mucosa
E.
Compression of the bronchus from the outside
Specify the basic mechanism of bronchial obstruction in infants on fig.13:
A.
Foreign body in bronchus
B.
Mucus inside the bronchus
C.
Reduction of bronchial muscle
D.
*Swelling of the bronchial mucosa
E.
Compression of the bronchus from the outside
C.
D.
E.
186.
187.
188.
189.
190.
191.
192.
193.
194.
195.
196.
197.
198.
199.
200.
201.
202.
Specify the basic mechanism of bronchial obstruction in children 1-5 years on fig. 13:
A.
*Foreign body in bronchus
B.
Mucus inside the bronchus
C.
Reduction of bronchial muscle
D.
Swelling of the bronchial mucosa
E.
Compression of the bronchus from the outside
Call procedure in the picture on fig. 14:
A.
Inhalation
B.
Nasal instillation
C.
Taking the material for planting
D.
Nasal insufflation
E.
*Cleansing the nasal passages
Specify the basic mechanism of bronchial obstruction in school children with bronchial asthma on
ig. 13:
A.
Foreign body in bronchus
B.
Mucus inside the bronchus
C.
*Reduction of bronchial muscle
D.
Swelling of the bronchial mucosa
E.
Compression of the bronchus from the outside
Specify the basic mechanism of bronchial obstruction in preschool children with bronchial
asthma on ig. 13:
A.
Foreign body in bronchus
B.
Mucus inside the bronchus
C.
Reduction of bronchial muscle
D.
*Swelling of the bronchial mucosa
E.
Compression of the bronchus from the outside
At what degree of respiratory insufficiency used this method (on fig. 15) of oxygen therapy?
A.
0
B.
1
C.
*2
D.
3
E.
4
Specify the purpose of this procedure on fig. 15.
A.
Cleansing the nasal passages
B.
Control of O2 concentration on breathing
C.
Control of CO2 during respiration
D.
Inhalation
E.
*Oxygen therapy
What procedure is shown in the picture on fig.16?
A.
Bronchoscopy
B.
*Laryngoscopy
C.
Pharyngoscope
D.
Endophotografiya pharynx
E.
Endophotografiya larynx
Specify the indications for laryngoscopy in children on fig.16:
A.
Identifying the causes of changes vote
B.
Identifying causes of pain in the throat or in the ear
C.
Identifying the causes difficulty swallowing, foreign body sensation in the throat or the
presence of lood expectoration
D.
Detection of laryngeal lesions, narrowing his or violations of the airway
E.
*All of the above
Enter the preparations for laryngoscopy on fig.16:
A.
Irrigation throat by lidokain
General anesthesia
*Refrain from taking food and fluid
Conduct allergy testing
Chest X-ray
Specify the conditions when the laryngoscopy (on fig. 16) is not done of children?
A.
*Obstructive bronchitis
B.
Foreign body upper airway
C.
Differential diagnosis of false and true croup
D.
Difficulty swallowing
E.
Sudden attacks of cough
What is depicted on the fig. 17?
A.
UV sterilizer
B.
*Oxygen tent
C.
Protective mask
D.
Mask for apparatus Ambu
E.
Incubator
This method oxygen therapy is most effective (on fig. 17)?
A.
*During 1-st year
B.
For 2-7 years
C.
For school children
D.
All ages
E.
Newborns
Children of any age using this method oxygen therapy on fig. 18:
A.
During 1-st year
B.
For 2-7 years
C.
For school children
D.
*All ages
E.
Newborns
When using this method of oxygen therapy on fig. 18?
A.
*RI І-ІІ st.
B.
RI ІІІ st.
C.
Asthmatic status
D.
Hypoxic coma
E.
Stenosis of the larynx ІV st.
What is depicted on the fig. 19?
A.
Cleansing the respiratory tract
B.
Control of O2 concentration on breathing
C.
Control of CO2 during respiration
D.
*Inhalation
E.
Oxygen therapy
What used to inhalation in stenosing laryngotracheitis on fig. 19?
A.
Expectorants herbal concoctions
B.
b-blockers
C.
Anesthetics
D.
Soda-saline
E.
*Decongestants mixture
What used to inhalation in obstructive bronchitis on fig. 19?
A.
*Expectorants herbal concoctions
B.
b-blockers
C.
Anesthetics
D.
Soda-saline
E.
Decongestants mixture
What used to inhalation of bronchial asthma on fig. 19?
B.
C.
D.
E.
203.
204.
205.
206.
207.
208.
209.
210.
211.
Expectorants herbal concoctions
*b2-agonists
Anesthetics
Soda-saline
Decongestants mixture
What used to inhalation of acute tracheitis on fig. 19?
A.
Expectorants herbal concoctions
B.
b2-agonists
C.
Anesthetics
D.
*Soda-saline
E.
Decongestants mixture
What used to inhalation for angina on fig. 19?
A.
Expectorants herbal concoctions
B.
b2-agonists
C.
*Anesthetics
D.
Soda-saline
E.
Decongestants mixture
What is depicted on the fig.20?
A.
Ultrasonic nebulizer
B.
Cardio-Respiratory Monitor
C.
*Apparatus for the artificial lungs ventilation
D.
Infusion dosing
E.
Apparatus Ambu
This form of the chest is called on fig. 21:
A.
*Barrel chest
B.
Hyperstenic
C.
Hyposthenic
D.
Asthenic
E.
Normal
This form of chest indicates on fig.21:
A.
*Emphysema
B.
Attack of asthma
C.
Obstructive bronchitis
D.
False croup
E.
True croup
Put the diagnosis of patient with chest X-ray on fig. 22.
A.
Acute pneumonia
B.
*Acute obstructive bronchitis
C.
Acute bronchiolitis
D.
Foreign body
E.
Congenital heart disease
Describe the changes on the radiograph on fig.22.
A.
Changing the shape of the heart
B.
Hilar infiltration
C.
Enhancement bronho-vascular pattern
D.
*Diminished of the vascular pattern on the periphery and increased in the central parts
E.
Deformation of the bronchial pattern
What is depicted on the fig 23?
A.
Epistaxis
B.
Coryza
C.
Stridor nasal
D.
Symptom of "the rabbit's nose"
E.
*Allergic rhinitis
A.
B.
C.
D.
E.
212.
213.
214.
215.
216.
217.
218.
219.
220.
221.
222.
223.
224.
225.
226.
227.
228.
What indicates this symptom on fig 23?
A.
Acute respiratory infection
B.
Epistaxis
C.
Sridor nasal
D.
Allergic rhinitis
E.
*The beginning of an asthmatic attack
What period of asthma conducted allergic skin tests (on fig. 24)
A.
Initial
B.
Acute
C.
Asthmatic status
D.
Healing
E.
* Remission
What are the allergens most often the cause of asthma in children (on fig. 24)?
A.
Occupational irritants
B.
Tobacco smoke
C.
Cockroaches
D.
*Domestic dust mites
E.
Pollen
What is depicted on figure 25?
A.
MDI - Metered dose inhaler
B.
*Peak flow meter
C.
Nasal spray
D.
Spray for the throat
E.
Spray the mouth
What is depicted on figure 26?
A.
*MDI - Metered dose inhaler
B.
Peak flow meter
C.
Nasal spray
D.
Spray for the throat
E.
Spray the mouth
For any disease using this method on fig. 26?
A.
*Bronchial asthma
B.
Obstructive bronchitis
C.
Bronchiolitis
D.
Stenosis of the larynx
E.
All these
The child of 10 years complains of high temperature, pain in abdomen, and pain during urination.
In rinalysis: protein – 0.33 g/l, leucocytes – in all visual field, erythrocytes 5-10 in visual field.
What nvestigation is it necessary to do to know the level of urinary system damaging (Fig. 87)?
A.
*Urographya
B.
To take urine by catheter
C.
Bacteriological test of urine
D.
Ultrasound investigation
E.
Zimnitskiy test
The child of 9 years become ill acutely: temperature is 39 C, pain in lower back, and pain during
rination. Pasternatskiy symptom is positive bilaterally, more in the left side (Fig. 88). What is the
most robable diagnosis?
A.
*Acute pyelonephritis
B.
Acute viral infection
C.
Acute cystitis
D.
Acute glomerulonephritis
E.
Kidney colic
The child is 10 years old. The complaints are: increase of temperature, pain in abdomen, and pain
uring urination. In analysis of urine: protein – 0,33 g/l, leucocytes – in all field of view,
erythrocytes 5-10 in ield of view. What investigation it is necessary to prescribe to know the level
of damaging of urinary system Fig. 87)?
A.
*Urography
B.
To take urine by catheter
C.
Bacteriological test of urine
D.
Ultrasound investigation
E.
Zimnitskiy test