Krok2 - Medicine - 2013

Krok 2 Medicine 2013 1
1. A 28-year-old patient complains of

infertility. The patient has been marri- A. Right-sided tubal pregnancy
ed for 4 years, has regular sexual life B. Right ovary apoplexy
and does not use contraceptives but has C. Acute right-sided salpingoophoritis
never got pregnant. Examination revealed D. Pelvioperitonitis
normal state of the genitals, tubal patency. E. Incipient abortion
Basal body temperature recorded over the
course of 3 consecutive menstrual cycles 5. 5 weeks after hypothermia a 22-year-old
appeared to have a single phase. What is patient developed fever, weakness, muscle
the most likely cause of infertility? pain, inability to move independently.
Objectively: tenderness, induration of
A. Anovulatory menstrual cycle shoulder and shin muscles, restricted acti-
B. Immunological infertility ve movements, erythema on the anteri-
C. Genital endometriosis or surface of chest. There is a periorbi-
D. Chronic salpingoophoritis tal edema with heliotropic erythema.
E. Ovulatory menstrual cycle Gottron’s sign is present. What study is
required to verify the diagnosis?
2. A 40-year-old female patient has been
hospitalized for attacks of asphyxia, cough A. Muscle biopsy
with phlegm. She has a 4-year history of B. Aminotransferase activity
the disease. The first attack of asphyxia C. Pneumoarthrography
occurred during her stay in the countrysi- D. ASO titre
de. Further attacks occurred while cleani- E. Rheumatoid factor
ng the room. After 3 days of inpatient
treatment the patient’s condition has si- 6. A 24-year-old patient consulted a
gnificantly improved. What is the most doctor about enlarged submandibular
likely etiological factor? lymph nodes. Objectively: submandi-
bular, axillary and inguinal lymph nodes
A. Household allergens are enlarged. Chest radiograph shows
B. Pollen enlarged mediastinal lymph nodes. In
C. Infectious blood: RBCs - 3, 4 · 1012 /l, Hb- 100 g/l,
D. Chemicals colour index - 0,88, thrombocytes - 190 ·
E. Psychogenic 109 /l, WBCs - 7, 5 · 109/l, eosinophils -
8%, stab neutrophiles - 2%, segmented
3. A 13-year-old girl complains of peri- neutrophiles - 67%, lymphocytes - 23%,
odic prickly pain in the heart regi- ESR - 22 mm/h. What study is required to
on. Percussion revealed no changes of verify the cause of lymphadenopathy?
cardiac borders. Auscultation revealed
arrhythmic enhanced heart sounds, A. Open biopsy of lymph nodes
extrasystole at the 20-25 cardiac impulse. B. Ultrasound examination of the
ECG showed the sinus rhythm, impai- abdomen
red repolarization, single supraventricular C. Mediastinal tomography
extrasystoles at rest. What is the most li- D. Puncture biopsy of lymph nodes
kely diagnosis? E. Sternal puncture
A. Vegetative-vascular dysfunction 7. A patient operated for acute paraprocti-
B. Rheumatism tis undergoes antibacterial and detoxi-
C. Nonrheumatic carditis fication therapy, the local course of the
D. Myocardial degeneration disease has the positive dynamics. Since
E. Intoxication syndrome the operation the patient has had chi-
lls, pyrexia, tachycardia, euphoria for five
4. A 28-year-old patient has been taken days. The doctor suspected sepsis. What
to a hospital for acute pain in the lower study will confirm the diagnosis?
abdomen. There was a brief syncope.
The delay ofmenstruation is 2 months. A. Blood culture for a pathogen
Objectively: the patient has pale skin, B. X-ray of lungs
AP- 90/50 mm Hg, Ps- 110/min. Lower C. Liver ultrasound
abdomen is extremely painful. Vaginal D. Determining the rate of microbial
examination reveals uterus enlargement. contamination of wound
There is positive Promtov’s sign. Right E. Determining the rate of average-weight
appendages are enlarged and very pai- molecules
nful. Posterior vault hangs over. What is
the most likely diagnosis? 8. A painter working at a motorcar
plant has been diagnosed with A. Tuberculous meningitis

moderately severe intoxication with ami- B. Secondary purulent meningitis
de compounds of benzene. The in-patient C. Epidemic cerebrospinal meningitis
treatment resulted in a considerable D. Serous meningitis
health improvement. What expert deci- E. Pneumococcal meningitis
sion should be made in this case?
11. A 13-year-old girl has a 5-year histrory
A. The patient should be issued a sick list of pain in the right hypochondrium irradi-
for out-patient treatment ating to the right shoulder blade. The pain
B. The patient may get back to work attacks are usually associated with diet vi-
providing he will keep to hygiene and olations, they are short and can be easily
sanitary regulations relieved by antispasmodic drugs. During a
C. The patient should be referred to pain attack, palpation of the abdomen is
the medio-social expert commission for painful, the pain is most intensive in the
evaluation of percentage of work capicty projection of the gallbladder. What is the
loss most likely diagnosis?
D. The patient should be referred to
the medio-social expert commission for A. Biliary dyskinesia
attributing the disability group because of B. Chronic cholecystitis
an occupational disease C. Chronic gastroduodenitis
E. - D. Chronic pancreatitis
E. Duodenal ulcer
9. A 58-year-old female patient came
to the antenatal clinic complaining of 12. A 24-year-old patient got a puncture
bloody light-red discharges from the injury below the Poupart’s ligament
genital tracts. Menopause is 12 years. accompanied by intense arterial bleedi-
Gynaecological examination revealed ng. The best method to temporarily stop
age involution of externalia and vagi- the bleeding in the patient would be:
na; uterine cervix was unchanged, there A. Compression band
were scant bloody discharges from uteri- B. Esmarch’s tourniquet
ne cervix, uterus was of normal size; C. Maximum limb bending
uterine appendages were not palpable; D. Compressing a blood vessel with a
parametria were free. What is the most clamp
likely diagnosis? E. Wound suturing
A. Uterine carcinoma 13. A 64-year-old patient complains of
B. Atrophic colpitis severe pain in the right side of chest,
C. Abnormalities of menstrual cycle of dyspnea, dry cough which appeared
climacteric nature suddenly on exertion. Objectively: the ri-
D. Cervical carcinoma ght side of the chest lags behind in the act
E. Granulosa cell tumor of ovary of breathing. Percussion reveals tympanic
10. A 7-year-old boy had complai- sound. Auscultation reveals pronouncedly
ned of headache, nausea, fatigue for 3 diminished breath sounds on the right. Ps-
weeks. His condition gradually deteri- 100/min, weak, arrhythmic. AP- 100/50
orated, headache and general weakness mm Hg. Cardiac sounds are decreased.
progressed. The boy had bronchitis at What disease can be suspected in this pati-
the age of 3. His father has a history ent?
of pulmonary tuberculosis. Objectively: A. Right-sided pneumothorax
body temperature 37, 5oC, conscious, li- B. Right-sided hydrothorax
es supine, with the hip and knee flexed C. Right-sided dry pleurisy
to 90 degrees, nuchal rigidity +6 cm, D. Right-sided pleuropneumonia
partial ptosis of the right eyelid, the di- E. PATE
lated right pupil. General hyperalgesia
is present. Liquor: transparent, pressure 14. An 18-year-old patient since childhood
- 400 mm of water column, protein - suffers from bleeding disorder after mi-
1,5%, cytosis - 610/3 with predominant nor injuries. His younger brother also
lymphocytes, sugar - 1,22 mmol/l, chlori- has bleeding disorders with occasional
des - 500 mmol/l. What is the most likely haemarthrosis. Which laboratory test will
diagnosis? be informative for diagnosis verification?
A. Clotting time A. II degree flame burn of hands with an

B. Fibrinogen rate area of 4/
C. Blood clot retraction B. II degree flame burn of hands with an
D. Thrombocyte count area of 2/
E. Determination of prothrombin time C. IIIa degree flame burn of hands with an
area of 4/
15. A patient complains of fatigue, lack D. III degree flame burn of hands with an
of appetite, pain and burning sensation area of 4/
in the tongue, numbness of the distal li- E. IIb degree flame burn of hands with an
mbs, diarrhea. Objectively: pale skin with area of 2/
lemon-yellow tint, face puffiness, brown
pigmentation in the form of a "butterfly", 18. During the periodic medical exami-
bright red areas on the tongue. The li- nation an assembly fitter (works on
ver is 3 cm below the costal margin, soldering details) didn’t report any health
soft. Blood count: RBCs - 1, 5 · 1012 /l, problems. Closer examination revealed
colour index - 1,2, WBCs - 3, 8 · 109 /l, signs of asthenic-vegetative syndrome.
thrombocytes - 180 · 109 /l, eosinophils - Blood included red blood cells with
0%, stab neutrophils - 1%, segmented basophilic aggregations and a somewhat
neutrophils - 58%, lymphocytes - 38% higher number of reticulocytes, uri-
monocytes - 3%, RBC macrocytosis. ESR ne had a high concentration of delta-
- 28 mm/h. What diagnosis are these aminolevulinic acid. The complex of
presentation typical for? symptoms indicates the initial stage of
chronic intoxication with:
A. B12 -deficiency anemia
B. Iron deficiency anemia A. Lead
C. Aplastic anemia B. Manganese
D. Acute erythromyelosis C. Mercury
E. Chronic adrenal failure D. Tin
E. Ethanol
16. Medical examination of a 19-
year-old worker revealed generalized 19. A patient complains about sudden
lymphadenopathy mainly affecting the onsets of paroxysmal pain in the right
posterior cervical, axillary and ulnar lumbar region. 2 hours after the onset the
lymph nodes. There are multiple injecti- patient had hematuria. Plain radiograph
on marks on the elbow bend skin. The of the lumbar region shows no pathologi-
man denies taking drugs, the presence cal shadows. USI reveals pyelocaliectasis
of injection marks ascribes to influenza on the right, the left kidney is normal.
treatment. Blood count: RBCs- 3, 2·1012/l, What is the most likely diagnosis?
Hb- 100 g/l, WBCs- 3, 1 · 109 /l, moderate
lymphopenia. What study is required in A. Renal colic
the first place? B. Acute appendicitis
C. Bowel volvulus
A. ELISA for HIV D. Torsion of the right ovary cyst
B. Immunogram E. Right renal pelvis tumour
C. Sternal puncture
D. X-ray of lungs 20. Examination of a group of persons
E. Lymph node biopsy living on the same territory revealed
the following common symptoms: dark-
17. A patient got flame burns of both yellow pigmentation of the tooth enamel,
hands. On the dorsal and palmar surface diffuse osteoporosis of bone apparatus,
of hands the blisters are filled with serous ossification of ligaments and joints, functi-
fluid. The wrist joint region is hyperemic. onal disorders of the central nervous
The forearms were not injured. What is system. This condition may be caused
the provisional diagnosis? by the excessive concentration of the
following microelement in food or drinki-
ng water:
A. Fluorine
B. Copper
C. Nickel
D. Iodine
E. Cesium
21. A 50-year-old patient complains of A. Panzinorm forte

bursting pain in the left lower limb that B. Insulin
is getting worse on exertion, swelling in C. Gastrozepin
the region of shin and foot. Objectively: D. Contrycal
left shin and foot are doughy, skin of the E. No-spa
lower shin is indurated and has a bronze
tint, subcutaneous veins are dilated, there 25. A patient is on the sick leave for 4
is an ulcer with necrotic masses. What is months continuously from the date of
the most likely diagnosis? injury. The treatment is going to last for
1-2 months more. Who has the right to
A. Postthrombophlebitic syndrome extend the duration of medical certificate
B. Chronic arterial insufficiency for this patient?
C. Acute arterial thrombosis
D. Deep vein thrombosis of the lower A. Medical advisory commission after
limbs medico-social expert commission exami-
E. Gangrene of the lower extremity nation
B. Medical superintendent
22. A 12-year-old boy has a 6-year hi- C. Medical advisory commission after
story of insulin-dependent diabetes. The inpatient treatment
disease is labile. Since recently there D. District doctor by agreement with a
have been periodical rises in blood department chief
pressure. Microalbuminuria test gave E. Medico-social expert commission
positive results. The patient’s condition
corresponds with the following stage of 26. Full-term pregnancy. Body weight
diabetic nephropathy: of the pregnant woman is 62 kg. The
fetus has the longitudinal position, the
A. Stage III - early-stage nephropathy fetal head is pressed against the pelvic
B. Stage I - renal hypertrophy and inlet. Abdominal circumference is 100
hyperfunction cm. Fundal height is 35 cm. What is the
C. Stage II - histological changes in the approximate weight of the fetus?
kidneys
D. Stage IV - advanced clinical A. 3 kg 500 g
nephropathy B. 4 kg
E. V stage - chronic renal failure C. 2 kg 500 g
D. 3 kg
23. A 48-year-old patient was found to E. 4 kg 500 g
have diffuse enlargement of the thyroid
gland, exophthalmia, weight loss of 4 kg 27. A rural hospital serves 6200 people.
in 2 months, sweating. Objectively: HR- Preventive examinations were planned
105/min, AP- 140/70 mm Hg. Defecati- for 560 farm workers with different risk
on act is normal. What kind of therapy is factors. 400 workers underwent preventi-
recommended in this case? ve examination. 120 individuals were
found to have cardiovascular problems,
A. Mercazolil 90 of them were registered with a di-
B. Radioiodine spensary department for health care mai-
C. Propranolol ntenance. Which indicator should be used
D. Lugol’s solution to assess the organization of health care
E. Thyroxine maintenance at the hospital?
24. A 48-year-old male patient complains A. Share of workers who actually
of constant pain in the upper abdomen, underwent preventive examinations
mostly on the left, that is getting worse B. Share of newly diagnosed patients
after taking meals; diarrhea, weight loss. C. Share of persons subject to preventive
The patient is an alcohol abuser. 2 years examinations
ago he had acute pancreatitis. Blood D. Share of diseased persons
amylase is 4 g/h·l. Coprogram shows E. Incidence of cardiovascular diseases
steatorrhea, creatorrhea. Blood glucose
is 6,0 mmol/l. What treatment is indicated 28. A 20-year-old patient complai-
for this patient? ns of severe headache, double vision,
weakness, fever, irritability. Objectively:
body temperature is at the rate of 38, 1o C,
the patient is reluctant to contact, sensi-
tive to stimuli. There is ptosis of the
left eyelid, exotropia, anisocoria S>D, A. Posterior vertex presentation

pronounced meningeal syndrome. On B. Anterior vertex presentation
lumbar puncture the cerebrospinal fluid C. Presentation of the bregma
flowed out under a pressure of 300 mm D. Brow presentation
Hg, the fluid is clear, slightly opalescent. E. Face presentation
24 hours later there appeared the fibri-
nous film. Protein - 1,4 g/l, lymphocytes - 32. During medical monitoring of labor
600/3 per mm3 , sugar - 0,3 mmol/l. What and professional training of 6th grade
is the provisional diagnosis? schoolchildren the school doctor found
that lessons in carpentry workshop are
A. Tuberculous meningitis held on Friday as the fourth and fifth
B. Meningococcal meningitis lesson of a total of 90 minutes, the motor
C. Lymphocytic Armstrong’s meningitis density at the first lesson is 69%, and 65%
D. Syphilitic meningitis at the second. Does the lesson organizati-
E. Mumps meningitis on meet the hygienic requirements?
29. A 32-year-old patient has developed A. Meets the requirements

an acute condition after hypothermia: B. Does not meet the requirements in
temperature - 40oC, cough with 200 terms of training duration
ml of sputum per day. The sputum is C. Does not meet the requirements in
purulent, foul-smelling. To the right of terms of motor density at the 1st lesson
the lower lobe the mixed moist rales can D. Does not meet the requirements in
be auscultated. Blood tst results: WBCs - terms of motor density at the 2nd lesson
18, 0 · 109 /l, ESR - 45 mm/h. Radiographi- E. Does not meet the requirements as
cally: in the lower lobe of the right lung there are two consecutive lessons
there is a thick-walled cavity up to 6 cm
in diameter with a high horizontal level. 33. During coal extraction in a mine the
What is the most likely diagnosis? concentration of coal dust in the working
area is 450 mg/m3 (MPC is 10 mg/m3 ).
A. Lung abscess What occupational respiratory disease
B. Fibro-cavernous pulmonary may develop in miners?
tuberculosis
C. Lung cyst A. Anthracosis
D. Decomposing lung carcinoma B. Allergic nasopharyngitis
E. Infiltrative pulmonary tuberculosis C. Byssinosis
D. Siderosis
30. A family consists of 5 persons. E. Talcosis
The husband is a stope miner. His
spouse is a housewife. Their 20-year-old 34. A patient with suspected pheochromocytoma
daughter works as a kindergarten teacher. has normal blood pressure in the peri-
Their 18-year-old son is a student. The ods between the atacks and a tendency
grandmother is a pensioner, she has di- to tachycardia. Urine test revealed no
abetes. Which member of this family can pathology. It was decided to use a
be primarily classed among the group of provocative test with histamine. What
persons with a high risk of tuberculosis in medication should be prepared to provide
the planning of preventive examinations emergency care in case of a positive test
for tuberculosis? result?
A. Grandmother A. Phentolamine
B. Husband B. Pipolphen
C. Daughter C. Nifedipine
D. Son D. Mesatonum
E. Wife E. Prednisolone
31. A newborn’s head is of doli- 35. A 54-year-old patient complains of

chocephalic shape, that is front-to-back frequent painful urination, chills, fever
elongated. Examination of the occipital up to 38o C. Urine test results: protein -
region revealed a labour tumour located 0,33 g/L, WBCs - up to 50-60 in the field
in the middle between the prefontanel of vision, RBCs - 5-8 in the field of vi-
and posterior fontanel. Specify the type sion, gram-negative bacilli. Which of the
of fetal presentation: listed antibiotics should be preferred in
this case?
A. Ciprofloxacin A. Chronic type A gastritis

B. Oxacillin B. Chronic type B gastritis
C. Erythromycin C. Chronic type C gastritis
D. Tetracycline D. Menetrier disease
E. Tseporin E. Stomach cancer
36. The share of circulatory diseases was 40. A 45-year-old female patient complai-
15% in the total of registered diseases ns of frequent liquid stools with a lot of
among city population. What statistic indi- mucus, pus and blood; pain across the
cator is it? abdomen, loss of 7 kg within 6 months.
She has a 1-year history of non-specific
A. Extensive ulcerative colitis. What group of drugs
B. Intensive should be preferred for this patient?
C. Demonstrative
D. Ratio A. Corticosteroids
E. Average B. Antibacterial
C. Sulfonamides
37. During a regular medical examination D. Nitrofurans
at a metallurgical plant 20% of workers E. Polyenzymes
were found overweight (body weight was
5-14% higher than normal), and had early 41. A 24-year-old female teacher complai-
signs of obesity (grade I-II) with Quetelet ns of dizziness and heart pain irradiati-
index from 26 to 30. What products share ng to the left nipple. Pain is not associ-
must be reduced in the diet of this group ated with physical activity and cannot be
of people in the first place in order to relieved by nitroglycerin, it abates after
normalize their body weight? taking Valocordin and lasts an hour or
more. The patient has a nearly 2-year hi-
A. Bakery products story of this disease. Objectively: Ps- 76
B. Vegetables bpm. AP- 110/70 mm Hg. Heart borders
C. Fruit are normal, heart sounds are clear.
D. Milk and dairy products The ECG shows respiratory arrhythmia.
E. Meat and fish products Radiograph of the cervicothoracic spi-
ne shows no pathology. Lungs, abdomen
38. Several hours before, a 28-year- are unremarkable. What changes in blood
old patient suddenly developed acute formula can be expected?
headache and repeated vomiting, then
lost consciousness. Objectively: focal A. No changes
neurological symptoms were not found. B. Leukocytosis
Pronounced meningeal symptoms were C. Thrombocytopenia
revealed. AP - 120/80 mm Hg. Accordi- D. Leukemic hiatus
ng to clinical and liquorological findi- E. Increased ESR
ngs the patient was diagnosed with
subarachnoid haemorrhage. After admi- 42. A 60-year-old male patient, who works
nistration of dehydrants the patient’s as a construction worker, complains of
condition somewhat improved. What is pain in the right hip and knee joints,
the main component of further emergency that is getting worse on exertion. These
care? presentations have been observed for
the last 5 years. Objectively: the pati-
A. Coagulants ent is overnourished. Right knee joi-
B. Anticoagulants nt is moderately deformed. Examinati-
C. Antiaggregants on of other organs and systems revealed
D. Fibrinolytics no pathology. Blood tet results: WBCs -
E. Corticosteroids 8, 2 · 109 /l, ESR - 15 mm/h. Uric acid - 0,35
mmol/l. What is the most likely diagnosis?
39. Gastric juice analysis of a 42-year-
old male patient revealed absence of A. Deforming osteoarthritis
free hydrochloric acid at all stages. B. Reactive arthritis
Endoscopy revealed pallor, thinning of C. Gout
gastric mucosa, smoothed folds. Mi- D. Rheumatoid arthritis
croscopically the atrophy of glands with E. Reiter’s disease
intestinal metaplasia was found. What di-
sease is this situation typical for? 43. Chief physician of a polyclinic
encharged a district doctor with a task to
determine the pathological prevalence of appeared 5 days ago after a contact with
disease N in his district. What document a person having ARVI. Objectively: the
allows to estimate the disease prevalence child is in grave condition. Temperature
in the population of a medical district? of 38o C, cyanosis of nasolabial triangle is
present. RR- 54/min, nasal flaring while
A. Prophylactic examinations register breathing. There was percussion dullness
B. Statistic coupons (+) on the right below the scapula angle, and
C. Statistic coupons (-) tympanic sound over the rest of lungs.
D. Statistic coupons (+) and (-) Auscultation revealed bilateral fine moist
E. Vouchers for medical appointments rales predominating on the right. What is
the most likely diagnosis?
44. A 32-year-old female complains of di-
zziness, headache, palpitation, tremor. For A. Acute pneumonia
the last several months she has been under B. ARVI
outpatient observation for the increased C. Acute laryngotracheitis
arterial pressure. Since recently such D. Acute bronchitis
attacks have become more frequent and E. Acute bronchiolitis
severe. Objectively: skin is covered with
clammy sweat, tremor of the extremities 48. A 40-year-old patient complains of
is present. HR- 110/min, AP- 220/140 mm fever up to 39o C, cough with sputum and
Hg. Heart sounds are muffled. Blood test blood admixtures, dyspnea, weakness,
results: WBCs - 9, 8 · 109/l, ESR - 22 mm/h. herpetic rash on the lips. Objectively:
Blood glucose - 9,8 millimole/l. What di- respiration rate - 32/min. Under the
sease is the most likely cause of this crisis? shoulder blade on the right the increased
vocal fremitus and dullness of percussi-
A. Pheochromocytoma on sound were revealed. Auscultation
B. Essential hypertension revealed bronchial respiration. Blood
C. Preeclampsia count: WBCs - 14 · 109 /l, ESR - 35 mm/h.
D. Primary hyperaldosteronism What is the provisional diagnosis?
E. Diabetic glomerulosclerosis
A. Right-sided croupous pneumonia
45. A 55-year-old male has a 1,5-year B. Focal right-sided pneumonia
history of viral cirrhosis with symptoms C. Cavernous tuberculosis of the right lung
of portal hypertension. Over the last D. Lung cancer
month the weakness has progrssed, E. Exudative pleuritis
there appeared coffee ground vomit. Fi-
brogastroduodenoscopy revealed vari- 49. A patient underwent stomach resecti-
ceal esophageal haemorrhage. What drug on. During the operation, the left upper
should be used to reduce the pressure in limb of the patient was abducted and fi-
the portal vein? xed to the operating table for anesthetic
management. Postoperatively, the pati-
A. Vasopressin ent developed dysfunction of the upper
B. Reserpine extremity in form of "drop hand."This
C. Calcium gluconate symptom results from the damage of the
D. Dicynone following nerve:
E. Furosemide
A. Radial nerve
46. In an urban settlement situated on the B. Axillary nerve
riverbank an outbreak of hepatitis A was C. Ulnar nerve
registered. The disease might have water D. Median nerve
origin. This assumption can be confirmed E. Musculocutaneous nerve
by growth of the following indicators of
water quality: 50. In the morning a patient had nausea,
abdominal discomfort, single vomiti-
A. Number of coli-phages ng, dry mouth. In the evening, the
B. Escherichia coli index patient presented with the increasing
C. Oxidability general weakness, double vision, diffi-
D. Presence of benign leptospirosis cult swallowing of solid food. Objectively:
pathogen ptosis, mydriasis, anisocoria, absence of
E. Index of fecal coli-forms gag and pharyngeal reflex, dry mucous
membranes. The previous evening the
47. A 9-month-old child presents with patient had dinner with canned food
fever, cough, dyspnea. The symptoms
and alcohol. What is the presumptive di- tive airway pressure). Ro-gram of lungs
agnosis? shows reticular and nodular pattern, air
bronhogram. What is the most likely cause
A. Botulism of respiratory distress syndrome?
B. Food toxicoinfection
C. Intoxication with unknown poison A. Hyaline membrane disease
D. Acute ischemic stroke B. Segmental atelectasis
E. Poliomyelitis C. Bronchopulmonary dysplasia
D. Congenital pulmonary emphysema
51. An 8-year-old child complains of fever E. Edematous hemorrhagic syndrome
up to 38, 8o C, throat pain when swallowi-
ng, skin rash. Objectively: lacunar tonsi- 55. An 8-year-old child with a 3-year
llitis, circumscribed hyperaemia and history of diabetes was hospitalized in
enanthema of soft palate, pinoint-sized hyperglycemic coma. Specify the initial
skin rash, mostly in the folds and on dose of insulin to be administered:
the flexor surfaces of the extremities,
pale nasolabial triangle. Which antibiotic A. 0,1-0,2 U/kg of body weight per hour
should be administered in the first place? B. 0,05 U/kg of body weight per hour
C. 0,2-0,3 U/kg of body weight per hour
A. Penicillin D. 0,3-0,4U/kg of body weight per hour
B. Gentamicin E. 0,4-0,5 U/kg of body weight per hour
C. Ampicillin
D. Lincomycin 56. A 12-year-old girl undergoes
E. Tetracycline regular gastroenterological check-ups for
duodenal ulcer, biliary dyskinesia. What
52. A 28-year-old female patient with a is the recommended frequency of anti-
six-year history of Raynaud’s syndrome relapse treatment?
has recently developed pain in the small
joints of hands, difficult movement of food A. Twice a year
down the esophagus. What kind of disease B. Every 2 months
can you think of in this case? C. Every 3 months
D. Once a year
A. Systemic scleroderma E. Three times a year
B. Periarteritis nodosa
C. Rheumatoid arthritis 57. A 47-year-old patient came to see a
D. Systemic lupus erythematosus doctor on the 7th day of disease. The di-
E. Pseudotrichiniasis sease developed very fast: after the chill
body temperature rose up to 40o C and
53. A 16-year-old girl had had polyuria, lasted up to 7 hours, then it dropped
polydipsia for 2 months. She had lost abruptly, which caused profuse sweat.
8 kg with a good appetite. The patient There were three such attacks occuri-
was urgently hospitalized for abdominal ng once in two days. Two days ago the
pain and nausea. Examination revealed patient arrived from Africa. Objectively:
glycemia at the rate of 18 mmol/l, pale skin, subicteric sclera, significantly
glycosuria at the rate of 24 g/l. Insulin enlarged liver and spleen. What is the
and infusion of isotonic solutions of sodi- cause of fever attacks in this disease?
um chloride and glucose eliminated these
problems, including thirst. What is the A. Erythrocytic schizogony
most likely diagnosis? B. Tissue schizogony
C. Exotoxin of a causative agent
A. Diabetes mellitus type 1 D. Endotoxin of a causative agent
B. Diabetes mellitus type 2 E. Gametocytes
C. Renal glycosuria
D. Diabetes insipidus 58. On the 2nd day of illness a 27-
E. Secondary (symptomatic) diabetes year-old patient complains of unbearable
headache, repeated vomiting. Objecti-
54. A boy was born at 32 weeks gestati- vely: the patient is in a grave condition.
on. 2 hours after birth he developed He is conscious but adynamic. Lies in a
respiratory distress. The RD severity forced position with his head thrown back.
assessed by Silverman score was 5. The There is no skin rash. Nuchal muscles
respiratory disorders progressed, respi- are evidently rigid, there are Kernig’s and
ratory failure couldn’t be eliminated by Brudzinski’s signs. to - 39, 5oC, Ps- 120/min,
Martin-Bouyer CPAP (continuous posi- AP- 130/80 mm Hg. The leading syndrome
of this disease is caused by: Heart sounds are muffled, rhythmic.

ECG: Rv1+Sv5=15 mm. X-ray picture
A. Liquor hypertension shows the bulging of pulmonary artery
B. Liquor hypotension cone, right ventricle enlargement. What is
C. Affection of the cranial nerve nuclei the most likely cause of this condition?
D. Haemorrhages into the adrenal glands
E. Hyperthermy A. Pulmonary heart
B. Atherosclerotic cardiosclerosis
59. A 42-year-old female patient suffers C. Dilatation cardiomyopathy
from micronodular cryptogenic cirrhosis. D. Mitral stenosis
Over the last week her condition has E. Primary pulmonary hypertension
deteriorated: she developed convulsions,
mental confusion, progressing jaundice. 63. A 40-year-old woman with a history
What study may give reasons for such of combined mitral valve disease wi-
aggravation? th predominant stenosis complains of
dyspnea, asthma attacks at night, heart
A. Determination of serum ammonia problems. At present, she is unable to do
B. Determination of cholesterol ethers easy housework. What is the optimal tacti-
C. Determination of alpha-phetoprotein cs of the patient treatment?
D. Determination of ALAT and ASAT
E. Determination of alkaline phosphatase A. Mitral commissurotomy
B. Implantation of an artificial valve
60. A 60-year-old patient complai- C. Antiarrhythmia therapy
ns of recurrent pain in the proximal D. Treatment of heart failure
interphalangeal and wrist joints, their E. Antirheumatic therapy
periodic swelling and reddening that
have been observed for 4 years. X-ray 64. A 25-year-old patient complains of
picture represents changes in form of having dull heart pain for the last 10
osteoporosis, joint space narrowing and days, dyspnea on mild exertion, palpi-
single usuras. What is the most likely di- tations. The diasease developed 2 weeks
agnosis? ago after a respiratory infection. Objecti-
vely: acrocyanosis, AP- 90/75 mm Hg, Ps-
A. Rheumatoid arthritis 96/min. Cardiac borders appear to be shi-
B. Osteoarthritis fted to the left and right. Heart sounds
C. Gout are weak and have triple rhythm, there is
D. Pseudogout systolic murmur at the apex. ECG showed
E. Multiple myeloma sinus rhythm, complete left bundle branch
block. What is the most likely diagnosis?
61. A 28-year-old patient has been hospi-
talized for the pain in the epigastric regi- A. Infectious-allergic myocarditis
on. He has a 10-year history of duodenal B. Exudative pericarditis
ulcer (DU). Recently, the pain character C. Infective endocarditis
has changed: it became permanent, persi- D. Myocarditic cardiosclerosis
stent, irradiating to the back. There are E. Vegetative-vascular dystonia
general weakness, dizziness, fatigue. The
patient has put off weight. Objectively: 65. A child undergoes in-patient
HR- 68/min, AP- 120/80 mm Hg. What is treatment for acute staphylococcal
most likely cause of deterioration? destruction of the right lung. Unexpectedly
he develped acute chest pain on the ri-
A. Penetration ght, dyspnea, cyanosis. The right side of
B. Haemorrhage chest lags behind in the respiratory act.
C. Perforation of duodenal wall Percussion reveals dullness in the lower
D. Exacerbation of duodenal ulcer parts on the right, bandbox resonance in
E. Stenosis development the upper parts. Borders of the relati-
ve cardiac dullness are shifted to the
62. A 57-year-old male patient complai- left. What complication has most likely
ns of dyspnea on exertion, heaviness developed?
in the right hypochondrium and shin
edemata towards evening. Objectively:
temperature - 38, 1oC, HR- 20/min,
HR=Ps=92/min, AP- 140/90 mm Hg.
There is apparent kyphoscoliosis. In the
lungs single dry rales can be auscultated.
A. Right-sided pyopneumothorax ameter. Excretory urograms show normal

B. Pleural empyema condition on the left, and the deformati-
C. Spontaneous pneumothorax on of the superior renal calyces with sati-
D. Exudative pleuritis sfactory function on the right. What kind
E. Right lung abscess of disease can you think of?
66. Examination of a 13-year-old gi- A. Simple cyst of the right kidney
rl revealed acute glomerulonephritis, B. Multicystic kidney disease
nephritic syndrome at the initial stage wi- C. Multiple cysts of the right kidney
thout renal dysfunction. What is the main D. Tumour of the right kidney
drug of choice for the basic therapy of this E. Right hydronephrosis
patient?
70. While staying in a stuffy room a 19-
A. Antibiotic year-old emotionally labile girl developed
B. Prednisolone severe weakness, dizziness, blackout,
C. Curantyl nausea and loss of consciousness without
D. Heparin convulsions. Objectively: the patient is
E. Saluretic unconscious, the skin is pale, extremiti-
es are cold. AP- 90/60 mm Hg, Ps- 96/min,
67. A 28-year-old patient consulted deficient, breathing is shallow. Pupillary
a surgeon about pain, edema and and tendon reflexes are present. There are
hyperemia of the left side of his face, no pathological signs. What is the most li-
weakness, fever up to 39o C. These mani- kely diagnosis?
festations has been present for three days.
Objectively: there is an inflammatory infi- A. Syncope
ltrate of the left nasolabial fold 4x4 cm B. Vegetovascular paroxysm
large with a necrotic core in the center, the C. Epileptic attack
pronounced edema of the left side of face, D. Hysterical neurosis
moderate nuchal rigidity. What treatment E. Transient ischemic attack
is needed?
71. A 13-year-old boy complains of pain
A. Hospitalization, antibiotics, anti- in the upper third of his left thigh, body
coagulants, rest temperature rise up to 39oC. There is a
B. Antibiotics, surgery under general swelling in the upper third of thigh and
anesthesia inguinal fold smoothness. The extremity is
C. Wet-to-dry dressings with antiseptics, in a half-bent position. Active and passi-
aspirin ve movements are not possible because of
D. Physiotherapy, immunomodulators the sharp pain. What is the most likely di-
E. Antibiotics, angioprotectors, daily agnosis?
dressings
A. Acute hematogenous osteomyelitis
68. A 6-year-old child complains of B. Acute coxitis
frequent liquid stool and vomiting. On the C. Intermuscular phlegmon
2nd day of desease the child presented D. Osteosarcoma
with inertness, temperature rise up to E. Brodie’s disease
38, 2oC, Ps- 150 bpm, scaphoid abdomen,
palpatory painful sigmoid colon, defecati- 72. A 12-year-old cild has been hit on
on 10 times a day with liquid, scarce stool the stomach. The patient is in moderately
with mucus and streaks of green. What is grave condition, has a forced position in
a provisional diagnosis? bed. The skin is pale, Ps- 122/min. The
stress on the left costal arch causes a
A. Shigellosis slight pain. There are positive Weinert,
B. Salmonellosis Kulenkampff symptoms. Macroscopically
C. Escherichiosis the urine is unchanged. What is the most
D. Intestinal amebiasis likely diagnosis?
E. Yersiniosis
A. Spleen rupture, abdominal bleeding
69. A 48-year-old patient complains of B. Left kidney rupture, retroperitoneal
having dull pain in the right lumbar regi- hematoma
on for over three years. USI shows that C. Rupture of the pancreas
kidneys are of normal size, at the upper D. Liver rupture, abdominal bleeding
pole of the right kidney there is a fluid- E. Rupture of a hollow organ, peritonitis
containing formation up to 12 cm in di-
73. A 30-year-old multigravida has been vacuoles. Make a diagnosis:

in labour for 18 hours. 2 hours ago the
pushing stage began. Fetal heart rate is A. Complicated cataract of the right eye
clear, rhythmic, 136/min. Vaginal exami- B. Senile cataract of the right eye
nation reveals the completecervical di- C. Diabetic cataract of the right eye
latation, the fetal head in the pelvic outlet D. Tetanic cataract of the right eye
plane. Sagittal suture in line with obstetric E. Radiation cataract of the right eye
conjugate, the occipital fontanel is near
the pubis. The patient has been diagnosed 77. During her first visit to the prenatal
with primary uterine inertia. What is the clinic a pregnant woman was referred to
further tactics of labour management? other doctors for mandatory consultation.
The patient was refered to:
A. Outlet forceps
B. Labour stimulation A. Internist, dentist
C. Cesarean section B. Internist, surgeon
D. Skin-head Ivanov’s forceps C. Dentist, surgeon
E. Vacuum extraction of the fetus D. Surgeon, oculist
E. Therapist, oculist
74. A patient complains of frequent, bulky,
frothy stools with greenish mucus, crampi- 78. A 59-year-old male complains of heart
ng pain in the umbilical region, abdomi- pain, cough, fever up to 38o C. Three
nal murmur, body temperature at the weeks ago he suffered a heart attack.
rate of 39o C. The patient associates the Objectively: Ps- 86/min, rhythmic, blood
disease with consumption of soft-boiled pressure - 110/70 mm Hg. Auscultation
eggs. What is the most likely pathogen? reveals pericardial rub, rales beneath the
shoulder blade. Radiography reveals no
A. Salmonella pathology. Blood count: WBCs - 10 · 109 /l,
B. Yersinia ESR - 35 mm/h. ECG shows no dynamics.
C. Shigella It would be most reasonable to administer
D. Enteropathogenic E.Coli the drugs of the following pharmaceutical
E. Vibrio cholerae El Tor group:
75. X-ray picture of chest shows a density A. Glucocorticoids
and an abrupt decrease in the upper lobe B. Antibiotics
of the right lung. The middle and lower C. Direct anticoagulants
lobe of the right lung exhibit significant D. Nitrates and nitrites
pneumatization. The right pulmonary E. Fibrinolytics
hilum comes up to the dense lobe. In
the upper and middle parts of the left 79. A 40-year-old female patient complai-
pulmonary field there are multiple focal ns of headache, dizziness, muscle
shadows. In the basal region of the left weakness, occasional cramps in the
pulmonary field there are clear outlines of extremities. She has been taking anti-
two annular shadows with quite thick and hypertensive medications for 10 years.
irregular walls. What disease is this X-ray AP- 180/100 mm Hg. Blood potassium -
pattern typical for? 1,8 millimole/l, sodium - 4,8 millimole/l. In
urine: alkaline reaction, the relative densi-
A. Fibro-cavernous pulmonary ty - 1012, protein and sugar are not found,
tuberculosis WBCs - 3-4 in the field of vision, RBCs - 1-
B. Atelectasis of the right upper lobe 2 in the field of vision. Conn’s syndrome is
C. Abscessing pneumonia suspected. Which drug should be chosen
D. Peripheral cancer for the treatment of arterial hypertensi-
E. Pancoast tumour on?
76. A patient complains of impaired far vi- A. Spironolactone
sion. Previously his eyes often turned red B. Propanolol
and hurt. Objectively: the eyes are not C. Enalapril
irritated, the cornea is transparent, anteri- D. Hydrochlorothiazide
or chambers are median deep, their liquid E. Clonidine
is transparent. The iris of the right eye
has not changed in colour, its pattern is 80. A 27-year-old patient complains of
unchanged. The pupil is of irregular shape, nasal haemorrhages, multiple bruises on
scalloped. Biomicroscopy of the crystalli- the anterior surface of the trunk and
ne lens reveals the areas of opacity and extremities, sudden weakness. In blood:
Hb- 74 g/l, reticulocytes - 16%, RBCs - the patient is pale, mucous membranes
2, 5 · 1012 /l, platelets - 30 · 109 /l, ESR- 25 are cyanotic, breathing rate is 24/min,
mm/h. What is the most effective measure tachycardia is present. In lungs: dimini-
for the treatment of thrombocytopenia? shed breath sounds, moist rales over both
lungs, crepitation. What is the most likely
A. Splenectomy diagnosis?
B. Iron preparations
C. Hemotransfusion A. Pneumonic plaque
D. Cytostatics B. Miliary tuberculosis
E. Vitamin B12 C. Influenza
D. Ornithosis
81. After lifting a load a patient felt E. Sepsis
undurable pain in the loin. He was di-
agnosed with acute lumbosacral radiculi- 85. An 8-month-old baby has decreased
tis. Which of the following is contraindi- appetite, pale skin, enlarged right side
cated for this patient? of abdomen. Palpation the right side of
abdomen reveals a dense elastic tumour-
A. Warming procedures like formation 10x7 cm large. There is
B. Dehydrating drugs a positive ballotement sign. What is the
C. Analgetics most likely diagnosis?
D. Vitamins of B group
E. Intravenous injection of aminophylline A. Nephroblastoma (Wilms’ tumour)
B. Liver tumour
82. The institutions which take part in C. Congenital hydronephrosis
medical examinations can be prevention D. Colon pathology
and treatment facilities, medical board E. Intestinal tumour
of Ministry of Defense, medical board of
Ministry of Home Affairs, medico-social 86. An infant is 3 weeks old. Since bi-
expert commissions, forensic medical rth there has been observed periodical
boards etc. What institutions are responsi- vomiting within a few minutes after feedi-
ble for temporary disability examination? ng. The amount of vomitive masses does
not exceed that of previous feeding. The
A. Prevention and treatment facilities infant has age-appropriate body weight.
B. Sanitary-and-prophylactic institutions What is the most likely cause of this
C. Medico-social expert commissions symptom?
D. Medical boards of Ministry of Defense
E. Medical boards of Ministry of Home A. Pylorospasm
Affairs B. Esophageal chalasia
C. Adrenogenital syndrome
83. While lifting a heavy load a 39-year-old D. Pyloristenosis
patient suddenly felt a severe headache, E. Esophageal achalasia
pain in the interscapular region, and
started vomiting. Objectively: the pulse 87. A city somatic hospital with 300
is rhythmic, 60/min, AP- 180/100 mm Hg. beds consists of the main building whi-
The patient is agitated. He presents wi- ch houses the therapeutic and surgical
th photophobia, hyperacusis. There are departments. Several separate buildings
positive Kernig’s and Brudzinski’s signs house the maternity, pediatric and radi-
on both sides. In blood: WBCs - 10 · 109 /l. ologic departments that are connected
CSF is bloody, cytosis is 240/3. What is the to the main building by underground
most likely diagnosis? walkways and above-ground covered
skybridges. Specify the building system
A. Subarachnoid haemorrhage of the hospital:
B. Sympathoadrenal crisis
C. Acute hypertonic encephalopathy A. Central-unit
D. Meningococcal meningitis B. Centralized
E. Ischemic stroke C. Decentralized
D. Free
84. A 45-year-old patient, a sailor, was E. Combined
hospitalized on the 2nd day of the di-
sease. A week ago he returned from 88. A 13-year-old girl complains of fever
India. Complains of body temperature of up to 37, 4o C during the last 2 months
41o C, severe headache, dyspnea, cough after recovering from ARVI. Objectively:
with frothy rusty sputum. Objectively: malnutrition, diffuse grade II enlargement
of the thyroid gland feeling dense on provisional diagnosis?

palpation, exophthalmos, tachycardia.
What kind of pathological syndrome is A. Status asthmaticus
it? B. Chronic obstructive bronchitis
C. Bronchiale asthma, moderate gravity
A. Thyrotoxicosis D. Foreign object aspiration
B. Hypothyroidism E. Cardiac asthma
C. Hypoparathyroidism
D. Hyperparathyroidism 92. Blood typing resulted in positi-
E. Thymomegaly ve isohemagglutination reaction with
standard sera of А(II) and В(III) groups
89. A 53-year-old female patient complai- and negative reaction with sera of 0(I)
ns of cardiac pain and rhythm intermissi- and АВ(IV) groups. What is this result
ons. She has experienced these presentati- indicative of?
ons since childhood. The patient’s father
had a history of cardiac arrhythmias. A. Faulty standard sera
Objectively: the patient is in grave condi- B. The first blood group
tion, Ps- 220 bpm, AP- 80/60 mm Hg. C. The second blood group
ECG results: heart rate - 215/min, extensi- D. The third blood group
on and deformation of QRS complex E. The fourth blood group
accompanied by atrioventricular dissoci-
ation; positive P wave. Some time later 93. A patient complains of jerking,
heart rate reduced down to 45/min, there throbbing pain in the III finger on the
was a complete dissociation of P wave and right hand. The patient associates these
QRST complex. Which of the following pain onsets with an injury by a nail. The
will be the most effective treatment? finger skin is hyperemic and tense, palpati-
on with a bulbous-end probe reveals the
A. Implantation of the artificial pacemaker most painful area. What is the provisional
B. β-adrenoreceptor blocking agents diagnosis?
C. Cholinolytics
D. Calcium antagonists A. Subcutaneous felon
E. Cardiac glycosides B. Pandactylitis
C. Bone felon
90. On the 2nd day of life a full-term D. Paronychia
boy developed mild jaundice of skin and E. Articular felon
mucous membranes, the general condition
of the child is normal. Blood test results: 94. Sanitary examination of the burns unit
indirect hyperbilirubinemia - 120 mmol/l. for adults revealed that 4-bed wards had
The child’s blood group is A(II) Rh(+), an area of 28 m2 . What is the minimally
his mother’s blood group - B(III) Rh(+). required ward area for this department?
What is the doctor’s tactics of choice?
A. 40 m2
A. No drug therapy B. 24 m2
B. Treatment with enterosorbents C. 28 m2
C. Treatment with prednisolone D. 30 m2
D. Treatment with cholekinetics E. 52 m2
E. Blood transfusion
95. A patient presented to a hospital
91. A 49-year-old patient complains of with a carbuncle of the upper lip. The
dyspnea, cough. There are no sputum body temperature is 39o C. There is a
discharges. He has repeatedly used pronounced edema of the upper lip and
salbutamol and intal but with no effect. eyelids. What is the surgeon’s tactics of
Objectively: he is only able to sit whi- choice?
le leaning on the table. Cyanosis of
face, acrocyanosis are present. Breathi- A. Hospitalize in the surgical unit
ng is shallow, laboured, in some parts it B. Administer out-patient course of antibi-
cannot be auscultated; there are diffuse otics
rales, expiration is significantly prolonged. C. Disclose the carbuncle and administer
Heart sounds are muffled, tachycardia is out-patient treatment
present. Ps - 112/min, AP- 110/70 mm Hg. D. Administer physiotherapy
Liver is located near the costal arch. There E. Disclose the carbuncle and administer
are no peripheral edemata. What is your antibiotics
96. From urine of a 14-year-old boy with test results: ESR- 47 mm/h, total bili-
the exacerbation of secondary obstructive rubin - 86,1 mmol/l, direct bilirubin - 42,3
pyelonephritis Pseudomonas aeruginosa mmol/l. Total protein - 62 g/l, albumins
was isolated with a titer of 1000000 mi- - 40%, globulins - 60%, gamma globuli-
crobes per 1 ml. Which antibiotic is most ns - 38%. Viral hepatitis markers were
advisable to be administered in this case? not detected. The antibodies to smooth
muscle cells are present. On ultrasound
A. Ciprofloxacin the portal vein diameter was of 1 cm.
B. Ampicillin What is the most likely diagnosis?
C. Cefazolinum
D. Azithromycin A. Autoimmune hepatitis
E. Chloramphenicol B. Primary biliary cirrhosis
C. Gilbert’s syndrome
97. A 62-year-old male patient complai- D. Cholangiogenic hepatitis
ns of intense pain in the left leg that E. Hemachromatosis
suddenly arose three hours before, leg
numbness and coldness. During the year 100. A patient is 60 years old, retired,
there has been pain in the leg while walki- worked as deputy director of a research
ng, hypersensitivity to cooling. Objecti- institute. Behavioural changes appeared 2
vely: the left foot and shin have marbled years ago after the death of her husband:
skin, subcutaneous veins are collapsed. she stopped looking after herself and
The foot is cold, active movements of leaving the house; then she refused to
the foot and toes are preserved. Pulse is clean the apartment and cook. Mental
present only on the femoral artery. There status: temporal disorientation. The pati-
is rough systolic murmur above the artery. ent does not understand many of the
Make a provisional diagnosis: questions, is confused; does not know
how to cook soup or fasten a button.
A. Acute occlusion of the left femoral Her speech is characterized by stumbli-
artery ng and logoclonia. She does not recognize
B. Occlusive disease doctors, fellow patients. She cries a lot but
C. Stenosis of the left popliteal artery can not explain the reason for tears. What
D. Acute thrombophlebitis is the mechanism of this pathology?
E. Acute arterial thrombosis ileofemoralny
A. Atrophy of the cerebral cortex
98. A 28-year-old patient complai- B. Atherosclerotic changes in cerebral
ns of profuse, painful and prolonged vessels
menstruation. Before and after the C. Serotonin deficiency
menstrual period there is spotting lasting D. Impaired conversion of dopamine to
for 4-6 days. Vaginal examination reveals noradrenaline
that the uterus is enlarged correspondi- E. Disorder of melatonin metabolism
ng to 5-6 weeks of pregnancy, has limited
mobility, is painful. Appendages are not 101. A 70-year-old patient with a
palpable. On the 15th day of the menstrual strangulated inguinal hernia called a
cycle, the uterus was of normal size, pai- therapist in. The strangulation took place
nless. On account of stated problems and 10 hours ago. There are signs of intestinal
objective examination the patient has obstruction. The skin over the herniation
been diagnosed with internal endometri- is hyperemic. What is the tactics of choi-
osis. Which drug should be used for the ce?
efective treatment of this patient?
A. Emergency hospitalization to a surgical
A. Duphaston hospital
B. Synoestrolum B. Referral to a surgeon
C. Parlodel C. Cold to the hernia, analgesics, antibioti-
D. Ovidon cs
E. - D. Reduction of hernia after a narcotic
injection
99. A 24-year-old female patient complai- E. Reduction of hernia
ns of pain in the right hypochondrium
that is getting worse after taking meals; 102. An employee was on a business trip
nausea, fever up to 37, 7oC, icteric skin, to another city, where he fell ill and was
pain in the large joints. These presentati- hospitalized. The sick leave certificate can
ons have been observed for 8 months. be issued:
Objectively: hepatosplenomegaly. Blood
A. With the permission of the head doctor 106. Examination of a 38-year-old pati-
of the city hospital ent who had been hit with a blunt object
B. With the permission of the deputy head on the left side of chest revealed a
doctor after the disability examination fracture of the X rib with fragments di-
C. With the permission of the deputy chief splacement, parietal pneumothorax. The
doctor in charge of medical work patient complains of pain in the left
D. By doctor in charge and chief of subcostal area. Objectively: the patient
department is pale, AP- 80/40 mm Hg, Ps- 138/min,
E. By doctor in charge of poor volume. USI reveals fluid in the
left abdomen. Splenic rupture is present.
103. A 14-year-old boy with a history What treatment tactics should be chosen?
of chronic tonsillitis and sinusitis has
developed a feeling of heart irregulari- A. Drainage of the left pleural cavity
ties and additional pulse. HR- 83/min. followed by laparotomy
ECG results: regular impulses with no vi- B. Immediate upper median laparotomy
sible P wave that occur every two sinus followed by drainage of the left pleural
contractions, QRS complex is dramati- cavity
cally deformed and prolonged to over C. Immediate laparotomy and alcohol-
0,11 s, T wave is discordant followed by novocaine block of the X rib
a complete compensatory pause. Specify D. Anti-schock actions followed by
the arrhythmia type: laparotomy after the arterial pressure rise
E. Left-sided thoracotomy immediately
A. Trigeminal extrasystole followed by laparotomy
B. Bigeminal extrasystole
C. Partial AV-blockade 107. A baby is 3 months old. The mother
D. Complete AV-block consulted a pediatrician about lack of
E. Left bundle branch block breast milk. After several test weighings
it was found that the child had to receive
104. An 8-year-old girl periodically has supplementary feeding. What is the opti-
sudden short-term heart pain, sensation mal milk formula for this child?
of chest compression, epigastric pain, di-
zziness, vomiting. Objectively: the patient A. Malysh
is pale, respiratory rate - 40/min, jugular B. Milk formula № 2
pulse is present. Ps- 185 bpm, of poor C. Milk formula № 3
volume. AP- 75/40 mm Hg. ECG taken D. Whole cow’s milk
during an attack shows ectopic P waves, E. Malutka
QRS wave is not deformed. At the end
of an attack a compensatory pause is 108. Examination of a newborn revealed
observed. The most likely cause of the skin redness that appeared immediately
attack is: after birth and reached the maximum
intensity on the second day of life. What
A. Paroxysmal atrial tachycardia is your provisional diagnosis?
B. Sinus tachycardia
C. Paroxysmal ventricular tachycardia A. Simple erythema
D. Complete AV-block B. Toxic erythema
E. Atrial fibrillation C. Transient erythema
D. Erythema nodosum
105. A 45-year-old patient with acute E. Annular erythema
abscess of the left lung has suddenly
developed acute chest pain and dyspnea 109. A 27-year-old sexually active female
while coughing, tachycardia has increased. complains of numerous vesicles on the ri-
The control Ro-gram shows collapsed left ght sex lip, itch and burning. Eruptions
lung, the air in the left pleural cavity regularly turn up before menstruation and
and a horizontal fluid level. What is the disappear 8-10 days later. What is the most
mechanism of this complication? likely diagnosis?
A. Abscess burst into the pleural cavity A. Herpes simplex virus
B. Bullae rupture of the left lung B. Bartholinitis
C. Inflammation spread to the visceral C. Primary syphilis
pleura D. Cytomegalovirus infection
D. Atelectasis of the left lung E. Genital condylomata
E. Acute cardiovascular insufficiency
110. A 38-year-old patient has suddenly
developed pain in the left side of his chest, score was 4. Which of the following is a
suffocation. Objectively: moderately risk factor for a spinal cord injury?
grave condition, Ps- 100/min, AP- 90/60
mm Hg, breath sounds on the left cannot A. Difficult delivery of the head and
be auscultated. Chest radiography shows shoulders
the collapse of the left lung up to 1/2. B. Young age of the mother
What kind of treatment should be admi- C. Pernicious habits
nistered? D. Uterine inertia
E. Chronic hypoxia
A. Passive thoracostomy
B. Rest, resolution therapy 115. A 10-year-old child has been admi-
C. Pleural puncture tted to a hospital with a closed crani-
D. Operative therapy ocerebral injury with suspected cerebral
E. Active thoracostomy edema. The patient is in grave condition,
unconscious. The dyspnea, tachycardia,
111. A 40 week pregnant secundipara is hypertension are present. Muscle tone is
28 years old. Contractions are very active. increased, there is nystagmus, pupillary
Retraction ring is at the level of navel, the and oculomotor reactions are disturbed.
uterus is hypertonic, in form of hourglass. The mandatory component of intensi-
On auscultation the fetal heart sounds ve care is dehydration. What diuretic is
are dull, heart rate is 100/min. AP of the adequate in this case?
parturient woman is 130/80 mm Hg. What
is the most likely diagnosis? A. Furosemide
B. Mannitol
A. RIisk of hysterorrhexis C. Hydrochlorthiazide
B. Mazolysis D. Spironolactone
C. Disturbed labour E. Moduretic
D. Complete hysterorrhexis
E. Attack of eclampsia 116. A 57-year-old patient taken to the
surgical department by ambulance has
112. A 10-year-old patient has a hi- been provisionally diagnosed with acute
story of mild bronchial asthma. During intestinal obstruction. Acute pancreatitis
a regular check-up the patient should be is suspected. What is the most informative
recommended: method of study to verify the diagnosis?
A. To avoid allergenic food A. Plan radiography of stomach
B. To avoid body tempering procedures B. Biochemical blood analysis
C. Not to go in for sports C. Complete blood count and clinical
D. To avoid spa treatment urinalysis
E. Not to go to the seaside D. Fibrogastroduodenoscopy
E. Ultrasound
113. A 26-year-old patient with left lower
lobe pneumonia experiences an acute 117. After myocardial infarction, a 50-
chest pain on the left during coughing. year-old patient had an attack of asthma.
Objectively: diffuse cyanosis, extension of Objectively: bubbling breathing with
the left side of chest. Percussion reveals frequency of 32/min, cough with a lot
high tympanitis. Auscultation reveals no of pink frothy sputum, acrocyanosis,
respiratory murmurs above the left side swelling of the neck veins. Ps- 108/min,
of chest. There is a deviation of the right AP- 150/100 mm Hg. Heart sounds
cardiac border towards the midclavicular are muffled. Mixed moist rales can be
line. What examination will be the most auscultated above the entire lung surface.
informative? What drug would be most effective in this
situation?
A. X-Ray
B. Bronchoscopy A. Nitroglycerin intravenously
C. Bronchography B. Pentamin intravenously
D. Pneumotachometry C. Strophanthin intravenously
E. Spirography D. Dopamine intravenously
E. Aminophylline intravenously
114. A baby was born by a young smoker.
The labour was complicated by uterine 118. A baby born after fast labour has
inertia, difficult delivery of the baby’s palsy of hand muscles. Grasp reflex is
head and shoulders. The baby’s Apgar absent, as well as hand-to-mouth reflex.
Hand sensitivity is absent. What is the A. Emergency notification on infectious

most likely diagnosis? disease (form № 058/o)
B. Sick child care certificate
A. Dejerine-Klumpke palsy C. Infant’s record (report form № 112/o)
B. Duchenne-Erb’s palsy D. House call record (form № 031/o)
C. Total lesion of the brachial plexus E. Child care sick leave
D. Muscle paresis
E. Bernard-Horner syndrome 123. Hygienic expertise of a sample taken
from the batch of grain revealed that
119. Against the background of angina 2% of grains were infected with mi-
a patient has developed pain in tubular croscopic Fusarium fungi. On the ground
bones. Examination revealed generalized of laboratory analyses this batch of grain
enlargement of lymph nodes, hepatoli- should be:
enal syndrome, sternalgia. In blood: RBCs
- 3, 6 · 1012 /l, Hb- 87 g/l, thrombocytes A. Sold without restrictions
- 45 · 109 /l, WBCs - 13 · 109 /l, blasts - B. Tested for toxicity
87%, stab neutrophils - 1%, segmented C. Used for forage production
neutrophils - 7%, lymphocytes - 5%, ESR D. Used for ethanol production
- 55 mm/h. What is the most likely di- E. Destroyed
agnosis?
124. Examination of a 43-year-old man
A. Acute leukemia objectively revealed pallor of skin and
B. Erythremia mucous membranes, loss of tongue papi-
C. Chronic lymphocytic leukemia llae, transverse striation of fingernails,
D. Chronic myeloid leukemia cracks in the mouth corners, tachycardia.
E. Multiple myeloma Blood test results: Hb- 90 g/l, anisocytosis,
poikilocytosis. The most likely causative
120. In order to reduce weed growth on agent of this state is inadequate intake of:
agricultural land, some herbicides have
been used for a long time. In terms of A. Iron
environmental stability these herbicides B. Copper
are rated as stable. Specify the most likely C. Zinc
route of their entry into the human body: D. Magnesium
E. Selene
A. Soil-plants-humans
B. Soil-microorganisms-humans 125. Factory’s sectorial doctor chooses a
C. Soil-animals-humans group of chronically ill people. He takes
D. Soil-protozoa-humans into account the duration of etiologically
E. Soil-insects-humans related cases with a temporary disability
over the last year in each of the workers.
121. A selective population research study The employees will fall into this group if
was aimed at exploring the effect of air the duration is:
emissions from a metallurgical plant on
the obstructive bronchitis morbidity in a A. 40 days or more
city. The calculated correlation coefficient B. 60 days or more
was +0,79. Evaluate the strength and di- C. 20 days or more
rection of the relationship: D. 30 days or more
E. 10 days or more
A. Direct, strong
B. Inverse, strong 126. 6 people live in a modern flat wi-
C. Direct, average th the total area of 60 m2 . There are
D. Inverse, average TV-video equipment, radios, microwave
E. - ovens, computer. The residents of the
flat complain of bad health, occasional
122. A general practitioner visited a 2- headaches, arrhythmia, conjunctivitis.
year-old child and diagnosed him with What is the most likely cause of this condi-
measles. The child attends a nursery, has tion?
a 5-year-old sister. What document must
be filled in for the effective antiepidemic
measures in the given health locality?
A. Electromagnetic fields
B. Anthropotoxins A. Status epilepticus
C. Carbon dioxide B. Frequent generalized seizures
D. Tetrachlor plumbum C. Frequent jacksonian seizures
E. Formaldehyde D. Hysterical attacks
E. Frequent complex partial seizures
127. A man abused alcohol, drank away
the property and wages thus getting hi- 131. A 45-year-old patient complains
mself, his wife and two underage children of fever up to 40o C, general weakness,
into deep financial problems. He was regi- headache and spasmodic contraction of
stered in a local drug abuse clinic. His wife muscles in the region of a shinwound. The
asked a family doctor, what kind of petiti- patient got injured five days ago when ti-
on she could file in court: lling soil and didn’t seek medical attenti-
on. What kind of wound infection can be
A. On restriction of her husband’s civil suspected?
capacity
B. On recognition of her husband’s A. Tetanus
incapacity B. Anthrax
C. On recognition of her husband’s partial C. Erysipelas
incapacity D. Gram-positive
D. On recognition of her husband’s E. Gram-negative
incompetence
E. On recognition of her husband’s disabi- 132. A 60 year-old female has been sufferi-
lity ng weakness, dizziness, fatigue over the
last year. Recently she has also developed
128. A child is 12 years old. He complai- dyspnea, paresthesia. Objectively: skin
ns of a dull aching pain in the epigastri- and mucous membranes are pale and sli-
um and right hypochondrium, that is ghtly icteric. The tongue is smooth due
getting worse after taking fatty or fried to the loss of lingual papillae. Liver and
food, headache, weakness, nausea, low- spleen are located at the costal margin.
grade fever. Abdominal palpation reveals Blood count: Hb- 70 g/l, RBCs - 1, 7·1012/l,
a marked resistance of muscles in the right colour index - 1,2, macrocytes. Admini-
hypochondrium, positive Kerr’s, Ortner’s, ster the patient a pathogenetically justifi-
Murphy’s symptoms. What is the most li- ed drug:
kely diagnosis?
A. Vitamin B12
A. Chronic cholecystitis B. Vitamin B6
B. Acute appendicitis C. Ascorbic acid
C. Viral hepatitis D. Iron preparations
D. Acute gastritis E. Vitamin B1
E. Acute pancreatitis
133. Analysis of organization of medi-
129. A 3-month-old girl presents wi- cal care in a regional centre has shown
th rhinitis, dyspnea, dry cough. These that every year about 12% of patients
manifestations has been observed for receive inpatient care for diseases that
two days. Objectively: the child has don’t require round-the-clock monitori-
pale skin, acrocyanosis, shallow respi- ng and intensive care. What are the most
ration at the rate of 80/min. Percussi- appropriate organizational changes requi-
on reveals handbox resonance over the red to address this problem?
whole surface of lungs, massive fine rales.
What is the most likely diagnosis? A. Development of medical care forms
replacing the in-patient care
A. Acute bronchiolitis B. Changes to the statute of outpatient
B. Pneumonia clinics
C. Mucoviscidosis C. Development of primary care
D. Foreign body of the airway D. Restructuring of specialized care
E. Acute bronchitis E. Upgrading of hospital facilities
130. A patient had 4 generalized convulsi- 134. A newborn (mother’s I pregnancy)
ve seizures within a day. Between the sei- weighing 3500 g presents with jaundice,
zures the patient did not maintain clear lethargy, reduced reflexes. Objectively:
consciousness (was in a coma or stupor). second grade jaundice of skin with saffron
Specify his state: tint, liver - +2cm, spleen - +1 cm. Urine
and feces are yellow. Blood count: Hb- 100 kely diagnosis?
g/l, RBCs - 3, 2 · 1012 /l, WBCs - 18, 7 · 109 /l,
mother’s blood type - 0(I) Rh(+), baby’s A. Acute bartholinitis
blood type - А(II) Rh(-), bilirubin - 170 B. Labial furuncle
C. Acute vulvovaginitis
mmol/l, indirect fraction. ALT, AST rates
are normal. What disease is the child most D. Bartholin gland cyst
E. Carcinoma of vulva
likely to have?
138. A 28-year-old female patient has
A. Hemolytic disease of newborn, AB0-
been admitted to a hospital. She states
conflict
B. Perinatal hepatitis to be ill for 12 years. On examination she
has been diagnosed with bronchiectasis
C. Hemolytic disease of newborn, Rh-
conflict with affection of the left lower lobe of
lung. What is the optimal treatment tacti-
D. Biliary atresia
cs for this patient?
E. Physiologic jaundice
A. Left lower lobectomy
135. Doctors of a polyclinic conduct
a statistical research of the disease B. Left-sided pneumoectomy
C. Antibiotic therpy
outcomes in two groups of patients (those
registered with dispensary departments D. Active drainage of the left pleural cavity
E. Bronchopulmonary lavage
and unregistered ones), depending on
age and level of hygiene. What type of 139. 4 weeks after myocardial infarction a
statistical tables would be most suitable 56-year-old patient developed acute heart
for profound analysis of the interrelation pain, pronounced dyspnea. Objectively:
between the above-mentioned variables? the patient’s condition is extremely grave,
there is marked cyanosis of face, swelling
A. Cross tabulation and throbbing of neck veins, peripheral
B. Analytical pulse is absent, the carotid artery pulse is
C. Group rhythmic, 130 bpm, AP is 60/20 mm Hg.
D. Simple Auscultation of heart reveals extremely
E. Developing muffled sounds, percussion reveals heart
136. A 57-year-old female complains border extension in both directions. What
of having a sensation of esophageal is the optimal treatment tactis for this
compresion, palpitation, difficult breathi- patient?
ng during eating solid food, occasional A. Pericardiocentesis and immediate
vomiting with a full mouth, "wet pi- thoracotomy
llow"sign at night for the last 6 months. B. Oxygen inhalation
Objectively: body tempearture - 39oC, C. Puncture of the pleural cavity on the left
height - 168 cm, weight - 72 kg, Ps- 76/min, D. Conservative treatment, infusion of
АP- 120/80 mm Hg. X-ray revealed a adrenomimetics
considerable dilation of esophagus and E. Pleural cavity drainage
its constriction in the cardial part. What
pathology is most likely to have caused 140. A 15-year-old boy feels pain in the
dysphagia in this patient? region of the left knee joint. Objecti-
vely: the soft tissues in the affected region
A. Achalasia cardiae are infiltrated, the joint function is limi-
B. Primary esophagism ted. Radiography reveals a focus of bone
C. Hiatal hernia destruction in the distal metaepiphysial
D. Esophageal carcinoma segment of the left femur. The destruction
E. Reflux esophagitis is accompanied by periosteal detachment
137. A 37-year-old patient complains of and a defect formed within cortex of
acute pain in the region of genitals, Codman triangle bone. X-ray of chest
swelling of the labia, pain when walki- shows multiple microfocal metastases.
ng. Objectively: body temperature is What is the most likely pathology?
38, 7oC, Ps- 98/min. In the interior of A. Osteogenic sarcoma
the right labia there is a dense, painful B. Fibrosarcoma
tumour-like formation 5,0x4,5 cm large, C. Chondrosarcoma
the skin and mucous membrane of geni- D. Ewing’s sarcoma
tals is hyperemic, there are profuse foul- E. Juxtacortical sarcoma
smelling discharges. What is the most li-
141. On the first day after a surgery for di- tation: she makes stereotypic grimaces,
ffuse toxic goiter a patient developed di- exposed, masturbating in front of a loud
fficulty breathing, cold sweats, weakness. laugh, repeating the stereotypical abusive
Objectively: pale skin, body temperature shouts. The patient should be assigned:
- 38, 5o C, RR - 25/min, Ps- 110/min, AP-
90/60 mm Hg. What early postoperative A. Neuroleptics
complication occurred in the patient? B. Antidepressants
C. Tranquilizers
A. Thyrotoxic crisis D. Nootropics
B. Hypothyroid crisis E. Mood stabilizers
C. Postoperative tetany
D. Acute thyroiditis 145. A young woman with seborrhea adi-
E. Compression of the trachea by the posa has numerous non-itchy light brown
hematoma and white spots with clear outlines and
defurfuration on the torso and shoulder
142. A 49-year-old patient consulted a skin. What is the provisional diagnosis?
doctor about difficult swallowing, voice
hoarseness, weight loss. These symptoms A. Pityriasis versicolor (scaly skin disease)
have been gradually progressing for the B. Tinea corporis
last 3 months. Objectively: the patient is C. Seborrheic dermatitis
exhausted, there are enlarged supraclavi- D. Pityriasis rosea
cular lymph nodes. Esophagoscopy E. Vitiligo
revealed no oesophageal pathology. Whi-
ch of the following studies is most 146. 10 days after birth a newborn
appropriate in this case? developed a sudden fever up to 38, 1o C.
Objectively: the skin in the regi-
A. Computed tomography of chest, medi- on of navel, abdomen and chest is
astinum erythematous; there are multiple pea-
B. X-ray of lungs sized blisters with no infiltration at the
C. Multiplanar imaging of esophagus base; single bright red moist erosions wi-
D. Radioisotope investigation of chest th epidermal fragments on the periphery.
E. Ultrasound investigation of mediasti- What is your provisional diagnosis?
num
A. Epidemic pemphigus of newborn
143. A 45-year-old female patient B. Syphilitic pemphigus
complaining of general weakness, nausea C. Streptococcal impetigo
and vomiting hass been delivered to a D. Vulgar impetigo
hospital by the ambulance. Recently there E. Atopic dermatitis
has been a lack of appetite, weight loss.
Objectively: hyperpigmentation of skin, 147. An emergency physician arrived to
blood pressure at the rate of 70/45 mm Hg, provide medical care for a hangman taken
bradycardia. Additional studies revealed out of the loop by his relatives. The doctor
the reduced concentration of aldosterone revealed no pulse in the carotid arteri-
and cortisol in blood, decreased excretion es, absence of consciousness, spontaneous
of 17-ketosteroids and 17-oxyketosteroids breathing and corneal reflexes; cadaver
in the urine, hyponatremia, chloropenia, spots on the back and posterior parts of
hypokalemia. What therapeutic measures extremities. A person can be declared
are required? dead if the following sign is present:
A. To administer glucocorticoids, mi- A. Cadaver spots

neralocorticoids, and a diet with a high B. Absence of spontaneous breathing
content of cooking salt C. Absence of corneal reflexes
B. To prescribe a diet with a high content D. Pulselessness
of cooking salt E. Unconsciousness
C. To administer prednisolone 148. A 40-year-old patient is registered
D. To administer aldosterone in a narcological dispensary. Somatically:
E. To administer insulin skin is dramatically hyperemic, sclera are
144. A 23-year-old female patient has a injected, hyperhidrosis is present. AP-
mental disease since the age of 18, the 140/100 mm Hg, heart rate - 100/min.
course of disease has no remission peri- Mental state: autopsychic orientation is
ods. At a hospital the patient mostly intact, allopsychic orientation is distorted.
presents with non-purposeful foolish exci- The patient presents with motor anxiety.
There is a look of fear on his face. He Prostate-specific antigen rate is of 5 ng/ml.

refuses to talk about his problems and What is the most likely disease that caused
asks to release him immediately, because acute urinary retention?
he "may be killed."This state developed a
day after a regular drinking bout. What is A. Prostatic hyperplasia
your provisional diagnosis? B. Prostate carcinoma
C. Sclerosis of the prostate
A. Delirium tremens D. Tuberculosis of the prostate
B. Organic delirium E. Acute prostatitis
C. Paranoia
D. Alcoholic hallucinosis 152. A 10 week pregnant woman was
E. Alcoholic paranoid admitted to a hospital for recurrent pain
in the lower abdomen, bloody discharges
149. A 35-year-old female patient has gai- from the genital tracts. The problems
ned 20 kg weight within a year with the turned up after ARVI. The woman was
normal diet. She complains of chill, sleepi- registered for antenatal care. Speculum
ness, shortness of breath. The patient’s examination revealed cyanosis of vagi-
mother and sister are corpulent. Objecti- nal mucosa, clean cervix, open cervical
vely: height - 160 cm, weight - 92 kg, canal discharging blood and blood clots;
BMI - 35,9. Obesity is uniform, there are the lower pole of the gestational sac was
no striae. The face is amimic. The skin visible. What tactics should be chosen?
is dry. The tongue is thickened. Heart
sounds are muffled. HR- 56/min, AP- A. Curettage of the uterus
140/100 mm Hg. The patient has consti- B. Pregnancy maintenance therapy
pations, amenorrhea for 5 months. TSH- C. Expectant management, surveillance
28 mkME/l (normal rate - 0,32-5). Crani- D. Hysterectomy
ogram shows no pathology. What is the E. Antiviral therapy
etiology of obesity?
153. A patient with fibromyoma of uterus
A. Hypothyroid sized up to 8-9 weeks of pregnancy
B. Hypo-ovarian consulted a gynaecologist about acute
C. Hypothalamic-pituitary pain in the lower abdomen. Examination
D. Alimentary and constitutive revealed pronounced positive symptoms
E. Hypercorticoid of peritoneal irritation, high leukocytosis.
Vaginal examination revealed that the
150. A 26-year-old patient consulted a uterus was enlarged corresponding to
doctor abut sore throat, fever up to 9 weeks of pregnancy due to the fi-
38, 2oC. A week ago, the patient had angi- bromatous nodes, one of which was mobi-
na, didn’t follow medical recommendati- le and extremely painful. Appendages
ons. On examination, the patient had were not palpable. There were moderate
forced position of his head, trismus of mucous discharges. What is the optimal
chewing muscles. Left peritonsillar regi- treatment tactics?
on is markedly hyperemic, swollen. What
is the provisional diagnosis? A. Urgent surgery (laparotomy)
B. Surveillance and spasmolytic therapy
A. Left-sided peritonsillar abscess C. Fractional diagnostic curettage of the
B. Meningitis uterine cavity
C. Phlegmonous angina D. Surgical laparoscopy
D. Diphtheria of the pharynx E. Surveillance and antibacterial therapy
E. Tonsil tumour
154. A 40-year-old female patient
151. A 77-year-old patient complains of complains of having a bulge on the anteri-
inability to urinate, bursting pain above or surface of neck for 5 years. Objecti-
the pubis. The patient developed acute vely: Ps- 72 bpm, arterial pressure - 110/70
condition 12 hours ago. Objectively: mm Hg, in the right lobe of thyroid gland
full urinary bladder is palpable above palpation reveals a mobile 4x2 cm node,
the pubis. Rectal prostate is enlarged, the left lobe is not palpable, the basal
dense and elastic, well-defined, with no metabolic rate is 6%. What is the most
nodes. Interlobular sulcus is distinct. likely diagnosis?
Ultrasonography results: prostate volume
is 120 cm3 , it projects into the bladder
cavity, has homogeneous parenchyma.
A. Nodular euthyroid goiter headache in the occipital region, nausea,

B. Nodular hyperthyroid goiter choking, opplotentes. The presentati-
C. Riedel’s thyroiditis ons appeared after a physical exerti-
D. Mixed euthyroid goiter on. Objectively: the patient is excited.
E. The median cervical cyst Face is hyperemic. Skin is pale. Heart
sounds are regular, the 2nd aortic sound
155. A multigravida at 39 weeks of gestati- is accentuated. AP- 240/120 mm Hg, HR-
on has been delivered to a hospital having 92/min. Auscultation reveals some fine
a regular labour activity for 8 hours, the moist rales in the lower parts of the lungs.
waters burst an hour ago. She complains Liver is not enlarged. ECG shows signs of
of headache, seeing spots. AP is of 180/100 hypertrophy and left ventricular overload.
mm Hg. Urine test results: protein - 3,3 What is the most likely diagnosis?
g/l, hyaline cylinders. Fetal heart rate is
140/min, rhythmical. Vaginal examination A. Complicated hypertensic crisis,
reveals complete crevical dilatation, the pulmonary edema
fetal head is on the pelvic floor, sagittal B. Acute myocardial infarction, pulmonary
suture is in line with obstetric conjugate, edema
the occipital fontanel is under the pubis. C. Bronchial asthma exacerbation
What is the optimal tactics of labour D. Uncomplicated hypertensic crisis
management? E. Community-acquired pneumonia
A. Outlet forceps 159. A patient complains of being unable
B. Cavity forceps to get pregnant for 5 years. A complete
C. Cesarean section clinical examination gave the following
D. Vacuum extraction of the fetus results: hormonal function is not impai-
E. Conservative labour management red, urogenital infection hasn’t been
found, on hysterosalpingography both
156. After a contact with chemicals a tubes were filled with the contrast medi-
plant worker has suddenly developed um up to the isthmic segment, abdominal
stridor, voice hoarseness, barking cough, contrast was not visualized. The patient’s
progressing dyspnea. Objective exami- husband is healthy. What tactics will be
nation reveals acrocyanosis. What is your most effective?
provisional diagnosis?
A. In-vitro fertilization
A. Laryngeal edema B. Insemination with husband’s sperm
B. Laryngeal carcinoma C. ICSI within in-vitro fertilization
C. PATE program
D. Pulmonary atelectasis D. Hydrotubation
E. Pneumothorax E. Laparoscopic tubal plasty
157. A 58-year-old patient complains of 160. Six months ago, a 5-year-old child
general weakness, loss of 10 kg of wei- was operated for CHD. For the last 3
ght within 1,5 months, progressive pain weeks he has complained of fever, heart
in the lumbar region, increased blood pain, aching muscles and bones. Exami-
pressure up to 220/160 mm Hg, subfebri- nation results: "white-coffee"skin colour,
le temperature. Objectively: in the ri- auscultation revealed systolic murmur in
ght hypochondrium palpation reveals a the region of heart along with a noise in
formation with uneven surface and low the III-IV intercostal space. Examinati-
mobility; veins of the spermatic cord and on of fingertips revealed Janeway lesions.
scrotum are dilated. Blood test results: What is your provisional diagnosis?
Hb- 86 g/l, ESR- 44 mm/h. Urine test
results: specific gravity - 1020, protein - A. Infectious endocarditis
0,99 g/l, RBCs - cover the whole field of B. Sepsis
vision, WBCs - 4-6 in the field of vision. C. Nonrheumatic carditis
What is the provisional diagnosis? D. Acute rheumatic fever
E. Typhoid fever
A. Renal tumour
B. Urolithiasis 161. A 45-year-old female patient has
C. Acute pyelonephritis worked as a painter for 14 years. Contacts
D. Acute glomerulonephritis with synthetic paint result in face skin
E. Nephroptosis redness, swelling, intense itching, oozi-
ng lesions. The symptoms disappear after
158. A 58-year-old patient complains of a the exposure to chemical agents, but recur
even at the smell of paint. The symptom by pain syndrome. Objectively: body
intensity progresses with relapses. Make a temperature is at the rate of 36, 8oC, Ps-
provisional diagnosis: 78/min, abdomen is soft and painless,
the symptoms of peritoneal irritation are
A. Occupational eczema present, palpation reveals a dramatically
B. Simple contact dermatitis enlarged, tense gallbladder. What disease
C. Contact-type allergy are these symptoms typical for?
D. Urticaria
E. Toksikodermiya A. Cancer of the pancreatic head
B. Duodenal ulcer
162. In a cold weather, the emergency C. Acute cholecystitis
room admitted a patient pulled out of D. Chronic cholecystitis
the open water. There was no respiratory E. Lamblia-induced cholecystitis
contact with the water. The patient is exci-
ted, pale, complains of pain, numbness of 166. A 22-year-old vegetarian patient wi-
hands and feet, cold shiver. Breathing rate th signs of malnutrition consulted a doctor
is 22/min, AP- 120/90 mm Hg, Ps- 110/min, about smell and taste distortion, angular
rectal temperature is 34, 5oC. What kind stomatitis. Objectively: expressively blue
of warming is indicated for this patient? sclerae. The patient was diagnosed with
iron deficiency anemia. What is the domi-
A. Passive warming nating clinical syndrome?
B. Infusion of 37o C solutions
C. Hot compresses A. Sideropenic
D. Warm bath B. Anaemic
E. Hemodialysis with blood warming C. Haemologic
D. Haemolytic
163. Survey radiograph of a 52-year-old E. Myelodysplastic
worker of an agglomeration plant (28
years of experience, the concentration of 167. A 13-year-old girl was admitted to
metal dust is 22-37 mg/m3 ) shows mildly the gynecological department with heavy
pronounced interstitial fibrosis with di- bleeding, which appeared after a long
ffused contrast well-defined small nodular delay of menstruation. Shortly before,
shadows. The patient has no complaints. the girl suffered a serious psychotrauma.
Pulmonary function is not compromised. Her menarche occurred at the age of
What is the provisional diagnosis? 11, she has a 30-day cycle with 5 to
6 days of moderate, painless bleeding.
A. Siderosis The patient is somatically healthy, of
B. Silicosis normosthenic constitution with height
C. Anthraco-silicatosis of 160 cm, weight of 42 kg. The pati-
D. Silicatosis ent is pale. Rectoabdominal examination
E. Anthracosis revealed that the uterus was of normal si-
ze and consistency, anteflexio-versio, the
164. A week ago a 65-year-old patient appendages were not changed. What is
suffered an acute myocardial infarction, the most likely diagnosis?
his general condition deteriorated: he
complains of dyspnea at rest, pronounced A. Juvenile bleeding
weakness. Objectively: edema of the B. Ovarian cyst
lower extremities, ascites is present. Heart C. Hysteromyoma
borders are extended, paradoxical pulse is D. Girl is healthy
2 cm displaced from the apex beat to the E. Amenorrhea
left. What is the most likely diagnosis?
168. It is planned to build a multi-
A. Acute cardiac aneurysm disciplinary hospital with 500 beds in a
B. Recurrent myocardial infarction town. Specify the location of a polyclinic
C. Acute pericarditis within the medical centre:
D. Cardiosclerotic aneurysm
E. Pulmonary embolism
165. A 64-year-old patient has been
referred to planned hospitalization
for general weakness, poor appetite,
progressive jaundice which appeared over
3 weeks ago and wasn’t accompanied
A. At the main entrance A. Post-castration syndrome

B. In the garden and park area B. Premenstrual syndrome
C. In the centre of the territory near C. Early pathological menopause
medical buildings D. Secondary psychogenic amenorrhea
D. It is not allowed to place the polyclinic E. Physiological premenopause
within the centre territory
E. In the service zone 172. A 2-year-old child in a satisfactory
condition periodically presents with
169. A 48-year-old patient complains of moderate proteinuria, microhematuria.
weakness, subfebrile temperature, achi- USI results: the left kidney is
ng pain in the kidney region. These undetectable, the right one is enlarged,
presentations turned up three months there are signs of double pyelocaliceal
ago after hypothermia. Objectively: ki- system. What study is required to speci-
dneys are painful on palpation, there is bi- fy the diagnosis?
laterally positive Pasternatsky’s symptom.
Urine test res: acid reaction, pronounced A. Excretory urography
leukocyturia, microhematuria, minor B. Micturating cystography
proteinuria - 0,165-0,33 g/l. After the urine C. Retrograde urography
sample had been inoculated on conventi- D. Doppler study of renal vessels
onal media, bacteriuria were not found. E. Radioisotope renal scan
What research is most required in this
case? 173. Explosion of a tank with benzene at a
chemical plant has killed and wounded
A. Urine test for Mycobacterium a large number of people. There are
tuberculosis over 50 victims with burns, mechani-
B. Daily proteinuria cal traumas and intoxication. Specify
C. Nechiporenko urine test the main elements of medical care and
D. Zimnitsky urine test evacuation of population in this situation:
E. Isotope renography
A. Sorting, medical assistance, evacuation
170. A 22-year-old patient complains B. Sorting, evacuation, treatment
of amenorrhea for 8 months. Menarche C. Medical assistance, evacuation, isolation
occured at the age of 12,5. Since the age D. Isolation, rescue activity, recovery
of 18 the patient has a history of irregular E. Sorting, recovery, rescue activity
menstruation. The patient is nulligravi-
da. The mammary glands are developed 174. A 26-year-old patient with affective
properly, nipples discharge drops of mi- bipolar disorder has developed a condi-
lk when pressed. Gynecological study tion manifested by mood improvement,
results: prolactin level is 2 times higher behavioural and sexual hyperactivity,
than normal. CT reveals a bulky formati- verbosity, active body language, reduced
on with a diameter of 4 mm in the region need for sleep. Which of the following
of sella. What is the most likely diagnosis? drugs are most effective in this case?
A. Pituitary tumour A. Neuroleptics with a sedative effect

B. Lactational amenorrhea B. Antidepressants with an activating
C. Stein-Leventhal syndrome effect
D. Sheehan’s syndrome C. Neuroleptics with an activating effect
E. Pituitary basophilia D. Tranquilizers
E. Antidepressants with a sedative effect
complains about hot flashes and feeli- 175. An emergency doctor has diagnosed
ng of intense heat arising up to 5 times a 32-year-old woman with generalized
a day, headaches in the occipital region convulsive status epilepticus. The deteri-
along with high blood pressure, palpitati- oration in the patient’s condition is caused
ons, dizziness, fatigue, irritability, memory by a sudden gap in the epilepsy treatment.
impairment. 6 months ago the patient Specify the doctor’s further tactics:
underwent extirpation of the uterus wi-
th its appendages. What is the most likely
diagnosis?
A. Hospitalization in the intensive care accompanied by nausea. Surgical exami-

unit nation revealed moist tongue, Ps- 76 bpm.
B. Hospitalization in the department of AP- 130/80 mm Hg. Abdomen was soft,
neurology slightly painful in the right iliac region
C. Hospitalization in the department of on deep palpation, the symptoms of the
neurosurgery peritoneum irritation were doubtful. In
D. Outpatient monitoring by a blood: RBCs - 4, 0 · 1012 /l, Hb- 135 g/l,
neuropathologist WBCs - 9, 5 · 109 /l, stab neutrophils - 5%,
E. Outpatient monitoring by a segmentonuclear - 52%, lymphocytes -
neurosurgeon 38%, monocytes - 5%, ESR - 20 mm/h.
176. A 19-year-old patient complains Specify the doctor’s further tactics:
of dyspnea on exertion. He often has A. Emergency operation for acute
bronchitis and pneumonia. Since chi- appendicitis
ldhood, the patient presents with cardi- B. Hospitalization, dynamic surveillance
ac murmur. Auscultation revealed splitti- C. Send the patient home
ng of the II sound above the pulmonary D. Refer the patient to a district therapist
artery, systolic murmur in 3 intercostal E. Administration of additional examinati-
space at the left sternal border. ECG on: abdominal ultrasound, x-ray contrast
showed right bundle branch block. What study of the gastrointestinal tract
is the provisional diagnosis?
180. A 55-year-old patient whose
A. Atrial septal defect menstruation stopped 5 years ago
B. Open ductus arteriosus complains of vaginal dryness, frequent
C. Aortarctia and painful urination. Gynecologist
D. Aortic stenosis revealed signs of atrophic colpitis. Urine
E. Mitral insufficiency analysis revealed no peculiarities. Whi-
177. 20 minutes after a normal delivery ch locally acting product will provide the
at 39 weeks a puerpera had a single proper therapeutic effect?
temperature rise up to 38o C. Objecti- A. Vaginal suppositories "Ovestin"
vely: the uterus is dense, located between B. Vaginal tablets "Tergynan"
the navel and the pubis, painless. Lochia C. Vaginal cream "Meratin Combi"
are bloody, of small amount. Breasts are D. Vaginal gel "Metronidazole"
moderately soft and painless. What is the E. Vaginal cream "Dalacin"
optimal tactics?
181. A 63-year-old patient with persistent
A. Further follow-up atrial fibrillation complains of moderate
B. Antibiotic therapy dyspnea. Objectively: peripheral edemata
C. Appointment antipyretic are absent, vesicular respiration is present,
D. Manual examination of the uterine heart rate - 72/min, AP- 140/90 mm Hg.
cavity What combination of drugs will be most
E. Expression of breast useful in the secondary prevention of
178. A 30-year-old patient got in a car heart failure?
accident. He is unconscious, pale, has A. Beta-blockers, ACE inhibitors
thready pulse. In the middle third of the B. Beta-blockers, cardiac glycosides
right thigh there is an extensive lacerati- C. Cardiac glycosides, diuretics
on with ongoing profuse external arteri- D. Cardiac glycosides, ACE inhibitors
al bleeding. What urgent actions must be E. Diuretics, beta-blockers
taken to save the life of the patient?
182. A 57-year-old patient had an attack
A. Tourniquet above the wound of the of retrosternal pain that lasted more than
right thigh 1,5 hours. Objectively: the patient is inert,
B. Tourniquet below the wound of the adynamic, has pale skin, cold extremities,
right thigh poor volume pulse, heart rate - 120/min,
C. Artificial lung ventilation AP- 70/40 mm Hg. ECG shows ST elevati-
D. Precordial thump on in leads II, III, aVF. What condition are
E. Plaster bar these changes typical for?
179. A 75-year-old male patient complains
of slight pain in the right iliac region. The
abdominal pain arose 6 days ago and was
A. Cardiogenic shock nodes were not changed. USI results: in

B. Arrhythmogenic shock the superior external quadrant of the right
C. Perforated gastric ulcer mammary gland there was a big formation
D. Acute pericarditis of increased echogenicity, sized 18x17 mm.
E. Acute pancreatitis The patient was provisionally diagnosed
with fibroadenoma. What is a doctor’s
183. An 8-year-old boy has a 2-year hi- further tactics?
story of blotchy itchy rash appearing
after eating citrus fruit. The first eruption A. Surgical removal of the tumour prior to
occurred at the age of 6 months after the pregnancy
introduction of juices to the baby’s diet. B. Dynamic follow-up
Father has a history of bronchial asthma, C. Surgical treatment after pregnancy
mother - that of allergic rhinitis. What is D. Radical mastectomy
the most likely diagnosis? E. Nonsteroid anti-inflammatory drugs,
oral contraceptives
A. Atopic dermatitis
B. Psoriasis 187. A patient is 31 years old. Double-
C. Pityriasis Rosea contrast barium swallow revealed a filli-
D. Urticaria ng defect on the posterior wall in the mi-
E. Quincke’s edema ddle segment of esophagus. The defect
looked like a well-defined oval 1,8x1,3 cm
184. On the 10th day postpartum a large. Mucosal folds adjacent to the defect
puerperant woman complains of pain and were intact, peristalsis and elasticity of
heaviness in the left mammary gland. the walls remained unchanged. Digestive
Body temperature is 38, 8o C, Ps- 94 bpm. tract problems were absent. What is the
The left mammary gland is edematic, provisional diagnosis?
the supero-external quadrant of skin
is hyperemic. Fluctuation symptom is A. Esophageal tumour
absent. The nipples discharge drops of B. Achalasia cardia
milk when pressed. What is a doctor’s C. Esophageal burn
further tactics? D. Diverticulum
E. Barrett’s esophagus
A. Antibiotic therapy, immobilization and
expression of breast milk 188. A 50-year-old patient has worked
B. Compress to both mammary glands at a chemical plant for 15 years. His
C. Inhibition of lactation work involved using xylene solvent. The
D. Physiotherapy patient was hospitalized with suspected
E. Opening of the abscess and drainage of chronic intoxication. He was found to
the mammary gland have anemic syndrome. What is the first-
priority measure of secondary anemia
185. A 25-year-old patient has been admi- prevention?
tted to the hospital with the followi-
ng problems: weakness, sweating, itchi- A. Job change
ng, weight loss, enlarged submandibular, B. Administration of glucocorticosteroids
cervical, axillary, inguinal lymph nodes. C. Administration of iron supplements
Objectively: hepatomegaly. Lymph node D. Including seafood into the diet
biopsy revealed giant Berezovsky-Reed- E. Including meat into the diet
Sternberg- cells, polymorphocellular
granuloma made by lymphocytes, reti- 189. A 49-year-old patient complains of
cular cells, neutrophils, eosinophils, fi- itching, burning in the external genitals,
brous tissue, plasma cells. What is the frequent urination. The symptoms has
most likely diagnosis? been present for the last 7 months. The
patient has irregular menstruation, once
A. Lymphogranulomatosis every 3-4 months. Over the last 2 years
B. Lymph node tuberculosis she presents with hot flashes, sweating,
C. Lymphoreticulosarcoma sleep disturbance. Examination revealed
D. Cancer metastases to lymph nodes no pathological changes of the internal
E. Macofollicular reticulosis reproductive organs. Complete blood
count and urinalysis showed no pathologi-
186. During self-examination a 22-year- cal changes. Vaginal smear contained 20-
old patient revealed a mammary tumour. 25 leukocytes in the field of vision, mixed
Palpation revealed a firm, painless, mobi- flora. What is the most likely diagnosis?
le formation up to 2 cm, peripheral lymph
A. Menopausal syndrome
B. Cystitis A. Amiodarone
C. Trichomonas colpitis B. Flecainide
D. Vulvitis C. Encainide
E. Bacterial vaginosis D. Moracizine
E. Digoxin
complains of recurrent attacks of intensi- 194. A 38-year-old male works within the
ve pain irradiating along the ureters. Uri- range of ionizing radiation. At a routi-
ne test results: protein - 0,37 g/l, RBCs- ne medical examination he presents no
20-25 in the field of vision, WBCs - 12- problems. In blood: RBCs - 4, 5·1012/l, Hb-
14 in the field of vision. What method 80 g/l, WBCs - 2, 8 · 109 /l, thrombocytes -
of instrumental diagnostics is the most 30 · 109 /l. Decide if this person can work
informative for the diagnosis? with sources of ionizing radiation:
A. Intravenous urography A. Working with radioactive substances
B. USI of kidneys and other sources of ionizing radiation is
C. Computer tomography contraindicated
D. Radioisotope renography B. The patient is allowed to work with
E. Cystoscopy radioactive substances
C. The patient can only work with radi-
191. 2 weeks after labour a parturi- oactive substances of low activity
ent woman developed breast pain bei- D. The patient can be allowed to work
ng observed for 3 days. Examination after an extended medical examination
revealed body temperature at the rate E. The patient is allowed to work with
of 39o C, chills, weakness, hyperaemia, radioactive substances for the limited
enlargement, pain and deformity of the period of time
mammary gland. On palpation the infi-
ltrate was found to have an area of softeni- 195. A puerpera breastfeeding for 1,5
ng and fluctuation. What is the most likely weeks consulted a doctor about uniform
diagnosis? breast engorgement. Breasts are painful.
The body temperature is of 36, 6o C. Milk
A. Infiltrative-purulent mastitis expressing is difficult. What is the most li-
B. Phlegmonous mastitis kely diagnosis?
C. Lactostasis
D. Serous mastitis A. Lactostasis
E. Mastopathy B. Infiltrative mastitis
C. Purulent mastitis
192. A 22-day-old infant had developed D. Fibrocystic mastopathy
red subcutaneous nodules from 1,0 to 1,5 E. Gangrenous mastitis
cm large on the scalp. Later the nodules
suppurated, body temperature rose up 196. A 28-year-old male patient complains
to 37, 7o C, there appeared symptoms of of regurgitation, cough and heartburn that
intoxication, the regional lymph nodes occurs every day after a meal, when bendi-
grew bigger. Blood test results: anemia, ng forward or lying down. These problems
leukocytosis, neutrophilia, accelerated have been observed for 4 years. Objective
ESR. What is the most likely diagnosis? status and laboratory values are normal.
FEGDS revealed endoesophagitis. What
A. Pseudofurunculosis is the leading factor in the development of
B. Pemphigus this disease?
C. Vesiculopustulosis
D. Scalp phlegmon A. Failure of the inferior esophageal
E. - sphincter
B. Hypersecretion of hydrochloric acid
193. A 70-year-old patient consulted a C. Duodeno-gastric reflux
doctor about arrhythmic cardiac activity, D. Hypergastrinemia
dyspnea. Objectively: AP- 150/90 mm Hg, E. Helicobacter pylori infection
extrasystole arrhythmia (10-12 beats per
minute), left ventricular systolic dysfuncti- 197. A 24-year-old patient had been deli-
on (ejection fraction at the rate of 42%). vered to the thoracic department with
Which of antiarrhythmic drugs should a chest injury, a fracture of the IV, V,
be administered as initial therapy in this VI ribs on the right. Plan radiography
case? shows the fluid level in the pleural cavity
reaching the III rib on the right. Puncture had experienced antenatal fetal death due
blood contained clots. What is the optimal to hemolytic disease. What is the optimal
treatment tactics? tactics of pregnancy management?
A. Emergency thoracotomy A. Early delivery
B. Pleural puncture B. Delivery at 37 weeks of gestation
C. Thoracentesis and thoracostomy C. Screening for Rh-antibodies 2 weeks
D. Hemostatic therapy later and early delivery in case of further
E. Medical thoracoscopy titer rise
D. Introduction of anti-Rh (D)
198. A 10-year-old patient complains of immunoglobulin
skin itch that occurs at night. Objecti- E. Ultrasound for signs of hemolytic
vely: multiple paired papules, burrow disease of the fetus
tracks in the interdigital skin folds, on
the anterolateral surfaces of abdomen and 200. A 7-year-old female child has
buttocks. Specify the period of regular developed an acute condition. She
medical check-up for pupils of the class complains of a headache, two onsets of
where the patient learns: vomiting. Objectively: deferred reactions,
body temperature - 39, 3o C, pronounced
A. 2 months hyperesthesia, nuchal rigidity, positive
B. 2 weeks superior and inferior Brudzinski’s signs,
C. 5 days symmetric Kernig’s sign. What is the
D. 6 months provisional diagnosis?
E. 1 year
A. Meningitis
199. Examination of a Rh-negative B. Food toxicoinfection
pregnant woman at 32 weeks of gestation C. Craniocerebral trauma
revealed a four-time rise of Rh-antibody D. Toxic encephalopathy
titer within 2 weeks, the titer was 1:64. E. Encephalitis
In the first two pregnancies the patient

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Krok 2 Medicine 2013 1

1. A 28-year-old patient complains of

plant has been diagnosed with A. Tuberculous meningitis

A. Clotting time A. II degree flame burn of hands with an

21. A 50-year-old patient complains of A. Panzinorm forte

left eyelid, exotropia, anisocoria S>D, A. Posterior vertex presentation

29. A 32-year-old patient has developed A. Meets the requirements

31. A newborn’s head is of doli- 35. A 54-year-old patient complains of

A. Ciprofloxacin A. Chronic type A gastritis

of this disease is caused by: Heart sounds are muffled, rhythmic.

A. Right-sided pyopneumothorax ameter. Excretory urograms show normal

73. A 30-year-old multigravida has been vacuoles. Make a diagnosis:

of the thyroid gland feeling dense on provisional diagnosis?

Hand sensitivity is absent. What is the A. Emergency notification on infectious

A. To administer glucocorticoids, mi- A. Cadaver spots

There is a look of fear on his face. He Prostate-specific antigen rate is of 5 ng/ml.

A. Nodular euthyroid goiter headache in the occipital region, nausea,

A. At the main entrance A. Post-castration syndrome

A. Pituitary tumour A. Neuroleptics with a sedative effect

A. Hospitalization in the intensive care accompanied by nausea. Surgical exami-

A. Cardiogenic shock nodes were not changed. USI results: in

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