2023 May

2023- May-k2-Medicine Krokology.
com
Important notes ✍️🙋‍♂️
• This is revision 3 of May-2023. You can make sure if revision 2 is the last
revision by clicking here.
• My opinion about this booklet is that repeated ideas are many BUT need clear
focus and good preparation to get them, which require you to have good time
and stress management during the test. So, it’s a difficult exam but passing
mark is completely doable. Just make sure to prepare well and I hope your
exam is easier than this one.
• Kindly, before rejecting my answers, try to study the question carefully maybe
there is a reason behind the answer, after that we can discuss the question
together; you might be right and I will be happy to correct it , that’s how
any content get to the best results; continuous revision .
• You can practice this year in exam and study mode on Krokology along with
all bases and booklets for free.
• Thanks for all who participated in the revision of this booklet specially:
Dr. Khalil Azrak, Dr. Noon and Dr.Mohamed Zokailah 🙆‍♂️❤️
Repeated ideas D. Endemic goiter

Ideas here are repeated or very E. Midline cervical cyst
related to previous questions but in a
different context. 2. After semolina was introduced
into diet, a 1-year-old child for 2
1. A 55-year-old woman came to months has been presenting with loss
a doctor with complaints of thyroid of appetite, irritability, loss of body
enlargement that could be observed mass, and copious and foul smelling
throughout the last 2 years and a stools. The skin is pale and dry, the
discomfort during swallowing. hair is brittle. The abdomen is
Objectively, she has signs of distended, while the limbs are thin.
hypothyroidism. The thyroid gland Stool test shows high levels of fatty
on palpation is dense, non-fused with acids. What is the most likely
the surrounding tissues and mobile diagnosis in this case?
during swallowing. The regional A. Irritable bowel syndrome
lymph nodes are not enlarged. B. Functional diarrhea
Laboratory testing detects antithyroid C. Celiac disease
antibodies in the blood serum. What D. Lactase deficiency
is the most likely diagnosis in this E. Mucoviscidosis
case?
A. Thyroid cancer 3. A 19-year-old pregnant
B. Hashimoto's thyroiditis woman was hospitalized into the
C. Acute thyroiditis department of pregnancy pathology.
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2023- May-k2-Medicine Krokology.com
Her term of gestation is 36 weeks, the gastroenterologists, who were unable

fetus is large, with breech to find any gastrointestinal pathology
presentation. The woman has a in the patient. The prescribed therapy
severe form of diabetes mellitus. was ineffective. What condition is
Cardiotocography detects fetal most likely in the patient?
bradycardia of 90 / min. No labor A. Organic brain disorder
activity can be detected. What are the B. Functional dyspepsia
tactics of pregnancy management in C. Somatoform autonomic
this case? dysfunction
A. Breech extraction D. Depressive disorder
B. Childbirth through the natural E. Chronic alcoholism
birth canal
C. Labor stimulation 6. A 34-year-old woman came to
D. Continuation of pregnancy a doctor with complaints of muscle
E. Urgent caesarean section weakness, thirst, increased urination
at night, paresthesias, and seizure
4. A 5-year-old child became attacks. Objectively, her general
acutely ill with the fever of 39.2°C. condition is satisfactory, her face and
one episode of vomiting, complaints legs are doughy, her pulse is 80 /min.,
of cramping pain in the abdomen, her blood pressure is 200/110 mm
tenesmus, and of movements that Hg, the II heart is accentuated over
produce a sequent bowel feces and a the aorta. Complete blood count
large amount of mucus with pus and shows K levels of 3.1 mmol /L and
blood streaks. Examination detects a Na levels of 165 mmol /L. ECG
dense sigmoid colon that is painful to shows inversion of T waves and
palpation. Make the diagnosis. depression of S-T segments.
A. Salmonellosis Ultrasound detects hyperplasia of the
B. Cholera right adrenal gland. What is the
C. Acute appendicitis provisional diagnosis in this case?
D. Rotavirus infection A. Hypoparathyroidism
E. Shigellosis B. Essential hypertension
C. Glucosteroma
5. A 45-year-old patient was D. Primary hyperaldosteronism
referred for a consultation with a E. Pheochromocytoma
psychiatrist due to complaints of
abdominal pain and discomfort that 7. A 45-year-old man with a
occur in emotionally straining history of myocardial infarction
situations. Objectively, no changes of developed a brief attack of
the gastrointestinal tract were palpitations, accompanied by the
detected. The complaints first arose sensations of lack of air, fear, and
over 10 years the background of a vertigo. His blood pressure is 90/60
severe alcohol poisoning against. The mm Hg. ECG during the attack
patient has been repeatedly visiting shows extended QRS complex (0.13
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seconds) with the heart rate of 160 A. Chronic enteritis

/min., discordant shift of ST segment B. Crohn's disease
and T wave, dissociation of atrial and C. Dysentery
ventricular rhythm. What disturbance D. Cancer of the large intestine
of cardiac rhythm is it? E. Nonspecific ulcerative colitis
A. Atrial fibrillation
B. Paroxysmal supraventricular 10. A 14-year-old girl developed
tachycardia morning fever, cheilitis, stomatitis,
C. Paroxysmal ventricular photosensitivity, leukocytosis of
tachycardia 24*109 / L, and thrombocytopenia.
D. Frequent ventricular extrasystoles Laboratory studies detect antinuclear
E. Ventricular fibrillation antibodies in a high titer. Make the
provisional diagnosis.
8. Forensic autopsy of the body A. Juvenile idiopathic arthritis
of a 59 year-old man, who died B. Systemic lupus erythematosus
suddenly at home without signs of C. Dermatomyositis
violent death, shows pink skin and D. Systemic scleroderma
mucosa, liquid bright-red blood, and E. Sepsis
bright-red plethoric internal organs.
Forensic toxicology blood testing 11. For 12 hours, a woodcutter has
detected 1.44 ° / 00 of ethanol in the been working outdoors in windy
blood and carboxyhemoglobin levels weather at the air temperature of + 4-
of 55 %. What is the cause of death in 5 ° C. His shoes were compressing
this case? the distal parts of his feet. Now he
A. Alcohol poisoning complains of a pricking and burning
B. Aniline poisoning pain in his toes 1-3 on both feet, pain
C. Carbon monoxide poisoning in the interphalangeal joints, and
D. Arsenic poisoning decreased skin sensitivity in toes 1-3.
E. Potassium cyanide poisoning Examination detects slightly
edematous toes, bluish skin, painful
9. A 26-year-old woman and reduced movements in the
complains of cramping abdominal interphalangeal joints, slightly
pain, diarrhea with a significant reduced skin sensitivity, and retained
amount of mucus and blood, and pulsation of the arteries on the
fever of 37.5-38.0° C. Objectively, dorsum of the feet. What is the
her skin and mucosa are pale, the provisional diagnosis in this case?
body type is asthenic. Palpation A. First degree frostbite
detects pain along the large intestine. B. Acute interphalangeal joint
Colonofibroscopy reveals edematous arthritis
wall of the rectum and sigmoid colon C. Critical ischemia of the feet
erosions, small ulcers, and mucus D. Crush syndrome
with blood in the lumen. What is the E. Obliterating endarteritis
likely diagnosis in this case?
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12. After eating mushrooms, a 30- laboratory testing to confirm food

year-old person developed nausea, poisoning?
vomiting, and absence of urination. A. Urine for clinical analysis
On the third day after the onset of the B. Vomitus
symptoms, this person sought C. Saliva
medical aid. Laboratory tests show D. Blood for clinical analysis
elevated creatinine levels of 700 E. Blood for hemoculture
mcmol /L. and urea levels of 32
mmol /L. What treatment tactics 15. A man was repairing a fence
should be chosen in this case? and injured his right elbow with a
A. Hemodialysis wire. Three days later he developed
B. Diuretics edema, hyperemia, reduced range of
C. Detoxification therapy movements in the joint, intense pain,
D. Peritoneal dialysis and local and general increase of
E. Antidote therapy temperature. Objectively, the right
elbow is enlarged, the skin over it is
13. During preventive medical edematous and hyperemic, regional
examination of middle and high lymph nodes are enlarged, thickened,
school students, doctors were and painful. Palpation of the right
determining, whether the biological elbow detects sharp pain and
development of children matches fluctuation. Make the provisional
their calendar age. For this purpose, diagnosis.
the doctors were using the following A. Lymphadenitis
criteria: annual increase in body B. Erysipelas
length, ossification of hand bones, C. Bursitis
number of permanent teeth. What D. Hidradenitis
additional developmental indicator E. Abscess
should the doctors include, when Confirmed by official test center.
examining children at this age?
A. Chest circumference 16. 84. A 27-year-old patient
B. Development of secondary sexual developed a fever of 38.7° C, lumbar
characteristics pain, weakness, and headache after
C. Hand muscle strength an overexposure to cold.
D. Vital capacity of the lungs Examination detects a positive
E. Body weight Pasternacki. What is the provisional
diagnosis in this case?
14. A food poisoning occurred in a A. Acute urethritis
canteen, affecting 15 people. The B. Acute pyelonephritis
clinical presentation of the poisoning C. Acute cystitis
indicates its staphylococcal etiology. D. Acute glomerulonephritis
What biological materials, obtained E. Urolithiasis
from the patients, must be sent for
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17. A 40-year-old man complains significant edema of the underlying

of a rash all over his body and slight and surrounding tissues.
itching. He has been ill for 3 months Examination shows an ulcer up to
and associates his rash with a 2.5-3 cm in diameter, with. clear
neuropsychiatric trauma. margins, the bottom that resembles
Objectively, he has multiple pink "old lard" in color, and an underlying
papules covered with silvery scales cartilaginous infiltrate. What
on the skin of his torso, scalp, and laboratory test must be prescribed
extensor surfaces of the limbs. What first in this case?
will be the provisional diagnosis in A. Smear for acantholytic cells
this case? B. Eosinophil count
A. Papular syphilide C. Treponema pallidum test
B. Pityriasis rosea Gibert D. Skin scraping for mycosis
C. Seborrheic dermatitis E. Bacterial culture
D. Lichen ruber planus
E. Disseminated psoriasis 20. A 58-year-old man had a
moderate ischemic stroke in the right
18. A 32-year-old man came to a hemisphere of the brain 10 days ago.
doctor with complaints of painless At the time of hospitalization, the
rashes that appeared on his knees 4 deficit score on the NIHSS scale was
months ago and now start to appear 9 points. He suffers from moderate
on his elbows too. The rashes itch and arterial hypertension, atrial
bleed when scratched. The patient fibrillation, urolithiasis, and gout
notes that on his elbows rash (remission). What must be prescribed
appeared after he had been scratched to the patient for secondary
by a house cat. Physical examination prevention of stroke?
detects dense erythematous plaques 2 A. Aspirin, 100 mg per day
to 3 cm in diameter on the knees and B. Clopidogrel, 75 mg per day
elbows. The plaques have a clear C. High doses of lipid-lowering
contour and are covered in silvery agents (e.g. atorvastatin-80 mg
scales. What is the most likely per day)
diagnosis in this case? D. Oral anticoagulants (warfarin or
A. Psoriasis NOACs dabigatran, rivaroxaban,
B. Cat scratch disease apixaban)
C. Eczema E. Drugs that improve cerebral blood
D. Contact dermatitis flow
E. Seborrheic dermatitis
21. A 25-year-old woman was
19. For three weeks, a 29-year-old hospitalized at 11 weeks of
patient has been observing a painless pregnancy with complaints of pain in
ulcer on the skin of the vermilion her lower abdomen. Two weeks ago
border of the lower lip The last week, she had a severe case of rubella.
the ulcer became accompanied by Bimanual examination detects a
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formed cervix, the cervical inlet is muscles, loss of appetite,

closed, the uterus is enlarged up to 11 constipations, rapid fatigability, and
weeks of pregnancy, the uterine a subfebrile body temperature.
appendages are normal. What Objectively, she has dysphagia,
treatment tactics would be optimal in symmetrical arthritis, skin thickening
this case? on her hands and feet, atrophy and
A. Administration of uterotonics small ulcers on the fingertips,
B. Termination of pregnancy Raynaud's syndrome, telangiectasia.
C. Prolongation of pregnancy What disease is the cause of such a
D. Minor caesarean section clinical presentation?
E. Administration of antispasmodics A. Systemic scleroderma
B. Rheumatoid arthritis
22. A 64-year-old man came to a C. Dermatomyositis
doctor with complaints of edemas of D. Raynaud's disease
the legs, lower back, and anterior E. Systemic lupus erythematosus
abdominal wall. He has a history of
chronic bronchitis with 24. A 38-year-old patient
bronchiectasis. Physical examination complains of pain in the area of the
shows the following: body metatarsophalangeal joints of toes 1-
temperature-372° C, blood pressure – 2 on the right foot. Examination
110/75 mm Hg, pulse – 82 /min., detects bluish-purple skin over the
respiratory rate 19 /min. General affected joints that is hot to the touch.
urinalysis results are as follows: There are nodular formations
specific gravity- 1025. protein 9.9 g covered with thin shiny skin in the
/L, leukocytes 2-3 in the-vision field, area of the auricles. What drug must
erythrocytes 1-2 in the vision. field, be prescribed for this patient as a part
no casts. Daily proteinuria is 11.4 g of the urate-lowering therapy?
per 24 hours. Blood biochemistry test A. Allopurinol
shows the following: total protein-52 B. Methotrexate
g/L, albumins -30 g /l, cholesterol-9.6 C. Nimesulide
mmol /L. What type of kidney D. Febuxostat
disorder is most likely in patient? E. Colchicine
A. Tubulointerstitial nephritis,
nephrotic syndrome 25. A man suddenly developed a
B. Diabetic nephropathy, nephritic sharp retrosternal pain that radiated
syndrome into the left arm. Objectively, the
C. Pyelonephritis, urinary syndrome patient was excited, his skin was pale,
D. Glomerulonephritis, nephritic the respiration rate was 38 / min., the
syndrome, blood pressure was 180/110 mm Hg.
E. Amyloidosis, nephrotic syndrome Later he lost his consciousness, fell
down, the pulse on the major vessels
23. A 36-year-old woman could not be detected, the pupils were
complains of pain in her joints and
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evenly dilated. What is the diagnosis A. Thrombosis of the central retinal

in this case? vein
A. Clinical death B. Diabetic retinopathy
B. Agonal state C. Hypertensive angiopathy
C. Coma D. Embolism of the central retinal
D. Cerebral circulation disorder artery
E. Heart attack E. Hypertensive angioneuropathy
26. After the extraction of the 28. A 20-year-old woman has

second molar, the patient's body been developing rhinitis and
temperature increased. He developed conjunctivitis in August September
pharyngeal pain on the left, for the last 8 years. The last year
infiltration, hyperemia of the lower during this period, attacks of
part of the anterior palatine arch, and bronchial asthma started occurring as
displacement of a tonsil towards the well. Skin testing detects
midline and upwards. Regional hypersensitivity to Ambrosia pollen,
lymph nodes are painful to palpation. The antibodies that cause the
The otolaryngologist diagnosed the exacerbation of this condition belong
patient with paratonsillar abscess. to the following class of
What is the route of infection spread immunoglobulins:
in this case? A. Immunoglobulin G
A. Hematogenous B. Immunoglobulin D
B. Lymphogenic C. Immunoglobulin E
C. Entry of a foreign body D. Immunoglobulin A
D. Odontogenic E. Immunoglobulin M
E. Tonsilogenic
29. A 30-year-old woman
27. Within 2-3 hours, a 58-year- complains of menstruations missing
old man developed multiple spots in for a year. She has history of a
his vision, after which the vision in massive postpartum hemorrhage.
his right eye darkened. Examination Objectively, her secondary sex
detects eccentric visual acuity of organs are normally developed, the
0.02. The pupil is moderately dilated, hair growth pattern is of the female
its direct response to light is reduced. type. Bimanual examination detects
Ophthalmoscopy detects multiple normal uterus and uterine
hemorrhages of varying size and appendages. What is a possible cause
shape on the fundus of the eye of amenorrhea in this case?
("squashed tomato" sign), the optic A. Ovarian insufficiency
disc is edematous and hyperemic. B. Thyroid disorder
The patient has a history of essential C. Adrenocortical necrosis
hypertension of II B degree. What is D. Hypothalamic insufficiency
the most likely diagnosis in this case? E. Pituitary necrosis
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30. A pregnant woman suffers 32. An 18-year-old adolescent

from essential hypertension of the bought at a store a salad with smoked
first degree. At 35 weeks of gestation, fish, mushrooms, and mayonnaise.
she developed edemas of the legs and Six hours after eating the salad, he
anterior abdominal wall. Her 24-hour developed progressive weakness,
urine protein is 5 g/L, the blood vision impairment, "fog in the eyes",
pressure increased to 170/120 mm and problems with swallowing. He
Hg. She developed a headache and was hospitalized. Examination
her vision became worse. Four hours detects the body temperature of 36.0
of intensive treatment had no effect. °C and pale skin and mucosa. The
What tactics would be necessary in patient is adynamic, answers
this case? questions sluggishly. The pupils are
A. Conservative management of the dilated, with reduced response to
delivery fight. The patient's voice is hoarse,
B. Continuation of the intensive his oral mucosa is dry. What type of
therapy food poisoning can be suspected in
C. Preparation of the cervix for this case?
preterm birth A. Staphylococcal intoxication
D. Immediate delivery by caesarean B. Botulism
section C. Mushroom poisoning
E. Labor induction D. Fish poisoning
E. Salmonellosis
31. A 40-year-old man complains
of impaired vision, rapid heartbeat, 33. A worker at a workshop that
and an aching pain in the muscles of produces car batteries came to a
his back, lumbar region, and legs and doctor with complaints of nausea,
in his shoulder and hip joints. loss of appetite, sharp pain in the
Objectively, the signs of uveitis can abdominal cavity, and constipations.
be observed. X-ray detects blurring Examination reveals elevated blood
of the contours of the sacroiliac joints pressure, bradycardia, an enlarged
and single syndesmophytes between liver, pain in the right subcostal
the vertebral bodies. Laboratory region, a grayish blue stripe on the
testing detects antibodies against gums, and gray skin. Complete blood
HLA-B27 antigens, anemia, and ESR count indicates the presence of
of 28 mm / hour. What disease causes erythrocytes with basophilic
such a clinical presentation? stippling and reduced hemoglobin
A. Ankylosing spondylitis levels. Aminolevulinic acid and
B. Deforming spondyloarthrosis coproporphyrin can be detected in the
C. Rheumatoid arthritis patient's urine. What is the most
D. Systemic lupus erythematosus likely provisional diagnosis in this
E. Reiter's syndrome case?
A. Aluminum poisoning
B. Cadmium poisoning
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C. Lead poisoning
D. Mercury poisoning 36. Preventive examination of the
E. Food poisoning population of one of the Ukrainian
cities detected spotted tooth enamel
34. The pregnancy is first, the term and generalized osteosclerosis with
of gestation is 38 weeks. The fetus is calcification of the intervertebral
in the longitudinal lie, the ligaments in 25 % of the residents.
presentation is cephalic, with the What is the most likely cause of these
head pressed against the entrance to symptoms?
the lesser pelvis. The expected A. Insufficient fluorine levels in
weight of the fetus is 3500.0 g. animal products
Contractions occur every 5 minutes B. Insufficient fluorine levels in soil
and last for 25-30 seconds. The fetal and water
heartbeat is 130 / min., clear and C. Excessive fluorine levels in
rhythmic Vaginal examination shows vegetable products
that the cervix is shortened to 1 cm, D. Insufficient fluorine intake with
the cervical canal allows inserting 1 tea
finger width (2 cm). The amniotic sac E. Excessive fluorine levels in water
is intact. What labor management
tactics should be chosen in this case? 37. A newborn baby developed a
A. Tocolytic therapy rash on the body. The mother was not
B. Caesarean section registered for prenatal care checkups.
C. Amniotomy After birth, the child scored on the
D. Manage the birth through the Apgar scale 7 and 9 points at 1 and 5
natural birth canal minutes of life respectively. Physical
E. Stimulation of labor activity examination revealed the following:
body temperature-37 ° C, pulse- 145
35. A four-month-old child / min. respiratory rate-33 / min.,
suddenly became ill. The following petechial rash on the torso,
symptoms has appeared: an increase Auscultation of the heart detects a
of the body temperature to 38,5°C, systolic-diastolic murmur in the left
one-time vomiting, lethargy. In 10 subclavian region. What is the most
hours, on the buttocks and lower likely diagnosis in this case?
limbs appeared a rash in the form of A. Syphilis
petechie, spots and pustules. Some B. Toxoplasmosis
hemorrhagic elements are with C. Herpes simplex virus
necrosis in the center. What disease is D. Cytomegalovirus infection
most likely present in this child? E. Rubella
A. Meningococcemia
B. Hemorrhagic vasculitis 38. A 59-year-old woman
C. Scarlet fever complains of pain and edema in the
D. Flu small joints of her hands, shortness of
E. Rubella breath, weakness. This condition
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lasts for 8 years already. Objectively, technical lyceum shows signs of

her body temperature is 37.8 ° C, she cheilosis that manifests as
has fine punctate hemorrhages on her maceration of the epithelium in the
torso and limbs, ulnar deviation of place where the lips close. The lips
the hands is observed. The borders of are bright red, with isolated vertical
the heart are shifted to the left, a fissures covered in red brown scabs.
systolic murmur can be detected over These clinical signs are most likely
the apex. Her pulse is 96 / min. Her caused by the insufficient intake of a
blood pressure is 170/100 mm Hg. certain substance with food. Name
Complete blood count shows the this substance.
following: erythrocytes-3.2 10¹2 / L, A. Retinol
Hb-108 g / L, leukocytes-6.8 10 % / B. Ascorbic acid
L, platelets-220-10 / L, ESR-48 mm / C. Thiamine
hour, C-reactive protein (+++). D. Calciferols
General urinalysis shows the E. Riboflavin
following: specific gravity-1016,
protein-2.8 g / L, leukocytes 10-12 in 41. A 27-year-old woman, gravida
the vision field, erythrocytes-2-4 in 1, para 1, was hospitalized into the
the vision field. What is the most maternity ward. She had a 3-year-
likely diagnosis in this case? long history of primary infertility
A. Chronic glomerulonephritis Contractions started 9 hours ago,
B. Thrombocytopenic purpura occur every 4-5 minutes, and last 20-
C. Systemic lupus erythematosus 25 seconds The waters broke 2.5
D. Rheumatoid arthritis hours ago. The fetal heartbeat is 136
E. Rheumatism / min. The small segment of the fetal
That’s how krok center solved it in head lies in the plane of the inlet into
the site. the lesser pelvis. The cervix is
smoothed out, its opening is 4 cm.
39. A 2-year-old child suffers The amniotic sac is absent. What
from frequent and long-lasting complication occurred during the
respiratory diseases and childbirth?
pancreatogenic malabsorption. A. Discoordinated labor activity
Mucoviscidosis (cystic fibrosis) is B. Normal labor activity
suspected. What study is necessary to C. Primary weakness of labor
confirm this diagnosis activity
A. Immunogram D. Pathological preliminary period
B. Sweat chloride test E. Secondary weakness of labor
C. Bronchoscopy activity
D. Chest X-ray
E. Karyotyping 42. A 25-year-old woman
complains of pain in her right iliac
40. During preventive medical region that lasts for 10-12 days
examination, one of the students at a already and a menstruation delay of
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7-8 weeks. Palpation detects pain in examination would be the most

the right iliac region. Gynecological informative in this case?
examination detects pain in the right A. Tension cyst of the right lung.
vaginal fornix, but no enlargement of Tracheobronchoscopy
the uterus or ovaries. A right sided B. Right-sided tension
ectopic pregnancy is suspected. What pneumothorax. Survey X-ray of
examination method would be the chest
optimal in this case. C. Mediastinitis. Survey X-ray of the
A. Ultrasound chest
B. Thermography D. Airway foreign body. Diagnostic
C. Metrosalpingography and therapeutic bronchoscopy
D. Pneumogynecography E. Right-sided hemothorax. Survey
E. Pelvic X-ray X-ray of the chest
43. In recent months, a 29-year- 45. A 24-year-old woman

old woman developed complaints of complains of a popular-rash on her
pain in her right iliac region, diarrhea external genitalia. The rash is
with mucus and pus, pain in the hip painless, without itching, clearly
joints, and periodic increases in body separated from the healthy skin. Two
temperature. The abdomen during months ago, a round ulcer with a hard
palpation is soft, with tenderness in smooth bottom located on the
the right iliac region. Irrigography patient's labia majora disappeared on
shows that the mucosa resembles a its own without a treatment. What is
cobblestone pavement, the ileocecal the likely diagnosis in this case
junction is narrowed. What disease A. Measles
can be suspected in this case? B. Typhus
A. Tuberculous ileotyphlitis C. Secondary syphilis
B. Crohn's disease D. Pityriasis versicolor
C. Whipple's disease E. Toxidermia
D. Gluten enteropathy (celiac
disease) 46. A newborn boy was brought
E. Pseudomembranous enterocolitis into a hospital on the second day after
the onset of the disease. His parents
44. A 7-year-old boy after a fall complain of his fussiness,
from a height presents with rapid and regurgitation, fever of 38.5 ° C, red
shallow breathing and cyanotic face. skin with infiltration in the area of his
The right half of his chest takes no lower back. Objectively, the child is
part in the act of breathing. in a severe condition, inert, pale,
Percussion detects tympanitis in this suckles poorly. In the lumbar region,
region, while auscultation detects no on the sacrum, and on the buttocks
breathing there. What pathology is there is an infiltration with hyperemic
the most likely cause of this clinical areas and a soft spot 8x7 cm in its
presentation? What instrumental center. The stool is 10 times per 24
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hours with green coloring and mucus. body stretched out, her spine curved,
What is the most likely diagnosis in her jaws tightly clenched, and she
this case? stopped breathing. Then she
A. Phlegmon of the newborn developed clonic seizures and
B. Congenital soft-tissue tumor marked cyanosis. After that, the
C. Hemangioma seizures stopped, a deep noisy inhale
D. Adiponecrosis occurred, and blood-stained foam
E. Erysipelas appeared on the patient's lips. What is
the most likely diagnosis in this case?
47. A 63-year-old man came to a A. Hypertensive crisis
doctor with complaints of marked B. Diabetic coma
general weakness, poor appetite, C. Epilepsy
weight loss, joint pain, and heaviness D. Eclampsia
in the right subcostal area. Complete E. Chorea
blood count shows the following:
erythrocytes 3.4 10¹2 / L, Hb-102 g 49. A 16-year-old boy developed
/L, color index-0.9, platelets-640 dizziness. Objectively, his heart rate
*10⁹ / L, leukocytes-138 *109 / L, is 35 / min., his blood pressure is
blasts -1 %, promyelocytes-2 %, 85/45 mm Hg, the heart borders are
myelocytes-13 %, juvenile-12 %, not enlarged, the heart sounds are
band neutrophils-16 %, segmented loud and clear. ECG shows P waves
neutrophils-31 %, basophils-3 %, disconnected from QRS complexes,
cosinophils-8 %, lymphocytes-9 %, dissociation and different rhythm of
monocytes-5 %, ESR-30 mm / hour. atria and ventricles are accompanied
What is the provisional diagnosis by varying location of P wave in
A. Chronic myeloid leukemia relation to QRST complex. This
B. Leukemoid reaction presentation is most characteristic of
C. Acute leukemia the following disease:
D. Erythremia (polycythemia vera) A. Atrioventricular dissociation
E. Chronic lymphocytic leukemia B. Sinus bradycardia
C. Atrioventricular block (II degree)
48. A 22-year-old pregnant a D. Extrasystole
severe condition was hospitalized in E. Complete atrioventricular block
on. Throughout the past three days, (III degree)
she developed edemas, headache,
nausea, and one episode of vomiting. 50. A 55-year-old woman
Objectively, her consciousness is complains of deformed finger joints
clouded, her blood pressure is and pain in them during movements.
160/130 mm Hg. She presents with Objectively, there are small bony
small fibrillar twitching of the facial formations on the lateral surfaces of
muscles and problems with nasal the distal interphalangeal joints. The
breathing. During transportation, the formations are slightly painful to
woman's arms started twitching, her palpation. What are they called?
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A. Bouchard's nodes hospital. The current hospitalization

B. Tophi was due to behavioral disorders in the
C. Rheumatoid nodules form of reticence, refusal to eat,
D. Heberden's nodes periodical chaotic excitement with
E. Erythema nodosum stereotyped movements. During the
examination, the patient is sluggish,
51. A 30-year-old woman came to remains in bed, and no contact with
a doctor with complaints of milk him can be made. He does not answer
discharge from her breasts and no any questions, his position is
menstruation for the last 5 months. monotonous, he is hypomimic. The
She had one physiological childbirth "proboscis" sign, the waxy flexibility
four years ago. The development of of the muscles, and the "
her breasts is normal. Bimanual psychological pillow sign are
examination detects a reduced in size observed. This condition lasts for a
uterus and normal size of the ovaries. week already. What is the provisional
MRI detects no cerebral pathology. diagnosis in this case?
Thyrotropin levels are within the A. Catatonic schizophrenia
normal range, prolactin levels in B. Simple-type schizophrenia
blood serum are elevated. What is the C. Hebephrenic schizophrenia
most likely diagnosis in this case? D. Reactive stupor
A. Sheehan syndrome E. Schizophrenia with paranoia
B. Hyperprolactinemia
C. Pituitary adenoma 54. A 55-year-old woman
D. Polycystic ovary syndrome complains of diarrhea, irritability,
E. Hypothyroidism and peeling and pigmentation of the
open areas of her body (neck, hands,
52. A 14-year-old girl has short and feet). Her history indicates that
stature, broad shoulders, webbed corn is one of the main components
neck, and no signs of puberty. Her in her diet. The woman rarely eats
intelligence is normal. Ultrasound of other vegetables and legumes and
the lesser pelvis shows hypoplasia of does not eat meat or fish. What is the
the uterus and the absence of ovaries. most likely diagnosis in this case?
Karyotype of the child is 45, XO. A. Pellagra
What pathological syndrome can be B. Scurvy
suspected in this case C. Psoriasis
A. Klinefelter syndrome D. Biotin-responsive dermatosis
B. Patau syndrome E. Beriberi
C. Edwards syndrome
D. Turner syndrome 55. The patient, a chemical plant
E. Down syndrome worker, while working with an
aggressive liquid, accidentally
53. A 37-year-old patient was spilled it on his overalls, receiving a
repeatedly treated in a psychiatric chemical burn on his right thigh and
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lower leg. After removing his C. Syphilis

clothes, the following was revealed: D. Reactive arthritis
on the front inner surface of the right E. Gonorrhea
thigh and the front surface of the right
lower leg with a transition to the 57. A man complains of red and
dorsum of leg cannot sit still on the sore skin on his right calf.
chair, gesticulates, suddenly starts Objectively, his body temperature is
singing. laughing, reciting poems. 38.5°C; his inguinal lymph nodes on
She thinks she is “the healthiest and the right are enlarged and painful; the
the happiest and claims that everyone skin is red, with clear boundaries
envies her good looks and beautiful between the redness and healthy skin;
voice”. According to her relatives, edema is observed; there are vesicles
she has not been sleeping at night for filled with a dark liquid; palpation is
the past 5 days and her appetite has painful. What is the provisional
increased. Three years ago, she was diagnosis in this case?
treated by a psychiatrist for A. Herpetic infection
depression. What syndrome is most B. Phlegmon of the leg
likely in this patient? C. Varicella
A. Delirium D. Erysipelas
B. Attention deficit hyperactivity E. Cutaneous anthrax
disorder
C. Manic syndrome 58. A 64-year-old man fell to the
D. Twilight state floor, landing on his left side.
E. Depressive syndrome Objectively, shortening of the left
limb and external rotation of the hip
56. A 27-year-old man came to a are observed. The patient is unable to
doctor with complaints of pain and perform the straight leg raise test.
swelling in his toes II and III on the During palpation and tapping on the
left foot, redness of the eyes and heel, the patient feels pain in the hip
purulent discharge from them, and joint. What is the likely diagnosis in
painful urination. Patient history this case?
taking revealed that the patient has A. Contusion of the hip joint
several sexual partners and rarely B. Femoral neck fracture
uses condoms. Physical examination C. Hip dislocation
revealed bilateral conjunctivitis and D. Greater trochanteric fracture
dactylitis of the toes. Blood test E. Fracture of the upper third of the
shows ESR of 40 mm / hour. X-ray femur
of the to detects an increase in the
volume of soft tissues and joint space 59. A person has been hospitalized
narrowing. What is the most likely with the diagnosis of trichinellosis.
diagnosis in this case? What food product is the likely cause
A. Gout of this helminthiasis?
B. Rheumatoid arthritis A. Rabbit
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B. Poultry pressure of 150/100 mm Hg. Clinical

C. Beef urinalysis shows the following:
D. Mutton specific gravity-1021, protein-9 g/L,
E. Pork erythrocytes 40-50 in the vision field,
hyaline casts – 4-6 in the vision field.
60. A 65-year-old woman came to What is the provisional diagnosis in
a doctor with complaints of weakness this case?
in her left limbs. The weakness A. Exacerbation of chronic
appeared in the morning and was glomerulonephritis
gradually increasing throughout the B. Acute pyelonephritis
day. Objectively, her consciousness C. Myxedema
is clear, her blood pressure is 190/100 D. Acute glomerulonephritis
mm Hg, her heart rate is 80 / min., E. Heart failure
rhythmic, a systolic murmur can be
detected on the neck in the projection 62. During coke production, the
of the bifurcation of the right concentration of dust in the air of the
common carotid artery. Examination working area has been for many years
of the neurological status detects a exceeding the maximum permissible
smoothed-out nasolabial fold on the concentration by 4-8 times. What
left, deviation of the tongue to the disease is most likely to develop
left, a decrease in the muscle strength among the workers in this industry as
of the left limbs to 3 points, tendon a result?
reflexes are S > D, the Babinski sign A. Anthracosis
is positive on the left, left-sided B. Byssinosis
hemihypersthesia is observed. What C. Asbestosis
is the most likely diagnosis in this D. Silicosis
case? E. Siderosis
A. Dyscirculatory encephalopathy
B. Acute hypertensive 63. A 36-year-old patient
encephalopathy complains of suffocation attacks with
C. Hemorrhagic stroke predominantly problematic
D. Ischemic stroke exhalation. The attacks occur up to 2-
E. Multiple sclerosis 3 times a day and can be relieved by
inhalation of 2-adrenomimetics. This
61. Two weeks after a case of condition lasts for 10 years already.
tonsillitis, a 29-year-old patient Objectively, the chest is expanded,
noticed facial edema, weakness, and percussion detects a bandbox
decreased work capacity. Gradually, resonance over the lungs,
he developed shortness of breath, leg auscultation detects harsh respiration
edema, and lumbar edema. with prolonged exhalation.
Objectively, his skin is pale, his heart Laboratory analysis of sputum
sounds are weakened, he has detects numerous eosinophils,
hydrothorax, anasarca, and blood Charcot-Leyden crystals, and
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Curschmann spirals. What is the A. Primary amenorrhea

provisional diagnosis in this case? B. Pituitary tumor (Cushing disease)
A. Spontaneous pneumothorax C. Pituitary amenorrhea (Sheehan
B. Chronic obstructive bronchitis syndrome)
C. Bronchial asthma D. Uterine pregnancy
D. Cardiac asthma E. Stein-Leventhal syndrome
E. Carcinoid syndrome
66. A 42-year-old patient has been
64. A 46-year-old man came to a hospitalized into the trauma
doctor with complaints of a rash on department. X-ray reveals a pelvic
his hands that appeared one week ago fracture. Objectively, unassisted
and is accompanied by severe urination is not possible,
itching. The patient has a history of urethrorrhagia is observed. Palpation
bronchial asthma and has seasonal detects an enlarged bladder and a
allergies. Physical examination painful swelling in the perineum.
detects dry skin of the hands and What is the provisional diagnosis in
multiple erythematous papules and this case
vesicles with scrous contents, as well A. Perineal hematoma
as areas of lichenification and B. Bladder trauma
excoriation, on the back of both C. Acute kidney failure
hands. What is the most likely D. Urethral trauma
diagnosis in this case? E. Reflex urinary retention
A. Psoriasis
B. Seborrheic dermatitis 67. A victim has a II-III degree
C. Contact dermatitis burn injury that covers 15% of the
D. Eczema body surface. On day 20 after the
E. Scabies injury, the patient presents with a
sharp increase in the body
65. A 30-year-old woman came to temperature, general weakness, and
a doctor with complaints of frequent shallow respirations. The
menstruations that have been missing blood pressure is 90/50 mm Hg. the
for two years after her second pulse is 112 /min. What complication
childbirth. The childbirth was can be suspected in this case?
complicated by a massive bleeding. A. Acute intoxication
After giving birth, the woman started B. Anaerobic infection
noticing hair loss and weight loss. C. Purulent bronchitis
Objectively, the woman's body type D. Pneumonia
is asthenic, her external genitalia are E. Sepsis
hypoplastic, the cervix is cylindrical,
the body of the uterus is small and 68. A 72-year-old patient came to
painless, the uterine appendages a doctor with complaints of hand
cannot be detected. What is the most tremors, stiffness, slowness of
likely diagnosis in this case? walking and speech, and difficulties
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in performing routine household

chores. Physical examination detects 71. Several chemical fundus
general bradykinesia, hypomimia, detects narrowing of the retinal body
emprosthotonus, "shuffling" gait, from atmospheric air. What is the
hand tremors at rest, D > S, plastic type of joint action, where the overall
type of increased muscle tone, the " effect on the human body is more
cogwheel rigidity " phenomenon, and than the sum of the individual effects
marked postural instability. What of each separate substance included
medicines must be a primary part of in the combination?
the treatment regimen for this A. Antagonism
patient? B. Combined action
A. Antidepressants C. Complex action
B. Medicines containing levodopa D. Potentiation
C. Medicines that improve E. Isolated action
microcirculation
D. Anticholinergic agents 72. A 26-year-old woman, who
E. Anticholinesterase drugs has been suffering from rheumatoid
arthritis for 8 months, has edemas of
69. A 10-year-old boy was treated her elbow, radiocarpal, knee, and
in the cardiology department for ankle joints, and rheumatoid nodules
rheumatism, first attack, active in the area of her elbow joints.
phase, second degree activity. Complete blood count shows ESR of
Discharged in a satisfactory 57 mm / hour and C-reactive protein
condition. What drug should be (+++). X ray of the joints reveals
prescribed in this case for prevention marked osteoporosis. What medicine
of secondary rheumatism would be used as the basic therapy in
A. Bicillin-5 this case?
B. Ampicillin A. Diclofenac sodium
C. Oxacillin B. Methylprednisolone
D. Bicillin-1 C. Infliximab
E. Erythromycin woman D. Meloxicam
E. Methotrexate
70. What is the type of joint action,
where the overall effect on the human 73. It was found that for every 100
body is less than the sum of the births, women with risk factors had
individual effects of each separate 30 preterm births, while women
substance included in the without risk factors had 5 preterm
combination? births. What statistical method of
A. Potentiation data processing would be optimal for
B. Combined action a doctor to use to estimate the validity
C. Antagonism of differences between the groups
D. Isolated action that are being compared?
E. Complex action A. Standardization method
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B. Calculation of relative values respiratory viral infection or damage

C. Calculation of the Student's to the bronchoarary apparatus. A side
criterion effect of ramipril is suspected. What
D. Calculation of average values drug can be used to replace ramipril
E. Correlation analysis in the treatment plan?
A. Torasemide
74. A 40-year-old woman has B. Enalapril
been suffering from epilepsy since C. Nifedipine
she was 15. Generalized epileptic D. Nebivolol
seizures occur 2-3 times a month at E. Valsartan
night and are accompanied by
involuntary urination and defecation. 76. A 14-year-old girl is being
After a psychotrauma (her father's examined by a pediatrician.
death), the attacks became more Objectively, she has a tall stature,
frequent and now occur every 2-3 asthenic body type, striae on the skin
minutes. The woman does not return of the abdomen, blue sclera. She was
to consciousness between the attacks, diagnosed with a scoliotic posture
her pupils are unresponsive to light. and chest deformity. She has
What is the most likely diagnosis in hypermobile joints; her fingers and
this case? arms are long. Cardiac ultrasound
A. Absence seizure visualizes a mitral valve prolapse.
B. Hysterical attack What is the most likely because of
C. Epileptic psychosis her tall stature?
D. Status epilepticus A. Noonan syndrome
E. An increase in the number of B. Marfan syndrome
grand mal seizures C. Klinefelter syndrome
D. Williams syndrome
E. Ehlers-Danlos syndrome
New questions
Questions here are new but still, you 77. A pregnant woman at 38
can guess some of them. Many weeks of pregnancy was hospitalized
questions here can be found in usmle into the maternity hospital with
preparation material like FA and UW. complaints of a small amount of
bloody discharge from the genital
75. A 65-year-old patient was tracts and a sharp pain in her entire
prescribed pharmacotherapy abdomen that started one hour ago.
(ramipril, atorvastatin, amlodipine, No labor activity can be detected.
acetylsalicylic acid, bisoprolol) for Objectively, the patient is pale, her
essential hypertension with pulse is 100 / min., her blood pressure
concomitant ischemic heart disease. is 100/60 mm Hg, no fetal heartbeat.
Two weeks later, he consulted a Palpation detects tense and painful
doctor about a dry cough. uterus. Make the diagnosis.
Examination detects no signs of acute A. Placenta previa
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B. Placental abruption E. Epidural hematoma

C. Uterine rupture
D. Acute kidney failure 80. A 19-year-old patient
E. Intranatal fetal death complains of a dry cough, muscle
Confirmed by official test center. pain, and a fever of 39 °C. A sore
throat and subfebrile body
78. The patient's son has filed a temperature were observed for the
lawsuit after his mother died of breast last week. Objectively, the
cancer. Due to the fact that in the past respiration is harsh. Complete blood
she survived a stroke and had count shows the following:
diabetes, aggressive cancer therapy leukocytes 10.0 10 % / L, leukocyte
was contraindicated for her. She was left shift, ESR-26 mm / hour. Chest
suffering from severe pain, but X-ray shows an intensified
doctors at the outpatient clinic were pulmonary pattern, low-intensity
unable to obtain even 1 mg of focal shadows in the lower segments
morphine for her treatment. What of the right lung. What medicines
kind of care should have been should be prescribed in this case?
provided in this case by the primary A. Aminoglycosides
care doctors to relieve the patient's B. Penicillin antibiotics
condition? C. Sulfanilamides
A. Secondary medical care D. Second or third generation
B. Primary medical care cephalosporins
C. Palliative medical care E. Macrolides
D. Tertiary medical care
E. Emergency medical care 81. A 12-year-old child has been
diagnosed with bilateral pneumonia
79. A patient was hospitalized into of mycoplasma etiology with mild
the neurosurgery department with a disease course. What drug must be
closed craniocerebral injury, a prescribed for treatment in this case?
fracture of the right temporal bone. A. Second generation macrolides
Five hours later, the patient's B. Aminopenicillins
condition sharply deteriorated, he C. Antifungal agents
developed respiratory disorders, D. Aminoglycosides
periodical tonic seizures, and E. First generation cephalosporins
anisocoria (dilation of the right
pupil). What complication can be 82. Screening detected
suspected in this case? phenylketonuria in a two-week-old
A. Characteristics associated with baby. What treatment must be
the course of concussion prescribed for this child to prevent
B. Subarachnoid hemorrhage ' severe complications in the future?
C. Brain abscess A. Hormone therapy
D. Ischemic stroke in the area of the B. Sunbathing
right cerebral peduncle C. Antibiotic therapy
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D. Vitamin therapy. 85. After giving birth, a 25-year-

E. Special diet old woman developed increased
weakness in her legs and unsteady
83. A 46-year-old patient walking. She has been suffering from
complains of double vision and this condition for 6 years already.
drooping of the eyelids that occur Every autumn, she notes a
mainly in the second half of the day deterioration of her condition.
and almost completely disappear Objectively, the woman is euphoric
after a rest. Examination detects and exhibits a reduced critical
slight bilateral ptosis, reduced lateral attitude towards her condition. She
movement of the eyeballs, diplopia, has horizontal nystagmus, high
and positive proserin (neostigmine) tendon reflexes, foot clonus,
test. Make the diagnosis. pathological foot reflexes, no
A. Oculopharyngeal muscular abdominal reflexes, ataxia during the
dystrophy Romberg test, and intentional tremor
B. Olivopontocerebellar atrophy and missing during coordination
C. Kearns-Sayre syndrome tests. Temporal pallor of the optic
D. Myasthenia discs is observed on the eye fundus.
E. Progressive supranuclear What is the most likely diagnosis in
ophthalmoplegia this case?
A. Myasthenia gravis
84. A 36-year-old man came to a B. Multiple sclerosis
doctor with complaints of burning C. Amyotrophic lateral sclerosis
retrosternal pain that usually occurs D. Acute disseminated
1-1.5 hours after eating and becomes encephalomyelitis
worse in a horizontal position. E. Dyscirculatory encephalopathy
Esophagogastoduodenoscopy (EGD
test) detects two lesion foci in the 86. A 3-year-old boy has been
lower third of the esophageal hospitalized with severe edemas.
mucosa. The foci are up to 5 mm in Objectively, the boy is pale, his blood
size and located within one-fold. pressure is 90/60 mm Hg, he has
What tactics would be optimal in this oliguria. General urinalysis shows
case? the following: color- yellow, specific
A. Monitoring in the inpatient gravity 1020, protein levels-3.5 g / L,
department erythrocytes leached,4-5 in the vision
B. Surgical treatment field, leukocytes 2-3 in the vision
C. Prescription of proton pump field, 24-hour proteinuria 6.6 g. The
inhibitors cholesterol levels are 9.8 mmol / L.
D. Prescription of clarithromycin What next step in the patient's
E. Prescription of non-narcotic management would be optimal?
analgesics A. Zimnitsky test
B. Monitoring throughout the next
week
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C. Computed tomography without 89. A 22-year-old young man

contrast came to a doctor with complaints of
D. Kidney biopsy fever and cough with yellow sputum.
E. Nechiporenko urine test These symptoms have been observed
for the last seven days. Physical
87. The mother of a 4-year-old girl examination shows the following:
came to an endocrinologist with body temperature 38.3° C, blood
complaints about the abnormal pressure-130/70 mm Hg, heart rate-
structure of the child's external 79 /min., respiratory rate. 17 /min.,
genitalia: hypertrophy of the clitoris SpO₂- 95 %. Auscultation detects
and an enlarged labia that resembles moist crackles on the left. Survey X-
a scrotum, Additionally, the child ray of the chest reveals left lower
exhibits accelerated growth, as well lobe consolidations. What drug
as growth of axillary and pubic hair, should be prescribed to the patient in
and lowering of the vocal timbre. this case?
What examination is necessary to A. Trimethoprim /sulfamethoxazole
confirm the diagnosis in this case? B. Ciprofloxacin
A. Measuring the 17-OH C. Gentamicin
progesterone levels in blood D. Azithromycin
serum and 17-ketosteroids E. Levofloxacin
excretion rate with urine
B. Measuring the ACTH levels in 90. A full-term girl with chronic
blood fetoplacental insufficiency was born
C. Karyotyping from the second pregnancy that
D. Measuring the TSH levels in risked termination at 25-27 weeks.
blood During the childbirth, the umbilical
E. Bone age assessment cord was revealed to be wrapped
once around the neck of the baby, the
88. A three-year-old boy has been extraction of the shoulders was
suffering from stool retention since difficult. After the birth, the Apgar
birth. Every 3-4 days, the mother scale was used to evaluate the baby's
gives her child enemas. The boy lags condition at the first minute of life:
behind his peers in physical no breathing, the heart rate of 50
development. Objectively, he has /min., total cyanosis, atony, areflexia.
pale skin and distended abdomen. What would be the Apgar score in
What disease can be suspected in this this case?
child? A. 2 points
A. Peritonitis B. 4 points.
B. Hirschsprung's disease C. 3 points
C. Intestinal tumor D. 0 points
D. Helminthiasis E. 1 point
E. Coprostasis
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91. A 26-year-old pregnant venereologist. What will be the main

woman was hospitalized into the component of the therapy prescribed
intensive care unit at 36 weeks of her for this patient?
pregnancy with complaints of an A. Penicillin antibiotics
intense headache in the frontal B. Cycloferon or other
region: Physical examination immunomodulators
detected the following: blood C. Macrolide antibiotics
pressure-170/90 mm Hg, pulse 85 D. Drugs of the tinidazole group
/min., respiratory rate-15 /min., body E. Sulfonamides
temperature-36.9° C, edema of the
limbs, fetal heart rate-159 /min. 94. Within several days, a person
During the examination, the woman developed a reduction in the
developed an attack of generalized peripheral vision, resembling a flap,
tonic-clonic seizures. What drug on the outer side. The patient does not
must be administered first in this know the cause of this condition. The
case? eye is calm, the optical media are
A. Phenytoin transparent. On the nasal side of eye,
B. Diazepam ophthalmoscopy detects a gray “sail”
C. Magnesium sulfate with vessels that wavers during eye
D. Lamotrigine movements. The optic disc and blood
E. Sodium valproate vessels are without changes. What is
the most likely diagnosis in this case?
92. An 18-year-old adolescent was A. Lens subluxation
diagnosed with a duodenal ulcer for B. Retinal detachment
the first time. The test for C. Hemianopsia with a neurological
Helicobacter pylori is positive, the pathology
pH of gastric juice is 1.0. What would D. Initial signs of glaucoma
be the optimal treatment plan in this E. Vascular pathology of the retina
case
A. De-nol (bismuth subcitrate) + 95. A 6-year-old child became
trichopol (metronidazole) acutely ill and developed fever,
B. De-nol (bismuth subcitrate) + headache, and pain during
cimetidine swallowing. Three hours later, a
C. Clarithromycin + omeprazole bright-red fine punctate rash
D. Quamatel (famotidine) + appeared on a hyperemic skin. The
amoxicillin rash is more numerous on the lateral
E. Omeprazole + oxacillin surfaces of the body and in the
natural folds. The oropharyngeal
93. A person diagnosed with a mucosa has a clearly demarcated
urogenital chlamydial infection hyperemia and there is a purulent
based on the clinical manifestations plaque on the tonsils. What disease
and laboratory examination data has can be suspected in the child?
made an appointment with a A. Diphtheria
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B. Measles heterogeneous moist crackles in the

C. Infectious mononucleosis lungs. What complication has
D. Rubella developed in this patient?
E. Scarlet fever A. Pulmonary edema
B. Pulmonary embolism
96. An 18-year-old young man C. Ventricular septal rupture
came to a doctor with complaints of D. Hypertensive crisis
cramping abdominal pain, frequent E. Cardiogenic shock
liquid stools with mucus and fresh
blood. The symptoms have been 98. A 45-year-old man came to a
observed for the last four months, doctor complaining of a sore throat
during which the patient lost 10 kg. and fever that last for ten days. The
Physical examination shows soft patient has a history of ulcerative
abdomen, painful on the left along colitis, is a smoker, and has been
the large intestine; the sigmoid colon smoking one pack of cigarettes per
is spastic. Complete blood count day for ten years. The patient's father
shows the following: erythrocytes- died of cancer of the large intestine at
3.2*10¹2/L, hemoglobin-92 g/L, the age of 50. Physical examination
leukocytes -10.6*109/ L, ESR-34 shows the following: body
mm/hour. Bacteriological culture of temperature-38.6 ° C, blood
feces shows negative results. pressure-130/80 mm Hg, pulse- 72 /
Colonoscopy revealed inflammation min., respiratory rate-18 / min.
of the large intestine with the loss of Examination of the oral cavity
vascular pattern, as well as an area of reveals erythematous pharynx and
increased bleeding with clear exudate in the tonsillar crypt. Antigen
boundaries. What treatment tactics test for group A streptococcus was
should be chosen for this patient? positive. What procedure that doctor
A. Repeated collection of a stool can recommend for secondary
sample for bacteriological testing prevention of cancer would be
B. Surgical treatment optimal for this patient?
C. Transfusion of packed red blood A. Flexible sigmoidoscopy
cells B. PSA test and digital rectal
D. Prescription of prednisolone and examination
mesalamine (mesalazine) C. Colonoscopy
E. Prescription of metronidazole D. Low-dose CT scan of the lungs
E. Fecal occult blood test
97. A 65-year-old man with acute
anterior myocardial infarction 99. In a 70-year-old woman, chest
developed an asphyxia attack. fluorography shows a shadow of a
Examination detects diffuse heterogeneous structure over the left
cyanosis. His heart rate is 100 / min. dome of the diaphragm. X-ray with
His blood pressure is 120/100 mm contrast detects the abdominal
Hg. Auscultation detects numerous segment of the esophagus in the chest
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cavity. What is the most likely of the abdominal cavity. What is the
diagnosis is in this case? most likely diagnosis in this case?
A. Achalasia cardia A. Croupous pneumonia
B. Benign esophageal tumor B. Lung abscess
C. Hiatal hernia C. Community-acquired focal
D. Esophagitis pneumonia
E. Esophageal diverticulum D. Nosocomial pneumonia
E. Exudative pleurisy
100. For intensive infusion therapy,
a patient with acute respiratory 102. One week ago, a 68-year-old
failure underwent subclavian vein woman suddenly developed pain in
catheterization using the Seldinger the left half of her chest and shortness
technique. After administration of of breath. Objectively. the following
600 mL of the infusion solution, the is observed: cyanosis, distended neck
patient's condition sharply veins, pulse- 100 /min, blood
deteriorated, tachypnea increased pressure –110/70 mm Hg, respiratory
from 26 / min. to 40 / min., tidal rate-28 /min., liver +4 cm, the left
volume decreased from 400 ml. to lower leg is edematous and sharply
250 ml. Auscultation detects sharply painful to palpation Auscultation
weakened respiration on the right. detects a dull lung sound on the left,
Percussion detects a dull sound. What below the scapula; sonorous moist
complication developed in this fine vesicular crackles are present;
patient? the borders of the heart are expanded
A. Pulmonary edema on the right, the II heart sound is
B. Pulmonary embolism accentuated over the pulmonary
C. Hydrothorax artery. ECG shows deep S waves in
D. Acute heart failure. leads I and aVL well as deep Q waves
E. Cerebral edema in leads III and aVE and a negative T
wave in leads III and aVE What is the
101. A 34-year-old man fell ill 3 most likely diagnosis in this case?
days ago after an overexposure to A. Pleurisy
cold. He complains of a fever of B. Thromboembolism of pulmonary
39.2°C, marked general weakness, artery branches
sweating, and cough. The cough was C. Myocardial infarction
initially dry, but within the last 24 D. Croupous pneumonia
hours a small amount of "rusty" E. Pericarditis
sputum was produced. Objective
examination detects herpes on the S1 Q3 T3 is typical for pulmonary
lips. Percussion reveals a dull sound embolism.
in the lower pulmonary lobes.
Auscultation detects bronchial 103. A 42-year-old man, a miner,
breathing and tachycardia. No was freed after 12 hours spent under
changes were detected in the organs the rubble. Objectively, his both
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lower legs and feet are pale; there is 105. A 38-year-old pregnant
no pulsation on the peripheral woman, gravid a 2, gestation term of
vessels, no sensitivity, and no passive 23-24 weeks, has type 2 diabetes
movements in the joints. He was mellitus, for which she receives
hospitalized with tourniquets applied metformin in the dose of 2500 mg per
to both limbs. What urgent first aid 24 hours. Laboratory analysis detects
must be provided in this case to glycated hemoglobin (HbA1c) levels
prevent myoglobinuria and acute of 72 %. What further treatment
kidney failure? strategy should be chosen for this
A. Do not remove the tourniquets, patient?
provide hyperbaric oxygenation A. Increase the dose of metformin to
B. Remove the tourniquets, provide 3000 mg per 24 hours
detoxification therapy B. Discontinue metformin and
C. Do not remove the tourniquets, switch to sulfonylureas
provide detoxification therapy C. Add GLP-1 analogues to
D. Remove the tourniquets, provide metformin
hyperbaric oxygenation D. Prescribe insulin therapy and
E. Do not remove the tourniquets, discontinue metformin
amputate the limbs above the E. Continue the treatment unchanged
tourniquets
106. A 62-year-old man complains
Source: of constant pain in the epigastrium
https://тестування.укр/testing/question/ and weight loss of 12 kg. Physical
67056 and instrumental examinations
Krok 2 2020 Ukrainian booklet. (fibrogastroscopy with biopsy,
abdominal ultrasound, and chest X-
104. A patient with epilepsy ray) detected cancer of the body of
suddenly developed status the stomach without signs of distant
epilepticus with generalized seizures metastasis. Histology reveals
after self-discontinuation of moderately differentiated
antiepileptic drugs. What are the adenocarcinoma. What scope of
first-line drugs for the treatment of surgical intervention is advised in
this condition? this case?
A. Doxepin, amitriptyline, mianserin A. Ivor Lewis procedure 2
B. Diazepam, lorazepam, midazolam B. Proximal subtotal gastric
C. Levomepromazine, clozapine, resection
quetiapine C. Gastroenteroanastomosis
D. Topiramate, oxcarbazepine, (gastroenteric bypass)
carbamazepine D. Distal subtotal gastric resection
E. Gabapentin, pregabalin, E. Gastrectomy
ethosuximide
107. On the fourth day of life, a
healthy newborn child developed
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melena and started vomiting blood. A. Cerebral contusion, subarachnoid

Coagulogram reveals prolonged hemorrhage
prothrombin time, decreased B. Concussion
prothrombin index, and deficiency of C. Meningoencephalitis
plasma factors II, VII, IX, and X. D. Post-traumatic
What is the most likely disease in this meningoencephalitis
case? E. Cerebral contusion, basilar skull
A. Hemorrhagic disease of the fracture
newborn
B. Hemolytic disease of the newborn 110. A 32-year-old patient looks at
C. Disseminated intravascular the pattern on the wallpaper and sees
coagulation syndrome the lines begin to move and form
D. Hemophilia A silhouettes of fantastic animals.
E. Neonatal sepsis Instead of a lighting fixture hanging
from the ceiling, he sees a giant
108. A 42-year-old man complains octopus. What psychopathological
of weakness, palpitations, symptom is it?
nosebleeds, and skin hemorrhages. A. Derealization
His condition progressively B. Pseudohallucinations
deteriorates throughout the last C. Visual hallucinations
month. Objectively, his condition is D. Functional hallucinations
severe, he has petechial and spotted E. Pareidolic illusions
hemorrhages on the skin of his limbs
and torso, lymph nodes and spleen 111. For the last 3 months, a 68-
are not palpable, the pulse is 116 / year-old woman has been suffering
min., the liver is +2 cm. Complete from pain attacks in the heart that last
blood count revels pancytopenia. for 10 minutes. The pain attacks
What disease can be primarily occur in response to the slightest
suspected in this case? physical exertion. She does not take
A. Hemorrhagic vasculitis nitroglycerin because of severe
B. Hypoplastic anemia headache. She was repeatedly treated
C. Acute leukemia for ischemic heart disease and had a
D. Acute agranulocytosis myocardial infarction. Her blood
E. Werlhof disease pressure periodically rises to 160/80
mm Hg. ECG shows cicatricial
109. After falling and hitting the changes in the posterior wall of the
back of the head, a child lost hearing left ventricle. Auscultation reveals a
in the right ear and developed systolic murmur over the aorta. What
peripheral paralysis of the right facial is the most likely diagnosis in this
nerve, discharge of a clear fluid from case?
the right auditory canal, and diffuse A. Aortic aneurysm with aortic
neurological symptoms. Make the dissection
provisional diagnosis. B. Recurrent myocardial infarction
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C. Stable exertional angina pectoris, E. Anti-HAV IgM

FC IV
D. Unstable angina pectoris 114. Potatoes that became green or
E. Stable exertional angina pectoris, started sprouting, as a result of
FC II incorrect storage, taste slightly bitter.
What toxic substance contained in
112. A man was undergoing such potatoes can cause food
treatment for a myocardial infarction. poisoning?
On day 13, his chest pain increased A. Solanine
and he developed shortness of breath. B. Muscaridine
Objectively, the following is C. Phasin
observed: temperature-38.2° C, pulse D. Muscarine
respiration rate 112 / min.,26 / min., E. Helvellic acid
fine bubbling crackles can be heard
under the right shoulder blade. On 115. On day 3 of life, a newborn
day 15, he was diagnosed with right- presented with a deformation, edema,
sided exudative pleurisy. Complete and hematoma of soft tissues in the
blood count shows the following: left supraclavicular region. The arm
leukocytes – 8.9*109/L, eosinophils- is pressed to the torso, passive
8 %. ESR-24 mm / hour. What movements are accompanied by
complication of myocardial fussiness of the child. What is the
infarction occurred in this patient? likely diagnosis in this case?
A. Recurrent myocardial infarction A. Erb's palsy
B. Dressler syndrome B. Phlegmon of the newborn
C. Pneumonia C. Non-displaced subperiosteal
D. Pulmonary embolism fracture of the left clavicle
E. Cardiac asthma D. Osteomyelitis of the left clavicle
E. Displaced fracture of the left
113. A 25-year-old woman had an clavicle
abortion half a year ago. She
complains of loss of appetite, 116. A 31-year-old woman came to
weakness, and arthralgia. Two weeks a gynecologist with complaints of a
later, she developed dark urine and menstruation delay of 2 weeks,
jaundice. Against this background, morning sickness, and smearing
her general condition continues to bloody discharge from the vagina.
deteriorate. Viral hepatitis is The pregnancy test was positive.
suspected. What marker of viral Ultrasound detects no fertile egg in
hepatitis is likely to be positive in the the uterine cavity. In this case, the
patient patient must be referred for the
A. Anti-HEV IgM following study:
B. Anti-CMV IgM A. PAPP + hCG levels in blood
C. Anti-HBs B. Progesterone blood level
D. Anti-HBc IgM C. hCG level in blood
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D. Dynamics of hCG levels in blood A. Obesity

E. Magnetic resonance imaging B. Excessive emotional and nervous
strain
117. An 82-year-old woman was C. Stress
hospitalized into the cardiac D. Sensitivity to weather changes
intensive care unit with complaints of E. Age (over 40 years), sex,
a sharp pain behind the sternum, a hereditary predisposition
sensation of lack of air, and
weakness. Chest X-ray shows that the 120. A 32-year-old patient suffers
transverse size of the cardiac shadow from epilepsy. Suddenly, without any
is enlarged, the shape of the shadow cause, the patient became excited.
is triangular and has rounded Objectively, the patient is disoriented
cardiodiaphragmal corners. Cardiac in the personal identity and
contractions are of small amplitude environment, has visual and auditory
and arrhythmic. These X-ray findings hallucinations of threatening content
most likely correspond with: and delusional ideas of reference and
A. Myocarditis persecution. There are expressions of
B. Dilated cardiomyopathy fear, anger, and rage on the patient's
C. Exudative pericarditis face. The patient's behavior is
D. Trilogy of Fallot aggressive, accompanied by
E. Aortic stenosis destructive actions. What
psychopathological syndrome is it?
118. Examination of a newborn girl A. Delirium syndrome
detects a hemorrhage on the child's B. Hebephrenic syndrome
head. The hemorrhage is limited to C. Paranoid syndrome
one cranial bone, does not pulsate, D. Twilight state
and is painless. What condition did E. Manic syndrome
the child develop?
A. Intracranial birth injury 121. A person fell from a ladder
B. Neonatal pemphigus from the height of 2 m. An
C. Hydrocephalus emergency medicine physician
D. Cephalohematoma suspects a vertebral compression
E. Physiological birth-related edema fracture at the level of L1-L2.
Objectively, the blood pressure is
119. Essential hypertension, as an 100/60 mm Hg, the pulse is 104 /
important non-communicable min. What aid must be provided to
disease, is the most common type of the person at the scene of the accident
arterial hypertension, in which there A. Analgesia, antishock therapy,
is a persistent increase in blood transportation into the inpatient
pressure up to 140/90 mm Hg and department
which is influenced by exogenous B. Schneck's vertebral anesthesia,
and endogenous risk factors. What transportation into the inpatient
factors are endogenous? department
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C. Analgesia, transportation into a menstrual cycles. Objectively, the

hospital on hard stretchers following is observed: blood pressure
D. Transportation into the inpatient 80/55 mm Hg, pulse - 54/min., height
department in the position lying - 168 cm, weight-48 kg, genital
on the side hypoplasia. What medicine would be
E. E. Analgesics intramuscularly, the optimal choice for this patient?
transportation in a sitting position A. Human normal immunoglobulin
Confirmed by official test center. B. Infliximab
C. Hydrocortisone
122. A 54-year-old man was D. Hydroxychloroquine
hospitalized with complaints of E. Methotrexate
general weakness, fever of 38.6 ° C, Present in Ukrainian booklets.
shortness of breath during significant
physical exertion, and frequent 124. A 64-year-old patient with a
nosebleeds. He works in production tumor of the sigmoid colon and
of plastics, where he comes into chronic thrombophlebitis of the deep
contact with aromatic compounds. veins of the right leg is scheduled for
Objectively, his skin is pale and dry. a surgery. What is the optimal
Complete blood count shows the medicine for prevention of deep vein
following: erythrocytes -2.1∗10¹2 / L, thrombosis in this patient?
Hb-90 g / Leukocytes -2.2∗109 / L, A. Phenylinum (Phenindione)
eosinophils 1 %, band neutrophils-1 B. Low-molecular-weight heparin
%, segmented 75 %, lymphocytes-20 C. Acetylsalicylic acid
%, neutrophils myelocytes ESR-32 D. Regular heparin
mm / hours. What is the most likely 3 E. Rheopolyglucin (Dextran)
%, platelets-30-10 % / L, diagnosis in
this case 125. A 52-year-old woman came to
A. Chronic nitrobenzene intoxication a doctor for her annual preventive
B. Chronic benzene intoxication checkup. Her father has a history of
C. Chronic lead intoxication cardiovascular disease. Physical
D. Chronic aniline intoxication examination of the woman shows the
E. Chronic tetracthyllead following: height-172 cm, weight 77
intoxication kg, BMI-26 kg/m², body temperature
36.8°C, pulse 81 / min., respiratory
123. 113. A 20-year-old woman is rate 16 / min., blood pressure-
being treated for anemia 160/100 mm Hg on both hands.
(hemoglobin-72 g/L). A year and a Ophthalmoscopy of the Fundus
half ago, she had an involuntary detects narrowing of the retinal
miscarriage with a significant blood vessels Laboratory values are within
loss at 16 weeks of pregnancy, after the normal range. What should be
which the woman developed memory prescribed in this case to reduce the
deterioration, fatigability, of appetite, patient's risk of death caused by
dry skin, brittle nails, and irregular cardiovascular diseases?
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A. Dipyridamole E. Undergo a mammogram once a

B. Nitroglycerin year
C. Warfarin
D. Aspirin 128. A woman complains of
E. Enalapril frequent and copious foamy stools
without pathological admixtures,
126. Forensic examination of the cramp-like pain in her periumbilical
body of a baby detects the following: region, rumbling in the stomach, and
weight-3500 g. body length 50 cm, fever. From her history, it is known
the umbilical cord is smooth, moist, that she was eating soft-boiled duck
shiny, without signs of drying. lung eggs. What is the most likely
float tests are positive. What is causative agent of her condition?
indicated by the results of the lung A. Salmonella typhi
float tests in this case? B. Shigella sonnei
A. Primary atelectasis C. V. cholerae
B. Hyaline membrane disease D. Escherichia coli
C. Secondary atelectasis E. Salmonella enteritidis
D. The child was born dead
E. The child was born alive 129. Among the population living
near a pesticide production factory,
127. A 54-year-old woman came to the number of congenital
her family physician for a preventive malformations that manifest as
checkup. Objectively, the following central paralysis, idiocy, and
is observed: height 164 cm, weight- blindness of newborns is
84 kg, blood pressure-130/80 mm dynamically increasing. Compounds
Hg. The patient's history indicates the of what chemical substance can cause
menopause for 5 years. The patient's the development of these
mother died of breast cancer, the pathologies?
patient's younger sister suffers from A. Mercury
mastopathy. Examination detects no B. Strontium
lumps in the patient's breasts, the C. Chrome
organs of her lesser pelvis are within D. Iron
the age norm. Her cervical cytology E. Cadmium
results are normal. What advice can
be given to this woman? 130. A 49-year-old man complains
A. Regularly perform breast self- of angina up pectoris attacks that
exam occur when he walks up to 500 m. He
B. Undergo the next regular checkup has a many-year-long history of
in 2 years chronic bronchitis. Examination
C. Undergo regular checkups every 3 detects a small number of dry diffuse
months crackles in the lungs, the respiratory
D. Undergo an MRI of the breasts rate is 18/min The borders of the
heart are expanded to the left, the
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heart sounds are muffled, the heart observed, the heart rate is 98 /min.
rate PS=86/min., the blood pressure The Silverman score is 9 points.
is 160/100 mm Hg. Complete blood Additional oxygenation did not
count shows the following: Hb –160 improve the child's condition. What
g/L, leukocytes – 6.4*109/L, ESR–7 must the doctor do next?
mm/hour. ECG shows hypertrophy A. Tracheal intubation
of the left ventricle. What group of B. Tactile stimulation.
drugs is contraindicated in this case, C. Positive pressure ventilation of
taking into account the concomitant the lungs
pathology? D. External cardiac massage
A. Long-acting nitrates E. Artificial pulmonary ventilation
B. Beta blockers
C. Antiplatelet drugs 133. A premature newborn boy
D. Calcium antagonists (pregnancy 5, birth 1, gestation term-
E. Angioprotectors 27 weeks) has irregular respiration of
< 30 /min, after birth and SpO₂ of 70
131. A 64-year-old man is %. Retractions of the pliable areas of
undergoing outpatient treatment for the chest and expiratory groaning are
ischemic heart disease, diffuse observed. Without oxygen support,
cardiosclerosis, persistent atrial generalized cyanosis occurs.
fibrillation, and functional class III Auscultation reveals crepitus in the
heart failure. The pharmacotherapy basal segments. There are no data on
consists of cordarone (amiodarone) the prevention of respiratory distress
twice a day, torasemide every other syndrome in the baby. What
day, and trimetazidine twice a day. treatment tactics must be chosen in
The family physician recommended this case?
taking warfarin (3 mg per day) to A. Administer the surfactant
prevent thrombus formation. What preparation intratracheally within
parameter should be measured in this the first 15 minutes after birth
case for optimal control the B. Provide artificial pulmonary
effectiveness and safety of the anti- ventilation with an Ambu bag and
coagulant therapy? a mask
A. Erythrocyte sedimentation rate C. Administer the surfactant
B. Lee-White clotting time preparation intratracheally 2
C. International normalized ratio hours after birth
D. Fibrinogen levels D. Prescribe an antibacterial therapy
E. Platelet count E. Provide oxygen therapy using an
oxygen tent
132. A baby with the gestation term
of 30 weeks was born with the body 134. A pediatrician needs to
weight of 1100.0 g. Three hours after analyze the infant mortality rates.
birth, frequent apneas appeared, What must be taken as the unit of
"gasping" type of breathing is observation for this purpose?
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A. A case of death of a child within 137. A 25-year-old pregnant

the first month of life woman complains of fever of 38.5° C
B. A case of death of a child after 28 that lasts for two days already, cough,
days of life. and shortness of breath. She
C. A case of death of a child under developed these complaints after an
one year of age overexposure to cold. Auscultation
D. A case of death of a child within detects-crepitation and localized
the first 7 days of life moist crackles in the lower part of the
E. A case of the death of a child right lung. Percussion-detects there a
during childbirth dull sound. Complete blood count
shows the following: leukocytes
135. A 35-year-old man was found 11.0-10 % /L, ESR-22 mm /hour.
dead in his own garage. Forensic What antibacterial agent must be
examination detects the following: prescribed in this case?
horizontal closed strangulation mark, A. Carbenicillin
petechial hemorrhages on the skin of B. Amikacin
the head and neck, facial cyanosis, C. Doxycycline
marked livor mortis, and multiple D. Amoxicillin
Tardieu spots. What indicates that the E. Levofloxacin
man did not die by hanging?
A. Petechial hemorrhages on the skin 138. A patient complains of pain in
B. Horizontal strangulation mark the lower back, weakness in the right
C. Multiple Tardicu spots foot, and impaired walking,
D. Facial cyanosis Examination reveals painful
E. Marked livor mortis palpation of lumbar paravertebral
points. Cough impulse sign is
136. Examination of a victim of a positive. The Lasegue sign is positive
traffic accident detects cyanosis and on the right at the angle of 70. The
problems with breathing. The patient Achilles reflex on the right is absent.
is in a severe condition, the right half There is t weakness in the extensor
of the chest lags behind in the act of muscles of the right foot, the patient
breathing, the intercostal spaces are has problems with standing on the
widened on the right, a bandbox right heel. The patient was diagnosed
resonance is observed during with lumbosacral radiculitis and right
percussion, breathing cannot be foot paresis. What group of
heard during auscultation. What is medicines must be prescribed in this
the most likely diagnosis in this case? case?
A. Acute purulent pleurisy A. Vitamins
B. Total hemothorax on the right B. Anticholinesterases
C. Open pneumothorax C. Analgesics
D. Valvular pneumothorax D. Nonsteroidal anti-inflammatory
E. Pneumoperitoneum drugs
E. Nootropics
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clothes, the following was revealed:

139. After the birth of twins, the on the front inner surface of the right
postparturient woman developed a thigh and the front surface of the right
massive hemorrhage from the natural lower leg with a transition to the
birth canal. The placenta and birth dorsum of the foot, there are yellow-
canal are intact. The uterine fundus is gray patches with fragments of
located above the navel, the uterus is epidermis in some places. The
soft to palpation and does not respond affected skin areas exhibit tactile and
to the administration of uterotonics. painful hypoesthesia. What
What is the most likely cause of the emergency aid must be provided first
bleeding in this case? in this case?
A. Uterine hypotonia A. Apply baking soda solution
B. Uterine atony B. Dress the lesions with oil
C. Retained placenta bandages
D. Damage to the uterine cervix C. Apply ethyl alcohol
E. Uterine rupture D. Rinse the lesions under running
water
140. A 6-year-old child developed a E. Dress the lesions with aseptic
fever of 375° C, stuffed nose with a bandages
small amount of mucous discharge,
and a scratchy sensation in the throat. 142. The mother of a 6-month-old
On the fourth day after the onset of boy came to a pediatrician. She is
the disease, the temperature concerned that her child has not
normalized but complaints of pain in received any vaccinations. There are
the legs appeared. The child started no health complaints. Objectively,
limping and dragging the left leg. the following is observed: body
Muscle tone and reflexes are temperature-371° C, respiratory rate
decreased, while sensitivity is 20 /min., blood pressure -100/70 mm
retained. What disease can be Hg, the child's height and weight are
suspected in this case? within the range between the 50th
A. Diphtheritic polyneuritis and 75th percentile. What tactics
B. Paralytic poliomyelitis must the doctor choose in the
C. Botulism immunization of this child according
D. Polyradiculoneuritis to the regulatory documents issued
E. Influenza with associated by the Ministry of Health?
encephalopathy A. The child requires no vaccination
B. Postpone the vaccination and
141. The patient, a chemical plant make an appointment in a week
worker, while working with an C. Perform a Mantoux test and make
aggressive liquid, accidentally an appointment in 2 days
spilled it on his overalls, receiving a D. Administer BCG, MMR, and
chemical burn on his right thigh and DPT vaccines
lower leg. After removing his E. Administer BCG vaccine
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According to Ukrainian
This question was found in Ukrainian classification: polyuria (due to
booklet 2020. decreased reabsorption) and normal
creatinine and urea levels are typical
143. A 48-year-old woman for compensated phase.
complains that within the last 8-9
months she had very heavy periods 145. A 45-year-old man complains
that impair her ability to work. For 2 of an intense retrosternal pain that
years, her health has been monitored radiates into the lower jaw and occurs
by a gynecologist for uterine fibroids. at rest, at night, several times for 10-
Objectively, her cervix is cylindrical, 15 minutes. During a pain attack, an
clean, the cervical opening is closed; elevation of the ST segment can be
the body of the uterus is enlarged up recorded on the ECG in leads V 3-4.
to 9-10 weeks of pregnancy, firm, What is the provisional diagnosis in
mobile, and painless; the appendages this case?
on both sides cannot be determined; A. Myocardial infarction
the parametria are free; the fornices B. Prinzmetal angina pectoris
are deep; mucous discharge is being C. Stable angina pectoris, functional
produced. What is the most likely class II
diagnosis in this case? D. Stable angina pectoris, functional
A. Dysfunctional uterine bleeding class IV
B. Juvenile uterine bleeding E. Progressive angina pectoris
C. Uterine fibroids and pregnancy
D. Endometriosis that predominantly 146. A girl with the weight of 3100
affects the body of the uterus g was born at home from her mother's
E. Uterine fibroids third pregnancy. On the third day, the
mother noticed small hemorrhages in
144. A woman with polycystic the umbilical wound, as well as "red
kidney disease observes an increase dots" on the selera of the child's eyes.
in her 24-hour urine output to 2-2.5 The mother was not registered for
liters. Dynamic nephroscintigraphy prenatal care checkups. She is
shows the following: total glomerular breastfeeding her baby as needed.
filtration rate 34 mL / min., serum Physical examination detects
creatinine-84 mcmol / L, urea-8.0 subconjunctival hemorrhages.
mmol / L. What stage of chronic Laboratory testing revealed that the
kidney failure is it? hemoglobin levels were 155 g /L, the
A. Compensated mother's blood group was B (III) Rh-
B. Latent positive, while the child's blood
C. Intermittent group was A (II) Rh-negative. What
D. Polyuric is the optimal tactics to prevent the
E. Terminal progression of this condition in the
child?
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A. Prescription of iron preparations 148. A boy suffering from

to be taken orally bronchial asthma started to
B. Transition to formula-feeding experience suffocation attacks
with iron fortified formulas several times a day. During the last
C. Administration of vitamin K attack, inhalation of astmopent
D. Administration of human (orciprenaline) had no effect.
antirhesus Rh0 (D) Intensive therapy was unable to stop
immunoglobulin the attack. The child was transferred
E. Transfusion of packed red blood into the intensive care unit with the
cells. diagnosis of II degree status
Mother is R+ → no R factor asthmaticus. What was the leading
incompatibility. So, most likely the mechanism of the development of
child has hemorrhagic disease of this condition in the child?
newborn and needs vitamin K A. Spasm of the bronchial smooth
administration. muscles
B. Complete refractoriness
147. A 28-year-old woman came to (blockade) of beta-2-
a doctor with complaints of a sharp adrenoceptors
pain in her lower abdomen and a C. Increased secretion of bioactive
short-term loss of consciousness at substances by mast cells
home. The last menstruation was 12 D. Inflammation of the bronchial
days ago. Vaginal examination mucosa
shows that her uterus is of normal E. Edema of the bronchial mucosa
shape and painless; the appendages Confirmed by official test center.
on the left are slightly enlarged and
painful to palpation, the posterior 149. A 48-year-old patient
fornix is overhanging, tense, and complains of frequent constricting
sharply painful. What is the retrosternal pain that radiates into the
provisional diagnosis in this case? left shoulder and left scapula. Pain
A. Pedicle torsion in a cyst attacks occur at night, at complete
B. Apoplexy of the right ovary rest, and last 10-15 minutes. During
C. Ectopic pregnancy the visit to a polyclinic, no ECG
D. Exacerbation of chronic adnexitis abnormalities and no changes in the
E. Right-sided pyosalpinx patient's general condition were
Confirmed by official test center. detected. What examination would
be most important for clarification of
There is a typo, and answer should be the diagnosis?
apoplexy on the left. This answer is A. Repeat ECG in a week
confirmed by a Ukrainian B. Bicycle ergometry
Obstetrician and was also found in a C. Catheterization of cardiac
Ukrainian booklet with the same chambers
answer. D. Holter ECG monitoring
E. Echocardiography
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Confirmed by official test center.
150. Approximately 40% of

patients with bacterial pneumonia
develop concomitant pleural
effusion. This diagnosis can be
confirmed by chest X-ray in the
direct vertical projection, if there is at
least:
A. 500 mL of liquid
B. 300 ml of liquid
C. 100 ml of liquid
D. 200 mL of liquid
E. –
Confirmed by official test center.
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Important notes ✍️🙋‍♂️

Repeated ideas D. Endemic goiter

Her term of gestation is 36 weeks, the gastroenterologists, who were unable

seconds) with the heart rate of 160 A. Chronic enteritis

12. After eating mushrooms, a 30- laboratory testing to confirm food

17. A 40-year-old man complains significant edema of the underlying

formed cervix, the cervical inlet is muscles, loss of appetite,

evenly dilated. What is the diagnosis A. Thrombosis of the central retinal

26. After the extraction of the 28. A 20-year-old woman has

30. A pregnant woman suffers 32. An 18-year-old adolescent

lasts for 8 years already. Objectively, technical lyceum shows signs of

7-8 weeks. Palpation detects pain in examination would be the most

43. In recent months, a 29-year- 45. A 24-year-old woman

A. Bouchard's nodes hospital. The current hospitalization

lower leg. After removing his C. Syphilis

B. Poultry pressure of 150/100 mm Hg. Clinical

Curschmann spirals. What is the A. Primary amenorrhea

in performing routine household

B. Calculation of relative values respiratory viral infection or damage

B. Placental abruption E. Epidural hematoma

D. Vitamin therapy. 85. After giving birth, a 25-year-

C. Computed tomography without 89. A 22-year-old young man

91. A 26-year-old pregnant venereologist. What will be the main

B. Measles heterogeneous moist crackles in the

melena and started vomiting blood. A. Cerebral contusion, subarachnoid

C. Stable exertional angina pectoris, E. Anti-HAV IgM

D. Dynamics of hCG levels in blood A. Obesity

C. Analgesia, transportation into a menstrual cycles. Objectively, the

A. Dipyridamole E. Undergo a mammogram once a

A. A case of death of a child within 137. A 25-year-old pregnant

clothes, the following was revealed:

A. Prescription of iron preparations 148. A boy suffering from

Confirmed by official test center.

150. Approximately 40% of

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