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C) it often metastasises
NT - 1.1 it can mimic mitral stenosis during
These can be heard in mitral stenosis, D)
physical examination
except for: Show comment and answer
INT - 1.6
apical holosystolic murmur radiating Which one is true about the
A)
towards the axilla mechanism of action of digoxin?
low-frequency apical diastolic
B)
murmur A) it inhibits the Na-K-ATPase
C) opening snap it lowers intracellular
B)
D) loud first heart sound Na+ concentration
Show comment and answer C) it increases intracellular ATP levels
INT - 1.2 D) it enhances cAMP-production
Part of the therapy of decompensated
it decreases Ca-release from the
heart failure, except for: E)
sarcoplasmic reticulum
Show comment and answer
A) mineralocorticoid-antagonists INT - 1.7
B) diuretics All of the following statements about
C) digoxin nitroglycerine are true, except for:
D) parenteral volume expansion
E) ACE-inhibitors it increases intracellular cGMP
A)
levels
Show comment and answer
INT - 1.3 B) its primarily metabolised in the liver
Causes of acute left ventricle failure, it can induce significant reflex
C)
except for: tachycardia
it significantly prolongs AV-
D)
A) asthma bronchiale conduction
B) acute myocardial infarction E) it can lead to postural hypotension
C) hypertensive crisis Show comment and answer
D) severe aortic stenosis INT - 1.8
The typical side effect of nitrates is:
Show comment and answer
INT - 1.4
Characteristic of hypertrophic A) hypertension
obstructive cardiomyopathy, except B) headache
for: C) bradycardia
D) sexual dysfunction
might be combined with mitral E) anemia
A)
insufficiency
Show comment and answer
digoxin is important in the early INT - 1.9
B)
stage The typical features of Prinzmetal
C) often familial angina:
D) diastolic dysfunction is common
E) syncope is a common symptom ST segment depression during
A)
angina
Show comment and answer
INT - 1.5 B) negative T waves during angina
Features of atrial myxoma, except for: C) pathologic Q waves during angina
D) elevated necroenzymes
the most common form of primary
A) E) ST segment elevation during angina
cardiac tumors
Show comment and answer
it can be diagnosed with
B)
echocardiography
INT - 1.10 E) ischemic cardiomyopathy
Types of unstable angina pectoris, Show comment and answer
except for: INT - 1.15
The most important risk factor of
A) angina at rest atherosclerosis:
B) crescendo angina
C) effort angina elevated serum LDL-cholesterol
A)
D) new-onset angina level
Show comment and answer elevated serum HDL-cholesterol
B)
INT - 1.11 level
The most common pathology of C) elevated serum triglyceride level
myocardial infarction: D) elevated serum cholesterol level
Show comment and answer
A) coronary embolism INT - 1.16
B) rupture of an atherosclerotic plaque Risk factors of coronary artery disease,
C) dissection of coronary walls except for:
growing of an atherosclerotic
D) A) positive family history
plaque
E) coronary inflammation B) diabetes mellitus
Show comment and answer C) smoking
INT - 1.12 elevated serum HDL-cholesterol
D)
Normal mean electrical axis in the level
front plane, except for: E) metabolic syndrome X
Show comment and answer
A) +60° INT - 1.17
B) +90° The ideal target value of serum LDL-
C) –45° cholesterol in a diabetic patient after
myocardial infarction:
D) 0°
E) +45°
A) < 1,8 mmol/l
Show comment and answer
B) > 2,6 mmol/l
INT - 1.13
If acute myocardial infarction is C) < 3,5 mmol/l
suspected, the following diagnostic D) > 3,5 mmol/l
procedures should be carried out, Show comment and answer
except for: INT - 1.18
A 65 patient with a history of smoking
A) EKG presents with sudden pain in his left
blood tests (to measure CK-MB and leg. The limb feels cold, the toes are
B) pale and peripheral pulse can not be
troponin)
C) physical examination palpated.
D) cardiac stress test
A) deep vein thrombosis
E) echocardiography
B) Buerger’s disease
Show comment and answer
C) embolism in the peripheral arteries
INT - 1.14
Ischemic heart disease can present D) Raynaud’s disease
with, except for: Show comment and answer
INT - 1.19
A) acute myocardial infarction Paramedics arrive to a 55 year old
B) stable angina patient with chest pain that started 3
hours ago. On the patient’s ECG they
C) deep vein thrombosis
notice ST segment elevation in leads I,
D) sudden cardiac death aVL, V5 and V6. What should they do?
Accessory pathway-mediated reentry
transfer the patient to the regional tachycardy (AVRT) can be terminated
A)
Emergency Department with, except for:
transfer the patient to the regional
B) A) propafenone
Coronary Care Unit
transfer the patient to the regional B) adenosine
Cardiology Department for a C) lidocaine
C)
troponin test and if it’s positive, D) radiofrequency ablation
transfer to a PCI center.
E) verapamil
transfer the patient directly to the
D) Show comment and answer
closest PCI center.
INT - 1.24
Show comment and answer A regular wide QRS complex
INT - 1.20
tachycardia can not be:
Upon the physical examination of a 45
year old man without any symptoms a
A) ventricular tachycardia
soft systolic murmur and ejection click
can be heard in 2L2. These have been supraventricular tachycardia with
B)
known since he was a child. What is bundle branch block
the most likely diagnosis? atrial fibrilltion with bundle branch
C)
block
A) patent ductus arteriosus antidromic atrioventricular reentry
D)
B) coarctation of the aorta tachycardia (WPW-syndrome)
C) ventricular septal defect atrial flutter with bundle branch
E)
block
D) Ebstein’s anomaly
Show comment and answer
E) pulmonary valve stenosis INT - 1.25
INT - 1.21 A patient was admitted to the
Correct statements about aortic Emergency Department because of a
stenosis, except for: palpitation that started three hours
earlier. On his ECG an atrial fibrillation
A) it causes pulsus parvus et tardus. with rapid (150 bpm) ventricular
B) it can cause syncope. response was seen. His blood pressure
C) it can cause anginalike chest pain. was 130/90 Hgmm. In the patient’s
Austin-Flint murmur can be heard history there wasn’t anything that
D) indicated structural heart disease.
upon auscultation
What is the best first step in this
it causes concentric left ventricular
E) situation?
hypertrophy.
Show comment and answer
A) pharmacological cardioversion
INT - 1.22
Correct statements about aortic B) immediate electrical cardioversion
insufficiency, except for: C) coronarography
immediate anticoagulation to
D)
it causes pulsus celer et altus prevent thromboembolism
A)
(Corrigan’s pulse). E) cardiac stress test
B) it can be acute and chronic, too. Show comment and answer
it usually doesn’t lead to left INT - 1.26
C)
ventricle dilation. Which one is the most common
D) it can be congenital. permanent arrhythmia?
it predisposes to infective
E) A) ventricular extrasystoles
endocarditis.
Show comment and answer B) atrial fibrillation
INT - 1.23 C) ventricular tachycardia
D) supraventricular tachycardia
E) junctional escape rhythm who has chest pain at exertion the first
Show comment and answer step should be:
INT - 1.27
A patient who has been taking A) stress echocardiography
amiodarone for a long time was B) excercise test
prescribed a fluoroquinolone antibiotic C) stress perfusion scintigraphy
because of a respiratory infection. She
D) Holter ECG monitoring
had recurring, short-term syncopes
that had never occurred before. Which E) stress MRI
one is the most likely cause of the Show comment and answer
syncopes? INT - 1.31
The best first-choice drug for
hypotension induced by the bradycardia during myocardial
A) infarction is:
medications
torsade de pointes ventricular
B) tachycardia induced by the A) isoproterenol
medications B) theophyllin
sinus bradycardia induced by the C) atropine
C)
medications D) dobutamine
her symptoms are not induced by Show comment and answer
D) her medications, it is just a INT - 1.32
coincidence The most common side effect of ACE
AV block induced by the inhibitors is:
E)
medications
Show comment and answer A) diarrhea
INT - 1.28 B) cough
These could be the first ECG findings in C) vomiting
the acute phase of myocardial
D) erythema
infarction, except for:
E) anasarca
A) pathologic Q wave Show comment and answer
INT - 1.33
B) inverted T waves
Which disease(s) cause(s) systolic
C) ventricular fibrillation hypertension?
D) ST segment elevation
E) ST segment depression 1) aortic insufficiency
Show comment and answer 2) thyreotoxicosis
INT - 1.29 3) beriberi
Pathologic Q wave in leads II, III and 4) atherosclerosis
aVF with isoelectric ST segment and
positive T waves indicate: A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
A) acut ischemia C) Answers 2 and 4 are correct
acute phase of a progressing D) Only answer 4 is correct
B)
myocardial infarction E) All four answers are correct
C) previous myocardial infarction Show comment and answer
aneurysm after myocardial INT - 1.34
D)
infarction Aortic aneurysm can be caused by:
E) subendocardial ischemia
1) arteriosclerosis
Show comment and answer
INT - 1.30 2) Marfan’s syndrome
In the diagnostic workup of a 60 year 3) vascular syphilis
old patient with a history of smoking 4) giant-cell arteritis
A) Answers 1, 2 and 3 are correct Which one(s) is/are correct?
B) Answers 1 and 3 are correct
1) Aspirin has no effect on the
C) Answers 2 and 4 are correct prostacyclin production of the
D) Only answer 4 is correct endothelial cells.
E) All four answers are correct 2) According to multicenter trials
Show comment and answer aspirin reduces the chance of a second
INT - 1.35 myocardial infarction.
The possible cause(s) of perciarditis: 3) It takes 24 hours for heparin to
build up its anticoagulant effect.
1) uremia 4) Heparin and alteplase are
2) transmural myocardial infarction treatment options in pulmonary
3) tuberculosis embolism.
4) metastatic cancer
A) Answers 1, 2 and 3 are correct
A) Answers 1, 2 and 3 are correct B) Answers 1 and 3 are correct
B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct
C) Answers 2 and 4 are correct D) Only answer 4 is correct
D) Only answer 4 is correct E) All four answers are correct
E) All four answers are correct Show comment and answer
Show comment and answer INT - 1.39
INT - 1.36 Which diuretic-side effect
Secondary cardiomyopathy can be combination(s) is/are correct?
caused by:
1) furosemide - hyperuricemia
1) hyperthyroidism 2) chlortalidone – ototoxicity
2) beriberi 3) spironolactone – gynecomasty
3) amyloidosis 4) etacrynic acid - hyperuricemia
4) glycogenosis
A) Answers 1, 2 and 3 are correct
A) Answers 1, 2 and 3 are correct B) Answers 1 and 3 are correct
B) Answers 1 and 3 are correct C) Answers 2 and 4 are correct
C) Answers 2 and 4 are correct D) Only answer 4 is correct
D) Only answer 4 is correct E) All four answers are correct
E) All four answers are correct Show comment and answer
Show comment and answer INT - 1.40
INT - 1.37 Risk factors of ischemic heart disease:
ACE inhibitors:
1) smoking
1) decrease blood pressure 2) hypercholesterolemia
2) decrease aldosterone levels 3) hypertension
3) increase bradykinin levels 4) family history
4) stop the deterioration of the left
ventricle ejection fraction A) Answers 1, 2 and 3 are correct
B) Answers 1 and 3 are correct
A) Answers 1, 2 and 3 are correct
C) Answers 2 and 4 are correct
B) Answers 1 and 3 are correct
D) Only answer 4 is correct
C) Answers 2 and 4 are correct
E) All four answers are correct
D) Only answer 4 is correct INT - 1.41
E) All four answers are correct Chest pain can be a symptom of:
Show comment and answer
INT - 1.38 1) aortic stenosis
2) mitral prolapse syndrome B) Answers 1 and 3 are correct
3) peptic ulcer C) Answers 2 and 4 are correct
4) Morgagni’s syndrome
D) Only answer 4 is correct
E) All four answers are correct
A) Answers 1, 2 and 3 are correct
Show comment and answer
B) Answers 1 and 3 are correct
INT - 1.45
C) Answers 2 and 4 are correct Diagnostic tests with the ability to
D) Only answer 4 is correct detect asymptomatic angina pectoris
E) All four answers are correct (silent ischemia):
Show comment and answer
INT - 1.42 1) dobutamine stress
Treatments that reduce morbidity and echocardiogram
mortality after myocardial infarction 2) Holter ECG monitoring
(secondary prevention): 3) exercise test
4) ABPM
1) beta-blockers
2) anti-platelet drugs A) Answers 1, 2 and 3 are correct
3) HMG-CoA reductase inhibitors B) Answers 1 and 3 are correct
4) ACE inhibitors C) Answers 2 and 4 are correct
D) Only answer 4 is correct
A) Answers 1, 2 and 3 are correct
E) All four answers are correct
B) Answers 1 and 3 are correct
Show comment and answer
C) Answers 2 and 4 are correct INT - 1.46
D) Only answer 4 is correct Early and late complications of acute
E) All four answers are correct myocardial infarction:
Show comment and answer
INT - 1.43 1) ventricular fibrillation
Diagnostic options to determine 2) left ventricular aneurysm
myocardial viability: formation
3) cardiogenic shock
1) low-dose dobutamine stress test 4) pericardial effusion
2) positron-emission tomography
3) stress perfusion scintigraphy with A) Answers 1, 2 and 3 are correct
Tl-201 reinjection B) Answers 1 and 3 are correct
4) Doppler ultrasound C) Answers 2 and 4 are correct
D) Only answer 4 is correct
A) Answers 1, 2 and 3 are correct
E) All four answers are correct
B) Answers 1 and 3 are correct
Show comment and answer
C) Answers 2 and 4 are correct INT - 1.47
D) Only answer 4 is correct Treatment option(s) of heart failure:
E) All four answers are correct
1) pharmacotherapy
Show comment and answer
INT - 1.44 2) heart transplant
Contraindications of cardiac exercise 3) mechanical circulatory support
tests: devices
4) cardiac resynchronization therapy
1) acute myocardial infarction
2) chronic heart failure A) Answers 1, 2 and 3 are correct
3) unstable angina B) Answers 1 and 3 are correct
4) beta-blocker therapy C) Answers 2 and 4 are correct
D) Only answer 4 is correct
A) Answers 1, 2 and 3 are correct
E) All four answers are correct
Show comment and answer 3) it is caused by coronary spasm
INT - 1.48 4) it should be treated with calcium-
Risk factors of atherosclerosis: channel blockers
Both of them are correct, there is Both of them are correct, there is
A) A)
causal relationship between them causal relationship between them
Both of them are correct, but there Both of them are correct, but there
B) is no causal relationship between B) is no causal relationship between
them them
The first part is correct, the second The first part is correct, the second
C) C)
one is wrong one is wrong
The first part is wrong, the second The first part is wrong, the second
D) D)
one is correct one is correct
E) Both of them are incorrect E) Both of them are incorrect
Show comment and answer Show comment and answer
INT - 1.123 INT - 1.126
Most types of diuretics require Implantable cardioverter defibrillator
potassium supplementation because can be used as the treatment of
most of them increase the potassium arrhythmia because these devices can
excretion with urine. cure the underlying disease which
caused the arrhythmia.
Both of them are correct, there is
A)
causal relationship between them Both of them are correct, there is
A)
Both of them are correct, but there causal relationship between them
B) is no causal relationship between Both of them are correct, but there
them B) is no causal relationship between
The first part is correct, the second them
C)
one is wrong The first part is correct, the second
C)
The first part is wrong, the second one is wrong
D)
one is correct The first part is wrong, the second
D)
E) Both of them are incorrect one is correct
Show comment and answer E) Both of them are incorrect
INT - 1.124 Show comment and answer
Long-term use of ACE-inhibitors INT - 1.127
reduce the left ventricle hypertrophy Sporadic ventricular extrasystole for
because their use decreases the serum healthy patients without significant
bradykinin level. complaints also require antiarrhythmic
treatment because antiarrhythmic
Both of them are correct, there is medication clearly improve the
A)
causal relationship between them survival.
Both of them are correct, but there
B) is no causal relationship between Both of them are correct, there is
A)
them causal relationship between them
The first part is correct, the second Both of them are correct, but there
C) B) is no causal relationship between
one is wrong
The first part is wrong, the second them
D) The first part is correct, the second
one is correct
C)
E) Both of them are incorrect one is wrong
Show comment and answer The first part is wrong, the second
D)
INT - 1.125 one is correct
Radiofrequency ablation is the first E) Both of them are incorrect
choice treatment of the symptomatic Show comment and answer
INT - 1.128 E) Both of them are incorrect
The anticoagulant treatment of atrial
fibrillation is based on the CHADS2-
VASc2 Score because the DISORDERS OF GALLBLADDER AND
thromboembolic risk increasing effect BILEDUCTS
of atrial fibrillation depends on the
patient’s other clinical features. INT - 8.1
Which one is the most important factor
Both of them are correct, there is in gall clearence?
A)
causal relationship between them
Both of them are correct, but there A) gastrin
B) is no causal relationship between B) nitrogen monoxide
them C) secretin
The first part is correct, the second D) cholecystokinin
C)
one is wrong
E) VIP
The first part is wrong, the second
D) Show comment and answer
one is correct INT - 8.2
E) Both of them are incorrect Which one is the most frequent
Show comment and answer gallstone?
INT - 1.129
Paroxysmal supraventricular A) Cholesterol stone
tachycardia is a mostly lethal B) Bilirubin stone
arrhythmia therefore these patients
C) Mixed stone
require combined antiarrhythmic
treatment. D) Oxalate stone
Show comment and answer
Both of them are correct, there is INT - 8.3
A) Which one is the most frequent
causal relationship between them
Both of them are correct, but there complication of an ERCP?
B) is no causal relationship between
them A) Perforation of the duodenum
The first part is correct, the second B) Infection of the bile ducts
C)
one is wrong C) Acute pancreatitis
The first part is wrong, the second Hemorrhage of the major duodenal
D) D)
one is correct papilla
E) Both of them are incorrect E) Paralytic ileus
Show comment and answer Show comment and answer
INT - 1.130 INT - 8.4
In case of acute myocardial infarction, Which symptom is not characteristic to
the use of beta blockers is preferred if disorders of biliary excretion?
there is no contraindication because
beta blockers reduce the oxygen A) abdominal distension
demand of the myocardium. B) ”fullness” feeling
C) severe steatorrhoea
Both of them are correct, there is
A) D) abdominal discomfort
causal relationship between them
E) pain under the right ribs
Both of them are correct, but there
B) is no causal relationship between Show comment and answer
them INT - 8.5
How often is the outlet of the ductus
The first part is correct, the second
C) choledochus and the ductus
one is wrong
pancreaticus joint (Ampulla of Vater)?
The first part is wrong, the second
D)
one is correct
A) 10%
B) 30%
C) 50% 1st, 2nd and 3rd answers are
A)
correct
D) 70%
B) 1st and 3rd answers are correct
E) 90%
C) 2nd and 4th answers are correct
Show comment and answer
INT - 8.6 D) only 4th answer is correct
Which of the following agents facilitate E) all of the answers are correct
biliary excretion? Show comment and answer
INT - 8.9
1) CCK Which of the following does decrease
2) secretin the spasm of the Oddi sphincter?
3) bile salts
4) adrenalin 1) nitrates
2) chocolate
A)
1st, 2nd and 3rd answers are 3) cholecystokinin
correct 4) morphin
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct 1st, 2nd and 3rd answers are
A)
correct
D) only 4th answer is correct
B) 1st and 3rd answers are correct
E) all of the answers are correct
C) 2nd and 4th answers are correct
Show comment and answer
INT - 8.7 D) only 4th answer is correct
Which are the factors predisposing to E) all of the answers are correct
gallstone formation? Show comment and answer
INT - 8.10
1) pregnancy What are the indications of endoscopic
2) sudden dieting sphincterotomy?
3) meal rich in unsaturated fatty
acids 1) choledocholithiasis
4) resection of the small intestine 2) Oddi-sphincter-dyskinesis
3) acute recidive gallbladder attack
A)
1st, 2nd and 3rd answers are resulting in acute pancreatitis
correct 4) carcinoma of the pancreatic head
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct 1st, 2nd and 3rd answers are
A)
correct
D) only 4th answer is correct
B) 1st and 3rd answers are correct
E) all of the answers are correct
C) 2nd and 4th answers are correct
Show comment and answer
INT - 8.8 D) only 4th answer is correct
What is the procedure to choose in E) all of the answers are correct
case of incidentally discovered Show comment and answer
gallstones not causing any INT - 8.11
symptomes? Which of the following procedures are
useful for functional examination of the
1) surgical removal of the gallbladder?
gallbladder
2) lithotripsy performed with 1) liver scintigraphy
ultrasound 2) MRCP (magnetic resonance
3) starting a lasting gallstone cholangiopancreatography)
solubilizer medication 3) intravenous urography
4) informing the patient of the 4) cholescintigraphy
gallstones and personalized
therapeutic consideration
1st, 2nd and 3rd answers are 1st, 2nd and 3rd answers are
A) A)
correct correct
B) 1st and 3rd answers are correct B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct C) 2nd and 4th answers are correct
D) only 4th answer is correct D) only 4th answer is correct
E) all of the answers are correct E) all of the answers are correct
Show comment and answer Show comment and answer
INT - 8.12 INT - 8.15
Which enzyme of the bile contributes What is the most important
to fat digestion? differentiating laboratory parameter in
cases of obstructive jaundice?
1) lipase
2) cholic acid 1) elevated direct bilirubin
3) colipase 2) elevated total bilirubin
4) neither of the aforementioned 3) elevated urinary UBG
4) no UBG in the urine
1st, 2nd and 3rd answers are
A)
correct 1st, 2nd and 3rd answers are
A)
B) 1st and 3rd answers are correct correct
C) 2nd and 4th answers are correct B) 1st and 3rd answers are correct
D) only 4th answer is correct C) 2nd and 4th answers are correct
E) all of the answers are correct D) only 4th answer is correct
Show comment and answer E) all of the answers are correct
INT - 8.13 Show comment and answer
What is the Courvoisier-sign? INT - 8.16
What is the most important role of the
1) pain under the right ribs + bile during digestion?
jaundice + fever
2) jaundice + melaena + epigastrial 1) exretion of bile acids from the
pain body
3) fever + jaundice + tactile 2) fat emulgeation
resistance in the upper abdomen 3) activation of trypsin
4) tactile, not painful enlarged 4) contributing to lipase’s
gallbladder connection to the fat
1st, 2nd and 3rd answers are 1st, 2nd and 3rd answers are
A) A)
correct correct
B) 1st and 3rd answers are correct B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct C) 2nd and 4th answers are correct
D) only 4th answer is correct D) only 4th answer is correct
E) all of the answers are correct E) all of the answers are correct
Show comment and answer Show comment and answer
INT - 8.14 INT - 8.17
Which of the following diseases can Which statements are true regarding
cause direct hyperbilirubinaemia? biliary functions and blood cholesterol
levels?
1) Gilbert’s syndrome
2) Rotor syndrome 1) Elevated biliary functions elevate
3) haemolysis blood cholesterol levels.
4) choledocholithiasis 2) Elevated biliary functions
decrease blood cholesterol levels.
3) Elevated biliary functions elevate only in permanently functionally
LDL levels. damaged gallbladders.
4) Bile is the only elimination route
for cholesterol from the body. both the statement and the
A) explanation are true and a causal
1st, 2nd and 3rd answers are relationship exists between them;
A)
correct both the statement and the
B) 1st and 3rd answers are correct B) explanation are true but there is no
C) 2nd and 4th answers are correct causal relationship between them;
D) only 4th answer is correct the statement is true, but the
C)
explanation is false;
E) all of the answers are correct
the statement is false, but the
Show comment and answer D)
explanation itself is true
INT - 8.18
Which of the following may be both the statement and the
E)
complication of gallstones? explanation are false
INT - 8.21
1) obstructive jaundice Sudden dieteing does not predispose
2) acute pancreatitis to gallstone formation, because
3) cholecystitis environment in non-functioning
4) chronic pancreatitis gallbladders favors gallstone
formation.
1st, 2nd and 3rd answers are
A) both the statement and the
correct
B) 1st and 3rd answers are correct A) explanation are true and a causal
relationship exists between them;
C) 2nd and 4th answers are correct
both the statement and the
D) only 4th answer is correct B) explanation are true but there is no
E) all of the answers are correct causal relationship between them;
Show comment and answer the statement is true, but the
INT - 8.19 C)
explanation is false;
Solubizing the gallstone which is
the statement is false, but the
smaller than 2 cm and has been D)
explanation itself is true
formed during pregancy is advised
both the statement and the
later, because pregnancy is only a E)
explanation are false
temporary state predisposing to
gallstone formation. Show comment and answer
INT - 8.22
Laparoscopic cholecystectomy is a
both the statement and the
lower load for the patient compared to
A) explanation are true and a causal
relationship exists between them; open cholecystectomy, because the
abdomen is not opened in a large
both the statement and the
surface.
B) explanation are true but there is no
causal relationship between them;
both the statement and the
the statement is true, but the A) explanation are true and a causal
C)
explanation is false; relationship exists between them;
the statement is false, but the both the statement and the
D)
explanation itself is true B) explanation are true but there is no
both the statement and the causal relationship between them;
E)
explanation are false the statement is true, but the
Show comment and answer C)
explanation is false;
INT - 8.20
the statement is false, but the
All gallstones should be surgically D)
explanation itself is true
removed, because gallstone is formed
both the statement and the both the statement and the
E)
explanation are false B) explanation are true but there is no
Show comment and answer causal relationship between them;
INT - 8.23 the statement is true, but the
C)
Abdominal ultrasound examination can explanation is false;
detect gallbladder carcinoma with the statement is false, but the
great security, therefore gallbladdder D)
explanation itself is true
carcinoma is usually detected at early both the statement and the
stage. E)
explanation are false
Show comment and answer
both the statement and the INT - 8.26
A) explanation are true and a causal Klatskin tumour can be easily removed
relationship exists between them; surgically, because the tumour is
both the statement and the located in the porta hepatis.
B) explanation are true but there is no
causal relationship between them; both the statement and the
the statement is true, but the A) explanation are true and a causal
C)
explanation is false; relationship exists between them;
the statement is false, but the both the statement and the
D)
explanation itself is true B) explanation are true but there is no
both the statement and the causal relationship between them;
E)
explanation are false the statement is true, but the
C)
Show comment and answer explanation is false;
INT - 8.24 the statement is false, but the
Gallstones are generated in the D)
explanation itself is true
gallbladder, because in the gallbladder both the statement and the
the concentration of the bile is at least E)
explanation are false
fivefold.
Show comment and answer
INT - 8.27
both the statement and the The common bile duct (ductus
A) explanation are true and a causal choledochus) usually leads to the
relationship exists between them; duodenum through the minor papilla,
both the statement and the because the duct of Wirsung leads to
B) explanation are true but there is no the duodenum through the ampulla of
causal relationship between them; Vater.
the statement is true, but the
C)
explanation is false; both the statement and the
the statement is false, but the A) explanation are true and a causal
D)
explanation itself is true relationship exists between them;
both the statement and the both the statement and the
E)
explanation are false B) explanation are true but there is no
Show comment and answer causal relationship between them;
INT - 8.25 the statement is true, but the
C)
Treatment of chronic abdominal explanation is false;
complaints occurring after the statement is false, but the
cholecystectomy is easy, because in D)
explanation itself is true
these cases with the introduction of both the statement and the
antacid treatment most symptoms can E)
explanation are false
be ceased.
Show comment and answer
INT - 8.28
both the statement and the Ultrasound scan detects bile duct
A) explanation are true and a causal stones with great certainty, because
relationship exists between them;
ultrasound is absolute reliable in the both the statement and the
E)
detection of gallbladder stones as well. explanation are false
Show comment and answer
both the statement and the INT - 8.31
A) explanation are true and a causal In case of gallstones the first choice of
relationship exists between them; treatment is always medical stone
both the statement and the dissolution, because it is cheap and
B) explanation are true but there is no only 10% of gallstones recur within
causal relationship between them; two years.
the statement is true, but the
C)
explanation is false; both the statement and the
the statement is false, but the A) explanation are true and a causal
D) relationship exists between them;
explanation itself is true
both the statement and the both the statement and the
E) B) explanation are true but there is no
explanation are false
causal relationship between them;
Show comment and answer
INT - 8.29 the statement is true, but the
C)
The surgical solution of bile duct explanation is false;
stenoses is advised, when the the statement is false, but the
D)
intervention with ERCP is unsuccessful, explanation itself is true
because surgical intervention is both the statement and the
E)
cheaper than stent exchanges. explanation are false
Show comment and answer
both the statement and the INT - 8.32
A) explanation are true and a causal Gallstone production is common in
relationship exists between them; small bowel diseases, because in these
both the statement and the cases the reabsorption of bile acids
B) explanation are true but there is no that keep the bile in solution is
causal relationship between them; damaged.
the statement is true, but the
C)
explanation is false; both the statement and the
the statement is false, but the A) explanation are true and a causal
D) relationship exists between them;
explanation itself is true
both the statement and the both the statement and the
E) B) explanation are true but there is no
explanation are false
causal relationship between them;
Show comment and answer
INT - 8.30 the statement is true, but the
C)
Prophylactic antibiotic therapy in explanation is false;
obstructive jaundice decreases the the statement is false, but the
D)
complication rate of ERCP, because the explanation itself is true
assurance of free bile flow is of both the statement and the
E)
secondary importance. explanation are false
Show comment and answer
both the statement and the INT - 8.33
A) explanation are true and a causal What is the first choice of
relationship exists between them; examination?
both the statement and the
B) explanation are true but there is no The 45-year-old woman with known
causal relationship between them; bile stones complains of a cramping,
the statement is true, but the severe abdominal pain under the right
C) ribs irradiating in the scapulae,
explanation is false;
beginning about 30 minutes after
the statement is false, but the
D) eating and associated by nausea.
explanation itself is true
During physical examination she
indicates a strong pain on pressure C) gastric perforation
under the right ribs, and fluctuating D) hydrops vesicae felleae
resistance can be felt here.
E) choledocholithiasis
Show comment and answer
A) abdominal CT
INT - 8.36
B) stomach X-ray What therapuetic interventions are
C) gastroscopy considered?
D) abdominal US
The 45-year-old woman with known
E) chest X-ray
bile stones complains of a cramping,
Show comment and answer severe abdominal pain under the right
INT - 8.34
ribs irradiating in the scapulae,
What lab test helps setting the correct
beginning about 30 minutes after
diagnosis?
eating and associated by nausea.
The 45-year-old woman with known During physical examination she
bile stones complains of a cramping, indicates a strong pain on pressure
severe abdominal pain under the right under the right ribs, and fluctuating
ribs irradiating in the scapulae, resistance can be felt here.
beginning about 30 minutes after
1) inserting a central venous
eating and associated by nausea.
catheter and administering nitrates
During physical examination she
2) laparoscopic cholecystectomy
indicates a strong pain on pressure
3) endoscopic sphincterotomy and
under the right ribs, and fluctuating
stone extraction
resistance can be felt here.
4) complete fasting, conservative
1) white blood cell count medical treatment
2) serum-amylase
3) total urine 1st, 2nd and 3rd answers are
A)
4) direct bilirubin correct
B) 1st and 3rd answers are correct
1st, 2nd and 3rd answers are C) 2nd and 4th answers are correct
A)
correct D) only 4th answer is correct
B) 1st and 3rd answers are correct E) all of the answers are correct
C) 2nd and 4th answers are correct Show comment and answer
D) only 4th answer is correct INT - 8.37
E) all of the answers are correct What is the next examination of
choice?
Show comment and answer
INT - 8.35
The 78-year-old man is admitted to
What is the most probable diagnosis?
the hospital because of significant
The 45-year-old woman with known weight loss and jaundice. Abdominal
bile stones complains of a cramping, US confirms a gallbladder without
severe abdominal pain under the right stone and dilated intrahepatic bile
ribs irradiating in the scapulae, ducts, the extrahepatic bile ducts are
beginning about 30 minutes after not wider.
eating and associated by nausea.
During physical examination she A) iv. cholescintigraphy
indicates a strong pain on pressure B) abdominal CT
under the right ribs, and fluctuating C) ERCP
resistance can be felt here. D) percutaneous transhepatic drainage
Show comment and answer
A) acute pancreatitis
B) gallstone ileus
INT - 8.38 A) bypass surgery
Which laboratory results help in setting
B) ERCP, stent implantation
the diagnosis?
C) duodenal tube
The 78-year-old man is admitted to D) treatment with ursodeoxycholic acid
the hospital because of significant E) bedrest, supportive treatment
weight loss and jaundice. Abdominal Show comment and answer
US confirms a gallbladder without INT - 8.41
stone and dilated intrahepatic bile Typical symptoms of Caroli syndrome:
ducts, the extrahepatic bile ducts are
not wider. 1) recurring cholangitis
2) haematuria
1) normal CRP level 3) shaking chills, fever
2) elevated erythrocyte 4) peptic duodenal ulcer
sedimentation rate
3) high LDH level 1st, 2nd and 3rd answers are
4) elevated CEA level A)
correct
B) 1st and 3rd answers are correct
1st, 2nd and 3rd answers are
A) C) 2nd and 4th answers are correct
correct
D) only 4th answer is correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct E) all of the answers are correct
Show comment and answer
D) only 4th answer is correct
INT - 8.42
E) all of the answers are correct Morphological characteristics of Caroli
Show comment and answer syndrome:
INT - 8.39
What is the most probable diagnosis? 1) fusiform dilation of intrahepatic
bile ducts
The 78-year-old man is admitted to 2) crooked cystic duct
the hospital because of significant 3) bile duct stenosis
weight loss and jaundice. Abdominal 4) shortened common bile duct
US confirms a gallbladder without
stone and dilated intrahepatic bile 1st, 2nd and 3rd answers are
ducts, the extrahepatic bile ducts are A)
correct
not wider. B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
A) acute cholecystitis
D) only 4th answer is correct
B) acute hepatitis
E) all of the answers are correct
C) primary biliary cirrhosis
Show comment and answer
D) bile duct tumour (Klatskin)
INT - 8.43
E) pancreas head carcinoma Criterion of early cholecystectomy in
Show comment and answer case of gallstones:
INT - 8.40
What is the treatment of choice? 1) jaundice
2) previous abdominal operation
The 78-year-old man is admitted to 3) cholangitis not responding to
the hospital because of significant antibiotics
weight loss and jaundice. Abdominal 4) within 24-72 hours after the
US confirms a gallbladder without formation of symptoms
stone and dilated intrahepatic bile
ducts, the extrahepatic bile ducts are 1st, 2nd and 3rd answers are
not wider. A)
correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct Possible cause of gallbladder
D) only 4th answer is correct hypokinesia:
E) all of the answers are correct
1) diabetes
Show comment and answer 2) extended starvation
INT - 8.44
3) pregnancy
Criterion of the solution of gallstones 4) steroid treatment
with bile acids:
1st, 2nd and 3rd answers are
1) permeable cystic duct A)
correct
2) calcareous gallbladder
3) well contracting gallbladder B) 1st and 3rd answers are correct
4) age above 50 years C) 2nd and 4th answers are correct
D) only 4th answer is correct
1st, 2nd and 3rd answers are E) all of the answers are correct
A)
correct
Show comment and answer
B) 1st and 3rd answers are correct INT - 8.48
C) 2nd and 4th answers are correct Can be typical symptom of tumour of
D) only 4th answer is correct the ampulla of Vater:
E) all of the answers are correct
1) jaundice
Show comment and answer 2) fever
INT - 8.45
3) pruritus
Characteristics of gallbladder polyps: 4) diarrhoea
1) 95 percent are benign
1st, 2nd and 3rd answers are
2) can be detected with ultrasound A)
correct
3) adenomas larger than 10 mm are
precancerous B) 1st and 3rd answers are correct
4) inflamed polyps are common C) 2nd and 4th answers are correct
D) only 4th answer is correct
1st, 2nd and 3rd answers are E) all of the answers are correct
A)
correct
Show comment and answer
B) 1st and 3rd answers are correct INT - 8.49
C) 2nd and 4th answers are correct Possible symptom of
D) only 4th answer is correct postcholecystectomy syndrome:
E) all of the answers are correct
1) constipation
Show comment and answer 2) weight loss
INT - 8.46
3) nausea
Characteristics of Mirizzi’s syndrome: 4) diarrhoea
1) obstructive icterus
1st, 2nd and 3rd answers are
2) normal bilirubin level A)
correct
3) dilated hepatic duct
4) diarrhoea B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
1st, 2nd and 3rd answers are D) only 4th answer is correct
A)
correct E) all of the answers are correct
B) 1st and 3rd answers are correct Show comment and answer
C) 2nd and 4th answers are correct INT - 8.50
D) only 4th answer is correct Possible cause of postcholecystectomy
syndrome:
E) all of the answers are correct
Show comment and answer 1) cystic duct remnant syndrome
INT - 8.47
2) bile duct stenosis
3) remaining bile duct stone 3) duodenal diverticulum
4) gallstone ileus 4) ileocecal valve
1st, 2nd and 3rd answers are 1st, 2nd and 3rd answers are
A) A)
correct correct
B) 1st and 3rd answers are correct B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct C) 2nd and 4th answers are correct
D) only 4th answer is correct D) only 4th answer is correct
E) all of the answers are correct E) all of the answers are correct
Show comment and answer Show comment and answer
INT - 8.51 INT - 8.54
Characteristics of cholelithiasis: Predisposing factors of acute
acalculous cholecystitis:
1) can be detected in 10 percent of
the population 1) prolonged starvation
2) more common in women thn in 2) immobility
men 3) hemodynamic instability
3) its incidence increases with age associated with severe abdominal
4) its prevalence does not change diseases
with age 4) nonalcoholic steatohepatitis
1st, 2nd and 3rd answers are 1st, 2nd and 3rd answers are
A) A)
correct correct
B) 1st and 3rd answers are correct B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct C) 2nd and 4th answers are correct
D) only 4th answer is correct D) only 4th answer is correct
E) all of the answers are correct E) all of the answers are correct
Show comment and answer Show comment and answer
INT - 8.52 INT - 8.55
Characetristics of juxtapapillary May be the complication of
diverticulum: choledocholithiasis:
both are correct, there is a causal both are correct, there is a causal
A) A)
relationship between the two, relationship between the two,
both are correct, there is no causal both are correct, there is no causal
B) B)
relationship between the two, relationship between the two,
the first is correct, the second is the first is correct, the second is
C) C)
incorrect incorrect
the first is incorrect , the second is the first is incorrect , the second is
D) D)
correct correct
E) both are incorrect E) both are incorrect
Show comment and answer Show comment and answer
INT - 10.45 INT - 10.48
In patients over 50 suffering from In acute kidney injury, pre- and post-
membranous glomerulonephritis renal causes have to be excluded, as
cancer screening is necessary, since in acute kidney injury may develop in
older age tumour antigen-containing elderly patients with the use of
immune complexes more frequently NSAIDs.
cause membranous
glomerulonephritis. both are correct, there is a causal
A)
relationship between the two,
both are correct, there is a causal both are correct, there is no causal
A) B)
relationship between the two, relationship between the two,
both are correct, there is no causal the first is correct, the second is
B) C)
relationship between the two, incorrect
the first is correct, the second is the first is incorrect , the second is
C) D)
incorrect correct
the first is incorrect , the second is E) both are incorrect
D)
correct Show comment and answer
E) both are incorrect INT - 10.49
Show comment and answer In Type 1 diabetes mellitus, initial
INT - 10.46 symptom of the renal involvement is
Acute diffuse poststreptococcal the increase of glomerular filtration
glomerulonephritis is characterised by rate (GFR), which decreases to its
fever and inflammatory symptoms, original value as glucose metabolism
therefore the patient has to be treated normalizes in the majority of patients.
with antipyretics.
both are correct, there is a causal
A)
both are correct, there is a causal relationship between the two,
A)
relationship between the two, both are correct, there is no causal
B)
both are correct, there is no causal relationship between the two,
B)
relationship between the two, the first is correct, the second is
C)
the first is correct, the second is incorrect
C)
incorrect the first is incorrect , the second is
D)
the first is incorrect , the second is correct
D)
correct E) both are incorrect
E) both are incorrect Show comment and answer
Show comment and answer INT - 10.50
INT - 10.47 In the case of diabetic kidney disease,
The main symptom of patients with RAAS-inhibitor therapy is given due to
nephrotic syndrome is pyuria, abnormal albuminuria, as RAAS-
therefore, changes causing obstruction
inhibitors decrease the intraglomerular
pressure. both are correct, there is a causal
A)
relationship between the two,
both are correct, there is a causal both are correct, there is no causal
A) B)
relationship between the two, relationship between the two,
both are correct, there is no causal the first is correct, the second is
B) C)
relationship between the two, incorrect
the first is correct, the second is the first is incorrect , the second is
C) D)
incorrect correct
the first is incorrect , the second is E) both are incorrect
D)
correct Show comment and answer
E) both are incorrect INT - 10.54
Show comment and answer Abnormal albuminuria is inadequate
INT - 10.51 for screening the diabetic and
Stages of the renal alterations are hypertonic renal damage, because the
similar in Type1 and Type 2 diabetes range of abnormal albuminuria is >30
mellitus, as both types of diabetes mg/day.
mellitus develop as the result of
severely damaged insulin production of both are correct, there is a causal
A)
the pancreas. relationship between the two,
both are correct, there is no causal
both are correct, there is a causal B)
A) relationship between the two,
relationship between the two, the first is correct, the second is
both are correct, there is no causal C)
B) incorrect
relationship between the two, the first is incorrect , the second is
the first is correct, the second is D)
C) correct
incorrect E) both are incorrect
the first is incorrect , the second is Show comment and answer
D)
correct Association question
E) both are incorrect Link the symptoms indicated by
Show comment and answer numbers with the matching
INT - 10.52 pathological clinical pictures (with
Nephropathy may be present at the capital letters)!
time of the diagnosis in Type 2
diabetes, as diabetic nephropathy INT - purpura -
belongs to the so-called 10.55
macroangiopathies. INT - acute kidney injury -
10.56
both are correct, there is a causal INT - glomerular type -
A)
relationship between the two, 10.57 haematuria
both are correct, there is no causal INT - nephrotic syndrome -
B) 10.58 without the presence of a
relationship between the two,
the first is correct, the second is diabetic retinopathy
C)
incorrect
A) minimal change disease
the first is incorrect , the second is
D) B) vasculitis
correct
C) urinary obstruction
E) both are incorrect
D) diabetic nephropathy
Show comment and answer
INT - 10.53
In general practice, CKD-epi equation
is used for estimating the kidney
function, as its determination requires
the collection of 24-hour urine sample.
Association question C) both of the above
Link the symptoms indicated by D) none of the above
numbers with the most matching Association question
pathological clinical pictures (with Match the therapeutic possibilities
capital letters)! marked by numbers with the clinical
picture marked by capital letters in the
INT - proteinuria above 3.5 - treatment of which the given
10.59 g/day therapeutic possibility is the most
INT - glomerular type - appropriate treatment of choice.
10.60 haematuria
INT - pyuria + bacteriuria - INT - management of -
10.61 10.67 homeostatic/volume
INT - erythropoietin therapy - balance
10.62 INT - potassium-sparing diuretic -
10.68
A) renal anaemia INT - erythropoietin -
B) nephrotic syndrome 10.69
C) nephritic syndrome INT - dialysis -
D) uroinfection 10.70
Association question
Link the symptoms indicated by A) renal anaemia
numbers with the most matching B) pre-renal acute kidney injury
pathological clinical pictures (with C) severe acute kidney injury
capital letters)! D) nephrotic syndrome
Association question
INT - proteinuria above 3.5 - Match conditions marked by numbers
10.59 g/day with the most appropriate concept!
INT - glomerular type -
10.60 haematuria INT - screening of albuminuria -
INT - pyuria + bacteriuria - 10.71
10.61 INT - acute post-streptococcal -
INT - erythropoietin therapy - 10.72 glomerulonephritis
10.62 INT - decrease in GFR -
10.73
A) renal anaemia INT - decreased proteinuria -
B) nephrotic syndrome 10.74
C) nephritic syndrome
D) uroinfection A) cardiovascular progression
Association question B) cardiovascular regression
Link the symptoms indicated by C) early screening for cardiovascular
numbers with the most matching disease
pathological clinical pictures (with D) no increase in cardiovascular risk
capital letters)!
ENDOCRINOLOGY
INT - low glomerular filtration -
10.63 rate
INT - 11.1
INT - kidneys are of normal size -
Main manifestations of multiple
10.64 or enlarged
endocrine neoplasia type 1 (MEN1):
INT - it develops unnoticeably, -
10.65 almost symptomless
pheochromocytoma,
INT - the kidneys’ concentrating -
A) hyperparathyroidism, Leydig-cell
10.66 ability is not disturbed testicle tumor
A) acute kidney injury
B) chronic renal insufficiency
pheochromocytoma, D) treatment with dopamin antagonist
B) hyperparathyroidism, pituitary treatment with somatostatin
adenoma E)
analogue
hyperparathyroidism, pancreas Show comment and answer
C) neuroendocrine tumor, pituitary INT - 11.5
adenoma In case of a patient receiving thyroid
pheochromocytoma, medullary hormone substitution due to a thyroid
D) thyroid carcinoma, pituitary ablation therapy of papillary thyroid
adenoma carcinoma, laboratory results show a
hyperparathyroidism, suppression of TSH level and normal
E) pheochromocytoma, pituitary free T4 and free T3 levels. Is it
adenoma necessary to modify the dose of the
Show comment and answer thyroid hormone substitution (l-
INT - 11.2 thyroxin)?
The appropriate test to certify
acromegaly: the dose of l-thyroxin is appropriate,
A)
no modification is needed
investigation of the diurnal rhythm reduction of the daily dose of l-
A) of serum growth hormone (GH) B) thyroxin is necessary due to the
concentration suppressed TSH
investigation of the serum growth increase of the daily dose of l-
B) hormone (GH) concentration in C) thyroxin is necessary due to the
morning’ hours suppressed TSH
investigation of the serum growth no modification of the dose of l-
C) hormone (GH) concentration during D) thyroxin is needed, but we shall
oral glucose tolerance test give thyreostatics in addition
investigation of the serum growth Show comment and answer
hormone (GH) concentration after INT - 11.6
D)
administration of growth hormone- We can use it as a serum marker of
releasing hormone (GHRH) medullary thyroid carcinoma:
Show comment and answer
INT - 11.3 investigation of serum
It is characteristic for subclinical A)
thyreoglobulin
primary hypothyroidism: B) investigation of serum calcitonin
C) investigation of serum osteocalcin
clinical signs of hypothyroidism with
A) normal serum thyroid hormone investigation of serum parathyroid
D)
levels hormone
the hormone levels refer to primary Show comment and answer
INT - 11.7
B) hypothyroidism without clinical
signs Endocrine disorders causing diarrhea,
except:
low free T4 and free T3 levels with
C)
normal serum TSH
A) medullary thyroid carcinoma
normal free T4 and free T3 levels
D) B) gastrinoma
with elevated serum TSH
C) carcinoid tumor
Show comment and answer
INT - 11.4 D) pheochromocytoma
Primary therapy of prolactin-producing Show comment and answer
pituitary microadenoma: INT - 11.8
The appropriate test for the
A) pituitary surgery clarification of Cushing’s syndrome,
B) pituitary irradiation except:
C) treatment with dopamin agonist
investigation of 24 hour urinary free there is no connection between the
A) D) pituitary macroadenoma and the
cortisol (UFC) excretion
investigation of serum cortisol after double vision
B) administration of low dose Show comment and answer
dexamethasone INT - 11.12
investigation of the diurnal rhythm It is characteristic for the lack of
C) growth hormone (GH) in adults,
of serum cortisol
except:
investigation of serum cortisol in
D)
morning hours
it is associated with unfavorable
investigation of the diurnal rhythm A)
E) lipid profile
of salivary cortisol
it is associated with increased water
Show comment and answer B) content of the body and water
INT - 11.9
retention
Radioiodine treatment can be used
against the following diseases, except: it is associated with unfavorable
C)
fat/muscle mass ratio
after the surgery of papillary thyroid it is associated with weakness and
A) D)
carcinoma discomfort
after the surgery of follicular thyroid Show comment and answer
B) INT - 11.13
carcinoma
Diseases with polyuria, except:
after the surgery of medullary
C)
thyroid carcinoma
A) primary aldosteronism
autonomous thyroid nodule causing
D) B) primary hyperparathyroidism
hyperthyroidism
C) diabetes insipidus
E) Graves’ disease
D) diabetes mellitus
Show comment and answer
INT - 11.10 SIADH (syndrome of inappropriate
E)
It is characteristic for primary antidiuretic hormone secretion)
aldosteronism: Show comment and answer
INT - 11.14
suppression of plasma renin and It can be the cause of growth hormone
A) (GH) deficiency in adults:
high plasma aldosteron
high plasma renin and high plasma
B) A) pituitary tumor
aldosteron
normal plasma renin and high B) skull trauma
C)
plasma aldosteron C) radiotherapy
high plasma aldosteron, plasma D) pituitary apoplexia
D)
renin is not relevant E) all of the above
Show comment and answer Show comment and answer
INT - 11.11 INT - 11.15
In case of a patient with pituitary Diseases with hirsutism, except:
macroadenoma, double vision evolved.
What can be the reason for that? A) Cushing’s disease
B) hypopituitarism
suprasellar spread of the pituitary
A) C) polycystic ovary syndrome
macroadenoma
lateral spread of the pituitary 21-hydroxylase deficiency form of
D)
B) macroadenoma to the cavernous congenital adrenal hyperplasia
sinus Show comment and answer
INT - 11.16
downward spread of the pituitary
C) macroadenoma and penetration Hereditary tumor syndromes with
into the sphenoid sinus pheochromocytoma:
1) von Hippel–Lindau syndrome 3) hCG (human chorionic
2) multiple endocrine neoplasia type gonadotropin)
2 4) FSH (follicle-stimulating
3) neurofibromatosis type 1 hormone)
4) multiple endocrine neoplasia type
1 A) answers 1., 2., and 3 are correct
B) answers 1. and 3. are correct
A) answers 1., 2., and 3 are correct C) answers 2. and 4. are correct
B) answers 1. and 3. are correct D) only answer 4 is correct
C) answers 2. and 4. are correct E) all four answers are correct
D) only answer 4 is correct Show comment and answer
E) all four answers are correct INT - 11.20
Show comment and answer Which tumors are associated with
INT - 11.17 elevated serum chromogranin A
Which are tumor suppressor genes of concentration?
the followings?
1) carcinoid tumor
1) RET 2) gastrinoma
2) MEN1 (menin protein encoding 3) pheochromocytoma
gene) 4) insulinoma
3) RAS
4) VHL A) answers 1., 2., and 3 are correct
B) answers 1. and 3. are correct
A) answers 1., 2., and 3 are correct C) answers 2. and 4. are correct
B) answers 1. and 3. are correct D) only answer 4 is correct
C) answers 2. and 4. are correct E) all four answers are correct
D) only answer 4 is correct Show comment and answer
E) all four answers are correct INT - 11.21
Show comment and answer Applicable treatment in thyrotoxic
INT - 11.18 crisis:
It may be a symptom of Graves’
disease: 1) thyrostatics
2) iodine preparation
1) diarrhea 3) beta-adrenergic receptor blocker
2) tachycardia 4) plasmapheresis
3) pretibial myxedema
4) fine hand tremor A) answers 1., 2., and 3 are correct
B) answers 1. and 3. are correct
A) answers 1., 2., and 3 are correct C) answers 2. and 4. are correct
B) answers 1. and 3. are correct D) only answer 4 is correct
C) answers 2. and 4. are correct E) all four answers are correct
D) only answer 4 is correct Show comment and answer
E) all four answers are correct INT - 11.22
Show comment and answer Typical in subacute granulomatous
INT - 11.19 thyroiditis (de Quervain’s thyroiditis):
Which are glicoprotein hormones of the
followings? 1) it is associated with the painful
swelling of the thyroid gland and fever
1) TSH (thyroid-stimulating 2) it is common cause of permanent
hormone) (definitive) primary hypothyroidism
2) LH (luteinizing hormone) 3) ESR is elevated
4) it often recurs after healing
A) answers 1., 2., and 3 are correct
1) hypernatremia, that leads to
B) answers 1. and 3. are correct
severe neurological symptoms
C) answers 2. and 4. are correct 2) antidiuretic hormone (ADH,
D) only answer 4 is correct vasopressin) overdosage can be one of
E) all four answers are correct its causes
Show comment and answer 3) its treatment can be water
INT - 11.23 administration through a nasogastric
In case of differentiated thyroid cancer tube
radioiodine ablation 4) its long-term prognosis is usually
good, because other regulating
1) is applicable after total (near systems may compensate the role of
total) thyroidectomy the thirst center
2) is applicable instead of total
(near total) thyroidectomy A) answers 1., 2., and 3 are correct
3) the condition of its application is B) answers 1. and 3. are correct
high serum TSH level (that can be
C) answers 2. and 4. are correct
achieved by the discontinuation of
thyroid supplementation for a certain D) only answer 4 is correct
time in patients receiving thyroid E) all four answers are correct
supplementation, or the administration Show comment and answer
of TSH product) INT - 11.26
4) is applicable before total (near It is common in acromegaly:
total) thyroidectomy
1) diabetes mellitus
A) answers 1., 2., and 3 are correct 2) hypertension
3) sleep apnea
B) answers 1. and 3. are correct
4) osteoarthrosis
C) answers 2. and 4. are correct
D) only answer 4 is correct A) answers 1., 2., and 3 are correct
E) all four answers are correct B) answers 1. and 3. are correct
Show comment and answer C) answers 2. and 4. are correct
INT - 11.24
D) only answer 4 is correct
Which diseases are associated with
hyponatremia? E) all four answers are correct
Show comment and answer
1) SIADH (syndrome of INT - 11.27
inappropriate antidiuretic hormone Which form of congenital adrenal
secretion) hyperplasia is associated with
2) diabetes insipidus hypertension and hypokalemia?
3) Addison’s disease
4) primary aldosteronism 1) steroid 21-hydroxylase deficiency
2) 11β-hydroxylase deficiency
A) answers 1., 2., and 3 are correct 3) defect of the gene encoding
STAR protein (steroidogenesis acute
B) answers 1. and 3. are correct
regulatory protein)
C) answers 2. and 4. are correct 4) 17α-hydroxylase/17, 20-lyase
D) only answer 4 is correct enzyme deficiency
E) all four answers are correct
Show comment and answer A) answers 1., 2., and 3 are correct
INT - 11.25 B) answers 1. and 3. are correct
The injury of the thirst center of the C) answers 2. and 4. are correct
hypothalamus may cause primary
D) only answer 4 is correct
adipsia. What are the characteristics of
this? E) all four answers are correct
Show comment and answer Association question
INT - 11.28 Connect the various symptoms
It is typical in Turner syndrome: (indicated with numbers) with the
disease (indicated with letters) that it
1) the syndrome is caused by the is most associated with!
total absence of an X chromosome,
thus the karyotype of these patients is INT - 11.30 polyuria -
always 45,X INT - 11.31 scant body hair -
2) apart from the typical features INT - 11.31 scant body hair -
(short stature, pterygium colli, low INT - 11.32 tall stature -
posterior hairline, low-set ears, short INT - 11.33 round, “moon” face -
metatarsus, cubitus valgus) cardial
and renal malformations are often A) diabetes insipidus
associated B) Cushing’s disease
3) the cause of the typical primary C) Klinefelter syndrome
amenorrhea is the decreased LH and D) panhypopituitarism
FSH production of the pituitary Association question
4) in childhood for the treatment of Connect the various symptoms
short stature growth hormone (GH) (indicated with numbers) with the
products are applicable disease (indicated with letters) that it
is most associated with!
A) answers 1., 2., and 3 are correct
B) answers 1. and 3. are correct INT - nephrolithiasis -
1) long disease course, with good 2nd, 5th and 6th answers are
therapeutic responses, no refractory A)
correct
cases
3rd, 6th and 8th answers are
2) durable course, rather indolent B)
correct
features, sometimes only parrtial
2nd, 4th and 7th answers are
responses to therapies, CD5/CD19 C)
correct
coexpressed cell count exceeds 5 g/L
in peripheral blood Show comment and answer
INT - 13.29
3) immunglobulins are elevated
ITP attributes:
4) low immunoglobulin levels
1) Isolated thrombocytopenia
1st, 2nd and 3rd answers are 2) pancytopenia and
A)
correct
thrombocytopenia.
B) 1st and 3rd answers are correct 3) Significant splenomegaly.
C) 2nd and 4th answers are correct 4) Splenomegaly is usually absent,
D) only 4th answer is correct however, steroid refractory cases may
E) all of the answers are correct respont with 60-70% durable
remission rate to splenectomy
Show comment and answer
INT - 13.27 5) Template bleeeding time
What is/are diagnostic criterium of prolonged.
chronic lymphocytic leukemia 6) Prolonged clotting times.
1) Fever, painful lymphadenopathy, A) 1st, 4th and 5th answers are correct
elevated CRP B) 2nd and 3rd answers are correct
2) Leukocytosis with left shift 2nd, 3rd and 6th answers are
3) Monoclonal gammopathy C)
correct
4) CD5/CD19 coexpression cell Show comment and answer
count exceeds 5 G/L in peripheral INT - 13.30
blood Heparin complications
A) Hypertension A) Anti-apexin V.
B) Myopathy B) Anti-beta2 microglobulin I.
C) Hyperpotassemia C) Anti-beta2 glycoprotein I
D) Cataract D) Anti-cardiotliptin
E) Glaucoma E) Anti-lupus anticoagulant
Show comment and answer Show comment and answer
INT - 14.2 INT - 14.7
Which autoantibody is NOT specific for Which autoantibody is specific for
poly-dermatomyositis? MCTD?
A) Anti-Ku A) Anti-PM-Scl
B) Anti-Mi2 B) Anti-U1 RNP
C) Anti-SRP C) ANCA
D) Anti-Sm D) Anti-SS-A
E) Anti-Jo1 E) Anti-dsDNA
Show comment and answer A) SLE
INT - 14.8
B) Polymyositis
Which is true about immunofluorescent
staining of antinuclear antibody? C) Systemic sclerosis
D) MCTD
A) The staining is nucleolar in SLE E) Sjögren’s syndrome
The staining is homogenous in Show comment and answer
B)
MCTD INT - 14.13
The staining is nucleolar in systemic Which autoimmune disease is NOT
C) commonly associated with B-cell
sclerosis
D) The staining is homogenous in RA lymphoma?
The staining is against centromer in
E) A) SLE
myositis
B) Systemic sclerosis
Show comment and answer
INT - 14.9 C) Rheumatoid arthritis
Which is NOT a polysystemic D) Polymyositis
autoimmune disease? E) Sjögren’s syndrome
Show comment and answer
A) Polymyositis INT - 14.14
B) Systemic sclerosis Which is NOT a symptom of
C) Sclerosis multiplex antiphospholipid syndrome?
D) Sjögren’s syndrome
A) Habitual abortion
E) MCTD
B) Frequent migraine
Show comment and answer
INT - 14.10 C) Thrombocytosis
Which statement is NOT typical in D) Increased risk of thromboembolism
systemic autoimmune diseases? E) Livedo reticularis
Show comment and answer
A) Familiar aggregation INT - 14.15
B)
Sometimes medicines or chemicals Which medicine DO NOT causes SLE?
can trigger them
Antinuclear autoantibodies are A) Etanercept
C)
frequent B) Procainamide
D) Males are affected mainly C) Infliximab
The disease can worsen or improve D) Hydralazine
E)
during pregnancy
E) Rituximab
Show comment and answer
INT - 14.11
Show comment and answer
INT - 14.16
Which genetic constellation is typical in
In what percent of patients with
autoimmune diseases?
undifferentiated autoimmune diseases
(NDC) develops definitive autoimmune
A) HLA-DQ2-DR4
disease?
B) HLA-A1-B8-DR3
C) HLA-A8-B27-DR4 A) 5-10 %
D) HLA-B7-B27-DR3 B) 15-20 %
E) HLA-A1-B7-DR4 C) 30-40 %
Show comment and answer D) 50-60 %
INT - 14.12
E) 70-80 %
Which of the following is the most
frequently occurring systemic Show comment and answer
INT - 14.17
autoimmune disease?
In which case can be NDC diagnosed?
C) Membranous lupus nephritis
In the presence of three typical Mesangial proliferative lupus
A) D)
clinical symptoms nephritis
In the presence of one typical E) Focal minimal lupus nephritis
B) clinical symptom and two
Show comment and answer
autoantibody positivity’s INT - 14.22
In the presence of two clinical In which disease elevated CRP level is
C)
symptoms and two autoantibodies NOT typical?
In the presence of two clinical
D)
symptoms and one autoantibody A) Rheumatoid arthritis
In the presence of one clinical B) Sjögren’s syndrome
E) symptom and three typical C) SLE
autoantibodies
D) Intercurrent infection
Show comment and answer
INT - 14.18 E) Dermatomyositis
Which process is NOT typical in the Show comment and answer
pathogenesis of SLE? INT - 14.23
Which is NOT a typical cause of death
A) DNA repair disorder in SLE?
B) DNA methylation
A) Cardiovascular disease
C) Tissue citrullination
B) Kidney failure
D) Increased B-cell activity
C) Central nervous system lupus
E) Decreased regulatory T-cell activity
D) Pulmonary fibrosis
Show comment and answer
INT - 14.19 E) Secondary tumors
Which biological therapy is appropriate Show comment and answer
for the therapy of SLE? INT - 14.24
Which pathogenetic process DOES NOT
A) Etanercept plays a role in the development of
systemic sclerosis?
B) Infliximab
C) Belimumab
A) Microvascular disorders
D) Adalimumab
B) Immunopathological disorders
E) Tocilizumab
C) Tissue citrullination
Show comment and answer
D) Collagen deposition in the organs
INT - 14.20
Accelerated atherosclerosis and E) Macrovascular disorders
increased cardiovascular mortality are Show comment and answer
NOT typical in which disease? INT - 14.25
Against which antigen is oriented Anti-
A) Rheumatoid arthritis Scl70 in scleroderma?
B) SLE
A) RNA polymerase I
C) Sjögren’s syndrome
B) DNA polymerase I
D) Antiphospholipid syndrome
C) DNA topoisomerase III
E) Systemic sclerosis
D) RNA polymerase III
Show comment and answer
INT - 14.21 E) DNA topoisomerase I
Which is NOT a real histological type of Show comment and answer
lupus nephritis? INT - 14.26
Which is NOT a diagnostic criterion of
A) Diffuse lupus nephritis systemic sclerosis?
B) Sclerotizing glomerulonephritis
A) Sclerodactylia
B) Paroxysmal scleroderma C) Positive Rose-Bengal test
C) Star-shaped scars on the fingertips D) Schirmer-test <5 mm/5 min
D) Bibasilar pulmonary fibrosis E) Positive salivary gland scintigraphy
E) Esophageal dismotility Show comment and answer
Show comment and answer INT - 14.31
INT - 14.27 Which agent is NOT appropriate for
Which medicine is NOT appropriate for treating glandular symptoms of
treating the vascular symptoms of Sjögren’s syndrome?
systemic sclerosis?
A) N-acetylcysteine
A) Nitroglycerin B) Tear point occlusion
B) Calcium antagonists Methylcellulose containing artificial
C)
C) Angiotensin II receptor antagonists tear
D) Beta receptor blockers D) Infliximab
E) Sildenafil E) Pilocarpine
Show comment and answer Show comment and answer
INT - 14.28 INT - 14.32
Which is NOT among the clinic Which disease is NOT an element of
pathological subtypes of inflammatory MCTD?
muscle diseases?
A) Rheumatoid arthritis
A) Adult polymyositis B) NDC
B) Tumor-associated myositis C) Polymyositis
C) Juvenile poly-dermatomyositis D) SLE
D) Inclusion body myositis E) Systemic sclerosis
E) Ossification myositis Show comment and answer
INT - 14.33
Show comment and answer
INT - 14.29 Which disease constitutes diagnostic
Which is NOT among the diagnostic criteria for MCTD according to Alarcon-
criteria of inflammatory muscular Segovia?
diseases according to Bohan and
Peter? A) Pulmonary fibrosis
B) Swelling of the back of the hand
Elevated levels of CK and LDH C) Pulmonary arterial hypertension
A)
enzymes D) Esophageal dismotility
Intensifying weakness of distal E) Swelling of the fingers
B)
muscles
Show comment and answer
Positive muscle biopsy with INT - 14.34
C)
inflammation, necrosis INT-14.35. Which systemic vasculitis
D) EMG disorders affects the medium-sized vessels?
Skin symptoms specific for
E)
dermatomyositis A) Churg-Strauss syndrome
Show comment and answer B) Takayasu arteritis
INT - 14.30
C) Kawasaki disease
Which is NOT among the American-
D) Cryoglobulinemic vasculitis
European Consensus Criteria for
Sjögren’s syndrome? E) Polymyalgia rheumatica
Show comment and answer
A) Anti-fodrin antibody INT - 14.35
Which systemic vasculitis affects the
Anti-SS-A and/or anti-SS-B
B) medium-sized vessels?
antibody
A) Churg-Strauss syndrome B) 2. and 4. are correct
B) Takayasu arteritis C) only 5. is correct
C) Kawasaki disease D) 1., 3. and 5. are correct
D) Cryoglobulinemic vasculitis E) all answers are correct
E) Polymyalgia rheumatica Show comment and answer
INT - 14.39
Show comment and answer
INT - 14.36 Diagnostic criteria of Sjögren’s
Histopathological forms of lupus syndrome according to the American-
nephritis: European Consensus system:
1st, 2nd and 6th answers are A) multiple endocrine neioplasia type 1
A)
correct B) von Hippel–Lindau disease
B) 1st, 3rd and 6th answers are correct C) ataxia teleangiectasia
C) 3rd and 6th answers are correct D) multiple endocrine neioplasia type 2
D) 1st, 3rd and 5th answers are correct E) neurofibromatosis type 1
Show comment and answer Show comment and answer
INT - 15.79 INT - 16.2
Severe aspirin intoxication can cause: At which pregnancy age is
amniocentesis recommended?
1) high anion gap metabolic acidosis
2) hypoglycemia A) 4–6 weeks
3) hypoprothrombinemia B) 10–12 weeks
4) tinnitus
C) 15–17 weeks
5) one marrow depression
6) respiratory alkalosis D) 20–22 weeks
E) 24–26 weeks
1th, 2nd and 4th answers are Show comment and answer
A) INT - 16.3
correct
B) 3rd and 5th answers are correct Among the following chromosome
abnormalities which one is the most
1st, 2nd, 4th and 5th answers are
C) frequent?
correct
D) 2nd and 6th answers are correct
A) Turner-syndrome
Show comment and answer
B) Edwards-syndrome
INT - 15.80
Which of the following is true for C) Down-syndrome
ARDS? D) Patau-syndrome
E) Williams-syndrome
1) therapy refractory hypoxia
Show comment and answer
2) increased dead space INT - 16.4
3) high mortality What does the term penetrance mean?
4) bilateral opacities on the chest X-
ray A) the frequency of a genetic alteration
the frequency of a certain What does the term compound
B) phenotype int he case of a certain heterozygosity mean?
genotype
C) a form of genetic regulation More mutations are responsible for
the expression of small molecular A) a certain disease in autosomal
D) dominantly inherited syndrome.
weight RNAs
E) region of chromosomal regulation The importance of Y chromosome
B)
alterations in sex-linked inheritance.
Show comment and answer
INT - 16.5 In the case of autosomal
What proportion of the human genome recessively inherited disease,
is protein-coding? different mutations on different
C)
allelles of the same gene are jointly
responsible for the develeopment of
A) 3%
the disease.
B) 10%
A rare regulatory mechanism in the
C) 25% D) case of X-linked dominant
D) 40% inheritance
E) 60% The emergence of different
Show comment and answer pheotypes due to different
E)
INT - 16.6 mutations int he case of autosomal
Which one of the following diseases recessively inherited diseases.
has the lowest penetrance? Show comment and answer
INT - 16.10
A) multiple endocrine neoplasia type 1 Which pattern of inheritance is
B) multiple endocrine neoplasia type 2 characteristic to blood relation
between parents?
C) neurofibromatosis type 1
D) cystic fibrosis A) autosomal dominant
E) haemochromatosis B) autosomal recessive
Show comment and answer C) X-linked dominant
INT - 16.7
Which one of the following diseases D) X-linked recessive
does not predispose to E) polygenic
pheochromocytoma? Show comment and answer
INT - 16.11
A) von Hippel–Lindau disease What is the chance of the emergence
of an autosomal recessively inherited
B) Gardner syndrome
disease in the offspring of two
C) multiple endocrine neoplasia type 2
heterozygote carriers?
D) neurofibromatosis type 1
E) inherited paraganglioma syndromes A) 10%
Show comment and answer B) 25%
INT - 16.8
C) 40%
By definition, what is the frequeny of a
D) 50%
mutation?
E) 60%
A) < 1% Show comment and answer
INT - 16.12
B) <5%
What is the chance of emergence of an
C) < 10%
autosomal dominantly inherited
D) < 20% disease in one child of an affected
E) < 30% heterozygote individual?
Show comment and answer
INT - 16.9 A) 10%
B) 25% Which chromosomal abnormality
C) 40% affecting the sex chromosomes has the
highest incidence?
D) 50%
E) 60%
A) Turner syndrome
Show comment and answer
B) Klinefelter syndrome
INT - 16.13
For which mode of inheritance is the C) Triple X sydrome (superfemale)
following statement true: of the D) 46XX male
offspring of an affected male and a E) 46XY female
healthy female, all sons are healthy Show comment and answer
and all daughters are affected? INT - 16.18
For which listed chromosome
A) X-linked recessive abnormality are the following
B) X-linked dominant symptoms characteristic:
C) autosomal recessive immunodeficiency,
hypoparathyroidism, congenital heart
D) autosomal dominant
defect?
E) polygenic
Show comment and answer A) Cri du chat syndrome
INT - 16.14
B) DiGeorge syndrome
Among the following diseases, in which
case does genomic imprinting not C) Down syndrome
constitute to the pathogenesis? D) Turner syndrome
E) Prader–Willi syndrome
A) Prader–Willi syndrome Show comment and answer
B) Angelman syndrome INT - 16.19
C) Beckwith–Wiedemann syndrome Which one of the following symptoms
is not characteristic to Turner
D) cystic fibrosis
syndrome?
Show comment and answer
INT - 16.15
A) short stature
Over what frequency of occurrence in
the general population is a genetic B) streak gonad
variant considered a polymorphism? C) primary amenorrhea
D) asthma bronchiale
A) 1% E) coarctation of the aorta
B) 7% Show comment and answer
C) 10% INT - 16.20
D) 15% Which one of the following symptoms
is not characteristic to testicular
E) 20%
feminization (complete androgen
Show comment and answer inensitivity syndrome, Morris
INT - 16.16
syndrome)?
The trisomy of which chromosome is
the most frequent in live-born new-
A) nromal pubic hair
borns?
46XY with normal female
B)
A) 13 phenotype
B) 17 absent inner genitals, hiányzó belső
C)
női nemi szervek, rövid vagina
C) 19
az androgénreceptor mutációi
D) 21 D)
állnak hátterében
E) 22 X-kromoszómához kapcsolt
Show comment and answer E)
öröklésmenetű
INT - 16.17
Show comment and answer Which one of the following symptoms
INT - 16.21 is not characteristic of cystic fibrosis?
Amog the following diseases which one
is not autosomal dominantly inherited? chronic obstructive pulmonary
A)
disease
A) Marfan syndrome B) deficiency of the exocrine pancreas
B) cystic fibrosis C) diabetes mellitus
C) Huntington’s disease D) meconium ileus in new-borns.
D) familial adenomatosus polyposis male infertility due to absence of
E) hereditary retinoblastoma E)
vas deferens
Show comment and answer Show comment and answer
INT - 16.22 INT - 16.26
Which statement is false for Which one of the following is false
phenylketonuria? regarding Duchenne muscular
distrophy?
A) autosomal recessively inherited
it is the consequence of mutations A) X-linked recessive inheritance
B) of the gene encoding phenylalanine it is the consequence of mutations
hydroxylase B) of the largest human protein,
the main symptoms are diarrhea dystrophin
C)
and secondary malabsorption one manifestation is the
C)
elevated phenylalanine levels cause pseudohypertrophy of the calves
D)
severe neurological symptoms weakness of the muscles begins in
D)
E) it is screened routinely in new-borns adulthood
Show comment and answer elevated serum levels of creatine
E)
INT - 16.23 kinase
Which one of the following hereditary Show comment and answer
metabolic diseases does not affect INT - 16.27
purine metabolism? Which of the following statements is
false for Huntington’s disease?
A) Tay–Sachs disease
B) Niemann–Pick disease it belongs to trinucleotide repeat
A)
C) Hurler syndrome disorders
D) Rett syndrome it follows autosomal dominant
B)
inheritance
E) Lesch–Nyhan syndrome
the disease manifestates in
Show comment and answer C) adulthood, usually after 40 years of
INT - 16.24
age
Which one of the following statements
one manifestation is severe
is false for cystic fibrosis? D)
hypertension
the most common fatal autosomal during familial inheritance, the first
A) recessive disorder among symptoms presents at earlier age in
E)
Caucasian race the offspring of the affected father
(anticipation)
B) the frequency of carriers is 1/25
Show comment and answer
C) the frequency of carriers is 1/500 INT - 16.28
it is the consequence of mutations Which of the following disorder is not a
D) of a protein involved in the transport trinucleotide repeat disorder?
of chloride ions.
ΔF508 is the most common A) fragile X syndrome
E)
mutation. B) myotonic dystrophy
Show comment and answer C) Huntington’s disease
INT - 16.25
D) Friedreich’s ataxia A) vitamin B1
E) Rett syndrome B) vitamin B2
Show comment and answer C) folic acid
INT - 16.29
D) vitamin C
Which one of the following is not
characteristic to diseases of the E) vitamin A
mitochondrial DNA? Show comment and answer
INT - 16.33
they can be inherited from the Which hereditary tumor syndrome
A) does not predispose to breast cancer?
mother and from the father
by a main rule, they can be
B) A) Li-Fraumeni syndrome
inherited only from the mother
B) mutations of BRCA1 gene
main characteristics include the
disorders of the nervous system C) mutations of BRCA2 gene
C)
(including the sensory nervous D) von Hippel–Lindau disease
system) and the muscle system E) Cowden syndrome
there may be wide phenotype Show comment and answer
D)
variability INT - 16.34
heteroplasmy is one of the main Which of the following syndromes is
E)
reasons of phenotype variability not associated with chromosomal
Show comment and answer instability arising from deficient DNA
INT - 16.30 repair?
Which following characteristic is false
for acute intermittent porphyria? A) neurofibromatosis type 1
B) ataxia teleangiectasia
A) autosomal dominant inheritance C) Bloom syndrome
B) high penetrance D) xeroderma pigmentosum
mutations of porphobilinogen E) Fanconi anemia
C) deaminase are responsible for the
disease Show comment and answer
INT - 16.35
severe abdominal pain which At which pregnancy age is chorionic
D) cannot be explained by organic
villus sampling recommended to be
reasons
performed?
vegetative nervous system is often
E)
affected A) 4–6 weeks
Show comment and answer B) 10–12 weeks
INT - 16.31
Which apolipoprotein E allele is linked C) 14–16 weeks
to Alzheimer’s disease? D) 18–20 weeks
E) 24–26 weeks
A) APOA Show comment and answer
B) APOC INT - 16.36
C) APOE1 When is prenatal diagnostical
procedures recommended?
D) APOE2
E) APOE4 A) advanced maternal age
Show comment and answer de novo chromosome abnormality
INT - 16.32 B)
in the previous child
Which of the following vitamin’s
deficiency has been mostly associated one parent carries structural
C)
with the development of neural tube chromosomal alteration
defects? D) in all three of the previous cases
E) none of the previous cases
Show comment and answer heteroygosity may have a protective
INT - 16.37 E)
effect against malaria
Which of the following disorders cannot INT - 16.41
be detected by fetal utrasound Which of the following diseases is
imaging? inherited in autosomal dominant
manner?
A) holoprosencephaly
B) neural tube defects A) multiple andocrine neoplasia type 1
C) omphalocele B) neurofibromatosis type 1
D) Huntington’s disease C) von Hippel–Lindau disease
E) cystic hygroma D) all three of them
Show comment and answer E) neither of them
INT - 16.38
Show comment and answer
Which two chromosomes are affected INT - 16.42
by translocation in the case of Which chromosome is affected in
Philadelphia chromosome? Prader-Willi syndrome?
A) 9 and 22 A) 3
B) 8 and 14 B) 12
C) 9 and 14 C) 15
D) 8 and 22 D) 17
E) 10 and 14 E) 19
Show comment and answer Show comment and answer
INT - 16.39 INT - 16.43
Which one of the following is not a Which of the following is false for Tay-
characteristic of the fragile X Sachs disease?
syndrome?
A) lysosomal storage disease
it causes moderate mental
Lisch nodules of the iris is a
retardation in affected boys and B)
A) characteristic
mild mental retardation in affected
girls cherry-red spot on the retina is a
C)
characteristic
it belongs to trinucleotide repeat
B) D) neurodegenerative disease
disorders
enlarged testicles is a characteristic hexosaminidase A deficiency plays
C) E)
of the disease in affected boys a role int he pathogenesis
congenital heart defects are Show comment and answer
D) INT - 16.44
fequently observed
Which of the following is the most
the disease is the consequence of
E) severe manifestation of thalassaemia?
FMR1 gene mutations
Show comment and answer
A) HbH disease
INT - 16.40
Which one of the following is not a B) hydrops fetalis
characteristic of glucose-6-phosphate C) hemolytic anemia
dehydrogenase deficiency? D) cerebral infarction
E) extramedullary hematopoiesis
A) X-linked recessive inheritance
Show comment and answer
frequently observed in INT - 16.45
B)
Mediterranean countries Which three chromosomal trisomies
predisposes to hemolytic anemia in can be compatible with life therefore
C)
homozygotes being rarely present in live-borns?
D) mental retardation is frequent
A) 15, 17, 21 INT - parathyroid hyperplasia, - )
A) Dukes-staging system
INT - 17.15 E) medulloblastoma gene receptor
PRO abbreviation is often used in Show comment and answer
oncology drug development. It is the INT - 17.20
abbreviation of: For which chemotherapeutic agent is
the citrovorum factor or folic acid used
A) Progression Related Outcome as a "rescue" compound for the
B) Patient Reported Outcome protection of normal tissues and thus
Show comment and answer high dosage chemotherapy?
INT - 17.16
What is the RECIST criteria used for in A) methotrexat
oncology and in oncological clinical B) bleomycin
trials? C) cyclophosphamid
D) adriamycin
In solid tumors, the response to
anticancer treatment in imaging E) vincristin
A)
studies is evaluated by these Show comment and answer
criteria. INT - 17.21
RECIST relates to the Mesna may reduce the toxic damage of
B) determination of cell surface the bladder. Which cytostatic agent is
receptors in solid tumors. it used for?
Show comment and answer
INT - 17.17 A) 5-fluorouracil
In ca.10% of cancer patients, B) adriamycin
hypercalcaemia occurs due to tumor C) cisplatin
cells producing materials. Such D) cyclophosphamid
materials are the following, except
E) methotrexat
(indicate the exception):
Show comment and answer
INT - 17.22
production of parathormon-
A) The following side effects may occur
likepeptide
immediately or early after cytotoxic
B) calcitonin
therapy except (indicate the
C) active metabolits of Vitamin-D exception):
D) prostaglandins
E) TGF-α és TGF-β A) nausea / vomiting
Show comment and answer B) urocystitis
INT - 17.18 C) renal failure
Which gene's defect is the most
D) phlebitis
common in human tumors?
E) azoospermia
A) c-raf Show comment and answer
INT - 17.23
B) c-myc
Which phase of the cell cycle is
C) K-ras affected by taxane type cytostatics?
D) p53
E) c-fos A) G0
Show comment and answer B) G1
INT - 17.19 C) S
What is the meaning of MDR?
D) G2
E) M
A) minimal disease residue
Show comment and answer
B) multiple drug resistance
C) maximal dose rate
D) mesenchymal disease risk
INT - 17.24 CA-19-9 tumor marker test is the most
What is the machanism of action of valuable in the follow-up of the
camptothecin cytostatics (irinotecan, following disease:
topotecan)?
A) ovarian cancer
inhibits the depolymerization of B) hepatocellular carcinoma
A)
microtubules
C) testicular cancer
B) topoizomerase II. inhibitors
D) breast cancer
C) topoizomerase I. inhibitors
E) pancreas cancer
Inhibition of DNA function and cell
D) Show comment and answer
division in phase M
INT - 17.29
Show comment and answer CA-15-3 tumor marker test is the most
INT - 17.25
valuable in the follow-up of the
The following is valid for antimitotic
following disease:
chemotherapeutic drugs:
A) ovarian cancer
causes covalent crosslinking of the
A) two polynucleotide chains in the B) hepatocellular carcinoma
dual spiral of DNA C) testicular cancer
they inhibit DNA synthesis through D) breast cancer
B) the inhibition of important enzymes E) pancreatic cancer
of purine or pyrimidine synthesis. Show comment and answer
they inhibit the polymerization of INT - 17.30
C) tubulins, i.e. the formation of mitotic AFP (alfa-foeto-protein) tumor marker
spindles. test is the most valuable in the follow-
They inhibit the depolymerization of up of the following disease:
D) tubulins, i.e. blocking the mitotic
spindle. A) ovarian cancer
E) C and D B) hepatocellular carcinoma
Show comment and answer C) testicular cancer
INT - 17.26
D) breast cancer
Which compound belongs to the strong
opiates? E) pancreatic cancer
Show comment and answer
INT - 17.31
A) codein
CA125 tumor marker test is the most
B) oxycodon
valuable in the follow-up of the
C) tramadol following disease:
D) dextropropoxyphen
Show comment and answer A) ovarian cancer
INT - 17.27 B) hepatocellular carcinoma
Targeted therapies for treatment of
C) testicular cancer
solid tumors except (indicate the
exception): D) breast cancer
E) pancreatic cancer
A) adalimumab Show comment and answer
INT - 17.32
B) imatinib
β-HCG tumor marker test is the most
C) sorafenib
valuable in the follow-up of the
D) cetuximab following disease:
E) sunitinib
Show comment and answer A) ovarian cancer
INT - 17.28 B) hepatocellular carcinoma
C) testicular cancer
D) breast cancer C) renal cancer
E) pancreatic cancer D) chorionepithelioma
Show comment and answer E) osteosarcoma
INT - 17.33 Show comment and answer
In case of prostate cancer, which of INT - 17.40
the following tumor markers should be Which drug was the first approved
followed? „targeted therapy” in the treatment of
hepacullular carcinoma?
A) β-HCG
B) CEA A) sorafenib
C) PSA B) bevacizumab
D) CA-125 C) gefitinib
Show comment and answer D) vandetanib
INT - 17.34 E) ipilimumab
Which factor is not used for monitoring
Show comment and answer
or as prognostic factor in tumors? INT - 17.41
According to clinical studies, the
A) CEA sorafenib treatment in patients
B) PSA diagnosed with primary hepatic cancer
C) β-HCG (hepatocellulray carcinoma),increases
D) TSH the overral survival. Is this true or
E) p53 false?
Show comment and answer
A) true
INT - 17.35
What is the most common histological B) false
type of malignant oesophageal cancer? Show comment and answer
INT - 17.42
A) leiomyosarcoma Choose the correct answer!
B) epithelial carcinoma
The mortality of colon cancer is
C) adenocarcinoma A)
constantly increasing
D) rhabdomyosarcoma The mortality of colon cancer has
E) melanoma been decreasing since the
B)
Show comment and answer introduciton of effective
INT - 17.36 chemotherapy
What is the most common primary The mortality of colon cancer was
tumor site in Krukenberg tumor? rapidly increasing between 1965
C)
and 2000, since then it has been
A) breast cancer stagnant
B) gallbladder cancer The mortality of colon cancer hasn’t
C) rectum cancer D) changed significantly in the past few
decades
D) pancreas cancer
In first world countries,colon cancer
E) gastric cancer
E) has the highest mortality rate of all
Show comment and answer cancers
INT - 17.37
Show comment and answer
In case of haematogenous
INT - 17.43
dissemination, the following tumors
Chemotherapy drugs used in the
usually give a pulmonary metastases
treatment of colorectal cancer, except:
first, except one type of tumor:
A) 5-fluorouracil
A) gastric cancer
B) capecitabine
B) breast cancer
C) oxaliplatin Carcinoid syndrome is present in
D) irinotecan E) less than 10% of all neuroendocrine
tumors.
E) docetaxel
Show comment and answer
Show comment and answer INT - 17.48
INT - 17.44
The following malignant tumors,during
Treatment option in the therapy of
hematogenous spreading metastatize
rectal cancer:
at first to the liver, except:
A) total mesorectal excision
A) gastric cancer
B) neoadjuvant chemotherapy
B) colon cancer
C) adjuvant chemotherapy
C) panreatic cancer
D) VEGF inhibitor drugs
D) adrenal gland carcinoma
E) all of the above
E) gallblader cancer
Show comment and answer
INT - 17.45
Show comment and answer
INT - 17.49
In which malignant disease ”DNA
Of the following factors which ones
mismatch repair error” is the most
should be measured-calculating the
frequent?
Notthingham Prognostic Index?
A) Li–Fraumeni-sydrome
A) size of the tumor in centimeter
B) MEN-2 syndrome
B) histological grade
C) retinoblastoma
C) lymph node status
hereditary, non polyposis colon
D) D) all of the above three factors
cancer (HPNCC)
Show comment and answer
E) Wilms-tumor
INT - 17.50
Show comment and answer During the histological evaluation of
INT - 17.46
breast cancer we use the „NPI”
Which of the following malignant abbreviation. What does it stand for?
cancers don’t ususally metastatize to
the bones?
A) Norfolk Predictive Index
B) Notthingam Prognostic Index
A) thyroid cancer
Show comment and answer
B) breast cancer
INT - 17.51
C) renal cancer In the case of breast cancer which NPI
D) colon cancer score is considered as poor prognosis?
E) prostate cancer
Show comment and answer A) below 3,14
INT - 17.47 B) above 5,4
Correct statements regarding the Show comment and answer
neuroendocrine tumor (NET), except: INT - 17.52
Which of the following ones is NOT a
A)
Neuroendocrine tumors are rare risk factor of breast cancer?
entities
The incidence of neuroendocrine A) no children
B) tumors has been increasing in the B) early menarche, late menopause
past 30 years.
C) promiscuity
Most of the neuroendocrine tumors
D) BRCA1 mutation
C) are classified as "non-functioning"
types. E) sister’s breast cancer
Neuroendocrine tumor most Show comment and answer
D) INT - 17.53
typically affects the pancreas.
What is the most common sypmtom of The survival rate of renal cancer-
the intraductal papilloma of the breast? thanks to the widely used screening
A)
methods- has increased in the last
peau d’orange symptom (orange few years.
A)
peel symptom) In the case of obvious imaging test
enlarged lymph node at the findings, which suggest malignant
B) B)
unilateral side tumor, surgical therapy can be
bloody fluid discharging from the indicated.
C)
nipple In the treatment of renal cancer,
D) ekzematous skin lesion C) surgery is the only definitive and
possibly curative option.
painful,red, swollen, palpable mass
E) In the case of metastatic.renal
in the breast
cancer palliative nephrectomy
Show comment and answer
D) should be performed, even if the
INT - 17.54
patients are in good general
Which type of breast cancer affects
condition
typically both sides?
In the case of small peripheric
tumor of the kidney laparoscopic
A) invasive ductuscarcinoma
partial neprehctomy is an option.
B) medullar carcinoma E) The most common indication of
C) mucinosus carcinoma radiotherapy is the palliative
D) lobular carcinoma treatment of intracranial and bone
metastasis.
E) papiliar carcinoma
Show comment and answer
Show comment and answer
INT - 17.59
INT - 17.55
Diagnostic methods in the screening of
In the case of an 22-years-old female
prostate cancer:
patient, a mobile, non-painful palpable
mass was discovered in the right
breast with a diameter of 2,5 cm, and A) rectal digital examination
no change in size during the menstrual B) PSA-test
cycle. What is the most probable C) PET-CT
diagnosis? transrectal ultrasound-guided
D)
biopsy
A) fat necrosis E) A, B and D
B) fibroadenoma Show comment and answer
C) carcinoma phylloides INT - 17.60
D) mastopathia fibrocystica The gold standard for treatment of
bone metastases of prostate cancer is:
E) tubularis carcinoma
Show comment and answer
A) GnRh analogue drugs
INT - 17.56
Which one is not a paraneoplastic B) radiotherapy
symptom of renal cancer? C) antiandrogen drugs
D) bisphophonates
A) anaemia E) chemotherapy
B) weight loss Show comment and answer
C) fever, subfebrility INT - 17.61
D) tiredness and fatigue Choose the CORRECT answer!
E) hematuria
In spite of the increasing incidence
Show comment and answer of prostate cancer, the mortality
INT - 17.58 A)
caused by the disease has been
Choose the INCORRECT answer! slightly decreasing.
Increased risk was observed with E) Ewing-sarcoma
family history of the disease, as Show comment and answer
B) hereditary genes which can cause INT - 17.64
susceptibility to prostate cancer Which type of germ-cell testicular
were indentified. tumor cannot be classified into the
Although prostate carcinoma can be non-seminoma group?
observed in 30-40 % of men above
C) the age of 55, the disease is A) choriocarcinoma
ususally diagnosed over the age of
B) Yolksac tumor
65.
C) teratoma
In 95% of the cases, prostate
cancer orginates from the D) spermatocytic
D)
“peripherial zone”, and it is usually E) polyembrioma
multifocal. Show comment and answer
E) All statements are true. INT - 17.65
Show comment and answer Which cell-type does the majority of
INT - 17.62 testicular cancers originate from?
Choose the INCORRECT asnwer!
A) Leydig-cell
After radical prostectomy, if the B) Sertoli-cell
PSA level is above 0,4 ng/ml, C) germ cell
A)
hormone and/or radiotherapy is
D) endothel cell
necessary.
E) epithelial cell
Treatment with antiadnrogene drug
should be introduced few days Show comment and answer
B) INT - 17.66
before applying the LHRH analogue
at the star of hormone therapy Which one is the most common
testicular germ-cell tumor?
In the case of metastatic prostate
cancer systemic chemotherapy
C) A) teratoma
should be started as soon as
possible. B) endodermal sinus tumor
During intermittent hormone C) embryonal carcinoma
therapy, in the "treatment holidays" D) choriocarcinoma
D)
the sexual potential of the patient
E) seminoma
usually is restored.
Show comment and answer
When prostate cancer metastatizes INT - 17.67
to the bones, hormone and Choose the INCORRECT answer!
E)
bisphosphonate therapy is the first
choice treatment.
In the case of cryptorchism the
Radiotherapy in prostate can be A) incidence of testicular cancer is 10-
F) used for curative or palliative 40 times higher.
purpose as well.
Testicular cancer is the most
Show comment and answer B) common malignancy among young
INT - 17.63
adults.
Elder man is hospitalized with back
The most common type of testicular
pain, X-ray describes oval masses in
among infants and children are the
the lumbal spine, and PSA-level is
teratoma and the yolksac tumors,
elevated What is the most likely C)
between 15 and 35 years the non-
diagnosis? seminoma, between 40 and 60 the
seminoma.
A) metastatic thyroid cancer
Testicular cancer is bilateral in the
B) multiple myeloma D)
1-7% of all cases.
C) metastatic prostate cancer Regular self-exams are useful for
E)
D) metastatic pacreatic cancer early detection of testicular cancer.
In the case of testicular cancer monochemotherapy is equivalent to
,swollen, enlarged testes, abnormal the irradiation of the paraaortic
F) inguinal lymph nodes can be region.
generally palpable during physical Show comment and answer
examination. INT - 17.70
Show comment and answer Which one is the most important risk
INT - 17.68 factor of the transitional-cell carcioma
Choose the CORRECT answer! of the bladder?
1st, 2nd, 3rd and 4th answers are INT - 17.126 Alkylating agent -
A)
correct INT - 17.127 Antimetabolite -
B) 1st and 4th answers are correct INT - 17.128 Alkaloid -
C) only answer 1 is correct INT - 17.129 Antibiotic -
1st, 2nd, and 4th answers are INT - 17.130 Nitrosourea -
D)
correct
E) all of the answers are correct A) Actinomycin D
B) vinblastine
Show comment and answer
INT - 17.124 C) carmustin
Which factors or diseases caused by D) melphalan
them can be associated with the onset E) 5-fluorouracil
of malignant tumors?
1) Schistosoma haematobium
2) Helicobacter pylori
3) Streptococcus pyogenes
4) Aspergillus flavus
5) Actinomycosis
Association question INT - 17.147 Lung cancer -
Which cytostatic agent causes toxic INT - 17.148 Phaeochromocytoma -
damage to the listed organs - INT - 17.149 Carcinoid -
primarily? INT - 17.150 Hepatoblastoma -
A) Mycoplasma pneumoniae
B) Streptococcus pneumoniae
C) Influenza virus
D) Legionella spp.
Association question
Match each clinical presentation with
the most likely pathogen!
A) adenovirus
B) Norwalk-virus
C) rotavirus